Document 7OB3vjE3a8vRpBm4vqpk2dQ4o

FILE NAME Owens Illinois Library OWL DATE 1931 DOC OWL009 DOCUMENT DESCRIPTION Relevant Article & Abstracts from The Journal of Industrial Hygiene and Toxicology THE JOURNAL OF INDUSTRIAL HYGIENE EDITORS DAVID L. EDSALL M. D. S. D. United States EDGAR L. COLLIS M. D. M. R.C. Great Britain VOLUME XIII JANUARY DECEMBER 1931 PUBLISHED BY HARVARD SCHOOL OF PUBLIC HEALTH Boston Mass 360 THE JOURNAL OF INDUSTRIALINDUSTRIAL HYGIENE in Muscular Activity V. Changes and Adaptations in Running Jour Biol Chem 1928 78 445 33. ADOLPH E. The Nature of the Activities of the Human Sweat Glands Am Jour Physiol 1923 66 445 34. BAIRD M. M. AND HALDANE J. B. .: Salt and Water Elimination in Man Jour Physiol 1922 56 259 35. KITTSTEINER C Sekretion Kochsalz- gehalt und Reaktion des Schweisses Arch f Hyg 1911 73 275. Quoted in 31 36. VIALE .: Absorption et ^'limination cutan^'ede l'eau et du chlorure so- dique Arch ital de biol 1915 63 321. Quoted in 31 37. CRAMER .: Ueber die Beziehung der Kleidung f zur Hautth^/tigkeit Arch Hyg 1890 10 231 38. H^ GLERF. AND UEBERRACK K ^ ber . den Wasser- und Salzstoffwechsel nach Schwitzen Wien Arch f inn Med 1927 13 465 39. SAYERS R. R. AND DAVENPORT S. .: ' Review of Literature on the Physiological Effects of Abnormal Temperatures and Humidities U. S. Pub Health Rep 1927 42 933 40. Queries and Minor Notes Jour Am Med Assn 1931 96 133 and 2055 41. ELLIOTT M. .: Heat Exhaustion on Men Mil Surgeon 1908 22 227. Quoted in 3 This is sho and one Notices are For ntntrry y in par aut BRASIVE BRASIVE Clark AIR condit coal mi and Wa coolomet ' power mine mine Bedfo ee RESTOS bercul Cumm workers sis bo a BESTOSI bestos Gloyi ATMOSPHE PUNZENE ( 4 pound : pors i Smyt HOOD . Kirk of of plu * HERS ER eral CRON from | Dude ick Diova "egr { 33 ou Ward | fs A min ( ONE = c power CHANIDE Re DENTAL 1 $6 wes 09B8 AWULIOD CANo2DyO Te Ror CE SIG ow e e MME HAP ee rer eeee i, mea Tew eet Me igh org re rr (o 1D} lie th^/tigkeitth^/tigkeit th^/tigkeit th^/tigkeit ERRACK stoffwechsel stoffwechsel arch inn arch. .inn. inn ) on the the VOLUME XIII INDEX INDEX SUBJECT HYGIENE, matter matter in VOLUME XIII HYGIENE and This subjtehcetresufbojercet itnhdeerxefionrdeexlaoolklfroeradrienagding matw terothred JOURNAtL hJeOfUolRloNwAinLg IINDNUDSTURSIATLRexIcepAtiLon HYGIENE Notices NMeodtiNotciceessona ere indexed under this on entry .: entry parenthesis For author index see page PAGE ; __ eon normal normal ies U. ies. 2 933933 PPub. 2 933 _ otes. 133 2055 2055 , 133 an SurgSeurogneon 1908 . Surgeon, 1908,, #2 PAGE hazard ABRASIVE iABRASIVE ndustry industry hazard hazard conditionswoworrkikngiwnogrkcaipnacgitcyapacicatpacyity Ain ccoaolndaitniodnsWarner relation relation Bedford in . DUST retent.ion factors involved in involved involved in retent facti ors io nvolvn ed in DYSMDYESMENNORORHERA RDYHSMEENORARHEAamamoongng female clerks at Insurance Company Metroplitan Metropolitan owe - _ 3 : 3 i }m : co ling coolometer measuring cooling power Weeks measuring 261 workers Gardner 135 sputum temperatures mine reduction reduction temperatures reduction reduction mine, Bedford dust Warner primary 77 ASBESTOS primary berculous berculous infection infection and Cummings Cummings Gardner asbesto- method method staining sputum sputum asbesto- bodies bodies sis BESTOSIS BESTOSIS Gloyne bestos workers workers method staining staining Gloyne Gloyne method method staining eee . eee ee 65 85 85 ATMOSPHERE Air ANZENE see Air. toxicity ; pounds toxicity of Smyth . 87 air determination determination apors determination Smyth of Ip air + OD 227 pressure industry in industry basophilia m le punctate - * of punctate basophilia basophilia plumbism Lane basophilia control ) basophilia control 314 Schwartz dermatitis HpEluRmbSism * Schwa ) rtz .--- potency 233 ER carcinogenic BON MONOXIDE Twort ) min- Dudding from MONOXIDE sealed compartments compartments and Freder- ick Dudding Dudley Dudley DIOVASCULAR impairment impairment Freder- ... oo. importance of points ELECTRIC injuries importance points ELECTRIC contact in and pulse Kouwenhoven Langworthy discharge of and injuries produced by im- generator discharge Kouwenhoven . Lanagnwdordt eahty h EMPLOYMENT sickness rates Stevens FACTORY workers negro cardiovascu- 164 lar impairment in cardiovascunegro physical impairment 157 in Allen workers industry industry FATIGUE in 185 ce impairment subjective side 185 pag 293 FUMHEeSrrseeteyntio.n-o-c f:c fc ac cc tors involved 185 Brown injuries injuries impulse Langworthy injuries GENERATOR produced impulse 326 eeenee Kouwenhoven cence National Institute Cumming Cumming of treatment preven- preven- tion with chloride 347 347 HYPERTENSION 347 HYPERTENSION sodium Blood Blood pressure HYPERTENSION ; : night DIOVASCULAR egro factory dental workers ( Ward Pedley Pedley Montreal 269 and Montreal e Ward ....164 HOMETER for cooling HOMETER measuring Weeks measuring power NSIDE von Bernewitz 115 269 115 DENTAL clinic ..---nceeererct 115 DENTAL DENTAL clinic night Montreal primary Dar asbestos effect on 269 <a tuberculous tuberculous infection Gardner Gardner Ei: hazard Cummings Cummings industry on rational industry Clark rec- 343 ~ rational calculating calculating rational obtained _ ords obtained obtained Owens counter 343 tention concentrations Broumstein Broumstein below 10 concentrations concentrations below 50 tention : Ri. ver cubic Brown below 50 mtention, concentrations 285 woe porenbie meter (Brown). ...-- sulphur determining for dioxide Smith and determining 338 338 silicosis conference INTERNATIONAL Badham conference conference i Johannesburg 169 Badham Johannesburg Badham Warner Warner ane- mo mom mete ertBee dfr ord Warner Warner 4 punctate mation Krans Fipcuncktatle ebnaseosptih-i1l4ia0 1 control r^le ( Lane .. basophilia control 276 LINSEED dermatitis dermatitis Barnes 49 coal miners 19 19 METHYL CHLORIDE miners ....------0007"" , Somers temperatures toxicity White 273 of Bedford temperatures 135 135 Bedford Bedford Warner (Bedford and Warner)...--.sreres 273 135 . : 362 JOURNAL JOURNAL INDUSTRIAL INDUSTRIAL HYGIENE Miner, coal, radio PAGR study of PAGE PAGE coal radiographic radiographic study in- dustrially healthy conditions coal miners Wales capacity in relation relation awtomrkoisnpghercic apacity capacity relation relation and Warner .. mineral mineral SKIN diseases N NATIONALInstitute Health U. S. NATIONAL Institute Institute Health 1 prevention Public Institute Institute Health Cuming Cumming SPUTUM Health Service 1 cardiovascular SPUTUM workers impairment ae imipmpaaiirrmmenetnt Allen asbestosisimbpoidniegser impinger impairment physical impairimmpeanirtment SULPHUR impairm impairmene t impain rment t 157 157 an OIL mineral carcinogenic mineral carcinogenic carcinogenic potency of 204 TUBERCULOSIS from mings on compartments monoxide PAINT production carbon carbon production sealed in Dudding 97 333 PHYSICAL Dudley among negro factory workers Allen 3 . 157 dermatitis cyanide international conference international Pacy Johannesburg Badham conference diseases butchers dermatitis dermatitis le cy. anide rash von Berne- 115 linseed treatment CHLORIDE CHLORIDE SPUTUM asbestosis SPUTUM and ddere matir tis matitis heat asbestosis asbestosis bodies treatment Glo- and cramps Glo- 347 method method ee 15 4 a in, 85 of SULPHUR Smith and for 83 determination Smith and 338 reduction 338 TEMPERATURE Warner reduction 135 of TUBERCULOSIS primary asbes- 135 dner Cum- Cum- TUBERCULOSIS Gar 97 on Gardner 65 mings a9 National Institute Institute Health Cumming miners miners reloa-f RADIOACTIVE SUBSTANCES dangers in refining Schlundt McGavock and McGavock and Brown 117 a1 Warner). tioBnedforadtmosapndheric atmospheric atmospheric conditions conditions 252 Warner Bedford and 252 ve eeeeesaes 1 \e . HYGIENE SUBJECT INDEX 363 ternational -burg 1930 conference conference BadhamBadham butchers BOOK NOTICES PAGE ) Criminal Kessler dermatitis dermatitis Liability eed 115 RIDE in treatmBeanrtnes . 49 1 of heat Glo- cramps bodies te osis bodies in method method of 347 .. impinger loyne .. impinger hygiene iIoDnE iomfpinger impinger unit for Smith and Pregl Tt tee, 338 Gewerbekrankheiten mine air reductionreduction of Warner) Accidental Alexander injuries . eeeeee F. and Staub H The the Judge and the Pub- 331 Alimentary tract protozoan parasitism of Lynch . parasitismparasitismparasitism Allen J. R. and Walker J. H Heat- ing and Ventilation 331 Appel K. E. see Strecker E. A. Atmospheres mine Payman and Sta- tham cece eee 266 Brezina E Internationale ^ bersicht ^...ber nach den Berichten der Gewerbeaufsichtsbe- h^rden der Kulturl^/nder ^...ber die PAPAGGE E Kessler H. H Accidental Injuries The Medico Aspects of Workmen's Compensation and Public Liability Protozoan 331 Lynch K. M Protozoan Parasitism of the Alimentary Tract Pathology Diagnosis and Treatment Mental in industry Elkind 231 Microanalysis quantitative organic ...... 116 Mind human view of and how it works Strecker and Appel Mine atmospheres Payman and Sta- tham 0 persPo ayman n anda Stl a- 266 Gardner rimary, effeecffectt of asbesGardner and Cum- THe eee teeeeeeey, 6597 ublic Health Service stitute of Health of Jahre 1920 bis 1926 Criminal judge and public Alexander and Staub Alexander . ceeeees Currie J. R A Textbook of Hygiene Disease prevention in community Hil- liard 00... ce eee eeeeesenesseues 45 144 82 144 , Oberteuffer D. see Williams J. F. Occupation vol ) and health encyclopedia ce cece ccceceaeevecaeenees 292 Payman W. and Statham I. C. .: Mine Atmospheres 266 coal miners in rela- ospheric conditiconoditniosns Warner ) .. re Nurses .. Hygiene Hygiene 84 232 Elkind H. B Preventive Manage- ment Mental Hygiene in Indus- . eee eee cence ee Talbot Epilepsy Talbot 84 231 Epilepsy treatment of 232 Epilepsy Flury F. and Zernik .: Sch^/dliche Gase D^/mpfe D^/mpfe Nebel Rauch- und Staubarten .. Rauch- Rauch- Rauch- und 292 Food analysis Woodman 231 Gas Sch^/dlicheGase D^/mpfeNebel Rauch- und Staubarten Flury and ZernikZernik ... Pregl F Quantitative Organic Micro- analysis .. . eee ccc cee ee ceecuees 116 Protozoan parasitism of alimentary tract Lynch Quinine in general practice Johannes- sohn ccc ce cece ee ccc enceceeees 144 Oberteuffer Schools industrial hygiene for Wil- liams and cenen ees 82 Silicosis records of international con- ference held at Johannesburg 1930 183 Statham I. C. F. see Payman W. Staub H. see Alexander F. Stimson P. M A Manual of the Com- mon Contagious Diseases 84 Strecker E. A. and Appel K. E Dis- covering Ourselves A View of the Human Mind and How It Works 144 Epilepsy 232 Talbot F. B Treatment of Commu- Turner C. E Personal and nity Health tence eeenaee 82 Hygiene personal for nurses Egbert 2 Hygiene textbook of Currie 82 Industrial diseases international re- view of 1920-1926 Brezina 45 Industrial hygiene for schools Williams and Oberteuffer Injuries accidental Kessler 331 International conference on silicosis Johannesburg 1930 records .... 183 Johannessohn .: Chinin in der Allge- meinpraxis bocce eeneees 144 Unemployment case studies of 144 Ventilation heating and Allen and Walker . Allen and(Allen Allen and 331 Walker J. H. see Allen J. R. Williams J. F. and Oberteuffer D Industrial Hygiene for Schools 82 Woodman A. .: Food Analysis Typical Methods and the Interpretation of Results 231 Workmen's Compensation for acciden- tal injuries Kessler 331 Zernik F. see Flury F. sent considerable difonon artificial media knowledgment must be ections will be made for bibliography chusetts General . with bibliography bibliography bibliography W York The COMMON CONTAGIOUS Philip Moen Stimson ciate in Pediatrics Coredical College Attend- illard Parker Hospital Floating Hospital of Chief of Clinic Depart, Cornell Clinic School Horace Mann Schools ent the School Physi 1928-1930 Fabrikoid index and illustrations . & Febiger 1931 H. Feb. 1981 THE JOURNAL OF INDUSTRIAL HYGIENE VOLUME XIII MARCH 1931 NUMBER 3 A METHOD OF STAINING THE ASBESTOSIS BODIES FOUND IN THE SPUTUM OF ASBESTOS WORKERS S. ROODHOUSE GLOYNE M.D. D.P.H. Pathologist City of London Hospital for Diseases of the Heart and Lungs Victoria Park London T HERE is a consensus of opinion that the asbestosis bodies found T in the sputum and lungs of asbestos workers do not stain with the ordinary aniline dyes This failure to stain has been one of the difficulties hour and then recentrifuged and the deposit mounted as a wet preparation By this means the asbestosis bodies become a dark brown to black color according to the length of time they have been exposed to the hematoxylin in working out their relation to the histology of the disease and in determining their composition By employing the following technic the bodies can be made to take on a definite color which enables them to be better studied HEMATOXYLIN After digestion of the sputum with equal quantities of concentrated anti- formin as described by Stewart and Haddow 1 and centrifugation the Antiformin is pipetted off and replaced by a 5 per cent solution of Ehrlich's hematoxylin Bluing of the hemaxylin immediately takes place owing to the remains of the alkaline anti- formin The mixture is well shaken and allowed to stand for a half to one * Received for publication Nov. 22 1930 PRUSSIAN BLUE REACTION The reaction of the asbestosis body to Prussian blue was first described by Cooke and Hill 2 and McDonald 3 The foregoing technic is used but the following mixture is substituted for hematoxylin 2 per cent potassium ferrocyanide part 1 per cent hydrochloric acid parts With this technic the asbestosis bodies are colored a brilliant blue A potassium ferricyanide mixture may also be used but the results are variable some asbestosis bodies being stained others not AMMONIUM SULPHIDE The same technic is used but am- monium sulphide is substituted for hematoxylin or potassium ferocyanideferrocyanide The asbestosis bodies are then colored 85 86 THE JOURNAL OF INDUSTRIAL HYGIENE black This color can be removed with hydrochloric acid DISCUSSION When examined microscopically the hematoxylin specimens give the impression of having hematoxylin deposited on them rather than having actually taken up the stain but after washing overnight the asbestosis bodies still retain sufficient stain to be colored a dark brown With the ferro- cyanide ammonium sulphide technic the bodies are homogenously stained The advantages of this technic are 1 The minute details of the asbestosis body can be better seen than in the unstained preparation e.g. the central core of asbestos fiber generally stands out clearly and can sometimes be seen running across a gap between two segments of the asbestosis body rather like the string between beads on a necklace The fiber takes on the stain only very sometimes indeed not at but the contrast with the stained body is sufficient to demonstrate quite clearly its existence The outlines of the segments are also very clearly seen and the small subsidiary bosses on the sides of the asbestosis body and the cracks in the segments are better distinguished by this method than in the unstained preparation .-+ 2 These reactions support the view that iron enters into the composition of the bodies The Prussian blue reaction is a known test for iron and am- monium sulphide is universally employed as a group reagent for iron Hematoxylin also has an affinity for iron but the reaction in this case is inferior to that given by the other methods The amount of iron found in raw asbestos varies considerably According to Merewether 4 the two main varieties of asbestos used in industry are 1 a larger portion known as chrysotile a hydrated magnesium silicate with a low percentage of iron oxides 0.7 to 4.4 per cent and 2 a smaller portion known as crocidolite amosite and tremolite which have a high percentage of iron oxides 3.2 to 44 per cent The latter group is the one used in the factory which produces the cases seen at this Hospital Cooke and Hill 5 have also suggested that blood may enter into the composition of the asbestosis body Oxyhemoglobin contains 0.335 per cent of iron 6 BIBLIOGRAPHY 1. STEWART M. J AND HADDOW A. C Demonstration of the Peculiar Bodies of Pulmonary Asbestosis Asbestosis Bodies in Material Obtained by Lung Puncture and in the Sputum Jour Path and Bacteriol 1929 32 172 2. Cooke W. E. AND HILL C. .: Pneumokoniosis Due to Asbestos Dust Jour 47 232 Roy Micr Soc 1927 3. McDONALD .: Histology of Pulmonary Asbestosis Brit Med Jour 1927 2 1025 4. MEREWETHER R. A The Occurrence of Pulmonary Fibrosis and Other Pul- monary Affections in Asbestos Workers THIS JOUR 1930 12 198 239 5. Cooke W. E. AND HILL C. F Further Observations on Pulmonary Asbestosis with Special Reference to Asbestos Dust and the Curious Bodies Found in the Lungs Jour Roy Micr Soc 1930 50 15 6. STARLING E. H Principles of Human Physiology Fourth edition London J. & A. Churchill 1926 H. March 1931 THE TOXICITY OF HENRY Assistant Professor ,, INTRODUCTION title of this pap T gest a very wide rar pounds about the some of which we have ( information but about th we know little or nothi recently appealed to by a company to outline a prog handling of a compound th know was used in industr the toxicity of which noth published so far as I know However though the d benzene are legion yet themselves into certain r about certain members of w information In most ca of a class act on the syster manner and differences i differences of degree rat kind There are except general rule however sc will be pointed out later GENERAL CONDI Benzene C6H6 is the s .. pound of all and the bo the basis on which all t formed The called * Read before the Sectio Hygiene of the American Association Fort Worth 1930 Received Vol 13 No. 3 o com Bre 64 THE JOURNAL OF INDUSTRIAL HYGIENE ord as facts quite as significant to our ec- employment standards would furnish onomic and social health as are births and deaths and contagious diseases to employment information as fundamental as physical sickness and death our physical public health The official registration of all cases of employment discharge with actual reasons would involve obvious difficulties Nevertheless some provision under which industrial management might submit to a properly constituted governmental function the undisguised facts of its experience in maintaining rates in sociologic studies The facts thus revealed should go far toward laying a foundation for practical measures sounder than the impressions and sentiments upon which sociologists and economists and government offi- cials have hitherto been obliged to base their efforts toward the relief of unem- ployment STUD LA T templa pneum Sarana twelve attenti halatio of ind that tl gated and sol action several in conn hard s suited with a Hoffma perimen tion to of Dr. 1 tion of Labora ceedingl plant a perimen 1928 exposed The stu * Rece h h OY STUDIES ON EXPERIMENTAL PNEUMONOKONIOSIS VI INHA- ne LATION OF ASBESTOS DUST ITS EFFECT UPON PRIMARY - TUBERCULOUS INFECTION g LEROY U. GARDNER AND DONALD E. CUMMINGS ne From the Saranac Laboratory for the Study of Tuberculosis Pan The Edward L. Trudeau Foundation Saranac Lake New York experimental investigation Tof the reaction to inhaled asbestos dust had long been con- since so much interest has recently been manifested in the subject of asbestosis a preliminary report is sub- templated as a part of the study of mitted at this time pneumonokoniosis carried on at the Saranac Laboratory during the past ASBESTOS DUST twelve years During that time little The dust employed in this study attention had been paid to the in- halation of asbestos dust as the cause when dry is a light fluffy white stringy substance composed of short of industrial disease It was hoped fibers and irregular particles Com- that this substance might be investi- mercially this grade of asbestos is gated because it is a relatively soft and soluble silicate the study of whose known as King's floats For a proper understanding of its physical action might shed some light upon several of the vexing problems arising characteristics a brief consideration of its occurrence in nature and its in connection with the inhalation of method of preparation is necessary hard silicious dusts It admirably The Thetford asbestos is known as suited our plans therefore to comply with a suggestion of Dr. Frederick L. Hoffman that we undertake an experimental investigation of the reac- chrysotile a member of the serpentine group of minerals Pure chrysotile is a silky white fibrous substance but the presence of iron in varying states of tion to this substance At the request oxidation usually gives it a greenish of Dr. Hoffman the Asbestos Corpora- tion of America has furnished the or greenish color It is composed of tightly packed bundles of Laboratory with 600 pounds of exceedingly fine asbestos dust from its plant at Thetford Quebec The experiment was started in January 1928 and animals have now been exposed for two years and five months The study is not yet completed but smooth flexible fibers which are about 0.05 micron in diameter and which vary from 1/8 inch to 6 inches in length In nature these fibers occur in veins which are embedded in hard serpentine rock The thickness of the vein determines the length of the * Received for publication July 18 1930 fibers which run across it - 65 tye yee oR To eee ee RaeBe lt victors ae Nn ea ich ota Bhesa aIe Oye OE ee . at en ere . 66 THE JOURNAL OF INDUSTRIAL HYGIENE The King's floats grade of asbestos contains only short fibers which occur in very narrow veins The hard ser- pentine matrix rich in small veins is crushed dried recrushed screened and pulverized and finally passed over shaking screens from which the fibers are withdrawn by suction The material is then graded by screening and the fraction which passes the finest screen is allowed to settle in a large room Such material King's floats contains not only short fibers but in The dust has a specific gravity of 2.26 It loses only about 1 per cent of its weight when heated at 110 yet in a moist atmosphere sufficient water is absorbed to increase notice- ably its tendency to clumping or matting In chemical composition pure chrysotile is chiefly composed of crystalline hydrated silicate of magnesium 3MgO 2H2O It is however seldom free from impurities which partially replace the magnesium to form more complex silicates Ferrous iron is the most common contaminant and it may sometimes constitute as much as 10 per cent of the mineral as it occurs in nature A portion of this iron may be oxidized to the ferric state The following analysis has been made from samples of the dust used in the study FIG Asbestos dust X90 addition many small particles of serpentine rock Microscopic examination reveals the fact that particulate matter is far in excess of fibrous material The particles vary in size from 10 microns to 0.5 micron in diameter The fibrous traction is less uniform In length the fibers vary from 1 mm to 1 micron or less Many isolated long smooth thin flexible strands are seen while others consist of short thick bundles with broken ends The fibers are highly refractile when viewed by polarized light See Fig 1. % Total SiO 00. ce. eee 39.32 Fe2O3 Al O. 3 CaOCaO re 8.84 8.84 0.67 MgO 0... cece 35.56 Alkalies and loss 2.87 Combined water 12.74 Free SiO by rational analysis= 2.6 The material reported as aluminium oxide and ferric oxide was largely the latter Preparations of the dust stained with potassium ferricyanide and dilute hydrochloric acid indicate that there is ferrous iron in the ma- jority of the fibers a few exhibit irregular staining with ferrocyanide Anderson and Clark 1 have shown that treatment of Thetford chrysotile with hydrochloric acid completely destroys the typical crystalline pattern Pr Ee ee Ce DEPT Se Ce ea Ot Ce er REACTION TO INHALED ASBESTOS DUST 67 gravity of 1 per cent at 110 re sufficient ase notice- umping or of the material produced in Bragg's ray diffraction technic Careful and repeated search has failed to disclose any yellow structures resembling asbestosis bodies in the dust previous to its residence in the sated by frequently changing the position of the cages on the racks As measured by the operation of the motor the daily period of exposure is eight hours but since the animals remain in this room during the night ion pure ed of crys animal The appearance and method of development of these structures will be discussed later the actual exposure is much longer considerable time being required for all the dust in the atmosphere to settle magnesium s however ties which gnesium to 5. Ferrous EXPERIMENTAL PROCEDURES The general plan of the experiment is the same as that previously em- In warm weather the period is somewhat shortened by opening the win- . dows when the motor is stopped in the evening From the commencement of the experiment on Jan. 20 1928 until ntaminant stitute as he mineral portion of - the ferric ployed in studies on granite 2 marble 3 carborundum 4 and quartz 5 In the present instance animals are kept in cages along the walls of a room 6 by 8 feet and 8 the present date the dust exposures have been continued for eight hours on six days a week with the exception of a period of three weeks in the month of January 1930 when the motor was has been dust used feet high provided with two 3 by 5 foot windows A cloud of dust is maintained in the atmosphere of this being repaired Dust Concentration room by apparatus located in an The amount of dust in the atmos- alcove 6 feet from the nearest animal phere of this room has been checked % 39.32 This apparatus consists in a horizon tal drum 2 1/2 feet long and 1 1/2 with a Greenburg impinger apparatus Samples taken on Feb. 35.5635.56 feet in diameter placed 8 inches above 14 1928 one month after the experi3 the floor Its top is open and in it ment was started showed the concen- i: rotates a metal paddle whose shaft trations given in Table 1 .. 12.74 projects through the end of the drum The rate of suction on the sampling lysis= and then through the partition into apparatus was 1 cubic foot per minute an adjacent room in which is located the sampling times were fifteen min- luminium an electric motor By properly selected pulleys and countershafting the utes and thirty minutes Owing to the fibrous nature of the dust the rgely the The dust speed is so regulated that the desired dust concentration can be maintained particles were not filtered before the counts were made but the very large ricyanide Ventilation is secured by opening one particles those greater than 100 indicate the ma- ~ exhibit vanide of the windows an inch or more from the top The animals are kept generally in pairs in 12 by 12 by 12 inch wire cages set on racks at the sides microns were simply neglected in counting Particles over 1.5 microns in diameter magnified ninety times were counted in the usual re shown and back of the room While it will manner in a Sedgewick cell hrysotile mpletely : pattern be shown that the dust concentration progressively decreases from the floor to the ceiling this factor is compen- * Appreciation is expressed to Mr. Morris Dworski for making these dust determina- tions . oe Yer yay gt me Bega,Mines are vacate 1 oS aoe se it. Riel Pi,* t Bars. Nean Nee Ra clibnceitcerBsranco eee ies greinr 0 tae Rao BO td cate 89 THE JOURNAL OF INDUSTRIAL HYGIENE after being allowed to settle for thirty minutes The smaller ones varying from 1.5 microns to 0.5 micron in diameter were counted in a hemo- cytometer chamber at a magnification of 410. The usual blank controls on the distilled water used to collect the dust samples were made and the number of accidental particles was subtracted before the results were tabulated This concentration was maintained with little variation until January 1930 when the speed of the paddle was accelerated and the amount of sus- days before the dust inhalation was begun forty of them were placed in the dusting room and twenty were kept in a normal atmosphere as controls Two years after the experiment was started twelve dusted and twelve normal guinea were in- fected with tubercle bacilli This group was then set aside without fur- ther exposure to the dust All the rats and rabbits and four of the guinea were used in studying the uncomplicated effects of inhaled asbes- tos dust Each of the various groups will be described separately TABLE DUST COUNTS COUNT NO HEIGHT OF | INTAKE FROM FLOOR ft 12 22 2 22 Average 3 4 4 4 Average .. MILLION PARTICLES PER CUBIC FOOT OF AIR A = 100-10... X 95 B 10-1.5 X 95 C | 10-0.5... x 410 1.5...or less C-B Total A+ C . 1.130 1.258 1.194 0.450 0.400 0.425 8.033 6.625 7.329 4.960 4.440 4.700 56.666 51.600 54.133 35.000 43.333 39.166 48.633 44.975 46.804 30.040 38.893 34.466 57.796 52.858 55.645 35.450 43.733 39.591 pended dust was increased approximately ten times The majority of the animals to be discussed in this report however were subjected only to the smaller dust concentration In this experiment 128 guinea eighteen white rats and seven rabbits have thus far been used A portion of the guinea were infected with tubercle bacilli in an attempt to determine the influence of this dust upon a tuberculous process One group of three guinea were infected with tubercle bacilli four PATHOLOGIC LESIONS Tuberculous Guinea Up to the present date twenty months after the commencement of the dust inhalation fourteen animals or 26 per cent of the group have died of epizootic pneumonia and fifteen more succumbed to other conditions such as enteritis and peritonitis As this experiment was designed to demonstrate the maximum effects which could be produced by the in- haled dustrelatively few of the ani- J. I. Oe ad ke a ap Ee RS Ae RRR Le ee ees REACTION TO INHALED ASBESTOS DUST 69 lation was e placed in three mosphere as the experi- dusted and mals have been killed A number have however been sacrificed at 30 60 90 354 610 782 and 847 days Commencing with the eighth month of exposure the effects of the dust have also been followed radiographi- black particles and few short spicules of doubly refractile material are visible in the alveoli budding off from the respiratory bronchioles A few multinucleated dust cells are s were in- cally in the living animals ae tin cilli This The pulmonary localization of in- ithout fur- haled asbestos differs from that of any 2a . All the four of the other dust thus far studied Granite quartz carborundum and soft coal tudying the t haled asbes- particles penetrate the terminal air spaces of the lung and large quantities ious groups ultimately localize in the subpleural alveoli Asbestos dust presumably because it is so largely composed of elongated fibers is carried by the in- spired air only to the distal respiratory | Total A+C bronchioles and there the major portion of the material comes to rest Mononuclear phagocytes from the FIG Cross section of lungs of guineapig exposed to asbestos dust inhalation 840 days Normal siz~ adjacent connective tissues enter the 57.796 52.858 lumen of the air passages and engulf the particles The phagocytes with their contained fragments of dust are 55.645 frequently pushed aside into the 35.450 43.733 alveoli which pouch out of the sides of the bronchioles where many of them remain indefinitely More dust 39.591 entering the lung is held up by the partial obstruction created and fur- VS ther reaction is largely proximal to the Pigs point of original localization A few particles pass beyond into the proximal wenty ncement of portions of the alveolar ducts but in the majority of cases the deposition of en animals , have died and fifteen conditions tonitis As signed to um _ effects by the in- of the ani- asbestos dust occurs within respiratory bronchioles of the second and third orders and in the alveoli given off directly from those structures Fig 2. In after guinea killed thirty days starting the dust inhalation occasional small mononuclear phago- cytes containing a number of brown or FIG Roentgenogram of guinea exposed 880 days to asbestos inhalation tissues encountered The lymphoid of the bronchial tree exhibit a moderate degree of hyperplasia The lymphatic . trunks coursing through the bronchial walls are wide open but no dust cells or other material can be found in H. Vol 13 ae Ny See eee SE 8 ONS AR 3A a : Nod ee. enma agre apy ae ea _ TO . a Ee ane * i CO peep Pee Atte ONoy y - Sea et ne aa as TTDDS SPLT IEE tad OL Se 70 THE JOURNAL OF INDUSTRIAL HYGIENE their lumina The tracheobronchial lymph nodes exhibit no more dust containing cells than those in any normal animal kept in a laboratory atmosphere At sixty days the number and size of the dust cells in the terminal respiratory bronchioles is considerably in- creased The lumina of some of the lateral alveoli are completely blocked by masses of mononuclear phagocytes and larger giant cells Some of the latter have six or more nuclei Fre- quently in Zenker tissues these phagocytes have a diffuse yellowbrown color which is presumably due to the presence of dissolved iron in their cytoplasm In tissues fixed in formalin and stained with acidified potassium ferrocyanide such cells exhibit a diffuse blue coloration In addition there are certain particles in their cytoplasm stained very deep blue which are probably the source from which the iron is dissolved Doubly refractile intracellular spicules are numerous they are most readily demonstrated in polarized light After sixty days exposure to dust the first evidence of that peculiar structure which has been called a curious body is detected We prefer to adopt Stewart and Haddow's 6 designation of asbestosis body and shall use the latter term exclusively After two months the number of asbestosis bodies is small and they are atypical in appearance The most common form is a shaped swelling at the end of a smooth pale greenish fiber Some present small fusiform swellings along the course of a short fiber They are seen almost without exception inside of large giant cells After ninety days exposure the number of these structures has very markedly increased and they have assumed their typical form The smaller ones are still contained in giant cells but many long forms appear to be free in the stroma of the lung The amount of cellular reaction has not kept pace with the number and size of the foreign bodies It still con- sists of collections of mononuclear and giant phagocytes within the lumen of a localized group of air spaces together with a very slight infiltration of the adjacent septa Hyperplasia has occurred in the lymphoid tissues associated with the bronchi proximal to the foci of maximum dust reaction but no phagocytes have carried dust particles into the lymph nodules The lymphatic trunks are widely distended but they contain no cells or dust particles The tracheobronchial lymph nodes also show wellmarked hyperplasia but the number of dust containing cells is still small During the next four months no animals were killed but nine died of various accidental causes In them it is found that increasing quantities of dust are accumulating in the vicinity of the respiratory bronchioles and that the amount of cellular reaction is some- what increased Asbestosis bodies so extremely abundant that as many as eight have been encountered in an oil immersion field They are practically absent in other portions of the lung The other changes in the lymphoid tissues and lymphatic ves- sels remain much the same There is as yet no evidence that appreciable amounts of dust are being transported to the tracheobronchial lymph nodes In three guinea killed on the 357th day the amount of reaction has REACTION TO INHALED ASBESTOS DUST 71 has very hey have rm The developed to such a degree as to be visible on gross section of the fixed lar appearance with defined borders They are arranged radially on the sur- face and suggest a relationship to the tained in ng forms ma of the ar reaction imber and t still conuclear and e lumen of s together tration of oo - plasia has id tissues i proximal t reaction arried dust 1 nodules are widely in no cells acheobronshow well- FIG Longitudinal section of bronchus and its peripheral branches Exposure 357 days Approximately X45 Note that dust reaction is localized to region of respiratory bronchioles No reaction in lymphoid tis- sues FIG Peribronchiolar dust reaction in in normal guinea exposed 840 days tissue stain Approximately CXo9n0 nective he number till small nonths no ine died of In them it uantities of the vicinity les and that tion is some- is bodies at as many ntered in an y are pracrtions of the ges in the nphatic ves- e There is appreciable transported ymph nodes tilled on the reaction has FIG Longitudinal section of bronchus and its peripheral branches Exposure 436 days Approximately X45 Note that dust reaction is localized to region of respiratory bronchioles region tissue Uniformly distributed over the entire surface of both lungs are fine yellowish ovoid flecks of granu- FIG Early tuberculous reaction in focus of asbestosis endogenous extension 357 days after infection Approximately 90 finer bronchioles All are of approximately the same size and none exceed 1 mm in diameter Microscopically those foci are similar in every way to 72 THE JOURNAL OF INDUSTRIAL HYGIENE the type of reaction already described The walls of the bronchioles proximal to alveolar ducts are thick but this is due solely to an excessive local accumulation of phagocytes There is no evidence that fibroblasts are of the air spaces adjacent to the deposits of accumulated dust phagocytes At first only a few cells are involved but after still another 100 days a true fibrosis accompanied by the formation of very considerable proliferating The dust cells have amounts of collagen has developed not migrated to any extent from the The walls become progressively thicker original foci of localization none are found in the pulmonary lymphoid and encroach upon the lumen of the air spaces The epithelium of the tissues but some have been trans- latter contracts and becomes cuboidal ported to the tracheobronchial lymph so that the area of reaction resembles nodes Figs 4-7 In the medullary a gland with a heavy connective tissue sinuses of the latter location there are stroma The lumina of these gland- now definite clusters of stained like atelectatic air spaces are more or BG: iron containing phagocytes In their less completely filled with compact ory. ORrat cytoplasm many irregular black or masses of dust cells and brown- brown particles and refractile elon- stained giant phagocytes whose cyto- gated spicules are recognizable Occa- plasm is gorged with dust particles sionally a giant cell is seen partially fibers and asbestosis bodies In the surrounding a very long fiber which thickened septums there are many of may project beyond the limits of the the latter which are generally extra- cell One such fiber measured 25 cellular Figs 6 9 and 10. . microns in length No asbestosis The amount of dust carried into the bodies are seen As yet the only tracheobronchial lymph nodes now evidence of reaction in these nodes becomes more abundant It consists consists in an active proliferation of the follicle cells While asbestosis bodies cannot yet be found in the lymphoid tissues they do occur outside the lung Two of the day animals had developed a chronic fibrous pleurisy and occasionally in the connective tissue there are small clusters of phagocytes containing dust and asbestosis bodies In an isolated field five of them have been counted On the 449th day two asbestosis bodies are found within a giant cell in the tracheobronchial lymph nodes All animals killed or dying on and after the 505th day are characterized by the proliferation of fibroblasts This reaction is confined to the walls largely of amorphous or granular black or brown particles with many doubly refractile spicules which fail to stain specifically for iron Occasionally a few giant cells sometimes in small clusters contain asbesto- sis bodies The stroma of the nodes about the masses of dust cells now exhibits a limited amount of fibro- blastic proliferation The latest stages of the reaction of asbestos dust thus far produced are manifested in the lungs of five guineapigs of which three were killed on the 782nd day and one on the 840th day All five exhibited a large number of subpleural white nodules at least 1 mm in diameter uniformly distributed over the surface of the lung REACTION TO INHALED ASBESTOS DUST 333 acent to the 1 dust phago- few cells are 1 another 100 companied by considerable as developed sively thicker lumen of the clium of the radiographic e e On section of the organs sharply The first examination demarcated ovoid areas are disclosed to demonstrate definite changes in the ee a in every part of the lung One lung was obtained after a dust expo- so animal shows fibrous pleurisy over mes cuboidal tion resembles nnective tissue i these gland- S are more or with compact and brown- s whose cyto- ust particles dies In the FIG Magnified field of Figure 8 FIG Peribronchiolar focus of asbesto- Connective tissue stain Note strands of are many of ee sis guinea exposed 782 days Approx- collagen between gland alveoli Ap- nerally extra- imately X70 proximately X140 e 10. rried into the nodes now are em > T oere , e x - ora It consists or granular s with many s which fail iron Occasometimes in asbesto- of the nodes 1st cells now int of fibro- e reaction of produced are f five guineakilled on the e 840th day e number of lules at least niformly disof the lung a) ay . BS Se FF eg . a r an Py oaka Ca ay e ide w of Bok eee . 5 ad 7 oe . FIG Magnified field of Figure 8 Note gland X140 air spaces Approximately portions of the lung without evidence of an underlying pneumonia The tracheobronchial lymph nodes are deeply pigmented in their central portions FIG 11.Asbestosis in rabbit exposed days Approximately X140 Note giant cells one of which has invaded nodule of lymphoid tissue sure of two years At this time the presence of very fine mottling was detected in the lower portions of the lung fields After another five months ss Boe a ya fy Aees aneS COM Cf ar a a.Seware. be RD ne!operas ' ag i CRs ae ' Weta, a8 as oe ya OI ae cA a 74 THE JOURNAL OF INDUSTRIAL HYGIENE had elapsed the changes had become much more marked As illustrated in Figure 3 they consist of strands of epithelium which occasionally dips into the thickened septums to form gland- like structures In marked contrast coarse mottling which radiate outward and downward from the hilum The outlines of the mediastinum and the pericardium are obscured by similar shadows Whether the apexes are also involved cannot be definitely determined Pathologic changes in the lungs of to the previously mentioned areas of fibrosis in the respiratory bronchioles these more peripheral foci include practically no dust cells or asbestosis bodies One lobe of this lung is covered by organized fibrous pleurisy which also fails to exhibit dust deposits experimental animals are much more Examination of the trachea and stem readily demonstrated radiographically if the lungs are removed from the bronchi both by direct and by polarized light has failed to demonstrate thorax and inflated before exposure appreciable amounts of dust or local oe to the ray Roentgenograms have reaction The only evidence of irrita- ww been made in this manner of animals tion is the presence of an occasional with developed asbestosis and the polynuclear leukocyte on the ciliated = So shadows produced are characterized by a pronounced thickening of the linear markings which extend outward surface and the distention of the goblet cells with mucus More peripherally the connective tissue coats of from along the main bronchi to the the bronchi of the second and third margins of the lung orders exhibit considerable infiltration Microscopically the lungs present lesions similar to those already de- with lymphoid cells and some engorge- ment of the blood vessels The other scribed but they are more extensive and fibrosis has become more marked In stains for connective tissue abun- viscera the spleen liver kidneys pancreas and abdominal lymph nodes have been uniformly free of dust or dant collagen formation is now apparent in the walls of the respiratory bronchioles and their alveoli Dust cells and asbestosis bodies are very abundant evidence of reaction attributable to it In the guinea the development of the early two years and five months response to inhaled asbestos dust may The extension of the process from the be summarized as follows , terminal bronchioles proximally into The particles and elongated fibers of respiratory bronchioles of greater di- ameter is obvious In addition to these characteristic asbestos dust do not during this period penetrate so deeply into the air passages of the lung as do the other changes the lung of one animal dusts previously studied The major exhibits more or less circumscribed portion is held up and phagocytosed in es foci of fibrosis in the alveolar septums peripheral to the usual reaction zone the lumina of respiratory bronchioles and the alveoli given off from their The lumina of the included air spaces walls Increasingly large masses of age are normal in size and apparently phagocytes accumulate in the lumina een fully distended Their walls are lined of these air spaces and many of the PO with easily visible cuboidal or flattened cells migrate into the framework of Rag y dips into rm gland- 1 contrast l areas of onchioles i include asbestosis lung is s pleurisy ibit dust and stem by polar- nonstrate t or local > of irritaOccasional e ciliated 1 of the re periph- coats of and third filtration "engorgeThe other kidneys ph nodes f dust or able to it elopment e months dust may d fibers of ring this to the air the other The major cytosed in ronchioles rom their masses of ne lumina ny of the ework of REACTION TO INHALED ASBESTOS DUST 75 the adjacent lung tissue In this late development Only after 700 location there develops a low grade days do fibroblasts begin to proliferate chronic inflammatory reaction charac- in the medulla of the nodes terized by infiltration with monocytes and a few lymphoid cells Approximately 500 days after the commence- Asbestosis bodies have not been found in any animal killed before sixty days of dust exposure When ment of dust inhalation the connective first discovered they are small some- tissue cells in the walls of the bronchi- what atypical in form and generally ole and its alveoli begin to proliferate contained within the cytoplasm of Thereafter the reaction is charac- phagocytes Within the next sixty terized by increasing amounts of days they rapidly increase in number fibrous tissue which develops in the size and complexity of structure immediate vicinity of the dust cells The larger ones appear to be liberated The thickening stroma encroaches from the cells and ultimately to be upon the lumen of the air spaces whose free in the air passages or intracellular epithelium being compressed appears spaces In most cases these struc- ea presumably = cuboidal as is the case in pulmonary tures because of their atelectasis The picture produced size are not transported from the point somewhat resembles glandular tissue where they first develop in the lung In addition to this lesion which is Occasionally they have been found in characteristic of all the animals exam- the tracheobronchial lymph nodes and . ined one of three of the last guineapigs killed showed a further change consisting in focal areas of fibrosis in in areas of chronic fibrous pleurisy In these instances they are usually intracellular the alveolar septums peripheral in the Rabbits pulmonary unit to the point of dust localization Five rabbits exposed to asbestos Changes in other structures of the dust for 40 53 149 253 and 330 lung are not striking There is well- days respectively have thus far been ~_ marked hyperplasia of the lymphoid killed and studied Within the period tissues in the periphery of the lung of time included the reaction to the but dust containing phagocytes do not inhaled dust has been characterized by migrate toward and enter these masses increasingly large focal collections of as is the case with quartz inhalation mononuclear and giant phagocytes Dilatation of the large lymphatic These as in the guinea tend to vessels in the connective tissues of the accumulate in and along the respira- bronchi and blood vessels has been a constant finding in all the animals of the series Even thirty days of dust inhalation would appear sufficient to produce this effect Its cause has not been discovered thrombi within the lumen of the lymph vessels are lacking and a central obstructive lesion in the tracheobronchial lymph node is a tory bronchioles although in the last two animals killed some collections of dust cells have been seen in the more peripheral air spaces In marked contrast to their behavior in the guinea the phagocytes exhibit a tendency to migrate into masses of lymphoid tissue This occurs early and has been observed in all but the 76 THE JOURNAL OF INDUSTRIAL HYGIENE first animal killed It is probably due to anatomic differences in the two species In the rabbit abundant deposits of tonsil lymphoid tissue are situated directly beneath the epithelium throughout the course of the bronchial tree in the guinea the lymphoid nodules are not so readily accessible The phagocytes are filled with great quantities of doubly refractile dust spicules but no typical asbestosis bodies have yet been discovered When stained for iron none of the fibers in the first four animals reacted In smears of lung tissue from the last animal killed on the 330th day a few elongated fibers exhibited irregular deposits of both ferric and ferrous iron and there were occasional globular swellings along their course But these fibers did not present the usual golden color of an asbestosis body and the alterations in structure were in no way characteristic No suggestion of fibrosis or even reaction in the framework of the lung adjacent to the collection of dust cells has been discovered but it is still too early to expect much change In the guinea the first indication of fibrosis was found on the 500th day Albino Rats Repeated attempts to study the reaction to inhaled asbestos in the white rat have been defeated by the development of epizootic pneumonia often complicated by abscess formation The first series was composed of twelve animals all of which succumbed to this infection One survived for 450 days but in all of them the reaction to chronic pneumonia so obscured the picture that no deductions were possible In December 1929 six new apparently healthy rats were placed in the dust room During a period of 118 days three have been sacrificed and one has died All of them have had pulmonary abscesses In only one animal which was killed on the seventieth day could asbestosis bodies be detected and in this case prolonged search of smears of the lung tissue stained for iron has revealed only two of these structures One was very small but typical in appearance The other consisted of a bundle of fibers frayed at the end and upon one of the fibrils were a few irregular swellings In another rat killed after 118 days no asbestosis bodies have been found THE ASBESTOSIS BODY Since the development of the peculiar structure termed an asbestosis body in the lungs of animals compelled to inhale asbestos dust may have an important bearing upon the general problem of pneumonokoniosis it de- serves detailed consideration The forms encountered in the lungs of guinea in every way resemble those pictured in the human cases While individual specimens exhibit marked variations there are certain features which are characteristic of all the forms observed The fully developed body consists of a brilliant yellow beaded or haustral rod which may be either straight or curved Its color resembles that of the hemo- siderin deposits found in areas in which hemorrhage has occurred In length they vary from 1 to 250 microns and in width from micron to 10 microns The shorter ones are usually straight but the larger forms are curved or even coiled They do not stain with any of the dyes ordinarily used for E tly healthy rats room During hree have been s died All of nary abscesses ich was killed on could asbestosis nd in this case nears of the lung has revealed only 5. One was very pearance The bundle of fibers upon one of the gular swellings after 118 days ave been found SIS BODY at of the peculiar asbestosis body Is compelled to may have an Don the general okoniosis it de- eration red in the lungs y way resemble e human cases ecimens exhibit here certain characteristic of ved The fully sts of a brilliant or haustral rod raight or curved at of the hemo- in areas in which rred In length 250 microns and -on to 10 microns usually straight s are curved or io not stain with Hinarily used for REACTION TO INHALED ASBESTOS DUST 77 tissues but Wright's blood stain is absorbed to some extent giving greenish cast Fixing fluids and the usual histologic stains have no appar- ent effect upon them IronIron in the ferric state may be demonstrated by - 4 FIG Asbestosis bodies in guinea lungs Nos 1 to 10 from smears of lung tissues Nos 11 and 12 in sections Approximately X560 No. 1 shows a smoothly coated fiber in No. 2 no fiber is visible No. 7 shows show various forms of this coating material cracked along fiber Other Other illustrations structure ae trap RAS 78 THE JOURNAL OF INDUSTRIAL HYGIENE Pe ee treatment with potassium ferrocyanide the process of preparing sections ee MO, 8 8 co in dilute hydrochloric acid McDonald and Stewart Examined under polarized light they are not doubly refrac- and smears cannot be determined Fig 12. . The lung of the rabbit apparently sia:SE tile The shorter forms are usually offers a much less favorable environ- found within the cytoplasm of a ment for the production of the asbesto- ine foreign body giant cell longer ones sis body than that of the human being et ats ae e ee FIG Atypical asbestosis bodies from lung of rabbit exposed 330 days 8 and 9 are artificially produced asbestosis bodies X840 Nos Oe may be coiled within such cells but or the guinea Nothing faintly ee more usually they lie free in the lumen resembling one of these structures has of an alveolus or in the intercellular been found until the dust exposure has St spaces of the pulmonary framework been continued for a period of eleven Whether they actually exist in the free months At that time in hematoxylin state during life or whether owing to their elasticity they are set free in and eosin preparations occasional fibers are seen which have a muddy greenish gpa ing sections determined it apparently able environf the asbesto- human being pe oe Semen days Nos cae wing faintly uctures has xposure has ay od of eleven ematoxylin sional fibers ly greenish REACTION TO INHALED ASBESTOS DUST 79 hue but they do not exhibit the regular beading or the characteristic golden color seen in the guineapig Preparations stained for either ferrous or ferric iron demonstrate a few very long fibers containing irregular swellings of a deep blue color Whether typical asbestosis bodies will ever develop in this animal remains to be demonstrated Fig 13 Nos 3 and 4. In the lung of the white rat they would also appear to be very uncom- mon although the widespread incidence of chronic pulmonary infection among the animals thus far exposed in a measure invalidates the results Thus far only two asbestosis bodies have been discovered in one animal of this species If the environment were favorable it would seem probable that more of these bodies would have been detected even in the presence of complicating pneumonia Our observations have led us to believe that the asbestosis body devel- ops as the result of chemical changes taking place within or about inhaled asbestos fibers The dust previous to contact with the pulmonary tissues shows no such structures A period of time which varies with different species of animals must elapse after the fibers have entered the lung before the asbestosis body makes its appearance The first forms encountered are differ- ent from those seen later They consist of iron containing sheath or nodular swellings along the sides or at the ends of a fiber From such points further extensions occur until in some cases the whole filament acquires a uniform coating which is brittle Fig 12 No. 1 Movement or other stress causes the coating substance to crack separating it into segments , Fig 12 No. 7 Chemical action continues and the segments tend to elongate in a direction at right angles to that of the original fiber Extension also takes place at the ends of the fiber so that it increases in length Small fragments may also serve as nuclei for chemical activity about them spherical or ovoid masses develop The resultant forms exhibit many variations Per- haps the most common ones consist of an axial fiber traversed at intervals by a variable number of thickened cross- bars Often one end and sometimes both ends are swollen and spindle shaped In other instances the central fiber cannot be discovered possibly it has been dissolved the body then consists of a row of globules Sometimes these are of uniform diam- eter frequently they decrease progressively from one end the other In guinea exposed for more than two years many bizarre branching globoid forms are seen which resemble clusters of tuberous bulbs An observation which merits com- ment is the scarcity of asbestosis bodies in the tracheobronchial lymph nodes Presumably because of their size the majority of the inhaled asbestos fibers are not transported to distance any by phagocytes Never- theless after exposure to the dust has been continued for somewhat over a year appreciable numbers of doubly refractile staining fibers can be found in the lymph nodes of the mediastinum They are embedded in the cytoplasm of phagocytes which have migrated from the lung After two years large masses of such dust cells have accumulated and yet asbes- 60 THE JOURNAL OF INDUSTRIAL HYGIENE tissue tosis bodies are not found in any number in the tracheobronchial lymph bonate among other constituents Samples of the peritoneal fluid were nodes Those which do occur are withdrawn with located in clumps of giant cells It is capillary pipettes believed that the formation of the few twenty and sixty days after asbestosis bodies found took place in the injections In each series the fluid exhibited large numbers of dust con- the lung and that they were then taining monocytes and in both the transported to the lymph nodes in emboli of asbestos groups large giant cells were phagocytes Why do asbestosis bodies numerous No sign of an asbestosis occur so rarely in the material which body could be discovered Dissolved has been transported to the lymph nodes iron was detected in the cells from the granite series but none could be Were the fibers during their period of in those from found residence in the lung deprived by either of the asbestos - groups solution of iron or some other sub- On the stance necessary to their production seventieth day and again on the 110th or are the transported fibers day one animal from each different from those essentially group was killed The amount of remaining in the reaction was surprisingly insignificant lung or again is the environment furnished in the Careful search revealed minute foci of lung especially favor- pigmentation in the able for the production of asbestosis omentum of each bodies animal At seventy days no sugges- To answer the last tion of an asbestosis body was dis- possibility injec- tions of asbestos dust have covered but at 110 days a few very te been made small but typical bodies were found in ge into other portions of the body In a smear stained for iron the the peritoneal cavity of the guinea nodule from of an omental attempts to produce asbestosis bodies one animal injected with have met with but slight success In the King's floats dust The asbestos one series each fiber and the iron containing granite guinea was injected with c.c. of a heavy suspension of the _ animals did not show them These King's floats dust which was findings were confirmed subsequently so pre- pared by sedimentation 7 that only by histologic examination of the While the particles varying from 2 to 4 microns remaining animals of this were present This material it will be recalled contains not only asbestos experiment are still under observation it hardly seems probable that asbes- fiber but a considerable amount of tosis bodies will develop in any num- iron and other material Another ber Aside from its failure to favor the series received a like amount of pure formation of these structures it is asbestos fiber cut and ground into the finest possible state This fiber was obtained from a vein of Thetford ore As a control a third series was injected with a suspension of granite from Lorain County Ohio This rock contains free silica and ferrous car- surprising that the peritoneal cavity exhibits so little reaction to the injection of very considerable quantities of this foreign material When more insoluble dusts such as coal quartz and carborundum are injected very appreciable deposits are found in the constituents cal fluid were lary pipettes our days after series the fluid of dust con- 1 in both the antcells were an asbestosis d Dissolved cells from the could be found * the asbestos and again on nal from each 2 amount of insignificant minute foci of ntum of each ys no sugges- dy was dis- s a few very were found in of an omental injected with The asbestos ining granite _ hem These subsequently L of the tissue imals of this - observation c that asbesin any numre to favor the ctures it is Loneal cavity to the injecquantities of When more coal quartz jected very found in the REACTION TO INHALED ASBESTOS DUST 81 omentum and beneath the parietal peritoneum In the subcutaneous tissues at- tempts to form asbestosis bodies have been somewhat more successful In logic salt solution The iron free portion formed a smooth turbid opalescent suspension while the untreated portion produced a green floccu- lent one Two c.c. of each of these - an uncompleted experiment designed to determine whether certain dusts ~ might cause a dissemination of infec- - tion with tubercle bacilli of attenuated ' virulence daily repeated injections of asbestos dust suspensions were made into the subcutaneous tissue of the suspensions were injected into the subcutaneous tissues of the groins of each of six guinea the untreated suspension on the right side and the iron free material on the left When ' examined thirty days later all the animals had palpable nodules at the groin of guinea previously injected with tubercle bacilli in the same area site of injection of the untreated material and none on the opposite In all thirty injections totaling 3 mg of very fine dust King's floats were made Most of the material has side At this time one of the guineapigs was killed On the right side there was a nodule 10 mm in diam- not yet been examined but in one eter filled with greenish necrotic animal dying in 102 days and in three material while on the side there more killed 264 days after the " dust was only a faint suggestion of pigmen- injections were completed the subcutaneous tissues exhibited large masses of foreign body giant cells containing many typical asbestosis bodies With a view to determining whether tation in a very slightly enlarged superficial inguinal lymph node Smears made from the material on each side failed to demonstrate goldenyellow bodies When stained for iron the iron of the asbestosis body is derived from the dust or from the with potassium ferrocyanide numer- ous uniformly blue fibers were seen in animal body the following experiment the abscess produced by the untreated has been performed A mixture was material but only a few short un- prepared which contained equal parts stained fibers could be discovered in of very finely divided pure asbestos fiber and fine whole asbestos dust _ King's floats the latter composed of particles between 2 and 4 microns in diameter Both of these elements were included because the pure fiber from asbestos veins contains so little iron The mixture was divided into twoparts and from one of them the iron was completely removed by digestion with hydrochloric acid and subsequent washing Both fractions were sterilized by heating at 100 for the smears from the opposite side There was no suggestion of an asbestobody As in the case of the peritoneal cavity the impression is gained that a part of the dust may have been dissolved in the body fluids The effects produced at sixty days were identical The absence of asbestosis bodies on the right side is attributable to the lack of sufficient time for their development the disappearance of the injected material on the opposite side one hour and suspended in physio- is most surprising To be concluded IENE hrbuch der Intoxika- 1 edition Stuttgart , 1906 vol 2 p 789 termination of Aniline ir THIS JOUR 1920- Book of Organic w York John Wiley - : Das Toluylendiamin | sung auf den Thierf exper Path u 1 14 231 : Die Wirkung des auf den Thierk^rper Weitere Beitr^/ge zur erus Ibid 1883 16 STUDIES ON EXPERIMENTAL PNEUMONOKONIOSIS VI INHALATION OF ASBESTOS DUST ITS EFFECT UPON PRIMARY TUBERCULOUS INFECTION Concluded LEROY U. GARDNER AND DONALD E. CUMMINGS From the Saranac Laboratory for the Study of Tuberculosis The Edward L. Trudeau Foundation Saranac Lake New York PRIMARY TUBERCULOUS INFECTION IN never seen The course of the infec- _ PULMONARY ASBESTOSIS tion in such guinea is generally To determine whether inhaled asbes- tos dust affects the course of tubercu- lous infection the same procedures have been employed which were used in the previously reported experiments on other dusts i.e. granite 2 marble 3 carborundum 4 and quartz 5 For this purpose animals them exposed to asbestos infected by causing have been them to inhale small numbers of tubercle bacilli of the attenuated strain R By this means in undusted guinea a limited infection of the respiratory tract is produced with lesions comparable with those of the primary complex in man They consist of a variable number of small discrete subpleu- ral tubercles in the lung together with a more extensive involvement of the tracheobronchial lymph nodes The pulmonary tubercles caseate and then the bacilli die The caseous matter is absorbed and after a period of from eighteen months to two years complete resolution of the entire nonprogressive Figs 18 19 and 20 During the period from 1920 to 1928 . there were three instances of generalized tuberculosis among 251 guineapigs infected with this organism as controls to different dust experiments In one of these three there was some question as to the identity of the | animal In the last three years however eleven instances of disseminated disease have been discovered among 148 controls similarly infected The occurrence has been sporadic and only one animal in a group of twentyfive or fifty such controls exhibited evidence of spreading disease The cause of this apparent accentuation in virulence has not been ascertained It is hard to believe that after main- taining a constantly low degree of virulence for a period of thirty years the R strain has rather suddenly been altered As far as is known the gly- cerin broth on which it has been culti- vated has been prepared in the same manner as heretofore The dosage used for inhalation infection has been lesion takes place 8 Macroscopic maintained at a constant level The disease of the spleen and liver is almost only discoverable factor which has not 97 aene e aLg, 98 THE JOURNAL OF INDUSTRIAL HYGIENE been controlled is the guinea used for the experiments They have regu- introduction of epizootic pneumonia into the animal house It had not been considered necessary to perform routine _ intracutaneous tuberculin REACTI low virulent artificial 1 been fection may have d accidental infection with FIG Primary subpleural tubercle partially healed by fibrosis Below it and to the left is a nodule of lymphoid left tissue Slightly hyperplastic removed foci of dust reaction No are spread because lished Exposed to both dust and infection 357 days Approximately X20 FIG Healed fibrous tuberculosis in - an area of asbestosis Simultaneous ismuraetetloyduXs4t5and infection 838 days Apperxopxo-- FIG Inactive Inactive sub sub in undusted control anim has commenced 654 days Approximately X110 FIG Another tubercle primary subpleural from which has the same lung as Figure 14 reaction spread locally into an area of dust Approximately 20 larly been purchased from one farmer On their receipt they are quarantined for a period of three weeks to avoid the Approximately FIG Section of bestosis from uncomplicated as- ing more same lung as Figure 16 showfibrosis than tissue stain usual Connective 90 tests as no case of accidental tubercu- losis had ever been recognized among this stock It is possible that these recent cases of apparent spread of the J. H. March 1931 FIG Inactive Inactive sub sub in undusted control anin has commenced 654 day Approximately X110 lent strain Generaliz t however has always n ance only after ma : Vol 13 ry 3 No. 3 IENE izootic pneumonia house It had not ecessartyo perform aneous tuberculin f REACTION TO INHALED ASBESTOS DUST 99 low virulent artificial tuberculous in- fection may have been due to previous accidental infection with a more viru- residence in the animal house Subinoculation tests are now in progress in an attempt to determine the type of fibrous tuberculosis in Simultaneous expo- tion ~ da 83y 8 das ys Approx- FIG Inactive subpleural tubercle in undusted control animal retrogression has commenced 654 days after infection Approximately 110 FIG Healed subpleural tubercle 654 days after infection Approximately 110 of uncomplicated asing as Figure 16 showan usual Connective ximately X90 f accidental tubercu- n recognized among possible that these parent spread of the J. H. March 1931 FIG Inactive subpleural tubercle in in undusted control animal retrogression has commenced 654 days after infection Approximately 110 FIG Partially healed tubercle in wall of large bronchus Location atypical 357 days Approximately 130 tubercle bacillus responsible for this lent strain Generalized tuberculosis disturbing manifestation ~~ however has always made its appear- But in spite of these occasional in- ance only after many months of stances of disseminated tuberculosis in Vol 13 No. 100 THE JOURNAL OF INDUSTRIAL HYGIENE the control animals this method of testing the effect of inhaled dusts upon tuberculous infection is of value The great majority of the controls not exposed to dust inhalation exhibit nonprogressive pulmonary tubercles which ultimately heal by resolution On the other hand almost every animal similarly infected and exposed to the inhalation of quartz dust dies of generalized tuberculosis unless premature death from epizootic pneu- monia or other causes supervenes In the asbestos dust experiment two groups of guinea were infected with the attenuated R strain of tubercle bacilli.2 One lot of sixty- three normal animals were subjected to inhalation infection and four days later forty of them were placed in the dusting room where they have been A second group of twelve guinea- pigs which had been exposed to asbestos dust for a period of two years under the conditions described above were infected by the inhalation of an approximately equivalent dose of R. tubercle bacilli At the same time twelve normal animals were infected as controls Both the previously dusted animals and the controls were then set aside in the general animal room to be allowed to live as long as they would This second test was designed to demonstrate whether the alterations in pulmonary anatomy and physiology produced by the in- haled dust would affect a tuberculous infection Infection Coincident with Dust Inhalation curred kept under the conditions already Of the forty guinea originally described until death occurred remaining twenty of this The infected and placed in the dusting group were set aside in a normal atmosphere chamber thirty are now dead Seven were killed and the as controls to the infection From have died of remainder this experiment it was hoped that the of various causes four effect of inhaled asbestos dust generalized tuberculosis seventeen tuberculous infection upon a with more or less extensive epizootic mined might be deter- In the animals thus exposed pneumonia and the rest from various accidental causes Nine asbestos particles would continue to and are still alive enter the lungs during the period of apparently well at the time of this tubercle formation If solution or report two years and three months after infection Some evidence of other chemical reaction should occur spread of the tuberculous these changes might conceivably affect been observed in process has the activities of the tubercle bacilli it has been ten animals in six The method of confined to the lungs infection has been described elsewhere 2 The dosage em- while in the other four it involved the ployed for the present infection consisted of six puffs from abdominal viscera as well Pulmo- a DeVilbiss vaporizer containing a suspension of R tubercle nary cavity developed in four animals bacilli The water clear suspension was In most of the cases an extension extension of the tphrrepoaurgehdpabpyercesnotrtihfautgatthieorne waenrde ffirlotmrattieonn tuberculous infection had at to twenty isolated bacilli in each oil im- mersion some time previous to death and broth field No clumps were present The bacilli were grown on glycerin subsequent healing resulted in fibrosis of all the the first group for eight days the second for secondary lesions In all twenty days the tuberculous animals even those H. March 1931 REACTI y <7" : dying lesions with generalize tend to be fibro exudat initvypee Of the twenty trols twenty are dead 595 days of generalized culosis with extensive : spleen liver and abd nodes The remaining cumbed for other rea died of pneumonia and t various accidental cal 244th day the tubercu the lungs had healed to that all evidence of disappeared With the noted the other anin after this time showe foci of scar tissue at 1 former tubercles In t were healed fibrous tub scopic dimension in the The distribution of tuberculous foci in th asbestosis group is some not only are the us tubercles formed but ir few foci are found in th lung apparently origi phoid tissues at bifu bronchial tree Fig 2 monary lesions are asso customary lymphatic m tracheobronchial lymph development of exten that location Many nary tubercles are inde of dust reaction and a this occurs the nor resolution is free to foci resolve completely disappear Others: extend into areas of du about respiratory bron such contact is establis Vol 13 No. YGIENE oup of twelve guineai been exposed to asbesriod of two years under described above were he inhalation of an equivalent dose of R At the same time animals were infected Both the previously and the controls were in the general animal wed to live as long as his second test was onstrate whether the pulmonary anatomy produced by the in1 affect a tuberculous ncident with Dust | a , alation uinea originally eRe dusting ced in the one are now dead pere . and the remainder 5 StYetU pear I ahd arious causes four 4 erculosis seventeen 3 - extensive epizootic os e rest from various 2 Nine are still alive Il at the time of this and three months Some evidence of rculous process has ten animals in six ned to the lungs our it involved the as well Pulmo- ed in four animals an extension of the on had occurred at is to death and resulted in fibrosis y lesions In all mals even those REACTION TO INHALED ASBESTOS DUST 101 are dying with generalized disease the much more marked than that lesions tend to be fibrous rather than by either irritant alone produced exudative in type is the result Of the twenty infection con- Extensive chronic inflammation and granulation tissue develop but the trols twenty dead One died after dust cells do not 595 days of generalized chronic tuber- culosis with extensive disease in the migrate into the interior of the tubercle as in the case of spleen liver and abdominal inhaled quartz Nevertheless the nodes The lymph subsequent course of the tuberculous remaining nineteen suc- process is altered In some instances cumbed for other reasons Twelve there is merely an interference with died of pneumonia and the others from usual process of the various accidental causes By the resolution so that excessive fibrosis and calcification of 244th day the tuberculous lesions in the necrotic central the lungs had healed to such areas result In an extent that all evidence of caseation had other cases some product is produced possibly soluble silica which causes disappeared With the one exception renewed multiplication of the bacilli noted the other animals autopsied after this time and a spread of the tuberculous showed only minute process foci of scar tissue at the site of the The extension takes former tubercles In two place locally were healed fibrous cases there about the primary foci of infection tubercles of micro- Fig 15 and there is also scopic dimension in the spleen of tubercle bacilli to the metastasis The distribution of the peribronchio- primary tuberculous foci in the lungs of the lar foci of dust reaction Fig 7 New tubercles develop in the latter location asbestosis group is somewhat atypical which are temporarily progressive and not only are the usual subpleural which may even break down to form tubercles formed but in addition not few foci small cavities Usually however the are found in the depths of the lung apparently originating in lym- process tends to come to a standstill and ultimate phoid tissues at bifurcation of the healing with fibrosis and considerable anatomic deformity is the bronchial tree Fig 21 These pul- result Fig 16 The spreading dis- monary lesions are associated with the ease is usually confined to limited customary lymphatic metastasis to the areas in the lung and death has with tracheobronchial lymphlymph nodes and the but one development of extensive disease in exception occurred from other that location Many of the pulmo- causes Such endogenous reinfec- tions have first been encountered 203 nary tubercles are independent of foci of dust reaction and apparently when days after the beginning of the experi- ment The last animal of this this occurs the normal process of group studied died on the 838th day of resolution is free to proceed Such endemic pneumonia which was foci resolve completely and ultimately localized to strictly disappear Others are one cephalic lobe The extend into contiguous to or lungs show no trace of subpleural about areas of dust accumulated primary foci of infection but in the _ respiratory bronchioles When deeper portions along the course of the such contact is established a reaction large bronchi are healed fibrous tuber- Vol 13 No. 3 102 THE JOURNAL OF INDUSTRIAL HYGIENE cles with plaques of bone and marrow elements in their centers These have been interpreted as the remains of primary tubercles produced by bacilli which did not reach the periphery at the time of infection because of the obstructing dust in the bronchioles Elsewhere about respiratory bronchi- oles are very massive circumscribed foci of fibrosis containing the compressed remains of gland air spaces Whether all of them were once the site of specific tubercle cannot be definitely determined However the occasional occurrence of concentric masses of scar tissue enclosing a few giant cells suggests in some instances the presence of tubercles In other organs the tracheobronchial lymph nodes and abdominal viscera there are also many caseous fibrous tubercles spread in the preestablished scar tis- sue and undergo extensive caseation Early metastasis to the tracheobronchial lymph nodes occurs and the most extensive foci of reaction are found in this location In fact in one guineapig dying of an acute pleurisy on the twenty day no pulmonary tubercles can be discovered whereas the lymph nodes are heavily infiltrated with masses of epithelioid cells All the animals dying on and after the thirty day show very extensive tuberculosis of the spleen and hepatic lymph The infectious process exerts a very noticeable effect upon the reaction to ani- the dust In all but one of the mals the amount of fibrous tissue about the respiratory bronchioles is much more marked than in tuberculous Infection Superimposed upon an Established Asbestosis animals exposed for the same period In two of them which are uncompli- cated by the presence of epizootic pneu- Of the small group of twelve guineapigs infected after two years exposure to asbestos dust six died and three were killed during the following fortyeight days Three of those dying presented an acute tuberculous pneumonia involving only one lobe of the lung and two an acute hemorrhagic pleural effusion Pulmonary tubercles were first found in the fourth animal dying on the thirty day all of the remaining five showed some evidence of pulmo- nary infection The majority of the tubercles occurred not in the usual subpleural zone of the lung but in the areas where dust reaction had already been established In some instances there are also characteristic subpleural lesions The peribronchiolar tubercles monia the alveolar septums in wide areas peripheral to the foci of localized dust are extremely thick and fibreus It is of interest to note the effect of the infectious process upon the asbes- tosis body The development of caseation in an area of reaction containing these structures ultimately destroys them They lose their characteristic yellow color fail to give a Prussian blue reaction and are apparently so completely disintegrated that not even a supporting fiber remains Polarized light fails to reveal refractile elements In the walls of small tuber- culous cavities developing in foci of dust reaction the various steps in the destruction of the asbestosis body can be studied The cause of their dis- appearance has not been determined but it is possible that the change in } } ished scar tisive caseation tracheobron- and the most are found in n one guinea- pleurisy on O pulmonary red whereas ly infiltrated d cells All id after the y extensive and hepatic certs a very reaction to of the ani- .ssue about * is much berculous e period uncomplitic pneus in wide localized { fibreus : effect of e asbest of case- ntaining destroys cteristic give a appared that mains fractile tuberfoci of in the ly can ir dismined ige in REACTION TO INHALED ASBESTOS DUST 103 hydrogen ion concentration incident to caseation may favor solution of the foreign bodies trate into the ultimate divisions of the primary units of the lung the major part of them come to rest in the DISCUSSION respiratory bronchioles It will be The physical and chemical recalled that these structures are properties of asbestos are so unlike those of any lined not by ciliated but by smooth cuboidal epithelium and that at other dust previously studied that when inhaled particles of this sub- inter- vals along their walls are the of openings stance provoke an a variable number of alveoli As reaction in the unusual type of result the bronchial tube at this lung point is no longer smooth walled but is very Localization of Dust irregular in contour This roughness The fact that a fiber is probably at least one of the factors as long as 100 and even 200 microns can be inhaled responsible for the arrest of the elongated spicules and fibers and ultimately reach the finer branches in the which catch of the bronchial tree is openings of the lateral alveoli surprising and controverts the accepted ideas of the In marked contrast with this is the behavior of effectiveness of the upper respiratory a particulate dust like quartz the major portion of protective mechanism Whether such which structures enter the lung in full exten- passes through the lumen of a respira- sion or whether they are partially tory bronchiole and enters the alveolar duct and its further ramifications coiled has not yet been determined Coiled fibers do Having come to rest the asbestos not occur in the dust particles are itself In any case it is difficult to ingested by free alveolar imagine a structure of such phagocytes As so much of the mate- making its dimension rial consists of elongated fibers giant way against the normal cells are current of ciliary action - It is very prone to develop With- gener- ally assumed that prolonged inhalation in the cytoplasm of these cells the chemical changes responsible for of dust provokes a chronic bronchitis but in the case of asbestos dust no the development of that unique structure the morphologic evidence of such asbestosis body occur The proc- a change has been observed within a period of ess requires a period of two months before approximately the characteristic two and half years It is quite alterations are possible that the physiologic activities produced of the altered ciliated epithelium may be without demonstrable ana- tomic changes In support of such a view is the fact that very long fibers have not been discovered in the deeper portions of the lung until the dust inhalation has been in progress for several months Chemical Reaction and Asbestosis Body : That the changes in the inhaled material are truly chemical in is indicated by the appearance nofadits-ur ~ solved iron in the cytoplasm of certain phagocytes at a time previous to the Unlike other dusts asbestos fibers AA a4 17 appearance of the asbestosis body The presence of the iron imparts a 104 THE JOURNAL OF INDUSTRIAL HYGIENE and it reacts specifically with potassium ferrocyanide and dilute hydro- chloric acid As previously noted study of the structure of the asbestos fibers indi- cates that iron occurs in intimate com- bination with silica and even in the best grade of chrysotile it actually replaces some of the magnesium Chemical changes involving one con- stituent of the asbestos molecule must affect its other components The presence of iron uniformly distributed throughout the cytoplasm of a phagocyte may indicate either hydrolysis of the ingested dust or solution of at least part of the original constituents and a subsequent release of silica This silica may exist in any of several physical states as soluble colloidal or insoluble silica or as soluble silicate By study of the chemical structure and the method of formation of the asbes- tosis body it should be possible to discover the actual mechanism by which structural alteration of an in- haled silicate occurs The asbestosis body has been subjected to various chemical tests by several investigators Cooke 9 and McDonald 10 first described this unusual foreign body and stated that it did not stain with aniline dyes but gave a marked iron reaction They also noted that it was not doubly refractile McDonald 10 and Simson 11 also presented a theory for the formation of the golden bodies from asbestos Stewart 12 claimed the presence of asbestosis bodies in histologic sections of lung as diagnostic of pulmonary asbestosis Cooke 13 later called attention to the relation between the iron content of asbestos dust and the iron reaction of asbes- tosis bodies He noted that they were not digested by trypsin and that they contained less iron than chrysotile He also noted that they failed to cast a characteristic pattern when treated by the ray diffraction method of Bragg though a central fiber could be demonstrated with a dissecting microscope He therefore concluded that they were fibers of vegetable origin covered with colloidal aggregates of adsorbed blood proteins Stewart 14 replied to Cooke's suggestions and stated that all the reported cases of asbestosis had exhibited these curious structures Stewart 15 later noted that antiformin did not destroy them Gloyne 16 stated that the asbestosis body withstood calcination but lost its yellow sheath after treatment with concentrated sulphuric acid leaving a thin central fiber He reported the body as refractile on dark ground illumination We have been able to confirm many of these findings and we have also attempted to prove conclusively whether or not the asbestosis body contains organic matter Since it resists calcination without change in configuration or color and since it is not digested with either pepsin and hydrochloric acid or trypsin it is not to be regarded as protein in nature More- over asbestos fibers fail to adsorb proteins when placed in blood or pep- tone broth media for several months This curious structure is not soluble in any of the usual organic solventsand fails to show charring with sulphuric It will be recalled that the asbestosis bodies and even their supporting fibers ultimately disappear in an area of tuber- entirely solution culous necrosis The explanation is not entirely clear but may be due to a high degree of alkalinity created in the degenerated cells at they were and that they 1 chrysotile ailed to cast a en treated by iod of Bragg ild be demon- ; microscope at they were covered with sorbed blood replied to . stated that sbestosis had structures 1 that anti- em Gloyne estosis body ut lost its r treatment ic acid leavHe reported dark ground nfirm many have also at- ely whether ly contains resists cal- in configu- e it is not : and hydro- is not to be ure More- to adsorb ood or pepral months t soluble in olventsand h sulphuric he asbestosis orting fibers sea of tuberation is not be due to a cated in the REACTION TO INHALED ASBESTOS DUST 105 acid Consequently it is considered to be an inorganic structure Inasmuch as a central fiber can be readily demonstrated in nearly all instances the body is undoubtedly derived from asbestos partial solution of the inhaled dust is responsible for the development of the asbestosis body the following observations may be cited When studied by Bragg's ray technic asbestos fibers exhibit a characteristic crystal- The marked iron reaction of the line pattern which is lost upon treat- asbestosis body is not to be confused with that obtained on the dust pre- ment with acid Cooke 13 using the same method showed that asbestosis vious to contact with the animal body In its original state the iron in the fibers is almost wholly in the ferrous state while in the asbestosis body only ferric iron can be detected This structure is therefore regarded as an oxidation product of the original dust In an attempt to prove whether the iron of the asbestosis body was already present in the fiber or whether it was derived from animal tissues the experiment was made in which asbestos bodies exhibit no crystalline structure Ray and Ganguly 17 state that precipitates formed from solutions of ferric chloride and sodium silicates which are identical in color with the asbestosis body also yield no crystalline pattern by ray As further evidence of physical alteration is the fact that the asbestos fiber is highly refractile in polarized light whereas the asbestosis body has completely lost this property We have attempted to reproduce the fibers freed from iron by leaching with hydrochloric acid were injected into It has been assumed that the demonstration of iron in the outer coating of the asbestosis body is evidence of hydrolysis of the subcutaneous tissues of guineapigs as noted above It was unsuc- the original asbestos fiber on which the body formed But actually this finding does not constitute definite proof unless an cessful because the acid treatment rendered the asbestos soluble in the endogenous source from blood pigment can be excluded We have thus far failed to eliminate this source of iron However body fluids and no significant reaction occurred One month after the injection practically no trace of the fibers could be discovered and only a very the demonstration of magnesium in the asbestosis body would furnish equally convincing proof of hydrolysis and the objection that it was derived from the tissues could hardly be raised for the amount of this substance in the body is slight fibrosis marked the site Treatment of asbestos fibers for the extremely small An attempt has therefore been made to develop a microchemical test for magnesium It has been found that determination of free silica disclosed the ease with which the chrysotile both asbestos fibers and asbestosis bodies are definitely stained a light green color when treated on microslides with a molecule could be opened If enzymatic action or hydrolysis of the fiber dilute hydrochloric acid solution of pararesorcinol followed by a bath of sodium hydroxide is assumed to take place in the presence of body fluids it is quite possible that proof e: the ferrous or ferric silicate existing in the fiber is oxidized and hydrolyzed ene directly to produce the asbestosis The presence of magnesium in the outer layers of the asbestosis body is convincing of hydrolysis of the inhaled dust This color reaction is given only by magne- sium cobalt and nickel substances which do not occur in sufficient concentration in the tissues to cause reaction Therefore endogenous sources for the coating material body of the asbestosis body are assumed to have As evidence that hydrolysis or been eliminated 106 THE JOURNAL OF INDUSTRIAL HYGIENE asbestosis body from asbestos fibers by immersing them for prolonged periods until finally the membrane becomes impermeable in buffer solutions of various hydrogen ion concentrations both above and below neutrality The solutions have been adjusted with agar and silica gel to a viscosity near that of the cell Oxidizing agents have been added and the reaction has been allowed to proceed in the incubator for six months No yellow structures were obtained We have however been able to reproduce the structure of the asbestosis body quite closely by other means Iron free asbestos fibers are impregnated with an iron salt by Microscopic structures of fibrous character suggesting asbestosis bodies have been produced both with dilute solutions of an iron salt and a soluble silicate and with iron and silica sols 19 These observations lead us to conclude that the asbestosis body is a derivative of the crystalline asbestos fiber which has been oxidized and hydrolyzed to a yellow amorphous structure As such it can be regarded as the first direct evidence of altered chemical composition in an inhaled silicate dust heating to dryness in a dilute ferric chloride solution and ignited The fibers are then placed in a solution of sodium silicate The iron salt adher- ing to the fibers reacts rapidly with the silicate producing a curiously shaped yellow structure which very closely resembles the asbestosis body Fig 13 Nos 1 and 2 A similar reaction is involved in the production of the familiar phenomenon the silicate garden 18 If a crystal of ferric chloride is added to a solution of sodium silicate goldenyellow filaments often several inches In the animal body the evidence thus far accumulated would indicate that the lung of the guinea and of man furnishes the most favorable en- vironment for the development of the asbestosis body Asbestos fibers trans- ported from the lung to the tracheo- bronchial lymph nodes not ordinarily appear to produce these structures Possibly prolonged residence in the lung has deprived them of their capacity for further reaction or possibly some necessary factor is lacking in the lymph nodes It is believed that the few asbestosis bodies found in the in length rapidly develop which exhibit irregular swellings and buds Ferric silicate is probably formed nodes were transported after attaining full development in the pulmonary air spaces Injection of asbestos dust This product is partially hydrolyzed producing a thin wrinkled skin of silicic into the peritoneal cavity of guineapigs has failed to produce characteristic acid streaked with ferric hydroxide This skin acting as a semipermeable membrane permits diffusion to take place and a high osmotic pressure develops with a consequent rupture of the membrane Further hydrolysis occurs and the reaction repeats itself structures in any quantity In the subcutaneous tissues they do develop but the period of incubation is nearly twice as long as that required in the lung Practically no asbestosis bodies have formed in the lungs of rabbits and albino rats The necessary environ- mental factors which are lacking in ane becomes ; of fibrous estosis bodies h with dilute and a soluble and silica sols id us to con- is body is a lline asbestos oxidized and yellow amorch it can be et evidence of sition in an the evidence ould indicate pig and of favorable en- pment of the s fibers transthe tracheo- not ordinarily se structures ice in the lung r capacity for ossibly some king in the eved that the ound in the fter attaining e pulmonary asbestos dust y of guinea- characteristic tity In the y do develop tion is nearly quired in the estosis bodies of rabbits and sary environ- re lacking in REACTION TO INHALED ASBESTOS DUST 107 any of these situations are entirely not sufficient for the production of asbestosis bodies unknown Attempts to determine whether the Pulmonary Fibrosis asbestosis body will develop in the inhalation animal when any of the theoretically That the continued of asbestos dust is responsible for the necessary elements are lacking have The development of pulmonary fibrosis is thus far met with little success that now unquestioned From many parts experiments in vitro indicate of the world come radiographic reports crystalline ferric or ferrous silicate in viscosity and a of fine fibrosis in the lungs of persons the inhala- a medium of proper essential exposed by occupation to fiber for support are probably tion of this substance The findings to the production of these structures from at least ten postmortem examina- In our attempt to determine whether have furnished reliable evidence iron derived from the tissues could be tions that the shadows seie n tn he roentgeno- fibrous substituted for the iron inherent in are produced by areas of the chrysotile molecule we have been gram tissue 20 In guinea experi- __ defeated by the fact that the manipula- ments reported in this paper it has tion necessary to remove the iron from that been shown that the fibrosis begins in the fiber apparently renders soluibnlthee body fluids those portions of the lung where the is localized and that this reaction structure The injection and the inhalation of dust detected in ray pictures after dark Barre granite dust which con- can about two years exposure to the con- tains both free silica and iron have of dust used Fig 3 never resulted in the formation of centration The earliest evidence of proliferation structures in any way suggesting of fibroblasts has been encountered asbestosis bodies The solution of micro- approximately 500 days after the iron can be demonstrated by is commencement of the dust exposure chemical tests and it generally in the immediate assumed that the silica is also ulti- It first appears accumulations mately dissolved Intraperitoneal in- vicinity of the largest of dust cells which occur in the jections of granite from Lorain County respiratory bronchiole and its adjacent Ohio have been made because ma- alveoli As amounts of increasing terial contains iron in the unusual form dust accumulate in the walls of these is of ferrous carbonate No suggestion of an asbestosis body has been dis- light covered In the light of subsequent otherwise structures structures thethe amount ofof fibrfoisbisrosis sltriucktuerewsise increased In the otherwise normal pig guinea guinea migration migration of dust studies studies it is now recognized recognized that the peritoneum is not a proper location for a test and subcutaneous such inocula- tions have been made with this already substance but it is too early to report on them Thus far it would appear that the mere presence of iron and free silica is cells to intrapulmonary lymphoidlymphoid tissue has not been encountered and in consequence the nodular foci of fibro- sis which are so characteristic of the reaction to quartz dust fail to develop The occurrence in one of the last animals killed of a more diffuse fibrosis peripheral to the point of salting Og 108 THE JOURNAL OF INDUSTRIAL HYGIENE At maximum dust deposition suggests more that collapse induration incident slowly than asbestos in the occlusion of to respiratory bronchioles guinea After 910 days the maxi- may play an important later mum period of experimental exposure stages of the disease process to granite the lungs show large Asbestos dust a silicate of magne- sium is relatively soluble in fluids masses in of dust filled phagocytes lying the lumen of the alveoli along the parable with those of the com- alveolar ducts and atria In the tissues The asbestosis body develops only after adjacent septums there is a slight solution has occurred in the thickening due to the presence of environment proper The development of lymphoid and monocytic cells but these structures in the lungs of guinea- fibrosis is entirely lacking The sig- pigs and of human beings is the first nificant feature is the absence of dust direct evidence of solubility of particles in the connective tissues of the an inhaled dust known to produce pul- lung In the tracheobronchial lymph nodes on the other hand dust accumu- monary fibrosis It still remains be a demonstrated whether lates in such quantities that stance is the dissolved sub- develops within one fibrosis factor responsible for the two year and after multiplication of fibroblasts in pneu- years exposure the lymphoid tissues are largely destroyed by a monokoniosis In this connection the _ evidence from asbestos series of true silicotic nodules It has inhalation in the rabbit should prove most valuable been postulated that fibrosis has not developed in the lung of the _ If after a proper period of animal exposure typical asbestosis bodies should still exposed to granite because the dust particles do not be lacking and if fibrosis should like- intimate come into sufficiently wise fail to develop it would be logical to conclude that fibroblasts contact with the fibroblasts of the alveolar walls In the lymph were not stimulated because no solution of the nodes on the other hand fibrosis begins early and dust had occurred Thus far the nodules typical because silicotic reaction of the rabbit has only been are produced because heavy studied during an exposure period of concentrations of dust are brought into 330 days The only sign of asbestosis close proximity with connective tissue body formation is an irregular swelling elements The conditions of the of certain fibers which give micro- with experiments chemical tests for iron evidence of granite and asbestos dusts would theoretically fibrosis is entirely lacking The 500- favor a greater reaction in day period of exposure when true the former case The concentration of granite dust was over fibrosis appeared in the eight times as is anxiously awaited guinea great as that of asbestos 287,700,000 particles less than 1.5 microns in Comparison between Reactions to diameter perper cubic foot of air for ; Asbestos and to Other Dusts Granite dust which is known to pro- voke the formation of extensive fibrosis in human beings appears to act granite and only 34,466,000 particles of the same size for asbestos However the greater solubility of mag- nesium silicate together with its peculiar localization probably is the estos in the ays the maxi- ntal exposure show large gocytes lying coli along the ria In the is a slight presence of C cells but g The sigsence of dust issues of the chial lymph ust accumu- hat fibrosis . and after lymphoid yed by a es It has is has not he animal ' the dust ufficiently Sibroblasts he lymph silicotic se heavy ught into ive tissue criments ts would action in ration of imes as 700,000 rons in air for articles. Howf magth its is the REACTION TO INHALED ASBESTOS DUST 109 factor responsible for the production of the more rapid and extensive pulmonary fibrosis by asbestos dust Quartz which is generally accepted as the most active of all the nontoxic dusts which are inhaled in industry is much less easily dissolved than asbes- tos and yet it will produce extensive fibrosis in the lungs of experimental animals more rapidly In guinea pulmonary fibrosis and even necrosis has been observed after one year's exposure to quartz dust in rabbits typical silicotic nodules are formed in eighteen months The difference in the rate of reaction to quartz and asbestos has been ascribed to several causes With equivalent concentra- tions of dust in two given atmospheres more quartz than asbestos particles will be inhaled and reach the paren- chyma of the lung This is presumably due to the relative differences in the shape and the surface characteris- tics of the particles After phagocytosis quartz particles seem to possess the ability to stimulate a rapid migration of the dust cells so that they concentrate large masses of dust about nodules of intrapulmonary lymphoid tissue Here again but by a different mechanism the foreign bodies are carborundum does excite fibrosis and structures suggesting silicotic nodules have been discovered As in the case of granite proliferatioofn fibroblasts occurs at the point where they are in intimate contact with sufficient numbers of dust laden phagocytes Whether solution of carborundum by the body fluids is possible has never been determined From these observations on the reaction to various types of dust an hypothesis has been developed that fibroblasts proliferate in response to sufficient concentrations of a soluble substance liberated by the action of the phagocytes on the included dust particles The soluble substance probably diffuses through the membrane of the intact phagocytes but it is only stimulating to fibroblasts in the immediate vicinity The undefined soluble substance possibly silica in some form is rapidly neutralized after leaving the cells in which it is produced and it exerts no effect upon more remote connective tissue ele- ments The process of neutralization may be chemical in nature or it may be a result of absorption by some other type of cell which is itself unaffected collected in circumscribed areas Sub- Theoretical Consideration of sequently perhaps as the result of Pneumonokoniosis solution of the quartz a local pro- liferation of fibroblasts takes place Carborundum dust has produced no In a previous paper dealing largely with the reactions to granite and carborundum dusts 21 it was sug- pulmonary fibrosis after exposure as gested that the primary lesion of pneu- Fe long as three or four years In the lung it is treated much like granite monokoniosis consists in the develop- ment of an obstructive fibrosis in dust collected in phagocytes which the tracheobronchial lymph nodes remain within the air spaces so that attended by stasis in the afferent M M the dust cells establish no contact with the underlying connective tissue In the tracheobronchial lymph nodes lymphatics in the lung and ultimately followed by a perilymphatic fibrosis When only these two types of dust had 110 THE JOURNAL OF INDUSTRIAL HYGIENE - A been studied such an hypothesis to the looked tempting for the only trace of asbestos dust cells but for causes fibrosis in the lung in these cases was inherent in themselves they do not migrate to these vessels situated about the large lymph trunks . Masses of dust filled phagocytes lay Tuberculous Infection and for many months in the air spaces and Asbestosis Where inhalation infection is insti- apparently provoked not the slightest reaction of the connective tissues tuted simultaneously with commence- ment of dust But subsequent experimental investi- of exposures the majority gation has modified this concept it is inhaled tubercle bacilli localize in small peripheral lymphoid masses in now believed that fibrosis develops wherever sufficient amounts of dust of zone immediately beneath the pleura This is the proper type come into intimate characteristic of such infection contact with fibroblasts The pri- with the organism used in the experiment A certain number mary obstructive lesion in the tracheo- rest come to bronchial lymph nodes occurs with atypically in the deeper lymphoid tissues along the intermediate bronchi quartz inhalations but not with asbes- tos Undoubtedly such a lesion has possibly because they are mechanically arrested by inhaled dust tens the development of reaction in The particles the lung for it reduces elimination and majority of the tubercles formed concentrates the dust but it is not undergo spontaneous resolution which is the outcome of the infection in essential to the production of pulmo- most normal control nary fibrosis animals cer- One further point in connection with tain number of tubercles by accident localize in the state of the lymphatics deserves proximity to foci of localized dust If comment In the contact is sufficiently experimental asbestosis both in the intimate these tubercles spread locally guinea and in the and more remotely into foci of dust rabbit the lymph vessels are widely reaction about dilated after as short an respiratory bronchioles from exposure as A new crop of tubercles develop in thirty to sixty days Inhaled this location and these asbestos dust is not transported to the may progress and even form small cavities but the ctornascihdeeorbarbolnechial lymph nodes in any ultimate outcome is usually healing quantity and no obstructive lesion has been produced at this with more or less extensive fibrosis and calcification The time Therefore in this case the dila- tuberculous tation of these vessels process is practically never generalized other must have some throughout the lung but is generally cause possibly it is merely a confined to small nodular foci Blood physiologic response to intrapulmo- stream metastasis is usual and nary irritation Asbestos filled phago- scopic disease in the macro- cytes do not enter these channels be- times in the liver spleen and some- cause they are apparently relatively rence almost is common an occur- inactive but epithelioid cells contain- controls never found in infection In the thirty animals of ing tubercle bacilli may leave the lung in this group dead at the time of this great numbers Apparently the report a spread of the lymphatic channel of escape is open tuberculous infection occurred in 32.2 cent In GIENE ust cells but for causes mselves they do not * vessels ection and Asbestosis tion infection is insti- usly with commencexposures the majority cle bacilli localize in lymphoid masses in a y beneath the pleura istic of such infection m used in the experi- in number come to 1 the deeper lymphoid intermediate bronchi they are mechanically aled dust particles the tubercles formed cous resolution which of the infection in trol animals A cer- ubercles by accident ty to foci of localized Intact is sufficiently percles spread locally ly into foci of dust piratory bronchioles ubercles develop in . these may progress all cavities but the is usually healing s extensive fibrosis The tuberculous ily never generalized ng but is generally nodular foci Blood is usual and macro- e spleen and some- s common an occurr found in infection mirty animals of at the time of this of the tuberculous in 32.2 per cent In REACTION TO INHALED ASBESTOS DUST 111 40 per cent of them the tuberculosis had subsequently more or less completely healed by fibrosis It seems probable that in the remaining mem- bers of the group a similar result would have been attained had they not died prematurely from accidental causes Where inhalation infection was superimposed upon a established asbestosis of approximately two years standing the primary localization of the tubercles was atypical Many of the tubercle bacilli were mechanically held up by the reaction to the dust in the respiratory bronchioles It would appear that many perhaps the majority of these organisms were phago- cytosed and carried directly into the distended lymphatic trunks The earliest manifestation of tubercle formation occurred not in the lung but in the tracheobronchial lymph nodes a condition which has never before been observed in experimental inhalation infection Some organisms local- ized in the foci of dust reaction and then produced tubercles a certain number of bacilli passed to the periphery where typical subpleural lesions developed The major portion of the guinea comprising this group died or were killed during a period of forty- eight days after infection Within this time not much extension of the intrapulmonary infection had occurred The tracheobronchial lymph nodes were heavily involved in all animals dead after the thirty day It is too early to state what will be the ultimate outcome of infection super- imposed upon a preestablished asbes- tosis From these experiments it would appear that inhaled asbestos dust is capable of exerting some stimulating effect upon tubercle bacilli of attenuated virulence To exert this effect the dust and the tubercle bacilli must be brought into rather intimate association This occasionally occurred when the infection and the onset of the dust inhalation were simultaneous it was much more common where infec- tion was superimposed upon an already established asbestosis The dust per- haps by the action of its dissolved prod- ucts or by alteration in tissue reaction initiates a renewed proliferation of the tubercle bacilli and the infec- tion spreads But this stimulating effect is only temporary and ultimately the foci of new disease tend to heal by fibrosis In this respect inhaled asbestos dust differs from quartz which incites continued and progressive multiplication of the bacteria and consequent spread of disease As has been observed with the other types of dust granite and carborundum the presence of asbestos in the lung of an animal infected with tubercle bacilli promotes more extensive fibrosis than is produced when either the organism or the dust is acting alone Where the two irritants are concentrated in the same area each provokes the formation of granulation tissue which ultimately organ- izes to form fibrosis But even in areas of dust reaction remote from the site of tubercle the fibrosis is excessive an effect for which explanation is lack- ing Figs 15 and 16. SUMMARY Guinea have been exposed for eight hours daily for periods as long as two and third years to an atmos- phere containing approximately thirtyfive million particles per cubic foot of asbestos the en dust Canadian chrysotile 1.5 microns and less in due to the contraction of the included Rabbits and albino diameter alveoli and consequent compression rats have likewise been exposed for shorter of the epithelial lining cells In the days periods 330 rabbit sufficient time has not yet - The experiments demonstrate that elapsed for fibrosis to be expected tn fibrous structures at In the lungs of guinea asbes- iyRy 200 microns least as long as tosis bodies apparently identical with Ate can pass the protective mechanism of the those described in the human being On tract and enter theulppuenrg reAsnpaitraotmoircy have developed after an exposure of R R evidence of injury to this mechanism approximately seventy days In the rabbit these structures have not been I is wanting Re Inhaled asbestos dust does discovered after exposures as long as not 330 days In the albino rat they are RA penetrate to the terminal alveoli of AT the lung as is the case with very Only two small typical late substance such a particu- forms have been discovered in one as quartz The major portion is held up in the respira- animal exposed for seventy days The prevalence of chronic infections of the tory bronchioles There phagocytosis lung in all members of this takes place and there the material possibly responsible series is remains localized at least for a period Asbestosis bodies of two and third apparently fail to years cytes containing asbestos Phago- form in the tracheobronchial lymph particles migrate into the lateral alveoli given nodes of guinea They may be transported in small numbers to off from the walls of the bronchioles and considerable numbers these tissues and to areas of chronic pleurisy ultimately They have not been discovered in the penetrate the adjacent connective tissues In the guinea transpor- peritoneal cavity 100 days after injec- tion of dust In the tation of dust particles to intrapulmo- sue of the subcutaneous tis- nary and mediastinal lymphoid tissues is so slow that groin typical forms were found 102 days after the injection of changes in these struc- 3 mg of dust tures play little part in the early Asbestosis bodies development of asbestosis In the are not present in rabbit dust cells begin to asbestos dust previous to contact with the lymphoid tissues of appear in animal tissues They are produced by sixty days after the the lung within oxidation and hydrolysis of the chryso- commencement of the inhalation thereafter they con- tile molecule The formation of these structures is the first direct evidence tinue to migrate in increasing numbers that the body is capable of In the guinea fibrosis in the effecting walls of the respiratory bronchioles and changes in inhaled silicate particles their lateral alveoli is first The chemical processes involved have manifested after 500 days exposure Thereafter been discussed in extenso Attempts at artificial production of asbestosis this type of reaction progressively bodies in vitro have been increases in intensity and extent partially suc- The resulting atelectasis is responsible cessful solutions of ferric chloride and sodium silicate have been made to com- for a gland appearance which is bine in the presence of a fiber to pro- YGIENE raction of the included onsequent compression al lining cells In the at time has not yet sis to be expected of guinea asbesarently identical with in the human being after an exposure of eventy days In the ictures have not been exposures as long as he albino rat they are y two small typical n discovered in one or seventy days The onic infections of the bers of this series is ble ies apparently fail to cheobronchial lymph pigs They may be all numbers to these s of chronic pleurisy en discovered in the 100 days after injecthe subcutaneous tis- typical forms were fter the injection of es are not present in ious to contact with hey are produced by rolysis of the chrysoe formation of these irst direct evidence capable of effecting 1 silicate particles esses involved have extenso Attempts ction of asbestosis been partially suc- ferric chloride and been made to come of a fiber to pro- REACTION TO INHALED ASBESTOS DUST 113 duce more or less typical forms The asbestosis body is therefore analogous to the known silicate garden Attempts to produce asbestosis bodies in vivo by the injection of dusts containing iron salts and silicates have thus far failed The failure to produce them in tissues other than the lung and subcutaneous tissues of guinea and man has not been explained Comparison between the localization and the reaction to asbestos and other types of inhaled dusts has been shown The points at which inhaled dust is localized in the lung or lymph nodes vary with the type of dust Granite remains within the pulmonary air spaces and produces no local reaction fibroblasts for several years In the tracheobronchial lymph nodes characteristic silicotic nodules develop within two years Carborundum likewise has failed to affect the stroma of the lung even in four years but fibrosis the lymph nodes has been observed Quartz is rapidly concentrated by migrating phagocytes in the pulmonary and mediastinal lymphoid tissues In these places it provokes an early and rapid multiplication of fibroblasts Asbestos as it is inhaled is concentrated in respiratory bronchioles and their lateral alveoli Phagocytes carry it into the walls where fibroblasts are stimulated Lymph stasis plays little part in early asbestosis the structure of this dust tends to localize it within the lung from the start Lymph vessels are dilated in the absence of detectable obstruction The dilatation may be a direct result of pulmonary irritation Primary tuberculous infection is in- fluenced only to a limited degree by inhaled asbestos This conclusion has been reached after inhalation infection with attenuated tubercle bacilli strain R In normal guinea such in- fection produces tubercles in the lung and tracheobronchial lymph nodes comparable to the primary complex in man The lesions caseate and the pulmonary foci heal by resolution Spread of the infection with macroscopic disease in other viscera is very rare In the asbestos experiment one group of guinea was infected at the outset of dust inhalation a second group two years after the commencement of dust exposure In the first series 32.2 per cent of the animals showed some evidence of spreading tuberculosis New disease began as a local extension from primary tubercles and metastasis to areas where dust reaction had occurred was common Rarely small cavities developed in the secondary foci The tendency to healing by fibrosis was marked at autopsy 40 per cent of the cases showed healed , fibrous tuberculosis macroscopic disease in the spleen and sometimes in the liver was common The contrast with animals similarly infected but exposed to quartz dust is marked In them every exposure longer than five months resulted in generalized chronic tuberculosis of the lungs and other viscera For the second asbestosis group infected the localization of tubercles was atypical Many bacilli were trapped in foci of dust reaction Some produced local tubercles others immediately entered the dilated lymph vessels and were transported to the tracheobronchial lymph nodes Tu- berculosis in these nodes sometimes occurred without involvement of the lung Early disease in the spleen and hepatic lymph nodes was the rule 114 THE JOURNAL INDUSTRIAL INDUSTRIAL HYGIENE The ultimate outcome infection The infection dust ultimate outcome outcome of infection observed group not been observed asbestos independently and tubercle bacilli the lung lung produced fibrosis than did lung either either acting independently BIBLIOGRAPHY aOtea Commonly McDONALD Relatively 1, ANDERSON V. , AND AND CLARK L L.: ANDERSONH. V. Rays the Classi- Classi- Cooke W. .: Pulmonary Med Pulmonary Asbestosis Application Application Fibrous Silicate Minerals Jour Histology of Pulmon- Pulmon- Commonly Termed Asbestos In- McDONALD Histology 1025 Pulmon- Pulmon- 2. Commonly Termed Chem1929 21 924 924 Asbestosis Asbestosis Pulmonary Asbestosis Asbestosis + GARDNER Engin Engin Studies the Rela- RelaGARDNER GARDNER SIMSON SIMSON .: Pulmonary Pulmonary1928 885 Mineral Dusts Tuberculosis Tuberculosis tion of Relatively EarlyLesions Lesions in South Africa The STEWART STEWART Pulmonary Pulmonary Immediate Immediate Di- 885, Experimental PneumokoniosisPneumokoniosis agnosis PulmonaryAsbestosis Asbestosis Di- Experimental by Granite Pro- Pulmonary 1928 509 at Inhalationand and their Influence on Pulmonary Necropsy Pulmonary Pulmonary Asbestosis Asbestosis Influence Rev. Pulmonary Tuberculosis Tuberc 1920-1921 734 734 Coo--"E Coo--"E585 Pulmonary Pulmonary ary Asbestosis, STEWART M. .: 3. GARDNER L. U. AND , Idem II The DWORSKI .: STEWART Ibid 675 J.: Pulmonary Asbestosis. sions Produced by the InhaElaartliyonLeo-f STEWART M. .: 15. ing Sputum for Asbestosis Asbestosis Bodies Marble Dust andand their Influence 1922 Bodies Pulmonary TuberculosisTuberculosis Ibid 1922 Ibid 1929 581 for Presence the 1923 6 782 GLOYNE R The The 4. GARDNER L. Idem III The Experimental tively Early Lesions in Experimental Pneumokoniosis Produced their In- borundum Inhalation and Tuberculosis Tuberculosis fluence on Pulmonary Tuberculosis Ibid 1923 , 344 8. GARDNER , U PneumonokoniosisPneumonokoniosis Pneumonokoniosis The mental Pneumonokoniosis Primary Tu- Reactivation Reactivation Lung Inhalation Inhalation bercles bercles in Granite Granite and Carborun- of Quartz Granite 1929 833 dum Dusts J. and Haddow Haddow 6. STEWART Demonstration Demonstration of Peculiar Peculiar Bodies Demonstration Asbestosis Asbestosis Asbestosis Asbestosis of Pulmonary Material (Obtained Bodies Puncture Puncture the Sputum Jour Path and Bacteriol Bacteriol 1929 Jour 172 and 7. CUMMINGS Studies Experi- P. 16. Asbestos Fibre Fibre the Lesions of the Asbestos Workers Tubercle Tubercle 1929 of 404 Workers, RAY R. The The Conditions Conditions 17. Optimum Optimum Conditions Alkali Forma- Sili- tion from Alkali Jour Phys cate Solutions Solutions Part I. Phys Phys Chem 1930 Silicates Silicates in In- VAIL New Soluble York 18. dustry dustry New York 79 in In- Catalog Co. EVANS W. 9n MOORE Growth Growth Resembling Resembling Resembling 19. Forms Organisms and Products Products n Slowly Organisms Organisms from Metastable Solutions Deposited Inorganic Colloids Proc Roy Inorganic Series 1915-1917 1915-1917 Soc London Series Proc. MEREWETHER MEREWETHER E. A. PRICE PRICE PRICE MEREWETHER 7. mental mental Pneumonokoniosis Pneumonokoniosis Pneumonokoniosis Pneumonokoniosis IV Separation Particulate Particulate Matter Smaller than Screen Graded Fractions Fractions THIS JOUR 1929 Resolution GARDNER L. Healing by Resolution Resolution 8. in Experimental Experimental Experimental Pulmonary Pulmonary in culosis Rev. 19221923 6 163 Tubere., 1929- 1923, 6, 163, Dust Infection 20. Lungs and pression pression in the Asbestoands DInduustrsy tIndSuustpr-y Part I. London London M. Stationery Stationery Office 1930 the Asbestos Gardner Gardner L. Tuberculous Tuberculous Infection and Tuberculosis 21, Experimental Experimental Experimental Pneumonokoniosis Pneumonokoniosis Tubercle Tubercle 1924-1925 336 by Tubercle Pneumonokoniosis, Tubercle, 1924-1925, 6, 336, 443, YGIENE cle bacilli in the lung ibrosis than did either ependently : Pulmonary Asbestosis our 1927 2 1024 : Histology of Pulmonis Ibid p 1025 : Pulmonary Asbestosis ica Ibid 1928 1 885 .: The Immediate Diulmonary Asbestosis at id 1928 2 509 Pulmonary Asbestosis Pulmonary Asbestosis : A Method of Examin- for Asbestosis Bodies . The Presence of the e in the Lesions of kers Tubercle 1929 Ganguly P. B The litions for the FormaGel from Alkali Sili- Part I. Jour Phys , 352 uble Silicates in In- York The Chemical c 1928 p 79 Qn EVANS W. .: h Resembling Living their Products Slowly Metastable Solutions olloids Proc Roy ries B. 1915-1917 89 R. A. AND PRICE on Effects of Asbestos ings and Dust Sup- Asbestos Industry 4 H. M. Stationery uberculous Infection as Modified by Pneumonokoniosis 925 6 336 443 THE CALLED CYANIDE RASH The Editor Journal of Industrial Hygiene Sir Braddock and Tingle's article on Called Cyanide Rash in Gold Mine Mill Workers in the JOURNAL for September 1930 interests me because I can add sixteen years personal experience and observations from New Zealand and the state of Western Australia to the other countries listed As a cyanide salt we first used potassium cyanide but this was superseded as in all countries by sodium cyanide The solutions were a stock liquor of up to 20 per cent from which the working solutions of 0.1 to 0.2 per cent were made Ordinarily these working solutions were cold but when in some plants the roasted ore was mixed therewith the solutions became hot and remained warm to the end of the process An odor of cyanide pervades every gold or silver ore treatment plant and renders smoking unpleasant As Braddock and Tingle conclude the rash appears to be a dermatitis is it is a superficial aliment the blood is not a factor I had the rash more or less severely on the arms and face especially at the hair roots others had it there and on the legs Drinkers and nondrinkers and smokers and nonsmokers alike were affected but not everyone employed around cyanide As far as my observation went as one handling cyanide salts and solutions also as a foreman and metallurgist there was no lack of personal cleanliness among the men as suggested Some men became immune to the rash after being affected for a time others had to change their jobs The wearing of rubber gloves helps but they induce sweating which often starts a rash As rule we used potassium permanganate solution but zinc oxide ointment also alleviated the trouble which as Braddock and Tingle conclude is probably due to irritation by the strong caustic excited by lime used in the process We never considered it as cyanide poisoning but simply a skin outbreak M. W. VON BERNEWITZ Pittsburgh Pa December 19 1930 THE JOURNAL OF INDUSTRIAL HYGIENE already 1931 4 THE some other some other source 9. young young person under other source of 9. approved approved in writing the local 18 years young age of age of shall be allowed allowed work to " approved district which the Provided bath shall that Regulation work situated situated situated which shall on suit- not apply any young Regulation shall shall young person already ssel where water employed August August Except where is de- so The occupier that the where water which official conveniently Placard an upward Cautionary shallshall that the that the affixed affixed to the rkers rkers conveniently effects or drinking drinking tchehrome chrome the position position as to affixed one suitable suitable supply supply be works such such persons employed employed as to drinking at each point supply drinking drinking water supply be employed drinking Drinking Water racticable steps shall taken taken rve the water and vessels from ination employed person made and for record record bya responsible inspections kept in the such inspections Register to be record Health Register kept in the e occupier shall make such arents for first aid treatment of to persons employed as will Parr II with the requirements laid shall t factories in Section 29 Act , rkmen's Compensation that 1d in addition shall see that ttaid box is provided and im- supply of ointment and im- le waterproof employed 12. very person Surgeon in ined urteen days or at such other urteen days specified writing in 28 specified Chief may Inspector Factories Factories Factories Chief which notice ocfoncerned concerned andsshuachlexlami- . Duties person employed shall or without the concurrence in mis- occupier occupier responsible responsible person appliance the charge interfere pursuance Regu- in provided pursuance pursuance lations in these Regu- person employed employed wear protective and under Regulation shall deposit clothing when being the protective clothing provided provided worn Regulation under shall place when not Regulation Regulation Every person employed shall 13a himself himself t ealth ealth persons all employed shall form approved the Chief Factories suspension suspension suspension of person yed without written or ved Surgeon entered Register the Health Register or atthe Health Register, suance Regulation Regulation Regulation suance shall after suspension person after suspension shall shall work in process involving with with liquid from without written written bath without sanction sanction the Health entered entered attached attached the Health Register Register from the entered in Surgeon, Register, or attached to the H. SUBJECT INDEX TO VOLUME XIII index to all the reading matter in the ABSTRACTS OF THE Literature OF ITNhDiUsSTisRIaAsLubHjYeGcIt ENE and one should therefore look for the subject word The name of the author follows the subject entry in parenthesis For author index see page 288 PAGE PAGE ABSENTEEISM in coal mines Vernon Bedford and Warner 255 ACCIDENTS see also under Safety specific occupations and specific parts of body ACCIDENTS and diseases international congress of see International Con- AIR conditions see also under Heat Humidity and Temperature infiltration through wood windows Larson Nelson and Kubasta pollution pollution Simpson et al pollution amelioration amelioration of Green fourteenth report 1927- engineer's 267 37 248 gress clinic Shellowes 22 save electric fatal Pietrusky 22 refrigerating machines Wen- 191 pollution from engineer's standpoint Meller eradication pollution smoke eradication to save health value of sunshine Tonney IndufsitrialnrdouImnsdtusrtiriaallprevepenrttiaoinning Rossi 156 248 problems neuroses law to 154 Barreto Martineck 156 study and DeYoung York pollution soot particles in New York City air Free probl W e om ls - pollution special problems Wol- proneness psychologic 98 man Blanke Boston Farmer cee cie eee ene eee Elevated Rail- removal of allergens from Blanke 248 238 reduction by Boston 35 for fine powders Roller way Slocombe . separator ACCUMULATORS see Batteries velocities influence of on skin tem- of men at rest and at work ACID see under names of specific acids perature Palmer Palmer.... ACROLEIN use of for detecting leakage Liese functional Palmer 194 of methyl chloride from multiple ALBUMINURIA removal from air Blanke 248 Schrenk refrigeration system ALLERGENS ALUMINIUM baking powders effects of Patty and Yant 6 habitual of on utilization of use use of for detecting leakage of methyl food Kraft reer 102 refrigerators chloride from Yant 5 AMINO ACIDS treatment of tar tumors Schrenk Patty and Sayers ..... of with Vl^sde Coulon and Nicod 206 ADHESIVE PLASTER bandage healing 128 AMINO COMPOUNDS aromatic indus- wounds under Dabasi trial illnesses produced by AGRICULTURE child labor in in Colo- 231 rado Mautner Abbott Bell and Mayer gets aromatic poisoning in fly paper by Abbotteeee eens Bispham GGGG factor^ Rosenthal Deussen 231 children in McGill . GGGG aromatic production of bladder tu- AIR analyses in Illinois mines Miller 238 by Sch^/r mors explosibil- explosibil- 110 explosibil- analyzer for fine powders Roller GGGG AMMONIA and air mixtures and mine gases MacEachern comparative temperatures with vary- 231 ity of Banik ANILINE poisoning Bonzanigo 196 ing air movements underground 104 tumors of bladder results of opera- our homes Ranson home Bu s l- 3 tions for Simon conditioning cooling our homes Bul- ANTHRACOSIS Cummins and Sladden 48 Schulte lard 0... cece application eee nee eens of and tuberculosis ( . ... 17 conditioning problems application 122 in coal miners Cummins .. spu- heat and moisture losses during Miller origin of pigment in anthracotic spu- work Houghten Teague 266 tum Paviot Chevallier and Badi- Car- and Yant occupational disease recent Car- nand occupational tess 169 conditioning and progress 217 ANTHRAX as occupational disease ~~. rier Vernon Cheney conditions in pithead baths Vernon 93 Smyth and Uhlenhuth neeeeeee campaign against Uhlenhuth Uhlenhuth 30 charged with Bedford and Warner conditions thermal exchanges be- disinfection of skins tween bodies of men working and fatBarl octaszeuCa hretien J aunli denJulien Julien 30 atmospheric environment Houghten Teague Miller and Yant 214 94 in industry Schmidt .. 271 SUBJECT INDEX 273 PAGE BLOOD high daily and monthprleyssruhryethm in Brown 101 pressure high occupational impor- tance Dumas 257 pressure in lead poisoning Petroff 25 pressure low after burns Blalock 245 pressure reduction in after trauma to extremity Blalock 245 stream composition of fluid that es- capes from after traumas Beard and Blalock . 245 transfusion gas poisoning and Sen- nelnesls vessels cancer cells in in tar cancer Babes boil tubular te ubularbr oilerss boilers 167 BOILER work in hot tubular boilers Van Themsche and Wautriche 216 BOILS see Furunculosis BONE roentgen sign of plumbism VogVogtt) ... shadows produced by lead in growing skeleton Park Hackson and Kajdi for formam lin Haa ckson l Hacksoni ean nd 201 BOOKBINDER formalin eczema in Lutz . cece ceca ese eee 209 BOTTLE making physiologic and hy- gienic experiments in drjawzew Lessen Dobrin Sirota Kuand Tutkievitsch 0.005% 186 BRAIN effect of carbon monoxide on barrier apparatus of Gr^...nstein and Popowa 161 lesions from carbon monoxide Se- merak and Bacon 162 BRICK cork workers cancer in Sch^...rch0.0.0 Hud. leson a0 nd. John-. John-. John- 236 son son BURNS asphalt epithelioma following ( Gunsett . escapes escapes from 125 composition of fluid that escapes from blood stream after Beard and Bla- lock ... ccc cece cece eter ee eees 245 low blood pressure after Blalock 245 wax paraffin treatment of Cook 100 prevention of pain and treatment of NovPa fab Pfabk treatment treatment 128 silver foil treatment of Pfab 100 Underhill superficial changes in capillary permeability induced by Kapsinow and Fisk 181 superficial composition of edema fluid resulting from Underhill and Fisk 0... cc cece cece eee eee ees 181 superficial composition of tissues under influence of Underhill Fisk and Kapsinfo luid fw or- 181 superficial extent of edema fluid for- mation induced by Underhill Fisk Kapsinow 181 superficial nature and effects of Un- derhill Kapsinow and Fisk 181 superficial relation of blood chlorides to chlorides of edema fluid pro- duced by Underhill Fisk and Kapsinow ccc. c cece eee neces 181 tannic acid treatment of Prioleau 100 PAGE BURNS types pathology and management Pack and Davis - whirlpool baths and posterior splint- , ing to overcome contractures in Hilbert . contracues contractures contractures contractures contractures 129 CABINET makers dermatitis venenata in due to Brazilian walnut wood Schwartz . relieverelieve 244 CALCIUM CHLORIDE use of to relieve peristaltic pain Bauer Salter and Aub coat: 202 CANCERCANCER c chihmnieymsn wee epsydisadppieasr-appear- ance of Richter 111 following injury by burning asphalt Gunsett 0.0... cece cee eee 125 in cork brick workers Sch^...rch236 industrial Teutschlaender of 192 industrial incidence and cause of Bristol 0... cece ee eee ee eens 227 occupation and Jacobs 111 occupational Blum and Bralez America Pedley occupational in occupational neoplastic disease _ ... 192 Haa- oc ur ence gensen 0. eevee various various 227 occupational occurrence in various countries Koinuma 191 occupational of bladder and prostate Kennaway Henry and Kenna- way . .111 193 occupational of hand Epstein 157 of lungs Joachimsthal miners Pir- chan and Sikl Sikl 3 of lungs Joachimsthal miners Sikl 194 of lungs industrial Doubrow 228 producing factor in coal tar pitch Shiba Kennat way KennawayKena naway.. producing substances Kennaway 136 producing substances fluorescent Kennaway spectra of and Hieger 136 producing tars and oils spectra of Hieger dioxide 136 skin due to carbon dioxide snow Manse Streef n Streef Stres ef 89 233 tar Bonne Lodder and Streef 89 204 tar Calvanic Streefo eees 135 tar Fabris 0.0. Mel anby M6 elanbyMell. anby.0 .2: 05 167 tar Watson and Mellanby 205 205 tar cancer cells in blood vessels in Babestissue tissue eens 167 tar changes in elastic tissue in Sed- ginids tissue ree nee es 136 tar in Baden Brenner Choldin eres 134 tar predisposition to Choldin 135 tar susceptibility and resistance to acids Maisin 204 tar treatment of with amino acids Vl^sde Coulon and Nicod 206 tarred streets as cause of Lehmann 167 CANNING pineapple in Hawaii employment of women in Manning 54 CARBON BISULPHIDE see Carbon Disul- phide in CARBON DIOXIDE and oxygen in air simplified Haldane apparatus for determination of Marschak 47 outbursts in mines 84 THE JOURNAL OF INDUSTRIAL HYGIENE DIOXIDE CARBON PAGE physiologic effects high CHILDREN child labor and figures PAGE 56 physiologic effects prevention of Brown poisoning in mine disasterdisaster at Neurode snow skin cancercancer due to Mansens CARBON DISULPHIDEDISULPHIDE poisoning Holm- infections ) child labor health hazards child labor in agriculture and farm life in Colorado Mautner Abbott Bell and Bispham child workers on city streets 0... McGill employment of in New Jersey Mc- GillGill and Skinner in agriculture McGill work COMPANIES Eastman Kodak Company n work of Comstock Endicott Johnson Company " service of Carpenter Four Wheel Drive Auto Co skin in operati Fredenberg . sent e Milwaukee MONOXIDE asphyxia neuro- resulting from Chornyak and SayersSayers ... 257 Guillain Thurel and Desoille 162 brain lesions from Semerak detection of in air with ampoules of plating palladium salt solution solution Berger and Yant school leaver and factory work CHIMNEY SWEEP cancer disappearance of disappearance 111 CHROMIC ACID dermatitis Werther 96 96 mist acute effects of Schwarz and Sieke CHROMIUM plating plating establishments health conditions in F^rster .. plating health hazards in Blair 163 health of worker in Trum- per occupational plating occupational risks in Railwa Electric Railwa Light Company accident c Shellow Carolina Pacolet Mills South Carolina program of FullerMilan Pirelli rubber factories Milan of tuberculosis .... Workmen's COMPENSATION see Workmen's pensation COMPRESSED AIR tools see Pne tools moisture CONDENSATION of moisture con Roels determination of in air Zapadinskii Leonov regulations Great Britain plating effect on barrier apparatus of brain poisoning with manifestations of sen- i 161 effect on nervous systemsystem Swetnik sitization case report Smith .. gas mask Stampe and Bangert dermatitis Nightin- CHRYSANTHEMUM in exhumed cadaver examinatexi aminatio ons n Nighs tin- poisoning fatal from gas heating of CLEcRleKricpahlysiwcoarlkeerxsamiMnuathilobnesrogf mMacl-e Cord and Allen 85 poisoning in battleship blisters 233 pulse rate readings on clerks Brit- poisoning in hat industry ten and Wallace Strauss poisoning in industry ( CLIMATE and work Strauss review SayersSayers and Daven- of working hours to Ishi- poisoning relation port hara treatment of by light 9. CLINIC acM cidi entl ofw Mila wau ukek e Ele ecte ric poisoningKoza Railway and Light Company Shel- mice Shel- response of mice and low international canaries to Yant Patty Schrenk and Ber- factory international Rollier COAL dust explosions see Explosions danger CARBON TETRACHLORIDETETRACHLORIDE to dust in treatment of pulmonary tu- berculosis Glaser fat in poisoning with macroscopicmacroscopic pul- mine see Mine coal miner see Miner coal monary artery MacMahon and mining see Mining coal ( CARBUNCLES in miners tee Fisher 235 pulverized hazards protection of Spitzm^...ller CARDIOVASCULAR lesions in machine workmen Wietfeldt COAL TAR see Tar Muhlberg Allen and COLDS common effect of ultraviolet system functional light on Doull Hardy Clark and poisoning LyublinaLyublinla ead 261 Herman Doull 173 CELLULOSE lacquer see under Lacquer common of ( etiology varnish see under Varnish Bourn and McComb 195 Vogt CONTRACTURES CONTRACTURES of hand Koch COPPER content of human Kleinmann and Klinke determination of in biologic m t Inouye and Flinn liver in food cirrhosis of liver due drianoff Conk brickworkers brickworkers canc Sch^...rch 0... mills sickness COTTON spinning mills sickness - operatives in Hill CYANIDE poisoning new trea Schmidt . DEHYDRATION by pilocarpine varied dietary conditions ( hill and Fisk U produced by various means U hill and Fisk . DEPARTMENT STORES health and turnover in Ho Pidg limited price women in Pidg DERMATOSIS see Skin diseases DIATHERMY surgical in treatme wounds ... DIET Nutrition see also pilocarpine DIET dehydration by pilocarpine U varied dietary conditions U Fisk hill and poisoning poisoning DINITROBENZENE poisoning Bo igo CEMENT dust and tuberculosistuberculosis J^tten and Kortmann 139 . order CHAUFFEUR minimum visual visual acuity of common etiology of Shibley Mills and Dochez labor in Mills Mills COLORADO child labor in agriculture and farm life in Mautner Abbott Bell and Bispham COMFORT effect of variations in relative humidity on Miura skin Bonzanigo DIOXAN vapors acute respon guinea to Yant Sch Waite and Patty internat DISEASE and accidents internat congress of see International gress working with and use of corrective glasses Kan- rs temperature' in relation to Ward . COMPANIES Boston Elevated Railway Railway accident reduction work of Slocombe caused by working with pneu tools Seyring in industrial diseases scheduled in industrial many Teleky Collis prevention of Collis occupational medicolegal as Kummel SUBJECT INDEX 275 PAGE COMPANIES Comstock Eastman Kodak Company nutrition work of . eeeeeeeeeee Endicott Johnson Company medical service of Carpenter Four Wheel Drive Auto Company skin infections in operatives of Fredenberg Milwaukee Electric Railway and Light Company accident clinic of Shellow health Pacolet Mills South Carolina health program of Pirelli rubber .. fafcatcotroireises Milan Milan teens study of tuberculosis in Com- COMPENSATION see Workmen's Com- COMPRESSED pensation Pneumatic AIR tools see Pneumatic tools CONDENSATION of moisture control of Vogt . e ccc c eee eee ete ee scene CONTRACTURES of hand Koch COPPER content of human organs Kleinmann and Klinke determination of in biologic material Inouye and Flinn in food cirrhosis of liver due to An- drianoff oo... cece Cork brickworkers brickworkers eee eee cancer eee in Sch^...rchsickness ves, COTTON spinning mills sickness among operatives in Hill CYANIDE poisoning new treatment Schmidt ..........00se005 se eees 175 105 20 212 164 DEHYDRATION by pilocarpine under varied dietary conditions Under- hill and Fisk cee a cence produced by various means Under- hill and Fisk labor labor DEPARTMENT STORES health and labor Ho turnover in limited limited price women in Pidgeon DERMATOSIS see Skin diseases DIATHERMY surgical in treatment of Spitzm^...ller wounds DIET see also Nutrition . e eee e eee pilocarpine DIET dehydration by pilocarpine under varied dietary conditions Under- hill and Fisk DINIigoiTgoROBENZENE poisoning Bonzan- DINITROCHLOROBENZENE poisoning Bonzani poisoning g poisoningo of DIOXAN vapors acute response of guinea to Yant Schrenk Waite and Patty DISEASE and accidents international congress of see International Con- . gress caused by working with pneumatic tools Seyring in nees industrial diseases scheduled in Ger- many TelekyCollis industrial prevention of Collis occupational medicolegal aspects Kummel ccc e ee eee cece . 181 181 106 51 90 181 196 10 21 154 189 155 PAGE DISEASE trauma compensation medi- industrial colegal relations unsuspected in industrial workers workers 155 Squsi kins chae rged charged wr ith 224 DISINFECTION of skins charged with anthrax Brotzu DIVERS DISEASE prophylaxis Blattner and Zangger 130 Dock laborers skin injury in due to salt Somogyi 209 DRINKER RESPIRATOR analysis of case reports Drinker Shaughnessy Shaughnessy and Murphay rrest 149 treatment of respiratory arrest in Murphy Drinker and Drinker 149 DRINKING facilities in places of employment Correll 150 268 Duco retrobulbar neuritis due to Goldmann . events eeeeeeneees DUST abatement Engle . 34 248 absorption of solid air dispersed material by respiratory system Weber . disease res. piratory Russell Russell system system and pulmonary disease Russell cement and tuberculosis J^ttenand KortmanPetrn off Petroff chamber Wigdortschik and Petroff 138 clay slate and tuberculosis J^tten and Kortmann - -clinical symptoms of dusted lungs von D^hren coal in treatment of pulmonary tuberculosis Glaser - ... " control Gum Pescz hPesch .. determination of in rooms Pesch - ... dusted lungs and roms tuberculosis B^ under Explosioh ns Explosions Explm osionseeee explosions see under Explosions fluCeookepnCookee umonokoniosis due to industrial control of by legislation Sch^...rmann= influence on health of man animals and plants Natho inhalation changes in red blood pic- ture following Scharlau 28 inhalation inhalation experiments Haynes 28 pathologic anatomy of dusted lungs Schritubd erculosis td uberculosistuberculosis e tuberculosis pneumonokoniosis and tuberculosis in dusted lungs J^tten producing materials dustless filling and packing .... relation to infection Kettle rock pulmonary changes in miners due to Policard and Martin stone disease legal establishment of Reichmann . . stone maladies in Ruhr miners Hustenten . tobacco and tuberculosis J^ttenand KortmaAbn rest J^n tten toxic effects of Abrest zinc action on health and accumulation in organs Nuck Remy and Holtzman Remy an nd 48 THE JOURNAL OF INDUSTRIAL HYGIENE tained in a second wash bottle By passing a known quantity of air through these two solutions sulphur dioxide and hydrogen sulphide at concentrations respectively of 0.017 to 0.6 mg and 0.092 to 0.6 mg per liter can be evaluated with satisfactory accuracy by determining the sulphuric acid formed D. INJURIES FROM URSOL IN THE FUR INDUSTRY R. L. Mayer and M. F^rster Abstr as follows from Zentralbl f Gewerbehyg June 1929 N. S. vol 6 pp 171-178 171-178 in Bull Hyg July 1980 vol 5 p 571 Ursol is the commercial name given to metaphenylenediamine and is regarded as a frequent cause of dermatitis The authors emphasize the importance of functional tests applied to the skin in addition to mere reliance on the family and occupational history If such testing is applied the number of cases alleged to be due to ursol falls considerably The diagnosis ur- sol poisoning from the history is no more to be relied on than a diagnosis of lead poisoning from the presence of punctate basophilia Altogether 181 persons employed in the fur trade were examined of whom 111 in the course of their work had suffered from dermatitis or asthma Of these 111 45 per cent showed asthma existence of eczema and 38.7 of a combination of the two was found in 16.2 per cent On testing their skins with a small piece of 2 per cent para- phenylenediamine vaseline 44.1 th cent showed hypersensitization ursol Forty per cent of those with eczema gave positive reactions 30.2 of the asthmatics and 72.2 per cent of those who showed presence of both conditions The authors regard 44.1 per cent as directly due to ursol and 55.8 per cent doubtfully so The general question of sensitization of the skin is then discussed in particular relation to ursol M. L. DUST HAZARDS AND THEIR EFFECTS MINER'S LUNG AN INVESTI- excellent illustrations GATION INTO THE ANTHRACOTIC LUNGS are given of the OF MINERS IN SOUTH WALES macroscopic and microscopic condi- S. L. Cummins and A. F. tions seen The paper opens with a Sladden Jour Path and Bacteriol 1980 vol 33 useful historical r^'sum^o'f earlier references to anthracosis and pp 1095-1132 other forms of dust diseases The authors hold This study of the black lung of coal miners is unusually thorough It is that the blackness of coal miners lungs is due based on to coal any iron present is quite an examination of lungs from thirty in subsidiary amounts Frequently cases many of whom died fibrosis is present caused by dusts accidentally In addition to the pathologic examination analysis of thirty- other than coal and particularly , by silica from four of the lungs was carried intervening rocks Such Details of these out fibrosis blocks the lymph flow of the and form the analyses are given 4 lungs and coal dust collects in abun- 4 such most extensive series of dance in such lungs Normally coal 4 analyses yet published Eleven dust is fairly rapidly removed from ABSTRACT healthy lungs but it may so collect in of fibrotic lung as to form a of nodule coal At times local takes necrosis place with cavitation quite apart from any tuberculous infection Discharge from such cavities accounts for the black sputum of miners Wherever the coal particles were found most concentrated analysis showed the con- tent of silica to be particularly high that The conclusion is reached anthra- cosis is not a simple condition but exists only as a subdivision fibrosis usually due to silicosis ably the lungs of miners of lung Probinterfered with by different dusts account for the high death rates from dis- pulmonary eases particularly bronchitis among coal miners on certain fields even though their death rate from tubercu- losis is usually low Nevertheless a be condition of anthracosis may pro- nounced without interfering with the general health L. C. disea coun Brita ence carri dust been is c and poss tain due fine caus whi fata fecti fibro radi ASBES- ASBESTOS AND PULMONARY TOSIS V. Dhers M^'d du travail July 1930 vol 2 pp 147-172 Sept. . 187-209 1980 long article the author use- fully summarizes relating information to the occurrence of occupational as- bestosis A history of the use of this mineral and its properties is to- given gether with its chemical composition Then a description follows of the indus- trial uses to which it is put during which dust may be generated par- ticularly during weaving operations The lungs of workers become affected in direct proportion to the length of time they have been exposed to it until after twenty years of work 80 per cent are affected Statistics and in- formation as to the occurrence of lung sun POP B. 198 A the We at asb thi sev s no e of d in 1om ABSTRACTS 49 healthy lungs but it may so collect in fibrotic lung as to form a nodule of coal At times local necrosis takes place with cavitation quite apart from any tuberculous infection Discharge from such cavities accounts for the black sputum of miners Wherever the coal particles were found most concentrated analysis showed the content of silica to be particularly high The conclusion is reached that anthracosis is not a simple condition but exists only as a subdivision of lung fibrosis usually due to silicosis Prob- ably the lungs of miners interfered with by different dusts account for the high death rates from pulmonary diseases particularly bronchitis among coal miners on certain fields even though their death rate from tuberculosis is usually low Nevertheless a condition of anthracosis may be pro- nounced without interfering with the general health L. C. ASBESTOS AND PULMONARY ASBES- TOSIS V. Dhers M^'d du travail July 1930 vol 2 pp 147-172 Sept. 1930 pp 187 209 In this long article the author usefully summarizes information relating to the occurrence of occupational as- bestosis A history of the use of this mineral and its properties is given to- diseases among asbestos workers in all countries but particularly in Great Britain are brought together Refer- ence is made to experimental work carried out by exposing animals to the dust the results of which have not all been published The lung condition is characterized by dyspnea cough and the presence of asbestosis bodies possibly in the sputum but more cer- tainly in the lungs These bodies are due to organic material deposited upon fine spicules of dust The fibrosis caused is general throughout the lungs which are so damaged as to lead to a fatal issue without any secondary infection necessarily occurring Such fibrosed lungs may be detected by radiography but the shadows thrown are not so coarse as those of silicosis Diagnosis must depend largely on a knowledge of the occupation of the worker Prognosis generally is un- favorable since treatment is unsatis- factory The only thing to do is to abolish the dangers by suppressing the hazard Efforts made to this end are summarized The article is accom- panied bya full bibliography contain- ing fifty references It ought to be a useful contribution to which anyone interested in asbestosis will turn.- E. L. C. gether with its chemical composition Then a description follows of the indus- trial uses to which it is put during which dust may be generated par- ticularly during weaving operations The lungs of workers become affected in direct proportion to the length of time they have been exposed to it until after twenty years of work 80 per cent are affected Statistics and in- formation as to the occurrence of lung PULMONARY ASBESTOSIS A RE- PORT OF A CASE AND A REVIEW W. B. Soper Am Rev. Tuberc Dec. 1930 vol 22 pp 571 584 A man of 30 years was admitted to the William Wirt Winchester Hospital West Haven Conn on May 26 1929 at which time he had been exposed to asbestos dust over a period of about thirteen years No indications of the severity of the exposures i.e dust 50 THE JOURNAL OF INDUSTRIAL HYGIENE concentrations are given He was admitted to the hospital four months after he had stopped working At that time his weight was 142 pounds or 8 pounds below his best weight Physical examination showed 5 cm chest expansion con- siderable dyspnea particularly on ex- ertion sputum occasionally blood streaked but negative for tuberculosis occasional r^lesburning pain over the whole chest nervousness irritability and constipation of three months standing Several nontender asbes- tos corns were seen on the hands Blood picture and urine showed noth- ing unusual ray picture was dis- tinctive of the cobweb appearance noted previously by Wood see Tubercle 1929 vol 10 p 353 The patient was discharged on July 2 1929 and reexamined on April 9 1930. During the nine months interval he had rested at home Dyspnea had increased the burning pain in the chest had been superseded by dull drawing pain above the left breast and weight had increased from 142 to 162 pounds Respirations were 25 and even ordinary speech produced shortness of breath the complexion was leaden with noticeable cyanosis of the ears hands and skin on pressure chest expansion was 1.5 cm as compared with 5 cm nine months previously R^les were considerably more definite and more widespread than nine months earlier Among the author's conclusions are the following The most common single symptom is dyspnoea This and the other symptoms are essentially those of a progressive generalized lung fibrosis The physical signs of uncompli- cated pulmonary asbestosis are sub- stantially those of generalized fibrosis of both lungs and basal pleurisy ray examination is of great value in establishing the diagnosis Asbestos contains but a very small amount of free silica but probably conduces to a more hasty evolution of any accompanying tuberculosis as in the better understood forms of silicosis An immediate diagnosis at autopsy is said to be made possible by simply squeezing out upon a slide a drop of lung juice from the fibrosed tissue and covering with a cover The asbestosis bodies in large number are < ~ readily visible under the microscope -P D. PNEUMONOCONIOSIS DUE TO FLUE DUST W. E. Cooke Brit Med Jour Nov. 15 1980 vol pp 816-817 Detailed analyses are given of boiler scale and flue dust and also of dust particles found in the lungs of a man who had been a boiler cleaner for 113 months He died from tuberculosis while rays suggested advanced pneumonokoniosis The lungs were fibrosed throughout and dust and dust cells were found in excessive amount Although the silicious matter in the pulmonary dust was proportionately less than in the flue dust the occupa- tional exposure is held to have cer- tainly originated the pathologic condition The process of flue cleaning is not favored during twelve years twenty men have been employed and have given up the work Excepting two of these one of whom worked only one day and the other one week the average period of employment was fifteen months while the nearest approaching the period of the deceased man was thirty months - C. 2m ABSTRAC A STATISTICAL STUDY OF PUL- MONARY CHANGES FOUND AMONG MIN- ERS WORKING IN ROCK DUST A. Policard and E. Martin Bull Acad de m^'d1980 vol 104 pp 333-343 A clinical and radiographic examina- tion was made of 175 men using rock drills in mines in the basin of the Loire some being rayed on several occa- sions As many men came for exami- nation on account of illness the percentage of lung trouble found cannot be held to be representative Nevertheless when divided according to length of work nearly 50 per cent were normal with less than one year of work as compared with 25 per cent with ten years or over of work No informa- tion as to age is given which might quite invalidate the findings Two certain points emerge one is that even ten years of exposure to mine dust does not necessarily cause pulmonary fibrosis and the other than an unusual number of cases of open tuberculosis were discovered No ray picture diagnostic of silicosis was found but progressive changes in the appearances were of value in detecting the silicotic condition The authors hold pulmonary silicosis to be a particular instance of tuberculosis developing under special conditions L. C. SOME ASPECTS OF SILICOSIS P. Heffernan Tubercle 1980 vol 11 pp 481 489 ; tha tha lun fibr whi age logi silic cast int be pla dito soa nor pro ciat dry sup fail sigi and The and cert exit of t othe risk inh tem phy less tub WOMEN AND CHILDREN 1 WOMEN IN CENT STORES AND LIMITED CHAIN DEPART- MENT STORES M. E. Pidgeon U.S. Dej ~ 76 - 119 119 ABSTRACTS 51 A STATISTICAL STUDY OF PUL- MONARY CHANGES FOUND AMONG MIN- ERS WORKING IN ROCK DUST A. Policard and E. Martin Bull Acad de m^'d1980 vol 104 pp 333-343 A clinical and radiographic examina- A discussion is presented rather than new facts The idea is advanced that silica may react by toughening lung tissue generally while nodular fibrosis occurs at the site of lesions of tion was made of 175 men using rock which tuberculosis is the most common drills in mines in the basin of the Loire agent Such nodules may be radio- some being rayed on several occa- sions As many men came for exami- nation on account of illness the percentage of lung trouble found cannot be held to be representative Never- theless when divided according to length of work nearly 50 per cent were normal with less than one year of work as compared with 25 per cent with ten years or over of work No informa- tion as to age is given which might quite invalidate the findings Two certain points emerge one is that even ten years of exposure to mine dust does not necessarily cause pulmonary fibrosis and the other than an unusual number of cases of open tuberculosis were discovered No ray picture diagnostic of silicosis was found but progressive changes in the appearances were of value in detecting the silicotic condition The authors hold pul- monary silicosis to be a particular instance of tuberculosis developing under special conditions L. C. SOME ASPECTS OF SILICOSIS P. Heffernan Tubercle 1980 vol 11 pp 481-489 logic indicators of more extensive silicotic changes taking place but not casting visible shadows Silica enters into certain forms of life and so may be expected to interact with protoplasm The reaction may be expe- dited by such a medium as alkaline soap with acute silicosis as a result normally the reaction is a chronic process Its development is associated with increasing dyspnea and dry pleurisy Should tuberculosis not supervene cardiac hypertrophy and failure ends the scene Physical signs alone are not diagnostic nor is a skiagram a history of exposure to risk and symptoms must also be present The fibrotic changes are progressive and cannot be inhibited Coal and certain other dusts may facilitate the exit of silica but silica has some power of bringing about the retention of dusts otherwise excreted Prevention of the risk must be effected it lies in keeping inhaled air free from a suspensoid sys- tem of silica which behaves physically as a gas The risk may be lessened by minimizing exposure to tuberculous infection L. C. WOMEN AND CHILDREN IN INDUSTRY | WOMEN IN CENT STORES AND LIMITED CHAIN DEPART- STORES M. E. Pidgeon U.S. Dept. Labor Women's Bur Bull No. 76 1980 pp 56 ! This bulletin covers personal infor- 29 THE JOURNAL OF INDUSTRIAL HYGIENE to form ient conglomeration larger OF OFSILICOSIS ected shadows and a gradual Am IN MAN R. G. Mills om Jour Hyg Jan. 1931 vol 13 escing phenomena which are asso- d with pp 224-234 srt stonecutters wet sand- The spicules of the e grinders and sand blasters sponge Spongilla water d act: circumscribed shadows fragilis are com- RE appear Sen clearly in the lungs of stone posed of opal a form of hydrated silica which is similar to rs Weak diffuse and cloudy chemical quartz in its ows are characteristic of the coal when reactions These spicules an lung silicotic shadows introduced into the tissues of for the most are howalso animals are slowly but definitely dis- part ray picture of the evident solved proving conclusively that silica seamen schamotte workers shows less nodule forma- is soluble in the tissue fluids of animals rer ene and a somewhat and presumably of man This con- SS greater expanse firms the nnected shadows assumption held by many the second part of the students of silicosis that particles of ae HE ERB ted the results of the paper are silicious material are gradually con- enty sand examination verted into the colloidal statestate and * blasters twenty of such exert as a 3.9 1 had indications of silicosis in the a fibroplastic influence on SN ent stages lungs of miners and other exposed MA industrial workers Definite fibrosis E EFFECT OF PROLONGED EXPOS- of the lung of a dog into which the spicules had been introduced OF THE SILICEOUS SPICULES of ^ that there is suggests ER SPONGE Spongilla Fragilis To ACTION OF ANIMAL TISSUES A concomitant injury attributable to the disappearance by RIBUTION TO solution of the silicious elements of the | THE PATHOGENESIS spicules Author's Summary UPATIONAL AFFECTIONS OF CUPATIONAL ECZEMA M. Opim Arch Dermat and Syph 1931 vol 23 p 346 e dermatitides may be divided the following groups 1 In dertis sensu strictiori the skin is able al with the irritant almost every- skin reacts to certain strong irri; e g croton oil even if with t variation the course is acute ng soon follows the removal of the n 2 In toxicoderma there is a enital or acquired idiosyncrasy slightest irritant evokes it The ation period is short The effect rked and the course acute 3 In THE SKIN AND SPECIAL SENSES eczema the entire skin is sensitized For this reason the intensity of the irritant may be slight The development of dermatitis is gradual The course is prolonged and healing delayed Occupational eczema is among the most frequent of eczemas the most frequent of skin diseases and the most frequent of all diseases The predis- posing factors important immer- sion of the hands in water soap alkali . or acid and the influence of heat cold and mechanical action Occupational eczema is allergic but the predisposing factors mentioned play an important part Dermatitis artificialis acuta OF INDUSTRIAL HYGIENE ABSTRACTS - 125 larger dual 3880- * OF SILICOSIS IN MAN Am Jour Hyg Jan. pp 224 234 R. G. Mills 1931 vol 18 and- The spicules of the ters water sponge Spongilla fragilis are com- pear posed of opal a form of hydrated tone silica which is similar to quartz in its udy chemical reactions These coal when introduced into the tisspsiucesuleosf how animals are slowly but definitely dis- lent otte solved proving conclusively that silica is soluble in the tissue fluids of ma- and animals presumably of man This con- a inse are tion of in Os FA / ' firms the assumption held by many students of silicosis that particles of silicious material are gradually con- verted into the colloidal state and as such exert a fibroplastic influence on the lungs of miners and other exposed industrial workers Definite fibrosis of the lung of a dog into which the spicules had been introduced suggests that there is a concomitant injury attributable to the disappearance by a nr^' F. *a A solution of the silicious elements of the SIS spicules Author's Summary sembles occupational eczema The patch test has only a limited value Attempts at desensitization have produced only slight results as follows from Bull Assn fran^pour l'^'tudedu cancer 1980 vol 19 p 459 in Am Jour Cancer Jan. 1981 vol 15 p 357 DERMATITIS DUE TO SENSITIZATION TO CONTACT SUBSTANCES DERMATI- TIS VENENATA OCCUPATIONAL DER- MATITIS B. Kesten and Arch Dermat and Syph vol 23 pp 221 237 E. Laszlo Feb. 1931 In eighteen of a series of twenty patients suffering from dermatitis venenata or occupational dermatitis the etiology was determined or corro- borated by patch tests In the remain- ing three there was an exacerbation of the dermatitis when the substances were applied to the sensitized skin In all of the cases there was freedom from dermatitis when the specific substance was avoided The sensitizing substances were paraphenylenediamine sodium bi- chromate novocaine novol potassium mercuric iodide primrose poison ivy A workman aged 50 years was burned on the back of his hand by a small piece of burning asphalt The wound did not heal and three months later there was a nodule at the site of the injury 1 cm in diameter The mass was excised and found to be squamous epithelioma with large keratotic pearls a few mitoses and a moderate inflammation of the stroma Pain in the wound rendered it neces- sary to remove the sutures and some small nodules on the border of the scar were submitted to microscopic exam- ination and found to contain some remnants of the growth After this second operation the lesion was treated with radium and healing occurred The case is too recent to know whether further metastases will take place Four similar cases from the litera- OF THE SKIN AND SPECIAL SENSES ph . ed erole ryriith te he is y he ect In eczema the entire skin is sensitized For this reason the intensity of the irritant may be slight The development of dermatitis is gradual The course is prolonged and healing delayed Occupational eczema is among the most frequent of eczemas the most frequent of skin diseases and the most frequent of all diseases The predis- posing factors important immersion of the hands in water soap alkali or acid and the influence of heat cold and mechanical action Occupational eczema is allergic but the predisposing factors mentioned play an important part Dermatitis artificialis acuta pyrethrum mascara face powder and face cream In the dilutions used none of these substances was found irritating to the normal skin Passive transfer of sensitization was unsuccessful A case of local sensitization and desensitization to potassium mercuric iodidies reported In most instances dermatitis venenata and occupational dermatitis result from local cellular sensitization to specific proteins acquired by pre= vious contact of the substances with the skin Authors Authors Summary A CASE OF EPITHELIOMA DEVEL- OPING RAPIDLY AFTER AN INJURY BY BURNING ASPHALT A. Gunsett Abstr ture are referred to In three burns were followed by rapid development of cancer in the fourth however the tumor in this case on the lip did not appear for two years after the burn and hence cannot be absolutely correlated with the injury Two similar instances of the development of an epithelioma following burning of the skin with sulphuric acid are also on record WARTS FROM MINERAL SUBSTANCES A. P. Dewirtz Abstr from Roussky Vestnick Derm March 1980 pp 243 et 247 in Ann de dermat 30 1930 syph Dec. This writer when examining work- ers among asbestos found a kind of 126 THE JOURNAL OF INDUSTRIALINDUSTRIAL HYGIENE dermatosis It is chiefly confined to author says that this is the first } the palmar surfaces of the hands and sion on which these asbestos woacrctas- i fingers in young people who go about have been brought to the notice of the without shoes it occurs also on the soles of the feet The right hand is dermatologist He suggests that sur- gical removal is the only advisable usually more extensively involved course to pursue P. W. than the left The individual lesions consist of apparently noninflammatory round or polygonal topped warts They vary in size from a millet seed to pea Sharp needles of asbestos enter the skin and thus produce these papillomas The thin skin of youth and the flexures of the joints are particularly vulnerable and on these parts the warts are chiefly found They are most objectionable because of the pain and discomfort they cause when walking and because of the trouble and inconvenience they give to those who handle tools These little ERUPTION CAUSED BY RESINS OF TREES Longin Abstr as follows from Bull Soc fran^ de dermat et syph July 1930 vol 37 p 741 in Arch Dermat and Syph Feb. 1981 vol 23 p 333 constituents Three cases of eczematiform erup- tions produced by volatile re escaping from freshly hewn wood reported In one case there was an exacerbation when an intradermal injection of an extract of the suspected wood was administered tumors are well known to the opera- tives and are called verrues d'amiante or asbestos warts The irritation they produce leads the employees to re- move the fine spicules of mineral which stick into the skin either with pin or a needle or with the nails This gives only partial relief as the little tumors continue to grow or recur on the same place The histologic picture was examined and described by Dewirtz The horny and malpighian strata are largely increased In the dermis are a large number of round and polymorphic cells situated especially in the papil- lary layer In these warty growths Dewirtz has found the crystals of asbestos These he accuses of being the cause of the thickening of the rete mucosum and the basal layers and of the formation of giant cells The whole condition turns out to be a very slow chronic local inflammation The OCULAR HYGIENE IN INDUSTRY V. de Uzeda Abstr as follows from Folha med 1980 vol 11 pp 290-292 in Bull Hyg Jan. 1931 vol 6 pp 20 21 This is a brief sketch of the condi- tions of interest to the ophthalmologist as they are met with in industry Reference is made to the risks of work- ing in defective light in excessive artificial light and the aggravation which may arise in morbid conditions already existing e.g. myopia Secondly there is a discussion on the irritant effects of certain gases especially in chemical factories of dust or larger particles in those working with metal or stone intoxications as from mercury phosphorus nitrobenzene arsenic etc the effect of heat as cataract in those attending to furnaces in glassworkers and others and finally trauma from fragments of wood metal glass or stone causing various degrees of damage from slight conjunctivitis to ABSTR actual penetration of the anterior chamber and its complications and sequelae H. S. THE FIELDS OF VISION IN MINERS NYSTAGMUS C. F. Haycraft Abstr 528 as follows from Brit JourJour Ophth Oct. 1930 vol 14 p Arch Ophth 1931 vol 5 p . From study the of the fields of vision in a series of forty of cases miners nystagmus of which thirty- five were old and eight were new cases that is certified as suffering from the months disease within the previous six the author arrives at the following conclusions INDUSTRIA SHOULD LAYMEN GIVE INJECTIONS OF LOBELIN AND CARDIAZOL L. Teleky Med Welt 1929 no 2 consider A large number of doctors injections of lobelin of extraordinary value in restoring life in cases of appar- suggests ent death and Teleky here that as doctors are bound to take time arriving on the scene of the emergency teaching laymen should be trained to give injec- tions as part of first aid It is generally objected that it would be dangerous for laymen to give injec- tions but in giving first aid in industry they often undertake methods which may involve greater risks Thus the of Silvester and other methods ' arti- ficial respiration broken ribs and while injury to the liver have occurred the tongue may be injured by drawing of it forward and fixing it In cases trismus opening the jaws may cause wounds the teeth of lips and broken The use of the pulmotor which i recommended in factories requires 4 ABSTRACTS 127 actual penetration of the anterior chamber and its complications and sequelae H. S. THE FIELDS OF VISION IN MINERS NYSTAGMUS C. F. Haycraft Abstr as follows from Brit Jour Ophth Oct. 1930 vol 14 p 523 in Arch Ophth Jan. 1931 vol 5 p 146 From the study of the fields of vision in a series of forty cases of miners nystagmus of which thirtyfive were old and eight were new cases that is certified as suffering from the disease within the previous six months the author arrives at the following conclusions In a large percentage of cases of miners nystagmus there is a definite alteration in the fields of vision The most common change is a concentric contraction for white A large num- ber of patients show contraction for red and blue and interlacing of these colors is frequent The amount of contraction of the fields is usually but not invariably a measure of the severity of the disease In the absence of physical signs the change in the fields described combined with typical subjective symptoms can be relied on in diagnosing miners nystagmus or in determining that recovery is still insufficient to permit work underground INDUSTRIAL SURGERY SHOULD LAYMEN GIVE INJECTIONS OF LOBELIN AND CARDIAZOL L. Teleky Med Welt 1929 no 2 A large number of doctors consider injections of lobelin of extraordinary value in restoring life in cases of apparent death and Teleky here suggests that as doctors are bound to take time arriving on the scene of the emergency laymen should be trained to give injections as part of first aid teaching It is generally objected that it would be dangerous for laymen to give injections but in giving first aid in industry they often undertake methods which may involve greater risks Thus in the _ Silvester and other methods of arti- ficial respiration broken ribs and injury to the liver have occurred while the tongue may be injured by drawing it forward and fixing it In cases of trismus opening the jaws may cause wounds of the lips and broken teeth The use of the pulmotor which is recommended in factories requires training and skilful manipulation The bandaging of a broken limb may be the cause of great injury Compared with these risks those from giving injections are small Thirty years ago it was quite common in clinics to give injections without any aseptic or antiseptic precautions and at the present day many morphinists give injections through their clothing without any serious results Lobelin is kept in ampoules in emergency aid boxes and it would not be difficult to teach the giving of injections as part of a first aid course It has been found in cases of gas poisoning in D^...sseldorfthat firemen trained in first aid arrive on the scene a half to a quarter of an hour before the doctor and as every minute is so important it would be a great advantage if these men were able to give injections of lobelin and even of camphor or cardiazol if necessary J. C. 142 THE JOURNAL OF INDUSTRIAL HYGIENE Sommerfeilnddustry PhfRemeE frequently those who are employed in the mills where the dust is The fact that mild degrees of prepared Since our practical experience goes back injury Schott K^/stleare found lung and only a short time as is true also of among workers ex- Schultze's work there is posed for a number of years and that positive to be said nothing other health derangements occur concerning the ac- tion of this kind of dust on the lungs result of severe exposure in together with the results as a e of men engaged in this type of work of our ex- Dust with a high quartz content or periments show that cement dust is not entirely harmless Care clay slate dust mixed with a high con- tent of silica taken therefore to avoid must be Ge should however be ment of the develop- eliminated as far as possible Further too large a quantity of dust in RE research is necessary in order to show manufacturing and to insure efficient Aa Oe how pure clay slate dust behaves removal of the dust by suction At first glance our experimental ste. experimentally and especially to de- termine the degree of results with tobacco dust hazard with be at appear to varying silica content ' variance with previous experi- ie Our next study will be devoted Nima mental results as well as with the ee the dust problems to statistics on the incidence of Clo dusting If involved in rock losis in tobacco trades tubercu- clay slate dust should culosis That tuber- actually prove to be injurious to the occurs among lungs there are available several other kinds of dust which are less denied tobacco workers cannot be but the opinion at the present time is and which harmful that this is not due satisfy the requirements of entirely to em- mining authorities We may ployment in dusty work but is brought aA for example limestone mention on by other causes of a social and dust which economic contains only about 3 nature We cannot con- per cent of silica and has a high lime content vince ourselves however that tobacco dust is entirely harmless We there- Moreover official tests have shown that it meets all the requirements fore stress the importance of improving the industry Our animal of hygienic conditions especially of ments with it have been experi- women workers of furthering voca- satisfactory completely An exhaustive tional selection of prohibiting em- concerning this subject will report ployment of young persons and par- our next publication appear in ticularly of installing efficient dust The relatively slight injury caused by cement dust in our experiments is in complete agreement with previous practical experiences and statistical studies Only a few authors have ascribed a tuberculosis tion to this promoting ac- dust and their views are longer significant since statistical stud- ies have nowhere established a high tuberculosis mortality with certainty removal systems and of eliminating the possibility of infection observations on tobacco dust inThhaelsa-e tion clearly show that other factors are responsible for the dust injuries and particularly for the tuberculosis They demonstrate the correctness of K. B. Lehmann the Nestor of industrial hygiene in his assertion that poor nutrition bad living conditions weak constitution and susceptibility OF INDUSTRIALINDUSTRIAL HYGIENE lung mills ince The fact that mild degrees of Sommerfeld injury Schott back K^/stleare found and workers among ex- > of posed for a number of ning other health years and that derangements occur as ac- result of severe a exposure in industry together ngs with the results of ork our ex- periments show that cement dust is or not entirely harmless Care on- taken therefore to avoid must be be ment of too the develop- her large a quantity of dust in manufacturing and to insure efficient OW removal of the dust by suction ves At first glance our le- results with tobacco experimental dust appear to th be at variance with previous smteanttisatlics experi- in results as well as with the to ek losis on the incidence of tubercu- tobacco id culosis occurs trades That tuber- e tobacco frequently among workers cannot be denied r but the opinion at the is 1 that this is present time of not due entirely to em- ployment in dusty work but is other on by brought causes of a social and 11 f economic nature We cannot con- vince dust ourselves however that tobacco l is entirely harmless We there- fore stress the importance of improving hygienic conditions especially of ployment women workers of furthering voca- tional selection of prohibiting em- of young persons and par- ticularly of installing efficient dust removal systems and of the eliminating possibility of infection These responsible observations on tobacco dust inhala- tion clearly show that other factors are for the dust injuries and particularly for the tuberculosis They demonstrate trial the correctness of Lehmann the Nestor of indushygiene in his assertion that poor nutrition bad living conditions weak constitution and susceptibility ABSTRACTS a 143 to infection play a more important ASBESTOSIS BODIES IN SPUTUM AND r^le in the production of tuberculosis than do moderate dust concentrations We hope that we have shown by these observations that it is possible by means of animal experimentation es- LUNG K. M. Lynch and W. A. Smith Abstr as follows from Jour Am Med Assn Aug. 30 1980 vol 95 pp 659-661 in Arch Path Feb. 1981 vol 11 pp 291 292 pecially with tuberculosis immune animals to evaluate the danger of In microscopic sections of lung from the body of a worker in an asbestos different occupational dusts by ex- factory who died from a gunshot tensive parallel studies and to reach wound numerous asbestosis bodies . conclusions which are in agreement with statistical and practical results were found in the alveoli the walls of the alveoli the deeper pleural tissues Ickert confirms our opinion by a comparison of the findings of J^ttenand Arnoldi with recent and old statistics The statistics show a scale of dust risk which Ickert states agrees exactly with the experimental findings of J^tten and Arnoldi Further studies on the relation of the bronchi and the interlobular framework in thrombi in the veins and in the peribronchial lymph glands Associated with them were black gran- ular pigment in the lymph glands a yellow granular substance a reaction of mononuclear and polymorphonuclear giant cell phagocytes and in the framework structures a cellular occupational dust and pulmonary tu- increase in fibrous tissue The asbes- berculosis will be of value especially if they are extended over a long period tosis bodies were seen in the sputum of three people who had been workers of time and include observations on in an asbestos factory one as long be- chronic dust inhalation The correct fore as six years In the sputum evaluation of such animal studies can these bodies had a central filament result only from extensive series of of a transparent slightly greenish- comparable experiments with various kinds of dust furthermore statistical and other research findings as well as the social and economic conditions of the various groups of workers must be taken into consideration If stud- ies are carried on this way it is our opinion that it will be possible eventually to reach a definite decision in regard to the industrial dust problem tinged needle crystal On this were deposited nodules blebs and ... segments of a homogeneous refractive substance These bodies were from 12 to 140 microns long and from 1 to 12 microns thick They did not take the ordinary dyes for tissue and sputum They could be stained by the Prussian blue reaction for iron It is suggested that the iron content of the deposit was of tissue origin prob- ably from the blood / | 206 THE JOURNAL OF IND HYGIENE HYGIENE THE THE JOURNAL JOURNAL OF the and, removal of On the other Th0e.03 0.075 absorption tar skthienother The dose was 0.03 0.075 gm daily daily tul tul removal removal from by cases tumor dis- Su dis. preliminary treatment petroleum petroleum appeared produced produced treatment effect the an thirty seven entirely entirely regression fit was continued nine fir fir being decreased decreased the i grow and in im in TREAFTMUENTRTTREHAETMRENINVTESTIGATIONS INVESTIGATIONS INVESTIGATIONS THE two TUMORS WITH CERTAIN CERTAIN AMINO ACIDS MICE regression A. Coulon and F. regression controls not of fil single discovered case case regressimade on been discovered propor- ptewtee as follows from Compt Compt rend A . we even more seven with twenty twenty treated carcinoma subcutaneously seven biopsy were equimolecular given equimolecular equimolecular mixture tially proline mouth mouth tumors con- Par- in six grow tinued and remained remained or by both grow grow, and con routes stationary One remained i Beihefte z Zentralbl Gewerbehyg no Reviewed Reviewed follows in B1u9 l1l930 pp Nov. . whether recover recover or as waste hasbe work to ampri ly amply illustrated ilustrated illpusrtroatdeduct . The photo- photo- got graphs both and diagrams which work well and diagrams reproduced.- reproduced.- reproduced.- clearly hygienic with with importance subject and and aes ngineering side technical technical be direct such is medical officer officer of service service to lays health health stress on the the aspect the problem first dual aspect of presents the catching up importance as dust dust formed and render- ing ing dust innocuous innocuous innocuous and secondly secondly method dealing method method Naturally treatment traeatmenft ttreeatmernt wards afterwards Naturally according will nature end industry according the dust its industry nature H. S. and clearly reproduced.- of which - HLS, reproduced, CONIOSES Med 581-540 581-540 This March 1981 Epidemiology Epidemiology and 18-22 Abstract pp Medi- Medi- author author of work done with summary summary of dust diseases Lectures since author's author's Milroy 1915. Studies Studies silico- of sis may have shown that impair- ing advanced without health but may superimposed superimposed of the the dust qu fatally health; but itGenerally superimposed superimposed may J. H. Generally superimposed JH, OFOF INDUSTRIAL HYGIENE e other kin by The dosedose was 0.03 cases roleum . daily appeared twenty 0.075 ct the sed other remained esults appeared tumor there the tumor ; tumor thirty animals tionary contained entirely in partial regression continued to grow it This last group dis- seven in nine in sta- THE ICE l^s str was to exert begun discoveArmeodngdiscovered two treatment begun after treatment and before it had had exert its full effect had time Among controls not a single regression had been forty- case of . two in glutamic d tion of made up the ur acid to ontewo omfolecules of d propor- acid even cystinecystine promised to got recover rid sufficient commercial commercial commercial of or whether it has as a got The work both by photo- , all of which clearly reproduced.- This Abstract by author ) | ork presents a article summary | ce the with regard to dust health aaduvatncehdor's itsLeedlicfsteauserses Generaly Studies Milroy may be have shown that silico- Lectures advanced without without impair- silico- but it impair- lly may superimposed Generally | H. t ABSTRACTS 207 tuberculosis hastens the termination Such infection may precipitate latent fibrosis Other dusts may set up fine generalized fibrosis seriously impairing the pulmonary functions but not predisposing to tuberculosis Asbestos is particularly injurious other silicates such as basalt are harmful Pure coal dust seems to be quite neutral but raw coal often contains sufficient minerals to originate fibrosis while fibrosis may so retain coal particles in the lungs as to block the lymph passages and impair function Radiography displays the presence of fibrosis but gives no clue to the causative factor When silicosis is present the shadows tend to be nodular superimposed upon pro- nounced arborization Reference is made to recent mortality records associated with different dust hazards Clinical and pathologic studies are summarized which are concerned with dusts of iron ore cement coal asbes- tos and marble THE PRESENCE OF ASBESTOSIS BODIES IN THE FAECES IN A CASE OF PULMONARY ASBESTOSIS S. R. Gloyne Tubercle April 1931 vol 12 pp 158 159 This short note describes how asbes- tos bodies in cases of pulmonary asbestosis may be found by emulsifying the feces in four to five times their volume of 5 per cent formalin in saline and then centrifuging the product which will be found to con- tain a scanty number The bodies which have probably been swallowed in sputum show less than usual of the typical yellow coloring mat- ter as though the pigment were partially destroyed by , juic-eEs L. C. intestinal SILICOSIS AND MINing J. S. Haldane Tr Inst Min Eng 1931 vol 80 p 415 In earlier papers the author concluded a that no danger to health would arise from stone dusting pro- vided suitable shale or other material was employed and b that the unusually high bronchitis mortality rate among colliers in the higher age groups is due mainly to the strain on the lungs caused by muscular exertion In the present paper Dr. Haldane reviews his conclusions in the light of the full data containeidn the Regis- General's Decennial Supplement for 1921 to 1923 The phthisis death rates for the various groups of underground workers are distinctly lower than those for all occupied and retired civilian males Even in that group engaged in making and repairing roads which includes the work of ripping stone roofs and driving roads in stone the death rate from phthisis at all ages above 25 is lower than for the standard population It is mentioned however that in exceptional cases great risk may occur among men driving roads in highly silicious rock particularly when machine drills are used The Mines Act of 1911 required certain precau- tions in the use of these drills but the clause was practically ignored As a result cases of silicosis have been discovered in the Somerset and South Wales coal fields The thesis is advanced that the inhalation of coal dust and shale dust as among coal miners coal boat loaders or cement workers stimulates The Effects of Dus Inhalation Tr Inst Min Eng 1917-1918 vol 55 p 264 The Health of Old Colliers Ibid 19151916 vol 51 p 469 THE JOURNAL OF INDUSTRIAL HYGIENE DUST HAZARDS AND THEIR EFFECTS CONGRESS OF INDUSTRIAL MEDICINE Foreign Letter ItalyItaly Jour Am Med Assn Feb. 14 1981 vol 96 pp 542-544 This letter contains an account of the Ninth Congress of Industrial Medicine held Rome The subject before the Congress- Problem of the Re- bodies were intracellular and their study suggested that they were formed by the deposition on asbestos fibers of iron containing substance elaborated by the cell The shortest exposure to be followed by the appearance of the bodies was five months L. C. spiratory Pathology of -was FURTHER divided into several parts Caccuri OBSERVATIONS ON PUL- of Naples discussed the MONARY ASBESTOSIS WITH SPECIAL etiology and REFERENCE TO ASBESTOS Dust pathogenesis of respiratory diseases due to dust Coppa of Naples the and THE CURIOUS BODIES FOUND IN THE LUNGS W. E. pathologic anatomy and the clinical Cooke and C. F. Hill Abstr as follows from Jour Roy Micr Micr aspects of respiratory dust diseases Pastena also of Soc 1930 vol 50 p 15 in Physiol research in Naples radiologic Abstr Feb. 1981 vol 15 p 626 pneumonokoniosis Ab- In a case of stracts of these papers are included in suspected pulmonary the letter Communications were also asbestosis sections of the lung or macerations of the tissue revealed a presented concerning the respiratory large amount of fine > diseases of coal heavers and of workers dust but the fine granular black - t in hemp.-K. R. D. spicules of fiber x which make up the bulk of asbestos ee3. ASBESTOSIS BODIES dust were not found There were 4 i IN THE SPUTUM A STUDY OF SPECIMENS present however large fragments 5 i fs WORKERS IN FROM FIFTY to 360 microns closely resembling in ute AN ASBESTOS MILL F. W. Simson and size shape and color various constit- le Jour Path and A. S. Strachan uents of asbestos dust These large ee vol 34 pp 1 4Bacteriol Jan. 1931 fragments are found in the lung em- ee Es The result is reported of bedded in fibrotic or necrotic areas of aa ee examining sputum from fifty workers who which they are the cause In addi- were tion curious bodies were present which AS intensively exposed to asbestos dust in a mill in South are believed to be diagnostic of pul- bodies were Africa Asbestosis monary asbestosis These bodies were easily demonstrated by direct thick films They were found eventually shown to consist of a cen- tral of best by examining specimens taken core asbestos fiber enclosed in early in the morning in the adsorbed d^'brisK. D. evening the mouth and nasal pharynx were too ANTHRACOSIS loaded with dust for the bodies to be SILICOSIS AND TU- easily detected The sputum was BERCULOSIS IN MINERS Cummins Lancet Jan. 31 S. L. 1981 always mucoid in character often vol 1 pp 235-238 , resembling egg albumin No tubercle bacilli were found The asbestosis The claim is made that anthracosis is a dual condition in which coal dust F INDUSTRIAL HYGIENE SAND SAND THEIR EFFECTS -DI- bodies were m intracellular study suggested and their that they were formed by op the deposition on asbestos fibers of he iron containing substance elaborated .ne .e- ri ASBESTOSIS e MOFNUARRTYHER OBSERVATIONS ON PUL- REFERENCE WITH SPECIAL TO ASBESTOS DUST AND THE CURIOUS BODIES FOUND IN LUNGS THE W. E. Cooke and C. F. Abstr as follows from Jour Hill } Micr Soc 1930 vol 50 p 15 iRnoPyhysiol , Feb. 1931, vol 15 p 626 AbstrIn a case of suspected pulmonary the asbestosis sections of lung or macerations of the tissue revealed a large amount of fine granular black dust but the fine spicules of fiber which make up the bulk of dust were not found asbestos There were present however large fragments 5 to 360 microns closely resembling in size shape and color various constit- uents of asbestos dust fragments are found in These large in bedded in fibrotic necrotic or the lunglung em- necrotic areas of which they are the cause In addi- tion curious bodies were are believed to be present which diagnostic of pul- monary asbestosis These bodies were eventually shown to consist of ral core of asbestos fiber a cen- enclosed in adsorbed d^'brisK. D. ANTHRACOSISANTHRACOSIS SILICOSIS AND TUERCULOSIS IN MINERS S. L. oulm1mipnps 23L5a-n2c3e8t Jan. 31 1931 The claim is made that a dual anthracosis condition in which coal dust i ABSTRACTS 123 is retained in the lungs owing to a state of fibrosis with lymph blockage The pathologic condition arising from dust inhaled together with the coal and which in all probability is closely associated with the life of exposure not only to coal dust but to stone dust as well.-E. L. C. also chemical analyses are similar so far as the content of silica to those found in cases of pure silicosis In certain cases of hard heading work where rocks rather than coal are mainly tackled by the miners silicosis develops which is indistinguishable from that seen in other cases of silica risk But when coal has been the chief dust inhaled no tendency to succumb from tuberculosis is found and the suggestion has been offered that coal dust exerts a protective influence against tuberculosis This idea is however not definitely accepted at least the suggestions to explain why the coal miner has a low mortality from tuberculosis although his lungs show definite fibrosis are not accepted Professor Cummins now puts forward the possibility that carbon particles in the lungs adsorb the active principle of tuberculin He points out that such adsorption occurs in vitro since be has found that finely powdered dust of anthracite coal is capable of ad- OBSERVATIONS ON THE DIFFEREN- TIAL DIAGNOSIS OF SILICOSIS BY MEANS OF THE ROENTGENOGRAM AND AN INVESTIGATION INTO THE RISKS OF SAND BLASTERS Lochtkemper Abstr from Arch f Gewerbepath u .. Gewerbehyg 1980 vol 1 pp 271-302 in Ber ^...d ges Physiol u exper Pharmakol Oct. 8 1980 vol 56 p 182 The author distinguishes roentgeno- logically the various forms of silicosis pneumonokoniosis caused by quartz dust The first stage is characterized by enlarged hilum glands and by increased vascular markings the second stage by numerous infiltrated and iso- lated nodules and increased induration ; the third stage by the called snow- storm effect which is partly an iso- lated and partly a confluent mottling The rate of dust inhalation and the concentration of the quartz content are important in the resulting roentgen picture Among workers in industries whose dust contains free silicic acid- sorbing a large proportion of the active principle from old tuberculin diluted with normal saline solution Whether or not carbon dust particles bathed in the tissue juices retain this adsorbing power requires further investigation Some clinical facts appear to favor the theory Certainly nega- tive sputums are more common in clinically tuberculous coal miners than in other clinically tuberculous adult males Although any excessive liabil- ity to tuberculosis is absent in the case of coal miners a high mortality from bronchitis among old colliers is present sandstone grinders stonecutters sand blasters porcelain workers and stone hewers are found in the ray picture of the lung near the enlarged hilum small sharply defined shadows from pinhead to pea in size some of which are isolated and others joined by fine streaks The thickness of the nodules is greater in sandstone grinders and stonecutters than in porcelain workers and stone hewers and in occupations in which a mixture of quartz and clay dust is inhaled In the further development there is a gradual increase in the small shadows with an 240 240 the THE dust particles THE JOURNAL OF INDUSTRIALHYGIENE HYGIENEHYGIENE Particles and on the 38 particles Calcium many is 10 pp 601-634 601-634 Bull Hyg 1981 6pp 467 468467 468 467 468contai, ning a long article article containing points importance importance importance Hyg, con- interested in hyperemia alveoli The PNEUMONOKONIOSIS AND TUBERCU- PNEUMONOKONIOSIS PNEUMONOKONIOSIS Willis LOSIS Medicine Dec. Abstr follows 1980 follows 418-506 in Am vol pp , Jour Pub Health 418-506 1981 1981 vol 21 p 565 study study the original original interested subject subject chief by those The . chief The whole like Caesar's description divided divided into three detail of presents considerable considerable the The conditions whichiwnordkeursstpneru-y is the on but except pneu- is those engaged drills but process later not pneu- the grinding masks Illustrations use district the and Illustrations of of use district processes machinery differ- of machinery are well differ. This This is review of the whole of pneumonokoniosis and tuberculosis tuberculosis ship between tuberculosis prophylaxis and monokoniosis and and prophylaxis and treatment thirkidlogram per chemical investigations part details pulmo- pro- tissue investigations the presence the shows presence tin no silica iron aluminium aluminium estimation lead Quantitative gave of 10.9 kilogram the (no kilogram the summary need It It quite justice to per thousand ferric oxide abstract abstract itself justice an the paper since since in itself interpretation interpretation kilogram kilogram expressed 2.5 gm per as the un- complete summary kilogram tissue expressed and important important important contributions interested this field kilogram was 0.45 gm iron . ferric oxide 0.34 as iron the who interested interested in kilogram symptoms symptoms Anyone Anyone dust effects reference work resulting disablement disablement produced produced fibrosis of problem problem invaluable invaluable invaluable reference reference resulting disablement from fibrosis cardiac cardiac this The paper with bibliog- and consequent cardiac cardiac he raphy references references bibliog- a bibliog- mischief author author rightly demands detailed prophy- prophy- raphy raphy raphy references, lactic demands force measures measures should put industry industry MINERS reduce the sickness proportion wr follows follows from Orosco 1981 which employs large large proportion wiies follows from Semana Semana 1981 as reduce the sickness proportion proportion proportion to mR Semana m^'d., 1981, vol. in an industry which employs a large Proportion of Om ti & OF INDUSTRIAL HYGIENE e air nian ium con- sto- 467 468Bull June J3une8 no 10 pp 601-634 1931 vol 6 pp in in Bull . Hyg is a long article containing importance and con- interested in the nd subject The chiefchief features only to coli can be referred coli here whole whole like Caesar's description here Gaul ic is divided into three of imnatic presents partspTnehtuhe-e conditionmsaticconditions detail grinding a in considerable .11 conditions under which the industry the ils The workers use but dril s drills n the grinding except those engaged process later do not protecting the any Il ustrations use ent processes masks Illustrations district the mines and the differ- reproduced and machinery are well ing conditions , showing the actual work- conditions of the second part gives employees clinical histories The typical cases and clinical histories of QuantitaQutaintviteative of tin per 2.7 and estimation tin no estimation gave kilogram of the kilogram of the | ch an industry employs a large proportion of { ABSTRACTS 241 . the workingmen of the country A CASE OF PULMONARY ASBESTOSIS H. H. S. . H. E. Seiler and M. D. Gilmour Brit Med Jour June 27 1931 vol 1 pp Y PULMONARY ASBESTOSIS II IN- 1112 1114 CLUDING THE REPORT OF A Pure Case The pathologic findings are reported K. M. Lynch and W. A. Smith Am Rev. Tuberc June 1931 vol 23 pp 643-660 of a fatal case of asbestosis uncomplicated by pulmonary tuberculosis The man died aged 42 after twenty- In survey of all available literature three and fourth years of occupa- on the subject up to the present time tional exposure to asbestos dust in a _ we have collected 172 cases of pulmonary asbestosis There are references to this subject in one or two abstracts notably those of Bridge and of Sir Thomas Oliver but specific cases are not enumerated In four cases belonging to Wood's series the diagnosis was doubtful and in the majority of others the diagnosis was based entirely on clinical and roentgen findings There were twenty in which the diagnosis was confirmed by the finding of the asbestosis bodies in the sputum in the lung juice by puncture or by nec- textile mill Death was due to cardiac failure secondary to back pressure from massive generalized fibrosis Before death cyanosis was pronounced and diffuse fine mottling of a silicotic type was detected on ray The macro- scopic appearances were typical of dense pulmonary fibrosis with other organs secondarily affected heart nutmeg liver and indurated spleen and kidneys The fibrosis was generalized with no nodules or whorls as in silicosis no polymorphonuclear cells were to seen in the bronchi or ropsy Necropsy has been made on elsewhere Asbestosis bodies were eighteen cases In three of these the disease was complicated by pulmonary tuberculosis three by lobar pneumonia three by bronchopneumonia and one was a traumatic death In abundantly present and also a great deal of yellow pigment in the form of granules and globular masses No tuberculous lesions were found.E. L. C. four the authors failed to give a com- plete report stating only that the THE FORMATION OF THE ASBESTOSIS necropsy confirmed the diagnosis Including the very first case recorded that of Murray in the Charing Cross BODY IN Tubercle 399-401 THE LUNG S. R. Gloyne June 1931 vol 12 pp Gazette of 1900 which apparently received little attention until resur- Pictorial presentation is given in this short note of the formation of rected by Cooke there are now four records of necropsy on uncomplicated pulmonary asbestosis Except those asbestosis bodies They appear to be formed by the deposition of some organic material around an asbestos reported by ourselves and those by Pancoast and Pendergrass and four others by Simson from South Africa these cases have all developed in the British Isles Authors Summary fiber this material then fissures or cracks giving rise to the appearance of segments finally fragmentation from the asbestosis body may separate portions There is evidence that iron 242 THE JOURNAL OF INDUSTRIAL HYGIENE is a component of the material de- posited on the inhaled fiber During the reaction which takes place solution of a fraction of asbestos occurs but evidence is lacking as to how the long . asbestos particles which are far longer than the diameter of a dust cell are introduced into the pulmonary tissues ; -E C. SILICOSIS T. H. Belt Canadian Med Assn Jour Dec. 1930 vol 23 pp 802-804 This is a general discussion of silico- sis and of the various theories as to the method of action of silica dust in the lungs C. S. DIAGNOSIS OF PULMONARY SILICO- PNEUMONOCONIOSIS THE DE- LAYED DEVELOPMENT OF SYMPTOMS J. A. Britton and J. R. Head Jour Am Med Assn June 6 1981 vol 96 pp 1938 1939 Most clinical and statistical studies of silicosis have been made on groups of men still employed in dusty trades From such statistics one cannot say what is the late effect of short exposures In this paper we have reported four cases of silicosis or silicosis and tuberculosis which developed many years after relatively short exposures These instances suggest the necessity of revising the conception of the length of exposure necessary to produce the disease and make it seem probable that after relatively short exposures suffi- cient dust must be deposited in the SIS C. Garin Abstr as follows from Presse m^'dApril 18 1931 vol 39 p 568 in Jour Am Med Assn July 11 1981 vol 97 pp 143 144 Garin states that most of the authors cited by him reported cases licosis in which tuberculosis was present None of them attempted to bring out the differences between the two condi- tions He stresses mostly the roent- gen side of the question In his roent- gen studies he found that about 85 per cent of the cases are those of a granular silicosis He believes that the granular aspect of chest roentgeno- grams is not positively that of pure silicosis and it should not serve as an exclusive base for diagnosis of silicosis The diagnosis between simple silicosis with a granular picture and pulmonary tuberculosis is however easy the lungs to set up a progressive fibrosis which only after many years becomes patients with silicosis have no fever and the condition is progressive On sufficiently extensive to produce symptoms They tend to indicate that the other hand diagnosis becomes almost impossible in cases of silico- men in the work develop symptoms only after many years of exposure not because that length of exposure is necessary but because it takes a long time for the disease to develop -Authors Conclusions tuberculosis in which the tubercle bacillus interferes with the develop- ment of a pure silicosis In such cases it is impossible to pronounce the pa- tients sick with silicosis or with pure tuberculosis One can only make a diagnosis of silicotuberculosis F INDUSTRIAL HYGIENE de- ing ion but ong ger are Cs | F Canadian SILICOSIS. T.T. H.H. Belt. Canadian Med Assn Jour Dec. 1980 vol 23 pp 802 804 This is a general discussion of silico- sis and of the various theories as to the method of action of silica dust in the lungs C. S. DE- DIAGNOSIS OF PULMONARY SILICO- SIS C. Garin Abstr as follows from Presse m^'dApril 18 1931 vol 39 p 568 in Jour Am Med Assn July 11 1981 vol 97 pp 143 144 Garin states that most of the authors cited cited licosis by him reported cases in which tuberculosis was present None of them attempted to bring out the differences between the two condi- tions He stresses mostly the roent- 0- gen side of the question In his roent- gen studies he found that about 85 per d cent of the cases are those of a granular silicosis He believes that the granular aspect of chest roentgeno- grams is not positively that of pure silicosis and it should not serve as an 1 exclusive base for diagnosis of silicosis The diagnosis between simple silicosis with a granular picture and pulmonary tuberculosis is however easy the patients with silicosis have no fever and the condition is progressive On the other hand diagnosis becomes almost impossible in cases of silico- tuberculosis in which the tubercle bacillus interferes with the develop- of a pure silicosis In such cases imtentis impossible to pronounce the pa- tients sick with silicosis or with pure tuberculosis One can only make a diagnosis of silicotuberculosis ABSTRACTS 243 OCCUPATIONAL INFECTIOUS DISEASES OCCURRENCE , TREATMENT AND PREVENTION CASE OF ANTHRAX IN MAN C. * ciation with pneumonia He describes j Rasch Abstr as follows from Ugesk f the postmortem appearances of two i i Laeger March 19 1931 vol 93 p 307 miners who had died of this In addi- i in Jour Am Med Assn June 18 tion to the ordinary signs of pneumo- 1931 vol 96 p 2080 nia he found throughout the lungs Rasch reports the case of a man on extensive deposits of foreign material whose hands two lesions developed rich in manganese which had led to after he had handled a cow with an- fibrosis of the lungs thrax A scraping made under the He considered that his findings crust on the larger plaque when together with the clinical experience of stained with methylthionine chloride the medical men in the district of Gies- revealed numerous typical anthrax sen where the manganese ores are bacilli This result is almost always mined explained the prevalence of the obtainable he says if examination of pneumonic symptoms but the classical untreated primary anthrax is made symptoms of chronic manganese poi- during the first three days Treat- soning are unknown in the district in ment with 0.75 gm of neoarsphen- question M. L. amine three times daily at intervals of from three to five days together with VIOLET RADIATION AND RE- hot local applications was followed by SISTANCE TO INFECTION INTRANASAL rapid recovery K. D. INFECTION WITH THE PNEUMOCOCCUS AND WITH BACTERIUM LEPISEPTICUM PNEUMONIA IN BROWN IRON ORE MINERS Schopper Abstr as follows from Arch f Hyg Sept. 1980 vol 104 pp 175-188 in Bull Hyg April 1931 vol 6 p 322 In this paper Schopper after referring to the recognized peculiar symptoms of chronic manganese poisoning has followed up the other aspect of its action namely the asso- IN THE RABBIT M. Hardy and J. Chapman Am Jour Hyg Jan. 1931 vol 13 pp 255 280 Exposure of rabbits to direct sun and to artificial radiation from a mercury arc had little or no effect on mortality rate and on resistance to pneumococcus and Bacterium lepisepticum infection and little effect on blood counts and antibody formation P. Y. OCCUPATIONAL AFFECTIONS OF THE SKIN AND SPECIAL SENSES DERMATITIS FROM CELLULOSE VARNISHES J. Rousset M^'ddu travail May 1981 vol 3 pp 76 82 The occurrence of outbreaks of skin 1 troubles in a furniture factory led to investigation of the composition of the varnishes used The composition of the fluids used for filling and for clean- ing the wood and for diluting the varnishes is given These fluids con- tain a number of volatile grease sol- vents Experiments by applying them to the skin failed to reproduce the condition which occurs in the workers but wood vinegar and benzene two of the constituents did cause some ery- Vol 13