Document 8R56pOjgLva99zzYM6LpKdJDK

FILE NAME: Abex (ABX) DATE: 1948 Feb DOC#: ABX242 DOCUMENT DESCRIPTION: Industrial Hygiene Newsletter Article - Some Thoughts on Silicosis O e 8, N u m b el iarv 1948 Sme Thoughts on Silicosis consideration of th e se facto rs is essential before aw ards for disability, based on vague roentgenographic shadows an uncertain exposures, should be granted L. E. H am lin, M. D ., American Brake Shoe Co. OTm ' m ore u n re la te d conditions whose X -rav appearances closely Svsteius whi istalled on s*lnlgiiicosis. jj^thaps m ore th a n an y o th er ( to have resull1I-, ^,i;+tiinoTnl. h a s d em o n stra te d th e inex- aiirr ad u cnts, h i t4ill" itude 'of diagnostic standardsi a t U nfortunately, th e experience of the last few years does no t ^ s t a n t i a t e this rosy outlook. Trem endous advances have been m ade in controlling the silicosis are recognized, the unreliability of the roentgenogram alone as a diag tic m easure becomes obvious and accur ate in terp retatio n is correspondingly In order to * 4 ,,,,,,trol. it I kPoftioGnaarlddniesreaasned. For other investigators hazard b u t knowledge of often ^ T s d tu a tio n of this kind points out the control, it seem s to be lacking, especially m those ' necessity of accu m u latin g facdual1 d a ta i m ethod of f shown th a t, fa r from being fa ta l th e q u a rte rs w here it is m o st , u.rqf 3 on exposure through industrial hygiene 1 g system i r noted form is nondisablm g needed. Physicians, m dustnal a surveys. Such appraisals m ust include p p a n y engim ^ept^in extrem e degrees of fibroses. otherwise, still m ake a d m * * * o enough sam ples to be tru ly rep resen ta \ th e bulk of ;eT e has been so m uch inten siv e stu d y occu p atio n al fibrosis because of th e tiv e T h ey should faith fu lly p o rtra y at. each mac silicosis th a t it m ig h t a p p e a r t h a t ch est X -ray p a tte rn a n d /o r a ^ sto ry a c tu a l w orking conditionsi and^ en v iro n vclone qd u sti "se"jit-ileerreemmaaiinnss tioo bi *e done-. C om-placency em p lo y m en t in a supposedly d u s tj m e n ta l hazard s. One should n o t be iiains and s e c o ting to boredom h a s crep t m to in d u stry . N o consideration is given to concerned so m uch w ith the am o u n t of re thus reliev e* picture, an d on occasion speale the fact th a t dependable estim ations o visible d u st in the atm osphere of a trouble-free o p | ougsing th e su b ject h av e been m ro- respirable sized particles of dangero . w orking place as w ith th e n u m b er of svstem lias b i ed ,vith a n o te of apology for b u n g dusPt an d safe atm o sp h eric co n cen tra " oramb l actually reach harm ful particles th a t aotu J , joi.ing very s a | such a shopworn, dusty to p - tions have been established. T he P a n t th e alveoli of the lungs an d are retained. Ifew individuals im bued w ith un- physician is frequently unaw are th a We have seen reports of plant survey ld u strial solvei Itified optim ism h a v e even, p re d ic te d such sta n d a rd s exist a n d m an ag e m en t w here obviously th e h y g ien ist h as been m m ended by I t since we have learned everything has been lax in bringing th e m a tte r t too im pressed w ith visible d ^ t aroun e verv nuiuGicjL t silicosis, th e ap p licatio n of m odern h t* a tte n tio n . In d u s tria l compel-- a shake-out where careful analysis is presented: jthods of control will soon m ake th e commissions need to be rem inded th a t revealed m ostly smoke, steam , an a n t m anufactu' lease an o th er vanishing e n tity . Irtio n with (ree > t a te n ta tiv e dei below accepted safe lim its. T his sam e u for this operal C H EST C O N D in O N S W H O SE X -R A X S S I M O N E S .U C O S .S individual missed a really serious du t m it for appro' sting ab o u t 12,1 m inute from m achines. Al ie operation, O rganic- design emploij ic feet, w hich vl t only in clfeci Inorganic ,t vapor b a z a r ing production. tions are Indies Inert ie div ersity of e presented to solution in re Toxic Proliferative ,n w ith th e exal of ventilation pll h e a lth hazards] [M ycotic----- al of 2,600 ventj nitted io our el e 2,587 p lan s wl| )51 were ap p ro ! Yeasts and Molds workom at. I ^MMiscglla-ngovis-- jeted thereby i | t.o noxio"" d il phis plan examl ated 1,707 p i ,f the ventilal tion and for jem ent. A. Industrial hazard where free silica was P ^ e n t high concentrations b u t was not evident (a) Byssinosis. because the general atm osphere P (b) Bagassosis. (c) T abacosis. (a) Anthracosis. _ (b) Radiopaque D eposits-- ('Barium (Baritosis). i Iron (Siderosis). VTin. vS" ` ' f " has been given to nodular p attern s observed in th e X -rays of w orkers ex posed to significant concentrations of fron dust. Reports from this country and abroad have shown th a t such_ex (c) B eryllium . (d) Asbestosis. B. N onindustrial (a) Aspergillosis. (b) M oniliasis. (c) W ood d u st spores. (d) Coccidioidom ycosis. (e) B lastom ycosis. ows alm ost identical w ith thos silicosis even in occupations where tests d ate a practically complete absence of free silica in the a tm o s p h e r e ^ * * m ortem findings on some of the viduals h av e d e m o n stra ted deposits of iron particles^ m the lung wm itWtnh nenuho aevveidneontceed of si mfi.ib.laror sxais-,rraayy c h a n g&e s (f) A ctinom ycosis. (a) M iliary tuberculosis. in certain grinders (b) Sarcoidosis. (c) M itra l Stenosis. (d) Cancer (M tastass). (e) V ascular changes. (f) M iliary calcicosis (W heatcna) of time, the average being about Analysis of ^ ^ f x l y ^ i f f r a c t i o n , and^estim ations of p'article size an d per- (g) P o ly c y th a e m ia V ra. {C o n tin u e d o n page 16) (h) Bronchiolitis. 16 In d iisiril H ygiene N ew sletter V olum e 8, N u m b er 2 1 sat.ion law, injuries are reportable to the Industrial Accident Commission and are adjudged for compensation under it. The term injury as used in this law, in cludes any injury or disease arising out of employment, including injuries to artificial members. Legally, occupational diseases as such are not recognized, b u t under the defi nition of injury all occupational dis eases are covered. The law is th ere fore a complete coverage, or blanket, occupational disease, as well as injury, law. Since this law has such broad cover age, m any illnesses are reported which do not appear in the reports of m any other States. For example, m any in fectious diseases have been ruled com pensable when they have been con tracted by medical and nursing person nel from contact with patients. Upper respiratory infections contracted as a result of exposure to inclement weather, and tenosynovitis arc other examples. The term "com pensation" defines both treatm ent and indem nity pay m ent, a n d is fu rnished as follows: " Ail medical, surgical and hospital tre a t m ent including medicines, medical and surgical supplies, crutches and appara tus, including artificial members th at m ay be reasonably required to cure and relieve from th e effects, of th e injury." T reatm ent m ust be given for any in jury or illness arising out of the em ploy m ent although no indem nity is paid for the first 7 days of the disability. In as m uch as th e em ployer is liable for the im m ediate treatmfent and the law is well enforced, practically all injuries or illnesses are rep o rted . FVhen th e em ployee first appears for treatm ent, an initial report is sent to the Industrial Accident Commission by the attending physician or surgeon. The Bureau of A dult H ealth of the State D epartm ent of Public H ealth, through an agreem ent with the D epart m ent of Industrial R elations receives from th e la t te r 's D ivision of L ab o r S ta tistics and Research a copy of all injury reports which are considered to be occu pational diseases. These first reports are studied and followed up by the Bureau of A dult H ealth and each m onth sum m aries are prepared of all the cases reported. F o r several years 1,000 to 1,200 of these initial reports of occupa tional diseases have been received and studied each m onth. SILICOSIS-- (C o n tin u e d fr o m p a g e 5) centage of free silica indicates th a t the am ount of free silica of respirable size in the atm osphere is no t sufficient to produce the variations noted in the tim e indicated. However, there is enough iron oxide in the air to cause them . In an effort to determ ine whether this dust can produce silicosis we have been conducting experimental work a t the Saranac Laboratory for the past year and a half. Animals exposed to typical concentrations of particles col lected in the foundry cleaning room have shown no evidence of th e disease thus far. Moreover, there has been no tendency to activate tuberculosis in those anim als experim entally infected. The reaction resembles th a t produced by oth er in ert dusts. The stu d y will be coniinued for a t least another year when a com plete report will be made. I t is hoped th a t the results of this work will aid m aterially in the proper evaluation of occupational disease and discourage the diagnosis of silicosis based on im proper and inadequate claims. U ntil sincere consideration is given to the hygienists' findings, erro neous decisions are going to be m ade. Heretofore, the accum ulation in the lungs of dust particles below one-half micron in size has been considered of little consequence. Recent studies by H atch and K indsvatter, however, have shown very clearly th a t exposure to low mass concentrations of quartz particles, smaller than one-half micron, results in significant alveolar retention in test anim als and produces demon strable lung change in a relatively short tim e. I t is pointed ou t fu rth er th a t because of the known patho genicity of quartz w ith decreasing size, particles below one-half m icron m ay be of greater im portance in the etiology of silicosis th an is comm only thought. In this connection, the use of the electron microscope m ay well result in revision of much of our present thinking on the p a rt played by submicroscopic p arti cles in the production of occupational disease. The injection of recent observations into the study of silicosis should provide the stim ulus for more intensive research since th e problem is far from solved. While it is tru e th a t thei s still much j to learn ab o u t silicosis it should not be! assumed th a t definite standards for j diagnosis and control of the disease do] not exist. Present day m ethods which j take into account such essentials as a complete occupational history, accurate ' evaluations of exposure to respirable sized particles of harm ful dusts, ade quate physical gent interpreta examinations and intelli tion of satisfactory chest j roentgenogram s, have been very effec-3 tive in establishing the existence of this] occupational condition. Periodic em ployee health exam inations, including j chest X-rays, provide an efficient adjunct ] to engineering and hygienic control of| the hazard, while the sensible appliea-,1 tion of sound ventilating principles] will result in safe atm ospheres and] better places to work. R eferen ce H atch , F. T ., a n d K in d sv atter, V. H .: | Lung R etention of Quartz D ust Smaller] than One-Half Micron. J. Indust, j Hyg. & Toxicol., 29: 342-346, Septem -j ber 1947. EXHIBITS (C o n tin u e d fr o m page 14) purpose of the exhibit, the basic id eaJ the facts to be presented, the techniquej to be used, and a budget of the prob \ able expense. A preparatory sketch showing floor| an d wall space, p artitio n s, panels, electrical installations, color, and c a p " tions. All-inclusive copy of captions, ex-1 planatory m atter, charts, slogans, dia*| grams, and other w ritten, drawn, orj printed m atter. A budget showing probable prepara-1 tion, construction, and operation ex-| penses. While such a procedure m ay seem j rath er form al for some of the simple ex-i hibits set up locally, the beginning ex-1 hibitor m ight be surprised at the goodf effect achieved by the discipline of a] little paper work. A simple and usable bulletin for the! a m a te u r ex h ib ito r is E xhibits, How toj Plan and Make Them issued by the! N atio n al P u b lic ity Council, 130 E a s t| 22nd Street, New York, N. Y. (60| cents). 3 a>., o O I d> n 3o So CL CD XI >ca* E TcJr CO cao. o x> CD o L_ _2Q <CU o oQ) oo X(DI X3 CD Q_ OO <CTDOD Q_ O 2 tc E CD