Document 8R6ebqe2V7YD9BaxZgdgvOebe

FILE NAME: National Safety Council (NSC) DATE: 1937 Oct DOC#: NSC189 DOCUMENT DESCRIPTION: Transactions of the NSC - 26th National Safety Congress - 2 Pgs - Industrial Tuberculosis - A Public Health Factor 326 Tzeenty-sixtli National Safety Coiu/ress Industrial Nitrsim/ Section If not it nil! probably lie best fur him to be advised of this fact at the outset and given assistance in securing rehabilitation voca tional training; after which he may return to his former place of employment qualified to o f these investigator- seem to point do some special work. In Ibis case he <LgEH T p s J i a - t h a t noxious fumes in g reat be given consideration tor reernploynicji^*- -fpirllion will produce im mediate irrila- He will be happy because he will ijj (tiOtlS ill the upper respiratory tract overcomnie a handicap and learned dllmuiCI jM |0 iuch serious complications of the can still be independent. O e d e m a , pneumonia and in some eases Industrial Tuberculosis-- A Public Health Factor B y H. J. S P E C T O R . B .S., M .D. A ssistan t H ealth C om m issioner and C hief of M edical Section, JJrif *fthepatient. : faitftttions on soldiers who were gassed lh world war, made by Metz, indi- #1 farther that noxious fumes, when in^04 Into the lungs, do not h a d to the fttfltyMncnt of either acute or chronic pul&Hrf tuberculosis in most instances, f r o m observations the writer is inclined St. L ouis H ealth D ivision, St. Louis, Mo. yitifre with this viewpoint. The term industrial tuberculosis is som e what misleading because it may be thought that industry is the direct causative factor in the production of tuberculosis. But tuber culosis is a germ disease, directly caused br ibe tubercle bacillus. No industry, no mat ter how h arm tu l it may be to the human body in general, is capable o f directly p ro ducing the disease tubcrcu|o-]s without the presence of tubercle bacilli. Tfow can we explain then the big Il moi tality rate from tnberenh in certain industries ? T o seek an answer to this question, one must consider the subject of so-called in some abrasive industries, is the presriirtf! I Improper Sanitation and V e n tila tio n inorganic dust in concentrated form (tmployces exposed to changeable tcmpvr- tam ing abnormal am ounts of pure to excessive moistures and working Industries like bard rock mining, qiumyI ! - iA Improperly ventilated and unsanitary grinding and sand blasting have ;i lijff Will expose themselves to the risk of morbidity and mnrtalitv rate from in', nm'ng their resistance, tints predisposing culosis attributable to ibis cause, ifmi'oi (SmUflves to the development of tubercuexposed to sueli an atmosphere ovvr .1 . m<< 4* well as other respiratory diseases. longed period of lime will develop -liur and the latter will h a d to the tlcvt'loyiMi' (octal and E c o n o m i c F a c t o r s of tuberculosis in mam instances. il I an accepted fact that tuberculosis Asbestosis is a disease similar to - heKf an infectious disease, is capable ot which may contribute to the morlmlit pftlh'lng and actually does produce active tuberculosis. However the evidence at u* <4retiloMs in people regardless of their cut in this direction is not convincin' Mil and economic rank, ft is also true TABLE 1 D e a t h r a t e s f r o m t u b e r c u l o s i s p e r 100,OUO K a i n i u l l y o c c u p i e d m a l e s 15 to 64 y e a r s o f ano i n M'lr c t o t l s t a t e s a c c o r d i n g to e c o n o m i c g r o u p s . d'MO) Tuberculosis (R espiratory Form) A verage, all occupations A v o ray r, professional Ktoiip Average, lawyers & judges Pk yricians ami surgeons A verage, proprietors. manattors & otiicials uX7.-I 12S..! MM 29.4 I t.X H a n k e r s , b r o k e r s , m o n e y Ien< lei's M a n a g e rs am i ofHcials Builders, building contractors Average, clerks & kindred workers Real estate agents Average, aericultural workers Averamr, skilled worker & foreman M oulders, founders, casters Policemen A verage, unskilled workers Factory & building construction laborers 272 33.1 u2.\ 2.8,S to.7 7 t. J 155.-5 4 P .IS .U 221.7 Average, servant classes 17V I Servants & cooks 15ri.-- W aiters tubcreuloMs in this economic y n m p heconu*'* a m ajor puhlic health problem. Miss Whitney's study was based on m o r tality statistics ol males only. Sonic iipduhi into the morbidity according to occuparimi can Ito had from a rcccttl Mtid\ thal wc have made in the St. Louis Health iVparimoni on dl.V'M reported cases of tu b ercu losis male and female as seen from thr dustrial tuberculosis from the broader aspect in general, but especially from the viewpoint 2. O rgan ic D u st #il poverty goes hand in hand with tuberfrttfl# and that most tuberculosis will be viewpoint of occupation. \Ye found in Table H that the occupation^ of possible existing predisposing factors in T h ere has been considerable discti"ini fotod in Underprivileged people. of o r bO per cent could be classified cidental to certain industries. T h e contribu to the role of organic dust in the preuliutal TM< fact has recently been confirmed u n d er H) m ajo r heads, while the remaining tory factors which m ay play a role in the o f tuberculosis. T h e high mortality < tWfolcilly by Miss Wliitn ev, who in a study 12,551 could be classified under o95 occupa development o f tuberculosis are many in from tuberculosis in tobacco workers. >1 Mforth rates by occupation reveals that the tions. U is inUwvstuvi to note that "hott-e- number, but for the sake o f clarity may be workers and tailors was responsible t"i tilled worker, the one who usually w orks classified under tw o main headings, f l ) early belief that organic, dust was .1 - hours and most often in an unventilated environmental, and <2 ) social and economic. Irihutory fac tor in the production of '>* *4 nnunitary environment, the one w ho TABLE II Environm ental Factors culosis. T he work of Landis of I'!jiladvlti--"* witty receives meagre compensation lor which is based on autopsy studies "I'* M kfvices, ha a very hiuh mortality raft* S h o w in g m /rttp a tin u s o f .11,900 re p o n e d fa -;'o f tu b e rc u lo sis in c ity o f S t. J,oui> (P b y i.jo .tl inel.) Industrial environm ent lias long been rec lungs of 50 patients wlm bad been rw" tuberculosis. On thy o th e r hand, thy 1 ognized as a most im portant contributory for many years to organic dusts, ili-l'i"1 WWtman who receive - a fair salary and . *tllWUaity out of doors with little pbysi- ru *' . 'T otal X . o f T u b e rc u lo s is C a se s T o t a l N o . o f O lcic u p a tio n s ,U,a'>U 705 factor in the causation o f upper respiratory (bis concept since none of these I'alin* ( . 0 % o f C a s e s in 10 m a j o r o c c u p a t i m i ' diseases. For instance it is k now n th at em showed evidence in their lungs ol gW Mtrtion has a comparatively lo w -death 41) o f C a s e s in <'>' r e m a i n i n g o c c u p a t i o n ' ployees in dusty trades, and those usually tuberculosis. At the present time it is i1* j ^ t While the lawyers, the judges, the 1. H o u sew o rk 7651 d exposed to high tem p eratures, excessive (rally held that organic dusts do not prod** "**** and the manufacturers, representa- U n s k ille d labor 5 1 1`> moisture, to bad weather conditions gen erally, and to noxious fumes are among the disabling disease of the lungs and arr predisposing factors in the developin'111 |Ni i f the higher economic bracket (if so- Wy, have the lowest death rates as seen in 3. C lerica l w ork 4. S hoe w orkers . Porters 23H 883 661 8791 or tSf, o f people in the ten t w orkers who frequently are forced to absent tuberculosis. TMMCTOmpanying table. wTftijat public health interest is the fact 6. W aiters & Cooks 660 7. T eam sters 639 m ajor u u u i'im ...... either did h ouse work or handled themselves from their employment because of sickness. 3. N oxiou s Fum es V'tlg^fervant, the cook and the waiter, 8. S a le sm e n 519 516 food. 1. In o rg a n ic D u st The effect o f noxious fumes on the ^vltives o f the lower economic rank, 190.. SLtauudnednrtes sses 480 Sally high mortality rates. Since and their relation to tuberculosis has ^represent frequent sources of T otal J 41 One o f the most serious environmental studied by W intcrnitz o f Yale. Metz oi $}p,,community, the control of factors existing, especially in the mining and U. S. Veterans Bureau and others, iM