Document 99E6OBBbRrmnOZ8rjq9G2Lwve

FILE NAME: Metropolitan Life (ML) DATE: 1949 DOC#: ML158 DOCUMENT DESCRIPTION: Dr. Abrams Report on Trip to Johns-Manville Diatomaceous Earth Plant with Discussion of Medical Policy & Pneumoconiosis Cases SUBJECT! Trip to Santa Barbara County Health Department and JohnB-Kanville DiatomaceouB Earth Plant at Lompoc, on June 16 and 17, 19^9 1EPOBTER: Herbert K. Abrams, M.D. Chief, Bureau of Adult Health Health Department; Conferred with Dr. I. 0. Church, Health Officer of Santa Barbara County Health Department, and Dr. 1 T. Buaby, Chief of the Tuberculosis Section of the County Health Department, The Health Department has no eig~ nlfleant data concerning the Johns-Manville Plant. They have no records on tuberculosis morbidity in this area, as they have never done a survey. About once a year the County Tuberculosis Association stations a miniature X-ray unit in Lompoc, but only relatively few persons in the community avail them selves of the opportunity. Dre. Church and Busby will send the Bureau data on tuberculosis mortality for this area, but their impression was that It was not excessive. Dr. Church at first expressed the opinion that the tuberculosis mortality in the Lompoc area was lower than that in other parts of the county, but later retracted this statement. He has not seen the plant for three years a n d was glad of the opportunity to see it again. The Health Department is at present doing a aerology survey of the employees of the plant. There is a branch office of the Department in Lompoc, Vhere several persons including a sanitarian and nurse are stationed, Johne-Hanville Plant: The entire morning of June 17 was spent at the Johne-Manville Plant In Lompoc, Dr. Church and Dr, Busby accompanied me. The first part of the morning was spent in conference with Dr. Walter Anderson, the physician who is employed part-time by the company* Dr, Anderson ordinarily spends one fcour in the morning at the plant, and is available for emergencies. He is a general practitioner In Lompoc and has been plant physician for several years* There ie also a full-time nuree, who works during the day. The mill is a 2U-hour operation, and emergency first aid materials are available in the event of injuries at night. Our conference with Dr. Anderson took place in the X-ray room of the medical department. A short time after we had started our dis cussion, Mr. Legge, industrial relatione manager for the plant, came in and stayed for the remainder of the conference although the conversation was almost entirely devoted to medical and clinical aspects* The medical policy of the plant is as follows: Every applicant for employment receives a pre-employment chest X-ray, Interpretation of the films is quite stringent and persons are rejected if suspicious lesions are found. All employees receive an annual chest film and a close-out film upon termination of employment. Ho other laboratory procedures are done vdth the exception of blood and urine procedures on selected employees. With regard to the pneumoconiosis caused by diatomaceous eaith, the following salient points were brought out at the conference: 1. Employees are exposed to the dust from diatomaceous earth in MET-0000349 t r i a l exhtb m - 2- various forms: the crude powder; the so-called "natural8 powder; the calcined powder; and the dlatomaceoue earth which is calcined and fluxed with soda ash to form several materials including glass, trydimite, and crystobalite. (There 1 b also the possible exposure to silica containing duBt from the clay used in the manufacturing of synthetic bricks.) 2. There are two major typee of pneumoconiosis which result; (a) the linear and (b) the conglomerate. The linear type, apparently resulting from ex posure to the crude powder only, 1 benign, apparently causing no disability. Pathologically, it is characterised by a Tenon* vascular fibrosis. The conglom erate type is malignant, being progressive and eventually fatal. Pathologically, there 1 a callular fibrosis, hyaliniiation and necrosis. In this type there occurs a central hilar contraction of the lung tissue with resultant emphysema and blebs In the periphery of the lungs. Hr. Anderson described the stages of dlatomaceoue earth pneumoconiosis as: P^, Pp, P,^ and then conglomeration. P-j is the etage of reticulation and at this point It resembles what is seen in Berylliosis. 3. Dr. Andersen still feels the crude dlatomaceous earth 1b harmful than the processed material, but ie less strongly convinced of this than formerly. In any case he believes that most of the employees at the plent are exposed to more than one type of duet and the question is largely academic. He has seen many cases with the linear type develop the conglomerate type and is upable to account for the precise cause of the change, less b* Dr, Anderson has already seen about five case* of pneumoconiosis from dlatomaceous earth complicated by tuberculosis. Be mentioned one such case had died Juet the veek before our visit. He therefore 1# beginning to question the old concept that dlatomaceous earth pneumoconiosis is resistant to tuberculosis. Dr. Anderson mentioned that he end Dr. Smart will probably soon ppbllsh their long-awaited article on the subject In The Journal of Industrial Hygiene and Occupational Medicine. Tour of the Plant; Mr. We were taken on a tour of the Legge. Most parts of the plant were a plant by Mr. Westmont, the seen in cursory manner. Manager, and Unfortunately, by the time we arrived at the mills, they were closed down for lunch and were therefore not seen in operation. The following improvements may be mentioned: 1 Mr, Westmont stated the company 1b trying to develop some system for ventilating the cabs of the large vehicles which scrape and dig the diatomaceous earth out of the ground. One such vehicle already has an experimental ventilatedcab. 2. Paper bags with a Bpecial type of flap opening are now used exclusively, with the exception of the material which is used for special pur poses by the plant itself which is bagged in cloth sacks. There seems to be quite an elaborate system of local exhaust devices for eliminating the dust in connection with sacking operations. 3 saw a newly constructed building containing lockers, ahcwers - 3- and lunch tables and chalre for the employee of the mill, (Apparently there le no similar arrangement for the other employees.) Numerous employees were J ohserved eating their lunch at their work place. "\ In general, the mill appeared to he in good housekeeping order. (The tunnelB and glory holes were not seen closely.) 5. (The conpanfr has now removed all employees who were formerly living on the premises of the plant to a housing project Just completed in Lompoc. The company has built seventy-two small frame houses which axe available to the employees either hy rental or sale. Dr, Smart later pointed out that this move was motivated hy his diagnosis of dlatomaceous earth pneumoconiosis in a young man whose only exposure to the dust was by virtue of having resided on the premises of the plant. (Dr. Anderson says (diagnosis not The plant now employs approximately 500 persons. Of theses about (definitely 87 work in the mines and quarries; 125 lu the mills; 15 in the brick His;(made. Hoti 150 on maintenance and repair; and about 100 who are engineers, techniciens(for moving and office personnel. All are males, with the exception of 9 women who work(ytE not t in the plant and 15 in the office. About 20$fa of the employees are Mexican, (but for There is an 85# annual turnover of employment. (improving (housing. Suggestions for Future Work: ( HEA) 1. It is suggested that a community-wide miniature film survey be done on the entire community of Lompoc, The town'1 population 1 about 5*000 This was discussed with Drs. Church,Bushy and Anderson. Dr. Anderson felt that such a survey would be very useful in giving some idea of the extent of chest pathology in the area and in uncovering possible old caBBs of dlatomaceous earth pneumoconiosis While Dr. Church was not so enthusiastic about the idea, he felt that it could be done If we believed it advisable. This Idea was also discussed with Dr, Smart and Dr. Oechsli, and both are enthusiastic about it. It is suggested that miniature films be used for screening and follow-up with lU" x 17s films, 2. A complete engineering survey of the plant Bhould he done hy the Bureau of Adult Health. No 6uch study has been done here since 19W*. Since then many change* have taken place and the time is now appropriate for a thorough check. If po66ible, the engineering findings should be correlated with the medical data, both that uncovered hy the Burvey suggested above and the medical data in Dr, Anderson's files. Dr. Anderson will welcome such a Btudy and suggested that when we want to do it we should communicate with him, Dr. Smart also felt such a study would he desirable, (On the Monday, June 20, following my visit to the plant, Mr. Bush in Los Angeles received a call from Mr, WilBon, of the Johna-Manville Plant, requesting him to come up for con sultation on dust collecting end counting procedures.)