Document DMBaw4joxV92aZVgZ8LrNeYJO

i m I- ' u '.m r , i 4ft-'- s H 10 4, Colored male, age 34; worked in asbestos plant 2 years and 6 months. His physician believes this was a case of uncom plicated tuberculosis. Was not inmate of hospital or sanatorium. No information could be obtained on the other two cases. Total and permanent disability claims: 1. Male, employed in asbestos plant 3 years. His physician states that he first came under his observation with an old estab lished case of tuberculosis about 2 years after asbestos employ ment started. Also had tuberculosis of the kidney nnd cervical glands. 2. Male, employod in asbestos plant 8 months. His physician states finding of old fibroid tuberculosis with tubercle bacilli in sputum. No X-ray available; but according to physician, as bestos bodies were found in sputum. 3. Male, 10 years' employment. Two physicians who treated him at different times are now inclined to believe this man is not tuberculous, but has asbestosis. 4. White male, was reexamined at time of investigation. His physician reports well nourished, husky looking, good color, no cyanosis; no clubbing of fingers; diminished expansion; incessant cough; X-ray shows fine mottling disseminated through both lungs. No evidence of tuberculosis. Probably a second stage asbestosis. _ 5. White male, 13 years in asbestos plant. Is now in sanato rium. An interesting case. His physician states that he has ex tensive asbestosis nnd pulmonary tuberculosis; cavity in right lung; sputum loaded with tubercle bacilli and asbestos bodies; believes tuberculosis long antedated asbestosis. This patient is progressing in a satisfactory manner. It was not possible to locate the other three cases of total and permanent disability who had been diagnosed as having pulmonary tuberculosis. On the basis of the information obtained, the deaths in death-claims cases appear to be due to uncomplicated tuberculosis; three of them were Negroes, who were probably tuberculous at the time their employment in the asbestos plant commenced. Of the 8 disability claim cases, 1 was uncomplicated tuborculosis and 2 were uncomplicated asbestosis who wero put on disability because of a mistaken diagnosis of tuberculosis. In this same com munity we know of one death due to uncomplicated asbestosis in an individual with many years' employment in tho industry.8 CONCLUSIONS 1. Prolonged exposure to asbestos dust caused a pulmonary fibrosis of a type different from silicosis and demonstrable on X-ray films. Clinically, from this study, it appears to be of a type milder than silicosis. 2. Cases of definite cardiac enlargement were frequently found to be associated with asbestosis. * Personal communication. 3. A predisposition to tuberc indicated in this study. 4. Asbestosis as observed in l marked disability in any cose. 5. It is not known how much of pneumonia and acute nontut 6. It is not practicable as yet t dust content of air. 7. Tho amount of dust in the . bo substantially reduced. HECOMX It is recommended-- 1. That tho industry seriously asbestos plants. 2. That new employees be ex examination of the chest, and re tuberculosis or pneumoconiosis. 3. That employees be examine but at least every 2 years, this examination of the chest. 4. That the industry sponsor s as well as studies on effects of ash ACKNOWi The authors wish to express tl aided in making this study possi ployees of the asbestos companies and gave every facility for securir, University of Pennsylvania, for 1 interpreting X-ray films, and to L States Public Health Service, sun Bureau of Mines Cooperative Ci pretation of all the X-ray films lis prcciation is also expressed to Dr. Lynch, of Charleston, S. C., for ir aa to the pathology of asbestosis;4 S. C.; to Dr. Joseph H. Wyatt, Fellows, of New York, for assist iDr. Paul O. Snoke, of Lancaster, Danville, Quebec, Canada; and to E. Cummings, of the Saranac Lab study of the pathological effects < 4 Asbestosis bodies In sputum and lung. By Kenr. /our. Am. Mod. Assoo., Aug. SO, 1930, vol. 95, do. 9, j