Document DdGZZr9Ep4jgbeOqZjDgkN46O

FILE NAME: Owens Illinois Library (OWL) DATE: 1956 DOC#: OWL045 DOCUMENT DESCRIPTION: Archives of Industrial Health - Many Abstracts Related to Studies of Asbestos and Illness *- \ I \ ; ! i V o l u m e 13 1956 PUBLISHERS AMERICAN MEDICAL ASSOCIATION CHICAGO 10, ILL. ur*a), h-, -n";!, a h w a r. ES OF IND U STRIAL HEALTH usual a t autopsies; (2) by reexpanding e: (3) by clamping the trachea before matin before section. An experimental at had received intratracheal injections sed for preparing the lungs for section, es between the form and arrangement 1and those in lungs prepared by other i. the vast majority of dust cells were frequently found over the phagocytes ! animals that survived, a considerable and the lymph follicles were almost ked with carbon-filled phagocytes or gocytes were nearly always adjacent e appearances suggest that, over the positions and show no evidence of . an epithelial lining had formed over :he 11 photomicrographs, in which a ing phagocytes. Ilapse with those where collapse has dust-containing phagocytes is within ley are not dislodged during respira- lining of phagocytic cells, which, in >wn; deposits of dust thus formed the majority of anthracotic foci are ial tissue or in the lymphatic system :. L. M iddletox [B ull. H yg.J. \ rasites. G. Declercq, E. Balliere (Xo. 28/29) 8:3-5, 1955. ed by intense itching and showed and sweating. The shoulders and the trouble to contact with wood . the irritating spots persisted for ,>ed the irritation temporarily. The easuring 1 to 2 mm., rather like a ids. It was one of the numerous 929]). The place of origin of the having to deal with such infected epidemic. E L. Collis. r. Barsotti and L. P armecciani, ttion realized in the past 10 years ' has been observed among pyrite itional origin are still frequently I and rock, sulfur dioxide can be slow oxidation of the mineral in the mineral is highly brittle and during the explosion of mines. 1-2 ppm, now and then reaching exertion and. particularly, when signs; with the passing of time cheal irritation are frequently t the broncho.vascular network, peribronchial-type reticulation he basal median regions. After markable improvement of the ABSTRACTS FROM CURRENT LITERATURE roentgenological picture, but the clinical conditions almost always remain the same. Pulmonary tuberculosis is seldom associated. With regard to occupational insurance in Italy, such disease should be recognized as caused by sulfur dioxide (Item 18 of table dated Xov. 15, 1952) ; miners would thus profit by manifold benefits, such as being entitled to a compensation in case of perma nent disability starting from a 21% decrease of the working capacity: they would be better treated, and, above all, they could get rid of the fear of silicosis which at present is often mis taken for chronic occupational bronchitis. Criteria for forming the differential diagnosis are analyzed, and suggestions are given for prophylaxis and treatment. F rom t h e A uthors' S umm ary. Incidence and C haracteristics of L ung Cancer in A sbestos W orkers. G. J acob and M. Bohlig, Arch. Gewerbepath. u. Gewerbehyg. 14:10-28, 1955. This is a study of the incidence of lung cancer among asbestos workers in Dresden, with numerous references to and analyses of the literature. Cancer of the lung developing in asbestos workers is not recognized as an occupational disease in W est or East Germany. The interna tional literature is based exclusively on the results of autopsies; the incidence among asbestos workers appears to vary between 12% and 17%. In Dresden, however, from research into cases at the clinic and among asbestos workers, it appears to be a rare occurrence. It is estimated that only about one-fourth of these workers have an effective exposure to the dust. In cooperation with the roentgenological and radium institutes the authors reviewed the cases of asbestosis reported since the middle 1930's ; they numbered 339 in all stages ; in the first stage, O-I, there were 42 women and 61 men ; Stage I, 43 women and 74 men ; Stage II, 32 women and 61 men; Stage III, 13 women and 17 men. Silicosis was found in eight men. In 5 women and 10 men active, open tuberculosis was found; in this series the incidence of active tuberculosis was 4.4%. Four fatal cases of lung cancer in asbestos workers, which occurred in Dresden up to 1954, are described. The first patient was a woman of 46, who had been employed for three years, when young, as an asbestos weaver; autopsy showed typical asbestosis, with asbestos bodies and with squamous-cell epithelioma of the right middle-lobe bronchus; no mtastass were found; the asbestosis was not diagnosed during life, the roentgenological changes in the lungs having been regarded as due to congestion. The second was a man of 49, an asbestos weaver, in whom abestosis was diagnosed roentgenologically, with a tumor in the left lower lobe and one in the right radius ; autopsy showed asbestosis and bronchial adenocarcinoma, with transitional squamous-cell epithelioma in the left lower lobe, mtastass, and a caseating tubercu lous lesion in the left lower lobe. The third was a woman of 57, who had worked in asbestos, between 1922 and 1930, for three years as a molder and five years as a weaver; she died in 1954; there was a definite asbestosis and a solid, spreading carcinoma of the right upper-lobe bronchus, with infiltration of the lung parenchyma and widespread mtastass. The fourth was a man of 66, who was known at the clinic as an asbestosis patient, diagnosed roentgenologically five years before; he had been employed in asbestos as an opener from 1927 to 1930 and as a spinner from 1931 to 1948; autopsy, in 1955, showed a right-side bronchial carcinoma, with widespread mtastass in the lymph nodes, liver, and skeleton. A long discussion of the literature on cancer among asbestos workers includes an examina tion of the characteristics of the disease; the duration of exposure to asbestos dust and the latent period between exposure and diagnosis of cancer; the localization of the tumor, char acteristically in the lower lobes; the histological nature of the tumors, the cell types and struc ture, and the statistical evidence. These characteristics are no longer convincing evidence of a high incidence of cancer in asbestosis. In the future, cases of cancer of the lung in asbestosis should not be published individually but should always be considered in the framework of the whole asbestos industry in the region. E L< M iddleton [B ull. H yg.]. S pontaneous F issuring i.v Joints in Caisson W orkers. P . D ak, I. Rzsaiiegyi, and J. Dvai, Acta med. Acad. sc. hung. 8:125-131, 1955. In the course of the medical investigation of 195 caisson workers, most of whom were healthy young men between 25 and 30 years of age, x-ray examinations of the knee joints were also made. In 25 of these x-ray pictures taken in the anteroposterior position, sickle-shaped translucent streaks were seen between the mesial condyles of the tibia and femur, following the contour of the femoral condyle. In some instances, instead of a continuous streak, a few tiny, pearly, translucent areas were noted. These appearances are considered to be caused by 615 ES O f INDUSTRIAL HEALTH .uditions, no evidence was forthcoming >f the benzene products in the workshop E. L. Collis. .ganese. J. R odier. Arch. ntal. profess. tect, if possible, definite changes at an te that poisoning was starting before .n of how advanced were the clinical causing the toxemia.) Xo important d, but the phenolsulfonphthalein test hepatic function was hardly modified, ny definite result. Tests of endocrine e was a diminution of the elimination The blood picture showed a definite blood cells was also present in 44%. lical signs in speech and gait, should etabolism, and in the elimination of E. L. Coi.ws. & :osis. A. P olicard and A. C ollet, i i A; e sputum and in the lungs of cases -y occur also in anthracosis. These -- broken ends of asbestos fibers. But 1 any part of a coal fiber and not photomicrographs. the surface of coal particles. The |. in undetermined. Their occurrence > equency of processes of absorption individual miner. E. L. Collis. ION AT t h e B eg inning OF 1955. t d'Hygiene des Mines 10:1? v im - information regarding dust sup* in an appendix. T he information ley tell how dust control is being nd, by wet drilling, by capturing ssages or using hygroscopic salt k thereafter is also described, hat, on the whole, improvement be done to bring all dust under E. L. Collis. N EDIAMINETETRAACETATE. A. tor 45 days with daily 2.5 gm. "b excretion, decreased copro1 level in one patient decreased >gical values during treatm ent d cells and the coproporphyrin ntration had increased, while [C h em . Abste.J. ABSTRACTS FROM CURRENT LITERATURE S ilicosis H azard in th e W orking of Clays. L. P eretti and E. Occella, Med. lavoro 45:700-714 (Dec.) 1954. The joint authors of this paper are teachers of mineralogy and applied geology and of petrography and mining. They discuss the formation, the chemical composition, and the molecu lar structure of a variety of clays and clay-containing minerals which are used in such indus tries as brickworks, potteries, foundries and in the manufacture of refractories and of cement. In judging the .silicosis hazard of handling such clay materials, their various properties have to be taken into consideration; such are the content of free silica, more particularly the crystalline form, the size of the particles, and their liability to be easily given off and diffused and to be inhaled by those working in the affected atmosphere. The minerals with which the authors are here concerned are sedimentary formations which were derived originally from primary rocks by processes of erosion, transport, and settling, in the course of which they may have acquired an increased content of free silica. The paper discusses various types of mineral concerned and its association with other geological formations, its origin and development, as affecting the original and the final content of free silica. Because of the fine structure and complex composition of these clay materials, their chemical and petrographic analyses are often not sufficient for an assessment of their likely role in causing silicosis or other pneumoconioses; additional determinations (thermal, x-ray, electrolialytic, and other techniques) may have to be undertaken. Clinical and other evidence suggests that the property of free silica of causing fibrosis in .he lungs is enhanced when certain hydrosilicates are associated in the atmospheric dust. J. Caicchi ( B ull. H yg.]. A sbestos and P ulmonary Carcinoma in a n A sbestos S p in n e r : N otes on the I nduction ok I.ung Cancer by A sbestos F ibers. G. R ombola, Med. lavoro 46:242-250 (April) 1955. The first case of pulmonary carcinoma occurring in Italy in a subject affected by slight .sbestosis is described. The malignant neoplasia was observed in a woman, 49 years of age. vho for 29 years had worked as a spinner in an asbestos factory. The diagnosis formulated in :ie was confirmed by postmortem examination, the gross and microscopic findings of which ire briefly reported. The present clinical, pathological, and statistical knowledge diagnosed on be capacity of asbestos to cause tumors is summarized. A tumor should be diagnosed as occu pational in nature only when the statistical data correspond with the experimental researches. A'hile there are many statistical data (though not agreeing for all countries), experimental .searches are few and are not concordant. According to the author, a hypothesis should be adopted whereby the capacity of the different types of asbestos to cause tumors would differ according to their chemical composition. F rom t h e A uthor's S ummary. i'.KFEcrs of O xygen I ntermittent P ositive- P ressure B reathing in C ases of S ilicosis and in Cases of E m physem a w it h S evere R espiratory I nsufficiency. E. S artorelli, Med. lavoro 46:411-418 (June-July) 1955. The effectiveness of the oxygen intermittent positive-pressure breathing was studied experi mentally in seven silicotics and in six cases of emphysema with severe arterial anoxemia by means of two devices fitted with tightproof oronasal masks (Bennett's apparatus and Pneophore M.S.A.). Oxygen was given with a spectacle-type nasal catheter for control experiments. Blood oxygen saturation was measured with the "Cyclops" oximeter during oxygen inter mittent positive-pressure breathing and oxygen therapy with nasal catheter. Experiments have shown that in all patients affected with lung diseases, who during breathing "i atmospheric air presented blood oxygen saturation rates varying from 55% to 89% according tn the subject, oxygen intermittent positive-pressure breathing with Bennett's apparatus or with the Pneophore gives way to complete disappearance of the arterial anoxemia, while the oxygen therapy by means of nasal catheter, though producing a more or less evident reduction of the arterial anoxemia, has in no case led to increases above 95% of the arterial blood oxygen saturation. Results obtained show that oxygen intermittent positive-pressure breathing, for its effective ness in cases of lung diseases with severe respiratory insufficiency, should be preferred to the common oxygen therapy with nasal catheter as a method for the administration ot oxygen. F rom the A uthor's S ummary. 505 A. M. A. ARCHIVES OF INDUSTRIAL HEALTH ABSTRACTS FROM Cl regarding the normal blood pictures under varying conditions, no evidence was forthcoming that the changes were affected by the low concentration of the benzene products in the workshop air- E. L. Cot.u>. S tudy of B iological Changes in P oisoning by M anganese. J. R opier, Arch. mat. proto-.. 16:435-442, 1955. A study was made of 151 cases of manganism to detect, if possible, definite changes at an early stage of poisoning, which could be used to indicate that poisoning was starting before serious progress had taken place. (No indication is given of how advanced were the clinical symptoms of toxemia or of the extent of the exposure causing the toxemia.) No important interference with the function of the kidney was found, but the phenolsulfonphthalein test indicated retention in 40% of the patients. Similarly the hepatic function was hardly modified. A number of other diverse tests were applied without any definite result. Tests of endocrine function were more profitable. In 80% of the patients there was a diminution of the elimination of 17-ketosteroids, with an increase in basal metabolism. The blood picture showed a definite lymphocytosis in 41% of the cases. A mild increase in the blood cells was also present in 44%. An expert seeking for signs of manganism, apart from clinical signs in speech and gait, should look for alterations in the blood picture, in the basal metabolism, and in the elimination ot urinary 17-ketosteroids. Couis Silicosis H azard in the \ \ 45:700-714. (Dec.) 1954. The joint authors of this petrography and mining. They lar structure of a variety of cl tries as brickworks, potteries, In judging the .silicosis haza have to be taken into consider crystalline form, the size of tlv. and to be inhaled by those v the authors are here concerned primary rocks by processes of have acquired an increased con concerned and its association as affecting the original and th Because of the fine structun and petrographic analyses are causing silicosis or other pneu dialytic, and other techniques) Clinical and other evidence the lungs is enhanced when cc- ! Curious A sbestosis B odies Seen in Cases of A nthracosis. A. P oucard and A. C ollet. Arch. mal. profess. 16:460-462, 1955. The plea is entered that the "curious bodies" seen in the sputum and in the lungs of cumof asbestosis are not only to be seen in that condition; they occur also in anthracosis. Tinbodies are held to be ferruginous protein deposits upon the broken ends of asbestos fibers. A sbestos and P ulmonary C.\ of Luxe. C ancer rv A si 1955. such bodies occur in anthracosis; they may be deposited on any part of a coal fiber and v . The first case ot pulmonar; only at an end. Illustrations of such deposits are shown in photomicrographs. asbestosis is described. The in. The bodies are deposits upon submicroscopic defects in the surface of coal particles. T exact chemical nature and mechanism of these deposits remain undetermined. Their occurredmay depend not so much upon the coal particles as upon the frequency of processes of ahsorptv and the constitutional factors of metabolism peculiar to each individual miner. E . L. Colli s. who for 29 years had worked ; life was confirmed by postmor are briefly reported. The prese the capacity of asbestos to cau> pational in nature only when t While there are many statistic Campaign A gainst D ust in B elgian Coal M i n e s : P osition at the B eginning or 195 G. D egueldre, Communication 126, Hasselt: Institut d'Hygiene des Mines 10:1 researches are few and are no adopted whereby the capacity < according to their chemical con (March 15) 1955. Colliery companies in Belgium are called upon to render information regarding dust si- pression by filling in yearly a form, copy of which is given in an appendix. The informati so collected is now published, embodied in a series of tables. They tell how dust control is bei: advanced by using damp methods when loading coal underground, by wet drilling, by capturi the dust when it is generated dry, by damping underground passages or using hygroscopic s.v on them. The practice regarding shot firing and return to work thereafter is also described. A report of this kind is prepared every year. It indicates that, on the whole, improvenv has taken place, but the point is still stressed that more must be done to bring all dust um!. safe control. E. L. Collis. T reatment of L ead P oisoning w ith Calcium E thylenediaminetetraacetate. P letscher, Schweiz, tned. Wchnschr. 85:128-131, 1955. Intravenous treatment of two cases of chronic Pb intoxication for 45 days with daily 2.5 gw,, doses of Ca ethylenediamine-tetraacetate resulted in increased Pb excretion, decreased copro porphyrin excretion, and an improved blood picture. The Pb blood level in one patient decreased to normal, while in the other it increased from normal to pathological values during treatment. By 18 weeks after the end of treatment, both the number of stippled cells and the coproporphyrin concentration in the urine had again risen. The fecal Pb concentration had increased, while both blood and urine Pb concentrations were normal. [C h e .m. A bstr.J. E ffects of O xygen Intermit axd in Cases of E mphysf Med. lavoro 46:411-418 ()t The effectiveness of the oxy mentally in seven silicotics ami means ot two devices fitted witl M.S.A.). Oxygen was given wi Blood oxygen saturation wa mittent positive-pressure breath- Experiments have shown thaof atmospheric air presented bk> to the subject, oxygen interim with the Pneophore gives wayoxygen therapy by means ot ua of the arterial anoxemia, has in saturation. Results obtained show that c ness in cases of lung diseases v common oxygen therapy with tv 504 A. M. A. ARCH11'F.S OF IXDUSTRIAL HEALTH surveys." This is one of the most detailed long-term surveys of tuberculosis in a defined population ever undertaken. In addition to providing information on the relation between coal miners' pneumoconiosis and pulmonary tubercuosis, it should eventually provide us with additional valuable information with regard to the possibility of eradicating tuberculosis in limited population groups. J ohn P emberton, M.D., Boston, B er yllio sis: A Case R eport. I. B. S neddon, Brit. M. J. 1:1448-1450 (June 18) 1955. Not many cases of berylliosis have been reported in Great Britain. The one here described \va. m a woman, aged 25, who had worked three and one-half years at a rotary shearing machine trimming metal strip containing 2% beryllium-copper alloy. Although the shearing blade of the machine revolved slowly, fragments were thrown off with jagged edges which caused cuts and scratches on the hands, forearms, and legs. The patient came under notice with numeroti' linear granulomatous papules on the fingers, palms, forearms, and legs and with a granulomatuu> wound on the dorsum of the left foot. She also complained of a dry cough and increasing shortnes- of breath. Slight exertion produced shallow breathing. X-rays of the lung fields showed a generalized, very fine stippling, not so dense as in sarcoidosis. Patch tests with 1% and 2f< solutions of beryllium sulfate and beryllium nitrate gave in 48 hours a strongly positive eczematous reaction. During the height of the skin reactions the lung lesions became temporarily more active. After a full consideration of the causation of the lesions seen, the case was held to fulfill all the criteria for a diagnosis of systemic berylliosis. P T M o rtality from L ung Cancer in A sbestos W oukf.rs. R ichard D o l l , Brit. J. Indust. Med. 12:81-86 (April) 1955. This study of lung cancer is a statistical study based on 105 consecutive autopsies done or. former employees of a large asbestos works. In these 105 autopsies, abestosis was found to lpresent in 75 cases, absent in 30. Lung cancer and asbestosis were found associated in 15 case in three cases lung cancer was found, but asbestosis was absent. From Company records it was determined that 113 men had worked for at least 20 years i: places where they were liable to be exposed to asbestos dust. Thirty-nine deaths occurred i: this group, whereas only 15.4 were expected. Eleven of the excess deaths were attributable u lung cancer, although only 0.8 deaths were to be expected. Other respiratory and cardiovascular diseases caused 22 deaths, with only 7.6 being expected. It is concluded that lung cancer is . specific industrial hazard of certain asbestos workers, and the average risk among men employe. 20 or more years is approximately 10 times that experienced by the general population. S herman S. P into, Denver. P rimary L ung Cancer i s S outh W ales Coal-W orkers w ith P neumoconiosis. W . P. L. James, Brit. J. Indust. Med. 12:87-91 (April) 1955. In autopsies on 1827 South Wales coal miners with pneumoconiosis, lung cancer was foun in 5.1% of those with simple pneumoconiosis and in 1.4% of those with the massive fibrosis tyj" of disease. Autopsies on 1531 South Wales men who were nonminers showed lung cancer v 5.4% of the cases. Histological study showed the types of cancers were very similar in bot! miners and nonminers. Distributions of metastases were also quite similar. The suggestion imade that early death front pneumoconiosis among coal miners may have the effect of reducing the incidence of lung cancer among miners in a coal field such as South Wales. S herman S. P into, Denver. P ulmonary F ibrosis in N o n -F errous F oundry W orkers. H . E . H arding and A. I. G. M cLaughlin, Brit. J. Indust. Med. 12:92-99 (April) 1955. This study is primarily a review of the lung changes found at autopsy in six men who had worked in nonferrous foundries. Chest x-rays taken at a time late in each man's life had suggested the presence of lung changes which were fibrotic in nature. At autopsy these lung changes were found to be either whorled silicotic nodulation, linear or stellate fibrosis, or transitional stages between these two. The occupational histories suggested that- silica exposure came from the use of silica parting compounds or from the dust produced by the removal of sand from castings made in sand molds. No figures for the intensity of a possible silica exposure are lven- S herman S. P into, Denver. 286 a b s t r a c t s f ro m currf.x t L eptospiral S erology in S cottish Brit. J. Indust. Med. 12:100-102 i In a Scottish colliery 11 cases of lep' among the colliery's 2700 men. To stud; 201 blood samples were obtained from a were somewhat reluctant to participate, younger men. One per cent of the go leptospiral infections. This is compared 6.9% among New York fish workers. Occupational D erm atitis Caused ) Brit. J. Indust. Med. 12:169-171 ( Aseptic operations were performe< terminating in rubber gloves were seak manipulations within the box. Ethylen purposes and allowed to remain for 18 the rubber gauntlets absorbed enough < and arms when they were inserted i gauntlets during work was found to r< dermatitis. D isabling P neum o co nio sis from L: -r: (July) 1955. Eight cases of pneumoconiosis, five described. Three of the men showed t disabled; and one had died of the disea- showed fibrosis, which suggested the a The mean duration of employment: Though no data as to the size, com appreciable dust exposure is inferred fr analyses of limestone processed by g: Limestone from the mine in which th It is concluded that there is a dc: "and mining of at least certain limestc by free silica in the limestone dust, a: stone dust does not appear to inhibit I nhalation of Coal D ust. C. X. This paper is a summary of the Among the subjects treated are the fi at various distances downwind exp deposition and retention of dust in Under ordinary conditions at coal-dm (0.28 to 28 mpef), the healthy lung ithat concentration the mechanism im permanent working conditions. The exposure would be a better guide. I ncidence and P revention of D u J. Roy. Inst. Pub. Health & H: Some account is first given of th known is silicosis, caused by inhalim by x-ray shadows and by postmoru known to cause trouble differs in t! ABSTRACTS FROM CURRENT LITERATURE L eptospiral S erology in S cottish Coal-M iners. R. S. F. A dam and P. N. Edmunds, Brit. J. Indust. Med. 12:100-102 (April) 1955. In a Scottish colliery 11 cases of leptospiral infection were found during the period 1940-1952 among the colliery's 2700 men. To study the incidence of possible subclinical leptospiral infection, 201 blood samples were obtained from a random group of the colliery employees. The older men were somewhat reluctant to participate, and the samples were somewhat weighted in favor of the younger men. One per cent of the group had serological findings suggestive of unrecognized leptospiral infections. This is compared with 2.1% found among New York sewer workers and 6.9% among New York fish workers. S herman S. P into, Denver. Occupational D ermatitis Caused by E thylene O x id e . A. Royce and W. K. S. Moore, B rit J. Indust. Med. 12:169-171 (April) 1955. Aseptic operations were performed in a completely sealed box. Long rubber gauntlets terminating in rubber gloves were sealed in the armholes and provided a means for carrying on manipulations within the box. Ethylene oxide gas was introduced into the box for sterilization purposes and allowed to remain for 18 to 24 hours before being flushed out. It was found that the rubber gauntlets absorbed enough ethylene oxide to cause dermatitis of the operator's hands and arms when they were inserted in the gauntlets. A current of air introduced into the gauntlets during work was found to remove the excess ethylene oxide satisfactorily and prevent dermatitis. S herman S. P into, Denver. D isabling P neum oconiosis from Limestone D ust. A. T. D oig, Brit. J. Indust. Med. 12:206 (July) 1955. Eight cases of pneumoconiosis, five in limestone grinders and three in limestone miners, are described. Three of the men showed no disability; three had partial disability; one was totally disabled; and one had died of the disease. In the fatal case histological examination of lung tissue showed fibrosis, which suggested the action of silica alone unmodified by other dusts. The mean duration of employment in the limestone industry of the eight cases was 26.1 years. Though no data as to the size, concentration, and composition of air-borne dust are given, appreciable dust exposure is inferred from observations of limestone grinding and mining. Recent analyses of limestone processed by grinders indicated a free silica content of 1.8% to 11.5%. Limestone from the mine in which the miners worked had 3.9% to 11.9% free silica. It is concluded that there is a definite pneumoconiosis hazard associated with the grinding and mining of at least certain limestones, that the lesion produced is almost certainly produced by free silica in the limestone dust, and that the high percentage of calcium carbonate in lime stone dust does not appear to inhibit the action of free silica. K. W . N elson, Salt Lake City Inhalation of Coal D ust. C. N. Davies, Colliery Guard. 189:442-445 (O ct.) 1954. This paper is a summary of the author's lectures given in courses in the United States. Among the subjects treated are the following: travel of dust underground; dust concentrations at various distances downwind expressed as percentage of concentration near the source; deposition and retention of dust in the lungs, and requirements for safe conditions of work. Under ordinary conditions at coal-dust concentrations of 10 to 1000 particles per cubic centimeter 10.28 to 28 mpcf), the healthy lung is equipped to dispose of the dust without danger, but above that concentration the mechanism may eventually break down. X-rays cannot be used to assess permanent working conditions. The examination of lungs of deceased miners with known exposure would be a better guide. I , , , . H yc D igest. J. Incidence and P revention of D ust D iseases in B ritish Industry. A. I. G. McLaughlin, Roy. In st Pub. Health & Hyg. 18:218-239 (Aug.) 1955. Some account is first given of the various types of chest diseases caused by dust The best Known is silicosis, caused by inhaling fine silica dust. The changes wrought in the lungs as seen by x-ray shadows and by postmortem inspection are well known. But each of the other dusts known to cause trouble differs in the pathological changes set up and in the tendency caused 287 A. M. A. ARCHIVES OF IXDUSTR1AL lll-. U. i . to accept tuberculous infection. There are dusts, especially the organic dusts, which originale , maximum of clinical symptoms, such as asthma and bronchitis, with a minimum of lung chanci. and without any tendency to tuberculosis. Every dust calls for special inquiry before it can i.. pronounced harmful or particularly dangerous; probably none can be passed as quite harmit.. or beneficial. Nevertheless, as industrial processes become more and more mechanized and i-aji!. many clouds of dust exist which have not yet been brought under control. Examples of patho logical findings and of dusts in creation are shown in illustration. Information as to the mcuii-n.-.. of these many dust diseases comes from death certificates and from compensation claims ulii-nthe disease has been scheduled for compensation. The varieties are named as silicosis, which is far the most widespread; asbestosis: c<,;,; pneumoconiosis, which today accounts for most of the compensation claims ; talc pneumoconioM. ; Shaver's disease: beryllium granulomatosis; manganese pneumonia; bagassosis, and byssino;:. Then there are the dusts causing occupational asthma, all of organic origin, and others which are carcinogenic. The industries in which these troubles occur seem to increase year by year as research progresses. Frequently ex[sure is to mixed dusts ; here a second dust may accentu ate the action of the first, yielding a mixed pathological entity, or one may modify and even neutralize the action of the other, or the two may not react on one another. One of the wonders of modern industrial hygiene is the way in which one after another these diseases is being minimized or abolished. Great sandstone wheels have given way y, innocuous wheels for grinding metal articles; parting sands in foundries must no longer com: :-, siliceous material; ground silica must not be used for placing china and pottery ware go:to be baked ; sand must not be used for blasting newly founded articles. Alumina is being mix-. ; with silica dust to neutralize it. Next, the dangerous dust must be brought under control i engineering means, by locally applied exhaust drafts, or by wet methods of working. La>: when all else fails, well-devised masks can be worn, although workers seldom care to \u them. Tables are given showing the information in the hands of the factory inspectors rclau to deaths and compensation claims occurring in the industries concerned. Only by looking lu . to the beginning of this century can the observer appreciate what has been done and is bci done. The whole picture is well painted by the author of this well-arranged article. E. L. Coli.is. I n c id enc e o f Cardio v asc ula r A ffections A mong Coal M iner s. F. L avenne and : B elaven, H asselt: Institut d'Hygine des Mines Communication 127,10:19 (April 28) 1!;; First, an inquiry was made into the cardiovascular effects of mining work in hot conditio:, underground. Miners who had worked at least five years under unfavorable conditions we compared with others who had worked under better conditions ; no significant differences we: found. Then the incidence of cardiac abnormalities was estimated in 200 unselected miner between the ages of 25 and 60 working underground, as well as in 400 miners who had bee referred to the Institut d 'Hygine des Mines by industrial physicians at periodic examinations. Valvular heart trouble was not found because of the care taken when examining men befor they were engaged for underground work. The incidence of cardiac arterial trouble, hip', pressure, and coronary disturbance was low below age 40, after which it rose to reach 16'. after age 50. The medical and physical examinations carried out are explained in detail, any the results are set forth in tables. The occurrence of chronic cor pulmonale was unusual, excep . when pneumoconiosis was present. Heavy physical work was found conducive to cardiovascular troubles, increasing with age. The suggestion is made that no one should be taken on for mining work if he is over age 35. Stress is laid on the value of the electrocardiogram in doubtful cases of cardiac action. Cardiovascular affections are a frequent cause of invalidity among miners and rank second to illnesses of the respiratory system. Collis P roblem of R h in it is a n d A sthma in Bakers. C. P estalozzi and U. VV. S chnyder, Schweiz, med. Wchnschr. 85:496 (May 21) 1955. Of 159 bakers employed with two large and three medium-sized bakeries in Zurich, Switzer land, 42 showed symptoms of respiratory allergy. All 42 had allergic rhinitis, and 6 had allergic rhinitis and bronchial asthma. A familial tendency to respiratory allergies was observed in 12 (28%) of the 42 bakers, while such a tendency w a s observed in only 9 (8%) of the 117 bakers without any allergic symptoms. Young people with a familial tendency to asthma or rhinitis 288 ABSTRACTS FROM CI RRUS should be informed about their predias bakers. In all 159 bakers scratch i they were employed with, and intracu wheat. Twenty-iour (66%) of the thin of urticarious type to the tests with th< ' with the extracts of wheat or rye. ^ The clinical aspects of the rhinitis abundant watery secretion (rhinorrhc; the rhinitis in bakers is an allergic rl: other causative factors, in addition to occurrence of asthma in bakers. ~4 Most of the examined bakers show of 12.7 years of sensitization. The ini even decades, in more than two-third rhinitis was associated with asthma, tl: average 18 years' duration of rhinitis, to 15 years' duration of the rhinitis o Plimasin (a proprietary compound sympathomimetic drug), pyrilamine benzyl-alpha-amino-pyridine hydrochi' -cv: of mild flour rhinitis in patients who bakers with severe rhinitis specific d< matic treatm ent.. Ca l c iu m F.DTA in T r ea tm en t o r Rossi, Riforma med. 69:398 (A Good results in treating lead poi.were obtained in six lead workers wl solution in daily doses of 2 gm. for course of treatment after a seven-da urinary excretion of lead increased i while the lead blood levels were chanp a lead complex by exchanging the ca "that does not have the toxic action j calcium-disodium in lead poisoning is used for the purpose, but greater clink S ilicatosis Ca used by S epio l it e . & A case is described of silicatosi- [meerschaum]), which has not hitbert and after considering the possibility tl- concludes that the initial fibrosis was P ulmonary Changes D eveloping -U- Fortschr. Geb. Rontgenstrahlen 6 In studying the industrial hygien workers who were employed in one (alumina), and in "two alumina reduc- In examining the workers, speci; respiratory symptoms. W orkers witl orders had been excluded from work tions. Each worker was subjected whenever there was the slightest susp: w ere observed but these do not con merging into the other. In the first shadows and some pale foci; in the ! A. M. A. ARCHIVES OF INDUSTRIAL HEALTH years is given, and a comparison made between those employed in processing cigarettes, other employees, and a comparable sample of the local population. The results of this study show that the total mortality rate among employees engaged in processing cigarettes for the American Tobacco Company is definitely lower than that among the general population of Virginia and North Carolina. This is true for all causes, for cancer, and for cardiovascular diseases. The death rates for respiratory cancer and for coronary disease among employees of the American Tobacco Company do not differ appreciably from those among the general population. C H . W ood, Boston. T he P r e se n t S tatus of S u.iconf. P rotective Creams. R. R. S uskino, Indust. Med. 24:413 (Sept.) 1955. "There is good reason to believe that the clinical protection afforded by a silicone formulation depends on its ability to provide an intact film which will repel or be relatively unaffected by specific chemical substances throughout the period of exposure. The efficacy of the repellent action is determined by (1) the physical and chemical properties of the silicone fluid, (2) the concentration of silicone, (3) the nature of the vehicle and its ability to make a uniformly repellent mixture with the silicone, and (4) the manner and schedule of application." Chemical and laboratory tests are described which were used to assess the relative value of four different silicone creams in protecting against exposure to commonly used petroleum fractions, polar solvents, water, usage concentrations of hand soap, laundry soap and laundry synthetic detergents, soluble cutting fluids, cutting oils, formaldehyde, phenol, aqueous solutions of mineral acids, alkalies and salts. It should be emphasized that the present silicone creams are not therapeutic agents hut should be used strictly as prophylactic devices. While disappointing results have previously been obtained in clinical trials with a cream containing 2% silicone, good results can be obtained with creams containing 30% or 52% silicone. The latter creams are more expensive and not always pleasing from the cosmetic viewpoint, but if correctly selected for a specific irritant, they can be of great protective value. q W ood Boston S y p h il is in I ndustry. J. G. D ow ning, J. A .M. A. 158:468 (June 11) 1955. The author gives a rough estimate of 600,000 cases as the prevalence of syphilis in industry in the United States. Tn one large organization in which 90% of the employees accepted a serologic test, 4% were found to be positive. In another firm in which the employees were on a "higher socioeconomic" plane, the prevalence rate of a positive serologic test was 0.23%. A table is presented showing a decline in Connecticut from a prevalence rate among industrial workers of 4.0% in 1949 to 2.9% in 1953. The author concludes that syphilis will remain a problem for some time to come. He is of the opinion that it is worth while attempting to find these cases in industry, so that the services of highly trained employees may be retained and so that unjustifiable claims for disabilities due to syphilis and not to occupation may he eliminated. In areas where the prevalence rate of syphilis is high, the author recommends a serologic test as part of the preemployment routine examination. The advisability of employing applicants with positive blood serology should be decided not by management but by competent physicians. J o h n P emberton, M.D., Boston. C a r c i n o m a o f t u b L u n g i n A sbestosis: R eport ok T w o A dditio nal Cases. K. M. L ynch and II. R. P ratt-T iiomas, South. M. J. 48:565 (June) 1955. The authors present the histories of two additional patients with asbestosis and bronchogenic carcinoma. These cases bring to 4 the number of patients with carcinoma of the lung in an autopsy series of 49 cases from workers in an asbestos-manufacturing plant who showed demon strable deposits of asbestos in their lungs. This is an incidence of 8.2%. The incidence of car cinoma of the lungs in the hospital service during the same period and in the same age range as the cases of asbestosis was 1.5%. This incidence of 8.2% is by far the lowest incidence recorded among live -eric- relating 0 ll1- nr..L!eie ..r - c . . . ABSTRn desquama attempt to alveoli atv sion from asbestos < develop a bronchogt monary t analogus i for or ag statistical S tltiv of Q uai Ku.it D eck L uft Conti Albu. The Oi means of pulmonar; S tudy of I. Qv ContiI ssued R akei, for M Design aerosols. described ators. A I'1 A "F oll< CULOS This i> tubcrculosi addition to advanced . Research culosis nu 40% do at lation over over 5 and after the fi tuberculin-. All but 2 oi hospital. Aft ! TH ier in >g r, isc ng >13 on by nt theily of im Iry >ns re ng te, re ed ry a a A ial a ad ad d. -St Its IS. \f. lie m nras ed ABSTRACTS FROM CURRENT LITERATURE desquamation of the bronchiolar epithelium and an outpouring of numerous macrophages in an attempt to phagocytizc the fibers. Fibroblastic proliferation and collagen deposition in the walls of alveoli and about the terminal bronchioles follow at a later stage. Experimental proof of progres sion from hyperplasia to neoplasia is difficult to produce. Mice exposed to concentrations of asbestos dust having the proper specifications as regards particle volume and size do not develop asbestosis or carcinoma, although pulmonary adenoma is frequently present. In fact, bronchogenic carcinoma of man has no counterpart in other animals. It appears that the pul monary tissue of dogs may respond to asbestos dust in a manner somewhat more closely analogus to man. Until a valid biologic experiment can be evolved, it appears that the evidence for or against the possible carcinogenic effect of the asbestos fiber will rest primarily on statistical evidence and personal opinion. S tudy of tiik M ec h a nism ok A bsorption ok P articulates in th e R espiratory T r e e : I. Q uarterly R eport Xo. 1, S eptember 1 -D ecember 1, 1953. A rnoi.d E. R eik, M ary C. E i.i.iott, T h o m as L. C h ifk e u .e, and Clayton S. W h ite. II. Q uarterly R eport No. 2, D ecember 1, 1953-M arch 1, 1954. A rnold E. R eif, T homas L. C hiffeli.e, U lrich C. L uft, J ames Clark, Clayton S. W h ite, M ary C. E lliott, and H elen S. B aker, Contract Da-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. The operating characteristics of the Roller Particle Size Analyzer were investigated as a means of producing closely sized aerosols. Preliminary results are reported from studies of the pulmonary absorption of various dyes and particles of various sizes in rats and dogs. N uclear S c. A bstii. S tudy of the M ec h a nism of A bsorption of P articulates in the R espiratory T r e e : I. Q uarterly R eport N o. 4, 1954 ( I ncludes an A ppendix : A utomatic E lectronically Controlled R espiratory Cycling V alve). Jam es Clark II. S ummary ok R eports I ssued S ince D ecember 1, 1953. A rnold E. W hite, M argot P. H olcomb, H elen S. B aker, and C layton S. W h ite, Contract DA-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. Design and performance are described of an air-jet nebulizer for the production of water aerosols. Methods are described for determining the particle size of water aerosols. Design is described of an automatic, electronically controlled, respiratory cycling valve for animal respir ators. A brief summary is included of results from aerosol inhalation studies with rats. N uclear S c. A bstr. A "F ollow-U p" Chest X -R ay S urvey in the R hondda F ach : I. P ulmonary T uber culosis. A. L. Cochrane, J . G. Cox, and T. F. Jarman, Brit. M. J. 1:371 (Feb. 12) 1955. This is an interim report on an ambitious and interesting attempt to eradicate pulmonary tuberculosis from an isolated Welsh coal-mining valley with a population of some 24,000. In addition to the intrinsic value of such a program, the authors wish to test the hypothesis that the advanced and progressive stage of coal miners' pneumoconiosis, known to the Pneumoconiosis Research Unit of South Wales as progressive massive fibrosis (P. M. F.), is a form of tuber culosis modified by pneumoconiosis. Only 1% of these cases give a positive sputum in life, but 40% do at necropsy. At the first survey in 1951, 87% of the female and 92% of the male popu lation over 5 years of age were x-rayed. At the second survey in 1953, 91% of the new population over 5 and 95% of those previously surveyed were x-rayed. The chief preventive measures taken after the first survey were the B. C. G. vaccination of children under 5 years of age, who were tuberculin-negative and were in contact with active cases, and the hospitalization of active cases. All but 2 of the 112 active cases were hospitalized, but not all were willing to remain long in hospital. After the first few' months there were nenrlv i'" -iVs in .......... . : r comparison made between those employed in processing cigarettes, other iparable sample of the local population. ts study show that the total mortality rate among employees engaged in for the American Tobacco Company is definitely lower than that among n of V irginia and N orth Carolina. This is true for all causes, for cancer, r diseases. The death rates for respiratory cancer and for coronary disease lie American Tobacco Company do not differ appreciably from those among n* C H. W ood, Boston. s o f S ilicone P r otec tiv e C ream s. R. R. S u sk in d , Indust. Med. 24:413 ison to believe that the clinical protection afforded by a silicone formulation to provide an intact film which will rej>el or be relatively unaffected by bailees throughout the period of exposure. The efficacy of the repellent by (1) the physical and chemical properties of the silicone fluid, (2) the* one, (3) the nature of the vehicle and its ability to make a uniformly i the silicone, and (4) the manner and schedule of application." ratory tests are described which were used to assess the relative value of e creams in protecting against exposure to commonly used petroleum nts, water, usage concentrations of hand soap, laundry soap and laundry 'Oluble cutting fluids, cutting oils, formaldehyde, phenol, aqueous solutions lies and salts. It should be emphasized that the present silicone creams are s but should be used strictly as prophylactic devices. While disappointing ly been obtained in clinical trials with a cream containing 2% silicone, Jtained with cream s containing 30% or 52% silicone. The latter creams are lot always pleasing from the cosmetic viewpoint, but if correctly selected they can be of great protective value. c H WooD> Boston- rv. J. G. D o w n in g , J. A .M. A. 158:468 (June 11) 1955. a rough estimate of 600,000 cases as the prevalence of syphilis in industry In one large organization in which 90% of the employees accepted a re found to be positive. In another firm in which the employees were on a c" plane, the prevalence rate of a positive serologic test was 0.23%. A >wing a decline in Connecticut from a prevalence rate among industrial 1949 to 2.9% in 1953. The author concludes that syphilis will remain a tc to come. H e is of the opinion that it is worth while attempting to find y, so that the services of highly trained employees may be retained and aims for disabilities due to syphilis and not to occupation may be eliminated, revalence rate of syphilis is high, the author recommends a serologic test iployment routine examination. The advisability of employing applicants rology should be decided not by management but by competent physicians. J o h n P em berton, M.D., Boston. L ong in A sb e st o sis: R eport of T wo A d d itio n a l Cases. K. M. . P ratt-T homas, South. M. J. 48:565 (June) 1955. it the histories of two additional patients with asbestosis and bronchogenic es bring to 4 the number of patients with carcinoma of the lung in an ises from workers in an asbestos-manufacturing plant who showed demon>estos in their lungs. This is an incidence of ft.2%. The incidence of car* the hospital service during the same period and in the same age range as was 1.5%. T his incidence of 8.2% is by far the lowest incidence recorded ting to this problem, one of which reports an incidence of 16.3%. erence from this and other series does not allay the suspicion that there between th^, tw o conditions. i produced by asbestos dust is fielicvcd to be due to the physical nature t desquamation of the bronchiolar epithelium and an outpouring of numerous macrophages in an attempt to phagocytize the fibers. Fibroblastic proliferation and collagen deposition in the walls of alveoli and about the terminal bronchioles follow at a later stage. Experimental proof of progres sion from hyperplasia to neoplasia is difficult to produce. Mice exposed to concentrations of asbestos dust having the proper specifications as regards particle volume and size do not develop asbestos is or carcinoma, although pulmonary adenoma is frequently present. In fact, bronchogenic carcinoma of man has no counterpart in other animals. It appears that the pul monary tissue of dogs may respond to asbestos dust in a manner somewhat more closely analogus to man. Until a valid biologic experiment can be evolved, it appears that the evidence for or against the possible carcinogenic effect of the asbestos fiber will rest primarily on statistical evidence and personal opinion. S tudy of the M e c h a n ism of A bsorption of P articulatks in t h e K esi'ikatoky T r e e : I. Q uarterly R eport N o. 1, S eptember 1 -D ecember 1, 1953. A rnold E. K eif, M ary C. E lliott, T ho m as L, C h iffeli.e, and C layton S. W h it e . II. Q uarterly R eport N o. 2, D ecember 1, 1953-M arch 1, 1954. A rnold E. R f.if, T homas L. C hifffxle, U lrich C. L uft, J am es C la rk , C layton S. W h it e , M ary C. E lliott, and H elen S. B a k e r , Contract Da-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. The operating characteristics of the Roller Particle Size Analyzer were investigated as a means of producing closely sized aerosols. Preliminary results are reported from studies of the pulmonary absorption of various dyes and particles of various sizes in rats and dogs. N uclear S c. A bstr. S tudy of the M e c h a n ism of A bsorption of P articulates in the R espiratory T r e e : I. Q uarterly R eport N o. 4, 1954 ( I ncludes an A ppendix : A utomatic E lectronically Controlled R espiratory C ycling V alve). J am es Clark II. S um mary of R eports I ssued S ince D ecember 1, 1953. A rnold E. W hite, M argot P. H olcomb, H elen S . B aker, and Clayton S. W h it e , Contract DA-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. Design and performance are described of an air-jet nebulizer for the production of water aerosols. Methods arc described for determining the particle size of water aerosols. Design is described of an automatic, electronically controlled, respiratory cycling valve for animal respir ators. A brief summary is included of results from aerosol inhalation studies with rats. N uclea r S c. A bstr. A "Follow-U p" Chest X -R ay S urvey in th e R hondda Ea c h : I. P ulmonary T uber culosis. A. L. Cochrane, J. G. Cox, and T . F. Jarman, Brit. M. J. 1:371 (Feb. 12) 1955. This is an interim report on an ambitious and interesting attempt to eradicate pulmonary tuberculosis from an isolated W elsh coal-mining valley with a population of some 24,000. In addition to the intrinsic value of such a program; the authors wish to test the hypothesis that the advanced and progressive stage of coal miners' pneumoconiosis, known to the Pneumoconiosis Research Unit of South W ales as progressive massive fibrosis (P. M. F.), is a form of tuber culosis modified by pneumoconiosis. Only 1% of these cases give a positive sputum in life, but 40% do at necropsy. A t the first survey in 1951, 87% of the female and 92% of the male popu lation over 5 years of age were x-rayed. A t the second survey in 1953, 91% of the new population over 5 and 95% of those previously surveyed were x-rayed. The chief preventive measures taken after the first survey were the B. C. G. vaccination of children under 5 years of age, who were tuberculin-negative and were in contact with active cases, and the hospitalization of active cases. All but 2 of the 112 active cases were hospitalized, but not all were willing to remain long in hospital. After the first few months there were nearly always 40 known infectious cases in the valley, who were carefully supervised by the public health nurse. A t the second survey it was found that there had been a marked fall in the prevalence of infectious tuberculosis among the women and a lower fall among the younger men. There had been a slight increase among the older miners and ex-miners. "In spite of ample hospital accommodation, 35 (amongst whom were ta f - r i r . in ...... i, r .. * A. M. A. ARCHIVES OF 1SDUSTRIAL HEALTH P hysiological Observations on M en W orking in S upposedly L imiting E nvironments in a W est A frican Gold M ine. W. S. S. Ladell, Brit. J. Indust. Med. 12:111-125 (April) 1955. This study of physiological reactions of men working in an atmosphere near tolerable limits was made in two areas of a mine. In one, the dry-bulb temperatures were 93 to 93.5 F ; wet-bulb, 92 to 925 F ; air movement, 60 to 70 ft. per minute; basic effective temperature, 91.5 F. In the other, the basic effective temperature was 93 F. Further observations were made on men in the laboratory under controlled conditions which produced an effective temperature of 95 F. In the mine itself no sickness was found attributable to the heat. The men avoided heat stress by taking frequent rests and withdrawing to cooler parts of the mine during blasting operations. Under controlled laboratory conditions with an effective temperature of 95 F, some subjects had a rectal temperature rise to 104 F while doing measured work. Under such conditions the pulse rate rose to about 190 beats per minute. Trained miners under such conditions were found to sweat at the rate of 16.3 ml. per minute, while untrained novice miners had a rate of 12.1 ml. per minute. There was some evidence that trained miners had a somewhat lower chloride con centration in the sweat than did untrained subjects. From these studies there was no indication that the West African deep miner has an unusually high heat tolerance. In all environmental heat-stress conditions, work rhythm as well as climatic conditions must be assessed when considering the tolerability of the working place. S iierman S. P into, Denver. B lood E xam inatio ns in I n d u stry : A Comparison of B lood Cell Counts from E ar L obe and T humb P ulp. A. B utterworth and N. Goodman, Brit. J. Indust. Med. 12:172-173 (April) 1955. Blood samples were obtained from the ear lobe and the thumb pulp of 35 workmen. Total white blood cell count, differential count, red blood cell count, and hemoglobin values were found to be quite comparable in each worker when the samples of blood from each site were compared. S herman S. P into, Denver. T he E nergy Cost of S ome I ndustrial O perations. D. T urner, Brit. J. Indust. Med 12:237 (July) 1955. The energy expended in carrying out 48 different jobs involving light to heavy physical effort was estimated by (1) subjective assessment--job analysis by time study and observation cthe work--and (2) determinations of the metabolic rates of the workers. There was clos> agreement between the two methods of estimation. It is suggested that satisfactory informatics to aid in the proper placement of unfit or elderly factory workers can be obtained by subjectiv appraisal of various tasks without need for metabolic rate measurements. K. W. N elson, Salt Lake City. T h e E ffect of H eat Stress on Minew o rk ers w ith R egard to Loss of W ater a n ; E lectrolytes. W. M. P olitzer and A. K ing, South African M. J. 10:155 (Dec.) 195-;. The response to salt-and-water loss was studied in 81 mine workers who were engaged i: heavy manual labor in the hottest areas of the St. Helena Gold Mine in South Africa. Atmospheri. conditions consisted of an average dry-bulb temperature of 86 F, an average wet-bulb temperatur. of 84 F, wet kata cooling power of 13.3 meal, per second, and 92% humidity. Underground observations were carried out during November, December, and January, the hottest months o' the year. The clinical and biochemical examinations did not reveal any evidence of a pronounce sodium chloride deficiency and its sequelae, i. e., muscular cramps and heat exhaustion. Th< presence of a high incidence of sweat rashes in 9 of the 81 miners and the pronounced temporal^ loss of weight during the shift indicated that profuse perspiration did occur. The temporary fluid loss which occurred during work was replenished within 18 hours of rest. This mild temporary dehydration was not detectable by biochemical or hematocrit determinations but only by weight recordings. No departures from the normal range of values in respect to serum chloride, urea, sodium, potassium, total protein, and packed cell volume were observed. I t had been expected that, as a result of acclimatization, the sweat would be very dilute. However, electrolyte determinations showed that this was not the case, and some values were high. 182 ABSTRACTS FROM CURRENT LITERATURE The miners' diet contained sufficient salt and water to replace electrolyte and fluid loss. Salt was available at meal times and could be used liberally to supplement the diet according to the desire of the individual miner. Several miners stated that they had a marked appetite for salt and consumed it liberally at their meals. Most miners said that they consumed water during working hours, but 11 miners denied drinking any water. The administration of sodium chloride in the form of salt tablets, in excess of the amount consumed in the ordinary diet, is regarded as unnecessary. No cases if heat exhaustion or heat stroke were observed. The best method of preventing heat exhaustion and heat stroke is the provision of atmospheric conditions of temperature, humidity, and air movement of such a nature that they are within the limits of the body's powers of adaptation. Under present conditions there appears to be no risk of heat exhaustion in the mine studied. Occupational Diseases and Hazards Rheumatoid A rthritis in Males: A n Epidemiological Study of a W elsh Mining Community, W. E. M iall, Ann. Rheumat. Dis. 14:150 (June) 1955. Miall says that Caplan pointed out in 1953 that some patients with rheumatoid arthritis, ..mong coal miners with pneumoconiosis, can be recognized from a characteristic chest x-ray appearance. An epidemiological investigation of this new syndrome showed that this nodular lung fibrosis was associated with rheumatoid arthritis in more than 50% of cases; it also suggested hat the prevalence of rheumatoid arthritis was increased among men with complicated pneumo coniosis. To determine whether the progressive massive fibrosis of complicated pneumoconiosis was an etiological factor in the development of the arthritis, a survey of rheumatoid arthritis was undertaken in a Welsh mining valley in which progressive massive fibrosis was common among the miners. Immediately before an x-ray survey was started in the valley, a census was taken of the population, and during this census a note was made of all persons said to be suffering from arthritis. Ninety per cent of the population over the age of 15 was subsequently x-rayed, and each person was asked whether previously or now he had painful swellings of the small joints of the hands or feet. Medical practitioners and the rheumatism clinic provided lists of patients with rheumatoid arthritis. All patients with rheumatoid arthritis found from these four sources were asked to submit to x-rays of chest, hands, and feet and to a differential agglutination test; criteria by objective evidence were used in the diagnosis of rheumatoid arthritis. The survey showed that, though the prevalence of rheumatoid arthritis among all patients with massive fibrosis is about 2.7%, compared with 0.6% among miners without massive fibrosis, the prevalence of the disease among miners does not differ significantly from that among nonminers, and therefore it is most unlikely that massive fibrosis predisposes to rheumatoid arthritis. It is concluded therefore that neither exposure to dust nor the lung changes of complicated pneumo coniosis play a causal role in rheumatoid arthritis. Evidence obtained confirmed the observations of other investigators that heredity plays an important causal role in rheumatoid arthritis; this is also true of Caplan's syndrome and of patients with the characteristic Caplan chest x-ray findings without arthritis. Caplan's syndrome and the present findings suggest an inherited abnormality of tissue reaction, not confined to the skeletal system, in those with, or presumably liable to develop, rheumatoid arthritis. This hypothesis would account for the numerous descriptions of cases of rheumatoid arthritis accom panied by active tuberculosis which have appeared since Poncet described tuberculous rheumatism in 1902, but it does not confirm Poncet's view'that tuberculosis is a cause of rheumatoid arthritis. Bronchial Carcinoma in P rinting'W orkers. E. A sk-U pmark, Dis. Chest 27:427 (April) 1955. Surveying the occurrence of pulmonary carcinoma in Sweden, Ask-Upmark found that an analysis of the material observed at the University of Uppsala during the 20-year period from 1031 to 1950 showed that the number of cases observed during the last decade is about twice the number observed in the previous decade. The cause of this increase has not been completely explained, although the increased consump tion of cigarettes may or may not be of importance. 183 A. M. A. A R C H 'E S OF IND U STR IA L H EALTH regarding the normal blood pictures under varying conditions, no evidence was forthcoming that the changes were affected by the low concentration of the benzene products in the workshop a 'r- E. L. Coi-Lis. S tu dy of B iological C hang es in P o iso n in g by M ang anese. J. R odier, Arch. mat. profess. 16:435-442, 1955. A study was made of 151 cases of manganism to detect, if possible, definite changes at an early stage of poisoning, which Could be used to indicate that poisoning was starting before serious progress had taken place. (X o indication is given of how advanced were the clinical symptoms of toxemia or oi the extent of the exposure causing the toxemia.) Xo important interference with the function of the kidney was found, but the phenolsulfonphthalein test indicated retention in 40% of the patients. Similarly the hepatic function was hardly modified. A number of other diverse tests were applied without any definite result. Tests of endocrine function were more profitable. In 80% of the patients there was a diminution of the elimination of 17-ketosteroids, with an increase in basal metabolism. The blood picture showed a definite lymphocytosis in 41% of the cases. A mild increase in the blood cells was also present in 44%. An expert seeking for signs of manganism, apart from clinical signs in speech and gait, should look for alterations in the blood picture, in the basal metabolism, and in the elimination of urinary 17-ketosteroids. E . L_ CoLLts Cu r io u s A sbestosis B o dies S een in Cases of A nth r ac o sis. A. P olicard and A. Collet, Arch. mal. profess. 16:460-462, 1955. The plea is entered that the "curious bodies" seen in the sputum and in the lungs of cases of asbestosis are not only to be seen in that condition; they occur also in anthracosis. These bodies are held to be ferruginous protein deposits upon the broken ends of asbestos fibers. But such bodies occur in anthracosis; they may be deposited on any part of a coal fiber and not only at an end. Illustrations of such deposits are shown in photomicrographs. The bodies are deposits upon submicroscopic defects in the surface of coal particles. The exact chemical nature and mechanism of these deposits remain undetermined. Their occurrence may depend not so much upon the coal particles as upon the frequency of processes of absorption and the constitutional factors of metabolism peculiar to each individual miner. if E. L. Collis. C am paign A gainst D ust in B elgian Coal M i n e s : P osition at t h e B eginning of 195? G. D egueldre, Communication 126, H asselt: Institut 'Hygiene des Mines 10:1/ (M arch 15) 1955. Colliery companies in Belgium are called upon to render information regarding dust sup pression by filling in yearly a iorm, copy of which is given in an appendix. The information so collected is now published, embodied in a series of tables. They tell how dust control is beinadvanced by using damp methods when loading coal underground, by wet drilling, by capturin: the dust when it is generated dry, by damping underground passages or using hygroscopic sai: on them. The practice regarding shot firing and return to work thereafter is also described. A report of this kind is prepared every year. It indicates that, on the whole, improvetnei:: has taken place, but the point is still stressed that more must be done to bring all dust unde: safe control. E . L. Collis. T reatm ent of L ead P oisoning w it h Calcium E thylenediaminetetraacetate. A. P letscher, Schweiz, med. Wchnschr. 85:128-131, 1955. | Intravenous treatment of two cases of chronic Pb intoxication for 45 days w'ith daily 2.5 gm." doses of Ca ethylenediamine-tetraacetate resulted in increased Pb excretion, decreased copro- porphyrin excretion, and an improved blood picture. The Pb blood level in one patient decreased to normal, while in the other it increased from normal to pathological values during treatment. By 18 weeks after the end of treatment, both the number of stippled cells and the coproporphyrin concentration in the urine had again risen. The fecal Pb concentration had increased, while both blood and urine Pb concentrations were normal. [C h e m . A bstr.]. 504 ABSTRACTS FROM S ilicosis H azard in ti 45:700-714 (Dec.) 1' The joint authors of petrography and mining. ' lar structure of a variety tries as brickworks, potte. In judging the .silicosis have to be taken into con crystalline form, the size < and to be inhaled by th< the authors are here conci primary rocks by processc have acquired an increase: concerned and its associa as affecting the original a: Because of the fine stru and petrographic analyses causing silicosis or other dialytic, and other techniq Clinical and other evic the lungs is enhanced wh<. A sbestos and P ulmo.nar of L ung Cancer by 1955. The first case oi puliv asbestosis is described. Tl who for 29 years had wor life was confirmed by po- are briefly reported. The ; the capacity of asbestos to pational in nature only wl While there are many st. < researches are iew and a: adopted whereby the capa according to their chemiea E ffects of O xygen I nti and in Cases of E mi Med. lavoro 46:411-41 The effectiveness of tin mentally in seven silicotic, means of two devices fitted M.S.A.). Oxygen was givi Blood oxygen saturatio mittent positive-pressure b Experiments have show of atmospheric air present: to the subject, oxygen ii with the Pneophore gives oxygen therapy by means of the aTterial anoxemia, h saturation. Results obtained show ; ness in cases of lung disc; common oxygen therapy v V i ^ ^ X , Mr i i i ni-- OF IN D U STRIAL H EALTH ions, no evidence was forthcoming ie benzene products in the workshop E. L. Collis. .vese. J. Ropier, Arch. mal. profess. :, if possible, definite changes at an that poisoning was starting before of how advanced were the clinical iusing the toxemia.! No important but the phenolsulfonphthalein test patic function was hardly modified. '", v definite result. Tests of endocrine . was a diminution of the elimination '"he blood picture showed a definite blood cells was also present in 44%. ical signs in speech and gait, should tabolism, and in the elimination of -*- E. L. Collis. osis. A. P olicard and A. Collet, e sputum and in the lungs of cases ;y occur also in anthracosis. These y broken ends of asbestos fibers. But-'' n any part of a coal fiber and not photomicrographs. _ the surface of coal particles. The ain undetermined. Their occurrence frequency of processes of absorption h individual miner. E. L. Collis. itio.v at the B eginning of 1955. tut d'Hygiene des Mines 10:17 er information regarding dust sup* n in an appendix. The information They tell how dust control is being round, by wet drilling, by capturing passages or using hygroscopic salt work thereafter is also described, es that, on the whole, improvement ust be done to bring all dust under E. L. Collis. r iiylenediaminetf.traacetate. A. ' ation for 45 days with daily 2.5 gm. ied Pb excretion, decreased copro* blood level in one patient decreased ithological values during treatment. tippled cells and the eoproporphyrin concentration had increased, while [C hexi. A bstr.]. ABSTRACTS FROM CURRENT LITERATURE S ilicosis H azard in the W orking of Clays. L. P eretti and E. Occella, Med. lavoro 45:700-714 (Dec.) 1954. The joint authors of this paper are teachers of mineralogy and applied geology and of petrography and mining. They discuss the formation, the chemical composition, and the molecu lar structure of a variety of clays and clay-containing minerals which are used in such indus tries as brickworks, potteries, foundries and in the manufacture of refractories and of cement. In judging the .silicosis hazard of handling such clay materials, their various properties have to be taken into consideration; such are the content of free silica, more particularly the crystalline form, the size of the particles, and their liability to be easily given off and diffused and to be inhaled by those working in the affected atmosphere. The minerals with which the authors are here concerned are sedimentary formations which were derived originally from primary rocks by processes of erosion, transport, and settling, in the course of which they may have acquired an increased content of free silica. The paper discusses various types of mineral concerned and its association with other geological formations, its origin and development, as affecting the original and the final content of free silica. -- Because of the fine structure and complex composition of these clay materials, their chemical and petrographic analyses are often not sufficient for an assessment of their likely role in causing silicosis or other pneumoconioses; additional determinations (thermal, x-ray, electro- dialytic, and other techniques) may have to be undertaken. Clinical and other evidencewiiuggests that the property of free silica of causing fibrosis in the lungs is enhanced when certain hydrosilicates are associated in the atmospheric dust. J. Calchi [B ull. H yg.]. A sbestos and P ulmonary Carcinoma in an A sbestos S p in n e r : N otes on the I nduction of Lung Cancer by A sbestos F ibers. G. Rombola, Med. lavoro 46:242-250 (April! 1955. The first case of pulmonary carcinoma occurring in Italy in a subject affected by slight asbestosis is described. The malignant neoplasia was observed in a woman, 49 years of age. who for 29 years had worked as a spinner in an asbestos factory. The diagnosis formulated in life was confirmed by postmortem examination, the gross and microscopic findings of which are briefly reported. The present clinical, pathological, and statistical knowledge diagnosed on the capacity of asbestos to cause tumors is summarized. A tumor should be diagnosed as occu pational in nature only when the statistical data correspond with the experimental researches. While there are many statistical data (though not agreeing for all countries), experimental researches are few and are not concordant. According to the author, a hypothesis should be adopted whereby the capacity of the different types of asbestos to cause tumors would differ according to their chemical composition. F rom th e A uthor's S ummary. Effects of O xygen Intermittent P ositive-P ressure B reathing in Cases of S ilicosis and in Cases of E mphysema w ith S evere R espiratory I nsufficiency. E. S artorelli, Med. lavoro 46:411-418 (June-July) 1955. The effectiveness of the oxygen intermittent positive-pressure breathing was studied experi mentally in seven silicotics and in six cases of emphysema with severe arterial anoxemia by means of two devices fitted with tightproof oronasal masks (Bennett's apparatus and Pneophore M.S.A.). Oxygen was given with a spectacle-type nasal catheter for control experiments. Blood oxygen saturation was measured with the "Cyclops" oximeter during oxygen inter mittent positive-pressure breathing and oxygen therapy with nasal catheter. Experiments have shown that in all patients affected with lung diseases, who during breathing "i atmospheric air presented blood oxygen saturation rates varying from 55% to 89% according to the subject, oxygen intermittent positive-pressure breathing with Bennett's apparatus or with the Pneophore gives way to complete disappearance of the arterial anoxemia, while the oxygen therapy by means of nasal catheter, though producing a more or less evident reduction of the arterial anoxemia, lias in no case led to increases above 95% of the arterial blood oxygen saturation. Results obtained show that oxygen intermittent positive-pressure breathing, for its effective ness in c a s e s of lu n g diseases with severe respiratory insufficiency, should be preferred to the common oxygen therapy with nasal catheter as a method for the administration of oxygen. F rom the A uthor's S ummary. 565 A. M. A. ARCHIVES OF INDUSTRIAL HEALTH T ransactions of th e S eventeenth A n nu a l M eeting of t h e A merican Governmental I ndustrial H ygienists. A merican Conference of Industrial H ygienists, 140 pp., June, 19SS. Conference of Governmental Occupational Health Study in the Diatomite Producing Industry: Environmental Aspects, Dr. Lewis J. Cralley. Occupational Health Study in the Diatomite Producing Industry: Medical Aspects, Dr. W. Clark Cooper. The Health Hazards of Working with Flame-Proofed Fabrics, Mr. Irving Ettinger and Mr. Martin Jeremias. The Control and Disposal of Radioisotopes, Mr. G. W. Morgan. The Manufacturing Chemists Association Labeling Program, Mr. Sanford J. Hill. Mercurialism in Cinnabar Reduction in Idaho, Mr. Howard L. Burkhardt. Reduction of Incidence of Silicosis After Seventeen Years of Dust Control in the Barre, V er mont, Granite Industry, Mr. Harry B. Ashe. Uranium Operations on the Colorado Plateau, Mr. J. D. Torrey and Mr. P. W. Jacoe. Performance of Automatic Louvers in Industrial Ventilating Systems, Mr. Irving Kingsley. The Effect of the Calcium Chelate of Disodium Ethylene-Diamine Tetraacetic Acid on Lead in the Blood and Urine of Battery Workers, Dr. Ira A. Manville and Dr. Robin Moser. Potentials of an Occupational Health Program in a State Department of Health, Dr. Daniel Bergsma. Need for Threshold Limits, Dr. Miriam Sachs. Engineering and Chemical Application of Standards, Mr. Allen D. Brandt. Mimeograph copies are available in limited supply from Mr. Charles D. Yaffe, U. S. Public Health Service, 1014 Broadway, Cincinnati 2, Ohio. Physiology and Nutrition Economy of W ork U nder the Influence of I ncentives. B. P etz, Arhiv. hig. rada 5:321329, 1954. The question whether incentives are harmful to the organism has been very little investigated. According to the results of Bujas and Petz, the organism works more economically in the state of increased motivation. The author has tried to check these results by measuring the degree of fatigue after the work with and without special motivation. The fatigue was measured by letting the subject repeat static work of the same intensity after a pause which was not long enough to provide complete recovery. The experiments were performed with a mercury dynamometer. Results: 1. The endurance while performing static work was prolonged under the influence of increased motivation. Fatigue after such prolonged work was equal to the degree of fatigue which occurred in experiments without additional motivation and shorter work. 2. When in experiments with increased motivation the subject's effort was suddenly stopped at the moment corresponding to his maximal endurance without motivation, the fatigue was smaller than after the same work performed without additional motivation. The author concludes that the increase in work output caused by incentives is not due to an increase in energy expenditure but to a better and more economical use of the available energy. The author considers that incentives should be used within the normal working time and within the normal intensity limits of the average everyday work but not to increase the maximum work output; they have to be means to make the work easier and decrease the fatigue. Only in special cases should they be used also as means to increase the work output. From the A uthor's S ummary. Occupational Diseases and Hazards Significant Case of P neumoconiosis in a Soft-Coal W orker. L. L. F riedman, A. M. A. Arch. Int. Med. 95:328-332 (Feb.) 1955. The paper presents the case history of a soft-coal worker who had worked for an unspecified time at drilling in a coal mine when he first complained of breathlessness at the age of 46. His x-ray then showed simple pneumoconiosis. He continued to work underground for six years, after which an x-ray showed early progressive massive fibrosis in both lungs, and he gave up his 282 NDUSTRIAL HEALTH A merican Conference of -.rexce of Governmental v : Environmental Aspects, Medical Aspects, Dr. W. . Irving Ettinger and Mr. Sanford J. Hilt, lardt Jontrol in the Barre, Ver- Mr. P. W. Jacoe. is, Mr. Irving Kingsley. Tetraacetic Acid on Lead e and Dr. Robin Moser. nt of Health, Dr. Daniel randt. s D. Yaffe, U. S. Public Arhiv. hig. rada 5:321* n very little investigated, economically in the state measuring the degree of was measured by letting was not long enough to iged under the influence to the degree of fatigue irter work. 2. When in stopped at the moment was smaller than after entives is not due to an of the available energy, -mal working time and i increase the maximum lse the fatigue. Only in . tput thor's S ummary. . F riedman, A. M. A. ked for an unspecified at the age of 46. H is ground for six years, 's, and he gave up his ABSTRACTS FROM CURRENT LITERATURE work because of dyspnea. His sputum was negative for tuberculosis, and his tuberculin skin test was negative in dilutions of 1:100 and 1:1000 then and subsequently until his death at the age of 57, by which time he had developed extensive massive fibrosis with severe emphysema at both bases. Serial x*rays are given and lung sections prepared by Professor Gough, both confirming massive fibrosis with ischemic cavitation. The patient was treated with isoniazid and dihydrostreptomycin without effect. This case confirms the relentless progress of progressive massive fibrosis and coal miners' pneumoconiosis after exposure to dust has ceased, in the absence of a positive sputum and despite anlituberculosis therapy. Its particular interest lies in the observation that the Mantoux reaction w:Js neative- C. M. Fletcher [B ull. H yg.]. Occupational Cancer of the U rinary B ladder in D yestuffs O peratives and of the Lung in Asbestos T extile W orkers and I ron-Ore Miners. G. M. Bonser, J. S. Faulds, and M. J. Stewart, Am. J. Clin. Path. 25:126-134 (Feb.) 1955. The value to the cancer problem, as a whole, of the study of occupational cancer in the field and by experiment, together with the time lag between these two aspects, is discussed. A short consideration of the total amount of cancer in any population follows, and a classification of the types of recognized occupational cancer. More detailed consideration of industrial bladder and lung cancer follows. In regard to the former, the extent of the hazard, the nature of the chemicals involved, and their metabolism in various species are discussed. In regard to the latter, the occurrence of lung cancer in a group of 72 male and female asbestos textile workers and in 192 hematite miners in Cumberland, England, is described. The common factor in these two types of occupational lung cancer (in asbestos textile workers and hematite miners) is silica, and it is suggested that this may be the carcinogenic agent. The presence of silica (as silicic acid) causes pulmonary fibrosis which precedes the initiation of the malignant process. The fibrosis is usually of smaller degree, however, in those lungs in which cancer supervenes. On published evidence the case for an etiologic relationship between nodular silicosis per se and lung cancer is much less strong than in silicosis associated with siderosis and in asbestosis. Hueper (1952) examined the literature very thoroughly and came to the conclusion that "the available evidence supporting a causal relation between silicosis and cancer of the lung is unimpressive." It seems possible, therefore, that the fibrous nature of asbestos or the presence of hematite dust may exert a modifying effect on the chemical action of the silica or on the fibrotic process itself. Further study of the nature of the carcinogenic process in pneumo conioses is thus obviously needed. F rom the A u th o rs . S ummary And Conclusions. Treatment of Acute and Chronic Lead Poisoning with D isodium Calcium V ersenate. J. F. Wade J r. and J. F. B urxum, Ann. Int. Med. 42:251-259 (Feb.) 1955. Five patients with acute or chronic lead intoxication successfully treated with disodium calcium versenate (Ca EDTA) are reported. Ca EDTA produced a marked increase in urinary lead excretion which was maximal during the first 12 hours of therapy. Loss of body lead into the urine was accompanied by (a) rapid and striking amelioration of all signs and symptoms, including an "acute abdomen" ; (b) disappearance of gingival lead lines, and (c) return to normal values of basophilic stippled red blood cells and serum indirect bilirubin; no immediate reversal of decreased erythrocyte osmotic fragility. Mo toxic effects from Ca EDTA were observed. Ca EDTA affords a safe and effective means of therapy of acute and chronic lead poisoning. Since this paper was submitted for publication, the authors have successfully treated 14 additional patients with acute or chronic lead poisoning with disodium calcium versenate. B ull. H vg. Mortality A mong Workers in Cigarette Factories. H. F. D orn and W. S. Baum, Indust Med. 24:239 (June) 1955. This is a brief report of the survey carried out in the American Tobacco Company plants in Virginia, North Carolina, and Kentucky. A comprehensive health service and group-insurance program was initiated in 1946 for all employees. An analysis of the experience of 70,532 person 283 A. M. A. ARCHIVES OF INDUSTRIAL HEALTH years is given, and a comparison made between those employed in processing cigarettes, other employees, and a comparable sample of the local population. The results of this study show that the total mortality rate among employees engaged in processing cigarettes for the American Tobacco Company is definitely lower than that among the general population of Virginia and North Carolina. This is true for all causes, for cancer, and for cardiovascular diseases. The death rates for respiratory cancer and for coronary disease among employees of the American Tobacco Company do not differ appreciably from those among the general population. ' C H. Wood, Boston. T he P resent Status of S ilicone P rotective Creams. R. R. Suskind, Indust. Med. 24:413 (Sept.) 1955. "There is good reason to believe that the clinical protection afforded by a silicone formulation depends on its ability to provide an intact film which will repel or be relatively unaffected by specific chemical substances throughout the period of exposure. The efficacy of the repellent action is determined by (1) the physical and chemical properties of the silicone fluid, (2) the concentration of silicone, (3) the nature of the vehicle and its ability to make a uniformly repellent mixture with the silicone, and (4) the manner and schedule of application." Chemical and laboratory tests are described which were used to assess the relative value of four different silicone creams in protecting against exposure to commonly used petroleum fractions, polar solvents, water, usage concentrations of hand soap, laundry soap and laundry- synthetic detergents, soluble cutting fluids, cutting oils, formaldehyde, phenol, aqueous solutions of mineral acids, alkalies and salts. It should be emphasized that the present silicone creams arc not therapeutic agents but should be used strictly as prophylactic devices. While disappointing results have previously been obtained in clinical trials with a cream containing 2% silicone, good results can be obtained with creams containing 30% or 52% silicone. The latter creams are more expensive and not always pleasing from the cosmetic viewpoint, but if correctly selected for a specific irritant, they can be of great protective value. q j j W ood Boston S yphilis in Industry. J. G. D owning, J. A .M. A. 158:468 (June 11) 1955. The author gives a rough estimate of 600,000 cases as the prevalence of syphilis in industry in the United States. In one large organization in which 90% of the employees accepted serologic test, 4% were found to be positive. In another firm in which the employees were on a "higher socioeconomic" plane, the prevalence rate of a positive serologic test was 0.23%. A table is presented showing a decline in Connecticut from a prevalence rate among industrial workers of 4.0% in 1949 to 2.9% in 1953. The author concludes that syphilis will remain a problem for some time to come. He is of the opinion that it is worth while attempting to fin ! these cases in industry, so that the services of highly trained employees may be retained Mnd so that unjustifiable claims for disabilities due to syphilis and not to occupation may be eliminated. In areas where the prevalence rate of syphilis is high, the author recommends a serologic tes'. as part of the preemployment routine examination. The advisability of employing applicantwith positive blood serology should be decided not by management but by competent physicians. John P emberton, M.D., Boston. Carcinoma of the L ung in A sbestosis: R eport of Two A dditional Cases. K. M. Lynch and H . R. P ratt-T homas, South. M. J. 48:565 (June) 1955. The authors present the histories of two additional patients with asbestosis and bronchogenic carcinoma. These cases bring to 4 the number of patients with carcinoma of the lung in an autopsy series of 49 cases from workers in an asbestos-manufacturing plant who showed demon strable deposits of asbestos in their lungs. This is an incidence of 8.2%. The incidence of car cinoma of the lungs in the hospital service during the same period and in the same age range as the cases of asbestosis was 1.5%. This incidence of 8.2% is by far the lowest incidence recorded among five series relating to this problem, one of which reports an incidence of 16.3%. Thus statistical inference from this and other series does not allay the suspicion that there may be an association between the two conditions. The tissue reaction produced by asbestos dust is believed to be due to the physical nature of the asbestos particle rather than to any chemical constituent. The asbestos fiber causes 284 DUSTRIAL HEALTH rocessing cigarettes, other ng employees engaged in y lower than that among tor all causes, for cancer, - and for coronary disease eciably from those among Z. H. W ood, Boston. :in d , Indust Med. 24:413 by a silicone formulation relatively unaffected by efficacy of the repellent he silicone fluid, (2) thety to make a uniformly application." -ess the relative value of mmonly used petroleum undry soap and laundry ihenol, aqueous solutions --sent silicone creams are :es. While disappointing containing 2% silicone, :. The latter creams are but if correctly selected H. W ood, Boston, e 11) 1955. _of syphilis in industry employees accepted a he employees were on a gic test was 0.23%. A rate among industrial syphilis will remain a vhile attempting to find -s may be retained and ition may be eliminated, imends a serologic test i employing applicants >competent physicians. ton, M.D., Boston. t o n a l Cases. K. M. '5. -tosis and bronchogenic >ma of the lung in an it who showed demonThe incidence of carthe same age range as .est incidence recorded nee of 16.3%. ie suspicion that there o the physical nature asbestos fiber causes ABSTRACTS FROM CURRENT LITERATURE desquamation of the bronchiolar epithelium and an outpouring of numerous macrophages in an attempt to phagocytize the fibers. Fibroblastic proliferation and collagen deposition in the walls of alveoli and about the terminal bronchioles follow at a later stage. Experimental proof of progres sion from hyperplasia to neoplasia is difficult to produce. Mice exposed to concentrations of asbestos dust having the proper specifications as regards particle volume and size do not develop asbestosis or carcinoma, although pulmonary adenoma is frequently present. In fact, bronchogenic carcinoma of man has no counterpart in other animals. It appears that the pul monary tissue of dogs may respond to asbestos dust in a manner somewhat more closely analogus to man, Until a valid biologic experiment can be evolved, it appears that the evidence for |r against the possible carcinogenic effect of the asbestos fiber will rest primarily on statistical evidence and personal opinion. S tudy of t h e M echanism of A bsorption of P articulates in the R espiratory T ree: I. Quarterly Report N o. 1, S eptember 1-D ecember 1, 1953. A rnold E. R e if , Mary C. E lliott, T homas L. Chiffelle, and Clayton S. W hite. II. Q uarterly R eport N o. 2, D ecember 1, 1953-March 1, 1954. A rnold E. R eif, T homas L. C h iffelle, U lrich C. L uft, James Clark, Clayton S. W hite, M ary C. E lliott, and H elen S. B aker, Contract Da-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. The operating characteristics of the Roller Particle Size Analyzer were investigated as a means of prftffucing closely sized aerosols. Preliminary results are reported from studies of the pulmonary absorption of various dyes and particles of various sizes in rats and dogs. N uclear S c. A bstr. S tudy of the M echanism of A bsorption of P articulates in the Respiratory T r ee: I. Q uarterly Report No. 4, 1954 ( I ncludes an A ppendix: A utomatic E lectronically Controlled Respiratory C ycling V alve). J ames Clark II. S ummary of Reports Issued S ince D ecember 1, 1953. A rnold E. W hite, Margot P. H olcomb, H elen S. Baker, and Clayton S. W hite, Contract DA-18-108-CML-5050, Lovelace Foundation for Medical Education and Research, Albuquerque, N. Mex., Jan., 1955. Design and performance are described of an air-jet nebulizer for the production of water aerosols. Methods are described for determining the particle size of water aerosols. Design is described of an automatic, electronically controlled, respiratory cycling valve for animal respir ators. A brief summary is included of results from aerosol inhalation studies with rats. N uclear Sc. A bstr. A "F ollow- U p" Chest X-R ay S urvey in th e R hondda F ach : 1. P ulmonary T uber culosis. A. L. Cochrane, J. G. Cox, and T. F. Jarman, Brit. M. J. 1:371 (Feb. 12) 1955. This is an interim report on an ambitious and interesting attempt to eradicate pulmonary tuberculosis from an isolated Welsh coal-mining valley with a population of some 24,000. In addition to the intrinsic value of such a program, the authors wish to test the hypothesis that the advanced and progressive stage of coal miners' pneumoconiosis, known to the Pneumoconiosis Research Unit of South Wales as progressive massive fibrosis (P. M. F.), is a form of tuber culosis modified by pneumoconiosis. Only 1% of these cases give a positive sputum in life, but 40% do at necropsy. At the first survey in 1951, 87% of the female and 92% of the male popu lation over 5 years of age were x-rayed. At the second survey in 1953, 91% of the new population over 5 and 95% of those previously surveyed were x-rayed. The chief preventive measures taken after the first survey were the B. C. G. vaccination of children under 5 years of age, who were tuberculin-negative and were in contact .with active cases, and the hospitalization of active cases. All but 2 of the 112 active cases were hospitalized, but not all were willing to remain long in hospital. After the first few months there were nearly always 40 known infectious cases in the valley, who were carefully supervised by the public health nurse. At the second survey it was found that there had been a marked fall in the prevalence of infectious tuberculosis among the .women and a lower fall among the younger men. There had been a slight increase among the older miners and ex-miners. "In spite of ample hospital accommodation, 35 (amongst whom were 10 cases of progressive massive fibrosis) of the 112 cases which were infectious in 1951 were still infectious in 1953, and 46 new cases of tuberculosis developed in the valley between the two 285 abstrac ts fro m c u r r e n t l it e r a t u r e ork because of dyspnea. H is sputum was negative for tuberculosis, and his tuberculin skin was negative in dilutions of 1:100 and 1:1000 then and subsequently until his death at the e of 57, by which time he had developed extensive massive fibrosis with severe emphysema both bases. Serial x-rays are given and lung sections prepared by Professor Gough, both ntirming massive fibrosis with ischemic cavitation. The patient was treated with isoniazid i dihydrostreptomycin without effect. This case confirms the relentless progress of progressive massive fibrosis and coal miners' .umoconiosis after exposure to dust has ceased, in the absence of a positive sputum and despite uibercuiosis therapy. Its particular interest lies in the observation that the Mantoux reaction - negative. C. M. F letcher [B ull. H yg.]. upatioxal Cancer of the U rinary B ladder in D yestuffs O peratives and of the L ung :n A sbestos T extile W orkers and I ron-Ore Miners. G. M. Bo.vser, J. S. F aulds, ,sd M. J. S tewart, Am. J. Clin. Path. 25:126-154 (Feb.) 1955. 'he value to the cancer problem, as a whole, of the study of occupational cancer in the field v experiment, together with the time lag between these two aspects, is discussed. A short deration of the total amount of cancer in any population follows, and a classification of the - of recognized occupational cancer. ' re detailed consideration of industrial bladder and lung cancer follows. In regard to the , r. the extent of the hazard, the nature of the chemicals involved, and their metabolism in species are discussed. In regard to the latter, the occurrence of lung cancer in a group J male and female asbestos textile workers and in 192 hematite miners in Cumberland, :ul. is described. common factor in these two types of occupational lung cancer (in asbestos textile workers matite miners) is silica, and it is suggested that this may be the carcinogenic agent. The oe of silica (as silicic acid) causes pulmonary fibrosis which precedes the initiation of the .-.ant process. The fibrosis is usually of smaller degree, however, in those lungs in which . -upervenes. On published evidence the case for an etiologic relationship between nodular per se and lung cancer is much less strong than in silicosis associated with siderosis and 'tosis. Hueper (1952) examined the literature very thoroughly and came to the conclusion e available evidence supporting a causal relation between silicosis and cancer of the - unimpressive." It seems possible, therefore, that the fibrous nature of asbestos or the v <>! hematite dust may exert a modifying effect on the chemical action of the silica or tibrotic process itself. Further study of the nature of the carcinogenic process in pneumo- - is thus obviously needed. F rom the A uthors' S ummary and Conclusions. vest of A cute and Chronic L ead P oisoning with D isodium Calcium V ersenate. Wade Jr. and J. F. B urnum, Ann. Int. Med. 42:251-259 (Feb.) 1955. v. patients with acute or chronic lead intoxication successfully treated with disodium versenate (Ca ED TA ) are reported. 1.i KDTA produced a marked increase in urinary lead excretion which was maximal during 12 hours of therapy. " nf body lead into the urine was accompanied by (<i) rapid and striking amelioration mis and symptoms, including an "acute abdomen"; (b) disappearance of gingival lead '. I return to normal values of basophilic stippled red blood cells and serum indirect : no immediate reversal of decreased erythrocyte osmotic fragility. .\ ic effects from Ca ED TA were observed. : l>T.\ affords a safe and effective means of therapy of acute and chronic lead poisoning. this paper was submitted for publication, the authors have successfully treated 14 i patients with acute or chronic lead poisoning with disodium calcium versenate. Bull. H yg. ' \ mong Workers in Cigarette F actories. H. F. D orn and W . S. B aum, Indust 24:2.19 (June) 1955. 'i brief report of the survey carried out in the American Tobacco Company plants in - \..rth Carolina, and Kentucky. A comprehensive health service and group-insurance ' a- initiated in 1946 for all employees. An analysis of the experience of 70,552 person 285  IXqUSTRIAL HEALTH t autopsies; (2) by reexpanding by clamping the trachea before lefore section. An experimental received intratracheal injections preparing the lungs for section, veen the form and arrangement hose in lungs prepared by other ast majority of dust cells were ntly found over the phagocytes its that survived, a considerable he lymph follicles were almost ith carbon-filled phagocytes or s were nearly always adjacent arances suggest that, over the ions and show no evidence of ;>ithelial lining had formed over photomicrographs, in which a iiagocytes. with those where collapse has containing phagocytes is within e not dislodged during respirag of phagocytic cells, which, in deposits of dust thus formed lajority of anthracotic foci are sue or in the lymphatic system M iddleton* [B ull. H yg.J. ites. G. D eclercq, E. Bal(Xo. 28/29) 8:3-5, 1955.- >y intense itching and showed . sweating. The shoulders and trouble to contact with wood irritating spots persisted for the irritation temporarily. The .ring 1 to 2 mm., rather like a It was one of the numerous I). The place of origin of the ing to deal with such infected lemic. E. L. Collis. arsotti and L. P armegciani, II realized in the past 10 years is been observed among pyrite nal origin are still frequently nd rock, sulfur dioxide can be w oxidation of the mineral in e mineral is highly brittle and luring the explosion of mines. 2 ppm, now and then reaching ertion and particularly, when igns; with the passing of time eal irritation are frequently the bronchovascular network, leribronchial-typc reticulation basal median regions. After arkable improvement of the ABSTRACTS FROM CURRENT LITERATURE roentgenological picture, but the clinical conditions almost always remain the same. Pulmonary tuberculosis is seldom associated. With regard to occupational insurance in Italy, such disease should be recognized as caused by sulfur dioxide (Item 18 of table dated Xov. 15, 1952) ; miners would thus profit by manifold benefits, such as being entitled to a compensation in case of perma nent disability starting from a 21% decrease of the working capacity; they would be better treated, and, above all, they could get rid of the fear of silicosis which at present is often mis taken for chronic occupational bronchitis. Criteria for forming the differential diagnosis are analyzed, and suggestions are given for prophylaxis and treatment. F rom t h e A uthors' S ummary. I ncidence and C haracteristics of L ung Cancer in A sbestos W orkers. G. J acob and S M. Bohlig, Arch. Gewerbepath. u. Gewerbehyg. 14:10-28, 1955. This is a study of the incidence of lung cancer among asbestos workers in Dresden, with numerous references to and analyses of the literature. Cancer of the lung developing in asbestos workers is not recognized as an occupational disease in West or East Germany. The interna tional literature is based exclusively on the results of autopsies; the incidence among asbestos workers appears to vary between 12% and 17%. In Dresden, however, from research into cases at the clinic and among asbestos workers, it appears to be a rare occurrence. It is estimated that only about one-fourth of these workers have an effective exposure to the dust. In cooperation with the roentgenological and radium institutes the authors reviewed the cases of asbestosis reported since the middle 1930's ; they numbered 339 in all stages ; in the first stage, O-I, there were 42 women and 61 men; Stage I, 43 women and 74 men ; Stage II, 32 women and 61 men; Stage III, 13 women and 17 men. Silicosis was found in eight men. In 3 women and 10 men active, open tuberculosis was found; in this series the incidence of active tuberculosis was 4.4%. Four fatal cases of lung cancer in asbestos workers, which occurred in Dresden up to 1954, are described. The first patient was a woman of 46, who had been employed for three years, when young, as an asbestos weaver; autopsy showed typical asbestosis, with asbestos todies and with squamous-cell epithelioma of the right middle-lobe bronchus; no mtastass were found; the asbestosis was not diagnosed during life, the roentgenological changes in the lungs having been regarded as due to congestion. The second was a man of 49, an asbestos weaver, in whom abestosis was diagnosed roentgenologically, with a tumor in the left lower lobe and one in the right radius ; autopsy showed asbestosis and bronchial adenocarcinoma, with transitional squamous-cell epithelioma in the left lower lobe, mtastass, and a caseating tubercu lous lesion in the left lower lobe. The third- was a woman of 57, who had worked in asbestos, between 1922 and 1930, for three years as a molder and five years as a weaver ; she died in 1954; there was a definite asbestosis and a solid, spreading carcinoma of the right upper-lobe bronchus, with infiltration of the lung parenchyma and widespread mtastass. The fourth was a man of 66, who was known at the clinic as an asbestosis patient, diagnosed roentgenologically five years before ; he had been employed in asbestos as au opener from 1927 to 1930 and as a spinner from 1931 to 1948; autopsy, in 1955, showed a right-side bronchial carcinoma, with widespread mtastass in the lymph nodes, liver, and skeleton. A long discussion of the literature on cancer among asbestos workers includes an examina tion of the characteristics of the disease; the duration of exposure to asbestos dust and the latent period between exposure and diagnosis of cancer; the localization of the tumor, char acteristically in the lower lobes ; the histological nature of the tumors, the cell types and struc ture, and the statistical evidence. These characteristics are no longer convincing evidence of a high incidence of cancer in asbestosis. In the future, cases of cancer of the lung in asbestosis should not be published individually but should always be considered in the framework of the whole asbestos industry in the region. E. L. M iddleton [B ull. H yg.]. S pontaneous F issuring in J oints i.v Caisson W orkers. P. D eak, I. R ozsahegyi, and J. D evai, Acta med. Acad. sc. hung. 8:125-131, 1955. In the course of the medical investigation of 195 caisson workers, most of whom were healthy young men between 25 and 30 years of age, x-ray examinations of the knee joints were also made. In 25 of these x-ray pictures taken in the anteroposterior position, sickle-shaped translucent streaks were seen between the mesial condyles of the tibia and femur, following the contour of the femoral condyle. In some instances, instead of a continuous streak, a few tiny, pearly, translucent areas were noted. These appearances are considered to be caused by 615