Document Ddy76DZRaO0b34qG5Bqw4No9N

FROH 503 528 7151 PS INDUSTRIAL HYGIENE AND TOXICOLOGY Votin u s 19 SEPTEMBER, 937` N umber 7 TH E PROBLEM OF POSSIBLE 8TBTEMIC1EFFECTS FROM CERTAIN CHLORINATED HYDROCARBONS* Cecil K. Drinker, Madeleine Field Warren and Granville A. B ennett Department of Phytiology, Harvard School of Public Health and Department of Pathology, Hanard Medical School, Boiton, Matt. THE use of chlorinaled naphtha lenes and compounds of allied pharmacological (mobilities is extremely wide, and with the steady growth of the use of electricity is cer tain to expand much farther. For years it has been known that many of these compounds cause a troublesome acne, and there is a large literature upon this phase of the subject. Our investigations have not been concerned with chloracne but with the possibility of systemic effects following ingestion or inhalation of such products. In the spring of 193d, the HaJowux Corpora tion, a division of the Dukelite Cor poration, called our attention to three fatal cases of jaundice in workmen using chlorinated naphthalenes and chlorinated diphenyl, and requested that the subjwt tie iiivi.'ntizrvtrd ai Received for publication June 30, 1037. rapidly and thoroughly as possible.t In brief these cases were as follows: Patient 1. Male, age 21. The previous medical hiitory of this man was In no way significant except for the fact that he had an attack of jaundice about 0 weeks prior to his fatal Illness. Late in December, 1930. he became badly constipated and had much abdominal pain and distention. When ad* mitted to the hospital he was slightly Jaun diced and was evidently very ill. He wiu somewhat anemic and his skin, particularly upon the arms, face, chest and back, show*! many pustules. He died after a brief period in the hospital, and at autopsy was found to t The Halowax Company makes mnv products besides chlorinated naphthalenes, and it has come to our knowledge that all of these products are indiscriminate Iv called " halowaxes" by purchasers and users, and are lumped together a possible causers <i{ acne ami even of avstemie disease. sine "halowax" (a merely a trade designation rare should be taken tn d*-*cnb rnm|*iun.|j b /'lh e tr chemical nnm"* and tbo* nv.-i-I condemnation which v both troublesome sod misleading. 283 1-KUn 5 0 3 5 2 8 7 1 5 1 P6 284 JOURNAL OP INDUSTRIAL HYGIENE AND TOXICOLOGY 1937 have a. cirrhosis of the liver with acute yel low atrophy superimposed upon It. This man had been exposed to low concentrations of vapors arising from a mixture of tetra and pentachlomaphthalenes, together, with approximately 10 percent of a refined chlo who had been exposed to trichlornaphthalene. Of these 13 were found to have mild digestive complaints, anorexia, nausea and vertigo, but Courtoia-Suffit remarks finally, 11Ab 3. A m i x t u r e o f p e n rinated diphenyl. While both he and others engaged irr the same work bad chloracno, there were no other disturbances of health in fellow workmen, nor was there any pre cipitating cause for the acute yellow atro phy such as treatment with arspbenomine sorption Is certainly possible and we have for proof of It some of the diges tive and general complaints which have been due to it. But they appear to be of little consequence considering c h lo rn u p h t In d e n t In u d d itio u , -u h lim a te ( 3) w e n * c o l l r i - h - d i n n i l s u b c u ta n e o u sly . N o n e o f tin * : i m m : d > r* or exposure to dangerous concentrations of carbon tetrachloride. Patient t. This was a young man who died in February, 1936, after an acute illness characterized by jaundice. He had been expused to fumes arising from a mixture of the mildness of the digestive troubles and the absence of respiratory phe nomena." In Touroine's cases the exposure was to a trichlomaphthalene, whereas the , I th e s u b lim a te ir*< m - a f t e r 2m o n t h - w e r e u m i i a u t o p s i e d . T l 'ii-' -i- m a ls re n d v in e 4 -n '-- d a y :tm l tin * In ** *i. penta and hexachlornaphthalenes. There is no record of chloracne. The patient worked with a large number of other people of whom but one (Patient 3), a close friend, had significant illness. Patient 3. Another young man employed American cases of acute yellow atrophy were exposed to compounds of higher chlorination. Our own experiments indicate that trichlornaphthalenes re quire enormous dosage, far beyond * . T hose reerivim: *1 - i wen* even in- * - .\iiti> v in ` striking eh.i . li-MTilieil, with Patient 2. He became jaundiced in March, 1936, and died after an illness of 2 weeks. A careful autopsy resulted in a diagnosis of acute yellow atrophy of the liver Here again no history could be ob tained as to a precipitating cause, and there was no record of preceding attacks of jaundice. anything encountered in industry, in order to produce liver damage. Teleky (1927) reported a number of cases of chloracne in persons exposed to chlorinated naphthalenes with a chlo rine content ranging from 14 to 53 per cent. He found that the lower the . I j i | | a n ile yell*- suggestive telude tlint th id e u e s <n them are e i atrophy of: At the *. In addition to these three very re chlorine content the less the acne. j Flinn ami !. cent fatalities, we have learned of four Mittelst&dt (1935) examined a number other possible cases, none of them of cases of chloracne due to trichlor- It | f a c.t t h a t ( ' ol acute yi fatal. All of these have had jaundice naphthalene arid reported a number of J in m e n w u r * . and the entire group consists of iso vague general complaints but nothing lated individuals who have been picked in the. nature of serious disease. Re ' ^ t h a i e n e s !< ' . to th e m . out of large groups having the same garding his animal experimentation, exposure. In but one instance, Pa Lehmann (1919) reported that ani I th e s,amt e b e g in n in g tient 1, is there record of antecedent mals fed chlorinated naphthalenes re ` 4.ne n disturbance of health, and the general fused to eat after a time and that, ' literatim - health of fellow workers has been good. whether poisoned by inhalation or by : th e s e s u l> -' Such cases have not been reported feeding, at death showed "peculiar" j 1. W ill. in the medical literature and only occa lesions in the liver. Flinn and Jarvik i tim i u f m sionally can one find reference to sys (1936) gave subcutaneous injections of . a n d J u rv ii. temic effects of any sort. For exam enormous doses of chlorinated naph i or even - ple, Courtnis-Suffit (1934) reports on thalenes dissolved in paraffin oil to , iq x m liu n work i! by Tuumi:' and his ns.o- rabbits. The compounds used were ' 2. Tl.. "iates ( l`J'54) who examined W) workers as follows; i that the r nun JUU f 13 1 P7 their initial loss in weight and were gaining. The liver lesions were similar to tliose round in rats fed penta and hexachlornaphthalenes plus 10 per cent chlorinated diphenyl but not so marked. Summary of gross feeding expertments.--Of the various materials fed rats in large doses trichlbrnaphthalene plus traces of tetrachlornaphthalene was quite innocuous. Tetra and pentachiornaphthalenc showed definite liver damage. Penta and hexaclilornuplithalencs caused a similar grade of injury. The addition of chlorinated diphenyl to penta and hcxachlornaphtlialeiins increased the toxicity. Chlo rinated diphenyl alone produced liver IMuns hut in the dosage used was less effective than when mixed with highly cli'orinated naphthalenes. In no case did the compounds used produce acute yellow atrophy but the lesions ob served indicate this might be possible if one found a dosage which could act for the proper period of time. Feeding Precise Doses by Stomach Tubs The compounds employed were sus pended in gum acacia. In figuring the dosage the total amount a man of 50 kg. would inhale in an 8-hour day assuming an air concentration of 20 mgm. per cu. m. was first calculated and reduced to milligrams per kilo gram. The rats and rabbits received this dose each day. The compounds used were those employed in the gross feeding experiments and the results were essentially similar though the lesions were less severe. Subcutaneous Injections The .-ame gum "crn-h Mispcnsions were injected subcutaneously into rats and rabbits, the dosage being calcu lated on the basis of 4 mgm. per cu. m. of air. Again similar results were obtained. In all such experiments there must of necessity be differences in the degree of effect but invariably the liver was the sole organ affected and the lesions were those already described many times. D iscussion These experiments leave no doubt as to the possibility of systemic effects from the chlorinated naphthalenes and chlorinated diphenyl. As in the ca^e of the effects upon the skin, the degree of chlorination seems to determine the systemic toxicity, and it is a striking thing that when tricliiornaphthalone is reached systemic effects are never marked and are produced with the greatest difficulty. It is most remark able, too, that all the compounds tested attack the liver and the liver alone. During the past few months we have determined the organically combined chloride in the livers of ani mals very severely poisoned by penta aod hexachlornaphthalenes but have found no increase over normal figures, though the livers, as determined histo logically, were very severely affected. At the present time we are conducting inhalation experiments on a chlorin ated diphenyl containing 55 per cent of chlorine instead of 64 ppr cent as in the case of the experiments reported in this paper and on a compound with a chlorine content between tri and tetrachlornaphthalene. Wc arc also determining the degree to which the diet may increase or decrease toxicity, this being suggested by similar work upon carbon tetrachloride. In the basis of these experiments I ^ roL 19, no. 7} EFFECTS | and on many field dete I different compounds in tl * rooms, it appears safe j * tainly easily attained, t j that the air breathed J more than 0.5 mgm. per I of these compounds at naphthalene. In the cos | compound concentration: i are permissible. We many examinations in n ; plants that such concen j been greatly exceeded di 20 years, and we are cor fact that our rat ex; ** been inexorably const human exposure is neve Time and careful obse change these opinions as but today we are convii: * safe. Impregnating tan [ arrangements utilizing tli . hydrocarbons are easy tu j safeguard. Compared ; lead tetraethyl and man; i%i * CouRtois-SurriT: tude am | professionnelle par le : talne. Ann. tie m*d : (193-1). Abstr. uf pap*r A., and Mn thei.. ll m professionnelli's par U ses drivs. Prat m<335 (1934). . Flwn, F. B.. and J aryik. v certain chlorinated napt i liver. Proc. K.xp**r 36, MS (19301. Lehuann, K. B : Kurret Arheits- und t*ru*rh**V ; tel, Leipiig, icrj fp J.'l M<un 503 528 7151 P3 ULOGY ISepi. 1937 losage being calcuf 4 mgm. per cu. m. miliir results were such experiments sity be differences feet but invariably sole organ affected were those already 1C3. ScilON leave no doubt y of systemic' effects `<1naphthalenes and .vI. As in the ca>e the j-kin, the degree .us to determine the Mid it is a striking i.'lilonmphthalene is *licet* are never <iinhnni with the It is must remark 'll the* compounds liver and the liver I- past few months ird the organically in the livers of aniv poisoned by penta inlmlcncs but have over normal figures as determined histo ry severely affected, -.e we are conducting inents on a chlorinMtnming 56 per cent .I of 64 per cent as xperiments reported a u compound with ut between tri and dene. We arc also degree to which the or decrease toxicity, uul by similar work .u chloride. *f these experiments * ml. 19, no. 7\ EFFECTS OF CHLORINATED HYDROCARBONS 299 and on many held determinations of different compounds in the air of work rooms, it appears safe and it is cer tainly easily attained, to ventilate so that the air breathed does not contain more than 0.5 mgm. per cu. m. of any of these compounds above trichlornaphthalene. In the case of the latter compound concentrations of 10.0 mgm. are permissible. We know from many examinations in many different plants that such concentrations have been greatly exceeded during the past 20 years, and we are conscious of the fact that our rat exposures have been inexorably constant whereas human exposure is never so ordered. Time and careful observation may change these opinions as to standards, but today we are convinced they are safe. Impregnating tanks and other arrangements utilizing the chlorinated hydrocarbons are easy to hood and to safeguard. Compared with benzene, lead tetraethyl and many other com- pounds, these substances are very little toxic and operations employing them can easily be safeguarded; It may be argued that where possible trlchlomaphthalene should be used, but this compound will cause acne and if employed very carelessly might do more. Furthermore, higher chlorina tion is often essential for highly prac tical reasons. The solution consists in thoroughly adequate ventilation plus good housekeeping around all wax containers. A final word of caution bears upon the use of>carbon tetrachloride as a wax solvent. Obviously this- compound adds readily to the toxicity of the highly chlorinated waxes. If carbon tetrachloride is used, ventilation should be excellent, but in our opinion it would be better to dispense with car bon tetrachloride and depend on other solvents, especially upon those con taining no chlorine. BIBLIOGRAPHY CouRTOis-Scrrn: tude sur I'intoxics,toti professionnelle par le trichloronaphtalne, Ann. de md. lgale, 14, 423 (1934). Abstr. of paper by T odhains, A., and Mnthel, B.: Dermatoses professionnelles par la naphtaline et ses drivs. Prat. md. fran., 75, 335 (1934). F liNN, F. B., AND J ART!K, N. E. ! Action O certain chlorinated naphthalenes on the Hver. Proe. Soc. Exper. fliol. St Med., 35, 118 (1930). Lxumann, K. B.: Kurzes Lehrbuch der Arbeiti- und Gewerbehygiene. 5. Kir sel, Leipzig, 1919 (p. 251). Mittelstadt, O.: Gewerbeschfidigungen durch Haftax (Trichloraaphthalin). Inaug. dissert., Jena, 1935. T ebbens, B. D.: Portable combustion ap paratus for field determinations of chlorinated hydrocarbons. T his J., 19, 2W (1937). T elekt, L,: Die Pernakranlcheit (Chlor* acne). Kiln. Wchnecfar., 6, 897 (1927). T ouraine, A., Solente, MNrneL, n., AND Aubbon: Cinquante-quatre cas de dermatites par tricldoronaphtaline. Bull. Hoc. dermal et ayph., 41, 203 (1934). JJiO ( i 3 1 P9 .an 300 JOURNAL OP INDUSTRIAL HYGIENE AND TOXICOLOGY [Scft, 1337 D iscussion Da. Cecil K. D rinker: Wo have had incline them to. First of all I shall ask quite a long morning, but since Dr. voa Oat- Dr. Sayers if he will open the discussion tingen has to leave, I am going to oak him for us. to say a word. Dr. R. R. Savers (Chief, Division of Dr. W. P. von Oethnuhn (Direotor, Industrial Hygiene, National Institute of Haskell Laboratory of Industrial Toxicol- Health, U. S. Public Health Service, Wash gy, Wilmington, Delaware): I wish to con ington, D. C.): Dr. Drinker, Ladies and gratulate Dr. Drinker and hia group on the Gentlemen: It gave me a great deal or pleas very interesting and excellent work on the ure to have the opportunity to listen to the subject, I also wish to congratulate the excellent and interesting discussion and Halowax Corporation on the fact that they presentations made this morning. Dr. didn't spare any effort to elucidate the prob .Drinker, and I might add, the members of lem so that the dangers which apparently the Halowax Corporation, have discussed are connected with the use of this material this matter with us, os well os the manu can he controlled. facturers of'the diphenyls. 1 jureonally believe that there is no toxic We have been doing some work but not iiiuterial which cannot be used safely if it is nearly as extensive as that carried on here. handled properly. In order to handle such The work that we have been doing seems to mate rials properly during the different oper confirm the work that Dr. Drinker has car ations it is absolutely essential to be famil ried on. I think there are certain parts of it iar with the tnxicity and especially with the that we can very well keep in mind. nwliantsm of the action. Since there is no We are dealing with toxic substances, but aninml which corresponds In all Its physio- ws are dealing with toxic substances each logical characteristics to the human being and every day in industry--harmful sub H is important that such compounds be stances, hazardous substances. That these studied with different species of animals so eon be controlled is well known, no matter that one can get a cross-section of the poten what they are, and that we can use them and tial dangers. use them in a safe manner. Dr. Drinker In addition, this fact illustrates the im has called your attention to the fact that portance of the pre-employment and peri this apparently has been done and can be odical examination of workers in such work. done in any of the plants where halowax is As was pointed out by Dr. Drinker, there used. I have information from one or two are individuals who are apparently more of the other men who are in the audience susceptible to certain toxic agents than that In plants whe're damage has been done others. On the other hand, we have to try --skin damage and apparently liver damage to detect the very first algos of incipient to some of the workers--the manufacturers poisoning in order to prevent more eerious have since corrected the conditions and ap damage. In the present instance it is very parently have adequate engineering con difficult to find these very first symptoms trol supplemented with adequate medical because there are no adequate methods, but control. f trust that in time the scientific profession After all, the proof of the pudding is in will, supply the medical profession with the eating. If the man does not get the dis adequate methods which will allow the ease your engineering control is successful. physician to determine incipient damage of If he does get the disease, no matter what the organ before serious clinical symptoms you have done in the way of engineering, become manifest. you haven't been successful. We must go Thank you. hand in hand. Neither profession alone Afternoon Sestion can be successful. We have got to work together whether we like it or not. I bap-, Dr. Cecil K. Dtiinxeji: In this discus pen to like It. sion I will call on one or two individuals and There is one other thing. As far as mate I shill expect others to speak sa their notes rials are concerned I think we ought to b* * I itI I j i1 i | i 1 > col. IP, no. 7] EFFECT. smart enough to use every cessfully. If this materb adapted for a certain purp> it. Another material the vious to this for insulation was flammable, caused a i approximately 107 men lo, say approximately 187 be never just sure whether I( I t might have been one or ti were quite sure that 167 lot happened when they had i with this material. They electric cable. It was co armor on tbe outside. It n `and was being lowered in to , proximotely 3000 feet deep to a steel rope. It slipped bottom of the shaft. When inspecting It he ht-t it on f bids cap-lamp. The rorbui the fire killed tbme men tli mine. Many oi t-uur-e Here we have haiar. Now we have an> I'.er -i due to the to u r mati-m.' evaluate them, t***ftam { I am informed, &r- tit* not just sure how fiamuiaL flammability prohibit chlorination inrr*ar* iJ-i also increases n v -ur creases, according '.> Dr , think that checks * it.i .Si- have-these haiur-J* t *i.a control them. 1 i -um** we can. Perhaps we can `Vwf '.*# . are better even -.. , present time I a:n better, I am a*D.--; * i submarines, i t n i,,'< - non-flammable t - of their electric a. * Du. Cecil K you care to say a Dr . Alrxrt * *. * of Occupational . . . . . . neeticut Depar*Conn.): Dr. l)r-* anything tb it I * * this material it. I f\ ( jUi) Did i' 1^1 P 10 0 0 V fr?epf. 1957 -<f all I shall ask <>n the discussion hief, Division oi :iunal Institute of ith Service, Woshiikcr, Ladies and treat (leal oFpleaaity to listen to the ^ discussion and ': morning. Dr. \ the members of have discussed -etl as the manu- me work but not t carried on here. i*n doing seems to Drinker has carfi'rtain parts of it 1>in niitul. oubstmices, but substances each *ry -harmful aub:i*es. That these ';nmvn, no matter cun use them and r. Dr. Drinker . to the fact that done and can be here halo wax la from one or two ; in the audience iqe has been done ntly liver damage 'he manufacturers .uditious and ap.Migingering con.adequate mediral ihe pudding is in t*.i nut get the dis'.trol is successful. \ no mutter what ty of engineering, -ful. We must go profession alone imvo got to work it or not. I hap- (. As far a* mateik we ought to be col 19, no. 7\ EFFECTS OF CHLORINATED HYDROCARBONS 301 smart enough to use every one of them suc cessfully, If this material is particularly adapted for a certain purpose we should use it. Another material that was used previoua to this for insulation purposes, which was flammable, caused a disaster In which approximately 167 men lost their lives. I say approximately 167 because they were never just sure whether it was 167 or 168. I t might have been one or two more but they were quite sure that 167 lost their lives. I t happened when they had Insulated a cable with this material. They bad an armored electrio cable. It was covered with lead armor on the outside. It was 1200 feet long and was beingloweredinfcoamine shaft ap proximately 3000 feet deep. It was lashed to a steel rope. It slipped and fell to the bottom of the shaft. When the foreman was inspecting it he set it on 6re with his car bide cap-lamp. The carbon monoxide from the fire killed those men that were in that mine. Many of course escaped. Here we have one hazard, a fire hazard. Now we have another one, a health hazard due to the toxic materials. We have to evaluate them. Certain of these materials, I am informed, are also flammable. I am not just sure how flammable they are but flammability probably decreases as your chlorination increases. But your toxicity also increases aa your chlorination in creases, according to Dr. Drinker, and I think that checks with other findings. We have these hazards to balance but we can control them. I feel quite confident that we can. Perhaps we can find other substances that are better even than this material. At the present time I am advised that we have no better. I am advised that in ships, such os submarines, it is quita important to have a non-flammable substance for the insuletiun of their electrical wire. Dr. CcctL K. Drinx rs : Dr. Gray, would you care to say a word! Dr. A u s n r S. Grat (Director, Bureau of Occupational Diseases, State of Con necticut Department of Health, Hartford, Conn,): Dr. Drinker, [ don't think there is anything that I can Bay except that we used (his material in Connecticut and we had a number of so-called cases. All I can say is a confession of ignorance on our part at that time and I was very glad to see that your digging Into the literature as thoroughly as you have hasn't elicited any further infor mation than we were able to get, basically. About all we could find was about the two cats that our friend, Lehmann, experi mented with. We got In touch with him and he confessed that the amount that he had given the oats and bis method of determin ing it were probably subject to very serious scientific criticism, and we agreed witb him on that point. We felt, and I am very glad that it is what you feel as a result of your experiments, that if we put in an efficient ventilation sys tem sufficient to prevent the dermatitis, we probably wouldn't have liver damage. That is what we did entirely empirically. i think that is about all I have to say. [ have been delighted to be hers and to have as many members of my staff here as I could jack out of the office. We have been de lighted to Liston to the discussion. D r. Cecil K. Dmnxer: May we now make the discussion general and those who have questions please volunteer. Mr. Manfred Bowditcr (Director, Division of Occupational Hygiene, Massa chusetts Department of Labor and Indus tries, Boston, Mass.): I would like to second very.strongly what Dr. Sayers has said with regard to the approach to this problem in proper control rather than by prohibition, which seems to-me wholly unnecessary not only in this case but in the case of other toxic substances with which wo have to deal. The problem of proper ventilation seems to me relatively simple from what I have heard of the situation thus far. The problem uf maintaining that ventilation properly does not seem to me quite so simple. I think it is going to be quite necessary that there should be a very adequate inspection uf the plants using the materials and l can assure you that that will be the case here in Massachusetts. When this trouble first broke in this state a little over a year ago wo issued a quite strunjtfy worded warning letter to all plant using these substances tnd it has all along i-Kuri s u i 528 7151 :*?&sSSffi P 11 302 JOURNAL OP INDUSTRIAL HYGIENE AND TOXICOLOGY [Sepf. 1SJ7 been my plan bo follow that up with a fur ther letter bringing the situation os we now know it, as a result of Dr. Drinker's work, to the attention of users in this state. In that letter we shall unquestionably advo cate the concentrations that Dr. Drinker has suggested this morning. One point that I think is worth comment ing on in that connection is the question of identification of the substances. I t Is ex tremely important from the state adminis trative point of view that employers using these substances should know what they are using. They are identified a t present only by numbers. If we list those numbers in a warning letter which we send out there are likely to be changes in those numbers, The Halowax Corporation is a progressive con cern and it is going to be putting out bigger and better halowaxes all the time. The company's cooperation in this present investigntUm has been such that I feel assured thut they will take the proper steps to see tlmt we in the state offices and also the users of the products will know what we are using. I wunder whether Mr. Brown would care to say anything about that. Mr. SAt/DFonn Brown (President, Halowax Corporation, New York, N. Y.): There are orne aspects of this situation on which I think I can enlighten the medical and state and civic authorities, with respect to the commercial and practical aspects. If you go into the research laboratories of auy large chemical manufacturing company today you will find anything from one to a thousand different new ehemic&rproducta which have not yet been put on the market, riuiuc of those may or may not be toxic. The problem so far as the chemical manu facturer is concerned is a question of timing. You have heard this excellent presentation given this morning by the Drinker brothers ns to the work that they have done here. Should you take a product of which you have developed, say, 5 or 10 gm. and spend 550,000 on research to determine whether or not it is toxic or should you wait until you have determined whether you have a market fur it? If yuu ore pruducing only one hundred substances a year you can see that that would run into boxcar numbers in the way of dollars and cents before you ever sold .any. That is the problem we have had in this case. It has been on the market for 25 years. Until within the past 4 or 5 years there has never been any intimation that it would cause any systemic effects. Thou sands and thousands of workmen have dealt with millions and millions of pounds of cer tain of these materials, particularly the trichlornaphthalenes. Then we come to the higher stages, combined with chlorinated diphenyl and other pruducts, and suddenly this problem is presented to ub. We bad asked various authorities in terested in public health, going back over a period of 15 to 20 years, to investigate it but there.wasn't much enthusiasm for it. Mr. Bowditch suggested that we take it up with the Drinker brothers at this institu tion, which we did. You know the results of that work. Now so far as these changes are con cerned, they are beyond our control to a certain extent. We will manufacture a product--let's call it 1234. It has certain chemical and physical characteristics. It is supplied to a cable manufacturer. It is composed of certain constituents. There may be somB tetrachlornaphthalene. trichlornaphthalene, paraffin, a little pitch or bitumen, and possibly some chlorinated diphenyl. It does a certain job but he wonts it to a little more plastic or he wants Its viscosity or the specific gravity changed. Possibly by a change m those constituent! of only 1 per cent we can get that particular property. We can't sell it to him as the same product eo we put a new number on it. Basically, however, if the variation in the chlorinated naphthalene or the chlorinated diphenyl constituent hasn't changed, the toxic property of that will not change. When it comes to a question of cooperat ing with the state authorities in that con nection, if there were some major change made in a product we would have no hesi tancy in advising them and we would also advise our customers. Virtually every con sumer of these materials at some time or another has been given their technical or chemical designation along with their vari ous properties, whether they be phyaical'or chemical. Those ara some of the practical problems col. 19, no. 7J EFF m * with which all manufa ; are confronted today, I synthetic organic field 1 merit is sa rapid that u ; can'teven keep up with ments sometimes, in kr * doing. Mr. F. R. K iiuer I sger, York Wlreworka. < i York, Pa,): I am certi t this opportunity tu sa reference to the experl' our York plant I perl again in this *xper the best teacher I !i problem at Yik *ith through the e It is only U v- ir\ ** neighborhood I 1*m -* various degree *l :i;ia all know. I .<t r *- severely fiifii --j as their ski!, man died m* : * *r uted his 'i vapors hut * was an atp-e' of the aut>-i<- . : that it was * . . . . work. Kn- - < was e m p l u > * : tion that U* *. * , * thin, pallid .i. . 4 - . not say ir*-'ti physical maa* . he present*--! * ever, it ivu , the time w* plained uf*1 advised that * rapidly . I n in the ho:*i * . died. More sen . that we ha : '< . tion as far *. first ream had was * p lan t. 1 . that fur t c , aid but it- e> well hat* winds an i . r n.u ri O.S 528 ?151 P 12 rca.'! : 7Cj; -> :Y [Sept. ISS7 i you ever sold '.ve have had in the market for puct 1or 5 years lunation that it >tfecta. jThou.men have dealt f pounds of cerirularly the tri,\q come to the ith chlorinated ?, und suddenly us. authorities in* in back over a - investigate It luisiusni for it. t we take it up At this instituiimv the results .iiigci are contr control to a :uiufiu-tiire a It bus certain .u-tcrisiic,*. It ''*iurvr. It is tueiits. There jilitliuleiu;. triii liulu pitch mu) chlorinated in jub but he tic or he wants .ravity changed, -i- con stitu en ts that particular t. him as the a number on U. v.iriutiun in the the chlorinated t changed, the *iot uliunge. i.mi of eobpuratics in that con- major change have nu healwe would alao nully every con st some time or ir technical or with their variv he physical or ncllcal problems fof. 19, no, 7\ EFFECTS OF CHLORINATED HYDROCARBONS 303 with which All manufacturers of chemicals are confronted today, particularly in the aynthetin organic field where the develop ment is so rapid that uur sales departments can't even keep up with the research depart ments sometimes, in knowing wbut they are doing. Ms. F. R. ICaimer (Assistant to Man ager, York Wireworks, General Electric Co., York, Fa.): I am certainly pleased to have this opportunity to say a few words with reference to the experience we have had at our York plant. I perhaps should say that again in this case experience alone has been the best teacher. 1 have lived with the problem at York with the men who went through the experience from its beginning. It is only 1} years ago that we had in the neighborhood of EOto 60 men afflicted with various degrees of this acne about which you all know. Eight or ten of them were very severely afflicted--horrible specimens as far .as their skin condition was concerned. One man died and the diagnosis may have attrib uted bis death to exposure to halowax vapors but we are not sure of that. There was an atrophied condition found as a result of the autopsy but we are not definitely sure that it was or was not connected with his work. Knowing the man os I did when he was employed, with the superficial examina tion that he had, he appeared to me very thin, pallid in his appearance, and I would not say from piy poor knowledge of the physical make-up of the human being that he presented a healthy appearance. How ever, it was only for a 6 months' period from the time of his employment that he com plained of this constipated condition and we advised that he see his home physician. It rapidly developed to the point where he was in the hospital and in a very abort time he died. More serious than that perhapa is the fact that we had 50 other men In very bad condi tion os far as the acne was concerned. The first reaction that several of our executives had was to throw it out--get it out of our plant. They didn't want anything like that for treating wire. But that was easily said but not so easily done. We might just as well have thrown our business to the four winds and said, "We'll close up," because there was no substitute and there is none today in Bpite of all the efforts we have made through our own research laboratories to find one. But we did develop--and t was most closely associated with it--and set up & routine for bringing these men back to nor mal health conditions. A number of them were sent to Dr. John H. Stokes and to Dr. O. H. Ferry Pepper of the University of Pennsylvania Hospital, and the others to Dr. Isaac R. Pels at Johns Hopkins. Through their recommendations and studies we employed a trained nurse and two local physiciana and you might ay wiabUahad a small hospital and its facilities at the plant. Through the application of quartz light, x-ray, mechanical removal of comedones and the treatment of pustules that de veloped in later stages, an utterly strict routine where the worst cases were adminis tered to each day for a period of 15 to 20 minutes, another group who were less seri ous three times a week, and still another group once a week, we have in this year und a hall brought each and every man back to a normal skin condition. Those who were very seriously afflicted do sboir scars, but otherwise their skin ii as healthy in appear ance os my own, I tell you we are very proud of the fact that they are still all em ployed and the amount of halowax that we are using today Is even greater in quantity and in types than ws were using a year and a half ago. With the adequate ventilation system we have installed, with the routine for change of clothing from street clothing to work clothing when they coma to work and the reverse of that process, with the assurance that a shower will be taken before the street clothing is again put on, we have found no recurrenco of this skin trouble. Each and every man working with halowax products, either from solution, from solid compounds or handling the wire naulated and treated with it, Is examined twice yearly with a com plete physical examination, including blood analysis and efforts to determine any liver damage. However, there is the point which was very definitely brought out this morning. We do not know as yet when this thing starts. I believe it would be of great help r m j i (' v '. : ' . i; :`t^ ' 304 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY (Sepi. 1937 to ua all in industry if some very funda mental work was done on humans, as Dr. Jones mentioned before we came into this meeting, some control In fundamental work to determine some method whereby we may determine the Inception of any liver dis order. i We have had our men examined In groups three times since the trouble developed and nothing has shown up In any one man. We have learned and appreciate the fact that we must handle hazardous materials, but we luive learned how to handle them. I t has been a very great experience for us and for myself, and again the best teacher. Dr. Cecil K. Drinker: Can you recol lect the air concentration that you are main taining now with your present ventilating equipment? Mr. F. R. K a iu e r : We have had two examinations made af the air by Mr. Wil liam F. Henipcrly and they average from 0.2 to O.U mgm. per cu. ra. We recently dis covered one condition which was found as the cause of a high reading In one of the examinations. The compound is one that is not manufactured by the Halowax Cor poration that is used rather infrequently, perhaps not more than SO gallons of It In a 0 month period. It is in the form of a paste, reduced with solvent to a paste form, and it was not known that it contained a chlorin ated solvent la certain percentage. We dis covered it only recently through the analy sis of a sample and we found that that woe the cause of throwing the results off to a high value. It was then aboutSmgm. percu. m., 1 believe. T hat ia going to be eliminated now. T hat is a combination of toluene and carbon tetrachloride solvent. When that compound is exposed to the air the chlorin ated solvent odor is completely masked by the toluene. I t is lost. I was able to detect it only by removing the head of the drum and immediately smelling the odor of carbon tetrachloride. Aa soon aa that head was removed fora period of 10 seconds the tolu ene predominated and we had no knowledge of the other boing in there. Mr. Arthur G. Deter (Research Engi neer, United American Bosch Corporation, SpringEeld, Mass.): Do I understand you to a&y that those men who were afflicted are back on the same job? Mn. F. II. Kaimer: They all returned to normal skin health, as I eay, and are work ing on the same job. Dr. Cecil K. D rinker: Dr. Schwarts, you have seen a good deal of this general subject. Dr. Louis Schwartz (Medical Director, Dermatoses Investigations, United States Public Health Service, New York, N .Y.): I am primarily interested in dermatitiB and it was only because of my researches in that field that I happened to come across infor mation given to me by Dr. Gray that there were some cases of yellow atrophy of the liver attributed to halowax. I can only talk from personal experience about the skin eases. I know from what I have seen and from what I have heard from doctors who have been treating these cases that if they are treated like an ordinary acne vulgaris and kept away from further large exposure they all get well, with the same results as acne vulgaris. Those who have large pus tules may have scars resulting and those who have superficial pustules or only come dones won't have any scars. As far a9 prevention goes, I felt even be fore this investigation was undertaken that this substance, like any other poisonous substance, can be bandied and used in in dustry provided proper safety precautions are taken, and I so advocated at the meeting in Pennsylvania when this was discussed. About ventilation and safety precau tions, I think that while we cannot, with our present knowledge, delect by any chemical teats the early symptoms of intoxication from this substance, the skin offers an easy way of proving whether your method of ventilation is efficient or not. If there are any cases of acne or uf this dermatitis occur ring in a plant where halowax or the chlorin ated naphthalene or chlorinated diphenyls are used, then that shows that there is suf ficient concentration of these substances in the air to cause plugging of the follicles and to cause a skin condition. If there is suffi cient concentration to do that there may be P 13 val. 19, no. 7] E l sufficient concentra! poisoning in the few sensitive to the aeti bona. Everybody la them. If they were people who hsve bet stances, more would disease and it woul very much earlier. ' in Germany as early While I cannot methods outlined her of ventilaLion and sc ir you go iato a plan I any acne present am this material you wi sufficient of the subati acne and consequent! be dangerous to the hypersensitive to its Dr. Cecil K. Dm> tical point in renard U mining these suKitnnr pointed out this mu several pieces nf app, It has seemed dcsirah men who arc here Ilia pie of years, luir* w learning, that we em confine our analyses ratus, so Lhat at least comparable aa we ran i to place. I don't know much the subject: perhaps, an idea or two about t Mn. WsRnxN A i'.i Hygienist, Bureau I eases, State of '.ijine. Health, Hartf.ir.f. .( mination of the ;,a. . wouldn 't be pr-ferai*.< perly discuss tlir m*[ throughout the ........ lion of chlorifiat-.j Da. Cecil K I 'iun m that ia cooi rr'-^.] . to discussions y. B r a n d t s f l r r --a r t detenoioing a hito at ItaM , 1 *tl interest ( . ,< FKOll 5 0 3 5 2 8 7 1 5 1 P 14 [Sept. 1037 mdersland you t>-were afflicted y all returned to v. and are work- c Dr. Schwarts, .1 of this general 1teilicnl Director, United States v. York. N. Y.): .n dermatitis and searches in that me ncrosa inforCray that there atrophy of the* .ix. I can only 1eabout the akin l have seen and .iiii doctors who isea that If they ry m:ne vulgarte r large exposure .ami: results as have large pusittifig und those tw or only eomoA* J, I felt even beundertaken that other poisonous 1 and used in inifety precautions i-:d a t the meeting is was discussed. I sufety precau>cannot, with our . hy any chemical uf intoxication kin offers an easy your method of not. If there are dermatitis uccurax or the chiorincinated diphenyls that there is suf'B-se substances in d the follicles and If there is suth(hut there may be Mi. tO, no. 7] EFFECTS OF CHLORINATED HYDROCARBONS 305 sufficient concentration to cause systemic poisoning in the few people who lira hyper sensitive to the aetion of these hydrocarbone. Everybody is not hypersensitive to them. If they were, of the thousands of people who have been handling these sub stances, mors would have contracted this disease and it would have been reported very much earlier. This material was used in Germany as early as 1914 or 1916. While I cannot add 'anything to the methods outlined here for safety in the way of ventilation and so forth, I can say that if you go into a plant and find that there is any acne present among the workers with thin material you will know that there is sufficient of the aubetance in the sir to cause acne and consequently sufficient perhaps to be dangerous to the few people who are hypersensitive to ha action. . Dn. Cecil K. Drinker: There is a prac tical point in regard to the question of deter mining these substances in air. My brother pointed out this morning that there are several pieces or apparatus for doing this. I t has seemed desirable to a number of the men who are here that during the next cou ple of years, while we are in a position of learning, that we endeavor, if wo can, to confine our analyses to one piece of appa ratus, so that at least our results wilt be as comparable as we can make them from place to place. I don't know much about this phase of the subject: perhaps, Mr. Cook, you have an Idea or two about that. Mr. Warren A. Coot (Chief Industrial Hygienist, Bureau of Occupational Dis eases, State of Connecticut Department of Health, Hartford, Conn.), Oo the deter mination of the balowax I wonder if it wouldn't be preferable to have Mr. Hemperly discuss the method be has been using throughout the country for the determina tion of chlorinated naphthalenes. Dr. Cecil K. Drinker: I think so far as that is concerned it Is beat to leave that to discussions with Mr. Hempcrly and Dr. Brandt afterward. But the question of determining sume uniformity of technic far a while at least Is, I think, a matter of gen eral interest to us. Mn. Warren A. Coos: I am not quite sure that I have in mind exactly what you want in thot regard. In connection with sampling? Dr. Cecil K. Drinker: Yes, In con nection with the whole technic of determin ing the material in air, length of sampling, type of apparatus, and so forth. I t has been suggested that we endeavor to agree upon some uniform procedure for that and as figures begin to come in, as they will n the course of the next couple of years, we will a t least have them on a comparable basis. Mr. Warren A. Cook: In that regard there is no question but what the determina tions and results of analyses of the concen tration of injurious materials in air, corre lated with pathological findings or freedom from pathological findings, are real factors in further substantiating toxic limits which are originally given us from animal experi mentation. In order to obtain data which are of value along that line It is desirable to know to what extent, in terms of milligrams per cubic meter, workers are exposed to In breathing any potentially injurious material. Jt seems to ms that one of the things that should be done, which many of tbe plants and many of the organisations equipped to make determinations of injurious materials In sir should do, is to make an effort to develop one group and aeries of results which will represent average exposures of workers to chlorinated naphthalenes. In getting that figure I think that it is of great importance that we should consider average daily exposure. There is a tendency very often in taking samples of air to determioe maximum exposures, to get the exposure over a IS or 20 minute period when the worker may be actually tending a pot where the material is being used, whereas during (be subsequent half hour he may be 40 or 50 feet away from that particular location. Therefore, for one thing, it seems to me it would be extremely desirable to nhtain In formation In as many plants and as many locations oa possible uf the av erag e expo sure, taking into consideration not only the worker's maximum expotura while actually r nun 3 U J OXV <1 O 1 P 15 at work with these materials but also his much smaller exposure and possibly even lack of exposure as he may go to other parte of the room or even to other departments during the course of the day. Another type of determination which seems to be extremely desirable to have is concentrations of the chlorinated naph thalenes at certain reference points. I believe that Mr. Hemperly very carefully duplicated these reference points in each of the plants where he took his determina tions. He took the samples, I believe, at breathing level and a certain measured dis tance from the pots where the chlorinated naphthalenes were being handled, so that next year he could go back to those same locations or others could take determina tions a t those same locations, which are definitely fixed and recorded, and learn whether, due perhaps to clogged pipe lines or to fans which might become loaded*with tho condensed chlorinated naphthalene, there might bo poorer ventilation than origi nally designed and higher concentrations nf the chlorinated naphthalene than origi nally determined. It deems to me that it would be an ex tremely desirable thing to have made avail able for all of ua who are making these determinations these reference points so that in Massachusetts and in Connecticut,, at one plant or at another, a considerable gruup uf workers could be taking samples at this one particular point with reference to the source of generation of the vapor. Such resul Is would permit a comparison of knowl edge between plants. In that regard it happens that there Is a committee of the American Public Health Association which is charged with the devel opment of chemical methods for determina tion of atmospheric contamination such as lhnl.now under consideration. It seems to lue that it might be a very desirable project for that committee to consult with the in vestigator of the Halowax'Corporatlan and suggest to all of those who are doing work uf this type, nftcr some discussion, what reference points could be adopted and also irhul should be done in connection with gotting these average exposures. Aa a matter of fact our committee will discuss that very feature and possibly include It in our report before the A. P. H. A. in October as one of the projects which we shall carry out at that time. As I have not given this consideration. I am afraid my discussion is not as connected os I might wish it to be. We have a real problem here and one that deserves some study. D a . Cecil K. D rinker: Would it be of service to the American Public Health Asso ciation Committee if a sub-committee from this meeting, collected perhaps by my brother and those of you involved with these problems, were to make it recommendation to the A. P. H. A. as to the things you have brought up and as to suitable apparatus, and let the final statement come from the Association after they have considered that material? Mn. Wahren A. Cook: I think that would be a splendid idea because wo havo a hulk nf information mi this particular material. A number of individuals have given much thought to the development of apparatus, both the combustion method which we have here and also the continuous record type of apparatus which Professor Drinker mentioned this morning. 1 think that it is a sufficiently important project that a sub-committee made up from this group could give that committee a very definite atser. [Personnel of the Sub-committee: W. A. Cook, chairman, A, L. Coleman. H. B. El kins, W. B. Fulton, S. W. Gurney, E. R. Hayhurst, Vf. F. Hemperly, F. W. Schl, and A. N. Setterlind.J Ma. H ervsy B. E lkins (Chemist, Di vi sion of Occupational Hygiene, Massachu setts State Department of Labor and Indus tries, Boston, Mass.); In connection with what Dr. Schwartz has said, 1 am not sure that I am in complete agreement as regards the use of skin lesions as warning agents. It Is my understanding that in insulated wire plants the chlorinated diphenyls are very commonly compounded with the chlorlnatad naphthalenes. It is olio my under standing that these are more likely to cause* a severe akin irritation than the straight chlorinated naphthalenes. On the other hand, irora Dr. Drinker's judge that the straight cl thalene was nearly as toxi mixture of it with a small rinated diphenyl. In the condenser factor our coses there is no chloi used and no acne of the t the reports on the Insulate Dn. R. Emmett K bllt (! iral Co., St. Louis,Mo.): I anything to the laboratory has been quite a little bun lion in the last several ye: our plants where we have I: Ing this chlorinated diphet our observation that ulthu sion we did have a more i series of skin eruption* whi able to attribute a* to onus Impurity in the benzene we the chlorinated diplmnyl, w any systemic rear;i..i,< it We have examined th**nt * from what laboratory li* might help us and fr*-m i! point. Also fri-rn hlori alone there have been no * poisoning reported I don't believe that we r laboratory result* into >hi without paying r.,nMdiTai the volatility of difT-r-nt -u way they are linuic -i-t-d Dn. J ohn A. IIooxkt matologut, Hal'iu m i ..r;- Mlch.): [have had with the dermal* i. **. lcm. The experi*-. - t , at Wyandotte defii.;1- * tosia did incre** used ra th e r than th - *i*. naphthalenes. From the dii*'u.--i *u I think the oIij-t**< ; that the chanr..- 41 problems will -li-i;; .-,r , is probably tm* * .. certain .......................... , ure. you mix-.; . , hiring men h , -. t these product - ,. a r r. u t i UUO D i a i' 131 P 16 [Sepf. iff57 her as one of carry out at usideration, I as connected have &real serves some Vould it be of Health Asao*r,mittee from haps by mv I with these i>tnmeii'dation inga you have :i: apparatus, .me from the .iijiilered that ! think that ;u?o we have ii particular duals have '.'Jopmcnt of tion method continuous .mb Professor my. I think rtani project up from this .uttee a very .nittce: W. A. mu, II. B. EIiiirney, E. R. \Y. Sehl, and hemist, Diviac, Massachu* ;or and Indusnncction with f am not sure tit as regards irning agents. I in insulated liphenyls are dith the chlo:tlno my underlikely to cause n the straight On the other cof. 10, no. 7j EFFECTS OF CHLORINATED HYDROCARBONS 307 hand, from Dr. Drinker'a work one would Judge that the straight chlorinated naph thalene was nearly as toxic at least as the mixture of it with a small amount of chlorin&ted diphenyl. In the condenser factory where we had our cases there is no chlorinated diphenyl used and no acne of the type described in the reports on the insulated wire factories. Dn. R. Emmett Kzlxt (Monsanto Chem ical Co,, St. Louis, Mo.): I can't contribute anything to tho laboratory studies but there has been quita a little human experimenta tion in the last several years, especially at our plants where we have been manufactur ing this chlorinated diphenyl. It has been our observation that although cm une occa sion we did have a more or less extensive series of skin eruptions which we were never able to attribute as to cause, whether it was Impurity in the benzene we were using or to the chlorinated diphenyl, we have never had any systemic reactions at all In our men. We have examined them very closely both from what laboratory tests we thought might help us and from the clinical view point. Also from chlorinated diphenyl alone there have been no cases of systemic poisoning reported. I don't believe that we can transpose the laboratory results into the actual humans without paying considerable attention to the volatility of difieren t substances and the way they are being used. Dn. J ohn A. Hooket (Consulting Der matologist, Halowax Corporation, Detroit, Mich.): 1 have had considerable experience with the dermatological angle of this prob lem. The experience at the Halowax plant at Wyandotte definitely was that the derma tosis did increase when compounds were used rather than the straight chlorinated naphthalenes. From tho discussion we have heard today I think the observation Dr. Drinker made that the chances are that dermatological problems will disappear along with the other la probably true. However, I think that certain precautions, certain insurance meas ures, you might say, should be taken in hiring men who are going to work with tim e products, even though we are going to attempt to got the concentrations low. \Ye saw this morning that the effect of these products was on the liver and that if some one working to these products developed liver damage from soma other source the chances of his having serious trouble was increased.' Therefore, inasmuch as there is no test to tell whether a person has had liver disease, certainly in the preliminary medical examination of applicants for work the his tory at least should be gone into very care fully for a history of previous liver diseases. There are other things that should be taken into consideration also. One is the. history of syphilis, because syphilis docs have an effect on the liver. If there is any history of syphilis f don't think that that man should be hired, A Kahn teat should be taken and 1 think that it would be a good plan to take Kahn tests on men at stated intervals, because they might develop syphilis after they are hired, I think those things should he done even though we feel that if the rom-entratiou of these vapors in the air is kept uj [mv as was recommended this morning, (he chances of having toxic effects are very small. Mr. F. R. Kaiuer: I would like to clarify a point of Dr. Hookey's. You mentioned at the beginning of your talk that your experience in acne condition was more pronounced from the compounds of various materials with chloronaphthafene than with the straight ehlaronaphthalenes. Did you mean by that, that the acne condi tion actually was paore pronounced with the compounds than with the straight chloronaphlh&lene or was that due tu the fact that you were in a plant operated in a different fashion? In other worda, you handled your numerous wire compounds in more of u batch operation. That Is my understand ing from Mr. Brown. is it a fact that the straight chloronaphthalenes are less harmful in so fur m avne is concerned or Is it because of the handling of batch compounds? Dr. J ohn A. Hooxey: Thai la a question that would be difficult to answer. I based my statement on the fart that In taking a general survey nf these cast** ifu*r I sTarti-d working with them the men *r. *>nl-nl said r-KUii s u o 3 ZU 7151 P 17 308 JOURNAL OF INDUSTRIAL HI 3IENE AND TOXICOLOGY [Sept. ISS7 that they developed acne more often and more severely after they started making compounds. It may he that it was in the method of the handling. Mb. F. R. Kaibier: You say that the con dition increases with the increased chlorine Content mid we are attributing tho acne pri marily to the chlorine radical. If that is true, what are we to associate Insofar as these various other constituents are con cerned, such as various plasticizing agents? How much do we know about those insofar ns development of acne is concerned? Some of these compounds have a half dozen con stituents in them other than chlorodlphenyl and chloronaphthalene. We are at the present time considering the chloronaphthalene us the busic element responsible for the acne condition which we have. We know very little about what the other mate rials may or may not do. Dr. J ohn A. Hooket: I don't know dbulll these other materials. Perhaps Dr. Si'luvartz would know something more about them. Dr. Louis Schwartz: It Is well known in industry that there are many compounds that cause- acne. For Instance, paraffin ucnea and oil acres have been known for a long time. Paraffin acnes, wax acnes, are simply a mechanical plugging of the fol licles of the skin by the minute particles of wax that fall on the akin. I think that the aenu caused by these chlorinated naph thalenes and diphenyls, because it is caused by hath--I w.13 down at the Swan Chemical Company where they make chlorinated di phenyls ami they have acne there just the same us over at Wyandotte where they make the chlorinated naphthalenes--I believe that that is caused by the same thing, a blocking up of the follicles of the skin, the formation of the comedone and then the comedone becomes infected and forma a pustule. They don't all pustulate because they don't all become infected. Many of these men never have any pustules. They just have little white elevations on their skin. In thoee people who are In the acne age, the youngsters of 18. 20, 22 and 23, aont vulgaris Is most apt to occur. The sebace ous glands are most active and they seem to have It much more than the older people in whom the sebaceous glands are not so active. We keep a clipping of all articles relating to Industrial dermatitis in my office and I recently read an articlo in a German maga zine In which they report in Germany a similar acne condition from chlorinated phenols and chlorinated benzenes and solid waxes. It seems that this acne-like condi tion is not peculiar to halowax or chlorin ated naphthalenes or diphenyls hut can occur with any condition that blocks up the sebaceous follicles of tlie skin. Dr. Ratal Meeker (Special Agent, Stats of Connecticut Department of Labor, Hartford, Conn.): 1 am full of questions. As a statistician I am a little bit suspicious of averages, so 1should think that we should .taka maxima as well as averages in getting at the threshold dose nr the dangerous im pregnation of the atmosphere with these poisonous compounds. I just wanted to drop that as a hint for this committee to consider in its work. In spite of what you said at luncheon, Dr. Drinker, I still think it is rather impor tant to determine how the plugging of the pores actually does occur, whether they are plugged os Dr. Schwartz has suggested, from the particles falling on the outside of the skin or whether they are plugged, as so many doctors have informed me, from Inside os it were. The fumes are breathed, the substance gets Into the blood stream. It is thrown off through the pores of the skin and the pores are plugged. I think it is rather important to determine that because it seems to me, from the slight knowledge that I have of the industrial application of halowax compounds In insulating wires, that the plugging of the skin, if it is just an out side plugging, may take place either from handling a solid substance or from the coating on the wire after It becomes cold. I haven't heard anybody say anything about those Massachusetts cases of very severe dermatitis and I am not ao sure but what there was soma question of liver dam age there. Nobody hna said anything about them at all. There if no question there * ' < wm ' t * 1 ( , *** . ( rtif. 19, wt. 7] EFF that the condition, wli lions might have been, cold wire, in a conS I think this needs a g Dr. Drinker, than you have been able to give curious about is the wi the protective labor lai both the employer and 1 listened with very expositions of suggest! cation of halowax, chit and diphenyl. It seer left very much to ba i why the application vj pound, If it is necessai to use this rather dange be done in a practical! please, Dr. Drinker, I Mr, Reeves of the l Corporation to tell ho1 it. IT I am any juds safety devices they li; eliminating entirely b nil cuiiumiuntimi from rated lmlowax as unyoi cation uf hnl'iwnx, cith> or where it is iip|)lii-*l under hooding mul .\i; ratus, and it seems to L Mr. B. H. Reeves General Manager, R. Corporation, New Ha\> very glad to tell uf nor help the picture along been more ur leas puruM* in as much us we mutiu/: of wire. We have m**. ture that lie ran mtu. j fact that shortly after benzene as a solvent !>>r We got into it-- ... . xene fumes and l14d tventilating system 1.* fumes from the mm-hu.. compounds to the ai Installation of thut *qm to get a substitute f.,r out of the picture We are still m t!,e >, vise It as far a- h'niirs . " s i , There i- . equently w\.. u>> ij jl O C 1 3 1 P I8 i *CV ISepf. 19S7 ref. W, no. 7] EFFECTS OF CHLORINATED HYDROCARBONS tt 309 up. The sebaceand (hey seem to older people in mb nre not so ! articles relating i my office and I n German mngaf in Germany a rum chlorinated metics and solid dime-like condi -wax or chlorm'n^nyii but can ;:it hlocks up the ;n. that the condition, whatever the complica tions might have been, came from handling cold wire, in a confined area of course. I think this needs a great deal more study, Dc. Drinker, than you and your associates have heen able to give it as yet. All I am curious about Is the way we can administer the protective labor laws in order to protect both the employer and the employee. I listened with very great interest to the expositions of suggested pots for the appli cation of halowax, chlorinated naphthalene and diphenyl. It seemed to me that they left very much to be desired. I don't see why the application of tho halowax com pound, if it is necessary, as l assume it is, to use this rather dangerous substance, can't wax we had a head start as far as the ventilating system was concerned, since ours was already installed and adaptable to a compound with n henzenft solvent rather than a melted halowax compound. In order to keep tho fumeB of a highly volatile sol vent under control we did develop a prac tically complete enclosure for tho container In which tho compound was placed and exhausted that container in order to prevent any escape of the fumes from it. When we changed to the halowax compounds we fol lowed the same scheme of applying the compounds and used a completely enclosed pot. There is a hols in one Bide for the wire to go in and one on the other side for the wire to come out. There is enough exhaust Special Agent, be done in a practically closed pot. If you suction on the enclosure to prevent any liunnt of Labor, please, Dr, Drinker, I wish you would ask fumes from getting out of the openings .11 of questions. Mr. Reeves of the Rockbestos Products whore the wire enters and leaves. Of course ilt1bit suspicious Corporation to tell how they have handled periodically it Is necessary to open the pot >1; that \ie should It. If I am any judge of equipment and to replenish the compound or make adjust 'lei1* in act Lint; safety devices they have come as near to ments. In that case e have the ventilat Im- eliminating entirely from tho atmosphere ing aystem interlocked with the door that .. rii with theafl all contamination from fumigutrd or evapo the operator opens so that when he opens just Minted to i.i i-ommittee to rated Imlowax as auyono. All of the appli it he increases the amount of air travel cation of halowax, either in the melting pots about ten-fold. - I ut luncheon, rather Imporplugglng of the or where it is applied to the wire, is done under hooding and with ventilating appa D r. R otal M e s s e r : What is the veloc ratus, and It seems to be entirely adequate. ity when the door is open? almieuthejru t^hneyicaure, u tho outside of c plugged, as so Ime, from Inside re breathed, the it stream. It la of (he skin and liiuk it is rather dial because It t knowledge that ;:lii*nlion of halu mni wires, that it is just an out;djce cither from '** or from tho it becomes cold, ly suy anything eases of very not jo sure hut lion of liver daml anything about i question there Corporation, New Haven,'Conn.): I will be very glad to tell of our experience If it will help the picture along. Our experience has been more or less parallel with Mr. Kaimcr'a in as much os we manufacture the same type of wire. We linva avoided the serious pic ture that he ran into, probably due to the fact that shortly after 1923 wa were using benzene as a solvent for asphaltic materials. We got into anemia difficulties with ben zene fumes and had to install a complete ventilating system to remove all those fumes from the machines that applied the compounds to the wire. Following the Installation of that equipment we were able to get a substitute for benzene, so we got it out of the picture. We are still in the same fix as every one else Is at far as finding a substitute for halowax. There is none that we kuow of. Con sequently when we went to the use of halo feat. That is the linear velocity. We check that every week on every opening at every machine with a velometor, a small instrument which is easy enough to operate and reads directly. Whenever the velocity falls below that figure the pipe connecting that machine Is taken down and cleaned, because there will be condensation inside the pipe to cut down the air flow and reduce the ventilation efficiency. Dn. Rotal Meeker: What do you think of that trap device shown? Mh. B. IT. Rssvxs: I don't know what to think of that. I don't know whether it would be practical or not. I w u gmug to nsk Dr. Drinker whether In pnulng the air laden with halowax fumes through thr boxes ol rata there was any deposit of halowax in the enclosure. r K u ri s u o y 151 " w' u ^ 9 g 8 P 19 v 31 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY (Scpl. JM7 Dn. Cecil K. Drinker: Yes. It 1b detectable readily through the outflow pipe. M. B. H. Reeves: Those In the far end probably didn't get the concentration. Dn. Cecil K. Drinker: We change the position of the boxes each day.- The ones furthest away move into the nearest posi tion, so tliut over a period o`l weeks all are exposed equally. complaints were bona fide. We had no dif ficulty in handling cold wire and the men had no skin trouble. Yet when they did the same thing with possibly the application of heat In tunnels, ships and bo forth, they actually did develop trouble. We have UBed, of course, the Icterus index In following some carbon tetrachloride cases and I wondered what you have to say about that. la that nf no value at all in the case of liver damage in this material? Du. Emeut It, H ayhujist (Consultant in Industrial Hygiene, State Department of Health, Columbus, Ohio): I would like to ait if it wouldn't be possible to put a cold water line around that trap and deposit it nil before the air escapes from the trap. Mu. B. H. Reeves: We have tried cool ing the surface of the exhaust pipes in order (if cuiimitrutc the deposit in one place and inaki! it tmiicccssury to remove long lengths uf the ventilating system. While we have found u slight advantage in doing so It hasn't at all paid for the expense. It is much easier to take the piping down. Con sequently I doubt the possibility of remov ing it all by cooling the surfaces of the trap. It might be possible, by buildings labyrinth of refrigerating coils, to collect it. But then you would have the problem of remov ing it from the coils after you had collected It and it would involve rattier complicated procedure. Du. B. L. Vosburqh (Medical Director, General Electric Company, Schenectady, New York): We have heard about the pos sibility of preventing liver damage and skin trouble among manufacturers of wires and cables and so forth, but like the old rhyme, every dog has fleas and the fleas have fleas, we also have customers who use wires and L'tiblcd in tunnels, in enclosed spaces, splic ing them together and doing all sorts of things. I am not at at! certain that we know wlmt the concentration of these chlorinated hydrocarbons id under those conditions. About the time we wore having so much trouble a t our York factory some of our customers began complaining. We thought we were hoving n hysteria of halowax mania throughout tbo country. Some of their Dr. Cecil K. Dmnxer: I don't think bo until it gets so extreme thut we know it any way. Dr. B, L. Vosburoh: I did write down a few questions that came to mind. Some of them have been answered and some are foolish but I shall ask them anyhow. It oacurred to me that if trichlornaphthalene has been proved to be practically Innocuous, isn't it a problem of research largely for tlio Halowax Corporation to use only that one material adopted with other known chlorinated compounds to meet the requirements of customers? That is one of the foolish ones probably, but I shall just ask it. Furthermore, how lung is it reasonable to expect the liver to recover after it has been pretty well damaged. I talked to you and you said you hadn't worked that out with tha animals as yet. D r. Cecil K. D rinkeh; In that case we set aside a certain number of animals to recover, after knowing that a certain amount of damage hud been done. Then we started tu kill them but we invariably ran out of rats before they ran out of lesions. We don't know how long it lasts. . D b. B, L. Vosburou: Have you given them calcium and glucose as you would with carbon tetrachloride? Dr. Cecil K. Drinker: Not yet, but we are doing an experiment now with one group on a very high calcium diet and another group on a calcium free diet. The wlwle question of calcium In the diet, of giving milk daily to these people may be worth while. roi. /P, no. 71 EFFEC D r- B. L. Voburob . questions in mind. I i what Mr. Brown would : * billty of using only t , chlorinated naphthalene * Mr. SANDFonu Bp simplify our problem ex from the commercial S1 ' the toxicity standpoint * I think that Mr. Knlmi to object because he wo the technical effects he The sonic thing appliei industry where we are chlorinated products. The problem ns we which we intend to stu ,, j . our program f-r this c will be done under i Drinker brother', is t demarcation and "hetl Complirntf'd *fin* M some one thine *' ft we rouid r:*** remove l per m : uent with ... *i ** and eUmiikit** a lovely aolmi ' i able to attain '-..it 1 r ,ona of the llungi As I Saul - with which a . . % thetie m o % some st u n commercial . . question -.1 < * , the work. whether - - - to learn :* * Dr. i h. some o ih< - the i . Dr. 1; more w n` on sypi all ) i>ii* , ri\uu j u j (lo1 P 20 ;; Mp\ v is,,i(. /as7 '<<Itati ini tlif- .ii..l lliu iuutl aliuti tlicy did ilu* upiilii'iitUtn * tlitfV I I.-Iila imlcx . .oMni'ide cases ve tu say about * nil In the case urial? 1don't think so we know it any id write flown a dud. Some of .ir.tl .suine tire a mtyimw. it (rii-lilnrnaph* Ik- |irin-li,:ally - in of research ;i>irati(iii to use (I with other Is t j meet the ' T hat is one ly. but 1 shall a reasonable to .ite r it has been iikud to you and *d that out with In that case we r of animals to that ii certain < dotie Then it we invariably : ri out of lesions. :t lusts. Have you given *vou would with :: Not yet, but we *wwith uiie group diet ami another in-i. The whole hu diet, of giving hr may bu worth vet. 19, no. 71 EFFECTS OF CHLORINATED HYDROCARBONS 311 ** Dr. B. L. Vosbcboit: I just had those syphilis during the time they are working questions in inind. I would like to hear for you, you are probably going to loso some what Mr. Brown would say as to the possi very important employees. It would seem bility of using only this one innocuous that it would be worth while to give serious chlorinated naphthalene. consideration to seeing that conditions are proper and suitable for them to continue Mr. Sandford Brown: That would simplify our problem exceedingly, not only from the commercial standpoint but from the toxicity standpoint. But If we did so I tblnk that Mr. Kalmer would be the first to object because he wouldn't be able to get the technical effects he desires in the cable. working for you and that they have proper treatment. In other words, I don't believe that is a good or sufficient reason for dis charging those employees who do develop syphilis. Wo have not found that to be true in other places and I question whether this is one of the places. I may be in error. The same thing applies throughout all the Industry where we are using these higher chlorinated products. The problem as. we see it, and it is one which we intend to study further (we have our program for this continuous work that will be done under the direction of the Drinker brothers), is to try to find a line of demarcation and whether or not within this complicated chemical structure there is some one thing that causes the trouble. IT we could take hexuchlornaphibalene and remove 1per cent of some unknown constit uent with which ivb are not nuw familiar and eliminate the toxicity, that would be a lovely solution. Whether we will over bo able to attain that I don't know. That is Mr. Sandford Brown; I want to take this occasion to express un behalf of the Halowax Corporation my thanks for the excellent cooperation we have received from various state authorities and our customers as well in this investigation. I believe you have all formed the opinion, based on what you have heard this morning, that our whole motive here ia to oonduct this on an ethical, scientific and constructive basis. In collaboration with the Monsanto Chemical Company we have a much mare comprehensive program in view to carry on. Therefore we want to continue that same type of cooperation. There is one thing that I want to bring up one of the things we have in mind. in that connection, which wifi have to be As I said before, that is one of the things observed bythe stale authorities, when they with which all manufacturers of these syn go out to make these inspections. That is thetic organic products are confronted at the necessity of not creating mob hysteria some stage, either in their laboratories or in on the part of the workmen in the plants commercial developments. It is lamely a her these inspections are made. Mr question of timing as to when you should do Hemperly has run into some very interest / the work, how much you should do, and ing situations in the various examination* whether you know how to do it. You have he has made. I know that he would be gln.i to learn that first. to relate them and give the benefit of his experience to the heads of any of these state Dr. Cecil K. Drinker: Unless there is same other important matter I will declare the meeting adjourned. departments who will have the direction of this work. Otherwise I can see where will be unable to get the full cooperation of not only the individual workmen but the Dr. R. R, Sayers: May 1 say a word more with regard to what Dr. Hookey stated on syphills7 If you are going to eliminate all your workers who happen to develop plant foremen and the management, and we must have that if we are to get the results that we are shooting for over the next sev eral months or years. This thing may con tinue, probably will continue for years.