Document EXjaodGg4enB1aygv81dRNvn

Occupational Diseases FRIDAY MORNING SESSION October 9, 1936 Tas session was called to order by the ~nm:an, Dr. Hart E. Fisher. Vice-Presitest for Health, National Safety Council, and Chief Surgeon, Chicago Rapid Transit Co., Chicago, who presided, introducing the speakers. The Lesser Known Facts About Common Occupational Diseases By DR. ROBERT B. HUNT ' Medical Advisor, American Mutual Liability Insurance Co., Boston Probably the leader in the parade of iruuitrfal diseases is an acute or chronic rfe--.-nation of the skin which we call cematitis. This disease may present it- P-'f ha any type of shop, factory or foun dry, Any paste, powder, gas or liquid *=ch comes in contact with the cm- jicyee's skin, even the water supplied by ie town in which he lives or works, mas se tie potential cause of such a skin csturbar.ee. Tee wide diversity of causes together *xa the varying susceptibility of differ ent individuals makes the problem of tcctrol difficult. . IXuch investigation is under way to ictc--ir.e why one person may be sus ceptible to a certain substance While an other is not. It has been proved many t=tes that a poisonous substance formed witbia the body has been able to prolong tee action started by some external influ- A printer de'veloped a marked tecuatitis from ink which persisted for t't'3 rears. Finally food tests were made fsd thowed that he was susceptible to lettuce, which, when removed from his et cleared the skin. He returned to his ttual occupation without a return of ryruptoms. tee poisoning of allergic substances is ^uahv an accumulative process. It takes t~s to produce a manifestation of dis- ^e-._but let any other substance cause J~e cisease, and the irritating food may of sufficient strength to magnify its lction. All cases of dermatitis cannot be cured by eliminating offending foods, but fur ther investigation along these lines may give us a clue with which to lessen the loss of time from work and the discom fort now produced by industrial derma titis. Lead Metals The distribution of lead poisoning is quite extensive. ` The skin of the body is a protective covering, and as long as it remains in tact it does a good job except in the case of tetraethyl lead, which is used in blend ing gasoline and which is readily absorbed through the skin, having a tendency to create changes in the nervous system. The effect of other forms of lead, through that avenue of entrance, is practically nil, which explains the extremely low poisoning rate in typesetters, painters and others who continually come in contact with metallic lead. Lead in any form, introduced through the mouth, acts rather slowly when com pared with the inhaiation of lead dust or fumes. However, no matter what the portal of entry may be, lead is acted upon by the body fluids. and so converted that it may eventually be deposited with in the bones. ' Those bony safe deposit vaults may retain their lead contents for days or for years, and if the j'expo'Swe is removed, may also free- the, Employee of all signs i r117 00U0-J-1 Occupational Diseases 119 Although the actions of various dusts differ within the body, the exposure to ubestos. fibres, present in the weaving md grinding of dry asbestos material, offers another type of dust which may :ause fatalities among workers. The organic dusts from cotton, silk, ivooi. tobacco, flour and similar sub stances are practically harmless. Such dusts rarely reach the lungs but may cause irritation of the windpipe and larg er air tubes and result at the most in a mild bronchitis.' The factor which should be borne in mind, particularly when dealing with silicosis and afbestosis, relates to the progression of such disease. When changes occur within the lungs as a re sult of the presence of such dusts, nature forms scar tissue to heal suph lesions but may fail to stop when the job is finished. As a result, the continuation of that heal ing process may lead to such structural changes within the lungs that partial or total incapacity. may follow months or years after the employee has been re moved from his dusty occupation. Benzole-Benzene Benzol is a distillate of coal tar used extensively in industry. It is an essen tial ingredient in the manufacture of ex plosives. It is an excellent solvent for grease, oils and cements, and because of that "property it is important in many phases of the rubber and cleaning indus tries. In the manufacture of shoes ben zol may "be an ingredient of the dressing applied to the leather and of the cement which fastens the heels and soles. Xot only in the shoe trade but in other branches of industry where employees work with gummy, sticky material, the workers soon learn of the solvent and cleansing action of this liquid and use it freely for that purpose upon' themselves. The subsequent (--'break of skin af flictions may be toe first indication of such unauthorized use. Benzol is extremely poisonous, enter ing either through the nose or mouth or absorbed through the skin. Its action within the body is varied and may pro duce a multitude of signs and symptoms. The bone marrow becomes affected which in turn alters the character of the blood: hemorrhages are common; it may cause death. The fumes from benzol are heavier than air and lie near the floor, which is an im portant point in the engineering prob lem of ventilation. The members of the benzene group are absorbed through the skin, and more cases of poisoning are found when men perspire than when their bodies are cool. Probably the answer to that is that the fumes may solidify as they cool and the powder may settle on the skin. The sweat on the body may dissolve this dust so that it is more readily absorbed through the increased surface blood supply. Chlorinated Hydrocarbons This group of petroleum derivatives has been known to science for years but during the past decade its advance into the industrial field has been widely dis tributed and most important. Led by carbon tetrachloride and its chemically associated members,- it has furnished in dustry with refrigerants for ice chests, excellent solvents for rubber, wax, oil and grease, thinners for lacquers and a very fine household necessity for the re moval of spots from clothes. Hospitals have been using it more and more for the removal of adhesive plaster. Due to the non-flammability of car bon tetrachloride, it is used in fire ex tinguishers. The rapid evaporation pro duces fumes which may smother a small blaze, but we must not forget that ex cessive heat of the actual fire may bring about combustion sufficient to produce such biproducts as hydrochloric acid and phosgene gas. Like its associated mem ber, chloroform, it may "produce sleep when inhaled by an individual, and only 1/350 of an ounce in a quart of air is necessary to produce such action. That thought must be remembered when a large quantity of those liquid products is spilled on the floor, perhaps accidentally. Action should be started at once before the liquid gasifies, and employees should be notified to keep their heads up to avoid the low ceiling of gas. Chemists have developed and intro duced to indust^*"many new products, the basis of w'njfch is the chlorinated hy drocarbon;.. These derivatives of petro- oooo-_;; 120 Twenty-fifth National Safety Congress leum distillation are frequently combined others of the danger. Even if remor^ with those from coal tar to form valua from the poisonous gas at that period ble chemical combinations. They have the damage actually done by the gas ear been placed on the market so rapidly result in permanent physical damage. " that medical science has been unable to determine their physiological effect upon Infection the health of man. We have known that some of these chemicals are capable of creating changes in the liver, and only recently in a city in Massachusetts one of these newer products caused the death of two employees and a battle to retain life among two others. The skin is a protective covering of the body against infection and is ex tremely efficient as long as it remains in tact, but allow it to be broken or punc tured, introduce bacteria, and a battle ensues between the offensive agencies ainfection and the defensive powers of the Carbon Monoxide body. The winning of such a struggle may determine the presence'or absence at You remember the adage, "Where there is smoke, there is lire." We might add to that, "Where there is fire there -is carbon monoxide." This odorless but poisonous gas may occur in any industry or in any home, but the poorer the ventilation the better the chance of producing physical incapacity. Since the advent of the motor C3r, whose exhaust pipe may pour forth as high as 6% of carbon monoxide, we are all exposed to that gas. particularly in crowded cities. The ordinary passenger car liberates about two cubic feet per minute, and one can readily estimate the physical damage that may be done if such a motor is allowed to run within the doors of a poorly ventilated garage or shop. Fortunately, serious cases of such poisoning are not common among those employed in public garages, but many of those employees are likely to complain of headache and faintness at the end of a day's work, especially in colder weather when doors and windows remain closed. In the steel industry, where gas is used as the heating agency in the blast fur naces, care must be used to provide proper ventilation. Within the mines, workers are warned to allow enough time incapacity. Infections are common throughout industry, but two .types are particularly prominent -- infection result ing from anthrax and infection among meat packers and fishermen. Many of our fur, hair or wool-covered animals may contract anthrax. The germs of that disease defy the ordinary methods of sterilization and may linger on hides, bristles or hairs for long periods of time. Tanners, wool sorters, and hair or bristle workers may introduce the anthrax spore beneath their skin and undergo much physical suffering and sometimes death. Infections are frequently found among meat and fish packers and those engaged in deep sea fishing. Although death rarely occurs."the loss of fingers, hands and nasty septic wounds are the result. Punctured wounds, cuts, abrasions, burns and scratches are potential avenues of entrance for bacteria which would seem to be waiting everywhere at ail times for such a break in the skin. Early medical treatment might often save later surgical interference, not to mention the accompanying discomfort, incapacity and perhaps the loss of an essential body part. Summary following blasts for the escape of this gas. Being a colorless, odcriess and taste less gas, quick of action within the hu man body, the manifestation of the very first symptom may be too late to save a workman from partial or total incapacity or perhaps death. I feel that the time has come when an employer must demand of a manufacturer the answers to two questions: 1. How will your product affect my business? 2. How will your product affect the health of my employees? That cSSTTo^er is entitled. tn hnnety Because the exposed person suffers first from motor paralysis, he may be unable to help himself or men to warn answers lia'sed upon sufficient chemical and phygjological examinations oi the questionaljie product. That manufacturer r| 000007 -- Occupational Diseases 121 -- held responsible tor the ills ~~.y; r by the use of his product and :e can guarantee its safety, it has -3 nuez in industry. Too many lives 3v: leer. lost or jeopardized by too ;:di mew ledge of a product's action -cr. ttese who handle it. Tat :r.cicence of lost time due to ill--;j me injury in industry ha. been lessened by the many agencies -rorxm; along lines of safety. When in dustry has been made fool-proof by the substitution of non-toxic preparations for those now found to be harmful, and when each employee is imbued with the idea that constant thoughtfulness and care are most necessary for the maintenance of health and happiness, then, and not un til that idealistic stage has been reached may vigilance and perseverance to main tain and preserve health, limb and life be lessened. prd-Employment Examination as an Aid to the Control of Industrial Diseases By DR. W. C. TEMPLER Medical Director, Coming Glass Works, Corning, N. Y. '.V; may well ask whether or not phyacsi elimination is of any value to the Tcric ar large, rather than limit the disrcisioi to the control of industrial diEtses In the conservation of life and real": much progress has been made in dte emiication or control of such diseases a oarer in epidemic form, as well as mat me of disease which is not truly eetcemc. but occurs in such frequency mar mr.eral health programs arc neces sary. Much has been done to control stci itsabling illnesses as heart disease, zrteru-sclerosis, kidney disease and dia betes; ind something has been accomziiscet. in the control of morbidity, which tenets to. at least, make people happier dumuni good health, even though an inEcasai span of life is not gained. Pirsical examination has played a large ~ie ii accomplishing these things, betause-.z was through physical examination cc ntysical observations that investiga tes vttre led to exert themselves to find 1 remedy for the cause of such condittes. Small-pox is no longer prevalent, te Sach observations, which led to =3 cmtrol by vaccination. Malaria and rttlcTr fever have been brought largely truer control, and knowledge is now inriaKe in the control of venereal diJ;43es.. if the proper physical examination trd laboratory methods are used to arrive t i eagnosis. We are all familiar with results obtained in decreasing the death rate due to tuberculosis. In fact, in the treatment of all epidemic-type diseases that have so far been eradicated, the examination of patients to determine the severity of symptoms and the im provement has been of foremost value. Knowing that the average span of life has been increased eight years in the last quarter century and assuming that the above mentioned factors have had some bearing on it, could we decry the value of physical examinations for the general population ? If we know that examinations made by insurance companies and their associating examining institutions, the clinics run by the United States Public Health Service, and the great mass of physicians, who ail carefully examine their clientele, have been of value in the control of disease, may we not assume that examinations !n industry will help control the incidence and extent of industrial disease, particu larly when the life expectancy of in dustrial workers is less than that of the general population? In fact on April 14. 1936, at the Na tional Conference on Silicosis and Similar Dust Diseases, called by the Secretary of Ua'v-ir. Dr. R. R. Sayers of the_ United States Public Health Service said, "Pre liminary and periodiyt***ical and roent genological examination should be made of all employees qngaged in industrial processes where there is a potential if i K 000GG8