Document Evr35La9pzB8Xomk47k2QoNNL

i J ,llK* -': - - 11 JC3; ".. CCOCNjNTTEENNTST^*:-T 7.' " O* *' - Public OeeopatteffsLtHT^eM 77 Vital Statistic U _ >wA, 210 .* Epidemiology ' 3^-' arf. :i; ttT... . Mstsrsai sad Child Health *.' 211*7 Heating, Lighting aad Yemilfr tfen ... _ ... US HuOrUoe _ ^ US Health ot Stactart** Norses d ' ,'.^ Feodstafia .. 2a . Hospital Stxfli - - - _ x':J. fait Peiamtiftf ^ 250 Health of Old Pereoss Ad the.- : ^ htyeoaeo a*4 Mfeoiogy ChroricailyMl .-. 22ff\ &CMtmaftac4fii Dimsaa* t";: Taberealoeia ... Qhwwis Cardie-ftespiratsry: - `V^ r'; Venereal Diieaeee --. ... ... -- 28 --. 2S3 ... rtrt ... 2S0 :_ General tnfectiTg OieeattS ... 283 id*'.*';- 1' - - Closer - - .SSf^vr. Bacterieiegj aad Jertnusity _. 283 3j.;i Mtotitaeau OUsa--s-e--e -T* -.S---*----- ' Heeterseeatie sod Baoterieidal 5i*'?ji -. Saaitatio* ' Wxtar and Senansiag iw8SVy Trodt Waste ,-^kvv... Bnbstancea? Diaiirtaetie* Baths .7723 east K'^-a-aotefi* _ ... -- Baateriophafts ............... .'^Vtrwee m ... ... faae Dbpoeai ... 2S ' tatentitty ... ... 2S3 37 300 302 329 ^rv . Atacspherie PeMatiefi ... BS .J frene Krrtce ... ... 322 'V'* For deiaSed Comestt* se* p. 12 r.i BUREAU OF HTCfENf A TROPICAL DISEASES K i is i, s <; s 54,o>S%2-*SrJ v *; -- * BULLETIN OF HYGIENE March. 1961 of ihcse cases showed the features of mesothelioma. In the ensuing 2 years 8 additional eases occurred in the same neighbourhood and 5 elsewhere in the Union. The possibility that exposure to asbestos might be a causal factor was suggested by the fact that the first case was accompanied by asbestosis ami 10 of the other cases were referred to hospital from a large asbestos mining area. These observations stimulated the present inquiry. 33 cases <22 males and 11 females, ages 31-681 of diffuse pleural mesothelioma were collected and with 1 exception ail had been exposed to the inhalation of asbestos dust icrocidolitc). The senes included workers at the mines, transport men and individuals living in the vicinity of the mines and mills. Details of the individual cases are . tabulated; the items include year of birth, age at diag nosis. race. *<x. asbestos exposure, diagnosis i biopsy or necropsy or both), histology and period of survival in month* after diagnosis. 6 patients arc still alive and in ihe 27 fatal cases the survival period varied between 5 and 48 months, mean 14*6 months. According to an addendum 2 months after the submission u manuscript the number ( ease* observed had increased from 3? to 47. In 45 of this total there was a possible exposure to croeidoiitc. In 1 case a mesothelioma -if the peri* toncum was present. 3 of the cases are described in detail and the article is excellently illustrated by pathological and histological specimens and radiographs. The authors, quite reasonably, regard the findings as highly suggestive of an acdoiogrcal relationship between mesothelioma of the pleura and exposure to crocidolite asbestos. Nevertheless they emphasize that the evidence is not conclusive and so wish this paper to be read as a preliminary communication. [The authors are to be commended for this original and continuing study. At the Pneumoconiosis Conference (see Procecdint/s of the Pneumoconiosis Conference. South Afkic*n Council fox Sci. and Inoust. Res~ London. I960. J. and A Churchill Ud.) held at the Uni versity of Witwatersrand in 1959. Dr. J. C. Wagner gave a preliminary account of this work. Among the final recommendations adopted by the Conference was the following (No. 12): " That the relationship between exposure to asbestos and mesothelioma of the pleura, which appears more prevalent in South Africa, should be further investigated. " This investigation would be facilitated by the estab lishment of a central registry of cases under the South African Council for Scientific and industrial Research." (Address P.O. Sox 4788. Johannesburg. South Africa.) Between 1930 and 1946 I attended many necropsies on cases of asbestosis. These derived from a factory engaged in the processing and fabrication of asbestos textiles from crocidolite (Cape blue) asbestos. An outstanding feature of many of these cases was the gross thickening of the pieura. The appearance was peculiar in that the whole lung seemed to be uniformly ensheathed is a cuirass up to i inch thick. Professor J. Gough. Cardilf. has pro duced bcautifuMargcsections of such cases, in which this cuirass is displayed by diilcrential staining. Only once do I recollect that Dr. S. R. Gt-Orve reported the pleural con dition as malignant. A search of the original reports and sections at the London Chest Hospital might now produce some interesting observation.] x. Xfeiklcjohn Bohme. A. Asbestose und Lungencarcinom. L Mil* teilung. (Asbeto*u and Cancer of the Lungr Id - Part) Arch. }. Ge-nrerbepoth. u. Ccwerbehvg. 1959. v. 17. No. 4. 384-95, 2 rigs. [16 refs.] ' The first communication deals with the results of ** periodical examinations of 250 workers in an asbestos factory. Examinations earned out at intervals of l or l years revealed 92 cases of asbestosis. Investigations of a similar type had already been earned out in Dresden by Bohuc and Jacob {this Bulletin, 1956, v. 31. 648] and by Braun and Truan [ibid. 1958. v. 33. 1142). The 92 cases comprised 32 in stage 0-1. 26 in stage I. 14 in stage I-II or II. and 20 in stage II--111 or III. 6 patients had died of asbestosis and cancer of the lung. Autopsies were performed in ail 6 and details of each are give# in full. The reports of the autopsies confirm the knows fact that carcinoma in asbestosis cases is generally localized to the parts most arfectcd by the asbestosis namely, the lower lobes. In contrast to the usual experience only 1 was a squamous carcinoma, the others being either of an adenomatous or of the undilfcrentiated type. The carcinoma appears to arise from seveni centres: in 4 of the subjects meustases were present In one patient, the cancer was not recognized during life: the appearance of a tumour may be masked by the radiological changes produced by the asbestosis. Even at post-mortem examination, the diagnosis of neopiasm may depend on the histoiogicai examination. The age at death, was on the average 51 years and the average duration of exposure was 29 years. Cancer appears in patients with asbestosis in later life and after the asbestosis has existed for many years." The autnor agrees that his figures are too small to allow a definite conclusion. ChaAes L. Sutherland Bohme. A. Asbestose und Lungencardnom. IL Mit- teilung. ani Cancer of the Lunc. 2nd Part) Arch. f. Ge^verbepath. u. Gex-rrbrhvg. 1959. v. 17. No. 5, 457-62. ' In the first communication. 6 cases of earcinoma were described as occurring in 92 cases of asbestosis. but ;i the very miid cases are omitted the figures are 6 cases in 60 110"..). The author now extends his study by using data supplied by the Textile and Clothing Trade Com pany. Augsburg. This Company covers the insurance of the asbestos factories of north Germany with tne exception of the Frankfurt area. Subjects compensated under the Fifth Regulation. No. 28 (asbestosis) and No. 2Sb (asbestosis is combination with carcinoma of the lungi. numbered 125 during the years 1952-58. There were 31 deaths during that period and post-mortem examinations were performed on 20. In 11 of these the diagnosis of carcinoma was verified. In 7, other causes of death were found and 2 remained uncertain. In one case of the > I not submitted to post-mortem the cause of death was given as carcinoma of the lung. In half of the verified cases of carcinoma, the condition was diagnosed or suspected during life. In a further case where the patient was still aiive the diagnosis was made by resection of the lung. Of the 125 subjects with asbestosis 63 were women and 62 men. Carcinoma was verified in only 2 of use ... i Voi. l'\ No/ 3 OCCUPATIONAL DISEASES 237 /omen who died, but it was found in 12 of the I? spite of the most intensive clinical ami especially rr -vho died. Heavier smoking arid more intense laboratory investigations, including inhalation of aerosols .re to dust in men may account for this difference of mother-of-pearl dust, patch testing of the intact and ;/i incidence. scarified skin, the use of antihistaminics etc., no allergic Carcinoma might have developed in a few of these condition was found, though inter alia the investigations persons even if there had been no asbestosis. and this showed that the concentration of Zn in the dust of the night have been the case where there was a new growth particular shell used (7Vo<7im,t macassar) was very much ,pf the pleura with only mild asbestosis. Moreover, in higher than has been reported in the literature hitherto, i few cases the tumour was is the unaffected uppeHobesr --while again 50% of the dust particles were less than \,t 3ut in general the results point to a causal connexion io size, also not previously reported. between the presence of asbestosis and the appearance No final conclusion was reached as to the aetiology of a carcinoma. This is admitted in the wording of except that it was definitely occupational, and iiw .:r*:iof No. 2Sb of the Fifth Regulation. case has been found in the literature. Charles L. Sutherland W. K. Dnttseombe <IPUNG. M. D. Jt BECH. A. 0. Tale Pneumoeonioets. Trans. Ass. Indust. Med. Officers. 1960, OcL, v. 10, No. 3. 35-93. 11 figs. Talc is a hydrated magnesium silicate fMgsSi040n-Hs0 ar 3Mg0'4Si0,,H,0). Talc is refated to both asbestos and mica, the commercial form contains no free silica, investigations in America in the 1930$ left little doubt -.hat talc dust could give rise to a pneumoconiosis on its account. Mer\vmhla (this Bulletin. 1934. v. 9, JO] and McLaughlin [ibid. 1949, v. 24, 975] investigated ne disease in the rubber industry. It may be said that :: present anyone working with rubber is liable to be txposed to talc dust buz cases only occur when evolution '{ dust is high; the proportion affected is small. Cases - occurred in the pottery industry in the manufacture insulation of pylons, is the paper industry and si* "aufacnire of lead accumulators. Talc produces :/ nstie bodies in the lesions similar to those found :nV. ^estosjs. but the author is not satisfied that every :sie pneumoconiosis should be included with asbestosis :o the category of fibrous silicatosis. Details are given of 7 cases comprising 4 lead casters. 1 tyre extruder and 2 who had dusted or sprayed liominium castings. It is unfortunate that the results if physiological tests, particularly those indicating the :ossibie presence of alveolar capillary block, are not aciuded. Charier L. Sutheriand Aoousrro. A. < Fassiccchi. P. A. Fesbre da inalanone di polvere di madreperla. (F^rer eu*ti by the inhalation of .llother-qf-Peari Dust] Med. d. Isvora. I960. Ocl. w 51. No. 10, 612-23. (12 refs.] g~gn<h summary. TTiis is a long and detailed report on one patient who,ffer havtog worked at making buttons of mother-of-peari '-t < vein began to have febrile attacks in the afternoons, hese attacks occurring one or more bours after he had rsiarted work after the midday break. The attacks, vhieh at first were occasional, gradually became daily md consisted of fever up to 39*-40*G with shivering and yacacfte. No other signs or symptoms were found isd there were no organic changes. The attacks stopped ebea be was transferred to other work, only to start ,ptw when he returned to button-making. The condition therefore regarded as definitely occupational but ia Gross, P- Westxjctc, Marian L & McNekney. J. M. CInm Dnt: a Study of ita Biologic Kffcctn. Arch, indust. Health. Chicago. 1960. Jan., v. 21, No. !, 10-23, 9 figs. [10 refs.] The authors made a comprehensive investigation of the effects of glass dust on the conjunctiva, gastro-intestinal tract and lungs of guineapigs and rats. la the study of possible eye irritation the conjunctiva wa* dusted with finely milled giass ilakes of average thickness 5 and mostly less than 50u in diameter. No ill effects were demonstrated. la the ingestion studies, similar milled glass flakes to the amount of 10% in one group of young rats and 50' in another were added to the normal Jiet fur one >ear. There were no significant changes in health. All of the 10 rats sehich ingested such massive doses of glass as the equivalent weight of their daily food survived the year's experiment. Pmt-monem examinations in both groups showed no abnormalities. The pulmonary studies consisted of intratracheal injections of coarse glass suspended in com oil. of core 011 itself, and of fine glass (mean diameter l-l). quartz and kaolin, each suspended in water. (Com oil had to be used as the suspending medium for the coarse glass to counteract the rapid settling which occurred in water.) 15 rats were used for each type of injection. ? being killed from each group at the end of 6 months and survivors at the end of 12 months. Inhalation studies were also conducted with fine glass, quartz and kaolin on 3 groups of 40 rats and 3 groups of i< jvdneapigs. exposures continuing for one year and examinations being made at 6 months, one year and two years after starting exposure. The pulmonary reactions to both coarse and fine glass were minimal and consisted of small focal aiveoiar collections of macrophages with a !mle proliferation of aiveoiar lining causing slight thickening of alveolar walls. The lesions are described as non-fibrogenic although in some a few collagen fibres were noted. Glass dust deposits in lymph glands were completely inert. Ouartz produced less marked lesions than expected, silicosis being not apparent or very slight on naked eye examina tion. while microscopically the consolidations were more cellular, irregular and contained less collagen. The lesions produced by kaolin were similar to out slightly more severe than those produced by gloss dust. The possible reason for the unexpected inhibition of silicotic fibrosis