Document GmvwL5Vgq4JxoaDepb1Mrnx5r

NOV-QB-2002 WED 04:26 PM SHEPARD HOFFMAN ESQ FAX NO. 2145220420 .. . -vtfi'sf .... * . * . * * .. \fA OF LUNG IN MITII, M.D. College of the State of ' ' position of major in oast a more common 'ithin recent years. >rablo importance in . both the Bohemian i centuries from pnlfil known as Schneo- \ of these cases, state osis," and thoyare the degree of pneu: "the question aL ,, of the foreign vsis in one of their m, silicic acid, chloh, cobalt, nickel, or rs have done, upon eing oncounterod in e "anthracosis" in 1 are inclinod to atiRis, while Simpson ation of silicosis in .ing cancer in pneurccorded two cases us report of its ocough the record of arge. ses, as well as thoir ary asbestosis with e of his death, first of the Roper Hoser" old, weak, and PtfLMONAHY ASBESTOSIS 57 emaciated. His chief complaints were pains in the right side of the "stomach," right side of the back and shoulder, and shortness of breath. History: Prior to 1931 the patient's health was good and practically no time was lost from work as a result of illnoss, although for five years he had noticed some shortness of breath. He had had influenza in 1918, but except for that had always been well. In 1931 he lost three days from work on account of sharp pains in his back, extending down over the three lower ribs. Nino months later intermittent sharp shooting pains occurred involving his right shoulder. These lasted about ten days. Except for the shortness of breath, there were no further symp toms until Nov. 7,1933, when thero were renewed attacks of pain involv ing the right shoulder, axilla, and the three lower ribs on the same side. The pain occurred about ovory hour and lasted about thirty minutes;. It seemed to bo more severe daring the night. The pationt also beeamo quite weak and seemed to lose weight. He was now compelled to quit work and seok medical aid. During November and Decomber, under medical care, ho grew woakor and lost more weight, his dyspnea was aggravated, and a cough, productive of wiry, white mucoid sputum de veloped. On Jan. 8, during a spoil of coughing, he expectorated fresh blood mixed with mucoid material. The family history was not significant. Occupational History: The first exposure to a dusty atmosphere occurred when the patient was about sixteen, when he bogan to work in a cotton mill as a weaver. He first worked in a place with open doors and windows, and later a humidifying system was installed; hie did not consider the atmosphere excessively dust laden. He continued work as a weaver in various cotton mills until 1913, when ho obtained a job as a weaver at an asbestos factory, which ho held until just prior to hospital admission. During limes when his work thero was sus pended he did odd jobs, with apparently no occupational hazards. Be ginning in 1913, he worked in an extremely dusty atmosphere, in spite of the fact that windows and doors were kept open as much as possible. About 1923 a humidifying system was installed, but this be considered very inefficient, though it improved the atmosphere somewhat. In winter the heating system kept the air in the plant too dry to allow settling of dusty particles. In summer, when all doors wore kept open, air from the forced draft from the " preparation room," emptying out side the plant, entered the room in which the patient worked. The last five or six months of his employment he was at " wot work " in stead of dry weaving, reducing the exposure to dust. He was accus tomed to work overtime, since he was paid by the yard. This man, then, worked as a cotton mill weaver for approximately twenty-two years and as an asbestos mill weaver for some twenty-one years, which may account for certain features of silicosis in the lungs, in addition to those of asbestosis. Course: Throughout his stay-in the hospital the patient continued to complain of persistent pain along the right costal border and right