Document JNGopBpM6Mjr7RRbB4De9d6gX
53
yi
TRANSACTIONS
of the
MeINTYRE-SARANAG CONFERENCE
on -
OCCUPATIONAL CHEST DISEASE
Edited by C. W. II. Schcpcrs, M.D., D.Sc,
T. . /ial!y Sershae IjaUq, It. V. 1-cbi 7, fi, fthrf 9, 1955
AMERICAN MEDICAL ASSOCIATION PRESS Chicago 10, Illinois 1955
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A. I, G. M:1 AUGliUN, M.D., F.r. C.P., L. nd.n
The Story of dust diseases in Great Britain j-h.k Lock 3 long way. E. L. Coiiis. in his classitnl Milroy Lectures of 1915, quoLed lU-rlicn. Spencer as saying that t'.IC Starling
of human progress was the "localization nf iiidiistrio." There was such a localization in prehistoric factories for Hit: making of flint implements at Grime's Graves, near Brandon in SulTolk, where the flint kmtppera still use innls like the deer-horn picks of their prehislurie aneesiors. Fit 1914. Collis showed that llli^e workers have a high mortality from silicosis. He said that it is prehahls that ''the starling point of human progress" was asso ciated with at least one form of pneumoconi osis. It lias hcen long known that the dust of flint, which is nearly pure SiOj. is dangerous .10 health. Over 200 years ago. Thomas Ben son, of Newcastle under Lyme, was granted a patent for grinding flints by a wet method. At that time it was said that a man who ground lhc flints dry could not live longer than i wo years.
Out greatest localization ol industries took place during the Industrial Kevolmion, and this was really the starting point of our intvurive knowledge about the effects of dust on tin- king.
Tl*e first notable contribution was that of l'tarMin (1S13). who. after many autopsies, drdtlrd that the black pigment in the bron chial nodes and tire lungs was due to the in halation of small particles resulting from lhc burning of coal, wood, -ml rubor inflammable materials. T(tc German pathologists, on lhc "her hand, lb,ought that lhc pigment came from itisidethe body. Mciklcjohn (1951) has 'h-i-cribed tl;r hitherto little-known and u"-
ki'to; dtil fur yi.Mir* :'n:i April 7, 1955. If. M. MuJIcal Insficcior or l-aciorics.
markable oiutrihthiims o: the .-'citi'li p::;-richins of the IS00\- on the connection belu-.i-n disease of the lung* and cutii du*:: he a! mi: II* how Hie incidence of authnicpsis diminished with improved ventilation of the mines. The Scmtish physicians decided lh;U simple e<oi ilust was comparatively harmless and that Stone dust was the really noxious factor.
, Charles Turner Thackrah. a physician in Leeds, played a major part in the study of nc-
cvpatiuv.al diseases fincluding the dv.M dis eases J tn Great Britain. In his hook "The Effects of Arts, Trades, ami Professions." the second edition of which was puhhshcd in 1S32. he crystallized the idea that the inhala tion of large rjuantitics of dusts "f any kind can damage the lungs hut that some dusts are more harmful than others. 11:- courhisi'ius were based nn first-hand observationworkers in hospitals, in their homes, and in the. factories.
Two other great Englishmen in the history of pneumoconiosis about the middle n: the 19th century were T. B. Peacock and 11. H. GrCcnhow, Peacock first established miners' disease as an entity and distinguished it clin ically front pulmonary tuberculosis before little was known about bacteriology and noth ing about x-rays, Crcenhow carried out the first large field investigations into the dusty industries of England and Wales, including
the heavy-metal industries, the potteries, coal, copper, and lead mining, and even agriculture. In the Transactions oj the J'otooiotnru! -ST-
cii'ly of London (1SG0-1X66) there are to he found excellent descriptions by bosh of these physicians oi the disease, which was later t'i be called silicosis by Visconti, in 1S70. They
even found the dust of free silica :n the lungs and examined it under polarized light.
For a long time after litis excellent work nothing much was done nbnm the tins: dis eases. but about the beginning nf ibc gf/ll)
T* 'T4r*`W-rr"
cmiirv a nf-iv i:n: r< -r bvgitii ;i> In1 taken i:i
hi the l;ot 50 years in fin.'i Ih'dsi:; cis
;in:i'.-ui m-t
in England l.;r. rd-u in '.''I'whcrc). there ha.i li< III i:i;"ii-ici' ii.-Ji
niuvr ji.vt. ui ih'i irlil, .\!<(mt t!ie >::iik into t.ll .'I'jicct.' i f the du.-t di i'tisis. Midi as
:iniv i!it
,i,r liif i;: gcucn'.l began in in causatiriti, pathol igy, incidence in various jit-
crease. n:vi viii'ri.* was :m urge for increased du.'iries, and prevention, bur the first 25
s;ui pnidiivti-'M--an urge which Imsgrad- years or so. much <'i the impetus came from
u. dly githnvi -:in-ti:mil. Wilii tilt rcpl.'.fC- II. M. Medical lmpcclors of l;acturies, and
v. inii: in" !i;nni tiiii.'-r i>y the machine. dusty prominent i,i Hi" study of the chest diseases
processes Ikiw In conic more dusty and malt- were Collis, Middleton, and Meriwether. It
i.i diisi coulrm have lagged behind output. 1 lit refl.il [ i: I. lu.ru a rcmark.-ildi; increase of the ineidi niv i,i die .hot diseases.
might be said that they played almost a lone hand, with meager facilities for iiivefligaiion. However, they were helped greatly by hospi
A nmcwunhy contribution in 1 S92 was
Arlidge's ''k on die occupational diseases, which was only ii:e second to be published in England.
tal physicians, general practitioner;, radioiogisls. and pathologists. nniabiy Hall. Kohertfluw. Kettle. Gloync. and Cooke. During this period much attention was paid to silicosis,
Ill lVO-l, .1. S. Haldane and his colleagues ascribed the high mortality among tiii miners
to the inliaiaiitm of rock dust'. A little earlier, fiufi phthLis among slate workers was shown to be related to tin: dust of slate, particularly wlicn it had a high quarts: content.
K. L. (,'i.liis i )9lel pinpointed the dust of free silica as ti-,c main cause of most of the dust disease;., lie also drew attention to the role iliat dust inhalation plays in determining the mnriuliiy from lung diseases experienced by the general population. Long ago he showed the influence of air pollution on the mortality from hrng diseases in general. Though Collis did this work -ID years ago, lie is always up-to-dair. He had, and still has. an uncanny knack of seeing to the heart of any problem. Just now in England there is controversy nbullt chrunic bronchitis and emphysema and whether they can be held to be caused hv the inhalation of dust. It is true that the incidence of chronic bronchitis and emphysema is high among the general popula tion, and the possible causes arc legion. It is
and it. with luliercnlosis, was established as being the cause oi disability and death in most
of the industries where there is exposure to the dust of free silica. Puri {assn, regulations laving down dust-control measures were is sued by the l-'actory Department tor most of the major industries. Notable contributions were Collin'* work, already mentioned, vu the role ol irce silica and Middleton's field in vestigation (with E. L. llr.tklinj into the grinding industry in 1923. In the late '20's, a series of brilliant observations by Cooke,
Gloync. Burton Wood, Stuart McDonald, and M. J. Stewart on the clinical, radiological, and pathological features of a new disease,
which Cooke named asbestosis, led to field in vestigations by Mercwetherand Price (1930). These firmly established that the dust of as bestos was dangerous to health, and it was the first time that the dust oi combined silica, as opposed to free silica, was found to damage the lungs. The condition, as Lcgge points out, was first seen in 1906 by Murray'or Charing Cross Hospital, but little or no notice of it
dilheillt In decide nn Arlidgc's words) how was taken at that time.
much of the malndv is "towu-madc" or `trade- An important landmark was the passing of
made.'' )tm as (.'uiiia showed years ago, an the Workmen's Compensation (Silicosis)
agent which irritates the lung parcuehvuia Can Act of 19IS, which came into force in 1919.
also irritate the bronchial mucous membrane- l:ur the first time compensation for disable
At priwnt there is one industrial pulmonary ment or death was given in respect of an in
tlisease of which the diagnosis is made largely dustrial pulmonary disease. The Act pro
on the presence of chronic bronchitis and vided initial and periodical medical exumino-
i-iupliytcnui, and that is byasinosis.
lion ui all worker? in the nunuurii'S industry
St
~;r---CYrT?-.-
i
i dust /w;;,-i.svi'.v ;
i and suspension f::.
uosi- of simple >!!: with tuhiTculiids. , sponsible for the cn" betculosis Oliicers : ministering sanatoriaNational Health In was revised in 1925. : provide for examinati' This was the beginui: Siheoeis and AsbcsK'.-: its first (and only i f' C. L. Sutherland.
A close Medical Inspectoral:1 Silicosis and Ashesm-i.groups working under general, the Medical ii field investigations wlti. ol silicosis (or asbesw-'. process and which led t the various compensate members of the Hoard , Manchester. Stoke on also carried out field in ous industries, such as and Bryson, 1929), gr;.. Bryson. 1929), ami p; 1949J. But perhaps thsuit of the ionnatintt o. there was begun a sy;-' collection of case hist, r together with nr-mpail'., mortem findings.
At first the Board W.' duitries, but gradually i. and more and more dcome under exnminaiim fraaorics industry firs: pcnsalinn scheme in 19. 1927. and sandstone win
the Various Industries processes of mining, qi: blasting in silica rock, t; ing of siliceous maierl: processes in steel ioinn dries) and metal work
ic tin mmes. In 193-1 thScheme was amended t.
{
!
i
I
' Great Britain (as
iiueis.'is e re.-earrh
, (I!wn.-vJ, such :ij
/lent-1 ii' various in-
.. For the
25
impvtu- came from
r? ,.f Factories, and
if ihe cheat ditseares
and Mervweiher. It
played almost a lone
ies (or investigation.
jc<l greatly by hospi-
raciiliom-ri, rndiolo-
mtably Hall. Robert-
J Cooke. Hill ing this
vas paid io silicosis,
5, was established as
fny and death in most
llicrc if exposure to
ori fossil, regulations
ol lncasuiCS were *3[Kirtnicut iVir most of
\otaMp foiurilnuions
k?\- nKMilinnffl. on tlift
Middleton's liold in-
Maeklin) into tbe
*5. In tbe late '20's,
creations by Cooke,
Siuarr McDonald, and
clinical, radiological,
res oi a new disease,
rcstosis, led to field itt-
:i!icr and Price (1930).
.d that the dust of ar-
io hcahb, and it was
lust of combined silica,
i. was (ound to damage
m.asLcggc points out,
by Murray at Charing
,lllc or iiv notice of lC
(
iark was tbe passing f .iptnsaticni (SilicoJ's) imt into force in 1919. npensation ior disable' ftn In respect of ail ">* liscase. The .Net pr' ulical medical csantiiw' lie refmciorios iiuJusir.1
jil'S'T JIISliAM.S IX CKHAT KJUTAIX
iind sf pension from the inrliislry on a diag nosis ol simple ailieosis ns well as silicosis with tiil ci'cnlosi,-. The medical officers re sponsible for tlie examinations were tile Tul/ficnlosia Officer* of the I.oe:,) Autliority inSiiiiitistcring sanatorium benefit under the
N'.iiiou.'d Health Insurance Act. The scheme was revised in 1925. and again in 1931. 10 provide for examinations by a medical board. This was the beginning of the whole-time Silicosis and Asbestosis Medical Board under its first (and only) Chief Medical Officer,
C. 1- Sutherland.
A close association began between the Medical Inspectorate oi Factories and the Silicosis am! Asbestosis Medical Board, both groups working unde- the Home Office. In general, the Medical Inspectorate made the field investigations which established tbs risk of silicosis (or asbestosis) in an industry or process and which led to the establishment of the various compensation schemes. But the
members of the Board (stationed at Sheffield, .t Manchester1, Stoke Oil Trent, and Cardiff) l also carried out field investigations into vari
ous industries, such as sandstone (Sutherland and Bryson. 1929), granite (Sutherland and Bryson, 1929), and potteries (.Meihlejolltl, 1949). But perhaps the most significant re mit ol the formation oi the Board was that l I there was begun a systematic and valuable \J collection of case histories with x-ray films, together with occupational details and post mortem fimliiijja,
At first the Board was limited to a few in
dustries, but gradually its scope lias increased
and ijiorc and more dusty industries have
come under examination. Workers in the re
fractories industry first came tinder a com-
1>ntsnticm rcboiue in
metal grindors in
B927, and sandstone workers in 1929, In 192S,
the '\ aricnis Industries Scheme included the
Processes of mining, quarrying, drilling, and
Hasting iii silica rock, the crushing and grind-
l"g of siliceous materials, and also isolated
Processes in steel foundries (not iron fomt'-itsj am] metal works, in potteries, and in
m minvf,, ],, 1034 ip,. Yimous Industries
vliuiie was amended to include coal milters
with Mliensis: in KM.5! Iwuriliu; nrc miners were iiieUubvl, uml in 19.y flute miners. Workers with U.shesto.sis Weie first compeilsnled in 1931 ; compensation for hyssinnsiwas introduced in 19.1 and was dealt unit by a specially constituted hoard, J'neuiiipcoiiiufis. as opposed In classical silicosis, in coal miners was lir'utghl under the compensa tion schemes in 19-13 and in coal trimmer* in 1946. The Various Industries "scheme was again amended in 1946 to include tv.olders of iron castings who used siliceous parting pow ders and also blasters of any type of metal castings to free them from adherent sand, even if the blasting abrasive was nimsiliceiwi.
The National Insurance (Industrial Injuries) Act was passed in 1946 and altered the whole bosij of compensation in that it became tbe re sponsibility of the Government hut with con tributions from employers and workers. Ber yllium "poisoning" became compensable in 1949. In 1934 all foundry workers (iron, steel, anti nonfe-rrous) became entitled to compcnsaiion under the Industrial Injuries Act. A fuller account of the development of com pensation in Great Britain has recently been written by Mciklcjohn (1954). The Silicosis and Asbestosis Medical Board v.-a.< trans ferred irom the Home Office in 1946 to the Ministry of National Insurance (later com bined with the Ministry oi Pensions). The Board was divided into a series of Pneu moconiosis Panels, hut they work in much
StntnQ way ae thu Bo:irJ did. otcopt that mere is now no Chief Medical Officer.
The various compensation schemes men* tigngd above reflect tbe evolution of tbe study of the industrial lung diseases in Great Brit ain. There arc comparable legal enactments and regulations designed 10 COIllrOl the risks in each industry, hut they are too numerous
to mention in deiail.
To "flash hack" a little, in 1936 Middleton iii his Milrov I.ecuircs, reviewed the position of the dust diseases in Great Britain. He covered a'.! the dusty trades, including coal mining, but at that time only cases of silicosis ill coal miners were recognised as being eligi
ble for compensation. Most oi tbe miners.
5
F'v. t.t imwiiB'i
a lj:n<l!icj,/!'-r'. f'.rifl#T>-, nr >bad
imt
>! ... Jm vr.1 ili.ii il > ri- v.-:i- ;i ni^li incidence of
*1 htu" di .i-.im.
nin! minci s, particularly
a. ,':;uin` tjii.iri viii^', tfiidiinr'. ami urc->m;i. J 111.4 ttrni'I1 iiiCiv.des ivortiiTS nil .-s.nii-tnuc,
milistnm.'. ''filslmte, slate, {,'raiiitc. and '.(her
ynenus rucks. The risk varies nil!) ilic aiauit!)! nl free silica in ilic ruck and. of
ui .S'liill) Walv- v. kich wii- i-.u\ vklS'-ical S'.li- course, v.i:)i the [irulcclivc illea.mris atlujilftl.
"-iv .\ttuW t,i !(i- i viiliT.ic wrist drawn from o'- lio'liii.,.. ,,i il.c Silit'iMS and Aslicstosis Mf'diral II`<i!!i)\vinn 1a- paper, there
Utccntli- some limestone fiuarrymei) have* contracted silicnsis, but the limesinnc co;ilaincd ;i ir.iriy l;i"li [irnjiyrtiCiil <'! free silica.''
''ran ii ,i-ni-> ii( ininisivc hive-ii'ealions by Jtt this k'roup conId he inckak'd rock imwe!-
Medical Ivt-v'-urcji C '<iHDiril into tilt llCililll ors, in uIkiiii ihu On--el of silicosis nitty hi;
H iii imiiI minim'. i\)`,jeh on't-ri-tl Ml n5- very rapid. As regards stoic workers! a bil-
Mu lt :i* diuii'iil. radii.gripliiv, anti enviintiiui-iii.il t M'!ii-;it Ki M ,irl ii Council Spcm.iI hv,t | !7l.l| II |1')43|- awl UI
liard-iahlc maker lins rccentjy received cr..npensnri/m for siiicotfte.
! I1''" | j. Tin- ini|.i.riant fad emerging from
>his work u.iv (?i-ii lord ihi.'t In- itself could ' anv ]iin-iiiiiipfiini'i ii.. and this was iVilIrmtd.
nra-rni fQS.vi
-----------------------1030-1951
a. |ii'i*vimin)v nii'iiii'iji'd. hy the lasKalfioil 01
i iiunii-iwaiim* io i "iii miners ami trial trim-
m-rv In l'M,\ l:s' I'lii'iiiniiciiiiii'si.-- Research
I nil "I tin- Mdlirnl lie-cnrcli t'nimcil was SCt
||(| ill < ai'iliii', ami :,|| nujircs.MVf Iiorii' of work
li-iM'ini'r^vil mi vaninix a.spceis m` void miner#'
pm-lmiurtm*,tM-. Ttiiri wm k is \s'CII known,
imil | jin^ivM', lliin-itirL', m Unlit my remain*
ilio iiliurrvtiiiimt nininlv in the iln-t diseases
>'-iil|iii" (min v.nr'i; in places which conic
nii'ti'r tin- ("n-iiirii N Acts, will only hidden*
lid TdVminvsi in Cnjil iniliing.
Sll.lfi . ,S
SUu-um- tins been fI Hind in lie ;i cause of disability in iliw jwinjj Uroad groups of indii'.irifs as well ;ii in coal mining and oilier tonne of nriiiiii.e. mh'Ii as liu, hematite, copper, Liriii-s, and tire chic
1. l\Yi 1`ai`iimil" industry. This group iiv lii'li-. iln- Mial.iiii" nf silica bricks, furnace
Fiff. 1.--Cliarl slinivlii^ iJiiiiiiiisliinjr numbers of deaths am<me tnetal erindcrs durintj ilie period 1930-1951, inclusive.
4, Metal grinding. The silicosis risk in the grinding of metals has greatly dimitii.ditd. owing to the replacement of the sandstone grinding wheels wish artificial ones comiioieii of Carborundum, alumina, or emery. Apart from tire lower 'toxicity'' oi tin; dusts from
'!i iiliaillliii" and ri I.up.ling, iuul 1 Cturt SCllmg these substances, the wheels arc much liarder
iiiid rt-pnii mg,
than sandsirme, and less ilnst is created. Lint
1. ('niii i'i. indii'irv, Workers in this group the grindets of callings (iron, steel, and non-
i.;m Uismi vugne.'-il ill lUc inamuacture of ferrous) are still exposed to a silicosis risk on
li>'lli cat llinnvart and china with their various account of the presence of luirmd-on sand on
Mtlidis isimis :uul as Him millers and puli.liters. the castings. The diitiinbhiiig mmiher of
I III- Mlli*llhumn "I* Lirniwul (llill by ailtipifia lor deal Its among grinders is shown in the chart
llir jitiuiii;; n| U: fim Wiirc lias resullvd ill a tlnniniilimi ni di-.ilhs frtmi silicnsis ai'Uiil^ -.Mal.i'ls in llial ] it i h'im.
P'V >) * ftuig, A. T.; VaI'lib!* dual dim.
MAT P!Sf:An;A ,
5. ,Onii'11.3"St':>g. *' f 11130) showed, hint (itishitin l .'ii ahei'fd g;ul to lib replaccvl lit * sit'ei. stich as steel si, yam) as tin aiirasive u the Blasting of Castin Rcguk'.'-iduS. The [<t'( ,
oi ships' hulls does n. lations fbecause legaii dcj. hut it is Ihoityiu 0! silicosis ill the ; '
tisctl in the open air " conslniclion. o. g.. in t metal suriaces for ihe :
Ci. Manufacture of a' ton shnu'ffl in iy,i!: !.. abrasive snaps carried * Or Subanite silicosis, tie. lewis Tlirrc was a iiiemu factory in Loiui--:
192S. tehcii llitre nvi'i workers. This c.vpcriri. control in the proem-f and 1952 there were nit: anwng this type uf w to state the incidence nbteansc there is a rr.;,
(mostly young woiue:; flour in still being used f efforts are being made ' | substitute which wilt ! manufacturers and the ' new cases of silicosis in
7. Foundry indliHtr--' - foundry iudustry has
great detail during f) am) the results were pul : form Dy yicLautjhVm m Lung Diseases of lit" i Workers"). Ikithiiluri: |_ ns ncll us clinical and .* j souiti 3000 workers, si'1 ji varying risk of filicuto.'.
; inticiuiiosir. (to ivhtch. : j low) in die earinus r
t workers. I Steel fcttlers (tlri-sa f ers) it,-id a severe risk, i
V
.W, U'OJlUX
` :u'<! UrOnvip^. . ui-.)i e::n*1 lull:-,
c. giamd', and other isk varies with \he in the r.nk anil, of ve measures adopted, ne quarvymen have l :hc limestone con>ur(ion oi tree silica* included ruck tunnell oi Mlico.iii may lie
slate workers, a bilcccutly received com-
-I9S7
-Si
. h n f* nj n R p1 !
jjj uuiOiJJiiiiiiUL i
5 - -* / f. C n> -s - I
: climmi>!iinc numbers ef I mlcrs (brink- llic pcricO j
Tlie silicosis risk in has "really diminished, uent <it the sandstone nificial ones composed nina, or emery. Apart ity" of tlie (1usis iVoni; vla-els arc iiuigli hnnlw is dust is created. But ;s (iron, si eel, and Hou sed to a silicosis risk oil :C oi lmr:ied-cm sand of .imhndiiug number of s is shown in the chart
Mii-hed diiiA-
jifST pjspjxn.? ix ckv.at iikn.ux
5. jtili. rtK Mi'Jvv.-'-iIut (li/.tn) showed. had a high silicosis risk. 1 lie position l-.as altered materially after sand bscn,, m 1: replaced by other n<msilia'ui'..s ahrasivrs. such as Steel shot, anil since the use of sand a> an abrasive was prohibited in 1949 by iltc J'.i.n-'.ing of Castings (and other Articles) Regulations. The processor wet sandblasting ui ships' hull3 does not come under the Regu lations (because legally a ship is not an arti cle). Put it is thought dial there is also a risk of silicosis in the job- Sandblasting is still ilfcd in the open air on works of engineering
cnnsinicuuii, e. g., in wider lo pte[Mie huge
mend surfaces for the application of paint.
<5. Manufacture of abrasive soap. Miildlei.iii .mowed in J930 that die manufacture of abrasive soaps carried with it a risk of acute or subacute silicosis, accompanied by tubercu losis. There was a disastrous experience at one factory in London between 1921 and 192R, when there were 13 deaths among SI workers. This experience led lo rigorous dust control in the processes, but between 1941 and 1952 there were nine deaths from silicosis among this type oi worker. It is not possible l< slate the incidence of disease and disability, because there is a rapid turnover oi labor (mostly young women) in die job. Silica Ilnur i; still being used as an abrasive, though uTiin s apv-beirrg-rnirde-tQ^find a less harmful si4*i-tftiite which will be ac2CptaUc to the /rfianui'acinrers and the users. There vrett no new cases of silicosis in this trade in 1953!\,
t. Foundry industry. The iron and steel iuiui-lry industry has been investigated in great detail during die past 10 years or so, and the results were published in 1950 in book inrm by McLaughlin .v.i<l others (`'Industrial I.ling Diseases of Iron and Ftccl Foundry M urlitrs"). Pathological studies of W eases,
.1' Well as clinical and x-ray examinations oi
'"iiw 3000 workers, showed that there was ; varying risk of silicosis and mixed tins: pneu
moconiosis (to which reference is made bc-
Si'n the various caiegoricj^Tioundry
faci iliai lb- tlx-1 from tin- pneumatic lianune: is uni onl'.i'aivd. Th,. main ]t:ii1iril>igic:ii loin:-,
was classical siiieosis, with or without tuberciilijsii Among iron fotlleri, the risk was not
so great as among steel fetilcrs, and the main pathological lesion found was mixed dust |jneLimoeu:iioi.is, iticjugli classical jiitircisis did occur, Steel molik-rs were less adViud by dis ease ami disability than iron mqbleis, though statistically the incidence of x-ray abnormal ities was greater among steel workers. More deaths occurred among iron welders, and this fact appeared to be related to the use oi siliceous parting powders. The use of siliceous
parting powders lias now been prohibited by
thi Foundries (Parting Materials) Regula tions, 1950. Silicosis still occurs untong shot blasters of both iron and steel castings, but the risk is controlled by ventilation and per sonal protective devices, and the numbers oi eases and deaths, in contrast with the experi ence among steel fciders. are not increasing. Other categories of iron and sled foundry workers arc subject to much lesi risk than llv. above groups oi workers. Xcw and strin gent regulations -Iron anti Steal Foundry Regulations j were issued in 1955. They re quire strict dust control in [be dusty proc
esses.
The question of pneumoconiosis among noniciTous foundry workers is now being ex amined in detail. Lalaicd eases oi -ilicosis and mixed dust pneumoconiosis have occurred .among boLh casters and dressers of nonmrrc us naetols. but an extensive survey lias not vy. been carried out. Harding and McLaughlin t bali-e described the pathological, clinical, ra diological. and environmental details of six
al cases.
Table 1 shows the number of new eases of pneumoconiosis (i. c., silicosis and mixed de..-t pncmuoroiiiosis) in foundry workers diag nosed by the Pneumoconiosis Panels in 1953.
These figures can be regarded as an under statement of the real position. More than half
''eel fciTfJIs flTIDiSers or cactiilgi c-l-nu-
t ] Ur(|iu;:. IJ. I-;.,
trsJ had a severe risk, largely owing lo the To bo f'tiMiM'cd.
Mcl.ai^hlm. A. I.
$7
--f n- O-i .-fr
, `.WW-A1ti i.
V"Mri.A(;cnux
IhIYI' 1.
BIST MSEASHS IX
'J ! --.V.:, C.u,`.< / l -.vm, >i:.',
i.-1'l r je-?.
Ohii; a;> .0
1-^tai
iiv'z ................. ,p,............ ............. j>T
irr-s.
.............................................. ..,..........
I j ::i lut.iiijry
fi'.iVl Tft.iUikijr......................................................................
21
4J| r^r 11.^7............................................... 2
WfMerji :.i.s.d... .M...ir.i.i.t.r.j....fi.n....e..a.*.tr.o..ji..-.$... rlcnolnc
CMifiwI jtvt.:ijrv nrl`....... ........................................ jl*
Tornl...................................................;....... i9i
' 1 wr;u.v-v,V',n of
hoJ }.-< 1/cci) exposed
lo ruui iJus: lor v.irjntjt I'C.'U. U.
or the eases in iron molder, <-nmc from ore
lit Table 2 details arc givenoi fatal cafesuf silicon and asbestos is invctieattd inlly In die .Medical Inspectorate of f actories between 1930 and 1933. The average ages at death and the length of employment in the dusty inilustri1e4s are also given.
It is seen that as regards silicosis the manu facture of scouring powders and sandblasting we}9re the most dangerous industries, with the
lowest average age at death and the shortest average period oi employment. Another in teresting point is that tuberculosis occurred in nbout half of the cases of silicosis, whereas it was found in only about two-fifths of the
t j*
Jr
bI\f l
i. i I
1j.|K.ar.iii<.vs of asbert-
..,!l;e ch.-mge in lhai i. ..nr.uid-glnss shadow, :. pear. He thinks it pitihal '. p;'d;c lessened expm-u re period, owing K> ihc rim exhaust ventilation to the life use oi personal proti ni asbestosis. however, a; workers who do asbestos: l/iilers. In this process, liesios Is being .sprayed, it adequate protective metis-.hi'eausc the workers are
area where there had been on x-ray survey of three fuundriC'S. Jr more iron foundries J-.nd been similarly surveyed, more cases would have been found. In certain steel foundries the
cases of aslvwtotis. The average age at death and the length of exposure in the cases of as bestosis were much lower than in the silicotic group as a whole but more on the level oi
imr.si-.vT ro,
Ho^v uifitu* cafe.*; oi nicosit. a^beKOMS* cent mine*
dre.scrs (chippcrs or castings cleaners) are sandblasters and makers of scouring powders.
Table X-~Dcaiks fi
x-rayed each year. Inn a complete picture of The connection between asbestosis and
the inn- position wili nm bo obtained until all worke rs undergo periodical medic,al examina tion. This statement also applies to other
cancer of the lung is becoming clearer, and in one-series of 100 autopsies on asbestosis cases there were 25 eases of cancer of the lung,
ImuijttT
............. .
SlDtltUiUfi..................................... of iiiv(ui>. rti................
dusty industries.
Wyers (19-19) has pointed out that the x-ray
Ht'.Mrtoritt...................................................
Tadlk Z.--Fain! Cases of Silbasis ear! Asbnlosts Investigated by Factory Department, 1930-1953
Coal nlniar.................. .........
. .............Olbft HllDixr;.................................
.....
Luuoo tif)'>ii;iv0isJ....................
Snitstclx
D..IKI, 2nQ.
Areppff# Are ac D^aiu,
Yf.
Durotloo o(i)mrJoTJncot
Looeeft,
Average.
Ye. Yr. Tr.
Tain!................... ...........
NoaoctCiiAfiOniii......................
totter?
Siiiro5U ....................................................... Miiro.4i* minj tubcrrulmis..........................
01.7 i. 2.ft 36.1 id* DU 31.7
etc.) occur in Great Rr.f mentioned that at the pre:
St'll-l^CQO
possible to give accurate li.
2Jll^Ofit9 Wl\li luU(VL>1ol..........................
OrJacJJn^ v! SJctnlf StUtApti........................... Silicons M'jiu luUrciiiAsis.),.,.................
COS '
C9. fri.O
Cf.d U.0
Cl A x.o
9.0 SO
11.0 ZJ9
37.0 37,4
35.0 33.0
kiwis at risk in tlic varum ses. Both the Registrar Ministry uf Labour classi Itroups loo broad to give-
SaoeMisIlD.
the populations in the tin
^fueo^is wH)i tubprn.'losll........................
)li<ui[iiAmre of seouTlnc povd?ra SlllPOSJi..................................................... Ml.fOSJj fc-Hh (UL-vfculQiij..........................
W.i .o i.t in 40.2 40& a.D m
JO.S 3T-* .5 1 l.i 2-9
1.3 7.0
those in the possession of O."Ul0n>; anti iraclvd nnioa.i It may be possible in m:vi k,'e more accurate inform.-,
M/<c<NftJu*oit* bJl)lO>U With tVtsCrt,ndgH....................
47.0 U UJ &7.C W1.0 0.7 SI .3
tie done now is to state tinrvporu-il in ihc Kvgi-urar-G the figure,, for cine year uf i!
Slllfa)||.....................................................
AJUM'jfli ^-I'l'inrti......................................................... Whit (Of*-rvl?Oaii0. .................
c;.& J.3 3J.1 si.i 0.7 SI.3
OA 18A 40.^ 110 0.9 n.i
"t'itd by tin- Jhicumnconii'i'
I he deaths from all forii. f-sis Iictween 1`'-IQ and I' ^-"h'huul .`mil Whiles are oi
So'
ivr| nl Ml;| CJlFCh <f
iiilly 1 \v 1-*rit*.- ii(`Vv.riri|
j
j> I
m ilciUli ;im! in ilic tUtsiy iudiis.
< Mlirnfis the Miami* ,-rs atid Muidbl.i.sinij' industries. will) ibe
j.
:i
r I
j
, S
ill. and ilic shortest vnicni- Another in-
ibvieuiusis occurred of silicr'iis, whereas
1 |
: j
/ill twO-fiflliS 01 the j .avtm'ic nge at rlrall, '
iv in iIn'cases of as-
r than in the silicotic tore on the level a.' of scouring powders.
|
! \ {
fen nshostosis and
.'min" clearer, and in rs on ashcsiosis eases cancer of the lung. e<) tint that the x-ray
1
| j
{
i9S0`29SS
Iaii >:iArlorn:rot ; Shorltil. .wrrfttc.
\T. VI.
4I
i t
1 i
i.S 3,0
9.0 >.0
11.0 <i
1.7 5,0
:.s 5-0
1 1^ I 0.7
i i.; 5 0.7
1 0.4 o D.a
99-' 34.7
I ( 33.0
*1.9 83.0
13.* 31.1
*3 7-0
llJ 31-3
*1.1 jt.i
10.0 n<
p:ST /J/.Wi.-.'.V.n.S' IX CKIiAT /W/.f/.Y
^ppenmnee!! of asiiCMi'Mi nrc undi'ignmg tOini' change in lh:>.t nuiluhiv as *>;<.<< 1 w ,.ii,i::ii!-gbi># shadow# wv In ginning n< ;ippeai. 1 le thinks it prubahl,.' that ihi# i> hvcuusu of the lessened exposure in dual over a l.mgcr peri'nl, fi'.'.-in" to the rignmns upplicaiion of esliaiisl ventilation to the dusty processes and
il,c use iif personal prtitcciivc device#. Cased ashesiosi;, however, are now appearing ii
workers who do asbestos lagging of pipes ant 1 boilers. In this process, particularly ii as |
liesins is being sprayed, il is difjicull to apply adequate protective measures, more especially Premise the workers are usually peripatetic.
rKtsi'..'- f i ipi i )0.i
How many cases of pneumoconiosis (silicosis.ashcstosis, coal miners' pncvunoeoitiosis,
in all iiuluslrii's there weiv s7n'i death#
frnin occupati- mil lilii'.-i'-:# n: l!:i- iur.g ill ike
ld-yvnr pvrbid, iir.d it "ill I'v '-rev. ihm the
t'.lal \V:,rlv l.^eiv*- MV
V |-.y. t Hvi* lie:
same period there were death# ir-.in r.f'uocciipalinn:i! (ihrosis of the lungs. Ahout two-
thirds ui the total number rif deaths in the
occupational group occurred in CO'-] minors,
who form the hrecsl group inborn 700/100i
exposed to dust inltaiatioti. Tltg figure# rose
steeply front 232 in 19-10 hi 937 in 1951 (in
1952 tiic figure dropped slightly, to 912). I:
may well he that part oi the increase is due to
more! accurate diagnosis, or at least to greater interest in the pneumoconiosis problem,
among coal miners. In Figure 2 is shown a
comparison, based on the crude figures of
Table 3, between the coal miners and fariorv
XABLr S---Deaths frem AtI Types a! Pneuntaee'vosis "> England and IVales, 19d0-l9cl
Jmliitt nr
r/nifries .......................... ........................ ............................................... ................
ilrlorfirst tt( ill el u Id. Git........................ .................
UrfrnrMrieU............................. .Miw-fJInupou* ................... ..................... iiinl iitmihr.................................... tHIirr niloifr;........................ .\iie*io9 ....................................................
iw 41
7
Tflial......... .................................... . XoupCrtJMIIS:ml ..................................... ............... <Ml!
JMX IW! isi; 1941 & <7 41 32 41 E* it 77 K w
26 % 51 34
j: 7 7 C 9 b 7 ii 13 M
316 WO 37C 321 2h7 40 46 43 3D *v> 37 21 6 10 n
6 1 1 10
*23 <3* it*
tXM
*401 445 4!h asi zext
]f*iC im: ISi? )9l9 15.7i ir.i
19 il 4S C3 73 c;
61 U) Cb ii
71
32 5C 37 i SI
e ID 1* 4;i y~
13 13 6 6 2."* 7*; 7.V* Mi ;u:
;i 30 49 61 42 sii
if. if* 13 IT i: 3,5
94
0 Tn
s
U-1J 015 t:\\ IJW l.U-7 1.7-vi
>:* CK CT<1
7K
m 770
217 niT
s:o K1 t\
6.M7
etc.) occur in Great .Britain? It should be mentioned that at the present time it is impossible to give accurate figures of the popu lations nt risk in the various trades and proc esses. Both the Registrar-General and the -Ministry of Labour classify occupations in groups too broad to give specific figures of tlie populations in the dusty industries, and those in the possession of employers' asso ciations and trades unions are not complete. It may tic possible in scveiul years' time to give mure accurate information. All that can be done now is to state life numbers of deaths
fl'POrLlid to llio RogUtrar-GomjraJ ixrul u give
the figures for one year oi the new cases tliag-
iio.scd by the Pneumoconiosis Panels.
The deaths from all forms of pneumocom">is between 19-10 and 1951, inclusive, in f-'igland and Wales are given in Table 3.
workers. In the factory processes, the yearly number oi deaths was going down until 19-13, but there has been a flight rise in the later years.
In both groups, it should be emphasized that the deaths in each year arc- related to conditions which obtained in mine# nntl fac tories some years previously, possibly 10 to 20 years or even longer.
AYie Cures in Factory Occupt:lions.--The following Table 4 gives the numbers of new cases oi pneumoconiosis diagnosed by tbc Pneumoconiosis Panels in 1953. These fig ures have been kindly supplied by the .Minis try of Pensions and Kaiimtal Insurance, bn: it sliuuld be noted that they differ slightly as regards the numbers in each occupation irom the figures originally supplied. The Ministry usually chi#>ities die case# a: falling huo tin:
S9
t V-
/*' .o* -- -
U"
vMfUmnux i
r.-,r
ttx1** rr*- an T>rrg cr rx*\<.
remainder iIiitl v.a.i rxj,,..rnic f.,r varyini' pt.
y.u;i.J .v--
.4.' 1*1
H'
1U.U.I
Ml >* `*i 1*
, j
ill
i .i
si.' i*
r*LTsmjenn-\ r'*
7
tat. I*) fM M| |<*| l*t? Nl )ltf f*iJ HU
Hr. 2.--O-.nri showing trends of rieadis from
ribrOM- oi I''( !::mcs
coal miners and factory
Workers dunuR the period 1940-1051, inclusive.
category of the last jobs done by the workers, where.-!? Dr, G. 0. Williams. of the Factory Department. lias reclassified some of tilt eases tin ilic basis of all occupations clone by each
worker in order to determine the most likely cause (ii the pneumoconiosis.
There were S96 cases of pneumoconiosis diagnosed. and this figure includes 54 cases of liyssinosis. The cases with an uncomplicated occupational history numbered 665. and in the
rind . i<> -tIi;-r dusis. n.ainiv en.'ii du-d. .\<lditipii.il ('.'cpiiMiie Id coal <!u.-t occurred lualnlv in those industries siiuaicd in ct/nl-mimiig area.,, stub a# refractories, sione (sandstone and granite). pottery, slate. ami iomulry indiiMrirs. 'j'he pottery industry cuntriliutyd the greaiest number of eases (.'53.mainly silk cosis). and the foundry industry came nest with 1W cases. There arc roughly 25.000 penlery and about 22Q.000 foundry workers (iron, steel, and non ferrous) :?nit is probable thru the p.uury industry has ,T higher pneu moconiosis risk titan fliuudries. Such general Statements are not oi much value, because therisk varies frc.ni proecsr Ip pi ncesS Within the same industry. The substitution ni ground fliiii by calcined alumina has reduced the sili cosis risk among placers of biscuit '.arc in potteries, whereas the fettling oi steel castings is still a dangerous job.
.Yeti' Cases in Mining.--Table 5 gives the numbers of new eases of pneumoconiosis oc
curring in ail mining operations in 1953.
These figures show clearly the tremendous problem which faces the coal-mining industry.
There is no space to give in detail the varying
degrees of severity of pneumoconiosis found in the 404S eases, hut the figures are given in the "Digest oi Pneumoconiosis Statistics
Table 4.--,Yi"r Caver of
Factory Occilfiitionj
--39-3
InduiW}
(1) ftcfroriMrltt ................................................................
t4> Ku>w wortetF UsihJMOfif. ttaniloV...........
U) )`cHfrr ................ ,,......... ............................................
<0 Slflir borers (ijofirrylfti; n<l tplltiine)........ rj) ftmnrirk'J ........................................................
10) Mrta) t riii.Jin^ (cllirr than fuuftrjrictfl..............
(7) -Sahih.litFlXic ...................... ..........................
<*) Sht/i l-bsilai:................................................................. i'J) I'UfUiXV irixnmnthn-. *ip.........................................
(tyj JiwltfT
.......................................................... .
OI) ,\hr.n*.hr wIwl nmriuUi-tuir..................................
Ili> .\ehreitrj ............... ............................
|13> A>*ruifc
...................................
(tl) <.f ;*!>)>.if n:u) rnri/ir) rlectri-det,,..,,,..........
fTin tv.tflttnu.,......,...............................
(litI l`t(luh
.............. ....................
tl!) t'l.ftl irlimnhii;..................................... ............ ............
(1}) AJlurll.tlioom ................................... .......... .............
Tc.lil................... ......................................................
SoOttwr
xpo\ire
M 2SI Cl Ul
S i 4 17 4 & 11
1 iO 10
*wa
OihFrPudl K*pisure
' Cyot
1C 10 M 70 2?
4
Outer'
,,
1 u ft 9 ..
j,, 1
ft 9
14 ,, ,,
N
Teial 55
)tu
7 P ; 21 5 3
1 54 )d it M-- sm
1 * '
\
ii
?
if
i
i
t
i
?
f -i
l
f.
113. k t s. *
a i
< f V
v'.v.u.c .
t;<l l.M ill>111:11: *
,* Htini'. ,11 J>' 'la>
ot*T ila>* ' u\U`,u
,;t I.i'h'l millin.'.* ..
T.ii;;).......
hmri'Vn lirf i-J,
I'mvcr (1954)' I* more than 599c u; lisahility. and only ilisahhd.
The luv.uhcr of c: Jjiiiinishiug. but t!'. mimcling are u>u;;" ,evert- silicosis.
ucs'is ornuit r 1
About the middle partmem began to 1 'lusts. Middleton, in to dusts, such as t,: gulir, talc, china el:.: the same year Dui;., lished a jwper on 1! the lungs oi electric-, has iiriscn a world and radio]iai]iie dust; witribtnors have lm
di-rgrass, \`Oru-al(l, a-
most iiitcrt'fling on:' 'ven the alUrntion llUfriirfcl.'ilitTn of N-r Ifcaiiic the .\-ray iV: "'is. and .-.I'.iniiosis. 1 l'aiiuiml hisiories at:1'
or, t.v misinken inr '"ugs. ]n f.ict, nn ;>!.
'fteii found in a work b-akiiiiv. Thy study W' lilt excellent wfivl; (193tf ntni later Crnv
90
I} li
w,v
;ue for varying pc. :.! i'um. Adtli-
, peeiim-d mainly
.0 ill wul-minin"
. Blunt ( Snllditciic
c. and foundry inlit.-irv cimm'lmia1 * (553. mainly aili* '.filialry crime next
nugldy 25.000 p<Hfoundry workers
<) ; vi il i< probable i;is a higher pneu-
.ncS. Sin'll general i value. because the process iviihin the Uliilion of "round as reduced Hie Sill ed biscuit ware in in" of steel castings
ii
\
!
1
--Table 5 gives the ai'.cuiiincoiiiosis ocilions in 1953. rlv die tremendous al-uiining industry.
detail die varying
mmcconiosis found c fixtures arc given oenniosis Statistics
i t ii
tx TOittl
CO
SSI m
HO
1
ft
1 3
ft
3
U
1
M
V> 2t CM
i
,,r.s; iushushs ix i.-nn.ir iu;n.iis
y4]Ij,|, 5Coses Of I'o.!;mn(cmos\!--W\{
I i n:: *
hiliKlry
r,*
\i.
,1, i'..al
......................................................
Tin ...............................................................
it) J1
mmfnfi,,.......................... .
14r r.'ff* nitiLic i....................... .
3 J
\h
tu: r flitt-nMim:.................................... it..
l.Wl '`.mint;.................... i*| Tiuit"'lr.i
2 *
5 3
Trttil.......................................
*.o;!>
r_V0 enw In rhcrl, oil t-lmlr, ur b^lxu (iTu-sl Jryn^ouc
ViniHiNUi fire t\y Niivrnt dun.
iiUo
lo e<4
for 1953." issued by the Ministry of Iceland J'oncr (1954). It can be said, however, that
more than 50% of the cases hod only slight disability, and only about 3% were totally disabled.
The number of eases in hematite mining is (liminisliiiig, but tbc small numbers found in tunneling arc usually instances of rapid and severe silicosis.
llfSTS OTHER THAN S1UCA, ASBESTOS,
AND COAI.
About [he middle 1930's the Factory Dcjci/ament began to turn its attention lo other dusts. Middleton, in his 1936 review, referred to dusts, Shell as tripoli, silliinanitc, kieselguhr, talc, china day, and fullers' earth. In the same year Doig and McLaughlin pub lished a paper on the x-ray appearances of .lie liinga of clcctric-arc welders. From llliS has arisen a world-wide study of the inert and radiopaque dusts, and notable American cumribinors liavo been Sander, Eiucr, Pen. dvrgrass, Yonvald, and Hamlin. Perhaps the must interesting outcome of this study has hen the alteration oi the approach to the Mlttpretalion of x-ray films of the chest, lHv;m<c ihe x-my features of siilcrosis, Icin'. ''-i.-, nml siaunosis, in the absence of oeeuI'atifinal histories and clinical examinations, etui be mistaken for fihrotic changes in the lung.., in factj an alarming x-ray picture is 'Men found in a worker who has little nr no di.-abihiy. Tlic study of sidorosis was helped
excellent work of Stewart and Fattlds 1 , i.i.cj jaicr Craw (l`>37) on the hema
tite mill'T*. ill ut.i.T .;! ullji tile ] - - i `I l Sl.linuiid tn be ii.ii,rn-.:,i*."-i, uiti'il uiYi'mpaniiil
by lubtTciilu.t i:.w'>. later win',. t 1 *'47/ in 1`lunituiluh'. luU'ivnlv.-iK {mm tin- !i< i;.:ui:e mines ami in improved dust cunuii] HKth'iii, is of major iiu[inrt:mcc.
Other ii.iii;-:i:ii :i.'- a;:i) du-ts unicl) have been studied ir.clutlo those of boiler sealers, graphite winker.-, grain dockers, and worker? exposed to beryllium and it? oxide.-', to the dust of leather mixed nilli other dusts, and to bagasse. Attention has also been given to exposures to tile dusts of aluminum, mangauese, and vanadium nml t<t .x.-iJi;ui vivur-
ring hi workers expnscd to the double salts of platilium and also to various wood dusts. Such'as western red cedar.
Patlivbi/y.--A great deal of work has been done on the pathology (gross, histological, and experimental,) of coal miners' lungs'by Gough. Harding, King. Hepplestor. Wright. Gloyne, Xngclsclimidt. aud others. 1 might, however, state some conclusions about paIhology which Harding and I ('with our l.-mColleague. F. Rocitlliuusc Gjoytie i have ar rived at after studying the lungs nf workerin many diverse industries.
Until about 10 years ago. the pathology o: the dust diseases was dominated by the ela??ieal silicotic nodule fFig. ,Vi. Ir, the same way. before a diagnosis couid be made. ii:-. patient had to have x-ray undulation, or ikivlivssi'eal "snowstorm'' effect. ClUfiiCal Silicosis usually occurs after the worker has been exposed lo dust containing a high prDporii'm of free silica. It is becoming ii'.ercnsiiigli
dear, in our opinion, that even small propor tions of free silica in a dust can cause a fibro sis which is composed of nodules not oi ihc classical type (Fig. 4). The arrangement of the fdivrs is linear and radial, nnd the outline of the whole nodule is stellate. It looks like a black star. Harding, Gloyne, and I huvi
applicd the term mixed dust pneumoconiosis, Or mixed dust fibrosis, lo tliix nodule. Il ha; been found in foundry workers, especially in cleaners oi iron castings, in person? exposed
to the dust of graphite comaitiiitg about 10% free silica, and in boiler sealers who arc ex-
51
Mi-f.AClillt.l y
J' I.' .1.-- ii'.-M ir:.e<-:- (.'ll Vr /.2i.
-iiv i.wlme frnii! Inii'/ i'll n )) ; limuioxylii; a:*.'! e-ain;
mixed dust pm-untnri uiijj.is nodule. Indeed, i hrre arc also nodules which show .1 transi tion Mage between 1 he mixed du; nodule and
ihc classical one (I:ig. >). H should he men tioned Ihni ihc x-ray appearances of the Iunj;s
of a worker with mixed dud pneumoconiosis
differ lililc. if at all, from those 01 one with
s>lieoU, mid the disease is jusL as disabling
and as fatal,
j
Jiotlir Sealers' Pyu'iwipccuiosis.--experi ence tie pulmonary diseases in ships' boiler
sealers illustrates well the e&ology oinnixed
tli'.ft pneumoconiosis. These inen arc exposed u> mixed dust which varies according to
the type oi fuel used to heat the boilers and
also according to the source oi the water used
I1-1 .-1 mixed dn-i with a low proportion >.f 1.., Tin- 1:0;.! nodule of coal miners' pnt'tsivicnimisi). ha- much the same appeari:r.e<; a- n-.-.i- iu:m. i dust pnL-f.luoeiei.oSIS
(.'ua! contain-; varying proportions of ini >iliea. In any ease. the common dcIV.'.iiiur-l'ir i:: tlni-x ca.-c-s and occupations ill v.-'nidi this type of nodule is found appears to he tit'- presotv.o of a -mall puiponion oi free filini in the dust. Where (here is a high pro portion, ns stated above, tlte classical silicotic noduli.- is found, lint in the same case, there may he Unit the classical nodule imJ the
F`-:. --Mixed Ottst pnCuinocoiiio#!. nodule irom a auV. huhr's limn; liemaioxylin and tosin; x 24,
Fir. 1.--Transition nodule, from mixed dim pneu moconiosis nodule 10 silicotic nodule in an iron drisK-r's 111115; Ucniawxyliu ami tosin: x --1-
in them. It contains carbonates, silicates, iron, and carbon. There is usually under 5^o oi free silica. Inn there is ofinn a high pro portion of irou and its oxides. Flue dust contains more iron than does tlte scale oil the water t>;l>t.-ri. fOinciiiiii'S a.s much as
!u tin' hrsl cast- oi 1toiler sealers' pncunioermiusis the wurkcr had been scaling boilers for over -10 years (.Harding. Tod. anti McLaughlin. I(M4j. In HbiiJ nu x-ray film oi his chest showed nvdulntion in the upper and 1'niter lung fields, and in the lower nones reticulation for mi.-ron.iduhuiun), ,\t that time we made a tcmaiivi' diagnu.-is of ,-ilicosi- in lliv upper tunics, who sidernsis in ihc hniei fin's. .Seven years laicr the patient
t
i
DV.'iT Ji/.sJ;.-I.Vd\
died r>{ cancer of I!,examination of llu: h.i the cancer; die |ir5--nodules in ihc upp, f
the lower cones 1 v. rcdculadoii i there v carlion and iron du.-t fibrosis. In all other , were nodules rtf mix' Up lo Ihc present (i.-:--on nine boiler scale.type ol fibrosis, Only
silicotic nodules in .-idfalso died 01 cancer oi
well have been jiarilc
substances pre.-eni in .
The change from c. ships' boilers has hr. problem. The dust causes symptoms nf hr 111 a high proportion id that ihis is due to the in Ihc oilsnoi. Yt'illiaiv.. an iniercMiijn scries 1,:
point. My colleague-, examining (with cliii:
environmental dct.-iib(-ome 300 of them; i apOf*# wlu-ft; j[lC (iUih
pii-sstrii^er liners::
tijjiuion hr\> nut
c> '
p**v$Cnl we have not
damage as was shown
ia the port of Hull,
fishing trawlers arc r::
we have found three .
P'leimioeoiiiosis amonv
ease of cancer of the !
pro[torliim 01 eases n
ptin-.mocottiiisis (uid d-
f d/e Phi'uniat`1111iosi wori< on tale pneumne-
in the United States an
lfIj-5; 1 >rvv;.',eu (I||il
Kfddcil. rv-10; .Sivgal bi'% lp-)d, vie.;. Mi-r.-
111 fttiglam), Mudictl tl
features of rubber ww live ii was not m;
M. } '> r. tn IS'
Indeed, 'i i\*.` a I, raisi*-
r.u-i 1* 'kU-.'v :.n] It i! be menanve.* oi'the lungs
i is i j |
thust ni wif with . ju^L a- disabling
rmimiix.--Hxperis in ships' boiler ctiolngv oi mixed c men .ire exposed orics according to Ml the boilers and c oi the water used
si- . . _
A'*
{. rV
- :/
-,VS> V
:
(rein mixed dust pnev-
ic nodule in an iron and cosin: X
nrboimes. silicates, is usually under 5Jo s often a high protisides. Flue dust Joes the scale on the
;S much as 4S#.
lcr scalers' pneumoliren scaling boilers larding, Tod, and
193$ an x-ray film
ulmion in the upper d in the lower zones ulr.lanun). At that vc diagnosis of ?i!iwith si.Jerosis in il'-f rn later the patient
1 j '
/<(',> /' Jv'.-'/-* J-'1 ,'-'1
/ / i i. ? i .v
diedI di (-'IjVCl' Nl uinnli"hi nf da
liic cancer 1 i,:>.i' : liod iiks in the up; the lower zones
teal fi'ivi-tir
It.t'*........ .
.
carbon and iron dust in the kings, with no
:3m' In -Mid', tin- hi-l-i'Oc.il i*;ir.-:: .
i jiii-vc-1 r::-.' .. ( title jiin-ir.ii-Hir:i--i.- | Me
' . l-by.jcri, and ! Jimlv.ns. l,,if,i. A man. vmrs oi age, had worked inf 37 years it: a nihlaT-lire incinry. b-iv b had been exposed to a fairly Inch e.Miccu'.ratiuit of lair iln-i. Moderately advanced pnr-.t-
fibrosis- In all other parts of the lulls; thefe moconiesis oi both lungs was nmnd at au H-rm nodules oi mixed dust pneumoconiosis. topsy fin addition to incompetence of the
I_'p to the present time wv have had autopsies aortic valvej. Throughout the lutttr Mib-iancc
on nine boiler sealers, and sill showed this were scattered small gray tvx'.nlcs, mure
(vpe oi kinusis. Only one scaler had classical numerous in the lower lobes. In some areas
silicotic nodules in addition. Hut five of them the i nodules had coalesced In form small
apo died of cancer of die lung, and this may masses. The filters appeared to be arranged
,,cll have keen partly caused by carcinogenic concentrically around small vessels, giving
substances present ill the SOOl.
thcliinprcssion of whorling. but unt like the
The change from coal to oil as a fuel for -hips' boilers Iws brought with U another problem. The dust front oil-fired boilers causes Symptoms oi bronel-.ospasm or asthma ill a high proportion oi cares, and It is likely that this is due to the presence of vanadium in the oil soot. Williams f 1952) has published an interesting scries di cases illustrating this point. My colleagues and 1 arc at present
ajijiVarance of silicosis. There were, ill addi tion, many "curious" or talc bodies, resem bling, hut easily distinguishable imm, asbes tos bodies. Much dust, which [roved ;n be talc, appeared in the scciirins. and it was thought at the time that lire particles ver-' all fibers. More recent work on lilt lung by Nagclsthmidt % lias shown that the hull; of the dust is in the form of plate? with (inlv a
examining (with clinical, radiographic, and environmental details) the boiler scalers (iomc 300 of them) in the port oi South* anipton, where the boilers of ocean-going and large passenger liners arc cleaned. The inves
few libers. At least three other autopsies on eases of
talc pneumoconiosis (all from rubber works) have been made, and they show similar fea tures to the first published case. Small sur
tigation has not been completed, but up to the present we have not Sound as much lung damage oa was shown in a previous inquiry in the port of Hull, where the boilers of fishing trawlers are mainly sealed. So far we have found three eases oi compensable
veys have been made on workers exposed to talc dust in various industries, but larger ones have been [banned to take place shortly. It - clear that talc dust, though llhrogcmc. is tw- so active as asbestos in damaging the lungs.
pm:iiii,c>coniosis among 50 workers and one Leather Dressers' Fucinm>eoi:iosis.~-Qa- .
citso of cancer of the lung, together with a operation between the directors of elicit clin
proportion of cases with lower degrees of ics, the mass radiography units, and the
Pneumoconiosis and disability.
Medical Inspectorate of FaciurieS has been
Talc PncnutocamQvs.--A great deal of work on talc pneumoconiosis has been done Stt the United filatec and Canada (Etrccescn, JW3; IDrecsscn and Dnltn Valle, 1935; Liddell, 19!0; Sicgal, Smith, and Grcenhbrg, 19-13. etc.). Mere-wether 0933-1931). m England, studied the x-ray and clinical
instrumental ill bringing (o tight hitherto unsuspected causes of pneumoconiosis. .Since (he mass radiography cnmj>aij;n was begun iii 19-lS ior the early detection of ca-ti of pulmonary tuberculosis, some 13.000,000 j*.-rsems have undergone examimitwn. Many factory populations have been surveyed, and
lv;;lures of rubber workers exposed to talc
t Nattvlschniiilt, G.: Personal irm.iiv.imeanoii lo
l.'ut it was not until 1949 that we were llie aylhor.
03
I;:.iu-lcd nm.-mg them have liven i ictnries '."gerc (here r-- a tl-i-l risk. Tlie v.nrkrrs ;i|
le;nlier factory were examined lw Hr. ii-ign Kam.-ny. w the W.-m-i'nil M:,-r R.v'i-
egraphy Unit. Itc drew tmr raimti'iti to the fact `.!:;n in cue department a high [ii-'iprir(ir::i n: lhe workers .-hourd abnormal x-rnc
changes, whereas in Ollier rlf|ju rtmen: x.
uli'.rc there was iin bust. tic abnormalities
v,<tv n-cu. Iii tlie department
ike high
jircj^iriinii of x-ray nhnormalilio.-. skint
iuailrit xcjill china clav mu) cnkinni curtinnale
arc dressed on rapidly revolving felt wheels
revered wiili a layer of line I'arhonmdum
;i.,wder. The job is very rlti.ty, tli-.iijjb it is
dnr.c under exhaust ventilation. The cltist is
composed of much fine leather dust, with smaller proportions ol china clay < kaolin), calcium carhonnlc, mid Carborundum. It was found lliat the dust contained about 0/C of free silica. The x-ray films showed all stages n: shnnrmality, varying from cnrlv reticula tion (micronndidniion l through undulation to massive shadows. In n few cases iherc was clinical evidence of disability. (hie man with nu x-ray film showing ma.vdvc shadows had died irciu "iisihina and pne-uinonia'' a year before the invcMigation begun. and th.ere was no autopsy. In spite of the tart ilia: up to
the present time no pathological evidence has bra-ii available*, ii is likely that the condition
ill fall into the group o' the mixed dust piieunioeemiores. The dust uf china clay, which I fir years has been thought lo be com paratively harmless, is becoming more mid more suspect. F.vim apart from china day. the presence uf a .small propuriion ol ire* silica is prima facie tvider.ee dial (he dressing of such skins i a hazardous occupation.
IteryUium J>iu'itn:or.i!is and (Inniulauiniosis.--It is remarkable dial liriiislt experience
meiiial details c.f five nur,fatal cases, one uf whom is ll've very ill. The oilier f-mr cases are (idler recovering, up ikrir condition is stationary, it is also remarkable that five out of six affected workers were chemists en gaged in the development of the heryliimn lamp [.curlers. At lhe factory where rise fatal case of beryllium granulomatosis occurred, 150 oi the other workers wore examined cliniraliy and radiographically'and no more eases were found, though there had heen con siderable exposure to lhe dusf of the lamp powders in the early iL-ivs. lt"is undeniable that beryllium oxide is toxic, Imt examina tion of the histology oi the lungs oi the one fatal case has led me to held the unorthodox view that beryllium was not the sole cause of the condition. There were two types of le
sion : one of a granulomatous type- in which there were giant and epithelioid cells, ami the other in which were many fibrotlc nodules indistinguishable from silicosis. Under p'lruj'zcd light many doubly retractile particles were seen in (lie nodules, nntl an eminent erystaHographcT stated that these were cristobalite, one of the most active tortus ot free silica. This is not surprising, because one oi tile ingredients oi the lamp powder is silica gel (2a^c), which in the preparation of the powder is heated up to about 1100C. The changed methods oi prqwrimj the lamp pow der have eliminated both the beryllium oxide and the free silica, so that the risks both of beryllium granulomatosis mid of silicosis have
also been eliminated.
"J>nai)iwconwsis" flow Vegetable Dints. --Apart from cotum, not a great deal of work lias been done on the vegetable dusts. The illnesses noted among cotton workers include mill fever, a transitory illness which affects nearly all new workers in cotton, flax,
of beryllium |imi:uitiniti5 r.nd gr.tmilom.ilnsis is not ns extensive as that in die l'idled Slates, though many workers have been cxpo.-cd to die dust oi I'morcM crn lamp powders containing beryllium oxide and also the dust and limies from the alloys. Only one d,-ath has oi-rurroil. and the Factory l'leparnnent ha- eoliecied dillitnl. X-ray. ;,,nt coviron-
and hemp mills and nlso in malt bouses; "Monday fever" (Oi Hiding); weavers'
cough, and hyssinosis.
llyfsiunsis develops niter about 20 years as a named progression from "Monday fever"
ami in its final stage has the rhnraciensiies of chronic bronchitis and emphvsema. As
Schilling
-M -ms, though it was dc-
<>j
ves'r nisu.-isiix
scribed by fireeuho, its etiology i,- still m
but characteristic
.aid brcuth'.v.'SM.'S'i ,r.
ually extends lo oils
disease progresses. "
. symptoms nrr very rentnin worse uti Mm t day. It causes no s-p. } the lung fields." In f in the rollon card an.' most irom the discus:.
ers who eleiui the card ally aircard. As men:! 4 ers with hvssimisis an
\ special scheme.
Uagasso.ds.---Only > Iry handles liagas.-e h the sugar), and bag mainly in those workbagasse in a dry state, acute bronchiolitis, v,. severe dyspnea, and x-1 Showing gotcraliwd teen cases of this- aciih the notice oi the Factof these have been :h and 1 Inmilnn-.-Wtu-r.-: Taylor t I'J l2 j, am! (Id-Jo.i. The last eg Since wc got the lirm under water, there li cases.
1'itrtiicrs Lung.---I':-
lung was first described
and after that F.wciii l a great deal of work on
features fimilar to in',
occurs mainly among v.
i l
handling moldy liny dv.
is regarded ns being
y
i
Faweill was firmly <:
eases ot the conditio!
time to time by physiol
districts.
Dtinuiiernuksh in ( nor, IUrmoit, and Fa;:, the rljiiica) features inpcaiancts in a group
1
iveilux i
:;>i:t!
u:)C ul
cih. r him- cn't-s
,U'ir vuiuliliuu is i-bahte llinl live out
were chcrnisl* tinI iif the beryllium
tirv where (lie fatal
omnttuds occurred.
rs were examined
oally and no more
here In') been con-
dust ot the lamp
t. It is umlcnialilc
ixic. Inn exniuma-
e lungs of the one
)ltl tlie uiionliotb.v
at tlie role cause oi
e two types of tc* Otis type, in which
tdioid cells, and the
iy filirotle nodules
Osis. Under polar-
reiructilc particles
. and ;ui eminent
. these were cristo-
live forms oi free
. because one of
powder Is silica
preparation of the
out 11 DOC. The in" the lamp pow*
ic beryllium oxide
the risks both oi
ml of silicosis have
i I
; j j : | i | ! i ;
Vegetable Dusts. a great deal of
t vegetable dusts, f cotton workers nr\ illucfs Wllich rs in cotton, lbs,
in malt houses;
'ling) ' weavera
about 20 years as "Monday fever" he characteristics emphysema. As jugh it wn< dc-
rl /V.f/.VW:.? IX XKK.'T UW!.UX
Wlilieil by (iretT.Smw nearly UK) year* ago, iis rwnl.igy is slid olvcnrr, Ji pre-mts an odd l,.,t ch.ir.'ieteii.-tie history vf 1.110.1 tightness mid brr.tililt'r'sness on Mondays, which gratl-
i,,,!!v rslvn.U to oilier working il.'IVS as 11)C
Thirty r.i i!u..c ni.'.i Imd piihiiiilMty ::!w: 1i.isK hut II utluTS lud x-ray v 1 :s:r ;> - -v.ageslivv uf the prvwii.Y i.f j.nenni. n;i;'.`is. Fourteen had normal x-ray liluw. Analysis of the du.-ts from various grains slm.ved
disease progresses. "In its later stages these small percentages oi free silica: oat dim, tV.r
symptoms are very distressing, but usually instance, had 5'/i. No autupsk-. have licen
remain worst on Monday than on any other carried nut, hut it seems that a ease ha? been
day. It causes no specific x-ray changes in made cut for an extended invt^tigati .ti of
Ihc lung fields." In tlie main, the workers larger groups of grain dockers.
in the cotton card and blowing moms suffer most from the disease. Strippers am) grind ers who clean the carding engines arc especi ally nfleeted. As mentioned previously, workers with hyssinnsis arc compensated under a
Grafhitt Pneumoconiosis.--1( has been ipmul by same observers iii La-land (Dan ner, 1945, 19-ty, ami 1949; Gluync. Marshall, and Uoylv, 1949, aild Harding ami Oliver. l(Mit) that workers exposed to the dust
special scheme.
of natural graphite develop radiographic
Dogassosis.--Only one factory in the coun changes in die lungs and disability. The range
try handles bagasse for sugar cane without of x-ray abnormalities closely resembles that
the sugar), and bngassosis has occurred seen in coal miners. Pathological and experi
mainly in those workers who were grinding mental studies (G'oyiic and others. 1949.
bagasse in a dry state. The combi ion is an Harding and Oliver, 1949) show ih:n the
ncutc bronchiolitis, with high temperature, condition falls into the group of tlie mixvtl
severe dyspnea, and x-ray picture of the lungs dust fibroses, the fibrotie nodules having a
showing generalised miliary shadows. Fii- linear and radial pattern as opposed to the
teen cases oi this acute disease have come to whorlcd fibrosis of the classical silicotic
the notice of the Factory Department j some noduifl. Natural graphite contains small per
of these have been described by Castledeu centages (of the order of 5$)-UKc) m tree
and llaujiUon-Patcrson 0942). OHlison and silica. There is as vet no evidence that pure
Taylor 0942), and Hunter and -Perry graphite will produce a simiiar condition.
(194<j). The last ease occurred in 19-H3. Manganese Pneumonitis.--Si few ca.-e= oi
Since we got the firm to grind the bagasse manganese poisoning affecting the nervous
undcr water, there have been no further system occurred in the middle 1930s in
eases,
workers grinding manganese dioxide for use
Farmers Lung.--Farmers', or threshers', in lamp batteries. In 1946, Lloyd Davie.- re
lung was first described by Campbell (1952), ported a high incidence o: pneumonia in a
and after that Faweitt (1930 and 193S) did group of workers exposed to numganesu di-'
a great deal of work on the condition. It has oxide dust in the manufacture of potassium features similar to bagnssosis, but, since it permanganate. Animal experiments by LI-v-J
Occurs mainly among workers who have been handling moldy hay during a wet summer, it is regarded as being caused by a fungus, Faweitt was firmly of this opinion. Single eases of the condition are described from time to time by physicians in the agricultural
districts, Piiriiniofom'ojis in Crain Dockers.--Dun-
tier, Hcrmoti, and Uagitnll described in 1916 the clinical features and abnormal x-vny cppenrauces in a group of oo grain docker?.
Davies and Harding (1949) confirmed that manganese dioxide irritated the king tis?ue and caused intense infiltration of the alveolar walls and alveoli. Later gramdnmatfitis changes developed in some instances. These results arc ip line with those described by workers in other rnumrics.
Vanadium Pneumonitis.--Myers (1942) recorded Ids observations on workers expocM 10 vanadium penio.xide dust, tu-.d Ms result*
Mc/,.11 i,7/f./.Y
;*;V binr l" iiu/. i: dfidribed by Sjiil.c:;;
1 !*'- \h it) S's r('.Cl. The ci'ifeels .ire a cuinl'i-
n:i: ;) oi py.-lc mit jjoivWjni ug ;;:iu irritation
Ol' tl plilmti:: :w
hr.die.y in soillt
tiis'/S to hri.ncitos
ami ji'.w.m.uma.
5 mill \\Ttiiani s (19'2) hnvc dercribod llil* i:i; irkc.'l 1 iroiib' jfO.Sja.',in ucairriiiff in
worker:i C.^JH`50'lJ 10 idie Miot of oil fuel, which
is th- tight to In: caused hs Uio high percent-
''i vanadium in the spot.
CHunm'
The portion n regards Ihc (just diseases in Great llriunn may lie summarized as Col loss'*:
1. During the past 50 years, the risk o sili cosis in inosi of ilic major industries has been (irmly cstn IWished. Liiiil the late 1920's. free silica sv:u the only dust which was thought in damage the lungs. Asbcstosis. caused by the (lust of a combined silica mineral, came into prominence about that time. In the mid dle 1930's. attention was given to tin* effects of other dust; on the lungs, such as iron and its oxides, and of radiopaque dusts, china tiny, sillimaniie. kice!gulir,. talc, and mixed dut containing free silica.
During' the middle IO.iO's also, the effects of coal dusts on the lungs were given increas ing attention, and extensive surveys were carried out, fulminating iii the formation of the Pneumoconiosis Research, L'nit of the Medical Research Council in 1945. The coal miners numerically constitute the greatest problem of dust disease in Great Britain.
2, Despite the combined efforts fit inspec tors of factories and mines, physicians, chcmsi.-tf, nigiitecri. and research workers, the deaths from pneumoconiosis have continued to rbc yearly. The reasons for this increase ntay be found in more accurate diitgnnsis oi the condition and in the publicity given to occupational di.-enses oi the lungs, leading to more frequent mention of pneumvconiosis by physicians on death certificates. But a more
111.nly cause is (lie nr^e i.ir inrrvn-cd rpeed of
prndiiedon, and the introduction oi machines
$ ''lag, A. T.: I'npnhliWictl d-U4. %
width make a div.ly procc.-s mure dusty and cans': a lag ip cluM-control methods,
.1. Compensation for industrial pulmonary disease began jimit after 191S, and gradually most of the processes anti industries which damage the lungs are being brought under the provisions of the various Acts of Parlia ment. The Industrial Injuries Aet of 194G removed the resjXJitsibility for compensation front employers and insurance bnmpnuics to the Government. Since then cases taken under Common Law against the employers have increased rapidly.
4. Numerous legal provisions, contained both in Acts of Parliament and in Regula tions. have been brought into force. Routine inspection by inspectors of factories and mines has been instrumental in limiting the numbers of cases of disability and death brought about by inhalation of the dangerous dusts.
5. It is expected that more accurate infor mation about the incidence of the duit dis eases vvill be obtained in the near future, when statistical studies of the information obtained by the Pneumoconiosis Panels have been carried out, and when the report of the Registrar-General about the occupational incidence of disease at the time of the 1951 Census becomes available. At the present time no reliable information exists about the populations at risk in each industry and process.
6. Surveys of the population by mass radi ography to delect early tuberculosis are bringing to light information about the ef fects of dust in some hitherto unsuspected occupations.
7. -Many problems about dusts and the lungs are still unsolved, and some would say that we have only just begun to attack the
fringes of the problem. Nevertheless, a great deal has already been accomplished.
Assistance in compiling the information con tainer! in litis caper was rendered l>y I^r. P, K. Vv.-.ihcr ami iliv imnii1,er of the Pncnmnconio'is I'iiikIs of the Ministry oi )'c:isin:i and Rational I mm .nice: IJrs. K. It. A. Mcrcivcihcr. A. T. Doij:. and l>. 0. Williams, of the Fac-mry Department.
- - .--r---v,--- rwo-o Is'..*7/.'
\
I m sr nisn.-tsns t-
l
Mink-try <4 I.alutuC an I K. I [.irilttij;. l.stvlv c*I (I. Niini'isriiniiilt, of the . Laltoraturirs. Shetiicld.
Bini.Kh
Arliilce. J. T.: Hygiene. I - Occupations, bonCion. ;
Camp'*:!!. ,t. M.i Acute Ps-> with )iny. Brit. M. .1. '
Cnjlledvr*.. I.. I. M-, ami :. Batassosis: An liu!u.-' M. J. 2:475. 1942.
Collie, K. L: Irulnslriul Fpcrial Reference ; Health as.r:;, tsi-t-c
CoaUc. W. E.: Pulmonary 2:1024. 1<j27.
Craw. J. l nioort I'\Vjk\ir.tii' sis rtf Haematite Iron 19: S. 19J7-
Cnntrol and Elimination Coast Haematite Iron Indost. Med. 4*o0,- If1*:'
Davies. T. A. L.: Manga;' Jmlact. Med. 3:111,
-and Hardine. II- K-: . Further Clinical im>!
lions, Urii. J. Indtist. .
Doig. A. T., ami McLatipl:!
pear.mecs oi die I.un
liIs i*
ders. Lancet 1:771. Ik. Clearing of X-ltay Shu.
vM*i Lancet 1;7?V. VJ'.
). *
Dreessen, W. C.: Effects r on the Limes, J. hidin',
and Delia Valle. J. M.
Dusi in T'o Georgi i
Poh. Health Rep. 5Gi;
Dumicr. L.: Observations
in Graphite Worker,1-. t 1945.
7 Observations on the P f rneninoeouiosis, Rril.
I*i
----llcrmon. K,, amt ):.u cuttiosis In Dockers
r Seeds, licit. J. Radi"':,
f -----ami I'.apiall, D. .1.
Graphite Workers, 1'
]!M9.
i
Fassritt, K.: Funcoiil Ciin 'J. Radiol 0:172 :,,ld .
i Occupation.':! Hiicases cultural Workers. licit
Ciilliwvi), J. A,, and Tasini, Notes of Ivor Cases.
fI.
1
.1.', i. il 'i.ll' IV
> litiiiv dusty "'licllituls.
.ri.il iin!:it:i]j.iry IS, anil ^rinUinlly mduMrius wliicli
Jiri>ut>iit mulcr l- Act' I<f I iinrici Aa of 11M0 t< >r omijiv.i.cuion me companies to lien ca.'Crf taken ,<l tile employers
Minis. contained . tint! ill 14cii!u* i farce. Kctitinc vf factories and il in Imiiiing? tliti lililv am! death of tile dant'eroiis
c accurate iniorr>f the dust tlisihc near htiiire, the information :M* Panels have
e report at the .ie occupational ime of the 1951 At the present hi exists about lit industry and
on liy mass ratliuberculosis are n about the cfrio unsuspected
dusts and the
some would say in to attack the
rilieless. a groat ilifilind.
information con ed by Pr. 1'. K. 5 1'tiviiiiioeinii'iiU aiii gnil National Mhcr, A. T. Du!::, toiy Department,
I
/>( >r /;.'>/
ix cxi.a" tu-ri.tix
Mim-11,'' 1
:.ii.I ! Siti:.'1: Dr. II.
].*, ] i.nrdiiiff' laialy ,'f Klii '-li M L'ul vi'r*i:v. .1". I Jr.
fj, N;i::i`I i,;:ii:i,ll, of the gaiety in .Miii-1-
ircil
LaW.'iimity Nufnelil.
Rlr.UOGKAJ'HV
Atlidyc. J T.: Hygiene. J1i-ej^Cl, and Mortality ol Occupations, 1-uadt.ii, Pcrcivu! & Co., 1&92.
C.aniiihdl. .1. M. t Acute .Symptoms Following Wort with Hay, Brit, >!. J, 2:114.1 19.12.
Cas'.lcdcn. 1. M., and llttmiltnn-Paicrsoii, T. L.: naflifsosis: An Imhi.-trial l.imy: Disease, DHt. M. ;. SftrK, 1942.
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rp.lLii- .
if. A Vvi^A
V,7//./jV
II-J- :!'r:t nf G-.ittneiiNlliiiil fr,i O.Cl'J'Siio.ial ) i,:::u:s 'n (be,*.: ]i:i!.:.:il. Lril. i midst. y.i 1):15S, P'4.
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:
Thackrnh, C. T. t L'llCCl* of Arts, Trade;, and Pro fessions, ar.d ol Civic Slates and l!M>iti of Living, oji J-fta!:!i and Longevity, fed. 2, Lon don, Longman, 31132.
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W'vcrs, H.: Some Toxic Effects of Vanadium
Pcnloxidc. llril. J. lnden, Med. 3:177, 194fl. Asbettosis, Postgrad. M, J, 2Si031, 1949.
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One of Ok important :,rda associaicff will' !): iliifirv is lint of .air-luiTin's i# not ft new pruh' uranium mines have a!1-dust and radon gas. It, linl experience u'itli tl in the European uraium. was an extremely hi;:' eemccr.1
The control of radi'in sense an economic :i. greater the expenditure r intitt (he less rise elcyr|csttrc. The problem i`.;r lish reasonable levels tvonld insure safety of t being over'y conservaiiv expensive. Ttvo appront have been made. The \ ccntration of radon (3X ibo Schneeberg mid Jo.-i been used ps lire basis majiinumi permissible ci r'lncs/liter.5 In praelit fliric-s^liter has been n:; cxieut. The other tippre of establishing safe wm-' is Ikisc-cI on a iiiaxiiiniiri > doi-ajie rate 10 (he It: ffin/iveek.5 Am estinuuv fnnrcturatirm oi tliO p:tri: lion which if iuhtiled t-v
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