Document KG4Qzqn6YGVejQpO3xpQg1y0Q

FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY002 DOCUMENT DESCRIPTION: Text of Presentation by Dr. Vorwald [Intro] RECEIVED F.H.H&S ' 4SS: DATE: JW 1, W?0 -MM---------------- -- ADDRESS OF WELCOME - HDOCTOR VORWALD: Ladies and Gentlemen: ARTHPR J VORWALD.K.D. The members of the Staff of the Saranac Laboratory and of the other departments of the Trudeau Foundation, are delighted to act as hosts to you who come here for the Seventh Saranac Symposium. On behalf of those members, I am privileged to extend a most cordial welcome to you all, especially to those of you who have cone from distant lands, to partici pate in this Symposium, You represent many different in terests and include physicians and engineers, lawyers and insurance executives, specialists in compensation and lacor matters, and representatives of management and of labor. Although those interests are diverse, never theless, t ^ e ir^ar^*/4 have a common objective, namely, to give the utmost in health and happiness in our way of life, as indicated in the Foreword of your printed program. I wish, again, to impress upon you that the topic to be discussed at this Symposium must be limited. Those topics have broad application, and they are not restricted to individual companies or Industries, nor do they concern only a single group such as the employer or the employee, the insurer or the insured. The tail's , during the course of the week, will cover a wide range of subjects, which yeu will<vexplore in friendly d**cns**on. As hereto fore, this Symposium will give all of us the opportunity RECEIVED F.H.H1S 4 S S 3 DATE:_JifL 3 t Kfo M.E.M______________ 2 to exchange Ideas In an Informal way, which will further our understanding and solution of problems pertaining to some aspects of pulmonary disease in the industrial worker* Ve hope, sincerely, that your deliberations will benefit ua all in our common objective, and that you will look back with pleasure and satisfaction to your so-journ here in Saranac Lake* In opening this Symposium, it is my privilege to make certain announcements which I shall try to do every morning or periodically during the day, to keep you inform ed and to assist you. in your stay with us* As you realize, there is Registration at the John Black Room. We had hoped to register all before this session* However, shortly after nine thirty, we saw that was going to be impossible, because it would delay our meeting this morning. Ve thought It was more important to get on with our discussions then to have you register* However, we do hope that you will register sometime during the day* Those of you who come to join us from outside of Saranac Lake, on registration, will receive white badges. Those of us who reside in Saranac Lake will receive color ed badges, the green for members of the Trudeau structure, the pink for members of Saranac Lake medical profession, legal profession, and others who have an interest and w*ll PKECDOCOSIOSIS ^ Ji.J. u a M.r. > t" A. RECEIVED F.H.HiS DPAATTPE.;_311U11L t? -i 1We7vQ M.LM Scptonber i1o0a..* to a preliminary etatament concerning this Panel it is isportent tc drtmto, dl.e.Sng. * = * y top. to agree on terms* . conceded vith occupational dl.aa... cf >* ^ t o * lataUtlto et duet-- occupationali djhi.M.a....... vvf-ebllcchh ooccccuurr ell orer the vcrld, 4,ath, and vtlch do not occur except u oceu- vhich may eeuse disability ana w w i petionel dle.ee... The inporUne, of the,, di,cases hue *.==. receded, ,, ftx ,, d . Industrie! condition, ere concerned. uitMn tie peet forty- fiT* yeexs. The pertlculer diee.ee vhich he. .epecielly attracted ettention is vhat ve now call silicosis. ihout 1918 Lendl, .toted thet organic duete-textile dust. vegeUhle duet, vood dcev^ld not cue. the definite o p t i o n a l lung ....... . s becoming nor. and recognised e. the evidence of eunveps of a=y , * rwTrevealed thet various diseases to which industries began to accumulate, ani, . trade names had become attached were one end the same. The villain of this^ piece is silica-- principally free silica end to e lesser ertert various dus.s of combined silica. Unoet everybody breathes eiliee in one fom or Bother during . e- tinei everybody inhales voter vapor. The one does not develop dust of the lung; the other does not drove. t vhen the dosage of either dust or voter beecnes too large for the respiratory ^ to cope vith, unforbBate , Ve u e concerned vith occupational diseases results follow. So to repeax. ef the lungs caused by the inhalation of dust. " RECEIVED F.H.HSS U U U l . DATE: JUL j t 1970 M.E.M These diseases are of alow onset sad art characterised by the formation of pulmonary fibrosis accompanied by a varying dsgrse of dysjxxea. Some of these diseases are further characterised by an increased susceptibility to infection, particularly by the tubercle bacillus. They present a radiologic picture which nay be quite characteristic but which at tines nay also be con fusing. However, these X-ray films of dust diseases of the lungs show a pathological involvement nore or less evenly distributed throughout both lungs. The added factor of infection, when present, nay confuse the diagnosis especially Ahx. when the nature and extent of dust exposure not Imovn. Ve know a greet deal about the occupational disease of the lungs due to the inhalation of oryeialioe silica. There is still nueh we do not Imov about silicosis, the term com only applied to this disease, in spite of the fact that a tremendous amount of research has been carried on. We know less about the action of asbestos end still less about the results of inhaling diatomceous earth. Ve nay say the same about silicates such as talc, kaolin and others. Ve recognise that each of these dusts acts in a specific manner upon the pulmonary tissue. Ve have alsc learned that a combination cf one or nore dusts or the action of silica in combination with a non-siliceous dust nay alter the pathological end clinical picture. Ve still do not know too nuch about these dust diseases. Consequently I believe ve should abandon any attempt or habit of referring to these diseases by a generic ten unless the specific etiologie egent is mentioned also. The void commonly in use todey is pneumoconiosis. This vord means nothing. The proper term is pneumonoconiosis which means something. There -TV /. J.U 7r i- i ^ Jill RECEIVED F.N.H&S DATE: r . . o(jQ2 M.E.M * t a tendency to 1a elude under this generic tera uarioue Inhalation diseases of unrelated nature. These occupational dust diseases of the lung comprise a perfectly distinct clinical entity, at least to those vho ha-re worked in this field and who are familiar with working conditions and their effects upon health. Metal fume fever r line chills y allergic asthma^- carbon monoxide poisoningy/ lead poisoning, r mercury poisoning ~ nitrous fume poison ing- m ell* inhalation diseases. Certainly there is nothing to be gained hy attempting -to lump all these under some generic term. I hare not mentioned coal. The role of coal dust in causing pulmonary disease is still not dear particularly when we appreciate that many coal dusts contain varying amounts of silica. It is evident that there is an occupational disease of coal miners which by its nature ana clinical manifestations can properly be classed as a pneumonoconiosis. Much research work is being carried on in many places. Until we know more, it would be an advantage if we abandoned such terms as pneumoconiosis or that still more objectionable tera "silicatosis" ana siderosis" and use specific definitive terms, viz., occupational dust disease of the lungs - or pulmonary fibrosis - due to the inhalation of silica or asbestos ar^coal in the so end so industry in such a place. b The terms silicosis and asbestosis have become so widely accepted that it is evident that they will continue to be generally used. The definition of silicosis is not entirely satisfactory, but it has been recognized and accepted by compensation tribunals ell over this country. Consequently, I believe that the tera silicosis should be restricted to the specific pulmonary disease caused by o*ys4*i4me silica. dr. V0KU2: in Ccc^&rt' RECEIVED F.H.H&S Jl'p3 DATE: JUL 311379 M.E.M x*#>^,,v *^TV*_ i*-' i^s rot ir.cUrod to 11 " vla>erti.tSAb*4 tsros blit- VOUlu i-C-r -- , ... silicosis uA o.ttoie, vbi ,, t to tf! tftcss"**t*o "ioc'nt-ffT ,,c , - *t -- those Kpail-zy|Ma"e"ryJ condition* i cauced try w d ir i.c ^ . s,-'P_ _- *.>--* / r*` ^*-c- r .,,rf u rin es s i * rsspoct to OUOIOF - ^ ^ o' t * ** ccnditior.o bo v et* t* * t to ns esosjo - j^ a tr y <- :*S te te t Jcbclnticn c n * U*rt**> er**>st in Ew-*- -- aruch. & A1>Ai