Document KRLB3LyE0qLqwMQ2g69nMyDQN

FILE NAME: Owens Illinois Library (OWL) DATE: 1936 DOC#: OWL014 DOCUMENT DESCRIPTION: Relevant Articles and Abstracts from The Journal of Industrial Hygiene and Toxicology THE JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY EDITORS DAVID L. EDSALL, M.D., S.D., United States EDGAR L. COLLIS, M.D., M.R.C.S., Great Britain VOLUME 18 JANUARY, 1936-- DECEMBER, 1936 PUBLISHED BY THE WILLIAMS & WILKINS COMPANY Baltimore. Md. SUBJECT INDEX TO TEXT AND BOOK REVIEWS. VOLUME 18 This is a subject index to all the reading matter in the J ournal op Industrial Hygiene, and one should, therefore, look for the subject word. The name of the author follows the subject entry in parentheses. Item s starred are book reviews. For author index, see page 801. PASS PAGE '.'absenteeism, sickness absence and Benzene exposure, urine sulfate deter- labor wastage, P t. 1, M easurem ent minations as measure of (Yant, and incidence in light work (Smith, Schrenk, Sayers, Horvath, and Leiper, and Culpin); P t. 2. Labor R ein h art)............................................... 69 wastage (Greenwood and S m ith ). . 581 exposure, urine sulfate determ ina `Accidents, and diseases industrial, tions as measure of, plant study of from chemical action (B erger)........ 568 (Yant, Schrenk, and P a tty )............. 349 `electrical, fatal, electric current in Beryllium oxyfluoride, poisoning (von H olstein-R athiou).................... 468 by vapors of (G elm an)...................... 371 'industrial. Seventh International Blisters, see under Skin diseases Congress of Occupational Accidents Blood pressure observations, clinical and Diseases, Brussels, July, 1935.. 130 studies in lead absorption (Bel Acetone, methylalcohol and their knap) ................ 380 mixtures, relative toxicity of (Skli- sugar concentration, effect of nico anskaia, Urieva and M ashbitz).. . . 106 tine containing diets on, of albino methylalcohol and their Tnixtures, relative toxicity of: II. Their rats (Wilson and D e E d s)................. 565 action on white mice (Mashbitz, Carbon disulfide, low concentra Sklianskaia and U rieva).................. 117 tions of, toxic effects of (Wiley, Am borne infection (Chope and Smillie) 780 Air Conditioning, controlled hu Hueperand von O ettingen).............. 733 *Carbon monoxide asphyxia and re midity in industry (Marsh)............ 369 boating and (Allen and Walker). . . . 90 suscitation with oxygen and carbon dioxide (H enderson).......................... 135 a `spital (Yaglou).................................. 741 m normal life (Drinker)...................... 767 poisoning (D rin k er)............................... 637 poisoning and heart infarcts Ai.lergv and neoplasia w ith special reference to occupational tum or formation (Hueper)................. 140 *'i nose and paranasal sinuses !Hansel).............................................. 469 *W m.ysis, colorimetric methods of Snell and Snell)............................... 338 *Axtiiraco-silicosis among hard coal miners (Sayers, Bloomfield, Dalla- Vallr, Jones, Dreessen, Brundage, id Britten)....................................... 337 C.turax infection, prevention of, in ''"ilen textile processing (Mac- , donald)................................................ 357 ' "m m , dust, survey of employees -xnosed to (McPheeters)................. 229 i -to-iis, pulmonary, incidence and ^ ""cnosis (Donnelly)........................ 222 "'' of employees exposed to ii' stns dust, (McPheeters)......... 229 '!',I'iiehio conditions, industrial, : termination of solvent vapors means of activated charcoal ok and Coleman)........................ 194 (K roetz)................................................. 794 poisoning from compressed air (Bernz and D rin k er)........................................ 461 Carbon tetrachloride, chronic tox icity of, animal exposures and field studies (Smyth, Smyth, and Car p e n te r )...^ ............................................ 277 Charcoal, activated, in determ ination of solvent vapors in air (Cook and Colem an)............................................... 194 Chloro-butadiene, 2-(chloroprene); toxicity and pathology, and mech anism of action (von Oettingen, Hueper, Deichmann-Gruebler and W iley )..................................................... 240 Chloroprene, its toxicity, pathology and mechanism of action (von Oet tingen, Hueper, Deichmann- Gruebler and W iley)......................... 240 Chromium toxicology,(Brard).............. 369 Circulation of young workers with regard to occupational rating (F rst).................................................... 794 795 M t r 2 72*, I 9 M j ! I II i I I j j i ` c i 1 PULMONARY ASBE8T08IS: INCIDENCE AND PROGNOSIS* J. D onnei.lt, M .D. Mecklenburg Sanatorium, Huntcrtvill, N. C. WITHIN a comparatively short time the occupational disease, pulmonary asbestosis, hns beromc a matter of considerable impor tance, not only to manufacturers of asbestos products, but also to the workmen engaged in the industry. That the serious industrial hazard of thin type of work has not previously received sufficient attention is becom ing more apparent. The manufacture of ash-stou products has increased more llmu four-fold in tho last 20 years, and hence, because of the greater number of workers exposed, and Hie more frequent recognition as a pathological entity of the resulting pulmonary condition, the subject of nsbestosis has rapidly assumed greater importance. It is indicated that the owners of asbestos plants, and the workers them selves, are beginning to realize that exjKisure to asbestos dust is a serious occupational hazard, and it also is apparent that these workers must be protected against the hazard as effec tively as is possible. That this pro tection can be made complete seems very doubtful. It seems to be the opinion of engineers that the most Received for publication January 19:10. Rend before tho Industrial Hygiene Sec tion of tbo American Public lloufta Associa tion at the Sixty-fourth Annual Meeting in Mibvaukco, Wis., Oct. 8, 1995. effective types of suction apparatus now in use will remove a maximum of not over 90 per cent of the dust, but the remaining 10 per cent may lw definitely injurious. In 1910 protec tive devices of the suction type were placed in a certain asbestos mill, ami yet 15 years later cases of asbestos;* with fatal termination were reported among workers from this plant. Since the most efficient type of protective machinery know n apparently docs not completely protect, Although the num ber of workers affected is probably somewhat reduced, and the time re quired for the production of an ad vanced type of disease is probably lengthened, the problem becomes a matter for serious consideration. In the case of any industrial em ployee presumed to be physically handicapped by any condition or dis ease, supposedly caused or aggravat'd by conditions under which he has worked, there enters the question of compensability. Pulmonary asbest osia has not as yet been widely recog nized as a compensable disease in states having laws governing the compensation of workers. If such eases are viewed as compensable un der the Industrial Compensation Laws, it will be nectisary to decide the degree of disability in each individual in order that proper rating may 1' made. "W `-r '!.'>-*>** "`AijU.' `.V **''' '* V -^A y ?-s- v.-a^^WLiiAL^. '- It, mo. 41 PULMONARY ASULSTOSIS 223 Practically all writers on the sub l e t are agreed that the principal -ymptom of the condition is a varying degree of dyspnea, and that the physi cal signs arc those found in fibroid tuberculosis. Hence a definite diag nosis cannot be made by a physical examination alone. 'I'bc x-ray film, however, is distinctive, in that it -hows a picture of pathological changes in several particulars different from those found in the x-ray films of any other respiratory abnormality. The presence of the condition can be dem onstrated b y the x-m y film alone, but the degree of disability cannot be estimated unless the .symptoms and physical signs are also considered. The dyspnea is usually out of propor tion to other symptomatic manifesta tions, and is the one symptom which, in the more advanced cases, precludes any form of muscular exertion. Tor that reason, an asbestotic victim is unable to sell his labor on the ojk-ii market, and must be rated os totally disabled. I have seen no statistics in the literature in regard to the incidence of asbestosis among the workers in the industry. It would seem to he a matter of some importance to deter mine the average number of employees who may be now, or who arc likely to become, disabled by the condition. I have lately had occasion to review the x-ray films of 161 workers in asbestos mills. Of these, fifty-two showed definite evidence of asbestosis in varying degrees. Of the 151, eightysix had worked in asbestos for jieriods varying from 4 to 20 years, and in this group were found lifty-one of the |y.si!ive cases, a percentage of 59.3. 'There waa only one case with definite X-ray evidence of asbestosis who hud worked lc.-.s than I years in the indus try. Of the 52 workers with evidence of asbestosis only four had worked less than 5 years, forty-eight having been employed for 5 years or more. There were eleven with an advanced ty|>e, no one of whom had wi cked less than X years, (hie of these advanced eases had been ex [wised to asbestos du.-t for X years, two lor 9, and one each Ibr It), II, 12, II, 15, |(i, 17 and 20 years. Unfoi Innately l have no record of the length o f:etvice of tlie-.-o employees in the various departments of the mills, all of which are limps .'riomihly dusty, but. it. is agreed that the carding room is the dustiest, ami the weave room probably next. It. is presumed that the dustier the work, the more likelihood there is that pathological changes in the lungs may result. It is noteworthy, however, that some employees work in asbestos plants for years without suffering any pathologi cal changes in the lungs, as far as vail be detected in the x-ray films. In this series of 151 employees, ninety-nine showed no positive evi dence of asbestosis in the films. Tive had worked in asbestos for li years, three for 7, three for S, four for 9, six for 10, one for 11, ami one for 15 years. All tin- others bad worked for periods, varying from a few months to 5 yeals. Since the pereenlage of those in the scries who wore affected was so high, it seems remarkable that so many could lie entirely free from (lie ermilit ion even after years of expo sure. Since Ihis prucc. a is non-infeetioiiH, the term "physical resist mice to disease" is not. applicable. It is true that muscular development avails "'V'i's : ^ .-.I*- J* 1 -l * -v >,,; "gsqggg - jw ,` v :-.C* T ' up; i.iiiinfaMi % *"Wm>">"OTT'I'll111'... 224 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY \AVt , i r . nothing as a protection against tho culosis. One lmd been working disease, since well developed men arc asbestos for 10 years, another s - ns frequently affected as those not so 4 years, and the third for 2 y well develop'd. It is also possible There was no evidence in the him that, some individuals may be aus- that the presence of asbesto.-is had eeptiblo even though exposed to low yet. had any tendency to activate t! concentrations of dust. tuberculous lesion. The films of I It is the opinion of some writers workers showed evidence of tuhenu- i * (hat the inhalation of asbestos dust lous infection without any pathologic d mid the consequent production of changes indicating asbestosis. t nshestosis has a tendency to exacerbate these, eleven showed healed childhood old tulx rculou.s lesions. 'This opinion type tuberculosis, but none of the- ) is apparently not universal. Mere- had worked longer than 15 month - i wri her (1) says "from a review of 12 in asbestos. Two workers sh o w , I fatal cases of confirmed asbestosis it healed childhood type tubereuln-i t :ip|>ears that asbestosis . . . is less fre with no asbestosis, one of when: quently accompanied by tuberculosis had spent 8 years in the work and than is silicosis." Gardner and Cum the other 6 years. There were 5 fib mings (2) slate that "primary tubercu showing apparently arrested adulf tyj- ! lous infection is inlluenced only to a disease with no asbestosis. T h ^ - limited degree by inhaled asbestos." films were of employees who had Kgbert (3), in an analysis of 28 eases .-pent the following periods in this of pulmonary asbestosis with fatal work: One each for 4, 6, 7, and ft termination ns reported in the litera years; and one, no term of service ture, found that tuberculosis was given. There was 1 ease with an present in only 0 eases of the 28, and apparently healed and calcified miliary in only 3 instances was death due, tuberculosis with a history of only s primarily to tuberculosis. months' service in tho industry. It is universally agreed that silicosis In the 151 films there wore only does tend to exacerbate old tubercu four which, from an x-rav standpoint, lous lesions. In fact more or less were diagnosed as probably active rapidly progressive tuberculosis is tuberculosis of flu1 adult type. One considered the most frequent, and of these had been in sendee for *> must serious complication of silicosis. months, and one each for 15 month--, Uoisliniere (H says that silica is the for ti years, and for 10 years. Since I only phthisis-producing dust. In ob- case had worked only 5 months and serv.nlions lor several years I have another 15 months, it would seem im been unable (o (ml evidence that the probable that this type of work could inhalation of ashes!os dust, or the be the cause of their active disea.-'a condition ashes!o. is itself, has .any particularly as the films of both en-c- tendency to render active old, appar indicab'd a chronic .vpo of discs-- ently healed tuberculous lesions. In and apparently not an acute exacerba this series of lf)l workers there were tion. There remain for consideration three who had a definite asbestosis in 2 active eases with 0 and 10 years' addition to an apparently healed tuber service respectively. Agreeing that j v. & ' f T T'*' - 1i f f g *1'.O -, l V- . 4 .* `4v**..*,, t**" ' *k- V *' ml. 18, nu. 4) rULMONAUY ASliKSTOSIS tbc work in asbe.-ilos may have aggra vated their pulmonary condition, 2 cases of active tuberculosis in 151 workers m ans a decidedly low per centage, if tills tyjie of industrial occupation has any tendency per sc to exacerbate old tuberculous lesions. Tuberculosis uf an active type may lie found quite as frequently in the routine examination of workers in any industry, regardless of whether or not the occupation be dusty. Com I . The x-ray films of one mau who has worked approximately 10 years in asbestos illustrates the fact that employment in this industry even for a long time does riot tend always to re-activate old tuberculous lesions. The first film, taken April 2, 1050, shows some fine fibrosis on both sides from the 6th to the 9th posterior ribs, thickened interlobular pleura with some involvement of the diaphrag matic pleura, and a slightly '`shaggy" heart outline, these patliological changes indicating a probable nsbestosls which is not very fur udvunccd. In addition to this condition the film shows a tuberculous infiltmliim in the right apex, which appears to bn in a quiescent state. The second film, taken M ay 3, 1035, indicates that the tuberculous lesion still remains inac tive, although a period of 5 yi nrs has elapsed since the previous film was taken. This man left the uabestos industry for a while during this jiei iod, but returned to it about 2 years ago. One of the most important problems in the consideration of pulmonary asbc tosis Is whether or not the disease is progressive, even after an individual handicapped by it ceases to work in the industry. Information ou this question is of considerable moment in rating (he eventual degree of disability of a worker, cither in the assessment of damages in civil suits or in claims umler Slate ( 'om|H'us:Uion Laws. Sparks (.a) slates that the disease is apparently progressive, not even the cessation of exposure to the dust cheeking its spread. Wood and (Jloyiie (t*) stale that once aslieslosis bodies are found in the sputum the course of (lie disease ap|>cars pro gressively lowaward, and cessation of exjiosure then does not cheek the spread. Many writers consider that silicosis is a progtcssivc disease, regardless of whether or not there has been cessa tion of exposure. However, Sayers (7) says that ``a tuau suffering from .simple silicosis generally improves wben removed from the dusty atmos phere and placed in suitable surround ings." Iloislinierc (4) says: "Silicosis by no means always progresses after the hazard has ceased, nor Iocs it always produce tulierctilosis." It is reasonable fo assume llmt the eventual HTeet of the inhalation of a dust which sometimes contains as much as 99 per cent silica might lx* somewhat more severe than that caused by a dost which contains a maximum of only 2.(1 |s r cent. It seems to lie true, however, that the fibrosis in ashesfosis is produced by a much shorter exposure than is the rule in silicosis, tiaidner and I'tmimings (2) say: "The particles and elongated libers of asbestos dust do not, during this period |2 years and 5 mouths), penetrate so deeply into the air passages of the lung ns do the other dusts previously studied. The major portion is held up ami pha gocytosis! in the lumiua of respiratory E32Pi+v-* r r - "Z'T* instil i V* . <r to**. as* 220 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Apr., ws* bronchiole and the alveoli given off Case H I . 0 . A. B , w hile m it* from their w a lk " Since the condi- Quit his work in the card room o r an (ion is not nil infectious profess, it asbestos plant in June, 1931, aft r tJiould not rout tin' to progress on rc- having worked continuously fur x niovnl of the causative fuctor. Gnril- years. The first film was taken .(nee ner ;in<l ('uiuiuiiigH (2) stato that thn 13, 1931; the pccon <| film, January ..o nslivstosis body umi the production 1935. The first film shows n h iln '-r ` of fibrous tissue in the lung is caused fibrosis over the lower tw o-thirdi i t by hydrolysis of asbestos fibers in the the lung9, the usual "sh aggy" hear: i tissues. Theoretically, then, extension outline and ndhosive pleurisy. IL. l of the pathologieul process should cn.se was diagnosed well-advanced 4 coni inn' until nil asbestos libers re hestosis. The last film shows v i 1| maining in the lung arc hydrolyzed, extensive progression of the condition, which may require a considerable time. the fibrosis having extended in to the Several of m y eases seem to indicate apices, and also become more dense. i that (lie rapidity of progress of the fibrolic change in the lungs after cessation of exposure is dependent to In spite of the fact that this nmu ha had no exposure for a period of 34 years, the condition has steadily I- some extent on the amount of involve come more extensive. A t the time ment which occurred before the indi this is written he has begun to show vidual m in ed work. To illustrate this symptoms of progressive heart failure, point,eousiileration of additional x-ray and a fatal termination seems in films of 3 cases reported in 1933 may evitable. be of interest. Case I V . R. G. J., white male. Case I I . 1>. S. W., white male. Quit his work in the card room of an ( eased work in card room of asbestos asbestos plant in April, 1930. Th" plant, in January, 1929, after working first film was taken April 23, 1930, only 18 months. The first film was and shows tine fibrosis and mottling taken June 13, 1931, and shows a over the lower lung fields with some J [airly extensive fine fibrosis, a "shnpginess" of the heart outline a-' l ``shaggy" heart outline ami some pleural adhesion-. The next lilm, involvement, of the pleura. The sec taken September 2, 1931, lfi months ) ond film was taken on March 8, 1933, after the first film, shows some in approximately I years later. Com crease in the pttlnmnarv t'bmsis. Tins parison of tin; two films indicates man, under rest tree1meat, improved that in the I year interval the densi his general physical condition ma ties at the hila have increased notice terially. He was advised not to return ably, the pulmonary fibrosis has ex to work in an asbestos plant, but he tended toward the apices, and the md not heed this advice because he hypertrophy of both the right, and felt that he must make an attempt left heart has increased. Symptomat to care for his family. He started to ically, the dyspnea has noticeably work again in Me /, 1933, and con increased within the last year. The tinued until October, 1934, when lm man has not been exposed to asbestos was forced again to leave his job. * dost since January, 1929. The final film, taken August 30, 1934, } t : li-i V* T 111 'fj1 '* rrr IT- ,^WI~"r y - *?/&. ...in . - ; * * * } : 4 . ' ut&tUi y v i T1 f * " r ,, '' iy * ,' ' * > ? -r _ rrfLf'^ ol. 18, no. 41 PULMONARY ASHKSTO.SIS 227 indicates extensive progression of the fibrosis well up into the* apices, and a definitely hopeless outlook. In fact 1Ills man is beginning to manifest the physical 6igns and symptoms of pro gressive cardiac failure, which, in my opinion, is the terminal result most frequently met with in pulmonary ashes tosis. The rate of progress of the condition in Case II, and the extensive progress in Case III, even though there was cessation of exposure in both cases, qualifies the statement of Wood and Gloyne (6) that ``once asbestosis bodies are found in the sputum the course of the disease appears progres sively downward." Asbestosis bodies were not found in the sputum of Case II, but were found in that of Case III. The sputum of Case IV was at first negative for the bodies, but they are present since the condition has become far advanced. Inciden tally careful examination of the spu tum of cases with definite asboslotic involvement in the lungs frequently fails to exhibit asbestosis bodies. The high percentage of pulmonary asbestosis (34.4) found in this series of 151 workers, indicates unquestion ably the need for more complete protection of employers in asbestos mills. Sufficient evidence has been produced to prove that the inhalation of asbestos dust is productive of serious impairment of health. In fact, the victim of asbestosis, as a rule, eventu ally becomes totally disabled from i ngaging in any form of labor. The most prominent and lasting symptom of this disease is dyspnea, and this is out of all .proportion not only to the physical signs found in the lungs, but uL-tO to the pathological changes depicted in the x-ray films. It is this symptom which very frequently pre cludes any form of physical exertion. Furthermore, even in those cases iu which the x-rny films show a negligible increase in the pathological process over a period of years, there is no indicated improvement iu the dyspnea. Serial x-ray films indicate that the condition is slmvly progressive even when exposure has been discontinued for several years. The prognosis for extension of life after cessation of exposure in the eases iu which involve ment is not far advanced is encourag ing, but the ho|)o for amelioration of tile dyspnea is not encouraging. An industrial worker is entitled to every pmterliou that may safeguard his health, so that ho may cam a livelihood for himself and family for at h ast a reasonable period of years in the work in which he is most skilled. If lie is prevented from con tinuing in such work because of im pairment of health through no fault of his own, he is entitled to some remuneration for his loss of earning power. That protection of asbestos workers has been woefully lacking in the past has been definitely shown. It is imperative that such protection, ns nearly complete ns possible, bo provide <1 by mill owners. KHiciont protective devices will be far less e.xjiensive in the final check up than the aggregate of numerous claims for compensation and frequent damage suits. That complete protection can be afforded by the devices in use at the present time seems to be somewhat doubtful, but workers are entitled to the highest type of protection which the engineers familiar with the hazard ciui provide. ''fir :. *v * : V .. A-> W'-cs. . ss; lllMslftAs b e """swg yr iHiKiwriimmiiii (I'.'im iuiimmm --- - ; anm ; 228 JOURNAL OK INDUSTRIAL HYGIENE AND TOXICOLOGY t Ip. . - BIBLIOGRAPHY 1. Meriw ether, K. U. A.: A memorandum on nsbcBtosis. Tubercle, if , 00, IOfl, 152 (1033, 1934). 2. GM[>NKn, L. U., AND C umminos, I>. E.: Studios on experimental pncumokoniosis. VI. Inhalation of asbestos dust; its effect upon primary tuberculous infection. Turn Jour., 15, 05 (1031). 3. Kimnur, D. 8.: Pulmonary asbestosis: Report of a easo with necropsy find ings. Am. Rev. Tubcrc., St, 25 (1035). 4. BotsLiNitne, L. C.: Silicosis and rid tuberculous. J. Missouri Btau '! Assoc., JO, 300 (1033). 5. S par, J. V : Pulmonary liklie.;.. Radiology, IT. 1210 (1031). g. WooD, IV. I)., AND Gf.Or.NE, S. it ! monary asbestosis. Lancet, J /n. 1 (1030). 7. 8 a t m r , R. R .: Silicosis--Review history, pathology, and prevent U. 8. Pub. Health Repts., (1034). i j i i "4* i f 4 i i 1 yc a-- $ : x \. V--* 8 * ' ' ii'X - - < si - . * . t > ` . .4. ' * A SURVEY OF A GROUP OF EMPLOYEES EXPOSED TO ASBESTOS DUST* S. B. M cP heeters Charlotte, North Carolina HE dangerous dust diseases, silicosis and asbestosis, are be T ing widely studied* at present. It has been estimated that there are more than 750,000 silicotics in the I! Paited States while there are only ;;.j,t)00 to 40,000 persons engaged in he asbestos industry in the world. In the United States in 1929 a total nf 9,237 persons were said to be em ployed in the manufacture of asbestos products other than steam packing and pipe and boiler covering. While it employs a relatively small number of persons, the asbestos industry has had a remarkably rapid expansion and by reason of the widespread and varied uses of its products which include "matches, filter pads, paints, roofing, high pressure jointing, electrodes, brake linings, clutch rings and insu lating material in a great variety" the industry occupies an important, increasing, and permanent place in our economic establishment. Asbestos is described chemically as a hydrated silicate of magnesia con taining little iron and almost no calcium. It is a fibrous mineral which can be split up into flexible fibers for spinning and weaving. When it is processed some of these fibers are fragmented. The fine fragments are inhaled by the workers. It is the particles smaller than 10 microns which 'Received for publication January 7,1936. are the cause of the distinctive pul monary fibrosis called asbestosis. Gardner writes that ``these asbestos particles are phagocytosed as they are caught on the irregular walls of the terminal bronchioles. The phagocytes for the most part migrate directly into the substance of the adjacent walls and there stimulate growth of connec tive tissue cells. There results a collar of fibrous tissue about the ter minal bronchioles which contracts and constricts the tubes. The constriction produces collapse of the distal alveoli (atelectasis). The collapsed area be comes fibrous from mechanical causes (collapse induration). In asbestosis unlike silicosis there is little or no transport of dust into the lymphatic system and no nodule formation." "Intervening units (between the af fected lobules) not being involved still contain air and permit the passage of x-rays. Consequently the roentgeno gram fails to show massive homogene ous shadows. " The appearance on the film has been frequently likened to ground glass. This paper reports the results of a survey of 210 persons exposed to asbestos dust. The conditions im posed upon the survey did not permit the thoroughness of study to be desired, but all of the employees were given a brief, general clinical examina tion which included taking their past 230 JOURNAL o r INDUSTRIAL HYGIENE AND TOXICOLOGY [.-t pr,, 19% lioilth and ocnipafional history and a physical examination. No labora tory examinations were made. All hail a silicic film made of the chest. The dust concentrations are not equal in the various departments. In the preparation department the proc esses of grinding, crushing, and mix ing are carried out. Here the quantity of dust is greatest and consists almost TABLE 1 ------------ . ---------------------------------------------------------- -- SUMHKH -- PEN T.sr -- T o t a l e x a m i n e d ................................ Normal limes .................................. P ulm onary fibrosis, linear ty p e H c a v v linear sli.-nlows in th e c a r d i o p h r n i e a n i r l e ................... Cardiovascular pathology . . . . Pleural adhesions ................ A /. \ 1C"* l o b r s lionv pathology ............................. ........................... Pleuro-|>cricardial a d h e sio n s. . B r o n c h i e c t a s i s ........................................ A s b e s t o s i s q u e s t i o n a b l e ................... A s b e s t o s i s m o d e r a t e ......................... A s b e s t o s i s a d v a n c e d ........................... Primary pulm onary tu b ercu losis: P r i m a r y f o c i ..................................... ( d e i f i e d I v m p l i n o d e s ............. Secondary pulm onary tubercu- lo-is: M i n i m a l ................................................ M o d e r a t e l y a d v a n c e d ................ I :tr a d v . - n i m l ................................ 2111 123 fl 11 21 7 o i .*> 3 2(1 25 8 6 5 2 -t 0 :>s 8 1 3 5 2 11 4 3 3 0 0 1 ! 2 3 1 1 0 5 11 8 3 8 2 8 2 3 0 9 19 0 0 entirely of asbestos particles. In the other departments the material proc essed is a mixture of asbestos anil cotton. Here the proportion of as bestos particles is less and the total dust is also less. Table* 1 summarizes the various types of pathology noted in the films. Of the 210 persons examined, forty-five ere negroes. The films of one hun dred and twenty-three, 58.5 per cent, re regarded as showing lung-fields that were normal, except for a small primary tuberculous focus in one, Of the 210 films, fifty-three, 25.2 per rent, wore regarded as showing definite or questionable evidence of nsbesto-i>: of the fifty-three, 20 films were elas-ed as questionable. Had stereoscopic re takes been allowed, it is believed that this number could have been greatly reduced. The indispensabilitv of a competent roentgenologic technic needs to be emphasized. Thirtythree films, 15.7 per cent, showed definite asbestosis; in twenty-five, 11.8 per cent, the process was moderate in extent; and in eight, 3.8 per cent, more advanced. In the remaining 31 films various types of thoracic pathol ogy wen* noted, none* of which were ascribable to asbestos dust. 'fable 2 presents the normal lung group and shows the distribution of the group in the various age-periods; the incidence of cardiovascular abnor malities seen in the films and dyspnea according to age-periods; the number with chest expansions averaging ap proximately J inch, 1$ inches, 21 inches and 3 | inches; the total number of employees in each department whose* lungs were normal, and the numbers and lengths of exposure to asbestos dust of those in the several departments. 'fable 3 shows the incidence and extent of asbestosis from increasing periods of exposure in the several departments. In this table employees are placed in tin* department where they work at present. It is obviously a practical impossibility to trace the transfer of each individual from de partment to dervirtov* o,.,l ... tic ml. 18, nn. .;] EXPOSURE T management states that somethin like 95 per cent of employees contim in the department in which" they bega t it has been assumed in the discussi that the employee has been at 1. present work throughout his exposur From this analysis it appears th of 9 persons exposed for more than years to dust concentrations effecti in producing disease, four, 44 per cei T Analysis o f G rou p of ! 15- 24 ye ^ Number in each age period. , Dyspnea................... Cardiovascular abnormalities. Chest expansion \ ................. 30 ! i ; ! 0-1 j Number in each grade........... Years of exposure .................. Departments: Preparation ......................... Carding ................................ Mule spinning . ................ Spooling .............................. Twisting................................ Winding............................... Ring spinning .................. Weaving................................ Maintenance......................... 2 i i i 4 ! 0 1 5 , 3 11 19 1 8 4 Total .............................. 61 escaped asbestosis; of 32 persons posed for more than 10 years similar concentrations, fourteen, per cent, escaped; of 70 persons exposed for more than 5 years fo: five, 64 per cent, escaped, and of \ persons exposed for more than 2 yt and less than 5, twenty-four, 85 cent, escaped. Prolonged exposur disease-producing concentrations dust alone does not seem to have I rol. IS, no. 1,1 EXPOSURE TO ASBESTOS DUST 231 management states that something like 95 per rent of em ployees continue in the departm ent in w hich'they began, it has been assumed in the discussion that the em ployee has been at his present work throughout his exposure. From this analysis it appears that of 9 persons exposed for more than 15 years to dust concentrations effective in producing disease, four, 44 per cent, sufficient in a great percentage of these cases to produce asbestosis. Attention is called to the fact that in the sam e departm ent, that is, where the concentration of dust is the same, som e exhibit the disease after a short exposure while others, after much longer exposures, escape. N or is the incidence of disease always as great among those who have been TABLE 2 Analysis of G roup of E mployes with N ormal L cnos AGE 15-24 years 25-34year 3S--44 years 45-54years 55-44years Number in each age p eriod.. 36 Dyspnea................................... 1 Cardiovascular abnormalities. Chest expansion.\ ................. 0-1 Number in each grade........... 2 Years of exposure................... 1-2 57 6 2 1-2 in. 67 2-5 22 1 3 2-3 in. 48 5-10 6 2 3-4 in. 3 10-15 2 1 2 Not recorded 3 15-20 TOTAL 123 9 9 123 Departments: Preparation.......................... 4 1 5 Carding................................. 6 4 4 2 16 Mule spinning...................... 5 1 4 1 2 13 Spooling .............................. 3 2 4 1 10 Twisting............................... 11 1 5 1 18 Winding ............................... 19 1 7 3 30 Ring spinning ................... 1 1 2 Weaving................................ 8 2 8 1 1 20 Maintenance........................ 4 3 2 9 Total.................................. 61 1 14 35 10 3 123 escaped asbestosis; of 32 persons ex posed for more than 10 years to similar concent rations, fou rteen , 43 per cent, escaped; of 70 persons so exposed for more than 5 years fortyfive, 64 per cent, escaped, and of 28 persons exposed for more than 2 years and less than 5, tw enty-four, 85 per cent, escaped. Prolonged exposure to disease-producing concentrations of dust alone does not seem to have been exposed for equal periods in depart ments where concentration of dust is greater as among those who work in departments where it is less. The incidence of disease increases with the duration of exposure and the concentration of effective dust, but not directly or constantly. No length of exposure or concentration of dust produced the disease in more than 60 per cent of persons exposed in any 232 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY Hi [Apr., 19SS department. It seems to be true everywhere, that some workers are not affected however long the exposure or high the concentration. These facta suggest differences in suscepti bility. As to what deficiencies in defense or possible reinforcements of the attack exist in those in whom asbestosis occurs, other than the recognized difference in the compe- were made to observe the behavior of respiration in response to the changing ventilatory demands of graded physi cal exercise. Dyspnea here means that the persons replied "yes" when asked, "Do you have any shortness of breath under ordinary circum stances?" This "yes" is understood as meaning that these persons when engaged in usual activities were with TABLE 3 Analtsis or Errscr and Doration or Exposure in Various Departments DURATION Of IXT060M O-I yean H y itn M O yttn 10-ttyean &EAvntmxT s! X i n 1X s *1 1 i 13 n i3 .a It 5 1 i t 1 0 1 1 0 1 1 it .9 e 1a la II O i *0 | 4 O1 1 t O n io * * Z 1 3 < I s i i < Z Z or 3 < z i, i 1 < P reparation... C a rd in g ............. Mule spinning. S poolin g............ T w istin g ............ W inding............ Ring spinning. W eav in g ............ M aintenance... 33 8 7l 55 33 15 15 20 20 11 10 10 66 86 2 33 22 11 33 11 54 1 54 1 72 32 13 5 1 3 4 86 2 65 1 e 711 98 1 1 1 12 9 1 2 531 1 1 i 713 2 i 32 1 321 32 1 64 11 11 5 113 3111 Number of i employm | l-20ye*r i 1 10 3 1fi 3 O1 1 "Ot Z or S < i1 42 2 11 11 21 1 S ;||| 'll' T o ta l.............. 71 70 i Number with d y s p n e a ........ t Cardiovascular d ise a se ........... 3l 28 24 2 2 70 45 8 12 5 32 14 7 9 2 9 4 2 2 1 3 723 2 2 3 1 f 2 2 42 1 2 5 11 -ff, i "O tency of the protective mechanisms in different individuals, no conjecture is ventured. As of silicosis, dyspnea may be said to be the characteristic symptom of asbestosis. ' The dyspnea here re ported does not refer to more fre quent, more forceful or embarrassed operations of the respiratory mecha nisms objectively manifest. N o tests cater or less frequency conscious of an unaccustomed sense of inadequacy attending the ventilatory ' process. This experience was not infrequent among persons with lungs roentgenologically and by physical examination normal, occurring in 6.1 per cent. The experience was more than twice as frequent among those With definite asbestosis. Six of the 33 asbestotics |(18.1 per cent), stated that they h sonic shortness of breath; three of < gX-25 moderate cases and three of tie f^morc advanced. Rut the most : t*- vanced cases showed no s|Krial resp v tory effort during examination a m Fio. I.--Moderate asbestosis. He. ^no cyanosis and none declared feof or impaired ability to carry >, heir jobs. Among the thirty-t fcf.'Asbestot<?*, dyspnea was t\vic< .'frequent in those under 45 year P ^ 'age, 42.1 per cent, as in those ^ 45 years of nge (21,4 j>cr cent). ' Y" i w, iot. iS, no. 41 EXPOSURE TO ASBESTOS DUST 233 t jj|(18.1 jx'r font); stated that they had of ; the twenty-four with dyspnea " gome shortness of breath; three of the showed cardiovascular pathology in 25 moderate cases and three of the 8 the films and also had high blood more advanced. But the most ad pressure, but none of the five had van ced cases showed no s|>ecial irspira- definite asbestosis. Dr. William S. ^ t o r y effort during examination and McCann reminds us: "Respiration is Pig . I.--Moderate asbestosis. Heavy pectoral muscles exaggerate the appearance of fibrosis. _^no cyanosis and none declaml lack ` id or impaired ability to carry on at ^their jolrs. Among the thirty-three iJisbestotics, dyspnea was twice as frequent in those under 45 years of ^;;age, 42.1 j>er cciit, as in those over ^ '4 5 years of age (21.4 per cent). Five not a function of the lungs alone but of the heart, blood and tissue ability to absorb oxygen, and also to undergo oxygen want such as the trained muscles of athletes withstand oxygen want." Decreased chest expansion m a y V JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY ^ {Apr., 1936 said to be the cardinal sign of asl>csto- sis. Among the normal lung group, 56 per cent had an expansion under 2 inches, 44 per cent above 2 inches. In the group with definite asbestosis, 69.6 per cent, had a chest expansion of less than 2 inches, 30.4 per cent, had an expansion above 2 inches. The proportion of those with the lower degree of expansion was increased about 24 per.cent among the asbes- totics. Chest expansion depends not only on lung distensibility but on the mobility of the bony and soft tissues of the thoracic cage and of the dia phragm. It is often astonishing how training and practice can rapidly in crease chest expansion. The indi vidual learns to exercise fully anatomic capacities which were present prior to the training. From the foregoing findings it appears that the assumption that &' sense of air want and restricted chest expansion are due to an existing as- bestotic involvement of the lungs roentgcnologieally manifest, should not be made too hastily. ' : Studying the compatibility of as- bestosis with length of life and work it is to be noted that: One employee with advanced asbestosis above the age of 55 who had worked in dust more than 15 years was still able to work. One employee, 54 years old, with advanced asbestosis w h o had worked in dust more than 10 years was still able to work. Three em ployees with moderate aslxntosis and above the age of 44 who had worked in dust more than 10 years wore still . able to work: Of this group of 5 I' asbestotics above the age of 44 (three "with moderate asbestosis and two with advanced asbestosis), one com plained of shortness of breath. Of the eleven with moderate as]Ketosis and the three with advanced asl>estosi.s who had worked more than 10 years, one, (7.1 per cent), complained of shortness of breath; those fourteen men had chest expansions which com pared favorably with the normal lung group.- Sixty-six and two-thirds per cent of these. 14 asbestotics had a chest expansion under 2 Linches, whereas 56 per cent of the normal lung group had the same limits. But 78.9 per cent of those with definite asbestosis who had worked in dust under 10 years had chest expansion undtr `2 inches and 26.3 per cent complained of shortness of breath. The older persons, whether with mod erate or more advanced asbestosis, appear better adjusted to the disease. The average exposure for the cut in* group with asbestosis was 10.2 years, for those with moderate as!>estosis 10.3 years, and for those with ad vanced asbestosis, paradoxically, 10.0 years. If the entire group with asbestosis is divided into those below and those above 40 years of age, the exposure of those with moderate asbestosis below 40 years of age was 9.5 years and above 40 years of age, 12.4 years. For those with advanced asbestosis the corresponding averages were 9 and 11 years respectively. Advanced asbestosis may exist in late age-periods with working ability not impaired below the level of con tinued employability in the depart ment where the disease was incurred. No very rapid development of the disease was noted. Only 2 cases (occurred where the exposure had been less than 5, years, A s'a rule 5 or more years of exposure was required no, 41 : . EXPOS IM cause the disease. No crate or massive lesions such *j in silicosis where infection is s Ip - posed were found in those a- i cases. . The progression of tin jg. in this group was very slow. (The, evidence presented as ct of asbestosis upon tuber l'this survey Is somewhat 1. kptca! tuberculous infiltratio in the films of 17 emp! was no other evidence of tu {Sl;:.* .-; V4*--'/ i L . V . ; - EXPOSURE T0) A8SBBEESSTT0SO:DS:UD8UT8T-.\^-' - ' , . 235 - cause the disease. No eonglom-.. lasts seen in these'films. If it can be 1 erate or massive lesions such as occur assumed that most of these infiltra- ,<r in silicosis whore infection is .superinl- .tions formed in the late 'teen age or ., posed were found in these asbestosis l>efore 25 years of age, then exposures cases. .The progression of the disease to asbestos dust varying from 5 to 15 in this group was very slow. ; years had produced no evidence, of \ ->'vv ,Fio. 2.--Advanced asbestosis, emphasized at left base. Upper lung fields ~ ~ - -- emphysematous. ^ > ; . ' . ' ; . 'The., evidence presented as to the activation to be seen in the films.' ct of asbestosis upon tuberculosis Four of these apical tuberculous in- 'fthi^.survey is somewhat lim ite d .filtrations were found in/asbestotics, ' ? peal .tuberculous infiltration - was Ttwo with moderate and two with more . ^'ihi the films of , 17?employees; .'advanced process^/ Six lesions with i jms no other evident of tubercu-Tv clinical significance were observed: 2 JOURNAL OF INDUSTRIAL HYGIENE ANDTOXK'OLOGY [Apr., minimal and 4 moderately advance! (American Sanatorium Associai ion Classification). One moderately ad vanced lesion was found in a man 24 years old who had Ijcpu exj>osod to aslu'stos dust in tho winding deparf- garded himself as in good health. One of the moderately advanced le sions was found in an employee 57 years of age whet had worked in the winding department lor i) years and showed no evidence of ashestosis. \ wk li, no. 4] EXPOSURE pertinent had moderate asbestos The tuberculous lesion in this c; could satisfy rigid criteria of a hea lesion. Three of these lesions w active and were accompanied by cl eal manifestations. The one les associated with asbestosis was hee and the employee apparently wat good health. One of the two mini lesions was in a man 24 years of who had worked 15 months in 4 twisting department and whose f. did not show asbestosis; one in a 1 37 years of age who had worker years in the winding department Group op 24 E mployees with Ab*i I'm. -Luterai jMixitiim. (Same ease na Fig. 2.) meat for 6 years. Tho lesion ap|K>nred "soft" and unstable; there was, how ever, no evidence of accompanying asbestosis. The disease jin this mod erately advance) case was clinically manifest, though the employee re- third employee yvitl a moderately advane'; tuberculous lesi,,,, had worked in the twisting department for jq .wars but had no nslmstosls. The fourth, an employee 3 7 years ,,L ago who had forked in the waiving de- Number of employee# in each age- : period...................................... Dyspnea.......................................... Hypertension............................ Years of exposure............................ Number of employees..................... Asbestosis......................................... bad no asbestosis. One of minimal lesions was apparently h It is felt that no evidence l aggravating effect on tubrculo, asbestos dusting is to be foin i these cases. Only one of tb 0 eSnkally significant lesions wa 'reompamed by asbestosis and lesion had every appearance of healed. The incidence of pul tuberculosis (2.8 per cent), is reg f ' u comparable to the incider, r many other industrial groups in "the association is close and pro. 1 and-whose general standards of and hygiene arc not as good as TABLE 4 Group op 24 E mployees w ith Abno rm alities op th e H eart or Aortic Shadow % / AO. Number of employee in each ageo Dyspnea............. .......................... 0 Hypertension................................. 0 Year* of exposure.......................... 0-2 Number of employees.................... 4 Asbestosis...................................... 7 9 5 3 1 2 1 1 6 8 4 3 2-5 5-10 10-15 15-20 2 9 9 3 2 had no asbestosis. One of these twenty-four abnormalities were found minimal lesions was apparently healed. _ in the 45 negro employees. A Wasser- It is felt that no evidence of an man test was not allowed. Ten of aggravating effect on tuberculosis by these negroes were under 45 years of asbestos dusting is to be found in age and one over 55 years of age. In these cases. Only one of the six this group of 24 employees with ' clinically significant lesions was ac- cardiovascular changes, three had a "eompanied by asbestosis and that normal blood pressure and the rest had lemon had every appearance of being hypertension. Five of the group with healed. The incidence of pulmonary cardiovascular abnormalities had def- ; tuberculosis (2.8 per cent), is regarded inite asbestosis, three of these were ' ll comparable to the incidence in negroes under 35 years of age (Table many other industrial groups in which ,5). / : the association is close and prolonged Waring and Black in an admirable ^ind-whose general standards of living ; paper discuss, "The Syndrome of Ob- tnd hygiene are not as good as might struction in the Lesser Circulation" r <7,,,- \ r n,, rovn nnd 238 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY j [Apr., 1938 give as its clinical features, cyanosis, dyspnea, polycythemia, and right ventricular preponderance. The blood was not examined in the cases here described and no electrocardiograms were made. Cyanosis and dyspnea were not observed in any of the 5 asbestotics with cardiovascular disease. In view of the pathology characteristic of asbestosis, namely, constriction of the terminal bronchioles with no perilymphatic or perivascular fibrosis as in silicosis, less obstruction tions in the group does not appear to be excessive. To make a scientific appraisal of the effect on the employees in this plant of exposure to asbestos dust, it is necessary to know how many employees during the 15 to 20 years Covered in the study have died or quit and how many of these had asbestosis. This knowledge is not available. Certainly it might add greatly to the gravity of the picture. The most that could be done was to note the effect TABLE 5 Asbestos with Cardiovascular Lesions BMIXOTU ' MPLOT 0.11 o.9S im oTii 0. 131 im o m no. 138 BMFLOYKS no. 197 Age.............................. R a c e ............................ Blood pressure.......... Years of exposure... Asbestosis......., ......... D y s p n e a ..................... Chest expansion....... X-ray pathology. . . . 44 White 174/96 13 Moderate No 2.5 in. Enlarged - aortic ' /' shadow / , - -v) / y 53 White 170/110 8 Advanced No 1.5 in. Enlarged 'aortic shadow. t Enlarged left ven'tricle 27 Blaek 158/104 7 Moderate ' No 1.5 in. Enlarged aortic shadow. Enlarged right and left ventri cles 30 Black 130/92 10 Advanced No 1.5 in. Enlarged heart shadow. . Both ventricles en=>' larged ; 30 Black 134/90 7 Moderate No 1.5 in. Enlarged aortic shadow / / V of the lesser circulation would seem on those now present in the plant, to be expected in asbestosis than in after varying periods of exposure. silicosis and consequently less strain on the right heart. Summary The frequency of respiratory infec tions was investigated. - Each em ployee was asked, /'Have you had severe colds, 'flu,* or pneumonia and how often?" None said they had had 1. In addition to duration of expo sure and concentration of effective dust, it appears that individual re sponse to the inhalation of asbestos pneumonia, six sand they had had ' dust is aq important factor in the . "flu," eight mentioned having had production of asbestosis. colds since being exposed to 'asbestoa. v 2. Asbestosis is infrequently found vfduat, and one spoke of having frequent r before 5 years of exposure to industrial ^colda. /Thereported'.respiratoryinfec- concentrations; of asbestos dust-'. In rol. 18, rw. 4!,;. . KNi this group even under dui 'continued 15 years or more, did not progress to an involvement'attended by m cal m:mif(`stations or dis-dii 3. Koentgenologirally a<: bestosis was not ineoinp; ability to work at the proee it was incurred. Cont in entailing cxixisurc to diseasi concentrations.of aslx-sto* < increases the extent of film is to i>e advised against. 4. The evidence presen! study warrants the opinion the reduction of-dust con now feasible by-available .inating devices, the incidet '1 , I: V, I 'rol. 18, no. , - * EX POSL'RE TOiASIi I Iffi! '<vir if tJSE#!- ... -'* ^ <--->. me this group even under dusting which--- iiificaht,' nlM>csfosis'?\vQuId hi time ..continued lo years or more, the disease"''approach the~vanishing point. ,vt-' i^'did not progress to an extent of/- 5. ,;i\o -t activating or aggravating* i.J. involvement attended by marked cliiu-. ^-0^ ^ - abjwt`<wlust or cal inanififestations or disability. ` ? tubereulosw^vas olx*crvcd. " ^ 3. Roontgenologically advanced as- ' !^u' yhleiMK* of this atutly,'as^ bestosis was not incompatible with *' to the effect of asliostasis on the W :: ability to work at the proc-ss in which *.c i r e u b t . . . ^ it was .incurred,. rC, ontinuedi s.wor,k vmorOithan intp1re,ssions.;'- It does.no"UV.) ... ,. , . Csilggcst^uny. marked tendency on ttiLVs entailing exjxisure t(>bscase producing t0sLs> With the degree o f j , concentrations of aslx-sto* dl^t;Slt)wly^^voIyep1-I^ ^ j )^ voj increases the extent of fib res and circulation.'* " sl.V ^ is to lie advised against. ....... ... y^No' increasc of respiratory infee^ 4. The evidence presented in. this. ^ t jo n ^ w it f .n T ^ ^ ^ v stiidy warrants the opinion''thati with 8. /Th;re \i^Jsoinc ?e\'i<leiice which **53!S{ :: the mlnetion: of-dust' concentration ^sugg(sfsithut!'sibcstbsisdeveloi>s more now feasible hy^ nvnilnliln (lii^t. clim- ranidlv in vomxrcr nersons than in i/ inating devices,- I: .V :\~ rV.M 192 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY PAQK Anemia, pernicious, from chronic car bon monoxide poisoning (Berger and G rill)........................................... 101 Aniline intoxication with severe cya nosis (Loeper, Soulie and Marchon). 158 resorption by plant and animal tissue (Lieb).................................................... 183 ANTHHACENE-alizarine-chromate group, wool dyes of eczema and hyper sensitivity to (Kohler)..................... 12 Anthracosis, inhalation of coal dust by guinea pigs (Ichok and Glarner). 109 pleural pigmentation and pleural nodules (Kreipe)................................ 109 pulmonary, simulating lung tumor (Gutz)................................................. 39 silico-, of coal miners (Cummins). . . 26 Anthracosilicosis (Dreessen and Jones).................................................... 180 Anthrax (Beckmann)............................. 114 from ulcus molle of penis (Borzow and Finkel).......................................... 136 treatment with large doses of anthrax serum (Metzulescu)........................... 114 Antimony, history, production, use in industry and poisonous effect (Habeck)............................................. 51 Apatite dust, effect of, on experi mental animals (D ahl).................... 25 Aphasia as symptom in caisson disease (Oka)................................................... 92 Appetite, influence of odor on (Win slow and Herrington)...................... 57 Argyria, occupational (Harker and Hunter)............................................... 165 ARM-nerve paralysis in case of lead poisoning (Gerbis)............................ 5 Arsenic carcinoma, industrial (Mi- y a ji)...................................... 137 damage to liver, chronic, investiga tion of (Stoeber).............................. 177 determination of, hy means of Pni cillium brevicaule (Breiter)............. 105 effect of, on muscle (Nonenbruch, Stary, Bareutber and Thelen)....... 177 in hair, nails, determination of (Schwarz and Deckert)................... 105 poisoning, chronic, symptoms of tabes in (Stokvis).............................. 51 poisoning, ocular affections in (Che- purin)................................................... 139 trioxide, study of handlers of (Irvine and Turnacliff).................................. 83 Arseniuretted hydrogen, see Arsine Arsine, action of (Heubner and Wolff). 105 poisoning (Gillert)............................... 159 poisoning by, at zinc sulfate plant of lead works (Spangenberg and K tzing).............................................. 127 poisoning, chronic (Kiese and Bertram)............................................. 105 poisoning, occupational of physician (Baader).............................................. 51 Artificial respiration, efficacy of (Thiel)................................................. 143 Artificial silk, see R ayon Asbestos fabricating plants, nature and am ount of dust encountered in, and effect on workers' health (Fulton el a l.)...................................... y, Asbestosis (A lw en s)................................ (B oh n e)................................................... rn (L an za)..................................................... Pts. 2 and 3.(Fulton et a l.) ................. y two cases of squamous carcinoma in (G loyn e)................................................ s Asphyxiation, carbon monoxide, slow (B eck ).................................................... I7i. Atmosphere, diurnal variation of inter - mediate and large ions of, at Wash ington, D . C. (Wait and Torreson). (Ci Atmospheric conditions, effects of re duced cooling powers on water balance and related effects (Lee and M ulder)................................................. 44 conditions, electrical and hygro mtrie, relation to surgical skin infections in E gypt (K n ip fer).---- 56 conditions in hot and deep mines, 21st report of, on energy output of coal-miners (M o ss)............... ....... 43 conditions in hot and deep mines, 22nd report of, time study of coal face workers (Moss andH a lls). . . . 43 conditions, outdoor, subjective reac tions of human beings to (W'inslow and H errington).................. . conditions, see also Air Conditioning, Cooling, Heating, Ventilation, etc. pollution of American cities for 1931-- 1933 (Ives, B ritten, Armstrong, Gill and G oldm an)............ ................ 8G pollution Research Committee for year ended 31st March, 1935, 21st report...................................................... 9S pressure, evidence that mammals cannot acclim atize to 10% oxygen or 20,000 ft. altitude (C am p b ell).. 117 pressure, increased, physiological effects of (Koslova, Schutov and F a rfel).................................................. 41 Australia, lead in urine of workers in Mt. Isa Mines, Queensland (Shiels). Ill lead poisoning a t sm elter in Queens lan d ......................................................... 22 Automobile, cases of professonal in toxication among Diesel motor-bus drivers (C a stro v illi).......................... 69 drivers, hours of work (N e v e u )........ 145 industry in 1934, wages, hours, employment and annual earnings in (Tolies and L a F ev er)................... 94 Back, injured, of working man (Muir). 48 strain and sciatica (O ber).................. 14 B acteria, effectof radium on (Spencer). 19 in air passages of anesthetized ani m als, behavior of (M argaritis)___ 78 technic which completely excludes air contamination of bacterial cul tures (Spencer).................................... 19 v 8 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Jan., 1936 do). 18, no. 1] -Jty motely resembling those of silicosis by 6. Though there is an excess of tubercu Review of Literature on injecting sericite." The authors realize that their results "may not exactly repre losis deaths among foundry-workers, pneu monia, which is the cause of about one- it, - Breathing D usts with S pi ence to Silicosis, Part 111 sent the pathological changes produced by fourth of all deaths of foundrymen, appears ringlon and S. J . Davenport. the inhalation of sericite by miners" but to be the greatest occupational hazard in Mines, I. C. 685T, (Oct., 1935) they feel that the results may be useful for the comparisons which are made possible the industry.--Authors' summary. ' , In this Information Circulai MS- deal with the economic and lep I between quartz, sericite, and other dusts.-- T w o Cases of Squamous Carcinoma of Philip Drinker. the Lung Occurring in Asbestosis. dust disease in industry, and chosen list of references. S . R . Gloyne. Tubercle, pp. 6-10 (Oct., A summary and general con F amilial D isposition to Silicosis. I. 1935). complete the series and it is Lochlemper. Aerztl. Sachverst&nd.-Zeit- The two cases described were women ,,that this valuable informatici ung, vol. 41, pp. 174-175 (1935). workers in an asbestos factory. One, aged in book form.--H . N . Lawson. The author writes of a family several 35, had been a spinner for 8 years and sur members of which contracted silicosis vived for further 9 years. The other, aged shortly after working in the same industry, 71, worked only for two periods of 6 and 13 D ust Storms and T heir Post where they were exposed to quartz dust. months as a mattress maker and lived for on H ealth. E. G. Brown, Members of another family, on the other 15 years afterwards. No etiological asso and R. L. Labourn. U. S. hand, showed only light cases of silicosis, ciation between the carcinoma and the Repts., vol. 50, pp. 1369-131: although they had worked some years under asbestosis is claimed. The malignant le 1935). the same conditions. The author draws sions wrere small and were not recognized " 1. The dust storms which 1 attention to the fact that there may be a during life. They were circumscribed with in the central west are the dim family disposition to silicosis, although he no extension to important structures; no period of decreased rainfall, a 1 cannot assert that this is true.--L . Teleky. secondary deposits were present. The as of vegetation, and high winds. bestosis was fairly advanced and of long "2. Crop and livestock lost E pidemiological Aspects of Silicosis and standing; pigment, asbestos fibres, and large. It is believed by aut: T uberculosis. A . S . Pope and D. asbestosis bodies were pushed aside by the although there has been mu< Zacks. A m . Rev. Tuber., vol. 32, pp. 229242 (1930). advancing growth. Neither disease seemed to be sufficiently advanced to have caused DUST, SMOKE, FUME!- 1. In representative groups of both gran death by itself;the combination was fatal .-- ite- and foundry-workers in Massachusetts the frequency of silicosis, and of silicosis with tuberculosis, was found to be posi tively correlated with the duration of expo sure to dusts containing free silica and to the concentration of such dusts in the E . L. Collis. Lung F unction and X -ray Pictures in the Legal E stimation of L ung D amage from Dusts in Compensation Cases. W. Schmidt, E. Gaubalz, and Holtzmann. P residential Address. R . . de Sm idt. J . Chem. Met. . Africa, vol. 36, pp. 18-28 (.4i A review of the methods of tion and dust control in the f gold mines. The author em occupational environment. Aerztl. Sachverstand.-Zeitung, vol. 41, pp. little progress was made unti 2. Among the granite workers examined, 178-182 (1935). was approached with the vie silicosis alone was found in 15.2%, and sili The authors have investigated lung dam mine air must be treated in p cosis complicated with tuberculosis in 7.6%. age from dust inhalation by procedures same way as gassy mine air. 3. Tuberculosis is the cause of death in other than x-ray. Lung function was deter should be controlled to prod; over one-third of all granite-workers, a mined spirometrically, the apneic pause and dilution. Mine air filtration : proportionate mortality three times that in residual air was determined and work tests given highly satisfactory rose foundry-workers, and four times that in all were performed using an ergometer. Vital mines. males of 20 years and over. capacity alone was found insufficient for The author questions the w! 4. Among the employees of 10 Massachu judging functional disability but the apneic cation of cooling as a means setts foundries, silicosis was found in 8.8% pause and residual air gave a convenient the high temperature and hie and silicosis with tuberculosis in 2.6%, a objective scale for judging emphysema deep mines. Dry methods o: total frequency of one-half that found in while the work studies gave useful data on but face one serious obstacle granite-workers. the heart action. It was established that wet methods of control are no 5. The silicosis found in foundrymen was working capacity and disability could not the miners and the general pi not only less frequent but also less advanced be judged by x-ray alone--facts which are in mental to safe work in dusty i in degree than that in granite-workers. general acceptance.--L. Teleky. will have to be educated to methods.--T. Hatch. 52 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY \Apr., /SS-; DUST HAZARDS AND THEIR EFFECTS Studies on the Absorption or D ost in THE R eSPIBATORT PASSAGES. II. AB SORPTION o r M anganese D ioxide D u st. O. Ehrism ann. Ztschr. f . Hyg. u. Infectionskrank., vol. 117, p. 66t (19SS). The author subjected rabbits to daily exposures of 4 hours, over a period of 3 months, to manganese dioxide concentra tions of 10-20 mgs. per cubic meter or he gave them a maximum of 3 gms. of manga nese dioxide by means of throat probe over a period of 33 weeks. He found increased amounts of manganese in the organs, though no more in the lungs than in the other organs; there was a decrease in the erythrocyte count and in the hemoglobin content. The white blood picture showed no changes. Studies with cats gave similar results. Thus, it was shown that inhaled and swallowed manganese behave similarly; pneumonia did not result from manganese dust inhalation.--L. Teleky. Asbestosis. A . J . L am a. J . A . At. A ., vol. 106, pp. 368-69 (Feb. 1, 1936). As this paper is shorter it is necessarily less complete than that by Lanza, McCon nell, and Fehnel (These Abslt., vol. 17, p. S3). It is general in character, gives the history of asbestosiB, the clinical picture, a brief discussion of the roentgenogram and of the pathology. Lanza estimates that there are about 10,000 men exposed to asbestos dusts in plants employing about 12,000. Merewether and Price estimated that there were about 2200 similarly exposed in England in 1930.--P h ilip Drinker. T he Action of Silica. C. P. McCord, It. Ainslee, J . Johnston, and R. L. Fleming. Indust. Med., vol. 5, pp. I '- i n 1936). The often encountered assertion tint i .. existence of silica and alkali dust in iinhnuy. constitutes extra hazardous work n'hd;. tions is unproved, but not no-es-nrir, u:.. founded. Extensive investigations of ti,,. workers in six plants simultaneously i posed to silica and alkali dusts provided in, evidence of an accelerator action by nlk ,. lies. The entire absence of silicosis stiggoi. the possibility of an inhibitor action. Animal experiments with guinea pigs in which the peritoneal cavities wore injected one or more times with 0.1 or 0.2 gm. each of silica and alkali (sodium carbonate, sodium bicarbonate, magnesium carbonate, <>r limestone), yielded no results proving either an accelerator or inhibitor action of alkalies in the production of silica nodules. Tinpresence of alkalies markedly increased the distribution of silicotic nodules throughout the abdominal cavity, which action is apparently solely due to the mechanical distribution of the silica by increased mo tions of abdominal organs, induced In alkali irritation. The primary toxicity of silica and silica gel mixed with alkalies is much greater than is true for silica, silica gel or alkalies ahme. --Authors' summary. Silicosis and Silico-Tuberculosis in Metallurgical P lants. M . France-*' Med. del Lav., vol. 13, pp. 41-953 {Jio' ,. 1935). The author describes and discusses i:i cases of silicosis or silico-tuberculosis in metal workers and points out necessary precautions in plants where the silicons hazard exists.--L. T. Fairhall. DUST, SMOKE, FUMES, AND VAPORS: THEIR DETERMINATION AND ELIMINATION D etermination of P hosgene. PP. P. Yard, J . C. Olsen, H. H. Slorch, J . B. Littlefield and L. Schefian. Ind. and Eng. ' Chem., vol. 8, pp. 0-5 (Jan. 15, 1936). An article of comparatively recent publi cation (by Olsen and others) criticized the results previously reported by the Bureau of Mines in measuring phosgene in the gases from excelsior fires which were extinguished by carbon tetrachloride on the basis that the analytical method gave erroneously high values. This bureau, with the cooperatien of the manufacturers of the carbon tclracbloride-type fire extinguisher, has repeated the investigation under a reproduction of the former conditions, except that a differ- 86 JOURNAL OF INDUSTRIAL H Y GIEN E AND TOXICOLOGY [June, 1936 lution of fibrosis in chronic silicosis, begin ning with lymphatic obstruction followed by accumulation in the parenchyma of the lung and nodular fibrosis. In "acute sili cosis'' the usual order is reversed. In the case of asbestosis he inclines to the belief that the magnesium is leached out of the molecule of hydrous magnesium silicate and that the residual silica then produces silicosis indirectly. His experience with sericite indicates that this substance re mains unaltered in the tissues for a period of 1 year without producing anything but a foreign body type of reaction. He is not y et willing to conclude that sericite is entirely innocuous. Tuberculosis, the usual cause of death in silicosis, is discussed only parenthetically; the author mentions the various theories suggested to explain its frequency.--L. U. Gardner. Silicosis. Some D ifferential D iagnos tic P roblems. E. Mayer and IF. Grethman. A m . Rev. Tuberc., vol. S3, pp. 813-331 (Mar., 1936). It has been estimated that in the United States there are 500,000 to 1,000,000 people employed in occupations in which a silicosis hazard exists and that there are about 65,000 such persons in New York City. The dis ease is often unrecognized in the general hospital because clinicians are unfamiliar w ith it and its differential diagnosis is diffi cult. The diagnosis of silicosis is based on occu pational history, symptoms, physical examination and x-ray. Occupational his tory and x-ray are very important in the diagnosis. The occupational history should be spe cific as to kind of exposure and length of time in each dusty occupation. It is necessary to establish a definite history of exposure. The silicotic patient has few complaints; the most constant are dyspnea and cough. Fever is absent unless infection is present. There is great disproportion between the patient's complaints and the x-ray findings. Extensive disease (silicosis) may be present and but few abnormal physical signs elicited. Diagnosis is really made by exclusion. The physical findings are com mon to general pulmonary fibrosis with emphysema. There is restricted diaphrag matic movement. There may be dimin ished or intensified breath sounds and hyperresonant areas. Rles are absent in pure silicosis which is a more consistent finding than in any other pulmonary disease. The essential types of abnormal shad ows seen in silicosis are (1) small discrete shadows, (2) linear strands and (3) homo geneous shadows of varying size, indicating the presence of silicotic nodules, thick fibrous trunks and conglomerate massive fibrosis, respectively. Infection (tubercu losis) is considered to be present when the shadows begin to lose their sharp outline and to coalesce. Compensatory emphy sema adds to the difficulty in making a diagnosis. Four case histories and x-rays are pre sented. The diagnosis of silicosis is often difficult because it is frequently impossible to obtain an accurate history from a patient in a general hospital. The physical signs and symptoms are inconclusive and frequently the x-ray is unreliable because of confusion w ith other pulmonary diseases. Silicosis not infrequently presents itself in atypical form.--A . E . Russell. Asbestosis. W . Aewens. Zlschr. f . Gewerbehyg. u. U nfall., vol. JS, pp. 1-6 (1936). The author reports on the lung examina tion of 35 employees o an asbestos plant. Thirteen workers gave negative x-ray re sults, 12 were doubtful first degree asbesto sis, 7 showed first and second degree asbestosis, and 3 third degree; these last had worked in asbestos for 21-24 years; one of them, who had worked also with kieselguhr showed silicosis as well.--L . Teleky. DUST, SMOKE, FUMES, AND VAPORS: THEIR DETERMINATION AND ELIMINATION Atmospheric P ollution of American Cities for the Years 1931 to 1933. J . E . Ives, R. H. Britten, D. W . Armstrong, W . A . Gill, and F. H. Goldman. U. S . Pub. Health Bull. No. 334 (Mar., 1936). This study extended from June, 1931 to March, 1933 and included determinations in 14 cities of dust concentrations by count, shade intensity on white filter paper (Owen's automatic filter) and by weight. voi. 18, no. 6) The number of condensation obtained. Continuous rcc" tained with the automatic fi tions were made with the otl twice a year for about a we' except in Washington where records were obtained. It was found possible t( cities into three groups ac level of atmospheric pollu figures are given in the fol I GBOtrp I. Baltimore, Boston, ! Chicago, Pitts burgh, St. L ouis.. II. Buffalo, Cleveland, New Orleans, New York, Philadelphia. III. Detroit, Los Angeles, San Francisco, W ashington ............ All cities................... 1 Shade of dust spot o: paper compared with s shade. t* The collected dust con r carbonaceous matter an amount of sulfur correl the amount of carbonact dian particle size was 0.5 Amount of pollution v. December rather than J weather was more sev during both years of obs months showed twice as f3 summer months with pa the carbonaceous matte Maximum daily pollu- 7:30 a.m. and a secom I served in the evening; : day was caused mainly rents and was therefo days than cloudy and o in the summer than in - pollution was less th; although the differenci in the winter as in t rain was found to hav 1X IC 0L 0G Y (Oct., 1936 ulosis: R oentgenologic the D ifferential Diagno6c. W isconsin Med. J ., vol. 6) -alls attention to the value actohme pdeitaegnntorsiosenotfgtehneolcoognicdail- i . tfalls of roentgenology are id the proper technic is given lictures. The points of the agnosia of roentgenograms in silicosis, and silico-tubercu1. T he author points out the he understanding of the find1chests and the close cooperashould exist between the 1st and elinican.--N . De- -is P roblem: Some Medical l P hases. O. Sanders. KY*l. J ., vol. S3, no. 5 (1936). XX) foundry workers examined ! years in Wisconsin, less than nd to have sufficient pathology a change in occupation. The that there will be a decline in e of silicosis with the closer of medical and engineering He stresses the need for pret and periodic physical examinalete medical and occupational id routine x-ray examinations of 1 men engaged in the industries silicosis hazard. The schedule h the writer worked allowed for ing of a copy of the findings to yee; another copy of the exam,s delivered by the employee to iyer, thereby fulfilling an ob:o all parties concerned.--N. _ of Artificial Abrasives in the Industry. F ritz and ffremer, chutz (Reichsarbeitsblatt, Part >. 125-130 [1936). tool and cutlery industry, 1929ut 1000 cases of pneumoconiosia 308 cases were compensated a* icosis of which 172 died. The amzation handling the insurance 'ore recommended the substitution ill abrasive stones as they do not osis whereas the natural ones do. vol. 18, no. 8] ABSTRACTS 133 Against this the manufacturers of the natural stones appealed. The authors, among the foremost indus trial inspectors, explain that after over coming the initial difficulties, the intro duction of artificial abrasives proved to be technically and economically satisfactory. They then appealed after an opinion in favor of the manufacturers of natural stones had been handed down, and showed that the artificial abrasives contained only 7.57% free silica, and that the dust generated by them consists m o stly of magnesium oxides which, according to a decision of the Reich health authorities, is not to be considered as causing silicosis.--L . Teleky. Silicosis in Sandblasters: the Examina tion of Sands Associated with Sand blasting. F. S . Fowweather. J . Hyg., vol. 36, pp. 67-73 (1936). In sandblasting the sand is rapidly ground into a fine siliceous dust, whether used as the abrasive agent or introduced on the articles treated. The use of steel shot docs not decrease the hazard if any sand is present. At least some of the dust is of a micaceous nature, in the form of sericite or a similar mineral. In spite of the opposite view of some, free silica dust is the major factor of sandblaster's silicosis.--Chem. Abstr. Asbestosis. A . Bohne. Deulsch. med. Wchnschr., vol. 62, pp. 928-930 (1936). This is a short discussion of asbestosis, a description of a fatal case and data on the spread of asbestosis among the workers in an asbestos factory. An investigation showed that 4 of 14 workers showed mani festation of the disease after 1 year (the duration of work of the others is not given). --L . Teleky. DUST, SMOKE, FUMES, AND VAPORS: THEIR DETERMINATION AND ELIMINATION Measurement of the Radiation to A study of different hydrocyanic methods. which Roentgen and R adium Workers The polysulfide method determines the are Exposed. 1. C. Jacobsen and J . cyanide as well as hydrocyanic acid and Ambrosen. Acta Radiologica, vol. 17, likewise some of the carbon disulfide (by p. 252-255 (June, 1936). decomposition of the ammonium carbon In modern roentgen installations with polysulfide while boiling) ;hence high results completely enclosed tubes the screening are given; however, it is satisfactory for against stray radiation is very effective, but practical purposes. The complex ferric by carelessness the staff may be exposed to cyanide method (Feld) gives a possibility considerable irradiation. In the packing of thiocyanate formation if the gas contains of radium applicators the danger is greater, oxygen and hydrogen sulfide. Only one- since effective screening cannot be carried half of the cyanide is determined as hydro out. cyanic acid; the results are somewhat lower This paper describes the results of obser than those of the first method. The easiest vations made on roentgen and radium method for all-around use is the m ethod of workers. The workers carried small con absorption of hydrocyanic acid in strong denser chambers while going about their sulfuric acid and titration of it as ammonia. work, and the charges in these condensers It is sufficiently accurate.--Chem. Abstr. were afterwards measured. The measure ments were carried out regularly over a Microcolokimetric D etermination of period of 3 months. In the case o f roentgen Benzene in Blood and Urine. S . J . workers m ost o f the readings fell in the Pearce, H. II. Schrenk, IV. P. Yanl. U. interval of 0.02 to 0.03 r per day; for the S . Bur. M ines Repl, Invest, no. 3302 (1936). packing of radium the results ivere roughly A m icrocolorimetric method for the de 5 to 10 tim es higher.--T. Bedford. termination of small am ounts of benzene in blood or Urine IB described. The benzene Determination of H ydrocyanic Acid in is aerated from blood or urine and swept Gas. H. A . J . Pieters and K . Penners. into a small amount of nitration acid, after net. Gas, vol. 55, pp. 402-W (1935). which the method described in Bureau of 26 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Feb., 1996 once, 7% twice, and 1.4% several times. In P revention of Silicosis in the Porcelain other words, 5015 stone cutters had at least Industry. Hartmann. Zenlralbl. f . Ge- one examination, and of these, 686 (13.7%) werbehyg. u. U nfall., vol. 12, pp. 141-150 showed some silicotic changes. (A ug.-Sept., 1995). This study indicated that 8656 or 88.3% Hard porcelain is made from 40-60% clay, of the persons examined had no silicosis, 25-40% quartz, and 20-30% feldspar. Soft 10.6% were found to have a slight silicosis, porcelain is made from 25-40% clay with while the remaining 1% were classed,as various proportions of quartz and feldspar. moderate or severe silicosis. It was found The general processes of porcelain manu that it took about 20 or more working years facture are described in considerable detail to develop silicosis and that 50% of the and illustrations are given. Having par workers show a slight silicosis in about 13 ticular reference to silicosis prevention, years. The beginning of silicosis was found there have been in force in Germany since to be independent of age. The number of April I, 1934, in the ceramic trade, rules re cases with a change of occupation was found quiring (1) cleanliness and order, with re to be too small to draw any conclusions on moval of apilled material; (2) workplaces this point. where silica dustiness cannot be properly It is shown that in approximately 500 controlled otherwise, should be enclosed or cases where marked silicosis appeared, the the dust be exhausted. When these meth trade life averaged 18.3 years. The length ods fail, suitable respiratory protective of life among those suffering from severe equipment is required; (3) workplaces must silicosis was found to be approximately 6-7 be cleaned up not less than once a week, years. " In a m ortality study of 493 severe using wet sawdust or vacuum sweepers. silicosis cases, 37% were found to be due to The author stresses the need of coopera uncomplicated silicosis following heart fail tion between physicians and engineers, and ure, while 63% of the deaths were due to points out that in 1933 the ceramics associa silicosis accompanied by tuberculosis." It tion paid out 585.025 RM for accidents and is unfortunate that no data are presented on 600,101 RM for silicosis. In th at year there the severity of exposure, or on the composi were 35,936 workers employed in this trade. tion of the dust, so that more information --P hilip Drinker. 1 would be available on the etiology of this disease.--J . J . Bloomfield. E tiology of Silicosis. W. R . Jones. 1 Zenlralbl. f . Gewerbehyg. u. U nfall., vol. Pneumoconiosis with Special Reference 12, pp. 151-155 (A ug .-S ep t., 1995). to the Silico-Anthbacosis of Coal This paper is a good summary of the Miners. 5 . L . Cummins. B rit. Med. J ., author's well known sericite theory and pp. 287-290 {Aug. 17,1995). particularly of his unrefuted proofs of the ' The author believes that coal dust may difference between the composition of fine exert a beneficial effect by adsorbing toxic air-floated dust and that of the parent rock. substances and thus reduce the likelihood of The eighteen photomicrographs and camera tuberculosis in silico-anthracotic lungs. lucida drawings are essentially the same "The classical state of miners' dyspnea (in as those published previously.--Philip coal miners) is very marked and is expressed Drinker. in the death returns as a high bronchitis mortality, the terminal effect of a high Asbestosis. P art 2. T he Nature and tuberculosis mortality is much diminished Amount of D ust E ncountered in As through the operation of coal dust as an bestos F abricating P lants. P art 3. adsorbent for the toxic products of tubercu T he E ffects of E xposure to D ust En- j lous foci in the lungs." The importance of countered in Asbestos F abricating > preventing the dissemination of dust, as P lants on the H ealth of a Group of from drilling, is emphasized. The work of Workers. W. B. Fulton el al. Penna. W. R. Jones indicates that it might be well Dept. Labor and Industry. Spec. B ull. No. i to study carefully the stone duets used 42, Sept. 20,1935. to prevent coal dust explosions.-- P h ilip Employing the sampling methods out Drinker. lined in Part I of this series (Spec. B ull. No. n > l. 18, no. 2] 37, Oct. 1,1934), impinger samples col , in alcohol, a study w as made of the as': fabricating industry in Pennsylvania Part 2 of the series, the results of this are given. It was found that the cone (ion of dust in the plants decreased ;. quality or length of the fibers increase!1 the various m illing operations, whit described in detail, dust coneentratioi creased in the following order-, prep: carding, weaving, spinning, twisting, ing, and warping. Due to the fii nature of the dust, the average partich is stated in tw o diameters, longitudina transverse. A sbestos dust in the wo: breathing zone was shown by petrogr: analysis to contain no free silica. The part of this series consists of an accoucomplete physical examinations of 64 sons. F ifty-six of the subjects had previous exposure to asbestos dust, t had had very little exposure and were as controls, w hile the other subject found to have had previous exposui silica dust. Fourteen of the 56 worker.ployed in the textile'departm ents oi fabricating plants showed both clinical roentgenological evidence of asbest The study w as too limited to permit formulation of permissible standard: dustiness, but a reduction in the asbv dust concentration in the operations stu is shown to be necessary. The bulletin closes w ith a bibliograph 125 references on asbestosiB and gen dust determination.--R . Page. H ygienic and Clinical-Roentgenol cal I nvestigation of Pulmonary F cosis in a J apanese F oundry, S. 1oda, C hief Doctor, Steel-m ill Hospita. Yawata, J a p a n , 1935. This is the report of an extensive invt gation of pneumoconiosis and atmosph pollution in Japanese foundries. A gr of 715 workers were examined clinically 314 of these were radiographed. Th workers included electric truck operati manufacturers of firebrick, cement 1. operators, molders and general plant lal ers as well as stam p mill operators and sa blasters. From the cases studied, 25 w> diagnosed as silicosis, 81 as possible piv moconiosis, and 2 as tuberculosis. Dur the two years (1933 to 1935) covered by , rof. 18, no. 8] ABSTRACTS 27 87, Oct. 1, 1934), impinger samples collected in alcohol, a study was made of the asbestos fabricating industry in Pennsylvania. In Part 2 of the series, the results of this study arc given. It was found that the concentra tion of dust in the plants decreased as the quality or length of the fibers increased. In the various milling operations, which are described in detail, dust concentrations de creased in the following order: preparing, carding, weaving, spinning, twisting, wind ing, and warping. Due to the fibrous nature of the dust, the average particle size is stated in two diameters, longitudinal and transverse. Asbestos dust in the workers' breathing zone was shown by petrographic analysis to contain no free silica. The third part of this series consists of an account of complete physical examinations of 64 per sons. Fifty-six of the subjects had had previous exposure to asbestos dust, seven had had very little exposure and were used as controls, while the other subject was found to have had previous exposure to silica dust. Fourteen of the 56 workers em ployed in the textile'departm ents of the fabricating plants showed both clinical and roentgenological evidence of asbestosis. The study was too limited to permit the formulation of permissible standards of dustiness, but a reduction in the asbestos dust concentration in the operations studied is shown to be necessary. The bulletin closes with a bibliography of 125 references on asbestosis and general dust determination.--R . Page. Hygienic and Clinical-Roentgenologi cal Investigation o r P ulmonary Sil i cosis in a J apanese F oundry, S . K u roda, Chief Doctor, Steel-mill H ospital o f Yawata, Japan, 1935. This is the report of an extensive investi gation of pneumoconiosis and atmospheric pollution in Japanese foundries. A group of 715 workers were examined clinically and 314 of these were radiographed. These workers included electric truck operators, manufacturers of firebrick, cement kiln operators, molders and general plant labor ers as well as stamp mill operators and sand blasters. From the cases studied, 25 were diagnosed as silicosis, 81 as possible pneu moconiosis, and 2 as tuberculosis. During the two years (1933 to 1935) covered by the study five cases became totally incapaci tated and six more died (4 from silico-tuberculosis). It was estimated that among those working with quartz, 8.65% had sili cosis, 16.21% possible pneumoconiosis, and 1.08% pulmonary tuberculosis, while among the workers on steel castings, 6.61% had silicosis and 12.2% possible pneumoconiosis. Workers on magnesite and chromite ores, slag-stamping operations, cement kilns, limestone, dolomite and iron ore plants showed few symptoms of lung fibrosis. D etailed accounts of the examinations, classification of findings, and results of autopsies are given. The author estimates the average age and average exposure as follows: quartz workers --42.9 and exposed 17.6 years, chamotte workers--42.6 and exposed 17.1 years, other pulverizing workers--40.1 and exposed 17.11 years. The average incubation period for incapacitating pneumoconiosis is estimated at 18.1 years while the duration of the sick ness (which is usually complicated with pul monary tuberculosis) averages 2.2 years making the total course 21 years. The morbidity of the workers exposed to dust was as follows: (a) with quartz--80.9% among edge-mill workers, 45% among kiln operators, 33.6% among electric truck operators, 31.4% among molders; (b) with chamotte--30.5% among molders, 27.3% among electric truck operators, 22.7% among edge-mill workers, 22.2% by workers on raw materials, 12.3% by oven operators; (c) with magnesite ore--37.3% among clinker workers, 12.9% by formers; (d) in cement work--22.7% by workers on raw material. During 1926-1931 the general annual accident and sickness rate of workers in industry was 1.98% of wrhich0.76% were from respiratory diseases, while the loss by fire brick workers amounted to 3.48% of which 1.88% were from respiratory diseases. Gravimetric dust determinations by thimble and gasometer showed 920 mg. dust per cbm. of air in the quartz screening room, and 65.2 mg. per cbm. near the edge-mill, 85.3 mg. per cbm. near the chamotte edgemill, 486.5 mg. per cbm. near the cement kiln, and 298.4 mg. in the cement bagging room. [Dust counts taken with Shimazu's apparatus appear too low to compare with gravimetric determinations.--Abstractor] Silica contents of the composite dusts are 104 THE JOURNAL OF INDUSTRIAL HYGIENE [17, no. 5 50 mgs. per cu. m eter and in the presence of approximately 1500 d u st particles per cc. up to 10 to 15 microns in sire. Those under 1 micron (43.4%) and 1 micron (30.2%) were the most common, The exposures lasted from 10 days to 8 m onths. Macroand microscopic observation of the organs of the rabbits showed that athrol dust pro duced about the same changes as the dust of other plastics (ebonite and bakelite), that is, inflammatory affections of the nasal and adjoining cavities. In the long expo sures, dust thrombi and especially terminal alveolitis ensued. In the experiments last ing up to 2 months it was ascertained that there was an increase in blood neutrophiles and a decrease in lym phocytes, whereas in the longer experiments a reversal of the behavior of this elem entary form of the blood was noticed. Thus athrol, in its effect on the organism, seems to occupy a middle place between the organic and in organic dusts.-- From the author's German summary. R esults of X - R ay C hest E xaminations among 2500 Workers in a " H eavy In dustry" P lant. L . M . Warfield. In dust. Med., Ju n e, 1936, vol. 4, p p . 302-306. A study of x-ray films (flat) of 2500 work ers in a heavy industry plant is reported. Based on a classification of silicosis accord ing to nodule size, of m ild, moderately severe, and severe, 145 (5.8%) of those examined had evidence of silicosis. Of these, 90% were foundry workers. Of the remaining 10%, m ost gave histories of pre vious work in mines. Among 692 foundry workers, 81.3% were negative, 1.3% doubtful, 8.8% mild, 8.2% moderately severe, and only 0.4% severe. Of these last cases, three in number, one had been a miner for 10 yrs.; the other two were 60 and 71 years of age. N one of these men complained of sym ptom s nor were they disabled. Silicosis among foundry workers appears to be milder and slower in its development than among granite cutters or sand blasters. There were 11 cases of healed tuberculosis with silicosis and 13 cases in non-silicotic lungs. "In this particular foundry the menace of tuberculosis appears to be no greater than it is in the city at large." The impression is gained from this study that foundries may be operated practically without undue hazard to the health of the workers or limitation of their working ca pacity.-- Theodore Hatch. Silicosis and Asbestosis: A M emoran dum. Home Office, H . M . Stationery Office, London, 1935. The present position regarding compen sation for pulmonary fibrosis is usefully summarized in this brochure. During the three years 1932-4 there were certified 435 deaths from silicosis and 1,444 instances of disablement, and 5 deaths with 60 cases of disablement due to asbestosis. A short description is given of the origin and devel opment of silicosis; and then are stated the industries and processes in which silicosis occurs. Means of prevention are grouped under (i) suppression of dust, generally by the use of water, (ii) ventilation so applied at the point of origin of the dust as to pre vent its access to the air of workplaces, (iii) other preventive measures such as furnishing each worker with a separate supply of dust-free air to breathe or wear ing efficient respirators, and (iv) initial and periodic medical examinations, under which workers with defective respiratory physique are excluded from the industry and anyone found to have pulmonary tu berculosis is suspended from further em ployment. The medical arrangements for examinations and for certifying cases are described. All these medical matters are carried out by a Board of experts from whom there is no appeal. The compensa tion schemes differ in minor details for various industries; they cover the getting of ganister and other highly siliceous ma terials, the getting and manipulation of sandstone, the grinding of metals on sand stone wheels, a long list of processes en tailing risk of inhaling silica dust in such industries as the manufacture of pottery, fettling of steel castings and sand-blasting, and the asbestos industry.--B . L . Collis. Silicosis--An Interpretive R eview ok Accumulated E xperience. C. O. Sappington. Indust. Med., A p r., 1935, vol. 6, pp. 173-177. A brief discussion has been given covering