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FILE NAME: Phenolic Resins (PHR) DATE: 1936 DOC#: PHR031 DOCUMENT DESCRIPTION: Book Excerpt from Industrial Dust; from Eagle Pitcher File CiA \ ff." H ygienic Significancet and Cord-mi urement PHILIP DRINKER, 8.B., <//^iw-iria/ Hygiene, Ha'ttard ScJuxd of pytbHc h H lh AKD T H E O D O R E HATCH, B.S., SDL f-juirudor in Industrial Sanitation, Uarsard School o f P uhlio H ealth &rud H arvard Graduait! SeXt>ol o f E ngineering F irst E nm o.v B k c o so I:.i>'f u a s j o s r S - i' i ' McGRAW-HILL BOOK COMPANY, Inc. NEW YOBS AND LONDON - less i CONTENTS p* CHAPTER I P hysical P roperties of D usts, Fumes and M ists................................. Definitions--Settling Velocities--Flocculation--Wetting--Electri cal Properties--Optical Properties. CHAPTER II E ffects of D usts and F umes upon M a n ................................................... 20 Respiration and Pneumoconiosis--Silicosis--Asbestosis Toxic Dusts--Metal-fume Fever--Allergic Reactions--The Dusty Trades. CHAPTER III P hysical and Chemical F actors in P neu m o co n io sis..........................43 Quartz--Hardness--Solubility--Silicates, Asbestos, Sencito The Silicosis Potency of Dusts--Particle Size--Differential Disintegra tion and Selective Settlement. * ' CHAPTER IV P ermissible D ustiness...................................................................................... The Retention of Inhaled Dust--Ash of Dusted Lungs--Standards of Dustiness: Quartz; Coal; Cement and Limestone; Lead; Zinc Oxide; Manganese--Limitations in Standards. CHAPTER V T he D ust Su r v e y .............................................................................................. Historical--Outline of Survey-- Requirements and Limitations of Dust Determination. CHAPTER VI D ust D etermination......................................................................................... SI Settlement--Filtration--Impingement: Konimeter; Owens' Appa ratus; Continuous Recorder. CHAPTER VII D ust D etermination-- (Continued) .............................................. .... . . HO Impinger: Lightfield arid Darkfield Counting fyndailmeter --Electric Precipitator--Thermal Precipitator--Comparison of Sampling Instruments. * CHAPTER VIII D etermination of P article Size: ................................. . 133 _.... Collection of Sample-^Measurement: Screen Analysis; Microscopic;... Elutriation; Determining Size of Submicroscopie Particles--Graph ical and Mathematical Analysis of Particle-size Data. vii ,y;V.v` *: a u firf -- Uv:r>feaTe,vr . - * ) t 'jjCA-Jri T j, -rZ<C*V\ ' i1, -j- S'-Llvi- : f''s:>yv*'-irp- r v>- - - -<S 1 rH- ^'aCSrwsrJS7p*.-v' i Av; X;- t n1 ' "TL?.'..Vo-. : lt, yvf !,-T, ; l-S--f^"fc-n- O.'is'V .- . " t -y*.,y* .- .X f*.e ----.V{*v,.;iv"v it l -'ni. JL-*- ".; -... .' : - '..y-, ;.y :-\u .. * ^ ; *- V.-Vy- -. , a* . - - f ' v " r- ' -X k: - -yA-,".--V-. . \ T ; ' - R'-.i ` ; //' i "v ^ A C ' & `V- 'hA-VV''`'"y-.- '' . *- v t ,* - ' .'K>* *?... -' ,v->..-. ;- fr* /> ". V *' U*-'.K V- * **y ^ /-* ; ' : ^ - * > ?- -V '',*-.j?' C* :^-;-Vw^.; a '<X`~--Jtyr ~ ' > . - t -.v.-' ' t u '. ,1." .'d%rMVi-'i :'':V-v ' v ' ^A.O':d-V'i-, CONTENTS /u s P aox CHAPTER IX , C hemical a_\t> M ixzsuxooical Analtsbb................. ' ' ' ' ' ` ` . 153 . c S l i t t o n and T reatm ent of Air-bome D u st-R eco v ery of D ual from Lungs--D eterm ination of Free and Combined Sdica-^Com - i * i . j Ppiv'ntrrs.Dliic M ethod--Im m ersion M ethod Sputum--Identification of Asbestos* Bodies. CHAPTER X E B m S S T T s L ^ , of' DpptLpmveMmg D , S I p - " 1 ' * * * * B,.c,r o; W o * I 1 * * " Ventilation-Personal Protection-Housekeeping. CHAFFER XI ^ DESS s r i S ^ i ^ r D y n a m i r P r o i e c H o n ; by Air' C u rro n ts -C o n - Dust j Aerodpiiffiie Characteristics of Exhaust 1 "f I S X d , - ! Roqoioe'i B*" ! " * " K S * " "" Exlmwst Piping: Basic Equ.fio.; i Hood 0li C X stru etio n ; 'Location of Fan. ' ' Amount of CHAPTER XII 220 ................................................................................. of' p ^ l e s - A i r Cleaning f M Cleaning--Discharge Stack-- CHAPTER XIII 233 Air -cleaning Ai-paratcb F iltration. . P o ro sity -- Physi* Particle\Size--Concentration-- cloths--^Construction and ,,I O opdilio.m s-B .C P ~ l Filter M aterials, Resistance, and Filtering Efnci y. CHAPTER XIV 261 W rt.n o e i F .ci.l' K B ibliograph? ............................................... ^ N ame Jn d e x ...................................... Subject ................................................................... g2 INDUSTRIAL DUST ' fully that, if he has silicosis, he got it in Canada and Canada will take care of him. , , ., In the case of a first-stage silicotic without tubercular mfectio , there is no method, as yet, for determining his lessened efficiency. The lung change, if any, caused by his dust inhalation is too small to measure. . ,.... f McCann and H urtado (177) have estimated disability from lun? fibroses of various origins but have not yet succeeded m developing a method th a t is simple enough for routine use by compensation boards, insurance examiners, and the like. _ I neir orocedures involve various simple measurements of respiratory function but they have not established any methods of delectus fibrosis which are more sensitive than the present *.~ray examination. . - Of course, industry would welcome a diagnostic routine to detecting early harm from dust or, better, for forecasting harm. No such method is available and it seems fruitless to e x ^ t such help. The pneumoconioses are not diagnosed until harm is demonstrable by X-ray. _ Collis (42) has stressed the difference between the age gTOip- ings in pulmonary tuberculosis and in silicosis, with or withou tubercular infection superimposed. Tuberculosis most preva lent between the ages sixteen to twenty-four, while silicosis rarely becomes disabling until Later in life. Inasmuch as a good many years of dust exposure are required before the aveiage case rilicosis (or asbestosis) becomes evident, it is obvi0U* ^ at ^ not likely to be acquired early in life. However, there is epidemiological side to the question which is of and it is that which Collis especially emphasized. ^ The aserag healthy individual has acquired a fairly effective TM ^ i t y or resistance to tuberculosis. His chest X-ray is one or more healed scars or fibrosed areas from Such an individual, Cummings emphasizes (211), a ^ silicosis risk than the man who shows no evidence of past exp^m e to pulmonary tuberculosis. Consequently it is wire to ..elect for dusty jobs men who are past the age of forty and not 3oung *men just taking up a trade. . . . ..... Asbestosis. ' The X-rsy ptcUm. of -k .ofuelos to the layman. The effect . fibrosis. Characteristic silicotic nodules are absent and extn tI i t EFFECTS C the expert roentgen history is complete. The pathology pr The asbestos fibers it off, causing what .migration or trans] nodes .and no fori Fig- 13. As the at * ." * V.\a. is.---AibiStoaUU' nrea causes senou suggests that the of second-stage a work of the heart work to pump bf normal king. ,.n:^r-cTs it si point, the victim has ceased. But seen patients will - V! . iKE* Canada ifeeiion, Bcieney. a is too ty from :-eded in use by Their pir&tory ejecting X-ray tine for g harm. -expect il harm groupwithout . prevas rarely i many case of iat it is e is an . ortance . iverage munity 0 show culosis. better rposure ' sele i young c chest diffuse 1 even 2 ` , . ' . : . > r _ ' . * | | . ; ' . . . EFFECTS OF DUSTS AND FUMES UPON M AN *3 the expert roentgenologist withholds his diagnosis until the case history is complete. . , ..... The pathology produced by asbestos is not like th a t of sthccsis. The asbestos fibers group about the neck of an alveolus and shut it off, causing what is known as atelectasis. There is no definite migration or transportation of the dust particles to the lymph a odes and no formation of the fibrous nodules as shown hi F ig. 13. As the atelectatic areas increase, the reduction m lung area causes serious dyspnea or labored breathing Lanza (loS) suggests th a t the enlarged hearts noted frequently m Ins of second-stage nsbestosis may be the result of the increa.. ^ work of the heart resulting from this condition; it takes more work to pump blood through the atelectatic than through the Eln alicoJs it i^ m s to be a gerierabnile that,"after a certain point, the victim's condition grows worse even if ^ d u s t e x p i r e has ceased. B ut Wood and Gloyne (2oS) state th a t they nave seen patients with asbestosis "whose condition appears to have 11 \ : < } l\ ! ; i. f i ; : sU. V Si t{ i-J a ( tlf-44* ) b I; ? i 3  f f Is* t 13 r ' _ -i ri*- - ? 84 INDUSTRIAL DUST remained stationary nee stopping work in the factory,513 but they advice definitely that the asbcstotic individual be removed from Ms dusty job. Merewetker (183) and Lanza are less certain on this point. ^ Asbeslosis Bodies. In the lungs of patients who died after prolonged exposure to asbestos dust and in the sputum of men with considerable asbestos-dust exposure are found what first were called curious bodies and later osbsslosis bodies (Fig. 15) While somewhat similar .bodies occur in the lungs of coal workers end even of normal persons, it is admitted that asbestosis booiea in sputum are characteristic of asbestosis. blew art (23) gites considerable diagnostic weight to their presence. ^ Pneumoconiosis m Animals. Silicosis has been proouetd experimentally by quartz dusting guinea pigs, rabbits, ^rruca, eats, and domestic fowl, thus emphasizing the specuicity of quartz dust to biological tissue. In like manner asbestosis has been produced in experimental animals. The Equidae, such as horses and mules,' apparently are not susceptible to ordinary' pulmonary tuberculosis but there is no reason to believe they have any special immunity or resistance to silicosis. The normal silica content of horses5' or mules lungs is not known but it would seem wholly reasonable to use the lungs of animals which have worked 5 to 15 years underground sn mines as physiological dust samples. A brief report on Inis subject was published by Haynes (121) but data such as one needs u e singularly lacking. _ TOXIC BUSTS Poisoning from inhaling toxic dusts is much more likely than poisoning from swallowing them. Dusts th at reach the Jungs may pass directly into the blood stream, thence to the heart, and immediately be pumper, all c er the body. Distribution to all the body tissue is thus brought about rapi !y and effec tively. B ut dust taken in with the food goes to the stomach and the major part passes out in the feces. Some is picked up ..by.the portal blood circulation and moves on to the liver. That portion which causes poisoning must first pass through the liver, which is an effective filter and detoxifier; only then can it enter the general circulation. * EFFL The pracri between the t (103) states, A great des who sov.giit to grinders sgair clean overfills escape of lead ; iun&Uiy this 1 roust never 1> enter the bod) , three times r ( ; ten hours of k t Goadby (' ; poisoning nv over ten tir. Drinker and foreig.. dust : ( 1S8) emph: ; from inhaled ; th a t the ab. rapid and m dose by mot . All this ( expressed b) i now beginw danger of be : 1 them in foo- * Metal-fui . ing of dust malady that i cf metal fui l lead, proba^. i About 2 t metallic or followed by .......... following a ncom forta day he feel .... ?} A . % Vrj a u ii t-u 7> f \*j *4/* VV M --**-* N i os> b o j j if" scr- *,Tn < : o f '0 0 i s s i 9 Z AQ? -ou 'M f H V ^jMTWW" ^?aw>!S!nS8 wO Ia* ! 1 it i :J> I ft By N. IRVING SAX Toxicologist, General Electric Co. Sdr&rectady, N. Y. Assisted by M . j . O 'H E R I N pur.gicidt L nborato"J General Electric Co., Schenectady, N- T. and W. W. SCHULTZ General Engineering Laboratory G ourd Electric Co., Schenectady, K. T. .................... BOOK DIVISION................................... fat'Cu!i N 'rlO L D P U B L IS H IN G C O R P O R A I S O H 330 W est Forty-Second St.t Mew York 1 8 , U.SA , 1951 .4. * ARSENICAL MIXTURES OR COMPOUNDS 1 4 GENERAL CHEMICALS Arsenica! Mixture or Compounds, N. O. $.* Solid Hazardous Properties: Poisonous materials. See Arsenic. Shipping Regulations: f Poison B 352, 354* Poison label 200 lbs. (max. lot.) Arsiixi-ienl Kip, Liquid (Sheep Sip) Hazardous Properties: Poisonous liquid. See Arsenic. Shipping Regulations: f Poison B 338, 349* Poison Label 55 gals, (max. lot) Aiisn.issd Bust Haierdous Properties: A poisonous material. See /.\4 -sne, Shipping Regulations: f Poison B 352, 355 Poison label 200 lbs. (max. k>t) Arsenica! H ue Dus* Hazardous Proper'ties: Poisonous material. See Arsenic, Shipping Riga!aliens: f Poison B ' 352, 355 Poison label 200 lbs. {max. lot) Arsenous Arid, Solid - Hazardous Properties: A poison. See Arsenic. Shipping Reguiatims: f Poison B 352, 351* Poison label 200 lbs. (max. lot) Arsenous uid Mercuric .Iodide Solution, Liquid Hazardous Properties: A poisonous liquid. See Arsenic and Mercury. Shipping Regulation-;:! >- Poison B 338, 349 Poison label SS gals. (max. lot) Axdua Asfi'uimimi Allowable OoncsrJrolion ip. AirH O.On parts \z:z million. Hazardous Properties: bee Arsor.se Caution! / sine can be liberated from unusual places. . instance, in cleaning out steel tanks which contained concentrated sulfuric acid it is pos sible to liberate arsine; although concentrated sulfuric acid does not react with steel, dilute add does react with it momentarily, liberating b-'drcpen, which reacts with the arsenic, form ing arete. This is but one of the very numerous " possibilities forindustrial-exposure to this toxic material. ' d/nwpw.- Arsenic hydride; aneniuretted hydrogen lArxwla: A*H, M. Wt: 77.9 . i t . 1.; --113.5*0 . P.: - 5$*C Density: 3.484 g/liter PkuriptHsn: Colorless gas Shipping Regulations:^ Pol son lab el {!). ArZVihi:Zlam b fr ilewrioi:is p?op<r>'ItPS: A to sic material. See Ars Synonyms: 3-Diamiao-4-dihydroxy-! -areenobenaens hydrochloride; 606 Formula: CiH,sAsjN':0>2HC!.2H,0 U . U'u 475.0 Description: Light yellow hygroscopic powder Shipping Regulations:^ None. Arilc* ' Trade mark of a refrigeration grade of methyl chloride. A proprietary material. See under component as listed. Asbestos P articles or Asbestos iHxst Maximum Allowable Concentration in Air:9 5 million particles per cubic meter. Hazardous Properties: Asbestos is a class name for various minerals of a fibrous nature. T he com mercial material is mainly fibrous serpentine, known as chrysotile. ffie. this material merely constitutes a nuisance,,dtjgt. The"-figure given for the M. A. C. is probably the safe limit. There is a specific lung disease known as asbestosis, which may be caused by this material; it can also cause chronic con junctivitis with hypertrophy (6). Asbestosis is a comparatively new disease which was first degcnLcd oy English wnters Li'A0 to ..sC.S). Finely ground asbestos is said not to be dan gerous, and this theory is supported clinically. The time necessary to develop sb.stosis is from 7 to 9 years, if the exposure concentration is fairly high. Lower concentrations are iikely to require 15 to 20 years of exposure. Once established, the disease is progressive, even though exposure has stopped, it would seem that the irritation cue to this materia! `>related to its physical nature rather than its .-neancal composition. The first sign is dyspnea; tne cough is us>ially dry and auscultation reveals few if any physical signs; kiss of weight, peflor and cyaxiosis arc also early symptoms. Later, emaciation and chest symptoms appear. There is a distinction between this disease and Acosis, i.i., the chest appears emaciated and l&r s the robust character noticed in silicosis. JL>, SilD. Jib..Li''-Pf1'a *:v insulating, and firc-oroofaig industry or wheye tins materialJs.&tabjDcri with .textiles.^. TtiSmcnTwei '`Antidotes: Rest and removal from exposure are indicated. Consult a physician. Storage end Handling: ytt^Q.pja~sa&gSu in in&h cpncentrat\Qris..,or...to.._suikno\s'n_j;oiicentrau/;'"s _jefasbcstosjjactkks P >ldssarrggiratr y pro tection of an approy .A'ilTb. Ai.pb.at5 Hazardous Properties: Asphalt causes skin eruptions which vary roughly in relation to the specific gravity and boiling point of the phalt cr bitumen. It can cause dermatitis. The funset evolved are s .axious and unpleasant with a strong odor, s.o that kettles of this material SBe list of abbreviations and symbol, page vii. t S ection 5 give* com plete ICC S h ip p in g Regulation* JVxmbiyj i-p, p^xmnUuistt rejer to tiUralurt eitaiions, page a. A I GENERAL i Leins' Lo. 1 4 diiconuot i i evolved 2 i%? a fire ha \ Fu.:rt herrr | ast; jir.ph \ P'J>fk at/iXL j for u , t !f ;,s a dar. as a pa i:sating f i roofing I * as a con. * ' V c T f? C 1 hot ?.so` 1\ this Is a i TfoiAOVCC 4 VoriAtnc ci^cnsiv i i f X. 5 \ \ L f ; ;* \ * 4;rH3 h to 'a~ . ; ~.S.- irt 'cities iiiilf ti h-latinr g'-.O'jld 7, ,. 1 . ,^ , , r'\oulu o ohoc^ s i-.O Oj"<: C'OV/o I.'.Ot b i > ot to ]:<: cn t Sem \ To -:ray' c'liOr: r/cM T ; \5 ;;' iiu !\ 1 ifiT/'ui'i/c i . ............... optic 1 vlhcr i r-'ifer .cut. 1 A .'ip ir'f i/blfo.foTto o I !*<*Ksx&s&gszi ,3!S333SS222SSI5SSt i X Hlbrt jrtoiB^deiKsareBaa@s^-S$ss5ss5iS!^^^ESS$SE15 I-:M:*FA!-:cn 1,115RARY I 1 3 . C OCCUPATIONAL MEDICINE AND . INDUSTRIAL HYGIENE By RUTHERFORD T. JOHNSTONE, A.3., M.D. ' * Consultant in Industrial Health; Lecturer at the - University of California, Los Angeles Formerly Assistant Professor of Medicine, University of . Pittsburgh School of Medicine; Formerly Director of Department of Occupational Diseases, Golden Stale Hospital L . With One Hundred Seventeen Illustrations . Seven in Color St. Louis THE C. V. MOSBY COMPANY . 1948 -if ies as does occu- e original pages there have been .s of n utrition, o r :w, have not been textbooks of their is com forted by al aspects of the l processes, their ges will be found vhich the average ,who m ust rem ain is field, the magni?ork, occupational castings. Many of live leaders; not a ociety of America, ssion to use certain ) the entire staff of tion in this present am grateful to Lee i double duty while ser meticulous edit to a m ost tolerant ere involved in h e r lowledgement. The is dependent upon u this book -should at aly real knowledge, t and converts itsell at iiie brain or dries rd T. J o h n s t o n e tm &,... ; ' ft CONTENTS I -Eg PART ONE Page _ CHAPTER I T omorrow' s Doctors (T h e Background and t h e F uture of Industrial Me d ic in e ) .............................................................................................. ......................... u . CHAPTER II Industrial Me d icin e and W o r k m e n 's Co m p e n s a t io n ................................................... 2a Personal injury, 29; Bv Accident, 29; Arising Out of find in the Course of ' Employment, 29; In the Course of Employment, 30. CHAPTER III T h e N eed of Sc ie n t if ic P roof in Medicolegal Co n trov ersy. ....................... 54 ' CHAPTER IV F unctions of t h e I ndustrial P h y s ic ia n .................................................................> ^7 - CHAPTER V i.\ Q T he T eaching of I ndustrial Me d ic in e ................................................................... ,J> ......'.....7 ..... .... ... CHAPTER VI ......... T he Basic Approach to a D iagnosis of O ccupational D is e a s e .............................. >5 CHAPTER VO _ . _ "J '* IAiio-RATofiy P rocedures of Value in t h e D iagnosis of t h e O ccw pa iiln al Diseases ................................................................................. .. ................................... '* 9 m&m CONTENTS PART TWO CHAPTER M il Page T h e I ndustrial So lv en ts.............................................................................................. ........... 3V Saturated and Unsaturated Compounds, SO; Chains and Rings of .Atoms, 90; The Aliphatic Compounds, 91; The Aromatic Compounds, 91; The 'Alcohols, 92; The Aldehydes, 92; Acids and Esters, 92. CHAPTER IX T h e Aliph a t ic H ydrocarbons.................................................*.............................................. Petroleum Series, 9; Gasoline, 100; Occupational Exposures, 100; Path ology, 100; Signs and Symptoms, 100; Laboratory Findings, 101; Dis ability, 101; Treatment, 102; Illustrative Cases, 103; Tetraethyl Lead, 106; Toxicity, 106; Pathology, 107; Symptoms and Signs, 107; Prodromal Period, 107; Physical Examination, 107; Complications, Sequelae, and Convalescence, 107. ' CHAPTER X The Aliph a tic H ydrocarbons--Cont'd ................. .............................................* The Alcohols, 109; Methvl Alcohol, 109; Ethyl Alcohol, 110; Propyl Al cohol 110; Butvl Alcohol, 110; Amyl Alcohol, 111; Treatment, 111; The Glycol, 112; The Aldehvdes, 114; Occupational Exposures, 114; Propny. Laxis of Formaldehyde Poisoning, 115; Treatment of Forma; dchyde roison-ing, 115; The Ketones, 115; The Aliphatic Acids, 116. / " * CHAPTER XI T h e Al ip h a t ic H ydrocarbons-- Co n t 'o. ltd The Aliphatic Oxides, 118; Carbon Monoxide, 118; Properties, 113; Occu pational Hazards, 118; Pathology, 118; Diagnosis, 120; Differential Diag nosis. 124; Sequelae of Acute Carbon Monoxide Poisoning, 124; .treatment, 127; Carbon Dioxide, COa, 130; Carbon Oxychloride, COCI2. 130; Aliphatic Kitrile Compounds, 130; Pathology and Physiology, 130; Signs and Symp toms, 131; Tests, 132; Medicolegal Aspects, 132; Treatment, l.vl; u s e s sion, 135. CHAPTER XII T h e H alogen ateo H ydrocarbons......................................................................................... * 186 Methyl Bromide, 136; Properties,.136; Tests, 136^ Pathology, 138 ; Signs Dichjor.Oi;than... ..(H2CI-CH2CD Cff-OI), 144. 0 X mmiimmiMs^m CONTENTS CHAPTER XIII Prg;; T h e Chlorinated H ydrocarbons................................................................ ........................... 747 . Carbon Tetrachloride (CCM (Tetrachloromethane) 143; Occupational \ / Vses, 148; Pathology, 148; Signs and Symptoms, 149; Laboratory Tests, 150; Possible Disability, 151; Treatment, 152; Preface to Case Histories 154; Comment, 156; Trichloreihylene (CIIC1CCP), 158; Pathology, 158; Signs and Symptoms, 159; Laboratory Tests. 160; Possible Disability, ICO; Treatment, 160; Tetrachlorethane (CHCPCHCI2), 162. CHAPTER XFV Chlorinated N a p h th a len es and D ip h e n y l s ..................... ............................................. 1S5 Occupational Exposure, 165; Pathology, 165; Signs and Svmotom*, 165; Laboratory Tests, 106; Disability, 166; Treatment, 156; Naphthalene, 163. -f . CHAPTER XV Miscellaneous Aliph a t ic Co m po u n d s................................................................ .. 171 Carbon Disulfide, 171; Occupational Hazards, 173; Resume of Group Study, 171; Pathology, 172; Signs and Symptoms, 174; Differential Diagnosis, 176; Medicolegal Aspects, 178; Treatment, 178; Case History, 179; Sulfur Cornpounds, 179; Hydrogen Sulfide, 179; Occupational Hazards, 179; Path ology, 180; Signs arid Symptoms, 180; Medicolegal Aspects. IPO; Treat ment, 180; Sulfur Dioxide, 182; Occupational Exposure, 182; Sian; and Symptoms. 182; Medicolegal Aspects, 182; Treatment, 183; illustrative Cases, 183. CHAPTER XVI I Halogens and Halogen Compounds........................................... ................ ................... 335 I Chlorine, 185; Signs and Symptoms, 185; Treatment, 185; Fluorine, 186; i > Hydrogen Chloride, 187; Hydrogen Fluoride, 18 /; Case Report, 189. Si . | CHAPTER XVII i T h e Aromatic H ydrocarbons................................................... . ......................................... 130 / Benzol, 190; Occupational Exposure, 190; Pathology, 190; Blood Picture, / 193; The "Latent Period" of Benzol. Poisoning, 200; Summary, 201; Signs r . / and Symptoms, 201; Laboratory Tests, 202: Possible Disability, 202; Treat- ] !/ meat, 202; Case Histories, 204; Tohiene.,.205; XyloL.208j Solvent Naphtha, 1 * _ 208; Trinitrotoluene, 208; Laboratory. Tests, '210;...Treatment, 2; 1; Casd : History, 211; Tetryl, 214; Nitrobenzene, 214; Aniline, 215; Phe ol, 215. -! ....' CHAPTER XVili ' T hk Oxides of N itrogen.............................. .................. .......................................... - . . . . 213 Occupational Exposure, 218; Pathology, 218; Signs and Symptoms, 219; treatment, 220; Case Histories, 221; Ammonia, 221; Signs and Symptoms, 222; Medicolegal Aspects, 222; Treatment, 222; Case History, 223. $ 'f > CONTENTS CHAPTER aIX Paje mi ^"Tl-TTmCKLOROETKANE), 2,4-DlCHLOROPBl. *' 0 X i A C E 1 JC A C ID , AND T h IO G L Y C O U C A C ID AND T k i O G L Y C O L A T E S............ 22-1 DDT or 2,2-bis-(P-Chloropheny])-t,3,l-Tnchloroelhane o 4-Dirhn rophenoxy Acetic Acid, 228; Thioglycolic Acid and ThioglyVoates! si! PART THREE THE METALS CHAPTER XX L ead 234 / Occupational Exposure, 234; Absorolion and FxrrcHo n? Tacc 00,1 m Lead Encephalopathy, 257; Prophylaxis, 257; Case RistoriV^ Ms Ca d m iu m CHAPTER XXI Mcvuj^uunat exposure, 2 0 o; Pathology, 265; Sir.ns ar * D"abimy' 56i Symptoms inhalations . 265 266; 267 ; CHAPTER XXII Beryllium , " ; ...................................................................................................... .. 277 Pii y i?>tqi?n ,ExPs.uTM. 277 Etiology, 278; Pathology, 278; X-Rrv Fi m f n l l f c c I H ^ e 0" 8' :::U; DifferCnUa! g n o s i s , 28;- Tr'r.:;- `CHAPTER XXIII Ar sen ic 289 Occupational Hazards, 289; Pathology, 289; General Discussion 289- Ai-ine oi hydrogen arsenide, 291; Differential Diagnosis 29;T f ets 9": Medicolegal Aspects, 292; Treatment, 292. s' " " ' CHAPTER XXlV Ma n g anese,. Ma g n esiu m , P h o s p h o r u s, A n t im o n y , and Zin c . 295 Manganese, 2a5; Occupational Exposure, 295; Pathology `>as- 'Ffv.,-f r.., Rood, 297; Absorption and Elimination of k a n g a n e s? '297- ' E ^ g n ^ u m 2<ioV. 5 ifleren.t.ial Diagnosis, 298; Tc ;s, 298;' Treatment, 299; loY* hoinhr-n; % T PAhr nal Ex5??.af& SO2! Pathology, 302; Treatment, olorV 30^ h7 i n l ' ant* Antimony, 300; Occupational Exposure, 306; Pub- S s n s . " 1* ** . *. 12 '-'VT.'TTK r.ri.- 7 ..-Sc * ;w - * ~ ' y , :" .-a ^ ^ n fK S tx^ & i ^ ^ 'A S S Sf CONTENTS Page CHAPTER XXV Mercury, Ch r o m iu m , Co pper, and Alum inum . . . 310 Mercury, 310; Occupational Exposure, 310; Pathology, 310; Signs and Symptoms, 310; Laboratory Tests, 311; Treatment, 311; Case Histories, .312; Chromium, 314; Occupational Hazards, 314; Signs and Symptoms, 314; Medicolegal Aspects, 315; Treatment, 335; Copper, 336; Aluminum, 316. CHAPTER XXVI S e l e n iu m , T ellurium, Vanadium , and R a dium . ................... ..................................... 317 Selenium, 317; Occupational Exposure. 317; Pathology, 317; Signs and Symptoms, 317; Treatment, 319; Tellurium, 321; Occupational Exposure, 321; Pathology, 323 ; Vanadium, 322; Vanadium Penloxide ns Toxic Prod uct, 322; Signs and Symptoms, 323; Radium. 323; Alpha-Rays, 32-1; BetaRays, 32*1; Gumma-Rays, 325; Pathology, 325; Signs and Symptoms, 325; Treatment, 325. CHAPTER XXVII Metal F ume F ever .................. ............................... ................................................ Pathology. 32S; Immunity. S28; Signs and Symptoms. 329; Medicolegal Aspects, 330; Treatment, 330. PART FOUR THE DUSTS CHAPTER XXVill Siuoosis ................... .................................................. ........................................ ................... 333 Silica In Industries, 333; Asbestos and Talc, 334; Mica, 335; Sodium Silicate, 335; Silica Gel, 335; Lime-Soda Glass, 335; Definition of Silicosis, 836; Sisc of the Dust Part ele, 336; Permissible Concentrations, 836; Length of Exposure, 337; Diagnosis, 337; Signs and Symptoms. 337; Path ology. 342; Spread of Fibrosis, 342; Alveolar Consolidation, 343; Produc tion of Dyspnea, 344; Silico-Tuberculosis, 344; Other Complications, 345; Additional Aids in Diagnosis, 346; Disability, 346; Employability of the Person With Silicosis, 351; Treatment, 357; Results of Treatment, 353; Case Reports, 355; Chemistry of Minerals, 357. CHAPTER XXIX An t h r a c o s iu c g s is 331 Findings in Governmental Survey, 361; Symptoms, 2 il; oasis oi Diagnosis 361; Groups Studied, 362; Prevalence and Exposure, 362; Safe Limits o Exposure, 363; Respiratory Disease, 363; Signs and Symptoms, 364; Path ology, 364; X-Ray Findings, 366; Medicolegal Aspects, 367. 13 -:c & CONTENTS CHAPTER XXX Paga A S B E S T O S rS SignS and Symptoms, 368; Pathology, 368; Action of Asbestos and Silir? o8; itLcroscopac Appearance, 372; X-Rcy Findings, 372; Medicolegal Aspects, 372, ' .. , CHAPTER XXXI Silicious D usts of Un d eterm in ed P athologic S tatus ......................... Talc, 373; Bauxite, 375; Diatomaceous Earth, 382; Tripoli, 334. CHAPTER XXXII T h e I nert D u s t s ....................................................................................... Siderosis, 387; Byssinosis, 389; Cement Dust, 394; Calcium and Magnesium - Carbonates, 396; Carbon Dust, 396; Tobacco Dust, 396; Mill Dust, 396- Discharge of Dust Into Air, 390; Grain or Mali Fever, 397; Mica Dust 398' CHAPTER XXXIII T uberculosis and P neu m o nia in I n d u str y ........................................... ...................... 402 / Respiratory Irritants: Dusts, Fumes, Gases, 403; Lead Absorption Versus ^ Tuberculosis, 405; Temperature and Humidity Versus Tuberculosis, 406; Tuberculosis Among Steel Plant Workers, 406; Tuberculosis in the Foun dry Industry, 407; Tuberculosis in Granite and Marble Workers, 497; Tuberculosis in Hard Rock Miners, 408; Fatigue as a Factor in Industrial Tuberculosis, 408; Summary, 409; Industrial Environment and Pneumonia 411. CHAPTER XXXIV T h e D e r m a t o s e s ................................ ................................... ................. .................................... 413 Occupational Hazards, 413; Definition, 413; General Considerations of Etiology, 413; Diagnosis, 414; Epidermophytosis, 419; lufeetious Ee?ematoid Dermatitis, 420; Turpentine Dermatitis, 421; Baker's Dermatitis, 421; Cosmetician's and Barber's Dermatitis, 423; Cement Dermatitis, -123; Dermatitis Artefacta, 424; Onychia, 426; Syphilis, 426; Medicolegal Aspects, 427; Treatment, 427; Infectious Eczematoid Dermatitis, 432, CHAPTER XXXV On SEN T herapy i n Occupational Med icin e . . . . 434 14 i. ipiiKS S ' ' ~T : - CONTENTS % % CHAPTER XXXVI l'n Ki- S y n th etics ...................................................................................................................................... Synthetic Rubber, 438; Synthetic Fibers, 446; Rayon, 440; Nylon, 448; Cellophane, Sealing Caps, 450; Cellulose Sponge, 450; The P asties. 451; Thermosetting Resins. 452; Phenolic Resins, 452; Urea-Formaldehyde Resins, 453; Melamine Resins, 453; Aikyd Resins, 454; Thermoplastics Based on Cellulose, 454; Cellulose Ester Plastics, 454 ; Cellulose Acetate, 455; Ethyl Cellulose Plastics, 455; Thermoplastic Resins. 456; Acrylic Resins, 456; Vinyl Resins, 457; Vinyl Alcohol and Acetal Resins, 457; Vlnylidene Chloride Resins, 457; Styrene Resins, 458; Protein Plastics, 458; Casein Plastics, 458. H CHAPTER XXXVH Special I ndustrial P rocesses ................................................................................................. `6 * Electroplating, 464; Anodic Treatment, 465; Degreasing, 467; Recom mendations, 47?; Pickling, 472; Heat Treatment, 473; Sand Blasting, 475; Shot Blasting, 476; Tumbling, 476; Casting (Molding), 477; The Ceramic end Pottery Processes, 477; Diesel Engines, 478; The Fluorescent Lamp Process, 479; Storage Battery Manufacturing Operations, 479; 'Welding, 481; Oxyacelylenc Welding, 481; The Oxyacetylene Flame, 482; Electric Arc Welding, 484; The Metallic Arc Process, 485; Shielded and Unshielded Arc Welding Processes, 485; Electric Resistance Welding, 486; Hazards of Welding, 488; Composition of Welding Rods, 489; Metallizing, 490. , CHAPTER XXXVI )I Industrial H ygiene-- General ................ ........... .................................................................. 93 General Plant Hygiene, 494; Plant Lighting, 495; Natural Lighting, 495; Artificial Lighting, 496; Functional Use of Color, 499; Explosion Hazards . of Dusts, Gases, and Vapors, 500; Gases, Vapors, Liquids, 500; Respiratory Protection, 502; Gas 'Masks and Cartridge Respirators, 503; Filter Respira tors, 504; Care of Equipment, 505; Respirators With Impervious Clothing. 505; Hose Masks, 505; Abrasive Blasting Protectors, 506; Oxygen Breathing Apparatus, 506; Air-Line Respirators, 507; Cleaning and Maintenance of Respiratory Devices, 508; Eye and Face Protection, 59; Impact Goggles, 509; Corrective Goggles, 510; Face Shields. 511; Acid Hoods, 511; Chem ical Goggles, 512; Welding and Babbitting Masks, 512; Harmful Rays, 512; Preventing Skin Infections, 515; Skin Cleansers, 516; Cutting Oils, oiC; Safety Clothing, 516. ....... .................... CHAPTER XXXIX ................" " ................ Industrial H ygiene-- General---Con t'd ................................ ............................................. Control of Hazards, 517; Manner and Method of Exhausting, 518; Hoods, 520; Large Open Hoods, 520; Lateral Exhaust System, 521; Flexible, Ex haust System, 521; Spray Booths, 521; Protection Against Corrosion, 522; Application and Design of Duct Exhaust Systems, 523; Duct orzes, 5xy; Transport Velocities, 529; Conveying Capacity, of Ducts, 529; Construc tion, 530. 15  l ' X'^T " " ' v. ;V.*'V. ;=>T r^' 'ai'K t- r 't 4 -* <CkU\* , VT" C?" " 5Jr? a e * ri2 i. /* ^ '> * * J , k 'v i ^ ***` S c CONTENTS . CHAPTER XL i 'asc Industrial Hygiene--General-- Cont'd ........................ *......................i)Jj .,w Appraisal of Hazards, 531; Dust Collection and Analysis, 531. CHAPTER XU P re-Employm ent E xaminations and t e e P lacement P rogram............................ U 2 The Job Placement Program, 544; Elements in Successful Pla-eme- d i s placement, E l W rkCT' 54?: EvaJuatiB the Job' 548; P sych i^ ran ii'joi; APPENDIX T h e Ch e m ic a l s in Com m on T rade-N ame P roducts............................................ ILLUSTRATIONS IN COLOR Fig. S3. ; Bone marrow (femoral) (Photomicrograph) ................................. 2i, ~ Spleen (Photomicrograph) ....................................... .,, ............... p t 25. Spleen (Photomicrograph) ........................................... ........ - i.V? 25. Spleen (Photomicrograph) ......................................... ` ` 27. L iv e r (Photomicrograph) .........................................../ ................ ^ 28. Lymph node (Photomicrograph) ..................................... ^ 23. Blood cells of anemia of lead poiso n in g ........................... 3? 1C . f m w 'Vi-v ss" titm CHAPTER XXX ASBESTOSIS Asbestosis is.a comparatively new disease. *Ihe first comprehensive reports regarding asbestosis came from the English writers in the years between 1920 and 1925. In A m erica In the early th irties studies were m ade by L anza, Sayers, Bloomfield, and others. Asbestos is a hydrated magnesium silicate. Occupatjpn^!_e2y>os,age occurs In l.bQs&lEad5,jdi&ia^lJ-:LJ^ processes. Signs and Symptoms.--As in silicosis,1 the first sign is dyspnea, the cough is usually dry, and auscultation reveals few, if any, physical signs. Loss of weight is usually noticeable, the color is pale, and cyanosis is a fairly early sign. A fter some time, fine, crackling' rales may be heard, an d the chest appears em aciated and lacks the robust character noticed in silicosis. Early asbestosis must be dificrentiated from acute ernpnysem a. If tuberculosis is present, the symptoms m ay take on the character .of tins disease, but this com plication is fa r less .frequent than in silicosis. Pathology.---- P clmoxary Changes.--T he pulmonary fibrosis of asbestosis is dih use in character, peribronchial, and basal m location in contrast to smcosis in which the fibrosis is nodular in character and present in the upper part of the lungs. As ..'.e process continues, the fibrosis extends into almost all portions of the lung tissue. Bronchiolectasis an d d ion* ehiectasis are present within the substance of the nhroid areas, un.> b ro n ch o p n eu m o n ia and acute tracheobronchitis often cause tue tienili of these patients. The p le u ra e, especially in the basal regions, arc tmchencd an d adherent. In som e cases the pleural sac is completely obliterated, In others a fibrous or serous exudate may be present w ithin it. Action of Asbestos and Silica.--The difference between chrysotije asbestos and quartz silica in their mode of action has caused considerable sp ecu la tio n as w ell as ex p erim en tatio n . G ardner- p articu la rly , n!^hc S a ra n a c L ab o rato ry , c a rrie d on intensive stu d y of these two m aterials. He fell th a t w hile*the action of free silica is chem ical in n a tu re , fine action of asbestos is m edianica!. He statesi: ' ------- *`\Yc-have- come to the -conclusion -that, inhaled .asbestos fibres are irritating not because they are silicates but because limy are sii IT fibres w h ich m ech an ically Irrita te the lungs. L n tik c the free silicas, tnese minerals w ill not stimulate fibroblasts in an y part of the body; only those in the lungs are nfleeted. It was inferred that these organs were ' 368 a lie c te11 1>ccoust* and conlinumis t if asbestos was l that 2 m icrons it Uenlly destroyed tos were- currie developed hi spi of 12-5 iniHion l> contrast in a p n' of long fibre ns two Years.'' If the eft re decrease in .size particles nave f becomes m ore ' W ith fibrous us The histoloj Even under the Injection there 1 of aurocy-es nThe connective th e asbestos id>f eon Ira els, fine n animal:;, a t lens exposure to tiw* reason is the << surface of the i bodies" (rig s. ; F in ally , It i m inerals only they arc librmi monarv Irritars group is g re a h fad , clirysofib' silicate, i-crpen would seem i `> coin posit io oi One point 1 vutiens: m unfi eonelusiou has known that ui though in fom : extremely fine, in A m erican j> ASBESTOSIS SC9 affected because the movements of resp iratio n arc so m u c h m ore rapid ami continuous than those of oilier viscera. T hen it w as discovered that if asbestos was ground very finely so that few of the fibres w ere longer that 2 m icrons in length the irritating property o f the asbestos w as p ra c tically destroyed. Inhalation experiments %vlth such 'tine chrysoldo asbes tos were carried out over a period of several years. h>o hbrosis nns developed in spite of the fact that an average atmospheric concentration . of 125 million particles per cubic feet of air has 1> cn maintained. In contrast in a previously reported experim ent one-third this concentration of long fibre asbestos dust produced well m arked fibrosis alter about two years." If the effect of asbestos were chemical, one would expect tnat a decrease in size would accelerate tissue response. With free silica large particles have little effect, but as their size decreases cellular reaction * becomes more vigorous and even constitutional symptoms may ensue. With fibrous asbestos the reverse is true. . The histology of early ashestosis does not suggest a chemical in ju ry . Even under the most extreme conditions that can be created by ariiiicia? injection there is no preliminary phase of tissue necrosis with infiltration of leucocytes as occurs with high concentrations of very lin e 'q u a rtz , The connective tissue cells merely multiply very slowly in areas where the asbestos fibres arc caught in the bronchioles. As collagen forms an d contracts, the air spaces are obliterated h.y,scar tissue. In experim ental animals, at least, this change is not a progressive one a fte r cessation of exposure to the dust as is the case in (he response to quartz. Ferhaps the reason is the deposition of the peculiar iron-containing coating on the surface of the inhaled fibres giving rise to t]|e characteristic "asbeslosss bodies" (Figs. 50-aiid 51). *};c . Finally, it is most suggestive that among dozens of different silicate minerals only the five known as asbestos.-. vH ieh a re unique because / they are fibrous in structure, should be commonly recognized as monarv irritants. The variation in chemical composition within ttvds .group'is greater than that betw een them and massy o ilier silicates. In fact, chrysolite asbestos lias the sam e chem ical formula as a nonilbrous silicate, serpentine, which is physiologically inert. Obviously irritation would seem to be associated w ith the physical ra th e r than tne chem ical composition of these m inerals. One point of practical significance may be indicated by these otiser- I valions: nam ely, that very finely g ro u n d asbestos is not dangerous. T h is _ ~""'conclusion'has 'support in clinical observation, fo r it Iras long-been ^ known that at the Thetford M ills th e re was no clinical asbestos's even \ though in former years the atmosphere was very dusty and the d- si w as extremely fine. T he fact that fabrication of fibres of the same m in eral in Am erican plants could produce disease was one of tire puzzling tea- 370 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIEXS i\ rii k . ' -1. ^ + ' L . A JJ ` *.'V* ' V - i j ? " / V. ^ ' ' ` r - f , 1 * * V & Z S 2 * ' ^?>P, > / . . t ;.i* - , V n t fe<- A * K , l v ` .r.---~ Mvri k - r . . ' ,* Z V .7 .<.'. >:'- ` - i - i - C 'C : i . v s w * . . . T :_ .- I I * i :'' i t V `; ' 'iV S - fe -.-. V ' s i ; 5- & c ^ \ - H ib V i :< - & '. tr . . V v - ' P ^ . I 2-V y elevra. iil,) "*. i; 'cT 'v ,,> Kt . ^riv j > * f- . P T ' - %f 'V ` '. s ' W * ***:d v->if.- z 'J **,*'5. - ,, ? 4/o * *"r r - v. . . . a &"t i . ... T * " * 'i * `,,ti - p 1**P`V-> '**-. 8 >'**4' r- '- r ^ y tf^ j t . -- A & bfstniU K o d irs s c o n ip a n le d I>y ti!int auiicum-, SDtflraen 525S.) * &rrt'-i t i e v k . J ASB-ESTOSS E-vU-b> '^ 1's*-4^ ./ / '\ ^ isn ,Vt ^ ^->'/.>'n-vv^:..v'^.**--*:-rt.^ .J--V**-^%-\* H .. $2.--'SetiSo ci a lang la asbf>*Jo*&* &Brdrar.) 'i <**V S^V 'I '^V3 ^,'*~w-- . ' '>,, *. - `r ^ "v'a V/J>.>.>y' . i j ? >.'JS.. - 3 '. V. -fr . P lg . S .-- X -r e y Jm o p sH n it rtil * f.b r * ln * I* . P o d r r s r a s s .) " "``"'""'"''''"''npo'WMwwwoimKS^saaiKaBSS^^ r. . , !.54it.tiv iVt'i 'AySPi '*-- S72 oCCLWnOXM. KWICtt: AX iKDCSTWAL HYGIENE i|nres of M s d i s c . Bui these e ^ e r im e u .s >> e" j o* is a thickening of the alvwilar septa as a r c . J Sion. The alveolar spaces progression of the disease, nm orns /-c ^ - ^ , o la r stru c tu re g rad u aliy d isap p ea rs, an``i J" S 'jh r r r s J^ 'r r s M ^ - piwiiocvl. WWi the riveihcre is now dense ... ........ 0 f fibrous --^-iu!s" It has CcrystulHi' disabling ; been stud, siily w ith ; degree. I ef being c As yet no gallon by icm aiu tu ai each.extrem ity. M any are arran g ed like s U ^ s . ' i - w ith the largest a i t h c end o f t n e euam.^ .r ,, , fld to X-Ray Findings. Certain pecuD^-a^s ^ xst us ^ Aelc he nccoir silicosis. In ashestosss, the lesions ma findings trem olite. According to the experience of or`Wo-lhirds of the mineral,, in asbestosis are largely um rlet ` ` ^ llons 0f the lungs are &k dusting a lung fields, wnile m silica^ i. - M - 1 x-ravSwill reveal lessened <f involved. In moderately athimcec, as "j * tra ^ h en ed , and there in V. .+ ventilation of the lung rseaus, Ine i~ j ^ The vascuiar shadows Valle 5 si Is a "ground-glass appearance to l u c ^ c . s s , feeb thai a noted In: lose their identity, ^ CKiosh h u n reliab le a n d th a t the niiUlAc! : ers 3 too! S S S S f S t & . U . y o f ruarkedtv c . l v ^ c i i to msHe . hbrohs ; entfal diagnosis from the roentgenograms (i % h ^ Medicolegal A sp ects.-Il is felt that the ^ , sgh asbestosis i^ otW hc from fifteen ^ tw e n ty cVoMncre,ntrTahteional,lo%w\naublea concentration is in0o,UnndMsOwQU r1-rrriilwift.et.s ps er cubic loot of a 's k e between 0.5 and 5. , .. vi ' Oucc-cctublirkci. tbe "S ` 1 " " o f exposure. The basis for d.oKnosis is - m l . '> ' m o rb id i1. ohsereat "The i'yspru'3. yiu- uUiiU'ii volariU'ni yi'C-:.e;H ! !:>VO!Vfi i.'iii'fs i't' Silicosis. Eelrrenccfj - iiC.'.f. -r: y,-udiH-i 1 K iiiim it' 1. Larisa, A. J .: Asbcstor-s, J.A.M.A. 10`^ ^ jS ^ ^ to silicosis. Indus!. Met!. 2 . G a r d n e r , U U .: R e c e n t D e v e lo p m e n ts >n ^ U x u o n _ th 45 (Fc...), 19i0* . i , ..s ,,r,.i, New York, t 38. Oxford Univcr- 3. P e n d e rg ra ss. K. P .: JM hcosis a n d A ^ t o M . , ..4 p re f-cn! pa si pm - hr pi'S-bs U sercfnr aily Press, PiiTuM- ----- r acDaaald, S-: Mlllsy Fulcw>'y A,iyrtlol*. BriS. S . i,;~ - ' ' ? -%i -,s is