Document LpypZpLa6qojm1woL5nG7MEDd

aI General Headquarters, August 29, 1933. Personal & Confidential Mr. A. R. Fisher, Manager, Manville Factory * QUESTIONS ASKED ER. A. J. LANZA AND HIS ANSWERS VERBAIUM Attached is copy rode by Mr. Kottcanp's office of questions asked Dr. A. J. Lanza by our local physician at Waukegan and his answers; also the reoccinendations by our plant physician. I would like to have you turn this over to saneone who could review this correspondence and then go over it yourself and write ne your opinion of it. - cc - Mr. J. P. Kottcaop Waukegan Factory S. A. WXUIW6, Vice President QUESTIONS ASKED DR. A. J. LANZA AND HIS ANSWERS VERBATIM Question No.l. Among eleven eoployees in the Textile department, all exposed to asbestos dust, one only wears a respirator, several an being questioned claim they cannot wear them continuously especially in hoc weather. Should all employees be forced to wear these respirators whether subjected to ituch or little asbestos dust? Is any such difficulty experienced at the Manville N.J. J-tf plant or other places of which you have Joiowledge? Answer: Respirators are not satisfactory. It is possible to construct a respirator which will filter out fine dust, but it would offer so much re sistance to respiration that it could not be worn continuously on an eight hour shift. There are on the market stall face nasJc respirators which are equipped with positive pressure and these are both satisfactory, efficient, nd comfortable but they cannot be worn except by a person who stands in one |olace as they have to be hooked up with a rubber tube to an air line. I doubt if they would be practical in a textile plant. Questions No.2. Do you agree with my reecuvendation that enployees definitely be made aware of the fact that asbestos dust is hazardous to their health? My idea is that a poster be placed at one or more ccnspicuous places in the de partment, signed by the physician, stating that the dust is injurious, ad vising the continuous use of respirators while at work and cleansing of hands before eating lunch and after work. Your an this please and particularly is there ary addi tional advioe that should be given? Answer: This is partially answered by No.l. I doubt if the hazard is sufficient to justify warning posters as might be vised where lead, benzol or carton monoxide are concerned. This is especially true in view of the extraordinary legal situation. If anything is sard at all, it world be better to make a general statement that the company is taking steps to control the amount of dust in the air for general health purposes. Any action oantemolated at Waukegan would probably be influenced by the experience at other '.ants of the Cespany. Question No. 3 Do you regard the finding of asbestosis bodies in the sputum as pathogenesis of asbestosis? I have one enployee with x-ray and physical findings pointing toward asbestosis but not sufficiently definite that I can be positive as to whether or not she has asbestosis. However, every one of four or five speci mens of sputum examined show typical asbestosis bodies. On the other hard, is it possible for a person to have asbestosis and not be able, with careful and thorojgh searcdi to find asbestosis bodies in the sputum? Answer: The presence of asbestos bodies in the sputum only implies that the individual has been exposed to *gj-<r.gtr*c dust. I am not certain of the exact pathological significance. My impression is that the presence of asbestos bodies in the sputum indicate sane definite lung pathology. I be lieve it is quite possible for an individual to have asbestosis without asbestos bodies in the sputum. Question No.4. Are you of the opinion that the added information derived frm stereoscopic films of the*chest justified the procedure of taxing a stereo on every case that is to be x-rayed? This is the conclusion I drew fran Dr. Pancost's talk in Chicago. Do you consider it advisable and practical that an x-ray film be taken of every employee in the Waukegan J.M plant who is exposed to asbestos or silica dust? TO date I have x-rayed only those cases suspected, frtxn history or physical findings, of having asbestosis of other lung pathology. Answer: Stereoscopic films are better than single films. They are also more expensive. In our work at the Picher Clinic, we used single films simply on account of the expense involved. You can diagnose silicosis or any other form of pneumoocniosis from a single flat film. On the other hand, you can probably get a more complete and accurate idea of the eract condition of any given case from a stereo. If it is the intention to determine what may be the* extent of pneumoconiosis among employees, obviously the only thing to do is to x-ray all of them and then correlate your findings with the length of exposure and nature of the job in order that you nay get a fairly accurate idea of what the hazard is. ~ Question No.5. ( I have made a diagnosis of asbestos is an an eiployee who has been working in the card roan of the textile department six years. This place is extremely dusty. He is not disabled. In my judgment the best disposi tion of such a case is to remove him frtn the dust and give him a job in sane other part of the plant. Frtn your renarks in Giicago I believe this was your advise as to the disposition of such cases. Answer: It is difficult to answer this question. I think it would depend upon the man's age, the nature of his work, his length of service, and other considerations which might have sane bearing. If he is well along in years and shews no disability, it may be just as well to leave him alone. One of the difficulties and vexations in trying to deal with the problems of pneumoconiosis is that economic as well as production factors must be balanced against the medical factors. Question No. 6. We have what seaas to be an unforburate situation existing in the fact that the asbestos textile department including loans, twisters, pools, etc. occupies one side or about half the width of a long building, the ocher side of which is occupied by the packing, brake lining and ocher departments in which there is very little dust. The card roan, or rose dusty part of the textile department is isolated by partition. Further isolation of' the textile department involves considerable expense. Should or would you be guided by the dust ouunts and other observations in these adjoining departments? Answer: I think the answer to the situation outlined in this question is the control of dust in those processes that cause it. When everything possible has been done- to accarplish this result, it may then be necessary to isolate or confine the dusty processes so as to avoid needless exposure of other employees not concerned in these processes. This is a situation that occurs in many different types of industrial hazard. It calls for nothing more than the application of ccrn;n sense to the problen.