Document MJrxXeNy6MG97NLy6D0o154Kz

FILE NAME: DuPont (DUP) DATE: 1936 DOC#: DUP073 DOCUMENT DESCRIPTION: Journal Article - Environment and Man Industrial Medicine Environment and Man ./.tifi ^ A b stra c ts o f Papers Presented in a Symposium on E nvironm ent and its A upon H a rv a rd Tercentenary C e l e C Z l School o f Public H ealth, Boston, A u gu st 24-29, 1936-- ^ Reported by / \ s A PART of the celef ~ \ oration of the Harvard c. O. Sappington, M.D., Dr.P.H x x Tercentenary, a sym posium on the environment and its effects unon "Protective tor in Industrial Sanitafl Harvard Schools of Ej H etT u n n g^ u gu st62^29^ 1936^CT? chief^ub- Brown, Chemist, Gas Section P ittsburX * ment Station, U.S. Bureau o?MineS g f a i Se I ef disease!1' p h yologt i nn Zl ^Z Tf tSI Z ", ApPlicatiof of Air GCondiit,i high pressures, carbon monoxide poloning occu?. rence of gaseous impurities, toxicology of organic vapors and gases, toxic dusts, p n e u m S m io se fS - plication of air conditioning in normal life and in hospitals, and the set-ups in laboratories of inrfnc trial toxicology and industrial hygiene. ' The program presented was as follows- " M^ D A Y -"The Effects of the Social ` Environ- ment, by Dr. L awrence J. H enderson, Abbot and cMosv b n i w L ratory of Industrial! HacfJi'i t v , Dr*' E V0N Oettingen, Dire S S to r .Lr?rat0ry f Industrial Toxicology^ tr ia M ? v i^ a?v!reL?nd <<A Laboratory of In ky Warren E. Cook. Chief In f l S Conn?*?' ? ate DePartment of HealthT % l S f ectl2 Ut 'fa of P u b b c V Df " onstratin hi the Harvard! C lir d ^ T L 1^ ? ' visits to the Indu? W iiM iiia jS i P u b lic H e S ib 1?A-1 p b e m istry , H a rv a rd School of p u b lic H ealth , A ir-B orne D isease," by Dr. Wilson G. Sm illie, Professor of Public Health A d m in S {ration, Harvard School of Public Health: "Bac teria and Pollen in Air," by William F. Wells " u S H"althamtaiy SC`enCe' HaTM rd Sch 01' Tuesday--"The Physiological Effects of High Temperatures and Humidities," by Dr. Cecil K Drinker, Professor of Physiology and Dean H ar vard School of Public Health; "fodustrial S ? o t ditioning, by Constantin P. Yaglou Assistant ofr 0p?7bi-r m Hyiene> Harvard School D j l 10 Heal,t,hl' TThe Physiological Effects of High Pressures, by Louis A. Shaw, Assistant Pro fessor of Physiology, Harvard School of Public Industrial Operations in Compressed Air, by Ole Singstad, Chief Consulting Engineer on Tunnels, Port of New York Authority WWeeddnneessddaayy--"` CCaarrbboonn MMonnmovxWidoe Poisoning," bv Dr. Cecil K. Drinker; "vO-'cvc^uuririte!inxcLee anda Soifginmifiicance of GaseO AoIuI sO IT mW-l pV Muritie l Y l U , ' sTM ,"ti by 1____YWY T __i_l__lia m P^ . Yant Supervising; Chemist, Health Laboratory Section and Supervising Engineer, Pittsburgh Experiment Station, U. S. Bureau of Mines; "The Toxicology of Organic Vapors and Gases," by Dr. J ohn S F oulger, Haskell Laboratory of In d u strial Toxi ' cology, Wilmington, Delaware; "The Toxic Dusts " by Dr. L awrence T. F ahihall, Assistant P r S o r of Physiology, Harvard School of Public Health. J.H U R S D A Y -- " P n e u m o c o n i o s e s ; ** t ^ a^abion, by P hilip Drinker, Professor of wfaHSi rian iH^giie? ' Harvard School of Public Health, Clinical Aspects, Diagnoses, Prevention," by Dr. W. Irving Clark, Physician to The Norton Company, and Assistant Professor of the Practice of Industrial Medicine, Harvard School of P ublic t*o"ryv,- Harvard Business School. M g u e " Monday--August 24 D R. LAWRENCE J. HENDERSON in sde l iled tb he EffectS of Social Environment,"3 o r ttb,hef dwWhes+teexrnpe^Eleencctericat CthoemHpaanwyt,hoCrhniecaWgo! relation to experimental work during a perioJ five years, piirticuiariy relating to the social? relays dUTb10n " the, manufacture of teleplu { \ Principal results as reported init North W w fb WeJ e P,tviously descnbed by n 8? S . ehe^ ' in The Human Factor (Vcl Pf j p , 1935i- ,Th? ongmal "rest room" wai uunnttiilf 1iq93S2, AwPhbrei1n, Ifo9r21r'eaasnodnsconnottincuoendnetocteodpe! _he experiment, it was abandoned. In ga there was a gain in production for a numb years during this experiment. Lantern st showing the working conditions of these w were exhibited in Dr. Henderson's present" and the minute-to-minute output was measur means of graphs representing these data. A a of weekly output was also shown, and an ave increase in output of 30% was noted. Of pari S L int^ est were the data on correspondent fluctuations in output. "Determinations" w| e similar to mathematical correlations i t : ..... o *h"l+6g*h* 'c.uoirirreasppuounadeence min one uini val of time eexxcceeDptt min tthhpe instance ^of -o-n-e--e--m-p-lo A series of these "determinations" were given graph, showing a complete collapse in these termination relationships four months after'' first observations were made. At a further kite' , J h r e e TM nths ? e best state of integration' loabtsperrvetdin o*f any time in t.h...e...s..e..r.ie--s. Five mmoun dd ePttePrrmm i nl a t+i ndnieffVei renmti pic--tu__re___w___as ^presen.ted. byy"| determinations b ^ u s c a rearrangement of seal nth . al at K-V loi la rn ver Tsit be : ace twa. aps ad an ^ DSi [be "ev ons 1'SI `.V ttbe vce pia eia! orti ace rei Son ; 3y 1 add rta atii p sigi Ire iy to zati Piai r Ion tl [linen real of fsigr . tha Ibbur: b tion p "th atine: tfarr i.roui anre ai tmanv , Ih' veral ^expei ' tant Syone know bysical ` aie a Dnges nd the se ai iwrirnm Vol. 5, No. 11 INDUSTRIAL MEDICINE Page 551 Effects j ird initation, >f Engi: Health; LTON E. Experi- litioning Applica-ONSTAN- . , tal Toxi- : director, 'gy, Wilf Indus* f Indus si, Hart- d School \ idustrial Massay, West Labra- peaking it," first Works ago, in eriod of ial side lephone in this by T. (Vol. 9, vas in operate td with ;eneral, rber of slides women itation, ired by ^ graph iverage >articunee of which were interployee. ;/en by ;e "de er theiterval >n was nonths by the eating Three id five months later another breakdown occurred. In January, 1932, which was 10 months after the last observation, some adjustment was still going on and apparently the individuals had a feeling of resignation rather than progress. The second experimenF'reported by Dr. Henderson was in a bank-wiring room, this experiment having been previously described in a' monograph entitled "Management and The Worker," by F. J. Roethlistberger and W. J. Dickson. The method in this experiment was two-fold, consisting of indirect/ conversational interview and direct observation. The situation here was a little different from that in the relay assembly test room--in the latter in stance the cooperation of management and work ers was at a higher level and the aims of the two groups were apparently in perfect accord.^ In the second experiment reported, however, informal .'organization by the group itself had defeated the purpose of the supervisory organization. No rela tion between the results of the test and the output was evident, and it is from this that the essayist reasons that output is a form of social behavior, lere supervisory control had failed. This, howver, was not due to an insufficiency in the wage >lan because the social considerations outweighed the economic considerations. Scientific selection and placement do not secure corresponding results --social conflict is evident in such instances. An important principle to be kept in mind is the re sistance to too rapid change in environment, and apparently the chief function of informal organi sation among employees is this resistance. Ordi- harily technical organizations are set up favoring rapid changes, and such changes rob the employee of certain things of importance to him in his work. Scientific management has not well appreciated the significance of real social relationships. The good results of the first experiment were due prob ably to the eauilibrium between the technical or ganization and the social organization in the group. Social relationships usually call for more consider ation than economic phases or the psychology of the members of such groups. Should one not know the real sentiments of others in supervising? T he' rate of change apparently is most important, and the significant thing in the Hawthorne experiment' was that the output rose regardless of the number of hours worked or the rest periods given or not given but changed on or from the test of social relationship changes. Dr. Henderson concluded that "the social environment is what sentiments, routines and rituals make it. From the most per fect family in the world take away the sentiments, the routines.' and the rituals, and the residue will be unrelated individuals. No doubt the social en vironment (various social system) of a factory is in many ways less important and far less perfect than the social system of a good family. But in several respects it is the same kind of thing and, as experience shows, it is in several respects im portant enough so that it cannot be neglected bv anyone who wishes to plan wisely, or even merely to know what he is doing. Environment is at once physical, chemical, biological, psychological, eco nomic and sociological. As a rule we have all the strongest feelings about its sociological properties and the least intellectual awareness of them. Often these are the most important properties of the environment. Let us study, weigh, modify and use them." D R. DAVID B. DILL, in speaking on "Fatigue," first cited Viteles' definition of this term-- stating that really fatigue is "a failure to maintain equilibrium." There has been no proof of the real existence of chemical fatigue products, and bore dom is not an explanation of fatigue. Ordinarily the industrial job does not demand a greater in crease in the metabolic rate than three times the normal--the individual can increase his metabolic rate 10 times, so that there is a considerable factor of safety. Fatigue may be muscular or sensory in origin. Stevenson's classification was used, which has first for consideration the accumulation of fatigue substances which have not been scientifi cally demonstrated. In certain experiments in' which subjects were worked on treadmills and the lactic acid measured in the blood, it was found that this existed in certain measurable propor tions, and it was demonstrated that while lactic acid may be used in measuring fatigue, it should not itself be considered the cause of fatigue. On a group of steel workers for instance, the maxi mum amount of lactic acid was 13.1 mgs. per 100 cc. and 8.4 mgs. as a minimum with- an average of 10.3 and a resting base figure of eight to 12 mgs., bringing this picture into a normal fluctuation. The second consideration is the exhaustion of' energy reserves and has especial reference to the reserve of carbohydrates in the body, In a similar group of workers the blood sugar was shown to be a maximum of 142, the minimum 81 and the aver age 103, which shows no significant change. In such workers also no significant amount of acetone was discovered. In heavy industrial work, there fore, carbohydrate depletion is not an important relationship. Laird states that maltose is prob ably effective in avoiding difficulty in this connec tion. Haggard and Greenberg found an increased output after the administration of free meals, but Dr. Dill is not certain that this relationship is a clear one in the avoidance of fatigue, but suspects that there may be some psychological reaction here which was favorable. The third important relationship is the inadequacy of oxygen intake-- this is especially noted in cardiacs or in high alti tudes where it may have some signifiance. Fa tigue in aviators is especially important and may be due to excessive generation of nervous im pulses. There is apparently a very wide difference in individual reactions to extreme altitudes. The fourth important consideration is the alteration of the physico-chemical state, and it was here that Dr. Dill specifically related the Youngstown Sheet & Tube Company's experiments relative to the control of heat exhaustion and heat cramps by the administration of salt in drinking water. The water intake in such men varies greatly--being between three and 10 liters per day per man; on hot jobs a man may drink as much as eight to nine liters per day resulting in considerable salt de pletion; if continued and a return to normal is not reached within a period of several days a break down results. Chemical blood studies of hospital cases showed the occurrence of dehydration and a lowering of the chlorides in the blood to as much as 15%--there was also an increase in the serum quotient and also an increase in the red blood cell count. There has been a great deal of difference in the opinion as to the osmotic pressure but experi ence has shown that a normal osmotic pressure is maintained. An isotonic salt solution is the real Page 552 INDUSTRIAL MEDICINE November/ solution of the cramp problem, and a reference to f l r,` i i t nn^dyn?uWor?t at Youngstwn was made in this regard. There is no support for the theory that should concern itself very definitely with thl havior of different bacterial forms in air. water under a temperature of 50F. is harmful. It has been found for instance, that water at a tem- Pf riaU\re f 46 ,with ^ in Pr Per admixture (1/10 t 1%) gives the desired results. More recently considerable experience has been reported with 21 cases of heat cramps by treating them in the hospital with a level teaspoonful of salt every half hour for three doses with as much water as they cared to drink; these men were able to return to work within the next 24 hours after the adminis tration of the treatment. The relationship of the administration of sodium chloride to exhaustion is not so evident as in cases of heat cramps; it is quite possible that in such instances the difficulty may be due to overtime work and the free con sumption of liquor. The Boulder Dam experience was also detailed briefly by Dr. Dill. In summary, the mechanics of this problem have been discussed but the various factors are mutually independent and so the problem is extremely complicated. WiLLIAM F. WELLS presented the final p on the Monday program, "Bacteria and fen m Air. In reviewing the history of theborne theories it was stated that this had practically abandoned, but within the past; years experiments have shown soine intere LSUr ,, ch w arrant reconsideration of thisi th e Wells centrifuge was described and shown *n eTM slides. Emphasis was placed on the that droplets dry before reaching the ground behave much as the air itself. In air-borne ' tion the drying of matrial and the viabili' forms under these conditions is especially inr tant. Persistence of viability varies extrem from % hour to 96 hours according to the font bacteria. Droplet nuclei from humidifying terns show a very definite association with particles. The droplet nuclei are also found' systems using contaminated water for humi" ing. Illustrations were given by lantern s" D R. WILSON G. SMILLIE prepared the next showing the difference in comparison between subject on "Air-Borne Disease." Pasteur's number of bacteria as cultured from outside experiments and various early theories were'firsatir from the sneezing of various individuals;, detailed in this presentation. Two important meth from clinics and wards, and air from cotton m* ods of procedure stand out in these investigations, cruhse mesasairyibset staukgegnesatesdanthaintdtehxe oaflpthhea csotrnetapmtci"' namely, the experimental method and later the use of the microscope. The spontaneous genera tion of air similar to the way in which the Bacr tion theory was very much emphasized and came Acohdisiscucsosinosnidoerfeadiri-nbotrhnee cinofnetacmtioinnavtieornsuosfcwona11 in for a great deal of discussion. Pasteur set out to investigate this theory and settle it, and he re infection occupied a considerable amount of. peated many experiments of previous investiga spwreesresntthateiornap--id maier-thboodrneof isnpferecatidonofcnearstaoipnhlayi, tors, attracting the attention of Lister relative to antiseptic surgery. Lister was the first to discover geal groups of bacteria. Particular emphasis that the use of carbolic acid sprays in operating. polragcaendismon rdeilsaetaivsees toresmuoltritnaglitfyr,ommonrbasidopithya,rryenp; rooms really had no relation to the occurrence of ' septic changes in surgical operations. The prin able diseases, days spent in bed from respira' ciple of the transmission of disease by water and dtiimseeaseasl,l aonfd walhsiochinrdeussutlrtiaflrodmiseainsefesctciaounsinogf i' by food was the first serious blow to the so-called air-borne theory of disease. The transmission of type. Concerning the effect of ultra-violet li_ disease by insects was also a refutation of this oonf cBoalocnilileussoccoclui,ritinwcausltfuoruensdasthoanteaafpepwroearcmheinsi theory; for instance, the transmission of malaria and yellow fever by various types of mosquitos lamp. A difference in humidity causes a varia1"' served as an illustration. Respiratory disease also hinumthiedibtayc--tetrhioecreidbael ipnogwaerpraencdipdietactreeadsreospwbiethtw" was considered as an air-borne disease--Chapin first showed a restricted radius of transmission as 50 and 55 relative humidity. The best results evidenced by the distance of droplet transmission obtained with high pressure quartz lamps. | and the viability of the infecting agents. More re various experiments during the past few ye* cently there has been an interesting possibility of is apparent that sedimentation and filtration1 psittacosis epidemics being air-borne. Because of mvioolreet erfafedciatitvioenonislamrgoerepaerftfiecclteisveofodnussmt aanllder all these facts it is felt that a reopening of the subject of air-borne infection is timely. As a part tides, particularly those that contain bacteria.! of this presentation the physical properties of sauirmamnaalryys,isthienftohuensdeaetixopnerhiamsebnetesnalnadidofbosresravnai"" gases, dusts, and bacteria in relation to air-borne transmission were considered. Air infection was and the control of air in certain instances--in'; investigated by many different men, among them future a wider application can be made to pr cal problems. -- being successively Pasteur, Tyndall, Michael, Koch, Hess, Franklin, Petrie, Winslow, McDonald, and Wells, the principles being precipitation, filtra tion, and other methods not so well known. In summary, it should be kept in mind that bacteria in air are passive and not active; that dust in the form of spores is important and that human drop lets are also equally significant on certain occa sions; bacteria pollution is higher in dirty rooms and under dry summer conditions and does not depend directly upon air currents for dissemina tion; is heavier in cities. The next research Tuesday--August 25 D R. CECIL K. DRINKER, in speaking on subject ."The Physiological Effects of HTemperatures and Humidities,**made reference high temperatures both inside and outside of,, dustry. Proper consideration should be giveri^ the internal environment of the body whidfwater. The neutrality of the body fluids has a value of 7.3. The hydrogen iron concentration1 be expressed as 0.00000005 N; the hydroxyl centration mav be exnressed no n nnnnniw xr ~ Vol. 5, No. 11 INDUSTRIAL MEDICINE Paye 553 :may be a shift of as much as 0.0000001 N. It may, perature, so that heat-intolerant individuals will ^therefore, be concluded that reactions to heat can not be allowed to take the risk. Such a scheme is not be .wide in range but are protective in type. now working with considerable success in South VWarm bloodedness is certainly a subject of impor African mines. ; tance in considering reactions to temperatures; as | illustrative of this principi differences in the 1temperature charts of infants in conditioned and i1non-condit'ioned nurseries were exhibited. The OLE SINGSTAD, Chief Consulting Engineer on Tunnels, Port of New York Authority, pre sented the subject "Industrial Operations in Com I subject of sweating is also of significance, and f sweating may be either mental or'\thermal in classification. Reference was made particularly "Jo the work of Y. Kuno in his paper on "The Physi- pressed Air." This paper discussed the use of compressed air as an atmospheric medium in which men work below the water level in shaft, tunnel, and foundation construction, and in diving ' ology of Human Respiration." The work of Talbot and Michaelson, at Boulder City, Colorado, was cited particularly in reference to heat cases ex perienced during the work done on the Boulder Dam. Citations were also made in reference to Shattuck's conclusion relative to the heat effects in ".different countries. Approximately 4,000 deaths occurred in this country during the last heat spell in the summer of 1936, so that this constitutes a real problem in public health. The effects of tropi . cal climate are important because of individual developments, and cases were cited to illustrate this principle. The basal metabolism is usually operations. It presented the problems relating to the safety and health of those who are employed in this kind of work, and described the develop ment and extent of the precautionary measures and regulations that are used on the job in the practical solution of these problems. The coopera tion of the medical and engineering professions during the past 30 years or more has produced marked success in the control of compressed air illness, as is evidenced by the record given for 15 subaqueous tunnels constructed in the New York district. Some of the more recent trends in the regulation of compressed air work were also noted. depressed in such instances as compared to a mi nority of cases in which the metabolism has fol lowed a level or has risen. Regular exercise has been found favorable to white men in the tropics. There is a lack of good data and methods of em ployment selection with reference to heat and heat :environment. Humidity and sunlight are relative ly unimportant except as adjuncts to temperature effects. In discussing Dr. Drinker's paper, Dr. Shattuck said that there had been an increase of ;heat effects among the Irish in Massachusetts, and also he made reference to the experience of the British in India. Wednesday--August 26 D R. CECIL K. DRINKER, in discussing the sub ject "Carbon Monoxide," stated in part that the material on this subject was rather selective. This poison is an old one, having been recognized by Claude Bernard. The plasma of the blood car ries little oxygen (0.36 cc. per 100 cc. of blood); while whole blood shows 20 cc. per 100 cc. of blood. The hemoglobin is of great importance to mam mals. A practical point is that complete saturation of the blood occurs at a pressure of 100millimeters of mercury, but at 50 millimeters pressure the blood is 80% saturated--this fact having great C ONSTANTIN P. YAGLOU, of the Harvard significance in observing phenomena at high alti School of Public Health, in presenting the tudes. The ability to take up oxygen depends subject "Industrial Air Conditioning," stated thatu.,pon the partial pressures of oxygen in the en factory work is generally known to lower vitality, vironment. The influence of carbon dioxide and increase susceptibility to disease and reduce the incidentally carbon monoxide is most important span of life. Aside from toxic dusts and gases, in affecting the power of the blood to take up oxy which are taken up in other papers, two other seri gen and in this connection the rationality of the ous hazards are recognized; intense heat and sud- oxygen-carbon dioxide treatment of carbon mon den changes in temperature. The first part of the oxide asphyxiation was discussed. There is an paper dealt with the chief occupational diseases increase in the number of red blood cells when , in hot and cold trades, and the effects of abnormal breathing pure carbon monoxide; in actual prac air conditions on accidents, efficient working ca- tice there may be a decrease or an increase, the pacity, sickness and mortality. Evidence was pre decrease being due to contamination by benzolsented in tables and charts showing direct rela containing substances. Splenic contraction forces tionship between severity of exposure to abnormal new red blood cell forms into the circulation. air conditions and degree of unfavorable response, There can be no doubt that an anemia accompanies as manifested in increased morbidity, mortality, carbon monoxide effects, but it certainly is not of , and accident liability, and decreased working ca the pernicious type. The acute effects of carbon pacity. In the control of acute and chronic haz monoxide are not commonly observed except ex . ards resulting from excessive heat or cold, venti perimentally. Haldane has given the most graphic lation and air conditioning methods are not always description of his own personal experience in the ;effective, and they should be superseded by medi breathing of carbon monoxide in various amounts, cal methods. Much has been accomplished by the. and charted his symptoms at different saturations industrial physician in decreasing sensitivity to corresponding to different intervals of time. The external heat by prophylactic methods applied to characteristic finding is weakness in the legs; an ' the worker, by control of fatigue and alcoholic increase in breathing begins at a saturation of ^habits, and by periodic examination of the work about 30%. Sudden exposure to large amounts of ers for detecting early symptoms and instituting carbon monoxide provides a rational basis for the prompt remedial measures. Still greater possibili- administration of oxygen and artificial respira J ties seem to lie in the selection and gradual adapta- tion. The headache which is one of the character- Page 55,4 INDUSTRIAL MEDICINE Novemberp of carbon monoxide over long periods-of time pro vides a rational basis for oxygen and carbon di oxide. In acute cases of poisoning there are vas cular changes m the central nervous system, with nerve cell damage shown in different parts of the bram; however, the spinal cord may also be af fected. Few survive to show sequelae. In the experience of the New York Consolidated Gas Company in the establishment of emergency sta tions, 21,000 cases have been gathered since 1926. In mental hospitals having 81,000 cases in 10 years there were 39 cases which were seen which were due directly to carbon monoxide exposure: to these were added four others later, of these 43 cases 10 strumental in forming approval regulations! gas appliances which have had some influe the prevention of carbon monoxide poise Carbon monoxide still is produced in conside quantities around blast furnaces and in.someSu ers sulphur dioxide is a by-product occurring,! frequent regularity. Of the chemical confa nants of air, refrigerants and fumigants are off siderable significance. In closing, Mr. Yant i that he would name the gaseous impurity ha m order as follows: low oxygen; carbon oxide; hydrogen sulphide; the oxides of nit and sulphur dioxide. showed no neurological signs and 10 died before neurological examination was possible. It is sig nificant that over this period of years there have been observed no neurological signs except in in stances of history of unconsciousness. There seems to exist a lucid period of seven to 21 days in all instances. Neurological sequelae may or may not be permanent in any instance. Inhalation treat ment was started in 1921. It has been amply dem onstrated that there have been fewer deaths in the New York experience after the adoption of 7% carbon dioxide oxygen mixture. Methylene blue is distinctly contra-indicated as the treatm ent of carbon monoxide poisoning, and there have been some cases of untoward results reported from the f15 / cinaily. i<: is to be especially kept m . mind that artificial respiration should be ad ministered m all cases where the breathing is D R. JOHN S. FOULGER, of The Haskell i oratory of -Industrial Toxicology, Will ton, Delaware, read the next paper on "The' cology of Organic Vapors and Gases." The creasing use of solvents and of "vapor pha actions is making the hazard from toxic'x and gases one of the most important in inHiy, medicine. The lack of odor and invisibilit vapors, their ability to penetrate clothing anc condense on^ moist surfaces, make exposure! ticularly insidious. Their major route of ah tion into the body, through the lungs, allov rapid distribution to all tissues and especiaL the central nervous system and the heart. knowledge of the toxicology of organic vap scanty. Methods of air sampling and of detea and estimation of individual vapors are not:^j developed. The pathology of the central ner system in cases of industrial poisoning is pr* W j 'cMILmLI.eiA-MPrPe.seYnAteNdT,thoef sthuebjeUc.t S".OBcucruerareuncoef tvnA<f!5mfiCanCe of Gaseous Impurities." Many types of gases are to be found in industrial rela- T S T '?Uch as the man-made gases, gases which ^ ade in C00Peratin with nature, gases result ing from chemical and metallurgical processes tfw m cmbustion. In 1777 Cavendish es tablished the constituents of normal atmosphere and this computation is still used at the present day; the impurities are of relatively little moment m normal atmosphere. Marsh gas is f o u n d ^ e ^ : cally unexplored. Because of this lack of infon tion all vapors or gases should be considered! until proved otherwise. All containers and 1 ratus should be handled with care. Broken ft lines and tanks should be approached onlra workers protected with suitable gas masksa gloves. At all times cleanliness of workers a their clothes is essential in prevention of expo Immediate treatm ent of exposed workers mua given carefully, always remembering that pul nary edema, which frequently follows expos ' irritant vapors and gases, may also be causTM improper use of manual methods of artificial! uutteeddr. e,HHyvdHror^grebn0nsulphide eixsisatlssoaswaidneliymdpoisrttrainbt stratum gas and is of particular importance in ffacoc 6Um actlvlties. In the coal mining industry gases are of great importance; marsh gas is evolved piration. Because many toxic vapors have.j layed action, complete rest and continued mei observation are essential for 24 to 48 hours i exposure. " in great amounts and also contamination from ex plosives occurs, the U. S. Bureau of Mines having approval regulations to minimize difficulty from this contamination. Oxygen deficiency forms one of the important problems in mines. In considermg sewage gases, marsh gas and water are formed and these substances occur also in silos and holds of ships In manhole gas problems, explosions are due probably to leaks of gas as shown in the Boston experience. In gases which are the result of com bustion, there is still a great controversy as to the mechanics of burning carbon and hydrogen com pounds. In any kind of combustion, the lack of oxygen makes for the greatest development of carbon monoxide. It is estimated that 50 billion tons ot carbon monoxide are produced every year from automobile engines, which has led to the determination showing that there will be one part of carbon monoxide in 10,000 parts of air 1000 v ears tipnnp TVio Pi irnon ni T\/Ti ~ T__ l .___ , D R, LAWRENCE T. FAIRHALL, Professor of Physiology, Harvard Schol public Health, discussed the subject "The Tf Dusts." There is considerable overlapping iri| physical 'states of dusts, fumes, and gases.);" susceptibility of individuals is a consideratio this subject. Particle size is of relative unir tance except in the case of silica dust. Va types of metallic and other dusts were class Lead poisoning is on the wane but still is ant portant subject of control. Arsene is the most; portant derivative of arsenic from a toxieolq standpoint. Antimony poisoning is somewh in industry. Mercury in vapor form is of ti erable importance, although in hatters me poisoning has occurred from other forms, v coal w ith 5% of iodine has been suggested canister adsorbent of mercury vapor. Toxic? cally manganese and zinc are somewhat - * te>. net Hy lie; c ie See 1-a. ice pise ,t Ipor. ; o at a: Hoc; fbas ion ati |dy Inrsd >RO 13-var of tt'ctioi ;ar . as Bused Irad tide iinha action last . Silici 1th . me tttent ' the i list fui, re is Kthe r< silic aerai e I,a ch; lical talc ladden ; mine ,1 marb huge c at gyps lend, event e. P.limesto nee was ) i publi; ayed. i tig ma |e. compu i such ye dd and 1 dato ha i "dust flo er, 1936 ` V ol. 5, No. 11 INDUSTRIAL MEDICINE Page 555 ons for in exposed persons. Spectroscopy is an important real practical value--such as from 0 to 5, 10 to 20, lence in examination procedure in establishing harmful etc. As a standard of conversion between the isonmg. concentrations of substances which are toxicologi gravimetric and volumetric analyses of dust con iderable cally significant. There are some of the alloys centrations, the equivalent of one milligram being e sifielt- . which are of great importance. Cadmium salts equal to three million particles was proposed. The ing with are of great toxicological significance and have original work done by Lanza in 1914-15 on Joplin iontami- been increasing in commercial use, (reference was lead and zinc mine workers in which gravimetric e of con made to Prodan's w ork). Chromium is of impor analyses were used is still authoritative and valid. it stated tance largely in the form of dusts and chromates Especial emphasis was placed on size grading when hazards' and as vapors emanating from plating tanks. The estimating the quartz content of rafter samples. , on mon- toxicology of organic compounds in dust form is A method which is found to be of practical value is litrogen, not so certain at the present time, and it may be the petrographic analysis of the original material said to be important from the point of view of and a chemical analysis on rafter samples, check vapors and gases which are coincident with the ing back. Of considerable significance was a cell Lab- dust of such organic compounds. It is usually not graph showing the reduction in the occurrence of Vilming- recognized -that sampling methods are as impor tuberculosis as dust control was accomplished, 'he Toxi- ta n t as analytical methods. Emphasis was placed based on South African experiences. The in on local and general effects in regard to toxicologi hase" r e - . cal basis of different types of substances. The defi R. W. IRVING CLARK spoke on "Clinical D c vapors nition of effects is more difficult in quality than in Aspects, Diagnoses, and Prevention of the ndustrial quantity. There is much more to be done in the Pneumoconioses." Pneumoconiosis is a disease of ibility of study of absorption and transportation of toxic the lung resulting solely from the inhalation of ig and to dusts in the human organism. dust. There are a large number of inorganic dusts sure par>f absorp- Thursday--August 27 which will produce slight fibrosis of the lung de- . tectable by x-ray, but not producing functional allows of ROFESSOR PHILIP DRINKER, of the Har disability. These are called inert dusts. There P ecially to vard School of Public Health discussed "Causa are two active dusts which produce disability. art. Our tion of Pneumoconioses." Four different types ofThese dusts are those of free silica and of asbestos. vapors is reaction are produced by the inhalation of dust-- The pathology of silicosis is characterized by the detection first, and most important, are the pneumoconioses, presence of fibrotic nodules scattered through the ! not well such as silicosis and asbestosis--second, reactions lower two-thirds of both lungs. The pathology of tl nervous caused by the toxic dusts such as lead, cadmium asbestosis is characterized by an interstitial is practi- and radium--third, the inhalation of metallic fume fibrosis involving the lower half of both lungs. f informa- particles known as. metal fume fever--and fourth, The symptoms of silicosis and asbestosis are ered toxic the inhalation of organic dusts constituting allergic similar, the most important symptom being dys and appa-j reactions. Definitions of silicosis were referred to, pnea. oken pipe such as those devised by the International Congress I only by on Silicosis at Johannesburg, the American Public HEODORE F. HATCH discussed "Design of T nasks and Health Association, Sayers and Jones, and Edgar Exhaust Hoods for Dust-Control Systems." cers and of Collis. i A lantern slide graph showed the tubercu Dispersion of microscopic dust particles away from i exposure, losis mortality directly proportionate to quartz a dust-producing machine depends upon the move rs must be content ,of inhaled dust. Hardness and inertness ment of the air into which the particles are thrown oat pulmo- are the important properties of free silica dust. A and is not dependent upon their mass or the veloc -xposure to chemist would not suspect silicon dioxide as being ity with which they are projected. Consequently, caused by harmful, according to its chemical properties. the function of the exhaust hood is to overcome the tificial res- There is no comparative toxicity table available outward movement of dust-laden air (and draw it - 5 have de on the relative potencies of the various forms of into the hood) and not to separate the dust from ed medical free silica. Tables were exhibited showing the air in which it is suspended. The problem prop hours after; mineral composition of a typical granite dust, and erly involves two steps: first, eliminate or reduce also a chemical analysis of the same sample. The as much as possible all air movement in the zone Chemical relationship between sericite, asbestos of dust production; second, select the proper shape , Assistant and talc was shown. The work of Cummins and of hood and locate it to operate with maximum 1 School of Sladden and the U. S. Public Health Service on efficiency and determine the minimum rate of air `The Toxic coal miners was compared. Limestone, dolomite flow through it necessary to draw all dust-laden ping in the and marble are all soluble dusts and are tolerable air into the exhaust system. Some simple rules gases. The in huge concentrations. It has also been shown of procedure and elementary equations for cal ideration in that gypsum dust is not relatively harmful. Re culating the desired rate of air flow were given, re unimpor- commendations for rock dusting in coal mines to although the experimental determination of the st. Various prevent explosion have officially included the use latter Under actual working conditions was re e classified, of limestone, dolomite and gypsum dusts. Refer commended as the most satisfactory means of es ill is an im- ence was made to Zenker's original work on sider- tablishing the necessary capacity of the exhaust he most im- osis published in 1867, and the volume was dis system. oxicologlcal played. A tab u latio n of com parative exposures newhat rare during many years on different occupations and R. CARLTON E. BROWN, of the U. S. Bureau D is of consid the computations of the approximate exposure for of Mines, spoke on "Protective Equipment." ers mercury all such years according to the method of Bloom- There has been a confusion in the terminology of >rms. Char# |field and Dallavalle were demonstrated. Mavro- respiratory protective apparatus. Dr. Brown's ggested as a gordato has referred especially to what are known classification of using the word respirator to ap Toxicologi- as "dust floods." It is especially to be remembered ply to all types of protective apparatus was il lat unimpor- when reporting dust concentrations that nothing lustrated. Atmospheres in which protection is Page 556 INDUSTRIAL MEDICINE November contaminated by objectionable or irrespirable gases or vapors, those contaminated by particulate matter, and finally, combinations of these. Types of service which protective equipment is capable of rendering were classified as continuous, inter mittent, and routine. The various approval sched ules in effect at the present time as devised by the Bureau of Mines were described. Schedule 21 especially designed for the approval of the efe ficiency of mechanical filter respirators was dis cussed in detail. The requirements of a good res pirator include adequate protection, reasonable comfort while wearing and a reasonable service period. practical at the present time. Low concentra odors can be dealt with by passage of the;: through activated charcoal, but this is not, d on an extensive basis at present. There has no progress in tobacco smoke odor control, washing problems ordinarily accentuate thisf ficulty. Body odor intensity is related to r culation of air, as shown by platted grap' introduced by Yaglou. The old standard of 30, 50 cubic feet per minute should be changed to} to 500. Air movement ordinarily ranges in : instances from seven to 25 feet per minute."~ crease in ionization occurs indirectly with then* ber of persons involved--this has no known sig? PFriday--August 28 cance at present. The commercial applicatio humidifying shows a gain in the weight of van ROFESSOR PHILIP DRINKER discussed types of substances. It has been demonstra "The Application of Air Conditioning in Nor that the control of acidity or alkalinity of air,* mal Life." Distinction was made between venbe a definite preventive of deterioration of pa-" tilation and air conditioning, the former meaning and bindings. Practical experience seems to} merely to change the air, whereas air conditioning dicate that it is better to control the wash wa changes the physical properties in the air. The in an air conditioning system than to pass the: real objective of air conditioning is comfort, and through a deodorant. Air conditioning can be the lay estimate of real air conditioning is comfort vocated on the basis of comfort. There are- at the present time. The factors which should be adequate data at the present time relative known in any problem are the temperature, the health effects. " relative humidity, air movement, carbon dioxide content, odor intensity, dustiness, and finally th' degree of ionization. All of these are measurable except odor intensity. The physiological require ments are much easier to satisfy than the so- called psychological requirements. To fulfill the requirements of air conditioning, the human being is treated as an object--giving off a measured amount of carbon monoxide and using a measured amount of oxygen and radiating heat. Reference was made to the Handbook of Ventilating Engin eers regarding data on air conditioning as being a valuable reference. The comfort zone as worked out by Yaglou was demonstrated--worked out on the basis of a low air velocity corresponding to 15 to 25 feet per minute and using the convection form of heating. The so-called "effective tempera ture" scales have been based on comfort and opin ion of experimental subjects. Acclimatization is . of considerable importance in theatre air condi tioning, and the differences between the inside and outside temperatures should not be great enough to cause discomfort. Graphic data have been platted on this subject for reference, and pertain to application to exposures of less than three hours. Reference was made particularly to differences between British and American cus toms, which were explained on the basis of dif ferences in weight of clothing. For outdoor weather, equipment must be provided on an "ex tremes" basis since a difference of 60 variation in diurnal temperature is not infrequent. Con vection is the principle here. Data on the effects of cold walls were given in the form of a chart. Dust and bacteria are not important problems in air conditioning. Pollen removal is obviously im portant to certain people. Ordinary bacteria are not taken out in air conditioning. Odor is an old problem, in which we are concerned with body odors, which are somewhat soluble, gases from outside sources, particularly manufacturing, and organic odors which are not water-soluble. All such problems can be treated by oxidizing the odors with agents such as chlorine or ozone, but the excess of the oxidizing agent is the real prob lem. The use of ozone for recirculation is not C ONSTANTIN P. YAGLOU discussed Application of Air Conditioning to Hospi This is a different problem from air conditio s in schools, offices, or theatres. Cooling is * accomplished by portable room coolers--here a ficulty is encountered on account of the small of many rooms in hospitals and, therefore, i t } good procedure to put the apparatus under?, bed. The experiments were done in'this worlc1 premature nurseries, in the giving of anesth* in the use of oxygen chambers, in the treatment hay fever and asthma* and in the case of the plication of fever therapy. In experimental in premature nurseries, it is important to main a constant temperature and a relative humi of 65%. With such conditions the gastro-inte al mortality was decreased. The criteria on w the results of these experimental data were fin. judged were stability of body temperature;.: creased weight; decrease of the gastro-intes'/' syndromes, and decreased mortality. The pn lem is to maintain high humidity--approxima 65%--but the comfort of doctors and nurses be considered. The temperature is not so im. ant, but infants must be kept warm continuer The problem of administering gas anesthesia the control of static electricity. The answer: this problem is proper humidity control. The erican Medical Association figures that 60% be safely and economically used. With this is an air exchange of 10 to 15 times per hour, problem of air conditioning may also be ap to the x-ray room. Sterilizing rooms should treated by exhaust ventilation. Postopera' wards also find this an advantage. In o~ chambers temperature and humidity can be trolled within fair limits. The optimum tem, ture here is 60 to 65, with a relative humidi 25 to 40 and an oxygen concentration of 60%. Slides were shown with a cross-sec1' oxygen chamber and a flow sheet of test__ tions. Allergy in relation to hay fever can} controlled by two methods, by desensitization by air conditioning. This condition is accompl ed chiefly by filtration with a temperature of 7Q Vol. 5, No. 11 \ INDUSTRIAL MEDICINE Page 557 80 and a relative humidity under 65%. Small filter units for the purpose of controlling allergic : reactions are now available on the market. In : fever therapy, Walker's experimental work was cited relative to the destruction of cancerous tis sue. There is a different application in this field. It may be the patient and not the disease that should be treated in relation to air conditioning. WARREN A. COOK, Chief Industrial Hygien ist, State Department of Health, Hartford, Connecticut, presented the subject, "A Laboratory of Industrial Hygiene." The design and equip ment of a laboratory of industrial hygiene must be well adapted to the function it is to serve in occupational disease control. The purpose of the laboratory cannot be fullfilled, no matter how complete the physical appointments may be, un DR. W. F. von OETTINGEN presented the sub ject "A Laboratory of Industrial Toxicol , ogy." Industrial medicine, like the control of ' tafiious diseases, forms part of the large field of ' preventive medicine. The impressive success gained in the field of prevention of infectious dis eases which resulted in the control of such dis eases as cholera, typhoid, typhus, plague, and diphtheria, was only possible after their cause : had been discovered and their action had been *elucidated. Industrial medicine is still hampered i in its success by the considerable lack of informa tion regarding the cause of industrial poisonings and especially with regard to the mechanism o action of numerous chemical compounds, lh is handicap becomes more serious m view of the steadily increasing number of chemicals ot the most diversified nature being constantly produced , by the chemical industry all over the world. In ' order to give the industrial physician all the m- less it is manned by a staff trained in making the necessary determinations, in conducting field csotnudies, and in interpreting the results. Qualifi cations for such personnel are briefly discussed by Gray in a paper which also presents the place oc cupied by the laboratory in relation to the entire occupational disease control organization. An ex tensive experience in coping with occupational dis ease problems has conclusively demonstrated the vital importance of a well designed and well equip ped industrial hygiene laboratory. The essentials in the design of an industrial hygiene laboratory have been presented, together with a description of the laboratory from which this paper was con tributed. General types of equipment for the industrial hygiene laboratory were discussed, both for field and laboratory operations. Equipment for specific determinations of dusts, metals and metalloids, organic solvents, vapors, gases and illumination were briefly described. " formation necessary for the prevention, early de V., tection and treatment of poisonings, it is not sul ' ficient to determine the toxicity of chemical com The Injured Workman pounds and to elucidate the toxicological symp toms which may be observed under different con ditions, but it is more essential to establish the pathological-changes in the different organs and to study the effect of such substances on the --Methods of Handling to Get Him Back on the Joh-- B y N eil E. E ckelberry, M.D., Surgeon-in-Charge, Medical Department, metabolism and their fate in the organism, be Consolidated Edison Co., Inc., and Affiliated cause it is frequently not the compound proper Companies, New York City but its oxidation or split products which produce the deleterious effect. For these reasons the lab oratory of industrial toxicology has to be com posed of three departments, toxicology, pathology, and bio-chemistry, which work together m close collaboration. The arrangement of a laboratory of industrial toxicology was discussed, and the ; lecture was illustrated by lantern slides. In the discussion also a number of special arrangements were included which have been developed for ` certain specific purposes, such as the production ot constant, high dilutions of vapors and toxic gases, of droplets, and of fine suspensions of solids m air It was pointed out that the complexity of the problems in industrial toxicology requires a study from different angles by men who have had special training in their line, and for this reason it does not appear advisable to set up small units for the study of such questions because these would necessarily suffer from lack of facilities and of the necessary diversified staff. It appears to be more reasonable that small concerns of similar interest collaborate in establishing and manitaining such a laboratory, which would result m a more complete and more detailed knowledge of the toxicological properties of chemical com pounds and their potential dangers Without such knowledge, industrial medicine will be hampered , in its progress, and only after these foundations - -^ i _*j t_nf those con- sentGcl. There I CANNOT resist the temptation to emphasize the keynote of the Safety Congress by re minding you that the best method of getting a man back to work is the prevention of his in jury. * However, until we reach that Utopia of human perfection, the problem of getting the injured back to work is an important and serious one. While accident prevention methods have markedly decreased the number of those tempo rarily or permanently incapacitated, the problem once the injury has occurred is fully as important as prevention, as far as that particular individual is concerned. In discussing the subject, it is understood that the broader viewpoint is taken, i.e., not only m returning the man to work but also getting him back in the best possible status. The question should not be "how soon did you get him back, but how well did you get him back." Have you given him the best possible opportunity for the pursuit of happiness, gainful employment and economic independence as regards himself, his family, industry and society as a whole? This of course must be gauged by the inherent capabil ities possessed by the individual before the ac cident. , . ,^ , Before any method can be devised, there must b-e a, thorou-gh understanding of the problem pre-