Document MMOO8V4a2mRwBD8z7zedVRDak

G o Q. ; r\- ^ S'' C<;-75X3iWED1^^ MORNING SESSION o October!?, 1940 " 1& ne^^m :Onptk^ Disease, F-nginwfing Department, . Aetna planned ^M.\aTIaDeI;'..IXMi^Bli^' was 'stalled * Casualty Surety Company,; Hartford, border by the Chairman/Walter S.Paine, Conn., whopresided. . > ; Panel Discussion CHAIRMAN, PAINE: At every inerting : Considered as Industrial Injuries ?" This that Ihave attended in thif^pongress some- , wBlbe handled by H. AuNdson, Director onehairnused theqoestkm ofinbistrial dis- Workmmeenn's Co. m.pensation De_partment, - eas^;.tidi. =li*5Mtitc-whkdi^Iias ' been Wisconsin Industrial Commission of Mad- nraligncd in somc cases and has buna $* Ison. tasy vpn;,die;;;pi^Cbf'!otfiers...Tls horwever, - We all. regret thatrsevere illness keeps (Should iid^iB;iqr wiy destroy me realities.- Dr. Panhi Brdnn, Snpervisor ; of Industrial dot are badcofthe industrial disease prohr Hygiene Unit; of Wiscohsin State Board of - Health at Madison, from bring present " .. In the discasaon of this broad probfenv wS have idod the medical profession and the law to m Each phase of the prob^ ynR^ ^qnsed on an or derly ta^:;;\il(e';babe:'bs^niBd as'-the first The. panel will. be-:, opened on; "Health Hazards in Spray Painting." Dr. Walsh. 's\ .0 $> SprayTainting ope of the Aftpr lif basfinished "his preamble, wewill ask tbe members on the floor jd presentanyqnestion they mayy " ................... .. :.e. .V T: . * V ' *' ; DR. EUGENEWAI^H:Painting is a ,,jtopic. 'fii^;-h^^itc^v^:.'<Bq^dabie'; atten1 ttnn - TlKre has ;heen;an increasing number" of hazardsvmgWjbriPinhv/ the, trade. Most ____ .. of - these have. reonvei.vri 'paf- nbwmg^jects,febcdis- -...'fiadbi^^m^^^p^'Tew.' jieart It-hasbeen cussed: "Health Hazardsin 5pray;Paint- ^modern to me wide nse offhe-spray ing:" Drv Edgehei'Walsh,Assodate Super and bf thelacqoervpartiailarly. Many.of visor,' ofMedkal Harvester Company, CSheir.cv.ai.cg.eo.*,.-.wTniltleornpeantibtahaisl- - jthnedsfoclvjreinytshaan;d&P4romduSct^s^' nsed;in the paint subject <> in'the experinwiital stag^, so f^ as dse and . "Fatigue ahd lts Relation to Ooap&nl so far: as theif: hazards ta> health are con - Disea^^ ra taken op by Dir.-N9bdt EruCr,;!lXrector of /Lahora- torks,Moont cerned. ^ (. -ov; .i . In the. cjd dayS; of brndi or dip or flow psaintia^-'isC31r.yim^(^::tBSp^];i^dhben^ip{ rather *The.Toa^timits bf Common'Solvents." ' low volatihty ware onplbyei -and the, T&swbjec^ ."'by eDr, -' - ard^assodot^ljdiacd^^yra^ii^ Ekton L. Belknap, oCMilwankee. , V" . However, when w ebme:^ fee spray gun, *SsiProwM^ Dr, Bd* partknlariy in its pse jn "the knap -will almhandlejthissabject .op^b hiinjtdersi we esaow .... . fSfcm;'^A&Sotisf--'T^:';'mll.;' behandled '<$ishnts;'-..' - byDr. M. J.' Rtoter,; Ddtoatpk&ist and Thequantities- used; ^S^h3ologi5^ d^ and >tolydiitil-:m;;::]flib' * .: Tbei IastI bdt dne of d^ most imprnt^ Uhi^d - Stat^ reach^^^;^ wfflj be "SMMiOcciipatidhal Diseases^ Be flops.'Mtoyrn>a^.toiK.anea^ prw;:^ O 166 29th National Safety 'Congress In the paints w0hav0^fdHbw**& late aids: first, tbepigments.^ . l are nsed to snake growing trend `definitetyaway . apaitt;ba^lp5^- " '\ ns tHaBridcntyy.,rie.s_o7 lt- bearing pigme^'toward^rio^Iesidi^tnints.' Many of the wi.%_,, .... V_L peculiar hazards. Jifsugr- of rtiwn -are'rela-' lively innocnons and can be nsed witfa rela tive immunity'. ':} /'-A'/.- .'.y .'V /A '-'.S, ; .'oiie-jWBs'i;t&TO^5-"if ifi So far, as the fluid oonstitiienfs ofpaints larminplc^,:^ are concerned, m the qrderof yrfatiHty in ^ . -q^Tg^aArii^ ` __. general, m teinC1 ^ o- r+ something'bfJtt^natiOTi^jnStito. l\Iff-eea-vk,"ir ^ are, largely, for paints;; tbe .panaffins, oils and varnish; varnishAsrith some turpentine :. .The methods of contrcd are;. Hirst, die. or some spirits of varions and snndryM^pes. - The lower the voiatilityr;qfawansji if-it is' we^rbbrtiqoed' ingettingawayfrora lead- ' a toxic product; the greate'die^ The ordinary paints iini ki^as^u be; considered togethabecaasetlttp^ of the solvents,-, largely, is wbat W wirii .to deal with. Tte srfvoBfe nsrf aie rdrtivdy low boiling products .wbichyr^^ ily, snch as acboi^-4^ uWy--s-Aet-u**u.-1j ^ _ . vidqpmg^ pigmienbaM.; ri^ A;,;7' 1-!: acetate, amyl acetate;and, so forth., *'.. V. Aixmier >^ctpr that has been coRsidded / Next, die . paint most have a diliimL, In and is of importance today, m reducing the ordinary paints--oils, turpentine or spints taxiaty^is ;the. 'mbdian*Md;tde^^tnhpt''/^r - may be used. In ''the iacqners~aloc4k>l, toluol, xylol, mineral spiritshave beenused. fancy, no. precautions -^srere;;taken. The - en- , . In the past, benzol wais hsed.' We areglad guiCOT wcrcaT ptnicttiiny^ffliwittfl iq; it to say that there b a growing .trend away A ;n^;'wuldf^iraiy,;wifli^^^brraw>mi' from the nse of benzol, which has cumula spies^'ilm'^Mbtt^ iKpatkToday.. " tive actions in die human individual, result - however, widi ; die^dmikipihent ) of tower ing in the low1 grade chronic toxidties due - prtsmxevqjmiy. jpuu,' ;vriA,^;deyefepn^, to a depression of die block^fbrnuhg organs.. of engineering methods of bmdbrol of.vapbn . There is a. definite trend toward, less fterie and fumesanddnsts iadenttbtheprooes% diluents. , -' - i . The nett essential part of die lacquers, tor we bavelesstottcdy. ' " r. If an indivkhial cwp^ai^ is a!^ in ob* . eludes the driers; such as ethyl bictate or* servisgandcohtronmgthe^te present;' ceUasolve, monomethyl ethers and various very little in . other chemical prodncts; of known. * j'3 processes. .This'.includa^`.'o^;bcufse,'tfae known toxidties. Aly tl^\ anitf 1^3? ^..sitidsniy ;pi^pda^^.fl^mdb^d^'- e^- flexilizer or asobsiahee giving flow to the wnci A WNaUc Qt.|Dft iPOii8in>i-ny&iciii5t ifl.- plastic These am'hdadv^ldsdr^nMEnglpw- } the dagihee^sjph^ ,;.. volatility products;' triphenylpliaspbati; cas-; tor oil, camphorand others, again of known ' gmeermgmediodsare rutfearihletocontrol . and nnknown toxicity. ; The toxidties of the various individual ;OtJh*lV.erKvrUl,aS; ^UWd>-r1s-*i-w!-'i**a**-i1t'Lc'iw<^*J>*- <y?>r*1 . `:V- products are oftm .known. It is not the toxiaty of the pure product, however, that ,, we axe.often concerned with. lt is the product whidt is used commerdalty. It is offcn action, sotpro.ljinjffli tiyS;jn69pii]Si|Mi^ the impurities inminuteqnanifitics that: add * fo-the toxiaty. For; example; vre{my;^- tbereis, in tbecase of xytol, stoat question . major.jp<w^Jl)p>3w^%^^ as to its inherent toxjdtyjfHdweve^ rgnfesfipttS&C?. pursnetiiis J(i 1 benzol is so frequenttya coatanrinant,_we r do have some benzol bmdty to Be ootaid- , be;carried^ frbni dw alsb-from A';;- ;:j * Ct Occupational Disease ! iMaQr'w;prpceed1' ` show on' the>s^rs|y;Mo&>v0^^^ 167( are'; : dnnnie brofat^ painty *T::Ae ;sol- m<Mnff a--^W;<Mf>}>',HhA^<ii^r?iiiit.- Vents.'.'''/';::i''-'.`;" .:vV-?-14t;i.'.',*,T; ,,' F*'i4Lii\ 'jf :' .y.>. ___ _ .[^n^biSe:^i'fa^eiCji^ieiBV''an3r-r9DanaaL'- " If Hkdohe,^ and Antiao^^-1*^7gi^'to;.ti^.`fiict?.. - :tne process -;to,,coosttme aiy;; length of : - : -D- RwW-.-.AI.i*B..'*-T*:^ 'ttig -ffo r^in^jfl^^wwi|^i^iiiiiected_:- ja' it is ^gasoline. The*traight paraffin' dOs.may ire* ../. strit-insomeberizbl:^ a > "-XJjNty*tg*^rwtUidol/wt4to't.e.'e:co&idM(&>1lhi ' instances it liM beensaidtonm as high as ROBERT Bf.^BURNS Afinncjota 10 pier cent in certttinigasoHnei, That Is not theremetbbdjbyx-W from :*. >;' vii--. . - ..". ^jiti niinii jn tte^JriuT regqwy^wwcjK^ ms sotne^ronc prop*^ 29th National Safety Congress buy protection of the supplied air type; sup diluents used in the lacquers which we are plied also with a darcoal camster 'at the now employing- The.process isvety much., man's waist, so dat ute -he-breaks the foe-same. .- ;v.:- connection temporarily to go backinthe Thoe has.been;sdcoe/dtamge intbe.feugth room, he still las the protection of the char- of time iequired. to diy tiiese lacquers^ but;. coal camster. The connection/ when broken, foe constituents arethe same as they were. automatically.shots off both the air supply W.^JKRA^ O'. and alsotbe air.cotmection, so that he cannot breathe theroom air. . Company, WestAJKs;WisJ^ been recent cfo^ga in;reg^rd to thediluents 0 MR. WALSH: That.certainly is a fine used .m paint.Qmton few of the largeroil arrangement. companies are nov^rofokang hydrogenated DR. ALICE HAMILTON (Division of naphtha. Therio contain considerable Labor Standards, U. S. Department- of quantities, of bermd and tbluol.1 wonder if Labor, Washington, D. C): In foe Division there had been any experiments made wifo of Labor.-Standards in Washington some regardtothe tratidties? - two or three years ago, when .I was visit ing automobile plants; I wastold theywere BearolFroumedHpon making a change in their coatings. I wonder whether that has .proved to .be true? They DR WALSH: I should have mentioned, told .me they were, substituting synthetic when we were spealtingof toxkitiesofsol- . resins for. nitrocellulose and. as a solvent ventvthat tiw mecal professkin frowns were using hydrogenated petroleum prod-. tq tie im f fttiiiil iu. a idvut or Sr nets which had very low volatility. It li^tmanyproportion.Wejustdon't Mi seemed as if that were going to be a revo beoaol, regardless.of'Sts perccntagc/'hecimse lution in coating in antomobBc factories. I it is so ea9^fov^^^':of';foii^\'^'':'foe; - should.like very modi to know whether that chronic effects.of;its -poisoning'iCoroe"on so change has been made. slowly i^?|o:'inKao^ -tp. CHAIRMAN PAINE:. Can anyone an swer the question of Dr. Hamilton? DR. WALSH: I would like to say to Dr. Hamilton concerning the substitution of synthetic resins for mtrocdlnlose products in the automotive industry particularly, most of us receive all qf our information concerning the newcrdcvclopmcntof haz on you beforeyon.know iL It itquiies rather . dose observation;wberejrer there is any benzol or toinoL ' So far 'as.the hydrogenated naphthas are - concerned, it bas-bm;.s^.;tfof}foe;hytirbr genation doesnotchange foe strnc- tureof foenaphtla^ and it does not increase, particularly, its tooriaty.il it isihrriativdy ards from no person.other titan Alice Ham-' ilton. If anyone in the roomcan answer the there is'the prpblem pf tiie tpxicities question, I am sure that she can. Sbe beau- inherent tbthe hydrogenated naphtha itself. tifully reviewed theentire !iteraturerin a But we 'would much prefer not tbseebeh- pnMication that she produced in 1936 Called .iolatalL . "Recent Changes in the Painter's Trade" CHAIRMANPAINE: DrHamiltoii/did which' is Bulletin No. 7 of the U. S. De- yon wifo to say anyfomg else on the subr - partment of Labor. It is a beautiful pfesen- " jject? tatioo, and it is worth while for any of you ' DR;HAMILTON: I think not My study interested in the paint industry to read & of the subjeefisfouryears old. I thought Concerning the question at hand, I know perhaps very importantthings had come to, of no particular changes at the moment that lightsincethen. Apparenttybenrol is foil a" have been instituted In the industries that. I jhridng daager foddt' arisesin all sorts of have been acqtainted with. I do know font unexpected ways, especially as weuse more such things are in progress. As Dr. Ham cracked gasolinefoanwe did before. I quite ` ilton suggests;, I thinkthat they are changes agree tied it is fometiimg that should "be in die right direction, in many instances. avoided. \v . 'i ' DR A. L. BROOKS (Fisher Body Di vision, General.Motors Ccwp.); We do quite a lot of spray painting. I believe there las been no radical change in foe solvents and We always advise the substitution of toluol, when postible^forbenzbl, but I don't think any industrial physician wonldbe will ing to give it dent bill of health to toluol. \Vear 'fospici Gfotpi tiring wfijUrt accnr. peri**! thatj tion. * Occupational Disease 169 "SV * . . : ' . - n . jeare beginning tolookupon it withmore0 definitions, of iie itenn "occnpatiofial dis- ^suspkioii.Dr. Gammon of the dn Poot- t?ease." *.*! V- ;'% CooipatiybeBevesitis<mnchi ^ Now, any fotigde.lt ' Is almost.!' ' limitsthe * ^dntpntidr in>i ..... ...... .. . ......... wemay dividual who perils, epfobu^vitel dtsa^ yatex vI think . most recogniKjyroffi^ is' thatIpr^x^y;rwodId beinthe H^tidliec- also *otia5tltiafe''at:':^sAe-.<'<b>^U^^i^v-^I>lv dtben Ho*VV'..' Vo,.'.'-r;^- ; words, that we' j '' ' 'MSi GuioiAK; (Bau^itt' Compaq): I tkxal disorderwhi& mustbe' tnated,:which` wonldliketo; offerone'' nmbr .ob^Miio. most berecpgnized and. correded, and itsj Commercial toluol, as sokf m tins country, cansesdwtimafrd. y . 'j doesjwttcpntiriri: any.measurable ambontof . The mechanism of fatigue is grounded in; benioL> V4".- ';" c- , a very, complex e^haajfidn whidi is not ' -CHAIRMAN PAINE: We wffl have to yet clear, .add prohabty 'wbo't be clarified pass.oa to the nextsabject: "Fatigue aud its ,nntil -a great deal of irh^tigative work has Rglatkxito Occupational IXsost.-Tlns sab" "been dooe. Bnt in tint pa^ few?years a con- ject' will !fe; opoied by. Dr^ Norbert Erner, aderabk amountof:investigation :has; been;,, Directorof Laboratories, MotmlSinai Hos ,dooev mostnbtably attbeHarya^ pital Jditwaoloeef .1 ^ Industrial Hygimeiuhderi'I^^ up fo'recent times, igreat deal of- Fatigue and OccupatioaalDiseue work ^has beendobe, particuIarlyinGeip tsany and latterly in Russia;5'tbe;object b^'. DR. NORBE&T ENZER: At tetftfairty in tbe morning l generally have a very low lerel: of activity `and suffer from fatigue. Fatigue isa state of bodily ill health, of transient':character.' It lit cyanesCei^ as weunderstand it and asthe term is commonly ing^.in the Eoit^ean^^ investigatioas, to find; ont what circumstances ofempldyment exx^ tribated tofatigu^,fow comstances. of cmirioyjiiHft'to. .prevent: fa tigue and, hence, to increase the output ~E t. the 'indmdnal in terims of his occnpat 1fsufasteigdobe"otUt-stohafatsrtaataeinodfntshteryiisndchornidounailedju,t wwkwbich makes itimpossiMe forhimto . perform what magr be considered aiAwerage goodmitput.0 ,Wy_ :i is cnaiaaenxea Dy.ocntni sjrxnp&Dins* it is*wf Zander ideal conditiobs of. uwesfigafitia . by certain objectrvefiridings whichlvrillelaborate in a moment : Now, tite! thing flat we:. lade at preset' so far as its applicability to;the praetke bf. industrial tnedidne is coocerned, is a yardstkkoffatigae. Anatnberof fincstigatioaa. are going^on in that directiqn. and I thiidc before long-something wilTcothe of it Broadly spealdi^ two main channds of investigation are^ teiiig eirried on. One fa a state of- fatigae0relative to -ihe mnscnlar;, In thestnetestsense ^ term, I sup- capacity of the individnaL; In other words,- pose anoccupational disease is that condition We relitc tnosde strength to the k>ad. The tritidi caa be diiec^r trabed to spene agent?1 other is. a; form of fatigiK wbidi I think & or - adripciWpmHsittaaniMcime i&n*<r tamaal^SiifiimutaiiiiVt^AdiiliiMidJii raaamnaa going to Xb.e1-'._m9o--r-e--i-m---p-o+r*t-a--n--t-a--s--t-i-m--e---g-o--e-s- on, bd labeled .iu tbe"caasative'^ctor pf the dis and is related to the nervous system. That ease.- Bnt as oor horixon widens- and oar arises ont of the fact' that fatigue, is pro concept of disease becomesyfiroader^ and as duced fy agencies 'which impalr the ability we interpietlhe^^ wwd "disease" .as It was of the brain to send impubes to the ; originaily used in ^ G^^ sense, a state^of peripheral muscles so that work may Be, varotiori., bom headtl^^`^disksasei; then we . mnst regard aif omiiritional disease as any state of in:h^Ui' whidi has^^ te utdltol^Vdmtmsfahi performed.- . ," Now. mohotofiy of worit may be, the greater contributor ito i^rigue. I use that as> an illustratido.jFor exabmphv we found out; Undbr; that ilefinitiba .flipro lordly .a in one,sa^r:imrestigati^;,that'indivi disease '.whichi^tkrideri' some tna^mabie, state' employed ut work whidrre^ed ^ of ahurs,t ooti|dn't; be related; to ,<what the; and nimbleness irnd aJfiigh degree of mdital^ man is doing; Those are the two extreme alertness fatigued in less than a. twenty- o 170 29th National Sqfity Congress, four-honrperiod. Inotherwords, if.;*'cer tain standardof in fhf OOOld <i>nirfraV |m V^lwyrfjaIIfjnffyffipyt so ^stHlfhat ^ ^ and.that ;tjha&: lated tothe abpityofra to regulatetheir mtt^lar acfiyily; in co ordination. i..-- . v.V ;?i-vV-^-.-. Now, m jobs position, manipolatioo of jnstmpwaits, or monotony ofexerase, - ha. lciisi|-?ofVa^^e mHst be lecogniTCdby.thc inlttsfnal physj- dan. *'/ Theoccopatiocal disease; conversely, may prodnee afatignewbkh mj^ nbt be ineoog-' /.' tries,1'will;.jjrixbi^a^dSmirartSptf-bf^fi^gne'v. nized radess^lmnHlmdrialsa to critical examination. ^or exaxnpl^ we have noted that indmdnalswith * mSdtlyperOf '.-'some- 'of';ibei;fiesi^^ hypertension, increasedbhxdprttsnre,jMcve v- a^pe^;'bl/i&ia^:^V'tiie!^idn^^?-aii^'. in many insancB aJoimib^.Ate^ of visitia^ritj^ than iodiyiditals wimse ldood pFessihres are - dactioa^e-ra'goow normal. Or an-ehlaxii^heart, dneto vahro*, . sojjne questions: lar diseasev a leaky yalye^ will prodoce. the same phenomenon; or individnals withdia- betes or mdhridnals tb^inveal^ metabolic rate; beca^ of.a\tiiyrmd^g^uul ' CHAIRMAJIPAI^ disturbance; or indhridnals who' sne ab " qnes&mifrom^theiflow normally obese '^ aQ diow Taratiocis m ftwr ftrfipw ftirwtmV?t \ r- The onlywaycihai aspect ofthe subject * ^ksq*o-qf .m'* r*e* *un-'i*on.'jO;*?irIatnot*t0s1 ^cs;ot^xia> can properly be investigated,isto abroach dgne:Thepsy^^ it bom the medical point of ykw firsL Ex- patting ro(^ip|^/inyscparb; licddit^ amrnatkm of the ndindnal banmes tfaeim portant dung;-It is importanttoapply crit Tint ' ical standards of cvalnatibn, then to attempt" ^of'theTO^|^ to correct them'hy medical program. ..... upone poatrjBamdy, The industrial factor of fatigue, which! - to the-"mental 'iV mentioned first calls fbr 'a recogrition.that ' Again, thcTpsyi------- r-.-- certain lands of woric .can prodnce -fi^MV and then to apply methods which will r&re it I want to Olostrate just twb: . If we recognize fat a ccrtainoocupaticn produces fatigwywe have discovenedthings which will relieve thefatigoe.Anian;whose job calls for standjngsat ^ bc>^ m mprfe: or less one position,' doingthe same job over and over again, win bine fid^tiewmdi can ble relieved if . he canperiodkallysit down,- because Ins oxygen cdnsmnption in he sitting position is gready redo^^over ' individual dfhigh 1,0, the standing positiQn,and be pdtorms yir- tnally qoently he has arvailablegpcatcr-reservesjof energy for Ms performancel -.-Yr: " ;: 172 29th National Safety Congress . 0^ not entirely..true that experience with a job million dass.The most recent report classes is a guarantee against falsie. them as 400. Hi"\ .CHAIRMAN PAINE: In order that yon The third group of'300 parts per million may not be fatigued, Lam goingto change; indude ttoTfoSpirihg: Methanolor wood the subject l~am asking Df.Belknap to take "alcohol -whSi; -as-youvknow.may have -a die two nextsubjects, 3. and 4: "TheTaxic serious effectoo virion add caS&e blindness; Limits of Common Solvents"and**Lead in toluol and xylol, tctrachlorethylene, tri- 1 Industrial Processes," and dwell on those chlbrethylene andtarfentine. subjects as one. the fourth group; which fasdropped to 100 parts per million, indude carbon tetra- Toxic Limits of Solvents' diloride.and ethylene dichloride. ; ` ? . ~h DR. ELSTON L BELKNAP: Mr. Chairman, I know there may be sewatdistinguisbed guests but I. am sure that we in die medical professka always.feel peculiarly honored when Dr. Hamilton is m die audi- - Then tbe fifth group of TSjparts per mi. lion, benzene anddichforbtnzene; and dually nitrobenzene, which we; fortunately, actually, use very rarefy, a* a solvent, is 5 puts permiOfon. i'-.;?' ence. If there has been anyone who has I think it ur'inaportant to.remember that' been responsible for bringing to the aftcur .these solvents, if zn suScieiit concentration, don of American indnstry and the nreblj may kSD. TMs is m arntradBcdoo tovthe profession the"importance of toxicology*'jti 'other subject tbatlfave been given, which industry, I think it-is Dr. Hamilton. is/l^d, which very rarely IdOs- These sol I will emphasize a few of die toxic limits of die common solvents, so-called thresholds. vents Idl^ first of all, 'V simple suffocation, if tbey are fised inan'endosed .apoioiev- such as hi a-vat Bot the sinister elemoit of the ticularly such as Doctors Drinker, Haggard and Hamilton, there Is no threshold that is arbitrarily perfect; and die actual decision of whether or not the solvent has been toxic is die observation of the patient who has been exposed to that solvent, by a physician wlio must determine whether or not there has been a temporary intoxication and tritether or not dime has been a residual. ' ects the central nervous.system because,; as you know.tbese solvents are-fat solvents, and our nervous' system is largely tnade up of 'totty tissue or tipbid tissue, so the nerv ous system Isvery easily affected.,We have Involvement, therefore; of the eye; one of the most highly devrioped nervous struc-< tures.Then wefave central nervous system involvement; paralysis, Inability to walk.' Also, we must, realise that .aome ol diese Dr. Walsh has really 'veiy' ably covered solvents actuallydiznage the liver and the the subject of the hazards of spray paint* .kidney, canting aa acute Britibft disease It ing.and solvents which are tbe chief hazards * is thought tfatsome of diem: may cause of spray painting; but I will mention a few rirrhoris oftbelirer. " which I have grouped in increasing ord$r of Fortunately, one of the best solvents and . toxicity. _ . one1 of the most daugeroos is not included . As an example of probably the least toxic In the. list at all now, die tetrachJorcthylene solvent--I say tout toxic because no advent.. group used In die airplane Mutty m- die is not potentially toxic; ht fact, some go so pest That had the peculiar amlity to attadc. far as to say that all good solvents are toxic every part Itf the bodby-fndtiding the heart --there is gasoline. It has been stated' that musde. That, too, is said to b^.'a contam- 1,000 parts per million is a safe, limit for inantof some of our other solvenis.fIt has. continued exposure. The matter of contam been ^mentionedthat(jpoitil^riwjjgnner ination by .other substances sarih as benzol contammance m tekhtomhtieoe wu really . in 5 to 10 per cent>in certain, gfablinei cer-<?the reason why trkhkjretbylene had orig- . tainly would alter that safe threshold. inallv had a rather hsd name. The next group of, solvents which are slightly more toxic, are tbe amyl and butyl acetates and ether which are allowable, in 400 parts per million. Some authorities still state that they belong in the 1,000-part-per- I think cite ofdie^most; important things to reroember in dealing with tbe control of a good tidyimt is dflit we^are dealingwith a potentially dangerous" substance .'and hot make any dfort'to coooeal that fact from' *o 2) .- <: ' O' _,..? -' in .-;' V "'"> TM Occupational Disease 17S anyone in the factory. We, of the medkaP more than thirty feet away, they were doing profession i have; always, felt that we like to spray painting,"and they were dmng it prop^ put ourcardson UjetaMeWe know,that it erly. Insteadof exhaustingthe sprity' dver- is a greatdeal simpkacto follow, the. anctent Jiead' and bringing it :ri^t Tack m the' axiomand telltbe truth. So thatpl admire, -worker'snose, they hadv^r^tc^aavndes- for instance, the beflgfl company which pots neath ithe objects 0tdbe"spnty^ airi;took on its barrels, the word "Poisoo.,, I am not. advantage ofdraftas well as sdction. They in aporitibn to know whether tbey more or hadgoodenguKrimgjrpu^^ and staff, less did that because they were told to, but bnt they simply didn't know what they were I know they do it . uring incthis parficularliistaiice .* * ^ ** * . I. thinlfethere are many other companies I had another ekpericnee with a man who that shoold pot the same label oa^their prod was aso-called neorotielthinlunostof yon ucts. In tins coiuieetibat I Would like to tell, can spot the. neurotie ifyou have had pny of a case; dad I warhsfced to see, rwhere a shop experience. This man .certainty- Was. yoang boy,*m -ffaicfvmiddle,of `die. summer, .He had been to half a dozen doctors. One woritin$? in n shop which mademotors, sod-. told hirahewasgoingto die, and another one said there was n^ung the matter with wasdizzy.and bad to stop work. He was him. - working.with asobstance whichhe regarded ' .Again' I demanded to see die .shop. We asharmless.. - M', o found hewassprayingan aluminum print When I first heard of the caseJ insisted .with ? farmfem solvent, > dilnent; with I would vantjo see the process and see the good, suctmn and aj^ si^gim. How- plant and get hty infonnatioo .firrihmd *,"*. on forthertatowith hunaiKi con- iatber dan attempt to talk Mamie foreman- Ssmatsoaipom theforeman.1 found hewas by |d#0K (TbemecBcal proferition as a whole is leaming thath can only. fulfill its - responsibility hydemamfing die ri^d to know all about the exposure of the padents thm oome into their hands.) 0 ftbe ooentan in tbe shop who was .delegated to clean die spray guns.at die.end ol,die. working day. He wmdd sit down, and squirt material which heicaDed' chloride, in -and out of the spray guns, and lean over die vat he was working with. Finally, he noticed he When 1 went hittPtbe shop I found that .began to get happy- and^whistle and sing, this .worker wasUring a largn paint brush,:1 and he began to look forward to die experi dipping ft into W large bwlofUquid, which ence at tbe end of every day. However, he then slapped on the motorjo" gef the finally he nodoed he visa getting weak, he gteascRoff. Onthls partknlar hot day he wai dragging ^ne leg and his heart was evotvedthc idea Of setting a fan, which gt^ig very nit. ordinarily, perhip4f^ Unrtte.f front.him, directijropporitethe h_ow-l--o---f3 material and bfcwthe fumes directty m hlsa face. .Hegot coJed,andthen he got sick. Well, this illustrates one other sample This was/a largecorporadbo. Yes, they were using chloride Fhiaity. iafter great-difficulty, and hayttig: to go ib .die .treairarer rof the Paslced tbe foreman what was in that organixadoo and grihg ^lhto the files we materia), and he'arid he didn't Inkiw exactly; found that this was a nmterial Which they it was stock material, perfectly safe,as far had honffiit from a suppty house in another aa he k^. I: aali ^Wdl, I; would like t? ' city, and they did not know what was in it .know wind it Is." So there wu considerable We fimrity found out it was ethylene di- upsetting of routine. We finallywent out chldride c' : into a^hed fa'die-yard,completety dark; wegfinrity got- a flashlight, and we`found a barrel of.-benzol marked "Poison." The cotme of that individnal is ihteresttngi in dud we pirt Idm in the hospital. It peventurity cost tint company quite-a lot of Now, no one inthat wop knew what they money. tw^ iu tHs to. find out all\I could were doing. Thereyrbreadbzen. other work leairn about die aetkm of; that : particular ers each doing the same.''thing hut who, substmwe I put tbe mriiindie hospitri tiiree fortunately, had.hot gotten this brilliant idea or four wedcs ahd did a number of ddicate of theiarif v.- tests on hint /. The curious thing, about thispartiqilar Wdl, lie 3UTie through, md interestingiy shop^was that in mother department, not we^fotmd that he had ah opportunity to do> o *o . . '} . - . 174 29th National Safety Congress vdop a cold ooce^or: twice. ;Ev<^ .time-he plante, when 1. came there ,about ten years did, he developed jaundice. Tben,bfcoitree, agowewere;hav^\t..i$nde^ we didhverfttm^mtes^andfomidredQC' 24. lead tied'of that We found he had a weakening which cmrespoods/pro^ of the heart muscle. Werfoond 'a definite: ceotage pf 15 to 16:reppr^fy;ti&^ loss of die reflex in one ankle-joint, showing H&tb. Semqe m,(wmlc;ai&)|j. a definite involvement ofthe central nervous. 'jtofive.yeara;^Y system. ' medical .deputmen^ " " We were able to get all die physicians to ' mentandmaiu^enienitvre^d agree that this man was cbinsiderafriy-dfe an inddence pf 2 per lOp^and^f^ ablOd, that it waidoe to his occupation. Yen - five' years we have had. ^ lead will understand, I was seeing mm not. for ' poisetfukg ata^Westti stillhandling lead, himsdfimt for the oompany.I think a good and we' are stiU hamdOng it in ur^amo^ts. many of them thought I* bad been a litde . 1 think that in toe stor^battety generous to this malingerer. This man went try; probably, menare exppsedpotentiaDy, ahead and got a large settlement. I don't at least; to the greatest, concentration of 'lead know anything further about the case except for absorptkm direcdy.mto.didrbodksti^ that I did hear that the man died and thtt in' any othef- industry...I am gladtoreport the death certificate sud-adnhoaS:rof die that; - having cfoUowed this:partiailar -group liver and heart failure." Unfortunately, we . of workers of about 80 ,for dus perio4 at didn't have an autopsy to confirm it die. end:.of ten years they ,are:.rerta!nfjr:just In my opinion, the toxic solvent is one of die most dangerous' substances' andit. may seriously disable and ldH as hea&tixy abd/ m tnahy respertsYLthink bealthierlhan.the general rtmbf^ latkit. Of we-have': reducedtheir lead abstoi^CM^'hii^/t^^^;.!^!^ ->^ak Lebd inlnduttry down 'die7 iflqracal'rtssiiitai^ - protection. They. occatibitellyfhareKlaitgc As a preface to the subject of, lead in industry r would like-to< say that I am not doses of lead. Maiy"of'ttewe:^sraalteiks' .wiiteEe .. ... ...J .... or "I--- specializing entirely .in' industrial wwDpw;. ous lead absorptioointhe periodof. ob I am one of that increasing group wbofeel servation. -. - ; ; ;;':. - ^' that industrial medicine is not a specialty. in Lead is oneof the mast widdy ased soitself bat is-merely a division of internal ,r called poisons :iivcwell rtr:2O0;industries. medicine or diagnosis, the large, field , of I think there is no doubt birt infdte ^rge medicine wbichin,,private practice cone- industry die bsteartLis well opbtrolledi Firrt sponds to or is correlated with the field of of aH, it is recognized ..and^flbenPew^y-tefefo . general surgery. I am-glad tbatalargepro- is given: Nomgiaise is spared'tortiidythe pordon of my practice is still private prac teen and to reduce' toe continuance of any tice. I am also consulting medical;'director exposure. However,- inithersmalL industry, to one of oar' industrial concerns ih: Mil-.. which is the najor'pprtion of indurtr^ in , waukee, with branches'over die couhby, so . this country, leadiin ppudotoJ^crcwttng BPthat I have an opportunity to see lead and and evm rilicosis, 'whidh;gpt tbe.ttnter,`of other toxic materials. - dtp stage in rerent ye^ire^^ When you see a man who. has said), "I .. coasin, has now- tafcm a'badc'stq), aiid kad have lead poisoning," do nofrforget lje may- las amte back into itS o^' to with; have some other disabilities and'diseases, -die ever increasing ateofsplvaitSi -S. such as acute appendicitis, gallbladder^-ldd- - ,;I' would like; to?Stresi^agani ' dte^danger ney colic and so forth. Ininyprivate prac here is.one"of -t&t^'loye ' tice my interxit has-been sharpened so that our tirpxdilte'' '2d;'4dMi I always make an'effort- to take ayery care- large pfcmt;;lYwiHC tajpS^^^^&pmg^rJdie; ful occupational history pna patient; even though he maycometomepurdyasaheairt . poisonmgbocurawi^ im; case; lung case or what-have-yoo. portent factof^Y\>Y/ * In this particular plant ih Mdwaiikee,,. ^; The most;importard is,die;^^ which began by baving and stiH has,-:as a . industry^ Thtf"timcs^ large propbrtionof its woric;'storage battery `mobiles and tru^;^irltt^at&;w^ ' of - ^ 3 ' *, - ^ Occupational Disease ~ . D-'" p - .?> - .* . . - . coot^ ^ j^ny of:'yoa-1aj^r(*hey.: weresal. have seen agnat-'niaiQb^^ .firstaniodfiie&:offl^lead paste whiclvijCWr lw' type ;ofvsIdp. inda^try,^catting: up hold SSfox^**^** ...... ... .. never sew^ndl':lai^^%'-r^^^C>f. : ; eotoK; this a^^T#tw^Tfie: Navy .1 vhea they Uhfortti- ___............. '-is. .' . ' '.doctors, .are..\ibt:^'veCT/vieobd^'ba: ;up-- i*fl'-\...'j-l.' gbenpnachmegrin^^ . in^^ndUR^;iiifcaveoheud agreatdeab are Jaeayy;.aocLafe.jtoo.;;ia^ge,.toyce, ttuiaied.- eotttnr Miwfrnt,ttii|iM.iWi;.TW'<^ '.' periencg^inordSna^ ` it ii,Te^<farp,yqu^^ <-. ; ytpccc KKiins*oeeosaostiiuteq py 'ouier.. - groiocu ot Uiijjovcr. *. vBere:^icbro^^^^ of' ;:. ' fp^^vyfcd,^in!cdaMe^ dast^whexe lowin'- ic^j^rbdenviattfse-Sta^ .- .rcmenber tbat^dastvrik^ di- ' -.tkn, to.' ^ ,> In x*sth&l^ ifaj^ ; eyaporahid m3k|in^ i^VwiliitUiiil-Inr.IxmL '' theoocmtry; .v. < * ; ;.-. `f'-o:y:/;<>:.-"'-''.'' ' ` ."-r^ * \ ' - * '.": ' 'ex;-. ' O-" * .** .,JS> ` \2 176 29th National Safety Congress lead poisoning. However, as a matter of statically. controlled so the, temperature of practical interest, I dtink it is very difficult the lead does not exceediStiO degrees? to get there in' ordinary indnsby, and I ' DR. BELKNAPr>That is a good prac- would more or less formulate 3. as a safe ' tical questioru As we loww. kad melts at a level. I dunk it has also been fotmd by other, much, iowertemperatnre- whenyolatifized. . workers. However, if you get over 3'you Inmy experience, kad does hotrealljrvola certainly have the possibility of serious lead tilize until aroundl,000 or l,l(Mdegrees. absorption. Inthis groupof workers tint Tam fol I want to emphasize that mere lead ab lowing; someyears ago, large kad. ppts, two sorption does not mean the titan has lead or three feet'in dander, wj^unhoeded bei; poisoning. He may- have a lead .line, may cause of. certafo changes in teduncal pro- have lead in the urine, .08 milligrams per. cedure, and tire plant never gotarotmd to liter, but that does not make-lead poisoning. ' - the hood.' I disapproved' .of tint and re That is merely evidence of absorption. He peatedly said they would have cases .ofclead must have, in addition, clinicalSymptoms of poisoning there if thfy didrft hood. They one of the three types of lead absorption. . said they would just as soonas it was ptac- As a final word in regard to .the role of the medical profession in its cooperation In. industry, it seems to the -that the medical man should first of aU lie responsible to the highest man in authority in the'plant, so that he can go direct to him with any prob lems that arise,'and before any new-pro-' cednre is used or any hew chemical, have a conference with'the physician torsee-whether there is any possible danger, whether there, are volatile solvents or Raid, so that the! danger to the men may be prevented before it happens. ticaL It has never been practicable, and I am* here to say we.havc had no lead casesO develop to the point of disability, and we have had .very little lead absorption result from thafcThe same men have worked,there. for ten years,dPP*ng Wad oitt of the pot; inridentalty/at temperatnres ranging usually 1 from 850 to 950 degrees^lh titis group of -, linotype workers we fonndno evidence of lead absorption in some of the shopswhere tiny hadifio suction. T would, not-sayin my own experience that hooding'is nfecssary at 500 degrees. I am not halting a plea for absolute sub stitution for and avoidance of the~use of lead; I think industry cannot get along with out the use of lead, cahnotget along without the use of a number of these.solvents; but if industry.is forewarned,'and if the worker is informed correctly so he will cooperate in the use of protective devices and, finally, the medical profession is allowed to see the pa MR. CARR: I wonder1 if'time-is any evidence to indicate the toxic limit for butyl alcohol, could be raised above tint given? We hid experience over sonfe twenty years with the same -group of mcn, w6rking in amcentratioQs fnmr.200fo 4(W parts per' nuHkv and under careful examination they have shown no indifotion of trouble. . . < One other question is whether much work tient as often as they see fit, perhaps every has been done on toxic limits of dioxene? two or three weeks, then there need occur DR. BELKNAP:. I- thhik Dr. Hannltoo no occupational disease in industry. - will have to state if she riolb'vhittet'^t . CHAIRMAN PAINE: Are there any have toxic limits established for dkarene. questions on either one of these subjects that ; DR. HAMILTONi Dioxene is the trade you would like to ask?.. ' name for diethytenecbloride. Notoxklimit MR. HUTTER: What is tire effect of the f smell'of kerosene on the worker? Is that a has been established for thatr We considered it a Burly safe solvmt imta scHhe-'my disastrouscases occurred in Eb^and from permanent effect or just temporary? . qver-exposur^v^cauring fivedeaths. ; Since DR. BELKNAP: As for asTknow, there then we have lo6ked tipon it;vritii a good is no ill effect from the inhalation of kero deal; more- suspicion.There, has'not been sene. enough workdone on it to; establish ary R. S. SKYRM (Employers Liability As - mairiiwiwif allnuaKU ^nnfWi|r3tin*H, surance Corporation, Boston): Would Dr. DR. BELKNAP:^ al Belknap recommend tire direct venting of cohol, the butyl radical acetpte isnrachless lead pots on linotype machines where tire toxic than, ethyl or latigfe partiOoforiy. So pots are electrically heated and;'thermo I would be mteresWd in yom poi^ bf view. a ^* Occupational Disease ( 177 1- think probably It. couldAe made at safe The problem confronting the physician is limits/'." \ ' to determine the crehUionship betWeen the /MRGUMMARiI want.to.endorse amiplctdythe principle of raarimnm&earanocs . ofsaf?ty standards in engineering, bdttbey . qtawild be-basedoii:Actual data/Asregards^ tolpene,there?havc beeri enonnons quantities skin disease "and the pccnrational emriron- ment, to,discbverAe natn?eof theoffending agent and to adoptmeasnres derigned.to cnrco the condition and prievent its occur- . rence. . Q. '.V-' . -i //. used: kfwrbi^:.iQdi^'^iee'; spray ^ There, are many* predisposing canses of paintmgeame into use. Itissprayedmto the occupational dermatosivsnch as tmcleanli- -air as Jjde mist; and even thoughit evap- ness ofworkrootns, of clothesand of per- ' oratesat a slpWerirate than benzol, if>3yon ~ son. Previous skindiseases as, forexample, inhale themist, you get severeeffects, ifit eczema; are p&.&Hl^:bec^ nid^- is toxic- ualswiA eczema react seven times more I bare etaploydrs in four states. Near .York State/New Jersey, Ohio and Connecticut, wixrfor'the past sixtem years have nothad' any reported casesof chronictoluene poisontag; yet Ohio m Ae^pasPaxteen.years has hadover 69 eases ofpoisoning from ggso- frequently to exter^^irritanlsthan non- < eczematons. individuals. The sldn of the young and old is moresusceptibtetoirrita. tion and infection thanthe^skin of perrons, in middle life. Dry skin tamore vulnerable to irritants jdum o3y ddn. line'in the petrotacm indnstry. r. The sldn of certain parts of the body is . ; ' ; 'J . ~i .. As to the^expcrnaental remits, I can find . no rnriiH<ta1ifa^ nvKf^tTiig thi' tOadcity J shoeflddbeisddi .a -low vatae.Some ofthe coafosion arisesr from .tire failure to dis tinguish between chronic and acute poisoning. lt is a fact that in extrandyhigh con-' centrathms,. toluene and .jcylene are more " toxic te benzol; thatis, ifyqugomto a chamber where thereare 20,000 parts per million, yon would be uncmtacioas gender from itrfnetw and:,xyknej' than yoa would with bcniene^bot dat is anentirriy separate phenomenon from. Ae slow chronic poisoa- especially senativc for mSfcmce. that of the grids send gcnitalta- Anything whi<h lowers the antinal tfare^old of xeastance of the skin may act as,a predi^>ostng factor in the prodaetkm of; dermatitis iatnd of infections lesions. These factorsindiidebniises, marked sweating and maceration, prolonged exposnre of the sldn to water and specially to alkalisand reputed scrnN^g of ffiesddn. These agents tend to remove the normal protective, coats of the skin, that is Ad outer horny layer,.and Ans expose, the sensitive emdomal cdls directly to irritadng materiaL A point fairly recently emjAasized is that tog.' :;// ; " : ` . Y . individuals wiA common aAkte'S foot are , CHAIRMAN PAINE: The' next ftopic modi! more prone to oaxt^Acxal dermatitis -mil be "Sldn^'Affectioiis? and that will be. of the 'hands.. Apparently this mfection of handled by Dr. If. J. Renter.0 . the feet acts as a sensitizing factor. SkmAffections, ' & . The actmd causes: broccnpational derma toses sire medatncA 'phya^l and biok^ic . DIt*1d. J. REUTER: When we consider to what extent the skin ofAe worker is exposed&to injuries, the actknofchernical irritants it - is hot- surprinng'tltat bctatpbfibbbl-'ridh ifisr; astats apd cbemkal irritants. Medianical agents produce briris mid lacerations, as well as frietkn and pressure resulting in yarions inflammations and.Aickentaj^ of theridn. eases'. are".i major ptbMcmitol^ The ' The phjrsical agents .which may prodnee Umted States Pnbfic HealA ..Serrice resti- an. ocicn^kAxial , dennatqsis are heat and mtaadlyer oent of occupatioaaldiseases cold, ritftar dry or wet; electricity, nltraviokt areskhTdiseasta^ study jays, either from 'Ae stm or .auiifidal,. and in lOftOOD workers andfound;Inthe coarse ' x-tays tar raditmi. 6fayeart:Aatbneptf were^affriaed-vn^ as a ' resoltbfsfli^^?6rk.'- -3Ms^d:S^indtide.. The btatogSc agents are Ae common bacteri^ ^n^a^:panisite& " For Ad most p^- however,., occapational orennary pas infections of scratches or affections of the slran aref the resmlt of con abrasions. tact ffdA taritants of a diemical nature, O1 o... vf" ,, -6. . 178 . 29th National Safety .Congress. usualiyatids or alkalis producing simple in DR &EUTER: I have had very little flammation ofthe skin. , occasion to pass on a question of cancer of As a subject for discussion, I might<5ay fee Skin arising from alleged contact- wife that probably cleansing agents feed by the ' some carcinogenic agent. worker* are one of the most potent factors G T.:DENSMORE (Hoppers Co, St. in the causation ofoccupational dermatitis. Paul, Minn.): I would like to hear a little CHAIRMAN PAINE: This is a subject in which there are a number of men inter ested. Will you expedite your questions? DR. ENZER: I would like to atk Dr. about the effects of coal tar and creosote dis in relation to cancer find whatnot, and also the bihalation of the creosote va pors Reuter to say`a work about skin cancer in DR. REUTER: Regardingrthe develop- occupational exposures. ment of cancer from cm! tar, and creosote, I have had no experience. We do know that SkfaCander : coal tar is fee nearest to. fee skin and does produce -an inflammation about fee .hair DR. REUTER: Ewing has set forth five follicles called folliculitis. It is undoubtedly postulates which must be fulfilled before r due to fee plugging of the foIKcles wife fee- accepting trauma as the cause of given can-; tar and pmhaj sdine stimulation of fee cer. Ewing states: "Firststhe authenticity epidermal layers of thesldn from fee tari) and adequacy of injury must be estab which sets up_ this inflammatory reactions lished." That is, fee patient's statement re around fee hair follicles. I feink tbe same is v garding injury must be substantiated, and true wife creosote. But, regarding fee actual there must be actual tissue damage. development .of hypertrophic lesions of the "Second, the previous integrity of fee skin, particularly cancer, I lave had no ex wounded part, before fee injury must be perience. - established. " DR BELKNAP: As for creosote, I have "Third, fee cancer or tumor must arise at had no actual cases brought to toy atten- the point of injUry.* . tioo^As far as I know, the fumes -woold be no more irritating; possibly, than causing'an - "Fourth, theremustbe a reasonable time irritative cough.; I know of no cases, really. limit between injury and fee development .of Of acute chronic bronchitis' or other car-, the tumor." That is, if the tumor develops dnoigBric results. within two or three days after the injury, it isn't reasonable that in that short a time a CHAIRMAN PAINE: We witt kave tumor could have developed.' any other'questions to the end of theses- 'sion and hear Mr. H. A. Nelson, Industr&f "Fifth, the positive' diagnosis must estate ' Commission of Wisconsin, on fee question? life that there is an actual tumor present "Should-occupational diseases be considered and fee nature of fee particular tumor." as industrial injuries?* CHAIRMAN PAINE: Dr. Enrer, do yon want to speak to fee point? Disease Ya. Injury DR. ENZER : I thought Dr. Renter-might say a word about the increasing attention now bring givfcn to highly complex chemical agents which have fee property of inducing cancer in fee experimental animal. We know of certain agents,which have that-property, in the human. The commonly known dne' is tar cancer. We know also of eertain aniline products which would produce cancer of fee skin, of the urinary bladder, and so on. I ; H. A. NELSON: Mr. Cbainuan: The ^question which I have been atrigned is sus ceptible of treatment in several ways. We can treat it in a highly ^technical way and qhibble about the court construction ofthe -word *Tnjmy" or wieean treat it In agen- eral way'and ask whether occupational dis- eases should be rompeosaled. .That, is fee real erme of fete questioni today.' ` ^ think that subject is highly complex, hot I It,; sometimes astonishes me that, thirty think it should be brought to your attention years after the passage of compensation aids feat in the dermatology of today we deal we are still disputing this question-of not only wife dermatitis but also deal wife whether we,, shall compensate a condition tumors. which may cause fesabflityjlnd which arise* - Occupational Disease 179 oat of mdtistryjust as clearly as does an employes whohavethisaecniaiof dosage, accidental>injury..There are various ways of , it may he that in periods of^depression the meeting tfc. ^ is to expense to him. will berather greatfor the do nothing <aboot it mritoatis what about time bring, and that mtistlbe met in various eighteenstatra mtteUnioaare dbing.Tbey~ ways. EmpIcyers .are himtoutarito. Most of are not: compensating occupational diseases them would like; to do toes* toings but they ataE Out of toecrther stain there ate a are also to competition with each other, and lew which, ate compensating all occupa that means there,7hriut be Jaws and regula tionaldiseases, and some, of them,are com* tions for. the compensating of occupational pensatingby schedule. . disease if the job is to be done in a satis Now, schedules 'ate usually designed so factory w^y. 3. that there.the a great many diseases which ..arenamed, but very generally you win find 'Unit thf^y leave ont die one occupational dis ease. which causes the most disability. For example,' silicosis is left put of agireat many of .die state-law*. which bave schedules. Therefore, silicosis^wtikh isa serious occupationaLdisease is not compehrated. * Another reason that is often given is that industrial commission* and accident boards .tore unable to .decide thequestiori of occu pational dise^ ` as., to causation; between the process and the final condition Which re sults in disability. I think that is a rather fatuons objection," in view of the develop ment which has bran made in medical sci , Wbenw* go back to the priihe principles ence within the last few years. at workmen's compensation,we wonder why 1 think those questions are no more diffi the compensation fathers didn't lace the' cult to deride than the' questions of aggra question at the time the Compensation acts vation of preexisting conditions which are were passed.. That was the time, to do it clearly under the law, if we may ascribe Either through inadvertence| or, In some `"cases,: through occupational them to accidents, and also to the obscure conditions which are ascribed to accidents were left oat of, the laws pretty. generally, and as to which compensation boards and but acddental mjuries were to lecomptn* commissions have to make decisions every rated.; I- thmktoat was langy. because of 'day. o ' thexatherviolent split from me old comnsmt. . .* *- r law system and leaving out of consideratioir the.question of negligence. It was a rather ' Can Stamp Out Disease * Potent split, but: itissurprismg that in all of these years occupational diseases still re main micompensatedlm to many states. : But the most glorious tiling that has been accomplished by occupational disease laws is the fact that employers have become con When we consider the natureof an occu- scious of toe faet that they can'stamp Out patkal disease; wfaidi is umany^a slow, :-occupational disease. I.am glad to say that insidiousproems, over which; the man him ' to Wisconsin we have practically - stamped self, theemployee/has no/eontrol, but over out silicosis, tftatin a few years more it is which toe .employer. ^as., these physicians going to be practically a negligible thing. have told you this^moming; has the entire Dr. Belknap has shown you how lead pois power, of control^ there .seems to be one oning can. be almost entirely eradicated... ; hondredtimes .more reason why the em-r That is the glorious thing which we have plpyee Who cannot protect himself in any achieved through the passage of occupa- . possible way should be .compensated lor oc tional disease laws. 1 want to give a very cupational disease" rather titan tor aedden- few figures showing the drop in silicosis in talinjury.' ` - . the State of Wisconsin .since 1933 to 1939. I. suppose there is no' quetoon but that .3 These figures are the^percentages of com the rmal crux of the matter Is that of ex pensation which were paid in silicosis cases pense to the empipyer,1 mid that comeS be- as compared .with the total, fit`1933 the fig cuirapItibftojst^MaeQr^fiabdi^. Here ure was 9.4; 1934,8.8; 1935, 7.9; then S and . has been "ah accrual ofdosage which finally ,2'and ,9'per rent, and, in toe year 1939, 1.3 eventuates in disease, and this accrual is per centwhich we figure is getting about such that the disease way:comeat a given onalevd, moment ' ,5s . I think1 there is no question but that the II the employer, has si large number^of . public :is demanding that occupational dis- 180 29th National Safety Congress y ease be compensated. The'trend is coining taken. Disability due top sickness over die ocl I believe that industry and . society mil ten-year period was'calculated and seen for be gratified when the problem has been each individual man. There certainly was no solved by whatever methods may be adopted masked difference in sickness rates and in and suited to die different states. disability rates in the wdders as compared CHAIRMAN PAINE: Are *here any questions you want lo ask Hr.. Nelson be fore we 90 into the general discussion? . . to the general run .of employees working at their ride in die same -plant and in die same economic situation. ADOLF AMRAM (Hamlin & Co, New York Gty): We passed a compensation law in New York State some two or three years ago. Perhaps yon recall that first we passed a most illogical law, the all-inclnsive act which acted most disastrously not only to in dustry itself but to'the workmen. You are familiar with die history and die recall of that act I dare say in a number of states it is absolutely right and proper the compen sation act should include silicosis, but it should include silicosis on a schedule basis, When you,are considering welders who are cutting painted materials, lead-hearing paints, or wbojare' weldingin confined spaces, you have aL different'problem; but, lor the ordinary welding groups working in' alarge, airy room, with ordinary precantions and ventilation, their health is jnst as good as any other group of workers. If' they are cutting print or toxic coatings of any kind or lead-bearing steel, or if; they are 'working in a confined spaa; then additional respiratory protection is. .necessary. as I think is the case in Illinois. So far as the question that was rampant MR. NELSON: AH states are not as . afew .years ago,that is thedevdopment of so-called' fibrosis of die lungs doe to wrid- fortunate as some other states. I think-we are showing generally throughout all of die states that the problem can be solved. in& we have not found this to he-die case. Dp. Enzer and Dr. Sander at- HOwankee have had occasion to examine at postmortem Protection for Welders a few of these individuals who have been welding for long periods of time in confined spaces, usually. They did find' there was an CHAIRMAN PAINE: We have a few increase of iron in the lung but no' fibrosis minutes. Anyone in die audience has die cansing harm. privilege of asking this panel of doctors any questions they want to raise on these main subjects. Recently, we also have examined another group of welders, that is a variant oLthe welding,, trade, scarfers, in die continuous J. S. GREEN (Edgewater Steel ^ . production of steel These scarfers use a Oakmont, Pa.): I would like to ask to what long torch and blow out die defects in the extent an ordinary welder in a small plant ., billets rather than chiseling;them out This should be protected? Once in a while there group also, while it is an infant inthegroup will be a hardening material, which has of welders, apparently have ho health' haz poisonous results. Other times there will be ards of any consequence in their trade. In flame cutting of print on a product* which , other words, T^tiunk if ordinary praan- will raise some noxious poison. To what ex- : tipns, so far as ventilation and'so forth are tent would a welder or a cutter have to be concerned, we need not be' concerned other protected? than if we are using lead or: chromium or CHAIRMAN PAINE: The question is, some of the toxic materials. how are we going to protect, -and what is CHAIRMAN PAINE: Dr. Enzer wfll the exposure to welders on' new material speak for a minute on the subject and then or on old material that has. been painted? Dr. Belknap will follow him right .up. I will ask Dr. Walsh to answer that ques . DR. ENZER: I want to seize die oppor tion. tunity to make some comments relative to DR. W^LSH: Within the past couple of the general, attitude of this panel discussion. years we have had occasion to go over a- It is most important that in any approach group of about 1,000 welders. Of that group to the'-problem of industrial herith we .re some 300 have been welding for ten or more . member that a.statistical analysis of groups years. They were gone over from the clinical ( is not a trne criterion of the health of the point of view. X-rays of the chest were individual In other words; jnst like the sur- |*r Occupational5 Disease 181 gcori who might boast' of a 99per wot as those which simply have mill scale on ) recovery rate from a specific operation, the them. individual who'happened to belong to that $4 per:cent constitutes 100 per cent mortal ity for the individual There is .a very sharp contrast there. ; R. J. WOODHOUSE .(Continental Cas ualty Company, New York City): Ihad>S case a short time ago that I was called upon' to investigate. The man' worked in a small Now.wiien we. talk: about safe limits of printing plant where he was assumed to toxic solvents, safe limits' of. tone agents, have-contracted lead poisoning. After mak safe Kmits of an industry, we most remem ing impinger tests which proved negative, ber tbit the problem is not going to be an award was given.by the commission to solved ; fgr .a blanket-, generalization of a the widow.m the amount of $13,000. The problem, but Itya carbfnl^and meticulous' 'lead was,,tndted around 650 to 700 degrees analysis and stady of1 the individuals ex and the experts , proved: that- toxic fumes posed,tothe industry. | know of no other' were not liberated. , mgr that this can. tie dope except that inrdnstry realize tbit the j profession of medi cine forms tbe keystone to the solution of tiiese problems. I wonderwhat yardstick the referees used to measure those cases,' in the face of such expert testimony. MR. SKYRM: I would like to know the N. DHLBELKNAP: I nmply wanted to am- plify what has already7been mentioned, and that is w|ien a welder or tntter%oik^ai0 tdrdafof hemlock poisoning and poison ivy to sldn disease. ; material wot 1b beenrpainted'Or erirtrd , DR. REUTER " Poison ivy, of course,'is with feajl, belc.of course, probably will ac the most common pkmf: that causes denna- quire lead absorption in a serious, fashion . titis. Hemlock is occasionally the . .cause. abont as quickly as^if not quicker than, in' Prison hy is an intense irritant to most any otberway. people's siting. It is a question of whether in It is very simple now, with the respira tors^we haveavaflabfe, for a shop wdder, itsdf it is not mi irritant to all people's sWn- ,, / ''..A... triienever he is domg-tbat type ofwoik, to We used to think we knew the cause of nse aidi'a Rgiiiatdr. In my own particular prism ivy dermatitis, hut spore recent work seriesof cases oege of cor cases of lead ab- , hasTabded ratbm to :disprove that we do saptibn>ixha a .wdder who-.had Jbecn re ' know the actnal came of what it is in the pairing some ovens containing a. large plant that, .produces dermatitis. Apparently amount oflead. _ ", it 4s-a water-soluble fraction rather than an Also, I had occasion1 recently .to see half oO. a dozen cases of."cutters who' were cutting' Its relation to occupational disease de np tanks in a-large, chemical phmt-These steel -tanks had. been lined with lead. They could hot understand why the men.- were getting lead. They-, went through the lead witii a tordr 3000 or' dOOOdegrees' and they pends on yriot the faditfdual Is driug. If he is exposed to.it in his occupation, for ex ample, as a farmer, WPA worker, lumber man or any occupation thatbeeps an' individnal oat-of-doors, and he contacts prison absorbed lead, exceedingly rapidly. It is hot. ivy. it certainly -would be an occupational a'fifficrit question to solve at all but it is*a. disease.!.Poison ivy dermatitis is apt to be matter of haying perfect confidence in what a mudi more violent dermatitis than that the work is for andpreparing for it from hemlock. UK. CARR: h connection with'wdding, CHAIRMAN PAINE: Mr. Gumaer, we hay^ bad fasteners of zinc dulls from ^wfllyou repeat your question? work on galvanized iron. We have also-had nitrons futile 'poisoning from the nse of coated electrodes^ ;,, >' P. W. GUMAER: The question was, what is the basis of the comparatively low maxi mum concentration of.toluol in the absence I. would also like to call attention to; a rof any reported 'occupational disease cases, relatively new development, that of the flame' .fad are there any experimental data to war cleaning of metals before printing, by the rant such a low concentration where such use of a spedri oxy-acetykne torch. That 3 experimental data<deals with chronic poison- indudes .previously painted metals as.well ing and noi with acute poisoning? > . M 182 29thi National 'Safety Congress ' f7* DR. BELKNAP: The question Is, whether toluol is really as toxie as I inti mated it tnigbt-be; being permissible in only 200 parts permillion. Is that right;' Mr. Gtanaer? ''. The Ameriiar; a committee^**:!irqrk. /ini small :.sadiCMnnntj^CVVe; dealing with ventv<*rhon'mbnm Association has, field,'with .a ^Justjvf ; MR. GUMAER: Yes. ^ bon.disulphide and hydrogen sulphide.There DR. BELKNAP: As as the official we Have bear able to get prettyaccurate- authority-jof that-is concerned; it b taken from the code tor safe concentrations of; -' Weareaw ' wriam ^nnV iTtawf Miwl Mn<tr|W| otb&sTirhidi we filing fo jte 'increawj^y whose authors are Bowditcb, Drinker.Hagr important in,:the nm^tkms"'industry.': We gard and Alice. Hanrittonwhk&agpearod -nr? ; hope'to.'beisMe tio 'me:^^;:'mmre'jaccnrete.v the June I940issueofthejoornrfof In figures theu.J3tatit S'a .^erjr.'-di^mBlpt^M;. dustrial Hygiene and Tcacioofegy. : ' I do not know whetberthereisany prac tical experimCTtalwoAhadcingftat^np, but inasmuch .as toluol and xjdol are very closely related to benzoy l assume that the authors felt that it asytt.cooldnot befgivwi an entirely safe record, 'for iqstanc^ com pared to gasofihfr .. accurate figure is tyhaving a_ comtun^l - .inquiry ists -and the :yentih^km latginee^ ; we fotvefokhowhowma^y in a given wmkrqom^ a lgxveti m . -tion, smdalsoatwhat-cooeeritra^ ; casescomei-'-- : jr- \ . :.* We could do that-witii tfie four I have I will say, among a group of workers who. mexrtioned,batitmeans, as-yod se^ a great have been working with adequate protection for several years with tclool sdhrents, I have dcd of-anl k the' physicians* otaftinii^ rdom. Bringing - seen no general reaction.: .V DR. HAMILTON: May I speak to that gard toJeadjwe can do it pridt^ftityrith for just a moment? That presentation* to regard tomercury, and we have: pretty, good' which Dr.^BeBcnap refers was' got out . data with regard /to zinc oxide: fumes in simply because a small group, of us fdt galvanizing fooo aad brast fo^adries aiid that we might as well let .the public know - one smdtfog;.but the n^dftiwfotetaajces what was onf best {piess at the present mo still are.more or less in the realm of goess- ment with regard to maximum allowable' work. . concentrations of the most commonly used v CHAIRMAN PAINE: May L in ymr solvents. It is founded very largely on guess behalf and m behalf bf the National Sifety work. Council, thank foe, gentibnen'. oo the plat- The quantity of LQOBparfe per million for fonn wbo have fo kindly led us in this dis- gasoline is guess;, and so is 200. parts..of cossion? Will yoo\expresx that thanksby toluene. We are hoping that we shall be able giving them a rising vote? to give more accurate figures presently. ... Tlre at^knce arose and ap^anded. . > ; . ADJOURNMENT o v SJ - . - <7 Ci A