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S T 0850642 ABSTRACT OF THE LITERATURE OF INDUSTRIAL HYGIENE SUPPLEMENTARY TO THE JOURNAL OF INDUSTRIAL HYGIENE EDITORS DAVID L EDSALL, M. D.. S. D., United State. EDGAR L. COLLIS, M. D., M. R. C. S,, Great Britain VOLUME XIII JANUARY, 1931--DECEMBER, 1931 PUBLISHED BY HARVARD SCHOOL OF PUBLIC HEALTH Bo*ton, Mau. S T 085064*4 48 THE JOURNAL OF INDUSTRIAL HYGIENE tained in a second wash bottle. By passing a known quantity of air through these two solutions, sulphur dioxide and hydrogen sulphide at concentrations, respectively, of 0.017 to 0.6 mg. and 0.092 to 0.6 mg. per liter can be evaluated with satisfactory accuracy by determining the sulphuric acid formed.--P. D. Injuries from Ursol in the Fur Industry. R. L. Mayer and M. Fdrster. Abstr. as follows from Zeniralbl. f. Oewerbehyg., June, 1929, N. S. vol 6, pp. 171-178, in Bull. Hyg., July, 1980, vol, 8, p. 571. Ursol is the commercial name given to metaphenylenediamine and is re garded as a frequent cause of dermati tis. The authors emphasize the im portance of functional tests applied to the skin in addition to mere reliance on the family and occupational history. If such testing is applied, the number of cases alleged to be due to ursol falls considerably. The diagnosis "ur sol poisoning" from the history is no more to be relied on than a diagnosis of lead poisoning from the presence of punctate basophilia. Altogether 181 persons employed in the fur trade were examined, of whom 111 in the course of their work had suffered from dermatitis or asthma. Of these 111, 45 per cent, showed existence of eczema and 38.7 of asthma; a combination of the two was found in 16.2 per cent. On testing their siring with a small piece of 2 per cent, para-' phenylenediamine vaseline, 44.1 per cent, showed hypersensitization. io ursol. Forty-six per cent, of those with eczema gave positive reactions, 30.2 of the asthmatics, and 72.2 per' cent, of those who showed presence of both conditions. >a The authors regard 44.1 per cent.; directly due to ursol and 55.8 per ceb doubtfully so. The general question of sensitization of the skin is then discussed in particular relation ursol.--T. M. L. <*> DUST HAZARDS AND THEIR EFFECTS COAlrMlNER'8 LUNQ. An INVESTI GATION INTO THE ANTHRACOTIC LuNGS of Coal-Miners in South Wales. S. L. Cummins and A. F. Sladden. Jour. Path, and Bacteriol., 1980, vol. 88, pp. 1096-1182. This 6tudy of the black lung of coal miners is unusually thorough. It is based on an examination of lungs from thirty-eight cases, many of whom died accidentally. In addition to the path ologic examination, analysis of thirtyfour of the lungs was carried out. Details of these analyses are given, and form the most extensive series of such analyses yet published. Eleven excellent illustrations are given of th$ macroscopic and microscopic condi-. tions seen. The paper opens with 4' useful historical rfeumd of earlier refaf ences to anthracosis and other forma of dust diseases. The authors hold that the blackness of coal miners' lungs is due to coal; any iron present is qui in subsidiary amounts. Frequent fibrosis is present, caused by dusts other than coal, and particularly by silica from intervening rocks. Such fibrosis blocks the lymph flow of th lungs, and coal dust collects in ab dance in such lungs. Normally dust is fairly rapidly removed f ST 0850645 ABSTRACTS 49 healthy lungs, but it may so collect in a diseases among asbestos workers in all fibrotic lung as to form a nodule of countries, but particularly in Great ooal. At times local necrosis takes Britain, are brought together. Refer place, with cavitation quite apart from ence is made to experimental work any tuberculous infection. Discharge carried out by exposing animals to the from such cavities accounts for the dust, the results of which have not all black Bputum of miners. Wherever been published. The lung condition the coal particles were found most is characterized by dyspnea, cough, ooncentrated, analysis showed the con and the presence of asbestosis bodies, tent of silica to be particularly high. possibly in the sputum, but more cer The conclusion is reached that anthra- tainly in the lungs. These bodies are oosis is not a simple condition, but due to organic material deposited upon exists only as a subdivision of lung fine spicules of dust. The fibrosis fibrosis usually due to silicosis. Prob caused is general throughout the lungB, ably the lungs of miners interfered which are bo damaged as to lead to a with by different dusts account for the fatal issue without any secondary in ins, high death rates from pulmonary dis fection necessarily occurring. Such eases, particularly bronchitis, among fibrosed lungs may be detected by coal miners on certain fields, even radiography; but the shadows thrown though their death rate from tubercu are not so coarse as those of silicosis. losis is usually low. Nevertheless, a Diagnosis must depend largely on a condition of anthracosis may be pro knowledge of the occupation of the nounced without interfering with the worker. Prognosis generally is un .-general health.--E. L. C. favorable, since treatment is unsatis factory. The only thing to do is to Asbestos and Pulmonary Abbes- abolish the dangers by suppressing the tosis. V. Dhers. Mid. du travail, hazard. Efforts made to this end are July, 19S0, vol. 2, pp. 147-172; Sept., summarized. The article is accom 19S0, pp. 187-209. panied by a full bibliography contain In this long article the author use ing fifty-six references. It ought to be fully summarizes information relating a useful contribution to which anyone to the occurrence of occupational as interested in asbestosis will turn.-- hestosis. A history of the use of this E. L. C. mineral and its properties is given, to gether with its chemical composition. Pulmonary Asbestosis. A Re Then a description follows of the indus port of a Case and a Review. W. trial uses to which it is put, during B. Soper. Am. Rev. Tuberc., Dec., which dust may be generated, par 1930, vol. 22, pp. 671-584. ticularly during weaving operations. A man of 30 years was admitted to The lungs of workers become affected the William Wirt Winchester Hospital, in direct proportion to the length of West Haven, Conn., on May 26, 1929, time they have been exposed to it, at which time he had been exposed to until after twenty years of work 80 per asbestos dust over a period of about cent, are affected. Statistics and in thirteen years. No indications of the formation as to the occurrence of lung severity of the exposures (:.e., dust VoL u No. s ST08506U6 50 THE JOURNAL OF INDUSTRIAL HYGIENE concentrations) are given. He was admitted to the hospital four months after he had stopped working. At that time his weight' was 143 pounds, or 8 pounds below his "best weight." Physical examination showed 5 cm. chest expansion, con siderable dyspnea particularly on ex ertion, sputum occasionally blood streaked but negative for tuberculosis, occasional r&Ies, burning pain over the whole chest, nervousness, irritabifey, and constipation of three standing. Several nontender "asbes tos corns" were seen on the Blood picture and urine Bhowed noth ing unusual. X-ray pioture was dbtinctive of the cobweb appearance noted previously by Wood (see TVhrcU, 1929, vol. 10, p. 353). The patient was discharged on Jhiy 2, 1929 and reexamined on A|a 9, 1930. During the nine months' interval he had rested at fc*-- Dyspnea had increased, the baaaai^ pain in the chest had been mipi iwhil by dull, drawing pain above the left breast, and weight had increased from 142 to 162 pounds. Respirations were 25 and "even ordinary speech prodnced shortness of breath"; the wnmfiwinn was leaden, with notioeable cyanosis of the ears, hands, and akin on pro--ic; chest expansion was 1.5 cm. (as com pared with 5 cm. nine mnntfc* pre viously). R&les were con--knably more definite and more widogncad than nine months earlier. Among the author's conchiaions axe the following: "The most common singfa is dyspnoea. This and tie symptoms are essentially tW of a progressive generalised lung "The physical signs of umipBcated pulmonary asbestoeis arc sub stantially those of generalized fibrosis of both lungs and basal pleurisy. "X-ray examination is of great value in establishing the diagnosis. "Asbestos contains but a very small amount of free silica but probably conduces to a more hasty evolution of any accompanying tuberculosis, as in the better understood forms of silicosis. "An immediate diagnosis at autopsy is said to be made possible by simply squeezing out upon a slide a drop of lung juice from the fibrosed tissue and covering with a cover-glass. The asbestosis bodies in large number are readily visible under the microscope." --P. D. Pnbumonoconiosis Dub to Flue Dust. W. E. Cooke. Brit. Med. Jour.,Nov. IS, 1980, vol. 2, pp. 816-817. Detailed analyses are given of boiler scale and flue dust, and also of dust particles found in the lungs of a man who had been a boiler cleaner for 113 months. He died from tuberculosis, while X-rays suggested advanced pneumonokoniosis. The lungs were fibrosed throughout, and dust and dust >11b were found in excessive amount. Although the silicious matter in the pulmonary dust was proportionately less than in the flue dust, the occupa tional exposure is held to have cer tainly originated the pathologic con dition. The process of flue cleaning is not favored; during twelve years twenty-seven men have been employed, and have given up the work. Except ing two of these, one of whom worked only one day and the other one week, the average period of employment was fifteen months, while the nearest ap proaching the period of the deceased man was thirty-six months.--E. L. C. J.I.H. March, Wtt 0618 ilue nail ibly tion , as 3 of w iply p of and The are pe." J. LH A, IM1 ST 0850647 ABSTRACTS 51 A Statistical Study of Pul monary Changes Found among Min ers Working in Rock Dust. A. Policard and E. Martin. Bull. Acad, de mid., 19S0, vol. 104, PP- SS8-84S. A clinical and radiographic examina tion was made of 175 men using rock drills in mines in the basin of the Loire, some being X-rayed on several occa sions. As many men came for exami nation on account of illness, the per centage of lung trouble found cannot be held to be representative. Never theless, when divided according to length of work, nearly 50 per cent, were normal with less than one year of work, as compared with 25 per cent, with ten years or over of work. No informa tion as to age is given, which might quite invalidate the findings. Two certain points emerge: one is that even ten years of exposure to mine dust does not necessarily cause pulmonary fibro sis; and the other, than an unusual number of cases of open tuberculosis were discovered. No X-ray picture diagnostic of silicosis was found; but progressive changes in the appearances were of value in detecting the silicotic condition. The authors hold pulmonary silicosis to be a particular instance of tuberculosis developing under special conditions.--E. L. C. Some Aspects of Silicosis. P. Heffeman. Tubercle, 1980, vol. 11, pp. 481-489. A discussion is presented, rather than new faots. The idea is advanced that silica may react by toughening lung tissue generally, while nodular fibrosis occurs at the site of lesions of which tuberculosis is the most common agent. Such nodules may be radio- logic indicators of more extensive silicotic changes taking place, but not casting visible shadows. Silica enters into certain forms of life, and so may be expected to interact with proto plasm. The reaction may be expe dited by such a medium as alkaline soap, with acute silicosis as a result; normally the reaction is a chronic process. ItB development is asso ciated with increasing dyspnea and dry pleurisy. Should tuberculosis not supervene, cardiac hypertrophy and failure ends the scene. Physical signs alone are not diagnostic; nor is a skiagram; a history of exposure to risk and symptoms must also be present. The fibrotic changes are progressive and cannot be inhibited. Coal and certain other dusts may facilitate the exit of silica; but silica has some power of bringing about the retention of dusts otherwise excreted. Prevention of the risk must be effected; it lies in keeping inhaled air free from a suspensoid sys tem of silica-in-air, which behaves, physically, as a gas. The risk may be lessened by minimising exposure to tuberculous infection.--E. L. C. WOMEN AND CHILDREN IN INDUSTRY Women in 5-and-10-Cent Stores and. Limited-Price Chain Depart ment Stores. M. E. Pidgeon. U. S. Dept. Labor, Women's Bur., Bull. No. 76, 1980, pp. 56. This bulletin covers personal infor- Vol. 13 No. 8 ST08506U.8 122 THE JOURNAL OF INDUSTRIAL HYGIENE DUST HAZARDS AND THEIR EFFECTS Congress of Industrial Medi cine. Foreign Letter (Italy), Jour. Am. Med. Assn., Feb. 14,1951, vol. 96, pp. 542-544. This letter contains an account of the Ninth Congress of Industrial Medicine held in Rome. The subject before the Congress--"The Problem of the Re spiratory Pathology of Dusts"--was divided into several parts. Caccuri of Naples discussed the etiology and pathogenesis of respiratory diseases due to dust; Coppa of Naples, the pathologic anatomy and the clinical aspects of respiratory dust diseases; Pastena, also of Naples, radiologic research in pneumonokoniosis. Ab stracts of these papers are included in the letter. Communications were also presented concerning the respiratory diseases of coal heavers and of workers in hemp.--K. R. D. Asbestosis Bodies in the Sputum: A Study of Specimens from Fifty Workers in an Asbestos Mill. F, W. Simeon and A. S. Strachan. Jour. Path, and Baderiol., Jan., 1951, vol. 54, pp. 1-4 The result is reported of examining sputum from fifty workers who were intensively exposed to asbestos dust in a mill in South Africa. Asbestosis bodies were easily demonstrated by direct thick films. They were found best by examining specimens taken early in the morning; in the evening the mouth and nasal pharynx were too loaded with dust for the bodies to be easily detected. The sputum was always mucoid in character, often resembling egg albumin. No tubercle bacilli were found. The asbestosis bodies were intracellular, and their study suggested that they were formed by the deposition on asbestos fibers of iron containing substance elaborated by the cell. The shortest exposure to be followed by the appearance of the bodies was five months.--E. L. C. Further Observations on Pul monary Asbestosis, with Special Reference to Asbestos Dust and the Curious Bodies Found in the Lungs. W. E. Cooke and C. F. Hill, Abstr. as follows from Jour. Roy. Miar.1 Soc., 1950, vol. 50, p, 15, in Physiol. Abstr., Feb., 1951, vol. 16, p. 626. In a case of suspected pulmonary asbestosis sections of the lung or macerations of the tissue revealed a* large amount of fine granular black dust, but the fine spicules of fiber' which make up the bulk of asbestos dust were not found. There were present, however, Jarge fragments (5 to 360 microns) closely resembling in size, shape, and color various constit uents of asbestos dust. These large fragments are found in the lung em bedded in fibrotic or necrotic areas of which they are the cause. In addi tion, curious bodies were present which are believed to be diagnostic of pul monary asbestosis. These bodies were eventually shown to consist of a cen-; tral core of asbestos fiber enclosed in adsorbed dibris.--C. K. D. Anthracosis, Silicosis, and Tu berculosis in Coal-Miners. S. L. Cummins. Lancet, Jan. 51, 1931,' vol. 1, pp. 255-258. The claim is made that anthracosis is a dual condition, in which coal dust J. I. H-~ May, 1931 ABSTRACTS ST 0850649 123 "ja retained in the lungs owing to a gtate of fibrosis with lymph blockage. ;The pathologic condition arising from dust inhaled together with the coal and also chemical analyses are similar, so far as the oontent of silica, to those found in cases of pure silicosis. In . certain cases of "hard heading" work, [where rocks rather than coal are ' mainly tackled by the miners, silicosis develops which is indistinguishable 'from that seen in other cases of silica sk. But when coal has been the chief dust inhaled, no tendency to succumb cm tuberculosis is found; and the iggestion has been offered that coal Just exerts a protective influence gainst tuberculosis. This idea is, however, not definitely accepted; at st, the suggestions to explain why he coal miner has a low mortality *rom tuberculosis, although his lungs ow definite fibrosis, are not accepted, cfessor Cummins now puts forward " e possibility that carbon particles the lungs adsorb the active principle f tuberculin. He points out that ch adsorption occurs in vitro, since e has found that finely powdered dust anthracite coal is capable of adrbing a large proportion of the tive principle from old tuberculin *uted with normal saline solution, .lether or not carbon dust particles bathed in the tissue juices retain this adsorbing power requires further inves tigation. Some clinical facts appear favor the theory. Certainly, negave sputums are more common in ilcally tuberculous coal miners than other clinically tuberculous adult Although any excessive liabil- to tuberculosis is absent in the case f-coal miners, a high mortality from inchitis among old colliers is present, which, in all probability, is closely as sociated with the life of exposure, not only to coal dust but to stone dust as well.--E. L. C. Observations on the Differen tial Diagnosis of Silicosis bt Means of the Roentgenogram and an Investigation into the Risks of Sand Blasters. Lochtkemper. Abatr. from Arch. /. Gewerbepath. u. Gewerbehyg., 19S0, vol. 1, pp. 71-808, in Ber. u. d. gea. Physiol, u. exper. Pharmakol., Oct. 8,1980, vol. 56, p. 188. The author distinguishes roentgenologically the various forms of silicosis, pneumonokoniosis caused by quartz dust. The first stage is characterized by enlarged hilum glands and by in creased vascular markings; the second stage, by numerous infiltrated and iso lated nodules and increased induration ; the third stage, by the so-called "snow storm" effect, which is partly an iso lated and partly a confluent mottling. The rate of dust inhalation and the concentration of the quartz content are important in the resulting roentgen picture. Among workers in industries whose dust contains free silicic acid-- sandstone grinders, stonecutters, sand blasters, porcelain workers, and stone hewers--there are found in the X-ray picture of the lung, near the enlarged hilum, small, sharply defined shadows from pinhead to pea in size, some of which are isolated and others joined by fine streaks. The thickness of the nodules is greater in sandstone grinders and stonecutters than in porcelain workers and stone hewers, and in occu pations in which a mixture of quartz and clay dust is inhaled. In the fur ther development there is a gradual increase in the small shadows with an oLu ST0850650 124 THE JOURNAL OF INDUSTRIAL HYGIENE incipient conglomeration to form larger connected shadows and a gradual coalescing, phenomena which are asso ciated with stonecutters, w;et sand stone grinders, and sand, blasters. The circumscribed shadows appear less clearly in the lungs of stone hewers. Weak, diffuse, and cloudy shadows are characteristic of the coal dust lung; silicotic shadows are, how ever, for the most part, also evident. The X-ray picture of the schamotte stoneworkers shows less nodule forma tion, and a Bomewhat greater expanse of connected shadows. In the second part of the paper are reported the results of the examination of twenty-five sand blasters, twenty of whom had indications of Bilicosis in different stages. The Effect of Pbolonged Expos ure of the Siliceous Spicules of a Water Sponge (SpongiUa Fragilis) to the Action of Animal Tibsues: A Contribution to the Pathogenebis of Silicosis in Man. R. 0. Mills. Am. Jour. Hyg., Jan., 1931, vol. IS, pp. 24-234. The spicules of the fresh-water sponge, SpongiUa fragilis, are com posed of opal, a form of hydrated silica, which is similar to quartz in its chemical reactions. These spicules, when introduced into the tissues of animals, are slowly but definitely dis solved, proving conclusively that silica is soluble in the tissue fluids of animals, and presumably of man. This con firms the assumption held by many students of silicosis that particles of silicious material are gradually con- ' verted into the colloidal state and as' such exert a fibroplastic influence on the lungs of miners and other exposed industrial workers. Definite fibrosis. of the lung of a dog into which the, spicules had been introduced suggests that there is a concomitant injuiy attributable to the disappearance by', solution of the silicious elements of the ' spicules.--Author's Summary. OCCUPATIONAL AFFECTIONS OF THE SKIN AND SPECIAL SENSES'. Occupational Eczema. Af. Oppenheim. Arch. Dermal, and Syph., Feb., 1951, vol. 23, p. 346. The dermatitides may be divided into the following groups: (1) In der matitis, sensu strictiori, the skin is able to deal with the irritant; almost every one's skin reacts to certain strong irri tants (e. g., croton oil); even if, with Blight variation, the course is acute, healing soon follows the removal of the poison. (2) In toxicoderma there is a congenital or acquired idiosyncrasy. The slightest irritant evokes it. The incubation period is short. The effect is marked and the course acute. (3) In eczema the entire skin is sensitized. For this reason the intensity of the irri tant may be slight. The development of dermatitis is gradual. The course is prolonged and healing delayed. Occupational eczema is among the most frequent of eczemas, the most frequent of skin diseases, and the most frequent of all diseases. The predis posing factors are important: immer sion of the hands in water, soap, alkali or acid, and the influence of heat, cold, and mechanical action. Occupational eczema iB allergic, but the predisposing factors mentioned play an important part. Dermatitis artificialis acuta re-1; May, 1WI ST085065 I 206 THE JOURNAL OF INDUSTRIAL HYGIENE absorption of the tar. On the other hand, removal of fat from the skin by preliminary treatment with petroleum ether produced an opposite effect, the number of tumors being decreased. As the authors point out, other investigators have obtained results directly contrary to those described in this paper. Further Investigations on the Treatment of Tar Tumors in Mice with Certain Amino-Acids. F. VUs, A. de Coition, and J.-L. Nicod. Abstr. as follows from CompU rend. Acad. d. sc., 1980, oo1.191, p. 850, in Am. Jour. Cancer, April, 1981, vol. 15, p. 898. One hundred and seven mice with tar cancer (verified by biopsy) were given an equimolecular mixture of alanine, cystine, and proline by mouth, subcutaneously, or by both routes. The dose was 0.03 to 0.075 gm. daily. In twenty-six cases the tumor dis appeared entirely; in thirty-seven there was partial regression; in nine the tumor continued to grow, and in thirty-five animals it remained sta tionary. This last group, however, contained a number of mice that died less than fifteen days after treatment was begun and before it had had time to exert its full effect. Among fortytwo controls not a single case of regression had been discovered. A mixture made up in the propor tion of two molecules of d-glutamic add to one of l-cystine promised to be even more successful. Among twenty mice treated, the carcinoma disappeared in ten and regressed par tially in six more; three tumors con tinued to grow, and one remained stationary. DUST HAZARDS AND THEIR EFFECTS Contrivances for Dustless Fill ing and Packing of Dust Produc ing Materials. Beihefte z. ZentraJbl. f. Gewerbehyg., no. 19, 1980, pp. 48. Reviewed as follows in Bull. Hyg., Nov., 1980, vol. 5, p. 897. This publication on a question of very great hygienic importance deals with the engineering side of the subject and as such is too technical to be of direct service to the medical officer of health. The author lays stress on the dual aspect of the problem: first, the importance of catching up the dust as soon as it is formed and render ing it innocuous; and secondly, the method of dealing with it afterwards. Naturally, the treatment will differ according to the industry, the nature of the dust, its quantity, and whether it is of sufficient commercial value to recover, or whether it has to be got rid of as a waste product. The work is amply illustrated both by photo graphs, and diagrams, all of which are well and clearly reproduced.-- H. H. S. Recent Vrews on Pneumonoconiobe8. E. L. Collis. Proc. Roy. Soc. Med., March, 1981, vol. 24, pp. 581-540 (Epidemiology and Stale Medi cine, pp. 18-22). (Abstract by author.) This article presents a summary of work done with regard to dust diseases since the author's Milroy Lectures, 1015. Studies have shown that silico sis may be advanced without impair ing health; but it may itself end fatally. Generally superimposed j. i. h. ABSTRACTS 51*0850652 207 tuberculosis hastens the termination. Silicosis and Coal-Mining. J. Suoh infection may precipitate latent S. Haldane. Tr. Inst. Min. Eng., fibrosis. Other dusts may set up 1981, col. 80, p. 416. fine, generalised fibrosis, seriously In earlier papers1 the author con impairing the pulmonary functions, cluded (a) that no danger to health but not predisposing to tuberculosis. would arise from stone dusting, Dro- Asbestos is particularly injurious; vided suitable shale or other material other silicates, such as basalt, are was employed; and (b) that the un harmful. Pure coal dust seems to be usually high bronchitis mortality rate quite neutral; but raw coal often among colliers in the higher age contains sufficient minerals to originate groups is due mainly to the strain on fibrosis; while fibrosis may so retain the lungs caused by muscular exertion. coal particles in the lungs as to block In the present paper Dr. Haldane the lymph passages and impair func reviews his conclusions in the light of tion. Radiography displays the pres the full data contained in the Regis ence of fibrosis, but gives no clue to trar-General's Decennial Supplement the causative faotor. When silicosis for 1921 to 1923. is present the shadows tend to be The phthisis death rates for the nodular, superimposed upon pro various groups of underground workers nounced arborization. Reference is are distinctly lower than those for all made to recent mortality records occupied and retired civilian males. associated with different dust hazards. Even in that group engaged in making Clinical and pathologic studies are and repairing roads, which includes the summarized, which are concerned with work of ripping stone roofs and driving dusts of iron ore, cement, coal, asbes roads in stone, the death rate from tos, and marble. phthisis at all ages above 25 is lower than for the standard population. It The Presence of Asbestosis is mentioned, however, that in excep Bodies in the Faeces in a Case tional cases great risk may occur of Pulmonary Asbestosis. S. R. among men driving roads in highly Gloyne. Tubercle, April, 1981, vol. IB, silicious rock, particularly when pp. 168-169. machine drills are used. The Mines This short note describes how asbes-` Act of 1911 required certain precau tos bodies in cases of pulmonary tions in the use of these drills, but asbestosis may be found by emulsi the clause was practically ignored. fying the feces in four to five times As a result, cases of silicosis have been their volume of 5 per cent, formalin discovered in the Somerset and South in saline and then centrifuging the Wales coal fields. product, which will be found to con The thesis is advanced that the tain a scanty number. The bodies, inhalation of coal dust and shale dust, which have probably been swallowed as among coal miners, coal boat in sputum, show less than usual of loaders, or cement workers, stimulates the typical deep-yellow coloring mat ter, as though the pigment were partially destroyed by intestinal juices.--E. L. C. 1 The Effects of DuBt Inhalation. Tr. Inst. Min. Eng., 1917-1918, vol. 55, p. 264. The Health of Old Colliers. Ibid., 1915-- 1916, vol. 51, p. 469. ST 0850653 208 THE JOURNAL OF INDUSTRIAL HYGIENE the phagocytic activities of the lung, and thus confers a relative immunity from phthisis. As compared with coal, shale, or clay duBt, the dusts of china clay, slate, and feldspar are very slowly eliminated, and it is suggested that this explains why neither the china clay used in potteries nor the feldspar in true granite pro tects against silica. Dr.- Haldane dissents from the idea put forward at a recent Congress at Johannesburg, that the risk of silicoaiB is simply pro portional to the proportion of free silica in the dust. Instead, he suggests that the action of free silica in paralyz ing the phagocytes is commonly over come by the action of other substances in eliminating them, but where these latter substances are absent or in sufficient the silica action is pre dominant. The view that the high bronchitis mortality is due to heavy muscular work is reasserted, although it is conceded that "it seems practically certain that excessive inhalation of coal-dust or shale-dust must cause bronchitis, and ought therefore to be avoided." In a subsequent dis cussion Professor E. L. Collis quoted comparative mortality figures for miners in different coal fields. It was shown that the comparative mortality from bronchitis in 1921 to 1923 for miners (hewers and getters) varied between the extremes of 33.8 for Leicestershire and 139.3 for South Wales, as compared with 49.6 for all occupied and retired males. It was suggested by Professor Collis that these differences hardly accord with differences in the work done, and do not support the musoular exertion theory of Dr. Haldane.--T. B. Silica Content op Normal and of Tuberculous Lung. R. Piazza. Ri~ forma med., March 9, 1981, vol. 47, p. 869. OCCUPATIONAL AFFECTIONS OF THE SKIN AND SPECIAL SENSES Boils and Carbuncles among Miners. S. W. Fisher. Lancet, April 4,1981, vol. 1, pp. 760-751. The occurrence of boils among miners at one colliery led to an inquiry which covered forty-nine collieries; about 200 men were examined. The main factor in the causation of the boils was found to be a wet bulb temperature of 76F. or over. At such temperatures the men work stripped, i.e., wearing shorts and boots. Boils occurred more often on men who sweated profusely; their bodies were covered with a fine wet film of coal dust. The condition seems to be analogous to prickly heat and boils which occur in India in the rainy sea son. The fact that no men working in mines which had pithead baths were found to have boils, points to the value of cleanliness as a preventive measure. Some evidence of infection from man to man was found; cases followed one another in a given working stall. The offending organism was the staphylo coccus, which under warm, moist conditions gained access to the open sweat glands and hair follicles.-- E. L. C. J. I. H. Oct., mi ABSTRACTS ST085065U 241 the workingmen of the country.-- H. H. S. Pulmonary Asbestobis II. In cluding the Report of a Pure Case. K. M. Lynch and W. A. Smith. Am. Rev. Tuberc., June, 1931, vol. 23, pp. 843-660. In a survey of all available literature on the subject up to the present time we have collected 172 cases of pulmo nary asbestosis. There are references to this subject in one or two abstracts, notably those of Bridge and of Sir Thomas Oliver, but specific cases are not enumerated. In four cases belong ing to Wood's series the diagnosis was doubtful, and in the majority of others the diagnosis was based entirely on clinical and roentgen findings. There were twenty-seven in which the diag nosis was confirmed by the finding of the asbestosiB bodies in the sputum, in the lung juice by puncture, or by nec ropsy. Necropsy has been made on eighteen oases. In three of these the disease was complicated by pulmonary tuberculosiB, three by lobar pneu monia, three by bronchopneumonia, and one was a traumatic death. In four the authors failed to give a com plete report, stating only that the necropsy confirmed the diagnosis. In cluding the very first case recorded, that of Murray in the Charing Cross Gazette of 1900, which apparently received little attention until resur rected by Cooke, there are now four records of necropsy on uncomplicated pulmonary asbestosis. Except those reported by ourselves, and those by Pancoast and Pendergrass, and four others by Simson from South Africa, these cases have all developed in the British Isles.--Authors' Summary. A Case of Pulmonary Asbestosis. H. E. Seiler and M. D. Gilmour. Brit. Med. Jour., June 27, 1931, vol. 1, pp. 1112-1114. The pathologic findings are reported of a fatal case of asbestosis uncompli cated by pulmonary tuberculosis. The man died, aged 42, after twentythree and one-fourth years of occupa tional exposure to asbestos dust in a textile mill. Death was due to cardiac failure secondary to back pressure from massive generalized fibrosis. Before death, cyanosis was pronounoed; and diffuse fine mottling of a silicotic type was detected on X-ray. The macro scopic appearances were typical of dense pulmonary fibrosis, with other organs secondarily affected--dilated heart, nutmeg liver, and indurated spleen and kidneys. The fibrosis was generalized, with no nodules or whorls, as in silicosis; no polymorphonuclear cells were to be seen in the bronchi or elsewhere. Asbestosis bodies were abundantly present, and also a great deal of yellow pigment in the form of granules and globular masses. No tuberculous lesions were found.-- E. L. C. The Formation of the Asbestosis Body in the Lung. S. R. Gloyne. Tubercle, June, 1931, vol. 12, pp. 399-401. Pictorial presentation is given in this short note of the formation of asbestosis bodies. They appear to be formed by the deposition of some or ganic material around an asbestos fiber; this material then fissures or cracks, giving rise to the appearance of segments; finally, fragmentation from the asbestosis body may separate portions. There is evidence that iron Vol. i No. 9 ST 0850655 242 THE JOURNAL OF INDUSTRIAL HYGIENE is a component of the material de posited on the inhaled fiber. During the reaction which takes place, solution of a fraction of asbestos occurs; but evidence is lacking as to how the long asbestos particles, which sre far longer than the diameter of a dust cell, are introduced into the pulmonary tissues. --E. L. C. Pnetjmonoconiosib. The De lated Development op Symptoms. J. A. Britton and J. R. Head. Jour. Am. Med. Assn., June 6,1981, vol. 96, pp. 1988-1989. Most clinical and statistical Btudies of silicosis have been made on groups of men still employed in dusty trades. From such statistics one cannot say what is the late effect of short expo sures. Id this paper we have reported four cases of silioosis or silicosis and tuberculosis which developed many years after relatively short exposures. These instances suggest the neoessity of revising the conception of the length of exposure necessary to produce the disease and make it seem probable that after relatively short exposures suffi cient dust must be deposited in the lungs to set up a progressive fibrosis, which only after many years becomes sufficiently extensive to produce symp toms. They tend to indicate that men in the work develop symptoms only after many years of exposure, not because that length of exposure is necessary but because it takes a long time for the disease to develop. --Authors' Conclusions. Silicosis. T. H. Belt. Canadian Med. Assn. Jour., Dec., 1980, vol. 88, pp. 808-804- This is a general discussion of silico sis and of the various theories as to the method of action of silioa dust in the lungB.--M. C. S. Diagnosis op Pulmonary Silico sis. C. Garin. Abstr. as follows from Presse mid., April 18,1981, vol. 89, p. 668, in Jour. Am. Med. Assn., July 11, 1981, vol. 97, pp. 143-144. Garin states that most of the authors cited by him reported cases of silioosis in which tuberculosis was present. None of them attempted to bring out the differences between the two condi tions. He stresses mostly the roent gen side of the question. In his roent gen studies he found that about 85 per cent, of the cases are those of a granular silicosis. He believes that the granular aspect of chest roentgeno grams is not positively that of pure silicosis and it should not serve as an exclusive base for diagnosis of silicosis. The diagnosis between simple silicosis with a granular picture and pulmonary tuberculosis is, however, easy: the patients with silioosis have no fever and the condition is progressive. On the other hand, diagnosis becomes almost impossible in cases of silicotuberculosis, in which the tubercle bacillus interferes with the develop ment of a pure silicosis. In suoh cases it iB impossible to pronounce the pa tients sick with silicosis or with pure tuberculosis. One can only make a diagnosis of silicotuberculosis. 1,1. E. Not., INI