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FILE NAME: General Electric (GE) DATE: 1943 DOC#: GE037 DOCUMENT DESCRIPTION: Book Excerpt - Principles and Practice of Industrial Medicine rr \ V.:- r The Principles oj INDUSTRIAL Edited FRED J. WAM Professor, Preventive am M&DICa L c o l l k u i CONTRIB Otis L. Anderson R. N. Anderson Anna M. Baetjer J. J. Bloomfield J. A. Calhoun J. M. Carlisle George H. Cross Donald E. Gumming Charles F. Engel John H. Foulger Augustus Gibson T. Lyle Hazlett Albert Hemming F. F. Hcyroth Joanna Johnson R. T. Johnstone George Zur A William H' BALT1M' TUE WILLIAMS & W] lit 1M 'An d er so n , Ot is l-., IVSr,., M .U ., J'.A Surgeon, United State? Public lb sion of Venerea] Diseases, Nati Maryland. A n derson, R ichard N., B.A., M.A. Director of the Division of Rehaf (.ion of (be Virgiiuii State Dry Virginia. B a e t je k , A nna M., Se.D. Associate in Physiological liygie Health, The Johns Hopkins U B loom field, J. J. Sanitary Engineer, United States States' Relations Section, Divis Institute of Health, Bethesda, C a lhoun, J. A., M.D. Medical Director, American Viscc ware. C a r lisle, J. M., M.D. Medical Director, Merck and 1 Professor of Industrial Medic Medicine, Philadelphia, Pennsy of Industrial Health and Hygit of Health. Cross, G eorge H., M.D. Associate Professor of Ophthalmi Gradual* School of .Medicine, C C umming, D onald E., B.S.* Associate Professor, Department c of Industrial Hygiene, Universii Denver, Colorado. : E n g e l , C harles F., M.D. Assistant Medical Director, West: ing Company, East Pittsburgh F oulger, J ohn II., M.D., Ph.D., F.A.( Medical Director, Haskell Labora mington, Delaware; Associate Medical College of Virginia, Ric * Deceased , 111*2. X LIST O F CON'TTIIlilJTORo G ibson, A ugustus, M.D. Physician, Merck and Company, Rahway, New Jersey. H azlett, T. L y l e , M.D. -y Medical Director, Westinghouse Electric and Manufacturing Com pany; Professor, Industrial Hygiene, Univetfeity of Pittsburgh,Pitts burgh, Pennsylvania. H emming, Al b e r t , M.B., Ch.B. Physician, Merck and Company, Rahway, New Jersey. H ey ro th , F ra n c is F., M .D . Assistant Professor of Research Physiology, Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. J ohnson, J oanna, R . N. Supervisor, Industrial Nursing Division, Employers Mutual Liability Insurance Company, Milwaukee, Wisconsin. J ohnstone, R utherford T., A.B., M.D. Director of the Department of Occupational Diseases. Golden State Hospital, Los Angeles, California; Formerly Assistant. Professor of Medicine, University of Pittsburgh School of Medicine, Pitts burgh, Pennsylvania. K ehoe, R o bert A., M.D. Research Professor of Physiology, Director, Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. K ronenbehg, M ilton H., M .D. Chief, Division of Industrial Hygiene, and Industrial Medical Super vise)-, Department of Public Health, State of Illinois; Assistant Professor of Bacteriology and Public Health, University of Illinois Chicago, Illinois. K uechle, B. E., A.B. Vice-President and Claims Manager, Employers Mutual Liability Insurance Company, Wausau, Wisconsin. L u c k iesh , M a t t h e w , D.Sc., D.E. Director, Lighting Research Laboratory, General Electric Company, Nela Park, Cleveland, Ohio. M acule, W il l a r d , M.D. Associate Professor of Research Physiology, Associate Director, Ket tering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. M cK e e , It. W., Pu.D. Instructor in Industrial Hygiene, School of Public Health, Harvard University, Poston, Massachusetts. LIST O l - M orris, S arah I., M.D., I1-V C Professor of Preventive Mcc sylvania, Philadelphia, Pc Torse, K en n eth , M.S. Industrial Engineer, Divisii Department of Public He . Moss, F rank K., E.E. .. Physicist, Lighting Research Nela Park, Cleveland, Oh - P eterso n , C . M., M.D. Secretary, Council on Indus tion, Chicago, Illinois. R obertson, D. F., M.D. Associate Medical Director, Jersey. R o ssiter, F rank S., M.D. Medical Director, Carnegh Pennsylvania. Saw yer, W illiam A., M.D. Medical Director, Eastman 1 Schw artz, L ouis, M.D. Medical Director, United St Dermatoses Investigations National Institute of Healti T hompson, Lorix A .,B h.D . Director, Population Study, mond, Virginia^ W am pler, F red J., M.A., M.D., Professor, Preventive and It Out-Patient Cliiiic, Medical Southern Biscuit Company WrujAMs, G eorge Ztin, M.D. Associate Profess! of Pathol mond, Virginia Member of 372 PRINCIPLES AND PRACTICE OF INDUSTRIAL M E D IC IN E VU. OTHER PNEUMOCONIOSES . There is considerable disagreement in the medical literature concerning the exact etiology of certain types of pulmoniary fibrosis due to dust inhalation other than silica dust. Asbestosis, siderosis, and antbracosis are the most important of these fibroses. g Asbestosis It has been well proven that a peculiar type of linear pulmonary fibrosis is caused by minute asbestos fibers inhaled by workers in industries utilizing asbestos for the manufacture of fire resisting material, insulation, certain fabrics and ropes, paints, roofing, tile, etc., as well as the manufacture of asbestos itself. Asbestos is magnesium silicate and is the only; silicate which has experi mentally been proven to produce a pulmonary fibrosis without exposure to silica. The onset and clinical course of asbestosis is similar to th a t of slowly progressing silicosis jnd the s3'mptoms in the later stages are identical. Fatal termination is usually by complicating pneumonitis, cardio-vascular. decompensation, or tuberculosis. The roentgenopathology is typical and not difficult to differentiate from silicosis. Gloyne and Merewether state that the roentgenological appearances of asbestosis are revealed typically as a general lack of translucency with a fine pinhead mottling. This is the characteristic "ground glass" appearance. The film should always be compared with a film of a normal patient and a film of a silicotic patient taken with the same exposure. The diagnosis depends upon a definite history of exposure to asbestos dust including sufficient period of exposure, roentgenological appearance, decreased pulmonary capacity, and the finding of asbestos bodies in the sputum of patients not yet removed from exposure to the dust. These asbestos bodies are well described and usually illustrated in most text books of clinical pathology. The pathology may be summarized -in the single statement, that it consists of a persistent, progressive, diffuse perialveolar fibrosis of the lungs. T ie fibers may be seen on histological examination to lie embedded in the fibrous walls of alveoli and bronchioli and each fiber appears to be encrusted by an iron-containing yellow pigment. As would be expected, in the later stages the fibrosis becomes confluent and 'massive.' 1 ' 1* ' . ' v ", ` Siderosis > ...... ` Siderosis is chiefly a red pigmentation of the lung tissue due to inhalation . of iron-containing dust frequently found in hematite miners.- `Experi mentally, fibrosis.has not been produced by pure, iron or iron oxidc. dust pn; and only when mixed with has ty fibrosis result. Therefore, unle siderosis by itself is asymptom f W - c l i n i c a l findings. .. ... Black pigmentation of the lui types of carbon particles is co industrial cities. Most marked There is some controversy cone carbon dust of itself can produo ' elusive experimental evidence th : I t is the author's opinion that al ' v are due to an admixture of Riling. ; fibrosis due to respiratory disr produces no clinical findings or d RE American Public Health Association: coniosis and the Committee on & tional Diseases, Year Book, 1933, B elt, T . H ., Irwin, D., and King, E persons without occupational exp< ' J., 34 (2): 125-133, 1936. Burke, H. E .: The detection of minei Hyg., IT: 27, 1935, C ole, L. G., and Cole, W. G .: Dysp ; 113: 1216,1939. | Cummins, S. L.: The augmentation of t*fV- tubercle bacilli. Brit. J. Exp. Pj D rinker, P., and Hatcr, T .: Industri E llman, P.: Pulmonary .asbestosis: i tures, and associated, risk of tube) Gardner, L. U.: Pathology of so-cal 1240, 1933. Gardner, L. U.: The pathology and coniosis. J. A. M. A., 114: 535-54 Gardner, L. U .: Recent developments Feb. 1940. Gardner, L. U .: Studies on experimei vy; of healing primary tubercles in the m 1' ' carborundum dusts.7 Am. Revt of `"' .GlOTNE,' S. R., ANDMeBEWETHER, E.T BtT'; ' : H atch,' T., and THOMrsdN, E. W.: A ra] quantitation for routine plant opei . I nternationa!. L ab&our 1'P ffice y:.Pneu ^ reporte, serios F (Tnd:vHyg.),