Document QXoBEbqx0bKX64ZEnOXnXqrzL

TOL. 53, IVo. 5 AL'CFTbST. 1843 2 DEPOSITION EXHIBIT *3-Id s^rsr. By DR. H. VON' WEDEl, DR. WiLLIAM A. HOLLA*, AND DR. JAMES DENTON Deportment oj Pathology, White Plains Hospital, and the Department of Health. Westchester County, l\'cw York P OK over twenty years chlorinated naphthalenes have p* i> . :i extensively used for insulating wire and in the 8 manufacture of certain electrical equipment. Chlor inated naphthalenes and chlorinated phenyls (sold mdc" the trade names of Halowax and Arochlor'' have marked electrical, he."' .and moisture resisting proper ties. rind are practical'.}' non-inllammable. Their use in tin- manufacture and yeparation of many types of elec trical equipment has b"cn tremendously increased, due to '' e enormous increase iti the use of such equip ment for the prosecution of this present world war. In some mills hot concentrated Halowax is used to salivate wire insulation, while in other mills the com pounds are dissolved in organic solvents, the solutions then being used cold to saturate the insulation. In bc'.:' these processes the wet insulated wires are dried m drying tubes or ovens. During this drying process dange-ous concentrations of chlorinated compounds are given off. - It has been known fo" many years that these com- p'f."':s cause acne-lik" eruptions. In recent years seri- 4'ornmissioncr o* Health, heeler Comity. N. V. ous systemic effects have been recognized. Durmg the past year main- cases of skin eruption and in ''`bon. six fatal cases of a peculiar type of subacute yellow .'.trophy of the liver have occurred among the v "'kers in two wire and cable mills. At the .""quest o'" die management of one of t'vse mills and :r conpcra'l.-m with the Department of Health of W est: ester (.' t'r.'.y (X. Y.), one of the authors undertook an investigation of the mill in order to abuse the management and the Department of Health as c means of pe vention ' ; the cutaneous lesions and svstemic effec's .suiting .rom these toxic hvdrocarbons. This .on 1 used t' e cold process for saturating the wire insula'km. As the study progressed, it became apparent that the toxic lesions resulted freer, inhalation, by men v.'> -king in or near the drying ovens ami ab'< uy some w.her in ''hod (if absorption, presuma! 'y through Dc skin. Tws fact was clearly shown, because -iy o''t' cueform eruptions occurred among the t oper g the s." oration baths -and n-'t exposed t" the ir\"' ion " . ar i. A few of the acne-form er.U'tions o r - vd .up mg workmen handling the cold `unshed win '' a mill-room far removed `'-'m any possible ini":' .ion 419 WATER PCB-SD0000038832 hazard. Women working in tile same mill runn -,viih the affected men showed no acne-form eruptions. None of these women handled the toxic substances. An investigation was begun to determine \vh; . sys temic effects would result from the admmistr.v.. :i of these substances to experimental animals by in!)..'...'.inn, ingestion and by surface application of the sub.-nmees to the skin. This article describes pathological changes observed in man and experimental animals resulting fiont absorption of these toxic substances, and suggests , means of preventing this absorption, Historical Lehmann in 1919 (lj found that .animals which were led or which inhaled chlorinated naphthalenes lost ap petite and at death showed peculiar lesions in the liver. Flinn and Jarvik (2) in 1936 reported three cases of yellow atrophy of the liver occurring in three widely separated plants. Experimental studies on rabbits, using different compounds of chlorinated naphthalenes, indicated that the toxicity of these compounds in creases. with the increasing degrees of chlorination. Flinn and jarvik (S) later reported nine cases of yellow atrophy of the liver occurring in mills where chlorinated naphthalenes were being used to impregnate wire and other electrical equipment. The)'.concluded that the cases of yellow atrophy of the liver occurring among the employees were .probably due to exposure to chlorinated naphthalenes. Drinker, Warren and Dennett (4) in 1938 described the morphological changes in the liters of rats exposed to chlorinated naphthalenes and chlorinated phenyls. These investigators administered the toxic substances by inhalation, feeding and subcutaneous injection. They found that the tri and tetra chlorinated naphthalenes produced only slight pathological changes in the liver, unless extremely high concentrations were used. How ever, animals exposed for six weeks to the higher chlorinated naphthalenes ir. low -concentrations regu larly showed marked liver damage, even though tbev gave no clinical evidence of such toxicity before death. The toxicity of each compound seemed directly related to its degree of chlorination. W idespread liver degeneration can exist for several months without producing any evidence of ill-health in the animals, suggesting that the alterations take place slowly. Animals given a sublethal close of chlorinated compounds, when given a very small dose of carbon tetrachloride immediately died, even though such a small dose of carbon tetrachloride given to a normal animal would nor materially affect it. Exposure of rats to either highly chlorinated naphthalenes or chlorinated diphenyl results in a type of liver injur)' differing con siderably from the liver lesions resulting from carbon tetrachloride (5, 6) and chloroform (7) poisoning. The changes resulting from exposure to the com pounds employed in their stud)- involved all portions of the liver lobule, even though the initial morpho logical changes were more pronounced in the liver cells nearest the hepatic veins. The changes were degen erative in nature, first cloud)' swelling then fatty infil tration and fatty degeneration. Complete disintegra tion of the cells with areas of necrosis finally resulted, regardless of the method of administration. This de generation was characterized by accumulations of large amounts of acidophilic hyaline material. The characteristics of the liver changes produced can be markedly altered, quantitatively and qualitatively, b) varying the degree of exposure. Flood examination during life revealed no significant abnormalities, and the injurious effects of these compounds were mani fested solely in the liver. The investigators concluded from their experiments that lower air-concentrations must be obtained in the case of the more highly chlorinated naphthalenes and chlorinated diphenyls, than for trichlorinated naphtha lenes, if a safe environment for workmen is to be as sured. Yarglou, Sands and Drinker (S) reporting on the ventilation of wire impregnating tanks using chlori nated hydrocarbons, showed that the requirements for the ventilation of such tanks varied greatly with the type as well as with the size of the tank, They sug gest that an exhaust slot about 2 inches high extending along the full length of the tank with lateral ventilation was the most effective method of ventilating such tanks. For any given concentration of chlorinated naphthalene the degree of chlorination had no appreciable effect on ventilation requirements. Greenburg, Mayers and Smith (9) in 1939 reported three cases showing the .occurrence of similar patho logical changes in the liver in three young adults known to have been working with chlorinated naphtha lenes and diphenyls. They briefly summarized the systemic effects resulting from this exposure and made recommendations for prevention. Drinker/T/D in 1939 reported further observations on the possible systemic toxicity of certain of the chlor inated hydrocarbons. From this stud)' he concluded that the permissible limit for air contamination with trichlor naphthalene was 10 nigm. per cu. m.; for tetra and penta chlor naphthalene, 1 rngm. per cu. m.; for pema and hexa chlor naphthalenes, O.c rngm. per cu. in.; and for the various chlorinated diphenyls 0.5 rngm. per cu. m. ... Cleary, Maier and Hitchings (llj in 1938, reporting on the metabolism of chlorinated naphthalenes, stated that no significant storage of the material could be de tected in lung, liver, skin or kidney, nor was an)' sig nificant amount excreted in the urine. Both the rat and the dog apparently were able to remove and ex crete the chloride promptly. A rise in the unitary ethereal sulphate fraction, but no significant change in the neutral sulphur excretion, was noted after chlor inated naphthalene feeding in the dog. Riley (12) in 1943 stated that poisoning may result from inhalation of vapors, from prolonged skin con tact with the vapor, liquid or solid phase, and from in gestion of the chlorinated material. Cranch (13) in a recent personal communication to one of the authors, stated that the eff ect u: these waxes on the skin resulting in the appearance oi acne is not determined by the presence of chlorine alone, but is due rather to the compound effect of chlorine and a tar derivative. No such marked tendency to acne for mation results from exposure to chlorinated petroleum derivatives, sue!) as chlorinated paraffin. When Chlor inated naphthalene is combined with chlorinated di- phenvl, a more active acne is produced. Liver damage is not likely to occur following exposure to chlorinated naphthalene alone, but may occur from exposure to chlorinated diphenyl combined with chlorinated naph thalene or other tar derivatives. The severity ot the acne is not correlated in any way with the degree of liver damage which might occur. _ Cranch suggests that other factors are probably in- 420 RUBBER ACE, AUGUST, 1945 WATER PCB-SD0000038833 voived in the cases showing liver damage, besides ex posure to chlorinated waxes alon.e. '1'he important point brought out in this communication was the fact that skin reactions with acne formation have been noted in men handling only the finished product, with no appreciable vapor exposure. As far as be knew, no liver cases had been attributed to skin absorption. He suggests that the absorption of these materials through the skin is very slow as compared with inhala tion absorption. (.'ranch also suggests that prevention depends first on the greatest possible reduction of vapor exposure and skin contact; second, on protection of the skin Iw means of cold creams and adequate bathing.. Toxic Effects in Man Resulting from Exposure to Chlorinated Naphthalenes and Diphenyls Jt has long been known that chlorinated naphtha lenes and diphenyls are skin irritants. The lesions have been described by Schwartz (14) and others. The effects are first noted on exposed parts---either from fumes or from direct contact with the chemicals. Contamination of clothing results in more generalized distribution of the irritant effects. In workers with greasy skins and hypertrophied sebaceous glands, the effects are more frequent and prompt. After exposure of about six months, few workers fail to develop lesions. _ The skin affection usually begins as a generalized folliculitis. Occasionally there is diffuse pigmentation of the skin of exposed areas. Later comedones, acne like pustules and sebum cysts develop. These latter lesions tend to be chronic and on healing mnv leave permanent scars. Generalized papulo-pustular erup tions have been described. In the cases observed in this mill the skin lesions have been confined to the ex tensor surfaces of the arms, the back of the neck, the mandibular surfaces of the face, and along the hair margins. The lateral surfaces of the thighs have fre quently been involved. Tn addition to the skin lesions, symptoms of sys temic poisoning have appeared in some workers. The first complaints arc digestive disturbances, burning of the conjunctivae, and in some instances sexual im potence and haematnria. It is not known just how frequently fatal poisoning results from absorption of these chemicals. It is worth noting, however, that six workers, formerly employed in these two mills, have been studied post mortem. One of the post mortems was performed by one of us and the other five by pathologists in this industrial area. We have had the privilege of examining the pathological material from some of these necropsies. ]n these six cases, death was in every instance due to subacute liver necrosis. Since subacute liver necrosis is an uncommon disease and since all six workers had been exposed to absorp tion of the chemicals in Haiowax and Aroehlor, it is logical to suppose that these chemicals were the cause of the liver necrosis. In all these cases the livers were much reduced in size. Their weights ranged from -400 grams to 1100 grams. A review of the pathological changes in the autopsv material shows nothing of much significance, except in the livers. The-.hepatic lesions varied in character and intensity in the different cases, apparently depending upon the susceptibility of the different subjects, or possibly upon the length of time of exposure to the toxic agents. All the livers were markedly distorted in shape, coarsely granular and mottled in yellow am! red. For the most part they were very firm, although some showed large soft red areas. On section, their cut surfaces varied from mottled vellow .and red with scattered necrotic areas to large yellow-gr;iv areas show ing small necrotic center's. In our ease, there was a complicated melange of liver necrosis and cirrhosis. In all of the cases, however, there were large areas of degeneration and necrosis. The distinctive feature of this chemical intoxication is, clearly, liver necrosis. The cirrhosis and scarring are apparently attempts at repair. In the autopsy material it is difficult to determine what portion of the liver lohuie is primarily affected. In some the whole lobule is involved, while in others the lobules are so deformed that definite loca'i/.a'.ion F impossible. In general, i; appears lira! in the more acute cases, necrosis of the liver cells is the prime feature. In tire more chronic cases the liver necrosis was complicated by scarring repair and regencalion of liver lobules. Experimental Materials cm ployed: In the animal experiments which we have conducted, the chemicals used, were those regularly employed in .and supplied to us by the mil! for this purpose. Thev were I iabwax and A.rochlor in concentrated state and dissolved in naphtha and troluoil. Tire effects of the solvents alone (naphtha and troluoil) were also studied. In these experiments white mice, guinea, pigs and rnbbiw were employed. Three routes of introduction of the chemicals have been used--viz: by inhalation, by-ingestion and by ap plication to the skin. 'I he first two avenues of absorp tion have been extensively investigate!.! by other .cork ers, but to the best of our knowledge there lias been no systematic study of the systemic effects of skin absorp tion of these chemicals. Observation at the plant leads us to the conclusion that the skin is an important av enue of absorption of these chemicals. Therefore we have in our experiments directed particular attention to this mode of absorption. The inhalation and feed ing experiments .which we have carried out have con formed to the methods outlined by Bennett. Drinker and Warren (4). They have proven useful, as con trols, in gauging the importance-of leshms produced by skin absorption. The skin absorption experiments were performed for the most part with rabbits. Approximately 9 square inches of the hair on the backs of a series of rabbits was removed with clippers, the remaining hair shaved off and the resulting small skin abrasions al lowed to heal for three days. These experimental ani mals were kept in cages alongside normal control rab bits. Yi ml., 1 ml., and \V> ml. of diluted Haiowax and Aroehlor, containing 0.8 gnu. dry Haiowax per ml. and 0.6 grm. Aroehlor per ml., respectively, was dropped on the shaved areas by means of a calibrated syringe. After allowing I he chemicals to partially dry for about five minutes, the animals wee returned to their cages. The substances were administered daily, in tiie above-described manner, because of possible criticism that some of the chemicals might have been absorbed by ingestion or inhalation, this entire series of experiments was duplicated, following the same gro ce `.we cited above, but with the precaution of covering the application areas with molded celluloid guards. RUBBER ACE. AUGUST, 1943 WATER PCB-SD0000038834 These celluloid guards were made by culling a.id bending shee; celluloid into proper shapes and binding their sharp edges with adhesive lape. A tier each daily skin application the guards were replaced and firm!'.' strapped in place with adhesive tape passing comp'.e.e. ly around the animals' bodies. This procedure, we ln liew, precluded any possibility of inhalation or inges tion of the toxic substances. Jr, no instances were the 'guards removed or loosened by the animals1 movements in their cages. To avoid skin irritation the inner sur . faces of the guards which might come in contact with the skin were coated with vaseline. A third series of skin absorption experiments was conducted in a similar manner, except that before the **' daily skin applications were made the shaved areas were covered with a thin layer of Protek. This sub stance is a cheap and apparently efficient type of cold cream used by mill workers. After experiments with naphtha and troluoil alone, extending over four months, no animal showed any skin lesion resembling those caused by Plalowax or ' Arochlor, either bv inhalation, ingestion or skin ab' sorption, and no animal died of whatever mild effects these substances might have caused. We therefore felt that tlie acne and the systemic effects observed in the remaining experimental animals could not have been caused by either naphtha or troluoil. Tberesults ,, of all three methods of absorption with both chemicals showed essentially the same type of skin lesion and liver necrosis. It was found that the rabbits were more _ uniform in their reactions, and the dosage could be v more easily evaluated. Therefore, all the Inst experi ments Were made on rabbits. The extent of the skin lesions and liver necrosis depended on tlie size, fre quency and number of inoculations. Animals inoculated with large doses every dav, whether by inhalation, feeding or skin absorption, lied before definite liver necrosis developed. Animals inoculated with moderate and small daily doses lived for longer periods, and at necropsy showed skin lesions and subacute yellow atrophy of the liver, simu lating the lesions observed in man. Animals sacrificed after a short series of small doses, showed slight to moderate degrees of liver degeneration, evidenced by . fatty infiltration. Four to five days after the first dose of chemical " was dropped on the skin, all regrowlh of hair was com'.-pletely destroyed. The skin became markedly red dened, small papules and blisters formed, and finally the external epidermal layers desquamated. Some pustular lesions developed which were very similar to _ those seen in man. On necropsy, the livers of the ani_ mals were the only viscera showing any definite changes. The animal livers varied in appearance. Ex ternally they were mottled in red, yellow and brown. They were finely to coarsely granular, and showed no marked abnormality in size. On section, the livers of the animals receiving tlie smallest dosage showed only a change in color, being more or less diffusely yel low with no gross evidence of necrosis. Jn animals re ceiving larger or more numerous doses of tlie toxic sub stances, there were opaque yellow areas of necrosis scattered throughout tlie liver substance. The lesions were 'definitely degenerative in type, ranging from moderate degrees of fatty degeneration to marked hepatic degeneration and necrosis. Those . resulting from skin absorption of Halowax and Aro chlor were essentially identical to tlie lesions produced by inhalation of these substances. The rabbits treated with Protek before application of the chemicals to their skin, were partially protected ana the chemical absorp tion retarded. There were similar but milder skin and liver lesions. Normal control animals kept in identical environment as the experimental animals developed no skin lesions and showed no fatly degeneration or liver necrosis at autopsy. Methods Recommended to Safeguard Workers Exposed to Chlorinated Napthalenes and Diphenyls Tlie first step taken should be the formation of a working committee consisting of the superintended, the chief engineer, the chief chemist and the consulting or plant physician of the mill. This committee should formulate practical changes, wherever found necessary, to as far as possible protect the workers front the haz ards of these toxic compounds. Because of the urgent need for these critical war materials, no changes should be advocated which will in any way slow down or pre vent tlie greatest possible productivity of such impor tant mills. . Protection must consist of prevention from inhala tion, ingestion and skin absorption of these chemicals. Skin absorption, while long recognized as causing acne-form eruptions, has not in our opinion received proper consideration from the standpoint of systemic effects. Toxic effects from inhalation are without question the most important because of the speed of absorptic... and the probable high dosage of toxic substances ab sorbed. Therefore, adequate ventilation is tlie primary consideration in any mill. The mill rooms and mixing house should be ventilated by intake and exhaust fans of sufficient volume and velocity to remove the ma jority of the fumes. The drying tubes and drying ovens should be ade quately ventilated ami seeded as nearly air-tight us prac ticable. To accomplish this, large intake vents should be placed near the floor in the doors of the drying ovens, Large high-velocity exhaust fans and an ade quate number of large exhaust stacks leading up above the roof of tlie mill should be installed. After tlie steam in tlie drying ovens has been turned off, fresh cool air from the mill room should be pumped through the ovens for a sufficient time, in sufficient volume and of a velocity of approximately 2000 cub. ft. per minute, to bring down the temperature of the drying ovens to that of room temperature, before opening their doors to unload. Daily analysis should be made of the air in these ovens. They should not be opened for unloading unlii chemical analysis reveals less than 0.3 mgm. of chlor ine, expressed as Halowax or Arochlor, per cubic meter of air. Tlie drying tubes surrounding the wet impreg nated cable should be ventilated by suction applied at the far end of the tubes. The air flow through the tubes should be sufficient to cool the saturated cable to a temperature at which no significant amount oi. vapor is given off from the cable after it leaves tlie drying tul)e. The impregnating vats should have permanently hinged covers fitted with flanges that extend down ward inside the tank, to avoid soiling the outside of the tank from dripping. These vats should be completely enclosed in a ventilation hood, with a hinged door in front. These hoods should be ventilated through a properly constructed lateral exhaust ventilation system. Yarglou, Sands and Drinker (S) recommend an ex- 422 RUBBER ACE, AUGUST. 1943 WATER PCB-SD0000038835 Jiavi.-l slot approximately 2 inches high extending along the back, the full length of the tank, placed .approxi mately 6 inches above the level of the liquid wax in the impregnation vat. Various speeds of exhaust should he tried, until the proper speed is indicated by chemical analysis of the air in front of each hood. Jn the coki process, Halowax anti Arochlor are dis solved or diluted with solvents in mixing vats. The Halowax and Arochlor should be introduced into these ..its with as little manual handling as possible. The vats should be kept covered at all times with a hinged cover, except when actually being filled. The work men should not be allowed to place their hands inside these vats, even for taking the specific gravity of the mixtures. This can easily be accomplished by a longhandled glass thief introduced through a small opening in the cover of the tank-. The specific gravity should be observed outside the tank, after removing the thief. The chemicals should be pumped outside of the mixing house to a loading platform through permanent pipes fitted with proper gate waives. Such pipes should be connected by'proper couplings to tank trucks. The lank trucks filled with the chemicals should then be driven to the felting mills, where they are emptied into conveniently located distribution tanks. The chemical compound should then be pumped or fed by gravity from the distribution tanks to the impregna tion vats through appropriate sized pipes,'not less than 2'inehes in diameter. Separate lead pipes should ex tend downward to the wits from the main feed lines. Each pipe, just before it empties into the impregnation vats, should have a gale valve the full size of the pipe and of simple design so that it cannot become clogged by the mucilaginous fluid. After the fluid chemical in the impregnation vats becomes contaminated by loo much asbestos debris, the sludge remaining in the tank should be exhausted through exhaust pipes at least 4 inches in diameter, connected at or near the bottom of each impregnation vat. Such exhaust pines should be attached at an angle leading out from the back of the vats and extend into receiving sludge vats with a simple gate valve the full size of the pipe placed near their lower ends. The remains of the asbestos sludge, which does not flow FIG. 1--Human Liver: Late effects of liver ne crosis. Bile ducts and cafillarics, no liver cell regenera tion. FIG. 2--Human Liver; Right half of the field shows destroyed liver lobules without repair, the left half of ihc field shows regenerated and degenerating liver cells. FIG. 2--Rabbit Liver: Effects of skin absorption of Arochlor--moderate dosage--half of the liver cells arc opaque and granular, the other half contains large fat droplets. The darker areas arc haemorrhage, FIG. 4--Rabbit Liver: Effects of inhalation of Halowax--IS doses--showing complete liver necrosis. FIG. 5--Rabbit Liver: Effects of skin absorption of Halowax, showing complete liver necrosis, FIG. 6--Rabbit Liver: Effects of skin application of Halowax after application of Protek, showing par tial liver necrosis. RUBBER AGE, AUGUST. 1943 WATER PCB-SD0000038836 through the pipes, should be .-.craped out of the vats and pushed into the sludge vats by means of a long handled square-ended steel paddle. If the exhaust pipe should become clogged by the thick mucilaginous substance, a 4-foot long steel push rod with a 3-inch 'flat bell at its end should be used to push the obstruct ing sludge into the receiving vat. lloth the paddle anti the push rod should be stored in a vertical metal con ' tainer. The sludge vats should be of the correct capacity to ' receive the largest amount of sludge that may be cx- ^hausted into them, and of appropriate height and di ' ameter, so as not to obstruct the passage ways. All ^.sucli vats should he interchangeable. The tops of these vats should be constructed so that their entire top. with the exception of a 1-inch overhang rim, is open, A slide sleeve should be placed in this overJiang rim. A strong metal sliding cover should be pro vided for each vat. An opening to receiv e the 'metal - pipe should be placed in the slide cover, fitted with an tingle extension to receive the solid 4-inch pipe from .the saturation vat. * After the sludge vats have sedimented for an ap propriate time, the good fluid Halowax should he pumped into receiving tanks through a pipe containing a glass observation window. After all the good chem ical has been removed from the sludge vats, the re ; maining sedimented sludge should be (lumped into burial ditches by placing the vats in an automatic dumping machine, so that no hand will have to touch *,-the edges of the vats. The vats should not be cleaned out until their inside surfaces become covered with too much hardened chemical. The hardened sludge is then softened with an appropriate solvent and scraped off the sides of die vats with a long-handled squareended steel paddle. Elbow-length, thin, impermeable gloves should be used by the men when they adjust the nuts and screws ot the mechanism in the vats. They should be taken off immediately, when the men have finished the job, to avoid excessive perspiration. The outside's of the impregnation vats should be frequently washed down with a proper solvent, to keep them free from the toxic , chemicals. . After the above recommendations have been followed . out, the personal factor has been almost completely eliminated. Clean working clothes, consisting of long*.sleeved overalls fastened at the neck and wrists, should be provided. These clothes should be laundered fre quently, daily if possible. All eating of lunches, etc., should he forbidden in the workrooms. Candy, cigarettes, chewing gum and other vending machines of such nature should be placed in recreation rooms that should be provided for the work ers. . In and out locker rooms and shower baths should be installed, so that the workmen coming to work leave their street clothes in the outside lock'er room and pass through the shower room to the inside locker room, where they put on their clean work clothes and cover their hands, faces and necks with some type of cold Cream or skin lotion. They should then be checked out by a checking system before they are allowed to go into the mill. When leaving work for lunch, thev should he checked back through the inside locker room, where they should thoroughly wash their hands, faces and ' necks with soap and water before going to lunch. If .they are going home they should also cheek through the inside locker room, where they leave their soiled clothes, take a complete hot soap shower bath (there fore sufficient shower baths should be provided) and are then checked out to the outer locker room. Here they put on their street clothes. This not only protects the workmen, but also their families, as it lias been shown (14) that wives handling and washing such clothes and children playing with their father while he was wear ing the soiled work clothes acquire the same type of skin lesion as the workmen themselves. All new workers should be examined by the mill physician, and all men and women with a history of previous jaundice, liver diseases or skin diseases should be rejected or should be placed in departments where toxic substances are not handled. All workers in the mills where cables saturated with chlorinated naphtha lenes and phenyls, whether wet or dry, are handled, should be periodically examined for skin lesions ami systemic effects. No women who are pregnant should be allowed to work in these rooms, as they are notably very susceptible to liver toxemia. All workers in these mill rooms and all new employees should have frequent periodic laboratory tests made to determine whether or not any liver disfunction is present. Such labora tory examinations should include Hanger's Cephalin- choleslerol flocculation test, bilirubin content of the blood serum, and icteric index. If any one of the three show results exceeding the normal limits, the worker should be re-tested within one week ami if such abnor mality persists or increases such workman should be removed from this toxic hazard at once. As it is a known fact that oilier conditions, such as gastro-intestinal upsets, etc., may cause one or more of these tests to show transient moderately abnormal findings, the first test should not be considered conclu- .sive, nor should such workmen be barred from their work until such abnormal findings persist or increase. At present the New York State laws relating to health in industrial plants are placed under the juris diction of the State Department of Labor and the local health department. Where a county health department has been established or where a properly functioning city department exists most of the health hazards in industry could be handled more readily by the local department than by the state. This is due to the fact that the state has but few employees to cover a large area, while the local health department is immediately available and often more familiar with local conditions and hence able lo keep in closer contact with the indus try and over a long period of time if necessary. Laws should be passed making it necessary tnv medical directors of industrial plains to report at once all toxic disease conditions relating to industrial employ ment directly to the local health department, who would then make an investigation of existing conditions and. if possible, arrive at the solution of the difficulty, then make the necessary recommendations to the industrial plant, also lurffshing the Stale Department of Labor a report of ,.ne investigation and the recommendations made. L. cases where the investigation discloses that more extensive work is needed or the services 01 specialists required, the Department of Labor should then be called upon to complete the work'. In this maimer the slate could be saved considerable time and trouble and be able to devote itself to more intensive work in other plants where its services were more urgently needed. . The responsibility for the enforcement of the laws relating to protective measures in industrial plants should be placed upon the local health departments. 424 RUBBER Arr. AUGUST, 1943 WATER PCB-SD0000038837 In localities where no competent or responsible health department exists, the investigation and enforcement should be made by the Department of Labor, At present in Westchester County there is a sanitary code established by the County Health Department which covers the regulations relating to food handling, food inspection, dish washing, management of cafeteria in general, together with sanitation and water supplies. These regulations are enforceable by the County health authorities and are in addition to those covered in the state sanitary code. Only by compulsory reporting of all toxic industrial conditions and the cooperation of the state and local departments with the industry can these conditions be eliminated. The plant management must be assured that the aim of such "procedures is to aid them and that production will not be interfered with. Discussion For over twenty years reports have been published dealing with the toxic hazards of chlorinated naphtha lenes. Every one agrees that definite systemic effects can occur from inhaling or ingesting these toxic sub , stances. There is also general agreement regarding the acne-form eruptions that are caused by skin contact to them. To our knowledge no one has stressed the importance of the systemic effects caused by skin absorption. Therefore this publication is primarily concerned with the systemic effects caused by skin absorption. It is very difficult in humans to prove that systemic' effects occur from skin absorption, because the work men quite naturally are subject not only to skin absorption but also to the hazards of ingestion and inhalation. Workmen in mills far removed from inhalation hazards and working only with the cold finished impregnated wires and cables, have in many instances acquired acne-form eruptions due to these chlorinated naphthalenes and chlorinated phenyls. None of these workmen, as far as we can ascertain, have shown recognizable systemic effects due to their absorption. This is understandable, as we know that liver function tests only show definite results when an appreciable liver degeneration has occurred. None of the six fatal cases showed any evidence of jaundice or other systemic effects until a few days to a week be fore hospital admission. They were in contact with these toxic substances for periods ranging from two months up to nine months. They all died within one to three weeks after hospital admission, All of our experimental animals showed definite liver degeneration or necrosis in varying degrees, whether or not they were protected by Protek, when liquid chlori nated naphthalene or diphenyl was administered by dropping it on their shaved skins. Even- precaution possible was taken to safeguard these animals against the toxic effects of inhalation and ingestion. Parallel experiments were conducted by inhalation, by feeding and by skin absorption. All three series of animals showed the same type of liver degeneration. The difference in liver lesions found depended entirely on dosage and number of inoculations. During these experiments, none of the animals showed recognizable svstemic effects until a few days 'before death. The animals killed during the course of the experiments showed no recognizable effects. Every animal killed showed some degree of liver degeneration. Normal control animals showed no liver lesions. The experiments cited indicate that ch'orinatec! naphthalenes and diphenyls cause systemic effect? in animals whenever they absorb these toxic substances. , whether by inhalation, ingestion or skin absorption. It _ would therefore seem probable that if experimental ' . animals react in this way, man will also. P.ecause of the aforementioned facts, recommenda tions were made to the mill and were to a great extent followed out. For the past five months, not one single case of skin eruption or systemic disease, attributable to these toxic compounds, has occurred in this mill. Two deaths ami between ilfiy and one hundred cam? of acne-form eruptions occurred in this mill within the previous six months, before these changes were insti tuted. Therefore, the practical evidence would seem ^ to indicate that if the above recommendations are carried out workmen will be almost completely pro- . lecled. The cost of such changes will be quickly absorbed by the saving in man-hours, lowering of insurance rates and greater efficiency of the workers. The relations of the workers towards the management must of necessitv be vastlv improved. Summary - 1. Studies concerning the toxic effects of citlori- _* nated naphthalenes and diphenyls on experimental animals are reported. 2. These studies were undertaken because of the occurrence of acne-form eruptions and deaths among workmen in two wire and cable mills where these compounds were being used. 3. The compounds experimemaky stud:ed were administered to animals by inhalation, inge.-Mon and skin absorption, 4. Liver degeneration in experimental animals is caused by skin absorption of either chlorinated naph thalene? or chlorinated diphenyls. 5. Histological examination of the viscera of these experimental animals showed that important toxic effects are manifested only in the skin and liver. ~ 6. The liver degeneration ha? been descried and illustrated. 7. The degenerative effects in the liver have beer. shown to be essentially identical regardless of whether the toxic substances were administered by inhalation, ingestion or skin absorption. 8. Methods are recommended to safeguard workers in mills using these toxic compounds. ** 9. Laws should be passed making it compttisory for' _ all mills using toxic chemicals to adequately safeguard ' their workmen from such toxic hazards. 10. Inspection of the plants and authority to enforce _ protective measures should be placed under the Department of Health. REFERENCES . "9>* (1) Lehmann. K. B.: "Kurzes Leiirtmch tier Arhcit und Gewcrbehygicnc," S. Hirzel, Leipzig, 1919 (p. 251). _. (2) Flitm. F. R. am! Jarvik, X. E.: Action of Certain Chlorinated Naphthalenes on the Liver. Prac. Soc. Exp. Biol, end Med., 35, 118 (1936). ' (3) Flinn, F. JL, and Jarvik, X. E.: Liver Lesions Caused bv Chlorinated Naphthalenes, .diner. Jour, of Hyp., 27.* 19 (1938). (4) Bennett. G. A.. Drinker, C. K,, and Warren, M. F.: Morphological Changes in the Livers of Rats Resulting. * from Exposure to Certain Chlorinated Hydrocarbons, J. Imlu.il. Hyp. & Tox., 20, 2 (1938). (Conlv,lin'd on FoUoivinn Paoc) RUBBER ACE. AUGUST, 1943 425 WATER PCB-SD0000038838 (Z1 Gardiier. G. ii., I1 rc. vc, R. C,, i e,:-:;. A,,!!, K. K., Marie, E. L>., T!n.:r.;.>o:i, .M. J., \\ e!!\ !!. S., iim; LuniM.n. P. lJ. : Suidie.- or, tin- i'a;R.k Tcai Hi-waugy oi Experi mental Car!i..a Tetraclikiri lc Row/iiing, Hu!!.' Julius Hopkins Ho*?.. 36, Hi7 0925 i. (9) (dar.wv.(i. K,, am! Karuuarauic. \V. A. E.: Uarii. Telravkloridc t. irrjod-- ii: Rclu'.On w Liver Kegencrat:u:., J. J'.illt. C5 Hoe!., 42, 3 (193o), (7) Whipple, (1. H., a;111 Sperry. J. A.: dliR/rummi I'oisun mg : Liver Xivr.i>i> am', Repair, Hull. Johns Hopkins llosp., 20, 27,s (ly;i9). (S) A'ai vs R,, Sami-, )'. W., a:u! Drinker, P.: Yciuilaliun oi Wire Impregnating Tanks Using idlilorinaled Hydrucarhuns, ./. Indus!. Ily</. A To.w, 20, 401 (1938!. *,- (0) (10) (11) (12) (13) (14) (ireenlr.irg, L., Mayers. M. K., ami Sn;i;a. j\. K.. Systemic Effects fro:.', Exposure to Certain Chlorinated 1 lydrocarbchs, Indus:. Hyp., IS. 11 (l'AD). Drinker, C. K.: Further OU.-ervaiioas or, the J "osstMe Systemic Toxicity oi" Certain of the Chlorinated Hydro carbons with Siiggev.ion-, ior J'crr.iissilile Conccmrations in the Air oi Workrooms, J. Indus!, llxy. Ix Tux., 21, 153 (1939). .. Cleary, Ed A ., Alaier, .1., and Hitch,in;ns, C. H.yThc Aletaliolisin oi CMurmaied Naphthalenes, J. IT". C hem. 127, 403 (1930), Riley, E. C.: ind. Hull., 22, 50 (1943). Crunch, A, G.: Personal communication. Schwarz, L.: Dermatitis from Synthetic Resins and Waxes, diner. Jour. I'ul>. lleailh, 26. 58;, (lV3;i). Rs2nite Bonding Process j{ XhW method uf L>ecliity natural or synthetic rttb* f{ Per to melai. or plastics to metal, recently announced by the U. S. Stoneware Company, Akron, Ohio, rnanumeturers of Tygon synthetic materials and corrosionresistant equijimcttl, is reported to not only do away with costly brass plating processes, but to develop a .bond from three to five times as strong. The new method, known as the Reunite Ponding Process, de velops a bond between rubber and metal ranging from 0 lbs./sq. in. to as high its i2'o0 ILs./sq. in. on a pul! test. This compares with bonds ranging from 250 to 41X1 IPs./mi. in, obtained by present methods. Whiie tile bond develops its maximum strength at room temperatures. its strength over a range of --40J;. to as high as 300'']7. is said to be substantially stronger man bonds obtained by com eniiona! processes. A national independent research laboratory, using methods similar to those specified by A STM, reported as fol lows : "Discs of rubber, half an inch thick, were vul canized between two steel discs, two square inches in area, which had been cleaned and coated with Reunite cement. The direct pul! necessary to tear the assemble .apart was then determined (;u at room temperature, cb) immeoialeiy .alter immersion in boiling water for .five minutes, and ; c i after heating for 30 minutes in ;i.n oven at 300&F. The following figures are tvpical of tests made during the year, although in a considerable number o; cases still higher figures were obtained.'' separation ul' tile bond occurred under pulis well above 300 pounds. The process is simple in application. The surfaces to he joined are brushed, sprayed or dipped w.th Keanite. After being permitted to dry tor an hour the stiriaces are joined and the unit vulcanized by any of the con ventional methods. It may also be used to bond metal to metal, or leather or wood to metal or to each other. The bond--metal to metal--ranges from. 1,000 pounds to as high as 3,000 Ibe./sq, in. on a combined shear-pull lest. On bonds formed between synthetic rubber am: metal, plastics and metal, or wood and metal, the mu terials themselves gave way before ihc bund. The Reunite joint is unaffected by fresh or salt water, is non-corrosive to metals, possesses excellent eon'usion- resislance in itself, and has high dielectric strength. While Keanite is formulated through cyclic modifica tions of materials high on the critical list, it is available for immediate shipment for essential end-uses. Present applications include fabrication of airplane assemblies, motor mounts, sound and vibration dampeners, instru ment mounts, composite metallic and plastic units, ami tanl< lining assemblies. . Tkw or J lux' 11 SKi'.ut.vrniN /lunluoss (// Rusher (Shore) ---------------Slreuplh oi .dssemhlx (in pounds) Room Temperature 2 ITT 50 Ul 5u 18s5 1912 3800 5l>5 ini 560 JoO' / 39(1 397 312 . 'Tile Reunite bunding Process is suitable for bonding natural or synthetic rubber, or plastics, to almost all metals: iron, steel, stainless steel, magnesium, alumi num, aluminum .alloys, copper, bronze or brass. The accompanying illustration shows a lest sample of aluminum, 53/ in. iong by 195 in. wide by 1/16 in. thick bonded to tire tread rubber 34 in. thick. The rubber was cut away from a portion of die aluminum strip, and conventional line-pull tests were applied. Standard specifications call for such an assemble to withstand a direct pull of 19 pounds. On this test no 4^ \A V Test sample of aluminum, in. lour/ by Jj/5 in. wield by 1/16 in. I hick, bonded to tire tread rubber of `4 in. thickness by the Neani/c Process. In the lest (see text), no separation of the bond occurred under pulls 7cell alnroe 300 pounds. RUBBER ACE. AUGUST, 1943 WATER PCB-SD0000038839