Document Qk9LEqDEmk110EVjvVoD11rM6

<n*9*** publUMd 40 p'Omoit s tlw'-ght noon *nd eenetming m.s~il . .d'lcin* *nd *r#n>*t'ie trf. To *twl nd it i!l eonUin 'bow* rtportv dlgtltl. sthor prountotloiii. togttW with pommorti. Tti# oditoriol pel- to ncour*9* 4f*l diicinvw*. b eontfibutiont or* invittd. BiC. tS . Pt- OS. Th* oditon '!ll ovoroUo ear* m~cV, ing on tb* accuracy of data prii . but in all othar roipocfc artic1,, -------opiniont of wb*h oiprauion it allovod ara tha opiniont of thair aufhon__tha : oditon ratofvin; m all cam Hi* right -to commant on tho tama, in tha cur rant or any tubtaquant ittim, at tho* may ba inclined. - ' " The Journal of Occupational Diwatei and Traumatic Surgery ---- -" With which *f conjoiidatcd "The Industrial Doctor" and "International Journal of Medicine and Surgery." The Science, the Law and the Economics of lnd jiume 11 April, 1942 Hypertension in Workers over Forty Yea ' ---A Preliminary Report~ - - - Arthur M. Master, H.D,, and Simon Dack, M.D., New York City pHE blood pressure in workers 40 years of ace and . 45 years of age or over. Stieglitz", too, has empha JL over has not been studied sufficiently. Although it sized the same facts, i.e,, that 40% of population" is been recognised for many years that the blood 1980 will be over the age of 45. The interest of the ressure rises steadily with age, only a relatively small clinician and the physician in industry in the incidence., umber of blood pressure readings in the older age of hypertension in people over 40 lies further .in the roups has been available. Many blood pressures of fact that in the present war emergency many more -jdents, soldiers and workmen have been published, men and women of the older age groups will be em ut the age of these groups generally ranged between ployed than ever before, whereas hitherto they were. 3 and 40 years. These studies have been cited in a probably discriminated against to some degree. - revious paper.* One of the largest groups was that rudied by Britten and Thompson*5 3w*ho found that in Material ' . ' -- : 1138 male workers over 40 the systolic pressure was VtTTTH the whole hearted cooperation of DR. R. D. . 30 mm. or more in 16% in the decade 40-49 years, ' ' ' MUDD, Medical Director, Chevrolet-Grey Iron 5.6% in the decade 50-59 years, and 51.2% in those Foundry, Saginaw, Michigan, a division of General' 0 years or over, " . .... , ......... ... Motors, of DR. G. H. GEHRMANN, Medical Director, E._, In the previous paper referred to above1 we plotted L Da Pont de Nemours & Co., Wilmington, .Delaware, he incidence of hypertension in the general population and of DR. EDWARD MCSWEENEY, Medical Director,r 3 calculated from 42,000 published figures. It was* New York Telephone Company, dr. michael lake," nown that the incidence of hypertension (150/90 or Medical Director, R. H. Macy & Co., New York, and nore) rose from 5% at the age of 25 to 45% above DR. LOUIS HAUSMAN, of B. Altman Co., New York, 35 years. Although the number of cases in the age . we obtained blood pressure readings in 5453 workers, iroup 40 years or over was relatively small, we inti 40 years of age and over, comprising 3665 men and mated that hypertension in the general population was 1788 women. '" none frequent than was ordinarily appreciated. This In all cases the blood pressures were taken by phy as emphasized by Robinson and Bruger* who con sicians by the auscultatory method. The sudden cluded from a study of approximately 4600 persons 40 diminution in intensity of the sounds (fourth phase) 'ars or over that about 40% of the adult population was taken as the diastolic pressure in about one-third :3 prehypertensive or hypertensive. In this report and to one-half the cases, while in the remaining the total -n others in preparation4 we are presenting an analysis disappearance of sound (fifth phase) was considered as >f the blood pressure in the general population 40 years the diastolic level. Since the majority of opinion fa f age or over as based on readings obtained in work vors the sudden loss of sound intensity as the correct ers in industry, hospital patients, and inmates of homes diastolic blood pressure it will be seen that our diastolic or the aged. figures are on the conservative side, i.e., in many cases . ^no"dodge of the true incidence of hypertension in they are lower than they should be. The medicat direc * e.Jpcr,tns^ population is of fundamental importance n the study of arteriosclerosis, hypertension and the ^PPg process. Its importance is enhanced when one ! members that the nation's population over 40 is ncrcasing yearly by the millions. Dublin* has calcu li6* *th*a*t,li m the year 1940, G.S% of the population tors took pains to reassure and calm the patient, and the average or final resting blood pressures were recorded. The blood pressure readings were those of applicants for jobs, those obtained during periodical examinations every half to two years, and in the case of the New York Telephone Company also at times 3fionftn-f`ars ase or 0Vt'r comprising nearly J.uw.000 persons, and 26.5% was -15 years of age over. He estimates that in 1930 the corresponding ^rcentages would be 14.4 and 40.37, or 22,000.000 per- J^over G5 years of age and.about 61,300,000 persons of enforced retirement, i.e., age 65 for men and 55 for women. In this company, as probably in the others, any active employee or retired employee could have a voluntary examination any time he wanted. In general the companies were liberal in their ac .'j'jHospital. yew Vivk Citr- . ceptance of employees, taking even young workers with Ps4Sr'it is known that .the workers are changed every ,, The evaluation of the occupational disease hazard the job being part of a rotating course given , ,;as .we encounter it in the field is of vital importance ** -J&4et *"!**" ** plant--! .in the economic control-of a potentially injurious ^Aj^are/ oT course, many related subjects which -exposure." The two principafmethods- of evaluating profitably, be discussed in a paper of this type, the severity of .the health hazard are through obser- ^sSftvas-thejiffects on. the skin of washroom soap; of. .vation of the occupational environment and through ^JSjn^cdmpdUnds; of the action of oils; as well as the examination of the t-^ Tjgj ofmany solvents on the skin--but time forbids IglncTusiOh. ..Tit can be said that the control meas-' Use and Limitations of Eyesand Nose" ' " .. _ PC06v" fffisciissed here, coupled with this company's estab- CO MUCH emphasis has Been placed ^n'ehemical and . policy^ of'good housekeeping and general plant V physical testing iff the air for contaminants that ^ i wc:~have lowered our dermatitis cases to less' the question has been raised: Are bur'eyes and noses " cases per 1,000 men a month. .. ; . of no assistance to us in the evaluation of hazardous m&ji i . ~ * * * ---- - 1 *. . * -; **. operations? Can only the chemist with his thermal' nncleanliness of the skin Is the chief decomposition apparatus,'backed by a laboratory full , __Jijj3;spoaing cause of industrial dermatitis, the em- .of beakers, volumetric flasks and spectrophotometers,' -erajif^ should provide adequate facilities for the care of ^vftTwuloreea' .personal hygiene while at work. This state whether there .is. top the worker's breathing zone? mOurc'hmutrsitchalomraenthbyeleanremeidn,..tSS3 Include sanitary washrooms equipped with hot and with an interferometer or a tri-per analyzer if he is ajn^tiuhhing.'water; a non-irritating soap, towels, and to avoid a chemical procedure for obtaining this IMjffi^iicrtaln conditions, bath showers. - - ' information? . :...... .-. . .. "-- '^ther prominent measure ia the'elimination of ' The answer is that it is necessary to utilize physical gfliniaterials from contact with the worker by, and chemical methods in many situations in order to fimpartially enclosing the operation, so that ' evaluate the hazard if we wish to avoid the dangerous, he'i ^'-fumes, vapors, or dusts are prevented from 'procedure of waiting to see. if the worker's health is h*3 n.1 h T*f4""' hiitthe"worker. - Vr.-';r\` actually being affected. . But before, discussing the jjnportanfrfactor in the prevention of skin^infec-, fithelise of-protective clothing,, provided this type -application of these methods, let.me. point put certain^ conditions where the eyes .'and nose are of/use' fn~ . ^. STentTk kepf fn' gobd repair, is cleaned and'dis- arriving at an opinion of. the hazard--and also some" `periodicallyr after return, to stock when: used _ of the precautions which. should be observed if the~- Htlprice# before, being reissued totmother 'employee: - f.S **' disinfecting, solutions "are mentioned^-*' eyes'and nose are to be employed as guides! K such ; sensory diagnosis of a condition, one must be. on guard' Butionof hypochlorite for rubber. Articles, and' not only against optical illusions, but against olfactory ^ lelicate fabrics, a soap_ solution^containing a .illusions as welL :; '.i.'.',~^r- gj^othes.disinfectant. 4v- w-" .-vv* ' ' Let ns make a`survey ! o'f a. manufaetbiing plant' hut-important control measure Tis-the use'of without benefit of the ^ruck-load of gadgets which Uve&kin creams. These creams form a "protec- are the bane of the industrial hygienist's ambalatory.. erfilm" between the skin and industrial poi-.. excursions and find out what we can do and how far; gfcj^-.dlrt^trid' grime likely to cause the dermatitis, we can go in the evaluation of the health hazard. ;_1 nducts should be non-irritating, and should, ""speaking, be insoluble or nearly so in the Tagainst which they are to protect They should . /-'removed at the end of the work period with pttffwarm water. At least two or three standard xeJucessary^. Occasionally-a- particular expo- - grtnrequire a special formulation._____ . _ ... . ^Oontrol measures discussed here, together with ifiany's continued good housekeeping policy, has rthejhddence of dermatitis in our Rouge plant {JfjEIh.l^ cases for each 1,000 of plant popula- The plant we visit includes a convenient variety of operations--but in this respect it is not different from numbers of actual-plants on which many of us call or . where we carry on our work. As we step from the office into, one end.of the. factory, _we .find.ourselves, in is department where electrical receptacles are being produced of asbestos compounded with a synthetic resin. The first operation involves emptying bags of short asbestos fiber into mixers. No imagination was wasted on this operation; it is accomplished'simply by weighing the burlap bag and dumping it manually into the mixer--following with a conscientious shaking cea- *-/ ' .JcA L.. and BEKSUAX, H. T.: Occupation.! Darmatltla, fwlit *K-S*S U9M). of the bag to make sure it is entirely emptied. This operation is intermittent, but while it is being done there is a cloud of asbestos in the air which even the most casual observation would not miss. The evaluation of the severity of this dust exposure ^p^crOccupatronal Disease Hazard requires one additional element which is often over +.***- - ----. Evaluat,ion in the Field-- ., ... . Warren A. Cook, ' tSOHMsr, division of Industrial Hygiene and Research, Zurich General Accident ` Insurance Company, Ltd., Chicago _=_. ^.. i*4^rr- ^ea4`ve and reliable information is eon- ton---xatj&gj; ~ becoming available concerning the a aivs.iJ'g 5-;,mdu?triaI materials which cause inj'ury looked, the duration of the exposure. If a batch can be made up in 20 minutes which will provide enough material for the whole day, then it is probable that a respirator approved by the U. S. Bureau of Mines for Type A dusts would suffice. But if the operation is repeated every hour, general observation could be considered sufficient grounds to evaluate the hazard as excessive and to serve as the basis of a recommenda tion for control. _. In the adjoining room, we find the batch being fed *thkose which may be considered innocu- into molding machines and the receptacles being apply -this knowledge on the toxic placed on racks. The plant superintendent is well -materials, it is necessary to have means satisfied with the effectiveness of the exhaust ventila whether or not the exposure is within tion system installed when this new operation was begun a year ago, and he expects our approbation of Pag* IS* INDUSTRIAL MEDICINE Va the "installation. It is easy to say, "Yes, that is a days and work weeks, this matter of duration assnccrr! 'splendid exhaust system" But what if such an off increased importance. A year ago a man may S3P hand comment closes the subject and six years later been exposed to silica flour two hours a week in 4gr -one or two of the dozen girls on the operation develop preparation of a paint for some one customer. asbestosis? If the condition does look good, what evaluation of the hazard at that time may have ny' ^criteria can be used as guides? ' - -- ` Criteria for Evaluation of Dust Hazards .. -it to be negligible. Today, that customer's order's* > have increased so that all day long several men weighing up batches of silica flour as the inerTS^ I[1NbeTHgEuafridrsetd place, too against. quick snap-judgments If an unjustified OK is should given, terial for this same paint From the point of tit* of the paint formula, the silica flour is part of tit- the health of the worker may be jeopardised; if a "inerts"; but from the industrial hygiene poinca*' condemnation, then money may be spent unnecessarily, view it falls within the category of silicosis-produeWn to say nothing of developing & lack of confidence of dusts known as proliferative materials. And if a pjja management in your judgment. liferative dust is present throughout the entire woitT In the case of the asbestos dust condition, our eval day and week. It should be given careful attenSSp uation of -the exposure should be based on the knowl in order to ascertain definitely whether or not Htiftt edge that the present toxic limit for asbestos is five is being affected. . million particles of dust per cubic foot of air. This 3. As an aid in learning which dusts may can- is a very small concentration, so small in fact that injury and which are relatively safe, research W. the condition may look good even to a critical eye and still present an exposure greater than this low limit. Some indication of the amount of dust present in the air may be obtained by noting the layer of dust been conducted on the action of various dusts injection into guinea pigs. The interperitoneal fic tion is a measure of the effect of these dusts on beis^ inhaled into the lungs. Publications1 on the resafiy on nearby settling places after learning how long of these tests may be obtained from -the Divisiou'.flT: a time has elapsed since they were.last cleaned. If Industrial Hygiene, National Institute of HeaRfch only a thin layer of dust has accumulated over six Bethesda, Maryland, and it is probable that inform*?;] months or a year and there are no visible puffs of dust tion on the reaction of certain dusts not included Sc] .escaping from the operation, it is probable that the these publications could also be obtained -on ii . ___ condition is satisfactory. ' The dusts are divided into three groups: (1) absorpr In the case of asbestos dust, however, and this tive, such as calcium carbonate or marble dust; ^-1 holds with even more certainty for dusts high in free inert, such as aluminum oxide or emery dust, and' silica content, the toxic limit is so low that the only proliferative, such as silica flour ami tripoli. DustsitJ: safe procedure is to have recourse to actual dust deter proliferative group are those which produce silieqtjjfj minations. This is especially important where the on sufficient exposure. -/ ; v . .=335^ .injurious condition is not'immediately, evident but .4. If general observation does not Indicate* an olfS^j requires years to develop as in the case of asbestosis ously dusty condition where the free silica percenisj^ .and silicosis. . . . ' . of the dust is appreciable -- in which case cbii| .. What rules can be laid down in the evaluation of measures should be immediately instituted--dust 'd dust hazards in the field? Although individual condi terminations should be made, unless they are.'qbfel tions call for specialized treatment, a number of gen ously negligible. . ............... .. eral suggestions can be made............. Without going.into a very extensive discussion^., 1. Obtain some reliable indication of the free silica the methods of determining the concentration .'content of the dust. A few specific items can be men various industrial contaminants in workroom tioned. In foundries, parting compounds may be pheres, the standard method of dust determination;^^ largely tripoli which is free silica or they may contain this country is the impinger.* -This device, originaislS less than 5% free silica. Manufacturers' statements by Leonard Greenburg, has since been made . to the latter effect can usually be depended upon. The portable and is commercially available as the so<alici~ . Compensation Inspection Rating Board of New York "midget impinger" through the Mine Safety AppU^ maintains a list of parting compounds containing less ances Company.* Other devices such as the konimeteg] than 5% free silica for which credit is allowed in the and the Bausch and Lorab dust counter collect.: compensation rate. Dust collected in arresters con samples and are useful control instruments.4 : nected to sandblast rooms has been used as a parting 'compound in some small foundries. This of course Exposures to Toxic Dusts and Fumes - is high in free silica. . QWt plant survey continues and we proceed to'S^; In the rubber industry, much- dust is frequently ^ adjoining department where a litharge-glycerin^ present from the use of soapstone powder or talc in cement is being used for attaching glass lenses t?r preventing unvulcanized rubber sheets from sticking polished metal reflectors. A group of girls are working together. Where true soapstone or talc is used, the around a large table, each being provided with a one?" free silica content is low, usually negligible. Imported pound carton of litharge. The housekeeping is seruj stocks of these materials are now disappearing from pulously clean. All hygienic measures such as adequate.*' the market and ground minerals obtained in this washing facilities are provided and their use rigid')''*! country are being substituted. Quantities of pyrophvl- adhered to. The operation involves removal of litharge: ; lite, itself a combined silicate, are being utilized as a by means of a spatula from the carton onto a gla^f^ satisfactory substitute; but this pyrophyllite may in plate where a smalt amount is mixed with glycerine-' clude large proportions of quartz--21 and 22^. The prior to being applied to the end of the glass evaluation of the potential hazard might thus be changed from negative to severe on the basis of the free silica content of the "soapstone." : 2. A second important factor in the evaluation of There is every appearance that conditions are satis factory. But where workers are handling toxic mate*, rials such as lead in a powdered form, it is dangerous,to take for granted that exposures are within sa*Cv a dust hazard, and in fact of most of the occupational limits on the basis of appearances alone. Even thought disease hazards, is the duration of the exposure. In lead oxide is heavy and tends to settle more rapiulp- these days of accelerated production and longer work than dusts having lower specific gravities, very fineliV 294z *rr indu. strial medicine page X0-"t * gftgjnateriaf will' remain suspended owing to aif in fitting the respirator properly"to his face, keeping ' s^J&fcements in a room. . . , _ the head bands under proper tension, and holding the happens that general observation of just such an resuited in the opinion that conditions were respirator lead, even on his face while he is being exposed fd when supervisors are not in the immediate., -- fj- riSSfc-No determinations of lead in urine, of basophilic vicinity. The filter-type respirator may not be provid-.V: 5htent of the blood, or of lead in air were made. Six ing adequate protection even under ideal conditions, *- . + - ^Sufceks aafftteerr this o-peration was. starte-d . two, of the and determination of lead in urine may well be con- ' ??Sfirl'developed lead poisoning, one sufficiently severe ducted as a means of verifying the general impression ' J^hPfeius'e a brief period of hospitalization. Any one of tha.t .th.e worker is...b..e..i.n..g....p..r.o. perly..p.r.otected. :;.-rTX'i --Jia'-threc methods of determining whether the expoIsrjam'was excessive would have led to institution of Exposure to Organic Solvent Vapor .. --\ - . ^ iiwrentive measures. ^ AS returning to the main part of the plant, we find :*3Fln a'separate building in the yard of our hypo- ^ that an insulating compound is being used to im "^StCjftieal plant, a purification process is being conducted pregnate the abestos covering woven over copper cable. - ~:y K~n lead sheathing which is used over and over again in The bitumen used as the impregnating materia) fs-:;~- r~; ^3&$enection with vulcanization of rubber insulated dissolved in a solvent mixture. Some years before, ' V-ishlfc-'" Here tons of lead are being handled. Where toluol had replaced benzol as a thinner for this mate-"'..'fi by^small amount of litharge in the previous depart- lial and the amount of solvent vapor getting into the \ if may have caused us. to treat the hazard very work-room atmosphere wds within safe limi`3, At the - ,JIy( the presence of large quantities of lead tends present time it should not be taken for granted that.. >; --al r_e_iicn-.m^5o-re careful consideration. After being such an operation remains within safe limits, but n being^ j5i^wtid':in a cupola, the lead is run into large shallow specific inquiry should be made as to whether benzol i-_; res " ^TT^-'where the impurities were removed by fluxing. is again beings used since most of the toluol is going ision volumes of air are removed from the area over into the manufacture of TNT. If benzol is once more.;. ='r` Healtl ^rrgggt'12-foot diameter pots, and, in this department being introduced into this operation, it is still possible - nformat personal hygiene Is of the. best. In view of the . to keep the exposures within safe limits but. it.is not ;^^i" uded Magnitude of the operation^ air samples are collected considered good industrial hygiene to depend upon. inquiry^ 3g&Jead. determination and our results show that gen- the intensity of the odor as an indication of the con- absoip^T *tiil^atmospheie throughout this building contains ' eentratlon of benzol vapor present.' The concentration^*''"^, -^njSust and funie in amounts well within safe limits. of benzol can be determined by a number*of methods; andJJ! Qj'.'jtnmiking any evaluation of an occupational disease by. air analysis using chemical methods or by such .. Dusts fiff ' jit is of much importance to note carefully physical methods as the heat of combustion method silictalt . .. her-certain operations may be carried on for- using a device known aa the benzol indicator, by the_XV<: a^paratively brief periods from time to time which interferometer or by. adsorption on such solid ad an obVK i^yJesuit In sufficiently excessive exposures to raise sorbents as silica gel or activated charcoal. - " . . " " rcentt] __ idaily and weekly absorption of such material to ^ As was the case in connection with lead exposures,..._ : coni 3Bjjgef6iis limits. Before concluding the collection of mi integrating method can be employed-as a measure'^'-* dust dfi *'iii?rifr>amples in this lead purifying building, sam- of the extent of exposure to benzol over the previous'^.' .re obrii "fkS-Wece taken to show the exposure of the man dur- few days. This test involves the analysis of urine for .. . tnirthe fluxing operation and also while the pots inorganic and total sulphates,* an easily conducted test'` jre~ being skimmed. The exhaust ventilation re which can be made in chemical laboratories of most " : wnd the dust and fume properly during the fluxing, plants without involving special equipment. Analyses nation is jhELjJhe"worker who skimmed the..pot placed the . of the air are of value,*-IS. particularly in locating^^r. .Mttlbarrow directly behind him and as he de_posited those areas and operations where benzol exposures are riginatedli^IhVjiross into the wheelbarrow a cloud of dust was the greatest. But for the evaluation of the hazard, . \ ide directly past his breathing level by the powerful the urine sulphate test gives us our best information- - so-calhr^gTranst fan over the pots. During this skimming short of blood tests which do not show a positive in-' 7 Appu'-J^^Sggation it was found that there was high lead intake dication until after some damage has been done. ' - .onimet*f^&%this-worker even though the operation was of com- We have mentioned that the odor of the benzol lect gr* *tHritively short duration. The control measure was should not be depended upon in determining whether :,TMiy- apparent once this one exposure was evalu- or not exposures are excessive. One of the reasons being severe. for this is that the toxic limit of benzol is compara- - . __-^where operations, introduce comparatively high ex- lively low--100 parts per million being the maximum ed to ^.^CJJSttires. intermittently and with some degree of irreg- concentration to which workers- should be exposed - -glycerm* 3k=*vityf a type of test which permits summation of over any period of time, and, secondly, benzol is not____ lenses M intermittent exposures is particularly valuable, one of the more odoriferous solvents. s working-Jr-*ir tests can be carried on over a long time to show Where we are dealing with some of the lesser toxic ^ :th a one^^^i^r representative results, these are helpful, but the solvents many of which fortunately have more distinct . T is sert'-KT test in such a case is the analysis of urine for odors, then the sense of smell will serve to a certain s adequ^.j^l1^*:-. ... extent as an indication of the hazard. As pointed out - se rithe development of rapid techniques such as ' by Patty in a publication on rapid methods for the u'lithart* 1 thizone and dropping mercury electrode meth- determination of gases in the air,J the most universally :o a SuaT?' ^*sults of urinalysis for lead are becoming more available rapid method of detecting and estimating glyceril^^T^uy^available as a means of evaluating the hazard, gaseous contamination is by odor. He cautions, how- ". -lass the amount of lead excreted in the urine is an ever, that individual sensitivity to odors varies con-____ are saw^? ^sieiit measure of the total lead intake throughout siderably and fatigue occurs rapidly. Consequently uxic T^orWay. every opportunity should be taken for the correlation _ dangef^^. *Je the worker may be protected by means of a of one's individual sensitivity to odors with the con-'- *1' ithin ijg? .^"type respirator approved for lead dust or lead centration of the materials causing such odors usually ' *n thQy*V:jfaeworker's Ups and nostrils should be closely expressed in terms of pans per million. Te rapi ^ y;^^v`ed aj an indication of the effectiveness of this After one finds that he associates a strong odor- - - very and of the conscientiousness of the worker of some such solvent as isoamyl acetate with a concen- ~ ~E&: V; _. > .. Page 196 INDUSTRIAL MEDICINE April, 1912 tration of one-quarter the usually accepted toxic limits, rather than after symptoms have developed is in line he should keep in mind that it is the initial inhalation with enlightened industrial hygiene methods. of such an atmosphere which should be used as an During the last war, considerable numbers of cases indication. If we walk slowly toward a process pre of poisoning from trinitrotoluene were experienced. senting an organic solvent vapor exposure, our noses There is much activity in this country today to avoid become progressively fatigued as we approach the recurrence of such cases in our own TNT plants, but higher vapor concentrations closer to the operation. cases are already being reported from abroad. In one Consequently we may have little appreciation that foreign country, a recent report gave seven cases of there is a strong odor of the vapor even though the TNT jaundice with two deaths and, in another, a exposure may be within injurious limits. If odor is group of 13 workers had to be hospitalized as a result to be used as a criterion, a good technique to follow of TNT exposure, four of whom died. In the more is to wear a respirator provided with activated charcoal effective control of dust and vapor in TNT produc cartridges. Only when the observer is at the operation tion and loading plants in this country, improved itself should the respirator be removed. The opinion methods of determining the concentration of this concerning the intensity of the odor should be predi material in air have been developed. A colorimetric cated on the first few inhalations. Since one's sense method has been devised by Pinto and Fahy, of the of smell may be less intense at certain times than at Massachusetts Division of Occupational Hygiene.11 In others, it is a much safer procedure to use the nose shell filling operations the nose and the eyes do not to decide that the condition is dangerous where control. provide sufficient indication of excessive TNT ex measures can be easily taken rather than to depend posure. Actual chemical analyses of the air are nec upon the nose as the last word in deciding that a essary. condition is satisfactory. It must be admitted that In conclusion it may be stated that in the evaluation although the canine nose may identify a smell with of occupational disease hazards in the field, much can certainty, the human olfactory end-organ is more con be done in spotting conditions which are obviously venient than reliable. severe on mere observation of the condition. Where Reliability even of precise chemical methods should the condition presents some question as to the severity not be accepted blind!/. It is always well to test the of the exposure, then specialized methods should be tester. A thoroughgoing example of checking a newly utilized as a measure of the degree of the hazard. As developed method is that described by Barnes and we have indicated, these determinations can be made Speicher in the determination of formaldehyde in air.1 through air analyses or through certain determina Using an impinger with distilled water as the collect tions on the urine or blood of the worker. The purpose ing medium, only about 50% of the formaldehyde was of the evaluation of the hazard is that conditions retained in a five-minute sample, but 93% of the presenting excessive exposures can be disclosed before formaldehyde in the air of a test chamber was con actual injury to health occurs. After control measures sistently collected when 1.25% potassium hydroxide have been instituted, then these checks should again be was used as the collecting medium. made so that it can be known definitely that they Some of the Newer Health Hazards are effective. Where it is found necessary to institute air analyses y~\F the newer exposures to occupational disease haz or similar technical measurements, the Divisions of ards incident to the present emergency, a mercury Industrial Hygiene of mo3t of the industrial states are poisoning hazard was evaluated by Goldwater and available to manufacturers for study of their condi Jeffers11 as being excessive through observation of tions. A number of the leading insurance companies clinical symptoms and an interesting action pointing also have such facilities available for concerns which to the source of the exposure. A new anti-fouling paint they insure for compensation, and certain companies was being used in the New York Navy Yards which extend this service where group life or group disability had to be heated prior to its application. The men coverages are in force. Some of the universities pro who were spraying the heated paint, or who were in vide consultation service. Private consultants are also the vicinity of the fumes being given off from it, available. Frequently, an initial complete survey of a noticed that any gold rings which they were wearing condition by some one of these specialized services can developed a silvery coating, obviously from the for be followed up by inspection or by routine analyses mation of a mercury amalgam. In addition to this, conducted by the plant engineer or chemist Recording a silvery deposit was formed on the ship's hull in the instruments have been developed for such materials as area where fumes from the heated material made carbon monoxide, sulfur dioxide, carbon disulfide and contact with it. With symptoms of mercury poisoning hydrogen sulfide, but the initial cost of these tend showing the need for control measures and the pres to be rather high. ence of this amalgam showing the source of exposure, Judgment and experience count for much in the control measures were soon instituted. evaluation of the occupational disease hazard, but Today we are hearing much about the greatly ex where there is any question as to the need for intro panding synthetic rubber industry. Acrylonitrile or ducing control measures, or where such control meas vinyl cyanide is one of the initial materials for pro ures run into any appreciable cost, or inconvenience, ducing one or more of the "Buna" rubbers. Since the then this evaluation can best be based upon such substance contains the poisonous cyanide radical, it specific data as is to be provided by determinations was believed desirable to institute a study of the toxi appropriate to the exposure. cology of this material to provide information on which to evaluate the extent of the hazard. By ascer References: taining the toxicity of this material, which was found to cause death of dogs on exposure to concentrations of only 110 parts per million after as little as four hours, these investigations11 permit the proper evalua tion of the hazard so that adequate precautions can 1. MILLER, J, W,, and SAYERS. R. R.: The response of iwritorival tiuue to industrial du*u. pub. Umltk JkVDf.i,. $g, flptiK 2. GREEN BURG, L., and BLOOMFIELD. J. J.; The iro Differ dust unplin? appnmtu*. Pub. Health Rrpts., 47, | H133). 3. LITTLEFIELD, J, B,, and SCHUEKK. H. H.: Dust samtdinff with th Bureau of Mine* irmiim impinger. uainsr a new hand-operated pump. Bur. of Minn R. /. 3387 U'.'3S), be taken and industrial exposures kept within safe 4. BLOOMFIELD. J. and DALLAVALLE, J. M.s The deter limits. Such means of evaluating the hazard before mination and eontrol of irultifttrial dim. Pub, jitatth Bull. 217. Mti7. (1P35). -'4f if, = ioJine' NO. i -...-=. INDUSTRIAL MEDICINE - - Page 157 - f^c-iAiutear r. c. pouIUUUA'of contrwC ci Wd_ji*p*ar W- --...10: S*uUa njpllnt far _eeatiol ef itmmpi*,:* Uncur'.tltj, Of CUes ,rienced._7 to avoid uotSt but; __ _ j.tnAat,Hw.ara..ia.M4i.9ax. - ,, 2<, a- tmt). . _ . ____ S;.^fT-p*Trr F. A-i Rapid m*thod for tha determination' at |11U ' 12. DUDLEY. H. C,, nad'NEAL, P. A-r. Toxiteiotr of oerrtooittOo flSf^ttodir. 10. <) ,, _ ' ' - -^"Tl Wonido). L A itodr of tb acute toxicity. fMi. tl. I7-SS S5(ifil7TABNES, E. C.. and SPEICHER. H. W-: Tb* diMrminatlon of ,<42). -- -------------------------- ....... - ' - . In 6n$7*%j ^MSiSSaidtliTde in air. //. f1naddwwtt. ffw. * Tex.. .2.4..,...1..0..-.1...2.....(I42). " , ,-T *iL?ftDBDiKER. P.: Vapor* and lhair iwotisa oituunmcnL. AJ.PMt . "IISL- PINTO. 31. S&-. and FAHY., J., Pp4.;. Aa Raw eoliorlimatrtfea mrtW for th* determination of TNT {*,*,. trtnltrotolu.n.) in air. Ibid- cases ofr arS&iMT..(}. v'-. - t. --- . -.r.*c2<-2 (H*2}. ". ' - -- ' other, f afer::.'.:':- : '':--......... ............ "'' ' ------------- *:suit':vi -heVinora*"" &&*-**:r5 Plant Hygiene Studies - control. Since the physician must in produc- .' many situations recommend specific tnproved"3 toca.tn,j-dJ efttift*1___a_n_d*1--win>. emveenr!vc'mapaatbelreiaolr spursopceecstsedoor f ecnavuisroinng- ^.tchoenterofflemcteivaesurneastuorrepaosfs jpurdogpomseendt oonr . ofthi5 .I<.............tjoP of unhe&ithful occupational' injury or disease,. the exact location. - existing installations, a knowledge of _ >rimetrie"^ A of the an& IjvJT-j ss do nor'" fv^gpoaures is a primary function of industrial physician. Technically, fisaihjexposure ;: s degneii as any working " !^-y**dition or environment, process, at^^eration or material used in manu- 'of each., and exposed! Identification the number of of Exposures workers - the fundamentals of industrial by- - g"i*e"ne~ *engin' eering is a most useful piece of equipment for him to possess. 'Control procedures fall in one of the . ETNT ex.'ft during which is capable of causing an nec^ ^Siiiirmfnl physical effects. These may, xposures are important by nature, following major classifications: extent and the degree to which ' 1+ Subtitution~h*rmJcu m*urita irt tub- , ^i^Sjcccasion, be so obvious that work- they may be controlled. Most indus' Utut4 tor trouble* -- rvaloatioo^ much ca$ U'4rb<themselves are perfectly familiar* , ,^rfah' tbeir source. Most frequently trial hygienists believe that sufficient information exists about control meth ----- 2. AlUratJou tt >TDCiing or r ` lS " , *' '1; StfTegntioD pj opontlon*. cnaoiifactur" aeeo.bs'Wveeivovehuel^esrl^ryiftjyriKUSp^i^j^fljUp^nevidrfie'oco.edissnic.dtwrpeiih8lxlylpsoerifcoxapvthleoesetuoxerafefbmeaecinnttdhaoetniinomaawdooeosrqtkf umseaeemcnny-- - ods in of all duced w: general to permit, safe handling but very new or. recently intro substances in industry. ^ ^vRiciandn in- .4. CPtur of duxU, fottna* vista, vo^ors of *' ."V fmMt *t tbo point of orirfo* ' * L Vm of ponossl prwtcctlr# xwJ&mont* ~,;i*T1hePrainctcuipalle-aspopflitceantiorenqoufirtehsesae gfaig*-h1._ urard/ As" L-tvw.Tjj requires diligent combined dustry are .extremely diivveersLein: andd '^.deIegsrere ooff ssppeecciiaalliizzeedd kknnoowwlleeddggee aanndd.:'.';, be~madeyy 3Si?Mbr highly ` - - -- ieterinioi^* .TjgKginMring personneL te purpoae^ N-tiwijMuitic methods at. _______ __ condition^sed befor^ 1 m&isur ` d again I that the RE-tbat dependable f*2^on which data may program be" ' ^ Abnonuitti** ef air tiwm. of ~ ? *baonRUB**oftBip*LtitiadbuniiSltf.! . New Processes . .'.IT-T.-------- C. Damon***. control can be based Plant ' . D. D*leti* Uhmisation^ .. ----- p" if.studies have proved to be re- E. Du*t. - - AU, NEW processes, materials or.. i. modifications. of old ones should _ ggbhjvand to require least expenditure ' ige and, money.. The procedure is F. InfKtigu. : '.'.T ' ' . be investigated in. much the same way--r G. Radiant curst.-, -- ------ H. Jt*m*t*d motion; pressor*, stock. *~ V.V " ' "and in advance of installation to pre-"" Wiariy one of taking periodic in- J. Poison - . - - *" vent, the introduction of unexpected " ir analyse*' 5oJ7- of nnsatisfactory occuna-- - Subheadings under the major title exposures. , ' ` . __ ." ivisiona ' -...______ ; states heir cosdT fkiWatjjoa of Exposures romDaniw;2^^'1MI,CE in Isrge and small in- of poisons are most numerous, and a complete list of .ill substances capable of causing local or systemic effects is * very considerable one. In the case Maintenance of Control -- -- Dlant medical inspections - are an ^ essential phase of control mainte*_-j_ ucr- nosm-^p^aSni^t"f*^^54tlUfe7-*'h?t*r^pedlm.amtnorei-tat lshufyecgscic_etea_nsb_es_lifs_u;sh_lt_mui:_fde*_in_ce__tes_sar"t_-r:aae_ssri_eun_ltgi_kzlsgiek_^tee_eslsyptlt_syss. - pfrfom, tUintrdpucstriaPlMsuibfsfttratnitcieosM, th-eAlriisstinogf npnottenn+tii>atl expos.u,-roe^s becomes altmmo/s.tt -nt-ra-i-na-c-l-e pahpydsc-ico-i--ansnesq*-u--er-o-n-utl--ytinToeLfT. "th~eT ibndeusef*t--.. inspections should occur periodically. p disabuKT^J&fjU*followed; endless. ' .__ ; ........ . .. ,, . Sites of greatest exposures need fre rsities -complete list of aU materials quent attention, possibly constantly _ ats ate *1^ ,- fcjawd in manufacture, should be se- Engineering Studies...... ........ ..... .... repeated chemical' and engineering _ Faurvey of .*--Those capable or suspected of services caB ^S|gs*bimg trouble should be suitably in- ollowing location'and identifica , evaluation. Others are visited in re-rr tion, the physician should indicate lation to their importance. Periodic .,e analy* :*2SS*t^i 00 list. in the record his estimate of theplant walks by the medical depart- ... TJocordinl^^vJ^^-^tP* in manufacture should seriousness of each exposure. If doubt ment personnel throughout the entire tI-i-i. -u If-J* described, preferably in the form exists about its exact nature or satis establishment is particularly sound ,T :nat,eJl -ni or schematic repre- factory control,' assistance is needed practice. Occasionally, inspections - lisulftde Z^^r-teststios,' to indicate the flow of goods from an industrial hygiene engineer. should be made in company with offi- . these ft;.r-*n.ia raw material to finished product. In fact, confirmation about the sever cers of the firm, particularly those re- . iuch in _ hazard, d for n: ^ -introl tnea**,, convenieno^; . upon s**torminatioi ScjVThorouch inspection of the premises is essential to test Lv>hduii0T1j drawn fronl the inventory ^s.ntoterials and processes and to ot^*p conditions of work *** potential contributors to end lowered production. It *ot *3e forgotten that harmless tsay under certain condi- or- in susceptible individuals be~^?-VtmfuL In the same way, no ity of most exposures is often highly desirable and it is routine practice in many manufacturing concerns for an engineer with suitable qualifications to verify all preliminary estimates. Qualitative and quantitative analyses of each exposure are available in this way for use as factual evidence if necessary. All determinations of this character should be suitably entered in the records. . sponsible for production, personnel, plant conditions and safety. Active interest and cooperation from man agement is quite as great an element ` of successful medical department ad ministration as cooperation from the--: workmen. Employees most emphatic ally need instruction and regular su pervision in order that adequate . _ understanding may exist about the . ' continuous and proper use of protec* _ i.il. tis*i>**3t.v : The -75. : Duet w h*oJ^V*r*T-.` c bow much care has been ex**`V;fe* "* preliminary investigation, ~fc^otal or unsuspected sources of -will- be missed unless every the working environment is WJT -r scrutiniaed. Control of Exposures ' tivo devices. - - - - 'j; Amas'pcahshitnoaioesonrnyeaslatsaidnbtihlsiseamhbeoiindltiidtoyaunsshtofreouiatrclmcpuahosdytfesqoiscuceiacatutnetheddsreateenTtpoelhlamaeromttimf'e*renieinncn.lsoHtotrtad4fsl0hla.cso-tioysuioslndnttleermocaalodnnidunmtafgetihntahetsoeucdroemtaphstieee,edssitcihnooaef-fl ---_ M.i TS BatL'--l- *' --record should be made of T*kn from Bolletia U of IS* U. 3. DasirtDRmOi*uoBntEaRoaTfti*JLS.aubVnoAr*,.N- E"b<.r!rleiL4uOLnU*tIiSonI. DKoUeBaLroI*N oanmef and sptviitl notations shout foilow-np - visits and inspections. Forms can readily be devi-rd which will facilitate . ft ^"Ftisre 1$3 INDUSTRIAL MEDICINE _ . the uniform recording of ell results ; that the practicing physician called combustion was carried .on in of pUnt inspection. ' Medical inspection has- .: additional on to serve in'iitdustry'may have ac-_ spheres varying in oxygen eess to ready'sources-of: consultation. _from_un appreciable excess c i advantages. It provides opportunity and special information. 'Preliminary ` point where production of gas< ifor-thorough , familiarity .with every plant, hygiene studies should in many .essentially from destructive d Job in the plant. Information of this 'cases he arranged .through qualified' tion rather than actual oxidatio character is of the greatest useful . consultants. .Obscure exposures will., Ferguson stressed the possibi' ness in relating work assignments to - require aid of this same description. : combined effects of noxious go the physical and temperamental qual Assistance can frequently be se- atmospheres containing var-ou ification! of workmen. It is reassur . cured by application to experienced binatiomfof them. . ing to employees to know that plant * industrial physician^ or industrial - . 'February 25, 1942, DR. ad conditions are under observation by . hygienists. Occasionally consulting ROSS smith. Division of Industr: medical personnel. It is equally satis services are provided by insurance giene, New York State Departn m* factory to employers to realise proper records are available in that case companies or trade associations to member companies. A few city and Labor, addressed this group effects of industrial dust on the claims arise out of alleged unhealth ful conditions of work. .. u............. county health departments have es tablished bureaus of industrial hy- Chicago Section * Ta** T. Application in Small Plants - - . t giene for investigation and consulta- ' tion about occupational exposures. If bs physician serving a small local resources fail, assistance may be plant should be guided - in his ap sought through bureaus of industrial HE Chicago Section presen' subject of "Organic Solvent Exposures" at a meeting on J 8, 1942. DR. MILTON B. KRONE proach to unhealthful exposures byhygiene in state health or labor de Director, and renneth m. moi these same general principles. Fre partments, and these in turn have the dustrial. Hygiene Engineer. quently he will need special technical advantage of specialized information Department of Public Health, I assistance.' Committees on industrial and investigating facilities supplied of Industrial Hygiene, gave the health are being developed in state by the Division of Industrial Hygiene - of their medical and engincerin and county medical societies in order of the U. S. Public Health Service. of carbon disulfide and hydros fide exposures in the syntbet: `-^.American Industrial.Hygiene Association News of Local Sections r.'-r casing industry, dr. James h. s . of the Laboratory of Industris .'due, Eastman Kodak Compa cheater, discussed the general Michigan Section----- : --------- ?-- *: : ' with. Sottft Common lntetrial 'of "Solvent Vapor Exposure he Michigan Industrial Hygiene' Sohrenta" -- JAMES H. STERNER. MJ>,, Laboratory of InduetrUl Medicine, Eattraen Society had an all-day Conference Hodak Company, RoebwUr, New York* Ton Industrial Health ConservationF, riday raiar - Friday, March 27,1942, at Hotel Stat- Pler, Detroit. The program gave timely RESIDING--CLARENCE D. SELBY. If Medical CewuHant. General Motor* Cor discussions of conditions affecting _health in present-day industry, and of methods for conservation of the health of industrial workers, as follows: ' poration, Detroit MkbJfan. MTraiainf of ImluttrUl Personnel In Michi gan"--HENRY P. VAUGHAN. Dr, PJL, Du. School of Public Health. University of Mlchl* fan. Ann Arbor. Friday Moraine -' .. ` **Fluorograoblc Survey* with a Disctttstoq of Relative Merit* of Various Sice Fhaorographs** included results of. the work had in progress concerning th of some of the newer petrolesr late solvents. . ....... February 5, 1942, the Chics . tion heard melvin j. ey, * "Constructiva Human Re! Industrial hygiene is,.. of ' largely concerned with techr.ii methods for provision of h working environment, b' PRESIDING--MR A. O. THALACKER. A Soerotary. Detroit Rx ProdoeU Co., Dttniw - "A Study of the Wilioa Combustion Ana* tyxor for Chlorinated Hydrocarbon*'--PAUL =T. REZIN, Field Supervisor. Bureau of Indus trial Hygiene, Department of Health, ' f-TT* "Tori.ltv at LmS CWnmt."--GORDON C, HARROLD. PUD- Industrial Kraianiit, In- doatrial Hrstn* Laboratorifa. Cbrnlar Cor poration. Datroit- ' 1 Tba D*tmination of 7tne Orid. Puma fa .Alt"--WILLIAM G. FREDRICK. Sc-D.. Cbi.f ChomUt. Burtan of Industrial Unrttfla. Dtttait DapartiRiRt at Health. Drirolt. Viaitina Hun* S*rrfa* for tba Small Flint" --MISS LUCILLE HARMON. R.N.. Sapar- riior. lmtutrial Xanins Sarrica, Visitin* nano Asaociatian. Datroit. .. . "Industrial Safety is Mteilpaa and its R]n. tion to Industrial HysUn*"--JOHN W. GIB SON. Chairman. Commission.! ol Labor and Industry, t - .1 __ ..Friday Afternoon PRESIDING--KENNETH E. ilARKUSON. A M.D.. Dinctor. Burno at Industrial Hy. ian*. Michigan Dopartmcnt at Health. Lan- liM. "Tba Fhysiolorie Action of Light Metals"__ STEWART F. MEEK. Assistant Modlcnt --BRUCE H. DOUGLAS. M.D,, Commissioner, through proper human relsti and C. C. BIRKELO. kJ), Roentgenologist. Department of Health. Detroit. On January 14, 1942, at Lansing, Michigan, the following subjects were, discussed: effective accomplishment be this or any other phase of it production. ' Practical Application of It Ventilation is the subject to "SSfety at Work"--C. Jf. EMERSON. Ptr- tannri Man.gtr, Wolrarina Bra*. Works. Grand Rapid*. ' sented by JOHN m. kane, 1 of the American Air Filter C 'Intercfting the Private Physician In Indu*- Louisville, Kentucky, at th< irlal Health- --J. DUANE MILLER, Chairman. Committee on Industrial Health, Michigan State Medteal Society, Grand Rapid*. meeting on April 2. This m< to include discussion of ir. "Syphili* ' in Industry- --F. J. WEBER. problems and methods of th> Fast AaiUtant Surgooa, United State* Public tion. Since many health haz; Health Service, Washington, D. C. (With sound Aim.) to be controlled through rerr On February 18, 1942, DR. louis ventilation, this subject is of Schwartz, Director, Office of Derma value. toses Investigations, National Insti The Chicago Section is sp tute of Health, Bethesda, Maryland, the Session on "War-Time I discussed "Industrial Dermatitis in Defense Industries." dr. schwartz covered the control as well as the cause and incidence of occupational dermatoses. Hygiene Problems" to be hel oMtayth5e-7,M1i9d4w2.esTt hiSsasfeecsysioCn,o: for Wednesday afternoon, M eludes the following program **Tb* Industrial Health of Womf Director. Chrytltr Carpcratinn, Detroit. "Whit, fina.rs" --W1I.UAM T. KREBS. M.D.. Medical Director. Hudson Motor Car Company, Detroit. "Industrial Health Activity in Michigan"--- i. DUANE MILLER, M.D.. Chairman. Com. miturn an Industrial Health, Michigan State Medical Society. Grand Rapid#. "Some Special Frnblcme in Our War-Time Industrial Health Program "--C. O. Sapping. TON. M.D., Dr. F.H.. Industrial Consultant. Metropolitan New York Section Tim# production'4 -- MARGARET TERT, Women'* Bureau. U. S. Dc? he Metropolitan New York Section Labor. WaihinsftoR, D- C. Theard MR. the Pyrene cMeoarncue fae.ctfuerrincgusCoonm. opaf ny,W"N*Tr*#eTwlJlemrMiuriIianrrdiaaunissdtryO:etnhdr Nt* App Metallic > present a talk on "Fire Gases" at the HAROLD H. STEINBERO. M-D. meeting held January 21, 1942. Of Director. People* C*, Lift special interest was the variety of mixed fire gases, together with the Company, Chicago. "SolvenU"-- HENRY F. SMYTI nior Inrttiaitrial Fulloi*. ileHon CbitKO* relative quantities of each which P'lrtRbuTfh. * "Fatlfu* in Induatrr"--ROBERT It. FLINN, St,D,, put A*mani Surgeon. Divlsiun of In* * dvmal Hrccnte National Institute of K*ith. BfiJiihlft. Maryland* might be expected from the combus tion of certain classes of substances. Results of work were presented where ,4E<T#ettv* Industrial Tim* Condition*'4--H. G. DYKTUJ Bureau of Indostrial Hyeirt Dvnanmcat o/ Heaiti. Lar.tms. I