Document XRmJL4pz805RoQ7bD66eBwY2R

iiuii! large plant. ui .uij u>.\ic material inrougnout this in general, it can be said with a - certainty that the>c changes are brought T* *-c skin, primarily by the contact of the sl.- Ul >* Chlorinated Naphthalenes and Diphenyls vapors of these compounds, or by actual ^ v them in the form of solid or parnculateC,,,'',M LEONARD GREENBURG, M.D., have found, for example, that workers rr',`tL`' _ Executive Director, Division of Industrial Hygiene, fumes have more acne than those expov.^1'^ New York State Department of Labor alone, and we have also found that work*'* THE chlorinated naphthalenes comprise a group of chemical substances made by the addition of vari ous amounts of chlorine to a naphthalene base. amount of chlorine may vary from three to six or pos sibly more atoms providing compounds from trichlornaphthalene to hexachlornaphthalene. In the same manner, the varying amounts of chlorine are added to a diphenyl base providing a group of compounds of varying chlorine content. ' As a rule, the final substances, as used in industry, are mixtures of differing chlorinated naphthalenes. Earlier, these were, as a rule, possessed of a lower to the solid material or its particulate veloped dermatitis. In this connection On h x TheaFnudltodnesacnridbeMaatcthaseewosf is very interest]' ' an infant, 2,/i lr,s- t(,e _ri-T, TTJ vrhne-yy1.. ;* F -tars Mu developed the dermatitis as a result of C(, soiled working clothes of its father whTvvl* u habit of playing with the child prior to eK, .If- f`* clothing. ,,fc':r r ^ More recently, dermatitis among Schwartz6 has cable strippers described employed cu,, building establishments and working which had been impregnated with these ms-sjmm p,<*u r.rc*i4~L* -IT `lard . ty J *c f LaU rCvh.lki degree of chlorination and later on the compounds were usually of a higher degree of chlorination with varying amounts of chlorinated diphenyls added thereto. These substances are not new. Perchlornaphthalene was used in Germany during the last war. It is to be clearly understood that these groups of compounds are not manufactured by any one company but rather by approximately five in the United States, and they are sold under varying trade names by the manufacturers. The chlorinated naphthalenes and diphenyls are val uable industrial products. Because of certain prop erties which they possess, we may briefly state these valuable properties as follows: 1. Resistance to water and alkali. 2. High insulating value. They possess high dielec tric constant. 3. Thermo plasticity. . 4. Quite stable chemically. 5. Flame resistant. For these reasons, these substances possess much value industrially in the making of electric condensers, and in the insulation of wire and cable, etc. Systemic Effects tIFelNtirnaacnTuHatEaenndUdyenpJleiltoaenwrdtvaciaSkht7trlaootirepnnsha,y1p9sho3yt6shf taetahlmemenicoelin.vegefTferhmcewetssneerienwfinortherd0--kueKpnpin:oolgnfrrc.t,ed^ *7/-it? ' M1, ;1"0<fu3: bub verified by animal experimentation. In 1937^ Dn'-T^'^'5sr,c Warren and Bennetts reported such liver among animals exposed to the material by inhaU*r^:'|t <rt til danipdhesnimylilacromfinpdoiunngdss.weTreheosbetaliantetderwaituhthtthhoeerscchahllsoWorir..vv*^/ '&y1iWO0f-';- tion four non-fatal cases among humans and the p-. tr,c fatal cases previously cited by Flir.n and Jarvik ' * A'- :o I should like to cite two or three cases which "'1 #'<*** have encountered in our own experience'1 and may be of interest from the point of view 0f dumttti^*AA'f***^ EE-y'5' of exposure prior to this type of poisoning-. A .g. irrll years of age was engaged in soldering electric*.! cr*.. oil 'v c: densers which were impregnated with tri- and tctrv'vs chlornaphthalene for a period of approximately KT^v:^TEtunei months. The autopsy for this case showed mild to ?'{7?s !r vere degeneration of the liver and presented & 0i picture of what is generally known as acute atrophy. It was apparent in this case that the lattetuS ,, Method of Use in Industry organ displayed areas of healing and new area* TPHE chlorinated naphthalenes and diphenyls are used -* in industry by two methods: 1. A cold method in which the material is dissolved in a solvent usually a mixture of petroleum naphtha and toluene, and 2. A hot method wherein the material is rendered plastic by heat. pa thologj*. ' -v | J f|e In the second case, a man 24 years of age develops4' jaundice after five months of exposure in the coatlr^ nooaff pwthimtihreeasleanwnedist.hfoHwuearxwmcaoosnntathawsinailynagtferrothmtehehwiogjarhukenrdfoiccrhelaobrpienecairtseM^fb'U-ift.4Wtf Eto0pri quite intense, with general malaise and loss of appt-f| tite. After two months more of work he was sent to Toxic Effects * hospital, where he rather rapidly passed away. Tb< ;v'| ^ " TN THE United States, the first three cases of acne autopsy in this case showed extensive areas of neerwj produced by chlorinated naphthalenes were reported and fibrosis of the liver with regeneration. x;S L k by Sulzberger1 and his co-workers in 1934. Fulton and Matthews,- of the Pennsylvania Department of Labor, In a third case, published by Drs. Mayers $ Smith,10 of the staff of the New York State Dcpirt* ^ reported 101 cases of dermatitis in a wire insulating ment of Labor, an 18 year old girl became ill Mp* jV tei) plant in 1936. five months of exposure in the soldering of electr.<*- tb) In 1936, Dr. Louis Schwartz,3 of the United States condensers. The waxes in this case were compos-- Public Health Service, described cases of acne pro principally of trichlornaphthalene. She was hospiut-^% ' m duced by chlordiphenyls, and in the same year, Jones ized and recovered after a long and slow period and Alden1 reported similar findings. convalescence. A) ' : tie Df'i t In 193S, Mayers and Silverberg described acneform skin eruptions in workers makmg electrical con densers.5 Recent Industrial Experience .. URiy G the past year the Division of Industrial H.T` r'.i.gc _ \L) ^ r_ giene of t^50 g+Qto Fipnnrtment of L** I?- Round Table Discussion, Reflation in ihe Use of Toxic Substances. National, Conference of Governmental Industrial Hycicnists. Roches ter. New York. May 24, 19-13. bor has conduc using chlorinated w 00036 WATER PCB-SD0000032499 rA ntasu^ ^ ,out.in % f ' %VltH 1 i.'uter. ^ ''Posed u d to duS ! have dt. rePort ^ 'y Pictyr* fvit*f'*h(*>.c0.J?j"cwr.veoalramkteiivnrsealtyiionnfethwoef- inwdourk*setrrys. in the cases of enlarged two factories liver--five in palpation. p inarison in these two plant? showed a very much hr incidence of acneform dermatitis in one of the fc'f P as compared with the other; namely 21fi as f^HJlred with GOfc, the former being in the cold ffpo`frmJoacP-e5',s'hsrme eeesnttabelmisphlmoyeinntg and the the hot latter being in the esprocess only. TT he der- h* titis appeared to take place on the average in about month's jn the hot process plant as compared with ' **? h ` 'Vlt>l % months in the cold process plant. as >n the ne>ng hu Cendusins c A result of our general re-study of this whole cases of 1 at ship, th cables 'ounds. /V problem and our experience in two recent out- |.5) as well as several isolated experiences we desire w draw several basic conclusions: 1. Chlorinated naphthalenes and diphenyls are in ,-ricral highly toxic compounds and must be used with strenve care. Industrial hygienists should make every e form of. ported by ';ing with :ngs wen , Drinker, changet' ahalation, ilorinated `Iso menthe three vik. vhich we ad which duration A girl 17', .deal con- h nd tetra-;, elv seven , ild to se2 .'.4 1 a dear;I Vor; to see that such exposures are controlled, in so fjr as humanly possible. In this effort, we do not be lieve it safe to rely on limiting atmospheric concentra tions but rather to depend on a maximum of mainte nance and engineering control. 2. Toxic exposures may be more readily controlled where the cold or solvent method of impregnating cable j, employed than where the hot process is used. 3. Of the known cases of liver disease in our experi ence, the available history and experience generally points to exposure to vapors or fumes from the hot process. There is no clear evidence in our experience, jithough it is possible that skin absorption may pro duce systemic poisoning. Physiologically we see no reason why this is not possible. However, most der matitis cases do not develop liver damage. Finally, I should like to call attention to a group of recommendations which were agreed upon by all of the groups involved in the last outbreaks of poisoning as being of utmost importance in control of this hazard. e yellow,' he latter areas of Recommendations r tnless there is a very good reason for using the hot 'D method of impregnation all new installations eveloped coating iorinated a period became of appe- . nt to the ay. The necrosis thould use the cold or solvent method of impregnation with chlorinated naphthalenes and diphenyls. Where the hot method is now being used it should be changed over to cold, if possible, or surrounded with every known protective measure. 2. General hygienic measures should be followed, but in no case should these be allowed to supersede engineering control of the primary source of the ex posure, the operations in the plant. The following hygienic measures may be considered ers and Departill after lectrical mposed .ospital- . :riod of 1 good practice where these compounds are handled. (a) Two lockers for each worker exposed to chlorin ated waxes (one for working and one for street clothes). (b) All work clothes above the underwear should be provided and laundered at least twice a week by the management. (c) The workers should change to clean underwear at the end of each shift before getting into his street clothes. ial Hvof Laplants In this (d) Supervised cleaning: (1) At noon the workers anould remove outer clothing and scrub hands and face under supervision. (2) At the end of the shift they anould. be required to take a supervised shower before changing back to street clothes. lion of the foreman,, nurse, medical, or plant super intendent. (f) All departments handling chlorinated synthetic waxes should be thoroughly cleaned according to a prearranged schedule. This should include the removal of all deposits of waxy material from the machines, floors and surrounding objects. Workers doing the cleaning should be provided with protective clothing and supplied air or organic vapor masks where exhaust ventilation is inadequate or not possible. 3. The foremen of all departments where this ma terial is handled should be apprised of the toxic nature of the material and instructed in safe handling pro cedures. These men should make it their duty to check up on the workers in their departments and instruct them in safe practice. 4. Pre-employment and periodic physical examina tions should be made of all exposed workers. These should include the taking of a full clinical history, with special emphasis on gastro-intestinal disturbances and dermatitis. In addition, the skin should be care fully examined periodically and the more reliable liver function tests performed. Gastro-intestinal complaints developing in a worker at any time should be a signal for an immediate medical check-up. A history of liver disease, jaundice, or antisyphilitic treatment should automatically exclude a worker from jobs involving a possible toxic exposure. Pregnant women should not be employed where there is a possible exposure to the synthetic chlorinated waxes. 5. Engineering control of plant operations cannot be overemphasized but specific recommendations are not applicable to all cases. It would be wise for a plant using this class of materials to check their control measures with the state industrial hygiene agency, the insurance carrier and some competent consultant be fore occupational disease occurs. Bibliography 1. Sitlzbercer, M. B., Rosenberg, A. I., and Shek, I, I.: Acneform eruptions. Note York Stale J. A/cd., 34:899, 1934. 2. Fulton*, W, B., and Matthews, I. L.: A preliminary report of the dermatological and systemic effects of exposure to hexachloronaphthalene and chlorodiphenyl. Pennsylvania Dept, of Labor, Spec. Bull. h'o. is 1936. 3. Schwartz. L.: Dermatitis from synthetic resins and waxes. Am. J. Public Health. 26:5S6, 1936. 4. Jones, J. W., and Aldex, H. S.: Acneform dermatergosis. Arck. Dermatol. < Suphil., 33:1022, 1036. 5. Mayers, M. R., and Silverberc, M. G.: Skin conditions resulting from exposure to certain chlorinated hydrocarbons. J. hid. Hyp. < Toz.. 20 :244, 193S. 6. Schwartz, L.: An outbreak of halowax acne ("cable rash''} among electricians. J.A.M.A., Vot. 122. p. 15S, 1943. 7. Flinn, F. B,, and Jarvik, N. E.: Action of certain chlorinated naphthalenes on the liver. Proc. Soc. Expcr. Biclop. Med., 35:115, 1936, Also, Liver lesions caused by chlorinated naphthalene. Am. J. Hypicnc. 27:19, 193S. 8. Drinker, C. K., Warren, M. F., and Bennett, G. A.: The prob lem of possible systemic effects from certain chlorinated hvdrocarbons. J. hid. Hyp. & Toz., 19:2S3, 1937. * 9. Greenberg, L.t Mayers, M. R.. and Smith, A. R.: The systemic effects resulting from exposure to certain chlorinated hvdrocarbons. J. Ind. Hyp. < Toz.. 21:29, 1939. ' 10, Mayers, M. P*., and Smith. A. R.: Systemic effects from exposure to certain chlorinated naphthalenes. Industrial Hygiene, ludnst. Bulletin, New York State Labor Dept., January. 1942. Abstract of Discussion Manfred bowditch (Boston): A few issues ago an article appeared in the Journal of the American Medical Association dealing with that subject of cable wire treating. One of the two authors is here; he might say a word or two on that subject. PjR. irving R. tabef.shaw (Boston); Those were experi- I~y' ments to remove wax from the skin, and, as you know, it is practically impossible to get off. DR. greenburc mentioned scrubbing, but that doesn't do it. As a matter of fact, workers themselves have attempted everything, even washing their faces with ether and using the harshest abrasive soaps. , 00037 WATER PCB-SD0000032500