Document Yj38L0BkRbOeGJMaJkV0zq21k

FILE NAME: General Electric (GE) DATE: 1943 DOC#: GE194 DOCUMENT DESCRIPTION: Book Excerpt - Other Pneumoconioses [Principles & Practice of Industrial Medicine] F.'ft r ? ti- T r- k.- r rPhe Principles and Practice of INDUSTRIAL MEDICINE Edited by FRED J. WAMPLER, M.D. Professor, Preventive and Industrial Medicine M E D IC A L C O L L E G E OF V IR G IN IA CONTRIBUTORS Otis L. Anderson R. N. Anderson Anna M. B aetjer J. J. Bloomfield J. A. Calhoun J. M. Carlisle George H. Cross Donald E. Cumming Charles E. Engel John H. Eoulger Augustus Gibson T . Lyle Ila z le tt Albert Hemming F. F. Heyroth Joanna Johnson R. T. Johnstone George Z R obert A. Kehoe M. H. Kronenberg B. E. Kuechle M atthew Luckiesh W illard M achie R. W. McKee Sarah I. M orris K enneth Morse F rank K. Moss C. M. Peterson D. F. R obertson F . S. Rossi tei W illiam A. Savvyei Louis Schw artz Lorin A. Thonijioon Fred J. W ampler W illiams A William Wood Book BALTIMORE THE WILLIAMS & WILKINS COMPANY l >1`1 *R- 'J%if Si * LIST OF CONTRIBUTORS A n d e r so n . O t is L , B.Sc , M.D.. F.A.O.P Surgeon, United State Pi'Wt Health Service, Assistant Ch'of Dn-j. sion of Venereal Diseases, National Institute of Health, Betliesda, Maryland. A n d e r so n , R ic h a r d N., B.A., M.A. Director of the Division of Rehabilitation, Special and Adult Educa tion of the Virginia State Department of Education, Richmond, Virginia. B a e t je r , A nna M., S c.D . Associate in Physiological Hygiene, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Maryland. B loom field, J. J. Sanitary Engineer, United States Public Health Service, and Chief, States' Relations Section, Division of Industrial Hygiene, National Institute of Health. Betliesda, Maryland. C a lh o u n , J. A., M.D. Medical Director, American Viscose Corporation, Wilmington, Dela ware. C a r l is l e , J. M., M.D. Medical Director, Merck and Company, Rahway, New Jersey; Professor of Industrial Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania; Executive Director, Bureau of Industrial Health and Hygiene, New Jersey State Department of Health. C r o ss, G e o r g e H., M.D. Associate Professor of Ophthalmology, University of Pennsylvania, Graduate School of Medicine, Chester, Pennsylvania. C um m in g , D ona ld E., B.S.* Associate Professor, Department of Medicine, and Director, Division of Industrial Hygiene, University of Colorado School of Medicine, Denver, Colorado. E n g e l , C h a r i,e s F ., M .D . Assistant Medical Director, Wcstinghousc Electric and Manufactur ing Company, East Pittsburgh, Pennsylvania. F o u l g er , J ohn II., M.D., Ph.D., F.A.C.P. Medical Director, Haskell Laboratory of Industrial Toxicology, Wil mington, Delaware; Associate Professor of Industrial Medicine, Medical College of Virginia, Richmond, Virginia. * D eceased D c eem bei, 1912. LIST OK CONTRIBUTOR G i b b o n , A u g u s t u s , M.D. Physician, Merck and Company, Hallway, New Jersey. H a z l e t t , T. L yj.e , M.D. Medical Director, Westinghouse Electric and Manufacturing Com pany Proicssor, Industrial Hygiene. University of Pittsburgh,Pill,-. Laugh, Pennsylvania. H e m m t n o . At,b e r t , M.B., Ch.B. Physician, Merck and Company, Rahway, New Jersey. H e y r o t h , F ra n cis F., M.D. Assistant Professor of Research Physiology. Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. J ohnson, J oanna, R. N. Supervisor, Industrial Nursing Division, Employers Mutual Liability Insurance Company, Milwaukee, Wisconsin. J o h n st o n e , R u th e r fo r d T., A.B., M.D. Director of the Department of Occupational Diseases, Golden State Hospital, Los Angehy California; Formerly Asshiaut Professor of Medicine, Univeisity of Pittsburgh School of Medicine, Pitts burgh, Pennsylvania. K e h o e , R o b e r t A., M.D. Reseaich Professor of Physiology, Dheelor, Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. Jv r o n e n b e r g , M ilto n IP, M.D. Chief, Division of Industrial Hygiene, and Industrial Medical Super visor, Department of Public Health, State of Illinois; Assistant Professor of Bacteriology and Public Health, University of Illinois Chicago, Illinois. Iv u e c h l e , B. E., A.B. Vice-President and Claims Manager, Employers Mutual Liability Insurance Companv, Wausau, Wisconsin. L u c k ie s h , M a t t h e w , D.Se., D.E. Director, Lighting Research Laboratory, General Elect)ie Company, Nela Park, Cleveland, Ohio. M acule, W illard, M .D . Associate Professor oi Research Physiology, Associate Director, Ket tering Laboratory' of Applied Physiology, College of Medicine, University' of Cincinnati, Cincinnati, Ohio. M cK e e , R. W., Pii.I). Instructor m Industrial Hygiene, School of Public Health, Ilarvaid University', Boston, Mrsoaohusotfs. LJST OF CONTHIHUTOKS XI M o r r is , S arah J., M.D., F.A.C.P. Professor of Preventive Medicine, Womans Medical College of Penn sylvania, Philadelphia, Pennsylvania. M o r s e , K e n n e t h , M.S. Industrial Engined, Division of Industiial Hygiene, Illinois Stale Department of Public Health, Chicago, Illinois. M oss, Frank IP, E.E. Physicist, Lighting Research Laboratory, General Electric Company, Nela Park, Cleveland, Ohio. P e t e r s o n , C. M., M.D. Secretary, Council on Industrial Health, American Medical Associa tion, Chicago, Illinois. R o b e r t so n , D. F., M.D. Associate Medical Director, Merck and Company, Rahway, New Jersey. R o s s it e r , F r a n k S., M.D. Medical Director, Carnegie-Illinois Steel Company, Pittsburgh, Pennsylvania. S a w y e r , W il l ia m A., M.D. Medical Director, Eastman Kodak Company, Rochester, New York. S c h w a r t z , L o u is , M.D. Medical Director, United States Public Health Service, and Chief, Dermatoses Investigations Section, Division of Industrial Hygiene, National Institute of Health, Bethesda, Maryland. T h o m p s o n , L o r in A., Ph.D. Director, Population Study, Virginia State Planning Board, Rich mond, Virginia. W a m p l e r , F r ed J., M.A., M.D., M.P.H. Professor, Preventive and Industrial Medicine, and Administrator, Out-Patient Clinic, Medical College of Virginia; Health Consultant, Southern Biscuit Company, Richmond, Virginia. W il l ia m s , G eoroe Z ttr, M D Associate Professor of Pathology, Medical College of Virginia, Rich mond, Virginia; Member of Armed Forces, Lt. Com. U.S.N.M.C.R. 372 PRINCIPLES AND PRACTICE OF INDUSTRIAL MEDICINE VII. OTHER PNEUMOCONIOSES There is considerable disagreement in the medical literature concerning the exact etiology of certain types of pulmonary fibrosis due to dust inhalation other than silica dust. Asbestosis, siderosis, and anthracosis are the most important of these fibroses. Asbestosis It has been well proven that a peculiar type of linear pulmonary fibrosis is caused by minute asbestos fibers inhaled by workers in industries utilizing asbestos for the manufacture of fire resisting material, insulation, certain fabrics and ropes, paints, roofing, tile, etc., as well as the manufacture of asbestos itself. Asbestos is magnesium silicate and is the only silicate which has experi mentally been proven to produce a pulmonary fibrosis without exposure to silica. The onset and clinical course of asbestosis is similar to that of slowly progressing silicosis Tid the symptoms in the later stages are identical. Fatal termination is usually by complicating pneumonitis, cardio-vascular decompensation, or tuberculosis. The roentgenopathology is typical and not difficult to differentiate from silicosis. Gloyne and Merewether state that the roentgenological appearances of asbestosis are revealed typically as a general lack of translucency with a fine pinhead mottling. This is the characteristic "ground glass" appearance. The film should always be compared with a film of a normal patient and a film of a silicotic patient taken with the same exposure. The diagnosis depends upon a definite history of exposure to asbestos dust including sufficient period of exposure, roentgenological appearance, decreased pulmonary capacity, and the finding of asbestos bodies in the sputum of patients not yet removed from exposure to the dust. These asbestos bodies are well described and usually illustrated in most text books of clinical pathology. The pathology may be summarized-in the single statement that it consists of a persistent, progressive, diffuse perialveolar fibrosis of the lungs. The fibers may be seen on histological examination to lie embedded in the fibrous walls of alveoli and bronchioli and each fiber appears to be encrusted by an iron-containing yellow pigment. As would be expected, in the later stages the fibrosis becomes confluent and massive. .. , Siderosis Siderosis is chiefly a red pigmentation of the lung tissue due to inhalation of iron-containing dust frequently found in hematite miners. Experi mentally, fibrosis has not been produced bjr pure iron or iron oxide dust PNEUM OCONIOSIS 373 and only when mixed with hazardous concentrations of silica dust does fibrosis result. Therefore, unless the patient is also affected with silicosis siderosis by itself is asymptomatic and produces no roentgenological or clinical findings. Anthracosis ' . . > Black pigmentation of the lungs due to inhalation of smoke and other types of carbon particles is common particularly in residents of large" industrial cities. Most marked blackening is produced in coal miners.' There is some controversy concerning the question as to whether or not carbon dust of itself can produce a pulmonary fibrosis. There is no con clusive experimental evidence that pure carbon dust will produce fibrosis. It is the author's opinion that all instances of fibrosis in anthracotie lungs are due to an admixture of silica dust in the inhaled air or an inflammatory fibrosis due to respiratory disease. Anthracosis is asymptomatic and produces no clinical findings or disability. REFERENCES American Public Health Association: Report (joint) of the Committee on Pneumo coniosis and the Committee on Standard Practices in Compensation of Occupa- . tional Diseases, Year Book, 1933, p. 100. B e l t , T. H., I r w in , D ., and K in g , E. J .: Silicon and dust deposits in the tissues of - persons without occupational exposure to siliceous dusts. Canadian Med. Assoc. J., 34 (2): 125-133, 1936. B u rk e, H. E .: The detection of mineral particles in the sputum in silicosis. J. Ind. Hyg., 17: 27, 1935. < - C o le, L. G., and C o le, W. G.: Dyspnea of silicosis: What causes it? J. A. M . A., 113:1216,1939. - ' ' C umm ins, S. L .: The augmentation of action of anthracite and other dusts b y dead tubercle bacilli. Brit. J. Exp. Path., 21: 64--70, Feb. 1940. D r in k e r , P., and H atch, T .: Industrial Dust. McGraw-Hill, 1936. : E llman, P .: Pulmonary asbestosis: its clinical, radiological and pathological fea- . tures, and associated risk of tuberculous infection. J. Ind. Hyg., 15: 165, 1933. G a rdn er, L. U .: Pathology of so-called acute silicosis. Am. J. Pub. Health, 23: 1240,1933. .. -- G ardner, L. U .: The pathology and roentgenographie manifestations of p n e u m o coniosis. J. A. M. A., 114: 535-545, Feb. 17, 1940. G a rdn er, L. U .: Recent developments in relation to silicosis. Ind. Med., 9: 45-49, Feb. 1940. J ' G a r d n er , L. U .: Studies on experimental pneumonokoniosis. V. The reactivation of healing primary tubercles in the lung by the inhalation of quartz, granite, and TM ' carborundum dusts. Am. Rev. of Tuberc., 20 (6), 833, (Dec. 1929). "* ; G lo y ne, S. R., and M e r e w e t h e r , E. R. A .: Asbestosis. O. &H ., (Brochure), 19387' H atch, T., and T h om pson, E. W .: A rapid method of dust sampling and approximate quantitation for routine plant operation. Ibid., 16: 92, 1934. ' I n tern a tio n a l L a bo u r O f f ic e : Pneumoconiosis, a list of references, studies and. reports, scries F (Ind. Hyg.), No. 15, 1932.