Document ZnE5g0ZdOme4RJRJq63vGwnDO
FILE NAME State of the Art Literature SAL
DATE 1952 DOC SAL054
DOCUMENT DESCRIPTION Journal Article - Industrial Cancer of the Lungs
l
a
4
tree
:
ts
|
.
Prevenirdent postgraduate course in Medical Aspects of Workmen's Compensa
i * Hon
Irudemy
New
York
University
Post Crudunte
Vertical School and American
\ Irudemy of Compensation Medicine October 22:27 1931 niversity Hospital New York City
Hd
actact
ibu
uite
Tin
and
Ne fet
Nae
14:80 .101-
230
Industrial Cancer of the Lungs
By
{
MAY R. MAYERS M.D.
Chief Medical Unit Division of Industrial Hygiene and Safety Standards New York State Department of Labor
HE FIELD FIELD of environmental cancer continues
tafe
-
rrTt | ade
.........
10190 F
thest
three
..
th
tete -100-
1100
vernal
1881989
ciau
to fill out special promise largely beranse here we are dealing with a few specific chemical and physical agents which it has been demonstrated can produer canver under certain circumstances and at specific primary sites of predilection predilection predilection In view of how little is known of the etiology of eancer in general this cannot fail to de impressive Unfortunately the number of environmental carcinogens so isolated is very
small and little is known of the physiological
ar chemical mechanisms involved Neverthe
1 the mere fart of the absorption into the bady at Unown UnowUn nown or suspreted carcinogens of exogetimus exogetimus origin provides au usual opportunity to study
these mechanisms the processes of detoxification
and conjugation for example or of storage and excretion Identification furthermore leads to wider Lowledge of environmental distribution
and
turn
tives
the precise comlitions provides hope for the
cantra measures
of exposure
development
This in of effer
Laboratory experimentation has thus far
711-
the Jenn
Khairman New York State Deempational Caneer Committer The views expressed in this paper are entirely thusse of
of the author wit in any sailbur an ollicial report of
.. Committee The Comite's Committee's views will be reported
Fe later state upsan complecompletiontcoimploetinon of its stands stands
C
March May 1952
brought to the fore approximately 200 chemical substances which which appear to be capable of pro-
ducing cancer in appropriate experimental anis mals Very few of these however have been shown
to be carcinogenic for man Spreies specificity plays ^ prominent role in all animal research and so it is not surprising that findings on animals of certain species cannot be directly extrapos
lated to man The ostengenie saremmas for ex
ample which have been produced in rabbits bs
beryllium beryllium have in comuterpart in humans Mine
which have been exposed to such chlorinated
hydrocarbons as earlion tetrachloride or chloro
form or to certain certain of the aromatic computrids
or who have been feil selenium
hepatomas never cherved in
have develand develand
W lien one
limits one's inquiry stiff further in the respiras respiras respiras
tory tract and more specifically the lungs as
primary cancer sites one comes up with a cna
few known etiological agents Many substanees substanees
are suspect but at the present instances are inconclusive or
time dat~ ^fin munst highly controvers
sial
Whatever the cause the ineislence of lines care
ver is sufficiently high at present a major health problem possibly
jullie health health OF 392698a7 sree tts
to constitute
... problem in
Sa yee
(
we
ol a
e
we!
ew
health Lung enneer has been increasing especis ally during the last two or three decades at a rate apparently beyond that of other cancer sites There is no general agreement as to whether this increase is real and absolute or merely apparent and relative and many interpretations have been offered But it is quite striking that this steady increase has occurred during a period characterized by remarkable technological advances in this country a period in which increasing numbers of workers are being exposed to a greater number and variety of chemical and physical agents in the industrial environment
than ever before The fact that many of these chemical substances are present in the air of the workroom in the form of noxious dusts gases
fumes mists and so forth has also been duly noted It is natural enough therefore to speculate that perhaps the industrial environment plays an etiological role in this increasing inci_ dence of lung cancer Indeed inhalation of air contaminants in general including smog gver
cities is receiving an unusual amount of serious
attention at the present time
Industrial Hygiene ConsIDERATIONS
To those of us who specialize in the field of industrial toxicology and who are particularly concerned with the physiological and metabolir mechanisms associated with the development of the occupational diseases industrial lung cancer presents a special challenge as still another occupational disease Many and diverse clinical
entities are known to result from the inhalation
of industrial air contaminants under certain cir-
cumstances Some of these occupational diseases are characterized by pathology of the upper respiratory passages others by lung pathology It might be useful therefore to briefly examine this experience to see what light it can shed upon the development of lung cancer in industrial work
.
> >fi >
Perhaps one of the most striking ohse Vations
is that the inhalation of these noxious dust^gases and fumes from the air of the workroom does
not necessarily or even usually result in injury to the respiratory tract Indeed their adverse ef fects upon the body are often to be found else where Lead for example whether inhaled as dust or fumes reaches the alveoli of the lungs But it does not produce lung pathology It is car
ried away in the blood stream and causes lear
poisoning a systemic disease Similarly all indus
trial solvents enter the boily by inhalation but
insofar as we know their toxicological effects effects are
in areas remote from the respiratory tract Carbon tetrachloride for example has a predilection for the liver and kidneys varl~-m disulphide for
the central nervous system and benzol for the
hematopoetic system Inhalation of beta naje thylamine may produce cancer of the bladder but apparently never of the lungs Arsenie is of special interest at present in connection with studies on smoking and lung cancer However
there is no definite evidence as yet that inhala-
tion of arsenic is capable of causing lung cancer It has always been more especially associated only with the cancer of the skin and of the eyelids
The Pneumoconioses This group of occupation-
al diseases as you well know is characterized
by the inhalation into the lungs of foreign dust particles usually less than mierous in size and the development of characteristic lung pathology
The pneumoeoniuses are of interest to us here
because the dusts involved tend to be irritating
the lung pathology produced is of the chronic type taking many years to develop and a fair relationship has been established between pathol ogy and dosage . dosage being measured in terms of the number and size of the dust particles in
the air and the duration of exposure
Silica and asbestos are of among the dusts which fall
special importanee into this category
The environmental conditions for their develop-
ment are essentially similar Nevertheless silico-
sis is not apparently associated with or productive
of lung cancer whereas asbestusis very probably Is there a chemical difference which arrounts
for the one being carcinogenic and not the other/
Are differences in the physical characteristics of
responsible silica and asbestos dust
? We do
ue
not
know
Aruto and Chronie Irritation
Workers in indus
try are exposed to air cintaminanitn the work
room which are far more irritating to the res
piratory tract than is either silica or asbestos
Those which do not reach the lungs may never-
theless he responsible for severe Lacrimation or
for varying degrees of local irritation of the
nose and throat Exposures may be elintas
or intermittent concentrations in the air man
be high or low Sume air contaminants are highly
irritating even in low concentrations Others are
irritating only when concentrations are extremely extremelextyremely
<ompensation ompensation Medicine
.
indur indur
but n
but
Cmal
de for or the
.
1 mapie Ladder is of 1 with
KCVET
nhalas nhalas
NUIT
ciated velide vation- vationrized aktant eo and
coology
here
ating
STAHIL a fair cathol
tere
7ae,
So high Some are sensitizing agents In any event it is of interest that in industry large numbers of workers have been exposed for a great many years to variety of chemical air contaminants
which are irritants
In plating for example continued
exposure to chromic acid mist may result in ul
errations not only of the nose but of the skin Perforation of the nasal septum is typical fineling Nevertheless even though large numbers of
such workers have suffered from these conditions
for a great evidence at
many years present that
there such
appears to be no
lesions ultimately
develop into cancer of the nose or cancer of the
lungs
When one goes un an examination of indus
maton trial lung pathology caused by exposure to other highly irritating substances such as chlorine gas or nitrous fumes one finds the same apparent lack of any carcinogenic mechanism at work Cons
tinual cor
exposures exposures to varying varying
concentrations for long periods of time have
caused such conditions as chronic bronchiolitis
alcolitis and bronchitis Single intense exposures
+m have produced acute bronchitis pneumonia or
even ^'demaof the lungs But repeated acute and
chronic exposures over many years do not seem
to have resulted in the development of lung can-
ver insofar as we know
1.1940'
ogre,
velops
silico nctive
bably
artes
Ther vies of 9 tread
ate
trbeess
worke worke
Fase
teradabe,
bOROPe
vend te
++ the
TVGORERpe
...
dighly
7s
ae
Industrial
dusts and
-
gases
such as flour De
formaldehyde -- which act as sensitizing agents
temel to cause asthma in allergie individuals Re
peated
ondary
asthmatic attacks in turn produce secs chronic respiratory conditions such
eltronic bronchitis emphysema or bronchiectasis
But again no relationship has thus far been demis
unstrated between linng cancer and any of these
chronie conditions whether of industrial origin
DF not
The inhalation of toxie dusts such as sugar
dust or spices may be highly irritating to the nose
and throat because of their chemical reactions
with mucous seeretions Even a physiologically
inert dust called such as wood dust when
continually deposited on the mucous membranes of the unse and throat tends to canse mechanical interference with eiliary action and in other ways
impairs impairs normal physiological functioning of the
upper respiratory tract And yet thereis no exidenec at present to indicate that such prolonged exposure is associated with primary respiratoes
,
vole,
NORMAN NORMNAORNMAN NORMAN 1882
The data now available are obsionsly too limited
to warrant any final judgment However it would
seem that respiratory cancer is not necessarily at
rate associated with chronic irritation of the
any
respiratory tract resulting from the inhalation of
oir contaminants in industry
Synergistic Action of Chemicals and Drugs- Drugs-
Bothin industrial toxicology andin medical thera-
peutics one encounters thefamiliar phenome of synergism Exposure to a single substance in amounts which are completely innoruns may be
come toxic when thisis eambined with a dose of
another toxic substance which would have beetl
equally safe if given alone This principle has been well established both for experimental ani-
mals and for man as von well know
And yet as a practical matter it is all ton often
overlooked that workers in the course of a lung
life are expensed to multiple multiple multiple playsical playsical and chemis
eal agents in their environments bath in and nut
of industry The principle of synergism synergism is opera-
tive here as elsewhere elsewhere
however Frustrating this
be to the research w^...rkersin the field of ver may
empational camer Differences in Susceptibility Differences in ins
dividual susceptibility to disease pervades pervades all of elinical medicine It is a familiar phenomenon
in the occupational diseases and in environmental cancer Among persons doing essentially the same work some apparently get lead poisoning or develup canert while their workers du nol
Age and sex differentials are not well unders
stood in general But in the field of lung cancecr ancer
there are indications that there may be signifi-
cant shifts both in age and sex invidence when when
exogenous carcinogens are responsible Thus while
the incidence of lung cancer is higher for men
than for women in the general population this
relative ses incidence may apparently be signifi
cantly altered in situations where same necupational exposures as
women have the the men Simi
larly the incidence of urenpational lung cancer
appears to affect a somewhat somewhat younger age groupgroup
than that characteristic for the population cas ct
whole
Safe Dosage and Prevention Prevention Since taxicity is
in general a function of dosage
where dasige dasige
is measured in terms of intensity and duration
of exposure the occupational occupational diseases are amenable to control by well established undustrial livgiene techniques For thi t re 18 ... Ly ae ooree taeedeld tee dew . deste eho etl. i
.
Ps ssca teat yb aie PES TOT ERE 1G TTMOM TT mewhee SEH N ast sp reperecnns stein samert rnb " " "
potentially toxic substances in industry These
are know as Maximum Allewable Concentrations
M.A.C. While allergy synergism and some other
matters which we need not go into here present
complications these standards have proved invalue able for the prevention of occupational diseases
They are constantly being improved and extended
as new seientific data become available
It is unfortunate therefore that equally convenient and simple relationships between dosage toxicity and carcinogenicity do not seem to exist
in the field of environmental cancer It is not
helpful to know that a chemical substaner is toxic
because this does not apparently indicate any thing as to its carcinogenicity and vice versa Lead
has already been cited as a toxic chemical which
is not carcinogenie Beta napthylamine conversely is carcogenic but has never been known to pro-
duce systemic poisoning And so the maintenaner
in factory workroom of Maximum Allowable
Concentrations will not necessarily insure working conditions if a potential carcinogen
pens to be present
safe
hap-
It has recently been suggested that there is a
critical dose for each carcinogen of exogenous or-
igin and that cancer will ultimately develop once
this dose has been reached whether as a result
of single exposure or cumulative absorption over a period of time But even eindd such dusage he accurately determined one would still for purposes of prevention face the formidable problems created by the fact that caneer may take a great many years to develop that it may also develop after a relatively short exposure and that there may be a lag of years between the pertinent ess
posure and the development of the camver
KNOWN AND SUSPECTED GARLANDGENS
Let us now turn to a consideration of spemile
factors in the industrial environment schich are
known to produce lung cancer or which are sus pect and under investigation
1. Organic Chemicals
dave includes such substances as far asphalt
pitel oil lamp blacks cachum blacks and vari
mus types types of sunt Thus far the results in all cases
have been either negative or inconclusive insofar
as caneer of the respiratory tract is cuncerned Sunt has always been of special interest because
it was responsible for the classical serutal concer of chimney sweeps These hays must have inhaled
considerabile soat in the course of their work
and yet no suggestion has come us to the ef-
feet that they also developed lung cancer Perhaps the diagnostic techniques of those days were
ton inadequate For that reason special interest attaches to a statistical study made by Dr. Dorn of the relation of lung cancer to atmospheric
sout from domestic and industrial sources In this
study he found the incidence in he lore in Pitts-
burgh as compared with live other large cities Commercial suits prepared from natural gas
and uil residues are also under investigation The
carbon black industry is a supporting experie
mental research in this field and further data of
interest anay be forthcoming in the near future Exhaust Exhaust gases from diesel and gasoline engines
have very naturally come under suspicion But here again investigatious as to the incidence ot
lung cancer among persons heavily exposed such as policemen street cleaners garage mechames
and automobile drives have all been negative Crude mineral oil and far are still in the doub~te
ful category Tulsalation of of arrosals processed
mineral oil and shale uil funues from creosoak~-
and anthracene uil 13. 1 benzpbenyzpy renes and partien- partien-
larly crude parallin oils on the heavier fuel oils
are all under suspicium suspicium at present They are being
investigated lut na conclusive data are available
thus far Tumes in
Special attention is being tabacco smoke Fopropyl
given to tar ait inhaled
as
vapor in connection with the manufacture manufacture
of isopropylisopropyl alcohol is the only chemical in the
aliphatic aliphatic group that is suspect as a cause of lung
Ref
2. Faorganu ( hemicals
'
Ang
the
organic organic
chemicals
none far
Ang
,
has been definitely shown to be capable of producing Fung eauver Many are still under investi gation Juit the data now available are ineonelu-
sive and contradictory The products of incomplete
have been studied as well as
combustion of cuaf its various distill
tion and fractionation products These studies
Asbestos The relation of asluiskis ta
:
feer long suspected has received new
tion from the 1919 Annual Report at
~ ung .8114
contermas contermas
the Chiet
Medical Inspector at Facturies in England England Daar
ing the period from PP21 16 19:16 inchi 237
deaths were reported either caused by asbestosis asbestosis
" in tricthrich aslusstasis aslusstasis had been . "
Nevrispss Nevrispss Kamen Kamen Kamen at the dungdeunge coe pele tat a " a era neee
1.4
:
t'umpensation t'umpensation t'umpensation Medicine
q
a
xin 31 of these cases or
high compared with a
rent for cancer of the
13.2 per vent This is very
general incidence of 1 per
lungs among all adults ex-
amined at necropsy in England Moreover the
es distribution seemed also to suggest the pres
ence of an neempational careiningen The histologic
chararter of the cancers - squamous cell in
stead of carcinoma --~ and their histoges netic derivation in that the bronchial mucosa was
LET
LET
a
involved rather than the alveolar epithelium was interpreted to indicate the presence of a specific exogenous carcinogenic agent as the etiological
factor in this instance inhalation of asbestos dust
The development of cancer of the lungs is bes lieved to be more directly related to azbestosis
the disease than to the inhalation of asbestos dust
se Differential diagnosis by ray between ar
per
bestosis and lung cancer presents all of the diffic
culties one would anticipate It has been suggested
that eytological examination of the bronchial ses erations might well be included in periodic examinations of workers exposed to asbestos duet
whenever clinical or ray evidence suggests the
possibility of a cancerous cancerous lesion CarefuCarleful histofogical studies of lung tissue postmortem in all
such cases would also provide valuable data
has been estimated that 20,000 workers are
now employed in producing industries industries in
this country and Canada
:
Nickel Carbonyl to nickel carbonyl in the nickel works in England has also been
=t _eame
the subject of special investigation and report by the Chief Medical Inspector of Facturies In
a review of the incidence of nose and lung van-
ver between the years 1923 and 1918 inclusive
he found 47 cases of cancer of the nose and 10 of cancer of the lungs among these work-
rases
ers The average duration of exposure before the
development of cancer was 23 years for the muse
cases and 25 years for the lung cases The avere
age length of time between diagnosis and death was short and by the end of 1943. 16 of the nasal
and 12 of the lung cases had died The precise
vausalive agent has not yet been identified am
i
the matter continues to be under active investis
|
gation However there is no comparable expuri-
ence in this country
|
The Chromates The etiological role of the
| chromates in the
been pretty well
production of lung established in this
cancer has country in
Au last few years and these huidlings huidlings 4" co
March March May 1932
firmed previous European experience
In 1948 at the request of the chromiu prm o-
ducing industry Drs Machle and Gregorius made a study of deaths from cancer of the respiratory
tract from 1937-1947 in five pruluring
plants Dr. Mancuso the year following examined the records of all employees who had workeil
or more between 1931 me year
and
1949 in
chromate producing plant in Ohio Dr. Bartjer
then reviewed all of the European and Ameri-
can experiener and reported on a stily of b~-r
uwn in which she analyzed the records of two
producing hospitals
in Baltimore located near a chrminates
plant In each of these studies the in-
vidence of lung cancer among the chirume work
er was significantly high
A total of 112 case reports were thus enflected enflected
of cancer of the respiratory tract among worker
exposed to chrome producing
facture of chrome
Of these 10 worked industries 14 in the
pigments 2 in other
in the
manus
indus-
tries three of the cases occurred in Ger
37 the United States and each in
many
Switzerland and England The chemical tan-
ces believed to be responsibile are the hexahexavvalentahexavallentheexavnaletnt
chrontiume compounds particularly and k
monochromate or dichromate and zine chromate
inhaled as dusts While the mechanisms
are
not
known
certain
observations were made which are of interest
Dr. Must * were found to be primary
bronchingenie carcinomas In few instances the
upper upper respiratory tract or the oral region were
involved The incidener of caneer in other tissues
was not high
2. Ju som Pasts an exposure exposure of four years
appeared to be sufficient In must rases however appeared
a great mLANY years of exquisure were Tu sonur instances there was a latent
Moree: IFy,
period of
variable duration between leaving the exposure
and the development of the eateer 3. The expospre could not be
evaluated in these cases Presumably however ^fin
years gone by this type type of work was very dusty
4 Lang cancer in these workers showed a
somewhat somewhat younger age distribution than that for
occupational occupational lung cancer
5. There wil mu itulication
that
....
pereaenine
posed in chromates more than normally
in other neempane mpattionsineoempnatisons were were
liable to maker maker ni th- tee
feat dee
eet
i
.
In New York State there is exposure to chrunte
and its compounds in a variety of industries In the mining and extraction of chrome ore which is ferrous chromite in the manufacture of chrome pigiments including zine and lead chromates in chrome operations where there is expus
sure to chromic acid and chromie acid mist in
the leather industry where chromium sulphate and sodium bichromate are used in tanning engravers are exposed to ammonium hichromate and also to asphalt Since both of these substances are under suspicion the Division of Industrial Hygiene decided to make a special stunly of these workers
lu engraving the copper plates are enated with a thin sensitive film of gelatin and ammonium bichromate and the plate is then exe posed to light behind a negative The penetration
of light through the transparent areas of the nege
ative causes the formation of a insoluable
chrominusgelatin film which is resistant to acid
The parts not exposed exposed to light remain soluide and are washed off Prior to etching all large curs
faces which are gelatin and which would
ordinarily have to be eaten away are coated with an asphalt paint which is resistant resistant to arid After the plates have been etched in a ferrie eldoride
solution these areas are reamed out with the aid
of rotary electrie cutting tools
An muisederted series of 664 engravers were rayed in cooperation with the chest clinic of the New York City Departownt of Health No pulmonary neoplasms were found The matter is
still under investigation
3. Radiation
Exposure to radiation is on the increase tol only in imdustry but in hospitals hospitals and research
laboratories everywhere Radium dial painting is
booming again as a result of industrial expans
sion for defense The examination of metal cast-
ings for flaws by the
has become routine in active enbalt is being
use of radium and ray foundry operations Radioused increasingly for this
purpose at present The fluoroscope has not only
made its way into retail shoe stores but used
in many industries as an examing devire
for
the detection of misplaced mails in shoe manufac
ture for examination of metal inserts in plasties
for the detection of foreign bodies in packaged
foods and on Radioactive statie eliminators are
16
utilized to prevent fires in dluzesu of im~...ustries
and operations These include include publishing houses plastie fabric manufacture teletypteleetype machine in-
stallations etc. Radioactive isotopes are stepping
out of the expert hands of technical personnel in research laboratories and are now finding their
way into the hands of lay workers not at all fa-
miliar with the potential hazards to health which
are involved nor with the precautionary meas
zures which are essential for safety
Wherever there is radinactive dust in the work-
room air -- however invisible to the naked eye
one is presented with a known known etiological agent
in the
production
of
hung
cancer
There
is
as
yet very little information as to what constitutes
a safe clitst count or how much radioactive
dust one might in general anticipate in specilie
operations Too few dust counts have as yet been made tu provide this basic experience However However
standards for radon gas in the air of the work
room emanating from radioactive materials press ent there have been established also for ruudust
in the expired air of of the air samples is samples must be sent
tion laboratories for
individual workers Taking not too difficult difficult But these
to highly specialized radiaanalysis and this is fairly
expensives expensives expensives
In such
plants there is usually
simultanes simultanes
exposure to various types This type type of exposure will
of external
not produce
radiation lung can
eer
trol
but adequate
measures are
lead shielding and other come
nevertheless essentifaolr the
prevention of cancer elsewhere elsewhere in the bondly
RESTARGAT RESTARGAT
It is quite apparent that industrial lung san ver indeed the whole field of environmental vaneer has been barely scratched and that there is still a great deal of pure speculation current .
despite all efforts to establish the facts 0
| The difficulties which are hindering progres
are not immediately but become q^te
clear as sats as intensive work is begin Must
important occupation
dies of it
perhaps is the tart that a worker's at the time he develops cancer or is rarely the etiological factor The
cause may
tion which
be he
found in some previmis previmis decupa- decupahad some 10 15 or 25 years earlier
vo an occupation difficult to ascertain at the time
of his present illness or death and difficult ter evaluate For any investigation at this later date
Cumpensation Cumpensation Cumpensation Cumpensation Medicine
eee toe
ae
4 1
ot
C
C
Tome
an ot
posed will usually reveal environmental conditions very
different from those to which he had been exbefore The further fart
so many years
that rapid technological advances are the order of the day in industry and that labor in this country is highly mobile presents many serious stumbling blocks to the research worker at every
Co
denominators in the industrial
of these rommon
and statistical correlations prepared
environment
on the basis of these data there is good reason
to believe that the etiological components of this
environment will largely contime to elude the
-
oS
researeli worker
There is however one practical contribution |
which can be made by almost every practicing ">
te In tuTrhne New York State Occupational Cancer Con
to mitter tried to overcome these olistacles by inters
viewing viewing some 4000 eancer patients at the Roswell
a
ef
7 Park Memorial Hospital where accurate clinical
at and pathological diagnoses were available In
these interviews a serious attempt was made to
ts
wb) obtain a detailed occupational history going back
"
to the patient's first job Each such occupation
* was then evaluated by specialists in the field of
D
mf
industrial
hygiene
in
order
to
ascertain
as
ne-
eee eurately and as completely as possible all of the
h
environmental factors to which each patient had
OD
of lus working life
~
leen exposed in the course
ne
_ Since each
patient
found was
to have had about
or 5 different jobs on an average and numer
1112
nus almormal elements were involved in the work-
wee
14.a-
ing environment environment of each job the number of vari-
introduced into the
ables which were inevitably
study was sueals ttu make our statisticians shud-
der And yet these variables are inherent in any
effort to get at the facts and they cannot be in-
whether in his office in the outpatient
pdheypsairctimaennt or in the hospital: and that is to take |
careful occupational history on all patients
a
suspected whether they are
want
and to record
of having cancer sucressive necupations necupations necupations
or
oft
OY -
visits More than that sorial welfare
subsequent
or
for a good
services can contribute by providing
be filled out >
verupational history on all Foirnmclsudteo applications applications
by applicants This would
for Workmen's Compensation 1 nemployment nemployment
Insuraner Placement Sickness Insurance and
of social security Labor Unions Unions
any other type
sickness records could similarly include this type type
of information Aside from the fact that social .
security numbers im death certificates are now beginning to make it possible to go back and learn something of the cancer patient's previous previous s
work records along the lines above indicated are la
nowheres in be found at the present time If
conscientiously compiled from on however oo.
information of information would beeinte avail
a vast soiree
able during the next ar 201 years as to the ore
mured
There are a few industries such as chromate
manufacture for example or
of aniline dyes where one or
the manufacture more artive car-
empational exposures of persons who ultimately
desetop raneer Whether this vision al Future benefits is sufficiently inspiring in overcome nale
ural resistanc^to undertaking additional work in
vinogenic agents so dominate the industrial en- The present is the big question question mark . .
7 8lte
utal
there jeni
,
|
serene
q'uite-
Vimal
ther's
PT IT
. The
sempas
cartier Time
ity tee
C
appreciated vironment as to highlight the the fact of the high
of cancer among those workers It
incidener
however that this
not sufficiently sufficiently
one of the umre exceptional
poolially represents
the environ
Situations in industry By and large
particular a
mental characteristics of
or even a particular workroom
partienlarnepcreoscseasrsily or even usually pathogno-
are not
industry
or workroom
monic
monic
for
that
industry
process
of the same abnormal environmental fac
Many
combinations are to be fourul
tors in different
in a great variety of totally unrelated industries
For that reason statistical cors
and occupations
cancer site and
relations between a given primary
are not meerse
specific industries or occupaptriaocntiscal method has
sarily fruitful Until some
and isolaris i
tuan developed for the identituation
The
The
great
value
and
limitations
limitations
limitations
limitations
of
of
researchi
work with
laboratory animals as
experimental developing leads for the detection al oe
method of carcinogenie agents in the industrial industrial eus irment
are ton well known in this amlienie In warent
ae
ce
more than passing mention mention
. Se
sewnsy
AND
a
CANCEL
CANCEL CANCEL SHENS
There has been striking increase in the inci-
dence of lung cancer and because this has largely
coincided with advances in teclmological proes
ress in this country there is a very natural sus-
picion as to cause and effert Of the many organie
and inorganic inorganic chemical and plissical plissical agents which
For suspert and umehrumehr investiinvestiggation ainvestigtation iinveostignation it the pore su
bet time unato
tere 1 bee .: tte sa?
17
C
March May 1932
weet re mee
cated as causative agents in the production of in
dustrial lung cancer The chromates nickel carbonyl in English nickel factories radioartive sulistances and probably asbestos
An effort was made to evaluate the role
chronic and
of both
acute irritation in the
of industrial lung caucer by reviewinprgoductwionhparotductiiosn
known of some of the more familiar
diseases which are
occupational
characterized by chronic and
aancudtethpeathloulnoggsy oNfothe upper respiratory passagespassages
necessary relationship couldi
be demonstrated However a final determination
must await the development of far more precise precise
and complete data than are now at hand
1
i
t
se
{
BIBLIOGRAPHY
obaster A .: Pulmonary Carcinome
chives of Industrial stymien and
in Chroma Worker
417-516 Nov 1910
Occupational Medicin~- 211 211
This inspector of Faciones Annual
ten London His
Report 1947
Majesty & Stationery Ower
Mileal Size
15.1
90. 1987
River F. and Claus P. Trimer of the
awing Injections of Urethane
Lung in Rais Fale
saro 7.342 1947
.
titry Carbomo Tancut Hu
Ware Carcinogenic Gurney at to Carcinogenic Aeneity
1:41
Wang
Frontal
totedhave been
USPOSTUSPOT
Setant Agency USPOST
JR riyar riyar
MD
Ozzupaona
Unomia
Carcinogens
Arg
cha Ozzupaona Ozzupaona Carcinogens Bsn, 19
les.g PS Minimal Number : Anesthelic Liteinan^ k 'quired to inquce i mer TV ent fast 4823 IMT
et lai
re hee
~
on
19477
19477
Mareen W.C
ale Medicine and
Hueper W.
MD Envi .:
Surgery 2012 40-12 7.75.5 3
M.D
and
Occasiona Charles C. 1nemas 142 Springma Line and All
na tornai tornai
Discain Discain
^ M^ new at Pulmonary Carit
{ oof
^ une al August la
Atonte L. L. and lor in Mier by Ann
W.
Atonte
eeom ML avacc
ML Coldste th
A.
Smoring A.
and at that 145.5 Seee
k and Fe
i 41831
dw
Frost. iets
fee
On, avaeans
Stede GLa ect oe
ce Luna
oe rates
Paunings Paunings
:
.
in et
Healin tone.co
ita Gregorias
United
Mer hy)
Reports 63114 1946
I F Worker :
Concesantry Concessantry Concessantry Concessantry Concessantry Concessantry
Aromate Hir dunha Ind
1946
cee
1946
Ciconiam Worker
F.
383 AS. Maye
ef
and lent oe,
:
1780912 Fo;
ra Yare Sane Oosss ase,
30.
*
Menge 11
M
ot
and Strath Strath MOR : kee
in S
Au J
se 3
Oe
Eng Lionis S. MI
8
wb
:
18 IRCT Oe gene.
Pos. Sun. # and :
Come neve
Incarnce in the Los ns 11:45 1950
sat te ay Anquier Con Con
-.a .
MSD om, a
net
.
~
co
A na. try
+ tuner
S16 gt
Sjem
.:
ncidit of Prima -
Sjem
Netence Netence
in
to in
flat Act
1.
...
168164.
13/1437 attest.
13/1437 13/1437 13/1437
Mee em ee ge + is .. si
U. Mangaline Mangaline
Oe eke
L fey
Craniuema
oat
Craniuema
ne
|
ce
oleae
tt
Aadwatone
Seemee ew 14
Mina
Fambre Fambre
2 L. and transi transi
in a KS
Avant A stains
tg
:
with Spi
we ee
Soosegers et igre guna, Tr Tee
.
Compensation Compensation Medicine