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FILE NAME State of the Art Literature SAL DATE 1942 Apr DOC SAL033 DOCUMENT DESCRIPTION Journal Article - The Occupational Disease Hazard foo. toot 7 vr. . a re magazina 1. published to promote thought upon and concerning thoughtlat and and it traumatic will contain Pfi items reports digests he other presentations together with an comment ' The editorial pol is to encourage frank discussion -nis basis contributions ere invited Toes Medicin Medicin Medicin Medicin Medicin Reg U B. Pat O5 ~~" The editors will avercise care in check ~~ ~) ing on the accuracy of data printed - = +z but in all other respects articles and .. - opinions of which expression is allowed =3 _ are the opinions of their authors ; .. Bditors reserving in all cases the right - _ _to comment on the same in the cur *" : 2: nives rent or any subsequent BS as ther - = may be inclined The Journal of Occupational Diseases and Traumatic Surgery ee es With which are consolidated The Industrial Doctor and International Journal of Medicine Science Science the Law and the Economics of IndustrialNIndustrial Hestit.ORE Hesti.ORE COUNT fs April 1942 PLAINTIT'S ENumber 2 Loe 1/2/87 A. W. _ Hypertension in Workers over Forty Years Age , Hypertension a enendorent co - Preliminary Report . - ARTHUR M. MASTER M.D.and SIMON DACK M.D. O28 et thes 5 New York City ee 3 HE blood pressure in workers 40 years of age and _ 45 years 1 over has not been studied sufficiently Although it sized the as been recognized for many years that the blood 1980 will of age or over same facts i.e. be over the age in- Stieglitz too has empha- oe) kia : that 40 of population of 45. The interest of the 0.2 ressure rises steadily with age only a relatively small clinician and the physician in industry in the incidence . amber of blood pressure readings in the older age ' roups ee cerious has been available Many blood pressures of soldiers and workmen have been published le of these groups generally ranged between years These studies have been cited in a fact that in the present war emergency many more men and women of the older age groups will be em- ployed than ever before whereas hitherto they were ..aaAi- 7 7 probably discriminated against to some degree FSB cerious paper One of the largest groups was that udied by Britten and Thompson who found that in Material so, gs 538 male workers over 40 the systolic pressure was . 50 mm or more in 16 in the decade 40-49 years 5.6 in the decade 50-59 years and 51.2 in those :. years -. -- ee Toae e Rte wei tee _ _ ee In the previous paper referred to above we plotted MUDD Medical Director Chevrolet Iron Foundry Saginaw Michigan a division of General Motors of DR G. H. GEHRMANN Medical Director E I. Du Pont de Nemours & Co. Wilmington Delaware he incidence of hypertension in the general population 3 calculated from 42,000 published figures It was hown that the incidence of hypertension 150/90 or more rose from % at the age of 25 to 45 above New York Telephone Company DR MICHAEL LAKE ~ = Medical Director R. H. Macy & Co. New York and = DR LOUIS HAUSMAN of B. Altman Co. New York oc? 5 years Although the number of cases in the age we obtained blood pressure readings in 5453 workers - Toup 40 years or over was relatively small we intimated that hypertension in the general population was 40 years of age 1788 women and over a comprising 3665 men and : ST more 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 luded from a study of approximately 4600 persons 40 diminution in intensity of the sounds fourth phase ~~, jears or over that about 40 of the adult population 3 prehypertensive or hypertensive In this report and was taken as the diastolic pressure in about third - ' to half the cases while in the remaining the total a others in preparation we are presenting an analysis of the blood pressure in the general population 40 years disappearance of sound fifth phase was considered as 7 the diastolic level Since the majority of opinion fa- - of agoer over as based on readings obtained in work- rs in industry hospital patients and inmates of homes for the aged the of the true incidence of hypertension in Kgneonwelreadlgepopulation the the study of agiangging process wae is of fundamental importance arteriosclerosis hypertension and the Its importance is enhanced when one that the nation's population over 40 is g yearly by the millions Dublin has calcu rysearsof = year 1940 C.Sc of the population 2,000,000 2,000,000 years age or over comprising nearly estimates Or over and 26.5 1980 45 years of age percentages estimates that in 1980 the corresponding percentages would ons 65 be 14.4 and 40.37 or 22,000,000 per- over 65 years of age andabout andabout 61,500,000 persons >= vors the sudden loss of sound intensity as the correct diastolic blood pressure it will be seen that our diastolic figures are on the conservative side i.e. in many cases they are lower than they should be The medical directors 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 of enforced retirement i.e age 65 for men and 55 for womenactive 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 acceptance of employees taking even young workers with 3 e { SteSdtudentStudent the workers every importance ae it is known that being disease weeks the job are changed The evaluation of the occupational . partof a rotating course given ~as we encounter it in the field is of vital vital disease hazard er - employeesin the plant . <2 musi in the economic control a potentially injuriou.s ThereThere are of course many related subjects which - exposure The two principal methods of evaluating : would profitably be discussed in a paper of this type _ the severity of the health hazard are through obser-| compounds environment examination worker through = the astheeffects on the skin of washroom soap of vation of the occupational ; of the action of oils as well as the of : miting skin En ofmany solvents on the re time forbids- Use and OP Limitationsof Eyes Nose i inclusion It can be said that the control meas- and and : aarkrkFERdiscussed SO that ark FER ita ric piness the chief 7 Wey Oe SUMMARrYedisposing . here = FER coupled with this company's estab- FER policy of good housekeeping and general plant MUCH emphasis has beenplacedon chemical and = physical testing of the air for contaminants have lowered our dermatitis cases to piCnEesSsUMM1 ARY casemsiyTpsheee roe 1,000 1,000 men a month chee SUMMARY SUMMARYAs uncleanliness of skinis the 2 less ~ the question has been raised Areour eyes and noses ms o the of no assistance to us in evaluation of hazardous operations Can only the chemist with his thermal ' - decomposition apparatus backed by a laboratory full - cause of industrial dermatitis the em- of beakers volumetric flasks and spectrophotometers = SaBe= ErseernTeuisnrEnmpilonygees towels procedure sanitary for obtaining soap and chemical amity See. eeeeenother necessary utilize physicalE eSe ~ desing elimination of 3 should provide adequate facilities for the care of state whether there is too much trichlorethylene in personal hygiene while at work This a = a the worker's breathing zone , Or must a man be armed include | washrooms equipped with hot and with an interferometer or per analyzer if he is wie Den NS Bf water a irritating soap . to avoid a == this | fercertain conditions bath showers information ' -: teh sents is to that prominent measure is the The answer is it is one materials a nt from contact with the worker by and chemical methods in many situations in order to . orpartially enclosing the operation so that - evaluate the hazard if we wish to avoid the Yast er Ss ~ preventedfrom ons dangerous ie fumes vapors or dusts are NE the sf AEemt fing the worker oe = . procedure of waiting to see if the worker's health is .* actually being affected But before discussing the afingimportant prevention infec- methods skin -application certain of Uns factorin the of these me pointout provided 7a clothing protective importanttheuse of this type conditions where the eyes and nose are use in re . iisskeptingood repair is cleaned dis- . arriving at an opinion of the hazard also some Sage ipment employe.- ed Teta periodically after return to stock when of the precautions which should be observed if the before worker . being reissued another employee.- employee.- eyes and nose are to be employed asguides In such. eeEe typesof disinfecting solutionsare mentioned . sensory diagnosis of a condition one must on guard meee lution optical illusions olfactory : ab Ba of hypochlorite for rubberarticles and not only against but against Cara delicate containing Cara solution a illusions fabrics <? well survey a containing ow _ as ... of manufacturing Cara For socontrl ap a otherdisinfectant measure3measure meloe wn. important - of ery controlmeasureisthe use Cara . Ive skin These creams form a protec- = 2 Let us make without benefit a survey of the truck of gadgets plant | which iE Barrier film creams ae Barier and d AAllllyy Ally pur A Pr paw filmbetween the skin and industrial poi- ordirt grimelikely to cause the dermatitis Ally products should be irritating and should speaking be insoluble or nearlynearly so in the Ally againstwhich they are to protect They should Allyholly removed at the end of the work period with and warm water At least two or three standard excursions and find out what we can do and howfar we can go in the evaluation of the health hazard The plant we visit includes a convenient variety of operations in this respect it is not different from numbers of plants on which many of us call or - where we carry on our work As we step from the . : *, = - ee peaieke Soe Sa a ; office into one end the factory we ourselves- is seAe Ex are necessary particular expo- Occasionally = in a department where electrical receptacles are being US E nd are a require a special formulation __ control measures discussed here together with produced of asbestos compounded with a synthetic "= are ompany's BR resin The first operation involves emptying bags of aaa ompany's = ompany's ompany's continued good housekeeping policy has pes Read the of dermatitis in our Rouge plant short asbestos fiber into mixers No imagination was - ae incidence = of 7 12 cases for each - 1,0010 ,000 plant popula- wasted on this operation it is accomplished simply by weighing the burlap bag and = t er ~~ dumping it manualty than ~ LEVIN month emptied eteLkEVIN 6 217-229 Occupational Dermatitis eS O.Li . ee ee nee ee O. Li and BEHRMAN H. .: Mad 217-229 1939 7 into the following with a conscientious shaking of the bag to make sure it is entirely 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 exposure The evaluation of the severity of this dust " requires one additional element which is often over- looked the duration of the exposure If a batch can be made up in 20 minutes which will provide enough Director Director Director Division Director Division WARREN A. Cook of Industrial Hygiene and gineering Research Zurich General Accident &Liability Insurance Company Ltd. Chicago extensive and reliable information is con- alantly alantly becoming available concerning the alantly industrial materials which cause injury + 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 a recombienda- ag excessive and to serve as thebasis of a tion for control et being In the adjoining room we find the batch into fed- those which may be considered innocu- into molding machines and the receptacles being and to well superintendent order apply this knowledge on the toxic - placed on racks The plant is dermining materials it is necessary to have means satisfied with the effectiveness of the exhaust ventila- Td dermining within dermining exposure operation vues whether or not the is tion system installed when this new 7 operation was begun a year ago and he expects our approbation of e i " eee. Page 19 INDUSTRIAL MEDICINE April , cae the to this 10 t assume gs" set installation It is easy say Yes that is a daysand work weeks splendid exhaust system But what if such an off- increased importance -hand comment closes the subject and six years later _ been exposed to silica matter of duration assume A year ago a man may flour two hours a week in y= Sore = vid z -one or two of the dozen girls on the asbestosis she ~. If the condition does good -criteria can be used as guides operation develop preparation of a paint for some one customer look . what evaluation of the hazard at that time may have she * ee I. it to be negligible Today that customer's ordesr< he a - - Criteria for Evaluation of Dust Hazards _ IN THE first place too quick judgments should 7 be guarded against If an unjustified OK is given = the health of the worker may be jeopardized if a condemnation then money may be spent unnecessarily have increased so that all day long several men gy weighing up batches of silica flour as the inert terial for this same paint From the point of vviiewew of the paint formula the silica flour is part of point inerts but from the industrial hygiene point @: view it falls within the category of silicosis to say nothing of developing a lack of confidence of management in your judgment m dusts known as proliferative materials And if a liferative dust is present throughout the entire work zoreepeers epers epersespte Sera. In =. ce Wace:. In the case of the asbestos dust condition our evaluation the exposure should be based on the knowledge that the present toxic limit for asbestos is five million particles of dust per cubic foot of air This is a very small concentration so small in fact that the condition may look good even to a critical eye day and week it should be given careful attent health - in order to ascertain definitely whether or not which - is being affected 3. As an aid in learning cats dusts may cats injury and which are relatively safe research has been conducted on the action of various dusts rea = 1 char ubl ubl the figh figh sar So . =. x. . 3 -- = -- 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 on nearby settling places after learning how long a time has elapsed since they were last cleaned If injection into guinea pigs The interperitoneal rea tion is a measure of the effect of these dusts on being resin inhaled into the lungs Publications on the of these tests may be obtained from the Division Industrial Hygiene National Institute of Heard 45 1 Tel only a thin layer of dust has accumulated over six St... months or a year and there are no visible puffs of dust probable SSsSaescaping from the operation it is -7---- -_c-onditionis satisfactory that the Sy~477 In the case of asbestos dust however and this - holds with even more certainty for dusts high in free Bethesda Maryland and it is probable that informa tion on the reaction of certain dusts not included lan publications inqaler these could also ! The dusts are divided be obtained on into three groups 1 absorps for tra ) tive such as calcium carbonate or marble dust inert such as aluminum oxide or emery dust and ) Leac 8-4 = silica content the toxic limit is so low that the only proliferative such as silica flour and tripoli Dusti SEaz SEaz .. safe procedure is to have recourse to actual dust deter- minations This is especially important where the . " injurious condition is not immediately evident but those which proliferative group are ah produce onsufficient exposure a7 does not 4. If general observation silicosis SPREE indicate an obit . Tiagex develop requires years to nal and silicosis as in the case of asbestosis _ What rules can be laid down in the evaluation of dust hazards in the field Although individual condi- tions call for specialized treatment suggestions can be made- eral indication the free silica : 6-1 Obtain some reliable a number of gen- : ~ of -- content of the dust A few specific items can be men- nously dusty condition where the free silica percentage & t.he of the dust is appreciable which case cont Edy measures should be immediately institu-tdeusdt oby terminations should be made obSy pRe ously negligible 2 1... , unless they oby are a discussion See extensive . Without going into a very discussion the methods of determining the concentration of . ( various industrial contaminants in workroom atmos ea foundries tioned In parting compounds may be y largs ely tripoli which is free silica or they may contain Sjors-ltess than % free silica Manufacturers statements __.. to the lattereffect can usually be depended upon The -.;,.- Compensation Inspection Rating Board of New York =__ maintains a list of parting compounds containing less than % free silica for which credit is allowed in the compensation rate Dust collected in arresters con- . Bot pheres the standard method of dust determination this country is the impinger This device tk, originaler portable 3 by Leonard Greenburg has since been made more and is commercially available as the called " midget impinger through the Mine Safety Applic ances Company Other devices such as the konimeter and the Bausch and Lomb dust counter collect gre samples and are useful control instruments nected to sandblast rooms has been used as a parting compound in some small foundries ~ is high in free silica ae This of course In the rubber industry much dust is frequently - present from the use of soapstone powder or tale in ~~ ExposuresExposures to Toxic Dusts and Fumes - ., wore OUR proceed plant survey continues and we to 3 to adjoining department where a litharge cement is being used for attaching glass lenses ' _ mo, ao KE _ \ -#: ae oeed . preventing unvulcanized rubber sheets from sticking together Where true soapstone or talc is used the free silica content is low usually negligible Imported stocks of these materials are now disappearing from the market and ground minerals obtained in this country are being substituted Quantities of pyrophyl- lite itself a combined silicate are being utilized as a satisfactory substitute but this pyrophyllite may in- clude large proportions of quartz and 22. The evaluation of the potential hazard might thus be changed from negative to severe on the free silica content of the soapstone - 2. A second important factor in the basis of the evaluation of a dust hazard and in fact of most of the occupational disease hazards is the duration of the exposure In these days of accelerated production and longer work = polished metal reflectors A group of girls are working around a large table each being provided with a one pound carton of litharge The housekeeping is scru : adequate = pulously clean All hygienic measures such as adequate R=} rigid- provided washing facilities are and their use rigidr- igid- adhered to The operation involves removal oflitharseglass- by means of a spatula from the carton onto a glass-glass- se * plate where a small amount is mixed with glyceriseglycerise &..T prior to being applied to the end of the glass lens ~ every There is factory appearance that conditions are But where workers are handling toxic satis J-. nd matermater form dangerous rials such as leadin a powdered to take for granted that exposures it is dangerous within limits on the basis of appearances alone EvenEven though _ lead oxide is heavy and tends to settle more rapid $c. than dusts having lower specific gravities very finelf .oa _ . a . a om +: mee nee INDUSTRIAL MEDICINE Page 105 + have in the will remain suspended owinto g air movements movements ina room observation such _ It happens that general observation of just such an rf. Feces . SoUperation resulted in the opinion that conditions were He in No determinations of lead urine of basophilic of the blood or of lead in air were made Six Content eks after this operation was started two of the Ee. Hals Ima Ima : developed lead poisoning one sufficiently severe to cause a brief period of hospitalization Any one of EY gare three methods of determining whether the expo- - of gare was excessive would have led to institution of - in fitting the respirator properltyo his face keeping ee the head bands under proper tension and holding the respirator on his face while he is being exposed to lead even when supervisors are not in the immediate vicinity The filter respirator may not be provid- ing adequate protection even under ideal conditions. * and determination of lead in urine may well be con- ducted as a means of verifying the general impression that the worker is being properly protected Exposure to Organic Solvent Vapor _ --- Meee Preventive measures a3 _. in our In a separate building in the yard of our hypo- CHECKER ERECTURERNING to the main part of the plant we find 7 that an insulating compound is being used to im- we thetical plant a purification process is being conducted pregnate the abestos covering woven over copper cable = entios lead sheathing which is used over and over again in health fornection with vulcanization of rubber insulated - cause cause table ch has Si ment sts on I reac Here tons of lead are being handled Where small amount of litharge in the previous depart- may have caused us to treat the hazard very sightly the presence of large quantities of lead tends F- 15 result in more careful consideration After being 1 being Seis led a cupola the lead is run into large shallow The bitumen used as the impregnating material is dissolved in a solvent mixture Some years before toluol had replaced benzol as a thinner for this mate rial and the amount of solvent vapor getting into the ~~~ work atmosphere was within safe limits At the -. : present time it should not be taken for granted that x such an operation remains within safe limits but | : specific inquiry should be made as to whether benzol -; resul fs where tx the impurities were removed by fluxing is again being used since most of the toluol is going 7. Large sion volumes of air are removed from the area over into the manufacture of TNT If benzol is once more Health ;. Health Ege foot diameter pots and in this department * being introduced into this operation it is still possible forms o in Rei personal hygiene is of the best In view of the to keep the exposures within safe limits but it is not = in Enguitude samples aded of the operation are collected considered good industrial hygiene to depend nquiry 2 lead determination and our results show that gen- the intensity of the odor as an indication of the con- : absorpte atmosphere throughout this tl building contains centration of benzol vapor present The concentration within ; absorpte of .- st dust and fume in amounts well within safe limits of benzol can be determined by a methods methmeo thd odss ) and In making any evaluation of an occupational disease by air analysis using chemical methods or by such silicosis Se it Dusts it is of much importance to note carefully physical methods as the heat of combustion method ~ silicosis Ether mmparatively operations may be carried on for using a device known as the benzol indicator by the =pmmparatively brief periods from time to time which interferometer or by adsorption on such solid ad- result in sufficiently excessive exposures to raise sorbents as silica gel or activated charcoal ara daily de and weekly absorption of such material to As was the case in connection with lead exposures n ~~ r 453 ngerloiumists Before concluding the collection of an integrating method can be employed a measur^' dust de ngerous _ obvi samples in this lead purifying building sam- of the extent of exposure to benzol over the previous 44 were taken to show the exposure of the man dur- few days This test involves the analysis of urine for ssion- fluxing the operation and also while the pots inorganic and total sulphates an easily conducted test ssion- rere being skimmed The exhaust ventilation re- which can be made in chemical laboratories of most 1 of moved the dust and fume properly during the fluxing plants without involving special equipment Analyses atmos Epoemoved the . 1 worker who skimmied pot placed the of the air are of value particularly in locating nation Mz barrow directly behind him and as he deposited ' those areas and operations where benzol exposures are - @ dross iginated The into the wheelbarrow a cloud of dust was the greatest But for the evaluation of the hazard _ more nwn directly de past his breathing level by the powerful the urine sulphate test gives us our best information- -<. called ~ haust fan over the pots During this skimming pration y Appli it was found that there was high lead intake onimeter jee worker even though the operation was of com- ect grab paratively short duration The control measure was gr": adily apparent once this one exposure was evalu- as being severe ae posures ed to 2 2 Where Where operations introduce comparatively high ex- 3 intermittently and with some degree of irreg- glycente a type of test which permits summation of darity lenses se intermittent exposures is particularly valuable working- "owe - working- working- air tests can be carried on over a long time to show by th one =r representative results these are helpful but the ES by - is scr test in such a case is the analysis of urine for rigiof- with adequate where available dithilzone y tens se rigiof- with the lithangt dithzone CSE with dithizone development of rapid techniques such as lithangt BO = dithizone and dropping mercury electrode meth- a gian 2 e results of urinalysis for lead are becoming more giycer available as a means of evaluating the hazard lass the amount of lead excreted in the urine is an are work a measure of the total lead intake throughout Where day short of blood tests which do not show a positive in- ~777 -_ dication until after some damage has been done _ . - We have mentioned that the odor of the benzol --- = __ - should not be depended upon in determining whether or not exposures are excessive One of the reasons ---- for this is that the toxic limit of benzol is compara- tively low parts per million being the maximum concentration to which workers should be exposed - over any period of time and secondly benzol is not .. one of the more odoriferous solvents Where we are dealing with some of the lesser toxic solvents many of which fortunately have more distinct odors then the sense of smell will serve to a certain 077 ~ extent as an indication of the hazard As pointed out - by Patty in a publication on rapid methods for the 7 77 7 determination of gases in the air the most universally available rapid method of detecting and estimating gaseous contamination is by odor He cautions how- ever that individual sensitivity to odors varies con- siderably and fatigue occurs rapidly Consequently - every opportunity should be taken for the correlation 4 ithin ketryWpheree ithin though ee ar erved en rapidi re rapiidni c etruvreed very nar the worker may be protected by means of a respirator approved for lead dust or lead the worker's lips and nostrils should be closely as an indication of the effectiveness of this and of the conscientiousness of the worker 2 JE 7 of one's individual sensitivity to odors with the con- centration of the materials causing such odors usually expressed in terms of parts per million After one finds that = he associates a strong odor- . of some such solvent as isoamyl acetate with a concen- Page 196 INDUSTRIAL MEDICINE April 1942 __ tration of quarter the usually accepted toxic limits he should keep in mind that it is the initial inhalation . of such an atmosphere which should be used as an fiindication If we walk slowly toward a process pre- senting an organic solvent vapor exposure our noses become progressively fatigued as we approach the higher vapor concentrations closer to the operation Consequently we may have little appreciation that there is a strong odor of the vapor even though the exposure may be within injurious limits If odor is to be used as a criterion a good technique to follow is to wear a respirator provided with activated charcoal cartridges Only when the observer is at the operation itself should the respirator be removed The opinion concerning the intensity of the odor should be predicated on the first few inhalations Since one's sense of smell may be less intense at certain times than at others it is a much safer procedure to use the nose to decide that the condition is dangerous where control 33 . measures can be easily taken rather than to depend upon the nose as the last word in deciding that a condition is satisfactory It must be admitted that although the canine nose may identify a smell with certainty the human olfactory organ is more con- venient than reliable Reliability even of precise chemical methods should not be accepted blindly It is always well to test the tester A thoroughgoing example of checking a newly developed method is that described by Barnes and a, | Speicher in the determination of formaldehyde in air." Using an impinger with distilled water as the collecting medium only about 50 of the formaldehyde was retained in a minute sample but 93 of the formaldehyde in the air of a test chamber was consistently collected when 1.25 potassium hydroxide was used as the collecting medium Some of the Newer Health Hazards THE newer exposures to occupational disease haz- ards incident to the present emergency a mercury poisoning hazard was evaluated by Goldwater and Jeffers as being excessive through observation of clinical symptoms and an interesting action pointing ! to the source of the exposure A new fouling paint was being used in the New York Navy Yards which had to be heated prior to its application The men who were spraying the heated paint or who were in the vicinity of the fumes being given off from it \ noticed that any gold rings which they were wearing j developed a silvery coating obviously from the for- mation of a mercury amalgam In addition to this a silvery deposit was formed on the ship's hull in the area where fumes from the heated material made contact with it With symptoms of mercury poisoning : showing the need for control measures and the pres- ence of this amalgam showing the source of exposure control measures were soon instituted : Today we are hearing much about the greatly ex- panding synthetic rubber industry Acrylonitrile or vinyl cyanide is one of the initial materials for pro- : ducing one or more of the Buna rubbers Since the substance contains the poisonous cyanide radical it was believed desirable to institute a study of the toxi- f ay cology of this material to provide information on which to evaluate the extent of the hazard By ascer- 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 investigations permit the proper evalua- : tion of the hazard so that adequate precautions can be taken and industrial exposures kept within safe limits Such means of evaluating the hazard before rather than after symptoms have developed is in line with enlightened industrial hygiene methods During the last war considerable numbers of cases of poisoning from trinitrotoluene were experienced There is much activity in this country today to avoid recurrence of such cases in our own TNT plants but cases are already being reported from abroad In one foreign country a recent report gave seven cases of TNT jaundice with two deaths and in another a group of 13 workers had to be hospitalized as a result of TNT exposure four of whom died In the more effective control of dust and vapor in TNT production and loading plants in this country improved methods of determining the concentration of this material in air have been developed A colorimetric method has been devised by Pinto and Fahy of the Massachusetts Division of Occupational Hygiene In shell filling operations the nose and the eyes do not provide sufficient indication of excessive TNT ex- posure Actual chemical analyses of the air are nec- essary In conclusion it may be stated that in the evaluation of occupational disease hazards in the field much can be done in spotting conditions which are obviously severe on mere observation of the condition Where the condition presents some question as to the severity of the exposure then specialized methods should be utilized as a measure of the degree of the hazard As we have indicated these determinations can be made through air analyses or through certain determina- tions on the urine or blood of the worker The purpose of the evaluation of the hazard is that conditions presenting excessive exposures can be disclosed before actual injury to health occurs After control measures have been instituted then these checks should again be made so that it can be known definitely that they are effective Where it is found necessary to institute air analyses or similar technical measurements the Divisions of Industrial Hygiene of most of the industrial states are available to manufacturers for study of their conditions A number of the leading insurance companies also have such facilities available for concerns which they insure for compensation and certain companies extend this service where group life or group disability coverages are in force Some of the universities pro- vide consultation service Private consultants are also available Frequently an initial complete survey of a condition by some one of these specialized services can be followed up by inspection or by routine analyses conducted by the plant engineer or chemist Recording instruments have been developed for such materials as carbon monoxide sulfur dioxide carbon disulfide and hydrogen sulfide but the initial cost of these tend to be rather high Judgment and experience count for much in the evaluation of the occupational disease hazard but where there is any question as to the need for introducing control measures or where such control measures run into any appreciable cost or inconvenience then this evaluation can best be based upon such specific data as is to be provided by determinations appropriate to the exposure References 1. MILLER J. W. and SAYERS R. .: The response of peritoneal tissue to industrial dusts Pan Hearth Rep 36. 264-72 1941 OMFIELD 2. GREENBURG and OMFIELD J. dust sampling apparatus Pub Health Depts 47 3. LITTLEFIELD J. and SCHRENK H. with the Bureau of Mines minket impinger using a pump Bur of Mines R. 3387 1938 .. The impinger 664-75 1932 .: Dust sampling new operated operated 4. BLOOMFIELD J. J. and DALLAVALLE J. .: The deter- mination and control of industrial dust Puu zanattk Ball 237 1- 1985 2 =r a fos tty, Vay tPayoA nt Poules re 7 + bataitites 5 as HEP eer Bek My a. a 4 a i. & t ie ha i @ i: ii, itp C hn a ai Rg et ag 1i Se om ey at e bee itee an men Ce 908375Hbth 7 ytea a ea 908375H908375H iedpe 908375H in.line in.line ^ in.line . =? of cases cases Tr ; a t \ : Leas one In one In RS cases of INDUSTRIAL INDUSTRIAL INDUSTRIAL MEDICINE > miniBnAgRNESE. samplceosntrol Routine atmospheric Possibilities - of Page me nt Tarmaldehyde SAYERS ASPHA( PINTO Mercury p^'sisunre deterHmiOnoRatfVioAnToHf No. trinitrotoluene & ayet nd 197 C. less than hour urine of of lead exposure by10. 10. La meee J. Indust Hyg & Toz aarpling for control ventive Engineering Impurities CYANTCYANT W. P. Foundation of AmericSaeries Bulletin 2. Part 8. Industrial H. SCHRENK H. R. Part ... Pittsburgh 1939 ee re A and REINHART W .; Urine Sulfate determinations ~ 11. GOLDWATER L. J. and JEFFERS C. ; .: Ty poisoning Toz p^'ssureof benzene exposure J. Indust Hyg & 18. 69-88 as a from the use of fouling plastic paint J. Indust Mercury poisoning 1`PATTY 1`PATTY F. .: Rapid methods for the determination 1936 oe 24. 21-23 1942 and Hya " Hya Tox the air AJ.P.H. 30 1191-98 1940 determinati n gases ar atmos 12. DUDLEY H. C. and NEAL P. A Toxicology = acrylonits De acrylonits De wT & BARNES E. C. and SPLICHER H. W The = in air J. Indust Hyg & Tor 24 10-17 ~ vinyl cyanide A study of Toxicology of 7 | 1942 2 S the fe aa cr ute toxicity Ibid 2427-36 ae +0 DRINKER P Vapors and their routine measurement 1942 , 13. a S. and FAHY J. .: meet. 1940 measurement the 1963-67 ce ee eee for : determination of TNT 2 4 6 A new colorimetric meth Coe) 24 21-25 1942 a in air Ibid tm -- sane toes . - he he more a he more Hygiene produc- ~~ Plant Studies " 77 ' control Since the physician must in == mproved HE location identification and con- .. many situations recommend aad ' of of - this ExposureExpossures trol unhealthful occupational every material , process or environ- control measures or specific | . is rimetric fee: Exposures a primary ment capable or suspected of causing of the effective pass judgment on = of ny - the function industrial physician of injury of or disease the exact location -- existing nature installations proposed or 7 _ _ . Technically exposure is defined as any working ~ each and exposed the number number of workers the fundamentals a knowledge of of industrial - - environment - process Condition or see owe ete : | giene engineering is a most usebfuyl- a in possess operation or material used in manu- Identification of Exposures - > 27 piece of equipment for him to TS 7. . Se nec- XPOSURES valuation facturing which is capable of causing Charmful physical effects These may extent 2.7. are important by nature and the degree to which Control procedures fall in one of the following major classifications o. =. .- aor 2 in occasion . be so obvious that work- theythey may be controlled 1. Substitution materials are sub- | valuation in themselves Most sufficient much are perfectly familiar - trial hygienists believe that 2.* stituted for those causing troubleare 2. Alterations Pr, me with frequently their Most source obviously periodic ;=.< periodic obviously physical physical examination of em- information exists exists about control ing in processing or manufactur 7" ods in general to to meth- 3. 7 . = manufactur en manufactur manufactur Segregofaopteriatoion ns Where 7%: foreewisll 1. prove to be the most sensen- - of all but very ne pw ermit safe handling 4. ._ Capture of dusts fames mists vapors or| e ane sitive index e severity ee Industrial equipment gen should of the effect on workmen or recently intro . duced substances in ~~ .: gases at the point of origin 5. Use 7 7 oc Inandustrliadl ustrial exposure and inadequacy` '** Problems of this industry to of personal protective be to application Elsewhere should IndustrIi control measures nature likely be ~l The actual dis- encountered by by the physician in in eral of these gen . covery : Fort requires diligent combined dustry dustry are extremely extremely diverse and principles often requires a high degree of be made 3 Efforts 33 by highly trained medical and -!. widespread have been made . specialized ~ technical skill- knowledge and from etermina E45 gineering personnel In any case to classify them One One of the most obtainable erly qualified prop- a e purpose SS stematic methods are essential in useful outlines is the following following engineers and: industrial _ qualified hygienists conditions <-> order dependable data may - + be A. Abnormalities of air pressure OF on gored which a program of B. Abnormalities of temperature and humidity New Processes ee eee dequate 3. control can be based Plant C. Dampness ... _.. iece ALL rmeees yer .: te iece studistudieses have proved to be re-re- DE.. DDeufsetctive il: lumination wot a os ~ NEW processes - materials or of r analyses ~93=" Tentoroyf = visions of wget - exposures states are yn: eir cond = companies =o IPERIENCE PLANT - are eerns rns whicwhhich companies atat establishments _nance 3 disability are followed rsities pro- its are also = fable to require least expenditure | F. Infections woe modifications old ones should time and money The procedure is Radiant energy are ewes eee wec et ur t. be investigated much the same ; sentially one of taking periodic in- H. Repeated motion motion pressure shock ~ ~~ and in advance of installation to way<way< unsatisfactory ~- J. Fuisons oe vent the introduction of pre tional risk occupa-- - - : Subheadings under the major title unexpected ~ unexpected _ a of poisons are most numerous and a Maintenance Location of Exposures a complete list of all substances capable of Control | of causing local or systemic effects is . ~Msro~ in large and small in- a very considerable considerable one In the medical inspections an -- Ser dastrial at suggests . of . allergic manifestations case essential phase of control mainte- -- -+ plant hygiene studies are likely from industrial - arising _nance and consequently of the indus- indus- be most successful if certain steps ~ potential exposures substances the list of 7 trial physician's routine These are endless exposures becomes almost inspections should occur ' = materials - A complete list of all materials ._ <- . Sites of periodically greatest exposures need fre * a a survey of a asing FOLOWING FOLLOWING __~ ervices can La in manufacture should be se- asing Those capable or suspected of asing asing ated trouble should be suitably in- list on the list ated steps in manufacture should described naterials as preferably in the form sulfide and +5 terd entation these 2 Occasionally TRE material finished product the Torking uch in the - nclusions Torking azard bu for entation diagram or schematic repre- to indicate the flow of goods raw to Thorough inspection of the premises is essential to test nclusions drawn from the inventory materials and processes and to late other conditions of work convenience ich are potential to contributors up upoonn Sa, not and lowered arminations arminations arminations arminations arminations : lances not be forgotten lances cog lances may under production It that harmless harmles condi- certain condi- Grin Grin susceptible individuals be- ter ter ter harmful harmful In the same way no how much care has been ex- |. INS preliminary investigation tionaltional A or unsuspected sources of TE wil will l will be missed unless every the working environment is full serutinized A:record be | should made of oo Industrial Health JAMA Engineering Studies oe location and identification the physician physician should indicate in the record his estimate of the seriousness of each each exposure If doubt exists about its its exact nature or satis- factory control assistance is needed from an industrial industrial hygiene engineer In fact confirmation about the severity of most exposures is often highly desirable desirable and it is routine practice in many manufacturing concerns for an qualifications engineer with suitable to verify all preliminary estimates Qualitative and quantitative quantitative analyses of each exposure are available available in this way for use as factual evidence if necessary All determinations of this character should should be suitably suitably entered in the records Control of Exposures 9 SOON as the industrial physician has established a source source of occu- pational disability he must must set the machinery in motion for adequate VANE Taken from Bulletin 11 of the ment Labur Decupation Diagnostic Diagnostic Sun by LOUIS I ROBERT J. 1941 U. 3. Depart Hoe and LUBLIN and quent attention possibly constantly : repeated chemical and engineering evaluation Others are visited in lation to their re- importance Periodic plant walks by the medical depart- ment personnel throughout the entire establishment is particularly sound -- practice inspections should be made in company with off- cers of the firm particularly those re- _ 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 ally need ~- Employees most emphatic- instruction and regular su- pervision in order that adequate understanding may exist about the continuous and | tive devices proper use of protec- _. The record system of the mmedeicdail cal department should contain copies of- recomblemiations leading to the in-- stallation of control metsarea the date of installation and the dates of and special visits and notations about follow inspections Forms can readily be devised which will facilitate ooo cot | ., ' a yy waeene ears ree st nay Sy el cas & hE Ss SS . Page 198 aan . cee ee " ee ee INDUSTRIAL MEDICINE a, \ to be industry consultatpionhfe~rraCotheimmcoassgopheroefs on unhealth- ~<*- recording of all results ~ that the practicing physician called combustion was carried .. the uniform of plant inspection ee TT on to serve practicing in may have varying in oxygen conu an appreciable excess to - Medical inspection has additional - cess to ready sources Preliminary point where production of gases v | advantages It provides opportunity with every and special information plant hygiene studies should in many essentially from destructive disti tion rather than actual oxidation + for thorough familiarity Information of this cases arranged through qualified _ --* job in the plant Z of the greatest useful- consultants Obscure exposures will | FERGUSON stressed the possibility character is work assignments to - require aid of this same description { combined effects of noxious gases ness in relating the physical and temperamental qual- It is reassur- Assistance can frequently be se- containing various ec cured by application to experienced - binations them ifications of workmen to know that plant industrial physicians or industFr ebi ruaarly 25 1942. DR ADELA HOES Division of industrial . ing to employees under observation by hygienists Occasionally consulting -, SMITH conditions are medical personnel It is equally satis- services are provided by insurance giene New York State Departmen this factory to employers realize that companies or trade associations to _ Labor addressed group on A few city and effects of industrial dust on the lu records are available in case member companies proper claims arise out of alleged county health departments have es- Chicago Section - *. ful conditions of work 7... .. tablished bureaus of industrial hy, giene for investigation and consulta- Chicago Section presented in Small THE : Application Plants = "777 7" tion about occupational exposures If . subject of Organic Solvent Vi : serving 8 small - local resources fail assistance may be Exposures at a meeting on Janu THE THE industrial physician his bureaus of 8 1942. DR MILTON H. KRONENT dL plant should be guided ap- sought through health or labor de- - Director and KENNETH M. MORSE proach to unhealthful exposures by Fre- hygiene in state and these in turn have the dustrial Hygiene Engineer Illi : these same general principles partments information Department of Public Health Divi quently he will need special technical - assistance Committees on industrial advantage of specialized and investigating facilities supplied of Industrial Hygiene gave the re .- > health are being developed in state . by the Division of Industrial Hygiene| of their medical and engineering s ~ and county medical societies in order of the U. S. Public Health Service _ of carbon disulfide and hydrogen i . fide exposures in the synthetic Hygiene Association ial American Industrial News of Local =.Michigan Section T Michigan Industrial Hygiene ~ DR casing industry James H. STER of the Laboratory of Industrial ! Mens Sections Icine Eastman Kodak Company . ,chester discussed the general su - Experience with Some JAM ExperienceE JAMS ES H. Laboratory of Industrial Common Industrial STERNER M.D. Medicine Eastman of Solvent Vapor Exposures included results of the work he had in progress concerning the i . Society had an day Conference Kodak Company Rochester New York of some of the newer petroleum c on Industrial Health Conservation Friday Evening eee tbe wee late solvents tee, ! Friday March 27 1942 at Hotel Stat- > ler Detroit The program gave timely - discussions of conditions affecting --health in present industry and of methods for conservation of the health D. SELBY M.D. P CLARENCE RESIDING Medical Consultant General Motors Cor poration Detroit Michigan Training of Industrial Personnel in Michi- HENRY HENRY F. VAUGHAN Dr. P.H. Dean School of Public Health University of Michi . February 5 1942 the Chicago tion heard MELVIN 3. Constructive Human EYAN Relat _. Industrial hygiene of cr largely concerned with technicol of industrial workers as follows ~ 7! Friday Morning -7 PRESIDING A. 0. THALACKER Secretary Detroit Rex Products Co. Detroit -- A Study of the Wilson Combustion Ana- _ lyzer for Chlorinated Hydrocarbons se F. REZIN Field Supervisor Bureau of Indus- - trial Hygiene Michigan Department of Health tg08e tOee a . Lansing - Toxicity of Lead -GORDON C. gan Ann Arbor . Fluorographic Surveys with a Discussion of Relative Merits of Various Size Fluorographs BRUCE H. DOUGLAS M.D. Commissioner and C. C. BIRKELO 3.D. Roentgenologist Department of Health Detroit On January 14 1942 at Lansing ~ :: Michigan the following subjects were . . . discussed Safety at Work M. EMERSON Per- methods for provision of hea working environment but through proper buman relation effective accomplishment be ma this or any other phase of indu production -= Practical Application of Indu Ventilation is the subject to b sented by JOHN M. KANE En |HARROLD Ph.D. Industrial Hygienist Industrial Hygiene Laboratories Chrysler Cor- poration Detroit > The Determination of Zinc Oxide Fume in - WILLIAM G. FREDRICK Sc.D Chief oe Chemist Bureau of Industrial Hygiene Detroit Department of Health Detroit Visiting Nurse Service for the Smail Plant sonnel Manager Wolverine Brass Works , ; Grand Rapids Interesting the Private Physician in Indus- J. trial Health DUANE MILLER M.D. Chairman Committee on Industrial Health Michigan State Medical Society Grand Rapids Syphiliisn F. Industry J. WEBER Past Assistant Surgeon United States Public Air Filter American of the American Air Filter Con Louisville Kentucky at the 2. meeting on April This mee to include discussion of indi problems and methods of their tion Since many health hazar MISS LUCILLE HARMON R.N. Super visor Industrial Nursing Service Visiting Nurse Association Detroit - Industrial Safety in Michigan and its Rela- . tion to Industrial -JOHN W. GIB- SON Chairman Commissioner of Labor and nu. Industry Lansing . te . ___ Friday Afternoon MARKUSON KENNETH M.D. Director Bureau E. of Industrial Hy- giene Michigan Department of Health Lan- sing The Physiologic Action of Light Metals Health Service Washington D. C. With sound film On February 18 1942 DR LOUIS schwartz Director Office of Dermatoses Investigations National Insti tute of Health Bethesda Maryland discussed Industrial Dermatitis in Defense Industries DR SCHWARTZ covered the control as well as the cause and incidence of occupational dermatoses to be controlled through remo ventilation this subject is of e value The Chicago Section is spo the Session on Time Inc Hygiene Problems to be held of the Midwest Safety Con May 5-7 1942. This session sc for Wednesday afternoon Ma cludes the following program The Industrial Health of Women STEWART F. MEEK M.D. Assistant Medical Director Chrysler Corporation Detroit Metropolitan New York Section Time Production MARGARET TERT Women's Bureau U. S. Depar White WILLWI ILA LIM AM T. KREBS M.D Medical Director Hudson Motor Car Company Detroit Industrial Health Activity in Michigan J. DUANE MILLER M.D. Chairman Com+ mittee on Industrial Health Michigan State Meshent Society Grand Rapids Some Special Problems in Our Time - Industrial Hearth Program O.C SAPPING . TON M.D. Dr. P.H. Industrial Consultant Chicago Fatigue in ROBER H.T FLINN M.D. Past Assistant Surgeon Division of In ** dual Hygiene National Institute of Hewith Bethesda Maryland Maryland THE Metropolitan New York Section heard MR GEORCE E. FERGUSON of the Pyrene Manufacturing Company present a talk on " FFii re re Gases at the meeting held January 21 1942. Of special mixed mixed interest was the variety fire fire gases gases together together with with of the relative quantities of each which might be expected from the combus tion of certain classes of substances Results of work were presented where Labor Washington C. New Materials and New Apple Time Industry Tejonum Tejonum and Other Metallic Ma HAROLD H. STEINBERG M.D. Medical Director Peoples Gas Ligbe Company Chicago Events HENRY HEHNENRRYY F. F. S SM MY YTTHH mor Indutrial Flow Mellon Pittsburgh Pittsburgh lifective Industrial Hogte on Time Conditions C. DYKTOR DYKTOR fee Bureau i Industrial Hygiene Department of Heath Lansing