Document dDRkMEXkYroRae3rBbZXxeNOq

Occupations! Disease Control THURSDAY MORNING SESSION October 19, 1939 The session planned for the discussion of problems in industrial occupational disease control was cailed to order by A. S. Johnson. Assistant to the Manager, Engineering Department, American Mu tual Lialtility Insurance Company, Bos ton. Mass., who presided. The problems were presented as a panel discussion, and Chairman' Johnson introduced the mem bers of the panel, as follows: Roy S. Bonsib, Chief Safety Inspector. Standard Oil Company of New Jersey. New York City. . Warren A. Cook, Division of Industrial Hygiene and Engineering Research. Zurich General Accident & Liability In surance Company, Chicago. Dr.' A. o. Cranch. Industrial Toxicology . Department. Union Carbide Company. New York City. Dr. Leonard Grecnburg, Executive Di rector. Division of Industrial Hygiene. New York State Department of Labor. New York City. Willis G. Hazard, Personnel Division. Owens-Illinois Glass Company, Toledo, O. Dr. E. G. Mcitcr. Director, Industrial Hygiene Laboratory, Employers Mutual Liabilitv Insurance Company, Wausau. Wis. Dr. O. A. Sander. Milwaukee. Wis. The' Discussion Plan CHAIRMAN JOHNSON: We have agreed to have a working base from which we will talk. This working base from which we will try to develop our opinions is what 1 choose to call a triangle of re sponsibly. visualizing what may be called the three A. B. C.'s of an equilateral tri- anule. ' At the top of this triangle is manage ment of an industrial enterprise, the man who has to pay the bills, the man who hires the labor, the man who worries about their health. On the left base is the medi cal side. They are the group employed to carry out the medical part of industrial management's responsibility. And on the lower right is the third base of this tri angle where we find the engineers or in dustrial hygienists, who have to develop and prepare for the operating group the controls of occupational disease, as far as engineering is concerned with controlling them. Now. there is a strong tie between the medical and the engineering phases through that base line of the triangle. What we hope to do in discussing each topic is to develop that tie. which we will call the balance of opinion between the medical phases developed by the uoctors on tny left, and the engineering phases de veloped by the engineers on my right. I would like to ask this panel a ques tion. For a great many years occupational hazards have been studied in one indus try or another. Would this panel feel. let us say. sanguine that any industrial enter prise i now ready, hv employing proper personnel, by searching out the answers wherever they may he found, to solve an occupational disease problem if they have one. and by the proper solution maintain the safety and health of the employees? Put another way, arc we still groping in the dark on some of these hazards by reason of conflict of om'nion. ronflirt of experimental data and theoretical expres sion bv folks who f nd the theoretical haz ard in exposure because it is suggested in the hook? Will'Dr. E. G. Cranch talk briefly along this line of suggestion? DR. CRANCH: This question is a broad one: Is any industry satisfied that it is in a uositiem to solve an occupational disease on the basis of present informa tion ? I would say, absolutely yes, for th- maioritv of occupational disease problems arc sufficiently understood to adopt-efR- cirnt measures for control. " - I JO i \ J1SV/1 National Safety Congress I `p.itioti and llio particular sukiiantcs etti- consider carefully the opinion expressed ph-yed. there. Yertt will observe that he ha lllAIKMAN JOHNSON': I would like lo :isk Dr. Creenhurg to amplify just urn- point,. H ll>e survey about which Dr. SauJer spoke discloses no specific occu pational disease hazard as haring caused any | athology--and that is the situation ih.it obtains in most plants--hut still there placed the burden upon bis own profes sion, by careful discussion, of course, with the management that is lo pay the bill: but the decision must rest with the doc tor upon the evidence as presented by the conditions of the plant and the employees themselves. . may b: some moderate exposures lo this THert ii no cook book formula which or lo t.iat. and the management wants to says, you must put employees through the be perf'ctly sure/ how often as a general mill at standard intervals. But the making thing s.iould those men come up for re of medical examinations is another thing. examination? It always presents problems, because men Understand, this survey has disclosed no pathology, no damage, nothing you can put your teeth in or hang your hat on as indicating a great need for engineering changes in current methods of control. frequently are frightened when they know they are being examined to see it there is anything the matter with them, not just being examined to sec if they are all right. They are always fearful that somq dire calamity may overtake Re-examination Periods them soon. It is a real personnel prob DU. GKEEXUL'RG: That would largely depend on whether there were any lem, one that has to be handled with judgment. hazardous materials being used in the plant. If the condition of the men at the time of the initial examination was quite negative and uoihazardous material is be ing used in the plant, I should say the dcci-ioil as to whether or not you are going lo have physical examinations is largely I am going to ask Dr. Cranch if. in his long experience of examining a great many employees for operating exposures that might, not be hazardous, he has al ways been able to keep those cmplovccs calm and collected and quiet and quite content with what things were found. an open one. and a matter of wide judg DU. CRANCH: Physical examination ment. programs for occupational disease con For example, in the ease of a depart ment store's employees, where young women net as salesladies, under ordinary conditions, it might not be necessary or desirable to give them physical examina tions more than once in five years, per haps not even then. If, on the other hand, the physical ex aminations were quite negative, and yet toxic materials arc being employed, the derision would depend on how toxic those materials are and what the analysis of the plant atmosphere shows. trol can hardly be divorced from a physi cal examination program aimed at general health conservation. Where it is possible to have a medical service, where the physi cian is in daily contact with the man. physical examination presents far fewer difficulties than where it is done'only for the sake of occupational disease control. If an outside physical! comes in lo ex amine certain groups of men at intervals of from one month to two years, uieii logically have a right to expert that then may he something going wrong with those who arc called in frequently, and It seems to tile that the answer to the that leads to considerable nervousness on question is a matter of judgment which their part as till what will be found. must he based on a comparison of the rilative hazards of the exposure as com pared with the cost and desirability of continuing intensive physical examination, -md only by knowing the detailed facts can one arrive a| a sound decision in a particular given iustancr. There is. a matter of psychology ami practice ill carrying out such a program of examinations, ft is much simpler, where il is possible to arrange it. to have reason ably frequent cxainitialioiis for general health conservation, and these examina tions. then, will he included in tin- regular CHAIRMAN JOHNSON: 1 think procedure and help to determine the efforts that it is very important for you all m of an occupational disease exposure. Occupational Disease Control \J7 As Dr. Greeithurg said, we do not at with surveying to locate and lind the * tempt as a rule a routine examination at hazard that they want to control. a fixed interval of a year, we will say. The periodicity of our re-examination is Will Willis Hazard discuss that one! determined largely by several factors: MR. HAZARD: It seems to me that first, the possible exposure to occupational the most important thing that the doctor disease hazards; second, what we notice in can tell the engineer is what his findings connection with that man's health as the arc from the physical examination. That days go by. more or less determines how serious the Our supervisory force is usually in structed to send in any man who seems a little under the weather, who does not seem to he doing ivcjl, who seems to he hazard is; it often isolates it to certain in dividuals in the plant, and that points the way to places that should come under en gineering control in that regard. slipping a little. Froth their recommenda .CHAIRMAN JOHNSON: 1'crhaps tions often we pick up cases that certainly you have already visualized what I am require examination' which otherwise' leading to. I want Mr. Bousih to develop would easily have been overlooked. Another thing wl'ili^i we have lo remem ber is that many symptoms are common not only to occupational disease expo sures incident to life in general; and the medical program lor the control of occu that a little farther. Here we have the medical examination installed to disclose what is wrong, ii anything. I want him to develop the engineering control method. What fact and what data does he need to go about his business? pational disease is therefore extremely Engineering Control important in that the contact must be es tablished with the men to determine what changes are going on and what is their origin. CHAIRMAN JOHNSON: The im portant point to me is that you cannot drag in a physician from the outside who is a total stranger to your problem, merely became he is an expert toxicologist or ex pert something else, and ask him to set up a medical examination or control program MR. BONSIB: Since the amount of damage to the human mechanism depends upon the exposure and the concentration the engineer should know the maximum allowable concentration to which lie would have to maintain the working atmosphere or the working condition, and as an en gineer that is something that the medical profession must give so that the enginerr will have something lo which to work. for about a week, and then depart. I think the answer to the question, then, Hire him lo consult with your own physician, but let your own physician so fold the occupational disease program in is that it is very essential that the thresh old or maximum allowable concentration permissible be known. to the general health conservation pro CHAIRMAN JOHNSON: I do not gram. that the findings of the one serve to think we will quarrel about that. I am augment and support the findings of the certain no engineering group will stick other. out its neck lar enough to define lor the Now I am going to talk to the engineers, and assume that a survey has been made in which we have discovered a hazard sufficiently dangerous so that, in the doc medical profession what constitutes the safe threshold limit. It is not quite the answer to the question I had in mind, however. tor's opinion, something ought to be done about it. I am not assuming that it has gone so far as to kill men, but it has mani fested itself ci|hcr in moderate early symp toms or sonic actual demonstrable pa thology in a few. For a great many years, you know, the medical profession has been conducting its work successfully In industry, main taining tlic greatest degree of confidence between the employees and the doctor through the fact that the doctor never I want to asli this group of engineers revealed what was the mailer with tin what they waul the medical men to tell man if there was anything wninr.__Lie them which they may use lo utmost ad grades the men in a general way--employ vantage in their own work in connection able. or employable subject to medical I JO wUlM 4 U* 4U/IU* congress scr\ii'- .i employable in limited expo* much dust. It had hern shown that Mire*. gypsum dust itself does nut cause silicosis \ iti'"1 | have blown open a question here: ,i( ;i *"1 n't,,,iin.thnhetirltdtuottuchitehosvrerinmofeof nrfmahcatt?vheeabbeeoneugntincethxee-r li.nii weakening that professional or injury to the lungs. tyVIierc there is silica sand, we look for that injury to the lungs and the development of lihrosis and silicosis where the exposure?-is high and continued over a long period oi time. CpnVi<U *'* , which he has established in lhe *'** 'w. i. whom In- i examining? WUm 1 u.nit this group of engineers to t an they use adequately mass Consequently, where about half of the material used in this operation was silica sand, it was the guess of the engineer that here was a condition which had to lie con SIlioT*" 1,1,.,i or information about the crouo. " ',ih.mt having to know that Mike UamV'i.*", I;i is about one month from otncfju"1" wiih a disability: Will you tlc\clop !>' ' , \li. Hazard? , >tK * i \ ' MCI): It seem; to me it is `uro' ... -d-lc for the engineer to use .il.c \'M'U > c-nll; in a purely statistical ;n.i::s: * I. does not have to know who i* v<*' * whether it is Mike Datnbrowski r . .'i i he. It is extremely impor*.int * '1 , know the number of people who .u- .wing the same ailment and the I**.:' *' .. of people who arc working in the >'.< > , ut or the plant as a whole. MK , \>'|:: 1 do not sec how you ,\i:-. ' . icaiust something unless you know v : is going to do: and I do not -ee >" .. : can provide necessary pro !rc:: > , .. ::es without knowing to wlial :ste:.'. ' '.nt to go on them. You nui't know *' .'bold limit to which the snh- c material, whether it is gas. is causing the trouble. If . vw what :he toxic limit is. . . wm.: it takes to make people . much the human mechanism :.tki*'g due allowance for the trolled effectively to keep tin* ilu-t ruiicenIralion down to very low levels. To everyone's surprise, the x-ray exami nations of workers who had been exposed to these operations for a niinditr of years, showed that there was no development oi fibrosis. Further engineering data was collected. ' and it was found that two things hap pened. In the first place, the grain size of the sand was rather uniformly large and well washed. There was no abrasive action to produce a great ninuher of line particles. In the air itself, the concentra tion of free silica was not 50 per cent, or wlial it was in the main material, hut only one or two per cent. Finally, laboratory examination showed that where you get quartz dust falling, or where you would ' get gypsum dust settling out of the air fairly rapidly, the quartz dust settled out more rapidly, and the combination of quartz and gypsum settled out even more rapidly than either one alone, due to the fact that the gypsum dust caused agglom erations with the silica dust, ami you had large groups of particles which caused this more rapid settling. 'Vi .. > o: the susceptible. I do not Now. the data obtained through the engineer can provide the medical examination >giqd the x-ray was . a*nrc. wliat gave the hint that the cost and the ... i ? ::`.l maintain that the .::: is the essential thing for .. :o know. That gives him . . l oo: a:. Ir. other words. completeness of the ctliitrol at that opera tion was not as great as it would normally bc thought to lie by the engineer walking into the situation. . :ki: concentration to the CHAIRMAN JOHNSON: I think that . .*. '.licit i: wil: not make auy- illustration hinds together these various `.he length o: exposure ncccs- points. ` ct that pericr. must he cx- I have watched that particular study de veloped with a great deal of iutrrc-t. and. An instance might he for a fact, the engineers did nut know, or . ether factors than threshold did not have to know, anything about the . wen utilized. For example, men as individuals; the doctor kept that ,,..n industry, in certain plants in his files completely. .rt * . ts known as a sanded plaster Now let us summarize for ju.-t a mo tr.ir ' g operation where there is meut. to see where we have arrived. We Occupational Disease Control 13'.- have the doctors and the engineers as the two bases of our triangle. Our panel feels sanguine that hazards can be controlled. We know enough, there is enough knowl edge in the aggregate to control them. We say that the need for a medical pro gram is as vital as the need for an en gineering program; that the doctor ought, to lie the plant doctor, augmented by such specialists as lie nerds to employ to couii scl with him; that they have a certain amount of factual information that they must turn over to the hygienist or en gineer for his use as-a check for his per formances, and that the medical crowd should tell the engineering crowd how low the hazard must lie taken to consider it reasonably safe; that the engineers arc perfectly willing and able to tackle the hazard in some fashion if they know those things; and the periodicity of the exami nation to find out whether the engineers did a job or not depends upon the condi tions ns the doctor finds the record written in the men themselves. Of course, the engineers arc going to continue to use the instruments of survey to check their own results. Now I am going down to our printed program and explore some of the ques tions suggested there. The panel will dis cuss phases of exhaust systems. Arc there in the engineering catalogue;, data de scribing machinery of one kind or another to make it possible*for the engineer to design an exhaust system if lie wants it. or thinks he needs it? Arc there enough high grade, glorified vacuum cleaners on the market to pick one out of the catalogue and install it in the plant, and expect it to produce results ? Dr. Mcitcr, will you develop your thoughts on present market conditions of. tailor-made exhaust systems as against engineering design of exhaust systems to fit the individual plant circumstances? Exhaust Systems - DR. MEITER: In my opinion, there is not available ready-made exhaust ventila tion equipment. The assumption that you can select from a catalogue and ventilate your problem; lias been a great drawback in the progress of this work. Ity that I mean this: Oftentimes a con cern will have, say, a local tin worker. They call him in and he. without know- ing what the requirements arc of thr State Code, without knowing the liu-<ts tc which the gas, dust or fume lias to be exhausted, immediately sets about and de signs a hood. Then, without even knowing lion much air can lie handled by that hood, he looks into the classified section of the telephone Imok and calls up the fan company. The tan company lias a salesman, Imt ic i< not in. so the office girl looks up the . :chnica! data, and the company ships the I in. When this ventilating system h, finallj installed, the sheet metal -vorkc- says, "Well, the sheet metal work porti. .1 of il is all right, and that is all I guarantee." Then the fan company, on the other hand, says that the fan delivers a certain volume of air at the speed shown in their catalogue, so they wash their hands of it. And finally, when the whole thing is in it doe; not work and a job ha; been poorly dour* So the point I wish to make is that ventilation, no matter how simple, requires technical knowledge and technical instru ments to determine when the system is really working. CHAIRMAN .IOlfNSON~: I think Dr Mcitijr has put his finger on a vers critical point. When I speak about engineering control. I mean engineering control, and J do not mean tinsmith control. I.rt me illustrate. Sander talked about the meta* fimn fever, zinc shakes. Visualize, if you will, the problem of a shipyard building de stroyers for the I'nitcd States Na\v f galvanized sheet plate, with a great deal of electrical welding work to he done in confined space5, in the little tanks and cells of whirl] the ship is constructed. There is a plant set up in the field, you might say. lying for nearly a year at its fitting-out basin, a little plant about .125 feet long and 10 feet wide. 25 t-> 10 feet molded depth and heaven only knows how many tanks in it (they get down to pretty smatl sizes) with welding to he done in most. In those confined spaces welding, steam-fitting and electrical work must lie done. Can you imagine a tailor-made ven tilating system being used there? Now let us go to the next question, protcetivc creams and lotions. I.rt us have clearly in mind that a cream or a lotion i; smeared on the skin for a purpose, and rorijig mill niolii.nl dcpnrtim-nts is cjsenli.il to propel Iv control dost hazards, l.o on tin- .smaller plants, those having |t`l' nr _W cinpli'vce.t, cope with this pr<|l>i-ni and ili ti iinine whether or not they l.-i'i' a h;i/.artlous dint condition or any other ih i np.itionnl disease condition? It wo'.dil he impossible in many eases for lt:c<c small plants to set up elaborate and ov;\'iisiu- control departments. T > le. d the answer in a definite direcI am going to suggest that perhaps i.i .nisui) lies ill the recent dcvelnpnnait almost ou-ry industrial State, divisions : o.aupatioual di-vase hygiene, either in the Department of Labor or the Depart* ii-ir: of III.illli. I am sure Dr. Leonard tireenhure would like to answer that iiui-stion. The Small Plant Problem . DR. tuREKXUl'RG: There are two l`-:"js that the smaller plant may do: one Is :o make use of its instiranee company to :!ie inllest extent; and the second is to e-.ake use ot snelt facilities as the state lias .it disposal, cither the Department of l.ulvr or the Department of Health. In approximately oO states in the Union, '-.ere are divisions of industrial hygiene in either the Department of Labor or the Department of Health, and in a few cases l:i both, and they are always prepared and e.-.ger to help the smaller plant, particu larly with such problems as this. Many of the insurance companies have developed divisions of hygiene and have experts on their staff who arc also pre pared and able to render service along these lines. It seems to me that the big ees: problem is to get the small plant : -.-.--.;eeiiieiit to recognize that the stum h'.i-e block is management itself. Once recognition has been achieved, it is a relatively simple thing to obtain prache.iily tree service from either of these organizations in an effort to really i1,.,- -n-tr-.i tii e preventive work. CHAIRMAN JOHNSON: Let me add one thought to that answer. I am familiar ,i>T most of those divisions. In none of :is therr anybody carrying a big -tick to brow beat or to hammer into shape iV.v small plants that want help. They are already giving help in an advisory i a droit. There has been fear, at times, that you could not let a state man into the plant without expecting him to change a recom mendation into an order overnight. I have not seen that in this treatment of the occu pational disease problem. I rffn not telling you that it does not exist: 1 say I have not .-ecu it. ,, I have here a question for our engineers. Yesterday they were talking about ueld ing metal and fume fever, and so forth. Here is the qdcstiou: Does an exhaust system from electrical welding adect the ly pc of eld : As I view this question, it means this: When you weld with an electric u elding process using a coated electrode, the llux- ing ol the coating produces an umbrella or tent over the weld are itself and thereby excludes the air from the are and prevents oxidation of the steel which is being cast into the hole being fillet) up. and prevents oxidation of any of the material nr metal that is in the fused state. , Now the question is. if you stick a heavy exhaust there and pull away that vapor which provides the protection, do you ruin your weld? Is the control for health at the expense of the weld, or would it be better to forget tlut and limit the time of tbc welding? , Docs anybody here want to answer that? MR. BONSIB: I think that if you have general ventilation there vvbnhl be very little danger of destroying that umbrella that Mr. Johnson has mentioned. Ol course, it is advisable to remove those fumes ns near tbc source,of origin as pos sible. You have to get wfijijn eight inches, and not more than that, to really gel effi cient results, and being that close you do not 'require more than Wtl or 200 lineal feet per million. I do not think there is`enough eooling action to do damage. As a matter of fact, some tests vve were interested in making seemed to imlirate that there was no dam age done. However, you come where the damage would lie done" if you exceed that, lint I do not think you need to exceed 101) or 200 lineal feet per million. If you have general ample ventilation, then yon do not have any danger, in my opinion. CHAIRMAN JOHNSON: That seems to be a logical conclusion. It is ccitainly an opinion based upon observation of that sort of problem. The next question is; run of fire clays; but I am not giving-the "Is there enough silica in the average fire brick to affect workers seriously?" In other words, if vve explore clay for medical answer. It is my thought, that the hazard produced in the clay prodm ts is not an inherent our, hut one thrown in by violent agitation due 11> drv grin.ling its refractory property on the one hand, njirralifi'H ami it< plasticity on the other, is llicr,- a descending order of silicosis hazard from the fire brick on the one side, down through plastic china ciayjor paper clay on the other? Lit u< ro on In another ini, rrxim n m lion 'To wltvt extent are the in. ,<li.r with which this panel arc l.vnili,, pro viding washing facilities, and vvli.vt . re the advantages of washing in shower;, : n-l so Mr. Hazard, the questioner wants you forth, accruing to the employees out. >* one to talk about the amount of hazard in the hand, and the employer on the oth'e and fire clay, and for want of a better defini how is the thing paid fur?" tion let us leave out 'the Canister brick which is a brick the sand of which we know to lie pretty close to 100 per-'ccnt silica. Well, we know that in some states, washing facilities arc required by iivv in certain types of industries, and in others they arc put in. MR. HAZARD: I think this is really a medical question. But there 4re certain fire bricks which arc very high in silica, and certain others which have practically none or a negligible amount in them. You (have a range there from what might lie called a dangerous condition, down to one where you are practically sure no danger I can visualize the need to develop this question in two ways; one for the con trol of a serious occupational disease ex posure such as lead: and the other, the general industrial hygiene, to get folks to wash on the developed fact that by care ful washing a great many of the dermatitis (exists. . problems solve themselves. It seems to me that if you had a fire Will Dr. Cranch talk about the pro brick with very high silica content, with vision of washing facilities? the chipping and knocking of the brick- DR. CRANCH: Washing facilities are iiayer against the brick, it might stir up most desirable things in any ylant. large I considerable dust and might be a silicosis t or small. As ihc Chairman has said, it is hazard, but I would like to hear the medi the most important factor in the preven cal side on that question. tion of occupational dermatitis, to say CHAIRMAN JOHNSON: Will either nothing of general hygiene to the work of the doctors discus's the inherent toxicity men. of the fire clays as they are normally The vicissitudes of trying to establish handled in the manufacture of brick? any adequate washing facilities in in DU. GREENBURG: It seems to me dustry arc great. My first experience the Chairman ought to tell us vvliat the occurred over forty years ago as a work percentage of free silica is in the fire clay. man. In that plant there was no water He has talked around the question, lint .available, although it was a large plant, he has not told us the crux of the whole and unless you sneaked from the job and problem. went around to a faucet which was used CHAIRMAN JOHNSON: The prob lem seems to me to be related to the notion that maybe these mixtures are, so mixed that other things beside the silica produce an alleviating or an ameliorat fur sprinkling the front lawn, you bad no water available. It was not expected that hands should lie washed. A man worked at Ids job, ate his liuu-li. worked all day and went home so black as a rule you ing cdcct to prevent what silica there is could not tell his race. from catismg silicosis. Later I became much interested in the Clays do not seem to produce silicosis. development of washing facilities I re It is the dry-pan grinding of all kinds of member in one very large plant we pul tilings that produces enormous quantities in excellent washing facilities, and it was of dust some of which contain silica, and surprising to see bow they were abused I cannot remember at this moment just even to the point where in some cases vve what the amount of silica is in the ordinary had to discontinue service. In other or- v