Document dnY2q0R0nBJv17JGqQ4wZvRr9

FILE NAME: Sprayed Asbestos (SPRA) DATE: 1932 DOC#: SPRA001 DOCUMENT DESCRIPTION: Medical Journal Article - Asbestos in London Tube Railways 374 Tax U W 3 T ,] pabuambht. and coma to the notice of the police:--The totel number of each accident* recorded in Greet Britein wee 181,486. of which 8402 resulted in fetal injuries to one or more persona The corresponding figures in 1830 were 150,703 end 7074 respectively. The number of persons killed in 1031 was 8885 end 202,147 injured, as against 7308 and 177.805 respectively in 1030. There was thus in 1031 a considerable increase in the total number of accidents resulting in per sonal injury which were recorded by the police, but a decrease in the number of fatal accidents as compared with 1030. The figures for England and Wales show similar changes, the total number of accidents resulting in personal injury being 105,521 (an increase of 23,127), and fatal accidents 5851 (a decrease of 486). The total, number of persona killed or injured in England or Walm was in 1831 100,831 (an increase of 22,320), and the "% killed 6026 (a decrease of 400). These changes in the number of persons killed and injured respectively suggest th a t the increase in the total number of accidents resultini' in personal injury may be more apparent than real, anc attributable to the police obtaining fuller information regard ing the accidents which occur by reason of the institution of the motor patrols and the new requirements of the road traffic Act as to the reporting of accidents. The figures from many police districts support this view, but it is to be noted on the other hand that those for the metropolitan police district show a decrease in the total number of persons injured, as well as a decrease in the number killed, the totals for 1831 being 1324 killed and 54,422 injured (not fatally), as against 13U8 and 55.827 respectively in 1030. On the other band, in some police districts, including, for instance, parts of K ent and the West Hiding of Yorkshire policed by the county police, there was an increase in 1031 in the number of persons killed as well as in the number of persons injured. Amongst the cities and borouglia in England and Wales, Birmingliam had the highest total of killed or injured during 1031--namely. 5088, an increase of nearly 800 over the previous year. This figure, however, is exceeded by Glasgow, where the number of persons killed or injured was 5004. which is, however, nearly 300 less than in 1930. The Liverpool figures show an increase in persons killed or injured from 4447 to 4048, and those for Manchester an increase from 3571 to 38)8. Wales, aa a whole, bad a total of 232 killed and *422 injured, as compared with 270 killed and 5810 injured during 1030. In Scotland the correspond ing totals show a decrease of 124 killed and an increase of 1427 injured, the totals for 1931 being 059 and 17,342 respectively. Rates of Relief. prepared to coordinate the muses1 pension e e ) J ^ E 8 federated voluntary hospitals and iirm unidual Sir K Hilton Yoono replied: I would friend to the provisions of the Local Government .Sy 'W Officers' Superannuation Act, 1922, and ^1>' Section 8 and 16 of th a t Act. I am. aa n r r ^ M Mr S have been, willing to consider any practicable *r~r*** tho lines mentioned in tho second part of the c m 2 ? 1*% no such scheme has aa yet bean submitted. ' "uoa, ^ MONDAY, FEB. 8RL -iS *- London Tube Workers and Asbestosis. Dr. O'Doxovan asked the Home Secretary if 'vaadvised that the precautions taken to prevent w f disease in workers lining London tube* with asbeatn. *** adequate.--Sir Herbert Samuel replied: powers of control in respect of this work under the sw ** or other Acts, and have no information at present precaution* taken. I will moke inquiries, howsvst ..T* G.M.C. and Indian Medical Degrees. the faculties of medicine in Indian universities *and*i!2 stage had beea-raached in the aetting up in IndU ^T* Indian Medical Gouncil.--Sir 8. H oare replied et* conditional recognition accorded by th e General M*i2! Council to the medical degrees of certain Indian univen22. was withdrawn in March, 1930, A reviled draft Bill S S S establishment of an All India Medical Council h u W prepared, and it is hoped to introduce it in the Isdu! Legislative Assembly a t an early date. -w w Importation of Boneless Meat. Lord Scone asked the Minister of H ealth if be wonU consider the advisability of prohibiting tho imnartatfaa of boneless meat, in view of the difficulty of detect!!* unsoundneas or disease in such meat.--Mr. Ernest Rwwrr (Parliamentary Secretary to the Ministry of Health) repliedTho importation of bonclcaa meat which affords in in X ^ ' means of identification with definite parte of a cares* a prohibited under the Imported Food Regulations at 1911 My right lion, friend is now considering the amendment of these regulations so as to require a recognised -'*'-`-1 certificate of the country of origin with all imports of bah meat less than the wlioio-------- Mr. Albert asked the Minister of Health what steps had been taken to prevent differentiation in the rates of relief paid in areas where similar conditions prevail.--Sir E. Hilton Yoir.vu replied : The amount of relief to be afforded is for the decision of the public assistance authority in the light of the aarertained needs of the individual case. I have no power either to require uniformity or to define what, for the purpose of assessing relief, are similar condi tions. As regards the area to which my lion, friend called my attention in an earlier question, I am informed th a t the local authority have taken action to remove the difficulty to whicli lie referred. Maternal Mortality. . Mr. McEntee asked the Minister of Hoalth when the publication of tho report of the departmental committee on maternal mortality might be expected.--Sir E. Hilton Youno replied : The interim report of tills committee was published 18 months ago. I have not yet received any further report, but I understand tliat the committee hope to present their final report very shortly. Rural Housing. Mr. H urd asked the Minister of Health the number of rural district councils in England and Wales who made applications fur special Exchequer assistance under the provisions of tho Housing (Rural Authorities) Act, 1031; the total numlter of houses included in their proposals; and the number of homes wliich the Central Advisory Com mittee had recommended for erection under this Act.-- Sir E. H ilton Yoono replied: Applications bavo been received from 145 rural district councils of wliich six were subsequently withdrawn. The remaining 130 applications were in respect of 0735 houses. The committee arc not yet in a position to make actual recommendations. They have informed 97 authorities th a t they are prepared to entertain applications to the extent of 1501 houses for the agricultural population. Pensions for Nurses. Dr. O'Donovan aakod tho Minister of Health if he was able to give the details of existing arrangements for the interchangeability of pension schemes for nurses, sisters, and matrons in municipal hospitals; and if be would be TUESDAY, FEB. 9tH. Boys Working Underground at Night. Mr. Tinker asked the Secretary for Mines if he had eoasidered the request from the Miners' Federation of Gnat Britain to meet them to discuss tho position of boys the age of 10 years working underground on night shifts: and if he was prepared to meet them.--Mr. Isaac Foot replied : The answer to both parts of the question is in the affirmative. Safety in Mines. Mr. Tinker asked the Secretary for Mines how many safety-in-mines conferences had been held ; was it his inten tion to liavc the proceedings and subjects that wen dis cussed published and available to mine workers; and i it was his intention to hold similar conferences.--Mr. Isaac F oot replied : The sixth district Safety Conference wss hdd a t Nottingham last Saturday, and was attended by aomr 4000 persons representative of nil interests in tbs minis! industry. I intend to lu>!d another conference a t Swansea in March, and the eighth and final conference probably at Birmingham in April. Every mining area in the couairy will then have been covered. The proceedings at the* conferences arc well reported in the local press; and the material is used in the various safety publications of my department, and in the lectures and demonstrations ca * smaller scale by which the work of these large conference is being followed up. Sunday Repairs to Xelepbones. Mr. H utchison asked the Postmaster-General whsthtf* in view of the fact th at no telephone repairs were earn** out between 1 P.1L on Saturday and Monday morauf' except in the cose of thoae telephones belonging to doe**this privilege could be extended to tbe general pu)*j seeing tliat no money was refunded in respect of tbepsnvs in wliich their telephones were out of working orderr" Mr. W hite. Assistant I'oatmnster-Generml. replied: 7"* present arrangements for fault repair during week-eDy apply not only to Iho circuits of doctors, but aiso tO"" alarm, police, hospital, and other circuits where the i diato restoration of communical Ion is in the general pa61! interest. My right lion, friend is considering whether is possible to extend their scope. - [ lancet.] Cancer among W< David Grenveza aak received not.!fleatit , men employed a t the mnece. and the nui the last three yea at these works ) _L replied: Kotin S e d only in the case of < T t * r , pitch, or Cfrtair S tem of cancer have t " * in, and I am inform ment is aware, there which would expose test of the Depart: r has gone throug the last three years . T im works died from ca K j a n y ground in any c with the employe STamploved daring th. gtsge of death in the Grenfell asked if t . of * very high rate o: i , of tho form of cancer " h was the same kind i ___. H- Samuel : No. I * V-1*K. js not disproportio S ao lly . nor do any par ^ p articu lar kind of ca *Mr. Grenfell ask ed the ftil eve on th e subject ^possible of the num ber > .x S r H . Samuel sa id tb s & i been made. If Mr. t ' A . which would show t ream out of 1100 w jg their employment he (As m atter. Continental Vegeta) ^Tlajor Carver asked t 1 gtrtm ent lied invcsiigr oath disosse in this com s( Continental vegetables d such investigation.-- Si IS* made into tbe source fgot-snd-mouth disease, tte disease m ay be m tru gg of other com m odities, i that inflection was definite d Continents! v eg etab le forthcoming which would imports o n these grounds. . UeuL-Coloni l F kkman had been rvfertvd to th Bssearch Committee. . Sir J . Gilmour sa id t always going on into foo } Milk for T Mr. McExtee asked th Uoa how many local edt milt for school-children. Council schem .-s: a n d with milk through th e schemes a t the la te st cm ftriiam cnturv Secretary : Bating the week ending authorities in E ngland u school-children tinder See Art, 1021. Mv rig h t I: .national Milk lh ib licity ( t* receiving milk under Local A uthoriti. Dr. Salter asked tin *<4 local authorities in J p a tte d rli*amncv ortlorw f : the num ber j W n actually ponUrnoU vtu& brr of liouMM a n d *4moiUh<-<l a* a com m it fMt. E. Huo-.vv replied : i 'tte* in England Anil jttdcr tlu* Housing A ct jKKttes, atill 41 clearance f 'f *. 3 '* * 4 i %c 410 th e lancet,] [t e h . 20, ANNOTATIONS A S B ES T O S IN LONDON T U B E RAILWAYS. If it be true that asbestos fibre wm woven into cloth and used in ancient Borne, the medical profession has been negligent in its failure, until quite recently, to detect the existence of chronic industrial pulmonary asbeatosis. The first fatal case of pulmonary asbestosis was recorded by H. 1L Murray in 1800, and a full account of the disease was given two years ago in our own columns1 by Dr. W. B. Wood and Dr. S. R. Gloyne. The Home Office inquiry into the effects of asbestos dust on the lungs, published shortly afterwards,* has been followed by the adoption of active measures to suppress dust in asbestos factories. In many such factories the introduction of exhaust ventilation and the replacement of dry processes by wet have changed the atmosphere in which the work is carried out until it is now free a t least from visible dust. The operation of cleaning the carding machines by steel brushes, undoubtedly a potent source of fatal pulmonary asbestosis, has now been replaced by a vacuum method. In view of the fact that the dust particle producing the lesion in the lung has a diameter of only 2 p to 10 p it is obvious that the dust must bo suppressed at its source ; the use of respirators is futile. Illustrations were recently given in the daily press of an experiment which has been devised to coat the Loudon tubes with asbestos in an attem pt to minimise noise. In these illustrations the workman -was provided with a double projector, fitted with triggers by which hu released from two iudeiieudcnt jets a spray of pulverised asbestos, apparently under considerable air pressure, and a spray of some adhesive solution. recognition and study that we must look for ad v a^' iu our knowledge. The condition is so common*! to be an ideal subject for study by the general pr**? tioner, and in an essay awarded the Sir ChJjFj ! Hastings clinical prize for 1030, Dr. H / o i Gunewardcne1 records observations and couchiMoJ [ on the " sudden severe attacks " affecting the ueryos! system that are met with in this disorder. He flag: I that minor paralytic and sensory phenomena are men common than the major apoplectic fit associated ) with a severe cerebral htemorrhage. These m i^ , attacks may bo either permanent or transient, and 1their duration is sometimes only a matter of minnt** or hours. In distribution they may be liemipWi, ; monoplegic, or localised to one part such as the eye or tongue. The sensory phenomena are similar to the motor in distribution, and take such forms ' as porasthesia, numbness, pain or blindness. | Dr. Gunewardeue finds that severi cerebral hamor- . rbage is rare in patients whose diastolic pressure is I leas than 135, whereas the less severe strokes occur with diastolic pressures of between 115 aud 125. no case being seen with a diastolic pressure less than 114. i His observations also show that cerebral hn-worrhage is unusual in patients under observation who have been warned to lead a quiet and restricted life, i whereas fatal luumorrhage is likely in patients carrying oil their normal occupation and making no , allowance for their hypertension. He also makes it clear that both fatal cerebral haemorrhage and transient strokes are very uncommon oner cardiac failure has begun or there is clinical evidence of cardiac enlargement. _____ . According to the illustrations the asbestos powder RESU LTS OF GA STRECTO M Y FOR C A N C ER passed through the atmosphere for something like six inches before meeting the stream of adhesive. Though it is true that the workman was provided with a mask, it is equally true that his clothing was covered by asbestos powder. Kxjiericnce in asbestos factories would indicate that, should the experiment of the Loudon tultc railways lead to an extensive use of this method for deadeniug noise in all the under* ground railways of l^mdou, then a large increase in industrial pulmonary asbestosis may be ex acted in years to come. In the House of Commons last week (sec p, 374) Dr. W. J. O'Donovan asked the Home Secretary if adequate precautions had been taken to prevent fatal lung disease in workers lining Loudon tulxw with asbestos. Sir Herbert Samuel replied that lie had no powers of coutrol iu respect of this work uudur the Factory or other Acts, and had .no information at present us to the precautions taken. Hut he promised to make inquiries. In a communication * to the Academy of Medicine, on Jau. 19th, Prof. H. Hartmann reviewed the late results iu 125 cases of gastrectomy for caucur of the stomach, observed for periods ranging up to 27 years. Of tbc 25 paticuts who showed no sign of , relapse, all but one liad been under observation since tbc ojicration for periods varying between 1and 27 years. There were, further, seven patients who had died, but not of caucer, and these deaths had occurred from 3 to 18 years after the operation. Another group included 13 patients, the cause of whose death from 2 to 13 years after the operation was not known; there may, perhaps, have been some deaths from recurrence of the disease among these 13. Lastly, there were 80 paticuts, whose . death was due to recurrence of the disease, in 31 cases during the first year, in 35 during the second, in 8 during the third, and in 6 during the fourth year after the operation. Altogether 39 patients (or 31 per cent.) survived the operation by three years HIGH BLOOD PRESSURE AND STROKES. or more, and i 'rof. Hartmauu is inclined to put ** 29 or 30 per cent, the proportion of his patients for Despite much investigation since Allbutt's original . whom a cure could be claimed. *Ho has achieved description of high blood pressure there is still doubt ` this comparatively successful result, not so much j>y about its cause and symptoms, especially in the 1sacrificing the greater part of the stomach, as hi .e a rlie r stages. It is, as a rule, only later on, when the removing with the greatest care the groups of gU""* condition is fully developed and grave symptoms I which are most subject to invasion. He argn* have supervened, that patients with hyperpiesis are that even hotter results would certainly follow earlier seen and studied by the specialist. Since by then 1diagnoses and 0]>erations performed before the disess* irreparable damage has been done, it is to earlier ; had extended beyond the first relay of gland* ' Ilis conclusion that " lo caucer de l'estoinac e-t 00 1Tin: L an cet, 1030,1., US. j bon cancor au jmint de vue operatoire" i m0i* * IU-|M>rt mi Effects ol Asls-stos D ust on tbc Lungs und Dust .Suppression In the AslirstoH lu r iu s tr r ; Memvethcr, R . A., 1 Brit. Mud. Juur., Ja n . 3UU>, p. ISO. .unrl IT ia:, C. \V,, 19311. L u n d o u : H.M. S U t. Office. SCA THE L ancet, 1930, I., ;o. 1 Dull, de l'A'.sd. du Mud., evil., No. 3. ,g. His still mo other cases l in the se u gome rea* rjng this com rt to his so or iu general by [ at the age of :of an operat than 30 fear II she would gjo of cure of c flfcerbaps, of acad ajoTpatients ope yTTii-r iierturbed Sirring 50 veers PHYSK sSlt is well knov jnfgnts do not *be< gjin some eases i k j t and eoium ei Expression of the Jfa. Treaeher ColSi' Ana is not beca' develop'd at birt reflex action in oonditional reflex jaljvarv gland tl sceveu ilie tlioui Jats pby*i'd<>gieai dual and m the elephant- or eru< that uu animal* < Mr. Liml>ay .loin squeezing the jui< g it into their cy the myth. The Iscryutal -eerettoi it keep* tbc suri and free from m second place tha lysozyme, .lets as is the fimrtton, n is weeping, but which may in- n upon any imtutic Mr. Collin- eons immunity of mf in whom t'rede'.birth i> more p r laeryiuul secretin in the very di employed. F or young infant do reflexly to any o of drops acts as s the other proie especially the tir Associated with orbicularis oculi fibres of it situut the lid and know are found to be than in ary ot closure of the 1 vessels from the pressure due to i a closed glottis. ' lirtt. Jour. 542 the lancet,] A CAMP FOR UNEMPLOYED MEN. [MARCH 6, ]j- ARTIFICIAL PNEUMOTHORAX. To the Editor o/ T iie L ancet. Sir ,--The note in your issue of Feb. 27th (p. 450) by Dr. J. D. Macfie and Dr. A. J. P. Alexander on the follow-up of artificial pneumothorax cases is of great interest and importance. With their assess ment of the practical value of this method of trea t ment I am entirely in agreement, but it would be of special interest "to know further details of the cases that have died, particularly as regards the mode of death. It is to be hoped that they will publish a more extended study at a later date. It is, I think, to be regretted that more investiga tion has not been carried out in this country on a really large scale as to the ultimate cause of death in cases of pulmonary tuberculosis treated by artificial pneumothorax, with special reference to the spread of disease in the contralateral lung. Even now, despite all the work that has been done by different observers and the vast amount of material available for statistical purposes, we are still to a large extent ignorant of the factors which should go to form the criterion of suitability in our selection of cases for pneumothorax treatment. My impression, after some years of clinical experience, is that phthisical patients fall roughly into three groups : those that go downhill whatever treatment is employed, those that recover and achieve permanent arrest in almost any circum stances, and those that occupy a middle position, so to speak, in whom one's treatment may well be the deciding force between life and death. I am inclined to think that it is the last group which furnishes the most successful results in pneumo thorax treatment. Moreover, there is. 1 believe, a strong impression among many who have worked at the subject that while the immediate prognosis of pulmonary tuberculosis is more favourable in A.P. cases, the ultimate outlook--i.e., as regards length 0f i[fe--is better in patients in whom cure has been attempted by more natural means. I am, Sir, yours faithfully, " Maurice D avidson. Wimpole-street, \V., Feb. 28tb, 1932. Our first pioneer group, which will go into camp i March, must grow at first by the addition of men * courage, initiative, and vision, capable of bui]dup a tradition of hardihood and mutual help; . the purpose of this letter is to ask that the names addresses of such men--great numbers of whom im^ be known to your readers--may be sent to tfe. lion, secretary at 2, Devonshire-place, W.l. Tb should be between the ages of 18 and 25. If they* entitled to unemployment or transitional beneft the Ministry of Labour has agreed that these mayL paid over for their maintenace while under training.-J We shall be very glad to supply full informationt anyone interested. & We are, Sir, yours faithfully, (Sgd.) I. N orman Glaister, D. L. T ucker,- E. Schofield, R. T urner, B. Stanley, A. W estlaki. F. Talbot, 2, Dcvon^hirc-place, \\\, Feb. 27th, 1932. ASBESTOS IN LONDON TUBE RAILWAYS. . To the Editor of T ile L ancet. Sir.--With reference to the annotation on pageffS of your issue of Feb. 20th. we, as inventors of Uf process referred to, give you herewith a few pult* culars. which we trust will enable you to arrive life, better conception of the work which is at pn being carried out in the London Lnderground tun" Particular attention is drawn by you to the He**;, Office inquiry into the effects of asbestos dust out lungs, and it will be seen that ventilation and tkl replacement, wherever possible, of dry process*^, wet. form the basis of the safeguards recommit1 of which advantage has been taken by the de* of our apparatus. c As will be seen on examination of " Methods far. pressing Dust in Asbestos Textile Factories,' w**. b tn c tiw } <2 ^ ' T =,, A CAMP FOR UNEMPLOYED MEN. To the Editor of T he L ancet. S ir .-- We believe that it is within the experience of all medical men in general practice that chronic unemployment almost inevitably leads to deteriora tion of mental and physical health, and that this adds to the difficulty of re-entering organised industry. With unemployment as widespread as it is now, the progressive inefficiency in the community from this cause becomes a menace not only to the happiness of millions, hut to our communal ability to take the initiative if opportunities present themselves for a revival of trade, and to our capacity for reorganising our social structure if progressive rationalisation of industry demands it. We are closely associated with a group of social workers known as the Order of Woodcraft Chivalry, which has set on foot a scheme of national non military service. This has been devised so as to give opportunity to all young men who have either voluntary or involuntary leisure, to devote it to a full time camp course of training, directed to the main tenance of physical fitness, mental alertness, initiative, and citizenship. We are not yet ready to undertake the regeneration of demoralised men, though we hope to be so soon. the Home Office (1931), a system of tunnel* on pages 11, 31, and plate opposite pg , are reproductions of photographs taken in _ provides an incoming supply of fresh - any possible traces of dust from the v> J worker, and we would point out tha t what takes place in the Undergroun apparatus being so arranged that kept constantly supplied with n811 ' dust or atomised adhesive is blown a immediately by the natural current through the tunnel, assisted w h e re ^ ^ mechanical means, for which full Pr0 -> made. v wn In addition, a special study has ^ question of suitable adhesives, . - liquid can be used through the s .A , completely saturate the fibre delive '<?;