Document e7eG0JR0KQ9402Rd0qev6Dpg4

196 OCCUPATIONAL TUMORS AND ALLIED DISEASES tion of cancers in sweeps from that generally observed are significant. Cusack reported a single case of soot cancer from Ireland (1847), while Butlin claimed that chimney-sweeps' cancer was unknown in Scotland [Syme (1835)]. While the evidence presented demonstrates that soot cancer of the skin, and probably as well as some of the internal organs still represents an impor tant occupational health hazard in England and Wales, these industrial neo plasms did not play at any time a significant role in the European continent and in the United States. The first communication on the subject from Germany was published by Stohr (1882), who referred, however, exclusively to the occurrence of chimney-sweeps' cancers in England. Subsequent reports dealing with chimney sweeps' cancer appeared from this country in great intervals and described individual cases [Krohn (1826)} Altmann (1827)} Kohler (1835)5 Mohns (1876)5 Junginger (1889)5 Roser (1886)5 Baum (1874)5 Richter (1930); Dutschke (1931)]. Baum stated, according to Butlin, that chimney-sweeps' cancer made its appearance in Hannover after 1874, that is, twelve years fol lowing the more extensive use of coal in place of wood for heating purposes. When Richter in 1930 asserted that not a single case of chimney-sweeps' cancer had been recorded in Germany during the preceding 40 years, Dutschke reported an instance of this industrial neoplasm observed by him during more recent years. Nevertheless, chimney-sweeps' cancers were always rare in Ger many and were exceptionally so during more recent times. Similar conditions seem to prevail in France. While Merat (1820)5 Marjolin (1828)5 Nelaton (1850)5 Lebert (1851)} and Bang (1927) wrote on this subject, none observed a case of this industrial cancer. It is stated that Selle (1787) as well as Alibert (1817) saw several cases among the chimney sweeps of France. It seems to be doubtful, whether or not any instances of this occupational neoplasm have been observed in Belgium [Anciaux (1816)5 Zoude (1841)} Butlin (1892) ]. This applies to Denmark [Hannover (1852); Bang (1927)], Sweden [Sandberg (1903)] 5 Austria, Italy, and the United States [Warrenj Haagensen (1933)} Carozzi (1934)]. The occurrence of a single case of chimney-sweeps' cancer in Norway was recorded by Guldberg (1927), after Gade had contended in a publication appearing in the same year that no tumor of this genesis had been observed in this country. Kocher quoted Rouges as seeing several cases of sweeps' cancer in Switzerland. A report of Krzykowski (1876) mentioned the .occurrence of inflammatory ul cers in sweeps in Poland. IV. EXPOSURE The marked and striking numerical discrepancy existing in the incidence of chimney-sweeps' cancer in England and in all other countries has-been the subject of numerous studies and speculations. There seems to be a com bination of several reasons of chemical, technical, architectural and social nature which accounts for this peculiar phenomenon in England.