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INTERNAL CORRESPONDENCE #2- /From PITTSBURGH MEDICAL DEPARTMENT Re: INDUSTRIAL HIGIENE To R. S. Adams ^ C. G. Bell /MffWfiJ -n--tT ni-rym. F. B. Colby if.` "Cbnosa otf W. G. Dotson B. H. Droz G. J. Fickes Olean Cleveland * Edgewater - Badin Wenatchee Vancouver 1 ` 5: <ob" &s - Alcoa FaD. /A/-^ C* U>0 e4 hrfc-Gs rame: (it M. A. Marr - Buffalo R. H. Moore - Rosiclare J. J. Moroney - Massena <H-d- -- R. E. Paine isPracht - Vernon Tlirirnnpnrti-- 'J. T. Quirk - Bridgeport R. C. Roberts - E. St. Louis J. V/. Schachtele - Chillicothe R. E. Schenk - Detroit H. A. Semken - Rockdale D. F. Shantz - Richmond C. S. Short - N.K. C. L. Teubert - Chicago E. M. Trimble - Bauxite Mining W.V .M.Williams - Alcoa Smelting R. G. Wood - Lafayette E. B. Youngblut - Lancaster If Attached are the following items which should be of considerable interest: 1. A.C.G.I.H. Threshold Limit Values, 1955* 2. Information on aluminized cloth for protection against radiant heat. 3* Hazardous exposure to so-called safe solvents. ii. Letter from Mr. J. T. Hobbs re Controlled Atmosphere Generating Units. LVC/db cc: Dr. D. A. Irwin Mr. C. L. Bradshaw Mr. T. Bonney Lester V. Cralley J r no i i * u * APC 001309 THRESHOLD LIMIT VALUES FOR 19SS Adopted at Hie Seventeenth Annnel Meeting of the America* Ctaievooce of Governmental Indmtnel Hytieeiih, Itrfftio, April 24*21, IfSS T T ALL'US arc given in the following tabulation for the maximum average atmos ' plieric concentration of contaminants to which workers may be exposed for an eight-hour working day without injury to health. These values are based on the best available information from industrial experi ence. front experimental studies, and, when possible, from a combination of the two. They are not fixed values but are reviewed annually by the Committee on Threshold Limits for changes, revisions, or additions as further information becomes available. Threshold limits should be used as guides in the control of health hazards ami should not be regarded as fine lines between safe and dangerous concentrations. They represent conditions only within which it is felt that workers may be repeatedly exposed, day after day, without their health being adversely affected. It is felt, at the present time, that workers should not be exposed to a working environment containing any of these substances in excess of the value indicated. These values are not intended for use, or for modification for use, in the evaluation or control of community air pollution or air pollution nuisances. ESTABLISHED VALUES CASES AND VAPOSS S' RSTAVCl*. prst* Acetaldehyde ................................. . 200 Acetic acid..................................... . 10 Acetic anhvdrtde .......................... . S Acetone.......................................... . 1.000 Acrolein ............................................... . 0.5 Acrylonitrile ...................................... . 20 Ammonia ............................................. . Amyl acetate ................................. . Amyl alcohol (isoamyl alcohol).. . Aniline ........................................... . Arsine ............................................. . Benzene (benzol) ........................ . 100 200 100 s o.os 35 Bromine ......................................... . 1 Butadiene (1,3-butadiene) .... 1.000 Butanone (methyl ethyl ketone). . 250 Butyl acetate (n-hutyl acetate).. . 200 Butyl alcohol (n*hutanol)............. . 100 Butyl ceilosolve (2-hutoxyethanol) 200 <ln<TANCE rrat' Carbon dioxide ............................. . 5.000 Carbon disulfide ........................... . 20 Carbon monoxide.......................... . 100 Carbon tetrachloride........................ . 25 Ceilosolve (2*ethoxyethanoI) .... . 200 Ceilosolve acetate (hydroxyethy! acetate) .......................................... . 100 Chlorine ........................................ . 1 Chlorobenzene (monochloro* benzene) ..................................... . 75 Chloroform (trichloromethane) . . 100 1-Chioro-l-nitropropane............... . 20 Chloroprene (2-chlorobutadiene) . . 25 Cresol (all isomers) .................... . 5 Cyclohexane ................................. . 400 Cyclohexanol...................................... . 100 Cyclohexanone .................................. . 100 Cyclohexene ...................................... . 400 * I'lrlt of vapor or ut |>cr mtllfin fUH' il ail, ly v< iltlltU S21 APC 001310 SUBSTANCE rfU* Cyclopropane..................................... 400 o-Dichlorobenzene ........................... 50 Dichlorodifluoromethane ................ 1.000 1.1- Dichloroethane ........................ 100 1.2- Dichloroethylene .................... 200 Dichloroethyl ether.......................... IS Dichloromonofluoromethane .......... 1,000 1.1 -Dichloro-1 -nitroethane.............. 10 Dichlorotetrafiuorocthane .............. 1.000 Diethylamine..................................... 25 Oitnethylaniline ( N -dimethyl- aniline) ......................................... S Dimethylsulfate ............................... 1 Dioxane (diethylene dioxide)........ 100 Ethyl acetate..................................... 400 Ethyl alcohol (ethanol)................. 1,000 Ethylamine ....................................... 25 Ethyl benzene .................................. 200 Ethyl bromide................................... 200 Ethyl chloride ............................... 1,000 Ethyl ether ....................................... 400 Ethyl formate................................... 100 Ethyl silicate ................................... 100 Ethylene chlorohydrin .................... 5 Ethylene dibroinide (1,2-dibromoethane) ...................................... 25 Ethylene dichloride (1,2-dichloro- ethane) ........................................... 100 Ethylene oxide .................................. 100 Fluorine ............................................. 0.1 Fluorotrichloramethane .................. 1,000 Formaldehyde ................................... 5 Gasoline ............................................. 500 Heptane (n-heptane) ...................... 500 Hexane (n-hexane) ........................ Hexanone (methyl butyl ketone).. Hexone (methyl isobutyl ketone).. 500 100 100 Hydrogen chloride............................ Hydrogen cyanide ............................ Hydrogen fluoride............................ Hydrogen selenide............................ Hydrogen sulfide .............................. Iodine ............................... '................ 5 10 5 0.05 20 1 isophorone ......................................... Mesityl oxide .................................... Methyl acetate .................................. Methyl alcohol (methanol)............ 25 50 200 200 Methyl bromide ................................ Methyl cellosolve (methoxy- ethanol) .......................................... 20 2S 522 INDUSTRIAL HEALTH SUBSTANCE TTM Methyl cellosolve acetate (ethylene glycol monomethyl ether acetate) .............................. 25 Methyl chloride .............................. 10 Mcthylal (dimethoxymethane) ... 1,000 Methyl chloroform (1,1.1trichlorocthane) ........................... 500 Methylcydohexane ......................... 500 Methylcydohexanol......................... 100 Methylcydohcxanone ..................... 100 Methyl formate .............................. 100 Methylene chloride (dichloromethane) ...................................... 500 Naphtha (coal tar) ....................... 200 Naphtha (petroleum) ................... 500 Nickel carbonyl................................. 0.001 Nitrobenzene .................................... 1 Nitroethane ...................................... 100 Nitrogen dioxide ............................. 5 N itToglyccrin.................................... 0.5 Nitromethane .................................. 100 2-Nilropropane ................................ 50 Nitrotoluene .................................... 5 Octane .............................................. 500 Ozone ................................................ 0.1 Pentane.............................................. 1.000 Pentanone (methyl propyl ketone) 200 Perchlorcthylene (tctrachloroethylcne) ...................................... 200 Phenol .............................................. 5 Phosgene (carbonyl chloride)........ 1 Phosphine............................................... 0.05 Phosphorus trichloride ................... 0.5 Propyl acetate ................................ 200 Propyl alcohol (isopropylalcohol) 400 Propyl ether (isopropyl ether)----- 500 Propylene dichloride (1,2-dichloro- propane) ...................................... 75 Stibine................................................ 0.1 Stoddard solvent ............................. 500 Styrene monomer (phenyl ethylene) ........................................ 200 Sulfur monochloride....................... 1 Sulfur dioxide................................... 10 1,1,2.2-T etrachloroethane .......... 5 Toluene.............................................. 200 o-Toluidine ....................................... 5 Trichloroethylene............................. 200 Turpentine ........................................ 100 Vinyl chloride (chloroethene)........ 500 Xylene................................................ 200 APC 001311 THRESHOLD LIMIT VALVES TOXIC DUSTS, TUMES, AND MISTS SUBSTANCE mg. rex CU. M.f Antimony ................................................. 55 Arsenic...................................................... 0.5 Barium ( soluble compounds)................ Cadmium ................................................... Chlorodiphenyl......................................... 0.5 o.l 1 Chromic acid and chromates as CrOa.. 0.1 Cyanide as CN......................................... 5 Dinitrotoluene.......................................... Dinitro-e-cresol ....................................... Fluoride ................................................... 1.5 t2 2.S Iron oxide lume....................................... 15 Lead ........................................................... 0.15 Magnesium oxide fume........................... 15 Manganese ................................. ............ 6 Mercury ................................................... 0.1 Parathion (O.O-Diethyl-O-p- nitrophenyl thiophosphatc) .............. 0.1 Pentachloronaphlhalene.......................... 0.5 Penlachlorophenol................................... OS Phosphorus (yellow) ............................ 0.1 Phosphorus pent'achloride...................... 1 Phosphorus pentasulfide ........................ 1 SUISTANCI mc.rt* CU. M.t Selenium compounds (as Se)............... 0.1 Sulfuric acid.............................................. I Tellurium ............................................... 0.1 Tetryl (2,4,6-lrinitrophenyl- methylnitramine)................................ 1.5 Trichloronaphthalene ............................. 5 Trinitrotoluene.............'.......................... 1.5 Uranium (soluble compounds)........... 0.05 Uranium (insoluble compounds).......... 0.25 Zinc oxide fumes...................................... 15 Radioactivity: For permissible concen trations of radioisotopes in air see "Maximum Permissible Amounts of Radioisotopes in the Human Body and Maximum Permissible Concen trations in Air and Water," Hand book 52. U. S. Department of Com merce, National Bureau of Standards, March, 19S3. In addition, see "Per missible Dose from External Sources of Ionizing Radiation," Handbook 59, Department of Commerce. National Bureau of Standards, Sepl. 24, 1954. t Milligrams of dull, fume, or nisi per cubic meter of air. MINZJUa DUSTS SUBSTANCE MfPCTt Aiundum (aluminum oxide)...................... SQ Asbestos ......................................................... 5 Carborundum (silicon carbide).................. 50 Dust (nuisance, no free silica).................. 50 Mica (below 5% free silica)................... 20 Portland cement ......................................... 50 Talc................................................................. 20 SUBSTANCE UPPCrf Silica high (above 50% free SiOi)................. 5 medium (5 to 50% free SiOi)............... 20 low (below 5% free SiOi)..................... 50 Slate (below 5% free SiOi).................... 50 Soapstone (below 5% free SiO).............. 20 Total dust (below 5% free SiOi)............. 50 t Million! of particles per cubic foot of air. TENTATIVE THRESHOLD LIMIT VALUES The following values are suggested for further consideration before being presented for adoption as established values. ( marks materials added this year and for which bibliographic material has been prepared. The other materials appeared in last year's report.) It is proposed that the entire list will be presented for adoption at the meeting of the American Conference of Governmental Industrial Hygienists in 1956, if no reason to the contrary is forthcoming. Aldrlo (l.2.l.4,10.)fr'bexAehloro4.4.4a.M.Shxtbrdro-1.4.M-d)mcthftDooarhthaleDC} Ally! alcohol .............................................................................................................................................. Ally! propyl dlralftde.............................................................................................................................. Animate (ammoolum amldoaulfate).............................................................................................. benzyl chloride ......................................................................................................................................... I Butyl amine .............................................................................................................................................. Butyl mercaptao ..................................................................................................................................... Calcium amoatc ..................................................................................................................................... Cblordaor <l.S>4.i.6.7.6>octacbioro-Sal4.7.7a utrahydro-4.7-mcthaDOtn<ianc>............... I Cblonne trlfluorlde ............................................................................................................................... I Chlorinated diphenyl oxide................................................................................................................. Crag Herbicide <aodtum-2..dlchloropbooxy ethyl aultatc).............................................. 0.26 b 2 lb 1 6 10 03 2.0 ` 0.1 0b 16 mg/M* ppm ppm mg/M* ppm ppm ppm mg/M* mg/M* ppm mg/M* mg/M* 523 APC 001312 INDUSTRIAL HEALTH t,4'D(2.4-Jkbtoro0b*aosrMUe add) ...................................................................... D. D. T. (LS bU><^cUoropbc9ylHJJ*Meblortbaa) .................................... DiMUM alcohol <4*bydrox7*4*mtbyl pifiuouot !).......................................... I DfboraM......... .............................................................................................................. DfeMrio (l,l.S,4.10,l<hbaxacfe)oro4.1. doxT*).i.UMUJ4-04tdrdre-Mi,l- dliMtbaboaapbtbalaoa) ....... *............................................................................. I DtRuorodlbromoactbaM .......................................................................................... DUcobotyl kttoaa ....................................................................................................... EFN (lUtTkMUnpdsT) ibiooo Udmm pboapboaau)................................. . Ethyl ncreaptaa ........................................................................................................, ft Etbykcuo dlamiM......................................................................................................... ft EthfkM iii _............................................................................................... Ferro vanadium duet................................................................................................. Furfural ....................................................................................................................... ft Furluryl alcohol ........................................................................................................ ft Hydradno..................................................................................................................... I Hvdrofefi bromide .................................................................................................... I Hydrogen peroxide. M%............................................................................................ iUrdroouioooe ............................................................................................................. liopropyiamioc ........................................................................................................... Lead arnoaic ............................................................................................................. Llodaoe (bcxacblorocyrlvbvxaoc, gamma isoiucr)............................................ Ualalboa <0,0*liuatbyl ditbio pboepbate of dtaibrl ludrtapiosucdbatt).. Mctboxycblor (UdiparametboxypbcayM.14.trtcbioroetbaaa) ..................... ft Methyl ictiyltai ........................................................................................................ Methyl iaobutyl earblaol (methyl amyl alcobol)............................................... Methyl mercaptao...................................................................................................... Molybdenum ft (aoluble compound*) ........................................................................................... I (InaotubM compound*) ....................................................................................... y*NHroaaUiae............................................................................................................... Orgaoo mercurials (as mercury)............................................................................. Percblorometbyl mercaptan .................................................................................... Fbanylbydratine ........................................................................................................ Flerie add .................................................................................................................... ft Propykae Jmiae .............................................................................. .......................... Fyridwe ....................................................................................................................... ft Quinone......................................................................................................................... Sodluio hydroxide...................................................................................................... fiullur bexaOuorkI* ............................................................................................ Sulfur peotafluorldc................................................................................................... TEDP (tetraethyl dltbtuoo pyropboapbatei...................................................... l'EPF (Utraetbyl pyropborpbate)........................................................................ . ft P-Tertlary butyl toluene............................................................................................ 1 Tetrabydrofuraa ....................................................................................................... I Tetraniuomatliaoa ................................................................................................... Titanium dioxide ...................................................................................................... I Trlfluuromooobromoaetbane ............................................................................... Vanadium (ViO* dust) ........................................................................................................ . (V0 luuiei ........................................................................................................ ft Zirconium ................................................................ 10 tnf/W* 1.0 mr.'M* 10 pplQ 0.1 ppm OFft mg/M 100 ppm ftO ppm OF mg/M* ISO ppm 10 ppia ft ppm 1 mg/M* ft ppm too ppm 1 ppm a ppm l ppm i ag/M* 6 ppm 01 mg/M* OF mg/M* 1ft mg/M* 1ft mg/M* 1,000 ppm 1& ppm . ftO ppm . ft mg/M* . 1ft mg/M* . 1 ppin . 0.01 uig/M* . 0.1 ppm . ft ppm . 0.1 mg/lfa . 1ft ppm . 10 ppm . 0.1 ppm . t mg/M* . 1,000 ppm . O.OSft ppm . 0.1 mg/M* . 0.0ft< mg/M* . 10 ppm . 7ft ppm . 1 ppm . u mg/M* ppm OF mg/M* 0.1 mg/M* 6 mg/M* Beryllium: During the past few yean, several papers have appeared in tbe literature which report a limit fl` *y P*r eubie meter el air for beryllium. Aiming these is the paper by Van Ordsirand. H. S.: BerylUoai*. A. U. A. Arek. Imdust. Hyg. 10:2)2*2)4 (bepc) 19S4. and one by Sterner, J. H.. and Lisenbud. M.: Epidemiology of Beryllium Intosicauon. A. hi. A. Arek. hUmtt. Hyp. 4:12)151 (Aug.) 1951 Conflicting data from industrial eapcncnce baa caused tbe Committee to postpone the tufication of a Threshold Limit for this material. It is apparent that more cpidcmiolofic work n needed for Ibc establishment of a deiimte value. Reference material has been prepared on each of the above substances and, though in some instances rather meager, is available for distribution. The committee would welcome suggestions of substances to be added and also comments, additional references, or reports of experience with these materials. Williau L. Ball L. T. Fairhall Kingsley Kay H. E. Stokingki A. J. Voiwals Louis F. Weller Allan L. Coleman, Ounrman APC 001313 Re: ALUMINIZED CLOTH We have had the occasion to study an aluninized cloth produced by the Minnesota Mining and Manufacturing Company. The coating is produced by a new process in which most of the original properties of the cloth are maintained. Yfe have been impressed by the material and believe that the aluminized duck made into aprons and sleeves can be an effective shield for radiant heat. 3-M was contacted for a list of protective clothing fabricators who use their material. The following companies were given: Wheeler Protective Apparel, Inc. 22h West Huron Street Chicago 10, Illinois Mine Safety Appliances 201 N. Braddock Avenue Pittsburgh 8, Pa. Industrial Gloves Co. Danville, Illinois Industrial Safety Specialties Co., Inc. Eighth u Chestnut Streets Perkasie, Pennsylvania Safety Clothing & Equipment Co. 1000 E. 6<?th Street Cleveland 3> Ohio American Optical Southbridge, Mass. Literature has been received from the above companies and while all market face shields and aluminized asbestos, only the ; afety Clothing & Equipment Co. and the Mine Safety Appliances furnish clothing ma ,e from aluminized duck. It is suggested that those with radiant heat the above material. problems consider the use of L. V. C. APC 001314 1M BO-CALLXD (AFX OLVENTS-HUCHES Beecher*' alio found the difference between placebo and morphine more striking with 5% carbon dioxide inhnlution than with inhalation of room air. A panial explana tion for this fact it that the depreuion of the respiratory center it manifeited flnt by a decrease in its reserve, ns measured by iu ability to respond maximally to the drivfat force of an increased pressure of carbon dioxide in the arterial blood. A second factor of importance, demon strated by Loeschcke and associates " it the increase in ahwoiar and arterial pressure of carbon dioxide that oc cur* after a dote of morphine. This acts in a compensa tory fashion by increasing the stimulus to the respiratory center and thus masking the effect of the drug in patients breathing room air. A third possibility comet to mind, however. Ordinary respiration it subject to a certain amount of voluntary control. The greater variability in respiratory rate and minute volume between subjects when breathing room air than between the tame subjects breathing 3% carbon dioxide " suggests that the use of a powerful involuntary retpiratory stimulus may override voluntary factors and thus reduce the variance due to noodrug factors. Because of simplicity of measurement, it it customary in many laboratories to report respiratory minute volume in such studies, although effective alveolar ventilation b actually the information desired. The use of respiratory minute volume rather than effective alveolar ventilation teems partially justified by the failure to find significant **"! in respiratory rate after administration of mor phine in the dotes used. Although this lends support to J.4.M.A. *rpl. IS. I'M the use of this purnmeter as a valid index nt rc'|'ii;iior> depression, the technique may lead to an undcrcsimuitimi of the depressant effects of morphine, if the dead space docs not change signilicnntly. the per cent decrement in effective alveolar ventilation would he even greuter than the decrement in respiratory minute volume, since the percentage of this volume contributed by dead space would be greater after administration of morphine than after administration of a placebo. SUMMARY AND CONCLUSIONS A study of pain relief in 122 putients after operation revealed only slight increase in potency and duration of analgesia of morphine when the dose wus rinsed from 10 to 15 mg. The side-action liability and respiratory effects of these two doses were studied in 10 healthy vol unteers. In this latter group, a trend was observed toward greater respiratory depression with the larger dose, and a significantly higher incidence of troublesome sideeffects was recorded. A review of the literature indicates that 13 mg. doses of morphine are probably unnecessary to relieve pain in the majority of patients receiving this drug and are apparently more productive of undesirable tide-effects than 8 to 10 mg. doses, in view of these findings the routine use of 13 mg. seems unwarranted. The optimal dose appears to be 10 mg. per 70 kg. of body weight. It. Xl!l, a. S.. aad Imhff. H. X.: Aaahwsfe Piwrnsr anj .VJ, Aciion Liability in Man o( Hciua/nnt. WIN 11*1.1. *-Mrili>l tiin.atomorfUiin*. Mnooon, Lwo-l-nwwihMltfM and Pcnumarsilal .soduwn. a, a Funner eiton to Safina Mnnou. or Evaluation m Analaew. lima,. I. Pharmacol. A taper, lherap. IOSi 101 (Jun.i test HAZARDOUS EXPOSURE TO SOME SO-CALLED SAFE SOLVENTS James P. Hughes. M.D., Cincinnati There is scarcely an industrial plant or a business that .does not um some solvents. The kinds and the quantities vary from the con of type cleaner in the secretary's desk to tank car loads of leu familiar substances used as de greasing agents in the metal trades or as vehicles in the manufacture of chemicals. There are hazards in the han dling of all solvents because of their appreciable volatility. Some danger may be recognized by the user, but flam mability and explosiveness are more likely to be consid ered than philological action. The selection of a solvent for a specific purpose de pends on technological factort, tu:h as required action, volatility, handling practice (including vapor recovery), the tendency of the substance to leave a residual film on metal surfaces, cost, and availability. The safety aspect may be introduced as a last consideration but. perhaps, only in terms of risk of fire or explosion. The final choice usually is a compromise. While none of the criteria for selection can be ignored, only rarely is it possible to meet all of the demands made. The purchasing agent may sug gest a low cost petroleum distillate, the fire chief may ______w Laboratory, Drpanmrm of Prtvrmw Medici m4 iMMBOUl Httitit. Dpnmni of Medici*#. U*icn M -- I--HI Cotton of UedkciM. I m fee 111* AobuaI Meetto| of the America* iMwetrul Mygie boo. Cfctcaoo. April Jt. l4 wunt carbon tetrachloride, and the safety engineer may propose a new preparation of dubious composition labeled "Safely Solvent--Nonioxie." No one will he completely satisfied, und the industrial hygiene adviser may be least satisfied of all. A situation threatening to health now may arise. One solvent may he accepted with out question as being "safe" from the point-of view of toxicity and then handled quite carclcssl); another, rec ognized as being relatively toxic and requiring some control measures may be inadequate!) controlled. Trouble can occur in either of these situations as sug gested by some recently observed episodes. pulmonary edema causld hy LXI'OSURl iu METHYLENE CIILOKIDI Case I.--A Negro male luhorcr. aged IV. was admitted to Cincinnati General Hospital because of shortness of hr.-aih, cough, and suhstcrnal pain of eight hswits' Juration. On his lust day of employment in a metal parts assembly shop, he h.ul Ken given the job of degreasing small copper gaskets b> Jipping them into an open drum of methylene chlonde lie staieJ that the solvent buth "fell like ice water" on his hare hands. He haJ smarting of the eyes on bending over the drum, and he noted an oppressive odor. The work area was found to he in a small, dart, brick garage. There was no ethaust ventilation or mechanical equipment o( any kind for the movement of an. During the 1 alter pari of the shift this boy complained of excessive f.inguc. weak ness. sleepiness. lighlhcdcdnctv. chilly sensations, and nausea. APC 001315 \..l, l*. Nil. 3 HO-CAM-ED AFF. iOLVENTS--HUGHES Ul lit alii*i .1 ihi.iI ni lour liiMtr of wuik. He fell a%iccr .M iuiti Hit! on luimn ih hour* luief fell very weak. %Hon of iMtMiti. .uni hail *i i!r>, nonproitiiciivc cough. He had uiNonul ji.nn o;t toughing and deep hrcaihtng. On mUoi'tornt in the hmprta) ho icmpcruitirc **\ ini F. PiiIm: i.tie I no. ami icNpit.itory rule 42. (here mild rcpinHcir> ilntie". Kale* vae Heutd at Ihe Hum: of ihc right luni am! octa* Mon.illy cite* here over Ihe cheM. On u roentgenogram of Ihe cheM iheie *a* JiIIunc. fussy inlihraium dtonhuted MUicrall) ihioMislioui hoih limit lieliU. characlcriMic of pulmonary edema (ne ligiitci. Ilicic +.ts no eonpinetiviti or irritmian of the akin I he pmom .<* ireuied with 100.000 ttrtit% of penicillin tnira- nniNAiil.HK evet> ciirhi hnur> hut did mil require the admiiwMra* non of ox>gen Within 12 hmirN ufier admission and IH hour* .iiier ihe laM expooue. there win loiul relief of aympiomx: the tciopctutoic. P'dsc rule, and respiratory rutc were normal. Faint itiNpii.iioiy anil expiratory rule* were Mill heard at the have of hotli lung*. hut ihe%e had disappeared a few hours later. The results ol complete Mood eell count. urinulysi. blood culture, ami hioml urea nitrogen determination remuincii normal. C hest locnigcmtgmm* made after intervals of thiec nml live days were normal, and ihe patient was then discharged from the hospital. Methylene chloride. ;iUo called dichloromethanc. CH.CI.-. has come into increasing industrial use as a paint remover, refrigerant, and. less extensively, as a depreus ing solvent. It has a pronounced narcotic action, but it is more irritating to the respiratory system und more excitatory than is chloroform.' In industrial use only slight acute cllccts had been reported until 1952 when Moslouit/ and Shapiro reported the clinical histories of four men exposed to a high concentration of methylene chloride vapor in a plant where un olcorcsin was ex tracted from vegetable material.' There was loss of con sciousness in all of those exposed, with one immediate death and some irritation of the upper respirutory true! ol short duration in the others. Methylene chloride had been described by Browning as "practically harmless" in ordinary use.' When the local vendor of the solvent was advised of the illness of the boy relerred to above he stated vigorously that some oilier solvent must have been used, since methylene chloride is so "sale.'' As a mailer of fact, this was found lo he ihe only volatile substance in the shop. The sug gested masimum tolcrahle concentration of methylene chloride under conditions of regular industrial employ ment I- .'mi ppm. Nevertheless, it should be recognized that tin. solvent is capable of acting as a pronounced ic'pu.iioiv iiulant Ihe probability of some absorption nt the solvent tluoiigh the 'Win. in addition to the inhala tion ol vapot. must Is.- considered as a contributing factor in this case. I lie halogcn.ilcd hydrocarbons arc excreted cluelK thiough the lung', regardless ol the mode of ab sorption I'ulmon.iiv iriitation may occur as a result ol the exaction, as well as the absorption, ol these sub stance' Ml t I III g SI Ills MU I IISV ISC, | M-CIM HI III n i k \< III i noil l m u si < .si ' -- \ ..line til.ile 2'->e.ir-*IJ sale, trainee of a cheni.cal .t'hipanv w,.s a.lnuiie.t io a hospital in another co> in April. |h*i. he.aitse ol jaundice. weaCne--. and anorexia Ihe otuei ot siutpiom. ha.I ueeiiiie.l lh .la.s earlier, with n.msc.i. vonming. latl mine. Iighi brown .i.iol., and deepening jaundice, bur .is nionili. priur hi ihe nn.ei id symptoms he had worked on mainlenan.e and repair of solvent circulating ...icni. in dry cleaning c*iabh.hnicni.. but a period id 11 weeks up io ihc umc thai he hc.anie ill he had worked regularly on leirachloriK-thylenc unnlit. |oh .tune, included the refilling of sy.ieni. wrih solveni. mechanical repair., and leu running ot unlit. When emergency repair, were necessary he often worked 12 lo 16 hour ehlfie and sometime, over week end. without regular days eft. Exposure to the solveni. both a. liquid and vapor averaged over eight hour* per day. When line, were repaired aome of the aotvent drained out onio the floor. The servicemen often worked Mar Ihate tpilli. I he cleaning plant, usually were hoi, humid, aod poorly venti lated. No glove, or other personal protective equipment wvre used. On one occasion thit man had spilled a pall of utraehloroethylene over hi. shirt and trousers. He noted a burning aad tingling sensation of the akin until ha changed his (gmients several hours later. On two or three occasions he became light headed when the concentration of vapor seemed especially heavy hut returned to work after a short period In fmh air. The odor of tetrachloroethylene became increasingly distasteful to him during this period. For two weeks before the onset of lllatst there was eacessivc fatigue and unusual difficulty in rising to M.wnisrltoef.nt of lh* ch*sl of rush sapoaed to motkytsas fc.s* I). I he medical history was not significant except that the patient had received one intramuscular Injection ol penicillin in the ireutment of a brief episode of nausea and vomiting on Fab. 7, Iv.'V lu week, prior io the onset of this Illness. He rarely drank any type of alcoholic beverage and never io the point of intoxication. On admission to the hospital he was jaundiced. The results obtained from tc.it of liver function were grossly abnormul and suggestive of hepatocellular dysfunction. He made an uneventful recovery, but when he was examined four weeks later iherc was Mill some evidenee of Impaired liver functloa. 1 he results of hemogram and urinalysis were within normal limits. He was removed from work on systems designed tor the use of chlorinated hydrocarbon solvents but continued in the job of sales and maintenance work on other types ol solvent unlit, ten months after the acute Illness, he reported that on one or t Hrnviun*. E.. "Io.Ichy of Industrial Organic lolvaats. New Yart, ( hemi*i PvMibjMfif lamfitftp. toe., jfjj. 2 MmknwiK, a*J thamro. H : Fatal Bapoaur* M Matftytam l hUkfiar Varne. a M A. Arch (Mull. Hy* litll (Am.) 1*92 i lMrahoid tiffin VaUdCE (or 10V*. Atom* ( Uw MM t flM Amriuan Lnn<fftMsC ot Uo*mmtmal I*4vernal HrpMho. CkMath iMd, A M A Arch l*4wi Hyi Bi)0 (Jam) 1*94. APC 001316 23* MM AI.I.KI) SAVt: *0!.\>\T*--HUiMKh two occasions when he hud worked briefly wur h irtwhltwi'ethylene system he hud experienced Aunvu immediately on de tecting the faint odor of the totvcni. Tctruchlnrncthylcnc. rCI;:{'Clr. oIm> culled perchlorcthylcne. is usually placed lowest in toxiciiy in the ascending series of chlorinated hydrocarbons used as dry cleaning agents ' Until recently no unchallenged eases of toxic cllccls front its industrial use had been reported Colcr and Rossniillcr huve note presented some clinical observations us being suggestive of impairment of liver function in three men of a group of seven engaged part time in the degreasing of small steel disks in u tank con taining tctruchlorocthylenc.' Complaints of headache, nuusca. lighthcadcdncss. fatigue, stuggering gait. and mental contusion were said to have been common tinning these men. Concentrations of tctruchlorocthylenc in the atmosphere of the workroom were reported to average from 232 to 2K5 ppm parts of air. In our patient little or no precaution hud been taken to avoid inhulution of solvent vapor or contamination of the skin since tctruchlorocthylenc was regurded us being "practically nontoxic." Symptoms of narcotic effect on several occusions preceded the episode of ucuic illness characterized by jaundice. It seemed clear that this man hod ubsorbed tctruchlorocthylenc in substantial amounts. The temporal relationship of the onset of ucutc hepatitis to repeated hazardous exposures suggests that solvent intoxicution was either the sole causative fuctor in the illness or a contributory factor in rendering the liver susceptible to uttuck by an infectious agent. These two cases show injury to workmen resulting from the permission of inexcusably cureless handling of compounds of a relatively low order of toxicity, but dif ficulties ulso may arise in dculing with solvents ucccptcd as highly toxic when the measures provided for the con trol of exposure to them ure cither inadequate or un enforceable. NAUStA AVU VOMIT IMO CAU.MUJ HY hXI'IHitlKf. TO CAKIION Ti l KAtTIt.ORIDI. ( SSI ,V--A while fcmulc luhnralnry icchniuun. ii||eJ Ih. reported to the bureau of industrial hcalih ul Ihc t incinniiu Health Dcparimcni that she had pisi become ill on the job while handling carbssn Icirachloridc. She eomptmncd of nausea and headache and had hecn unable lo laic her lunch. She was em ployed in ihc quality control laboratory of a manufacture! of roofing materials. A principal |oh duly was the solvcm cstracuon ol asphalt from samples of roofing paper. 1 his was done accord ing lo a standard spccillcaiion by boiling strips nf ihc asphaltimpregnated paper in a 1.000 ml. healer nf carbon icirachloridc on an electric hoi plate inside an enclosed hood equipped with an eshausi fun. 1 he strips in the healer were ugiuticd ul intervals uf iwo or three minutes during the *t> minute extraction period Hkiracied mutcriji und spent solvent were poured oft into u drain inside the hood once or twice during cuch cviructinn und Ihc healer was rclUlcJ. A glass sliding panel on ihc Ironi of ihc hoosl was raised for this purpose. Tempcruiurc and luimtdiiy in thc iuhorutory room were conirollcd hy air conditioning. Ihc girl had worlcd on this job for u period of two years Shortly after being hired, on a day when the odor of carbon icirj. chloride was strongly perceptible, she hud had headache, nausea, and vomtung. causing her lo lose three days Irons worl. One ycur tuicr a similur episode occurred, and again she was olT worl for several days. She now experienced nausea on days when out side wind velocity was so great us to interfere m.irlcilly wnh the In a. I nlr. H K . Small Inuu.rr, nu Hiwsmlllrr. A si A Arsh II a lriiashtiwrihslenr tirsaui Inslusi Hu mi 111 isrni Ivsi He*. IS. t'U aciNin of Ibe Maul rshauu fan I be illness repot led lo ihc health deparimeni hud ns onset on such a day. I here was improvement afier K'ing outside the laboratots lot several Imwiix. atlhough headache persisted during ilic evening ( tsi 4.-- A white lemulc lahsuaiury Irchmcmn. agetf 22. employed on the same pits us the woman in case .V enmpluinol uf nausea ami helehing and was unable to lulc her luneh on this lay While die had nexer been so ill us to rrmain off worl. she did report mild nausea when she ileieeted a heats odor of carbon icirachloralc in the laboratory. I lus occurred on the aserage of once weeklyAn inspection nf the InKiraiory wus made lew hum. after the report was rcectved. I here was said lo huve been Itnlc change in conditions since the onset of symptoms in the technicians Samples of air collected at the breathing rone nf workers standing at the hood contained carbon icirachloridc in average conecmra dons of from VI to .144 ppm. Air movement at the opening face of Ihc hood varied in vcl-Kiiy from reflo 211 fi. Per minute. It was determined that the ex haust fun was toiully ineffectual in removing cnniuminulcd air from the hood under eenuin recurring conditions of outside wind velocity and direction, such as occurred on the day nf our inspection. Al these limes positive pressure wus created inside ihc hood, the direction of air flow wus reversed, and rontaminuicd air entered Ihc workroom when the Irani panel was raised. Keenmmendulinns were made for redesigning the exhaust system with the erection of a short stack lo curry off Ihc vapor. Herlodic deter minations of Ihc effectiveness of the proposed changes and added precautions in ihc handling of carbon Icirachloridc by the icvhmduns were suggested. .Suhstiiuiion of a less toxic solvent was not possible because of standardization nf the extraction technique. Carbon icirachloridc. a highly toxic substance, was being used in these cases under conditions erroneously retarded as entirely safe. These two cases ure reported for the purpose of emphasizing that complete safety in the handling of this treacherous solvent can he assured hut rarely, and never when provisions for Ihc protection of personnel ure inadequate nr unenforceable. In general, the principle of substitution of u less toxic mutcrial should he followed whenever possible. toxu amhi vopia CAiisr.n iiy rxposuni to miihasoi ( am 5.--A Negro laborer. aged 3V, was admitted lo ( incin* nuii General Hospital completely blind, eompl.lining uf vomiting, uhdommui crumpv und severe headache of two days' dortnron. with increasing lo** of vision ux the other symptoms hud sub sided. I he unset occurred 4K hour* after a Saturday night drink* ing hoot during which he h;id consumed tit least onc*hulf pint of a mixture o( wine und uhout un equal pun of u clear, color* lc** liquid that he had drained from u metal drum ut his place of employment. On admission to the hospital he u not acutely Ilf. T here was slight mKCOon nf the conyonvma. The pupil* were dilated equally, measuring h mm. in diameter. Neither reacted to light except for occasional slight htppu* on strong stimulation, hm both contracted briskly on convergence. Ihcre wa* slight mar ginal blurring of the optic disk*. The retina wa* normal cseepi for the pcnpapillar) region*. vkhieh were slightly cdcmaioo*. with reduced transparency and obscuring nf the deeper blood vessel* the carbon dioxide capacit) of the plasma was 4< vol. '* anil the ennecntration of chloride* 47* mg. per l(Mt cc. the result* of tc*t* of liver function were withm normal limit*, the hemo gram wu* normal There were numerous hyalin east* in the urinary sediment on udmision and onlv a feu on *uh*cqitcnt Jay* Ihc urine had a pH of 5.h. N specimen was ictcd fn the pre*enee of formic acid h> a gallic acid nuthod hvloie and afici reduction nf portion* of the distillate to formaldehxde formic acid wa* found to he present n High concentration. I he patient worked ui u plant engaged in the reconditioning of metal drum*. He h.td drained of? liquid from the bottom of a returned drum, thinking n to he grain alcohol. Ihc drum was found to have contained a lacquer thinner composed ol "hydro* carbons , mixed alcohols . and butanes or esters ** Three other men ul*o hud drunk some of ihc uduheruted wine APC 001317 V til. 15*. No. 3 mmai.iko kaw: wii.vksis--hi (an* W One ol these. the patient in case l. wa* mlmuieil in the hospital ,ii the moh1 unit* with lihi ii( tiMiin and uctdo*i* und the other two civ vnl in have Kwl nausea iiml vomiting. the patient admitted that 11 common piacticc foe employee* in dunk matcti.it horn leimncil dtitm*. .ililtough Ihn via* in violation ol eompanx tide*. He wav dtschaiged improved. except Ini In** l vision. nn the ninth hiKptui day. Ihiee fttumli* later he *till miilil h.uel* peivcive movemeni in htiiiht light. and Kith optu link* wen* matkedly utiophied. ( 4*i f. A Negro jamtoi. aged '0, when brought in I meinnati i ienet aI Hospital wa* a*niely ill. with tmpaticJ vision nl two il.i>*` duration. Du tin? ptevnui* S.mirila> ami Sami a lie hail thunk latgc amount* nl the lacquer ihinnci described m va*e V I he novel nf symptom* ncvnncil with severe headache nn Mnn ila> utternoon A tew hmn* later he h.-gan in vnmii. He became incniull* ennliiM'il. re*llc**. and then ih*nilenieil. Iheie w.i* progressive dimming nt vision nn M.mduy night ami lue*da*. On admission tnihe hiKpital Wednesday mommy he w.i* nnahle in petci'ivc liyht. I he enniimetiva* were slightly mKiial. `I he pupil* were widely ami equally diluted and did not react to light. On (unduscnpte examination thete was *hyht edema ol the retina* at the periphery nf both upiic disk* and macula*. I he caihnn dioxide eapaetty nl the plavma wa* Mm vol. . the concentra tion nl chloride* wa* Ml* mu. per ItMt ce.. and the blond had a pH nf 7.M. I he result* nf ie*i% nf hvet function weic within normal Itmii*. I he henmiiram wa* normal The urine hail a pit nf h. and a trace of alhttmtn wa* found. Iheie were no ca*t* in the sediment and nn reducing *oh*iancc* by die Henediei ie*i. Sodium bicarbonate wa* administered intravenously over a pen.'.I nf 12 hoot*, with considerable clinical improvement. H> the third hospital das the patient was lully nrtenteil I here was no light perception by the right eye and only slight perception by the left. I he right pupil wa* lived, and the left reacted sluggishly to light; he wa* unable to converge I he fundi weic unchanged. An clcciincaidingram on the fourth hospital da* had a I wave of low collage in leads 1 and 2. with inversion of the I wave in lead* \. V. V. V.. interpreted a* indicating nonspecific noncardial damage. A needle hinp%y of the liv'ei w.i* taken on the sixth hospital day. nine day* alter mgv*iun of the alcohol. I hi* wa* reported a* bowing a few foci ol nonspecific liver cell necrosis. *1 he patient was discharged on the ninth hospital day. On examination tise week* later hi* vision was 3/21KI in each eye. He wa* barely able to hnd hi* way through door* ami to avoid large object*. I here wa* now pronounced optic atrophy with deep cupping of hoih disk*. ( 4*i 7.-- \ Negro laborer, aged M. wa* brought to the ( in* ctnn.iti (icncf.il Hospital receiving ward because of the sudden onset of hi** nf vision, lie stated that he had been in good health until the da* before, when he had nausea, fever, chills, weaknc**. Iighiheadeiiness. excessive thirst. anil mild shortness of breath tin exertion. On wakening the following morning he was unable to perceive light with the left eve and only puriiull* with the right. While the other symptom* improved during the next 4K hour*, he gradual!* lost remaining vtsiun in the right eye. He was admitted to the hospital for study eight duv* alter the onset of symptom*. Me wa* now able to perceive light lor the hr*t lime in four day* I he pupil* were equal, markedly dilated and dal not react to light oi .isCommoO.tiion I he ovtdur lundi were of normal appearance | he patient ul lir*l denied the ingc'iion ol methanol or an* other unusual substance, bin stated lhai tic ofien drank whiskv over week end*, orthnanlv *'X" ht.ind. and had last tt.ul a think two day* before the on*ci ol svntptom* He had been cmploved for l< vear* in the opeiation tf a wash tank in which used metal drum* were dipped m scwhum hvdioxtdc a* a lu* step m ie*ondtturning I he drum* were received from local industrial plant* and usually had contained *omc *hcmu\il eompooml I ighi othei men engaged in the same work app.oentiv were in good health I he manager reported that, while it wa* strict!* against plant rule*, it wa* common practice for workmen to drain the resid uum from drum* that had an alcoholic odor I he paiicm w,* l.i*i observed to do thi* one month bcliuc the un*et ol illne** when he Idled a bottle from a drum and drank j portion ol r. Near ihi* man* work station at the plant un empi* whisky bottle labeled "X** brand wm* found O.CI u (H-ru.l Ilf i: mnnth. there '* |ruiliul imnrnvcmcnl nf \i.ii.il .icuity lo maximum iineorreeteii vi.mn nf -0/Yu rtfhi e>e jnJ 4/IIKI left eye. niih riMilu.it evkirn-c nl optic .trophy mure m.nCeil on the left .nle Methanol poisoning urixing out of industrial exposure is xccondarx in importance to that due lo mgexiion of iidullcralcd liquors A few validated eii'Cx of poisoning nl workmen following the inhalation of the vapor of methanol or ahxorplion of the liquid through the skin have been reported, liven some of these hear the suspi cion that the solvent nta) have been ingested as well. 'I he chief danger of its use in industry still is the tempta tion to drink it. The cases described here, while not compcnsahlc as being due lo occupational disease or injury, might have been prevented by closer control of solvent handhng. T he two unrelated episodes of typical methanol poisoning with blindness in men engaged in the recon ditioning of metal drums have led me to regard the dis order as an unusual risk of this occupation, related to the temptation to drink from chemical containers that have the odor of alcohol. In all cases of Monday morning blindness Saturday night drinking habits should he con* sidcrcd and industrial sources of methanol investigated. Sl'MMAHY There is danger in the handling of ull solvents, ulthough lire and explosion arc feared more commonly than arc hazards to health. T he selection of a solvent for a specific industrial use is a compromise between tech nological requirements and considerations of safety. Significant absorption of organic solvents by workmen max occur as a result of cither one of two errors: the acceptance of inexcusably careless handling of com pounds ol relatively low toxicity or the provision of inadequate control measures in dealing with more toxic ones. Instances of pulmonary edema following exposure lo methylene chloride and of ucutc hepatitis in a man exposed to tctrachlorocthxlcnc are described as examples of the first type of error. The second is illustrated hy the report of cases of illness due lo exposure to the vapor of carbon tetrachloride and blindness Irani the ingestion ol methanol obtained at work. i ilcn and Hcihcsdu Avc* (IVi. Ihr biological Approach lo Immunity.--In world that i* full of microorganism* capable of infecting living t**uc*. it i> i positive necessity for survival that most experiences of infection by .m\ given microbe should be followed ltr*i by recovery and secondly hy persisting insusceptibility to an attack of the same d*e.t*e 1`erh.ip* the important factor m the development of the particular type* of immune region with which we arc I.imdiar m man w.i* the evolution ol hi* mammalian ancestor* tm the mo*i p.m a* relatively solitary arboreal animal* in uopiv.il jungle* In *och environment* it *ccm* likely that the major type of pathogen ih.o would be encountered would he iho*e protozoa und *`iru*c* spread by m*eei--especially mosquito -- vector* li i* not improbable that the type of immunity chtirac* ten*uv of human being* i* c**cniiulty something evolved to deal clUvi.vely wiih intecuon by mo*quiinborne viro*c* of the ycliow-icvcr typv Ai lcu*i we can be *urc that immunity i* a me*nam*m that ha* been evolved to deaf with the entry of foicign murooig.intsm*. mio the body, and lhai it ha* been perfected bs ihe normal prove** of selective survival--Sir Macfarlanc Hornet. M IT. 1 he Newer Approach to Immunity n |i* Hcjnng on Medicine and Biology. zmW> Mriht nl Journal. July N. IVSj APC 001318 J. T. HOBBS INDUSTRIAL HYGIENE COMMITTEE ALCOA FABRICATING PLANTS COPY April 27, 1^55 to: DR. LESTER V. CRALIEY INDUSTRIAL HYGIENE DEPARTMENT PITTSBURGH Re: CONTROLLED ATMOSPHERE GENERATING UNITS Not long ago we had an unfortunate experience at the Alcoa North Plant which could have had serious consequences. *<e felt that it would be worthwhile tc give you a general account of the incident in the hope that the information might be of benefit to other plants. Two brick masons entered the combustion chamber of a controlled atmosphere generating unit to make repairs. They did not open all available ventilating parts or provide any forced ventilation of the chamber. The men were overcome presumably by residual CO or CO2 gases. Luckily, both were removed from the chamber quickly and given treatment at first aid. Henceforth, at Alcoa no one will enter these chambers without opening all parts and providing forced circulation. An attendant viill always be on hand outside the chamber to provide immediate aid if necessary. Best personal regards JTH:MP 'J. T. HOBBS APC 001319 Sound Pressure - D ecibels APC 001320 DAMAGE RISK CRITERIA AND ITS MODIFICATIONS BY PROTECTIVE DEVICES (von Olerke, "Personal Protection." A.I,H.A.Quart. 15, #1, 44, Mar.1954)