Document gbbn1441zkORyB580qz4YoE6e

Legal Section Industrial Commission of Ohio 246 North High Street Columbus, Ohio 43215 RE: OD 24357-22 Richard Charlton U.S. Steel Corp. Lorain, Ohio Attention: Ms. Judy Spencer Dear Ms. Spencer, Per a telephone conversation, on February 13, 1986, contact was made with officials at the U.S. Steel Corporation (Pittsburgh), in an effort to determine whether the claimant's occupational exposures could have contributed, aggravated, and/or caused his medically diagnosed condition. The claimant has been diagnosed as having: 1) Chronic obstructive pulmonary disease (COPD). 2) Chronic bronchitis; acute exacerbation-hemoptysis. 3) Positive PPD skin test. The claimant originally worked at the McDonald. Ohio facility of U.S. Steel Corp. When the plant was closed down in March of 1981, the claimant wa3 transfered to the Lorain, Ohio facility, where he completed his tenure at U.S. Steel. The following account of the claimant's work history at U.S. Steel was extrapolated from medical records located at the Pittsburgh corporate offices: 1953 1961 1976 1977 1981 1982 1983 Labor tr - Truck Driver Laborer - Truck Driver - McDonald plant - closes, claimant goes to Lorain. - Layedoff - Retired Slag Dept. Slag Dept. Slag Dept. Slag Dept. Blast Furnace Oper. y lustrial Commission of Ohio Division of Safety and Hygiene 246 N. High St Columbus, Ohio 43215 F. Celeste, Governor * Leonard T. Lancaster, Industrial Commission Chairman Emory Hugusist. Vies Chairman OsorgeC. Smith III, Member A. Connor, Member s Robert L McAfllstar. Member John A. Pomps*. Safety and Hygiene Superintendent Lou Gergj.'y, Assistant Superintendent Richard Charlton - OD 24357-22 Page 2 n summary, the claimant worked approximately 24 years in he "Slag Dept. " of the McDonald plant and 1 year as a Blast Furnace Oper." at the Lorain facility. Slag is a complex mixture of side products, and :onsists of wastes resulting from the smelting of metals and iHoys. After haLdening, it assumes a stony or glassy ippearance and is characterized by its relatively low tpecific gravity (generally 2 to 4). Slag is formed from ihe dirt of ores and their concentrates, from fluxes added m smelting operations, from substances formed by the sorrosion of the refractory lining of smelting furnaces, and Trom fly ash. The processing of slag entails a number of operations /hich are fraught with health hazards. Slag in the molten itate is a source of intense heat, infrared radiation, and (ases (sulfur dioxide and carbon monoxide). Slag in the solid state is capable of producing a considerable amount of lust; this is liable to arise in particular during crushing, transport and packaging, as well as during the grinding of facing slabs and the production of mineral wool. The dust formed by basic slag has irritant properties /arying in intensity according to the amount of free alkali contained in it. Bessemer converted slag has the most pronounced pathogenic effect. It can cause sever pneumonia, accompanied by spasmodic coughing fits and not infrequently by haemoptysis, dyspnoea, prostration, fainting, and albuminuria. Prospects of recovery are poor, and 5095 of cases are fatal. Excessive fatigue, alcoholism and infectious diseases are predisposing factors for the development of such pneumonia. Moderate pneumoconiosis, which is fairly frequently observed amoung workers exposed to the effects of slag dust, is also regarded by seme specialists as a further predisposing factor. (1) It was noted from a past medical history report dated 3-27-85, contained in the facsimile file, that the claimant had pneumonia approximately nine years prior. The claimant apparently came down with pneumonia in 1976 during the latter part of his tenure in the "Slag" department at the McDonald plant. It is impossible to assess the exact work conditions experienced by the claimant at the McDonald Steel Works facility, because it is no longer in operation. This is unfortunate, due to the fact that approximately 24 years of the claimant'r working life was spent at the McDonald facility. It is obvious that the exposures experienced there, would be "most" significant in attempting to determine a causal relationship. The exposures experienced at the Lorain facility, because they occured in the latter part of the claimant's work history, are not-highly 3 Hichard Charlton - OD 24357-22 Page 3 significant in regard to their overall contribution to the "chronic" diability experienced by the claimant. The characteristic pathological features of bronchitis were first described by Reid and consist of an increase in the mucus-secreting glands of the airways. In the human it is the mucous secreting glands of the large airways that are mostly responsible for mucous secretion and that are predominantly involved in bronchitis. It is now clear that mucous gland hypertrophy occurs as a result of any chronic irritant effect on the airways and that cigarette smoke, dust, and air pollutants, such as sulfur dioxide, ozone, and ammonia, not to mention particulate matter, can all act as the inciting factor. The heavier and the longer the period of exposure, the greater the likelihood of developing bronchitis. In trying to study the effects and frequency of bronchitis in a working population, it becomes evident that there are two important confounding factors, namely, cigarette smoking and age. In smokers, cigarette smoking completely overshadows the effects of dust and air pollutants. Numerous Investigations have shown that the continued inhalation of dust leads to the development of bronchitis as manifested by chronic cough and sputum. Over the past several years a definite relationship between the prevalence of these symptoms and the level of dust exposure has been demonstrated both in coul miners and in South African gold miners. It become difficult, however, to separate the effects of cigarette smoking and dust in cigarette smokers, since the effects of smoking overwhelm those of dust. For the most part it is possible to detect the consequences of dust exposure only in nonsraokers, although in some studios cigarette smoking and dust appear to have had a synergistic effect. (2) It is important to note, according to medical records at the Pittsbugh facility, that the claimant smoked cigarettes for approximately 28 years. An evaluation form filled out by the claimant references the fact that he started smoking at the age of 19 years (1953) and quite in December of 1981. The form further states that the claimant smoked on the average one half a pack of cigarettes per day. By far the most potent factor, though not the only one, causing chronic bronchitis, is cigarette smoking. There is suprisingly modest support for the concept that industrial dust or irritating fumes play ~ role in the development or aggravation of chronic bronchi . .< or emphysema. It is difficult to accept the belief that no role is played by these agents, particularly with respect to place of residence, medical care, and so on, and general air pollution overshadow any demonstrable strong influence of Y Bichard Charlton - OD 24357-22 Page 4 industrial dust, fumes, or gases. In studies in which these other factors are corrected for, there is some suggestion that occupational dust per se may contribute to chronic bronchitis, even though it is not the most potent factor.(3) Every detailed investigation of the symptoms of chronic bronchitis and some on the emphysematous lung have brought to light the harmful effect of smoking cigarettes. A graded relationship between the intensity of smoking and the prevalence of disease has been observed. Although occupation makes a contribution to the initiatlion, progression, and outcome of chronic bronchitis, its contribution is very small compared to the effects of smoking. (4) Chronic bronchitis may occur after repeated exposure to chemical irritants. Usually, however, the underlying cause is cigarette smoking. (5) In summary, the claimant worked approximately 24 years at the McDonald Steel Works facility, primarily in the''Slag" department. The claimant was known to have had pneumonia, which is a potential result of slag dust exposure. It is well documented that long term inhalation of dusts can cause chronic bronohitis (a type of chronic obstructive pulmonary disease - COPD) with cough and sputum production similar to what the claimant is experiencing. The causal relationship, however, is complicated with the claimant's relatively long history of cigarette smoking, which is well known for its contribution in the development of chronic bronchitis. The claimant's occupational dust exposures could have contributed to the development of chronic bronchitis, however, his history of cigarette smoking, as referenced amoung many literary sources, would appear to be the most potent contibuting factor. The existence of a cause-effot relationship between the claimant's occupational exposures and his medical disability is questionable. Respectfully submitted. Marc L. Corbett Industrial Hygienist Richard Charlton - OD 24357-22 Page 5 REFERENCES l- EncyelQEaadia Sit Occupational. Health and. Safety. International Labour Office Geneva, 1983. p. 2061. 2. Occupational Lung Diseases. Morgan and Seaton, Second Edition, W. B. Saunders Company, 1984, pp. 521-537. 3. Volume I, General Principles^ Patty*s Industrial Hygiene and Toxicology. J. Wiley and Sons, 1978, p. 193. 4. Encyclopedia of Occupational.Health and Safety international Labour Office. McGraw-Hill, 1974, pp. 331-334. 5. Chemigal._Haaards ot the ..Workplace, N.H. Proctor. Ph.D., J.P. Hughes, M.D., J.P. Lippincott Company, 1978, p. 74. ^ RECORDS CERTIFICATION ! undersigned, an employee of the Bureau of Workers' Compensation, eby certify that the microfilm images on this reel of microfilm rofiche are complete and accurate reproductions of the original ! of the __________ S..*.// __ as accumulated during the course of business, and that it is the established procedure department to microfilm its records for permanent file and to of the original records after microfilm reproductions have -/ Oate U