Document jNBq3k4zNn3rQM4ZjerJ8ZXVy

ST 0852907 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE By RUTHERFORD T. JOHNSTONE, A.B., M.D. Consultant in Industrial Health; Lecturer at the University of California, Los Angeles Formerly Assistant Professor of Medicine, University of Pittsburgh School of Medicine; Formerly Director of Department of Occupational Diseases, Golden State Hospital With One Hundred Seventeen Illustrations Seven in Color St. Louis THE C. V. MOSBY COMPANY 1948 ST0852908 Copyright, 1948, By The C. V. Mosby Company (All rights reserved)' Printed in the United State* of America Press of The C. V. Mosby Company St. Louis ST 08 52909 PREFACE Unlike the words which preface most books, these few constitute the epilogue rather than the prologue. They are written in retrospection of a Completed task and at its end the author finds himself asking, cut bono? Will this book be looked upon as a collection of cold medical data or will he who reads it sense in it the poetry and romance of occupational medi cine; will he recognize the story of great achievements, and the challenge to come into the arena where the fight is still on to make the life of those who toil worth living ? Will this book be able to define for the student, for the medical educator, and for a considerably large segment of the medical profes sion the true meaning of occupational medicine? Will the following pages be able to convey to the reader that occupational medicine is that phase of practice which is concerned with the working and living habits of the worker as well as with the physical conditions under which he works and lives? Will it be apparent to the medical profession that when the doctor offers and industry accepts an adequate industrial health program, the great mass of American citizens will never tolerate the political administration and control of their health? These and other questions crowd the mind as the ink dries on the last page. Although occupational medicine has been designated in recent years as a specialty, it is by no means a restricted specialism. If properly practiced, it approaches a return to the intimate concern of a physician for his patient, so nobly exemplified by the old family doctor. In this respect occupational medicine stands in sharp contrast to the limited specialties in medicine. For occupational medicine is not interested in the patient's eyes alone, or his allergy, or his heart. It is interested in man and all that aids or hinders his welfare. In the rise of preventive medicine, occupational medicine has assumed the foremost role. For too many years it was believed that it is the purpose of pre ventive medicine to eliminate diseases. But occupational medicine rec ognizes that man's health and happiness are affected by many other factors such as nutrition, mental hygiene, housing, sanitation, recreation, noise, vibration, lighting, ventilation, atmospheric pressure, climatic changes, and a myriad of other influences. To the untutored, many of these subjects would appear to belong in the field of engineering, but such an assumption is far from the truth. Any engineering plans designed to benefit mankind must take into consideration the nature of the human organism. Likewise the physician needs to know more about engineering principles and control measures before he assumes the guidance of men's lives toward comfort and health. Surely no other 7 ST08529 I 0 phase of medicine undertakes such a gamut of activities as does occu pational medicine. In thumbing through the copy of this book, the original pages having been sent to the publisher, we realize that there have been certain omissions. Critics will wonder why the subjects of nutrition, or aviation medicine, or industrial nursing, to mention a few, have not been discussed. The answer is that these problems warrant textbooks of their own. To offset any remorse in this regard the author is comforted by the fact that he has adequately combined the clinical aspects of the occupational diseases with a description of industrial processes, their appraisal and control. He feels that within these pages will be found not only his personal experience, but also material which the average physician will seek in vain in his textbooks. To whom am I indebted? To too many individuals who must remain nameless. I am forever grateful to the pioneers in this field, the magni tude of whose labor I cannot forget. Because of their work, occupational medicine runs in'forger molds and turns out finer castings. Many of these have been pioneers in this field and are still active leaders; not a few of them are fellow members of the Ramazzini Society of America. To W. B. Saunders Company I am indebted for permission to use certain materials extracted from a prior book of mine, and to the entire staff of The C. V. Mosby Company for their excellent cooperation in this present publication. Then there are those more intimate associates. I am grateful to Lee Stockwell, my faithful secretary of ten years, who did double duty while this book was being written; to Susan Engreen, for her meticulous edit ing and preparing of this manuscript; and finally to a most tolerant wife who accepted graciously the impositions that were involved in her husband's proclivities for writing. ' Nor should the reader be ignored in this acknowledgement. The usefulness of what has been written in these pages is dependent upon him. His application of the principles outlined in this book should further the objective to which it is dedicated. `The knowledge which a man can use is the only real knowledge, the only knowledge which has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain or dries like rain drops off the stones." Los Angeles, Calif. Rutherford T. Johnstone 8 ST08529II CONTENTS PART ONE CHAPTER I Tomorrow's Doctors (Thb Background and the Future of Industrial Medicine) ............................... Page 17 CHAPTER II Industrial Medicine and Workmen's Compensation.......................................... 25 Personal Injury, 29; By Accident, 29; Arising Out of and in the Course of Employment, 29; In the Course of Employment, 30. CHAPTER III The Need of Scientific Proof in Medicoleoal Controversy............................. 54 CHAPTER IV Functions of the Industrial Physician.............................................................. 57 CHAPTER V The Teaching of Industrial Medicine.................................................................. 69 CHAPTER VI The Basic Approach to a Diagnosis of Occupational Disease......................... 75 CHAPTER VII . Laboratory Procedures of Value in the Diagnosis of the Occupational Diseases ........................................................................ 9 81 ST08529I2 CONTENTS PART TWO CHAPTER VIII Page The Industrial Solvents.......................................................................................... 87 Saturated and Unsaturated Compounds; 90; Chains and Rings of Atoms, 90; The Aliphatic Compounds, 91; The Aromatic Compounds, 91; The Alcohols, 92; The Aldehydes, 92; Acids and Esters, 92. CHAPTER IX Thb Aliphatic Htdrocarbons.................................................................................. Petroleum Series, 99; Gasoline, 100; Occupational Exposures, 100: Path ology, 100; Signs and Symptoms, 100; Laboratory Findings, 101; Dis ability, 101; Treatment, 102; Illustrative Cases, 103; Tetraethyl Lead, 106; Toxicity, 106; Pathology, 107; Symptoms and Signs, 107; Prodromal Period, 107; Physical Examination, 107; Complications, Sequelae, and Convalescence, 107. 99 CHAPTER X The Aliphatic Hydrocarbons--Cont'd.................................................................. 109 The Alcohols, 109; Methyl Alcohol, 109; Ethyl Alcohol, 110; Propyl Al cohol, 110; Butyl Alcohol, 110; Amyl Alcohol, 111; Treatment. Ill; The Glycols, 112; The Aldehydes, 114; Occupational Exposures. 114; Prophy laxis of Formaldehyde Poisoning, 115; Treatment of Formaldehyde Poison ing, 115; The Ketones, 115; The Aliphatic Acids, 116. CHAPTER XI The Aliphatic Hydrocarbons--Cont'd............... 118 The Aliphatic Oxides, 118; Carbon Monoxide, 118; Properties, 118; Occu pational Hazards. 118; Pathology, 118; Diagnosis, 120; Differential Diag nosis, 124; Sequelae of Acute Carbon Monoxide Poisoning, 124; Treatment, 127; Carbon Dioxide, COj, 130; Carbon Oxychloride, COCI2. 130; Aliphatic Nitrile Compounds, 130; Pathology and Physiology. 130; Signs and Symp toms, 131; Tests, 132; Medicolegal Aspects, 132; Treatment, 133; Discus sion, 135. CHAPTER XII The Haloobnated Hydrocarbons............................................................................. 13(5 Methyl Bromide, 136; Properties, 136; Tests, 136; Pathology, 136; Signs and Symptoms, 139; Disability, 139; Prevention, 140; Treatment, 141; Case Histories, 141; Methyl Chloride (CHjCl), 142; Properties, 142; Pathology, 142; Signs and Symptoms, 142; Tests, 143; Medicolegal Aspects, 143; Treat ment, 143; Illustrative Cases, 143; Dichlorodifluoromethane (CCI3F2), 144; Dichloroethane (CH2CI-CH2CI), 144; Ethylene Chlorohydrin (CH2CICH2-OH), 144. 10 CONTENTS ST08529I 3 CHAPTER XHI Page Thb Chlorinated Hydrocarbons............................................................................... 147 Carbon Tetrachloride (CCL) (Tetrachloromethane). 148: Occupational Uaea, 148: Pathology. 148; Sign* and Symptom, 148; Laboratory'Testa, 150; Possible Disability, 151; Treatment, lUi Preface to Case Histories, 154; Comment, 156; Trichlorethylene (CHClCClj), 158; Pathology, 158; Signs and Symptoms, 159; Laboratory Tests, 160; Possible Disability, 160; Treatment, 160; Tetrachlorethane (CHChCHClj), 162. CHAPTER XIV Chlorinated Naphthalenes and Diphenyls........................................................ 165 Occupational Exposure, 165; Pathology, 165; Signs and Symptoms, 166; Laboratory Tests, 166; Disability, 166; Treatment, 166; Naphthalene, 169. CHAPTER XV Miscellaneous Aliphatic Compounds........ -......................................................... 171 Carbon Disulfide, 171; Occupational Hazards. 171; Resume of Group Stndy, 171; Pathology, 172; Signs and Symptoms, 174; Differential Diagnosis, 176; Medicolegal Aspects, 178; Treatment, 178; Case History, 179; Sulfur Com pounds, 179; Hydrogen Sulfide, 179; Occupational Hazards, 179; Path ology, 180; Signs and Symptoms, 180; Medicolegal Aspects, 180; Treat ment, 180; Sulfur Dioxide, 182; Occupational Exposure, 182; Signs and Symptoms, 182; Medicolegal Aspects, 182; Treatment, 183; Illustrative Cases, 183. CHAPTER XVI Halogens and Halogen Compounds........................................................................ 185 Chlorine, 185: Signs and Symptoms, 185; Treatment, 185; Fluorine, 186; Hydrogen Chloride, 187; Hydrogen Fluoride, 187; Case Report, 189. CHAPTER XVII The Aromatic Hydrocarbons.................................................................................... 190 Benzol, 190; Occupational Exposure, 190; Pathology, 190; Blood Picture, 193; The "Latent Period" of Benzol Poisoning, 200; Summary, 201; Signs and Symptoms, 201; Laboratory Tests, 202; Possible Disability, 202; Treat ment, 202; Case Histories, 204; Toluene, 205; Xylol, 208; Solvent Naphtha, 208; Trinitrotoluene, 208; Laboratory Tests, 210; Treatment, 211; Case History, 211; Tetryl, 214; Nitrobenzene, 214; Aniline, 215; Phenol, 215. CHAPTER XVIII The Oxides of Nitrogen ......................................................................................... 218 Occupational Exposure, 218; Pathology, 218; Signs and Symptoms, 219; Treatment, 220; Case Histories, 221; Ammonia, 221; Signs and Symptoms, 222; Medicolegal Aspects, 222; Treatment, 222; Case History, 223, 11 ST08529I4 CONTENTS CHAPTER XIX Page DDT (2,2-Bis- ( P-Chlorophen yl) -1,1 ,1-Trichloroethane) , 2,4-Dichlorophenoxy Acetic Acid, and Thioglycolic Acid and Thioolycolatks........ 224 DDT or 2,2-bis-(P-Chlorophenyl)-1,1,1-TrichIoroethane, 224; 2,4-Dichlorophenoxy Acetic Acid, 228; Thioglycolic Acid and Thioglycolates, 2S1. PART THREE THE METALS CHAPTER XX Lkad ......................................................................................................................................... 234 Occupational Exposure, 234; Absorption and Excretion of Lead, 234; The Fate of Lead in the Body. 235; Pathology, 236; Signs and Symptoms, 240; The Basis for Diagnosis, 249; Differential Diagnosis, 250; Sequelae of Lead Poisoning, 251; Treatment, 253; Treatment in Lead Palsy, 257; Treatment in Lead Encephalopathy, 257; Prophylaxis, 257; Case Histories, 258. CHAPTER XXI Cadmium ............................. ....................................................................................... 265 Occupational Exposure, 265; Pathology, 265; Signs and Symptoms, 266; Laboratory Tests, 266; Disability, 266; Treatment, 267; Inhalations, 267; Case Histories, 268. CHAPTER XXII Beryllium ............................................................................................................................ 277 Occupational Exposure, 277; Etiology, 278; Pathology, 278; X-Ray Find ings, 281; Signs and Symptoms, 284; Differential Diagnosis, 284; Treat ment, 284; Case History, 284. CHAPTER XXIII' Arsenic ...................................................................................................................... 289 Occupational Hazards, 289; Pathology, 289; General Discussion, 289; Arsine or Hydrogen Arsenide, 291; Differential Diagnosis, 292; Tests, 292; Medicolegal Aspects, 292; Treatment, 292. CHAPTER XXIV Manganese, Magnesium, Phosphorus, Antimony, and Zinc............................ 295 Manganese, 295; Occupational Exposure, 295; Pathology, 295; Effect on Blood, 297; Absorption and Elimination of Manganese, 297; Signs and Symptoms, 298; Differential Diagnosis, 298; Tests, 298; Treatment, 299; Magnesium, 302; Occupational Exposure, 302; Pathology, 302; Treatment, 304; Phosphorus, 304; Antimony, 306; Occupational Exposure, 306; Path ology, 306; Zinc, 307; Chronic Poisoning, 307; Medicolegal Aspects, 308; Treatment, 308; Zinc Chloride Burns, 308. 12 CONTENTS ST08529I5 CHAPTER XXV Page Mercury, Chromium, Copper, and Aluminum....................................................... 310 Mercury, 310; Occupational Exposure, 310; Pathology, 310; Signs and Symptoms, 310; Laboratory Tests, 311; Treatment, 311; Case Histories, 3l2; Chromium, 314; Occupational Hazards, 314; Signs and Symptoms, 314; Medicolegal Aspects, 315; Treatment, 315; Copper, 316; Aluminum, 316. CHAPTER XXVI Sblbnium, Tellurium, Vanadium, and Radium..................................................... 317 Selenium, 317; Occupational Exposure, 317; Pathology, 317; Signs and Symptoms, 317; Treatment, 319; Tellurium, 321; Occupational Exposure, 321; Pathology, 321; Vanadium, 322; Vanadium Pentoxide as Toxic Prod uct, 322; Signs and Symptoms, 323; Radium, 323; Alpha-Rays, 324; BetaRays, 324; Gamma-Rays, 325; Pathology, 325; Signs and Symptoms, 325; Treatment, 325. CHAPTER XXVII -Metal Fume Fever....................................................................................... 329 Pathology, 329; Immunity, 329; Signs and Symptoms, 329; Medicolegal Aspects, 330; Treatment, 330. PART FOUR THE DUSTS CHAPTER XXVIII Silicosis ............................. .......................................................................................... 333 Silica in Industries, 333; Asbestos and Talc, 334; Mica, 335; Sodium Silicate, 335; Silica Gel, 335; Lime-Soda Glass, 335; Definition of Silicosis, 336; Size of the Dust Particle, 336; Permissible Concentrations, 336; Length of Exposure, 337; Diagnosis, 337; Signs and Symptoms, 337; Path ology, 342; Spread of Fibrosis, 342; Alveolar Consolidation, 343; Produc tion of Dyspnea, 344; Silico-Tuberculosis, 344; Other Complications, 345; Additional Aids in Diagnosis, 346; Disability, 346; Employability of the Person With Silicosis, 351; Treatment, 352; Results of Treatment, 353; Case Reports, 355; Chemistry of Minerals, 357. CHAPTER XXIX Anthracosilicosis ...................................................................................................... 361 fadings in Governmental Survey, 361; Symptoms, 361; Basis of Diagnosis, 361; Groups Studied, 362; Prevalence and Exposure, 362; Safe Limits of Exposure, 363; Respiratory Disease, 363; Signs and Symptoms, 364; Path ology, 364; X-Ray Findings, 366; Medicolegal Aspects, 367. 13 CONTENTS CHAPTER XXX Page Asbestoses 368 Signs and Symptoms, 368; Pathology, 368; Action of Asbestos and Silica, 368; Microscopic Appearance, 372; X-Ray Findings, 372; Medicolegal Aspects, 372. CHAPTER XXXI Siuciovs Dusts of Undetermined Pathologic Status Talc, 373; Bauxite, 375; Diatomaceous Earth, 382; Tripoli, 384. 373 CHAPTER XXXII Tub Inert Dusts 386 Siderosis, 387; Byssinosis, 389; Cement Dust, 394; Calcium and Magnesium Carbonates, 396; Carbon Dust, 396; Tobacco Dust, 396; Mill Dust, 396; Discharge of Dust Into Air, 396; Grain or Malt Fever, 397; Mica Dust, 398. CHAPTER XXXIII Tuberculosis and Pneumonia in Industry 402 Respiratory Irritants: Dusts, Fumes, Gases, 403; Lead Absorption Versus Tuberculosis, 405; Temperature and Humidity Versus Tuberculosis, 406; Tuberculosis Among Steel Plant Workers, 406; Tuberculosis in the Foun dry Industry, 407; Tuberculosis in Granite and Marble Workers, 407; Tuberculosis in Hard Rock Miners, 408; Fatigue as a Factor in Industrial Tuberculosis, 408; Summary, 409; Industrial Environment and Pneumonia, 411. CHAPTER XXXIV The Dermatoses 413 Occupational Hazards, 413; Definition, 413; General Considerations of Etiology, 413; Diagnosis, 414; Epidermophytosis, 419; Infectious Ecze- matoid Dermatitis, 420; Turpentine Dermatitis, 421; Baker's Dermatitis, 421; Cosmetician's and Barber's Dermatitis. 423; Cement Dermatitis, 423; Dermatitis Artefacts, 424; Onychia, 426; Syphilis, 426; Medicolegal Aspects, 427; Treatment. 427; Infectious Eczematoid Dermatitis, 432. CHAPTER XXXV Oxygen Therapy in Occupational Medicine 14 434 CONTENTS ST0852917 CHAPTER XXXVI I'llgl! Synthetics ................................................................................................................ 43K Synthetic Rubber, 438; Synthetic Fibers, 444; Rayon, 446; Nylon, 448; Cellophane, Sealing Caps, 450; Cellulose Sponge, 450; The Plastics, 451; Thermosetting Resins, 452; Phenolic Resins, 452; Urea-Formaldehyde Resins, 453; Melamine Resins, 453; Alkyd Resins, 454; Thermoplastics Based on Cellulose, 454; Cellulose Ester Plastics, 454; Cellulose Acetate, 455; Ethyl Cellulose Plastics, 455; Thermoplastic Resins, 456; Acrylic Resins, 456; Vinyl Tfesins, 457; Vinyl Alcohol and Acetal Resins, 457; 'Viayiidehe"Chloride Resins, 457; Styrene Resins, 458; Protein Plastics, dol bn*45f Plistics, 458. CHAPTER XXXVII Special Industrial Processes................................................................................... 461 Electroplating, 461; Anodic Treatment, 465; Degreasing, 467; Recom mendations, 471; Pickling, 472; Heat Treatment, 473; Sand Blasting, 475; Shot Blasting, 476; Tumbling, 476; Casting (Molding), 477; The Ceramic and Pottery Processes, 477; Diesel Engines, 478; The Fluorescent Lamp Process, 479; Storage Battery Manufacturing Operations, 479; Welding, 481; Oxyacetylene Welding, 481; The Oxyacetylene Flame, 482; Electric Arc Welding, 484; The Metallic Arc Process, 485; Shielded and Unshielded Arc Welding Processes, 485; Electric Resistance Welding, 486; Hazards of Welding, 488; Composition of Welding Rods, 489; Metallizing, 490. CHAPTER XXXVIII Industrial Hygiene--General ............................................................................... 493 General Plant Hygiene, 494; Plant Lighting, 495; Natural Lighting, 495; Artificial Lighting, 496; Functional Use of Color, 499; Explosion Hazards of Dusts, Gases, and Vapors, 500; Gases, Vapors, Liquids, 500; Respiratory Protection, 502; Gas Masks and Cartridge Respirators, 503; Filter Respira tors, 504; Care of Equipment, 505; Respirators With Impervious Clothing, 505; Hose Masks, 505; Abrasive Blasting Protectors, 506; Oxygen Breathing Apparatus, 506; Air-Line Respirators, 507; Cleaning and Maintenance of Respiratory Devices, 508; Eye and Face Protection, 509; Impact Goggles, 509; Corrective Goggles, 510; Face Shields, 511; Acid Hoods, 511; Chem ical Goggles, 512; Welding and Babbitting Masks, 512; Harmful Rays, 512; Preventing Skin Infections, 515; Skin Cleansers, 516; Cutting Oils, 516; Safety Clothing, 516. CHAPTER XXXIX Industrial Hygiene--General--Cont'd................................................................. 517 - Control of Hazards, 517; Manner and Method of Exhausting, 518; Hoods, 520; Large Open Hoods, 520; Lateral Exhaust System, 521; Flexible Ex haust System, 521; Spray Booths, 521; Protection Against Corrosion, 522; Application and Design of Duct Exhaust Systems, 523; Duct Sizes, 527; Transport Velocities, 529; Conveying Capacity of Ducts, 529; Construc tion, 530. 15 CONTENTS ST08529I 8 CHAPTER XL Page Industrial Hygiene--General--Cont'd............................................................... 531 Appraisal of Hazards, 531; Dust Collection and Analysis, 531. CHAPTER XLI Pre-Employment Examinations and the Placement Program........................ 542 The Job Placement Program, 544: Elements in Successful Placement, 546; Evaluating the Worker, 547; Evaluating the Job, 548; Psychiatry and Job Placement, 552. APPENDIX The Chemicals in Common Trade-Name Products............................................. 555 ILLUSTRATIONS IN COLOR Fig. Page 23. Bone marrow (femoral) (Photomicrograph) ............................................. 198 24. Spleen (Photomicrograph) ........................................................................... 198 25. Spleen (Photomicrograph) ........................................................................... 198 26. Spleen (Photomicrograph) ....................................................................... . 198 27. Liver (Photomicrograph) ................................................................. 198 28. Lymph node (Photomicrograph) .................................. .......................... 198 29. Blood cells of anemia of lead poisoning.................................................... 238 1<> ST08522 c PART ONE CHAPTER I TOMORROW'S DOCTORS (The Background and the Future of Industrial Medicine) Suddenly, medicine has awakened to a fresh responsibility. In the dawn of a new day it sets forth along an untried highway into the future. In centuries past, medical science has been applied to the prevention or treatment of disease and to the relief of those who are ill. But the sorrows or troubles which arise from causes other than disease have received far too little attention. With man's emotions, with his need for happiness, for laughter, and for spaciousness, with the impor tance of comfort or the significance of a friendly helping hand it has rarely concerned itself. Out of a dilemma created by traditionalism, medical science is now faced for the first time with its social and economic obligations. This sudden confrontation was brought about by World War II, when it became apparent that man's industrial productivity is strictly related to his mental and physical well-being. This discovery was not made by medical men alone but was rather the joint observation by repre sentatives of industrial management as well as medicine. During the war years, industrial medicine was expanded to what was widely considered a fantastic if not a fanatic scope. Certainly not all the phases of a comprehensive program of industrial medicine can be considered as medicine in the traditional sense of the word. In the war-born expansion of this program industrial medicine emerged from its lifeless past, in which it had seemed to revolve in idle circles, to become a new force in the health of the American people. Today, industrial medicine has assumed a prominence equal to any other phase of medicine, and a broader type of medical practice can be expected to develop under its influence. But before scanning future horizons, let us look at the early history of industrial medicine. Contrary to common belief, industrial medicine is not young, for it had its inception in antiquity. To indicate its age, it is sufficient to mention only a few of the physicians in olden times who took cognizance of industrial diseases: Hippocrates described lead colic as well as the toxic properties of this metal. Galen cited diseases peculiar to miners, tanners, fullers, chemists, and others. In the Sallier Papyri one may read of the effects of certain occupations upon the Egyptians of an early day. Even a form of industrial hygiene was practiced by 17 ST 0852920 *8 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE the ancients, for Pliny the Elder writes that in certain dusty trades the workmen tied bladders over their mouths to prevent the inhalation of dust. Many of the earlier physicians, such as Agricola, Martial, Celsus, Dioscorides Pedanius, and Herodicus, have discussed the influence of their occupation upon the health of workers. But intriguing and romantic though its history may be, these pages are too limited to people them with all the important personages in the field of occupational medicine who have preceded our own generation. One name, however, cannot be passed over lightly, for it is more brilliant than all the others. In a century which gave us Newton, Galileo, Boyle, and their famous contemporaries Harvey, Malpighi, and van Leeuwenhoek, there was born in Capri, in 1633, the patron saint of industrial medicine, Bernardino Ramazzini. His ability to observe, investigate, and then to describe with a facile pen has been matched but rarely since his death in the year 1714. After being graduated from Parma in 1659, Ramazzini continued his studies at Rome under Professor Antonio Maria Rossi. Following this, he spent a short time practicing in Viterbo but contracted malaria, which induced him to return to his native Capri to regain his health, fn 1670 he moved to Modena, where he was appointed professor of medicine in the recently restored university of that city. For a few years his life was pleasant, but then there followed a succession of unfortunate clashes which precipitated a bitter struggle with his fellow practitioners. This discord gave rise to a vitriolic correspondence with his hostile confreres, but Ramazzini won this joust with his penetrating mind and easy pen. In reviewing the life of this man, one is amazed at the diversity of his interests, his immense capacity for work, and the variety of contributions which he made to medical literature. Of him Garrison 1 states: "He was a versatile polvhistorian, poet, philosopher, erudite clinician, epidemiologist, medical meteorologist and sanitarian." An enthusiastic modern admirer of Ramazzini is Robert T. Legge, of the University of California at Berkeley. Not content with an occasional collector's item, Dr. Legge has gone to Italy to tred the same ground, live in the same towns, and delve into the little old book shops to uncover some precious bits of Ramazzini lore. Writing of the recogni tion accorded Ramazzini, Legge slates: "Distinguished men of science and letters found their way to the ducal palace (Modena). Among these was the famous Baron Gottfried Wilhelm von Leibnitz, the German philosopher who paid many visits to Ramazzini, whom he recognized as a scholar and investigator. They discussed barometic and hydrostatic problems, a subject Ramazzini studied and experi mented with in relation to epidemics. Leibnitz was so impressed with his learning and publications, it is inferred, that he recommended tomorrow's doctors STQ85292I i Ramazzini to the president of the Viennese Academy of the Curiosi Naturae to be elected to its membership with the title of Hippo crates III." Other honors came to Ramazzini. Because of his learned disserta tion on "febris tertiana" he was elected a member of the Academie of Caesareo-Leopoldina at Vienna. He was invited to lecture at the University of Padua, where he made several noteworthy addresses. During his twenty-nine years at Modena he wrote a great number of treatises and books on a wide variety of subjects, but only one of these will be mentioned at this time; namely, De Morbis Artificum Diatriba (The Diseases of Workmen). Since Ramazzini was such a brilliant clinician and was so deeply concerned with a variety of diseases which were also of interest to other learned physicians of his day, one is forced to speculate as to what caused him to spend so much time in the study of the diseases of workmen. In that delightfully whimsical book called A Blind Hogs Acorns, McCord 3 suggests that during the years that Ramazzini was smarting under the barbs of his confreres he spent many hours among the more sympathetic craftsmen of his community. It was then that lie became interested in the occupation of well diggers. Not content with talking to these workers in their "off-work" hours, lie would himself descend into the wells, equipped with thermometer and barometer, to talk with the diggers, inquiring as to their health and what effect underground work had on them; he made observations on subterranean waters and on the characteristics of the antiquity in the different layers of the earth, their odors and gases. He also acquainted himself with the trades of silk workers, painters, dyers, glass makers, tanners, bakers, stone workers, metal workers, chemists, and others. All told, his famous book contains forty chapters dealing with the various diseases of working men. It is unfortunate that a selection of the classical descriptions which Ramazzini left for posterity cannot be reproduced in this chapter. Suffice it to state that there are many examples relating the signs and symptoms of such diseases as mercury poisoning or lead poisoning which are worthy of any modern textbook on the subject. For instance, of those who work with mercury, he says: "They become asthmatic, paralytic, and liable to vertigo, their complexion assuming a dangerous ghostly aspect . . . Few such workmen continue in that way to old age, for if they do not die while young they become miserable, their neck and hands tremble, their teeth fall out and their legs are weak and maul'd with scurvy." In addition to his classical description of the occupational diseases of his day, Ramazzini left two statements which bear repeating, not as simple observations but rather as dictums worthy of adherence bv all :I ST0852922 20 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE who would practice this form of medicine. The first of these was his exhortation to all physicians to ask of their patients not only the usual questions regarding their health but also to inquire without fail "of what trade are you?" The other command of the old master was that physicians should learn the nature of the occupational diseases in shops, mills, mines, or wherever men toil. Osier believed that clinical medicine is best learned in the wards of hospitals, but Ramazzini taught that occupational diseases are most effectively studied in the actual environment of the workers. If organized labor has ever paid tribute to Ramazzini, it has escaped this writer's attention; yet, though workers may not realize it, this man who died nearly three hundred years ago was one of their bene factors. While others may have championed the cause for better pay, shorter working hours, or better industrial relations, our patron saint dedicated his life to the improvement of the conditions under which men must toil. Upon the foundation which he established still rest the industrial hygiene and sanitation of our times. He condemned lack of ventilation and unsuitable temperatures and urged that men in dusty trades should work in spacious rooms; he counseled rest intervals in work of prolonged duration, as well as exercise and correct posture, and deplored the poor facilities for bathing which prevailed in his days. It is said that most famous men are not appreciated until some years after their death. With Ramazzini, the reverse is true, for he became famous and was admired in his own life time, only to be almost forgotten during the succeeding decades. Recently, however, his memory, his deeds, and his books have been revived by the founding of the Ramazzini Society in America, a group of thirty-one devotees of industrial medicine. This society, of which the author is a proud member, has no officers, no dues, and no bylaws and does not even hold scheduled scientific congresses. It merely proposes to perpetuate the memory of Bernardino Ramazzini by gathering annually to exchange ideas and to toast his memory with posca or with a sweeter facsimile thereof. And, furthermore, it is the unwritten purpose of this group to stimulate the practice of industrial medicine in the United States. But to return to the historical sketch of industrial medicine: In the eighteenth century Percival Potts became interested in the cancer of chimney sweeps, while Willan described the skin lesions in bakers. Thackrah, living in the manufacturing district of Leeds, wrote about his observations concerning the diseases of workmen. But it was the effort of Thomas Percival, a Manchester physician, which led to the first Factory Act in England. In Germany, Tissot was concerned with the hazards of stone masons, while phosphorus, the dusts, and toxic gases were also mentioned in the German literature. Following the tomorrow's doctors ST0852923 21 industrial revolution, the English Factory Act of 1833 stimulated similar movements in Germany and France. It was then that the De Morbis Artificum Diatriba was republished and widely distributed, urging the people to enact better legislation. In the twentieth century in England, Sir Thomas Oliver published Dangerous Trades, followed by Diseases of Occupation (1908). In collaboration with Sir Kenneth Goadby, Sir Thomas Legge wrote Lead Poisoning and Lead Absorption. About the same time, phosphorus poisoning received the attention of Andrews in the United States. Also in this country, Kober and Hanson as well as Kober and Hayhurst added important contributions to the literature dealing with industrial diseases. Admitting the omission of many other important names in the field of industrial diseases, we come to the present generation, but discretion forbids the author to evaluate his own contemporaries. It will remain for history to pay tribute to those who, by their investiga tions and the promotion of industrial hygiene, have made the United States the most progressive country in the world for the protection of the working man. But it would be an inexcusable omission indeed not to honor the most famous daughter of Ramazzini, Dr. Alice Hamilton who, in the early years of this century, climbed the dilapidated steps of Chicago slums to visit men stricken with lead poisoning. In her early medical days she became associated with Jane Addams of Hull House fame and was most zealous in the cause of the underprivileged. It was probably for this high, humanitarian purpose which she steadfastly maintained throughout her active years that she entered the field of industrial medicine. She travelled the breadth of this land to investigate different types of occupational exposure; she wrote many articles and is the author of several noteworthy books. By her works she deserves a place among the great physicians who have influenced the course of American medicine. The author wishes to acknowledge the great pioneer work of Dr. Alice Hamilton and bows reverently in the d'rection of Hadlyme, where she is enjoying her sunset years. If industrial medicine is of such ancient origin, the question must be asked what may have retarded its progress to a status comparable to that of other branches of medicine. There are those who would answer that in the United States industrial medicine in its earlier years fell into evil ways: that it became - "contract practice," "insurance medicine," or "finger wrapping." To a certain degree this is true. Too often industrial medicine was only a stopgap for those whose interest lay in more lucrative fields. And yet, all these explanations are correct only in a superficial sense. For the real answer one must go deep into the socioeconomic history of the United States and begin by asking questions of a different ST085292U 22 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE nature, as, for instance: Why is it that America has no adequate system of rural medicine? Why has this nation lagged in its nutritional program, and in slum clearance? In the correct answer to these questions will be found the reason why industrial medicine has been late in reaching the prominent position which corresponds to its great importance. Only within our own time has this country approached its social responsibility. Except for the occasional lone voice, our social and economic philosophy has ignored mass welfare. Industrial management was no more interested in the working environment of its employees than it was in their living conditions outside the plant. How then was it possible for industrial medicine to grow? Organized medicine is likewise to blame. Far too long it has frowned upon this type of practice, or at least has lent it no encourage ment. Those who controlled the policies of our medical societies believed that industrial medicine threatened to undermine the cherished patient-physician relationship. Yet, to no appreciable degree has that relationship ever been disturbed by industrial medicine. What the leaders of organized medicine did not realize until recently was the necessity of a program to provide medical care for the masses; they did not consider that tuberculosis, venereal disease, malnutrition, cancer, and the like are group problems which can best be prevented by utilizing the machinery which controls and motivates large groups. Until lately it has not been understood that an industrial organization is a social structure which lends itself to the application of our ability to guide human relations and our plans for mass preventive medicine. This was demonstrated by the high degree of efficiency attained by the industrial tuberculosis program 4 of World War II, through which a greater number of early cases of tuberculosis were detected than through any community-sponsored program. Likewise, medical education has placed little emphasis on indus trial medicine. A few medical schools have recently augmented their courses by adding varying degrees of instruction in this field which, however, are mostly didactic. But proper emphasis on the subject is still lacking. Under these circumstances it cannot be expected that students will be seized with a zeal to enter the field of industrial health; and even if they did so, it still remains doubtful if they will be equipped with sufficient knowledge, as long as industrial medicine is taught in a half-hearted manner by inexperienced teachers when indeed the teaching of this subject is imposed upon them while they are engaged in lecturing on subjects largely unrelated to industrial medicine. So much for the past and its obstacles. But what of the future? Its possibilities are limitless and unpredictable. Obviously, the future will include an ever-expanding program of preventive medicine, encompassing the control or elimination of tuberculosis, cancer, heart tomorrow's- doctors ST0852925 23 disease; venereal disease, and other scourges; the future will continue to improve preventive measures against industrial injury or occupa tional illness; it will expand research in the field of industrial toxicology. But it proposes to do more--much more. Industrial medicine contends that we must cease looking upon the working man as an eight-hour a day problem, in which only his occupa tional environment is of concern. No longer can the industrial laborer be classified as a mechanical component of the machinery of industry. We have realized that the worker is a member of society, whose working, playing, and living is a twenty-four-hour problem. Such a concept entails consideration of all his faculties, his capacities as well as his deficiencies. It includes a program which will safeguard his hearing, his vision, his nutrition, his skills, aptitudes, experience, intelli gence, and emotions. It is the object of industrial medicine to utilize the cardiac, the epileptic, the cripple, the blind, the elderly, and all those who desire to work instead of being forced to accept the beneficence perpetrated upon them by an unwitting government. Man's work is related to his home, his social environment, his philosophy, his economics, and his happiness. Adjustment of these relationships in the largest segment of our adult population can be achieved by utilizing the facilities which industrial medicine has to offer. No doubt, the uninformed critic will say that these aims belong in the field of social science and that they should be left to the social worker. But such a contention must be emphatically contradicted. The responsibility for the well-being of the industrial worker is the obligation of trained physicians rather than that of a group equipped only with a smattering of the physiology and psychology of man. Social agencies have not been sufficiently effective, nor have they made the most of their opportunities. The improvement of working condi tions for the underprivileged is not to be left solely to legislative acts, much as these are necessary to insure full success. Politicians have not added in any measurable way to the sorely needed comfort of these great masses of people. The wage level may have been raised and the worker may have won rights which had previously been denied to him. But none of these steps can decisively improve the standard of health among the working population without the leadership of the medical profession. It was the bitter cry of Isaiah that with the multiplication of the nations, their joys had not been increased. True it is, that much sorrow and strife will always be with us in a world that is not--and never will be--Utopia; but if Isaiah could look with us into the future, he would see the great army of American workers enjoying their labors amid circumstances which are the prerequisites for a longer, healthier, happier life. To realize that obligation, industrial medicine is charged ST0852926 24 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE with the greater share of the responsibility. For the physician the call is clear, the opportunity abundant, and the field diversified. References 1. Garrison, F. H.: Life as an Occupational Disease, Bull. Acad. Med. 10s 682, 1934. 2. Legge, R. T.: Bernardino Ramazzini, His Life, Deeds and Book, Indust. Med. 15: 8, 1946. 3. McCord, C. P.: A Blind Hog's Acorns, Chicago, 1946, Cloud, Inc. 4. Hilleboe, H. E., and Gouid, D. M.: Conquest of Tuberculosis in Industry, Proceedings of the Sixth Annual Congress of Industrial Health, Chicago, February, 1944. 5. Long, C. F.: Medicine, Labor and Industry Join Hands in Philadelphia. Proceedings of the Sixth Annual Congress of Industrial Health, Chicago. February, 1944. ST0852927 CHAPTER XXX asbestosis Asbestosis is a comparatively new disease. The first comprehensive reports regarding asbestosis came from the English writers in tho years between 1920 and 1925. In America in the early thirties studies were made by Lanza, Sayers, Bloomfield, and others. Asbestos is a hydrated magnesium silicate. Occupational exposure occurs in those trades where it is used for packing, insulating, or fire proofing, or where it is combined with cotton or other material in textile processes. Signs and Symptoms.--As in silicosis,1 the first sign is dyspnea, the cough is usually dry, and auscultation reveals few, if any, physical signs. Loss of weight is usually noticeable, the color is pale, and cyanosis is a fairly early sign. After some time, fine, crackling r&les may be heard, and the chest appears emaciated and lacks the robust character noticed in silicosis. Early asbestosis must be differentiated from acute emphy sema. If tuberculosis is present, the symptoms may take on the character of this disease, but this complication is far less frequent than in silicosis. Pathology.-- Pulmonary Changes.--The pulmonary fibrosis of asbestosis is diffuse in character, peribronchial, and basal in location in contrast to sili cosis in which the fibrosis is nodular in character and present in the upper part of the lungs. As the process continues, the fibrosis extends into almost all portions of the lung tissue. Bronchiolectasis and bron chiectasis are present within the substance of the fibroid areas, and bronchopneumonia and acute tracheobronchitis often cause the death of these patients. The pleurae, especially in the basal regions, are thickened and adherent. In some cases the pleural sac is completely obliterated; in others a fibrous or serous exudate may be present within it. Action of Asbestos and Silica.--The difference between chrysotilc asbestos and quartz silica in their mode of action has caused considerable speculation as well as experimentation. Gardner- particularly, at the Saranac Laboratory, carried on intensive study of these two materials. He felt that while the action, of free silica is chemical in nature, the action of asbestos is mechanical. He stated: "We have come to the conclusion that inhaled asbestos fibres are irritating not because they are silicates hut because they are stiff fibres which mechanically irritate the lungs. Unlike the free silicas, these minerals will not stimulate fibroblasts in any part of the body; only those in the lungs are affected. Tt was inferred that these organs were 368 ASBESTOSIS ST0852928 369 affected because the movements of respiration are so much more rapid and continuous than those of other viscera. Then it was discovered that if asbestos was ground very finely so that few of the fibres were longer that 2 microns in length the irritating property of the asbestos was prac tically destroyed. Inhalation experiments with such fine chrysotile asbes tos were carried out over a period of several years. No fibrosis has developed in spite of the fact that an average atmospheric concentration of 125 million particles per cubic feet of air has been maintained. In contrast in a previously reported experiment one-third this concentration of long fibre asbestos dust produced well marked fibrosis after about two years." If the effect of asbestos were chemical, one would expect that a decrease in size would accelerate tissue response. With free silica large particles have little effect, but as their size decreases cellular reaction becomes more vigorous and even constitutional symptoms may ensue. With fibrous asbestos the reverse is true. The histology of early asbestosis does not suggest a chemical injury. Kven under the most extreme conditions that can be created by artificial injection there is no preliminary phase of tissue necrosis with infiltration of leucocytes as occurs with high concentrations of very fine quartz. The connective tissue cells merely multiply very slowly in areas where the asbestos fibres arc caught in the bronchioles. As collagen forms and contracts, the air spaces are obliterated by scar tissue. In experimental animals, at least, this change is not a progressive one after cessation of exposure to the dust as is the case in the response to quartz. Perhaps the reason is the deposition of the peculiar iron-containing coating on the surface of the inhaled fibres giving rise to the characteristic "asbestosis bodies" (Figs. 50 and 51). Finally, it is most suggestive that among dozens of different silicate minerals only the five known as asbestos, which are unique because they are fibrous in structure, should be commonly recognized as pul monary irritants. The variation in chemical composition within this group is greater than that between them and many other silicates. In fact, chrysotile asbestos has the same chemical formula as a nonfibrous silicate, serpentine, which is physiologically inert. Obviously irritation would seem to he associated with the physical rather than the chemical composition of these minerals. One point of practical significance may he indicated by these obser vations: namely, that very finely ground asbestos is not dangerous. This conclusion has support in clinical observation, for it has long been known that at the Theftord Mills there was no clinical asbestosis even though in former years the atmosphere was very dusty and the dust was extremely fine. The tact that fabrication of fibres of the same mineral in American plants could produce disease was one of the puzzling fea- 370 OCCUPATIONAL MEDICINE AND INDUSTRTAi E Pig. 50.--Right lung, showing markedly thickened pleura with fusion of Interlobar pleura. Dense fibrous tags over entire surface. (U. S. Public Health Service, Bulletin 'it 1.) Fig. 51.--Asbestnals bodies accompanied bv glunt cells. (U. S. Army Medical Museum, Specimen 52255.) ST 0 3 5223' 372 OCCUPATIONAL MEDICINE AND INDUSTRIAL HYGIENE lures of this disease. But these experiments offer a plausible explanation. The fine dust in the mills is composed of serpentine and extremely short chrysotile fibres; that in the spinning and weaving mills contains many more long fibres. Microscopic Appearance.--In the early phases of the disease there is a thickening of the alveolar septa as a result of fibroblastic prolifera tion. The alveolar spaces contain numerous alveo'ar phagocytes. With progression of the disease, fibrosis becomes more marked and the alve olar structure gradually disappears, and in its place there is now dense fibrous tissue. The few remaining alveoli which lie in the area of fibrous tissue are lined by a low cuboidal epithelium and have a glandular appearance (Fig. 52). Scattered throughout the lung in both the diseased and healthy parts are spindle-shaped structures (first described by McDonald*) known as asbestosis bodies. These bodies are slender in their center and bulbous at each extremity. Many are arranged like strings of graduated beads with the largest at the end of the chain. X-Ray Findings.--Certain peculiarities exist here as contrasted to silicosis. In asbestosis, the lesions may be bilateral or largely unilateral. According to the experience of Pendergrass,3 the roentgenologic findings in asbestosis are largely limited to the lower half or two-thirds of the lung fields, while in silicosis the upper portions of the lungs are also involved. In moderately advanced asbestosis, x-rays will reveal lessened ventilation of the lung fields, the parietal pleura is thickened, and there is a "ground-glass" appearance to the picture. The vascular shadows lose their identity. Nodulation is absent. Pendergrass3 feels that a roentgenologic diagnosis of early asbestosis is unreliable and that the condition must be moderately or markedly advanced to make a differ ential diagnosis from the roentgenograms (Fig. 53). Medicolegal Aspects.--It is felt that the time necessary to develop asbestosis is, on the average, from seven to nine years in a fairly high concentration; with a less severe concentration, from fifteen to twenty years. The allowable concentration is 10,000,000 particles per cubic fool of air, of a size between 0.5 and 5. Once established, the disease is progressive^ even after the cessation of exposure. The basis for diagnosis is similar to that given under Silicosis. References 1. Lama, A. J.: Asbestosis, J.A.M.A. 106t 368 (Feb.), 1936. 2. Gardner, L. U.: Recent Developments in Relation to Silicosis, Indust. Med. 9: 45 (Feb.), 1940. 3. Pendergrass, E. P.: Silicosis and Asbestosis, New York, 1938, Oxford Univer sity Press. * McDonald. S.: Histology of Pulmonary Asbrstnsis. Brit. M. J.. 2, 1025, 1927. ST0852932 CHAPTER XXXI SILICIOUS DUSTS OF UNDETERMINED PATHOLOGIC STATUS It has long been the opinion of most investigators that only free (crystalline) silica and asbestos (a silicate) are capable of producing a disabling pulmonary fibrosis. For many years many of the silicates have been studied experimentally, and their action has been observed clinic ally with no evidence that these silicates are harmful to any appreciable degree. Recently, however, several of the silicates have been suspected of being capable of producing a fibrosis not unlike that due to free silica. As yet no conclusive opinions have been reached and until more investi gation by capable authorities is carried out, the status of these dusts must remain undecided. Talc Talc is a hydrous magnesium silicate. When it is mined, talc may be accompanied by other minerals such as serpentine, dolomite, and tremolite. Occupational exposure includes, in addition to mining the mineral, the preparation of talc for fillers in paint, linoleum, paper, dusting agents, and cosmetics. In 1933 Dreessen1 and subsequently in 1935 Dreessen and Dalla Valle2 studied the effects of talc mining in Georgia and Vermont and noted that x-ray pictures revealed diffuse fibrosis, but whether this con stituted a disabling pneumoconiosis was debatable. Porro and co-work ers 3 took the definite position that talc did cause a disabling pulmonary fibrosis and attempted to correlate the mining and milling of talc with a morbidity among these workers. In 1942 they made the following observations on fifteen cases with a history of exposure to talc: "The symptoms arc those characteristic of disabling pneumoconiosis: dyspnea, cough, chest pain and weakness. Vital capacity was extremely low. The gross pulmonary changes in all cases are stiffening of the lungs, poorly ouUined grayish bands and nodules appearing in the parenchyma and moderate enlargement of the tracheobronchial lymph nodes. Emphysema is universally present but is not grossly recognized in the mild case. In all except the least involved case, extensive intrapleural adhesions are found and in all advanced cases there is a cor pulmonale. Microscopic Changes consist chiefly in irregular areas and bands of cellular fibrosis surrounding the vessels and bronchi and producing thickening of file alveolar wall. Histiocytes and fibroblasts are numerous in proportion to collagen fibers. Asbestosis bodies are frequently present in the lesions. This implies a degree of similarity between asbestosis and pneumoconiosis due to talc. While tuberculosis or other complications may be present, pneumoconiosis in itself is a reaction of living tissue to injury and therefore an inflammatory disease resembling other chronic inflammation. Diffuse haziness is the most constant roentgen abnormality and is probably the 373 ST0852933 INDEX A Abdominal cramps from selenium, 317 from tetryl, 214 pain from carbon tetrachloride, 149 from chlorinated naphthalenes, 166 from TNT, 209 Abrasive blasting protectors, 506 Absorption, maximum possible, 94 of noxious substances, 78 Accident hazards, 549 meaning of term under compensation acts, 29 Accidents arising out of employment, 29 color as prevention of, 499 industrial, 74 Acetaldehyde, 92 aniline, 443 Acetate rayon, 446 Acetone, 115 and butanone, combined action, 116 Acetylene, 481 welding, cup goggles in, 512 Add, colloidal silicic, 335 dippers, hazard of hydrogen chloride, 187 hoods, 511 solutions in electroplating, 462 Add-fast diphtheroid organisms, 278 Acidosis from carbon tetrachloride, 153 treatment of. 111 Aeae from chlorinated naphthalenes, 166, 169 from tar, 414 Acrolein, 114, 115 hazard in heat-treating process, 475 Acrylic acid, formula of, 456 resin plastics, properties of, 456 Acrylonitrile, preparation of, 440 Actinic conjunctivitis from welder's arc, 489 Ante yellow atrophy from carbon tetra chloride, 157 from chlorinated naphthalenes, 165, 169 Adenitis from eczematous dermatitis, 421 Adhesions, intrapleural, from talc, 373 Adipic acid, process of making, 449 Adrenalin, caution against use of, 160 Aarobacter cloacae, 389 Ape factor in TNT poisoning, 209 in tuberculosis among miners, 363 of workers with tuberculosis, 407 Air, alveolar, concentration of vapors in. 97 concentration of ammonia, 222 of anthracite particles, 362, 363 of asbestos, 372 of cadmium, 266 of carbon monoxide, 120, 123 tetrachloride, 150 of DDT, 225 of hydrogen chloride. 187 of lead, 249 Air, concentration--Cont'd of manganese, 299 of methyl bromide, 136, 139 of silica dust, 336 of sulfur dioxide, 182 of TNT, 209 of zinc, 308 conditioning, methyl chloride in, 142 contaminants, sampling and analysis, of. 531, 532 discharge of dust from, 396 expired, concentration of gas or vapor in, 96 lead analysis of, 249 ` pressure extremes, health hazard, 549 to respirator, temperature of, 508 velocity and rise of vapor, 521 branch and main ducts, 529 Air-line respirators, 507 Airplane industry, plastics in, 451 Albasan, health hazard, 443 Alcohol, amyl. 111 butyl, 110 ethyl, 110 ice cold, for hydrogen fluoride burns. 189 isopropyl, 110 methyl, 92 poisoning, symptoms, 100 treatment of, 112 propyl, 110 Alcoholic sodium hydroxide, prepara tion of, 210 Aldehyde ammonia, health hazard, 444 Aldehydes, 92 occupational exposure to, 114 Alibour water, prescription for, 432 Aliphatic acids, 116 compounds, 91, 171-184 hydrocarbons, 99 nitrile compounds, uses of, 130 oxides, 118 Alkali cellulose, 447 xanthation, 448 Alkaline baths in electroplating, 462 Alkyd resins, useful properties, 454 Allergic dermatitis, 516 reaction to cotton dust, 390 Allergy and occupational dermatoses, 413 in flour mill workers, 396 in mill workers, 396 occupational dermatoses, 413 All-inclusiVe system of compensation, 27 Alloying of machineable stainless steels, selenium hazard, 317 Alpha-particles, 324 Alpha-rays, 324 Alum in casein plastics, 459 Alurailite treatment, 466 Alumina powder in treatment of sili cosis, 354 Aluminite process, 465 ST085293U 578 INDEX Aluminum, 316 Anoxia, 122, 123 anodic treatment of, 465 from nitrogen dioxide, 219 extractors, hazard of fluorine, 186 hydroxides, experiments with, 353 Anthracosilicosis, diagnosis of, 361 prevalence and exposure to, 362, 363 powder, treatment of silicosis, 352, symptoms of, 361, 364 353 x-ray findings in, 366 production, hydrogen fluoride haz ard, 187 therapy in industry, 354 Alveolar air, concentration of gas and vapors in, 96, 97 consolidation, 343 Amblyopia from carbon disulfide, 175 Ammonia, medicolegal aspects, 222 poisoning, symptoms of, 222 Ammonium chloride for deleading, 256 persulfate, dermatitis from, 422 thioglycolate, 232 `'jL. Amphetamine sulfate for mercurialism, 312 Amyl alcohol. 111 formate, 116 Amyostatic symptoms from manganese, 295 Anemia, aplastic, 209, 210 blood transfusion in, 203 from benzol, 191, 201, 202, 203 from ethylene glycol monomethyl ether, 113 from gasoline intoxication, 102 from lead, 236, 254 from inethyl chloride, 142 from toluvlene-diamine, 445 from TNT, 210 from vanadium, 322 in arsenical poisoning, 291 in radium poisoning, 325 in zinc poisoning, 308 liver extract and iron in treatment, 203 secondary 102 Anesthesia from industrial solvents, 435 Anesthetic gases, 109 action of, on heart, 147 Anesthetics. 435 Angina pectoris from carbon disulfide, 176 Antimony in biologic materials, 306 trioxide, inhaled, toxicity of, 307 Anuria from carbon tetrachloride, 150 from methyl chloride, 142 Anxiety states from carbon disulfide, 176 from tetraethyl lead, 107 Apathy from carbon monoxide, 121-127 from trlchlorethylene, 159 Aplasia, medullary, from benzol, 190 Aplastic anemia from TNT poisoning, 209 Aquamarine, 277 Aralac, 446 Arc flash burns, welding hazard, 488 welding, effects of fumes from, 404 Aromatic compounds, 91 hydrocarbons, 190 Arsenates of lead, 290 Arsenic dust, skin, irritation, 290 occupational hazard, 289 poisoning, differential diagnosis, 292 motor palsy, 290 treatment, 292 skin lesions from, 290 white, arsenical poisoning from, 289 Arseniuretted hydrogen, arsenical poi soning from. 289 Arsine, arsenical poisoning from, 289 formation of, 291 in pickling process, 472 Art glass workers, hazard of fluorine, 186 Arterial blood, concentration of gases and vapors in, 96, 97 Arteriosclerosis and lead poisoning, 251, 252 Arthritis from selenium, 317, 318 Artificial -leather factory, benzol fumes, . 204 Anhydro formaldehyde aniline, prepar ation of, 445 Aniline, 215 Ankle clonus from manganese, 298 lighting, recommended levels, 496 respiration, 102 in hydrogen sulfide poisoning, 180 silk, 172 Ankles, cement dermatitis of, 424 Asbestos and silica, action of, 368 edematous, from benzol, 204 fibers, 334 from carbon tetrachloride, 150 inhaled, 368 Annealing. 473 Asbestosis, 339, 341 Anodic process, sulfuric acid in, 466 i bodies, 369, 370, 372 tank with no ventilation. 46(i from talc, 373, 374 treatment, 465 fibers, 368 Anorexia from tluorine, 186 medicolegal aspects, 372 from radium, 325 pulmonary changes in, 368 from tetrvi, 214 symptoms of, 368 from TXT. 209 x-ray findings in, 371, 372 from toluene, 208 Ascites from chlorinated naphthalenes, Anoxemia from carbon monoxide, 127 169 from chlorine, 185 Ascorbic acid, benzol poisoning, 204 from hydrogen arsenide, 291 therapy in lead intoxication, 257 oxygen therapy, 434 Asordin, 148 relieved liv carbon dioxide. 435 Aspergillus glaucus. 390 INDEX ST0852935 579 Asphyxia from carbon monoxide, 435 types of 118 Asphyxiants, chemical, 88 on respiratory system, 435 Asphyxiation, acute, with delayed symptoms, 121 Asthenia from carbon disulfide, 176 Asthma from cotton dust, 389 from fluorine, 186 from grain smuts, 397 from sulfur dioxide, 183 in cotton workers, 389 Atelectasis from talc, 374 Atoms, chains and rings of, 90 Atropine, sulfate and ammonia, 223 Automotive industry, plastics in, 451 B Babbitting masks, 512 Backache, 30 Bagasse dust, pulmonary disturbance from, 398 Bagassosis, symptoms of, 398 Baker's dermatitis, 418, 421 BAL in peanut oil-benzyl benzoate solu tion, 293 for mercury poisoning, 311 dosage, 293 Barber's dermatitis, 423 Bare-electrode welding, 486 Barrel type chest from cotton dust, 389 Barvtes, x-ray diffraction analysis, 357 Barytosis, 357 Basal metabolism, effect of selenium, 319 Basophilic aggregation lest, 242, 244 stippled cells, 242 stippling in lead poisoning, 237 Battery makers, hazard of manganese, 295 Bauxite, composition of, 375 furnace workers, symptoms of illness in, 377 Beauty parlor worker, effect of benzene poisoning, 195 thioglycolic acid hazard, 232 Benefits, medical, workmen's compen sation, 48 permanent and temporary total dis abilities. 34 statutory for widows and orphans, 32 Benign pneumoconiosis from diatoina- ceous earth, 384 from dust, 387 Bentonite, x-ray diffraction analysis, 357 Benzaidehyde preparation, toluene haz ard, 205 Benzedrine sulfate, 312 Benzene,190 ring, 91 workers, hemoglobin in, 195 Benzine, 99, 190 Benzinoform, 148 Benzoic acid preparation, hazard of toluene, 205 Benzol, effect on liver. 191 intoxication, sulfate index, 202 "jag", 202 poisoning, anemia from, 203 treatment of, 203 blood picture in, 193 bone marrow reaction in, 190 diet in, 203 laboratory tests, 202 signs and symptoms of, 201 thrombocytopenic purpura, 199 Beryl, 277 Berylliosis, 277 Beryllium alginate, 277 aluminum silicate. 277 copper, 277 glass, 277 poisoning, differential diagnosis, 284 x-ray findings, 281 sarcoidosis, 277 sulfate dust, inhalation of, 278 Beta-particles, 324 Beta-rays, 324 Bile, radium in, 325 Blackhead itch, 166 Bladder tumors, 215 in dye workers, 444 Blank, pre-emplovmeni examination. 542 Blast furnace operators, sulfur dioxide hazard, 182 furnaces, carbon monoxide hazard. 118 Blasting, abrasive, protectors for. 506 sand, 475 silicosis hazard, 336 Bleachers, hazard of chlorine. 185 of fluorine. 186 of sulfur dioxide. 182 Bleaching of textiles, hazard of man ganese, 295 Bleb, emphysematous, from anthraco- silieosis, 3(57 Bleeding from gums in benzol poison ing, 195, 202, 204 from nose and gums from-trinitroto luene, 210 Blepharitis in cotton workers, 390 Blind spot, 175 Blindness from carbon monoxide, 121 Blood abnormalities from exposure to benzene. 195 arterial, concentration of vapors in. 97 bright red, in cyanide poisoning, 131 changes from carbon disulfide, 173 concentration of gas or vapor in, 90 count in arsenical poisoning, 291 in benzol poisoning, 202 in lead poisoning, 242 effect of antimony on, 306 of benzol on, 193 of manganese on, 297 erythrocyte mechanism in, 237 How during bodily rest. 96 -forming organs, injury from benzol. 190 in carbon monoxide poisoning. 119 ST0852936 580 INDEX Blood--Cont'd in ethylene glycol monomethyl ether poisoning, 113 in toluene poisoning, 208 Robert's examination of, 132 lead concentration in, 249 platelet count from nitrogen dioxide, 219 pressure elevated by carbon tetra chloride, 150 temporal^ rise, 253 sedimentation rate due to benzene, 199 smear, preparation of, 245 sputum from talc, 374 stain, formula for, 245 tannic acid test of, 124 transfusions in anemia, 203 Blue line, 250 Blurred vision from methyl alcohol, 109 Body harness for hose lines, 506 Boeck's sarcoid, 277 Boils from cutting oil, 516 Bone marrow, effect of benzol, 190 in lead poisoning, 236 Bones, radium poisoning, 326 Boot and shoe industry, trichlorethylene in, 158 Bottle caps for sealing, 450 Botulism, 292 Brain, action of anesthetic hydrocar bons on, 97 edema of, in lead poisoning, 240 hemorrhage from tetraethyl lead, 107 in carbon monoxide poisoning, 120 in methyl bromide poisoning, 136 Branch and main ducts, air velocity in, 529 Brass, 316 chills, 329 Bread dough dermatitis in bakers, 421 Breweries, carbon dioxide gas near, 130 Brewers, hazard of fluorine, 186 Brewing, use of formaldehyde, 114 Brick, silica, 333 workers, magnesium hazard, 302 Bricklayers, cement dermatitis, 423 Brittleness of red blood cells due to lead, 236 Bromine, 185 Bronchial asthma from p-phenylenedia- mine, 446 Bronchiectasis in asbestosis, 368 Bronchiolectasis in asbestosis, 368 Bronchitis and cement dust, 395 from cadmium, 265 from gasoline, 100 from hydrogen sulfide, 180, 181 from methyl bromide, 136 from sulfur dioxide, 102 from vanadium, 323 Bronchopneumonia from asbestosis, 368 from benzol. 204 from cadmium oxide, 266 from gasoline. 100, 102 from hydrogen sulfide, 180, 181 from nitrogen dioxide, 219 Bronchospasm from vanadium, 323 Bronze, 316 Bronzing of skin in arsenic poisoning, 292 Buffers and polishers, protection of, 525 Buffing and grinding wheel duct, segre gation of, 525 Buna S ana Buna N, 438 Burning of skin from trichlorethylene, 162 Burns, arc flash, 488 from hydrogen fluoride, 188 of skin from carbon dioxide snow, 130 from methyl bromide vapor, 139 in arc welding, 488 Butadiene, new method of producing, 438 vapor, effect on skin, 442 Butanone, 115 Butt welding, 488 Butyl alcohol, keratitis from, 110 rubber, resistance of, 441 vulcanizates of, 441 Butyraldehyde aniline, health hazard, 445 Byssinosis, definition of, 390 from cotton dust, 389 symptoms of, 389 C Cable coverings, chlorinated naphtha lenes in, 165 rash, 166 Cachexia from fluorine, 186 Cadmium- and zinc-plating tanks, 463 occupational exposure, 265 oxide, effects of, 275 poisoning, symptoms of, 266 treatment of, 267 Caisson workers, hazard of hydrogen sulfide, 180 Cake dough dermatitis in bakers, 421 Calcium and magnesium carbonates, 396 carbide, 482 cyanide powder, 133 for manganese poisoning, 299 for radium workers, 327 gluconate for intestinal colic, 253, 259 in diet, 203 Canisters of gas masks, identifying ' colors, 503 Cannery workers, onychia, 426 Canopy hoods, 520 Carbolic acid, uses of, 215 Carbon, 89 arc process of welding, 485 dioxide absorption, symptoms of, 130 for anoxemia, 435 snow, 130 disulfide, neural poisoning. 172 poisoning, amblyopia, 175 corneal reflex, 176 differential diagnosis, 176 erroneous diagnosis, 177 medicolegal aspects, 178 neuropathy in, 177 ST0852931 INDEX 581 Carbon disulfide poisoning--Cont'd psychiatric attention, 178 symptoms of, 175 production, hydrogen sulfide haz ard, 179 risumt of group study, 171 dust, 396 monoxide, 435 acute asphyxiation from, 120 hemoglobin, 119 poisoning, acute anoxemia. 127 differential diaanosis, 124 symptoms of, 120 quantitative tests, 123 oxychloride, 130, 149 tetrachloride, 147, 435 degreasing agent, 148 narcotic action of, 148 poisoning, epinephrine contraindi cated, 152 proteins in diet, 153 renal injury, 148 symptoms, 149 Carbona, 148 Carburizing, 474 Carcinoma, 345 Cardiac failure in silicosis, 345 impairment from anthracosilicosis, 301, 362 Cardiorenal disease from manganese poisoning, 297 Cartridge type respirator, 503 Casein plastics, dry process of manu facture, 45s Casting, 477 Castings, cleaning of, 472 Catarrh, chronic, from sulfur dioxide, 182 of upper respiratory passages from cotton dust, 390 Cellophane, moisture-proofing process, 450 Cellosolve, 113 Cellulitis from eczematous dermatitis, 421 Cellulose, process of making, 447 acetate, properties and uses, 455 -butyrate, properties of, 455 ester plastics, 454 nitrate, properties of, 455 sources of, 447 sponge, process of making, 450 thermoplastics based on, 454 workers, sulfur dioxide hazard, 182 xanthate, chemical reaction, 447, 448 Cement dermatitis, 419, 423 dust, incidence of tuberculosis from, 395 Central nervous system, effect of carbon tetrachloride, 158 of lead, 240 of nitrobenzene, 215 of toluene, 205 of toluylene-diamine, 445 injury from carbon monoxide, 119 unit, medical service, 58 Centrifugal shot-blast machine, 476 Cephalin flocculation test, 151 Ceramic and pottery processes, 477 industry, hazard of lead, 478 Cerebral hemorrhage from lead, 262 vessels, engorgement of, by tetraethyl lead. 107 Cerebrospinal fluid, analysis of, in diag nosis, 251 Chains of atoms, 90 Charcoal ovens, carbon monoxide haz ard, 118 Chemical goggles, 512 handlers, hazard of dermatoses, 413 pneumonia, 411 Chemicals in common trade name pro ducts, 555 Chemistry, aid in diagnosis, 87, 92 of minerals, 357 Chest expansion decreased from anthra cosilicosis, 361 oppression in, in cotton sampler, 391 pain from cadmium, 266, 269, 270, 274 from talc, 373 roentgenograms in silicosis, 338 tightness from TNT, 209 Children, statutory benefits, 32 Chills, brass, 329 from cyanides, 134 from malt fever, 397 from metal fume fever, 329 Chip traps, 525 Chloracne, 166 Chlorinated diphenyls, 165 hydrocarbon compounds, dermatitis from, 516 hydrocarbons, 147 naphthalenes, 165-170 laboratory tests, 166 parenchyma, 166 skin lesions, 166 systemic intoxication from, 160 symptoms of, 106 Chlorine, uses of, 185 Chloro compounds, physiologic action, 147 Chloroethylene, 442 Chloroprene, narcotic properties, 442 preparation of, 440 Choreiform movements from carbon monoxide, 121 Chrome compounds, protection against, 429 `^Chrome holes," 315 on hand, 414 Chromic acid process, 467 iron, 314 skin rash, 315 ulcers, medicolegal aspects, 315 wet dressings, 315 Chromite, 314 brick, 477 Chromium, medicolegal aspects, 315 occupation hazards, 314 -plating tank, lateral exhaust method, 522 poisoning signs and symptoms of, 4 Chrysotile asbestos, action of, 368 o' i' - o uS'-'. S M U 582 INDEX Cinnamon dermatitis in bakers, 422 Circulatory collapse from nitrogen di oxide, 219 failure from gasoline, treatment of, 102 Cirrhosis and atrophy of liver from tetrachlorethane,, 163 of liver from chlorinated naphthalene fumes, 169 Clay in ceramic industry, 477 products industry, 477 Cleaning ojjerations, organic solvents, Cleansers, skin, 516 Cleansing agents, industrial dermatitis. Clothing, 427 care of, in personal hygiene, 167 impervious, for rescue work, 504 removal of, for diagnosis of skin lesion, 415 Clubbing of fingers from anthracosilicosis, 361 Coal mines, carbon monoxide hazard, 118 tar dyes, 215 Coated electrode welding, 486 Coatings of alloy and nonferrous rods, 490 Cold-molding compounds, lubricants in, 451 sweats in malt fever, 397 Colds, effect of sulfur dioxide, 182 Collapse of lung in bauxite worker, 380 Colloidal silica hydroxide, 342 silicic acid, 335 Colonic spasm from lead, 259 Color dynamics, 499 for safety in industry, 499 Coma from benzol, 202 from carbon disulfide, 175 from carbon monoxide, 129 from cyanide poisoning, 131 from gasoline, 101 from hydrogen sulfide, 180 from methyl bromide, 139 chloride, 142 Combustion of oxygen und acetylene, chemical reaction for, 482 Comedones and pustules from chlori nated naphthalenes, 166 Compensation act, exemptions to, 26 for partial disability from silicosis, 348 heat stroke or prostration, 31 in silicotic disability, 346 , "Compensation medicine," 25 physical condition of employee at time of injury, 30 plus medical treatment, 31 workmen's all-inclusive system, 27 fatal injuries, 32 in industrial medicine, 25 medical benefits, 48 occupational diseases, 38 second injury funds, 50 silicosis, 42 Compounds, saturated and unsaturated, 90 Compresses, cold wet, for -dermatitis, 430 Compression molding of plastics, 455 Concentrations, suggested maximum permissible, 573 Congestion of lungs from methyl chlo ride, 142 Conglomerate anthracosilicosis, 366 Conjectural medical testimony, 54 Conjugated products, tests to determine presence of, 83 Conjunctivitis, actinic, 489 from ammonia, 222 from petroleum distillate fumes, 102 from vanadium, 323 in cotton workers, 390 ultraviolet, 488 Constipation due to lead absorption, treatment, 241, 253 from nitrogen dioxide, 219 Convulsions from carbon monoxide, 121 from cyanides, 134 from gasoline, 101 from hydrogen sulfide, 180 from methyl bromide, 139 chloride, 142 from selenium, 317 Copper, 316 ducts for corrosive conditions, 530 mining, silicosis hazard, 336 refiners, tellurium hazard, 321 Cor pulmonale from talc, 373 Coramine for gasoline intoxication, 102 Corium of skin, capillary dilatation, 398 Corn meal as cleansing agent, 429 Corneal intlammation from butanol, 110 from butyl alcohol, 110 retlex in carbon disulfide poisoning, 176 ulceration, 183 ulcers from hydrogen sulfide, 181 Coronary heart disease, 156 Corrective-goggles, 510 Corrosion, protection against, 522 Corundum, manufacture of, bauxite hazard, 376 Coryza from cement dust, 396 from vanadium, 323 Cosmetic makers, talc hazard, 373 Cosmetician's dermatitis, 423 Cotton dust, allergic reaction, 390 velocity rate for, 529 linters pulp for cellulose, 447 sampler, nocturnal dyspnea, 391 x-ray findings of chest, 392, 393 worker, asthma in, 389 Cough from ammonia, 222 from anthracosilicosis. 361, 364 from asbestosis, 368 from bagasse dust, 398 from bauxite. 377 from benzol, 204 from berrylium, 284 from cadmium oxide, 266, 268, 289 from chlorine, 185 INDEX ST 0852939 583 Gough--Cont'd from cotton dust, 389 from cyanides, 134 from malt dust, 397 from metal fume fever, 329 from methyl bromide, 139 from nitrogen dioxide, 219 from selenium, 317 from silicosis, 337 from talc, 373 from tetryl, 214 from trinitrotoluene, 210 from vanadium, 322 from syrups in cadmium poisoning, 267 Counsellors, trained, 554 Cover goggles. 510 Cows fed 2,4-D, 230 Csacking, process of, 99 Creatine excretion, effect of lead, 240 Cristobalite, cause of silicosis, 383 Croton aldehyde, 114 Crude oil, distillation of, 99 Crying in carbon disulfide poisoning, 175, 179 Crystalline substances, diffraction pat tern, 358 Cup goggles, 509 Cuprammonium rayon, 446 Cuprous oxide, inhalation of, 316 Cutting oils, dermatitis from, 516 Cyanic solutions, hazard, 462 Cyanide and carbon monoxide poison ings compared, 119 baths in electroplating, 462 for surface hardening, 474 poisoning, 130, 435 symptoms of, 131 tests for, 132 treatment, 133 rash, 131 Cyanides, effect on blood, 130 Cyanmethemoglobin, 131 Cyanogen, 130 chloride. 130 Cyanosis from anthracosilicosis, 361 from asbestosis, 368 from bauxite, 382 from beryllium, 284 from carbon monoxide, 129 from ethylene chlorohydrin, 144 from gasoline, 103 from nitrobenzene, 215 from nitrogen dioxide, 219 from nitrous fume fever. 221 from phosgene, 161 from silicosis, 338 from trinitrotoluene, 209, 210 D Date packers, methyl bromide poison ing, 139 DDT aerosols, experiments for toxicitv, 225 as insecticide, health hazard, 227 experiments, 225 food contamination, 228 DDT--Cont'd precautions, 228 smoke, 224 Deaths from asbestosis, 368 from benzol, 202 from cadmium oxide, 266 from carbon disulfide, 175 from hydrogen sulfide, 180 from nitrogen dioxide, 218 from phenol, 215 from selenium, 317 from talc, 374 from trlchlorethylene, 158 Degreasing of metals, method of, 468 tanks, design and make, 470 gas-heated, 470 local exhaust ventilation, 472 location of, 470 use of aniline in, 215 use of trlchlorethylene, 158 Delayed reactions, methyl bromide, 137 patch test, 416 Deleading, calcium in diet, 254 high phosphorus and high vitamin diet, 255 Delirium from arsine, 292 from hydrogen sulfide, 180 Delustering of viscose yarn, 448 Dental defects from fluorine, 186 Depressive states from mercury, 310 Dermatitis urtefacta, 424 baker's, 421 barber's, 423 cement, 423 cosmetician's. 423 criteria for diagnosis. 415 due lo poison oak, 431 to rubber gloves, 431 to sweeping compound, 428 to uncleanliness, 515 from arsenic dust, 290 from carbon tetrachloride, 150 from grain smuts. 397 from methylene aniline, 446 from smut spores, 397 from tetryl, 214 from trichlorethylene, 162 in plastic industry, 459 infectious eczematoid, 420 treatment of. 432 local treatment, 430 of fingers from butyl alcohol, 110 recurrent attacks, 516 turpentine, 421 Dermatoses. 413-433 industrial, disability from, 427 occupational hazards, 413 synergic action. 414 treatment of, 427 Dextrose solutions in carbon tetrachlo ride poisoning, 153 Diagnosis, laboratory investigation, 79 of occupational disease, incompe tence in, 75 Diarrhea from carbon tetrachloride, 149 from hydrogen sulfide, 180 from lead, 241 from selenium, 317 ST 0852940 584 INDEX Diatomaceous earth, 382 worker, reaction in lung, 384 silica, crude, 382 Diatoms, 333, 382 Dichlorodifluoromethane, 144 Dichloroethane, uses of, 144 2,4-Dichlorophenoxy acetic acid, 228 spraying of pastures, 229, 230 Diesel engines, operation of, 478 type of exposure, 478 oils, 479 Diet, deleading, by high calcium, 254 in anemia, 102 in carbon disulfide poisoning, 178 tetrachloride poisoning, 153 in manganese poisoning, 299 in selenium poisoning, 320 low calcium, high phosphorus, 256 Diethylene glycol, 113 Digestive disturbance from hydrogen sulfide, 180 from sulfur dioxide, 182 Digitalis in carbon tetrachloride intoxi cation, 154 Dilated capillaries from fiberglas, 399 2,3-dimercaptopropanol, 293 Diphenyls, chlorinated, 165 Dipole, 385 Disabilities, estimation of, 64 permanent and temporary total, bene fits for, 34 Disability, estimation of, 64 from ammonia, 222 from anthracosilicosis, 367 from arsenic, 292 from benzol poisoning, 202 from chromium, 315 from cyanides, 132 from gasoline, 101 from hydrogen sulfide, 180 from Industrial dermatoses, 427 from metal fume fever, 330 from methyl bromide, 139 from methyl chloride, 143 from silicosis, 346 from sulfur dioxide, 182 from trichlorethylene, 160 industrial dermatoses, 427 means of estimating, 348 nonoccupational, 74 partial, from silicosis, 346 Discoloration of tongue from vanadium pentoxide, 323 Diseases, occupational, workmen's com pensation for, 38 Disinfectant workers, sulfur dioxide hazard, 182 ' Disinfectants, hazard of chlorine, 185 Disk, Whipple ocular micrometer, 535 Disorientation from gasoline, 101 Disturbance in gait from manganese, 295. 297, 300 from trichlorethylene, 159 Diuretics and cathartics in selenium poisoning, 320 in carbon tetrachloride poisoning, Dizziness from antimony, 306 from arsine, 291 from cadmium oxide, 260, 268 from carbon dioxide, 130 monoxide. 120, 121 tetrachloride, 149 from dichlorethane, 144 from ethyl alcohol, 110 from hydrogen sulfide, 180, 182 from methyl chloride, 143 from nitrogen dioxide, 219 . from trichlorethylene, 159, 161 from vinyl chloride, 442 Dogs, cyanide poisoning, 133 Dolomite, 373 Double vision, methyl bromide poison ing, 141 Dreams, terrifying, from tetraethyl lead, 107 Drillers, silicosis hazard, 337 Drowsiness from carbon dioxide, 130 from gasoline, 101 from hydrogen sulfide, 180 from lead, 259 from trichlorethylene, 159 from trinitrotoluene, 210 Dry ice, 130 cleaning industry, use of carbon tet rachloride, 148 of trichlorethylene, 158 Dryness in pharynx from vanadium, Duct exhaust system, 523 size, 527 Ducts, conveying capacity of, 529 in fire walls, insurance regulations, 526, 562 location, 524 Duodenal ulcer, 253 Dusky skin from anthracosilicosis, 364 Dust, calcium and magnesium carbon ate, 396 carbon, 396 cement,. 394 collection and analysis, 531 cotton, respiratory effects of, 389 estimation of silica content, 346 explosion hazard, 500 grain, air contamination, 396 granite, 407 in glass .industry, control of, 478 marble, 407 mica, 398 mill, allergens in, 396 particles, method of counting, 534 removal by exhaust hoods, 519 storage, 501 tobacco, 396 Dusts, 331 explosion hazards, 500 industrial, 77 inert, 386-401 Dye makers, sulfur dioxide hazard, 182 workers, ammonia hazard, 222 chlorine hazard, 185 fluorine hazard, 186 INDEX ST 0852941 585 D70 ad pigments used in plastics, 451 Dyspepsia from nitrogen dioxide, 219 Dyspnea from ammonia, 222 from anthraeoailicomis, 364 from asbestos!*, 368 from bagasse, 396 from baaxite, 37S from benriliora. 284 from cadmium. 269, 274 oxide. 268, 273 mm carboa dioxide, 130 from carboa disulfide, 176, 179 from cotton dust, 389, 390 from gasoline, 103 from phosgene, 161 from silicosis, 338, 344, 345 from talc, 373, 374 from vanadium pentoxide, 323 in bauxite furnace workers, 377 nocturnal, 391 production of, 344 Dysuria from hydrogen sulfide, 180 E Ear lobes, blniah discoloration of, from TNT, 209 Ears, roaring of, from carbon monoxide, Cath, dwtoaiareous, 382 Eeehymosis from benzol, 205 Ecxema from formaldehyde, 115 Ecaematoid ringworm and Industrial dermatitis, 419 Eacmsioai lesions of occupational or igin, 414 Edema from carboa monoxide, 120 fram chlorinated naphthalenes, 166 fram phosgene, 161 from selenium, 318 of brain from high octane fuel, 100 from lead, 240 from nitrogen dioxidev 219 from tetrachlorethane. 163 of face and ankles from carbon tetra chloride, 156 of kidneys from naphthalene, 169 of hangs and brain from ethylene chiorohydrin. 144 and kidneys from phenol, 216 from carbon monoxide, 120 from selenium, 317 from tetraethyl lead, 107 f pancreas ana spleen from phenol, 216 Education, medical, industrial medicine in. 22 Educational program in industrial med icine, 59 Elbows, sheet metal, 530 Electric arc welding, 484 battery makers, chromium hazard, 314 furnaces, carbon monoxide hazard, 113 resistance welding, 486 Electrocardiographic changes in carbon monoxide asphyxia, 126 Electrocolorimetric determination of collected dust samples, 539 Electroplating, cadmium hazard, 205 chromium hazard, 314 hydrogen chloride hazard, 187 principles of, 461 tank, with large open hood, 520 Electrostatic flornilation method of dust sampling, 531 Emerald, 277 Emergency units, maintenance of, 57 Emery, 375 Emphysema from anthracosilicosis, 361 from cotton dust, 389 from silicosis, 344, 345 from talc, 373, 374 in cotton sampler, 393 Employees, safety devices for, 502 Employer's Liability Act, 25 Enameling industry, hazard of lead, 234 Encephalitis, disseminated, from car bon monoxide, 120 Engineering control measures, 464 Engravers, hazard of hydrogen chlo ride, 187 Eosinophilia from antimony, 306 in fluorine workers, 186 Epicardium in methyl chloride poison ing, 142 Epidermophytosis, 419 Epigastric cramps from dichloroethane. 144 pains from silicosis, 337 Epileptiform seizures in arsenical poi soning, 291 Epinephrine contraindicated in cardiac collapse, 152 for nitrite shock, 133 Epistaxis from tetryl, 214 Epithelioma in arsenic poisoning, 291 Eruption around draining sinuses, 421 Eruptions, self-produced 424 Erythema muitiforme, 416 of skin from methyl bromide, 139 Erythrocytes, formation and function of, 237 Esters, 92 Etchers, hazard of hydrogen chloride, 187 Ethyl acetate, 116 alcohol, 110 butadiene from, 438 bromide, 137 celluloke plastics, properties, 459 Ethylene chiorohydrin poisoning, symp toms of, 145 uses of. 144 cyanohydrin, preparation of, 440 dichloride poisoning, symptoms of, ' 144 uses of, 144 glycol, 112 monomethyl ether, 113 Euphoria from gasoline, 101 I ST 0852942 586 INDEX Examination, physical, in occupational disease claim, 63 pre-employment, 58 Examinations, periodic, (or executives and office workers, 59 Examiner, competence of, 58 Excitement from carbon dioxide, 130 from gasoline, 101 from hydrogen sulfide, 180 from tetraethyl lead, 107 Executives, periodic re-examinations for, 59 Exemptions to compensation act, 26 Exhaust ducts, location of, 522 recommended gauges, 530 fan, location of, 523 hoods, 518 systems in foundry work, 477 Exhausting, method of, 518 Explosion hazards of dusts, gases, and vapors, 500 relief vents, 527 Explosive gases, 501 Explosives, dust system for removal, 526 hazard of nitrobenzene, 214 of nitrogen dioxide, 218 Exposure to dust, safe limits, 363 to noxious substances, degree or con centration, 78 Exterminators, methyl bromide in, 136 Extraction of fats and oils, carbon disul fide, 171 Eye disturbance from cyanides, 134 examination, 513 injury from eyelash dye, 445 from hydrogen fluoride, 189 irritation from aliphatic acids, 116 from sulfur dioxide gas, treatment of, 183 protection, 509 strain from cover goggles, 510 Eyeballs, frozen, from sulfur dioxide, 182, 184 Eyelids, chronic ulcers on. 315 contact dermatitis of, 421 dermatitis from varnish remover, 421 inflammation of, from arsenic dust, 290 puffiness, from benzol, 204 swelling of. from ammonia, 222 Eyes, care of, in hydrogen sulfide poi soning, 181 effect of arsenic vapor, 293 of butadiene vapors, 442 of chlorine, 185 of DDT, 226 of methyl alcohol, 109 of sulfur dioxide, 182 ' glassy, in cyanide poisoning, 131 inflammation of, from hydrogen sul fide, 180 irritation from acetone, 115 from butanol, 110 from ethylene chlorohydrin, 144 from formaldehyde, 115 puffy, from carbon tetrachloride, 150 sclera of, effect of chlorinated naph thalenes, 168 F Fabric handlers, hazard of dermatoses, 413 Fabrication of tires, Buna S, 441 Face mask, 511 protection, 509 shield, 511 swelling of, from trichlorethylene, 161 Facial contours, respirators and, 504 expression from manganese, 298 Fat necrosis of pancreas, 169 Fatal injuries, workmen's compensation for, 32 Fatigue, factor in industrial tubercu losis, 408 from aniline, 215 from antimony, 306 from benzol, 205 from carbon tetrachloride, 150 from manganese, 297 from silicosis, 338 from sulfur dioxide, 182 from tetrachlorethane, 163 from tetraethyl lead, 107 from trinitrotoluene, 209 in industrial tuberculosis, 408 occupational, defined, 409 Federal strength specifications for lenses, 510 Feet, fungous infection of, 419 Feigned lesions, 425 Feldspar, 333 in ceramic industry, 477 Ferrous sulfate preparations, 103 Fertilizer manufacture, hazard of hy drogen fluoride, 187 Fever, grain or malt, 397 metal fume, 329 Monday, 390 Fiberglas, 398, 446 effect on lungs, 398 summary of experimentation, 400 Fibrosis, 387 from asbestosis, 368, 372 from beryllium, 280 from calcined earth, 384 from diatomaceous earth. 384 from talc, 374 in cotton workers, 390 of lungs, 331 spread of, in silicosis, 342 Fibroulcerative pulmonary tuberculosis from talc, 374 Fibrous asbestosis, 334, 369 hyperplasia in anthracosilicosis, 360 pleural adhesions from talc, 374 Fillers used in plastic, 451 Filter respirators, 504 Filtration, dust samples by, 531 Fingernails, fissured eczema of, from butanol, 110 hydrogen fluoride burns, 188 Finger tips, effect of formaldehyde on, 115 of wet mercury on, 313 -wave solutions, dermatitis from, 423 INDEX ST0852943 587 Fire brick, 477 extinguishers, carbon tetrachloride in, 148 Fireproofing of electric cable, selenium hazard, 317 Flame, reaction at inner cone, 482 Flammable liquids, 501 Flanging, cause of cadmium poisoning, 275 Flash weld, 488 Flatulence from tetryl, 214 Flexible exhaust system, 521 Flour dermatitis in bakers, 422 mill workers, allergy in, 396 "Flour improvers," dermatitis in bakers, 422 Fluorescent lamp industry, beryllium poisoning, 277, 279 process, 479 lighting, 497 powders, 285 Fluorine, industrial uses of, 186 Fluorosis, 186 Fluxing agents in ceramic industry, 477 Flux-shielded welding, 486 Flying objects, injury from, 509 Foaming at mouth in cyanide poisoning, 131 Focal infections and dermatitis, 414 Fog tracts, 325 Folic acid, 211, 213 Food, DDT contamination, 228 Foot candles for overhead lighting, 497 Formaldehyde aniline, preparation of, 445 dermatitis from, 423 poisoning, treatment of, 115 production of, 92 Formalin, 114 Formaniline, preparation of, 445 Formula 12, 429 Foundry workers, sulfur dioxide haz ard, 182 Free silica in dust, method of determin ing, 540 Fremitus from anthracosilicosis, 361 Freon, 144 Frit, manufacture of, 260 meaning of, 478 Frothing at mouth from methyl bro mide, 139 Fruit decay, carbon dioxide from, 130 juice stand employees, onyehia, 426 Fujiwara reaction, 150 Fumes, inhalation of, welding hazard, 489 metal, immunity to, 329 Fumigant, methyl bromide as, 136 Fumigation with cyanides, 130 Fungi, 389 Fungous infections and industrial der matitis, 419 of feet and groin, 414 Fur cutters, mercury hazard, 310 Furnace tenders, carbon monoxide haz ard, 118 Furunculosis in cement workers, 414 in oil workers, 414 Fused silica. 334 Fusion welding, 483 G Gait, disturbance of, 295, 297 Gamma-rays, 325 Ganglion ceils, effect of manganese, 295 Gangue, 295 Garage mechanics, carbon monoxide hazard, 118 Gargles in cadmium poisoning, 267 Garlic odor of breath and sweat from tellurium, 322 Gas conductor lamp, 479 manufacturing plants, carbon monox ide hazard, il8 masks, 503 -shielded welding, 486 solubility in tissue, 96 Gaseous tumors from magnesium, 303 Gases and susceptibility to tuberculosis, 403 and vapors, explosion hazard, 500 reactive and non-reactive, 98 Gasoline, 99 signs and symptoms of exposure to, 100 Gastric ulcer and lead poisoning, 253 Gastrointestinal catarrh from ethylene chlorohydrin, 144 disturbance from antimony, 306 from carbon disulfide, 176 from selenium, 317 from tetrachlorethane, 163 Genoscopolamine for mercurialism, 312 Gentian violet for dermatitis, 432 Giddiness from benzol, 202 from carbon disulfide, 175 from trichlorethylene, 159 Glare, 495, 498 reflected, 498 visible, mask protection from, 512 Glass and enameling industries, silica in, 336, 478 blower's cataract, 512 coloring, cadmium hazard, 265 tellurium hazard, 321 decolorizing, selenium hazard, 317 etchers in ceramic industry, hazard of hydrogen fluoride, 187 etching, hazard of formaldehyde, 114 fibrous, 398 soft, 335 spicules, effect on skin, 400 wool, skin irritation,.399 workers, hazard of hydrogen fluoride, 187 of magnesium, 302 of manganese, 295 i Glazers, hazard of lead, 234 Gliosis from manganese, 295, 297 Glycols, 112 Glycosuria, 125 in metal fume fever, 329 Goggles, chemical, 512 corrective, 510 cup, 509 ST 0852944 588 INDEX Goggles--Cont'd impact, 509 proper fitting of, 511 spectacle type, 509 Gold mining, silicosis hazard, 336 Grain dust, velocity rate for, 529 mill workers, allergy in, 396 mills, discharge of dust from, 396 smuts, 397 Granite, 333 Gray stage in trichlorethylene poison ing, 161 Greenburg-Sraith impinger for air sam pling, 531 Grinding and buffing wheels, air veloci ty, 529 booth, down-draft ventilation, 527 Grit soap, dermatitis from, 429 Guanidine retention in carbon tetra chloride poisoning, 153 Gummas, syphilitic, 426 H Hair dye, dermatitis from, 423 in chronic arsenical poisoning, 292 loss of, from arsenic dust, 296 lotions, dermatitis from, 423 waving preparations, thioglycolates in, 231 Hairdresser, occupational dermatitis, 423 Hallucinations from carbon monoxide, 121 from methyl bromide, 141 Halogenated by hydrocarbons, 136 Halogens and halogen compounds, 185 Halowax, 165 Hamilton, Dr. Alice, 21 Handicapped persons, residual ability, 546 Handlers of oils, hazard of dermatoses, 413 Hands, chromic ulcers on, 315 of radium workers, cleansing of, 326 protective measures, 429 Hanger's test, 151 Hard coal miners, silicosis hazard, 336 rock miners, tuberculosis in, 408 Hatband dermatitis, 428 Hazard of acetaldehyde aniline, 443 of albasan, 443 of aldehyde ammonia, 444 of aldehydes, 114 of antimony, 306 of arsenic, 289 of arsine, 291 of benzol, 190 of beryllium, 217 of butyraldehyde, 445 of cadmium. 265 of carbon disulfide, 171, 178 monoxide, 118 of chromium, 314 of DDT, 228 of dermatoses, 413 of diatomaceous earth, 382 Hazard--Cont'd of diesel engine operation, 479 of dust, 500 of fluorine, 186 of heat-treating process, 475 of hydrogen chloride, 187 fluoride, 187 sulfide, 179 of lead, 234 of magnesium, 302 of manganese, 295 of mercury, 310 of methylene aniline, 445 of naphthalenes, 165 of b-naphthol, 444 of a-naphthylamine, 443 of b-naphthylamine, 444 of nitrogen dioxide, 218 of p-phenylenediamine, 446 of plastic industry, 459 of selenium, 317 of sulfur dioxide, 182 of talc, 373 of tellurium, 321 of tetramethyl thiuramdisulflde, 446 of thioglycolic acid, 231 of toluene, 205 of M-toluyienediamine, 445 of trichlorethylene vapor, 469 of welding, 488 Hazardous occupations, 553 Hazards, appraisal of, 531 control of, 517 Headache from aniline, 215 from arsine, 291 from benzol, 202 from butanol, 110 from cadmium oxide, 266, 268, 275 from carbon dioxide, 130 disulfide, 175, 176, 179 monoxide, 121 tetrachloride, 149, 150, 155 cotton dust, 39u cyanides, 131 dichloroethane, 144 from ethyl alcohol, 110 from ethylene chlorohydrin, 144 from gasoline, 101 from hydrogen sulfide, 180 from lead, 241, 259 from malt dust, 397 from methyl bromide, 139 chloride, 142, 143 from naphthalene, 169 from nitrogen dioxide, 219 from tetrachlorethane, 163 from tetraethyl lead, 107 from tetryl, 214 from throbbing, from carbon monox ide, 120 from toluene, 208 from trichlorethylene, 159, 161 from trinitrotoluene, 209 from vinyl chloride. 442 Health hazard in operation of degreas ing tank, 469 occupational, 549 INDEX ST0B529W Health--Cont'd of disabled workers, 547 service, industrial and community, coordination of, 73 Hearing, disturbance of, 176 Heart disease and carbon tetrachloride, 156 effect of anesthetic gases on, 147 of carbon monoxide on, 119, 126 of tetraethyl lead, 107 of trichlorethylene on, 158 enlargement from methyl chloride, 143 lesions from ethylene chlorohydrin, 144 rhythm, anesthetic gases on, 147 right, congestion of, in cyanide poi- soning, 131 Heat factor in methyl cellosolve poison ing, 113 prostration, when compensable, 31 stroke, meaning under compensation acts, 31 -treating process, hazards, 475 treatment of metals or alloys, 473 Heatronic molding process, 452 Heavy-welded black iron ducts for gran ite dust, 530 Hector mine-run bentonite, analysis of, 357 Helmet in abrasive blasting, 506 Hematopoiesis, 191 Hematoporphyrinuria from lead, 236 Hemoglobin, carbon monoxide affinity for, 119 effect of DDT, 226 elevation from toluene, 206 mean corpuscular, 195 Hemoptysis from anthracosilicosis, 361 from beryllium, 284 Hemorrhages from cadmium, 265 from carbon monoxide, 119 from dichloroethane, 144 from nitrogen dioxide, 219 from tetrachlorethane, 163 from tetraethyl lead, 107 petechial, from gasoline, 100 from methyl chloride, 142 subarachnoid from benzol, 191 Hemorrhagic infarct of lung from talc. 374 Hentriacontane, 479 Hepatic insufficiency in carbon tetra chloride poisoning, 152 Hepatitis, toxic, 209 Hepatomegaly from toluene, 206 Hernia, 30 Hexaraethylene diamine, 449 Hexylresorcinol, 154 Hides, arsenical poisoning from, 290 High octane fuel, exposure to, 100 Hood and airline for sandblast operator, 476 static suction of, 520 Hoods for grind^inj?, polishing, and buff- in exhausting process, 518 Hose masks, 505 Hot environments, health of workers in, 407 Hydrated magnesium silicate, 368 Hydrobrotnic acid, 136 Hydrocarbons, aliphatic, 99 anesthetic action of, on brain, 97 aromatic, 190 chlorinated, 147 halogenatea, 136 Hydrocyanic acid, 130 Hydrofluoric acid, use as pickle, 472 Hydrogen arsenide, formation of, 291 chloride, symptoms of exposure, 187 fluoric acid, *04 fluoride burns, first-aid treatment, 188 double action on skin, 188 liberation of, by magnesium, 302, 303 sulfide, action of, 435 in permanent wave preparation, 231 in pickling process, 472 medicolegal aspects, 180 occupational hazards, 179 poisoning, signs and symptoms of, treatment, 180 Hydrous aluminum oxide, 375 silica, 335 Hygiene, personal, for workers, 73, 427 plant sanitation and, 73, 493 visual, 513 Hyocine, 312 Hyperbilirubinemia from lead, 236 Hyperemia of lungs and kidneys from phenol, 216 from methyl bromide, 136 of pancreas from beryllium, 279, 280 Hyperplasia after exposure to benzol, 191 Hypertension and lead posoning, 252 I Ideal weld, 485 Idiocy from carbon monoxide, 121 Igneous rocks, 333 Illumination standards, various types of work, 496 Impact goggles, 509 Impetigo, 416 Impingement method of air sampling, 531 Incandescent or filament lamp, 497 Industrial accidents, 74 and community health service, co ordination of, 73 dermatitis, change of work, 430 defined, 413 local measures in treatment, 430 dermatoses, medicolegal aspects of, 427 protective measures, 427 treatment of, 427 hazards, control of, 517 health administration, 71 program, effectual measures, 543 service, distribution of, 72 hygiene, appraisal of hazards, 531 f ST0852946 530 INDEX Industrial hygiene--Cont'd program, 493 training and maintenance, 504 Irrigations and gargles in cadmium poi soning, 267 Irritability from antimony, 306 medicine, aims of, 23 from carbon disulfide, 176 and traumatic surgery, 73 from mercury, 310 causes of retarded progress, 21 from tetryl, 214 course outlined, 71 Irritants which act on respiratory sys educational program, 59 tem, 88, 435 in medical education, 22 school curriculum, 69 periodic re-examination, 58 placement program, 59 Isolation for hazard control, 517 Isopropyl alcohol, 110 Itching in eczematous dermatitis, 421 of skin from trichlorethylene, 162 pre-employment examination, 58 workmen's compensation, 25 physicians, classification of, 72 J functions of, 57 Janitor service throughout plant, 495 plant medical department, internship Jaundice, 157 in, 71 from arsenic, 291 processes, special, 461-492 safety man, 505 from carbon tetrachloride, 150, 156 from chlorinated naphthalenes, 166 solvents, German literature, 89 physiologic reactions, 94 toxicology, experimental research, 89 tuberculosis program, 22 from hydrogen arsenide, 291 from tetrachlorethane, 163 . from toluyene-diamine, 445 from trinitrotoluene, 209 Inert dusts, 386-401 Jaw pain, phosphorus intoxication, 305 Tnfarct of lung, hemorrhagic, from talc, Job appraisal, accident hazards, 549 374 information, 550 Infections, focal, and dermatitis, 414 Infectious ezcematoid dermatitis of hand, 420 treatment, 432 Infrared radiation, protective lenses, 512 Inhalation of gas or vapor, 95 Injection molding, 455 matching worker to, 545, 546. 548 placement, physical demands, 548 program, 544 psychiatry and, 552 working conditions, 548 Joint pains from phosphorus, 305 Jugular vein, concentration of absorbed vapors, 97 Injuries, fatal, workmen's compensation for, 32 Injury, physical condition at time of. 30 to eyes from albasan, 443 Ink pigment making, selenium hazard, 317 Inks and lacquers, use of formaldehyde, 114 Insecticide. DDT, 224 sprays, carbon tetrachloride in, 148 Insomnia from carbon disulfide, 179 from methyl chloride, 142 Inspection, regular, in industrial hy giene, 504 Insulin, 154 Insurance carrier, 64 Internal hydrocephalus from carbon monoxide, 120 Interstitial keratitis in congenital syph ilitic, 426 K Kaolin, 375 Keratitis from N-butyl alcohol, 110 interstitial, 426 Keratoses from solid compounds of ar senic, 291 Kerosene dermatitis, 516 Ketones, 115 Kidney and bladder injury from bu-naphlhylamine, 444 irritation from albasan, 443 Kidneys, congestion of, in methyl chlo ride poisoning, 142 effect of carbon monoxide, 125 carbon tetrachloride, 150, 155 ethylene chlorohvdrin, 145 tetraethyl lead, 107 Knuckles, chromic ulcers, 315 Kodapak, 450 Interviewers and counsellors, trained. 554 ' L Intestinal colic in lead poisoning, 237, Laboratory investigation in diagnosis, 240. 253 79 tract, hemorrhage of, from carbon tests for cadmium poisoning, 266 monoxide, 119 pre-employment examination, 544 lead absorption from, 235 Labored breathing from ethylene chlo- Intracranial pressure from lead, 240 rohydrin, 144 rise in, from carbon monoxide, 120 Laborers, industrial, classification of, 23 Intranasal drops in cadmium poisoning, 267 , Lachrimation in formaldehyde poison ing, 115 Iron-containing dust, inhalation of, 387 | Lacquerers, hazard of nitrobenzene, 214 INDEX S T 0 8 5 29 tfIJj, Lacquers, solvent naphtha as diluent, 208 toluene as diluent, 205 Lactate-Ringer's solution, lt2 La grippe regimen in metal fume fever, 330 Lange test, manganese poisoning, 299 Lassitude from cotton dust, 390 from ethyl alcohol, 110 from gasoline, 101 from metal fume fever, 329 Lateral exhaust system, 521 Latex, 441 Laughter from carbon disulfide, 175 from manganese, 298 Laundry soap, dermatitis from, 429 sodium silicate in, 335 workers, carbon monoxide hazard, 118 Lead, 234-2G4 absorption and excretion of, 234 versus tuberculosis, 405 analysis of air. 249 arsenate poisoning, symptoms of, 290 carbonate, effect on rats, 290 chromate paints, chromium hazard, 314 colic, 250 ducts for corrosive conditions, 530 dust, 234 transport velocity, 529 encephalitis, 240, 251 encephalopathy, treatment of, 257 fixation of, 235 in urine, 247 intoxication from misplaced decimal point, 262 occupational exposure, 234 on red blood cells, 23(1 palsy, treatment, 257 phosphate, 255 poisoning, ascorbic acid therapy, 257 basis for diagnosis, 249 basophilic stippling. 237 blood count in, 242 differential diagnosis. 250 symptoms of, 240, 241 treatment of, 253 refiners, tellurium hazard. 321 Lebedev method of producing buta diene, 438 Lens, Federal strength specification, 510 Lenses, size of, 510 Lethargy from carbon disulfide, 170 from trichlorethylene. 159 Leucemia from benzol, 191 Leucocytes. 195 Leucocytosis in metal fume fever, 329 Leucopeuia from benzol, 193, 200, 203 from xylol. 208 Liability, workmen's compensation, 28 Libido, loss of. from carbon disulfide, 710, 179 Lighting, artificial. 490 industry, use of inert gases in, 479 natural. 495 plant, 495 system, color painting in, 498 Lime-soda glass, 335 Linoleum making, talc hazard, 373 Lips, discoloration from TNT, 209 effect of arsenic dust, 290 Lithography, chromium hazard, 314 Liver disorder, 166, 167 effect of arsine, 292 of benzol, 191 of cadmium, 265 of carbon monoxide. 125 of carbon tetrachloride, 149, 155, 157 of chlorinated naphthalene, 165, 166 of cyanides, 131 . of ethylene chlorohydrin, 145 of ethylene dichloride, 144 of methyl chloride, 142 of neoprene, 442 of tetraethyl lead, 107 of toluene, 206 extract and iron in benzol poisoning, 203 dosage, 300 parenchyma, test for disturbance in, 151 Load area, 527 Lockers.for workers, 427 need for two, 167 Lockheed Aircraft Corporation, classi fication of applicants, 550 medical program, 543 Loelller's rnethvlcne blue, formula for, 245 Loss of appetite from aniline, 215 from antimony, 306 from bauxite, 377 from carbon tetrachloride, 150 from chlorinated naphthalenes. 166, 167 from cotton dust, 390 from lead. 240 from manganese. 300 from nitrogen dioxide. 219 from silicosis, 337 from tellurium. 322 from tetraclilorethnnc 163 from trichlorethylene, 159*. Hit from trinlrotoluene. 210. 212 of strength from carbon tetrachlo ride, 150 of hair from arsenic, 290 of weight from anthraeosilieosis, 361. 364 from asbestosis, 368 from bauxite, 377 from benzol, 202 from beryllium, 284 from carbon disulfide, 179 from carbon monoxide. 128 from chlorinated naphthalenes, 167 from cotton dust, 389 from tluorine, 186 from hydrogen sulfide. 180 from nitrogen dioxide. 219 from radium, 325 from trinitrotoluene. 210 ST08529U8 592 INDEX Lung, collapsed, with emphysematous bleb, 351, 382 lymphatic drainage of, in silicosis, 342 reactions, of diatomaceous earth in, 384 Lungs, congestion of, from nitrogen di oxide, 219 edema of, from tetraethyl lead, 107 effect of ammonia, 222 of beryllium, 278 of carbon monoxide, 125 of carbon tetrachloride on, 149 of cyanides, 131 of flberglas, 398 of glass wool dust, 400 of sulfur dioxide, 182 elimination of gases through, 97 hemorrhage of, from carbon mo noxide, 119 from tetraethyl lead, 107 in anthracosilicosis, 361, 364 in asbestosis, x-ray findings in, 372 in beryllium poisoning, 275 in cadmium poisoning, 265, 266, 274 in chlorine poisoning, 186 in ethylene chlorohydrin poisoning, 145 m methyl bromide poisoning, 136 chloride poisoning, 142 linear markings in anthracosilicosis, 366 x-ray shadows, 339 study of, in beryllium poisoning, 281 Lymphangitis from eczematous derma titis, 421 secondary infection, 421 Lymphatic drainage of lung in silicosis, 342 Lymphatics, effect of magnesium' on, 304 Lymphocytosis from benzol, 200 from carbon tetrachloride, 150 from toluene, 206 from xylol, 208 in fluorine workers, 18G M Macrocytic anemia from methyl cello- solve, 114 Macrocvtosis from benzol, 193 Magnesite, 477 Magnesium carbonate, 396 casters, hazard of fluorine, 186 casting, 477 * foundries, hazard of hvdrogen fluo ride, 187 occupational exposure, 302 poisoning, treatment of, 304 silicate, hydrated, 334 sulfate for constipation due to lead, 253 for deleading, 256 Malt dust, reaction to, 397 fever, symptoms of, 397 Manganese, alloys of, 295 effect on blood, 297 elimination of, 297 occupational exposure to, 295 poisoning, differential diagnosis, 298 liver tnerajjy, 300 predisposition for, 295 signs and symptoms of, 298 vitamin Bi ana calcium, 299 Marble dust, workers in, 407 Masks, 180 hose, care of, 506 welding and babbitting, 512 Masons, cement dermatitis, 423 Match manufacture, hazard of manga nese, 295 Matches, safety, 305 Mean corpuscular hemoglobin, 195 Meat protein in diet, carbon tetrachlo ride poisoning, 153 Medical service, industrial, 57 testimony, qualified, 54 Medicine, industrial, age of, 17 early history of, 17 new concept of, 87 Medicolegal aspects of anthracosilicosis, 367 of asbestosis, 372 of industrial dermatoses, 427 of metal fume fever, 330 of poisoning by ammonia, 222 by antimony, 308 by arsenic, 292 by carbon disulfide, 178 by chromium, 315 by cyanides, 132 by hydrogen sulfide, 180 by methyl chloride, 143 by sulfur dioxide, 182 by zinc, 308 of silicosis, 348 Melamine resins, 453 Memory, effect of carbon disulfide, 179 of carbon monoxide, 121 Meninges and brain, nyperemic, in methvl bromide poisoning. 130 Mental changes from carbon monoxide, confusion from methyl bromide, 139 from methyl chloride, 142 Mercaptoacetic acid, 231 Mercurialism, 310 Mercury, microdeterinination of, in bio logical material, 311 occupational exposure, 310 poisoning, laboratory tests, 311 signs and symptoms of, 310 treatment, 311 vapor lamps, 497 wet, 313 Metabolite extraction, test for TNT, 211 Metal ague, 329 bearings, antimony used as alloy in, 306 etching, hazard of nitrogen oxide, 218 fume fever, immunity to, 329 medicolegal aspects, 330 ST 0852949 INDEX 593 Metal fume fever--Cont'd Minnesota, medical review board, 56 signs and symptoms, 329 Molding, 477 treatment, 330 compositions, plastics from, 451 picklers, hazard of hydrogen chloride, powders from melamine resin, 453 187 sand, 477 spraying, 490 Molds and fungi in cotton dust, 390 workers, hazard of dermatoses, 413 for casting resins, 453 Metallic arc process, 485 in cotton dust, 390 taste from tellurium, 322 in grain dust, 397 Metallizing a shackle pin, 491 Monday fever, 390 gun, 491 Monel metal ducts for corrosive condi hazard of cadmium, 265 tions, 530 process, phases of, 490 Monoalkyl ethylene glycol ethers, 113 Metals, cold state, 77 Monocytes in carbon disulfide poison cutting by oxyacetylene, 484 ing, 175 heat-treating process, 473 Morbidity and mortality, occupational, light, injuries from, 302 72 preparation of surface before spray Mortality from respiratory diseases, 364 ing, 490 Moth repellents, naphthalene for, 169 Methacrylic acid, formula for, 456 Mountain sickness, headache in, 122 Methane, structural formula, 89, 90 Mucosa of mouth in mercury poisoning, Methanol, 109, 137, 138 310 Methionine, carbon tetrachloride poi Mucous membranes, effect of arsenic soning, 152 dust, 290 Methyl acetate, 116 of ethyl alcohol, 107 alcohol, 92, 109 of formaldehyde, 114 poisoning, acidosis in, 111 of phosgene, 130 benzene, 205 Multiple exhaust systems, 524 bromide, 109 neuritis, arsenical poisoning, 290 effect on basal ganglia, 138 from cellosolve, 113 narcotic action of, 137 sclerosis, 177, 253 pathologic changes caused by, 138 Munitions, antimony as alloy in, 306 poisoning, signs and symptoms of, plants, dermatitis in, 516 Muriatic acid, 187 treatment of, 141 Muscle cells in lead poisoning, 237 tests for, 136 Muscles, effect of lead, 239 cellosolve, 113 Muscovite, 335 chloride, chronic intoxication, 142 Muscular cramp from manganese, 300 poisoning, medicolegal aspects, 143 stiffness from carbon disulfide, 176 signs and symptoms of, 142 weakness from carbon dioxide, 130 treatment, 144 Musical instrument makers, hazard of Methylene aniline, health hazard, 445 magnesium, 302 diphenyldiamine, 445 Myalgia due to lead intoxication, 241 Metrazol for gasoline intoxication, 102 in ammonia poisoning, 223 Mexican steel workers, tuberculosis in, N 4U7 Mica, 333 dust, x-ray markings, 398 miners and silicosis, 398 Midget impinger, all-glass 532 Mildew in cotton dust. 390 Milk, effect of 2,4-D, 230 Mill dust, allergens in, 390 Minerals, 333 chemistry of, 357 Nail polish dermatitis, 423 beds, formaldehyde on, 115 Nails, trophic changes from arsenic dust, 290 apparatus, Naphtha, 99 and naphthalene, differentiated. 170 Naphthalene, chlorinated, occupational | exposure, 165 symptoms of poisoning, 169 I b-Naphthol, effect on skin, 443 health, hazard, 444 Miner's asthma, 361 Naphthylamine, health hazard, 444 Miners, fibrosis in, from carbon dust, Narcosis from dichloroethane, 144 396 Narcotic action of methyl bromide, 137 hazard of hydrogen sulfide, 180 effects of butadiene and benzol com of cryolite, hazard of fluorine, 186 pared, 442 pulmonary infection from unthraco- and toluol compared, 442 silicosis, 363 Nasal mucosa, chromic ulcers, 315 Mining industry, hazard of tuberculosis, 408 ulcerations from tetryl, 214 septum, chrome holes, 414 of hard silicosis rock, silicosis haz perforation of in arsenic poisoning, ard, 336 290 ST0852950 594 INDEX Nasopharynaitis from sulfur dioxide. Neuroses from methyl bromide, 139 182 from trichlorethvlene, 159 Natural lighting, 495 Nausea from acetaldehyde, 444 from antimony, 306 from arsenic, 291 "Neutral" flame, 482 Nickel plating, 462 Night terrors from carbon disulfide, 179 Nitrated cellulose, properties and uses, from carbon disulfide, 175 from carbon monoxide, 120 from carbon tetrachloride, 149 from chlorinated naphthalenes, 10(5 455 Nitric oxide, preparation of, 218 Nitrobenzene, 214 Nitrocellulose, 446 from cyanides, 131 manufacture, hazard of nitrogen ox from dichloroethane, 144 from ethylene chlorohydrin. 144 ide, 218 Nitrogen dioxide, color variation of, 218 from hydrogen arsenide, 291 occupational exposure to, 218 from lead, 241 oxides of, 218 from malt dust, 397 tetroxide, 218 from metal fume fever, 329 from methyl bromide, 139 from methyl chloride, 142 from naphthalene. 169 Nitrous fume poisoning, blood, platelet count, 220 pressure, 220 Nocturnal attacks in malt fever, 397 from tellurium. 322 dyspnea, case report, 391 from tetryl, 214 Nodulation, 339 from toluene, 208 from toluylene-diamine, 445 from trinitrotoluene, 209, 212 massive conglomerate, 340 Nodules, anthracosilicotic, 365 confluent, 343 Necrosis from dichloroethane, 144 microscopic appearance, 366 of bones from radium, 325 silicotic, 344 of jaw bone from phosphorus, 305 Nonferrous castings, 477 Negro steel worker, 407 Nonfogging device for goggles, 512 Neon light, 479 Northrup Aviation Company placement Neoplasia, 193 program, 551 Neoprene, 438 Nose and throat irritation from ali clothing for body protection, 188 phatic acids, 116 effect of, on liver and kidneys, 442 from butanol, 110 for hose to transport oil, 441 effect of chlorine on, 185 reactions in process of making. 440 of sulfur dioxide on, 182 Nephritis and lead poisoning, 253 in arsenic workers, 290 from methyl chloride, 142 Noxious substances, degree of absorp hemorrhagic, from arsine, 292 tion, 78 Nephrosis due to carbon tetrachloride, Numbness from carbon tetrachloride. 148 150 Nervous disorders in mercurialism. Nylon, 66, 448, 449 treatment of, 312 system, effect of carbon disulfide, 173 O of carbon monoxide, 119, 125 of carbon tetrachloride, 148 of hydrogen disulfide, 180 of lead on, 252 of methanol, 109 in manganese poisoning, 295, 297 irritants to, 88 Nervousness and restlessness from gaso line, 102 from antimony, 306 from benzol, 202 from beryllium, 284 from cyanides. 134 ' from gasoline, 102 Neural poisoning from carbon disul fide, 172 Neuralgic pains in arsenical poisoning, 290 Neuritis, peripheral, due to lead intoxication, 251 i ! | | ; ! Occupation and pneumonia, 411 psychologic hazard of worker, 552 Occupational disease claim, complete physical examination, 63 estimation of disability, 64 method of reporting, 62 diseases, diagnosis of, 75 77, 78 workmen's compensation for, 38 fatigue, 409 ' health hazards, evaluation, 549 illness, 29 morbidity and mortality, 72 Office worker, periodic and pre-employ ment examination, 59 Oil distilleries, carbon monoxide haz ard, 118 or cement workers, furunculosis in, 414 refining, hazard of hydrogen disul fide. 180 retrobulbar, from trichlorethvlene, 159 Oils, cutting, dermatitis from, 516 from seeds and bones, carbon disul Neuropathy from carbon disulfide, 176 fide in extraction of, 171 INDEX ST085295I 595 Ointment, prescription for, 431 Pain--Coat'd Olefines, 99 from tetryl, 214 Oliguria, treatment of, 154 from vanadium pentoxide, 323 Olive oil, effect on rabbits, 137 in epigastrium from arsine, 291 Onychia, 426 in extremities from carbon tetrachlo Oppression between shoulder blades in ride, 150 cotton sampler, 391 in intestinal colic from lead, 241 Optic atrophy from arsenical insecti relief of, in chlorine poisoning, 186 cide, 291 retrosternal, from bagasse dust, 398 disk, blurring of, from carbon disul Painful gums in mercury poisoning, 313 fide, 176 Painters, enlarged livers from toluene, nerve, effect of carbon disulfide on, 206 175 turpentine dermatitis, 421 in arsenical poisoning, 291 Paints, solvent naphtha as diluent, 208 Optonics, 499 Organic acids, 92 toluene diluent of, 205 Pallor of skin from vanadium pentox chemistry, 89 dusts, 386 solvents as thinners, 570 in cleaning and. degreasing, 568 Organized medicine, 22 ide, 323 Palms, thickening of skin from arsenic dust, 290 unilateral tertiary squamous syphilide of, 426 Osteomyelitis, 421 Palpitation of heart from nitrogen di Osteosclerosis in chronic fluorine intox oxide, 219 ication, 186 Palsy in arsenic poisoning, 290 Oxidation, continual, 96 in lead poisoning, 239 in tissues, effect of cyanides, 131 Pancreas, effect of cadmium, 265 Oxides of nitrogen, 218 of tetraethyl lead, 107 Oxidizing acid solutions in electroplat Papaverine hydrochloride for anuria. ing, 462 154 Oxyacetylene flame, heat of, 482 Paper making, talc hazard, 373 for cutting metals, 484 Parachutes, nylon for, 449 operations, hazard of nitrogen diox Paraffins, 99 ide, 218 Paraldehyde, 114 welding, 481 Paralysis from cyanide poisoning, 131 Oxygen breathing apparatus, 506 of muscles from carbon disulfide, 178 carbon monoxide supplanting, 119 of respiratory center from sulfur di deficiency, hose masks for, 505 oxide, 182 in steel tanks, 505 Parenchyma in chlorinated naphtha effect of cyanides on, 131 lene poisoning, 166 ' for welding, 481 injector mask, 436 Paresthesia in hands and feet from car bon disulfide, 179 masks for formaldehyde gas, 115 therapy in ammonia poisoning, 223 in cadmium poisoning, 268 in carbon monoxide poisoning. 127 in chlorine poisoning, 185 in methyl bromide poisoning, 141 in occupational medicine, 434-437 in pulmonary edema, 434 under pressure for pulmonary edema, 436 inhalation of, 435 Oxyhemoglobin, 119 | Paris green in insecticide, 289 Parkinsonian syndrome from carbon monoxide, 129 Parkinsonism from carbon disulfide, 176 from carbon monoxide, 121 postencephalitic, 177 Paronvchia in soda fountain worker, 426 Pastures sprayed with 2,4-D, 230 Patch test, medicolegal possibilities, 418 reactions, 416 Peach kernel odor in evanide poisoning, P 131 Penicillin, 284 Pain around heart from carbon mon in chlorine pneumonia, 186 oxide, 127 Penicillium glaucum, 390 from anthracosilicosis, 364 . Perchloric acid, danger of, 465 from bauxite, 377 I Perfume makers, hazard of methyl chlo- in arms and legs from carbon mon j oxide, 129 J ride, 142 of nitrobenzene, 214 in big toe after lead exposure, 241 Perfumed creams, dermatitis from, 423 in chest from anthracosilicosis, 361, Perfumes, cosmetician's dermatitis 364 from, 423 from cadmium oxide, 266 Pericardium, hemorrhage of, from car from talc, 374 bon monoxide, 119 ST0852952 596 INDEX Periodic re-examination, frequency of, Physician for pre-employment exami 58 nations, 543 scope of, 544 free choice of, in organized medicine, Peripheral neuritis from arsenical poi 27 soning, 293 outside walls of industry, functions from lead absorption, 251, 259 of, 62 Perm A Chor, 161 within an industrial plant, 57 Permanent wave customer, thioglycolic Physicians, industrial, classification of, hazard, 232 72 solutions, hydrogen sulfide, 231 Pickling. 472 Personal hygiene for workers, 73 tank, large open hood, 520 in radium workers, 326 use of cyanides in, 130 measures, 167 workers, hazard of nitrogen dioxide, injury, meaning of term, 29 218 protection in hazard control, 517 Pigmentation, dark, from chlorinated safety in placement of handicanned naphthalenes, 166 worker, 547 from iron oust, 387, 388 Personality change from carbon mon oxide, 127 from lead, 259 of lungs, 387 from carbon dust, 396 from iron-containing dust, 387 traits in iob placement, 553 of skin from fiberglas, 400 Personnel directors, 548 Pimples from chlorinated naphthalenes, Perspiration from inhalation of naph 166 thalenes, 169 Petechial hemorrhages from carbon monoxide, 120 from methyl chloride, 142 from gasoline, 100 in cyanide poisoning, 131 in skin from benzol, 204 Petrographic examination for presence of quartz, 359 Petroleum distillates, 435 hydrocarbon series, 91 refiners, sulfur dioxide hazard, 182 spirits, dermatitis from, 516 Pewters, antimony as alloy in, 306 Phagocytes with hemosiderin from ben- sol, 204 Phenol in benzol poisoning, 202 uses of, 215. Phenolic resins, cast type, uses of, 452 heatronic molding process, 452 P-phenylenediamine, cause of dermati tis, 423 health hazard, 446 in hair dye, 446 Phlebotomy for pulmonary edema, 186 Phosgene, 130, 149 exposure to, 161 hazard, 470 Phosphine, formation of, in pickling process, 472 Pityriasis rosea, 416 Placement program in industrial prac tice, 59, 542 selection of examining physician, 543 of workers, occupational health haz ards, 549 physical demands, 548 Plant inspection for diagnosis of occu pational disease, 80 lighting, 495 sanitation and hygiene, 73 surveys, 59, 73, 80 Plasterers, cement dermatitis, 423 Plastic coloring, selenium hazard, 317 industry, hazards to workmen, 459 incidence of dermatitis in, 459 Plasticizers in plastics, 451 Plastics, casein, 458 cellulose ester, 454 combined with metals, 451 compression molding, 455 ethyl cellulpse, 455 hazard of phenol, 215 injection molding, 455 protein, 458 use of, 451 Platelet count in nitrous fume gassing, 220 Pleura, hemorrhage from carbon mon oxide, 119 Phosphocreatine level in muscles, effect Pleural adhesions from anthracosilico- of lead, 240 sis, 364 Phospholipid metabolism, 151 from asbestosis, 368 Phosphors, 479 effusion from gasoline, 100, 101 Phosphorus poisoning, osseous system, Pneumoconiosis, 341 305 benign, 387 Phossy jaw, 304 definition of, 331 Photoengraving, hazard of nitrogen di oxide, 218 from talc, 373 Pneumonia and industrial environment, Photography, chromium hazard, 314 411 use of cyanides in, 130 croupous, from manganese, 297 Physical ability in selective placement from carbon monoxide, 121, 125 program, 547 from chlorine, 185 demands in job appraisal, 548 I from nitrogen dioxide, 219 INDEX ST0852953 597 Pneumonia--Cont'd in cadmium poisoning, 268 in industry, 402-412 industrial environment and, 411 Pneumonitis, chemical, 278 from cadmium, 265 from chlorine, 185 from gasoline, 100 from hydrogen chloride, 187 Pneumothorax from bauxite, 377 from calcined earth, 384 Poisons to kidney and liver, 88 Policemen and firemen, pneumonia in, 411 Polychromasia, 242 Polychromatophilia, 242 Polyneuritis from carbon tetrachloride, 150 Polyneuropathy in carbon disulfide poi soning, 177 Polyvinyl alcohol, preparation of, 457 Portland cement, ingredients of, 394 Positive patch tests, 418 Potash feldspar in ceramic industry, 477 Potassium beryllium sulphate, reactions of, 278 iodide for deleading, 256 Pottery glazers, hazard of manganese, 295 making, silicosis hazard, 336 Powder diffraction pattern for quartz, 359 Pre-employment examination, 58, 542, 543 Printer, contact dermatitis, 430 Printing and photography, use of trich- lorethylene, 158 Projection spot weld, 488 Prbpyl acetate, 11G alcohol, 110 Propylene glycol, 112 Protective creams for industrial derma titis, 429 Protein plastics, 458 Proteins in diet, carbon tetrachloride poisoning, 153 selenium poisoning, 320 Proximal tubule, injury to cells of, 149 Psoriasis, 416 Psychiatrist on medical department staff, 553 Psychiatry and job placement. 552 Psychic disturbances, mercurialism, 310 Psychologic effect of color, 499 Pulmonary complications from gaso line, 102 disturbance in bagassosis,, 398 edema from ammonia, 222 from benzol, 204 from chlorine, 185 from hydrogen chloride, 187 from methyl bromide, 136, 139 from nitrogen dioxide, 219 from petroleum distillates, 435 from sulfur dioxide, 183 Pulmonary edema--Cont'd from trichlorethylene, 160, 161 oxygen therapy, 434 under positive pressure for, 436 fibrosis from asbestosis, 368 from dusts, 331 from talc, 373 infection from anthracosilicosis, 361, 363 from asbestosis, 368 infections, relationship to dust, 395 inflammation from gasoline absorp tion, 100 tissue, irritants to, 88 tuberculosis in hard coal miners, 363 ventilation. 94, 350 Pupillary reflex in carbon disulfide poi soning, 176 Purple spots on skin from trinitroto luene, 210 vision from methyl bromide, 141 Purpura hemorrhagica from gasoline, 101 idiopathic thrombocytopenic, 200 of skin from benzol, 191 Pyogenic infection in cement derma titis, 424 Pyrene, 148 Q Quartz, formation of, 333 chemical analysis for presence of, 359 diffraction pattern, 359 in treatment of silicosis, 353, 359 Quinine dermatitis in barbers, 423 R Radiant energy, health hazard, 549 Radioactive elements, properties of, 324 Radiocondensers, chlorinated naphtha lenes in, 165 Radium dials, protection of workers, 326 poisoning, anemia, 325 preventive measures, 326 symptoms of, 325 treatment of, 327 properties of, 324 workers, protection of, 326 Raincoat cementers, keratitis in, 110 Rdles from anthracosilicosis, 361 from asbestosis, 368 from bauxite, 377, 382 from carbon monoxide, 129 Ramazzini, Bernardino, 18 Society in America, 20 Rash from cyanide poisoning, 131 from trichlorethylene, 161 Rayon, 171, 172 carbon disulfide in, 171 viscose, process of making, 172, 446 Rays, harmful, 512 Records, industrial medical, 61 Red blood cell count, effect of DDT, 226 cells, effect of lead, 236, 242 ST 0852954 598 INDEX ' Reducing a|ents, workman's hygiene. Retinal hemorrhage from lead, 240 Rhinitis, perennial, from grain smuts, Reeling from carbon disulfide, 75 397 Refining and reclaiming of lead, hazard Rhonchi from bauxite, 377 of lead, 234 Ridge welding, 488 Reflection of daylight, 495 Reflectors, 497 Ridging of fingernails in baker's derma titis, 422 Refractories, 477 in soda fountain workers, 426 Refrigerant, methyl chloride as, 142 Ringworm infection, 420 Refrigeration plant, carbon dioxide gas Rock workers, pulmonary infection, 363 hazard, 130 Rocks, igneous, 333 workers, methyl chloride poisoning Roentgen therapy, benzol poisoning, 203 in, 142 Rotary furnace for recovering of cad units, hazard of sulfur dioxide, 182 mium, 274 Refrigerator plant, electric, workers in, Rotogravure printers, effect of benzene 404 poisoning, 195, 205 Refuse plants, carbon monoxide hazard, Rubber and rubberlike products, classi 118 fication, 439 Renal disease, 153 butyl, 441 injury from carbon tetrachloride, 148 cement worker, effect of benzene poi Resins, 451 soning, 195 acrylic, 456 globes, dermatitis from, 431 alkyd, 454 noods, 511 as protective coatings, 454 formed by copolymerization, 457 synthetic, 438 Ruby glass making, selenium hazard, melamine, 453 317 phenolic, 452 Rusts in grain dust, 397 styrene, 458 thermoplastic, 456 thermosetting, 452 S urea formaldehyde, 453 Safety cans, 501 vinylidene chloride, 457 hazards, job placement, 549 vinyl, 457 match, 305 Resonance, impaired, from anthracosilicosis, 361 Respirations in cyanide poisoning, 131 in methyl bromide poisoning, 139 Respirators, air-line, 507 cartridge, 503 filter, 504 wearing of, 261 of others, in job analysis, 549 rules and safety orders, 575 Salicylic acid, filtering media, 540 Salivation from mercury, 310 Salt solution, interstitial, for acidosis, 112 Sand blast operation, 473, 474, 475 rooms, air velocity for, 529 Respiratory diseases among hard coal with downdraft ventilation, 528 miners, 363 Sandblasters, silicosis in, 337 disturbance from nitrobenzene, 215 Sand-lime brick, 334 failure from hydrogen sulfide, 180 Satellitosis from manganese, 297 function tests after aluminum powder Saturated compounds, 90 inhalation, 353 Saturation of tissues, rate of, 97 infections among cement workers, value, determination of, 96 395 Sausage casing, artificial, 450 irritants, 403 health hazard, 549 Sawdust and shavings, velocity rate for, 529 irritation from selenium, 317 Scabies, 416 protection from dust, fumes, and Scar tissue in silicosis, 342 gases, 502 "Schedule coverage," 26 protective equipment, 503 system of compensation, 26 rate in nitrous fume poisoning, 220 Scleroderma from arsenic dust, 290 system, effect of chemical agents dn. Scopolamine hydrobromide in mercury' 435 poisoning, 312 tract in cadmium poisoning, 274 lead in, 235 Scotomas from carbon disulfide, 175 from trichlorethylene, 159 Restlessness from dichloroethane, 144 Scratching in eczematous dermatitis. from mercury, 310 421 from methyl chloride, 142 Scrotum in arsenic poisoning, 290 Reticulation. 339 Sealing caps, 450 Reticulocytes, calculation of, 244, 246 Seam weld, 488 counting of, 246 I Seborrheic dermatitis and industrial Reticulocytosis, 242 i dermatitis, 416 INDEX ST0852955 m Second injury funds, workmen's com Sinusoids, effect of benzol, 204 pensation, 50 Skeletal system, fixation of lead in, 235 Secondary anemia, treatment of, 102 Skin allergy from smut spores, 397 Sedation in cadmium poisoning, 267 burns from methyl bromide vapor, Selective placement of workers, 545 139 Selenium, absorption of, warning, 319 occupational exposure, 317 from phenol, 216 welding hazard, 488 poisoning, diet in treatment, 320 signs and symptoms, 317, 318 Sequelae, acute carbon monoxide poi cleansers, 516 effect of acetaldehyde, 444 of ammonia, 222 soning, 124 of arsenic, 289, 290, 292 Serpentine, asbestos and, 369, 372 of chlorinated naphthalenes, 166 Sewer workers, hazard of ammonia, 222 of DDT insecticide, 228 of hydrogen sulflde, 180 of formaldehyde, 115 Shade numbers, standard lenses, 512 of hydrogen fluoride, 187 Shadow, industrial, accidents from, 498 of magnesium, 302 Shadowing of lungs in bauxite worker, of selenium, 317, 318 378 of trichlorethylene, 161 Shadows, x-ray, 339 infections, prevention of, 515 Shampoos, oil, dermatitis from, 423 lesions, feigned, 425 Sheet metal elbows, 530 reaction, flberglas, 398 Shields, face, 511 reactivity, refractory period. 417 Shirt factory, methyl cellosolve poison trichlorethylene absorption by, 159 ing in, 113 Sleepiness from hydrogen sulflde, 180 Shoe polish workers, hazard of nitro- from manganese, 297, 298 . benzene, 214 Shortness of breath from anthracosili- cosis, 361, 364 from beryllium, 284 from silicosis, 337 Shot blasting, 476 Shrinkage of lung tissue from diatoma- ceous earth, 384 Siderosis, 332, 387 Silica and asbestos, action of, 368 brick, 477 high temperature on, 334 exposure to, 337 in ceramic industry, 478 Sleeplessness from antimony, 306 from bauxite, 377 from nitrogen dioxide, 219 from tetraethyl lead, 107 from tetryl, 214 Slot velocitv, 471 Slow butt welds, 489 Small plants, control of hazards, 493 Smell disturbance from sulfur dioxide, 182 Smelters, hazard of lead, 234 of sulfur dioxide, 182 workers in, tuberculosis rate, 404 free, 540 Smuts, grain, 397 fused, 334 Soap, abrasive, substitutes for, 429 gel, uses of, 335 powders, dermatitis, 429 health hazard. 549 Soapstone, use of, 334 hydrous, 335 Soda fountain workers, onychia. 426 permissible concentration of, 336 Sodium bicarbonate for acidosis, meth Silicious dusts, 373 od of calculating dose. 111 Silicon dioxide, 333 for deleading, 256 chemical analysis, 359 in welding rods, 490 Silicosis, 333-360 aids in diagnosis of, 346 aluminum in treatment of, 352 complicated by tuberculosis, 345 signs and symptoms of, 337 simple, 338, 344 treatment of. 352 quartz in, 353, 359 workmen's compensation, 42 x-ray diagnosis of, 338 Silicotic nodules, 339, 340, 344 confluent, 343 Silicotuberculosis, 338, 344 pathologic changes, 345 Silk, artificial, 172 bisulfite, reducing agent, 429 lactate. 111 nitrite, treatment of cyanide poison ing, 133 silicate, 335 thioglycolate, 232 thiosulfate and liver extract, 300 Soldering, hazard of cadmium, 265 Solvent naphtha, uses of, 208 Solvents, effect on skin, 516 j industrial, classification of, 88 i in synthetic rubber industry, 443 ! organic, as thinners, 570 used in degreasing, 468 Somnolence from nitrobenzene, 215 from tellurium, 322 workers, hazard of ammonia, 222 Spasm in larynx from hydrogen chlo- Silver mining, silicosis hazard, 336 I ride, 187 nitrate for dermatitis with pus forma I Spasms in throat from cyanides, 134 tion, 431, 432 | Special industrial processes. 461-492 ST0852956 600 INDEX Spectacle goggles, 509 Spectral, 148 Spectroscopy for presence of quartz, 359 Speech defect from aniline, 215 from manganese, 295 from methyl bromide, 139, 140, 141 from nitrobenzene, 215 Spelter shakes, 329 Spice dermatitis in bakers, 422 Spinal fluid, carbon monoxide in, 124 Splash-proof eye cup goggles, 512 Splashes from molten metal, injury from, 509 protection from, 511 Spleen, effect of benzol, 191, 204 of cadmium, 265 of carbon monoxide, 125 of cyanides, 107 of tetraethyl lead, 107 Spot or instantaneous urine analysis, 248 welding, 488 Spots on films of welders, 490 Spray booth, 470, 521 vapors, benzol in, 522 paint booth, 523, 524 painting with cellosolve, 113 Spraying of trees or orchards with cyanides, 130 Sputum, foul-smelling from bagasse dust, 398 frothy, from bauxite, 377 in cotton sampler, 391 in silicosis, 337 Staggering gait from hydrogen sulfide, 180 from methyl chloride, 142 from nitrobenzene, 215 Static suction requirements, 520 Steel, 295 oxides and nitrides in, 485 plant workers, tuberculosis among, 406 Stiffening of lungs from talc, 373 Stiffness of legs from manganese, 297 Stimulants, respiratory, 181 Stippled cell determination, 242-246 Stoddard solvent, dermatitis from, 516 Stomatitis from mercury, 310 Stone finishing, silicosis hazard, 336 plants, velocity for, 529 Storage battery grids, antimony as alloy in, 306 industry, 405, 479 Styrene, 440, 442 polymerization of, 458 resins, 458 Subendocardial hemorrhage from car bon monoxide, 126 Submarines, carbon dioxide gas in, 130 Suffocation from chlorine, 185 Sugar dermatitis in bakers, 421 Sulfanilamide in chlorine pneumonia, 186 powder, 304 Sulfapyridine in chlorine pneumonia, 188 Sulfate index after benzol inhalation, 202 Sulfathiazole in chlorine pneumonia, 186 Sulfonamides, 284 Sulfur compounds, 179-184 dioxide and tuberculosis, 404 as refrigerant fluid, 404 medicolegal aspects, 182 poisoning, symptoms of, 182 treatment of, 183 dye works, hydrogen sulfide hazard, 179 Sulfuric acid makers, sulfur dioxide hazard, 182 Sulphuretted hydrogen poisoning, symptoms of, 1/4 Sunburn and arc burns, 489 Supplementary lighting, 497 Susceptibility to tuberculosis, fumes and gases on, 403 Swallowing, difficulty in, silicotic pa tient, 355 Swing grinders, flexible exhaust system, 522 Sylpharp, 450 Symposium on tuberculosis in industry, summary, 410 Syndrome, hepatorenal, from carbon tetrachloride, 148 Synergic or synergistic action, derma titis from, 414 Synthetic fibers, 446 rubber, 438 industry, acrolein in, 115 Synthetics, 438-460 Syphilides of palm, 426 Syphilis, 177, 426 T Tabacosis, 396 . Tabes and carbon disulfide, 177 Tailor shop presser, carbon monoxide hazard, 118 Talc, description and uses, 334 occupational exposure, 373 pneumoconiosis, symptoms of, 374 worker, difficulty in breathing, 374 Talkativeness from carbon disulfide. 175 Tanneries, hydrogen sulfide hazard, 179 Tannery workers, hazard of ammonia. 222 Tannic acid test of blood, 124 Tanning, use of formaldehyde, 114 Taper-shielded welding, 486 Taste disturbance from sulfur dioxide. 182 Teca nylon, 446 Teeth, effect of selenium, 318 infections and dermatitis, 414 Tellurium absorption, symptoms of, 322 occupational exposure, 321 INDEX ST 0852957 601 Temperature and humidity versus tu berculosis, 406 elevation of, from methyl bromide, 139 of electric arc, 485 of oxyacetylene flame, 482 Tense persons, dangers for, 553 Tension, health hazard, 553 In mercury poisoning, 313 Test, cephalin flocculation, 151 estimating degree of disability in sili cotic, 350 for cyanide poisoning, 132 for methyl bromide, 136 to determine physiologic or organic changes, 84 presence of conjugated products, 83 of toxic agents in biologic mate rials, 82 Testimony, conjectural medical, 54 Tetra, 148 Tetrachlorethane, properties of, 163 Tetrachloromethane, 148 Tetracol, 148 Tetradecane, 479 Tetraethyl lead poisoning, physical ex aminations in, 107 toxicity of, 106 Tetraform, 148 Tetramethyl thiuramdisulfide, health hazard, 446 Tetryl dermatosis, 214 rash, 212 Textile printing, chromium hazard, 314 workers, chlorine hazard, 185 Thermoplastic resins, 456 Thermoplastics based on cellulose, 454 Thermosetting molding powders, 459 resins, 452 Thiamine chloride in neurologic mani festations, 161 hydrochloride, 299 Thioglycolates, 224 effect on hair, 232 Thioglycoiic acid, 224, 231, 232 in cosmetic use, 232 Thiokol, 438 preparation of, 441 FA, lining for gasoline tanks, 441 Three-dimensional seeing, 499 Throat, burning of, from ammonia, 222 constriction of. in cyanide poisoning, 131 dryness in cadmium poisoning, 266 effect of chlorine, 185 sulfur dioxide, 182, 184 in cyanide poisoning, 131 spasms from cyanides, 134 Thrombocytopenic purpura due to ben zol poisoning, 199 Thymol-barbitone test, 150 Thymol turbidity test, 150 Tile ducts, breakage of, 530 setters, cement dermatitis, 423 Tissues, action of magnesium in, 302 body, solubility of gas in, 96 scrubbing of, in chromic poisoning, TNT, 208 poisoning, tests for, 210 treatment, 211 Tobacco and tuberculosis, 411 dust, 396 Toluene, 91 chronic exposure to, 206 industrial uses, 205 Toluol, 205 Toluylene-diamine, types of action, 445 Tonsils, infected, and dermatitis, 414 Tool grinding, 518 Tooth, extraction of, in benzol poison ing, 201 Toxemia in tetrachlorethane poisoning, 163 Toxic agents in biologic materials, tests for, 82 hepatitis from TNT, 209 monocytes, 175 nephrosis from carbon tetrachloride, 150 Toxicity of solvents, 77 Toxicology and industrial hygiene, 72 Tracheobronchitis from asbestosis, 368 from nitrogen dioxide, 219 Trade name products, chemicals in, 555 Translucent coatings for windows, 495 resin, 453 Transparent paper, process of making, 450 Transparit, 450 Transport velocities, 529 Transverse striations of nails in soda fountain workers, 426 Trauma and tuberculosis, 411 Traumatic wounds and infectious ecze- matoid dermatitis, 420 Tremolite, 373 Tremors from manganese, 300 from methyl chloride, 142 from mercury, 310, 313 from tetraethyl lead, 107 of Angers from vanadium, 323 Trichlorethylene, 147; 158, 435 decomposition, 468 degreasing tank, 468, 471 laboratory tests, 160, 162 poisoning, diet in, 161 skin involvement, 162 symptoms of, 159 treatment of, 160 vapor, 468 Trichloronaphthalene, 165 Trichophyton intradermal test, 419 Tridymite, 384 Trigeminal paralysis, 159 Trinitrophenyl methylnitramine, 214 Trinitrotoluene poisoning, bone mar row damage, 210 symptoms, 209 treatment, 211 Tripoli, electrostatic charges, 385 x-ray diffraction pattern, 384 Trubenizing, 113 Truck drivers, carbon monoxide, 123 ST0852958 602 INDEX Tubercle bacillus, 405 Tuberculosis, 341, 345, 356 among steel plant workers. 406 among workers in smelters, 404 and cement dust, 395 and tobacco dust, 396 fatigue a factor. 406 from talc, 373 in industry, 402-412 in foundry industry, 407 in granite and marble workers, 407 in hard rock miners, 408 in industry, symposium on, 409 of larynx in silicosis, 356 sulfur dioxide and, 404 versus lead absorption, 405 Tubule, proximal, injury to cells of, 149 Tumbling, 476 barrels, air velocity for, 529 Tumors,.gaseous, from magnesium pow der, 303 Tunnel builders, hazard of hydrogen sulfide, 180 Turpentine dermatitis and insurance carrier, 421 Twitching from carbon monoxide, 121 from cyanide poisoning, 131 "Two-dollar" examination blank, 543 Type foundry worker, hazard of anti mony, 306 U Ulcers, chromic, wet dressings for, 315 from arsenic dust. 290 Ultraviolet radiation, protective lenses, 512 Unconsciousness from carbon monox ide, 120 from gasoline, 102 from hydrogen sulfide, 182 from nitrobenzene, 215 from trichlorethylene, 158, 162 Unsaturated compounds, 90 Upper respiratory tract, hydrogen chlo ride, irritation of, 187 Urea-formaldehyde resins, 453 Urinary selenium excretion, rate of, 319 sulfate, 202 Urine analysis, instantaneous, 248 pre-employment examination, 544 collection of, for lead determination, 247 color of, from hydrogen arsenide, 291 concentration of gas or vapor in, 96 determination of mercury in, 311 effect of chlorinated naphthalenes, 166 effect of DDT, 226 of selenium on, 319 in arsenical poisoning, 291 in carbon tetrachloride poisoning, 150 . lead content in, 247 selenium in, 319 spot specimens, 248 Uterus, hemorrhage of, from carbon monoxide, 119 V Vagus nerve, hydrogen sulfide action on, 180 Vanadium exposure, symptoms of, 322 pentoxide, syndrome of, 323 poisoning, signs and symptoms of, 323 Vanilla dermatitis in bakers, 422 Vapors, accumulation of, 98 and gases, nonreactive, 98 elimination of, 97 explosion hazard, 500 inflammable, lower explosive limits, 575 reactive and nonreactive, 98 Vascular lesions in carbon monoxide poisoning, 119 Vasomotor symptoms from carbon di sulfide, 176 Venesection in chlorine poisoning, 185 in gasoline intoxication, 102 in methyl bromide poisoning, 141 in nitrous fume poisoning, 221 Ventilation, pulmonary, 94 system, design for, 522 for degreasing tanks, 470 on cadmium and zinc tanks, 464 Ventriculin, 203 Vertigo from aniline, 215 from butyl alcohol, 110 from carbon dioxide, 130 from carbon disulfide, 176, 179 from carbon tetrachloride, 150 from cyanides, 131 from ethylene chlorohydrin, 144 from methyl bromide, 139 from methyl chloride, 142 from nitrobenzene, 215 from tetraethyl lead, 107 . Vinegar, neutralizing agent, 428 Vinyl alcohol and acetal resins, 457 chloride, 442 resins, 457 Vinylacetylene, 441 Vinylbenzene, .440* 442 Vinylidene chloride resins, 457 Vinyon, 446 Viscera, congestion of, from tetraethyl lead, 107 Viscose, 447 rayon, 171, 172 workers, svmptoms of poisoning in, 174 Visible glare, protection from, 512 Vision, blurred, from methyl alcohol, 109 Visual disturbance from benzol, 202 from carbon disulfide, 175 from carbon tetrachloride, 148 from methyl bromide, 139 from methyl chloride, 142 from nitrobenzene, 215 from tetraethyl lead, 107 hygiene, 513 survey trailer, 514, 515 tests for carbon tetrachloride, 150 INDEX ST 0852959 603 Vitamin B and calcium in manganese poisoning, 299 Vocational needs, education for, 69 Voice, effect of manganese, 298 of silicosis, 355 Volatile substances, absorption of, through lungs, 94 Vomiting from arsine, 291 from benzol, 202 from carbon monoxide, 121 from carbon tetrachloride, 149, 155 from chlorinated naphthalenes, 166 from ethylene chlorohydrin, 144 from malt dust, 397 from metal fume fever, 329 from methyl bromide, 139 chloride, 142 from naphthalene, 169 from selenium, 317 from trichlorethylene, 161 from trinitrotoluene, 210 Vulcanizers, sulfur dioxide hazard, 182 W Walking, difficulty in, from manganese, 298, 300 Wallpaper manufacture, chromium haz ard, 314 Washing habits, careless, dermatitis from, 515 Watch dials, radium in, 324 Water glass, for sealing cardboard car tons, 335 Weakness from anthracosilicosis, 361 from benzol, 202, 205 from beryllium, 284 from carbon dioxide absorption, 130 monoxide, 120 tetrachloride, 150 from cyanides, 134 from dichloroethane, 144 from ethylene chlorohydrin, 144 from lead, 239, 240 from manganese, 300 from mercury, 313 from metal fume fever, 329 from radium, 325 from talc, 373 from trinitrotoluene, 210 of eye muscles from tetraethyl lead, 107 Webster test, 210 Weedicide, 229 Weeping due to manganese, 300 Weighman at grain elevator, nocturnal attacks, 397 Weight loss from anthracosilicosis, 3(51, 364 from asbestosis, 368 from bauxite, 377 from benzol, 202 from beryllium, 284 from carbon disulfide, 179 monoxide, 128 from chlorinated naphthalenes, 167 from cotton dust, 389 Weight loss--Cont'd from fluorine, 186 from hydrogen sulfide, 180 from nitrogen dioxide, 219 from radium, 325 from trinitrotoluene, 210 Welder's arc, ultraviolet conjunctivitis from, 489 Welders, siderosis in, 387 Welding, bare-electrode, 486 butt, 488 coated electrode, 486 electric arc, 484 flux-shielded, 486 gas-shielded, 486 hazards of, 489 lead hazard, 234 masks, 512 metallic arc process, 485 ridge, 488 rods, composition of, 489 shielded and unshielded arc, 485 spot, 487, 488 taper-shielded, 486 Well workers, hazard of hvdrogen sul fide. 180 Wet mercury, effects of handling, 313 process in hazard control, 517 sawdust, transport velocity, 529 Wheat products, selenium in, 319 Whipple ocular micrometer disk, 535 White arsenic, 289 crude coal tar paste, 432 White's crude coal tar paste, prescrip tion, 432 Widows, statutory benefits, 32 Wire cloth shield, 513 Wood glass, 398 pulp for cellulose, 447 turpentine, dermatitis from, 421 Worker and job, 73 at coke ovens, sulfur dioxide hazard, 182 evaluating, 547 in granite dust, tuberculosis in, 407 selective placement of, 545 Workers with dyes and explosives, haz ard of toluene, 205 with explosives, hazard of ammonia, 222 with physical defects. 545 Workmen's Compensation Act, diver gence in coverage, 26 free choice of physician, 27 interpretation of basic phrase, 28 state variations in, 27 all-inclusive system, 27 fatal injuries, 32 medical benefits, 48 occupational diseases, 38 permanent and temporary total dis ability, 34 schedule system, 2G second injury funds, 50 silicosis, 42 Wrist drop from lead, 64, 237, 259 arsenate spray, 290 in lead palsy, 257 ST 0852960 INDEX x X-ray diffraction analysis, 357 principle, 358 findings in anthracosilicosis, 386* in asbestosis, 372 in beryllium poisoning, 281 in workmen exposed to diatomace ous earth, 384 shadows, categories of, 339 X-rays, chest, 101 Xylene, 91, 208 Xylol, toxicity of, 208 Z Zinc-cadmium ore, arsine from, 292 Zinc chills. 329 chloride burns, treatment of, 308 mining, silicosis hazard, 336 poisoning, chronic, 307 diet in, 308 medicolegal aspects, 308