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FILE NAME: Talc (TALC) DATE: 1951 Mar DOC#: TALC101 DOCUMENT DESCRIPTION: NY Dept of Labor Monthly Review Dust Inhalation in Relation to Pulmonary Disease NewYork State ueparimeni o j ^ zdot^> fINTHLY R E V IE W _>QN T0J) o o CDivision o fIndustrialHygiene &SafetyStandards Cl CD E ARMY V_ o_l. _30_________ ---------------------_--_-_--_-_-_-_--_-_----MT7--archi--, 1951-_-_--_-_--_-_--_--_----------------INDUSTRIAL NUTRITION FOR DEFENSE NoT CO >> Florence F. Brener, Nutritionist Medical Unit MEDICAL 4 gal- industrial expansion for defense, as fr war, im mediately involves shortages- m manpower, which are reflected in the need for longer hours, a faster pace more night shifts and the employment of an increasing number of women. These special con ditions inevitably result in added P S o d l towTthand strains. The physical needs of the body towith stand this additional strain may, m p a r , be met by having good wholesome food available m the plant. In industrial establishments, desirous of maintain ing optimum production and good worker morale, serious consideration should be given to providi the best in-plant feeding facilities practicable. This need not necessarily be ! cafeteria: A lunch counter or a rolling cart may, under certain circumstances, adequatelyS*8 meet the needs of the particular plant S^The foods served should be selected ^ Provide maximum nutrition at low cost. Menus should be adapted to the particular type of feeding facilities available in the plant. They should be planned with an understanding of food values, good nutrition and a knowledge of the dishes which are popular with plant personnel. The foods served should pr - sent eye and appetite appeal. The menu should al ways include the standard basic seven nutrients re- cuired for good health, while consideration is also given to the caloric needs of workers -- a higher calorie menu for those doing heavy work or work * ing unusually long hours (3000 - 4000 glories per dav)- a menu of lower caloric content for workers o / l i 'ght assembly jobs or sedentary collar workers (2500 - 3000 calories per day). A low cal orie diet for workers is not to be confused with a reducing diet. In general, the food eaten durmg thc lunch hour, in the plant should provide y 3 tol/2 of the worker's total food requirements for theday. Milk is always the beverage of choice,whether one is considering a high or low calorie menu, because it is an unusually nutritious food. , ,, The menu is not only the bill of fare or list or dishes available to patrons; it also provides the bas ic pattern from which the food is purchased, pre pared and served. The menu should be planned at least a week in advance; preferably two weeks a head. When planning menus for industrial cafe terias or other in-plant feeding fae^Ues it is nec essary to be guided by the number of work shifts or whether the plant will be working overtime. Con sideration should also be g? ,, year, holidays and pay days, the lowi that during periods of heavy pi ^^-..., ^ , - time work, and on pay day (particularly if the checks are cashed on the premises) the industrial feeding facilities are patronized more than on other dain plants where the majority of workers are en gaged in heavy production, the caloric needs are high and should be met by properly planned menus offering hearty foods which will supply a high total caloric intake. This may be obtained by into the menu, foods which are high m fats, starch es and sugar. Examples of foods high in fats are. fat meat or bacon; butter or margarine, gravies, mayonnaise or other salad dressings made with oil, and cream, either sour, sweet or whipped. Foods high in starches and sugars inciude such foods as bread or bread products; waffles and griddle cakes, puddings, pies and other pastries; maple syrups fellies, jams, preserves, sugar and candy. It is not usually sufficient, however, merely to offer the high calorie foods; portions must be large if a high total caloric content for the meal is to be obtained. With increased hours of work, special attention should be given to mid-morning and mid-afternoon rest periods. Snacks delivered by rolling carts dur ing these rest periods, or otherwise available to workers, will contribute greatly to reduction of fa tigue and to increase production. The same prin ciples apply to industries where heavy seasonal activities are the rule. The following is an example of a high calorie lunch menu: Cream of tomato soup or other creamed soup Roast pork or other fat meat, with gravy Fried potatoes or candied sweet potatoes String beans, Carrots or other green or yellow Waldorf or banana salad with chopped peanuts or mayonnaise Bread or rolls with plenty of butter or margarin6 Pudding with whipped cream or pie a la mode Tea^ or coffee with sugar and cream or hot chocolate with whipped cream The high calorie foods in the above are the creamed soups, fat meat with gravy, fried white or sweet potatoes, salad with nuts and mayonnaise, The material on this page was copied from the collection of the National Library of Medicine by a third party and may be protected by U.S. Copyright law pudding -- preferably in such form that they may be conveniently taken away from the counter to be eaten at a nearby table or elsewhere. Limiting the menu in this manner will avoid the possibility of too many left overs. It will facilitate speed of prepara tion, thus making for more efficient use of limited counter personnel. It will also help the worker reach a decision quickly when choosing his noon day meal, thereby saving everyone's time including his own. It is recommended that whenever possible a nu tritious and low priced "Special Lunch"*and"Special Snack" for mid-morning and mid-afternoon be offered and an effort be made to promote interest in it on the part of workers. The "Special" for the day may not realize a large profit, but the wise cafe teria manager knows that increased volume in sales can overcome this disadvantage. It is essential to add, at this point, that industrial feeding facilities should be operated primarily for the welfare of the worker rather than for profit. Nevertheless, the industrial cafeteria manager never wants to operate at a loss, if he can help it. Moreover, the extent of the subsidy required from management will often determine whether or not feeding facilities in the plant will survive. A particularly well thought out nutritious "Special" either for lunch or the mid morning or mid-afternon "Snack" will be found to provide necessary volume of sales to make it prac ticable and at the same time give the worker good value for his money. To help boost sales for such "Special" food offer- ing, effective use can be made of nutrition educa tion posters or other literature. Talks to workers on the subject are very useful. For the "Snack Special" in plants having mid-day rest periods, many simple inexpensive combina tions are possible. In general it is desirable to have it priced at no more than 12 cents, because in most industrial plants coffee and a doughnut are sold at that price. A snack combination consisting of milk, fresh fruit and a cookie can be sold for 12 cents. When featured it is a popular choice as against the less nutritious doughnut and coffee. Other snack combinations can be made up of ( 1) 1/2 pt. of milk and a sandwich of cream cheese on whole wheat raisin bread; (2) ice cream and a cookie or a simple ice cream sandwich; (3) 1/2 pt. of milk and a bag of raisins and nuts. With imagination many other inexpensive combinations can be devised. The industrial worker during a period of rapid industrial expansion for defense, or for war, is call ed upon to make a supreme effort to achieve maxi mum production. To provide him with the best possible nutrition in the plant at the lowest possible cost is a vital contribution not only to his health but to the country's defense effort. If the industrial cafeteria manager is not well versed in nutrition, as applied to menu planning and food preparation, he should not hesitate to seek advice or counseling on the subject. The nutrition ist of Division of Industrial Hygiene of- New York State Department of Labor is always available for such consultation, without charge. DUST INHALATION IN RELATION TO PULMONARY DISEASE J ohn E. Silson, M.D. Medical Unit (Continued from the February 1951 Issue) Specific pulmonary pathology has also been shown to be produced by exposure to fumes and dusts of certain of the metals, notably beryllium and cadmium. Both these substances actually are systemic poisons, but since industrial exposure to them occurs primarily by inhalation, the principal pathology is usually present in the lungs. Beryllium is responsible for two types of res piratory diseases.23 One is an acute inflammatory reaction varying from a mild pharyngitis or bronchitis to a massive pulmonary edema, which occurs principally among workers exposed to sol uble salts in the beryllium refining industry. The other is a chronic pulmonary granulomatosis de veloping after a delay of several months to years, which occurs primarily among workers exposed to dusts and fumes of the metal, oxide, and certain complex silicates (fluorescent compounds). It is characterized by a nodular fibrosis giving a char acteristic x-ray picture, and a diffuse thickening of the alveolar walls. The outstanding symptoms are dyspnea, fatigue, anorexia, severe weight loss and intractable cough. The mortality is high, and some degree of permanent disability remains a mong nearly all those who survive. Inter-relations between the acute and chronic forms, and the oc currence of an intermediate subacute type, indi cate that they are probably all widely different manifestations of the same disease process. The pulmonary pathology due to cadmium24 is generally encountered when workers unwittingly create cadmium fumes without adequate protec tion: for example, in flame cutting or welding cadmium plated iron. It first causes a cough and dryness of the throat, which then progresses to severe constricting chest pain and dyspnea, diz ziness, chills and prostration. The pathological pic ture is that of pulmonary congestion and edema, with interstitial pneumonitis, hemorrhage and cel lular infiltration. The term siderosis25 has been applied to a be nign pneumoconiosis due to exposure to dust and fumes of iron and its oxides, usually seen among hematite miners, welders and other iron workers. Pathologically, siderosis consists of a deposition of phagocytized iron particles distributed in nod ular fashion along the lymphatics. Outside of the mechanical effects of excessive pulmonary accum ulation previously discussed, its importance lies chiefly in the necessity of differentiating it from silicosis, with which it had frequently been con fused in the past, particularly among foundry workers. The nodules in siderosis are more dis crete and sharply defined on x-ray, and there is no tendency to confluent nodulation or hilar en largement. a The matenai on this page was copied from the collection of rhe National Library of Medicine by a third party and may be protected by U.S Copyright law. Organic Dust Diseases Bibliography A few materials of organic origin have been found to be responsible for specific types of pul monary pathology. Notable among these is ba gasse,2which is the residue of sugar cane after Hardy, H.L., and Tabershaw, I.R.: Delayed Chem ical Pneumonitis m Workers Exposed to Beryllium Compounds. J. Indust. Hyg. & Tox. 28:197 (1946). 2. Machle, W. & Gregorius, F.: Cancer of the Respira tory System m the United States Chromate-Pro- extraction. This material has been extensively (d1948)S Industry' Public Health Reports 63:1114 used in the manufacture of insulating board and 3. Pneumoconiosis and Tuberculosis other building materials. It shreds readily when ,e z- Zenlralb1' ' Gewer- ! handled dry, with the production of a fibrous dust. Dernehl, C. U. and Nau, C. A.: Some New Aspects A high percentage of workers exposed to these fi and Approaches to the Problem of Dust Disease's bers have developed, after about two months, an acute bronchiolitis with high fever, extreme dys Industf Med. 14:744 (1945). ceases. 5. Mayer, Edgar: Clinical Evaluation of Disability in pnea, productive cough, weakness and weight loss. 094?)nary Dlseases m industry. J.A.M.A. 116:97 X-rays show scattered miliary shadows through tirlehq;T; andT?e? e^ n' W` C- L-: influence of Par- |t pounteutmheonluian.gTfhieelddsisweahsicehumsuaayllygocloenartsouap,cbonuftlumeanyt 7. TT^oUxeoircaotgft300nR' 7D2 ' (U1948hDXPaOvSenUpreo-rt, S. J.: RHeyxgie`wanodf be fatal or result in chronic fibrosis or bronch Snenial pe rn Efff cts of Breathing Dusts, With iectasis. Special Reference to Silicosis. U. S. Department of Both acute and chronic pulmonary diseases have 8. the Interior, Bur. of Mines, Bull. No. 400. ' Clark, W. Irving: Clinical Aspects, Diagnosis and been reported among cotton workers. The former27 Treatment of Pneumoconiosis. J. Indust. Hyg. and Toxicol. 18:537 (1936). consists of an acute febrile illness with productive 9. cough and dyspnea, resembling an acute bronch Occupation and Health, itis. It usually resolves completely, but may oc (Jan m s f ' Internatlonal Labor Office, Geneva casionally result in a chronic bronchitis. It is be lieved to be due to the dust of the fungi or bac teria which grow on damp, unsterilized cotton. The chronic disease,28 known as byssinosis, consists of 10. ,Amor' A- J-: Chest Disease in Industry. Practi tioner 149:326 (1942). 11 w i7 r > K` M; .A-: Diseases of the Lung Resulting fromOccupational Dusts other than Silica. Thorax a progressive fibrosis, usually associated with em physema and bronchiectasis, which develops after many years of inhalation of cotton fibers. It is not 12. Derbes, V. J. and Winsor, T.: Occupational Allergy (1944)e ReSpirat0I'y Tract Ann. Int Med. 20:255 yet known whether it is a specific fibrotic response an allergic reaction, or the end result of repeated subclimcal acute infections. Summary To summarize, there are a number of types of pulmonary pathology which can be caused by the inhalation of excessive quantities of particulate 13. Hamilton, A. and Hardy, H. L.: Industrial Tox icology, Secoond Ed., p. 481 (Hoeber, 1949) 14. JAXMST l4 0 " f l 9CS f , . f 'he LU"g 15. Johnstone, R. T.: Occcupational Medicine and In dustrial Hygiene, p. 382. (Mosby, 1948). 16. Shaver C. G. and Riddell, A." -R.: Lung Changes Associated with the manufacture of Alumina Ab rasives. J. Indust. Hyg. & Toxicol. 29:145 (1947). 17. Jephcott, C M.: Fume Exposure in the Manufac- matter, varying from specific fibrotic reactions (1948) Alumina Abrasives. Occup. Med. 5:701 with a characteristic picture to an increased in cidence of a form of pathology usually considered non-industrial in origin. Size, composition and structure of the particles are all factors determin ing the nature of the response. Pathological re actions generally result when the capacity of the filtering and phagocytizing mechanisms of the resPeatery tract are exceeded. These reactions may be fibrotic, inflammatory, degenerative, allergic, carcinogenic or merely mechanical impairment of function. The best known cause of pneumoconiosis is free crystalline silica, but amorphous silica, silicates, 18. Stone M. J .; Clinical Studies in Asbestosis. Am. Rev. Tuberc. 41:12 (1940). 19. Siegel, W., Smith, A. R., and Greenburg, L The Dust Hazard in Tremolite Talc Mining. Am J 20. Roentgenol. 49:11 (1943). ' Vestal, T. F., Winstead, J. A. and Joliet, P. V.' Pneumoconiosis among Mica and Pegmatite Work 21. ers. Indust. Med. 12:11 (1943). Smith, A. R. and Perina, A. E.: Pneumoconiosis (1948) Synthetlc Abrasive Materials, Med. 5:396 22. Gough, J.: Pneumoconiosis in Coal Workers in Wales. Occ. Med. 4:86 (1947). 23. Silson J. E Benjamin, L. P. and Wilson, S. C.: The Use of Beryllium in New York State. Monthly and even silicon carbide have been shown to exert deleterious effects. Coal dust, certain metals, and a few organic compounds, have also been indicted as the cause of specific lung pathology. A careful evaluation of both the clinical picture and the oc cupational history is necessary in every case of chrome pulmonary disease to rule out a possible etiological or aggravating factor in the patient's working environment, and to ensure an optimum prognosis by eliminating all future exposure to any harmful atmospheric agents found. S r 2 8 i 3 V'( f l4 dU" ' H yg" R Y' S'a,e D' `- ' 24. Spolyar, L. W., Keppler, J. F. and Porter, H. G.: Cadmium Poisoning in Industry: Report of Five Cases Including One Death. J. Indust. Hyg. and Toxicol. 26:232 (1944). 25. Sander, O. A.: Benign Pneumoconiosis Due to (1947) FUmeS and Dusts` Am' J- Roentgenol. 58:277 26. Sodeman, W. A.: Bagasse Disease of the Lungs Arch. Int. Med. 73:365 (1944) S 27. 28. S T o S tfe^ S Iir' CUSh' IMU,t f i ' n25i5L (i9B4y3)Sin SiS- * Ind'" t HTM' " 0 T" -