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FILE NAME: Kohler (KOH) DATE: 1936 DOC#: KOH107 DOCUMENT DESCRIPTION: Journal Articles - The Journal of Industrial Hygiene THE JOURNAL OF INDUSTRIAL HYGIENE a n d TOXICOLOGY EDITORS DAVID L. EDSALL, M.D., S.D., United States EDGAR L. COLLIS, M.D., M.R.C.S., Great Britain VOLUME 1 8 JANUARY, 1936-- DECEMBER, 1936 PUBLISHED BY THE WILLIAMS & WILKINS COMPANY Baltimore, Md. SUBJECT INDEX TO TEXT AND BOOK REVIEWS. VOLUME 18 Hvgiexe, and one shU w " Pilous the subject entry in parentoesS. For author index, 'see p a g e " ite t, h6' !" J URNAI' 0F ^ mistrial t J 7 " ^ Th TMme f the auth^ are book reviews. . bsfxtehsm, sickness absence and aninddinnpcVid|Setnacgee'm-Plrigh.'t Mwoeraksu(rSemmiethnt Leiper, and Culpin); Pt. 2 Labor wastage (Greenwood and Smith) 581 ATMromJ fch-emaincadl, adcitsi-eoanse(sBe-rdgeurf)tn a l,'c81 ^ectrical fatal electric current'in , 0 rl Holstein-Rathlou)... 4fis '( a ' feventh International aannddDnTisSeSasefs0, cBPUruPsasteilsn, aJul lAyc,c1i9d3e5nts n n ^-roxE , methylalcohol _an__d t,,heir mInis<iktUai-rae,SVI-nree-lavtaivaentdoxMicaistvhboiftz()Skli- 106 rd.-alattiivvep01t!0o1xiac?iltdy tohf,e:ir I'IP. ixTuhreesiri 1'.d] .on ,on. w hite ImU Uic. Ce l(Mashbitz, : -^hanskaia and Urieva). . . . 117 i,-HHT ^ nfeCtion (ChopeandSmillie) 780 ^ .maiidd-i?ty "m,Tiin d?uINsGtr'y (cMonatrroshll)e.d. hu- 369 - 4 S f S ei.* ''" " d w "lle r,:::: \,:iVUrmal lde ( D r i n k e r ) . ' i ' 7t l o ierenCed tne plasia ^ ith sPeciai Benzene exposure, urine sulfate deter-P mmations as measure of (Yant l t h i ) . Sayers: . Horvath' and 69 exposure, urine sulfate "determina tions as measure of, plant study of (ra n t, Schrenk, and P a tty )....... 340 Beryllium oxyfluoride, poisoning by vapors of (Gelman)............. 371 Blisters, see under Skin diseases Blood pressure observations, clinical studies in lead absorption (Bel KnaP )............'................. 300 sugar concentration, effect ofnico- r'Jll diets on, of albino rats (\\ llson and D eEds)............... 555 Carbon disulfide, low concentra tions of, toxic effects of (Wilev Hueper and von O ettingen).... 733 Carbon monoxide asphyxia and re suscitation with oxygen and carbon dioxide (Henderson). 13= poisoning (Drinker). . rS P^ and h e a n t ' - v ^ . : ' S " S u S a tlo n a ltu m o r 140 . :Hansel) ^ paranasa* sinuses poaisnodniDngrifnrkoemr)c.o..m...p..r.e..s.s..e.d...a..ir v(Bernz 461 Carbon tetrachloride, chronic to il icity of ammal exposures and field , '^nenSandS^relT)e^r' C ^ i ^ d I studies (Smyth, Smyth, and Car ... Penter)................................ ' ''nineT fS n,C0SISn r nK 'hard'eoal Wile TnSn / er?x BloomfieId, Dalla- Charcoal, activated, in determination llp dones, Dreessen, Brundage, of solvent vapors in air (Cook and ri-!|d Britten)'. .......... 337 Coleman)........................ 194 !!.i'h.nlnfteCun' Preven ti n ' o'f| ' in Chloro-butadiene, 2-(chloroprene); dunaid). t le precessing (M ac toxicity and pathology, and mech 357 anism of action (von Oettingcn, Hueper, Deichmann-Gruebler and G/ Wiley).................................... 240 Chloroprene, its toxicity, pathology , PmPlovees exposed to 1''itFHicda4tJf OlcPheeters)......... 229 1`rri 11 n at . o^ ion dition-s , of solv e in nt d ustrial, vapors v!?a"nd Coofleamcatinv)ated charcoal 194 and mechanism of action (von Oettingen, Hueper, DeichmannGruebler and Wiley)..................... 240 `Chromium toxicology, (Brard)........... 399 Circulation of young workers with regard to occupational rating (Burst).............................................. 794 795 JW T n 2 2 2 - , 193 6 PULMONARY ASBESTOSIS: INCIDENCE AND PROGNOSIS* J. Donneixt, M.D. Mecklenburg Sanatorium, Huntersville, N. C. Wtance, ITHIN ft comparatively short time the occupational disease, pulmonary aalx^tosis, has be come a matter of considerable not only to manufacturers of effective types of suction apparatus now in use will remove a maximum of not over 90 per cent of the dust, imbuptorthe remaining 10 per cent may lx definitely injurious. In 1910 protec asbestos products, but also to the tive devices of the suction typo were workmen engaged in the industry. pluced in a certain asbestos mill, and That the serious industrial hazard of yet 15 years later cases of nsbestosw this type of work has not previously with fatal termination were reported received sudicient attention is becom among workers from this plant. Since ing more apparent. The manufacture the most efficient type of protective of asb-stos products has increased machinery known apparently docs not more limn four-fold in tho Inst 20 completely protect, Although the num years, and hence, because of tho ber of workers affected is probably greater number of workers exposed, somewhat reduced, and the time n*- and the more frequent recognition as quired for the production of an ad a pathological entity of the resulting vanced type of disease is probably pulmonary condition, the subject of lengthened, the problem becomes a aslicstosis has rapidly assumed greater matter for serious consideration. importance. In the case of any industrial em j It is indicated that the owners of ployee presumed to be physirally asbestos plants, and the workers them handicapped by any condition or dis 5 selves, are beginning to realize that ease, supposedly caused or aggravated i exjK)sure to asbestos dust is a serious by conditions under which he has i occupational hazard, and it also is worked, there enters the question of apparent that these workers mual bo compensability. Pulmonary asbesto- protected against the hazard as effec sis has not as yet been widely recog tively as is possible. That this pro nized as a compensable disease in tection can be made complete seems states having laws governing the very doubtful. It seems to be the compensation of workers. If such opinion of engineers that the most eases are viewed as compensable un der the Industrial Compensation Laws, Itrrcivcd far publication .himmry it will be necessary to decide the 'a im. . Rend before tho Industrial Hygiene Sec degree of disability in each individual tion of tho American Public Ilouftn Associa in order that proper rating may lx1 tion at tho Sixty-f ourth Annual Meeting in Milwaukee, Wis., Oct. 8, 1935. made. 1  *??*"** '-j ;;. .'ft' * . - . '>:.. v' i-**5. '. `.'H? I'm! tniTf-`>,fiiili<lifi*ili>iitti' , ,w. 41 PULMONARY ASUL.STOdls 223 Practically all writers on the sub ject are agreed that the principal ymptom of the condition is a varying degree of dyspnea, and that the physi cal signs arc those found in fibroid tuberculosis. Hence a definite diag nosis cannot be made by a physical examination alone. The x-ray film, however, is distinctive, in that it -hows a picture of pat hologieal changes in several particulars different from those found in the, x-ray Hints of any other respiratory abnormality. The presence of the condition can be dem onstrated by the x-ray film alone, but the degree of Usability cannot be estimated unless the symptoms and physical signs are also considered. The dyspnea is usually out of propor tion to other symptomatic manifesta tions, and is the one symptom which, in the more advanced cases, precludes any form of muscular exertion, for that reason, an ashestotic victim is unable to sell his labor on the ojien market, and must be rated as totally disabled. I have seen no statistics in the literature in regard to the incidence of asbestosis among the workers in the industry. It would seem to he. a matter of some importance to 1tor mine the average number of employees who may be now, or who arc likely to heroine, disabled by the condition. I have lately had occasion to review the x-ray films of 161 workers in asbestos mills. Of these, fifty-two showed (.finite evidence of asbestosis in varying degrees. Of the 151, eiglityt-ix had worked in asbestos for jioriods varying from 4 to 20 years, mid in this group were found fifty-one of the positive cases, a percentage of 59.3. There was only one case with definite x-ray evidence of asbestosis who bud worked less than 1 years in the indus try. Of the 52 workers with evidence of asbestosis only four bad worked I(*ss Ilian 5 years, forty-eight having been employed for 5 years or more. There were eleven with an advanced ty|s`, no one of whom had worked less than 3 years. One oi these advanced eases bad been exposed to asbestos dii.-t for .3 years, two lor 9, and one each lor It), II, 12, 11, 15, Hi, 17 and 20 years. Unfortunately l have no record of the length of service of these employees in the various departments of the mills, all of which are mi<|U. ..tionahly diisly, but. it. is agreed that the carding room is the dustiest, and the weave room probably next. It is presumed that the dustier the work, the more likelihood (lure is that, pat hologieal changes in the lungs may result. It is noteworthy, however, that some employers work in asbestos plants for years without sulfering any pathologi cal changes in the lungs, as far as can be detected in the x-ray films. In this series of lot employees, ninety-nine showed no positive evi dence of asbestosis in the films, l' ivc hud worked in asbestos for 1 years, three for 7, three for S, four for 9, six for 10, one for 11, and one lor 15 years. All Ibe others had worked for periods varying from a few months to f> ycais. Sinee the pern ill.age ot those in the series who were affected wits so high, it seems remarkable that, no many could lie entirely free from the ennriit ion even after veal's ol expo sure. Since Ibis jiroee i is non-iiifeetious, the term "physical resistance to disease" is not, applicable. It, is true tliut muscular development avails F"jjartiirawni'ni'iDuiiiiifOTimiamira 224 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Anr , ; r . nothing as a protection against tho disease, since well developed men are ns frequently affected as those not so well dcvelojied. It is also possible that some individuals may be susceptiblo even though exposed to low concentrations of dust. It is the opinion of sonic writers (hat the inhalation of asbestos dust and the consequent production of nsbestosis has a tendency to exacerbate old IuImtciiIous lesions. 'This opinion is apparently not universal. Merewel her (1) says "from a review of 12 fatal cases of confirmed asbestosis it apiiears that asbestosis . . . is less fre quently accompanied by tuberculosis than is silicosis." Gardner and Cum mings (2) slate that "primary tubercu lous infection is inlluenccd only to a limited degree by inhaled asbestos." Egbert (3), in an analysis of 28 eases of pulmonary asbestosis with fatal lerminution as reported in the litera ture, found that tuberculosis was present in only 0 cases of the 28, and in only 3 instances was death tine primarily to tuberculosis. It is universally agreed that silicosis does tend to exacerbate old tubercu lous lesions. In fact more or less rapidly progressive tuberculosis is considered the most, frequent, and must serious complication of silicosis. Boeliniere (It says that silica is the only phthisis-producing dust. In ob servations for several years I have been unable to find evidence that the inhalation ol asbestos dust, or the condition asbeslo'is itself, has anv tendency to render active old, appar ently healed tuberculous lesions. In this series of lf>l workers there were three who had a definite asbestosis in addition to an apparently healed tuber culosis. One lmd been working asbestos for 1ft years, another he 4 years, and the third for 2 y< There was no evidence in the him that the presence of asbestosis hvl yet. had any tendency to activate t! tuberculous lesion. Tho films of workers showed evidence of tubercu lous infection without any pathologic d changes indicating asbestosis. i these, eleven showed healed childhood typo tuberculosis, but none of thehad worked longer than 15 month in asbestos. Two workers show J healed childhood type tubcreulnd with no asbestosis, one of when: had spent 8 years in the work and the other 6 years. There were 5 fib showing apparently arrested adult tyjw disease with no asbestosis. The--- films were of employees who bad .-pent the following periods in rids work: One each for 4, 6, 7, and ft years; and one, no term of service given. There was 1 ease with r.n apparently healed and calcified miliary tuberculosis with a history of only S months' service in the industry. In the 151 films there were onlv four which, from an x-rav standpoint, were diagnosed as probably active tuberculosis of the adult type. One of these had been in service for *> months, and one each for 15 months, for 1years, and for 10 years. Since I ease had worked only 5 months and another 15 months, it would seem im probable that this type of work could be the cause of their active diso:i.-<\ particularly as the films of both ea -- indicated a chronic ype of discs-- and apparently not an acute exacerba tion. There remain for consideration 2 active eases with t> and It) years' service respectively. Agreeing that j ' i L . . v " ' rTiM^ ' - PULMONARY ASIIK.STOSLS the work in osbe.-ilos may have aggra vated their pulmonary condition, 2 eases of active tuberculosis in 151 workers serins a di'ridedly low per centage, if thus tyjie of industrial occupation has any tendency pir sc to exacerbate old tuberculous lesions. Tuberculosis of an active tyjx; may be found <piite as frequently in Hie routine exiiniination of workers in any industry, regardless of whether or not the occupation be dusty. Case / . The x-ray films of one man who has worked approximately 10 rat mg (he eventual degree of disability of a worker, either in the assessment of damages in civil suits or in claims under Slate <'oiu|>cus:Uion Liws. Sparks (5) slates that the disease is apparently progressive, not even the cessation of exposure to the dust cheeking it, spread. Wood and Cloyue (li) stale that once asbestosis bodies are found in the sputum the (nurse of the disease apiiears pro gressively downward, and cessation of ex[sisure then does not cheek the spread. years in asbestos illustrates the fact that employment in this industry even for a long time does not tend always to re-activate old tuberculous lesions. The first film, taken April 2, 1050, shows some fine fibrosis on both sides from the 6th to the 9th posterior ribs, thickened interlobular pleura with some involvement of the diaphrag matic pleura, and a slightly "shaggy" heart outline, these patliological changes indicating a probable tnbestosls which is not very far udvaneed. In addition to this condition the film .hows a tuberculous infiltration in the right apex, which appears to bo in a quiescent state. The second film, taken May 3, j<j;55, indicates that the tuberculous lesion still remains inac tive, although a period of 5 y< urs has elapsed since the previous film was taken. This man left the usbestos industry for a while during this jreriod, but returned to it about 2 years ago. One of the most important problems in the consideration of pulmonary asbe tosis is whether or not the disease is progressive, even after an individual Many writers consider that silicosis is a prngiessiw disease, regardless of wis ther nr nut Ihero has been cessa tion of exposure. However, Sayers (<1 says that "a man suffering from simple silicosis generally improves when removed from the dusty atmos phere and placed in suitable surround ings." Hoisliniere (4) says: "Silicosis by no means always progresses after tlx' haznid bas cea-scd, nor docs it always produce tuliereiilusis." It is reasonable to assume that the eventual elTcct of the inhalation of a dust which sometimes cnuluiu.s as much as 99 per cent silica might be somewhat more severe than that caused by a dust which contains a maximum of only 2.6 |x r cent, It ms nis to be true, however, that the fibrosis in asbestosis is produced by a much shorter exposure than is the rule in silicosis, (ardner and Cum mings (2) say: "The particles and elongated libera of asbestos dust do not, during this period (2 years and 5 moiithsj, penetrate so deeply into the air passages of (he |mig as do the handicapped by it ceases to work in other dusts previously studied. The the industry. Information on this major portion is held up and pha question is of considerable moment in gocytosis! in the lumiuu of respiratory 220 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Apr.. LWrf bronchioles and tho alveoli given off Case III. C. A B , white male. from their walls." Since tho condi Quit his work in the card room or an tion is not an infectious process, it asbestos plant in June, 1931, aft r should not continue to progress on re having worked continuously for s moval of the causative fuctor. Gard years. The first film was taken Ju re ner and OummingH (2) state that the 13, 1931; the Hcrund film, January ..n iislicstosiH body and the production 1935. The first film show.-, a biln"-r of fibrous tissue in the lung is caused fibrosis over the lower two-third < i t by hydrolysis of asbestos fillers in the the lungs, the usual ``shaggy" hear: tissues. Theoretically, then, extension outline and adhesive pleurisy. Ik; of the pathologieul process should ease wan diagnosed well-advanced continue until all asbestos libers re bestosis. The last film shows a maining in the lung arc hydrolyzed, extensive progression of the condition, which may require a considerable time. the fibrosis having extended into tin- Several of my eases seem to indicate apices, and also become more dense. i that the rapidity of progress of the In spite of the fact that this man ha fibrotic change in the lungs after had no exposure for a period of 31 cessation of exposure is dependent to years, the condition hns steadily In some extent on the amount of involve come more extensive. At the time ment which occurred before the indi this is written he haa begun to show vidual ceased work. To illustrate this symptoms of progressive heart failure, point,consideration of additional x-ray and a fatal termination seems in films of 3 cases reported in 1933 may evitable. be of interest. Case IV. R. G. J., white male. Cmc II. 1). S. W., white male. Quit his work in the card room of an <'eased work in card room of asbestos asbestos plant in April, 1930. Th- plant, in January, 1929, after working first film wns taken April 23, 1930, only 18 months. The first film was and shows tine fibrosis and mottling taken June 13, 1931, and shows a over the lower lung fields with some lairly extensive fine fibrosis, a "shngginess" of the heart outline a- 1 "shaggy" heart outline ami some pleural adhesion s. The next film, involvement of the pleura. The sec taken September 2, 1931, 10 months 3 ond film was taken on March 8, 1933, after the first film, shows some in approximately I years later. Com- crease in the pulmonai v f-bmsis. This pari.Min of the two films indicates man, under rest trea`;nent, improved that in the t year interval the densi bis general physical condition ma ties at, the liila have increased notice terially. He wns advised not to return ably, the pulmonary fibrosis has ex to work in an asbestos plant, but he tended toward Ihe apices, and the u id not heed this advice because Ill hypertrophy of both the right anil icit that he must make an attempt left heart has increased. Symptomat to care for his family*. He started to ically, the dyspnea has noticeably work again in Mac, 1933, and con s increased within the last year. 'The tinued until October, 1934, when 1m man has not been exposed to asbestos was forced again to leave his job. . 1 dust since January, 1929. The final film, taken August 30, 1934, 1* > <- *4<V u>l- * ' ' 1 , .VW'4 4 ?"> '.-r *A .! ., : >v ' ' ' ' ' - . * Tfc^rv _ * '-yVlT A r-,, f ~ ; * v ' v > '? * -r . - Ir *Wily.w*i*..../dlrf 'a-. ' ri' 'ol. 18, no. 41 PULMONARY AbllK.SfOHl.S 227 indicates extensive progression of the fibrosis well up into the apices, and a definitely hopeless outlook. In fact tliis man is beginning to manifest the physical 6igns and symptoms of pro gressive cardiac failure, which, in my opinion, is the teiminal result most frequently met with in pulmonary asbestosis. The rate of progress of (he condition in Case II, and the extensive progress in Case III, even though there was cessation of exposure in both eases, qualifies the statement of Wood and tlloync (6) that "once asbestosis bodies are found in the sputum the course of the disease appears progres sively downward." Asbestosis bodies were not found in the sputum of Case II, but were found in that of Case III. The sputum of Case IV was at first negative for the bodies, but they are present since the condition has become far udvuneed. Inciden tally careful examination of the spu tum of cases with definite asbeslotic involvement in the lungs frequently fads to exhibit asbestosis bodies. The high percentage of pulmonary asliestosia (34.4) found in this series of 151 workers, indicates unquestion ably the need for more complete protection of employees in asbestos mills. Sufficient evidence has been produced to prove that the inhalation of asbestos dust is productive of serious impairment of health. In fact, the victim of asbestosis, as a rule, eventu ally becomes totully disabled from engaging in any form of labor. The most prominent and lasting symptom of this disease is dyspnea, and this is out of all .proportion not only to the physical signs found in the lungs, but uLso to the pathological changes depicted in the x-ray films. It is this symptom which very frequently pre cludes any form of physical exertion. Furthermore, even in those cases iu which the x-ray films show a negligible increase in the pathological process over a period of years, there is no indicated improvement iu the dyspnea. Serial x-ray films indicate that the condition U slowly progressive even when exposure has been discontinued for several years. The prognosis for extrusion of life after cessation of exposure in the eases in which involve ment is not far advanced is encourag ing, but the lu>i)o for amelioration of the dyspnea is not encouraging. An industrial worker is entitled to every pmteelioo that may safeguard his health, so that he may earn a livelihood for himself and family for at least a reasonable period of years ill flie work in which he is most skilled. If he is prevented from con tinuing in such wank because of im pairment of health through no fault of his own, he is entitled to some remuneration for his loss of earning power. That protection of asbestos workers has been woefully lacking in the past has been definitely shown. It is iinpt rative that such protection, as marly complete ns possible, be providi d by mill owners. KHieient protective devices will bo far less expensive in the final cheek up than the aggregate of numerous claims for compensation and frequent damage suits. That complete protection can be afforded by the devices in use at the present time seems to be somewhat doubtful, but workers are entitled to the highest type of protection which the engineers familiar with the hazard cun provide. A . v - uU, iirfrt^i wrtWftidi* mg|B|m|ri niwmiTinnwnnr- T...iatir. i. i mi T ^ es a s r " v g u r IH' H"l'r--Till' pf3^rr'"S1''}"|'| *1 228 JOURNAL OK INDUSTRIAL HYGIENE AND TOXICOLOGY Mp<. ' BIBLIOGRAPHY 1. Merewbtiier, K. u. a.: A memorandum on asbcstosis. Tubercle, IS, 00, 100, 152 (1033, 1934). 2. Gaiuinki, L. U., and Cuuminos, I>. E.: Studies on experimental pnemnokoniosis. VI. Inhalation of asbestos dust; its cffcot upon primary tuberculous infection. Turn Jour., IS, 03 (1031). 3. Kimnur, D. H.: Pulmonary asbestosis: Report of a caso with necropsy find ings. Am. Rev. Tut>erc., Si, 25 (l93o). 4. BotsLiNitnc, L. ('Silicosi and rid tuberculous. J. Missouri Btnt, V Assoe., JO, 300 (1033). 8. Sparks, J. V : Pulmonary t*be-;..Radiology, 17, 1219 (1931). 6. Wood, W. B.. and Gi.otne, S. it v monary asbestosis. Lancet, 2Ja\ ' (1930). 7. Saters, R. R-: Silicosis--Review history, pathology, and proventi, U. S. Pub. Health Repts., (1934). !i i J : t 4f \ \ ! tl-. 1 i m ite, fi-'-: ; & x-\ *j , * 'ikr-'t ' ' - . * ' *>: ` . ` ' ' A SURVEY OF A GROUP OF EMPLOYEES EXPOSED TO ASBESTOS DUST* S. B. M cP h eeters Charlotte, North Carolina THE dangerous dust diseases, silicosis and asbestosis, are be ing widely studied* at present. !i has been estimated that there are are the cause of the distinctive pul monary fibrosis called asbestosis. Gardner writes that ``these asbestos particles are phagocytosed as they arc more than 750,000 silicotics in the caught on the irregular walls of the t aited States while there are only terminal bronchioles. The phagocytes 'j,l)00 to 40,000 persons engaged in for the most part migrate directly into lie asbestos industry in the world. the substance of the adjacent walls In the United States in 1929 a total and there stimulate growth of connec <'f 9,237 persons were said to be em tive tissue cells. There results a ployed in the manufacture of asbestos collar of fibrous tissue about the ter products other than steam packing minal bronchioles which contracts and and pipe and boiler covering. While constricts the tubes. The constriction it employs a relatively small number produces collapse of the distal alveoli of persons, the asbestos industry has (atelectasis). The collapsed area be had a remarkably rapid expansion and comes fibrous from mechanical causes by reason of the widespread and varied (collapse induration). In asbestosis uses of its products which include unlike silicosis there is little or no matches, filter pads, paints, roofing, transport of dust into the lymphatic high pressure jointing, electrodes, system and no nodule formation." brake linings, clutch rings and insu "Intervening units (between the af lating material in a great variety" fected lobules) not being involved still the industry occupies an important, contain air and permit the passage of increasing, and permanent place in x-rays. Consequently the roentgeno our economic establishment. gram fails to show massive homogene Asbestos is described chemically as ous shadows. " The appearance on the a hydrated silicate of magnesia con film has been frequently likened to taining little iron and almost no ground glass. calcium. It is a fibrous mineral which This paper reports the results of a can be split up into flexible fibers for survey of 210 persons exposed to spinning and weaving. When it is asbestos dust. The conditions im processed some of these fibers are posed upon the survey did not permit fragmented. The fine fragments are the thoroughness of study to be inhaled by the workers. It is the desired, but all of the employees were Particles smaller than 10 microns w'hich given a brief, general clinical examina Received for publication January 7,1936. tion which included taking their past 229 230 .loi RNAI, OF INDUSTRIAL HYGIENE AND TOXICOLOGY [Apr., /SJC li'.'ilih and omipafional history and a physical examination. No labora tory examinations wen* made. All had a single film made of the chest. I he dust concentrations are not equal in the various departments. In the preparation department the proc esses of grinding, crushing, and mix ing are carried out. Here the quantity of dust is greatest and consists almost TABLE 1 N'lM* Ten 1I E H i F . N r Total examined ................... Normal Inn us .................. Pulmonary fiDriisi-, linear type Heavy linear shadows in the eardinphrenie a n g le ............ ( 'urdiovaseular pathnlogv . . . . Pleural ndhe>iiin< A/.\gos lobes ................. Bony pathology .............. l'lenro-|'i i( ardial adhesions . . Bronchiectasis ......................... Asbestosis questionable........... Asbestosis m oderate............... Asbestosis advanced................ Brimary `pulmonar)' tubercu losis: Primary foci ................. ( 'deified lymph nodes ...... Si-eondary pulmonary tubercu losis: Minimal ............................ Moderately advanced ......... Far advanced ................... 2111 123 58 8 0 13 11 5 2 21 11 4 7 33 2 00 4 1 ! .*) 2 3 3 14 2(1 0 5 25 11 8 8 3.8 5 28 5 23 2 00 4 to 00 entirely of asbestos particles. In the other departments the material proc essed is a mixture of asbestos and cotton. Here the proportion of as bestos particles is less and the total dust is also less, Ttthlt' 1 summarizes the various types of pathology noted in the films. Of the 210 persons examined, forty-five were negroes. The films of one hun dred and twenty-three, 58.5 per cent, were regarded is showing lung-fields that were normal, except for a small primary tuberculous focus in one. Of the 210 films, fifty-three, 25.2 per cent, were regarded as showing definite or questionable evidence of nsbeshi>: of the fifty-three, 20 films were clas-ed as questionable. Had stereoscopic re takes been allowed, it is believed that this number could have been greatly reduced. The indispensability of a competent roentgenologic technic needs to be emphasized. Thirtythree films, 15.7 per cent, showed definite asbestosis; in twenty-five, 11.8 per cent, the process was moderate in extent; and in eight, 3.8 per cent, more advanced. In the remaining 31 films various types of thoracic pathol ogy were noted, none of which were ascrihable to asbestos dust. Table 2 presents the normal lung group and shows the distribution of the group in the various age-periods; the incidence of cardiovascular abnor malities seen in the films and dyspnea according to age-periods; the number with chest expansions averaging ap proximately $ inch, 1J inches, 21 inches and 3J inches; the total number of employees in each department whose lungs were normal, and the numbers and lengths of exposure to asbestos dust of those in the several departments. 1able 3 shows the incidence ami extent of asbestosis from increasing periods of exposure in the several departments. In this table employees are pl.aced in the department where they work at present. It is obviously a practical impossibility to trace the transfer of each individual from departnimt to rot. IS, m>. -!! EXPOSURE T management states th at somethin like 95 per cent of employees contim in the department in which' they bega 4 it has been assumed in the discussb that the employee has been at 1. present work throughout his exposur From this analysis it appears th of 9 persons exposed for more than years to dust concentrations effecti in producing disease, four, 44 per cei T Analysis of Grocp of ! r 15- 24 years 1 Number in each age period Cardiovascular abnormalities. Chest expansion \ ................. Number in each grade........... Years of exposure................. 35 ! 1 j 0-1 i 12-2o i1 s Departments: Preparation........... -............. j 4 ! C a r d in g ............................... 0 i Mule spinning .................... 5 i Spooling .............................. 3 Twisting............................... 11 Winding . ............................ 10 Ring spinning ................... 1 Weaving............................... 8 > Maintenance........................ 4 Total .......................... .. 51 ^ A \ ' escaped asbestosis; of 32 persons posed for more than 10 years similar concentrations, fourteen, per cent, escaped; of 70 persons exposed for more than 5 years fm five, 64 per cent, escaped, and of persons exposed for more than 2 y> and less than 5, twenty-four, 85 cent, escaped. Prolonged exposur disease-producing concentrations dust alone iloes not seem to have I fol. 18* rm. "il EXPOSURE TO ASBESTOS DUST 231 management states that something like 95 per cent of employees continue in the department in which'they began, it has been assumed in the discussion that the employee has been at his present work throughout his exposure, From this analysis it appears that of 9 persons exposed for more than 15 years to dust concentrations effective in producing disease, four, 44 per cent, sufficient in a great percentage of these cases to produce asbestosis. Attention is called to the fact that in the same department, that is, where the concentration of dust is the same, some exhibit the disease after a short exposure while others, after much longer exposures, escape, Nor is the incidence of disease always as great among those who have been TABLE 2 Analysis of Groop of E mployees with Normal Lcnos AGE 15-24 yea 25-34year 3544 year 45-54years 55-54years Number in each age period. . 30 1 Cardiovascular abnormalities. 0-1 2 1-2 57 6 2 1-2 in. 67 2-5 22 1 3 2-3 in. 48 5-10 6 2 3-4 in. 3 10-15 2 1 2 Not recorded 3 15-20 TOTAL 123 9 9 123 Departments: 4 1 5 6 4 4 2 16 5 1 4 1 2 13 3 2 4 1 10 11 1 5 1 18 19 1 7 3 30 1 1 2 8 2 8 1 1 20 4 3 2 9 Total................................. 61 14 35 10 3 123 escaped asbestosis; of 32 persons exposed for more than 10 years to similar concentrations, fourteen, 43 per cent, escaped; of 70 persons so exposed for more than 5 years fortyfive, 64 per cent, escaped, and of 28 persons exposed for more than 2 years and less than 5, twenty-four, 85 per cent, escaped. Prolonged exposure to disease-producing concentrations of dust alone does not seem to have been exposed for equal periods in departments where concentration of dust is greater as among those who work in departments where it is less. ^ The incidence of disease increases with the duration of exposure and the concentration of effective dust, but not directly or constantly. No length of exposure or concentration of dust produced the disease in more than 60 per cent of persons exposed in any - ' . '.'..-i' - 232 JOURNAL OP INDUSTRIAL HYGIENE AND TOXICOLOGY 1 Wpr-. 1 department. It seems to be true everywhere, that some workers are not affected however long the exposure or nrgh the concentration. These facts suggest differences in suscepti bility. As to what deficiencies in defense or possible reinforcements of the attack exist in those in whom asbestosis occurs, other than the recognized difference in the compe- were made to observe the behavior of respiration in response to the changing ventilatory demands of graded physi cal exercise. Dyspnea here means that the persons replied "yes" when asked, "Do you have any shortness of breath under ordinary circum stances?" This "yes" is understood as meaning that these persons when engaged in usual activities were with TABLE 3 SKTAXTOum 0-1yean a is Preparation. . . Carding........... Mule pinning. Spooling.......... Twiating.......... Winding.......... Ring pinning. Weaving.......... Maintenance... Total............ 71 Number with dyspnea....... Cardiovascular disease......... dc&atiom or sxroauas 1-4 ywn o! !I 1g 4-10you* 10-14yaan *1 A J 1 h0 i 9 f0j 2 t 1 jJ j 1 .2 3f 1 Is z * 2 1 a i X *TJ 19 a o <z Z i & 1 X J*< 7232 1 1 13 5 1 3 4 7 1 3 2 1 86 2 32 1 65 1 321 9711 32 1 98 1 64 11 1 1 11 12 9 1 2 5 1 1 3 631 1 3111 28 24 70 45 8 12 5 32 14 7 9 2 723 2 24 2 1 23 25 11 14-20 yean tency of the protective mechanisms in different individuals, no conjecture ia ventured. ..* As of silicosis, dyBpnea may be said to be the characteristic symptom of asbeatoeis. The dyBpnea here re ported does not refer to more fre quent, more forceful or embarrassed operations of the respiratory mecha nisms objectively manifest. N o tests greater or less frequency conscious of an unaccustomed sense of inadequacy attending the ventilatory process. This experience was not infrequent among persons with lungs roentgeno logically and by physical examination normal, occurring in R.l per cent. The experience was more than twice as frequent among those With definite asbestosis. Six of the 33 asbestotics W. IS, no. 4[ EXPOSURE ' ^(18.1 per cent), stated that they h fegom e shortness of breath; three of ' 25 moderate eases and three of tie # 'in o n ! advanced. But the most : vanced eases showed no social resp tory effort during examination a Pio. 1.--Moderate asbestosis. He. ^no cyanosis and none declared ^gLof or impair! ability to carry o. I&J their jobs. Among the thirty-t &i|trf*sbestoti<-s, dyspnea was twief |p : frequent in those under 45 yeai age, 42.1 per cent, as in those years of age (21.4 >er cent). jioi. 18, no. 41 EXPOSURE TO ASBESTOS DUST 233 (18.1 iK-r cent), .stated that they had 80,110 shortness of breath; three of the 25 moderate eases and three* of the 8 ore advanced. But the most ad vanced eases showed no s|xrial rospira. - tory effort during examination and of the twenty-four with dyspnea showed cardiovascular pathology in the films and also had high Mood pressure, but none of the five had definite asbestosis. I)r. William S. McCann reminds us: "Respiration is r ' : Fia. 1.-Moderate asbestoses. .Heavoyf fpibercotsoirsa.l muscles exaggerate the api>earanee i0 cyanosis and none declared lack or impaired ability to carry on at ^their joixs. Among the thirty-three (lysl)n<`a was twic0 as .frequent in those under 45 years of 42.1 j)er eeiit, as in those over -45 years of age (21.4 per cent). Five N not a function of the lungs alone, but of the heart, blood and tissue ability to alxsorb oxygen, and also to undergo oxygon want such as the trained muscle's of athletes withstand oxygen want." . Decreased chest expansion may be 234 JOURNAL OF INDUSTRIAL HYGIENE AND T O X I C O L O G Y ^ ,, m e t J a ! ! thT rdinaI T f aS,,sto" 8. `5 normal lung grouP> f n ! .r r Z a had an eXpansion un(1<>r 2 S 4 per cent above 2 inches, In the group with definite asbestosis 69.6 po,ce,,t,hac l.c h e ,p a n ,to n ,,i PIai,10d ^ Shortness of % Z h * Of tho 'levcn with moderate asl>csfn and the three with advanced a.si>est,,T who had worked more than 10 v e n ^ S bj,k\ Z7 one (7 I "n ,y ' ,* 1 fourth a . r c p L o n \ z i 0'2 h d T * ' s Z d h?d chosw " paf r " h ie h " ,m" ~ 1- gree of expansion was increased about 24 per.cent among the asbes- totics. Chest expansion depends not only on lung dlsteasibility but on the mobility of the bony and soft tissues of the thoracic cage and of the dia phragm. It is often astonishing how training and practice can rapidly in crease chest expansion. The indi vidual learns to exercise fully anatomic capacities which were present prior to the training. hrom the foregoing findings it appears that the assumption that a' sense of air want and restricted chest expansion are due to an existing as- ' cent of these 14 asbestoties had a chest expansion under 2 inches whereas 56 per cent of the normal' inng group had the same limits. But 78.9 per cent of those with definite asbestosis who had worked in dust under 10 years had chest expansion under 2 inches and 26.3 per cent complained of shortness of breath. The older persons, whether with mod erate or more advanced asbestosis, appear better adjusted to the disease. The average exposure for the entire group with asbestosis was 10.2 years, for those with moderate asliestosis 10.3 years, and for those with ad vanced asbestosis, paradoxically, 10.0 - .*..j w' .t . . hestosis is. divided into those below t ___ Wl ftq< * - i above 40 yearn o H g, , T e bestosis with length of life and work exposure of those with moderate it is to be noted that: One employee asbestosis below 40 years of age was with advanced asbestosis above the 9.5 years and above 40 years of age, age of 55 who had worked in dust 12.4 years. For those with advanced more than 15 years was still able to asbestosis the corresponding uverages work. One employee, 54 years old, were 9 and 11 years respectively. with advanced asbestosis who had Advanced asbestosis may exist in worked in dust more than 10 years late age-periods with working ability was still able to work: Three cm- , not impaired below the level of con- ; ployees with moderate asbestosis and tinued employability in the depart- ' above the age of 44 who had worked ment where the disease was incurred. in dust more than 10 years were still No very rapid development of the ' able to work. Of this group of 5 disease was noted. Only 2 cases asbestoties above the age of 44 (three Ioccurred where the exposure had been , with moderate asbestosis and two less than 5, years. As a rule 5 or ^ with advanced asbestosis), one com- . more years of exposure w as,required * fe-r,;- . po1.18, no, i] EXPOh jp 4o cause the disease. No c Iterate or massive lesions such in silicosis where infection is > & posed were found in these a Ite cases. . The progression of tilt in this group was very slow. j?.The evidence presented as Sect of asbestosis upon tuber this survey Is somewhat l ipical tuberculous infiltratio d in the films of 17 emp! was no other evidence of tu `pol. l8, no. It' E X I ^ P R E 'T d 'A iS B E S T O S lD P S T ^ ^ ^ ^ ^ v 'jv .- ,V '->Y :: _ ' ; ''X -,i -;' * ';;'.''' ''f' *;* : : ' ttj **. to cause the disease. No eonglom-... lasts seen in these filnis. If it ran be erate or massive lesions such as occur assumed that most of these infiltra- in silicosis where infection is superinl- .tions formed in the late 'teen age or posed were found in these asbestosis l>efore 25 years of age, then exposures cases. . The progression of the disease to asbestos dust varying from 5 to 15 in this group was very slow. ^ - years had produced no evidences of i} r>i`Irv ' f mv: *? . *V KM:' 'H-I.. Fiq. 2.--Advanced asbestosis, emphasised at left base. emphysematous. A ' Upper lung fields The. evidence presented as to the activation to be seen in the films. .ect^ of asbestasis upon tuberculosis Four of these apical tuberculous i n - .... ;thia-survey Ls somewhat limited.- filtrations were found in /asbestotics, ' '! pical .tuberculous infiltration - was ` two with moderate and two with more . , ,in; the films of l7'em ployees -advanced proccsse^/ Six lesions with j, 3.was no other evidence of tubercu- - clinical significance were observed: 2 JOURNAL OF INDUSTRIAL HYGIENE AND ", TOXICOLOGY ' [Apr., t m mimai and 4 moo<dl<erately advance! (American Sanatorium Association ( lassifi<`ation). One modrraately ad vaneed lesion was found in a man 24 y a rs old who had Ie-,on exjMised to asbestos dust in the winding dleo.part- arded lumself as in good ]i0:ltl One of tlie moderately advanced le Mons was found in an employ,.. ;J7 years of a,, who had worked`,, the winding department lor ) years an<l showed no evidence of ashestosis.' \ f -- iffflmilllffBp r * ' ; - -*TSAv' JRBfcjEL * Flo, 3. --Lateral |Nwitinn. (Same cusn iw Fig. 2.) ment for 6 years. The lesion ap|>earod third employee with a moderately adsoft and unstable; there was, how \ancc(J tuliereulous lesion had worked ever, no evidence of accompanying i" the twisting department for 10 eamsbtonKstrosis.i The>d...i.s.e..a.sUe11\Sinmt,hMi,s` m-ovi,l`,ars lit hl>audt nhoad asnboostaossbisostoTsihse. The eratey advanced .case, was clinically 'fourth, an employee .'17 yearn oTaL mamfest, though the employee re- ' who had forked in the weaving , i wL IS, no. 41 EXPOSURE ' - partment had moderate asbestoThe tuberculous lesion in this c; could satisfy rigid criteria of a hea lesion. Three of these lesions w active and were accompanied by cl cal manifestations. The one les associated with asbestosis was hea ind the employee apparently wa. good health. One of the two mini lesions was in a man 24 years of who had worked 15 months in twisting department and whose did not show asbestosis; one in a i 37 years of age who had worker years in th e winding department Group o r 24 E mployees with Ab 15 Number of employees in each ageperiod........................................... Dyspnea........................................... Hypertension.................................. Years of exposure.......................... Number of employees.................... Asbestosis........................................ had no asbestosis. One of minimal lesions was apparently hi . It is felt that no evidence c aggravating effect on tubrculo, asbestos dusting is to be foui these cases. Only one of th ; clinically significant lesions wa eoropanied b y asbestosis and lesion had every appearance of healed. The incidence of pulm tuberculosis (2.8 per cent), is reg " s comparable to the incider. many other industrial groups in Ithe association is close and pro. andwhose general standards of Inn hvrnann orra rartf OS m \ A /1 * 1 18, no. 4] EXPOSURE TO ASBESTOS DUST *- ,'7***** r 237 partment had moderate asbestosis. ;The tuberculous lesion in this case could satisfy rigid criteria of a healed lesion. Three of these lesions were active and were accompanied by clini cal manifestations. The one lesion associated with asbestosis was healed and the employee apparently was in good health. One of the two minimal lesions was in a man 24 years of age who had worked 15 months in the twisting department and whose films did not show asbestosis; one in a man 37 years of age who had worked 12 years in the winding department and ; The films were studied to discover any.accentuating effect of a focus of tuberculosis on the surrounding as bestosis. No convincing evidence of such an effect was seen. Tuberculosis and asbestosis were coincident in only 5 employees. The average dura tion of exposure for the five was 10.4 years and for the entire group with asbestosis 10.2 years. No accelerating effect of tuberculosis on asbestosis could be inferred. Twenty-four films showed abnor malities of the heart and aortic shad ows (Table 4) and eleven of the TABLE 4 Group or 24 Employees with Abnormalities or the Heart or Aortic Shadow t 1S-Myean S-Myean 35-44yean 41-Myean 54-Wyean Number of employee in each age- period........................................... 0 Dyspnea.............. ............................ 0 Hypertension................................... 0 Years of exposure............................ 0-2 Number of employees..................... 4 Asbestosis......................................... 7 9 5 3 1 2 1 1 6 8 4 3 2-5 5-10 10-15 15-20 2 9 9 3 2 had no asbestosis. One of these twenty-four abnormalities were found minimal lesions was apparently healed. __ in the 45 negro employees. A Wasser- It is felt that no evidence of an man test was not allowed. Ten of ggravatbg effect on tuberculosis by these negroes were under 45 years of asbestos dusting is to be found in age and one over 55 years of age. In these cases. Only one of the six this group of 24 employees with efinically significant lesions was ac- cardiovascular changes, three had a wmpanied by asbestosis and that normal blood pressure and the rest had krion had every appearance of being hypertension. Five of the group with healed. The incidence of pulmonary cardiovascular abnormalities had def- tuberculosis (2.8 per cent), is regarded b ite asbestosis, three of these were _** comparable to the bcidence b negroes under 35 years of age (Table many other bdustrial groups b which ,5 ). / -the association is close and prolonged Waring and Black b an admirable whose general standards of liv b g ; paper discuss, "The Syndrome of Ob- d hygiene arc not as good as might struction b the Lesser Circulation" r 104O nnd Journal o r industrial hygiene and toxicology 1938 give as its clinical features, cyanosis, dyspnea, polycythemia, and right ven tricular preponderance. tions in the group does not appear to be excessive. 10 The blood was not examined in the T _ make a scientific appraisal of cases here described and no electroa*nd7 ,dTy &mB wWereerenot^obdgee-rveCdy^anosis the " * * * 2 Plant of exposure to asbestos dust it is necessary to know how many of the 5 asbestotics with cardiovascular employees during the 15 to 20 yea* disease In view of the pathology covered m the 8tudy have died or quU characteristic of asbestosis, namefr and how many 0f these had constriction of the terminal bronchioles This knowledge is not available. Cer- D0 ^ ^ P t a t i c or perivascular taml.y might add greatly to The If fibrosis as m silicosis, less obstruction ^ a[ `t^ of the P^ture. The most that could be done was to note the effect Age. Race. Blood pressure...... A3 White 27 Black 30 Black Years of exposure... 170/110 158/104 130/92 Asbestosis. Dyspnea... ___ 8 Advanced No 7 ' Moderate 10 Advanced Chest expansion.., X-ray pathology.. 1.5 in. ' No 1-5 in. No 1.5 in. Enlarged ' aortic Enlarged aortic Enlarged heart shadow, shadow. shadow. v Enlarged Enlarged Both ven .. > left ven right and tricles en tricle left ventri larged elea of the lesser circulation would seem to be expected in asbestosis than in silicosis and consequently less strain on those now present in the plant, after varying periods of exposure. on the right heart. The frequency of respiratory infec S ummary tions was investigated. - Each ero- 1. In addition to duration of expo Ployee was asked, "Have you had severe colds, 'flu,' or pneumonia and ; how often?" None said they had had sure and concentration of effective dust, it appears that individual re sponse to the inhalation of asbestos - said they had had ' dust is a? important factor in the i > ,H' ." gift mentioned having had production of asbestosis. ^ colda since being exposed to asbestos ;' 2 . Asbestosis is infrequently found g d u r t, and one spoke of having frequent n ' -^id a. The reported'respiratory infec- before 5 years of exposure to industrial concentrations o^ asbestos-dust-'. In ml. 18, no. .{! EX 1 this group even under die Ncontinued 15 years or more, 'did not progress to an ", involvement at tend! by nr cal manifestations or disjibi .. 3. Koentgenolngically ar bestosis was not ineomp; . ability to work at the prove it was incurred. Cont in entailing exjinsure to diseasi 1 concentrations of aslx-stos i increases the extent o f film is to l)e advised against. . 4. The evidence present study warrants the opinion 'th e reduction; of-dust eon now feasible by- available.. . mating d evices, the ineidei *VV;-^r ` ;N.' hI'T'* a * ->. "--jl , v 'v,- * *. . *" :\ - 'I -v ji , it `As: . ,'tul. 8, no. >KX m5 -:wbKw-fil m f this group oven under dusting w h i c h ^ n i ^ n ^ S ^ w ^ w d d ' in ` t'im v l .continued Id years or.more, the disease ` approach the5vanishing point. p d i d not progress to an extent o f / 5^|P^oA ctivating *or 'a g g r a v a tin g ^ i;: involvement attended hy marked c l i n i - a s d i e s t a s dust or aslx^tosia oh^^*1 cal manifestations or disability.- : ` ^tubereniitwwAvhs ojjwrved. - / $. ** 3. Roentgenologieally advanced as-V?^ Q -T l, evidence of this s t i i W ^ a s ^ ^ bestasis was not incompatible with i:.* ....... .1. _ . cffeet.of asljestosia on the ^csser^^* wiM' e V / ' ,i y M '/; "'Tv'f -..A!-1 *. -1^ s p r *'4*: i &ri >,TX S i s > *V * - *>*;<' -4*' , 192 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOG.Y PAO Anemia, pernicious, from chronic car bon monoxide poisoning (Berger and G r i l l) ........... ......................... 101 Aniline intoxication with severe cya nosis (Loeper, Soulie and Marchon). 158 resorption by plant and animal tissue (Lieb)................................................ 183 ANTHRACENE-alizarine-chromate group, wool dyes of eczema and hyper sensitivity to (Kohler)................... 12 Anthracosis, inhalation of coal dust by guinea pigs (Ichok and Glarner). 109 pleural pigmentation and pleural nodules (Kreipe).............................. 109 pulmonary, simulating lung tumor (Gutz).............................................. 39 silico-, of coal miners (Cummins). . . 26 Anthracosilicosis (Dreessen and Jones)................................................ 180 Anthrax (Beckmann)........................... 114 from ulcus molle of penis (Borzow and Finkel)....................................... 136 treatment with large doses of anthrax serum (Metzulescu)........................ 114 Antimony, history, production, use in industry and poisonous effect (Habeck).......................................... 51 Apatite dust, effect of, on experi mental animals (Dahl).................. 25 Aphasia as symptom in caisson disease (Oka)............................................ 92 Appetite, influence of odor on (Win slow and Herrington)..................... 57 Abgyria, occupational (Harker and H unter)............................................ 165 ARM-nerve paralysis in case of lead poisoning (Gerbis).......................... 5 Arsenic carcinoma, industrial (Miy a ji).................................................. 137 damage to liver, chronic, investiga tion of (Stoeber)............................ 177 determination of, by means of Pni cillium brevicaule (Breiter)............ 105 effect of, on muscle (Nonenbruch, Stary, Bareuther and Thelen)....... 177 in hair, nails, determination of (Schwarz and Deckert).................. 105 poisoning, chronic, symptoms of tabes in (Stokvis)............................ 51 poisoning, ocular affections in (Chepurin)............................................... 139 trioxide, study of handlers of (Irvine and Turnacliff)............................... 83 Arseniuretted hydrogen, see Arsine Arsine, action of (Heubner and Wolff). 105 poisoning (Gillert)............................. 159 poisoning by, at zinc sulfate plant of lead works (Spangenberg and Kotzing)........................................... 127 poisoning, chronic (Kiese and Bertram ).......................................... 105 poisoning, occupational of physician (Baader).......................................... 51 Artificial respiration, efficacy of (Thiel).............................................. 143 Artificial silk, see Rayon * Asbestos fabricating plants, ,m ..r and amount of dust encountered u and effect on workers' hi-ti' (Fulton et al.).................... Asbestosis (Alwens)......... ........ (Bohne).......................... ' ....... .J1' (L a n z a ) ................................... . 5 Pts. 2 and 3. (Fulton et al.) .......... !y two cases of squamous carcinoma in *' (Gloyne)................................ ` , Asphyxiation, carbon monoxide slow h (Beck)....................................' ' 17(. Atmosphere, diurnal variation of inter mediate and large ions of, at Wash ington, D. C. (Wait and Torreson) (J Atmospheric conditions, effects of re duced cooling powers on water balance and related effects (Lee and M ulder)............................................ 44 conditions, electrical and hygro mtrie, relation to surgical skin infections in Egypt (Knipfer)....... 50 conditions in hot and deep mines, 21st report of, on energy output of . coal-miners (Moss)......................... 43 conditions in hot and deep mines, 22nd report of, time study of coal fa c e workers (Moss andH alls). ... 43 conditions, outdoor, subjective reac tions of human beings to (Winslow and Herrington).............................. 2 conditions, see also Air Conditioning, Cooling, Heating, Ventilation, etc. pollution of American cities for 1931-- 1933 (Ives, Britten, Armstrong, Gill and Goldman)........................... SO pollution Research Committee for year ended 31st March, 1935, 21st report................................................ 98 pressure, evidence th at mammals cannot acclimatize to 10% oxygen or 20,000 ft. altitude (Campbell).. 117 pressure, increased, physiological effects of (Koslova, Schutov and Farfel).............................................. 41 Australia, lead in urine of workers in Mt. Isa Mines, Queensland (Shiels). Ill lead poisoning at smelter in Queens land............................................... 22 Automobile, cases of professonal in toxication among Diesel motor-bus drivers (Castrovilli)....................... 69 drivers, hours of work (Neveu)....... 145 industry in 1934, wages, hours, employment and annual earnings in (Tolies and LaFever)................ 94 Back, injured, of working man (Muir). 48 strain and sciatica (Ober)................ 14 Bacteria, effect of radium on (Spencer). 19 in air passages of anesthetized ani mals, behavior of (M argaritis). . . . 78 technic which completely excludes air contamination of bacterial cul tures (Spencer)................................ 19 V 8 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY lJ an.t ]9Sg motely resembling those of silicosis by injecting sericite." The authors realize that their results "may not exactly repre sent the pathological changes produced by the inhalation of sericite by miners" but they feel that the results may be useful for the comparisons which are made possible 6. Though there is an excess of tubereu. losis deaths among foundry-workers, Pnen moma, which is the cause of about onefourth of all deaths of foundrymen, appears to be the greatest occupational hazard"in the industry.--Authors' summary. between quartz, sericite, and other d u s ts .- Philtp Drinker. Two Cases of Squamous Carcinoma of the Lung Occurring in Asbestosis Familial Disposition to Silicosis. / Lochlemper. Aerztl. Sachverstdnd.-Zeitung, vol. 41, pp. 174-175 (1935). The author writes of a family several members of which contracted silicosis shortly after working in the same industry, where they were exposed to quartz dust. embers of another family, on the other hand, showed only light cases of silicosis, although they had worked some years under the same conditions. The author draws attention to the fact that there may be a family disposition to silicosis, although he cannot assert that this is true.--L. Teleky. N. R. Gloyne. Tubercle, pp. 5-io ((),< 1935). vL > The two cases described were women workers in an asbestos factory. One, aged 35, had been a spinner for 8 years and sur vived for further 9 years. The other, aged 71, worked only for two periods of 6 and 13 months as a mattress maker and lived for 15 years afterwards. No etiological asso ciation between the carcinoma and the asbestosis is claimed. The malignant le sions were small and were not recognized during life. They were circumscribed with no extension to important structures; no secondary deposits were present. The as E pidemiological Aspects of Silicosis and T uberculosis. A. S. Pope and D. Aacks. Am. Rev. Tuber., vol. S3, pp. 229 242 (1935). ' bestosis was fairly advanced and of long standing; pigment, asbestos fibres, and asbestosis bodies were pushed aside by the advancing growth. Neither disease seemed 1. In representative groups of both gran ite- and foundry-workers in Massachusetts the frequency of silicosis, and of silicosis to be sufficiently advanced to have caused death by itself; the combination was fatal -- E.L.Collis. with tuberculosis, was found to be posi tively correlated with the duration of expo sure to dusts containing free silica and to the concentration of such dusts in the occupational environment. 2. Among the granite workers examined, silicosis alone was found in 15.2%, and sili cosis complicated with tuberculosis in 7.6%. 3. Tuberculosis is the cause of death in over one-third of all granite-workers, a proportionate mortality three times th at in foundry-workers, and four times that in all males of 20 years and over. 4. Among the employees of 10 Massachu setts foundries, silicosis was found in 8.8% and silicosis with tuberculosis in 2.6% a total frequency of one-half that found'in granite-workers. 5. ia e silicosis found in foundrymen was not only less frequent but also less advanced in degree than that in granite-workers. Lung F unction and X-ray P ictures in the Legal Estimation of Lung Damage from Dusts in Compensation Cases. W. Schmidt, E. Gaubatz, and Hollzmann. Aerztl. Sachversland.-Zeitung, vol. 41 vo 178-182 (1935). ' ' The authors have investigated lung dam age from dust inhalation by procedures other than x-ray. Lung function was deter mined spirometrically, the apneic pause and residual air was determined and work tests were performed using an ergometer. Vital capacity alone was found insufficient for judging functional disability but the apneic pause and residual air gave a convenient objective scale for judging emphysema while the work studies gave useful data on the heart action. It was established that working capacity and disability could not be judged by x-ray alone-facts which are in general acceptance--L. Teleky. fol. IS, i] f!iU 3V' ft r' Bjvibw of Literature on Breathing Dusts with Sri j Nce to Silicosis, Part III rington and S. J. Davenport. Mines, / C. B85T, (Oct., 1935} In this Information Circulai deal with the economic and lei' dust disease in industry, and chosen list of references. A summary and general con complete the series and it is that this valuable informatioi in book form.--H. N. Lawson. Dust Storms and T heir Post ON Health. E. G. Brown, and R. L. Labourn. U. S. Repls., vol. 50, pp. 1369-lSt 1935). "1. The dust storms which 1 in the central west are the dim period of decreased rainfall, a 1 of vegetation, and high winds. "2. Crop and livestock lost large. It is believed by aut: although there has been mu< DUST, SMOKE, FUMIE Presidential Address. R. . de Smidt. J. Chem. Met. .' Africa, vol. 36, pp. 18-28 (.4i A review of the methods of tion and dust control in the r gold mines. The author em little progress was made unti was approached with the vie mine air must be treated in p same way as gassy mine air. should be controlled to prod; dilution. Mine air filtration : given highly satisfactory resi mines. The author questions the wi cation of cooling as a means the high temperature and hit deep mines. Dry methods o: but face one serious obstacle wet methods of control are no the miners and the general p; mental to safe work in dusty i will have to be educated to methods.--T. Hatch. 52 JOURNAL OF INDUSTRIAL HYGIENE AND TOXlCOLOG\ l-V -, /sj., DUST HAZARDS AND THEIR EFFECTS $8 'Jj Studies on the Absorption or Dust in Indust. Med., vol. 6, pp. 17-2 (j,,, 'rS td the Respiratory Passages. II. Ab 1935). m sorption or Manganese Dioxide Dust. The often encountered assertion tint fl O. Ehrismann. Ztschr. f. Hyg. u. Infec- existence of silica and alkali dust in nuu.t..,,.. tionskrank., vol. 117, p. 662 (1955). constitutes extra hazardous work ......S The author subjected rabbits to daily tions is unproved, but not neces^iriU 1 exposures of 4 hours, over a period of 3 founded. Extensive investigations ,,f i,,(. | months, to manganese dioxide concentra workers in six plants simultaneously ,.x. ;J tions of 10-20 mgs. per cubic meter or he posed to silica and alkali dusts provide,i | | gave them a maximum of 3 gms. of manga evidence of an accelerator action !>\ ;,ik:i. j l nese dioxide by means of throat probe over lies. The entire absence of silicosis Migg,-M. D a period of 33 weeks. He found increased the possibility of an inhibitor action. J amounts of manganese in the organs, Animal experiments with guinea pigs lu S though no more in the lungs than in the which the peritoneal cavities were inject,.,| II other organs; there was a decrease in the one or more times with 0.1 or 0.2 gin. each (,f erythrocyte count and in the hemoglobin silica and alkali (sodium carbonate, sodium | content. The white blood picture showed bicarbonate, magnesium carbonate, ,,r j no changes. Studies with cats gave similar limestone), yielded no results proving either ij results. Thus, it was shown that inhaled an accelerator or inhibitor action of ulknl i ti and swallowed manganese behave similarly; in the production of silica nodules. The .. pneumonia did not result from manganese presence of alkalies markedly increased the I duBt inhalation.--L. Teleky. distribution of silicotic nodules throughout ' the abdominal cavity, which action is apparently solely due to the mechanical * A8BESTOSIS. A. J. Lama. J. A. M. A., distribution of the silica by increase,1 vol. 106, pp. 568-69 (Feb. 1, 1956). tions of abdominal organs, induced In As this paper is shorter it is necessarily alkali irritation. less complete than that by Lanza, McCon The primary toxicity of silica and silica nell, and Fehnel (These Absts., vol. 17, p55). gel mixed with alkalies is much greater than I t is general in character, gives the history is true for silica, silica gel or alkalies alone. of asbestosis, the clinical picture, a brief --Authors' summary. discussion of the roentgenogram and of the pathology. Lanza estimates that there are about 10,000 men exposed to asbestos dusts Silicosis and Silico-Tubercclofis in M e t a l l u r g ic a l P l a n t s . M . France.*, >. in plants employing about 12,000. Mere- Med. del Lav., vol. 15, pp. 241-253 wether and Price estimated that there were about 2200 similarly exposed in England in 1955). The author describes and discusses la 1930.--Philip Drinker. cases of silicosis or siiico-tuberculosis in metal workers and points out necessary T he Action of Silica. C. P. McCord, II. Ainslee, J. Johnston, and R. L. Fleming. precautions in plants where the silicosis hazard exists.--L. T. Fairhall. DUST, SMOKE, FUMES, AND VAPORS: THEIR DETERMINATION AND ' ELIMINATION D eterm ination of P hosgene. IE. PYant, J. C. Olsen, II. H. Slorch, J. B. Littlefield and L. Scheflan. Ind. and Eng. n Chem., vol. 8, pp. 20-26 (Jan. 16, 1956). An article of comparatively recent publi cation (by Olsen and others) criticized the results previously reported by the Bureau of Mines in measuring phosgene in the gases from excelsior fires which were extinguished by carbon tetrachloride on the basis that the analytical method gave erroneously hath values. This bureau, with the cooperation of the manufacturers of the carbon tetra chloride-type fire extinguisher, has repeat' the investigation under a reproduction n the former conditions, except that a diucr- P U JJ, no. 41 . analytic11 method jje found in these sixt, ch excelsior fires were T(0j i l sealed chamber rang * by volume, with an jpL-jB. When carbon tet: M apped on an I-beam previ |t " j j beat and without fir l i ^ n u n t of phosgene found IjrkMe results are in substai K jjb those formerly reporte, Jg M in es. The report gi f^aenption of the experime methods and a tabulati, gained. The rapid reacti Pfae formed with other p Pgiaea and with walls of the X | tests were made is p, ideBy discussed. B It is not the intention o: PjSaeourage the use of carb, EJtpe fire extinguishers, wh! Pjbr stopping incipient fire ' determine the decompo which may result from the cjhould be recognized and Hated.--Authors' summary. The Determination oi Quantities of H tdroci ruCATiONS in Plants 1 Toxicology. M. T. / Laffitte. Bull. soc. chin pp. 1088-1096 (1955). One cc. of the slightly to be analyzed is placed ii the tube closed with a par which is suspended a da sodium picrate paper prep the method of Guignard (( 1, p. 866). After standim temperature the color of t pared with that of control the same manner to sol, known quantities of hydr little as 0.002 g. of hydr liter can be determined, starch or ammonia and ii values obtained are a litt hoi, castor oil and liver a do not interfere; heart ti the hydrocyanic and ca error.--Chem. Abstr. 86 JOURNAL OF INDUSTRIAL HYGIENE AND TOXICOLOGY [June, 1936 lution of fibrosis in chronic silicosis, begin ning with lymphatic obstruction followed by accumulation in the parenchyma of the lung and nodular fibrosis. In "acute sili cosis" the usual order is reversed. In the case of asbestosis he inclines to the belief th a t the magnesium is leached out of the molecule of hydrous magnesium silicate and th at the residual silica then produces silicosis indirectly. His experience with sericite indicates that this substance re mains unaltered in the tissues for a period of 1 year without producing anything but a foreign body type of reaction. He is not yet willing to conclude that sericite is entirely innocuous. Tuberculosis, the usual cause of death in silicosis, is discussed only parenthetically; the author mentions the various theories suggested to explain its frequency.--L. U. Gardner. Silicosis. Some Differential D iagnos tic Problems. E Mayer and IF. Grethman. Am. Rev. Tuberc., vol. S3, pp. SI 3-321 (Mar., 1936). I t has been estimated that in the United States there are 500,000 to 1,000,000 people employed in occupations in which a silicosis hazard exists and that there are about 65,000 such persons in New \o r k City. The dis ease is often unrecognized in the general hospital because clinicians are unfamiliar with it and its differential diagnosis is diffi cult. The diagnosis of silicosis is based on occu pational history, symptoms, physical examination and x-ray. Occupational his tory and x-ray are very important in the diagnosis. The occupational history should be spe cific as to kind of exposure and length of time in each dusty occupation. It is necessary to establish a definite history of exposure. The silicotic patient has few complaints; the most constant are dyspnea and cough. Fever is absent unless infection is present. There is great disproportion between the patient's complaints and the x-ray findings. Extensive disease (silicosis) may be present and but few abnormal physical signs elicited. Diagnosis is really made by exclusion. The physical findings are com mon to general pulmonary fibrosis with emphysema. There is restricted diaphrag matic movement. There may be dimin ished or intensified breath sounds and hyperresonant areas. Rles are absent in pure silicosis which is a more consistent finding than in any other pulmonary disease. The essential types of abnormal shad ows seen in silicosis are (1) small discrete shadows, (2) linear strands and (3) homo geneous shadows of varying size, indicating the presence of silicotic nodules, thick fibrous trunks and conglomerate massive fibrosis, respectively. Infection (tubercu losis) is considered to be present when the shadows begin to lose their sharp outline and to coalesce. Compensatory emphy sema adds to the difficulty in making a diagnosis. Four case histories and x-rays are pre sented. _ The diagnosis of silicosis is often difficult because it is frequently impossible to obtain an accurate history from a patient in a general hospital. The physical signs and symptoms are inconclusive and frequently the x-ray is unreliable because of confusion with other pulmonary diseases. Silicosis not infrequently presents itself in atypical form.--A. E. Russell. Asbestosis. W. Aewens. Ztschr. f. Gewerbehyg. u. Unfall., vol. 43, PP- 1~9 (1936). The author reports on the lung examina tion of 35 employees of an asbestos plant. Thirteen workers gave negative x-ray re sults, 12 were doubtful first degree asbesto sis, 7 showed first and second degree asbestosis, and 3 third degree; these last had worked in asbestos for 21-24 years; one of them, who had worked also with kieselguhr showed silicosis as well. L. Teleky. DUST SMOKE, FUMES, AND VAPORS: THEIR DETERMINATION AND ' ELIMINATION Atmospheric P ollution of American Cities for the Years 1931 to 1933. J . E. Ives, R. H. Britten, D. W. Armstrong, W. A. Gill, and F. H. Goldman. U. S. Pub. Health Bull. No. 224 (Mar., 1936). This study extended from June, 1931 to March, 1933 and included determinations in 14 cities of dust concentrations by count, shade intensity on white filter paper (Owen's automatic filter) and by weight. col. IS, no. 6] The number of condensation obtained. Continuous rec. tained with the automatic fi tions were made with the otl twice a year for about a we' except in Washington where records were obtained. I t was found possible t< cities into three groups a r level of atmospheric pollu figures are given in the fol GROCP i I. Baltimore, Boston, ! Chicago, Pitts burgh, St. Louis... II. Buffalo, Cleveland, New Orleans, New York, Philadelphia. III. Detroit, Los Angeles, San Francisco, Washington........... All cities................. i Shade of dust spot o: paper compared with s shade. The collected dust con carbonaceous matter an 1. amount of sulfur correl the amount of carbonac. dian particle size was O.o Amount of pollution v, December rather than J weather was more sev during both years of obe months showed twice as $3 summer months with pa the carbonaceous matte Maximum daily pollu: 7:30 a.m. and a secon- served in the evening, ` day was caused mainly rents and was thereto days than cloudy and o in the summer than in pollution was less th; although the different in the winter as in t rain was found to ha\ )XICOLOGY [Oct., 1936 ulosis: R oentgenologic the Differential Diagnobe. Wisconsin Med. J v o l . -6 ). alls attention to the value competent roentgenological a the diagnosis of the conditfalls of roentgenology are id the proper technic is given uctures. The points of the agnosis of roentgenograms in silicosis, and silico-tubercu1. The author points out the he understanding of the find1chests and the close cooperashould exist between the 1st and clinican.---N De- is P roblem: Some Medical l P hases. 0. Sanders. Wi*l. J., vol. 35, no. 5 (1936). )00 foundry workers examined 1years in Wisconsin, less than nd to have sufficient pathology a change in occupation. The th at there will be a decline in e of silicosis with the closer of medical and engineering He stresses the need for pret and periodic physical examina,lete medical and occupational id routine x-ray examinations of 1men engaged in the industries silicosis hazard. The schedule h the writer worked allowed for ang of a copy of the findings yee; another copy of the exam 's delivered by the employee to ,yer, thereby fulfilling an oO o all parties concerned. tificial Abrasives in th* try. Fritz and K`rer^ ' . (Reichsarbeitsblatt, SO (1936). md cutlery industry, w- X) cases of pneumoconio lases were compensated , , Of which 172 died. , tion handling the isura"" commended the substitute rasive stones as they 0 whereas the natural ones Vol. 18, no. S] ABSTRACTS 133 Against this the manufacturers of the natural stones appealed. The authors, among the foremost indus trial inspectors, explain that after over coming the initial difficulties, the intro duction of artificial abrasives proved to be technically and economically satisfactory. They then appealed after an opinion in favor of the manufacturers of natural stones had been handed down, and showed that the artificial abrasives contained only 7.57% free silica, and that the dust generated by them consists mostly of magnesium oxides which, according to a decision of the Reich health authorities, is not to be considered as causing silicosis.--L. Teleky. Silicosis in Sandblasters: the Examina tion of Sands Associated with Sand blasting. F. S. Fowweather. J. JJyg vol. 36, pp. 67-7S (1936). '' In sandblasting the sand is rapidly ground into a fine siliceous dust, whether used as the abrasive agent or introduced on the articles treated. The use of steel shot docs not decrease the hazard if any sand is present. At least some of the dust is of a micaceous nature, in the form of sericite or a similar mineral. In spite of the opposite view of some, free silica dust is the major factor of sandblaster's silicosis.--Chem. Abstr. Asbestosis. A. Bohne. Deutsch. med. Wchnschr., vol. 63, pp. 998-930 (1936). This is a short discussion of asbestosis, a description of a fatal case and data on the spread of asbestosis among the workers in an asbestos factory. An investigation showed that 4 of 14 workers showed mani festation of the disease after 1 year (the duration of work of the others is not given). --L. Teleky. ' UKE' FUMES' AND VAPORS: THEIR DETERMINATION AN ' ELIMINATION ` Measurement of the Radiation to which Roentgen and R adium Workers are Exposed. I. C. Jacobsen and J Ambrosen. Acta Radiologica, voi. 17 p. 259-955 (June, 1936). ' In modern roentgen installations with completely enclosed tubes the screening against stray radiation is very effective, but by carelessness the staff may be exposed to considerable irradiation. In the packing of radium applicators the danger is greater, since effective screening cannot be carried out. This paper describes the results of obser vations made on roentgen and radium workers. The workers carried small con denser chambers while going about their work, and the charges in these condensers were afterwards measured. The measure A study of different hydrocyanic methods. The polysulfide method determines the cyanide as well as hydrocyanic acid and likewise some of the carbon disulfide (by decomposition of the ammonium carbon polysulfide while boiling); hence high results are given; however, it is satisfactory for practical purposes. The complex ferric cyanide method (Feld) gives a possibility of thiocyanate formation if the gas contains oxygen and hydrogen sulfide. Only onehalf of the cyanide is determined as hydro cyanic acid; the results are somewhat lower than those of the first method. The easiest method for all-around use is the method of absorption of hydrocyanic acid in strong sulfuric acid and titration of it as ammonia. It is sufficiently accurate.--Chem. Abstr. ments were carried out regularly over a Period of 3 months. In the case of roentgen workers most of the readings fell in the `tervai of 0.02 to 0.03 r per day; for the Packing of radium the results were roughly 0 to 10 times higher.--T. Bedford. Microcolorimetric Determination of Benzene in Blood and Urine. S. J. Pearce, H. H. Schrenk, IF. P. Yanl. U. S. Bur. Mines Rept. Invest, no. 3302 (1936). A microcolorimetric method for the de termination of small amounts of benzene in Determination of H ydrocyanic Acid in Gas. H. A. J. Pieters and K. Penners. 'let. Gas, vol. 55, pp. 402-404 (1935). blood or urine is described. The benzene is aerated from blood or urine and swept into a small amount of nitration acid, after which the method described in Bureau of 26 JOURNAL OF INDTTSTnrAT INDUSTRIAL h y g ie n e a n d TOXICOLOPV 7% twice, and 1.4% Severn! O S l o r d f s m 's t 1-470 SeVeral times' I" one examination, &t least -^reXr" rrr88-^ showed some silicotic changed J0-6% were found to have a slight S`!!C0S1S' while the remaining \<y llght slhcosis, '* P revention of Silicosis in the Pop Industry Harhn ,,THE " orcelain vxrbehyg u S / ' ; ' &- ' voL "* w - m 2^ 4ncv P0rcelain is made from 40-60^ pi moderate or severe sUicSis It aSS.ed' as that it took about 2f) nr ' !t Was found to develop s, z - ;nf; r vorkir^ - - workers show a slilh t r ^ of `he years. The beeinnf 8` 'i!0818 ln about 13 to be inde^endTn^of^age8' Th^8 WaS^ound cases with a chan vp nf S ' lh e number of to be too small to d^ CCUpatlon was found this point. dmW any in clu sio n s on J , `, : : z s TM ;* * ; i . v . 8,d i 8 3" " * p,;:" ' d' oMife among those suffering f m ^ e" gth silicosis was found tn K g f m severe facture are described Prcelain manu*nd ill,tr.tL " " , rt ,"i" " ,d" * bl'd e ta il tmular reference to fill? H "g par there have been in force in C* PreVention April !. 1934, i,, the ceramic since quinng (1) cleanliness a ' ruIes re' mval of spilled material S ' ^ where silica dustiness ' ^ workplaces controlled o th e rX e ^ the dust be exhausted l l ?n d Sed or ds fail, suitable r .When these meth- . ip m eit ta P ***TM years, " in a m o r t a l i t y V t S d y S ^ ^ silicosis cases 37<y c y ot ' 93 severe uncomplicated 2 . 1 , 1 ' ? " " * " * nee. while 63% of the Jjl,ong heart fai|. silicosis necoi^anVd by toh13 T d'" * the severity of exposure 6 Presented on tion of the dust ^ thai r n ^ comPosi- would be available on lnformation disease, j , * *" ">6 wet sawdusTor vacuum * '" k' The . uthor ,tte ,,,,TM h e " r,'d"!,eP; r' ' tion between nhv.;,: , ed ` coopera- Pints out that in 1933"the^ engmeers' and tion paid out 585 025'Rlu f erami.cs associa- 600,101 RM for s i l S i f 1rf raccidents ad were 35,936 workers emnl year there -P h ilip Drinker emp'yed ln this trade. Pneumoconiosis with Speciat p pph m - m (Aug. l7, m l ) . B n L Med' J - exert a X e X a f e f f e c V b y X ^ i 1184 may substances and thus reduce th o T ^ r u t0X` tuberculosis in s i l i c o - a n t W ^l The classical state of ml , , ,ungs. coal miners) is very marked and y8Pn6a (i" n the death returns ,, L d sexpres8ed mortality, the terminal "effect tuberculosis mortalitv i u f a hlgh through the operation o f 'X l d u S " ^ adsorbent for the tnvb. . 1 dust as an '- 'o c i in Onhecen. Preventing the d ls ^ - i i . ImPortance of (comdrillfnj , f " ' r ' " :0" ' <*" *. * 'V. R- d o ,, , ld ," P,h" `!'f ; Tl-c work to study carefully the * mi8ht be well to prevent coal dust ex I*"6- dUStS used Drinker. 4 exPlos>ons.--Philip SiTZiVivr-'^ nlhort woll d cl the Particularly of his ,,,,tT ! the0ry and difference between t h e Prfs of the air-floated dust and th .C mpositlon of fine The eighteen L 1 f the parent rock, lucida drawings ar ICr0graPhs and camera as those published eSSent!alIy the same Drinker. PUbhshed P r e v i o u s l y . - . ^ Asbestosis. Pabt 9 m. at Amount of D ust Enc *E ature a n Workers. W B Full F ^ HOCP 01P Dept. Labor anh r ., * el aL PTMna. 4Z, Sept, so, tOS5 StrV' SpBC- Bul1- No- lin e X l0part1g1l ioffetthh8isamsepnHens8(5mpeect.hBodusll. Nuot.- n>l. 18, no. 2) S7, Oct. 1, 1934), impinger samples coll in alcohol, a study was made of the as: fabricating industry in Pennsylvania Part 2 of the series, the results of this are given. It was found that the conci linn of dust in the plants decreased quality or length of the fibers increased the various milling operations, whic described in detail, dust concentratioi creased in the following order: prep: carding, weaving, spinning, twisting, ing, and warping. Due to the fi; nature of the dust, the average particb is stated in two diameters, longitudim. transverse. Asbestos dust in the wo: breathing zone was shown by petrogr: analysis to contain no free silica. The part of this series consists of an accou1 complete physical examinations of 64 sons. Fifty-six of the subjects had previous exposure to asbestos dust, t had had very little exposure and were ns controls, while the other subject found to have had previous exposu: silica dust. Fourteen of the 56 worker.ployed in the textile'departm ents of fabricating plants showed both clinical roentgenological evidence of asbest The study was too limited to permit formulation of permissible standard dustiness, but a reduction in the asbe dust concentration in the operations stu is shown to be necessary. The bulletin closes with a bibliograph 125 references on asbestosis and gen dust determination.--R. Page. Hygienic and Clinical-Roentgenol. cal Investigation of P ulmonary F cosis in a J apanese F oundry, S. / oda, Chief Doctor, Steel-mill Hospita Yawata, Japan, 19S5. This is the report of an extensive invi gation of pneumoconiosis and atmosph pollution in Japanese foundries. A gp of 715 workers were examined clinically 314 of these were radiographed. Th. workers included electric truck operat. manufacturers of firebrick, cement 1 operators, molders and general plant lal ers as well as stam p mill operators and sa blasters. From the cases studied, 25 w d ia g n o s e d a s s ilic o s is , 81 a s p o ss ib le pn- moconiosis, and 2 as tuberculosis. Dur the two years (1933 to 1935) covered by . rx'l. 18, no. 2] ABSTRACTS 27 37, Oct. , 1934), impinger samples collected in alcohol, a study was made of the asbestos fabricating industry in Pennsylvania. In Part 2 of the series, the results of this study arc given. It was found that the concentra tion of dust in the plants decreased as the quality or length of the fibers increased. In the various milling operations, which are described in detail, dust concentrations de creased in the following order: preparing, carding, weaving, spinning, twisting, wind ing, and warping. Due to the fibrous nature of the dust, the average particle size is stated in two diameters, longitudinal and transverse. Asbestos dust in the workers' breathing zone was shown by petrographic analysis to contain no free silica. The third part of this series consists of an account of complete physical examinations of 64 per sons. Fifty-six of the subjects had had previous exposure to asbestos dust, seven had had very little exposure and were used as controls, while the other subject was found to have had previous exposure to silica dust. Fourteen of the 56 workers em ployed in the textile'departm ents of the fabricating plants showed both clinical and roentgenological evidence of asbestosis. The study was too limited to permit the formulation of permissible standards of dustiness, but a reduction in the asbestos dust concentration in the operations studied is shown to be necessary. The bulletin closes with a bibliography of 125 references on asbestosis and general dust determination.--R. Page. Hygienic and Clinical-Roentgenologi cal Investigation of P ulmonary Sili cosis in a J apanese Foundry, S. Kuroda, Chief Doctor, Steel-mill Hospital of Yawata, Japan, 19S5. This is the report of an extensive investi gation of pneumoconiosis and atmospheric pollution in Japanese foundries. A group of 715 workers were examined clinically and 314 of these were radiographed. These workers included electric truck operators, manufacturers of firebrick, cement kiln operators, molders and general plant labor ers as well as stamp mill operators and sand blasters. From the cases studied, 25 were dliagnosed as silicosis, 81 as possible pneu moconiosis, and 2 as tuberculosis. During the two years (1933 to 1935) covered by the study five cases became totally incapaci tated and six more died (4 from silico-tuberculosis). It was estimated that among those working with quartz, 8.65% had sili cosis, 16.21% possible pneumoconiosis, and 1.08% pulmonary tuberculosis, while among the workers on steel castings, 6.61% had silicosis and 12.2% possible pneumoconiosis. Workers on magnesite and chromite ores, slag-stamping operations, cement kilns, limestone, dolomite and iron ore plants showed few symptoms of lung fibrosis. Detailed accounts of the examinations, classification of findings, and results of autopsies are given. The author estimates the average age and average exposure as follows: quartz workers --42.9 and exposed 17.6 years, chamotte workers--42.6 and exposed 17.1 years, other pulverizing workers--40.1 and exposed 17.11 years. The average incubation period for incapacitating pneumoconiosis is estimated at 18.1 years while the duration of the sick ness (which is usually complicated with pul monary tuberculosis) averages 2.2 years making the total course 21 years. The morbidity of the workers exposed to dust was as follows: (a) with quartz--80.9% among edge-mill workers, 45% among kiln operators, 33.6% among electric truck operators, 31.4% among molders; (b) with chamotte--30.5% among molders, 27.3% among electric truck operators, 22.7% among edge-mill workers, 22.2% by workers on raw materials, 12.3% by oven operators; (c) with magnesite ore--37.3% among clinker workers, 12.9% by formers; (d) in cement work--22.7% by workers on raw material. During 1926-1931 the general annual accident and sickness rate of workers in industry was 1.98% of which 0.76% were from respiratory diseases, w'hile the loss by fire brick workers amounted to 3.48% of which 1.88% were from respiratory diseases. Gravimetric dust determinations by thimble and gasometer showed 920 mg. dust per cbm. of air in the quartz screening room, and 65.2 mg. per cbm. near the edge-mill, 85.3 mg. per cbm. near the chamotte edgemill, 486.5 mg. per cbm. near the cement kiln, and 298.4 mg. in the cement bagging room. [Dust counts taken with Shimazu's apparatus appear too low to compare with gravimetric determinations.--A6s/rac/or[ Silica contents of the composite dusts are 104 THE JOURNAL OF INDUSTRIAL HYGIENE [17, no. 5 50 mgs. per cu. meter and in the presence of approximately 1500 dust particles per cc. up to 10 to 15 microns in size. Those under 1 micron (43.4%) and 1 micron (30.2%) were the most common. The exposures lasted from 10 days to 8 months. Macroand microscopic observation of the organs of the rabbits showed th at athrol dust pro duced about the same changes as the dust of other plastics (ebonite and bakelite), that is, inflammatory affections of the nasal and adjoining cavities. In the long expo sures, dust thrombi and especially terminal alveolitis ensued. In the experiments last ing up to 2 months it was ascertained that there was an increase in blood neutrophiles and a decrease in lymphocytes, whereas in the longer experiments a reversal of the behavior of this elementary form of the blood was noticed. Thus athrol, in its effect on the organism, seems to occupy a middle place between the organic and in organic dusts.--From the author's German summary. Results of X -R ay Chest Examinations among 2500 Workers in a "Heavy In dustry" Plant. L. M. Warfield. In dust. Med., June, 19S5, vol. 4, pp. 302-306. A study of x-ray films (flat) of 2500 work ers in a heavy industry plant is reported. Based on a classification of silicosis accord ing to nodule size, of mild, moderately severe, and severe, 145 (5.8%) of those examined had evidence of silicosis. Of these, 90% were foundry workers. Of the remaining 10%, most gave histories of pre vious work in mines. Among 692 foundry workers, 81.3% wore negative, 1.3% doubtful, 8.8% mild, 8.2% moderately severe, and only 0.4% severe. Of these last cases, three in number, one had been a miner for 10 yrs.; the other two were 60 and 71 years of age. None of these men complained of symptoms nor wore they disabled. Silicosis among foundry workers appears to be milder and slowor in its development than among granite cutters or sand blasters. There were 11 cases of healed tuberculosis with silicosis and 13 cases in non-silicotic lungs. " In this particular foundry the menace of tuberculosis appears to be no greater than it is in the city at large." The impression is gained from this study that foundries may be operated practically without undue hazard to the health of the workers or limitation of their working ca pacity.--Theodore Hatch. Silicosis and Asbestosis: A Memoran dum. Home Office, H. M. Stationery Office, London, 19S5. The present position regarding compen sation for pulmonary fibrosis is usefully summarized in this brochure. During the three years 1932-4 there wore certified 435 deaths from silicosis and 1,444 instances of disablement, and 5 deaths with 60 cases of disablement due to asbestosis. A short description is given of the origin and devel opment of silicosis; and then are stated the industries and processes in which silicosis occurs. Means of prevention are grouped under (i) suppression of dust, generally by the use of water, (ii) ventilation so applied at the point of origin of the dust as to pre vent its access to the air of workplaces, (iii) other preventive measures such as furnishing each worker with a separate supply of dust-free air to breathe or wear ing efficient respirators, and (iv) initial and periodic medical examinations, under which w'orkers with defective respiratory physique are excluded from the industry and anyone found to have pulmonary tu berculosis is suspended from further em ployment. The medical arrangements for examinations and for certifying cases are described. All these medical matters are carried out by a Board of experts from whom there is no appeal. The compensa tion schemes differ in minor details for various industries; they cover the getting of ganister and other highly siliceous ma terials, the getting and manipulation of sandstone, the grinding of metals on sand stone wheels, a long list of processes en tailing risk of inhaling silica dust in such industries as the manufacture of pottery, fettling of steel castings and sand-blasting, and the asbestos industry.--E. L. Collis. Silicosis--An Interpretive R eview ok Accumulated Experience. C. O. Sappington. Indust. Med., Apr., 1935, vol. 6, pp. 173-177. A brief discussion has been given covering