Document n9Vb8zJd71xNKzEjq8EgG6D6

a, Jr /T .) - yp 2./ / TRANSACTIONS, MEDICAL AND J ENGINEERING SECTION f j' TENTH ANNUAL MEETING f/l ^ T>taction* Serks, ifa&uin No. 6 Ittmt frt-T if rm wm?v/ vEfismr v-nronm C. O. SAPPINGTON, M. D,, Dr. P. H. Xadturtri*! T. LYLE HA2LSTT, M. D. nrfifwUttwawPaati4* QefTi*ftn V ("LEROY U. GARDNER, KTBT ''T v ft--wrMmft Btiny t acmANCfi,Ar. >4T*i uTb. hamIin, Wtww. AjnHAA RmM **ej ^"x^ttaI Sander, fit a *'* <&npfer, yggn^nteft^ Md34 pbANcS"C^OCBraTPh.' if W. C. L. HEMEON, M. S. E. a HYATT |{idei<fiu HjflweP*ac4kttct> W. M. GAFAFBB, D. Sc. ICtaWmf.iR*tMBUUtw#aJ Vwt, U. & mMBMKk 8*rv>s4 +% Re<ffo3 T4^ /M* 3ft. ,INDUSTRIAL HYGIENE FOUNDATION *459 FIFTH AVENUE 1946 PITTSBURGH 1>, PA. W V-03824 Part IS of TRANSACTIONS TENTH ANNUAL irESTTNO OF INDUSTRIAL HYGIENE FOUNDATION OF AMERICA. !N< NOVEMBER 14-16, 2045 i i >*v /. :'7 T ^. PRESENTATION OP CERTIFICATE OF ACHIEVEMENT FROM THE NAVY TO THE INDUSTRIAL HYGIENE INUNDATION OF AMERICA BY CAPTAIN E. W. BROWN (MO USN AT OPENING OF TENTH ANNUAL MEETING AT MELLON INSTITUTE PITTSBURGH. PENNSYLVANIA NOVEMBER U, 1945 It la with dUllsct pkaeare that 1 tone here lWs mentfn* n behalf at the Navy le resent the award of the Certificate of AeWeeewefct fer war er?ie l the SodtutrUl Kyfiefte Fewrtstbn of Anerke. I will refer tirieSy at this point (e Uur (rfgftJScaoee of this award In Telethon in the Army *iut Nary "S," The Utter waa granted te certain '$ /fr '/ '-A 4-:$ :> '"I '; ti > :X } a: I TRANSACTIONS MEDICAL AND ENGINEERING SECTION TENTH ANNUAL MEETING A, i. LAN-iA, M. D. ana PHtUP DRINKS, Sc. DJ Presiding. I DR. LANZA: The first Ham on the afternoon program U the preacatatwi of a preflrotoBry report on one of the project* that the Foundation is eonducHnft namely, an evaluation of Industrial Health Department Func tions bi>4 Relationships. It gives me gnat pleasure to introduce t yea Dr. Sappingiun. 9c INDUSTRIAL HEALTH DEPARTMENT FUNCTIONS AND RELATIONSHIPS Preliminary Bsport on a Foandation Field Study Now in Preyresa C. 0. SArriNGTON, K.D., Dr.P.Hi Meet surveys ot this type are predominantly quantitative---this study is qualitative for the meet part. although some quantitative data Will be secured, we are interested particularly In finding oat what the policies and proecdorss of industrial health departments tn, tow they are admin* istered, amt what the molts are a* to the efficiency of their application The great majority of the contacts were made io person and will con tinue to be so (since the survey Is now oaly abt completed), (dthongk in tome instances, err account of reetrktisns of travel and ether difficulties, the minority has been reached by correspondence. Contacts, which have been made in person for the pan several yean, have been used and nr eaea have been mode. The active work began on tire stud? during April, 194$ and will be continue* Into 1W0. It is expected that several hanctrod different plants will be Included, involving sa industrial population ot ever one million persons, including large, medium and axieH plants in thirty different states, with many diversi fied types of manufaetDring--whieb will constitute a fab statistics! sample of what is going on in Industrial health departments over the nation. *AttertsiMadtaatileen'MBeIdtoiesfiS ot TTa*(M*.eiomnpeoCMbtatl*rreUanf*, MiMedeircaanl eC*omCmomfUpcaen, y; Member, i Harvard 3?nei of Public Member, Foundation'* Dear* of Tvuatece, and ChaimiM, Prevents^ KDifie<unc Commutes. I industrial Health Oorttultant 1 OUTLINff OP SURVEY MATERIAL A rather comprehensive outline has been used kt t guide in securing information. This oatlme ean ba summarized a* follows: A. General Jslonaation Name; location; dale; products; average employment; person in charge; community population; date of establishment. 9. Pcrflonntl Total--phyekiona, nurses. dentists, eonaoltunts, supervisors, specialists, tcehnkione--full and pan time, Sefeetcoa methods. C. Physical Sets? of Department 1. Location, accessibility, distance to hospital. Z gjse end (somber et mama. 3, Arrangement--eep*in (W * C--M Fj. 4. Scat rooms end beds. 6. Equipment {surgery, Hhtees, laboratory, special). 6. Cost (investment, maintenaeeft salaries, ether}. D. Department Functions 2. Dispensary service {experience). 1 Examinations (kind end number, when made), 8. Dental aervtee (Inside or outBlde--*rouotf. 4. ludiatrlel Hygiene service (ip--oot--Wnd--iraooat)/ 8. Comoti&n oi physical defects (natere end slope). 6. First eld end safety (reiponsIbtiKy end nature). 7. Instruction {Sanitation---Health and Bsfefcyh 8. Caseflndlng activities, 9. Medicolegal problems. 10. Mental hygiene. 12. Records, Reports, Statistics <methods, useaK fi. Relationships <Intiaor3--Extrameral) 1. Department rapeasible to whom? 2, Relation to other department* or divisions. 2. Fun or partial authority. 4. Relation to private practitioners, governmental agencies. 5. Rehafe$Vtstien, labor and puWrc relations, ft Insurance provisions (group. heepUal, ete.J, family care. F. JiMtiflettisa for Department Reasoes--profession*!, economic, social, ether, sepported by data, experience and opinion. (i. Hbcdlany !. Departmental record fora*. 2, Photograph* (satap, processes, protection), 3. Department*! door plans. It seems Advisable at this time to select three phases o! this investiga tion for brief discussion, strewing the fact that these subjects ore discussed only from the viewpoint ei incomplete dais, hit retiring that there are ccrtafn definite trends s?k>wr by the present results. These subjects are: the 2 ejects of rccoomcioR ami civilian adjustment activities on Industrial health department services; acme of the intramural relationships of Industrial health deportments; and the. costs of industrial health aerricei. Effects on Recaaverskn As tbk study has been conducted during the war emergency and also will be continued during part of fee reeoBverelon and adjustment period, there opportunity for obtaising idsas regarding.the effects of recwrm riots &nd civilian adjustment upon industrial heskh Berries*. Exprearioos of opinion were obtained from fGH&c&l directors, personnel managers, safety iapcrvUora, and others, from widely scattered large, mediant and small sisrd plants of diversified manufacturing, aud may be briefed as follows: 2. Temporary reduction of working force* will necessarily be refloetod m tempontry reduction of profearionei personnel, with the result feat health services for she time being will be redaewi io qoentity but not in quality. Daring ttb period of adjustment, a Considerable number of industrial plants will take advantage of this situation io enlarge and rebuild their department?, kirtatilng additional equipment and ecrrices, sa TUtarlaU and personnel become more readily available, 2. The effects of reconversion will naturally vary with the type of products manufactured and the number of plants whfch were doing 109% war production. Reliable business figures indicate that only 26% of planes need cadre reconversion. 3. A nemher of skilled observers have noted a decided fm* prevartwrA i* the reduced nwabtr of ht&fth taispfcdjfts, apparently because of the readjustment to shorter hoars, relief from the pressure of production aed the general ererloty gamerated because of the possibility of being oaSed into tiia armed fortes. The renUa show reduced incidence of nervous indigestion, insomnia, eumataive ffltigu^ and aervoas etoostkm, t< well aa the finding of pro gressive lowering of blood pressure readings in employees of eg years of age end over. 4j On (He other bend, in some quarters there has been aa increase in the incidence of occupational dfecete In pleats which have bed no such experience during 4h* year* of the war emer gency. *Tti!a may he due to the kyiag off of prefmionel personnel and termination of employment of other*, ft probably will have a relationship to the general increase in the number of eempeesatieft claims, especially following a ported when the refection sad place ment of workers was difficult because of the war emergency and fee shortage of professional personnel, 6, Whoa, however, production assumes Its normal fev*fe, py increased production level* due to peacetime demands, there will tend to be an ebnermtQy large load placed upon industrial health deportment* brcaaec ei rapH end increased employment, S. 1'hue fir ib* etpertao* with npteeameut f retenfog -nterana hae boen favorable, for tiw most part, indications, however, tend ahow that greater dlfflciiltles may be generally experienced b&cause of fee "Buper-senioriiy" of oelenns end the health prob lems of the older employees hired during the war period. In fact, 3 in some plants, :c i* conceivable that ell male employees may even tually be veterans, Hi instances where the sexes were fairly equally dtrided during Use war. ?. Although there may be souse executions, such as Isstanoc# whore executives seam to feel that Industrial health wa solely a wartime measure, in companies where a good health program has been in effect for yearn, maintenance of this program will eesilnee. 5. Th* differences between peak employmeot daring the war emergency and low employment during the prwent reconversion period probably do not give a true expression of Ihe number of pet* sons employed because of housewives who have returned to their homes, farmers who have returned to theirformer occupation, and ether Individual* who had either entered war work to evade mili tary service or have migrated bach to werit where production is limited to civilian prodocte. 9. The increased interest la indoatrial health service* shown by organised labor groups will oblige management to give increas ing attention to healthful weriring environment, ss well ss goad medical rerrkes, regardless of the constant broMerrfng of the state compensation acta. Therefore, any retregraeton which may recur temporarily will be foilowed aeon by farther progression* There is no question that medical services Hi Indostry will play a greater part in industrial management concepts than ever before. 10. One element In sustaining and maintaining *' adequate industrial health service is the opportunity to maintain prnductba st a high level--this Interdependence la apparently overlooked In the battle for shorter working hour* and more pay, %t. Professional pertonnel in Industry hoe rtever had a greater opportunity to demonstrate the economic six! industrial relations values of a well organised health maintenance program, Returning veterans and aging employees will require frequent physical cheek* ups needing competent assistants and adeqsale equipment. This $s no time to retrench ta the activities of industrial health depart ments. If ibis should bo done, mounting compensation and beatlb insurance costs will more than offset the rest of adequate health programs. Intramural Kelattonahips The dUeoaeioB of this subject will he limited to a brief consideration of the relationship of the industrial health department to other departments within the same organization or plant Tor quite soma Unto there have been varying difference* of opinion as to the result* recurring whs the chief physician or jbcsliea! director reports to the Industrial relations division or ffteot, as compared with the effects which result when the same medkal Stem report to top management. There are those who believe the! top management should be primarily interested in good health for employee* and take an aetWa Interest la the health program, white other* belteve that good result* may be secured by going through other division* rotber than tv top wnnugcrasnt. Perhaps mot* depend* upon the type of men to whom the reporting is done and tbeir active Interest and cooperation; porhap* *l a greet deal of the 4 success attained deprnds upon rellunee and confidence bring placed in medical leadership, with as litUe management interference a* possible. Apparently good results have boon obtained from both methods, although there are those who feel that from a strong organisation point of view, reporting to top management Is to be preferred. Incomplete data available op to the present time show the percentage of these relationships in the following table: INTRAMURAL RELATIONSHIPS Reporting to lop management............... .. ....... lift Health Department ha* final word ........... ........... --< T7% Industrie! Relation*. Health, Safety an a par--..--. 66ft It can thus be seen that more than one-haH of Uta establishment* con. Ueted up t the present tlme ehow medteal and beeHh departments report ing to top management; the majority of Inttaneu show that the health departmea* has the final word on health ptubhms, and relatively the same gcrctnUgv of relationship is tree for Industrial relations, health and safety divisions being on a par administratively. Experience has * indicated that because of the limited number of physicians available to industry during the war emergency, there was con siderable need for depending on lay technical assistants and open none* to the extent that industrial physician* learned much about administration. .Hus haa proved to be advantageous because It made industrial health administration more similar to other industrial practices or procedures. However, it may not prove to be ao beneficial, because too much rtiegeties of medical functions to others than pfeysteten* may be carried ever lata peacetime practice and result in a deterioration In the quality of the aerrieo. This may he the reason why even among the "higher-ups" there la s feeling that the lea* interference with the technical functions of the health depart ment, the batter it can be administered. AJi manner of variations in medical department.adminulrmliem hove beet encountered In this survey thus far. There have been instances where the department report* to a personnel committee Instead cf to one person: to a service officer, a layman; and other instance* of reporting to * general manager by way of the medical director who Is ti* ehtef of the service. In one establishment, of long standing, it was found that the medical director1# noma has appeared, for the first time in the history of the organ isation, with the other officers of the company. Sv I* too early M say that this may or may not be a trend, but the occurrence snsy be Interpreted in various ways; it certainly seams wise that top management should know at first hand the problems of modteal and health serriees, and that these be discussed directly with top management; It seems wls* also that the medical director sheuW have administrative teeth with top management and appre ciate more intelligently the problems of management. To this end, aeh an assoelation seems advisable and advantageous. There are, however, a great many who believe that the osedteal officer should neither be management nor labor, hut should represent an IntcHtgtnt liaison between them, which by the very nature of the fbnetlons of the modteaJ officer In hi* deportment seem an intelligent classification. Ttu* subject wifi meet with further discussion end consideration during the continuation and completion of this surrey. $ Cost ol Health Services ' The cost of Industrie! health ixjvkes has Song bcoh a favorite pastime of industrial physician*, skatirticiaM and Industrial fSocutleea, wave feel ing that there should he economic justification entirely en a monetary ba*ia, while others believe that the indastrial relations factors ere saffrelent /or |ostifie*tioft of the Investment; still other* use both appraisals in their evaluations. . 11 b pei within the purriev of this dtveoesion to deeide which in the most ration*)! but rather to diatom some M the fnndsrnenu's and give experiences from incomplete data. Peetore Influencing cost may be cited s follows! J, Type of service (ki*4 sM scope}, s. Basie needs--Aype of Industry, h. Conceptions of personnel. 2. PmaUkif marXtt (sRlariee--equipment--supplies). S. Administrative method!. 4. Namber of employee*. It may *ara obvious that the kind ef service rendered (namely, Hs extent and nalera) should certainly be a /actor tn the cost ef the service, bat this seeds farther discussion; for example, there are certain types o industry, especially these manufacturing preebiofi mrtrumenta. which need, because of economic necessity. a very extensive mditttrisJ vision scrHce; tbera ere otfwrv in wbiefe the aaSora of tha industry demands an extensive toxicological program; both of these wit! naturally infereait the cost of the aerrfM, 7t tWffptiene of the pvrwjBite) ctf she Mgsnfzatkm map differ-- the execslive may think that a certain type of service Is WfirWitad Wily * because It may cove Jem than *#3(Mrlrpe. Alas, the bra/csaJoAS) poranssra have their opinions, the pbyatcien and the nurse, and In many instance* the peraennel directors and safety aopervlaors fee) that they have seme Import ttnt ideas as !* tbs kind sad extent of the aer*ien which should be rendered The prevailing market as to anfcrfet ef ?rofe*fon? personnel, and m to the prices of equipment and supplies, has definite effect upon cast Administrative methods will affect lbs cost of industrial he*Hh service*. When* then is centralised system and supplies are bought on a whrfewle basis and distributed /rent acentral point, as ocean in some Industrial meti cal sections of the armed services asd also in some private industries, it >a obvfeaa that the unit cost may bo reduced with reject is equipment and. supplies, ever tint whkh obtain! in <ktenlf*lfed groups, where the loco! medical oJSeer sn order whet he chooses, oven within won- l^ast in the importance of the /acton which (ntdeace cost, Is the ruimbr o( employees--wo have found, however, that the number of employees Is not always indirectly proportional to &e cost of the serwrn we .wwtiJ ktthaSriw with a few hundred employes* having a anil coat psr person per year considerably below the cost la larger industries Wfch well- administered service. There are various methods of cost rating which ated brief eoneCtlsration. These are as follow*: 6 UNIT HATING OF COSTS 1. Per capita per year. 2. For capita pee 1,006 man hours, 3. Per JiOO payroll. d. Percentage a/ payroll ProbaUy she most common method of ot rating k the first one neroed, namely, per capita cost per year. Perhaps one which may bo moat easily appftod, and which may Wcof general In later years, is the cost In terms of percentage of Msywl). which may be tnora undtrsUsdafcla d compar able for the use of statisticians or executives. tt has boon possible to assemble sums material on costa with reference to s numlrtf of if>ffcwit types of ptantn. The /showing fable abowj these relationships: Aenfl* Par CP`t No. Plant* C( Per Tear Hunmer Bmai*ir*e 106 27' =; 21 a . 6.02.318S 2^1 * 74.76 3.16-10.63 6,S3- 550 1059 im C55 6.74 430574 tS*,S45 113544 246543 The first group of plants In this tabulation were ell 1b the same type of industry and under the same general administration, as were aleo' the third group. The fourth notation la an example from the industrial medical lec tion of one branch the armed forces and shows a low variation ia range of cost per capita par yasr and a low average ewt per capita per Tear, beeau& of the possibility of stendardisiog on costs /or equipment, euppUeC, and pfllsrira. 71)* second notation refer* to a heterogeneous group of plants of ell types of manufacturing in which, es one can see, these was a greeter range of per sspka coat per year and a Wgker average per capita cost per yi&r. Thete figures art mtrrty attempts to convey a rough idea &a e the ring* of per eapft* eoat asd ihs avarsga ptt rapita root, end do not repre^ seat comparable values. It will be pesatble to work out eortaln eomparitos factors both with re9>reet to cost and saving* on a percentage payroll besle, according to the ftRoving oatike: COMPAKtSON FACTOitS--COST AND SAVINGS *g P*?re?>) COST 1, FeraOBnel, 2, I&vettmest. 3, Sopplles. SAVINGS }, Omptmration PrtnunrajL 2, Turaover, t. Absenteeism. 4, Placement. 5. SoUer Ugh$#g. $. Uu Fatigue. 1 In ih* final ftport we will be able to show that a substantial saving tan bt made on a percentage payroll basis, ever the cost according to the items given, which are susceptible to ttaosletien into monetary values. There has beets a great deal of dlfficoity In securing tree east raises from Industrial e*tah>ishmBts, and an example will now be given of the kind of difficulty that bat beoa encountered, The following table shows the difference in safety sod medical cost* in a very well organised a*d main tained division of a large national corporation; &afetr 1944 ...................... s&.&o 1943 .................. . .30 Metfteef *3.60 2.45 $&5Q Average ............. *2.96 28 *12.00 *6.00 4 Use fallacy of using overage per capita costs p4r year is well demon* tooted here- One can easily sec that this average Is not a true measure of the coat fiueioatiims in two wosccutivc years. The same kind sod quantity of strvfce was rendered daring each of these yean. Officials attribute these differences in cost solely to a change la concept by fbe accounting depart ment as to what the same report form revested. It tltfs can occur la s weil-maaaged corporation, what part be said of others I We are beginning, therefore, to doubt tho Validity of figures preriouaty flsoted by muiy of ss la various reports. ?hl*j howeve4 Is no reason why we should discontinue collecting cast figures end studying them care fully as to source, treatment end soundness. What can be done to make cost figures comparable 1 We feeUeee that a 'foolproof'* moM form can be devised for cost accounting departments, accompanied by simple, brief Instructions, The form would epnttia expense items, common to ail plant health procedures in one industry. Later, this night be adapted to industries of varying kinds of manufacture and oervicea. Gna of the first Uake to bo attacked will be to rrieke a standard, rcfatty thought out definition of what ptaot wadieal expense is and what tt is not, sb that the expense Items may be mutually eaefaeive. tf this can be done, it may represent, ax ess of our statistician friends has said, real contribution to Industry. DR. LANZA: This paper wifi now be Slscsssad by Dr, T. Lyle Haslet t of tbo Westlnghoosc Electric Corporation. DR. 1IAZLETT: Now that you have heard Dr. Sappiagton'a report, yoa cut readily see tbs tremendous value that sack reports will be to ua In the maintenance of cur Health Department functions In industry. I think that w* have not in the past presented obc side of (he picture as it should have bscn presented to management. Rcrhops we have been too busy and perhaps we have considered cur services too much as routine work, Sfxnegerecat should receive a complete aumtfi&ry of oar activities and aecorapUsbcKQU each year, jost es it does frefn other departments. The {Reparation and submission of such report* will inevitably lend to a S greater amount of preventive work in industry. We know what has been accomplished in the safety field. A great deal of the energy and effort that was put into that program resulted in an actual coat saving through redaeed compensation and medical expenses. ! think ihnt the accomplishments of our medical prevention program can be presented in the same way. We are alt faced with problema in our management relatione, at times a little acre serious than at others. In this period of reconversion I drink we do bare that in view, net as reach perhaps aa jn (he 20's or the early 30`s, bat fteveribetow it it something that we must think about and must dracoes with management Adequate measures of the accomplishments of reedteal service are lacking. We do not know, far example, how much has bees saved by the tuberculosis pre vention program--the tremendous number of ytare otherwise Test In cuddle life from this diocese, which is a loss bo industry and to the community. 1 think that Dr, Sappingtoa's continued study wQi be meet helpful Because of the lack of on!form coat accounting eyrie. comparative onto of Medical Department servhes Have had flttto meaning. Due to different eceooatmg procedures various other items only Indirectly related hare beea charged to medical service. Thire 1# no msestitm in ray mind that we art in the bagieidtrg of a new cyela In industrial medical service. During tire war you know how ranch attention was paid to absenteeism. K to the coatinoing duty of manageneat to understand what can be done to keep eur workers ob the fob. f think that a study like this will be of trenendoue raise, and tirtt from It will come a method of making meaningful eomparism* of aeeereptiahreentt and coats of medical services and abo of providing management with factual information. I am sure that management do*ires sach information, wWeV ha* not been presented to them at a rule, Whan they see just what raedf. cal service can do in the prevention of dbeaee through eoetrrol of environ ment and in the reduction of absenteeism, and when we do what we east to reduce to the vary minimum this waste In bdoriry front sickness. 1 t sure that medical service will show a definite profit in dollars and cento. DK, LANZA: l think you will agree with me that the task that Dr. Sepplngton has undertaken on behalf of the Foundation le aei a simple one, but on the other hand those of ua whs know Dr. Sapptagton know that he will come up with Use right answer. The next Itore is "Accurate Dlogrtotie of Silicosis." There to always something new, and It give* me great pleasure at tins time to mlredoce to you the gnl!Tnan who needs no introduction to this aodtenee, Df. Gardner. 9 ACCURATE DfACNOSlS OF SILICOSIS-- POSSIBLE SOVRCES OF BR^OR LSROY U. GARDNER, M. D.` Probacy most of you ik wondering why,_gpBour of this program should fae oeVtfted''Eo'itteh''g'TI`ito and hcrit^vttd sjgcosia. ISvefyone prerenrptobftMy. ^ that the diaftpmi* af ifcJtf'BlTrbr** banes: * history oKS^ijnt^'M^iTPKff. mradii.* fK? dentoaxtration oTa chstacT^Hsbc ^HbK<<beUajriR <V'X^r'filsistrf the cfeft. And a aja'jftgl ^BtntftS|>gnasrKtcb reyetis verf iW aanormai signs In most tmeompl(extra cues. All of w accept these fundamentals to theory Imt in practice they bps too often neglected. Paris. abjective mav wako him torrrt ttnit f^rSn^lwra; llt^. Af ^rT ^?gttnffr,a(a8j1t5aA to the diagnosis. En?M the lawyer or the phyaadan reoreainting e demSnrBiy eompeaiatfen we hear that tire plaintiff must bare rilfeeais btesue stl oS *bit Indactrisl life has bees spent in xtr industry whet# atmosphere c-ootaint so tnaoy atiBlon perils! of free silks dost Yet * glance *t the claimant'shZ *-T*y films may show nothing to support the contention. From the roant-i^T ganotogiet or th internist of sit urban medical center nrarwi ih'^Mgwojg aTslljeoeSs Because wre njm MmJi * geirettfixo* no&dar pattern and the subject reports that he b* w*ed at a dusty Job. Neither roentgenologist nor Internist is in e position to *htaJa tbe dctoSs of the occupational his tory that will indicate whether the dust contained algnifleait quantities of free silica- Proof of Espotore I am here lu lead a dtecusrion emphastriag the necessity f&f ^fqfrUih. >n*. criteriaJnCerefy'caskduimowd aa sflicMia, ' Uxtew there is preotymt the subject bee oetn eaaojooje free aiitca dtfwt fyp years_we hare nq~ri * * ' -1 1 aakative of sflkqsia. Soda patterns may be proditecd fc nthor causes, soared them the resultaf inhaled nvatarlala offeor tW ftee alika and aorac to Infections aTagrtemg- aaiwrera wnwb should bi disclosed by e Urar-1 osgh physical examination. I shall call attention to several condition* that ar* being confused with anieoas today and the three speaker* who follow me wfll elaborate upon thalr apparent racers, Some of then arc at least associated with disability and some are apparently benign; some tenet to be due in whole or in part to the environment of Indcotryj some are wholly uerelited 71m causes of many are still unknown but assertions of industrial origin see frequent Among these conditions to the settled tc wridgrri aldcraila which was disensse-d'btrthv Stkttflerss our isw kAauai meeting, "in theorythe nodalar shadow# on tbe x-ray film aw east by focal collections of minute iron partiefcw within the Jungs; fibrous tissue raaetlen and mbltant symptoms are lacking. This explanation st first seems adequate, for all subsUctces of high atom** weight opaque to x-ray and In suffleiciU local concentration they east shadows on a film. Example* of such sub#t*rwe* an? the com pounds of barium and the rare earth minerals which Or. Creech will discuss. US (WC But mere opacity to x-rays doss not explain the production of nodular shadow patterns simulating silicosis. Iron mitten have sidereal* whether t&ey work in hematite or magnetite, but they develop noduiatioo only when they faihele enough quarts with the iron. We know this from a study of Hteralfy thoceands of films correlated wHh detailed occupation histories and from over 50 autopsies with mteenlogjcal analyses of the hrags. On the oilier hand, organic iron from the blood may at tlmee east nodular shadows which slmolste silicosis. In the form of valvular heart disease known as mitral eteitorte there is interference with tbe circulation in the Jungs; blood cells escape into the air spaces and duct cells then concentrate their contained iron in small focal spots. Perhaps even a more striking example of the effect of the blood is seen ki the films of men who have been trapped artdergrcand in mine explosion*, in thern tho films demonstrate the sudden appearaoee af fine nodtriation, but Ihto disappears again after a month or so. The effect be* set been eheeked by, autopsy but it la assumed thst malt hemorrhages ki tire iuagm are responsible for tbe nodular shadow*. Whether iron or merely tin eolNctiun of blood itself casts the shadows rectsrne to be established. Research is in program at tbe Sarasac Laboratory to define tire esw* ditions'^Snder which iron, tbe rare earths and other radio>cp*qa substonees Taay produce charge* simulating tillcoria. Superikbti Resemble.nee Another dl*c*o is 00* brine reoogrriacd_whkh superficially reeeraMes oodolation nS silSoftii. Tn> re outtaoaarv ssrcoWcaUx sonar^o^v a tuber* cle4ike infection of unknowa owe, "he nodular "shadows are" aaUomlf fi(S.PUni(cd tbroughout both lungsTut they are exceedingly asuitl. They may become confluent but they never enlarge to the use of silicotic nodules. This disease occur* here and there throughout the population at large bet has frequently been attributed to pulmonary Irritants of Industrial ettriroamenle. 1 recall one ease from a rayon mill, one from an ssbestes plaet and another in a graphite minor. Recently a eeariderabte number haa been found in industries using bccyfThim and its compounds. It has act octunad la every plant using these reatcrisb. Nose of Its vtotlsre has bad more than slight or casual exposure to dust af these minerals. It has not boon possible to reproduce sarcoidosis with beryllium compounds in xalmab. As a working hypothesis we are assuming that while tire Infection may develop iu tbe absence of beryllium, the causative organism grows more readily In tire presence of this substance. A timber combination esisto in the cxm of the luberetc bacfllui and free silica. Certain azparimsBto} observations make it necessary tocoraider radiation aa weS as l&fectiea among the hypo thetical inciting eaoaei ef this condition. Much most be done before it can be Concluded thot sttrccidosis h an industriaT^Sigw. 77re Ssratrec l,dW>fftory ho* an elaborate program ot^resciltb bJ>on this problem. Miliary CsWfifstio* Mont of you Irew seen or hrard oi tbe cooditieR csiJed stitiavy caielflestioe of the lungs. Here the x-ray reveals ncdules, oftoo scattered through out both lungs, but these nodules are of unusual deru&y sod their distribu tion is not uniform. They were sneo thought to be due to Infection wHA a mculil, aspcreillus, hut this view has not been substantiatod ft is assumed 11 that they represent heeling f same form af.infection whose nature b atlli crAcows, Jj mild not fc* tofcemlnsia, for three people have never been sick. Ths cares are matt common along the Ohio Elver and in Mwscuri and Kansas. Analysis oi the nodolee shows nothing hut cWhn and phosphorus in the proportions normal to human tissue. They cause no problem n (flag* nosts unless there happen* to be an associated bktory of employment in the mine*; then in compenesllon cues there tay he difficulties. Recently I have had occasion to atody a caw of fielder fibres!* whfeh was dtegacsed as eiJteoiie by et surriber of expan Ttn&Sge?to}egtelA Before death w* araolree felt that this was the most probable cava*, although the occupational history apparently did not support tM view. The man's only 4asty employment was 37 years In a Umeatoaa kiln, ah-d hb job was on the platform where the reek coming from tbs quarry wai dumped into the top ol the M3a. At the time we had no analysis of thd rfc or the dost In whkh he worked, but w aaapeeted that they most have contained some quarts. later they ware rosde erxflaSe, but slgnlfiamt qualities of free tiUe* were'lacking. Subsequently the man died of an apparently unrelated cane and an aatopey vaa obtained. Hie lusgs showed chronic bronchitis and emphysema and may uniformly scattered noddies, bat they were not of stUeetfe type. Analysis revealed only 0.04 percent bf total silks; no fre silica o? any other substance* known to cause fibrosis. The oMef components of the ash were carbon and Iron. FBffis of another man employed at the same job skewed a tqggwrtloo of nodolation. The. diagnosis of sUkosij has net keen substantiated end can b definitely excluded. The nature of this disease still remains an unsolved problem. Its pithdegy/doe* wot eonferra to that of any ordinary disease*, it resembles most the changes some* Umei seen In coal miners, but to then there is ueualt> enough quart* to account for the ivedules. Since such pictures do not occur regularly In lime* stone quarryman, crushers or kiln tenders, nc $s forced to conclude that factor* pceubar to this individual were mpotndblu. Wb,th* the Inhalation of a dust that U irmceuous for most persons played any part la a question that cannot row be answered. Nodular X-rev Patterns The various conditions that have born cited all ntoftlfrot thenoelvea hv nodutaa's^uy pauwti&raft.ja.lfisp^'lia'r Uveji Jlim0jWi as iilleotfg ortBVff lajcaagifl? >ggg cvgoSary fn irtfTtff-* -tort could bo escratd byahyloinvceInfe*dnp1o*sit*io*n"stuck.awscotrte*n**"Jb1 uthfeiwftaecSta^.atgInnifi. cshtscgrec. The knowledge tuarguch BuhdUMfB KtfrftfaaM make uTlKffi. ^UM2^TS!diii^^8THEOi>s. particutariy in caa< wW, environmental eoadrtiona 'irt DfiImtUar'.orl>ol elSaa'rrii;y d*efined' . Mors prog ress ha'rtade'jl'VAsnwSBUlftrlsts'WfwjSrt n*f*etv riw4i>ii i'.hrfm* 5Brl. lUpffcd fiUtUHtltiun ihsi tnia ri>uig bo mtorpretod as watery of Jtilequaie pxjfgWre'ttHr&S'kiika.. / . ACCURATE DIAGNOSIS OF SILICOSIS-- SOME BXAMPLJgjW BBBOB ^ ' A. Q. C&ANCH, M. H.* .Along with iha disym*^ hv nr fim*4*ar. t tiVn M mention fear i tvAw of SvwKtiee*. '** Save com* to attention io the last few years.* TSeohWietKJBl x-tVf`ftHgjMmliLapme TespectostMl.tingtftooagf amcaslaT r / A* / >trsL is a group ot iQ&iJjUt&i expaaeo to aast rr*{ Sh 0XidM~snd fioorldea. used *- *** ** IlhtnriimMns- ^rKna. i ..as%%"hhrree compouonda of suoecks m*alerials h creioai, janthanum, neodymium, praseodymium ml some of the other 'Myrniums" present la the material Irom which the Id Wetabnch light aunties were setado. They have high atomic weight, dose to that of Wktm d lead, which are quite opaquo to x~rey. This metarial le mined to very Sne, almost Impafpahfe puirder. Theso men bore W some crposure t iltiea, heeaaae In the ceone of thdr work they do have occasion to mis batches containing some silica. This evposiJse Is anally only once or twke a month and relatively miner. U weuM be difficult to sec How thla exposure would produce any appreciable degree of fil^osls. 0 of those mtn sbeat 60 yean of age had Inflaewu. He hod also hod chronic broocMtis and acme heart trouble. 'While convalescing from his initocnaa hia chost wag x-eojed aad the ftltw ws# SSa/Wng. Be decided to put b\ 0 clelm for compensation on the basis of tbe z*rey Sodlags. Tke Compccration Commission made a total disability award on the ground that while ether conditions might be present the x-f*y Indicated sdrewetd silicosis, and this determined the award. The second case was a pmeg sun in the same department wh late* had mfoe&sa. He had a cheat x-ray and a the basis of similar findings also made e claim for silicosis. Although h tt&ft muck fees ccpowre tfecre wat reswrkaUe e^mls7ily in bis films ftpd in thou of tbe first case. Zn his eaw. however, while the Commission confirmed the diagnosis of jtlfcoth o tbe basis of z-ny findings, so com- penaetion was awarded, ss no disability ecatd be demonstrated. Other men with this exposure were x-rayed, and a third css found who, altar fire or six years' exposure, showed about tbe same x*ny appearance fa* a rather dUFost shadow suggesting rtedalation. This man never pat be a claim, asyiftg, "i Jnre no itixobiUty. What could I claim?* There three eaeaa would appear lc itlastiute e condition due ta Inhalation of an x-rey opagoo du*,t. rather than to thv presence of a fibrosis. When chief reiUnco ia placed n x-ray findings.such a <*ndtttwi might lead to error in diagnosb. No Silka Esposure Another lyiH' <if ent tomed up as the result of draft board tnir. tiea. One of ibcxu v*vi n young tnBft ts his eeriy twenties wtro hod never aone anything but go 10 school and do office work, with the exception nf seven weeks' plant work, three week* at ona time ami fear at another. Fart Of his wnrk Involve*! emptying two or three bags of groand aka rnio * mixer. Seme days he had to do this twice, but usually only eaee a day. There wax no creature to MSke. After hb draft board etaminaUon he was Hole* CsrbiOa and Cavbsa Corps**1 44- daeisfeg unsecesisite tor nffftary Jttiy beeuftso of `advanced riJimJ*'' Reporting u> us, he wu referred l a prominent cheat specialist, who dlsgamJ h?s case *a silkoala beeause of hU exposure to sDiefc--as a silicate. On discussing this with the specialist be was at flrat br>willing t* eonridcf any other diagnosis, jn spite of tie extretrtclr minima? ixpester*, aorf 4ht to mitt, not free silk*. He finally admitted that the x-ray findings might he due to other cesees. Ken l* the film os which the diagnosis <d sdlcosif was `'Med.. Here 1# film a year and eight months later. w*ft nothing sig nificant iXowfcig--certainly no tfOckJatfun or even linear *.Wpuu. 7W years of constant study, during which tubomloels wag very definitely ruled out, resulted 1b b dlsgfttots el Bowl's sarcoid. Between the Uw of the two films siwjwti there ware probably eight or ten esarionaiicnj, some show* !ng decrease asd some raappeftranea of tit shadow*. luring s?i &&> time the boy felt well and vaa free frem aoy cljnfeal aymptema. But this ease ni diagnosed by draft board essminers and by a chest specialist as sill* coats on x-r*y evidence alone. The second draft board case Waa rejected after x-ray with a diagnosis ef sUkcib, hut 1 do not hare hit films hen. This ift&o't x-ray shewed a widely diffused shadow, not parilealariy nodular, hot diagnosed as silicosis BoverthHesS. 'Hie man was about 30 years old and worked in a dweUfrce chemical pleat- At the opposite end of the bcnMing, os nether floor was an enclosed filter wbleh contained gone silica--&e only allies ki the plant. This man was referred to one 0} our universities for stody and the final diagnosis *r*a'o>i$nilstnoc$--a heart condition pure bad simple--the x-ray shadows bring doe to congested pulmonary vessels. This*mar/had teen fair general health and there was nothing la hie history or developed In a rareful stsdy of ihe case to indicate eoylhiag like silicosis. Another Cssa Uever!bed The last caao Is a mystery to . HeVaa being examlaod by tie drift hoard, and ail went well until **ked where he worked. U Is repotted that on hearing the name of the plant, examination tlopperf onUf n x-ray couttf be obtained, and he was then told that He was in the advanced third stage of silicosis with general tubercular complication*, that he had only a abort lima to Hve, and by all means ehoald go right to a HcfipiUh That boy came bach really locking tick? So bad been working right along iW bed not ftft 111, and row reported he had beta told he bad only 4 few months to live. He was immediately referred to a competent radiologist who, after careful examination., aa1d He could And aetMnK on which to base even a suspicion of attleoels. K* was then referred t the head of a tobereufesfa aaattarium who, also after thorough nasrdnxtisn, could find rm basis for diagnosis ot either illieesla or tabmulosla. Or. Gardner has also seen the film* end reports in this case and has concurred in the opinion of the ethers who examined him after bis rejection by the draft board Nevertheless claim has bvvo made for disability due to alKc-whj. based apparently entirely open Ihe reported statement of the draft board. -- **' These case# Illustrate only four kinds of error wliitih may occur In interpretation of x-rays. Throe showed x-ray finding* which might easily have been confused with silicosis, and yet thorough examination strewed had no relation to It ACCURATE DIAGNOSIS OF SILiC^lS-- ATYPICAL MODULATION iKTOUNDE' norwnpftc a \rt\ oinm' ^ 1. K. Fbr aewra; yvur* we Sau'&?*n concerned 9ith chest x-ray findings among griwfers and burncra In out foundries feaeaus* tha patteni of nodnlatien observed in the rocat^anogram, the clinical aspects and history of occupational exposure, are inconsistent whh tha present conception of sllfCOSSS. The first mdcatm el incompatibility occurred during a periodic x-ray survey in 1941, in which a dlffoM, discrete pofiuhtioa appeared In serial film* of burners following a period of wpeaara nUogrihw too short pro duce such charges, if dae to sfika. Similar patton* were observed fn films of grind*ra. Since it is an accepted fact that a riUc* \oum& fftssta is ell 1 foundries, it waTalgawcd that m gCTitttttfffrSsenlp the roea^egnograsaa / w regbasWlMglhcoiia. SaU they were wlitpfareioq.' At inac itraswa wara'nJY I faauilc~wi^t the worit ofbander aml'gnaeg (1938) wewerswelj aware that cues of atypical noduiation had bees described in the literatus*. Onr bservatioM, Lhcrciort, maJ independeatiy, aad the findiaga were BuSeicnlly ebvioos tq direct aUentian to th fart that we wtn pwbeWy dealing *li a condition other shan silicosis, tfaflka the eases of <<den^i described by Sander and Rmtrp, tH man hi oar group *e known to have some degree of capture to free silica well an Iron exlda. IHprittioB of the Operatic A description ^ the eperaUon lh the one plant where ft* graaUH rruMber of ftcae cases developed w>U be repraxahtativ* ot all of them. There 1 Is only a variation In the p*rc*ot of the man lsvelveef in asett plant, and ftki Is directly related to the extent to which the cleaning and grinding departmeat is walled off fram other cp*rations which might afford som dilution of the daat. In the plant where the greatest aumber and bigheeV perecnUge of mm showing Lboae x-ray patterns were foend. the cEeutSig room it 1 large hsildlng with about 3&AS0 square feat of fioor am and n volume of approximately 3,900,000 cable ftxL For the raoat pert, it Is ep*a to ether buUdlxga only throoeb doorwiyx, and tirec watts have e wtodow*. Three shifts are wgrkcd with tkfi. 4b, and 20 men or the day, evening, tsd nfgbt shifts mpeclively. Castings ranging from a few pounds to sever** tone In weight are shaken oa\ of fto maids while stlU hot and, after the cores are knocked out qukkiy; they arc annealed. The castings theft qtKneked ia water and token to tbu hunting floor where g*U, risen, and fins ere burned off with oxy-Bfctyleno torches, Soma .pits and Holes are filled V this point by Hkifie wrlillug. Here the coslings enter the cleaning room; small pieces are tumbled *nd tbe> ,-uc flnWtefl on ped<-itaj grinders whfeh are wall exhausted. The lUru>H.^. *>U*rk'j*i f^Sr SVios Cwnpxa?*. 19 larger piece* ah flnhhcri witfe stiff wmg frnmc find swntl hand grinder*. Theso pieces usually have aond odhcring ia there, maeh of which o honed into the surface, It w*s U?o practice to go over practkntiy the entire aurfaca with tbo grinding wheels to predutd a clean met*! surface u welt a* to smooth off weld* end the sections where gates, mem and fins had hero horned off. These grinding operation* art productive ol a large amount of dost es well m the Urge particle* eew as sparks, This dust is composed of the abrasive material, the wheel binder (plaatie), sand, scale, and the rootal which (ns; or may not be completely dxidacd. Local exhaust had been applied to the awing frame grinders only Sn a very miner degree. Control Measures The email local exhaust hood under a swing frame grinder had not bean found very satisfactory, as R wM in the way of tome operations itsd was effective la collecting the dost in only a few esses. Grinding booths were suggested and although successful for swing frame grinders at another plant, were sot used hors because the building structure did not lend itself readily ta their instaflatien, A circulars heeler, ualng sn ineffective steel wool uM eok* dust filter was altered to permit the coatimiow mtrodueUoa of outride air through the heating criU. This *u dene in J943 and showed a distinct drop in the average dust concentration kt the end of the building when It was located. Then wu a significant change at the other end of t$* building where there is some general exhaust ventilation a( the root 130.060 eftn.)./ Since the condition behaved to be stifeosi* eoali only be attributed to the sand on lh eastings, a hydroblast was instated few in 1943 to clean the i surface of the castings before thoy were ground. Although this Aid greatly I redace the amount of eUlea in the air-borae dust* the total number of duet { particle* per euHir foot of sir was just about the same as It bad been before i the hydroNaul was Repeat x-rays in 1944 still showed pregres* ! slow pt the rilteoriHike pattern in some oases* although the araoont ni silica dust In the air h far below what is generally considered the threshold limit of five million particles per cubic foot. __ Twri Atmospheric Dust One hundred and thirty-throe midget impinge? and electrostatic pro- i collator receptee aver a three-year period during thk months from August j to December were collected. These ranged from 4.0 to 67.2 million particles l per cubic foot, sad it h noteworthy that only six out of the one hundred / nnd thirty-three samples showed over five million fiarttelee of silica dust | ot cubic foot of air, and only one reached R.5 mttHofc. Analyst* of Air-bora* Duet Samples Saoples were studied by *-rey diffraction, petrographic nod chemical analyses of pooled Iwplngsr samples ol afr-feorae dost After removing tho metallic elements by digesting the duct with hydrochloric acid, the Insoluble residue consisting of quarts, corundum, rutile and iron glass or other &UI* cates was separated into site fractions, and the composition of these deter mined, $t was found that nearly all the iron wa< present as the magnetic eticto Fc*Ot and existed mostly os fornu *wr n% fine yarUctex tew than mkron in diameter, but there ware many clumps up to 40 microns, and spheres (probably iron glow) up to ^ microns- The quarts content of the entire sample was higher in the fraction above ton roteruns. There was tittle of the highly active forms of fm attfea (cristohalHe not error &41ft snd tridymite 0): meet of it existed m ordinary quarts, particle* three microns and fere in diameter constituting only about 94ft bf weight at the sample. COMPOSITION OF DUST BEFORS FRACTIONATION Me. 1 tern** N*.** . ft ft Total SiO, ............... i Quart* ............... ... c/S \ Crietobalite ......... .. FaOt .................................... Mn .................... .. Corundum .... ........ . Carironatca ................... ...... ftutife ............... ..................... Loss en Ignition 6J> 3.1 0.1 DO TS2 S.9 IS trees tree* 65 8.9 32 06 0.6 67A 76 41 tne trace 85 Clinical ObaervatteM Tim Required f-,r Jrewstepmroi *t Nodiiatkm Sixty-eight grinders and burners were ob*erred over a period of 18 years. Chert roentgenogram* were mads in 1933, 1954. 193A 1942, 1943, and 1944. A few of th men were t-rayed in the taterrratag years. The following tabulation (peg* 19> is an attempt to demonstrate the length of time required for development of noduiatlen in x-ray. Including those whs had definite nodalatten In their fira* *-ray and I allowed a progression after six year* to around degree, togotVar with thoea \ ad. who weut from normal at early indefinite changes to actual fibre*!*, twenty. 1 nine f st'Tt) of the affected men developed noduUtlon within el* yean. * of Eapoi.Br? Dust exposures in 08 grittdees and burners ranged from five to 40 yean. Those are tubulated as followsi DUST BXP08UR& IN 08 GRINDERS AND BURNERS WHO SHOW MODULATION vsf4 Na. f Men 6 to i9 ................... 6 VntlM ? 10 to 20 .......-...... .. 28 41 20 to 00 . SO 89 3d to 40 23 it should be pointed cut that all of thus* worker* have wot been ton* stitvUy employed u the wot: |ob aad. * have hwl daat exwawt* In It o'.hcr fndiuirtt*. A number*have wevKcsi in eon) minon. quarrt**, potteries, eic., ami many have hnd previous foundry experience in other locations. Generally speaking. however, the majority nt old employee? with many years ot experience in the same plant Nor does the fact that they have been grinder* lor only a few years represent the Entire exposure. These men have all beco exposed more or less constantly fa the tame atmospheric conditions as shown by representative air samples throughout the cleaning rooms sod machine shops. Routine physical examinations or these individuals have not revealed ilgnlfUs&t clinical findings and, although air sampled over three yearn indi cate a definitely dusty operation, there does not appear to be enough free flic* to eoastitot* a hward, certainty net e&eogh Ic produce the rapidly developing nodalattans observed In some employees* Jt-rayt. If, on the other hand, these hg wirkiogs are doe to iron oxide jrfgrdcnUtion, there appears to he enough iron oxide in finely divided farm in the atmosphere to cause it. / * 4 18 V ! * ? f TIM E REQUIRED FOR DEVELOPMENT OF MODULATION YEARS > uoT58tnpoN jo sesso 69 20 o-. DISCUSSION DR. 0. A, SAN&ER (Hedkal Committee. Industrial Hygiene Fcarxia,t>on): 2a order to summarite this di*cra*iB, I should Hk to re-defin the term "pneumoconiosis/' which is widely misunderstood not oaly among Jay. men, but among physicians as well. It sImply mean* "Dast added to the Jungs," without any laptiestioa of flbroajs or disability. At a matter o# fact, ell adults, psrtieuferly those living in eltics, have iane degree of poaumeccskseic, in that all have tome *othr*rtk pigmentation f tbelr {ansa dot to constant inhalation of carbon particle* threagfc the yean. This seldom it sufficient to be viawlited by s-rmy, bat k clearly teen at ail postweu-tem examination* of adults. Moat pneumoconioses which become visible on x-ray films result from industrial dust exposures, Tie moot etraHkarrt of time have bee* stUcoeis sad aebestcsls, in both of which the x-ray shadows are east by Abroea tissue reaaftt??g from the toxic S2rj?ejc properties of free silka sad asbestos Abus. U la because of these two ftbrotic pstu&oconiose* that lha medical miod has Bs^wiated fibrosis wHh all the pneamecanksea. At Inert Dusts We now hnow, however, that there are dost* which may became &d~m the* iTmpMtm ol tWTaitga witca are entirety mtru to tftat cause no ovetyrowlh d ewwctlv* tieme hi ifte~hJtig*. .Ameer each ' >**. M>H hOaiBiO mtteil Whig* nos'4 rcaduy absorbed into the Mood stream as lose, lor example, Metal dust* which become deposited In the hm* lymphatics may be entirely raert, with no fibrosa tissue whatever HaulUng from t)mr presence. This m veM shown in the ease of Iron in the postmortem stody pofelished by Ewser and the apesfre* In 5W81' * and reported at your meeting two years ago, ht which a tank welder who showed x-ray changes shrrelvting atikosk had no fibtoes iikwo in his hrit#5 vh tttididd *t portmertam. The ahaderive simu lating ailJcosls were believed to be due entirely to mdta-cptqtie iron putkle collections in the lymphatic ehannah and nodes sorroendtag the blood ves sels and bronchi. This postmortem finding has only recently been verified by MeLaugMSn, Barrio* Oreut and Harding,* a group of E.tgUsh Investigator* who have been interested i& tide subvert for many yean. A stiver polisher suing rouge (iron oxide, Fe^O.,), whose x-ray film had shown stippled and mkalited shadows, wsa found at postmortem to have collections of Iran partMec in the long lymphatics and no fibrotie change*. Tbs published microscopic seettom from these lunge were atatilar in every way to those published by us in tite welder study. B-define Term Those observations require a re-leflnig of the tarn "aiderosis," first introduced by Zenker in 18CC, As with tits genenl term "pneomoccalorie/* so also with the specific term "itderosSs," the definition is simply "Iron dust added to the lung* Sender's definition trafcrta&ately Implied tint Iren deposits in the lungs resulted Id fibrosia, bseauw his eases had fibrosis due to associated tuberculosis. Later pstHokgktl reports of iron miners' tangs usually were cuac* of ydcro-ailicosis, the observers coRcloding that the Iron 21 was the racse of the fibrosis ratter than the aNka. W* how Voow that iron oxide Is mitre*? inert hi the tissues, bet that cofieettow erf large numbers of particle* will cast shadow* On x-ray ihno. The tew "ilitnaij,' there fore, a perfectly proper provided the Isplfeatwn of fibrosis is achided. The first stf<fc is a mere repeat chssl x~rkf fibs of fe* welder foreman reported here two years ago, who tee shews no changes in the discrete psesAwtodular shadows wbtrh we still belkve ere due to inert eriteetiens of iron azide around blood vessels. Ho no longer is exposed to welding fume*, /or which roeson w* had expected to see erftfence of some absorption of the iron, bat no changes have occurred. He still works every day. atlQ swims considerably each rammer and still Is entirely without symptoms on exeeiiea. Wo now ter* tees rfeerelag bin periodically for over SO years. Difference in X-ray Appearance While his chest film is os the screen, t should Jrte to Indicate s /ew prints of difference In x-ray appearance between uncomplicated eiiemta end silicosis, whereby we believe that we can &fferri)sto the two. The htlam shadows at She lung roots are not enlarged with aldereris as they are with silkroslj, because the Iren dcpralte cause no fibrosis fe the root stands and therefore no enlargement of these glands. Also, the iron collection shadows always are more discrete and sharply defined than are siticotle nodal** s* on Aina snd there is ne tendency to conftuowe u with tlUeeeU. Based on these dlfferenltal prints, we have bees able to "spot* eeme weidera by.the x-ray sppeararrt* alone Wore wp knew the occupation, The second alM* % Chat of a young welder who did stews S$ psKwi csnSoed work taride of pontoons lor landing barges, b*t only ever a period f 39 months. HU pre-employment fika wta entirely clear, but definite discrete stippling u noted on the film made to month* later. This Is the shortest exposure ** have e*ra showing evidence of iter* oxide deposit* fb the blag*. Th* fume ecpentr*ti9R8 teride of the pontoons were extremely dense, with no attempt at vantitoHon until three x-ray Ranges were discev* md ft ie toteteattog that is spite f the obviously intense welding fame exposures, tide welder bad none of the upper respiratory irritative symp toms frequently observed among shipyard welder*. Iron Otkfo Pome The third slide It that of ax electric welder, age fiO, who worked to a steel foundry tleaning worn for 22 years until 1949. HU exposure, there* fore, w*a similar to tfia ease* which Sr, Hareft* stewed, there haring been some silk* exposure along with the exeerelve Iron hide tame exposure*. Developed attack of "Sa" carl; in IdW, which was folUwed by marked MerUoaal dymet not present before the attack. This persisted to such a degree that be felt enable to cehttow hit work and filed claim for com* peniaUen. HU doctor** opinion wsa that ho was totally and permanently disabled as a teraU of an advancedaodjlirsilicotis.wKwh hecalled advanced teeosd staffs, tl was oar eptols* shat tbi* probably ** a combined lesion, aldwvaHUosls, but th*t wo believed that the alUsorie was minima) m degree becaine of th* small hilum shxdoon. We printed out that his height was 5* 2' and his regular weight had been about Uff. Paring sad after the j)1nws, hi* weight mcreased to tffO tbs, five second tffcn shows the marked 22 riev^ion of (be t'jupUrsscn on fall inspiration a* & resalt of this increased which sfKhublei)>y was iho T*ajor rates of the cxertloaal dyspnea and easy fatigue, with hysterical waoifeatotiona which undoubtedly exag gerated the symptoms. Our Industrial CommUrioa. however, after an inde pendent examination at a well known midwestero clinic, concluded that the incapacity fer work was dec to an advanced second stage sHkttte and awarded compensation for tote) permanent disability lato in IfUQ. Ha has net worked since then. We have observed him from time to ttmfr and hauc /oyed Una evklcoee of dyypfi** a* his weight decreased. The recent film, which is slide four, shows marked improvement to the diaphrag matic excursion and the dyspnea t* much less than in iStff. Only a slowly increasing Arthritis prevent* him from drink light war* sow. The medlco-lcgal implication* here are obvious to that where the cheat x-rey film shows noftuUf shadows simulating sllkoala and where thore also * is an admitted allUa exposure, no matter how alight, the ca will be re garded as primarily elUmato Other factors which mar ^redoes nsdular or .stippled lung shadow* will he disregarded if nay degree of silica exposure 1can be shown. ,vnlinucri education of the medical profession and our Indus- 'trial Commission* will be necessary to tn*he them aware that an x-ray shadows^W*g a nodukr psteeco are oot due 2a *f&ori*. * P&alrete'tem Studies A pfea is maeto to un ail who are Interested in the mere accurate diiU^i^^022535SnSSCSSE!SS3SHS3IIS32^52!7T'' effort to ohuto ugteiisd poaunontem aft>dto~on^' all loch Inara. Toffa* hs^arlftCT`Woqufitely~ax4reed tl pattern Hue weid?r| wbo ftima stewod'Iatt, andervtanda out to his Kings and baa glvea hft eonaent for th^r atudy whes Ms time arrive*. Dr, Gardner will receive one of those lungs for aoslyeb and the other will up u> ite `Softer who testified that this man wax totally aad perMmenUy dj&ahkd because of silicoets, Rcfsrenc i. JR. e>no<t,Xv*Ht..i(Us*. (ms Toxflc.i-at t ;ct5t5f1r.tl bung Cluisf** * arw Arc WwOare. S *ncr. o a VneilifT I6I*,, ! in on f.vn# Cha*s To EWcifJe Are WWdar*. s.Metau^Un. A l .ft,: Grout. 1. U A.; 2-ttM, II. J.s and HsMtn*. H. g.t Iron n*Wo lM3i ,tnO >* tonu* vt ivor ymaten. i^seot xt M vw. 1, ms. (Mam* i, sws>. to DR. PHILIP KUNXEft;'the last iw# paper* til *ftenen er* ci ipeelsl 3ntetat to tbs engineering profession. The ftrat, on improvements in the seeoracy of mastering the rilJoosia hazard, u by Dr. Holden end Hewn. Hennart Hyatt, aiembtra of the Foundation staff. ACCURATE MEASUREMENT OF SILICOSIS HAZARDS--NEWER METHODS P, B. HOLDEN, PK 0.,` W. C, L. HSMBON. &. S,,* find E. C. HYATT* The impoimlbnuy el diagnosing sUleosb from ebsst rntiijgencjrsffu eteM atx* the need for correlation of the x-ray finding* mt* dust operate. It fe, therefore, of primer? Importance the* a te appraisal he made of riBca dost exposures. The appraisal is dependent opon the evalu ation of the following factors1 How much doit (a In the sir? Whet hr its parade sfeaf What >a the dost sootposltias fit She i^spJraMe #te? For how long is the workman exposed to the dust? The failure to accurately determine any one of, theta variables cae result Jn so hMcesrato eoBcfashm. We belle** that the particle else com position of dust has not received attention o&mracnsiwaU with K* Impor tance. In tide paper we propose to shew means of mdararisg particle rise composition, Abo, data obteiaed from several industries Will ie presented to sutotonUsto th* validity tj toe techniQuea. Psftirir Site and Comporitleo During toe early eisaafc stadias on silicosis1 the corapodUon of dopt w dalestlMd b? the analysis of israplca of settled dml (so-eallcd rafter samples). This .practice seemed logical, as material which had settled on ledges and rafters had reached those position* after floating toevsgh the tSr, l**tar> H wee prerta Ihct it It jwpearidte If jvigt the chemical and mineralogies! composition of the dust that actually gets toto toe lungs o# exposed workers by analysing either the parent material or rafter samples. Staffer sample*, beams* of the higher settling rate of coarse particle*, con tain an exaggerated portion of them. M compared with the numberiu the air. Number and Weight v, Pmlrie Site For tf'rcrtl yean ;i b bean esrr practice to employ toe rieefcrastetic precipitator f9r too eoBeetiw* d samples of dust for composition analysis, collecting them from the breathing tone of worfcraoo. The analysis of these samples, however, consistently showed the presence of dual particles >* Urge ea SO microns or even larger. Analysts for free *Ulc* la always reported on a percent by weight basis. Therefore, the presence of one SO micron particle woeld have as mush effort *o the analyeia aa would *>000 fire micron particUs, It waa therefore logical to modify oor lachnlgoei to Include separation i , of tfc^ eir-borae dust samples Into two rise fractions. We chase to seps* * industrial t)*jr1ns jroo*fen 24 1 * 4 i t rate too dut Into pattlon* at the five micron level. The five tplerec end (era dost is designated as respirable tout, in toe sense that It ii only tola frac tion that reaches the kmg depths, and Ha analysis provides the data for appraisal of the rifles dost exposure. In earlier work Hatch and Moke* reported that 79 percent of the weight of dual In foundry samples waa eantribsted by particles over 10 microns whereas those amounted to wily one percent of too total number. The I-H-F Dust Ssmpfer Hie satisfactory application of ate* Reparation required qusntittes of air-born* oust emoontlng to several hua&Pd TrJiFsgranw. fa om instances U waa necessary to operate too electrostatic precipitator daring several work days to accomplish this result. This waa Mnsraette*!,' Aceonfirtgiy, we developed n >mpotiUon dost (ampler af greafer alr-Sow ea^oelty, v^ieh employs MlkyiVc acid &a the filtering media. This materiel was tint enggrated by British workers fer obtaining dust samples from air of mines for cherries! and petrographic analyst,* Oar Htetnisiast constate of a rectan gular hex whose aider cowlsfc of iateiebangeaUc double Kreesa, The box Is 3 Btehea wide end Id inches sQaare, Tbers is a oM-lnch opitng at one end from which ate can be drawn through toe filter. side of tb filter Is rdailc from two 100-mesh eopper amena which serve aa supports toe * Xlt'iTxfo layer of salicylic arid crystals. A number of sets of toes* (Uter screens have been provided fer the tostrureent so that they ears he filkd In the laboratory, attached together, and transported for field work. !t is necessary to make Certain that then are ao large openings to the MiJeyUc arid fitter met. The greetnee of Urge openInga vW rmfeeo toe efiwteney of fUtratsen, raqtorsng tosger periods of time fot to* colleetion vf the asenple. Air from the breathing aon of workmen Is drawn through the filter, empioytag t sawtil Viwr, ha^e owdlfitd ear eSectrosWtte praripitstor so tost it can be used u * source of faction, drawing approximately 29 ruble feet of air per mbnto. The eleetrostetk precipitator with the I-H-F filter "iV tocrc/oro cefleel s mush dost ia ent hour a* lb praripttstar alone will collect In oae day. Two other blowers which we commonly a*e with the fitter drew fiO and $$ coble feet of sir respectively. Treatment ot Semples SshcyHe acid resembles mse^ated blotting paper. However, it will dissolve eompfetely is skohol lesvtog lha, dost ssspended The dust is fUterod from the alcohol on hardened filter paper {Ko. fid WhstoaanJ in a Baechnw funnel employing section. It Is neeessary to wash the dust until ell of the sRiicylie acid is mnoved. Th* dust Is toen washed from the paper with alcohol aKd separated into rite fractions, The rite separation is accomplished by segmentation of toe teem dust. This Is done by a repeated settling procedure with the fines being removed by suction at each thxc interval. Wo settle the coarse dust from a fi.fi centimeter bytsr of thcM lor 46 mltMee to separate Save). rakrfff A multiple unit for this purpose will 8|se fraction four samples st one time. 26 Composition of Industrial Oust* burins- the pass 12 months we hat# applied these techniques for tie appraise! of nurooces silica dust exposures. Some of the results are preanted in Table I. \% will be noted that In mg*t at these instances there *e significant difference is potties size composition, ft is of particular interest that in some exposures ti>* free silica content of the foes exceeds that of the coarse fraction of the dust. This aide even treater weight to the argument that the correct appraieri of exposares to dost mtrinin# free *Uka should be made on samples c dust m the respirable sixes. ^ow Is it possible for a powdered material that costains 35 percent free aftUa to make a dust that contains only one-third reach; or one con. tslnfcig 65 percent free silica, ttg in a typical glow boose bakfe, to make (hist that contains only 24 percent free silk*? Dr. V?> It donee h9 offend an interesting aaajeyy.4 ffappoee * slot* wall Is composed of 900 pounds of quarts reek bound logrite? *fe a weak Hww mortar *fJgbing too pounds. This wall wossld consist at percent free silica as quarts. Suppose Jhafc a workman starts decnoHsMsg the wall with a skdge hammer. The dust he will raise will sbriawly be overwhelmingly mortar dust ecotablrg 3KU* free sfliea, a resnlt that bears no relation to the composition of the erttftml mixture. tn Industry* mechanical mixtures of powder materials that make dust ftt ehnoet Inrarta&Jy afcow a different ocwppriikw. Jn g&ui batch mix* turn the silica sand contains very little fine free riUea, to ptkt doit *> compared with otW fine Ingredients. Jn pottery ciay bodice, the <l*y ntlla**to r* much finer lb tfe powdered quartz aad therefore form dost roach more readily then the latter. A similar effort Is noted In foundries. In a fcrty ;rn foundry we feamf only eight percent freo aliks jo the byeetisWe dust fimot moWfng and kbakieoi. It is clear that many Iron fourtdrin hive ttwh !** impor tant exposure to sfiSc* than la Commonly believed ' Granite Dual Competition At this point it fa fogyeat to inquire whether &M paHkle tiie compost t$on data cast be correlated with the effects of dust so workmen. The limit of fi million particle* of quarts per cable foot of nlf, whkh Is accepted fey many authorities* Is based to a large extent upon the 9are* greaHe study of the 0, S. PnfeUe Health Service.' In that study the wegositfon of the dust to which workmen were exposed wet determined without reference to partfafe site. We most therefor* conclude Chat tmtew reeeHs obtained by the technique Just described can be correlated With the Barre results, they would be of doobtfsl vsh. We obtained three samples of dust, ora frost dust collector In the Barr* field and two frost Massachusetts granite sheds, and separated each into rtspirablt and nea-respirsble dost rises. The two slw fraction* j each duet were then analyzed by *.ry dlffrsetloa* The matte appear In Table it These resuite show conclusively that th* conclusions reached by the U, 9. Public HeaHh Service on maximum allowable dust exposure apply wtilf eqoal fore* If the composition f the free silica in the air-borne dost l baaed on the five micron end lass fraction of the dust. H seems probablo M I- i. <1 S w B y x -ra y diffraction analysts. i that th* compoaenU at tfc gcxoite ire all crushed to the seme extent hr hammering processes. This wonld account for the seme attics; content of roars* and fine partlek*. The appraise! of silica dust exposure bp.dost count eloee or by dost eouM and cdmpcsHion on other than respirable dost U* It outmoded. Down thJe road Ilea the exptajuUoa for many o{ the enoeialoas melts which are reportwi from time to time wherein the effects on workmen do net correlate with the appraised exposure. TABLE II. GRANITE DUST --COMPOSITION ANALYSIS SOUflCE OP SAMRLS W*t. PVCVtBt fe SHIsa In Tsur Duet Umpl* Wet. Pvrvent PCM SllfuU RsirireWv Fraction Earn Granite I Uxreeh*Rtta Granite U 4$ 32 49 Massachusetts Granite U 34 { Referencs i Hcsttft n< Worwpnfn nr *--. X*pyr i Industry). U. 8. ?*Wia fteott* Butfcttn 5ST tlHSt. Du* <G**n:t* j. "><0 atecrate*tea) et Alr.lrwrfic Fuundo' Sju:, T. Kaitfi nj C. Kh, J. Uy*. til 9i ()*>,, s, VrnoJnantliue oS#a1Wt mPeitetati*n*gtoorf tmu*rnt. fMlnimam*liiruMr:eMt. a(Ntthoe*w, *is. ,j.if.Uw)..i cod 55. Y. A. i.tmeoals In TifHiih Co*l Klnc*: Ffsfc*r. 9. w Triiw. lnt, Minin* TGn*M. Un4o*> SS: <J*S4-IMS>. Se OlievacXm try W. H. 46nw. DR. DRINKER: Would anyone like to ask Dr, Rofdeti a question on the technique which has Veen described? DR. GARDNERJ l would like to congratulate at. Holds* on this devel opment of a meehankm it* collecting Uw eir-bew reap!** which will enable m to secure tide eery newest? Information. All of us working In this field Mi the need foe some means of securing samples of air-borne dust whkh could be lncUoaeted by also to as to toim^lne the amount of free sIHea in the sttes which we know are dangerous. This apparatus, I think, provides the means that we have all been looking for. and 1 want to coogntulate Mrs for the job that he has dene. DR. HOLDEN: t would like to say at this priftfc that the development of this Instrument l principally due to Weea that were presented by Mr, Remeon. - DE, DRINKER: Are time any odr question*^ 25 A MEMBER: What is the influence of humidity a* tha technique T DR, HOLDEN: From what work we have done so far it haa ne influence. We have not taken sample* In atmospheres of high Humidity. DR. DRINKER: Ferterdaf as inrwvatioe mu introduced to many engi neering members o! this ergauitatiaB. We had art engineering confsenca which Mr. Remeon, the next speaker, organised. It wan one ef the BveUest meeting* and the most infomatlv* aod, ttchntcadly speaMsg, one of the moat notable ones that we bare had. i welcome this chaw* to thank Mm personally for what he did for us yesterday. It is a groat pleasure to hifcrodure Mr. Jlrmeon. ti i CONTROLLING INDUSTRIAL HEALTH HAZARDS ^ (Fotmctetioa Plant Surveys in 1S45) W. C. L. HEMEON, M. 8.' First, i should like to report briefly on the Engineering Conference held here yesterday for plant engineers of member companies. St was attended by about ?0 engineers. Tbc plant engineer is expected to ktsow at least a UUie Me about every osgmeering subject--or perhaps I should eay i io expected to know everything about everythir*. The purpose of the con ference was to provide a medium for exchanging ideas on practical prob * lem* of executing recommendations for improving working condition* in the plant, including ventilation and dost control. Only an outline of the topics discussed will I?e presented bare. A ccmeeatratad digest of the direusafoB will be prepared nd made available to member companies later. Wc diseuased, first, various engineering details f air conditioned crane eebe, <\ subject that U receiving Increasing attention as a mean* of pro tecting the crane operator from extreme* of heat or ef dost and fumt. Following this there was an axteariv* and profitable dtseoaaios of the prublct.) of maintaining duets free of dust accumulations, m the cnee of dost exhaust aysterna, tt is act always appreciated that dust exhaust systems : he designed and operated to be eolteleaning. Cold draft* In work areas during winter weather occupied our attention ee well as the problem of the air aterillaatlon for the factory. Two ether topics on the agenda related to the breederproblem el sir volume require ment* tat controlling contsmhtar.tt where the proses* itself Induces a flew of air. The general subject ef duet eolleeUoft was coveted In the final hour of the day. f TIi* consensus of those encoding the meeting *n that it wtt well worth while and should be continued. We may, therefore, term thb the "first annual" engineering conference. wmiRiiu.i. laxijw^r, TnCuMtviw Ilyxiene rcubdation. 29 i Tho dissuasion on "The Accurate Blsgnesls of Silicoara" by Dra> Gard ner, Hamlin, Cran<h and Sander brings together reeont developments of cheat radiology with rwtsiomenta of oWer principles. They Hluxtrnta clearly the felanfcpeiKknM of iodosirial medicine and industrial hygiene. As vu pointed oui, tfre must be a known history of froc silica exposure to justify a diagnosis of riiicosts, but (bis fact is sometimes overJacked; oftes free silks is inferred to be present, wbea sti iadestrlel hygiene <exsm' Ittstion of the plant will show that It nonexistent r present only Jo insignificant amoants. The *-r*y pictures of foendry workers showing what appears to be riikotls, but apparently la not, provoke speculation. Because free silica ia present, foundry dost 1b often erroneously considered to be an Important siHeoris producer. The meaaarements by the Industrial bygiesist in this ease,* showing only very smell amounts of free elite* id the respirable dust, resulted, properly, in questioning the diagnosis. The JAiJU sad tahniqaea e{ the industrial hygienist are e necessary tool in the diagnosis of aUicosfc. How often does this situation occur in other Industrie* with ether dasU, where there h a sHtcusis reputation? Summary of Work Control of duet continue* to be onr moot frequent plant problem. The ztDi of our activity can pwbepa best be pictured id these figure* Mr Hyatt and Or. Holden performed more than 1,050 (hat counts 'in the past IS month*--hkh mean*, by the way, 10,000 individual mimmeope field svsnts. In addition, they have <Mak>ed about XSt atmospheric competition dost samples and processed them for site separation in alcohol for analysis by x-ray diffraction. This work he* been distributed among potteries, glass plant* foundries, refractories and several other industries. Several hundred additional analyses were mads for lead, mercury, selamom, arsenic, cadmium, antimony and mlscetianeoin gases tod vapors kt a number of dkferent Industries stick as steel, rubber, chemical, buta diene, chlorine, and machinery manufacture. Fetteri** Oaring the past year the Foundation carried out the meat extensive engineering stenty on dust control In the pottery industry that has ever been conducted, The impmed techniques described by Dr. Holden and Mr. Hysti bare afforded an Invaluable perspective In this study u well as In cur ether engineering work. In many Instances tats have proven that some opera? Hons require dust control equipment, where It ^ad previously been thought otherwise. Just the reverie was tm in ether cases. For instance, it baa always been supposed that jlggeraen, batten-out and meld runners are eipesed to important silicosis ksssrds doe to the duet cooflHIeas inherent in -their eeespaiion. But In a nwnbdr of plant* this was found not to be the case. The tespirabU freed*n. of 4a*t often eoatataed only 32-13% free sitae cron though the day body being worked contained 36%. So with dust count* of only 8 or ? million it >S clear that the fret silica exposure in the dust breathed is very small. , 30 H (ms betti 1m:U1 thoJ dusty floors are a major source of atmospheric dust in potteries. We hive proven (bat the dust kicked up into tfte elr by plant traffic In potteries is insignificant compared with ether source*. V?a fully egret that a clean plant with chian doors is good bsrinosa and we advo cate it, Vut It Is Important W understand that It does not contribute mate rially to sjlfcosls Jmwrrt*, ni feest in the pottery industry. Wtiet Flint Between 10 and 16 years ago certain potteries requested their flint suppliers to add small quantities of water to the material In order to reduce Ihe dual from handling. The practice was inaugurated arid raeeha&ksl difficulties overcome within two or three years and 18 Is now common. The nominal moisture content Ss 3 percent and ear stadta have proves that bft the Sint is uniformly moist to this extent, there Is practically so dust in Its handling. In practice the material does not maintain uniform metstai*, contest, due to partial drying in transit, and some dual Is possible when ft is handled, The effect, However, of this relatively simple measure has be a spectacular reduction in dust from flint. Simple though it be, it raarke the "igV- revolutionary improvement mpocting dust control that the indus try harcnwn. We have developed various sopptementary measure* to counteract the effect of drying utit and to completely eliminate tbedtatard. . The addition of (restore to powdered material* whose dust is a haurd to heaith has applications to other materials and irolurtee--notably silica MtnoiK for hlrt sllka brick masonry work and for dusty sand that is to be shavclod from th freight w in ueWt&xg. Air Pollution Wo eoniutaed work oo genera) air pollution durisg the year with several hundred measurements cf sulfur dioxide concentration* in the vicinity of a smelter and e power plant--(til of which were below significant concen trations from the standpoint of plant life). We conducted a'preliminary Invefitigatipn of odors and fume* alleged to affect & wide are* in a middle western city, and Have appraised dust pollaUon problems by measuring rota of Just escape from stack*. All strews in fbe wind indieste that industrial communities ere beeoroisg more irt*iatent In redaction of geeerof pollution. The establishment of procedures for first'Identifying industrial sources of ccnlamlnatkm, and secondly weighting them aa to relative im portance seem* Inevitable in the future of eoromaaiiy control program*. Tbs Rbsonce of such engineering d*M probably account* for the actios by one official of a certain city that has been.plagued by smoke sod irritatiag fume*. TH official advises the public to `.'Avoid UB* 6f loetaereton, if possiblei do not belkj bonfires: do pot operate an automobile which con sume* an exeesuve amount of oil; end avoid beating rugs or otherwise releasing dual into the atmosphere"! (tits from TrieMeretbjIen* It Has often b*wn stated erroneously that phoegeo* gas is readily formed from tricMorciKylwve nod droller solvents when their vapors are exposed to elevated temitomtuns by flames or hot metet One of our staff 31 J Investigated compJelnte by electric welders ot IrHtatter vapors that hod oauwJ hoapiUtiiaUw of wtnl with vsvm ta* irritation. The woh&ns m fecated near a degreasing Uok and (he presence of trichtcnthflene rapera m (be im asggaeted Ue formstion of phsigete gas. T&sta far phosgene ondar rimahtted eondftfens 'Were negative ev4n though the Inves tigator observed strong irrit*ti* of the opper rMnte*7 tract The nature of the li-rifcatrt as&xtenec has net bean identified although the eon* senttiB au that sever* hang irritant itarilar tv phwgvne was In fact formed hr the metion of the cto**fe area c triehletethyleua vapor. Weld ing, therefore, should hot he carried on near a scarce of trwhSoretfcyl***, eeeh a* a dtgretaer, and any earn;fefeU of respiratory Irritation emor> maintenance welders should be [nreatlgated without delay. Starting Helmets Occasionally we And, aa in a meant eaaa, am Improperly funettentag helmet In are by as shraatvs blasting worker. Although ibe helmet was of a type approved by the Sumo of *Hn, a dust eontastratton of SB tmlVmt was loinri foalda. lavestigstWo showed this was a rawdt ot ineufbrier* sir supply. Bccanw a helmet carries Bursae of Hines approval doe* not mean that it w>l) protect the mM stematlectip. Tbt Bureau's approval eaJHwt extend to the lastaUatioB at the plant, and it it Important that the flow ot ah be measured for adequacy, and sot merely asaoraed. Glams .Tanka Tbs dost that arista at Urn feed ead of glasa tanks, due to changing ot the batch, is carried upward violently and does not eonatitete an; hazard to health. However, the resultant acnomiTatien at settled dust on the tank roof ever a period of time require* periodic tamevil for technological reaaana, and the removal process create* a major dust huisaaco for a time. One plant hoi ettafosted this duet at Its source by fboding ths material from, an overhead supply bin through a vertical shot* that la always full, to a abort eeraw conveyor leading to the tank. Coal# of Central Production of the atomic bomb posed some ot tHe moat apeewuiar {fnJuxtriai hygiene berartis ia Victory. Safeguards ware boft Into those plant* and atomic bomb workers *w protected from the insidious effects of crippling radiant energy and toxic tttaeepberic emanations. These precau tion* were an integral part of the problem of manufacture of (he aranJera for the bond) and illustrate a principle that Is applicable W more common* place problem! in engineering! control of occupational disease hs&ards. That is, that any hunitieu* industrial operation can be carried on in reasonaWc safety if preventive ntuuw ere properly cngh*erd. Uewlly, adequate control to moderate in cost, but sometimes the money expenditure is high. Control ocrafiMtaliy may require % hindsmcnul change in operating methods. When the ebsngr takes the shape of a major proj ect it should be engineered to incorporate all poeelbte operating cost 1m- provemeuu at the same time te help justify the capital outlay. Onq should not make the mistake of assuming that the at an exhaust system or other means of control is alt lose, it may shew a ddtutte S2 economic return on the expenditure which makes It stt investment f like the example afforded In the ventilation for woWing* futsee fat shipyards, which incidentally are Innorsoua fumes. Jteaa and Drinker report tbati l "Tot the average shipyard, the total annual cost of the vanritaring program, ioelodtng both labor and depreciation of equip ment, n 15 percent of tbe total annual payroll of the welding department. Can the successful control of fumes Increase the daily welding by 1.5 percentt--If a weldor bums 1? pounds of rod a day under poor conditions, can ha ami wiM he bum an additional quar\ ter pound of red when the compartment la wan ventilated! Tea, ir. fact he will burs considerably more. Welding superintendents have estimated that output In confined area* on the huHa increased by throe to five pounds of rod per max after a good ventilation system was iMsislied.* This la a tangible benefit, other oxample* of which can be found In Other ,*enptotr*.