Document npNDxoL82vm3g4vq198KmwK76

f 't VOL 3- > 'o . 5 'i; J A --* > 's*&&*'. S- & / ,^ro*J A U G U S T , 1943 j Observations on the Toxic Effects Resulting from Exposure to Chlorinated Naphthalene and Chlorinated Phenyls with Suggestions for Prevention By DR. H. VON WEDEL, DR. WILLIAM A. HOLLA*, AND DR. JAMES DENTON Department of Pathology White Plains Hospital, and the Department of Health, Westchester County, A'ew i'orfc PO"Rc-ver rwer.ty years chlorinated naphthalenes have s-rtr. extensively used for insulating wire and in the "ar.uracture of certain electrical equipment. ChlorTited naphthalenes and chlorinated phenyls (sold -er :hc trade names of Halowax and Arochlor) have -iTr.tc electrical, heat and moisture resisting proper*.ei. ar.c are practically non-in flammable. Their use in ma-ufacture and preparation of many types of elecequipment has been tremtndously increased, due tnormous increase in the use of such equip" cr.: ;cr the prosecution oi this present world war. 1" jot.s milis hot concentrated Halowax is used to i'.utv.t wire insulation, while in other mills the com- are dissolved, in organic solvents, the solutions t-rir.g used cold to saturate the insulation. In **' :h-;* processes the wet insulated wires are dried ' cry-.r.g tubes or ovens. During this drying process concentrations of chlorinated compounds fjif, tren known for many years that these com-j '.'ause acne-like eruptions. In recent years seri * * r- o: H u i : n . \\T ic f ie r C ounty, N.. V . ous systemic effects have been recognized. During the past year many cases o: skin eruption and in addition six fatal cases of a peculiar type of subacute yellow atrophy of the liver have occurred among the workers in two wire and cable mills. At the request of the management of one of these mills and in cooperation with the Department of Health of Westchester County (X . V.), one of the authors undertook an investigation of the mill in order to advise the management and the Department of Health as to means of prevention oi the cutaneous lesions and systemic effects resulting from these toxic hydrocarbons. This mill used the cold process for saturating the wire insulation. As the study progressed, it became apparent that the toxic lesions resulted from inhalation by men working in or near the drying ovens and also by some other method oi absorption, presumably through the skin. This fact was clearly shown, because many of the acnefonn eruptions occurred among the men operating the saturation baths and not exposed to the inhalation hazard. A lew of the acne-farm eruptions occurred among workmen handling the cold finished wire in a mill-room far removed from any possible inhalation 419 GENP 009836 773449 nazara. Women working .in Che same mill rooms with the affected men showed no acnc-form eruptions. None of these women handled the toxic substances. An investigation was begun to determine what sys temic effects would result from the administration of these substances to experimental animals by inhalation, ingestion and by surface application of the substances to the skin. This article describes pathological changes observed in man and experimental animals resulting fiLrtn absorption of these toxic substances, and suggests means of preventing this absorption. Historical Lehmann in 1919 f l ) found that animals which were fed or which inhaled chlorinated naphthalenes lost ap petite and at death showed peculiar lesions in the liver. Flinn and Ja rrik (2 ) in 1936 reported three cases of yellow atrophy of the liver occurring in three widely separated plants. Experimental studies on rabbits, using different compounds of chlorinated naphthalenes, indicated that the toxicity of these compounds in creases with the increasing degrees of chlorination. Flinn and J a rv ik fJ J later reported nine cases of yellow atrophy of the liver occurring in mills where chlorinated naphthalenes were being used to impregnate wire and other electrical equipment. They concluded that the cases of yellow atrophy of the liver occurring among the employees were probably due to exposure to chlorinated naphthalenes. Drinker, W arren and Bennett (4) in 1938 described the morphological changes in the livers of rats exposed to chlorinated naphthalenes and chlorinated phenyls. These investigators administered the toxic substances by inhalation, feeding and subcutaneous injection. They found that the tri and tetra chlorinated naphthalenes produced only slight .pathological changes in the liver, unless extremely high concentrations were used. How ever, animals exposed for six weeks to the higher chlorinated naphthalenes in low concentrations regu larly showed marked liver damage, even though they gave no clinical evidence of such toxicity before death. The toxicity of each compound seemed directly related to its degree of chlorination. Widespread liver degeneration can exist for several months without producing any evidence of ill-health in the animals, suggesting that the alterations take place slowly. Animals given a sublethal dose of chlorinated compounds, when given a very small dose of carbon tetrachloride immediately died, even though such a small dose of carbon tetrachloride given to a normal animal would not materially affect it. Exposure of rats to either highly chlorinated naphthalenes or chlorinated diphenyl results in a type of liver injury differing con siderably from the liver lesions resulting from carbon tetrachloride (5, 6) and chloroform (7) poisoning. The changes resulting from exposure to the com pounds employed in their study involved all portions of the liver lobule, even though the initial morpho logical charges were more pronounced in the liver cells nearest the hepatic veins. The changes were degen erative :n nature, first cloudy swelling then iatty infil tration and fatty degeneration. Complete disintegra tion of the cells with areas of necrosis finally resulted, regardless of the method of administration. f This de generation was characterized by accumulations of large amounts of acidophilic hyaline material. The characteristics of the liver changes produced can be markedly altered, quantitatively and qualitatively?^ varying the degree of exposure. Blood examinaSl- during life revealed no significant abnormalities, the injurious effects of these compounds were " * fested solely in the liver. The investigators concluded from their experia that lower air concentrations must be obtained in 'jj^ case of the more highly chlorinated naphthalenes chlorinated diphenyls, than for trichlorinated naphtha;^ lenes, if a safe environment for workmen is to beac^' sured. 3 Yarglou, Sands and Drinker (8) reporting on ventilation of wire impregnating tanks using chloii.'* nated hydrocarbons, showed that the requirements the ventilation of such tanks varied greatly with type as well as with the size of the tank. They sfi*! gest that an exhaust slot about 2 inches high extenrfwJS; along the full length of the tank with lateral ventilation" was the most effective method of ventilating such For any given concentration of chlorinared naph the degree of chlorination had no appreciable effect ventilation requirements. Greenburg, Mayers and Smith (9) in 1939 repo three cases showing the occurrence of'sim ilar pa logical changes in the liver in three young adshr known to have been working with chlorinated napht&f lenes and diphenyls. They briefly summarized systemic effects resulting from this exposure and mafcl? recommendations for prevention. Drinker (10) in 1939 reported further observaocwl on the possible systemic toxicity of certain of the chkr inated hydrocarbons. From this study he concluded!; that the permissible limit for air contamination with*' trichlor naphthalene was 10 mgm. per cu. m .; for lerirV and penta chior naphthalene, 1 mgm. per cu. m.; fers penta and hexa chlor naphthalenes, 0.5 mgm. per m .; and for the various chlorinated diphenyls 0.5 per cu. m. Geary, Maier and Hitchings (12) in 1S3S,' reporting^ on the metabolism of chlorinated naphthalenes, stately that no significant storage of the material could be tected, in lung, liver, skin or kidney, nor was any sig-j nificant amount excreted in the urine. Both the raQf and the dog apparently were able to remove and -2 crete the chloride promptly. A rise in the urinaty.- ethereal sulphate fraction, but no significant change i a ^ the neutral sulphur excretion, was noted after chior-^-- inated naphthalene feeding in the dog. Rilev ( IT) in 1943 stated that poisoning may result from inhalation of vapors, from prolonged skin coo-i tact with the vapor, liquid or solid phase, and from gestion of the chlorinated material. .^C Cranch (13) in a recent personal communication one of the authors, stated that the effect of these waxes!L; on the skin resulting in the appearance of acne s 3* 3- determined by the presence of chlorine alone, but is* due rather to* the compound effect of chlorine and -a^ tar derivative. Xo such marked tendency tc acne mation results from exposure to chlorinated petroieus^A derivatives, such as chlorinated paraffin. When chior^ inated naphthalene is combined with chlorinated <_> phcnvl, a more active acne is produced. Liver damage.-? is not likely to occur following exposure to chlorinated^- naphthalene alone, but may occur from exposure chlorinated diphenyl combined with chlorinated r.ao0" thalene or other tar derivatives. The seventy c. -- acne is not correlated in any way with the ceg'ee liver damage which might occur. Cranch suggests that other factors art prebaa-; GENP 009837 773450 RueBER ACE. Aucc-S" . the cases shou-ing liver damage, besides ex10 cMrinated waxes alone. The important iff^ b ro u g h t out in this communication was the fact -{fc^sJdr reactions with acne tormation have been j men handling only the, finished product, with .= preciable vapor exposure. - As far as he knew, : ;er cases had been attributed to skin absorption. suggests that the absorption of these materials ' nju^h the skin is very slow as compared with inhalajin absorption. ^-Craoch also suggests that prevention depends first ^ai'the greatest possible reduction of vapor exposure sd.s& contact; second, on protection of the skin by of cold creams and adequate bathing.. Efects in Man Resulting from Exposure f iCSiofiMtsd Naphthalenes and Diphenyls f ^ I t.h a s long been known that chlorinated naphtha* j r i b a and diphenyls are skin irritants. The lesions fere been described by Schwartz (14) and others. ^ISc, effects are first noted on exposed parts--either fumes or from direct contact with the chemicals. - SC oQ tam m ation 0f clothing results in more generalized ^sribution of the irritant effects. In workers with ^ ^ a s v skins and hypertrophied sebaceous glands, the '-^dnets are more frequent and prompt. A fter exposure about six months, few workers fail to develop .-^faioos- .v=3^The skin affection usually begins as a generalized /^fofficuHus. Occasionally there is diffuse pigmentation rSiftfae skin of exposed areas. Later comedon, acneBfie pustules and sebum cysts develop. These latter -Mesons tend to be chronic and on healing may leave r----oanent scars. Generalized papulo-pustular erup-a i have been described. In the cases observed in i . mill the skin lesions have been confined to the ex* "ijEisor surfaces of the arms, the back of the neck, the osBaodibuiar surfaces of the face, and aiong the hair _-_anrgins. The lateral surfaces of the thighs have fre* ^sTspmtly been involved. ? 5 la addition to the skin lesions, symptoms of sys-tsaic poisoning have appeared in some workers. The .infest complaints are digestive disturbances, burning j^othe conjuncrivae, and in some instances sexual im^ggteicc and haematuria. ==j&Et is not known just how frequently fatal poisoning from absorption of these chemicals. It is worth ^ g iog. however, that six workers, formerly employed ^Sj^tbese two mills, have been studied post mortem. '|^ K .o f the post mortems was performed by one of ;^~as and the other five by pathologists in this industrial We have had the privilege of examining the Jgical material from some of these necropsies, these six cases, death was in every instance due ~$t!?:suhacute liver necrosis. ^rSmce subacute liver necrosis is an uncommon disease .^aod since all six workers had been exposed to absorpf the chemicals in Halowax and Arochlor, it is to suppose that these chemicals were the cause ^v^t.the liver necrosis. In all these cases the livers were reduced in size. Their weights ranged from 400 to 1100 grams. A review of the pathological -.-T *nges in the autopsy material shows nothing of much T nincance, except in the livers. The. hepatic lesions L led in character and intensity in the different cases, fXi/jP^etUy depending upon the susceptibility of the afferent subjects, or possibly upon the length of time fristr t t P3ure *n the toxic agents. All the livers were markedly distorted in shape, coarsely granular and mottled in yellow and red. For the most part they were very firm, although some showed large soft red areas. On section, their cut surfaces varied from mottled yellow and red with scattered necrotic areas to large yellow-gray areas show ing small necrotic centers. In our case, there was a complicated melange of liver necrosis and cirrhosis, tn all of the cases, however, there were large areas of degeneration and necrosis. The distinctive feature of this chemical intoxication is. clearly, liver necrosis. The cirrhosis and scarring are apparently attempts at repair. In the autopsy material it is difficult to determine what portion of the liver lobule is primarily affected. In some the whole lobule is involved, while in others the lobules are so deformed that definite localization is impossible. In general, it appears that in the more acute cases, necrosis of the liver cells is the prime feature. In the more chronic cases the liver necrosis was complicated by scarring repair and regeneration of tiver lobules. Experimental .\faterials employed: . In the animal experiments which we have conducted, the chemicals used were those regularly employed in and supplied to us by the mill for this purpose. They were Halowax and Aro chlor in concentrated state and dissolved in naphtha and troluoil. The effects of the solvents alone (naphtha and troluoil) were also studied. In these experiments white mice, guinea pigs and rabbits were employed. Three routes of introduction of the chemicals have been used--Hz'.* by inhalation, by ingestion and by ap plication to the skin. The first two avenues of absorp tion have been extensively investigated by other work ers, but to the best of our knowledge there has been no systematic study of the systemic effects of skin absorp tion of these chemicals. Observation at the plant leads us to the conclusion that the skin is an important av enue of absorption of these chemicals. Therefore we have in our experiments directed particular attention to this mode of absorption. The inhalation and feed ing experiments which we have carried out have con formed to the methods outlined by Bennett, Drinker and Warren (4). They have proven useful, as con trols, in gauging the importance of lesions produced by skin absorption. The skin absorption experiments were performed for the most part with rabbits. Approximately 9 square inches of the hair on the backs of a series of rabbits was removed with clippers, the remaining hair shaved off and the resulting small skin abrasions al lowed to heal for three days. .These experimental ani mals were kept in cages alongside normal control rab bits. Yi ml., 1 ml., and 1 ml. of diluted Halowax and Arochlor, containing 0.8 grm. dry Halowax per ml. and 0.6 grm. Arochlor per ml., respectively, was dropped on the shaved areas by means of a calibrated syringe. After allowing the chemicals to partially dry for about five minutes, the animals were returned to their cages. The substances were administered daily, in the above-described manner. Because of possible criticism that some of the chemicals might have been absorbed by ingestion or inhalation, this entire series of experiments was duplicated, following the same pro cedure cited above, but with the precaution of covering the application areas with molded celluloid guards. ACE, AUGUST. 1943 GENP 009838 773451 421 These cellulod guards were made by cutting and bending sheet celluloid into proper shapes and binding their sharp edges with adhesive tape. After each daily skin application the guards were replaced and firmly strapped in place with adhesive tape passing complete ly around the animals' bodies. This procedure, we be lieve, precluded any possibility of inhalation or inges tion of the toxic substances. In no instances were the guards removed or loosened by the animals' movements in their cages. To avoid skin irritation the inner sur faces of the guards which might come in contact with the skin were coated with vaseline. A third series of skin absorption experiments was conducted in a similar manner, except that before the daily skin applications were made the shaved areas were covered with a thin layer of Protek. This sub stance is a cheap and apparently efficient type of cold cream used by mill workers. A fter experiments with naphtha and troluoil alone, extending over four months, no animal showed any skin lesion resembling those caused by Halowax or Arochior, either by inhalation, ingestion or skin ab sorption, and no animal died of whatever mild effects these substances.might have caused. We therefore felt that the acne and the systemic effects observed in the remaining experimental animals could not have been caused by either naphtha or troluoil. The results of all three methods of absorption with both chemicals showed essentially the same type of skin lesion and liver necrosis. It was found that the rabbits were more .uniform in their reactions, and the dosage could be more easily evaluated. Therefore, all the last experi ments were made on rabbits. The extent of the skin lesions and liver necrosis depended on the size, frequency and number of inoculations. Animals inoculated with large doses every day, whether by inhalation, feeding or skin absorption, died before definite liver necrosis developed. Animals inoculated with moderate and small daily doses lived for longer periods, and at necropsy showed skin lesions and subacute yellow atrophy of the liver, simu lating the lesions observed in man. Animals sacrificed after a short series of small doses, showed slight to moderate degrees of liver degeneration, evidenced by fatty infiltration. Four to five days after the first dose of chemical was dropped on the skin, all regTowth of hair was com pletely destroyed. The skin became markedly red dened. small papules and blisters formed, and finally the external epidermal layers desquamated. Some pustular lesions developed which were very similar to those seen in man.- On necropsy, the livers of the ani mals were the only viscera showing any definite changes. The animal livers varied in appearance. E x ternally they were mottled in red, yellow and brown. They were finely to coarsely granular, and showed no marked abnormality in size. On section, the livers of the animals receiving the smallest dosage showed only a change in color, being more or less diffusely yel low' with no gross evidence of necrosis. In animals re ceiving larger or more numerous doses of the toxic sub stances, there were opaque yellow areas of necrosis scattered throughout the liver substance. The lesions were definitely degenerative in type, ranging from moderate degrees of fatty degeneration to marked hepatic degeneration and necrosis. Those resulting from skin absorption of Halowax and Aro chior uere essentially identical to the lesions produced bv inhalation of these substances. The rabbits treated with Protek before application of the chemicals^ skin, were partially protected and the chemial lion retarded. There were similar but milder d e liver lesions. Normal control animals kept in idf3i environment as the experimental animals devctaS&J skin lesions and showed no fatty degeneration o r t S necrosis at autopsy. * Methods Recommended to Safeguard Workers Exposed to Chlorinated Napthalenes and Diphenyls The first step taken should be the formationj^iJ working committee consisting of the superimoSH* the chief engineer, the chief chemist and the coainSj or plant physician of the mill. This committee , formulate practical changes, wherever found necess " to as far as possible protect the workers from the1 ards of these toxic compounds. Because of the jb need for these critical war materials, no changes be advocated which will in any way slow down or* vent the greatest possible productivity of such ire tant mills. ...**.*' ^ Protection must consist' of prevention from lion, ingestion and skin absorption of these chearic Skin absorption, while long recognized as c acne-form eruptions, has not in our opinion rt proper consideration from the standpoint of s\ effects. Toxic effects from inhalation are without oues__ the most important because of the speed of absorpir and the probable high dosage of toxic substances sorbed. Therefore, adequate ventilation is the prmutir consideration in any mill. The mill rooms and house should be ventilated by intake and exhaust: of sufficient volume and velocity to rerove the jority of the fumes. '* ^ The drying tubes and drying ovens should be 15 quately ventilated and sealed as nearly air-tight as pra ticable. To accomplish this, large intake vents shoal* be placed near the floor in the doors of the ovens. Large high-velocity exhaust fans* and zat quate number of large exhaust stacks leading up sbortvj the roof of the mill should be installed. After steam in the drying ovens has been turned off. fr cool air from the mill room should be pumped thrTsgfc the ovens for a sufficient time, in sufficient volume- of a velocity of approximately 2000 cub. ft. per mintfcg^ to bring, down the temperature of the drying ow to that of room temperature, before opening their dc` to unload. Daily analysis should be made of the air in ovens. They should not be opened for unloading!*? chemical analysis reveals less than 0.5 mgm. or chk ine. expressed as Haiowax or Arochior. per cubic of air. The drying tubes surrounding the wet imp^T nated cable should be ventilated by suction applied- the far end of the_tubes. The air flow through J*fS tubes should be sumeient to cool the saturated czbie== a temperature at which no significant amount of is given off from the cable after it leaves the dnispp tube. The impregnating vats should have permanotJE^ hinged covers fitted with flanges that extend ward inside the tank, to avoid soiling the outside o:J*3p tank from dripping. These vats should be compictsfe enclosed in a ventilation hood, with a hinged door from. These hoods should be ventilated tr.ro u ? ^ properly constructed lateral exhaust ventilation system Yargtou, Sands and Drinker ( S) recommend an GENP 009839 773452 RUBBER ACE, AUCUST. approximately 2 inches high extending along the full length of the tank, placed approxiinches above the level or the liquid wax in the ^nation vat. Various speeds of exhaust should .T?sie<l. until (^e Proper speed is indicated by chemical * of the air in front of each hood. e cold process. Halowax and Arochlor are disor diluted with solvents in mixing vats. The ^ j^ r a x and Arochlor should be introduced into these as little manual handling as possible. The should be kept, covered at all times with a hinged except when actually being filled. The workL'^jn should not be allowed to place their hands inside vats, even for taking the specific gravity of the Aytwres. This can easily be accomplished by a longr n ^ e d glass thief introduced through a small opening i^ tb e cover of the tank. The specific gravity should H^bserved outside the tank, after removing the thief. Infc chemicals should be pumped outside of the mixing r a is e to a loading platform through permanent pipes gl^d w ith proper gate valves. Such pipes should be Hjijccted by proper couplings to tank trucks, jp rtlc tank trucks filled with the chemicals should then C j^nvea to the felting mills, where they are emptied ^5o- conveniently located distribution tanks. The "aoni&l compound should then be pumped or fed by r'srity from the distribution tanks to the impregna l a vats through appropriate sized pipes, not less than laches in diameter. Separate lead pipes should exjn d downward to the vats from the main feed lines. Exs pipe, just before it empties into the impregnation should have a gate valve the full size of the pipe l aed-of simple design so that it cannot become clogged .Tf the mucilaginous fluid. /A fter the fluid chemical in the impregnation vats h f n contaminated by too much asbestos debris, the l i remaining in the tank should be exhausted |TJfewgh exhaust pipes at least 4 inches in diameter, ^'jaaected at or near the bottom of each impregnation Such exhaust pipes should be attached at an r i p e leading out from the back of the vats and extend ; s s receiving sludge vats with a simple gate valve the L 2 size of the pipe placed near their lower ends. The je a in s of the asbestos sludge, which does not flow i-g - : *1-- Human Liver: Late effects o f liver neBile ducts and capillaries, no liver cell rcgmtra- P ^ r/C . 2-- Human Liver: Right half o f the field destroyed liver lobules without repair, the left f- fif f th* field shows regenerated and degenerating r ceils. Erl!?" rVr^G- $-- Rabbit Liver: Effects o f skin absorption of i JrpenLor-- moderate dosage-- half of the liver cells are I anc^ granular, the other half contains large'fat t f^plets. The darker areas are haemorrhage. *-- C ^ --Rabbit Liver: Effects of inhalation of *: " Ca-'C-r-- 18 doses-- showing complete liver necrosis. - FIG. 5-- Rabbit Liver: Effects of skin absorption i . dewax, showing complete liver necrosis. * ' 6--Rabbit. Liver: Effects of skin application Jiclow cx after application o f Protek, showing pari~ t*| **er necrosis. Pi C*.. GENP 009840i_ 5? ER ACE. AUCUST. 1943 .. 773453 423 ...-.i ii*.c iiiouiu uc acrapeu out or me vats and pushed into the sludge vats by means of a long- handled square-ended steel paddle. .If the exhaust pipe should become dogged by the thick mucilaginous substance* a 4-foot long steel push rod with a 3-inch Hat bell at its end should be used to push the obstruct ing sludge into the receiving vat. Both the paddle and the push rod' should be stored in a vertical metal con tainer. The sludge vats should be of the correct capacity to receive the largest amount of sludge that may be ex hausted into them, and of appropriate height and di ameter, so as not to obstruct the passage ways. All such vats should be interchangeable. The tops of these vats should be constructed so that their entire top, with the exception of a l-inch overhang rim, is open. A slide sleeve should be placed in this over hang rim. A strong metal sliding cover should be pro vided for each vat. An opening to receive the metal pipe should be placed in the slide cover, fitted with an angle extension to receive the solid 4-inch pipe from the saturation vat. A fter the sludge vats have sedimented fo r an ap propriate time, the good fluid Halo wax should be pumped into receiving tanks through a pipe containing a glass observation window. A fter all the good chem ical has been removed from the sludge vats, the re maining sedimented sludge should be dumped, into burial ditches by placing the vats in an automatic dumping machine, so that no hand will have to touch the edges of the vats. The vats should not be cleaned out until their inside surfaces become covered with too much hardened chemical. The hardened sludge is then softened with an appropriate solvent and scraped off the sides of the vats with a long-handled square- ended steel paddle. Elbow-length, thin, impermeable gloves, should be used by the men when they adjust the nuts and screws of the mechanism in the vats. They should be taken off immediately, when the men have finished the job, to avoid excessive perspiration. The outsides of the impregnation vats should be frequently washed down with a proper solvent, to keep them free from the toxic chemicals. After the above recommendations have been followed out. the personal factor has been almost completely eliminated. Clean working clothes, consisting of long- slecved overalls fastened at the neck and wrists, should )>e provided. These clothes should be laundered fre quently, daily-if possible. All eating of lunches, etc., should be forbidden in the workrooms. Candy, cigarettes, chewing gum and other vending machines of such nature should be placed in recreation rooms that should be provided for thv work ers. In and out l k e r rooms and shower baths should be installed, so that the workmen coming to work leave their street clothes in the outside locker room and pa>? through the shower room to the inside locker room, w here they put on their clean work clothes and cover their hands, faces and necks with some type of cold cream or skin lotion. They should then be checked out by a checking system before they are allowed to "ft imo the mill. When leaving work for lunch, they should le checked back through the inside locker room, where they should thoroughly wash their hands, faces and necks with soap and water before going to lunch. If they are going home they should also check through the inside locker mom. where thev leave their soiled GENP 009841 ciotnes, take a complete not soap aitower bath 7 fore sufficient shower baths should be provid^ are then checked out to the outer locker room. Heju put on their street clothes. This not only p ro te ^ workmen, but also their families, as it has beat g (14) that wives handling and washing such doth^e children playing with their father while he w *? ing the soiled work clothes acquire the same skin lesion as the workmen themselves. ./Jos- All new workers should be examined by physician, and all men. and women with a "histofi previous jaundice, liver diseases or skin diseases d be rejected or should be placed in departments!, toxic substances are not handled. All workers'^ mills where cables saturated with chlorinated lenes and phenyls, whether wet or dry, are hancC' should be periodically examined for skin lesio^S. systemic effects. No women who are pregnant s ^ j be allowed to work in these rooms, as the}' are n very susceptible to liver toxemia. All workers in mill rooms and all new employees should have frtqj periodic laboratory' tests made to determine or not any liver disfunction is present Such tory examinations should include Hanger's cholesterol flocculation test, bilirubin content a: blood serum, and icteric index. If any one of the show results exceeding the normal limits, the should be re-tested within one week and if such mality persists or increases such workman should k removed from this toxic hazard at once. As it is a known fact that other conditions, gastro-intestinal upsets, etc., may cause one or of these tests to show' transient moderately abnena findings, the first test should not be considered cond sive, nor should such workmen be barred from ths work until such abnormal findings persist or inciea. At present the New York State laws reiarinj5 health in industrial plants are placed under the joy diction of the State Department of Labor and the we* health depanmem. Where a county health deparnnel has been established or where a properly funcuctos city department exists most of the health hazards* industry could be handled more readily by the loo; department than by the state. This is due to the fat that the state has but few employees to cover a laipf area, while the local health department is immediate^ available and often more familiar with local conoid^ and hence able to keep in closer contact with the inda?" try and over a long period of time if necessary, Laws should be passed making it necessary ftf: medical directors of industrial plants to report at on*: all toxic disease conditions relating to industrial ment directly to the local health department, who then make an investigation of existing conditions ass if possible, arrive at the solution of the difficulty. d**-; make the necessary recommendations to the industn. plant, also furnishing the State Department of _Lata?i a report oi the investigation and the recommendatk?*, made. In cases where the investigation discloses w* more extensive work is needed or the services.*-!*-, specialists required, the Department of Labor snoo^i then be called upon to complete the work. In manner the state could be saved considerable time afls- trouble and be able to devote itself to more intensity work in other plants where its services were urgently needed. Tne responsibility for the enforcement of the k.Cjj relating to protective measures in industrial planet should be placed upon the local health depart 773454 -"^ifre-{i RUBBER ACE. AUGUST. js where no competent or responsible health exists, the investigation and enforcement if f T bc made by the Department of Labor. 'n ^ cstciie3ter County there is a sanitary "177*^51jshed by the County ' Health D epartm ent' * overs the regulations relating to food handling, ^ ,-pection. dish washing, management of cafeteria , together with sanitation and water supplies, -lations are enforceable by the County health - - and are in addition to those covered in the 'S^aonnDit?a r y co^de. z f by compulsory reporting of all toxic industrial Shoes and the cooperation of the state and local E-fnoents with the industry can these conditions be 2 i ted . The plant management must be assured ^ tb e aim of such procedures is to aid them and that bn will not be interfered with. i=jor over twenty years reports have been published with the toxic hazards of chlorinated naphtha* Every one agrees that definite systemic effects ^ occur from inhaling or ingesting these toxic sub s e a . There is also general agreement regarding "time-form eruptions that are caused by skin contact atfaem. To our knowledge no one has stressed the Ktaxice of the systemic effects caused by skin npdon. Uiierefore this publication is primarily concerned *5 h tbe systemic effects caused by skin absorption, fca very dimcuit in humans to prove that systemic a occur from skin absorption, because the work.' 1. quite naturally are subject not only to skin *^tion but also to the hazards of ingestion and \ on. Workmen in mills 'f a r removed from a .on hazards and working only with the cold s&ed impregnated wires and cables, have in many asances acquired acne* form eruptions due to these anisated naphthalenes and chlorinated phenyls. . Sac of these workmen, as far as we can ascertain, 'areshown recognizable systemic effects due to their . sorption. This is understandable, as we know that . ** nmction tests only show definite results when an 5?edable liver degeneration has occurred. None of the i r fatal cases showed any evidence of jaundice or systonic effects until a few days to a week be; Sire'bospital admission. They were in contact with :Soe toxic substances for periods ranging from two ^rths up to nine months. They all died within one to I weeks after hospital admission. --^ O L o u r experimental animals showed definite liver ..^aeration or necrosis in varying degrees, whether or they were protected by Protek, when liquid chlori de! naphthalene or diphenyl was administered by *^*?ing it on their shaved skins. Every precaution d ^ l e was taken to safeguard these animals against effects of inhalation and ingestion. .M allei experiments were conducted by inhalation, feeding and by skin absorption. All three series of d*!* showed the same type of liver degeneration. ^ difference in liver lesions found depended' entirely 'dosage and number of inoculations. During these ^^m enrs, none of the animals showed recognizable ic effects until a few days before death. The * killed during-the course of the experiments no recognizable effects. Every animal killed : ***d some degree of liver degeneration. Normal : ^ ro l animals showed no liver lesions. The experiments cited indicate that chlorinated naphthalenes and diphenyls cause systemic effects in animals whenever they absorb these toxic substances, whether by inhalation, ingestion or skin absorption. It would therefore seem probable that it experimental animals react in this wav, man will also. Ileeause of the aforementioned facts, recommenda tions were made to the mill and were to a great extent followed out.. For the past five months, not one single case of skin eruption or systemic disease, attributable to these toxic compounds, has occurred in this mill. Two deaths and between fifty and one hundred cases of acne*form eruptions occurred in this mill within the previous six months, before these changts were insti tuted. Therefore, the practical evidence would seem to indicate that if the above recommendations are carried out workmen will be almost completely pro tected. The cost of ,such changes will be quickly absorbed by the saving in man-hours, lowering of insurance rates and greater efficiency of the workers. The relations of the workers towards the management must of necessity be vastly improved. Summary 1. Studies concerning the toxic effects of chlori nated naphthalenes and diphenyls on experimental animals are reported. 2. These studies were undertaken because of the occurrence of acne-form eruptions and deaths among workmen in two wire and cable mills where these compounds were being used. 3. The compounds experimentally studied were administered to animals by inhalation, ingestion and skin absorption. 4. Liver degeneration in experimental animals is caused by skin absorption of either chlorinated naph thalenes or chlorinated diphenyls. 5. Histological examination of the viscera of these experimental animals showed that important toxic effects are manifested only in the skin and liver. 6. The liver degeneration has been described and illustrated. 7. The degenerative effects in the liver have been shown to be essentially identical regardless of whether the toxic substances were administered by inhalation, ingestion or skin absorption. 8. Methods are recommended to safeguard workers in mills using these toxic compounds. 9. Laws should be passed making it compulsory for all mills using toxic chemicals to adequately safeguard their workmen from such toxic hazards. 10. Inspection of the plants and authority to enforce protective measures should be placed under the Department of Health. REFERENCES (1) Lehmann. K. B,: "K urin Lehrbuch tier Arbeit und Gewerbehygiene," S. H inel, Leipzig, 1919 (p. 231). (2) Flinn, F. B.. and Jarvik. X. E .: Action of Certain Chlorinated Naphthalenes on the Liver, Froe. Soc. .r/*. Biol. and Mtd., 35, 118 (1936). (3) Flinn, F. B.. and Jarvik, X. E .: Liver Lesions Caused bv Chlorinate!I Naphthalenes, Amcr. Jonr, of Hyg., 27, .19 (1938). (4) Bennett. G. A., Drinker. C. K.. anti Warren. M. F : Morphological Changes in the Livers of Rats Resulting from Exposure 10 Certain Gtlorinated Hydrocarbons. /. Induit. Hyg. Sr Tox., 20. 2 (1938). ( Continued on Foilozring Page) ! ; ACE, AUGUST. 1943 G EN P 09842 773455 425 vj; UAroncr, u. rt., Grove, K. Gusraison, R. K., Marie, E. D,, Thompson, M. Wells. H. S.. and Lamson, P. D .: Studies on iJie HatholojicaJ Histology of Expertmental Carbon Tetrachloride Poisoning, SuJl. Johns Hof kins Hotf., 36, 107 (1925). (6) . Cameron, G. R.. and Karunaratne, W. A. E.: Carbon Tetrachloride Cirrhosis in Relation to Liver Regenera tion, J. Path. r Bad., 42, 1 (1936). (7); Whipple. G. H , and Sperrv, J. A.: Chloroform Poison ing: Liver Necrosis and Repair, Bull. Johns Hefkins Hasp.. 20, 278 (1909). (8) Yarglou, C. P., Sands, F. \V., and Drinker, P .: Ventila tion of Wire Impregnating Tanks Using Chlorinated Hydrotarbons, J. indust. Hyg. Tor., 20, 401 (1938). (9) Greenburg. U M ayen AL R , and Smhn.;' Systemic Effects from Exposure to Certain Hydrocarbons.^/ndiuf. Hyg., 18, 11 (1939). ( 10) Drinker, C, K. : Further Observations on the ] Systemic Toxicity of Certain of the Chlorinated arbons with Suggestions for Permissible Cc tions in the Air of Workrooms, J. /dun. Hyg 21, 155 (1939). (U) Cleary, R_ V , Maier, J.. and Hitchings, G. H.- Metabalism of Chlorinated Naphthalenes, /. fiia r 127.403 (1939). : .T^ 12) Riley, E. C : tnd. Boil. 22, 50 (1943). (13) Cranch, A. G. ; Personal communication. (14) Schwarz, L .: Dermatitis from Synthetic .VMU_ Waxes, Amer. Jour. Pub. Health, 26, 586 (1936)^- Reanite Bonding Process A NEW method of bonding' natural or synthetic rub ber to metal, or plastics to metal, recently announced by the U. S. Stoneware Company, Akron, Ohio, manu facturers of Tygon synthetic materials and corrosionresistant equipment, is reported to not only do away with costly brass plating processes, but to develop a bond from three to five times as strong. The new method, known as the Reanite Bonding Process, de velops a bond berween rubber and metal ranging from 900 Ibs./sq. in. to as high as 1200 lbs./sq. in. on a pull test. This compares with bonds ranging from 250 lo 400 lbs./sq. in. obtained by present methods. While the bond develops its maximum strength at room temperatures, its strength over a range of ---40F. to as high as 300eF. is said to be substantially stronger than bonds obtained by conventional processes. A national independent research laboratory, using methods similar to those specified by ASTM , reported as fol lows : " Discs of rubber, half an inch thick, were vul canized between two steel discs, two square inches in area, which had been cleaned and coated with Reanite cement. The direct pull necessary to tear the assembly apart was then determined (a) at room temperature, (b) immediately after immersion in boiling water for five minutes, and (c) after heating for 30 minutes in an oven at 300F. The following figures are typical of tests made during the year, although in a considerable number of cases still higher figures were obtained.*' separation of the bond occurred under pulls well 300 pounds. The process is simple in application. The surface be joined are brushed, sprayed or dipped with Ri After being permitted to dry for an hour the stir are joined and the unit vulcanized by any of the ventional methods. It may also be used to bond-oof to metal, or leather or wood to metal or to each The bond--metal to metal--ranges from 1,000 \ to as high as 3,000 lbs./sq. in. on a combined shearji test. On bonds formed between svnrhetic rubber-ai metal, plastics and metal, or wood and metal, the teriais themselves gave way before the bond. __ The Reanite joint is unaffected by fresh or salmis; is non-corrosive to metals, possesses excellent corrosr resistance in itself, and has high dielectric streagdc While Reanite is formulated through cyclic modSi' tions of materials high on the critical list, it is avaioHr for immediate shipment for essentia! end-uses. Presrf applications include fabrication of airplane assembnec: motor mounts, sound and vibration dampeners, infiament mounts, composite metallic and plastic units, a i tank lining assemblies. T e st or Ro n S ei*a n a t iu x Haruess of fiubber (Shore) Strength of Assembly fin founds) Room Temperature 21T F 50 1885 595 60 1912 592 50 1890 560 MTF 360 367 312 The Reanite Bonding Process is suitable for bonding natural or synthetic rubber, or plastics, to almost all m etals: iron, steel, stainless steel, magnesium, alumi num, aluminum alloys, copper, bronze or brass. The accompanying illustration shows a test sample of aluminum, 5Ya in. long by 1*/: in. wide by 1/16 in. thick bonded to tire tread rubber ]4 in. thick." The rubl/er was cut away from a portion of the aluminum strip, and conventional line-pull tests were applied. Standard specifications call for such an assembly to withstand a direct pull nf 19 pounds. On this test no 7Vjf sample of aluminum, in. long by wide by 1/16 in. thick, bonded lo tire ire^ S /t rubber of x/s in. thickness by the Reanite frocessA^^ In the test (see te.rt), no separation of the occurred under pulls well above 10 pov*&~Ss. 426 773456 RUBBER ACE. AUCUST. \|?-1 009843 G E tfP '