Document oemo7nbLzwQ1XGjyzoD3KBy0R

444 LOUIS SCHWARTZ Ibrelile observed that infested hides can transmit anthrax to man and adypc their sterilization with boiling water. Other French dermatologists and thebefun tioDal dermatoses described by them during this period were: Potton, d'eiiMb among silk winders; Lespian, dermatitis caused by coal tar; Recourt and Che||l| dermatitis caused by potassium bichromate. Bazin in 1862 published a claslf' tion of the causes of occupational dermatitis. In Germany the outstanding contributors to the literature on occupalffi dermatoses during the nineteenth century were Casanave, Schedel, Von |ra Hebra, Eulenberg, and Hirt. European legislators about this time inaugurated compensation laws fira. industrial accidents, then for certain industrial diseases including dermal After 1900 the interest in Europe concerning occupational dermatoses 'ilfcf* and there were noted contributions to the literature by such eminent derai gists as Blaschko, Jadassohn, Bloch, Mayer, Oppenheim, McLeod, Sequif cival, and Prosser-White. ' `l, In the United States there was but little interest in occupational derffia before World War I. There were only a few scattered contributions bygl American dermatologists, Hazen and Lane especially. During and after World War I there was a great increase in industriaflaw in the United States, resulting in more occupational dermatoses and tlf| became of greater interest to dermatologists. Contributions to the literaitul made by such men as Gardner, Fordyce, Lane, Foerster, Downing, WHii berger, and others. _ _____ ___________ TnT928 the" United States Public Health Service organized a sectiSn* study of occupational dermatoses. Since then interest in the subject haslmcL greatly in the United States; the literature now abounds with new bbsellp and our compensation laws are including occupational dermatoses''amcraf compensable diseases. At the present time all states have laws under wfuJfS pensation for certain occupational dermatoses may be obtained. II. Incidence The records of state boards of health and state compensation boarTs,si imoMs been showing a yearly increase in the number of cases of occupational' dernmTWj* This iS`lafgelV"the'result''b`f"educafibhal'work among physicians"and"eiifor?e{n3 of reportingJlaws.i'For- instance, in 1933, the Connecticut compiensffion boardiwS ported 386 cases of occupational dermatoses and none were reported by pin whereas in the month of December, 1943, alone there were reported nehrIy$Kffi casesi-and during^all of 1'943-neaTly 2QQR:nase3iiIfd;hp^0Q0aKsg8Si?wf;Jfas<niiw 300 reported by the compensation board, showing that the number' of ca'ic-ylpf occupational dermatitis sufficiently severe to cause absence from work bf'-onc-wwi or more is not increasing, but that physicians are reporting the ..casesist^^S treating. California in 1933 reported 1150 cases of occupational denMtj||| OCCUPATIONAL DERMATOSES 445 ||l||asiin 1943 there were close to 5000 cases reported. The reasons are the same imvendor Connecticut. ||hservative estimates of an annual incidence of 30,000 cases of occupational faStb'oses in the United States are now known to fall far short of the actual num^Muk,examinations in factories show that, any time a survey is made, more ^^^gr.cent (sometimes 10 to 15 per cent) of all the workers have occupational alMS8e8...0f 60 million workers this would give a conservative estimate of at GSfPjnirual loss in time from work plus cost of medical care, compensation, fJBjsfgfgourt awards for occupational dermatoses approximates 100 million lKlllfmlnn*ually. S-nif:uCau8e8 of Occupational Dermatoses and Their Classification j roost frequent cause of occupational dermatoses in the United States is Pnoleum^oils and grease. This is not because these are more powerful skin irri-. rother chemicals, but because more workers are exposed to their action Bay other class of irritant chemicals. Practically all machine tools use 5 and lubricants. Next in etiologic frequency are the volatile solvents, t5h|j|l plants, and materials encountered in metal plating. With our entrance ^KorldiWar II, dermatitis from explosives ranked in frequency with those in Mboyi list. This, of course, ceased with the war. ourse of our studies in the various industries we have found the highest uilmn 1pT o'ccupational dennatoies^among workers engaged in the manufacture TMy^Lj||be resins containing formaldehyde, such as the.phenol-formaldehyde ^^Sd^among workers engaged in the manufacture of chemicals and dyes. pIB*A. PREDISPOSING CAUSES ||||||||ornified cells of the epidermis, the pigment, and the secretions of the ^^^Mfficonstitute the defense of the skin against the action of external irri-. hfiwne'lcornified cells are attacked by strong alkalies,Ibut will withstand the l^^OTairly strong acids and some solvents. ^jfefp,frction8 of the skin, consisting principally of water, liquid wakes, and 'ohtli`erhivjacfaas diluents,:.tp water-soluble, skin irritants aSjWell.as forming, a l^^^SqoSfig Sgainit them. The pigment ofThe iltih, mefanih, aids to protect of light. The perspiration, however, sometimes aids the action by macerating the skin, and by dissolving solid- irrijants and thus actually to come in contact with the skin. ' '' ^^^^en-mgs^rn^tbBtslf-i:nf:thfi-d.Uftt.a-O.f_glftrLda-anfLthe-hair-;f011iRlesr are the ^^lb'rtions because through them irritant chemicals that do not affect the MvwVff -;may penetrate the skin. Thinning of the cornified layer and breaks Isuib as are caused by wounds and lesions of skin diseases also'Offpr ntry for external irritants.