Document omxBREd4x2Orwaob65MpDeVMX

aiiaaftVi'.itiiSi'i^M CteFl I Historical Notes ` ITT1 inililliirtTi i^ntii^^aiaay l i > i I The Konicide Club (1932-1940) I ' A Brief History j Theodore F. Hatch, Sc.D. and Eugene P. Pendergrass, M.D. I ( i j In January, 1932, a small group of physicians, scientists and ! engineers met informally at the Pittsburgh Laboratories, U.S. ; Bureau of Mines to exchange experiences and views concerning the problem of silicosis in U.S. mines and factories. No list of the participants is now available but the number probably did not ex : ceed 20, representing essentially all the research institutions and j field investigative groups in the country at that time. Particular in| terest centered around standardization of atmospheric dust samj pling and assessment of dust exposures and the parallel medical procedures for evaluating the respiratory injury found in exposed J individuals. There was great need for such standardization to inj sure comparability of results, derived in the same manner by all in1 vestigators. One recommendation coming from the meeting was I to develop a sturdy, all-glass impinger designed to be easily duplicatable, and to settle on a standard method of dust counting. | The modified Greenberg-Smith impinger resulted and is still in use, ' 35 are the counting techniques delineated at that time. Beyond i these specifics there were wide-ranging discussions of the many | other aspects of the silicosis problem. Great enthusiasm over this two-day conference and the desire to continue such meetings ! were expressed by all the participants with the further wish to j keep the meetings small and informal to insure lively debate and j exchange of views. At the end of the meeting, Drinker proposed a ; scheme for the calling and conduct of the meetings. He suggested the name "Konicide Club" and on February 12, 1932, he sent the : following letter to all participants, plus a few additional in , cividuals. Because of its typical Drinker style, the letter is given in j full, followed by the names on the first mailing list together with their respective institutional affiliations. Konicide Club February 12. 1932 At a recent meeting at the Bureau of Mines, Pittsburgh a number of us , decided to start an informal, small, and very select (f) club with the above V_ _____________ . From the Graduate School of Public Health, University of Pittsburgh (Dr Hatch. ' Professor Emeritus) and the School of Medicine. University ol Pennsylvania. ! Philadelphia iDr Pendergrass, Professor Emeritus). name and with the purpose of having occasional meetings to discuss research problems on the relation of dust to health. The club will have no dues, will meet anywhere or any time any member desires and can per suade at least one other member not in his own organization to meet with him. The meeting will select its own chairman as the club has no president and does not propose electing one. If the members present see fit. they will send a notice or minute of their meeting to the secretary, who will pass it along to the other members. Any member publishing an article on anv phase of the dust question will either send through the secretary a reprint to each member or mail the reference to his paper. The membership will be kept small and is to be elected from time to time by a committee of Messrs. Yant and Leake and the secretary. Until February 1, 1933, Drinker will serve as secretary, which means at tempting to do the dirty work a secretary should do. such as arranging meetings and attending to correspondence. On February 1. 1933 Drinker will appoint his successor. ` Your suggestions as to other members would be appreciated, but bear in mind that we do not want members not now engaged in investigative work on dust. We want the membership kept small and above everything to be informal and no precedents to be established. Attached is a list of proposed members. Please be good enough to send the secretary word as to whether or not you wish to become a member. Philip Drinker, Secretary 55 Van Dyke Street Boston, Mass. Konicide Club Members (First Mailing List -- about March 19321 Bureau of Mines. Dept, of Interior, Washington, DC.: Mr. Daniel O Harrington; Mr. F. B. Meriwether; and 4800 Forbes Street. Pittsburgh. Pa.; Mr. W. P. Yant; Dr. C. E. Brown. Chicago, III., 330 South Wells St.: Dr. C. O. Sappington. Employers Mutual insurance Co, 800 Empire Building, Milwaukee, Wis.; Mr. E C. Meiter. Harvard School of Public Health, 55 Shattuck St., Boston, Mass.: Mr. Philip Drinker; Mr. Theodore March: and Dr. VV. I. Clark, The Norton Co., Wor cester. Mass. \fe(ropo//tan Life Insurance Co., 1 Madison Avenue, New York. N.Y.: Dr. A j. Lanza; Dr. W. J. McConnell; Mr. ]. W. Fehnel. Norths estern University, Medical School. Chicago, III Dr- James A. Brit ton. Owens-Illinois Class Co.. Toledo, Ohio: Mr. W. G. Hazard. Public Health Service. Treasury Department. Washington, D C.: Dr. R. R. Journal of Occupational Medicme.A'ol. 19, No. 5/May 1977 ' 351 WjjYiTifflffiffir Sayers; Dr. Albert E. Russell; Dr. R. R. Jones; Mr. |. J. Bloomfield; Dr. J. M. Dallavalle. Saranac laboratory. Box 551, Saranac Lake. N.Y.: Dr. L. U. Gardner; Mr. Donald Cummings; Dr. Homer L. Sampson; Mr. Andrew Redlin; Mr. Thomas Durkan. Toronto, Ontario, Parliament Buildings: Dr. George Blair Brink; Dr. John Grant Cunningham; Dr. A. R. Riddell. University of Pennsylvania, University Hospital. Philadelphia. Pa.: Dr. H. K. Pancoast; Dr. E. P. Pendergrass. Slate Department of Health, Hartford, Conn.: Dr. A. 5. Gray; Mr. Warren A. Cook. Westinghouse Electric & Manufacturing Co., Medical Dept.. East Pitts burgh, Pa.: Dr. T, Lyle Hazlett; Mr. Edgar C. Barnes. Six additional names were on the membership list in the last days of the the Club: Manfred Bowditch, W. C. Dressen, Leonard Greenburg, Oscar Sa"der, H. H. Schreuk and Charles R. Williams. The first meeting of the new club was held at the Saranac Laboratory on April 2, 3,1932, attended by Messrs. Gardner, Clark, Pancoast, Pendergrass, Clifford (guest), McConnell, Leake. Brown, Meiter, Fehnel, Hatch, Bloomfield and Cummings plus other mem bers of the Saranac Staff. The first day was devoted to the pathology of silicosis and the second to dust sampling and count ing. Some of the highlights of the meeting were summarized as follows and give an idea of the state of knowledge of silicosis in 1932: the hazard from a silicious dust is in proportion to its tree- silica (S1O2) content, provided that no inhibitory substance is present; other compounds of silicon have not produced fibrosis in experimental animals (except magnesium silicate which produces a different kind of fibrosis); intravenous injection of S1O2 produces fibrosis in the suprahepatic lymph node followed by fibrotic nodules in the liver; no similar fibrosis is produced by aluminum oxide. Respecting dust counting, there was lively discussion of dark-field vs. light-field microscopy, especially with reference to ease of particle counting in the <1 ju range. To change from light-field, however, would entail a considerable series of com parative counts. There was no agreement on such a change. A second meeting was held in conjunction with the National Safety Congress in Washington on October 3-5, 1932. Messrs. Gardner, Russell, Bloomfield, Hatch and Drinker presented a series of "dusty addresses" (Drinker's wording) to the congress. This was, perhaps, the first large gathering from U.S. industry before which representatives of the small group of pneumoconiosis specialists presented the dimensions of the silicosis problem and the needs for its control. Messrs. Thompson, Leake, Russell, Bloomfield, Yant, Brown, Gray, Cook, Cunningham, Gardner, Hatch and Drinker were present at the club meeting on October 4th. The relative merits of dark and light-field illumination in dust counting were further discussed with a final conclusion to continue with the lat ter. All agreed, however, that an easier method would be welcome. An important contribution was made by Or. Clark, who outlined recommended procedures for a continuing medical con trol program in the dusty industries. The application of these procedures, so well understood and commonplace now, was only beginning in the early 30's. - -- For the 1933 meeting (November 11th and 12th), Drs. Pancoast and Pendergrass were the hosts at the X-ray Department, Hospital of the University of Pennsylvania, Philadelphia, Pa. With their colleagues they prepared for this meeting a very comprehensive series of subjects for discussion. The first day was devoted to clinical examination in silicosis and the importance of associated diseases, especially tuberculosis, pneumonia and other respiratory diseases. During the second day, discussion was directed mainly to radiological techniques and differential diagnosis between silicosis and silico-tuberculosis and lesions simulating silicosis. At 352 the end of the second day, Dr. Gardner spoke briefly on "What is Known About Asbestosis", an early contribution to a subject that looms so large today in the occupational health field. It is not too much to say that this was the most detailed seminar on the medi cal and radiological aspect of the pneumoconiosis problem presented in the United States up to that time (1933). ' The next meeting was held in Washington, January 13-14, 1935, under the auspices of Dr. Sayers and associates. Office of Industrial Hygiene, U.S.P.H.S. Among the topics discussed were: recognition of the roentgenologic changes, etc., described at the earlier Philadelphia meeting, as significant diagnostic events in the development of silicosis and the essential procedures to be recommended in both medical and environmental control of dust hazards. Dr. Sayers and associates reported on the findings of the recent PHS study of the health hazards in anthracite coal mining and Sayers and Miller described their findings from intraperitoneal injection of dusts in experimental animals. In the course of this meeting, as in earlier ones, there was much discussion of the need to establish limits of permissible dustiness to serve as guideposts for effective dust control efforts. Out of these came Cummings' suggestion of the formula used for many years subsequently to calculate acceptable levels of dustiness in proportion to the free silica content of the airborne dust, starting with 5 x 10'- mppcf for pure quartz. This formula, with some modification, is still widely used in other countries as well as the U.S. We recall also his view, shared by Dr. Lanza, that no "safe" level of dust exposure could be set for individuals with any degree of tuberculous infection. This dictum was laid down, of course, to emphasize the absolute necessity for tuberculosis prevention along with control of the in dustrial dust hazard. This gathering was of particular significance as a preparatory session for two meetings shortly to be held: one at the Mellon In stitute, out of which came the "Air Hygiene Foundation" (now In dustrial Health Foundation) and the other, the 1936 Silicosis Con ference, sponsored by Miss Perkins, the Secretary of Labor. Konicide dub members played leading parts in the planning and conduct of both of those meetings. In January, 1936, a club meeting took place at Harvard, organized by Drinker and Hatch. The importance of particle size in the etiology of pulmonary dust disease was emphasized. Brown discussed respiratory dust deposition and retention; Hatch report ed on the striking variations in the composition of mineral dust as particle size is reduced, with particular reference to the decreasing SiOz content with particle size for dusts from granite, sandstone and oiher silicious minerals. Professor Larsen of Harvard's Geology Department demonstrated petrographic techniques for dust analysis and discussed size limitation in such analysis. Dr. C. KDrinker described the lymphatic system and discussed its im portance in the development of silicosis and P. Drinker reported on nasal dust filtration. Later in 1936 (November 23rd and 24th), Drs. Lanza and McConnell and Bill Fehnel offered a program at the headquarters of Metropolitan Life Insurance Company, New York City. The first day was devoted to medical questions and progress in animal studies. Speakers included Drs. Gardner, Sampson, Lanza, Pen dergrass. During the second day Dr. Greenhurg described a New York state program of industrial hygiene and Fehnel discussed a dust control program in an asbestos plant. Decrease in S1O2 con tent with particle size found in industrial dusts, notably in foun dries, was also a topic of continued interest. On |uly 12th and 13th, 1937, the club enjoyed the hosjaitality of the Montreal Mining Co., Montreal, Wis., with whom the Saranac The Konicide Club/Halch and Pendergrass -sat is t lediolem 1935, strial ition arlier the a be dust r the ming rneal this need sosts lings' ly to tree :f for idely new. id be This olute re in- stoiy n In,v InConabor. ; and vard. ze in own oortist as asing tone alogy dust C. K. , imarted and .rters ' first limal PenNew (Laboratory had close association. The program, arranged by Dr. Ringo, Medical Director, was focused on the health problems of I the ferrous mining industry, with detailed discussion of the problems encountered in the Montreal and neighboring mines. Speakers included Drs. Gardner and Sampson who emphasized the j significant differences in the pathological and roentgenological f changes seen in the iron miners, compared, for example, with granite cutters. The medical facilities and dust monitoring equip ment employed at the Montreal mine were inspected and club members enjoyed an underground inspection trip. The meeting (concluded with a general review and summary of the medical and engineering problems encountered in the industry. | On )anuary 22, 1939 another meeting was held at the University [ of Pennsylvania under arrangements made by Dr. Pendergrass. The ! program was devoted to the health problems of the asbestos in I dustry. Titles of separate lectures were: General Survey of the Asbestos Industry and Its Engineering Problems: Experimental | Pathology Concerning Asbestosis; Clinical and Roentgenological j Survey of the Asbestos Industry; Pathology in Patients Dying with . Asbestosis; Roentgen Studies in Industries Having Asbestosis. Speakers included Drinker, Gardner, Sayers. Dreesen and Drs. j James Bullett and Rush Shull, euest speakers. I Over the years there had been frequent inquiries by non ' members about the club activities and increasing pressure to in ; elude in its deliberations individuals not engaged in pneumo- I coniosis research, especially by lawyers concerned with com pensation claims. These widening interests and more particularly, the organization of the American Industrial Hygiene Association in 1939 suggested to the members that the "exclusive" Konicide Club had served its purpose and its activities should be concluded. There were no more meetings. It is difficult at this late date to recapture the excitement and stimulation that one found in the club meetings. In the course of the successive conferences, new findings and new research and investigative procedures were quite regularly brought to our at tention. In many instances these required abandoning old ideas and adopting new ones, but these changes did not come easily for the proponents had to defend their proposals against much (con structive) criticism by their colleagues. One of the fortunate con tributions was to bring together from the start the scientists and practitioners from both sides of the problem, respecting both man and environment -- biological science and medicine together with physical science and engineering. The collective responsi bility of such teams of specialists for the development and appli cation of preventive measures for the control of silicosis and other disabling occupational dust diseases was constantly emphaszied. Not the least accomplishment was learning to talk to each other and each to recognize the essential need for the skills of the others in the joint solving of important health problems. The expansion of this concept in dealing with other job-related diseases has given special strength and effectiveness to the whole occupational health effort in the United States. I j i t ! Regulated Progress Scholarly review is such an effective barrier to novelty that a new idea can seldom be announced to the world until it has first been sold to the establishment. Most innovators are ill-suited to promotional work, and begrudge the time and effort. Many ideas die at this stage. The innovator must buttonhole important people to enlist their support, or perhaps apply for a grant to study his innovation. If successful, this gets the idea on to the grapevine which is its announcement to and acceptance by the world. Publication is a formality, like a letter confirming a telephone call. By thus standing astride the channel of communication, the establishment maintains its rule and regulates progress for its own convenience. -- from 'Evolved Conspiracy" by Charles McCutchen in The Sciences. July/August 1976 ioun- ity of anac grass Journal of Occupational Medicine/Vol. 19. No. 5/May 1977 353