Document pB2Y704aQakYnqaXMpkG2qm0d

f33EfiZL6SIS 423 tTOSOSS 1 brief wrier ef esrreat 'rsoslc:*? end *rrJ ,* - *...... ,, Cf /< T, / rei'-tlonsti? betCi slestosis end tuberculosis. Asbestosis has bees declared e eonpenaehle disease in the ^revises ef Quebec, tecs increasing aedieo-legal Interest is the estahlishsant ef this dio^soiio md eveluetion. ef any contributing factors* Autopsy of osbeitrs ainers h..s disclosed evidence ef active tuberculosis end asbestodis la the sees individuals***2 la Sbetferd Clnas, dim. a substantial part ef ell the asbestos 1b Canada ie policed, the ssrtallty froc tuberculosis has la the pest 16 years approrin'-t*ly doubled la contrast to * significant uccli.<e la tba fcrovineial rate. These developer:ts bare arterially helped tr> create t!ie ispression ia the ftrorlace ef Quebec tint there Is a cased relationship between tuberculosis and as'stasis to the carefully esccastrated an'. j-ncrslly accepted relationship betmer. silicosis end taborculosis* Obeermtlops fa frit Previous studies of workers exposed to asbestos dost have not diselored a higher taeidecoe ef tuberculosis sang sorters with clinical sad X-ray evidence ef -useebeds* Lease? la 1935 eecclnded that asbestos dost did net predispose to tuberculosis* Xa his eoaisatisa af 126 sorters la tec Industry ia tee United States, 53*15 sew found to have definite X-rsy evidence of ehhestosis* Tae cases ef active tuberculosis cere found* Qae ef these sac a worker with asbestosis* Ia 1936* reviewed tecay fils of 151 workers la asbestos sills sad fend evidanee ef asbestosis eseae 34*45 cf tee grwv* Do eases of active tuberculosis were found eoeg wartere site asbestosis* Ob the ether hand, is tee grew? without asbestosis he fend fbw active eases ef tuberculosis* Tse ef these active cases had hoes Is tet asbestos industry six sad ten years respectively* Donnelly conclude.! teat there was ao tandnoy per as is this type ef industrial eolation MET-617 2 te cacerbitc old t'jLe-`Culo;ij- lwsin.s. }.' i.....'ft wv. < iOiiitl* So ___ j *< .siiit iu irat*;-# with asbestosis. The three Irdiridusls with tuberc-Hosis bed beer. crowed to asbestos dist 6, 9, ad 13 7mts respwctirwly. Is fire eases heeled pulnanaiy tuberculosis and asbestosis were found in assoed -.tlon. Sic arenas duration of exposure for the 5 was 20U years cad for the astire ?oip 10.2 'care. CeTaeetars decided there is a* accelerating effect of tuberculosis on asbestosis. In raaation of tils erideioe it ea be said that X-rar wad elisicsl stales ears* asbestos washers in the United Str.ies does not retell a significantly greater eoiEit of tuierculoois tx ex eeted Is the routl craiaatioa of workers in any industry. Moreover, t ere is as evidxaoo fron these studies to Indicate that lonj exposure te asbestos dust ectintco or .ccclcr-tc: the tdMCcaleus process, both these obserr..tious srw in contrast to fi. ulngw aeons workers exposed te free silica. pr-zjfg- 01 serrations Shore hare been no puhlidied reports of studies aeons eslestos workers in Canada with respect to the prevalence of ashestools or of tuberculosis in the as'estos industry. Ja 1990 ftdlsQr. end bis ssseeictss physically and by X-ray 195 asbestos workers in tbs tons of Xsbsstos and Thetford Claes.* the results of this surrey appear in Table 2. USLZ1 f exailnad % with sore then 10 years ilSSESSft ia 22 Thetfard tflncs. 51 13U # with ssbestcsls t vlth asfaesteals lb U 12.7 uu 3 Oae ease ef active tuberculosis mts found s? tie 19* irf'-'iv,'- - -- ---------------- r-a.j <i&s'L:eu*' rtJ^T f-nsc tlat the tuLereJasis aartality is 7ssit>rd tines for the years 192', 1927, esei 1927 cono-xci fr.vrTj.llr wit' the tuberculosis nertolity for the Province of Cuc:e. fJTZZ 1 Arer.-e TtC-jeulaaie E-rthlit- far All A-cs oer IOC.002 Place 1926-28 19ZD-12g gaay laebee Retford 123*6 137.9 73*6 252#1 35 -- 83 * Uorevcr, si ace this r*?"-rt of Pedley there has ucc. e dusp ehczf* la the tuberculosis a-rtality rcl.-.ti-ashi-' bc-treea Ihetftrrd Bncs sod the Previses ms s sbole. Table 2 shoes tiut la the Province of Cashes the averts* rate far the three years 1710-12 has decreased 35# ceunsred to the average rate for the years 1726-2S. This com*noads to e^erlcoee eleeahert la Csadda sad the Baited States. Oa the other bead, la Retford -lass for the carTeopandifig period tuberculosis wrtslity bee iaexeaesd aore thia 80 The obvious ssdstsaee of e sort-as tubsrcdeals probles la Retford fiaes bus led t* speculation rocardiag the iafluoee of ahbestos dost. Tobareulosla Mortality Ttaaftr If the industrial soperse* to asbestos dust Is a significant factor la exacer bating or accelerating tuberculosis see *-uld axnact to find a rigaiflcant diffsrsaee ia aales over 25 years of see since, is Retford Vises, practically all ef thia part of tie populatira act In aUltar? sarvlee eerie la the asbestos Industry. Joel*- ec^aaalc f&ctore ere !*> ic^t tz rsirttar. to -fta^rwlo*4,?, irt. /*^5 WL * oas pn ii cut test store satia- eeaaaeic factor* war* daniaaut the tuberculosis oortslity rates fer both husbands ad rive* were siEiiarlr affected; where iadurtrial factors played a lcadir- role the standardized nort_llty rates for the husbeadz gre. tly wires.7 that of the Throat the coTartosy of the Dco-jraober of the Proeiacial Onistry of Health sad Social Tclfsre, Sr, ?=ul farrot, -se sere furnished the number of deaths froa taberc-losis by a~e k: sex for the Tears 1939 to 1943 far the cities of Tbetfori Ulnar, risaus'd, CMccutiai, Cep de raiiclclre, St. I-yualathe, St* Jr.,cnd 7_Heyfidd, as well ee for the ftroriaee one the J.-wiaian as a whole. Of too six ers-TZtities picked with, these &b;jtctcrirti&r la rind, the teen of Ihsousid was thought sare nearly to eospere tdth Qietfozd Hines, except insteed of asbestoe oiaii.; itn principal industry is lmleriu.; ad wood finishing (see Table 3, p. 4a). TABLE 4 Sian the Average Eortality Sate by Sex far ill Ages In Prowlnee sad la the Cerae relected Casualties 1940-1942 ramxt or c uzszc Cep de la Psrielslae St. Hytdathe St. Jobs ValleyfSeld aiconttel Ihetfszd Blues Hiaouakl Tuberculosis Death rate per 100,000 All Ages _______*.>- T--1^. 77.5 55.9 84.5 75JL 101.7 141.3 190.1 171.9 80.8 44.5 90*9 109.* *5.3 149*1 223.9 2870 t. 4* - ?orrulati9Q Tbatferd !2acai 12,000 Hlnaasa 10,090 Ce? Malaise 13,000 Three lirer* 45,800 Qzlesutisi 25,000 St, Hjecinthe 18,500 Velleyfield 20,609 Industrie# Asbestos alslag e4ltb Health PutuS, / Prirtte Ratio E-irgs Officers* ttiit Curses Pbrsieizas P-l**57 1 15 12 2/1000 Imberiag, wed 1 ft-iahiad 14 10 1/1000 Rubber afg., 1 Steel fb3dr7, be-, cf{. silk 1** 6 2 1/6500 Paper, lines 1 fg,, rubber. Ires 19 40 2/1150 HaeSms, pulp, 1 peer, Iras ftji,, cle? products 14M 10 19 1/4500 (iscl. 7 epeea.) Textile sfg, 1 Iftnltiom, other 1 mt Isdustries, cotton, silk ltw 6 15 U 1/1300 10 1/2000 full^tiae fceallh -affieere V Including 1 daHit <_- indudlng 1 tb, ipeelallst jMMiadql|e 2 full-tiae phyldaai cnr.Tssr;;i caastisvsss a tjltto.I' Visual iarpectisn ef tie Bills of the three c.-bests* open,tars sere *- , Dust **# v* a,',* *,***"' 'nv.'ir* '- ; i- - . .. - report*: to us 1-7 esrpctcit observers. Sever.1 c**ufi.t*3cs premi. in the cilia tf-.itf: rruld fever the spread of pulsoaary fr-borculosis. it ^rhnfcu e-p.rur to be cnrelesr about spitting and otter personal halii c aedar to keep ware la cold vcntLer they huddle It groups In wooden cabia-llke eadlosurcs* Those seesaw about 6* r 6*# They usually coatiiii a beach or two *r"> a cb.\lr> with asce faceting facilities} a snail tin can oa the nM'1 m> la used for drsrette butts, spittle-, or lefV-orcr flood. Za one u tin drinking cup has ban. it wTo for aaar years* It la obvious th_t, if there is an espl-yae with tubercle bacilli in Ids sputum, tLcre ecrlrosssotcl conditions itrrrr the spread of tuberculosis* It slau be noted t ut la revise ef tha decth in tha does Insured with the C-xzrxrj a difference in tuberculosis cartclity was fouad. la rina A between 1941-1911, eicht deaths ware due to tuberculosis with a rats ef 2*2 per 1,000 asploTe^Tears* la Iline 3 for the correspoudinc period there were tee tuLerculosis deaths with a rata of 1.1* It was ir Clac A that the cost coasoicuous vnsaoitaxy practice, the caeca drinking 00, was fated* Base Hiring conditions are seeded and it is eonca practice for efalldrao and addt to share beds, this is m iapertaat factor favoring the transmission of tha disease- c only hecause it promotes closer human oeatect butt, by Interfering with adequate rvrt, the individual's resistance to infection is lowered* Beer eating habits and food selection which prevail alee contribute to the lowering ef resistance to taberenlosis t These observations on aavlroanaatal factors art adnittedly onperfleial beeaaae of the brief tine available for inspection end observation. Iivortheleas, beeaaae of tfaaii probable importance in creating and tuberculosis in tha eemmity, further investigation ef tha would seen te be warmsited* 5 Trtc. Tail* 4 it will be notsd tf'-t three of *c -.coen torca f:r ft -* I -- - . . V* - * W - - * ' f - t --3**-' ?3ndi\ BiriV. than ncles Tnccferd -Jrr: sir : *'irtl in tl-1 s. iier nd;Tis i.;.' <._c esc sen Lac uec; cttcroted for tic cor.si.tics cf '.iisrns'-'i t';1 X: etiorc. Jlines ai tie results &rpc--r in Tn'-ic 5. Intcrprc-tnvioa ic JLT'lc It iueenus* of the- sdl r-jaier of oersa_a involved in tit ct gw-re in tic tto casnusdiler. It la of i.--icr.rt t* sale, iocevcr* tint arr< TietforJ c-les t' c nartilitr *te is rccarded in ados ajed 15-24. In Einansil sales ttc hi-^ast ret* i'r in the erour 35 and elder* Ifcctferd fcilis a^ad 25-34 htva f.a highest rate In either sale or facsle rrovr*, beia*. 519.2 per 130*000* es i?ur tiaea tie ftrovincid rate for tie aero e-os. tie rate In tie carrasoondinc & x .to? in "irrvaii fenalcs la 446.4 aiid: ia senrlr three ttnr.r die Prcrizclel rat* in tic cnee T"r-' Xubercjiocis Jr tdcas a ;ii.h tall in HineujCd resides 25 aid older. ~c--. J.- mV; is fair tiaaa tY.: of Provi'.dd ''cedes of tLi sane ^ea# .V arc Iosif Dc- v.s g.d Death "ates o=r 133.003 1940-1542 112 411 A\-as 3-24 25-34 35- Prer. of fuebee Deaths Let* 3838 1107 *03 1913 97.5 45.2 102.1 116.2 Tdzr^rl Seethe int* 17 171.9 5 93.3 2 114-4 10 300.9 Ihctforf.. 'lines loitha late 36 190.1 13 UL.3 10 342.9 13 245.0 4CZ 411 ices 0-24 25-34 35- Pnt. of Deaths Bate 4019 16U 1072 1333 30.8 62.7 134.1 83a Harold Jietford Tinea Seethe Sets Deaths Bate 32 287.3 43 223.9 13 211.9 18 162.5 9 446-4 16 519.8 30 334.7 9 178a 6 grcnrrMi? It is obvious that tuberculosis sartslity is excessive ia the tor_ of Jhetfsrd fines. But t'cre is no indication fror these dat. thvt occuration is a dosiasnt factor becsusoi 1) the nortality is equally bad an m-; fancies; 2) it is excessive ir. the e-c -u- ttsder 24 vhere there is little sr n* industrial exposurej 3) tu`.v c~T-.it ir _ls? c serious rroblcr ir. RiB~ushi ifccrc there is no asbestos industry. 7z~ .*0 rad oox distribution of" nort-litr fee. tuberculosis resettles the pic-.s. 'c s.* t--/culoris ia a hc_vi y seeded, susceptible ?*p-latioa with a eub.-testi.pz-- ert-> of the aortal it: occurring in Vat.'-, sexes under art 24 and the rs.-arily of dcuhbs under _;e 35* Tiitr* is n? evido.ee, if trbestos du*t is a factor, th_t it r. sculler free eilic- is. it? isflua:ee 'ft tuberculosis sociality. Cartful sad therrug'.: uort-Lity studies^3 eaoaj gra. ite cutters ir. the State of Versont rcreuiad th-t ;c;. -rc subject t- ea excessive frequency of ue-tf:e fror pulranary talerculoeis, r.-t lcause of ea exceptional rlsb of contact infect! r.:, or because of inferior ph; *1 - uc, or beexuse of unfavorable housing conditions or ether sanitary deficiencies, but urirurbly bicause of the occnpati~nal exposure. Tr.is sese conclusion bes been rt-ic'-xl iaercry other study of voriors eho contract silicosis. J:.fortiiT.ttljr vs verv unable tr er-lculate expected deuths based oa the Prev'octal * rrtcr -,cc .use the age groupings obtained ttr Ihetfora dines and Idaoushl did net csrrcsooad tr the age goualajs cvailable in the cv.sus data for the Province. "or further ineight into fee nu.-nitudo of fee tuberculosis p -oblen in these tee conxu itier, it voubl be dcsirublc not o.--y t' errstroet such expectancy tables, but to carry out case-finding studies in these end sinllor eocnnitiee in the Province of 'uebuc* egnetogns 1. rased os currmt nortality data, tuberculosis ir Thetford hLoes, ia eer.trest to best cospnltlss la the fcnviaee as sell aj the Previaea u a *ole# ha* ' substantially increased* 2* Rlsouald., a lueberisg tovn, cosparahla. to Thotfard Sines la soelo-eessasle conditions, nailed sad public health resources, has a hUh tuberculosis eortcliiy eosparable to Sietford Hines* 3* Analysis of the tuberculosis eartality by aad sox la ThCtford Xines, in the ether easacaltlce sad is the Province aoss that both sales sad fancies in Tbetford suecact to the disease with approadantaly the --frequency* This Is not the nortditr picture seen chare there is Industrial exposure to free silica* A* Adalttedly o*sr data is inade^U-te Tor final conclusions, nevertheless there la no indication froa this aartality study ttat deconstrata* asbestos per se . in Tbetford lanes is the e^use of the high tuberculosis eortality. 5* farther aortelity studies dtould -be rede to eonstruet expectancy tables for age sad sex la Tbetford Claes, Riaouskl, aad perhaps elseebere la the Jtrorriace* 6* Tuberculosis ess^fladlag surveys tfiould be aade both la Tbetford Claes end eocpereble eeennnitiee* 7* Health education concents* premtian of the disease is seeded, as veil as lapcoved sanitation, particularly la the plants* George H* Vheatlsy, S*S* Assistant Tiee-freaideat, telfsre Bstropolitaa Life lasuranee Caapsay Br* X* 1* Teas, lkaager of Occupation Bating*, has contributed to this study by valuable suggestions regarding the haadling aad iaterpretatiea of the date as vail as by asking fee statistical analysis* Sr* A* J* least Associate Bedleel Streeter, has very gneroualy permitted us to use his unpubll Aad date secured by Pedlcy la 1930 ea asbestosis ad tuberculosis la miners ef tbetford ad Asbestos* Sr* Lena has also advised aa the preperatioa of tha final report* Sr* 9* L* Burnette, Assistant Tie^Preoidat, Canadian Head Offiee, seeded for a the infcreation a the soclo ecnconic oonditicna of the selected eemnitles*