Document pBedG1o1yY67VmppdoL4pedqk

SURVEYING THE PLANT D. J. LAUER, M.D. CINCINNATI THE CASE presented by Dr, Hasterlik represents a serious challenge in diagnosis.. The etiological agent must be determined before intelligent treat ment can be given and before preventive technics can be instituted to protect others. Three features stand out in this case which beg for an investigation of its occupa tional origin. 1. The implication that there is a relationship between this illness and a specific industrial operation. (There is some evidence that the same or a similar illness had occurred previously on an apparently similar job in a different plant.) 2. The occurrence of a very similar disease syndrome in two fellow workers who were engaged in the same operations. 3. The time relationship of the syndrome. If one accepts any or all of these premises, then the etiological agent must be sought within the work environment. This study is approached by surveying the plant. The extensiveness of such an investigation will be dependent on the fruit fulness of the search, and vice versa. A plant survey is divided into four steps*1: (1) the interview, (2) the inspec tion of the plant, (3) the industrial hygiene survey and (4) the medical survey. These fall more or less into logical sequence, each succeeding step enhancing its antecedent.2 THE INTERVIEW Arrangements are made for an interview with the plant manager, or someone with authority in the plant -- more particularly,, one who is intimately familiar with the operations in question. A frank presentation of the problem is made to him. The occupational history of the patient is supplemented by a more detailed description of the type of work performed, the products manufactured, the materials handled, the manner in which these materials are processed, the by-products and the modes of use. It is important to know the number of other workers engaged Dr. Lauer is assistant-professor of industrial medicine at the University of Cincinnati and medical director of the Hilton-Davis Chemical Company, Cincinnati. Read before the Section on Preventive and Industrial Medicine and Public Health at the Ninety-Ninth Annual Session, of the American Medical Association, San Francisco, June 29, 1950. -- / 1. Patty, F. A.: Industrial Hygiene and Toxicology, New York, Interscience Publishers, Inc., 1949, vol. 2. 2. Johnstone, R. T.: Occupational Diseases : Diagnosis, Medicolegal Aspects and Treat ment, Philadelphia, W. B. Saunders Company, 1948. 150