Document r7poRn9gKeMzZ8XO7b0GLyye

FILE NAME: Sprayed Asbestos (SPRA) DATE: 1932 DOC#: SPRA001 DOCUMENT DESCRIPTION: Medical Journal Article - Asbestos in London Tube Railways 374 Tax UW3T,] pabuambht. nd oum to the notice of the police:--The totel number of each accident* recorded in Greet Britein wee 181,486. of which 8402 resulted in total injuries to one or more persona The corresponding figures in 1830 were 150,703 end 7074 respectively. The number of persons killed in 1031 was 8885 end 202,147 injured, a* against 7308 and 177.805 respectively in 1030. There was thus in 1031 a considerable increase in the total number of accidents resulting in per sonal injury which were recorded by the police, but a decrease in the number of fatal accidents as compared with 1030. The figures for England and Wales show efwiflar changes, the total number of accidents resulting in personal injury being 105,521 (an increase of 23,127), and fatal accidents 5851 (a decrease of 486). The total, number of persona killed or injured in England or Walm was in 1831 100,831 (an increase of 22,320), and the "% killed 6026 (a decrease of 400). These changes in the number of persons killed and injured respectively suggest th a t the increase in the total number of accidents resultini' in personal injury may be more apparent than real, anc attributable to the police obtaining fuller information regard ing the accidents which occur by reason of the institution of the motor patrols and the new requirements of the road traffic Act as to the reporting of accidents. The figures from many police districts support this view, but it is to be noted on the other hand that those for the metropolitan police district show a decrease in the total number of persons injured, as well as a decrease in the number killed, the totals for 1831 being 1324 killed and 54,422 injured (not fatally), as against 13U8 and 55.827 respectively in 1030. On the other band, in some police districts, including, for instance, parts of K ent and the West Hiding of Yorkshire policed by the county police, there 'as an increase in 1031 in the number of persons killed as well as in the number of persons injured. Amongst the cities and borouglia in England and Wales, Birmingliatn had the highest total of killed or injured during 1031--namely. 5088, an increase of nearly 800 over the previous year. This figure, however, is exceeded by Glasgow, where the number of persons killed or injured was 5004. which is, however, nearly 300 less than in 1930. The Liverpool figures show an increase in persons killed or injured from 4447 to 4048, and those for Manchester an increase from 3571 to 38)8. Wales, aa a whole, bad a total of 232 killed and *422 injured, as compared with 270 killed and 5810 injured during 1030. In Scotland the correspond ing totals show a decivaae of 124 killed and an increase of 1427 injured, the totals for 1931 being 059 and 17,342 respectively. Rates of Relief. prepared to coordinate the muses1 pension federated voluntary hospitals and iipm unidual i * l**P*-il Sir K Hilton Yoono replied i I would friend to the provision* of the Local Government J iT ' W Officers' Superannuation Act, 1922, and ositiiM ^1' Section 8 and 16 of th a t Act. I am. aa n r r ^ M Mr S have been, willing to consider any practicable tho lines mentioned in the second part of the a % no such scheme has aa yet been submitted. MONDAY, FEB. 8m. London Tube Workers and Asbettosis. Dr. O'Doxovan asked the Home Secretary vv- advised that the precautions taken to prevent **i disease in workers lining London tube* with asbeatn. *** adequate.--Sir Herbert Samuel replied: powers of control in respect of this work under tha s w * or other Acts, and have no information a t present precautions taken. I will make inquiries, howevJ ..T* G.M.C. and Indian Medical Decrees. the faculties of medicine in Indian universities * ^ 2 * 2 5 stage had beea-reached in the aetting up in IndUJr* Indian Medical Gouncil.--Sir 8. H o a re replied tv* conditional recognition accorded by th e General MaiS! Council to the medical degrees of certain Indian nmroiJU- was withdrawn in March, 1930, A reviled draft Bill S S S establishment of an All India Medical Council h sa t2 ! prepared, and it is hoped to introduce it in the Isdu! Legislative Assembly a t an early date. -waa Importation of Boneless Meat. Lord Scone asked the Minister of H ealth if be woaU consider the advisability of prohibiting the imoortsUe* of boneless meat, in view of the difficulty of detecthe unsoundneee or disease in such meat.--Mr. Ernest Rwm (Parliamentary Secretary to the Ministry of Ileslth) repliedTho importation of bonclcaa meat which affords means of identification with definite parts of a carcass prohibited under the Imported Food Regulations at 1911 My right lion, friend is now considering the amendment of these regulations so as to require a recognised -''-`i certificate of the country of origin with all imports of bah meat less than the a-lioio-------- Mr. A l b e r t asked the Minister of Health what steps had been taken to prevent differentiation in the rates of relief paid in areas where similar conditions prevail.--Sir E. H ilton Yor.vu replied : The amount of relief to be afforded is for the decision of the public assistance authority in the light of the aarertained needs of the individual case. I have no power either to require uniformity or to define what, for the purpose of assessing relief, are similar condi tions. As regards the area to which my lion, friend called my attention in an earlier question, I am informed th a t the local authority have taken action to remove the difficulty to whicli lie referred. Maternal Mortality. i. Mr. McE n tee asked the Minister of Hoalth when the publication of tho report of the departmental committee on maternal mortality might be expected.--Sir E. H ilton Y ouno replied : The interim report of tills committee was iublislic-d 18 montlis ago. I have not yet received any urthcr report, hut I understand tliat the committee hope to present their final report very shortly. Rural Housing. Mr. H urd asked the Minister of Health the number of rural district councils in England and Wales who made applications fur special Exchequer assistance under the provisions of tho Housing (Rural Authorities) Act, 1031; the total numtier of houses included in their proposals; and the number of homes wliich the Central Advisory Com mittee had recommended for erection under this Act.-- Sir E. H ilton Yoono replied: Applications liavo been received from 145 rural district councils of wliich six were subsequently withdrawn. The remaining 130 applications were in respect of 0735 houses. The committee arc not yet in a position to make actual recommendations. They have informed 97 authorities th a t they are prepared to entertain applications to the extent of 1501 houses for the agricultural population. Pensions for Nurses. Dr. O'D onovan aakod tho Minister of Health if he was able to give the details of existing arrangements for the interchangeability of pension schemes for nurses, sisters, and matrons in municipal hospitals; and if be would be TUESDAY, FEB. d m Boys Working Underground a t Night. Mr. Tinker asked the Secretary for Mines if he had eoasidered the request from the Miners' Federation of Gnat Britain to meet them to discuss tho position of boys A* the age of 10 years working underground on night shifts: and if he was prepared to meet them.--Mr. Isaac Foot replied : Tito answer to both parts of the question is is the affirmative. Safety in Mines. Mr. Tinker asked the Secretary for Mines how many aafcty-in-mincs conferences had been held ; was it his mira tion to liavc the proceedings and subjects that wen dis cussed published and available to mine workers; sod if it wax his intention to hold similar conferences.--Mr. Isaac F oot replied : The sixth district Safety Conference was hdd a t Nottingham loot Saturday, and wax attended by somr 4000 persons representative of all interests in the minis! industry. I intend to iu>ld another conference a t Swans* in March, and the eighth and final conference probably at Birmingliam in April. Every mining area in the country will then have been covered. The proceedings at the* conferences arc well reported in the local press; and the material is used in the various safety publications of my department, and in the lectures and demonstrations on * smaller scale by which the work of these Urge conference is being followed up. Sunday Repairs to Xelepbones. Mr. H utchison asked the Postmaster-General whetherin view of the fact th at no telephone repairs ware earn** out between 1 P.1L on Saturday and Monday momufexcept in the cose of those telephones belonging to doeMj*this privilege could be extended to the general seeing tliat no money was refunded in respect of thepsnvs in wliich their telephones were out of working order"" Mr. W hite. Assistant Poatmoster-General. replied: m present arrangements for fault repair during week-eow apply not only to Iho circuits of doctors, but also t o "" alarm, police, hospital, and other circuits where the i diato restoration of communication is in the general pa61! interest. My right lion, friend is considering whether is possible to extend their scope. - [ lancet.] Cancer am o n g W< David GaEnm u. aak received net.!fleatit , men employed a t the nsce, and the nui the last three yea at these works j _L replied: Kotin S e d only in the case of < T t * r , pitch, or Cfrtair S tmm of cancer have t " * in, and I am inform ment is aware, there which would expose ,est of the Depart: r has gone throug the last three years . T im works died from ca K T e n y ground in any c with the employe STemplovcd daring th. ge age of death in the Grenfell asked if t . of * very high rate o: ju a of tho form of cancer " h was the same kind i ___. H- Samuel : No. I e js not disproportio S eally . nor do any par ^ p articu lar kind of ca *Mr. Grenfell ask ed the iii.iitni eve on the subject possible of the num ber > .'iS rH . Samuel said th s been made. If Mr. t ' A . which would show t vests out of 1199 ' jtl their employment lie 4Ae m etier. Continental Vegetal ^TU jor Carver asked t 1 eartm ent liad invevtigs oath disaase in this com ef Continental vegetables d such investigation.-- Si ise made into the source fgot-and-mouth disease, tte disease m ay be m tru g e of other com m odities, i that infi-ction was definite ef Continental w eetabb-s forthcoming wliich would imports o n these grounds. . Ueut.-Colonel F kkmax had been referred to th Besearch Committee. . Sir J . Gilmour sa id t always going on into foo } M ilk for T Mr. McEntee asked th tion how inane tocal cdt milt for school-children. Council schem es: a n d with milk through th e schemes a t th e la te s t cm ftriiam entury Secretary t B u in g tliu week ending authorities in E ngland u school-children u n d er Ser Art, 1021. Mv rig h t I: Kstional Milk l*ublicity ( a*s receiving milk u n d e r Local A uthoriti. Dr. S.m.teii asked tin local Authorities in 1 p a tte d clearance onler* f 1:jii : tltv n u m b er j W n actually conllrm<d vtu& brr iiouMM a n d a* a con#w*it a***. E. Jluour* replied : i tie* in KtiRland Anil W * jttdcr Uh* Housing A ct jKKttes, ami 41 clearance  ' 1 'f . 3 '* 4i %c 410 th e lancet,] [ r e a . 20, ANNOTATIONS ASBESTOS IN LONDON TUBE RAILWAYS. If it be true that asbestos fibre wm woven into cloth and used in ancient Borne, the medical profession has been negligent in its failure, until quite recently, to detect the existence of chronic industrial pulmonary asbeatosis. The first fatal case of pulmonary asbestosis was recorded by H. 1L Murray in 1800, and a full account of the disease was given two years ago in our own columns1 by Dr. W. B. Wood and Dr. S. R. Gloyne. The Home Office inquiry into the effects of asbestos dust on the lungs, published shortly afterwards,* has been followed by the adoption of active measures to suppress dust in asbestos factories. In many such factories the introduction of exhaust ventilation and the replacement of dry processes by wet have changed the atmosphere in which the work is carried out until it is now free at least from visible dust. The operation of cleaning the carding machines by steel brushes, undoubtedly a potent source of fatal pulmonary asbestosis, has now been replaced by a vacuum method. In view of the fact that the dust particle producing the lesion in the lung has a diameter of only 2 (i to 10 p it is obvious that the dust must bo suppressed at its source ; the use of respirators is futile. Illustrations were recently given in the daily press of an experiment which has been devised to coat the Loudon tubes with asbestos in an attempt to minimise noise. In these illustrations the workman -was provided with a double projector, fitted with triggers by which he released from two iudeiieudcnt jets a spray of pulverised asbestos, apparently under considerable air pressure, and a spray of some adhesive solution. According to the illustrations the asbestos powder passed through the atmosphere for something like six inches before meeting the stream of adhesive. Though it is true that the workman was provided with a mask, it is equally true that his clothing was covered by asbestos powder. Kxjierience in asbestos factories would indicate that, should the experiment of the Loudon tultc railways lead to an extensive use of this method for deadeniug noise in all the under* ground railways of l^mdou, then a large increase in industrial pulmonary asbestosis may be ex a cted in years to come. I11 the House of Commons last week (sec p, 374) Dr. W. J. O'Donovan asked the Home Secretary if adequate precautions had been taken to prevent fatal lung disease in workers lining Loudon tulxw with asbestos. Sir Herbert Samuel replied that be had no powers of coutrol iu respect of this work uudur the Factory or other Acts, and had no information at present us to the precautions taken. Hut he promised to make inquiries. HIGH BLOOD PRESSURE AND STROKES. Despite much investigation since Allbutt's original description of high blood pressure there is still doubt about its cause and symptoms, especially in the .e a rlie r stages. It is, as a rule, only later on, when the condition is fully developed and grave symptoms have supervened, that patients with hyperpiesis are seen and studied by the specialist. Since by then irreparable damage has been done, it is to earlier 1Tin: Lancet, 1030,1., US. *IU-|M>rt mi Effects ol Aslswtoa Dust on tbc Lungs und Dust .Suppression In the Aslirstos luriustrr ; Memvether, R. A., unti Price, a W.. mil. Lumlou : H.M. SUt. Office, see The La.vokt, m o, 1., 0. recognition and study that we must look for adva^' iu our knowledge. The condition is so commons! to be an ideal subject for study by the general prae? tioner, and in an essay awarded the Sir C ha2 ! Hastings clinical prise for 1030, Dr. H / o 1 Gunewardcne1 records observations and coiichidom j on the " sudden severe attacks " affecting the uenrm! system that are met with in this disorder. He flag: I that minor paralytic and sensory phenomena are mn j common than the major apoplectic fit associated ) with a severe cerebral hoemorrhage. These m i^ , attacks may be either permanent or transient, and 1their duration is sometimes only a matter of minnt** or hours. In distribution they may be liemipWi, : monoplgie, or localised to one part such as the eye or tongue. The sensory phenomena are similar to the motor in distribution, and take such forms ' as parsthesia, numbness, pain or blindness. IDr. Gunewardeue finds that severi cerebral basmor- . rbage is rare in patients whose diastolic pressure is Ileas than 135, whereas the less severe strokes occur with diastolic pressures of between 115 aud 125, no : case being seen with a diastolic pressure less than 114. 1 His observations also show that cerebral hn-worrhage is unusual in patients under observation who have been warned to lead a quiet and restricted life, : whereas fatal hicmorrhage is likely in patients carrying 011 their normal occupation and making no , allowance for their hypertension. He also makes it clear that both fatal cerebral hmmonhnge and transient strokes are very uncommon on ce cardiac failure has begun or there is clinical evidence of cardiac enlargement. ______ . RESULTS OF GASTRECTOMY FOR CANCER In a communication * to the Academy of Medicine, on Jau. 19th, Prof. H. Hartmann reviewed the late results iu 125 cases of gastrectomy for caucur of the stomach, observed for periods ranging up to 27 years. Of tbc 25 paticuts who showed no sign of , relapse, all but one liad been under observation since tbc ojicration for periods varying between 1 sad 27 years. There were, further, seven patients who had died, but not of caucer, and these deaths had occurred from 3 to 18 years after the operation. Another group included 13 patients, the cause of whose death from 2 to 13 years after the operation was not known ; there may, perhaps, have been Home deaths from recurrence of the disease among these 13. Lastly, there were 80 paticuts, whose . death was due to recurrence of the disease, in 31 cases during the first year, in 35 during the second, in 8 during the third, and in 6 during the fourth year after the operation. Altogether 39 patients (or 31 per cent.) survived the operation by three years or more, and 1'rof. Hartmann is inclined to put ** 29 or 30 per cent, the proportion of his patients for . whom a cure could be claimed. *Ho has achieved ` this comparatively successful result, not so much j>y 1sacrificing the greater part of the stomach, as hi removing with the greatest care the groups of gta""* I which are most subject to invasion. He argued that even hotter results would certainly follow earlier diagnoses and 0 ]>erations performed before the dise*** ; had extended beyond the first relay of gland* ' His conclusion that " lo caucer de l'estomac est a0 j bon cancor au jmint de vue opratoire" i m0i* 1Brit. Med. Jour., Jao. 3UU>, p. ISO. 1Dull. le l'A'.siI. do Md., evil., No. 3. ,g. His Still mo other cases l in the ss u gome rea* rjng this con: rt to his sc or iu general by [ at the age of :of an operai than 30 fear II she would jo of cure of c flfcerbaps, of acad 3j*rpatients ope 5 a tlv lierturbed jarring 50 veers PHYSX sSlt is "`ell knov ,,fonts do not *be< in some vase 1 and i-ommei Expression of the Jfa. Treacher Colii' this is not becaeveloiH-d at birt flex action in conditional reflex jalivarv gland tl even tin- thoui Jae phyMidoglcai flnal and in the elephant' or croi that no annuals 1 Mr. Lindsay .loin squeezing the juh gait into their ey the myth. The lacryutal -ccrctioi it keep* tin- stir! and free from >u second place tha lysozyme, acts as is the function, 11 as weeping, but which may in- 11 upon any imtutit Mr. Coilin' eoii' immunity of inf in whom t'redd'.birth i> more pr laerymul .-ccretio in the very di employed. For young infant do reflexly to any o of drops acts as the other prove especially the tir associated with orbicularis oculi fibres of it situat the lid and know re fourd to be than in ary ot -closure of the 1 vessel' from the pressure due to 1 closed glottis. ' nrit. Juur. 5 4 2 t h e la n c et,] A CAMP FOR UNEMPLOYED MEN. [march 6, ]j' ARTIFICIAL PNEUMOTHORAX. To the Editor o/ T iie Lancet. Sir,--The note in your issue of Feb. 27th (p. 450) by Dr. J. D. Macfie and Dr. A. J. P. Alexander on the follow-up of artificial pneumothorax cases is of great interest and importance. With their assess ment of the practical value of this method of trea t ment I am entirely in agreement, but it would be of special interest *to know further details of the cases that have died, particularly as regards the mode of death. It is to be hoped that they will publish a more extended study at a later date. It is, I think, to be regretted that more investiga tion has not been carried out in this country on a really large scale as to the ultimate cause of death in cases of pulmonary tuberculosis treated by artificial pneumothorax, -with special reference to the spread of disease in the contralateral lung. Even now, despite all the work that has been done by different observers and the vast amount of material available for statistical purposes, we are still to a large extent ignorant of the factors which should go to form the criterion of suitability in our selection of cases for pneumothorax treatment. My impression, after some vears of clinical experience, is that phthisical patients fall roughly into three groups : those that go downhill whatever treatment is employed, those that recover and achieve permanent arrest in almost any circum stances, and those that occupy a middle position, so to speak, in whom one's treatment may well be the deciding force between life and death. I am inclined to think that it is the last group which furnishes the most successful results in pneumo thorax treatment. Moreover, there is. 1 believe, a strong impression among many who have worked at the subject that while the immediate prognosis of pulmonary tuberculosis is more favourable in A.P. cases, the ultimate outlook--i.e., as regards length 0f i[fe--is better in patients in whom cure has been attempted by more natural means. I am, Sir, yours faithfully, " Maurice D avidson. W im pole-street, \V ., Feb. 28tb, 1932. Our first pioneer group, which will go into camp i March, must grow at first by the addition of men * courage, initiative, and vision, capable of buildup a tradition of hardihood and mutual help; . the purpose of this letter is to ask that the names taj, addresses of such men--great numbers of whom im^ be known to your readers--may be sent to tfe. lion, secretary at 2, Devonshire-place, W.l. Tb should be between the ages of 18 and 25. If they* entitled to unemployment or transitional beneft the Ministry of Labour has agreed that these may L paid over for their maintenace while under training,\i We shall be very glad to supply full informationt anyone interested. & We are, Sir, yours faithfully, (Sgd.) I. N orman Gl a is t e r , D. L. T ucker,- E. Schofield, R. T urner, B. Stanley, A. W estlaki. F. T albot, 2, Dcvon^hirc-place, \\ \, Feb. 27th, 1932. A SBESTO S IN LONDON TUBE RAILWAYS. . To the Editor of T ile L ancet. Sir .--With reference to the annotation on pagetiS of your issue of Feb. 20th. we, as inventors of Uf process referred to, give you herewith a few pul* culars. which we trust will enable you to arrive life, better conception of the work which is at pn being carried out in the London Lnderground tun" Particular attention is drawn by you to the ilo*;, Cilice inquiry into the effects of asbestos dust out lungs, and it will be seen that ventilation and tife replacement, wherever possible, of dry process^ wet. form the basis of the safeguards recommit1 of which advantage has been taken by the de* of our apparatus. c As will he seen on examination of " Methods far. pressing Dust in Asbestos Textile Factories,' w**. btrtcti} of Cur"t:, A CAMP FOR UNEMPLOYED MEN. To the Editor of T h e L a n cet. Sir .--We believe that it is within the experience of all medical men in general practice that chronic unemployment almost inevitably leads to deteriora tion of mental and physical health, and that this adds to the difficulty of re-entering organised industry. With unemployment as widespread as it is now, the progressive inefficiency in the community from this cause becomes a menace not only to the happiness of millions, hut to our communal ability to take the initiative if opportunities present themselves for a revival of trade, and to our capacity for reorganising our social structure if progressive rationalisation of industry demands it. We are closely associated with a group of social workers known as the Order of Woodcraft Chivalry, which has set on foot a scheme of national non military service. This has been devised so as to give opportunity to all young men who have either voluntary or involuntary leisure, to devote it to a full time camp course of training, directed to the main tenance of physical fitness, mental alertness, initiative, and citizenship. We are not yet ready to undertake the regeneration of demoralised men, though we hope to be so soon. the Home Office (1931), a system of tunneli on pages 11, 31, and plate opposite , are reproductions of photographs taken in _ provides an incoming supply of fresh , ' any possible traces of dust from the v> J worker, and we would point out tha t - what takes place in the Undergroun apparatus being so arranged that kept constantly supplied with n811 ' dust or atomised adhesive is blown a immediately by the natural current through the tunnel, assisted w h e re ^ ^ mechanical means, for which full Pr0 -> made. In addition, a special study has ^ question of suitable adhesives, 8<* . - liquid can be used through the s .A , completely saturate the fibre delive '<?;