Document vBR23aJ22Kd9g5ezbLZJRdv89

FILE NAME: Owens Illinois Library (OWL) DATE: 1950 DOC#: OWL027 DOCUMENT DESCRIPTION: Journal Article - Chemical Carcinogens Archives of h Industrial Hygiene and Occupational Medicine EDITORIAL BOARD PH ILIP DRINKER, C hief E ditor 55 Shattuck Street, B oston 15 THEODORE F. HATCH, P ittsburgh FENN E. POOLE, G lendale, C alif. ROBERT A. KEHOE, C incinnati FRANK PRINCI, D enver FRANK A. PATTY, D etroit WILLIAM A. SAW YER, Rochester, N. Y. JAMES H . STERNER, R ochester, X . Y. RICHARD J . PL U N K E T T , M .D., C hicago, M anaging E ditor Volume 1 1950 P U B L IS H E R S AM ERICAN M EDICAL ASSOCIATION CHICAGO 10, ILL. t INDEX TO VOLUME 1 The asterisk (*) preceding the page num ber indicates an original article in the Archives. Subject entries are made for all articles. Author entries are made for original articles. Book Beviews and Obitu aries are Indexed under these headings in alphabetical order under the letters B and 0 , respectively. Absenteeism, significance of nonoccupatlonal disability, *1 sickness absenteeism in Finland, 585 Acaricldes; toxicologic studies on new mitt* clde bis (parachlorophenoxy) methane; acute and semichronic toxicity, 341 Accidents: See also Trauma; Workmen's Compensation and Insurance; and under nam es of industries industrial personal factors in; study of accident proneness in industrial group, 371 inuiry vs. gout, 592 irerention; Industrial physician and acci dent prevention, *101 'ri.mnent of common industrial Injuries, '8 i-uminofluorene: See Fluorene And. sulfuric; effect of protective ointment ..i prophylaxis of ulcerations due to ^tlfuric ad d in workers in copper am monium processed rayon. 362 ' . uric; removal of mists and dystp <from . .r by beds of fluidized solids, 37-0 a e . M .: Toxicologic studies on new ...ticide bis (parachlorophenoxy) methane; lie and semichronic toxicity, *341 : <r toxicity of 1 ,1 ,1 -trichloroetbane : Hthylchloroform) determined by ex- - riments on laboratory animals, *225 :..il Preparations: See Dyspnea v r -.antics: See Aviation and Aviators A -r -.-is: See Air; Inhalation o ld : See Old Age v .: > . -.Uural Workers; farm rehabilitation a south Carolina, 353 titii problems In industrialized agrlcul- ' .re. 254 \ r ;tmospherlc pollution; report on ob- rvations in 5 years ended 31st March, : `U. 594 1 '-ditionlng: See Ventilation -itIon of aerosol partldes, from ibot-- ,,'as streams, 491 ' .'rung for air purity, 596 puliation of aerosol particles dis- -'<<1 from stacks. 491 r--t.itlc precipitator for continuous . ;.viing of sulfuric add aerosols and r air-borne particulate electrolytes, <: See also Carbon Monoxide; . : etc. .' i.-c legal regulation of air pollu;:u pollution of industrial estab- mh hv chlorine and mercury vapors - > sanitary evaluation, 589 ` - -*: See Respiratory Tract I rfuryl: See Furfuryl - impiing and determination of <.|-*mrine exhaust gas and In **r. 4i5 1 ii;<t Aluminum Compound t mor- -> -f bauxite-fume pneumoconiosis Aluminum and Aluminum Compounds--Contd. solubility of silica and alumina, *323 Therapy : See Pneumoconiosis American Association of Industrial Dentists; annual meeting, 598 American Medical Association; Council on Foods and Nutrition and Council on Industrial Health; Indiscriminate admin istration of vitamins to workers in in dustry, *573 Amines ; vesical lesions due to aromatic amine; study of statistics and prevention, 361 Aminofiuorene ; See Fluorene Ammonia and Ammonium Compounds ; re moval of mists and dusts from air by beds of fluidized solids, 370 skin sensitivity to cetrimide (CTAB), 365 Anaphylaxis and Allergy : See Asthma Aniline and Aniline Derivatives ; effect of feeding aniline on urinary bladder In rats, 127 Aniline Dyes: See Dyes Anthracosllicosis : See Pneumoconiosis Anthrax, cutaneous, diagnosis and treatment of, 357 Apparatus: See also Instruments electrostatic precipitator for continuous . sampling of suiruric acid aerosols and . other air-borne particulate electrolytes, . *556 Armed Forces Personnel: See also Aviation and Aviators; Veterans; etc. ocular injuries in armed forces, 696 Armies: See Aviation and Aviators; War Arnold, M. F. : Arsine poisoning; study of 13 cases, *437 Arsenic and Arsenic Compounds ; arsine poisoning; epidemiologic studies of out break following exposure to gases from metallic dross, *419 arsine poisoning; study of 13 case, *437 chronic arsenic poisoning, 486 Arsine: See Arsenic and Arsenic Compounds Arteries, Coronary: See Coronary Vessels Hypertension: See Blood Pressure, high Arthritis, as late sequel of trauma of wrist from Industrial accident, 118 rheumatoid, and trauma, 489 Asbestosis : See Pneumoconiosis Ashenburg, N. J. : Acute inhalation toxicity of beryllium; enhancing effect of inhala tion of hydrogen fluoride vapor on beryl lium sulfate poisoning in animals, *398 Acute inhalation toxicity of beryllium ; 4 definitive studies of beryllium sulfate at exposure concentrations of 100, 50, 10 and 1 mg. per cubic meter, *379 Asthma, bronchial, caused by chromium tri oxide, 588 bronchial, caused by inhalation of wood dust, 473 bronchial, caused by Kejaat wood (pterocarpus angolensis) ; wood dust as In halant allergen, 481 diagnosis of asthma, emphysema and sili cosis by inhalation of aerosols contain ing vasodilators or vasoconstrictors, 362 Atmosphere: See Air Atrophy, Optic: See Nerves, optic Audition : See Hearing 3 os# ; retention o f vapors end gases In human nose and lung *36 uclear Energy; See Radioactivity utritloo: See also Diet and Dietetics; vitam ins - - indiscriminate administration of vitamins to workers la Industry *573 ystagmus, miner's, 356 bltuartes: Sappington, Clarence 0. 267 'ccupatlons: See Industry and Occupations cta-khuO; toxic action o f chlordan, *13 il Aspiration Pneumonia: See Pneumonia, lipid distribution, effect and fate of oil aerosol particles retained in lungs of mice, *20 effects of prolonged inhalation of oil fogs on experimental animals. *237 Mineral: See Petrolatum, liquid 'fitments; "barrier ointment" for protec* tloo o f skin of rubber workers, 482 effect o f protective ointment in prophylaxis o f ulcerations due to sulfuric add in workers In copper ammonium processed rayon, 362 Jld Age; experiment In education of older workers, 255 summary of physical findings of employees over 66 years of age, 254 trends o f employment in relation to prob le m of aging, 472 liken, H. G .: Chronic pulmonary beryllosis in workers using fluorescent powders con taining beryllium, *195 >,0-DSetbyl O-Para-Xitrophenyl Thlophosphate; paratblon Inhibition of cholin esterase, *633 >pbthalmology. Industrial, common problems in, 369 isteomyelitis; natural history and treatment of pulp space infection and osteomyelitis of terminal phalanx, 486 ?a*e. R. C .: Significance of nonoccupational disability. *1 *a!n; analysis o f 56 cases o f back pain, 369 1'a in t; monoxide from burning paint, 121 Paralysis, sp inal; concept of rehabilitation applied to paraplegia, *65 Paraplegia: See Paralysis, spinal Parathion Inhibition of cholinesterase, *633 Periodicals; Today's H ealth Is new name for Hygeim, 113 Peritoneum; peritoneal reaction to Injected fused (spherical) and unfused (spiculate) quarts; pathologic studies, *499 Permanent Waving: See Cosmetics Peters, T.. Jr.: Metabolism o f labeled carbon disulfide in guinea pigs and mice, *54 Petrol: See Petroleum Petrolatum, liquid; chronic lipid pneumonia following occupational exposure, 105 Petroleum Industry; significance of nonoccupational disability, *1 Petroleum; unusual symptoms in petrol tank cleaners, 123 Petronella, 8 . I .: Arsine poisoning; study of 13 casts, *437 Phalanges: See Fingers and Toes Phenoxymethane, parachloro; toxicologic studies on new mitlclde bis (parachlorophenoxy methane; acute and semichronic toxicity *341 PbotoA f it f H s : S e e tin der L ig h t Photography; mercury poisoning from finger print photography; occupational hazard of policeman, 365 Pneumoconiosis--Continued stratigraphic study of hill of lungs in course o f silicosis, 482 Physical Examination; medical examination of 500 African railway workers, 354 study o f serofunctlonal changes in patients with silicosis, 361 P hysicians: See also Obituaries annual meeting of American Association of Industrial Physicians and Surgeons, 471 doctor's role In Industry, 353 industrial physician and accident preven tion, *101 relationships between industrial medical department and private physician, *452 Pigmentation; pigmentary disturbance follow ing exposure to monobenzyl ether of hydroqulnone, 120 Pigments; toxicity of cadmium sulfide and cadmium sulfoselenide pigments. *677 Pilonidal Sinus, Interdlgltal, 258 Poisons and Poisonings : See also under names o f substances, as Ammonium and Ammonium Compounds; Aniline; Arsenic and Arsenic Compounds ; Ben zene ; Beryllium ; Cadmium ; Carbon Bisulphide; Carbon Monoxide; Carbon Tetrachloride ; Chlordan ; Fluorene ; Fluor* ides; G as; Lead; Mercury; Methyl Bromide ; MethylantUne ; Naphthaline ; Nltroanallne ; Nltrophenol ; Nitrotoluene ; Thiourea; Trichloroethylene; Uranium; Xylidlne ; Xylose ; etc. hazards in use of new poisons, 485 Policemen ; mercury poisoning from finger print photography ; occupational hazard of Pilots: See Aviation and Aviators policemen, 365 i luto, S. S . : Arsine poisoning; study of 13 Porphyria: See under Urine cases, *437 Pottery Industry; silicosis in potteries, 478 Ptiometer; airfoil pltometer, 597 Postgraduate Education : See Education riumbism: See Lead, poisoning Pneumatic Tools; role of repeated trauma by pneumatic drill in production of amyo trophic lateral sclerosis, 115 Pneumonia; acute dermatitis and pneumonitis in beryllium workers; review of 406 cases in 8 year period with follow-up on recoveries, 116 acute pneumonitis In beryllium worker, 118 lipid, chronic, following occupational ex posure, *105 Powders ; chronic pulmonary beryllosis in workers using fluorescent powders con taining beryllium, *195 Precipitator, electrostatic, for continuoussampling o f sulfuric acid aerosols and other air-borne particulate electrolytes, 556 Preventive Medicine: See Medicine, preventive Princl, F. : Prolonged inhalation of cadmium, *651 Pneumonitis: See Pneumonia Pneumonoconiosis after exposure to sulfur Proudflt, J. P . : Chronic lipid pneumonia following occupational exposure, *105 dioxide fumes and dust from coke fires, Psychiatry, place of in industry, 584 587 among workers in plant engaged in grind ing synthetic abrasive materials, 355 and infection, 474 and tuberculosis in dockers dealing with grain and seeds, 480 .tiuhracosilicosis and Us symptomatic treat Psychosomatic Medicine: See under Mind Public Health: See also Hygiene and Sani tation; Industry and Occupations; Medi cine, preventive ; etc. meeting of Advisory Committee on Industrial Hygiene to Public Health Service, 112 ment, 356 clinical evaluation of disability In anthra- Publications: See Literature; Periodicals ctisilicosis, 475 contribution to study of "cor pulmonale" in silicosis, 120 diagnosis of asthma, emphysema and sili cosis by inhalation of aerosols contain ing vasodilators or vasoconstrictors, 362 due to inhalation of graphite dust, 483 *v g g shell" calcifications in silicosis, 257 electrocardiographic studies In anthracoslllcoals. 475 emphysema In anthracoslltcosts, 474 ctiolngic study of silicosis due to dust of diatomaceous earth, 360 impairment of pulmonary function in unthracosilicosis, *133 in graphite workers, 479 l.ite silicosis In sandblaster, 361 morphology of bauxite-fume pneumoconi osis, 115 mortality and survival rates In males with 'ilicosis or sUico-tubercuiosis, 480 r. o-cpinine" In dyspnoea o f coal-miners, Quartz; peritoneal reaction to Injected fused (spherical) and unfused (spiculate) quartz; pathologic studies, *499 petrographic determination of quartz In presence of claylike minerals, 596 Radiations; exposures from use of shoe-fitting fluoroscopes, 266 lesions o f eye from radiant energy, 474 potential dangers In uncontrolled use of shoe-fitting fluoroscopes, 266 protection, bibliography on, 266 Radio ; diffuse pulmonary granulomatosis in young women following exposure to beryllium compounds in manufacture of radio tubes; report of 5 cases, 483 Radioactivity; beta ray burns of human skin, 264 hazards to physicians, patients, nurses, and others from use of radioactive isotopes, 265 i'O observations on blood of cyclotron workers, ; status of aluminum In therapy and 266 ; rophvlaxis of silicosis, 355 safe disposal of radioactive wastes, 265 ; r -Mcin of consistent radiological diagnosis .a at miner's pneumoconiosis, 476 ; `dnmtiary asbestosis; anatomlcopathologic of case, 362 ** . ii.oi to carbon dioxide in, *358 * -inthracosla and tuberculosis In ^ ;hTlamta coal mine, 588 Radiodermatitis ; See Roentgen Rays Radiology ; protection of personnel engaged In roentgenology and radiology, 265 Railroad Workers ; medical examination of 500 African railway workers, 354 Raynaud's Phenomenon : See Fingers and in potteries, 478 Toes, blood supply In sandstone workers, 478 ' : <>i* <>f mediastinal lymph nodes and ftiniplicaCtons, 115 Rayon Industry; hygienic evaluation of de centralized ventilation in spinning plant of viscose rayon factory. 597 362 INDUSTRIAL HYGIENE AND OCCUPATIONAL MEDICINE E ffect of P rotective O in tm en t in P ro ph y la x is of U lcerations D ue to S u lfu r ic A cid in W orkers in Copper A m m o n ium P rocessed R ayon. E. Z anetti, Med. d. lavoro 40:139 (M ay) 1949. Observations were carried out on 15 workers in the spinning department of a large factory in which copper ammonium processed rayon is produced. It was noted that the continuous contact of the workers' hands with the rayon thread soaked in a 3 per cent sulfuric acid solution caused lesions of the skin in about 35 per cent of the workers. The lesions consisted of maceration of the skin of the hands, ulcerations of the hands a'd fingers, chronic purulent perionyxis and changes of the nails. The protective effect of the "invisible glove" of barrier ointment is excellent. In the cases observed by the author lesions and ulcerations rapidly healed, perionyxis disappeared and the nails greatly improved. The skin of the hands and fingers regained smoothness and softness. E m pyem a of N asal S in u s e s as an O ccupational D isea se D u e to D ust I nha la tio n . W . S chmidt, P r a c t oto-rhino-laryng. 11:282, 1949. Schmidt says that in the course of animal experiments carried out over a period of years attention has been given to the effect of industrial dusts on the mucous membranes of the nose and of the nasal sinuses. Rabbits exposed to industrial dusts frequently presented empyema of the nasal sinuses. This empyema does not differ in its effects on the mucous lining from the empyema of the nasal sinuses of human subjects. Consequently when dealing with workmen who are exposed to dust the physician should give special attention to the nasal sinuses in addition to the main cavities of the nose. D iagnosis of A sth m a , E m physem a and S ilicosis by I nhalation of A erosols Containing V asodilators or V asoconstrictors. J. C. G er rits, Nederl. tijdschr. v. geneesk. 93:1507 (M ay 7) 1949. Gerrits shows that respiratory disturbances which follow the inhalation of an aerosol of a bronchoconstrictor substance ("acetylcholine 1 per cent") can reveal the existence o f a latent bronchospasm. Likewise the inhalation of a bronchodilator ("aleudrine 1 per cent" ("aleudrine" is isopropylartereno!]) wilt show to what extent emphysema is reversible. Thus the inhalation of aerosols can be of help in arriving at a diagnosis. In healthy subjects these aerosols cause no changes. The author says that in 9 of 13 patients with silicosis bronchospasm wa$ detected by means of these aerosol tests. H e suggests that this might explain the discrepancy between the slight roentgenologic changes and the severe functional! disturbances and shortness of breath in certain cases of silicosis. P ulmonary A sbestosis; A natomicopathologic Study of a C ase. A . F ranchini and G. C anepa, Med. d. lavoro 40:161 (June-July) 1949. A man 40 years old had worked in a factory for twenty-two consecutive years, applying insulating material to articles of asbestos. H e never complained about respiratory disorders, and he died as a result of a streetcar accident. The anatomi copathologic diagnosis of the cause of death was that of cerebral paralysis resulting from concussion of the brain and fracture of the cranial base. During the necropsy 1 the lungs were found to be the seat of extensive asbestosis, manifested as extensive sclerosis mainly of the base and middle zones of the lungs. Photographs of the ' lungs are shown. Histologic features were fibrosis of the basal and middle zones of the lungs. There were also lymphoid cell infiltrations, thickening of elastic tissue, reticulum uniformly thick in the sclerotic zones, very numerous asbestosis bodies uniformly occupying the'lungs, hyaline degeneration and asbestosis bodies in the ABSTRACTS FROM CURRENT L IT t neighborhood of the lymphoreticular texture of the cortica' Ilymph nodes. x ! On the basis of this study the case is interpreted, dealt \ two other cases unique in Italian literature. The authors disproportion between the gross features described and th the worker never having complained. The results pr prophylactic and therapeutic treatment and economic assist: generally, particularly of those who apply insulating mater Industrial Toxicology T h e V a l u e of B er y ll iu m D eterm inations in t h e D i /. F. R. D utra, J. C holak and D. M. H ubbard, Am. J . ( Chem. Abstr. 43:3119, 1949. The diagnosis of acute or chronic beryllosis may, in son the beryllium content of the urine. Beryllium was isolated f- working in beryllium plants who had no symptoms o f b< had previously had the acute pulmonary condition. Dt beryllosis, the urinary content of the element varies from negative results do not exclude beryllosis, and in an oc may never be excreted in the urine. Appreciable amounts lungs of all patients dead from beryllosis, except those os occupational chronic condition. In some cases beryllhr other tissues. q, I ntravenous P rocaine H ydrochloride in A sph y x ia D ui R eport of T h r e e T reated Cases and T wo U ntrea TROENCEPHALGRAPHIC CORRELATION. C. W . OLSEN, / Ray and E. W . A myes, Bull. Los Angeles Neurol. S T h u article was abstracted in the Journal of the Ameru (141:101 [Sept. 3] 1949). Solubility and R elative T oxicity of L ead C hromate I S . F . M eek , Indust. Med. 18:407 (O c t) 1949. In this study Harrold and Meek extended their previ for forty months 26 men exposed to lead chromate in qua: of those regarded as safe for continuous exposure. In their "Summary and Conclusion" the authors state: ` lead chromate cannot cause lead poisoning under certain coi we have presented makes the appearance of lead intoxir highly improbable in the industrial exposures which are ! This conclusion is based almost entirely on die solubility compound. In those instances where the amounts of lead c dissolved in body fluids, are equal to, or less than, the amoun and eliminated without harm to the organism, the potentia important factor. The factor of solubility, in this inst. p article size and, p erh ap s, of o th e r possible influencing fac pounds soluble to a great degree in body fluids are depend' in regard to the rate of solution and other factors such as tl fine particles in protecting envelopes. j g HERXV ABSTRACTS FROM CURRENT LITERATURE 363 neighborhood of the lymphoreticular texture of the cortical zone of the pulmonary .lymph nodes. ' ! On the basis of this study the case is interpreted, dealt with and compared with two other cases unique in Italian literature. The authors direct attention to the disproportion between the gross features described and the awareness of trouble, the worker never having complained. The results prove the importance of prophylactic and therapeutic treatment and economic assistance of asbestos workers generally, particularly of those who apply insulating material. Industrial Toxicology T h e V a lu e of B ery llium D eterminations in t h e D iagnosis of Berylliosis F. R. D utra, J. C holak and D. M. H ubbard, Am. J. Clin. Path. 19:229,1949; Chem. Abstr. 4*:3119o, 1949. The diagnosis of acute or chronic beryllosis may, in some cases, be supported by the beryllium content of the urine. Beryllium was isolated from the urine of persons working in beryllium plants who had no symptoms of beryllosis, although some had previously had the acute pulmonary condition. During acute or chronic beryllosis, the urinary content of the element varies from day to day; hence a few negative results do not exclude beryllosis, and in an occasional case beryllium may never be excreted in the urine. Appreciable amounts were recovered from the lungs of all patients dead from beryllosis, except those of persons with the nonoccupational chronic condition. In some cases beryllium was recovered from other tissues. C hemical A bstracts. I ntravenous P rocaine H ydrochloride in A sphyxia D ue to Carbon Monoxide : R eport of T h r e e T reated Cases and T wo U ntreated C ases w ith E lecTR0ENCEPHALGRAPH1C CORRELATION. C. W . OLSEN, A. A. M aRINACCI, J. W . Ray and E. W . A myes, Bull. Los Angeles Neurol. Soc. 14:1 (March) 1949. This article was abstracted in the Journal of the American Medical Association (141:101 [Sept. 3] 1949). Solubility and R elative T oxicity of L ead Chromate II. G. C. H arrold and S. F. M eek, Indust. Med. 18:407 (Oct.) 1949. In this study Harrold and Meek extended their previous work by observing, for forty months 26 men exposed to lead chromate in quantities greatly in excess1 of those regarded as safe for continuous exposure. In their "Summary and Conclusion" the authors state: "W e do not conclude that lead chromate cannot cause lead poisoning under certain conditions, but the evidence we have presented makes the appearance of lead intoxication from this source highly improbable in the industrial exposures which are likely to be encountered. This conclusion is based almost entirely on the solubility characteristics of this compound. In those instances where the amounts of lead compounds which can be dissolved in body fluids, are equal to, or less than, the amounts which are transported and eliminated without harm to the organism, the potential saturation limit is the important factor. The factor of solubility, in this instance, is independent of particle size and, perhaps, of other possible influencing factors, whereas lead com pounds soluble to a great degree in body fluids are dependent on particle size, both in regard to the rate of solution and other factors such as the transport of extremely fine particles in protecting envelopes. R j . S herwood, Brookline, Mass. CHEMICAL CARCINOGENS J. R. HELLER Jr., M.D. Director, Notionol Cancer Institute, Nationol Institutes of Heolth BETHESDA, MD. BOTH the industrial and the general population are being exposed to a growing list of chemicals, some of the biologic properties of which are still undetermined. There is a need for biologic assay of these substances. This is one way for an industry to .determine whether it deals with actual or potential cancerigenic agents. In addition to the chemical cancerigens already identified, experimental animal research has shown that several hundred other chemical compounds have cancerigenic properties. As substances are being continually introduced, the job is never done. This is one of the reasons why the National Cancer Institute set up a cancerigenic study section with a laboratory. We of the National Cancer Institute hope to speed research by joining our efforts with those of industry, which has long been pursuing investigations in its own labora tories, as well as with those of the universities. For some time, industry has been aware of the challenge of environ mental cancer, and it has been endeavoring to meet that challenge with practical solutions where scientific knowledge has permitted. The remarkable progress made over the past SO years has largely been achieved by industry itself. The interest shown in the past, and even more recently, by representatives of industry who have conferred with the National Cancer Institute and the Division of Industrial Hygiene of the Public Health Service, has been stimulating. We welcome a closer relationship with all of those interested, so that through cooperative effort there will be full protection of industrial employees and of the general public as well as of the interests of industry. This is a job that industry can do more effectively and more efficiently than any outside agency. Industrial physicians and management have the practical experience and specialized knowledge that come from living with the problem. The rest of the investigators are on the periphery of the problem. While we are anxious to be of assistance in every feasible Delivered at the combined meeting of the American Industrial Hygiene Asso ciation and the American Association of Industrial Physicians and Surgeons, Chicago, April 25, 1950. 390 I HELLER-CHEM ICAL CARCINOGENS 391 way, the future control of occupational environmental cancer hazards is, as it has been in the past, mainly a task of industry itself. I want to assure industry that there is no thought in any one's mind to impose codes at a time when leadership in this field clearly belongs within industry itself. In all the research that has been done in the field of cancer we have ARCINOGENS CR Jr., M.D. e, Notionol Inslitatcs of Health DA, MD. come to know or suspect the inciting cause of less than 1 per cent of all types of cancer. The results of research are largely concerned with chemical agents, some inorganic and some organic in nature. Given the required intensity, type and duration of exposure, agents of either of these groups may produce cancers in various organs. ral population are being exposed to a During the past 20 years a vast amount of research has been made j the biologic properties of which are >r biologic assay of these substances, termine whether it deals with actual addition to the chemical cancerigens \al research has shown that several have cancerigenic properties. As >duced, the job is never done. This .itional Cancer Institute set up a ratory. We of the National Cancer , joining our efforts with those of ig investigations in its own labora- niversities. of chemical substances. These research efforts have been rewarding, for we know now that some 200 chemicals are capable of producing cancer in appropriate experimental animals.* Since the chemical carcinogens relate to controllable factors, investigators should not fail to do exhaus tive research in the chemical field. The need today is for broader exploration. Tables 1 and 2 summarize the known and some of the suspected chemical cancerigens, along with their target organs and their points of exposure, and the types of cancer produced. Table 1 shows the inorganic group of chemical agents; table 2 presents the organic group. Those which have more recently come under suspicion are followed by a question mark. aware of the challenge of environ- Although not yet implicated in human cancer, other environmental oring to meet that challenge with substances have produced animal cancers. Among them are estrogens,2 knowledge has permitted. The urethane,3 certain chlorinated hydrocarbons,4 beryllium 5 and selenium. past 50 years has largely been Experimental animal research is useful in that it flags the potentially crest shown in the past, and even dangerous chemical agents. However, our investigations are slowed up industry who have conferred with ; at this point. Even though chemical agents which are hazardous in the Division of Industrial Hygiene of 1. Hartwell, J. L .: Survey of Compounds Which- Have Been Tested for stimulating. We welcome a closer ted, so that through cooperative industrial employees and of the sts of industry. Carcinogenic Activity, Federal Security Agency, United States Public Health Service, 1941. 2. Abramson. W., and Warshawsky, H .: Cancer of the Breast in Male, Sec ondary to Estrogenic Administration, J. Urol. 59:75, 1948. Fitzsimons, M. P .: Gynaccotnastia in Stilboestrol Workers, Brit. J. Indust. Med. 1:235, 1944. iore effectively and more efficiently physicians and management have ! knowledge tliat come from living estigators are on the periphery of he of assistance in every feasible 3. Nettlcship, A., and Hensbaw, P. S .: Pulmonary Tumor Induction with Ethyl Carbamate, J. Nat. Cancer Inst. 4:309, 1943. Henshaw, P. S.: Minimal Number of Ancsthcstic Treatments with Urethane Required to Induce Pulmonary Tumors, ibid., 4:523, 1944. 4. Edwards, J. E .: Hepatomas in Mice Induced with Carbon Tetrachloride, J. Nat. Cancer Inst. 2:197, 1941. ie American Industrial Hygiene Asso- 5. Gardner, L. U .: Osteo-Sarcoma from Intravenous Beryllium Compounds in Rabbit, Federation Proc. 5:221, 1946. Industria! Physicians and Surgeons, 6. Nelson, S. A.; Fitzhugh, O. G., and Calvery, H. O .: Liver Tumors Fol lowing Cirrhosis Caused by Selenium in Rats, Cancer Research 8:230. 1943. m INDUSTRIAL HYGIENE AND OCCUPATIONAL MEDICINE laboratory have been identified, it is not easy to establish whether these chemicals have an identical effect in man, since the development of the T able 1.-- Inorganic C hem icals Canccrlgcnic Agents Arwnlcals ............................................ Chrom ates .......................................... Chromo pigm ents?.............................. Nickel carbonyl?.................................. Asbestos? ............................................ Radioactive chemicals....................... Type ot Contact Cutaneous............. A lim entary........ R e s p ir a to ry ........... R e s p ir a to ry ........... Respiratory... C u ta n e o u s ............. A lim e n ta ry ............ R e s p ir a to ry ........... Systemic................ Organs Affected and Types of Cancer Skin (basal cell and squamous cell carcinom a) Lungs (carcinoma?) Lungs (carcinoma) Nasal Sinuses (carcinoma) and lungs (carcinoma) Lungs (carcinoma) Skin (carcinoma and sarcoma) Bones (sarcoma) Lungs (carcinoma) Blood-forming organs, lymph nodes (leukemia and lympho sarcoma?) T able 2.--Organic Chemicals Cancerigcnic Agents Aromatic amines Beta nanhthvlam ine....................... Benzidine ...................................... . Benzene? ....................................... Coal tar, pitch, asphalt, soot, bitumen, creo.ote-oll, anthracene oil (3 ,4-hcnzpyrenc)........................ Shale oil Lubricating oils.............................. Crude paraffin oils.......................... P etro'eums and petroleum products (High Bolling) Lubricating oils............................... F w l o ils............................................ Type of Contact Ciitnncm in............ R e s p ir a to ry ........... A lim e n ta ry ............ C u ta n e o u s ............. Rpspiratorv........... C u ta n e o u s............. R e s p ir a to ry ........... (ftnnos) C u ta n e o u s ............. R e s p ir a to ry ........... C u ta n e o u s ............. R e s p ir a to ry ........... Organs Affected and Types of Cancer Bladder, ureter, renal pelvis (car cinoma) Blood-forming organs, lymph nodes (leukemia, lymphosar coma [?], myeloma (?]) Skin (carcinoma) Lung (carcinoma) Skin (carcinoma) Lung (carcinoma?) Skin (carcinoma?) Lung (carcinoma?) disease in man has been known in many instances to take many years. About the best that we can do is to temper our experimental laboratory research according to the clinical pattern of the known cancerigens in setting up a hypothesis with which to study the chemicals which have been flagged as potentially dangerous. NATIONAL M EDICINE y to establish whether these inee the d evelop m en t o f the meats Organs Affected and l'ype9 of Cancer Skin (basal cell and squamous cell carcinoma) Lungs (calcinom an Lungs ;(carcinoma) Xasal Sinuses (carcinoma) and lungs (carcinoma) Lungs (carcinoma) Skin (carcinoma and sarcoma) Hones (sarcoma) Lungs (carcinoma) Blood-forming organs, lympli nodes (leukemia and lympho sarcoma?) cals Organs Affected and Types of Cancer Bladder, ureter, renal pelvis (car cinoma) Blood-forming organs, lymph nodes (leukemia, lymphosar coma [?], myeloma (?]) Skin (carcinoma) Urne (carcinoma) Skin (carcinoma) l.ung (carcinoma?) 'kin (carcinoma?) I.une (carcinoma?) ices to take m any years, experim ental laboratory ie know n cancerigens in hem icals w hich have been H E L LE R -C H E M IC A L CARCINOGENS 393 i F or instance, the m anufacture of isopropanol by-products seem s to be im plicated in the occurrence of cancers of the nasal sinuses and lungs am ong w orkers em ployed in those operations. T he osteogenic sarcomas \ produced experim entally in rabbits by injections of certain beryllium com pounds raise the question w hether sim ilar lesions of the bones m ay ultim ately develop in hum an beings affected by pulmonary berylliosis.7 T he hepatom as appearing in m ice given chlorinated hydrocarbons, such a s carbon te tr a c h lo rid e ,4 or ch loroform ,79 or fed se len iu m 0 or v ariou s aromatic azo co m p o u n d sR also raises our index of suspicion in relation to the human problem. Since carbam ates are used in the manufacture of rubber, the cancer of the lung developing in m ice treated w ith certain carbamates has human cancerigenic implications. In view o f the recognized carcinogenic action of soot from dom estic sou rces, on m an an d e x p e rim en ta l an im als,10 it appears to be pertin en t to study the various types of com m ercial soots on a long range basis. A short term study m ade in plants producing carbon black has shown Ii no sign ifican t in c re a se in cancer incid en ce over the period o f stu dy 11 hut it is d esira b le th at stu d ies o f com m ercial soots be continued for 15 to 30 years, since this is the probable latent period. T h ese illustrations show hove research done on laboratory anim als can serve to alert us to the chem icals which may possess potential cancerigenic properties in hum an subjects. Considering that a danger of the chem ical cancerigens lies in the slow , alm ost unnoticeable harm that com es from contact w ith them , it m ight be w ise from a preventive j)oint of view to consider all chem ical agents w hich have elicited cancers in anim als as h avin g the potential properties for producing cancer in the human organism . T he results of som e experim ental research m ay be sufficiently con clusive to perm it a fairly general prediction of the clinical analogy. t F or exam ple, data are available to indicate that certain distillation and 7. Eschenbrcnner, A. B .: Induction of Hepatomas in Mice by Repeated Oral Administration of Chloroform, with Observations on Sex Differences, J. Nat. Cancer Inst. 5:251, 1945. i 8. Orr, J. W .: The Production of Liver Tumours by Azo Compounds, Brit. M. J. Bull. 4:385, 1947. 9. Guycr, M. F., and Claus, P. E .: Tumor of the Lung in Rats Following Injections of Urethane (Ethyl Carbamate), Cancer Research 7:342, 1947. Larsen, 1 C. D., and Heston, W . E .: Induction of Pulmonary Tumors in Mice by Anesthetic Agents, Cancer Research 5:592, 1945. 10. Earle, J . : Cancer Scroti, in The Chirurgical Works of Percival Pott, London, Wood & Innes, 1808. \ 11. Ingalls, T. H .: Cancer Incidence in the Carbon Black Industry, Arch. Indust. Hyg. & Occup. Med. 1:622 (June) 1950. 394 IN DUSTRIAL H Y G IE N E A N D O CCUPATIO N AL MEDICINE fractionation products of coal, oil and shale which have been found to elicit cancers in mice have the same effect in man.12 It is remarkable' that there is apparently no relation between toxicity and cancerigenicity of chemical agents. While some are highly toxic, others display a very low degree of toxicity. Some of the toxic ones are benzene, nickel carbonyl, arsenic and radioactive chemicals. Notable for their lack of toxicity are the cancerigenic aromatic amines. As a rule, the toxic dose of a chemical is definitely higher than its cancerigenic dose. Thus, precautionary standards suitable for coping with toxicity hazards in plants will prove to be inadequate for controlling cancerigenic hazards of the same chemicals. It is noteworthy for epidemiological and diagnostic reasons that some of the environmental cancerigens are ambivalent, inasmuch as they exhibit, when given in proper doses, anticancerous properties.13 It seems that many of the functional and anatomic reactions elicited by the chemical cancerigens are not related to, or a part of, the cancerization process. These manifestations may serve as stigmas of exposure and thus represent warning symptoms. Mention should also be made of the gradually changing picture in the types and sites of environmental cancers observed.1 While the majority of occupational cancers caused by chemicals discovered before the turn of the century affected the skin, those revealed during the last four decades appear to affect other organs. These are aromatic amines, radioactive chemicals and chromates; possibly we should consider among these asbestos, nickel carbonyl and isopropyl oil. In general, these chemicals have been found to affect the bladder, bones, hemopoietic tissue and organs of the respiratory tract (lungs and nasal sinuses). Moreover, it is now recognized that certain chemical cancerigens, formerly related exclusively to cancer of the skin, may elicit cancers in other organs also. So identified are tar, mineral oil, radioactive 12. (a) Henry, S. A.: Study of Fatal Cancer of the Scrotum from 1911 to 193S in Relation to Occupation, with Special Reference to Chimney Sweeping and Cot ton Mule Spinning, Am. J. Cancer 31:28, 1937. (b) Twort, J. M., and Lyth, R.: Concentration of Carcinogenic Material in Mineral Oils by Distillation Processes, J. Hyg. 29:161, 1939. (e) Oliver, T . : T ar and Asphalt Workers' Epithelioma and Chimney Sweeps' Cancer, Brit. M. J. 2:493, 1948. (d) Hill, A. B., and Fanine, E. L .: Studies in the Incidence of Cancer in a Factory Handling Inor ganic Compounds of Arsenic, Brit. J. Indust. Med. 5:2, 1948. (e) Neubauer, C .: Arsenical Cancer: A Review, Brit. J. Cancer 1:192, 1947. 13. Allemann, R .: Ueber das Blasenkarzinom und fiber jugendliche Blasengeschwulsttrager, Schweiz, med. Wchnschr. 76:1009, 1946. Henschero: Chemotherapeutik des Blasenkarzinoms mit Aminokorpern, Arch. f. klin. Chir. 189:19, 1937. Haddow, A.; Harris, R. J. C., and Kon, G. A. R .: Inhibition of Growth by Amino-s-Diarylethylenes, Biochem. J. 39:ii, 194S. <F> OCCUPATIONAL M EDICINE ,d shale which have been found to effect in man.1* rently no relation between toxicity s. While some are highly toxic, toxicity. Some of the toxic ones nd radioactive chemicals. Notable erigenic aromatic amines. As a mitely higher than its cancerigenic suitable for coping with toxicity quate for controlling cancerigenic and diagnostic reasons that some ambivalent, inasmuch as they antieancerous properties.1* It natomic reactions elicited by the . or a part of, the cancerization ~ve as stigmas of exposure and gradually changing picture in the observed.1 While the majority cals discovered before the turn revealed during the last four These are aromatic amines, ibly we should consider among >ropyl oil. In general, these dder, bones, hemopoietic tissue s and nasal sinuses), certain chemical cancerigens, he skin, may elicit cancers in ar, mineral oil, radioactive of the Scrotum from 1911 to 1935 ' to Chimney Sweeping and Cot(b) Twort, J. M., and Lyth, R.: al Oils by Distillation Processes, I Asphalt Workers' Epithelioma i3, 1948. (d) Hill, A. B,, and er in a Factory Handling Inor1. 5:2, 1948. (e) Neuhaper, C.: 192, 1947. und fiber jugendliche Blasen009, 1946. Henschen: Chemon, Arch. f. klin. Chir. 189:19, . A. R .: Inhibition of Growth >45. HELLER--CH EM ICAL CARCINOGENS 39S chemicals and arsenic. These have been found to produce cancers of the lung, the nasal sinuses, bones and hemopoietic tissue. During the last four decades there appears to have been a remarkable increase in the number of cases of lung cancer which have been attributed to the chemical carcinogens.11 Statistical analyses of large series of cases of lung cancer have failed to reflect these occupational relations. Never theless, the observations cited should be given consideration through studies directed at determining the cause or causes of the apparent increase in the frequency of lung cancer in this period. Even in this short discussion of the chemical cancerigens the vital role of epidemiology is conspicuous. Often it has been the effect of a chemical agent that has led to the identification of the agent as a cancerigen. Field research augments the laboratory, whether it precedes or follows laboratory research. Experience has shown that epidemiological study is an effective means of research. Through this means we can obtain a wider knowledge of the nature and variety of the chemical agents. Epidemiological studies should take into account the known peculiarities of the recognized environmental and especially the occupational cancers. They should be sufficiently broad to include consuming industries as well as producers of known or suspected cancerigens, and the entire present as well as the former worker population that had appreciable contact with cancerigenic chemicals. Special attention should be paid to any unusual frequency of cancer of a specific site among employees in a restricted plant depart ment or operation. Where chemical cancerigens may have polluted air, water or soil, the surveys might well include the general population living in the fume or. waste disposal zone. Much of this information can be obtained from medical and employ ment records and can be supplemented by data from public health departments and insurance carriers. As can be seen, the gathering of epidemiological data requires investigation of many sources of information. In some areas a great deal of initiative may be necessary, because there are no apparent sources of information. Analyses of death certificates from various parts of a state or within different states may yield suggestive data as to the presence of a local environmental or occupational cancer hazard. Often these data are meager.14 14. (a) Lisco H., and Finkel, M. P .: Observations on Lung Pathology Fol lowing the Inhalation of Radioactive Cerium, Federation Proc. 8:360, 1949. (b) Lorenz, E .: Radioactivity and Lung Cancer, J. Nat. Cancer Inst. 5:1, 1944. (r) v Pirchan, H., and Sikl, H .: Cancer of the Lung in Miners of Joachimsthal, Am. ' J. Cancer 16:681, 1932. (d) Teleky, L .: Occupational Cancer of the Lung, J. Indust. Hyg. & Toxicol. 19:73, 1937. Hill and Fanine.1M Neubauer.1* 396 IN D U STRIAL H YGIEN E AND O CCU PAT IO N AL M E D ICIN E On the other hand, if the industrial conditions are exceptionally simple and have acted over a long period on a rather stable population, it is, in general, not too difficult to ascertain the suspected occupational or environmental cancerigenic chemical. This is especially true if employment data concerning cancer patients and information about the substances used, produced or handled in the local industrial establish ments are available for long periods. Striking examples are those offered by the lung cancers occurring among the cobalt miners in Schneeberg, Saxony, in Germany.15 Another is the history of the pitchblende miners in Czechoslovakia.14c In these relatively isolated and mountainous regions the mining of cobalt and uranium ores in radioactive mineshafts and the production of cobalt or uranium pigments and radium represent the occupational environment of the population. As the vast amount of literature shows, industries have contributed and can contribute much to the field of environmental cancer if they have the resources to undertake epidemiological studies. Where resources are not available, and industry recognizes the need, provision may be made for such surveys through appropriate state agencies. At the present time, environmental cancer surveys are being carried out by state agencies in New York, New Jersey, Ohio, Colorado, Pennsylvania and California to ascertain the relative merits of such epidemiological approaches in areas having highly diversified as well as relatively singular industrial activities. In stable population groups, such as those of industry, medical records may provide invaluable source data. The chances of obtaining more definite information about cancer are usually much better if medical and employment records carry data which can be analyzed for the incidence rates and the topographic distribution of cancers among workers employed in different operations. From data so recorded it is possible to determine whether a cancerigenic hazard may be present somewhere in the various operations of the plant, what site in the body is mainly affected and what type of agent and of exposure is most likely responsible for the occurrence of the cancers, if they do occur. It is beneficial to industry itself if analytical surveys of this type become a part of the routine medical and hygienic care in all those plants which produce, handle or use any of the chemical cancerigens mentioned previously. As has been established by some plants, in industrial organizations where such hazards are already recognized, periodic analyses are useful in showing the effectiveness of the pre cautionary measures taken. IS. Hueper, W. C .: Occupational Tumors and Allied Diseases, Springfield, 111., Charles C Thomas, Publisher, 1942. H ELLER--CH E M IC A L C A R C IX O C E X S 397 Wherever it is obvious, or industry suspects, that a cancerigenic chemical may pollute the air, water or soil beyond the confines of the plant area, the cooperation of the local health department should be enlisted. The health department can aid industry in ascertaining whether or not such pollution factors may have any appreciable effect on the people living in the fume or waste disposal zone of plants. Observation of neighborhood cases of berylliosis offers an illustration of the potential effects of such minute contaminations of the environ mental air.1* It is well to keep in mind that hazards may extend into the cancer field through the atmospheric release of carcinogenic chemicals in the form of fumes, dust, gases and vapors. It is important in surveys conducted in industries having recognized or suspected cancerigenic hazards that provision be made for ascertaining the fate of former workers known to have sustained effective exposure. The inclusion of these workers is essential for the accurate calculation of incidence rates of the exposed population. Of greater import, it will provide data for determining the minimal exposure time required to cause cancer. Also, it will be of value in guiding industrial management in future employment policies relating to the formulation of industrial codes and in specifying the length of time which may be considered safe for workers to be employed in hazardous operations. The discovery and effective control of chemical cancerigens naturally require the cooperation of many persons. Broadly, it calls for the joint efforts of local, private and state health agencies, on one hand, and of industrial and labor organizations on the other. Wherever industrial factors extend into the environment of other states, as sometimes may be the case, cooperation between these many agencies and those of the neighborhood states will be required to effect control in the total area. We are entering an era in which increased attention is being given to all health problems arising from environmental factors. Immediate attention is being given those which arise from pollution of the human, environment. Counterparts to environmental cancer control may now' be found in many other fields. Association with representatives of these other fields offers the opportunity to exchange information of mutual benefit. The results of environmental, and especially occupational, cancer investigations, whether these deal with already known or with new hazards, should be widely disseminated. It is extremely important that this information be promptly communicated to the medical profession at large. Since the physician is usually the first to see cancerous and pre- 16. Hardy, H., in discussion on papers of Pendergrass and Robert, Hatch, Corcoran, Machlc, Shaver and Wilson, in Symposium on Industrial Diseases, Radiology 50:781, 1948. 398 IN D U ST R IA L H YGIEN E AND OCCUPATIONAL MEDICINE cancerous patients, this information will alert him to existing cancer hazards and speed early diagnosis and treatment. With this information the physician is in a better position to aid materially the solution of the environmental cancer problem. It will enhance his opportunity to con tribute to medical literature. The physician's case histories are still one of our best means of ascertaining occupational exposure to cancerigenic agents. Because of the unusually long latent period of environmental cancers, it is essential that the physician's aid be elicited in observing those former workers who were effectively exposed to occupational carcinogens. Not only will many of these workers have changed their occupations, but many will have moved into other states. Some industries have taken the initiative in setting up programs for medical supervision of former employees who were exposed to potent occupational carcinogens. This is a complex type of program to operate. In any program which is largely concerned with a transitory aspect, it is extremely difficult to obtain a 100 per cent net response. However, through practice and experience, improvement will be achieved. Gradu ally, as the idea of this type of service spreads, cooperation may be expected from many groups and individuals. It is a worthy program, and it merits both wide cooperation and wide application. O ur common experience in the control of other public health hazards has shown us that the effectiveness of control measures runs parallel to frank and open acknowledgment when the facts are known. This is well exemplified by the success of a program of the food industries in which employee and industrial participation brought far-reaching control of environmental hazards arising from tuberculosis and typhoid. A similar success story may be written in connection with environmental cancer hazards, as these are dealt with in a similar fashion. In many instances the success of a control program is dependent on the industrial organization's taking the employee into its confidence. Since all pre ventive measures are not based on mechanical devices, the intelligent cooperation of the exposed worker concerning the precautionary and preventive measures adopted by management may be required. Cancers caused by environmental chemical cancerigens are amenable to existing public health methods as to detection and control. An appreciable portion of the sharp drop observed in the incidence of the infectious diseases as well as in their death rates has been the result of preventive measures--that is, the elimination of contact of the population with the causative agents. The epidemiological characteristics and the nature of the chemical cancerigens leave little doubt that we can achieve effective control if we apply public health methods similar to those which brought success in the field of infectious diseases. > OCCUPATIONAL MEDICINE i will alert him to existing cancer <1treatment. With this information <o aid materially the solution of the ill enhance his opportunity to conivsician's case histories are still one upational exposure to cancerigenic it period of environmental cancers, oe elicited in observing those former ! to occupational carcinogens. Not re changed their occupations, but tes. litiative in setting up programs for yees who were exposed to potent implex type of program to operate, emed with a transitory aspect, it per cent net response. However, ovement will be achieved. Gradu- ice spreads, cooperation may be -iduals. It is a worthy program, id wide application. "rol of other public health hazards control measures runs parallel to 1 the facts are known. This is rogram of the food industries in tion brought far-reaching control n tuberculosis and typhoid. A >i connection with environmental i in a similar fashion. In many im is dependent on the industrial its confidence. Since all prechanical devices, the intelligent nceming the precautionary and ement may be required, emical cancerigens are amenable to detection and control. An bserved in the incidence of the ath rates has been the result of ition of contact of the population iological characteristics and the little doubt that we can achieve , methods similar to those which is diseases. H E LLE R --CHEM ICAL CARCINOGENS 399 The research that is needed to solve the mysteries of environmental and occupational cancer presents a challenge of tremendous proportions. It involves a study of thousands of case histories of cancer patients. It involves the devising of new technics in the''gathering of case histories to provide much more background detail than we get in most case histories today. It involves the laboratory testing of suspected cancerigenic agents. It involves a program of follow-up study of exposed workers. It involves a study of the safety procedures and preventive measures adopted or to be adopted in plants where carcinogenic agents are handled. In view of the lack of knowledge of where the danger lies, or the extent of it, no one is in a position to say today just what remedial action is needed. But in view of what we do know, we have to consider precautionary action now to protect the workers involved and the general public. As industry becomes cognizant of cancerigenic agents, it will begin to introduce or perfect safety procedures in all its plants. In time there will follow provision for periodic and extensive medical supervision of all exposed workers. As we increase our understanding of all the factors involved, changes in industrial operation may be necessary in some cases in order to protect employees and the public. It is important to emphasize, however, that more knowledge than we now have must be acquired before such action would be justified in many instances. Much of the discussion today has been concerned with potential dangers, but attention is being given to them because their magnitude has not yet been fully determined. It is obvious that the study of chemical cancerigens will continue to be an active and provocative problem for some time to come. Our knowledge will increase with the participation of scientists, of manage ment and labor, of public health agencies, physicians, and the many individuals and groups concerned or affected by the problem. Through cooperative effort, fruitful results are inevitable.