Document wrxZ7m0ojxn5jqmRb79ynN4q3

FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY003 DOCUMENT DESCRIPTION: Text of Presentation by Dr. Sanders ' S S fE W ' Br. Tcrv.id, *..b.r. * -* f tb* S W # , U B i , *, d.fih.d by S.rdn.r* to / opMoooio.l.' 1. t t. ,, t. . n i,,.. - * . * - * * tb* i" tt* ; uht;n q u e s t i o n or r a t i o n to th. du.t OP 1-Pdi-- t * fMCti;- Tb.r. oppoor. to b. ppo.oor. 1 qrt.r. to li.it th. tor. o the. du.t ....... which u.. 1 fibre.1. od pot.hti.1 ,, b i u t x . t . w e * * * * t,ro a* " uore`l l t ; .. to o.y thot th. world how i. to ...... . n . t b.c.u.. it suits soaeone'e convenience. th. P...OB giT.U to li.it th. t.P. i. Quit. Uhd.p.t.hd.bl. i. .... .t.t.. Vh.p. th. word .po.u.cconio.i.. i. U th. co.p.e.tich u . .. - - .....- -- ;; - 1B th... .t.t.. i. .ofri.i.ht u ......... - too ort.B th.P. i. . ttpt to d.t.p.ih. th. typ. or du.t i.w.lw. .p th. .It.ht of th. rsuiting p.thologic.l eh.ng t. .. th. soundest ..lutiou of th. probl- i to ooo.lc.r .11 ef u. bowing pn..ocohi..ls ............ u t . ..tt.P 1. oup led' - r r * U w. .11 JirtlCU' th.t th.t is tPU., th.h th. t.P. h.. .0 PUO. ih occup.ti.0.1 ...... . n . th. di.tion.ry - t.xtbooh d.finitions .u.t h. r.wi..d - th. .fibPOSi.' ipli..tiOh P.BOW.d. Th.P. OOW is .u.h .Tlo.uc. , IB th. post d.e.de th.t th.p. .r. nuBercus has been accumulating in te p lo.etiT. du.t. which ..... no fibro.i. .t .11- first or .11. L t u. looh .t ... od Cough' -- gross 1. ..etioos .bowing . aoderete eount od .0 . 1 du.t P.t.ntion, which is P&TE. J U L 1 MEM ,, , pir.U . in app.nranc. t. no.t city dv.ll.r.' Inn,.. lot. th. 1 .petition ef th. pif.t nre.nl tb. bleed T....1. firing . nedulnr npp.nrnnet e. ere.. ...tie. .1 tb. 1(. W.r. tb. eo.l dn.t rndl.pqe, tb. I-ray p.tt.r. nl.e would b. nodular u d tb. X-ray dlngne.l. tb.n would b. "pnreneeenle.l. du. to e.rben du.t." But b.- ... nntbr.eetle pl*.nt.tl.n In ned.rnt. d.gr... 1. not ri.li..d by l-ru, ucb . cb.t 111. 1. r.nd *. 'healthy lung.,* * *ott ef .nr eb..t 111*.. That 1* pr.eL.ly tf trt,U* with tb. t.rn bn. nrl.w. Me.t pby.lelnn. think ef it r.dle- legie.l t.rn, wh.r... it net.nlly nenn. only du.t in th. lung.,* vh.th.r it enn b. Tl.n.lit.d by X-rny or not. 1 number ef ln.etlr. or in.rt dn.t. nov nr. r.cegni..d vhlet nr. r.ndlly ...n rndlelegle.Uy vh.n r.tnin.d In fflei.nt nneunt. yir.t2 w.r. th. v.ld.r.' .Id.re.l. ... d. te r.t.ntlen in th. lung, ef iron oxld. pnrtinl... Tb. X-y p.tt.rn 1. di.er.t.ly nodnU r nnd elo..ly r..bl.. nednlnr .ilieo.l. by X-rny, y.t po.t-nert.n ,tdl bnr. .hewn no .rid.ne. ef flbre.l.. 1. fnr .. w. b.r. b..n .bi. to d.t.rnin. In th. pn.t fift. ye.r., iron olid. 1. n truly in.rt or innetlr. dn.t. Crlnd.r. nnd flnn. entt.r. of .t..l >ny hnr. .lnllnr iron oxld. .xpo.ur.. of .ufflei.nt d.gr.. to b. ri.uali. 3,4 fcy X-ray a* BOdUlatiOB. th. t.rn ..ld.ro.l.* for .uch iron plgn.nt.tion 1. n p.rf.ctly proper on., but .. with pn.unoeonio.l. th.r. nu.t b. no inplic.tien ef fibro.l. in th. t.rn. Z.nk.r5 d.fin.d .ld.ro.l. n. n .flbro.l. ef th. lung. du. te iron,* which 1. (juit. und.r.tnnd.bl. b.c.u.e tb. Iron uln.r.* lung, .tudl.d by Z.nk.r In 1867 w.r. fibrotie. Be ' ineorr.etly nttrlbut.d th. flbro.l. to th. Iron rnth.r tb.n te th. quart, dn.t which .11 th. nln.r. had br.atb.d along with th. Iron. Thy actually vere cases of slderosilicosls. ... ^1^ 5006 Additional e x e m p t * lD*rt iI"*'U T , 4u,t* " * tlD oxl4, ,, d barlun mxid.. M k h. t . U . 4 tm d.gr.. r..lt in d.,.. eharply d.fln.d nodul.ti.n by I - W - Xt i #t ," t *X' tr... demolition ef particul.t. mat.rial, .11 .tndi.. ef eueh " * haw. ehown . " i,P`lr,d 1 M ` f U # C U e 8 ' e.#e$ vtr# M tirtU o m l . Function ttudiof bJ^Stocklsfi^ of tvo tia e B.rtlk7 in C.cbo.lowakl. .nd Bundon and Hugh.. in thin e.nntrj bar. .hovn th. abl.no. ef fibro.l. in detailed pe.t-.ort.. .India, ef two ..... With tin d.p.lt. Ib. tern tanmo.H- i p.rfaetlj PTMp.r for tin pign.nt.tion prewided th.r. i. no Implication of fibro.i. in th. t.rn. S.w.ral barium oxid. or barite.i. ... bar. b..n r.port.d bp P.nd.rgra..7 in whleb tb.r. w.r. b.awy d.po.it. of barinn dn.t in th. lung, without .ynptem.. On. of tb... b.. con. to po.t-.ort.n .tudp,10 which clearly .bow.d tb. barium d.po.it., but unfortunately th.r. wa. an ...oclat.d anthraoo.llioo.i. du. to tbi. p.r.on'. .arll.r vork in ntbrocitc ninec. Tbi. bring, u. to th. t.rn 'benign pn.unoconiesi., first ud by P.nd.rgra..11 in 1945, whloh ..... unpopular in many quart.r.. My only obj.otlonto it 1. that tb. b.nign d.slgn.tlon lnpli.s that .11 otb.r pn.unooonio... ar. nlignant. whloh i. not tru.. Son. fibrotio pn.unooonio... .r. quit, benign, ..p.oi.lly wh.n ninin.l in d.gre.* Tb. t.rn in.rt pn.uaoconic...* probably is pr.f.r.bl., I.T.rtb.l..., b.nign- no.t likely will .tick b.o.u.. it ..r... tb. T.ry ue.ful purpo.. of ..tting apart tho.. pn.unooonio... which ar. known not to e.u.. flbro.l. or Impaired lung function and not to predispose to tuberculosis. A. for tb. compound t.rn., 1 fetor tb. r.t.ntlon of -.ld.ro- .illoo.l.- if both hl.tory and X-ray pattern .ugg.et that th.r. ha. M.E.M been iftffieltat free ailica ixpowri aXoag vith the iron to c w m silioosis aad the root lymph aodo ooom definitely enlarged on the cheat film, ii you know, eidero.i. aloae dost aot cause enlargeaent of the root shadows, which makes thia aa important point in differen tial diagnosis. *Anthraeosilicosis*ihould be retained only for these eases in which there is a clear-cut history of free siliea exposure mlong with the coal dust and the chest film show, clear-cut evidence of a nodular pattern resembling silicosis. In the absence of signi ficant silica exposure in a coal miner with pin-point or nicro- nodulation and emphysema, the term pneumoconiosis of coal workers* seems the best devised so far. I cannot agree, however, that that diagnosis is proper if the only I-ray eridence of pathological change is emphysema. More about this will be heard from Drs. Fletcher and Hugh-Jones. In conclusion, I beliere very strongly that there are sufficient sound reasons to retain the present generic definitions of pneumo coniosis and the more specific terms of silicosis, siderosis and the others as well. If the general word pneumoeonisosis- is eeusing o much trouble in medicolegal circles, let's take it out of our occupational disease lavs. It should merer hare been there in the first place. There those pneumoconioses which are known to cause disability when in sufficient degree of development should be so clearly defined that there is no cause for quibbling ever terms. Vith continual education of nedcal students and the medical pro fession and vith constant repetition of the statement that -pneumo coniosis is not synonymous vith fibrosis,- the misunderstandings of the past will gradually fade away, And never forget to add that you and I-- ell of us-- have a pneumoconiosis." References i,,'M,, 1. Gardner, 1, V. The Pathology and Roentgenographic Manifestations of Pneuncconioais. J.A.K.A. 114: 535-545 (Peb. 17) 1940. 2. Enter, V. and Sander, 0. A.: Chronic Lang Changs in Electric Arc Welders. J. Indust. Eyg. ft Toxicol. 20: 333-350 (Kay) 193B. 3. Sandar, 0. A.: Benign Pneumoconiosis due to Metal Punas and Duets. Anar. J. Roentgen. 58: 277-82 (Sept.) 1947. 4* Hamlin, L. E. at al and Porvald, A. J. at al. Siderosis-- A Benign Fneunoconiosis due to Inhalation of Iron Duet. Indust. Med. ft Surg. 19: 151-180 (Apr.) 1950. 5. Zenker, P. A. Baber Staubinbalatienskrankheiten dcr Lungen. Deutsches Arch. f. klin Med. 2: 116, 1867. iliccr: 2009 Conaent UR. TORKALD: Ae I Interpret Dr. Sander* vievs, I btUevt be la In ttrcr of retaining the vord jneuaoconiosie and using it in its *** aen.e, and of having it refer only to the inhalation of dust and not to ayaptonatclogy or to the character or extent of pathology vithin the lung. He agrees vith A-