Document xyX7KXEvOVZEVvJ7aQRRjZrQ

FILE NAME: Baldwin (BALD) DATE: 1954 DOC#: BALD075 DOCUMENT DESCRIPTION: Journal Article - Occupational Diseases Occupational Diseases THOMAS F. MANCUSO, M.D,, M.P.H. Reprint from . . . The Ohio State Medical Journal Vol. 50 November, 1954 No. 11 Reprinted by -- THE OHIO DEPARTMENT OF HEALTH  Occupational Diseases THOMAS F. MANCUSO, M. D,, M. P. H. IN2,3O00h,i0o00thweoriknedrusswtrhiaol apreoppuolatetinotniallcyomsupbrijseecst The Author hteoalotchcuhpaaztaiordnsal rdeissuelatsiensgafnrdomindeuxsptorisaulreputbolictoxic substances in their working environment. These visioDnr.oMf aInndcuussotr,iaCloHluymgbieunse,,isOchhioiefDoefpatrhtemeDnit diseases may be of a serious nature affecting the of Health. vdaerpieonudsinvgitaulpoonrgtahnes naantduresysotfemthse oftoxthice dbuosdtys,, ftruamtieosn,sminisvtos,lvevda.porIsn, goernegraaslesa abnrdoadtheclacsosnifciecna such as nitrous oxides produce chemical pneu tcihoenmoicfaol ccaugpeanttisonmalaydisbeeasegsroduupeedto ipnhtoysitchael faonld mraodniuiams. mEaxypopsuroredutcoex-srearyiosuasndbuermnasnaatniodnscafnrocmer low(1in)g Tfooxuirccadtuesgtos,riems:ists, fumes, vapors and walshoileprtohfeoubnldoloyd aaffnedctebdloboyd-froardmiaitnigon.orgIannfsraraerde (2) gPahsyessi;cal states of the' environment such rbaliynsdnmesasy. produce cataracts and methyl chloride, nasoisete; mperature, radiant energy and ofOtchceupiantdiounsatrliadlermdiasetoasseess aarnedthreesmulotstfrforemqueenxt (3) pMhyecshicaanlicsatrlaifnacatnodrsmosvuecmh enats, anpdressure, pirorsituarnetstoorchaesmisckailns swehniscihtizearcst. asInpcriidmenatrayllys,kiint (4) dInufsetcritaioluosccuapgaetniotsns.connected with in itsomchsadraiscateprpisetairc wofhtehnisthdeermpeartsiotins tihs attaktheen saywmapy SCOPE OF OCCUPATIONAL DISEASES farpopmearthoen rweo-erxkpinogsuerenvuinrolensms epnrtevaenndtivuesmuaelalysurrees inhCahleedmictharlsoumghaythbee arebssporirbaetdortyhrotruagcht tohre taskkienn, have been taken. tahtrowuogrhk thfreomdigiemstpivroepterracwt odruke ptorocceosnsteasmionratdioune OCCUPATIONAL EXPOSURES The magnitude and complex nature of the tsoonlaalckproofteacdtievqeuamteeacslueraensi.ng Cfahceimliitcieasls ainnd gpeenr oncucmubpeart,ionvaalrideitsye,aseanpdroblloecmatioisn reoflfectiendduisntritehse. earcaultevaorry cinhrothneicir atnodxicmityay; thafefierctefofencets omr amy obree Tuthileirzeinagrehuonvderred1s2,o5f00vamrieadnucfhaecmtuircianlgs ainnddumstraitees oamrgpalnes, tahtatdisfifleicrean, tastibmesetso.s aWnde kbneroywll,iufmor perxo rtoiaxlisc wduhsitcsh, fruemqueisr,evaepxopross,umreisotsf ainnddivgiadsueaslsantod doufcleoncghaonrgepseirnmtahneenlutndgusrwatiitohn.physical disability oprthoecerssfeasc.torOs heiovollevaedds dtuhreinngattihoen minanthuefapcrtoudriuncg disBeeansezosl,oftothlueenbelooadndandothbelorods-oflovremnitnsg porrogdauncse. ftioounndorfiesstaeselwaenlldasglealsesctraincadl ianpptlhiaencneusmabnedr thoef Chaalrobgoennatteetdrachhylodrriodcea,rbtoetnrsacphrloodreutcheanteoxaicndefoftehcetsr cvearraiemtyic oafrtms.anuTfhaectusrteadteprisodnuocttesdanfdorinidtsuswtriidees oanndthcearbliovnerdaisnudlphkiiddneeyasff.ectMtahnegabnreasine, amnderccuerny in all sections of the state. The State of Ohio has a rather remarkable traSlomneervcohuesmsicyasltsemm. ay produce specific cancers dwiistthriinbuittisonvaorfioiunsducsoturinetsiesboatnhd lathrgeere ainsdhsamrdallyl saumcihneass. cDanecsetrrucotfivtehechbalnagdedserindutehetoboanreomhaatvice adnustarrieaal ewmhpiclohymdoeenst. noItn htahvise rseosmpeectfoprrmactoicfailnly ofocrcautriroends doufethteo naarssaelniscepatnudm pahsoswpehlol rauss.lesPioenrs epvraecryticpehs,ysaicnianophpaosr,tuwniitthyintothestuardeya ahnedlivoebssearnvde otof tchheroomraiul mca,viatlykarleiesus,lt afnrodmaceixdcse. ssiTvheeexgpaossturroe itniodnivalidudaislseawsehso. haEvveenbeaegnriacfufllitcutreed wpriethsenotcscuipma icnhteemstiicnaalsl ctraapcatbleis ofafafecctitnedg assymsypstotemmaitcicpaloliysonbsy. pthoertawnitde-oscpcruepaadtiounseal ofhecahlethmicparlosblienmsthethsrporuagyh cyaGnaosgeesnssucchauases caasprbhoynximatioonno,xiwdeh,ilephootshgeernegaasneds ianrsgenoifc,crnoipcsotianned athned vDaDriToushaivnesebcteiecnidecso.mmLoenadly, PrPacretisceenteadt tAhepriAl nInSu,al19M54e,etbinegforoef tthhee SOehcitoionStaotne GMeendeicraall roercgoagnnicizepdhobspuht attehse sruecchenats in"cpraeraasthiniognu"se anodf Association, in Columbus. 1032 "dTraEmPaPti"c a(tnedtradeetahdyllypyirnopthheoisrphtoaxteic) ehffaevctes. beOecn fIinledthewicthaisne soifx cmlaoimntshsfilaedftefrordissialibciolistiys boergainnsy. cvuapriaettiyonoafl codnisdeitaisoenss atnhdenin ma atryemoecncduorusunnudmerbear opltihceartiodnisemasuestobfethmeadreesptoiratthoeryIntdraucsttr,iatlheCoamp ofWdieffekrneonwt etnhvaitro9n8m.6enptearl ecxepnot soufreas.ll the manu mbeigssainonorwwitihthinin soinxe myoenatrhsaaftfeterr tdoetaatlh doicscaubrirleitdy. fsaivceturoifngtrainndspuostrrtiaetsionin, tahgericSutalttuereo,f cOohnisot,ruecxticolun, Tachceorpdainygmetont afofreemsecdhiecdaul leserevsitcaebslisihsedarrbayngtehde esptce.a, khinagv,e sm1,a0l0l0inodrusltersises edmoplnooyteehsa.ve Gaedneeqruaalltye ImnidttuesetriaolfCothmemisSstiaotne inMcoedoipcearlatiSooncwieittyh. a cTohmis minedduisctarliessewrviitche.lesTs htihsanis 50p0arteimcupllaoryleyes.true of kbnaorrwielerdfgreombyathpeatpiehnytsiacniadnerneambloevsehsimthetofinreamncaiianl treTmheendloaucsk neoefd,mloendgicarelcosgenrvizicedes, wrheipcrhesreenqtusireas usanrdyerbturteamtmoreanllty,wnitoh laondgoecrtofrorasa lopnagrtiacsulnaercoesc athecroe-obredipnhaytesdiciaenffsortot tfaokreimcaprerovofemtheente.mpUlonyleeesss and proper arrangements made for satisfactory cupUantifoonrtaulndatieselyas,ef.ew physicians have a personal acquaintance with the working environment of mbeedirceaclosgenrivziecdes,noocrcupcaotniotrnoallleddi.seasBeasscicaanllnye, iththeei tahceuitre paaptpieenndtsi.citiTshfeorsyexmapmtopmlescoanf laenadd hcaovleicbaenedn fcouupnadtiaotnioanl fdoisretahseesprreevlaetnetsiontoanthdecopnrotrvoilsioofn oocf cthoenfulesaedd, ebxuptosaurephoyfsichiiasn pwatiitehnta wkonuolwd lebdegein oaf adequate medical services to these industries. bweettfeinrdpmoasigtaionnesetopoeivsoalnuiantgeanhdismiulllntiepslse. scAlegroasinis, RESPONSIBILITY OF PHYSICIAN, PATIENT, EMPLOYER. AND COMMUNITY hwaovueldtwloinok-lifkoer smymanpgtoamness.e pHooiwsonminagnyinphaypsiactiiaennst tieTnhtefoprhtyhseicicaonrrehcats daiagrnesopsoisnsoifbialintyoctcouphaitsiopnaal eItmpisloyneedceisnsarthyefomranthuefacpthuyresicoiafn,drtyhebreaftoteriei,est?o deaisseeasneo.t oTnhley raefcfeocgtnsittihoen porfogannosoicscubpuattiaolnsaol mdiasy obtain an accurate occupational history from workers who become their patients. mcoonddiiftyionthsefucortuhreser owfortkreamtmigehntt. proUlnondger tcheertaeixn phTyhsiecipanatiteontprinovtiudrenhhimas waitrhespcoomnspibleitleityantod tahce pwohseurreeas arnedmovthaelrferfoomrewoargkgmraayv aretesultthine pirlelnveesns cinugraotef adlaltahisofsyhmisptwomorskanasd wtheellfaacstotrhse rreelaptoinrtg tdioisneaasneds chuarev.e Scoimntirlaairnlydicceartitoainns spoercirfeicquinirdeumsterniatsl tmoanthegoielslneinstso. aIndoschtoorr'ts, oefvfiecerywthimene hae wisobrkeiinngg svuecrhselyas afafleccothoal,n fionrdiveixdaumalplew,howhhiacsh bweielnl aedx ttroeratwedithfosromane iilnlnfoersms,ahtieonshoaublodutprhoivsidoecctuhpeatdioonc, pisosaednteocecsasrabroyn teemtrearcghelnocryidet,reaantdmaetnrtopfionre winhsiecch tthyepenoufmwbeorrko,fthyeeamrsatheeriawlsasheemhapnlodyleesd aantdththaet ticIidfe thpeoispohnyinsgicidaune rteocopganraizthesiona.s the etiologi_c sthuebnstanwcoeusldto inwchluicdhe hethiiss eixnpfoosremda.tioTnheondoctthoer aogr eontthecrertcahilnorsinoalvteedntshyldikreoccaarbrboonns, theteraccahnloreisdtei, winoforkrmera'stiocnaseis hsiesltdoormy cgairvde..n tIot tihsebedcoacutoser tthhaist masattehethdeisdaabmiliatgy,e atondthhee lcivaenr tohrenkiddenteeyrsmiansewtehlel deaifsfeicsultpieassshauvnerecoocgcnuirzreedd. anTdheoccpuaptiaetniotnaslhoduilsd cThhoeiceproofpetrreadtimagennotsisof atnhde torcecautmpaetinotnaolf daisneaosec. briTnhge thpehywsiocriaknphlaacse atorethspeodnosicbtoilri.ty to his i_n cinuptahteionsaelnsdeisetahsaet aalsllo hoceclpuspaatiopnaatilendtisfeinaasensciaalrlye dexuasmtriianlatieomnpslooyneermtpoloyperoevsidreefeardreedqutaotehimp.h^ysTichaisl ccoalverceodst,bytrceoamtmpeennsta, tiodniaginnoOsthicio, taensdts,thheomspeidtail issenosfe fitnhaantcicaulrsimorpyoretxanamceintaotitohnes cmomaypapnayssinotvheer bwihllesn, etthce.,' parroeppearidclabiymthaeppIlnicdautisotrniahlaCs obmeemnisfsiiloend tehxeistriencgogdniisteioanse owf itah pthhyesiccaolnsceoqnudeintcioen thoar t ptrhee and approved on a particular worker. COMPENSATION itnhdeirvidaugaglramvaaytedbe beympelmoypeldoyamnedntt.he Udinsedaesre sfuucrh duAstnriaolcccoumpapteionnsaaltiodnisbeoaaserd aicsc"oarddiinsgeastoe ptehceuliianr cpoenndsaittiioonns ctohsetscfoomr paannyydiissetahseenorsuilblnjeecstsetso wchoimch result from the aggravation of any previous tcoupaatipoanrttiocuwlahricihndaunstreimalplopyroeceesiss, ntoratdoer,dionraroilcy subjected or exposed outside of or away from conTdhietiomn.ost obvious considerations in this regard h isAlelm cpllaoiymmsenfto."r occupational disease must be acraesedsiahbaevtees,oscycpuhrrielids, wanidth hceoanrtsiddiesreaabslee. dAamctaugael 1033 tloossthetointhdeivicdoumalpaansyw. elTl haes lcoosnssiodferaabfloeoftinoarnclieagl isnibitluitryn odfecarecaosmesmtuhneityulttiommateainftinaianncpiaeloprleespwohno nonhealing fractures of a are unable to work. sthyephnileictiecssaitrye otwf oadielqluusattreatieoxnasmiwnhatiicohnse.mpAhatstihzee LEGAL REQUIREMENTS saammineattiiomnes,inthethpehycosincdiaunct mouf stthekseeepphhyissirceacloerdxs tioTnheanredspsopnrseiabdiliintgy ooffaaphcyosmicmiaunniicnatbhlee pdriesveaesne ctioonnfsihdiepntiaanldonnotareplreoapseerinpfhoyrmsicaitaionn-pwatiitehnotutretlhae snuizcehd.as Hdeipreh,thaesrsiaistoanr csemiasll gpiovxenistowetlhlereccoomg cfoornstehnits orfeatshoen ptahtaietntphhyesichaals eexxaammiinnaetdio.nsItari-s mdisuenaistye tboy ththeelorceaplohrteianlgth oofffitcheer wcoitmhmtuhneicsaubble uCs,uaanlldy Dc,l.awsshiifciehdreinlafteoutro bthroeadselceactteigvoerpielsa:ceAm,eBnt, sceoqnutaemntiniadteinotnifiacnadtiomn eoafnsthoefcsaprrreieard.or Tshoeusrec,earoef of the employee according to certain types of work. dthrraomuagthicthaendeffoervtisdeanntd mcoeoapnesraotifonporfevtheentgieonn theTheestpabhlyissihcmiaenntmoufstparolspoergueimdeplmoyamnaengtempoelnictieins esirtaulatpioranctiintiorengearsr.d toWoecchuapvaetioenxaalctdlyisetahsees swamithe cthoonsceerwnihnog haivnedivhiadduatulsberwcuhloosiasreor vheanndericeaapl pdeids, twhiell etxhceeyptioocncuthr aitnoenplyideinmuicnufsaushaliocni.rcuHmoswtaenvceers, einadseu,starnyd inprorbelgeamrds otof mthaeteirrniptryopaenrd pwlaocmemenenitr. twhheicrhespwoanssibeisltiatbyliosfhetdheinphy19si2c0ianbyisthaeleGgaelneornael Cpleorytaminentbapsoiclicpiersinchiapvlees breeelnatienxgprteossetdhesbey enma AsicssiaenmbwlyhooifsthcaelleSdtaitne oorf aOthteiond"sthaatpaetvieernyt wphityh tnieocneaslsaorryganfoizrattihones pinhytshiecsiaenfietolds.keeIpt isadeeqquuaalltye aonccuopcacutipoantaiolndaisledaisseeawseithisinrie8quhiroeudrstotorethpeorSttathtee raescothrdes doisfeatsheess,einpjhuyriseics,alanedxadmeiantahtsionosf wasorkweerlsl Dpuerppaorstem."ent(SoefeHaecaclothmpoannyainfogrfmormse.t) up for that forThceurrreecnotgannitdiofnutoufreanrefoecrceunpcaet.ional disease areThseesnet troeptohretsOhoifo oDcceuppaarttmioennatl odfisHeaesaelsthwfhroicmh tsheeekpthoydsiectiearnmiinseathbeasciacusneecaensdsiutnydberetfaokree phreevceann adlelmairoeloagsicoafl thevealsutaatteionforomf tthhee gbeaosigsrafpohricaanl edpisi toicvceurm. eaBsuyreissoilnationrgdeor rthcaotntortohlleirngcasthese mpraoyblneomt ttrhiebuitniodnusotrfiedsiseinavseoslv, etdhewirhtiycphe,arthee pnluotmtebder,asanids tmheainpthaiynssiciparnodduecctiroenasefsorctohmepeemnspaltoioyner.coTsthseadnid donAen iinllucostmramtiuonnicoafbltehidsispeoasinest.is the large num roefctneawndpeirnsdoinrencetl, fiinntaenrcriuapltiloonss odfueprotoductrtaioinninogr btoerbeofooccccuurrpiantgioinnaladpearmrtiactuoslaers cwithyicihn wOehrieo.fouTnhde lhoasss roefal emxpeearnieinngcetdo ethmeplpolyaenets oiwnnesrm. allSupclhanatns ococmcuepattoionoaulr daitsteeanstieonrefproormts, thheowpehvyesri,ciadnids bnuott epfufbolritcbryestphoenpsehytsoictihane apllsaonftaicnilietsattaebsliashfianvgoriatbales fdreormmatthietisnehwasdpapoecrcurerrleedasews htihcaht arensuelptieddemiinc oaf a "Tshaefee"mpplaloceyetro iwnotrukr.n has a responsibility to tcharleleadteinnedto sdtertiekremianteathceecrtaauisne polfantht.e dWeremawtietries tahuethpohriytysicaiannd irnespdoensisgibnialtiitnygtotoinhsiumre ththeatprtohpeerer apnrodcefsosunudsedit iwnasthedume atnouafaccthuarnegeofinautthoemogbliulee wpriellrogbeativnoes.infArilnsog,emtheenetmopfloymeerdsichaoluldethpircosvidoer soefatthecoovcercsu.paItifonthael rdeisheaadsesbeienn tphriospienrstraenpcoer,titnhge tthhee tpohxyicsicsiuabnstwanitchesauusthedenitnic thinefoirnmduatsitoryn wabhoicuht plorgoibclaelmbawsoisuldbyhathvee bOeheino sDpoetpteadrtmonenatnoefpHideeamltiho, mquaayntiatfiefesctintvhoelveedm, palonydeessu,bstheqeuirenitdecnhtaifnigcaetsionin, lcoonmgmbuenfiotyre ciatusbiencgamaelaabomr-amjoarnapgreombleenmt diinsptuhtee mvoalnviunfgacttuorxiincg supbrostcaenscseess. wThihceh pmlaanyt opchcyusriciiann in addition to the effect on the employees' health. sthheoupldlabnet pprroocveidsseedswaintdh tahne onpepcoerstsuanriytyFtiorssttuAdiyd STATE ASSISTANCE The physician by fulfilling his responsibility fraecmiluitnieersatoiornpenresocensnsealr,yantdo hpeersfhoormuld ibnedugsitvrieanl ionffitchiealrestpaotretinaggeonfcyanenoacbcluepsa, titohneanl, dtihseeasteechtonitchael medical services of a higher caliber. The physician has an important responsibility rpeossoaulrciens tohfe tihdeensttiafitceatitoonbeanpdlaccoedrreacttiohnis odfisa taobiltihtye ocromillmneusnsitwyhficohr mthaey rperseuvletnitnioann oefcoanodmisir ptercohbnleicma.l stTahffe cSontastiestinHgeaolfthmeDdeicpaalr,tmenegnitnehearisnga, loss, whether due to injury or sickness, for this and chemical units which conduct the necessary 1034 FORM CERTIFICATE OF INDUSTRIAL OR OCCUPATIONAL DISEASE OHIO DEPARTMENT OF HEALTH COLUMBUS 15, OHIO CERTIFICATE OF INDUSTRIAL OR OCCUPATIONAL DISEASE Name of Patient -- (Last n-am.e.)....... - ..... (First name) (Second name) Z* Address: Street and No---------- --------------- City or Village------------------- 2$a. 18 ? o PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DISEASE Sex Age Color Country of Birth Diagnosis --------------------------- OS U8* Chief symptoms and conditions <ZJ eO ej3 Sindgivleo,rcmedarr(iwedri,tewitdhoewwedo,rdo)r . U5<Stti 52oI?os2 tr Occupation (a) Trade, occupation, or work (in which dis Date first symptoms appeared ------------------ <i/> gum. ease was acquired) .................. ................ Particular kind of work in such trade, etc. Complicating diseases (such as alcoholism, " AB syphilis, tuberculosis, etc.) .......-..............-- wz: 1aSJ,s Date of entering this occupation Employer's name ------------------- tS. ?=g8iz2 Address --.....-------------------- What substance(s) or condition(s) in your Employer's business (goods made or work opinion caused this affliction? ...................... Z u done) ............-- -------------------------------- < 2*3ai> = 5"eCS.2oo (b) NPraemvieoousf ooccccuuppaattiioonnss: E(ynetaerr)ed (yeLaerf)t Duration (ac(tCuhaecl,k ewshtiicmh)ated) .i5j*j *Ss Additional facts e 2M,W PrevDioiusseaislleneosrsiellsn,eisfsany, due to occupatYioena:r Date of diagnosis ...... ........... -............<195-- (Signed) .......... ..................... ............, M. D. . ........, 195 ... (Address).................. -......... Mail to DIRECTOR OF HEALTH, Departments of State Bldg.. Columbus 15. Ohio FoSreeInOsttrhuecrtiSoindse ipnrdisuesttrhiael ehvyalguieantieonstoufditehse. mTahneusfeacstuturdiniegs mcaotme roifalstoxaincddupsrotsc,esfsuems;esa, tmmoisstpsh, erviacpodresteormr ingaatsieosn; maneaalsyusriesmoefntschoemf icilallumcionmatpioosnitioannd ofvenmtialtaetriioanls; aenvdalupartoicoensseosf tomewdhicicahl tahnedwnourkrseirnsgarseerevxicpeossedin; pdulasntrtisa;l nteocxeicssoalorygy.protective measures; and in poEseaschspteycpifeic ofindinudsutrsitarly haenadlthindpirvoibdlueamls.planInt emaecdhicianlstaanndceenogfinoececruinpgaticoonnatlrodlismeaesaes,urtehserwe haicrhe caannd cparnevceonnttrothlethoececxurterenntcoef tohfe atdodxiictioenxaploscuarseess. Trehqeuirmeeddiacarel adnedsigennegdinfeoerrintghecospnetrcoiflicmperaoscuersess, othpaetrattihoen, moarxitmoxuimc saulbloswtaanbclee icnovnolcveendt,raitnionosrdbeer wadiothpitnedthbey ltihmeitsPuabslicspHeceifailetdh bCyouthnceilreingu1la9t4i6o.ns tioTnhael kdeeyrmsaotliuttiiso,nfotor tehxeamprpelvee, nitsiontoofkeoecpcutphae 1035 cmounmta.ct Tohfetrheeairrerictaenrttasinwbitahsicthaepspkroinacahtesa tmo ianci llautnegr caanscigernifaincdantdiegdro. upInofantohtehemr epnladnetvewlohpeerde coofmthpelismhatnhuisfaacntudritnhgesperoacrees:s, (1(2)) toadtaelqueantcelolsoucrael dthyaets 2w0eyreearms alnautefarctdueraetdh,s ofrbosmervbatliaodndser schaonwceedr acnlodthignegn,era(l4)exehnafuosrtcevmeenntitlatoiofn,cle(a3n)linpersost,ecti(v5)e ammigohntg etxhpeecetm. plIonyeneesitwheerrecfaasre gdrideatthere twhaonrkeornse, pinrodtuescttriivael colienatnmseenrsts., I(n6)eftfheect,ustheeno,f tnhoengirernitearnatl tthhiesirpafratmiciulileasr doisreatsheeoirr dpehaytshicwiainths e"mapsslooycmiaeten"t fparcaicltiittieiosnear tehcahsnitcharlouagrmh , thsoe tuosespoefakt,hfeorstuastee btiemcaeuiste taokfetshebetswo-eceanlleodccluapteantitonpaelrieoxdp,osthuereloanndg iennvitrhoenmideenntatilficfaactitoonrs awndithcinontirnodlusotrfy siunspeocrdteedr tthyepe aocftueaxlpodseuvreelotphmenenits forfequtheentldyisdeeasscer.ibeTdhaiss thoisceamrrpylooyuetr,hiasndrestopohnissibciloimtymtuonihtyis. patient, to ctohmrosnicmaanyd btheeddeelavyeelodpmweenetkso,f dmisoenatshes,anodr syyemaprs ocAcuppahtiyosniacliadnisewahsoe asnudspewcitssheosr torehcoavgenizteeschnain alifotseirs,thfeorocecxuapmatpiolen,almeaxyposoucrceurocacsurrleodn.g Basery1l2 cSatlateassHisetaalnthceDmepaayrtmreeqnute.st that help from the years after exposure. There are difficulties too in this matter of "GROUP ASSOCIATION" "chasesmoicciaaltsionb.e"ingWueserdealainzed tihnetrroedaurceedhuinndvreadrisouosf ma"nAisfesostcidataiiolyn"inofthfeacptroarcsticfreomof ombesdeircvinaeti,onesspeis csoeqmubeinntatsioenrisouisn eifnfedcutsstroyn tthhaet hmumayancabuosdey saunbd cfiinadlliyngwsheinn othnee ceoxraremlainteastiosynmopftoamspaantidenpth. ysTichael tmhoant thssymorptyoemasrs oafftedrisethaesecrmitiacyal oefxtepnosudreev. eloIpn "inagsstoociaatgiorno"upIrwatihsehr ttohaenmtpohoasniezeindisivtihduaatl,resulacth addition, the last place of employment is not necessarily the work place where the initial ex aPserahagprsouap foefwwoilrlkuesrtsratoironas cowmilml uhneiltpy: at large. posure occurred. Individuals move from job to job as you well know, and the recognition of an whLeeret iunsvibtaetgiionnswwitehreanexteevnednetd itno aattsemndalla tcoowmn "association" of such an exposure and the detec tion of the chronic disease which may deveh- mSautnuirtdyaysuepvpeenri.ng Tahned m4eatol w8ahsousresrveladteronthea rkenqouwirleesdgceomopfrehseunbsisvteanwcoerks hiussteodriesinandvasrioomues pdeiaorprlheeawhaondatvteonmdietidng.becaTmhee idlol ctworithwhnoausweaas, industries. MEDICAL PROGRESS csyalmlepdtomtos moafnyfooodf tphoeisohnoimnge.s rHeceogdniiszceodvetrhede that all of the individuals had the same symp ofInyoculosminagy, Ihasvheoultdhelikoepptoorctuonmimtyenotfthdairtescotimnge taonmds,atallthaetesatmhee staimmee. foTodheatdotchteorsaamsseocpialatecde tthhee mmeadnicuaflacsteurrvinicges oorf parnociensdsuinsgtryofengaagseidngilne the cause of the disease with the eating of this particular meal. pamrooduunctts owr huesrienga agrpoaurpticouflaermcphleomyeiecsal winoulldargbee RELATING TO INDUSTRY ecxapreofsueldly torectohred syaomuer osbusbesrtvanatcieo.ns Ioff ytohue swyomulpd relNaotiwngletto uisndtuasktery.an Wexeamfinpdlewoofrk"earsssocclieaatnioinng" toms and findings of these employee patient" whom you examine, you may be able to make ochultoraidetainnkawroitohmathsaotlvisenntotcaplrloepderclayrbvoenntitleatterad. cpoorrrteulnaittiyonesxiostfs mwehdeitchaelr itmhepoorbtasnecrvea.tioTnshisreloapte ASinnceumthbeerir owf owrkorkisertshebeocnoemecoimllmaonnd faccotlloarpsien. twoheathelarrgtoe oar sisnmgalell dgerpoaurptmoefnt emorploayneeesn, tiorer tahsesoircihaitsetdorwy,itiht tisheeivridweonrtk.their illness is directly plaUnnt.doubtedly many occupational diseases are ciaTthioense" wtwhoichexIamhpalvees doerscilrliubsetdrattoionysouofar"easismo cbleaesnsifuiendrecaosgnnoizneodccbuypatthioenaplatiinenot,ritghien eamndplohyaevre, maceudteiateinlycidoebnsterpvreodducbiencgauasen athceuyte rdeilsaetaese,tothaant is, the development of a disease or illness from and the physician as well as the community. It must be remembered that many contribu a few hours to one or two days following exposure. tdieovneslopmeadde frtoomthethepro"girneistsialofasmsoecdiiactinioen"weoref poLsuerte.us Snoomwe c2o00nsmideenr wthoerkcehdroinnica tpylpaent owf heicxh oubltsimervataetliyonlsedbyto tfhuerthprearctsicciienngtifpichyinsivceiastnigawthioicnhs manufactures chromates and about 12 to 15 years and discovery. 1036