Document xz8Ygq7R1j7kN4pB72ojgm2M0

Plumbo-Phobia": Recent Trend in Frequency of Industrial Lead Poisoning WM. C. WILENTZ, mj >., an d ANTHONY MEOLA, m.t . Putin Amb o y , New Jk b s y 4 T'> ,, ^ r Rom- ./ - - >- - -AMERICAN PRACTITIONER an d DIGEST OF TREATMENT March 1955 VoL 6 No. S r' comiCKt 1955 by J. B. LIPPINCOTT COMPANY Philadelphia 5, Pennsylvania 0000-NLI-000022573 v r * * " * * < Progress ,n *** prtrention f distant arising in industry point tha way to prevention of types of dittos* not so rtiattd. "PLUMBO-PHOBIA": RECENT TREND IN FREQUENCY OF INDUSTRIAL LEAD POISONING * WM. C. WILENTZ, M.D., ANTHONY MEOLA, M.T. Perth Amboy, New Jersey EVERAL years ago, one of us wrote a paper1 1939 to and including 1953 (15 years). The employ S regarding the widespread misunderstanding and fear of lead exposure in our industries. The ment during that period varied from 450 to 650 men. The total number of cases treated for lead poisoning title of the paper was Plumbo-phobia. This term waswas 85 (Table I). Of this group, 43 were hospitalized used to emphasize a strange misunderstanding on the and 42 were treated as ambulant patients. The larg ' part of the medical, legal and industrial groups con est number of cases treated during any one year was cerning the prevalence of lead poisoning in industry. 19 in 1948. Of this group, nine were hospitalized In order to determine whether or not a similar mis and ten were ambulatory. During the past five years, understanding exists as to the actual prevalence of only nine cases have been treated, with only two re industrial lead poisoning, a comprehensive survey was quiring hospitalization. made covering (1) our own experience at the National We are very happy to inform you that no cases of Lead Company; (2) statistics from our own state agen lead poisoning have occurred during the past three cies, and (5) statistics from the rest of the states in the years in our plant. To accomplish this has been no country. easy task. It required the sincere and close coopera Before presenting these facts, it might be worth tion of the executive, engineering, production, per while to remind you of the tremendous continued sonnel and medical departments, working as a unit. usage of lead. It has been reported that there are Nothing else could have brought about this significant about one and one-half million to two million work downward trend to realization. ers exposed to the lead manufacturing processes in In the state of New Jersey, it has been estimated4 the United States. About one and one-fourth million that about 20,000 men are employed in the various tons of lead are processed yearly. This is a lot of lead industries. Table II shows that from the year men and a lot of lead. Felix Wormser, in his brilliant paper Facts and Fallacies Concerning Exposure to Lead,* states that the following industries utilize lead to the greatest Ta il s I.--Rtntmt tf Ltad Iniaxieatio* Casts: National Ltad Co., Path Amboy, N. J. (1939-1953) extent: storage battery manufacturing, the sheathing of telephone and power cables, manufacturing of Ye a * Ams u l at o s y Ho s p it a l paint pigments and the manufacturing of tetraethyl lead for use in gasoline. It is also known that there are only a few industries that do not use lead or one of its alloys in some form. In 1940, the United States Public Health Service reported * that there were 16,80S plantr in 15~ states, and that 54~per cent of the one and one-half million workers in these plants were handling lead or its compounds. These facts clearly demonstrate the tremendous utilization and importance of this valuable metal in our industrial life. We shall now proceed with our survey at the Na tional Lead Company, which coven the period from * Read at Tri-State Joint Conference, American Industrial Hygiene Attn., Newark, N. J., December 4, 1953. Totals 42 43 3SS 0000-NLI-000022574 356 AMERICAN PRACTITIONER and DIGEST OF TREATMENT MvcA 19JJ Ta b l I II.--Industrial Ltad Poisoning Casts: Stw Jersey (1941-1952) [IITa b l e .--Industrial Lead Poisoning Cases (L'SA) (1948-1952) Ye a r 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Total To t a l Fa t a l o r To t a l Pe r man e n t Dis a b il it y Pe r man e n t Pa r t ia l Dis a b il it y Te mpo r ar y Dis a b il it y 49 1 20 28 94 4 63 27 78 1 47 30 80 0 34 46 86 0 43 43 66 0 38 28 59 0 26 33 51 1 28 22 43 0 35 8 22 1 16 5 31 1 14 16 30 1 20 9 689 10 384 295 1941 to 1952 inclusive (12 yean), 689 cases were re ported to our state agencies. A breakdown as to the type of caw involved in this group should be of some interest. Ten cases were awarded total permanent disability, 384 cases were given permanent partial awards, and 295 cases were given temporary disabil ity by the compensation bureau. The largest num ber of cases reported during any one year was 94 in 1942, and the smallest group was 22 in 1950. It is interesting to note that there has been a de cided downward trend during the past six years, as evidenced by the following statistics: in the period from 1941 to 1946, 453 cases were reported, while from 1947 to 1952 there were 236. Although the yearly average for the past six years has been about 40 cases, it is significant that only 22 cases were reported in 1950, 31 cases in 1951, and 30 cases in 1952. These facts by themselves tell the story of the great progress being made in this state. Our survey throughout the country (Table III) was made by personal communications with the various state agencies, such as the health departments in some states, and compensation commissions and bureaus in others. The period covered by our questionnaire was from 1946 through 1952 (five years). Thirty-eight states reported their findings. Seven states (Delaware, Louisiana, North Dakota, Oklahoma, Oregon, Ver mont and West Virginia) informed us that this dis ease was not reportable in their states (Louisiana did, however, report one fatal case). Three states (Iowa, Rhode Island and Texas) had no available statistics. St a t e Cas es Re p o r t e d Pe r ma nent To t a l o r Fa t a l Pe r ma nent Pa r t ial Dts. Tempo r a *y Dm- ABILITY Alabama 2 (2) 2(F) Arizona 0 (5) Arkansas 8 (2) 8 California 208 (4) 1 (F) 207 Colorado 57 (3) 5 46 Connecticut 9 (5) 18 Delaware NR Florida 13(5) 13 Georgia 44 (5) 2 42 Idaho Illinois 29 (5) 137 (5) 2 (F) 29 35 71 Indiana Iowa 21 (5) X 21 Kansas 3(5) 2 t Kentucky Louisiana Maine 17(5) NR 1 (5) 12(5) 1 (F) 1 (F) 1 15 75 Maryland 45 (5) 2 10 33 Massachusetts 131 (4) 131 Michigan Minnesota 31 (5) 162 (5) 3 4(F) 23 1 157 Mississippi 0(5) Missouri 8(4) 8 Montana 7(3) 7 Nebraska 46(5) 46 Nevada 3(5) 12 New Hampshire New Jersey 1 (5) 177 (5) 4 1 113 60 New York 166 (4) 13 (9F) 5 148 New Mexico 3(5) 12 North Carolina 72 (S) 23 49 North Dakota NR Ohio 332 (5) 332 Oklahoma NR Oregon NR Pennsylvania 419 (5) 5 414 Rhode Island X South Carolina South Dakota 0(5) Tennemee 0(5) Texas X Utah 20(5) 20 Vermont NR Virginia Washington 87 (5) 29 (5) 1 86 1 28 West Virginia NR Wisconsin 3 (4) 2 41 Wyoming 0(5) Totals 2337 45 (20F) 209 2083 NR--Not reportable in those rata X--Information not available. F--Fetal ease*. ()--Numbers within parentheses--yean tabulated. 0000-NLI-000022575 YdueBt 6 Nuaber i AMERICAN PRACTITIONER and DIGEST OF TREATMENT 357 although the condition is reportable by law. One state (South Carolina) completely ignored our ques tionnaire. The ten states reporting the largest number of cases were as follows: Pennsylvania, 419 (five years); Ohio, 332 (five years); California, 208 (four years); New Jersey, 177 (five years); New York, 166 (four years); Minnesota, 162 (five years); Illinois, 137 (five years); Massachusetts, 131 (four years); Virginia, 87 (five years) and North Carolina, 72 (five years). Thus we see that in these ten states, 1891 cases (80 per cent) out of a total of 2337 throughout the country, were reported. Our survey also shows that there has been a de cided drop in the over-all mortality rate from this disease. Only 20 deaths have been reported through out the country during the past five years. Of the deaths reported, nine occurred in New York and the remaining 11 cases were distributed in six different states. This is in sharp contrast to past records as given by Hoffman,* which show that in 1936, 132 deaths occurred; 71 in 1942, and 47 in 1943. CONCLUSIONS It is generally agreed that it is quite impossible to obtain absolute and reliable information regarding the incidence of industrial lead poisoning in many states. This unhappy situation is the result of sev eral factors such as: (1) failure on the part of some companies to report their cases, (2) non-mandatory laws for the reporting of these cases in some states, (3) where reportable, cases not always checked for reliability, (4) lack of sufficient personnel in the agen cies of some states, (5) listing and classification of cases improperly catalogued and (6) listing of only cases of death in some states. Fortunately for us, our New Jersey agencies are devoid of these deficiencies and are doing an outstanding job. We are convinced that the term "Plumbo-phobia" is applicable to this aspect of the subject in that there are considerably fewer cases of lead poisoning today than one would be apt to believe from reading some books and periodicals which are dearly outdated. We feel that there is some justification for stating that there has been and is continuing to be a definite and decided downward trend in the frequency of indus trial lead poisoning throughout the nation. Our investigation dearly discloses that lead poison ing is becoming less and less frequent, and that lead poisoning in the fatal form will be a rare occurrence even though lead and its compounds are being used in greater quantities today than ever before. Credit for this great progress can be given to (1) the lead industries: they are cognizant of their responsibility and have continued to provide the necessary capital to install the most modern protective equipment, as well as providing the services of competent medical offidals; (2) to the state health and compensation de partments, which provide essential aid and assistance wherever and whenever requested; (3) to such organi zations as the Lead Industries Association and the American Industrial Hygiene Association, of which your local organization is an integral part. We sincerely hope that our survey will serve a useful purpose in providing us all for the first time with substantial, comprehensive statistical data which hitherto have not been available from any one source. BIBLIOGRAPHY 1. Wilentx. William C: Plumbo-phobia. IndusL Med., 13: 253, 1946. 2. Wonnser, Felix: Facts and fallacies concerning exposure to lead. Occup. Med., 3:135, 1947. 3. U. S. P. H. S.: 8, 1940. 4. Personal communication. 5. Hoffman, F. 1_: Bureau of Labor Statistics, Washing ton. D. C, 1944. Industrial Darmatitis Leonard F. Wb*r, MD., Chicago, III. Cmdmud M IBImtu tidied Inred Th e me d ic a l c x t t o u a in the dJa^nosj^M industrial dermatitis due to sensitizers are: (1) the dSea during, or within a few weeks after, the time the worker begins handling sensitizers. A delayed onset does not_ rule out the sensitization factor in some cases: (2) anjc tion of the eruption after cessation of wqrJt^e''j>eriod of weeks or months. Sensitization to_thefTsubstances may .prolong the course of the disease. Added bacterial infec tion, or the retention of causal substances may prolong or ^change the ------ - ^hf |l*`l~ri',-r'rTpnce of derma- is returned to identical sensitizers in his Bstrial worErT*r**Uization dermatitis begins in the areas of maximum exposuzeTShd-thisis usually the hands; (5) fellow employees show similar eutafteoqsjiisease, or the disease is known from previou*.experience to be caused by exposure to the sensitizer. 0000-NLI-000022576