Document zQ4LRxQYGw5R8p8knkDambEdz

nificance from the standpoint^, litigation but are of publicity it has V, ;ived would indicate. A hydrated no apparent consequence as far as health or disability magnesium silicate, it is believed to produce its effects is concerned. In 1938 Sander and Enzer described through mechanical plugging of the alveoli by long findings in welders who had no known exposure to fibres (over two microns) which have an irritating silica but whose chest x-rays showed marked nodula- effect on the lung tissue. There is some associated tions almost indistinguishable from silicosis which fibrosis which is responsible for the characteristic were demonstrated to be the result of inhalation of ground glass appearance observed in the roentgeno iron oxide fumes. The. borders of these shadows were gram. The greatest occupational hazard exists in min generally more sharply defined than those of silicotic ing, handling and crushing crude asbestos. nodules and the hilium shadows less prominent Post Fungi are filamentous plants of simple structure mortem findings on one case, who died from accident, which include a variety of yeasts and molds capable of gave no indication of fibrosis either grossly or his producing disease in the lungs as well as in other tologically. On microscopical section, deposits observed structures of the body. A common fungus, aspergillu3, about the blood vessels were simple pigmentations consists of many species of molds one of which, asper- which gave the typical Prussian Blue reaction for gitlus fumigatus, attacks the lungs and is responsible iron. Development of clinical symptoms and suscepti for the disease known as aspergillosis. Manilla albicans, bility to complicating infection were lacking. a yeast-like fungus, may produce primary lesions in In recent years our own experience with foundry the lung or sometimes gain access as a secondary in grinders and burners seems to indicate that much of vader. Infection with any type of this mold produces the nodulation observed in films of men working at "Moniliasis," a disease which may affect the skin as these occupations does not represent actual silicosis well as the pulmonary structures. Coccidioidomycosis,- but is the result of excessive exposure to iron oxide, Sporotrichosis and Blastomycosis are due to yeast-like similar to that described by Sander. Clinical findings organisms which generally cause a progressive infec and occupational exposure are not consistent with the tion affecting the mucous, cutaneous, subcutaneous, present conception of silicosis. The analysis of'repre osseous and visceral structures. Involvement of the sentative samples of air borne dust by x-ray diffrac lungs does occur in some cases directly through inhala tion, petrographic and chemical examination (over a tion of spores, and sometimes fungi may be superim three year period) indicates that there is not enough posed on existing diseased area. free silica in the atmosphere to constitute a definite In 1931 Towey, Sweany and Huron described a pre hazard but enough iron oxide in finely divided form viously unrecognized disease which occurred in 35 does exist to produce the pattern noted in the x-ray. workers who came in close contact with dust from Experimental work is now being-carried on in an effort' i. maple logs. The logs had been cut for more than a year to determine the effects of this particular dust on and were not disturbed throughout a hot, moist sum laboratory animals. - mer, a circumstance favoring fungus growth. The A comparatively new disease entity caused by beryl dust, which was of the consistency of lamp black, ac lium and its compounds has recently been established. cumulated beneath the cork layer of the bark and was Beryllium is a strategic metal which was of consider liberated during peeling or sawing operations. On ex able importance during the war in the production of amination it was found to be pure spores of a fungus precision instruments. The exact effect of this metal on -tentatively classified as nummularis or coniosporium the tissues of the body has not been determined but corticola. its `action is thought to be a toxic one, producing der Symptoms produced by inhalation of the spores were matitis, nasal irritation, skin ulcer and chemical pneu acute and asthmatic in character. They included dysp monitis. Van Ordstrand and his associates have re nea, cough, loss of weight and expectoration. The con ported their observations and findings in 170 cases of dition was considered an allergic response to sensitiza poisoning among workers in the beryllium industry. tion by the fungus combined with a possible toxic ele They noted that the disease was not limited to men ment in the spores. in one type of work or in one phase of production and X-ray findings were proportionate to the degree of the incidence and severity were proportional to the dyspnea observed and consisted of definite mottling degree of exposure and chemical irritation - of dusts throughout the lower halves of the lungs with in and fumes. The chemical pneumonitis which developed, creased hilar, basal and trunk shadows. Peribronchial in 38 workers represented the .severest form of the markings were increased throughout both lungs, ex disease and progressed without exacerbation or remis cept in the. apices. Physical improvement with clearing sion, either to complete recovery or to death. Roent of the x-ray occurred in all cases within two to three genologic changes in the lung fields did not appear months after removal from exposure. until two to three weeks after the onset of symptoms The general characteristics of mycotic infections of and physical signs. Changes were bilateral and diffuse the lungs are sufficiently alike to warrant their con in all cases and varied with the severity of the disease. sideration as a group. The x-ray findings may show In order of appearance the changes were (1) diffuse some variation, as they do in silicosis, but usually they haziness of both lungs, (2) development of soft irregu range from accentuated linear markings to miliary lar areas of infiltration with prominence of peribron sized densities which may coalesce. Advanced cases chial markings, (3) absorption of soft infiltration and may show discrete nodules scattered throughout the appearance of discrete large or small conglomerate parenchyma of the lungs. The differentiation from nodules scattered throughout both lung fields and (4) silicosis, tuberculosis, metastatic cancer, sarcoidosis, clearing of the lung fields after one to four months. etc., can be difficult and diagnosis in individual cases Necropsies on five patients showed a typical pneu should be based on correlation of clinical evidence and monitis. Fibroblasts with evidence of organization exposure with the roentgenogram. were present although in patients who recovered, no. Diseases such as coccidioidomycosis are endemic in fibrosis was evident on roentgenologic examination of some localities and while no* region is exempt, a higher the chest. incidence occurs in certain areas. There does not ap The so-called fibrosis due to asbestos fibres in the peal1 to be any occupational prevalence, but cases of lungs has long been recognized ? ' i occupations! .t rtvcotic infection do occur in certain industries, Re- ease. It does not seem to occ irequer!' ` ,5 --ntly a case of primary bronchopulmonary aspergil- SPNY 000236