Document zoz9OqKQMkajJgd8QYYBQqYZm

FILE NAME: Abex (ABX) DATE: 1948 DOC#: ABX259 DOCUMENT DESCRIPTION: Journal Article - Industrial Diseases of the Chest . w i. , in C H rS i" " -- " \itrs,l M .D .f CHICAGO A w u^if *' indusmal eflMt conditions ^ bu- .Ha- ' "n:h0U! a reVeW f SiIi- SO w ir-n ^ * ;a""" 4*' ec- pati0RaI t t t r is now sm. if ?? , " ! TM P a r a b l e Co consider m h e r than fUnr ' d ailment3 which "iste it diagnosis on hoch rta.-.agemert .,,A \ V R3,ceurate recognition and correction!'' " demand =SSS~ S= lack f o t,a? dsFr,a:ic d * n o .u in spite of the ~ S ? S S Z ^ J r r * * * is "Hen once he has beer. 7 \ Wr !C" th a t shadow, observ'd his r physlclan resoit of silicosis w :t significant exposu-e ch ^ u"" h" been " _!y__r_e_s_u_lt__in nM ::e"e "'"aatmmss 7*norr compenirseaqtUioln!nat's ' Prteenud at r s i - ' In Indianapolis. Acni l *:j ( : " " ------------ 1 Conference, fh "1 A" C-csn Bra Ite Shoe Company, icoor,,.,,,. 1W . ( Z fl" ? S , " " " ar7 1?prfih,!nS:oC Irt of ' - - T s ' ray ?a:erna u ind"Strial 0r "H indus * el usa.tive aeeBts apD,,3ibie ior * f f , ton3 ,n the industrial croup are dustI and taeaeeoo. r?Cansiecs mofabeyrsiaslins oaslishave.bween rep"or5t- pievallnr T * * ? - ' th* dile1" ms to be less Act of i s s ^ n j n .&;,?Und- whe ^ e Bysiinosi. a h i i i ^ f it rd4 eon,Pensatlon ior total dlsabdu> follow,ns periods of exposure up to 20 years ..ef ' " " annd^ ; U53baum'' l o w i n g a thorough In-' estisation of thei cotton industry In Mississippi in tlft' Vh i * Ulat ?" ' vidense WM found to ju s tify the existence of bysslnosls as a clinical entity among employees in a cross section of the cotton industry m that state. They did find that c S allergic individuals showed asthmatic reactions to hiph concentrations of cotton dust but no other manifestations of actual disease were evident. . .CaTsr:e,de" *nd Hamilton-Patterson,: in the B rit, ish Medical Journal, in 1942, described symptoms eonsiscms of dyspnea, cyanosis, violent eough scanty sputum, and mild elevation of temperature in workers exposed for one to two months to fibers ot bagasse, a waste product of sugar cane after the sec-S.-trubaeCdA byn ;Glll,i,sUon^ and TThaeylocor,nsdwitihoonstated th at tdhee-1*3 1. Bluer. W. 1_ and .Nussbaum. M. A.: Oetupational riln.-icji mention Industries il j. indust. Hr. * -ox.. 4,, February, . Caaidden. L. 1 M,, and Hamilton, J. I..; P atten o n Bacassosls : An Industrial Lu,,e D U ,,, e . Bela M e* J* 0 .4*3, October 24, 1942, 3. Oltllian. J. A,, and Taylor. F .: B arassosli- F u rth er- b t r " 1D r r r C" * a' B rlt M,d' J~ 5:S:7- So' ' m- 2 '::ZT. " B M " d 5 biUeral r - . ' `" " i p = , , . 4 Th; " l r a " ,h * " b" " W u u v n , , ,, w fjg c r e i Onraiioii, C ourtw T of Dp. J . H .,, . 3  o: 10 years convinced C. F. Lon** that "Tahacosis does not develop in the lungs o those who inhale tcoaccojust," His study covered an investigation o. 1,2-J ( employees with known tobacco dust ex posure as compared to 1,007 with no exposure. Dusts such as those produced irora limestone, chalk, marble, carbon, and cement may produce accentuated linear markings in the x-ray but they are relatively inert. They do not eause definite symptoms and frequently are only discovered in routine chest x-ray surveys. 3arium, iron and tin may produce radiopaque deposits in the perivascuJa r lymphatics and interalveolar septa which close ly simulate silicosis in its discrete nodular form but these residues do not appear to have real sig nificance except from the medicolegal aspect A possible exception may be found in Stannosis or changes in the lungs resulting from exposure to tin and its compounds. Observations by some work ers in this field in recent years have aroused sus picion that such deposits may not be entirely inno cen t However, thus fa r nothing definite in the way of toxic or pathologic manifestations has been established. The nodulations in are welders, described by Sander and Enzer in 1933, demonstrated that an x-ray pattern almost indistinguishable from sil icosis can result from the inhalation of iron oxide fumes. Exposure to free silica in these cases Was lucking and postmortem findings on one cast showed no evidence of fibrosis. Histologically there were simple deposits of pigment about the * Lone. C. F . Tobceo D ust and the Human Lung. Industrial Medicine, I f), September, 1939. 5. Sander ar.d E nzer: Chronic Lung Changes In Elec tric Are Welders. J. IndusL . Hyg. & T og, 10 :S, Mnj, 19S3. . ncL*nc ii SlUeoaU bicod vessels which gave a typical Prussian-blue reaction .o f iron. The striking similarity between these cases and a number in our own experience among s u n d ry grinders and burners led to the inauguration of a s experimental study on the effect of air-borne grinding dusts on laboratory animals. The work was begun approximately a year and a half ago under the direction of the * 5 I 1 U: Dr. I L\ Gardner at the Saranac Laboratory, S a - ,r ar L a .e .^ e w Vork. Analysis of re p r e s e n t \ ne dust ln this industry indicated * ..... *-- was not present in sufficient a.,,c': . . j to produce silicosis, enough iron oxide in - r ..a .,e steed form did exist to account for l ' r : ?i "5ETap" ie 1ehan^ " oh3'rvd. Prelim..ary ..nctngs in the iungs of animals after eight to je r. montns' exposure to this dust show faint dmuse c u t: pigmentation grossly i,, guinea pigs ane wrote rats, but microscopically only scattered inactive dust cells without evidence of actual fi- srosis. Chest x-rays of rabbits exposed to in- haiatitn o. the same dust for ten months were essenttaliy negative and the dust had so apparent effect or. accelerating tuberculous infection in ...ose animals in which the disease had been in- trocuced. * TV*. cc:- ?i:ionl1 fibrosis which results "from v..e in an itio n of asbestos fibers, particularly those over 2 microns in length, is believed to be caused by a messanical plugging of the alveoli or the -o. ---on of_f.brotic sieevea along the terminal bror.cr.ici. -a s condition is observed roost ire- quen-y in such operations as mining and crushing crude aiaestsa. Ia 1940 Gardner* stated that at I I that time 2T percent of exposed workers were in volved and in those with more than lo years ex pectance the percentage rose to 60. The eharae- teristic X-ray finding is the so-called "ground giass appearance which differs considerably from ' tne nod u lar pattern of silicosis. ^i*mr. the last few years lung changes have _ , ,-- knQ nontfno- r r a . ".^ jU n i.e stltlo n s o! Pneumoconiosis. J.A.SLA, "tcruiry. ] m . 6 . I FIGft! E III Slderoeli been observed in some workers' in the beryllium industry. X -ray findings range from diffuse ha:iness in both lung fields to discrete large or small nodules which may disappear after one to four months. While the aetion of beryllium is thought to be a toxic one, affecting the skin, nasal mucous memoranes and pulmonary tissues, its exact effect l.as not been definitely established. Van Ordstrandv ' ' T.a,,n ?enU5 a n d *t l L ! B*n-mum Polsortlnt, 1:S:1S, December IS, 1J<5. " . ---- - `- \ ,c Beryllium poison s V 1,0 warkers >n an industry in which the ntetal was used in the manufacture of precision ^ :ru rr.e n ts during the war. Chemical pneumonitii -cve.oped in 33 employees in this group and pro- Sressed without exacerbation or remission either Z r* " r0Very tDd" th- am inatm n on 5 cases showed typical pPnetuomoortneitmis ` deriRite nbrosis. In 1 3 Hardy and Taber ' FIGURE IV SnrroltloaU C<mrjr at n T, y, HamUerctr 8 siia'vS reported 17 cases a i delav*^ > were "serf er- j ,, , t oerymum compounds viduals, A few a7e 111 dsabUrf " h e T f `f ' - c u r e of the disease was J S o ^ e S / i r S d " f ln dif&.L"ltt*a ddUiarti^ ru ishL*froUmnPnoWduhliaehr s"ilicnosbise v<erury = s - ^ w i = s " < iS T iS fu S 1'L 'lS 'J" ** individual cases T h . .. tae the o -p io sis in considered fndus'trid TheyS` " " *re . us.u` I1y Rflt S ^ - E E r S Su=b a instance was p o r t e d >. c . . . o . c , ,,v a * . 9 5 , ,, 1>lb, r -a . o.. ..am t.-.e Industrial Comxiision o ' IlUm infection with Coceidloldes in, ^ itls caccidtoidomycosij, a disea e n d e x if in ' S F icu n s v J . California, Arizona, and Texas it ~ v i i " r ,or ' ta * ' - w " . r i d d " ," " 1,ccnfustd wuh coccidiosis,. which refers to a n nice! t he ordeT of ^ ' he.!,.oimf J Pa r u i t u ladoded under' the order of cocctdta of the class Sporozoa. The 10 n r . c ; ^ ; - c;u/ e d;s. ' f "*" - broncho tuberculosis. X-ra; fiusn: areas oi o: `.-.E ;e ':s r Den.i lar j! had,,'Vs or eon. 1S| ^e`,ent^ln? on the stag o:m=-; : o lungs lobes. Cav ; - . ion ` = ciamoj'-e 7 7 , l ' ! \ T ehr r be T ` l V n the b33" oi h* hii" ,nt0 the upper tuberculos.s. In mafc- the eiintcai histor- [ tl'" * '* ` f nsider n t only but aleo :he c.JU rE ' " P. ' "re and s - 7 findings, the identification 0 Coe tf ^ 'T '? coccidioidin and the , PJ CaCC:t!,0,d" immi's spherule, simulate s ^ ie o s ^ a r^ m fr * * 1' 3' appearlnMS may static carcinoma of the lu n * 0 " tuhe.reu!o3's<-metasaciated wi^h a# aMj u **** vaacu^a r changes u * miliary 7 ^ 1 Z Wi* al *`"osls. vera aTtd B s ' arcor<,^ :hlolit`a.| Polycythemia aideratior of 1 H" B a|fain "* > of the n '- s i , ! ? ' ? " t^ M p M u re and evaluation possibility^ of erro'raTnns t' " - 3hOUid Biirainate the ' diagnosis. " m v ,n ^ at 4 satisfactory d o i r i n ^ I i ! ; : -r. ^ i0"," b*r f caa" oi I . compousds has given* rise t" * bery llum and its whether this condition should h^d assiT ed occupational d^eas. c __ . . , ciassmed as an scribed ia 1575 a: which f" ' ^ " WM first de` he a skin B lliiL 7 ` , b." * !t w thought to r r :i:r ie v ;r ^ - ^ m sssss. ^ 11 methftdtUb' rel* baCIus 11 " eItb" by" J n fo | wethodi or animal innocuiation. Tuberculin t z r s ' r *v*"with- i s t r r r r v ung! inthe'*** <*5? ?n a recent editorial i,, The America R n ?et af' ereii/o,, PInnerW states th a t o all authors who titr o 7 n t* t3td " P'tiVB op!n!on m to the causa. , h_. p *n reoid lesions, the majority believe involved. * * * * U S Kata, Cake Reedia note that pulmonary lesiona re common in sareoidoaii but x-ray filTM 0f the chest are not a guide to the severity of th T d U e sl meet m t ? bserve? that w!d P r ad lung InvolveffneneerrjanlueVd MprUocieWssh.<^Onth.tihre* ofathleltrUh*andU,'wexetenosifvea S S * " * V t""r 1. tie can be seen in the chest roentgenogram. A bilateral nodulation resembling miliary tubw uiosb a" ssooriftt USinfLiltrartiio,enrVs,i-dmIi?larth*to^ caseowushUpeneumtiomneics tuberculosis, w th or without eavitation, Is present h la te t"! n y P monir>' " n o ta tio n is marked bilateral, symmetrical enlargement of the hilar and " peribronchial lymph nodes. The lesions have s ten" " f . % ref..lVe MmPlWy. leaving no residual fibrosis. In king's series of eases this occurred in " P 1f"'r. Max: Editorial on the EUoloer of Sar. br is i. R*Vl,W S Tuberculosis, s i f l . D oom - It. Katx. Sol. Cxk. a P,, anil Heed. H. R.- Sa, tCrmaldboesr!.J,NDewU ,Ensland J, ltd , -->., ,,1 JOJ. S? e!p-' 12 ' . I an aversus time of twenty-two months. Gardner^ IrCH?Ky st*ie d :, " Wh:l* `his disease ocean here and there throughout the population at large it has frequently been attributed to pulmonary irritants of industrial environments. Reeently a consider, able number have been found in industries using beryllium and its compounds. It has not occurred every plant using these materials. It has not been possible to reproduce a sarcoidosis with beryllium compounds in animats." HU conclusion was that much remains to be done before it can be stated that sarcoidosis U an industrial disease. Miliary calcification or "wheatenn." as it is some, times called, is a condition frequently seen in the chest x-rays of people living in certain states such as Missouri, Mississippi, Ohio, and Kansas, The multiple, dense, sharply defined nodular shadows have on occasion been diagnosed as silieoaU but their characteristic appearance, particularly when considered in connection with the possibility of oc cupational exposure, should eliminate such in in terpretation. The actual causative agent in the production of these densities has not been deft niteiy established but it U thought to be the resu lt' o healed infection of obscure origin. High, Zwerling it Furclow.u reporting on 113 eases of miliary calcification, tested 108 with tuberculin and hUcopiasmin. Of these, 104 eases, or 9S.3 percent, re acted to histoplasmin, while only 4 had negative reactions to this antigen. None reacted only to tu berculin. This finding appears to be strong evidence U . G artner. L. U. : The D lacnotlt ot SilieoaU. IndusL H r*. D ir.. .5 :11, November, le ts . H . Web, R. a . 2w ,r jln*t K. B . and Furcloiv. S t t... Dleaeminated Pulmonary Calcification. Public Health lU o o rt; Tuberculaala Control Isauo, i ; :t. January, 13 1 l t thai disseminated calcification are not caned b tufaerele bacilli but probably by the agent produc mg sensitivity to hlstoplasmiiu P edFbyCH u ^ V heU:nV i,:r mikraJ P"t lineal a*!d^ w ^MSm * Levinl3 in 19U- ' howe, ` " *r anti nd u llr P te rn s which might easily b. he xVav m'h Th` ^ ^ s h a S h ttrrooupbhlieedd bhlioo7d veWss"efls tshe0eUn gihnt h1o0ribs*ondtua*l steBcthioynpemr, the'miT " ^ 'e * " euIar enSorgement throughout pulmonary fields or calcium deposits resulting yiG V R E VI l5' K umt. B u sin , S,, and Lewin. L : Hillary Dsnsi u Asewuauu Wiib an tral stenosis, or Tuberculosis, <>;], starch, l . 14 with severe 5DmC!m" assneiatei v zr r ^ m?e&ht^ ^ S S T .'S S : 4 ? i h e p a re n t0 h ,V n f * * * s ^ s - Sr alo7nJrei',iM0,re45%nt f r S' ' ' co.vci.esio.vs atrimal .cmhes,t .,,conditions ius nToV^. . ?rS1?."" *'5;"f'' ,r" a F r -W M t :: .^ ^ ^ S ^ s s s s 15