M etzner and nom inated the o th er leading candidate, Lloyd F .

HUNT From the Department of Forensic Medicine The London Hospital Medical College RECEIVED FOR PUBLICATION FEBRUARY 4 1956 It is generally accepted that the inhalation of commercial talc powders can occasionally produce pulmonary disease This is usually fibrosis of a nodular type and only a few examples of massive fibrosis have been reported most of them without pathological description This is the report of one such case showing certain unusual features CASE REPORT charging and occasionally in amount of talc dust to which these years was negligible plate casting The he was exposed for CLINICAL HISTORY the gross radiological changes his physical state was remarkably good He first came under observation as an patient of the Miller General Hospital Greenwich nine years before his death when he was examined because his son developed pulmonary tuberculosis During the last " 10 years of his life he had several attacks of bron- chitis with cough and sputum and pyrexia These INDUSTRIAL HISTORY patient was 57 years were treated at home with early recovery Apart old at his death He joined the Army at the age of 16 at the start of the first world war During this war he was gassed although not severely When he left the Army he became a storekeeper in a food store In 1927 at the age of 29 he first entered the from these attacks he had a slight morning cough productive of a jelly greyish sputum He was not breathless on normal exertion Nine months before death all the phalangeal joints of both hands became swollen and painful with slight accumulator industry For the first six years he was employed in lead burning and was not exposed to dust After this he joined another firm as a plate caster The following 10 years i.e. between the ages ulnar deviation of the fingers The left ankle was transiently swollen There was no spindling of the interphalangeal joints and at this time there was early clubbing of the fingers His hands were radiographed of 35 and 45 was the only period during which he when he was first seen to exclude the bony changes was exposed to dust Lead accumulator plates were of sarcoidosis and again together with other joints A cast in a operated mould consisting of two when the knuckles became swollen None of these faces hinged at the bottom There were two men cast- radiographs showed any bony abnormality Clini- ing in one small room each with his own mould and cally the joint changes were considered to be mani- with a communal fired lead pot The mould was festations of pulmonary osteoarthropathy Unfor- oa at about waist height It was opened and then each tunately no joints were examined histologically after coer surface was roughly dusted with talc from a loosely woven calico bag or an old sock The bag was death and it is impossible to exclude rheumatoid arthritis It would have been of interest to make banged hard against the mould and a cloud of dust would arise Next the mould was closed and the this exclusion in view of Caplan's 1953 observation of the modification of miners pneumoconiosis in lead poured in It was cooled with water and opened and the plate removed The sequence was then repeated The patient was a good workman and cast up to 110 plates an hour being paid piece rates The talc bag contained about quarters of a pound of talc and about three bags were used in two days There was no dust extraction in the room and every- men with rheumatoid arthritis The only physical signs recorded in the chest during the period of observation were occasional r^lesespecially over the right lung Sputa were examined for tubercle bacilli by microscopy and culture repeatedly during these nine years Between four and six groups of sputa were examined yearly and no tubercle bacilli were thing was covered with talc dust The source of the talc used cannot be traced except for the last two years ever found The sedimentation rate was estimated at regular intervals and was on most occasions moder- of this period when it was obtained from Manchuria Canada or Egypt The plates are now cast ately raised but sometimes normal The Mantoux reaction was positive at a dilution of 10,000 An automatically in this factory and the mould faces are dressed with a cork compound; there is no dust risk whatever electrocardiograph taken three months before death showed no definite right ventricular preponderance An axillary lymph node was removed for biopsy six After 10 years of this work the patient was engaged for 12 years before his death in battery assembly and years before death to investigate the possibility of sarcoidosis There were a few doubly refractile A.

We will first consider the evidence that asbestosis leads in a proportion of cases to cancer of the lung.

M etzner and nom inated the o th er leading candidate, Lloyd F .

LIQUID RED LEAD (Modified)

We will first consider the evidence that asbesiosis leads in a proportion of cases to cancer of the lung.

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Weidlein President of Mel lon Institute His deep personal interest in the activities of the Foundation has been a major factor in the attainment of outstanding position Thus the Foundation has its present the wise counsel of had at its disposal at Mellon Institute leading scientists and the use of the best facilities and equip- ment obtainable Keeping Pace with OPPORTUNITIES OPPORTUNITIES It was not surprising therefore that by 1941 the scope of the Foundation's activities had expanded to other phases of environmental control The name of the organization was 3 e changed to Industrial Hygiene Foundation in keeping with the increasingly broader of activities in the industrial feld With each extension research the membership grew 19by519555 there were appeturimately apeturimately 370 outstanding com panies and associations in UnUinittededStates on its roster The Foundation's staff today includes physicians indus particularly particulary in the industries The staff is supplemented by five professional committeelegsal preventive engi- whose members aid in supplying facts and counsel and in supervising the Foundation's thoroughgoing studies and re- searches in these five sectors Member companies tap this rich source of accumulated knowledge and experience for the solution to their specific industrial health problems the con- oftrol health hazards and the development of health and medical programs The Board of Trustees is comprised of top echelon leaders in management technology science and education The Foundation's investigative activitiaersecarried on both The the field and in laboratories Environmental health members as are plant studies on specific phases of indus its members problems In the realm of medicine the Founda tion is an authority on the establishment expansion HF ducotfmedicalprograms Medical audits are made by to advise on control equippedrecornesqturiurcetmieonntisnfoerxissptiencgiplfantisc ations new plant design aatiibolnestomodeilfiimcaitniaotnseihnazpraorcdesTshesistodimviinsiimonizsetuodrieswhaeinrepovleutrion polution 4 and its control reviews plans for ventilating systems and attack on special cleaning problems guides scientific research carried on by the Foundation Basic includes investigations on the nature and at Mellon Institute of hazardous dusts fumes vapors and mechanism of action factors such as noise illu and on other environmental gases and radiant heat with special reference to actual mination of apparatus conditions of plant exposure The development is and techniques for collecting and measuring air pollutants an important part of this activity The Foundation's toxicological laboratory makes studies in the physiology toxicology and biochemistry of physical and chemical agents their mode of entrance into the body in relation to the physical and chemical condition of the atmos phere and their subsequent possible toxic action The find- ings serve as a basis for evolving proper control measures to protect the health of workers Each year at its annual meeting the Foundation brings together at Mellon Institute nearly 700 executives physi- cians attorneys engineers chemists and industrial health specialists This convention affords an op

MINUTES OF MEETING OF THE EXECUTIVE COMMITTEE OF THE GLIDDEN COMPANY Minutes of the meeting of the Executive Committee of The Glidden Company, held at the office of the Company, 1396 Union Commerce Building, Cleveland 14, Ohio, on Friday, March 3> 1950, at 10:15 o'clock A.M.

We will first consider the evidence that asbestosis leads in a proportion of cases to cancer of the lung.

MINUTES OF MEETING OF THE EXECUTIVE COMMITTEE OF THE GLIDDEN COMPANY Minutes of the meeting of the Executive Committee of The Glidden Company, held at the office of the Company, 1396 Union Commerce Building, Cleveland 14, Ohio, on Friday, March 3> 1950, at 10:15 o'clock A.M.

Weidlein President in the activities of lon Institute His deep personal interest the Foundation has been a major factor in the attainment of its outstanding position Thus the Foundation has present the wise counsel of had at its disposal at Mellon Institute leading scientists and the use of the best facilities and equip : ment obtainable Keeping Pace with OpporTUNITIES It was not surprising therefore that by 1941 the scope of the Foundation's activities had expanded to other phases of environmental control The name of the organization was 3 Na changed to Industrial Hygiene Foundation in keeping with the increasingly broader range of activities in the industrial United and by 1955 there were apparimately apparimately 370 outstanding com panies and associations in Stateons its roster The Foundation's staff today includes physicians indus trial hygienists chemists engineers and various technicians particularly in the industries The staff is supplemented by five professional committees legal preventive engi whose members aid in supplying facts and counseland in supervising the Foundation's thoroughgoing studies and re- searches in these five sectors Member companies tafportthhies rich source of accumulated knowledge and experience top echelon leaders in management technology science and solution to their specific industrial health probltehemcosn and trol of health hazards and the development of health medical programs The Board of Trustees is comprised of education The Foundation's investigative activities activities are carried on both in the field and in laboratories Environmental healftorh on an industry scale are conducted surveys many surveys surveys members as are plant studies on specific phases of indus trial health problems In the realm of medicine the Foundatrial is an authority on the establishment expanmsaidonebayndHcon duct of medical programs Medical audits are staf physicians to appraise existing health programs andis recommend improvements or changes to meet present and of specific oper future needs The engineering division the specificplants for equipped to advise on control requirements existing ations new plant design reconstruction in whenever pos and modifications in processes to minimize or pol ution sible to eliminate hazard This division studies air 4 guides control reviews plans for ventilating systems and and its attack on special cleaning problems scientific research carried on by the Foundation Basic includes investigations on the nature and at Mellon Institute of hazardous dusts fumes vapors and mechanism of action factors such as noise illu- and on other environmental gmaisneastion and radiant heat with special reference to actual conditions of plant exposure The development of apparatus and techniques for collecting and measuring air pollutants is an important part of this activity The Foundation's toxicological laboratory makes studies find- in the physiology toxicology and biochemistry of physical and chemical agents their mode of entrance into the body in relation to the physical and chemical condition of the atmos phere and their subsequent possible toxic action The ings serve as a basis for evolving proper control measures to protect the health of workers Each year at its annual meeting the Foundation brings together at Mellon Institute nearly 700 executives physi cians attorneys engineers chemists and industrial health specialists This conven

Professor David Ferguson, Professor of Occupational Health (a leading occupational health physician) and Mr Gersh Major of the School of Occupational Health and Tropical Medicine at Sydney University (a leading hygienist) were consulted. 8- - *.

The organic hardener also has less effect on chrome-nickel steels 7 or lead with which the cement might come in contact.

Lead In h alation - C alifo rn ia Su rvey - D r.