TABLE I. Table I.-Notification of Lead, Phosphorus, Arsenical, Mercurial, The principal figures relate to cases, the raised figures to deaths. Fatal cases not reported in previous years are included as both cases and deaths. Lead Poisoning.-The number of cases is less by 160 than that of last year, the reduction being due specially to noticeable falling off in incidence in ship-breaking and electric accumulator manufacture. In shipbreaking, the fall, unfortunately, is not ascribable to any large extent to the increased ability on our part to control. the cause (absorption into the lungs of volatilised lead) but rather to the lighter class of vessel now being broken up, which is not so (25592) C 3 heavily coated with lead paint; and partly also to the fewer numbers employed in the industry. Alternation of employment, however, in burning-one week in three off-with ordinary work in the yard, carried on in the open air, is said to have brought about considerable reduction in illness in one yard. The men themselves, however, at first strongly objected to undertake the heavier and more strenuous work in the yard as an alternative to the light work of burning, notwithstanding the danger attaching to it. A memorandum on the risks in the occupation, with suggestions as to the preventive measures practicable, was widely circulated early in the year. The revised Regulations for the Manufacture and Repair of Electric Accumulators came into force in March, and while the figures show that an impression has already been made by them their effective enforcement requires meticulous attention to detail owing to the extensive handling of the plates that takes place, with evolution of dust from each movement. So apparently simple a matter as cleanliness of floors and benches-which can only be effectively secured if the workrooms and benches are kept as clear as possible of obstructions-seems to give more trouble than the provision of elaborate systems of ventilation. While the number of cases in the pottery industry is the same this year as last, the deaths, it will be seen, are fewer-only five this year as compared with 18 last. An opinion had been expressed by a workers' representative on the National Council of the Pottery Industry that pottery workers in lead processes appeared to live longer now than they used to. The ages of those reported as having died from lead poisoning were compared in quinquennial periods from 1900 to 1924 and the figures below suggest prettily enough an average life now 10 years longer than it was 25 years ago, if not for the lead workers in the pottery industry (the small figures hardly justifying so wide a generalisation) at any rate for those who succumb ultimately from the effects of plumbism. This speaks well for the time, money, scientific and inventive genius shown by all concerned during the period in question. The table deals with males only; the number of deaths in females is very much smaller-39 in the period in question, as compared with 163 among the men. Average age of fatal cases of lead poisoning in the China and Earthenware Industry (Males only) over a number of years. Reference to an inquiry into the pottery industry is made later under the heading of " Dust," on page 75. Draft Regulations to apply to the use of lead paints in painting of vehicles were prepared and issued in conformity with the recommendation of the Paint Committee's Report of 1923. Apart from the danger of lead poisoning in this industry, paint spraying in the motor-car industry especially-has been enormously developed, fortunately, however, with the use of leadless colours as the safest and wisest precaution. The excipients of the cellulose coating-amyl acetate, butyl acetate, methylated spirit, a proportion of benzol and turpentine-require attention in the way of exhaust ventilation and fire prevention, but they do not carry with them the same risk to health as if lead colour were used. The absence of lead in paint spraying in the motorcar industry was abundantly shown by the occurrence of lead poisoning during the year in the spraying of articles made of cane and basket-work, painted to suit customers' tastes. Spraying apparatus, in cabinets provided with exhaust ventilation, was used; only one of the paints contained a lead compound, but, to obtain the desired results, many of the paints were mixed with white lead. Two cases of lead poisoning occured to men employed in sawing wood heavily coated with red lead and paint, removed from broken-up ships. The other men employed showed evidence of lead absorption. Locally applied exhaust ventilation had to be installed on all the machines where this wood was being dealt. with, and a periodic medical examination instituted. The manufacture of lead tetra ethyl and its addition to petrol in the United States gave rise to widespread apprehension as to the possibility of a general lead poisoning of the inhabitants from the exhaust gases, which has not been felt in this country. In the United States some 149 cases (with 11 deaths) occurred in the course of manufacture of this organic lead compound, and lead poisoning as we have never experienced it in this country, assumed the severest form it can take, namely, lead encephalopathy (brain symptoms). The Report of the Committee appointed by the United States Public Health Service to present a statement as to the health hazards involved in the retail distribution and use of tetra ethyl lead gasoline motor fuel makes it appear that the danger is limited to the processes of blending and ethylising in the manufacture of the substance. (in the absence of meticulous attention to detail) as this organic lead compound is absorbed directly through the skin; and expresses the opinion that "there are at present no good grounds for prohibiting the use of ethyl gasoline, provided that its distribution and use are controlled by proper Regulations.' * Report, dated 17.1.26, of the Committee appointed by Surgeon-General H. S. Cumming, United Public Health Service. (25592) C 4 The number of cases among house-painters and plumbers which came to the knowledge of the Department (notification is not obligatory) was 100 (12 deaths). Of these, 88 (9 deaths) occurred to house-painters, and 12 (3 deaths) to plumbers. House-painting, therefore, is shown to be easily first of the occupations giving rise to lead poisoning in this country. Comparison of these with the total cases of lead poisoning contracted in factories (326) shows that among house-painters in 1925 the cases were twice as severe as factory cases, the amount of chronic poisoning was four times as great, and incidence of the severe. symptom of paralysis also was greater. Arsenic.-Five of the cases were due to dermatitis and ulceration, most of them contracted in sheep dip works (from the use of white arsenic), but the remaining one was a case of epitheliomatous ulceration in a man, aged 48, who had begun work when 14 years of age and continued for 19 years in emerald green, at a time when the process was not controlled, as it is now, by automatic methods and locally applied exhaust ventilation. For the last 14 years he had been employed in a paint and colour works, with only very slight exposure to arsenic. The tumour was situated in the axilla. There still remained pigmentation of the skin of the abdomen and other parts of the body. Carbon Bisulphide.-Two cases occurred in the cold cure process in the rubber industry and the other—a very acute case, the symptoms being headache, vomiting, delirium, loss of muscular power, and almost complete anaesthesia (loss of sensation) from which he has only made slight improvement- in the manufacture of artificial silk. Dr. Henry and I shortly afterwards. (on different dates) examined some 12 men similarly employed in artificial silk and noted in several of them symptoms of absorption, such as headache, gastric disturbance, distaste for food, lassitude and depression. In the factory in question considerable attention had been given to the question of ventilation, but at the machines where carbon bisulphide was used this had not been sufficiently locally applied. This has since been remedied. Other effects on health in this very important new industry have been noted-e.g. irritation of the eyes from minute proportions of hydrogen sulphide gas present in the air in spinning rooms, and effects on the skin from the acid used in spinning. Aniline. Of the 31 cases, 25 occurred in chemical works where aniline compounds or intermediate products, such as di-nitrobenzene, etc., are manufactured, and six in bleaching, dyeing and printing works. In two of the cases (one fatal) in chemical works, tumours of the bladder led to notification. It was not quite clear in either of them that employment in the occupation had induced the growth.* Several of the cases showed the rapid way in which aniline, either as a liquid in the form, e.g. of aniline oil) spilled or splashed on to the clothes, or falling as dust (e.g. in the packing of paranitranilin) is absorbed by the blood directly from the skin. Arrived there, the aniline causes changes in the blood, and prevents the proper supply of oxygen to the tissues. Thus, Dr. Henry reports on one man who prepared and diazotised dianisidine in a print works; he suffered from dyspnoea, vomiting and unconsciousness for half an hour, while another had a similar attack from contact with paranitranilin. Toxic Jaundice.-Two cases (one fatal) were due to poisoning by AsH, gas contracted in the treatment of zinc flux containing a small proportion of arsenic residues with sulphuric acid (the symptoms were typical-haematuria followed by coppery jaundice and death from suppression of urine).† Anthrax.-The figures in Table I do not bring out very clearly the noticeable diminution there has been in the fatality of anthrax, due, no doubt, first, to greater knowledge of the appearances of anthrax-through the illustrated placard-and consequent earlier medical treatment; and, secondly, to the valuable effects of Sclavo's serum treatment. Excision of the pustule is never practised now at the Bradford Royal Infirmary or Dewsbury Infirmary. This diminution is brought out best when, as in the following table, the figures are grouped in quinquennial periods, and it is very much more marked in wool and hides and skins (a reduction of more than one-half) than it is in horse-hair or other industries. In other industries, and perhaps also in horse-hair, anthrax is less likely to be recognized. The fatal case is as follows: R. J., aged 41, collier 19 years, in Army 4 years, in dye works about 7 years. He acted as colour drier, removing colours in paste form from casks and spreading them on trays for the stove and removing dry colour from stove and emptying into casks. Stated to have used acid wool colours, direct cotton colours, a preponderance of azo colours, and during the last two years rubber accelerators (di-phenyl- and tri-phenyl-guanidine and thio-carbanilin) to a limited extent. He may occasionally have dried a naphthylamine sulphonic acid (peri acid). The second case was : A. S., aged 51, operated on for papilloma of the bladder; engaged in drying colours. The colours included a few azo colours and a few basic colours, e.g. acridine orange, and indine blue. As a boy he worked as a reacher-in" at a cotton weaving factory, after which he was employed for 5 or 6 years at a dye works. The following amounts of arsenic, expressed as trioxide, in parts per million, were found in the viscera by W. Collingwood Williams, County Analyst, Liverpool: Liver, 3.75 parts (equal to th grain in the whole organ); Spleen 3.5 parts; Brain, 2·0 parts: Hair, 45·0 parts: Nail, 45·0 parts. |