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82 NORTH CAROLINA MEDICAL JOURNAL February, 1941 The diagnosis of silicosis requires first of all a history of adequate exposure to silica dust, and secondly, a characteristic x-ray pattern. Both must be present. Physical examination is of little value. Besides silicosis the other important type of pneumoconiosis is asbestosis, caused by prolonged inhalation of asbestos dust. It is of especial interest in North Carolina because we have approximately 500 persons in the asbestos industry, many of whom have been found to be affected. Asbestos is a fibrous mineral, magnesium silicate, which can be spun and woven into cloth, tape, brake bands and other woven products, or ground and used in paints and paper. It does not contain free silica. Inhalation of this dust over a period of years produces a different type of pathology from that of silicosis. According to Gardner the dust particles are deposited mainly on the walls of the terminal bronchioles, where they stimulate formation of a fibrous cuff. As this contracts, it narrows the lumen and finally prevents air from penetrating into portions of the lung supplied by the bronchiole in question. This eventually results in both atelectasis and emphysema. The x-ray ap^ pearance of asbestosis is rather characteristic. Over the middle and lower portions of the lung there is a ground glass appearance, tending finally to obliterate the linear markings. In advanced stages the heart outline often becomes shaggy in appearance and the excursion of the diaphragm limited. Nodulation and conglomerate areas which frequently occur in silicosis are not seen in asbestosis. Also there is no evidence to indicate that asbestosis influences the development or course of tuberculosis in any way. The most distressing symptoms are dyspnea and a rather non-productive cough, and these are usually much more marked than would be expected from the x-ray findings. The average length of exposure required for the development of asbestosis is less than for silicosis. The diagnosis requires a history of adequate exposure and a characteristic x-ray pattern. The solution of the silicosis and asbestosis problem lies in prevention, because neither disease can be cured. It is chiefly an engineering problem and requires the control of harmful dust by various methods such as exhaust, ventilation, moisture, isolation of dusty operations, good housekeeping, substitution of materials and the use of approved Fig. 4. Advanced asbestosis. This patient worked in the preparation department of an asbestos plant fourteen years. He quit work some time prior to this examination on account of dyspnea and severe, slightly productive cough. The film shows marked fibrosis throughout both lungs and typical shaggy appearance of the heart outline. The case was classified as far advanced asbestosis. The patient died a few months after this film was made. respirators. Medical examinations both before and during employment are desirable to weed out those workers who have tuberculosis or other serious lung conditions which may increase their susceptibility to the effects of dust, and all those who have developed silicosis or asbestosis to a degree which makes it dangerous for them to continue in a dusty atmosphere. In North Carolina such a program has been under way since 1935, when the General Assembly passed the Occupational Disease Act which made silicosis, asbestosis and 23 other occupational diseases and conditions compensable and required both pre-employment and routine medical and x-ray examinations of workers exposed to silicosis dust. Some 10,- 000 such examinations and re-examinations have been made to date, including the workers in practically all dusty operations in the state employing more than five people. The results of these examinations have made it possible to spot the dangerous jobs, so that now industrial hygiene engineers and industry can work out suitable control measures. It is reasonable to assume that the continuation of such a program will eventually make asbestosis and silicosis very rare diseases. Abstract of Discussion Dr. S. B. McPheeters (Goldsboro): Dust has been defined as minute particles of solid matter suspended in air, or liquids, or lying upon the surface of objects. Drinker limits dust to particles, 150 to 1 micron; smaller particles he classifies as fumes and smoke. The tissue responses to dust are irritation, inflammation, infection, allergic reaction, toxic re-
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1941 |
Identifier | NCHH-17-002 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 2 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-002.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-002 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 82 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1941 |
Identifier | NCHH-17-002-0090 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed21941medi_0090.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 2 |
Issue Number | 2 |
Page Number | 82 |
Health Discipline | Medicine |
Full Text | 82 NORTH CAROLINA MEDICAL JOURNAL February, 1941 The diagnosis of silicosis requires first of all a history of adequate exposure to silica dust, and secondly, a characteristic x-ray pattern. Both must be present. Physical examination is of little value. Besides silicosis the other important type of pneumoconiosis is asbestosis, caused by prolonged inhalation of asbestos dust. It is of especial interest in North Carolina because we have approximately 500 persons in the asbestos industry, many of whom have been found to be affected. Asbestos is a fibrous mineral, magnesium silicate, which can be spun and woven into cloth, tape, brake bands and other woven products, or ground and used in paints and paper. It does not contain free silica. Inhalation of this dust over a period of years produces a different type of pathology from that of silicosis. According to Gardner the dust particles are deposited mainly on the walls of the terminal bronchioles, where they stimulate formation of a fibrous cuff. As this contracts, it narrows the lumen and finally prevents air from penetrating into portions of the lung supplied by the bronchiole in question. This eventually results in both atelectasis and emphysema. The x-ray ap^ pearance of asbestosis is rather characteristic. Over the middle and lower portions of the lung there is a ground glass appearance, tending finally to obliterate the linear markings. In advanced stages the heart outline often becomes shaggy in appearance and the excursion of the diaphragm limited. Nodulation and conglomerate areas which frequently occur in silicosis are not seen in asbestosis. Also there is no evidence to indicate that asbestosis influences the development or course of tuberculosis in any way. The most distressing symptoms are dyspnea and a rather non-productive cough, and these are usually much more marked than would be expected from the x-ray findings. The average length of exposure required for the development of asbestosis is less than for silicosis. The diagnosis requires a history of adequate exposure and a characteristic x-ray pattern. The solution of the silicosis and asbestosis problem lies in prevention, because neither disease can be cured. It is chiefly an engineering problem and requires the control of harmful dust by various methods such as exhaust, ventilation, moisture, isolation of dusty operations, good housekeeping, substitution of materials and the use of approved Fig. 4. Advanced asbestosis. This patient worked in the preparation department of an asbestos plant fourteen years. He quit work some time prior to this examination on account of dyspnea and severe, slightly productive cough. The film shows marked fibrosis throughout both lungs and typical shaggy appearance of the heart outline. The case was classified as far advanced asbestosis. The patient died a few months after this film was made. respirators. Medical examinations both before and during employment are desirable to weed out those workers who have tuberculosis or other serious lung conditions which may increase their susceptibility to the effects of dust, and all those who have developed silicosis or asbestosis to a degree which makes it dangerous for them to continue in a dusty atmosphere. In North Carolina such a program has been under way since 1935, when the General Assembly passed the Occupational Disease Act which made silicosis, asbestosis and 23 other occupational diseases and conditions compensable and required both pre-employment and routine medical and x-ray examinations of workers exposed to silicosis dust. Some 10,- 000 such examinations and re-examinations have been made to date, including the workers in practically all dusty operations in the state employing more than five people. The results of these examinations have made it possible to spot the dangerous jobs, so that now industrial hygiene engineers and industry can work out suitable control measures. It is reasonable to assume that the continuation of such a program will eventually make asbestosis and silicosis very rare diseases. Abstract of Discussion Dr. S. B. McPheeters (Goldsboro): Dust has been defined as minute particles of solid matter suspended in air, or liquids, or lying upon the surface of objects. Drinker limits dust to particles, 150 to 1 micron; smaller particles he classifies as fumes and smoke. The tissue responses to dust are irritation, inflammation, infection, allergic reaction, toxic re- |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-002.pdf |
Document Sort | all; nchh-17 |
Article Title | Pneumoconiosis |
Article Author | H. F. Easom |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-002 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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