Industrial pneumonoconioses, with special reference to dust-phthisis / by Edgar L. Collis.

  • Collis, Edgar L. (Edgar Leigh), 1870-1957.
Date:
1915
Catalogue details

Licence: In copyright

Credit: Industrial pneumonoconioses, with special reference to dust-phthisis / by Edgar L. Collis. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    dyspnciea, which occur in cases of dust- phthisis, are essentially different in causation and character from such cases of asthma. True dust-asthma, wiiich I have seen in a pronounced form among cotton strippers, is associated witli a physical configuration of the chest, and a type of breathing quite different from those seen among operatives who experience a heavy mortality from dust- phthisis. The course of the disease was far more distressing and more liable to invalidate the sufferer than the dyspnoea described among gold-miners and others. Cotton-strippers are exposed, at one of the first processes of cotton spinning, to dust arising from cotton husk and debris which is thrown in a fine cloud into the air when the cylinders of cotton carding-machines are brushed out or stripped. The amount of dust generated varies with the grade of cotton used, and is greatest from coarser grades, particularly from Surat and some American cottons, and least from finer grades, such as Egyptian. Each spinning mill usually deals only with material of special grades, so the effect of the different amounts of dust could be studied at different mills. Thus I found (5j) among men working on coarse grades of cotton 91 per cent, more or less affected, on medium grades 72 per cent, and on fine grades 62 per cent. Exposure to this dust has unpleasant effects for a chance visitor, who, not infre- quently, suffers within twelve hours from an attack of mill fever, with sharp but transient febrile symptoms, but operatives soon become inured to such attacks. An operali\e strip- ping cotton-carding machines, after years of work, varying from Iwe to twenty, according to idiosyncrasy and the amount of dust, finds his cliest becoming affected; at first the only symptom is difficulty in breathing on Mon- day morning, or after any interval away from the dust, and after the first day is over he may remain unaffected for the rest of the week. As time passes this difficulty becomes worse and extends later and later into the week, developing into a typical form of asthma as long as he is in the dusty atmos- phere. At the same time he loses flesh and becomes thin in face and body. As the'case develops the action of the diaphragm be- comes less and less effective, until the only action of this great respiratory muscle is to fix the lower ribs. At the same time the superior intercostal muscles and the extra- ordinary muscles of respiration are more and more called into play to carry on the ordinary act of breadiing. The sternum becomes more prominent and the chest barrel- shaped. ^Meanwhile the extra tax thrown on the lungs leads to some degree of emphysema. There is little or no sputum produced, and what little there is, is expectorated with difficulty. When this stage is reached, i.e., after about twenty years' work, the individual is usually compelled to seek other employ- ment, and so, although the employment is not arduous, few old men are found at work. 1 found only 139 aged 45 years and over in every 1,000, as compared with 231 metal- grinders and 434 lace-workers. The distinc- tive symptoms experienced are attacks of spasmodic asthma precipitated by exposure to dust. The trouble is, however, rapidly disappearing owing to improved methods of dust prevention, which are even enabling affected men to resume their employment. These operatives do not suffer markedly from phthisis, though there is some slight excess late in life; but they experience a high mortality from pneumonia, and an excessive mortality from bronchitis. Other cotton-operatives, weavers, occasion- ally suffer from an acute form of spasmodic cough Avith asthmatic symptoms, but this affection I believe (90) to be due to inhalation of a special mildew which from time to time appears on cotton thread; this disease, bo\\- ever, since it is probably a form of aspergil- losis, does fall within the definition previously laid down of a pneumonoconiosis, and only calls here for passing mention. Greenhow had previously noted {j8c & jgh) that carding-room operatives, especially those who strip the cards and the card- grinders, were very apt to become asthmati- cal about middle life in proportion to the amount of dust generated which varied with the grades of cotton used; but at that time the dust, owing to hand-stripping, was not generated so freely as -when I made my inquiry, and Greenhow gives no clinical description of the disease. He did, however, describe (sSd) the same condition among fla\-hecklers at Pateley Bridge, where he