Morton M. Ziskind

Lung Function Consequences of Dust Exposure in Asbestos Cement Manufacturing Plants

A comprehensive study of health effects associated with the mixed dust exposure in this industry has included the collection of clinical, radiographic, lung function, and dust exposure data on 859 workers in two plants. Evidence is presented supporting a dose-response relationship between indexes of dust exposure and lung function, similar to the previously reported relationship with extent of x-ray film changes using the ILO U/C classification. Lung volumes and maximum expiratory flow rates decrease in relation to increasing cumulative dust exposure while pulmonary diffusing capacity (DL) is not dust-dose related. Worders who had crocidolite exposure had smaller lung volumes, lower expiratory flow rates, and reduced DL when compared with those having only chrysotile exposure. When the study population is divided into exposure groups, data thus far analyzed suggest that the chest x-ray film will reveal small opacities as early as significant functional changes can be detected, but individuals may have functional reduction prior to the appearance of x-ray film changes.

Bronchogenic carcinoma in young men

Abstract 1.1. In a study of bronchogenic carcinoma occurring in a group of thirty men less than forty years of age, it has been found that twenty-three, or 77 per cent, of the primary lesions were peripheral in location whereas only six, or 20 per cent, were situated in the lung-root zone. (One lesion was too extensive to warrant classification.) Twenty of the peripheral lesions were nodular in nature and only three produced atelectasis. 2.2. In twenty-seven of the patients in whom the histology of the growths was established, there were eleven adenocarcinomas, eleven undifferentiated tumors and only five squamous cell cancers. 3.3. The presenting symptom-patterns, bronchoscopic results and cytologic studies of the sputum were consistent with the high incidence of peripherally situated neoplasms. Twentytwo patients (73 per cent) described chest and/or shoulder pain, usually of a severe degree, eighteen (60 per cent) had cough, and only four had experienced hemoptysis. Seven patients had no pulmonary symptoms on admission. Bronchoscopy was performed in twenty-three individuals but yielded a positive diagnosis on only four occasions. Of fourteen patients whose sputum was studied cytologically, the findings were negative in twelve instances and suggestive of malignancy in two. 4.4. Because of the inaccessibility of biopsy material, the diagnosis was established by exploratory thoracotomy in thirteen cases and by necropsy in four. 5.5. The rapidity of growth and spread of pulmonary cancer in young people is reflected in a number of facts: seven patients had evidences of central nervous system metastases when first seen, eight had foci of tumor in peripheral lymph nodes and, although fourteen cases were subjected to exploration, the tumors in only six were resectable. This procedure was curative in no known case. The average duration of life from the onset of symptoms until death was fourteen months, but of greater significance in this comparatively small series was the median value of 7.5 months and the fact that only 25 per cent of the patients lived longer than a year. 6.6. These observations, as a whole, represent a marked contrast to the manifestations of bronchogenic carcinoma in old people, and it is suggested that these variations represent the effect of different causal mechanisms.

The Effect of Isoniazid on Transaminase Levels

Abstract To determine if something other than isoniazid causes the serum glutamic-oxalacetic transaminase (SGOT) elevations in isoniazid recipients, tuberculin-positive hospital employees receiving...

Early lipoid pneumonia: Roentgenologic, anatomic and physiologic characteristics

Abstract The clinical variability of lipoid pneumonia is illustrated by three cases. The evolution of the disease has been demonstrated by serial roentgenograms. Rosettes and stippling are seen on the early roentgenograms and correspond to acinar consolidations in the experimental disease. When aspiration of oil continues, recent foci of disease are found together with areas of granuloma and fibrosis. That this disease can produce significant functional disturbance has been demonstrated in an asymptomatic patient with diffusely distributed lesions. Significant restriction of lung volume with poor gas exchange was present at a time when gross distortion of the lung had not taken place. Diagnostic methods for the demonstration of oil in the sputum are illustrated and briefly discussed; an alternative method utilizing fluorescence microscopy has been introduced.

Bagassosis: A Study of Pulmonary Function in 20 Cases

Excerpt The existing literature on bagassosis contains only a few incomplete studies of pulmonary function. The need for complete studies in a significant number of cases using modern physiological...

Incomplete Consolidation in Pneumococcal Lobar Pneumonia Complicating Pulmonary Emphysema

Abstract Chest roentgenograms and hospital records of 104 patients with pneumonia whose admission blood cultures were positive for pneumococci were reviewed. Clinical characteristics, laboratory an...

Effects of Asbestos and Beryllium on Release of Alveolar Macrophage Enzymes

Rabbit alveolar macrophages were exposed in culture medium to asbestos, beryllium sulfate, and beryllium oxide. The specific activities of the lysosomal hydrolases, acid phosphatase beta-N-acetylglucosaminidase and beta-glucuronidase plus the glycolytic enzyme, phosphohexose isomerase were determined in the medium, whole-cell homogenates, mitochondrial fractions, and supernatant. These hydrolases increased significantly in the medium but not in the mitochondrial fraction of cells exposed to dusts. Asbestos and beryllium sulfate were highly cytotoxic for alveolar macrophages in vitro and the data suggested that these agents were not associated with an increase in enzyme synthesis but rather a direct cytotoxic effect at the macrophage membrane level. For induction of enzyme release in vitro, a higher concentration of beryllium oxide was needed when compared with asbestos and beryllium sulfate. The cytotoxicity and enzyme release induced by these agents may represent an important nonspecific mechanism by which they induce inflammation and perhaps local proliferation of fibroblasts.

Prolonged Survival in Lymphangitic Carcinomatosis

Abstract A 60-year-old man had documented adenocarcinoma of the prostate and lymphangitic metastases to the lung. After orchiectomy there was marked improvement documented by serial pulmonary funct...

Respirable Silica Dust Exposure of Sandblasters and Associated Workers in Steel Fabrication Yards

An increase in incidence of silicosis has been noticed among sandblasters and associated workers in Louisiana since 1950. The duration of exposure to silica dust before death among sandblasters was observed to be much shorter than in other silicosis-producing industries. To study the dusty conditions, personal exposure of workers to respirable silica dust of high free silica content was determined in two steel fabrication yards. MSA Gravimetric Respirable Dust Samplers were used for dust sampling. Determination of free silica was carried out either by colorimetric or x-ray diffraction techniques. The majority of sandblasters, in spite of wearing various respiratory protective hoods, were exposed to excessive levels of respirable silica dust several times greater than the threshold limit value. Other workers in the yards who performed a variety of jobs and who did not wear any respiratory protective devices were also exposed to excessive levels of silica dust.

The Efficiency of Protective Hoods Used by Sandblasters to Reduce Silica Dust Exposure

Several types of respiratory protective hoods used by sandblasters were investigated in two steel fabrication yards. MSA Gravimetric Dust Samplers were used to collect respirable dust samples outside and inside hoods during sandblasting. Colorimetric and x-ray diffraction techniques were applied to the samples for free-silica determination. The majority of the sandblasters, who wore various types of air-supplied hoods, were exposed to an average level of silica dust several times higher than the TLV. Sandblasters wearing non-air-supplied hoods were at the greatest risk. Modern well maintained and properly worn air-supplied hoods offered fair protection during sandblasting periods, but the concentration of suspended respirable dust in ambient air during non-blasting intervals exceeded the TLV by several times.