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53
Industrial Diseases of the Lungs—Pulmonary Asbestosis.
So many cases have of late been seen at the Clinic (as suspected
cases of pulmonary tuberculosis) of an industrial disease of the
lunges occurring in asbestos workers exposed to asbestos dust, that
special reference must be made to this condition here. A large
asbestos industry is in the neighbourhood of the Borough, and
several patients in East Ham exposed to this dusty trade have after
a varying number of years, usually between 5-15 years, developed
chest symptoms which, unfortunately, are not observed until then.
My experience of the symptoms from the cases I have observed is
briefly as follows:—
The patient first notices some shortness of breath on exertion,
on an average some 5-15 years after exposure to the dust, and
with this a dry, hacking cough, so that an unfortunate patient may
be exposed for many years to the dust of asbestos before he notices
any harmful effects. The symptoms soon become persistent and
progressive, and, after a time, following acute attacks of respiratory
trouble, to which these patients are peculiarly susceptible
during the winter months, the cough is accompanied by some expectoration.
On examination of the sputum characteristic golden
yellow asbestos bodies are found. Night sweats are not uncommon,
and wasting occurs. In fact, symptoms may very closely
resemble those of pulmonary tuberculosis. The symptoms become
progressively worse, and the degree of respiratory embarrassment
in an advanced case is hardly conceivable. The asbestos dust
produces a fine diffuse fibrosis of the lungs, which commences at
the base and spreads upwards, finally invading the rest of the lung.
It has been estimated that there are roughly over 2,000 people
employed in the industry in various parts of the country. The
degree of mischief appears to vary not only with the length of
exposure to the dust, but also, to some extent, with the process
involved, namely carding, spinning, making of asbestos mattresses,
etc. The condition has, in view of the fact that symptoms are only
observed some years after exposure to the dust, only recently
been recognised and placed on a sound clinical basis. Dr. Merewether
of the Ministry of Health has recently written a very full
report of the condition which must be carefully distinguished from
silicosis—a well-recognised industrial lung disease occurring in
workers associated with free silica dust—the dust in asbestos
workers being produced by a complex magnesium silicate.