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    "localId": "75720556",
    "label": "Report to [A. Roeder], January 28, 1926",
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    "id": "75720556",
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    "contentType": "document",
    "title": "Report to [A. Roeder], January 28, 1926",
    "citationUrl": "https://catalog.archives.gov/id/75720556",
    "collections": [
        "Safety Light Collection",
        "Records Related to Radium Dial Painters"
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    "seq": 24,
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    "ocrText": "Radium- Thorium Poisoning.\nSeven girls employed at one time in painting dials with a luminous material\nhave died with pathologic conditions that require some explanation as to the cause\nto which\nand an examination of the exposure they, were sybjected to. The pathologic condition\nhas\nreferred to consisted of a mecrosis of the jaw which have been observed to generally\nfollow the removal of a tooth or dental intervention in the form of treatment of some\nkind. Severe anemia sets in terminating in death. This holds true for six of the cases\nThe seventh case did not develop# anemiosis of the jaw, but showed the anemic condition\nIt is commonly reported by her associates thatshe had eaten sea food the Sunday before\nher death which had rendered her ill. Besides the cases which have resulted in death\nthere havebeen several cases of jaw mecrosis among the girls that have been success-\nfully treated.\nThis mecrosis of the jaw in these cases APD said to differ from phosphorus poison-\ning or ordimary mecrosis or typical osteomyletis only in the mumber of areas involved\nin the first place, and the remote location of the areas from one another generalized\nbony involvement. After operative procedure these cases usually take OR a. very rapid\nform of mecrosis which necessitates operative procedures at weekly periods in order\nto out down the sepsis. In the later stages of the disease these necrotic areas pre-\nfaction\nsent 8. liquidfication which resembles more or less of a. gelatinous character rather than\na. bomy disinte/gration. One dentist speaks of a. case which he has successfully treated\nas alow grade infection of the mandible. This mecrotic condition differs in his 0-\npinion from the ordinary necrosis found in the jaw principally in the fact that it\nor\npresisted over such a. long period of time and showed 3. tendency to recur unless free\ntrainage was at all times maintained, Meaning by this that if the wound appeared to\nclean and was allowed to heal as in the ordinary case it would close up and them\nshow a recurrence of the condition. In the\nOrdinary mecrosis of the jaw is far more common than generally admitted but its\n2.\nPronosis is very good under proper treatment. Necrotic conditions have been found to\nexist in from twenty to thirty eases in a. dental elimic treating from 5000 to 6000\npaients per annum. Necrosis is a death of the tissue and must not be comfused with su ch\nforms of bone destruction as caries or suppurating osteitis in which the bone is des-\ntroyed by progressive cellular disintegration. In phosphorus jaw we have the actual\n37\nattacking of the tooth tissue. Thorpe found that fumes of phosphorus would destroy O.\nper cent of the weight of the tooth in twelve hours in cases of decayed teeth. As far\nas we know radium has no specific action on these tissues. The etiology of jaw mecro#\nsis is fairly well understood and includes systemic infections such as syphilis, tube\nberculosis, scarlet and typhoid fever. Imorganie poisons and drugs may act either by\nlocal applications or systemic absorption, as phosphorus, arsemic, mercury, hydrogen\nperoxide. Radium and X-ray treatment have been known to cause mecrosis. Besides den-\ntal lesions such as alveolar and pyorrhea alveolaris, to large proportion of the cases\ncocaine was\nhave their gemesis in the dental work. It was more common when used as 8. local anes-\nthetic.\nUnfortunately some of the cases under discussion are complicated by such things as\njoint trouble, diabetes and syphilitic conditions. Vincent's Angina was also present.\nThe question as to how commonly the early stages are to be found in other girls\nthat have worked in this industry is a matter of dispute. Several of the dental sur-\ngooms who have treated these girls claimed to have detected the incipient stages in t\nthe X-ray pictures of the jawa of a large mumber of the workers. Other competent sur-\ngeons who have examined the same films deny that any bone changes have taken place.\nSeveral of these suspected cases have had abseessed teeth which attending demtistere-\nfused to extract because he was afraid of starting at mecrotic condition. These teeth\nwere extracted by other demtists, the gums healed normally and no signs of any trouble\never appeared. It may be stated that the girls as a whole were worked up to such 9.\nstate that they were afraid to have any dental work done.\nAt the time I was called to investigate the possibility of OUR unsuspected in-\ndustrial hazard in the dial painting industry, the plant which had employed the girls\nso far discussed had practically shut down and it was impossible to make a. thorough\nexamination of their working conditions under the average working day condition. For-\ntumately Dr Cecil Drinker had made such a. survey when the attention of the plant officials\nwere first called to the suspected hazards. Dr Drinker's conclusions briefly were\nthat the condition arose from the girls' habit of pointing their brushes between their\nlips and thus permitting the ingress of small amounts of radio-active material into\nthe oral cavity. From his own work with zinc, he was inclined to lay the whole blame\non the members of the radium family present in the luminous paint.\nIt has been estimated that about two thousand girls had been employed in dial\npainting at the peak of the industry and my inquiries among the employees of different\nconcerns have failed to reveal a single case that was similar to those observed among\nthe employees of the Orange plant. Moreover we have made inquiries in England and other\nEuropean countries and find that there is no record of any jaw necrosis among their\ndial workers. It is interesting to note that my foreign correspondents call attention\nto the fact that the employees are warned sinced the cases reported in Orange against\npointing their brushes in their mouths. At least we may assume that this habit was uni-\nversal both from European reports and from my own observations in fac tories in this\ncountry.\nhas\nThe Orange Plant have had approximately 375 girls employed in dial painting at\ndifferent times. The number of girls employed at any one time varied with the work.\nFor this reason the number varied any from a. dozen to over two hundred.\nThe average employee remained with them from one to two years, while some of the more\nsteady continued the work five or six years. No cases were reported to the company\nuntil I923 when it was thought that one of the girls condiitions might be explained\nby her previous employment. She had left the employ of The Orange Plant three or\nfour years previously.\n4\nI was impressed in looking over the available data by the fact that all of the\ngirls who have died worked in the plant between the years 1917- 1920 and in some cases\nhad been away from the plant several years before pathologic conditions appeared. The\nquestion naturally arises as to whether there had been any change in the mixture in\nwere\nthat period or whether there were other shop conditions or infections present that was\nnot present in the later years or at other plants,\nThe luminous paint used in this work consists of a specially prepared zinc sul-\nphide mixed with small amounts of виррахх thorium-radium and very infintesimal amounts\nof copper. The zinc used is prepared from the best grade of zimc subphide obtainable\nby repeated precipitation. The radio-active compound is added in a soluable form to an\nemilsion of zinc sulphide and precipitated out with an alkaline sulphate with constant\nof\nstirring. It is hard to conceive the radium or thorium sulphate formed P.S. being in any\nthing but almost colloidal condition which must be adsorbed by the zimo sulphide. Th®\namount\namount of radium thorium present varies according to the grade of material required,\nbut it varies from 0.7 of a milligram to 3 Or 4 milligrams per hundred grams of zinc\nsulphide, When used this material is mixed with an adhesive compound by the girls in a\nsmall TO 00 porcelain crucible with a glass rod and then thimmed out with distilled\nwater. The girls are rather emergetic in their mixing and I have noticed droplets of\nthe mixture on their persons and clothes as well as OR the benches. Also in holding\nthe crucible with one hand during the mixing some of the paint got on the hand used to\nhold the container. The girls could be seen touching their hair and other parts of the\nbody with this hand and it was surprising how luminous these portions of the body became\nwhen flashed and them observed in a. dark room. The aprons which the girls wore were ob-\nserved to shine all over when returned from the laundry. We felt as if the paint had bm\nbeen 11 set II in the washing process. We have never been able to detect any luminousity\nany wheres except where actually contact with the paint by means of the brush, hands or\nsplashing could not expèatnit.\nThe girls apply the luminous paint to the dials with small camel hair brushes.\n5,\nIt has been their custom to point their brushes between their lips after applying it\nto the dial and dipping it in water. Many decorative painters of glass and china have\nthe same unsamitary habit, which has been the scource of lead poisoming. The number of\ntimes that any girl would put the brush to her mouth depended OR the individual. Pro-\nbably it was anywhere from two or three times a day to as many times for each dial\npainted. We learnt that the each girl W&S given her OTHER brush, that they often took\neach others brushes and of course this habit furnished an excellent method for conveying\ninfection. The amount of paint that a girl would use a day again varied with the type\nof work being done. It would be fair to say that an average amount would be 6 grams.\nTo got some idea as to the amounts of paint that 1 girl might possibly get into\nher mouth, four girls were requested to point their brushes on cloths which we collected\nand examined. The girls were also instructed to keep tract of the amount of paint that\nthey used in that time. Our results are as follows:\nC.M. Paint used I gram\nPaint on cloth 0.043 grams\nradium contents .00053\nmg.\na\n2 It\nIf\n#\n#\n0.205\n\"\n\"\nL.P.\n.0026\n#\n\"\nIf\nN\nit\nA.D.\nn\nIO \"\n0.342\n.0043\n=\nIO #\nn\nn\n#\n0.512\n#\n\"\nB.W.\n.0065\n#\n\"\nto\n0.576\n#\n#\nAverage for IO grams\n.0072\nThe paint that these girls were using Was supposed to contain 2.66 mgs of ra-\ndio-active material to IOO grams of zimo sulphide.\nIt is commonly reported that some of the girls # fairly ate It the material and\ndid $0 because of the feeling that if radium WS.8 0. oure for cancer they would never\nget it. It has been suggested that the habit of pointing the brush in the mouth is to\nblame for the jaw trouble; that particles of radio active material became lodged be-\ntween the teeth or in the roof of the mouth and caused an irritation that ended in ne-\ncrosis. This explanation has never bran proven satisfactory to us because of the common\nused of the tooth brush these days and the passage of fluid through the mouth. If a par-\nticle did become lodged in these places temporarily it must have been of such infinitesi\nthe\nimal quanitty as to make it seem highly impossible to cause the irritation necessary\nto end in mecrosis. Another theory that has been advanced is that the particle of radio-\nactive substance may get into the bone through the open spaces in the cancellous strue-\nture connected with pyorrhea. The X-Ray has shown open cancellous spaces connected\nwith pyorrhea. It might be possible that during an almost daily exposure that some ab-\nsorption of radio-active particles did take place just as pus or infectious germs are\nabsorbed in these pyorrheal open spaces. Statistically this does not seem probable as\notherwise we would expect to find other cases reported among the thousands of girls\nwho had the same general habit of pointing their brushes. The dentists who have treated\nthe girls employed at the Orange Plant admit that pyorrhea existed in almost all of the\ncases.\nWe studied the irritating effect of the luminous paint OR guinea pigs and humans.\nThe sides of a number of pigs were shaven and painted daily with the luminous paint\na\nfor two weeks. We could not detect the reddening of the skin either during the time that\nthe paint was being applied or at any time after the exposure had ceased. Three of us\nin the laboratory painted an area on our arms with the paint and permitted it to re-\nmain on the skin for twenty-four hours. No erythema develop at any time after the re-\nmoval of the paint though the observation was continued over two weeks. The gums of a\nnumber of guinea pigs and several goats were painted daily for a period of six months,\nmas noted\nno\nbut d uring that time any redness of the gum. One of the goats lost two teeth at differe\nent times and we took pains to rub the paint into the guras until the new tooth came\nthrough. Our observations were negative. Unfortunately this goat broke its leg and was *\nkilled and cremated during our absence thus preventing 118 from examining the jaw bone.\nAn X-Ray picture taken previous to the accident gave a negative reading. One of course\nmarked\ncould not expect to find any bone change in six months and 8. series of animals should\nbe studied over a period of years. This is especially true if intravenous injections\nof radio-active material is to continue.\nThe radium thorium sulphate is a. hu ndredo times less soluble than barium\n7.\nsulphate. The question arose in our mind C.D to whether any of the radium material\ncould be absorbed through the intestinal walls. We fed three guinea pigs 100 mgs.,\nof luminous paint containing 2.90 mga., of radium material per hundred grams of paint\nmuto the stomach\ndaily by placing the powder down its throat and then washing it down with the minimum\nant\namount of water. The pig was watched to be sure that it did not spit any of the material\nout. This was kept up until each pig had ingested two grams of theopaint. Ten days\nafter the last dose the pigs were killed with ether and dissected. None of the organs\nshowed any signs of the treatment. At the beginning of the experiment the pigs were\nquiet, but after several days became active and ate very freely. The foces and urins\nwere collected and tested forvradio-activity. The organs were examined separately, but\non\nthis does not mean so much for We did not drain the body of its blood before dissecting\nIn determising the radio activity a specially constructed type of Alpha ray electro-\nscope was used. First the natural drift, that is the time required for the quartz\nfilm to pass over a definite number of divisions in the eye piece was determined, with\nthe physical conditions in the instrument the same S.S when the sample was to be read.\nThe sample was them introduced and the time required determined for the quartz fibre\nto pass over the same divisions as used in the natural drift. It is obvious that any\nchange in the rate of movement of the fibre must be ascribed to a change bnoughtrabout\nby the iomization of the air within the chamber due to the presence of radio-active\nsubstances.\nWe are giving our average determinations on the three pigs in the folbowing table;\n8.\nOrgan\nDry Weight\nMirro gram radium element per gram\nof material.\n-4\nHeart\n3.4189 grams\n5 X IO 1\nLungs\n3.4618\n4.6X I04\nBrains\n3.3708\n2 X IO\n4\nSpleen\n2.9406\n2.5 X IO\n-3\nLiver\nI2.129I\n2.5 X IO\n-3\nKidney\n4.035\nI.6 X IO\n-3\nMuscle after burning 10.50\nI.6 X IO\nBones after burning 12.30\n.02 micro grams.\nTo feces for the first TO days contained I.55 micro grams per gram burnt material\n\"\nIf\n\"\nsedond \"\n17\nI.75\nn\n17\n\"\n17\n17\n13\n11\n\"\n*\n11\nIO days after exposure 0.23\n2\n\"\n\"\n\"\nIf\n19\nT. The @ urine samples remained more or less constant for the entire period and contained\nX\nradium element equivalent of 2.5 micro grams per gram evaporated material.\nTᵃᵉ original material contained by amalysis .058 mg* radio-active material in the two\ngrams fed the pig.\nOur results indicate that 97.85 per cent of the material ingested in twenty days\nmae\nis eliminated by at the end of ten days after the exposure had ceased. Or 2.15 per cent\nd\nhad been absorbed xxd through the alimentary tracE and still remains in the body.\nFive pigs whose jaws had been painted regularly each day for a. period of tin months\nduring which time each pig had received D.M. estimated dosage of three grams of the lumine\nous paint containing 2h66 mg* of radio-active element per IOO grams, were killed two\nopper celing the\nmonths after the last of paint. Their bodies were burnt to an ash and these ashes ex-\namimed with radium element equivalent with the following results.\nAnimal Scale Div. Read\nIst reading\n2nd Reading\nAverage.\nBlank\n60 - 50\nI97 sec\n197 see\n197 $30\nA\nII\nI94\nI88\nI9I\nIf\nB\nI95\n200\nI97.5\nBlank\n\"\n199\nI95\nI97\nC\nn\nI94\nI95\nI94.5\nD\nII\n194\nI96\nI95\n$\nn\nT98\nI98\nI98\nBlank\n11\nI98\nI97\n197.5\nA repeated\nIf\nI9I\nI92\nI9I.5\nblanks are normal pigs killed and treated the same way as the radium pigs.\n9.\nThe tests were made by alpha ray comparison which is considered very sensitive for\nfhe detection of radio-active material. Pigs B and 3 show NO radio- active material\nPigs C and D give a. slight indication of its presence, the the time required for a de-\nfimite drop in potential is so small as to raise the question of experimental error.\nPig A shows a. definite amount of radio-active material even if minute in quantity.\nThat there is 2. retention of radium-thorium material for some time after the ex.-\nposure is indicated by RR examination of the tissues of several persons who have worked\nwith the material. It is estimated that in the 08.89 M who had worked in the industry\nthe\nto within several months of her death that her boxes contained .200 mgs of radium equi\nlemt\nalent. The tissues of S, man who had been engaged in weighing and handling the CONCOR-\nmith am\nthe\ntrsted material and his exposure THE many times greater than the case M. Horever he\nnew of annual\ndid not have much exposure during the last year of his life. It is estimated that his\nN\ntissues contained .048 mga at the time of his death.\nlung\nWe HOW made an examination of persons who had been employed or were still en-\nployed in radium work. These persons were instructed to take a very through bath the\nmight before the test and to report at my office dressed in clothes that had never\nbeen worn in the factory or laboratory. A person who had nover worked in radium you\nmar\nused AS a control. From time to time a known quantity of radium were placed under the\nperson being examined and readings taken. The person being examined yes requested to\n0\nlie flat on the back in a. comfortable position and the electracope placed directly\nover the chest and readings taken as described. The results given below are given\nin the number of seconds divisions the quartz fibre will move in one second.\nB At present painting dials.\n.0026I dèv.\nL\n2\n\"\n11\n#\n.00266 #\nF. Control\n.00267\n2nd Day.\nS Has not worked in plant for six months\n.00849\nF\nIO.\nF Control\n.00831 Div\nS with IO micro ampule placed under her back\n.00903\nC Working in crystallizing room\n.00889\nF. Control\n.00844\n3rd Day.\nF Control\n.00322\nF Contro with two IO micro gran ampules placed under back\n.00545\nF Control with IO micro gram ampule under back\n.00430\n.00545 minus .00322 equals .00223 div. per sec for 20 micro grams radium\n.00430 11 .00322 2 .00108 div per sec for IC\n#\n11\n11\n4th-day\n4th Day.\nS ᵉ Engaged in plant\n.00279\nDuplicate test\n.00271\nF Control\n.00229\nDuplicate test\n..00225\nJ. Working in plant\n.00448\nWith 20 micro grama radium at knee\n;.00484\n\" 20 \"\n:\nunder back\n.00655\nF Control\n.00253\n4\nF\nA test of the expired air of * R.B. compared with the expired air of showed a.\nslight but definite signs of emanations.\nIn addition to the above tests we have examined five girls who are engaged in\npainting dials in another plant but in each case we could not detect any imcrease over\nmeand\nmer\nthe control, but each gave the same readings when a five micro gram ampule T-SDG placed\nher\nunder their backs.\nFrom our observations we feel that WG are able to detect the presence of radium in\nthe living organism without much trouble if all of the precautions are taken as to con-\ntrols etc. In the case of the last five girls we controlled the five ampule readings by\nobservations on G. guinea pig into which we had injected the same amount of radio-active\nmaterial.\nat\nOne may deduct from the above information that persons around a. crystallizing\nplant or where a. person may come in controt with the concentrated material daily a small\ndeposition of radium material may take place in the body This may be the result of\nthe\nbreathing in some of the actual material or as one of the decomposition products of\nemanations breathed in. inhded\nII.\nThe first indication of an exposure to radiations is generally found in the blood\npicture. Among the changes noticed are:\n(I) the rapid and profound destruction of lymphocytes, noted even with relatively\nshort exposure.\n(2\" ) the destruction of red corpuscles under prolonged exposure,\n(3/h ) the signs of blood destruction and lack of regeneration in the bone marrow\n(4) Modification of the normal relations between corpuscles and plasma resulting\nin the formation of non- corpuscular intravascular thrombus or fibrin formation with-\nin or outside the vessels.\nMottram calls attention to the fact that the red cells are not S.S sensitive to\n+\nradiation as are the leucocytes and R sustained low level of the later should be con-\nsidered as an indication of undue exposure to rediation. In fact be places NO much\npersons\nand\nemphasis OR this feet that he recommends that presented of consistent white count be\nlow 6000 should be removed from the exposure until the blood has become more normal.\nWith this knowledge we examined the girls in 8. number of factories and had some\nexamined for us in England. Because of the statement that the conditions of the em-\nployees of the Orange Plant were due to thorium, we purposely only made examinations\nmer\nin those plants that brought their material from the Orange Company. Thus we avoided\nfrom the hant as\nthe criticism that the girls we reported on did not have the same exposure that the\ngirls who had developed necrosis worked with as far RE the luminous point went. As far\nas wedenow this paint is the ame as has been used at all times. Hofmann reports that\nhe examined sixty girls using radium paint and found no indication of 111 health\nminhal\nmong them. I have talked with several girls who worked in one of the plants that he\nmade his examination 1/2 and got the same report as to pointing the brush in the mouth.\nThe girls all wore demtal films for us while others were placed around the shop or\nroom in which they worked. The films on being developed showed that they had the same\nattached\nexposure as the girls in the Orange Plant. We are inclined not to place much importance\nI2\nto the films because of the personal; habits of the girls discussed earlier in this paper\nand to the fact 9.8 is shown later on that un infinitesimal amount of the paint will caus €\na fogging of the film.\nEach girl was given a good physical examination, especial attention being given to\nan inspection of the gums and roof of the mouth. metances X-Ray examinations were made in notto\nw\ncases were possible but were negative in all engres. The gums of the girls as a rule were\nin a most excellent condition which seemsto be contrary to the girls who had trouble.\nIne girls were questioned about any dental work that had been done since seen they begin\ndial painting, especially as to axtractions. We found one girl who lind five years in\ndruble\nthe industry and who as the result of nn automobile accident had a compound fracture,\nThe bone healed in due season and nothing out of normal was noted.\nTo general findings are given in the following table. We have not included in\nour findings those of the girls in England but have presented them in a separate table.\nFor comparison sake we have also given the blood picture of two men over some months who\nhave been actively engaged in the crystallizing room of & radium plant. It is to be\nNo\nnoticed that the blood picture of these two mon one quite typical of radium exposure.\nWeight General Years Teeth ex-\nBlood Hb.\nchanges Appear-\nEm-\ntracted\nin\nMenstrual\nPres-\nDate\nColor\nRed\nWhi\nName Age in 6 mos. ance ployed this period changes Pulse sure\n(corr.)\nIndex\nCount\nCoun\nA.R.\n33\n+ 6 lbs.\n+\n10\n+\n0\nn\n96\n110/80\n102%\n1.06\n4.86\n10,000\nE.H.\n24\n0\nt\n1\n0\n74\n118/70\n94\n1.02\n4.61\n8,800\nA.M.\n34\nO\n+\n4\no\n120\n138/70\n96\n.9+\n4.92\n7,800\nI.H.\n22\n0\nslightly\n9\nO\n88\n118/66\n90\n1.00\n4.54\n9,200\nA.D.\n25\nO\n1\nO\n96\n106/74\n93\n1.01\n4.64\n6,000\nF.D.\n22\n0\n0\n0\nso\n127/87\n96\n.9t\n5.03\n6,500\nL.M.\n21\n110\n2\n64\n112/72\n94\n.9t\n5.15\n10,300\nR.C.\n22\n0\n0\n0\n84\n118/73\n105\n1.05\n5.02\n8,500\nR.M.\n25\n-9\n-\nand\n72\n120/80\n99\n1.01\n4.97\n8,200\nC.S.\n21\n-6\n0\n84\n110/70\n103\n1.05\n4.99\n8,700\nF.P,\n20\n0\n0\n70\n98/70\n99\n1.03\n4.87\n7,100\nH.M.\n22\n-2\n1\n76\n144/90\n106\n1.104\n4.86\n1 1,200\nA.D.\n21\n-4\no\n70\n123/80\n97\n.9t\n5.03\n7,400\nM.S.\n21\no\n70\n132/88\n97\n1.01\n4.80\n9,500\nM.D.\n25\n+3\n2\n84\n132/84\n99\n.9t\n5.02\nA.H.\n35\n0\n2\n72\n124/94\n105\n1.05\n5.09\n9,100\nB.W.\n18\n-5\n1 1½ minim 8 3 4 4 2 2 2 2 2 2 2 2 2 2 2 2 1a 1, 1 1 1\n78\n120/60\n101\n1.07\n4.71\n7,000\nJ.M.\n23\n0\nO\n92\n113/83\n100\n1.02\n4.94\nmismismist\n10,400\nE.B. 19\n-8\n0\nO\n78\n124.76\n100\n1.02\n4.96\n6,200\nH.M.\n20\nO\n2\n108\n120/78\n103\n1.05\n4.93\n7,700\nL.L.\n17\n+5\n3\nO\n80\n132/70\n97\n1.03\n4.77\n10,000\nH.M. 19\n0\nO\nO\n76\n114.70\n110\n1.05\n5.26\n8,30\nD.D. 22\n0\n0\nO\n96\n112/84\n96\n1.02\n4.73\n8,80\nE.M.\n19\n0\nF.\n2\no\n96\n132/90\n98\n1.00\n4.91\n10,00\nR.A.\n18\n0\nO\n0\n90\n116/72\n103\n.9t\n5.22\n9,80\nA.M.\n17\n+3\n0\n0\n78\n131/94\n97\n.9t\n5.06\n10,50\nB.E.\n26\n0\nO\n0\n70\n122/84\n106\n1.06\n5.08\n7,40\nB.B.\n26\nt3\n0\n0\n78\n128/88\n100\n1.04\n4.88\n8,50\nA.S.\n18\n0\n0\n80\n143/80\n102\n1.02\n5.09\n10,60\nU.M.\n15\n#4\nPale\n0\n88\n130/78\n99\n1.03\n4.89\n9,80\nD.C.\n18\n0\n0\n104\n128/82\n103\n1.00\n5.10\nJ.L.\n19\n0\n0\n116\n122/78\n100\n1.02\n4.95\n10,90\nE.M.\n/10\n88\n106/66\n95\n4.75\n9,70\n20\n1/ #\nO\n1.01\nL.P.\n18\n0\nO\nO\n78\n118/70\n100\n1.06\n4.75\n8,90\nE.B.\n21\n0\nXXXX\n1\n140/90\n.94\n6,50\n76\n101\n5.15\nG.M. 22\n0\n2\n0\n70\n122/80\n107\n5.16\n8,90\n1.04\n9,10\nN.R. 17\n0\n0\n70\n108/73\n101\n1.05\n4.77\n9,90\n(large)\n(Medium)\n(small)\nLarge\nWhite Neutro- Lympho- Mononu-\nUnclass-\nCount\nPhiles\ncytes\nclears\nEos.\nBaso.\nTrans.\nified.\n10,000\n60%\n26.5%\n10%\n1.\n%\n0%\n1. %\n0.5%\n8,800\n54.5\n29.7\n13.7\n0.7\n0.5\n0.25\n0.5\n7,800\n70.5\n22.\n4.5\n2.\n0\n0\n1\n9,200\n62.5\n28.\n7.5\n1.\n0.5\n0.5\n0.\n6,000\n60.\n25.5\n10.\n2.\n0.\n2.5\n0.\n6,500\n65.5\n24.\n6.\n3.\n0.5\n0\n1\n10,300\n61.\n27.\n6.\n4.\n1.\n0\n1\n8,500\n65.5\n26.\n4.5\n1.5\n1.\n0.5\n1\n8,200\n69.\n25.\n3.5\n1.5\nC.\n0.5\n0.5\n8,700\n66.5\n26.\n4.\n2.5\n0.\n0.\n1.\n7,100\n70.\n23.\n4.5\n2.\n0.\n0.5\nO\n1 1,200\n66.\n27.\n5.5\n1.5\n0.\n0.\nO.\n7,400.\n65\n25.5\n6.\n2.\n0.5\n0.\n1.\n9,500\n65.\n26.\n7.\n2.\n0.\n0.\nO.\n64.5\n25.5\n6.5\n3.\n0.\n0.\n0.5\n9,100\n68.\n22.\n7.\n1.5\n1.\n0.\n0.5\n7,000\n62.\n23.5\n11.\n3.\nO.\n0.5\n0.\n10,400\n66.\n25.\n7.\n1.5\n0.5\n0.\nO.\n6,200\n66.5\n24.5\n5.\n2.5\n1.\nO.\n0.5\n7,700\n66.\n25.\n5.\n2.5\n0.5\n0.\n1.\n10,000\n58.5\n25.\n13.\n1.\n0.\n2.5\nO.\n8,300\n64.\n24.\n7.\n3.\n1.0\n0.\n1.\n8,800\n70.\n22.5\n4.\n1.5\n0.\n0.5\n1.5\n10,000\n67.5\n22.5\n6.5\n2.5\n0.5\n0\n0.5\n9,800\n70.\n23.5\n4.5\n2.\n0.\n0.\nO.\n10,500\n64.\n25.\n7.5\n3.\n0.5\n0.\n0.\n7,400\n65.\n26.\n6.\n3.\n0.\n0.\n0.\n8,500\n70.\n22.5\n5.5\n2.\n0.\n0.\n0.\n10,600\n67.5\n24.5\n5.\n2.5\n0.5\n0.\n1.5\n9,800\n69.\n26.\n4.\n1.\n0.\nO.\nO.\n10,900\n67.5\n24.5\n5.\n2.5\n0.\n0.\n0.5\n9,700\n64.5\n25.5\n4.5\n3.5\n0.5\n0.5\n1\n8,900\n62.\n24.5\n9.5\n1.5\n0.5\n2.\no\n6,500\n60.\n28.\n8.\n2.\n0.5\n1.\n0.5\n8,900\n65.\n25.5\n5.5\n3.\n1.\n0.\nO.\n9,100\n64.5\n26.\n7.\n2.5\n0.\n0.\n0.\n9,900\n62.5\n27.5\n5.5\n3.5\n0.\n1.\n0.\ncontinued\nWeight General Years Teeth Ex-\nMenstrual\nHb.\nchanges Appear- Em- tracted\nChanges\nBlood\nDare\nColor\nRed\nWhite\nName Age in 6 mo. ance ployed in this period\nPulse\nPressure\n(corr.)\nIndex\nCount\nCount\nL.D.\n17\n-9 lbs.\nt,\n1-5 mo.\n1\n0\n76\n112/68\n102\n1.06\n4.88\n9,300\nL.W.\n17\n/7½\n\"\n+\n1-4 11\n5\n0\n78\n110/82\n105\n1.07\n4.95\n9,600\nA.V.\n16\n0\nDelicate\n1-2 \"\n0\n0\n80\n118/72\n103\n.97\n5.24\n9,000\nC.P.\n21\nO\nT\n1\nθ\n0\n82\n118/78\n100\n1.08\n4.65\n6,200\nH.H.\n18\nO\nT\n1\n3\n0\n108\n118/80\n100\n1.02\n4.98\n6,300\nM.C.\n18\n-2\nT\n1\n0\n0\n118/83\n103\n1.03\n5.05\n10,200\nE.M.\n17\n1\nI\n1\n0\n0\n70\n112/62\n106\n1.03\n5.18\n10,300\nE.L.\n16\nO\n11 mo.\n0\nO\n70\n116/82\n105\n1.07\n4.95\n7,800\nR.B.\n23\nO\n+\n10 \"\n0\n0\n78\n132/86\n104\n1.06\n4.91\n8,700\nK.R.\n28\n+5\nFrail\n8 =\n2\n0\n100\n110/78\n103\n1.05\n4.98\n9,100\nV.P.\n20\no\n3 #\n0\n0\n100\n120/75\n102\n1/\n4.86\n8,600\nB.\nO\n100\n1\n5.02\n12,300\nL.P.\n18\n0\n2 yrs.\n0\n0\n92\n112/78\n98\n1/,\n4.86\n7,800\nN.I.\n20\no\n3 mo.\nO\n0\n84\n126/66\n94\n4.50\n8,700\nD.K.\n26\n/10\n1\n7 yrs.\n1\nO\n104\n116/86\n98\n1\n4.96\n8,900\nE.K.\n29\n0\nT\n3\n0\n0\n78\n122/76\n96\n1\n5.06\n10,400\nA.P.\nT\n64\n112/78\n101\n1\n5.9\n7,100\nR.D.\n15\nO\n3 mo.\n0\n0\n90\n106/64\n100\n1\n4.81\n12,800\nB.W.\n18\n3\n1\n0\n68\n122/68\n95\n1\n4.75\n9,750\nC.F.\n19\nO\n1\n4 mo.\n2\nO\n86\n108/75\n98\n1\n4.78\n11,000\nE.M.\n21\n10\n2 yrs.\n0\n0\n103\n106/74\n94\n9\n+\n4.85\n8,500\n(large)\n(medium)\n(small)\nLarge\nWhite Neutro- Lympho- Mononu-\nUnclass-\nt\nCount\nphiles\ncytes\nclears\nEos.\nBaso.\nTrans.\nified\n8\n9,300\n63.5\n25.5\n8.\n2.5\n0\n0\n0.5\n5\n9,600\n68.\n23.\n5.5\n2.5\n0\n0\n1\n4\n9,000\n67.\n23.5\n5.\n3.\n0\n1\n0.5\n5\n6,200\n62.\n23.5\n9.\n2.5\n1.5\n1\n0.5\n8\n6,300\n72.\n22.5\n4.\n1.\n0\n0\n0.5\n5\n10,200\n64.\n26.\n5.5\n3.5\n0.5\nO.\n0.5\n8\n10,300\n66.\n26.5\n6.\n1.5\n0.\n0.\n0.\n5\n7,800\n65.5\n27.\n5.\n2.5\n0.\nC\n0.\n1\n8,700\n62.5\n26.\n7.\n3.5\n1.0\n0.\n0.\n8\n9,100\n63.5\n23.5\n8.\n4.5\n0\nO\n1.0\n6\n8,600\n67.8\n24.4\n7.4\n.4\n2\n12,300\n65.2\n27.4\n6.\n1\n.4\n6\n7,800\n62.\n27.\n9.8\n.8\n.4\nO\n8,700\n63.6\n27.8\n7.\n1.2\n.4\n6\n8,900\n65.\n25.8\n7.\n1.6\n.2\n.4\n6\n10,400\n64.5\n27.\n5.5\n1.5\n0\n.5\n7,100\n65\n25.5\n7\n2.0\n.5\n.5\n1\n12,800\n65\n25\n7\n1.5\n.5\n1.0\n5\n9,750\n63\n26.5\n7.5\n2.\n1\n8\n11,000\n63.5\n26\n7.5\n2.5\n.5\n0\nO\n5\n8,500\n70.5\n23\n5\n1.5\n0\n0\no\nLondon\nOctober 8 th 1925\n(6 teeth\n(9 teeth\n(5 teeth\n(3 teeth\nextr.)\nextr.)\nextr.)\nextr.)\nNAME\nE.BUDD\nC.BUDD\nCRAIGIE\nJOHNSON\nMARSH\nH.NOYLES\nD. MOYLES\nNORMAL\nAGE\n26\n23\n23\n24\n21\n23\n28\nTIME\n10 years\n8 years\n91 years\n5 years\n1 year\n1 year\n1 year\n(1924)\n(1925,infl)\n(infl.)\n(lumb.)\nSICK LEAVE\n2 days\n14 days\n20 days\n30 days\n16 days\n6 days\nNil\nRED BLOOD CORPUSCLES.\n5,600,000\n4,920,000\n4,100,000\n4,800,000\n4,980,000\n4,600,000\n5,600,000\n4 to 5 million\nper cmm.\nHAEMOGLOBIN\n90%\n80%\n78%\n84%\n90%\n90%\n92%\n80 to 100%\nCOLOUR INDEX\n0.8\n0.8\n0.9\n0.8\n0.9\n0.9\n0.8\nWHITE CORPUSCLES\n5,100 per\n7,100\n7,400\n9,100\n10,100\n10,800\ncmm\n11,800\n5 to 10,000\nPOLYMORPHONUCLEARS\n54.0%\n73%\n64%\n66%\n71.0%\n53.5%\n52.5%\n60 to 72%\n40.5%\nLYMPHOCYTES\n41.5%\n20%\n29%\n25%\n22.0%\n32.0%\n20 to 25%\nNil\nNil\n2%\n1%\n0.5%\nNil\nEOSINOPHILS\nNil\nNil\n1.5%\n0.5%\n1.0%\nBASOPHILS\nNil\nNil\n1 to 4%\nLARGE MONONUCLEARS\n4.5%\n7%\n5%\n8%\n5.0%\n5.5%\nNil\n0.5%\nSlight poikilocytosis Nil\nslight poikilocy-\nSlight\nNil\n4.5%\nNil\n3 to 8%\nATYPICAL REDS...\nand arinocytosis\ntosis & arinocyto- poiki-\nNil\nNil\nsis\nlocytosis &\narinocytosis\n5183\n4736\n6006\n7100\n5300\nTOTAL polymorphonuclears.\n2754\n6820\n3 to 7200\n1420\n2146\n2275\n2200\n4000\nTOTAL LYMPHOCYTES\n2091\n3520\n1 to 2500\nFairly normal\nSlight\nrela-\nFairly\nNormal\nMarked\nREMARKS\ntive lymphocy- Normal\nrelative\nMarked relative &\nA marked relative lymphocy-\ntosis 45% a little\n& absolute\nAbsolute lymphocytosis.\ntosis and a tendency towards\nlymphocytosis\nlow\nHigh total white count\na lencopenia & polycythaenia.\nTendency towards\nThe total number of polymorphonuclears\npolycythaenia\nis below the normal.\nSIGNED:\nA.B. Rosher\nH. B. B., age 24. Radon plant technician. Began work\nwith radium in 1922. General health up to May 15, 1925, good.\nDate\nR.B.C.\nW.B.C.\nPoly.\nLympho.\n7-24-22\n5,620,000\n5,950\n66\n34\n10-3-22\n5,300,000\n6,300\n76\n18\n12-13-22\n5,660,000\n5,500\n38\n50\n2-12-23\n5,510,000\n7,750\n44\n52\n4-26-23\n5,560,000\n3,900\n34\n62\n7-28-24\n4,960,000\n3,500\n70\n28\n10-8-24\n5,660,000\n4,500\n48\n42\n12-15-24\n5,570,000\n4,900\n66\n24\n2-6-25\n4,500,000\n4,750\n64\n32\n5-7-25\n5,350,000\n3,600\n58\n34\nA.L.M., age 33. Chief of radon department. Began work\nwith radium in 1914. General health from March 18, 1921 to\nMay 15, 1925, good.\n3-18-21\n5,620,000\n5,800\n74\n26\n5-20-21\n4,670,000\n6,750\n64\n36\n7-22-21\n5,240,000\n5,400\n74\n24\n9-30-21\n4,530,000\n4,450\n74\n22\n1- -22\n4,700,000\n4,500\n70\n28\n4- 5-22\n4,800,000\n5,100\n70\n30\n6-14-22\n4,690,000\n4,650\n66\n30\n10-4-22\n5,090,000\n5,250\n64\n33\n12-15-22\n4,780,000\n3,900\n62\n16\n2-14-23\n4,430,000\n4,500\n60\n32\n10-5-23\n5,150,000\n4,050\n60\n36\n12-11-23\n4,840,000\n5,400\n84\n16\n2-12-24\n4,600,000\n5,550\n60\n36\n8- 1-24\n4,550,000\n5,150\n74\n26\n10-8-24\n6,130,000\n4,650\n12-16-24\n5,160,000\n6,850\n80\n20\n2- 6-25\n4,600,000\n4,250\n68\n30\n5- 1-25\n4,520,000\n5,450\n66\n28\nI5.\nAn examination ofthese tables does not indicate in any way that these girls had\nbeen exposed to radio-active material. In studying the figures presented, we separated\nthe girls into groupd according to the time that they had been working with luminous\nmaterial. One has every right to expect that if the lum nous paint were a hazard that\nthose girls working the longest would give some indication of that fact, or at least\na certain percentage of the mumber examined would. Our analysis is ILS follows:\nI\nBlood Counts\n4 2 years up\n2 to 4 years\nI to 2ytears\nLess than a year\nI2 girls\n24 girls\nI5 girls\n7 girls\nRed 4.86\n4.86\n4.99\n4.96\n4.83\nWhite\n8350\n8260\n9050\n9530\nNeutrophiles\n64.5\n64.4\n65.I\n64.9\nLymphocytes\n25.7\n24.8\n25.1\n25.7\nThe average count for the girls working less than one year can be discarded because\nof the small mumber and because several of those who worked but two or three months\nshowed a high whit count. It would be better to consider the following figures which\ngame to the average of\nY.W. C. A. girls examined by Dr Larimore.\nDr R. C. Williams in his work with the wor\nI6\nDr R.C. Williams has adopted 7500 with plus or minus ten per cent as his normal for\nthe radium workers at the Bureau of Mines. This isof course the mean of 5000 to I0000\nwhich is taken as the usual normal limits for all conditions of mutrition.\nFrom the facts that we have presented one would feel justified in arriving at the\nconclusion that an industrial hazard did not exist in the luminous dial painting if it\na relight\nwere not for the deaths in Orange. Two of the girls in England seem to give some indi-\ncation of some exposure. Statistically also the evidence is against the assumption that\nsu h a hazard existed. If it were not so we would have every reason to expect to re-\nceide reports of other cases among the four or five thousand girls whomhave been engaged\nin this work in Europe and this country. Furthermore cases should have made their ap-\npearances in other factories besides the Orange Plant inasmuch as these other girls\nhave used the same material and have worked as long in the industry.\nWe are then brought to the conclusion that there must have been some peculiar\ncondition existing in the Orange Plant at the times the girls affected worked or else\nthe full effects of radium-thorium are not understood. As to the first effection we\nhave no way of telling at this date. All we can say is that we have testimony that the\ngirls did exchange brushes. Pyorrhae also was whinen.\nTurning to the second possibility we are comfronted by the fact that very little\nis known of the effects of mimute quantities of radium- thorium deposited in the bones\nand which may remain there for years throwing off radiations into the blood stream.\nEven the matter of excretion seem to be hazy as one from reading the literature would\ngain the opinion that radium ids eliminated from the body rather arapidly; something\nour experiments do not confirm.\n17.\nViol in his work on excretion found that 35 to 40 per cent of the radium injected in-\ntravemously was excreted in ten days and there after the excretion rate was around I per\nsentp per month He based his observations on an examination of the excreta. Wada in-\njected 25 and IOOO M. U doses of radium into a series of rabbits and at the end of\nfour mmoths he W.S unable to detect any radium in the organs of the rabbit getting the\n25 M U dose. I the case of the IOOO M U he found radium in the boxes and the amount\nfound bore a relationship to the amount injected. He has made an interesting observation\nthat may have some bearing on our problem. He feels that in order to get a. stimulating\neffect it is better to inject a large quantity at once as the part not eliminated at\nthe beginning is stored in the bones and thus furnishes the blood with a steady stream\nof emanations. On the other hand small doses given repeatedly act# OR all the cells of\nthe body and among them the blood forming cells and this repeated stimulation is ob-\nviously too strong.\nOur experiments bear out Viol to a certain extent. We injected an equal amonut Of\nradium into a. number of pigs and killed them off at stated periods, burming them to an\nash and making a. radium determination. This repo experiment is still being continued\nand will be reported at an early date.\nSome of our findings are:\nAnimal killed I5 minutes after injection\n4.21 micro grams\n24 hours\n3.73\n48 2\n3.I5\n7 days\nI.32\nI4 \"\nI.29\nGudzent states that quantities of .00I mg of radium equivalent increases the vital\nfunctions while amounts of .25 imhibit them. Both he and Beck feel that the effects are\nnot due to the radium itself but to the emamations. Beck discusses a toxema 3.8 the re-\nNW hought drut by\nsult of the by-products which result from their actions on the cellular structure. Due\nare\nto the iomizing action of radium probably many of its effects physical chemical changes.\nThe observations by Chamber and Russ indicate that the red cells of the human blood\nare hemolyzed much more easily by the alpha rays than by the beta and gamma rays.\nI8.\nClark and his associates in discussing tubes for insertion into maligmant growths are\nemphatic in their statements as to the effect of beta rays when glass tubes are used.\nglass walls of the tubes are not thick enough to filter out sufficient of the beta\nrays, hence there is frequently as intense sloughing, great pain and heavy fribnosis,\nleading\nwhich cuts off all circulation to the parts D.# to often result in further necrosis.\nThe prolonged action of the emamations in buriede tubes appear to have a particularly\ndevitalizing effect OR bones. With the metal meedles the irritating beta rays are fil-\ntered out and bone Recrosis has been observed to be much less frequent ith metal\nneedles.\nUnfortunately almost all of the redemations made RE to the efect of red i.um\nand its allied substances are concerned with relatively large amount of material, and\nmany of them OR external exposures. Even the experiments in which Mella speaks of minute\ndoses he refers to .05 mg for a. rabbit weighing approximately IOOO grams which mesns in\nproportion .35 mg for the 70 kilo man.\nthe\nOutside of the cases in Orange Plant we do not have any evidence that would in-\ndicate what & daily exposure to infintesimal amounts of radio active material will db\nto the organism. Futhhermore these cases are by no means clean out and one should be ver\ncareful in stating that they are the result of any radium thorium exposure. Other factor\nhave not been ruled out and bacteria infection has not been disposed of in a satisfacto\ntory manner. Long continued and carefully comtrolled experiments will be the only ways\nthat this important question can be settled.\nThe theory that the pathological condition is the result of the presence of meso-\nthorium instead of radium is not upheld by our examination of the girls. Mella has in-\ndicated in his work that thorium X does react on different tissues than radium, but his\nis the only observations that we have had and his results lack uniformity. His summary\nis that meither in the acute or chromic poisoming of the animal by thorium X can its\norgans.\ndeath be traced to changes in the blood forming animals. That there is a. directly op-\nI9.\nposed effect between Roentgan rays and thorium X. T\"e later exerts directly only &\nalight effect ion the lymphoid tissue. The myeloid tissue on the contrary is earlier\nand more intensely injured.\nIn considering the effect of Mesothorium and radium we must bear in mind cer-\ntain facts. Mesothorium decays 250 times as fast a.a radium does, and consequently in\nits pure state, weight for weight, its activity would greatly exceed that of radium.\nBut in these paints the quantity of mesothorium is not expressed in milligrams by\nweight but its equivalent in radium. Therefore the activity of the two compounds com-\npared bear the same ratio as the values assigned to the preparation.\nAlthough meso thorium gives off no rays, its first decomposition product after\nmesothorium has been separated gives off powerful beta and gamma rays. For this rea-\nson the operator must protect himself against these rays. On the other hand in the pro-\nduction of radium, the product giving the pemetrating gamma rays (RaC) is formed rather\nslowly.\nIn studying the possible effect of mesothorium that may become deposited in the\nbody one must bear in mind the fact the have period of radium is I580 years while that\nof mesothorium is 6.7 years. In the decay of radium we first have an @mamation having\na half period of 3.8 days. This is followed by the active deposit of rapid change ( RaA,\nRaB, RaC ) followed by an active deposit of slow change RaD, RaE, RaF. Radium D and\nE emit soft bets rays and have a half period of I6.5 years and 4.85 days respectively.\nRadium F or polomium emits alpha rays and has a. half period of 136.5 days. But in the\ncase of mesothorium the emamations have a half period of only 54.5 seconds. which is\nfollowed by thorium A,B, and C which are comparable to the same series of radium. Thor-\nium C is followed by orium D ( Th lead ) which is stable. amilar We have similar product\none\nin the thorium decomposition products to radom of the radium products which has a com-\nparatively long live emitting alpha radiations. The maximum range of an alpha particle\nfrom the thorium series is 8.6, while the for the radium series it is 6.94 cm."
}