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    "localId": "75721365",
    "label": "Report, February , 1927",
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    "id": "75721365",
    "sourceUrl": "https://catalog.archives.gov/id/75721365",
    "contentType": "document",
    "title": "Report, February , 1927",
    "citationUrl": "https://catalog.archives.gov/id/75721365",
    "collections": [
        "Safety Light Collection",
        "Records Related to Radium Dial Painters"
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    "seq": 14,
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    "ocrText": "1.\nRadio Active Interial on\nIndustrial Homed 1\nProderick 3. 125m.\nIn 1983, the attention of the United States Redium Corporation\nwas called to the possible existence of on industrial honord in their\nOrange plant by the statements of a dentist who suggested that the con-\ndition of one of his patients might be due to provious industrial -\nposure there.\nDuring the past four years there have been five denths nong\nformer employees of this plant who had been enauged in the work of\nthe\npainting/dials of instruments with Luminous paint.\nPathologic\nfindings in those cases and in those of one or two of the company's\nother employees, cell for an explanation on to their causes.\nThe pethologic conditions consisted of 8 necrosis of the\njust. which had been observed to follow the removal of a tooth or\ndontal intervantion of BOMO other Idni, noompanied by covere enerda\nterminating in donth. After such dental intervention, the cases do-\nveloped a very rapid form of nocrosis which necessitated operative\nprocedure at weekly intervals to combot the sepets. In the Inter\nstages of the discoss, those necrotic mress presented a liquifection\nof a gelatinous nature. The treatment also required that a free\ndrainage be maintained, for unlike the more common forms of necrosis,\nif the wound appeared to be clean and was permitted to honl, it closed\nonly to monifost Inter on a recurrence of the condition.\nThis necrosis of the jaw 1e and by dentists who trented the\ncases to differ from phosphores poisoning, ordinary necrosis or typi=\nonl ostemyletis only in the number of areas involved and their 100⑉\nIntion from one another.\nThe otiology of June necrosis Is fairly well understood and\na 9 1\nincludes such systemic infections as ayphilis, tuborculouis, conrlet\nand typhoid fever. Inorganic possens and drugs such as phosphorus,\nareonic, moroury, and hydrogen peroxide my not either by local appli-\ncation or systemic absorption. In addition to dental losions such no\nalvector absooss mad. prorthes alveolaris, a Large proportion of the\ncases of Sear necrosis have their genesis in dental work. In Phosphores\nfrom wa my have a direct nation on the tooth tiesus, but 00 for as 170\nlmow, redio-netive material has no specific nation on this tissue.\nRed&um and Terry trantment have, however, boon Inom to cause\nnecrosis. Dub in redium neurosis of the bone, which my not occur\nfor months or oven years after the exposure, porosity is first noted,\nwhich gradually develope into complete disintegration ml sequestre-\ntion. This bony disintegration is in marked contrast with the golo-\ntinous liquifection noted in the later stages of the cases under die-\ncussion. This culatinous consistency suggests a bacterial invesion,\nand modoration ty the secretions of the mouth. As & matter of fact, the\nfive cases reported were compliented by ayphilis, joint trouble, and\nVincent's Anginn.\nThe Orange plant had practically shub dom when I began my\ninvestigation of this problem, which made It impossible to conduct\na thorough study of the expesure of the employees on m average world-\n(1)\ning day. Portunately Dr. Ceell K. Drinker had mile as brief survey\nshortly after the attention of the officials of the plant had boon\ncalled to the matter. The Drinker's conclusions were that on addount of\n4\n- 3-\nthe excellent general conditions unler which the work was con-\ndusted in this festory and from his om study of the pathologie effects\nof sino, the nocrosis was due to the employees' habit of pointing their\nbrushes between the lips and thus permitting the ingress of small emounts\nof redio-active material to the oral cavity.\nThe question no to how provalent the early stages of necroats\nare mong other girls who have worked in this plant is & matter of die-\npuble Several of the dental surgeons who have tronted these employees\nhelieve that they have detected the incipient signs of hone degineration\nin at mumber of cases by mosns of X-troy pictures taken of the\nOther compotent dental surgeons who have the come films day\nthat my bone changes have teleas pince. Several of these supported\ncases have had abscessed tooth which the obtending dontist refused to\nextract because he was afreid of procipitating this necrotic condition.\nThese teeth vetre extracted by other dentists, the gmo healed normally\nand no signs of any trouble appeared.\nBetwoon four and five thousand girls in this country end in\nHurope have boon employed from time to time in dial pointing. The\nOrange plant has employed all together 375 cirls, the number worlding\nat any one time verying from twelve to over two hundred, depending on\nindustrial conditions, no this is a seasonal occupation. The average\nemployee remained with the company from one to tro years, while some\nstandier vorkers continued for five or even six years. Anong the 0>\nplayers examined by us, a member have been enguged In this work for\na period of six to nine years.\nThe luminous paint used in painting consists of a specially\nprepared sine sulphide mixed with smill amounts of radium or a mixture of\nmesotherium and radium salts, and very minute amounts of copper, men-\nganese and andmite. The radio active compound is added in a soluble\nform to an enulsion of sinc sulphide and precipitated out with an al-\nImline sulphate with constant stirring. It is hrad to conceive of\nthe redium or thorium sulphate being in anything but a very finely\ndivided condition which must be absorbed by the sinc sulphide. The\namount of radium or mesothorium present varies according to grade of\nmaterial required from 0.7 of a milligram to 3 or 4 milligrams per\nhundred grans of sine sulphide. This material is given to the girls\nin grom portions in bottles, and they mix it with an adhesive compound\nin & small porcelain crusible by means of a glass rod and then thin it\nout to the required consistency with distilled water. Some of the\ngirls are rather energetic in this mixing, and I have noticed droplets\nof the mixture on their persons and clothes no well as on the benches.\nThe crucible is hold in one hand during this operation, and some of the\npacint is apt to got on the fingors thus engaged. The girls were observed\nto touch their hair and other parts of their body with these fingurs, and\nit was surprising how luminous the parts of the body touched became when\n\"flashed\" and than examined in 8 dmrk room. The aprons which the\ngirls wore shone when inspected in the dark room after being returned\nfrom the Laundry as if the paint had been set in the washing process.\nNo luminosity on the body has been detected where actual contact with\nthe paint by means of the brush, hands or splashing could not explain\nit. The girls on being questioned confirmed this observation. The\npaint 16 easily washed off the person with soap and water.\n6\n9a he point is epplied to the dial by means of a smill ownel hair\nbrush. After suplication to the dial, the brush 1s dipped In water and\nthen wiped on a cloth. 20 has boon the custom to point the brush after\ndipping it in the water by dreaming se behrom the lips. It is on account\nof this habit that the vadio active point has been hold responsible for\nthe pathologic condition under discussion. It has been suggested that\nparticles of redicenctive substance Become lodged between the borth or\nin the roof of the mouth and counced. an irritation that endos In necresis.\n110 amanot subscribe to this explanation because our inquirion indicate\non general use of the tooth broth amount the employees. The passega of\nfood and fluid through the mouth would also tend to dislodge any parti-\ncles, especially as our tosts show that the adhesive compound 1d dissolved\nby the saliva. If 8 particle did become lodged in the bral cavity, 10\nwould be a quantity so minute se to make it highly improbable that it\ncould onnes any irritation tending to necrosis. Another theory 1a that\nthe particles of radio-active substance my posotrate into the concellous\nstructure of the bone through the open spaces asseed by prorrhon. It\nmight be possible that during on almost daily exposure some absorption\nof radio-active particles asd take place, just DE pas or infections genes\nare absorbed, in those phyershool opon spaces.\nA group of four girls was requested to point their brushed on\nclothes for a week, and at the same time to heep account of the amount\nof point used during that period. The residue of interial left on the cloth\ncorresponds to the paint left on the brush after it has boon dipped in water.\nOur findings are no follows:\n7\n-6-\nC.M. Paint used\n1 gram\nPaint on cloth 0.403 grams Radium contents. 00053 mgs\nL.P.\nPaint\n=\n2\n#\n=\n=\nIf\n0.205\n=\n=\n=\n0026\nA.D.\n#\nII\n10\n#\nII\n=\n#\n0.342\nH\n#\n=\n0043\nB.W.\n=\nII\n10\n=\n=\n=\n#\n0.512 If\nIf\n#\n0065\nAverage for ten grams paint used:\nPaint on cloth 0.576 #\n=\n=\n0072\nThe question naturally follows: If the girls should ingest the\nquantity of paint represented by the residue on the cloth, would it remain\nin the body indefinitely or would it be excreted? To determine thispoint\nwe have conducted a series of feeding experiments with animals lasting\nseveral weeks. During the entire time, the excreta were collected and the\nradium content determined. To confirm the results found by an analysis of\nthe excreta, we killed the animals at the conclusion of the experiment and\nand determined the radio-activity of the ashed carcasses. The alpha ray\nelectroscope was used in determining the radio-active deposits. The results\nof these experiments showed that apporximately ninety-eight percent of the\nradio active material contained in the paint was excreted within a few days\nafter the exposure had ceased.\nTo determine whether the luminous material had an irritating effect\non the mucous membrane of the oral cavity, the gums of a number of guinea\npigs and goats were painted with it daily for a period of six months. During\nthis time no irritation of the gums or mouth in any of the experimental ani-\nmals was detected. An X-ray examination showed no bone changes, but such\nchanges could hardly be expected to occur in six months. To reach a con-\nclusive finding, a series of animals should be carried over a period of years.\nThe sides of a number of the animals were shaved and painted daily\nwith luminous material for a period of two weeks. No irritation of the skin\n&\nwas detected either during the time that the paint ms being applied\nor at eaty time after the exposure had connod. Three colleborators in the\nlaboratory painted areas on the are and permitted the point to remain for\nteanty-four hours. No orythems developed at any time after the removal\nof the paint, though the atress were under observation continuously for\ntwo weeks. Questioning the employees also failed to reveal any In-\nstances where \"burns\" had boon noticed in any place where the Indians\nmaterial had coma in contact with the sidn.\nIt is generally conseded that the first indication of an exposure\nto rediation to to be found in the blood picture. Amoug the changes noted\nstret\n(I) The rapid and profound destruction of lymphocytes,\nnoted oven with relatively short exposure.\n(2) The destruction of rod corpunsies under prolonged exposure.\n(s) The signs of blood destruction and Lock of registration\nin the bone morrow.\n(4) Modification of the normal relations between corpusales\nand planna resulting in the formation of non-corpuscular\nintrovesentar thronbs or fibrin formation within or out-\nside the vossols.\n(2)\nMottrom calls attention to the feet that the red cells are not\nso sensitive to rediction 08 are the leunceytes and that a sustained low\nlevel of the latter should be considered as an indication of unduo expesure\nto radiation. In fact, he places so much exphasis on this that he recommends\nthat persons presenting a white count consistently below 6000 should be TO*\nmoved from exposure until the blood has become more normal.\nAnother test as to the offects of exposure to radiation was\nmade in our laboratory on animle injected with a solution of Time\ndium, to determine the prosence of radio active deposits in the\nliving body. For this purpose the - ray and the crenation clos-\ntroscope were used. Both proved very consitive in recording\ndeposits.\n*Approximately two thirds of the employees at prosent working\nat dial pointing in this country have been examined by us, and others\nin England have boon emmined by compotent modical non. This\nnation included, bosides the usual observations, 8 oursful inspection\nof the oral cavity, an X -my picture of the a. complete Throd\ncount, and wherever possible electroscope teste for determining the\npresence of radio active deposits.\"\nAbout half of these employees - used Invidus material contain-\ning both memothorium and redium. The factories using this miterial\nobtained 10 from the name source as the Orange plant. The findings\nseemed to be the same as for redium. Dontal films worn by the are\nplayers and placed in the various work wooms showed that the workers\nreceived the same exposure as reported by Drinker for those employed\nin the Orango plant.\nInquiries have failed to reveal a single esse of sear necrosis\noither in this country or in Europe emong employees outside the canoo\nreported in the Orange plant. Each employee was questioned as to\nany dental work, especially extraction, that she had undergone nince\nbeginning the pointing of dials. Wifty percent of the girls have Ind.\n9\ntooth extracted since they bogan working in the industry, the number 020⑉\ntracted varying from one to nino. All report that there ware no 111 of-\nfoots from this form of dental intervention. One employee was discovered\nwho had recently suffered B double feacture of the ferm, which had Initted\npromptly. the had been engaged in redium painting for five years. Actual\nemminations of the oral cavity should that no necrosis of the Jam existed\nand no irritation of the moous membrane other than pyerrhes. The\npointing of paint brushed in the mouth proved to be a comon hebit in\nall the factories inspected here and abroad. Inquiries also revenled\nthe fact that, although each employee was given has own brush, they at\ntimes took each other's brushed, which habit furnishes an excellent method\nfor conveying infection.\nA sussey of the findings of our examinations of the blood is\ndven in the following tablest\nDial Printing Imployees\nR.B.C.\nWelleCe\n1.6 por cent betwoon 4-4.5\n00.0 por cent Less than 6000\n05.1\n4.5-5\n10.1 par cent between\n6000-7000\n28.5\n5-5.5\n15.2\n7000-8000\n4.8\n5.5-8\n33.8\n8000-0000\n22.2\n9000-10000\n10.9\n10000-11000\n11.8\nover\n11000\nNoutroshiles\n3 per cont less than 00\n46.5 par cent betwoon 20-25\n95.2\nbetween\n60-22\n40.0\n25-27\n1.8\nover\n72\n10.5\n27-29\nLerse Honomuclast\n86.8 por cant between 3-8\nTosinephiles all fall\n11.2\nover\n8\nwithin the normal rango 2-4\n-20-\nthe hanoglobin WAS normal in each case, no were the pulse and\nblood pressure. No nenstrosl changes nor blooding between periods\nfrom the time of initial employment to the time of examination me\ndiscovered.\nFor the make of comparison TO are able through the courteny of\n(3)\nDr. Larimore to give a summary of the Mood pictures of = (proup of\n263 Y.W.C.A. girlst\nR.B.C.\nW.B.O.\n10 per cont less than 4\n26.5. por cont loss than 6000\n47.4\nbetween\n445\n20.5\nbetween\n6000-7000\n30.0\n4.5-5\n19.1\n7000-0000\n5.5\n5-5.5\n20.3\n8000-9000\n1.0\n5,5-6\n8.8\n9000-10000\n2.4\n10000-11000\n2.3\nover\n11000\nHeutrochiles\nResinoubiles\n26.8 per cant Loss than 60\n29.6 por cent less than 1\n60.4\nbetween\n60-72\n65.7\nbetween\n1-1\n14.8\nover\n72\n4.7\nover\n4\nUnfortunately date were Inclding to compare the Lymphocyte and largo\nnuclour counts.\nThis group consisted of supposedly norml individuals who Ind boon\nexposed to no industrial hasard. The average red count for the (TOU) was\n4.4 with extremes of 2.8 and 5.7. The average white count WAS 7200 with\nextress of 3200 and 12000.\nA further exemination of our tables does not indicate in my my\nthat the workers energed in pointing dials had been expossed to redie so-\ntivo material. In studying the filgures, 110 have separated the late\ngroupe according to the Longth of time the empLoyees have been working\nwith the Indian material. If the luminous paint is a handrd, one has\n-11-\nevery right to expect that those girls pointing with It for the longest\nperiod would give some indication of that fact, or at losst that a our-\ntain percentage of the number would. Our analysis is as follows:\n4-1/2 years and up\n2-5 yrs.\n1-2 yrs. less than 1 yr.\nBlood counts\nRod\n4.85\n4.99\n4.95\n4.83\nWhite\n8360\n9360\n9030\n9680\nHoutrophiles\n64.5\n64.4\n65.1\n64.9\n26.7\n34.8\n25.1\n25.7\nIN he table following $8 the Mood picture during several menths\nof two men who had been working in the opystallising room, where redium\nand monothorium 528 handled in Learge quantities end in & nore concentrated\nform them engwhere else in the process of mmufactures\nCASE\nDate\nR.B.C.\nV.B.C.\nPoly.\nTempho.\n7-34-22\n5,500,000\n5,950\n66\n35\n10-3-32\n5,300,000\n6,300\n%\n18\n12-13-22\n5,660,000\n5,500\n26\n50\n2-12-23\n5,510,000\n7,750\n44\nB)\n4-26-23\n5,560,000\n3,900\n34\n62\n7-28-36\n4,960,000\n3,500\n70\n28\n10-8-34\n5,600,000\n4,800\n48\n@\n10-15-24\n5,570,000\n4,900\n66\n24\n2-6-25\n4,500,000\n4,750\n64\n8\n5-7-25\n5,250,000\n3,600\n50\n34\nGASE 3\n3-10-01\n5,620,000\n5,800\nN\n25\n5-20-21\n4,670,000\n6,750\n64\nas\n7-22-01\n5,340,000\n5,400\n76\n26\n9-20-01\n4,530,000\n4,450\n70\nis\n1-\n22\n4,700,000\n4,500\n70\n28\n4-5-22\n4,800,000\n5,100\n70\n30\n6-14-22\n4,690,000\n4,660\n66\n30\n10-4-22\n5,000,000\n5,250\n64\n33\n12-15-22\n4,780,000\n3,900\n62\n16\n2-14-23\n4,420,000\n4,500\n60\n28\n10-5-23\n5,150,000\n4,050\nGO\n35\n12-11-23\n4,840,000\n5,400\n84\n10\n2-12-24\n4,600,000\n5,550\n60\n26\n0-1-24\n4,550,000\n5,150\n74\nas\n10-8-24\n6,130,000\n4,650\n12-6-24\n5,100,000\n6,800\n80\nDD\n2-6-25\n4,000,000\n4,250\n66\n30\n5-1-25\n4,530,000\n5,450\n06\n28\n-12-\nOne employee who has been orystallising redium is coming in con-\ntact with it for fifteen years tells no that his white count is never\nover 4500, and while belittling this fact, he admite that he is easily\nsusceptible to infections.\nAll electroscopic tosts to acortain the presence of radio-active\nsubstances in the bodies of the painters of lundnous dials were negative.\nFrom the facts here presented, I believe we are justified in ex\nriving at the conclusion that on industrial hesard does not exist in the\npainting of luminous dials. The only evidence contrary to this conclusion\nrests on the fact that tive employees at the Orange plant of the United\nStates Redium Corporation have died from some cause that cannot be determined\nat this date. Statistically the evidence is against the assumption that\na hasard exists. If 18 were not 80 TO would have every reason to expect\nreports of other cases among the four or five thousand girls who have been\nengaged in this work in Europe and in this country. Furthermore cases should\nhave made their apposrance in factories other them the Crange plant innomeh\nas other girls have used the same materials and have worked as long and in\nmany cases Longer than the girls who died. In addition, more time has elspeed\nin some of thees cases since the first exposure than had elopeed between the\nfirst exposure and the date of death of any\nof the Orange employees.\n2 he girls who died all worked together at the semo banch sometime\nbetween the years 1917 and 1922. A diagnosis of syphilis on a contributory\nfactor appears on the death certificate of one of them. To are informed on\ngood authority that a brother of another has suffered from an obstinate\npathologic your condition. He never came in contact with radio notive paints.\nIn other words, three cases are by no means clean out. Vincent's Angina has\nbeen known to produce a similar pathologic picture, ending sometimes in death.\nBacterial infection has not been ruled out in a antisfactory menner. Other\nfactors were present besides exposure to radium and mesothorium."
}