[Mobile miniature X-ray evaluation and pneumoconiosis: the role of the Clinica del Lavoro in Milan (1941-1948)]. / La valutazione schermografica delle pneumoconiosis (1941-1948): il ruolo della Clinica del Lavoro di Milano.

Since the end of the 19th century, X-rays have been used to detect lung diseases. In Italy, 207,096 miniature chest radiographs were taken from 1941 to 1948. Traditional radiographs gave better results, but miniature chest radiographs were useful for screening. Indeed, the development of mobile miniature chest radiography units resulted in an improvement in mass X-rays screening for the detection of penumoconiosis. These mobile miniature units were mounted on a bus chassis, a solution that allowed to easily reach workers. The authors analyze some models of X-ray wagon units used by the "Clinica del Lavoro" in Milan in the 1950s. From the point of view of medical museology, the preservation of these devices requires appropriate spaces.

From the definition of silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis, and pulmonary alveolar proteinosis (PAP).

The 1930 International Labour Office Conference on silicosis in Johannesburg identified silicosis by setting a medicolegal framework to its nosology: as with other occupational illnesses, its medical content was fixed under economic pressure. This article follows a reading of all the proceedings of this conference (debates and reports of experts) to examine their potential impact on the etiology and nosology of other diseases, specifically sarcoidosis and pulmonary alveolar proteinosis (PAP), "idiopathic" diseases in which inorganic particles may be involved. We propose renewed study of the role of inorganic particles in these diseases. To do this, we propose to mobilize detection means such as mineralogical analysis and electron microscopy and in depth interviewing that are currently seldom used in France, in order to establish diagnosis and the potential occupational and environmental origin of these diseases.

The pathologist's view of silicosis in 1930 and in 2015. The Johannesburg Conference legacy.

The 1930 International Labour Office Conference on silicosis in Johannesburg was a turning point in the history of silicosis and in the recognition of the associated pathologic patterns. Since 1930, pneumoconioses such as silicosis have become much rarer in developed countries and can now be diagnosed at an early stage based on clinical and radiologic criteria. However, in spite of these advances, pathologists must remember to look for silica in tissues, particularly when clinical and radiologic findings are more uncertain. Furthermore, nowadays pathologists essentially observe silicotic lesions as incidental findings adjacent to lung cancers. In addition to identifying the characteristic lesions, pathologists must also try to identify their causative agent, in the case of crystalline silica firstly by using polarized light examination, followed as appropriate by more sophisticated devices. Finally, pathologists and clinicians must always keep in mind the various implications of exposure to silica compounds in a wide range of diseases.

Risk identification and prediction of coal workers' pneumoconiosis in Kailuan Colliery Group in China: a historical cohort study.

BACKGROUND: Prior to 1970, coal mining technology and prevention measures in China were poor. Mechanized coal mining equipment and advanced protection measures were continuously installed in the mines after 1970. All these improvements may have resulted in a change in the incidence of coal workers' pneumoconiosis (CWP). Therefore, it is important to identify the characteristics of CWP today and trends for the incidence of CWP in the future. METHODOLOGY/PRINCIPAL FINDINGS: A total of 17,023 coal workers from the Kailuan Colliery Group were studied. A life-table method was used to calculate the cumulative incidence rate of CWP and predict the number of new CWP patients in the future. The probability of developing CWP was estimated by a multilayer perceptron artificial neural network for each coal worker without CWP. The results showed that the cumulative incidence rates of CWP for tunneling, mining, combining, and helping workers were 31.8%, 27.5%, 24.2%, and 2.6%, respectively, during the same observation period of 40 years. It was estimated that there would be 844 new CWP cases among 16,185 coal workers without CWP within their life expectancy. There would be 273.1, 273.1, 227.6, and 69.9 new CWP patients in the next <10, 10-, 20-, and 30- years respectively in the study cohort within their life expectancy. It was identified that coal workers whose risk probabilities were over 0.2 were at high risk for CWP, and whose risk probabilities were under 0.1 were at low risk. CONCLUSION/SIGNIFICANCE: The present and future incidence trends of CWP remain high among coal workers. We suggest that coal workers at high risk of CWP undergo a physical examination for pneumoconiosis every year, and the coal workers at low risk of CWP be examined every 5 years.

Pneumoconiose: relato de caso / Case report: pneumoconiosis

VDVB, 38 anos, masculino, há 5 anos trabalha com jatos de areia. Em julho/2007 paciente referiu dispnéiade instalação súbita, associada à tosse seca, sudorese noturna e astenia. Há 4 meses teve perda ponderal de 10 quilos. Foi internado em franca insuficiência respiratória. Não apresenta comorbidades nem faz uso de medicações. Ao exame físico apresentou taquidispnéia (freqüência respiratória: 40mpm), taquicardia (freqüência cardíaca: 135bpm), tiragens intercostais, estertoração crepitanteem bases pulmonares, diminuição de murmúrios vesiculares à direita e saturação de oxigênio de 86%.Ao RX de tórax havia condensações alveolares difusas bilaterais e de aspecto confluente peri-hilar e basal direito. BAAR negativo. PPD não-reator. Ecocardiograma mostrou tronco da artéria pulmonar e calibre mantidos,fração de ejeção de 59% e prolapso de válvula mitral. À tomografia computadorizada, firmou-se o diagnóstico de pneumoconiose, devido à presença de micronódulosconfluentes formando massas parenquimatosas e subpleurais, com presença de adenomegalia para-hilar;cavitações ausentes. Medicações em uso no momento da internação: atrovent, berotec, meticorten, talofilina.Após compensação da insuficiência respiratória e paciente teve alta hospitalar e foi orientado quanto à irreversibilidade caso e a possibilidade de transplante pulmonar.

Osler and the black corpuscles: profiles of three early students of phagocytosis.

The discovery of phagocytosis is associated indelibly with Elie Metchnikoff, who coined the term, but more than 30 persons had observed the phenomenon (or inferred its existence) before Metchnikoff came to dominate the field. Two of these early investigators were William Osler and George Miller Sternberg. Osler recognized carbon particles within the phagocytes of patients with miner's lung and carried out experiments in kittens. Sternberg only theorized about phagocytosis but, unlike Osler, bitterly contested Metchnikoff's priority of discovery.

The Osler slide, a demonstration of phagocytosis from 1876 Reports of phagocytosis before Metchnikoff's 1880 paper.

Recently at the Medical Historical Museum of McGill University, Dr. Rick Fraser discovered a microscope slide prepared in 1876 from the lung of a patient with pneumoconiosis. Photomicrographs show the presence of coal dust particles in alveolar cells. This case and several related ones had been reported in 1875 by William Osler, who also had demonstrated the cellular uptake of carbon particles in kittens injected with India ink. In 1869 a Philadelphia physician described the uptake of bacteria by leukocytes in saliva and urine. Both investigators postulated a protective role for this cellular phenomenon. Neither of these reports has been generally cited in histories of immunology. These two papers are summarized here along with a short review of other reports describing phagocytosis which predating Metchnikoff's entrance into the field.

Mineral fiber problems and their management: UK 1890-1935.

BACKGROUND: The first intimation that mineral fibers other than asbestos were biologically active, is generally identified with reports of experimental studies by Stanton and Wrench, and Pott and Friedrichs, in the early 1970s. In 1890 however, man-made mineral fiber was recognized to present human health hazards; in 1912 experimental study confirmed asbestos to be fibrogenic, and by 1935 other mineral fibers came to notice as potential lung hazards. METHODS: Published and archival sources have been reviewed to trace the emergence between 1890 and 1935 of the awareness of the health hazards of various fibrous minerals, and the development of strategies for their control. RESULTS: By the early 1900s there was evidence that the asbestos substituted for the man-made mineral fiber insulation material employed to improve the thermal efficiency of steam powered engines, presented a serious health problem. In the early 1930s, other mineral fibers came to be suspected of causing pneumoconiosis. CONCLUSIONS: Containment, local exhaust ventilation and personal respiratory protection were instituted for the amelioration of asbestosis, but because of the limitations of what was perceived to be reasonably practicable on economic grounds, and what was feasible technologically, their benefits were severely limited. Initial and periodic medical examination were introduced as precautionary measures, based on hope rather than on experience. When in the early 1930s, the investigation of coal mine dust and siliceous dust, threw up the hypothesis that fibrous natural mineral dusts other than asbestos might be fibrogenic, this was ignored and no further investigations were pursued and no precautionary measures were set in train.

The Medical Research Council Pneumoconiosis Research Unit, 1945-1985: a short history and tribute.

The Pneumoconiosis Research Unit (PRU) was set up to obtain the information needed to eliminate pneumoconiosis of coal workers. To this end, instruments and procedures were developed for dust sampling, delivering dust to animals, testing lung function, reading chest radiographs, conducting respiratory surveys and extracting the relevant information. A provisional estimate of safe working conditions was made using data from four pits. The National Coal Board extended the research to an additional 20 pits, refined the estimate and applied it nationally. Meanwhile at PRU aspects of treatment were explored, immunological techniques were added to the repertoire of skills, other occupational disorders were highlighted and new information obtained on biological variation in lung function and blood pressure. The work laid the foundations for medical epidemiology and evidence-based medicine. Starting in 1959, the Unit took the lead in a world campaign to control lung diseases due to asbestos. This account indicates how these successes were achieved, what were the failures, some tensions which developed and what might have been if some events had been handled differently. If there is a message, it is that for success in research the problem under consideration should be the prime focus of attention and resources.

The South Wales Miners Federation, Miners' Lung and the instrumental use of expertise, 1900-1950.

Oral history materials from the South Wales Miners' Library are used to examine the communal understandings of, collective responses to, the scourge of Miners' Lung (pneumoconiosis) in the 1920s and 1930s. Lay epidemiology in mining communities attributed an aetiological role to coaldust at a time when many experts believed miners' pulmonary disease to be bronchitic, or to be silica-induced. In their efforts to secure compensation claims for their members, union officials instrumentally used scientific expertise in a variety of forms: they contributed to epidemiological evidence; they lobbied for more government-funded research; they 'bought' experts; they duped expert witnesses; and they made sophisticated instrumental appeals to the supposed independence of favorable expert judgements. Eventually, miners' situated' 'local knowledge' became scientific orthodoxy, a success story which may be associated with the class-conscious miners' 'bump of irreverence' about expert knowledge, and with the divided character of the expert core-set, sections of which were receptive to miners' 'local knowledge' claims.