Usually gradual and repeated absorption of small quantities produces slow onset of symptoms, while sudden absorption of larger quantities of poison brings about rapid onset of illness. In the former case the poisoning is called chronic, in the latter, acute. Acute industrial poisoning is sometimes so sudden that the affected person cannot withdraw himself in time from the influence of the poison, nor prevent its entrance in considerable quantities into his system; this is often caused by the fact that the effect of the poison is so rapid that he is often suddenly deprived of power to move or of consciousness, and remains then exposed to the action of the poison until help comes. Such accidents are mostly caused by poisonous gases. Occasionally also considerable quantities of poison enter quite unnoticed into the body, such as odourless poisonous gases in breathing, or poisonous liquids through the skin. In chronic industrial poisoning unsuspected accumulation of poison takes place, until symptoms of illness ultimately reveal themselves; as the first stages of poisoning are not recognised in time by the person affected, he continues exposed to the influence of the poison for weeks, months, even years, until the chronic effect has reached its full development and becomes obvious. Such insidious industrial poisoning arises through the continual absorption into the lungs or stomach of small quantities of poisonous dust, gases, and vapours, during constant or frequent work in an atmosphere containing such gases; poisonous liquids also, by soiling hands and food, or by penetrating the skin, can produce slow industrial poisoning.
Industrial poisoning which in respect of its duration stands midway between acute and chronic is called sub-acute poisoning. This usually means that more frequent absorption of greater quantities of poison has taken place, though not in doses large enough to produce an immediately acute effect. This is important legally because industrial poisonings caused through the sudden absorption of poison in sufficient quantity to act immediately or to bring about subsequent symptoms of poisoning, are reckoned as accidents. Thus acute and many sub-acute industrial poisonings are accounted accidents. Chronic industrial poisonings, acquired gradually, count as illnesses. But as in certain cases it cannot be decided whether sudden or gradual absorption of the industrial poison is in question, this distinction is an unnatural one. It is also unnatural in the legal sense, for there is often no material reason for regarding as legally distinct cases of chronic and acute industrial poisoning. To this we shall refer later in discussing the question of insurance against industrial poisoning.
We have from the outset assumed that the effect of the poison depends not only on the nature of the poison itself, but also on that of the organism, considered both quantitatively and qualitatively.
Significant in a quantitative respect is the body weight of the organism, and the fatal dose of the poison must be ascertained and stated in connection with the body weight, calculated as a rule per kilo of the live weight.
The qualitative point of view must reckon with the differing susceptibility of organisms for poison. This varying susceptibility to the action of poison, the causes of which are very obscure, is called disposition.
Different species (of animals and men) exhibit often very different degrees of susceptibility towards one and the same poison; the differences in this respect are often very considerable, and one cannot simply transfer the experience experimentally gained from one species of animal to man or another species of animal, without further experiment. Besides disposition, sex, and still more age, often determine within the same species marked difference of susceptibility to a poison. Further, there is an individual disposition due to qualities peculiar to the individual, which makes some persons more than usually immune and others specially susceptible. Individuals weakened by illness are particularly susceptible to poisoning. Two diseases, in especial, favour the operation of poison, influencing disastrously the capacity for assimilating food, and reducing the general resisting power of the body; of these tuberculosis stands first.
Individual disposition plays in industrial poisoning a part which must not be under-estimated; it determines the possibility of acclimatisation to a poison; some individuals capable of resistance habituate themselves—often comparatively easily—to a poison, and become, up to a certain limit, immune against it, that is, they can tolerate a quantity which would be injurious to others not so accustomed. With other individuals, however, the opposite effect is apparent. Repeated exposure to the action of the poison leads to an increased susceptibility, so that acclimatisation is not possible. Innate hyper-sensitiveness of the individual towards a poison is called idiosyncrasy. Frequently, for example, this quality shows itself as hyper-sensitiveness of the skin towards the harmful action of certain poisons. A marked lowering in the sensitiveness, innate or acquired, of the organism towards a poison is called immunity.
The possibility of the absorption and action of a poison presupposes—speaking generally—its solubility, and indeed its solubility in the body juices.
In general, poison can be absorbed at very different points of the body; so far as industrial poisons are concerned, these are the mucous membrane of the respiratory passages, the mucous membrane of the digestive tract, and the skin, intact or broken. The rapidity of absorption depends on the nature of the poison, of the individual, and the channel of absorption. Of industrial poisons gases are relatively the most quickly absorbed; sometimes indeed so swiftly that the effect follows almost immediately.
Elimination of industrial poisons is effected principally by the kidneys, the intestinal canal, the respiratory organs, and, more rarely, the skin. Rapidity of elimination also depends on the nature of the poison and of the person poisoned.