Lead poisoning and lead absorption - Sir Thomas Morison Legge; Kenneth Weldon Goadby

The classification of industries was designed to represent the way in which the poisoning may be supposed to originate from (a) lead fumes (1 to 4), (b) handling metallic lead (5 and 6), (c) dust from lead compounds (7 to 14), and (d) lead paint (15 to 17). We attach now only slight importance to this attempt to define causation, as it will appear from our survey that we regard almost all cases as the result of inhalation either of fumes or dust.

The reports describe not only the particular attack, but also the general condition of the patient at the time of the attack. Very frequently a combination of symptoms—colic, anæmia, and varying degree of paralysis—are described as present, and when this is the case each one of them has been entered under the appropriate heading. The total number of symptoms, therefore, greatly exceeds the number of cases, but this does not affect the correctness of the estimate of each one as a proportion on the total number reported. The reports do not give detailed information such as can be gained from hospital records. Especially is this the case with the symptoms of paralysis and encephalopathy.

[Table III.] shows the number of reported cases included in returns for each of the years 1900 to 1909. On the total figures there has been a reduction of 47·7 per cent. In the several industries the salient feature is that the considerable diminution achieved is limited to industries—notably white lead, earthenware and china, litho-transfers, and paints and colours—in which, under regulations or special rules, locally applied exhaust ventilation for the removal of dust, and periodical medical examination of the workers, have been required. Where, owing to the nature of the processes carried on, it has been found impracticable, in the present state of knowledge, to apply local exhaust ventilation, and where periodical examination of the workers is lacking, as in smelting of metals[A] and industries using paint, there has been tendency to increase in the number of cases. In coach-building the increase is in part due to activity in the motor-car industry.

[A] This is now required by the regulations dated August 12, 1911.

TABLE III.—NOTIFICATION OF POISONING BY LEAD (under S. 73, 1901), 1900-1909.

Industry.			Reported Cases.
Industry.			Total 1900-09.		1909.		1908.		1907.		1906.		1905.		1904.		1903.		1902.		1901.		1900.
(1)			(2)		(3)		(4)		(5)		(6)		(7)		(8)		(9)		(10)		(11)		(12)
Lead poisoning			6,762	²⁷⁵	553	³⁰	646	³²	578	²⁶	632	³³	592	²³	597	²⁶	614	¹⁹	629	¹⁴	863	³⁴	1,058	³⁸
1	.	Smelting of metals	412	¹⁸	66	⁵	70	²	28	²	38	¹	24	¹	33	¹	37	²	28		54	³	34	¹
2	.	Brass works	75	⁴	5		6		9	¹	11		5	¹	10	¹	15		5		6	¹	3
3	.	Sheet lead and lead piping	109	³	9	²	14		6		7		9		7		11		12		17		17	¹
4	.	Plumbing and soldering	217	¹²	28		27		20	²	16	⁴	24	²	21	³	26		23	¹	23		9
5	.	Printing	200	¹⁷	21	¹	30	²	26	³	16	²	19	⁴	15		13	²	19		23	¹	18	²
6	.	File-cutting	211	¹⁹	8		9	²	10		15		12		20	⁴	24	²	27	¹	46	⁷	40	³
7	.	Tinning and enamelling	138	²	21		10		25		18	¹	14	¹	10		14		11		10		5
8	.	White lead	1,295	³¹	32	²	79	³	71		108	⁷	90	¹	116	²	109	²	143	¹	189	⁷	358	⁶
9	.	Red lead	108		10		12		7		6		10		11		6		13		14		19
10	.	China and earthenware	1,065	⁵⁷	58	⁵	117	¹²	103	⁸	107	⁴	84	³	106	⁴	97	³	87	⁴	106	⁵	200	⁸
10	a.	Litho-transfers	48		1		2		10		5		5		3		3		2		7		10
11	.	Glass cutting and polishing	48	⁹	4	²	3	¹	4		4	¹	3		—		4		8	²	11	³	7
12	.	Enamelling iron plates	52	¹	3		7		6		4		2		3		4		3	¹	9		11
13	.	Electric accumulators	285	⁶	27	²	25	¹	21		26		27	¹	33		28		16	¹	49	¹	33
14	.	Paints and colours	422	⁷	39	²	25		35	¹	37		57	¹	32	¹	39	¹	46		56		56	¹
15	.	Coach-building	697	⁴¹	95	⁶	70	³	70	³	85	⁷	56	³	49	⁴	74	⁵	63	¹	65	⁴	70	⁵
16	.	Ship-building	269	¹⁰	27	¹	15		22	¹	26	¹	32	²	48		24	¹	15	¹	28	¹	32	²
17	.	Paint used in other industries	452	¹⁸	42		47	¹	49	²	37	³	49	²	27	³	46	¹	44	¹	61		50	⁵
18	.	Other industries	659	²⁰	57	²	78	⁵	56	²	66	²	70	¹	53	³	40		64		89	¹	86	⁴

The principal figures are those of the cases, fatal and non-fatal; the small figures relate to fatal cases only.

For the sake of completeness the figures for the years 1910 and 1911 are given below. The grand totals are comparable with those for each of the years 1900 to 1909, but not the total for all of the several groups of industries. Thus, the name of heading No. 7 is altered to “Tinning of metals,” and No. 12 to “Vitreous enamelling,” because of regulations widening their scope, and now including cases which previously figured in No. 18, “Other industries.”

Industry.	1911.		1910.
Lead poisoning	669	³⁷	505	³⁸
Smelting of metals	48	³	34	⁵
Brass works	9	¹	7
Sheet lead and lead piping	12		4
Plumbing and soldering	37	²	25	¹
Printing	32	²	33	⁴
File-cutting	18	²	9	¹
Tinning of metals	13		17
Vitreous enamelling	19	¹	17
White lead	41	²	34	¹
Red lead	13	¹	10
China and earthenware	92	⁶	77	¹¹
Litho-transfers	1		1
Glass cutting and polishing	5		—
Electric accumulators	24	¹	31
Paints and colours	21		17	¹
Coach and car painting	104	⁵	70	⁶
Ship-building	36	⁶	21	²
Use of paint in other industries	56	¹	51	³
Other industries	88	⁴	47	³