Papers - Health and Safety in Mines - Pathological Reaction to Various Mineral Dusts (Abstract)

The human respiratory tract is an apparatus for the interchange of gases between the air and the blood. An important part of it are mechanisms to prevent the apparatus from becoming clogged with dust particles that are inhaled with the air. These mechanisms are adequate to protect the organ against most dusts, but silica and at least one of the silicates, asbestos, are tissue poisons which initiate changes in the connective tissues of the lung, incompatible with function. Silica is concentrated by the phagocytes in contact with the connective tissues of the lymphatic drainage system. An overgrowth of connective tissue occurs which interferes with the function of this system. More dust that may be inhaled can no longer be effectively eliminated from the lung. It accumulates in the functioning part of the organ and excites the formation of characteristic fibrous nodules and bands. These changes seriously impair the respiratory function. The shadows of such changes cast upon an X-ray film of the lung are discussed. The reaction to silica in the lung produces a marked increased susceptibility to tuberculous infection. It can be reproduced and studied in the experimental animal and has been observed repeatedly in human beings. Asbestos dust also causes fibrosis in the lungs but the mechanism of its development is different. The fibrous dust settles along the irregular walls of the terminal bronchioles. In this location it excites the formation of cuffs of scar tissue. This contracts and shuts down the tubes, resulting in a collapse of the air spaces distal to the obstruction. Such a condition in itself is a cause of fibrosis. The two causes, immediate reaction to the dust and collapse of the finer air spaces, bring about a generalized diffuse fibrosis. This reaction is not so regularly associated with increased susceptibility to tuberculosis as with silicosis. The case against sericite as a cause of silicosis has not been proved. Experimentally, sericite-free quartz will produce nodular fibrosis. Silicon carbide and aluminum oxide are quite inert in the normal animals. The former apparently increases susceptibility to tuberculosis in animals but whether the same is true in human beings awaits demonstration.