Occupational Asthma Reference

McCallum RI, Respiratory disease in foundrymen, Br J Industr Med, 1972;29:341-343,

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Robert McCallum, Newcastle University Robert McCallum

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Abstract

Concern for the health of foundry workers has a long history, perhaps almost as long as the craft itself. Hunter (1969) comments that 'the founding of metal is an ancient craft, so ancient that, under the weight
of tradition, both employers and workers have regarded the hot, dusty, and dangerous conditionsas inevitable; and industrial countries made no campaigns for better working conditions until about1930'. Apart from the general provisions of the Factories Acts, legislation specifically affecting iron and steel foundries is comparatively recent. Conditions
in foundries in the United Kingdom have been the subject of reports by a series of committees over the last 25 years-iron in 1947, non-ferrous in
1957, and steel in 1961. McLaughlin (1950) studied mainly the radiographic
abnormalities found in the lungs of iron and steel foundry workers. Pneumoconiosis is still a problem in these men and the recently published
figures (Digest of Pneumoconiosis Statistics, 1970) show that in 1969 there were 48 new diagnoses of pneumoconiosis in foundry workers (iron, 35 men;
steel, 11 men; non-ferrous, 2 men).

The most recent investigation of the health of foundry workers is reported by Dr. T. A. Lloyd Davies, at the time the Senior Medical Inspector of Factories, and his medical colleagues. The enquiry was made at the request of the Sub-Committee on Surveys and Statistics of the Industrial Health Advisory Committee as it had been suggested that foundry workers had more chronic bronchitis than other comparable workers in industrial areas. The study was called for in 1963, begun in 1964, and completed in the middle of 1965. The full report went to the Industrial Health Advisory Committee in May 1968 but was not published until 1971. Advantage was taken of three new developments since earlier studies of respiratory disease in foundry workers. These are the use of standardized questions in the Medical Research Council Short Questionnaire on Respiratory Symptoms; standard ventilatory function tests; and observers trained in interviewing techniques. Furthermore, the important role of cigarette smoking as a factor in lung disease, and, in particular, in dust diseases of the lung was well recognized by the time the survey was planned.

The survey was based on a 1 in 40 sample of the 130 000 people known to be employed in foundries. A total sample of 1 997 men was drawn randomly from four size ranges of foundries of four types of iron, steel, non-ferrous, and mixed. Men over 35 years of age were chosen to ensure that any factors
in the foundry atmosphere would have had time to operate. In the event, 1780 foundry workers, 93 % of the eligible sample of men aged 35 to 64, were
matched for age, height, and weight with 1 730 factory workers as controls. The controls were from engineering works of the same occupier of the foundry
surveyed, or a near one. The only significant differences between these two groups were that the controls had about 3 % more smokers which therefore
had to be allowed for in the comparison, and they were slightly less well off socio-economically. Although the authors refer to bronchitis from time
to time, they have coined two new terms for chronic bronchial disease-sputum-breathlessness syndrome and sputum-chest illness syndrome. The first of these is defined as production of sputum for at least three months together with breathlessness grade ii (i.e., dyspnoea when walking on the level with others at an ordinary pace) or more. The sputum-chest illness
syndrome is a combination of disabling chronic bronchitis with loss of work in which there is sputum for at least three months of the year plus one or
more chest illnesses. These are rather unwieldy terms but they have the advantage that they are more descriptive and specific than chronic bronchitis. The sputum-breathlessness syndrome was significantly more prevalent in foundry workers than in controls but the difference disappeared when a correction for smoking was applied. The prevalence of sputum-chest illness syndrome, on the other hand, increases with years of employment in foundry work, and this increase was nearly double that recorded in men in the control factories. It was found more frequently in foundrymen than in controls in all the regions studied except one. This
exception was explicable by the presence of four former foundrymen who had been transferred to the control factory because of sputum-chest illness
syndrome. Prevalence of this syndrome increased with smoking in all the men studied, and the combination of foundry work ana smoking gave a higher prevalence for all grades of smoking. Men not exposed to foundry or any other dust who smoke 25 cigarettes a day have as much sputum-chest illness syndrome as those who have never smoked but have worked in a foundry for 45 years. The rates of sputum-chest illness syndrome in the different
smoking groups suggested an additive rather than a synergistic effect. It is interesting that obstructive airways disease, although much more frequent in men with sputum-chest illness syndrome, did not seem to be associated with occupation. An unexpected finding was that men without the
sputum-chest illness syndrome had a higher forced expiratory volume in 1 second (FEV1.0) than controls and higher than the predicted values. Lung function in foundrymen declines more quickly with age than in controls but they have high lung function values at age 35 years. This is not explained by self-selection of men with better physique, and pneumoconiosis is unlikely to be involved. Only simple pneumoconiosis was seen and this was found in 143 foundry floor men (14 1 %) and 62 fettlers (34 6%). The most advanced form of this (category 3) was seen in only one fettler (0 6%) and
three foundry floor workers (0-3 %). These prevalence rates were applied to the whole foundry industry and it was calculated that between 2524 and 7767
foundrymen were potentially eligible for industrial injury benefit for pneumoconiosis. The discrepancy between the estimated number of pproximately
5 000 men with pneumoconiosis category 2 and 3 and the numbers recorded under the National Insurance (Industrial Injuries) Act is noted but not
adequately explained. Although this survey took place in 1964-65 it does not appear to have influenced boardings as the average number of foundry
workers in whom pneumoconiosis was diagnosed between 1966 and 1970 is only 47 per annum.

This survey shows that in spite of regulations introduced to suppress dust in foundries the foundry environment is frequently unsatisfactory. Work in
foundries is still notoriously dirty. As the young intending foundry worker is told when he reads about thiscareer choice (TheFoundry Industry, 1965),
'by contrast with the pattern shop which is invariably light and clean and sometimes air conditioned, the foundry itself looks less attractive. The sand commonly used is black and the workers, particularly the moulders, are apt to get somewhat dirty'. He is reassured, however, that the dirt will easily wash off in the shower baths which must be provided. But there is also heat which may be excessive, unavoidable noise, dust, and vibration. 'In fact, dust, smoke and fumes are inevitable by-products of many foundry processes...' but dust suppression or extraction and air filtration alleviate these nuisances to a great
extent.

In a booklet published in the Safety Health and Welfare Series 'Improving the Foundry Environment' (1962), it is pointed out that although in the past it has often been thought that efforts to keep a foundry clean were a waste of time because of the nature of the work, this idea was rejected as long ago as 1947 by the Joint Advisory Committee on Conditions in Iron Foundries. The booklet underlines the importance of proper standards of cleanliness in foundries and gives a detailed account of how to attain them.
Dust measurements and analysis and their interpretation are described, but in reference to methods of dust suppression it is remarked that it is unfortunate that so few foundries are in a position to estimate the efficiency of such methods. The additional hazards from gases such as carbon monoxide, sulphur dioxide, chlorine, and complex fumes from core
binders are referred to as well as particulate matter containing oxides of iron, lead, zinc, selenium, tellurium, beryllium, and phosphoric acid. Fumes
also arise from fluxes and degassing materials in non-ferrous foundries, from shell moulding, organic solvents, and other materials. This is a well planned and carefully executed survey and as it is clearly important that foundry conditions should be improved it is a pity that publication has been so long delayed. The survey raises questions about the nature and extent of occupational hygiene in foundries and the kind of medical advice available for their workers. One wonders what efforts are being made by the industries concerned to eliminate the essentially dirty and smoky nature of the work and to introduce techniques which are cleaner.

References
Central Youth Employment Executive (1965). The Foundry
Industry. Choice of Careers No. 19, 2nd ed., p. 39.
H.M.S.O., London.
Department of Trade and Industry (1972e. Digest ofPneumoconiosis
Statistics 1970. H.M.S.O., London.
Hunter, D. (1969). The Diseases of Occupations, 5th ed.,
p. 987. English Universities Press, London.
Ministry of Labour (1962). Improving the Foundr,' Environment.
Safety, Health and Welfare. New Series No. 17.
H.M.S.O., London.
Lloyd Davies, T. A. (1971). Respiratory Disease in Foundrymen,
Report of a Survey. H.M.S.O., London.
McLaughlin, A. I. G. (1950). Industrial Lung Diseases of
Iron and Steel Foundry Workers. Ministry of Labour and
National Service. H.M.S.O., London.


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