Coal dust: a clinical and radiological review of its effects on the health of coal trimmers

Abstract

"The importance of Dust as a factor in Occupational Mortality has attracted the attention of every living authority on occupational diseases from Ramazzini to Sir Thomas Oliver." This statement from a book "Occupational Diseases ", by an American author 3) - Goldberg, affords a fitting apology for a study of one of the less well known forms of dust hazard.The work entailed in writing this Thesis has been carried out by the author while engaged in General Practice. In all branches of Medical work one is brought into close contact with the lives of one's patients, but this is perhaps particularly true in the case of the General Practitioner, and to be of real service to his patients, he must understand something of the work they do and the conditions under which this work is carried out. Above all, he must attempt to give relief to the ailments his patients exhibit, and is often expected to afford this solace.in cases where advanced pathological changes render it impossible to do so. The medical problems arising out of Industry naturally vary with the particular occupation involved, and such problems will be of greater or lesser interest to the Medical Profession in general, according to the widespread or restricted nature of the Occupation, but individual Practitioners, working in an area with one or more basic industry, must thoroughly understand the special effects such occupation or occupations have on the health of their patients employed in the particular industry.Before this work was commenced, the author was impressed by the large number of men in his own area in South Wales giving their occupation as Coal Trimmers, who presented severe symptoms principally related to the respiratory tract, and to whom relief was afforded with difficulty. This prompted a desire to learn more of the mode of onset and the progress of the disability from which these men suffered, and it was felt that this desire could be gratified by a clinical and radiological review of a series of cases.A wide interest has been taken in the effects of dust on the Coal Miner. This is due in part to the striking nature of his work and in part to the large number of men involved all over the country. In any study of dust hazards, the miner usually comprises one of the occupational groups considered, and particular attention has been paid to the miner in South Wales in numerous papers by various workers.The Coal Trimmer has not received such wide attention. This occupation is briefly referred to in several papers and has been the subject of at least one Official Survey by the Medical Research 3. Council(11),but in view of the fairly widespread nature of the occupation, and the obvious exposure to large quantities of coal dust, it is felt that a special survey of this particular dust hazard cannot be without interest and importance.It is necessary to emphasise at the outset that the hazards attached to the occupation of Coal Trimming are to a very large extent different from those experienced by men engaged in handling coal at other stages of its production and transit. Were this not so, the study now presented would be a mere reiteration of facts already well known from work done on Coal Miners. The differences in the risks to which the Coal Trimmer is exposed, compared to those experienced by the Coal Miner, can best be appreciated by a note on the respedtive conditions of work

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