cultures of staphylococcus aureus, an organism causing boils, abscesses and other pus conditions. was Experiment II. The Bactericidal Action of Oils and Cutting Compounds. One cc. of a twenty-four hour broth culture of staphylococcus aureus added to ten cc. of each of twenty-two samples of oils and cutting compounds which had been previously sterilized for fifteen minutes at fifteen pounds' pressure in the autoclave. The results of this series of tests indicated that neither mineral oils nor cutting compounds are germicidal. At the same time they probably have little in the way of nutrient properties for bacterial growth. However, as growth did not disappear in many of the test mixtures in a period of twelve hours, the indication is strong that these mixtures may be capable of action as "carriers" of infection. In this connection there did not seem to be any difference between cutting oils and cutting compounds. Sources of Pollution. There appear to be many sources of pollution for the oils and compounds. It was found that all workers interrogated denied spitting into the reservoirs, but several men denying this practice were observed to do so in spite of instructions by foremen and officials to the contrary. As the operatives' hands and arms are in almost constant contact with these substances, the filthiness of this practice can be Cuspidors readily appreciated. should be supplied to all employes and insistence on their use is essential. In general, it is better to replace "Don't Spit" signs with cuspidors and signs calling attention to them, as "Use the Cuspidor." Mode of Spread. Due to these exposures, pollution is almost certain to follow, especially in those cases where employes have acne or where they have pus infection of the skin, or mouth and respiratory tract. This is more serious where machines are equipped with individual oiling systems and where cuttings and shavings are collected from the different machines and the oil drained off and filtered. The oil is usually heated slightly to facilitate the filtering process. It will be seen that if the oil from one machine is polluted with organisms and is mixed with oil having slight or no antiseptic properties and coming from many other machines, and later redistributed, infection is certain to be carried to any number of men. This is also true of machined parts which are covered with the oil and subsequently handled by men in other departments. Cutting compounds, on the other hand, are not usually recovered from cuttings and there is, therefore, less posibility of infection spreading from machine to machine, except by the small amount which adheres to machined parts. Here the effects of rapid drying and light probably cause pus-forming organisms within a the death of the great majority of few hours at most. But if the cutting compound becomes polluted in a given machine (as it usually is), the man working on the machine may be re-infected indefinitely. Wound Infections. Repeated minor injuries by steel splinters, etc., offer many opportunities for bacteria to enter the skin. These steel splinters are present in oils. and compounds in great numbers. as has been demonstrated by microscopical examinations as well as by magnet withdrawal (Shie). Conclusions. It is, therefore, concluded that oils and compounds are important factors in transmitting organisms which cause furunculosis and which infect wounds. It is concluded, also, that the mechanical action of these substances is an important factor in causing skin affections. It is evident that if these oils and compounds can be kept free from contamination the most important feature will be taken care of. Control. It would seem that the workmen could be impressed with the filthiness of the habit of expectorating in oil in which their hands and arms are almost continually bathed. It would seem, It would seem, also, that their attention might be forcibly called to the danger of working on machines while they have infections of any kind with which oils come in tontact. Employes having infections of this kind should report to the dispensary at frequent intervals so as to have the part dressed in such a manner as to prevent oils coming in contact with discharging sores. Washing facilities should be provided of a type to prevent men washing in the same water, running water being preferable. Towels used in common should be prohibited and every man should have his own cotton waste and wiping rags. There should be strict plant supervision and regulation of these features, if epidemics of boils and wound infections are to be prevented. intervals of sufficient frequency to keep the oil sterile. However, the oil that is reclaimed from the cuttings and steel shavings by draining and filtering could be heated to a temperature sufficient to kill all organisms. Pasteurization temperatures (140° to 165° F.) can be readily carried out, — 140° F. for twenty to thirty minutes suffices; higher temperatures may be used for proportionately shorter periods. In plants having central oiling systems, with large tanks from which oil flows by gravity to individual machines and is then returned to the tank, heat sterilization can be effectively carried out. Steam coils can be installed in the oil tanks and the oil heated to 140° F. for twenty to thirty minutes and from here allowed to flow to the machines. When the oil is re-collected from the machines it should again be sterilized and thus always reach the individual machine in a sterile condition. Chemical disinfectants have been suggested and used with varying success by a number of firms. Coal-tar disinfectants are apparently the only ones available as others have objectionable features, some of them corroding metals, others interfering with the lubricating properties of oils and compounds and still others being too expensive to be practical. Cresols have been extensively used in this connection, partly because of their high phenol coefficiency, and partly because they are the most inexpensive of the coal-tar products to use. Their use has been accompanied with indifferent success. Many objections have been raised as regards their use, the chief objections being their odor and their irritating properties to the skin. It has also been observed (as will be shown later) that they are apparently not effective as germicides when used in oils. Cresol dermatitis is frequently observed among workers exposed to cresol and it would seem that if used in oil in sufficient quantities to be effective as a germicide, it might defeat its purpose by creating an aggravating dermatitis that might readily become infected. A sample of cresol disinfectant was procured which was rated by the United States Hygienic Laboratory as having a phenol coefficient of 6.06 without organic matter and 3.21 in the presence of organic matter. In tests with organic matter by the Hygienic Laboratory, typhoid bacilli were killed in 21⁄2 minutes by a 1 to 180 dilution and in 15 minutes by a I to 375 dilution. As oils and compounds contain considerable organic matter, it was to be expected that the results with cultures of pus-forming organisms would be about the same, when the disinfectant was added to oils and compounds. Experiment III. To Determine the Effectiveness of Cresol Disinfectants in Cutting Compounds. A loop of staphy lococcus aureus was added to a 1-to-50 solution of the cresol disinfectant under discussion in cutting compounds. and the whole well agitated. thirty minutes cultures were made after the usual methods. Live bacteria were found. Bacteria were, of course, also found in higher dilutions. Hence the After disinfectant was not effective in a 2 per cent solution in oil in thirty minutes. It was effective in a control experiment in a 1/4 per cent solution in water in fifteen minutes. It is therefore apparent that the oil emulsion in the cutting compound exerts a protective influence over suspended bacteria. This was also brought out by applying the same tests to a drilling compound (which is similar to cutting compound but contains more water). The disinfectant in this case was effective in thirty minutes in dilutions up to 1-to-50. Tests were also made to determine the stability and effectiveness of the cresol disinfectant by making up two series of dilutions of the disinfectant in a drilling compound varying in strength from 1-to-10 to 1-to-300. The drilling compound was previously sterilized in the autoclave. Experiment IV. The Stability of Cresol Disinfectants in Cutting Compounds. To each tube in Series I a loop of twenty-four hour broth culture of staphylococcus aureus was added. and in thirty minutes cultures were made from each tube and the cultures incubated for twenty-four hours. The other series of tubes (Series II) was placed in the incubator for twenty-four hours at a temperature of 100° F. with the cotton plugs loosely in place, in order that evaporation of the disinfectant could readily take place (as might occur in practice). At the end of twentyfour hours each tube was inoculated with a loop of a twenty-four hour broth culture of staphylococcus aureus and at the end of thirty minutes cultures were made and then incubated for twentyfour hours. A series of dilutions of the disinfectant in normal salt solution was used as a control (Series III). The disinfectant was effective when combined with drilling compounds (Series I) in dilutions of 1-to-10 and 1-to 50 after a short interval (thirty minutes) but was not effective in higher dilution. The same results obtained in Series II, the disinfecting properties not being affected by attempting to evaporate the disinfectant. There was no growth in the salt solution in any of the dilutions, showing the effectiveness of the cresol disinfectant in simple watery solution (Series III). The sum of the experiments shows that oils apparently inhibit the action of the disinfectant in dilutions above 1-to-50 and therefore the disinfectant is not effective in weaker dilutions. The particular disinfectant used apparently formed a very good emulsion with the cutting compound, but it would have to be used in at least a two per cent solution. Hence the cost, disagreeable odor and irritating properties of the mixture would prohibit its use. This disinfectant resembles very closely the Liquor Cresolis Compositus U. S. P. and differs but little from other commercial cresol disinfectants, most of which have a relatively high phenol coefficient, like the one used. We can therefore conclude that cresol disinfectants are of but doubtful value for the purpose at hand. Requirements Necessary in a Chemical Disinfectant. A disinfectant to be satisfactory for this purpose should not be irritating to the skin, should not affect the lubricating and refrigerating properties of oils and compounds, should not stain or bleach or corrode metals or rot fabrics, should not have an unpleasant odor, should be cheap, stable, miscible and effective in water and oil and should be effective in both slightly alkaline and acid media. In addition, it should not be greatly affected by the presence of organic matter. Apparently, there are some commercial disinfectants having most of these properties, the principal drawback being that they are not effective in oil. Continued efforts I will have to be made to determine a satisfactory disinfectant for the purpose at hand. Intermittent Steam Sterilization Suggested. For the cutting compounds which are used over and over again in the same machines and which are not collected up nor filtered free from shavings and cuttings and hence in no part of their use pass through a common reservoir, it is suggested that passing hot steam into them two or three times a day for a few mintues at a time would aid greatly in reducing the mass of bacteria. present. It is suggested that a small steam pipe might be run into the reservoir of each machine or a steam hose used. Then before starting the machine in the morning and at the noon recess and in the evening the steam could be allowed to bubble through the cutting compound for perhaps fifteen or twenty minutes, in which time it is more than probable that the temperature would be so raised as to destroy most of the bacteria present. This is upon the principle that where bacteria for various reasons cannot be totally destroyed it is nevertheless very effective to destroy the vast majority of them to prevent the spread of disease. Summary The incidence of furunculosis and wound infection in certain establishments is apparently abnormally high and represents an important economic loss to the company as well as to the men affected. 2. Cutting compounds and cutting oils are vehicles or "carriers" for pus-forming bacteria and are responsible for engendering and spreading much furunculosis and wound infection. 3. The oils and compounds used appear inert to bacterial life, being neither germicidal, antiseptic nor directly supportive. 4. Employes are probably mostly responsible for the infection of the oils, but accidental infections would probably occur under the most favorable circumstances, suggesting the necessity of some means of sterilization of oils and compounds. 5. Education of employes in regard to expectorating into lubricants and reservoirs, interchange of towels and wiping rags, and the frequent cleansing of clothing, as well as the prompt dispensary care of all wounds and skin eruptions, are essential. 6. In purchasing oils and compounds from the manufacturer, sterile products should be specified. 7. Heat sterilization. of reclaimed oil before it is redistributed is important. This can be effectively carried out by heating the oil to 140° F. at least twenty to thirty minutes. There does not appear to be any satisfactory method of sterilizing oils and compounds by heat in individual machines. It might be possible, however, to use some form of in termittent steam sterilization at such points, for both oils and cutting compounds. 8. Experiments so far made. both by the investigators and by others have proved disinfectants to be of doubtful value, their efficiency being apparently impaired when mixed with oil. A commercial cresol disinfectant with a phenol coefficient of 3.21 in the presence of organic matter was not effective unless used in two per cent solution. The cost, odor and irritating properties of a two per cent solution would render its use impracticable. OCCUPATIONAL DISEASE IS DISTINGUISHED FROM INDUSTRIAL ACCIDENT BY OHIO SUPREME COURT The Ohio Supreme Court in a recent decision established a distinction between an occupational disease and an industrial accident or personal injury, which, aside from its importance as a guide to the carrying out of the workmen's compensation law, has interest for persons interested in the industrial side of public health work. The court ruled as follows: "I. A disease contracted in the natural and ordinary course of employment, by a person engaged in a particular calling or occupation, which disease from common experience is known to be a usual and customary incident to such calling or occupation, is an 'occupational disease,' and not within the contemplation of the workmen's compensation law. "2. The accidental and unforeseen inhaling by an employe, in the course of his employment, of a specific, volatile poison or gas, resulting in injury or death, is not an occupational disease." The Supreme Court in its decision affirmed a judgment of the Jefferson County Court of Appeals, which had reversed a ruling of the The InIndustrial Commission. dustrial Commission, in the decision thus set aside, had refused to pay a claim under the workmen's compensation law for the death of Edwin S. Roth, who had been killed by lead fumes from paint which he was thawing at the direction of his employer. The commis sion held that his death was due to an occupational disease, for which no compensation is provided by law. Roth's administratrix con tended that the death was due to "personal injuries sustained in the course of employment," and therefore came within the provisions of the law. The latter view was upheld. |