The role of staphylococcal infection in beat disorders of miners.

Abstract

Since the report of Collis and Llewellyn (1924) the incidence of beat knee and elbow per 1,000 underground workers has increased more than tenfold. It is evident that the ineffectiveness of preventive measures which they noted has not been overcome. In 1949, 9,900 cases of beat knee and 1,500 of beat elbow were certified. Some of the increase since 1922 may be due to slight changes in defining the disorders and greater readiness to seek attention. However, a substantial part appears real and attributable to both the more frequent working of narrow seams and the increased use of mining methods which involve more kneeling. Despite their importance as the second most common of all the prescribed industrial diseases, little work on these disorders has been published. The problem has recently been discussed by Watkins (1951), who emphasized the importance of early treatment in view of the failure of current preventive measures. In contrast to the more general survey of Collis and Llewellyn the present work attempts to identify the factors responsible for beat conditions by a detailed study, lasting a year, of men employed in a single low seam where a high incidence of the disorders was expected. Much of the investigation was bacteriological, for previously the traumatic element in pathogenesis had received more attention, to the especial neglect of the study of individual predisposition. The importance of this predisposition will be shown below and evidence submitted that it depends upon susceptibility to staphylococcal infection, particularly of hair follicles.