Mobile X-ray Unit Research Articles

A review of the pneumoconiosis problem in the United States.

NEUMOCONIOSIS, and more particularly P silicosis, has been the outstanding occupational disease disability problem of American industry for many years. It was of such magnitude that, for the period 1914 to 1940, most of the effort of the Industrial Hygiene Division of the Public Health Service was devoted to pneumoconiosis research; in this effort, many cooperative studies were done with the U. S. Bureau of Mines. Although the basic research era began in 1914, it was not until 1924 that instrumentation and diagnostic procedures had developed to the point where environmental conditions could be correlated with pathologic findings. With the development of the impinger and the mobile x-ray unit the Public Health Service in 1924 embarked upon a series of epidemiologic studies that culminated around 1940.'-'' By this time, three disabling types of pneumoconiosis had been recognized-silicosis, with and without complicating tuberculosis ; anthracosilicosis ; and asbestosis. The etiology, epidemiology, pathology and methods of prevention had been well defined, and it was believed that, through the application of developed engineering and medical principles, pneumoconiosis could be prevented. The period 1935 to 1940 also was one in which industry began to apply these developed preventive techniques on a very wide scale. This research had led to certain conclusions regarding the pneumoconioses, which need not be repeated at this time; however, attention is directed to two conclusions: (1) that some nonsilica components in industrial dust, especially iron oxide, may prevcnt or modify the action of silica in the body and may alter the tendency toward complicating tuberculosis; and (2) that asbestos was the only dust other than free sitica that had been shown to cause a lung

Incidence of tuberculosis among homeless men.

This study, an 11 months' intensive case-finding survey, is based on the client population of the Salvation Army Men's Social Service Center in Minneapolis. The center provides a rehabilitation program for homeless men. The majority of these men come on self-referral from Skid Row, although, at any given time, about 10% of the clients have been referred for rehabilitation as physically handicapped; 10% as parolees and probationers, and about 10% as provisional dischargees from the state hospital system. About 70% of the client population regards the abusive use of alcohol as its major problem. For five years preceding the start of this study, the center depended on the periodic visits of the Christmas Seal Mobile X-Ray Unit of the Hennepin County Tuberculosis Association to check the health status in regard to tuberculosis. During this period, no noticeable difference in incidence between the population here and the general population in Minneapolis

A pilot investigation into the occurrence of pneumoconiosis in large power stations in South Wales.

In the large electricity generating stations where coal is used both the coal and the resultant ash are enclosed and handled mechanically. Never theless, considerable quantities of dust are found on the tops of machinery, on ledges, and in crevices, and the workmen in some parts of the station get their faces and clothes covered with dust. As there have been, as far as it is known, no previous studies of the possibility of pneumo coniosis arising from exposure to dust in electricity generating stations, it was decided in the first instance to examine radiologically a group of men employed in these stations in South Wales. South Wales was chosen because the mobile x-ray unit of the M.R.C. Pneumoconiosis Research Unit, which could ensure films of a high technical standard, was close at hand, and pneumoconiosis was more likely to occur in stations handling coal from the South Wales fields where miners show a higher incidence of dust disease than in any other British coal field. It was also supposed that in this region, where the association of pneumoconiosis with coal dust is so well known, the cooperation from the men would be good. There was, however, one disadvantage which was not overlooked. Many of the men employed in power stations had also worked in coal mines for varying periods. If pneumoconiosis were found in these men it would be difficult to know which occupation had caused it. Four large stations were selected for the investiga tion because they were conveniently situated and were representative of the different conditions in this region, for example, in the type of coal used and the methods of stoking boilers. There appeared to be several sources of exposure to dust : from coal tipping in the bunker houses, and from the pulverizing mills and large pipes conveying the pulverized fuel, from the ash from boilers and precipitators, although much of the ash is carried away by water ; from the maintenance and repair of mechanical and electrical equipment by fitters and their mates, when a large amount of settled dust is disturbed, particularly in dismantling equipment ; and from the maintenance and cleaning of boilers and precipitators. It was not possible to separate the men employed on these jobs into occupational groups as most of the men are constantly changing their type of work. Bricklayers and laggers who are continually employed on this work, can, however, be con sidered separately. The bricklayers go inside boilers to chip away worn and broken silica bricks. During this work the boilers are open and a gentle air stream is passed through them but the men are exposed to considerable quantities of siliceous dust. The laggers strip asbestos off steam pipes being repaired, and are exposed to clouds of fine asbestos dust.

The Roentgen Treatment of Acute Peritonitis and Other Infections with Mobile X-Ray Apparatus

IN 1928, under pressure of necessity, a case of gas gangrene was treated with the mobile x-ray unit, and recovered. The mobile unit was the ordinary unit designed for mobile diagnostic work in general hospitals and rated below 90 kilo-volts. In the first report (1) on the treatment of gas gangrene with the mobile unit, two cases out of eight died. Both of those dying had trunk involvement. In the six who recovered, the infection was entirely, or to a great extent, limited to the extremities. From the outcome of these cases it was thought that probably the mobile unit did not have sufficient kilovoltage to obtain the necessary depth dose to effect a cure in the trunk cases. This led to a recommendation for the use of higher voltages in treating deep-seated or trunk infections. Since the maximum kilovoltage obtainable from the mobile unit had been used in treating the two cases which died, it was apparent that in the future cases with trunk involvement must be moved to the x-ray department if they were to be treated successfully, or some apparatus producing a higher kilovoltage must be designed to enable the radiologist to treat at the bedside. Since no bedside apparatus was available, we started to move these patients to the x-ray department. This was done, on a few occasions, and, as these patients recovered promptly, we felt we were well rewarded for our efforts. In fact, we were so impressed with the results that we decided to treat other infections in the trunk. Peritonitis, following acute appendicitis and other intra-abdominal infections, is relatively common and was selected for a trial. The immediate difficulty encountered was that of obtaining the permission of the clinician to move the patient with peritonitis to the x-ray department, and we fully agreed with the clinician that the dangers involved in moving the patient seemed out of proportion to the chances of improving his condition. The whole thing then resolved itself into providing some means of treating the patient with peritonitis without disturbing him in any way, and, as no equipment was commercially available for this purpose, we felt that it was our duty to devise some means of providing x-ray treatment at the bedside, for those who were too sick to be moved. In a short tour of the local x-ray dealers' basements, we were able to select from the stock of obsolete and discarded x-ray equipment, a suitable transformer which was mounted upon a wooden base carrying a tube stand. We found two such units, and built two mobile units; they have served our purpose very well. They are not, we hope, the last word in this type of equipment, as we appreciate some deficiencies in this assembly, but we look for a real piece of apparatus to be developed in the near future for this type of work, as we are certain that the results will warrant its production.2

PRESENT STATUS OF THE X-RAYS AS AN AID IN THE TREATMENT OF GAS GANGRENE

In August 1928 Dr. J. R. Dwyer, one of the attending surgeon's at St. Catherine's Hospital in Omaha, came to the x-ray department and inquired whether we had in the x-ray or physical therapy departments anything that might help him in treating a serious case of gas gangrene. The patient was a young man who had injured his knee in an automobile accident. He was in his twenties and, though a very robust individual, surgical consultants had advised against operation because the disease had extended to the groin. The patient was delirious and any surgical procedure seemed out of the question. We replied that there was nothing definite that we knew of but suggested that since the patient could not be moved from his bed we might use the mobile x-ray unit. He gave us permission to treat the man by any method that we thought might be of value

Review of High-Powered Mobile X-Ray Unit

The taking of a radiograph in a patient's home has long since ceased to be a novelty, and for the purpose very many sets have been manufactured of a type whose input must necessarily be sacrificed to portability, and this type of set is deservedly popular. It is manifestly impossible to pretend that one can satisfactorily cover the whole radiographic field under such poor operating conditions. The patient is usually extremely ill, and would tax one's ingenuity were it possible to transport him to the radiological consulting room, or hospital department equipped with the most modern apparatus. If we pause for a moment to consider progress in medical radiography during the past few years, from the specialist point of view, we observe that it is now almost standard practice in chest work to use current values of 100 milliamperes or more through the X-ray tube for the shortest possible time, and at varying tube-film distances up to two metres. It is also common practice to adopt a tube-film distance of 40 inc...

A Mobile X-Ray Unit

On behalf of Messrs. X-Rays Limited, Mr. Cuthbert Andrews (in conjunction with Messrs. Kodak Ltd.) showed a cinematographic film of a Mobile X-ray Unit which had been built by Messrs. X-rays Limited to the order of the Welsh National Memorial Association.