Calling the Laboratory

IT is a pleasure to have the opportunity of reviewing a Government Publication which is a report to the Minister of Labour and National Insurance, Northern Ireland, by the Department of Social and Preventive Medicine of Queen's University of Belfast. It is the story, clearly and succinctly narrated, of a scientific survey into an important industrial hazard by Professor Pemberton and members of his department. The spinning and weaving of flax have been carried out in Ireland for many centuries and historically there is no evidence of any respiratory hazard until, with the industrial revolution, mechanization of the various processes took place. It is not surprising that local interest in the Monday syndrome and associated respiratory symptoms was in evidence by ,studies and observations by Malcolm in 1856. Purden from 1873 to 1877 and much more recently by Smiley (1951 and 1961) and Logan (1959). The report indicates the origin of the Survey-broadly to enquire into the existence of an industrial disease not prescribed by the National Insurance (Industrial Injuries) Act (N.I.) 1946 resembling byssinosis of workers in the cotton industry. Definitions are made and the complex processing and spinning of flax of today are graphically and pictorially described. With the co-operation of some 23 mills, 3,052 workers aged 35 or over were examined using a questionnaire based on the M.R.C. questionnaire on Respiratory Symptoms (1960). Detailed questions were asked about the symptoms of byssinosis, smoking habits and previous chest illnesses and respiratory function tests were carried out. A 'dust survey' to measure the concentration of airborne dust in the various rooms in the mills. was mounted to determine association between dust levels and the prevalence of byssinosis. The findings in all these exercises are tabulated and discussed and there are some excellent X-rays. Finally, conclusions in relation to the five significant questions to which answers were sought by the Ministry are given in detail. The Monday syndrome is described and the general point is made that flax byssinosis is clinically indistinguishable from enmphysema and bronchitis as they occur in the general population. History of the development of the condition from the Monday syndrome combined with the appropriate industrial history enables a diagnosis to be made. Professor Pemberton and his colleagues are to be congratulated on the production of a very readable report which must be of interest to a wide range of doctors in our Province. Government appreciation of its scientific merit is indicated by legislation consequent on its recommendations not only for Northern Ireland but for Great Britain. C.W.K.