Pulmonary fibrosis in non-ferrous foundry workers.

Much has been written about fume fever (brass caster's ague, zinc chills, zinc shakes), and lead poisoning in brass foundries has been dealt with recently by Stalker (1947) and Hamlin and Weber (1947), but the references to pulmonary fibrosis amongst non-ferrous foundry workers are few. Stalker wrote that " the incidence of advanced silicosis has been generally low among [brass] foundrymen ". Many surveys of the incidence of pulmonary fibrosis in iron and steel foundry workers have been made, and some of them have also included groups of non-ferrous foundry workers. These include the reports by Trice and Easom (1936), Greenburg, Siegel, and Smith (1938), Sander (1939), Brown and Klein (1942), Riley, Butler, and Goren (1945) and Vigliani, Parmeggiani, and Zanetti (1948). The term " non-ferrous " includes alloys with a copper base (brass, bronze, and gunmetal) and also with an aluminium or a magnesium base. It is unusual to find specific references in these reports to brass foundries, and no pathological studies of brass founders' lungs have hitherto been reported. Since 1936 only 10 deaths from silicosis (with or without tuberculosis) in brass workers have come to the notice of the Factory Department. But these " accidental" cases give no information about the real incidence of silicosis in this trade. Only careful surveys, which combine clinical, x-ray, environmental, and pathological studies, provide such information. There may well be a close analogy between the brassand iron-founding industries. In the latter, it was thought for years that there was little risk of silicosis and other forms of pneumoconiosis, because few cases had come to the notice of either the Factory Department or the Silicosis Medical Board. When an extensive survey was made (McLaughlin and others, 1950) it was found that the incidence of silicosis and mixed-dust pneumoconiosis, particularly in moulders who made small castings, was moderately high, especially if siliceous parting powders had been used. It was also found that the dominant pathological lesion in these workers was the mixeddust pneumoconiosis nodule and not the classical silicotic nodule. Again, the non-ferrous metals, including brass, are cast either in sand moulds or in metal moulds (die-casting). No siliceous dust is created when diecasting takes place. If therefore the results of surveys (usually by radiography alone) of nonferrous foundry workers are given, and no attempt made to separate the sand-casters from the diecasters, a false impression of the incidence of silicosis will be given. In this article we present the pathological details of six non-ferrous (mainly brass) foundry workers (four moulders and casters and two fettlers) together with such clinical, radiological, and environmental details as were available. In five instances the casting of the various metals was done in sand moulds and in the sixth in iron moulds.