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February 27, 1973 Factory — Statutory duty — Fume — Inhalation of low concentrations of oxides of nitrogen over prolonged period — Chronic lung illness — Employers' constructive knowledge of health hazard — Medical and other publications — Whether sufficiently indicating health hazard from 1965 onwards — Factories Act, 1961 (9 & 10 Eliz. II, c. 34), s. 63 (1).

The paper aims to focus on airflow and heat transfer inside the human nasal cavity. The contribution of this work is the inertial analysis of the momentum and thermal stress of the cavity throughout the respiratory cycle.

By means of computer tomography scans, an accurate three‐dimensional anatomical representation of the human nasal cavity was obtained. A three‐dimensional numerical model is presented in order to predict the time evolution of flow patterns during a quiet breathing cycle, covering inhalation and exhalation. An inertial analysis of the momentum and a detailed study of the thermal behaviour during the breathing cycle is carried out.

Head loss, velocity and temperature values are in agreement with experimental results from previous studies. Based on these results, the influence of the inhalation and the exhalation on the flow pattern and air conditioning has been reviewed. Results suggest that the anterior and posterior turbinate regions are where the air conditioning is primarily produced.

The future goal is to investigate respiratory disorders to increase the effectiveness of the eventual treatment of the pathology. The model could be a useful tool to predict, for instance, the modification of the flow patterns due to septal perforations.

The transient resolution provides insight into the momentum and thermal inertia though the breathing which is far from being well understood.

In order to be able to use the aroma hand massage as a skill that can be done by a nurse who does not have a special aromatherapy technique, we examine anti-stress effects of simplified aroma hand massage for healthy subjects. We evaluated the anti-stress action of aroma hand massage and the different components of the procedure in 20 healthy women in their twenties. We used autonomic nervous function measured via electrocardiogram as an index of stress. After conducting a baseline electrocardiogram, we induced stress in the participants by asking them to spend 30 minutes completing Kraepelin's arithmetic test. We then administered various treatments and examined the anti-stress effects. Kraepelin's test significantly increased sympathetic nervous function and significantly reduced parasympathetic nervous function. Compared with massage without essential oil or aroma inhalation, aroma hand massage significantly increased parasympathetic nervous function and significantly decreased sympathetic nervous function. The effect of the aroma hand massage persisted when the procedure was simplified. The anti-stress action of the aroma hand massage indicates that it might have beneficial application as a nursing technique. There are several limitations in this study; ambiguities of low component/high component ratio of heart rate variability and bias by small subjects groups of the same women.

Stress damages us and our performance. It is a real part of most manager's experience and can be said to occur when significant demands exceed perceived management responsibilities and routines. Stress can be the essence of working life, and certainly need not always be damaging to us. But when it becomes excessive, it is something unwanted.

May 5, 1972 Factory — Statutory duty — Breach — Fume — Prolonged inhalation of low concentration — Chronic lung illness — Employer's actual or constructive knowledge of health hazard — Whether to be determined up to time when action brought — Limits of statutory duty — Whether need to act on expert speculation unaccompanied by hazard warning — Factories Act, 1961 (9 & 10 Eliz. II, c.34), ss. 4(1), 63(1).

The purpose of this paper is to explore inhalation levels and dermal exposure to toluene among printing workers who wore no personal protective equipment; it is conducted in a plastic bag factory. Using a charcoal cloth pad (CCP) as a dermal sampler to assess skin permeation of liquid toluene is also investigated.

In total, 27 stationary air samples as well as urine and dermal samples were collected over 9 days from 11 printing workers. Six pieces of CCP were wrapped on each of the workers’ fingers for the dermal sample collection. Air samples were collected and analyzed according to NIOSH No. 1501, and 65 post-shift urine samples were collected and analyzed using gas chromatography equipped with headspace sampler (GC-HS/FID). Multiple linear regression was employed to analyze the association between the studied variables.

The mean (SD) urinary toluene (UTol) level was 13.42 (9.72) ug/L. Toluene on the CCP (TolCCP) was a meaningful predictor for UTol (p-value=0.027) with r and r² values of 0.441 and 0.195, respectively. The r and r² of the model using the toluene time-weighted average concentrations in air were 0.739 and 0.546, respectively. The absorbed dose of toluene determined from the TolCCP ranged from 1.05 to 91.94 mg, accounting for 12.3 percent of the threshold limit value (TLV).

Dermal exposure was insignificant when workers wore respirators, but when not, dermal absorption could contribute to the overall uptake and exposure above the TLV. Appropriate gloves should be assigned to the workers to reduce dermal exposure to toluene.

In South Africa, many illicit drugs have only recently been introduced and drug-related complications are often new to treating physicians. Heroin-induced leukoencephalopathy has been reported elsewhere in patients who inhale heated heroin vapors, a method known as “chasing the dragon.” The purpose of this paper is to present two patients, known to have inhaled heroin a few weeks prior to presenting with progressive neurological deficits.

Case presentations: two young males presented independently within eight weeks of one another with progressive slurring of speech, incoordination and weakness of the limbs over a period of two to three weeks. Both were known heroin addicts, and were known to one another, and both had inhaled heroin prior to the onset of symptoms.

The patients presented with a pancerebellar syndrome with marked bilateral upper motor neuron signs. CT scans showed diffuse symmetrical hypodense lesions involving the cerebral and cerebellar white matter with normal CSF. Both patients deteriorated neurologically, became cardiovascularly unstable and demised. Postmortem in one of the patients showed a prominent spongiform leukoencephalopathy consistent with reports of heroin-inhalation injury to the brain.

Toxic leukoencephalopathy due to heroin vapor inhalation was first described in the Netherlands in 1982. It has not been reported to occur with other modes of heroin use; an unknown toxin contained in heroin pyrolysate which forms when heroin is heated, may be causative. Brain MRI typically shows diffuse, symmetrical white matter hyperintensities on T2 and fluid-attenuated inversion recovery sequences in the cerebellum, posterior cerebrum and posterior limbs of the internal capsule with a posterior-anterior gradient. Pathologically, spongiform degeneration with relative sparing of subcortical U-fibers is seen. No treatment has been proven effective, but antioxidants and Vitamin E may be beneficial. Mortality is high at 23-48 percent.

This report emphasizes that spongiform leukoencephalopathy as a rare consequence of inhaling heroin vapors does occur in South Africa and clinicians should consider this disorder in their differential diagnosis of acutely developing leukoencephalopathy.

An awareness program regarding this grave condition is planned.

The cardiovascular complications of patients inhaling heroin vapor has not been highlighted previously. These are the first patients from Africa described with this condition. A toxic component appears likely.

This study aims to perform flow simulations inside the acinus with fine alveolar pores (Kohn pores) using hexagonal cells and bottom-up geometric modeling, which enabled the elimination of invalid voids using previous top-bottom methods and spherical or circular cells.

Regular hexagonal cells were used to construct alveoli with no gaps via tessellation. Some hexagonal cells were fused to eliminate the inner boundaries to represent the structure of the bronchial tree. For the remaining hexagonal cells, the side lengths of the shared walls were adjusted to construct alveolar pores. Periodic moving boundaries with the same phase were set for all walls to describe synchronous contraction and expansion of the bronchi and alveoli.

More realistic flow characteristics in the distal lung were obtained. The effects of pore size and the mechanism of auxiliary ventilation of alveolar pores were revealed.

To the best of the authors’ knowledge, this is the first numerical simulation study on the function of multiple alveolar pores at the level of pulmonary acini, which will be helpful for simulating the dynamic process of cough and sputum excretion in the future.

Occupational exposure to dust is a major health and safety concern for workers in developing countries. Such laborers are often exposed to dust without being aware of its threat to their health. In the process of crushing stone, mineralogical materials are released into the environment. The material includes dust, fumes, ashes or other industrial waste which may constitute toxic elements. The purpose of this paper is to investigate the respiratory health problems of stone crushing industry workers in Bangladesh.

This cross-sectional descriptive research study was conducted by adopting a multi-method approach. Data were collected by use of a questionnaire survey, focus group discussions, in-depth interview and spirometric examinations. Focus group discussions and questionnaire surveys were conducted among 240 workers. The respondents were divided in six groups for the spirometric examination. The questionnaire was formulated by following standards set by the American Thoracic Society Division of Lung Disease questionnaire and European Coal and Steel Community. Data on respondent’s height, weight and smoking habits were collected by using a structured checklist. Meanwhile, lung functions were assessed by spirometry. A Statistical Package for Social Sciences was used to analyze the data.

The results show that there was a significant relation between respiratory problems and inhalation of dust and particulate matter and cigarette smoking. It also shows that coughing was the most common problem among the respondents. The majority of respondents suffered from obstructive types of respiratory problems.

Findings of the study reveals that chronic exposure to dust at stone crushing plants increases the risk of respiratory problems and the impaired lung function of workers. It also reveals that there is a significant relation between respiratory problems and inhalation of dusts and cigarette smoking. Raising awareness about health risks amongst workers could reduce these health hazards. The government should make a national policy for the prevention, control and elimination of silica exposure and silicosis. The results would help to raise awareness of the issue. Finally, it would raise awareness on respiratory health problems of workers at stone crushing industries in Bangladesh and help the government to make a policy for the prevention, control and elimination of silica exposure and silicosis, and thus enhancing public health policy and practices in the country.

January 15, 1973 Ironfoundry — Statutory duty — Breach — Noxious dust — Prolonged inhalation of noxious dust — Chronic lung illness — Employers' actual or constructive knowledge of health hazard — Test to apply when determining constructive knowledge — Whether employer should be aware of recent medical or scientific knowledge — Factories Act, 1961 (9 & 10 Eliz.II, c.34), ss.4(l), 63(1).