Abstract
With the exception of iron, lead plays a more
important part in the lives of the civilised nations
of to-day than any other metal. Among metallic
poisons lead is facile princepe. These two facts
raise the subject of lead poisoning to a position of
the first importance, not only from the point of view
of preventive medicine, but from the point of view
of the general practitioner and the community at
large whom he serves.
Lead enters very intimately into industrial and
domestic life. Apart from the smelting of the metal
itself, and from the preparation of its compounds,
lead is found in so many trades that an exhaustive
list would reach a very considerable length.
Among everyday occupations one might mention
plumbing, painting and lithographing; the manufacture
of china-ware, pottery and glass; the huge tin plate
trade which in turn supports the canned food industry;
and even the polishing of precious stones.
Lead may enter our houses in drinking water,
which is commonly conveyed in lead pipes and stored
in lead lined cisterns. Conditions may occur which
render a safe and potable water plumbo -solvent, and
serious harm may be done before the danger is realise
The use of tinned foods is increasing and they
are a necessity in our naval and military services.
Cheap tin plate, cheap enamelled ware and cheap
pottery may yield lead to acid contents.
Despite opposition and the advertisement of
substitutes lead paints continue to be used very
largely for every sort of purpose.
Lead and its compounds are ornni- present, and
wherever they are found in absorbable form they remain
a danger. Nor are the symptoms of early plumbism of
such a kind as to constitute any kind of safeguard
or warning. Absorption may be slow, the attack
insidious and recognition too late.
The toxic qualities of lead have been known for a
very long time, but to Tanquerel des Planches belong
the credit of the classical description of the signs
and symptoms. Sir Thomas Oliver of Newcastle-on-Tyne
has done much to increase our knowledge in recent
years, and to bring industrial lead poisoning into
prominence. Among other writers in the English
language may be mentioned Goadby and Legge in this
country, and Alice Hamilton in America.
The legislature of almost all civilised countries has
recognised the impairment of health and high mortality
suffered by workers in trades wherein lead may be
absorbed, and such trades are described as "dangerous
unhealthy industries". The Factory and Workshops',
Act of 1895 made cases of lead poisoning occurring
in factories and workshops notifiable, and it is at
this point that our statistical knowledge of
industrial plumbism commences. The order was repeated
in the Act of 1901, but it is noteworthy that
plumbism among house-painters and ship-painters is
not included. As notification in this class of
worker is voluntary, our returns are necessarily
incomplete, and this is the more regrettable as it
is believed that the incidence of plumbism is high
among them.
The beneficial results of legislation are shown
in the White Lead Trade. In the ten years 1900 to
1909 the cases notified had fallen from 358 to 32,
and the deaths from 6 to 2. "In 1912 the manufacture
of white lead no longer occupies the unenviable
position of first place in the list of trades in which
plumbism occurs. The position is taken by the
earthenware and pottery industry and close
upon it comes coach- building".
Such a chapter compares favourably with any in
the annals of preventive medicine, but the matter has
not been allowed to rest there. The Earthenware and
China Industry has been attacked by a
Parliamentary
Departmental Committee, and under the powers of the
existing Act comprehensive regulations were gazetted
on 7th January 1913. To these and previous orders
must be attributed the improved health of the workers.
The latest
information. calls attention to the
diminishing number of cases and deaths in most of the
trades concerned, and to the reduction in the severity
of the symptoms and in the number of chronic cases.
It is, however, admitted that during the War many
industries were adversely affected, and that the
improvement for this period is more apparent than real.
The especially baneful effect of lead upon women
and young people was made the subject of certain
recommendations by the General Conference of the
International Labour Organisation held at Washington
in 1919, and the points raised have been embodied in
the "Women and Young Persons (Employment in Lead
Processes) Act of 1920."
Still the incidence of lead poisoning remains
too high.
