FLUORINE INTOXICATION
A Clinical-Hygienic Study
With A Review Of The Litterature And Some Experimental Investigations.
By Dr. Kaj Eli Roholm



Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

Preface V-VII
PREFACE

Cryolite intoxication, a hitherto unknown disease among the workers at the Øresund Chemical Works, Copenhagen, was found in November, 1932, as a result of a profitable collaboration between the Industrial-hygienic Researches of the Inspectorate of Factories and Workshops and the X-ray Department of the Rigshospital. Professor P. Flemming Møller, the leader of that department, interested me in the disease and suggested that I should go more deeply into the problems of fluorine intoxication.

Through the medium of an appointment at private expense as Assistant Physician under the Inspectorate of Factories and Workshops, I was enabled to complete the principal part of the investigations which form the foundation of the present work. The material from the first investigation was placed at my disposal, including the blocks for the illustrations Figg. 16, 19—26, 28 and 29.

I wish to thank Professor Flemming Møller for inducing me to embark on the subject, for kind permission to examine my material by X-ray at the Rigshospital, for passing judgment on the radiographs of cryolite workers’ lungs, and for unflagging interest in my efforts.

To the Director of the Inspectorate of Factories and Workshops, Mr. E. Dreyer, and its Chief Physician, Dr. Sk. V. Gudjonsson, I tender my best thanks for their confiding the task to me and allowing me a free hand to complete it as well as for their interest and support. By his energetic labours for industrial hygiene in Denmark Dr. Gudjonsson laid the foundation on which this work was started.

A great deal of the work was done at the Copenhagen University Institute of Hygiene and the Budde Laboratory, to whose Director, Professor L. S. Fridericia, I am greatly indebted for hospitality, the best of facilities, and friendly interest. I am obliged to the staff of workers at the Institute for help and encouragement in the daily work. Miss Kirsten Becker and Miss Lotte Holm assisted me in tending the experimental animals and with the preparation of microscopic slides. Preparations were photographed in collaboration with Mr. Henrik Jensen and Mr. E. D. Lange. Some of the microphotographs are the work of Miss Margrete Falck, of the Copenhagen University Institute of Pathological Anatomy.

It would not have been possible to carry on the work without help and kindness from many quarters. Dr. O. Brinch discussed problems of bone pathology with me and gave me valuable guidance. Dr. J. Engelbreth-Holm assisted me in judging the microscopic organ changes. Mr. R. Bogvad, M. Sc, examined bone slides in the polarization microscope. Mr. H. Buchwald, the Chief Chemist, analyzed fluorine preparations for me and helped with the analytical part. Mr. C. J. Howitz, of Viborggaard Farm, Herlufmagle, and Mr. S. Hjortlund, the Veterinary Surgeon, Copenhagen, assisted me to tend and slaughter the large experimental animals.

Materials of many kinds, comprising case-records, radiographs, autopsy material and statistics, were entrusted to me by Professors H. M. Hou-Jensen, Poul Møller, K. Sand, Erik Warburg, and J. Collin, all in the Copenhagen University; Professor J. J. Hoist, School of Dental Surgery; Dr. M. Degerbal, Zoological Museum; the Chief Chemist H. H. Stevenius-Nielsen, of the Danish Fertilizer Company, Ltd.; Chief Physician G. Biering, Kommunehospitalet; Chief Physician Chr. I. Baastrup, Bispebjerg Hospital, and the Cryolite Mining and Trading Co. Ltd., Copenhagen.

The sending out of an international questionnaire was made possible through the kind assistance of Dr. Johs. Frandsen, Director of the Danish National Health Service, and the Ministry of Foreign Affairs.

With financial assistance from the Dano-Icelandic Union-Foundation I was able to undertake a journey to Iceland in the autumn of 1935 to investigate conditions connected with the sheep disease gaddur. When collecting literature I was given excellent help by many Danish and foreign libraries, but especially by the University Library in Copenhagen, where the officials were indefatigable in their readiness to assist. By means of a grant from the Budde Foundation I was able to make library studies in Berlin in the summer of 1934.

A number of investigators abroad very kindly placed materials of various descriptions at my disposal: Professor E. W. Baader, Berlin; Dr. M. Bonjean, Rabat; Professor J. Casares Gil, Madrid; Dr. Juan Chaneles, Buenos Aires; Air. H. T. Dean, D. S., Washington; Professor Niels Dungal, Reykjavik; Dr. Leon Goldemberg, Buenos Aires; Dr. F. S. McKay, New York; Professor L. Slagsvold, Oslo; Dr. Margaret C. Smith, Tucson, Arizona; Dr. H. Velu, Casablanca.

It was possible to accomplish the work in its present form through considerable financial support from the Øresund Chemical Works, Copenhagen. Mr. H. Tuxen, the Manager, Dr. A. Westergaard, the Secretary, as well as the employees and officials have displayed great interest in it and helped me in the course of my daily collaboration with them. So did Mr. C. F. Jarl, C. B. E., the Proprietor of the Works, who induced me to extend my investigations as far as possible in order to find out available prophylactic measures. The translation of the book is the work of Mr. W. E. Calvert, Copenhagen.

I tender my most cordial thanks to all who in any way have aided me in my work.

Kaj Roholm

Blegdamshospitalet, Copenhagen N.

February 1937