Schneeberger disease

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Schneeberger disease is an outdated term for a special form of lung cancer . This type of tumor was first described in Schneeberg miners .

history

The Schneeberg disease , also known as mountain addiction in the early modern era , accompanied the Schneeberg miners for many centuries. Triggers are the here due to the particular geology closely with BiCoNi ores overgrown uranium ores . Paracelsus first described Schneeberger disease in his book published in 1567. Another doctor, Martin Pansa (from 1607 to 1614 city doctor in Annaberg ), deals with the lung diseases of miners in his book "A getrewer advice in arduous mining and lung addiction", published in 1614. The doctor Johann Friedrich Henckel , who settled in Freiberg in 1712 and was named a mountain ridge in 1732, dealt with the various lung diseases of miners and smelters in his book "Von der Bergsucht und Hüttenkatze", published in 1745.

In 1879 Walther Hesse and Friedrich Hugo Härting published the study "Lung cancer, the mountain sickness in the Schneeberger pits". Hesse was a trained pathologist and practiced as a medical officer in Schwarzenberg between 1877 and 1879 . After taking office, Hesse was shocked by the poor state of health and the low age that miners typically reached. Härting was a mountain doctor in Schneeberg in 1865/66 . After autopsies on 20 miners, they concluded that the cause of death diagnosed as lung cancer originated in the mines. However, out of ignorance of the existence of radon and thorium-active radiation, they established arsenic dust as the cause. With their investigation, they were the first physicians to apply the epidemiological approach not only to infectious diseases, but to cancer. The work that Hesse and Härting had done in Schneeberg was exemplary for a number of other scientists - the best known among them is the work of Ludwig Rehn , who was able to prove in 1895 that there was a connection between work in an aniline processing industry and the occurrence of bladder cancer duration.

In 1884 Richard Ancke published in his dissertation "Lung cancer, the mountain sickness in the Schneeberger pits" investigations into the development of the Schneeberger illness.

Between 1922 and 1925, Schneeberger disease was first extensively investigated. In this study, a group of 154 Schneeberg miners, who worked underground for between 10 and 15 years , was compared with a group of 176 employees of the blue color works and 186 Oberschlema residents. In addition, 22 autopsies of deceased miners were made.

Due to the similar geological conditions of the Joachimsthal deposit , similar investigations began here. Julius Löwy from the University Clinic in Prague published the first results at the 4th International Congress of Occupational Diseases in Lyon in 1929 and showed the correspondence with Schneeberg's disease in his article "About Joachimsthal Mountain Disease". The disease was attributed to the inhalation of radioactive air and dusts containing arsenic. Further investigations were carried out in Joachimsthal from 1928 to 1930 under the direction of J. Markl and Augustin Pirchan. 323 active miners and 83 retired employees of the Joachimsthal mines were included in the investigation. Heřman Šikl from Charles University in Prague also performed 13 autopsies and found 9 deaths from lung cancer. On the basis of these investigations, in Law No. 99 of June 1, 1932, this lung cancer was recognized as an occupational disease in Czechoslovakia . In further investigations, 24 cases of lung cancer were found up to 1937.

In 1939 the Radium Institute was established in Oberschlema as a branch of the Kaiser Wilhelm Institute for Biophysics founded by Boris Rajewsky . The aim was to investigate the effects of the highly radioactive sources discovered in 1908 in the Marx-Semler-Stolln on the human organism.

With the establishment of the Joachimsthal radium bath in 1908, a boom in radon balneology broke out. With the discovery of the springs in Oberschlema, the way to build a radium bath was paved in 1918. In the baths, people trusted in the healing properties of radium . During the cures, people bathed in radium water, served drinking cures with radium water and inhaled radon in emanatories. The baths were visited by tens of thousands each year. The levels of these cures reached extreme heights: the baths had 700  ME (9418  Bq / l ) and the one-hour emanation 70 ME (942 Bq / l). During a drinking cure, three quarters of a liter of water with 3000 ME (40,364 Bq / l) was served daily for 30 days. Against this background, it is understandable that the research on this topic remained largely hidden from the public. It was feared that there would be no spa patients and the collapse of the radium industry, which used radium in articles such as creams, drinks, chocolate, toothpastes, soaps and other products. Between 1932 and 1937, thorium was also used in the French cosmetic series “Tho-Radia”. On the other hand, it must be stated that the effect of the radioactive decay products of radon has still been underestimated.

In 1939 Boris Rajewsky published a "report on the Schneeberg investigations" in the Zeitschrift für Krebsforschung . Alfred Screw, Alexander Janitzky and Alfred Krebs were involved. The aim of the work was to investigate the connection between the radioactivity in the Schneeberger pits and the occurrence of the Schneeberger disease as well as the level of the tolerance dose for occupationally exposed persons. For this purpose, measurements of the radioactivity of the rock, the water and the air in the entire Schneeberger mine field were carried out for three years. Rajewsky was able to prove that the inhalation of radon in connection with the inhalation of radioactive dusts can lead to lung cancer.

The Radium Institute took over the medical supervision of the pits in Schneeberg, Johanngeorgenstadt and Joachimsthal since its foundation . In evaluating Rajewsky's work, the Karlovy Vary Mining Authority issued a Mountain Police Ordinance in 1940 , in which a limit value for radon exposure in uranium mines was set for the first time in the world .

Work on lung cancer caused by radon emanation continued during the war. However, here too, in order to maintain the status of “vital to the war effort”, the interests of the military were increasingly addressed. In this context there is also a publication from May 4, 1942 by Boris Rajewsky, Alfred Straub and E. Screw at the Kaiser Wilhelm Institute for Biophysics with the topic “About the toxic dose when inhaling Ra emanation”.

The time from 1945

With the end of the Second World War the nuclear arms race began and with it the feverish search for uranium. While the bismuth and its offshoots explored and mined existing and new deposits in the Eastern Bloc countries, the same scenario took place in the USA . Although the connection between radon emanation, radioactive dust and the occurrence of Schneeberger disease was well known, these findings were ignored, at least in the first few years. While uranium mining in the Soviet Union was concentrated in the GDR and the ČSSR , in the USA it was in the states of New Mexico , Utah and Colorado . Radium was extracted here as a by-product even before 1945. During the mining boom, thousands of small mines were built here; there were 2,500 mines on the Colorado Plateau alone .

While the Bismut was aware of the problem, the American mine owners ignored all the scientists' warnings. A main argument was that the American and the Saxon-Bohemian deposits belonged to a different geological type. The background, however, was that it was financially completely impossible to operate these small mines under modern aspects and reasonable occupational health and safety conditions.

In 1952, the Czech physicist František Běhounek found out that the cause of the disease was not radon, but its radioactive by-products absorbed by dust particles. In the mid-1950s, the Working Level Month (WLM) was introduced in the USA as a unit of measurement for radiation exposure in uranium mines. 1 WLM is exposure as a result of inhalation of 1 WL over a month (170 h). 1 WL corresponds to 130  MeV / cm 3 .

Today, a distinction is made between short-lived radon-derived products of Rn 222 and long-lived radon-derived products of Rn 220. The International Commission on Radiological Protection (ICRP) publishes the international guidelines. For Rn 222 there were 12 WLM in 1955 and 4.8 WLM in 1981. For Rn 220, 14 WLM annual dose is given for 1981. Furthermore, there has been a move towards creating values ​​for a lifetime working dose. Here, however, the calculation is not in WLM, but in mSv. 1 WLM corresponds to 10 mSv. A lifetime working dose of 1000 mSv is recommended here. However, these values ​​only apply to workplaces exposed to radiation. With the latest limit values, the ICRP gives max. 20 mSv / a. For the population, the limit should be 1 mSv / a. However, these are all only recommendations.

Decision-making aids are the cohort studies carried out in several countries , in which the deaths from lung cancer of workers in the uranium mines and processing plants were compared with the statistically calculated deaths. In the study of the Eldorado miners in Canada , 16,236 male workers were examined in the period 1950–1999. The mean exposure was 50 WLM; 618 people died of lung cancer. This means an increase of 1.42 compared to the calculated statistical value. A cohort study of the miners on the Colorado Plateau included 4137 miners who had worked in the pits between 1950 and 1960. Here the increase compared to the statistically calculated value is 3.99, i.e. almost four times. A corresponding study of 5086 miners who had worked in uranium mines for at least one year between 1946 and 1990 was also carried out in France . Here an increase in the death rate from lung cancer of 1.43 was found.

The world's largest study was carried out by the Federal Office for Radiation Protection . 58,987 male persons born in 1899 or later who had worked at Wismut between 1946 and 1990 were recorded here. This study will be continued. Another study by the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety examined the causes of death of people in the Central Pathological Institute in Stollberg / Erzgeb. were autopsied. The institute was subordinate to the health service of Wismut. 19,337 people were used. 14,913 of these were employed by Wismut. In both studies, the development of lung cancer due to radioactive exposure is not primarily examined, but the entire health burden and the diseases that result from it. In addition to the evidence of an increase in the risk of lung cancer through radioactive exposure, an intensifying effect of arsenic dusts was also demonstrated. Contrary to the assumption that radioactive silicosis increases the risk of lung cancer, it was found that the lung cancer rate in silicotics is 29% lower than the lung cancer rate in miners without silicosis. After cardiovascular disease (33.5%), lung cancer was the second most common cause of death with 26%.

A summary study was published by Jay H. Lubin in 1994. He evaluated the data from 11 studies from a total of 67,746 miners. 2,736 cases of lung cancer were registered here, of which 2,620 (4.51%) were among the 60,570 uranium miners and 116 (1.61%) among the 7,176 other miners. However, these total numbers are not very meaningful as they do not indicate the percentage of deaths in the various studies.

The completed and ongoing studies have shown that the frequency of radiation-induced lung cancer cases increases with increasing radioactive exposure. There does not seem to be a 0 threshold. This means that even small doses can lead to illness over a longer period of time. However, this assessment has to be considered purely arithmetically, since radioactive exposure is not the only factor that causes lung cancer.

These radioactive loads from miners are not just limited to uranium mining. This affects, among others, also tin mines in China and the UK, Flussspatbergwerke in Newfoundland and the disused Flussspatrevier Wölsendorf and iron ore mines in the US, Sweden , the UK and France. The causes here are the mineral resources and secondary rocks containing thorium and uranium .

Wismut AG and Schneeberger disease

Since the partly radioactive dust and radon were known to be the main triggers for the disease, attention was paid to this topic at a very early stage.

In the early years, the general mountain police regulations for the state of Saxony of September 27, 1929 and the resulting safety regulations for weather management and firedamp as well as lighting and lamp management from 1932 applied.

The first safety regulations for weather management were issued by Wismut AG in 1949. Here, a fresh weather quantity of 3 m 3 / min fresh weather was required for each worker working on the busiest shift at the same time .

The first statutory regulations of the GDR on technical safety and occupational health and safety in ore mining, which also regulated the requirements for ventilation, were issued on December 30, 1952.

Thanks to measures to improve ventilation, the amount of weather available per worker and minute increased from 12 m 3 to 36 m 3 between 1960 and 1965 .

The weather shafts sunk in the following years made it possible to increase the amount of weather in object 09 to 74.2 m 3 per worker and minute from 1985 onwards. Similar values ​​were also achieved in the Thuringian districts.

The problem of dry drilling was also recognized and banned in 1949. However, it took until the mid-1950s for it to be implemented consistently, and in the case of ore mining even until the mid-1960s. The background was technical inadequacies, higher material costs and lower advance rates. However, wet drilling could not initially solve the problem of respirable fine dust. Only the coarse dust was bound by the aeration of the water.

Not only drilling played a role in dust control, but also the dust raised by loading and transport work. Therefore, after the blasting on site, everything was wetted with water and the stretches and bumps were kept moist either by spraying with magnesium chloride or by scattering magnesium chloride flakes.

From 1955, Soviet personnel of the geophysical service carried out measurements of radon exposure, and from 1957 systematic radon monitoring began by taking air samples. From 1965, measurements of the concentration of radon-progeny products were started at all permanently occupied underground workplaces.

Based on international standards, the ordinance on ensuring nuclear safety and radiation protection in the GDR set the effective dose of Rn 222 secondary products at 40 mSv (4 WLM) per year. Since there are no corresponding provisions in the Federal Republic of Germany's Radiation Protection Ordinance, this regulation continues to apply.

In addition, there were limit values ​​for the air concentration for radon-derived products at Wismut AG:

  • 4 MeV / cm 3 for personnel who are not professionally exposed to radiation
  • 40 MeV / cm 3 for occupationally exposed personnel and at the same time warning value with conditions
  • 120 MeV / cm 3 Closure of work places

The recognition of the Schneeberg disease as an occupational disease under the term "Schneeberg lung disease" in 1925 has been restricted to the Schneeberg area since its introduction. With the list of occupational diseases in the Soviet zone drawn up on December 27, 1947, recognition was extended to all ore mining operations in the Ore Mountains . Only the list of November 14, 1957 made general recognition in the GDR possible. When the list was revised on April 21, 1981, the term "Schneeberger Lung Disease" was replaced by the phrase "Malignant neoplasms or their precursors due to ionizing radiation".

In July 1952 the Silicosis Center (SKE) was founded. This was responsible for the annual lung x-ray of all miners from September 1952. The department for occupational lung diseases later emerged from the SKE. In 1960 the Commission on Radiation-Induced Lung Cancer was also set up. The Occupational Hygiene Center (AHZ) in Niederdorf, founded on September 7, 1967, examined the exposure to radon-derived products from 1971 with the help of a computer data acquisition program. Responsible for the statistics of radiation-induced bronchial carcinomas is the "Occupational Diseases Sector of the Regional Health Protection Inspectorate in the Wismut Health Directorate". Like all statistics on occupational diseases at Wismut AG, these statistics were also kept confidential.

On August 14, 1970, the SDAG Wismut's chief radiation protection officer presented an exposure table for the mining areas in the Ore Mountains, Thuringia and Vogtland . Here the radiation exposure was shown in WLM.

Due to the lack of measurement results from 1946 to 1956, the results of investigations from the 1930s and 40s from Ore Mountains and Czech silver mines were used for this period. From this date this table was used as the basis for the exposure assessment in the procedures for the recognition of occupational diseases.

Radiation exposure in the pits

year dose Unit of measurement
until 1955 30-300 WLM / a
1956-1960 10-100 WLM / a
1961-1965 5-50 WLM / a
1966-1970 3-25 WLM / a
1971-1975 2-10 WLM / a
from 1976 1-4 WLM / a

From 1971 onwards, based on the Radiation Protection Ordinance of the GDR, an exposure of less than 200 WLM was classified as low-risk and was therefore not sufficient for recognition of an occupational disease. Using information from the Central Statistics Administration of the GDR and information from the International Commission on Radiation Protection (ICRP) from 1966, according to which cancer cases double when exposed to 450 WLM, this value was set as the threshold value for the direct recognition of an occupational disease. In May 1988 the direct recognition threshold was lowered to 300 WLM, from June 1990 to 200 WLM. This value lasted until 1992. Since then, a case-by-case examination has been carried out in the accreditation practice. The basis for this is a model set up by Jacobi showing a proportional relationship between occupational exposure to radon secondary products and the additional relative risk of bronchial cancer. By 1990 the Wismut social security recognized 5237 cases of bronchial cancer. 98% of the cases were employees who were hired before 1955. Since the Unification Treaty, the third, fifth and sixth book of the Reich Insurance Code has been in force for the territory of the GDR. The disease caused by ionizing radiation is listed here under number 2402.

See also

literature

  • Julius Stoklasa: The importance of air radioactivity for the development of the Joachimsthaler and Schneeberger mountain sickness (=  German Medical Weekly . Volume 59 , no. 31 ). Georg Thieme, Stuttgart 1933, p. 1199–1200 , doi : 10.1055 / s-0028-1141516 ( abstract [PDF; accessed on February 3, 2014]).
  • Oliver Titzmann: Radium bath Oberschlema . The history of a health resort. Kurgesellschaft mbH Schlema, Schlema 1995.
  • Radiation exposure and radiation-induced occupational diseases in uranium mining using the example of bismuth . Presentation of the working group Uranium Mining and Radioactive Contaminated Sites (AKURA). In: Gerd Georg Eigenwillig, E. Ettenhuber (Ed.): Advances in radiation protection . 3rd, expanded edition. TÜV-Verlag, Cologne 2000, ISBN 3-8249-0610-4 .
  • Rainer Karlsch, Zbyněk A. Zeman: Urange Secrets . the Ore Mountains in the focus of world politics 1933-1960. Christoph Links, Berlin 2002, ISBN 3-86153-276-X .
  • Horst Wesch, Andreas Eisenmenger, Klaus-Michael Müller, Thorsten Wiethege: Radiological recording, investigation and assessment of mining contaminated sites - health assessment . In: Federal Ministry for the Environment, Nature Conservation and Reactor Safety (Ed.): Series of publications on reactor safety and radiation protection . BMU - 2005-652, 2005, ISSN  1612-6386 ( bmub.bund.de [PDF; 5.8 MB ; accessed on February 25, 2014]).
  • Hana Mášová, Emilie Těšínská: Science in the Service of Occupational Health . The Case of the Commission for “Miner's Disease of Jáchymov” in the Inter-war Czechoslovakia (=  Prague Medical Report . Volume 107 , no. 4 ). November 22, 2006, p. 447–460 ( pmr.cuni.cz [PDF; 127 kB ; accessed on February 25, 2014] en).
  • Rainer Karlsch: Uranium for Moscow . The bismuth - a popular story. 3rd, updated edition. Christoph Links, Berlin 2007, ISBN 978-3-86153-427-3 , p. 1877 ff . ( limited preview in Google Book search).
  • Werner Runge: Chronicle of the bismuth . Ed .: WISMUT GmbH. Self-published, Chemnitz 1999 (CD).

Individual evidence

  1. ^ Theophrastus Paracelsus von Hohenheim: On Bergsucht or Bergkranckheiten three books, in three tracts, written and described. This includes the origin and origin of the same diseases, as well as their successful preseruatiua and cures. All of them, miners, smelters, tasters, mills masters, goldsmiths, and alchemists, and all those who work in metals and minerals, are highly useful, comforting and indispensable. Ed .: Samuel Zimmermann. Sebaldus Mayer, Dillingen 1567.
  2. ^ W. Hesse, FH Härting: The lung cancer, the mountain sickness in the Schneeberger pits. Retrieved February 14, 2018 .
  3. ↑ Peter Hesse:  Hesse, Walther. In: New German Biography (NDB). Volume 9, Duncker & Humblot, Berlin 1972, ISBN 3-428-00190-7 , p. 22 f. ( Digitized version ).
  4. ^ Dan Fagin : Toms River: A Story of Science and Salvation. Bantam Books, New York 2014, ISBN 978-0-345-53861-1 , p. 125.
  5. ^ A b Dan Fagin: Toms River: A Story of Science and Salvation. Bantam Books, New York 2014, ISBN 978-0-345-53861-1 , p. 127.
  6. ^ Albrecht Scholz:  Schmorl, Christian Georg. In: New German Biography (NDB). Volume 23, Duncker & Humblot, Berlin 2007, ISBN 978-3-428-11204-3 , p. 263 f. ( Digitized version ). "In 1926, together with the internist Otto Rostoski (1872–1962) and the radiologist Erich Saupe (1893–1943) , he was able to identify “ Schneeberger Bergkrankheit ”as a work-related lung cancer."
  7. ↑ Otto Rostoski , Erich Saupe, Christian Georg Schmorl : The mountain sickness of the ore miners in Schneeberg in Saxony . "Schneeberger Lungenkrebs" (=  magazine for cancer research . Volume 23 , no. 4-5 ). Springer, May 20, 1926, p. 360-384 , doi : 10.1007 / BF02123213 .
  8. ↑ kszeifert: Radiant, beautiful, healthy - radioactive products. MTA-R.de, June 20, 2011, accessed on February 25, 2014 .
  9. ^ A b Alexander von Schwerin, Rainer Karlsch: The Oberschlema branch and the war research contracts of the KWI for Biophysics . In: RADIZ Schlema e. V. (Hrsg.): Research for radiation protection in the war years 1942 to 1944 . on the history of the Radium Research Institute Oberschlema, the branch of the Kaiser Wilhelm Institute for Biophysics in Frankfurt am Main, under the direction of Professor Dr. Boris Rajewsky (=  Radiz information ). 1st edition. No. 35 . Schlema 2011, ISBN 978-3-9811258-8-7 , pp. 30–31 ( pharmgesch-bs.de [PDF; 484 kB ; retrieved on February 25, 2014] Colloquium on the history of science in Bad Schlema on October 24, 2008. Radiz Schlema eV and Max Planck Society for the Advancement of Science eV).
  10. ↑ Association for Radiation Protection e. V .: Radiation exposure and radiation-induced occupational diseases in uranium mining using the example of bismuth . In Advances in Radiation Protection , April 1992, DNB 942792955

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