Dynamite Heart

Many industrial occupations have their own peculiar hazards. Coal miners are particularly susceptible to "black lung," or anthracosis, a disease caused by inhaling coal dust. Asbestos workers are known to develop cancer from breathing in asbestos particles. Now an outbreak of heart disease in a Wisconsin ammunition plant has brought out the fact that workers who handle nitroglycerin can develop a dangerous dependency on it. They can suffer heart pains and even death when denied exposure to the explosive.

The most recent evidence is provided by Dr. Ramon Lange, chief of cardiology at Milwaukee County General Hospital, who reviewed the cases of workers at the Badger Army Ammunition Plant near Baraboo, Wis. Last April a woman whose work at the plant involved handling nitroglycerin, a component of dynamite, was referred to him for treatment of chest pains, which seemed to occur only on weekends.

Lange listened to her story with skepticism, even when she told him that other women at the plant were similarly affected. "I thought this was some form of mass hysteria," he said. Nonetheless he put her in the hospital for more extensive tests. Before the first of the tests, however, the woman began to experience additional chest pains. Lange prescribed nitroglycerin, which has long been used medically for heart conditions. It relieved her pains and restored her pulse to normal.

That led Lange to suspect that she might be suffering from "dynamite heart." The condition, first described in 1941, results when overexposure to nitroglycerin causes blood vessels to dilate and to remain open as long as exposure is continued. But when the source of nitroglycerin is removed, the vessels contract, reducing the supply of blood to the heart.

Monday Angina. Further investigation confirmed Lange's suspicions. Of eight women employees of the plant who had suffered from "Monday morning angina," two had prolonged periods of coronary insufficiency, and three had had heart attacks. One of the three died suddenly on a Monday morning, despite the fact that an electrocardiogram taken only a few days earlier had shown her heart to be normal.

Six of the surviving women have switched to jobs that involve no contact with nitroglycerin. But other workers still run some risk, even though the plant's nitroglycerin dust levels are far lower than those allowed by the Government. One hundred and sixty employees work with nitroglycerin at the plant. Though only .6% of such an adult group would normally show signs of coronary heart disease, Lange found 5% of the employees to be suffering from some kind of heart handicap.

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