Phossy Jaw and Match Factory Worker

Uncovering the Cause of “Phossy Jaw” Circa 1858 to 1906: Oral and Maxillofacial Surgery Closed Case Files—Case Closed

Robert E. Marx DDS

Abstract:

·      Phossy Jaw à Exposed bone osteonecrosis exclusively in the jaws

·      Phossy Jaw epidemic from 1858 – 1906

·      Linked to yellow phosphorous, key ingredient in “strike anywhere” matches

·      Workers exposed to heated fumes containing yellow phosphorous à Later many developed painful exposed bone of the mouth while their office workers did not

·      Yellow Phosphorous, P₄O₁₀ when combined with water (H₂O), carbon dioxide (CO₂) and a common amino acid (lysine) results in bisphosphonates

§  1832 Discovery of easy ignition using yellow phosphorous

§  “Strike-anywhere” matches popular b/c easy to light à Very unstable and prone to accidently ignition through shaking or warm temp.

§  Convenience à Quickly adopted by industrial nations

§  Early on in response to accident, 1855 Swedish scientist safety match same as earlier match BUT using more stable red phosphorous instead (IGNORED)

§  1858 Start of medical reports of disease involving slow exposure of jaw

§  1862 Report by Simon to Brit. Parliament of Dr. Bristowe’s 61 case study

1.     Dull red area develop in gum à usually connected to infected tooth

2.     Ulcer formed or post tooth removal socket refuses to heal

3.     Swelling of gums or jaw

4.     Slow progression of bone described as porous, light, with a worm-eaten appearance like pumice stone

§  35 year old patient present with great external swelling, debilitated due to inability to eat

1.     Ear to ear jaw line, chain of ulcerated openings with discharge

2.     Toothless alveolar process was bare of soft parts, bone rough and brownish black

3.     Under chloroform jaw was removed by taking two halves out separately, no knife was needed, bone gave way completely

4.     Patient healed & improved BUT died 6 weeks later b/c upper airway obstruction

§  1863 – 1899 Numerous cases reported à Generating public & political awareness

§  1872 Finland bans Yellow Phosphorous matches, 1874 Denmark follows

§  1890 Founder of Salvation Army, General Booth & assistant James Barker begin activist campaign to expose dangers of match making industry

§  Early 1900s link between Phossy jaw and match making factories clear à 1906 Berne Convention – Ban on “strike anywhere” matches à All except US sign

§  US laissez faire refuses to sign ban

1931 Yellow matches finally disappear from US b/c high taxes placed on them

Primary sources:

- American Association for Labor Legislation. Phosphorus Poisoning: "Phossy Jaw" Menaces American Match Workers : Congress Must Abolish It. [New York, 1912].

- New York Times (1857-1922); Dec 7, 1911; ProQuest Historical Newspapers: The New York Times pg. 12