Epidemic Nosebleeds in Apple Packers

Griffith E. Quinby, MD, MPH
JAMA. 1966;197(3):165-168. doi:10.1001/jama.1966.03110030059025.
Text Size: A A A
Published online

A new disease of apple packers appeared in 1964 in Washington. Blood in nasal discharges ranged from mild staining to dripping hemorrhage. The disease followed chemical changes in the fabrication of two brands of blue-dyed apple-packing trays made from salvaged newspaper. A third tray made of plastic and a fourth of virgin wood pulp produced no such signs of nasal irritation. Attack rates of hemoglobin in nasal discharges in the control general population was about 25% during the same six-week period. All packers dripped blood from the nose in some plants. Nosebleeds decreased where newsprint trays were stopped. Bleeding began in packers switched late in the season from nonirritating to newsprint trays.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.