Document 0Y6x897xkBmr08ZqLY8waDdM

j X LEAD INDUSTRIES ASSOCIATION. INC, 1*1 MAOiaON AVCNUI Nrw v o ak , n . y. looiy mlnOM - UU COOK Ml '^a.'fcr Decenbcr 6, 1$& To All Meabere of the Health eod Safety OoenlttMt Throu^i the courteay of Horgea Deviaa of th* Laad Developarat A*or 1*11oo la London vo hava a copy for you of tfc Daw Brltlah Klniatry of Labour fiegulatlcoa pertalalag to eedleal imilM tlooa that d o w apply to all toduatrlaa UJlag laad. Za a dlacusalon recently with Ur. Buchanan of the Brltlah Klniatry of Labour I gained the lnpreealon that th sain reaaoo for eelectlxg tha heooglobln eetlnatloo teat, which la outlined la thla attached coenuclcetlon, vu that It la eeay and quick to perform. frankly, 1 as not such lapreaeed vita their teat aalactloo aod would be Interested la having ycur cooxati either for or agalnet. Thla la for your lnforeatlon. Very truly youre. WflBd Poo 0. fowl*r Secretary XA#rf|***t$sj ggsy **.. " '"' LIA11609 - Klnlitry of Labour TKI LEAD PROCESSES (MEDICAL EXMOTATIOM) RHJUIATI0H3 l$6k Introduction Lead p-olscnlng 1 an Industrial health hotard uhoie seriousness has Veen widely recognised for cany years. The principal processes Involving exposure to lead la factorial are covered by a number of Code* of Regulations under the Factories Act. These Regulstlocs are lilted la the Schedule to the Lead Proceiaei (Helical Examinations) Regulations. Under existing Begulatloci, employers are required to arrange for the periodic eedlcal examination of perecca employed la lead procenei. These exaslnstlcns are carried out by Appointed Factory Doc tore, who hare povtr to euipeDd pereooe dacxe they cocilder unfit for work In lead proceitaa, and vfco are reipooalblle for entrlee In the Health Beglitere required by the Begulatloci. Thaie Health Reglitere are open to examination by H.M. Factory Inipectori. It hai been koovn for a locg tire that these precaution! are not ae effective la detecting caici of lead absorption ae le deilrable. The main reason for thli Is that the aysptma of lead Intoxication, which Include cocitlpatloo, colic, weakness or paralysis of tha ouscles, occur only when poisoning is established. There are no premonitory signs of lead Intoxication which can ha detected la clinical examination. Hlthsrto, tha periodic examinations of lead workers carried out by factory doctors la accordance with Regulation# have normally been clinical exaalnatloos only. Haemoglobin Estimation The Lead Processes (Medical Examinations) Regulations have been aade with the object of providing a sore exact method of diagnosis of lead Intoxication. The Regulations require that once In every period of three monthe, the medical exaa1nation carried cut la pursuance of exlatlng regulations shall include a haemoglobin estimation by aa approved method. Although the clinical symptoms of lead absorption are not usually obvious to clinical examination until actual lead poisoning develops, the absorptloo of dangerous quantities of lead Into the blood stream can be detected at a much earlier stage by means of biological tests. There are several methods of doing this, some of vhlch require special laboratory fac 1111 lei and are therefore not suitable for uee In the aany small factorial vC-.ere lead processes are carried out. However, estimation of ths haemoglobin content of the blood can be carried out by simple and Inexpensive means, and It Is because 1*. has these advantages that lta use la required by the present Regulations. Haemoglobin Is the oxygen -bearing element present In the red blood cells, and deficiency In the haemoglobin content of the blood Is a sure indication of anaemia. One of the meet Important effect! of lead abeorptloQ le to Interfere with the forcatlon of haemoglobin, resulting in anaemia. Estimation of the haemoglobin content of lead workers is therefore a reliable way of ecreenlng them for exposure to laad. If the presence of anaemia is discovered, further Investigations are needed Vo determine whether this Is due to lead or to another cause. Therefore, the Regulations provide that if the haemoglobin content of the blood of any pereoo examined le found to be below a specified level, the appointed doctor may require e further haemoglobin estimation at any time. N 415.01 L I fi 11610 -2- A* stated ti>ove, the haemoglobin estimation It * screening method, Intended to supplsnent clinical examination. If enaecia la discovered, further lnvsetlg*tloni must therefore bs made to decide whether sn anaemic person has actually suffered lead poisoning. However, * person suffering ftxa serious anaemia, fren whatever cause, c&nnot be safely employed In a lead proceas, and a periodic haemoglobin teat la therefore the ooat comprehensive aa veil aa the Boat practical way of protecting lead vorfcert. Haemoglobin any be estimated by any reliable method, vblch la approved by the Chief Inspector of Factories, but a convenient and accurate method >&lch dems not require elaborate equipment la the copper sulphate method. Tfcl* la baaed on the fact that the haemoglobin content of a drop of blood can be co-re Lated, for practical purposes, vlth the drop's specific gravity aa measured in a solution of copper sulphate. A co-relation table facilitating this la set out In the Schedule to the Chief Inspector's Certificate of Approval under Regulation 3(2). Icveatlgatlon and Treatment of Lead Poisoning Under the Regulations, Appointed Factory Doctor* vill regard a haemoglobin concentration of 13 grans or less per 100 nlllllltres of blood (12 grass In the esse of vooen workers) as evidence of anaemia, which In a lead worker Is likely. In the absence of any other obvious cause and pending further Investigation, to be due to lead. At this point. It la recemended that the affected person should ba referred to hie general practitioner with appropriate lnforoetlco about the nature of the person's work. The Q.P. any either undertake Investigation hl**o If or refsr the person to hospital. The Ministry of Health have therefore oad* arrangements for hospitals to carry out any special test which say be Deeded. The coat of such further examination, lnveatlgatlon and treatment will be borne by the Rational Health Service. Vorkera found to be suffering frocs lead poisoning, or to be unfit for other reasons for eeplcyment Involving exposure to lead, nay be temporarily, suspended by the Appointed Factory Doctor frcn employment In lead processes. However, provided that there Is a sufficiently early diagnosis, modem clinical methods usually aake speedy recovery from lead poisoning certain. There 1% therefore, every reason for confidence that the Introduction of haemoglobin estimation as a first step towards diagnosis and cure will result In a decreaaa In tbs Incidence of Industrial lead poisoning. Health Registers and notification to District Inspectors The Regulations require that factory occupier* shall send to the District Inspector copies of tvery sntry cads In ths Health Pegtstsr by tha appointed doctor within aevea days after ths and of ths Booth In which ths sntry Is Bade. Tbs diagnosis and treatment of lead poisoning Is not In Itself sufficient to eliminate lead poisoning without measures to control the working condition* *ilch give rise to it. To facilitate tills, It is Important that H.M. Factory Inspectorate are fully and promptly Informed of all cases of lead poisoning, actual or suspected. This Is why it 1* required that Health Register entries shall be forwarded to the District Inspector, so that he may be Informed of the position In each factory In hit district. When It appears necessary, he will arrange, in consultation with ths Medical and other specialist branches of the Inspectorate at appropriate, for any Investigation vblch mssy be necessary Into envtroosental conditions and Into ths standard of compliance with ths relevant provisions of the Factories Act and Regulations. 'gWWHegii1.-1 i1 - >-'r.l.'t-l-uaj>i>sii,'jMi m megrimPf*Jl*Ai i y;fVtn,, i, 'i. L IA 11611 *3- Katlooel Insurance Benefits Lead pollening 1* e prescribed disease for Industrial Injuries Benefit, end persona found to have suffered Iced polsoclng by reason of their verb ere therefore entitled to It. The Introduction of the haemoglobin teit eay ld to e few people being impended fren vork In lead processes, vho ere eneeale but beve not suffered outright led pollening. If, ei e mult, thiy loee earnings, thli vlll be the reiult of noo-lndustrlal sickness, ehd euch people will be entitled to Sickness Beoeflt rether then Industrial Injuries Peneflt. Entitlement to Betlooel Insurance Benefit depend*, however, oo e vide range of Individual circumstances outside the cope of thli penpfclet end those seeking acre detailed Information are edvlaed to apply to their local office of the Ministry of Pensions end Betlooel Insurance. ,