Document 2NdmwOrE5B5RzD0dY8gwv6dRa

November 6, 1963 Mr. S. Sandler The Valsan Company, Incorporated 38 West 32nd Street New York 1, New York (10001) - Dear Mr. Sandler: I am afraid l have not made the matter of the "pill" and its use clear to you, despite ray previous effort to do so. I shall attempt to clarify this matter. I have been at this business for a long time, in industry and out, in clinical practice and out, and in this country and abroad. I think I know at first hand almost all of the practical problems. I know all too well that there are poor fapilities in many parts of the world, including many benighted areas in the United States, for dealing with the hygienic problems of the lead trades. These facts, however, do not justify one's closing his eyes and aiding and abetting unwise or improper practices, for this is rank deception, and when such deception l|s directs^ at the untutored workmen in socially and industrially undeveloped or underdeveloped countries (or similar areas in our own country), it is nonetheless vicious. It is better to be honest, and to recognize, sadly but truly, ithat men have risked their lives to earn their daily bread in the past, and that th^y may still have to do so. One may still have a conscience that has not been deluded. The use of milk, for example, as a prophylactic procedure in the lead trades is an utterly futile procedure, which contributes nothing. True, it aids nutrition, ^here this is poor, but it has no other effect. As to the use of such an agent as "versene" (more properly, disodium calcium versenate, also known under other names and referred to in short as E.D.T.A.), no more vicious practice has been advocated and sometimes followed, than that of providing endangered work men with tablets of this agent to be taken by mouth to aid in the elimination of lead from their bodies. It is a practice devised by men who know too little of the action of this drug, and who expect of it what it cannot do. We have used this drug therapeutically since it appeared, and we shall continue to use 1C carefully under appropriate conditions. It should not be administered by mouth, however, for when so administered it provides little or no benefit, and under certain conditions it increases the risk instead of decreasing it. In advising its use, therefore, you would be doing your friends and customers in industry a distinct disservice, and one which you should not, under any circumstances, be guilty of. This drug should be prescribed and administered by a physician who understands its action, and by no one else, and those to whom it has been administered should be under Close medical supervision, not because of a professional convention^but because this compound may induce certain bad effects. I am sending you, herewith, some reprints on the problem of lead absorption N6280 S. Sandler - (2) ~ November 6, 1963 and lead poisoning (including an editorial on the misuse of E.D.T.A. which I wrote for the Journal of the American Medical Association). I also include the chapter on lead in a published work on industrial hygiene, which I would advise you to examine with some care just to familiarize yourself with the problem with which you appear to be genuinely concerned. From this you will understand how futile it is to suggest prophylactic medication to industrial managers br to workmen in the lead trades,,as a substitute for control of exposure. You might just as well prescribe medicine for men who work with nitroglycerine as a means of convincing yourself that "these men need not be concerned about the risk of being blown to pieces. The chapter which I am sending to you may be a little "over your head" in spots, but it is written simply and will, I believe, acquaint you with the problm. Sincerely yours, RAK:vr Robert A. Kehoe, M.D. Enel. ~ 4 r 2 mentioned in letter (chapter and editorial) Occupational Lead Exposure and Lead Poisoning Value of calcium disodium ethylenediaminetetraacetate and B.A.L. in therapy of lead poisoning. P.S. I would very much appreciate your returning the chapter from the book when you have finished with it as this is my only copy. Thank you. RAK