Document 2jBrNN488o8L1beK5N7Z5mKM6

/ SM -3 5 HO She l l Oil Company ' INCORPORATED 50 West 50t h St r eet New Yo r k 20 June 26, 1946 D r. W illa rd Machle ' 610 p a rk Avenue Kiew York 21, Hew York My d e a r E r . M achle; Re S h e ll T his w ill acknowledge r e c e ip t o f your l e t t e r d ated June 20,1946, re tu rn in g the te n ta tiv e o u tlin e of your testim ony, w ith the various changes o r a l t e r a t i o n s th e re o n in p e n c i l. The o u tl in e s ta te m e n t has b een re ty p e d , g iv in g due e f f e c t to your changes and a lte r a tio n s ; and, in accordance w ith y o u r r e q u e s t , I am e n c lo s in g h e r e w ith such r e v i s i o n . I reco g n ize th a t th e en clo sed d r a f t sta te m e n t c o n tain s a number o f extraneous s ta te m e n ts; i . e . , o b serv atio n s whiqh are n o t p a r tic u la r ly re le v a n t to th e in s ta n t c a se . However, I f e e l t h a t , from a p r a c tic a l s ta n d p o in t, th ey are h e lp fu l in d if f e r e n tia tin g , in most in sta n c e s, the com plaints o f M i l l e r fro m th e u s u a l and cu sto m ary c a s e s . I n my o p in io n , su ch r e f e r e n c e s sh o u ld be h e l p f u l to th e r e f e r e e and th e members of th e Comm ission. And, u n le s s I am m is ta k e n , th e y w i l l be o f m a t e r i a l a s s i s t a n c e t o u s i n m a in ta in in g th e p o s itio n t h a t th e c la im a n t's case is an e x c e p tio n a l one. In ocher w ords, is n o t s u ffe rin g from r e s p ir a to r y , g a s tr o - in t e s tin a l or pbys io lo g i c a l n erv e and eye d is o rd e rs due to c o n ta c t w ith p etro leu m p ro d u cts ana t h e i r fum es, w hich is e v id e n tly th e o c c u p a tio n a l d is e a s e r e li e d upon by th e c la im a n t, p u rs u a n t to th e p ro v is io n s o f p a ra g ra p h 24 o f S e c tio n 3(2) o f th e Wor kmen *s Comp ens a t i on Law. W hile I re a liz e th a t th e en clo se d sta te m e n t is te n ta tiv e sad in com plete, n e v e rth e le ss I f e e l th a t i t is b e n e fic ia l to have your view s re d u c e d to w r i t i n g a t t h i s j u n c t u r e . I am ta k in g th e l i b e r t y o f fo r w a rd in g a copy t h e r e o f t o 'Dr. Holcomb and t o S h e l l 's l o c a l t r i a l a t t o r n e y , Mr. MacAffar. ' I am r e t u r n i n g h e r e w ith th e l i s t o f p u b l i c a t i o n s , h a v in g r e t a i n e d a copy fo r our f i l e . Very tr u ly y o u rs, PMP:FE Enclosures * P h i. l i p 3]v\.i. Pay 1n e, A ttorney ?MP :F 3 -6 /2 4 /4 6 D r. W illa rd Machio w i l l t e s t i f y s u b s ta n tia lly as fo llo w s : I am a p h y s ic i a n d u ly li c e n s e d t o p r a c t i c e m e d ic in e v d t h i n t h e S t a t e o f Hew Y ork. I s p e c i a l i s e i n I n t e r n a l M ed icin e and O c c u p a tio n a l M e d ic in e . I am a F e llo w o f th e Am erican C o lle g e o f p h y s i c i a n s . I s tu d ie d a t th e H a rv a rd M ed ica l S ch o o l and am a g ra d u a te o f th e U n iv e r s it y o f C in c in n a ti, C ollege o f M edicine. I did p o stg rad u ate work a t N orthw estern U n iv e rs ity School o f M ed icin e, th e M assa ch u setts G eneral H o s p ita l, th e Ohio S t a t e C o lle g e o f M ed icin e and th e New York P o s tg r a d u a te M ed ical S c h o o l. I was A sso c ia te p r o f e s s o r of S e se a re n p h y sio lo g y and A ss o c ia te D ir e c to r o f the g L a b o r a to r y a t th e U n iv e r s it y o f C i n c i n n a t i , C o lle g e o f M e d ic in e , wnere was engaged i n s tu d ie s in o c c u p a tio n a l p h y sio lo ry and to x ic o lo g y . I have :iaa f a r teen v s of experience in c lin ic a l ana la b o ra to ry re se a rc h i n o ccn p a cio n al to x ic o lo g y and m ed icin e. I have acted as a c o n s u lta n t on v ario u s ooovraationai m edicine and h y g ie n ic problem s in Europe and South American c o u n trie s . i am th e c o - a u th o r (w ith Dr. L a u re n c e B C henow eth) o f a t e x t book on I n d u s t r i a l H y g ien e, w hich was p r in t e d i n 1945j and I have c o n tr ib u te d numerous a r t i c l e s dealing; w ith o c c u p a tio n a l m ed icin e, to x ic o lo g y and p h y sio lo g y , which have been p u b lis h e d i n t h e m e d ic a l j o u r n a l s . 1 am an a s s o c i a t e e d i t o r o f th e Jo u rn a l of O ccu p atio n al M edicine, w hich is p u b lish e d by th e American M edical A s s o c ia tio n . I c o n trib u te d an a r t i c l e e n t i t l e d " T e tra -B th y l Lead CO I n to x ic a tio n and Poisoning: by R e la te d Compounds o f Load" to th e J o u rn a l o f th e A m erican M e d ic a l A s s o c i a ti o n . I am shown an i s s u e o f th e J o u r n a l u n d e r d a te o f A ugust 2L-, 1935, and th e a r t i c l e i n t h a t J o u r n a l on Lead P o is o n in g was w r i t t e n 4 by me. In t h i s a r t i c l e , I d isc u ss th e h is to r y , pharm acology, e tio lo g y , pathology symptoms and s ig n s , d ia g n o s is and tr e a tm e n t o f p o is o n in g p ro d u ced i n th e m anufacture or h an d lin g of c o n c e n tra te d t e t r a - e t h y l .l e a d . The p u b lish e d a r t i c l e 00046 and my s tu d y o f r e p o r te d w r iti n g s and o b s e r v a tio n s o f o t h e r s i n t h i s f i e l d . R e fe re n c e s to "the p u b lis h e d w r i t i n g s o f v a r io u s a u t h o r i t i e s a r e c o n ta in e d i n mv a r t i c l e . I a ls o c o n trib u te d an a r t i c l e e n t i t l e d "G asoline I n to x ic a tio n " to th e J o u r n a l o f t h e A m erican M e d ic a l A s s o c i a t i o n . I am s h o rn an is s u e o f t h e J o u r n a l under d a te of December 6, 1941, and th e a r t i c l e in th a t Jo u rn a l on G asoline I n t o x i c a t i o n '.vas w r i t t e n by me. I n t h i s a r t i c l e , I d is c u s s t h e p h y s io lo g ic and to x ic o lo g ic e f f e c ts o f exposure to g a so lin e of men employed in i t s p ro d u c tio n , d i s t r i b u t i o n and m a rk e tin g . B e f o r e w r itin g t h i s a r t i c l e f'o r th e m e d ic a l jo u r n a l , I exam ined numerous b o o ls and p u b lis h e d a r t i c l e s on g a s o lin e p o is o n in g ; and I made r e f e r e n c e s to su ch s t u d i e s i n my a r t i c l e . F o r n e a rly f o u r y e a rs d u rin g W orld War I I , I was a C o lo n el in th e U n ite d S t a t e s Army s t a t i o n e d a t F o r t Knox, K en tu ck y , w here I was t h e D ir e c t o r o f R esearch of th e Armored M edical R esearch L ab o ra to ry , a id engaged in re se a rc h on p h y s io lo g ic a l and to x ic o lo g ic a l problem s o f m i lit a r y p e rs o n n e l, such as v e n tila tio n o f combat ta n k s, e tc . G a so lin e i s a m ix tu re o f p e tro le u m h y d ro c a rb o n s . The u s u a l mode o f ab so rp tio n o f gasoline is through the re s p ira to ry t r a c t . G asoline vapor is h e a v ie r th a n a i r . In ta n k s , e x c a v a tio n s and p o o rly v e n t ila t e d e n c lo s u re s , th e d is p la c e m e n t o f a i r by th e h e a v ie r g a s o lin e v a p o rs may prove f a t a l w ith in a few m in u tes o r h o u r s . A cute p o iso n in g may r e s u l t when ex p o su re i s to v ery h ig h c o n c e n tr a ti o n s o f g a s o lin e v a p o r i n a i r , such a s may o c c u r i n ta n k s ; a n d , i n CO such in sta n c e s, th ere is l i t t l e d iffic u lty in d ia g n o sis. If death does,not . ensue, recovery is u su a lly w ithout serio u s a f te r - e f f e c ts . A sphyxia from g aso lin e fumes i s due to la c k of oxygen; and is somewhat lik e drow ning. I f th e p erso n does not d ie , th e re are u s u a lly no s e rio u s co n seq u en ces. G reater d iffic u lty in d iffe re n tia l diagnosis occurs in cases of c h ro n ic p o is o n in g . Any one o f th e m a n i f e s t a t i o n s o f c h r o n ic g a s o lin e p o is o n in g KE 00046 may o c c u r i n i n f e c t i o u s o r d e g e n e r a tiv e d i s e a s e s , t u t c e s s a t i o n o f e x p o su re in ch ro n ic cases should r e s u l t in a m e lio ra tio n o f symptoms. Exposure to lead poisoning by th o se engaged in th e m anufacture o r h a n d lin g o f th e e th y l f l u i d end th o s e engaged in th e m ix in g or b le n d in g o f th e te tra -e th y l lead -co n tain in g flu id into gasoline is qu ite d iffe re n t fro m t h e e x p o su re 'by th o s e r e g u l a r l y engaged i n h a n d lin g o r d i s t r i b u t i n g leaded gaso lin e in com m ercial q u a n titie s . In o th er fo rd s , th e handling and u s e o f g a s o lin e c o n ta in in g t e t r a - e t h y l le a d d i f f e r s from -the m a n u fa c tu re o f th e e th y l f lu id and i t s blending w ith g aso lin e a t r e f in e r ie s and b u lk maxing p la n ts . C onsequently, i t is n e c e ssa ry to d if f e r e n tia t e betw een a c tu a l p o iso n in g th a t occurs as a r e s u lt o f exposure to c o n c e n tra te d te tr a - e th y l le a d and th e t h e o r e t i c a l d a n g e rs w hich some h a v e assum ed may accompany th e use of leaded g a so lin e . A r e la tiv e ly sm all in d u s tr ia l group is p o te n tia lly exposed to th e hazards of the concentrated e th y l f lu id in i t s m anufacture or in th e m aintenance o p eratio n s on th e equipm ent in th e p la n ts where i t is m a n u fa c tu re d . A somewhat l a r g e r group o f men is engaged in b le n d in g th e te tra -e th y l lead containing flu id in to gasolines in various re fin e rie s in th e U nited S ta te s , b u t no cases of lead po iso n in g have been re p o rte d . T e tra -e th y l lead is a c o lo rle ss o ily liq u id (sp e c ific g rav ity 1.65S) w ith a sw eetish odor. I t is in so lu b le in w ater, b u t so lu b le in alco h o l and a c e to n e . T e tr a - e th y l le a d is in tro d u c e d o r m ixed in to g a s o lin e in amounts so sm all th a t th e fin ish e d product lacks the e s s e n tia l to x ic o lo g ic a l p ro p erties o f t e t r a - e t h y l l e a d . The maximum p r o p o r t i o n o f th e t e t r a - e t h y l le a d compound added to g aso lin e is approxim ately 1*1,260. Vapors a ris in g from tan k s holding leaded g a s o lin e do not c o n ta in a p p re c ia b le amounts o f le a d . The d iffe re n c e between th e v o l a t i l i t y of te tr a - e th y l lead and th e g aso lin e base w ith w hich i t i s m ix e d , i s so g r e a t t h a t a p p ro x im a te ly h a l f t h e g a s o lin e may b e e v a p o ra te d K* 0004620 t e t r a - e t h y l le a d in co m m ercial g a s o lin e may 'and e r g o - p a r t i a l deco m p o sit io n , w ith th e form ation of a v a rie ty of compounds, such as t r i s t h y l lead bromide o r hydroxide and d ie th y l lead s a l t s . These compounds m ay b e d is p e rs e d as f in e d u s t when dry s to ra g e ta n k s are clean ed The d eco m p o sitio n p ro d u c ts of t e t r a e t h y l le a d , -which may o c c u r upon long s ta n d in g in th e s to r a g e t a n k s , can p ro d u ce a c u te t e t r a - e t h y l le a d p o is o n in g . B u t t h i s r i s k i s in c u r r e d o n ly by men e n t e r i n th e tanks fo r th e purpose o f c le a n in g . This hazard does n o t e x is t w ith ta n k wagon or tru c k d r iv e r s . However, th e d ilu tio n o f t e t r a - e t h y l lead vdth g aso lin e elim in ates the danger of lead in h a la tio n , except in clean in g dry scaly storage tanks vdth cu t proper precautions* fly e x p e rie n c e i n d i c a t e s t h a t c h ro n ic i n t o x i c a t i o n o r p o is o n in g from g a so lin e i s extrem ely r a re in th e petroleum in d u s try . Chronic in to x ic a tio n r e s u l t i n g from e x p o su re to t e t r a - e t h y l le a d h a s n o t b e e n s e e n . By ''c h ro n ic in to x ic a tio n " I mean p o iso n in g w hich r e s u lts from exposure to g aso lin e vapor f o r lo n g p e rio d s o f tim e . I have had more th a n 2300 r e f in e r y w orkers under o b s e r v a tio n , i n some in s ta n c e s f o r as lo n e as te n to tw en ty y e a r s , and found no s ig n s of ch ro n ic g a so lin e p o iso n in g in any c a s e . N eg ativ e r e s u lts in re s p e c t to signs o f chronic gasoline in to x ic a tio n or poisoning were a lso obtained in s tu d ie s o f la rg e a m b e rs o f f i l l i n g s t a t i o n a tte n d a n ts , ta n k wagon d r iv e r s and g a ra g e m e c h a n ic s . On th e o t h e r h a n d , I found t h a t in c r e a s e d e x p o s u re o f w o rk e rs to co n cen tratio n s of gasoline vapor in poorly or inadequately v e n tila te d p la c e s, such as d ry c le a n in g p la n ts , m ight r e s u l t in ch ro n ic g a so lin e p o iso n in g . I r e a d a p a s s a g e fro m my e . r t i c l e i n t h e m e d ic a l j o u r n a l you have j u s t shown me and p u t i n my hands : . "In v e stig a tio n s and re p o rts over a span o f y ears have . dem onstrated th a t lead poisoning w ill not r e s u lt from th e use o f leaded g aso lin e as i t i s u su a lly handled in commerce. ' . The h aza rd i s lim ite d to th e m a n u fa ctu re o f t e t r a e t h y l lead and antiknock m ix tu re s, th e m ix tu re o f th e s e m a te ria ls w ith g a s o lin e and line c le a n in g o f ta n k s in w hich th e le ad ed gaso lin e is sto re d '1 (p.1965). . T h a t s ta t e m e n t r e f l e c t s my o p in io n th e n and my o p in io n now. I now r e a d fro m p ag e 1871 "Sequelae u s u a lly do n o t fo llo w chronic exp o su re; c o n s e q u e n tly a m e lio r a tio n o f symptoms may b e e x p e c te d to follow c e ssa tio n of exposure in chronic cases, and th is may b e t h e - b e s t e x p e d ie n t i n e s t a b l i s h i n g th e d i a g n o s i s . H y s te r ia o r p sy c h o n e u ro tic symptoms i n a p e rs o n w ith chronic exposure to gasoline should suggest the p o s s ib ility o f i n t o x i c a t i o n , and r e l i e f from th e s e symptoms sh o u ld fo llo w soon a f te r removal from exposu ra ." T h a t s ta te m e n t r e f l e c t s my o p in io n when my a r t i c l e was p u b lis h e d axid i t i s a lso my p r e s e n t o p in io n . I now react a p a s s a g e fro m my b o o k , e n t i t l e d . " I n d u s t r i a l H y g ie n e " , concerning o ccu p a tio n a l in to x ic a tio n o r poisoning due to in h a lin g o f te tr a e th y l lead gasoline: "The a lk y l compounds o f le a d a re th e m ost e x te n s iv e ly used members o f th i s c l a s s . T h e ir u se as an a n ti- d e to n a n t in m otor f u e ls has r e s u lte d in th e m anufacture and d i s t r i b u tion. of larg e q u a n titie s of th ese m a teria ls in th e petroleum in d u s try , p o iso n in g by th e a lk y l compounds o f le ad is c h a r a c te r iz e d by v a r ia b le i n t e r v a l s b e tw e e n ex p o su re and o n s e t of i l l n e s s and by pronounced m e n tal symptoms. C o m e rc ia l g a s o lin e s c o n ta in in g t e t r a e t h y l le a d p re s e n t no h a z a rd when used as a m otor f u e l. Cases o f p o iso n in g , which are r a r e , have so f a r been l i m i t e d to men en g ag ed i n th e rnanufac cure end m ix in g o f t e t r a e t h y l le a d o r to men engaged i n th e cleaning of gasoline tanks used fo r the blending or storage o f le ad ed g a s o lin e . In th e s e c a se s th e ex posure was to ' t e t r a e t h y l le a d o r to i t s d e c o m p o sitio n p r o d u c ts ." (p.l5C5) T h a t s ta t e m e n t r e f l e c t e d my o p in io n when my b o o k vas o r i g i n a l l y p u b lis h e d i n 1938, and r e p r i n t e d i n 1945; end i t i s lik e w is e my p r e s e n t o p in io n . I have made a p e rs o n a l, i n v e s t i g a t i o n o f th e w orking c o n d itio n s in M ilto n , New Y ork, u n d e r w h ich . t h i s c la im a n t p e rfo rm e d h i s s e r v i c e s f o r t h e o h e i l o i l Company i n o r d e r t o e s t a b l i s h th e e x t e n t o f h i s e x p o su re -to g a s o li n e fu m es. The lo a d in g r a c k , w hich I was a d v is e d vas t h e a l l e g e d s o u rc e o f c l a i m a n t 's exposure to g a s o lin e , i s . a sm all fo u r o r f iv e pump, ro o fed u n it w ith open s id e s , s itu a te d over an earth en sump, on a la rg e co n crete a re a w ith in th e b u lk p la n t. V e n tila tio n is e x c e lle n t, th e rack being s itu a te d in th e open, not le ss than f o r t y f e e t from th e n e a r e s t b u i l d i n g s , w hich a re low. The tw elv e t o f o u r te e n fo o t h ig h ro o f of th e s tr u c tu r e is f l a t and slo.aping, o f f e r in g no o p p o rtu n ity f o r p o c k e tin g o f v a p o r s . The p la tf o r m and sump w ere c l e a n , w ith no o d o rs o r s ta i n in g to s u g g e st e x c e ss iv e s p ill a g e o f g a s o lin e . I was ad v ised by th e S uperintendent o f th e b u lk p la n t th a t th e a re a is washed once each week. T h ro u g h -p u t from t h e e n t i r e r a c k i s a t a maximum o f a p p ro x im a te ly 6 0 0 ,0 0 0 g a llo n s p e r m onth. The lo a d in g fre q u e n c y i s a maximum o f f o u r t e e n t o f i f t e e n tim es p er day, viien w orking on a 24-hour b a s is . F uel is d e liv e re d a t th e r a te o f a b o u t 85 g a llo n s p e r m in u te , r e q u i r i n g a b o u t t h i r t y - f i v e m in u te s t o lo a d a m otor tr a n s p o r t t r u c k . I was inform ed by s a id S u p e rin te n d e n t t h a t lo a d in g is u s u a lly done by yardm an; only r a re ly done by tank; wagon d r iv e r s . I was f u r th e r inform ed by th e S u p e rin te n d e n t o f th e S h e ll b u lk p la n t a t T i l t o n , IIew Y ork, t h a t , d u rin g th e c l a im a n t' s p e r io d o f em ploym ent, f u e l d e l i v e r e d from th e s t o r a g e d e p o t was a p p ro x im a te ly 801' r e g u l a r g a s o li n e and 20% E th y l; no 100 octane g a so lin e b e in g handled from th e loading ra c k . In th e e n t ir e tim e s in c e th e p la n t h as been i n o p e r a tio n , th e r e i s no h i s t o r y of yardmen o r ta n k wagon d r iv e r s becom ing d iz z y , f a i n t , or confused from th e vapors o f g a s o lin e d u rin g lo a d in g o p e r a t i o n s . B ased u p o n my e x p e r ie n c e and ny p e r s o n a l in s p e c tio n o f th e circu m stan ces o f c la im a n t' s employment, I can say th a t he experienced le ss exposure to g aso lin e vapor th an is custom ary or u su al w ith m ost tank truck d riv e rs. On June 3 , 1946, I p e r s o n a l l y exam ined t h e c la im a n t and r e c o r d s o f h is p re v io u s m e d ic a l c o n d i t i o n h av e b een made a v a i l a b l e f o r my s tu d y and c o n s id e r a tio n , c la im a n t has none o f th e s e v e r a l ty p e s o f m e n ta l symptoms o r m a n ife s ta tio n s which a re p re s e n t in t e t r a - e t h y l le a d p o iso n in g c a s e s . C laim ant gave me no h i s t o r y o f h a l l u c i n a t i o n s o r d e l u s i o n s , w hich a r e c h a r a c t e r i s t i c o f su c h c a s e s . He h a s no am n esia f o r r e c e n t e v e n t s , w h ich i s u n ifo rm i n t e t r a e t h y l le a d p o is o n in g . Nor does he have p e rio d s o f c o n fu s io n w ith m is id e n b if ic a tio n \ V. o f p e rso n s and p la c e s , w hich I have found is u s u a l i n c a s e s o f t e t r a - e t h y l le a d p o is o n in g . Based upon such in fo rm atio n as I have a sc e rta in e d concerning th is c l a im a n t, I am o f t h e d e f i n i t e o p in io n t h a t he shows no symptoms w h a ts o e v e r o f g a s o lin e p o is o n in g o r le a d p o is o n in g . T here i s no e v id e n c e , i n my o p in i o n , t h a t lead or g a so lin e in to x ic a tio n played any ro le in th e p ro d u ctio n o f h is i l l n e s s . I am o f th e o p in io n t h a t c l a i m a n t 's d i s e a s e s a r e n o t e i t h e r by d i r e c t c a u s a t io n o r by d ire c t aggravation re la te d to prolonged exposure to , or in h a la tio n o f, fumes and v a p o rs o f le a d e d g a s o l i n e . My d ia g n o s is i s p r e d ic a te d on my know ledge of th e circu m stan ces under which th e com plainant worked f o r th e S h e ll O il Company, th e absence o f any h is to r y o f a s ig n if ic a n t exposure to o rg a n ic compounds of le a d , my e x a m in a tio n o f c la im a n t, my e x a m in a tio n o f th e m e d ic a l and c l i n i c a l r e p o r t s o f h i s d i s a b i l i t y ana my own know ledge t h a t s i m i l a r e x p o s u re s o? ta n k wagon d r iv e r s to fumes and v ap o rs from lead ed g a s o lin e have n o t le d to c h ro n ic poisoning in o ther in sta n c e s. The c la im a n t has reco g n ized and c h a r a c te r i s t ic d is e a s e s , nam elyt an a f f e c tio n o f th e h e a r t m uscle and an a s s o c ia te d d is e a s e o f th e lu n g s. T h e ir o n se t, c lin ic a l course and p resen t fin d in g s in th e se d iseases are c h a ra c te ris tic o f w ell-know n and o fte n -d e sc rib e d c l in ic a l e n t i t i e s . The clas.m ant has a non v a lv u la r h e a r t d is e a s e - m y o card ial d e g e n e ra tio n w ith in s u ffic ie n c y w ith marked l i m i t a t i o n o f p h y s i c a l a c t i v i t y . He a l s o i s s u f f e r i n g fro m c h r o n ic pulm onary emphysema ( s w e llin g ). T his is confirm ed by an X -ray r e p o r t d a te d June 18, 1946. The p re se n c e o f th e s e d is e a s e s e x p la in a l l o f th e c la im a n t's symptoms and d i s a b i l i t y . There may be d if f e r e n c e s o f o p in io n as to th e r e la tiv e im portance o f th e s e two c o n d itio n s , b u t I p la c e more em phasis on h is h e a r t d is e a s e , re c o g n iz in g , how ever, th a t h is lu n g c o n d itio n c o n trib u te s to h is d is a b i lit y and ,;Sk p' symptoms. Be t h a t as i t may, I am d e f i n i t e l y o f t h e o p in io n t h a t i n h a l a t i o n o f g a s o li n e funiss and le a d i n t o x i c a t i o n do n o t c a u s e h e a r t d i s e a s e . The d is e a s e s from -which th e co m p lain a n t i s s u f f e r in g a r e n o t a n a t u r a l in c id e n t o f h i s o c c u p a tio n as a ta n k wagon d r i v e r ; and th e y d id n o t , i n my o p in io n , r e s u lt from th e n a tu re and c o n d itio n s o f h is employment, to which a l l employees o f h is c la s s are s u b je c t and which d is tin g u is h e s i t from the usual ru n o f . o ccu p a tio n s and which is i n ex ce ss o f th e h a z a rd a tte n d in g employment i n g e n e r a l . I am o f th e f u r t h e r o p in io n t h e r e was n o th in g i n th e n a t u r e o f c la im a n t's d u tie s as a ta n k wagon d riv e r to account f o r any "o c c u p a tio n a l" d is e a s e , p a r tic u la r ly r e s p ira to ry o r g a s tr o - in te s tin a l d iso rd e rs due to in h a la tio n o f g a s o lin e fumes even though th e g a s o lin e handled by him co n tain ed te tra -e th y 1 lead. By " o c c u p a tio n a l" d i s e a s e , I mean one c o n tr a c te d i n th e u s u a l and o rd in a ry co u rse o f a t r a d e , o c c u p a tio n o r employment and w hich i s due to cau ses no rm ally p r e s e n t in such p u rs u it in ex cess o f th e h aza rd s o f employment g e n e ra lly . I n my o p in i o n , b a s e d upon my e x p e r ie n c e , t h e r e i s no p a r t i c u l a r to x i c h a z a rd i n b ein g employed as a ta n k wagon d riv e r-o v e r an extended p erio d of tim e, which d istin g u ish e s i t from th e usual run o f occupations or exceeding th e hazard a tte n d in g employment in g e n e ra l. In o th e r w ords, su ch d is e a s e s from w hich c la im a n t is s u f f e r i n g a re n o t i n c id e n t to o r commonly c o n tr a c te d i n t h e u s u a l and o rd in a ry co u rse o f th e p u r s u it o f g a so lin e ta n k wagon d r iv e r s g e n e ra lly '; nor have I found claim a n t's co n d itio n to be p e c u lia r to o r c h a ra c te ris tic o f th e n a tu re o f th e work he perform ed. \, N early tw enty y e a rs o f e x p e rie n c e have n o t shown th e e x is te n c e of danger to ta n k wagon d riv e rs employed in th e tr a n s p o r ta tio n o f g aso lin e c o n ta in in g t e t r a - e t h y l l e a d . No s u b s t a n t i a t e d c a s e o f le a d a b s o r p ti o n o r o f le a d in to x ic a tio n by ta n k wagon d riv e rs has been produced. S erie s o f s tu d ie s f a ile d to d is c lo s e any c l in ic a l evidence o f o c c u p a tio n a l lead p o iso n in g , as a c o n sequenoe o f ex p o su re t o le a d e d g a s o lin e , of tan3c wagon dr a v e r s . Low g ra d e i n f e c t i o n s a s s o c i a t e d w ith c h ro n ic i l l h e a lth , a r e f r e q u e n t ly accom panied w ith such symptoms as th o s e o f w hich H i l l e r co m p lain s His h is to r y d o e s'n o t give a c o n tin u ity o f symptoms. I f c la im a n t had been exposed to g a so lin e fum es, of s u f f ic ie n t m agnitude, to cause g asoline in to x ic a tio n , a d isease d ifieren - U from th o s e w i t h w hich th e c la im a n t i s a f f l i c t e d w ould have r e s u l t e d , and a a m o r s ; ni; sequence o f ev en ts would have fo llo w ed . (a ) T here -would have b een a h is to r y o f s e r io u s p o is o n in g w ith un co n scio u sn ess o f c o n sid e ra b le d u ra tio n , perhaps fo llo w ed by a o e rio d o f i l l n e s s from w hich th e re would have b een g ra d u a l reco v e ry from th e g e n e ra l d i s a b i l i t y , w ith , p e rh a p s, p e r s i s t e n t damage o r s e q u e ls , e s p e c ia lly r e f e r r e d to th e n ervous sy stem , and n o t to th e h eart or lungs. (b) There would have b een no p ro g re s s iv e d is e a s e w hich co n tin u ed i t s advance a f te r th e acu te a tta c k , and a f te r th e c e s s a tio n of exposure. A c c o rd in g ly , I an o f -tie o o in io n t h a t , b a s e d upon my e x t e n s i v e and lo n g e x p e rie n c e w ith problem s of g a s o lin e p o iso n in g , had cla im a n t s u ffe re d any in ju r io u s e f f e c t s from g a s o lin e o r i t s fumes and v a p o r s , te r m in a tio n o f th e e x p o su re by d is c o n tin u a n c e o f h is o c c u p a tio n as a ta n k wagon- d r i v e r would have r e s u lt e d i n im provem ents, r a t h e r th a n an in c r e a s e , i n h i s symptoms and c o m p la in ts . I n my o p in io n , c l a im a n t' s h e a r t and lu n g c o n d i t i o n a c c o u n ts f o r h is d i s a b i l i t y . I n my o p in io n , c l a i m a n t 's g a s t r i c u l c e r s may li k e w is e a c c o u n t f o r c e r t a i n o f h i s syraotoms o r c o m p la in ts . F u r th e r m o re , i n my o p in io n , c l a i m a n t 's eye tro u b le can account fo r h is a s s e rte d double v is io n and d iz z in e s s . 0004626