Document 2qDx6B8VdNBy070v2vYj2r2Dr

A STUDY OF THE HAZARDS ASSOCIATED TilTH THE SALE AND DISTRIBUTION OF ETHYL GASOLINE by ' Robert A. Kehoe, M.D., and Graham Edgar June, 1925. K' R 0 0 1 8 0 4 3 A STUDY OF THE HAZARDS ASSOCIATED WITH THE SALE AND DISTRIBUTION OF ETHYL GASOLINE Robert A. Kehoe, ( ^M.D. and Graham Edgard) June, 1925, I PRELIMINARY DISCUSSION 1. The Source of Information An investigation of the possible hazards arising by reason of the sale and distribution of Ethyl Gasoline is obviously made most readily and adequate ly through the observation of human beings who have been exposed to the condi tions under which the hazards may arise, for a long period of time. The hazards have been maximal, not in the streets, nor in the ordinary filling stations where Ethyl Gasoline has been dispensed, but, rather, in certain garages, where mechanics, car fillers, and drivers, taken collectively, have been exposed to all the hazards which have existed. For obvious reasons, the exposure to ex haust gas has been greater in the partially closed space of the garages. Like wise the inhalation of vapor of gasoline in the course of ordinary handling, and after spillage, reaches its maximum in such garages. Of the group of men who have been exposed, the garage mechanics have probably had the best oppor tunity for receiving injury, inasmuch as their varied work allows of a more . (1) Assistant Professor of Physiology,University of Cincinnati, Cincinnati, 0 . (2) Director of Research, Ethyl Gasoline Corporation, Dayton, Ohio. NOTE: The writers beg to express their appreciation of the assistance of num erous individuals in connection with different phases of the investiga tion. Mr. Lester Saunders, of the University of Cincinnati, assisted with the clinical work. The analytical work was carried out by Mr. Fred Thamann, who was largely responsible for perfecting the methad of analy sis, and by Mr. D. M. Philippi. Other members of the staff of the Ethyl Gasoline Corporation assisted the work in many ways. The officials of the Dayton Power and Light Company did everything in their power to facilitate the investigation. frequent and more prolonged exposure to all of the hazards, than that of any other group of workmen. Tho above facts lead one to the conclusion that a proper investigation of the problem would be made best by studying a consid erable number of mechanics, car fillers, and drivers, in some garage in which a large number of cars, all of which burn Ethyl Gasoline, have been in con tinual use for a long time. 2. The Type of Information: The information to be sought, in the study of such a group of men, should be obtained by the determination of all variations from normal health, including those which ere specifically due to lead poisoning, or are commonly associated with it, as well as other less definite, recognizable abnormali ties, which might be produced by any injurious agent. The importance of the latter resides in the fact that there are few, if any, abnormalities which may be said to be produced by lead poisoning alone, while there are a great number and variety of injuries which may be brought about by general poisons, including lead. Information in the-matter should be obtained by careful ques tioning, of each subject as to the exact nature and period of his exposure to lead in any form, as to any previous or present exposure to other poisons, and as to any previous or present illness or symptom. The subject should be given a very careful examination, by methods which will determine as nearly as pos sible, the exact status of his present health. The question of lead absorp tion should be investigated by the examination of adequate quantities of the excreta. ' 3. The Interpretation of Information: Since there are always variations from the normal of perfect health in any considerable number of men, it is absolutely necessary to collect data -3- from a group of men who have had no opportunity for exposure to the hazards, the effects of which are being studied. .These should be collected in the same manner, and by the same persons who examine the exposed group. Also, since there is no considerable body of data concerning the quantity of lead which may be excreted by persons who have not been exposed to the hazards under study it is necessary to obtain such data. The same method of analysis must be em ployed in the study of the excreta of exposed and unexposed groups,' in order to control the variation in the sensitivity of the various methods of lead analysis, and thus obtain comparable results. II METHODS OF PROCEDURE 1. Subjects for Observation: The garage of the Dayton Power and Light Company of Dayton, Ohio, was chosen as the site for observations on exposed men. In this garage Ethyl Gaso line has been used in all the cars and trucks, about 80 in number, since the first distribution of Ethyl Gasoline began in April, 1923.. The garage is a well lighted, average well ventilated, concrete garage, the floor of which is cleansed by means of running water, at infrequent intervals. There are five mechanics, two car fillers and a large number of drivers. The drivers do no filling or repair work. The labor turnover is very slight, indeed, so that practically all the employees have been under exposure during the entire per iod in vdiich Ethyl Gasoline has been used. Several of the subjects (noted in data) under study have been exposed to Concentrated Ethyl Fluid, during a portion of the time, by reason of the early method of distribution in small containers, so that these have had much more exposure to lead than is normal under present conditions of distribution. No unusual precautions of any kind are taken against lead absorption. In fact there is no fear in the mind of management or employees, of any danger from this source. Cars are coming and going during the entire day and some at night. All types of repair work ex cept especially difficult items, are performed hy the mechanics. All cars are filled with Ethyl Gasoline inside the garage, "by means of portable filling tanks and pumps* Spillage of gasoline on the floor may be seen by any casual observer* from time to time. When this occurs the gasoline is wiped up with a cloth by a bare-handed operator, who usually washes neither the cloth nor his hands thereafter. Control subjects were obtained by going to Columbus, Ohio, a city in which Ethyl Gasoline had never been distributed at the time of the investiga tion. An attempt was made to find a garage similar to that of the Dayton Power and Light Company. Since that was found to be impossible, an arrange ment was made with an employment agency for obtaining white men of all types, just as they appeared at the agency. They were employed by the day and re leased at night during the period of the observations. Among these were far mers, common laborers, skilled workmen, sailors, chauffeurs, and clerks. Most of them were in youthful or middle life. 2. Type of Data Obtained: All subjects were questioned carefully as to their occupation over a period of not less than five years previously, with special reference to ex posure to any type of lead. Exposed men were asked as to the details of their daily work during the time of their exposure. Control subjects were asked leading questions as to their having been employed in ind\*stries known to in volve contact with lead. A list of industries known to use lead to a greater or less extent was prepared and used ii* such questioning. When the appended data show that a given subject has no hiistory of exposure to lead, it is to be -5- remembered that every effort was made to discover some possible source of lead exposure in his case. A history of previous illnesses was recorded for every subject, in order to note any relationships which might exist between such illness and present health. At the same time careful questions sought out the presence of any present symptoms of illness. A physical examination '.was made by an examiner (Dr. Kehoe examined all subjects) who had no knowledge of the contents of the history. In every case an analysis of the urine, the determination of the haemoglobin of the stood, and a microscopic examination of a stained blood smear were made, in order to determine the presence of abnormalities. Appended hereto are typical histories and reports of examination of one control and one exposed subject, upon the blanks used in the investiga- dach subject was furnished with a pint size Mason fruit jar, and a "a.ion size glass bottle such as is used for vinegar, molasses, etc. The containers were chemically clean and were kept tightly closed. The subject was carefully instructed to put the excreta directly into the container, and cncer no conditions to use any intermediate container. The specimens of the exposed men were obtained under the supervision of the foreman. Those at ''-lum.Dus were obtained in a room rented for the purpose, during the course -vo or three eight hour days. The containers were not permitted to leave r 'on ou^ they and the subjects were kept under observation during the . ''o of collection. Close observation and rigid discipline were necessary <.. v. 'Lo ui'oup to prevent deception, errors, and practical jokes, which might result i 1033 or mixture of specimens. One or two incidents occurred which - the omission of the specimen obtained, from examination. (One -- nTM nifiTin|TnninBrrM^-- pp-- ...... .... .......... - -6- man was found to be adding water from a bottle which he carried with him.) In the case of each subject a fair sized specimen of faeces, and one to three liters of urine were obtained. Diuretics and cathartics were not used. The containers, which had been labeled previous to their use, with the name of the subject, and a number assigned to him by the examiner, were turned over to the analytical laboratory. The subjects were all unknown to the analysts, whose only information consisted of a name and a number on the container. Ill DATA. The mass of data obtained in the histories and in the examination of the two groups of men is too unwieldy for full presentation. The tables be low indicate the frequency of occurrence of certain variations from the nor mal in the two groups, from which comparison may be made of the two groups. The analytical findings are tabulated opposite the history of employment and exposure, where their significance may be adjudged to the extent to which that is possible. In Tables II, III, and IV, the expression "Questionable lead line" is apparently not a happily chosen one. It refers, however, to a bluish color of the gums, adjoining the teeth, which is seen frequently in pyorrhoea, but which, when there is a history of lead exposure, may sometimes be thought to be significant. It is sometimes.quite difficult to determine the presence or absence of the bluish or black precipitate which is formed in the gum margin when lead or any other metal which gives a black sulphide is being secreted. For that reason, the examiner made note of every bluish dis coloration of the gums, even where he was certain that it was the result of circulatory abnormalities in the gum margin, and labeled it as questionable, or as simulating to some degree a "lead line". .......... . . m,'. -7It is hardly proper to make comparison of the analytical data until it is reduced to some standard. The specimens of faeces and urine are not only different in volume and weight, out they represent varying periods of time of secretion. It is not possible to collect specimens without these variations. It has been considered advisable on this account to make calcula tions of the lead on the basis of unit weights of faeces, and unit volumes of urine. Table V and VI shov/ the results of such calculations foi* both groups of subjects. KE 0 0 1 8 0 5 0 -8- HI STORY Ho. 14 lame Date May 8th Age 22 Employment for past 5 years: Dayton Poirer and Light Co. entire time Filling cars with gps and oil up to Jan., 1925. Rough repair work since, fender work, steering gear repair. Has torn down motors. Period of handling Ethyl fluid: Exposure at intervals for more than year. Period of handling Ethylized gasoline: Exposure at times for year or more. Period of handling both: llature of exposure; Spilled fluid and gasoline on hands at times (a) Exhaust gas: 'When testing motors. (b) Gasol ine vapor: Y/hen testing cars, and checking up on gas. (c) Spillage of Ethyl Fluid: Several times. (d) Spillage of gasoline: Spilled in garage at times. Previous Illness: Tonsilitis and common colds. Nothing more. (a) Illness and disease in words of subject: (b) Symptoms and duration: Common colds of short duration. (c) Presumable diagnosis: Symptoms of any type now present Eg. Peridic headache: None Susceptibility of colds their duration: No Digestive disturbances: Never . Habits as to sleep: _ Sleeps very well Dreaming: Has dreamed at times for years, with nightmare. f Appetite: Good always Polyuria: No Nocturia: No Itching or burning of skin: No Changes of weight: Has gained since 1923, 6 lbs. Cramps: Never Yfeakness: No Nervousness: No Miscellaneous : 0018051 9- No. 14 Name Date May 8th General Appearance Healthy and robust Nourishment Well nourished Blood pressure 120-70 Temperature 98.8 Pulse 72 Eyes - Reaction to light Normal Extrinsic muscles 0. K. Vision Good Pathological Conditions None Accommodation Normal Nose - Abnormalities Obstruction on left Inflamations Acute rhinitis. Common cold. Mouth & Throat Irritated and red Teeth Fairly good Pyorrhoea Present Caries None Lead-line Tonsils and Pharynx Red especially around pillars None Ears - Audition Good Abnormalities None . Adenopathy None Skin Normal Chest (positive findings only) None Abdomen Normal Pelvis Normal Extremities Normal Central Nervous System: Reflexes Normal Tremor None Abnormalities None Urinalysis - Reaction to M.R. Albumin . Sugar Acetone Aik. Neg. Neg. Neg. Blood Hb. 95 Dare Smears Normal REMARKS : No suggestion of any lead poisoning. Ut 0 01 8052 -10- HISTORY No. 23 Name Date May 7t;h Age 28 Employment for past 5 years: Teamster 2 years 1920-22 Truck driver 3 years, 1922-1925 Odd jobs at times, as carpenter's helper, digging for plumbing jobs. No actual plumbing. Period of handling Ethyl Fluid: None Period of handling Ethylized Gasoline: Period of handling both: None Nature of exposure: None (a) Exhaust gas (b) Gasoline vapor (c) Spillage of Ethyl Fluid (d) Spillage of gasoline None . Previous illness: Measles as child. Influenza 1922. (a) Illness and disease in words of subject: Pleurisy after "flu" for about one week. Pains around heart at times for years. Catarrh since flu. (b) Symptoms and duration: Pains were sharpest in breathing. (c) Presumable diagnosis: Post influenzal pleurisy. Probably adhesions remaining. Symptoms of any type now present: Eg. Periodic headache: No Susceptibility of colds their duration: Frequent colds Digestive disturbances: Cramps in stomach several weeks 1923 Habits as to sleep: Restless every night for 3-4 years Dreaming: Scary dreams 2 times weekly Appetite: Good Polyuria: No Nocturia; At times. Not frequent. Itching or burning of skin: None Changes of weight: Very slight for years Cramps: In stomach after meals at times. Weakness: .Tired most of time. Nervousness: At nights so as not to sleep well. Miscellaneous: K 0 0 1 8053 11- No. 23 llama Albert Klott Date May tth General Appearance Healthy dark eyes and hair Nourishment Medium Blood Pressure 122-70 Temperature 97.8 Pulse 72 Eyes - Reaction to Light Normal Extrinsic Muscles 0. K. Vision Good Pathological Conditions None Accommodation Normal Nose - Abnormalities Slight obstruction due to deflected septum Inflamations None Mouth & Throat Mucous membranes pale Teeth Fairly good Pyorrhoea Present - slight Caries None Tonsils and Pharynx Red. Buried. Cryptic. Typical on Lead-line incisors above Ears - Audition Good Abnormalities None Adenopathy None Skin Scattered acne lesions on back and fe.ce Chest (positive findings only) None Abdomen None Pelvis None Extremities 0. K. Central Nervous System: Reflexes Normal Tremor None Abnormalities None Urinalysis - Reaction to M.R. Albumin Sugar Acetone Aik. Neg. Neg. Neg. Blood Hb. 80 Smears REMARKS: Blood smears show considerable number of polychromatophilic Etythrocytes but no stippling. KE 0 0 1 8 0 5 4 TABLE I SYMPTOMS OF ILLNESS PRESENT IN EXPOSED AND UNEXPOSED MEN -12 SYMPTOM Frequency of Occurrence Exposed Unexposed 22 subjects 64 subjects Periodic Headache Susceptibility to colds Chronic Constipation Gastric Cramps Insomnia Disturbing Dreams Poor Appetite Loss of Weight Polyuria Nocturia Fatigue Nervous Irritability . 1 1 2 l3 0 l1 0 0 0 0 0' l2 18 16 10 11 5 '5 1 5 3 4 5 1 Percentage Occurrence .'Exposed Unexposed 4.5 28 4.5 25 9 15.6 4.5 17.2 0 7.8 4.5 7.8 0 1 .6 0 7.8 0 4.7 0 6 .2 0 7.8 4.5 1 .6 ^ This man has had occasional nightmare Tor years 2 This man was a victim of shell-shock in the war *2 This man has had "dyspepsia" for many years 0018055 TABLE II PHYSICAL VARIATIONS FROM THE NORMAL IN EXPOSED AND UN2XP0SED MEN ABNORMALITY Subnormal Temperature Elevated Temperature Subnormal Blood Pressure Elevated Blood Pressure Pyorrhoea Alveolaris Severe Gingivitis Albuminuria Glycosuria Questionable Lead Line Definite Lead Line Polychromatolphilia Stippling Frequency of Occurrence Exposed Unexposed 22 subjects 64 subjects 3 29 45 6 19 2 12 13 47 6 43 15 01 3 15 02 13 04 Percentage Occurrenci Exposed Unexposed 13.6 18 27 9 50 27 4.5 0 29 0 4,5 0 45.3 7.8 30 18.6 73 67 7*8 1 .6 ' , 23.4 3.2 4.7 6 .2 Under subnormal temperature everything under 98 degrees is noted. Under elevated temperature everything above 98.8 Subnormal blood pressure refers to everything below 115 Systolic. Elevated blood pressure refers to everything above 140 Systolic. Under "Questionable lead line" is listed every bluish discoloration.of the gums which simulates in any way a lead line. Such discolorations are com mon in mouths which show considerable amounts of gum inflammation. A def initely recognizable lead line is something about which there is no ques tion. The questionable ones are noted because of the desire to omit no le sion about which there could be any question. Pplychromatophilia refers to a slight abnormality in the staining of red blood corpuscles, the signi ficance of which is unknown. Stippling is noted in any case in which a single stippled red blood cor puscle may be found in an entire smear, after staining by a standard, well controlled method. In one case four stippled cells could be found in 100 fields. In no others was more than one found." KE 0018056 -14- TABLE III HISTORY OF EXPOSURE, FINDINGS AND ANALYTICAL DATA DAYTON POWER AND LIGHT SUBJECTS Number Period . of of Subjot Exposure Occupation in Garage Nature of Exposure Findings Lead, in Millig;rams Faeces Urine 1 2 years Blender 2 2 years Driver Part time filler 3 2 years Driver Part time filler 4 2 years Driver Part time filler 5 18 mo. Driver 6 2 years Driver 7 2 years Driver 8 2 years Driver S 3 mos. Driver (in school pre viously) 10 2 years Driver 11 2 years Driver 12 2 years Driver 13 2 years Mechanic Blender 14 2 years Me chani c Blender Filler 15 2 years Mechanic Filler 16 2 years Mechanic 17 2 years Foreman Blender 18 2 years Driver 85 2 years Driver 86 2 years Driver 87 1 year Driver 88 2 years Driver Ethyl Fluid Gasoline Exhaust Ethyl Fluid Gasoline Exhaust Gasoline Exhaust Gasoline Exhaust 97.6 Temperature 114-70 Bl. Pressure Nothing else. None 97.6 Temp. Nothing questionable - (else lead line None . 0.50 0.30 0.32 0 .1 1 0.14 0 .1 2 0.17 0 .2 2 Exhaust Exhaust Exhaust Exhaust Exhaust 97.6 Temperature None other Questionable Lead line 112-60 Bid. Pressure 110-74 Bid. Pressure 112-74 B l . Pressure 0.45 0.08 0.14 0 .1 2 0.33 0.64 0.27 0.15 0.17 0 .1 2 Exhaust Exhaust Exhaust Ethyl Fluid Gasoline Exhaust Ethyl Fluid Gasoline Exhaust Ethyl Fluid Gasoline Exhaust Ethyl Fluid Gasoline Exhaust Ethyl Fluid Gasoline .Exhaust Exhaust Exhaust Exhaust Exhaust Exhaust None Questionable Lead line None No ne None None Polychromatophilia None 106-66 Bl. Pressure Healed Tube. 97.2 Temperature 104-64 Bl. Pressure None None None 0.42 0.09 0.32 0.08 0.27 Nil 0.30 0 .1 0 1.91 0.14 0.29 0.56 0.51 0.15 0.65 0 .1 2 Specimens lost 0.73 0.25 0.46 0.27 0.25 0.25 0.23 0 .1 2 KE 0018057 TABLE IV HISTORY OF EXPOSURE, FINDINGS, AHD ANALYTICAL DATA OF CONTROLS Number of Subjct History of Lead Exposure Findings Lead in Milligrams Faeces Urine 19 Ho history of exposure None 0.16 0.17 20 Occasional odd jobs of painting Questionable lead line 0.53 0.24 21 lg- years pipe joining with lead None 0.35 0.06 22 Enamel mfg. 1 yr. Occas. painting None 0.27 0.16 23 ITo history of exposure Typical lead line 97.8 Temperature 0.37 0 .1 0 24 Occasional painting at home 104-64 Bl.Pr. 97.8 Temp. 0.15 0 .2 1 25 Trucking metal.lead. Steam fitting 97.8 Temperature 0*45 0.13 26 Occasional odd job of painting None 0.17 0 .1 2 27 Coal miner. No other history None 0.35 nil 28 No history of exposure 112-80 Bl. pressure 0.33 0 .0 2 29 Marble worker. Occasional paintg None 0.74 0.14 30 Ho history of exposure 112-70 Bl. Pr. 0.23 0 .1 2 31 Odd jobs painting and plumbing Questionable lead line occasional ly Definite stippling 1 -1 0 0 0 *6 8 0.16 32 Occasional painting 110-80 El. Pressure 0.62 0.14 33 Painting 5 mo. recently 114-72 Bl. Pressure 0.05 0.09 34 Plumbers helper occasionally 110-76 Bl.Pr. 97.2 Temp 0.32 0.07 35 No history obtained No examination made No sample 0.08 36 No history of exposure 97.4 Temp. 0.14 9.10 37 Plumbers helper 1923 Stippling 1-100 0.06 0.13 38 Painter 3 years 102-60 Bl. Pr. 0.38 0.03 39 Painting 3 mo. 1925 Quest.lead line.97.2 Tem 0.24 0.04 40 Farmer. No history of exposure 97.2 Temp. 100-60 Bl.Pr. 0.24 0.15 41 Mixed Paint 3 mo. 1924 96.6 Temp. 0.30 nil 42 No history of exposure 104-60 Bl. pressure Questionable lead line 0.28 0.04 43 Engine painter 3 years 97.4 Temperature 0.30 0.05 44 Vulcanized tires 1923-1924 110-70 Bl. pressure 0.30 0.07 45 Painting 6 mo. 1924 96.4 Temp.112-70 Bl. Pr. 0.41 0.16 46 Plumber and pipe fitter 96.0 Temperature No sample 0.17 47 Occasional job painting 97.6 Temp.114-76 El. Pr. 0.18 0 .2 0 Questionable lead line 48 Plumber Questionable lead line 0.55 0.13 49 Released because of deception before being examined. Samples discarded 50 No history of exposure 97.0 Temp* 102-60 BL.Pr 0.38 0*13 51 No history of exposure 97.6 Temp. 112-60 Bl.Pr. Questionable lead line 0.37 0 .2 0 52 Occasional odd job painting 110-70 Bl. Pressure 0.55 0.06 53 No history of exposure Questionable lead line 0.33 0.18 54 No history of exposure None 0.42 0.13 55 Plumber 2 years None 0.42 0.18 56 Painting 2 weeks recently 97.8 Temp. 0.53 0.08 57 Ho history of exposure None 0.31 0.18 58 Occasional odd jobs painting Short periods as plumbers helper Questionable lead line 0.34 0.14 59 Painter None No sample 0 .2 0 60 No history of exposure Questionable lead line Stippling 1-100 0 .2 1 0.13 61 Tinner and roofer's helper 1923 97.8 Temperature 0.40 0.18 62 No history of exposure 97.0 Temperature 0.33 0.15 63 No history of exposure 100-80 Bl. Pressure 0 .2 0 O.ll 64 Painter for 3 years before 1920 97.6 Temperature 0.37 0.04 65 Plumbers helper 4 mo. 1923 Storage battery mfg. 4 mo. 1924 9 7 . 8 T ftT rn R n o 31 Odd jobs painting and plumbing Questionable lead line occasionally Definite stippling 1 -1 0 0 0 .6 8 0.16 32 Occasional painting 110-80 Bl. Pressure 0.62 0.14 33 Painting 5 mo. recently 114-72 Bl. Pressure 0.05 0.09 34 Plumbers helper occasionally 110-76 Bl.Pr. 97.2 Temp. 0.32 0.07 35 Ho history obtained Ho examination made No sample 0.08 36 No history of exposure 97.4 Temp. 0.14 6 .1 0 37 Plumbers helper 1923 Stippling 1-100 0.06 0.13 38 Painter 3 years 102-60 Bl. Pr. 0.38 0.03 39 Painting 3 mo. 1925 Quest.lead line.97.2 Tern. 0.24 0.04 40 Farmer. Ho history of exposure 97.2 Temp. 100-60 Bl.Pr. 0.24 0.15 41 Mixed Paint 3 mo. 1924 96.6 Temp. 0.30 nil 42 Ho history of exposure 104-60 Bl. pressure Questionable lead line 0.28 0.04 43 Engine painter 3 years 97.4 Temperature 0.30 0.05 44 Vulcanized tires 1923-1924 110-70 Bl. pressure 0.30 0.07 45 Painting 6 mo. 1924 96.4 Temp.112-70 Bl. Pr. 0.41 0.16 46 Plumber and pipe fitter 47 Occasional job painting 96.0 Temperature No sample 0.17 97.6 Temp.114-76 Bl. Pr. 0.18 0.20 Questionable lead line 48 Plumber Questionable lead line 0.55 0.13 49 Released because of deception before being examined. Samples discarded 50 Ho history of exposure 97.0 Temp. 102-60 BL.Pr. 0.38 0.13 51 ITo history of exposure 97.6 Temp. 112-60 Bl.Pr. Questionable lead line 0.37 0.20 52 Occasional odd job painting 110-70 Bl. Pressure 0.55 0.06 53 ITo history of exposure Questionable lead line 0.33 0.18 54 Ho history of exposure None 0.42 0.13 55 Plumber 2 years Hone 0.42 0.18 56 Painting 2 weeks recently 97.8 Temp. 0.53 0.08 57 Ho history of exposure Hone 0.31 0.18 58 Occasional odd jobs painting Short periods as plumbers helper 59 Painter Questionable lead line 0.34 0.14 Hone Ho sample 0.20 60 Ho history of exposure Questionable lead line Stippling 1-100 0 .2 1 0.13 61 Tinner and roofer's helper 1923 97.8 Temperature 0.40 0.18 62 Ho history of exposure 97.0 Temperature 0.33 0.15 63 ITo history of exposure 100-80 Bl. Pressure 0 .2 0 0.11 64 Painter for 3 years before 1920 "97.6 Temperature 0.37 0.04 65 Plumbers helper 4 mo. 1923 ' Storage battery mfg. 4 mo. 1924 56 ITo history of exposure 97.8 Temperature 97.4 Temporaturo 0.14 Nil Sample lost 0 .1 2 67 Ho history of exposure 68 Ho history of exposure 69 Ho history of exposure 97.4 Temp.Quest.load lino Hone 97.4 Tem.Quest.load line 0.24 0.32 0.60 nil 0 .1 1 0.05 70 Short period painting 1923 In tire factory 1921 Hone 0 .2 0 0.17 71 Occasional odd job painting 97.0 Temp. 112-72 Bl.Pr. 0.24 0 . 1 1 72 Ho history of exposure 97.6 Temp. 0.60 0.20 73 Ho history of exposure 97.8 Temp. 0.43 0.30 74 Plumbers helper and painter Hone 0.24 0.15 75 Street Cleaner 96 Temperature 0.23 0 . 1 2 76 Ho history of exposure 114-78 Bl.Pr.Ques.Id.line 0.37 0.04 77 ITo history of exposure. 97.8 Temp. 100-60 Bl.Pr. Ques.ld.line 0.72 0.07 78 Ho history of exposure Hone 0.16 0.15 79 ITo history of exposure Questionable lead line 0 .1 1 0.15 80 Plumbers helper 3 months Hone 0 .2 2 0.10 81 Ho history of exposure - 97 Temperature 0.14 0.07 82 Tire mfg. 6 mo.1924 (97.4 Temp.Slight anemia.Tbc.stippling 4-100 0.18 0.05 83 Plumbers helper 3 mo. 1925 97 Temp. Stippling 2-100 0.50 0.07 84 Storage Battery Plant 8 mo. 1919 Hone 0.54 nil Plumbers helper 2 weeks 1925 -16- IffiTHOD OF ANALYSIS Treatment of Samples. (1) The samples of urine were received "by the laboratory in gallon jugs of the type used for water, fruit juices, etc. The volume was measured and the samples made ammoniacal soon after they were received. The details of analytical procedure are given below. (2) The samples of faeces were received in pint fruit jars. They were trans ferred to silica dishes and dried on a steam plate to "apparent dryness." No attempt was made to bring them exactly to constant weight. Urine: Preparation of Solution for Analysis (3) The ammoniacal urine, after standing for at least 12 hours,, is filtered on 18 cm. folder filter paper, care being taken that all of the precipitate is transferred to the filter. Without being washed, the filter paper is transferred to a silica or procelain dish, and after being dried on a steam plate, is ignited in'an electric muffle furnace at a temperature not exceeding 600 degrees C. When the organic matter has been completely destroyed, the residue is treated as follows: The ash is moistened care fully with distilled water, and 5 cc of cone. Iiei is added, together with enough water to make the volume about 25 cc. Ths mixture is digested on a steam plate, and is filtered into a 400 cc beaker, any residue being washed six times alternately with hot 10% HC1 and hot water. The filtrate in the beaker should contain all the lead. The residue is usually insig nificant, and in these experiments has been disregarded. Analysis of Solution (4) The solution from (3) is neutralized by adding 25/o NaOH solution until a faint turbidity persists. If too much sodium hydroxide is added, the solu tion should be tpeated with hydrochloric acid again until it is perfectly K* 0018060 -17- clear and sodium hydroxide again added until a faint turbidity appears. The solution is diluted to 300 cc and after cooling, if necessary, is treated with hydrogen sulfied gas for one hour, and allowed to stand over night. The mixture is filtered on a 12.5 Whatman No. 40 filter paper, any precipitate being transferred to the paper by means of freshly prepared hydrogen sulfied water acidified with 1 cc. of cone. HC1 per liter. The paper and its contents are transferred to thebeaker in which the sulfied precipitation was made. The sides of the beaker are washed down with 25 cc. of warn (1 --l) hydrochloric acid containing 10 drops of cone. HNO3 . The mixture is digested with the acid until all sulfides have been dis solved and the paper is thoroughly white. The solution is diluted to 50 cc with hot water, and is filtered, the residue being washed 15 times with hot water, ^o the filtrate, which should be about 200 cc add 4 drops of a solution of methyl red, make just alkaline with 25% NaOH, then just acid with (1 :2 ) hydrochloric acid, and add 1 cc of (1 :2 ) hydrochloric acid in excess. Dilute to 300 cc and after cooling treat with hydrogen sulfied gas for one hour and allow to stand over night. The mixture is filtered on a 12.5 cen. Whatman No. 40 filter paper, the precipitate be ing transferred to the paper by means of freshly prepared hydrogen sulfied water containing 1 cc of cone. HC1 per liter. The beaker is washed care fully with this wash water and the filter is washed ten times. The sulfides are dissolved from the paper with 10-20 cc of hot (1 :1 ) nitric acid, the solution being caught in the beaker in which the precipitation was made. The paper is washed 15 times with hot water. The sides of the beaker, and the inside and outside of the tube from the hydrogen sulfied generator are washed with hot (l:l) nitric acid. The solution is evaporated to 5 cc diluted to 25 cc with hot water, and fil- 0018061 -18- tered through a 7 cm filter paper into a 150 cc beaker. The beaker is carefully washed with hot water and the filter paper is washed 15 times with hot water. The filtrate and washings are evaporated to 25 cc. and neutralized with 25$ JIaOH, free from iron and aluminum, a slightly alkaline water solution of phenolphthalain being used as indicator. The solution is made faintly pink with alkali, the color is just discharged with 5$ acetic acid, and 2 cc of 5$ acetic acid is added in excess. The solution is brought to boiling and 1 cc of 1$ potassium chromate solution is added. The mixture is placed on the steam bath for one hour, and is allowed to stand in a warm place over night. The mixture is then brought to boiling filtered on a 7 cm, ashless filter paper, the beaker being washed care fully vdth hot water, and the filter paper being washed 15 times with hot water. Any residue is dissolved in 5 to 15 cc of cold (l:2) hydrochloric acid, the paper being Trashed at once with cold water, the solution and washings being caught in the beaker in which the chromate precipitation was made. The sides of the beaker and the stirring rod are washed with cold (1 :2 ) hydrochloric acid. Colorimetric Estimation of Lead (5) A standard solution of lead (l cc = 0.10 mg. lead) is made by dissolving 0.1560 grams of pure lead chromate in 200 cc of 10$ HC1 and diluting to one liter. This solution maybe checked colorimetrically against stand ard potassium chromate solution. A one per cent solution of C.P. s-diphenyl carbazide in glacial acetic acid is used as reagent. For the analysis an aliquot portion of the solution of lead chromate obtained from (4 ) is taken, which should contain not more than 0.40 to 0.50 mg. of lead, the best results being obtained with about 0.20 mg. KE 0018062 -19- The sample is diluted to about 100 cc in a Nessler tube, and an equal volume of water put in another Nessler tube. 2 cc of diphenylcar- bazide reagent is added to each tube. From the color which developes in the first tube a rough visual estimate is made of the quantity of lead present and an amount of standard lead chromate slightly smaller than this is added to the blank tube. The colors of the two solutions are compared, and standard lead chromate is added drop by drop to the standard tube un til an exact match is obtained. Feces (6 ) The sample of dried feces is ashed in a silica dish in an electric muffle at 500 C - 600 C. When the organic matter is apparently destroyed the residue is moistened with water, acidified with HC1, and digested on the steam plate for some time. The mixture is then filtered, the residue washed with hot dilute HC1 and hot water, and the filter paper and its contents returned to the silica dish in which the original ashing was done. After being dried on the steam plate the dish and its contents are return ed to the furnace and ashed aga'in at 500 G - 600 The residue is treated with water and HC1 as before, and after being digested on the steam plate, is filtered, the filtrate being added to the first filtrate. The residue may contain traces of lead, and may be reashed and brought into solution with HF, and added .to the main solution. The lead in the residue is, however, always in our experience a very small fraction of the total lead present, and it seemed justifiable to neglect it in this particu . lar case. (7) The solution obtained from (6 ) is diluted and neutralized with 25% NaOh, exactly as described in (4) above,. The remainder of the analysis is exactly like that described under (4 ) and (5 ), except that the second M E 0018063 - '2 0 -- . hydrogen sulfide precipitation is repeated, the third precipitation being made exactly as the second is made. The precipitation as chromate and the colorimetric estimation are made just as in (4) and (5). NOTES (a) Reagents and Apparatus Lead free reagents were employed throughout. It is possible to purchase them in the market, but they must be carefully tested for lead. (b) Pyrex glass beakers, flasks, wash bottles, etc., were employed throughout. Soda glass funnels were employed. The dishes used for ashing the feces vrere 400 cc opaque silica; those used for ashing the urines were of opaque silica or porcelain. (c) General The ordinary technique of good analytical work must be observed most scrupulously if satisfactory results are to be obtained in analyzing or ganic material for small quantities of lead. Precautions as to the clean ness of the laboratory and of the apparatus are essential. In the present case no other work than the analyses in question was carried out in the laboratory employed for all work but the preparation of the samples. (d) (l) It has apparently been shown that ammonia precipitates practically all of the lead from urine as lead phosphate, which is carried down with the other alkaline earth phosphates. The procedure is so much more convenient than that involving the evaporation of the urine, that it vras employed throughout. If it is in error at all it is in the direction of giving slightly low results. Ref. Dr. L. T. Fairhall, J. Biol. Chem. (60) 485-8 (1924). As little as .05 mg. of lead in 3500 cc of urine can be detected. (e) (4) The exact details of the analysis are those decided upon after a 0018064 -21- oaroful study in this laboratory, and after a careful investigation of the literature. The essential features (with the exception of the colori metric method) are those of Dr. L. T. Fairhall (j. Ind. Hyg. (4) 9-20 (1922), but the exact conditions have been modified in several respects which have given more satisfactory results than the original Fairhall method, numerous tests of the method have been carried by working with lead free material and material to which known amounts of lead had been added. The following data are more or less characteristic: To test the accuracy of the method for urine two composite samples of urine were collected from workers at the laboratory. One of these was divided into six portions of 1 liter each and varying; quantities of lead were added to them by members of the research staff outside the analytical laboratory. The samples were then analyzed by the usual procedure. Sample Ho. 2 was divided into five portions and was analyzed after the addition of much smaller amounts of lead. The results follow: Lead Added Lead Found Sample IJo. 1 1 .1 0 mg. 7.00 7.00 1 1 .0 0 7.00 1 1 .0 0 1.13 mg. 7.47 7.00 1 1 .0 0 6.75 1 1 .0 0 Sample No. 2 None None 0 .0 1 0 .1 0 0 .1 0 0 .1 0 0 .1 0 0.08 0 .2 0 0 .2 0 To test the accuracy of the analytical method for feces and the possible influence of other metals, four samples were prepared as follows: 4 lbs. of beef was obtained, bone and fat separated, and the remainder divided into four 400 g. portions. All of these were ashed in silica dishes with K>= 0018065 -22- or without the addition of known Quantities of lead and other metals, the procedure "being that given above for the analysis of feces. Several fil ter papers 'were also added before ashing. The results follow: Sample Lead Added Lead Found No. 1 Ho. 2 Ho. 3 Ho. 4 Hone 1 mg. Hone 1 mg. .07 mg. 0.73 mg. 0.08 mg . 0.73 mg. Samples Hos. 3 and 4 had 1 mg. each of cad mium, bismuth, mercury, copper, arsenic, antimony, and tin added before ignition. The actual quantity of material in these samples is much larger than the samples of feces and required considerably larger amounts of reagents throughout. As a check on the accuracy of the colorimetric method, samples containing various quantities of lead chromate were analyzed by the colorimetric pro cedure . , Lead Added Lead Found 38 . 63 03 02 95 02 07 30 56 .38 .60 .03 .0 2 .93 .0 2 .06 .30 .56 Note the following: All indications are that the experimental method for lead gives results which are, if anything, slightly too low. Considerable study has been made of the losses of lead which may occur at different steps. Thus the neglect of the insoluble residue may introduce slight losses, rhich are apt to be greater the greater the amount of insoluble residue. Furthermore the study of the precipitation of lead as chromate under the conditions followed showed that a slight loss amounting to per haps a few hundredths of a milligram of lead is apt to occur, although the loss is considerably less than that observed when following the procedure of Fairhall (Loc. Cit.). ' The data on the samples of urine and feces from Dayton and Columbus fol low. In the attached chart these data have been plotted to show the gen eral trend of the results. The interpretation of these data is discussed below. Since the samples of feces could not be regarded as definite 24 hour samples it has seemed preferable to plot the lead per 100 grams of dried feces rather than the lead in the individual sample. The urine probably represents a more nearly true 24 hour sample, but for the sake of uniformity the results have been plotted in milligrams of lead per liter of urine. 0018067 -24- SAMPLES FROM DAYTON, OHIO, DAYTON POWER AND LIGHT CO. Sample Number Origin of sample Analy sis Number F E CE S Lead Lead mgs - Dry mgs. /lOO gms weight dry feces gms. 127 0.50 1.83 27.4 138 0.30 0*97 31.1 128 0*32 1*52 2 1 .1 129 0 .1 1 0*99 1 1 .1 188 0.45 1.49 30.3 130 0.14 3.11 4.5 139 0.33 1.05 31.5 131 0.65 1.62 40.2 189 0.27 1.62 16.7 140 0.42 1.73 25.4 132 0.32 1.08 29.8 141 0.27 ' 3.70 7.3 133 0.30 3.85 7.8 134 1.91 1.63 117.3 135 . 0.29 0 .8 8 33.0 136 0.51 1.44 35.5 137 0.65 1.70 38.3 284 0.73 1.04 69.9 283 0.25 1.95 1 2 .8 285 0.46 0.87 52.8 282 0.27 1.63 15.3 Analy sis Number U R IN E Lead Lead Volume mgs. mgs.per in liter cc. 113 0,14 0 .2 0 700 123 0 .1 2 0.08 1450 114 0*17 0.14 1200 115 0 *2 2 0.07 3000 234 0.08 0 .1 0 820 116 0 .1 2 0.25 470 125 0.15 0 .1 2 1270 117 0.17 0.14 1 200 235 0 .1 2 0.05 2450 12 o 0.09 0.06 1500 118 o.08 0.05 1500 124 Nil Nil 750 119 0 .1 0 0.07 1400 120 0.14 0.05 2900 112 0.56 0.40 1350 121 0.15 0 .1 1 1350 122 0 .1 2 0.08 1530 237 0.25 0 .1 1 2220 241 0.25 0 .1 2 2 100 242 0.23 0 .1 1 2 100 236 0 .1 2 0.04 2920 R E 0018068 -25- SAMPLES FROM COLUMBUS, OHIO Sample Origin of Humber sample 29 30 31 32 33 34 35 36 37 38 39 40 _________F E C 5 S_________ Analy- Lead, Lead mgs. Dry sis mgs /lOO gras.weight Humber ______ dry feces gms. _____ U R I U E___________ Analy- Lead Lead Volume sis mgs. mgs.per in Number liter cc. 267 0.16 2.26 7.1 220 0.17 0.09 1820 198 0.53 2 .2 2 23.9 231 0.24 0.16 1460 258 0.35 0.92 38.0 227 0.06 0.04 1460 269 0.27 2 .8 8 9.4 208 0.16 0 .1 0 1640 275 0.37 1.23 30.0 207 0 .1 0 0.05 2160 279 0.15 1.25 12 .0 214 0 .2 1 0.08 2580 2 86 0.45 0.93 48.5 180 0.13 0 .2 2 600 287 0.17 1.95 8.7 202 0 .1 2 0.08 1520 182 0.35 6.73 5.2 161 Nil Nil 2000 265 0.33 1.35 24.5 156 0 .0 2 0 .0 1 2620 185 0.74 3.27 22.7 155 0.14 0.06 2200 281 0.23 1.17 19.7 152 0 .1 2 0.07 1760 266 0 .6 8 3.13 21.7 230 0.16 0.13 1200 193 0.62 0.75 82.8 229 0.14 0 .1 0 1460 280 0.05 0.43 1 1 .6 ' 225 0.09 0.05 1940 277 0.32 1.05 30.5 233 0.07 0,03 2220 H o s a m pie 239 0.08 0.17 470 191 0.14 0.35 40.6 232 0 .1 0 0.07 1460 181 0.06 1.58 3.8 178 0.13 0.07 1880 278 0.38 2.30 16.5 206. 0.03 0 .0 2 1760 194 0.24 0.39 61.5 153 0.04 0 .0 2 1830 268 0.24 1.05 22.5 203 0.15 0 .1 1 1360 -26- SAMPLES FROM COLUMBUS (Cont'd) Sample Number Origin of sample 41 42 43 44 45 46 47 48 50 51 52 53 54 55 56 .57 58 59 60 61 62 63 64 Ana ly sis Number FECES Lead Lead mgs. Dry mgs. /l0 0 gms. Weight dry feces gms. Analy sis Numb er U R INE Lead Lead Vo lun?*. mgs. mgs.per in liter cc. 190 0.30 1 .6 8 17.9 150 Nil Nil 1220 276 0.28 1.35 20.7 159 0.04 0 .0 2 1830 195 0.30 1.42 2 1 .2 154 0.05 0 .0 2 2230 251 0.30 3.30 9.1 170 0.07 0.06 1180 184 0.41 1.59 25.8 209 0.16 0 .1 0 1520 N o s a m pie 199 0.18 0.39 46.5 263 0.55 1*87 29.4 179 0.17 0 .1 1 1520 238 0 .2 0 0.07 2680 212 205 0.13 0.09 1400 255 0.38 0 .8 8 43.0 169 0.13 0.09 1460 262 0.37 1.49 24.9 223 0 .2 0 0.14 1460 270 0.55 1.35 40.6 228 0.06 o.04 1520 260 0.33 0.73 45.1 221 0.18 0 .1 2 1520 197 0.42 ' 0.45 92.9 226 0.13 0.09 1400 254 0.42 1.99 2 1 .1 222 0.18 0 .1 2 1520 257 0.53 2.69 19.7 224 0.08 0.05 1520 259. 0.31 0.92 33.8 216 0.18 0 .1 0 1760 264 0.34 1.89 18.0 219 0.14 0.16 870 N o s a m pie 215 0 .2 0 0 .1 0 2140 261 0 .2 1 1.54 13.6 213 0.13 0.06 2200 290 0.40 1.48 27.0 218 0.18 0 .1 0 1760 288 0.33 0.72 45.9 217 0.15 0.09 1640 192 0 .2 0 0.73 27.5 164 0 .1 1 0.06 1750 256 0.37 2.03 18.2 ` 165 0.04 o. 02 1690 -27- SAMPLES FROM COLUMBUS (Contd) Sample Number 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 Origin of sample Analy sis Number F E c SS Lead Lead mgs. Dry mgs. /lOO gms. Weight dry feces gms. 253 0.14 0.61 23.0 272 Sampl<3 Lost 19*2 289 0.24 0.81 29.6 144 0.32 0.90 35.6 252 0.60 0.80 74.7 187 0 .2 0 2.28 8 .8 273 0.24 1.97 1 2 .2 200 0.60 2.42 24.8 146 0.43 0.42 103.4 145 0.24 0.53 45.4 196 0.23 0.33 70.2 271 0.37 1.91 19.4 142 0.72 1.44 50.0 186 0.16 1.36 1 1 .8 274 0 .1 1 1.64 6.7 143 0 .2 2 1 .2 0 18.3 147 0.14 0.50 28.4 183 0.18 2.31 7.8 148 0.50 1.52 32.8 149 0.54 2.31 23.4 Analy sis Number U R INE Lead Lead Volume mgs. mgs.per in liter oc. , 168 Nil . Nil 1640 211 0 .1 2 0.08 1760 162 Nil Nil 2160 163 0 .1 1 0.07 1650 167 0.05 " 0.03 1600 210 0.17 0 .1 0 1640 166 0 .1 1 0.06 1880 201 0 .2 0 0.08 2530 175 0.30 0.23 1300 173 0-15 0 .1 1 1300 151 0 .1 2 0.09 1300 158 0.04 0.06 700 160 0.07 0.06 1180 157 0.15 0.08 1850 204 0.15 0.09 1760 172 0 .1 0 0.08 1320 177 0.07 0.05 1400 171 0.05 0.03 1950 174. 0.07 0 .1 0 710 176 Nil Nil 1170 /t -28- We failed to find lead in analyses of Dayton and Columbus city -waters. VI CONCLUSIONS A consideration of the data and the calculations, together with the study of the grouping of symptoms and clinical signs in individual subjects justifies and compels the following conclusions: . 1. No individual in the two groups is suffering from lead poisoning. 2. All the individuals in the two groups have absorbed lead into their bodies from some source. 3. A group of twenty-two workmen who have been exposed to, apparently, the worst hazards associated with the sale, distribution and use of Ethyl gasoline, fails to show any indication of having been poisoned by lead. A comparison of their ailments of an indefinite type, which might conceivably be due to a greater opportunity for lead absorption, that is, normally, shows they are in better physical condition and that the occurrence of abnormalities among them is lower than among a controlled group of workmen taken at ran dom through an employment agency at Columbus, Ohio. 4. It is perhaps to be expected that the group of twenty-two workmen regularly employed by the Dayton Power and Light Company should be normally in some what better physical condition than such a group as that obtained from the Columbus employment agency, but in any case, the data gives no indication whatever that the enployees of the Dayton Power and Light Company have been in any way injured by their contact with tetraethyl lead. . 5. From the evidence presented herein it is not possible to state that these men so exposed to the hazards which some have claimed exist in connection with Ethyl gasoline have received any damage or have absorbed any lead as a re sult of their exposure to Ethyl gasoline. In fact, it seems quite probable, in view of the.-evidence, that the lead which they have absorbed has come from other sources. Mg.Pb/lOO gm. dried faeces o h * cu W o * O OO O OI a> o oo 08 roo 3 Mg.Pb/liter urine OO O O l--' CO O oo &. * en 62