Document 3N206MOdj57o3MVb2RZ5GnKan
I
5 December 1962
Mr. Fred C, Francis
Industrial Indemnity Company
1*f06 dixth Avenue
`
San Diego 1, California
re: .
318h> Valley, San Diego
Former employee of Vianderlicii Corporation
1^ 67 State streets San Diego 1, California
?ear - .r# Francis*
1 vac -shed to avalute Mr*
st the request of Dr*
0. ..r-.rDimgfe becuna of
of chronic load in**
toxicstion due to exposure to tetraethyl lead during this nan* 3
employment with the vhmderlich Corporation X first suw the
patient in my office on Hcvebfoer 105 1X62*
siuix 1 r iHSHExy cehfLiXKxsi 1) ins patient first consulted his 1 .li.X* 1 hr* Pedro vilo&rm&vs, eff 1612 ocyth Fvans streett fan d i o s o 13 t in anu&ryt 1962 vltla a; *ve^/3 of-tinnitus in
both ,,; r:; and fronts! headaches (It aht old h notad that the patient is n poor historien end w ore not /exactly certain : *.> to the validity of the dotes named)* Phis vas/not associated with
hearing loss II states that this vss Intc/nclttont until March,
I962 when it became almost eentirmous# Ilk has siso cooplainsd
cf dinainoss intermittantly over this aabs period of time* he
believes that bo heg.m@ rest aissy with the sost tinnitus and
chills and fever only t&lle yorhlng in f/he north heading In. the h'msIerXich. tunnel project* He states i M t his L*HD* gave him a
bitter rj>dicir to"ts.be in the ovoniagy far his headaches
cotseasnclag about Hoy* 1962 which help& the considerably* no states that t t m chills s M fever vhlci/ h a w been present for approxis&tely the last five months charred almost only when he
m verging- in. the tuniiol end w r s roiloved almost IsasdxatoXy
by placing a fan In his face*
TI10 patient also claScss to have hsd/lnacsaaiA s.lnee July*
Immediately after the possibility o t lead intosication was nado
l-mown to himself and th other vorlprs* fee consulted his UD
who- ic.nlled that the patient might/feave load Intoxication in July,
196S*
'
ho-patient has also complained or his head fooling stopped op especially in the loft nostril, lanlilary and supraorbital areas
9 December 1962 is?* Frsd G* Francis
Fge 'XfO
since October 26* 1962# Ho states that this 1s botter slace h nos been given pills by Dr# arbaufgu
the patient ..states that he was last alloyed on tbs 29th of October* 1962 whoa ho-was dismissed trim worm because of absenteeism. Ho claims that his absenteeism was a m to M s m&lng his family doctor? Or* Viloanueve for the rtasal congestion from which he was suffering*
other pertinent information arc that the patient has had s w a t s
since hsrch* 1962 and cramping of his hands on exertion without a fooling of pins or needles* feeing present* for approximately the Sotie period of time* ha ha 3 hsd Intermittent episodes of proccrdi&L pain with radiation into his left erst lasting a few minuts#
HHVIEM reveals no history of significant weight loss or
ain in the past year* ho pntisnt denies headaches prior to 1 9 6 2
otthheeyr twhigauni is.UnAuoucucsua?siiiuoAnia3lx h!iaisnag|Bovveir*# D;--ou sasl4s.aou tdeeenaitess <co;uuugphj** wheeling*
dyspnos and orthopnea* He has had belching sine approximately
i archs 1o62 but no diarrhea* craping or
end'no pi history
cf ."jaundice# ho denies dysuriOf. frequency or nocturia# he ec_m_ios
weakness* nervousness or vertigo prior to the present illness*,
flier is no history of heat Intolerance* disorders of the .joist
or of the shin*
PAhi H l d l C M reveals so significant childhood diseases and no history at rheumatic fever* typhoid fever* tuberculosis* pneumonia, or venera&t. disease* Past history includes on appendoctmxf end
removal of all M s teeth in 195f feecutusie of pyorrhea*
FnHLf KIGlOiQt revealed that his father died at 32 of old age end his ;.other died at m uskaewa og of $Ld age* Ihe patient lias 1? siblings* four dead of tmkaown causes* rau, the patient is unaware of any family history of diabetes* hetert troubla? allergies, hypertension* mental disease-or gout/
FbBGG'iAL niSXCKT z m m Is the patient is living with his c t - I M wif and has two children by a ferigar marriage whom he In. part
supports as well as M s comoa-law/wif* s toa children* He does
not snefee &n&'admits to drinking ^.proxisaately one plat of whi Si:oy a week but state that he fe-ss mvd* been intoricatod in his life*
He drinks no coffee and says ha sloops approximately four hours a day? Welch is his ncrnol amount of sleep*
KB 001257
5 Seccater
Kr* Traci c* Francis re:
Fcgn T:-2*se
PET:
o t i o a x t c s m i n imi
& spooky* tsitsculer colored m l 1 m distress# The patient sees&ed
soaetdiat agitated and destila towards inquiries and did
ntroytinsgeestoteoliecoistpreeahesydtitimnets#t'ype of inforsiaticsn w were
Height- 5 feet 9 laches* weight 212 pounds* iefgper&iure 93* i$9 pulso
30 ad regala* blood pressare B&a 160/10^.
Skin negative# Ho lesions m n*
Syes? ;-'npils rouml# roast veil to light aml aeeoanodetloo* Fundi
2a?as
Horngrade two arteriosclerotic changes only#
oprassi'canals end jsec&ranes
negative*
2k*oat*
artificial
dentures* KolS&leas aeon* tongue and gums negativo#
Techr Thyroid not onlargod or nodular# io carotid bruits# dodos:
ione significantly palpable in mck.f gupracl&vicuiar
cjxiHary'or iugulasi areas*
Xborax norssl shape# lunge clear to permission crai susanitation
Hearts of soft, grade two epical systolic susnsur voids onde bsfoxo
i|1# 12 oM- F2 distinct* 2 of higher and harpey quality
than f2 \dthcsub splitting $ thrills or satra ecuaie being
noted# Til not rioted amTa-pirc bs&t not palpali!* Heart .
m t er&trged to percussion but in view of the patient* s
thick thorax this is n o t m*pprlslng#
'
Spinti to deforssity or tenderness*.
ikioi'-cni toft? oscular* ho palpale organs* saigaa or hernia*
O-eaitoXia normal# Beets!* toft brovn stool* Prostate mildly en
larged without ateornai masses* Fo tenderness#
Extremities* Porsene polis pulso is palpable e:nd strong bilaterally*
ho odema, varices or discoloration#
ilmxcologles fsmGM.im$ cranial nerves* sensory* itotor amt coro*
tot&Lar systems ell grossly intact* beoreaeed pero@pt.ioa
in left"ear by the Hina tost with equivocal decreased per
ceptive .loss by the to M r test#
Stibsenue&t studios m m obtained upon the patient's admission to
Tharp ..ospitai* X&g patient was very loathe to go .and stayed only
one day* 'Approximately on week, prior to going to the hospital,
a SOP ropovi w a s obtained m z m outpatient and X wss verbally told
by sx-* Tarry Hogg that tb# p&tiont appeared belligerent ami in*
tomicatcd to hi# .nevertheless* the patient was sdssitted*- Xhe
physical findings on admission were essentially the s-soe.as those
obtained in my office and a persistant hypertension of spprottia&etoly
160 to 179 over 110 was noted*
''
KE 0012577
5 Becanbar 1962 hr* f r o d c* Francis mi
.
L98C&X&f VA9 'S3 ineliiued th foil ovlags Xlm bsp ms 73* .-rc&ogy
"DHO vcrc&ly reactive t;1 dilution, xttgativ at 1 *2 dilution*
w
dolrer negative 1 12 dilution* d?F ntgatIv#* drills specific gra
vity 1*313, negative for nlbirain., sugar and negutivs acUsantJ
h o r v g l o M n '<m 11-23-62, 12*6 uith has.tocr.it 3? tad Imuntoftrlt
os 11-2^62 cf U-3* HBC f,i0 consisting of 61 sags, 5 beads, 3
sosia.opb.iles, 29 lymphocytes* srul 2 ronocytas* M & t a l a t ,r.crpbalcgy
oiorsrsl* aatict&ocyia cotmt 1*3$* Borpfcclogy of rod calls vad other
oX&msnts normal* I searched those slides c&refvilXy for evidence
of basophilic stippling and was imobie tc find any* ed rate 22
corrected to 1? hintrobe units*
Chest- "-ray shew,! acme tortuosity of th descon;Ung seria vhieh
mould ho consistent m t h left /rtrlcuinr hypertrophy litre mas
othert/ir# negative* 9CCI ahovml sinus hradyeardlc, first degree
heart block mid left venfcyieulay.hypertrophy* "
"
'.ursbsr punctnr&^s parfortsed on 11-23-62, the opening yrsaarro being |3--ems* of m t & r tori the closing presswe' dll o* of -water* tppro%:.aoioly 15 oc?:,; of faintly opalescent fluid ores oatdined* fhe cell count on this fluid y;oa;-n ted. of 67 red .ells ,ood 1 vh.ito call* .ht5 protein yog V .1 eg*;!, the VDhh nos-moot.tve a oho load content 10 hcg*:S* hhe'potinnt fait rollaved of his 'waiiacko
for several hours fter t*'-m LP m m performed* the blood lead level
of 11-12-62. vas 30 nog*;*, the normal vain doing no to 99 nog*h* *.. repos-1 aartra, l#ad Xovex of 11-2*1-62 vas 10 ncg*;l, n o m o l haing uo to 39 ncg*il* A 2?* hour specimen for quantitative lead shewed a' total vobjzm of 2700 1# vith a total 'anautiiy of 130 ucr* or 30 ncg/Xiter, the normal values being up to So scg/liter*`A caphalin flocculation tost mis negative at 2% hours*
t m ill recall that in vy loiter to you f July 16, 1962 I noted
that at that tigs hr* Macon's urinary load level was 50.2 ucg.
pr 100 isl* at of July 3 and that a repast load level obtained on
Inly 13 for hr* Heron vaa 39*3 neg./tOO ml* itsese tests vorc
apparently dona in a different fashion than tha tests obtained In
`kwessbar end hone t*$ normal values are 1 ifforont* It should, howvor, M noted, that in none of fchesn coses did hr* As son* 3 'blood
or urinary levels e s o M d the upper U n i t of n o m n l values*
dy final IIjPBBJSICHS arcs 1) hypertensive cardiovascular disoaso causing liaadachas and fclanitins*' 2) Chronic onposure to totra*
K 0 u( 7d
5 ircoalar
i-.-r* tiyh re ? __
r;gi v J
ethyl ii.-w -.:. ;.C-: .
h foel 1s i g n i i t e e n t in , a r a l a icia / g t h e
cationi `'O 1rsceat a r i. iiits
i `h P ? -tien t in t e r o c e l v t tha&rapy f o r l il a fcgfht r a n s a n r i d d i I i l i a it& a a t t o a r r in g o v io >,ho :i<*rcy^n&<j&Lnpo> C lin ic * I a l i t i o r a l c o p ie s o f t h i s l a t t a r u i l l h t _e s t t t o th e caia rooaX-e '/ho r o c s iv o d
copies of ay report of J 0 I7 la, 19 6 2 for ^fadr Oicraitic/r r;
Gantants*
a c e r e t i ' i l l y 'ciOn.-O, t c o ,
J.Oj ^J,`. , r, '/ - -, ... . , . ,,- , . - P
-iKrit
;cj o.hoi't .* .-; V--.iOli| '.- Iff -T-1ti-
Cellaring i0 bora tory
'?dver naiea -h intanati
1:...V'
iineimio.t
; " . 0, .,,
Collage
ex* .;..aie cecie
' a v v i a r li e h '.,0 0 0 0 0 o f.ion ,
IM S? -i to 'k.mm -h ui l i . y.go I , 1a l i f o r o i r
t r * f r c i i h r r i u l * i o d i c i JL o i r c c i o r
.i-tig/i Crrr-orati
d i v e r c i i : / of C i n c i n n a t i C o l i c o oh' , .o d ia li
C in c in n a t i i c s Clio
,. .
ho* John. i* Doaro^ a i a t r i e t C r i t t f a ggio e sr
t e l i f o r a l a . D i v i s i o n of i n d u s t r i a i i a f e t y
t ?*5 t **th a v e n a r
*
-m i h le g o 1 v a i i f or iiia
K H 0012579
August 26, 1963
Donald L. Schmidt, M.D. 233 A Street, Suite 911 San Diego 1, California
Dear Doctor Schmidt:
I have reviewed all of the information which you transmitted to me in
your letter of August 15th, concerning
a former employee
of the Wunderlich Company of San Diego, C a l i f o r n ^ ^ a n ^ i have also gone
through the other information available to me in relation to the difficulties
experienced by employees of this Company during the period under discussion.
In specific reply to your question concerning the significance of com
plaints registered by Mr.
in May of 1963, I am constrained to say
that I cannot associate thesecomplaints with any toxic effects of the
absorption of tetraethyllead which may have been sustained by this employee
in 1962. This opinion flows naturally out of a very considerable experience
with persons certainly intoxicated (and in many instances severely intoxicated)
by tetraethyllead. The characteristic course of this disease, as seen over
and over again, is that,primarily, of a self-limited and completely
reversible functional disturbance of the central nervous system. In mild
cases the symptomatology may disappear in a few days, or may persist for
several weeks. In more severe cases, there may be some persistent evidence
of intoxication for as long as eight to ten weeks. It is obvious that
apprehension and introspection are likely to follow upon a toxic episode,
and that certain individuals will have difficulty in shaking off their con
cern for minor and common deviations from well-being. It is a fact, however,
that no chronic form of this disease has been seen, and that no residual
disease5or sequelae have been found^even in association with the more severe
types of intoxication which barely permitted survival, it is simply
impossible, therefore, to give serious credence to any persistent relationship
between tetraethyllead intoxication, as complained of by
in 1962,
and the symptoms of which he complained of in May of 1963. There is only
one complaint among those cited as having existed in May of 1963 - namely,
insomnia - which has suggestive implications, and it is all too well
known that insomnia in varying degree is a not uncommon complaint of human
kind under a variety of conditions, not the least important of which is
hypertensive vascular disease. The other present complaints do not fit
into the pattern of tetraethyllead poisoning in any stage.
I shall not submit a bill for the opinion and service rendered in this manner. I and ray associates have written and advised on this subject previously, and I do not object to giving such advice on this occasion.
N13182.01
Donald L. Schmidt, M.D. - (2) - August 26, 1963
Moreover, I trust that I shall not be asked to give a deposition or otherwise to enter formally into the consideration of this case, although I should not refuse to do so under appropriate conditions.
Sincerely yours,
RAK:vr
Robert A. Kehoe, M.D.
D O N A L D L. S C H M I D T , M. D.
INTERNAL MEDICINE AND HEMATOLOGY 2 3 3 A STREET, SUITE 911 SAN DtEGD 1, CALIFORNIA
BELMONT 2 -6 1 8 1
August 15, 1963
KB
Robert A. Kehoe, M. D. Kettering Laboratory Department of Preventive Medicine and Industrial Health College of Medicine University of Cincinnati Cincinnati, Ohio
Dear Doctor Kehoe:
This is a letter to follow uo our telephone conversation of August
14, 1963.
Mr. formerly an employe of the Wunderlich Company of San Diego, California, was allegedly exposed to tetraethyl lead between the period of March 26 and October 26, 1962. At that time he was discharged for failure to report for work.
Symptoms which the patient claimed to have during the period of exposure included ringing in the ears, headaches, insomnia, vomiting without abdominal pain, constipation, night sweats, intermittent dizziness, swelling of the lower lip and dryness of the mouth.
Six months later, on May 16, 1963* after no further know e x p o s u r e to tetraethyl lead, M r c o n t i n u e d to complain of poor memory, left-sided nasal stuffiness^xeadaches, insomnia, night sweats and constipation, and numb feelings which migrated over his body.
A urinary lead determination of November 25, 1963* was $0 micrograms per liter, the normal range by the method used being 0 to SO micro grams per liter.
Mr. has severe hypertensive cardiovascular disease which anted a t e a M s employment by the Wunderlich Company.
I am interested to know whether you believe that the symptoms of which Mr. ^^ B ^ c o m p l a i n e d in May, 1963 are attributable to his exposure to lead between March and October, 1962.
Tour fee for your comments may be submitted to Arthur W. Jones, Attorney at Law, c/o Higgs, Fletcher and Mack, 2250 Third Avenue, San Diego 1, California.
Tour comment will be greatly appreciated in this case.
0012582
Very sincerely yours,
J u l y 24, 1962
John R. Kiser, M.D. 2290 Sixth Avenue San Diego 1, California
Dear Doctor Kiser;
I acknowledge with thanks your letter of July 9, to which I would have replied at once had it appeared to be necessary. Being pressed for time, I delayed writing until 1 had put some other matters behind me. A letter from Dr. Schmidt, of which you have a copy, came this morning, and I think it advantageous to make a few comments on the situation involved in this correspondence, while it is fresh in the mind of all concerned. Lest my words should appear to have a cricital aspect, let me say that this situation was dealt with in a very satisfactory manner.
My comments refer to certain characteristics of poisoning with tetraethyl lead which seem not to be reckoned with in an entirely clear manner. It is not strange that this is the case, considering the negligible opportunity (fortunately) that has been afforded to physicians to observe this form of lead intoxication. Nevertheless, it is of some importance that there be physicians who have some knowledge of peculiarities of tetraethyl lead poisoning, for certain diagnostic procedures should be followed out at the proper time.
Aside from the acute nervous manifestations of tetraethyl lead poisoning which are its outstanding characteristic, there is little or nothing (except, of course, the history of exposure, when fully elicited) to suggest intoxication by lead. The encephalopathy bears little resemblance, symptomatically, to that induced by the absorption of large quantities of inorganic lead, and is not to be thought of in the same category. There are, moreover, no cases of peripheral neuropathy on record. It is also true that no chronic form of tetraethyl lead poisoning exists, the symptoms, whether occurring in response to a brief, severe exposure, being essentially the same when induced by prolonged, mild but significant, exposure.
The most striking peculiarity, however, from both the physiological and the clinical viewpoints, lies in the fact that there is practically no hematological evidence, micro scopically or chemically, of the presence or effect of lead in the blood. The usual microscopic findings (increase in reticu&ocytes and "stippled" erythrocytes) in inorganic lead
0 U I d .)c J
N13182.03
John a. Kiser,
Page Two
J u l y 24, 1952
poisoning are completely 1 aching, and, in addition, there is no change in the porphyrin metabolism. There is also a slight to moderate, often negligible, increase in the lead content of the blood (the conversion of tetraethyl lead in the body to inorganic lead is slow and slight, while the intermediate degradation products of tetraethyl lead are not taken up by the erythrocytes as is lead in inorganic form)* On this account, the determination of the lead in the blood provides no indication of the extent of the absorption of tetraethyl lead, and is, therefore, of no use, by itself, in the diagnosis of tetraethyl lead poisoning. The rate of the excretion of lead in the urine, on the other hand, following the absorption of tetraethyl lead, is clearly indicative of the relative extent of the absorption, (This is not to say that the blood should not be examined, for, in fact, the low concentration of lead in the blood, in association with a very high level of concentration of lead in the urine, is a typical finding in tetraethyl lead intoxication).
You will recognise from these facts, that the only useful medical measures in the supervision of men who may bo subjected to exposure to tetraethyl lead, are (1) the observation of the men for the appearance of the first symptoms of intoxication, and (2) the analyses of the urine for lead (including the use of a method of preparation which insures the chemical conversion of any organic lead in the urine to inorganic). Obviously, the monitoring of the atmospheric lead is important, but the surveillance of the men is imperative unless the lead in the air is of negligible proportions.
1 believe this information will be of interest to you, and while I trust you will not encounter situations that require its use, it may be that you will do so.
Cordially yours.
RAK:VD
cc: Dr. Schmidt Dr. Doty
Robert A. Kehoe, M.D.
0 0 12 5 S4
J A M E S F. C H U R C H I L L , M. D. L . H. R E O E L 1 N G S , M. D. J O H N C . S C H L A P P l , M. D. D O N A L D G . L A N D A L E , M. D. JO H N R. K IS E R , M .D.
9 July 1962
22S O SIXTH AVENUE SAN D IE G O I, C A LIFO R N IA
R obert A. Kehoe, M. D. The K ettering L aboratory C ollege of M edicine - E den A venue C in c i n n a t i 19 O h io
D ear D octor K ehoe:
T hank you v e ry m uch fo r y o u r kind le tte r and fo r fo rw ard in g tw elve blood k its to m e. I have d elay ed an sw erin g you u n til our situ a tio n h e re becam e m o re c la rifie d and I could give you som e d e ta ile d in fo rm a tio n .
I c o n ta c te d you in itia lly a t the su g g estio n of D o cto r E a rl W. D oty, the S outhern C alifo rn ia M edical C o n su ltan t fo r the E thyl C o rp o ratio n . D octor D oty w as in San D iego at th e re q u e s t of the E th y l C o rp o ra tio n and le ft som e u rin e co n tain ers fo r u rine an aly sis fo r lead and suggested that we obtain also som e blood sam p le c o n ta in e rs in the ev en t they w ere n e c e s s a ry . D o cto r D oty, I p re s u m e , w as c a lle d to San D iego a t the re q u e s t of the W underlich C o n stru ctio n C om pany th ro u g h the E thyl C o rp o ratio n who w as co n su ltin g on th is p ro b le m . I b ecam e in te re s te d at the re q u e s t of the W underlich C om pany as a m e d ical co n su ltan t fo r th e ir com pany although I am a p riv a te p ra c titio n e r in the sp e c ia lty of In te rn a l M edicine in San D iego.
O ur p ro b le m w as th a t the W u n d erlich C om pany is b u ild in g a tu n n el to h o u se a la rg e u n d erg ro u n d se w e r lin e . In the c o u rse of th e ir m in in g the w o rkm en w ent th ro u g h a s tra ta of e a rth w hich ap p aren tly had co llected a high co n cen tratio n of gasoline containing te tra -e th y l le a d . R andom s a m p le s of t h i s tu n n e l a t m o s p h e r e w e r e s h o w n to c o n t a in 15 m i c r o g r a m s p e r c u b ic f o o t of te tra -e th y l le a d w here I u n d erstan d a to le ra n c e of 4 m ic ro g ra m s is allow ed. A p p ro x im ately th irty m en w ere exposed to th is co n cen tratio n o v er a p e rio d of m o re th an 50 h o u rs . T he job w as sh u t dow n p ro m p tly upon finding th is h a z a rd and a rra n g e m e n ts w ere m ad e to c le a r the tu n n el of the noxious v a p o rs.
In the ev en t any of the m en p re s e n te d w ith sy m p to m s of o rg an ic le a d p o iso n ing it w as n e c e s s a ry to have som e check of th e ir le a d e x c re tio n and blood co n cen tratio n . A rran g em en ts w ere m ade at the la rg e g e n e ra l h o sp ital lo c ally fo r u rin e le ad d e term in a tio n on the th irty exposed m en . It w as fe lt e sse n tia l th at som e m ethod of acc u rately checking our la b o ra to ry re s u lts w as n e c e ss a ry so th a t D o cto r D oty su g g e ste d th a t we su b m it u rin e sa m p le s to y o u r la b o ra to ry as w ell as blood sa m p le s. F o r th is re a so n the blood k its w ere re q u e ste d .
N13182.04
J A M E S F. C H U R C H I L L , M. D. L . H . R E D E L I N G S , M. D. J O H N C . S C H L A P P I, M. O. D O N A L D G. LAN DALE , M . D. JO H N R. K IS E R , M.O.
9 Ju ly 1962
2 2 9 0 SIXTH AVENUE S A N D IE G O I, C A L IF O R N IA
R obert A. K ehoe, M . D. The K ettering L ab o rato ry Page Two
F o rtu n ately , none of the m en exposed re v e a le d any ab n o rm al lev el of le a d in th e ir u rin e as te s te d by o u r lo c a l la b o ra to ry . O nly one individual had any subjective com plaints and c a re fu l ex am ination r e v ealed th e se not to be re la te d to his in d u stria l ex p o su re.
F o r the p re se n t, our p ro b lem has been re so lv e d . The tunnel is alm o st co m p leted and the m en a re avoiding ex p o su re by w orking w ith clo sed oxygen b reath in g ap p ara tu s w hich they w ill use u n til com p letio n of this se c tio n of the tu n n el. I w ould lik e to re ta in the blood k its fo r the n ex t s e v e ra l w eeks u n til any p o s sib ility of la te sy m p to m ato lo g y h as p a s s e d and the stu d ie s at o u r lo c a l la b o ra to ry have p ro v en a c c u ra te and a d e quate .
Thank you v ery m u ch again fo r your kind co o p eratio n and in te re s t in our problem .
Y ours sin cerely ,
ohn R. K iser, M. D.
JR K :jbl cc to D octor D onald S chm idt
K E 0125S
July 2, 1962
John R. Kiser, M.D. 2290, 6th Avenue San Diego California 1
Dear Doctor Kiser:
Your telegram came too late on Saturday to enable us to respond to your request for containers for the collection of samples of blood for analysis for lead. The containers are now on their way and you should receive them shortly after, if not before, you receive this letter.
I write to let you know that we do not, as a rule, accept samples of anything for analysis without knowing exactly what we are doing and why we are doing it. This is in no sense a service laboratory; we have certain specialized facilities for research, and since we are concerned with medical problems, including diagnostic procedures, we make ourselves and our facilities available to our colleagues in medicine under suitable conditions. However, since our funds are earmarked for research, we undertake to be reimbursed for what it costs us to do these things, so long as the charge is not burdensome to the patient. In the latter instance, on the word of the physician, no charge is made.
The service, however, is not an analytical, but rather a medical (consultation) service. Accordingly we expect to be advised of the situation which calls for diagnostic services (or those of industrial hygiene) so as to suit the service to the needs and to interpret the findings in that relationship. We do not analyse any material until we have the information which justifies such analysis (or analyses).
Since I do not know your problem, I should like for you to let me know by return mall just what we are to be concerned with In conducting these analyses. If you are dealing with persons who are being subjected to exposure to lead in their occupation or otherwise, let me know the nature of the work, the nature and severity of the presumed exposure, the duration of employment in such exposure, and the last day (or time) of exposure prior to the collection of the samples. If the patients are ill let me have the account of their illness.
N13182.05
Cordially yours,
KE 00123
l 3 M y 19 & 2
M ttad o rlle h Company i4 y stat s tre e t San Diego 1
California
G en tlem en *
Ib is i s to re p o rt t o yea th e re s u lts o f my in v e s tig a tio n o f th e exposure o f your sen to dangerous le v e ls o f le tr& e th y l le a d
between th e p e rio d o f Jim s 28 arid J u ly 16* 1962# Aw n e a rly as
I can e v a lu a te , th a t# is now no danger o f overexposure to e ith e r ie tr s e th y l 1 m o r g as o lin e fim os in the c e n tra l area tu n n el o f th e M e tro p o lita n sower System# X s h a ll, however* co n tin ue to
m a in ta in lia is o n , both w ith your company and tote o f C a lifo r n ia D iv is io n o f In d u s tria l Safety#
HISTCHX OF m m m i w a a On June 23* 1962* a maximum air
re ad in g o f $ m leregrgas p or cu b ie fo o t o f a i r was noted w ith in
th e s h if t o f th e sower tem asi by Mr# M Hotsoa. o f th e E th y l Corporation# i a c o n ce n tratio n o f le a d is s u ffic ie n tly h ig h
th a t th e E th y l people do n o t a llo w workers to work a t storage
tanks f o r lo n g e r th an two hoars w ith t h is c o n c e n tra tio n o f load#
A ll work was h a lte d and a m eeting o f m y s e lf, C h arles Cooks, and
Oscar C h a ff f o r th e und#rX10h Ccmpenyf C a rl Johnson, John D upre,
H obart H u rray,. * S * S e id , J* Moore,, *#J.#-. W harf? o f th e D iv is io n o f In d u s t r ia l .S afety M w aM 'M ats o n o f th e E th y l C or
p o ra tio n 'and *- 'Hod&i&e and H* Cote o f la b o re rs lo c a l So# 89
was h o ld a t th e In d u s t r ia l S a fe ty D iv is io n O ffic e s a t 1921 4 th
A v e nu e i San Slogo on M'onday, J u ly 2' 1'96""2* A t th i's m eeting I t
was d e te rm in i: W m t a l l w orkers who had been w orking in th e tu n n e l
would proceed .to Sharp Hospital for urinary coproperphyrins end
cuantitativo ' urinary loads teiere consideration for return to
w o r k w o u l d hfe- given*.
l a t e r th a t d a y , o f f i c ia ls o f H it- W underlich C o rp o ratio n and tho
In d u s tr ia l S a fe ty C o m issio n 'v is ita d the. scene o f th e co n s tru c tio n and I t was decided b y .th e M u n d o rlich C o lo r a tio n , th a t th e y would wear oxygen masks and tanks, tea th e c o n s tru c tio n u n t i l such tim e m th e maximum c o n ce n tratio n s o f le a d in th e a i r would p e rm it them to re tu rn to b re a th s th e a i r b ein g p ip ed in to th e tu n n e l #'
I t should "bo noted th a t In . th e weak, p r io r to d is c o v e ry o f th is c o n c e n tra tio n o f le a d in th e a i r , three, men had com plained o f fe e lin g g id dy from g a s o lin e fames and had v is it e d lo c a l physicians#
R% 08583
N 1 3 1 8 2 .0 6
iSJUlylS Wunderlich Company Pag two
loa# o f those a m com plained of insom nia, a p re h e n s i n a n x ie ty ,
n ig h tm ares, headache o r d i f f i c u l t y w ith v is io n which a re th e
u su al s a n lfs ta tio n s o f in h a la tio n o f lo a d fames- which u s u a lly
cams encephalopathy befos?# o th e r ts&mifstations a re noted,
D i a i l a r i l y , th e re was no history to suggest g a s tr o in t e s t in a l
cramping o r d ia rrh e a hemolysis o r p e rip h e ra l neuropathy.
.
Work m s r e s o l d with respirator equipment on July % 19-62. On July 9 1 m s phoned by Bob Murray of th Industrial safety
Division, mho reportedaverag readings of 6 nleayograas per cubic foot with m a x i m readings of 8 micrograms per cubic foot in the tunnel, la accordance with Bthyl Corporation reflations X advised hr. Murray that, th# sen could not work without their respirator equipment for more than four hours in any one shift# By July 13, 1962 the readings throughout the entire tunnel m m legs then b mierogrsms per cubic foot except for n reading of o micrograms in om small pocket in which the mon wore not working* At that timo I advised Hr* Murray that the mea could
cease using respirator ^ipmaat but that subsequent readings
would have to be mad# to determine whether they could continue
to function without it, foae of the sea havo to my knowledge .
had any symptoms suggestive of either load cr hydrocarbon intoxi cation since work hes been resumed*
th three sen who consulted a Or* 8* M, Breuer of 502 8th Direct
Basons, California* prior to work being stopped on June 23, vere
. RHS* X phoned
"Sreucr and determined that Mr* liatt*s only-complaint was mild
vertigo- end that: Sr. Brener in examining him felt that there was
no need for laboratory studies# hr* McF&dd#n complained of
nausea, weakness, -chest pain, vertigo, and a feeling of intoxica
tion* A chest x-ray and complete blood count m m obtained by
Dr*. Brener and reported to--me m being normal two copier, of my
history and physiesl -of 7*6*6f. on Mr# H a r e enclosed, B#
seemed to b most symptomatic of the three, Muffle# It to say that
his ccmplaiats when he consulted Br, .reuer did not suggest lead
neefhalepatfcy' although thoy did suggest certain amount of
gasoline intoxication, A chest x-ray obtained on 7-3-62 at the
raiomar Hospital showed m evidence of active disease#- the
patient1# hemoglobin was slightly decreased for a m m of his ago,
1 2 * 6 gms* with a hematocrit of 3d and the white carat was at th
borderline -of upper n o m a i at 10000 with a differential of 60
sags*, b band# 2 eosinophil# 29 lymphocytes, 5 monocytes, l!o
stippling_ wag observed and the red cell morphology was essentially
normal, ikes findings do not suggest ad intoxication but. they
do not rule it oat# then l saw Mr,
" he was sssentially
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TELEGRAM
W . P. MARSHALL. Pr es id e n t
S F - W 1 (4-60)
DL=*Day Letter
NLs=Night Letter
LT:
.Intern " Letter
ational Telegram
.
T he filing time shown in the dare line on domestic telegrams is LOCAL TIME at point o f origin. Time of receipt is LOCAL TIME at point o f destination
I 2 3 7A EST JUN 50 62 CTB024 OB588
j
0 SDC330 NL PD SAN DIEGO CALIF 29
i ...... - -
DRCOBERT A KE0H0E
-
KETTERING. LABS COLLEGE OF MEDICINE EDEN & BETHESDA AVE C|N --
SHIP 12 LEAD FREE BLOOD SAMPLE CONTAINERS WITH COLLECTION INSTRUCTIONS
FOR LEAD ANALYSIS
,
JOHN R KISER MD 22?0 6TH AVE SA DIEGO CALIF 1
!.
//
s r> N ` t i f:
18 July 1962 'under!ich Company
Pag Pour
19*5
19.5
19*5 16.2
t^f.6 1*f#6 13.0 13*0
13 .0
13*0
13 .0
1j.xi
a.1
3.1
u .i
8 .1
* t
8-.8
0 .0
On. July 13 j?xid^tlo^aXrgMiiiga w e y taken on the three highest
values. nasmty
J H H B p H P 'It shcuXa. be meniicnad
that t6 normal range by this quantitative method is 0 to 60
nicrogmsu) per 100 milliliters Camples vora collected a the
noon lunch hour for e&eh of these three sea on a Friday so that
they had had a chance to aceuraselat lead thx*cutout the voe'lc sad
for at least four hours at uorh# :ihy had boon breathing air
"v-rithout the aid of a respirator for at least four hours the day
ofjfifce dotermlnation, She readings for these non w s as fo&lovai
7*, 26.5s
1^.9*
On the basis of these last determinations 1 feel the uorhors
i*r in all probability out of danger to- lead exposure* but as I have stated previously t-?s vtiXL eontimte to follow them sad to obtain lead air samples periodically# fhanic you for referring
this Interesting problem, to so# A copy of my history -aad physical
examination on M r M | is being sent to me. In addition to myself
three copies of this report are being sent to youj one to Hr* John a* Dtmra of the State Industrie! Safety Division? one copy
to Ao-bert A. Ks.hoe9 M.D* of the Kettering laboratory of the '
University of Cincinnati College of Medicine| and an additional copy to Or. `F ra n k Princl of the Kettering laboratory, the Ksales! Director of the Ethyl Corporation*
KE 001 ?-50 2
10 Juiy 1962
Uuaderlioh Ges&pany Page five! v i
X wish to else arpress ay deep gratitude to Dr Cohn H* Uiger ci this city who was instrtsaeatal in clarifying the situation obtaining tsueh of the background iaforaatlon offering &aay valuable suggestions* and referring this problos to ae,
fours very truly,
,A^7p V-icf V
~~
--/OTIoH :.i* C131TiJ-.it,
viti {iT
OC* Robert A* Kehoc* IUP* Kettering Laboratory University of Cincinnati College of Uediaine Cincinnati 19, O M o
Dr* Frank frinei, Uedical Director ethyl Corporation University of Cincinnati College of Uadicine
Cincinnati 19 ? Ohio
Ur. John. u. Dupra, District safety Knglnaer California Division of Industrial safety 1??51 lfth street can Diego 1, California
John H* Kiser* M.I).
2290 Sth Arenne* suite 10 3 San Diago 1 1 California