Document 3eORX3oJv1bgY6zpox2owwJdO

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE BETHESDA i4, MD. NATIONAL INSTITUTES OF HEALTH Tel: 656-4000 April 6, 1964 In reply refer to: AP 00371-01 Dr. Robert Kehoe Kettering Laboratory for Applied.Physiology University of Cincinnati Cincinnati, Ohio Dear Dr. Kehoe: The enclosed research grant application has been assigned to the Human Ecology Study Section for scientific review. The evaluation of this proposal will be baaed primarily upon the following considerations: 1. 2. 3. 4. /" The apparent scientific merit of the project, particularly in relation to other current research; The adequacy of the methods and materials proposed; The qualifications, of the applicants; .The adequacy of the facilities and the research envi ronment. ) We should like to have your comments on the above points and on any other aspects of the proposal that you consider pertinent. We would appreciate having your comments typed on the enclosed form and returned to us in order to be duplicated and distributed prior to our Study Section meeting. Since the application, like your reply, is confidential, it should be returned with your comments in the enclosed prepaid and addressed envelope.* Please accept my thanks, and those of the Study Section, for your assistance with this review. Sincerely yours Evelyn H. Halpin, Ph.D. Executive Secretary Human Ecology Study Section Division of Research Grants Enclosures *A reply by April 20 would be appreciated.so that we may forward your comments for the information of Study Section members. AP 00371-01 OCTSIZm OPIXIOR from Or. Robert A. Kehae University of Cincinnati "Relation Between Air Pollution and Lead Poisoning" 1. aCUOttlTIC MKItlTi Tbs primary design of the experimental prograa presantad herein is baaed upon a fallacy, stoich the work of the authors should hare recognized through their osn observations as recorded in their attached report. It has been established clearly in several urban canters in the U.S.A. that lead poisoning aaong children results, la the overehelniag proportion of cases froe.the ingestion of lead eoepouada, principally those represented in paint obtained^by exploring children, from disintegrating surfacea within neglected hones. (There ere exceptions, of course.) That cases of poisoning aay occur through the inhalation of laad compounds in the ataoaphere of the household, has been found in a nuaber of cities, including Chicago (aa referred to in this application) fron the use of battery boxes, as fuel. Present evidence indicates that the lead content of the as&ieat atmosphere of apparently characteristic Aaerican cities is incapable of causing lead poisoning in children or adults. If Chicago le aa exception to this, even in United (industrial) areas, it would bo a surprising fact which would bo worthy of detailed investigation (this sight be the case, despite the avail able data), were it not for the apparent fact, suggested by the data sub edited by the authors of this proposal, that the concentration of laad la investigated areas of Chicago is of the order of that of cities that have been investigated systematically. Noreoevwr, the further evidence subnit ted, aa to the levels of the concentration of load in the urine and, sore leportantly, the blood of children in the suspected areas of Chicago, Indicates clearly, in so far as the results can be regarded, as valid, that these children have not absorbed abnormal quantities of lead fron any source. (Incidentally the equivalent of the documentary evidence submitted with this application has been denied publication because the discussion within it is flatly contradicted by the data submitted.) Ibis bears on part 09 of this "Outside Opinion" but is pertinent here. The etiology of lead poisoning aaong children, generally, in American cities is known. Certain features of its epideeiology should. Indeed, bp investigated, specifically (a) the basic factor (or factors) that are responsible for its seasonal character, and (b) the significance of tine (the duration of exposure, whether prolonged or brief) and dosage, taken together, on the frequency of occurrence of encephalopathy (which is the lethal fore of the disease as seen with unusual frequency in children). These natters require investigation of the hoes environment of children, and intensive study of potential, incipient and eevere eases. The ambient air is, very largely if not wholly, irrelevant to the basic problem of lead poisoning in young children up to the age of 3.3 to 0 years of age. The N22313.01 Page a OUTSXn OPINION AP 00371-01 principal investigator should know this, and slnca ha doas not, ha has not familiarised hlaself or digested the information on this subject which is now available. One has reason to be interested in the lead content of the ataospfaere of Chicago (the statenents (or implications) concerning the blast-furnaoea of the stall manufacturing company referred to in the report attached to this application were examined by others and found to be ill-founded, but it may well be that there are some problems of this type in the industrial areas of Chicago). However, this has little or nothing to do with the immediately important problem of public health Involved in the unduly high incidence of childhood plumbism. (has this account, if no other (and there is another), this proposal is eade up of teo irrelevant parts, and it should net be prosecuted on the remote hypothesis that the teo might be found to be causally related. They should st least be dissociated, and prosecuted separately. As indicated previously, the primary environmental factor in lead poisoning in children should be the site of investigation. *. AOPjCACT ON mWOOB AND MATX&1ALB: the prior discussion touches upon the adequacy of the methods, materials and scientific personnel, it may be that the specific methods'of sampling sad investigating the atmospheric environment and the children in the environment, for the purposes described, are intrinsically satisfactory, so far as they go. The procedures with respect to the determination of the lead content of the air may be satisfactory. Likewise the methods of analysis of the blood sad urine of the children for lend (which is the moat Meeting of the procedures recoamended for employment) may be adequate. The data thus far obtained is both of these matters are comparable to those obtained elsewhere, and this fact suggests that they are reasonably satis factory. One has sons difficulty in viewing these data without bias, however, in view of the failure of the investigators to realise their meaning. In the fact of specific analytical data that demonstrate the lack of anything unusual in either the environment or the children (as s group), the principal investigator, an the heels of utterly non-specific evidence (coprophyrinurle), decides that an appreciable proportion of the children absorbed abnormal quantities of lead. Thus the methods in themselves seem to be aneweh at irrelevant. This is not s technician's quest, but one requiring scientific critique. 3. qpAuriCATicws or tat a p p l ic a n t s : This is a regrettable situation. The principal investigator is s sensitive end sincere man with instincts of a rea ponsibis physician (or so be seems, on personal acquaintance, to be). Hs seems utterly incapable of scientific objectivity, in the presence of the sad facts shout lead poison ing among children, so that he ignores the evldenoe of his own data, sad embarks on an experimental program in the spirit of s crusader, which has no likelihood of establishing any facts that are relevant to the experimental hypothesis. Although it is likely that useful information can be and will be so obtained, this, in the view of this consultant, is an unduly costly asana of obtaining facts which will have to be sifted out of ambiguous relationships. A fully competent co-investigator, could,if permitted, l/cr es n n n *~~r- Pag* 3 ODTSIEB OPINION AP 00371-01 direct this investigation Into highly productive channel*. In its present fore and with it* present guidance, it can hardly fall to confuse the issues under investigation. RAK:vr Date: April 13, 1964 Robert A. Kehoe, M.D. f Ifc&H 009P6