Document 446vb53pBwKLEKxKvD0JmvknR

C\ 0 u LEAD POISONING W R I N G CONSTRUCTION" OF THE GOLDEN GATS BRIDGE, 1954-1957 C( - l S' - t , Y' ^ . tv o s ^ c-- Lck. . UUa,<A L\ ^ c, u V' "V U L ^ i.ks C i- i U c o - j L l - "t Uecvrt 'U-^ G 01739 N25015 I INTRODUCTION : THE HOST, mHE ENVIRONMENT AND THE AGENT Tha subject "Plumbism among Golden Gate Bridge Workers" mbs chosen for the tern paper for Epidemiology e3 the writer has done some research on this particular epidemic in connection with his employment. In addition, the information, though incomplete, comes from the unpublished files of tha Californio Division of Industrial Safety and may have special interest and record value to the Kettering which has concerned itself extensively with this disease. In industry Ised is encountered ea metallic lead as well as various comPCu4ndc, principally oxides, carbonate^, sulphates, chrcmatcS(, sulphide^ and disilics'tate^. The hazard is not the same for all compounds, but var ie3 from almost nothing in the case oi* the disilicateja and sulphide^ to considerable in the case of the oxides. The t w e e evenues of entrance^into the body in order of importance are the respiratory trsct^tHnouth,/ and akin whan 1 is bTuKbsn. In this epiJemic the incidence was due to inhalation of the oxides, pbo (litharge) nb Pb^04 (Red Lead). One hundred and thirty cases were documented sa lead poisoning and symptoms'' sro 30 similar in almost all the cases that they can be typified by the following two cases diagnosed by L.H. Cotter in another epidemic when sn elevated railway in New York City was cut down. Cotter states (1) that incidence of inhaled lead poisoning ran as high as 30 percent when respir ators were not used. , Case 1. "G. M. A 44 year-old American born iron worker engaged in burning painted steel for four months, pain and constipation whole period. Became nauseated by smell of paint. Unable to sleep lest two weeks, Showed lead lino"and abdominal rigidity, urine 1 mg/liter, blood .2 mg/ IOC cc, basophilic stiopiing 0.9^ reticulocytes J,2%t blood count: TTGB l4 gm., R 30 4,000,000, W3C 000, neuts 60rf>, lumphs Jl%, monos Vfot eoa 5%, baaos 5^ ' - Case 2. "A.B. A 40 year-old French Canadian. Burned painted steel two months wearing cannister reopirator. increasing constipation, loss of weight, abdominal cramps, nausea. Showed lead line and tenderness and rigidity of epigastrium. Urine 01 mg/liter, blood 0.6 mg/100 c.c., basophilic stippling 1%, reticulocytes 7*5^ blood count: HG3 io gm., RBC 5,000,000, WBC 4,000, neut3 lymphs 26%, monos 6%aos 2f, basoo 1^." ^ The beginning of the epidemic, which extended over four years, wes in January 1954, when 5 employees of the subcontractor erecting the Marin bridge tower complained of leed poisoning symptoms. The peak wea reached in * A characteristic dark line on the patients' gums. 2 February of that year when 55 cases were reported and it tapered off through December 1957* See charts 1 cr.d 2. It appears tho epidemic ended because the job3 ended, rather than due to effective corrective action, in fact figures stated in this study are likely to be minimal because of the apparent reluctance of the contractor, the contractor's doctor and state authorities to sscribo the illnesses to lead. This reluctance i3 understandable from several view points. 1. Moat of those Mfected were engaged in riveting hot rivets into bridge morabWs painted with red load. This work is usually done in the open air, often in a stiff breeze. * 2. The wearing of forced-air respirators, the only really effective preverft^tive meesure, would bo difficult to enforce - because men working several hundred feet above the water and in precarious positions would probably be uncooperetive. 5. Air supply lines would be lengbthy, costly and cumbersomo. In only 17 of the cases is enough information provided in the form of accident reports and correspondence to determine tha subcl ini cal pro cess, or what might be termed the. incubation period. This information is shown graphically on Table I. The moan length of time for tho cub- cLiiiica! process was 57 days. In calculating tho moan, tha individual who reported sick after J02 days on the job, was omit tod. There is no discoverable reason in the file why this person (a riveter) should have had so much longer an incubation period, and so because of statistical variance he is considered a spefrt. The means for individual trades is as follows; bYg^evA.Svv- 47, Rivotors - 5l, Painters - 6l. Estimated * variants between these groups are as fellows* /grid reman (5) Riveters (J) painters (4) s; <>>>v n- S83 ' ' Estimated standard deviations ere* & Estimated standard deviation.- of the means i v : b'x "- V%ft. Estimated 95^ confidence levels (x>*-(l.96jf$)&roi 34 b -s 4-.1 From the above calculations one would conclude the b r t r l . : are'unrelated. However, other imponderable factors might, tend to invalidate *Red load paint is used as it has the property of expanding and contract ing with the steel during temperature changes, and it would appear reason able that the fumes would be blown away before boing inhaled. -y p.l'x-T.O ye g 01741 5 these statistics. 3ome men had been wording with lead paint for years end others just a short time; cannister gas Task3 were supplied, rnd though t'-'ey were ineffective, they would tend to prolong the incubation period. Only in one case does the file show that p man habitually wore ' hie respirator (see Chart 1). Some non were repeaters. This is noted only once in the sample (see chart 1) Nor i3 it ascertainable what men and to what extent worked inside or outside of the towers. To the industrial hygienist, probably the moat interesting sspect of this epidemic would be the attempted control methods, end this constitutes a history in itself. 'ahe first entry in the file concerning control i3 in vay of 195^ by a consultant, M.K., Bio-physicist -whose letter head shows him to be Technical Director of an organisation callod the "Institute of physio-Therapy." He seemed to feel discipline would solve the problem, and as a matter of Interest his letter to the California Industrial .Accident Commission is quoted in full. "Des z Mr H. Considering the existing avoidable deleterious health hazards faced by -workers called upon to paint the small cubicles -with in the sausslito Tower of tho Golden Gate Bridge, the follow ing is recommended to :fce rigidly enforced by you, as the Safety Engineer on the premises, for the benefit of all con cerned: ?-:?.3n::-`L hygit::e : Every worker on this job is selected for his present physical fitness cud his readiness to co-operate with the constituted authorities and his superiors on this job to keep him so fit. This, in return, will safeguard his health, strength end endurance. This i3 done not only because it increases his capacity to do his work right, but to enable him to stay on. the job uninterrupted and satisfactorily without incurring" preventahle._disabilities too costly for ell concerned. JOB: Three shifto at two hours each with forty minutes of rest in the open air between each shift constitutes a day's work of eight hours on this special paint job. ' SPECI/.L PLEDGE: In order to keep the men in best physical fitness, the work ers selected for this special job pledge themselves to nppaerr for work.in a strictly sober condition and with clean and wellaired garments upon their bodies, and that the overalls, shoes, gloves ana cap which they put on before sterting to work have been well aired during the preceding night and are free from 4 the noxious odor of turper i y - j r JT-- - u* 1. --. . *. m ^ U <. U. Y effects for their physical we .1-boing. The workers selected for this 3pecil job pled; ~v s~ .emsolves upon their honor, eft or working hours, to r mt up to v:err light, loose <.nc porou s clothes c.no to orevent oat ur co-or.lied ''colds." fur to ;oo:1 recreation Jtrv b1c, or at 1en , in s room .0ow. They wil m c strain and cr-^ating and m e SSO. Th ?o o q 3, also fruit in season and sne nastiest well. p out of doors, on mus cula r c"ces'.'aS3 li ving. ^ oy ll hil e on this job, d, so :c bu 1xy one hey ill eat slow ly V >fula rly and frequently, and they will be cautious not to oC."i.LOW pO13013 and infections to enter their body. "They v.'ill keep their teeth, gums and tongue clean. U-c sufficient water internally and externally. In short, they will work, plry, rest and sleep in moderation. VJhile nwuy from wor; they v: ;iou3-- ly do everything that will keep themselves in a "fighting trim" for the next day's labor and they v;ill report to the Medical, Director on the job at once for whatever symptoms nay arise ne cay's work. Asove wo rry , they .oust be cheer ) end not The poisoning from turpentine can become a serious a;tier for then, but no one on this job needs to become sick from the fuses of this material. Their health c m be easily pre served but their co-operation in vo doing is essential. Only through consistent, constant vigilance anc v.-kolosomo activity can this be attained end maintained with sofety." , r''h next entry is by the same consultant under the title of "Turpentine poisoning." -3 he describes the symptoms of such poisoning, they seem to conform remarkably to the symptoms of lead poisoning. The.third end last contribution by this doctor is en eleven page discourse on lead poisoning. This is followed by rn informative and valuable pamph let issued by the National Safety Council. (2) Had the practices recommended in this pamphlet been enforced, especially the use of positive pressure gs3 masks, the epidemic would heve been ended. Another pamphlet, this one by the U.3. Navy Deportment follows, which strongly recommends positive pressure gas masks, in particular the Willson mask sold by the Bullard Co. in San Francisco. Careful perusal of the file indicates to the reader that recommendations, good and bad, from the informed end from the ignorant, were treated in the same way. They were not discredited, and thoy were not acted on. And one keops turning the pages ond seeing casualty after casualty. Too n e x t entry is titled, "Rules for the E 1in ir.ation Poiscnin, " by someone icentifi ':*-j--^ j. . , ^ T**^ ^ ;ma: En gin e e r end Su pe r! p a r t , w i th c c\.ir>1>-sCT endcr.t of Safety oo: Tj:,ty and no suot t c n t t i o n o f missive t tn ratiatics, "t h e c o n t r o l . o f 1 ea :oisor.ing (from the oxyacetylone flame cutting of s t e e l c o a t e d v;'i itthh Ilead psint) no an occupational disease ia principally of hygiene.... " "Theoretically, by far the greatest percen- o : aau poisoning case3 result from the introduction of lead solids O- 3 0 i into the stoaach, a very small percentage by absorption through one iu _ , and a. still smaller percentage by aboorbtion through the <i--*i n`O.- The average of the various authorities on the subject place the V lues of these percentages at 3p percent, 10 percent, and p percent." "There is no reason for sen getting lead poisoning who take care of themselves and use the facilities provided for them by the company, as has been demonstrated by the experience of other industries, that (sic) these measures are successful." Me then goes on to list various musts ileanlineos, smoking, oropor clothe jloves, rinsing the mouth, drinking of citro carbonate instead of water, drinking of milk, keeping the stomach full, avoiding constipation end taking of calcium sulfate pills. He ende with the steteaent, "Any employee not observing these rules should be subject to immediate dismissal." in justice to S.G.S. his recommendations have some merit, and one concome gas masks. How ever ho recommends the cannister type which has little value for lead fumes in the two micron magnitude. The value of the positive pressure mack is that it maintains a pressure between the face) and the mask greater than ambient pressure, and so prevents any outside fumes or gases froa entering the ltfngs. Atl-this,point in the file there is a 15 page reprint of a report by a Dr. kcCord >aado at the 1929 seating of the American public Health Association. (5) This report adequately and comprehensively details oreven?s>tive aeesures and outlines an effective' safety program. ' i " Without laboring the point further or introducing other legitimate sdvice contained in the fils, it is evident that information necessary to prevent this epidemic was in the hands of those responsible for pre venting it and in retrospect is if difficult to understand why it was not used. .. . On February 15 195^ the California Department of Industrial Relations sent a telegram to the'{J. S. public Health Service in Washington D.C. requesting aid in an emergency study of lead hazards, in thSureturn " telegram, the Surgeon General offered to send a man on condition that the state pay his trevel expenses. The State wired back that the offer was appreciated but "we are unable to secure funds for traveling ex pense a." And 30 the ugly head of buresuocracy was raiaod and the svate continued processing compensation claims for load poisoning. On this same date the Golden Gate Bridge Advisory Committee requested the Industrial Accident Commission to take legal step3 to see that the tower for the San Francisco end which was being fabricated et pottetown ?s., be shipped and erected free from all lead paint on splices on parte 01744 6 oo whore field ri/eting would be ne nsery. On ;/2reh l, 19 two more cases we re report:ed. In or..3 onaa there wore 24, 000 3tZ.Tjpied colls in one c.c of blood., A 'Show caus e* wa e issued by the at at o t0 the Golden Or te 3r idgo and Highway DiSt riot %nu .o the ras ponsialo subeoni rs ctor for 3eth lohem Stoel, tfxe Men>j*+ inti o '/.arehall Qo'-zpen,y. ? r.'-j ordor requir od tho30 employers to ahow COuse why wo rk nhould no x be et opped unti 1 the 'ns zard was removed *o S&-, often the CO(jo fol lowing chow causes , the ho zsrd coni;inued e:nd resohed another pea* ( 2 8 C2 3 3 3 f in May of that y r. /.bout this tine (March 5th) it vies decided tG clean the offending holes with wire brushes. Rvery wire brush in Sen Francisco was purchased and an order was wired Eaat for about 400 Tore. This effort net with doubt ful success as the brucher were t^en exposed to red lead dust, and not all the paint could be brushed out. On March 28, a news pa.por article reported that the business manager of the iron workers union cade charges that the contractor was ineffec tive in eliminating the hazard. The following month Trades exposed to lead fumes were limited to a 45 minuto working hour ond given an hour long lunch period, in addition "he contractor was ordered by the industrial Accident Commission to mechanically ream all rivet holes containing lead. Jt is probable that the latter order was imperfectly enforced, but this coincided approxima tely with the completion of the North (Marin) tower, end the epidemic temoorarily subsided. ` It was stated earlier in this report that responsible parties wore reluctant to blama lead for the repetitious sickness among bridge 'work ers. Th ie will now be substantiated. 1. A previous attempt* to exonraterleadiaa -th- culprit was made on a Decomber pi > 1955' when'the!Genera 1 {.{onager of -the--Golden Gate Bridge nd Highway District sent tho following letter to the Industrial Accient Commission. Subject Acetylene Gas poisoning. "Symptoms which were first suspected of being lead poi3on- . ing have been noted in the case of R.D.M.... and G.I.H... who were both kept under observation several days. Lead poisoning wes not indicated. Investigation showed however, that it was probable that these two mon, who are employed by the McClintic Marshall Corporation on tho Marin Tower erection, were exposed to the fumos from the acetylene lights which were being used inside the column sections in confined spaces. As a result the contractors took immediate stops to supply eloctric lamps, in lieu of t^e acetilne types. It`was thought at first that lead poisoning might be resul ting from driving these heavy rivota into materials previously red leaded in the priming coating.I I thought this might be very interesting to you for your files on the above eubjoct. Very truly yours, . l/ 7 Hamilton ana Hardy hsva this to say about that. (A) "Vhon an acetyisno welder suffers an attack of 'gassing1 ths cause must be sought either in the metal he is welding or in eoce accidental impurity in the gas.... if he is helping to scrap battleships by cutting through ateol sheets which are painted with red lead, he will be likely to have lead poisoning." 2. parts of several paragraphs of a letter dated January p, 19>'4 from the supervising construction engineer of the Industrial Accident Commission to the General Manager of the bridge are quoted below: "....in regard to the case of G.I.K., Dr. Barrett tells me that his case has been diagnosed as ulcers of the stomach, end no sighs of lead poisoning were indicated. The case is not compensable."........."one other case has been reported as lead poisoning, namely but this too has proved-to be a case of stomach trouble and not lead poison!ng."...... 'Dr. Barrett informs me that it is almost impossible for a man to take enough lead into the elementary (sic) canal through fumo3 to cause lead poisoning." p. rnhe voice of ethics was heard crying in the wilderness on April 2, 19p4 in the form of a "physicians Report of Injury." This is a standard form submitted by law when an injury is reported. Under item o, "state briefly how injury was sustained" is the following* "Inhaling lead fumo3 whilst riveting. Ficked up from the street unconscious and taken to house, ''hen I saw him at 9 p.m., he was unconscious, cyar.otic, groan ing, doubled up in extremis, feeble pulse." Under "Remarks" or; .this form is stated, "After giving patient digalen pnd adrenalin hypo dermioally, I took patient to Ross Hospital where he was placed in a tub of hot water and stomach washed while in tub( Gastric lavage was clear. Awakened ih tub and complained of pain in abdomen and weakness." Signed. Dr. 0. ?. Lsrsor, Sausalito, California. Dr. Larson then sent the foilov/uo letter reoroduced below: "April 2, 195^ To the Medical Director* Industrial Accident Commission San Francisco, California . Dear.Doctor: , Herewith you will find roport3 cn two patients who consulted me privately for illness which proved to be industrial. The delay in sending the reports is due to the fact that the men wore referred to Dr. 3arrett, Chief Surgeon for McClintic Marsha 11. *Unfort'jnately this agency had no medical director. Safety order: enforcomont has now succeeded to the Division of Industrial Safety, which also has no medical director oh doctor. The letter was probably referred to the Supervising Construction Safety Engineer of the industrial Acci dent Commission. 3 CEr.not the ccremission insist upon the ins t s l l a t i o n ox-" p o w e r f u l suction fans, connected with hoses, which I s a t o l d i s *ha or.l y effective way to avoid these cases cf sor l o u e p o i s o n i n g . I t i 3 quite evident that gas nr ska and present uxvnocs u'r qux^o inace-uete. Very truly -cure, OV * 7. xTj <r Ar*^r'O"i*v"*> \ j - .O '.Ou*. - >- --; w U, aoc-or who xoor: ip.ia suer* enter set x.: nr.s cere or r. icr.t .:c u 1g -3 noted o state of iratoxicx tion. Tv io io pointed out in 1ight of the following quote from an Industrial accident Commission interoffice communication dated April 8, from the Supervising Conatructio: Sofexy Engineer;.... "As to the report of Dr. Larson that this can was picked up from tho street unconscious and taken to the house where Dr,, Lemon sew at y p.a. (sic) end he was unconscious, cyanotic, groaning, doubled up and extremis end feeble pulse.(sic) tho McGlintic-varshall has no record of such a condition, but did state t-Vn: the nan is s heavy drinker, and it i& possible be was in a state of intoxication on tho night of March 10th, referred to in Dr. Lcrsons report." (! On about yay 10, I9^h> a Dr. Moody at St. Francis hospital, S: n Fran cisco received four samples of drinking 'water used at the bridge, from Dr. Barrett, the company doctor for McClir.t ;c:. Marshall Company. Dr. Moody found B. Coli counts per cc of 1848 in one case end 5,0"^ in another. A local newspaper commented on this aspect as follows, under the headline, "Bridge Crew 'Le^d Poisoning1 Scouted." "Ccntamina*.cd wa` rather khan lead ooisonin,g6,, was the cause of 26 men being ill on the Marin project of the Golden Gate bridge. This report will be made to the idge directors tody by Chief Engineer Strauss. "The report will say that an investigation of the two mein sources of drinking -water disclosed that one 'was definitely contaminated. It will a'so point out that the men disclosed no lead in their system." On May 22, Dr. Barrett wrote the Industrial Accident Commission, "On the positive findings of Dr. Moody of the St. Francis Hospital, the infected sources of supply were' cut out with a decided improvement in the bowel condition of the various men at work." However, the water supplier, the Marin vster Diotrict on hearing of this took five samples of their own from five different locations, and wrote the commission as follows; "... the'analysis in our own laboratory showed ell camples to be negative or no trace of any contamination. "V,'e also communicated with prof. V. F. L^nglier of the University of California who is our consultant on all canttors pertaining to water puri fication. Mr. Langlier made a personal inspection and collected three more samples and the result of his analysis is reported to us in a letter dated May l4." "The'letter goes on to say the highest count prof. Lnngelicr found was 0.02 B. Coli per cc, and quotes his conclusions; "The results of all three samples collectively confirm analysis made in the District3-office 9 in San ""*0 1 end prove conclusively that the water supplied by the fi3tri ns ins ccr.foi*ns to the highest standards of purity. A trace of ccnt3min tier. such ss is indicated in the water from the contractors storage tan 3 of 1tv10 or no hygienic significance, and I doubt very vu ch that it could be the cause of the symptoms of illness displayed by sono of the mon workin* on this job, which ere c'aracteristicolly not those of water bo xoOc On June 193^ the turpentine issue was revived with s note froa the I r dust rial Accident Concise ion to the Golden Gate Rri > rnd High'./ay Die- g that the use of turpentine would not be tion.ed for pair.' g the int erior of the Marin tower. This in soite o he j.cct that on Ju no 213t the Industrial Accident Commi CO py of a letter fron the u.3. Bureau of Mines quoting D Alice Hamilton1 aS C=ying, (5) "it is considered safe to state that pa pure gum spirits of turpentine is non toxic iron the standpoint of vapors 0of-13 .*he solvent u ed."!! 6. These exerpt3 are froa a letter dati Industrial Accident Connission er.gineei 956 t0 the ;peeia 1 represent! to the McClintic Marshall Corporation: . the supposed Idge. ... it lost time of 6 ,5?0 days. On several of these cases I learned at the days were not lost so the parties -were actually worki in <0->+i.eel con- st ruction for contractors while drawing compensation from the -T McClintic Marshall Corporation. I cannot give you the full _^_ig_urc ) regarding this matter except to say that 71 cases and 6',570 days includes even the false claims." Despite the decision of the Induatrial Accident Commission on February Ip, 10p4 to have the splices or parts that required field riveting left clear of paint before being shipped to the site, a public health inspector noted on February 21, 1954, nThe elimination of the lead paint around the field_rivotod joints seems necessary. Cn steel which is already in place or cn the ground this seems doubtful of accomplishment except as the last resort." on March 24, 1954 the Industrial Accident Commission Engineer notified this inspector, "Considerable of this steel has been erected and I would roughly estimate that possibly one-third of the tower, when com pleted, will have had the holes cleaned of red lead paint, on the steel actually'erected, approximately one-third is riveted, Reaving one-third unriveted and uncleaned of the red lead paint." Despite the i'sjnefficaciousneso of the commissions' ruling, it probably was largely responsible for reducing disease incidence from 55 in February to 13 in May, 1954. Incidence continued to drop until construction of the Lime point tower on the San Francisco side the next year. Susceptibility and resistance were not considered of major importance in this study. From the literature it appears that anyone is susceptible 10 given sufficient exposure, sr.c that the body is not capable of building resistance to continually incroasirg increments of load fume3. However, one important aspect of susceptibility should be considered in thin type of worb. "No one under the age of 21 should be subjected to lead exposure ti "The general clinical conclusions of appointed surgeons in the various lead factories would be, we believe, that the eusccctibi lity of young persons i3 at least twice that of adulte, and there is some ground for supposing that the tissues of an adult, -when growth has ceasod, more readily adapt themselves to poisonous doses than do the deal with the absorption and tissues of a young person." t -e>l\imination 1 '; of "No.female under 4p years of age should be permitted to handle any dry substance or dry compound containing lead in any fora where the lead content is in excess of 2'i". (8) aha ?hysio 1or:ics 1 Action end toxicity of L d ; "'Thar. lead is ingested, mu ch of it passes through the- body unabsoroed, and is eliminated in the face 1 The greater portion of the lead that is absorbed is caught by the liver and excreted, in part, in the bile. For this reason, larger amounts of lead are necessary to cause poisoning if absorption is by this route, and a longer period of exposure is usually necessary to produce symptoms. On the other hand, when lead is inhaled, absorption takes place easily from the respiratory tract end symptoms tend to develop mere quickly. From the point of view of industrial poisoning, inhalation of lead Us much more important than is ingestion. " Lead is a cumulative poison, Increasing amounts build up in the body a d eventually a point is reached where s/mptoms and disability occur. Lead produces a brittleness of the red blood colls so that they hoaolyne with but slight trauma; the hemoglobin is not affected. Due to their in creased fragility, the red cells are destroyed more rapidly in the body than normally, producing an anemia -which is rarely severe. The losa of circulating red ceil3 stimulates the production of new young cello 'which on entering -the blood stream, are acted upon by the circulating lead, with resultant coagulation of their basophilic material. These cells after suitable atsining, are recognised as "stippled cells". 3 regards the effect of lead on the white blood cells, there i3 no uniformity of opinion. In addition to it3 effect on the red cells of the blood, lead produces a damaging effoct on the organs or tissues with which it comeo in contact. Mo specific, or characteristic lesion is produced. Autopsies of deaths attributed to lead poisoning and experimental work on animals, have shown pathological leoion of the kidnoy3, liver, male goned3, nervous system, blood vessels and other tissues. None of these changes, however, have been found consistently." (9) H i st o r y r nd Bt a t u c Remort ; Lead poisoning is the oldest recorded occupations 1 disease. plir.y the elder in the 1st century described necks worn by Iced v.-orherc. Hippocrates in the 4th century described adverse effects on miners one metallurgist /'a \ ti Greek, Latin sr.d irabian physicians know of lead colic following lead in gestion. Dioocorides in the 2nd century described load colic sr.d paralysis from swallowing lead end breathing its fumes. (11) >hil li ?p'U- p re clesLia, "Bombcstu s", the redcuotable Gwiss physicis W, 1Z\ he 16th caVitury docribod discs k>es from diST in,; ting and was .cad nd COCribed i'u'CiT COr.sumpt ion, as thms and dys onea. Re point ed out ellOCics Oj. cor.teraporary med ica theor ies and 1;aught the use of specifi emSdies ra thr t v-> bleed ir.g anc curgi"m.*;* (12) Around lc^5 Stockhausen described the "Colic of Poitou" endemic to a region ir. Prance where wine ferments tion was promoted by adding lead to ~t. n . r c Irene was noted in the early days France and England caused by lead in cider and r. I3p0 T'-nqu ar3l f^scjOue t r e a t i s e c o v e r i n g 12 17 uses. Ho was Oil ho ir.ha lotion of t lvCd p o i s o n i n g can bo t r a c e d t o 4A\ ->4.V-* Ta n q u Or e l , c v a s t amount o f linical onto. ,vrr. a sting to 'cote ib>. 'ro n c e , and Ge rman y. I'c i s i n t or- collected in 1924 before ethyl gasoline waa introduced had CT( less le-d than in similar saa?l3 collected ten years later. (15) .tub has shown in 1924 that injection of lead in the trachea lends to rapid intoxication. As much lead nay be absorbed from one such injection sc from 2. I. ocininistration which lasts for months. This is due to rapid phago cytosis and/to lead sobering directly into the circulation instead of pass ing through the liver as in G. I. absorption. Also excess phosphate ions in the G. I. tract keep lead insoluble and further decrees absorption. (14) As early as 1912, Lagge, a recognized_aut^ority in the field of lead in toxication makes this statement which is of special importance in reference to the c-oldea Gate Bridge epicsonic, "There can bo no intelligent control of the lead hazard in industry unless it is based on the principles of keeping the air clear of dust and fumes." (Ip) In 1946 patty had this to scy-. "Next to the smelting industry, the most danger from 3uboxide fumes would corns from the burning of lead, as in the application of a blow torch to a load surface or one coated with lead paint." Ko gives the maximum permisaable dose >3 1.5 mg per cubic meter. "'o establish background amounts, in 19 5 5 K*hoe, Theme-nn and cholr.k obtained excretion and absorption samples from primitive communities in Mexico which -voro isolated from natural and industrial lead contamination. They found lead in urine in 'mounts from .02 to .03 mg/lit., and .02 to .59 ng/24 hours in feces. Bisod samples ran.from .00 to .06 mg/100 grams of blood* (15) O17 50 12 Mere rec lead sot y X '* *. ` y L j '! 1 i: "b in ~ 0 \ f t e n d , 1 11/ 7 1 J Lj IT 0 1) C z 1 y d l i 0 ~ o i c 1 1 o r * t r- b 0 1 i a n o f t h o ;i n t i " c o r n i c i c i :he enzymes, interfe-rriu. ctor. (17) j o r i, f i i i c J j 1, i a C u ; n r . . v-iTTi 5 a r o d e i u , ne Ar.zonr.e Lsooratori-cc. /, 3 . note row r-rr.:: , .r'--^1 sno .^o at tuc university or Mil -n -.eve near; etucyong c:._ngos in erythrocytes by electron nic; ce co 0_0 observation, ultra thin sect icr.c of erythrocytes of guinea pigs poisoned with leed acetate ero owuuinsd. gone of the orythr ocyt so showed swollen end oltorec mitochondria no clusters of dor.se grunulea of obout 50 Angstrom dimeter with high electron scot taring pover. Those wore not roticutocytcs, 2 nd ..ore not observed in control animals. _ Load int orfore3 with the syntheses of hsers. since viuch of this synthesis occurs in the nitochcndria, it is believed these alterations are induced by lead. This confirms work done by Bessie and Brcton-(joriu3 ir. 1957 . Resort giegfeld (1?) lists the Ip62 consaaptiuno of Litharge or.d Rod Lend at 37>Cn'"! and 2y>0':0 tons respectively and states 2?,OTO tons was used in. saint and varnish clone, but that this 3 nowhere near the amount used AO years ego. However Rea Lead is still the world's standard for natal pro tective paints. Choi a5c states that sampling of sir from lyAl-yy was rand 0 2 end ir.t ornittant and in 19 5 5 '.continuous sampling vans introduced, though in relatively few locations. Xehoe says "The accumulated evidence of cur observations made " from tine to tine during the sect 20 years -substantiated by intensive- , investigations of human subjects in the Kettering Laboratory justifies the categorical statement that there io no hazard to the public from lead 7 content of the ambient atmosshere. IV Summary and Conclusion; The glaring deficiencies tire investigator becomes more and moro aware of as he follows this four year epidemic to it3 conclusion, ere misinformstion, apathy and lack of education. The letter two 'work hand in hand, dCt.U. information was available long before the bridge was built, but for the most part it was ignored for worse counsel, '/hat effective measures were enforced appear to have been enforced ha phaserdly end without conviction. Management attitude even for 50 years ago, seems to have been singularly unenlightened. A tendency to call a compensable disease contracted on the job by another name is quite apparent, in the bridge engineer, the con tra ctor's doctor and in the State inspectora. Since those days, the California Department of Industrial Relations has been reorganized to include s Division of Industrial Safety consisting of over lAo field engineers and supporting personnel, including a subsection, for industrial hygiene consultation, called the Environmental Engineering Unit. Four (and hopefully five) out of the sever, engineers in this group have Masters degrees either in Health Rhyoics or Industrial Hygiene. In addition the chief of the Division is sr. industrial hygienist Heedless to say work 01751 o f t he t y p A 1e a s i n g pr cr: s u r e g p n m a s k s . t 0t "he V** 3 4.*pi de n e ed fo r i]_ca-ni7str>.jo- longer permitted witho: * lince and compressor ps 00 3 i*,ive be e n o b vi a t ed by po rt ab 1 e Gi r s upp ly units such, as the Scott pack 'it h be e n fo u n d ne c e s s a ry' i n " a ny 3C O O S vo0 r0 0. worker needs unobstruc ed vis on, t o r e n u i r e n o s ks w i t h 3 c~ vnr l e 1e r "0 view! nr area. It is n0 10 nr0 r necessa ry y-1 /* Ii f0 ;nia , to ask for 1cn' cic tcnc 0 help. r*Va to ~'D00? ''ent of ?uM i c Health is ,,'11 staffed ith eXpor f3 in 1V'dus- tr~a! hygiene and has well enui 0 0 0 o lob0 ratcries, and 0nd ecd the envir0 nmenta1 unii vorns more closely with th1 ^ Do -artuent t0c-n vi Th it s 0ViTl. T 0m e n " `.v' sou.nties thr oughout the 01C'ic, have hea iVh deccrtu auta COICpareb Ie t c i.V -, J.4.vJ.taa1, and a few aro ooc sibly better. nn nt0 rest .ng obs r- vat 0 n at this point is that at leapt tnree Cal ifor ni<r. count 1 have be r. jUged commet ent by the At oaic gnsrgy Ccmmi ssion. to t5ke ove 4* yS*~V.0 -1 icen3---* ins pact ions of is otope use rs, at a tice wnen many stt tes have no t yet den0 tis. The uni ons too are better equip ped now to combat abus <33 su ch as r<S3U1X0d in this epidemic, and the write r can stato categrica IVV fro3 four year s of CI03 2 associai ion with union.busine es agente that U4ion actior. e10 ne would stc p such an epid eaic today. The rapy cons ists in preventing sbsorpt ion 0 r resorpti on of 1ag rom th0 s li-century tract, proaotir.g the urinary end biliary excretion of 1eod without dsasge to the excretory orgens, end accelerating deposition of lead in the bone, chelating agents hold great premise here, and may provide a complete cure for those afflicted with what has been regarded ^previously so a life long insult. , it oresent (1965) the moat effecti^e single therapeutic agent appears to be the calcium disocium salt of thjrlene diaainetetree catie ecic ('ZIP.i) or calcium disodiun edetetate (20). This compound fores a stable, soluble, non-toxic, virtually nonionio complex with lead ions. The result of adminis tration is usually a considerable rise in the urinary excretion of lead and at least a transient suppression of toxic signs and symptoms, including even the manifestations of lead encephalopathy. (2!) _ ./. V Bibiiogr 1. Cotter, L.v *> "Lead Intoxication by Inh 1st ion" Journal of Industrial Kygier.a end Toxicology, 2S;44, 1946. Lssd - Hen 1th practices psnphlot yTo. 5 published by the Rational Safety Council, ICS 1. Ohio Street, Chicago. 3 rd, Report of ths Committee on Load poisoning eeting of .c .yuericon public Health Associt ion, Sept cub 'inr.03polis, Minnesota. the nr.uc1 8~, 19 2 9 , 4. Hamilton and Hardy, Industriel Toxicology, Harper and Brothers, -p. 559/ 1949. ` -v " 5 . HaulIt on, Alice, Industriel ?oison3 in the United Sts Co., yew York, p 199, I9 2 5 . :u 6. Dr. Ofr ay P. McCord, "Standards of Industrial control," A?HA, 54 U*n> ?th St roe:t, Cincinna ti, Ohio. 7. Legge end Goodby'a, "Lead poicor.ing and Load Absorption," p. 55, 1917/ 0 Thomas M. Legge, Jou rnal of the Royal Society of Arts, Ho. 4CC7, p. 1C23, September 6, 1929. - 9 Irving Sax, Dangerous properties ci Industrial Materials, hnd Dditi Reinbold publishing Ccrp., yev/York/ I9 0 ? ? 951* 10 patty, Industrial Hygiene and Toxicology, lp4S. 11 Hamilton end Hardy, industrial Toxicology, lp49. 12. patty; op.cit. Ip. Hamilton and Hardy: op. cit. 14. f.ub, pairhall and Reznikoff, Recent Investigations of absorption ana excretion of lead in the organism, Journal of the American Medical Association, 85;588, 1924. 15* Leggo and Goodby, Lead poisoning and Lead Absorption, London, 1912 16. Kehoe, Thamann snd cholak, Lead Absorption and excretion in primitive Lifo, journal of Industrial Hygiene and Toxicology, lp: 257, 1955* 17. Zxerpta Medica Set 2/4 1951, P* 5^7. 18. AMA Archives of Industrial Health 1959, 20/5 (475-8). / 19. Lead Sym po s i um , February 25-27.19^5 the "ottering Laboratory. 20. 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