Document 4JM3beeo21ZJqBR5JKkvR2JqR

} ADDRESS THE SURGEON GENERAL U . S. PU B LIC HEALTH SERV IC E In d u s tria l Hygiene D ivision FEDERAL SECURITY AGENCY U. S. PUBLIC HEALTH SERVICE W A S H IN G T O N 2 5 , D. C. (Bethesda Station) September l6 , 19^6 Dr* Robert A, Kehoe K ettering Laboratory of Applied Physiology University of Cincinnati C incinnati 19 , Ohio Dear Dr* KehoeJ As you a re a c tin g as summarizer and p rin c ip a l d isc u sse r of the papers presen ted a t the Conference on Lead Poisoning in Boston on September 30, 1 9 ^ . Dr* Carl P eterson has re quested th at copies of the papers to be presented be forwarded to you* I am, accordingly sending you a copy of the sh o rt d is cussion of a n a ly tic a l methods viiich I am presenting* Sincerely yours, LZPimrk Enel* Lawrence S* P a irh a ll Senior S c ie n tis t (B) Chief, Chemical Section N22124 WPZIZZSL *>v& 5 m m t t t o i * n n s w t a B'itfiKr m u rapej T T W tt ' i l sisoiw m m & m m m u r r m I t I * net a? pwpooa a t fchia aao tlag to praoaat any nev aetbod a f lead am ira l or ay ae v prooa&ura fo r tba d ataxala&tl a l d a ta s ti o f lo ad la b io lo gic a l ufeataaoeg, feat rather to diam o o artaia phase o f the so alytteaX prefelona Which are praaaatad In e vitably fey the torpe o f aatarlaJ. b e la * aaalyaad fo r la&d* .. Xa tbs cour o f tba lo o t qaartar o f omturjr, a a la o s t all variety of aethods fe r load determ ination v lth ra forarne te the m oral p ro b i of leed peiaoatag baa fe davelopod a a l tb l bealtbgr tat of a ffa irs bao loa m ob to c la rify m ay of tbs ofeaeure probi of lead polecats*, Xt 1 parfaape ratb a r unfortunate th a t la m oral tbft tendency bao fea to gphaolftt aso f execution rath o r tbaa oourway o f m n tl c n , Ith roforoaoft to tbees aatbeda and, to ay alad , th la bas boon a d strla m t ralb a r Iba a help, She a sn d iffic u lty , a f e ro e , l a Ib nalyat a f load la body flu id a aod Uwwee baa fea Iba groat d isp arity f e a t the bulk of sto ria i aaalysad aad tba inuta aaonat ef ubatsaoo sought febea i t la re a lise d tb a t tba d a ta ra la a tle a frequently rrrc lre a arm ad a a tto r of a illle a th s of a exea la 1,000 e r 2,000 grane af fin id e r batanea Saranth Inanal Ooafersaoe Indus t r i a l go alth B o a t 3eptafer 30 1^ ^ 2 ad th a t tl to ta l saais&t of other laerB&aie constituent eccosewiaigr loo ta such auterlal a / s c a n t to 50 o r 100 gross, l i is o tr i eue the.} the se p a ra ti aal osatttatiT s tr a in a ti of these xtroasljr Bisle ttunat f load 1 eaoes aiiqfl? d iffic u lt Boueror, th s parotis* l s fu rth e r oeeplleated h? the fa c t th a t la a d d iti to sor* hoik of cocasNHiyta otthstascos, load i s also Man.nyi4m Vv saettata o f ether etne %kich aro p o te n tie ll/ d iffic u lt to separate frota I s s i. I t ls la&ood fnrtnnnta th at the n b ita o u B<nhwri tii< <mm *Ainwn ksoMt as ditsha lsao s a ^&n o ^so. vas^^bbi^s i tie n d s t to llz h t a i v u s l n a n^p ^p e s b o o o ^p Oj so an sad th a t th o i l a n l a ftp^aso^^pBsa^aoa properties of th is sohstcAM with rw ptot to aas? rotei* as to thorough!/ iarosttgated h? fisher Kith ths eld of th is safest, I t 1 possiti to separate load qpa&Utattrsl?' m tfeoagt i t Is pressai la ostro!? all *aouatt froa a t os? large mam% e t notovlal* I t 1 i n i th at a wsbor of other festaroes aro slatta**? separated, hat ths separation of tboso free load is sot too d ifficu lt a proti* 1% 1 unfortunate,, however, that so roch a tte n ti has ho davotod to ths further or fin al en d u e . of load h r Ma&o of this rorooat rather th&& to the effeetlve&ess v lth , 4<50 ^ 4 3 3 vbiak 1**4. 1 cp&r&tod fresi otbor m in i* a to*4Xib& few* 5&i* 1 u otorstsatollft beooaae a extrouely a&il aouat of land givo a pr~ iwuttao4 an i vtoy toc? color uator co rto la oaA&LttoM vtfcb th i reagent an i ito f u c ili V vitto vfrlcb oolariw otrU to to m lao tlto * or# o rrito cut la cw e m l sic (ruoto procedure etw ooly laviti . Co ttoat si, long rutti elaborato procedure bave baca otoptod la o rto r to a ls la is tt effoots of la to rfe ria e abtM wlthcwt toc reati/ affoetla `th proci vsXaatia o f laed lto alf Cb1 torlo* v*> a plt vhicto I beali aev 1U t dlaouss oro la to ta li fbo a&&2yttcal cheaiet la coafroatod l a b is loboratoqr w * k vitto navifii of im u Lt Im tbd iM tlit fiort a & 4ill<uuff o f r s o IjNp latto* fre^u sattjr ib is rtiuiros & ma%to o l of ti e ad a w m w J ragli,ng a ttra tte lo to ta li vbieb I s olaoat uaiqoo, Sa itole ecas, o*ab saaljrtts rtp ro so ata & toctoaiasl otolfrsnw xt of toi*ft erto ? m A ito* ta tu ili* goni MtS/oi to n a li/ ceto sa to sbtcrUa tbo ortoooo la t o / lavolred la tbo vario stop of aaal/ai V b ia i^ d ro u itta ir snob stop ia goto a v e/ th&t aooltoss Sebo? i s avoitod* S t Is th i* fo ci Xttrgsly ttaot 1 r*pultolo K`V 05044 u fo r th aevelopsunt of "mv" nathott f naelyeia, da Ih neod fa r by- p m e d i a t i voxk he grevo, particul& rly in th in c e n tric i f i e l i , teofcaologiotd advaAce beve kept pe.ee vdth th oheolet ad inatruaenta beve heen doveiped uhieb ro stly alH plify h it vaste end pariuipa predace g reci In o ra n e in output At th tene U se, auaiy of theoe in stru n en it bave p e n d tte d hi to avalliate q u sn titlee of mbetencea co n u d i se to he uadraened e f e t co e e rlta r day u, fa r in ete m e, beve th quarta sdcqre~talaaaa, th epeotro graph and tbe Geiger ceenter vbloh reepend to th preeenee of w j r anali eocunta of n a te ria l indaed* inatrum nta are of th greateat u tility and bave tended not oaly to extend Un f i a l i ef co tiv i ty of th analyat bui* In naay caaee, te esterni aowsracy o f abeervation, Xt lit tur* fortunata, hovevar, tb a t v ith tbe acquired f a e tllty e f operatloa aad th wideaing beriaan o f a p p lic a tin e a v e li aa tbe extra* le n a ltlv ity e f aoch inatrufiwnt, thera la a teadency oa th p a rt e f naoy te abort d r o u it operetta* vitheut te e alee# an attaaqtt ta f in i vhethey neh ehort-outa are vali&t to aU bstttute, in other vorda, f r tbe 5 known d o lloaqr of the lnstrusioat voridae under t beat of conditi oca the application at the Instruoeat te prooedxar of incerte.!* aocaragr. I t le staple to do tid e and to s h ift the resp o n sib ility fro* the analyst to the iastruoeuti hut no kaova preceduto ce* he carried very fa r without the a n a ly st's aaslny responsibility She fe e t th a t an Instmwent of erec t deltc&cy and undor proper circonstances of aoooracy i t used, does ac t la I ts e lf e ffe c t the tru e solution of an an aly tical probi* the analyst suet e t i l i acospt resp o n sib ility and tha degree to ehioh tid e resp o n sib ility le tsp o rtan t roete of oeuree, upon tin nature a t lde profeloa* do aa iaetoaoe a t tide X oan c ite tin applicati* of the sgpeotro graph ad the polarograph to the detersdnation of lead I* M ologlool nhsU aoee. bout 2D yaara age reflneaernta Ingo* to eppaar l a the to a rte epeetre graph uhioh g reatly fa c ilita te d i t e uoe and extended I te rene# l a the fie ld of an aly tical ohesdstiy, and q u an titativ e e s p lic a ti one; o f the epectroeraph were rapidly developed fid e hoe been f a c ilita te d by a e ra rsi mans perhaps tie sim plest of ahioh i s the cap erle * at the d en sities of a gira* lin o a t various concantrations with reference to the daeelty  of & eanparlftoa subst&iu lu taiova ccaoaatratlaa* Tarjr naiijr nodlficatloa* of smsd prooaduro bars baca i&troduood, dspandlog oa tb* natura of tha sa&ta r la i fo r analysis* Ubila a t f l r s t approoah tb is otas ta b & nothod of so lu ti o r of ny analytloal problemi and ladaad la f th g ro atast in portance to n&ny lam ljrtloal prtio n s, tbr ara plma* of ib is proooduro uhlob bava n atu ral lin tta tto n s# S re spactran, fo r laatanoo, 1 la general aost eu!table and Boit sta si tir a fo r nargr applications of tha Spootrcgrnpb but ta oro are facto rs, which, ban oloooly ia ra stlg a tad , indio&to tb a t froquentljr ibera or d if f ic u lt s la asaorlng tru* an* ly tie a l values* Sbs oro its o lf ls not ta s sislo tbiag th a l t f i r s t appoar* to bo* br# a r t erodati ont of t staratura vararla* freo tho p o sitiv o ta tbo negativo alaotroa and s a atol b o lli o ff, te tro ora v a ria ti oa s u tth ta s la th a aoovat of n a ta l a t rarlo u s pointu batvosa tao a le a trodas* M tbo ta sp a rstu rt of tea are , *idb la round (>7Q0C, a l l tha substaaoos la th a aro ara p a r ti/ lonsod s a i, duo to tea ole o tri o d fio ld , thooo loas andar la tee gas colono# % a n a ta l loas adirato to tea euteodo and ars a su trsliso d teera, diffusine aun/ as vapor# Iba xas u it 7* i s c o n c e n tra tim o f nautr& l m%&X fltaru tmd iena oonteutrkfcod iu e> th a r y e r Ju at afcove th cnthode 5 h is cutho Xeyvr e ffe t 1# u a ai no t a l le \iien s a a ll euaunta of uhstanco* a re v a lo ri s e i t u lihe uro* Sho tyyeo o f lin e e w aittud end t b e i r In tru siti oro Iso a ffe c te d V ti-e proum ae e i auch sa lly ie n ia s lle sufestanso* aa codina chlorlde* Xt la Giipexcnfc, therufor, ti*.t th d ire c t current w q is fa r uo;s coppie* thau l i ia cuutoiaerlly lelioved to te and th u t exectlag qjMintitfttivo varie re quireo CQualdtiratleu of tiuta* fcctora* Houover, lu Si>ite of th leuown d if f ic o lti # of eppllG ntiun o f th tpotjtr<t,iw4'li to tiio d o to m in u tio u o f Xend m& perhcp* l u t o t a l d i orescrd vi' thcq X w y o W ord o f d ato ru iu n tio u s ode o f vrliu&ry 14 v itti a c iu rla drop of tirine VUilo tu ia m y Ve in g re ssiv e to sene, i t l e to uayons f a t t il l a r viti* th f l e l d , o rely r i d ic a ! (me* I n sp i tu o f t i aswy d i f f l c u l t i e s attfeched to th e p p lic n tio a o f ti epoctregraph to deter* salanti one of tiiis cliaraoteri i t l a in th bande o f th oooseientlous nualyat, a & iaatru aeat of th vejy gre&test u tility to interotlAC nethod f a r th daterainnfcion of lead i s tim i of th a drappia m xw xy electrodo \fcioh w a f lr a t pwpoaed fa r th ia purpee* by Shifeeto, a apenea otodeat of Bayroraky*g, about l^EJ, *o polarr*ph u t i l i *tftg th tropplng aeroury electrodo has b#ea eppllsd to th dete? s&natioa of m t l m aunta f a. v u rlety of ubatane in A ditic to lead fa r a natbsi* o f yaara Xta pplio&tlca pende pon th In terp re tati * of ourreaW oit*# curres ofetalaed darla lectrcilystii and i t aqplepa a drappi aarouxy eleotrede in ordsr to prvida a freeh oathodle urfaca oontimoualy % epplyin a an ali and ateadlly imaroanl^g Tolta, a p o iat i reaohed ocrresponatn to tba depcsltioa p eten tlo l of th lon sou^ht M th ie p o ln t thera i a euddea ourrant or ovili to th dlaohange of th lon a t th o&thod* and d isso lu ti< of Mereury a t th anodo, Sfce T o ltele a t th eoeet of th eorreat cargo representa a depositi on p o to n tlal chornctorlstio of th ion, 2hls aarrent sansa n s c h u a H a i tinse Taino d va a ttn e ts>aa tba lo a oonnentr&tloa. end th ' 'I p ro p o rtianali ty betveaa th to ta l irisa and th concentrati sa o f th depositi lo a 1 datewdned by osllbr& tlon ogainst k&ota stendardo 2hs oppi!catin of th poLaroeraph to load enalyala e f body fin id a la l& Tltlsj& r sislo end f ow la contrai to aeaapi netruB aatol roedlos* vltoout fxurtbor etocks, tha radiarticol toree^**put osf toa tnatroaant la larga with axtreaa aura <sm era, bevavi?, to to lo an aljrtlcal vtluaa, s e / fo r la la urine, cxxsportol# v ito too obtoisad gr o th sr Maona la o rla r le atonia toa dealrad ocottracy, howarar, grani cera Huat to uod l a toa p u rlflo e tlo a e f er y end resgrat, toa o alib ratto n f toa IratW Brat* rad toa In te rp re ta ti on of rcao lta, a v a li m to toa eonstoocy of a lt cantoni rad e c id ity of toa so lstlan a axud/aad Oceania antora! must to barai jctrra rdlaosy praecation wuit to takan to re nava oxygan fro a toa a l tro ic a m uaed aa n to b b lar to ewaep cateto freM ito eU precedi* aleotrolyaia 1 antica to ta la tta r slaoa toa lap n ealo o eipaara to to acnatfeat pravaleot to n i eoanarada! s i tragan la uff1e ira tly pur fa r to la xanoM * Zn f r a t to a oooorstt datoraLoatlon ' ef u rla a rr load v ito toda laatxtwa&t ia mora o r la ta of raaaaroh oto and ia aa tlaa-eraisaslng to o l l i praaasta no ndrastagoa te toa reatin a asalyat tooaa in to ra a t U aa fccyxmA a qulck W itti o f aagr aert* Sto co lo rili trio datam tsntion o f I t wHtoy ruroTt of ditolsooa to t IO porteps ro*lved or* a tts a tlo a la rsoeai cecini teaa alaoat aiqr o(9wr BotiwkU Xt ala* te a Ite advaataeo of ra p id it a& Whara tea saettata of Xead tu au fficlo n tly l* rs , awl la tte absaneo f lo to rferin tibetana, l t 1 T iiy nful fa r te la purpos Sfc principi d iffio u lti te a t a mooaater fo r tee detoralaattoa of claat saettata of l --d. aro f i r s t of 11 te preconi of cortola o tte r --ta l ead i t e tmimna)' of di th l tono to oodtdis and ivo a lig h tly oXor*d so latian v ite ertala oxld&tiv eobsteao* te la teoeao partioalarX y p*rti*nt la te d*to rv in atica of hlood l&d teoro a stao tio a la uauallgr r*oordd la torna of 3 o r V aiarograaa o f la&d la a 10 gran oaa^l ot hlood te li* IoaA 1 n&qttaa' UoaohXjr prvaoat la Ite blood atroaa la ex tra--ly a lsa to oaouats, l t la dcubtful I f l t la proaaat to tea extoat te s t a au ater of tedivi duale te r# peatalatod a a rc a u lt of -- re a l a of te la t/p o . So fa r u I m suor, aitaldo o f w lahoxateaar, a oca haa tafcaa te trombi to compara ite ao ly tlo al vate tm Ite -- 1 10 grtuss of felood Ite a s a ffi d e a tly larga opaatitjr of teo se-- hlood to fin inooateatlhiy ite 'alt fo r aor al load* Xaataad, repaatod "dotrateati oa* of laad --da gtoa 10 erma 11 ampie of blood have been uaed as (ha basic fo r fix la g valu fo r blood load* H esy b Aid (hai (ha valilo har been ub*taaUetA by otrogrnphia, polerugraphlo and e le o tro ly tie nathod and (h at they a ll are coatie teat* Xi i only *hea one attm p t io neke serions study of laud tu thftw oonoonirationo of ( ee h (d m c n a t m v cassie of blood txr* 1 confronted, noi with (ho techalquee f iorottilgailon which ar su ffle lo n ily s ita la , bui Ith ih rugarlo of the n e te rla l sought and readings ( tr ibuiabie io other fo o te rs, th a t he i libelar to r e t i so hl opinion, I regard aost reported blood load vaine with considerable reserve and uggeet th a t nor lnr>Ug&tian be node of blood id th referons to I ts i& trinsio lead oontentp C ertainly, i t should not be d if fic u lt to te s t tbl by paratine lead guantitntlvoly fron one hundred tls* the usual mount used fo r analysis, i f analyses oan be nade o f 10 gran osles with tba jQMii anonraor nln1iwd fo r th is -- h Studi nalvse <** bo sude th pooled lo t of huaan blood, sa we hero dam , or ninni blood oaa be used, caap*ri*on being nade between 10 gran and 1 or 2 ktlograx munta of the sen blood. * 12 * I bring up th is point because there ho b eta a certain tendency to turro a blood lead deterelafttloa Rade In suspected oases of load poisoning and to re s t the diagnosis on the w adytlcal report & received la oases of th is typo a ch ild with an apparent high Hood lead Is la the vafortaneto position of pooaible treatm ent fo r load poisoning when diagnosi of disease o f an Infection nature is d iffic u lt or Obsauro , I f blood load velues are to ho important in th& dicgnoais of lend poisoning fu rth er 1 v estig atio n should he nade of th is subject in the in te re st of s c ie n tific accuracy* , 1 ham re ferre d to the question of blood lead scMwAat a t length because the d isp a rity noted v ith reference to the actual snouat present under ordinary condition* introduces on uncofifortnblo elenent in regard to data representing the anaunte present in actas! cosas of lead poisoning* On* fu rth e r point I should re fe r to in conne tic a vi.th chantonl data fo the aen sclen tifid sind* p o sitiv e re su lte frequently can y sore vetght than le v or negative results and the g reater the values reported tho sore d ran atic the effect* Perhaps I t sig h t he as v e il i f vs look behind Y ft & B 8 6 3 13 th i m m i s o rt oad atody the eource of teobaica l m ro 1% vcnld b# uafortaoate i f t a t h e f l e l d of 1lofcealstory w baro * slto a tio n aaalogoas to th&t rforroii te by 2* S Salth 1 c e rta in phases of eoansree ta tdtieh profosidca! analyste fera giunti fle d m 'higb* aaolyota ata& lot* analyste, the Hors f avarine os claaa and the Vuyere tfce tfer* A v u y eroat deal of resp an elb illty la attaebed ta tha dterm ination of 14 ae o diagnostic old In Isad polaoniag X astruneatiil rendine of tha g raateat aocnra gy a r t Obt&l&able fro a tha modem pparntus ro ila b lt te the presa&t dar baelat, Sut Mm intrnent lta e lf carnaot scpply tha in tellig en ce atoess&ry fo r aoourate analysis* fh* ooadact o f en nalytioal Operation ib m li natahi ia care tha aooumor of tha n a d ia s to tiMeh tho le strument le misoepUbl*. Za otber verde, th d w ilit feae a m at reapenslb ility ia uaelytiool vork of thi type* twe eo t 7 snob dpende upoa tbe ouicono of b is aalysla* Xt 1 aot affto U at lo fo llo a routine pro* coduro a&d to ** th a t. beosase ba haa folleued tha d irectio n s m l by vord, tfcat U a aalyU eal rsu lta oaat tn oorroot. A por flhenUt nay ebtal* poer ro m ita r itti a good precederei a oonpetant obsdt oaa efetala fa ir ly asrate re s u lts with en ladi r fera a t nathod, 2hase ohserrntiona *rs offered, not la a o r t i cal s p ir it, but la order to focue a tte n tio n on certain points th at frequently a rise with reference to an a ly tical aathoda used as diagnostic aids in cases o f suspected lead poisoning, A large washer of In restig u to rs have been end ere exploring such of th is fie ld , end fro a th e ir porserrerence and reeourcefulness I t i s to he hoped th a t ary of the obscure chapters in lead poisoning w ill hecoae s o rt completely clarified