Document 5Do8VQOzO1EZX3M69nyQnaddR

J une 26, 1957 Dr* F re d e ric k L Hoffman Cancer Hesearch Laboratory 135 South 3 6 th S tr e e t P h ila d e lp h ia , Pa* Dear D octor Hoffman 1 Thanks f o r your fu r th e r l e t t e r o f June 17 th I th in k you are q u ite r ig h t in b e lie v in g th a t p ressu re ought to be brought to bear on th e managements o f le a d p la n ts w ith s e r io u s lea d hazards# However th e type o f p r e ssu re which m ight be e x p e c te d to y i e l d r e s u l t s i s t o 3ctne degree som ething o f a m a tte r o f c o n je c tu r e # I n c i d e n t a l l y I am not speaking of sm all p lan ts belonging to sm all producers# R ather th e p la n t s which I have in mind are p la n ts owned and managed b y r a th e r la r g e o r g a n is a tio n s * I t would be somewhat d i f f i c u l t f o r me to i n i t i a t e any m easures f o r compelling changes in c e r ta in of the p lan ts which I have seen * Over a p e r io d of s e v e r a l y e a r s , we have made changes in a number o f le a d p la n ts and I have d e lib e r a t e ly s e l e c t e d what I th ou gh t would b e among th e w o rst lea d hazards to be found because I wanted to see th e maximal lim its of lead exposure, and the evidence of such exposure cn le a d e x c r e t io n and on c l i n i c a l sym ptom atology* My e n tr e e in t o th e s e p la n ts was p rovid ed through an under s ta n d in g t h a t I sh ou ld b e p e r m itte d t o make o b s e r v a tio n s fo r s c i e n t i f i c p u rp oses, and not f o r p u b lic a tio n in which u se was made o f names of o r g a n iz a tio n s * I f you w i l l r e f e r to cue o f my a r t i c l e s which appeared in the September 1933 number o f th e Jou rn al o f I n d u s tr ia l Hygiene# you w i l l fin d r e fe r e n c e to an unnamed w hite le a d p la n t and to another unnamed sto r a g e b a tte r y p la n t# I f you r e f e r to i t , you s i l l s e e th a t oases of p o iso n in g wore d e f in it e ly rep o rted to have occu rred among th e p la n t p o p u la tio n in which m ost o f th e men were e x c r e t in g e x c e e d in g ly h ig h q u a n t it ie s o f lea d # The le a d c o n te n t o f th e tw e n ty -fo u r hour f e c a l sam ple was as h igh as 0 .2 1 m illig ra m s in c e r ta in in s t a n c e s , w ith a number of r e s u lt s over 10 m illigram s* Such r e s u l t s , in our e x p e r ie n c e , correspond to atmospherio p o llu tio n s w ith lea d dust of the order of magnitude o f 10 to 40 m illigram s per 10 c u b ic m eters o f a i r . One o f the jobs in t h is p la n t in v o lv e s exposure to d u sts even g rea ter than those which I h ave in d ic a t e d * The men on t h i s job wear r e s p i r a t o r s , w h ile th e y are b e in g w atched) b u t even so I saw s e v e r a l o a se s o f p oison in g from I t in the c o u r se o f a years time* There is a somewhat s im ila r p la n t a l s o , o f which I have only in d ir e c t l<e B 0 0 4 8 2 N 4043 * -4 ' 2 know ledge, having seen more than one case of p o iso n in g in th e co u rse of s e r e r a l y e a rs , and I have autopsy d ata on two f a t a l ea ses f r o a th e s e p la n ts * I have in a y re c o rd s a n a l y t i c a l d a ta on one o r two e a se s o f en e ep h a lo p ath y which were brought to a y a tte n tio n * (W ithout r e f e r r in g e a re fu lly to ay re c o rd s, I can not be sure o f the p reelse nucwtoer o f e a s e s in th e d i f f e r e n t c a t e g o r i e s , b u t I have o eo asio n to s e e and o b ta in in fo rm a tio n on a f a i r p ro p o rtio n of a l l of the oases of lead poisoning th a t ocour in th is general seotlon of the country. X have a lso sesn a f a ir am b er of p lan ts a t considerable d istan ees from C in cin n ati. My g e n e ra l im p ressio n la t h a t where com pensation laws a re sfcrlet and are a sso e la te d w ith adequate in sp e ctio n of p la n ts , the hygienic conditions are s trik in g ly b e tte r than in those s e c tio n s of th e eountry in which n e ith e r com pensation law s nor s ta te lnspeetlona are ca rrie d out in an e ffe c tiv e manner. In any ease there is no q u estio n b u t th a t a la rg e percentage of th e i n d u s t r i a l e a se s a re p re v e n ta b le * What i s needed to produee good h y g len lo c o n d itio n s la a p re c is e knowledge on th e p a r t of th e managements of what can be done and wb&t has been done in o th e r s im ila r p lan ts* O bviously the ad v les of com petent m ed ical men would be o f th e g r e a t e s t u s e fu ln e s s in working out the d i f f i c u l t i e s in these p lan ts* U nfo rtu n ately In some o f than th e p la n t d o c to r i s in co m p eten t and p o o rly informed* In a d d itio n to t h a t , in some such p la n ts , th e doctors connive w ith th e management in avoiding th e w orst consequences of bad p la n t c o n d itio n s * X know of one In s ta n c e in which men a re examined from tim e to tim e and th o se who show th e most obvious ev id en ce o f le a d a b s o rp tio n a r e l a i d o f f in an e f f o r t to f o r e s t a l l com pensation claim s* From one p l a n t alo n e X have seen some e i g h t o r te n men in th e co u rse of th e p a s t two y e a rs who had a c tiv e le a d I n to x ic a tio n a t th e tim e th e y were l a i d o f f . Most o f th e s e men re c o v e r w ithout permanent d is a b ility fo r, in g e n e ra l, oases of lead poisoning w ithout c e n tra l or p erip h eral nerve involve* ment do reco v er sp o n tan eo u sly . I t i s th is very f a c t which j u s t i f i e s th e procedure f o r h a n d lin g th e men in th e minds of the management o f c e r ta in o f these p lan ts* From tim e to tim e , ax th e opportunity has affo rd ed I t s e l f , I have done what X oould do to s tr e s s the dangers e x is tin g in c e rta in o f the p lan ts which X have seen* X have been very cau tio u s not to appear as an e x p e rt w itn e ss on the s id e o f p l a n t managements in connection w ith wuch p la n ts . I have i n s i s t e n t l y p o in te d o u t, whenever X have been c o n s u lte d , th a t th e r e is no defense ag ain st claim s a risin g in such p la n ts, e ith e r re a l or fic titio u s * X have t r i e d to make i t c l e a r th a t th e managements o f sueh p la n ts are Jeopardising th e ir p o sitio n b efo re in d u s tria l ooumisions or b e fo re conmon law c o u r ts , and th a t th e y w ill e v e n tu a lly have la b o r d if f i c u lt ie s as w ell as being a t the raerey of every le g a l ste p taken a g a in s t them. However I must confess th a t in the main th ese co n d itio n s are e v e n tu a lly elim in ated only t e 1 00483 5 ban th e p u b lic and when th e group ra p ra a n tin g la b o r become s u f f i c i e n t l y inform ed to sak e I t hard f o r such employer* There 1 an o c c a s io n a l f a r sig h te d m anager who o u t o f h i a own decency and human u n d e rsta n d in g provide p ro p e r c o n d itio n s f o r th e workman* There is an o c c a s io n a l a d d i t i o n a l m anager who se e s th e h a n d w ritin g on th e w a ll and a tte m p ts to p u t hi house in o rd e r b efo re he la o oopelled te do so* In a d d itio n to th a t, insurance companies have p ro v id ed a v ery co n sid e ra b le amount of b o th p re ssu re and in fo rm a tio n * In my o p in io n t h e i r p re s s u re has been more s e rv ic e a b le than th e ir inform ation f o r th e one w ith o u t th e o th e r i s lik e ly to he o f l i t t l e value* In genera^ a f t e r a o se y e a rs of e x p e rie n c e , I am f o rc e d to Lthe c o n c lu s io n t h a t a v ery c o n s id e ra b le p ro p o rtio n of managements make o n ly th o se m o d ific a tio n s to w hich th e y are driven* U ndoubtedly th is is due to the f a c t th a t in part new h y g ie n ic m easu res a r e expensive* They e h te r in to the c o s t o f th e commodity and, th e re fo re , a c t as a h in d ra n c e In c o m p e titiv e f i e l d s * O bviously h e re I am speaking n o t only of le a d po iso n in g b a t of a g re a t many o th e r i n d u s t r i a l h a z a rd s* 'hen we besoms s u f f i c i e n t l y c i v i l i s e d , I th in k we s h a l l re g a rd i t as a n e c e s s ity to p rovide wortcing c o n d itio n s which are fre e a t le a s t of in s id io u s h e a l t h h azard s* '#e a r e making some p ro g re ss in th a t d ire c tio n * However, as an observer In the f ie ld r e a l p ro g re s s seems to me to oome v e ry slowly* I agree w ith you th a t d e f in ite s e p a ra tio n should be made betw een o ccu p atio n al o ases of lead p o iso n in g and those which occur in the g en eral population* In f a c t th e r e are many people who would f in d i t d i f f i c u l t to b e lie v e t h a t th $ re a re many c a se s o f n o n -o e e u p a tlo n a l le a d poisoning* I t would be very u s e fu l not only to have th is sep aratio n made, b u t to have such Inform ation a v a ila b le as would perm it one to e s ta b lis h th e ca u sa tiv e f a c to r In r e la tio n to illn e s s o r death from lead poisoning. R ecently 1 have been try in g to o b ta in same in fo rm atio n on th e o ccu rren ce of lead o r a r s e n ic p o iso n in g from sp ra y re sid u e s* My ex p e r ie n c e , and t h a t o f my o o lle a g e s a t H arvard, le a d s me to b e lie v e th a t moat cases of lead poisoning In In fa n ts and c h ild re n ocsne from chewing o b je c ts co a ted w ith m e t a l l i c le a d and le a d pigm ents* I am n o t q u ite s u r e , b u t I b e lie v e th a t every case, exoept one, in our H a t at children has had suoh a c a u s a tiv e f a c to r * I f we were a b le to put o u r f i n g e r on the m o st s i g n i f i c a n t f a c t s which cause le a d p o iso n in g o u ts id e of I n d u s tr y , we would c e r t a i n l y know a g re a t deal more about the dangers to the publio in th is c o n n e ctio n th an we now know* There a r e many o th e r th in g s which I could say about th e se problem and you w ill note th at the paragraphs above are ra th e r inadequate in th e ir d isc u ssio n of th e se problem s. This w ill only serve to show you what you p ro b ab ly a lre a d y know, namwly th a t I am tfp-n r A A OA ao t very c e rta in a t to hoa these d if fic u ltie s can b eat be solved X hare m erely been observing Individual facta and eaaea aa c a r e f u l ly aa p o a a ib le over a p e rio d o f some r e a r s in o rd e r to u n d e rsta n d as much as p o a a ib le ab o u t the occurrence and the sig n ific a n c e of lead in to x icatio n * X have n et been unm indful of th e s o c ia l problem o r of the in d iv id u a l problem aa X have gone along b u t X moat con f e s s th a t X have n o t seen any o l# a r* e u t means o f s e t t l i n g i t With k in d e s t p e rso n a l regards . C ordially yours BAEjia R obert A.' i'ehoo iLtf* i 00485