Document 6BXXx536nrD4LqQEe8rmxQN2d

D EP ARTM EN T OF H EALTH , ED U CA TI O N , AND W ELFARE PUBLIC H EALTH SERVICE W ASH IN G TO N 5, D. C. BU R EA U O F ST A T E SERV ICES Refer tos SH S--C February 12, 1958 Dr. Robert A. Kehoe The Kettering Laboratory University of Cincinnati College of Medicine-Eden Avenue Cincinnati 19, Ohio Dear Dr. Kehoe: Your very helpful letter was received today and read with interest. I appreciate the points you brought out and will discuss them briefly. 1. The emphasis given to this proposed program by Dr. Cann (director of our Poison Control Information Center, and a pediatrician) will be on lead poisoning in children. Since no contact will be made with large city health officers except by Dr. Cann, he can emphasize the excellent point you made about the paucity of lead poisoning in adults (other than from occupational causes). 2. Concerning the mention of the finger prick method of blood collection for lead (screening) analysis. This procedure is proposed not to the exclusion of the orthodox method of blood analysis, but merely as an additional investigative or research device. I share, and I am sure Dr. Magnuson shares, your doubt about the accuracy of this method. However, I feel no harm can come from investigating the possi bilities potentially inherent in this method if the analyses are not used for diagnosis or as a basis for treatment. Even negative findings would add considerably to our store of knowledge as activities develop, and because of our limited staff they are bound to develop slowly. I will keep in touch with you and I am sure that Dr. Magnuson will be seeing you from time to time. Please feel free to comment on our activities as you have advice to give. I recognize and respect your long association with this problem. A. L. Chapma# Assistant Surgeon General Chief, Division of Special Health Services Fobru ary 6 , 1958 D r . A. L . Chapman A ssist a n t Su r geon G en er al C h ief, D iv isio n of Sp e c ia l H ealth Se r v ice s Departm en t c? H ealth , Ed u cation and I'/olfare W ash in gton 23, D .C. R e fe r e n c e : SHS-C D ear D o ct o r Chapman: Re: Lead P oison in g I t r u s t t h a t you ' jd .l l n o t r e g a r d t h e t a r d i n e s s o f my r e sp o n se to you r l e t t e r o f December 20th as evid en ce o f any la c k o f i n t e r e s t on. my p a r t i n f u r t h e r i n g t h e w ork o f o u r C o m m it t e e , o t h e r m a t t e r s h ave cr ow d ed me an d h ave m ade by d e l a y u n a v o id able . I h av e gon e o v e r t h e co p y c f t h e "P l a n " an d i n my v ie w i t co v e r s w h at cer, r e a so n a b ly be done t o im prove th e s i t u a t i o n . 7 n ote t h a t th er e i s no sp e c ia l em ph asis cn le a d p o iso n in g in ch ild ren in th e e ar ly pages c f th e copy, except fo r th e p a r e n t h e t ic a l n o t at io n un der th e u n d er scor ed t i t l e on th e f r o n t p a g e . T h is may o r n et be w ise, bu t I s o f som e sig n ific a n c e to r e co gn ize t h a t th e problem o f n o n -o ccu p atio n al l e a d p o i so n i n g among a d u l t s i s a lm o st n o n - e x i s t e n t , an d t h e r e f o r e , many p h y s i c i a n s v-'ould w on d er w h at i n t h e w o r ld we a r e t a lk in g ab o u t . T h is m a t t e r w oiild be o f im p ortan ce in an y -public statem en t th at m igh t be isst ie d , and t h e r e fo r e I c a l l at te n tio n to i t a t t h is tim e. One o t h e r m a t t e r - n am e ly , p a r a g r a p h 2 . i n t h e Recom m en d at ion s o f t h e Ad Hoc C o m m it t e e , t o o k me by s u r p r i s e . I f t h i s r e l a t e s to a n a ly t ic a l work - i , e , d e t e r m im t io n o f le a d in a drop or two o f b lood , J b egin by bein g h igh ly sk e p t ic a l, sin ce th e problem o f co n t am in at io n o f su ch sam p le s w i l l loom so la r g e ( u n l e ss some s p e c i a l t e c h n iq u e i s d e v e lo p e d ) a s t o r e n d e r t h i s procedu re n ot on ly v a lu e le ss but fr an k ly m isle ad in g. I h eard no d isc u ssio n o f t h i s - I presu m e t h i s came up a f t e r I l e f t an d I may sa y t h a t I w ou ld h ave th row n a g r e a t d e a l o f c o ld w at e r on i t . Our p r e se n t problem r e l a t e s a g r e a t d e a l to th e a m b ig u it y o f t h e a n a l y t i c a l r e s u l t s which we now o b t a i n fr o m a number o f l a b o r a t o r ie s. O btain in g, b lood from c h ild r e n i s n ot alw ays e asy , but u n le ss th e tech n iqu e i s su b st a n t ia lly f a u l t l e s s , th e r e s u l t s a r e w orse th an w o r t h le ss. I 'l l be in t e r e st e d in h ear in g more about t h is, but I ad v ise goin g very slow ly in th is d irectio n . Sin cerely y ou rs, N 7546.01