Document 6ZG8aXZJvEaQm25vx6pqOEaR

I NSTI TUTE OF ENVI RONMENTAL HEALTH KETTERI NG LABORATORY ( 513) B7 2-57 00 University of Cincinnati Medicai Center 3 22 3 Eden Avenue Cincinnati, Ohio 4 5267 January 30, 1980 Sidney Lerner, M.D. College of Medicine 231 Bethesda Avenue Cincinnati, Ohio 45267 Dear Sid: Thanks for sending to me the letter from Doctor Givens of the Antioch Works of DuPont. I hardly think I should comment on this matter to Doctor Givens but you may wish to do so since you are in touch with him and may wish to continue so. The problem, I believe, is not what is the fact, but what the explanation is. I have little doubt in my own mind about this but I recognize fully that I may be incorrect since we do not have the data by which to judge the matter. It should be recognized, of course, that the specific significance of the con centration of lead in the urine can be determined only when one knows the volume of the urine on specific days. The question, of course, concerns the total amount of the excreted lead?assuming that the kidneys have not been damaged by the initial excretion of excessive quantities of lead. I'm afraid our colleagues have a tendency to deal with a rule of thumb without appreciating the possibility of the effect of elevated concentrations of lead upon the kidney itself, plus the possibility that considerable improvement may occur after the lapse of several days. Indeed there may be appreciable changes in the secretory affucenary of the kidneys. But whether or not such a thing can and does occur, the urinary volume^in unit th^.;is a very significant factor to be taken into account. If you should wish that I comment further to you or to him let me know for I should not like for him to speak or write further about this phenomenon, without considering the possibilities. There has been altogether too much discussion of matters of this type in situations which cannot be interpreted correctly, because of the lack of the proper information. There really is very little mystery about the facts in situations of this type, and I object to the introduction of mystery into them, through the failure to obtain pertinent data. Sincerely RAK:di Robert A. Kehoe, M.D. Professor Emeritus of Occupational Medicine