Document 6bBa8Kr7e23EdboL40Za0Mm69

2348235348232348485323535323234848485348484823234853234823235323232353232323484823232353234848 4853485348484853482323234848232348 r \ l i 5348535323532353234848532348535348 484823534853905348532353232353235348 001S368 March 1, 1971 Dr. Mappes -. Der Staatlich Gewerbearzt 463 Bochum Marienplatz 2, West Germany . - '' Dear Doctor Mappes: Please accept my thanks for your letter (and the enclosure of a copy of the alleged outcome of the Amsterdam Conference). I do not see Just what the effects of the publication of the "final paper" from the Amsterdam Conference will (or should) have on your official activities. This group has, so far as I know, no official authority, nor do I believe that international standards should be established by such an organization of professional men. This may be an wholly unacceptable attitude in a member of the International Commission and Association, but I have lived too long and have seen too much of the manner of the operation of people in this area of life to have much confidence in Its effectiveness. Standards change and must change as we learn more, and I do not believe, excepting for the purposes of government, in fixing them firmly in regulations. X have spoken against this in meetings of the International Association, and I shall do so again, if necessary. To advise, on the basis of evidence, is one thing, and this, in my view, is the proper role of the physician. To adopt standards for performance within an area of authority is, I believe, a governmental function, for such standards must be adjusted to fit local circumstances. As illustration, let us suppose that the length of the work-day or of the work-week differ as between two countries or provinces. The permissible concentration of lead (or of many other substances) in the air of workrooms must be adjusted accordingly. So also does the standard depend upon the dimunitlon of the risk associated with the existence of competent and effective medical supervision of employees. Despite what I have said above, however, I understand your concern for standards set by professional bodies which represent authoritative or presumed authoritative status. Finally, let me say that X have no present knowledge about who it wa3 that issued the report which has been published. The conclusions so stated may or may not be correct, but I know of no authority behind them. I would appreciate it if you would send me a copy (reprint) of the report as published. I intend to inquire into this and to bring the matter to the attention of the governing body of the Association at its next meeting in the Argentine Republic. This manner of adopting and promulgating international standards is not correct and should not be permitted to occur. As a report on a professional judgment, it is inaccurate since no consensus was formally adopted by the group in Amsterdam, while as an official judgment of a professional body, it is in no sense representative of the view of the majority of members, for, indeed, the members were not consulted. You may or may not know that I have been editing the original papers presented at 0018369 rcb i,m i the Amsterdam Conference, to the extent that those made available were accepted for publication by the Editorial Board of the Archives. In any case, it is not a little strange that I did not even know about the report until your message. I, therefore, have some reason to be concerned, and I shall make it my business to find out. Cordially yours, RAKiwb Robert A. Kehoe, M.D. Professor Emeritus of Occupational Medicine Dictated but not read 0018370