Document 6bjoarzLNkGDy0Ra45Zo7YGrd

A N D R E W F U C T C H I , P R E S I DE NT K . C . B A O W N e L L. v i c e P R t S l O i N T J . A . M A R T I N O , VICI PRESIDENT M M Z O L L E A.VICl KtSlOCNT ROBERT LINOLCY I H O F C L O , 60 E A S T 42no S T R E E T NTE W Y O R K 17, X . V M A N FRED BOWDITCH o iRt cTo n o r h e a l t h a n d s a f e t y A p r il 9, 1957 Robert A. Kehoe, M.D., Dir ector Ket t er in g Laboratory Un iversity of Cin cin n ati Eden Avenue Cin cin n at i 19, Ohio Dear Bob: Herewith i s a repr odu ction o f se v e r al ab st r a c t s cu lle d from th e cu r r en t issu e of the Br it ish Jou r n al o f Hygiene. Having in mind your masterful disquisition in the January 22, 1955 issu e o f th e J.A.M .A., I wonder i f you might fe e l in clin ed to pen a few t r an sie n t lin e s to Dr. P er r au lt and h is p a ls. MB: G W En closure no PELLETIN' OE H YGI ENE i' Y b n iu r v . I'.t.'iT G e o t h , O. & R i g n r , K. G. N y blyfr gift n in gsr isk. fA New Risk of Lead Poisoning] \ n rd isk Hy g. Tldsk r, 1956, v. 57, Nos. 9/10, 238-41. The En glish summary appended to the paper is as follow s:-- : " Two cases Of severe lead poisoning are described occurring in workers at a small workshop producing lead glass reflectors. The clinical picture was typical in both cases. Lead and corproporphyrin were found in the urine. Blood examin ation showed basophilic stipplin g of the red cells and a transient thiomlso- cytopenia. i " On inspection of the workshop the arrangements for protection 'again st lead dust were grossly inade quate. The personal hygiene was also below the stan dard required for lead workers. " These case illustrate th at the occupational risk can be great when new methods are used or new pro ducts are man ufactured in small workshops, especially when knowledge of the risks involved is lacking. Lei y, A (irvouKAW iN, Le dosage de l'ure saic'uin e d in s la prevention du saturnisme pro fesso.miel. [Th e Amount of Urea in the Blood with regard to the Prevention of Occupational Lead Poison in g] . l u l l . Multiti. 1`mjessit/iiiicllex. P aris. 1956, Sept.-Oct., v. 17, No. 5, 466-9. The auth ors propound the idea that persons with an abnormal level ot urea in the blood are more predisposed to sustain lead poisoning if exposed to a lead h azard. The abnormal level, however, may be due to some passin g: phase in metabolism ; free sweating mav be a cause,' or abnormal protein diet, especially if associated with alcoholism. Attention to diet may easily abate the abnormal level. An industrial doctor, examin in g for work en tailin g a lead hazard, should proceed with caution. A refusal to pass the in dividual may label him With an in ferior capacit for employ ment and do hint harm in the labour market. And the same applies' to removal from the hazard to safer work. The doctor must proceed carefully, pass the person an d keep a watch on h is further health. Notes on 24 instances are quoted: some with expo sure to lead and an abnormally high level of urea which became n otmal under a dietary ; some with high blood pressure or chronic neph ritis with no abnormal level of urea ; some with lead exposure but no sign s of lead absorption, but an abnormally high urea level ; some intended to face a lead hazard who are found to have1an abnormally high level ; and some with lead absorption and a high level. W hat should be regarded as a dangerous lim it is left undecided. *; E. L. Collin P e k u a u i .t , M., T i i c h a u t , R., Kr.oTZ, B., Bo u d n e , Dr eux, Ci.a v e i ., B. & Ch a i n , F. Su r IVfTicacit de l'E.D.T.A. calcique dans l'in toxica tion satu rn in i professionnelle. |Th e Efficiency of CaEDTA in Occupational Lead Poisoning] Irr/i. Mulini. Projesnionin'llet. Paris. 1956, Sept.-Oct., v. ;17, No. 5, 423-9. [29 refs.] Dis cussion 470-72. An acute case of occupational lead poisoning is described. The man, who was employed in making accumulators, had .been h andling for a year a mixture containing lead. 'He h ad paroxysms of abdominal pain and suffered from con stipation, severe headaches and pain s in the legs. CuEDTA was given by in tra venous perfusions, with rapid removal of all pain s and feelings of mjalaise. The perfusion was given over a period of 2-3 hours twice a day for 4 days and th is course repeated after an interval of 3 days. The headaches and join t pain s persisted until the second course. Punctate red cells soon disappeared from the blood and large amounts of lead were ex creted in the urine. The action of (,'aEDTA is considered at length. It is a chelating agent which means th at it captures lead or other metals from the tissues, converting them into soluble and non-tox.ic salt s; these salts are promptly carried to the kidneys to be excreted. Lead in the soft tissues and blood is first ch elated; then lead stored in the bones passes into the blood where it is chelated in turn. Metals which may be chelated are calcium, copper, lead, mercury, iron and chromium. In order to avoid chelation of normal calcium, leading to hypocalcaemia an d tetany, the calcium salt is used instead of the sodium salt. The lead excreted in the urine may reach 4 tngm. in a ch ild and 10 mgm. in an adult per day. The auth ors prefer, intravenous admin istration , since the contents of the stomach may neutralize some of the ch elating power before the drug reaches the blood. In discussion, a plea is entered for oral adm in istra tion in less acute cases to patien ts in h ospital but treated as ambulatory cases. Possibly EDTA might lx? used prophylacticall.v for workers unavoidably exposed to a lead h azard. EDTA is far less toxic than BA L; indeed no in jurious side effects have been seen. Its possible value in other conditions besides plutnbism has yet to be assessed. A successful ambu latory case is instanced. E. L. I.'ollis Ma y n a r d , L. S. & F i n k , S. The Influence of Chela tion on Radiomanganese Excretion in Man and MOU36. /. I'/iii. In rfstitin tion. 1956, Aug., v. 35, No. 8, 831-6, 3 figs. [12 refs.] Experimen ts were carried out on 9 human patients and on mice. " Mn (h alf-life 2-59 hours) and " Mn (h alf-life 5-8 days) were used as tracers in the investi gations. Mn was administered intravenously. It was found th at while Mn excretion in human beings is mainly faecal, pre-chelation with EDTA results in its almos t exclusive elimination in the urine for about 24 hours. After th is time it again becomes faecal. Experimen ts on mice in dicated th at the Mn excretion curves were divided into fast and slow components, and th at pre-chelation with EDTA not unexpectedly increased the fast component. The authors suggest that free and bound forms of Mn exist in the Exp and th at these may account for the observed behaviour of Mn. 1). G. Htirfetj N 24777.01