Document 6wvROkJ3LQ300JeQ9EqDm7e9m

A D D RESS A LL CO M M U N IC A TIO N S TO THE COMPANY Reply to 948 Union Trust Bldg Pittsburgh (19), Pa. Robert F. Col eman, Inc. Engineering - Investigating - Adjusting NATIONWIDE SERVICE 370 LEXI NGTON AVENUE NEW YORK, N. Y. September 14, 1943 CABLE ADDRESS: C O LIN D SER V , N EW YORK Dr. Robert A. Kehoe Kettering Institute of Applied Physiology College of Medicine Cincinnati, Ohio Dear Dr. Kehoe: In accordance with our conversation of this morning, herewith is my thought on the manner in which the lead and medical situation at the Johnson Bronze Company be handled. ...... .... These thoughts are crudely expressed because of lack of knowledge of the subject. I will appreciate your detailed instructions so that a proper program may be installed at once, coupled with your instructions necessary with the proper operation of such a program. During my conversation with you at your office, I have already expressed these thoughts ,but I want to put them down in concrete form in order that I may have a concrete solution and a concrete plan. First, DIAGNOSIS - Example: A man comes into the hospital and recites the usual symtoms of lead poisoning. The nurse will then take his story of the onset and progress of the disease as provided in the rough form attached herewith. / ,,, ' Secondly, the nurse will fill in from the records established by .examina tion of a group of employees employed in a like occupation and tiiis becomes part of this form. Then, sfr blood and urine*-eourrt will be takerpfinstantly so the doctor will have the exposure of the group, this man's story of his symtoms, and etc., plus laboratory tests upon which the doctor can make his diagnosis;:and when this is made, all of the data will be then forwarded to you to check the diagnosis. It is my understanding that this is agreeable to you. But fiieanwhile, so that this man may not lose any time accept in extreme cases, and to overcome the gossip and talk: of "Here's another lead case," it is my understanding that it is safe to give them a shot of calcium intravenous or muscula. \t o - p '/ / J /' Please prescribe the treatment of this nature in detail, the drugs to be used and the amount of doses and the number of doses that can be givenfor immediate relief, thus until you can check the diagnosis andprescribe the treatment, at least until the plant doctor becomes more familiar and has further experience. Can the treatment as outlined, or any other treatment you may recommend for the immediate relief of pain be repeated if necessary until your diagnosis reaches us. I am sure that you know it is not my intention to set myself up as the plant doctor but it is my firm intention to have the plant's doctor's diagnosis of lead to be substantiated by such facts as you may instruct us to obtain for a correct diagnosis. The plant is in no way committed to anyone for laboratory work. They want it done right whoever does it. I am enclosing a copy of the examination report for preplacement now in use. Will you please be so good as to review it, making any changes you recom mend and advise whether or not the present laboratory technician is competent to do this laboratory work. Am I correct in my understanding that you feel the interest of the Plant would be better protected by having spot tests made at your laboratory as well as pre-examinations for all alleged lead effection both blood and urine. What I am trying to get is a report so that, when I check it up or the nurse, we will know for sure whether or not this is a bonified lead case and this includes the safety limits against the results of the laboratory test, in other words, how we could determine whether it is lead or not by the results of the combined examination. I checked up somewhere that the safety limits of air are 1.5 mg of lead per 10 cu. m. I understand the safe limits by analytical results of blood and urine are as follows: mean urinal lead concentration below 0.10 mg per liter, mean blood lead concentration as high as 0.07 mg per 100 gm. Safe limits of stippling has been set at 800 to 1000 per million erythrocytes or 10 to 12 stipples erythrocytes per 50 microscopic fields. What I am driving at is how much lead the normal person can take without having disabling lead poisoning. Another thing that I would like to know and that is about the diet to be followed in bonified lead cases. As you know, they are putting on a combina tion industrial and welfare nurse, and it would be part of this nurse's job to see that the diet is followed out. I am also enclosing outline of Periodic Re-examination. You might be interested in knowing that all of the mechanical devices for ventilation have arrived and are now being installed. HZ 0013927 Page 3 September 14, 1943 It's my thought and, if I am wrong, please don't hesitate to tell me, to do this: to arrange with you for an air and dust test at once. Second, to clean the rafters and all other parts of the foundry, then to have spot examinations made of groups to be submitted to you; to draw rules and regulations relative to safety operations in the foundry including regu lations relating to clothing, baths, eating of food, lunch rooms, locker systems prepared by one familiar with all operations and work of all employees and the manner of performance giving the actual quantities of various metals used in the given time, providing an all over exposure to these metals. The frequency with which alloys of high-lead content are employed in a given period of time, the total output of bearings of high-lead content compared with those of low-lead content. This, we will send you in conduction with the spot examination so that we will end up by having a set of rules and regulations for safety. For you convenience, I am returning your report and your suggestions and your letter to Dr. Perry. We are going to ask Mr. Fishery to put in a sound proof and dust-proof room for examinations in the hospital. Of course, your recommendations relative to the prevention of the return into the foundry of debris now coming back from the stacks will be followed out. I talked to Mr. Flaherty on Saturday and outlined plans along the line of letter enclosed herewith and he is very much for it and wanted to discuss it with his two sons, and he is going to make up his mind Saturday what he'll do, although, he told me that he was very much in favor of the idea and believed that he would go along with us 100$. Consequently, I am anxious to present him this feature of the work Saturday because if anything comes out of my letter, I want to have this part of the work started at once. May I say here, that I have enjoyed greatly my association with you; i am deeply appreciative of your friendliness; to me you're my ''Lead Bible," and my kindest personal regard to you. HRB/ceh Enclosures