Document 85J4m03LqaNR685DvQwpRBOmo

mmmmmoonmmimthb fou^dw w fns flart ' '' OF THE JQHK30H BBQBZB COKPAHY OF gfetf CASTXX. PFMSTIAM*1A iii plant In question was visited on March >0 1942* in th company of Mr. 11 B. Bryant of ROoSbeGr&tL*JFbuiM&CJio%lsSemn* Ino. and his m massociate Mr. McBtil#, and -Mr. 4MM9n V0 an attorney'representing Robert F. Coleman in the case vs. Johnson Bronze Company. She afternoon of this day m a . spent 'largely in-'the discussion of th available facts in the .case. Mention is sad of th case in this memorandum solely for th purpose.of illustrating a point that . .1' i will be referred to later - that there'were no medical records in th possession o f t-h Johnson Bronze Company, from which th facts could be obtained or on which any medical defense against the claim could be baaed. Such facts as were available were fragmentary* wholly In adequate* and so far as they went wore,such as to show that the de ceased been, retained- in employment Tong.after ho should have h m n removed from hazardous load exposure But for th avails ;. : biXity of records obtained by physicians who 'had no rosponsibl lity toward the Johnson Brons Company * th nature of M s illness could not liav been surmised and the assumption that lie died of lead poison ing would have been justified for purposes of compensation. Under pre sent circumstances similar cases can be. esepected to occur* and it is imperative that th management of this industry have th information that will enable it to know th medical status of its employees* not only for the purpose of safeguarding their health but for the protec tion of the industry against ill founded and mistaken claims of occu pational illness. Specific recommendations will b mad for the pur pose of fulfilling this urgent need* in a subsequent part of this 9m mmomsSvast A second visit m s mad to th plant on th* following day, priisarily for th purpose of inspecting the founds:? and ascertaining its status fro an hygienic viewpoint. Conversation with th superia tendent of the foundry, with th engineer concerned with safety, and inwith th foreman and assistant foreman th foundry revealed many significant facts, while detailed examination of th premises fro th top of the roof to the ground floor supplied necessary details concerning th sources of fumes and dusts and th methods undertaken to control their dissemination* Th essential facts m y be summarised without reference to th means by which they were ascertained. The hazards arising from exposure to lead compounds are doubtless th most important to b considered, and. these will receive th most detailed attention, nevertheless there are other potential hazards which should b looked into, such as th exposure to cadmium and to silica* Fortunately th measures which will be reoc&BBs&dod to reduce lead exposure will also help la th case of cadmium. Hi exposure to silica, on the other hand will require same additional consideration. . Tjgad.cam la M amM -g head-containing materials in th atmosphere of the foundry exist in two forms, - (l> fumes given off from mixtures of metals melted at hi$h temperatures, and (2) dusts arising from materials contaminated with lead, fro th condensation and settling of fumes, and fro the fragmentation or virtual pulverisation of metals handled under a variety of conditions* Both .fumes and dusts contaminate th air breathed by workmen. At certain points, such as around th fur* mem and pots,'(the fumes go wherever the pots are taken, and therefore the bays are heavily contaminated at tiros), fumes are given off into the air 'in high concentration fhea fumes are distributed irregularly through the foundry, and no doubt their concentration varies greatly from tiro to tiro* the ventilation of the furnaces ie fairly effective, but the fumes that are removed are discharged to the outside of the plant In such a maimer and at such levels as to provide ample opportunity for their return into the foundry through windows and other openings* The fumes in the bays are not removed effectively, the ventilation her being quite unsatisfactory in volume and design. Bust free the sand-reelalmiag equipment is very badly han dled, and is generously distributed. In general the dusts are removed minadequately but to considerable extent, and these as veil as con densed fumes end debris from the furnace stack (cupalo) drop down on tli flat or gently eloping roofs,front which a portion of them ar swept bads into the shop end all other workrooms of th plant, a well as into the foundry, by every air current or broese that moves la tli proper direction* A very considerable proportion of the dangerous material that ie removed by ventilators and stacks is being reinti4 duced into the plant and recirculated, this being facilitated greatly by the fact that the foundry la under a continuous suction so that contaminated air is being' drawn in at very opening. Inaddition to the reiatroduetlon of contaminated air from th outside, the dust that arises from inadequate housekeeping is pre valent everywhere. Paftera, ledges, sills, and even the top of lockers in the wash-roesa are burdened with dust. This dust is also picked up by the strong air currents and is added to that which ori- of the and are therefor less readily inhaled and nbsorbod. Betm@n~ the inhalation of duet, the p&ptlole' of which are larger than those Kt 0013970 3 dtMceaecL ptrs pooj Pe &sq& t:q so %tio xmvy&wtnno&m ost jo <m j aott 034.jtojejcoir? ptra spoil o% Sure *s4j pae ejsojeq Strrq^oxo Sneqo son op tseat rn.it m&zo %&m\ q %axmm fiesttoasctma -vzxo ^nese^d sepun tr@x vj & otft &q pe^eo^Ptri si? poe e^enb &tpanQj mr, *%tmxC tu jo itoti &m mo m%ww corea the toellottlng of lead ocopoundat both thorns caught in th xtpp&v present difficult tini# stress trill be laid on rooammations to this #3 T* st G p .5 sP p0 p si 3 O0 P> 5 v.i H 0 4 sa B & is 1K P & O O 1 1 <o ri P d 2 A few additional inar justified explanation of attempt m s nad to look into- soa of those factors but z*cords infonsetloa were not readily available* RentIon is made of certain of thes points in order that information may be obtained on them in the future* For ax&xaple* the actual quantities of the various metala used up in_o given period of time provide a good .indose of the oven-all exposwe to these materials* Hone specifically the fre quency tilth -which alloys of high lead content are ployed in a given period of tine, and the total output of hearings of such high lead content as compared to those of low lead content, will give invaluable Ininformation concerning the exposure. other words, other things remaining unchanged* load exposure and the incidence of lead poisoning because of it, will correlate with the quantity and proportional make-up of the product handled In the foundry* The exposure will also bo influenced, by the weather and the composition of the population of the foundry, whether constant, or inconstant by reason of In %rapid labor turnover or rapid increase or decrease in number* well regulated industry it should bo possible to weigh those factors carefully by means of records that are leapt in convenient form for examination* The factors that influence industrial health from month to month ox from season to season should bo surveyed and appraised systematically just as the factors that are directly concerned with production* cost accounting and similar plant activities In addition to the foregoing factors that Influence the soverity of lead exposure* there is oaaclety among the men at present that induces a greater frequency of complaints * Every minor illness is regarded with apprehension* lest it result in serious illness or v in death* 3he correction of the latter situation can be achieved only by medical moans* and th-vrefore somewhat detailed suggestions and 7 rocosmeadations vil! be given along M s line* A considerable amount of attention lias been given by the - laamgoE-ent to the installation of ventilating equipment to correct som of the worst features of the present condition ia tho foundry* The program eontesspl&ted was looked into. It appears to be in accord with the principles that must guide all successful attempt of this kind, in that) (1 ) it provides for the collection of dusts at fusses, rather than merely drawing the out at dumping then into the sur rounding atmosphere to be deposited elsowlier or reintroduced Into 2'the plant i it provides for the introduction of loan tampered air to replace that withdrawn by suction, at (3) it tends to make the ventna t i o n independent of the natural opening of the foundry, in recognition of the fact that the latter serve not to help but to Amunbalance a properly designed ventilating system* far as it goes, the plan appears to be good, end it Is believed that a w of the items of equipment that have been ordered will be wasted. However the equipment will probably not be available for some time and meanwhile a w r y effort should bo m to bring the leed exposure under better control. Moreover, the program contemplated hoe not been designed to complete the Job of ventilation in the foundry* It soasa advisable that careful at detailed attention b given to the possibility of rearranging the foundry before m attempt is made to complete the ven tilating equipment If the furnaces at the pouring operations could b located in one part of the foundry, a carrier system could be ar ranged to convey the molds to the pouring site*. By this mean the hazardous operations could be concentrated in cn well ventilated area, and the men engaged in Intrinsically acm-hazardous occupations would KE 0013973 8 m&not b exposed t lead ft dusts. Th unfortunate aspect of the present lay-out of the foundry Is that most of the workmen need Anot have any lead exposure if the plant wer properly designed. further practical point la that fey distributing the tmsard throughout the foundry it becomes necessary to ventilate It all# The ventila tion must fee unnecessarily expensive, therefore If It Is to be ef fective, and In addition the difficulty and expense of mintaining reasonable temperatures in the foundry in cold weather are greatly multiplied * Th objection has been raised that the us of a conveyor system In a foundry of this typ doe not provide for the many types of alloys that must be used.. This objection does not appear to be valid, since a multiple conveyor system could bo used withsuitipl units of melting and pouring equipment# ' regardless of th equipment eventually installed for the removal of fuses and dusts, this Is but on aspect of the problem. It will fee necessary in any case to set up something approaching adequate meate&X and general hygienic facilities. Without these it will not fee possible to detemin what the hygienic status of the plant really Is now or at any future time, hacking such information the management of the plant will always be in the dark with respect to the likelihood of difficulties among the employees based cm actual . or alleged complaint of occupational Illness# ^E 001397 4 Itoeaaaandatlona X* The first requirement le to sot up a satisfactory typo of nodical supervision of the workmen* Cenverefetlon with Dr* David Derry has served to denonetret* that this c m be dene to the extent of the time that can be made available by Dr* Perry. As time go@ cm it is to be expected that more tisis will need to be given to diroot medical work in the plant* At present what is done should be correct in principle after Which it o m be expanded as conditions re quire and circumstances permit. *fho medical activities that should be undertaken Imediately are as follow i (l) All the mem sow employed in the foundry and all appli cants for future ^ploysent should b# given careful physical examinations, the records of which should be ccasplete* fhes records should be in the custody of the plant physician to be held by him in that degree of professional confidence that accords with ethical medical practice. (s) 111 medical records should contain the history of employment, a satisfactory general medical history, the details of a physical esaaimtlcm, and notations ccmcomlng advice given or treat ment rocoraaended (3) laboratory examinations should be mad in the each man, consisting at a minimum, of examination of the urine for albumin and sugar, ad xamimtion of the blood to detea&lne the- nun bor of erythrocytes, the number and. type distribution of leucocytes, the hemoglobin content, and the number of stippled erythrocytes per million erythrocytes* Other laboratory tests may bit carried out in ac cordance with the requirements of the case at the request of the physi omcian* Storeoscopio chest roc&tge&ogmuss m y be necessary in a Instance KEr 0013975 Ic) specially if t'rnvQ is reason to suspect clgs&fle&nt exposure to Betsilica# as in the ease of some of the solders. -^logical tests also say he required in some cases. In many Industrie these are required routinely. Th# advice of the plant physician on. this point should be followed* (4) All m n whose clinical picture suggests the existence of lead intoxication should have lead detrain#11o m mod on the blood and urine# as a means of cubstantinting or eliminating that diagnosis if local arrangements can b made to have such tests carried out , this work can be don locally. If not# this laboratory is pre pared to carry out such teats at cost for such a period aa may bo necessary for the maintenance of the program recommended* Detailed information on this point will be supplied to Dr. Parry# in the ex pectation that ho as the responsible physician will express his wishes to the management for their consideration. (5) Periodic re-exaiaination of the workmen and periodic rechecfelng of th laboratory findings should be carried out at such mintervals may be necessary aisfl feasible. Ill frequency with which this should be done will depend upon th actual severity of th expo sure encountered by workmen in th foundry. It is anticipated that observations will be mad to determine th extent of the exposure (see later reooBOMBndatlosMi in this regard.)# and that reeomendations as to th f m q m m z of the periodic examinations can b based thereon. In *any case# in view of the facts of recent months It Is believed that th# blood examinations (microscopic) must be repeated at quarterly Intervals * la th case of persons whose condition justifies th sus picion of undue load absorption they will have to be don at more frequent Intervals at th discretion of th plant physician. K- 0013970 11. his opinion justify such examination. He should supervia the nurses in all their work -and should provide standard written orders for the jpm ofhandling of all t Injuries and illnesses In other words he should direct all medical activities In the plant in detail and should keep himself informed of all that transpires that, may be related to health and medicine. (f) Tim plant physician should Inspect the plant carefully at once* and, at intervals, ^e should keep himself familiar with all the operations# with the various types of work in which the men are engaged, and with all changes that take place from time to time, to the end that he will understand the opportunities for hasavd that occur nono&lly or under unusual circumstances. (8) The reconaaendatlon of the physician, with respect to the disposition of men who are ill, end for the transfer of rsn to less hazardous jobs for medical or hygienic reasons,should bo regarded as mandatory. It is only under such conditions ".that he an bo expected to accept responsibility for the safety of the men, and that he can hope to gain the confidence of the men in M s professional efforts on their behalf. J 1 * fh second main necessity is to determine the present mmstatus of the in the foundry* with respect to their lead exposure and absorption* Air analyses have been mad previously, but it is not certain that the results of these ere representative of the facts at present. Certainly they cannot give the information that 1 needed with respect to the exposure of the men* for they fail to take into account lend that may be swallowed as the result of the conditions previously discussed. . It is believed that the best approach to this problem is IS to obtain sample of urine* i M fecea from selected men representative of the various occupations in the foundry sad la the roots accesaory mmto the foundry* This will involve the careful selection of on the basis of their reliability, their general stability with respect to the likelihood* of apprehension on their part, their willingness and ability to follow the simple instructions that are necessary for the ofcollection satisfactory samples, and the length of their service in a particular capacity Men who have been in the employ of the Company for s o t time are especially desirable for this purpose* M l classes of employees should be represented if possible. If this is not possible, a limited number of carefully chosen sen will provide the best samples. The men chosen should spend all their working day in tile foundry* The foreman and assistant foreman, one or two each of the .furnace icon* pourers, solders, shakers, sand conditioners, and checkers may best be studied. A janitor should be included, as wall as a minteswmee man if available, and a laborer who has been spending some i l m in the metal washing room# without entering the foundry A few men from shop areas contiguous to the foundry would also be useful subjects* Containers for the collection of these samples will he supplied in sealed bag * Those should he given to the m n whoa they are ready to- go home, after cleaning up and changing clothe Written instructions will be provided for each man, and in addition oral in structions will be provided for Issuance by the person who accepts the responsibility for this work. . She focal samples will reveal the general magnitude of the exposure to dusts by both Inhalation and swallowing, during the period of a day or two preceding the collection of the sample. Therefore, 13- ftthe samples moat collected after a working day, and not after a mweek-end or holiday The uri plea will show the 'exteat of the - load absorption of the Individual and thereby will Illustrate the severity of the exposure associated with his occupation. Deplete occupational histories an the selected man will have to be supplied to facilitate the interpretstion of the results. The examination records on these men should also he supplied. The analytical work will have to be done in this laboratory , and the offer to do It la based on the belief that it Is necessary for the proper carrying out of the program recosssended herein. The work will be d m at coat* aine this is a non-profit organisation# and an estimate of the probable cost can be arrived at by taking account of the fact that the actual cost of such work approximates $5.00 per sample analysed. 'The express chargee on the shipment of containers and samples will be defrayed by the Johnson Brens Company. Xa comeet Ion with this analytical survey* it is suggested ftthat blood smears on the men w d e in duplicate by the laboratory technician* he to examine one set and we another* 00 as to determine the extent to which agreement occur. This can be arranged by mean of direct correspondence between the laboratory and oumelvee* A report on this work with any additional reeaBBMautetlona that m y be justified will be submitted. - Rote 1 If it should not be feasible to carry out the procedure re- coanended above# it la possible that much the same information can be obtained by the collection of saiaplea of blood and small samples of urino by Dr. Perry in the course of his physical examinations The analyses of feces would be very useful but it can be dispensed with if necessary. The small samples of blood and urine are espe cially adapted to diagnostic work, while those reeosntnded'above arc more useful for determining the exposure. The cost of the analytical work would be the mm (per sample) regardless of the sis and nature of the ample, sine tin analytical manipulations and procedures are practically th 38330. The primary purpose of determining the severity of the lead, hasard is to find out how fan It 1 neescary to go with respect to control measure* and the frequency os' the medical examinations. An additional advantage lies in the fact that such data will provide a hose line fey which to measure the effectiveness of the steps that are taken to reduce the lead exposure. A ser5.es of samples of deposited dust haw been requested is order to determine the significance and the distribution of the dust hasard It la hoped that those can and will 'be obtained and forwarded before any significant changes can fee affected These sam ples consist of the following itemsj Cl) lust from top part of foundry near sand collecting and reclaiming equipment, (S) Rafter dust near men wash-room (2) Other samles (2 or 3) f rafter dust from Identified locations* (ft) fust from the top of lockers in the taen'a wash-room* (5)Finely divided material from, that which la taken to the motel washing rocm. 112. The third major reommendation has to do with the reduction of the present lead exposure in the foundry fey eliminating the vszmmmmvy ingestion (smllowlng) of lead associated, with the present lack of cleanliness on the part of the premises and the men. (l) 2t la entirely necessary that change-room and facilities of satisfactory character fee provided la a suitable location.. There should fee a double locker system, with lookers for the personal clothing of the men In a clean and uaocntami&ated part or room, with additional lockers for the work-clothes la a section or room that la certain to fee somewhat contaminated fey the men whan coming frea their KE 0013930 15* vork* Shoves* baths should b so installed that men oast go into then froQ the unclean side and emerge from then into the clean side* 1 Th&1 this is possible. so*called unolean id should be kept as clean as possible Busts should not be allowed to aoeuanilate (2) other sanitary facilities (toilets# and wash-basins for use before eating), should be so arranged that the wcleaan locker poem v i U not be contaminated by m m going and ceding from their work. (3) A lunch-reesa separate from the msts-roesss should be provided in such a location that it can readily be'kept clean sxid fro of dust and debris. M m must not be permitted to enter it without removing dust from their shoes .and clothing and vaahiig their hands and faces mn(*> Provision mast be made for clothing for who vork in the foundry. All clothing is to b@ furnished on some mutually agreeable basis and provision Is to be made for having work clothing laundered ' (3) Hulaa must b d r a m up, posted, and enforced by su pervision to the end that! . (a | All foundry change clothing before going to work and bath and change before returning, home; (b) That all men. wash their faces and hands and remove dust from their clothing and shoes before entering the lunch-room! (o) That no food or beverage (other than that in drinking fountains) be kept or consumed in any of the work-rooms of the foundry, or in any other place than the lunch-room* (d) That the chewing of tobacco during work hours be dis continued . (This rule is advisable but it may not b feasible to pro- X E 0013981 1 m l g a t and enforce it without undue resentment. In lieu of ouch a rule sen can. he instructed how to handle their tobacco with such cure as largely to prevent its contaatantion } a(6) Good housekeeping can be carried out even in by attention to a few simple principles. (a) All dusts that collect cm roofs, rafters, window ledges and. other fiat surfaces should be cleaned up frequently, pre Wferably vacuum cleaners. (b) All materials containing lead compounds can he kept in limited locations end disposed of before they dry out entirely, fhls applies chiefly to molding sand and debris, which can bo spread about carelessly or kept oleaned up so as not to be picked up by air currents. Other material should be kept in receptacles so far a possible, and when possible should be handled end transported In a moist state. Careful attention to details of this kind on the part of an intelligent and ingenious supervisor or safety engineer will eliminate much needless dissemination of t o t . Co) Host rooms, locker-rooms and lunchrooms must b kept entirely free of dusts, vast and debris. IV* The fourth recommendation 1 a corollary to the third, in that continual supervision of m m and critical examination of current practice is required to procure and m i n t ain safety in hazardous occupations. A tmn responsible for safety, and for the promulgation of safe practices should be delegated to work with the physician and the management in promoting safe practices and in on* forcing adherence to thesas. This Job requite intelligence, tact, human understanding, patience* and persistence. It is best if he has authority but uses it spert'-gly* Accordingly the best results or 1? usually obtained by a technical man* with experience in and rospoasl. bility for production#-vh m i l b respected by the a few* his kneeled# and training* If ho-la agreeable and persuasive at the cam time, M s task m i l be aster. He should see that any regulations agreed upon as desirable and mrnnmrj ar@ circulated understood* and cost* plied with * He should study the plant operations and their hazards and suggest means for improving the former and reducing the latter. April 0 1943 lettering laboratory of Applied Physiology College of Medicine Cincinnatit Ohio . KE 0033983