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mm .t.itoas. ;at zc t i t 'TO; ,...,,,.~r. &ill/ .or.'... i-o. zmmmm mimmm At 8 p*su on Friday^ ?2nd September* 19 yO, Dr* 8. Bearn, Physician at Dudley Hoad hospital,' Birmingham, phoned Dr* b* Davison, and Informed liisi that he had a case of tetra ethyl load poisoning in his ward, and requested details of treatment, especially as regards the advisability of using hA.L* (dinercaptopropanol)* He had been in touch with Messrs* boots Limited, Bsnufactiirir.g Chemists, Nottingham, who saBxax* fccture this drug, and was roforrod by tiers 'to Dr* Davison* As a result of farther phone conversations on the: sane evening and cn Datnrdayt 23rd Goptenber, it was learned that the can involved *./csonployed by J* Bhelan end Dons, Engineers end Contractors, 2Gb Pitsford Street, iiirsln.ghaot 10, and that L had been or.mj.oyed in tank cleaning in Steurport os about the 12th of the zonth* He was admitted to hospital at 2*9D p,n, on tho 20th having collapsed with abdominal pain* It was learned that there wos another patient involved is the sam incident in hospital at either Sford3icy or iterroridge, and that there were a few c-thcr cases ambulant* ihe Heads of H;e ilensfactvring, Deeretary *s and Operations Dopcrtmonts wore informed in that order* It was decided that Dr. Davison and hr. r.D* Diggs should visit Gtonrport, with a view to providing any help they csi-ld* Dr* J-.n* Higgs will render' a separate report"on tho izieidont* All following net at Gtourportf- hr* A*D*Pywse, Branch Engineer,Hegdnt Cdl Company* hr* h Dal chin* his assistant* "# > D.r* f*0ilehri3t, Assistant to the Chief Engineer, Ha gent Oil Company, London* j Dr# a.a* Diggs, Operations Department,. a .b .c . Dr*H*Davison, Hc-dical Department, A*^.C,' Hho A,?.R*B. was visited, end the site insr-ected* ; .ossrs# J.c. v/helcn, L*V* Coates* and. ># Gascoigne, nwuL''"'oos o<l J* v/helcn end Dons were medically examined by ^.''.tvh^n on the site. Qjidu At 8 T5. *1. Oil - riaay, W*lOl ***OptO;. ICCr, *l8p8, hr '* Hearn* Physician at Dudley Hoad Hospital, Hirsinghan, phoned Dr* H. Davison, arid informed hin that he had a case of tetra ethyl load poisoning in his ward* and requested details of treatment, especially as regards the advisability of using h.A.L* (diaercantooropanol)* He had been in touch vith ifessrs* Idiots limitedj Harmfacturing Chemists$ Hottingkan, who manu facture this drugf and was reforrod by thess to Hr*. Davison* As a result of further Phone conversations on tha sane evening and on Saturday. PPrd September* it was learned that the son involved was employed by *f* Hhelan and Sons, Engineers and Contracuors^au^TPitsford street, Hirsiiiglma 18, and that he had been employed in tank cleaning in Stourport oh about the 12th of the month* He was admitted to hospital at 1*?0 p** on the 20th having collapsed with abdominal pain* It was learned that there was another natient involved in th same incident in hospital at either -iordsley or Stourbridge, and that there were a few other cases ambulant* Hka Hoads of 'Clio daiEifaetuning, Hacrc-tary *s and Operations Departments were informed in that order. It was decided that Dr* Davison and Hr. H*H. biggs should visit otourport, with a view to providing any help they could. ;r, h.r:,bi8:-:s will render a separate report on the incident* 26.9.80. 'The following net at dtonrporti- Hr. A.H.Prowoe, Branch Engineer,Hegont Oil Company* Or. K* Halchia* Inis assistant. Hr# -.Gilchrist, Assistant to the Chief .engineer. Hegent Oil Company, London. H.r* n.B, Hdgg3,` Operations Department, a .h .C. Dr.H.Davison, Hadical Department, A.b.C. *2ho A.F.H.B, was visited, end the site inspected* Messrs* J.C. Whelan* L.V. Coates, and S* Gascoigne, enploveos cf 8* vihslan and Sons were medically examined by Dr.H.Davison on the site* A visit was made to Messrs. 8. Whelan end Aon, d o '.j . Pitsford It*, firminghans 18, the tank cleaning contractors, by Hr. 11* .wolchln, Hr. S,XU Diggs and Dr.k.Dsvison, whore a discussion was held with Hr. 8.J*Whelan, the head of the firo, and his son, hr* v' c. -idcn. A vxsit "was made to Dr.diey HoadHosnital, ...'irnin.'Tham* Dr. d.Davison discussed tax case ofHr* U,Hearn, and subsequently examined the former in the ward, later, a visit KE" 0021350 was made to v/ordsley Hospital, Stourbridge, where the case of Mr*l4Whelan, an in-pationt, was discussed with Dr, walker and Dr, s.V.alincski, residents in the hospital, Mw* Whelan was subsequently examined in the word. A.F.B.P** STOURPQBT Tank History The tank concerned in the incident is a cylindrical rivetted tank, 102 feet in diameter, 25 fact high, 4000 tons capacity, with a fixed roof, mercury sealed, and has two manholes, each approxi mately 30 inches in diameter, one at the bottom of the tank, end one placed eccentrically on the roof, The roof of the tank is at approximately ground level, There is a ditch approximately six feet deep, and throe feet wide, in concrete, surrounding the tank. From the*ditch the embankment surrounding the task slopes steeply away to the ground level* It was stated that Tank Ho* 3 was firstly put into commission sr gallon. In late 1947 the tank was filled with water to a depth of approximately 20 feet. It was out of commission until mid-July, 19o, when the water was removed to about one foot from the bottom* The roof man lid ixad been removed prior to the pumping operation. The bottom man lid was removed on the 8th August* The ventilation of tlie tank was that by natural w through iwo man lius* The tonic had not previously Teen eloped* ark Cleaning Contractors The contractors for the tank cleaning are liessrs* J,Whelan and Sons, 204 Pitsford Street, Birmingham 18* i-txM. gleaning The history of zhe tank cleaning operation is not clear. There are narked inconsistencies in the*stories of the tank cleaners. The following men have been involved in the tank clean ing, and are listed in the_estimated approximate order cf exnoswro to tetraethyl lead! Kif 002135 It would appear that^HBBB^was on the site about the . t'i September, and that^lgM^Kwaswith him on tho 7th and 8th, preparing for the tank Aifl&ning operation, Thev wore orobabiy ip and out of tho tank without protective equipment at this time, i'iioy also arranged for the running of sludge and prepared the pit for the burial of sludge. probably started on the job on about Monday, 11th SeptcHl^^^ymslan was last on the site on to 12th September. His brother, took over his supervisory duties on Wednesday, 13th oepu^SS?* Statements made by jii men regarding time tney von-ied on tm s^to rr z`"ven in the case histories* It vould^raear tha^n^heafternoon of Monday, lltli September, ( ^PHR&nd vHHHIe^tered the tank without any protective respiratory equipment, end were probably in the tank si -Ai 3. from three to four hours* They both entered the tank again in the forenoon of Tuesday, 12th September, and remained there until lunch time* They did not feel veil, so stopped work for the day, On that day. was also in the ttank, hbiut for how Ions it is difficult to determine* stated, that lie was in the tank on both_6ond and Tuesaay, zne jLLth and 12th. V| stated that was in the tank about half to two " ,in his Sesent state of mind, cannot v sure what stated that he returned to the .site on Monday is""is disputed by others* UJ n the .Idb ntermitreni4.y uniilrtne Septe the head of the firs, had been on site tiro wonithooneutdarey spira. tIo*ry pp-rootsescibtiloyne, nateltrheodugthhethtaantkhofoernatersehdortthe tank at all is disputed* Bathing facilities were available at the- blending plant, but wwoorueldnaoptpaelawraythsaut ttilhiseeirdwboyrktihnegseclomtehniIn. ga, their own admission. 'worn underneath the It protective equipment provided by the contractors, was at tiros soiled by the tank contents On approaching the tank on the afternoon of Tuesday, 26th, a marked odour of organic lead was detectable in the ditch surrounding the tank, into which part of the sludge water had been run* Immediately following tills observation, two boro hands appearad from the bottom manhole of the tank, carrying a bucket of slurry, which was decanted into the ditch* hr. Prdvse immediately ordered the cleaners cut of the tank. They mads their exit wearing canalster type respirators, and two of then were ungiov The mn involved were heesrs* nd mm Ihey were clad in cotton' fuxigarGC'^, vnicu we oiletr, . -- 'capes, varying types of headgear and rubber boots, All had -gloves available* During a discussion with the visitins rty, stated that if the party had visited the site the previous day7 they would have seen all wearing positive pressure air line hose respirators, but as they, the cleaners, had antici pated finishing off the tank quickly on that afternoon, they saw out the tank* Dr.Davison took hr.! aside, and had a long con- vernation with him* During t was noticed that I.rl " was wearing his ordinary shirt and tie, both of which wor^EaSned, and that there was a definite^dour of organic lead from the cbthes he was wearing* made various remarks about the difficulty in cleaning, their lack of experience in cleaning this particular type of tank and exhibited a definite lack of knowledge of the hazards involved from sludge bearing lead. It was learned also from this conversation that ho had not slept for some time, had diminution -- * " -*-*-- ~ -- ' horribly tired, not want to give K 002135 un stated that lie was in the rs_,v on both tjjfttvi cv and fu and 3.2th* x&vii Cart J&tnd thatiSBi/as in the task about half to two hours in all* state of mines., cannot ; e sure wnat CCClffTSd* -s-t-a--t-e--d t-h--a--t lie- returned to the site on un*a*v. i3th* Shis is disputed by others^ ___^_ .--------_ ^gy|yRemained oS the bb interniUenuiy Wntil the SSiMKS^WwStKtl^^ the head cf the firs, had been on tee site on one day possibly entered the tank io t a short tiro without respiratory protection, although that ne entered toe tank at all is disputed* Bathing facilities were available at the blending plant, but were not always utilised by these men. cn their own admission. II would appear that their working clothing, worn underneath the protective enuipment provided by the contractors, was at tirs soiled by the tank contents. On approaching the tank on the afternoon of Tuesday, 26th, a marked odour of organic lead was detectable in the ditch surrounding the tank, into which part of the sludge water had been run. Immediately following tills observation, two bare hands appeared from the bottom manhole of the tank, carrying a bucket of slurry, which was decanted into the ditch. Hr* Prows immediately ordered the cleaners cut of the tank. They made their exit wearing cannister type re spirrrfccrn^|n^^f^c^thcnwcrG tmglovc _The three men involved were l iessrs anci HP They were clad in cottonauSfSfeos, wmen were solXe%. wS^erprooT capes, varying types of headgear and rubber boots. Ml Iia^glove^ayailabl* During a discussion with the visiting party, llrSpHHBk stated that if the party had visited the site the prevdousHasy, they would have seen all veering positive pressure, air line hose respirators, but as they, the cleaners, had antici pated finishing off the tank quickly on that afternoon, they saw no particular necessity to Wear air line respirators, especially as tlie sludge which remained to lie removed was scattered through?- out the tank. Dr.Davison took hr. HflHBB saido, and had a long conversation witli hin. During onas, it was noticed that WtK/BBM was wearing his ordinary shirt aid tie, both of which wer^HHId, and that there was a definite odour of organic load from the dbthes he was wearing. Dr HHRl made various remarks about the difficulty in cleaning, their lack of experience in cleaning this particular typo of tank and exhibited a definite lack of knowledge of the hazards involved from sludge bearing lead. It was learned also from this conversation that ho ixad not slept for some tis, Und. diminution of visual acuity, was forcing himself to oat. fe horribly tired, but was trying to work it off, and that he did not want to give up as his brother had done* It is evident tkz this man was suffering from tetraethyl lead Poisoning. He was pale,. ssomewhat aarnaxrilourms,. ar.nnrdl had qm*u4it*e/* a notic*eaa,mble~ xtr.Le._mor of the facial musculature* As a result of subsequent discussion with hr. Prowse, he decided to stop tank cleaning immediately, pending further wineveekss.tigation of the individuals concerned, for at least two K 0021353 All the men concerned in the tank cleaning were interviewed and medically examined by fir*Davison* The following nodical histories should he read in tlie understanding tn'uaaut R--o--s-e o- --f t-ine individuals concerned are disorientated, and that there was some evasion in admission of misdemeanours. These histories are given in the order in which tiie_Jjadi3iluals, medically examined. on the 26th, and^ sn on 27th. i-lEDICAh HISICES' OF 1iiDlVID";ALS 90, Church Vale, West Bromwich, Aged 31j married, no y. Occupation Pipe Fitter* This man had no previous experience of tank cleaning, and ;tated that he started work with Itessrs. J.Whelan and Sons about tnreo cr four weeks ago, and did not know that he would have tank cleaning tno do*. 1hie had no idea of the haszaarrddss involved. (One wa: informed that he had assisted in the tank cleaning operation at Red Mile, near Nottingham, in August). Ha stated that ho first entered the tank about the 11th or X2th of the month, wearing rubber boots and gloves over Ills ordinary working clothes. He stated that the positive pressure air line had a double manifold* and that Mr. Whelan, he took turns to use tills, each being without one for^fWu^half an hour. (Cn subsequent enquiry, one was informed that Mr. Balchin had suggested, the use of a double nanifold, two using the air line to work inside, and the other out- side, each to snond. aonroxinately half an hour in the tank at a time* andboth stated that they did not use any re that he felt well on- the Monday and Tuesday, but on Wednesday, 13th, he felt giddy, had cold "spells", specially in the shoulders. He as sleeoless, and had bad dreams* In one dream he had a very Mad vomited in the evening* He had a "taste like a penny in his mouth all the tine". On the 14th he did not go to Stourport, but stayed in Birs&ngham* His symptoms remained the sane, his sleeplessness being worse. On the 15th lie went to sew his own doctor, whom, he stated, told him he was a "bundle of nerves", end. that -chore was nothing wrong with him* He stayed away from work on the 16th, and 17th, the symptoms remaining more or less the sane. He vomited again in the evening. Hiroughout the day he had suffered with retching. That evening he had a very vivid dream, in which he imagined himself as the Count of iiorito Crlsto. He seemed to be in a tavern when a bully entered, end he challenged him to a duel, which was fought in front of the king and queen* He got very K t 0021354 i* r>t ^vesi in the order in which the individuals were interviewed and radically exaiained, on the 20th, and on 27th, MEDICAL IiI3T0ia~ OF IriDIVlDBAM 90, Church Vale, West Bromwich. Aged 31* serried, no family. Occupation * Pipe Fitter, This man had no previous experience of tank .cleaning, and stated that he started work with Messrs, J.Whelan and Sons about three or four weeks ego, and did not know that he would have tank cleaning to do, lie had no idea of the hazards involved, (Oise was informed that he had assisted in the tank cleaning operation at Red Mil, near Hottingham, in August), He stated that ho first entered the tank about the 11th or 12th of the month, wearing r and that Hr, and he took turns to use tills, each being without one for about half an hour, (On subsequent enquiry, one was informed that Hr, Balchin had suggested the use of a double manifold, two using the air line to work inside, and the other out- side, each to amend anuroninately half an hour in the tank at a time* ^MHB^both stated that they did not use any respirauo^protectAOi^n^he 11th and 12th), This man stated that he felt well on the Monday and Tuesday, but on Wednesday, 13th he felt giddy, had cold "spells", especially in the shoulders. He was sleepless, and had bad dreams. In one dream he had a very bed "row" with his father-in-law, for vhora he has the highest regal'd and respect, lie was very restless, and found difficulty in getting into evim a light sleep# His appetite was poor on this day, and he vomited in the evening. Ho had <?. "taste like a penny in his mouth all the time". On the 14th he did not go to Stourport, but stayed in Birmingham* His symptoms remained the same, his sleeplessness being worse. On the 15th lie went to seo his own doctor, whom, he stated, told him ho was a "bundle of nerves", and. that uhore was nothing wrong with him. Ho stayed away from work on the 16th, and 17th, the symptoms remaining more or less the same. He vomited again in the evening, Tliroughouu the day he had suffered with retelling. That evening he had a very vivid dream, in which he imagined himself as the Count of i-onto Crlsto. lie seemed to be in a tavern when a bully entered, and he challenged him to a duel, which was fought in front of the king and queen* He got very tired during tills duel, but eventually stabbed the bully, and then declared himself to be the Count of Konte Crlsto. (This dream had obviously been very vivid, but it is not of the usual terrifying nature). He also shouted in his sleep one night about a horse he had seen on the cinersa, i He stated that he returned to work at Stourport on the 18th. He could not eat his breakfast on this morning. Be worked for a short time, when he shovelled earth at the sludge pit. The smell from the pit "turned his stomach", so he went home. Ho had drearns again that night, but does not remember tho details. On kET 0021355 the 19th easily# aching an ___ . _ __ felt stiff# He had twitchings in his muscles at this tins* Some oaloitation of the heart at this time, his symptoms remaining more or loss the same* He had no food at the week-end, 23rd and 24th, and on the latter day he started to have diarrhoea, which has persisted since. He *went to the pictures on the 23rd, and had remained ooor. On the 26th he stated that he had had a violent pain in the front of his stomach* from the tine he got tip, and it was still present. It appeared to be in the muscles, and not internal. ~ Intermittently" he had soon double* He had had a rash on his loft leg before starting the tank cleaning, and he states that since the sludge got on to it, it lias been very irritable, and that as had had violent pains in his toes on that side, and at tines has screamed out with the pain. Ho claims to be abstemious 1*4* hah He has retained his soiled works clothing at M3 home. Cn examination he was found to be pale, had an anxious look, tonse and apprehensive* He is of small physique* The temperature was sub-normal* pulse rate slow* and the blood pressure normal. He had marked tremor of his left hand and some slight twitching of the facial musculature, especially around the mouth* The tongue was moderately heavy coated, and tremulous* Hie rash on the left leg has almost healed, and is considered very slight disability. The central muscles of the abdomen, especially below the navol, were tory, cardiovascular and alimentary systems, A sample c.f urine was obtained for analysis, and a specimen of bloo<1U* aO. *n</s4>' moeroscopic examination* Further samples of urine will be obtained from his for analysis. In the meantime, it has been arranged with his employc-r that he be employed on open air work, arid a report cn his condition rendered daily, lie was stated to foci Hnot too bad" on the evening cf the 2?th. SffiMrt The symptoms and signs in this case aro compatible with mild tetraethyl load intoxication* Whether or not the additional ex posure on the forenoon of the 26th will aggravate the existing symptoms remains to be seen, but is considered unlikely. K l? 002135 Fitte2r9.4* Curbury street, Losells, .^irminghaEi 19* A^ed op, g-i'-w-ira xniw> .uuQ j*ud ween employed oy Messrs* J* Whelan and Sons f*or approximately three weeks, and the present tank was his first" experience of tank cleaning. 6 IS* stated that lie started work at Stourport on about the lUth Jeptesber* when he was engaged In pumping, and was outside th tek git day* On the 15th September he was inside? scraping* and ^worked there with an air line hose all day* and ho was dressad in dungarees* rubber boots* and gloves* Ik stated that he fcsi a lot of beer to drink chat night* and* contrary to his usual.custom* he could not sleep* He was restless* but had no dress* On the 16th he did not work at Stourport*. but slept badly thatmght*. On the 17th he was restless all day, -going off his food* and be got no sleep that night buthad no dreams. On the 18thand I9th* lie did not go to work* hod little appetite* but sl<ST?s* On tho 20th be returned to 3tourport* He does not remember how 3a felt that day* but was still off his food* On the 21st he was mt- at Stourport, and had a very bad dream which he remembers vivSSy in which he had to eat maggots* On the 22nd he saw double* and fitat evening ho had a dream 1n which lie was in a long dark tunas!* cad as he walked down, this tunnel* he became smaller and saaHnv On the 25th ho was again at Stourport, and m folt twitchin; in && muscles* He slant better on the night of the 25th than ho had fern for the past week* cM his appetite had improved slightly* fa examination* he was of- normal appearonce, 'FS-v temperature was :s e&2Smk s q 1* the pulse rats and blood pressure '/ere normal, ihe pipils were unequal* Apart from the above, no abnormalities wersTfcund in any of the systems* A sample of'urine was obtained. .nd crrange yants This man is* in our opinion* a mild clinical case of tetraethyl leal poisoning* and even with tlia addend exposure on the forenoon of the 20th* it is considered that ho will become no worse than lie is at posent* and that he should make a recovery within two weeks* 297f Xeknild Street* Hockley, Birmingham 18. Aged 3^, aaaSb&t-. three children*: Occupation Engineer* Son of the owner* He has been' engaged in tank cleaning at various times for tho past twenty years* but had never been engaged In cleaning a tank whhh contained leaded gasoline* nor on so large* He was normally digged in the maintenance of petrol pumps in garages* ha was evasive in his answers, and could not give his work periods and symptoms in chronological order* 1/3 oo He first came on to tho tonic cleaning iob on Wednesday, 13th, after his brother had become sick* and stated that he wore a . CV2 positive pressure air line mask and full protective equipment on O o ihaii day* On the iVth he had & stomach ache* and was sleepless at rSgiit* On or about tho 15th ha saw double and felt week* and tint easily. Ee went off his food, but tried to force himself k to <&t it was noticed 'that no had become pole* He developed a (Ml frontal headache* and heard telephone bells in Ms ears* and^Xsc load the sensation that people were talking to him* Ho hadisora looseness of the bowels, tout no pain* He had a "sick he had a lot of beer to arink chat mgnt* iXLiU. * vuuvtiMj -------s u e1 custom* he could not sleep* He was restless* hut had no dreads. On the 16th he did not work at Stourport, hut slept badly that night* On the 17th he was restless all day, going off Ms food* and ha get no sleep that night but had no dreams* On the 18th and 19th# he did not go to work, had little appetite, but slept* On the 20th he returned to Stourport* He does not -remember how he felt that day, but was still off hi3 food. On the 21st he was not at Stourport* and had a very bad dream which he remembers vividly in which he had to eat maggots* On the 22nd he saw double* and that evening he had a dream in wMeh he was in a long dark tunnel* and as he walked down this tunnel* he became smaller end smaller. On the 25th ho was again at Stourport* and lie felt twitching in his muscles. He slant better on the night of the 25th than ho had done for the past week* end his appetite had improved slightly. On examination* he was of normal appearance, The temperature was sub-normal* the pulse rate and blood pressure were normal* flie pupils were unequal* -^part from the above* no abnormalities were* found in any of the systems* A sample of urine was obtained for analysis* and specimens of blood for microscopic examination* and arrangements have been made to obtain further samples of urine* Comment This man is* in our opinion* a mild clinical case of tetraethyl lead poisoning, and even with the added exposure on the forenoon of the 20th* it is considered that he will become no worse than he is at present, and that he should make a recovery within two weeks* 297, Xcknild Street* Hockley, Birmingham 18* Aged 3*+* married* three children* Occupation - Engineer* don of tne owner. He has been engaged in tank cleaning at various times for the past twenty years* but had never been engaged in cleaning a tank which contained leaded gasoline* nor one so large. He was normally engaged in the maintenance of petrol pumps in garages* he was evasive in his answers, and could not give his work periods and symptoms in chronological order* He first came on to the tank cleaning 3ob on Wednesday, 13th* after his brother had become side* and stated that he wore a positive pressure air line mask and full protective equipment on that day. On the Ihtli he had a stomach ache* and was sleepless at night. On or about the 15th hs saw double and felt weak, and tired easily. He went off his food, but tried to force himself to eat. It was noticed that he had become pale. He developed a dull frontal headache* and heard telephone bells in his ears, and also had the sensation that people were talking to him* He had some looseness of the bowels* but no pain. lie had a "sick tummy feeling in his mouth" * and toothache in Ills front teeth. These symptoms have more or lass persisted since this date until the present tin* and he has tried to "work it off". He does not admit to any improvement, nor to his becoming worse. On examination ho was noticed to be palo, with sono twitchinrfc around the muscles of th mouth and chin. The oulse rate was 60 I par minute, the blood pressure 110/70* the temperature sub-normal* , -HE" 0021358 Some exaggeration of the reflexes, and a slight tremor at the , hands were noticed, out apart from these no abnormalities were detected in any of the systems on examination* A sample of ^rice was obtained at the time of this examination, and a further one obtained when he was seen the following day* Subse quent samples will be obtained from him* Specimens of blood were obtained for microscopic examination* It is considered that this man is a moderately severe case of tetraethyl Iced poisoning* He had exposure also at Red Bile, near Nottingham, before going on to the present tank cleaning job. There is a clinical impression that now he has been re moved from all exposure, and fully appreciates the nature of the condition, that there is a good chance of his making a full recovery without any marked deterioration in ills present con dition# >04 Pitsford 3treet, Hockley, Birminghara* Aged 66, married, throe children* He stated that ho was into tanks at Red Mile, but that he had not been into tanks at Stourport, and had only spent one day there, He did not admit to any symptoms or signs* He was very worried about the condition of his son ho had seen in hospital on Sunday, 24th* He said uUci .............had told him that he had had his appendix out before, end had had Ms appendix out again, and that the stitches were hurting him* He also said that his Michael had told him to go away, when ho visited him, and that hgwanted the bed lifted, and when he tried to fix the pillows, bed said f,Ho, lift the bed*. He said that his son talked a lot or rubbish the whole tins lie was there, and ho was very 'worried because the Sister in the hosnital had asked him if there was any mental trouble in the family* ` lie had assuro^iejMHiGt there was not as far as he knew* Bo had noticed ( r peculiar in his manner before going into hospital, irritable, and worrying about things that wore his, the gaffer's business, and not apparently been very tired, and had had difficulty completing pieces of work given to him. On examination, there was no evidence of tetraethyl lead poisoning. He has an elevated blood pressure. He felt bettor when the cause and symptoms of tetraethyl load poisoning wore fully explained to him* He 3aid ho would take more care in future tank cleaning jobs* He showed clothing used in the jobs wXOhfiicdh# was being sent to the laundry, and which smelt of organic Thore is no clinical evidence that this tetraethyl lead intoxication. :ian is suffering ^ 0021359 :r 133 Antrotoua Hood, Haadsvorth* HirndnghdS!* Aged 42, married. four children. Occupation - Pipe Fitter* -.iw.*-* n a regular employee of J. i&selan and Sons# was examined at Dudley Hoad Hospital* on the afternoon of the 27th* through the courtesy of Pr*G,Heam the nhysicisn la charge* He stated that lie had helped with the preparations for tank cleaning on the 7th an^Tuiordentoriber* and that ho had entered the tank at the sane on the after- v.-^rk was done, the better the bonus* and lie found "old man Whelan** a very docent employer* In reply to a leading question, he said that lie did not its an sir lino mash, and that the let in the pump was blocked* and that they had taken the one out of the air com pressor for tho pump* so that they could carry on with the 30b* He stated that it was "terribleM working in the tank with the smell* 833d he felt -HdrHr 8 short time* At Tuesday lunch .J...1*1 both ho and "felt so bad ..that they chucked the job for the day*7! That evening he fait off his food* did not sleep well* was not greatly troubled with bad dreams* but had some vomiting and diarrhoea* A few days later he had numbness and tingling in his hands and feet* He vomited Intermittently, and his appetite became worse end worse* The sleeplessness continued* and became * if anything 3 more Intractable*. He saw his own doctor* who said it was "nerves" in the first place* He developed some abdominal pain* which became progressively worse* lie saw his doctor again* who had him admitted to Dudley Boad Hospital on the 20th* One of his chief complaints was that he had difficulty in passing water* He has also passed some blood in his urine. He had also been troubled with muscular twitching* and noticed "a very bad shaking in his hands** He had not noticed any particular bad taste in his south* In answer to leading questions* he said that the bathing facilities at the installation were not laid on* and that they did not bathe on the first few days* As far as he remembered* he did not work at Stourport on Thursday* Friday* Saturday and Sunday, the 14th to 17th inclusive, but was there on the 18th* (One has been informed that ho was not at Stourpart on the 18th) Ho further stated that he drove the van to Stcurport on this day* and that the smell of the fumes from tho motor made him feel very sick* II said that at one time he had carried sludge in a waggon to the sludge pit* (There Is no corroboration for this statement)* IIo had been tank cleaning at Fed Kilo* near Jottingham* in aid August* and did not take any protective measures* On examination, his colour was good, his temperature and pulse rate were within normal limits. ..'here was no evidence of tetraethyl lead intoxication* (objectively), lie had still sous difficulty in passing urine, and one had tho impression that lie was still slightly disorientated. - This man, a regular employee of J* Ubelan and Sons* wr.3 examined at Dudley Road Hospital, on the afternoon of the 27th, tSsfough the courtesy of Drd*Hearn^th^Thysician in charge* Sat stated that lie had helped ^HIHHIHflHvslth the preparations 35sf tank'1 cleaning on the 7th and Uth of Sontenber* and that he had catered the tank at the sane tine as on the aftor- saon of Monday, 11th, and forenoon of Tuesdoy^!!5ra September* Bs said that he took no precautions at -all, ;is the quicker the issrk was done, the better the bonus, and he found "old man Whelan" a very docent employer. In reply to a leadinn question* he said Sat lie did not use an air line mask, and that the jot an the pump v&s blocked, and that thoy had taken the one out of the air con- ustBSsoT for the pump, so that they could carry on with the job* & stated that it was "terrible" working in the tank with the shc-11, and he short time. At Tuesday lunch tafc*- both lie anaSHHHHHfc Mfelt so bad ...that they chucked Us job for the day11, xnat evening he felt off his food, did no* sleep well, was not greatly troubled with bad dreams, but had s o bs -vomiting and diarrhoea* A few days later he had numbness and tingling in his hands aid. feet* He vomited intermittently, and hi3 afpetite because worse and worse* The sleeplessness continued, and became* if anything, more intractable* Ho saw his own doctor, who said it was "nerves" in the first place* He developed some sMeminal pain, which become progressively worse* Uo sew his doctor again, who had him admitted to Dudley Hood Hospital on the 2Sh* One of his chief coraplaint3 vss Hint he had dJ.fficulty in passing water* lie has also passed some blood in his urine, ho had bod baste in his south. In answer to leading questions, ha said that :ey rsssembered, lie did not work at Stourport on Thursday, Friday, Sstsrday and Sunday, the lbtli to 17th Inclusive, but was there on tie 13th* (One lias been informed that ho was not at Stourport on tie 1.8thJ. Ha further stated that lie drove the van to Stcurport os this day, aid that the smell of the fume3 from the motor made hla feel very sick* He said that at one tine lie had carried sludge in a waggon to the 3ludge pit* (There is io corroboration fcap' this statement)* Ho had teen tank cleaning at Bed Kilo, near Hcttingham, in mid August, and did not take any protective measures* On examination, his colour ves coed, hjs temperature and prise rate wore within normal limits, -here vras no evidence of tetraethyl lead intoxication, (objectively)* He had still some difficulty in passing urine* end one had the iiaparession that 210 was still slightly disorientated* He admitted defects in memory as to what actually occurred during the tank cleaning operation at Stotzrport* It haa been arranged with Dr. Hearn that samples of blood, urine and faeces will be collected for analysis, to be carried out by the A.^.C., and chat Or, Hearn will render a full report at the tine of discharge from Hospital, which will possibly be in another two or three weeks. .Qggaaafai Tills V* *+?*!* .CO of was the the eases which brought the presont incident A.i.C. Dr. Hoorn immediately connected the to the symptoar Kf 0021361 *3#. 9. of sleeplessness with the cleaning of the leaded petrol tank, and made a provisional diagnosis of tetraethyl load poisoning and then went to look no the resaining syaptoss to confirm his diagnosis* Ho spent the entire afternoon in the local medical library reading the literature on the sublet, which he did not find particularly helpful. Ha has boon given all th assistance within the newer of the Medical Department of this company* _ was a severe case of tetraethyl lead poisoning, snt tiis way to recovery. Belbroughton, Clent, Hear Hagley. 38, married. 2k behaviour of this man is evident from the foregoing case :ies. He was in the tank on the afternoon of tho 11th and morning of the 12th September without protection. He 3iad been gaged throughout August in the cleaning of some tanks at Red _ _lgS Ui 1/U UW4SU&S: admitted on the 18th September to Hordcley Hospital, Stourbridge. On admission, he was seen by Dr. Walker, the Junior Resident, who *K . T *?_ _*> . _ . V_ A 5 - ,, .1^ S *1 J' & m a . m Jt ia <U J"*. >3 -* ... t j >%. -U #*.*, T <"* #. face. He had a sedative, which had very little efface on him* ;ie kept all the patients in the ward awake for a few nights# His condition was characterised by alternative improvement and relapse. Shortly after admission he shouted out 111 have got tetraethyl load poisoning. I am dying* Four other sen have died." On the next day he said T*You had bettor get tho ofchGr four in here, as your treatment is making m well*" later* apparently, he got out of bed, and ran up and down the ward without his pyjama trousers on. Ho also throw food offered to him at a nurse, and made attempts to throw water over the Ward Sister* He also made a dash for the Hard Corridor, shouting that he was going to stop the children crying outside. On speaking to him in tho ward, he was fairly lucid, but had some defecl^^yaciaory, especially or recent events. ICo could not remerabeiJHP^Minama, nor was ho at all clear on the chronological order of tank cleaning* He also mentioned tho changing of tho jot from the air compressor to ths pump. Ho did not see why he should veer respiratory protection when there was a manhole open at the bottom of the tank, and another at the top, and wind blowing throug! After all, lie said he had to get the job don if he were going to nake any money, and it was more difficult to work with -protection. He could not remember whether he had a sister or not, and then remembered that bo had one* He could not remember whether she had any children, and then remembered she had one snail child, './hen nasinkuedtosif^hteerh,adsaawfa,rm, hhnavosaai.d*sn"aHiol ,o"naen"d. thTehnis, hsteastoitiaaennttlyi,ssom wrue. He did not remember his father*s visit on Sunday, nor his oeaaviour on tna day* lie remembered two very vivid dreams, one ynon no was wanting to get into tho corridor, but could not do sc LWSftaUfiA fnY>ir$ A nrrmnn Ann _ .r> ___________ . * ... And ftbiltlvon orvim* KB 0021362 flad psrticuleviy helpful. He has o&m given aLi ane assistance within the power of the 14cdleal Depart,jent of this Company. HBPas a severe case of tetraethyl lead poisoning, and is note^ctt the way fco recovery. Belhroughton, Cleat, Hear Eagley. 38, married. The behaviour of this man is evident from the foregoing case histories. He was in the tank on the afternoon of the 11th and corning of the 12th September without protection* He Iiad been engaged throughout August in the cleaning of soma tanks at Bed kilo, near Kottinirhas. Ho lied been ill since Tuesday, 12th, and changes of temperament became progressively more narked. Ho was admitted on the 18th September to vtordsley Hospital, Stourbridge. On admission, he was seen by Dr. Walker, the Junior Resident, who found m>w markedly mentally disorientated, excited, anxious and apprehensive. There vms a marked tremor of the.heads, tongue end face. He load & sedative, which had very little effect on him* lie haot all the patients in the ward awake for a few nights. His co:idltion was characterised by alternative improvement and relapse* Shortly after admission he shouted out aI have got tetraethyl lead poisoning* X am dying. Four other men have died." On the next day he said mfou had better get the other four in here, os your treatment is making me veil." Later, apparently, he got out of bed, and ran up and down the ward without his pyjama trousers on. Ho also threw food offered to hiss at a nurse, and made attempts to threw water over the Ward Sister. He also made a dash for the Word Corridor, shouting that he was going to stop the children ciying outside. On speaking to him in the ward, lie via3 fairly lucid, but had some defeet in memory, especially or recent events. He could not remember Cart's name, nor was ho at nil clear on the chronological order of tank cleaning. Ho also mentioned the changing of the jot from the air compressor to the tump. He did not see why he should wear respiratory protection when there was a manhole open at the bottom of the tank, and another at the top, and wind blowing througl After all, he said he had to get the job don if ho were going to moke any money, and it was mere difficult to work with protection, lie could not remember whether he had a sister or not, and then remembered that ho had one. He could not remember whether she had any children, and then remembered she had one snail child. When ssited if he had a farm, he said, and then, hesitantly, soma minutes aTte*-, said, MI have a small one"* Th3 statement is true* He did not rosseiaber his father's visit on Sunday, nor his behaviour on that day. He remembered two very vivid dreams, one outside, and he kept trying to go out and stop them. some cionole visioDf a bad taste la the south* oMominal pain* and ho thought ho had had diarrhoea, but was not sure. At the present KF 0021363 'i 10# tins ho is complaining of tingling in lips and tongue* From the ward records* he had apparently no. changes in temperature, and no raarkod changes in pulse rate* -respiratory rat and blood pre-sm?ro* but if anything tlie blood pressure had goae up* At the present tims there are no clinical signs of tetraethyl lead intoxication* although he is still disorientated# Arrangements hove boon made for the collecting and forwarding of samples of urine for analysis* Dr *.V*Kalicrski will render a report when he is dis* charged* which will probably be in two or three weeks* time. Tills isan has been and still remains* a severe case of tetra ethyl lead poisoning* It is noteworthy that although ho gave a load in his delirium that ho was suffering from tetraethyl lead poisoning, no notice was taken* and he was treated as & psychotic case* The diagnosis was realised only after discussion with the two medical officers concerned* Summary and Observations Five cases of tetraethyl load poisoning in tank cleaning are outlined in lay terms* The above report if read in con junction with the report by Mr* K*B*Biggs will make evident tbs dangers of partial or token observations of the imLnirrom precautions necessary for safety in tonic cleaning* As in post unfortunate instances of- this type* ignorance on tbs part of those involved* the proclivity of tank cleaners to take risks, and the particular difficulties in the cleaning of tanks of the typ Involved bring stress on the necessity for efficient* skilled * ' knowledgeable and constant supervision of workmen engaged in cleaning tanks which have contained leaded gasoline* The necessity for the careful observa tion of recommendations for clothing, bathing and handling of con taminated articles is also clearly demonstrated# One would like to express thanks for the help and co-operation extended by the Kegenfc Oil Coiapany Limited in tlie investigation and particularly to hr* R. LalcMn* /<[ _ 0021364 lit m ^AVldCn oo V^U I