Document B8eL0pn19bM3KY4ELeQ57EogL

PLAINTIFF'S EXHIBIT EXX 43 Arwu Y December, 1849* ention had been to pre* imiiar categories in which ould be listed. This has a forlorn hope; conse* npanying table lists, in* > fatalities following oral the dose appears to have ~ town. If this tabulation than direct attention to nrmation on this Impor* lave been well worth as* ians and toxicologists (ties in the current liter* ire known. and Carrol S. Weil) > t)Ol v t ihrl phthalat*. pfpylH abreot ST10N _____________ Reference J*r#e. Sot. xp. Biol A Mod* J04*. ___________ _____ ell* T.: "A Xmim! of ThomneoU Pit, p. Itl, eatr< nd Pjmujm: J. Am. Aoon., 30:01. 1941. I*. oit od, MMJ* H41. tut, and Fnaui No* Kn$, J. asm, it46. 'luorioe Ictojilotion/* 1937: It. MM* 136:460. 1048. U. end R091NS0N: Brit. if. J* 048. ________________ MMM* 70:10* 1041. . clt. nd Fhoiman: JMMM* 1X0$ d. _____ : op. clL. p. 403. .1 op. cit*. p 403. ayt, 70:80* 1046. WmoiiT: J. Lob. A Clin. Mod* 1044. _____________ Sg. J.Mod. Sci., 170:711, 11X8. v OrUont M. A S. J* 01$ L -Yfc, if. J* 1:10, 1044* <nc4t, 241:148, 1048. 4 Rxurx.: Am. J. Mod. SoU 1048. I Dim: Am. J. Mod. Sol 1043. id Tumm: 4*X*ftd PoUoa* at!more. 1044, p. 08. oaa PAam* June. 1043. Industrial Health Programs Pay Dividends MANFRED BOWD1TCH Director of Health and Safety, i Lead Industries Association, i New York, New York tbubt that you will not be disappointed Iwhen I tell you that I have not come here neairn of infodrutshteriaplurhpeoaslethofpcroitginragmsst,attihsteicsexotnentht eocfosts^J>UTyoBuKrt'OinKdEulIgeunncdeertinakoenethoisr exposition, 1 ask two digressions. ill-health in industry or the dollar savings that Firstly, as is the wont of us old gaffers, I may be effected through the impingement of would like to reminisce a bit. When I entered such programs on this aggregate of iil*hcalth. the employ of the Medical Department of the Sufficient reasons for not doing this are to me General Electric Company at Lynn, Massachu three'basic facts. setts, in 1926, I became, so far as I have ever The first of these is that, although a goodly been able to determine, the first industrial number of such cost estimates have been pub hygienist ever to be employed on n full-time lished, among them the quite recent and useful basis by any industry in this country. Honesty one of the New Jersey Department of Health, compels me to add that, being no tread-fearing it ia still true that, because of the variables angoi, I undertook this work knowing next to inherent in the problem, each program is in nothing about industry and even less about great degree a law unto itself in the matter hygiene. I was actually hard put to it to know 'of cost how to describe myself, for industrial hygien I The second it that wc have no worthwhile ists, now so numerous that they have their statistics on the extent or cost of ill-health in national and local associations and can hold i industry, let alone the costs of those physical regional meetings such as this one, were then I and mental conditions which, while perhaps very rare birds indeed. Yet despite these han not so recognised, arc anything but conducive dicaps, it was almost no time before I was to sound morale. And, in my opinion, we will aware of two heart-warming satisfactions. 1 never have such statistics, even ss to those knew that l was doing something definitely diseases properly designated as occupational, worth the effort, and there was apparent evi until they are made reportable by law as arc tuberculosis and other communicable maladies. dence that what I was doing was improving morale. To point up this second fact, let me tell you If tiiere arc amongst us here any younger of a little incident. The president of one of hygienists who sometimes feel that they are a the member companies of our association had bit behind the eight ball or are not wholly remarked to me that I should secure from our convinced that their efforts are appreciated, members reports of ail their lead cases. When a couple of illustrations of what I have just I broached this to the medical director of said may have the germs of helpful suggestion. another of our companies, a far-flung and On thus finding myself a ncophytic atom in admirably operated organization, he came back the G.E. colossus, I got myself a little note with "How can you get them when I can't book and started wandering through the works, get them myself?" looking for situations that seemed to enll for My third and final fact is the obvious one that, with so frail a foundation as to costs, any thesis that I might seek to build in terms of dollar savings would have little validity. So there will be no statistics. This does not mean, however, that I cannot express to you the most sincere conviction that any in dustrial health program, soundly conceived and administered in the light of the real needs cf the company and its workers, will pay divi dends quite as real as, if less tangible than, those which go out to the stockholders. I have that conviction and 1 hope to make clear to you why I have it. correction from some viewpoint of health. Hav ing satisfied myself ns to the proper corrective, I would approach the nmu in charge and nsU him to have tiie change made. The answer was almost invariably, "Why sure!"- -and the date was noted in my little book. When a month had gone by without visible change in the situation, Mr. Doc would be reminded that on such and such a date he had promised to do this or that. Sometimes a second month would elapse, with a seeond reminder, this time citing two dates, and after enough of this had gone on, I was gratified to learn that it was being said around the plant that, if you told Bowditch that you would do something, you "J" <!olr tout Hnrlon.1 Cun- might as well do it, as he would plague the *" n Ind""rUI K**llh` Houston, Tou. October daylights out of you until you did. And then one day a woman worker turned up EM002957 i December, 19W my considered opinion that trial medical men are really 'or this we must hold the t least in part responsible, to know too much about med* <t I have taught in two of '* of medicine, have informed traction given at a number .nk it may in all honesty be as undergraduate teaching ccupationai subjects is connost coses quite lamentably n we turn to post-graduate trial hygiene and medicine, mewhat brighter; yet even eports of enrollment at three Is that came to me only the one too rosy. law of supply and demand ing here. What incentive is i and aspiring M.D. to spend *h and large amounts of his sh in perfecting himself for well be rewarded, despite vith earnings far less than private practice? This questhe steps of industry itself, steps that we must pass in about the enlightenment that before anything approachdequate health programs is .anufacturlng establishments, major difficulties here? One, nuance in some management Id idea that medicai service 1. to be secured at the lowest Dr. Jones will do the job lollars less than Dr. Brown, ously the man for the job. nahility of the front office, laying down the law to its .ments, to conceive of deal* cal department in any other octors who arc really worth tty independent critters and t of being told by a mere should conduct their work, icf that, if the managers of Justries, in seeking medical re, would raise their sights sional ability, salary and that personality, to the level that I could mention, and would give their doctors full g but otherwise leave them ' ions, the schools, the workers oris themselves would all be ast, has had relatively little sh programs in industry, but hanging. With the increased VOL. 10, NO. 4 INDUSTRIAL HYGIENE QUARTERLY /'ape M participation of the workers themselves in the solution of their own hygienic problems, it is to be hoped that there will come an ever clearer realization that, when health is mixed with politics, the former is invariably the loser. Having been a state-employed Industrie health worker for fifteen years, and therefore perhaps knowing whereof I speak, I venture to suggest that, despite their obvious impor tance and accomplishments in the development of industrial hygiene services, somewhat the same hope might bo expressed with regard to the governmental agencies. All of us arc, 1 am sure, painfully aware of tho prolonged jurisdictional wrangling that has marred tho record on both federal and state levels, and all of us who have the cause of industrial health at heart must be glad of the apparent lessening of this quite indefensible bickering. Advances in industrial Health T seem to have managed to throw quite a few x bricks. Now, with your permission, 1 would like to pin on some well-merited posies in each of the above categories, for in at least partial compensation for the over-all lag which I am perhaps too prone to deplore, there have been many truly remarkable advances, for which due credit should be given. Among the industrial physicians there are of course a goodly number who constitute the true leaven of the loaf. It was dr. John j. wittmer of New York's Consolidated Edison Company who said recently, "It is certainly the responsibility of industry to see to it that 'manpower' receives such care and considera tion as is appropriate to its top position in the scheme of our industrial economy. I can't conceive of a plant manager in this day and age, ordering, installing and operating me chanical equipment without (1) determining exactly what was required of the equipm-nt. (2) securing the best equipment for his need*, (3) having it installed by competent mechan ics, and (4) establishing an operational main tenance program to insure optimal efficiency and useful life. Is there any moral or prac tical reason why we should do less for the in dividual, without whom the equipment could not have existed, lot alone be operated?" And another doctor, whom I am not at liberty to name, wrote me not long ago about two lead cases, saying of one that ho "was annealing steel. wires in lead baths, but in addition drinking leaded water out of his own faucets in a country home." To say that such etiological detective work is a credit to the pro fession seems to me but the faintest sort of praise. I need not bo told of the extreme difficulties faced by the medical schools in seeking to fit industrial medical instruction into an ever more crowded curriculum, and I am aware of the success that has met these efforts in some quarters. Confining mention to examples of modical school activity within the state of Texas, the industrial hygiene research labora tory being established by i>r. nau at Galveston bids fair to be a most valuable addition to n group of institutions of which we have ail too few, and the privilege of learning at first hand from dr. Kemf of his plans for the future of industrial medlcat teaching and research at Baylor has added not a little to the interest of my first visit to Houston. As to tho industries, I have already in dicated that there are those whose sights in terms of medical and health service are at a commendably high level. Since so revolution ary a change could not have come about with out the sanction of an enlightened manage ment, it seems appropriate to mention here the transfer last winter of the Socony-Vacuum Oil Company's human relations activities from its industrial relations department to its med ical department, the purpose being to permit the traditionally confidential doctor-patient re lationship to aid in solving personal problems adversely affecting the work of the company's employees. And as an example of excellent yet economical co-operative health activity for the benefit of industry at large, I would like to cite the fact that the smaller companies may secure the benefits of membership in the Industrial Hygiene Foundation of America for as little as fifty dollars a year. That labor is now ready to join with man agement and medicine in advancing the cause of health and safety-in industry on a truly sound basis is evidenced by the Washington meetings being held in an efTort to establish a permanent conference for that purpose, with representatives, of the American Federation of Labor, The Congress of Industrial Organi zations, the National Association of Mnnufaeturers, the U.S. Chamber of t'ommeree and the American Medical Association participat ing. Judging from what one of the medical members of this group has told me, the labor approach to the problem is on a high plane. It seems most unlikely that the recently created National Advisory Committee on In dustrial Health, with ten distinguished mem bers, can fail to notably benefit the Federal Government's industrial hygiene activities. Among the state and local units, of which there are fifty-eight in ail, it can hardly be expected that ail will operate at the same high level of efficiency. Many arc, however, doing excellent work, and I consider it a duty of niy present position to bring about cordial, and mutually profitable relations between these agencies EM002958 Page 98 INDUSTRIAL HYGIENE QUARTERLY December, 19. In the dispensary complaining of back pnln. I went to her work atation and found that she was one of a group who were winding tape insulation onto quite sizeable coils. And I also noted that, though she was inches taller than any of her mates, the Jig at which she worked was at the same height above the bench as all the rest. No appreciable gray matter nor cost were involved in raising the jig to a pro per height, or in auggesting a less arduous method of winding, but it was good to learn that the pain had disappeared, and better yet to have this worker say to me one day, "You don't know what it means to know that some body in the plant cares about such things." is there any one of us here who docs not share my conviction that such simply accomplished improvements pay dividends out of all pro portion to their cost? Industrial Health Programs Lagging vrcT with this conviction of mine goes an- *" other, that industry as a whole has hardly more than begun to appreciate the profit po tentialities of comprehensive health programs. Indeed, if this were not so, there would be little occasion for a paper such as this. So let us try to determine why health work in industry has lagged so far behind the indus trial revolution itself, for only by so doing may we hope to stimulate it to more rapid growth. This cannot but involve aome criti cism of the several parties to the problem, in which I assure you that I mean to be en tirely fair. First of all, it is axiomatic that a health program in industry must be under medical . guidance, for neither the hygienist nor the nurse is adequate to the situation alone. Such guidance, one might think, should be easy to secure, for there are now many full-time doc tors in industry, many more who serve indus try on a part-time basis, and still others avail able as consultants in industrial areas. Why, then, is it not more common? One reason, I believe, is that the concept of Industrial med icine as little more than traumatic surgery is still regrettably persistent. I subscribed to the dictum of dr. Alice Hamilton when she said many years ago that the company em ploying a thousand workers should have a full-time doctor, and 1 still subscribe to it, with perhaps the more modern proviso that it be a half-time doctor and a part- or full time hygienist or nurse. And I will go a step further and say that if this doctor or team of medical workers charged with responsibility for the health of a thousand industrially em ployed men and women do not find their time more than fully occupied, some change in per sonnel is indicated. In short, it is my considered opinion tli all loo few industrial medicul men nrc renl health-minded. For this we must hold t1 medical schools at leust in part responsib I do not pretend to know too much about me ical education, but I have taught in two our leading schools of medicine, have informmyself of the instruction given at a numb of others, and think it mny in all honesty 1 said that, as far as undergraduate teuehit of industrial or orrupntionnl subjects is ro cerned, It is in most eases quite lamentab inadequate. When we turn to post-grndun courses in industrial hygiene anil medicin the picture Is somewhat brighter; yet eve here, to judge by reports of enrollment at thr< well-known schools that came to me only tl other day, it is none too rosy. The old reliable law of supply and demar. seems to be working here. What incentive there to the young and aspiring M.I). to spen years of his youth and large amounts of h none-too-ready cash in perfecting himself ft work which may well be rewarded, dcspii his competence, with earnings far less tha he could gain in private practice? This quo: tion brings us to the steps of industry itsel and it is up these steps that we must pass i seeking to bring about the enlightenment thr. will have to come before anything appronrl ing universally adequate health programs i attained in our manufacturing establishment: What are the major difficulties here? Om 1 believe, is continuance in some managemen quarters of the old idea that medical servie is a necessary evil, to be secured at the lowes possible cost. If Dr. Jones will do the jo for five hundred dollars less limn I>r. Itrowi Dr. Jones is obviously the man for the jol Another is the inability of the front office which is used to laying down the Inw to it production departments, to conceive of dea' ing with its medical department in any othe way. Yet most doctors who are really worn "their salt are pretty independent critters anhave no intention of being told by a mcr layman how they should conduct their work it is my firm belief that, if the managers o all our larger industries, in seeking mcdica and health service, would raise their sight: in terms of professional ability, salary and tha intangible called personality, to the love achieved by some that I could mention, am having done so, would give their doctors ful front-office backing but otherwise leave thenalone, the professions, the schools, the workers and the corporations themselves would all be the gainers. Labor, in the past, has had relatively little to say about health programs in industry, buthis situation is changing.. With the increase- EM002959 I Page 100 INDUSTRIAL l^TGIENE QUARTERLY December, 1940 and our member companies wherever possible. many useful yardsticks for directors when I have been particularly impressed by the Ken they arc wondering whether the company needs tucky industrial health aurvey now being: con-' a new head. After all, the most important ducted by MR. w. w. stalker, director ot the part directors have to play in management is division in that state. - promptly removing the senior oflicor when I hope that, despite the rather rambling: over-all he is found not up to his job--yes, nnd I nature of my remarks, I have succeeded in without wasting time about it. i j making evident my conviction that industrial "By the same token, with today's competi health programs Ho pay dividends. I realize, tion for the most intelligent and efficient work i however, that, having now been engaged in ers, stockholders cannot long afTord directors the promotion of industrial health for nearly who do not realize the importance of top health twenty-five years, I may be suspected of some and safety conditions in their company's little prejudice in its favor. It therefore seems plants, nor managements which do not spend appropriate that I should quote, in conclusion, whatever money is necessary to give plant from two of tho men who pay for these pro people the maximum of health and safety grams, for it they are for them, as the execu assurance." - tive heads of outstanding industrial organiza And finally, I quote MR. Andrew Fletcher, ii tions, it must be for reasons far more practical president of the St. Joseph Lend Company, than mere prejudice. I quote first from an who on a similar occasion spoke ns follows: i address by MR. william b. given, president of "Good health is the most important asset l the American Brake Shoe Company, who said in life. I know of no company thnt has im at a meeting of the Industrial Hygiene Foun proved working and living conditions of its dation: employees that hat not obtained satisfactory "How effectively or how badly a Medical returns in dollars as well as in human hap iI Department functions should be one of the piness." i American Industrial Hygiene Association --New* of the Local Section*-- Georgia Section f\N October 13, the annual dinner meeting was held at Georgia School of Technology. The meeting was addressed by manfred bow- ditch, Director of Health and Safety, Lead Industries Association, New York City on his experiences in a talk entitled "Twenty-four Years of Industrial Hygiene." .- New England Section Collowino the annual conference held in Bos ton on October 28, the following officers were elected: Chairman, dr. f. j. vintinner, Division of Industrial Hygiene, New Hamp shire State Board of Health, Concord, New Hampshire; Secretary-Treasurer, dr. i.eslif. ait.vKUMAN, Harvard School of Public Health. Michigan Section '' f\N NOVEMBER 16, the MICHIGAN INDUSTRIAL hygiene society was addressed by dr. PAUL c. CAMPBELL, JR., of the Dermatoses Sec tion of the U.S. Public Health Service, Indus trial Hygiene Division, dr. Campbell reported on the investigative work which he has con ducted in many industries and particularly on a search for less hazardous chemicals for use in lithography. Metropolitan New York Section QN NOVEMBER 2, 1949, VICTOR K. LaMER, PII.D., Professor of Chemistry, Columbia Univer sity, gave a paper entitled, "Aerosols" in which he discussed briefly the problems and tech niques involved in the generation, size mea surement and use of monodispersed aerosols including a consideration of lung retention as a function of particle size. Philadelphia Section f~\N NOVEMBER 2, GEORGE D. CLAYTON', Chief of the Atmospheric Pollution Unit of the U.S. Public Health Service talked to the section on "Industrial Hygiene in the Study of At mospheric Pollution." Pittsburgh Section NOVEMBER 29, H. K. SCIIRENK, PII.D., Kcsearch Director, Industrial Hygiene Foun dation, spoke at the Section meeting on the subject "Air Pollution." Western New York Section 'T'llIS SECTION has just been organized and is to hold its meetings in Rochester since a large portion of the members live in this vicin ity. The next issue of the. Quarterly will carry a list of the first officers and the pro gram for the remainder of the year. E FO 02960