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Minutes of Meeting Ethyl Medical Department February 1, i960 Vernon Manor Hotel Cincinnati. Ohio '-sent at Meeting: ybv. Dr. Dr. Mr. Mr. Dr. Kehoe Kitzmiller Princi .i/heeler Cholak Sanders Dr. Schradin Dr. Bock Dr. Sprunk Dr. Brust Dr. Horton Dr. Davis Dr. Kitzmiller opened the meeting at 9*4-5 AM. a s the first order of business, Dr. Kitzmiller requested clarifi cation of the role of Dr. Kehoe as consultant to Ethyl Corporation and to the Medical Department. Dr. Kehoe replied as follows. He described the early history of his relationship to Ethyl Corporation. He stressed the delicate balance of relationships between his university responsibilities ana his responsibilities to the Ethyl Corporation. Since 195-u however, his role has been that of consultant to the Corporation with particular reference to the experimental work performed at the Kettering Laboratory for the Corporation. Ele has been par ticularly concerned where the problems under consideration relate to the matters of the public health. He has continued to main tain relationships with the United States Public Health Service ana the Canadian Government in these matters. In acioition, he has been concerned with the tetramethyl lead program and the organic manganese and nickel programs. Pie stated that his pre sent medical activities for the Corporation were entirely outside cf the day-by-day activities of the Medical Department. Unless consulted by the Medical Department, he planned not to be con cerned with the affairs and operation of the Medical Department. Dr. princi asked the question of who is to decide the priority of reports where individuals have dual responsibility, both to the Kettering Laboratory and to the Ethyl Corporation. Dr. Kehoe answered that the individual with dual responsibility .voulu have to make his own decision as best he could. Dr. princi raised a specific point in illustration of his question. It; had to no with a memorandum from Dr. Horton to Dr. Brust concerning information about the toxicity of AN compounds for an Ethyl brocnure. Neither Dr. Kitzmiller nor Dr. Sanders had been informed of this request. -c- --'-"-os suggested that this was a problem of intra-laboratory uni cation. That properly. Dr, Kitzmilier ana Dr, lancers ..a have been informed by means cf carbon copies of the corre.ence. Dr. Kitzmilier added that generally he would Hire to ive copies of all memoranda concerning the activities of the 1 i-epartment. However, in this instance he thouxnt that trie -nge of toxicological information could b hanclou wi thout irect knowledge. Dr. Kehoe suggested that generally tnese -'ms could be resolved without difficulty but that there a be instances ir. which it 'would be difficult to decios vher gat ions to the university endec and ooil gat Ions to tne Corlion started. He suggested that it would be important to ne responsibilities as carefully as possible to avole future acuities such as might arise in the areas of confidentiality /.formation. .lizmiller raised the question of the handling of confidential . nation by secretaries. Dr. Kehoe replica that in certain ..ness it is essential that secretaries be hirsa specifically ne affairs of the Corporation and be permitted to nar.dle con:.:lul information apart from the general university activities. ..itzniller raised the question which referred to an earlier r.c of Dr. Kehoe1s. Dr. Kehoe had stated that if the organi nai pattern interfered with the accomplishment cf the work of yoarenent that the organizational pattern would have to ce -asea. Dr. Kitzmilier suggesteu that if such were necessary ..me organizational pattern might be altered to avoid inter with the accomplishment of the work of the department. wise brought up the point that it is necessary for the Toxi"m Division to inform the Director of the Laboratory of its "ities even before the Director of the medical Department of .Corporation may be informed about the results cf certain of m-perimental projects that relate to the Ethyl Corporation > -' 'moe suggested that copies of correspondence sent to the 1 ledicai Director are not sufficient to inform the Director Laboratory and that personal and telephone con vers a tier:.-: '-iish the job more effectively, landers suggested that the problems of communication concernexperimental work were primarily a matter of Kettering Lacora- organization and it was not primarily a matter of concern of - pa ical Department of the Corporation. He ala request cluri%* ~-or: of his source of information concerning toxicologic infor-n if he were to remain the liaison between the Kettering Labory ana the Ethyl Research Laboratories at Detroit. w-r.aers suggested that he be informed as to how much Informa ere available about new materials ana wantea to know whether -t ..s -was to ge't his information directly from the Director o lettering Laboratory or from the Director of the Division 1 02250 of Toxicology of the Kettering Laboratory. Dr, Kohce suggested that this problem could r.ct be resolved at a nesting such as she present one. He added thus the Ethyl Cor sera cion has usually re ceived that information which is availuole as promptly as ,/as oractical to provide it. Dr. Kitzmiller added shat an organizational pastern is ceing sot V* IsJ Kp or t he ilea i cal Depart m e nt that will elimin a te t he r. iff i cu 11 ie whi C h ha ve ari s en in txhe pa sc. He asked Dr, K o ho 9 t 0 o lar s - J tne are a o f a c t ivi t ies o f che k stterin K Laboratory cha t -i r P r.o TC ne con c e rn oi the Medic al De pa rtment 0 f che Corpo ra ti o n, Dr. Kenc a sugg 0 steci tha t i t would n o t o e too g iffi c X J. Li t o s e o a -- rat e Vi 5 ur.ct X ons o f the M edical D apartment o f th o un 0 r por a ti or; fro m the a ct i v 1_ ties of th p Ks tterin g Labora tor y as re I a tea to tj rh 0 q ca 1 pro blems of t he Corpor a tion. Dr. keho a cl d ea na t ** p t oxi cc logi c info rmati on of int o rest to the Det r oi t Xj d. b 0 ra - b OX1 i es o z*l j. the c orpor at ion c ould be handled air e ct 1 .7 b j the Di rec- tor of t he Ket t ering La bo ra tory or by t.he pers ens i n c xh e la bo ra- tor V con ce rnea with the t ox icology activities. Dr. Kehoe added that there would be a time when the toxicologic information developed by the laboratory becomes of great impor tance tc the Medical Department. He cited the example of tetramethyl lead in its early evaluation in the laboratory. he also suggested that the transfer of this information from tne labora tory tc the Medical Department of the Corooration could be accom plished easily. . Kitzmiller asked about the priorities of research on new prod ts and as tc whether or not this priority was directed by the eds of the Detroit Laboratory or by pressure from tne Sales bertment of the Corporation. Dr. Kehoe replied tin t ir. t eras of e screening procedures the Kettering Laboratory knows only chat e Etnyi Laboratories at Detroit or at Bator; ucuge nave become "crested in the compounds submit tea for toxicity screening. Dr, Kehoe added that the laboratory is not concerned 'with tne interest of other activities of the Corporation reducing to new compounds screened by the Kettering Laboratory for tne uetreit nucoratory. hr, Kehoe suggested that at the Detroit and Baton Kouge La boratori-3, Drs. Sprunk and Bock were the members of the Medical Department of the Corporation concerned with the problem. Dr. Kitzmiller added that there Is now a consulting team within che Mecical Department to provide information to the medical depart ments at Detroit and Baton Kouge concerning the toxicity of new materials. Dr. Kitzmiller suggested that periodic progress re-- rts from Dr. Brust to the Director of the Lieuical department one Ccrooration 'would he lo the Medical Department in advising nr Z0 the physicians at Baton xiouge and at Detroit of che amount of in formation known on new compounds. Dr. Brust requested information concerning his past failures to provide information to the Corporation. He adcxed the following to illustrate his difficulties. He has received materials from the Ethyl Laboratory at Detroit for screening without any know ledge as to the potential use of the material to be screened. Expensive procedures nay be carried out which contribute no use ful information to the Detroit Laboratories before the Toxicology Division is aware of the potential use of the material. Dr, lie he e suggested that further information be requested from the Detroit Laboratories before any screening procedures have been carried out Dr. Bock mentioned the fact that until a few years ago re repre sented the Medical Department at Baton Rouge and screened all ma terials for the benefit of the Kettering Laboratory before they .vere shipped from Baton nouge to the Kettering Laboratory. In recent years, however, this system has broken ccvvn because of in ternal difficulties at Eaton nouge. Dr, Bock mentioned that prior to the day-by-day medical activities at the Baton Rouge plant were managed by the DuPont medical Staff located at that plant and chat: the Medical Lepart- sent of the Ethyl Corporation had only an informal advisory re- lationship to that department, He added chat the local medical activities at Baton Rou.ge have usually been a matter of concern only to the medical people at Baton Rouge. Hr. Cholak raised a question of his re la tier: snip to the weuicul Department of the Corporation. He wanted to know vvnether or not reports of analytical determinations go to the people in the Cor poration who request the services. The alternative would be the submission of reports to the Director of the Kettering Laboratory, Dr, Kehoe replied that all 'work bone by the Kettering Laboratory for the Ethyl Corporation should be reviewed by trie Director of che Kettering Laboratory or by some person designated by him to re view the reports. He added that chai-gss are made to she Cor poration by the Kettering Laboratory for work dcr.e as a service and therefore are primarily a function of the laboratory He auded that advice and consultation given by members of the Ketter ing Laboratory Staff to the Corporation at the time of visits to the places of manufacture or laboratory development are no t matter of concern to the Kettering Laboratory directly. Dr. Kitzmiller re-enforced the statement of Dr. Kehoe by reading memo from Dr. Kehoe to the Kettering Laboratory Staff ooncernin the furnishing of information directly to the outlying estsolish cents of the Ethyl Corporation. The memo requested cha t all ana lytical information performed for che Corporation by the Ketteri Laboratory be submitted to the Director for review prior to the a sending of this information directly concerned. -y of the ccor oo ra zlc: Dr, Kehoe presented a discussion > . h ^ .-a y*i t* onan.^e In o ? concerning the change in the Limit o:u.d itior of tosraetnvl l^ac to gasoline. recently the Unitec Stairs Public Health Service' agreed that 0 0 0 n s ext e " V** a PS cent log! ca 1 Eff also ent ic has pu bli sh tetr a 0 thyl the industry r.ay _ increa ,; => me loan content of ,-usolIr.-> il oo r jrtilxj.t*wrsh ,,,> Lr * * ^ sir i. w U. u '* Ci cco 0^ s uui/v.4 -a ti/ol xrxt -u; ie IncrJeraMspeh i?n., r*.. at Unit a b -- 1i 0' tt 'ka.bo at. ' ; z ^ c 1 \ ocn tthhee Le:'-"-f '** "` * rD* 0 f ti -*1 P b ]_ i c U EE...a,,xxsopoeeliccr~t.t*e Health S tho expo 0 t 01; a -iatmu.se I: t :i e use 1' The United of n ei the r .iwaxoa o TVU':' ;t;is aUOOteC; an attitude prohibiti r. * the Increase in leaning of gasoline but merely permitting th inuustry to proceeu on its own.. He auaec that the reversal _r; j h n ;n: r by tine ^ottering La boratom on the prohibition of ir.cressm ir.u. rontent of gasoline w 3 in measure influenced by the reports of tine market in 3 people and the Detroit Laboratories that lean cons mint Lon would not go up mark edly with the granting of percuss lor. to iricreuse the icuu limit from t> t*l to g. ml per gallon. Th: r. priviler:e will only be usea in areas where other me tnoas ox Jrtuiic Lug aim octane gasoline are not available to th e refiners. ;ting was interrupted at noon for lunch. Meeting was resumed at 1:00 Pit wi thout Dm Kehoe, Dr, Ki t zmiller called lor question:: r on coming the proceedings of the morning. Dr. Sprunk requested cla r L f i ca t ion of the memorandum, concerning the reporting of Kettering Laboratory analytical resale: Dr. Kitzmiller clarified this and icit aaia th^ desires of Dr, Kehoe tc review all Kettering analytical laboratory aatu trior tr e r.e 1 r c e i n g sent to t ns Various ci 0 p a r t in or. t s of she Coroo ration. Dr, Htzmiller also added shat the j-nu not r: 1 Health Team of th~ Hshy 1 Corooration- Medical D-'pa rtm.^nt at tru' netterin g Laboratory .-.a s ore pared tc go cut to ail oullyir. ; farLIltLea of the utiv'l Co r poration to advise concerning the role that the Kettering Labora tory should play In the control of haza roc at the hesea rc'n Laooratories ana at manufacturing facilities of the Ethyl Corporation, Dr. Litzmiller reaa the announcement ant description of' t.-.e In dustrial Health Team of the medical Deoartment of the Corooration. fhls will be available' for labor Inspection. Dr. Princi elaborated on the concept of the Industrial Health Team as follows. All medical advice to trie company should come from the Medical Director. All meaical control at the plant or research laboratory level should be nuncled through the chief physician at -6 laboratoryj concerned. Dr. princl des or: :f an hypothetical problem starting with oroc -lal. The procsour; uesorioea w* new information as rapidly as pc ssii - * -- JUU" ;his information in a company manual .hi nforma- also be available for des tributior. to other activities 5ration and to Public Health officials who may be con- the public health hazards associatea witn the use of ti. Dr. Prir.ci also describeu the Industrial Hymiene .Ich is in the process of being prepared by ile: Ui ct a. . . grind emphasized the need for an annual report which shoul -- suomiteed to the medical Director. Dr. Princi requested tha '.munications from members of the Corporation Lleuical Department toe laboratory not go to Dr. Kehoe routinely. If It is necsstor Dr. Kehoe to be notified concerning these requests that - so notified by separate communication. . hitzmiller clarified the role of Dr. Brust in the preparation : Zthyl Medical Department manuals. Dr. Brust will furnish in.mat ion available in the reports of the Toxicology Division of Kettering Laboratory and material developed out of r. evv experi r:t ^ 1 w'crk done by the Division of Toxicology. Trust raised the question of responsibilit yV on the part a 1 s n s : rave ling through the Detroit Laboratory who may ce oeo to give medical opinions on the scene. Dr. princi reit- d Z he policy that all members of the Cincinnati Medical De .cent v/no visit other facilities of the Corporation will re time physician on the local scene and that all opinions r 3 c o: .endations be delivered eiths: ;o t. j :i j or ' ur. c t. ,r. with the physicians recommend a tions to tine> l1o. cal peo- Dr Brust raised the question of unofficial reports or. tox- ` J O d* .ies and the hazards of resorting such information to - n p n personnel be: the final i o r nas oeen oozamea Pr ir. 1 replied that r:o information should be given unless e is enough reason to be certain that the answer Is valla. C* _ v, - rs reiterated tnis ooint. Buy Bock commented on the pros zectivs changes ir; the Meaical aecartment structure and in general expressed approval of the iaea. Be old raise several questions, however. i'he first question ns raised was that of titles of persons. He suggested that each plant nave its own plant Medical Director and that the heaa of one Central Medical Department of the Corporation be called Chief Meaical Director of the Corporation. Dr. Bock also rais^a the uestion as to whether or not the plant physician should oe re pons idle for the environmental survey and control of the plant. He was of the opinion that the physician should be concerned only with the detection of illness of individuals who work within zhe plant. There was considerable difference of opinion among other -7- oersons present as to whether the physician should be concern with industrial hygiene problems. Dr. Kitzniller reiterated fact that the Industrial Health Team was designed to provide service to the physician on the local scene. The reports of team will be made to the local plant onysician. The local pi physician will then be responsible for che transmission of th information to slant oersonnsl. Dr. Bock agreed that the Medical Director at the jlar.t coulu be the responsible person if his position in the management scale was commensurate with his responsibilities for the maintenance of the health of the plant. Dr. Kitzmiller surges tec chat Dr. Bock could command any of the resources of the Ileaical Depart ment for the evaluation of problem situations by communicating directly with Dr. Princi. Dr, Bock raised the question, cf the authority of the Medical De partment tc effect any changes in the operation of the plant. His experience at Baton riouge had led him to the oelief that management would have to be changed considerably before they would accept the concept that the Medical Department of the Corporation has authority to effect changes for the purposes of control of health hazards. Dr. Kitzniller suggested that the Medical Depart ment could use its influence if plant management were net receptive to suggestions made by the local medical department. Mr. Chclak raised the question cf whether or net she Inc us trial Hygienist, Mr. V,heeler, should inspect plants without prior announcement He contended that the unannounced a ppearar.ee of she Inc us t rial Hygienist would not be calculated to engender she maxi mum of co-operation on the part cf the plant manager. Dr, Princi agreed and stated that the description of the activities cf the Industrial Hygienist should be re-written so that his visits to plants ana research laboratories be primarily on a scheduled oasis. Mr. ./heeler explained tnat as of the present time he has covered on _y the manufacturing plants. He has been to trie Detroit Latcr^ series once on an informal visit. He has been invites to see ;;i_r. a s Sarnia, but-he has not as yet visiteo that plans. Is was agreed that the Industrial Hygienist ana sne -I no us trial Health Team would submit its report to both Dr. Princi ana to sne local plant Medical Director. The local Meuical Director will then have the responsibility to bring the recomr.enaa cions to the Industrial Health Team to the attention of the olar.t manager. Dr, Bock mentioned that Mr. Turner has recently macie specific rec ommendations in writing to the people who arc in the research ana development group concerning the communications pattern which should be followed for the purpose of handling the healtn control problems. Dr. Bock suggested that the Medical Department look into she specific 0W 9 9 -J 3- - recommendations made by Mr. Turner in this respect to cstermir.e whether or not they are in harmony with the recor.:msncations made by Dr. Princi at this meeting. hr. wheeler brought up the question of the differences of medical practice among che various plants. He cite~ the differences in practice in regard to audiometry ana to restrictions that exist between the Houston plant and the Eaton .\ouye plant. Dr. Princi suggested that such differences in practice be brought up at annual meetings of the Medical department ana oe aiscussed to determine whether or not there are good reasons for differences in oractice. Dr. sock agreed with the desirability of working out detail: Q m policy procedures for the medical departments of all plants at subsecuent meetings. Dr. shoe returned to the meeting at this point. He distributed conies of the reoort of he United States public Health Service concerning the addition of 4 cc of TEL to marketable gasoline. He stressed the points that (1) United States Public Health Service does not have the power to encourage the use of it, (1) that this report is neither a regulation nor should it be intex'pre tea as an agreement between -the United States Public Health Service and the industry to permit the industry to do this. Dr. ivehoe stated that to the best of his knowledge there are no state laws which restrict the use of t etraethyl lead in gasoline. He did mention the pro posed law in the state of California -which will set a maximum al lowable concentration for lead in the atmosphere. Just what this limit will be and how it will be anfcrc"a were not aiscussed. nenoe cesc bed prospective use o: tetramethyl leaa in gascli ; discussed the name of company involved an c the geographical : which this material is to be introduce Dr. Henoa aescrib U is experimental study in which the effects of tetramethyl lead rccmotive fuel were studied in a group of taxi-cat a rive r'e. . scussed the relative toxic ities of tetraethyl leaa an tul tnyl lead. He stressed" the fact that the character ,, as j the exhaust is not changed substantially when tetramethyl leaa Is substituted for tetraethyl lead in gasoline. Tetramethyl lead is considerably more volatile than tetraethyl lead. The rate of skin absorption of tetramethyl lead is much less than that of tetra ethyl lead. Dr. Kehoe has aiscussed the possibility of substituting tetramethyl lead for tetraethyl lead with persons in the Unitea States Public Health Service. These discussions have been held at an informal level. At this point persons in the United States Public Health Service are deciding whether or not a statement should be issued " >1 -g to the public relative to the substitution of tetrametnyl leua for tetraethyl lead. Under any circumstances, it will oe the obliga cion of the Ethyl Corporation to continue to obtain data on the likely effects of tetrametnyl lead on the public health until it is certain that tnese are not significantly greater than those of tetraethyl lean. Inasmuch as TML produces approximately one ana one-half times the octane boost of TEL of the same inorganic leua content. Dr. he hoe will suggest that for the present tine the industry limit the acaition of TML to the extent of 2 cc. Because THL is more volatile than TEL, Dr. Kehoe suggested that the handling problems associated with THL will be greater than those created by TEL. hr. wheeler added that the use of methyl chloride In the manufacture of THL may require more control than was required by the use of etnyl chloride in the production of TEL. Dr. Bock described the prospective plans for following the men at Baton itouge who will be making THL. Only three men will be con cerned directly with its manufacture. The maintenance personnel will be used interchangeably in the THL ana TEL units so that it will not be possible to follow their lead excretion rates as a con trol measure. No data were obtained from the personnel who worked with THL in the development stage. Hr. v/heeler also raised the question of the inaavisabllity of aerating to scrub THL out of the sludge of the manufacture of THL. High volatility of THL makes it inadvisable to do this. How this problem will be handled has not yet been aeciaeu. Dr. Brust described the experimental program contemolatec for the evaluation of toxicity of THL. Dr. Horton described prospective studies of the absorption ar.c excretion of fML as determined by use of raaio Isotopes, .-it pres ent, the laboratory is using tritiatea conpcunas. In the near future they hope to incorporate the use of x*aciur:-D in tetramethyl lead for the purpose of following the metabolism of tetrametnyl lead in animals. Dr. Kitzmiller closed the meeting at 5:55 BH.