Document EmXrXbx5g9D4GmLM0aBZD62vj

April 19, 1961 AIR MAIL R. Scott, M.L'. Shell International Petroleum Company Limited .aedicui :ivision St. ikTpn's Court Great St. Helen's London, jE.C.3. Your Reference: RHS/JK/A.4 Medical Division Dear Doctor Scott: I u..!i sorry to have been so long in replying to your letter of March iota. I've been laboring against serious difficulties to clear up a backlog of editorial work which Las accumulated in my office. This part of my work, in connection with reports and publications of the Laboratory, das grown, and I can no longer keep up with it in the odds and ends; of my time, and my correspondence has had to take second place. Tills is embarrassing at times, and it is always unsatisfactory, but there seems no help for it, for there just isn't enough time for every thing. The problem of the provision of milk for persons who are exposed-to lead is a troublesome one in this country, at times and in certain places. That this is so is our own faulty 'that, is. it is the fault of the doctors, for our brethren in the profession began it. Others in the profession have encouraged it, and various statements have been made about its benefits from time to time, and as recently as yesterday, so to speak. There is simply nothing in the idea insofar as a specific beneficial effect is concerned. Being concerned about this, as the result of questions that were raised by various persons, we took a look at it some years ago, along with certain other recommended prophylactic procedures in the lead trades. I had seen enough of its alleged benefits to be very dubious, particularly when it was used instead of satisfactory measures of environmental control. The best!that could be said for it was that it contributed usefully to tne diets of certain individuals and groups. The worst that could be said was that as a paternalistic gesture of management it tended to salve their consciences and to soothe the discontent of the employees with unfavorable working conditions. Our investigation took the direction of determining what if anything occurred, with respect to changes in the course of the handling of lead in the bpdy -of experimental subjects who were ingesting known quantities of lead over considerable periods of time. (We had looked into this previously by administering milk to patients whose excretion of lead was being determined over periods of months after the termination of an occupational exposure to lead sufficient to result in lead poisoning.) The results of the investigation of experimental subjects were such as to show R. Scott, M.D. -3- April 19, 1361 that no change in the rate of absorption or excretion of lead occurred in association with the administration of milk. It had been supposed by Aub and his associates at Harvard, that the "beneficial effect" of the use of milk by men exposed to lead was attritu table to the influence of calcium in promoting the storage of lead in harmless or essentially harmless form in the skeleton. They hailed this as a desirable measure of prophylaxis. Our experiments demonstrated that tins clous not occur. They went further to show that calcium, in much larger doeses than those associated with the administration of milk, had no such;effect as that postulated. This evidence took away the last shred of support for the use of milk in this manner. In short, the way to prevent lead poisoning is to control exposure to lead ana absorption of lead within satisfactory limits. The adminis tration of milk as a preventive is an empty gesture which is not justified by either theory or practice. I am sencing you a copy of a booklet issued under the responsibility of the .American Public Health association, and formulated by a committee of which I was Chairman. I did most of the work on this booklet, which is now in need of revision in certain respects. Its virtue lies in the fact that nothing is said in it that was not agreed upon unanimously by the members. The statement on page 20, with respect to milk may be htlpful,| coming as it does under the sponsorship of this large organization. Incidentally much of the material in this booklet is still far in advance of the general knowledge of physicians on this subject as well as of hygienic practice in many of our lead trades. I was in London a few days ago (just at the week-end, in passing through on my way home from Rome), and I would have been glad to see you. I had only a very short visit with my daughter, however, and I couldn't get to anyorie but my friends in Associated Ethyl and my daughter. I trust this is not too late to be of help to you. With kihuest regards., Sincerely, RAK s s s enclosure Dock let Robert A. iehoe, fi. i). . Occupational Lead Exposure and Lead Poisoning. (.American Public Health Association) 00 076