Document G5L9ZJpZMwrjm2bbMO0LG6dam

February 14, 1951 D r . Robert H. Rotte ltlO Madison Road Cincinnati, Ohio Dear Doctor Rotte : I am sending you herewith some data extracted from our records gathered over the years, beginning with 1928 and running through 1950* Tie information is not as complete as I would like, but it would take a great deal of time, and study to comb the additional information in a precise manner. I' have not load anybody who has had the time to go back to the hospital records and dig up the detailed information- What we have are the notes provided for us by physicians, members of the resident and house staff of the several hospitals involved, plus notations made by one or the other of us in telephone epnversations. As you look over these data you will be struck by the fact that there have been a number of years that have yielded no oases and no information. For obvious reasons I should not want to be quoted too extensively in this regard, but I think there is very little 'question as to what is the answer. B y reason of the changes in the personnel of hospital staffs, this problem has received much, little or no attention from year to year. You will note, for example, in the years from 1941 to 1946 we liad only one case report 2d to as or brought to oup attention. There is very little Cues .ion in my mind that this was the result of preoccupation with other aatbers during_ this period. In later years we had three cases in 1943, six in 1949 and twelve m One might draw the conclusion that there has been an increase in the number of such cases in the population, T i t t S , I doubt very much, 'he same causes* which were tive in bringing about cases in 1950 were certainly active in the previous years. There is nothing really new in the situation. It only illustrates the fact that when the doctors in the community are on the ale r t , and are looking for cases of a certain type, they may well be found. . The history of pica which runs throughout this series of cases is, in my mind, not to be taken too seriously. Anyone who has read any of the lite: ature on this subject in relation to children, will realise tha pica is spoken of regularly as^part of the background. Thus reference to this is very likely to be'made in the history, without very much comment as to its degree. After all the relevance of this history is a matter of degree only, since practically all children put their han^s aid everything else they can find in their mouths during certain periods in their eady life. The problem, therefore, is not so much that these children chew things, but that there are things in their immediate environment which offer oppor tunities to yield considerable quantities of lead. A careful study N 6102 Dr. Robert K^tte - (p) - February 14, 1951 i of the histoiirles of these children might give some _useful information. i The above is particularly true with reference to the specific sources of lead absorption. All too frequently no attempt is made to examine carefully into the household of the child to find the exact source of his lead intake. Most of the hospital records make assumptions on this point without giving the precise information that is necessary. We have here precisely the problem that occurs in industry. Unless one goes to the source of the accident or injury,., he does not know precisely vhat happened. Therefore, I am quite sure that in this- miatter* wo arc making guesses, which may be approximately correct in a fair number of cases, but which in the specific instance are based on inadequate information. ' , I trust that this information will be of use to you, and certainly if I can be of .thy assistance to your committee, please do not hesitate to call upon me. I am particularly interested In seeing to it that tie booklet t.sat is issued lias vise and practical information which can readiiybe <llowed ih the household. With kindest jregards, .' Sincerely yours, RAK ef Enc. Robert A* Kehoe, M. D. Cases of Lead Poisoning In Children Recorded ^ by The Kettering Laboratory by Years (No cases recorded during the years omitted) Y ear 1931 1932 1933 193^ 1935 1936 1937 1938 1939 1940 1943 1946 1947 1948 1949 1950 ' Number o f 2 1 1 1 4 5 2 4 3 5 5 1 2 2 3 ,- 12 Cases , Humber of Fatalities On Blood and Urine 2* 1 1 1 1 * 3 23 2 14 13 5 15 1 11 11 3 35 48 All Years 59 17 47 On Tissue 1 1 1 2 1 1 3 4 14 Comments 1. The histories of exposure as supplied were ill defined in most instances. The full case records may have been more informative. These were not investigated at this time. Paint from toys, furniture, woodwork in house, porch railings and unspecified sources was Incriminated sometimes by implication only, in 16 cases; battery casings us^d as household fuel were implicated in 2 cases; metallic lead toys were involved in 2 instances, one of which was fatal, and a lead nipjple shield was convicted in 1 case. 2. Pica was alleged as a factor in 22 cases. J>. Three of this series of cases occurred at considerable distances front Cincinnati (Philadelphia, Louisville and Cincinnati), the remainder being from Cincinnati or its environs.