Document GQGyaYDxkQpd0X1VGBd4ykwn

L. B. Grant, M.D. April 25, 1977 F. C. Dehn 10 West Medical Surveillance VCM Guidelines I have read the attachments to your April 4 memo several times and have reviewed them with my notes and recollections. The composition and content of the medical surveillance must be a medical decision. 1 am not qualified to comment on the content. If I draw parallels with my physical science background, there is far too much freedom by leaving too many things to the physi cian's discretion. To me this is not a policy because the action of the physicians will be quite different at one plant than at another. I think this can lead to potentially serious problems in the future. Howdo you determine if anyemployee's health will be materially impaired by VCM exposure--the physician's judgement. I think the exposure data for Caribe and Lake "Charles that"you presented Along with Perez-Roig's comments are exemplary of divergent judgements--if there is any significance in the tests being done for VCM workers. I think it may be other chlorinated hydrocarbons at Lake Charles that are complicating the enzyme tests and VCM exposure data. /zak cc: H. B. Lovejoy, M.D. F. C. Dehn SL 0*28?3