Document GzZ6NQqNGxzeq65V84k4K09Gx

-i--'-"fv.. At 8 p*m* on Friday^ ?2ad deptam ber, 19 0 Dr* 8. Hearn Physician a t Dudley Hoad H ospital hirrrdnghan, phoned Dr* b* Davison, and Informed liisi t h a t he had a case o f t e t r a e th y l lo c i poisoning in h is ward, and requested d e ta ils of treatm entj especially as regards the a d v isab ility of using h.A .L . (dinercaptopropanol}* He had been in ten ch w ith Kessrs* hoots Limited^ harm faciw ring C hem ists, Nottingham who uarmf a c ta re t h i s d ru g , and was r e f e r r e d by tiers 'to Dr Davison* As a r e s u l t o f fu rth e r phone co n v ersatio n s on the sane evening and cn Datrraay 23rd Dopteiiber i t was learn ed t h a t the saa involved * . / c s e m p l o y e d by J* Hhelan and Dons, Engineers and Con t r a c t o r s , 20b P its f o rd S t r e e t , B ircInshaB 18 a n d 'th a t h had been or.mj.oyed in tank c le a n in g in S to a ry o rt os about th e 12 th o f tire nonth# He was adm itted to h o s p ita l a t 1*59 p*m. on tiro 20th having c o lla p se d w ith abdominal pain* I t was learn ed th a t th e re was an o th er p a tie n t involved i s the saa in c id e n t in h o s p ita l a t e i t h e r Wbr&sicy o r S to u rb rid g e, and th a t th e re were a Heir o th e r cases ambulant* Ihe Heads of aius iisnufa e tu riu g , D eeretary *s and O perations Departments were informed in th a t order* ' It was decided that Dr* Davison and hr. y.h* Higgs should visit htonrport wish a view to providing any help tn8:- cci-ia# ir. .*n*aAgqs will render a separate reoort on the incident* '' hhe following net at Dtonrportt- ir* A*vi*Prow3o ranch Engineer, Hegnt Cdl Cosroany* hr# a* alchin* ills assistant* > D.r* f*0ilehri3t, Assistant to the Chief engineer, Hagent Oil Company, London* |' hr* h*h.Diggs, Operations Departnent,. a .h *c . Dr*H.Davison, hedicol Department, A*^.C,' ^ *Tho A,?.H*D. was v i s i t e d , end th e s i t e Insr-ected# ;.sors# ,jC v ad n ii I.*V* C oates, and. S* Gascoigne, t-?r>i3X'~',rcs c*4 A* Whelan and oens were m edically examined by Dr. GcvJfson"on Cho s i t e . . ' " v" * At 8 p#i3# on Fridsyj ?2sd September, 19 0, Dr D# Hear Physician at Dudley Bosd Hospital, Birmingham, phoned Dr E. Davison, arid Inforaed Mia that he had a ease of ietraethyl .load poisoning in his ward* and requested details of treatment* especially as regards the advisability of using B.A.L* (dimercaptopropanol) He had been in touch with Messrs boots Limited, :^armfact*'ring Chemists, Nottingham, who nanufacturs this drug, arid was referred by thsna to Dr. Davison* As a result of further phone conversations on the sane evening and on 3ataroav^83rd September, it was learned that the ssaa involved was employed by .8 Vfneian and Sons, Engineers and Contracnors* u4* Pitsford Street, Birmingham 18, and that he had been employed in task cleaning in Stourport on about the 12th of the nonth he was admitted to hospital at l.pO p.r. on the 20th having collapsed with abdosinel pain It was learned that there was another patient involved in the saeo incident in hospital at either Bordsley or Stourbridge and that there wore a feu other cases ambulant* Ihc loads of olee 1!eziufeeturieg, Secretary's and Operations Departments vero informed in that order it was decided that Dr* Davison and hr. h*H Biggs should visit otourport, with a view to providing any help they could* ;r* M M B i g - s will render a separate rsoort on the incident '' 2he following net at Stourporti - hr A,Vi.Prouse, Branch Engineer,Begent Oil Company hr H* Balchin* M s assistant. " hr* -Gilchrist, Assistant to the Chief Engineer, Hogent Oil Conpony, London. ' hr* h.h.vdggs, Operations Department, a b C. DrS.Davison, Eedicol Department, ABC 2ho A.F.K.B, was visited, and the site, inspected* Messrs J.C. Whelan, L.V* Coates, and 3*- Gascoigne, enploveos cf T* Whelan and Sons were redu-cally examined by Dr.D.Davison on tho site '. _ A visit was made to Ecssrs. 8. Whelan and Don, ;>ob pitsford At, Birmingham 18. the tank cleaning contractors, tv Br~B~ .wolchln, *ir* B*B.Diggs and Dr.E.Dcvison* whore a discussion \mu held with hr 8 *JWhelan, the head of the firm, and his scr.'hr* v P ...~ldC11* A visit was made to Dudley food Hospital, tirningiicia Dr. .Davison discussed tax case cifOflHIflfcwith Dr* U.liearn, and subsequently examined the former in tho word later, a visit was made to Wordsley Hospital, Stourbridge, where the case o:f Hr*M,Whelan, an in-pationt, was discussed with Dr, walker amid _Dr, s.V.Kalincwski, ressiiddients In the hospital, M * Whelan wTns subsequently examined in the word. A .F .K .D .* STOURPQBT Tank History The tank concerned in the incident is a cylindrical rivetted tank, 102 feet in diameter, 25 feet high, hOOO ions capacity, with a fixed roof, mercury sealed, and has two manholes, each approxi mately 30 inches in diameter, one at the bottom of the tank, and one placed eccentrically on the roof, The roof of the tank is at approximately ground level. There is a ditch approximately sis feet deep, and throe feet wide, in concrete, surrounding the tank. From the ditch the embankment surrounding the tank slopes steeply away to the ground level* It was stated that Tank I:Ic, 3 was firstly put into commission in 19b7, and used for base spirit. From 19**1 to early 19^7 it had contained leaded gasoline, some of which contained 5*5 c*c, T.F.L* nor gallon. In late 19**7 the tank was filled with water to a depth of approximately 20 feet. It was out of commission until mid-July, 195 when the water was removed to about one foot from the bottom. The roof man lid Siad been removed prior to the pumping operation. The bottom man lid was removed on the 8th August, 'The ventilation of the tank was that by natural wind through the two msn lius. The tank had not previously Teen cleaned. Tank Cleaning Contractors TIi contractors for the tank cleaning are ilessrs. J.Whelan and Sons, 2Gb- Pitsford Street, Birmingham 18. Tank Cleaning The history of zhe tank cleaning operation is not clear. There arc marked inconsistencies in the'stories of the tank cleaners. The following men have been involved in the tank clean ing, end are listed in the estimated approximate order cf exposure to tetraethyl leads " '' ` ' end It would appear that. __jwas on the site about the on September, and thati bWas with him on the 7th and 8th, p.repar,ing for the ^tahF operation. They were probably iii ana out of the tank without protective equipment at this time, noy also arranged for the uunningwof sludge and prepared the pit ior toe burial of sludge. probably started on the job Set t e ^ ^ ^ ^ ^ j l a n w a s last on the site on w;0 12th September. His brother, took over his siipervlsoi'y duties on Wednesday, 13th oept^5S?, Statements made non regarding vug fcici<ss tJiGy vorliGd on 'clie s^to cx*& r^ven in toe case histories, ` ,, ^o^l^^uear tlia^oi^heaftomoon of honday, lltli 002135 ji .1 from three to four hours* They both entered the tank again in the forenoon of Tuesday, 12th September, and remained there -until lunch time. They did not feel veil, so stopped vork for the day. On that day, f l H | | B u s s also in the tank, but for how long it is difficult to determine. stated, that ha was in the tank on both I&nday and ^aesIay^Sellth and 12th* stated that t H H H wa3 in ^ie terik half to two Ubu*- .in n i ^ a sent state of mind, cannot te sure what ____ stated that he returned to the ,,site on Monday. ibis' is disputed by others. ___ GB&<H fe B B ^ ^ M B K ?e m iu y 2g i ^ ?>nn ztnhee ,jjoobo minvteerrizmzixu.'rzoemnuiji.yy ux na iuiiiXx" tuune 0 1 S e p t e S B e r ^ ^ r T ^ l B B B H B l the head of the firm, had been on the site on one day only, a m possibly entered the tank for a short tiro without respiratory protection, although that he entered the tank a o a.11 is disputed. Bathing facilities were available at th.e blending plant, but were not always utilised by these non. cn their own admission. It would appear that their working clothing, worn underneath the protective equipment provided by the contractors, was at tires soiled by the tank contents. On approaching the tank on the afternoon of Tuesday, 26th, a marked odour of organic lead was detectable in the ditch surrounding the tank, into which part of the sludge 'water had been run. Immediately following this observation, two bare hands appeared from the bottom manhole of the tank, carrying a bucket of slurry, which was decanted into the ditch. *lr. Prows immediately ordered the cleaners cut of the tank. They mads thoir exit wearing canaister type r e s p i r a t o r s ^ m d t w o cf then were unglo three iron involved were Messrs. f B M I B B f e and " They were clad in cotton^ungareifj v n x e ^ e W soliJtR ___ 'capes, varyji-n.*g*0types of headgear a'n~`*d*'*-r*ubber boots. AAllll loves available. D"uri`ng a d`i`scussi`on wi.t.h..the vi-si-t-ing narfcy, stated that if the party had visited the site the previous day, they would have seen all wearing positive pressure air line hose respirators, but as they, the cleaners, had antici pated finishing off the tank quickly on that afternoon, they saw no particular necessity to freer air line respirators, especially as the sludge which remained to be removed was scattered through out the tank. Dr.Davison took aside, and hod a long con CsJ versation with him. During iiiiii, it was noticed that r.n 002135 was wearing his ordinary shirt and tie, both of which w o r ^ i a S n e d , ana that there was a deflnit^odour of organic lead from the clothes he was wearing. mad various remarks about the difficulty in cleaning, their lack of experience in cleaning this particular type of tank and exhibited a definite lack of knowledge of the hazards involved from sludge bearing lead. It was learned also from this conversation that ho hod not slept for some tine, t T3Ual.ac^it;y? was forcing himself to eat, felt horribly tired, out was trying to worx it off, and that he did not want to ruve up as nis brother had done. It is evident that this nan was suffering from tetraethyl lead poisoning. He was difficult to determine. , stated that ho was in the teak on both stated that _ in occurred^ Monday ffSe s`aa^ennsadt Txsxttqhas<e't.etoafsWkmlianbldot,uthchaaannlndfot1t2o-teht*wsourBheeowruhtrasCtairst all jgpj0 stated that he returnedtouh^si't^^n MRaSniones?ndnr,d?tta^r.y^^,^elor.a8ethd.ayaoi a is disputed by others* M B I P H H L opined on the oh intermittently unt*l w2 ^ the head of cnc firm, sed oeen on H y ^ M possibly entered the tank for a snort tine without respiratory protection, although that ne ontoreu ts tenic at all is disputed* Bathing facilities were available at uao clouding plant, wore not always utilised toy_ these co tiueir own adisission* would appear that their working clothing, worn undomoath tne protective ouipment provided by the contractors, was at soiled by the tank contents. L&f'Xi. On approaching the tank on the afternoon of Tuesday, 26th, a marked odour of organic lead was detectable in the ditch surrounding tho tank, into which part of the sludge water had been run. Immediately following tills observation, two bare lands ippoarod from the bottom manhole of the tank, carrying a buc,~ "' of slurry, which was decanted into "biiO ditch. Hr* Prows icmediately ordered the cleaners cut of the tank. They TMsuds tkcdr exit wearing cannlster type r e s p i r a t o r | ^ m | ^ f e f ^ ^ b c a w e r e usglovt The three iron involved were Iiessrs F " They were clad in cottoasTO^Sfecs, y m e n were soiled,. capes, varying types of headgear and rubber boots. M l nad rrioves available. During a discussion with the visiting party, stated 'hat if the party had visited tho site the previous cay, they would have seen all veering positive pressure, air line hose respirators, but as they, the cleaners, had antici pated finishing off the tank quickly on that afternoon, they sjaaww no particular necessity to Wear air line respirators, especially as the sludge which remained to }je removed was scattered through?- out the tank. Dr*Davison took Mr* aside, and had a long COB-' versation with him. Xu*ing this, it was noticed that _____ was wearing his ordinary shirt and tie, both of which were and that there was a definite odour of organic load from the dbthes he was wearing. Mr made various remarks about the difficulty in cleaning, thoir lack of experience in cleaning this particular type of tank and exhibited a definite lack of knowledge of the hazards involved from sludge bearing lead. It was learned also from this conversation that he ixad not slept for some time. Und. diminution of visual acuity, was forcing himself to oat, felt horribly tired, but was trying to work it off, and that he did nloott want to gz?i1vvqe upn ansa hisa brnotthheesrv h-vawdl done. It is evident 4 this man was suffering from tetraethyl lead Poisoning. He was pale, somewhat anxious, and had quito a noticeable tremor of the facial musculature. As a result of subsequent discussion with hr. Prowse, he decided to stop tank cleaning immediately, pending further investigation of the individuals concerned, for at least two weeks. K 0021353 All the men concerned in the tank cleaning were interviewed medically examined 'by xr#Davison* lie following radical histories should he read in the understanding that some of the individuals concerned are disorientated, and that there was sos evasion in admission of misdeaeanours*^ ^These histories_are_ ^ MEDICAh HISTORY OF XiiDIVIDHALS 90, Church Vale, Meat Bromwich* Aged 31 , starPied, no y* Occupation - Pipe Fitter* This aan had no previous experience of tank cleaning, and stated that lie started work with Messrs* Whelan and Sons about three or four weeks ago, and did not know that he would have tank cleaning to do* lie hod no idea of the hazards involved* (One was informed that he had assisted in the tank cleaning operation at Red Mile, near Nottingham, in August)* Ha stated that ho first entered the tank about the 11th or 12 th of the month, wearing rubber boots and gloves over his ordinary working clothes. He stated that the positive pressure air line had a double manifold, and that Mr. Whelan, M H M I p a n d he took turns to 'use tills, each being without one f o r ^ W C f t h a l f an hour* (Cn subsequent enquiry, one was informed that Mr. Dalchin had suggested, the use of a ^double manifold, two using the air line to work inside, and the other out side, each to snond anuroximately half an hour in the tank at a time* ar-d both stated tliat they did not use any respSrsto^r protection off the 11th and 12th), This man stated that ho felt well on the Monday and Tuesday, but on v/ednesday, 13 th, he felt giddy, had cold "spells", specially in the shoulders. He was sleepless, and had bad dreams* In one dream he had a very had "row*1 with M s father-in-law, for whoa he has the highest regard and respect* lie was very restless, and found difficulty in getting into even a light sleep* His appetite was poor on this day, ana ho vomited in the evening. Ho had a "taste like a penny in his mouth all the time". On the lM;h he did not go to Stourport, but stayed in Birmingham. His symptoms remained the same, his sleeplessness being worse* On the 15th he went to sew his own doctor, whom, lie stated, told him he was a "bundle of nerves", and that -chore was nothing wrong with him* He stayed away from work on the 16th, and 1/5 17th, the symptoms remaining more or less the sane. He vomited CO again in the evening* Tliroughout the day he had suffered with --H retching. That evening he had a very vivid dream, in which he CV2 imagined himself as the Count of iiorito Crlsto. He scorned to be o o in a tavern when a bully entered, end he challenged him to a duel, vnicii was fought in front of* the Icing and queen* He got very vetuol2y stabbed the bully, and then 'It ucclwTed uimself to be tno Count of Monte Crlsto* (This dream bad ho obviously been very vivid, but it is not of the Gsual t e r r i ? ^ nature;, he also snouted in his sleep one night about a horse e had seen on the cinema* In the order in which tiso individuals were interviewed and medically exaininadjjm^L^ on the 26th) and on the 27th, . L2SPICAL HISTORY OF INDIVIDUALS 90, Church Vale, West Bromwich. Aged 33., married, no family. Occupation * Pipe Fitter. This man had no previous cu-cporienco of tertk .cleaning, and stated that he started work with Messrs, J.Whelan and Sons about three or four weeks ago, and did not know that he would have tank cleaning to do, Ue had no idea of the basars involved, (One was informed that he had assisted in the tank cleaning operation at Bed Hilo, near Nottingham, in August), He stated that ho first entered the tank about the 11th or 12 th of the month, wearing rubber boots and gloves over Ills ordinary working clothes. He stated that the positive pressure air line had a double manifold, and that Hr, und he took turns to use tills, each being without one for about half an hour, (On subsequent enquiry, one was informed that hr, Balchin liad suggested the use of a double manifold, two using the air line to work inside, and the other out side, eachtc^jrand aucrosimately half an hour In the i-ark at a tine* stated that they did not use any respiratory p r o t e c t S H ^ f ^ h e 11th arid 12th), This man stated that he felt well on the Monday and Tuesday, but on Wednesday, 13 th he felt giddy, had cold "spells", especially in the shoulders. He was sleepless, and had bad dreams. In one dream he had a very led row" with M s father-in-law, for whom he has the highest regal'd and respect. He was very restless, and found difficulty in getting into even a light sleep# His appetito was poor on this day, and he vomited in the evening. Ho had a "taste like a penny in his mouth all the tine". On the lHth he did not go to Stoumort, but stayed in Birmingham. Ui3 symptoms remained tiie same, his sleeplessness being worse. On the 15th lie went to sat his own doctor, whom, he stated, told him ho was a "bundle of nerves", and that there was nothing wrong with him. Ho stayed away from work on the 16th, &aind 17th, the symptoms remaining more or less the sane. He vomited again in the evening, Tliroughout the day he had suffered with retelling. That evening he had a very vivid dream, in which he imagined himself as the Count of 1-onte Crlsto. He seemed to be in a tavern when a bully entered, and he challenged him to a duel, which was fought in front of the king and queen* He got very tired during tills duel, but eventually stabbed the bully, and then declared himself to be the Count of Konte Crlsto. (This dream had obviously been very vivid, but it is not of the usual terrifying nature). He also shouted in his sleep one night about a horse he had seen on the cinema. i * .. He stated that he returned to work at Stourport on the 18 th. -is could not eat his breakfast on this'morning. lie worked for a short time, when he shovelled earth at the sludge nit* The smell from the pit "turned his stomach", so he went home. Ho ihad dreams again that n$.fTvh. Tmt fines not rewnnh' f^e% nOn HE 0021355 the 19th he worked In fitting ohs, but felt very weak, and tired easily. His arms and .legs felt very heavy and he_ felt cold and aching all over, particularly in the legs and thighs which also felt stiff. He had tvritehing3 in his muscles at this tins. Some of these caused quite violent "starts*'. According to M s statement, he was again at Stourport on the 20th and 21st* He suffered from palpitation of the heart at this time, his symptoms remaining more I;*r. loss the samtoe*. iHfe IhiaAfdl wnso ffotond nat the week-end., 23^rrtdl and P2U-th*, and on the letter day he started to have diarrhoea, which has persisted since. He *went to the pictures on the 23rd, and had difficulty in seeing the picture. He felt as though ho wore very far had':* Ho slopt badly on the 29th and 26th, and his appetite remained poor. On the 26th he stated that he had had a violent pain in the front of his stomach, from the time he got up, and it was still present. It appeared no be in the muscles, and not internal. Intermittently he had seen double. He had had a rash on his loft leg before starting the tank cleaning, and he states that since the sludge got on to it, it lias been very irritable, and that he had had violent paizis in his toes on that side, and at Atimes v - -i f has screamed A * out with the pain. Ho claims to be abstemious Ho has retained his soiled works clothing at M 3 home. Cn examination he was found to be pale, had an anxious look, tons and apprehensive. He is of small"physique, The temperature was sub-normal, pulse rate slow* and the blood pressure normal. He had marked tremor of his left hand and some slight twitching of the facial musculature, especially around the mouth. The tongue was moderately heavy coated, and tremulous, Hie rash on the left log has almost healed, and is considered very slight disability The central muscles of the abdomen, especially below the navol* were extremely tender. There was no evidence of nyotatie (muscular) irratibility, apart from the face. Apart from the defects noted above, no abnormalities were found in the centra nervous, respira tory, cardiovascular and alimentary systems, A sample of urine was obtained for analysis, and a specimen of blood for mocroscopic examination. _ Further samples of urine will be obtained from his for analysis, n the meantime, it has been arranged with his employer that he be omployod ^on open air work, arid a report cn his condition rendered daily, lie was stated to foci "not too bad" on the evening cf V'.e 27th. SffiMrt Tlie symptoms and signs in this case are compatible with mild tetraethyl load intoxication. Whether or not the additional ex posure on the forenoon of the 26th will aggravate the existing"' symptoms remains to be seen, but is considered unlikely," Kl ? 002135 29^i* Curbury street, Lozells, -^irulnghaEi 19, A^ed o? Fitter. xhis :.an had been employed by hessrs, J.wfceian end Sons for approximately three weeks, and the present teak was M s first" .1 tv i- > ' / ' 6. 3i stated that ho started work at 3tourport on about the lU-th^September, when he was engaged in pusaping, and vas outside t.ViA m*r pti day* On the l^th September he vas inside, scraping, andi* worked there with an air line hose all day, sad ha was dressy in dungarees, rubber boots, and gloves# he stated that he bal a lot of beer to drink chat night, and, contrary to his usual,custom, he could not sleep# He was restless, but had no dress#: On the 16th he did not work at Stourport,- but slept badly thatmght*. On the 17th he was restless all day, -going offhis food,: and ha get no sleep that night but lied nodreams# Onthe 18thand 19th, lie did not go to work# had little appetite, but slet&r On ths 20th he returned to Stourport* He does not remember how .1 felt that day, but was still off his food* On the 21st he was sot at Stourport, and had a very had dress which he remembers vivJBy in. which he had to eat maggots On the 22nd he saw double, and Siat evening he had a dream in which lie wasin a long dark tunas!* sad as he walked down this tunnel, he becas smaller and srsaBesv On the 25th iio was again at Stourport, and lie folt tvitehin; in har muscles# He slept bettor on the night of the 25th than ho lied fens for the past wools, and M s appetite had improved slightly# In examination, he was of normal appearance* flu temperature van $h~norr2cl, the pulse rats and blood pressure were normal* bhe;pupils were unequal# ^part from the above, no abnormalities were*found in any of the systems# A sample o f urine was obtained. for malyslSf and specimens of blood for microscopic examination, cjnd:srrcngs3jQntS Slavo been made to obtain further samples of urine# This man is, in our opinion, a mild clinical case of tetraethyl Icai poisoning, and even with the added exposure on the forenoon of the 20th, it is considered that he will become no worse than lie is at present, and that he should make a recovery within two weeks* 297, Xeknild Street, Hockley, Birminghan 18# Aged 3^-, naxaSesd*;. three children*: Occupation Engineer* Son of the owner# . h' engaged in tank cleaning at various times for tho P.bst twenty years, but had never been engaged in cleaning a tank w h m contained leaded gasoline, nor on so large# He was normally engaged. 2a the maintenance of petrol pumps in garages* he was evasive in his answers, and could not give his work periods and syspSoms in chronological order# ' IO Ha first cams on to tho tonic cleaning ob on Wednesday, 13th, after his brother had become sick, and stated that he wore a -cv o positive pressure air line mask aril full protective equipment on o yf had a stomach ache, and was sleepless Z sl50Xli tlAt saw double and felt weak, and Arei easily# Le went off his icod, but tried to force himself k was notice:-, -that me nad become nolo* Ho developed a ofi irental headache, and hoard telephone bells in his cars, pia also nad the sensation that people were talking to him* Ho lie had a lot of beer to drink that. nagnt, ouu, -- usual custom, he could not sleep* He was rootless* hut had no dreads. On the 16th he did not work at 3tourport* but slept badly that night* On the 17th he was restless all day, goingoffM s food, and ha got no sleep that night buthad no dreams* On the 18 th and 19th lie did not go to work, had little appetite* but slept* On the 20th he returned to Stourport# He does not -remember how he felt that day, but was still off hi3 food* On the 21st he was not at Stourport, and had a very bad dream which he remembers vividly in which he had to eat maggots# On th 22nd he sew double, and that evening he had a dream in which he was in a long dar tunnel, and as ins walked down this tunnel, he became smaller and smaller# On the 25th he was again at Stourport, and lie felt twitch In his sruseles# He slept better on the night of the 25th than he had done for the past week, and his appetite had improved slightly. On examination, he was of normal appearance* The temperature was sub-normal, the pulse rate and blood pressure were normal* ilie pupils were unequal# Apart from the above, no abnormalities were found in any of the systems* A sample of urine was obtained for analysis, and specimens of blood for microscopic examination, and arrangements have been made to obtain further samples of urine* Qsmm& This man is, in our opinion, a mild clinical case of tetraethy lead poisoning, and even with the added exposure on the forenoon of the 20 th, it is considered that he will become no worse than he is at present, and that he should make a recovery within two weeks* 297, leknild Street, Hockley, Birmingham IS* Aged 3*f, married, three children* Occupation - Engineer* Son of tne owner. He has been engaged in tank cleaning at various tines for th past twenty years, but had never been engaged in cleaning a tank which contained leaded gasoline, nor one so large* He was normally engaged in th maintenance of petrol paraos in garages# ho was evasive in bio answers, and could not give his work periods and symptoms in chronological order# lie first cams on to th tank cleaning job on Wednesday, 13 th. after his brother had become side, and stated that he wore a positive pressure air line mask and full protective equipment on tnat day* On the lU-tli he had a stomach ache* and was sleepless at night* On or about the 15 th to saw double and felt weak, and tired easily* He went off his food, but tried to force himself *to G&ti# xt was noticed tliat H aad T^eoozse pale# He developed a dull frontal headache* and heard telephone bells in his ears, and also had the sensation that people were talking to him* Ho had sor looseness of the bowels, but no pain. He "had a "sick tumsy feeling in his mouth", and toothache in M s front teeth. These symptoms have more or lass persisted since this date until tne present tin, and he has tried to "work it off", to does not admit to any improvement, nor to his becoming worse. On examination ho was noticed to to pale, with sooo twitching .rounaa tne muscles of th mouth and chin. Hie puls rate was 60 r par minute, the blood pressure 110/70, the temperature sub-normal# -HE" 0021358 nt Sob exaggeration of the reflexes, mid a slight tremor of the ; jiands were noticed, out apart from these no abnormalities were *detected in any of the systems on examination# A sample of urine was obtained at the time of this examination, and a . ' further o n e .Obtained when lie was seen the following day* Subse quent samples will be obtained from him# Specimens of blood were obtained for microscopic examination It is considered that this man is a rnod'-rately severe case of tetraethyl Iced poisoning* He had exposure also at Bed Mile, near Nottingham, before going on to the present tank cleaning job. There is a clinical impression that now he has been re moved from all exposure, and fully appreciates the nature of the condition, that there is a good chance of his making a full recovery without any marked deterioration in M s present con dition# 20h Fitsford 3treet, Hockley, Birainghasu Aged 66, married, throe children# He 3toted that ho was into tanks at Red Mile, but that he had not been into tanks at 3tourport, and had only spent one day there. Ho did not admit to any symptoms or signs. He was very worried about the condition of M s son n ho had seen in hospital on Sunday. 2Vth. Ho said ana had told him that he had had his appendix cut before, and had had his appendix out again, and that the stitches were hurting him. He also said that M s Michael had told him to go away, when ho visited him, and that hewnrjted the bed lifted, and when he tried to fix the pillows, had said -'Ho, lift the bed", lie said that his son talked a" lot of rubbish the whole tisa was there, and he was very worried because the Sister in the h o sMtal had asked him if there was any mental trouble in the family." lie nad assuro^iejyjhat there was not as far as he knew# Ho had noticed r peculiar in his manner before going into Hospitalr irritable, and worrying about things that were his. the gaffer s business, and not ^QBH^liad apparently been very wired, and had had d i f f i c u l t ^ a ^ c o i ^ ^ ^ n g pieces of work given to him# On examination, there was no evidence of -tetraethyl lead poisoning. He has an elevated blood pressure. Ho felt bettor ween the cause and symptoms of tetraethyl load poisoning wore fplly explained uo him# Ho 3aid ho would take more care in V 1? ? 0 cleaning jobs# He showed clothing used in the jobs which was being sent to the laundry, and which smelt of organic Comment . _ ~k?re ~s clinical evidence that this from tetraethyl lead intoxication. suffering \ v - Or\* 133 Antrebus Hoad, Haodaworthf Blrminghasi* Age4 h2f married* four children. Occupation - Pipe Fitter* This nan# a regular employee of J. i-ihelan and Sons# was examined at Dudley Hoad Hospital# on the afternoon of the 27th# through the courtesy of Pr*G,Heara th nhysician in charge* He stated that lie had helped for tank cleaning on the 7th with the preparations and that ho had entered the tank at the sane time ns on the after noon of Monday# llth* and forenoon of Tuesday# i z m September* He said that he took no precautions at all# as tho quicker the work was done, tho better the bonus* and lie found n6ld man Whelan** a very docent employer* In reply to a leading question* he said that lie did not use an air line mask# and that the jet in tho pump was blocked# and that they had taken'the one out of the air com pressor for tho pump# so that they could carry on with the 30b* He stated that it was "terrible" working in the tank with the smell# and he felt short time* At Tuesday lunch tir-e# both he and "felt so bad .that they chucked the job for the day11. That evening he fait off his food# did not sleep well# was not greatly troubled with bad dreams# but had some vomiting and diarrliooa* A few days later ho had numbness and tingling in his hands and feet* Be vomited Intermittently, and his appetite became worse end worse* The sleeplessness continued# and became# if anything,. more Intractable*. Ho saw M s own doctor# who said it was "nerves" in the first place* He developed some abdominal pain# which became progressively worse* lie saw his doctor again# who had his admitted to Dudley Bond Hospital on the 20th* One of his chief complaints was that he had difficulty in passing water* He has also passed some blood in his urine. He had also been troubled with muscular twitchlngs* and noticed wa very bad shaking in his hands** He had not noticed any particular bad taste in his mouth* la answer to leading questions# he said that the bathing facilities at the Installation were not laid on# and that they did not bathe on the first few days* As far as he remembered* lie did not work at Stourport on Thursday, Friday, Saturday and Sunday, the iMsh to 17th inclusive# but was there on the 18th* (One has been informed that ho was not at Stourport on the 18 th) He further stated that he drove the van to Stourport on this day* and that the smell of the fumes from the motor made him feel very sick* II said that at one time he had carried CO sludge in a waggon to the sludge pit* (There Is no corroboration co for this statement)* He had been tank cleaning at Eed Kile* near Nottingham# in mid August# and did not take any protective C\2 measures* o o On examination* his colour was good, h3s temperature v^a uulse rate were within normal limits. ..here was no evidence of tetraethyl lead intoxication* (objectively)* lie had still sorsa difficulty in passing urine, and one had -trie impression that he aisoMentoted. He admitted defects in memory eu? r f ocSurrod dOTin-T tame cleaning operation % ?turport. It has been arranged with Dr. Hearn that' sables This S3sn> a regular employee of J* Hfcelaa and Sons* wr.3 OEBBined at Dudley Road Hospital, on the afternoon of the 27th, tiaough the courtesy of Dr.G.Hearn^tb^Thvsician in charge* 2s stated that lie had helped 'lith the preparations fcr tart'cleaning on the 7th and Uth of Sentenber. and that ho had catered the tank at the sate tire as on the aftor sion of Monday, 11th, and ferenoon of itesday^izra September Hs Said that h took no precautions at -all, as the quicker the issrk iras done, the better the bonus, and he found "old man Whelan" a very docent employer. In reply to a leading question he said, thst- lie did not use an air lino mask, and that tho jot an^ the pump vas blocked, and that thoy had taken the one out of the air con* saressor fer tho pump, so that they could carry on with the job* i& stated that it was "terrible11 work! is i*n t"he 't`an*k wi-th t he and he fo2. a short time* At Tuesday lunch fcSso^:- both ho a n d i ______ fr,elt so Dae they. chucked tbs job for the cay"! That evening he felt eff his food, did not. sloop well, was not greatly troubled with bad dreaiss, but had ssne vomiting and diarrhoea* A few days later he had numbness and tingling in his hands and feet* He vomited intermittently, and hi3 p e t i t e beesste. worse and worse* Th& sleeplessness continued, and became* if anything, more intractable* Ho saw his own doctor, who ssdd it was "nerves" in the first place* He developed s o m sMominal pain, which become progressively worse* lie sew his doctor again, who had hin admitted to Dudley Hood Hospital on the 2Qth* One of his chief coraplalnt3 wss that he had difficulty in passing water* He has also passed soire blood in his urine. He had also been troubled with macular twitchings, and noticed "a very has shaking in his hands'1* He had not noticed any particular bad taste in his mouth* In answer to leading questions, he said that the bathing facilities at the Installation were not laid on, and that they did not bathe on the first few days. As far as he rsnembered, he did not 'work at Stourport on Thursday, Friday, Saturday and Sunday, the ibth to 17th inclusive, but was there on the X3th* (One lias been informed that he was not at Stourport on tie 1.8th j. Ha further stated that lie drove the van to 3tcarport on th-f day, and that the smell of the fuse3 from tho motor made hla feel very sick* He said that at ono tine he had carried sludge in a waggon to tho 3ludge pit* (There is no corroboration fa r this statement)* n had been tan k cleaning at Eod Milo, near Hcttinghaia, in aid August, and did not take any protective measures* On examination, his colour ves good, h3s temperature ard jSiae rats wore within normal limits* -here was no evidence of tetraethyl lead intoxication, (objectively)* He hod still soru difficulty in passing urine* and one had the impression that lie was still slightly disorientated* He admitted defects In sensory as to what actually occurred during tho tank cleaning operation at Stourport* It has been arranged with Dr. Hears tliat samples of blood, urine and faeces will be collected for analysis, to be carried out by the A.^.C*, and that Or* Hears will render a full report at tho tine of discharge from Hospital, which will possibly be in another two or three weeks. .Qggsafob ;. Tills was the caso which brought tho prosont incident to the notice of the A.--.C. Dr. Hoorn immediately connected the oynptow K f 0021361 9* of sleeplessness with the cleaning of the leaded petrol tank, and made a provisional diagnosis of tetraethyl load poisoning and then went to look op the remaining symptoms to confirm his diagnosis He spent the entire afternoon in the local medical library reading the literature on the sublet, which he did not find particularly helpful* Ha has boon given all the assistance within the power of the licdical Department of this Company* _ was a severe case of tetraethyl lead poisoning, sol *he way to recovery* Belbroughton, Clcnt, Hear Hagley. 38 , married* fhe behaviour of this man is evident from the foregoing case histories* He was in the tank on the afternoon of the 11th and morning of the 12th September without protection* He lied been Giigaged throughout August in tho cleaning of son tanks at fed bile, near Nottingham* He hod been ill since Tuesday, 12th, and cringes of temperament became progressively sore narked* Ho was admitted on the 18th September to Hordsley Hospital, Stourbridge* On admission, he was seen by Dr* Walker, the Junior Resident, who found Him markedly rantally disorientated, excited, anxious and apprehensive* There was & marked treisor of cho.hands* tongue and face* He had a sedative, which had very little effect on him* He kept all the patients in the ward awake for a few nights# His condition was characterised by alternative improvement and relapse* Shortly after admission he shouted out "I have got tetraethyl lead poisoning* X am dying* Four other sen have died*" On the next day he said ?iYou had better get the otrier four in here, as your treatment is asking m veil#** later* apparently, he got out of bed, and ran up end clown the ward without'his pyjama trousers on* Ho also threw food offered to him at a nurse, and mad attempts to throw water over the Ward Sister* He also node a dash for the Hard Corridor, shouting that he was going to stop the children crying outside# On speaking to him in the ward, he was fairlv lucid, but had 30120 d e f e c ^ y u p m o r y , especially or recent events* Ho could not reaedbeflp|^Ski&nx>, nor was ho at all clear on the chronological C--2 order of tank cleaning* Ho also mentioned the changing of the lot from the air compressor to the pump* lie did not see why he should ro wear respiratory protection when there was a manhole open at the bottom 01 the tank, and another at the top, and wind blowing through CO After all, lie said he had to get the ob done if he were going to o nek ary money, and it was mere difficult to work with protection* o lie could not remember whether he hed a sister or not, and then remembered that ho had one. He could not remember whether sho had hi any children, and then remembered she had ono snail child# './hen he asked if he had a farm, he said, "Ho," and then, hesitantly* some ,v , ' , ula not leinembQT bis fbasth*er*s visit on SsutnadtnevmentnoL* oonav-i-our on onat day# lie remorabered two vary vivid dreams* one W6ntiaS to get into tho corridor, but could'not*do* so ifffe uor? bosons and dozens of nurses running past him, |hSm lSaa *> throw water over them. find particularly nelpful. m has been given ail tne assistance within the power of the Hedieal Depsurt.exit of this Coiapany. fas a severe case of tetraethyl lead poisoningt and is nay on the way to recovery Belbroughton, Cleat, Hear Eagley. 38 , married. he behaviour of this man is evident from the foregoing case histories. He was in the tank on the afternoon of the 11th and c o m i n g of the 12th September without protection* He liad been engaged throughout August in tho cleaning of seise tanks at Bed kila, near Nottingham. Ho had. been ill since Tuesday, 12th, and changes of temperament became progressively e o k marked. Ho was admitted on the 18 th September to Hordsley Hospital, Stourbridge. On admission, he was seen by Dr. Walker, the Junior Resident, who found him markedly mentally disorientated, excited, anxious and apprehensive. There vms a marked tremor of the.hands, tongue end face. He had a sedative, which had very little effect on him. He kept all the patients in the ward awoke for a few nights* His condition was characterised by alternative Improvement and relapse* Shortly after admission lie shouted out MI have got tetraethyl lead poisoning. X am dying* Four other men have died." On the next day lie said "You had bettor get the other four in here, as your treatment is making sk>wall*1' Later, apparently, he got out of bed, and ran up and down the ward without his pyjana trousers on. Ho also threw food offered to him at a nurse, and made attempts to throw water over the Hard Sister. He also made a dash for the Hard Corridor, shouting that he was going to stop the children ciying outside. Cn speaking to him in tho ward, lie via3 fairly lucid, but had some defect in memory, especially or recent events. Ho could not remember Cart's name, nor was he at nil clear on tho chronological order of tank cleaning. Ho also mentioned the changing of the jet from the air compressor to the pump. He did not see why he should wear respiratory protection when there was a manhole open at the bottom of the tank, and another at the top, and wind blowing throug After all, he said he had to get the job don if he were going to make any money, find it was more difficult to work with protection. He could not remember whether he had a sister or not, and then remembered that he had one. He could not remember whether she had any children, and then remembered she had on snail child, '.`/hen asked if he had a farm* he said, "Ho*"- and then, hesitantly, some a b a t e s after, said, WI have a srsalX one. Th 3 statement Is rue. He did not remember his father's visit on Sunday, nor his behaviour on that day. He remembered two very vivid dreams, one wnen ne was wanting to got into the corridor, but could not do so occause -uoro wore uosens and dozens of nurses running past Him and the only way ho could atop them was to throw1 "to? EL -`re?a ? * . lot of rata, a c S l t e e n S y t a T ^ uuooidc, and ne kept trying to go out and stop them. . admitted to becoming sleepless shortly after being in the ra-V\* Oeirio sick, giddy, having headaches, dimness of vision, some uouble vision, a bad taste in the mouth, abdominal paiD, and hs thought no had had diarrhoea, but was not sure. At the present KE" 0021363 'i Si. 10* t m ho is complaining of tingling in lips ana tongue* From the ward records, he had apparently no. changes in ioiiperature, and no marked changes in pulse rate, -respiratory rate iu;d blood pressure, but if anything tlie blood pressure had gone up* At tl&e there are no clinical signs of tetraethyl lead the present Aiintoxication, although he is still disorientated* Arrangements have been made for the collecting and forwarding of samples of urine for analysis* Dr*^*V*Iialinowski will render a report when he 'is is- charged, which will probably be in two or three weeks1 tiise. Tills isan has been, and still remains, a severe case of tetra ethyl lead poisoning* It is noteworthy that although ho gave a load in his delirium that ho was suffering from tetraethyl lead poisoning, no notice was taken, and he was treated as a psychotic case* The diagnosis was realised only after discussion with the two medical officers concerned* r*n******--. -- and Observations Five cases of tetraethyl load poisoning in tank cleaning are outlined in lay terms* The above report if read in conFunction with the report by hr* K*B*Biggs will 'make evident tbs dangers of partial or token observations of the B&rdasea precautions necessary for safety in Panic cleaning* As in post unfortunate instances of -this type, ignorance on the part of those involved, the proclivity of tank cleaners to take risks, and the particular difficulties in the cleaning of tanks of the type involved bring " stress on the necessity for efficient, skilled,"knowledgeable and constant supervision of workmen engaged in cleaning talks which have contained leaded gasoline* The necessity for the careful observa tion of recommendations for clothing, bathing and handling of con taainat-sd articles is also clearly demonstrated* _ One would like to express thanks for the help and co-operation extended by the Kegeafc Oil Coiapany Limited in tlie investigation and particularly to Mr* R* Balchin* _ 0021364 `AVI 30 n>T ao I