Document KJ7gE1K5MDyj9MX4BY9w0416X

V Subject. JMRAKDtnt GEBBKAL MAKAffiaKESS. MI8CBLLAIB0US. LEAD P0I808XKQ. ' -I.I-*,A'S5^' 'Docket go. n . To LOHDOH, Memo, So. 34276, ; ::: Date 25th August, 19 4 3 CONFIDggllAL. ' further to our Meiaorandum 34254 of 11,8*43 we now enclose-* One copy of Lead Poisoning - Preliminary Medical Beport and One copy of Details of Cases of Lead Poisoning Abadan 1942, '. These two reports complete the medical information ashed for in-your' telegram 5017 of 23* 7* 43* *-4 .(Signed) S* W* Higden* JSBF* KH" 0016392 .i PRBLIMIHABY M i^ArI^sRrArzmjsgss. In July end August of 1942, there occurred six cases of lead poisoning amongst workers in the Packed Oil Department all of whom displayed symptoms of Encephalopathy, Unfortunately the first case died of uraemia whichbad developed before admission to Hospital, and although we are morally certain that it was a case of lead poisoning, we were never able to prove the fact. The finding of lead in abnormal quantities in the urine of the other five cases led to a visit to the P.O.D. by the Chief Medical Officer and the Pathologist, who found the exigencies of the present War had led to a vast increase in the output of leaded spirits. A blast wall had been built around the Filling Section which made ventilation very unsatisfactory, and the rapid evaporation of the spirit at the very high temperatures willoh pertain in Abadan in the summer meant that the air was full of T.K.L. vapour, a fact which was later proved beyond any doubt. The C.M.O. and the Pathologist made certain recommendstic* which were immediately put into force with the result that there was an immediate' improvement in the 'figures of admissions to Hospital of cases suffering from lead poisoning. Diese recommendations were t- 1. Powerful forced ventilation should be provided at all the danger points. 2. The blast walls should be pulled down at once. 5. Better washing facilities be provided for workmen along with liquid soap in sufficient quantity, and increased W.C. facilities, 4. Provision for regular treatment of clothes by automatic cleaners. The figures of admissions to hospital are of interest. as_e_^daitte_4 to. h.Qspitai because, of symptoms July 1 October November 2 -jo A - 2~ December *# 1 .4 . It should be noted that the blast walls were built In May 1942, and that they were taken down In September 1942, The working month at the P.O.D* consists of 90 shifts* The Mo, of shifts filling leaded spirit in 1941 as compared with 1942 is given in the table below as well as the mean maximum and minimum temperatures for these years, Ho. of Shift (headed July 17 August 11 Sept* 28 October 27 loveiaborj J3L Mean Monthly iMms*s.K,s s sMjian^,,C?*) 112 *2 82*8 111*5 79*3 IO8 .6 0 7 3 *4 94.4F 62,8 65*0F 55.9 1942, ifo* of -,Shift (Leaded Mean Monthly ^ a e r a t a||t^ Salila) 70 110*5 85 it 114,1 106.5 8.1.8 5*8 9875*.01 I:9 *3 39* 2 - ?; .~ 3m v wcolrikma*Ititccwomicbloinldniebtdeioatnopsp,brercidineagctreeadab,soeutthientirlevlfesonrtuein,lfaotrtithouannt,ateeavnedrsytaptthreiensgsouf-raeffofa:irs*...'-iff In all, 54 persons were examined, and 59 were found to be excreting -lead in the urine in more than the generally accepted normal amount i.e, more than 0*14'sagas per litre of Urine* Of the 59 persons affected, 51 were suffering from symptoms, and an analysis is given of-the prominent symptoms displayed,-* : Mania #* 2 Weakness ' * if Fever - . * 6 Muscular Pains *#'": - z Diarrhoea - t1 1 , Malaria **. 2 (8.42 Pneumonia .. #* 1 (8.55 per litre), . TOTAL w It is to be regretted that at the time we were working short-handed,-and. as. a'}result there were many investigations which w would like to have carried out'but for which the time was lust not available so that only four cases were examined . . for Punctate Basophilia,-^ and all the. examinations ware negative* Apart from the two cases of Mania (Encephalopathy) no signs of any significance were found on examination of the Central Hervous System, and in no case was a lead line found on R 0016394 examination of the south. We find it noteworthy that all the eases who were . admitted suffering from a high fever showed a fairly high lead excretion, & point which we have not seen mentioned in any of the publications we have read on the' subject. During one of our visits to the P.O.D., we were asked to look at several cases of:desquamation of the feet-in. workers in the P.O.D. At the 'same- tin we were not aware of the fact that this was a sigh Of T*B.L* poisoning and we were equally certain that they had hone of the appearances of Petrol Dermatitis, There is no doubt in' bur alas now, however,.that these men wore suffering from desquamation due to T.5.L*\l) . . With regard to the distribution of the'affected and non-sffeeted.persons according to thair actual employment, the following is an analysis*~ ' lor than 0.14 sags. Less than 0,14 lead in urine, mi'.-'S.in urine Filling Section 25 9 Soldering. Section 8 4 Cleaning Drums with Petrol (1) General Duties (Office) 1 (0 .15 mgias) 2 Ho history obtained 2 Total 22- 2JL : As one would expect there is a. definite prepon derance of cases from Filling Section which show a high excretion of lead in the urine. The workers who. were filling petrol into tins, for purposes of cleaning, ire interesting as they must have been using leaded spirit for the purpose. The one office worker in the abnormal1* list can, 1. think, b ignored as his lead ., excretion is hardly;to be regarded as abnormal . ... -- Theqamount '.of le&d in 'the':atmosphere of the -'. Filling Section at the:P*Q,Pv was examined by our Chemical Do- ' pantment, end the following is an abstract from'their conclusions 1, Published data indicate that freedom from ill . . effects may. be expected if the lead in the .. ' atmosphere is kept below 2 tag. of lead per working . day equivalent to 4*6 cu.m, o f air in .8 hours. . . 2. Before the blast walls in the P*GD. wer pulled down, the ataaosphere at head height over the tinning 100 0.N, spirit (containing 4.7 ces. T.B.L, per gallon) under* summer conditions, contained 15-20 mg, lead per 4.6 cu.m, of air. ' , KZ 0016395 % % V*- % ^v ,5 \ * Nv * V % ?%yb^;v nV 5*' Under approximately the same conditions but after :, removing the blast wells the lead content averaged . 1 circa 7 g per.4.6 cu.m* of air. . ' . " .A I This figure is still too high, but since then Hie -:; syitss of suction ventilation referred to above has been i instituted and is working satisfactorily. The-amount of lead1 in the atmosphere at the filling Section will be estimated.; , i again in the summer when conditions arc comparable, and we confidently expect to find that the figure will be well inside , normal limits, . As regards Hie Soldering Section, the amount of lead in tbs etaosphere was satisfactory> being circa 1*7 mg* lead :v:. par 4,6 cu.m, of air, at 1| ft. above the surface of the molten solder. It will be appreciated from the above facts and figures that Hie handling of leaded spirits under certain .: : extreme conditions can constitute.a very grave hazard, & hazard' which, though unlikely to occur under noraal peacetime working':'' conditions is very liable to occur under the stresses of Production* ` At the same time, however, we are quite satisfied .. , that all Hist is required to make conditions entirely safe for :: workmen is an adequate system of ventilation, plus a keen watch! on all possible areas where'spillage is likely to occur. Since' tha blast, walls at the Filling Section were removed, washing facilities improved and the European personnel of the P.O.B, -r'" * made aware of the risks, there have been no further'cases of lead poisoning reported.fro the Refinery. ,_ ' Sd/ A. Anderson . - April, 1041. ' ' Ch.B*, . ' ' MEDICAL OFFICER, , Reference-* (i) R.A. Kehoe (1925) lour.Ass.Assoc* M e 001639G // C 0 P-T mm -- 1, * indicates that the symptom or sign, was'present, - that it was absent* A blank spsee>.'ladisetM uo 2* Only those ci-'Ses with an excretion of lead amounting, to - O, 20 sgms* or .sore per litre of urine are included, The are 3d such oases cs against 39 hose urinary exesetiim ' Y exceeded 0,14 mgsas. per litre of urine, the figure regarded as `Ncraal in our previous report* The reason for this Y change is that the Principal Chemist suggested that our : , original figure was too low* The results recorded hare wSSQf sousirate th&t as far as our investigations a r e ' e M e d - i ^ | the increased minimal figure makes little difference* 3* The length of time th&t these patients had worked in the ''f? Packed Oil Bept* varied fro 30 years to 4 month#* There-* Y fore the inference is that a no factor had caused iho ;. :.Y| Illness* 1 :YY| , ' ' . ./Yl 4 Knee jerks and 'Ankle Jerks were-done and noted in each ease* In the absence of a statement to the contrary it can be ` taken that they were present*- -- Y ' 5* The phrase *Ansessic and Undernourished could be applied to . 90S of the"-cases here noted. The- standard, of living just v thea was low and aany employees were newcomers suffering ..,. from latest'Malaria, - -; 6* Case Kos.21, 22, 23, 24 & 27 are five of the six cases re-Y ferred to in the first para of our previous report* TheY - sixth, sa we have already stated, died before a positive -*/ diagnosis was made, but in -retrospect we have little doubt-/, that ho was a case.of H&eephaiopsihy, ' - Yiff 7, This year, 1943? wo, have exsaftned eleven workers; in the ' ' P. 0*D. flie results of''urine estimation for lead are given in stgsus*' per. litre ~ 0 * X Q , :O*Q2,.O.Op, 0*11, 0*05, 0*08, ' , !?il, 0*08, 0 .09.nil and v8i04 ~ All. well below normal limits - '.--.f..,---.,, ,Vw-- T---,- -;.**-*",,V.--. Wt V;, ... ' '' - . ...Y-^Tv. 6*--This your, 1943, air -analysis''hove been done at th with the following- results .***; --'/ ' . . %YF' 24*6*43'-';,-/* 0*07 mis* Pb per Cubic Meter of sir, 7*8*43:;-"-"- Traces of Pb only, - . - :-u'-tH . Both these estimations were .carried out while the forced _* . draught system, o f 'veatilafcioawas in operation* ;-2h@ accejpslp working standard of safety is 0.15 mgms,per Cu* Moter, 9. .Unerring our jprevioiis report, last para, vig are now more than quite satisfied .that cn adequate sy^|em:/ o S ^ - vontilation is the" real Jsaswer/t the troubles &*^adSSM2fi4 1, + indicates that tbs symptom or sign was present, .--iii. '* that it m s absent* A blank space indicates no record*'"". 2 Only those cases with &a excretion of. lead asemting to f| 0*20 .or 's o m per. litre'of urine are included. Tinare are 34 such -.-oases .as.against.' 39 -wfettso urinary excretion: . 'exceeded :*M'itgMf&. per litre of urine, the figure regarded as formal is omr previous report* The reason for this change Is that Hi pnaeipSl"Chemist.suggested that our . original figure was.to# low. The results recorded hors do- nonstrate .that as far as. our investigations are concorned ;; the increased minimal, figure makes little difference* ` i 3, The .-length of time that those patients had worked in the ^ Pecked Oil Dept* varied from 30 years to 4 months. There- - fo ra the inference Is Hist & now factor had caused the i . illness*'. ( .' 4 4* She Jerks and 'Ankle Jerks, cm-done and noted in each ease| . fa the absence of. a statement to Hi contrary It can be * -taken that they were present* . - . .. Zt% 5* The phrase jinaeiaie and Undernourished could be applied to . 90S of the cases here noted, The- standard of living Just then w&s low and many employcos were newcomers suffering 7 from latent Malaria, ^ 6, Case 105,21, 22, 23, 24 & 27 are five of the six cases re*.;',' ferred to in th first para of our previous report, The sixth, as we have already stated, died before a positive -y diagnosis was made, but in retrospect we have little doubt that he as a case of Encephalopathy. 7. This year, 1945, we have examined eleven workers in the -". ' : P*0,D. The results of urine estimation for lead are given ;---' in agas, per litre - 0,10, 0,02, 0.05, 0*11, 0,03, 0,06, ; fill, 0,08, 0,09# SIl and ,0104 - .11.well below normal limits 8, This year, 1943#' air analysis have beca don at'the P.O.D, - with the following results t- 24,0.43 0,07 sags, Pb per Cubic Meter of ir. 7,8*43 Traces of Pb only, - Bota these''stlaatlonis'.'vsaro -carried out while the forced .. draught system of'ventilation was la operation* The accepted' working standard of safety is 0,15 mgais.per Cu, Meter, ; 9. Saferring' agadLaTto our previous report, last pare, we are- -' nowisore than quite satisfied Hint an adequate system of - v m tilatica is the'real-'answer.-.to the troubles experienced -i last year,, but at the a m a tine,'we fully agree' with -the - additional precautions outlined -in the Cheatcal & Develop- ' .-;44;meat- tiapt* oto -to: !&--Works Manager. (X&b.lob I0 .152 0 ) - y 1 -especially boctioab 2>:3. &- 4 under the heading BiscussIon*j-- Abadan, 17,8,43*