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FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1955 Nov 14 DOC#: API035 DOCUMENT DESCRIPTION: Minutes - API Medical Advisory Committee Meeting with Attachments ,H :.\T'r.MATi: N CNLY NOT FOR PUBLICATION AMERICAN PETROLEUM INSTITUTE METICAL ADVISORY COMMITTEE Twentieth Meeting November 1L, 1955 Fairmont Hotel San Francisco, California Members P r e s e n t : George M. Saunders, M.D., Chairman V. C. Baird, M.D., Vice Chairman L. E. Curtis, M.D. Kieffer Davis, M.D. R. E. Eckardt, M.D. K. R. Fourcher, M.D. C. H. Hine, M.D. T. J. Kelly, M.D. E. P. Luongo, M. D. C. R. Miller, M.D. M. N. Newquist, M.D J. W. Osborn, M.D. c. R. C. Page, M.D. J. Ruddock, M.D. Leo J . Wade, M.D. E. R. Ware, M.D. Technical Advisors Present: T. B. Albin C. T. Brown R. C. Cole E. K. Daniels J. W. Hammond L. C. Kemp, Jr. R. M. Landon R. C. Mlthoff A. C. Pabst T. B. Rendel Others Registered: Philip Drinker - Harvard University J. A. Spence - Standard Oil Company of California D. V. Stroop - American Petroleum Institute Members Not Registered; F. D. Gassaway, M.D. W. 0. Armstrong, M.D. Lamson Blaney, M.D. F. F. Boys, M.D. Marshall Clinton, M.D. S. William Crookshank, M.D. T. M. W. F. E. K. R. J. B. B. Ralph Frank, M.D. Kahle, M.D. Linder, M.D. Potts, M.D. Reeve, M.D. Schneider, M.D. I MINUTES OF NINETEENTH MEETING ACTION: The committee voted to approve the minutes of the Nineteenth Meeting a3 circularized by letter dated May 10, 1955. . API 07220 SUBCOMMITTEE REPORTS Fcllut- uusr.go, M.D, PV- ~ w . .C . -- < r> Or- Luorue presented the subcommittee report dated October 10, ccpies of which* had been transmitted to all members of the 1'ijai Advisory Committee by letter dated November 2, 1355 - ACTION: The report was accepted. - sucocmmittee on Co~C12 Aromatics - C. H. Hine, M.D., Chairman Dr. Hine presented the subcommittee report dated September 2C, z-r, copies of which had been transmitted to committee members by :e:ter dated October 19, 1955- ACTION: The subcommittee report was accepted. ^ cut committee on Carcinogenicity - Robert E. Eckardt, M . D - . Chairman Dr. Eckardt presented the subcommittee report dated -:tcber 3 1 , 1955, copies of which had been transmitted to committee -inters by letter dated November 2, 1955* ACTION: Following discussion of the report it was accepted by the Medical Advisory Committee. subcommittee on Dermatology - Leo J. Wade, M.D., Chairman Dr. Wade presented the subcommittee report dated October 6 , 1055, copies of which had been transmitted to all members by letter cared October 19, 1955* ' ACTION: The report was accepted and its recommendations were adopted as follows: 1) The skin physcology project of Kettering Laboratory was deleted from the 1956-1957 budget of the Medical Advisory Committee. 2) The proposal of C. A. Bauman for study of &7 cholesterol was referred to the S u b committee on Carcinogenicity in the under standing that Dr. Horton will study the subject. ! Subcommittee on Economic Poisons - L. E. Curtis. M.D.. Chairman Dr. Curtis reported informally on subjects of interest to 'Is subcommittee, particularly the establishment of poison centers in `^cicus cities . He o f f e r e d to c o m p i l e d a t a on the s e centers and to 'sve copies of the compilation sent to all members. ACTION: The subcommittee report was accepted. API 07221 f "r T -5CCMMITTES FZPCFT5 fp o r t ' d ) Folioles =nd Practices - K. R. Fourcher, M.D., Chairman Dr. Fourcher reported comments he had received frcm sub- ,---1 0 065 ~.er.:ers or. ore subject of standard basis for the statistical cf absenteeism as referred to the subcommittee by the Operating K c ccmr.ittee or. August 23, 1955* A copy of the subcommittee report *s"atoached as Appendix A. ACTION: The committee accepted the progress report. 0. ."ucccmm.lttee on Physical Agents - J. W. Osborn. M.D.. Chairman Dr. Osborn presented the subcommittee report dated 5-:-t'ember 3 0 , 1955, copies of which had been sent to all members or.'October 19, 1955- ACTION: The subcommittee report was accepted. subcommittee on Toxicological Reviews - Marshall Clinton, M.p. , Chairman In Dr. Clinton's absence, Philip Drinker discussed the status of the toxicological reviews. ACTION: The committee accepted the subcommittee report dated September 29, 1955, as circularized on October 19, 1955- - I* Program Committee - C. R. Miller. M.P . . Chairman s.; i; Dr. Miller expressed his appreciation for the cooperation assistance given in the arrangements and holding of the Medical Health Group Session. ACTION: The Medical Advisory Committee expressed its .... appreciation and thanks for the excellent program arranged and carried out by the Program Committee. Ill KEROSINE POISONING At request of Chairman Saunders, Dr. Osborn made a progress crt upon the informal liaison with Torald Sollmann, M.D., Chairman, mittee on Toxicology, American Medical Association. <i> o IV INTERDIVISTONAL COMMITTEE ON LABELING API 07222 , As a representative of the Medical Advisory Committee, 2; C. Pabst gave a brief progress report on the meeting of the inter- -ivisicnal committee held in San Francisco on November 12, 1955 i "Ep.l i v i t i o n a l c o m m i t t e e c n l a b e : (cor.t1d ) Turing discussion a member suggested that the Medical -ism:' T'mmittee should adopt a statement of policy to the effect JT- petroleum products should be sold only in containers . --"=''1 0 5 appropriate labels affixed by vendors. :.TTICN: Cn motion duly seconded the committee voted to table the suggestion; however, the committee thereafter voted in favor of educational work which would promote proper use and discourage improper use of petroleum products. V "BLOWS ON THE HEAD" At the request of Dr. Curtis this subject was referred the Subcommittee on Physical Agents for study and report. VI IN APPRECIATION ACTION; On motion by Dr. Baird, the committee requested Chairman Saunders to express its appreciation to M. J. Rathbone for his great contribution to the success of the Medical and Health Session held at the API Annual Meeting in San Francisco. The Committee also requested Chairman Saunders to thank Dr. Howard P. House and his associates for the excellent presentation of the noise pro blem at the Medical and Health Session. VII BUDGET The committee adopted the recommendation of the Operating Subcommittee for a solicitation of $75,000 from oil companies in contributions of the same amounts as given in 1955 and recommended "hat -his amount with the unobligated balance in the Medical Advisory Fund should be used in support of the 1956-57 program and budget as Sollows: University of Cincinnati Professor Philip Drinker University of Texas Miscellaneous expense Total - Carcinogenicity - retainer - Cg-C-j^ Aromatics ^ $58,500 3>000 20,000 1,000 $02,500 copy of report of Medical and Health Committee to Board of Directors is attached as Appendix B. API 07223 I I TUENTY~FIRST MEETING The committee voted to hold its Twenty-first Meeting on Monday, April 23, 1956> in Philadelphia, Pennsylvania, which coincides with the annual nesting of the Industrial Medical Association. IX ADJOURNMENT There being no further business before the Committee, ->e meeting was adjourned. Reported by D. V. Stroop for: F. D. Gassaway, M.D., Secretary Atoroved by: George M. Saunders, M.D. Chairman v; vji -2/2/; API 07224 t APPENDIX A X <v.* m i n u t e s o? t w e n t i e t h f e t i n g of MEDICAL AIUISTRY COMMITTEE [PIET CF THE SUBCOMMITTEE CN MEDICAL POLICIES ______ AND PRACTICES__________________ K . R. Fourcher, Chairman :-SENTEEl reviewing the matter of absenteeism, the Chairman and members of I^V Subcommittee drew freely from the experiences of other large -.-mpanies regarding this problem such as Esso Standard Oil and Eell :atorstcries. The suggestions outlined in this report cannot be called original, but they do embody basic principles which appear to ce sound 'r.e of the first things to be noted is that absenteeism occurs mainly ir'~a small number of employees. One worker has estimated that cne- 5% r.alf of the absenteeism is caused by of the people. Another group 75% % felt that of the absences were caused by about 15 of the people. Also, the role that the doctor plays in preventing absenteeism is r.ardly a major one. Certainly the majority of absences are these of less than a week, which may be due to a variety of causes, many of :hem not actual illness. If upon return to work they are sent through che Medical Department, the industrial doctor can state with decision that the employee is or is not able to return to work. However, in nearly every case it is impossible for the doctor to use any medical knowledge that he has to determine whether or not the employee was cr was not ill several days ago. Therefore, certification by the joctor in industry is not a desirable procedure. If definite pro cedures were to be established, it was felt that the simplest possible procedure was preferable. A central registry of absences would give us very good statistical information, but would do little to solve .he problem. In the following report are definite suggestions for the cure and prevention of absenteeism insofar as this is possible. Certain criteria are established but these should be amended to ccnform to the individual Company concerned and in certain instances ~.ay be changed for the particular department involved. It might create a great deal of difficulty in one department if one individual lost a considerable amount of time, whereas in a department which had some excess staff an absence might hardly be noticed. Therefore, -t is felt that the procedure should be varied to meet the precise r;eeds of the department or company concerned. SUGGESTED ABSENTEE CONTROL PROCEDURE Absenteeism is most properly the direct concern of division and department heads, because it is at this level that the absence of personnel is directly reflected in decreased service and efficiency 'ith the resultant increase in costs. For this reason the following suggested plan of absenteeism control has been outlined to place the API 07225 3'----W- . .sir.g and tarrying our the plan at the departmental .ead level. Since the plan also prcmulgares :e 'rain Lei inary !s it is felt that primary responsibility r its functioning should rest with those who are directly respon sible for an individual employee's performance. Service groups which biay ar` important role in the plan are called upon at the request of division or decarrment head. r-ie following criteria are used to define excessive absence: 1. When the number of absences for any reason (regard less of the length of each) exceeds five in one calendar year. 2. When the total number of work days absent for all reasons exceeds twenty per year for two consecutive calendar years. 3- When the number of absences are less than defined in (1) or (2) above but the division or department head has reason to believe the absences could have been avoided. Using these criteria, the division or department head reviews the absentee record of each employee every time he is absent. Employees with excessive absences are then called in for a discussion regarding their record with the division or department head. This discussion -would be in the nature of a frank and friendly review of the employee's performance record and efficient operations. While specific medical problems should be avoided , the discussion will probably go into the employee's general health status. The department head will then suggest to the employee that he visit the Medical Department, on his own initiative, for a full review of any health problems. This will serve three chief purposes: (1) The employee will know that his absenteeism is a matter of concern to his department head. (2) The feeling will be created that the department is interested in helping solve the problem, and (3) The way will be open for the Medical Department to make a review of the employee's health status, and, where possible, offer a solution. If at the time of the discussion the department head discovers that a personnel problem exists, it will be suggested to the employee that he visit the Employee Relations Department, in a similar manner. At the end of six months the employee's record would again come up for review. If r.o improvement has occurred the employee should be re quested to report to the Medical Department for an evaluation of medical status to determine if reassignment of duties is desirable and whether absences are consistent with his state of health. The purpose of his visit to the Medical Department should be carefully explained to the employee. The Medical Department will then give a definite opinion to the Department Head. (individual letter, no forms). API 07226 Y <l> l. a ) 1 .ryes'3 absences are felt to be consistent with his state :e would Then be subject to whatever administrative action -.bleated as cons istent with efficient operations and in :i3 abilities as determined by the Medical and/or Employee 'eoarments . -rj enp] eyes's absences are found to be inconsistent with his health cat us, a iurther discussion with his department head would follow and isoipli^a: y action taken. HF:rr.l cvember 7 1955 API 07227 .'1INDIES OF TWENTIETH MEETING C? MEDICAL ADVISORY COMMITTEE EFFORT CF MEDICAL AND HEALTH COMMITTEE M. J. Rathbone, Chairman The Medical and Health Committee has continued its super vision of the organization and work of the Medical Advisory Ccn-Ictse during the oast year. In addition and in accordance with action taken by the -:ard, an Interdivisional Committee on Labeling has been organized is now -working upon the several problems incidental to reg u l a tions governing the use of precautionary labels on sales containers petroleum products. As authorized in its budget for 1 9 5 5 _56> the Medical ,'viscry Committee has organized a research project to investigate -r.3 toxicity of Cq- C 12 aromatics. The work is being done by the vesical Branch of^the University of Texas under an API agreement e.-.d g r a n t . Also as authorized last year, preliminary steps have been :aken to establish liaison between the Medical Advisory Committee -:r.d the Smoke and Fumes Committee (Division of Refining) to the er.d -hat medical aspects of the smoke and fumes problem will be included ir. the research program of the Division of Refining. As recommended by the Medical Advisory Committee and on cshalf of the Medical and Health Committee, which has not held a nesting this year, I request approval for the solicitation of $75>0C0 icon oil companies in contributions of the same amounts as given in 1;55 to be used with unobligated balance in Medical Advisory Fund in support of 1956-57 p r o g r a m and budget as follows: University of Cincinnati - Carcinogenicity Retainer for Prof. Philip Drinker 1 University of Texas - Toxicity of Cq - C 12 Aromatics Miscellaneous Expense y Total $58*500 3>000 20,000 1,000 $82,500 cvember 15, 1955 API 07228 I ; Twenty-first Meeting April 22, 1956 The Warwick Philadelphia, Pennsylvania :RE SETTI L. 2. Curtis, M. D., Chairman V. C. Baird, M. D . , Vice Chairman W, 0. Armstrong, M. D. E. K. Linder, M. D. Lamscn Blaney, M. D. E. P. Lucngo, M. D. F. F. Boys, M. 3. C. R. Miller, M. D. J. V. Crcokshank, M. D. M. N. Newquist, M. D. R. 2. Eckardt, M. D. J. W. Osborn, M. D. T. M. Frank, M. D. B. B. Reeve, M. D, C. H. Bine, M. D. J. C. Ruddock, M. D. T. J. Kelly, M. D. G. M. Saunders,"M, D. Leo J. Viade, M, D. (represented by J. J, Thorpe, M. D.) --r-Zl-CAL ADVISORS PRSSEHT R. D. Bent E. K. Daniels A. E. Dooley Paul D. Halley J. W, Hammond Jack Spence R. M. Landon C. A. Neilson A. C. Pabst T. B. Rendel C. L. Samuelson, M. D. OTHERS REGISTERED Allan Collins Philip Drinker Robert R. Dugan, M. D. 0. C. Haier Brewster S. Miller, M. D. H, y. Prince, M. Di L. E. Renes W. E, Scovili G. A. Sinclair, M. D. D. V, Stroop AMBERS ;CT REGISTERED Marshall Clinton, M. D. Kieffer Davis, M. D. K. R. Fourcher, M, D, F. D. Gassaway, M. D. - Shell Oil Company - Harvard University - Continental Oil Company - Standard Oil Company (Ohio) - The Buckeye Pipe Line Company - Standard Oil Company of California - Phillips Petroleum Company - Standard Oil Company (Ohio) - Imperial Oil Limited - American Petroleum Institute R. C. Page, M. D. R. J. Potts, M, D. Ralph Schneider, M. D. E. R. Ware, M. D. API 07229 t The committee vote! cc approve the minutes of the Twentieth Meeting as circularized by letter dated December 22, 1955 II SUBCOMMITTEE REFCRTS Cteratir.g Subcommittee - L, 5, Curtis, M, D. , Chairman Dr. Curtis reported for the subcommittee. His report in the form of ''Memorandum of Meeting" April 22, 1956 is attached as Appendix A. ACTION: The report was approved. Program Subcommittee - B. 3. Reeve, M, D . , Chairman Dr. Reeve presented the subcommittee report which is attached es ;ppendix 3. ACTION: The report was accepted. Subcommittee on Atmospheric Pollutants - John C. Ruddock, M. D,, Chairman Dr. Ruddock presented the subcommittee report which is attached as Appendix C. ACTION: The Medical Advisory Committee voted to accept the subcommittee report and to recommend to the Medical and Health Committee that it should request the Division of Refining to include in its 1957 budget estimates an item of $20,000 in the Smoke and Fumes Funds for a study of the human health aspects of air pollution as proposed by the Subcommittee on Atmospheric Pollutants. Subcommittee on Cq - C12 Aromatics - C. H. Hine, H. D., Chairman Dr. Hine presented the subcommittee report which is attached as Appendix D. ACTION: The report was accepted. Subcommittee on Carcinogenicity - Robert 3. Eckardt, M. D., Chairman Dr. Eckardt presented the subcommittee report which is attached as Appendix E. ACTION: The report was accepted and The Medical Advisory Committee voted to recommend that the Medical and Health Committee should not object to the publication of: API 07230 1 ) !'.anuscri,pt entitled ''Carcinogenesis of Skin II". 2) 17 Abst,raecnttitled `'Relationships Between the Cccpcsim ion ar.d Carcinogenic Properties of . Various Refinery Streams". ucC e :n Zccr.cnic Poisons - J. V. Osborn, M. D., Chairman Dr. Ostern presented the subcommittee report which is attached as :oc=ndix F . ACTION: The report was approved. . sutsorjilttee on Physical Agents - Lamson Blaney, M. D ., Chairman Dr. Blaney presented the subcommittee report which is attached as Appendix G. ACTION: A majority of members voted to accept the report. Note: Doctors B. B. Reeve and J. J. Thorpe have requested to be recorded as having voted against the $5,000 contribution for research on noise. Subcommittee on Toxicological Reviews - Marshall Clinton, M. D., Chairman In the absence of Dr. Clinton, Dr. Baird presented the subcommittee report which is attached as Appendix H. ACTION: The report was accepted and the committee voted its appreciation for the outstanding services which had been rendered by Dr. Clinton as chairman of the Sub committee on Toxicological Reviews. The chairman was requested to inform Dr. Clinton of this vote of appreciation. Ill REPORTS BY LIAISON MEMBERS A. Dermatitis Survey - Leo J. Wade, M. D. In Dr. Wade's absence, Dr. Thorpe presented the report which is attached as .Appendix I. 3- American Standards Association - Allan Dooley Mr. Dooley gave a brief informal report supplementing his written report January 2k, 1956 on the status of ASA projects of interest to the Medical Advisory Committee. American Medical Association - J. W. Osborn, M. D. Dr. Osborn made a brief informal report. API 07231 ----A I 33 being cade by che Interdivisior.al M. Frank, pr. Frank seated chat the API program cf first aid training was levelctir.g most successfully. Note: Subsequently, Ir. Frank recorded his hope that each number of the Medical Advisory Committee would review the API First Aid and Safety Training Guide and would send his comments and suggestions to: T. M. Frank, M. D. American Oil Company Texas City, Texas IV TWENTY-SECOND MEETING OF MEDICAL ADVISORY COMMITTEE ACTION: The Committee voted to hold its twenty-second meecir.g during the Thirty-sixth Annual Meeting of the American Petroleum Institute with three sessions as follows: Monday, November '12th> l?5 - Cehrad Hilton Hotel ' 10:00 A. M . , Medicai, and Health Session . (open to all API'members and the public.) 2:C0 P. M . , Twenty-second Meeting, Medical Advisory Committee (Business meeting of members and their technical advisors.) Tuesday, November 13th, 1956 - Cor.rad Hilton Hotel 10:00 A. M., - 6:00 P. M . , MAC Round Table (unscheduled informal discussion by members only.) V ADJOURNMENT There being no further business before the committee, the meeting was adjourned. -pproved by: - I.^Curtis, M. D . , vn o Chairman. Reported by D. V. Stroop for F. D. Gassavay, M. D., Secretary API 07232