Document LgOvgx89OdO0GgrV6GR5JGwNb

September 5, 19^5 Dr. F . L. G o rre ll, City-County Health Unit, La8 Animas County , T rinidad, Colo. Dear Dr- G orrell: I n r e s p o n s e t o y o u r l e t t e r o f Aug ust 1 7 , t o w h i c h my r e p l y h a s b e e n d e l a y e d by r e a s o n o f my a b s e n c e fro m my o f f i c e , I am sending you a copy of a p u b lic a tio n of the American P u b lic H ealth A s s o c ia tio n , which I tr u s t w ill answer most of the q u e s tio n s you h a v e i n mind and w h ich a t th e same time w i l l g i v e y o u a f a i r statem ent, I b eliev e, of the public health problem of lead poisoning. There is perhaps one exception, in that the r e p o rt d eals with I n d u s t r i a l lead poisoning and says very l i t t l e about the sources of lead poisoning in the general population. I s h a ll attem pt b r ie f ly to outline certain aspects of the problem of lead poison ing in ch ild ren . In general c h ild re n 's toys, play pens, high c h a irs and o th er fu rn itu re , as manufactured in this country are not painted w ith p a i n t s of h i g h l e a d c o n t e n t . The m a n u f a c t u r e r s i n g e n e r a l h a v e recognized the h y g ien ic problem and have avoided i t f o r a number of y e a r s s y s t e m a t i c a l l y by t h i s means. I t h a p p e n s , h o w ev er, t h a t sm all shops do n o t always recognize th is s i t u a t i o n , and t h e r e f o r e t h e r e may be a s m a l l d i s t r i b u t i o n o f a r t i c l e s o f t h i s t y p e p a i n t e d w ith lead p a in t. Industry in general has attem pted to inform a l l of i t s r e p re s e n ta tiv e s so as to reduce th is danger so f a r as p o ssib le to the vanishing p o in t. However, th ere a re other sources of lead absorption in the case of ch ild ren . For example, baby's c r i b s and p l a y p e n s may be r e p a i n t e d by t h e o w n e r , an d h e r e t h e r e is nothing but the owner's knowledge, combined w ith the chance of what is available in the local paint market, to prevent the use of p ain ts of high lead content. Certain Imported to y s, p a rtic u la rly those painted w ith b r ig h t yellow colors have been found to be s o u r c e s o f d a n g e r . Moreover c e r t a i n toy'3 p r o v i d e d f o r c h i l d r e n , esp e c ia lly molding sets in which metal is melted and poured in to m o ld s to make s m a l l o b j e c t s , a r e s o u r c e s o f d a n g e r . We h a v e s e e n one o r two c a s e s o f le a d p o i s o n i n g in c h i l d r e n fro m t h e u s e o f l e a d n i p p l e s h i e l d s by n u r s i n g m o t h e r s . A n o t h e r s o u r c e o f p o i s o n i n g in c h i l d r e n , and a ls o in a d u l t s , has been the use in poor house holds of battery boxes fo r fu e l. This wood.heavily impregnated v i th le a d s a l t s when burned in a sto v e or f i r e p l a c e under s u i t a b l e c o n d itio n s gives r i s e to lead fumes in the a tm o s p h e re , exposure to vhich has produced a .rather large proportion of cases in th is c o u n t r y . We h a v e s e e n a number of c a s e s i n C i n c i n n a t i , one o r two Dr-. F. L. G o r r e l l - ( 2 ) - S e p te m b e r 5 , 1^45 of which have been f a t a l . Quite a series of cases of lead poi soning in children have been seen in Queensland, vhere they are b e l i e v e d t o h a v e r e s u l t e d f r o m t h e common p r a c t i c e o f a number of ] years ago of p ain tin g the verandas of houses v ith lead p a in ts . ! s m a ll c h i l d r e n k ep t en clo sed on these verandas a r e b e l i e v e d to have ingested considerable q u a n titie s of lead follow ing the con ta m in a tio n of t h e i r h an d s, toys and food by lead compounds which "dusted o u t" on th e p a in te d s u rfa c e as the r e s u l t of the w eathering of this paint under unfavorable prevailing clim atic conditions- I cannot vouch fo r the correctness of th is in te r p r e ta tio n of lead p o i s o n i n g among Q u e e n s lan d c h i l d r e n some tim e a g o . However, the s u s p i c i o n o f t h i s s i t u a t i o n ought t o l e a d i n d i v i d u a l s _ J .n g e n e r a l__to "be c a r e f u l 7 t o a v o i d t h e use --o f --bead--oacasounda. I n a n y _Larg:e_e x t e n t nn STlr-faces w i t h i n t h e m vlronmeniL-of--s m a l l --chi l d r e n . S m a l l , , ------ c h i l d r e n cravT~about on th e f l o o r and c o n ta m in a t e th e m se lv e s p r e t t y g e n e ra lly w ith any Kind of^clust or d i r t th a t Is w ith in t h e i r envi- ^ ro h m e n t. E v e n tu a lly ev e rv tn in g they get on t h e i r hands goes in to -H-rp-H^~fffnnths T and t h e r e f o r e c n n a ld ejj&el v p -p a t e r o ppe^-bunirbireg-- ----- T o r t h e d a n g e r o u s e x p o s u r e o f s m a l l c h i l d r e n o f a v a r i e t y o f _______ 1m p o r t a n n -~4n4-nr?nce~~on t h e a d u l t v i t h more c i r c u m s p e c t p e r s o n a l h a b i t s . P e r h a p s some p o i n t s h o u l d b e made of one o t h e r ~ p o t e n t T a r r hazafcTT V e te r s u p p l i e s i n some p a r t s of the e a r t h , n o t so much so in th e U nited Et a l e s , a r e l i k e l y to be con ta m in a te d a p p r e c i a b l y v i t h lead compounds. I t i s v e i l known t h a t c h ild re n are more s u s c e p tib le to the e f f e c ts of lead absorp tio n t h a n a r e a d u l t s and. a l s o t h a t c l i n i c a l l e a d p o i s o n i n g a s s e e n I n the child Is a mere serious disease than i t is in the a d u lt, generally speaking. Therefore, contamination of household water s u p p lie s v i t h leaG compounds i s more l i k e l y to a f f e c t c h ild r e n than the a d u lts . I rep eat th a t th is is not an im portant m atter in the United E tates, fo r our v ater supplies are gen erally handled in s u c h a way as to a v o i d s i g n i f i c a n t l e a d c o n t a m i n a t i o n . However, Im p ro v ise d and homemade a r ra n g e m e n ts f o r t h e s t o r a g e and d i s t r i b u t i o n o f v a te r - i n t h e h o u s e h o l d may r e s u l t i n t h e s i g n i f i c a n t c o r - tam ination of the v a te r v ith lead compounds, and th e re fo re this ^point needs to be taken i n t o acco u n t. I r e g r e t very much to have to t e l l you t h a t the th e r a p y of lead poisoning, especially in the case of c h ild re n , Is not in a very good way. There i s no s p e c i f i c treatm ent th a t o f f e r s any hope f o r very d r a m a tic r e s u l t s . The avoidance of l e a d p o is o n in g i s s t i l l the only s a tisfa c to ry treatment In the case of ch ildren. Treatment c o n s is ts in the main of the complete e lim in a tio n of exposure. Other-vise the treatment co n sists in taking care of p r e s e n t i n g symptoms as ad eq u ately as p o s s i b l e d u r in g the p eriod required to elim inate the large portion of the absorbed lead compounds. I tru st this information w ill satisfy your purposes. Vex-y t r u l y y o u r s , IAK e f P o b e r t A. Kehoe , M. D.