Document Lgmmr1QjJnww2w2Ypyg5Rx9wq

STANDARD OIL GOMPANY (i n c o r p o r a t e d i r n e w j k r s k y ) ' 30 ROCKEFELLER PLAZA, NEW YORK 20, N. Y. ROBERT COLLIER PAGE. M. D. m .. GBNERAL MEDICAL DIRECTOR ALFRED GAGE, M. D. MEDICAL DIRECTOR . THOMAS C. KIENZLE, M. B. KENNETH R. FOURCHER, M. B. ASSISTANT MEDICAL DIRECTORS December l4, 1949 ` , JOSEPH P. HOLT, PH. D., M. D. RESEARCH DIRKCTOft DELAVAN V. HOLMAN. M. D. INTERNIST RALPH F. SCHNEIDER, M. D. JAMES R. MCMILLAN. M. B. PBTSICIANS AT LARGE FRANK J. RUMMEL. M. D. Robert A. Kehoe, M. D., > lettering Laboratory fof-Applied'Physiology, 1College 'of-Medicine' /., / ' 'v' UaiYerisit^..,pf'r0iiiteiaaatii, .Ciacinpati,.. Ohio*. .. ......... ...,v . 'v V 4" ' Dear Doctor Kehoe; . '-:v --/' . Recently the problem-of lead absorption as indicated/bytheurinary excretion of lead, .has7arisen among, a group ..of workers in one :;of our affiliated companies. :It appears-thatL.the urinary lead values which have/been obtained are accurate since a control group of supervisory personnel; exhibited values.which fell within the expected normal limits-and delicate samples of the same man taken within ,one or, two t,days;of each Other have given comparable results to within 0.01 mg. per liter* Ehe .urinary ; values of-the group in whom ..increased lead ab sorption has-been suspected,, after correction-to; a standard specific gravity of 1.024, have fallen`into the range of 0.12:to 0.24/mg. , per liter. It is contemplated to follow up these urinary lead findings with medical examinations-of the exp0sed'workers and with indicated further laboratory invest!- , gations.-; In this regard I am writing-,to you for-your opinion on the relative merits of the ..basophilic stippling/test using-Vfri^it1 s stain, versus the basophilic aggregation test;developed'by ./McGordand co-workers,, and' outlined by R.H.HarkwithfK.D., in a bulletin prepared-by the Ohib Department'of'Health:ih December,-.1940* . In reviewing the literature of the relative merits of these two tests, it appear,s to me. that some workers seem to preferythe basophilic .'stippling test and others the 'basophilic .aggregation, tost.; .X ;woul& .be very, much 'interested to learn for which one-of. these .-Wo,..tests''you have a.preference, if any, recognizing of course the limitations ;of any ,hematological/examination of 'this/natures/ In your section on /Industrial Lead'.Poisoning in Volume 11`of Patty's Industrial; Hygiene and,,Toxicology, ryou seem :t6.. leave = the choice "between the two tests somewhat open. - .< I should also'be-veiy' much Interested in your .ideas on/the .possible effects of lead on the central nervous S5rstem, with particular ,referencV.to emotional syndromes such as emotional instability and anxiety-like states. One of the workers of the group referred to above in whom the urinary lead excretion was only O.O6 mg., exhibited a syndrome which the examining physician believed was emotional in origin and yet on questioning the supervisors of this worker, it was not felt that he had px-eviously demonstrated any of the manifestations of emotional ' disease. I realize- bf-h^sburs'e- that you cannot express an opinion, on this case with 3r. 2. A. Kehoe - Page 2. the limited information provided you in this letter, and this is not ay inten tion. -nor do I have any intention of using any information you may send me from a medico-legal standpoint, Bather 1 am interested in a general expression of the possibilities of lead absorption leading to the appearance of an emotional dis turbance. ITaturally it is understood that severe lead absorption may result in lead encephalopathy which, presumably indicates that lead can effect the central nervous system. In such cases of true lead encephalopathy'' the cerebro-spinal fluid pressure and/ or protein and cells are elevated. If lead can cause central nervous system manifestations of degrees less than true encephalopathy, such as emotional instability or anxiety states, do you have any information as to whether or not say* changes in the pressure,cells or protein of the cerebro-spinal fluid result? I should be most grateful to you for any information which you can send me in regard to the two topics discussed above, and I again wish to assure you that this information will not be used in any medico-legal sense but will only be used in assisting us to establish an adequate system of medical examinations for the men in whom we are suspecting increased lead absorption and for the inter pretation of the findings of these examinations. Yours very truly, BHHjfbp cc; Dr. J. P. Holt E. 2. 3CHAHP:?, I!. 3. K 0018460