Document MGEq429qzRnm6v56zX7bZ3BEz

Septem ber 4, 1953 M r. H erbert E. H illm an Technical D irector E aglo-P ain t and V arnish C orporation 49-20 Fifth Street Long Island City I , New York D ear M r. H illm an: The problem of lead poisoning am ong young children is a seriou s one with which we have been concerned for a goodly num ber of y ea rs. U nfortunately we have published little on the subject and nothing of a com prehensive nature in any w idely circu l ted publication, largely b ecau se of our prim ary preoccupation with d ise a se s of industrial o rig in . On the other hand, we have b een in touch w ith the w ork and ob servation s of oth ers elsew h ere in this country, and have given d iagn ostic a ssista n ce h ere and th ere a s o cca sio n a ro se. M ost of the actual and su sp ected c a se s in th is gen eral area , and som e of th ose in oth er c itie s in w hich th ere a r e no a n a ly tica l f a c ilit ie s , have com e to ou r a tten tio n fo r a n a ly tic a l a p p r a is a l, and th e r e fo r e w e h a v e a v e r y con sid erab le accum ulation of inform ation which rela tes to the incidence of the d ise a se , the so u rces of exposure, the extent of the absorption of lead , and the rate of m ortality. I en clo se a tabulation of the num ber of c a se s of which we have know led ge by y ea rs up to 1953. The data w ill give you som e insigh t into the scop e of the lo c a l p rob lem . The y ea r 195 3 has been a bad one from the asp ect of m ortality. The season for the appearance of c a se s (m ost of w hich, for som e unknown reason , com e in during the hot m onths of the y ea r) is not over, and I have hot tabulated the resu lts for the y ea r, but the data,it appears, w ill resem b le those of 1951. One m ight conclude that the in cid en ce of the d ise a se is unduly high in C incinnati, and that th ere has been a recen t in c r e a se (during the past few y ea rs). We do not b eliev e that eith er of th ese conclusions is ju stifie d . It is p rob ab le th at w e do not s e e anything lik e a ll of the c a se s in any y ea r, and that the num ber found and recogn ized is a function of the lo ca l in terest and diagnostic com petence of ph ysician s. F o r a n u m b er of r e a s o n s t h e s e h a v e b e e n h e ig h te n e d r e c e n tly . In ou r exp erien ce, the incidence of the (recognized) d ise a se in other c itie s, B altim ore, for exam ple, v a ries with the application of sa tisfa cto ry m eans of detection and diagn osis. W herever there are fa c ilitie s for m odern d ia g n o sis, the d ise a se is found. I would e stim a te , on the b a sis of our ex p erien ce, that th ere are con sid erab ly m ore than one M r. Kc. thou san.:. T h is, iu m e a n s P' minima;., to err c m uch laa sig n ifie he dons There i It is urn moldir... given fuel in y proxirr. deposi: ' of a ch fr o m sthe ho; " rith r from n. flaking left mu' F a in t c.' lik e (wr paint of s e e m tc from iv contai: contains lead in In m y fi out at a . th i3 su:r. control ; elim inate . content ` of your' c o n c e r n s.: in e ffe c ' legish. : o, : 953 .. iron in g p e r y e a r in th e U. 3. A . x e of m ortality in such c a se s , 7ml r ed f a t a lit ie s p e r y e a r a t th e itiinate, d elib erately designed 'c a of m ild c a ses m ust be very vie h ealth p ro b lem of r e a l eking 'should be done w h ile it can . ivee of exposure in our c itie s . . ;v f .c to r s co n trib u te. L ead -, u rho le a d n ip p le s h ie ld , h a v e -c -f b a tte r y c a s e s a s h o u se h o ld distance, at le a st, the 'o cf fu m e (w hich w as fa surfaces with which the hands .. lo g ic fa c to r . S e v e r a l c a s e s , ).i le a d pip e to b rin g w a te r in to . : *y o r in o th er r e m o te p la c e s . a:* of c a s e s (but not a ll) c o m e rcao of the city. C razed and . baseboards and porch ra ilin g s,- ippear to be the p rincip le so u rce, ms, b ed s, high ch airs and the about the precaution of using im portant s o u r c e . Som e c a s e s putty, picked by sm a ll fin g ers a ;.nrcty, as you know , d o u b tle s s , com pounds, w hile som e o tc be little justification for ion of this problem , as I pointed -a A s s o c ia tio n at th e G r e e n b r ie r ,, organized program of education and 'fa ctu rers, and d istrib u tors, to ; m ore than v ery m inor lead ; household and in the environm ent obim tarily by a w ise ind ustry properly, it w ill be accom plished u n ties and disadvantages through K 001308? M r. H e r b e r t E. H illm a n * (3) - S e p te m b e r 4 , 1953 .This p rovid es you with m o st of the fa cts and opinions d erived from our o b se rv a tio n s. If I can be of any a s s is ta n c e to you and to th e in d u stry g e n e ra lly in d ealin g with th is m a tte r , I should be p le a se d t h a /e you call upon m e. Sincerely yours, RAK EF Enc. Robert A. Kahoe, M. D. HB 0033083 Casas of Lead Poisoning Among Children in Cincinnati, in the Records of The Kettering Laboratory, by Years Confirmed b y Analytical Data Year Number of Cases Number of Fatalities On Blood and on Tissue rine " 1928 2 1931 1 1932 1 1933 1 1934 3 1935 1936 5 1 1937 4 1938 3 1939 5 1940 1943 5 1 1946 2 1947 2 1948 3 1949 6 1950 12 1951 18 1952 12 Ali Iears 7 1 1 2 1 1 1 1 1 3 4 7? 2? -------- 55 2 1 1 1 3 32 1 4 3 5 5 1 11 11 3 53 84 16 3 11 1 n 1? Comments ; 1. The histories of exposure as supplied were ;ill-defined in most instances . The full case records may have been more informative. These were not investigated at this time. Paint frm toys , furniture, woodwork in house, porch railings and unspecified sources was incriminated, some times by implication only, in 16 cases; battery casings used as household fuel were implicated in 2 cases; metallic lead toys were involved in 2 instances, one of which was fatal, and a lead nipple shield was convicted in 1 case. 2. Pica was alleged as a factor in 22 cases. Kg 0013085 N14888.01 LEAD POISONING IN CHILDREN Historical - Comparatively rare disease Use of lead nipple shields Use of cosmetics - face and neck - contaminating breast - Japanese Use of stains and dyes on hair - India More recently Frequent occurrence in Queensland Calling attention to paints of high lead content Present problem in USA Sources Inside paint - floors and other woodwork - painted plaster walls - window sills Immediate environment - playpens, high .chairs, cribs, toys Other - metallic lead toys - molten lead inhaled solid lead chewed - bullets, etc. Nipple shields still used occasionally Use of storage'battery boxes for fuel in household . Water supply - lead pipes Bullets in body - especially within a joint 0013000 LEAD POISONING A NURSERY THREAT Lead is not a new product, it is among the first metals known to and used by mankind, and its use at present is very extensive in almost every part of human surroundings, " ' The most startling danger of lead, from the aspect of the public health, is that which involves small children, g Age of child most susceptible from NINE MONTHS TO THREE YEARS. This is the 4 exploring age, when the child starts crawling and walking around 1 the house. The child puts things into his mouth; and to relieve f the discomfort of teething, the baby may chew on any available object The dangerous features of the disease in childhood are the following: 1. The child's exposure to lead often escapes the notice of the parents. 2. The disease is insidious in its development and the early symptoms often go unrecognized. 3. The disease in childhood is much more serious than that in late life, disablement or death being often the outcome. f - \ Sources of lead poisoning: - ' f\ L * 1. Chewing paint on window sills, toys, furniture& JJju fidL ) n* ' 2. Constant sucking on small lead objects such as to;f soldiers,1' paint rags, etc. 3. Swallowing chunks of painted plaster or loose flakes of old paint from inside or outside walls and eating them. 4. Removing putty from frames (windows, doors, pictures) and swa3.1owing. . Keep in mind the following: 1. That all paint used for inside purposes should contain little or no lead. 2. Reputable toy and juvenile furniture manufacturers do not use toxic paint in their products. ' 3. The real DANGER is when AMATEURS REPAINT AND USE AN UNSUITABLE LEAD BASE PAINT. 4. Surfaces from which paint is cracking or peeling provide/ bits . of paint d.s a source of lead poisoning. . Precautions to take: . ' 1. When refinishing woodwork, toys, childrens furniture (cribs, .... chairs, tables) be sure to get non-lead paint for the job. Per centage of lead should be on the label, if not inquire. Paint ' for inside use, -should never contain more than-1% or 2/o of lead. ^ 2. Prepared the surface before you start to painty remove all old * paint. Do not leave paint, turpentine, old plaster paint flakes around for child to eat. 3. Check woodwork, furniture, toys in your home NOW, Watch for teeth marks and. maintain a lead free environment. 4. Do not permit a small child to have or play with metalic lead in moulding sets or other toys. Ant older child with such a toy should be taught how to use and the dangers involved. THE GREATER CINCINNATI SAFETY COUNCIL THE KETTERING LABORATORY AT THE COLLEGE CF MEDICINE, UNIVERSITY CF CINCINNATI i LEAD POISONING How it affects small children Laad is not a new product, it is among the first metals known to man kind. Lead colic and paralysis were among the first mentioned diseases, and were associated withindustry. To a large fextent, lead poisoning as the result of occupational hazard does not exist. The chief danger today is when small children become affected.. Dangerous feature is the insidiousness of its development. The disease may become advanced in a child before it is suspected. Age of child most susceptible fromNMINB months to THREE years.. This is the exploring age, when the child starts crawling and walking around the house. The phild puts things into his mouth; and to relieve the discomfort of teething, the baby may chew on any available object. Symptoms of poisoning are difficult for highly trained physicans to diagnosis Vomiting, loss of appetite, irritablility and lethergy can occur with almost any illness of childhood. By the time more pronounced symptoms occur, especially convulsions, inseparable damage has been done to the brain. Sources of lead poisoning . 1. Chewing lead paint on window sills, toys, furniture. 2. Constant sucking on small lead objects such as toy soldiers, paint rags, etc. 3. Swallowing chunks of plaster or loose flakes of old paint from inside or outside walls and eating them. IMPORTANT: It is the day by day infiltration of lead that does the damage Keep in mind the following ' 1. It is recommended that inside woodwork be painted with material containing very little lead. 2. Reputable toy and juvenile furniture manufacturers do not use toxic paints in their products. 3. The real DANGER is when AMATEURS REPAINT AND USE AN UNSUITABLE LEAD BASE PAINT. Precuations to take 1 0-2 co 2 <o When fefinishing .woodwork, toys, childrens furniture (cribs,'chairs, tables) be sure to get non-lead paint for the job. Percentage of lead should be on the label, if not inquire. Prepare the surface before you start to paint, remove all old paint. Do not leave paint, turpentine, old plaster paint flakes around for a child to eat. 3 Check woodword, furniture, toys in your home NOW. lu Watch for teenth marks and maintain a LEAD FREE ENVIRONMENT AROUND A CHILD. T o L A-4^4 Greater Cincinnati Safety Council,y ji-ini cooppeerraattxiuoxni wi>u * _ t\ * Cases of Lead Poisoning in Children}Recorded 'by The Kettering L a b o r a t o r y by Years - (No oases recorded during the years omitted) CtUMM*2T IW mZZ'CX Confirmed byrAnalyrtticial Data Year Humber of Cases) Humbery of Patalities n Blo o d anal in T issue' I T OriHe. w 1931 1932 1933 193$ 1935 1936 2 1 1 .1 1 (/KA-lefy.* 5 l2 2. 1 ) / 3 S' i 1937 1938 1939 19$d 1943 1946 4f 33 5S 5s 1 1, 2z 1947 1948 1949 1950 2 2. 3 36L" 12 ti. ' MSf xL X. .n All Years !Z )Z -%1 k 1 <3(itjnuu* P&j . 1%44*r / 2 1 '; 2J f k1 1 L2 / f3 2. 3 3 1 21 f: 1 1 \ 4& t 1 1* 3. 3. i: 1 1 5 sr 5 y* 1t /1 l1 t 1/ I 1 f. 3 ^ 33 4. 4 f 4- * 5 8 % V V7? t ' 2* z r t 7 .? 7 ll ? /a II, 2S- 2? 7 f 73 11 11 1 7. 2. 'A ." 11 11 3 3i4 1,, __ n zf , Comments * X. The histories of exposure as supplied vere Ill-defined in most instances. The full case records may have been more Informative^ These vere not investigated at this time* Paint from toys, furniture, woodwork in house, porch railings and unspeclfled sources was lnerimInated,sometimes by implication only, in 16 cases; battery casings used as household fuel vere implicated in 2 cases; metallic lead toys vere involved in 2 Instances, one of which was fatal, and a lead nipple shield was convicted,_In 1 case 2. Pica was alleged as a factor in 22 cases. . . -- Three "of.this series of cases occurred at considerable distances V from Cincinnati (Philadelphia* Louisville and ) , the v \ remainder being from Cincinnati or its environs. ' .,,. S*--- ^ 6* 3 $ f j Ld .. .......... .... Frequency ibaltimore - from 1931 to July 1, 1949 Age in Years Eumber of cases White Colored of' 'Deaths White Colored Under 1 1 2 5 4 6 7 3 10 Total 1 37 12 1 32 13 8 '4 rs-'' 1 1 220 Largest number in any one year - 5 I Smallest number in any one year - 2 78 142 73 27 51 Cincinnati - Largest number of cases - 20 - 1951 8 7 from 1928 to 1953 - with 25 fata.lit.ies