Document NGOr7Na4JmKmMyven6LkXJELp

M ar ch 12 1956 M r. Lee ft. H ill, P residen t W estric Battery Company 4201 Galpago St r e e t Den ver 16, Colorado D ear M r, H ill: I sh all attem pt fir st to an sw er the d ir e ct qu estion in your le t t e r of M arch 3, a ft e r Which I sh a ll ven t u r e so m e u n so licit e d w or d s of ad v ice . The application of an alytical m eth ods to su itable sam p les of u rin e, or b etter st ill, to su itable sam p les of blood, or st ill b etter, to sam p les of both' u rin e an d blood, fo r the qu an titative determ in ation of th eir lead con ten t, is a soun d p r o ce d u r e fo r th e a p p r a isa l o f the sign ifican ce o f t h eir exposurW t o , an d ab so r p t io n of, le a d . It is th e on ly type of p r o ce d u r e wh ich is so b ased on ph ysiological fac t s and p r in cip les a s to en able one to m ake su ch art a p p r a isa l in t im e to p r even t d an ger ou s ab so r p t io n of le ad . v V- Th e "Bld od St ip p le " m eth od, a s you h ave c a lle d it , i s th at of exam in in g stain ed.cjlood film s on g la ss slid e s by m ean s of th e m icr o sco p e to est im at e th e frequ en cy of occu r r en ce of a cer t ain type of st r u ct u r al ch an ge in the red blood co r p u scles. Th is method is not specific for lead , the r esu lts vary without n e c e ssa r y relation sh ip to the exten t or sign ifican ce of the in d ividu al's absorption of lead , and while the procedu re se r v e s to som e extent to be h elpful ip the d iagn osis of lead, poison in g, it s u se a s a m e asu r e of preven tion is deplorably u n satisfactory. Th e lead h azar d s asso ciat e d with the m an u factu re of st or age b at t e r ie s ar e su ch th at effective m ean s fo r th e con trol of th ese h azar d s a r e an ab solu te n ecessity for the safety of the m en . Th is in volves alw ays the application of soun d con tr ol of th e en vir on m en tal con dition s by good en gin eer in g. Excep t un der m ost un u sual cir cu m st an ces it also r e q u ir e s car efu l,in telligen t m ed ical su p er vision . Th is does not of n e ce ssit y m ean th at the se r v ice s of a ph ysician on a fu ll-tim e b asis ar e requ ired . The tim e requ ired depends upon the size of the plan t an d the n u m ber of em p loy ees, but it is th e sam e in prin ciple and m eth od, r e ga r d le ss of the n um ber in volved. The m eth ods of which you sp eak sh ou ld bej ap p lied u n d er th e d ir e ct io n o f th e p h y sician , wh o, alon e, in th e ligh t of h is oth er clin ical in form ation and h is kn ow ledge of the plan t an d its operation s an d c h a r a c t e r ist ic s, sh ou ld in t er p r et th e r e su lt s an d recom m en d ap p r op r iat e act io n a s r e q u ir e d . Th e u se ajnd in t e r p r e t at io n o f th e t e st s of t h is type by laym en , n u r se s an d tech n ician s a r e in fact m isu se an d fau lty in terpretation , M r . Le e R . H ill - (2) - M ar ch 12, 1956 and un der certain cir cu m stan ces ar e actu ally ille gal. It is m y su ggestion th at if you do not h ave a ph ysician in ch arge of th is act iv it y , you sh ould obtain on e; th at you sh ould fi r st a ssu r e y o u r se lf of h is com peten ce a s a p h ysician ; th at, if th en , he is not su fficien t ly fa m iliar with th e p r ob lem s an d the m ean s of h an dlin g th em , you sh ou ld put h im in touch with p r o p e r ly in for m ed p e o p le . I sh ou ld be glad , fo r exam p le , to give h im su ch ad vice an d a ssist a n c e a s I can , eit h er at a d ist an ce, o r th rough a v isit by h im to th is Lab or ator y , plu s puttin g h im in touch with su it ab le pu blication s. / I am assu m in g, of co u r se, eith er th at you h ave no ph ysician to appeal to, or th at you r p r esen t relation sh ip to a ph ysician is u n satisfact or y , sin ce oth er w ise he would h ave w ritten to m e in stead of y o u r se lf. It seem s on ly fa ir to in for m you, t h e r e fo r e , th at you sh ould n et u n dertak e to op er at e a h azar d ou s m an u factu rin g en t er p r ise of th is type without the d ir e ct advice and guidan ce of a ph ysician who is com peten t in th is field of occupation al m edicin e. I r e alize fu lly th at th is is not alw ays the case , and th at is p r e cise ly why we con tin ue to h ave un duly la r ge n u m bers of c a se s of lead poison in g an d claim s of le ad poison in g in th e le ad t r ad e s in th is cou n tr y, an d e sp e c ia lly in ou r sto r age b atter y plan ts. Sat isfact o r y m ean s of preven tion ar e availab le, and t h ey sh ould be u sed . I sh all be all too glad to a s s i s t you hi puttin g th em to u se by h elpin g a ph ysician to h elp you. Sin cer ely you r s, RAK ef Robert A. Keh oe, M, D. BATTERY C O M P AMY 4 2 0 1 G A L A P A G O ST. , D E N V E R 1 6 , C O L O R A D O G L E N D A L E 7 7 9 1 March 3 19 Ketterin g Laboratories C in c in n a t i, Ohio Gen t i enien : Your la b o r a t o r y h as been recommended t o u s b y -the N at io n al Lead Company a s t h e o u t st an d in g a u t h o r it y on Lead P o iso n in g and t h e determ in ation o f lead in variou s in d iv id u als. We h ave a problem h er e a s t o w h eth er we sh ou ld u se t h e U fin e A n aly sis method or th e Blood St ip p le method fo r t h e d e t er m i n a t io n o f le ad con t en t in ou r w o r k e r s. Could you a d v ise how we m igh t g<P ab o u t g e t t in g recom m en dation s from you a l l a s t o what you f e e l i s th e b e st method as w e ll a s sa fe l im it s. Very sin c e r e ly you rs, WESTRIC BATTERY COMPANY IRHjbu P resid en t N 6024.01