Document O1rawgreN2geMX5vjNRBMO3Be

February 25, ID-47 Dr. V, E. Cbetz, Medical Investigator, ialety and Hygiene Livision, Industrial commission or Ohio, Columbus, Ohio. Leer Dr. Gbetz: > I am writing to you concerning a situation which In my opinion Is more than trivial to us both. It concerns the hygienic situation in the plant of Magnus Metal Division of National Lead Company in Cincinnati, this plant came to cur attention recently through the occurrence of a case of load poisoning some weeks ago, and it was our report oi this case to the Department of Health of the- Plate of Ohio,_vhich led, X believe, to your visit on December 27. By reason of our several contacts with the people- representing this company, in an effort to inquire concerning the conditions In the plane, which ve alv&ys do when the opportunity affords itself, we came upon their interpretation of your statement to them, following- your visit, that the conditions in this plant were not such as to have caused lead poisoning, and therefore ve might well be mistaken. I have encountered visit on white r following careful study of a number of referred cases and some further checking up on the operations. I was surprised greatly at the occurrence oi such an issue- at that time, and I cm even more surprised by it at uu: present time. It just does not- seem to me to be credible that you could feel that I or my clinical assoc is ties have made a diagnosis of occupational lead poisoning without having wholly adequate evidence on which to base our conclusion. In any case I have determined to write to you and to call your attention to certain mallei a which. In my opinion, are worthy of your con sideration. First let me point out, in connection with the plant of Magnus Metal Division, that we have under our observation at present in the General Hospital or elsewhere at least seven proved cases of lead poisoning among the employees of this plent. It appears that there are several others. These cases vary from relatively mild lead poisoning of the gastro-enteric type, to severe disabling and persistent lead colic, ana even to a perfectly typical case of bilateral wrist drop. The diagnoses in these cases have been made on the basis of unequivocal clinical anc! laboratory evidence, in association with such information about the plant conditions as Dr. W. E Qbetz - (2, - February 25, iy47 ve have been able to obtain. The officials of this company have corresponded with State agencies, and have sought an investigation at the hands of the Department of Health. Ultimately they have been referred to us by virtue of the Inability of the State industrial hygienists at this time to carry out the plant survey chat is necessary to appraise the significance of the entire situation. Ve have responded to the request from the company of ficials for- advice and have recommended to them what should be done, and hoK^guch of it ve are prepared to do. It seems probable and al^Sytnar^xnl hesitation on the part of these officials to. follow through on this necessary procedure, is occasioned by their uncertainty as tc our competence and good faith. r:.o the extent that this is true, it has been implemented in part by your letter tc them of Uenuary 2, of which X have a copy. It may veil be that the interpretation which has been put on your letter is net precisely what you would have intended. On the other hand, I believe you have expressed an opinion which is substantially counter to our own, ana on evidence which vos in no vise capable of justi fying your conclusion, I am not sure as to just vhet you were shown in this plant, or just what the conditions were when you saw it, but I think your conclusion rather obviously leaves something to be desired in view of the fact that ve have iound a surprising number* of cases of acute lead intoxication among the employees of this plant within the Iasi iev weeks. I am quite sure that you would not question the correctness of these diagnoses on the basis of the evidence available, there is no one of them about which there is the slightest question, since they fulfill all of the classical clinical as veil as the modern physiological criteria. I am sure that you are quite familiar with the extent to which ve have developed these latter criteria out of linical and investigalive work and broad industrial experience. lou will gather from wh&t I have said above that I am somewhat irked by this situation, xou are quite right. In addition, however, to some personal and professional firitetien, I am led l o these comments by much more significant conslccrsticns. fur public and professional responslbilities are quite as great as yours, ana yours are certainly not to be ignored. "feu and your associates, as well as ourselves, can ill afford a conflict of this type. Such a conflict can only have the elfect of injuring us both, and znoic- importantly, of militating against the accom plishment of our purposes in terms of the health of people employed in hazardous trades, Vith the information that is available* at the present time in relation tc industrial lead hazards, the problem of hdustrlal lead poisoning could be eliminated for all time, if we had but had the intelligent undersLanding of physicians, public officials and responsible industrial management. It is quite possible to measure occupational hazards in relation to load in precise terms. It is quite possible to define safe occupational' lead exposure. It is also quite possible to diagnose lead intoxi cation and to differentiate it from other disease processes in most HE *i U' >' \ Vt V. E. Cbetz - (2; - February 25, instances. Any controversy on matters of this type between offi cially responsible persons such a3 yourself and publicly and professionally responsible people like myself and my associates is foolish and wholly" unnecessary. Eou should know if you do not, that we do not make diagnoses of occupational or non-occupational lead poisoning without having complete and satisfactory clinical and laboratory evidence. fou should also know, if you do not, that ve have never convicted any plant of being hazardous in terras of lead exposure, without having the cold evidence on which to speak. I am not saying by thl3 that we are infallible. What I am saying is .that ve oo not come to a conclusion at all, unless ve are prepared to support it by adequate evidence, therefore, X should say aial when you walk through an industrial plant and look at the surroundings and presume to say, against cur evidence, that it seems unlikely that a man was poisoned ar, his work, you are doing us, yourself, and more impor tantiy the exposed, personnel, a heedless and unnecessary injury- Even with the years of experience that I have nad in the ie&a traces, I should feci the necessity for more precise information then can be obtained by ouch means . I am being blunc, but X am talking directly to you and not t 0 any third party- I trust you will not regard what I am saying a 2 anything other than an honest effort to arrive at a satisfac tory basis ior the consideration of our mutual public and profess 1 onal responsibilities. I have appreciated the direct contact;-: vi th you which X have had in the past, nub. I trust bn.ai there will no t be misunderstanding and personal or professional 'unpleasantness in the future. Ir is tc this end primarily, and to the improvement of industrial health In the corasuniiy arid elsewhere, that 1 mak'e- these somewhat pointed comments. Cordially 5curs, f-AK ef C .C - i Dr. Henry V;. ^ycier Er. Wnr. F . Ashe l oberl A - ,hehce p;. Xj . 0014192