Document OJ3KYpqRm79wmXxK05dwdkx5X

Memorandum On Research In the Department of Preventive Medic la and Industrial Health* College of Medicine, University of Cincinnati. Introduction The investigative work in the Department of Preventive Medicine and Industrial Health is carried on in two more or less distinct, but closely related, categories, namely, (1) that which la concerned with certain broad scientific disciplines which have application generally to medical research, namely, epidemiology and biometrics, and (2) that which relates to the hygienic problems of industry, including those of the community which stem from the operations of industry. Further to clarify these two categories of research, certain examples may be cited. Epidemiology, ia the first category, has long been an important discipline in the investigation of hygienic problems of various populations, having to do with the incidence and distribution of diseases therein. The epidemiologist must now concern himself with various forma of chronic disease which now have greatly amplified importance in human health, within both the industrial and general population. The role of biometry, in giving expression to hygienic facts, and in establishing the mathematical relationships toward their further investigation and elucidation, is achieving increasing significance within the Department. This has been recognised outside the Department to such an extent as to have brought forth the development and growth of a biometric (computing) center situated within the Department, but available to the entire Medical Center. This development, organised recently, and given adequate financial support through a large grant of funds by the U.S. Public Health Service, is actually the formal expression of an existing activity created by the biometric staff of the Department in its collaboration with investigators in other departments of the Medical Center. KK 0 0 0 3 15 4 2 The epidemiologic and biometric work of the Department is housed in the round floor of `Sherry Hall, where the participating staff functions as the division of Preventive Medicine. The other functional divisions of the 3oprtr*mt (Industrial Medicine, Industrial Toxicology, Industrial Hygiene Toraaology, <iad bibliographic doseorcii), housed in the Kettering Laboratory, are engaged in a variety of research project, nos of which involve all of the divisions of the Laboratory, including Preventive Medicine, while others are initiated and carried out solely within some ou of tuo division. A an -.pi of n coordinated urogram of reaearen, a project which was initiated in the division of Toxicology, an investigation of n't ior.io i - a n i - J V* o ? the absorption of beryllium nai;as'.i8, has ';wi extend* v aw env\s*i>;i..Kvsi,;t7 '. industrial joevationa la which beryllium is used,, involving tbs extent and character of <*1. conuaminatioit of t'.w fc?.?OBp:K.< tf '.yorhrooaw with finely divided beryllium a& the result of thuso op*iMt\,4.a, a jH into 've c '11x-t'cn c'.t i.v'or.uation coneerr >VJ;0 in such operations, aa*5 the orit >'al a:;;d<a*-ntion'of ;iftsidurdo of rnaustriai safety relating to the permissible ccu*r,*ntrt icn* of baryIlium (and it "a compounds) in the atmosphere of work arena. This work calls ir.to play every functional division of the laboratory, including n continuing search of current literature tor any and all pertinent information on beryllium. The present activities of the ioepsirtMerct, with respect to research., ure listed below, according to the functional division of the Department la which >ei<'h project was initiated, it should ho rer.ojyniiied ..l.rit very ..A:..- oi. these projects have remained exclusively within the division in which they originated, and that none of them has been prosecuted without frequent consultation of tiie principal investigator with his associates in the divisions of the Laboratory. 3 Division of Preventive Medicine Epidemiology A project on coapeting risks has been underway for scare time and will continue in the future. This is a theoretical problem concerning the effects exerted by nodical and hygienic practices on the disease patterns of populations. Specifically, one is concerned with the manner in which the decrease in the diseases of the early life of individuals affect the patterns of mortality in later years, especially as to deaths due to circulatory abnormalities and cancer. This is under continuous investigation by members of the staff* A grant for a study of the effects of low therapeutic dosages of radiation upon subsequent malignancies has just been obtained jointly by this Division and the Department of Radiology. the staff of the Division serve as consultants in a number of other current epidemiological investigationssuch as that concerned with mental disease in industry, and an examination of the needs of chronically ill individuals in this community which is being made by the Public Health Federation. Preventive Medicine The head of this Division has just returned from a foreign tour of investigation into the feasibility of medical training and facilities in certain underdeveloped countries. Another member of the staff is studying the treatment and control of alcoholics by several methods. Zt is anticipated that guidelines leading to proper treatment and to the selection of appropriate facilities for Individual patients will be developed. Mathematical Members of the biometrics staff have received a grant for the investigation of alternative bleaaathematical models which describe the deposition of inorganic substances in the tissues. K 0003150 4 Another project is being shared with members of the staff of Children's Hospital in investigating a model which permits the evaluation of new drugs used in the treatment of leukemia. Experimental A grant has been received to develop investigations in antibody responses to toxic exposure of animals and man. The reactions of man and experimental animals ill be followed during and after the termination of definable types of exposure, both In degree and time, to high energy fuels, pesticides, and similar toxic materials now commonly encountered in modern eosxiunitios, In industry, and in military situations. Training A training grant in epidemiology and biometry obtained last year has enabled the Department! train outstanding students in research and theoretical problems in medicine which require a special knowledge of mathematics and the ability to look at nodical problems through the eyes of a computer. A number of students in this class are actually engaged in various phases of n.edical research. Clinical Division (Industrial Medicine) An investigation of the applicability of the tolerable U n i t s of exposure to beryllium 4 in the planning stage, as aa extension of previous investigations of this metal and its compounds. The "normal" metabolism of chromium, boron and nickel is being investigated. This involves the determination, of the normal ranges of the concentration of these metals in blood and their excretion in the urine of various unexposed groups of industrial employees. The extent of the accumulation of cadmium and chromium in the human body from birth to death is also being investigated. 5 Another investigation is concerned with the variations in the gams** globulin fractions and enzrees in the blood, in chronic pulmonary disease. The extent of the absorption and csseretion of lead by various groups of person in urban populations is teeing investigated, in parallel with determinations of lead in urban atswsphere <c&rrted out by members of another division.) Measurements of pulmonary diffusion are teeing made on a series of patients and volunteer subjects, by means of rebreathing carbon monoxide. An investigation is being sad, in collaboration with the Neurological Disease Research Center of the USFIM in Guana, of the concentrations of trace metals in the blood of patients living in an area in which neurological disease occurs la high incidence. A continuing investigation of carcinoma of the urinary bladder is being prosecuted by the clinical followup of men formerly engaged in the manufacture of bensldine. Physiological effects associated with the manufacture and use of certain chlorinated hydrocarbon insecticides, are being investigated in a 10 year retrospective survey of men in a naaufactwing plant. A preliminary investigation is now under way. : ' Cccular irritation, in association with exposure to the exhausts of automobiles, is being investigated in a study of the effect of different fuel mixtures aad their exhaust products, in collaboration with members of the staff of the Robert A, Taft Sanitary Engineering Center of the U e8, Public Health Service Sax Cincinnati. An investigation of electrical impulses of the cornea, an an indication of irritation of the eye, is being made by a graduate fellow in industrial medicine. The electrical impulses picked up from the cornea of rabbits, are 0003153 ' ' ';'.AAx & to bo correlated with irritation of the human eye. Dermatologic Invest igratlona The research activities have been aceraod essentially with the role of environmental factors and the pathogenesis of contact dermatitis -- both of irritant and allergic origin. 'The .factors which have been under study are: ambient temperature and humidity exposure to cocaaan chemical materials {soaps, synthetic detergents polar and nonpolar organic solvents} substances which ere known to accelerate chemical carcinogenesis and ultraviolet and infrared radiation. la the past year it has been observed that exposure to ultraviolet light of 3209A and shorter wax' lengths, results in decreased reactivity of animal skin to at least one potent experisaontal sensitizer. It has boon observed, clinically, that wotting sad drying of the skin appear to increase the incidence of contact eruptions during winter weather. This is especially true of the dermatoses found among machinists and house wives. Further studies have be planned to explore th effects of repeated Emersion of the skin Chanda, etc.) in water alone as well hsj in fixtures of e&HEsoa chemical irritants, ea th structural, physiological and biochemical into* ity of th shin. These will include experiments to demonstrate the changes in the epidermis and the cutaneous barrier, of repeated wetting: and drying in relation to certain biochemical alterations and to impairment of the defeases of the skin against the penetration of foreign substances. Psychiatric Investigations (Industrial Mental Health - A-Joint Activity of the Department and the Department of Psychiatry) . Detailed data have been collected from the personnel records of 323 employees in Industry, and from the medical records of 138 of these, Th personnel and medical departments of th Industrial organisations have classified them as: long term absentees, short term absentees, accident cases, cases presenting interpersonal difficulties or inefficiency, repeated visitors to the 0003153 1 edical dispensary, and the "normal" effective employees. The supervisors have been interviewed to obtain ratings of their perforrsaace at work. Each sub group has been divided into ''experimentala" and two types of controls. The 117 "expermentals" have been gives psychological screening tests, and have been interviewed by a psychiatrist or caseworker. Diagnostic assessments have been formulated and rocoBaaendations made for help on problems, including suggestions to family physicians and referrals to community agencies# and psychiatric clinics. These procedures are being repeated 2-3 years after the initial study. C-orapsricons will be ssad* of the data in the records, as to changes in the "experimental'* as coshered to the two types of "controls." Economic estimates will be ra&d as to the value of any changes in relation to the costs of intervention. Other correlations will be studied bearing on the mental health of the ''xperimetttala." Air Pollution Division of Industrial ffyglono Technology A survey f air pollution caused by the peraticaa of a large steel mill is being carried out. (a) The soot fall is feeing easured at various locations in the city, in relation to the site of the plant# iron tin to time during a full year, . (b) The concentration of benssopyrene in the air in the vicinity of various operations ia the coke oven area, and at one representative Site in the residential area of the city# are being determined. (c) The quantities of various materials discharged from selected stacks of the plant are being measured. . \ A survey of air pollution caused by the operation of an electrometallurgical . \ plant (metal lllcides) is being made. . (a) The dust-fall at a number of sites surrounding the plant is being determined periodically throughout one year. 3 (b) Th relationship of the dvst-fall to the emissions from the stacks of the plant la to h determined. A conprehaasiv investigation of r;-h ia the air of Cincinnati Is near ccEpletton. <a> The air of Cincinnati -s being sampled periodically at 4 representative permanent sites and at case mobile station, aad these findings ar being correlated, so fa? as possible, v?ith analytical data obtained in an investigation of the lead content of the blood and excreta of representative residents of the city. CThls is an investigation participated ia by members of the Clinical straff of the laboratory, ns referred to previously.) Industrial Hygiene The metabolism of inhaled load la being investigated in human subjects who .are exposed to air containing: 0.13 rag. of lead, as the lead aesquioxide, per cubic Tnetcr, to determine the ultimate extent and the fate of tho lead absorbed under these conditions* The function of the division i to maintain tfce physical condition f these oxperiaents said to analyse the biological materials that result frosa the experimental design, Deterrsinsilloan? are being made of the occurrence and the concentration of Cd, ??i, Pb, r and B in necropsy from deceased person free of industrial exposure to these metals. Tfee selection of cases and the collection of the ttssuo* ate under the direction of physicians in the Clinical Division of the Department. An analytical method for determining thallium in body tissues is being developed. A method for the determination of thallium ia the urine has been devised and is in current use* &lvlsloa of Toxicology and Forensic Pathology Toxicology and m d e of action of certain organic-metallic compounds The alkyl lead compound, t e t m a e t h y l lead, has been under investigation K 0 0 0 3 16 1 9 fear so time, and is now earlag completion. This has been paralleled by additional work oa tetraethyl lead, to establish the nature and significance of subtle differences in the metabolism of the two coiapounds. Toxicology of various pesticides A series of insecticides has been investigated over the period of the post twenty years* These involve prolonged observations on animals subjected to exposure under varying conditions, In order to determine the limits of safety for their various usages, in so for as this can bo translated qualitatively Into experience. (Quantitative information concerning nan con be obtained only on the basis of human experience in industry or elsewhere or through observations on human subjects in the laboratory.) Experimental methods are being examined critically in an effort to improve their qualitative relevance to human experience, with special consideration fear their mechanisms of action. Six insecticidal products are under investigation at this time. Toxicology of certain chlorinated hydrocarbon solvents. Several representatives of the varied series of compounds are being investigated in a preliminary manner. The metabolism of an organic mercurial compound : A radioactive compound is employed, and is being followed in its distribution in the tissues and excreta of animals, by moans of measurements of radiation rather than by chemical analysis. Investigation of mechanisms of industrial carcinogenesis. This work, under way for many years, with special reference to cancer of the skin, is continuing and is concerned productively with the phenomena of chemical acceleration of carcinogenesis, upder the sponsorship of several industrial organisations* 0 0 0 3 16 2 lg&tloas of additives for food 11 Interested in the fluoridation of driakiag 'mter, will be published yearly. An seaoteted bibliography h the production, care and tyi of laboratory animals 1 being assembled, with the financial support of a grant frea the national Institutes of health (1953-2.362). A ccsapllaticn of about 1500 abstracts was published in Eecewber, X300, by the Federation of American r-ocieties for ExperUBensal Biology, as Supplement Jfo. 6 of Federation Proceedingsj a supplement will be published la the January^February, 1063, issue. ^ 0003164