Document QkdyEYzmLXprw6qyn45roEKy8

Ht>ao?nn4tta._ln Cona.getjon with Vlait to. Ayaa .Oo. ins. atmLJiJE^aa Various plant operations war# examined with the idea of noting the general character of the lead h&sards and the degree to which they night he deserving of study* the following notation are not designed to describe the operas ions or their fcasar&a In detail, but are. intended as a rough working basis for further study and also m tentative suggestions far calling im provements, fhB ..Shot..fatrsi The hazards in the prmmt method of making shot are those actually associated with operating proeedureo plus certain Incidental and txanceesestry lead exposures which arise frost relatively crude methods of bouselteeping and general sanita tion, The exposure to vapors of molten load at the top" of the tower may be appreciable, fhis could bo reduced if neceosary by giving further detailed attention to the ventilation especially over or at the side of the perforated pan into which the molten aetal Is run,. One suspects, however# that the cleaning up of the area around the melting pots and the equipment In this apace results in more dust than is necessary. By careful attention to the smoothness of the floor and by cleaning with a vacuum cleaner, the dust hero could largely be eliminated. On other floors, the handling of the shot, in sorting, F 0018536 N19693 that the chief exposure arises from the neouoaXanerm of dust in er&eics an<i on rough and irregular surfaces of floors and steps* to b disturbed by air current and by movements of the worteen when corryin^ on their normal uovk and when sveeping, ?he build ing* in other words* la not na clean as it could be* and is of such construction m to be difficult to hasp clean, St it should be found to be neoeasary to doorcase the lead exposure of the wen* it would, seen to be advisable to improve the building* {floors* steps etc,; and to do all cleaning by vacuum, nuch contact as the workmen have with dirty and dusty surfaces la somewhat- wore - itt*x>rt&nt hyglenieally than need bo* because of the poor quality of the wash-rooms* the failure to provide clothing for use during the work* and the absence of change rooao and double lookers, <?he need for these facilities as for the other hygienic steps referred to depends upon the magnitude of the over-all exposure to lead* which, presumably* will be determined by the study of a representative group of these men. It must be admitted* however* that the wash-room and the lunch room facilities ere rather elementary* and could not be regarded as adequate In connection with an hazardous lead trade. Certain other activities unrelated to the procedures in the shot tower* to carried on in that building* require comment, the preparation of the motel for sashing ballets that shatter when they hit* and the handling of this metal* are dusty processes* which if they are to be continued* should be reorganized completely end promptly. At present the dust evolved necessitates the use of respirators during certain operations and when floors and working spaces are cleaned up, She use of a respirator may be Justified In 0018537 _ 3 certain intermittent and comparatively infrequent Jobe, Othervise it la an admission of the unsatisfactory status of plant operations and should not he condoned except during periods when plant processes arc in a developmental stage la which the nature of the eventual bastards la unpredictable* The handling of dross in tills building la not satisfactory* 3ueh dusty materials should be segregated no quickly as possible Into a separate and well isolated area* find should be ; handled, so far as possible* by mechanical means, with specially deoirnod, dust-proof equiv&ent* The floors In such an area Should . . b tsaooth so as to be easily cleaned ami other equipment should bo. arranged in an orderly and convenient meaner with an eye to minimising handling* Cleaning Should be done by vacuum if possible. Indeed . where lead dusts occur, om may describe satisfactory cleaning methods, in goners!, as being either (1) by vacuum, or (2) by wet methods* - hosing* topping, or sprinkling* MtiSSJ&Wlfo Some degree of load exposure is certain to exist in connection with bullet molding by any of the processes now in use, as the result of fmm from .molten' metal, and dusts and metal particles which collect on floors and on equipment around the operations* The magnitude of the actual danger fross these combined sources is unknown but probably small, but again such improvement ns may be neoosaary for hygienic reasons can probably be obtained by more rigid and more efficient housekeeping* An additional and avoidable hazard nrlaeo from the tumbling of bullets punched out by the newer cold process. The tumblers produce considerable and, I should judge, dangerous quantities of duct of metallic lead* These should be carefully hooded to prevent K F 0018538 the dleseetln&tlon of dust* In thi* group of processes# also, wash-room and I'.jncs'wrooa ?wUiU&# of an attractive arc! e&nitnry type should be available for tb* works****, and its seem probable that otange* roots facilities and routine clanging of clothing merriing and evening would contribute to the ffeativaneas of general aanit&tion* file stmXlowln& of lead with tob&aoo and food can be avoided by proper attention to the elecaXlnes* Of clothing and person of worfc* urn* It enacts highly inadvisable to poraifc or to enseur&ge careXoeamsa in these natters* th mtoh carelessness stay conceivably bring the total lead exposure up to a dangerous XevX, whereas the unavoidable occupational oi&asare y not af itself be dangerous.,. In this connection, the habit of chewing tobacco %b distinctly not .-iavanta#eou3 to the worfeen end should not 'bo encouraged, One hesitates to advise the restriction of such a personal practice* It cocas probable that the use of carbon. or charcoal to provide a reducing atflttapbere overlying baths of xaoltm lead used for tapering steel* diminishes the Amo imaard alaoat to the vanishing point.* If, therefore, these load bath# are handled with care gainst spillage of $&&! or drooa, m that 'the floors and other surfoeee within the vicinity of the t**tasa are topt clean and free of aatcr&tls which could give rise to 4unt, there should be little hazard at the temperatares prevailing*. Here, again one question* the cleanliness of the surrounding and wonders aa to the quantities of lee.d which are wallowed by the worsen na the result of the dirtiness of hie ourmundinge, clothing, eta*, and a to the qusatiticc of dust which are unnecessarily &ianominated Into the air by strong convection current swooping across surfaces contaminated with load auxit#. K<= 0018539 5 ?artlamat............ In Rang*?. ?h stagnitude of the load exposure to ea who go In end out of the ranges la a uattor for conjecture* % saxisaX decree of the expoaure can beat bo determined by air analyse* and the algnlfloane can probably be assessed with sufficient accuracy by taking Into account the dogrso of the air contamination at the time of entrance of non and the duration of their stay within the ranges* 1 should reoonnond air sampling carried out in ouch a manner as to indicate the degree of contamination and the rr?te of subsidence of the load particles# As a housekeeping measure 1 should suggest the advisability of confining the disintegrated lead to the apace in which It is produced, by so designing the entrance to the ranges that a minima .amount of debris escapes ever the threshold* whether in the farm of particle# which fall an or outside of the door sill* or as material carried out on the shoes of non who enter* the construction of the doorway will solve the former item while 'a simple type of scraper at the entrance would probably tahe care of the latter* .. Various observations 'have been made on the lend content of the atmosphere in various parts of the plant. It is suggested that further observations be carried out during the coming year in order to obtain data which can bo correlated with periodic analyses on the excreta of vorhesea. By reason of the soaewh&t less than ideal condition' of the plant with respect to housekeeping and sanitation* .it seems certain that air analyses will not reveal the magnitude of the exposure of von&ssen in a comprehensive manor. Borrower* since respirators arc used in eo^e arose it is certain that air en&lyaee _ HE 0018540 6 * in vUl not yield a proper baal far tho eatiaaUsa v- of Inhaled load. Acconilnsly, there is evory reason to regard J> t*gora dnalrn to obtain analytical data on tins workmen ae Af^iP ana wlao. Under the conditions that prevail in this plant i la no other satisfactory way of determining the actual load exposure of these aeo. In order to obtain the moat adequate infer- nation by auoh norms it is neeeeoary to consider certain natters in the light of experience* 3ignifiBfince..of .Sha. Uod.CantenC g the Peeaa. 3ust-X&dea air when breathed Into the thorax results in the partial deposition of dust on the tissue of the lungs and nir passages* V ariable proportions of such duet* dependent upon a n mber of factors# enter the nasopharynx and eventually the alinantary tract* whence it %8 largely evacuated with the feces. roughly* therefore# the quantity of lead which appears in the faces on .v:y one day# minus the quantity ingested with the fojd# urink and chewing ' tobacco (or otherwise} on the day before* la equivalent .to th&t deposited m the nasopharynx a the result of breathing duat-indon air. On the basis of this principle the study of the fcoea of a gr^up ->f exposed worteen who have worked on the day before* will give a fairly Clear Idea of the extent of their exposure to Xo A0 whether through inhalation# careless ingestion# or a combination of the two. It i very useful#, therefore# to study the fecr*l lend dxcruticn of $sen who are actually working# but If two or rmre days Intervene between a working day end the collection of the sample of faces# the result ia valueless# Such samples should not be collected over the week end or during any kind of holiday or lay-off* saoat men# a single normal evacuation of faces is substantially equivalent to a 24-hour sonrolo. It is not necessary* nor is it feasible to collect a s?4-hour ffecal . KE 0018541 ? sample* since the single average sample has been found adequate. In order to avoid gross contamination of fecal samples with dust from the plant* It la memory to have the aen collect ouch samples at home. Accordingly the men arc instructed aa to what la desired* written instructions are placed in their hands* where these can serve any useful purpose* and the containers . &r*? either given to them when they are ready to depart to their homes or* better* the containers ore delivered to their homes where the sample can bo collected after or before warding hours, after tithing and changing clothes# The necessary instructions are given in the following paragraphs* The chemically clean Jar supplied for the collection of fscos must he kept m& opened in a place which ia clean and free of dust* and in which it will not bo overheated or frozen. It suet be kept scaled in its paper bag until it la to be used* A ciagle avernge or noma! evacuation should be collected directly into the Jar* No intermediate container my be used* mr should any preservative or other material be added to the sample* {If preservative la required a sufficient quantity will be added in this laboratory.) Orcat o&ro'mct be exercised against the introduction of dust or any other foreign materiel into the sample. Laxatives or cathartics nmt not be employed nor should any other taedioine be ts&en for at least fortyweight hours before the colloetion of the sample* except on the advice of the physician in charge. The rubber ring should be carefully adjusted* the top clamped carefully and securely* the Jar should be labeled with the none and dote* and sealed in its paper bag* K 0018542 \ 'S'-* Umplm should, he packed carefully to avoid breakage and shipped by qnyye to Or* nobert A. SCchoe* Kettering laboratory of Applied Physiology# Gelleg of hedicSn,* ^den Avenue# Cincinnati# Ohio* (?h8. Mmxtto/***.Sjt..mmzU*azfk* head in the urine# as distinguished fron that in the feoes# is the result of actual lead absorption* The urinary output and concentration: of lead vary with a number of factors#'chief among which# in order of doors?.sing importance# &r (1) the quantity of lead actually available in the tl&suea of the body# (2) the magnitude of the stream of lead entering the blood and tissues- from various* portals of `absorption* and* (3) the water intake and output per unit. . of time* tt tii individual under study is not actually absorbing significant quantities of load from the lunge or alimentary trset# the urinary lead level 1 indicative of the magnitude of the previous lead absorption# i*e* the lead content of the body a a whole. Thi stoke the determination of the- urinary lead excretion of great prac tical iapertanee as a mmux* of the magnitude of occupational lend ' exposure over a considerable period of time prior to the observations, To be of smximtl,value far this purpose* it is advisable to collect sample of sufficient volume to smooth out the variation due to the changes in rate of water intake and autp.it* Therefore smOI (spot) samples are less valuable .than samples collected over a considerable period of time, Spot samples* on the other hand# if collected with adequate care against minute oontmin&tlon# under the observation of the 'examiner* rule out the 'misleading influence of intentional' or accidental contamination of ample which nr collected by workmen without continual supervision* In some instance both types of urinary samples are necessary to ascertain the facts ss to the actual . K 0018543 3 urinary lead excretion, In either ease the greatest care possible Is repaired to. obtain ttncontaminated easg&es* ^he Instructions Hated below should bo strictly observed. fbe ehesloally clean bottle sullied for the collection of urine &uat be kept and opened in a place which is clean* free of dust* and neither excessively hot or of freezing temperature. It mat be kept sealed in ita paper hag until It la to be used and should be stoppered tightly and. returned to the bag after each use* Attempts should not be wl@ to obtain samples within n ptmt or during writ periods* unless the- premises are umtau&iX? clean and free of lead compounds* It le generally advisable to- hare the containers delivered1 to the hocis wh^re the ample can bo collected before and after work hours* after bathing and changing clothes. Urine should be collected directly into the container at convenient tinea over a period of hours or days until mt less than three quarts have- been obtained, Ho intermediate container nay be used* nor should any preservative or other material be added to the sample, (If preservative is required a sufficient quantity will be added to the container Six this laboratory*) Great care should be exercised against the introduction of duet or any other foreign material into the container during the period of collection, Unusual quantities of water or'other liquids -should not h taken in order to speed up the collection of the sample* nor {should wliolnc be taken* except on the advice of the physician in charge* during this period, Vhn the. sample has been collected* the bottle should be stoppered ti^itly* labeled with the name of the person or patient and sealed in its paper bag* KE 0018544 t^truetlanii for the Wt J^pA xaia.. cotton, of flpot ... of Urine Urine o&aploe mat bo tako in a apace which if? tree of dust* ?he subject or patient nunt remove any rkst laden clothing before entering the nsost in which the oasipl is to be token and nuat bathe. Approximately 3,0$ ee of urine should bo voided directly into the empls bottle 1st- the presence of the physician or attendant. stopper (and the protective cover of filter paper) should bo reseved and held by its ton in the hand of the at tenant so that it saay not ho contaminated through oontsot with desk* table nr other object. It should be restored to the bottle *3 soon as the aaaplo h&a been obtained, after which it should bo covered with the filter paper shield. Ho preservative or other rteterlCl nay be aided to the -sample. fhe bottle should be labeled with the no^e of tha patient and the date aud hour at which the mpu$-\Km taken, and passed with care e&tl&et the possibility of breakage in transit. It met be e&pbaeised that auet samples collected In industrial plants should be obtained under observation, after th ' worhatm has removed bio clothing-* end hsa b&thed thoroughly, and then lias entered a elenn rooss* free of duet* where the mp\ is voided* In every instance the stopper of tlio bottle should v* removed and hold by the examiner so it will not be put down on any table or shelf or oth&r surface. After the voiding of the actaple* it should bo returned directly to the bottle which then is capped -;ith the ?$4f?fr paper cover* and secured in pine by a rubber bend or string. It should also be stressed that wortaen entrusted with KE" 0018545 11 the collection of large applet* should b* given e&reful verbal instructions In such mmmv that they will understand fully what Is expected of them* Dlood,enplea# collected in the manner Indicated la the instructions listed below, are of use chiefly In verifying or cheeking the validity of urine samples* tfhen obtained in ouch manner that no possibility for contamination e&isata they are valuable in that they can- be obtained without any dependence upon the efforts of the person from whom they are taken* ?bey are not as valuable otherwise as urinary samples* For this reason their use in our hands is confined chiefly to diagnostic purposes, when on wishes to .obtain a spot aample of urine, and a-corroborative sample of come other material at the time of a olinioal examination* we suggest that such samples be obtained whenever a t&m potentially opposed to land hazards presents himself to the plait physician with oasrlainte which art compatible with or suggestive.of a diagnosis of plumb! sm. , Containers and naedloa o&m be amt on short notice for this purpose* sis. Blood samples t&mz be taken in a apses which is free of dust* Bespits this precaution it la necessary to use the most meticulous oars against the contamination of samples with surface or atmospheric dusts* the subject or patient must remove any dust laden clothing before entering the room in which the cample is to be taken, and must bathe* ?he cork should be removed from the tube in which the blood is to be drawn only during the withdraw! of the blood, and should not be Remitted to come in contact with the table top 0018546 13 - or any other potentially unclean surface hut should be held by its topmost part or laid down within its filter paper wrapping# and replaced as soon m the blood Sms bmn obtained* The filter paper cover should be replaced and scoured around the neck of the tube by mans of a rubber band* The sterile needle provided In a second tube should be used to withdraw approaloately 10 oe of blood directly into the blood tube* Under no oircumtst&ncea my my anticoagulant or other substance be added or any intermediate container be used# nor i$ay the needle bo sterilised by bailing in water. If the latter should b rendered nonaterile accidentally# it should bo flamed gently before use. After use it my bo rinsed out with cold water and returned to the tuba. Cotton should be placed at either end and around the hub to prevent breekag in transit* Tim blood sosplos should be labeled with the mm of the patient and the date and hour at which the s maple. was taken# and packed' with care to- see that the cork is secure# and that breakage nay hot occur in transit* The staple should, be mixed to Ur, Robert A, &&oe# lettering laboratory of Applied Physiology# College of Medicine# Cincinnati# Ohio* In order to determine the mgnitu&o of the lead ex posure associated with the operations discussed above# and to discover the variations that occur from operation to operation# and from time to time# a group of representative non should be selected# on the basis of their reliability in doing tihat is reauirfd of them and on the further basis of the constancy and duration of their m-- . KZ 0018547 13 ployment in relat ion to mm particular typo of ooeuzmt lsnal exposure* {this selection vtan made tentatively n% n conference between bra. Xeager and iCehce)* fhcse sum Should ho fallowed quarterly*, ao an to see. any seasonal influence duo to tmspereture* ventilation etc* by mane of fecal series and* m far no possible* by largo samples of urine* If large samples of urine cannot be obtained* spot samples may bo used* but far reasons indicated* these will be lees useful, titan X&rge samples* Blood samples could bo used to mip}&eflnt the spot urine samples-if desired* but the expound of the work will be- increased thereby* Containers for the collection of these Jiasslee will: . bo shipped by express from the laboratory* in numbers sufficient to care for the camples agreed upon*. If there are Cases' suggestive of lead intoxication among workmen during the year* it is suggested that blood copies -.and spot urine samples be obtained on them promptly for analysis and prompt report by telegram*, thee to be checked* later* If need be* by large samples of urine* It is further suggested that blood sws&rs bo provided on nil sea on whoa samples are obtained* and that these be sent.to us at the time the samples are forwarded* these should be unfixed* unstained smears taken on carefully cleaned elides* spread as uni formly as possible* end of a thinness suitable for differential counto, %y should be allowed to dry in the air* labeled and sent to ttst in slide boxes* the latter to be returned by us* Couplet* occupational histories and me&laal records should be supplied on each ease taken under fstudy so that our data will be as complete as possible* Heedless to say all Information KE 0018548 m obt&inod will bo held In confidence and stieh publications as result thersfroft will not raven! the st&roo of the data, Moreover, any confidential medical information unrelated to lead exposure on individual workman need not ho transmitted. j^<ou&aaaa,ag?!ii the actual cost of load analyses in this laboratory la approximately #5*00 pmr sample* ' propose to carry out this work at cost# and suggest that He&lngtoa Asm Company Xno, bo billed,, quarterly, for th* coat of the attaiytioal work at the rate above plus ouch oppress* postal and telegraph charges as nay accrue during the quarter* It any trips to the pleat arc required in connection with this mrk* the cost of travel in will bo aubnittsd promptly for prompt rei&buraaX* &aoh trips, obviously, will be. made only at the request of iteington Ats Any bill for cervices rendered by a ae&tbsr of the staff of the laboratory in connection t/itu any such trip will be- m&Jsot to mutual understanding in advance* Ho such trips are anticipated at present. of Applied Physiology 001S549