Document R2XmgppEQzbd21wkK6ZxgoXEX

February 12, 1944 19 Dr. David Perry# Newcastle, Pennsylvania Dear Dr. Perryi I have indicated to you previously my general feelings about the maimer in which the medical work at the Johnson Bronze Company plant in Newcastle should be carried out. In making certain specific recommendations, I should like to make clear to you that my Intentions are not to instruct you in matters of medical practice, but rather to do my best to clarify a situa tion which I am sure is unsatisfactory to you and which is not to the best interests of Johnson Bronze Company. Thus far I have accomplished little by my efforts on their behalf. However, I have decided to deal directly with Mr. J. P. Flaherty, to make specific recommendations, and to insist either that they be adopted In some reasonable manner, or that I be relieved of any further responsibility for collaboration. In order that there may be no misunderstanding of my meaning, and no loose ends in the program I propose, I am sending a copy of this letter to Mr. Flaherty, as veil as to Mr. Bryant by whom my-concern in thl3 problem was solicited. As you know I have outlined a general program of procedure for the correction of some of the worst hazards of the plant. This is in my initial report and need not be repeated. In that pro gram I discussed the necessary activities of the plant physician. Perhaps I was not sufficiently specific. I shall try to correct that. Obviously, the first move to establish this program must come from the management, but I trust you will go as far as you think wise and feasible In following through when the opportunity presents Itself. In that event, I wish to express my willingness to b of such assistance as I can in furthering this project. The medical program may logically be divided in two parts, that dealing with general medical supervision, and that concerned with the care of complaints and cases of illness. I refer you to part I, paragraphs 1, 2, 3, 4, 5, 6, 7# and 8, of my original report for my recommendations in this regard. These paragraphs partially cover the car of complaints and illnesses, but I want to amplify them, so that they may not be misunderstood. KE 0013957 Dr. David Perry - (2) - February 12, 1944 In r.he first place complaints or evidences of Illness and the handling of the entire procedure connected with them is primarily a medical matter in which laymen must not be permitted to act, except under instructions from the doctor, {if a doctor is not competent to handle these problems or if he cannot provide the time necessary to do so, it will do no good to hand the job over to a layman. Another doctor must be found, or help must be provided to do some of the work under the doctor's directions.) The first thing, therefore, 13 to have the man examined promptly. This examination should consist of & complete case work-up, with no diagnosis made or suggested until the doctor has satisfied him self as to what is wrong. Unless the condition is obviously nonoceupatlonal, all the laboratory work required to give a complete picture in relation to lead absorption, should be carried out. This requires complete hematological examination, clinical urinaly sis, and the analysis of blood and urine samples for lead, (it may be that blood analyses can be dispensed with latex*, but for the present they should be taken./. I recommend the following procedure. 1. I shall send tubes, needles and spot urine sample bottles to Dr. Perry's office, so as to avoid having them in the plant. 2. At the time of his examination of a man suspected of being ill, (if the latter is done at the plant, a short time afterward will do) samples of blood and a spot sample of urine are obtained by Dr. Perry in accordance with detailed Instructions that are provided in the attached sheets. (These cannot be obtained at the plant unless and until dust-free (filtered air) quarters are provided into which men enter only after removal of work clothes and bathing. It is an utter waste of money and time to carry on this work unless completely satis factory samples can be obtained.) p. Each set of samples Is to be accompanied by a letter giving briefly the salient facts concerning the man's place and duration of employment and the nature of his complaints or illness. The better the clinical information, the more definite can be the Interpretation based on the analyses. 4. If desired,the samples can also be accompanied by one or more dried, unfixed and unstained blood smears, such as are used for differential counts. We shall be glad to collect the Information on stippling for our own Information, but also for such use as it may be to you. 5. On the basis of the judgment of the doctor at the time of hi3 KF 0013958 Dr. David Perry - (5) - February 12, 1944 examination, (net waiting for all the results), the employee is kept out of his employment (assuming that he is actually off the job then he reports i'll), is sent home or to a hospital for treatment ('ey the plant doctor if his illness is occupational, by his own doctor if It is not), or is returned to his former job or to some other job that is suitable for him. Final disposition of hi3 case may have to await the receipt of all the laboratory infor mation, but meanwhile the doctor must decide what is the safest and best procedure. 6. The records of examination are the property of the doctor and he is responsible for their disposition. He should report such facts as in his judgment are necessary for the guidance of the plant management, and should make such other reports in compensa tion cases as may be .required by law or proper procedure. His detailed records, however, should not be open to use and examination by lay plant personnel. This, I believe > cover e situation except for the following: Ve can receive the samples by mail, will analyze them promptly and report them with a note of interpretation. If information is desired by wire, it should be so stated, in which case we shall wire the results to you when they are available. If you wish to introduce changes into the procedure, do not hesitate to suggest them. Cordially yours. UAK ef C. C. Mr. J. ?. Flaherty, Johnson Bronze Company, Newcastle, Pennsylvania. Mr. H. It. Bryant, Bobert F. Coleman, Inc., 948 Union Trust Building, Pittsburgh, Pennsylvania. f6cirt v,ATi"ohce7 M. D. KF 0013959