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January 6, i960 AIR MAIL Alleged Lead Poisoning Case Wilkes-Barre, P a . ance - Helper Mr. C. P. Bartlett Gulf Oil Corporation P.O. Box 8056 Philadelphia 1, Pa Dear Mr. Bartlett: I regret the delay in answering your letter of December IS occasioned by my absence from my office for a period just before and cUiring the holidays. I hasten to reply so as to avoid further delay. I shall be more than glad to answer the question raised in your letter if I can obtain some information about the onset and course of Mr. illness, and especially about his alleged exposur^^olead and the time relationships involved. It seems highly improbable that the illness complained of was due in any manner to hi3 absorption of lead, but then I may be completely wrong in my assumption (from the negligible amount of information I have) that the onset was recent. Let me point out to you and to all concerned, that the interpretation of analytical findings such as those reported, must be made on the fact3 concerning the alleged exposure to lead - its nature, severity and duration - and concerning all of the time relationships, especially the interval of time between the termination of the exposure and the collection of the samples for analysis. I have attempted to obtain the necessary information, but up to the present I have none. Dr. Strieker is mistaken in his belief that his treatment of Mr. Tredinnick would influence the level of lead concentration in the blood and urine. He is also incorrect in his opinion that the use of the chelating agentCalcium disodium versenate (EDTA), would provide a proper means for appraising his present status with respect to absorbed lead. The attitude occasioned by his views of this matter may bring about a controversial situation. If, however, you will see that I am provided with full information about this man's employment and his illness, I can give you an opinion which can be fully substantiated. N13184 Very truly yours, December 2, 1959 Emil C. Beyer, M. D. Ethyl Corporation 100 Park Avenue New York 17, New York Dear Emil: I send herewith the analytical report on the urine and blood of with a copy of my note to Dr. Douse. If yotniave any additional information on this man I'd be glad to have it to complete the record. You may or may not remember, that I keep a file on all cases of injury or alleged or suspected injury in relation to leaded gasoline as a part of the investigation of tills problem in the laboratory. I'm glad to hear from you again. While I'm no longer responsible for Ethyl's regular medical activities, I continue to deal with all ox the investigative or control work of the Laboratory, and will do so for some time to come. Best regards. Sincerely yours, RAX:ss Enclosures Robert A. Kehoe, M. D. N13184.01 ETHYL CORPORATION lOO P A R K A V E N U E B U I L D I N G AT 41st S T R E E T Y E W Y O R K 17, !N\ Y. November 27, 1959 Mr. J. Cholak Netterin s; Laboratory University of Cincinnati College of Medicine Eden and Bethesda Avenues Cincinnati 19, Ohio R e : Alleged Lead Poisoning Case Urine and Blood Samples sent by Dr. G. P. Rouse, Philadelphia, Pa. Dear Jack: Would you be kind enough to send me the results of the lead analysis on urine and blood samples forwarded to you by Dr. Rouse, representing the Gulf Oil Company, Best personal regards. Sincerely yours, ECB :mgw Emil C. Beyer, M.D. N 1 3 1 8 4 .0 2 K E 0.12GU November 23, 1959 Dr. George p; Douse, Jr., 2031 locust Street Philadelphia, Pennsylvania Dear Doctor Rouse: I am sending herewith a report of the analytical findings on the blood and urine ^BU IBRP* It seems likely that there may have been some correspondence concerning this man, but I do not have any information about him at hand, and since the results are entirely negative, I am not looking farther into the natter at this time. I have interpreted the report in the manner indicated by the results. If there is any further information which you might wish, or any unusual circumstances that require consideration please let me know. Cordially yours, Robert A. Kehoe, M. D. RAHkss cc: Dr. K. Kitzmiller Enclosures N 1 3 1 8 4 .0 3 Urine and Blood 1 1 - 1 6 - 5 9 b y Dr. George P. Rouse, Jr., 2051 Locust Street, Philadelphia, Pennsylvania Lead Analyses URINE Analysis Number Volume Specific Gravity M g . Pb/Liter 59A-11214 118 m l . 1.020 0.05 BLOOD Analysis Number Grams Mg. Pb/100 Grams - 59A-11215 Spectrographic Dithizone - 8.0 10.4 - 0.05 0.02 The levels of lead concentration in the urine and blood are in the mean normal range. This man has not absorbed any abnormal quantity of lead from any source recently. ' Signed: Robert A. Kehoe, M? D. ~ N13184.04 K'f 001 < \ r - r~t (' 0 j. tj Samples Collected: Samples Received: Samples Reported: 11-12-59 11-16-59 11-20-59 . KETTERING- LABORATORY UNIVERSITY OP CINCINNATI COLLEGE OF MEDICINE S e x H. A ge 9 s 6 b W D H o s p i t a l , W a r d ____ # Date History: (Including nature of exposure, actual time or surmised, and e s p e c i a l l y the last d a y or h o u r of and time of onset of illness; course of illness and previous pertinent medical history.) of exposure if known exposure; character present status; . Physical Findings: Laboratory Findings: Impression: Treatment (specify date(s): Investigation Desired: Note: The Kettering Laboratory makes a charge for reimbursement of the cost of services rendered on the customary professional basis of the economic status of the patient as determined by his physician. , ii. A. Sidney, Jr. P. N. Stiteler S. J. Payne J. A, Edwards Dr. G. P. Rouse - 2031 Locust Street Philadelphia, Pennsylvania \ October 2?, 1959 ALLEGED LEAD POISCNIHG CASE Wilkes-Barre, Pa. Motor Equipment Maintenance - Helper The Travelers Insurance Company Miners National Sank Building Wilkes-Barre, Pennsylvania Attention: Hr. J. V, Vogelbacker Supervising adjuster Gentleaaem i-.e are still concerned with the above alleged lead poisoning;,case, your Fil-..: Bo. U-S9273QO. Attached is a communication from Dr. u, d. Strieker, 521 Carey Avenue, v&ike-8-3arre, Pa. indicating his eacnaination of Tredinniek but also cojsaenting that the local Lebr&tories are not properly equipped to do a complete lead test, V-e have the facilities of the Medical Department of the Ethyl Corp. available to m and it it aeets with your approval, we should like to arrange to send to Dr. G. P. Rouse, here in Philadelphia, who has been closely associated with Gulf Gil Corporation and the Travelers Insurance Company. e can arrange for the Medical Department of the .Ethyl Ccrp. to send Dr. liouse the special lead-free containers so he can have the tests complete. fill you please advise if you are willing to assume the transportation costs, etc, and other incidental expenses in connection with this ns we feel this is to our mutual interests. If you do not want to assume the expenses, would you have any objections if w do so? Strictly from a. personnel standpoint, we want to make our the employee doe not have an occupational illness. 'e await your comments*- Very truly yours, N 1 3 184.06 KELLEY VISION GENERAL MANAGER .SiQN M A N A G E RS R . LAWLOR RETAIL AND J O B B E R SALES H. A . GODDARD. JR. DIRECT SALES G. T . RYAN S uPP LV ANO OPERATION G. R . W IT W E R ACCOUNTING AND OFFICE PETROLEUM AND IT S PRO DUCTS GULF OIL CORPORATION PHILADELPHIA SALES DIVISION GULF BUILDING CITY A VENUE AT SCHUYLKILL E XPRESSW AY December l, 1959 ALLEGED LEAD POISONING CASE Wilkes-Barre, Pa. Motor Equipment Maintenance - Helper M AILIN G A D D R E S S P. O. B O X 8 0 5 6 P H IL A D E L P H IA I,P A . t'- Dr. R. A. Kehoe Sloan Ketterling Labratories University of Cincinnatti Cincinnatti, Ohio Dear Dr. Kehoe: Our Dr. George P. Rouse, Jr., Philadelphia, submitted t^vour Labratory urine and blood samples of our who it is alleged suffered lead poisoning in October of t n ^ ^ y e a r ^ ^ ^ ^ Naturally, this has been handled as a Workmen's Compensation case with our insurance people either accepting or denying the medical expenses involved. Having the results of your examination indicating that the employee1s blood was normal as it relates to the levels of lead concentration, etc., our insurance people denied the payment of Dr. R. S. Strieker's bill ... on the basis that the employee did not suffer lead poisoning. Therefore, the responsibility was not that of Gulf Oil Corporation. . However, Dr. Strieker has recountered with certain allegations the way the tests were taken for blood samples was not proper. This is fully outlined in his letter of November 10, 1959 addressed to our Plant Manager, Mr. S. J. Payne. However, you will note that although the letter was postdated, it liras not actually sent to our Wilkes-Barre office to over a month later and was received on December 14, 1959* The question which we wish you would answer for us is whether or not you concur with Dr. Strieker's comments and could there possibly have been a lead poisoning condition previously existing which would not have been determined by the tests which were made several weeks later. Your early comments will be greatly appreciated. Yours very truly, N 1 3 1 8 4 .0 7 GULF OIL CORPORATION ; NC E S. J. Payne Wilkes Barre F. N. Stiteler CPB ECT ALLEGED LEAD POISONING CASE Wilkes Barre, Pa* Philadelphia ^To^Equipment Maintenance - Helper IN REPLY REFER TO Sjp.p DATE 12/1V59 We enclose a letter received from subject employee's physician, Dr. Robert S. Strieker, under date of Nov ember 10, 1959 (actually December 10) received in this office today. This letter was written by Dr. Strieker after reading the laboratory report furnished by Dr. George P. Rouse, Philadelphia, Pa* We phoned Dr. Strieker to find out what recommendation he would make, and he stated he had not seen this emp loyee to treat him since he had these tests made* He further stated t h a t ^ H H H H f c apparently is getting along fine, the wrist-drop is improving, and that no further action should be taken at this time* We refer this to you for your files, and any action you feel should be taken. end* CC H. A. Gidney Jr I /I A'-/ u/ / I / J N13184.08 KB 00v 6>,-** r% .1 0 R o b e r t S. S t r i c k e r , M. D. 521 CAREY AVENUE WILKES-BARRE, PA. PHONE: VA 3 -0 1 6 3 l-, 10 November 1959 DEC 1 i Rff'O . oi cow- OiSTTviCi 'u '/ Mr. S. J. Payne Gulf Oil Corporation, 226 Carey Ave., Wilkes-Barre, Pa. He: 31'Alexander Street, Wilkes-Barre, Pa. Dear Mr. Payne: After reading the laboratory report on the blood and urine lead determinations of the above mentioned patient, I would like to point out that they are incomplete and probably of little actual value. In explanation of the above statement, I would like to point out that when Mr first reported to me with a wrist drop, ^cnrorrLc lead poisoning was suspected. When we found that none -of the local laboratories were equipped to do lead determinations, It was suggested that perhaps the company would arrange to have these done out of town. In the meantime Mr. treated with as near daily injections of JwO mgms. Thiamine hydrochloride as his schedule permitted. The use of calcium to imobilize the lead in the soft tissues and circulating in the blood, was with-held until October 24th, in order to not affect the results of any tests that might be done. However, on this date we started Calcium tablets in addition to the Thiamine injections and obtained prompt clinical response. This treatment would tend to store the circulating lead in the bones and thus render a blood level or urinary excretion level to normal. This, however could be used as a base line, and the determinations repeated after the administration of Ethylenediaminetetraacetic acid (EDTA), which would release some of the lead stored in the bones, into the circulation where it could be measured. However, it is now over two months since the occurrence of the w i s t drop, and it is possible that even such a test done at this time would be of little significance. N13184.09 001231 o R. S. Strieker, M.D