Document RjDOLRqv8G5MgYdeK5Vbk7k9V

P-*.- - ' :r , 4 "v^ - V " ~' ;T r 3 .r ' T ^ \ ----------- ' ',,> - ' 1, -:'thyl Examination Cards i. '* i . *f r > *,- 1 iU4. v - Should be on physical sheet just preceeding "height". If it is necessary on history, put it in both places. Otherwise, eliminate age on history* .. Length -of present employment: Previous employment at same work: These should be separate with separate entries. The heading on the card suggests that the two separate quantities are lumped together. Lead Hazards: If possible should be ordered under headins such as: .. . Absorption by inhalation ` Particles or^uspensoids b Fumes Absorption by ingestion Absorption by both methods Other forms of absorption. I am not well enough informed to offer specific :p -: v; suggestions but the above will convey my idea. . In other words the lead hazards should be classified . on the card so that an analysis may be directed at any particular angle with no ambiguity and with a minimum of searching for the information. ' -. -AV ' Gasoline used: Should be recorded as leaded or not leaded . Under leaded should be reported either constant ude . for so long a time, or intermittent use. Muscular strength: This item will never yeild any amount of positive information because it depends upon the individual's estimate of himself. I should favor the : .substitution of a simple grip apparatus to be applied ' two or three times to each hand. T^is information might give us interesting correlations later on especially if reexaminations are done on a time base. At any rate it substitues a quantitative ejqtry for one colored by . -judgement. ' '. Skin eruption: Should be characterized as specifically as ' possible. I find entries .showing location but not char ... acter. For instanceV-van 'eruption on the back might have-^sft: . some significance, but if I am told that it is acne it takes on a different meaning. -3^r-A1*1'lrT? Polyuria: If present, how frequent. Nocturia: When frequency Is given it should be stated so that'' there is no ambiguity as to whether it is times per cLay,'^^f week,- or month. This general principle should apply, to all frequencies. - ; . ; fff|| If there is no practical objection, use both sides of the history-sheet so as to eliminate one card, - -- ' Ethyl'- Caads (2) `- Physical Examination Color of skin: Might he worth while to place on a anthropometric basis using a standard color scale or color top and the inside surface of the upper arm. Eye color might he introduced ' in the same way. The hair might he considered but these are points for'the staff to decided. What is known about hair changes in heavy metal intoxications? Would astudy of hair samples yeild anything? Possibly mieroscopic sections could be correlated with exposure? These things might be discussed. Un der Chest: Would like to get rib angle from physical exam. A flesh pencil outlines the rib angle for five to . six inches on each limb and then the angle is read off on a protractor. Outside of the above suggestions, the cards seem to be quite complete although there is always the possibility that / future findings will direct attention along a wholly unexpected line. At any rate I would not suggest eliminating any single item unles one particular one is gained only at the expenditure of a relatively large amount of effort. If there is such an item, it might be eliminated, but I would first want to know which one it was. LeBlanc