Document Rpzgz3OvNON0NgDRZENK4rJnX

Doeteur F|.orent Coste Professeui Agrege a la Faculte de M^decine Mddecin des Hopitaux de Paris 41, rue Cardinet Paris, December 24th, 1936 Dr. RA# hehoe University of Cincinnati College of Medicine Cincinnati, Ohio, U.S.A. Dear Dr. Kehoe, I was very glad to receive your letter, for I was just going to write you to ask you a certain number of questions regarding the subjects to which you refer. X would make the following comments on some of the points on which you want information : I. Eventual necessity of adjoining me another doctor. I think that this is useless for the time being, though I have been much more busy since a few years and especially I have been appointed Professeur Agrege at the Faculte de Medecine last year, it i3 quite possible for me to fulfill my work for Ethyl Export Corporation just now and I hope this will continue. If in the future I realize that I am not in a position to carry on all necessary examinations, I will advise you immediately. As long as I can do it myself and alone, X prefer it. As a matter of fact, an assistant v/ould be especially useful to me for the distant plants, and I should therefore choose him among the local doctors, whom I know far less well than those in the Paris region. I would therefore hlways be somewhat anxious as to the real competence, the capacity and the tact of the doctor selected. In consequence, I would ask you to drop for the moment the question of a medical assistant. II* Importance of Ethyl mixing plants now working in France. The number of Ethyl plants has increased to a relatively great extent. Here is a short list which will enable you to realize the present situation. 1) Paris district.- Desmarais Freres, Ivry Pather important volume of business, 6 blends of 200/400 cubic metres of gasoline a month. Standard Frangaise des Petroles, Saint-Ouen Rather frequent blends, but of little importance (45 cubic metres of gasoline) The Direction have promised to bring the number of mixes to normal. French Government. La Courneuve Lot vezy frequent blends. One blend per month, but rather important (1200 cubic metres of gasoline). Jupiter, Pantin Bather few blends, 4 to 5 a month, and of very little importance (40 cubic metres). Consommateurs de Petrole, La Plaine St.Denis little importance 450 cubic metres). 4 blends per month, of Lille-Bonnieres & Colombes. Colombes Infrequent blends (one per month). 2) Western district.- Consonraateurs de Petrole, Donges Rather numerous blends (up to 10 per month), but of small volume (55 cubic retres). Standard Franco-Americaine de Rafflnage. Port-.Ter6me :- About 8 blends per month (800 cubic metres). Raffineries de la Vacuum Oil Co.; -Port-Jsrorre t - Infrequent blends ( about one per month, of 500 cubic metres). 3) Eastern district.- Petrolest, Strasbourg Blends not very important (40 cubic metres) but rather numerous (4 to 9 per month). French Government, I.Ieta Less than 3 blends per month (200 to 400 cm.) French Government. La Forge Less than 1 blend per month (160 cubic metres) Propetrol, Strasbourg :-- No blends have been carried out up to non; I hear that they have received no Fluid yet. 4) North districti- Societe Generale des Huiles de Petrole, Courchelettes blends, less than one per month, and of small volume. Very infrequent Raffinerie de Pdtrol.e du Nord, Dunkerque Ho blends carried out yet. Consommateurs de Petrole. Dunkerque 5 blends per month (55 cubic metres). 5) Central district.- Societe Franpaise des Carburants, Gimouille One blend in 6 months (325 cubic metres). Very infrequent mixes. Consommateurs de Petrole, St. Priest Infrequent and little important blends, less than one per month (250 cubic metres). French Government, Gergy Infrequent, less than one per month (250 cm.) ' ^ 00j 3342 3 6) Southern district.- Raffinerles de Berre, Berre (visited Febr.1936) than one per month (500cubic metrres). Infrequent blends, less Compagnie Generale des Petroles, Aarsille since a very long time. No blends have been carried out Societe Generale des Huiles de Patrole, Lavera cubic metres a month. 3 to 1 blends of 100 Sompagnie Industrielle des Fetroles., Frontignan (100 cubic metrres). 4 to 5 blonds a month, Standard Franco-Americalne de Raffinage, Port St.Louis du Puionc blends per month (30 cubic metres). 4 to 5 Lille-Bonnierss & Colcmbes, Port St .Louis du Eh6ne (50 cubic metres;. One blend per month Jupiter, Port St .Louis du Rhone : 10 to 12 blends, of very little importance, (10 cubic metres). Are going to inert: so their production. A non tank is being erected to remedy the situation. 7) Southern-West district.- Desmarais Prores, Elaye Hot working ji>-et. ('.Till be starting directly), French Government, Bordeaux 3 blends every two months (140 cubic metre s). Consommateurs de Petrole, Pauiliac A1iout 5 blends of 50 cubic metres. A certain number of these plants do not work yet in a very active manner* In some of the plants in which the number of blends exceeds the authorised limit, you will note that the mixes are of very small volume, according to the quantity of Fluide which is used, nevertheless we have made all our efforts to obtain that the number of blends be brought down to the limit authorised by the regulation III. method followed for the examination of men. 1) Outside of the complete clinical examination involving, medical and occupational factors which could cause a man to be rejected from this work, I carry out in principle the following examinations : urine analysis, counting of white and red cells, test for haemoglobin by the Grower*s process, sometimes completed by that of Tallquvist (which is rather incorrect) and at blast taking of blood for test for stippling of red cells. For this test, I have always used the method which is outlined page 17 of your paper "A .Study of the Hazards associated with the distribution and use of Ethyl gasoline (P.A. Zehoe & F. Thanann April, 1928) I have also used, with certain men, the method of Lehmann (au blou de Toluidine). I make these tests myself at hone, whore I have the necessary equipment available. You will remember that I had bought a irderoscope and a certain,equipment for these tests. I prefer to carry than out myself, for it is important not to change the experimenter, and in this way I am sure that they are carried out in a eorroct manner, and I can take the results as a basis. This way of proceeding is also more economical for the Corporation. - HE 00.13343 4 At the "beginning, I made systematically on each examination the test for stippling of red cells, hut since a certain time I have only made some tests covering the men working on the busiest plants, considering the small volume and duration of the "blends carried out in a certain number of plants. Up to the present tine, I have not found any stippling of red cells on any man. On the other hand I have not rads, just now, tests for counting of red and white cells. I have only made tests for haemoglobin, I now intend, as regards most of the plants working since a certain time, to make a general control on all the men who have been carrying out a great .amount of mixes for a sufficient period of time. In the course of the first six months of 1937, I will take up again all the haematologic examinations, and. the tests for counting of red and white cells, haemoglobin and stippling of red cells, and I intend to publish, towards the middle of that year or maybe in the Automn, a paper involving my chemical and laboratory tests. This will be given for publication to one of our great medical newspapers, and of course I will submit it to you before. This will be therefore the first original document published in France on the results of Ethyl Gasoline activities.(in fact, Valentin's thesis ihvolves only a very small amount of tests arid it especially represents a general review of the question based on previous litterature). It would of course be desirable to include in this work the corresponding chemical controls and I was just going to write you on this subject 'when I received your letter. I would like to ask jrou the following two questions : 1) laethod of analysis of Lead in urine : YTnich is, at the present time, the method you consider the best, taking into account its accuracy and the difficulties it incurs. Is it advisable to use the one outlined in your papier ''The normal absorption of Lead" (Journal cf Industrial Kygien, Sept.,1933; page 261 and following) or the method mentioned by the British Commission in their report dated 1S30, or the method df SeeUcopf and Taeger (Zeitschrift Exp. lied.,1933) which is used by Profeeseur Fabre, by his pupil lielle Lera, and which has been followed by .Valentin in his thesis. Or should one have recourse to Cholak's spectrographie method. 2) Selection of a chemist : It is evidently possible for us to ask, according to your suggestion, for Dodds' cooperation at the Middlesex Hospital, but there will always be a certain difficulty to send the samples and moreover there is a risk that the connection may not be very intimate between an English chemist and us. On the other hand, this would set a certain limit to the scope of researches in France. Personally, and unless your opinion is different, I would, prefer to apply to a French chemist. I wanted to do it several years ago on the demand of Lienhard (engineer of the Ethyl Export Corporation) but this had no result and H. Lienhard told me at that time that he had no credit to undertake such tests in France. This is why I had dropped the question temporarily, with the intention of talcing the matter up with you some time; I think that time has come now for this. It is to be wished, although Ethyl Fluid begins to he in the common use, that we have on'hand a documentation gathered on the spot in French plants K o u i 4 4 f5 and supplied by competent French chemists. In the actual troubled state of social conditions, we must always mind that an incident may be given greatly exaggerated proportions in the name of hygien, and this could seriously hinder our activities. You tell me that you know of very few places where this delicate test is carried out in a correct manner. You con be assured that there is not a person more suspicious than I as regards the value of an experimenter. I know by experience how difficult it is to find a competent and consciencious chemist in whose results one can have confidence. However, I think that we can find here a chemist who would satisfy the requirements and whose figures can be relied upon. Please excuse me for not giving you any name for the moment. I must thick about it and consult several persons, for I hesitate at the present time between several chemists. On the other hand, I will have nothing under taken before knowing if in principle you agree to my suggestion to carry out these tests in France. As soon as this chemist is selected, I will ask hr. Sevan to send me with this person to London for a few days in order to study in detail the work done by hr. Foods. On the other hand, should one of your collaborators come #o Paris, he could be of great help to us for the starting of this work. I think that this question should be decided as scon as possible, in order that we may have started within two or three months, and so that the work I intend to carry out until the middle or the and of this year can include a sufficient chemical r>art. We shall start those iiuination not on.lv on workmen employed on the mixing plants hut also on men working at rcfi'neries or whose work involves exposure to Lead poisoning, and on normal citizen and country subjects. V/e will thou be able to repeat in Paris the researches which have been made in London on the Lead contents of the dusts gathered in various districts of the town. I would be glad if you could answer me very soon on these points and I will proceed immediately according to your instructions. in o u e With greetings of the season, Yours si nc erely, K 0Ui 334i)