Document V3rz8ez9OE4yoDJDDrDnDYQ2K

t/ July 10, 1958 M r, H en ry D oyle O ccupational H ealth P ro g ram D ivision of Special H ealth S ervices D epartm ent of H ealth, Education and W elfare W ashington 25, D. C. D ear H enry: I am sending to you, sep a ra te ly , a bundle of re p o rts , re p rin ts, p recau tio n ary in stru c tio n s and c e rta in o th e r ite m s of in fo rm atio n re la tiv e to the p ro b lem s -which r e la te to th e m a n u fa c tu r e , d is tr ib u tio n an d u s e of te tr a e th y l le a d an d lead ed g aso lin e. I am plagued by th e u n a v ailab ility of publications th a t would fill in the blank spaces in the account of what has been done, as w ell as the step -w ise developm ent of the fa c ts. Some of the unpublished re p o rts, copies of w hich w ere fu rn ish ed y e a rs ago to th e Public H ealth S erv ice, have been, depleted long sin ce , except fo r m y bound office co p ies. I am sending a copy of the re p o rt, m inus a s e rie s of ta b le s, of the investigation c a rrie d out by us in 1928. T h ere a re no av ailab le copies of th e o th e rs , the f ir s t of which was issu e d in 1925 and the la s t in 1932. T h ese, esp e c ially the la s t, a re of im p o r tance in reco rd in g the developm ent of the m ethodology of approach, and in dem onstrating c e rta in w eak n esses, since erad icated in la rg e p a rt, in both the physiological and the analytical concepts and p ro c e d u res. F o r exam ple, the investigation of the ex cretio n of lead by Leake and his a sso c iate s, as re p o rte r in B ulletin 163, was lim ited to the an aly sis of the feces, and it is now quite c le a r th at nothing of relev an ce could p o ssib ly have been le arn ed by thi3 approach to th is p roblem , and th at the sta tistic a l co m p ariso n s of the re su lts yielded by d ifferen t g roups of p e rso n s could not now be expected to have any im p o rtan t relatio n sh ip to the issu e u n d er in v estig atio n . The p ro c e d u re em ployed d eriv ed fro m the b elief, then the p rev ailin g view point, th a t the lead output of the a lim e n ta ry tra c t was essen tially an excretion, w hereas it is now evident, from our long study of the lead m etab o lism , th at except u n d er conditions of re s p ira to ry exposure to d u st (p a rtic le s ap p reciab ly in ex cess of 1 m ic ro n in d ia m e ter), o r in situ a tio n s in w hich th e a b so rp tio n of le a d is q u ite high>~the a lim e n ta ry lead cannot be d ifferen tiated fro m th at in g ested w ith food and b e v erag e s, except in balance experim ents. It can be noted in o u r e a rly p u b licatio n s (the s e rie s in JIH andT , 1933 and on th ro u g h 1936, including the f ir s t of two a rtic le s in JIH andT in 1934 and 1936, on "An A p p raisal of the L ead H azards A sso ciated w ith the D istrib u tio n and Use of G asoline Containing T etraeth y l L ead"), and the fa c ts a re d iscu ssed and explained on page 66 of the 1936 a rtic le , that som ew hat high m ean v alu es fo r K * 0009418 M r. H e n ry D oyle - (2) - Ju ly 10, 19^8 - * the u rin a ry lead ex cretio n of groups of p erso n s w ere obtained by us p rio r to the period 1934 through 1938, when the p re se n t fa c ilitie s and m ethods of collecting and analysing sam ples (w hereby the lo sse s of the analytical p ro ce dures w ere prevented, on the one hand, and the introduction of m inute quantities of lead fro m a v a rie ty of so u rces w as avoided, on the o th er), w ere developed to th e ir p re s e n t efficacy . In cid en tally th e two la te r a rtic le s in JIH andT su m m a riz e the m ost im portant featu res and facts of o ur sev e ra l field investigations (detailed re p o rts of w hich a re no lo n g er a v ailab le ) and in ad d itio n , th e la tte r of th e two d e sc rib e s som e fu rth e r o b serv atio n s on g arag e m echanics w hich led up to the la te r and m o re detailed in v estig atio n s of such m ech an ics, the re su lts of w hich have n o t b e en p u b lish ed . O u r fa ilu re (o r r a th e r m y fa ilu re , fo r I h av en 't found the tim e) to publish m any of o u r la te r in v estig atio n s, is an o th er so u rce of fru stra tio n to m e a t th is tim e in providing you w ith fu ll in fo rm atio n on the p re sen t situ atio n . The inform ation gained, fo r exam ple, in the sy stem atic clin ical and an aly tical regim en of hygienic co n tro l in the m anufacturing p lan ts, is of the u tm o st im p o rta n c e in view ing the: e n tire p ro b le m , and e sp e c ia lly in c o n sid e rin g the m arg in s of safety rep re se n te d in d ifferen t lev els of the lead m etab o lism . I have been gathering together th is inform ation in a sy stem atic m an n er fo r y ears, w ith the .purpose in m ind of w riting a m onograph on the su b ject, sin ce the d ata a re m uch too volum inous fo r.stu d y and p re sen ta tio n o th erw ise, I have a g re ed to get a t this, w ithin the com ing y e a r , on th e p re su m p tio n th a t m y re tire m e n t fro m th e M edical D irecto rsh ip of Ethyl C orp o ratio n w ill give m e tim e to do it. M eanw hile, what I have on hand could be m ade av ailab le to you o r your re p re se n ta tiv e fo r fu rth e r stu d y , if you w ish to .lo o k into it h e re .. The sam e a p p lie s, of c o u rse , to our c u rre n t investigation of the m etabolism of inhaled lead, as fa r as it has gone, and to o u r la s t field in v e stig atio n , th e volum inous d ata of w hich a r e now u n d e r study. A detailed re p o rt of the la tte r w ill be p re p a red . ; With re s p e c t to the ite m s w hich I a m sen d in g to you, I m u st a s k you to r e tu r n to m e, if you find it p o ssib le , any of the a rtic le s o r re p o rts of which you now have c o p ie s. In ste a d of sen d in g .you a c o p y of th e bound v o lu m e "L ead S tu d ie s" w hich I m en tio n ed to you, l am sending a ll but one of, th e m o re im p o rta n t in d iv id u a l p ap ers th at went into th is yolum e,. The:a rtic le om itted is M achle's account of "T etraeth y l Lead Intoxication and Poisoning By R elated Com pounds of L ead,1 JAMA 105 :578-585* 1935. T h e re a r e th in g s to .b e ad d ed to th is a r t i c l e , e s p e c ia lly on the la b o ra to ry side of the d iag n o sis, but it is m uch the b e st clin ical d e sc rip tion a v a ila b le of the m o re s e v e re c a s e s of poisoning. My p r io r a rtic le (which is included in the p re sen t sheaf) on the le ss sev ere and non-fatal types of poisoning is still the b e st d escrip tio n of this form of the d isease (since I saw m o re of it than anyone has had an opportunity to see ), but the o th er a sp e c ts of m y a rtic le a r e o b so lete. W ith re s p e c t to y o u r re tu rn of anything you do not need, I c a ll sp ec ific a tte n tio n to two ite m s , w hich you Should h a v e, btit w hich I can ill affo rd to supply to you. The one is the s e rie s of a rtic le s w hich a p p eared in JIHandT in 1033, beginning "On the N orm al A bsorption and E x cretio n of L ead. I. L ead A bsorption and E xcretion in P rim itiv e L ife. " The o ther is the "F in al R eport of the D epartm ental C om m ittee on Ethyl P e tro l, " issued by the B ritish M in istry of H ealth in 1930. I doubt th at the la tte r is obtainable fro m any o th er so u rc e, although I have m ade no attem p t recen tly . You m ay be fa m ilia r w ith this report,^ but if you a re not, has som e v e ry in te re stin g and p e rtin e n t M r. H e n ry D oyle - (3) - Ju ly 10, 1958 , ' inform ation in it. T h ere a re o th e r b its of re le v an t in fo rm atio n h e re and th e re , am ong which a s e r ie s of a rtic le s fro m S w itzerlan d i3 of sig n ifican ce in in d icatio n o f the ap p reh en sio n of c e rta in vocal p h y sician s th e re ,c o n c e rn in g the lead iii exhaust ga3 of autom obiles. M oreover, a s e rie s of a rtic le s by R ussian in v estig ato rs p re s e n t e x p e rim e n ts arid o p inions on te tra e th y l le a d in to x ic a tio n . I should say , off hand, th at none of th ese a rtic le s c a st m uch light on o u r p ra c tic a l problem s of in d u stria l o r public h ealth , but they d em o n strate that the issu e is not dead, and convey som ething - perhaps the fringe - of p ro fessio n al attitude elsew here. The m ineographed statem ent issued by The A ssociated Ethyl Com pany L im ited in Jan u ary 1944, re p re se n ts an abbrev iated account of the m ain re su lts and conclusions of m y su rv ey of th e situ atio n in th e N ear E a st and M iddle E a st (m ainly Egypt and Iran ), d u rin g the w a r, with re s p e c t to te tra e th y l lead poisoning am ong p erso n s exposed to ex cessiv e quantities of spilled and vaporized gasoline in im provised, crude and unventilated fa c ilitie s fo r canning, tran sp o rtin g and storing leaded gasoline fo r m ilitary p u rp o ses. This is highly pertinent inform ation which c le a rly in d icates the p re c ise n a tu re of the h a z a rd s of handling leaded g aso lin e and the type of situ a tio n w hich m u s t alwa.ys be a v o id ed , if such h a z a rd is to rem ain negligible as it is u n d er the g en erally p rev alen t conditions of the handling, dispensing and utilization of leaded gasoline by norm al com m ercial m ethods. '' T h ere a re a few o th e r p e rtin e n t m a tte rs to w hich no atten tio n is called in the m a te ria l w hich I am sending to you. T h ere a re s e v e ra l a rtic le s and num erous item s of inform ation fro m various so u rces, on the re su lts of the incom plete and, in som e in stan ces, the u tte rly lacking, m e a su re s fo r control of the handling of te tra eth y l lead during the w ar, in co u n tries in w hich inadequate o r no su p erv isio n was provided eith er by industry o r by governm ent - in G erm any, fo r exam ple, w here the previously established p recautionary regim en broke down, and in the a re a under R ussian governm ental and m ilita ry control, and in Japan. These m a tte rs a re of in te re st and im portance in dem onstrating the need fo r control, and in p redicting what m ight w ell happen anyw here when control m e asu re s fail o r a re lacking in application. We have, I b eliev e, the m o st com prehensive bibliography av ailab le on various aspects of the lead problem , and it is unlikely th at anything of re a l im portance has escaped u s. To the extent, th erefo re, th at the inform ation and facilities of th is L ab o rato ry can be of u se to you o r your a sso c ia te s, esp ecially as a m a tte r of saving tim e (for your a cc e ss to the w o rld 's published inform ation is u n su r p a sse d e lse w h e re ), you h a v e only to c a ll upon u s . I b eliev e th is ia the b e st I can do fo r th e p re s e n t, but if q u estio n s o c c u r to you o r your a s s o c ia te s , do not h e sita te to ra is e th em . KB 0008420 M r. H enry D oyle - {4) - July 10. 1958 . <=,* swri ta lk w ith you and D r . G a fa fer la s t w e e k , and I w as ^ * " * i u e you or a r r " gi" 8 it. With k in d est r eg a rd s, Sincerely yours, RAK e. Reprints under separate cover. Robert A. Kehoe, M. D. I t\ 0009421 . ' Studies on the A bsorption of L ead from Ethyl G asolin e - K ehoe, Tham ann and Sanders Addendum to R eport Dated N ov. 18, 1926, Studies on the A bsorption of Lead F rom Ethyl G asoline - Kehoe, Thamann and Sanders & A Study of the H ealth H azards a sso c ia te d with The D istrib u tio n and U se of Ethyl G asolin e - K ehoe, Tham ann, K itz m ille r , C rudgington, M achle, Sanders and Cholak R eport on A Study of the H azards of G leaning G asoline Storage Tanks (including G lossary) F inal R eport of the D ept. Com . on E thyl P etro l - London 1930 The A ss o c . Ethyl Co. Ltd - London - Sum m ary of C onditions R esp on sib le for Toxic H a z a r d s to W ork m en E n g a g ed in F illin g S m a ll C o n ta in e r s (up to 50 G allon s C ap acity) With L ead ed G a so lin e, and in H andling P a ck a g ed L ead ed G a so lin e to g e th e r with R ecom m endations for the avoidance of such H azards. - Kehoe ' On the T o x ic ity of TEL and Inorganic L ead S a lts - K ehoe .` The E x cretio n of Lead by N orm al P er so n s - K ehoe, Tham ann and Sanders TEL P oisoning - C linical A n alysis of a S eries of Nonfatal C ases - Kehoe The E xcretion of Lead - Kehoe and Thamann The B eh a v io r of L ead in the A n im al O rg a n ism , II. TEL - K ehoe and Tham ann On the N orm al A bsorp tion and E xcretion of Lead I. L ead A b sorp tion and E xcretion in P r im itiv e L ife - III. The S o u r c e s of N o rm a l L ead A b so rp tio n - L ead A b so rp tio n and E xcretion in R elation to the D iagn osis of Lead P oison in g - K ehoe, Tham ann and C h olak An A p p ra isa l of the Lead H azards A sso c ia te d with the D istrib u tion and Usp o f G asoline Containing TEL P art I - K ehoe, Thamann and Cholak N orm al A bsorp tion and E xcretion of Lead - K ehee, Thamann and Cholak 'The O ccu pational L ead E xp osu re of M en E ngaged in M ixing TEL (Ethyl F luid ) w ith G asoline - Kahoe and M achle An A p p raisal of the L ead H azards A sso c ia te d with the D istrib u tion and U se of G a so lin e C ontaining TEL. II. The O ccupational L ead E xp osu re of F illin g Station A ttendants and G arage M echanics - K ehoe, Thamann and Cholak H azards in the Handling of E thyl F luid and L eaded G asolin e - Kehoe E xp erim en tal Studies on the Ingestion of Lead Com pounds - K ehoe, Cholak, Hubbard, B am bach, M cNay and Story R eport on M ethods for the P u rification of W ater after Its T ransportation and Storage in C ans, D ru m s, and Tanks That have b een E m ployed as C ontainers for L eaded G asolin e - C holak, M cN ary, Bam bach and B urkey The P la sm a -C e ll P artition of Blood Lead - B am bach, Kehoe and Logan Lead P oison in g Sym posium - R ef: E xp erim en tal Studies on Lead A bsorption and E x cretion and T heir R elation s to the D iagn osis and T reatm ent of Lead P oison in g - Kehoe C holak, Hubbard, Bam bach and M cN ary E x p o su re to L ead - K ehoe T reatm ent of O rganic L ead (TE)..Intoxication w ith E datham il C a lciu m -D iso d iu m - K itzm iller, Cholak and K ehoe Isolation F rom L iver of TEL A fter its Inhalation - S teven s, Feldhake and Kehoe C ollection and A n alysis of Solids in Urban A tm osp h eres - Cholak, Schafer and H offer The N ature of A tm osp h eric P ollu tion in a N um ber of Industrial C om m unities - Cholak R esu lts of a F iv e-Y e a r In vestigation of A ir P ollu tion in C incinnati - Cholak, Sch afer and H offer M easurem ent of A ir P ollu tion - Cholak A ir P ollu tion in a N um ber of A m . C ities - Cholak, S ca efer, Younker and Y eager A C om parison of P a rticu late Loadings in the A tm osp h eres of C ertain A m . C ities - C ham b ers, F o ter and Cholak R egulations G overning the T ransportation of M otor F u el A ntiknock Com pounds ("Ethyl" A viation and M otor F lu id s) O ver In stru ctions fo r H andling "Ethyl" A ntiknock Compound s in Cans R egulations fo r Handling and M ixing "Ethyl" A ntiknock Com pounds - P a rtia l D rum ' M ixing E quipm ent - D rum E quipm ent - D rum to W eigh Tank Equipm ent - Tank E quip m ent ' .. M ethods fo r D eterm in in g L ead in A ir and B io lo g ic a l M a ter ia ls -iiS P H S KC 0008423