Document V3ygx15dK23G77NJ6EDkZ1Xow

September 4, 1953 Mr. Herbert E. Hillman Technical Director Eaglo-Paint and Varnish Corporation 49-20 Fifth Street Long Island City I, New York Dear Mr. Hillman: The problem of lead poisoning among young children is a serious one with which we have been concerned for a goodly number of years. Unfortunately we have published little on the subject and nothing of a comprehensive nature in any widely circul ted publication, largely because of our primary preoccupation with diseases of industrial origin. On the other hand, we have been in touch with the work and observations of others elsewhere in this country, and have given diagnostic assistance here and there as occasion arose. Most of the actual and suspected cases in this general area, and some c those in other cities in which there are no analytical facilities, have come to our attention for analytical appraisal, and therefore we have a very considerable accumulation of information which relates to the incidence of the disease, the sources of exposure, the extent of the absorption of lead, and the rate of mortality. I enclose a tabulation of the number of cases of which we have know ledge by years up to 1953. The data will give you some insight into the scope of the local problem. The year 195 3 has been a bad one from the aspect of mortality. The season for the appearance of cases (most of which, for some unknown reason, come in during the hot months of the year) is not over, and I have hot tabulated the results for the year, but the data.it appears, will resemble those of 1951. One might conclude that the incidence of the disease is unduly high in Cincinnati, and that there has been a recent increase {during the past few years). We do not believe that either of these conclusions is justified. It is probable that we do not see anything like all of the cases in any year, and that the number found and recognized is a function of the local interest and diagnostic competence of physicians. For a number of reasons these have been heightened recently. In our experience, the incidence of the (recognized) disease in other cities, Baltimore, for example, varies with the application of satisfactory means of detection and diagnosis. Wherever there are facilities for modern diagnosis, the disease is found. I would estimate, on the Mr. Kc. thou san.:. This, hi . means r minimum to err c much lam. signifie he dons There i It is urn moldir.; given fuel his proxirr. deposic of a ch from u the ho; "rith ; from ;i. flaking left mu' Faint c' like (v'h paint of seem to from m contai: contains lead in In my fl out at a . thi3 sun control ; eliminog content of your concern.a -: ineffec' legi si.. m : 953 ..mooing per year in the U. 3. A. xe of mortality in such cases. 7mired fatalities per year at the mtimafce, deliberately designed v; r of mild cases must be very lie health problem of real aiug should be done while it can . iree of exposure in our cities, i;o f .ctors contribute. Lead ., n rho lead nipple shield, have o of battery cases as household distance, at least, the 'o cf fume (which was uarfaces with which the hands .. logic factor. Several cases, -of lead pipe to bring "water into , : *y or in other remote places. 'or of cases (but not all) come mi of the city. Crazed and . baseboards and porch railings,- appear to be the principle source, ens, beds, high chairs and the sb'iout the precaution of using important source. Some cases nutty, picked by small fingers nircty, as you know, doubtless, compounds, while some c to be little justification for on of this problem, as I pointed Association at the Greenbrier organized program of education and 'facturers, and distributors, to more than very minor lead ; household and in the environment cluntarily by a wise industry properly, it will be accomplished unties and disadvantages through K 001308? Mr. Herbert E. Hillman * (3) - September 4, 1953 ^This provides you with most of the facts and opinions derived from our observations, if I can be of any assistance to you and to the industry generally in dealing with this matter, I should be pleased to hare you call upon me. Sincerely yours, RAK EF Enc. Robert A. Kehoe, M. D. H! 0013033 Casas of Lead Poisoning Among Children in Cincinnati, in the Records of The Kettering Laboratory, by Years Confirmed b: Year Number of Cases Number of Fatalities On Blood and Urine on Tissue 1928 2 1931 1 1932 1 1933 1 193^ 3 1935 1936 5 1 1937 4 1938 3 1939 5 1940 1943 5 1 1946 2 1947 2 1948 1949 3 6 1950 12 1951 18 2-952- 12 Ail Iears 2 1 11 11 3 2 32 1 14 13 5 15 1 1 11 1 11 3 3 53 4 84 7? 16 3 2? 11 1 n -----------T7---------------- Comments ; 1. The histories of exposure as supplied were ill-defined in most instances. The full case records may have been more informative. These were not investigated at this time. Paint from toys, furniture, woodwork in house, porch railings and unspecified sources was incriminated, some times by implication only, in 16 cases; battery casings used as household fuel were implicated in 2 cases; metallic lead toys were involved in 2 instances, one of which was fatal, and a lead nipple shield was convicted in 1 case. 2. Pica was alleged as a factor in 22 cases. KJ? 0013089 N14888.01 LEAD POISONING IN CHILDREN Historical - Comparatively rare disease Use of lead nipple shields Use of cosmetics - face and neck - contaminating breast - Japanese Use of stains and dyes on hair - India More recently Frequent occurrence in Queensland Calling attention to paints of high lead content Present problem in USA Sources Inside paint - floors and other woodwork - painted plaster walls - window sills Immediate environment - playpens, high .chairs, cribs, toys Other - metallic lead toys - molten lead inhaled solid lead chewed - bullets, etc. Nipple shields still used occasionally Use of storage'battery boxes for fuel in household Water supply - lead pipes Bullets in body - especially within a joint LEAD POISONING A NURSERY THREAT Lead is not a new product, it is among the first metals known to and used by mankind, and its use at present is very extensive in almost every part of human surroundings* The most startling danger of lead, from the aspect of the nubile health, is that which involves small children* Age of child most susceptible from KINS MONTHS TO THREE YEARS. This is the A exploring age, when the child starts crawling and walking around 'it the house. The child puts things into his mouth; and to relieve f the discomfort of teething, the baby may chew on any available object The dangerous features of the disease in childhood are the following: 1. The child's exposure to lead often escapes the notice of the parents. 2. The disease is insidious in its development and the early symptoms often go unrecognized, 3. The disease in childhood is much more serious than that in late life, disablement or death being often the outcome. Sources of lead poisoning: 1. Chewing paint on 'window sills, toys, furnitu(\ /re* ***uu* <" *y$ 2. Constant sucking'on small lead objects such as tof soldiers/ paint rags, etc. 3. Swallowing chunks of painted plaster or loose flakes of old paint from inside or outside walls and eating them. 4. Removing putty from frames (windows, doors, pictures) and swallowing. * | - Keep in mind the following: 1. That all paint used for inside purposes should contain little or no lead. 2. Reputable toy and juvenile furniture manufacturers do not use toxic paint in their products. 3. The real DANGER is when AMATEURS REPAINT AND USE AM UNSUITABLE LEAD BASE PAINT. 4. Surfaces from which paint is cracking or peeling provide/ bits of paint ds a source of lead poisoning. * Precautions to take: 1. When refinishing woodwork, toys, childrens furniture (cribs, .... chairs, tables) be sure to get non-lead paint for the job. Per centage of lead should be on the label, if not inquire. Paint for inside use, -should never contain more than 1/5 or 2fo of lead. 2. Prepared the surface before you start to paint-, remove all old paint. Do not leave paint, turpentine, old plaster paint flakes around for child to eat. 3. Check woodwork, furniture, toys in your'home NOW7. Watch for teeth marks and. maintain a lead free environment. 4. Do not permit a small child to have or play with metalic lead in moulding sets or other toys. And older child with such a toy should be taught how to use and the dangers involved. THE GREATER CINCINNATI SAFETY COUNCIL THE KETTERING LABORATORY AT THE COLLEGE CF MEDICINE, UNIVERSITY CF CINCINNATI KE 0 013 u d I LEAD POISONING How it affects small children Laad is not a new product, it is among the first metals known to man kind. Lead colic and paralysis were among the first mentioned diseases, and were associated withindustry. To a large fextent, lead poisoning as the result of occupational hazard does not exist. The chief danger today is when small children become affected.. Dangerous feature is the insidiousness of its development. The disease may become advanced in a child before it is suspected. Age of child most susceptible fromNNINS months to THREE years.. This is the exploring age, when the child starts crawling and walking around the house. The phild puts things into his mouth; and to relieve the discomfort of teething, the baby may chew on any available object. Symptoms of poisoning are difficult for highly trained physicans to diagnosis Vomiting, loss of appetite, irritablility and lethergy can occur with almost any illness of childhood. By the time more pronounced symptoms occur, especially conversions, inseparable damage has been done to the brain. Sources of lead poisoning 1. Chewing lead paint on window sills, toys, furniture. 2. Constant sucking on small lead objects such as toy soldiers, paint rags, etc. 3. Swallowing chunks of plaster or loose flakes of old paint from inside or outside walls and eating them. IMPORTANT: It is the day by day infiltration of lead that does the damage Keep in mind the following 1. It is recommended that inside woodwork be painted with material con4aining very little lead. 2. Reputable toy and juvenile furniture manufacturers do not use toxic paints in their products. 3. The real DANGER is when AMATEURS REPAINT AND USE AN UNSUITABLE LEAD BASE PAINT. Precuations to take When fefinishing woodwork, toys, childrens furniture (cribs,'chairs, tables) be sure to get non-lead paint for the job. Percentage of lead should be on the label, if . not inquire. 2 Prepare the surface before you start to paint, remove all o old paint. Do not leave paint, turpentine, old plaster paint flakes around for a child to eat. 3. Check woodword, furniture, toys in your home NOW. lu bo Watch for teenth marks and. maintain a LEAD FREE ENVIRONMENT AROUND A CHILD. Greater Cincinnati Safety Council, in cooperation^;^itirs Cases of Lead Poisoning in Children}Recorded 'by The Kettering Laboratory by Years Year (No oases recorded during the years omitted) j 'f~ rt -T- & y*~ CU^^XtT&Je Confirmed ipyTAnalytical Data Humber of Cases) Humbelcf of Fatalities dn Blood andj^ On Tissue' !3T 1931 1932 1933 1934 1935 1936 1-P.t.U- 2 1 1 1 5 ^2 2. 1 ) / 3 S' i 1937 4 4: 1938 1939 1940 1943 3 5 3 S 5 1 s1, 1946 2z 1947 1948 1949 1950 dst 2,' 2 3 6 12 33-. L tl. " ' 6r id , n !?s*~ IZ )Z All Years If %1 --v t- 1 k1 1 i2 1 (: 1 t1 1 1 /, 1 1 / l 1 1 33 A- 4 7 7? ` 2*. 7 2 ?r 2S' 2? t T /3u Lt*r / / 1 2. \ 1t f > * 4- 77 ?? 2 1 : 3 3 2 4 3 5 5 1 1 1 3 5 8 /fc /a 7f 2- 3 1 + 3. sr r 1 / f. 3 3~ 3 n 7Z 11 J1 1 2. 2, ' // " 11 11 y i y 3' 4 ^ zK***t 1 1-- n i./ Comments * 1. The histories of exposure as supplied were ill-defined in most instances. The full case records may have been more informative*' These vere not investigated at this time* Paint from toys, furniture, woodwork in house, porch railings and unspeclfled sources was Incriminated,sometimes by implication only, in 16 cases; battery casings used as household fuel vere implicated in 2 cases; metallic lead toys were involved in 2 Instances, one of which was fatal, and a lead nipple shield was convicted^in 1 case* 2. Pica was alleged as a factor in 22 cases. /-s=L~3'i''~""Three'"of this series of cases occurred at considerable distances 1 I from Cincinnati (Philadelphia, Louisville and &Lj, the \ remainder being from Cincinnati or its environs. ' ,/ _^ /* <Sl 4 Ld ____,_________ 0013 Frequency Baltimore - from 1931 to July 1, 1949 ~ Number Age in Years Number of cases White Colored of heaths White Colored Under 1 1 1 37 2 121 3 32 4 13 58 6 4 Largest number in any one year - fl Smallest number in any one year - 2 72 81 10 1 Total 220 78 142 78 27 51 Cincinnati - La.rgest number of cases - 20 - 1951 87 from 1928 to 1553 - "with 25 fata.lit.ies K6 0013 0 14