Document X7borDkyQMBvpG96bp8YXpXay

THE AMERICAN PUBLIC HEALTH ASSOCIATION, inc . LESTER BRESLOW, M.D. President MYRON E. WECMAN, M.D. Chairman of Executive Board MARION L. HENRY Traaiurar BERWYN F. MATTISON, M.D. Executive Director OFFICE OF SECTION SECRETARY PLEASE REPLY TO FRANCIS X. WORDEN, M.S. Western Electric 222 Broadway New York, N. Y. 10038 ROBERT A. KEHOE, M.D., Professor Bneritus Kettering Laboratory College of Medicine Cincinnati, Ohio 45219 August 19, 1969 Dear Dr. Kehoe: I received the attached letter today from Dr. John P. Curran and I know that you are, in my opinion, the best qualified physician in the United States to answer the letter. In essence, Dr. Curran questions the upper limit of normal for lead in blood 0.06 milligrams per 100 grams whole blood. He would like to know the basis for this level (e.g., population, age, socio economic status and environmental circumstances). z' Dr. Curran suggests that the upper normal limit be reduced to 0.04- milligrams of lead per 100 milliliters blood. What ao you think of this suggestion? * Please communicate with Dr. Curran. I would appreciate a copy of your reply. Many thanks for your cooperation. Sincerely, F. X. WORDEN, Secretary Occupational Health Section Att. Copy to: Herbert E. Stokinger, Ph.D. United States Public Health Service 1014 Broadway Cincinnati., Ohio 45202 John P. Curran, M.D., F.A.A.P. Director, Dept, of Pediatrics Medical Center Jersey City, New Jersey 07304 E. Lynn Schall New Jersey State Department of Health John Fitch Plaza Trenton, New Jersey 97th Annual Meeting of the American Public Health Association N21228 *5 t Jo h n P. Cu r r an , M.D., FA.-A.F. DIRECTOR DEPARTMENT OF PEDIATRICS *v Me d ic a l Ce n t e r JERSEY CITY, N. J. 07304 Ar e a Co d e 201 433-7000 August 153 19^9 Mr. Francis X. Worden Secretary Industrial Hygiene Section, American Public Health Association Western Electric Corporation 222 Broadway Hew York, Hew York Dear Mr. Worden: For several years I have been troubled by the standards for normal blood levels as published by the Committee on Lead Poisoning and accepted by the Poison Control Program of the Hew Jersey State Department of Health. I am particular ly concerned with 0.06 milligrams per 100 grams whole blood as the upper limit of normal. I have been unabld^to determine lArat any description of the age, socioeconomic status and environmental' circumstances of the population from which these values were derived. < Specifically, I think that the value of 0.06 milligrams may be too high as the upper limit, since it is quite likely that this figure is based on determinations from samples which include large numbers of children from old urban housing areas who have experienced increased exposure to lead. The upper -limit of normal can only be established by determining the range of values in children who do not experience such exposure. The sampling should include children from new urban or suburban housing that is known to be free of lead containing paint and plaster. I doubt that such a population has been utilized to obtain the values now,in current use. A more recent study suggests a range of 0.015 to 0.040 milligrams per 100 milliliters of blood, with a mean value of 0.017 milligrams. I know nothing about the patient population surveyed. I suggest that we have significantly divergent values from two different sources, and that the upper limit of normal for blood lead in children cannot be establish ed unless the samples are obtained from children who have not experienced an increased exposure to this metal. N21228.01 "ruL Mi'. Francis X. Worden. 2- Our last 100 determinations from children aged one to four, from old substandard urban housing, showed a mean of 0.019 milligrams per 100 milliliters of blood. I am led to believe that the value of 0.06 milligrams is too high, and that many childr4n with 0.01 and 0.05 milligrams per 100 milliliters'are in fact experienc ing unusually high and potentially damaging exposure to lead, but are excluded from, arty program of prevention and treatment. I suggest a more realistic upper limit Would be 0.04 milligrams per 100 milliliters. John P.: Curran, M.D., F.A.A.P. JPC:sm cc: Herbert Stokinger, Ph.D Mr.E. Lynn Schall