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K ETtER IN G LABORATORY EDEN AND BETHESDA AVENUES CINCINNATI, OH IO 452.19 . UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE DEPARTM ENT O F ENVIRONM ENTAL HEALTH ' ' . . . - ' . . . , July 26, 1967 Dr. Robert J.M . Horton H ealth E ffe c ts Research Program P u b lic H ealth S ervice 5008 Federal O ffice B ldg. C in c in n a ti, Ohio 45202 .__ Dear Dr. Horton: Last week's d iscu ssio n s id e n tifie d certain areas of the proposed lea d stu d y w hich req u ire m o d ific a tio n . The groups f e l t th a t rep eated aerom etric measurements should be conducted a t a l l * " T r i - C i t y s i t e s (ex c ep t P h ila d e lp h ia A irp ort) and th a t th e cadaver study should not be consid ered a t th is tim e. N eith er o f th ese changes m a ter ia lly changes the scope o f th e work, although f u l l tim e coverage o f sam pling s i t e s w i l l become e s s e n t ia l. In response t o o th er s p e c if ic comments, our resp on se would be as fo llo w s: 1) T im e ta b le : We b e l i e v e t h a t th e o r i g i n a l t h r e e c i t i e s b e resu rv ey ed in th e y e a r running from l a t e 1967 o r e a r ly 196 8. The a ctu a l tim e o f in it ia t in g the surveys w ill r e f le c t the ra te o f p ro g ress in r e - e s t a b lis h in g th e o r ig in a l s ta tio n s and o b ta in in g s u ita b le rtionitoring p e r so n n e l. I t i s n ot n ecessary th a t the e n tir e experim ental p rotocol be e sta b lish e d p rio r to the s ta r t of th is sam pling program. can During th e 'f o llo w in g y e a r th e s t a t io n s w i l l be moved t o new s i t e s i n C h ic a g o , New Y ork , and t h e W ashington a r e a . Sam pling w i l l be u n d erta k en i n 1968 t o c o n fir m t h e r e a d in g s made a t lo w - le a d s i t e s (such as Cedar Rapids) and to examine th e a d v is a b ility o f a ir and b io lo g ic a l s tu d ie s th e r e in 1969. 196 8 (old ) - 1969 (new) C incinnati Los A ngeles P hilad elp h ia ? Cedar Rapids (p ilo t) 1 or 2 -4 -8 -7 20 New York C h ica g o W ashington (& suburban) ? Cedar Rapids " . - \ -6 -6 -6 -2 20 2) A erom etric sam ple p o o lin g : To avoid o b scu rin g t r a n s ie n t h igh w eek ly le a d r ea d in g s in a m onthly p o o l, p o o lin g on a w eek ly b a sis w ill be regarded as the standard procedure. 3) B i o l o g i c a l sa m p lin g : T h is w i l l be con d u cted e s s e n t i a l l y as proposed w ith d u p lic a te an alyses o f blood specim ens. Early during the sta r t-u p p erio d , th e s u it a b ilit y o f "old s ite s " fo r b io lo g ic a l c o r r e la tio n s w ill be e sta b lish e d . In a l l p r o b a b ility Dr. Robert J.M . Horton Page - 2 some o f t h e s e w i l l be r e p r e s e n t a t iv e o f a su rro u n d in g r e s i d e n t i a l community and o th e r s w i l l n o t . Four s t a t io n s in C in c in n a ti, fo u r in Los h n gel.es, and perhaps two in P h ila d e lp h ia are d e s ir a b le fo r b i o lo g ic a l m easurem ents and c o r r e la t io n s . The e x te n t t o which th ese ten sta tio n s are included in the o r ig in a l n in eteen w ill be determ ined a fte r th e re-esta b lish m en t o f the "T ri-C ity" s i t e s . For p la n n in g p u rp oses we w i l l assume t h a t 8 a d d itio n a l s i t e s w i l l be r e q u ir e d . 4) H em a to crit f a c t o r s : A lth ou gh th e e f f e c t s o f hem oglobin le v e ls in p op ulation groups w ill probably n ot be o f s ig n ific a n c e , m icrohem atocrits w i l l be determ ined a t th e tim e o f each blood co llectio n . . 5) C o n tro l b lo o d sp ecim en s: Three r a th e r than two con t r o l le v e ls w i l l be u t i l iz e d and w i l l be a v a ila b le fo r in t e r laboratory com parisons. A nurse a t the C in cin n ati General H osp ital has been s e le c t e d to carry ou t th e program. She w i l l have custody o f th e tu b es and w i l l in tro d u ce them in to th e a n a ly tic a l p rocess accord in g to a sch ed u le d evelop ed by th e s t a t i s t i c a l group. Her p o st in the h o s p ita l w ill perm it her to have correspondence w ith o u ts id e la b o r a t o r ie s and a c c e s s t o th e L aboratory on a s u f f i c i e n t l y regu lar b a s is so th a t c o n tr o l specim ens w ill n o t be obviou s. 6) Tube and f i l t e r c o n t r o ls : B atch check s w i l l be con ducted to a ssu re con tin u ed freedom from contailTfnation. 7) C o r r e la t io n o f o ld and p r o p o se d a e r o m e tr ic a n a ly s e s : The L ab oratory w i l l a n a ly z e on a "blind" b a s is f i l t e r w edges r e ta in e d from the o r ig in a l stu d y . Volume o f Sam ples A. O r ig in a l s i t e s ' 1) C in c in n a ti - 4 s t a t i o n s x 1 p ool/w k x 56 wks = 2 2 4 2) Los A n geles - 8 " x 1 " " x 56 " = 448 3) P h i la d e l p h i a - 7 " x 1 " " x 56 " = 392 . .. 1064 {Most f i l t e r s w i l l be changed on a 2 - 3 x/wk b a s is . In h ig h f i l t e r lo a d a r e a s in Los A n g e le s , tandem pumps y i e l d in g 7 f i l t e r s /week w ill be u sed .) Dr. R obert J.M. Horton Page - 3 B. New s i t e s 1) Cedar R apids (o r e q u i v a l e n t NASH lo w - le a d , p e n d in g ' confirm ation; p ilo t stu d ies at various sta tio n s) 2 s t a t io n s x 1 p o o l/w k . x 56 w ks. = 112 2) Neighborhood s ta tio n s (assum ing 8 in a d d itio n to above) 8 s t a t io n s x 1 p o o l/w k . x 56 w ks. = 448 C. Blood Specim ens ( t o be run in d u p lic a te ) 10 g e o g r a p h ic a l (neighborhood) groups x 100 p er so n s = 1000 10 o c c u p a tio n a l groups x 50 p e r so n s = 500 D. M e ta b o lic S p ecim en s 6 grou p s x 10 p e r s o n s /g r o u p x 10 days x 2 s p e c im e n s/d a y = 1200 specim ens E. C o n tro ls, rech eck s, and m ise 500 specim ens We s h a l l o f c o u r se b e p le a s e d t o d i s c u s s d e t a i l s o f t h i s work w ith you a t any tim e . Very tr u ly yours LBT/lh L lo y d B. T e p p er, M.D A ssociate D irector KE 0018526