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November 21, 19^9 Mr. H. L. Clark, Manager, Southern California Plant, General Motors Corporation, 2700 Tweedy Boulevard, South Gate, Calif. Dear Mr. Clark: I have not had time since returning home to write to you concerning my visit .to your plant, nor do I have time not; to write in any extensive manner. However, it does occur to me that I might confirm one or two things that I said to you, while making a few additional comments on the contribution which we might make to the solution of your difficulties. First let me say that I enjoyed the visit and was interested keenly in the problem which was presented. There are a number of aspects of this matter that justify a very considerable amount of discussion, and among these I would rank in first place the consideration of the problem of the place, of your plant physician in your organisation. I have a feeling that part of your trouble is organisational in character and that it stems fx*om the fact that your chief medical man has neither the amount of responsi bility! or authority that he should have in an organisation of your type. I say this quite apart from the personal and pro fessional qualifications of such a man, since I am speaking in terms of a principle of organization. I shall not pursue this subject, at this time, since to do so would be impractical and, perhaps, even impertinent, but if you should be interested in my viewpoint on this subject, in relation to future developments, I should be very glad to give you my opinions and the facts and experience on which they are based. With reference to your hygienic problem, I repeat that there is no question in my mind that some of your men have absorbed dangerous quantities of lead and that some cases of lead poisoning have occurred amond these people. I am by no means certain that the absorption of lead under the conditions of your operations is necessary or unavoidable, and I have a rather strong suspicion that a proper attention to certain details in the supervision and instruction of workmen and in housekeeping might correct your difficulties. However, this remains to be seen. In my opinion, you should conduct a careful survey of the situation, by careful analysis of your records of employment and of job location in association with analyses of the blood and urine of a large proportion of the men who are employed in the area in which the hazard exists. You will remember that I offered our services in 0005541 Mi*. H. L. Clark - (2) - November 21, 19^9 in carrying out such analyses, and I did this for the reason that Mr. Patty had told me that his laboratory was in no position to do the work. If we are to do this, however, I should feel that it would be necessary for your people to supply me with the necessary information by which these results could be interpreted properly and to your best advantage. Such information would consist of the employment record and at least a summary of the clinical data on the individual workmen.. Incidentally, It is my opinion that information of this sort could be considered carefully in relation to every analytical result. Therefore, this Is a medical problem, and this information should be held exclusively In your medical department and not reported to non-medical personnel. The consideration of these data, like all other laboratory data on individuals,is a matter of medical record, and is subject to interpretation by medical people only. I have seen anxiety, apprehension, misinterpretation and general confusion arise out of the use of this information by laymen. In my opinion, medical records on employees, including all laboratory data, should be dealt with privately by physicians, and these records should be confidential. Under these circumstances the physician can deal with the employee in all matters in which illness is involved, and he need not and should not discuss these matters in detail with non-medical personnel. I might also point out at this time that the disposition of a workman,with reference to the continuation of his wTork in a hazardous job, should be done on the basis of a medical recommendation, and if the physician recommends that a man should be removed from his work, the man should be removed summarily. Any other practice puts a liability on the plant management, which, under our laws-is specific. In other words, in most of the states, the failure to follow a medical recommendation of this type, If it should result in injury or Illness or disability on the part of the employee, Involves the employer in criminal liability. I realise in saying this, that this situation necessitates a proper and effective working relationship between the management and the physician, and it may be that such a relationship does not exist In your plant. However, I am stating the case as it should be, and not necessarily as it i s . To get back to such a survey as I speak of, I should want the information Indicated above, so that I might be able to Interpret the analytical data individually and collectively so as to make recommendations to you and so as to be able to put my finger on where the difficulties lie in your operations. It may not be possible to do this as completely as one could wish, but It will not be possible to do anything useful with the Information unless this procedure is followed out. In other words, we In this Labora tory are unwilling to perform routine analyses for anyone. Rather it is our function to undertake to study occupational situations and to give our best advice and assistance In clarifying the . situation so that hazardous conditions can be corrected. I have already told you of my feeling that Doctor Johnstone can 0005542 Mr. E. L. Clark - (3) - November 21, 1949 advise you properly and give you the best possible assistance in your cases that are coming up for a hearing. However, if I can be of any indirect assistance, I shall be pleased to do so. Pinal 1^ I should like to confirm my statement that I hop, you might find the means of straightening out your situation with Doctor Bones so that he might continue to handle your medical problems. This may or may not be possible, and a great deal will depend upon the genuine down-to-earth qualifications of Doctor Bones. Nevertheless, I am convinced of his honesty and sincerity, and while these qualities are not enough, they represent tilings on which much can be built. I trust that you will accept my comments in the spirit in which they have been made and will recognize that I am undertaking to do what I can to assist you and your employees in difficult situations. It was a pleasure to have met you, and you will have some appreciation of the esteem in which I came to regard you from the fact that I an speaking as frankly as I an on such short acquaintance. Sincerely yours, Hoser>. n K e n o e , k. D RAK ef P. S. The receipt of Doctor Bones's letter of November 18, which iust came to my desk, does not alter my point of view concerning the survey in any significant manner. Ve shall carry through the analyses as promptly as possible and report them as requested. However, I should like to obtain samples of urine on your men in accordance with instructions which I shall send you, in containers which we will supply. I shall also want all of the other informa tion* requested above, so that I can help you as much as possible, and at the same tine learn something from the experience. P..A.2L . .'Vi . tiftt K k 0005543