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FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1947 Apr 28 DOC#: API005 DOCUMENT DESCRIPTION: Meeting Minutes & Attendee List - API Medical Advisory Committee For Information Only - Not fo r Publication AMERICAN PETROLEUM INSTITUTE MEDICAL ADVISORY COMMITTEE FIFTH MEETING Minutes of Meeting April 28, 1947 Statler Hotel Buffalo, New York jgfl3ERS_JPHEffiNT V. C. Baird F* F. Boys W. W. Brooks Kieffer Davis D. M. English /L5S0CIATES p r e s e n t E. W. Adams L. C. Beard, Jr. R. S. Bonsib M. N. Newjuist - Chairman J. P. Holt - Secretary T. M. Frank A. E. Hoag R. A. Jewett T. J. Kelly W. R. Levis E. K. Linder R. C. Page B. B. Reeve Melver Woody ' * * R. C. Cole N. J. Gothard H. P. Lankelma H. R. Viarrick F. M. Watkins H. D. Wilde H. H. Zuideoa GUESTS ` Marshall Clinton, Jr. N. V. Hendricks F. F. Heyroth R. A. Kehoe ADVISOR D. V. Stroop - API ` Total in Attendance - 32 MEMBERS ABSENT W. 0. Armstrong ' W. A. Morrison G. L. Sunner H. S* Thomsen ASSOCIATES ABSENT C. R. Brown T. G. Delbridge R. S. Driver E. W Ison A. J Koewing, Jr. D. W. L a m e r C. R. McKay R. B. Roapaor G. H. Taber, JT. Action I MINUTES OF PREVIOUS m n r . The minutes of the previous meeting, November 14 1944, were approved as circularised* _ ' API 06869 -2- n ggPTCff OF SUBCOMMITTEE O N CABCBIOGENICITY - DR. MeTVER WOODY. CKAIKAM The report of the .'.-.eeting of the Subcommittee on Carcinogenicity held March 14, 1947 was discussed. Photostat copies of three articles concerning [*/ carciTiOgenic properties of petroleum products that have appeared in "The j^icrican V/eclhLy, " "Life, and "Medicine" were presented and discussed. The report of the Subcommittee on Carcinogenicity was presented and is given in full in Appendix A* Dr. F. F. Hcyroth of the Kettering laboratory of Applied Physiology, University of Cincinnati School of Medicine, presented a progress report on the experimental carcinogenic studies that they are carrying out on several petroleum samples for the API. A letter from Dr. Heyroth to Dr. Woody, dated April 25, 1947, describing the results of the studies that are being carried out at the University of Cincinnati is given in Appendix B. ' Action - ' In receiving the Subcommittee 's report, the Modi'-".I Advisory Committee voted to adopt recommendations as follows: * V A. The animal experiments now under way at the Kettering Laboratory of Applied Physiology should be continued at least until the end of the current year. B. Extend the scope of investigation to a large number of samples so that they can be treated on a statistical basis rather than on a comparative basis using a small number of samples as in the present work. It would seem that the best attack would be to get out a form letter to a number of oil companies inquiring whether or not they would be willing to participate in such a program and, if so, request them to set aside barrel samples of catalytic recycle stock, catalytic rcsids, thermal recycle, hydroformer bottons, thermal resids and other samples,,and advise by what type of operation and under what conditions they have been produced. Then, after an analysis of responses to that questionnaire as many of these samples will be studied as is practical. C. The Chairman of the Subcommittee on Carcinogenicity is authorized to rcloasc samples up to one gallon of each, and to a total of 25 gallons, for physical and chemical studies with the objective of correlating these data with the tests on mice. The results of these physical and chemical studies shall be submitted to the Subconmittcc on Carcinogenicity. D. Establish a registry of malignancies to report to the Subcommittee on Carcinogenicity. This registry would collect data on all malignancies incident in employees of the pr i-olcum industry. It would set up its own procedures, forms, extent of data, follow-ups, pathology, treatment, outcome, autopsy reports, etc. after consultations with existing registries. E. Means must be found to refute the false and misleading statements that arc continually appearing in newspapers and magazines as to the prevalence of cancer among those who work in refineries and API 06870 -3- filling stations. The Subcomittcc on Carcinogenicity is authorized to do the following: 1. Initiate a literature survey on the possible carcinogenic effects of petroleum products to man. 2. Initiate a study of the physical and chemical characteristics of petroleum products in an attempt to obtain a simp]c procedure to determine whether a particular petroleum sample is or is not carcinogenic. 3. To have experimental studies carried out on sludge, lubricating oils, gasoline and other oils. in REPORT OF SUSCCmUTTSB ON CUTTING FLUIDS - DR. B. B. REEVE. CHAIRMAN The report of the Subcommittee on Cutting Fluids was presented to the Committee and is given in Appendix C. In receiving the Subcommittee's report the Medical Advisory Committee voted to adopt the follojrijng recommendations in the report as follows: Action " A. It is recommended that a complete survey of the literature and the compilation of a bibliography pertaining to dermatitis and other harmful effects of cutting-fluids be made. The survey should include 1. A review of the conditions under which cutting oil dermatitis most frequently occurs. 2. The part that bacteria dc or do not play. 3. Physiological mechanism of oil dermatitis. 4 The review should include the known components of cutting oilj i.e., mineral oils, fatty oils, additives, etc. 5. Tabulation of the state laws or regulations relative to the use of oils or to their composition. 6. As a result of this survey the investigator will recommend a program for further study of this problem including suggestions for remedial measures. It is understood that the participating members of the API Medical Advisory Conr&ttcc will assist and facilitate the reviewer in supplying him with whatever information is already available in the various companies. B. The Subcommittee recommends that a system of exchange of infor mation be established and correlated between the Independent Research Conn.ittec on Cutting Fluids and that of the API Modical Advisory Committee. C. It is recommended that consideration for rosoarch,be withheld until the survey has been made. API 06871 -V D. It is rcco.~ncr.cIcd that after the survey has been completed, consideration be given to the femulation of an educational program. The nature of this program will depend upon the information obtained from the survey. E. It is recommended that a grant be given to the Harvard School of Public Health to make this survey under the guidance of Dr. Marshall Clinton, Jr. F. It is recommended that a grant of $2,500 iron the $5,000 appropriated to the Subcommittee be made to carry on this work. IV COMMUNICATION CF JANUARY 20, 1947 FROM MR. G. L. SUMNER. CHAIRMAN OF SUBCOMMITTEE ON INDUSTRIAL DERMATITT 3 CF THE INDEPENDENT SEARCH COMLUTTSE ON CUTTIA-~ -IDS Mr. Sumner dcscribod the activities of the Independent Research Committee on Cutting Fluids and presented a report of a literature survey cn this problem. Some of his report is given in Appendix*IX It was the consensus of the Medical Advisory Committee that it would cooperate on this problem with the Independent Research Committee, and the Medical Advisory Committee was very appreciative of Mr. Sumner*s report and cooperation. REPORT OF SUBCOMMITTEE ON FLUORIDES - DR. A. E. HOAG. CHAIRMAN The report of the Subcommittee on Fluorides was presented and is given in Appendix E. _ . ' Dr. Robert A. Kehoo and Dr. Francis F. Heyroth of the Kettering Laboratory of Applied Physiology, University of Cincinnati College of Medicine, described the research program that they arc carrying out on the toxicity of fluorides for an industrial group of five companies (Aluminum Company of America, du Pont, Pennsylvania Salt Company, Reynold Metal Company, and Universal Oil Products). They stated that this was a fovuvyoar project to study the physiological effects of fluoride ions. The question of the desirability of the Medical Advisory Comittoo of the American Petroleum Institute contributing financial supr'-rt to this group of five companies to carry out these toxicity studies on flor.-... os at the University of Cincinnati was discussed. In receiving the report of the Subcommittee the Medical Advisory Committee voted to adopt the following motion: Action It is rccomcnded that the American Petroleum Institute should contribute $2,500 to the work being sponsored by an industrial group on fluorides at the Kettering Laboratory of Applied Physiology, University of Cincinnati College of Medicine, under the direction of Dr. Kehoo. The Chairman of the Subcommittee is authorized to make the noccs3ary arrangements subject to letter ballot cf approval by the API Medical Advisory Connittoc. API 06872 -5- VI g rxf? OF SUBCOIIUTTEE CN ?Z?:i3SI5LB CONCENTRATIONS - DR. V. C. BAL'D . CHAIRMAN At the request of Dr. V. C. Baird, Dr. Marshall Clinton, Jr. presented .)C progress report on the work that they have been carrying out at the Harvard university School of Public Health under the direction of the Subcommittee on permissible Concentrations, and the introductory material that will be distributed -th the toxicological reviews that have been prepared. This report and the production are given in Appendix F. The toxicological reviews were discussed as follows: Aluminum chloride Ammonia Benzene Boron trifluoridc Carbon tetrachloride Chlorex Cumene Cresol Furfural Hydrogen chloride Hydrogen sulfide o n carbonyl Nitrobenzene Phenol Sulfuric acid Styrene Toluene Xylene Action The following notions were voted by the Committee: A. An Editorial Committee will be appointed by the Chairman of the Medical Advisory Committee to review and approve the introduction presented by Dr. Clinton (sco Appendix F) and to advise the Institute staff on matters of format and other details of publication. The following persons were appointed to serve on this comittcc: Dr. J. P. Holt, Chairman Dr. V. C. Baird, Vice Chairman Dr. Marshall Clinton, Jr. Dr. M. N. Ncwquist (Ex-officio) Mr. D. V. Stroop (Ex-officio) B. The toxicological reviews on the following compounds were approved by the Coixdttoc and referred to the Editorial Committee for editing and publication, subjoct to approval by the Comittoc on Safety of the Board of Directors: Aluminum chloride Ammonia Benzene Boron trifluoride Carbon tetrachloride Chlorex ' API 06873 - 6- Cumene Crcsol Furfural Hydrogen chloride Hydrogen sulfide Iron carbonyl Nitrobenzene Phenol Sulfuric acid Styrene Toluene Xylene f i i C. It was voted to state on each review that recommendations contained therein are tentative, not final, and are only being published for study and comment by all readers. D. It was voted that Section 1 in Dr. Clinton's report, which reads as follows: "1. An evaluation of the acute and chronic toxicity of boron trifluoridc and flu o r ide-hydrocartjpn complexes. It is realized that this problem is being considered by the Subcommittee on Fluorides, but it is mentioned at this time fer the sake of completeness." would not be handled by the Committee on Permissible Concentrations but would be referred to the Fluorines Committee. E . It was voted to do nothing at the present time concerning the following recommendation given in Dr. Clinton's report, which reads as follows: "2. A survey of the extent and hamfulncss of air contamination by gaseous wastes from petroleum refineries, especially H 2S, SO2 and HF. 'That tho problem of SO2 pollution can become a most expensive and serious one has been amply demonstrated by the unpleasant experiences of many of the larger smelting companies, who have paid vast sums for crop spoilage. More recently, the west coast aluminum refineries have had similar experiences with damage to cattle by fluorides absorbed from the air by vegetation." F. Dr. Marshall Clinton, Jr. of Harvard University School of Public Health is authorized to carry out toxicological screening studies on compounds selected by the Subcommittee on Pcrnis3iblo Concentrations from those indicated in his report with the funds now available. These compounds will be those that arc of general interest to the petroleum industry as indicated in oarlior surveys made by the Subcommittee. The compounds from which some vd.ll be selected to be studied by moans of toxicological screening tests arc as fellows: Arc.TC.tic ncrcaptans, including thiophcnol Maleic anhydride Morpholine Di-tcrtiaiy butyl pare crcsol n-butyl p-anino phenol ' Toxicological Literature Surveys It was the consensus of the Medical Advisory Committee that any petroleum company having a desire to have a literature survey prepared on a particular compound should infern Dr. Clinton of their desire. After he has received several requests to prepare a review on a particular compound, he will circularize the industry and if there is general interest in a particular compound he will prepare a review on the subject. . VII pr.?nRT OF SUBCOMMITTEE ON MEDICAL POLICIES AND PRACTICES-DR. R.A. JEVCTT, CHAIKIN The report of the Subcommittee on Medical Policies and Practices was presented as givon in full in Appendix G. * * >* Mr. Stroop presented a summary on the mortality statistics for 1946 as reported by oil companies covering approximately 127,000 employees and annuitants. Action The Medical Advisory Committee votod to adopt motions as follows concerning this report* A. The API Medical Advisory Connittce endorses the principle of periodic examinations of employees. B. A majority of the members of the Medical Advisory Committee found that cil-conpany sponsorship of medical insurance for purchase by employees has definite value and should be encouraged. C. The Medical Advisory Committee endorses the policy of following up employees absent due to sickness by trained workers where possible, D. The Medical Advisory Committee recommends the carrying on of a continual health educational program for employees. E. Ihc Medical Advisory Comittoe endorses the principle of periodic inspection from a health standpoint of offices and plants by a doctor or a representative of the medical department. F. The Medical Advisory Committee endorses the policy that companies should keep statistics of mortality and morbidity. G. It was recommended that mortality statistics be kept by petroleum companies and that the Standard Classified Nomenclature of Disease be used in campiling this information. API 06875 -8- vm CQIUJNICATION OF APRIL 1. 1947 FROM DR. THOMAS T> MACKIE. PRESIDENT OF THE A1Z3ICAN FOUNDATION FOP. TROPICAL MEDICINE The communication fren Dr. Hackie as circularized on April 10, 1947 s ^scusscd by the Conr.ittee (3ce Appendix H)* It was the consensus that the ^jeetives of The American Foundation for Tropical Medicine were very worthwhile. ction ~ ' IX METHOD FOR TMFPRHTNT, MEMBERS fiF THE API OF ;70HK OF THE MEDICAL ADVISORY COMMITTEE It was voted that the Chairnan of the Medical Advisory Co.mittcc should present a report on the activities of the Medical Advisory Connittce to the Committee on Safety of the Board of Directors of the American Petroleum Institute at such time as is indicated. It was the consensus of the Committee that not all of the detailed activities cf the Medical Advisory Committee would.^>e reported to the Committee on Safety but that certain activities, depending on their nature and general interest, would be reported to the Beard Committee. Release of Information to the API It vas the consensus that any Medical Advisory Committee developments that arc of particular interest should be sent to Mr. Stroop to bo distributed to the members of the API. X NEW BUSINESS Kcrosinc - The question cf the toxicity cf kcrosinc when ingested, which v/as discussed in the meeting of the Committee on November 14, 1946, was considered. It was stated that this question had been referred to the National Safety Council. XI Next Mooting - It was the consensus that the next meeting of the API Medical /.dvisory Committee should be held on Thursday, vember 13, 1947 in Chicago, Illinois, and subcommittee meetings should be hexd on Wednesday, November 12, 1947. Approved: M. N. Newouist. M.D Chaimen J. P. Holt, M.D. Secretary 6-10-47 API 06876 Fcr Infoir.auion Only - Net for Publication APPENDIX A PROGRESS REPORT TO THE API IZDICAL ADVISORY COULUTTEE 3Y THE SU3C0iliITTEE ON CARCINOG2JICITY Dr. liclver Woody - Chairman April 28, 1947 report 1. The Subcommittee on Carcinogenicity submits the following progress The experimental work on animals, which was begun last year at the Kettering Laboratory, is being continued. It is still too early to draw any definite conclusions but one (Sample Y^3632) out of the eight samples furnished by vis produced lesions "teat grossly resembled papillomata in 11 mice out of 20 after 33 weeks. At the present time one of these tumors has boen excised and studied by moans of microscopic pathological examination and shows the tumor to be a squamous cell carcinoma which has invaded underlying striated mufcle. Whether any of the remaining samples will give positive findings by the end of this year remains to be seen. 2. A meeting of the Subcommittee was held in New York City on March 14, 1947 to review what has been accomplished and formulate plans for the future. It was agreed that an excellent start had been undo. Unsubstantiated allegations have appeared in both the technical and lay press that petroleum products arc carcinogenic. Although studies on animals show certain petroleum products to be carcinogenic to certain experimental animals industry statistics do not confirm this in man. Much remains to be done to get the facts. 3. On March 26th, at the request of the Subcommittee, Mr. Stroop sent out the following questionnaire to all members of the Advisory Comnittoe: "Please report below the number of cases of cutaneous or superficial cancer occurring among your employees in tho United States during 1946, in which the cancer was allcgod to have boon due to the occupation. If ycu have any such cases, kindly give pertinent details such as age, sex, nature of occupation, exposure, nature and location of lesion, diagnosis, tissue report, course of disease, autopsy report if any, and whether or not a Workmen's Compensation Award was grantod." Up to date Mr. Stroop has received reports from eight companies cover ing 99,435 employees, none of whom developed cancer during 1946. Rccomnenfiiti nn.< A. The animal experiments now under way at the Kettering Laboratory should be continuod, at least until the end of the current year. B. Extend the scope of investigation to a large number of samples so that they can be treated on a statistical basis rather-than on a comparative basis using a n.vn number of samples as in the present API 06877 ^PSNDIX A (Cart'd) - 2- work. It would seem that the best attack would be to get out a form letter to a number of oil companies inquiring whether they would be willing to participate in such a program and, if so, request then to set aside barrel samples of catalytic recycle stock, catalytic rcsids, thernc.1 recycle, hydroformcr bottoms, thermal rcsids and other samples, and advise by what type of operation and under what con ditions they have been produced. Then, after an analysis of responses to that questionnaire as many of these samples will be studied as is practical. C, The Chairman of the Subconsaittee on Carcinogenicity is authorized to reloase samples up to one gallon of each, and to a total of 25 gallons, for physical and chemical studies with the objective of correlating these data with the tests on mice. The results of these physical and chemical studies shall be submitted to Dr. Kchoc and to the Subcommittee on Carcinogenicity before publication. D, Establish a registry of malignancies to report to the Subcommittee on Carcinogenicity. This registry would collect data on all malignancies incident in employees of the petroleum industry. It would set up its own procedures, forms, extent of data, folloWMips, -pathology, treatment, outcome, autopsy reports, etc. after consultations with existing registries. E, Means must be found to refute the false and misleading statements that are continually appearing in newspapers and magazines as to the prevalence of cancer among those who work in refineries and filling stations. The Subcommittee on Carcinogenicity is authorized to do the following: (1) Initiate a literature survey on the possible carcinogenic effects of petroleum products to nan. (2) Initiate a study of the physical and.chemical characteristics of petroleum products in an attempt to obtain a simple procedure to determine whether a particular petroleum sample is or is not carcinogenic. (3) To have experimental studies carried out on sludge, lubricating oils, gasoline and other oils. Respectfully submitted, Dr. Me Ivor Vioody, Chairman Members: Dr. M. N. Newquist Dr. T. M. Frank Dr. A. E. Hoag Dr. J. P. Holt Dr. T. J. Kelly c. Dr. W. R. Levis Dr. R. Page Mr. L. C. Board, Jr. Mr. Roy S.> Bonsib Mr. H. P. Lanke l m Mr. H. R. Yforrick Mr. H. H. Zuidena Mr. D. V. Stroop API 06878 m r ir-fomaticn Only - Not for Publication APPENDIX B UNIVERSITY CF CINCHINATI C 0 CINCINNATI 19, OHIO p Y votorini Laboratory of Applied Physiology Medicine - den Avenue April 25, 1947 _nr_* *--'-~-TV''i* Y.oorj -r Hetv;]. suffal0- 1 ;v. York pear Doctor Wocdy: The follovdng represents the present status of the experiment on carcinogenicity. A3 you will sec, the picture has not changed materially since yur visit, although the number of animals in the group painted with Oil W 3632 has increased. * nil Number Date Painting Started if 3632 * 3631 * 3630 N 8295-2 N 8295-3 11896 11885 11980 White Oil White Oil 0.1 * L'cthylCholanthrene? Sept. 12, 1946 Oct. 7, 1946 Sept. 12, 1946 Sept. 12, 1946 Oct. 7, 1946 Oct. 21, 1946 Oct. 21, 1946 Jan. 2, 1947 Feb. 3, 1947 Feb. 3, 1947 Water Control Sept. 12, 1946 Number of Mice at Start 20 20 20 20 20 20 20 20 20 20 20 Number of Mice That Have Died Number of Mice With Tumors of Papillomas 6 11 5 0 4 0 3 0 1 0 6 0 7 . 0 1 . 0 1 ~ ' 0 0 0 7 0 The criterion for including a mouse in the number of those having tumors or papillomas has been the presence of a nodule of about a millimeter in diameter. In at least three of the oleven ,htuaor-boaring" mice in the group subjected to contact with Oil W 3632, more than one nodule is present. The first tumor became apparent during the twentieth week, while most of the others were first noted during the twenty-seventh and twenty-eighth weeks* The tuaor which you saw when you wore here was removed by biopsy during the twenty-sixth week. The pathologists report is as follows: An uilccrated papillomatous squamous cell carcinoma which invades and destroys the most superficial lamina of stratifiod muscle. The tumor is comprised of atypical largo kcratinizod cells with API 06879 PPSNDIX B (Cant'd) 2- largc vesicular nuclei; mitotic figures, .most atypical arc fairly common and binuclcate cells arc nunerous; there is cdcix. and infiltration of the underlying connective tissue by large mononuclear cells, lymphocytes and a few polys. One other animal of this group that died bore a tumor which on gross examination had a similar appearance. The sections of this tumor have not yet bccr. read. The other tumor-bearing mice arc still alive. I have brought this information together rather hastily in order that it may reach you in tine. Very truly yours, FFH:vr ce - Dr. H. A. Kchoc /s/ Francis F. Heyroth Francis F. Heyroth, LLD. API 06880 T A For Information Only - Hot for Publicati APPENDIX C REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON CUTTING FLUIDS Dr# B. B. Reeve - Chairman April 28, 1947 , it is recommended that a complete survey of the literature and the compilation ii* of a bibliography pertaining to dermatitis and other harmful effects of cutting fluids be made The survey should include: 1 . A review of the conditions under which cutting oil dermatitis most frequently occurs 2 The part that bacteria do or do not play. 3 Physiological mechanism of oil dermatitis* 4, The review should include the known components of cutting oil; i.e., mineral oils, fatty oils, additives, etc. 5, Tabulation of the state laws or regulations relative to the use of oils or to their composition. 6, As a result of this survey the investigators will rcc.qpnend a program for further study of this problem including suggestions for remedial measures It is understood that the participating members of the API Medical Advisory Committee will assist and facilitate the reviewer in supplying him with whatever information is already available in the various companies. B. The Subcommittee recommends that a system of exchange of inforoaticn be established and correlated between the Independent Research Committee on Cutting Fluids and that of the API Medical Advisory Committee. C. It is rccomcndcd that consideration for research be withheld until the survey has been made. . D. It is recommended that after the survey has been completed, consideration be given to the formulation of an oducational program. The nature of this program will depend upon the information obtained from the survey. E. It is rccomcndcd that a grant be given to the Harvard School of Public Health to make this survey under the direction of Dr. Marshall Clinton, Jr, F. It is recommended that a grant of $2,500 from the $5,000 appropriated to the Subcommittee be made to carry on this work. /s/ B. B. Reeve, Chairman f zf E. W. Adams X /s/ N. J. Gothard /s/ F. F. Boys /s/ F. Li. Watkins /s/ H. H. Zuidena /s/ Robert C. Page /s/ T h o m s J. Kelly /s/ L. C. Board, Jr. / s/ A. E. Hoag /s/ H. R. ".'arrick API 06881 T 1 c o p Y ?cr* Ir-f.rr.ation Orly - Net for Publication APPENDIX D THE TEXAS COMPANY 135 EAST 421 STREET NEff YORK 17, N. Y. January 30, 1947 jjr. G. L. Sunner Subcommittee on Industrial Dermatitis Independent Research Conraittcc on Cutting Fluids Westinghouse Electric Corporation 11 East Pittsburgh, Pa. * * Dear Mr. Sunner: I have read with interest your letter of concerning the work of your Committee on Industrial relates to Cutting Fluids. Your connunication will to the membership of the Medical Advisory Com i t t ce Petroleum Institute for their information. January 20, 1947, Dermatitis as it be circularized of the American A Subcomittcc on Cutting Fluids has just been appointed by the Medical Advisory Connittco of the API of which Dr. B. B. Reeve, Standard Oil Company (Indiana), is Chairman. The next meeting of our Medical Advisory Comittcc will be held in Buffalo, Hotel Statlcr, April 28, 1947. The subj'cct natter of your comunication will be presented for consideration at that meeting, after which Dr. Reeve will comunicatc with you. In the meantime, I wish to thank you for your interest and offer of cooperation in this connection. Very truly yours, i MNN-IPM cc - Dr. J. P. Holt Mr. D. V. Stroop (Blind) /s/ M. N. Newquist H. N. M< "Tuist, M.D. API 06882 ;ipaos d -2- t7 s s t i ::g h o u s e ELECTRIC CCRFCE..TICK East Pittsburgh, Pa. January 20, 1947 H. I:. Ncwquist i;,c Texas Company - 05 2jast 42nd S t . H r York 17, N.Y. Dcar Dr. Ncwquist: I understand iron Hr. C. II. Larson that you arc new the Chairman ;f the American Petroleum Institute Hcdical Advisory Coanittce for 1947; succeeding Dr. He Ivor Woody. I an Chairman of a Subcommittee of the Independent Research Ccmittcc on Cutting Fluids on "Industrial Dernatitis." This Connittcc feels that it would be higlily desirable to establish liaison with the API Hcdical Advisory Ce m i t tee, and I an therefore attaching a sum a r y of the work done by this Connittcc so far which is self-explanatory, After you have read this sumary, I would very nuch appreciate suggestions fron you for procedure. You Toll note that in the literature the opinions arc quite conflicting and that it is probable that sonc of this literature is propaganda for house organs dealing in protcctivco and curatives for industrial dernatitis. Our efforts, as you will note, arc confined to the type of dernatitis that results fron cutting fluids, and we would like to either de-bunk the propaganda or else cone up with something constructive that would clarify the picture for the users as well as the producers ^of cutting fluids. You vail note in the attached letter that we have three medical non on this Subcomittcc, and it is quite probable that you lenow then, namely Doctors Boys, Crunch and Pharris, and it is probable that one or more of then nay be on your API Connittcc of which you have just been appointed Chainann. I would very much appreciate hearing free you in the near futuro tdth particular regard to; (1 ) as to whether it would be possible for the nodical non to supply data on authentic eases of dermatitis resulting fron contact with cutting oils. (2) whether our Ccanittco can be of help to the American Petroleum Institute Hcdical Advisory Corxdttee on this problen* Very tru ly yours, .jSOlZ D (Cent'J) -3- TEST I H G H 0 U S E ELECTRIC CORPORATION East Pittsburgh, Pa. January 16, 1947 n p. F* Boys, Sinclair Refining Co., East Chicago, Ind. ~17\ '. g. Cranch, The Union Carbide . Carbon Corp., New York, N.Y. ji. n . Fcaron, Standard Oil Co. cf N.J., 26 Broadway, New York, N.Y. 7!i\ g . Hucbler, Chief Chemist, Sugar Beet Co., Saginaw, Michigan '7\ jar-.es McElgin, E. F. Houghton L Co., 303 T.7. L ehigli Ave., Philadelphia 33# Pn. nr! C* Pharris, Asst. Medical Director, United Aircraft Corp., E. Hartford, Conn, jr! F. Rosonstici, Tne Torens Co., 13$ East 42nd St., Hew York, N.Y. 0C - Hr. Joseph Geschclin, Chairman, Ind. Resoarch Committee on Cutting Fluids, 1015 Stephenson 31dg., Detroit 2, Michigan. CC - Dr. C* M. Larsen, Sinclair Refining Co., 630 Fifth Ave., Nov York, N.Y. * Independent Research Connttee on Cutting Fluids Subcommittee - Industrial D erratitis Gentlemen: 1. In order to clarify the v/orlc of the Subcomittce, a brief review of its history will be of interest to all of us. 2. The Subcomittee was formed under the Chnirnanohip of Itr. Fcaron in 1943. Due to a request by Hr. Fearon to be released of thejo duties on account of the pressure of other work, I accepted the Chairmanship early in 1945 It nas agreed that the first step should be a tabulation of literature bibliography in order to determine what work had been done on industrial dermatitis, particularly in regard to cutting fluids. 3. On October 8, 1945 I 'undertook to tabulate all the literature which I could find in addition to what lir. Fearon had accumulated, and submitted it in the form of a report to the general committee at a meeting in Detroit* 4. Dr. Pharris vnrotc me a very constructive letter of criticism on this tabulation, including the data it contained and the s u m a r y of conclusions. In brief, Dr. Pharris disagreed with many of the house organs regarding protective creams, including the propaganda and suggested placing the leading role of our investigation in the lap of the medical men of the oil refiners. He felt that bacterial contamination of cutting fluids is greatly over-rated in that the bacteria are almost always non-pyrogcnic. 5. I reported Dr. Pharris reaction at the Cleveland meeting on April 9 1946. His comments were well received and it was suggested that perhaps a liaison could be established between IRC and API. On April 11, 1946, I wrote to Doctors pharris and Cranch, suggesting that perhaps ire should meet for luncheon in the near future to map out a program, but received no reply. API 06884 Ur. C-cschclin vrrotc to Dr. Uoody and received a reply that there would from hin since that aeeting. However, Dr. Larson contacted Dr. Boys clair Oil Company), and advised on January 7 at a meeting of the general c i ttee ^ Dctroit* that API had aade a decision on the aatter and indicated that a liaison aight be established between us. One "grape-vine" rumor indicates a few producers who use chlorine and diphcnylnaphthalcne have not been very Operative and it is apparently this snag that has had a tendency to block -regress on the project. PU4 mmm .. m ^a a T4 ae> aAMU (4Ani VI A +a OAA toVSt A3A ViA a'AA0 vre hat is tod 1 os I. II. Ill* IV. V. VI. Straight mineral oils. Mineral oils containing (a) "Non-corrcsive" sulphur. (b) "Corrosive" sulphur. Sulphur bearing mineral oils with fats (such as lard). Straight mineral oils with fats (lard oil, etc.). Mineral oils containing fats, sulphur and chlorine. TJater nixed emulsions (a) Soluble oils (1) Super type - vdth large fat content with and vfithout chlorine and sulphur. (2) Ordinary soap and mineral oil emulsions. (b) Soap-paste compounds. U. Another angle brought up by Mr. F. Rosenstiel (who replaces Dr. Raymond dttee) is whether we can get agreement on a statement that itain no harmful bacteria - as a start. I personally have tho . make faster progress by taking one step at a time, i on individual cases would materially aid in nailing decisions, > have or can obtain authentic data, are requested to send then ui lor tabulation analysis and discussion. API 06885 Mr. Huebler lived close to this problem at the Navy Centerline Plant if*ch we operated for the IJavy during the war, and I a m asking him to submit the *ords, together with the methods used in controlling dermatitis there. r<?hcntic records of this type from any source will be valuable to the Conaittee. , You will perceive that as Chairman of the Subcommittee, I an trying to inject new life into this important subject. The news that the API is in a more ^ c a b l c mood to go along with us, gives the Committee renewed hope that wc may, Sir0Ugh our efforts, contribute something worthwhile to industry on dermatitis fro3 cutting fluids, cither from the standpoint of "debunking" propaganda or in Offering a constructive program for its prevention in the machining of metals. 14 I would like to call a meeting of the Subcommittee as soon as it seems desirable, and would like to suggest that this meeting be held in Pittsburgh, but be glad to entertain suggestions for other places. Perhaps New York would be more centrally located. Please express your opinion. GLS/ak Very truly yours, * >' /s/ G. L. Sumner G. L. Sumner Chairman, Subcommittee API 06886 r For I r - or^ation OiiLy - Ii: t :'~r Publication A P E DEC 5 REPORT TC H-2 .vPI 1EDICAL ADVISORY COIUTTEE ' Since the last31meTieltlinSgUXaCnuLeTfTfToErtE hOaNsFLbUeOeRnIrDuESde tc obtain from the of the Subcommittee expressions of their desires as to theApfrutiulre23,co1u9r4s7e '^'b:'rs,..orlc< conversationsDwr.erAe.haE.d rHactahg D-r.ChPa.ir!m7a.nLimnerman at the Boycc- sf institute relative to the plant physiological aspects of this problem "*t*c:'3' "sy_n_o_p,,s-iss- nf these discussions vravc transmitted to the Subcommittee. s.nd lore recently a meeting was held -with Dr. Francis C. Frary, Director of - -arch for the Aluminum Company of America. Dr. Frary is one of the worlds `^standing authorities on the subject. Some of the facts obtainod from him were verbally to tire Subcomittee. Later it is hoped to confirm to them such as he will approve. In the course of the above discussions i t can t c^ight that there is an industrial Group of five companies (Aluminum Company of America, du Pont, Pennsylvania Salt Company, Reynolds Llctal Company, and Universal Oil Products) " nsoring work on fluorides at the Kettering Laboratory under the direction of jjr. Kchoe. The annual budget is of the order of $17,000 per yoar. It was indicated by Dr. Frary that this Industrial Group night sympathetically entertain oarticipation of the API nodical Advisory Comittee. At the meeting yesterday considerable time was devoted to a discussion of the desirability of joining this group. It was the concensus that it was only logical and economical to do so rather than to initiate independent and perhaps duplicating research. The suggestion was made that three members of the Subcccrittee, representing different companies, visit Dr. Frary to more completely evaluate this matter. It was felt however such a procedure would be tine consuming and that the monies involved in travel and" salaries would in fact approach the .magnitude of a modest contribution. On the premise that the API Subcommittee on Fluorides would have access to the data and some voice in the steering of the rcsoarch the following notion was submitted: "That it be roconnendod to the API that it contribute $2,500 to the work being sponsored by the Industrial Group on fluorides at the Kettering Laboratory under the direction of Dr. Kchoe and that the chairman of the Subcommittee be authorized to make the necessary arrangements subject to approval by the API with respect to its participation in such a group study and subject to letter ballot of approval by the API liedical Advisory Committee." /s/ A. E. Hoag, Chairman /s/ F. F. 3oys /s/ Ti. R. Levis /s/ Kioffer Davis /s/ R. C. Cole /s/ E. /s/ L. /s/ E. /s/ N. /s/ ?. '.7a.de Adams */ _ eard, Ur. 3. Reeve J. Gothard \l. Uatkins API 06887 Fcr Inf:rr.iat,icjl On l;'_- Hot fc r Publication APPENDIX F IS7CHT TO THE API 23DICAL ADVISORY CGI IITTIE 3Y THE SU3CC11HTTEE ^ ssISG: C01ICZHTEATIONS OF TOXIC SUBSTANCES Ei THE PETHCIZIL: INDUSTRY Dr. V. C. 3aird - Chairman C 0 P Y HU13LE OIL & REFINING COMPANY P.0, Box 2180 Houston 1, Texas ARril.|8, 1947 Be: Deport of Subcommittee for Permissible Concentrations of To:a.c Substances in the ' Petroleum Industry. Dr. X. *.i. Nev/quist The Texas Company 135 East 42nd St. New York 17* N. Y. Dear Doctor Newquist: . Attached is a copy of the progress report of Dr. iiarshall Clinton, Jr. and a proposed introductory section for the reviews# Tie would like to have the desirability of initiating a research program at Harvard under the direction of Dr. Clinton brought 19 for discussion. B/fo Attach. Yours truly, /s/ V. C. Baird V. C. Baird, H.D. API 06888 ppSNDEC F (Contici) - 2- HAH7ABD UNL'IRSITY SCHOOL OF PUBLIC HZALTH V. C. Baird v--hlo Oil : Refining Company 55 Shattuck Street Boston 15, Massachusetts April 7, 1947 Progress Report Tjoar Dr. Baird: During the period from November to the present the compilation and ''oroulation of toxicological reviews has progressed fairly well, and reviews on nearly all of the substances selected for special emphasis last November are cither completed or nearly completed. Hie "kinks11 in the. system of preparing reviews are becoming ironed out, so the work seems to progress more easily, even though less definitive information is available on the toxicology of many substances now being investigated. Hie response of the medical and associate members of the medical advisory comittee on the tentative reviews has been most gratifying, and has resulted in the addition of a great deal of valuable information about the various substances. During the period, tentative drafts on the following substances have been sent to Mr. Stroop for distribution Carbon monoxide Kerosine Mercury Hydrogen fluoride Phosphoric acid Sulfur dio:ade Acetone Methyl ethyl ketone n-butyl p-amino phenol 2, 6 di-tertiary butyl Thiophene para cresol Alkyl ..i.rcaptans "'Aromatic nercaptans Acrylonitrile Maleic anhydride Morpholine Diethylene glycol Alkyl disulfides Dowtherm A Phosphorous pentasulfide Silica Naphthenic Acids In addition, final reviews on furfural and aluminum chloride were circularized some time ago, and final reviews on sixteen other substances were forwarded to Mr. Stroop on March 3rd for distribution prior to the Buffalo meeting. It is hoped, therefore, that the medical advisory committee will accept as official reviews on the following substances: Aluminum chloride Ammonia Benzene Boron trifluoride Carbon tetrachloride Chlorex Cunene Cresol Furfural Hydrogen chloride Hydrogen sulfide Iron carbonyl Nitrobenzene Phenol Sulfuric acid Styrene Toluene ' Xylene API 06889 -> An introductory section for the reviews has been prepared, and is ^,-or.tcd for consideration at this time (copy attached). pro During the ncurt si:; months we plan to continue preparing revicms on various substances. As our present "high priority" list is approaching ^usticn, it is hoped that a nevr list will be submitted by the committee. Tie f - ; ot in a position to know which substances are of the greatest interest to s, industry. V/e also plan to prepare final drafts for acceptance ne:ct November \ the substances circularized during the past six months, including the c'ceSary revisions and additions dictated by the suggestions which have been received fron the medical advisory committee. On the basis of the work carried on at Harvard so far, it is evident insufficient knowledge is available on the toxicity of the following svistanccs: Boron trifluoride Iron carbonyl Thiophene Alkyl mercaptans . v Alkyl disulfides Aromatic mercaptans, including thiophcnol iialeic anhydride llorpholine Di-tertiary butyl para cresol n-butyl p-amino phenol It docs not appear that immediate or intensive research is needed on all of these cr that such research is practicable or desirable, but certain problems arising from these and from our contact with the general field of to:lcity of petroleum substances are in need o f 'early solution. The following studies appear to be especially desirable: 1. An evaluation of the acute and chronic toxicity of boron trifluoride and fluoride-hydrocarbon complexes. It is realized that this problem is being considered by the subeaxuttee on fluorides, but it is mentioned at this time for the sake of completeness. 2. A survey of the extent and harmfulness of air contamination by gaseous wastes from petroleum refineries, especially H2S, SO2 and HF. That the problem of SO2 pollution can become a most expensive and serious one has been arply demonstrated by the unpleasant experiences of many of the larger smelting companies, who have paid vast sums for crop spoilage. 'lore r 2ccr.tly, the west coast aluminum refineries have had similar experiences with carnage to cattle by fluorides absorbed from the air by vegetation. 3. An investigation of the acute and chronic toxicity of the sulfur-containing hydrocarbons. It would appear especially desirable to obtain valid data on the acute and chronic toxicity for animals of thiophene and its derivatives, and of thiophenol and other aromatic mercaptans. Studies of the sulfur-containing aliphatic substances are less urgently needed, although the available information is far from adequate. _ 4. A basic study into the fundamental processes which govern the bkin absorption of fat-- soluble substances, and the alterations in skin structure and metabolism which accompany the development of dermatitis due to greases and API 06890 rrU\jr--rV (Con--1d) U 30 iar' -obtins- cexils. A variety of approaches arc available other than the conventional unsuccessful descriptive techniques of the dermatologists, /along ,e researches which appear promising would b1e studies of the rate of absorption t;1, egree of uptake vrithin the shin of fat-.soluble substances, using radioactive +ra'cceerr"tteecc,hniques; co_mbined with invetstigations of the alterations in tissue spiration accompanying such absorption. Ihe tracer technique approach would be re-ecialiy easy to apply in the case of the sulfonated oils. Certainly the past -^roaches to the problem of dermatitis from cutting oils or other fat-soluble ^stances have not produced spectacular results. It appears that a basic approach to the problem, using the newer techniques now available, night succeed. Our group at Harvard 'would be very much interested in a consideration 0f the problem of atmospheric pollution, or in a fundamental study of skin absorption and penetration of fat-soluble substances. We consider that we would be in a good position to undertake the first of these studies because of professor Drinker's long association with one of the larger smelting companies, ;iho had a serious pollution problem some years ago 'which it controlled only by constant effort. We would be readily able to handle the second study, on skin absorption* as we are already engaged in isotope tracer research and have a graduate student coming hero to study for his doctorate in public health. He desires to attack a fundamental problem in dermatology for M u thesis research. * Respectfully submitted, 1C, Jr. F Enclosure /s/ Llarshall Clinton, Jr. Marshall Clinton, Jr., .D. API 06891 0 Z D Z L F (Cor.t'd) -5- FkCPCSZD Z lTR C X CTICi: ?c?t TSIICOLOGICAL 55VISh'S The following to;dcological reviews have been prepared under the a,,-pices of the American Petrcleun Institute at the Harvard School of Public Health by Dr. Uarshall Clinton, Jr. and associates, under the guidance and Erection of Dr. Cecil K. Drinker and Professor Philip Drinker. They are presented for the information and guidance of the producers and consumers of the various substances involved. In general, these reviews arc limited to substances of particular interest to the petroleum industry. Certain basic considerations concerning the general to:dcity of petroleum products deserve consideration at this tine, eny of the toxic sub stances encountered in the petroleum industry are volatile .jgr occur as finely divided dusts, and are therefore capable of contaminating the air breathed by workers. Inhalation of this contaminated air nay lead to sufficient absorption of the to:dc agent to produce serious systemic poisoning. Liany other toxic substances nay be encountered by the skin, either in pure state or in lesser concentrations when added to petroleum products which are generally believed to be innocuous, liany of these to;dc agents are capable of being absorbed through the intact skin in sufficient concentration to produce serious systemic poisoning, without producing any local skin irritation. It is apparent, therefore, that serious poisoning may follow inhalation or skin contact with a wide variety of agents, -without the victim being in any 7<ay aware that the agent he is encounter ing is damaging or endangering his health. Such poisoning may occur after brief contact with the agent, or ray not become manifest until weeks, or oven months after such exposure, so that severe and sometimes irreversible damage may have resulted before the victim is aware that all is not well with his health. Poisoning duo to the ingestion of petroleum products or related substances is a less serious hazard, as it is commonly accepted knowledge that petroleum products (except those prepared for medicinal use) may be toxic when ingested. Little tnought, however, is given by most individuals to the possibility of poisoning API 06892 (Cant'd) A* ' jje tc inhalation or shir, contact Tilth substances, as they are unaware that the -,,-ill fail to exclv.de the toxic agent or that considerable doses .nay be n'jsorbcd iron the air they breathe. Poisoning occurring as a result of skin c~itact or inhalation nay develop insidiously over a long period of tine, and since local irritation of the skin or respiratory tract nay be entirely absent, relationship between exposure and effect nay be completely overlooked, prevention of such delayed or insidious poisoning depends on familiarity with the possible toxic effects of the various agents encountered, as well as constant vigilance to keep such contact at a safe level. Finally, it should be realized that many complex organic materials are carcinogenic. It is not possible to predict with any accuracy whether a given compound "111 or will not be carcinogenic, although those which contain the pr.enanthrene nucleus are suspect, and should be evaluated further before general use. Unfortunately, there is no adequate or general classification of the various substances encountered in the petroleum industry which includes a consideration of their toxic qualities. A substance nay or may not be capable of producing dermatitis or may or nay not be carcinogenic, but these features of its action cannot be brought out on the basis of any existing classification. A vorlang physiological classification of toxic agents which enter the body by inhalation has been developed b y Doctors Yandell Henderson and Howard W. Haggard. This classification admittedly fails to include the problems of skin absorption, dermatitis, and carcinogenesis, but nevertheless is considered to be of sufficient general interest to the users of those reviews to justify its inclusion in this introduction. For the sake of convenience and simplicity, the following classification `as established: I* Irritants. This class of gases, mists, vapors and dusts injure the air passages or lungs or both, and induce API 06893 .IX F (Cost'd) -7- inflammation of the surfaces of the respiratory tract. These local effects overshadov: any systemic effects occurring following absorption. Examples of this class arc a m o n i a and acid gases or mists, such as sulfur dioxide or sulfuric acid mists. II. Asphyxiants. This group of substances act b y virtue of the exclusion of oxygen from the tissues. Two groups of asphyxiants are recognized; the simple asphyxiants such as nethane, hydrogen, or nitrogen which, when breathed in sufficient con centration mechanically exclude oxygen from the lungs, and the chemical asphyxiants such as carbon monoxide, hydrogen sulfide - * or hydrogen cyanide, which interfere with oxygen transport by the blood, or oxygen utilization by the tissues. III. Volatile Drugs and Drug-like Substances. This group contains substances which do not injure the air passages or lungs, but act after absorption by the blood and transportation to the tissues of the body. A large number of volatile hydrocarbon substances are included in this group. -It is divided into various sub-groups, depending on the type and duration of disability or injury produced by the substance. It is not possible to predict accurately what sub-group a particular hydrocarbon or related molecule will occupy, but the following general rules are helpful. The unsubstituted aliphatic hydrocarbons usually coccrt an anesthetic or irritating effect on the nervous system, but seldom produce lasting injury. Aromatic hydrocarbons, on the other hand, are prone to produce lasting damage to the body, especially to the blood-forming tissues; chlorine-containing hydrocarbons typically exert a deleterious effect on the liver; and sulfur or nitrogen- API 06894 F (Cant'd) containing h;nirocarbons nay have varied severe and unpredict able systemic to:-dc effects. IV. Inorganic and Organor.ietallic Substances. This group contains a variety of substances of interest to the petroleum industry, such as inorganic phosphorous compounds or substances such as tetraethyl load or iron carbonyl. As the to'i.c effects of the various substances encountered in the petroleum industry vary widely, it is not possible to generalize the question of treatment. Although chronic poisoning is the more important, there is tine to investigate the question of therapy once the type of poisoning is recognized; therefore, the reader interested in the treatment of chronic poisoning is referred ` * V zo the individual reviews, as generalizations on therapy are frequently not valid, cute poisoning is less common, but when it occurs it nay constitute a medical emergency. Certain rules which apply to acute poisoning deserve emphasis at this time, as their immediate application may be life-saving. TJhen an individual has been overcome by a to:d.c gas or vapor, he should be immediately transferred to an area where the atmosphere is not contaminated, and kept warn and at complete rest. If natural breathing is interrupted, artificial respiration should be started at once, as the chances of recovery follovang cessation of respiration are inversely proportional to the elapsed tine before it is started. If artificial respiration is begun within four minutes of the time breathing ceases, the victim iias a fair chance of recovery; if the delay e:rtends to ten or twelve minutes, recovery is most unlikely. If the gas or fume has a direct action on the lungs, complete rest is essential, and pure oxygen should be administered. If the gas or vapor has no local effect, but exerts a systemic action, elimination can be greatly accelerated by the administration of oxygen containing seven per cent a_rbon dioxide. API 06895 r^DL (C=r.-*d) 'hen an individual has been immersed in, cr a considerable area of v-ir or clotdir." las been contaminated rath ar. agent known to exert a serious local or systemic action, the immediate removal of tie contaminating material ,,,c- tlie skir. and tic die carding of tic clothing is essential. In such an instance speed is imperative. Clothing should be cut away, and the skin should be cleansed by copious flooding `.rath cool water and gentle Triping. Agents other -.rater may be most desirable for removing certain substances, but rater is useful in any case because of its general availability. Substances not readily soluble in 'rater arc removed to a large extent by the direct mechanical action of tie rater. A brief consideration of the structure and purpose of the individual * V Hi reviews in tils series is presented at tils time. Each review presents the best irfomation available at tic time it was accepted for publication by the Medical Advisory Committee of tie American Petroleum Institute. It is the intention of tils committee to add to this collection regularly, as time permits, reviews on otler substances of toxicological interest to the industry, and subject each review tc mandatory reconsideration every three years, or ofter.er If requested by members of the I d e a l Advisory Committee. . _ Considerable variation exists in the amount of information presented and the completeness of the various reviews. Tils is inevitable, as they represent a compilation of available information, rather than any original investigation. The present state of knowledge with respect to many of the substances considered is incomplete and, in a few instances, almost entirely lacking. It is hoped that the collecting together of obvious deficiencies of our knowledge concerning the toxicology and safe handling of these substances will serve to stimulate the quest for further icnowledge. Thcso reviews should be considered a beginning, not an end. API 06896 Each review is organized along fairly definite lines for the sake of clarity and utility. The first section presents the information necessary to definitely identify the substance, while the second presents the general physical ^ E I D I X F (Contd) -lo-- j c;hecrnaiiccaa^l- proppee.r1ties of the substance. Particular emphasis is given those .^racteristics influencing volatility, as these have a marked influence on the of atniospheric exposure which is likely. Each review on a substance c0tJX)riLy encountered as a gas or vapor includes factors for converting milligrams 0f substances per liter of air to parts per million by volume and vice versa, as the toxicological literature uses both types of unit-age. These factors apply at a pressure of 760 mm. Hg. and a tenperature of 25C. and are based on the fact that one gram molecule of every gas occupies the same volume as one gram golccule of any other gas when measured under the same conditions of pressure and temperature. The third section considers the probablo conditions and sources of exposure to the substance, and the consideration presented in^subsoquent sections assume the type of exposures cited unless otherwise specified. Section four considers the toxicology of the substanco. The information presented in this section varies widely, depending on the present state of toiorrlcdgo. Where sufficient information is available to justify the procedure, this section is divided into general considerations, including information on metabolism and excretion} acute effects, chronic effects and, finally, safe limits of exposure for an eight-hour period, five days a week. The fifth section presents any available Information on the treatment of poisoning by the substanco under consideration, with particular emphasis on specific therapeutic measures. Section six considers the special proplaccmcrrb or periodic examinations believed desirable for workers likely to bo required to undergo significant exposures to the substanco. It is assumed that all workers will undergo a careful and complete preplacement examination, including a chest X-ray, and emphasis in examination is placed on special tests or examinations pertaining to tho substances under consideration. Section seven considers the safety precautions, both mechanical and personal, which should bo observed in handling tho substanco under consideration. The final section presented a scloctod bibliography documenting tho formation given in previous soction3. API 06897 JF 1 For Xr-Ceraation Only - Not for Publication APPENDIX G REPORT TO THE API L2DICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON MEDICAL POLICIES AND PRACTICES Dr. R. A. Jewett - Chairman April 23, 1947 y. N. Newquist, M. D., Chairman yedical Advisory Committee American Petroleum Institute Dear Doctor: On March 19, 1947, I wrote a letter to the members of ny subco m i t too, in which was set forth eight rocomendations on which I requested the members to express approval or disapproval# Four members replied# I quote below my letter of March 19, tabulating therein the opinions of the members, from which it will be noted that the majority of the subcommittee approved this report. I wish to add my approval to each of the recommendations# * You doubtless have read the report I made up and sent to Doctor Frank tc bo presented at the last January meeting# This report unfortunately arrived too late for presentation at the meeting, but was published in the minutes. I wrote this report as if it came with the approval of the connittco members, but in reality it was not submitted to them for signature# I am therefore submitting ter you recommendations made in this report, and would ask you to sign each one you approve - this for the purpose of presenting to the next meet ing of the whole committee recommendations approved by our subcommittee and not by mo alone. First Recommendation: A periodic physical examination of all employees. /s/ J. P. Holt, U.D. over 40. Biennial before? *) (Comment: 'Impracticable with present facilities available in industry.* Wo would be in agreement with a statement roadir. A periodic physical examination of all employees.') R E C O M M E N D A T I O N APPROVED' API 06898 rpENDIX G (Cent' d) -2- .Second Rccennendntir-n; That oil companies sponsor nodical insurance for purchase by employccs. /s/ J. P. Holt, .D. /s/ H. S. Thonson, I.D. (Undecided) /s/ T. J. Kelly, li.D. /s/ E. K e m Linder, il.D. (Undecided) R E C O M M E N D A ! ION A P P R O V E D U <9 Third Rccemendation: Folio;-up of cnployccs absent due to sickness by trained workers where possible. . /s/ J. P. Holt, U.D. /s/ H. S. Thonsen, M.D. (Undecided) /s/ T. J. Kelly, li.D. /s/ S. K e m Linder, U.D. RECOMMENDATION APPROVED , j i Fourth Rccomcndation: A definite rehabilitation plan for handicapped workers, vdth special enphasis on veterans. /s/ J. P. Holt, U.D. /s/ H. 3. Thonson, Li.D. /s/ T. J. Kelly, li.D. /s/ E. K e m Linder, II.D. R I COLIIEM P A T I 0 N A P P R O V E D Fifth Rccomcndatjcn: The carrying on of a continual health educational picgran for cnployccs. /s/ J. P. Holt, -1LD. , < > /s/ H. S. Thonson, li.D. /s/ T. J. Kelly, U.D. /s/ E. K e m Linder, LI.D. RECOMMENDATION A P P R 0V E D Sixth Rccomendaticn: Periodic inspection fron a health standpoint of offices and plants by a doctor or a representative of the nodical department. /s/ J. F. Holt, H. D. /s/ H. S. Thonson, U.D. /s/ T. J. Kelly, li.D. /s/ E. K e m Linder, li.D. RECOMMENDATION APPROVED API 06899 f I I 1 ^ppjjDlX G (Cont *d) -3- Additional P.cccnmcndations: 1. That a annual be published outlining special diagnostic procedures for the hazardous substances used in the industry, as being outlined by the- subcommittee on Permissible Concentrations, and the treatment for each could well be added. /s/ J. P. Holt, II.D. /s/ H. S. Thonsen, ii.D. /s/ T. J. Kelly, U. D. /s/ E. Korn Linder, Ii.D. RECOMKSNDATION APPROVED 2. That a study of the reasons for rejection of accepted applicants be compiled and published for a uniform policy of rejections. /s/ J. P. Holt, M.D. (Undecided) /s/ H. S. Thomson, II.D. (Undecided) /s/ T. J. Kelly, U.D. /s/ E. Kern Linder, U.D. * * RECOUHEMDATION APPROVED Please add any farther recommendations you may have on any subjects you wish presented. Respectfully submitted. #* * ** On March 28, 1947# I addressed the following letter to committee '.cabers. I received but one reply, from Y7. A. Kerrison, H.D. Therefore, these suggestions arc presented to you for whatever action you may desire to take: "Since ny letter March 19, 1947 with recommendations on which I requested your approval, I have received from a member of the ccnrdttec a list of subjects for consideration by our committee, and I am passing them along to you for your comments and approval if they arc to bo presented to the next meeting of the General Committee: 1 . Methods of talcing blood serology in the sales department areas; aro these done privately or by state laboratories? 2. Arc chc3t X-rays done routinely and, if so, how arc they handled in the field? 3. Are electrocardiograms done routinely, particularly on executives and service personnel over fifty (50) years of age? 4* What efforts arc being made in the industry for thorough vision testing of chauffeurs, particularly in rcfcronco to night vision, field of vision and depth perception?" API 06900 *"DIX G (C:ntd) -4- ? Since this letter, the following questions hove been presented for 1. Is it advisable to use local practicing doctors for re-examinations, or to send a full-tine company doctor to the scenes of employment to make these examinations? 2. Is it advisable to keep morbidity statistical data on the incidence of disease? If so, can reliable information be obtained vjhcn the cnployccs arc scattered? 3. Hot; many treatments, if any, should be allowed to cnployccs suffering from sickness or non-occupational injury located where dispensary, plant, and office service is available, without a direct cost to the employee? On February 7, 1947, I addressed a letter to ry subcammittec, in which I made the suggestion that we meet in Buffalo on the day previous to the General Committee meeting, on Sunday, April 27, in order to get something outlined. Of the replies I received, only two made reference to ny request - one member expressing agreement that the meeting should be held,.and offering to attend - :the other stating that willingness to attempt it it would be difficult for him to be present, but expressing if all the ether members were to attend. Respectfully submittcd: R. A. Jewett, II.D., Chairman Subcomittcc cn Policies and Practices. API 06901 For Inf:ration Only - Not for Publicle n APPENDIX H THE AMERICAN FOUIDATI Ol FOR TROPICAL MEDICINE Incorpore,ted 270 indison Avenue New York 16, N. Y. April 1, 1947 jlr. '.7. R. Boyd, President tnerican Petroleum Institute 50 West 50th Street jjew York 20, N Y. pear Mr. Boyds The purpose of this letter is to call to your attention the activities 0f the Anorican Foundation for Tropical Medicine, Inc., and to express the hope th:vt the American Petroleum Institute m y directly or-indirectly assist us in obtaining the desired support iron the oil industry in this country. The Foundation is a non-profit tax exempt organization incorporated under the membership Corporation Lavra of the State of New York. It was establish ed in 1939 by the American Society of Tropical Medicine and the American Academy of Tropical Medicine to organize and support teaching and research in tropical medicine in the United States. In 1946 Mr. Harvey Firestone, Jr. ix.de a large gift to the Foundation for the establishment of a research institute in Liberia. The Liberian Government in turn has granted to the Foundation the necessary lands adjacent to Roberts Field, the Army Air Base during the war and now a regular station on the Pan American Airways route to Leopoldville in the Belgian Congo. Construction of the first units of Liberian Institute will be started Ihis spring. The Institute is to be developed and equipped for fundamental research into the three major problems cf the tropics, disease of man, disease of domestic animals and the production of staple food crops. Direction of the scientific activities is verted in a Scientific Advisory Committee consisting of one member each from the scientific faculties of fifteen American Universities. Fiscal control is verted in the Beard of Directors elected by members of the Corporation ?iho arc designated for membership by contributors tc the Foundation. The Liberian Institute will be operated as an international center for research. Its facilities are to be offered to the World Health Organization. Reciprocal agreements arc being negotiated with research centers and schools of tropical medicine in Latin American, Europe, africa and the East. These agreements will rake the facilities of the Liberian Institute available to foreign scientists sponsored by the affiliating institutions, without financial subsidy however. In return these agreements trill provide for similar courtesies and facilities to scientific workers sponsored by the American Foundation for Tropical Medicine. The Foundation and the Institute have tv:o fundamental objectives both of vhiCh arc in the national interest. First, research into the fundamental Problems of disease in the tropics and second, by the application of effective API 06902 prSllX H (Cont'd) - 2- xu0(iS of disease control, to improve local health and local economics. The higi -icidcnCC C^ SCCSC z n z consequent economic inpoverishnent result front three ^jor factors -- communicable diseases of nan, diseases of domestic animals which linit food supplies for r.an, and inadequate agriculture vdth insufficient 5rcduct ion cf staple food crops. Improvement of these conditions will yield benefits to American Business through reduced production costs and developing packets. Second, the la cl; of a fully developed Graduate School of Tropical Medicine in the Yicstem Hemisphere constituted a serious handicap to the United gtetos in the Second World War, The Foundation therefore is working toward the ultimate development of such an institution in the United States which will provide competent training of American and foreign doctors and research workers ip preparation for work in tropical areas. The Foundation and the Institute can provide certain services to the companies supporting its activities. These include advice and assistance in obtaining competent consultants to advise on particular problems of special tropical areas; the organization of research into particular problems; field testing of new preparations for the treatment and control of human disease and disease cf domestic animals; field testing cf insecticides and fungicides of potential medical, agricultural, or comcrcial importance; and guidance in the training for work in the tropics of physicians and technical laboratory workers. TTM - nw Very sincerely yours, /s/ Thomas T. Uackic ' Thomas T. Uackic, President The American Foundation for Tropical Ucdicinc, Inc. Boatman Gray School of lledicinc l/inston-Salcn, North Carolina API 06903 -7- IX AlP POLLUTION CONFERENCE OF MANUFACTURING CHEMISTS' ASSOCIATION, APRIL 19-20, 19^9 By unanimous vote the Committee requested Chairman Hoag to attend the MCA Conference as the designated representative of the Medical Advisory Committee. X TENTH MEETING . It vas the consensus of those present that the Committee Bhould hold its tenth meeting in Chicago on Friday, November 11, 19^9, with subcommittee meetings to be held on Thursday, November 10, with a schedule such that Thursday afternoon will be devoted solely to a meeting of the Subcommittee on Carcinogenicity. XI . ADJOURNMENT There being no further business to be considered, the meeting was adjourned. Approved: A. E. Hoag, M.D. Chairman D. V. Stroop Acting for J. P. Holt, M.D. Secretary h-21-1+9 API 06995 For Information Only - Not For Publication APPENDIX A To Minutes of 9th Meeting of Medical Advisory Committee REPORT TC THE API MEDICAL ADVISORY COMMITTEE BY TEE SUBCOMMITTEE ON CARCINOGENICITY Dr. Mclver Woody - Chairman April 2, 1949 On Behalf of the Subcommittee on Carcinogenicity, I wish to present to the Medical Advisory Committee for transmittal to the Safety Committee of the Board of D irecto rs, the following report: Dr. Kehoe assures us that laboratory facilities for a colony of 10,000 mice (enough to test at least 200 samples in the course of a year) will he available at the University of Cincinnati not later than June 30th. This was made possible by the American Petroleum Institute grant of $40,000 for capital expenditures, of which $30,478 has been put into the new building and $8,264 has been put into new equipment, leaving $1,258 to provide additional apparatus as needed. These new facilities are earmarked for the petroleum industry. The American Petroleum Institute has first call on them. After its needs have been met, work can be undertaken for individual oil companies up to the capacity that has been provided by the capital grant. , From the grant of $25,000 for current expenses, with due regard for economy, $2,482 was used during 1948, and expenditures for the first 6 months of 1949 are estimated at $14,660. This will leave a balance of $7,858 on hand July 1, 1949. Dr. Kehoe estimates that a full utilization of these facilities by the petroleum industry will entail operating expenses of $122,000 for the year ending June 30, 1950. He also estimates that from $22,000 to $32,000 of this cost will be met by grants from individual oil companies for special work to be done on their accounts. The balance of $90,000 to $100,000 would be charge able to the American Petroleum Institute. In appointing Dr. A. Wesley Horton as Assistant Professor of Industrial Hygiene, the University of Cincinnati has selected an organic chemist with practical experience in polycyclic hydrocarbons, a knowledge of physical chemistry and an understending of our technical processes. He will devote his entire attention to the chemical aspects of the investigation and, having academic status, he can collect confidential data from competing companies without revealing the source from which it came. During the past 3 months he has called on many members of this committee, and conferred with many of their technical experts. He is now on the Pacific Coast and upon his return he will visit Oklahoma and Texas. On the basis of first-hand information thus obtained, he will prepare a list of samples to be tested at Cincinnati between now and July 1950. This list will be reviewed by the subcommittee and submitted to Dr. Kehoe for final approval. In appointing Dr. J. J. Phair Professor of Preventive Medicine, the University of Cincinnati secures an epidemiologist with practical experience in public health and hospital administration. He is still API 06996 A (Cent'd) -2- r0jsal88ioner of Health of Louisville, hut after July 1st he will he able to vote half hie time to American Petroleum Institute problems. He had. already nferred with the medical directors of several oil companies to see what laical records are available and to determine what epidemiological techniques can t>e use<^ advantage. The long incubation period of cancer is one of the factors peculiar to the problem. A cancer registry for the petroleum industry one of Dr. Phair's objectives, but he has his doubts concerning the success ful enforcement of laws that require the reporting of occupational cancer as advocated by some authorities. The National Cancer Conference which was held in Memphis, February 25-27 inclusive, under the sponsorship of the American Cancer Society and the National Cancer Institute of the U.S. Public Health Service was attended by over 350 investigators from all parts of the country, of whom 2k were assigned to the panel on occupational cancer. It was quite evident that the problem of carcinogenic agents in the petroleum Industry is an open booh and that control measures, both medical and technical, must be adopted, jt was also agreed that the petroleum industry is to be congratulated on having undertaken a comprehensive study of the pressing problems. A similar situation has developed recently in England, where the Medical Research Council has appointed a committee on occupational cancer of eight members, including Colonel S. J. M. Auld representing the Institute of Petroleum. He informs us that certain lubricating oils, notably those used in the textile industry, are being looked upon with suspicion and that some companies have undertaken the manufacture of white oils as substitutes, although there is no demand for them as yet. The valuable research done at Birmingham is now going forward with government support, and in view of the similarity of the problem in both countries, hr. Auld advocated a free exchange of information between the American Petroleum Institute and the Institute of Petroleum. It is recommended that: 1. The American Petroleum Institute exchange information on cancer with the Institute of Petroleum. 2. The allocation of funds to continue cancer research at the University of Cincinnati for the 12 months ending June 30, 1950 be increased from $50,000 to $100,000. API 06997 For Information Only - Net For Publication APPENDS B To Minutes of 9th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON FLUORIDES Dr. Eieffer Davis - Chairman April 2, I9U9 On March 30, 19^9, a meeting was held in Dr. Robert A. Kehoe's office at Kettering Laboratory, Cincinnati, Ohio, to discuss the research work on fluorides now under way at that institution. Representatives from all companies participating in this program were present - Pennsylvania Salt, Reynolds Metal, The Aluminum Company of America, du Pont, Universal Oil Products, and Medical Advisory Committee of the API. Doctors Hoag and Davis were present in behalf of the Subcommittee on Fluorides. The annual report on the progress of experimental investigation of the storage of absorbed fluorides by man and animals was discussed and accepted by the group. At this time the group considered that sufficient animal experimentation had been completed on this matter and future work would be limited to human subjects (adults). The following experiments are anticipated for this year: 1. Continuation of subject E.B. at the present level of ingestion, 12 mg. daily of fluoride as NaF, for several months. 2. Subject K.W. should begin a period of ingestion of fluorides, as NaF, at the rate 3 mg. daily, and continue that one or two years. r 3. Observations on subject E.L. are discontinued but should be resumed when metabolic balance has again been reached. k. Resume the collection of data on losses of fluorides through the skin when additional equipment has been Installed. A fifth experiment was proposed - to expose a subject over a consider able period of time to HF vapor, 1 part per million, and determine as in the ingestion procedures the amount of fluoride absorbed and stored. Because, how ever, of the great cost entailed in setting up the necessary chamber, other equipment and employing a subject, this procedure was deferred for the present time. When it becomes possible to undertake them,the following investiga tions, under the direction of Dr. Kehoe, should be carried out: 1. Extend research on analytical methods to improve the determination of fluorides in blood, in particular, and in other biological samples as well. API 06998 PPSIXIX 3 (Cont'd) -2- 2. The administration of fluorides in solution parenterally to study the relation of a maintained blood fluoride level to the rate of urinary excretion of fluorides. 3. Obtain data from workmen who have had several years of exposure to fluorides in industry, studying the loss of fluorides from the body and the reversibility of the total changes, chemical and pathologic, observed under conditions of exposure. Subjects might be available among employees of the industry. During the meeting it was brought out that a number of other companies interested in this problem should be given the opportunity to Join our group at Kettering Laboratory. By admitting others to this research problem not only would the information resulting from this procedure be further disseminated now to responsible companies, but, also, sufficient additional funds might be acquired to permit investigation of this problem beyond the work which was initially set forth. Dr. Frary was selected to correspond with peoples of these companies. Abstracts of a considerable number of articles covering work completed on fluorides experimentation by others have been compiled and will soon be in mimeographed form for distribution to the companies sponsoring this work. Sufficient copies have been requested to allow each member and associate of the Medical Advisory Committee to receive one. Dr. Kehoe was approached concerning the possibility of using Boron Trifluoride as a test agent in some one of these experiments. It was his opinion that a complete procedure should be worked out using the fluorides that were started with before testing other specific ones. Because of the recognized increasing importance of this problem, the Subcommittee on Fluorides suggests that the Medical Advisory Committee consider this a long-range program (two or more years) and that the American Petroleum Institute continue to support Dr. Kehoe and his group at Kettering Laboratory in this research work. -- This progress report is hereby submitted for your approval. API 06999 For Information Only - Not For Publication APPENDIX C To Minutes cf 9th Meeting of Medical Advisory Committee PROGRESS REPORT TC THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON PERMISSIBLE CONCENTRATIONS Dr. V. C. Baird - Chairman March 18, 191*9 PROGRESS REPORT American Petroleum Institute Project at Harvard School of Public Health Toxicological Reviews During the past five months, tentative drafts of toxicological reviews on arsine and amyl acetate have "been submitted to the Medical Advisory Committee for comments. Tentative drafts on acetic acid, betanaphthol, butyl acetate, cyclohexane, methylcyclohexane, mesitylene, amyl acetate, and hydroquinone have been revised in accordance with suggestions submitted by members of the Medical Advisory Committee and their associates. Treatment of B u m s I! A great deal of time has been devoted to the preparation of a report summarizing current concepts on the treatment of burns. The report gives particular emphasis to information available concerning the pathological physiology of the seriously burned patient. Measures designed to correct the systemic disturbances are stressed in the discussion of therapy. We are anxious to receive suggestions from the Medical Advisory Committee that will help us improve this report so that it vill prove to be of practical value to the physician who may not have the opportunity to review the vast and controversial literature on the subject. Silica Catalyst Problem A. Survey of Neighborhood Exposure to Catalyst Dust API 07000 We have requested information from members of the Medical Advisory Concittee on the silica-alumina dust distribution in the neighborhood of their refineries. Two companies have submitted quite detailed information on the matter and other companies have told us that they were planning to carry out such studies. The following data gives an indication of the magnitude of neighborhood catalyst distribution on the basis of surveys by two refineries: