Document ZJZX1OvdmVyj7Z9ydVLozK4NJ

INTEROFFICE MEMORANDUM Date 3 APRIL 1975 Subject--------------------------------------------- ------- To _ From G. J. MANTELL HOWARD L. WATSON TREXLERTOWN___________________ (Location, organization, or oeoartment) VALLEY FORGE (Location, Organization, or Department) cc: W. L. Ball Barr C. E. Blades R. C. Bruno/J. C. Schulter T. L. Carey R. Fleming J. Maerker W. M. Smith E. M. Spurlock A. R. Adams I received your memo of 24 March wherein you stated; 1. ) That the Trexlertown and Piscataway laboratories are not Tegulated areas. At the time of this writing, it is my understanding that the Pis cataway laboratories have nqt been found to be above the action level of VCM (.5 ppm). However, from the communication of J. T. Sebastianelli to C. H. Woman, dated 21 March, there is a question as to whether the Trexlertown laboratories are above tKe action level; or more possibly, a regulated area exists within the labora tory. Until a change in operating procedures has been developed to reduce employee exposure and new monitoring data taken, in accordance with Joe's letter, then the results that Woman took where he obtained a 1.12 ppm reading on Steve Stocker is very damaging. I therefore cannot answer your questions or comments which you stated relative to Trexlertown laboratories until this is cleared up. 2. ) It is your understanding at the. time of this writing that the Linwood laboratory personnel monitoring has placed them below the action level. 3. ) With regard to your policy an medical examinations for; a) New workers b) Present employees, at these locations. I can merely state that at the time of this writing, our Chemicals Group policy is that we will maintain the original VCM examination on a permanent record and they will be coded as "not now employed in an area above the action level". ' (320) AP00002569 6. J. Mantell 3 April 1975 Page 2 ) . For new workers going into these areas, we anticipate no examinations being required, unless the individual being hired has a long history of working with PVC/VCM at his previous employer. In this case, we definitely think the employee should be given the VO! med ical examination prior to hire, and the results of this examination wopld bear a great deal on whether or not the man is hired. In discussing the above policy with Len Ball, I wish to advise that he has taken issue with it and wrote me a letter concerning it, wherein he recommends that we utilize this examination for persons hired into these laboratories who may be associated with PVC/VOl. Copies of this letter were sent to group management. When I last checked with John Barr and Joe Sebastianelli, I was advised that the policy remains the same as I have stated at this time. HLWiheg . WaTsqn AP00002570 3S?V VT <~fe~ ^ memo from:' WAYNE G. CUSTEAD March 19, 1975 John Barr Manufacturlng Valley Forge KZClw ZD MAR 211975 J. ,T. BARR John: While this makes particular reference to treatment, it does support the contention that breathing dry air may not be all that detrimental. Ik) WC:vhm Attach. Wayne A crji* ftm&ift mm/ MMleri Product, Dfcriuor HOSPITAL EQUIPMENT AP00002571 ----- hr,'W u t i) MiMir.ti i \> pillicnis iigcdTwn weeks tu llirec year* aiimi'icd io iiti.;pital will* bwwr respiratory tract ink lions. 'Jihe diWrcn uvieV_ mprtt according to the c or absence of pneumonia mul/ur lower airway oli-.liuetion. The only difference in therapeutic regimen between t!ie control and experimental groups, was the use of a jet type nebulizer in the latter (air- shields croupcltc). No significant differences were found in the duration of physical signs or hospital course. Conclusions and recommendations In general it appears that most people believe that the breathing of dry air may be injurious to the respira tory tract. However, in recent times patients with chronic respiratory disease were often sent to dry de sert resorts for therapy. Perversely, we still persist in utilizing humidifiers when the air is cold and dry--this in spite of other data that shows respiratory infections to be uncommon in those people that live in the arctic or antarctic regions where the air by definition is dry. It is obviously correct to moisten the mucus membranccs of the respiratory tract when for one rea son or another they are dry. For upper airway disease, where lire natural humidification process may be ab normal or by-passed, this may be achieved by cold -humidifiers or steam, both do seem to play an impor tant role in therapy. Lower aim-ay disease may im prove With humidification due to the decrease ut fluid loss from die lungs with subsequent decrease in viscosi ty of secretions. This effect however may possibly be achieved by adequately hydrating the patient orally or parenterally (22). Parenchymal lung disease is probably unaffected by humidification of inspired air or mist therapy. At the moment cold humidification can probably best be achieved by means of mist nebulizers in tents or rooms, the ultrasonic nebulizer giving rise to a greater relative humidity than the jet type. Jet and ultrasonic water particle deposition in the upper and lower respiratory tract is generally poor with nose or mouth breathing, but is enhanced if breathing occurs through a wide oral tube or tracheostomy. Ul trasonic ncbulizatinn would have its prime indication under these conditions., With prolonged IcV^uumiJifioution or ntbulj/niion, a favourable environment is created for the growth of bacteria, particularly gram negative organisms (2.1). Hnbics in steam tents may have difficulties with temper ature regulation and children left naked in eolJ mist tents may have to utilize extra energy in order to main tain a normal body temperature, aggravating underly ing pulmonary or cardiac disease. Moreover, infants re ceiving volume controlled artificial ventilation, with an ultrasonic nebulizer as the inspired air humidifier, may develop water intoxication (24). Though neither a decrease in the pulmonary surfac tant, nor changes in lung mechanics have been shown to occur with chronic exposure to mist therapy (25, 26), humidification and mist therapy arc not without their dangers. References 1. Green ILL, Lane tV.Rj Particle clouds: dusts, smokes and mists, p.40. 2nd cd_ E. and F.N.Spon Lid- London 1944. 2. Niklyanta S., Tanasawa >'_ Trans. Soc. Mcch. Engr. Japan 62, 08, 1939. 3. Hrubeekr H.F.:3. Appl. Phvsics 29. 572, 1938. 4. Mercer T.T.. Goddard R.F., Flores R.Lj Aim. Allergy 23, 314. 1963. 5. Mercer T.T., Tillery M.I., Chow H. I-.: Amcr. hid. Hyp. Assoc. J. 29. 66, 1968. 0. Goddard R.F, Mercer J.J., O'Neill P.X.; 3. Asth ma Research 3. 353. 1968. 7. Wolfsdorf J, Swift D.L., A very M.E- Pediatrics -13, 799. 1969. 8. Mitchell A'./.: Amcr. Rev. Resp. Dis. SI, 627, 1960. 9. Dauirebande L., Bcchnan 11, Walkmhorsr II'-' Arch. Indust. II. 19, 3S3, 1959. 10. Task Group on lung dy namics th-posiiion and retention models. Health Phvsics 12, 173, 1966. II. Ban S. /A, Aspin At- U'ood D.E., Levison // Submitted to Pediatries, 1971. 12. Thomson M.I.- Short M.D.: 1. App!. Phy siol. 26. 535, 1969. 13. Walker J.E.C.. Welts P.E.. Merrill E. IK; Amcr. J. Med. 30. 259. 1961. 14. Bang B. G.. Bang F.B, Proc. Soc. Exp. Biol. Med. IQS, 516, 1961. 15. Blanshord G-- Arch. Middlesex Hosp. 3. 222. 1955. 16. Swift D.L., Wolfsdorf/_ Proc. 5lh Int. Cystic Fibrosis Conf- p. 135. Ed.: David Lawson. Published by Cystic Fibrosis Research Trust, 1969. 17. Milter W.F.: New Engl. J. Med. 231.3S9, 1954. IS. Mclltcws L. If- Doerslwk C.F.: Pedia tric* 39, 176, 1967. 19. Lifschitz M.I., Denning C.R.: Amcr. Rev. Resp. Dis. 102, 456, 1970. 20. Mathoes C. IK: Proc. 5th Int. Cys tic Fibrosis Conf- p. 156, 1969. 21. Kelscli R.C.. Barr A/- de Minli G.R.- Amcr. J. Dis. Child. 109. 495. 1965. 22. linker II.. Griffiths J.C.: Amcr. kcv. Resp. Dis. 97, 1136. 1968. 23. Reinar: J.A... Tierce A.K- Mays B.B., Sanford J.T.: 3. Clin. Invest. 44. 831. 1965. 24. Herzog T,, Norlunder O.P., Engstrom C.G.: Acta Anacsth. Scand. S. 79. 1964. 25. ModellJ.il., Ghnionna S.T, Alvarez L.AJ Dis. Chest. SO, 627. 1966. 2b. Mo.lell J.11., Giamonna S.TDuels J.IU Anaesthesiology 2S, 680, 1967. Prof. Dr.J. Wolfsdorf. Department ofPaediatrics, Transtuel Memorial Hospitalfor ChUdren.Joubcrt Street Extension, Johannesburg, SA 760 Uwrafwuliirht UmscHM/nwM ifitrtftMtiow. loud Jt. 1971. M*fi 11 AP00002572