Document aJg8w2Nxpz6aZ8paM98dJ6wYM

THE AMERICAN PUBLIC HEALTH ASSOCIATION, me. LESTER BRESLOW, M.D. Presiden t MYRON E. W ECMAN, M.D. Ch air m an o f Exacut iva Board MARION L. HENRY Troaiuror BERWYN F. MATTISON, M.D. Executive Director OFFI CE OF SECTI ON SECRETARY PLEASE REPLY TO FRANCI S X. WORDEN, M.S. Western Electric 2 2 2 Broadw ay New York, N .Y . 10038 . ROBERT A. KEHOE, M .D ., P r o f e s s o r B n e r itu s K etterin g Laboratory C ollege o f M edicine C in c in n a ti, Ohio 45219 August 19, 1969 , Dear Dr. Kehoe: I re c e iv e d th e a tta c h e d l e t t e r today from Dr. John P . C urran and I know t h a t you a r e , i n my o p in io n , th e b e s t q u a l i f i e d p h y s ic ia n in the U nited S ta te s to answer th e l e t t e r . In essen ce, Dr. Curran q u estio n s th e upper lim it o f normal fo r le a d i n b lo o d 0.06 m illig r a m s p e r 100 gram s w hole b lo o d . He w ould l i k e to know th e b a s is f o r t h i s le v e l ( e . g . , p o p u la tio n , a g e, s o c io economic s ta t u s and environm ental c irc u m sta n c e s). . z' Dr. Curran su g g ests th a t th e upper normal lim it be reduced to 0 .04 m illig ra m s o f le a d p e r 100 m i l l i l i t e r s b lo o d . What do you th in k o f th is suggestion? / P le a se communicate w ith Dr. C urran. I would a p p re c ia te a copy o f your r e p ly . Many th a n k s f o r your c o o p e ra tio n . S incerely, ( F . X. WORDEN, S e c r e t a r y O ccupational H ealth Section A tt. Copy to : H erb ert E. S to k in g e r, Ph.D. U nited S ta te s P ublic H ealth Service 1014 Broadway C in c in n ati., Ohio 45202 John P . C urran, M .D., F.A .A .P D ire c to r, Dept, of P e d ia tric s M edical C enter J e r s e y C i t y , New J e r s e y 07304 E. Lynn S ch all New J e r s e y S t a t e D ep artm en t o f H e a lth John F itc h P laza T re n to n , New J e r s e y 9 7 t h Annua! M eet ing of the Am erican Public Healt h Association and meetings of Related Organizat ions, Philadelphia, Pa., N ovem ber 1 0 - 1 4 , 1 9 6 9 N21228 ?1 * ' ' -tv * f v J o h n P. C u r r a n , M.D., FA.-A.F. D IRECTO R DEPARTMENT O F P EDIATRICS Me d i c a i , Ce n t e r JERSEY CITY, N . J. 07304 A r e a Co d e 201 433-7000 August 15j 19^9 1 Mr. F ra n c is X. Worden ' . Secretary ' I n d u s tr ia l Hygiene S ectio n , American P u b lic H ealth A sso ciatio n W estern E le c tric C orporation 222 Broadway Hew Y ork, Hew Y ork D ear Mr. Worden: For se v e ra l y ears I have been tro u b led by th e standards fo r normal blood le v e ls as p u b lish e d by th e Committee on Lead P oisoning and accep ted by th e Poison C o n tro l Program o f th e Hew J e r s e y S t a t e D epartm ent o f H e a lth . I am p a r t i c u l a r l y co n cern ed w ith 0.06 m illig ra m s p e r 100 grams whole b lo o d as th e upper li m it o f norm al. - . I have been u n a b ld ^ to d e te rm in e lArat any d e s c r ip tio n o f th e ag e, socioeconom ic s ta tu s and environm ental' circum stances o f th e p o p u latio n from which th e se values were d eriv ed . _< S p e c if ic a lly , I th in k th a t th e v a lu e o f 0 .0 6 m illig ra m s may be to o h ig h a s th e upper lim it, sin ce i t is q u ite lik e ly th a t th is fig u re i s based on d eterm in atio n s from samples which in clu d e la rg e numbers o f c h ild re n from o ld urban housing a r e a s who h av e e x p e rie n c e d in c r e a s e d ex p o su re t o le a d . The u p p e r - l i m i t o f normal can only be e sta b lish e d by determ ining th e range o f values in ch ild ren who do n o t e x p e rie n c e such e x p o s u re . The sam p lin g sh o u ld in c lu d e c h i l d r e n from new urban o r suburban h o u sin g t h a t i s known to be f r e e o f le a d c o n ta in in g p a in t and p la s te r. I doubt th a t such a population has been u tiliz e d to o b tain th e v a lu e s now ,in c u rre n t u se . A more re c e n t study su g g ests a range o f 0.015 to 0 .0 ^0 m illig ra m s p e r 100 m i l l i l i t e r s o f b lo o d , w ith a mean v a lu e o f 0 .0 1 7 m illig ra m s. I know n o th in g about th e p a tie n t p o p u la tio n surveyed. I s u g g e s t t h a t we hav e s i g n i f i c a n t l y d iv e rg e n t v a lu e s from two d i f f e r e n t s o u r c e s , and th a t th e upper lim it o f normal fo r blood le ad in ch ild ren cannot be e s ta b lis h ed u n le s s th e sam p les a r e o b ta in e d from c h i ld r e n who have n o t e x p e r ie n c e d an increased exposure to th is m etal. . ( Mi'. F r a n c is X. Worden. 2- Our l a s t 100 d e te rm in a tio n s from c h ild re n aged one to fo u r, from o ld su b stan d ard u rb a n h o u s in g , showed a mean o f 0 .0 19 m illig ra m s p e r 100 m i l l i l i t e r s o f b lo o d . I am l e d to b e l ie v e t h a t th e v a lu e o f 0.06 m illig ra m s i s to o h ig h , and t h a t many c h i ld r e n w ith 0 .0 ^ and 0 .0 5 m illig ra m s p e r 100 m i l l i l i t e r s ' a re in f a c t e x p e rie n c -- in g u n u su ally h ig h and p o te n tia lly damaging exposure to le a d , b u t are excluded xrom ary program o f p re v e n t io n and tre a tm e n t. I su g g est a more r e a l i s t i c upper l i m i t Would be 0 .0 ^ m illig ra m s p e r 100 m i l l i l i t e r s . ^ John P.: C urran, M .D., F.A .A .P. JPC : sm cc: H e rb e rt S to k in g e r, Ph.D M r . E . Lynn S c h a ll 1 04325