Document d3LmkZwLqOoErM4RV5bLOLeR

May 2, 1967 A lb er t Ft. Ko lar , M.D. Falk ir k H ospital Falk irk Place Cen t r al V alle y , N. Y. ' Dear Doctor Kolar: I am ask in g our a n a ly t ic a l lab o r at o r y t o send two se t s of con t ain er s, togeth er with th e n ecessary in st r u ct io n s fo r th e c o lle c t io n o f sam ples of u r in e and blood from your two p at ie n t s. Without e xp r e ssin g any sp e c ia l sk e p t icism on my p ar t a s t o you r d ia gn o st ic pr oced u r e, l e t me merely p o in t out t h a t lead p oison in g in house p a in t e r s i s a r ar e occu r r en ce, la r ge ly becau se t h e se men ar e n ot en gaged r e gu la r ly or even fr e q u e n t ly in work t h a t giv e s r i s e t o sig n ific a n t exposu re t o le ad . A Job t h at r e q u ir e s prolon ged "burn in g o ff" o r m ech an ical removal o f old p ain t in such a manner a s t o c r e a t e fin e ly d ivid ed p a r t i c l e s in t h e atm osph ere i s c e r t a in ly not common, so t h at th e r e a l exposure of th e p ain t e r t o sig n ific a n t Q u an tities o f lead is h igh ly in t er m it ten t. Un less he is g r o ssly c a r e le ss and sw allow s a co n sid e r ab le q u an t it y o f p ain t w ith food , tobacco or from ot h er t h in gs t h at ar e put in t o th e mouth, th e exposu re i s m odest. For t h i s r eason , I would p r e fe r t o give no ad vice a s t o th er apy u n t il th e r e su l t s o f th e a n a ly sis o f u r in e and blood ar e a v a ila b le . I t would a l so be advan tageou s from th e a sp e c t of th e urgen cy of any kin d o f th er apy, t o lear n th e c l i n i c a l p at t e r n s of t h ese two c a se s, sin ce th e exposure t o lead of t h e se men, i f si g n i fi c a n t , may have exten ded over th e p er iod o f 15 y e ar s.. I t I s more l i k e l y , I sh ould say , t h at th ey su st ain e d some un usual d egr ee of exposure r e ce n t ly a s th e p r e c ip it a t in g fa c t o r In t h e ir in t o x ic a t io n , and i f t h i s i s th e case th e in t o x ic a t io n , o f i t s e l f , may be con sid er ed with l e ss appreh en sion fo r th e fu t u r e . - Sin cerely you rs, RAK:wp D-etated but not read Robert A. Kehoe, M D. P rofessor Emeritus of O ccupation al Medicine 0081 7 N22306