Document dQY6ZyQK11k015Gdx5eg0KmrQ
August 2, 1948
D r . J . M . McDonald , State Board of Health,
1217 Pearl Street, Jacksonville, Florida.
Dear Doctor McDonald :
I have just had word that there is to be a meeting of the Florida
Industr^^Accident Commission in connection vith the cause of death
of an employee of Tank Cleaners, Incorporated, in
Jecksonvljl^^^?lorida, on August lo, 1948. It has occurred to me
that the evidence on which the death of this man might legally be
established may seem scanty, and therefore I write to give you my
opinion and to cite, very briefly, some of the evidence on which it
is based. Because of certain pecularities in the case I had some
initial skepticism^ as to the cause of death, but as^lhe facts
developed there is now no occasion for any doubt.
died
unqueslionably as the result, primarily, of a massive x-espiratory
exposure to the vapors of tetraethyl lead. Ve have undertaken to
establish just which one of the tanks which were entered for cleaning
was responsible for the deadly conditions of lead exposure. This
has not been done as yet to our complete satisfaction, but the evi
dence of the presence of tetraethyl lead in the sludge of several of
the tanks is unquestionable.
Our diagnosis is based on the history of exposure, the evidence of
tetraethyl lead in the sludge, the clinical course of disease, the
non-fatal episode of intoxication in an associate, and the evidence of
high concentrations of lead in the urine of the three men who suffered
exposure. The lead concentration in the urine
tiie
order of magnitude which we have found in associatlre^vith fatal cases
cf lead.intoxication. (For your information I should point out that
the lead concentration in the blood, following serious exposure to
tetraethyl lead is usually quite low. Something in the metabolism of
tetraethyl lead results in the failure of the absorption of the lead
compound into the red blood corpuscles, and therefore the lead
concentration in the blood is only slightly elevated, and in cases
of short duration it may not be elevated at all. In the instance of
the lead concentration found in the blood post-mortem was
T w t ] The urinary lead concentration in the case of
was u .56
mg. per liter. (The lead concentration in the urine of his associates
in this work, who were much less seriously exposed, were respectively
1.8 mg. per liter at the outset, and 0 .0 6 5 mg* per liter six days
later; 0.46 initially.) The foregoing facts establish exposure without
any question.
We have obtained the tissues of flfl^^for analysis, and in due course we shall have the analytical resuK^v Unfortunately,we have been swamped with analytical work at this, our vacation period, and therefore the results are not available at this writing. There is no question
*
Dr. J. M. McDonald - (2j - August 2, 1948
In our mind that the diagnosis of fatal occupational lead exposure
is -justified in the case o f ^ M B f c By the same token the episode of
illness of
can be accepted as having been a characteristic
case of tetrSCTnyj^eaE^Lntoxication. Fortunately, this man's exposure,
while serious, was brief, and therefore, with adequate treatment, he
survived.
I trust that this information will be satisfactory for your purposes. It can be substantiated by documentary evidence if need be, and it will be supported by further proof when our work on the case has been completed. If we can be of any service to you in this connection, please do not hesitate to call upon u s .
Cordially yours,
Robert A . Kehoe, M . D .
FAK ef
P.S. The results are coming through on the tissues of'
I have
two only, which,because of their size and composition, cam^through
first. The lead concentration in the muscle (ordinary striate muscle)
was 0 0 4 mg. per loo grams, which is remarkably high for this tissue.
The concentration in the bile was 2 mg. per 100 gleams. From this
one may assume that the lead concentration in the liver will be very
high indeed. "We believe,from the rapid course of this illness, that
this was one of the more severe cases of exposure.
R. A . K.
0006708