Document e1Qm1QXjpmkM5neR4DE1LzMDe

" a ** LEAD INDUSTRIES ASSOCIATION, INC. *1 HADIION AVtNUS NCW VOMX IT.KT, february 27, 1962 LEAD gWOTI And SAnrrf'BULLErnf* joTlMT To Makers of tfcs load Industrie# Association, Zao.t CSmBOOD IKAP POTBOTOC Qbau mm4 I7 the lattice of lead-base paint fro* Interior surfaces by Mali children le still a grave prdblea sad gives rlM to a great tool of publicit/ In tte pnu. Xa order to bslp solve this serious prcblaa our office maintains a policy of cooperation with Sealth Departments, Poison Control Centers, Fsdlstrlo groups and others. Ve urge our neater*. If tbs 000*sion should arise, to offer shatevex support can he managed for local efforts st controlling the hassrd. for Instance, one scaber eonpsny gave financial support to a local health department, vhleh support enabled that department to facilitate greatly Its progress of blood analysis. for your Information ve are tending nth this bulletin s copy of as article ahlch outlines the experience of the City of fhlledelyhla. Rillsdelphle operates one of our better Sealth Departments sad Is thing a sincere logical effort at ccotrolling this problem. DQTiad Kao 1 So 611U Son 0. fovlar Director of Bealth tad Safety { k' l 4 '( a "I LEAD /ClSO'I NO IH miADEUHIA, 1955 - 1960 Reprinted froo th Archives of Envlrofntl Hlth, Koveeber, 1961, Vol. 3 (pp. 575-579). Copyright 1961 by the Aaerlcan Kedlcal Association published under the auspices of the Boerd of Trustee*. Distributed Bf LEAD 1KDC5TSIIS ASSOCIATION C. 292 fadleon Avenue / :-5 tiew Tork 17, X.T. ii WWHgepi-< " t'wn^gjKipBP pj^egeapippijii. N 378.01 ^f w^'> "if'liftI Tiwfril^f'-^-r <*lirfWT--Yitv- rrV*'-"- "- Hn -* - -- m Lead Poisoning in Philadelphia, 1955-1960 TVIKOll piaiUMft m 4 TIMNI, M/M 4X9 KltrM ItKlM, fM raAtii/iiu Lad pniaaning in children tu* long been rcengntm] to be a aerauu* clinical and public health problem, evjwiaJly m targe and old catie*.'4 In ITiiladefjbia ajprta*mutely JO am are reported yarfy. and Itm 10% to JKt of diagramed patient* have died n the lat } year* (Table I). Many of thoae who turvrve hare permanent damage to the central nervout tyvtrm and, all too fre quently, mental retard*!***. The chelating agenta have marked a tignifkam advance in therapy, and yet the community priddcm remain* much a* before. Control ha* not been accnmjbahcd. nor don M teem to reel iatuuiad for pdt ramn |at I. I*M. Avied %j a (font Iwu ah* W K KiA*| Tlw Henry I'Wye* huOtate and de IVyniumn 4 rJbbe lliahh aad IWam Mabruu. IWwrvey af hnwilnin, klnl *4 VvUw, a*4 Ike lklikl|lii Dipiunt af NM* llealih, Canwiwuiy lf**Mi linvat in rarljr diagnoaia and treatment, drtirabie a* iKnl may be (rum * thmpeutic point of view. A cunprehentive (ntfrim of preven tion undertaken at a community level give* mote i-tomiae of aucrrca provided that it i* acri*n|ianid by ejvdrm'ioltgTe mature* for evaluating arfrjrrijiut.merit. Cootrrf lie* not only in informed medical and pvblic heahh irofmami but with other profrxxiooal gruujia and official agenbet and in Informed and determined cttiaxn npport. Childhood lead poiaooing differ* from other typra of accidental pointing la children became both expoaore and intoxica tion arc chronic rather than acute and be came mrfhnda foe both treatment and centred differ. For three rtaaom. a aeparate program for the control of lead poiaoning ni ntiUiiW by the rhiladHphia Department of l*uUac Health in 1950. In determining the relent to which lead |iioninf exiata in (hi* city it an bit found nrmaaiy to make the omdilinu a reportable diaeaie. Moreover, intealive* nere needed in order to obtain anything like erxnprrhenaive reporting. There incentive* took (he form of aerticc* Inch the Department, kgrthcr with co operating private agenciev could provide to reporting hmpitah and pfcyatciam: the invntigaiaa of cae. die collection and analyata of htaaung, laboratory, and field data, and aavavtancr in the removal of offend- |w*ta To the** general end* and toward an ultimate objective of control the Henry Ihijpu Invtilute and the ITuladeipbia Department of Health have developed a joint (eigtam f ronmhaticei and march with tki* rr|v>rt marking the 6r*t formal analytical acruRafJivhmnu However, it it the aprtific purjene of thia paper to go beyond the MaliKxal analyvii of data gathered to dale in an atinnpt to begin to kxaliae tpeei&c ewviruimtntal hatard* Oting the etavaient tpkdemaAgic appeonrh of atudying the thatribumm of rate* by `Time, place, and Reauha An analyata of lead poiwating in ITuLadd|4na by month of occurrence of acute 1 `WiAiiiti ** iiffiiaft'addftafe' .fei m TARi 1 ~-L**i twmi+4 im /*jUtWW>Ui. * 0 /T;*0,W*r<< h e a l t h / Mrmtk */ Owf* rn I aa Wm4 **** I I a a "lli 04 l f Nt I I I 4 I 4 a a a a at a mioilnUiioni (Table 1) mttli what kii been ihcMD in other atin like the enetph* ilitidn of infectious origin, the ftoiU iQmm it a warm weather diKac and eren cwwy F* I--Fiw ymrsM koj wi* rM b*4 *d- MMf MMrta ky % vwfav. (to toll *4 +hdk vu iW m mm f tad mi*a X-or* d 4* W*< bant* than wetbLht odmi 4 k*4 ywi*wf d nrr * Arvivu, atotsae WmnUwi %*v tut dn|*rvi4 *! (to cbd vw 4**u pear* fj *v Ik Anf. IM bifectioa of the 5 year total* mail that most am became mailed and were diagnosed w the winner month*. Hone ter. this feature of lomorr prmksoe mo m to be more dosdjr related to the manifest** tson of symptoms that to the infests* of lead. No one bon prroeijr what seasonal (actors art at work to make lead euccpfcaBtis a disease of the month* of sunshine, but the dreutatk* of had ioni in Che Mood. Kh the ctmdatioa of calcium ions, has powerful metabolic determinants. Kaf*jf1 and Rdbia * hare advanced el* lerinenul evidence to indicate1 that actinic rays of the summer an increase the abaorp '^S tmn of lewd from the intestine, an interpreta tion consistent with the cfmjcal studies of Ouv4in and Harrison* This j* a reasonable mtrrpetOticn, for x-rays of the k*vg ban will often reveal that a hifh degree of absorption and deposition of lead (Fiff. 1) has been gtang on for many months without remfitUcd clmical manifestation*. Factor* retahftf to <kx4fe are surely involved but to an undetermined degree. Thus Dads* Km emphasised that outdoor paint becomes dry and powdery in the hot sun, and (Sat transfer of lead in smwlge* and in rain water is favored. On the other hand, the now classical outbreak of lead poisoning bt 1911 in fUliimore due to the huremf of old buttery utiftfi was not brought to light until August r mv. iW awp luJ t<nra * fact far itum amncJn pcrceiing and a ana <ate ikanog (he prcvwan nun.1 A >frt aip (Fig. 2) of am arranged bjr irwVwr of gwtinite ia lUulH^ut HCto< that the elaniciwig of mr am wf lhr Unu artangimcwl of other* Rtf pnnriitc a amaotf Mn of tunnh which ml! ( uvM grade to maeouheil effort! 01 nw*ri4 Thr Itaarar futnhitMH ohuntj OCT OMJUliUr orth (he futtihilMi of hr*iill Inrlrf prom m iff biatn, ca rlprtrrl arret* ml m ipak area*. Ouun- C ttlf hr a (one!art nf tenement huaf llionrt. thr mtt at) pattern n aoch at to rr lU^rani dm factor* ocher dtaa the of Inf ia nif puet mar hr mftrf M leterifd arena. |tilff Utt t*Kff Ihrrmgh ancient tmfu. w local- trad pfhartM il the tmiftwinJ The fact* warrant farther aaljai of there diafnho- lt la a<te. race, amt ethnic |tn|a, by cfrjfrtitt eaoVnee of joint drn( (an arimtow oBv crib*. or (nail (hr (rtwer of paint (aln). and by eminaameataf latlort mdi aa twqcct nduorica and highway*-- fan imhaatrial amt Monohlr eahaaato arc. aa ta pmoaert out etaeaaherr in thr* iaaaar of the Aartuvn. ether potential aoetree* for (hr camaaMR of lead into the nmnanol The intake of lead through the mpuatury tract a areB luauwa to be (he moat effective way fur the metal to rain quickly mo (he human Mpmun la all event* a campaign for eiaitmf might be (nKatralel at ackvtrd atreeti and ahatracta of the city, thereby armding fiarqatica of money, pefaermei. and effort Apart (man thr diatribaition of earn in tune and their Itcaka in apace the third rjadawfopc dienetiaicai to be routinely eaananed involve* the iftMikdita of raaea according to prrwai diatriUmona Age. tea. and race arc the inf parameter* uuwaDy examined, ahhough h i (Tat4 2) may be quickly diamnaed here, for while there ia a alight esc*** of rate* among male*, there l* no Unking tendency for lead |raHnbq to fan* e< * mm mm i I m AXCMfVrs Of kNVtROSHLSTAL HtALTH Tim Z~L>U M A, Jr# tKmaieiy hifh shire of (hedirrmr Assuredly thi* U basically because they comprise Tt U r dtspraportkxialcty hijh percentile of the mxSftsti ix) the ~hi{h nik" irtti However, m m (here is rciMQ also to H[t th* contnbu* 1 Ury mAo c y x * of t varvety of personal, *od economic factors whkh ere u tN M dsfHrtdl to define f}4rmxjlafkany ii is \mx Porno Kic*n form An intrrcfclmf Crimp to a( separately from Ox Other* ntdtf br^ r*ibcT (Kim pd. Jlimntf, (be t*udy trf fiKi br (e ml rare mif U marc rmrdiflj The ege distribution of esse* d) tint jrwp ricn with few exceptions from year aod a Klf to 2 yon oi afc, dte ifr of create* 3 4n m jnjbic form due ri*i of iod intoxication from aiodow-sfl j dmnUrxa ol \V7 ca*o m children under * Cffijifllr, if tberc is one Mirrr of ,1 .*5 4 year* of eg* Jurw*( tSr 3 year period trad poisoning tluA Wh there t* ttftil P>>3 1^60 arranged br ovwdb of iff Two, foun foe doubt it is heavily traded paint of 3, fnkt of Ac* ursuheinent ftwjr --die )firlopt (hr 2 year-aid*. And 3-year* til chtWinm. One it Mt tore iMhn them the Ijye y*ed 25-JO years or more tp. and rxjcnrt*rr in this city and in other old otic* J rrporN different (fwpi At n*V, 4>(Tmt avoioki, or different erupt, to to Afoafc. Tou 3 --JxW Pi Utmmt m /dt-iW. *7 Parr r sUir Ora/ a year Apart. They di^ftbutKOi tend to confirm thr wQntKa of Ovdin Aod Ta. w * rjt Tmd !(Arfia that if (hr ctwM m't wupniff me y m ia partxwUr mnorf hr im; me be nofinMf tmtd (hr fofknrwsf wgwnrf, $me A me . me 4> a m m Am Where eases are duOfataf according to me a Aa race or rthmc pwp of nek (atmiH rm M * j* A (TiUr 3), Nfjfftei nv>tr4%ae a dtsptnfa** or rv j . ,vw mi i':-v*:.;V: -^V*. .lV/i>"^-V-V ; ;. ; yr^vi j> ;'>f:i r ; ? t t ^ ><i,a. U .40 rO/SOSISC^H/LAOSLTHIA m : ? 'I ' .* 4 i 1 j * ^4* such ii IUhimoec, Hoston, and Chicago Sal rvUUtshrd the tursrd. In Ph'Udclj*lu a survey o( Waded paints tt 100 dwellings occupied by Puerto ftkani v ii conducted in I9S&- This tr>ry disdoard that fC*^ of the dwrttmg unit! occupied by this gn>jp contained a| least one room in wK*cS the Wad content of pointed surface* wn atx*r the permissible (1%) limit. Comment Modi of the kind of data reported here i% 0(4 nrw, such n tbe dcvripci** tpwSerm* fkicy of Wad poitoamf at & disease of toddling infants with a Sitory of pica, the manifestations of which are mo*t frequently discovered m the summer months. What it new. w hrfmt. b the attempt to undcntiod and to crortml Wad putcuaf in hubdripkia in the tame way that cpdone in frettons were ttwdwd and controlled m the (u4 through uturned cooperation and insestigation W Sth f*nate and oAriil pub!* health acenoct and bmputv Tubemdoaaa, for rumple. has been a focal point of cooper* afnc effort an the part of the tVUfdjfiil the tVpartmmt of Heahh, mad the llmry Pupp* huitatt foe 50 yean. To the rod of an improved control of (he community dt*me the integrated application ftf cbmnsl. laboratory, and qwkmwlne wrthdi it now brine aimed at Wad pottmtn( by a rrntralirrd rqvrtm( of otn, by spat* wufpfll and foratton of the rrgWmt and hum of prate*! nV, by identification of popoUtm* at greatest ride, and finally through a tents of quMolfic and chrmkal io4n bring undertaken to drternwx the cavuL p(r)[biol. ueto mnrrwf, and other (*rtnr at the Wfc of obwnrd dninboiicnt lo other word*, the tff qwkmMikfic nrlkd* to the pruUem of Wad }wnng in I'StUdcljdia it bring made in onkr to attem{4 control on a f*d4* health Wsef by preventive measures rather than by trfyinf on etmkal efforts only. such M ewfly dugnm*% and treatment. Summary and Cooduaion Enough hat been accomplished by the reporting and mveMigaticm of case* of child' hood Wad poisoning to the Philadelphia Department of Health (Hat reasonably cWar indices of its rndrmkity and epwWmsoty art emerging Case* arc of the order of 50 per annum, and deaths in 1959 alone about doubled those of New Jersey's widely heralded oubrrak of eastern equine encepha litis These deaths are due lo Wad en cephalitis. and, as with other forms of severe encrjdialtttt. neumkjgkal sequelae are fre quently devastating. However, drspite progress, the identifier- lion of specific hazards in an appreciable percentage of cases reported each year requires further study before cfftnt prorot ten becomes an attainable reality, land paint in old dwellmgs is certainty a ma^or menace. Hut Wh mapping and field imestigafson of reported cases mggeat that other factors may be involved. Hn 4m a trials, MO. 473* CWWf Asa, rWMdfiwa A nnnxcu L MarMao. a D Ul VWi^ W O*- dm v mS tyml Rrtmsrt so Lead m a Cmm M (Mw^ Am. | )U$ci lUAHdC. 1*17. 2 IWKfcmt C Leaf r. ! < W OB* dm. Am ) Do Odd t* J Ws m, H ; Srfwlw. W >( j R.iWhif, H I; Pm**, A. S. and Snfi W. It, |n Lead fiAimac (fuo the Dwwf 4 Bort| Cams JAMA. M9.I4AM4B*. tttt 4 9U|mrs M, aad RU, U t: Leaf N- vovt: A CWsI and Dfmmfsnl S**W of |W Fartwi Idoncwf the Smowl Imkvf hi OuUrro. Am ) Da 0>hL At S*4t 1 Pjw. It K : Load r*oninc RevWw af As Urrm an4 Kryoet oo 45 Casas Vv&Mrtn Zi; JAV^CU. 1*5* * Kjyfbft, M, aod R*W\ 11 I. r Load N- sowww luMt ldowis| tW Sosaoaal loci- dmrr m Qsdrs Aon. ). Dt*. CkM *1 Ai, 1*41 7 CWs ) J )* and )fMs H L; TW l.ayam *4 Oalto to Lm< Natfks Mj *0*51 t*H A |>A L: Stmt Asforts of Aonradon rnUinrs ISAalrk* MJAM72, Ml * WiBtoau, H : hrmsl ewaawawicatiaa la fin 7m*i rtd p| |u wm: d u j mw iw gffiMww