Document emmkBggGv84r7Vqn4NZanQDdy

September S, 1939 Dr, Sidney McCurdy Supervisor, Medical Section Industrial Commisaion of Ohio Columbus, Ohio Dear Doctor McCurdy:- 1 send youheregyj^somem^it tardily report of our examination of This report was delayed by reason of my absence from the city on a brief vacation. The analytical results obtained after examination had been completed were not in keeping with the history and the physical findings, as will be noted in the report. For this reason my "associates con sidered it unwise to forward the report until 2 had returned to examine them and to attempt to explain them. Concerning these analytical reports, I may say that If they had not been done in this laboratory and if they had not been checked by two sets of samples, I would be exceedingly skeptical Of their accuracy. As the report indicates, we have never found bona fide results of the sort shown in this mans urine except under conditions of acute expo sure, and although I am not Justified in Jumping to conclusions, 2 can not but suspect that some very unusual type of lead intake occurred in the case of this man shortly . before he appeared here for examination. In some hundreds of cases of occupational lead exposure whleh have been studied by us over a period of years, we have never seen figures: of this order of magnitude even after a lapse of a few weeks after the cessation of exposure. It is simply hot reasonable nor sensible to attribute these high results to a moderate , lend exposure which had been discontinued two years previous," Therefore I am led to feel that either there is some unusual environmental factor in this case at present or else ws have been subjected to some intentional deception. Obviously one does not arrive at the latter conclusion on such evidence. It is, therefore, ray feeling that this matt should be studied further in order to determine what has occurred in his case. I have not felt that I was Justified in sending for him for any further study since such a study could not be carried out adequately without putting the claimant in a hospital where he could be kept under close observation and where his lead intake and output could be studied over a short period* 2 1 think it is also worth mentioning In connection with the report on Mr. that In an interval between two seta of examins while he was in Cincinnati, he mad a little tour of the city* from which he returned somewhat flushed of face, decidedly loquacious and smelling strongly of alcoholic beverages, the imbibition of which he stoutly denied. It will be noted In this connection that lie describes himself as very nearly a total abstainer in his history. In the interests of fairness, we have not stressed the point of alcoholism in our report* There is, however, ho question that alcoholism has played a role in this man*s physical state. I send herewith our fee bill for our services, and we shall await your further instructions if it is considered desirable to make any more observations on this claimant. Very truly yours. M": is Robert A. k'ehb 7' k'.lD. Hkr 0016892 O.D. 12316 9-3-1939 For examination, diagnosia and recommendations in tlie case of Q.B. 12316 Complete physical examination, consisting of = physical examination, micros cole blood examina tion, (red,white and differential counts, hemoglobin determination, count of stippled erythrocytes), clinical urinalysis, microscopic examination of urine, and analyses (5) on blood, urine and feces for their lead content.. . . . . Kfi 6689110 0S/t> ts $45 00 N19493.01 Ohip Industrial Commission Case. Sample of blood received November 2, 1959* Blood Analysis No. 39-^-5907 Grams - I4..I Mgs Pb/lOG gms -0.075 Reported: November 7# 1959 0016894 N19493.02 Ohio Industrial Commission Case. Blood sanple #ij. received November 4, 1959* Blood Analysis No. 59^-~39^1 G-r ams - 21.8 Mgs Pb/100 gms- 0.08 (Spectrographic) Mgs Pb/lOO gms- 0.07 (Dithizone) Reported: November 15, 1959 HE 0016895 N19493.03 Report'of Clinical Inyeetifatlej*- m o.s* xaixS `ddresss 1776 8. 93rd dtrsct# Cleveland# Ohio - %#i 53 Pate of xsaifcatim* asd Study October 30# 1939 to Sew* 6* 1339s* <% previous Ffi-jKsst listed &t$is? 15#. 1933)* Olaiaent reported to- Ciiselnn&ti <m October 30# 1939# Was seen n4 assay!* of blfcad and urine vers taHem* after which ha :va*:-admitted to Bmmmm Hospital# Silftan. Avenue# Cincinnati# 'Ohio* She collection of further ssaplee of excreta# a# - indicated hereafter# was begun at 6l00 P** October fDtfe* JuSimUUii^^ Sljtee-.August WW* she** Xmt exa&laed# lias not been bettor o f worse* Sas hod no seats illneas vsat has felt unable to work. Has bad ccaaicma adderstely severe abdotalnel osenpe with diarrhoea# ikt true oil or other suaUfaetatloM of pluabiaai* Oa Saturday# October SStb# following unusual exposure to old# developed severe pain lb right shoulAer which has continued steadily elnoe* Jbsin 1 Hatted to neighborhood of joint and:has h&m m -severe as to prevent voluntary movement of:shoulders* Oonersi physios! condition is essentially on* changed except for disability of right shoulder* Anterior and posterior.chest excursions arc possible without ssarJeed pain* the disability being nost'mr&eA in dMuctioh# there arc no sensory disturbances in `the area or hands# and the muscular strength of forearm and wrist la: good* tala tines not prevent sleep end when shoulder was supported by cling# %im oyoptage relented sufficiently in a. day: to permit having* the lesion Is believed to be aub~ acromial- bursitis* the faint punstete. deposit in' the left lower molar region- Is- unchanged and there 1 shoe mrgitjsl discoloration of the gum particularly on the lingual aspect- of the lower -Ine-lsora# which# however* does net appear to be-.a.lead line* Dissent tnu&nee of tootiWbriifshing end oral hygiene for % days paused m noticeable hang In the deposits* The &*ray examination (report attached) revealed a slight increase- In peribronchial me swings but m mere so than might be anticipated at the .patient:* age* fhi-a examination was requested in order to-determine whether, or' not the industrial lead exposure la W35 sight have been associated with considerable * poeure to siliceous dusts contateing load-which# It was tentatively believed# ould have been retained as -deposits, in the lungs to be subsequently released ever a long- period of time into the. blood and lymph atreams* fIt xrraye 4 not suggest that such deposits-' exist* 0016896 N19493.04 ~iT Q&t&ilfttioii %$m s-1/0 m*mtm 3tSgt>XS&$- - none WB0 V>tJ$Q Poly %3 Lynph.W Other laboratory finding* tfr essentially n^g^ttw. fSOCSIt. for .the rm&ta of ssalysee tg$- :lbs% #": Wfelsf^'- Soaiu* 3 , &aao. 5 il *MXe la the boepitol patSeaf ma nhed with toilet: privilege##, all clothing wa prorliled hf the hospital sod' Etedloa^lon vos United to. that prescribed by uo, Strery steel passed van collected a. an individual swsspl and all urine voided during.the wcefe of atoeem&lon wa collected in a^Mtoos* searles* fTOa 6*00 P.H. So 6sp^ P.* &3S2utmLMM Date Obtained nature of VoXciae or Wifg^.. ,,,... Oct. 30 th* V)3$ i?oy* 2 How. .4 Blood 103 oe*1 H oot. 30th Oat* Oct. 00 (>iino to. 31 6j.00 -V', .M. )i /V '-O $ . ?X - Wv. X lior. 1 - Row. 2 Wv. 3 * 3of. 3 How, 0 Mm* % MOV. 4 . 5 tfov. 5 ** We* 6 Brine *S HK5 so X%B oo 1300 no 1190 o U30 m Idfo os 15^0 c 3fm Oct.31X0iOO AK nov. i, 0U5 AM Wv. 2, U30 m MOV. 1 00v. 4 *OV. 5 MOV. e fee*Sest driaed) Jt * B & 4*2 gresas 30.3 fmisa 13.5 Brarjs 13*7 7* 3 sa.x 13.3 Wad in MiiUgrataar &p&T 100 forces A * ft 0.22 par liter 0.2% * tt 0.20 0.25 * 0%*M2jj * * 0.21 * O.X0 & j* * 9 0.18' g*S.0O in sa*tire * # 0.52 tS ft 0.2% 0.53 0.38 a * S3 * $ ft M Oh lead concentration in the blood mmv&m is consistently and unifomly above the normal and ia indicative at some recent anti continued lead exposure* since it does not dlailaish during the period of the observations* 2tw& !> it is not due to a single RE 0016897 5 jjif-n d.-)<39 of iager.twd lead during the few d;m lausdlatsly prsesditiR she yr&nin^tion. 'tlilfi mnolmlon 1$ verified by the urinary values rbieb eteo^ ;the ssse saiista3,.i3#d-t3.ersti0n* fh# swples* outfit*#' othir:hhli!l:# .issiosslt of : Is^d' l|r oft 1# . obvlouolly th result of the tngaottori of an aisssi}#& tjusntity of lead not longer than J2 hours the ars.rslnati.'n*. ^ry . 0asol4 4'fi f&Q&k liable on the day 0`f the o'v^rr'.M/. Me ,,'rrt hot & normal or ^eprofscntatlsrt^ euoen&tlim* hut .It olio o"0 ':! ,ti In 1 ,i h'\r.d c :/., "/ * h-vin- '. ~n > to *} -i'x*o th h--h c v-orr/pv t?co 3f n.!r::`?. f*:orr.,` .tif ,- ihoo-'n'-ht: fro,,'. :; v o p ' in '/ sir If?1-' corse:/, hr; '-r/'rr : '.oh <. .*t tr ;: - *; ' ".CO ' *- >o \*..-3 t'./r-. : /)-- ..ol. IS:.!',;*, ;rvire:.ncar. -i 'o ;'*: -- -ro 'r. *t-t ler C: r.iO tv uo i.irveily fro-o ^"."sro- ,v' :t /, -VirT:t*nn In vhioh he hr.*-. her*:- 'r \~ 't '.nr; lor-y -'u.trhi*'jf 7*-nr* -r-**o '.to.'*!;;/ for 'osa# ti-'e. o no- '/her voy ouoh : ,.-.atJ.ti*' r 1^-A aocur* *v , * i.r.?...o..o.......... : / oi* \:'.<: 0"r "it *. tec, 3.'Vi ?r*/ >:* 1 oyr-older It ''.rchruvic t.:ot " hie let.->*?<-i lo.h.\ro un^r:-l unde/ toe son:'it3 ins of > f 1 f * S* y 4 *A * -** * r4' * i ^ /0 , , *>,*, finw/l jv h ji O *** ii* v < * ' i / * 4^i!|l^Mi^M^j&''1!! **r *f + oOhr-rOf 'nt; . r.y cr :<* h'vo - *' /.'w-*. nrr,- h -r*r - lot: on ship -o r.r ,>co i z:oh 'o.`0'*-Jr'""- t*-'x!* rrvbx' -v.-** ;^ '-o ts:t arts# froio c, // c g o* 'T i<*k > o `ci: * ** ` 1 h '' *, 15.: .f. Vith the @^ption of the disability. '. oolrttrd vith the inve%%%*t m flad .# esrMsaes of lno&poitAt ion- ori disability that waiid dls^aiifi' this elaisssnt froa doia^ wprlg 8:'4*b5|S for a mn of his pJarsintts sad tfes soars# of;M. prmmnt lead Wtafe## which hs the effset of isalntslBing hbnofeally hl#i levels of load concentration in his blood .aad sssrdtn* la of omi- fildern^i:: iyfecr4st9 b-nt is uarslated to Ms former ihcSuttrial %m.&> OTtposiire* f4in#di Kstterln^ taborstojy of;' Applied l^grslslQ-gy Unliferslty of Oibslimtl Oimiihnstly Ohio US 0016898