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- t ri October 7, 19$9 l t a d Krovrt *j jrsrnc------------ To the Moabers of the Lead Industrie# Associations Tcrsdnatlng aorles of publication delays quit* beyond oar control, a coyl 1 anntary copy cf tha raocnDDfQS c? ms ms Hrorca coranc* hold In Chicago laat Horeefcer no* goes herewith to each indi vidual In oar nerbership who baa aakod to racalva these boll#* tins. Additional copies to oar nenbert vill bo two dollars each, a figure veil bale* thoir cost. Oar conference vms without question the aost Snportant and authoritatiro on problems of lead hygiene in asny years, and It Is hopod that the papers dellt o red by this outstanding group of speaker# vill have tha attention they deserra. I LIAO INDUSTRIKS ASSOCIATION M (AST 42N0 STRUT NSW YORK IT, N. Y. ^ 36^-^ UAO HYOHNI XOHmBKM - ' %. nnift$OAT# n o v s mu e r *, m ^ '. MOtMHO U&ltOM . . Mvdn4 Pin*** / ff*M W Mafdg, > ` Motrin 4--<**-- ' .' MOTIM fMi LMft L fiiiffU, ^mloy Nmwr, W t+dmMrtm Ammimtim,,.............I TmUs ft. 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'-,?^f ' " It-- :, ^ri, iii i*** :i -' i .. i J ' C ,c , ..v-^ * THUttOAY AFTOMOON SBUON <Ctf*4 8otWf*4 T- MmUm. lit), Cafo* m /ftfftrfrM r*fMfy. t 4*#*<--, CM/*n4......................... MOc v --o m, U4 bf U K. Bali, M.D, Amifim* #r*A# 5U Cws>ll ow^t, /s imm ......................................<.,,,*7.y..'.*............................ j'j-.f ' ' ' kma l o o m a t i a u - - . ,; ' ^. fMn C W*Wn, l-l, X4#t o-rf glotLMtf**. MWff. tforyfaorf.. ....4t WrVMOM. 1*4 by Ar*br A. JIim<. VI#* A*44, 4*wr<**a AfM tui*i| /mmmv C*v**f< IVi^/UM, |/i iw >m><...- moAY, n o v imn i r. ifM MOfttftMO tmtON ' OwlmM . JYilCrpimJ>iiiM* .LYj/W|Wmr.Smt<-*DC, nnMyrt4afrtwA'--Nfn4*i,*LXX m ifiikif or ** a x * mnuntt m 4 Am* A fh BmO*t > le4>, An w mI* fr^M*r / Hftom 5*JU*I . Hwfw~ W A*Im i HKtiMM, Ubr J. J*)lu OU*. Jr, Mi). AmU4*rnt N/mmt / ,- fnrftMnM, J%0 Mm J#p4a* &*ift / WHmm*, X*ryW.(..4l i wmi mnon uw tummiii r-- imwf fc *.'*' ?*: ft" '-' Lot H. MOW. M-D, K*rims lUI***, C/ofer--t* 1/ CMwN * , C*U*r / Sf*itM, tWIwti, 041*.. wwiriw or oo. Muua'f a w * ml iwrYi rmn, M br lUrrfot f lUr4/. SU), 4**ri*< /'Aro*.,CA**(. JTM--I CMa AmmAmt Oi C#**fW U90p*ft, g--gnwiUwlli,, MM UTMT 0M AM ttfStMIMTU. IMMHiffW or rMTM MDCl luruvKi nt aofwiao or k c mu rvsiacn to runiv mms Uj I0 COMIWKM IN TWI *TM<WVDI ., IUfcrt A- XriMf, M.D, iNr**t*r, XWfrH*| L*lMt*n), 0ajo#f4|o / CMmti CWItff / g^low. On Uh H OAir....................... WNCHfOM IISSION CUiroM 8--Met .' AmnufiMtrfMMfmNcifiMVMM Tb--m L. 8bI--on, M.D, IfrolfA OirMM twM, Lor Ahfl '^SjSra^.- LoWfotory, Lot AJom*t, Nm ...... oiiiiljMiHMii - t - . '.w ' ArmNOON stssiOH . ,' . . OllroM ' . . - . M*afr*4 BoWHth ; Moct--MM or ml k moo*s fAro, M bjr 0. Jtfcn Utwr. MJ), Jf#4Jof (Mr--r, Jn* 4 C--jo*?, MfMttffl, , MONO TAMA OMCVOMOM ........................................................... AUfiooct KotUt. U4 KriWot Coofortiwo ....................................... .tl ( LEAD INDUSTRIES ASSOCIATION lAD HYOtENI CONKtMCi NmnU *-7. 19M THURSDAY MORNING SESSION Nonmlw , I9J INTlOOUCnON y IOMCT L OfOHLO 8**TTtmrp TrrMufrin Ladle* and Goatfnnm: It 1* a pkaauro to hare tb* opportunity of aponaortM roertinp that Includm *eh * dUtinpubhed patboriap of punt* and from which ao much rood mo/ bo expected. Tb* caliber of thooo who h*t aproed to toko official port to tb* prupram. and of tboa* who bat* cocao to Uita and dimM with ti>no, mo#t corulaljr Indicate* a fruitful conferee**. For thuao of you who may not know too much about the toad WwtHw AMOcUtino, ! would Uk* to njiUlB that It la a uoo-prodt omniutiM of acoao ?0 land-minlnp, taohmp and refiainp. and manwfacturinp companion. Wbilo wo hav* many fawtboa, lododlnf h Wi procnotfoa. ruwcK technical a*rrica, fcoootnlc aerrico and tb* like, L.IJL loetr a|9 rtepaU*d Ita r**poo*ibUity ts thf Hold of Wad tifrirM. ta tb* 30 year* of our wliUw*. wo Karo aponaorod caw aiderabt* research la thla field, and wo are now ratherod at our third fl* fercnco of thla typo. Xort than a dread* apo. thia phaa* of our work araa put under Manfred Bowdlteh'a full-tiro* direction. Now, to pH lbo bportant part of thla meetlnp under way without further ado, I want to introdor* your official wekoroer, Mr. Folia Edpar Wormaer, dec praaldont of L.I.A. and of tb* St Joaeph Load Company. Lead hyriooo haa to*f been a *ub)*ct to whkh b* haa riren much Intoroated attention. )la wma tho ftnt merrtary of Ul.A. and hold tb* poaitloo for o*ariy 13 year*, when bo Wft to join hla preaont company. 8ub*qu*n0yt k* wma proaldnat of LJ.A. for thro# year*. Ho haa aUo mad* prrat contribution* throuph public aervka, hariaf oarlier thla yaar completed fire year* a* aaelatant arcrotary for mineral raaourcaa of tb* U. 8. Department of tb* lntorlor. Mr. Wonnaar. f Piywuumw.. !*M. U_ii.a*tpi. an.i / ( WflCOMI t r mix k >o a i w o imiu Vwy /Vr*Wl, /.W I'W* Free**#*!, Si. L*W A+~+**t>** \w I'wi, Jf, ! ia tKorrd to rr^rrwnt tto of rraaun why a wonderful metal *u<h aa lewd, be the Lewd Indurtriea A*<*lstii. Mr. J<>.a D. etc*w#d upon iu by 1 bountiful nstwra, can't to EfviWj, ho, unfortunate!j. cannot be w-ith we u*d safely and beneficially by alt of us It td*y. I oa for* to voM with to tite4 you wmdd to dift-uH to conceive of aa economy B*m% cprdiil trlnrM to Qktfn, end to **pra*a store tMa indispensable metal no longer wae tto top* lkit por deJiberatioei* will reeuh in ivaikU* to u. It hae mo ma ; everyday awa A *>utn*J exchange of view*. beneficial not only ttot we take for granted, especially la dfiring to oar industry but to BA&klni our automobile*. It doesn't MTfl {UMjbW Out twenty ;Mn Although my iocumbeocy la Washington kept have fUpHd fix* tto flnt cwiftmx* of phy me away from observing tto rtrwdy pcngrea* sicians and eurgerei* of member cocnpafiie* of that the medical profession waa making la tto Lend Industry Association vu told torr in ludjtftf tto lead haiarda and related problem*, Qlfifo At tto Palmer House. It ereros like 1 am eur* we *Q recognise ttot many medical yesterday to too. toM of 700 U Ulf room to reeewnh de-relopmmta eiare oar first rca/emct day ittHhto that and 700 w-iU rtmem* tot* given us aa assurance ttot we pmiowly tor bcw interesting it w a i to litten to Dr. did M psuwL. No doubt ttorr U still a lot of Joseph Aub And Dr. Falftolt, who hod dnoe so educational work ttot ha* to to doer where much pioneer work in tto told of lead pnU-mlftg. Ymr* tfa. I frit (tot tto Ln4 InJu^trifi AAsurlstlon rould Jutfy its eilitrrvrr solely M tto grvubd of tto opportunity it tod to Ignorance about lewd** properties or asm *ti| prevail*. But I did not come tore to take the time of thi* important meeting any longer than to ft- f work iA tto 6*44 of W*4 so ttot tto preee my own persona! delight at being tore a* toot*! could to used properly And lolriiigentiy. an interested listener. | am sure ttot out of thin and no ttot. whemer it crested a haxard in* OTfcmw* much gwd wlQ corns, and ! wih you dutri*JTy or publicly, tto proper control* could every eurcme. to introduced. I haven't changed my dm, I now take pleasure la turning thi* meeting I think you *koud know ttot a* tto work of over to our chairman. Mr. Bow-ditch. tto Association to* totw know* It to* r*> ret red international nn>ni!i( And nprumU* IIm. It also has tto benefit of Manfred Bow* crrAntwiN MANno nourprrrv: Tto first of ditch** great experience And knowledge la thi* our technical paper* wiU to by Dr. Eleton L. . important irr* t think w con aD Agree that Belknap, who haa been connected with tto* tto Lend Industrie* Association. And tto poo* storage battery industry longer than I CM pie behind it, drum cocnaxvtdstloo for tto remember. public-spirited a a4 frank approach they tore M. ULKKar: It 1* A pleasure to to with yoo given to tto tend problem. When All U raid again. It seems Just yewterday ttot w* had tto end done, wtot tto Irdtutriei went I* tto conference symposium herd that took place ten truth. They can then govern themaelvv* Ac years ago. I would also like to aay that although cordingly. Thanks to much brilliant work in it .<Uwan*t appear on tto program, tto co-author medicine, participated in by many of you la of thi* paper is my eon. who is tore with me my Audience, the truth, pleasant or unpleasant, today. He was associated with me for a con i* certainly what they hav* gotten. 1 am aure siderable time In some of this work and is now they will also get it from thle meeting. doing research in hematology, and teaching at It haa alwaya seemed to m* ttot there la no the University of Wisconsin. .-3 ii 4 1 weyuipw^;)t**1JJ| g `"'l11 ypvu'^si'.yiwp' CUNtCAl CONTROl Of HEAITH IN THE STORAOI BATTERY INDUSTRY By IUTON U MVKMAF, M.O. Wbrt the ser.ief author was ftrel as rocnultant medical director of a largt battery company 1a 193a, ths grfversl manager Asked that mar.fi getoert 1+ fidvled OSve A month regarding the level of lead absorptron t the worker* II* also *`4. * Miki your rcrommmda- tkc.s id-wi -- film fit the stars for what you think *txmU to doe* to prevent lewd absorption but dc*i be surprised if don't put into effect at) lb* rormnfivrtKUtloAfi fit tort. Hcwntf, hoop fT*f ai*d gradually We will put them Into Wft w mm fij we cfiA w-ock Umq Into er frodurikA schedule*." Over the Um company And their lc.urance carrier have bt-- slowly but failhfafly iraprceieg proteetivo m- gineeriag ventilsUua designed to collect lead dart fit tU source. The company U Globe L'nloc, find the IfiMirtM urritf, Employer* Mutual of Wfittsfin. Both by frrqvmt plmt toon And (Mr torro IaUo o with physical nod laboratory rxamlnntlesM of lho a m. lho Medical Department hu bm tU* to point out definite point* At *vrk places where production wjulfenet *fii defective of irjhdv^itsLe regarding du*t eoflertioft, thus caus ing Increased Uod Absorption. Howrtff, with the iocrwlfif ifnd of modern mnbiMi, the potential M hfiffird h* boon multiplied rapidly. In moot iftfUnm wo have aB fett thit we vert kvrbbf m n tons -- foreman. auperinleodent. engineers. general manager and Iho lead-exposed workmen tbmMltr*, ao w o O a i the Mfdkil Dt- f*rtsnent -- In a determined effort to reduce bn* Bun lend fitoorptim as rapidly w practical The rmh of ikli teamwork U demonstrated by the rodvetkm of the rate of disabling lend intoxication from 20% In 1929 to t% or S% vitkla the krtt tit yean, and by the fact that thereafter disabling tend intoxication or trtM tend poisoning ha* averaged only one every other year, and none at ait the last two yean. All of thane c a m* were of the simple lend colic type and were never complicated with lead palsy or encephalopathy. (Figure 1) The year 1929 was known to soms of you si the greet financial crash. That was the year lost Ufoce I came to the company when there was the greatest incidence of disabling trad in* toxic si ton. Then It tapered off fairly rapidly when we sorted out our most heavily exposed workers and had a very cooperative engineering group working to reduce the lead exposure. There was a tuny perhd, from 1934 to 1940, when we had only one case of lead Intoxication. Again la 1944, there was a peak of live case#. This w as the time when automobile produc tion the country over was at its peak, and we Vrfi working In many ln**srv<ce 10 hours a day. six days a week. all contributing to increased tend exposure and absorption. When you have 1c m time to get rid of lead, if there is any break in technique la protection, you will Immediately aee the re*pooae In In creased lewd ab*orptk>a. For the last 22 years, the Medical Department has always been able to am management and the torn themaeires of heavy lead absorption, so that the torn could bo ftwrtfd pending a miiKtkm of lewd exptwure. In the eight year* from 1934 to 1944, and the fire years from 1M4 to 194A, there were no eases at aB. ( Figure 1 > In aB c am* of actual disabling lead pniwjfting there has bem engineering break down or delayed repair of faulty engineer* lag ventilation equipment, or even carsUvO' news of suave of the men U using the respira tor*. Kccq y yr u* Concurrently with tb Medical Department'! warnings gained from qualitative testa, the en gineering protection has been In 4 process of eleady Improvement This has Included the In* stalUtioo of a very effective dust disposal eye* tem with a bag House used on the machine! which give off the |re*tewl amount of lead duet In addition to the cyclone system collertlng lead dust at other point* of Its evolution. During the process of Improving the engineering control, no m not to Interfere with the neraasary pro* ductlon, certain men have been equipped with respirators, both the regular face masks (Buroan of Mines Approved) as well as positive pressure airline masks in certain case*. Current samples show that all are now under the safe limit of T j>s"ww, -r w i k (IKl-JCNAT i t mg per JO cubic mrtcnt except two instance* of S3 ir.g and on* of J.3S mg contrasting the sesrrk for Mad lln* of the gufln* under a lea* Figure Ji, irt>*r>atioo of the W**d prvweur* i high lr\da from 1144 to 1W4 where air eafr.jj#* and the strength of the vter.acr nubl^ a* well In seven instances varied from ? mg to IS mg. aa laboratory studies including hemogtobia. iih RH (Figure 3) ber of etippied red cells per SO high power oil 0%rr th* poet Ti gran. th* wording envlroa- Immen km fteida, a rout in* uric*. and gualitatlro mriit ha# progressed from uocontr* {1*^3 Wad ex te*te of urine for r#prcprphyrl*. posure is th# totally unprotected wort of hand la tariou* learned circle*, 1 har* bee* arm* mixing and hand (arting. co through th# us* what ah'rkrd whm physicians har* a*4d that vf th* early automatic machine* which were Dot ther* may Dot tw any such thing ae a lead lift* wrU exhausted. and finally up to th* modem imyfy because they hare never eeea IL If yog mixing. pasting and aaarmUy, high-ynrtuctio* will look at the pp*r left Incisor area la Figure machine* where a gr*at amouat of eeg-loerrtng rmtllatioo equipe&rat haa bwn built Into the i, th* Wfl ceatraJ iaciaor, oppnaiu th* Lax* of the tooth, you win ae* th* "W4" tin*. la th* machine* ItMtn th* moment of th#ir first fesig*. gum. not oa the teeth, ther* la a row of dot* or For 28 gran w hat* had th* opportunity to trial# mark# which mean* a deposit probably study clinically a slowly changing group of W of Wad sulphide |a the guma. ThU will not waah to 100 men who har# L*m nposed to th# Inhala off. and It *iQ only disappear wha there U a tion of trad la varying rofwmLratiocu la storage reduced amount of cooceatmtloo of trod withia hattrTT manufacture. Whit# there has lm sew# the orgscUm. I know la the port that Dr. Aob wed t haw hi* rreideola take a email aectloa *f thla gum line and look at It under the microscope, the* aw* ran are a black depoait directly under the tnirnaa 5o here la the famowi "Wad li*" that w m de scribed over 100 year* ago Mon (ho Royal Variety, and knows aluce m th* Rurlockaa Ua*. Inridmtany. all of thoa* coaea were rase* where lead aalta had bee* used aa internal medication, acoorruftatlrmally. la the treatment of potUoU .J la the hcapltal at that Horn. 1 We have changed our therapy somewhat and do art prescribe Wad laternally any more, but th# Wad line from occupation*] etpoaar* exist* a* described oHrlnafly by Dr. Burton. I spent a little time oa that becaua* ther* has been mm* argument aa to whether there U Mck a thiag aa a Wad Uo*. In addition to th* dlolcal examine!loo of th* patient and th* Un-lift* laboratory rtodle* Haled i bore, there haa beeo clinical evaluation of the work place ia regard to Wad duel lahala- fli 1 tWo la the storage battery plant by th* earn physician This Involve* atudy and corrrlotioo of change of personnel, our tabor turnover haa been the worker'* actual operation* oa kla job, to> : very smalt, ao that the majority of our mm hate been working In thU earn* plant from At* to 90 gether with th* physician'* bnowtedg* of bla general physical condition and perweud haUta, year*. From th* beginning, our work ia th* iWmg with a medical eaaluatton of th* Wr*4 of diagnosis of bad absorption haa been baaed on the pioneering work of Aub, Fair hall, Minot, hla Wad aWrptlon. Whenever a man *bowed danger signals Indicating th* prot*bi|ity of aa Rrxnlkoff, and Allr* Hamilton.1 Impending disahling lead intoxkatlow. bo waa In thla aerie* of case* we har* depended rhlefly either movrd or given a pwiHv* preaaur* air- ujion the careful clinical examination of each worker at frequent interval* of from two to lin* reepiralor while engineering prcdectloa waa being installed or Improved. In 19Id, (a |wu caeca four week*, depending upon th* concent rslicm of threatened acute lead Intoxication, exported of hit lead rapture. Th* physicians have been time off from Work owing to lewd poisoning trained In th* general field of dlagnoatlc medl* therapy waa reduced from a period of several cine. Thla ha* Included ualng the medical skill* weeks to a few days by a course of Intravenous of hlatory, phyaicat examination Including a Calcium KDTA under a hospital regime aa do- 1W... ' I'lUD'-USW.. 'W.WJ'iww . .sktsaatSi / ijtppiap:;."R-miwp p. \ 3 0 m:\LTii in nir. s t o r a g e r a t t e r t is ix it h t cwy **d HAD AJtOt FTMX Wi - 100# Qm*i*iO T*-U . tftl r> Va#oW N*o*r*s TV * l'**s C** M. i |>i*i. H**4rw u*** C~M W 14 w* fis 4.*W ua-ico** * . - - *+ , V ** *-- - * *" h Air ? IIJ rt 4) 4 m* Jl III IJI V 14 tl* 4 41 4 4M 11 14 IA 4m It Hi a* H 1 am iM HI OM 4 > IIJ M 4S 1 IM dJl Slot 0M V tj U w 1 TOM Jl *n in IS H* n 41 I to* M Ml 4 1? It J n H 4 art J4 Ml IJI 4 12* M 44 4 MU JO MO 1J0 *4 1U n 4S > ** H Jilt IN he M IM n 4* H4 JO set U1 ? IU o *1 4 vm J4 am VI a 111 at m 4 i m rt Olrt OM M til as 41 s m fill SH Ml o n IIJ m H 4 n 14 MS M if thr 7 44 N If t9 M fV A4 A* IH4 imwi 1M mo ui us JO J4 sal HM tuff too ut its 1 JO xn f JO A4,~h 4 H *# * t^T |>*| Wf--o I tild * No ml Caki KDTA hai nrr bftfl firm to ooftm is thl* plant tfn uro, cWWrtW* t*f 21 fcwn* urtueo for qusntltottw Wad deterauastiou au done or*ry few month* to MppUwmt the repented riinktl ca*min*lk and the limpW qualitative test* uhlch ff* pcffarwd ewry (wv fU TMo u nrriid out for IS year*, fnoi 1*32 to 1*47. Hc^rotr. it woo found (hot the laformstion rained by thU more reined toot of quantitative Wad la t)o uiino *u of no more pnrtkil nlot then tho olmplor testa. la fort. It did not an^af u hdpful in our person*) oludy of IK# Indiriduol worker u did tho orijrinoi to*to of lood lino of yum*, otrenyth of wriat*, hemoyiobln, etippled ifC suunt *nd. Utcr. urino for porphyria. Tbooyh tho Medual Itepsrtmewt hod oftra bora uryed to aubotitute quantitative studies of tho urino for Wad li a arrwnlny tt in place of tho lood lino and stippled coll study, wo became convinced that quantitative lewd In tho urino study */** w a* not iif*. Therefore, study of tho lead lino, hotnnfloMn and etlppled cell count* wa* con* tlnuod throuyhout tho entire 21 yoora of chledy mdira) control of load absorption in tho worker. Routine oiaminaliofi of urino for qualitative toot for roproporphyrlnuria he* al*o boon done for th* (Mat nlrvo year* m a helpful adjunct toad* In* to a diajrnoela of lead absorption. Wo atiQ boilovo it ha* ba*lc ImpiicaUona la tho motah* oliacn of WtaJ A number of aathor* and clinkaJ oortm la tho field Koto noted that qal* lUtir* porphyria toeta are of diet tact value In uyyestiay lead absorption hwvenlny positive bo* for* stippled rcfW appear.*-*-**** Recently thio whole question of bad ibnrptkc aad intovicatloa ha* been boro rervelaated a* measured by both qu*lit*tir* and quantitation laboratory drlrmimtkn*. This intonalv* otody larolred IS mm. two of whom had worked for three years, fire for fit year*, two for 11 In 12 jear* and *U from 20 to 32 year*. Thoy had at] bora reposed to hoary Wad inhalation from limo to timo. It wa* already known that they had definite evidence of Wad absorption bo* cause of the simple thouyh frequent aortal studio* of history, physical eiamination, and quail* tatire bkmd and urine studies. Three men now haw faint but definite lead lino* and tho majority haw had on nrra*u-r stippled rctl count* of from 10 to 2i per f*0 oil immersion field*. Thos* If men were chosen before Uvoro wa* any knowledy* of thoir otart blood or urino quanlitatiw valuoa for Wad. Tho dinks) and qualitatlw loot* alone had already shown that Wad absorption wa* quite hlyh and that the** particular moa needed te bo wolchod closely. (Flyur# I) You will see an tho left th# column for quail* tatlw tests, and on th* riyM those for quantile* tie* tmta. -jgiij l if u,.,ij iMjm.ijM*i^u,wi*ym1 Jl1 ^ mu.iWflH 10 BEUtNAf In rryord to M oupoourw, as i m by air la flyur* X. bis hlrhoot load otpuoar* waa imIt mi, tb* hut colum of fly*roe mi Dm rifkl 1. but awr* rorontly only 0 M Ho la worklay roprrmnu the limit capoour* covertny a b ebaryo of automatic cartlnf whort ordinarily ptrtfl^ of oil analyse* from Ihlt to 1PM. I on w* think tbor* lo very llltl# oapewar*. W* know run Ihot you trill too tbor* boro bom mm flirty that wbra tbo trad otldo coolamlnatad scrap 3 hlyh b-reU Tbit It tbo omount of Wad in tbo (wrti non* oirr front tl-o paotiny lino, they aro olr por 10 cublr motor*. aad If > wioh to ro- dumped on a bolt and yo bock Into tbo poC due* It* tiler* por cm* cublr motor, fart man Wo bar* bad run loo at tb* point of dampiny, tbo doc Imol point to tb* bit. but sro now pioclny ouctioo around tb* reorayor Tbo column wool to tbo rlybt I* tb* moot ro* boh Itself. cmt air onoljtlo, and you to* It boa dropyod Tbor* was a* rllnlcal evidence that oortoaa, sharply. Tbit wa* doo* la ItK Howwuor, la Irrwveralbl* damarc bad bora dooo to tbooo moo " lbrot tnatonrm. wo or* all aftffhtly oror tbo by this dr*rou of lowd aboorptloa. If tt bod b**W permitted Ind cf 10 mo por 14 roMc motor*, frit that tranalont prriod* of Incrcoood Wwd ab* aamoiy. U tor and til af. ooridloa war* likoty U cans* sorlooo oryaalc Tbroo mm*. a* I hot* ooid brfor*. art orraarod daaiaro with noJdsok, Wo would aot bar* rw arcordlcy to docrmoloy rcncmtratio* of bod llod ontirriy on tbo avor* anally aralUbW toata to tb* artno. That lo pwrhap* tbo most Imports*! wblrb or* a mowaura of tb* ladirfdoaTa body ta* cwrrriatioa. t would Ilk* to polat out that. la art low to bod. W* wlabod oopoelolly to dotormlao tbooo It rasa* trbrro w* nor* Irylnf to so* If whether ortdonco of Impoodiay toad latoxkation tb* quantitative load fltt a* aay tafarmotioa could bo ar* abarpiy prudlctod by quaatilativv trbicb tbs quolltotic* toots did act ytrw. aadl toofa of aria* and blood lead, rather than by tb* lafarmatkn la aolrd la only *a* too, aambor man w*4ty obulsabl* tout* that u* bad bora oirbb This was a mao who waa ooco boartly aaiay for many yrar*. rapcwod to tbU nmcoatntioa of w*0 over tl What do** tbla rrrrot weak on a small yroup me, tboarb Bow only U mg por 14 rabk motor* af bwd obaorptioa caao* fraa tb* atorayr battory of air. Ho wo* uolny *a alrtlao rooptrator mewf ladaotry >b a* toyard* tb* as* cf qwallLatirw af tb* Um*. Tbor* wuro cortsia ported* wboa toot* cuatraatlay tb* no* af coavpiksted qwaati- bo bad to toko It oS lot mockla* repair*. Ho Utlro lot* wood ta a march far aarty caaaa af otror iboord a bad IIa*, lit. lacidontaQy, U alyallraat lowd abmrptloaT By olynlAcaat ia . tb* maa that haa wurkod S ymro and it aew mowat raara vrivorw dUobilay bad latoabatlaa b *Ta tb* plab" pbyulcaBy. bkoty to ocrar la sw* t# tbrw month* If a* tav- Ho bod only four alpM rod*, bomoyloblt avodiato effort b mod* to rrdorw tb* bad wa* P4', *r It-# yac, aad b* asarty aHray* baa poowr*. TbU raa bo dowo *itb*r by aioriay tb* bad a 4 pi** porphyrin toot la tb* aria*. worker *r by ln*l*tonro oa tb* so* of apprupristo Yo b too. la ad liwtonco* oarryd ana, that tbooo respirator* wbib defect* la arochaalcal protoe- catoa abow * lbrow to four pi** porphyria. tiro oqoipwnt or* briny cerrartod. la Ibis co**. aambor oiyht. tbo lood lias Imi la la IX of IX mow tbor* waa outdone* of b*ay ,? tbo aria* ta H and la tb* blood j MI Tbla U poor bad aboorptloa by both typo* af toata. la a*dy tbo *o-ooIWd tofo lorot of lowd la tb* aria* of -1ft: wo cam (number riybt la Finn 1) tb* slmpio but tb* blood U not much or*r tbo ao-caDod sppor qualitative toots omd ia abowtay only mlalma) limit* of tb* normal of Jtft. Many boo* *ald that oridoaro of bwd aboorptloa by otlppbd coll aad If w* bar* a roadlny of lood la tb* aria* of porphyria, tbouyb tbo quaatlUtlr* tool* abowwd or*r X tbot I* s trrrt coonpollbi* wllb a rowala- doitnito Ibosyb moderate indkatlooo cf faltly Imt Ut* of lood Inloclratiroi However, (well a boary load absorption. This b tb* ease wbera arlno lowd Irrot rorltloly of tlooif I* not diaf- tbo air coocmtration boa fruqaoatly boon oror nootlc of load polnolny. Pom* of thoa* aria* tb* mf* Hmlu of X my por It cable metor* af * raloo* rv* Unit* hlyh; orow ** biyb a* Xf. Abo, air. Tbo oporator b a rather rnnortontlou* aocr tb* Und loadt la many Inataaco* rua kirk, bat of tbo rooltlr* proooar* roaplralor aapplbd blah tbo an abow no symptom*. Hot bay (* hi* bod ocpooar* ahowa by air r How I would Ilk* to point out ra*o III# balanro rumple* wa* a* hlyb a* SI my por 14 ruble raa* rlybt. ta raa* oiyht, w* had rory till!* rrt- motors, shout arrow time* tb* rocowt roadlflf af done* by qualitative toot* of hoary load absorp XX TbU nun bod worked first a* a baad mlror tion. la com 11, tbrro waa tha uf* limit of load and thoa u a paatlny macbln* oporalar for tl la tbo urlno, U. and I* tb* Wood Od, but o# years. At no tlm* baa ho rrrr bad proa mtalatol qualitative to*to ho had a two plus load lla*. tl aymptoau auyymtlra of a pamlbU bad latost- otlpfdod rod*, with 7t' h*vwoyh44a, and a four rollon, but w* bar* watched hint closely and plua |v-rt>hyrln Hrrr tbo qualitative tooU aovfo rorcmmmdod Impnnomonlo la bU ac/iaoorlay or or lb* i|**ntlUtlr tools. pfutortUW, i r \\rv.v .* TV. - mi-jJS4*W'~ *< 5 "I 4 Tbo qusntlutJv* tacts md la o m rea# liimbn U. Flfur* S) by showiny normal limit* of lux! la uric* tad blood, vrhIW lha qualitative teats nmd of dangerous Wad absorption abowa by Wad Uu. atipptod coll aad coproporphyria la tb* urio# M wall l i a moderate secondary anemia. TbU individual hu nmr bare lit. though bo hi mrM la Dill itMip bottory riant >4 yuan. Modi Improved oegiorwring protection ha* barn (Ivan him aad mot* la |daaad. Arid* from those two o m, lh rrmainlaf IS showed that tb* individual* had potentially daayareua Imk of had absorption an miaaorad by both qualitative aad quantitative stadia* of had la aria* aad blood. Tb* advantage* aad disadvantage* of tb* tw* typaa of tasta taay b aaaiymd aa follow*: L Tb* advantages of tb* clinical aad quanta* Iht lati. A- rrertlcabUlty. with tb* nacaatily of dr*wins only a few drops of blood aad aritb only a v*ty small amount of lima demanded of tb* awe away from lb*ir work. B. Speed of datarmlaatioa I* aot*worthy, taking only IS mlaatao la caoo of aecb otlpplad (ad caL C. Than la no Ukaiibood of toad coetamina* D. Tbla awthoj maaaaraa both bad abanrp . tioa aad iataakatioe la iadirtdaal cam II. Tb* rblaf disadvantage of tb* ctlalcal aad fuaUtoUre last* U that tbaoratkaBy tbay are aot "apartV for bad. A. Tbr Wad Ua* U ladiatlagulahaM* frees a biamatb Ua* wblrb formerly waa prlU com* laoa wb*a biwnuth was sard for tb* trmtmrwt of syphilis. At tb* praaaat Um* pmldSta therapy baa roptacad tb* as* of bismuth. Tb* tbaoratlrs) peasibilitW* of a had Iin* briag coefaaad wttb awarury. thallium or sttvar ara very aaHkaiy baraaa* of tb* character aad rarity of aorb finding*. partlruUrty la kaown land warbar. B. Stlppiad rail* an aot apartV bacaoa* tbay may b* found aritb any ****** anrmla with a law Iwmoylobia da* to carcinoma. Ilodg. kia'a diaana* or leukemia. la Wad latealratWm, bowwrr. stippiad rail* ara usually pWntlfal wltb a aonvukl or vary alight rodurtWa la hamogWbi* As Cabot potntrd out In llt, tb* finding of many stippled rails with a raiatlvety alight drop la heanorMMa la rbarartsriatk of Wad Intoalratloe. It W net our taiwf that any on* spot count of stippled rrH* la diagnostic. Wltb tbr** or four *llppWd rvdla w* Kir* m*a M within normal limit* Wbaa atudylay a Wad worker. If bta *il|>pWd t*D rouat rlaa* quit* rapidly wltktn a lew day* from a baseline of all to 10 ap t* It or SO or ovar, ua* can predict that than baa bate a braakdowe of mylaawriay proUctice aecb as aritb a I an Kauai pip* or cracked Wad pot. If tb* atippWd toil curr* rontiaua* ta rW* abarpty nrbae checked every two or five day*, tb* man can b* moved before Wad Intoalratloe ocean. C. Copropurpbyrina In tb* arie* may bt markedly poaltie* due to otbar intoxicants such aa iMk I aad hrUlanba, but la tb* know* Wad worker its finding la a fraak four plus rarW color 1* moat likely to indicate copro porphyrinuria from Wad aharylit*. III. Tb* adraataya* of tb* quantitative teats are: A. Tb*y ran b* doe* ewtiMy by no* medical and aontorbaieai ptraonad. B. They ran yit* a rviatlv-riy rapid arrrnelay report ca tb* Weal of Wad absorption la a terra number of workers -- 100 or ovar. C. Tbaar teats ara truly specific caty for Wad. IV. Diaadeaatayuu of tafyiay aetiruly *e tb* faaatitatlv* teat* are: A. TWce is He poaaMUty *f ramiamlnathm la redartloa of aria* and Mood soaapiru, at w*B as tbr ohWrtio* *f tb* maw thins line to. obtaining adequate oarretybt urine* ar a Wry* 10 rc Mood sample fium tb* veto iwsleaf *f a few drop* from tb* acr. Eaue lb* advecstaa *f tb* quaalltatlv* study *f Mood aad tb* aria* ware of tb* dearer of Wed rewtanin*tice of each aaaq4*s *' H. There Is paucity of clinical labor*toriau equipped to give acrerate report* tram fa*at Itotie* stadia* of evry miautr feaatltW* of Wed foead la Mood or aria*. C. The** Unto measure Mod absorption ooty aad do net make a diayeosi* of bed latoziratWe. They do not abow tb* affect ef Wad oa a given ladividaaL Datarmlaatioa of atlppird crib la caaao ef Wed abaorptloe and Wad iatoelratioa la stiB ef yreat significant*. IWaidse oar owe o> pariaero. tbla I* bora* out by peUbhad paper* of otbar me* with osprrtenc* la tbla Witb la whatever manner land atworptWe |a dtayaoaad aad apart from tb* usually transient tbr** type* of Wad latmiratioa lletrd betcrw, tb* fuaatlee aria** aa to whether Wad absorption p*r a* has dnu* any lrr*v*r*ibW damage to lb* organism. Ald* from Wad colic, wltb ar without anemia, which occurs la SO*, of lb* cane* a tb* coam modest type of Wad latoalralWa from which tb* psltowt usually rarer*** without residual, there are tb* rare 1% or *. of rasas with Wad palatoa, TVoiyh thss* may orresloaeAy show raridual. such compUcaUan* are rare If property treated 'i It BELKNAP UAB AMOftfDON -- IS --m -- CUU4 X! Cm* T**** W**W4 UW O-Ur, f*mm iMm.fl.*,** 1+4 Umm S tfinwi^ Mik* 1 A. 4** II t Mt/SS 1IMS Ml k* Pm. In t r. Um 4 mm - is ms 'I 1 f. km 4 iwec**. mm mm Ml Wok4 Am aa Mm 4 bo* A. Onr ok*. 11 turn tnm Ml VoaMoOoo 1 P. km 4 4 (SMS IH/Vt Ml Urn 1 ba* * CM kon. mms ISMS Ml k* k*. C WWk 11 t <11/7* ISS/SS Ml Wet* 1m P. Om H IM/tt UMS Ml Wot* Am P. Oret. , a t ISMS N.f<n 1At Watob Am t* C P. a MS/SS ISS/IOS U4 Wotak Am II bL Cr* a ' m/n mm JM Wokk n C. A*m ii A. In* a maCrie i t**/n imm inm mm *f*w|P- ^ Mi twain aa W*M Aa*. M C Aom a is ms mm Ml tiWAat N lb Ink " . a iM/n mm Hn>n Ml OJt i'. ; -r'. <N*od taty* Myna, w na export'd bmllay period at thro* aaoath* adiayn aad albtaaala w*r* ah neyntlir*, aad ( U Um ptn. la Ik* v h j tun iMtwni of Inf addition, tb* total a*ntai profeiaa mat* d with* tar*ffcalapathy Mnntaf U adoK VMbn fa ia oarmal rat(i - - . ' acftn ladaatry. if tb* potiaot rwwn Umt * la nor ow* aapnfam aad kaowfadya *f tb* aft uatSjr bo Mvaclaa.11 iilacatura, w* arr kd to boli*** that men l*ad Tb# March for hidden rnifub of load abaorp- abaorptioo wttboart tb* nyaaptcaBa of load poky Uai ahoaafd yo forward. For example. they* Buy or annphalopathy caaaaa a* prnwaaant pbyaical b* a Irualnt, aondlxobUay weondxry aaaoiU harm to th* adult human. Farther, apart froaa aa ahawa h*r* ia two cam of th* It ca*a prw thorn rar* cam* of cnik with abort period* of a*tit*d la thla atody {number* thre* aad Hr*. arot* diaobility, thrr* I* no lacraaoa la piaat ab- Fiy*r* 1>. Tbcy ara briar (ivaa Iron aad wtO b* MBtarlwa or lorn of work ability la oar *ip*rt> BKtrtd temporarily froaa furlhrr heaey frad ax- anew. Thrr* ia aim a* welyht loan, no tmnlataad poaurr. W* an aUo conataatly amnhiny for blood pcomurr abnormality aad ao damay* to lb* pomibk objartlra eetdeoo* of any ptmaanf kidney aa amnnf by ro*tiao aria* aaaiyala, lajary front (brack load abaorpUoaa. wbik on* **** ao oridtnc* of linr daany* tithor Flyvr* 4 abort Ut* yoara worked aad tb* la th* form of Jaundk# or la lb* ortimatloa *f ayatptam* and blood pramar* for coaipariaoa total petrtein. (Flyer* 4) wltb lb* lint* wb*a Vbr aim war* bind many W* would walwan* roport* of cam* of other y*an m and aow wfthia tb* U*t month, la workr* la th* A*ld wh*r* th* qoalltatir* taota ? only on* ran* wa* tbrr* a rla* la blood proMOf* m**tln*d abo** ar* foOowtd out rootiuly aad aad that not too mark. la detail by a phyakiaa loyathar with th* Mr* Tbt* rorrrUtoa with tb* report that w* mod* complex yuantltatir* loot* of load abaorptioo. prevtoociy on blond prtwur* la work*** la th* load Induetry atudlcd orr a hrr-yoar tlmo, and Candmlaao aim with th* report and comment* by Or. Mayor* i. Toyeth** wltb rllakal examination aad and l>r. l(oniUt< aa to th* fact that lh*r* ovalsatian by a phyakiaa, tb* quallUtir* U*te . i do** ant **m t* b* aay drlfnlt* corroUlloa of rtlppled c*ft, bemoytobi* aad urla* porphyria botwooc loar, continued load alnorption and aa bat* proved edertlr* la aatimatlny k**la of lead incroaa* la blood pnaatir*. aUsrptloa. Thla I* tru* la th* majority of l**4- Th* reutla* aria** atadlod for mkroaropk eapoeed workera oUorved la thi* atoray* battary $ "...iwwp i - ^ t i ^ > -ir r * Mi ?Iff?, *' '*' 'i - ,,> &% <. - ':. ' 5 ', ' < \?-&l >r. :.* V: * Lm 4 ft* ' t;- V & ?. < % '*' 44I1 ?l <4i- ' *'S *!1 J ''I /I w .. j W'^. #* i. >" fj v, < ^ !';'t; 7*V: . f- 4 % fi ^ ,< r<l.'3 . ,:.* : Vi-f.'.' , , .w**, *.:,'*1* -wir !r if *$ ^Mafijittifijaiiiraiaigiii irtf >iaajw^iiliateaiiia>ttiMi^^ tkc4 ii&L !i in, I <* ^ Vj>f '.. ,v : 'Yi?.. : ' 'Xfi : -Sy if S^ ' *f>3 4 >,,] 4w l!ii t " nr Hi^aw i mi ffiitWiiMif \\W\m ihnm Pi! W i|lT i .^ .v'.-'/'i! f't t'ii'r- liiM*jj * |*"*7.*">*4S,iV** ' ' .!*)`tt*'... v' .'f*4>'' ...'). :* a. 1 V- .-5! , t t \ mut&mxitiudk iKMdii^iUikw44 S*"i' * .|4Un'fi I! !! l i pi fciS'S" ilj |l S 11111 I g I I g i ! i m Hi I li i In Ubwl7 l Acting cm thin jedgmani. (I) We included. aad atill do. a porphyria **am mmimw iI |nrlM > completely equipped laatlaa oa the pro employment aria* apaclmaa UUinio<7 ud wtlioriiid tlw mptorMat of a whkh 1* a part of oar eom|4*to dlaical exam- UuthraUL Inatioa. Vunt nn<ltp n ktld laeoh-lng plant Tht* aida Ugbt 1* InterorUng twcaa** wa ouprrvuloo, plant wyliyiH and U> (Ann at ataried th* prectlc* la aa riTort to prorld* ear nab*. The parpo*c of thtaa meeting* mat lyp* of control for oar work. Our medical da- i acquaint U an irtU Mir goal* and th* pariJaanl ha* raatlaaad lb* prectlc* bee*a*a a Klwli iklfd to mih (km. Th* anUip positive porphyria la aay degree, at a part at -detained aa adntlmioa ml Mir I**parlance aad Up per napli'J m*nt pky ical anamination, should a iwnaln Uul IW entire program mU br b* checked oat. It 1* a alga something l* wrong. roeductad la Dm opal. Briady, ear chackiag oat bai revealed a few caara Tea pan in thle approach to a prohlew at of a*cm trolled pre-cccupaltonal orpeaato to land, Uie Iyje u dnmnirid by aortii M indae' aoao* rather aignlhcaat respiratory rendition* trim. Looking bark, era bar* mr bad aajr lee- tom la dfrrt car action. Today Mr plant aad Tbl* type of arreewlag examination new baa Ua laboratory pareoaaet bar* fall arena to llalr approval of ear State Department at Health. bad report record* and. aa a raaoh at th* ladm Wa aa* H la fear plant* and the maw alamlana triaatloa aad Initial, fragatally bd| aa pin enameling Indaatry thaw* a preference far lb* point their taper* la working labaipm (bat terhai***. la a few raa** I bar* provided pee- produce alight elevation* la had *lgn*. Tbry ch* atoadardr and taught lay plant employ*** diatonalrato aa had phobia. W* bam bad aa to perform U# tout. Wa effort th* qeaatlan of cam of had tatoakstioa. lay reelnation at reaolta by requiring modend Wo raa report aa|y tor* *r Una altaatiaa* la naperetolaa at nS paaltlee if erlmwia IS yaara abania Ua fatally doctor at ama at Under *ena*l rimmataaru*. an leuflgya* wOl oar tat|1a) in With vague gartric dUtorhaarat predar* a aagatire porphyria a* a part at U* faaad H aicMiiry to atVi a toatotir* dir gentle pn wnplai anat anamination. From twe to Mg at had pohaaiag. Uta faiaiUar diBrolty at had weak* falhwing hi* atari to work ta th* lead tadeetri**' medical departmeeta. npoeore, ba wtl dwanariratr aa alnatad pare Oar idertlw natral aiaaaaraa maw lartedt: phyria. Broafly af tb* pin* *o* or pn two to- (I) Tae change* of crothiag par ant <f > krph rtety. Within ter* to all weak*. U* elrratlan ' ' hr beUiag fnm dally to Urraekly depending aa disappears. W* priiami Ula la orcouatad far Job awlganml. ill Ke masking aad sating hy tba fact that hi* ptyrMegy h adjaatod to Uhtt prior erallaf of fara aad baada. (41 th new M)viron**tst and 1* operating (onto Smoking aad eating prehlMUoa* la prodartha recede* and diacbarge land below tb* Witlmnia area*, (tr Daily h** of a daaa raaplratar. Each permissible heal I ertfl net dhpato that nrw ttapfeyaa h lalptf ten. Only tbraa anaa an amtdoye* Indoctrination produce* a degree at "rmpfralar ana*." ya< a Baeabrr at ewpluyn* adjustment la prraonal habit* and hygiene which voluntarily a*a raaplraton la otbrr anna, Wa ronld produce tb* aam* result*. Both potato bar* weenie tbi* becaoe# oar gtaaaa* contain *U- ealo* la toaeblag employ(e*. ran. rbroia *. tlRcmlvm, aatlmcay. potaaelem. Each aaootb ere public* a graphic demon*!rw ropprr, wnoraoeue. airkl*. bona, atroatlaa aad tkn of tb* had volume prorewjed by tb* plant. cadmlsm. to noma a free. (<) IhiaJ hrkrra: ama Wt think Ula h fanpartaat la ear rel* of plan- for itnet cbdhlag aad cot for work (lothing. lag all Ua card* cm tba lab!*. Early Is aar Oar laboratory work included roeapaitooaa at effort* to adurato tb* employee*. H wa* pnmlMa quantitative and aaalltatiira porphyria iadiag* to trace cectala had production Him*, depart* la Ua ariaa with blood lead*, ariaary had*, aad lent by department through Ur plant, by atreaa- atlpphd t*C *easts. lag teat result*. Today, with tba engineering We bailee* tba porphyria (back praridrd a change* aad Improved employ** adoration and bettor hedger***lag ntaiinaUcei than roeId be attitude, H I* no longer poaelbl* to da thin, la f obtained by etaminlag Mood aanrara Wa aatl> fact. We now And It difficult to ehtola a large waled 11% r(eater accuracy. Wa Wore farad rework group af rmpLiyee* with elgaiftraat peat- with aa orraehmal Be-gatlre Mood mnoar wbtrb tie* porphyria* from nrreaalng tret* to ehtola wa* td i|pcll by a argstlea porphyria, la blood aad urinary had* to make th* aarauaary addition, lbe Ubnralory mew-iveleviy thnoa* rrmachecka we think ahouid La a pari of a oon- rirtled th* value of lb* fodowlng point*; (I) ar*atle* altllude la ear m'trdl program. The aparlataaa war* aw>n (heerfufly flora by la our plant we teat (00 employe** par month, IK* *e(4oy *o*. it i Tim* and Ironbio to obtola la general, tree* aad pin* er>* poaltleea are at and prove** th* tparlaton* were greatly reduced. Hit greataet Intoreet to Uw employe**, aura** and 1 v----JS-- J -3 HEALTH c -o n t r o l in t h e c e r a mic in d u s t r y 17 IS* h(H; DtjailiMt M tlw; ntf Mini* It* dlrUul vf (roup Imv?.. Flu) two1. an riftmd to lSo medical director and immediate eupervlicr. The MfoniMf ntltwi rnrVIni technique*. Tbe dorttf'i riwl Ik Ii^h weakly "porphy rln choc Wv" iyepeadinp on clinical Andinpa, rtnpity.a.' hiaturim at eeartillvity to load, blood and rlurt M< an onbfid from tun plu to four Ru. Om far produced ao four three aad four pluH tbat wo aatUrpad tbo primp to 1actado two plus palUtw to oblaia It or 10 blood aad urinary bade a< check* par j*at lot control. Cat* ployav >ob rhufw oat of bod exposure krrci an twuflr only oareuary la tbo foar plua rinfi aad tin only If tbo employea baa two cooaoco* tlto wwtlr check* prodaciap foar piaa. 1 boliouo tbat tbo pafatUhed maximum atVrwablo coawaatnifaw of TO aUlicnm par cable meter at air ehould bo tvriaed to provide a aapfnlid aibatahfe cowcoatntloa for rack load coo*pound. Our Wad rMapowada raaro from 1*0 to TO', obwwatal lead aad aro baao obtained air valaoa ap to <4 miUlrraau of bad per ruble awtor with tbo employer, abouriap aarw (baa* Uaa la bad abuorplioa d|M. la oar can, tbo probability ad tbo plaat worklap aw otto bad compound esduaivety bap owoupb to obtain .ampin U nada Wo aouai]/ kaov anonl adjacent amoltoro at prladtap operation* prurooninp a oopanto bad comprnad.. Land plan cuwtplmo obey tbo law* of lamparalan obrn* lieu. la, elevated Irtnperalnn* wlO paodaco bad tape** arbm drprro at va|mrii*tba 1. aim n bird to tbe cbaaalral compuaiUoa of tbo plana. Certain plan raapbxn chemically bind tbo com* puarat raw material* lata blpbar atabtlity. Oar tirhakal ataff aoppaota tbat bipb aiomlaa baa tki. property. Other technical pemanel baao offend the uprntwa tbat tbo blpbor tbo vabacr. tbo pnator at bipbor tbo to*icily. Apparently tbia approach to aarioaa Iadnet rial toaicity probbtaa need, am aiied/ aad coo.(deration reiallaf to tritnl IteaHwiae compound*. Matb aeortbetblb proproew could bo made by the lewd producer* If tbry would coaaidrr tbo proUowia tbry an trylap la win from a anro practical palel of vbw. I refer epevlArafly to a meat altamtd ta reduce dewt by poilotitlnp InKarra. A* I undentand It. euna of tbe pallet. Iiief kinder, introduced undeainbb propartin lato tbo fiel.hed plaaa. la one or two trial rune latuMap potbtled material abort ano-balf millimeter In diameter, the prindirp actltw of tbe (dliti on Porto botwroei a plant and our mir ier deportment produced an unu.oaQy fine eked KkK pan u> a beatirr ronoeitratioa nf dud than uo normally nperimee with untraatad III harp*. Tbe alia at tbe prtlri may not lea aa Important aa recopultlon of tbe fact tbat lllbarpe aad many other bud compound* do not flay air borne for man than a fraction of a aoroad. Oete> bundrad-moah materia] la air-borne loepnf than SO-meoh material. Abo. Urpar pellet. will more In the batch aa It la worked In our proronlnp. I heartily eukarrihe to the ileaitb and Safety DMaieu of the Lead loduatriaa Anodatbu. Since barninr of their oporatlona approalmataly <14 year* ago, an have bad as opportunity to draw besrtly ao their advice aad couoaef. It U a alacare npret that- then la not awn ataf aad mosey to provide tbe nervine of the type they supply laduetry aad tbe public. Lead Compound, provide a mow uaeful piaae. Our iaduatry la lataraatad la acw market*. I am roaviared aoaaa new producta aad markets wtB rrqalrv acw properties la our product. Theca la aa riaaoa la avoid tbe aao at irad to reach tbeue rnciiuix powsrm: The paper by Mr. Frank trill sow be diacuaaad wader the loaderhip of Dr. C H. IIUm. who b CUalcal Fiwfaw* ear of Preventive Medicine at tbe t'nlvanity at California la Sea Fraarimm OtSCUSSIOM a. c. m. nm: I eh pell like to ramapbaalaa that the appearance at pocphyrlua la tbe aciaa la ant toi+Ijr 4WcinUt i| lMfMm4 MTHlki mi pmrfkjrrirn fwifwi mw i |l I tMlWf mi HdfiiK. mmt mi rWk Ut Wt c to* tivwr *e to* Uwl M likl mmj ! tk4 i# hriwlt aotel m( nnwi mi Dm mkkm **4 mktmmk krfwtliM TWt* tn, fcwnwr, ^tlitoUfV iimni tmm dWU*flyft( Mii ii|ufir|fc|rto 1X1, to* mt mK to tfck yto Wn. n4 tWf riuri; nUtW ynurwu f Ww* gimkim. IbfFftttf, Mto4 m4 Tfctol# <4r#i /. Cewmrn toy***. m. G*wmt**h9f,, J k, JVSJ) 4*totoMfe*tH U*t to* wli> mi 4*Mmrwml irtMrt roryAyrto*. m XimiiMu M kf cifWMt*tryky, Iff--w wHI Uw brtnivX lUnylUt *tf kti l( m4 Wt to*** tflytto Mf rifilM. Umh W 1 4m m4 Mkti mi Ute tlto* Utot mi to* turf to>ltolito to* lirunlu mi Utto autrrtoi* It r?WtMi ttor* AnyH* nt* tofiMc r*mnl trl Uirt tr* m; M toll to W *4*W*I*4. Hfftowr, h A( M to mj t itot m t ytotodtrt, ttort It ktok 4mgtrnm mi to*r4iltoft totwptoi Ihm r*wH 4 ttmtfe* to tlto uyipp>f|Jiyrtt ulto t*4 urtury iM llw4 to4 tott Til* M It wM will Ufru4| fr*^vy to4*>, |t vtlto to* rwr*k*4 fcy mm It ftort ifi, t*to to Mvt ttoto \%mkr*f\m4 Mf n*4ki) tlto XdiU ml Um V*ttoe*4(jr mi ('tllfffto to )to im* M m MmW< mi U*4 It U my nMtofttoMif lltl t Itoto W l4*t?tto mm tkt ffmm+imtm rttktr wkMjf. Tkt tottUtoljr Ur ft ytriklt tit* f to* fl*** frttt -3 i II DISCUSSION ' i - 1i si tbs ckrttln] ilrwlsn 1f Usl vitl Hi Iftrysts. IlM sa t bor*l anf stltrols SO aktiyoU syolost ob- Uof. I Vs** a* rtasso ts oratf lbs ass sf Isaf ts rsorb tbso* goals mt Um lot* tbs bof/. Dflu Umm fxtm, It its b io s : Is tbs ytobbra sf loaf latsstaatls* la ba mf riruwolill*s tbst wrWui onortirs. rbllfrta still strl *tills frosir-etly la tbs Bsstaa i Um i Imv M oot br |bvs U tlUflsi lbs stMrtt or** oof lbs Cost! Ws foot to* It trey sftsa la Urrokolf limit nlsM of 0.11 M'. yrlortyoUy Californio. o Uw Uaii lb*I It **tl roaryllroU tio yrawat M. a. a. trtas Osr kof ysiraolaf Is tstly la analysts. SUM* laUralulMM mI4 Is n**ln4 to sbllfroa wtao rboa yotal oa tbs cbooy brsslaf tbot Mnb tbs nlsUn |ptimUf>s sf tbs aoolontlor sat yst ay la tbo 1110`s Mr oof Wt Marta f tbls hi forms of tbs fifmnt Wof roByaaofa. Mr. Fro(si's U yolatof attb toof ylgmrata sa laslfo trtoo. At t*dU* bo**, Wms h , tsMiiMsf fvrtbss I* tbs , sar yortWalsr bssyHsI, as w ooywbm frsta taa nlrnusfisf of ksf lourb, *t*c* b* bos >ltl is It rasas *< loaf fadsxtrolio* trtovolly. Vory fra *l tbst olr nonMislUs *f |s*4 hirsts uf of tbrso nas frara aay stbor Barca. Ws hsar aa Unto nuMmUgr stars tbrsabaU bossto, *Us srrooUool rasa af a rbflf frrso tbs roastry abars rswfsnf wlU btrmlssttot *f Issi nmtlso yov oa olf-fsrbirorf |r*f riototolog asatromt bo* bora bras os4 tbs ybyoirsl stotos of aBytryrra. bov* syflaf ts tbs rsosbor'a alyylr* sr aMttasf sf tbst foM I* bon^nto oar srtfroca of sttbss froak art. bat yrartb-olty aB rotss ars fraB lbs stry os oobsttakol btottnttoo sbray bostoar sf tbs yrrlof idtiiml Is offtlka to tbs nsfooMK; la tbs M4 sf ta. tolba. Hot saysas bof say saysrtsaa* stt bsohh yraUrtlaa fos Its s*t is|t>iia. suit* latoolrotlsa frara astor frora Uof ytyro, arats la* nnt boa tbs trayroiltoHHy for nfstf sf Ha ytof tsnratls*? wrl softs no Imsaa of arfloory sots As Ms. W* bfirtt tbot aarb a yroblrsa scrsriaf abaa tbs Fraob bos bfntsf, rsrs sto yrofsrta Boy fool si* water sayyly la tbr olfrr yort sf too Fra aria* rssiHirolli foosttruco sf Inf, oof n arraalto aoa is as* 4- D-sHa* tbot tiara, tbs Irof mti st lo- tVry bos* aw* abtcb Vrloy (boa lots sootort srltb trrorrf *aKr s 1st Is lb* valss ssyyty la aaa area. tbs yroyarstisa os ssr*lo of fool. Ilksf softs stoaflo* tbst tbs lafastry bos nlbtoiff arrsytof aWtrb a* Ibsaabl yrrfosrf a bossrf of kof tartod. atlaa. Has OOysor rtro bof ssyocUaca attb tbot? o slooforf sf tbs ttsolHf sf fi* Inf wblrb smo W stfstof ts bt sstmtif from wslttorr sarfaroa. Is Ibis r*srf t waalf libs ts rrfts t* ssor scysrtsstes * bof o* tbs WiO Coost stlb tbo toofort f saaa lotfrryrrty ytosrf oof yolotrf ftibos frost ya. A A boat*: Cosra tar afolta atlll tr aUaaa fraB ttoaa u Usar, yottkalorly la ratal tma. abaa wotaf k aaaoryof to a la* fr*B a Syria* or a*C la a >yta of Uof ytyro. Wo ao* sasaa of that btatf fraB Itoor w tkaa, oaf tbro tbrro ara aka arrarlBil < lofts Aaolyois sbossf tbst tbo glass to *11 coolots as bleb at US sotrostoMs kof. oaf tbb was Irrsrf to to a fsUir bsoltb fiflm tsss* M aaa frit tbst sssttosof as* sf ftobrs attb aaotaMs rot** oat ta> aa* htoils* frwlnwrwtt arbors tbo 1sttoy Of woUr Hi* Wtlta liofraotolalog lath* Botsrtal fanlto, for a yrto f. tat a Mgb Irof aaa- Uot to tbr wator. :'. - v - , Uatotc* roalf rrsott la tatgoatka by toaaaBsn sf raoagb loaf ssss a % itli I sf list ts rssolt la lb atoo. Tbls yroblrB bos bs*a rortrrlaf attbist aay Tbror ar* rorr. bst tbrrs af* la tbo lltsrstsra at bort too royrsts sf strtasl syifrask* sf tbk Uof la larys anas sf ara taisilag fmltyiaisto. srrisas roots latosWatUn. I ass tar* that fos to tbo sfforts sf tbs Bsaltb oaf SoMy Ptslslsa sf tbs loaf lafastrtoo AssosioUsa sacb fsstbsr or* oralfrf la Aasortraa HrSostry. as lust: | aoat ts toy Jast sos thirty for sat l*4s*try. loaf r*aif i sots ft*r as asrt Wil (toss. Oar lafastry Is tokraaUf tat arw roorhrto. oof | ass roarlatof tbst ara yrofaru ar* istaf to r CMAntMoM botrsncM: Oar fiacaasloa haa foM ralhsr far afktf from tbs roTomk lafastry. Oar Baal paysr tbia ywralay will bs by Dr. Ilotmath II. Arbroab, Kisrstir* IHrortor it tbs ladootrial llyytmo Foarvfstkri la PHtobargb. Dr. Sebrrab win syrota sa `ll/gtoak Isaf Stoof. fairs ora grays rhlas abkta too Is sttslrnf Ina arfs," a Tory bmof snbfsct. - "' ?'- >: -. . ' ; jl ' A tiAiti ii irf ii ' i M^ITiitW 90 SC1IKKNK 111 coatnd to thorn point* vrh*r* ttolnh in U year* indiratoe tkat It ha* booa a rooaooaklo needed nod al th# u j m tom* aentny u a baeia value. Tkls doe* not nereaaarily avake it Ik* for aebctlay the typ* of cooUtil moot dcelraUe. brut choir* nor demcmetrate that oilMr value* of la lb* MtoUUfmMt of rootrol nt*i> the name yrnoral order of magnitude, *u<h a* O.i irn. air analyaee raa to ueed to check Ik* efToc- nr 0.2, tnirhi out have proved juat a* eatiefartory. theeveee of tto enyineorby fncaeurt*. Tkui air io fart, a etandard of 64 my ru m. kae recently liuinn hava a vaiqu* rob ia tka prevention been adopted by ACC III aod tko llyyiealc Guide* at harmful or otjerticeiabb iJicti from eoriroo* Cpamltteo of Ik* American indutlrial Hyyieo* mental reolamfaaate. . AenocUltao. Tko oatvo of eoch analy*** U awanlnyful. how- Tk* aula compound* of lend encountered la fw, oa*y when Oo| can bo Interpreted is larva Ik* aiormy*' battery plant wore: PbO. ph,0,, of prtotitlal buirf; hone# tko need for hygienic Pl/l*. aod rbiSO.lp aad Ikorofore tk* fiyurv etandard* for tko oacMinllM at rooUmioaota O.IS. previoculy quoted, nut refer to iTjinaorl In Ik* air. Itriedy. hyyieeic itufirfi for air to theae material*. Howrvor, tk* fiyare b trail ceocuwtratba* aro board oo laboratory rtoearth . time* iwod to refer to k*d" la aa aB-tadsatoa oainy aaimab, and Arid etudiei corretallny tko manner. Tk* ASA etandard la Umited to load Btedkai ibwnattou of npoeed poraooi ertth and It* Inoryanic reoipoond*. carbonate, aulfate, data o* Ik* nanMnlioa of cuaUmlaaati to Mt*. nitrate aad chloride. Whib it b Imprerti- okIrk lboy aro npoaod. Limited kvmaa experi eal and ennocoaaary to aatnbllek ladioidonl etnd- mentation la Ik* laboratory and exportroc* in ante fur each trod compound, it b reollatir I* Ik* tte* of a alaadard aorta U aabotantiaU ha make dlatiortioa betwore aolobb aad iaaaUbb validity or Indicate a Bead for minks. Tko better compound* in uatebibklay itnadnrdi for ayutemk Ik* rsrroiatioa betoto a air ccesrmtratioo aad poitoeia For example, tvro etandard* wore mtih offacta, tko fiMtor Ik* reliability of tko etaad- Hiked for aranlurn aad vanadium coaipowndi, ard. one for aolobb aad another far laaofabi* rap ' 5 II la aaaaiamety ayrood tkat Ik* Iraruiatko of Ik* reoedte of aahaal eijwrimroli la Iona* ponada TbU *am* principle abonld apply to b^ Compound* and 1* prooooUy nnder cmuldoratloa of kraaaa reepoot* kaa dofloit* limitation*. Hear* by a coenmiUoo at Ihi American Standard a factor of aafoty la a**d aad tki* aiay vary ' AeuorbUoa. . ' ; . widely. A etandard bated eo aaiiaal data aka* Aaotkor impoctnat farter la retard U air ia aaaattj leaeldirad toolatie*. Slaadarde bated rtuvrooIralion* U particle *b*. Tk* offretire dm* m Held atodiea ara, ia yoneral. atm retiabb. of bod l* tkat portion which mark** tk* Way* Hot cwiny to many farten. aoch a* limitatioa* aad It abeorted bio tk* blood lima. Tki* b of air analy** (vrid* (urtaatiooe la cooreotra- euppbmoated by th* bad which b retnlmd la lieaa phyeical atal* of tko reatamlaant aad tk* oppor reopi rotary tract remored by tk* kumboo at aaalyaoo otoatly oktaieedl, lark of actioo of tk* cilia, and ewatlourrd. Sine* probably Jtrocie* dlaiwetk jmndem oad Ik* dlfnlty * of lhe rwallowed kad b axrretad uik of eotimatiny part exposure*. Ikeo* valooa aleo aorbrd, a bry* poctioa of th* bod which enter* aro oelakfiekod oitk do* reaiidoratlo* to factor* tk* reupirmtory tract may not be nh*orb*d If of aafety- la e<kor wvrda, oeiay Ik* bet teU* lb* particle til* b large, and tk* air cooroetra- avaiUUo, hyylenic edaadarde for air rcfttctlr*. tkm. which it determined ia term* at veoiybt tioa* aro ecd kiykly acrvrat* tied value*. but may *rr*rt* the oxpoeor* ceoditbm*. Oo tk* ralk*r repototal Irooda of aiayahod*. otk*r hand. If all tk* particle* are pritewt a* a tlaeed m tko molt* of aa mylntoriny aad finely divided fume, tk* effect may b* eoenowhat medtoal ttody reatdacltd by Ik* V. 8. fiUk OedereotiaMled. - - HtoHk 8ervk* la a Moray* tottery pleat, H oaa It It not o murk tk* etandard which b ftsafiy tomlvdod tkat. t.iiejl tar prolueiyrd mpaent oUldiehed, hot retkvr It* proper am which b .5 it appear* tkat Ike limit of aafety under lb# con mart important. Tk* evaluation of Ik* potential i dition* encountered la tki* itady it aa atmuopkerir cwaeeolretloO of lead duel or fume* of kaiard of tk* environment ahoutd h* on]/ OM tarot of a weft balanced pcoyram, and aknnld ha l*a Ikaa I II miBiynm* per Id ruble meter* of correlated with vaytnmrtay aad medical roatref air." Prior la Ikit, a valve of Ok oty cu at. kad moaeure*. beoa Vted by mane. Olberv irci* of tko opialoa Ikal 0 1 l vac l> k*v and Ikal 64 my >v m oaa Bypbab Standard lor load b Uda* more reolletir Nee ectkaleat, a,nee Ike public*, la view at tk* limitation* of air analy*** and line la IVU of Ik# etnrar* battery rejvrt, Ik* tk* fart tkat aijuwure to bod c*apoond* Kaa hyylenic elaadard tar lead kaa bee* ytneraily moanlay only If bod akoorptba occur*. It era* accepted a* 6 Ik my tv m Tk* fail tt.al tkit natural I* Ur* to Ik* analyeb of bMoyical tlandafd kae boo* veeej aatrtoaefvUy t*`f abnvl malenali I* prwvid a meomre of bad ak*orp> V. -\* w- - , ; . ...... V IL~ 9 "I i HVC.1KMC IXAD STANDARDS Uoo. N umeroua *tudle* Rat * provided Buck quantitative Information on th# reiatlaoahlp be tween urinary i*ad rec/vlion and Mnnljr of *xpoture, And Ik* analyaU of urin* epeeI men* l* probably the noot common procedure for rraluatInjc trwd expoeur# and abaorptioo. Normal urinary lead excretion carle* from About 0.01 B# to 0.00 mg per liter to tart* umpire of * liter or more, and from 0 02 m* to 0.1J mf per liter la (pot (Ample* of SO ml or more. The b o a a value le la tk* order of 0.02 mt per liter. Valor* of 0.12 mg and 0.20 mf per titer Ra t * bee* fecerally need aa aa upper (of* limit for urinary le*4 excretion. However, con centration* conaideeabiy la excm* of tkee* levrle bate been found in tk* abeeoc* of nay alfaiAcant evidence of lend petaonlaf. Coovenely. evidence of lied poiaoniaf ka( ooradooaljy been obeerved erttk cocoentratlcpr le* tkaa 0.11 mf per liter. A* there may be aa overlap la tk* dietrtbutton curve* of urinary lend trreta la uaeapoied and oapooed penonad, a alaft* reeuh ha( tittle me*aInf. Repented nnalyee* notInf trend*, and the Aodinjr* In a fruup of expoeed peeeane, reveal more mennlnffal lafonoatloa on Ike mafaitade of Ike eapoaara The kifher tk* leral above lb* normal raar*. the greater tk* likelihood that poieoaJaf wtO error, bat tkere It no (pacific level above uhirh It caa be elated that poiaon* taf ealeta. la other word*. artnary lead aaatyum cannot la tkwuadrn be U**d ta dlacnoo* toad poieoalaf, bat they in of vain* when ueed la conjunrtna erttb other d*U and clinical Andlaf* la tbe mhutk* of the (lfslfirnar* of the npeen and la Ik* diafaooU of lead poUoalf. A* meotiooed prrrloualy, urin* analyam may ladlrau a loer level of abeorplioa ore* tboofh air tencentratloae may be blfk ootaf to larf* particle air* or insolubility. The mere* of tbl* ike may ocrur. la on* inetaoce la which air analy*** aboered ealuea well withi* acceptable limit*, aad th* urine enlueu wore quit* blfk. It me found tknl lb* npoaur* wa* from u aourr* vitaid* th* ptnst. Thu* tin two proredureo tan ho need to rapplemrat aack other la rvaluatiaf rapoouru to lead. ta nummary, dtkoufk a ataadard or limit value for trad kaa been aaUUUked, la pmetire a altdlnf aral* or raaf* la mor* roaimmly weed, for aaampfa, value* below 01 aif per liter of urine may In teMwidered of little or a* alfalfi* roar*, value# between 0.1 mf aad 02 mi Co*- etitul* aa Intermediate nee, aad tncreoaiaf vetue* above 02 mf are evidence of kaaardoua lewd eepnour* and th* need for Iraproved ** flnerrlnf control. Deed In tkla manner. In con junct bw with anvInnmmtal data and medical finding*, three need be little rootrover*; refard- Inf a alnft* alandard for the concentration of lewd ta tbe urin*. Myqlonk Stenderd for toed k) Reed The concentration of lend In tk* blood alao pewride* a helpful Indrc of lend expoeur* and nbeorptloo. It |W eervee n> an aid in the diafneeee of lead polaoninf by provldlnf definite trideer* of lead abeorpllan <- >d l* particularly valuable to case* of uoaepedftc *ymptomalok>fy. {Hood lead determlnatioo* have tk* advaataf* that th* aampi* caa be collected without th* active cooper ation of th* individual, and without th* riak of coalaminatloa. Blood lead concentrelion* nr* lane variable than aria* value*, and in rare tartanew* of kidney Impairment meet axcemlv* Abeorp lioa where urin* nnalyee* would fall to do no. In funeral, however, tk* ram* principle* apply to blood connutrntloo* a* to urin* coacuutru* ticeu: aamrty, there la no tpevific level of blood lend which caa he Interpreted aa Indicating that knd poieaalnf exiet*. Blood lend cowcootratloo* of (ho order of 041 mf to 0.04 mf are cem*ld*rod within the normal ranf* for prveona with no induetrial expoeure ta tend. Value* between O.Ofi mi and OM mf may be roealdend a traaaitloli on*. aad concentration* above 04fi >af are In dicative of unaafv oxpoaur* aad that coertruf meaeurv* ehould be iapraref. evvu thoofh a* alfaa or aymptama or clinical evidence of lend poieoalaf are perneat. There may be a dleigre* aaent rvrxrdlnf the fifurm fivoa; however, th* ptincipl* of a alidinf ecale U rrrtalaly mild aad aa ketf aa the value* are need to evaluate mpoeur* aad abaoeptloa of tend there la ao nood to place undue aifnlficnac* on a (pacific fifura. Hyyleni* Standard far taad In Printinf Water The aoUbllehawwt of a hygienic ataadard for tbe had rontewt of drinking water prevent* a amnewhat different problem n* th* Opportunity for control, monltortnf and aurTriilnac* la net na rewdily applicable to tk* feaeral public a* tt la to Industrial worker*. Since at lawet IK! th* V. S. Public Health Service ha* placed Umlt of 0.10 ppm of lead to driaklaf water, aad a water rapply avey be rejected If th* roacwutrxtiea I* above Ihi* level T5* rveulta of many anelyiee ladleal* that th* mean daily lend Intake of th* arornf* Hortb America* adult U about 02 mf of lend to food and bevernfee. This frame amount la eliminated dully * her* * there It An equilibrium between la* take and elimination And there le a* lewd fdm tlon. Aa # perimen! la which aa addltkma] 02 mi of lead per day wae added to th* avertf* normal tntak* of 03 mf, making a tcSal of 04 mr per day, rveutted In mm had retention. The mIi level of lend Infection In foud and drink ;'y y ! *. * , i mm's i U '1 cv' V i a nivi'ssio* appear* to Ha batwroe OJ my and Od my por day. The limit of 0.1 p**n (0.1 nr Pr IIlr) of aad interpreted within tha framework ad tha compreheneire knoeriedya of tha bioioyical action e lend for drinklny water therefore aeenu renaoa* of lead. ITyureo are not a auballtuta for aonnd able and nolU/actory. The keel apparently li Judrraarri. not hard to meet, o the reeull* of the analyalo of drlnklny water from 34 ritlro la tho Doited Staten tr a mean eniue of 0.011 nr per Iltrr with a ranrr of 0.001 nr to 0X14 nr par ltUr. Cliaian AM aowncTCB: Tha medeot lady who la |tdo to load tha diwueeion of Dr. Sctuwoh'e paper aald that aO eha cared to haea on tho HffMc Standard for laad In faW - The American Standard* AanorUllon ha* . .prorram waa tha erord "Cuoanhnet" aftar bar nun*. It la oaly right. thonrh. that wa ahonld aay for tha benefit of tha few here who may not know, eoUblialwd "Amerkon Standard SparifkaUaa* that Dr. Xaytre waa for many year* tha head of to Mlnimlw Hazard* to CliUm from Baaldnal tha medical work of tha ewry aarotlacl Dirtaion Surface Coatlnr Material*.' Tha atandard waa of Induetrial Ityytenr of tha New York State tho raoolt of action by a aubroanmltlco of a Sot- Labor Deportment. Peruonafly, I know of faw tional Committee on Haaarda to Children. 44, orynaUad on Marvh 12. ItU. Tha acop* of ac pmpda to whom I would turn more quickly for madkal adrko on induetrial land prntiliciu tivity of tha aubrummltte* war 11mitoi to tho potential hazard* to children ascii a* miyht coma DtSOnSON frooa tha handliar and naa of pointed artkke, ml ma t a. ma t k k s ; VftfdftvMMjr, am tha haaard briar from toxicity of coatlnr* chrw^ Mm M*< M nrtutMj bf turn><* < yw^iiiiKal' off and twalloirnd. Tha atandard aperifkntioM atala that "a liquid coat iar malarial to be deemed eoltnU*. from bmhh alandpoint, for naa ca artklra aoch oa faraltura, tnya, ate, or for iatarior naa in dweftlnr aalta share it mirht ba chewed by children (0) ahoQ not cootala trod compooada of which tha land coolant (calrtilaUd aa 1%) la In canao f+fU. MthjU; ffrwpA wtU tto toM totoM tMa to Ito t w M, U|Mm tMa far aftckj pr- yifi TVla yfwU w m mt mm yitlrn, . Wr tm nML to i<rtfaft Ito MUfTiih tto| art*k to mm. iia II HU to to mUa to rw tom tM af aafrtf rtaatorto mw4 HHt tto m *itk tto ki|W Mtoar, mi tto tkury Ual H I* wfrr to wm tto tto ><Wm. TW| 4m Mt MXxtoU tto fftct tto tto va| to vtok ttoy vfl t of 1% of tha total nrairht nf tha contained aotida mm tto tototoMM. ftto HmmSt mI m4 Mm tinclndlnr ptrmcnU and drier). . . * Thia tofkMl yrafartto wttotor H to m |ftoary tori* atandard la applicable to a aadh naa, nod la ` ' tha only atandard of which tha author 1* aware which Umlu tha tend content of paint. It woaM appear loftcal and rename!4* to aaaana that nay atandard daallnr with tha lead content of palat. from tha vtewpoiat of a honlth haaard, would ho hoard an arieotlAc and teebnotoyk daU trawMitoi fifmtM to Mtottor H ma to waf toW/ far |im ton* tu tiUtfm ywttto to tto Ust mt aafi<| atototo tm mm Mtiluma tto* to vUr MImmm M Mi WH a 4 <wt kkk to tofftoy <>a|*r*M la Mtort. tto mr*t< at; to m mi*1) ttot W| mmm to toato lafutrAttoi to ftflrUt to A*Mi A*4 torn#* aad not on tha unacieotlSr concept that, almply raAf* mm Miana^ tto awt^cA to mifif to* harauaa a aobatanca la "tank,'* lie naa ahontd rw^alrt to aU*4arto It to U^rtaat, '-. ba arbitrarily limited- It ahonld ba a fuadamewtal ttoffart, to rtamU amylaTfri to aatoiUnf ttot 'i concept that a aobatanca raa ba naad If it la abvwn that It* uaa for a partkolar pnrpoaa la tto Mtfrtala ttoy vtoli to m* muat to wtwto to ft; m tto to*to if (Mr r*i;arti* ywttMa to t ~l aafe, and that It cannot to rncluded almply bo* CIM* It la ttaaaad aa a polaon. tototottoa f Mra Mft; itaafirto. KaMtom Alap tom MMiilitai af mm ttnaifl art <f ac|tt tovt Uw m. wftikli ma Im Umm aUmfiAf. :3 * Summary Atottor toy rrwmp MfcWfc toto to Wi*4m* mm faat*M toto tto frftwHktl yy4ktto af Mfrty Mia I -5 ll baa bean daarty demonatrmtad that land irto MMyrtoM ttoM vto totk to toftototo tto* :'*<i armra In tha homan body wtthoot any adearao effect*, nad that a Imlr rwepuo** depend* an toto m4< nto M f*r af * farrwMit. Aa t>r frkrrAh m toO y*4nto4 wi, aaft| concentration, batiefactory hyylenle ataadarda rttAiarfa yrartto finttoit tori mAi aaf ftJM for lend hare loan oaUUiaked, and It ha* bean to MAtnf af tto IfrfortrtoJ r*tr**ia*t Dm to 4 demnnwt rated that lend can ha naed aafety If tha aiomiarda ara u*ed, end u*wl |Cw|er(r. Tha aalele rwUa# MfM'MMCt f (rfl rHintrrawi*. ttora Mto imd ; priMltoAl ItoHattob* to ttotr *fWMaa. Tto MMtor mt mit f* aAr*fto. aVWk tmm to li*hmant of etrndarda I* not an ohjertlre par M, toto* to tto wfiAAiy imttm *4 to# todHAMatt, hut rather a mean* of uldelnlay aa cdijartle* -- li ti*Mattt; liwfe-4 -- mmiMUmm to aiy mwm af tha prrraetloo af Harmful or objecti<*r*14* af- to *Ai)-to T>k to ift to to lAAim**w to **%lto fnrta Tha flruraa |tm la tha ataadarda haea tto riUat M tto Mtnr# af tto yarlMa* i mean In r oalr whan need by rempatant perwone lari; tto *r|M a t totomittoat *tf*MM mm to M THURSDAY AFTERNOON SESSION to *h I y nUitito tm wllrtl to vttiiM'i npf*wUN IlUfilWM. M*. t . C. Osr #Ut* U Um#4 vit* rtenia **4 a rrrjr ripul Cwwblatw sf IIriU) *f tto Ot/ ftf vVs it U 4*7, lit* mjf Suu Dlridr a/ Rylti W# (utn Wot# m tlk* Mt*14rfaUM of tto iiwai U fofvUtW* rvialiatf U Ux psrotissiSts tiA f MUrUit. I vvJ4 Hto Is Mk4cr*4M Wsl f>r. fefeftok U m>4 la IU mri*4ta| fffyrka, ttot ttoss (MrttoUr MAC 1m M4 to fMs U ttouRry i%Um ILm to MAfcU<7. ' 1 cmAM4 fall rvptf to tto rtoA i4 fr a mh h u if* n^ryabf wtot to a m Is a pfeiM tof* ttovt (to *UbU*hmst of (to* tfcJvss. It my ***4 food 1a a cvsrtrot**. feet vto* r roans U 4rf4 fun m4 */ tKit vs to** n - IM vjilk (to** MAC v J***. Oist tms *t to to to Us irsl A tofrus* It rtlU to tto Jsry, A*4 tto fr**7, lisM aft** Um. vtU t*4 for tto pUtoUf. . dutaniN Aoirpfrrit: Wt at * *ctodJs4 "*to ivoarwt* tfci* Aftomooe At two o'cWk witfc Dr. tonwl CV KcCtt to Oulrmju. Is tto totorim. Ivnrtoa will to wrid At 1I;4 to tto CU C*t Kooy THURSDAY AFTERNOON SESSION Nvamlr . W CMAOUtAN Mica: I ilmU Hko te take tbla opfonmUly. aa a tsteot of tbo Lead ladoo- Irin AaaoriatUm. Is >miw toy for lh Im |n(ra which bi b< irruni Unsir dtia. I aaaotna. Is tlto offacta of tiuM IWihi. I bps that lhaao who tn laleewtsd to diaewaalo# Use papere will try to auko Usair nacib to Ur poiaL Caw tUo aimpkiac ia tkocoatar tUU aotUat pvacaa bkicri Timm, araia, Unllfr jrvorwtf, bacattao otbccwiaa oar otoaocrpi* wtS ao< ytm, aad it will bo lapcUM for U* iKiqtiMt record that wo kaow who aoid wfcot. * Oor Ant paper, *Ttw Lead Coolest of Watar feoaa M tn4 Paialed Tanka," wiB bo pteoa bp llmer it. Eftlaa. In rector, Stato Dlviaka of Ocrapatioaal llrdm, Use CoauaeawoaHk JtAtotoMAAAtMU - . .. . . 1 0 M k . ^i^ryv^r -U'Wz&i ' ' ' vS*-' */'*' Jill jtlianirtnMiHl $ >$:; iwi M Z1X1XS drlnklay water. W# found them wee* threw U*t c o h UIh ^ onr .1 my of M per liter, end Ice* then i ray. Throe aampWe are *U from tanka not la artlv* aenrlea, bt u*d In land-by *ecvkw. On* of thn m from a tank that had Juet bceo pointed with K AT Kln.f point Tb* Other too <r*r* Iron a tank which bad beoa painted about throe port prrrlouajj', with th* Type I point. Apparently th* water la that tank bad very definite lewd content. How can w* recooriW tbeee rueutte with the Bndlnya of FalrhaQ aad Fraaer (f tb* FobUe Health Service that lead dUaohaa freely from lead palota rath a* theea weed la tbeo* etaodplpoa? The obvioua pianotic* la that the teatar dooa at etay la the teak loop eoouyh to pick up appreciable anooata of bad. The three etandplpee atodied moot therouyhly were la laetltutieoa where the dally water cuoeaapUo* approximated the tank capacity. We bare carried oat a few panel etadla* la oar laboratory and. la peml, confirm the report of the Public Health Secrkw. that appreciable taoeeU of lead are dbaolved. oepecUfly frcea Type I paint. Aa a matter of fact. Type t paiat with Hthary* added, whkk. we anderetand- la frequently need. ree aff appreciably (oore Wad duriny the Bret few mo*lie* than the atniybt red Wad la ofl. Oar rooulta, coaeerted leaf el lead dleaoleed per equate foot of earface prr day. are aumaaarbed la Table UL Taeaa UL tcaaaar oe raicaaa Kaeei.ee OlW____________ mo I mo no T** T>w> l* lothMOlw'Of'w M tn mo*l lei *wO* to . .. aa tie aa ear net aa* Tb* Bret twe week* la which they were teeted la w*t*r. tb* Type I paint with Uthary* yore off aa aeeray* of 11 mg ef bed per equar* foot per day. Th* atrelybt Type I paint rave off Wea than half that urnnt, aad tha Type IV paiat yare off ooe-tweatleth aa moch. New If w* taka the ever*ye retract kw ef Wad for tk* Bret nine month*, w* Bod the rale la yreatiy reduced, aad It amount*, oa aa averay* of tb* Brut ala* month*, Inrludlny tb* tret two week*, te .% mg per equar* foot per day for tha Type I paint with lltharr* added, a III!!* more Ibnn half that much for th* Type I paint and about a tenth that much of lb* Type IV point. Actually, with tb* Type IV paint, lhe eaperlmewt only ran a IHtt* over three month*. If w* aaaum* tb* earn# rail* of eolation ef Wad from tb* Interior of a ylvea ataadplp* m era* found la lb* ponol npertinent, w* caa con*, put* tb* rat* of water turner re neoded I* keep lb# Wad content within aperifted limit*. Sack calculation* for a etandpipa M feet I* d1 meter and If f**t hlfb are ebown la Table |V. Thla la a amall elandpipe (about 100,000 yellow I, aad repreueata ruthar aa unfavorable ratio of **r facu to malum*. Taata IV. Traaorn or Vim atm Caictxera* Lt*a Oaermr Nm TW alto* Nm>n UnlCamm fl.lb.my TVfdlMrfhO Ty#l Wb 1 * Inf rnand^ N 1 tmdhi WlbiilH Wi 1 Ut U il a1 M 4-1 Ml II 41 HM UM ItM HM Un Ktn It la aeea that even with ell boat paint*. dally cocaumpttou of Wea thaa th* capacity of lb* ataadplp* will nwatt la a Wwd cootrot, from tb* point, of lean than oo tenth tb* maximal allowable Ireel. With tb* Type IV paint, a muck lower coneoaption win yield the earn* reunite. With bryur tanka, a lower turnover t* nulid to effect aa equal dilution ef the Wad, aluce tb* area of tb* tank wall* aad bottom W Warn fat coewpariaoa with tb* volant*, than la tb* tmaSef tanka. Coeivwrueiy, with emeher ataadptpea a blyber rat* of water tarnever would be needed for dilution of tb* Wad. ;- I do not believe that any of tbeee who object to tb* aw of red Wwd paiat la etaadpipe* aari- ouaiy think that eoouyh coatamlaatlon ef tha drinklay water wiB reeult to peodet* a atyaiff. rant number ef car** of Wad tetoakntto*. Th* permtaribt* limit of .1 my per liter provide* a aubetanttal maryln of eafrty for the averay* In dividual. aa It ebould. And, accord!ay to our Bndlnya, thla level waa net even approached la meet of the aampten, ace would It bo la meet ayetoma. - It baa been preptoed, however, that *}- tbouyb Karmfa] Wvvb ef Wad are not produced la tb* drinklny water, ary larrvw** at *0 la Wad renauaptlon 1* undeairabi* aad aboaid be pea- vented. 1 ran ye atony with thla orfoment to a certain extent. If *0 tk* water tenaumrd by a lacy* population tontalned lead riykt up to tb* permleelbl* level, a rarefal eteliatkoJ atady mlyht reveal marrInr harmful effect* to a email number of Individual* with eeropntlena! or other rtpoeora* te Wad. elacu tb* amount *f adtllUceial Wad Intake required to produce la- tuilcatlon would be aemewbat rudured. A* tb* Wad content of the water b lowered eutwtantlaOy l*bw I my I, bowvvor, tk* law of dlmlaUklay return* would apply. I doubt vary murk that any ( 1 i s: i" * 5 n iri I 'll attii *Js3f f x;ix* WfPrfl !15 9 ?\\m f|f|Jfi* lk iffiialf' rHfmr? 18l WMii' f!e$sXi^ , ;-jm^ 0W.'SB*.: m> .'< .lyF'-av# ' I"'* * 616 rS I sHja!" !i iiHSH! !'i! t!! i| fstit :; ifjjl it liilniilii tiitimm UsIltSifrfU !i lisilli ,<iiiiili!ii f, !j[j5 tig i fhffb MrSlI 3-1 flfrfa *hJ ?!* tfmmmmr l *4 d is c v s s io n that jury may raiarn aa th* *4kt ayaliut Ccast+j>y A. 8 cr C, *at thanfon yo* aty wall face tha Boat dletr--lay llllyatiaa la nr ceronoa lav coart* that yw no iawtM. niiiiau urea : Th* diaruaalon of Mr. Wat ari' paper will t* U tr Mr. Arthar S. Johna--, Vlr# r--tderit of tha A--ricaa Mataal LiabiUty laaanara CwpMf. - MCUUIOM n. aarvot a. aaa a aaa: I vsat ta --ha thb |i k ii ] Aamtln aa UitrmM --Uriah It b etcher w feat lack ar goat aa y*at ayiaeerl-- wnltw that tha A--rlna Mataal baa tiprlearef *alr II ilbH l>*4 pebnalay caaaa tartar th* Uat It pin Kin at th**a van aaa- tbahiiay. n--irtay aaly Baikal trial--at if a frv WU la a tartar aat rary ahapb nedkal can. Of lha Ihna t--hiwy ram, a* aaa aa ipinn la aa-- --Hat bat hy a ana ah* aaccaif rather a--a eeaeduei thaa acher*. B vaa Bit rM; m, rat th* n*|i*mli* panaevt tbit i--ail la vifh. Th* --at aaa a aaltir ar aeityba* haraer aattai aa --a* palatof ibt, aat thb lantnt a frv v**ha af tnMilr. lactoevtolly, I aa etortbt that ntily UUW aheat ratting *p yitatot Meat alth atatybaa lanhea It b --nr aa* af th* pnhhr aaanai af bat > iluaiay. Th* amp jeflMey b j*M rieltent ap with M. Th* hail rae* ana aa leii --tin *a* ft-- th* byil patat af ek*. It va* aa aipaaan t* th* haaarti 1a a --ebtay aat ndelf a--paap. Th* --a hat ta- Umituet rtyeeare ant wry hetrf expo*err. By hebf I --aa he aalh*4 atreei th* premier*, hat h* hat Mhio( la t* Vtlh bat ar bat faaeae ai each. Cipeaara aa* rinlliret la--iWint ta pra- tara hb reaflllaa. hat th* tatretrial Cinnleet** f*aat ta favar. taraae* K va* tranaetntat that h* tit har* bat paieaaiaf. Their Male--at vaa that It b prkaa fart* ei'lfear* *f *rrvp*ti*a*J tiarha*. It b th* a* tent*I*--at af tha try that th* lerayiaeiHia Uva af th* meral Matai an a*t eaifeem. If aaythlay. naif W ten rhekic, I net beayiaa vhat It night ha T*t Watan epah* *f th* nnpinille* Uva prrrtotay rarla- tn nauly. tiirtaair* rinify, I thlak. U ayeiiwt th* --pbyer, aat T*t vaalt h* th* t**t la --y. |**t that N v*a aarlaitn b th* rat--t that a* thlrt party artba va* arallahli. The farartt* ipart tatay. If th* lav* f th* etaI* prart It, b I* tat* c--peieatl--. 1*1 th* ranfi aietlea nrrbr nhroytto kb labrrrt ta that aa--vt ef neeiry aat |e alter a thlrt party aarh at th* yeareal neirwUr, *a*thr natraet** ar a etppltoe aater th* prtaelpb *f pradaet* llahUlty, vit-li ta alt titrat* aat parptm tee mat* th* bjieet --player pahUc. A Iittie vert *e tv* *b*at th* HWralbatla* af th* bva hy eibatlay beetu. The raaevpt af tajirb* tally nnpaaeaMe aater th* etetule* hat a aaebva apart tartey th* lallalbaary y retat af tha bat half faaaa ynn. Thb haan M th* lav <f lateeaiity a* ippnet ta th* laeef a*ytiy*etn. Il *aet u ha that Ih-- ar f--r ar flea thereaaat taller* vaalt eatlb alnart aay rae*. hit hintnf *e k i hiatnt llty Channel tall*re U n--a tatay ta thru race* There ***-- te he aa-- rrtoeetri, haweaer, that vtlh th* iataUeaery pertaf pbtraitay tf, th* rala* af merry bvetlay *f, It axlyht he taf* to pntkt that th* net af (taka* v--If hiaf *t platoaa aff Uttb. ta*. I va* Utonatot ta T*fa entav--t that th* ariytaal --repi f arrttnt hat eiatiat tret to aar--|iaaa th* laahillty to aara vafa* ta* ta a pareerwl tojrry artotay aat af aat ta Ih* caarn af nyliyartl. aat h* hat tv* ar th-- catfart** af teeelcpaaiat than. It might h* a Hub to* Mnpla Then atm re Vila riaeidrnkll tfinaw ta tven Ih* y urceaal bjtry a*ttoa a* aarh aat th* tbablity a* aarh. I Beat la tahar thb a Uttb hit hmair ve --y ha --If tat* a pertat when tbiUlity aa a --an af baa af wratayi ar laahelity to V*eh y**a hy ih* heart, aat th* an fart af ye--*1 tajvry han--a th* rrltoibv. Lat e tah* th* pf elar tapir af th* pnnat ttaaa, teafana aUeyet to arto* aa* af aat tartac th* -- at tat--rial ray eaara. Th* aettoaa lary bt--a th* aniral atataa that an Bvv pbyiay vtlh that ynhbm whether th* tnl-- a*-- han ai--paiylf It a ttaUKy aa amarrf hy a l*a* af aaratay*. ar teafat** at a peneail bjery ta vhich teafa-- fit* palt ten peaaatlea. Thb yaeatlaa af baa af aaratay* haa alvaya he-- a tovyh Me*. Ter lewtaie*. * -- if nh--Mir a a--her af yean ay* vaa |aiy*f ta ha a ye--aarat aat total tinWitty aat vaa aanpaa- etoto. Th* raaa In net(airly y*t another Joh, atiS Mnpba h ta apparently pei health, aat hb aara lay* an ta ana* af any hr aaraat at th* nt |M|| ptart. I Vaalt IAr to aeaplify vhat Mr. Water, haa a*M with --part to baaiyeraeat art tateatray la girt Up eeertr* hy yraaealyatiay a peaaatar* aat th-- feeretliny H. Hb renirh vaa that th-- arha ** tahliehet c--leal *f bat a* aa apantlay paltry gal their Vewey hark --ay.fait. Lt -- rapee** M ta jaat a Uttb tt--at way. It b th* bl--ti-- af aar ta-- 1--yny ta hi yaitr winiay ta ta--n muito ayaiait atrttiau aat tajirbi that mlyht W teerrthrt M th* --ferereel n--ta that aria* avt af eparallay th* haebnea. Hit to been hialaeaa rteti, ar ta lie*re the laartlahle farepea* reartaele* af bat peieaaliy ***** srtoiay ait af taynel f*Um ta pnrtoe * eafe pine* ta avt b pitta --bite af aar wtrrvrltlay paltry. It mlyht ha helpful U vtat rp ay renniatl aa Water** papa* with thb aaa. It a**-- to -- that tt aelyht ha well ta aatahrlah th* th-- rrttarta which naet hr --t t* rrtahMib --aprmaMIlty ef a raw af bat pair--lag far vhlrh Ih* nay I .per My hr --yeaaihb aater tha r--ynutlia bv. I refer la tha toyel aapert aa H new U aaterat aat. Bei thie faitortir aa* if --niy romp-lay tajary. Tint, than aval h* eetoUlehat th* fart that < 3 3B o 1 c ifj p Pif rr i 1 i9Mi $* , $S mi m 'M -i |5$' ` '-fi | 15--* a^ I-- t< fi -? i *< ! m ,vlV>'4 4.Vr-i t : \i* . > i. . : M i* ' ; f. pyjpwpjggmgp^ .: * ky mtiMMay jJjtm/liiaiMiaSu jumiudlHf l*MnsiinifllSssi! ' "'ll mnHisaii! T > s 3* c n 5 >34 m 2m. yi s e a s o n a l v a r ia t io n in p l u mb u m 4T children l>M been attributed U earloea factor*. to high acixiroamenul temparatarae ar with a P.ipoeure to Ux mor# UUm nllrxrtaUt radia riaa In body tomparaturo."11 but 00ly thraa tion froa Ux eon la the tumnxr nhd the roeall* paper* bar* boon found which rotate tbla factor lag tncrenae la vitamin D baa bean Ux factor to load. Blackman* abonrad that rabbit* which moat prominently Implicated. Shafting aad Hoop- - war# aubjactod to JVC following a aarao-waak er" eugreated tbla tbawy cm Ua hii< (hat period of Mbmlanaooa Injectten* of Wad. died aiUmla D Inrreaae* (h* abooepfion ct laad (mat within lot hour*, where** thoa* almllariy In Uh latocUaaa If the diet contain* a high calcium- jected but kept at room temparaUira eretrod, low pboaphoroua ratio. tUpoport aad Rabin* aa did control rmbblto at VC. Tba body tom- to*tad tbla theory la xperimeou as rata. Aol- paratara af rabbit* at *7*C roaa t* or f *C A aaa* mala which war* fad a dtot eoetalntog laad aad caul vxrUtiontottx oaaceptibtUly of rabWte war* expaeed to tlx ana or glee* eaptlamantory to aabrutajxoop tojaettea* of laad eraa found by taw of rltamla D daily, led weight, bacanx Geomrth, at aLM tba avarag* aorrival time be ID or died, wlxraaa tbaea give* Wad bat kept ing mock ahortrr la aamnxr tbaa la whiter. la Ox dark wtUwot adtad rltamla D ohowad Oo Ux other band, Rapoport and Robin* in only raUrdaliao of growth. Added njfWt la ported that Ux ospoaar* of rate, which bad baaw gieao to tbla ultravioM rwdlatioa factor by Ox fad a high Wad dlat. to 40*C foar boor* par day. doao paraSal totwooa tbo aoaanaal diatribotioa had no apparewt effort on the animate to agdt* of caaoa aad tbo axatbly variation la Ox to* of a rla* to racial tamparatara af I* to t*C- . tonalty .of aatlracbltk radiatioa froaa Ox aaa la temporal* climate*.1* Although Ox torraan la oHrarloWt radiatioa Experiment on ERacH of Tamporohn* an Saaonpfh bty *f labaratary Anlwab to Uod Poiaonag* may aocooat for tba rmamor [ml la childhood Bacaaaa tba altnrtelat radiatioa tbaory did laad caaoa. tlxr* ar* aoox namna to doobt that not wen aa adequate oxplaaatino of tba aoaaonal It la Ox only factor tovolvod. Tbla tbaory da- diatributtea of Uxa* cbHdbood caaaa and bacaaaa patada oo Ox aaaompUan that tbaa* cblldraa bar* of tba few and ceafiktiag expertmaotel data`an : a low pboaphnroaa dlat aad'ar lack a normal aaaoaat of rltamla 0 la Oaair dlat. Altboogh tba affect af anrlrnoroaatal tomparntara oa land > peltewing. a aariaa af experiment# waa ondar rlUali O lacroaia* tba abaoeptloa of laad froaa taken la tbla laboratory to atody tbo adaeta af .t. tba got. Rabat aad hi* co-workara1* ahowid that anriroomanul Irmprrator* aad kuaidHy an tbo tltaala D bad no *017 marked adact oa Ux cow- anarapUMUty of laboratory animate to tend pal* cootratka of laad la lb* Mood If tba dlat caw* acnlag .> .--c .-,'<rs**%,**:;' talaod a high phcwphonx-low calcium ratio. Mica wrr* uaad to moat of the*# experimenta. With prepared milk fortified with vitamin D a* altboogh rata wart to*tod ocrnaloaxlly to cow* widely aaad by lower laroaoa famltlaa a* a major ftra tba raaulta on tlx mica. Tba two tamper*- aoorcr of food for tbair children. a lack of aoScl* aot vitamin D and a low phaopboros lalako tor* condition# etodled war* B*F with approzl* matefy Wi ralalir* bomldity aa the normal would not ba exported. FarUxrxaora. aadar aomo axpoaara and M'F a* tba high temperature an* . rondiliooa vitamin D larraaaa* tba deposition peaur*. la eoene caeca Ux bomldity xraa kept low af tba Wad la Ux boom. to Ux high temperature chamber but In moot af Another explanation which ba* baaw aaggaatod Ux experiment* a humidity of 11% waa aaad. to expiate tbla Mammal diatribotioa la that The body temperature of the mica varied con* children bar* awto opportoalty to aommar to aidenbly to both esrironmest*. bat tbo recta] ebrw extorter palate, which gaaxrally Cootala temporalor# of Ux alt* to Ux bet chamber* did mor* load tbaa Interior palate. Hooraar, data act imait more tbaa 1A*C *bor* the** to lb* from tbo Rah I mow llaahb Itejurtnxot aonoya normal cxpeaor*. la tlx Initial axparimanta Indicated that Indoor object* ar* Ux chtef group# af 10 to tO mica were axpaaad canttow* aoarraa of Ux lend lagawtad. ooaly to tba two tomparatorx* for thro* day* Tba other Important met ranmental roadltte* before and 14 day* after lajarttoa with lead. which haa bean auggwated aa tba farter raapow- They war* Injected either Intrxperilcmeafty ar alt-W for the naaaonal dUtrlbutbm of thane acuta Inlraveooualy with a aingte doaa of tend acetate Wad putooolng caaaa to children W tba lucre*** or oltrala aufRrteol to caux death In approxi to androamental tomparalort furlag tba earn- mately t0`, to 40% of tba aa Ira at T**F. In mmthi. Jurt aa to tba <a*e of ultraitetef nary expertmesl toatrol mica ** maintained radiation, tba monthly diatributtea of caaaa I* at each of the toot temporalare*. They war* In- Baltimore fottewa **17 cluaafy the monthly mail- Jartad with aadlut* aratoto or nitrate to amount* mom teaniwratura corra. A few tovmUgitorn hare reported an lnctxnf aoarepllbllity of ani mate to aunx drug* and cbxnliate with aipoaura f *>-- ~ \`X* ' * '1 ' /' * . -- .. , * : -ii'-.V.. ........... .. . SEASONAL VAHIATION IN PtAJMBlSU pnltn aUgbt lx oarrrUng Uou Wad Ihu thoaa t normal Umjxrotun. TSl* Uxory wao tootod by comparing Ux urtnu and fucnl Wad txrrrtica Rrftto TW Mto* to fttodrtwto fttot pwft to TW fttoi Jb*4* Um Ik rato it 73'F and (4T txnpmturo. Tlx do- Wrmlnollono abound Out Ox an 1 mail at Ux high c h a ik ma m wniATUnr: TV*nk wy murk. tmpmtan ramtrd algolllrantly Um Uad la Oxlr a hex ow a prri>i of 14 dayu foHourlag Dr. fl*et)r. TKft dUruMloa win b# hf Df. J. JtUua Jrx AwUUnt Trvimsar f Ux hlmxwi lajartioa of bad thaa tlx aal- frdialrkft. TW 4c 4m HopkUf Sebud <rf lUdi* nth Npt at rrr. Tlx doerrax In Ux outpat of Wad la Ux orltx *aa probably nitlad ta tlx Wwor taut aria# uolomu. tiara Kafcoa* tSond CiMo OttCUSStON that Ux artaary Wad output par Bait of tiax aarWd ta arrordanra arltli Ux aulnax of watar aarratod by tlx kidrxyt. Tlx total focal outpat of Wad *aa aba toainrtial baa at tlx blgb tot* prratara. A MiaWr of othor aaparlaxato art rumalty la progrant ta taut tarieua otbur Uxortao urklrfc might account for tlx larnaxa ta aaurapUbility of mica to Wad poiuoalag at high taaatxrmtara. It la bepud tlxl tlxoa aapariaxata aril! help to aaplaia tlx animal diutrlbo Uoa of childhood iaao. Vi 4. 4 naftUi. At Xa j I itoirtitUu Dr. |tdl)df ft ftftc ft**< tftUrwtotof WmlMto I itlrT1-* Uk M to H*f4t4*U wW( *W ku ftWtfti lW W ftf iiiwwit to rrWttrt&ft tW ftftto invlf--Iv tkto l Wt4 htoihtiN to rMtorr*. 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M-? >b Mv. kfc'' -SteaK' ; $&#r hHiHiiiiiill! rt m .. '-v.yjift-: -:;XW: -m 'iii'a'r. o p w <! Mf IF S rIso :8: .^44,- fcV j* ' j ..... . vVs.";^;-/i*L'V ?'**,*r\ . ".. . i*r1 ' i; . i ' ;)5v ^!: : ' .V.jS -. : - : : .. ! ' .'.!& SH '' *' ' sw i:. 1 " ' ' >-,t: ..`ivv*'"- *tr. ' s'.>? 4 'V- r '* . " ' uttH mnm.i I! s; s? ih [jr utm;t tw mm 111 rfc!*i [ si i;tm}{ iliUiin !; 1! lllMii! iiiiiifi! ill, It ifi !! Mil ** U k 1 >D t' if" I * i 5' x "". i. ; ! ... 01 Dis c u s s io n ' i Srftftaal/ aaaaatklaf trmm akac tint miwi It. K <rw, tW fuktuvRUj ^rantt. If > cu ampt plrkaft ap tka Saka* af palat, ala tka**. waa aaafta alrk aaft waa arat ta Dr. Bnftlrjr'a cliaW. Ml IcTlirrlMifU M l my aart/ aifta af rfl< arkaefta, Ifarytaaft aaft Joke* HapUaa. an karft i poaur* t* UU. Ml well U tka prertea I wu at wart wttk oa aa tkk pratlrta la BaKlatara. talking akoet. (la liUffmMt a id iararper*tlaa Tkla kauaa kaa aow b*e* porlrft aa anti far af aieia* *H4* aUetlar (oafwiaa lata tka kuataa fcaUutlaa aaft tka fuel]/ k attrtaft awl (*Ui ul IS# maaruptf natfi fectara Iaflii4 lata a kewleft prejart Wararaa It Jut Uat aafa dart. far tkat rkUft ta ft* tut aaft trap rhawtap aa Uk, Wa ar* ftnllaft aid a* *rpk*lltk a ittallaa aa a laWtHtf aaytay tkat pa atart aft pat It af tit# caartrel aaraaaa t|itm T>a aawjriaa tj tttaa wkan a tkttft raa tkrw H weelft aaft near tkk af lit Wala U Uaf parureUrl/ vpna tlta atlftaliae- altaallaa. A rkUft real rkrw eft tit* reUiaft. Ha rtfwilta wrkaal****. aeft tit# kf# awtartal aa tkrwa af wkat fa a* tka Saar ar aa a wtaftew am, akirk tka Wala fratk I# Strata If aaa Mariana aaaa 11/. wttk tkia* tyitiia# lataltif la axlftatka aaft n- I aaa ten paw tan raa lata titla arrar la Stf- fartlta. aaft rerulelr tit# InutkUa aaft nMf' aaala. I raatllr tka Krw Tart altaallaa arkrn ft ' i Ha i>t(aa k aaa af lira, a* an atriatil/ aa- rkllft af tea ftlaft k IM1 af laaft pahtt pil **! faattrlai tk* lift af aa aatawl ar a padraft Ska waa tataa ta tea ftiftrraat ftactan aaft wa* ee. BtamecToai wtuj*aa: la Haiti nil a* San ftlaft*at*ft u a tint lafartka aaft aa art. I aw* vj a rararft af an raaaa af tkllft laaft palat pair** tka Hark rwaafaw awt aa lea. aaft tkra aka waa t left pnaaltl/ llw aar atW rtaaaali;. araaa kra ftraft taaat/-!aar aa far rrporlaft tier* aa brer* tataa ta fear ftifftreat Ko#ptt*l aaft tkan waa a* ftla/itaala waft*. At ftaatk tka aarftinl axaatlaar titk war la 1*91. Osa kaadraft lattrtjra# af titan ftrrlftaft it waa laaft palat piltaalaft freaa aatiaf kta <M I aaaaft my fiamilat aa yetrrftay** pepm aaft will pal It all lata a eary frw aaaaaawta. ,4 Tlta Krw Yark dtp UWlt* malnaaaat a* Iaa4 palat au da Im It kaa ka faUaaaft k ffiaaaa aaft BUaak. Wat wWa wa waft# ear* ap. wa faaaft aw raelftat fatiaw H lira aaa M waa rktaftjr ftlrartaft otatuMM wminsr: Tka k O "EDTA Therapy ta Panopa wtlb gterrain laaft at plant wfcm rkilftrea raa rkrw. Wa an fttft I Abaorjftlaa freaa Jaftoatrial Expoaunt" fa Dr. fttfmwtijr. la aaa, trwnaaat reilteft frata wklck la* It. MUfar. Kattartaft Laboratory. t'ainnJi/ Ik* paM la paallaft aaft falllaf ta tka Saar, tit* pakft af ClarimaU Cotkft* ef MrdklM, Cladiiaatt. it !% baft. | ran M tit* aUketMa nan. A (MM a ... , ' V? '5 ,4 3 EOTA THERAPY IN PERSONS WITH EXCESSIVE UAO AftSORPTtON PROM INDUSTRIAL EXPOSURE , lylHH. MIUH, AO, Fu mIt i M tbMfptloa far peruona la Mwlij > nt; occur u imH of o m or non of tb# fol* -inf: Inadequacl** or failure* of exlrtin* mwm for control of proc u m la utikk Ioo4 or kod compound* oro tod; poor poroonol by* rt*a; individual or (roup afriouim or la* dlfmn; wnnriM oounoo of Inf ex posure; oof acddenlal ropoDuro to readily *b- ooftwd bad MapNDd>, xuch oo tetra-etbyl Inf. Bresoeo Unoo clrruawtaace* *tiH occur urttk mrprbla* frruMoqr, pkpicUu who or* reupoorfUe for On broil!) of ptmu tfifipf la ocnpotiMu io which tfcor* l* oxpoear* to bod, ood tboD* uho undertake to tract person* *u*p*rted of hort&r bod polaaeln*, out be ocuaolotrd with o book body of Ufonootloa tbot out ladado; (l) familiarity itb tb* aymptoaukdocy* phyaknl Radio**, ctlalcal laboratory Radio** tad tb* aatorol ctlalcal coarao of tb* qridnaf; it} kaowbd** at tbo rso*o at tbo coacuatratloa of bad la tb* tdood and aria* of pecece* wbo bn bad ao aaarual oxpomr* to bod. aad tb* dcalflranr* of drrlatioa* tram tboo* v u Io m wb*a obuiard by reliaU* analytic Method* forfonaod by competent, qualified pmocrod; <S) ruroraltha of tb* fact that orctala Radio** *acb a* a *in*tral bad Uaa, aa lucre*** la tb* Dumber* of *'*ttppbd~ *ejthrocyt** or derated bnb of bad la tb* bbod or aria* or* act, by theme dee*, diayoartlc of bod lotoxlratloa (4) a practical aad*r*toadlf>* of lb* phonnaralomr of potentialty a**fal therapeutic ayeola, tb* ladiratloa* for tbrlr as*, tbdr licitatlno*. pnmlbb baraifal etferia and oi-im. llefn* 1, Z and X. hoi* In* dlmuwed Iborourbly bewbrr*.' ** Mac* tb* prrrlou* Lead llyyien* Conference^ bdd It 1941. many foaciootlnf cootrlbutloa* bar* boon load* la tbrrapauUc*. Notabl* uuaf thro* boo bo*a tb* latrodoctlao aad uo* of EDTA (cthyteaediamlnetriraoctKic * If, rifure 1) aad it* oolu, all of wkich hr* "chelatin*" draft. Chdotioo b tb* ton* applied to tb* proem* *rbtt*by riar-llk* otrortar* b fonad la which a apodal typ* of boodlo* (coordinate) taka* plac* Irion ema* of tb* atom* that fora tb* rin*. A muKleabat poaltlr* lac rack aa bad a* rabicua, when lacorpeestrd la a rin* catapba or chdata, ao ba*r ntala* It* bale propeetl*#. A *eqo**trrin* octet b a compound tbal roada with multivalent poaitir* too* aad rrtaiaa tb**a la aa ualoab*d atat* la a watoroolubb product. EOTA aad It* Moao aad dbodlaa oalu. themfora. or* both cbdaila* aad oequmtorta* areata. WThaa cakfua la added, a tblaU b therefor*. adatbanril calriam dirndlaa fflfara Z) b tb* calrtaa chelate of tb* dbodlaa aa* of tb* acid, *d*thaadVXDTA.* ' . 4 ,' . ' Btaroncobyy . '' Tb* adauabtratiea of EDTA or Ha mam or dbodlaa aolta la tb* aalmal orysnbm yuault* la tb* cbolatba aad aibaiaatba of calcium. Bo cau* of IhU aMcfcaaba,'-II I* aot difficult la produce toxk aanifrelation* wltb thoor afeota.* To areM tb* pooalWIity of prvdadaf a otata of hypocaketala, edathimU caklutt-diaodlum b amd. Tb* admiabtratioa of tbit ewapound. la lira of tb* add or it* atooo or dbodlaa aaMa, do** aot prevent lb* removal of bod tram tb* body fluid*, aad ladirertly tb* oft tiwort, alac* H proceed* t* replace tb* calcium I* tb* rtn* bee**** of tb* creator aiabilllr of tb* MeO-? CM, /*4^**C**/\ IdathoaUl tattle*4>c4luai (fiaarb acorn) CaUbn diets** l*H of etkybatdioaitMbtrfl* cm* act* Cdelu* d>*od>un all of (ttDl**#*IMle) WfroactiM atld A*u* I M MILLER EDTA noplo. Tbe itawly (oraM M complea is highly soluble In wxter 81d * t.Se lead In the choirta U bound Arm!/ and U no longer M an ler.ixsd (tala. It does not aaart 1U characterislk toxic effects. It lx apparent at this point that three properties of adaUtamll caklura-dlsodium swat noma of lb* specifications foe a aaltabla or M<al therapeutic agent of this type; for aun|k Ua and product abac d ba watsc aolubla; It abould ba atabla and not readily broken doxrn by meUbolk or other manna artlbla the body; It should ba cxcrrUd rapidly; U should, for the ula of convenience, ba effective w Im* administered orally, and ba readily abaorbad; and Anally, It a'jonld ba ralaUvety non toxic urban adminlatarrd la affactlaa amonata oaar prolonged partodx of time. Tba laUar Includes ' tba effects that might ba induced by tba depletien of trace metala that are esesaeery for tba functioning of anryma systems and ocher Un lock macbanlama aritbla tba complex aaiaaal organism. It baa been demonstrated that adatbamU cal cium dleodlea la quickly and widely dispersed throughout tba soft tiaaoaa and fluids after latrXTenooa or lalramuaralar admlslstratk*. aad that it la not concentrelad significantly la any organ.' Tba romponad dene act appear ta enter tba cellular cawiponanta of tba blood, aad tba laid la tba apioal Bald la far below that found la tba plasma.* After parenteral adsaialetratlaa of the drat, excretion ocrure rapidly, primarily ris tbe kidneys. It wax found that eeer (0% wee eiixxlaated from the body witbia tbe Aret boar, while P0*V was removed withla teem bears. Tbe abeorptioa of tbe dray from tbe ali mentary tract la delayed and relatively poor. Evidence of renal deunsge baa been oheevved ia botnana and degenerative ebaarm la tba tobulaa of tba Udoeya have bean produced la animate when retstirely large doaea were administered eeer proloaged periods of lime.*-'* Tbe primary "delending" artioa la apparently areenaplisbed by removing the lend from the plasma and other body fluids Shortly after tbe Intravenous admlalstratlou of a done, the terete ef lead la tbe blood may rise" without produc ing adverse effects Tbe lead level then falls, aa accretion of tba complex proceeds Subsequently, tba lead content of tba blood may increase ap preciably, and It may attain vary nearly to |u original high level, aa tbe lead la tba skataCoa tends to cocne Into equilibrium with tba body Balds aad indirsrtly with tba eoft tlssuae of tba body. following upon tba admin 1strs'ion of tba theiatlng ageeit. tba rata of lead excretina la In creased grestly, reaching a peak anon, aad then 'apering off somewhat as tba adminietration of tba chelating agent la continued. Tbo recommended maximum does far admin istration Intravenously for each 10 pounds <44 kgl of body weight is 0.17 gns par hour, 043 gm par day, or 1.07 gm per weak.* Tba drag abould ba given. In a concentration not to ox- reed 5*v, in normal saline or In a S'v dextrous solution. Tbe maximum does per course of treat ment la 34 gm for each 10 pounds (44 leg) of body weight. Courses should ba separated by aa Interval of seven days, and It la Inadvisable to exceed two courses, anti] or uakna analytical results demonstrate a dear weed far farther therapy. Such need exists vrbaa tba cnocantraUaa of land la tba Mood fails lo diminish Mllsfaa- torily, or fails to remain well below a dangerous conrenlratkm. AB persona oadargolBg therapy abould ba checked frequently for srlflsora of renal damagu. - EDTA and An RrofbyUrii ef Lead UtsalesWan Tba routine, frequent or Infrequent, aas of adatbamU calcium-disodlum, or other prosit or future drags, aa prophylaxis against tba sherry ties of excessive quaetitle* of land rennet be condoned. As has always been true la the past, prophylaxis ran ba achieved safely sa|y by Mstrading tba sources of sxpooara to bid by the appikalloo of proper mas ceres of infretrial by- rkae. The attitude that this cannot ba scram- pUabad generally la -iadnatrial operations re , Berts either igasranco of tba true facta or aa on-. wtlUagnana to correct sneofe rradltlrna (There are exceptions which result from the brevity ef terlnla operations or tba occurrence ef unusual or unforeseen cooditlona.) In the orcsskmal cir cumstance where this ia not practicable. strict adherence to recognised aad propeeVy . supervised peraonaj protective meaauree la conjunction with provlsluo for adequate sanitary facilities, insia- tonca upon good personal hygiene aad sound medical supervision of tba workers, wiB pre vent tba development of cases of land iatoalra- Uoa. " Quito apnrl from the fendamenta) philosophy that prophylaxis should ba attained fay central of tbo environment, there are other valid rea sons for not employing adatbamU ralrium-dt-, sodium aa a preveulive measure, first, the texkotogk potentials of tba drag are not fully understood. The toxic efforts observed la bumaat aad animals from relsllvety abort periods M administration have bteu menUonad; kowveor, the affects that may ba produced by the sdsalaM- t' etlon of even low dueeu ova* proluetgad periods to humans are not known and are matters far conjecture. Reccmd, since this drag is aInert-ed poorly from the gastmlnteetlna] tract. It ta uailkrly that the additional quantities of lead that may ba eliminated by Its Usa would ba sullklent < i  ia'r.r :` 1 fe-5`*. "ir",' m j ii|ii!t.;i im 4)fww'.Mipinj j i lUjyipigj^tjjiji-Hiira'w_ij|ir,*ppMpp^ J a ' ^9 WW ***i^eyr.wf.-'- aaiMiMwwiMimi'rti - -i ifi irwi illiiriiii n i !>! Ill I  MB KiH^ktfBlillldaHiWUfiM '! Hi ! l-!:" s-r it Wi iii JP tHim mh iir*`l iiHi* i\\\ Ini!!; =!H=iii=i '?i i"*-t 1i ill!?! lliill! i if! r llwii >M = 3 t 3. * s1 i,?f ris` :i |7p ;5| h.?[5 ai=i;fu i Mff Crl.r! EDTA THKItAPr WITH CHILIWEN 87 af 6mrranaUf rmtnl tltaua anoxia naw^ml Puribar trldaora of tba iartdaooa ad tbla la tba aorapbalojwtby, tba (MW> lamparalurn- diaraaa waa throat apnn ua tbla paat aawuaar ragiiUtlni rantar waa partlytad by pharmaco by tba di>roT#ry of ratdmra of abaorptloo of logic mailfoim and bar body Itmi-araiar# lunar-id toxic amounta of bad aa a coincidental Aadlai to WOT. Tkn*,l. ah# wna btrrM to Iba oj<f. In two chlkirm wltb rthar major dlaordom. la - allnp room whan a radical darootpraoaloo of bar #arh lulanr# u m oo# clinical (iodine coaniaoo train wa* amai(l<iM by iki naonl of al- to both plumbiatn and to tba otbar dlwaaa l#d Mat all of two akalL axcnrt a aaraw atrip of to tba obtaining of blood for nnalyala far Ita boo* fm Ibo roolor onrtyiap tba paginal bad roatanb Uradby and bb roOtwgaaa bao tigoa Prior to IK# apnatlM, tba Allft braolb- almilariy ahowa tbat many anrarognitad------- laf bad baron*# ao infmqaatil tbat artifirial of bad abaorptioa la prtantially toxic amoonta rwapinlioa bad km raqalrad thmfhopt lb# ld la carlaia aagmaata of tba popolatio*. Tbay aprralioo and afurwarda aba na |darad la a obtalatd blood aparimana from 883 child raw fat Drink## rwaplrator. la addition to tba pndoai dinka la tba aocloaxonomlraQy deprind aortirw* tborapy with Varatwt aad bypotbmnla. aotl- of Baltlmora and la 44.4% tbofv waa aridanca rboliaargic draga aad a alow partite drip of of danparooa abaorptloo of load. akldUBod aailk wtto UHlalad u prrroat tba do- Tba tup of ClnclnuU (Plgon t) abowa tbat niopwiaat of a aooallad 'Coablaf'a tVar," aad a ralatlxaty astall araa of tba city roatrfbwtad a nortaat badaid# watch waa hogoa. Kmrtbo- abnoat aO of tba raaaa of bad paiaoatag batwiaw loaa, foor boor* foOewiag tba natlatlwi of aor- IfM and 1947. Tba letxdrrd araaa an tba laoa- pry aad oaly VI boara aflar tba chlid'a arrival mewt aartbaa. Partharmon. aa ortaa radawtlap at tba boaprtal. tba baart boat caaaad aad aba waa m*nt baa foread tba daatrortloa ad old baaaaa la dactarad dead. Tba raaoha af tba analytical oao ana. tba awn ncaat caaaa ban rent fraaa atadiaa for bad ara taxardad la Tabb L a rrpioa which, not too many yaan apa. faatarad ' tba foor baodnd. No aaw paiat baa baaa aAJ#d ----- liM 9mm Taaa L meow Twai Aati-xtoa m taan %. c itcft m4ii M4 m*m FVUIC* >4M rV IMOa to tbaao bcanaa; Inrtaad. tba axplanalloa far tba appaaraara of aaturabai la'tba fact tbat tba paiat bat baaa aOowad to enable aad faal; that baa wad iaformad famillaa aow Hr* la tba ana. aad that aorloarooctak naditbaa fraqaiatly pnaaat aooad child nariap. Tboa. ana tboapb atodcra boatabidd paint* may ba aaaaatlaBp . > Wan tbla aa idlad ar aaanaal can bbtory aor aarratin atipbt atop ban. but fapnttaUy thb U at ID aa aO lao typical pktnro. Soma two nab fallow-lag Elalna't daatb. oar cliniciuu aad patbsbpiata nek-wad bar caaa. Wa timid Ilka to nport aoaaa od tba coaciaabaa tooopbt oot la tbair dbtonlaak Aa airandy maatlnnad. bad paiaoaiap amoot rbltdm nmalaa a aarbaa taaaaro. It* reportad Inrldaaca b aay krala raflarta primarily tba ialaraat and nvaraeaaa od pfcyairlaa* nod tba raady availability af analytical atndba for bad. Aa an IDntiration ml IkIt fart, tba graph (Plpon 11 doplrta tba Iwridaara ml padbtrtc piaaridna la Clnrlanatl, wkara wa an ladaad fartouta ta ban axallabta Iba farlUtlaa af tba Xattariaf laboratory. II nty ba aotad tbat dariaf tba yaara IHI tbrowfh IHI only alfbt raaaa wan dlapnoaad. la IMI tba laridaora roaa, bat wa wara not yat alartad ta tba dlaan*#, for tbm od thru tifbt ra<w bad baao rnwwmaly thought b bo pad bony alii la, and It at only apen port* mortatn axamiulba tbat tba comrt dlapnoalt oat nuda. Tbla axparbnra Jtrrad oa abbatly and, na ran ba aaao, wa aooo found tbal tba ditanaa waa palb pnvabtrt. l c x o rouowme i mi-ip m tn etnejacat mtftttt. mm < Ytar Ppal t Tka Utidttta af Wad atiiWo. I V.' I <' | ' ?' : :[ i- r ir t H o SMITH Oral therapy for cbildroa >ih m uswbo with rare rarepUona, for not ml; U Vtrarao tqr tbb A route bat effective la removing bad fretn tba body, Iwt alto It It frnjufnllr difliruH to bo nor* taJa that tbt child*t tapotun to bad baa ended. A further problem we hart reef U tbt rxnrorbn* Uoa of cerebral ejmptome la tbt drat 4 to 4* boot* fodowing tbt la IHalloa of parootaral therapy with KOTA. To data, a change to tbo aabrwUncoue oi intramuerwlar (pate of admin* ; letration with tferti to Unit tbo ooloiao of Bold put baa not roaaltad la a dear-cot la* promnant la aar rtooHa Vo an aow rerun mending a more (radoal not of therapy, bn ginning with 4 ara of EDTA ptr bp of body weight over tbo Ant 4 boon aad then. If al a * f W ~ ~n inn- ^n ... ^.*--j . ou_ *. ***# < * Wmm mh w*i>i mo *< m*. Of m* h * mm* wmii>n ! w 4n*>m fc--' < **. <Hw n Jr rr~T~* I* A* fc<* m>if W h * HM MW* Mi*t frw * wM w A* vifW *** f W ^f. iwt nS, Inertatlag to 74 aga pee bg ptr 4 boare tor tour note day*. It oboald bo vtraoad that Votatwo la wot a rwratln drag, bat ana uaty to lower tbo oaooata of bod la tba body more rapidly thaa ocrure by natural prucaaoea. Therefore. Vertowt iliat cannot bo oonaidond a adequate therapy, oeperialty fa tba aon threwtraiag aanlfeeCatioao of bad ptdooalag, M fm. tit* Umt of childhood M pnlanalag EAorte to preeetrt farther npaoan to bod orfll nmali a pwbUc health protleoa foe many an abo reatnatod with dilBroitloa. tbo aajor yean to etna. '' of there btiag that tbo caoaoo tor pica an add Mm toning to Omrr, wo wlah to rtrooa a fow of tbo cltakal flfmom between <UU- folly wndoretood. To bo tun, la many neon, peythlatric abtwraabtba la tbo child or dia* ( hooT m4 admit plwabtaaa. Tho typical Bodlaga torbaara la hit oavirenment raa bo cacceood (a adalte of ptrt[Jonl onrltia, iMnalnl colic, aad bocatwo of that we rowtiaoiy oook tbo a** aad M kM along Uw pac aro aB gotta rare afataaco of ear oocial terrice department. How* la chlldreai. A Mu c h : rial paia doto error with rear, attitudee cannot bo changed overnight aad cuaalderablt (npnc;, bat it U aet M mitt ocoootmic dcprleatloa often defba comctloa. At* ao to owe tb* child to Into op or to bate a though a moderately ttten Iron dallriaacy baiMkc tUoML AeaorUltd witk Dm paia aro anemia U abnoet valvereaOy found, therapy with tateeminawt romIUng. anemia aad cooMIpa* Iron ban noC beta of mark value la abort!ag tkej. Tbr major concern of pediatrlclaae b tbo tho pica, crew thowgh tbo aatmlo It nilteed. high laritocf of encephalopathy. which ocroro Accordingly, aa la other forma of bad poleowlag, la about oac third of all childhood bad potaoaiag. pneetrtiro offorta aad ba baaed ttpoa ramom la the auMftant of any child found to hate Ing tbo aoarro of rtpeourt. To tbb ted. tba ibcrM potentially toclc amooata of bad. two labore of tbo health departmeole have ban of pnblwae aul br fared rvgardleae of tbo pen roaaidtrabb value aan a rate of plomWaa baa an or abararo of eigne of actsal latoabaUoo: ban reported. HowaeTr. Uttb baa ben doea to tbo touaedlato femoral of a* mack bad from Correct deagerooe eltuatloaa before poboolag tbo ooft tlaaooo aa poaalbb. aad tbo pmootba baa ocrarred, la aplta of oar knowledge of tbo if re-evpoaun to bad. For tbo fonaor problem. Opidatatcdogy of tbo dteeaeo. caViam dinndium EDTA or Vrnoao U tbo ac- Wan tbo dlataeo baa progwaaid to tbo * fepced dng of cboba bat therapy with it b repbalnpathb etaga, a real threat both to tbo far from idoai. Kvmeroua atodieo bare abowa braia and to Ufa tattle. Tba marked tending that tho Initial cowno of EtiTA five* lain* of tba myel In tlaaoa erlthla tba rigid boaade af naaal; mm* only a email par toot of tbo tba akaO reeutte la axtmno lacrtaoao la latra- local tod/ bad and aot am alt tbo bad la tbo craalal prttaan and 1* compneeloa of tbo blood aofl tiuuoe. On tbo arartg*. on]/ ii mtm of vaattlt aupplylng the braia. The lateartty ad tbo bad b cleared by tba Ant (woe and fear or braia reOi la Iboa tbraataaad by a no* la, aa well Are dar` time I* required for (hit. Accordingly, aa by pcaeiUa direct aoiyma pelanalog by tbo la Meat lattaacto n glrt at boat Iota tntM lead, la aa effort to dernaae cerebral matab* of therapy and at llmea nu; more aro iitodtd ollam aad tbeoaby to minimita any cerebral boforo tafo boob of bad la tbo blood eaeoa. metabolic deficit f oaygta or other aulritwU, ora ,Vt`. V," .S;- $#' I"ii'11 tr1Jipgw"ii^i**wtr- `":nr - ^ -A 1& ; ro; S>;' ' . 1 lltl^...... *' j :J - niHi Ii <j--rtiitMfciA -i..../.t.f..f.t.&'iSSfr. m*wm 'Art ; J-, i. "f; i?* iSHlijIb|*}!hjllUli*?! iiIleplSSllififll\li\lllM5ljl f > s *4/ V * *? tSf-i lil'liiii'lfili IIS ii'lilr 'V $5 rv Ijf^ -'l Sm .fV ***:' ijlpji.iii>'.ii'i]a!i)Mii''< ft *flittifrWU iV'**;':' . ' Wl JpilJiPP^S!^ . , , ,"4< ', *" .'^r \ *\.V K M r-T^^,< 1 m *j ;$!.*? . v fcrfrnm ...... - . -' - X "` l . f *A*r*`v- : *'*"*;- ; * " T" ; ,' ` v.i: ' . . V F*:- * v I": KJJTA THERAPY WITH CHILDREN . 01 Tto ftrtt Important pftiftt U Out of 4U|aiU, ftfckfc M rmltor KUiory *r* tor* Um friwr* | ptUwi4. OkfcW^Jly ft rkll4 k IrrUftUst, hn *iwr*iU, U tiiiv| **i m fftbftUf orlffti, Ui yrmiflmX coftrtipftUc* ft4 ^tfWW h IUa | *uk tvo |r1tntUr n*A or W* kfttf tto rW li Mir rUMvm itoi tl itdi tymp- 1mm* trrvf la cbU4 #f Ikta ftf* |m> i tto Mn* brf Uim particularly, r -** ftt ftay *Un Um, Umi rfcUdrvft ittM Mn ik if ftrtiw* |#r f*prn*fyltyr1. I 4*4 M Mtr Uk Ut tor# it W to ftw< rrtlftWft wfvM* tftf |ft ft*4 HfJ *AmpW te 4*. AO fm k 4 I mi* W wrttw, I mi* *4 rtWr, lkfi 4rop* f ft<W ftrid. u4 afcftto *tt. TkU W r*ftHh#4 ft*4*f ft WW*t Uffci a/W II ftUftdft If (K* riot U* ftft KfWi of ira4 imrihft, Ik* fttift* wfO itwft ft r*4- 4mA cmU*. faultily W rUr W *at rmliiiftt ftftigtl 4 W*4 irrrt*4 If j m f*t may niliafc nkr riMfv at ftU, lk* rWU4 Km W*4 p*k*aaiag# TW ant bfortal tki k tv kitkl* Uirfito tmlMit (Mil 4*mj. Okkniy tto rUU iIn all W rimiftid from Ik* ftewre* mt kft< krt Uii k ftf mm ftat fthrftjrt fmmft4, Xrftl, ftrttar M4 W aiftd* UffHlk Ifftd Mrt of tto tiMftt. Tkfc ra to 4e Vx ft nrifty af mrtbtoa. t*n^ If* |nn mgm * *4 to ftltolym tW eft04; k*> mr, t (m4 It v m matt to y*0 tka M mi ft|44l| Ikfta it vft to Wav* Hk t Bfm vitk ftlt tk* iWraywtk MM*fw tofft Uwij kt t *U UU to imitoftto* Ual Utk&y Ik itwft b m<* kjMl*a| tkftft tto -- ryfc>tMla Uk y*r I r*t to tto pitot wtorft I f*tt ttot towfrmkft kwiij to to* M *0 if tto* <k0> 4tvft ftft toft Ik? 4im4 tto altftitMt >r ftf rftrrpkftl^ftUiy. Tkk y*ar 1 to** c Uh H fty mi*4 mmf tot toav *f to** tod gwl wrm fHtft tto lmm*4tal* to* f rrrtftla 4*fey4raUftf ftCrMft toil ft* Hi^rulk ftffft (i rift par ci*i, to far tktft fto ** tot* tor4 Uta iaMiftHy ft*4 Km to fto*4 dscomprrasimi **** *ry. Tto toll pfti4 U to 4ft M* or tto ftttor t <*** **4 tot nit far kriuftii yrr**ar* mm4 Mnltlmi to. ft. ft. mr too4 la rWU4r*o atifl 4mm arror la tk* lnUr. V* fto4 to lot JiftMry ** a *K* 4w4 *f K*4 tvrpWrtK f4k*i*| eftktoo pM, vKkK, *f ftora*. (kml fftpto la oftjr if tto 4tu| trvfttitofttft. If* Urt*4 to malt a4 to rtto feiKvfttfloM. Tkk *m rff ftMtoly mriWt to rftkkra pat fMrptoliUi. Kftto4jr Mid fir I*ft4 toftwi H Jaouary. lUtooi w, h tot Kpp*ft W ka* tto ftftia* Mftfttoftl pHk ta toU*. ftft* tortailM la tto mu mt u miKi, tot vtitt ttor* ftr* ** ftt ftttor (Ian mi tto Ttor* ai*t to 4tor fftftir* ttoa kit *r *a>ifkt k fhiali D ttot pmifltftto W*4 yiiMftlaf la iwa rkiMr** ato la ftttor p*rl4ft. W k*4 ft M toUrM ftttfc ral Vtrwft* fttol H k* dfit **HVf Oar ftM'Vr* * t taK* tto rklUrr* u. ft tl tor artft* ftftMpt* to Mttotaatiftto tto W*4 r .avftiftft. rt**ft Mt tto (if *i4 fir* ttora MX** M*t Y*r*ft* Up mto* toto <n * (KU4 fwt at a! Y*r*#*ft ftft tU u, u Um TV rtiU4 f.M iMMvin* It# W*4 M Wn ##rV##l/ IU M*f, Wt V W*4 mMlw M V MMthf Ilk# IM *H( u tfc# M>t M V#r. IU# i^tu] (i4. t#4l pr*t#l*, ml Uf mj M*fW4lf frvi w#talri #r*u4 #Ifktj I* MW tm m>4 400 *>f , *t*4 I *n ## tXil V *M t4)7 ljn4 iff tfct# ttfrrimr*. If ftm girt ml Vrfm# Uk k4 to Ur Cl trarrt. yon Mt o!j! >Vrt tk# Vr### k4 i Ih *t#oit i tot f M atrntt *t>k H- Tk* Vr##*# I#*4 r**U*Io* ImT m*-igr (t/wt, u4 It t# grtUto ta W*k M kn la tk* IWm, a*4 |tt wt Ua4TWa Ik# ltd >*tat I m44 Uk# I* atk# W >k#ilt fmykyrta timtua. TWta I* a llttl* #t4m that aaalirkt ka* *aii4kln ta 4* *Uk latnatlay tk* M'hkrrta atat la nl*U*| W4 Da M#ta, I tklak H k ka* la#r*l*l*4 rak(4t# u4 atbar aalaiali wth I*a4 **4 *#y.i#4 Cfc#*i t* altfartaM ll(kt *Hk atk## tklaa* ril#l*d tauUal l#4 pika a cnat hrma la tk# aaaaal *4 yoryfcjrrla *#t##t ka th* aria* *4 tkm* aahaal*. H that aaaDcH. a* *th*r f|k haa* atpdk Mt tmlf ha# .*nlld U 4* akk Ik* Iliirillii *4 t**4, hut ala* ka# ***** #4art tk* ilnll-- *4 l#*4 4lW K b ta th# ha4r. **- a. a. araxatae: Mm wt art taa aatha- *4*#tW akaat KPT A. I k**k4 Uk# ta ra#tk*a faa acakaat wulhrin H a* a aara la tk* trwtuat 4 h*4 yli 1*1**. | hlkm It #a; k*rr a taal |li la Ur* tnatamot *4 ml# ptaatkha* fat ckHna. , I *k*II Uk t* naCtoa fa a*la*t Its ms Ib a4slta alara toaag a**s 4#4*kt#4/ 4l*a*4 a* la4M#tol ka4 irkmlnf gtt *#<l wtthaat th* m 4 KPTA, **4 *toiat w UIi .i th* a** a4 aajr 44aUjr* liwlaat A# ata *s rlraHj than %g IMm m aaaaj y#*rr u* ha maarlna tk#** fa- H **t *4 th* |#a4 isilinanl sM tfrail*a th* all# *r aaraika. thaw |*tl rH hr*tto. Th# a#* *4 CPTA arflt a*rrr *#*4irst* ba4 RatMalaf. A* a toatt## *4 fart. Dr. Jokatom* a fra frar* aa* la St. Ini* f*latr4 at that w *4 th* Hast* la La* At t I- 1*4 *t*rk*4 Ha ah>#M rrHk r.PTA to#tr*4 *4 la*aar*tlaa a aat*l pfgnm tor th* rr4*rtl*a *4 atawatorte Into* to bto la thr mrlfaaiat to *sfr Irrrk 1 tklak th* Uwfrtaat fllia k. a* Pro H*r4/ aa4 IroM to*aka*k*#4 flrHai, th* *a< *4 4U|mlt Wr tn art *4*r*lla th* Inn toStort, rrrlfrall *#4 ki uKal latrra*. Vitirta frttlaa to th* gtth oral |i*rtHJi*fM a*r th* Ia4#trl! akjr*kt*M ah* Mto 4li*niti sa4 trrat lam t a**11 *ito that arfaateatlsM **rh M thlr as*, aalrtototlto, HtoatotW *4lral ****** to aw4l> r*l Mtotoir* rtoaUUk *aa*I* *4 *mII4*4 phyalriac* la tk* wn*atiaaal 41**a*r*, to that liiiwt to fcmw tSUvr* taa r*a*alt vlth tha pkjilrtAM (to *4rlr* M to 4k*fX*#lr aa4 UaaUaiaL CHtttMtM WHiunar: Th* r>**l papto! "Prcfrm* llrpifi m aa Ktp*rtm*alal Inrrtolaatkak lA Tart*.#* *hlrh InAurar* th* Itmprin*** o4 Hum** RuUf't* ta Tlntoj I>irl44 L*mI Cf fw.ri.li in th* Aiow*i>h*r#." l.r Dr. Mart A. Krhra. IHrwtor, Ktolvrtof larlwrtalnrjr, L*ftI rto* alt* a4 Clnrianatl CU*r* ft McdklM. FROORESS REPORT ON AN IXFERIMENTAI INVESTIGATION OR FACTORS WHICH INFLUENCE THE RESPONSES OF HUMAN SUEJECTS TO FINELY DIVIDED LEAD COMPOUNDS IN THE ATMOSPHOtf fiy ROMIT A KtHOt, MLB. ILm mil w rf u nMlMxUry title far my roetribetloe to tbla pntna bnui I lldat km bow to tin i lottoo c o m. Prrbape yea Bay coma to tbo caertueioa tbot It woold bar* boon bettor bad wo yoae o s with tbo diacaaaloa of tbo oobjoct that wo wore denllay with loot prior to tbio Dm. I waat la rxpteJe my porp*. bowooor. aad ) poor attention to o m or two tblat* wbirh I Ibiah on ml faadaawatal iaportaaro. Wo ehaS Bederriaad tbo problem of load potaoalay bettor wboa wo anderelaad tbo meteboliea of kof la tbo haBoa orroalw aad orboa wo knew more aboat tbo pbyriobyy of tbla material. of tbio Biaoral oh mot. It' Bay bo of o o bo latoroat to rereyalM that wo probatdy know bmt o at tbo f miot time la tbo bold of tbo aloml awtaUJUm abort load tbaa oo do aboot aay other oloioat. I m obahlay of boailo. TbU lo only boraaao tboro an aene aow element* wbirh, boraooo of their too. ana. ban bora looked at with rcoaidorablo latrarity. Pot wttb rooport to tbo older olrfaooU. tboao that wo baoo booa rowe rood orlth for tbo Va>f pal -- there which. beroaoo of eor familiar* Ity with them. we tend to think of aa Winy weft oadorotood -- I think 1 caa nay with na<onbto aafoty that we probably know b o t o aboot tbio la roiotioa to lewd tbaa wo do la roaaortiao with aay ether not *1 la aay rare, I wiab to rorooat to yea, la a oory abort epare of time, what wo bare been aodor> taklay to do oeor a period that beyaa la IMS aad la otlO cootiaotay: to fertber daddata tbo metabolirm of hod la tbo hojaaa aryoalaBa After tbla, If Ub o permlla, 1 abaB wtab to re fer to MM practical ceoeidoratieaa that relate lo diayaoaia aad to lodoetrial kyyieaa. Oeor tbla period of liaw la tbo Kettoriaff Laboratory, wo ban been doeotiay oomfrea (a a baric otody of tbla prcbleaa. It beyaa wttb aa attempt to cioridate the orrarrearo aad tbo dieIribaUoa of lead la aatan aad la bloleyic BMteriab. TbU baa not been by aay mam com plotod. bat tbo aniertlal cnotribotiooa whkb wo ban made to tbio field won pobtlebed la tbair Initial form la 1M*. Then, a few yaan later, wo beyaa to atady tbo awtaboliwa of bad b bumaa aobierto oador ceodltioaa of both annul aad abaormal tatabo foOowiny tbo oral adadahttatloa of lead, oadertablay to determine pewrieoty what baptoaed oador tbo nalUliai of probmyod, coatlaaod adalaletntioa at eartabio beeie af doaayo. Tbo naaiia of tbeoo lanatlyallima ban aot an booa poUUbod. bat to tbo oatoat that tboy ban booa pobltobod. tboy appealed oeor a peri cl. af aovcral yean, endlay cbeot arm ar alyht year* ayo. Then aboot oiyht yean ayw. we boyaa to ctady tbo ether baporteat oarlaat af. tbla problem, from tbo petal of rtrw af ladoe try. aeawty -- wbat happen* u bad which b la tbo reoplred air; bow aad to what eatewt It b reeplred aad retalaed la tbo potoMaary apparatea, wbat happen to tbo rate# of aboeepllca. retention, oirretiea ander tboao (oadKhao. I i TiSaj'-i'.-rAv."/;,X ^ trv',; ir4^- ` iV.-v,**? n-Hiii jiniiiiniMii Hfisrfjsjinsiii.-. $K. 3""C'|i ?&- '):: M tirr^hlii|fit!iirif H=is*.!r5:in;hU r? * ,' A| xtt: ;^V. 'Jv. "Mr mi m f p^.r *|] *;' E- i^.L UlSrU^ ^ 8? IP- .4 It fund -*U\- -I || ii ?I sT a IS-cac H ;&{ u |U|i h "2|iL i! Ml; f? a.3- 5855 'u: !i rlll*h {if; I i& fi?d 1 s. fa a r 5^^ C* * 'lif i f*i *> c FRIDAY LUNCHEON SESSION NffmoUr 7, 19SI A SUMMATION Of THi CONFERENCf MtOCIEOINOS r THOMAS L SHIPMAN. M-O. CMinwAK m. rtu msmvncM: Tto aoanaa* morelap. too Said of raatorch la a boot tda Uoo trio be firm bp Mir old and pood tiieadL member of tto Warn. Todap. I foal ara aaoat Ton Shipman. Health Dliitloa Loodar'ef Utf rrcopaba H aa aach. ratopalto It choorfoOp. toa AUj w m SrUoliAc LaboraUxp, tat <Uiwi aad raaliao that raa torch haa much to afar, New Knln. that Mt bp bH It la elowtp unlocking tto prato ML THOM A* u imrxiM: Thie ku raaBp baoo kaa of tho A)tkkcr of bwd which have brow MM af Um mod atlmalatlap and aojopable ml pouting m for orar tto put two thntiaaad lapa that aap of im, t think. kin itlnM Tim poara. . am few lodwtriM that ora u raodp aod wiBlar Tto ladirldoal who la choara to aommartm a la air aad flarw their firatlwna aa IW l4 meeting of tola aort la la a rather oaeaviablo ladoatrp. I aai aora that wwy ooa of oa foil politico. Aa o taattor of fact. If Ihcr* la aap* that Um AaaodaUaa U to to mmUlalid u4 otw toro who would Ilka to toko ora tola Job, thanked for proridiac thin epporuoltp aptla to I weald ptadlp chaapo plena arith him. Tto qota cooaldee Um prablma of toad. And. Mr. Wone- tin arimo aa to whp Maafrtd aalactod KM. I arr, 1 hop* that poo will traaamil mp footing oa bat think that 1 hart aaaa a earn of Ued Uiia to too otoor oOron of too Aaaorlalioa. poUcmlop aloco I waa la medical achooL Wa MO. r. L wooMan: I wtl be glad to. Ttoak cortolalp hare ao lead Intoxication at Loa Ala* poo. maa. aitkougk coaalderable amount# af lead ara M. ammiM: Of iw ih H roaa wtthoot tap. Weed la a rmrlotp of wapa.'aad than to aa oa* Up toat toil topiao too a apathpiug. nad w* traatlp Mrrpdk ladoatrial hppioao proptoai too* arto toal aparkptap la. The ctmjdeCoip tlm* to cwatnl It. Porhapa. howoror, hariap aa aw torn aorrpp of Maafnd hoWitch la pratabtp ta mod aad coaaiap at tho problama frota a too toiop which lo larpofp nopaaaiUa for too raiallrolp anMated poiat of riow. I caa carry : praat aacraas of Ilia Marttap. aad apala t mi(to oot a aowuaarp which amp pB a ftw looao W nation hli aubtle approach to ttoao who an thrtada topothar. ': ' ' rrao--tof to apeak. atarlin* back aertp la too 1 weald like to meoilco each of tho tottod wlator. - ditto prtoaotattoo# that bar* boao made, hot 1 ' I ouM akw ilka to aaprora Joot a Word of raa oolp trp to touch oo them la proopa. toaaka aad apprarlalioa to too aiaaapraaawt of Tto aaaaaaariaor ia la a dilemma ta kaow too Drake llotei. wkirb kai aiado oa aO aa tom* whether to ahoald touch oo oalp a frw aiala fortablo wblto wo bar* tooa ton. potato which Ian arlieo darlap Um meettap, I hato Ifarnod a lot ia too laat two dap^ aad ar whether bo ehovld. ptara bp piece, po orar It la taluaUr kaewledg*. Ooo tklap that tola aad at leapt to touch oo creep poiat. A aecood Ofaaloa kaa oatpkaaljod whotp la that la tklo dilemma rrliU la that tto ettmmartaer caa whole matter of ladoatrial health wo ara dratlag oalp brinp oot theee potato which ara of lalrraot with two nkllK medklna aad oapiaoortap. I da to him porauaaDp, aad 1 am aura that about act thiak that alttor aM la atora laipirtaat thaa aap of poo would rive tto aonuoarp la a rrrp tto toher, tot aa tto attor hand I would rap dtlfefaat wap. thla: Tto dorter hp hlmaelf raa do a pmIp peed Wo rtarted atf peeterdap aioralap with Dr. Job Tto raptaoor bp biauolf raa do a protip fbflaap'i popor, and Immedlelrijr m quMe Im. food Jth Hot aalp bp worklnp together aad ' portoat point emerged. Thla waa broophl out approrlatlap aach ottor'f raopMuitolltp aad aot tmlp bp Dr. Ilellaap, bat aiea bp Mr. TaUlaa, point of lrw raa ttop da tto aort of rooadadwot Dr. Itraallod and Dr. Kehoa, all <d whom Job that tto mlfanrleo demand. atrnnii tto danper of Mtabilihlnp a dtapnoato New to thoaa of poo with leap awearotee, thaoo of plombliai puralp oa tto bula of labuntorp wordi aaap hare a familiar flap Tbop won taato. Aa ladlilduid with pluaabiua la a atok 1 apohea oa thla mo m errorUm tea prore apa bp poraoa Tto dlapnoala mart bo eotibUiHed bp i Dr. l-ania at tto npewlng of hia avmmarp of tho arirmea of tto phpilclaa oa tto bula of tha meeting, Te tto two akiSr, medwloe aad htoterp aad phpelrai oaamloatlna. aad with tho engineering whwk Dr. laru mentioned. I Ihlah fimArmattoa of latoratecp tret* of a wide wo mart add a third. Aa war ao idwloaa thla rartetp. SUMMATION OF THE CONFERENCE 7 la ccnrlderia* the Tnriour paper* whkh have bam (Ivan la th# put two dxyr, It It rather intern*! inj to grt beck to the procud Ian of ihr overtire tro /an are and And that moat of th* paper* (Iran lodxy and yeelayiUy have couaterparla in papart clvrw tan year* *eo. Dr. Brlkr.ap`a paper had two counterpart*, tKa papara by Innaha* and by Stlaoo. Mr. Frank'a paper on "Health Control la Ova Ceramic Induvlry" had a counterpart la the paper firm tan year* m by FHerman Pinto. Mr. Frank1a paper apnaeed. from the point of dew of the aafetjr aaftaaer. and Dr. Piato'a frwa that of the phyakiaa, the aarenatty of poollay the varteoa akltl* -- the phyricUa**, the eofety aoyinear'a and the leduetrial kyriwvUt'* -- In a control profrmm la lodukrie* urine lead. Dr. Srhreatk brooybt eat worn* poiata worth reiuiinhrrtne. la hie paper he beoosht up the fart that the Bomber* need for mailwmm allowrabie rooceotralkem. of aoroaaity most be Bead aa raldea, that tb-y are a coenprumU*. rapraaaotlac the pooled kaoarWdce of a croup of expert*. They rapraaaot a comprumU* la aaothar way, too. I think aO of oa will acre* that the only Ideal done of aay toxic material la aero. Eetebllahlac mailmom allowable cervceotraiion. therafoeev moat be a cecaprcesle* between aecw and an ebriovaty tealc doaa. Tbla la dearly trw* la the cnee of radiation. the Ml with which 1 aa the anwt familiar. We would like to her* ' wn doaee to radiation aa we would Uhe to have aero deaee to Wad throeeheet Indoetry. One ether point ahoeld be kept la mind. Mewlion waa mad* of the ercaalonal loweriaf of maximum aOewnhle cmcewtralkm* or pertainaible doer*. la auene caaaa It la perfectly trw* that a leweriac of a maximum allowable c o t ceatratioo repreeenta new hnowledce. that the anted*] I* la truth over* toxk thaa H war thoucht le be. la aceee ranee, bowerer, a lowerlac of thla aort may rrflect only aa loiproramaat la nr owa tarmlaokcy aad our ability to pro tact people. permlltiac we to approach mere rhealy the aero Idenl that we ahontd etdee for. It cartalAly la to bo hoped that tha rontrvrerey ef land pnlat laalda tanka wow ban bam ended, locked, tbe dlarsaeioa* of llartay Elkina aad Mart IMohlncac on thin eubjrrt war* Ihoeoerhl/ rantlnrlnc to b m. aad I certainly hare ae Worden about ddnklnf water that tame out ef a tank paiated eat th* laalda with land palat. I would lika la mantle* on* point that ado* I* my mind while liatealne to Ikdirwvaa Kyera. Onr ataihoda foe naalyalnc Uod. aria* and air far lend are coaetanlly Improving. allhouch they atlQ laar* aomethlnf to be deelred. One thine whkh e hae* not y*t lawn abia to do la to atwdy, not th* amount of land whkh I* beinf rulatln* ta th* blood, but th* amount of load whkh la fixed la bon* where w* cant cat at It; It aeetna to me that it la aa Important to know whnt la left behind a* It i* to know what hai been excreted. We really doot know accurately nhat th* body berdaai -- th* total burden of lead la a cane *f ptumblam at any decree yew theme to mewt'to -- I*. An we were comlac anr her* la th* plena th* day before yeeterday. Dr. Foremen pointed out to me a phraa* la a paper by Larkl# aad Tompoett from th* QmmrltHf Journal *f Afedf. dae, January IMA whkh I would like to toad: "In aay rroup of people expoaed to the haxnrd* of lead abeorptiow a limited aumber of caaao ef frank polaoalac <dQ rrealt. la the remainder, however, nira* ef toxkity win net appear, tha ehekton hadac aocceaafally latmobUiaed th* malar part of the abaorbed bod. There I* food evidence to euetmt that many form* ef acute dreee" -- aad here be refer* to wort of Aoh, Fairhatt, Minot. FwnihfWT. Brown -- "caa brief about rvkne# of thla ah Ha tal bed aad civ* dee to ayrntdem* of bod . I Utah thla la aomrOilac which we rivowld keep la mind, la th* caae which Dr. Hia* Cooled yeeterday. aad whkh ha* beca referred to by Harriet Hardy and other*, th* nwppoor* aace ef cirrulatlnc bod. the rvkea* of circmlallap lend, b a mailer ef UteneC Thl* mertlnc. of (mi**, would net have heed complete without Joha Foulgur. A* I ml Uetew lac to him ymterday, aa lame* enm* before ion It wae at th* time ef th* Bpnabh laqotritiOT aad Joha wa* oo* of th* Judd*, and I Jwat tboufhl how 1 would hat* to he the poor heretic that waa brourM ta front ef him. (laughter) Tbe Btalnorote whkh he mad*. I think nr* Incontewtnblr. Me la oppnud le eta aad ta liver of virtue, but he ha* pm in *ora* eery goad definition* of what *la aad rirto* are. I win jn*t poiat out one thine that he held: a compliance with etatutr* doe* act prwrid* if*, muaity; tud faith i* rmuirrd. That. I hope, will be reenrmbrrrd. Tea pear* *fo there wan a paper ffrea by Dr. John*. Thl* ptnr we added few to It, tad there wan a very afmlUr paper by Ited Juhnetorwx Ten prer* aco Dr. lama prdntrd ta th* fart that Dr. John* ririt*d hi* patient*, Dr. fwheaton* brought out the fact that h* vtalta them, undertand* them. Irik* ta them. AO of pw* her*. I am aur*. at* awar* nf the lancuncm that aria* t* dlff- /uni Indualrt** and of tk* Inability of th* *ver*c* phyaklaa In knnw what lh**e people are lalklnc nlwut, te y*t any kind of a riuual pkiur* of what their crcapetkm rwnQp navelda ) -ft:;''.#; .. -i j j.i i M SHITMAN My hlndortlai to MiuliU medicine a fend many jroara ago cam from a dear oU gootlmnan whom a frw erf you my remember. Dr. frank HrhuUnphl, at tkr General HUrtrlr la Lynn. Dr. flrhubmehl told me oar* bow he evaluated a doctor In Induelry. H* would vielt a plant aad base lha doctor lake him around through tha abopa. And If, uulrermaDy, tha workman turned from lhair Jobe and acid, **111. Doe.** ha frit that that doctor oaa probably all right. An In timacy brtwaan induct rial phyairtaa and work man ia tha area fan arc for tha aataMiahmawt af tha naAdfan which tdiriowaiy moat aalat. An for Tad Waleci* pupae, ha dwelt oa worriau that hare butWeed him. I doa*t think thar* ia anyone who ia better qualified to cooeider tha legal prubiefna having Is do with indnatrial medicine than Tad, aad caataialy if ara lamp tagathar tha atatcanaaiU mada by Joha Fowlrar, Tad Watera and Arthur Jobnorm, wa bare pinna thlnga to rantaibir. In Arthur Jofcnaoo'a paper. I particularly naaeanbar hla etatemeot about tha thru* criteria for acceptance of liability la compancation caeca. 1*1ret. tha eetaUUhmmt of a true and pueitive dlagnoala. Second, tha aatabllchmmt of an nrtaal cauaatlao factor for tha dlcraar ia uacctliwFinally. tha raiatcaaca of trua diaabllity. I oaily wtah that aD of tha member* of ah indnatrial ncridcot faonrda sndmdned thla at wriS at Mr. Johnson. . Ten yearn ago there arrrr two arena which raally peaaantad aomethlag naw, aomathlag which probably aaoaaid hot hare bam conaidrrad had there bam a medlar befoea that, la IKtg, Oaa of theca waa tha atudy of crJuhiltty and pertiria alia, an araa which waa act atrictiy naw to aoma iavootlgaton, hot I think It waa rather new to much of tha group at that meet ing. Tha aarood new topic waa tha uca of BAL in tha teaotmaot of piumhlam. Again thia year wa had two thlnga that war* naw. Wa had Anna Baetjer*a worh m tha effarta of teonperatcra. humidity and aaaaooa, and tha two papaaa an tha uca of KDTA la trealmmt. Anna liaetjer*a paper, la my opinion, wac outatanding. It hoc bam a difficult Jab, aad I fad that tha work wkirh Anna prevent'd thlc morning ia to be regarded aa only a preliminary report Obrioucly murk remalna to ba dona, and I caa riaoallaa bar next headache of trying to rrprurfore thia whole thing with immature, grow ing mice, noi ndult mica. Now, F.DTA wac not mmlimed laa yeara ago. II didn't aelet BAt. waa the new thing, but in hla paper on UAL Dr. F-agie aald: "I wtch to cuggoot that although BAL hae proved ae effort leu In tha treatment <rf rorialn typaa of heavy metal poieoaing. tharo la no ruanou to holleve that other eompounde may not ba developed which are even more effective and which, acting on the name princi|4e ae BA1, may aerva ta abetract lead from lie combinatim with liaeaen.** i feel very certain that at tha beat eccoinn of thia meeting, ten yeara from now, KDTA will have peaeed Into limbo, that wa orifl have paw Compouitda which win da tha Job wary anch better than BAL. Wa wound up with Boh Kahoa'a paper, aad It erne impeeweiva. What they ara doiag at Kettariag ia reemrih ia the grand meaner. When you atop to ronelder the deltam. tha maa boon aad tha boredom | Laughter] that ban gone lata thia -- I duo*l want la ait ia ana af thoaa chanabaro fur eevea aad a half hour* day even if you give me a dank aad a radio! | Laughter ]` But thia U realty tha fundamental approach. Thia ia uoiag mew. getting him la what moat nearly appro*imetre a toeic evarhlng environment aad atndyisg him. It ia a trunrnduua chore. and 1 believe that Boh aad hie aaeoriataa at Kettering are to b* not only congratulated but encouraged ta heap H op. 1 am aura that I do not have the Inat word here, berauee all thoaa who atiB wiah In talk will hate ample opportunity thia afternoon ta get queotUme or anrwara off their cfaaate. Wa have had. ae 1 aald. a epfmdid acre*lag. aad it ia with great ptmauro that 1 new turn It bach to Mr. BewdHch. e-Harman nowprrrn- Wu win wwawat at Im minuteo of two, alerting off with Dr. Unik dierueepui of I>r. Kebue'e paper, far which there waea*t time thia morning, and Wu ran then ruitlnue with whatever of tha varioue auhjeeta of the part two daya aayema deelrea to dieruaa further. ( DIic h iIw af Oft. KfHOf? fopae ad ftOUNO TABU DISCUSSION citatiMSN MAMrm atruTUTr*: W* *18 pro read with Dr. lawr'a diseusaloa of lr. Krho'e I*P*r. M. j o k m LAtea: I v m certainty lapnaaed with U Imonidnu augaltud* rf th* nwn> tUidr undertaken by Dr. KAw ud WU group. Eight )mn i(a I bad tba fbwan aad privi lege of bring an( then* *ko yaitirlpataf la lb< Mart of thta Mod;, la Ik* p*M amra yin, I kaw kad liltW or a* appurtuaity la fidm lu pfurecdiagv It n iw Ikal a *wb a nlnaitt rad Imjstrtaat. ddtiaf lato tk* mrtaholic rrlatlooaklpa of Wad. coaid hardly W don* Justice la twuaty minute*. Hy Ik* liaa* Dr. Krhoe kad kad Ik* apgartuaity la akMrfc a Uttk of tk* background of tk* iqoriant. tfccro aa littl* tlae* Wft to pmait oa to digest *kat wa* found. rruca tk* chart* that *cr* pot k*far aa tkla morning a fc* question* aro** ia my mtad Oa* K following tk* period of tk* lahalrUcu of kad aaagoloald*. Ibm *a* a rite la tk* Uid lend and. cnetcowlUaUy. la Ik* ariaary racra tio* of Wad. If 1 aried correctly Iroot tk* chart*. Ik* Mention dropped aft la tk* aria* rather abrvpt!/. k*r*a* tk* coatcat of Wad la tk* blood, after dlccootlaaatloa of npnsur*. tapered oft rath*r gradually If t remember correct!/, la /oar earl/ eeorh la tk* Torot tea and Thlrt lea, e>h*o Wad OBJ /ire* by mootk. after tk* d(M|e perkd *aa enrr Ike racrriloa tapered oft or*r a rather War and rradaal per iod. ThW did not aerea to te trve In th* subject* abenra here tkla morning. I eroold nb for comaeeot pa that. Aeotker point that eraao`1 dear to in* wa* tk* matter of wan* 30'. or 40', of partteWa which wr* retained la th* respiratory tract fallowIn* additional mposvr* I wood** If Ihlo *ao retolned, or deyew,ted oa the respiratory inurcaa. If It *ae depnalted, how enwrh of tt wae Wat la Iho mucous and therefor* >*a)lo**d later, a* 0* parlor*ted f I thlnb alt of u* are looking forward to th* doat public otion uf thla eroek It I* of aurk magnitude that on* nut alt dow* and artuall/ atudy It hefor# tMwe>iUe nenmeat may k* made I now Inelt* discuss!'at of thla paper. ML P. r. utezMtt: Tkla work of Dr. KrWi Ilea la coenpwtrty with what w* rnuet kaow la order ta kaow about a hat we are gulag t* accc*n|dlek. or or* nrromplisMag. wltk tk* a** of KDTA. Thee* haw been numerous nparta of cases that were treated by EDTA wkkh Indicated Ikal at tk* *eed of a rdatlerty akart course of trealwient. tk* aria* and Herd Mafia kad rrlarwed do*a to what ere rustsIdee a warn mat leerl Uo (c i*|Ib ih 4 exposure, aa w* haw la wtaay ***** of ladwetrial Wad poiowing, alao indicated by Dr. Kakoa'a work, akowa Utal tkear casco. If left akoa* to tk* norma! aartakallr and ehc radio* price* saa. Woatd taka appealeaatrty twice ae taeig ta Men bark to th* normal tla* aa tkry tret* la getting ap to tk*4r high WeL Warn** *i*r rewamealed to Ik* *fl*ct that KDTA. la fanalag a chelate wilk Wad, wa* M a awe-way pngnadUoa. bui followed tk* law* af threwtea] balance, la that tkerw I* aheay* a reversible action and II almply go** la oar direction ta a pedal of chemical kalaaca. If tkl* la eg, then it would b* pnaaltd*. la rledag KDTA la too larr* a da**, Ic locrioe* th* actaal Ink omoceale af WatlgahW Weed peweat la a critical caa* of lea Icily, each aa |a a child witb enrephalitU. la aty rttperWeec* whk rwulta and data ia th* a* of KDTA I how kad no can* that baa returned to aormol Wwta. crew after prolonged uw of EDTA far pool that re quired (or tk* r*4>*f of ryweptoen*. Although aria* Wevb would return to neev-etpuaur* I*w4* after alt to It weeka* freedom from to af tk* drug, they Mill ram* lock la practically tk* pert real meat Wwl* until after tkrwr to ail month*' lotermlttewt war of EDTA Tkl* I* react!/ erkat on* would etpect from Dr. KekaT'a preaentatlon. untewe tk* drug wr*r* refttlaoed peer a period of tlm* that would k* roughly proportional to th* tint* that thle p*tl*nt wa* atieorblog kta lead, acted up by th* faring af the Inereaeed rerfrtb-n due to EDTA. la otkrr wonts, If a alngl* Inkctlo* of KDTA rau**d a to fold, Ithour *c< ret lua of lead, ww eroold hot* to uy that that |rpreeM SO do/t laatead of on* day of getting rid of th* lead; and. of course, as th* KDTA conllnueu ta k* |lt, F Ik ; ' t i 70 D1SCISSION tb* amount ef M tn(>4 (ill eotll H narbaa a leva! when lb* itx-blUbl* bod Ntlid* of lb* boo** l* all onrrelod. Bui ft* k m ao tjino atWmft, chrmlral ouulUbftom bring* tb* blood back up to tbo balance -- determined bj th total amount of load la tbo ayatem. which anti la tb* boftoa. Therefore. to tcaaipllab dotoodlng. KDTA would haw to bo uftad m*t ft period of lira* twlro aa li( a< tbo police! waft accumulating blft load, divided by tb* maltlpb *f tb* ftftnlor of tb* rat* of nrtrtkn Cftoftod by KtlTA. ftad la atoot raooo EOTA baa td b**a ftiaf that load. M. (LftTox L. nuku: Yootorday. Dr. IUaf- bid Mapbaalaod tb* latportaar* of lb* ctiairlaa rcftvoldortng al tb* dlagiwrtic poortblUtton la a load oapoaar* c o m. Including ao* load road! tteaa. t bin two raooo la point la tb* baopttal rlfkt aow. Tb*y wor* op*rat*d upoa wttbla tb* Uftt weak. Tb*y bo<b preoontod tkrn>4n a* "fortdrop- do* to load Tb*y wort fortunately d frofta oar plaat. la fart, w* bar* never bad a ca** of foot-drop ta oar m otorag* battery ladartiy. Tb* place* wb*rt wa ** pM*t of tb* peripheral nouritl* load paloy raooo -- dun ar* aot vary many of them. | bora probably tnft *aly *U or dfkt -- hara bora la lb* braa* fooadrlfta wbaro tbota la a bag-contlneod low oapooure, arltb a lew bnl of bad atuncpllna Ooo of tboM cam wu a foraoro chargor la a anltftr wblch wa* adllai op aid ftaiaftbid battory platan. Tbootb It wa* a nlaUraly tad operation, tbry ueuaRy war* ftbio to rod! op two or tbn* of tb*** big cooiltrallor load* of r~ irtlit battaebo. Tbry bad eoly eight or to* aar* ripoood. Tblft Mpont wa* ** laloan* at flrrt however. that at oo* tlaft I nriot aiadid that tb* plaat b* rloood. pofhdlay adequate oaylaroriag venUtatkm. Thereafter. tb* wa wrr* aot aoat to m Tbry an tlD I* oprratlofti. with coly a fair amount of *agia**riag cootroL Ooo of tkooo aw* I bad trot w m la 1MI or 1 HI wbra b waa rbarging a areoitor frooa a email acsffeld, wltb tb* form * laloio* tbol whoa I ora* op Ut*r* atoadlng aval to him. I rooldat are blra boraoo* of tb* foam that worr btowlag took oot of tb* farnarw. In*id* of Iw* or tbro* alMtoft, I wao baiting plowty of ***** bad. Mr attO bad too* working Ikon, aad b# Anally dorbpod a Mdnp Mo bad drifted around fn*a oa* boo* pltftl to anrtber Tb*7 trot Uuught b* bad c<*gonlial porphyria. Wboa b* wa* taaty **at to aw for evaluation, I Ullevad that bo bod ft mild fort drop. Oort tlkoty oa tb* boot* of tb* bod ftboocpllo* |tot tbor* won rorlal* ft*port* of tb* too* tbt did art oorra etoar and tbat dldal add op to abew Itvat bad w*a raoolag M* ** bring tamaalag porootboolft. ar auaitqoo*. and crawling ftoaftatloo* of bl* tower by*, extending up toward lb* cheat. wttb a r*fttrtrt!oe dlrtrraa frofta tb* rplgnilriua rlfM tbrougb to blft mid-bark. Ncm* of tbat ftooadod Ilk* toad to m. Iloaorvr. wo did tnai him for tb* fort-drop wttb Vereeo* Inlravenoualy. With tb* rooohaot lerrrao* ta bad oxcrotio*, tb* fort-drop dtaapprared entirely. However, bo otin bad then* otboy ftymptocn* of pareotboaia, a we bad myetogram dofti* oa bln boraao* I didn't want to tore blai oot. Tb* bad liability waa over wltb tb* ctoartag of tb* foot-drop. A nytiorram won tb*a doe*, aad wr found a *pacworrupyiag boloa from tb* foertb to tb* ftlxth don*! vertebra. A Muraoufgecm op*r*trd oa him tblft wort aad found a lorallaod aracbaaldb tk Tb* patbwt had bad treated too* la tb* part Tbla waa *o localiftod tbat H am* bglialif to placb rtf tb* ftplaat cord itsrtf. Tbat U oo* c** whore. If wa bad Ort ported tb* dlngaartb procedure* moce or lam to tb* atb degree. probably ar*a*iaody would ban* mail s claim tbat thU aatlre altaatloa was da* ta bl* perrloo* bod abftorptkw. Tb* Oporatlaa hawed realty a localltod ftplaal cord boloa 80rrtatod to tb* occwpatioa. At tb* *am* tiaa* I bar* la tbv boftpital aaotkw aiaa with a UUloral fort-drop. Tb* ftttoodtag ararelogbt fait tbat It mart b dc* ta bad. Tblft maa waa a buntrr and told m* at gnat boftb baw b* a***r ma brtboced to ftlft tb* bad ftbot oat af tbo dark that b* fcitbd ftod at*, bat jurt ft<allowed It, had abot aad ftB. lift waa ab* operating a amafl atim* ratting operation. where bo uood a load-rontalalag htbricaat aa bl> morklaeftL Wbrthor tbat haj aaytblag to da with M wa* qemMrtiabK bat aayway, b* did hare a border-tin* Mood aad aria* bad. bet a* ntlpplod cotla aad aa bad liaa. Ha cer tainly bad a foot-drop, bet tbca h# bogaa to dftobp woakooo* ta hi* hand*. ta tb* oitoaoora. I atyartf bare B*rer ** a guadripbgta do* to bad. bet k* bad bora rapidly developing tbat (a the loot few week* W* aloo did a myotogram aa him. W* found that b* bad cervical aad lam bar dter*- lalor, tb* nrvteal dim will b* re moved, with probable cere of tb* gaadrlpiegto, Thor* wa* aartbor ran* where there waa load la tb* background. If wo bad aot followed K through Urau** It appeared atypical for bod, I aaa **r* tbat tb* iaouraar* cantor* la both ram would Karo boon paging permna*at total dunblllty More bag. Yoolorday Dr Hardy apoka of pluaabUm aa til being proaont la modem Industry. I Cec il 1nig would agree with tbat It atm **om* to cat up la lb* moot unexpected piece*. parttrelari; la lb* ftinail, aaouponrlood ptonlft. I wwold Ilk* to pert* briefly two or Ibra# c 1 ' 1  nilfctiri I ifi "lift ilia I.hiiirt^li'ai'rilli wBItfi fi|? fsfe? irfp ! !?[' i\ pP-- 2 3 ~ r-* F 8 f SfS-efi*6<***r rMi i *Elf iHfslsulffjLlrLli ] i i iji; rElfH rtfrs^ Irlll r [' 5 v-' ' ? -' .* 71 DISCUSSION j Our trouble la Industry, of ccaren. kw bam ojr pathoktrlat haa found a arther reuee for Iby Inhalation. Wr hart tht mrecrlUe thlnga, death. you uaderetand. Tht *er*nd question 1 would likt There haer been arena! exampice of thla, and to oak la. In that kind of rata la It frit nce- 1 think they point to the fact that rrea thourh nary to oat EIITA 7 there aai a comlderable amooat of lead la the tt l. J. (Hiaut.ll, Jl. Dr. Johnrtone, tht bk>ud and In acme vf the other tleeora, thla enrretioa of hod in tht frees of thtat chfidrta war a coincidental Andlny la aaeortoliou with ranger aa high aa 100 mg of bad par day. ThU a dtaeaee which waa llaelf fatal. la Art to SO timer tht ralwa reported for i- You aeked thia momIny hour oar petbologiet doatrlal type* of exposure. Tht Increased Inct picked up Ihla dUgnoela. There wert a couple denes of acult encephalopathy la children at of thlnra that made him aoeplrioua. la niroeot Compared with adulta depends, at Itaat l*r part, any raw where there **a nitaxa of acuta cere upen thtir Ban Intense Itad Mpoaure. ' bral edema and brala atom bemlatloa. oar palheb- X4L B. K nui: I ha cent BMiand nearly at ogt.u hare done two things: ana. looked at aaaay ra~rr aa Dr. Chlrolm. It certainly It the liver nod kidney far the Inctoetoa bodice trot la tht few chlpt I hart menaored that I that Blackman dearribed a food aaaay yauru hart area childrra tat. It la quilt otnrtooa that hack: and aocoedly, they have aeat the brala. ar tht ttpoaort la nwaota HlMtbar tht chlld*a part* of the brala. to the Katterlaf Laboratory treatee laeO-ieacy of pH control tad chemi for their coaftrmatloa by timer analysis. The cal bceneo.ta.lr adda to tht hasard. I deal laclueloa bodlca are acaaethlag that oaly make aa know. | had a feeilax It did. I think tht - auapect that thla child haa abaorbad eaceaalvo poaurt factor aad bt tht Boat Important oot amooata of laud- They don't prove the rflagnosia of afl. of the encephalopathy. That requirue tho far M. a. B. aarta: I. too. would faroe tht Opin ther atrp of cerebral tinon aaalyaia for lead ion that thia la a doat factor primarily. We atn nalHL that acant of tht Inda of lend la tht blood ml nun: la other words. thla la a noaepactf- art my hirh aa waft. Chlaotm haa already da- Ir cerebral edema having dranociat rated eapanuto arrfbed tht atool Aodlar*. and aurh lattaat to bad by Inclusion bodiee or Ita |raaaat la exposure la apparent la tht elide I ehourtd aa tlaaoa. It thru remalae for aiuwmai to taka tht the child that died. bedd atap and aay they beloof together. I don't think that anacoptfbttity la particu I think it la perfectly poaeltda that childrua larly a factor la terms of tht central nnwi with tarylag f igrno of cerebral adeem mlfht ayatean af children. We dn eee n cvOrctbm <f bare qalte aertoea morbid rhaafo add phyatotafflc dlacwaet Involving the neonJoyleal rj.lren. nhcre char.rr disturbance la Intcdligvoee quotient, ar aye probably la n factor bemoar myetlnlaalion perhape go blind If they Deed. I am totonoted of the central arrroua ayatroi haaaT occurred in what rauaoa the patient to die*, and whether until the latter part of the Aral year; but mye- It la related to bod la the brala of adulta at llaiiatlou le pretty weO cotepined by the time wall aa la children. the child fete to the aye when lead poiaonlaf I remember ao wefl dWamalaf tho caao of a cram. Negro malatenanrt tnaa la a etorayt battery h l Haaairr Banr: I war woodrrlsg if Dr. plant who had had rood- solid exposure add araa Smith could tell aa what amount of lead war la found dead la bti bed la hie boarding house, the brala tiaeoe of that atrtopey of tht child, and the rare araa brought up. Question aaarh --- ad ether attopeied children. I am atIR latar- lead poiarming? There were staggering automata tated la the idea that there la acme difference of lend la the brala. la the dlarussbm, I araa -i between the adult and the child la what tht Ibe cmly one who waa witling to pot kia death central atreoua ayateua doee la raapoaae to tonic and the Andlnga of land la tht brala together. laeatt. How meek do you treat to aay that cerebral M. (Mrm: Xa ! am etnbnrruaeed. I doo*! edema la lead-reUladT Sac what 1 am getting hare It on that Individual"a alide and ttiB haren'l found tht enact Am re. 1 Just have at! 1 am aeggaetlag that the rtuat af death could Kara been bear! failure, or eaceaeira ad- it free* Dr. Kehoe. If ni hlrh la Ihla Individ- mlalelratloai of Anlda. But whan doee oot aay aal child la otbrn, thourh, wt hart found thla la bad poisoning and bad-induced dealk7 that If there la teaa than J m* af tend por I am not naylng It arett, but 1 am trying to get ion yai of brain ll"oe, eren thourh clinically al '.ha problem of being ao beallaal to any that numerate haa aald there are Indtratlooa of lead bad la doing damage beraune you don't hart aa ectrephahpalhy. l>r. Kehoe hae been eery heel* many place* aa you want la Ik* equalioa. taat to make thla dUr>ula; and cm eark 1 muaint lal>r Ihlr point tew mirth, but I raalon when ke haa lean la the poaltloa of dif aea Dr. fiyrre wnnla to rlralghtew me out. fering with Uroae of or who won the clinicians, WL Btuui: I dost think I ran. -: *"*' * i '' *-\r -. .`-V * o'**.v r . 1>" ? ?>- I ", > `1 ' i. n fi^iftiwt ifiltfnwtoavTntfiirc ~ ^ Wi^aWrfj- -.; ,,.'-co 'MWrifiitwSbii^fr>^-i,ii j.niiiL'kVi'^iV aff^rra-ii S .' . ' ROUND TABL* 71 U yn wifl look at tha i^nrdMOMt, you quaatltatlniy, glvaa a food Idn aa ta who la wtB * that it baa bam cbaogad. Tbty changad gulag to tun ap la tba abb bay. 1 woald Ilka R about a month or n latar. ta guami with yn about tba aaa af calrlam Thtra la on* thing aura abort tha point of aa tbarapy. EDTA'a a*4 prophylarllcally, which rma brought pa. wtLtKTl: Porphyria, of count, ta aot tit bora today, aat that la, br rirtaf EPTA yn ao iht program, but I know mm who work la fa* prodora a Nr.M of falaa aoruritjr. Thar* bod pUnta who ban Urya porphyria azcratlon la ao gmUoa about It, and aaytklag that iQ aad han aonr goUn abb. Of count, I am aaly do that moat ba oaad caUttouaty. talking about porphyria caaaa, wbrn anrytblog What I ban baoa latawM ia obat ring hara alaa la withla normal Hmita. today aad yaatrrdxy waa tha gscotlm of *kat ml Ram: I tblab wa ban coma ta a nry baa happmad to our rakisia tbarapy. I am aarv that la what Dr. Ratknap bad la mtad. I tblak good ana of dbagraamaut. N. wtLDm: Wa bon racorda to aabataatlata t>r. Kaboa awU Kara that la mlad, wan ba tkb fort. pout tbla afWaoeu. tw. RAS0T: A good baahby ana. Tbla la tba I ban board Dr. Shlpmaa ulk aboat rattaf am whan wa oaad mon iaaustlgatlaw. I thib of aymptoma of load potaoulag, la tha Baa af laagt Um cowcapt that It la aB right ta lat KDTA. Did yoo roar aao anything aa apartarw- aw walk around with ladbn af pathologic lar la roor bfa aa tha rallaf af symptom by physiology, which la what a high porphyria la, giving latranooaa calctom tbarapy? It la la- whatoaar ll la. hacaaaa If tt b dot ta alcohol -- eradlbla. Nothing alaa baa roar baaa tana- aa Dr. Kswalhoff waa aayiag yaataaday aad whkh fartand that caa |tw yoa that rapid, opartnrw- baa ban abowa yaara ago -- tbaa mayha >omt S br rallaf from aymptem. Wo ban o*ad col- tktag Ima to bappn aboat that; but If yn gat cism for yoara. Thin. la aa tbarapy that 1 It with low bmioglftbla aad yn know Urn bad hrww of that baa ban pond to bo battor oxpoaoru. ... tbaa tha old-faahtnad calrlam tnlravnnoa ml vtuorrt: That la dUTanmt. . M. son: That lat ' ' s Oar Malta abotv ft anr tba yaara. I ban ' ml wrurrri: That Ja dUfamwl That lauT Tt to SO load tatoakotin caaaa rtfbt Bow. what I aabad you. If yn grt high porphyria Too tum By point of rbw. I am paracaaQy, awrotIona with otbar load algaa aad ainiliima, from sty own taptrbwra. at ID against dataodiag. that la a diffsnat alary. I caa ahow yn then t faal that It la aafar, sad man fnalbia, la or fnr dmaa caaaa of high parphyrlao. which M tba drittdlng procaaa (aha Ita natural (aim wa plain id. that had ao ladioatina of ryap- aftar ym ban guttm tbroasb with tba arsl* loom or algaa of bod inhabatba. I am art i tasa. Udklag about low hnwgbhla. low blood cooata, I dn*t atata that yaa caa Jad Iran tbaao tan who an azpooad. Somabody get tba Idn or high stippling caaaa. ml lam: Tn aad I would han ta aal up ban that wa an sot tranting than man. Tba tha staadards of laud latoxicallot aa than dorton who apobo today didn't wsat to gtva la amtual agrnmnt. My goarral with yn n aayno tba Idn that lbay an not trotting calrlam tbarapy mta n tha fart that calcium Ibaaa B>OB whn tbay aay Utay an parmlttlnf form tha laud Into tha hajr akatatou, nthar tkam to atrrata tba hod aatsnOy. I am tan tbaa out of tha body. And atom than la ana af yoo maaat that, baraom yoa do traat limit ta tba amount of bud that tha shsbtn tbni la your m porticoUr ftab low. And yn can hold, aataaa tba man la ptrwianntly nmond Sat wndarfal Malta. from bad tepoaan. tha risk of bod potanlag I am atlll >|>ImI dalaadlng from what | lx lacraoaad. Am I not comrt that forcing ban bawrd, particularly aftar what I ban laud lain tba baoa with cmblam la tha boats board aad nod about KDTA. for lit uas aa tbarapy! I would Ilka la oak aaa goastbw of yea. ML WUKMTt: Right. Dr. llardy. Do yn pavplt la Maaaarbuaatta ta. Haaor: Tba bob land goaa lata irai go afillnty oa porphyria tooting aa to whatbar form af phoaphala aad dlaappaar* la tha. . . . a man baa load polaoalng or aarlowa load as* ta WTLCXTt: Moblllaaal MoUHam tba bad pnaort? That U what I ban ban Informed. within tba bony atnrtura aad txkaa tba bod awt M. Mtairri Wa an trary aturb Impraaaad of rirvobtlra, thua giving Iba body a rhxncs wMb tba lavrl of porjdiyrta aorntlon la tba to taka a "braalhtr** and prapan far tba Bart arlrva a* aa Indax of tba laloalratlua. acd tba riaga, wbkb lx tba axeration of bad by normal, aipfwura. That ta tba point. If you Hava a natural matabnlk and phyxlobgk pruro whola group of papl la tba atoraga battary ML MxxnT. l)r. Jobnrtnot want* to }ia plant who ebow a wlda apartrum of bad valuta la DU inNNxTOMl: I think, Harrlrt, you ka flat, tba porphyrin, wa ban found, whn duna a datum algbt mora about tbla tbaa I do. . S'*1''"; .--iv- - `l+, '.rC <*$>;;' , s* <*:.. .rtVJ&v*: &'W" 0i% ;$8S$*r ' ' ''" 1 : ' v S;' -i* iWWIwg i*w Ifir a; $.4 "' `ft,. f` !% '; i; ?f 'V$ ^'3 ,T/ ,' "4| ^iy *5 *-i imm* I |ff 5J ` i **. rs ,-jHi! n\l\m immi r=i;ml m iltl twXF ri ll ? HlrJ jM mu isl|SsilriMifiifjiimii'iiijiitiij!i ri ich * ill? iiJUF fl iirilji.iii| r?i$ if I1! pi u ;: | MI: ?! i!iti[! I'i? H i ya- ;A ** r r,, ii-L* S'* * >5 *5g r^ . 3 Sn 2 3 W - _ ' 2jr -.* r- ;?}rr^J > iv/.'/j m 4;' ? ^ ' - . ; : ,-s !v SOUND TABUS TT live Wad excretion dody may be helpful U determining that * man Km na excessive body burden of Wad. when lSo usual load etudlea do Oof rrreal lUi burden. Until rlj ItM. wo la Colorado brlimd. M most other*. that a Ban did IX* bar* Wad pnlorailnf unWaa So showed eareoelve amounts of Wad la his excretions aad blood. Eotty la IM&, Dr. Bbermoa Pinto roforrod aa unususl caao to u for diagnosis and cant froaa a Wad smaller plant tocatod at 10.049 lot. Tata M-yrar-old male. a spantab-American. bad soar too yean of occupational Wad exposure. aad during tSo lad eight ran of that time bo bad bad periodic urinary Wad dadlaa tbd rarlod la a normal rang* froaa Ottt to 030 mt P*r liter corrected. For tea day* prior to oar seeing him. kl* earn phyeirixa bad (teoa kWa ItH r of sedlaaa IbloealfaU lntraimuuoly dally, with ao cbanc* la bia complaining of toaa ad tbo eariltf bo o of hla hands. and numb eon of bla fawna and kanda, of one axxtth's deration. Ho danled. and w aeon viable la obtala, aay pad blatery aaygeetire of Wad pot.' aeainc. rhyeical examination mealed dilata tion of kta left pupil. Ufuakiuua of hie Wft dtook. a altar Wad Uh (atiatld aaaatbtela to bie ettawa, loaa id deep teadoa rettrxse hi hie furrunwa, weakneaa la hie fanananuplnnten and pronator*. aad aa inability to retrmd bia wrlate and hpn. laboratory ooaadaatloao dwarf a aoraaal eplaal Bold and normal bidney and Knr fawliaa. TW< man aboard a Moderate hypwhmalr- annals. erttb a baaaa gtobia of 11.74 ran. Tbo exported aoraaal, at 10.004 feet ahltode hi lt pa. There ana ao bowqfiUkadippimr aor rstWwkcytcoia. Ilia i; aklu.-pbtlflL^irae U.T04,wilha normal dilfer- eattaL The bkod lrd`.waa 0.07 mg per 100 gm. aad bW 14-boar arlnary lead exrntWma Were OOfl att per Z*. %eara. while bU dally fecal lead eacretWaie ararled botarooai 0TB Maid 0 40 m per 21 hour*. Because of tbo typical oewradogWnl AndInga. -anemia nnd history ed leatd exposure, are made* presumptive diagnosis of Wed poiaoalag. ta aplte of the raietieety aoraaal body bordea tf M a< nAected by bla Mood, ariae and feral Wadroatents. After free dolly Intravenous treatments of 1 gm of Co KDTA, there wae atone ret era of bla forearm deep leadca reflexes. he rnuld exteatd ble Ba|rn end while boiler, and bit gaeMlet parwrtbesla. Inequality of pupils, ferial paralyale aad Wad line bad disappeared. During thane fwtr daye of preliminary treatment be excreted Ml nr of Wen After three month* ed laleeaaltteal treatment, arttk a total d do yea of Intreverxass l a KlrTA aad ft pa of oral t'a KliTA, tkle maa wae rllnkally rum|4etely well and returned to hla former work with ao dleoblllty. . ' Sinew tbit rare, torero] aimQar caaaa with normal range pretreotaeat Wad etwdlea bare Come to our attention aad bare beta treated with Ca EDTA with equally gratifying reuulta. One case war sure--folly treated e-tlh Ca EDTA la IMT. where la 1VS1 with the tame romplalata we bad suggested. but bad refund to make a diagnosis of lead pelacclng bacauae the petlent'e qualitative body fluid Wad otodieo were wttbla what we, aa arefl aa others, thea considered normal IlmlU. la then caaea, erttb the dramatic remisalua of symptoms after Ca EDTA. (be Increase la lead earrettoo wraa also dramatic. It occurred to w that la certain caaea, where relatively aoroml Wad (tndlee are found, with symjdcena ponaibly nanpatible with Wad Intoulratloa, a peovocatiee lewd exrratkw elody might be of nhx To do o > gm Cn EDTA tatreeiooee peweocatire tool and mfWct n >1 boor ariae epeclmea b a little clumsy When wo etudled the par titioned etcretloo of Wad la a II boor period after oslny I gm, I got, and 0.1 gm of Ca EDTA Intraeewoosly. we found that tbo camalatleo pereeat of tt-beor lead orrethm after the ewd ef the latraeewewe lafarloa at Ca EDTA. between the timlle of a *4 'gm and S gm dnt fattened a eery redopllratablo reree equal to 71 log . when I le the tint from the end at the latraeewewe lafwelew la boon, A pre liminary etedy of the Increased amount of lead excreted after a yntmthe led with 1.1 gm. 1 gm. and 1 yo, erne la the ratio aa 1 te to lA le to IT times, nefrtlesty. Tbla meoaa that U ttawo ae much Wad will bo excreted la the ariae of any particular individual nflor S cm efCk-EDTA ne wiH bo otcreted after 0.1 gm IndivideoW erttb Wwd aymptoom aad h 'hiotory at eaponwra. aad ccanpand tbeir eacgtttlew* with eeeeral aormal aobjerta with ao'l^rmyturne or bU^ory of Wad enpoeara. before eod htter treatBMwl with Co EDTA. la tbo leadexposed caeea. the erdlaory It hoer ariaary aarretWaHriipf Wad oflen otrrlanwd tbo a ironI etodWo/W a distinct aeparetiea of the ea- pooed aad aaw-oxpwwd groapa roald bo deter mined from the nmoont of tnrnwoed Si-boor Wad oarratWa after S cm of Ca EDTA. From tkeee etudlee wo bare tewtotleefy derided that If the Increase la the 14-baor artnary etc rattow after I cm of Ca KDTA latroionously w mar* tbaa IT my. thea It le preoumptiee that tbo Indteidual has mere than a aormal Iorreas o la his lly barxWa af Wad. If tho lacraaeo la Was than 0 U my. thea he preeam|4|nfy dooa aul here so atswcmal taeraas* la Wad body l-urdsa Cow>t*ratl<Hy Ihlo means that after 0.1 gm of t'a KDTA lalrasenowdy, ahkh raa ewelly be gteea fiom a Syringe gad rather rapidly, aa fcSi - if?' iBWIwpK'ff! ill v.c iMiMM Mil " 'OJtfjJfci': :. '..'iSKrSSS . -4mt' Jvilpi .: &:# i&fr. 1. ''.';'!ili;: . lA 'Hr. MUHMMilMx I[f<mi> iiiil'&ritAilii wiliiiMtoiittyiai r!ll!*U iUJH iz'rjj ?Hr?| !}! ill* ": - f ` w- _ j. ; .J v<*w ^ <hfcv.S- ;->-}<' . '.r.V k<c. S lijs'i-,.. .' .TVfrVsJ :? 1 - ---fti-h > nrtih Ajw>M&i3ESUMk ROUND TABt* coloxy, and tt mm to aa* tbat tb* work* which w *10 b* htarln* about Uo ytar* frvtm aow will larotv* a cootleoattoo erf tb **o*r*l itudUo oa lead phyaiolofy and load toalcoloyy, tudtri auch a* tbua* d**crib*d by Ana* Bartjr and Bob Kabo* today. Wo certainly would hop* that Un yaan Inn new w* wtO ba** non proda* laboratory t**ta for exact d*t*minalioa of tb* dofrat of load poiaoein*. and <*rtalnly w* bar* raaaoa to bop* that. ton yoara free* now, w* win know nor* about tb* Motoflcal *t?acta of *0Ukt) doaaa of l*ad. Tb* tact tbat wpa**r*o and blood sad ortao krct* ar* bapt kotow a cortata point do** ad ywaraat** tbat daaaar* toa*t botaff dona, dama** wblcb w* ar* *ttB onM* to dotrrmlna Now tbi* I* not anythin* dlrertad only at bad. Tb* h im thin* U tru* In a wid* variety of bride- Aa I aald at lunch, tb* Ideal expoaor* la loro. Seenrwbrr* bn worn aaro and what w* Bi*ht call parmiaalbl* Irrtla, tb*r* U aa area wblcb rwjulrta atady, aad ! -oald bop* tbat tblo win b* a topic oa tb* a**od* ta IMd. caanaiN nowwTC*: 1 doctor* tb* eoaforoaeo a> aa ood. aad I tbaak yoo aB for aaalrla* If ? ATTENDANCE LEAD HYOJENI CONFftENCI Novambar 6-7, 1*H LL Natknal Safety Carmel. Cbkaga. A ' J. C. Avb. Mi, Muiwlwtft 0<M>tl 1 artan. Mm. A# M. iMtjfr, ScD, Jobnt Keplifli Sch, Hyg. I Prrb. HwlA, liMniri, ML P. A UmbrMf, MD. latUnbam Stanl Campany, tltUrlrim. Pa. A D. lattk. Jr. Mi, CkvaUtrd CXnk. Oakland. Ok *. L Mip, Mi), Margvatta Uwioitj Scbad d Mifalw, Mtnaaiae Wh. L L labnap, Jr, Mi, Wic iw '* A F. In*. Mi), Cokrndn Urbanity Scbaal at Markka. (War, Cain. Oaa lafcraal. Rata3 faint I Walpapnr Oatriktan d Amtrka. St. twll, Man 0. M. Inrclna. land Indurtriac Aitocktina. Nan Ynri. N. Y. *Marrfmd lend deb, laad Matria) Arnecktian. Naa Ynri, N. Y. Mn Manfrnd IniMi. Naa Yal. N. Y. S. H. Inynr. Mi). Iiitin. MawacbactHt F. F. leyv. Mi). U.S-S. laad Unitary, Inc, tnd Cbkaga, lad. A L Iradky. MD. Tbn UrnvnrWty Herprtnl lakimara, Mi. C. 0. Irtdgae Indndriat MtdkJ Aaiddio. Cbkaga. & Mark lajy. Mi). US. Staal Carportiicn. (tttikf|R. Pa. 0. H. (yarn. Ui PeWk HaaMr Sarvka. CW-aati. Obk *. K. Iran, Mi). CUdran'i Mndktl Canta. Iirtin. Mm. X C. Cakndra. Mi), ladwrtrki Ik-Tart UWrdain. lac. HcHibrac*. I. K M. Cann, Mi). U.S. PeUk HaaMi Sarvka. Warbingtan. a C. X P. Carre*. MD. Cbkaga. Artak V. X Cartmp. Ganaral Matan Cnrparntkn. Oaten*. Midi A X Cbnalm. Jr. Mi), Jtbt* Hepliar Sdraal al Mrjicaa. Intfimara,' Mi Jnrapb Orirtin. MD. larok Urvnrt*y SMldi at Scbnal at Madkina, Cblciga. & G. D. CUytnn. Amaricaa Indantral Hyyaaa Aiaaciatiaa, Dntrnrt, Midi. G. H, Catnw, Jr, M.0, Craaa Camp any. CVctge A N. A Cabanba. Mi), Hadtaa, MiaadaaHl Frad Cwl HtvmltaaC Caiaatty Campany. tact Inland, A A G. Craneb. MD, Calanata Caraaratipa at Amtrke Naa Ycri, N. Y. M. F. Crate Jr, Mairdadnrinf CbamkH* Awacktkn. Waiblngtta. D. C. tk*a Dr intar. SeD. Harvard Scheai at Prtk HaaMfc. lenten, Mata. *. H. Dvpnd. M.0, Army Cbcmk d Caatar. Maryland td>ard teak. PhD. Snift and Campany, Cbkaga, A A F. lor, Jr, A/gnnna Natianal labaratnry, Onnnnrc Great. A *K A lbin*. pVO, Mnitacbmattc pirlnian Orenpatinnal Hygknt, tartan. Mate Tbnmnr Fanalar. Natianal Salr+y Cornel, Cbkaga. A Harry Farantan, M.0. U. at CaMamk Stknfrie labeatary. let Alamae Naa Mac. *J. H. FnUgnr, MD, Llit Pant da Nnmnvrt I Campany. Wlmlngtnn. Oai i w. Frard. Farra Carparatiare Onvakadj. Ok v A G. Fraiiar, M.0, Amarkan Academy at Padiatrlce Ivnnrtae A W. G. Fredrick, Sc 0, Oatrait Oapnrtmant at Hneltb, DetrnJt. Mkb. H. G. Gardmar, M.0, Inland Saal Campany. lant Cbkaga. ltd. 1. A Galdrratar. MD.. Cnkmbk UrJvarvty lebnnt at PWk Haahb, Naa Yari. A Y A. W. Gardan, Implayarn Mv*val liabJrty lravrana Campany, Cbkaga. A Mre A. W. Gardan. Cbkaga. Anak L I. Gardan. Zarxtr Intnraraa Campany. Cbkaga. A Sam Gene HaUam Ptndvah Campany. Cbkaga. A A M, Crabam, M.0, Tba fJUw Campany. Cbktge Mr P. 0 HaBay, Standard CM Campanv. Cbkaga. A L I. Hambn, M.0. Amarkan Irata >baa Campany. Cbkaga, A J. W. Hammtnd. Hmbk 04 I taTakna Campany, Havttan, Tae *Harrkt L Hardy, MD, Maonacbvtattn Ganaral Hatpital taolaa, Mace Aatba Partkiparrk ~-i ,S <* , W.^'- mS. ji. ATirSDASCe 0. C. HtrteU. PV.0, Wirttfi*! H**Mi, Hr.U. I t*My iimlw, KyJ 0*4. MUk. W. G. Haiard. Ovom-U.*oi GUtt Company, Toiodo, Qb*o *W. c. L Him*^ Hirnw Au mU^M, Ft, N V, Handbell. (m fcn*aar<b 4 Ln^inoorino Company, UmUa N. X C. H, Hina, M O . California i)tu**%*fy Mao*<al Cantor, San frontkeo, C<W. X 0. Holland. MX).. Ansirkifl Madcal Anocktion. Chicago, ML X C. MoUnbUd. M.D- Industrial ModCal AttOckfioA OhCift, flL J. S. Axitrictn btU S^M Company, OtKA^t, |BL X O. Jk )m\ Ciffftwy, Coroopofic, f. ' D. It Job**, MD,, C*<ago, Ma m A. S. Jo Mm, Wic m Mi^mI UWitf Mmt w Ctwptwy, V* Mm, It T, Jobn<+no. Ml).. l4 AAgakA'Caliorma F. T. Jung. MX). AMricjn MaXoal AaaoektioA CMuft, flL It A. ItoKoa. M O. U. of Laboratory, 0M 1. L Kooehk, Employa Mvtual UabJity MmiI Cowfiny, Wmw , WL Mrv I. L KmU*. Wmm, Wkcon*Jn U. Coi F. W. Ua M, MC. Amy CMctl CiMtr, MoyUM FM tango, tp4;o Mh J UW<ty CoofMy, MfoiUtt, Wk A. X Unu, MX). Ntv tori City. Nov York 0. X Uvor, MX). Jono* & UM Stool Company, rithborgb, ** *0. F. UvftMo, MX). 04m, fui W. W. MoHJoy. MX). Occupational Hy94<o I Mtrfictl SovleM, CWmM, 0M> May It Maron, MX). No* Yort Cty. Nov Yc4 X r. MeCanaA MX). Woftom Boctric Company, CV'<ia>, flL C. F. McCcN, MX). MkMfN Uwvty $<W of Public HooMt, Am Arbor. Mkk W. I M<Corynki I. F. Goodried Company, Abos Ohio W. T. M<CooiX Mak Stool Coopiay. |ot Chicago. laX L C MeGoo, MX). HoecMt Podor Company, lac. WftmingtoA Dot Ma L C McGaa, WMapov DoUvoro . T. L McGrow. MX). Boc+ri* S*orooo ftattory Comp toy. FVladatphla, Fti, 1W. G. Moado. Hartford AccMaot I lajro^ty Company. Chrcapo, flL - ! " L K Mflor, M O. U. of OciMti Kot+oring laboratory. CMmo K. OW# S. L M4w, MX). Mnbfaa Uwvty InatiMo of todaitrUl Hookb, Am Arbor. MkL It M. Moroo. U.S. Stool CorporokOA Fr+Hb^oV, F, XXm Maavia. National land Company, Quy, flL *F. F. Murphy. Haooak laad FlrodvcN. Me. HaomaaX fad. ` . C A. Na, MX). Umranity of Treat. Oalooitoo. too. It W, HoboA Amorkan Sooltoa ft Rtftanf Company, Soil laW Cfly. Utob X L Nmo MX), latima Kodat Company, ftacMit. N. Y* L F. O'tooU, Owtapo. r-rod #90W. M. Fatal, Noetrie Stor ftattory Company, FMUMpMa.fi. H. D. Foenet Jr. MX). Noetrie Starago lattary Company, QinUaL OM# X C lUXeftflo. Ford Motor Company, Do+rbom, Mkb. L N. labfmaA Notaonol load Caopaay, Granrto ON, flL X I. Itoo^o, M.0. Stored O* Company. Chicago, flL Pad ftoanAafl, MX). Corno! INwo'vty ModcaJ Coftooo, Nov Tori, N. Y* F, X lUbrA M.0. Momoriol Mod<al Cantor, SoH Loio Crty, Utob A. X ft4doft. MJ. Toronto Doportmord #4 HaoltW, TorordA Coa>odo DW ln$, Na*W FaW, Vamd ft Loe^wor AaaocktioA WaiMaftia, 0. C C. X Itofora. Hammond Load frodoeH. Ih . Hammond, InX K J. lUao. MX). Ilmok DopartmoM of fwbftc HooWi, Sprinffiold, & O. A Sandar, MX). Mlvaoiao. Wiaconao - H H. SaMad, M.0. O<*9o. Knob W. K Sawyor, M 0. Ufn^oaal AnaiUHaa of MacNnkH. KadatUf, N. Y. L L. SeNal. No Joraoy Ooparfmont of Hooftk, trontoA K X " Iabort StKindtor. GUbo-UnioA Inc. Mftvawtoo, Wk. H. H. Sebronk, Fb 0. Md^aNkol HyyWno FovadatioA FithW^k, f# t. t Sb.pmoa, M-0-. U- of Ca*Jo#n^i Sckntr*< lobar#(ory, Loa Alamo*, Nov Moo. X I S^^nor, Amor**an Mvtval UabJ.*y Imuran*a Company, W*l#f*oU, Mllfc H. 0. Sm*tb, M O., Ibo Cbadroo a Hotpdol Cmeinnoti, Obi# - *L W. Spotyar, M.0.. Mo m Mato ft*o*d of HoaNb. Indiananalia, InX X J. Stapv, M 0. Conntc<cvt OopaHmant of HaaNV, Hartford. Co m. H H. SUmbor^. W 0,, Cbna^a, Knb *H, |, (Mryw, Fb 0. U.S. FM* HaoNb Soroka, C*Mb*MtL OWo AetWo fartkJpank II _ ________ ___________________________W5Jr. ~+' + - '9t&1 " -.V# ,-Z-' i-^......' *. . *- r,-. "'iv-j- f- *f" ."g&e :-* .-_ ?._ *v,^W / , : c:-;j ; It ATTENDANCE A K Tiytor. Palo Homy Awjyw, M. . H#la* Ym^v M.O, National Load Cxtymy, CWi|i, S. f. A. Van AMa, MidtSfM L A Wad*, M.0,, Eu SU4^ Ol Company. Nh YM, N. Y. CaH W*}**n, N*K*n*l L*d Company, A. H. T. W*KrrtR Lumbarm**'* Mv+val Cti*Hy C^iity, CVlaapa. ft, f. L Warm, U.5.S* load Rafmafy, !*<_, **t CVkaoa, lad, #T. C. W*f*n, Mta and Stadbridoa, tahimpf*. Mi. Otfonca W*b#r, TV* t*4ar Hft Uwymy, Ha*y*. Wat# H. A W*W. Aa*rk* foundry****'* *CJ*+yt Om fUVn I. G. M. WW**rt*y. V O, Matrapolrt+a UU Uw*t* Ci^i^. Now Yort, H. V. f. K WWfilir, VtO,, Alo-CK#lma* Cww, MWidw, Wit, W. C. WltMi, M.D,, National Load Cpwytwy, fartii Aiw, K. A i Mn. W. C. YiHUH, Mfc Amboy. No* Jmm Hontincioa Wliiwt, M.0., UHww< City HaaHi pinMiuA laMmoa*, Mdl G. M. wftoaiaf. la** Standard OS Company, Non Tori, N. Y, L 0. WSaoo, Al O, WIm WaatiUI Hydiw# I taaaanfc MfcifdiHp, CWttfA ft. W. G. Wood, VU>,, NdM load Company, Gtaao C*y, a Mn. W. G. Wood, Gfanto Oy. U *f. A Wanoiir, load Indyttiaa AaaacMKaa I $4. Amtpfc Load C* Now Yori, R Y, - T, M. WortR HaE* and Company, Now YtR N. Y. W. f. YM ScO, MSno SoMy AppRancoa Company, *+tiUrnR fa. " :s t. L ZafUd, toad Udnattioa A notation, Haw Tori, H. Y* AcfGa forfUpaait , - ~----- --- - " >- >