Document jYB52X2pem1VYM76JeDnvnz5

June 29, 1948 Mr . F . E Vright, The Electric Storage Battery Company, Allegheny Av. and 19th Street, Philadelphia J> 2, Pennsylvania. , Dear Mr. Wright i I am sending you herewith two copies of a memorandum on the general situation of the two plants visited some days ago at your request. I have undertaken to deal in principles and not in details, in the feeling that consideration may be given to the details at an appropriate time if you and your associates so desire. I have been quite direct in my criticisms and in my expression of viewpoint, since I consider that the utmost frankness is necessary, and that nothing less would be acceptable. If I am mistaken in any respects, I shall expect you'to recognize that my opportunities for a study of your situation have been brief and inadequate. Indeed you will recognize that my principal recommendation relates to a careful program of fact finding, since no sensible recommendations can be made on any other basis . I should like to tell you that I am very much Impressed with the attitude and interest of Doctor Lanahan. I believe you are very fortunate in having a man with his viewpoint and qualifications. I trust that you will cherish him and implement his efforts. I should be .very glad to have him visit us at a mutually convenient time, and I strongly recommend such a visit on his part be authorized for a period which will make it possible for him to-make a careful study of the material which we have to offer him. I should feel a week spent in this manner would be highly profitable for him and for your company. Following such a period of study, the ground would be laid for any continuing consulting relationship that might appear tc be desirable. In this connection, I feel that you would be much better off if you could obtain advice and help nearer at hand. I am not prepared to tell you that Dr. Heinrich Brieger is adequately equipped to give you such assistance. However, I suspect that this Is the case, and I should feel that after a visit to u s , Doctor Lanahan would be fully prepared to arrive at his own conclusions on 3 this score. It is disadvantageous to you, as you well know, to have to send materials as far as Cincinnati for analysis, and if this work ] as well as their hygienic assistance could be provided at the 1 Jefferson Medical School, it would be advantageous to you, a n d ,1 am sure,helpful to Bridger and his associates. For our part, we are not trying to get out from under, but we have plenty to do, and our efforts are properly devoted, primarily, to helping people help themselves. Such actual service to industry as we may give, can better be devoted to Cincinnati Industry, for obvious reasons. Hr. R. E. Wright'- (2; - June. '29, 1948 It was a pleasure to visit your plant and your people, and I had the satisfaction of feeling that it was a useful as well as a pleasurable experience. I wish to make It as. useful as possible, and thei-efore I you care to raise any questions, or if you wish me to amplify my comments in any particulars, please do not hesitate to let me know. Cordially yours, IAK ef Enc Robert A. Kehoe, M D 0004118 MEMOIKDM OK VISI' TO TIE ALLEGHENY AVENUE AND KESCELTVILLE FLAKTf OF THE FLECTI IC t o SSg e BAT T U Y COMPANY (PHILADELPHIA ) These: plants, were visited on June lu, 19^8 in the company of the physicians, the Industrial hygiene engineer, and operating personnel, and afterward (at lunch and later; some discussions were entered into with executives of the company including counsel. A hurried survey of this type supplemented by information volunteered and obtained in response to queries cannot be regarded as an adequate basis for a full understanding of the many-sided problems associated with these industrial operations. A careful systematic and critical study of conditions would be required in order tc arrive at sound conclusions on which detailed recommendations could be made. Neverthe less certain facts are evident from the observations made at the time of this visit, and from the analyses of the urine and blood of certain men carried out at the lettering Laboratory from time to time at the request of physicians of the Company*. a M * Certain opinions, based oa ``these facts, are offered for consideration. It is apparent that the lead exposure in these plants is not being controlled adequately. The evidence for this lies in the fact, readily established by ordinary observation, that a number of the areas of the plant are grossly contaminated with dust, and, at least one area, with fume from molten metal. Further and quite obvious and significant evidence may be found in the very poor quality of the housekeeping and in the lack of caution and discipline on the part of workmen in dusty areas in the matter of use of respirators. The latter ere worn intermittently, without necessary relation to intermittency in the severity of the exposure, or they are worn about the neck instead of over the nose, or they are omitted entirely. That ^ 0004119 ! N6864.01 men have serious significance is proved by the occurrence of ' ' .' bv ' hazardous lead absorption among the men (as sixoviya. few analyses of blood ahd. urine of employees] and by the cases of lead intoxication that have been found within recent monthsi It is of great practical importance a in connection with this situation, that the state of the plant population in the natter of the actual hazard to which individuals and occupational groups are subjected is not known, and cannot be known by the means being employed at present for this purpose. One does not know what to anticipate as to the incidence of poisoning, nor where to expect cases to occ u r , except by means which are altogether too crude to be satisfactory. The air analyses may be precise, and for aught one knows they may be sufficiently -comprehensive.to delineate the order of magnitude of the exposure incident to various operations. However, the variations among the men, with respect to their use of respirators, introduce completely unpredictable factors into the estimation of the actual respiratory exposure. Moreover, the results of the air analyses are not correlated with the results of observations made on the work men. indeed the data of air analyses seem not to be regarded as medical information- This lack of the coordination and use of all the available information, and the lack of critical examination of all such assembled results, is evidence of a very serious failure in the composite program and viewpoint of the organization in matters of o C\i industrial health. Safety and health in an industry, and especially o in an hazardous Industry, Is a product of an Intelligent, skilled, o CD highly coorindated and Integrated effort _to study men in their working U* environment. The methods applied in the study of the men differ in detail from those applied to the study of the environment, but these are only parts of one and the saime approach. If they do not go along V, together vith substantially equivalent degrees of precision, and if the informtion of the ne type is not critically balanced against the other, neither serves a fully useful purpose. It is precisely for this reason that the methods currently employed in many of the lead trades in carrying out one or the other and sometimes both of these activities, arc ridden with prejudice, misconception, inaccuracy and futility. It is high time that some of the older and more backward of the lead industries,(for most of the older groups are definitely backward Jr should awaken to their archaic status in matters of industrial hygiene, End put into effect the coordinated, properly organized and and adequately implemented techniques that are now available. This matter is stressed, for, unless the viewpoint is changed and impiemented by a radical change in organizational procedure (not necessarily organizational structure) whereby all of th forces of industrial hygiene work together, nothing worthy of note will be accomplished. This is a highly expert technical problem, just as Is production. The task of obtaining the necessary facts and of assembling these in such manner as to lead inevitably to remedial measures and to the critical examination of remedial measures befor e and after they are applied, is a composite technical job requiring the expert skill of the physician on the one hand end the experienced and critical judgment of the industrial hygiene engineer on the other, but with the two types of information set beside each other as clearly and as completely as possible. Accomplishment of the task requires the support of management in implementing decisions reasonably and evidentially arrived at, and the corresponding cooperation of the workmen, who must understand what so they are being asked to do for themselves and why they are being/asked. The housekeeper must be part of the team, since effective and technically expert housekeeping must be maintained at all times. The responsibility UE 0004121 k. for the performance and coordination of the technical vork of Indus trial hygiene, including the housekeeping, should he put squarely on the shoulders.'of the people who can do this work, and If, vhen their efforts are properly backed and implemented, they are unable to achieve the desired goal of controlling the occupational hazard, they should be supplanted by persons who can. As things now exist, the responsi bility for decisions on technical matters appear to be shared by too many people whose opinions on such matters, if not worthless, are not sufficiently well grounded. Thus the choice of the medical techniques to fee applied to the study and professional handling of personnel is the responsibility of the doctor*, and it should not be made by anyone else, except .insofar as the basic social and economic policy of the industry, as established by its top executives, may put metes and bounds upon such activities. The adoption of this medical and hygienic ._ ' . .^ . . philosophy will- save much, of the wear and tear of the day's vork, especially In those matters in which decisive action Is required of persons who, themselves, have not the means of making intelligent decisions on technique and. procedure. If the foregoing comments are net entirely just In relation to the specific situation under consideration, they are at least pertinent in some respects, and they can be taken where they apply and discarded where they do not. In principle, they represent advice based on more than twenty years of intensive study of the lead trades, and they seem fundamental to the problem of why, when all the techniques for effective control of the hazards of the le&d trades are available, they ere applied only rarely in American Industry. In the specific instance, the impressions of this consultant, gained by casual and not obviously leading questions throughout a day's visit, are to the effect that the entire procedure of Industrial health activities in 5* this organization require wholesale overhauling, and that a first-class and comprehensive survey of the environmental conditions in every.part of these plants, as veil as a comprehensive clinical study oi the physical and hygienic status o f .the employees, are absolutely impera tive. The latter should be accompanied by the gathering of ample data on the extent of their absorption of lead. The current activities, except for minor but notable exceptions, are Inept in their concept, ineffectual in their practical application, and archaic in terms of their achievements. Tha t , for example, the nov discredited technique, (monthly counts of stippled erythrocytes), by which the doctor is supposed to obtain information on the extent of the lead exposure, of a workman,is prescribed and limited in an agreement between management and workmen, Is an expression of a viewpoint and policy that fall - . .' '. *. .. . ' utterly to recognize'the professional character and the technical natur of the doct o r 's work. That this has an historical background that necessitates great care and patience in Its correction is admitted. Nevertheless it has come about in large part, If not wholly, out of reprehensible medical practices in ..the Industry. If the doctor cannot earn and deserve the confidence of the workmen that his efforts on their behalf are fairly and competently executed, such agreements are inevitable. Ii the medical work is conducted in true professional spirit and in keeping with the best knowledge and skill available, co such agreements are unnecessary and indeed are absurd. Medical care C\l and clinical study in the hazardous trades are continuous evolutionary o o processes that are learned and modified by experience, by critical o consideration of their short-comings and achievements, and by the lit results of medical research. It is bur impression, that the present medical and hygienic staff is conscious of its needs and opportunities, and that It c a n meet the challenge of the present situation, If It is given backing, authority, and the tools required for the purpose. In this connection it is believed that Doctor Lanahan would profit greatly by an opportunity to study the techniques and results of an ' . *' adequate regimen of hygienic control, This could be achieved in a minimum-of time by a visit on his part to tie lettering laboratory . . i1 .. and perhaps, also, to an industrial plant at Baton Rouge, Louisiana, in which the measures of industrial hygiene have evolved out of a critical, investigative choice of the clinical, physiological and environmental techniques that yield an effective control of lead hazards that are much more serious potentially, than those of the storage battery industry. Ve hereby invite him to make such a visit at a mutually convenient time. TheCrescontville plant, so far as battery manufacture is concerned, is obviously better, from the aspect of design and present control of lead exposure of its workmen, than, is the older and larger Allegheny Avenue plant. However, on this plant site,'the small structurevhousing what is presumed to be a booster fan connected tc the smelter stack, is (or was on the day of this visit; the source of a vex^y large volume of uncontrolled fume . Apparently the fan, was not operating. The srnelter- building for the most part could only be describee as incredibly d i r t y , poorly' ventilated and generally lacking in any evidence of housekeeping. Smelters are apt to appear disorderly but it was all too apparent that this smelter had not had the benefit of careful.planning'-"from the aspect of industrial hygiene in the first instance, or of good maintenance for hygienic purposes, since- This condition was in striking contrast to thejjattery manufacturing plant, proper, and thereby It gave evidence that a hygienic program is not carried out consistently and effectively. In retrospect, it is this lack of' A concerted and well organized effort, this evidence that T*