Document jyqkZaoZ8nQ1RGGLGyqmBOK7R

/ Jljjt " -00dpich Co. - 'jin -uain Street August 20* 1942 oscluX examination made at the request of Dr. D. B. iowe, director. The B. F. Goodrich Co., Akron, Ohio. age 39, male, white, married, employed in manufacturing, grinding and mixing plant (mi p), B. F. uoodrich Co. Presenting Complaint Muscle pains, pains in feet and legs, tires easily, anemic. Previously felt well until about February 1, 1942. At this time he was transferred from his usual work of tire stacking to water washing synthetic rubber. After doing this work for about two weeks, he seemed drowsy and sleepy although he slept soundly at night and about February 21st noticed some unsteadiness on feet, a wobbly nervous sensation, noted especially on ,;etting up after sitting or lying down. not seem to have control of muscles of legs although control was better and almost normal after walking for a few minutes. There were no muscle or joint pains at this time. He felt fairly well otherwise although the appetite was somewhat diminished and a disagreeable taste was noted. xhere was approximately ten pounds weight loss. A physician, Ar, g . S. Hamilton, of Akron was consulted on March ljth, the chief complaint being loS3 of appetite, loss of weight, unsteady gait. Dr. Hamilton consulted Dr, Ao^e, Medical director of the B. F. Goodrich Co,, about a possible work hazard and was advised that there was a benzol hazard and that if.Mr, had not been feeling well, he should be hospitalized for observation" and determination of the cause of illness. Accordingly he entered the City Hospital, Akron, March 15th for observation and remained five days until March 20th, Specialists' examinations incluued eye, ear, nose andihroat, neurologic, and laboratory tests. According to -htatereent, all tests were reported as negative. iUuiie^^ been away from work for about six weeks until April pOth, he returned and on advice of the Medical Department was transferred from wasiiing to packing dry rubber. He was feeling much better but still not as strong as usual. xhe appetite was better and he had gained four pounds. The taste was more normal. backache was noted presumed to have resulted from the spinal tap. a 0 continued at this job of packing rubber for two or three weeks until about May 15th or 20th. xhen he was transferred to the Manufacturing Aepartraent compounding lead silicate. He worked in this uepartment until August 5th during which time he gradually lost pep, began to notice pains in the febt which he attributed to arch trouble :a,d . ^ 15th tae pains continued and centered into the ]oes, io-.,er part of stomach 'and sstall of the back. -here j -i- 3 ui ,.gnt pain in the wrist. Marin;; this period., tjiere was - - - , ,0Lon in motion ana r.o notaole Muscle weakness. Mie co ..fort was described as generalized axj&rp constant puin and u,;e'i ,-juacle soreness in the feet and legs. There seamed also so oe some --.uscular pain oi rath.-, r vague character in the lower part of the abdomen and the back. During this period these pains were -.core or less constant and at times prevented sloop, hiey became so disturbing that on August 2nd a physician* Dr. Dickson of Akron, was called because of their increasing severity. xIiey were not greatly relieved by medication arid continued until August 3th. At this time Mr. Morgan was advised by Dr. Dickson to ;:o to the Cleveland ^llnlc for general exa.in .tion. Stz*angely enough the .saarp pains disappeared August cjth^anngii the dull, deep-seated, muscular pain persisted. fs?.flHHHHrw-.-nt to the Cleveland '-'llnic *higust 3th as an out-pati^ffvTM^ returned again on August 10th at which time his examination -was- complete and the uiagnosis !tlead poisoning waraasa -id"aardiae. A review of. *%*. flHm^^occupatioi-.al history - revealed chat he had been employe^cythe B. P. Goodrich Co. in I929 for six to eight months, from 1933 until 19p3, ana from V)y) until the px-esent time, August 1942. Prom 1933 until 1956 he worked in tne reclaimed rubber department,_ a refining process having no special ,10rk hazards. From 1936 until 1933 and 1939 ana also in 1942 he worked- in the tire division curing tires, tnere being no obvious hazard in this work. In February l?k2 M'. n0i`-gan was transferred'to the synthetic rubber department. Mill 3, employed in water was-'ing synthetic rubber. `This work *ascarried out in a rather poorly ventilated room. An the manufacture of syntactic rue be r benzene was used and benzol fumes dame from the wet rubber during the wasuing process, bur ng the early phases of tills operation, there was no control established to eliminate these fumes. they were noted as strong, unpleasant, irri tating odors ana at times caused congestion of the eyes. This work was carried, out six hours daily, seven uays a week for six weeks wlthon^day off in this entire work period, about **arch lipth h.omplalned of sleepiness and staggering gait as noted in tnio^ls en t i ng illness. ile consulted Ms physician as noted above. ue ,as away fra work from Marph llfbh until April 23rd. upon Ms return to work in &ay 1942 he was transfeivred to the lead silicate plant .here his work consisted of weighing p0 lb. of lead silicate taken from a drum into a screen box on scales. The drum box and scales were inside of a ventilatea booth in -uich any dust is drawn to the back of the hood away from the opex'ator. h wore coveralls and leather gloves, the coveralls being changed once a week and took a d ally shower after work. For .more- complete details of tills lead silicate operation consult the attached report from the Office of the Safety iiv.ineer of the B. i**. Goodrich Go. After one .month of tMs work lean silicate manufacture was discontinued and was received from another plant. It was ground in a mill with on 027 screen to fine powaer. Approximately 1000 lb. of this material was ground dally. Further operations consisted in filling six or seven Kf 0016734 -3- 200-lb. fiber paper druns with the compound and also in mixing about 6j0 lb. of the ground powder with oil. Shis work was carried out during the month of July. xt was dons in a third floor room ap roximately I4.O x 20 x 2p feet with windows on all 3ides usually o>en on three sides, fhe grinding mill and scales were placed under a hood with forced ventilation. Regulations required the wearing of a dust respirator mask at all times. r. Morgan states that he always wore the mask when weighing and grinning the lead silicate but frequently removed it when away from the hood. ue also noted that fine dust settled on the flooi* and various objects in the room ana ohat mask was used when the room was swept aaily. ue was careful to wash his hands oei'ore eating and did not eat in the shop. General Review and Systems health very good prior to February 19^2. Bsu&l weight l8Q best weight iBip (Feb. 5* 194-2), least weight 168 (1936-dosestic worry), present weight about 170 to 172 (August 15, 1942). Head: Eyes: Ears: Hose1 C.R. G.I. G. U. Back, Headache every o.onth or 30 with sour stomach, some dizziness with flash of darkness on changing position quickly. Wears glasses for reading or driving, "far sighted", heasles as baby when less than a year old; settled in eyes producing muscle weakness of left eye. Rearing slightly impaired, no discharge, no history of earache. Broken in 1922 - no disturbance in sense of smell. hoes riot take cold easily, "slight catarrhal condition", frequent nose bleed as boy (17-19 yr*) Ho chest pain, no chronic cough, no hemoptysis, no sputum, dyspnea, ankle edema, palpitation or asthma. Appetite good, no foods disagree. Upset stomach a t times from eating too much rich food, nausea, vorating, head ache; attacks usually relieved by vomiting and improvement, follows after two or three hours. Bowels sluggish, takes agarol and occasional Ax-lax tablet. Usually takes a laxative about once a week. No cramping or colicky pain. Acute Indigestion for two or three hours in 1918. No jaundice. Nothing unusual about the stool. Drinks 4-6 glasses water daily. Seldom takes"a soft drink* uas an occasional glass of beer. Seldom drinks whiskey. Urinates three or four times daily l/2 to 1 pt. Nocturia last week or so, gots up about four o'clock, voids about a pint. Attack of dysuria every two or three months thought to have been caused by drinking alcohol, lasted a day or so and gradually disappeared. No noted blood, pus ,or gravel. No history of venereal disease. extremities ari(} joints: Dull pains in wrist3 and muscles of legs and feet and back as noted in P.I. ho previous difficulty. Kfc 0016735 forks six .-lours eiaily, seven days a week. Avera .os 3 hours sleep, ^iept .veil unt il present illness, Has not been sleeping as for past two weeks because of irre gular aours, infrequent dreams. ->i htnap; about lead poisoning ni: hit iia^us-'C: ibfch. 3 .okes one pac*c of cigarettes a week. Occasional -loe ana cigar during winter. Seldom, drinks, usual ly has bad nan ;over. harltal History Harried twice 1935"3^ and 194-1'-* Ko children or Miscarriages. Present wife in pood health. Personal history Born August <3, I903 Calhoun Bounty, dest Virginia, xived in >!est Virginia until 1929. xn Ohio since. Completed, high school 1337- "ived on a fun until 13 years of age. Boustabout work in oil fielas during summers and after school hours. Post office clerk during the winter. Columbia Chemical Company in the boiler .-ooi.i in I929 for three months. with B. P. Goodrich for eight months in 1929 ana since as noted under occupational history. wdu jobs in the intervals. ?hy s i cal Ex a.. in at i on General - A well developed, fairly well nourished w it male 33 years of age, /Q-l /2 inches tall, weighing 168 lb. (stripped)', sell oriented, alert and cooperative. Temperature 9J.8, pulse 38, respiration 2d. Clean shaven, dark beard, slight facial pallor, slight infraorbital shadow.. Skin: Of the body and hands essentially normal. uood color, elastic. Perspires readily from axillae. 'ew scattered inflamed hair follicles over the back. xnterdigital fungous infection both little toes. Slight scaliness over the dorstun of the left foot. Generous black h&iry growth over body, normal masculine distribution. Slight clubbing of fingers. Head: Scalp clean, formal growth fine black hair. Eyes Pupils equal and regular. act normally to light aid &e coramoa at ion . Slight nystagmus left ye with close vision and upon looking upward. phase- internal; internal convergence left eye. Ocular tension K 0016-736 W" Kars:: Nose: mouth: Neck: Cheat: Heart: abuoraen: approximately normal, -deft disc not seen . well because of inability to control eye movement, m.-nt fundus man.or pale, no. hemorrha :e or exudate. Veins moderately full, R-rteries very fine. *hysiolo ie cupping of discs, pale yellowish surface rith fairly v/elx defined clear margins. Drums appear normal and sli }htly retracted, Rearing all :htly diminished right ear. Slight deviation pf the septum to the left, o marked obstruction-right inferior turbinate; enematous and slightly congested. Nasal membranes pale and pink covered with some serous discharge and few crusts. 15 upper, 12 lower teeth. 1 and 5 ri:,ht lower, 2 right upper, 1 and 3 loft lower, and 3 left upper molars m-ssing. Gold cap of right upper central incisor. Silver amalgam and gold fillings. roor dental hygiene. Much sordes. Uums firm ana pale. Purplish line noted along margin of right lower lateral incisor on the buccal surface, all about the remaining lowbr molar on right ana also along the margin of the upper central Incisor on the buccal surface, 'There is some diffused purplish discoloration of the gum about the capped tooth, tonsils small and imbeoded. Pood particles In the upper pole of the right tonsil. No expressable exudate, rharynx not remarkable., Gag reflex active, Tongue ot coated - protrudes in mid-line without tremor or fibrillary twitching. Thyroid not enlarged. Trachea in mid-line. n0 abnormal pulsations or fullness of the veins. 53-1/2 inches, 40-1/2 inches expanded, oymmetrical. Fremitus normal. Respiratory movements free and equal. Pressure note equal and resonant throughout. KI and diaphragmatic excursion within normal limits. Breath sounds vesicular, N0 rales. Ho abnormal pulsation or thrill. PMI in fifth interspace. RCD Iq x 11. ESD 5* u~art sounds clear, regular. No murmurs. date dij., after 50 hops 112, 2 minutes after 100. ^lood pressure II8/76 lying down left ana, 103/70 lying down right arm. Radial pulses equal, normal volume and tension. Small pannicuius adiposis, ?.oderately muscular, symmetrical, relaxed. organs .or masses palpable. very slight colonic tenderness, more marked on the left slue. external inguinal rings intact. KE 0016737 enitalia: normal externally. ivectal; Small external hemorrhoids. `ight s Rhincter. Prostate .planet small, symmetrical, not tenuor. Lymp-i i:quest Superficial groups not unduly enlarged. Extremities,* crmal form ana function, 6rip 115 right, 90 left. xleurolo ;ic: Cranial nerves. 1-not tested; 2-see. natation' under eye, gross tests visual fields normal. Vision not. tested. 3, 4, and 6 - Reaction and nystagmus as noted. Paresis left external rectus (history of measles curing infancy with eye sequellae). 5 " Corneal reflex equal and active, no sensory or r.Qbor disturbance. 7 - no facial weakness, u - ^earing slightly diminished right ear (not tested with tuning fork). 9 and 10 - Palate in raid-line, do dysarthria. 11 and 12 - normal. .otor System:Upper extremities - posture well maintained, . usclo power good, coordination normal, muscular ovements normal, muscle tone good, no obvious atrophy or fibrillation. Lower extremities - power go d, coordination normal, muscle tone good. Reflexes1 biceps, triceps, wrist jerk and knee jerk active and equal. normal plantar flexion right ana left. Abdominals equal and hyperactive. Cremaster!cs equal and hyperactive. Sensations: J-hrjit touch and pain normal. Vibration and temperature not tested. Stereognosis normal "ait- normal, able to stand on either foot singly. Lu-i L-P. . r i. x ~'j a Y i?A Urinalysis. Clear amber, specific gravity 1.015, alkal. ne to methyl red, pH 7+G. ^ugar, acetone, albumin and blood negative, microscopic - few white blood and epithelial cells, no casts. flood examination d-l3 Specific gravity whole blood 1.0522, specific gravity plasma 1.0251, total plasma protein 6.I9 grams per 100 cc. estimated .red blood count 4# 4.00,000, estimated hemoglobin 84), estimated packed cell volume 44, pipette count done on oxylated blood q., 100,00, hemoglobin Dare 02>fc (16 grams per 100 cc regarded as normal), hemoglobin Leitz oxyhemoglobin method 12.1 grams, ear blood count (pipette) red blood count 4, 'yj)0.,u00, nemo ..lobin Dare 82p, wnite blood count 37?0> differential - Poly. 60, band. 5 l)> lymph, 27.5> mono* 45 oosin. l.p> baso. 1.0, stippled re a cells -j0 per 50 fields, seuir.ent-c tion time (w ntrobe *s vnotbod) la. KE 0016738 7/ - - icterus ..~dex approximately normal, hematocrit packed cell volume 4-0*0 . 0-19 Specific- gravity whole blood -1.0520, estimated red blood cell count 4,400,000, hemoglobin esti Led biip>, red bleed count pipette oxyl.-.ted blood ir,250,000, hemoglobin lure '3l^>, stippled red cells pj per p0 field, average red cell count from above es uluiat ors 4.3 million, average hemoglobin o2/c. For the Following re a cell detox*;ilnutions the following value-- were used. he;.:o lcoir. 12.1 rracs, rod blcou count 4.5 million, sacked cell volume ,-jj cc. per 100 cc,,, I.-CV 88 cu.m, (nor...al 82-y2), LiCii 26 micro micro grams (nor .al ^7-31), OHC p0;% (30^ normal). blood V/assermann and Kahn tests negative. 8-20 Hemoglobin ?3>., iffiC 6,850 (10:45 A.M.), BC 6,300 (2:00 P.k.), 2iiC 4,JlQ,0Q0, differential - poly. . 55, band. 15.5* lymph. 20.5, ,;.pno.. 6.5.* eoain. 1, base. 1.5# reticulocyte 156? stip led red cells 43. Icterus index approximately 3, hiiirubih 2.5 milrigrains per 1-00 cc, red cell fragility normal, beginning hemolysis O.44 per cent, complete O.pO per cent, reticulocytes 156 (per 50 field). Blood chemistry - Sugar 94, urea nitro ;en 14 milligrams per cent. iiKS_Examlnatipn Reveals normal sinus rhythm, rate dip, PR 0.2, pRS 0.06., upright complexes in all leads except J. L3 shows- low voltage ;RS, splintered, depressed S3. . These findings are interpreted as normal. quantitative Lead Analyses 3-13-42 Spot sample urine 0.17 milligrams per liter. Blood 0.075 milligrams per 100 grams. Large urine sample, 0.19 milligrams per liter. Feces 0.12 milligrams per gram of ash. Summary of Significant Finaln^s History of benzol exposure and intoxication in February 1942. with apparent recovery and return to work in good physical condition in May 194-2. Employed in grinding lead silicate during July and until August 2, 1942 with significant lead dust exposure. Chief complaints - ftugust 2, loss of pep; muscle aches and pains in the feet and legs, lower abdomen ana back. Significant Physical .Findings nystagmus, paresis. 6th nerve left eye (measles sequellae), blue line gums, moderate cardiac hypertrophy with normal SHG tracing, mild myocardial weakness. 0016739 "is'~ / 4j- Laboratory examinations reveal a mild nomocytic anemia and loau finain .3 in the urine ana bloou v/nich may be . .interpreted as inuicatin : probable si.nidi cant exposure. pia nostic Impression Probable .Quorate lean absorption with relatively mild Intoxication va.t;a the possibility o.f residual benzol effects as oor.^riDutm:; to the clinical picture cither directly or indirectly by increasLn;;; susceptibility to lean intoxication. . V. Ait'zmiller, M.P. KK 0016740