Document kajKXeOzeg512Dw50GaOEn4YD

iiencrandua on the occurrence or load poisoning euAong employees or the .`iagnua ctal Division oiT t:ve Sational Load Company in a foundry at \Q4) iv'eat Seventh street, Cincinnati 2* Ohio Suanary A lead haaard now ex late at the foundry of the iteip:ua ilofcal Division of the Uatlonal Lead Company that haa led to our seeing nlnoteen caaea of lead poisoning* The occupations of the affected smn varied throughout the foundry* SSany of the men sere not working with materials that give rise necessarily to hazardous exposure to lead* The duration of the exposure of the sick can was* on the whole* relatively brief* The principal tanifeatations of illness were losa of weight* appetite and strength* with colic and anemia* Under the conditions of the plant organisation* with reference to medical facilities* four weeks* on the average* were required to eat&biiah the diagnosis of the 1 linos a complained of. /The failure of provapt recorpUtion of tne Illness has worked great hardship on tho nen* oy aggravating their illness * by loaulng In any cases to its Improper treatment* -no by costing them cone-dcrablc sumo of .t-onc7 in ;r&dlcal and hospital bills* Ucat of the sick -ton a*v not returned to work* eau none of fcuen can return to their former jobs with safety* until t'as conditions which caused tnoir illness are brought under control* In all cases the rain presented physical and pnysiolo leal evidence of overwhelming lead exposure* a number had Illnesses that muds the definitive diagnosis difficult* The State Doparfcaont of Health lias hindered rather than helped the company In the recognition of this hasard, and so fur aa we can establish up to the present time* the State industrial 3 omnisaion has not allowed any claim x'or aoxaponsation, ,ou>ite the faot that at least 0x10 was u&do as early as beecmbor of 191+6 * The lack of prompt compensation has vcrkuu a great economic hardship on the affected rcen and their fa lilies* Considering the extent of the load absorption c: the i"n who have been examined, and the relative snortness of the period of the exposure of a number of them* it is apparent that provisions for the controi of the occupational load exposure In the plant were not planned or executed with the wisdom and skill that might properly be expected of an experienced and efficient industrial organisation* In fact the entire performance, in torn* both of environmental control and medical supervision, has been characterised by a rather rc-iarkabl-s degree of Incompetence* is9&?wi)te^.m It ,, i^^ojA-aftsL Jzs &Sj s Ij i L ii*sa.a Every man In this plant should be examined before ho is allowed to continue work* This examination should b adulate to establish the state of .his health and the 00 tent of hie lead exposure* Hen permitted to oontinue at work or to be newly e:;vioycd in Smla plunt aho-lu be maintained under careful hygienic (safety} supervision and medical care so as to prevent t:.e occurrence of further caaos of lauc; poisoning* 4. ^gifteerln,/ Control cf flssurd The faulty operating conditions that have lad to 02284 -> the severe lead exposure Ir. thin plant, should ' be corrected as promptly as possible by carefully designed piens baaed upon detailed knowledge of the loci and severity of present lead exposures* A system of pre-employment and periodic health examination of tho men should be established that is adequate both to protect the n against injury and to alios the diagnosis of lead poisoning, if present, to be established with Uio minimum of delay* k. Hygienic duaervlalQn A system of hygienic supervision of the plant should c established that Is adequate to appraise and control the lead hazard to which tho ran ore exposed* This system should meet the requirements of tho State health Department without bain;- dependent upon the State for its effectiveness. 5* health compensation An insurance schedule should be established that > will adequately compensate tnc men for inuustrial disease as soon s the diagnosis Is proved* .6 Value of f-urve'? to Parent. Company The study of this virtual epidemic of industrial lead poisoning and the means of its control should bo of great value to the National Dead Company, since its numerous v plants scattered over tho country may nave similar hazards. The i .formation gained tits re by, should, if properly applied. -tv- bo .he jneana or pro venting the repetition or this situation elsewhere, ft would appear either ttunt this organisation luckB the knowledge and i.ecruii'iue that would have prevented the occurrene# of tills virtual epidemic, or time it acted hurriedly and without coordination of responsibility in setting up and operating this plant, without having information as to its condition. Certainly, there is no valid excuse in these tines for the operation of so dangerous a plant without well organised arid effective precautionary measures for the avoidance of occupational illness anong the men,. Observations (see Table) ffeaber^f affected man Out of an average dally plant population of 120 men, nineteen employees with a definitive diagnosis of load poisoning have been studied at the Kettering Laboratory between Koveaber, 1946 and March, 1J47* ft is not knoun to us how many other men have had load poisoning, diagnosed by other physicians, or not ,lagnoaed at this tine, A.;0 \ The i.:en ranged in age from <12 to 37* with a uedi&n . age of 40, 2l2 Ten of the aen were white, and 9 colored. Four were r.oldera, J grinders and chippors, 2 worked In the "shako-out," 2 as pot-tonders, 2 as metul workers. ortaon, 1 na a furnaae tender, 1 as a pourer, rsd 2 others Iscellaneoua Joes* Ar>.rr eYi,Qua__Uad gxpoa-ure Four of tiie ran had worked In a lead trade for /earsj one had had lead palsy Intermittently Tor.J years. Three of these men beoutae ill early in the winter, fhe fourth* who had been in the Ara-od Services for several years arid had had only II*. months exposure since hie return, became ill later In the s/Intcr, The median time of employment before incapacitation with laavi poisoning was five months, with the range extending froa nar.y years to sevon weeks* flue iff onset of Illness The7 time of onset of illness cannot be set arbitrarily, beo&use different symptoms of poisoning characteristically appeared in sequence, and were so gradual and indefinite In their onset in some instance a s to be hardly noticeable* dlth this reservation in netting a definite time of onset of the illness, it imy be said ih, t one man had lead poisoning ahen no *& s .fired, one developed it in inventor, three in December, seven in January, five in February, ana two in March* bince .t Is not known whether -hose on arc actually representative of tne plant population or of the affects of the environmental exposure upon the plant population, no conclusions con be drawn as to the chan -lng severity of tho epidemic from this monthly incidence. :n o/ O/I oC 7 Tyne ox- Polscnlnst 411 of the ren had general symptomatology such aa lose of weight* loss of appetite and lose of strength. All bad, a mild to moderate anemia* One had a usvorc bilateral wrist drop* with an Incapacitating tremor* Twelve had severe* incapacitating colic* Five had alld colic* Two had no colic* fi&a-.B, dlUa&ai.U The diagnosis was established in from 10 days to 9 years (sici) after tne onset of the illness* with the median about k weeks* Tl.m o netuaa to Work The time at which any of these men should be permitted to return to work is a bit indefinite* Generally speaking* it would -spend upon the subsidence of symptoms and signs of poisoning* However, until the lead hazards are brought under control those -,en would be exposed to undue danger by returning to work* Under the present conditions, the/ siiould te kept out of exposure until they have returned to ttpprvximately normal levels of lead concentration in blood ana urine* *hc problem la further ccraplioated ay the lack of light work at the plant, and absence of evidence at this writing that the hazardous , xpoaure has been controlled* At present 7 of the en have returned to work* five in tne sane plant* tfe have been infox,aod that at least one of these men ha3 been incapacitated again since returning to work* dTjdejica of Ilxpoaure Lead lino - All of the on who had teeth had also a lead line* I 0 2 2 88 -7- Lea.d concentrations in blood and urine - The sedian blood load concentration was 0.19 and the urine 09 sag* por liter. These values are eight ana twelve tCrncs the hcrml levels, respectively, and are as nigh aa any we nave seen heretofore In any group of men with occupational lead exposure, oven in certain instances in which no effort hau been nade at any time to control obviously hazardous conditions. ,'ieveral men have had blood and urine lead levels so high as to be exceptional in our previous experience. Stippling - ihe stippled erythrocytes in the blood ranged from 2,000 to 20,000 per million erythrocytes, with a ueuian value of 10,000, *he blood of normal persons - rarely aho*e more than 1000 stippled erythrocytes per million, while persona with well controlled lead exposure rarely h.a*ve mere than l,ljOQ to 2,000. r ( digr.t of the men had complicating illnesses or conditions, wmlch on occasion added to the difficulty of establishing tae ulagnosls. One ram hod an appendectomy b-.-cau.. o Of a niiat^keu -! agnosia. Incidental Obaorvationy The first patient was reported to the State Department of health on 12-17-46. ^ollowin, this an in&pctor representing the Ohio Industrial Commission visited the plant and reported .hat no saw no very significant load hazard there. #0 have heard of no official action on the part of the State Department Of Health, or of the Inuustrlal Commission since the eighteen aubsoquont oases have boon reported* despite the Tact that: in every case the diagnosis has been substantiated by evidence that is wnoily beyond question# From the Kettering Laboratory oT Applied Phyalology, College or ifedieine. University or ^incinruiti, Cincinnati* Ohio Mo;iorandun by iSurch id*, IJltf -vobert A, hehoe , M*D* Director Observations o:< kamu' -frtal '^tale-fese with j= Hexae A& iolor Occupation jcmllaaon V he feel aorksr Jrirfis k& sr Loader PrDeevaiodus Kdjoeure Tine with Wft^iu hotel Onaat of illness.. heara fara 1530 no 6 :souths Mow. *46 Severity Date of Diagnosis tAetfuhrtaWtnoi* +++ wriat drop eb. *47 h-.rch + trerawr <wUt,i,(a.lioiase colic 14-17-46 :-eb.-aar. *i, ani;aia wt. lose tirkpatrlek sr `.reigning fonoon yours yeare Deo. *46 colic awttn.enloiaee teuruary asisaner 55 9 ttandywaui illleon .57 tr Shake-out lhadwiek 52 H .older ippe 50 3 grinder years years no 3 sooths no 5 yeare no 5 nonthe Dec. *46 uonoelinoia j-c-47 wt. lose Dee. *46 colic 3*47 awnte. raloiase Jan. *47 colic *-17-47 anoitia wt. loes Jon. *47 colic anenia *-17-47 wt. lose liaroh * 'otter lowland 35 nolder 35 V holder no JO nunthe Jan. *47 *** colic anenia *-*-47 no 4 yeare Jftl'if **7 colie < -13-47 anenia - Ulson sat ley Johnson prison .dwanis 23 a ?ot tender 35 drinder 2? H Aast. Poremsn 4: 3 copper -- 4^ 'jaaryar no no years no no 4 lit rig 6 weoka r1e4c^e.nfittlhys, 2 yours J cor.ths Jan. *47 +++ colic BIlO J44 Jan. *47 eanoelineia Jun. *47 * want.enlioase >eb. *47 colic i'eo. *47 colic au-.ia wt* lose j a-u 7-4,7 j *-4.*',-47 -17-47 *-26-47 5-17-47 Jrsh . (no Sitra lost pluTner 42 in -- itnuM tender no 4-1/2 your; Feb. *47 _ colie aneada -24-4?) wt. lose i 1 encsr J2 ,'ourr no j "ci.tne sCsrthur 22 'usko-out no 4 tenths .okaon 51* " Pot tending no 7 weeks vhtgoaery 1*0 older ao 3 weeks ?, g 02291