Document mE0eOK4mg2bZq0JVQkKJ0jQQ

UNIVERSITY OF CINCINNATI DEPARTMENT OP PREVENTIVE MEDICINE AND INDUSTRIAL HEALTH THE KETTERING LA SORATORY COLLEGE OP MEDICINE -- EDEN AVENUE CINCINNATI. OHIO 4BE1S CARLE ADDRESS KCTLAB CINCINNATI TELEPHONE; ES1<2S8 February 2, 1965 PERSONAL AND CONFIDENTIAL R. Emmet Kelly, M.D. Medical Director Monsanto Chemical Company 800 North Lindbergh St. Louis, Missouri (63166) Dear Enunet: I hope that you are planning to be in Columbus during some part, perhaps all, of the meeting of the Academy. Whether you do so or not, 1 want to see and talk with you privately sometime in the near future, and if we can do this in Columbus it will, I hope, be mutually convenient. In any case, 1 want to let you know what this is all about, so that you can consider the matter in advance, and if any inquiry need be made, you will have time to do so. Quite recently we have come across a disease, which{if it is occu pational, is or appears, at this time, to be entirely new. It has occurred in a very small number of men who work with polyvinylchloride in certain operations. The clinical syndrome is strange to the point of being bizarre, and it is not apparent whether it is, in fact, one syndrome or two, or even more* The most common aspect of it is that of Reynaud's phenomena, associated with pain In the tips of the fingers, actually, it seems, in the nail beds and with change in the shape of the distal phalanges with some resorption of the bony tips. There are, at times, nodular fibroses in fingers, hand and wrist, and in one case these changes were such as to elicit the diagnosis of scleroderma from a dermatologist. The correctness of this diagnosis may reasonably be doubted, but I cite it for descriptive purposes. .^ I shall be entirely willing, and am authorized to give you full information about this verbally, but I am not revealing the locus of the problem in writing at this time, since the people involved are deeply con cerned despite the fact that there are are very few cases, none of which has resulted in disability. It is difficult not to conclude, on the face of the evidence, poor as it is, that this is an occupational disease. We are committed to investigating it by any means that may be possible, but it is a tough job. As a first effort (after having examined the men involved, with considerable care), I am attempting to find out whether the condition has been seen among the employees of other manufacturers of polyvinylchloride. Anything you can tell me about this will be most helpful. The syndrome is the kind of thing which comes slowly, and involves only a very few employees; it may not have occurred at all among your workmen, or it may have been so ill defined or so poorly developed as to have been missed. There is RSV 0009157 PERSONAL AND CONFIDENTIAL R. Emmet Kelly, M.D. - (2) - February 2, 1965 no satisfactory basis, at present, for relating it to any specific feature of the process, and the best possible lead would be that of finding that it had occurred in other plants in which some common feature of the process might be found to be the common denominator. Whether your Company has had any relevant experience among their people or not, any information which you can give me, even negative experience, will be valuable in the"epidemiological'' process of including or excluding various factors. I shall make point of seeing you soon however, if you consent. Quite apart from this I hope to see you in Columbus, but if I can kill the two birds with one stone, it will be advantageous. With best regards. Sincerely, RAX:vr Robert A. Kehoe, M.D RSV 0009158