Document mbaze7ywVYZyXk0wk41N1ymRb

February 25, 1L*47 Dr V r. Cb tK , Medical Investigator, Gaiety and Hygiene Division, Indinversai donnaisaion oi Ohio, Golumous, Ohio. Dear Dr. betz: *' . I am writing to you concerning a situation, which in my opinion 13 more than trivial to us tooth. It concerns the hygienic situation in the plant of Magnus Metal Division of fictional Lead Company in Cincinnati, this plant came to cur attention recently through the occurrence of a case of load poisoning some weeks ago, and it vas cur- report oi this case to the Department of Health of the d a t e of Ohio, vhich led., I believe, to your visit on December 27- By reason of our several contacts with the people representing this company, in an effort to inquire concerning the conditions in the plant, vhich ve always do when the opportunity affords itself, ve came upon their interprta lion of your sta tement to them, following- your visit, that the conditions in this plant were not such as to have caused lead poisoning, and therefore ve might veil be mis taken. . I have encountered this situation once before following a visit on your part to the Hagle F idler plant In Cincinnati in which white lead va3 toeing manufactured by the Old Dutch process. I had reported certain cases oi1 lead poisoning as occurring in that plant, following careful study of a number of referred cases and some further checking up on the opera cions. I vaa surprised greatly at the occurrence oi' such an issue at that time, and I cm even more surprised by it at the present time. It just does net seem to me to be credible that you. could feel that I or my clinical associates have made a diagnosis 01 occupational lead poisoning without having wholly adequate evidence on which to base our conclusion. In any case I have determined to write to you and to call your attention to certain matters vhich, in my opinion, are worthy of your con sideration. First let me point out, in connection with the plant of Magnus Metal Division, that we have under our observation at present in the General Hospital or elsewhere at least seven proved cases of lead poisoning among the employees of this plant. It appears that there are several others. These cases vary-from relatively mild lead poisoning of the gastro-enteric type, to severe disabling and persistent lead colic, ana even to a perfectly typical case of bilateral wrist drop. The diagnoses in these* cases have been made on the basis of unequivocal clinical and laboratory evidence, in association with such information about the plant conditions as Dr. W. E. Qbetz - {2, - February 2$, 1V47 ve have been able to obtain. The officials of this company have corresponded with State agencies, and have sought an investigation at the hands of the Department of Health. Ultimately they have been referred to us by virtue of the inability of the State industrial hygienists at this time to carry out the plant survey that is necessary to appraise the significance of the entire situation. Ve have responded to the request from the company of ficials for advice and have recommended to them vhst should be done, and hoK much of it ve are prepared to do. It seem3 probable and al^Bviha^tnl hesitation on the part of these officials to follov through on this necessary procedure, is occasioned by their uncertainty as to our competence and good faith. To the extent that this is true, it has been implemented in part by your letter to them of January 2, of which I have a copy. If may veil be that the interpretstion which has been put on your letter is not precisely what you would have intended. On the other hand, I ' believe you have expressed an opinion which is substantially counter to our ovn, and on evidence which ves in no vise capable of justi fying your conclusion. X am not sure as to just vhet you were shown in this plant, or just what the conditions were when you sav it, but I think your conclusion rather obviously leaves something to be desired in vie1-/ of the fuel that we have found a surprising number of cases of acute lead intoxication among the employees of this plant within the last few weeks. I am quite sure that you would not question the correctness of these diagnoses on the basis of the evidence available, there is no one of Litem about which there is the slightest question, since they fulfill all of the classical clinical as veil as the m o d e m physiological criteria. I am sure that you are quite familiar vith the extent to which ve have developed these latter criteria out of clinical and investiga tive work and broad industrial experience. 7ou will gather from what I have said above that I cm somewhat irked by this si tusijen. ou are quite right. In addition, however, to some personal and professional tiritetien, I am led l o these commente. by much more ei.gni.ficant considerations . fur public and professional responsihilities arc- quite as great as yours, and yours are certainly not to be ignored. You and your associates, as well as ourselves, can ill afford a conflict of this type. Such a conflict cun only have the effect of injuring us both, and more importantly, of militating against the accom plishment of our purposes in terms of the health of people employed in hazardous trades. Vith the Information that Is available- at the present time in relation to industrial lead hazards, the problem of iidustrial lead poisoning could be eliminated-for all time, if v/e had but had. the intelligent understanding of physicians, public officials and responsible industrial management. It is quite possible co measure occupational hazards in relation to load in precise terms. It is quite possible to define safe occupational' load exposure, it is also quite possible to diagnose lead intoxi cation and to differentiate it from other disease processes in most K F 00 \ Dr. W. E. Gbetz - O) - February 25> 1 ^ 7 instances. Any controversy on matters of this type between offi cially responsible persons ouch 3 yourself and publicly and professionally responsible people like myself and my associates is foolish and wholly'unnecessary. lou should know if you do not, that we do not make diagnoses of occupational or non-occupational lead poisoning without having complete and satisfactory clinical and laboratory evidence, fou should also knov, if you do not, that we ave never- convicted any plant of being hazardous in terms of lead exposure, without having the cold evidence on which to speak. I am not saying by thi3 that we are infallible. What I am saying is -that we oo not come to a conclusion at all, unless we are prepared to support it by adequate evidence. Therefore, I should say uiat when you walk through an industrial plant and look at the surroundings and presume to say, against our evidence, that it seems unlikely that a man was poisoned t his vox'k, you axe doing us, yourself, and more? importantly the exposed, personnel, a heedless and unnecessary injury. Even with the years of experience that I have had in the lean trades, I should feci the .necessity for more precise information than can be obtained by ouch means . I am being blunt, but l a m talking directly to you and not to any third party. I trust you will not regard what I am saying as anything other than an honest effort to arrive at, a satisfactory basis ior the consideration of our mutual public end professional responsibilities. I have appreciated the direct contacts with you which X have had in the pact, and I trust that there will not be misunderstending and personal or professional unpleassntriess in the future. Ir is tc this end primarily, and to the improvement of industrial health in uhe communily and elsewhere, that X make these somewhat pointed comments. Cordially ;c\ J-AK. ef C -C *: Dr. Henry \ i . njder Dr. Hm'. F. Ashe }ober l A . Kc'hce Xj * 0014192