Document mpbxNvQbRqvQ2xQYoLnJ7qzBJ

Gen er al H ygien ic Measures and ^ F a cilit ie s Required In the Manufacture o f Te t r a e t h yl Ifceaft and In blen d in g E t h yl F lu id The p o t e n t ia l h azard s a s s o cia t e d wit h th e m anufacture and blen d in g o f E t h yl F lu id ar e p r obably th e most ser iou s t h a t can be found in any o f t h e lea d trad es However# th ey a r e cap able o f com plete co n t r o l i f proper p r ovision s ar e made to m ain tain an adequate d egree o f p r e cis io n and cau tion in ca r r yin g out p la n t op eration s I t i s exceed in gly d ou b t fu l i f t h is can be done u n less the most r ig id and c r i t i c a l m ed ical su p er vision i s est a b lish ed and m aintained# but the exp er ien ce o f th e p ast twelve yea r s has proved t h a t com plete su ccess can be a ssu r ed by th e means o f m easures o f con t r ol recommended h erein I t would b e most u n fortun ate# in view o f the dem onstrated adequacy of suoh methods# i f cases of in t o xica t io n and fa t a l i t i e s were t o occur in p la n t s n ot so sa fegu a r d ed , s in ce i t would be q u it e obvious t h a t such in cid e n t s were th e r e s u lt o f ca r e le s s n e s s or la ck of regard fo r p ast experience The co n t r o l m easures co n s is t of th e fo llo w in g co-or d in a ted types o f h ygien io s u p e r vis io n , namely, (1) a co n t in u a l c l i n i c a l study o f a l l workmen, (2) r e gu la r stu d y o f th e m agnitude o f th e lea d exposure and lea d ab sor p tion of r e p r e s e n t a t ive groups o f workmen through p er io d ic determ in ation s o f the r a t e of lea d excr etion in the u rin e and fe ce s , (5) r egu la r p er iod ic c r it ic a l survey of p la n t a c t iv it ie s and operation s by the p h ysiola n -ltvch a r ge, end (I4O r e gu la r d eter m in ation of th e lea d con ten t of the a ir of a l l rooms and workin g spaces in th e p^ ant C lin ic a l Work Hot on ly i s i t n ecessa r y t o m ain tain a 30sharp sea r ch fo r "clin ica l evid en ces of lea d a b sor p tion , bu t i t is a l im p er ative t h a t a l l typ es o f illn e s s among workmen be r ecogn ized and id e n t ifie d , i f t h er e i s to be a proper d egree o f m utual con fid en ce between th e workmen and th e m ed ical departm en t. I t i s n o t enough to be on th e lookou t fo r s u b je ct ive symptoms of in c ip ie n t in t o x ic a t io n , or t o watch fo r chan ges in the blood o f workmen# or to s e e th e cr u d er evidences of lead absorp tion . I t is also n ecessary to recogn ize the occu rren ce and th e ch a r a ct er of n on -occu p ation al d isea se and to see that i t is adequately cared fo r or at le a s t th at I t is brought to the a t t e n t io n of th e workmen, These th in gs can n ot be accom plish ed by cu r sor y and s lip -s h o d exam in ation s or by ce r t a in p a r t ia lly s p e c ific la b o r a t o r y t est s# b u t o n ly by ca r e fu l and r e gu la r stu d y of each workman as a whole In th ese occu p ation s each workman should be examined once a week, a t which time he is qu estion ed c a r e fu lly in sear ch of s u b je ct ive symptoms and ot h er evid en ces of in c ip ie n t illn e s s * The tem perature# p u ls e , blood p r essu r e, and weigh t should b e n oted and r ecor d ed , and the u r in e should b e examined &3 t o i t s r e a ct io n , and the pr esen ce or absen ce in i t o f su ga r , albumin and m lcr oseop le a b n or m a lit ies* Onee a month each man should h ave a com plete exam in ation of h is b lood , in clu d in g the enumeration of leu cocytes and e r yt h r o cyt e s , determ in ation o f th e hemoglobin and p er cen tage d is t r ib u t io n o f va r io u s typ es o f le u co cyt e s , and a quan t i t a t i v e d eter m in ation o f the number of e r yt h r o cyt es which show baso p h ilic gr a n u la t io n , ( "s t ip p lin g ") The t e e t h and gums sh ould be examined 2 fo r sp on gin ess or con gestion and fo r t h e presen ce o f a lea d lin e * e s p e c ia lly on th e in n er a sp ect o f th e gams op p osite th e m olar teet h * The s t r e n gt h o f t h e gr ip o f each hand should a ls o h e determ in ed and record ed * At le a s t once a yea r each man must have a com plete and d e t a ile d p h ysica l exam in ation * in clu d in g a gen er a l n e u r o lo gica l exami n ation . An i n i t i a l .exam ination o f a com plete and thorough type should he employed as the b a s is fo r th e s e le ct io n o f an e s s e n t ia lly sound and h e a lt h y op er a t in g crew* The r e s u lt s of t h is exam in ation should he c a r e fu lly record ed in the case o f a l l men accep ted fo r employment and sh ou ld he u sed as a b a s is fo r fu t u r e com parisons* Workmen sh ou ld he r e je ct e d * 1( ) When'they have had s ig n ific a n t exposure t o le a d compounds in t h eir previous occupations; 2( ) When th ey have had an illn e s s a s s o cia t e d wit h t h e ir p r eviou s occu p ation which in d ica t e s or s t r o n gly su ggests the occu rren ce o f s ign ifica n t lea d exposure in such occupation ; 3( ) When th ey have or gan ic d ise a se o f th e c ir c u la t o r y system* e s p e c ia lly symptoms and sign s o f a r t e r io - s c le r o s ls ; f (I4.) When th ey have or ga n ic d isea se of th e n ervous system* a h is t o r y of ep ilep sy* or of fu n ction al disturban ces associated with mental in sta b ility; (5) When th ey h ave or gan ic d isea se o f the kid n eys* li v e r or lu n gs; (6) When th ey have ot h er typ es of ch r on ic d is e a s e , such as t o n s i l l i t i s or g in g iv it is * which in th e opin ion of th e examiner I s u n lik e ly to respond to co r r ect ive m easures; 7( ) When t h ey are e xce s s ive ly a d d icted to the u se o f a lcoh ol* or when because of ignorance* st u p id ity* undue apprehen siven ess* or oth er evid en ces o f u n r e lia b ilit y * t h ey a r e u n su it ed t o employment in a p o t e n t ia lly haaardous occupation* 50(8) When th ey are le s s than 21 year s of age or more than I4.5 to yea r 3 o f age* Men should be removed from employment* (a) When they d evelop symptoms s u gge s t ive o f t e t r a e t h yl lea d in toxication * (b) When t h ey d evelop p h ys ica l sign s and la b o r a t o r y evid en ces of s ign ifica n t lea d absorption* (c) Tftien th ey d evelop or gan ic d isea se* which* in the mind o f th e exam in er, in vo lve s undue r is k t o t h e ir s a fe t y and t h a t of oth er s* (d) When th ey show a ca r e le s s or ir r e s p o n s ib le a t t it u d e toward th e h azard s o f the occu p a tion , or* a lt e r n a t e ly* when th ey show undue a n xiet y with, r e s p e ct to such h azards* --J -- . 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Excretory Analyses . - ..... . / I t h as bean shown t h a t th e stu d y o f th e le a d excr e t io n o f r ep r ea en t tive workers p ortrays a su r p r isin gly accu rate p ictu r e o f the co n d it io n s o f exp osu re to whloh th ey ar e su b jected * One can not d e t a il h er e th e s ig n ifica n ce o f such r e s u lt s bu t r e fe r e n ce can be had to our p u b lish ed accou n ts* S u ffic e i t h er e to say t h a t we do n ot b e lie ve adequate p r e cis io n can be obtain ed in the co n t r o l o f p la n t con d it ion s with ou t such in form ation * The methods employed In th e co lle ct io n o f samples and in t h e ir a n a lys is must have th e utmost p r ecisio n to be of valu e* In our exp er ien ce t h is work can n ot be done with in the p lan t* but must be car r ied , cu t elsewhere in order to avoid th e con tam in ation o f samples from th e p la n t environm ent* The d ia gn o s t ic l u e o f th e u se of a n a lyt ic methods on the blood and excreta* in suspected or d ou btfu l cases o f in t oxica tion * can n ot be over-em phasized* We b e lie ve t h a t such f a c i l i t i e s ar e ab s o lu t e ly e s s e n t ia l t o sound c li n i c a l work In t h is occu pation * . fle e t Supervision * The p la n t p h ysicia n should make a c r i t i c a l in sp e ct io n of the p la n t under op eratin g con d ition s a t in t e r va ls of approxim ately one month* a t which tim e h e sh ould c r i t i c i z e a l l th e procedures and recommend such changes as are a d visa b le fo r the m ain tenance o f s a fe t y* Air An a lys is * Equipment sh ou ld be in s t a lle d and op er ated r e g u la r ly to t e s t the a ir o f a i l workin g sp aces fo r i t s lea d con ten t* Long pipe lin e s and rubber ho3e lin e s must be avoided in c o lle c t in g a ir samples fo r a n a lysis* in order to avoid con den sation and absorption of t e t r a e t h yl lea d In the ca r r yin g lin e s * Methods have been d evised fo r ob ta in in g accurate^ r e s u lt s h er e* Complete d e t a ils o f methods and drawings o f apparatus w ill be su p p lied i f d esir ed * All the d a t a r e fe r r e d to above should be r ep or ted t o th e p h ysIcla n -in -ch a r ge and should be used by him to keep h im self and the management f u l l y inform ed as to th e h ygie n ic s t a t u s o f the p la n t as a whole* Cloth in g* P r o t e ct ive Equipment, and Washroom F a c i l i t i e s * E xce lle n t f a c i l i t i e s must be made a va ila b le fo r the p r o t e ct io n and cle a n lin e s s of th e workmen* Each workman must be p r ovid ed wit h com plete clo t h in g* so t h a t he may n ot* un der any c i r cumstances* make u se o f h is r e gu la r clo t h in g in th e p lan t* There must be a system o f double lo ck e r s * and com for tab le and adequate washrooms* shower bath s and t o ile t s * At the begin n in g o f th e day*s work the workmen must change in t o wor k-cloth in g* At lu n ch -tim e th ey must wash c a r e fu lly and e a t t h e ir lu n ch in a clea n lun oh room. At th e end of the day th ey must remove a l l t h o ir clo t h in g* bath e and change in t o t h e ir own clo t h in g* The proper arrangem ent of th ese f a c i l i t i e s w ill n ot on ly add to the w illin gn e s s o f workmen t o comply with the r egu la t io n s * bu t a lso w ill provide fo r such su p er vision as w ill n ot perm it ca r elessn ess on the p a r t o f the workmen* \ hm Im pervious glo ve s , d u st masks where r eq u !r e d , and a ir lin e masks as needed must be su p p lied and m ain tain ed in s a t is fa c t o r y co n d it io n by the management o f the p la n t . kT 0010126