Document o0Oa9L75EqRe6D8x5KxKeNV8

iidcicrandua on th e o c c u rre n c e o r lo a d p o is o n in g among em ployees o r th e Magnus to ta l D iv is io n o f Sue fa tio n a l Load Company i n a fo u n d ry a t IQ<? &'eat Seventh, s t r e e t , C in c in n a ti 5 , Ohio Suaparz A le a d haa&rd now e x i s t s a t t h e fo u n d ry o f th e ;teip:ua to ta l L*iv ie io n o f th e U a tic n a l h ead Cocrpany t h a t h a s le d to o u r s e e in g n in e te e n c a s e s o f le a d p o iso n in g * The occupations of the a ffe c te d sen varied throughout the foundry* any o f th e men w ere n o t forking v l t h m a t e r i a l s t h a t g iv e r is e n e c e ss a rily to hazardous exposure to lead* ihe d u ra tio n o f th e e x p o su re o f th e s i c k cien was* on th e whole* r e l a t i v e l y b rie f* Hie p r in c ip a l tju i if e a t a tio n s o f i l l n e s s ware lo s s o f weight* a p p e tite and stre n g th * w ith c o l ic and anemia* Under th e c o n d itio n s o f t ie p la n t o rg a n is a tio n * w ith re fe re n c e to m edical f a c i l i t i e s * fo u r weeks* on the average* were re q u ire d to e s ta b lis h th e d ia g n o sis o f th e iL in o sa com plained o f. The f a i l u r e oi prom pt r e c o r / i i t i o n o f tr*e i l l n e s s h a s worked g r e a t h a r d s h ip on th e men* oy a g g r a v a tin g t h o i r I l l n e s s * by lo a a l n g In any cases to i t s Im proper treatm ent* -no by co atin g th e cone A dorable suns o f .money in ;rsdioal and h o s p i t a l b i l l s * U czt of th e s i c k "son a a v s n o t r e tu r n e d to work, aa none o f fcnea can r e t u r n to t h e i r fo rm e r jo b s w ith s a fe ty * u n t i l tliO c o n d itio n s which caused th e ir I lln e s s a re brought under c o n tro l* In a l l c a s e s the rten p re s e n te d p h y s ic a l and p n y s io lo l e a l evidence o f overwhelming lead exposure* a number had illn e s s e s t h a t made th e d e f i n i t i v e d ia g n o s is d i f f i c u l t * The S ta te Lopartaontt of h e a lth lias h indered ra th e r th an helped th e company In th e r e c o g n i tio n o f t h i s h azard * and so f u r a s we can e s t a b l i s h up to th e p ro so n t tim e* th e S ta te i n d u s t r i a l 3 ix-:.iao-o.. raa n o t allow ed any clali-i fo r aoponsnfcion, ,o u > ite th e f a o t t h a t a t l e a s t 0x1 was eado a s e a r l y a s baecm bor o f 1^1+6. The l a c k v f prom pt co m p en satio n h a s vcrkuu a g r e a t econom ic h a r d s h ip on th e a f f e c t e d rcen a n d t h e i r fa-llie a. C onsidering the ex ten t of the load absorption c; th e -n who have been exam ined, an d th e r e l a t i v e s n o r tn e s s of tiie p erio d o f th e exposure of a number o f then# i t ie ' apparent th a t provisions fo r the co n tro l of th e occupational lead exposure In th e p la n t were n o t planned o r executed w ith th e wisdom and s k i l l th a t m ight p ro p e rly be ex p ected o f an experienced and e f f ic ie n t in d u s tria l o rg an isa tio n . In fa c t the e n tire perform ance, in te rn s both of environm ental co n tro l and n o d ic a l s u p e rv is io n , h as been c h a ra c te ris e d by a r a th e r J0- rc-iark ao li degree o f incom petence. /" > 1 . d ed icai. b x a rilh a tlo n a and C o n t r o l .o f h a z a rd E v ery man In t h i s p la n t sh o u ld be exam ined b e f o r e ho i s a llo w e d t o c o n tin u e w ork. T h is e x a m in a tio n ahould b a d e q u a te to e s t a b l i s h t h e s t a t e of h i s h e a l t h and th e Co t e n t of hie lead exposure. Hen p e r m itte d to e o n tln u e a t work o r t o be new ly e;.v-oyod in to la p la n t aho lu be m ain tain ed under c a r e f u l h ygienic (sa fe ty ) su p e rv isio n and m edical care so as to prevent the occurrence o f fu rth e r casca of leau poisoning. 4. H runcorln,/ C ontrol o f hasard The f a u l t y o p e ra tin g c o n u itlo n a th a t have led to th e s e v e re le a d e x p o su re Ir. t h i s p l a n t , sh o u ld ' be c o r r e c te d as prom ptly as p o ssib le by c a re fu lly designed plan s baaed upon d e t a i l e d icnowled ,e o f th e l o c i and s e v e r ity o f p re s e n t lead exposures* A system o f pre-employment and p erio d ic h e a lth ex am in atio n o f tho rxm sh o u ld be e s ta b lis h e d t h a t i s ad eq u ate both to p ro te c t the en a g a in st in ju ry and to a lio s the d iag n o sis of lead poisoning, i f p re se n t, to be e sta b lish e d w ith tiio minimum o f d elay * itaja-steV . A system o f h y g ien ic su p e rv isio n o f ilio p la n t should o e sta b lish e d th a t Is adequate to ap p raise and co n tro l the load hazard to ehlcn tho ra n are exposed* T his system should meet the requirem ents o f tho S ta te H ealth Departm ent w ithout being dependent upon the S ta te f o r i t s e ffe c tiv e n e ss. 5* h e a l t h CompehSAtioa . > An I:n s u ra n c e sc h e d>u le sh o u ld be e s t a b l i s h e d t h a t *111 adequately com pensate toe van fo r inuuatr*.! ulse-aae an soon s th e d ia g n o s is I s proved* 6. V alue ;.of. .Harvey to P a re n t Compare The stu d y of th is v ir tu a l epidem ic of in d u s t r ia l le a d p o iso n in g and th e means o f i t s c o n tro l should be o f g r e a t v alu e to th e N a tio n a l Dead Company, sin c e i t s numerous vp l a n t s s c a t t e r e d o v e r th e c o u n try may nave s i m i l a r h a z a rd s* The 1 .fo rm a t io n g a in e d tits r e by, s h o u ld , i f p r o p e r ly a p p l i e d , -h - be .he fnesna o r p re v e n tin g tho r e p e t i t i o n o r th is s i t u a t i o n e lse w h e re * t would a p p e a r e i t h e r t;*afc t h i s o r g a n is a tio n lu c k s th e knowledge and c.ee:^*i^ue th a t would have p re v e n te d th e o o cu rie n et o f tills v ir tu a l epidem ic, o r time I t acted h u rrie d ly and w ithout co o rd in a tio n of r e s p o n s ib ility in s e ttin g up and o p e ra tin g th is p la n t, w ith o u t having inform ation as to i t s co ndition. C ertain ly , there is no valid excuse in these tin e s fo r th e o p eratio n of so dangerous a p la n t w ithout w ell o r g a n is e d arid e f f e c t i v e p r e c a u tio n a r y m easu res f o r th e a v o id a n c e o f o c c u p a tio n a l i l l n e s s among th e men O bservations (see Table) Ifohfe* .afog.fe.q.! a m Out o f an average d a lly p la n t p o p u la tio n o f 120 men, n in eteen employees w ith a d e f in itiv e d ia g n o sis o f load p o isoning have been stu d ie d a t th e K e tte rin g L aboratory between K oveaber, 1 946 and M arch , 1947 * t I s n o t isnom to us how many o t h e r men have had lo a d p o is o n in g , d ia g n o se d by o th e r p h y s ic ia n s , o r n ot ,,lagnoaed a t th is tine A.;0 - \ The u en ra n g e d i n a ;;e from d t o 37* ith a u ed i& a . age of 40 Ten o f th e rcen w e re w h ite , and 9 c o lo re d * Qe,o.MP<lSftfln Four were r.o ld ero , p g rin d e rs and c h lp p o rs, 2 worked In th e "shako-out,'* 2 as p o t-to n d e rs , 2 a s m etul w o rk ers. ^z o re men* X aa a fu rn a a e te n d e r* X a s a pom**** nd '. o th e r s .. i s c e l l a n e o u a Joes* ' Mrm>ri e v to u s Lead axuosw re F o u r o f tM r e n had worked In a lo a d tr a d e Tor jo u r a ; on had had le a d p a ls y I n t e r m i t t e n t l y Tor 9 y e a rs# fh re o o f th e s e men bcouta i l l e a r l y i n th e in te r# he fo u rth * who had been in th e Armed S e r v ic e s f o r s e v e r a l y e a rs and had had o n ly 11* months expo s u re s in c e h ie r e tu r n * became i l l la te r In the inter# i t e , g s I p j s & j o l . &asrmi J & M \ ' The median tim e of employment b e fo re in c a p a c ita tio n w ith la ad p o iso n in g as f iv e months* w ith the ran^e extending from nar.y y e a rs to sevon weeks* fiu e Jot Onset of llln e a a The7 tim e o f o n set o f i ll n e s s cannot be aet a r b itr a r ily * beoause d i f f e r e n t symptoms o f p o iso n !n g c h a r a c t e r i s t i c a l l y appeared In sequence* and were so g rad u al and in d e f in ite in t h e i r o n s e t in come in s t a n c e s a s to be h a r d ly n o tic e a b le * d lth th is re s e rv a tio n in n e ttin g a d e f in ite time o f o nse t o f th e i l l n e s s * i t imy be s a id ih . t om man h ad le a d p o is o n in g ahen no as .f ir e d , one d e v e lo p e d i t in ii^venbor* th r e e i n December* sev en i n J a n u a ry , f iv e in F eb ru ary * una two i n Wared# d in ce -t i s n o t known w hether .lies .on aro a c t u a l l y r e p r e s e n ta ti v e of tiie p la n t p o p u latio n or of the a ffe c ts of the environm ental exposure upon the p la n t population* no conclusions can be drawn as to th e chan -lng e e v e rity o f tho epidem ic from t h i s monthly in c id en c e. Ty p o r ..P oisoning A ll o f the :ren had go a r a l sym ptom atology such so lo o o f .w eight* lo o o f a p p e t fe a n d lo s o r s tr e n g th * A ll had a m ild Co inodorata arcala One hau a vor b i l a t e r a l r i e t cirop* w ith an in c a p a c i b a tin g t r e o r . Twelve had vero* in c a p a c ita tin g c o lic . Five had a l Id e o lio . ? w had no c o l i c . gfttft.. , f ,ai.ftsBOAia The dittano a ls was atabliohed in from 10 dsys to 9 y ear ( le ) a f t e r trie o n se t o f th e illn e a e * w ith th e evadan about k weeks. TUw> o f R e tu rn to Work The tim e a t which any o f th e se s*n should be p erm itted to re tu rn to work la a b it in d e f in ite . G enerally peaking* i t would depend upon th e su b sid en ce o f symptoms und sirria of p o iso n in g . However, u n til the lead h azard 3 are b ro u p it under c o n tr o l th o se r,en would be exposed to undue danger by re tu rn in g to work. Under the p re se n t co n d itio n s* th e / should_te kept out of exposure u n til th ey have retu rn ed to approxim ately normal lev el of lead co n ceiitratio n in blood and u r i n e , fh a problem la f u r t h e r c c ra p lio a te d ay th e l a c k o f lig h t work a t the p la n t* and absence of evidence a t th is w ritin g th a t the hazardous . xposur has been c o a tro lle d . At p r e s e n t 7 o f th e on have r e tu r n e d to work* f iv e in th e sano p la n t. have been infoimtod th a t a t l e a s t one o f th e se toen h a 3 been i n c a p a c i t a t e d a g a in s in c e r e t u r n i n g to w o rk . idenow of. E xposure Lead l i n o - A l l o f th e on who had t e e t h had a l s o - 7- Laad o o n c e n tr a tlo n e in b lo o d and url.ru The m edian b lo o d lo a d c o n c e n tr a tio n a s 0 .1 9 &># and th e u r in e 09 mg p o r l i t e r . The a v a lu e s i n e ig h t ana tw elv e timan th e h c r m l lev la# re s p e c tiv e ly # and aro as nigh a s any we have soon h e r e t o f o r e In an y g ro u p o f men ifch o c c u p a tio n a l load ex p o su re# ovan in c e r ta in In sta n c e s in hi ah no e f f o r t huu been nade a t any tim e to c o n tro l obviously hazardous c o n d itio n s S e v e ra l men have usd b lo o d and u r in e le a d l e v e l s so h ig h a s to be e x c e p tio n a l in our p re v io u s ex p e rien ce * S ti p p l i n g - Xhe s t i p p l e d e r y th r o c y te s i n th e b lo o d ranged from #000 to 20#000 per m illio n ery th ro cy tes# w ith a '.eui&n v a lu e o f 10#0Q0. *he b lo o d o f norm al p e rso n a _ r a r e l y 3ho*e moro th a n 1000 s t i p p l e d e r y th r o c y te s p e r m illio n # w hile p erso n s 1 th e ll con t r o l l e d le a d exposure r a r e ly llave te r e tita n l , l)0 0 t o #000 .Cq g ;> llc a t ln a ..XUn e as <ts "' : d ig n t o f th e men had c o m p lic a tin g i l l n e s s e s o r c o n d itio n s# ' wnich on o ccasio n added to the d i f f i c u l t y o f e s t b i l jh in g tu e u i a :an o a ia * One ram had an appenuecto:r.y ' b .c &j . . o Of a ndLat^kcu -.1 a g n o s is * In c id e n ta l Shaorvatlony . h e f i r s t p a tie n t was re p o rte d to th e S ta te D epartm ent of h e a lth on 12 - 17 - 4 6 . ^ o l l o w i n t h i s an in s p e c to r r e p re s e n tin g th e Ohio I n d u s tr ia l Commission v is i te d th e p la n t and re p o rte d .h u t no saw no very s i g n i f i e a n t lo a d h a s a r d th e re * '/c liave h e a rd o f no o f f i c i a l a c t i o n on th e p a r t o f th e S ta te D epartm ent of H ealth# o r o f th e I n u u s t r i a l Commission s in c e th eig h teen aubsoquont caeca have boon reported* d e sa lt th e f a c t th a t in evory case th e dlA gnosia lias boon s u b s ta n tia te d by evi&enoa th a t i s w noily beyond q u estio n # From th e K e tte r in g L a b o ra to ry oT A p p lie d P hysio lo g y * C o lle g e o r iie d le in o , U n iv e rs ity o i C in c in n a ti* C in c in n a ti* Ohio !to;2orandu?n by Henry Ryder * iS arch k., 1 ^ 7 -vObcrt a * fehoe* Si.D* D irector Observation 04 Marcai. SnalbJ'ee Uh Lead f Sene Ad* lo lo rl O o e u p e tlo n jo a lin a o n V ile t a l s o rk e r ifre v lo u Lead T i m w ith Onaot oT E v ja o u re a,mm ; * t f l l H i r e s . I'eara T^ara U i3 s e v e rity Date or i-.eturn co .Lio.; noBi a L i i i i t Wr>r *M> w r is t d rop tr>B.~.or u iie .iia wt,, lo e b . *47 ii.rc h ir ir fi 46 9 Loader no 6 laontha U rkp a trlek 9 '.vei. lin g fore-nan yoars y e a rs ^lelean er 55 Iandyman years yoars illie o n 57 Shake-out no 3 months Ih a d w ie k 32 9 .o ld e r no 5 year i?P* T50 3 g rin d e r no 5 months 30V . *46 Dec. *46 Dec. *46 Dee. *46 Jen. 47 Jo. ' 47 co llo ano.'Ttia w t. lo c o lio aneiula w t. iosa co lio o reria w t. lo *M* c o llo anemia w t. Iosa +4 COHO enclisia w t. Iosa c o llo anemia w t. lo 12-17-46 3 -6 -4 7 34-47 -1 7 -4 7 -1 7 -4 7 : e b . - 4 a r , *1, teuruary .'orah * > o tte r towlond f i l a on sai le y rohnaon iirrio o n .a w a rd 8 35 u d d e r 33 ar .'/o ld e r 23 H ?ot tender 35 9 u r inder 2? Si A 3 8 t. forem an 4: li C lip p e r - in wyer no no no no years no no 30 month J an . *47 c o lle eneala 4 year Jati. *47 co lie anftrlm 4 ijtri* Jan. *47 eo lio ano .la 6 weeks Jan. *47 eolici anemia 14 .months, recen tly 2 years 3 months Jun. *47 i w t. loss anemia ob. *47 co llo I'&O, *47 c o l ic a;;e..ia w t. loss U-2.-..-47 -1 3 -4 7 - 7 -4 7 . ..-9,-47 .: - 1 7 -4 7 ; - ':-4 7 . 2-17-47 aarsh . (no SiiT* lo o t ) s lu ^ n e r 41 * :u rn a c e te n d e r no 4 -1 /2 yoarj i'eb . 47 +14 c o lio ane&la w t. Iosa ^ -2 4 -4 7 ) I. roncar :C artx u r 32 2 .-ourer 22 H 'w ko-out .e ] od 34 - Fot tending >atgotaar; ho older _ ._ .. . no j T-.Ol.tii i b . <47 co lie vj-.esile 2 - 33-47 no 4 esentila * Jb. 'u7 c o llo , areal 3- 0-4.7 no ? week -/ir. 47 c o llo ( j wooka) anemia (3 -2 4 -4 7 ) Do j) week a*r. *4? ( ) week) eo lio anemia / (3-4-^7) (^/eoeiet imratlon. 011- Sftflifefao. * U h I*ud P olaonlng ,t,^-n 1j M '. C'v jnaot of 'lin e a . 1<;J3 ijoverity o f Hofcurn to PU gnoala L I fh% nrK 4 w rlo t d ro p Peb* *47 * tre m o r nod a wt. l o ii_rch In itla i In itia l Urine Fb, fclood rb , thousnda p o r ;^ c i? lic tin g .aga/a__ . i l m ? ......, mi Il i o n ne 111n o ia _ _ 0 .20 0 *26 II 7a io. *46 444 c o llo 1-17-46 eb.-Hiar* *47 0,25 0.12 3 je s anemia * t. loas Deo. *4.6 c o llo anem ia v t. loa 0 *c, *4 6 444 oolio anesla t. Iosa cee. *46 collo anala e t. Iosa Jb n . *47 4444 o o lio anemia v t. loea Ja n . *47 444 o o lio anela e t. loia >-6-47 *647 --17*47 --17447 Fouruary baroli 0 .0 4 0 .3 2 0 .2 3 0 .16 0 .6 3 0 .14 0.13 0 .54 0 .1 7 0 .17 2 13 12 2 no no no no J a n . 47 c o lla anemia -2--47 1.5 0 .42 11 no iJar. *4? 444 c o llo ano d a Ja n . 47 4 4 4 e o lio ne d a -13-47 .-7*47 March 0.33 o*44 0 .13 / ( 0 .13 / 6 n l'.ppendectoiay no Ja n . *47 -*-* o o lio anemia Ja n . fi+7 i e t . lo ae anemia Ob. 4.7 c o lie i ..-26-47 > 1 7 -4 7 --6-47 (no tir a lo at) 0 .34 0.60 0 .32 0 .2 2 0 .1 1 0 .52 10 11 r 4 . yaa no \ JOB . so. 47 + c o lle -17-47 aneda * e t. loaa 0.22 0 .1 1 2 no 'ab. *47 e o lie 3-24-47) anemia ' e t. Iosa 1 .1 O.3 6 20 yaa t. *47 c o lio neala 30. *47 c o l i o , nenia ' i r . *47 o o lio ( , coica ) a n e d a . `47 - oolio t ceka) anemia f 2- 3 3 -4.M7 arch 0 .14 0 .2 0 2 3 - 6-47 0.44 0 .2 0 6 (3-24-47) ,1 / <3-24-47) 0.22 0 .1 8 0 .13 0.27 6 3 (O eacietrio) ooonYand a t-n d /trdt orror no no yea yea