Document o9VRRBdM5ZXoY2EJNex7EYknw

FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1950 Apr 24 DOC#: API013 DOCUMENT DESCRIPTION: Meeting Minutes & Attendee List - API Medical Advisory Committee For Information Only - Not For Publication AMERICAN PETROLEUM INSTITUTE MEDICAL ADVISORY COMMITTEE ELEVENTH MEETING AMBERS PRESENT Minutes of Meeting April 24, 1950 Hotel Sherman Chicago, Illinois Kieffer Davis - Chairman B. B. Reeve - Vice Chairman Marshall Clinton - Secretary w. 0. Armstrong V. C. Baird F . F. Boys T. M. Frank A. E. Hoag J. P. Holt (Rep. by 3t. E. Eckardt) T. J. Kelly E. K. Linder James W. Long E . P . Luongo M. N. Newquist Chas. A. Swan E. Richmond Ware Mclver Woody ASSOCIATES PRESENT E. W. Adams R. D. Bent R. C. Cole L . 0. Crockett T. E. DeVilliers Allan E. Dooley R. W. Faulk L . M. Henderson R. M. Landon H. P. Lankelma K. G. Mackenzie C. A. Nellson W. H. Price R. M. Shepardson F. M. Watkins GUESTS R. G. Birrell - Imperial Oil Limited A. R. Bowles - The Texas Company Philip Drinker - Harvard University . J. W. Hammond - Humble Oil and Refining Company A. W. Horton - University of Cincinnati Robert A. Kehoe - University of Cincinnati Chas. A. Miller * The Texas Company John J. Phair - University of Cincinnati A. 0. Seeler - Harvard University H. G. S. van Raalte * Shell H. R. Warrick - The Texas Company API STAFF D. V. Stroop Total in Attendance - 44 MEMBERS ABSENT Theodore E. Allen Wm. Crookshank L. E. Curtis D. M. English W. R. Levis Robert Bell Lynn R. C. Page API 07021 ^gPCIATES ABSENT W. R. Argyle L. C. Beard, Jr. J. S. Boylan C. R. Brown 2 J. B. DeLaune R. S. Driver H. G . M. Fischer N. J. Gothard E. W. Isom D. W. Larmer C. R. McKay R. B. Roaper H. D. Wilde Action I MINUTES OP TEKTH MEETING The Minutes of the Tenth Meeting, held November 11, 19^9, were approved as circularized. II REPORT OF SUBCOMMITTEE ON CARCINOGENICITY - DR. McIVER WOODY. CHAIRMAN The Subcommittee on Carcinogenicity submitted progress re ports (copies of which are attached hereto as Appendix A). The Committee discussed but deferred action on this report. Ill REPORT OF SUBCOMMITTEE ON FLUORIDES - DR. A. E. HOAG. CHAIRMAN Dr. Hoag reported progress. He submitted a report from the Kettering Laboratory (copy of which is attached hereto as Appendix B). IV REPORT OP SUBCOMMITTEE ON CUTTING FLUIDS - DR. B.,B. REEVE. CHAIRMAN The Subcommittee on Cutting Fluids made a report (copy of which is attached hereto as Appendix C) and recommended that this ma terial be made available to members and associates of the API Medical Advisory Committee and on request to representatives of contributors to the Medical Research Fund and to members of Institute committees which are interested in the subject. Action The Committee voted to make the report available in this manner. API 07022 r - 3 - v REPORT OF SUBCOMMITTEE ON PERMISSIBLE CONCENTRATIONS DR. V. C. BAIRD. CHAIRMAN The Subcommittee on Permissible Concentrations submitted a report (Appendix D) and the progress report from Harvard University (Appendix E). As suggested in the report, the problem of petroleum products used in conjunction with economic poisons was presented by pr. Kehoe and discussed in detail by the Committee. Action The report of the Subcommittee was accepted and all recommendatlons were adopted. VI REPORT CP SUBCOMMITTEE ON MEDICAL POLICIES AND PRACTICES DR. L. E. CURTIS. CHAIRMAN In the absence of Dr. Curtis no report was made for the subcommittee. VII FIRST AID AND SAFETY TRAINING COURSE Mr. Charles A. Miller presented an outline of a proposed first aid and safety training program. Action The Committee voted that the API Medical Advisory Committee endorses in principle the establishment.of an API First Aid and Safety Training program and will cooperate with the Central Committee on Accident Prevention in the establishment of such a program, and, further, that the Chairman is author ized to appoint a subcommittee to work with the Central Committee on Accident Prevention in developing the medical aspects of this program. VIII OCULAR EFFECTS OF CUTTING OIL ADDITIVES Dr. B. B. Reeve presented correspondence on this subject, for the information of the committee (copies were circularized to members on April 26, 1950). IX INDUSTRIAL iffQIENE FOUNDATION OF AMERICA Action The Committee voted to defer action on the question of Join ing the Industrial Hygiene Foundation. API 07023 X EXECUTIVE SESSION pgport of Subcommittee on Carcinogenicity Action ------ The Committee voted to accept the report of the Subcommittee on Carcinogenicity in the understanding that the report to be published would not Include data on the two hydrocarbons and that prior to publication the revised manuscript would be sent to members of the Committee for review. Report of Subcommittee on Permissible Concentrations Action " The Committee voted to authorize D. V. Stroop to arrange the details of payment of $5000 for Professor Drinker's services from July 1, 1950 to June 30, 1951* Changes In Organization ' Actions (1) The Committee accepted the resignation of Dr. Holt from the Editorial Committee and as API representative on the ASA Committee on Allowable Concentration of Toxic Dusts and Gases. The Chairman was empowered to appoint suc cessors to these positions. (2) The Committee voted to establish a subcommittee to study the question of eye problems peculiar to the petroleum industry. (3) The Committee empowered the Chairman to appoint a special subcommittee to report on the advisability of accumulat i d ing information and/or carrying on investigations of pe troleum solvents used in conjunction with economic poisons. (4) The Committee voted to continue its standing subcommittees on: (1) Medical Policies and Practices. (2) Permissible Concentrations. XI TWELFTH MEETING The Committee voted to hold its twelfth meeting at the Biltmore Hotel, Los Angeles, California, on Friday and Saturday, November 10, and 11, 1950. API 07024 - 5 - NOTE: Subsequently a number of members have requested that the meeting dates should be advanced one day so that the meeting would be held on Thursday and Friday, November 9th and 10th. Mentbers who object to this change are requested to inform D. V. Stroop immediately. In the absence of objections, arrangements will be made to hold the meeting on November 9th and 10th. XII ADJOURNMENT There being no further business to be considered, the meeting was adjourned. Approved: Kleffer Davis. M.D. Chairman 6/23/50 Marshall Clinton, M.D. Secretary API 07025 For Information Only - Not For Publication APPENDIX A To Minutes of 11th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON CARCINOGENICITY Dr. Mclver Woody - Chairman April 2 3 , I95O On behalf of the Subcommittee on Carcinogenicity, I wish to submit the following report to the Medical Advisory Committee for transmission to the Safety Committee of the Board of Directors of the American Petroleum Institute: ' Dr. A. Wesley Horton reported on the progress of the experi mental work at the University of Cincinnati. A report summarizing this work was sent to all members and associates of the Medical Advisory Committee on April 11. The report was accepted and approved. Dr. Horton stated that a report on the dose-response of the two strains of mice to various concentrations of methylcholanthrene would be submitted for publication in the Journal "Cancer Research" and that it would be desirable to include in that report the tumor in dex curves of two typical high-boiling catalytically-cracked oils. Dr. J. J. Phair described the proposed epidemiological study in the petroleum industry and distributed an outline of the procedures which should be followed. Dr. Phair18 report was accepted and approved with the understanding that the word "needed" will be used in place of "required" where it fits the context. (Dr. Phair's amended report is attached as a part of Appendix A). An exchange of samples, which will be identified only by code numbers, is being worked out with the Institute of Petroleum in England. It is recommended that the Medical Advisory Committee approve: 1. Publication of the report as described by Dr. Horton in his letter of April 7, 1950 to Mr. D. V. Stroop. 2. The proposed epidemiological study as de scribed by Dr. Phair. API 07026 UNIVERSITY OF CINCINNATI DEPARTMENT OF PREVENTIVE MEDICINE AND INDUSTRIAL HEALTH ^ g R I N S LABORATORY 1*` of MEDICINE-- EDEN AVENUE n . A T . 1 OHIO May 1950 CARLE ADDRESS: KCTLAR. CINCINNATI TELEPHONE: CAPITOI MM TO: Members of the Subcommittee on Carcinogenicity Medical Advisory Committee American Petroleum Institute ^ROM: John J. Phair, M.D. I am submitting herewith a revised Progress Report for the Proposed Epidemiological Studies of the Project on Carcinogenicity at the Kettering Laboratory. It contains the modifications and revisions suggested for the report presented at the meeting of the Subcommittee on Carcinogenicity of the Medical Advisory Committee held April 23, 1950 in Chicago. The standard clinical record and occupational history forms to be employed in gathering the information required for the Retrospective Study and the Current Registry are in preparation* and it is hoped that these can be distributed for immediate use early in June. It is planned that the code to be used in the tabulation of these data will be ready for circulation at the same time. As many personal visits as feasible will be made before the November meeting of the Subcommittee, so that a uniform handling of these records can be insured, insofar as possible, under existing conditions. As an additional activity of the epidemiological survey, a simple questionnaire requesting certain fundamental descriptive facts about each refinery or installation of the participating companies will be sent to each Medical Director in the near future. This will be the first step in the routine assembling of necessary basic information for this study regarding the employee population involved and the control measures presently in force or as adopted. JJPrhp API 07027 Por Information Only - Not for Publication Kettering Laboratory University of Cincinnati THE PROJECT ON CARCINOGENICITY PROPOSED EPIDEMIOLOGICAL STUDIES Progress Report for The Subcommittee on Carcinogenicity of the API Medical Advisory Committee April 23, 1950 Revision - May 1.9, 1950 API 07028 r PFESFTTT STATUS At the Sub sennit tee meeting held March Iobjectives ! I. were presented: The determination cf incidence of retrograde, hypertrophic or 25, 1950 bellowing and prevalence rates neoplastic reactions in employees of the Petroleum Industry. II. The comparison of these rates with those of the general population and other industries, III. The evaluation of control procedures that have been accepted, employed or recommended. | IV. The recommendation, if the studies justify the action, of standardized safety and control measures. The possible approaches to these objectives are: A Retrospective or Historical Study of all available records of such cases among the employees of the Petroleum Industry, A Current Registry receiving reports of such cases as they are discovered by and/or reported to the various Medical Departments, A study of the Employee Health Benefit Plan records with the hope that like data can be secured from other industries. Field Surveys of retrograde or hyperkeratotic lesions on exposed skin surfaces. A repetition of the studies which have pointed out an unusual hazard in the Slack TVax Process, The establishment of a Consultation Service to assist In the planning of comparable company studies. This last approach was not discussed at the Cincinnati meeting. API 07029 2 FUTURE PLANS It is proposed to implement immediately, insofar as possible and/or feasible, with due consideration and understanding of the wide variation in company policies, medical care programs, management interest and labor relations, the first two approaches, namely, (I) the Retrospective Study and (II) the Current Registry. I. Retrospective or Historical Study 1. Description This approach requires the assembling of the clinical records and employment histories of proved cases of Neoplastic disease known to have occurred among employees of the cooperating Petroleum Companies, regardless of site, type of tumor, degree of exposure to various carcinogenic hazards and employment status. --' - The Medical Departments, under this plan, within the limits of their legal responsibilities (See Appendix, Page 1), would be expected to forward to the Survey Group of the University of Cincinnati the records of all known cases of proved or suspected Neoplastic disease which have occurred among their employees during the period covered by their immediately available files. It would be expected that the details of the clinical records would be augmented, supplemented and/or verified, insofar as possible, by the various Medical Departments API 07030 - 3 - through their relationships with their subordinate offices, private physicians, hospitals, clinics and laboratories. To determine the degree of possible exposure to various potential carcinogens, the various Medical Departments would be expected to request that their Personnel Departments furnish, insofar as their records permit, a detailed employment history, including not only information regarding the employment of the patient in the company or industry, but also any other employment in other industries as covered by their records, (See Appendix, Pages 2, 3 lj- 5 and 6 for the details of the information to be requested on (1) the initial report, (2) the clinical record and (3) the employment history.) The Survey Group of the University of Cincinnati would be expected to set up the necessary clorical mechanism to receive the initial reports, to process the clinical records and employment histories and to provide interim and final summations to the Medical Advisory Committee. The tabulations and analyses would be arranged to protect the identity of the companies and/or the individual patients involved in the study through the use of a code system. 2 . Objectives The serious defect in this plan arises from the great variation in the amount and type of information available in files of the various Medical and Personnel Departments, for some companies, the need to collect this data is an entirely new concept. In others, even the provision of medical care programs for the employees is a relatively recent activity. API 07031 If Vi -k - This approach, even with optimum conditions, information and cooperation, can only furnish a crude estimate of the prevalence of Neoplastic disease among employees of the cooperating companies who have had exposures to the older conditions and processes. The tabulations cannot be used to ascertain the potential hazards of the newer processes. However, if a consistent pattern in the occupational histories of this group of cases was found, the presence of overlooked hazards in the older methods might be indicated. Furthermore, if an unusual distribution is reported with regard to type and site of tumor, further epidemiological studies of Neoplastic disease in employees of the Petroleum Industry might be limited to only certain types and sites. 3. Approximate Period of Study It is readily apparent that, due to the many diverse situations found in the industry, the variation in the degree of cooperation offered by the different companies, the time needed to secure general acceptance of a standardized report and the necessarv lag that will be encountered in setting up the clerical mechanism at the University of Cincinnati, this approach will require approximately two years to complete. It would be expected that the final report including cases as they have occurred up to and including January 1, 1951 could not be submitted before 1952. API 07032 - 5- II. Current Registry Description This approach envisions the establishment of a continuing Central Registry for Neoplastic diseases to be employed by the various cooperating companies to report routinely through their Medical Departments proved or suspected cases of Neoplastic diseases which occur among their employees, regardless of site, type of tumor, degree of exposure to H various carcinogenic hazards and employment status. The Medical Departments, under this plan, within the limits of their legal responsibilities, would be expected to report currently to the Survey Group at the University of Cincinnati all cases of proved or suspected Neoplastic disease which occur among their employees. It would be expected that, in addition to this notification, insofar as possible, a detailed clinical record would be completed by the various Medical Departments, augmented, supplemented and/or verified through their regular contacts with their subordinate offices, private physicians, hospitals, clinics and laboratories. Furthermore, in order to ascertain the degree of possible exposure of the reported cases to various carcinogenic hazards, processes or environment in or out of the Petroleum Industry, the various Medical Departments would be expected to request that their Personnel Departments farnish, insofar as their records permit, a detailed history, including not only a API 07033 - 6 - description of the job of the individual in the company and/or industry, but also all other employment covered by their records. It is hoped that this record can be augmented or supplemented, if necessary, by the Medical Departments, since, in many instances, the patient will be in direct contact with the Medical Director or his immediate subordinates. (See Appendix, Pages 2, 3 li 5 and 6 for the details of the information to be requested on (1) the initial report, (2) the clinical record and (3) the employment history.) It would be expected that the various Medical Departments, either directly or by securing the assistance of their Personnel Department, would furnish, periodically, similar employment histories for certain groups of employees in their company. The groups or samples required for this phase of the study would be selected with a direct request from the Survey Group, but only after personal consultation with the various Medical Directors and subject to the general approval of the Medical Advisory Committee. (See Appendix, Pages 5 and 6 for the employment history as used for cases which would be sought not for all, but only a sample of the total number of employees in the company or industry,) The Survey Group of the University of Cincinnati would be expected to set up the necessary clerical mechanism to receive the initial reports, to process the clinical records and employment histories and to provide periodic interim summations to the Medical Advisory Committee. The tabulations API 07034 7 - and analyses would be so arranged that the identity of the companies and/or the individual patients involved would again be protected through the use of a code system. In the attempt to calculate incidence rates for at least a fraction of the industry, it would be expected that the Survey Group would prepare the plan, subject to the approval of the Medical Advisory Committee, for selecting the needed employee groups for the population studies as previously described. I As an adjunct to the Central Registry, it would seem desirable to create a Central Pathology Service at the University of Cincinnati to whom the various cooperating Medical Departments could forward slides and/or tissues for I diagnosis and a uniform classification. This particular activity would stimulate the cooperation of the physicians in the search and reporting of cases to the Central Registry. It would also establish a uniform level for acceptance of a il case as one of proved Neoplastic disease. How this service can be established and financed still remains an open question. 2. Objectives This approach would furnish, in contrast to the prevalence rates of the Retrospective Study, an approximate estimate of the incidence of Neoplastic disease among employees of the cooperating companies, since it is hoped that, for at least a portion of the industry, adequate estimates of the number of employees involved and possible exposures to various potentially carcinogenic hazards will be obtained. API 07035 - 8 - It would be expected that this plan would augment, supplement and finally supplant the Historical Approach in defining far more accurately the hazard of the older processes. If successful, and since this will be a current registry providing for reports in the years to come, the analyses could be used to ascertain the hazards of the newer processes, provided that the study is maintained and supported for a sufficient period of time to take into account the long latent period commonly found with Neoplastic disease. It is also possible that this plan, in the future, will provide comparisons of incidence rates not only between various processes, but also geographic areas, racial groups, companies, other industries and the general population, 3. Approximate Period of Study It would be well to call attention at this point to the fact that the greatest obstacle to this approach is the dynamic almost fluid state of the technology of the Petroleum Industry. This situation will seriously interfere with any logical attempt to define accurately the degree and period of exposure, except in the very broadest of terms. It will be, likewise, the most dangerous factor in the estimation of exposed populations, since process changes bring about the frequent shifting of the employees in the refinery operations. Also, since it is generally accepted that Neoplastic reactions require usually a relatively long and heavy exposure to even proved carcinogenic agents, and that there is, likewise, usually a very long period between exposure and API 07036 reaction, it is readily apparent that the registry must be continued and adequately maintained for a considerable period .1 ' 1 of time before it will even begin to measure the hazard of J the newer processes. It is to be hoped, however, that I I satisfactory rates measuring the hazards of the older processes would be available much earlier. Hi API 07037 It is proposed to continue the exploration and the possible implementation, as soon and insofar as possible and/or feasible, with due consideration and understanding of the wide variation in company policies, medical care programs, management interest and labor relations, of the third and fourth approaches, namely, (III) Employee Health Benefit Plan Study and (IV) the Field Survey for Retrograde or Hyperkeratotic Lesions. The description, objectives and approximate period of study for both of these attractive and possibly feasible approaches must await further consultation, discussion and pilot trials before they can be brought to .the Subcommittee and/or Medical Advisory Committee for their consideration. It is hoped that these two avenues can be explored sufficiently during the summer of 1950 to permit firm planning at the November meeting. API 07038 - 11 - C. It is proposed to implement, as soon and insofar as possible and/or feasible, with due consideration and understanding of the wide variation in company policies, medical care programs, management interest and labor relations, the last two approaches, namely, (V) Repetition of the Slack Wax Studies and (VI) the Consultation Service, It is not proposed that the Survey Group take an active part in the Slack Wax Studies, but that the observations will be repeated by individual companies. It is hoped that the Survey Group of the University of Cincinnati, through personal contact, can make certain that adequate observations are secured so this question can be thoroughly explored and evaluated. In serving as an agency to insure that the individual company protocols are valid, acceptable and comparable, it is expected that they can act as a medium of dissemination so that the various other cooperating Medical Departments will have access to this" information. It is planned, likewise, that the Survey Group of the University of Cincinnati will stand ready to assist, upon the specific request of any Medical Department, in the planning of other studies to determine particular and/or unusual hazards. It is not expected that the information so gathered would be disseminated generally unless the interested company permitted this action. The sole objective for this approach would be to insure comparability of studies and observations In case general dissemination or comparisons became desirable. API 07039 T *> API 07040 December 20, 19L9 Appendix Page 1 rr Mclver Woody Leo Standard Oil Co. G ilding pear Doctor Woody: You have told me the plan is being developed to accumulate in the hands of investigators of the University of Cincinnati, who have been designated for the purpose, data with respect to operatives engaged in petroleum refining and petroleum handling who may have been determined to be suffering from or who may be suspected of suffering from cancer which may be attributed to their occupation or to contact with petroleum products. You have asked me if I see any objection from a legal standpoint to transmitting to the designated authorities at the University of Cincinnati the records of such patients. There has grown up a feeling, and perhaps a right, on the part of patients to have their consultations with their physicians and the physicians' records with respect to the patients treated as confidential between the physician and the patient. Even if the patient's right to have such communications and records treated as confidential is not fully established, I think our anxiety to develop cordial relations between our employees and company doctors ought to compel us to regard those communications and records as confidential. Starting from this premise, I think it is entirely proper from- a legal standpoint, and feasible from the standpoint of the relations we want to preserve with our employees, for you to report cases of the kind herein mentioned, provided you keep the identity of the patient strictly confidential. I suggest that these reports may be made under a series of code numbers or under fictitious names, you preserving in your confidential files the identity of the code number or fictitious name of the patient involved. I think if this anonymous scheme is observed in making the reports you have described' to me, it cannot offend the patient's legal rights. I feel equally strong it is not likely to cause any disturbance in the relationship between our employees and our company doctors. I would think that if the designated authorities at the Univer sity of Cincinnati desire to compile and use generally in the industry or with the public any statistics with respect to data of the kind herein described, which they receive from our company and from other companies, they ought to again use code numbers so that the identity of the company whose employees are embraced in the statistics will be carefully concealed. If the foregoing restrictions are observed, I think the confiden tial nature of the physician-patient relationship will be preserved, and, similarly, the confidential nature of the company records will be preserved and I do not anticipate any trouble would be involved. Very truly yours, ESH A Original Signed E. S. Hall API 07041 Preliminary Notification Appendix Page 2 Identification Data A. Code Number - All identifying data (Name-Address) to be retained by the Medical Director, correlated with the code number. B. Age (Year born) % C. Sex D. Race II. Clinical Data A. Type of Tumor B. Site of Tumor C. Date of Diagnosis- API 07042 Appendix Page 3 Detailed Clinical Record (To be completed in duplicate) (One copy to be retained by the Medical Director) Identification Data A. Code Number - All identifying data (Name-Address) to be retained in the office of the Medical Director. B. Age (Year born) C. Sex D. Race E. Marital Status F. Employment Status II. Clinical Data A. Dates 1. First Symptom 2. First Visit to Physician 3. First Diagnosis ij.. First Treatment or Hospitalization 5. Death B. Clinical and Pathologic Diagnosis - List of tumors to be reported which will be placed on the reverse of record. This list is not exhaustive but comprises the great majority of terms usually used. When there is doubt concerning the malignant nature of a tumor, it should be reported. API 07043 Appendix Page Carcinoma Sarcoma and any term of which one } Epithelioma Endothelioma Acanthoma Astrocytoma of these words is a part. Meningioma Myeloma Brain Tumors Medulloblastoma Chorioma Mesothelioma Chloroma Mixed Tumor Cholesteatoma Neurocytoma Embryoma 01igodendroglioma Ependymoma Pinealoma Ganglioneuroma Syncytioma Glioma Seminoma Granulosa Cell Tumor (Ovary) Symp athob1as toma Hypernenhroma Spongioblastoma Hodgkin's Disease Teratoma Leukemia Thymoma Lymphoma Paget's Disease (Breast) Lympho sarc oma Wilms' Tumor (Kidney) Linitis Plastica (Stomach) Ewing's Tumor (Bone) Melanoma Grawitz Tumor (Kidney) C. Primary Site and Stage D. Treatment Advised and Received E. Complications - Metastatic Sites III. Unusual Exposure to Possible Carcinogens - Including estimates of Degree, Type and Length of Time (As elicited by the Physician) List which will be placed on the reverse of the record. A. Physical Agents 1. Trauma 2. Radiant Heat 3. Solar Rays a. Ultraviolet Rays 5. Radioactive Substances or Roentgen Rays B. Inorganic Substances 1. Arsenic 2. Chromates C. Organic Substances 1. Aromatic Amines 2. Tar or Pitch 3. Soot i^. Creosote and Anthracene Oils API 07044 Detailed Occupational Record (To be completed in triplicate) (One copy to be retained by the Medical Director and Personnel Department) Appendix Page 5 I, Identification Data A. Code Number B. Age at Commencing Work C. Employment Status II. Occupations and Detailed Employment Record - Listed in Chronological Order A. Name of Companies and/or Plants I B. Products Handled by Worker C. Job Descriptions - The Broad Classifications which will be placed on reverse of card. 1. Production a. Riggers and Drillers b. Others 2. Refining a. Cracking (1) Catalytic (2) Thermal (3) Others b. Lubricant and Paraffin (1) Crude Wax (2) others c. Straight Run Distillation and Light Ends d. Special Products API 07045 T Appendix Page 6 e. Maintenance (1) Pipe fitters and Boilermakers (2) Others f. Control Laboratory g. Others 3. Transportation a. Pipe Line b. Fuel Oil Carriers c. Others 4 Marketing and Executive a. Service Station b. Others 5. Others - Specify in detail D. Periods Employed ill. Unusual Exposure to Possible Irritants - Including estimates of Degree, Type and Length of Time (As elicited by the Employment Record) (See list - Detailed Clinical Record) API 07046 1 For Information Only - Not For Publication APPENDIX B To Minutes of 11th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON FLUORIDES Dr. A. E. Hoag - Chairman April 23, 1950 ANNUAL REPORT on the ___ PROGRESS OF EXPERIMENTAL INVESTIGATION OF THE STORAGE OF ABSORBED FLUORIDES BY MAN The observations to be described in this report were obtained by the continuation of experiments in which three human experimental subjects were engaged. Earlier phases of these experiments were discussed in the Annual Reports for 1947 and 1948. Experimental Subjects The human experimental subjects employed in these experiments were, 1. EB, a 43 year old colored male, 2. KW, a 39 year old white female and 3. EL, a 37 year old white male. Recent physical and roentgenographlc examinations of these subjects Indicated that they have continued in good health and no changes of any sort were detected. Methods In connection with the materials Ingested and ex creted by the subjects, the following procedures were followed: Samples of solid food, milk, fruit juices, soups, et cetera, representing duplicates of all materials eaten during each day, were collected by each subject in a chemically clean glass jar, and duplicates of liquids (water, coffee and other beverages) containing little or no suspended material were collected in chemically clean glass jugs. The total daily urinary output was collected by the subjects in clean glass jugs and all feces were collected in clean glass jars. The separate samples of mixed foods collected by the subjects were homogenized in a Y/aring-type blender and por tions for each subject were analyzed on a dally basis. Sam ples of liquids were also analyzed on a daily basis and each sample of feces was analyzed separately. API 07047 APPENDIX B (Cont'd) 2 - The individual sample was ashed, the fluorides separated from the ash by a perchloric acid distillation, and the distillate titrated by the thorium nitrate baclctltration procedure commonly employed. For an experiment in which an experimental subject was to inhale low concentrations of hydrogen fluoride in air, an inhalation chamber approximately 160 cm X 190 cm X 190 cm, volume approximately 6000 L, was assembled. Panels in the chamber were covered with a transparent vinyl-type plastic sheeting. All other exposed surfaces of the interior were coated with a water-emulsion vinyl-type plastic paint. A small cylinder of anhydrous HF was connected to a copper tube (1/4 inoh in diameter) 6 feet of which was coiled to be immersed in heated oil where the HF was to be warmed to 45C prior to its introduction into a small steel tank. This tank, approximately 6 inches in diameter and 7 inches in height, was immersed in the same oil bath as was used for the coiled < copper tubing. This tank was also filled with oil and the oil displaced each time a oharge, 1 to 2 L, of HF was introduced into the tank. A side arm attached to the bottom of the tank allowed oil to be pumped into the tank at a measured rate and thus displace the HF at a measured rate. During this phase of the operation the HF escaped through a small monel orifice into a brass tube (3/4 inch in diameter) through which nitrogen was passed at the rate of 5 L per minute. The HF was thereby swept along and into a sheet iron pipe (6 inches in diameter) where it was mixed with air blown into the pipe at the rate of 295 L per minute. The interior of this mixing pipe and of the pipe (4 inches in diameter) connecting it to the inhalation chamber was coated with paraffin. The gaseous mixture was circulated Inside the inhala M tion chamber by means of small circulating fan operated on a table in front of and blowing away from the experimental sub ject. A glass sampling tube, coated with paraffin, extended into the chamber to a point just in front of the subject and samples of air for analysis were withdrawn by suction through a small impinger tube and through a small bubble tower. A solution of NaOH, 0.03 N, was used in the sampling towers to absorb the HF. The fluoride content of the liquid was deter mined by the usual titration proeedures without preliminary ashing or distillation. Results Subject EB Througnout 1949 tills Human experimental subject con tinued the ingestion of fluoride (as NaF) added to his diet at the rate of 12 mg per day. This experiment has been in progress API 07048 APPENDIX B (Cont'd) - 3- since June 28, 1948, and is expected to continue until July or Augusti 1950. During all of 1949 a part of the fluoride ingested by EB was not recovered in the urine and feces and in this respect the results were similar to those covering the initial weeks of the experiment and described previously. This con stituted a state of positive balance, referred to as storage i i of fluoride, and was found to vary from season to season. The variation was such as to suggest that the changes in the temperature of this geographical area paralleled the changes in the rate of storage. The total weekly amount of fluoride stored and the mean temperature for each week were tabulated and these values grouped into periods of 4 weeks, or roughly, into months. Analysis of the variance between months for the interval June 28, 1948, through January 15* 1950, and inter vals for 4 smaller intervals, 16 weeks each, within that period were recorded in Table 1 along with 4 still shorter >! intervals. These shorter intervals, 9 weeks each, were grouped into periods of 3 weeks and comparisons of the variance was made between these periods. The weeks considered in groups of four mentioned first above were labeled 4A through 4E in Table 1 and those in groups of 3 weeks were labeled 3A through 3D. The long interval, 4A, and the shorter intervals, 4B, 4C, and 4E, all showed variances sufficiently large that their significance (in terms of the possibility that the variance was due to ohance alone) fell in the range 0.05$ to 2#. However, removal of that part of the variance which was due to the influence of temperature reduced both the size of adjusted variance between months and the significance of the variance ratio. - Two relatively short intervals (3A and 3B) were selected from the warmer months of 1948 and 1949 so that the mean temperatures were fairly high) reasonably constant and as similar as possible in respeot to variation of the recorded temperatures. In a similar fashion, periods 3C and 3D were chosen in relation to the colder months of each of two winter seasons. Only the variance for 3A was significantly greater than the variance for the other periods. However,tthe varianoe ratios, after they were adjusted for the removal of the effects due to temperature, indicated that there was no significant variance between periods inside the 9 week intervals them selves. On this basis, it seemed safe to oonsider the average storage for 3A and 3B to be characteristic of the results obtained when the influence of temperature on the apparent rate of storage was at its maximum* For similar reasons 3C and 3D were taken to represent the storage under conditions of the minimum influence of temperature. The differences between the rates of apparent storage observed during warm API 07049 APPENDIX B (Cont'd) 4 - weather and the rate during a colder season (3C) suggest that as much as 18 mg each week (or 2.5 mg each day) may have been lost through the skin. In that case the true storage rate may never have exceeded 4*5 mg each week. From January 10, 1949 through January 15 1950, the average fecal elimination of fluoride by EB was 6.7 mg each week. This was very similar to the value, 6.1 mg, observed in the early weeks of the experiment and reported previously. Changes that have occurred in the urinary excretion of fluoride in the last year have not been large enough to seem significant except in relation to the changes in rates of storage referred to above. The average for the 52 weeks of 1949 was 57.7 mg each week and 7.1 mg per liter. Subject KW Excretion which exceeded in amount the fluoride in take by human experimental subject KW during the first weeks of 1949 was a reflection of the experiments previously carried out (described in the Annual Report for 1948). During a large part of 1948 this subject ingested fluoride, as NaBF,, so that there existed a state of positive balance, referred To in these reports as storage of fluoride. The storage rate was small, i 6 to 9 & and the actual amount stored during the course of some 34 weeks of observations totaled approximately 250 mg of fluor ide ion. Immediately after the cessation of fluoborate inges tion (December 20, 1948), the urinary fluoride excretion (0.96, 0.89, and 0.56 mg/day were the averages for the 1st, 2nd, and 3rd weeks respectively) fell to near normal levels. This period (control) of observations when no extra dietary fluoride was being ingested has been separated into three periods, January 4 through February 19, February 20 through March 28, # and March 29 through May 2, 1949* The amounts by which the ex cretion of fluoride exceeded the intake by KW during these intervals are recorded m Table 2.. During the first of these three intervals (January 2 through February 19), the mean daily output exceeded the mean dally intake (see Table 2), the difference of those means being a 0.94 4 0.023 mg. The probable error for this difference, 4. 0.023, was so large as to suggest that the apparent excess excretion of fluoride was just chance finding and did not, therefore, represent any genuine spillage (state of negative balance) by KW. However, the mean for the daily differences i themselves during this same period (see column 6, Table 2) did show stability and statistical significance. This suggests that spillage did occur up to and including February 19 and perhaps during the interval February 20 through March 27. The amount by which the fluoride output of KW ex ceeded the intake diminished progressively during the entire API 07050 APPENDIX B (Cont'd) - 5 - control period and kv: was considered to have reached a state of fluoride balance during the interval March 28 through May 2. Beginning May 3 and continuing through March 13i 1950, fluoride ion, as NaF, was added to the dietary intake of KW at the rate of 3 mg each day. The period of elevated fluoride intake has been broken into 6 shorter intervals and the mean daily difference between the intake and output of fluoride during each of these intervals was recorded in Table 2. The amounts stored were also recorded in this table. The total amount stored was approximately 200 milligrams, an amount about equal to the storage that might have occurred during the ex periment referred to above which ended December 20, 1946. Subject EL Throughout 1949 the excretion of fluoride by human experimental subject EL exceeded the dietary intake of fluoride; there was no other fluoride ingested by EL during this time. The spillage resulted from fluorides stored during an experi ment carried out during 1946 (April 14 through December 21) in which fluoride, as NaBF,, was ingested. During that period of time approximately 400 mg of fluoride were not recovered and were assumed to have been stored in the osseous tissues. Dur ing January, February and March, 1949, the elimination of fluoride by EL was 2.2 times greater than the amount that was ingested. Samples collected during May, 1949, showed that the output of fluoride exceeded the intake by 1.5 times. Resumption of collection of samples began August 17 and the mean results of their analysis are shown in Table 3. The output of fluoride by EL exceeded the intake by approxi mately 0.3 mg each day during all four of the intervals of time shown in Table 3* It had been hoped that a state of fluoride balance would be reached before the start of an experiment in which this subject would inhale low concentrations of hydrogen fluoride in air. However, it seemed evident that no significant decrease in the spillhge of fluoride had occurred between May 1949 and February 1950. Since there was no reason to antici pate any sudden decrease in spillage within the next few weeks, the next experiment was started without waiting for EL to re turn to a state of exact fluoride balance. It was found to be very difficult to maintain a specific concentration of HF in air inside the inhalation cham ber. When an average concentration of 2.5 ppm (as HF) had been reproduced several times without anyone in the chamber, a series of observations were begun on February 27, 1950. The presenee or e l in the chamber added to the difficulties in producing a uniform concentration of HF. The average concentration for 9 days was 1.5 ppm and the average for the several days varied from 0.96 to 1.84 ppm. API 07051 APPENDIX B (Cont'd) - 6 - At the start of a series of test runs, EL spent an average of 4 hours a day in the inhalation chamber. Although there was evidence of an immediate increase in urinary flu oride excretion, the data were still too meager to warrant their being included in this report. Discussion A different statistical treatment of our observa tions, the availability of data covering longer periods of observation, and directing attention more toward storage values than toward rates of urinary fluoride excretion have helped to clarify the question of losses of fluoride through the skin. By using the methods of analysis of variance, the effect due to temperature, acting as a co-variant by increasing or decreasing losses of fluoride through the skin, was es tablished. Although the linear regression for this relation ship has not yet been computed, the correlation between an in crease in the recorded temperatures and an increase in the amount of the positive fluoride balance was apparent in the statistical results. Existence of correlation between these two variants can be deduced from the following: (1) In the hottest weather when the average recorded temperatures were consistently high, the extent of the positive balance of EB was relatively large while the variability was not very strik ing (3A, 3B, and 4D of Table 1), (2) when colder weather prevailed and average recorded temperatures were consistently low (3C and 3D) the variance of the fluoride balance values was similarly unstriking but the extent of positive balance had fallen to less than 1/4 of the highest level, (3) the variance for the balance values was most marked during those intervening months that included marked variations in the temperature. The amount of the positive balance seemed to in crease if the temperatures were increasing and seemed to de crease if the temperatures were decreasing. From these obser vations it seemed reasonably certain that losses of fluoride by EB through his skin increased or decreased as the ambient temperatures increased or decreased* In our Annual Report for 1947 the attempt was made to establish a relationship between changes in recorded tempera tures and any associated increase or decrease in loss of fluoride through the skin. Since the previous efforts were directed toward the values for urinary fluoride excretion, it seems evident that the small, but perhaps significant varia i tions in the amount of the positive balance occurred but were missed when comparisons were made involving much larger quanti ties such as those found in the urine. Because of the relatively recent application of the analysis of variance to our data, the arlie* (1947 end 1948) observations have not yet been rechecked to see if either the recently adopted statistical approach or the more thorough examination of weekly or, wherever possible, daily balance values will yield additional useful information. API 07052 APPENDIX B (Coat'd) - 7 - The fact that we now have data covering much greater periods of time than in any of our previous experiments may be the most important new factor in our series of observations. It seems likely that intervals shorter than 16 weeks fail to reveal the effects due to temperature; for example, data for the last 9 weeks of period 4B were examined to see if a more pronounced variability due to changing weather conditions could be detected. Limiting the interval to those weeks show ing the most pronounced variations in temperature but at the same time shortening the interval being considered seemed rather to make less certain and less apparent the effect due to temperature. This was important in terms of the attempt made and failure to detect the influence due to changes in temperature (data for the interval August 16, 1948, through October 24, 1948 were used) which were described in our Annual Report for 1948. However, an interval of 16 weeks, June 28 through October 17, 1948, taken from this same series of ob servations has shown a pronounced effect due to temperature. Re-examination of other data collected during previous experi ments may be profitable. It has been assumed that at the time when the loss of fluoride through the skin was at its maximum the extent of the positive balance was approximately 23 mg each week. If it is also assumed that when the recorded temperatures were consis tently low no significant loss of fluoride through the skin and that 5 mg (3C in Table 1) represented the maximum weekly rate of retention of fluoride in the tissues of EB then the difference, 18 mg, would represent the maximum weekly loss of fluoride through the skin. That quantity would amount to roughly 20# of the fluoride absorbed by EB. One question that arises from such considerations is, why.wasn't a loss of this magnitude detected when these subJects~v/ere Ingesting fluoride at a level, 126 mg each week, as NaBF, ? The borates are known to penetrate the skin quite readily and the fact that the flu oride ion goes through the skin has been established for at least one of our subjects as well as those included in the in vestigations described by McClure (McClure, F. J. and coworkers: Balances of Fluorine Ingested from Various Sources in Food and Water by Five Young Men. J. Ind. Hyg. and Toxicol., 24: 199, 1948). -- The very most recent trend in the urinary excretion of EB though not described among the results in the preceding section, deserves a brief word. On seme days the amount of flu oride recovered in the urine has equaled or slightly exceeded the fluoride intake. This suggests that the rate of deposition of fluoride in the bones may have been decreasing or may have reached a state of equilibrium so that mobilization or fluoride keeps up with the deposition. Another related matter that may be relevant concerns the variance ratios for periods 4B, 4C, API 07053 APPENDIX B (Cont'd) - 8- and UE all of which show a reduction in variability of the data when the effects due to temperature are removed. Even though all three periods included months wherein there was great variability among the recorded temperatures, there was a progressive increase in the variance remaining after the effect due to temperature was removed. Both of the above observations indicate that perhaps some other variable was ex erting a progressively stronger influence on the results; a decreasing rate of deposition of fluoride in the bones of EB might be just such a variable. Additional data must be obtained before a more ex tensive discussion of this possibility is undertaken. Subject KW The experiment in which each day KW was ingesting 3 mg of fluoride as NaF had continued for a sufficiently long time and the extradietary ingestion was terminated March 13, 1950. The end of that period of ingestion was chosen so that the estimated amount of fluoride stored in the tissues (with out making any allowance for possible losses through the skin) would be very nearly the same as the amount of fluoride as sumed to have been stored by KW when fluoride, as NaBF^, had been ingested during a preceding experiment which ended December 20, 1948. A negative fluoride balance or spillage of fluoride had occurred (see Table 2) in the months following the experiment last mentioned above and it was deemed advisable to stop the administration of the NaF at a point which would make the two experiments similar in respect to the amounts of fluoride that had been stored in the tissues of KW. The ob ject was to discover whether additional and perhaps more definite evidence of spillage could then-be obtained, since the amount of fluoride ingested had been so small, evidence of spillage would indicate that storage had occurred. Should that prove to be the case then one can say that deposition in the tissues may occur at levels of fluoride intake that are quite low indeed. During the first weeks of the control period fol lowing the ingestion of NaF, the output of fluoride by KW (not recorded in the section in which the results were presented) was 2 times the amount of fluoride found in duplicate samples of the dietary intake. However, further discussion of these observations can best be undertaken at some later time. Subject EL The metabolic state of this experimental subject was such that fluoride output continued throughout 1949 to exceed the fluoride ingested in the food and drink. No other experi ment involving EL was started during this time. API 07054 APPENDIX B (Coat'd) - 9 - A great deal of time and effort was involved in. setting up facilities to produce a controlled concentration of HF in the range 2 to 10 ppm in the atmosphere. Most all of the manufactured devices readily available for measuring small volumes of gas would not function at all, or at least not for long, if HF were passed through them. The equipment thus far designed specifically for HF was not usable in the low range, 1 to 10 ml per minute, that was deemed necessary for our purposes. The apparatus and its arrangement, de scribed in the section on results, have not been particularly satisfactory and it may still be necessary to find better and perhaps entirely different means to create reproducible con centrations of HF in the range that is desired. In order to test the operation of the equipment and the reproducibility of the concentrations of HF in air achieved through its use, some preliminary inhalations were started. V Even at a very low concentration the HF was absorbed from the atmosphere to an amazing extent by the interior of the inhala tion chamber as well as by the clothing of EL during the hours he spent in the inhalation chamber. Urine collected by EL during the first twelve hours of the experiment, 4 hours of which were spent in an atmos phere containing HF to the extent 1.8 ppm, was found to have a fluoride concentration of 3*4 mg per L (the control level had been 0.97 mg per L) and a total fluoride content of 1.62 mg. Subsequent urinary excretion values should be very interesting when the concentration of HF in the atmosphere can be repro duced with regularity. 1. Continuation of an experiment in which EB has ingested fluoride each day to the extent of 12 mg, as NaF* has 1 made it possible to accumulate data covering intervals of time of sufficient length to permit identification of trends and re lationships that were previously vague or not evident at all. 2. Loss of fluoride through the skin by EB has been found to occur and was shown to have definite statistical sig nificance. The extent of the loss may have been 20% of the absorbed fluorides at the times when such losses were at the maximum. 3. Some of the fluoride ingested by EB was probably i deposited in his tissues, but the rate of deposition may have been diminishing. i 4. The statistical methods used to reveal these trends could well be used to recheck data obtained from SB in earlier experiments and to re-examine the data obtained from KW and from EL. API 07055 APPENDIX B (Cont'd) 10 5. An experiment In which KW had ingested fluoride each day to the extent of 3mg, as NaF, was terminated with the purpose of observing whether or not spillage occurs and, thus, to obtain additional proof as to whether storage did or did not occur in her tissues. 6. A start has been made in which EL has inhaled HF present in air to the average extent of 1.5 ppm. After the first inhalation of 4 hours duration, there was a rapid rise to 3.4 mg/L in the fluoride concentration in the urine. D i i API 07056 TABLE X FLUORIDE BALANCE ANALYSIS OF VARIANCE OF DATA OBTAINED FROM HUMAN EXPERIMENTAL SUBJECT EB Period No. Date Average Positive Balance mg/wk Variances Between Months with Effects Due to Temperature Included Removed Probability Level (#) and Variance Ratios Effects Due to Temperature * Included % Removed 4a 6/28/48 16.25 369.1 138.1 0.05 IO.5 0.5 4.1 1/15/50* 4b 6/28/48 23.63 355.0 65.7 2.0 4.1 20.0 1.1 10/17/48 4c 1/10/49 10.85 244.1 86.7 0.05 10.8 1.0 7.6 4D l%% 5/1/49 23.23 14.9 14.7 20.0 1.7 20.0 1.9 4e 8/22/49 10.36 276.5 221.4 0.5 7.5 1.0 6.4 12/18/49** 3A 7/12/48 21.42 291.2 265.3 5.0 5.2 6.0 4.2 9/12/48 3B 23.19 i 5.8 6.2 .20.0 1.3 20.0 1.3 mu 3C 4.66 1 1.5 1.9 20.0 6.7 20.0 5.4 \mi% 3D 12/19/49 2.95 24.5 24.4 20.0 1.5 20.0 1.3 2/ 19/50 API 07057 * Data not complete for Interval 10/18/49 through 1/9/50 and, therefore, not Included in these calculations. ** One week (10/31 - 11/6/49) omitted; Its Inclusion would not have changed the trend of the results but would have caused undue distortion. TABLE 2 FLUORIDE BALANCE DATA OBTAINED FROM HUMAN EXPERIMENTAL SUBJECT KW DURING 19^9 (AND FIRST 8 WEEKS IN 1950) Date 1Q49 No. Weeks Extra dietary F mg/day Total Intake mg/day Total Output mg/day Fluoride Balance Status mg/day Total Storage mg 1/4- 7 2/19 None 0.34 0.44 neg. 0.088 - 0.017 0.015 0.016 2/20- 5 3/27 3/28- 5 5/2 5/3- 4 5/30* 6/7- 6 7/18 None - None 0.34 0.017 3.0 - (as NaF] Same - - 0.39 0.009 - - neg. pos. pos. 0.075 0.019 O.O58 0.018 1.07 0.069 0.86 0.065 - - 30.0 36.1 7/19- 8 Same - 9/12 9/13- 8 Same - 11/7 - pos. 0.77 43.3 0.033 - pos. 0.68 38.1 0.053 11/8- 8 Same - 1/2 - pos. 0.72 40.3 0,039 1950 1/3- 8 2/27 Same 3.45** 3.07 0.053 pos. 0.38 0.053 21.3 209.1 * From May 30 through June 6 no samples were collected but the ingestion of F, 3.0 mg/day, was continued vithout interruption. ## The mean daily dietary intake of fluoride was 0.45 0.013 mg/day. API 07058 TABLE 3 FLUORIDE BALANCE DATA OBTAINED FROM HUMAN EXPERIMENTAL SUBJECT EL DURING 19^9 Date 1949 No. Weeks Urine Feces mg/L mg/day mg/day Total Output mg/day Total Intake mg/day Negative Balance mg/day 8/17- 8 lo/ll 10/12- 7 12/13* 12/14- 8 2/7/50 2/8- 3 2/26 - - - - - - 0.89 0.81 0.109 0.016 0.016 0.006 0.97 0.82 0.092 0.026 0.023 0.008 0.9^ 0.014 1.04 0.023 0.89 0.016 0.92 0.029 0.64 0.018 0.74 0.024 0.64 0.02 0.60 0.04 - O .30 0.023 - O .30 0.033 -0.25 0.026 - O .32 0.05 * No samples collected 11/4/49 through 11/14/49 I I A API 07059 i For Information Only - Not Por Publication APPENDIX C To Minutes of 11th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON CUTTING FLUIDS Dr. B. B. Reeve - Chairman April 23, 1950 1. Both the members and associate members of the API Medical Advisory Committee should have by this time received the re vised copies of "The Cutting Oil Dermatoses" prepared at the Harvard School of Industrial Hygiene by Mr. Kriete. The Subcommittee recommends the acceptance of this Review, with commendations to Mr. Kriete, subject to modifications of para graph 4, page 2, which now reads: "There are, basically, two approaches to this subject: first, measures to minimize contact be tween workers and cutting fluids which, in those plants on which information is available, have proved very effective (11); and seeond, the identi fication and the elimination of the tiologie factor in the cutting oils. It is with the latter that this review is largely concerned." to read as follows: . "There are, basically, two approaches to this subject both dealing with prevention: first, mini mizing contact between workers and cutting fluids by means of personal hygiene, protective equipment and other plant control measures which in those plants on which information is available, have proved very effective (11); and second, the identi fication and the elimination, if feasible, of the tiologie factor in cutting oils. It is with the latter that this review is largely concerned." The Subcommittee recommends further that this review be made available to members and associates of the API Medical Advisory Committee and, on request, to representatives of contributors to Medical Research Fund and to members of Institute Committees which are Interested in the subject. 2. Copies of Cutting Oil Dermatoses by Dr. Harry Shapiro of the Medical Unit of the Division of Industrial Hygiene and Safety, of the New York State Department of Labor, were received. It is recom mended that Subcommittee members write the New York Division of Indus trial Hygiene as individuals extending thanks and offering constructive criticism. API 07060 r i i For Information Only - Not For Publication APPENDIX D To Minutes of 11th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY SUBCOMMITTEE ON PERMISSIBLE CONCENTRATIONS _ Dr. V. C. Baird - Chairman April 23, 1950 Your subcommittee reiterates Its recommendations for publica tion by the Institute of 9 Toxicological Reviews which have been pre- I viously edited and accepted by the Medical Advisory Committee as r follows: . 1. Acetic Acid 2. Acetone 3. Beta-Naphthol 4. Butyl Acetate 3. Carbon Monoxide 6 . Cyclohexane 7. Hydrogen Fluoride 8. Methylcyclohexane 9. Phosphoric Acids In addition, your subcommittee submits for acceptance and reference to the Editorial Subcommittee for early publication, ten ad ditional Toxicological Reviews as follows: ~ ' 1. Ammonium Molbydate 2. Ammonium Nitrate 3- Amyl Acetate 4. Ditertiary Butyl Para Cresol - 5* Hydroquinone ' 6 . Maleic Anhydride 7. Mesitylene 8. Phenyl Naphthylamines 9- Silica 10. U.O.P. #5 And finally, there are still in preparation twelve reviews . which may be completed before the project expires on June 30. These include the following: 1. Arsine 2. Butadiene 3. Copper Naphthanate E. t) n t 5. Methyl Alcohol 6. Naphthalene API 07061 appendix D (Cont'd) 2 7. Nickel Carbonyl 8. Propyl Alcohol 9. Pyridine 10. Solvent Naphtha 11. Trichlorethylene 12. Triethanolamine in concluding the Toxicological Review Project, the sub committee desires to record the fact that no course of action is now open for the Medical Advisory Committee to follow in reviewing and revising the Toxicological Reviews as was originally planned. The literature review on thermal b u m s has been completed and is recommended for information of committee members and others up on request. It is recommended that the preface of the review should include a note to the effect that: "The following information is presented only for informa tion and is not intended as recommendation for therapy of b u m s ." It is recommended that all members and associates of the Medical Advisory Committee should express their appreciation of the valuable work done at Harvard University for the American Petroleum Institute by the adoption of a resolution as follows: WHEREAS, The work of the Harvard group in the prep aration of the Toxicological Reviews will be ter minated on June 30, 1950; and WHEREAS, These reviews represent a significant con tribution to our knowledge and information, NOW, THEREFORE, BE IT RESOLVED: that all members and associ ates of the Medical Advisory Committee express and record their gratitude and appreciation to the Harvard group, and, in particular, to Marshall Clinton, M.D. and A. 0. Seeler, M.D., for this contribution. Your subcommittee also recommends that the Institute should have representations on any ASA sectional committee which may be formed to consider the formulation of an American Standard Code on Industrial Hygiene. Your attention is called to a hearing in progress under the auspices of the Pure Food and Drug Administration and the Department of Agriculture on matters relating to economic poisons. You may wish to invite Dr. Kehoe to outline the scope and progress of the hearings. In conclusion, you are advised that the Subcommittee on Per missible Concentrations has almost completed its work assignments and should be able to report completions at the 12th meeting of the Medical Advisory Committee in Los Angeles, in November. API 07062 For Information Only - Not For Publication APPENDIX E To Minutes of 11th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON PERMISSIBLE CONCENTRATIONS PROGRESS REPORT American Petroleum Institute Project at Harvard School of Public Health April 23, I95O Toxicological Reviews During the past five months tentative drafts of toxicologi cal reviews on copper naphthenate, triethanolamine and pyridine have been prepared and distributed to the committee for their comments. Tentative drafts of reviews on solvent naphtha, alkyl nitrates, acetylene and methyl alcohol have been written and^stencils are being prepared. Tentative reviews on nickel carbonyl and thermal burns have been revised and distributed for comments. Mr. Bertrand C. Krlete has made certain revisions in his review, entitled ''Cutting Oil Dermatoses," that were suggested by the Subcommittee on Cutting Fluids, and a stencil of the revised review is being cut. Silica Catalyst Problem A. Animal Experiments - The guinea pig experiment referred to in previous reports has been concluded. Groups of guinea pigs were given intraperitoneal injections of finely ground quartz, fresh silica-alumina catalyst, spent silica-alumina catalyst, and a finely ground silicate, respec tively. On gross examination fourteen months after injection only the animals given the quartz showed any fibrosis. The pathologist has not submitted his report on the microscopic appearance of the tissues as yet. B. Survey of Neighborhood Exposure to Catalyst Dust No further information has been submitted on dust concen trations in the neighborhood of refineries using silica-alumina catalyst. Proposed Future Work Since this project will end on July 1 , 1950, we cannot under take new reviews but will devote the remaining time to the completion of reviews on trichlorethylene and carbon disulfide which have been begun and to the revision of tentative drafts as comments from the Committee become available. API 07063