Document omBx9xeEeLYn7d11EQMv2v5Gw

iH St a n d a r d Oi l Co m p a n y (lNCORPOBATKD IN MKV JKR8KY) ' ' ' -- 30 R O CK E F E LLE R P L A Z A , N E W YO R K 20, N . Y . . ROBERT COLD ER PAGE. M. D. . GBt TR R AL M E D I C A t D I R E CT O R - ' J V. ' : ' ` ALFRED GAGE, M. D. ' ' MRDICAL DIRECTOR '' ' _ .. ' ' ' '; <. '** ^ .- T H O M A S G. K I E N Z L E . M . D . , . E enneth b . fo u r ch er , m. d . ASSISTANT MEDICAL DIRECTORS . . ' h . . . . .' ' \ .. . / l. V v ;, - - V `' ...v - . . ,' ' *=V'` . . December lU , 19^9 ` , J O S E P H P . H O LT, P H . D., M. D . RESEARCH DIRECTOR D ELA V A N V . H OLM AN . M. D. : . INTERN IST R ALPH F. SCH N EID ER . M. D. J A M E S R . M CM ILLAN . M. D. PHYSICIANS AT LARGE F R A N K J . R C M M E L . M . D . :> V t Robert A. Kehoe, M. D ., .> K e tte r in g Laboratory fo f-A p p lie d 'P 3 y sio io g y ;, r . College o f Medicine"y ^ -v ' .! UxdYerisit^.,.pf'r0iaite ia a a t i; -V.` , .C incinn ati,. 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V R e c e n tly th e p r o b le m -o f l e a d a b s o r p t i o n a s I n d i c a t e d by -th e u r i n a r y e x c r e t i o n o f l e a d , .h a s 7 r i s e n among, a gro u p ..o f w o rke rs i'n -o n e :;o f o u r a f f i l i a t e d - - - ' com panies.;- I t ap p e ars t h a t 1.th e u r i n a r y l e a d v a lu e s -'w h ich have^been o b ta i n e d e r e accu rate s in ce a co n tro l- group .o f .supervi sory perso n n el; e x h ib ite d va lu e s , w hich f e l l w i t h i n t h e e x p e c te d norm al l i m i t s a n d d u p l i c a t e s am ple s o f th e same man ta ke n w ith in .,o n e o r, two t,days .! o f e ach o t h e r h ave g i v e n co m parable r e s u l t s to w i t h i n 0 . 0 1 mg. p e r l i t e r *- Ehe .u rin ary ; v a lu e s o f the gro up i n whom ..in cre as e d l e a d ab s o r p t i o n h as be e n -suspected^ a f t e r c o r r e c t i o n -to? a s ta n d a rd s p e c i f i c g r a v i t y o f ' 1.0 2^1-, h a ve f a l l e n `i n t o th e ran ge o f 0 . 1 2 : to 0 .2^;'m g. , p e r l i t e r . .* I t - i s .contem plated to fo llo w up th e s e ,,u rin ary le a d fin d in gs w ith m edical e xam in atio n s o f th e 'e s p o s e d 'w o rke rs and w ith i n d i c a te d fu r th e r la b o r a to r y i n v e s t i - g tio n s *-; In t h i s r e g a r d I am w r i t i n g . -t o 'yoij. f o r yo u r o p in io n on th e r e l a t i v e . m e rits o f t h b a s o p h ilic s tip p lin g / te s t u s in gAW ri^ t1s s ta in , ve rs u s th e b a s o p h ilic a g g r e g a t i o n t e s t -d e v e l o p e d by ;McCord and c o -w o rke rs ,, an d ' o u t l i n e d b y R.H .H arkw ith f M.D*, i n a b u l l e t i n -p r e p a r e d -b y t h e Qhib D e p a r tm e n t'o f' H e a l t h :i h De ce m be r,-.19^0 * .. 1 .. - l a revie w in g th e lite r a tu r e o f th e r e la tiv e m e rits o f th e s e two t e s t s , i t appear,s to m e .th at some w orkers seem to p re fe r,.th e b a s o p h ilic s tip p lin g te s t and o t h e r s th e 'b a s o p h i l i c a g g r e g a t i o n t e s t . V I woul -be ve r y, much 'i n t e r e s t e d to l e a r n fo r -w h i c h o n e -o f th e s e Wo,., t e s t s 'yo u h a ve a , p r e f e r e n c e , i f a n y, r e c o g n i z i n g o f c o u rs e th e l i m i t a t i o n s ;o f a n y,,h e m a to lo gic a l e x a m in a tio n o f `t h i s / n a t u r e i I n yo u r s e c t i o n on .In d u s tria l Le ad P o i s o n in g i n Volume I I `o f P a t t y *s I n d u s t r i a l 1:H ygie n e a n d ,,To x i c o l o g y , ryo u s e e m -tb l e a v e - t h e c h o i c e "be tw e e n th e two t e s t s somewha't o p e n . - -- ' I s h o u ld a l s o -b e -:v e i y much I n t e r e s t e d i n yo u r . i d e a s on ;th e p o s s i b l e e f f e c t s o f l e a d on th e c e n t r a l n e rvo u s - s ys te m , w i t h p a r t i c u l a r ,r e f e r e n c V . t o e m o tio n al syndrom es s uch a s e m o tio n al i n s t a b i l i t y an d a n x i e t y - l i k e s t a t e s . One o f th e w o rke rs o f th e gro up r e f e r r e d to abo ve i n whom th e u r i n a r y l e a d e x c r e t i o n was o n ly 0 .0 6 m g., e x h i b i t e d a syndrome w h ich th e e xam in in g p h y s i c i a n b e l i e v e d was e m o tio n al i n o r i g i n and y e t on q u e s tio n in g th e s u p e rvis o rs o f t h i s w o rke r, i t was n o t f e l t th at he had p re vio u s ly dem onstrated any o f the m an ife s tatio n s o f em otional d i s e a s e . I r e a l i z e - of-'/ tsburse- t h a t yo u c an n o t e x p r e s s an o p in io n on t h i s c a s e w i t h / Pr. a . hehoe - Page 2. the lim ite d in fo rm atio n pro vide d you in th is l e t t e r , and th is i s not ay in te n t i o n - n o r do I h ave an y i n t e n t i o n o f u s i n g an y i n fo r m a ti o n y o u may s e n d me fro m a m e d i c o -le g a l s ta n d p o i n t, B a th e r 1 am i n t e r e s t e d i n a g e n e r a l e x p r e s s io n -o f th e p o s s i b i li t i e s o f le a d abso rptio n le ad in g to th e appearance o f an em otional d is tu rban ce . ITa tu r a lly i t i s u n d e rs to o d t h a t s e ve r e l e a d a b s o r p ti o n may r e s u l t i n l e a d encephalopathy which presum ably in d ic a te s th a t le a d can e ffe c t the ce n tra l nervous system . In such cases o f tru e le ad encephalo pathy the ce re b ro -s p ira l flu id p re s s u re and/ or p ro te in and c e lls are e le va te d . I f le a d can cause ce n tra l nervous system m an ife s tatio n s o f degrees le s s than tru e en cephalo pathy, such as e m o tio n a l i n s t a b i l i t y o r a n x i e t y s t a t e s , do yo u h ave an y i n fo r m a tio n a s to w h e th e r o r n e t sap,- ch an ge s i n th e p r e s s u r e , c e l l s o r p r o t e i n o f th e c e r e b r o -s p i n a l f l u i d re s u lt? . I sho uld be most g ra te fu l to you fo r any in fo rm atio n which you can send me i n r e g a r d to th e two t o p i c s d i s c u s s e d a b o ve , and I a g a i n w is h to a s s u r e yo u th at th is inform ation w ill not be used in any m edico -legal sense but w ill only be u sed in a s s is tin g u s to e s ta b lis h an adequate system o f m edical exam inations f o r th e men i n whom we a re s u s p e c ti n g i n c r e a s e d l e a d a b s o r p ti o n and f o r th e i n t e r p re ta tio n o f the fin d in gs o f these exam inations, - Yo urs v e r y t r u l y , BHHjfbp cc; Dr. J. ? . Holt a . 2 . 3 CHAH2 :?, M. 3 .