Document oznDG7mqVn5m9gnd1OQKgYRo

IHI MfOJCAl lUUfTIN HUMILE OIL & REFINING COMPANY'S BAYTOWN REFINERY R. W. PIPKIN, M.D. and J. W. HAMMOND, M.S. Humble Oil <i Refining Company I. MEDICAL MEASURES The medical program at Humble OH 4 Refining Company'! Baytown Refinery for the control of the potential carcinogenic health hazard associated with the handling of high boiling catalytically-cracked oils and related materials waa started just as soon as the nature of the problem became known. It goes without saying that a program of this type requires considerable time and detailed planning for its. satisfactory establishment. In the beginning, the exact nature and scope of the problem was presented to Humble's top management in Houston and at the Refinery. It waa decided that the supervisors and employees alike should be Informed upon the exact and true nature of the potential health hazard Involved. A series of meetings waa held with two hundred and twenty super visors in February, 1949. These meetings were conducted by the divi sion head, the Safety Supervisor, and the Plant Physician. The scope, objectives, and control measurcs of the program and the po tential skin cancer hazard were carefully and briefly detailed. Super* visory and employee cooperation and assistance In carrying out the program were requested. The supervisors did a very fine job of communicating this information down through the lins organization. There were no signs of hysteria or marked anxiety of any kind from the employees. The response waa immediate, as noted by the in creased number and variety of skin conditions or lesions that were reported. Informing the employees upon this subject seemingly removed their reluctince to report for frequent medical examinetions. In fact, employees expressed their appreciation for having been told of the potentialities Involved and have cooperated in s very excellent manner. The general plan of procedure in the conduct of this program it the Baytown Refinery was evolved following an exchange of ideal between Humble and affiliated companies it a meeting on October 10, 1947. The addition of another physician and clerical employee 444 HUMIU 0(1 4 UHHINO COMfAHt'i 4AY1QWN HflNUT to the staff has been of great anistance in carrying out the required work associated with this undertaking. Medical examinations are being done at six-month intervals. Ex perience shows this to be quite satisfactory. Any employee having over ten hours working exposure in any one month, or more than five short exposures during a six months' period, is included In the examination schedule. An employee having had sufficient exposure to be included in this schedule is to be followed for a period of st least two years after he Is removed from the hazardous environment and longer if then considered necessary. The method of arriving at what constitutes a significant exposure is certainly an arbitrary one and it Is possible that other procedures would be equally suitable for this purpose. The actual working hours of exposure are caUlogued or recorded for Mechanical Department employees and, for the most part, their exposures are of the relatively short interval type. The rotation of the mechanics is assured and this seems favor able from the standpoint of reducing the frequency and length of exposure. Operating eraployeea are considered as having a less hazardous degree of exposure, owing to the nature of their work, but one of a continuing nature. From April 1, 1949 to September 1, 1950, inclusive, 3,010 skin ex aminations have been made with an average of 177 examinations per month. During this period of time, an average of 545 employees per month were reported as having working exposures. Many of these employees have had several exposures during this period of time. In ail, 81,181 hours of working exposure have been recorded during this period of time with an average of 4,575 working hours of exposure per month among mechanics. Ths greatest part of this exposure occurred from working on equipment it the two Catalyst Units st downtime. , Currently, 78 cases are being followed at Intervals ranging from one to three months where the akin lesion is of interest in this pro gram. These cases include cancer as well is warts, moles, keratoses, dermatitis, or any other suspicious lesions of any part of the body, regardless of whether or not the individual has working exposure to the high boiling catalytically-cracked oils. Forty-five cases having skin lesions were advised to get treatment and these are being fol- EM003019 EXX-MOR-003126 % THI MIDICAl BUUSTIN HUA4IU OU 1 SINNING COMMNn IATTOWN ItNNfir lowed. Any employee having a suspicious lesion or skin condition of interest may be examined as frequently as desired. It is the practice of the Medical Department to select employees for certain types of work or to recommend their removal from cer tain contacts with oils if It Is found that they have so-called cancer susceptible skins or have existing precancerous lesions which might become malignant provided they are exposed to these oils. A few of these cases have attracted attention and have been handled success fully. A great deal of clinical acumen and judgment Is seemingly neceiaary in some caaci to decide upon the advisability of making the recommendation to remove employees from possible contact exposure. To date, it baa not become ncccsaary to recommend removal of an employee because of a developing lesion associated with ths handling of these oils. If the necessity should arise, it is believed that the proper procedure can be developed. Often times, It is difficult to remove an employee from a working exposure because of limitations of available similar jobs governed by job classification, promotions, rate of pay, etc. This Is especially true for the operating group of employes*. No such difficulty confronts Mechanical Department em ployees. Much employee dissatisfaction can arise from this proce dure if careful planning is not done in advance of any action. Care ful evaluation of each Individual case and all the factors involved is highly Important to aaaura success in this undertaking. As concerns prompt treatment of lesions, a need developed for consultative dermatological, surgical, and pathological assistance. Consequently, arrangements ware made with the local M. D. Ander son Cancsr Foundation to cooperate with and asaist in this work. To date, ten small tumors, mostly of the verruca vulgaris type, have been surgically excised and tiaauc diagnosis has been made. Three of these cases were malignant In type.. Incidentally, the first of these cases sent in under the program resulted In the diagnosis of malignant melanoma of the right arm. The immediate advantage of such service were readily evident. This service la furnished at Company expense. It is felt that papillomas, warts, or other suspi cious lesions occurring on exposed surfaces of the body particularly upper and lower extremities and face, should be handled in the man ner just described. Accumulation of data from such cases may in time be helpful in evaluating the possible Incidence of skin cancer 4U from these oils. A group of the most interesting skin lesions seen hat been photographed and a series of lantern slides has been made. Dr. V. C. Baird, Mr. J. W. Hammond, and Dr. R. W. Pipkin are active as members of the Medical Department in directing and keep ing In touch with the progress of this program. Also, other members of the Baytown Refinery Health and Sanitation Committee, which consists of a member of Refinery top management, the Safety Super visor, the Assistant Industrial Relations Supervisor, and a rep resentative from the Laboratory Division, are active in this program. It is felt that the medical supervision is adequate, but a survey over the Refinery at frequent intervals is of the utmost importance with regard to what is being accomplished and to keep in touch with changing conditions. Plant personnel is constantly changing and so are the number of employees coming in contact with these oils. Con tinued application to the job at hand by all concerned is necessary. The Health and Sanitation Committee has been meeting at approxi mately three-month intervals for the past two years to review the progress of ths program. The minutes of these meetings reveal the scope and extent of the problems and accomplishments in the de velopment of tbs program. A "Manual for Safe Handling of High Bolling Olla from Catalytic-Cracking" is in the process of being prepared. It Is formulated along aimllar lines to the one put out by ths Safety Department of the Bayway Refinery, Esso Standard Oil Company. It li Intended for use at the Baytown Refinery by super visor and employes! with working exposures. Ths advantages of such a manual as a source of safety information for educational pur poses are readily evident. In accordance with ths recommendation of authorities that peri odic surveys should be made by representatives of the Medical De partment at approximately six-month intervals in plants where this problem exists, Mr. J. W, Hammond, Industrial Hygienist, Is per forming tbit function. Medical reports have been prepared and submitted at intervals; but, due to certain difficulties, it hss been impossible to furnish com plete medical data on all case reports and statistics. Since the sddition of one physician and a clerical employee to the staff in May, 1949, the records system la much more complete and dependable. The combination clerk-chemist Is a valuable addition to the staff. He Is capable of keeping up-to-date the records of skin examinations, E HO 03 02 0 44/ EXX-MOR-003127 IHl MIDtCAl tUUITtH follow-up examinationi, and furnishing monthly summaries of work done as well as obtaining occupational histories. This employee haj a scientific approach which tha average clerk does not possess. Like wise, this roan's ability la being utilised in the induitrial hygiene program as an aisistant in laboratory procedure! which require test ing by analytical methods, etc. The Medical Department is now in a position where occupational history and clinical findings can be cor related with a greater degree of accuracy and reliability. Ail known cases of cancer of any part of tha body, auspicious pre-malignant lesions, or other skin conditions of interest, past and present, are being summarized or are in the process of being summarized to furnirh the data that baa been requested. Admittedly, the data on some of these cases are incomplete, but it is believed that the in formation will be more complete In the future. The development of a precautionary control program associated with the handling of heavy catalytlcilly-cncked gas oils has seem ingly been retarded at times, yet a rather remarkable degree of prog ress has been made to date. The program has just retched the stage where the necessary medical data and statistics can be obtained for an evaluation of conditions as they actually exist concerning this potential hazard. To date, it is impossible to say that a single cue of skin cancer baa been found which could be usociated with the handling of these oils. A number of pre-malignant skin lesions or suspicious akin lesions have been found to be about the extent that one would expect in the average population. It may well be that evidence of multiple, rapidly growing skin papillomas will begin to appear out of all proportion to the usual incidence or tome other development may arise to focus suspicion on these oils in due course of time: hence, the reason for alertness and continued study of the problem. This program. Is noteworthy from the standpoint that It has established a cancer consciousness among employees and plant physicians alike which did not previously exist to such a marked degree. This within itself is certainly a valuable development in the field of cancer control. It is very gratifying to note that practically all major obstacles have been overcome In developing the medical program along the outlined procedures. Management and employees alike participat ing in this work have cooperated in a very fine manner. It may well be that ideas and procedures will have to be changed from time to time in accord with trends snd developments. 441 HU Mill OH S *tflfitNO COMTAHY'i IZHOWN IfflNIir II. INDUSTRIAL HYGIENE MEASURES The only materials under consideration at this time bv Humble Oil & Refining Company at its Baytown Refinery are the heavy frac- tlons of the catalytically-cncked oils and their concentrated prod ucts. , The number of employees in the Refinery having authority to han dle high boiling fractions of these oils and who work around or on the equipment that contains such has not been limited by Manage ment order. However, they are limited by restriction of issuance of work permits in these areas to those essential to efficient production and maintenance. It ia the responsibility of the process operators on tour to see that this regulation is carried out and that those assigned to or working around the units are informed of the po tential hazard. The formation of apecial repair crews has been considered but the execution of such a plan seemed to Management to belrolh costly snd cumbersome. Instead, it was agreed that whatever measures nscessary to protect the greater number of employees would be taken. Furthermore, it was Management's desire not to expose a few craftsmen to a greater potential hazard than the general em ployees in those respective crafts. This decision resulted In an Increase in the work involved In the control activities of the Medical, Safety, and Training Departments, Other adopted control measures tend to offset this extra work load. All personnel having jobs which involve a probable contact with these oil fractions are supplied, and muat wear, protective clothing. This equipment, which is supplied and cleaned by the Company, in clude! gloves, aprons, boots, gas masks, rubber suits, and coveralls. When any employe?'! clothe! ire soiled with these oils, the soiled clothing must be removed and, If necessary, the Company supplies coveralli. Protectlv equipment, except coveralls, ii cleaned by the Safety Department. Coveralls are laundered by a commercial laundry. The personal hygiene educational activities of this program arc carried out by the physicians st the time of the physical and akin examinations. At the same time, the employees are warned of the EMQ03021 44? EXX-MOR