Document pL0Qa4ar8pjLO14O8jXonpXd

Dr. L. W. Sanders Dr. L. J. Schradin Dr. K* V. Kitzmiller October 8,1935 In as much as I shall have to be away for a few days, I am making note of a few matters which I had expected to discuss \7lth all of you before any trips were undertaken this fall. Unfortunately I had to be away at the wrong time and was unable to attend to the matter. In order that this may not occur again through my absence, I am making use of this otherwise unnecessarily formal means. . WITH REGARD TO MIXING EQUIPMENT It has been suggested that each doctor be given a list of mixing points in his territory which are under question or about which there Is any current correspondence. In as much as I men fcloned one or two points to each of you, there seems little reason for making a list at present since with very few exceptions the equipment Is in fair condition, and the regulations are apparently being satisfactorily carried out. There is one point, however, about which I have some question. Shipping of drums of Fluid to plants which are equipped with storage tanks has introduced a complication in that there are no adequate storage facilities for drums at certain of these points. I consider it necessary to make sure that both full and empty drums shall be stored In the open air on such a platform as we have specified in the regulations for drum mixing. I have taken this matter up with the field staff and I believe that such situations as need correction will be taken care of promptly. However, any additional information which you can provide at these points will be useful in determining the extent to which hazards exist in the transportation of drums, and in their storage. I have tried to prevent the transshipment of less than oar load lots of Fluid in order that small, shipments might not be carried by local freight and thus increase the hazards in transportation. I believe the matter of transportation is being handled fairly satisfactorily, but I am not so sure that storage facilities for the drums are adequate, and I am not entirely certain that at some places these drums arc emptied in the open. In fact, at one point it developed that they had been emptied within the storage building. -- 2.-- v As a matter of policyt unless there Is some emergency situation 1 consider it wise to handle all matters with regard to equipment from this office. Prom time to time and for various reasons,our policy with regard to equipment changes. It is much easier, therefore, to handle this matter with uniform technique in which all the Information is put in my hands and transmitted with recomrend&tions through the Mew York office. In contra-distinction with this policy, each physician should hold himself responsible for taking any Imcediate action which might be indicated in so far as it concern s the men engaged in mixing. All these latter matters should be settledon the spot, if it is at all possible. MATTERS RELATING TO OUR RECORDS It would appear to be desi rable to adopt a more or les3 uniform manner of recording certain items of information which may later be useful in connection with various studies of the records. At present it is not always possible to make certain that the absence of a notation means the absence of any significant history. Moreover, the record of exposure to lead in the work of mixing, that of exposure to gasoline, the occupational history and the history of pre vious lead exposure, are not always sufficiently clear to be useful. May I suggest that the medical staff get together and agree upon some more or less uniform method of recording the information in these matters. The previous history of lead exposure should give the frequency of exposure, the duration over a period of time, and the magnitude of the ex posure in terms of the actual type of occupation. *Phis could he done in fairly simple terms If some understanding were arrived at as to what was meant by this, that, or the other expression. The total occupational history might better be set down in terms of actual dates by years in which the in dividual was engaged in this, that, or the other work* Initially there was no particular point in a complete occu pational history since we viere interested only in the question of load exposure. We might find, it very useful later on to have fairly detailed information as to the previous types of occupational exposure experienced by men under our care* Tlie history of exposure to gasoline might be amplified in some measure. At present the history of such exposure is rather too indefinite to be useful* In the matter of exposure in the occupation of mixing, I should consider it useful to make an estimate of the exposure of each man by indicating the frequency of mixing. Our other records will establish adequately, I believe, the quality of the equipment, and the care exercised at the individual plants. Any action which you wish to take jointlywhich will clarify these points will be quite satisfactory to me. K & 0004789 '