Document pd4NZMy5vdvDYmzvkyakpRMw

May 51, 1949 Dr. A. S. Cbaimov, San Francisco Polyclinic Hospital, 1555 Jackson Street, San Francisco, California-, Dear- Doctor Cbaimov t . ' -'i ~ C c; -; -g .. - v- It has been reported to me by indirect means t h r o u g i ^ M i ^ o f t h e oil companies that a patient of yours, named is developing or has developed blindness, presumably due to optic atrophy., and that this has been attributed somewhat, tentatively to p, occupational exposure to lead in connection with the cleaning of 'gasoline storage tanks. I am more than a little interested in this natter, since my associates and I in this Laboratory have been following the problems associated with the use and distribution of leaded gasoline for many years. I will give you my general reaction to this situation, but for present purposes, the primary matter of importance is that of determining whether or not this man lias had any significant exposure to lead compounds, and whether at this time he shows any evidence of abnormal, lead absorption. Inasmuch as there may be medico-legal matters at issue here, you may or may not wish to provide me with information concerning the case, but if you can do so, I should be very grateful, and I should also be pleased to . comment on the situation or to give you any assistance that may be possible. Specifically, if you wish it, I should be glad to send you containers with instructions for the collection of samples of blood and urine for analysis so as to determine whether there is any abnormality with reference to the absorption at this time. 'Jith reference to our experience, I should point out to you that the lead exposure associated with the cleaning of gasoline storage tanks, if such occurs, is a matter of absorption of tetraethyl lead or its organic decomposition products. The clinical picture of such lead absorption is quite different from that associated with the absorp tion of inorganic lead compounds, and I think you should know that peripheral neuritis, including lesions of the optic nerve, lias never been sen In this disease. Ve have seen well over 100 cases of lead poisoning of this type, and wo have followed the personnel in the manufacturing and other activities of this industry since 1926. Poisoning is always expressed by acute irritation of the central nervous system, with mental disturbances as the only important clinical picture. Chronic lead poisoning of the ordinary variety , does net occur, even under the conditions of prolonged exposure of low ox* moderate severity. Because of our experience I should regard it as most remarkable if a lesion of this kind were to develop on such a background. I should also point out, that the lead exposure associated with, the cleaning of gasoline dorage tanks can be, and has been, successfully avoided by the use of proper precautions. Dr. A. S. Chaiaov, San Francisco Polyclinic Hospital - (2) May ~$\9 1949 Obviously I do not know of the precise procedures folloved by this man., but I iaay be privileged to doubt that his work was done in the absence of such precautions* Obviously, this expression of opinion leaves me entirely billing to examine the facts without prejudice, for if this nan has had exposure# I should be very happy to aid in establishing such a fact. Cordially yours, ; .' 1.12 of C .C.: Dr. 'S. L. Rankin l o b e r - t " i i T i t e h b e ' > ' M . .. K t 0017271