Document pmezanYZ1X7DGvYOZpZ2X2ypj

desk o BERT A. KEHOE :':jP :tob er 27 1 9 5 4 C O */ cr ^ ;jS,i P>j ' (a m JL -- d Qc^ *~S**. yaJCts tf fLeJ) , iui^J u+St J L' J-jbff**' J t J - >*. tu & t *$ JU+C+m4_ leer srica t est w s t) 4&<W fie, Am ^ , , 7CaJ *** *l<| W`^ It, TC*' u x u m A *h &*v +.L+JU J z*UA-* l fc i f , th e o c c u r r e n c e o f l e a d p o is o n in g a m o n g orJ^x (jn-JLj< ` m ce w ith y o u r r e q u e s t . I w e n t o v e r t h i s lite r you sen t it and re tu rn e d it to a sheaf ATlMf~i dU snJ+ v P V , -, |A> AVh/ y . : / , ' V, tng f o r s tu d y in c o n n ec tio n w ith so m e in ten d ed w ritin g .^ U n fo rtu n a te ly , I h a v e h a d no c h an ce to d o th e w ritin g although I have gath ered up som e o th e r unpublished m a te ria l fro m se v e ra l so u rc e s. 1 seem to have boxed m y self in fa irly effectively w ith day to day w ork th at has fragm ented m y tim e fo r study. * ~ Since receiv in g your le tte r I have gone o v e r the re p o rt ag ain and this tim e in so m e d e ta il. In so doing I m ad e tw o p e n cil n o te s, one of w hich on the f ir s t page re la te s to a g larin g fau lt in th e tex t * a statem en t of D r. D rees serfs w hich is so w rong th a t h e should n ot be c re d ite d publicly w ith having m ade it. He m ay have lack ed ex p erien ce to th is extent a t th at tim e, o r he m ay have been m isunderstood in p a rt, but at le ast, our know ledge h as gone f a r beydnd the stag e re p re se n te d by. th is and som e of the e th e r d iscu ssio n s on lead poisoning in th is p ap er. A nother notation re la te s to the a n aly tical d ata on blood in th e ta b le , w hich, if the o th er tabulated facts a re valid, a re u tte rly w rong and w o rth less. The values re c o rd e d , w ith th re e ex ceptions (value of 0 .0 7 , 0 .0 9 and 0 ,0 7 lis te d in o rd e r fro m above dow nw ard) a re w ithin the no rm al ra n g e, and fa r fro m suggesting th a t th e se p e rso n s had le a d poisoning, th ey w ould p ro v e conclusively th at th ey did not and could not have been suffering fro m lead poisoning a t the tim e th ese an aly ses w ere m ade, if indeed, they had any re la tio n sh ip a t a ll tb the tr u e fa c ts. In addition th ey a re quite out of lin e w ith th e re s u lts obtain ed on the u rin e . H ence 1 w ould g u ess th a t the an aly tical w ork on both the blood and u rin e w as u n re lia b le . A s I have pointed out elsew h ere, poor an aly tical w ork is m uch w orse than none a t a ll, and th e re fo re b efo re attem p tin g to a p p ra ise the validity and m eaning o f th e o t h e r in f o r m a tio n in fixe a r t i c l e , I s h o u ld s im p ly d i s c a r d th e analytical data a s co n trad icto ry and m isleading. ' -- T his leav es m e in the unhappy position of assu m in g th at som e of the O ctober 27, 1954 Di*. L -orin E . K e r r A sst. E xecutive M edical O fficer U nited M ine W o rk ers of A m e ric a 907 F ifte e n th S tre e t, N o rth w est W ashington 5, D. C. D ear D octor K err: I am retu rn in g the re p o rt on the o c cu rren c e of lead poisoning am ong o rc h a rd w o rk e rs, in acco rd an ce w ith your re q u e st. I w ent o v er th is ra th e r h u rrie d ly som e tim e a fte r you sen t it and re tu rn e d it to a 3heaf of m a te ria l w hich I w as holding fo r study in connection w ith som e intended w riting. U nfortunately, I have had no chance to do the w riting, although I have g ath ered up som e o th er unpublished m a te ria l fro m s e v e ra l {sources. I se e m to have boxed m y self in fa irly effectiv ely w ith day to day w ork th at has frag m en ted m y tim e fo r study. Since receiv in g y o u r le tte r I have gone o v e r the re p o rt again and this tim e in so m e d e ta il. In so doing I m ad e two p en cil n o te s, one of w hich on the f ir s t page re la te s to a g larin g fau lt in the tex t - a statem e n t of D r . D re<esseris w h ich 3 so w ro n g th a t h e sh o u ld n o t b e c r e d ite d p u b lic ly w ith having m ade it. He m ay have lacked ex p erien ce to th is extent a t th at tim , o r he m ay have been m isunderstood in p a rt, but a t le a st, our know ledge h a s gone f a r beyond the stag e re p re se n te d by th is and som e of the e th e r d iscu ssio n s on lead poisoning in this p ap er. A nother notation re la te s to the analytical data on blood in the tab le, w hich, if the o th er tabulated! fa c ts a re v alid , a r e u tte rly w rong and w o rth le ss. The v alu es re c o rd e d , w ith th re e ex cep tio n s (value of 0. 07, 0. 09 and 0. 07 lis te d in o rd e r fro m above dow nw ard) a re w ithin the norm al ran g e, and fa r fro m suggesting th a t th e se p e rso n s had le a d poisoning, th ey w ould p ro v e conclusively th at they did not and could not have been su fferin g fro m lead poisoning a t the tim these an aly ses w ere m ade, if indeed, they had any relatio n sh ip a t a ll to the tru e fa c ts. In addition they a re quite out of lin e w ith the re s u lts obtained on the u rin e . H ence I w ould g u ess th at the an aly tical w ork on both th e blood and u rin e w as u n re lia b le . As I have pointed out elsew h ere, poor an aly tical w ork is m uch w orse than none at a ll, and th e re fo re b efo re attem p tin g to a p p ra ise the v alid ity and m eaning o f th e o th e r in fo rm a tio n in the a r tic le , I sh o u ld sim p ly d is c a r d th e analytical data as contradictory and m isleading. This leav es m e in the unhappy p o sitio n of assu m in g th at som e of the D r. L o rin E . K err - (2) - O ctob er 27 1954 : clin ical findings w ere valid, th at som e w ere probably not, and that proof of thp o c cu rren ce of lead poisoning am ong th ese people is not av ailab le. I think th at the th e sis th at such c a se s o c c u rre d in som e num ber is p robably c o rre c t, but the alleg ed ly sp ecific evidence both on the environm ental and clinical sides of the situ atio n is so w eak a s actu ally to su b tract som ething fro m the p lau sib ility of a sim ple statem en t o f the facts and opinions. It is im probable th at a ll of th ese diagnoses of lead poisoning w ere in c o rre c t, but on the inform ation given, it Is reaso n ab ly c e rta in , I b eliev e, th at som e of themi w ere in c o rre c t. . In sh o rt, if I w ere in y o u r p o sitio n , I w ould not open up m y self o r m y frien d s and a sso c ia te s to se v e re c ritic is m , by publishing th is re p o rt in th is fo rm . If I w ere to p u b lish it, I'd m e re ly re c ite the h is to ry of the potential ex p o su re, disp en sin g w ith the highly im ag in ary fig u re given by the tim e x co n cen tratio n calcu latio n ; I w ould sta te the c a se w ith re fe re n c e to th n u m b ers of cases re p o rte d as lead poisoning by attending physicians `d is p e n s in g w ith a l l o f th e d a ta o n th e a n a l y s i s o f u r i n e a n d b lo o d a n d b o ilin g dow nlthe clin ical findings to the o v e ra ll sym ptom atic p a tte rn , w ith o r w ithout the fig u res on the e ry th ro c y te s, hem oglobin and stippling. That is to say I w ould n o t a tte m p t to p ro v e th e c a s e , fo r the p ro o f is not th e re . I'd sim ply leave it on the m e rits of the m edical opinions, fo r w hatever they a re w o rth . They w ill then a p p e a r to be w orth m o re {rath er than le ss ) than they actu ally a re . If th is sounds like c lev e r ta ctics ra th e r than an honest rep re se n ta tio n of fa c ts, I can only defend it by saying th at th ese m edical opinions do have som e w orth and th at th ey should not be d iscred ited by in a d e q u a te M3 c i e n t i f i c ,, e f f o r t s . My c ritic ism s m ay seem som ew hat h a rsh , but I hard ly think they a re . R ath er I have u n d ertak en to be quite fran k , a s y o u r co u rtesy to m e d e se rv e s, w hile recognizing th at m y c ritic is m is m o re u sefu l a t th is tim e than it would be if it w ere given a f te r th e p u b licatio n of th e a rtic le . W ith k in d e st re g a rd s , C ordially yours, RAK ef Enc. R obert A. Kehoe, M. D.