Document q3B647DeqYon5Y3zk2O4RNd4R

FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1960 Apr 25 DOC#: API044 DOCUMENT DESCRIPTION: Minutes from API Medical Advisory Committee Meeting with Attachments TfOR c o m m i t t e e u s e o n l y MEDICAL ADVISORY COMMITTEE 29TH MEETING NOT FOR PUBLICATION April 25, I960 Council Room, The Manger Hotel Rochester, New York AMBERS PRESENT : J. W. Osborn, M. D., Chairman Leo J. Wade, M. D., Vice Chairman L. E. Renes, Secretary (l, 0. Armstrong, M. D. 7. C. Baird, M. D. (Rep. b y E. R. Herman) C. H. Baylor, M. D. R, G. Birrell, M. D. (Rep. b y E. A. Turcot) F. F. Boys, M. D. G. H. Collings, M. D. Kieffer Davis, M. D. (Rep. by Paul Heerwagen, M. D.) R, E. Eckardt, M. D. T. M. Frank, M. D. T. J. Kelly, M. D. E. K. Linder, M. D. C. R. Miller, M. D. T. H. Mitchell, M. D. J. C. Ruddock, M. D. G. M. Saunders, M. D. (Rep. by A. C. Pabst) Ralph Schneider, M. D. W. Wayne Stewart, M. D. TECHNICAL ADVISORS PRESENT: W. H. Barcus E. X. Daniels A. E. Dooley 3eo. Entvistle H. W. Gerarde, M. D. J. H. Johnston P. K. Kuhne C. A. Neilson A. C. Pabst Jack Spence (Rep. b y G. M. Wilkening) N. K. Weaver, M. D. MEMBERS ABSENT: R. M. Adams, M. D. T. E. Allen, M. D. J. W. Crookshank, M. D. L. E. Curtis, M. D. 1. R. Fourcher, M. D. F. D. Gassaway, M. D. R. Emmet Kelly, M. D. E. P. Luongo, M. D. B. S. Miller, M. D. R. C. Page, M. D. R. J. Potts, M. D. OSIERS PRESENT: Philip Drinker, Consultant 2. 0. Mattocks Lloyd Pickett, M. D. Scrique Quino John R. Scott, M. D. van Raalte, M. D. Robert A. Wise, M. D. Harvard University American Petroleum institute Gulf Oil Corporation Esso Standard Carter Div., Humble Oil & Refining Co. Royal Dutch Shell (The Hague) Humble Div., Humble Oil & Refining Co. API 07597 . OPENING RS4ARKS - 2- Chairman J. W. Csboro, M. D., welcomed all members present. He intro duced the following guests: John R. Scott, M. D., Lloyd Pickett, M. D., Enrique uino, Paul Heerwagen, M. D., H. van Raalte, M. D., and Robert A. Wise, M. D. tj. APPROVAL CF MINUTES OF 28TH MEETING The chairman stated that, inadvertently, part of Appendix J to the report 3f the Subcommittee on Specialty Petroleum Products had been omitted when the 3ir.utes of the 28th meeting were distributed. One was a report from Carl A. Nau, 4, D., and the other was a report from B. B. Reeve, M. D., to J. W. Osborn, M. D., concerning Dr. Reeve's attendance at the American Association of Poison Control Center's meeting. These omissions were distributed to the Medical Advisory Com mittee members and Technical Advisors on April 19th. ACTION: It was regularly moved, seconded, and unanimously passed that the minutes of the 28th meeting of the Medical Advisory Com mittee, held November 8, 1959; be approved as distributed together with the subsequent additions to Appendix J. ill. SUBCOMMITTEE REPORTS - A. Operating Subcommittee J. W. Osborn, M. D., chairman of the Medical Advisory Committee, that the only thing to report related to budget which will be discussed later. The minutes of this meeting are attached as Appendix A. indicated B. Atmospheric Pollutants Chairman J. C. Ruddock, M. D., reported on the activities of his subcosmlttee. The minutes of this subcommittee are attached as Appendix B. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. Dr. Ruddock read his eubconnittee's proposal in answer to Mr. Porter's request for advice from the Medical Advisory Committee as to the need for a research study on the carcinogenicity of auto exhaust. This is given in Appendix B. ACTION: It was regularly moved, seconded, and unanimously passed that this part of the report be accepted. C. C9 - Cj2 Aromatics In the absence of Kieffer Davis, M. D., chairman of the subcommittee, T- M. Frank, M. D., read the report of progress of the study of C9 - C]_2 aromatic research together with the recommendation of the subcommittee relating to further study. The report of this subcommittee is attached as Appendix C. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. API 07598 D. Dermatology - 3- Leo J. Wade, M. D., chairman of the subcommittee, reported on the activity 0f this group. S. Epidemiology In the absence of G. M. Saunders, M. D., chairman of this subcommittee, C. 3. Baylor, M. D., reported on the activities and receraendations of this sub committee relative to a study of heart effects in oil employees. It was suggested that this subcommittee prepare a brief questionnaire which might be used to obtain tbe desired information. A copy of this subcommittee's report is attached as appendix D. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. F. Medical Policies and Administrative Practices Ralph Schneider, M. D., chairman of the subcommittee, reported on the activities of this group. A copy of his report is attached as Appendix E. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. G. Physical Agents J. W. Osborn, M. D., announced that J. H. Hege, M. D., had resigned from the Medical Advisory Committee. Dr. Osborn appointed G. H. Collings, M. D., chairman of this group. Dr. Collings1 report was in two parts: (l) Recommendation I to continue support of research by Dr. Glorlg at the American Academy of Ophthalmol- ; ogy and Otolaryngology in amount of $2,500 for the year 1961-1962. (2) Re commends- ! tlon to discharge the Physical Agents Subcommittee or charge it with a specific assignment or transfer the responsibility to the Industrial Hygiene Subcommittee. A copy of this report is attached as Appendix F. 1 ' ' ACTION: It was regularly moved, seconded, and unanimously passed that the report be amended by deleting the recommendation to dis I charge the Physical Agents Subcommittee and that the amended report be accepted. H. Carcinogenicity R. E. Edcardt, M. D., reported on the activity of this subcommittee. His report is given as Appendix G. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. API 07599  1 -4 - Scecialty Petroleum Products C. H. Baylor, M. D., chairman of this subcommittee, reported on the activities of the group. A copy of his report is given as Appendix H, ACTION: It was regularly moved, seconded, and unanimously passed that I the report he accepted. J, Toxicological Reviews j H. W. Gerarde, M. D., chairman of this subcommittee, reported on its activities. A request was made that Dr. Gerarde and his subcommittee edit the toxicological Reviews before submitting them to the members of the Medical Advisory Committee for their comments. A copy of Dr. Gerarde's report is attached as . Appendix I. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted and that the subcommittee on Toxicological Reviews edit all future revised reviews before submitting them to the Medical Advisi.y Committee for their comments. K, Industrial Hygiene Mr. George Wilkening reported for Chairman Jack Spence on the activity of this group. A copy of this report is attached as Appendix J. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. IV. REPORTS BY LIAISON MEMBERS A. Joint Committee for Dermatitis Study - No report. B. Smoke and Fumes - J. C. Ruddock, M. D. indicated he is maintaining close liaison with the Smoke and Fumes Committee of the Division of Refining. He reported on the activities of this group. A copy of his report is attached as Appendix K. C. American Standards Association - The liaison with the American Standards Association committees were discussed in the Industrial Hygiene Subcomaittee meeting. D. Interdivisional Committee on Labeling - Dr. Allan Dooley reported on House and Senate bills before the current congress which relate to mandatory labeling of household-type chemicals sold in interstate commerce. Mr. Dooley also reported on the proposed revision of the API Labeling Manual, 2511. A copy of his report is attached as Appendix L. S. First Aid Training - Th M. Frank, M. D. reported on the activity of the Subcommittee on First Aid of the Central Committee on Accident Prevention of the This subcommittee is studying the desirability of adopting mouth-to-mouth breathing as the choice method of resuscitation. API 07600 ! t -? - F. Wax Committee - R. E. Eckardt, M. D., chairman of the Advisory ^cnanittee to the Vax Research Project, reported on the activity of this group, jo summary, the Advisory Committee has (l) submitted data with recommendations to the Food and Drug Administration for clearance of a Type 1 wax and a request for a year's extension of a Type 2 wax, (2) established an Analytical Subcommittee vhich has prepared an ASTM Method for determining the absorptivity of waxes. The group is also studying the need to standardize other tests used in complying with the FDA wax specifications, (3) started additional feeding tests to continue the study on Type 2 waxes, and (1+) planning to continue the wax research project at the same level of expenditure of $ 150,000 per year. (5) received an extension of a year from the FDA for Type 1 and Type 2 petroleum waxes. 0. Quarantine Service. The U. S, Public Health Service - No report. H. Interdivisional Committee on Petroleum Food Additives - No report. V. BUDGET FCR 1961-1962 The following budget was proposed: Atmospheric Pollutants C9 - C12 Aromatics Noise Specialty Petroleum Products Toxicological Reviews Consultant Administrative Expense $ 5,000 10,000 2,500 15,000 5,000 3,000 1.000 $1*1,500 ACTION: It was regularly moved, seconded, and unanimously passed that a budget of $1*1,500 be recommended to the Medical and Health Committee for the year 1961-1962. VI. NEXT MEETINGS The next meeting of the Medical Advisory Committee will be held in con junction with the Annual Meeting of the API in Chicago on November 11, 12, 13, and Ik, 1961. It was indicated that the Industrial Hygiene Association is planning to bold its spring meeting at a time and place different from the spring meeting of the Industrial Medical Association in 1961. At this time, the Industrial Medical Association had indicated that they are planning to hold their meeting in Los Angeles on April 11, 12, 13, and lit, 196l. The Industrial Hygiene Association group is tentatively planning to hold their meeting in Detroit on April 18, 19, and 20, 1961. ACTION: It was regularly moved, seconded, and passed that, assuming the IMA spring meetings are held as now indicated and the H A spring meetings are held as indicated, the Medical Advisory Committee and its subcommittees hold their spring meetings in Detroit on the 15th, l6th, and 17th of April, 1961. There were 22 for this motion and ** against. (Secretary's Note: Since this action, the meeting dates of the IMA and AIHA have been changed. Because it is necessary to make meeting room arrangements at the earliest possible moment, the date of the MAC and Subconnittee meetings must be established as soon as possible. The chairman will announce the time and place of these meetings in the very near future.) API 07601 ft y -6 - VII. KEW BUSINESS A. Chairman Oaborn reported it was with deep regret that he learned of the death of N. J, Gothard, of Sinclair Refining Company, who was one of the original ujeabera of the Medical Advisory Committee, 8. The question of submitting gratis copies of Toxicological Reviews to various organizations was discussed extensively by the various members of the jommittee. The attached list, Appendix M, was agreed upon a6 a desirable starting point. ACTION: It was regularly moved, seconded, and unanimously passed that the emended list shown in Appendix M be used for the gratis distribution of Toxicological Reviews. C. The chairman extended to R. E. Eckardt the congratulations of the Medical Advisory Committee on being elected President o f the Industrial Medical Association. The group extended Dr. Eckardt their best wishes. Approved: j. W. Osborn, M. D., Chairman 7/6/60 Reported by L. E. Renes, Secretary API 07602 I appendix a (A-l) MINUTES OF THE MEDICAL ADVISORY COMMITTEE'S ' OPERATING S U B C O M M i m B ' Sunday, April 2k, i960 6:00 P. M. The Manger Hotel Rochester, New York f?ffOSE PRESENT: J. W. Osborn, M. D., Chairman Leo. J. Wade, M. D., Vice Chairman L. E. Renes, Secretary V. C. Baird, M. D. Past Chairman (Represented b y E. R. Herman) C. H. Baylor, M. D. q, S, Ceilings, M. D. Kieffer Davis, M. D. (Represented by T. M. Frank, M. D.) E. W. Gerarde, M. D. E. 0. Mattocks J. C. Ruddock, M. D. Jack Spence (Represented b y G. M. Wilkening) ifiMBERS ABSENT: . R. E. Eckardt, M. D. G. M. Saunders, M. D. Ralph Schneider, M. D. VISITOR: Philip Drinker Harvard University I. INTRODUCTORY REMARKS BY CHAIRMAN J. W. Osborn, M. D., chairman of the Operating Subcommittee, welcomed those present. He indicated that regrets had been received from: Jack Spence, chairman of the Industrial Hygiene Subcommittee (represented b y George Wilkening); Kieffer Davis, M. D., chairman of the Subcommittee on C9 - C12 Aromatics (represented by T. M. Frank, M. D.); V. C. Baird, M. D., past chairman of the Medical Advisory Coomittee (represented b y Ed Herman); Ralph Schneider, M. D,; G. M. Saunders, M.D., and R. E. Eckardt, M. D. H. APPROVAL Of H O W E S ACTION: It was regularly moved, seconded, and unanimously passed that the minutes of the November 8, 1959 meeting of the Operating Subcommittee be approved as distributed. HI. PROGRAM SUBCOMMITTEE Chairman Osborn indicated that the Program Subcommittee had not been appointed for i960. The Operating Subcommittee is to handle what small amount of vorlc has to be done in planning the programs. The primary Job is to plan for the closed round table discussion at the fall meeting of the Medical Advisory Committee. ^ ifl year the Industrial Hygiene Subcommittee is to put on the program. API 07603 2 (A-2) jV. OIL MIST The Industrial Hygiene Subcommittee has been assigned the work on oil The chairman of the Industrial Hygiene Subcommittee has appointed a task gfoup to search for source of data and information on this subject. v< SUBCOMMITTEE POLICY QUESTIONS A. Atmospheric Pollutants Dr. Ruddock indicated that he has requested a date with Dr. Goldblatt for a meeting in New York on May 18th to discuss publication of his report on the medical aspects of atmospheric pollutants. Dr. Ruddock will review, with Dr. Goldblatt, his pipes to request a grant-in-aid from the Public Health Service. Dr. Ruddock reported that the President of the API requested the Medical Advisory Committee to initiate a study to determine whether an investigation should be started on the possible carcinogenic properties of exhaust gases. Chairman Ruddock requested $5,000 be placed in the budget for the year 1961-1962 for use of the subcommittee to continue their study on the Medical Aspects of Atmospheric Pollution. It was pointed out that there is still $1155*05 left in the fund raised b y the Division of Refining to study the aedixal aspects of atmos pheric pollution. B. C9 - C12 Aromatics This subconmittee is requesting $10,000 for the year 1961-1962 to be spent only if needed. It is hoped that the C9 - C12 experimental work will be completed by July 1, 1961. C. Carcinoaencity No budgetary requirements or policy matters to be discussed. D. Dermatology No budgetary requirements or policy matters to be discussed. E . Epidemiology No budgetary requirements or policy matters to be discussed. F. Medical Policies and Administrative Practices No budgetary requirements or policy matters to be discussed. 0. Physical Agents Subcommittee requests $2,500 for the year July 1, 1961 to June 30, 1962 for a grant to the Committee on Noise at the Academy of Ophthamology and Otolaryngology. There was considerable discussion as to whether the Medical Advisory Committee should grant varying amounts of money from year to year for the study of noise or settle on seme small sum, such as a thousand dollars, which could be assured the Committee on Noise. It was generally agreed that $2,500 should be granted now to the Committee on Noise. API 07604 % - 3- (A-3) Dr. Collings proposed that the duties of the Physical Agents Subcommittee be transferred to the Subcommittee on Industrial Hygiene. Subsequent discussion -- suited in a recommendation that the Physical Agents Subconnittee continue its activities but strike out item 2 in its present short-term goal of its scope of a c tiv itie s . H. Specialty Petroleum Products The subcommittee requested $5,000 for the year 1961-1962 to continue work beiog done by Dr. Daeschner, $5,000 for Dr. McKay, and $5,000 for Dr. Carl Nau. Dr. Qerarde is endeavoring to work out the difficulties which the techni cians working for Dr, Daeschner and Dr. McKay are having in applying Dr. Gerarde's analytical method for determining aromatics in human blood. I. Toxicological Reviews It is recommended that $5,000 for the year 1961-1962 be put in the budget to continue the work being done b y Dr. Drinker in his revision of toxicological reviews. It was generally agreed that the revision of the old toxicological reviews should be completed before writing any new ones. It was pointed out that the pro posed revisions to the old toxicological reviews have been completed b y Dr. Drinker. J. Industrial Hygiene No policy or budgetary requirements VI. DR. GOLDSLATT'S REPORT Chairman Osborn will work with Drs. Wade and Ruddock to try and get Dr. Goldblatt's p o r t published as soon as possible. No estimate, at the present tine, is possible as to the cost for such a publication. m . 1961-1962 BUDGET It was agreed that $1,000 should be placed in the budget for Administrative Sxpenses which are used to pay the travel expenses for Drs. Daeschner and McKay and others if they are required to attend subcommittee meetings or the meetings of the Medical Advisory Coartttee. Atmospheric Pollutants C9"- C12 Aromatics Boise Specialty Petroleum Products Toxicological Reviews Consultant Administrative Expense $ 5,000 1 0 ,0 0 0 2,500 15,000 5 ,0 0 0 3,000 1.000 $41,500 API 07605 ^II. REQUEST TO INVESTIGATE NEED FOR RESEARCH ON CARCINOGENIC PROPERTIES OF AUTOMOBILE EXHAUST The request from Mr. Porter to the Medical Advisory Committee to study the P*Bibie need for research on carcinogenic properties of automobile exhaust was * - if - (A-U) presented, by Chairman Osborn. It was pointed out that the conference with pr, Goldblatt for May l8th, may be helpful in determining any recommendation* vhich Dr, Goldblatt has as to possible fields of research. Chairman Osborn will set up a subcommittee, if necessary, to make the desired study, the results of vhich will be reported to the Medical and Health Committee as soon as possible. X. GRATIS DISTRIBUTION OF TOXICOLOGICAL REVIEWS The list of possible Institutions to receive gratis copies of toxicological reviews had been submitted to the members of the Medical Advisory Committee. Their comments were reviewed by the Operating Subcommittee. A suggested list was developed vhich is attached to the minutes of the Medical Advisory Committee, as Appendix M. X. NEXT MEETING The subcommittee meetings of the Medical Advisory Coamittee will be held oo Friday and Saturday, November 11 and 12, i960; In Chicago; the Operating Sub committee on Sunday evening, November 13, i960; and the Medical Advisory Committee on Monday, November I k , i960. The midyear meeting of the Medical Advisory Ccm- mittee is somewhat uncertain since the time and place of the Industrial Medical Association and the Industrial Hygiene Association are not firm. The officers of the committee will establish a desirable date for the midyear meeting of the Medical Advisory Committee and its subconsittees. XI. ADJOURNMENT The meeting adjourned at 11:00 P. M. Reported by ' L. E. Renes, Secretary APPROVED: J, W, Osborn, M. D., Chairman API 07606 > APPENDIX B (B-l) REPORT CF SUBCOMMITTEE CN ATMOSPHERIC POLLUTANTS John C. Ruddock, M. D., Chairman MINUTES Friday, April 22, i960 The Manger Hotel Rochester, New York Five members of subcommittee attended and 20 visitors. vere given the privilege of the floor for all discussions. The visitors The m i c 'tec of the last meeting, held November 6, 1959, at the Conrad ; Hilton Hotel in Chicago, Illinois, were approved as circulated. I The chairman opened the meeting with remarks pertaining to the general aspects of air pollution and his activities since the last meeting of the sub committee. In brief, the trends developing from researches in air pollution are . that the possibility of acute effects are becoming more remote and further future I researches are centering on chronic lung diseases which might be caused by contact i with minute amounts of pollutants repeatedly over a long period of time, i.e., j cancer, emphysema, chronic bronchitis, bronchiectasis, etc. It is becoming more I evident that the air pollutant problem does not arise nor is caused by effluents ! from refineries but is caused from the combustion and burning of petroleum pro ducts, particularly the automotive exhaust. The itinerary of travel by Dr. Goldblatt in his letter of April 5, I960, vas approved. He will arrive in New York on May 17, I960 and will visit Washington and Cincinnati and depart from New York on June 10, I960. Much discussion was had concerning the methodology of printing, publish ing, editing and distributing Dr. Goldblatt's report. The general opinion was that his report should not be printed in its present form. It is noted that Mr. Mattocks, Dr. Drinker, Dr. Osborn, Dr. Wade, and the chairman will meet with Dr. Goldblatt in New York on May 18, i960, and will resolve definitely such matters as: (1) Date of final completion of report, (2) Type and character of editing, and (3) Publication of report by USPHS, API or other and extent of distribution. (Note: It was suggested by Dr. Drinker that the report be filed as it is, in the American Documentation Institute in Wshington, D. C. Anyone may then obtain a microfilm copy at a nominal coat.) The scope and function of the subcommittee was adopted as read by the chairman, copy of which is attached. The Smoke and Fumes Committee has requested that the Subcommittee on Atmospheric Pollutants be represented at their meeting in Detroit on May 10, i960. Mr. T. B. Rendei and Mr. Herman Barcus were appointed by the chairman to attend this meeting aa liaison representatives. It was approved that the MAC request an allocation of $5,000 for the year 1961-1962 to continue the initial review of and critical evaluation of: literature &ad researches, contemplated, in progress or completed, in the field of air Pollution as it affects the health of the individual and the community, restricting the studies to those pollutants from the petroleum Industry. Mr. Chairman, I move the acceptance of this portion of the report. API 07607 * -2 - (B-2) The question was put and this portion of the report was accepted ^anioously. Discussion brought out the fact that in the area of epidemiology conclu d e s can not be made on the effect of air pollution on health because the facts 3re not available. A letter was read in which the President of the API requests tbst the MAC report to the Medical and Health Committee of the Board of Directors a3 soon as possible regarding the advisability of instigating research on possible Health aspects of atmospheric pollution, especially that part contributed by the jse of petroleum products, particularly as applied to automobile exhaust. This elicited much discussion both pro and con among the subcommittee members and visitors. It was finally the conclusion of the subcommittee that the chairman of tte MAC should refer this to an appropriate subcommittee to report back to the MAC &t its November meeting on the advisability and feasibility of instigating such a research program, as suggested by the President of the API. John C. Ruddock, M. D., Chairman Subcommittee on Atmospheric Pollutants API 07608 * - 3- Attachment (B-3) SCOPE AND FUNCTION SUBCOMMITTEE ON ATMOSPHERIC POLLUTANTS FUNCTION: 1. To accumulate and critically evaluate information on matters of health concera- ing atmospheric pollutants for which the petroleum industry may be responsible. 2. To be cognizant of technical researches being conducted by the petroleum industry, through the Smoke and Fumes Committee, as well as those technical re searches being carried out by the U. S. Public Health Service, various state health departments, universities, institutes and individuals and also those researches carried out by Air Pollution Control Districts everywhere. These researches should be considered in terms of pollutants of environmental air and pollutants of ambient air. 3. To follow-up researches on atmospheric pollutants that have not been published and that are incomplete with regard to the effect of pollutants on the health of the individual and the community. SHORT TERM GOALS: 1. To keep the Medical Advisory Committee informed of all developments in the field of air pollution and the effects of individual constituents of air pollution on the health of the individual and the community, especially those pollutants attributed to the petroleum industry by reason of their operations. 2. To disseminate among the membership of the Medical Advisory Committee such re ports, publications and bulletins which might be of interest to the members in the field of air pollution. 3. To accept assignments and report to the Medical Advisory Committee on any natters relating to atmospheric pollutants. b. To instigate such research projects which might determine the effect of air pollutants on the health of the individual and the community and to suggest methods or policy to the Medical Advisory Committee, based on the evaluation of facts, which might clear or lessen the liability of the petroleum industry for air pollution. LONG TERM GOAL: To continuously keep the Medical Advisory Committee advised of all developments in this field in order that research may be developed to confirm facts towards deter mining whether or not air pollutants, as related to the petroleum industry, are a medical hazard or a nuisance. API 07609 ?Z?CET CF SUBCOMMITTEE CN C9 - C12 AP.CMATICS Xieffer Davis, M. D., Chairman The Subcommittee on C9 - C?2 Aromatics met in The Manger Hotel, Rochester, New York, on April 22, 19?0. Five members were present or represented jpi about 10 guests were in attendance. A progress report by Dr. Carl A. Nau, chief investigator, was read. It vas -n ^ e na,ture of an extension of a similar report presented to the subcommittee in November 1959- 1# It confirmed and carried further the report of work done on white rats exposed to C9 - C10 and also C n - Cj.2, each in varying concentrations and exposure to benzene as a positive control. 2, In addition, it bore the first reports on exposure of monkeys to C9 - C^q and to Cjj. - C]_2 The data and observations were supplemented by a motion picture v&ich showed by the neurologic effects and irritation of these chemicals on nonkeys and rats. 3. Both rats and monkeys showed decided effects; irritation of skin unprotected by fur, narcotizing and tremor production, although both types of animals showed rather prompt recovery over night. It. In addition, the development of cataracts among rats showed a high incidence after exposure to C9 - Cj q and to benzene for a long time. 5. Blood changes in the rats were present but in general were not strikingly uniform. Dr. Nau's general conclusions sure: 1. Early manifestations of toxicity is a shift in the poly-lymph ratio. 2. A fall in white blood cell count in rats will only persist if exposure is con tinued and prolonged. 3. Rapid formation of cataract has been observed in rats exposed to 6l6 PPM of C9 - C10 (after cessation of exposure) and in rats exposed to 50 PPM of benzene (during and after the termination of exposure). b. Exposure of monkeys to 200 PPM C9 - C^q leads to appearance of tremors and other symptoms of central nervous system stimulation. Sane degree of tolerance to continued exposure may develop. There is a fall in white blood cell count in the exposed monkeys. The lower values resulting persist with continued exposure. 5- There are no significant changes from the normal in monkeys exposed to 50 PPM C9 - c10. 5l - Cl? 6. Monkeys exposed to 200 PPM of C]_]_ - showed some slight evidence of tremor, localized irritation as well as central nervous system stimulation. These changes not invariably observed. 7. Monkeys exposed to 50 PPM showed no significant changes from the normal. Howev*r, diarrhea occurred quite frequently in monkeys exposed to 200 PPM and or 50 API 07610 i - 2- (c-a) PPM C n - C^2 - It is believed that this effect is related to and caused by this material getting into the gastro-intestional tract. proposals To Complete The Study Of C9 - Aromatics: lt Complete microscopic studies for possible significant findings. 2, Statistical evaluations for changes herein reported. 3. Electrocardiographic studies of exposed monkeys. If. Continue exposure of monkeys as per previous proposals. 5. Determine threshold tolerance for odor in humans. 6. Compile, evaluate and report significant data with impressions and conclusions stated as supported by findings. 7. Determine reasonable permissible levels of exposure (200 PIW is probably too high based on these early findings on monkeys). Much work is still to be done but Dr. Nau hopes to complete it by July 1, 1961. Since there is no assurance that new findings may not occur and demand 1961, further study beyond July the subcommittee recommends an appropriation of $10,000 be made for the fiscal year July 1962, which will be expended only if necessary. T. M. Frank, M. D., Acting Chairman Subcommittee on C9 - Cj_2 Aromatics API 07611 1 REPORT CF SUBCOMMITTEE CN EPIDEMIOLOGY George M. Saunders, M.D., Chairman ATFSNEDC D In a report submitted by the subcommittee on November 9, 1959 and accepted by the Medical Advisory Committee, it was pointed out that in order to accomplish meaning ful and useful results of studies, the active and voluntary participation of medical personnel in units of member companies would be required. Areas proposed for pre liminary trial studies were: 1. A study of the comparative frequency of myocardial infarction among "blue collar" and "white collar" refinery workers, and 2. A study of the present health status of truck drivers. It was stated in the report that methods and procedures would be defined in a proto col if cooperation of suitable medical units were assured. To date, only two communications have been received by the chairman of the subcommittee offering to provide information. Cne unit offered to provide statistics on the health status of truck drivers, the frequency of myocardial infarction and the results of proc toscopic examinations. The other unit offered to provide data on myocardial infarction and truck drivers. The subcommittee appeals again for volunteers to provide information on two trial subjects - myocardial infarction and health of truck drivers. If several units can provide data, then details on methods of collecting and reporting data will be vorked out by the subcommittee. ' Pre-requisites for the proposed study of myocardial infarction are: 1. A concentrated population of refinery workers, 2. Certain characteristics of the population must be known, such as the total number, age, sex and, preferably, race, Job categories, length of service and a record of health experience, 3. An in-plant medical service adequately staffed and equipped to provide reliable diagnoses, and k. Adequate individual medical records. The methods to accomplish the suggested study of the health status of truck drivers vould be relatively simple. Recent health examination records of truck drivers from an unbiased sample vould be collected and analyzed to provide data on various characteristics including types and frequencies of abnormalities. It is requested that any member of the Medical Advisory Cconlttee who believes he could collect data on these two studies communicate with the chairman of this sub committee . The subcommittee does not request any funds for the coming year. George M. Saunders, M. D., Chairman Subcommittee on Epidemiology API 07612 1 a??zirzi s (s-i) REPORT CF SUBCOMMITTEE CN MEDICAL POLICIES AND AEmHISTRATIVE PRACTICES ' Ralph Schneider, M. D., Chairman The Subcommittee on Medical Policies and Administrative Practices met April 23, i960 with five members and eight guests present. Since the last report, in November 1959 this subcommittee has met and re-drafted the "Guiding Principles in Regard to the Scope, Objectives, and functions of Medical Program in Petroleum Operations" to include those changes prepared by the members of the Medical Advisory Committee at their meeting in November 1959* It is recommended that this new draft, copy attached, now be sent to each member of the Medical Advisory Committee so that they may either (l) Reject it, (2) Accept as it is, or (3 ) Accept it with whatever indicated changes they propose. The fined document, if any, will then be recommended to the Medical Advisory Committee in November i960 for adoption. Ralph Schneider, M. D., Chairman Subcommittee on Medical Policies and Administrative Practices API 07613 1 1 GUIDING PRINCIPLES IN REGARD TO THE SCOPE, OBJECTIVES, AMD FUNCTIONS QF MEDICAL PROGRAMS IN PETROLEUM OPERATIONS Introduction The term "occupational health program" means a program provided by aanagement to deal constructively with the health requirements of employees and employers in relationship to employment. The term "occupational medicine" is that branch of medicine vhlch deeds with the relationship of man to his occupation, for the purpose of the prevention | of disease and injury and the promotion of optimal health, productivity, and social adjustment. Occupational Health Programs Although a person's health is primarily the responsibility of the individual himself, an occupational health program represents management's recogni tion of its obligation to provide a safe work environment and its opportunity to assist in promoting optimum health among its employees. While circumstances may affect the extent of certain services vhich may enter into a comprehensive health ; program, a high quality of professional service must be preserved at all times. I Cooperation between physicians, industrial hygienists, nurses, technicians and other personnel of the occupational health program and management personnel re sponsible for the employment, safety and well-being of employees is essential. Occupational health personnel should cooperate also with private and official community agencies providing health, safety, employment and welfare services. Through the years many forms of occupational health programs have been developed from which has emerged an acceptable basic pattern. Experience indicates that success can best be assured when: 1. The program a. Observes the basic principles of medical service to the individual and conforms to medical customs in the community. b. Complies with existing laws. c. Emphasizes prevention and health maintenance rather than the treatment of injury and disease. d. Utilizes community medical resources when adequate or when they can be developed reasonably. 2. The professional personnel participating in the program a. Maintain high standards of professional service and conduct for the benefit of employee and employer alike. b. Cooperate and maintain proper liaison with other professional colleagues in the community and with the appropriate professional associations. c. Are engaged and compensated, and carry on their activities, with accepted ethical principles. API 07614 Frcm lice to tine, problems arise out of a misunderstanding of the proper scope of occupational health programs as contrasted with medical programs for per sonal (non-occupational) illness of employees. It is, therefore, essential that employers, employees, and physicians recognize the fundamental distinction between tnese two types of programs. The occupational health program providing medical care for personal (non-occupational) illnesses and injuries must be oriented to the work environment and to the health of the employee in relation to his job. On the other hand, when service rendered under occupational health programs exceeds the limits described ereafter, the occupational health program becomes to that extent a medical care program for personal illness and should be so recognized by all concerned. Medical Care Programs for Personal (Non-occupational) Illness These programs owe their existence to certain factors and circumstances in the employer-employee relationship not directly related to occupational health considerations. A major objective of such programs is to distribute the cost of medical service so as to lighten the economic burden on the employee. Some pro grams include dependents and/or retired employees as well as the employed group. They are usually designed to provide medical, surgical, and hospital care. Such personal medical care programs include both diagnostic and therepeutic services, and may be limited or comprehensive in scope. These programs are separate and distinct from occupational health programs, the objectives, activities, facilities and personnel of which sure described in the remainder of this statement. Objectives of Occupational Health Programs The objectives of an occupational health program are: 1. To promote the healthful nature or the greatest possible freedom from health hazards of its operation and of the environment and products of its operation. 2. To facilitate the placement of individuals according to their physical capac ities and their emotional make-up in work which they can reasonably perform with an acceptable degree of efficiency and without endangering their own health and safety or that of their fellow employees, and 3. To encourage personal health maintenance. The achievement of these objectives benefits both employers and employees in terms of improved employee health, morale, and productivity. Activities to Attain Objectives In order to attain these objectives the following activities (and the aaintenance of appropriate records) are essential: 1. Survey and knowledge of the work environment from a health standpoint. This requires periodic inspections of the entire premises used by employees, includ ing provision for, and appropriate participation in, the procedures and tests required to detect and appraise health hazards. Such inspections and appraisals provide current information on health aspects of work conditions, processes and substances used, which information is essential in evaluating symptoms, signs, and clinical laboratory data related to the deferential diagnosis of disease. API 07615 -3 1 This information, including those relating to stress and mental health, will aid in evaluating any health hazards that may exist and in making appropriate recommendations for preventive or corrective measures. 2, Health examinations. Unrealistic and needlessly stringent standards of medical fitness defeat the purposes of health examinations and of maximum utilization of the available work force. Health examinations should consist of: a. An initial examination to determine the health status of the individual in order to facilitate suitable placement in employment. This examina tion should include (l) his family and personal medical history; (2 ) his occupational history; (3 ) a physical examination, and (U) other procedures to help determine the individual's employability and his capacity for work. b. Subsequent examinations carried out at suitable intervals and designed to detect any sign or symptom of ill health related to employment conditions, to evaluate the health status of the individual in order to determine whether his health is compatible with his job assignment, and to forestall long-term disability by early detection of disease. All examinations must be conducted by physicians with such assistance from associated personnel as may be required. Prior to each examination, the individual should be advised as to its constructive purpose and value. At the con clusion of an examination, the physician should discuss his findings meaningfully with the individual. :When health defects are found, the physician should explain to the individual the importance of obtaining further medical attention, and encourage him to consult his personal physician. 3. Medical records. The maintenance of accurate and complete medical records of every individual from the time of his first examination or treatment is a basic requirement. Except when otherwise required by law, the confidential character of these records, including the results of health examinations, must be rigidly observed by all members of the occupational health staff, and such records must remain in the exclusive custody and control of the medical personnel. The patient should be informed of all pertinent health findings except when such disclosures would have an adverse effect on his health and well-being. A pri vate physician or other agency may be provided with a report of health findings when the patient so designates. Disclosure of health Information should not be made without the approval of the patient except when essential to fulfill the legal obligations, and then, only to the extent necessary to fulfill such obligations. It. Medical treatment. Every employee should be encouraged to have a personal physician. a. Medical care required by workmen's compensation lavs for occupational injury or illness should be directed toward optimum rehabilitation of the employee. The attending physician may be a member of the occupational health staff or any physician in the community willing and qualified to per form the essential services. b. Medical care in case of non-occupatlonal injury or illness is not a function of an occupational health program, with the limited exceptions noted below. Emergency cases should be given the attention required to prevent loss of life or limb or to relieve suffering until the patient is placed under API 07616 1 ) . 1+ . the care of a personal physician. For minor disorders, first aid or palliative treatment may he given if the condition is one for which the individual would not reasonably be expected to seek the attention of a personal physician, or to enable the individual to complete his current work before consulting a personal physician. In occupational health programs, requests for repetative treatment of even minor personal disorders should be discouraged, and such individuals should be referred to their personal physicians. c. The best interests of a patient are served by cooperation and communication between their personal physicians and physicians in charge of occupational health programs. In this way, prompt restoration of employees to suitable employment 1b encouraged. 5. Health and safety education. A high standard of occupational health cannot be achieved without familiarity with, and the observance of, fundamental health principles. The development of an understanding of these rules and the promo tion of their observance is an essential task in which an occupational health staff can render very valuable assistance. An occupational health program should promote the education of employees in matters of personal hygiene and health and encourage the use of safeguards pro vided to protect against any hazards to health which may be inherent in their jobs. The most favorable opportunities for carrying on health education and conseling will be afforded during visits to health facilities and through periodic inspections of the employee's place of work. Health and safety education involves the cooperative efforts of health, safety, and operating personnel. Such education should include not only the encourage ment of habits of cleanliness and orderliness but also instruction, in collaboration with the employee's immediate supervisor, in safe work practices and in the use and maintenance of available personal protective clothing and equipment. Experience has shown that health education is unlikely to be successful unless the employer demonstrates his sincere and continuing interest in the health of his employees. Likewise, employees should be encouraged to participate in the planning and conduct of health education activities and make full and effective use of occupational health services and facilities available to them. An occupational health program to be effective and acceptable to the employee, must be staffed b y objective and competent personnel who create an atmosphere of warm, sincere, and positive personal helpfulness. Personnel All phases of an occupational health program should be under medical supervision. This requires the appointment of a medical director, full or part time, who is a qualified doctor of medicine. Training and/or experience in occupational medicine is desirable. The medical director should have a responsible role in the development and interpretation of medical policy. He should administer the health program and be directly responsible to a designated official at the policy-making level of management. Additional physicians, as consultants or associates, may be required for an effective program. The duties of these Physicians should be clearly defined by the medical director. API 07617 1 ) Qualified associated personnel, selected and directed by the physician charge, are essential to the proper functioning of an occupational health pro gram. According to program needs, these may include industrial hygienists, nurses, first-aid attendants, and laboratory and clerical personnel. The industrial hygienist should have the knowledge and training necessary to survey and evaluate the work environment as well as the processes and products of the operation in order to make necessary recommendations to correct and control 3ny existing or potential hazards to health. A nurse should be a graduate of an accredited school of nursing, re gistered and legally qualified to practice nursing where employed. Training and/or experience in occupational health is desirable. She should assist the physician in the supervision of the health of employees while at work and in their health education. Her professional duties and nursing procedures should be clearly defined in writing by the physician to whom she is responsible. Cne or more qualified first-aid attendants, known to all employees, should always be available during working hours. They should receive periodic refresher instruction and be provided with specific written instructions by the physician in charge. Facilities The facilities of an occupational health program may be available at the place of employment or in the community. When provided on the employment premises, facilities should: 1. Be located in a quiet area, readily accessible to employees; 2. Be sufficiently spacious, well lighted, ventilated and heated; 3. Include waiting, consultation, examining and treatment rooms, and toilet facilities, to Insure adequate privacy and comfort; and it, Have appropriate medical and laboratory equipment. It may also be desirable to provide a rest or recovery room, dressing rooms and facilities for laboratory and radiological examinations. Conclusions Specific and detailed recommendations as to personnel facilities, and other aspects of individual occupational health programs obviously are beyond the scope of this statement. It is recommended that the local medical society be con sulted to assure that a given program is in agreement with the objectives of this statement and with established community practices. API 07618 ) REPORT CF SUBCOMMITTEE ON PHYSICAL AGENTS G. H. Collings, Jr., M. D., Chairman APPSliLIX F The Subcommittee on Physical Agents met at 2:00 P. M. on April 23, i960 in The Manger Hotel, Rochester, New York. Two principal topics were discussed and acted upon: A. It was the consensus that support should be continued to Cr. Glorig and his work on noise and deafness; since the petroleum industry has a noise problem, it is interested in finding better solutions to this problem and should support work of this type. It is recommended to the Medical Advisory Committee that support be continued to Dr. Glorig in the amount of $2,300 for the year 1961 - 1962. B. According to the present statement on scope, the Subcommittee on Physical Agents has three functions: 1 . To keep the Medical Advisory Committee informed on new developments related to physical agents, 2. To prepare a bibliographical review of the literature on physical agents, 3. To accept any assignments from the Medical Advisory Committee. Function No. 1 is also a function of the Subcommittee on Industrial Hygiene which is charged with keeping the Medical Advisory Committee informed on new developments in the whole field of industrial hygiene. Function No. 2 is obviously too large a task and an undesirable one for the Subcommittee on Physical Agents to undertake. Function No. 3 is understood for any subcommittee and need not be stated. There have been no assignments from the Medical Advisory Committee. Consequently, the Subcommittee on Physical Agents really has no signifi cant duties. A survey of a large number of Medical Advisory Committee members failed to elicit any substantial activities that the Subcommittee on Physical Agents might undertake. Consequently, it is the recommendation of the Subcommittee on Physical Agents that it be discharged. If, however, the Medical Advisory Committee feels that there are duties which the subcommittee should undertake, the present members stand ready and willing to carry out the wishes of the Medical Advisory Committee. G. H. Collings, Jr., M. D. Chairman, Subcommittee on Physical Agents API 07619 3EPCKT CF SUBCOMMITTEE ON CARCINOGENICITY R. E. Eckardt, M. D., Chairman a ??i ::d :x g '(o-i ) The Subcommittee on Carcinogenicity met in the Directors Room of The Manger Hotel in Rochester, New York, on Friday, April 22, i960. The subcommittee presented to Dr. Kehoe a number of suggestions made by subcommittee, Medical Advisory Committee members, and associates. Dr. Kehoe agreed to take these suggestions under consideration and to issue a revised report in advance of the fall meeting of the Medical Advisory Committee. In addition, it was agreed that a brief abstract or summary would be prepared. The subcommittee considered briefly the question of its scope and continuation, but decided to make its recommendations on both these topics for the fall meeting of the Medical Advisory Committee. The subcommittee did not believe it could, at this time, con sider the question of the carcinogenicity of the inhalation of oil mists. The subcommittee believes that suggestions for the continuation of certain phases of the research at The Kettering Laboratory are beyond the scope of its functions but, perhaps, fall within the province of the .Advisory Committee on Fundamentad. Research on Composition and Properties of Petroleum. It proposes that the suggestions of The Kettering Laboratory be transmitted by the Medical Advisory Committee through the Medical and Health Committee to the Advisory Committee on Fundamental Research on Composition and Properties of Petroleum through the Research Committee of the Board of Directors for their consideration. R. E. Eckardt, M. D., Chairman Subcommittee on Carcinogenicity API 07620 % copy MEMORANDUM TO: FROM: Dr. R. A. Kehoe Dr. A. W. Horton (G-2) APRIL 20, I960 Subject: Possible Further Development of Experimental Findings of API Project A number of the petroleum companies are currently interested in assessing the possible carcinogenic activity of various intermediates and products of refining operations by chemical methods. At the termination of the API project, the development of analytical procedures for the benzo c - phenantbrenes and certain other polycyclic carcinogens were left in an incomplete stage. Tritium-labeled polycyclics are now available. Combining our presently available instrumentation for liquid scintillation counting with the previously developed procedures for chromatography, absorption spectrophotometry, and mass spectrometry, a worthwhile development In this area is possible if the Subcommittee on Carcinogenicity feels that it might be desirable from their viewpoint. AWB:bk sgd: A. W. HQRTCN API 07621 APFSI^IX 5 REPORT CF SUBCOMMITTEE ON SPECIALTY PETROLEUM PRODUCTS (H-l) C. H. Baylor, M. D., Chairman The subcommittee met at 2:00 P.M., April 22, i960, in the Manger Hotel, Rochester, New York. ^ mbers Present: ' " Drs. Ralph Schneider and Horace Gerarde, Messrs. George Entwistle and R. C. Cole (represented by L. B. Renes); and Dr. C. H. Baylor, Chairman tim e r s Absent: Dr. W. W. Stewart and Mr. J. W. Hammond : Bitors: Drs. J. C. Ruddock, C. R. Miller, T. H. Mitchell, J. W. Osborn, T. M. ------ Frank, Carl Nau; Mr. E. 0. Mattocks subcommittee: I. Discussed briefly the reasons for changing the name of the subcommittee from the original one (Subconsnittee on Economic Poisons) to its present title. IX. Discussed the scope and function of the subcommittee as requested by the chairman of the Medical Advisory Committee in line with the memorandum dated March 28, i960 of Mr. E. 0. Mattocks to the Operating Subcommittee. The subcommittee generally agreed that the scope and function as de scribed in this memorandum could be construed to cover a tremendous field of activities and information. The members agreed that the subcommittee could implement these duties and responsibilities only within the limits of its time and membership. The subcommittee plans to review this outline with improvements in mind. HI. Summarized the present status of the kerosine study as follows: A. The quantitative colorimetric method for the determination of hydrocarbons in rat blood as devised by Dr. Gerarde has not worked out satisfactorily on human blood for Drs. McKay (University of Vermont), Daescfaner (Baylor University), and Nau (Galveston). These doctors have coimnunicated with Dr. Gerarde regarding these difficulties. At present Dr. Gerarde is re checking the method using human blood. He has informed the subcommittee that he thinks three months should suffice to perfect the method. B. Until this simplified method is satisfactory it will not be possible to collect a satisfactory clinical experience with kerosine ingestion and inspiration regarding its pathological physiology and best method of treatment. C. Considerable work remains to be done in this field in view of the contro versy between the medical groups for and against gastric lavage in the treatment of this emergency. D. The subcommittee thinks that these differences between rat and human blood as uncovered by these experiments may lead to valuable knowledge over and beyond that for which the experiments were originally devised. E. The subcommittee wishes to express its gratitude to these investigators and especially to Dr. Gerarde and his company who have participated in these studies without financial assistance from the A.P.Z. API 07622 -2 - (H-2) F. In view of the importance and difficulties encountered in the kerosine study, the subcommittee requests from the A.P.I. Medical Advisory Committee a further grant for 1961 - 1962 of $15,000. This sum will be allotted to the various investigators depending upon their needs, results, and number of cases studied. In view of the transfer of Dr. Daeschner from Houston to Galveston the subcommittee feels it advisable to continue a clinical contact with the Jefferson Davis Hospital in Houston since this institution appears to have the greatest number of patients suffer ing from kerosine intoxication. This plan may be arranged through Dr. Daeschner or some other pediatrician at this hospital. The subcommittee requested Mr. George Entwistle to join the American Associa tion of Poison Control Centers as a representative of the A.P.I. Medical Advisory Committee and act as a liaison officer at the meeting of this association in Chicago in October I960. Mr. Entwistle agreed to accept this additional responsibility. It is requested that the Medical Advisory Committee will endorse this action by the subconssittee. Dr. Ruddock suggested to the subcommittee that it look into a problem which has arisen in certain West Coast hospitals and will likely be encountered elsewhere sooner or later. Doctors in these hospitals have found no oil as yet that will retain its lubricating properties for surgical instruments when it has been subjected to sterilizing procedures adequate to kill all staphylococci. Mr. L. E. Renes informed the group that experience at Phillips Petroleum Company along these lines has shown that heating certain oils to 250 F for twenty (20) minutes will eliminate the staphylococci. These two experiences need comparative studies to arrive at satisfactory conclusions. C. H. Baylor, M. D., Chairman Subcommittee on Specialty Petroleum Products API 07623 ) REPORT CF SUBCOMMITTEE CII TOXICOLCC-ICAL REVIEWS H. W. Gerarde, M. D., Chairman APPENDIX I "(1 -1 ) jhe Medical and Health Committee has approved the publication of the revisions of the Toxicological Reviews on Benzene, Toluene, and Xylene. First drafts of the reviews on Cumene, Styrene, Cyclohexane, and Kerosine have been circulated to the members of the Medical Advisory Committee. Comments and suggestions received from the members will be incorporated in the second drafts, which will be re-circulated prior to balloting members for approval for publication. Additional first drafts of old reviews have been received from Prof. Drinker which completes his revision of pre-existing Toxicological Reviews. Prof. Drinker will be requested to prepare new Toxicological Reviews in accord ance with a request received from the Interdivisional Committee on Labeling. An allocation of $5000 is requested in the 1961 - 1962 budget for the pre paration of the new reviews. H. W. Gerarde, M. D., Chairman Subcommittee on Toxicological Reviews API 07624 ) REPORT CF SUBCOMMITTEE CN INDUSTRIAL HYGIENE J. A. Spencs, Chairman APPENDIX J (J-l) The subcommittee met on April 23, I960 vith seven members and twelve -uests present. & Liaison members reported on the activities of the American Standards ^gociation Committee Z-37, Toxic Dusts and Gases, Z-k, Industrial Sanitation, and *2-62, Industrial Hygiene Standards. The Z-k Committee is inactive, the Z-37 Committee has recently circulated drafts of new material to their Editorial Sub committee and the Z-62 Committee has recently prepared new information on industrial bygiene standards. The preparation of information on Industrial Hygiene Aspects of Petroleum Refining Processes is proceeding on schedule. It is expected that information on I ) reforming, 2 ) cracking, 3 ) alkylation, and U) Isomerization processes will be completed at the time of the November meeting of the Medical Advisory Committee. Information on current exposures of petroleum industry personnel to C9 G-,2 fractions is being developed by subcommittee members. Such information is designed to supplement the toxicity data recently developed by the Cg - Ct_2 Subcommittee. The health hazards associated with metallic carbonyls in petroleum operations were discussed by subcosmittee members. Although available information indicates that the procedures being employed in refineries help minimize the formation of or exposure to metallic carbonyls, the subcommittee plans to continually follow this potential problem and report findings. The Oil Mist Study Group has recently canvassed a large number of people in industry, agriculture, insurance, and government in an attempt to assemble available health and hygiene experience with oil mists. Replies from these groups have yielded limited infor mation on l) complaints of workers, 2 ) results of air sampling, and 3 ) a generally expressed interest in the subject. Little definite information was obtained. Out of the review of information assembled, the Study Group proposes the following: 1) Letters will be written to all members of the Medical Advisory Committee soliciting information on A) experience with and data on oil mist studies or complaints due to oil mists and B) suggestions for sources of additional information. 2) The Study Group will not pursue the carcinogenic aspects of this subject since another subcommittee exists for consideration of this area. 3) A literature survey will be made by members of the Study Group. *0 The Study Group will analyze findings obtained from the above procedures and will be prepared to take additional steps on the basis of these results. G. M. Wilkening, M. D. Acting Chairman Subcommittee on Industrial Hygiene API 07625 AP53NDIX K REPORT CF LIAISON MEMBER TO THE SMCKE AND FUMES COMMITTEE *' j The chairman of the Subcommittee on Atmospheric Pollutants is the liaison | aember of the Medical Advisory Committee to the Smoke and Fumes Committee. I enjoy aa excellent relationship with this technical group in the Division of Refining. I j kept advised of technical researches in progress that have been instigated by this group and, in turn, advise them concerning medical aspects of air pollution. 2 vas invited and attended, as a representative of the Medical Advisory Committee 0f the API, a meeting called by the U. S. Public Health Service in New York 0n December 19, 1959, to outline researches instigated by medical and technical groups in the API. In addition, I attended, on March 21, i960, a meeting called by the U. S. Public Health Service, in New Orleans, to formulate standard sampling techniqu8 for researches in air pollution. The Subcommittee on Atmospheric Pollution will have a representative at the next Smoke and Fumes Committee meeting. John C. Ruddock, M. D., Chairman Subcommittee on Air Pollution API 07626 APFEHDIX L REPORT OF LIAISON MEMBER TO INTERDIVI5ICNAL COMMITTEE ON LABELING (L-l) g.lgSj - Federal Hazardous Substances Labeling Act - (The Magnuson Bill) was jjjfoded in the Senate Committee on Interstate Commerce Committee along the lines recomniended last year by the Inter-Industry Group (CSMA, MCA, API, Association of Soap Glycerine Manufacturers). This amended bill, which is acceptable to the pood and Drug Administration, was reported out on February 2Uth and passed by the Senate on March 29th. pnnse 5260 - which is identical to the original S-1283 was the subject of a House ^committee hearing on March 14th. Representatives of CSMA, MCA, and FDA reCommended that H-526o be amended to agree with amended S-1283. The AMA made the saae recommendation it had made last year to the Senate. The AFL-CIO representative uas ashed to file his statement because the subcommittee wished to adjourn. s.1283 as amended would appear to exempt kerosine as a hazardous substance. This 5as occurred because of the recommendation of the LPGA. As amended, the bill reads: "The term 'hazardous substances' shall not include substances stored and intended for use as fuel in a heating, cooking, or refrigeration system. The API Interdivisional Committee on Labeling has, as its principal i960 assignment, a revision of the API Labeling Bulletin 2511. Allan E. Dooley API 07627 APPENDIX M (M-l) MEDICAL AND GIHER PUBLICATIONS Journal of the American Industrial Hygiene Association AMA Archives of Industrial Health Journal of the American Medical Association Annals of Occupational Hygiene API Abstracts Transactions of the Association of Industrial Medical Officers British Journal of Industrial Medicine Industrial Hygiene Digest Journal of Occupational Medicine Science (American Association for the Advancement of Science) Journal of American Public Health Association Industrial Medicine and Surgery NATIONAL MEDICAL ASSOCIATIONS American Conference of Government Industrial Hygienists American Public Health Association National Clearing House for Poison Control Centers Occupational Health Institute U. S. Public Health Service .. National Safety Council STATE MEDICAL ASSOCIATIONS Medical Association of the State of Alabama 519 Dexter Avenue Montgomery, Alabama Medical Society of Delaware Norman L. Cannon, Secretary 1206 Delaware Avenue Wilmington, Delaware Alaska Medical Association P. 0. Box 2569 Juneau, Alaska Arizona Medical Association, Inc. tol Security Building Phoenix, Arizona California Medical Association Room 2000 ^50 Sutter Street San Francisco 6, California Colorado State Medical Society 835 Republic Building 1612 Tremont Place Denver 2, Colorado Connecticut State Medical Society 160 St. Ronan Street New Haven, Connecticut Medical Society of the District of Columbia 1718 M. Street, N. W. Washington 6, District of Columbia Florida Medical Association, Inc. Box 1018 Jacksonville, Florida Medical Association of Georgia 875 West Peachtree Street, N. E. Atlanta, Georgia Hawaii Medical Association Mabel Smyth Memorial Building Honolulu 13, T. H. 36Idaho State Medical Association k Sonna Building Boise, Idaho API 07628 - 2 (M-2) Indiana State Medical Association 23 East Ohio Street Indianapolis 1)-, Indiana Nebraska State Medical Association 1315 Sharp Building Lincoln 8, Nebraska Iowa State Medical Society 529 36th Street Des Moines 12, Iowa Kansas Medical Society 315 West Fourth Street Topeka, Kansas Kentucky State Medical Association 20 South Third Street Louisville 2, Kentucky Lo u isian a State Medical Society IL30 Tulane Avenue New Orleans 12, Louisiana Maine Medical Association 1L2 High Street Portland 3, Maine Medical and Chirurgical Faculty of the State of Maryland 1211 Cathedral Street Baltimore 1, Maryland Massachusetts Medical Society 22 Fenway Boston 15, Massachusetts Michigan State Medical Society 606 Townsend Street P. 0. Box 539 Lansing, Michigan Minnesota State Medical Association b$6 Lowry Medical Arts Building St, Paul 2,Minnesota Mississippi State Medical Association 860 Milner Building Jackson, Mississippi Missouri State Medical Association 623 Missouri Building St. Louis, Missouri Montana Mdical Association T* R. Vye, Secretary Billings, Montana Nevada State Medical Association William A. O'Brien, III, Secretary 505 Chestnut Street Reno, Nevada New Hampshire Medical Society 18 School Street Concord, New Hampshire Medical Society of New Jersey 315 West State Street Trenton 8, New Jersey New Mexico Medical Society 223-22U First National Bank Building Albuquerque, New Mexico Medical Society of the State of New York 386 Fourth Avenue New York 16, New York Medical Society of the State of North Carolina 203 Capital Club Building Raleigh, North Carolina North Dakota State Medical Association Eltinge Building Box 1196 Bismarck, North Dakota Ohio State Medical Association 1005 Hartman Theatre Building Columbus 15, Ohio Oklahoma State Medical Association 1227 ClasBen Drive Oklahoma City, Oklahoma Medical Society of the State of Pennsylvania 230 State Street Harrisburg, Pennsylvania Rhode Island Medical Society 106 Francis Street Providence 3, Rhode Island API 07629 - 3- South Carolina Medical Association 120 West Cheves Street Florence, South Carolina South Dakota State Medical Association 300 First National Bank Building Sioux Falls, South Dakota Tennessee State Medical Association 319-325 Doctors Building Nashville, Tennessee Texas Medical Association l801 North Lamar Boulevard Austin, Texas Utah State Medical Association +2 South Fifth East Salt Lake City, Utah Vermont State Medical Society 128 Merchants Row Rutland, Vermont (M-3) Medical Society of Virginia 1105 Nest Franklin Street Richmond, Virginia Washington State Medical Association 1309 Seventh Avenue Seattle, Washington West Virginia State Medical Association 302 Atlas Building Charleston, West Virginia State Medical Society of Wisconsin 70U East Gorham Street Madison 3* Wisconsin Wyoming State Medical Society E. B. Anderson, Secretary Casper, Wyoming API 07630 NCT *OR r AMERICAN PETROLEUM INSTITUTE M71MEERS PRESENT: MEDICAL ADVISORY COMMITTEE 3QTH MEETING 9:00 A. M. Monday, November lk, i960 Conrad Hilton Hotel, Chicago, Illinois J. V/. Osborn, M. D., Chairman Leo J. Wade, M. D., Vice Chairman L. E. Renes, Secretary t 0. Armstrong, M. D. C. H. Baylor, M. D. r . G. Birrell, M. D. y. F. Boys, M. D. G. H. Ceilings, M. D. j. W. Crookshank, M. D. I, E. Curtis, M. D. Kieffer Davis, M. D. r . E. Eckardt, M. D. T. M. Frank, M. D. r . Emmet Kelly, M. D. T. J. Kelly, M. D. E. K. Linder, M. D. B. S. Miller, M. D. C. R. Miller, M. D. T. H. Mitchell, M. D. M. R. Plancey, M. D. C. L. Samuelson, M. D. Geo. M. Saunders, M. D. Ralph Schneider, M. D. W. W. Stewart, M. D. TECHNICAL ADVISORS PRESENT: VI. L. Avrett W. H. Barcus C. T. Brown E. K. Daniels A. E. Dooley H. E. Elkin George Entvistle P. D. Halley J. VI. Hammond N. V. Hendricks J. H. Johnston J. T. McCoy E. W. Midlam A. C. Pabst J. B. Rather J. A. Spence F. S. Venable J. K. Voorhees N. K. Vleaver, M. D. G. M. Uilkening MEMBERS ABSENT: R. M. Adams, M. D. T. E. Allen, M. D. V. C. Baird, M. D. K. R. Fourcher, M. D. F. D. Gassaway, M. D. E. P. Luongo, M. D. R. C. Page, M. D. R. J. Potts, M. D. J. C. Ruddock, M. D. G. A. Sinclair, M. D. OTHERS PRESENT: J. C. Calandra, M. D. VI. J. Coppoc B. V. Henson, M. D. E. 0 . Mattocks The Pure Oil Company Texaco Incorporated Standard Oil Ccrapany (Indiana) American Petroleum Institute API 07631 TI r. OPENDIG REMARKS - ' [ The chairman reported that Mclvor Woody, M. D. had written a note indicating his delight in seeing that the 16th year of the committee's existence tfaS beginning so auspiciously. Unfortunately, he was not able to attend the meeting. y -- ps haw s Dr. Philip Drinker had planned to attend the meeting but, due to an jjitimely sickness, had been unable to come at the last minute. The chairman announced the following new members: M. R. Plancey, M. D.; C. L. Samuelson, M. D.j and G. A. Sinclair, M. D. The following new Technical Advisors were announced: J. T. McCoy; J. K. Voorhees, and J. B. Rather. The following guests were introduced: Dr. W. J. Coppoc, Texaco Incorporated; and g. V. Henson, M. D., Standard Oil Company (Indiana). XI. PRESENTATION OF CERTIFICATE OF APPRECIATION Mr. C. E. Spahr, Chairman of the Medical and Health Committee, presented a Certificate of Appreciation to John C. Ruddock, M. D. Due to the untimely death : of Dr. Ruddock's wife, he was unable to be present. The Certificate was received by his assistant, M. R. Plancey, M. D. III. APPROVAL OF MINUTES ; ACTION: It was regularly moved, seconded, and unanimously passed that the minutes of the April 5, 19^0 meeting of the Medical Advisory Committee be approved as distributed. IV. SUBCOMMITTEE REPORTS % A. Operating Subcommittee J. W. Osborn, M. D. reviewed the actions of the Operating Subcommittee. The report of this group is attached as Appendix A. ACTION: It was regularly moved, seconded, and unanimously passed that the report be accepted. B. Atmospheric Pollutants J. W. Osborn, M. D. explained that John C. Ruddock, M. D., chairman of the subcommittee, was unable to attend the meeting due to the death of his wife, j The Operating Subcoonittee suggested that the following telegram be sent to J. C. Ruddock, M. D . : "The Medical Advisory Committee at its meeting November lk were deeply grieved when they learned at this time of your wife's passing. Your associates share your sorrow and wish you to know of their sympathies. We sincerely missed you and hope you will be with us at our Spring meeting." ACTION: It was regularly moved, seconded, and unanimously passed that the suggested telegram to J. C. Ruddock, M. D. be sent as an expression of the Medical Advisory Committee. C. R. Miller, M. D. reported for John C. Ruddock, M. D. on the activitie j of this group. His report is attached as Appendix B. API 07632 f - 3- C. R. Miller, M. D. explained the reason for the request that Mr. Porter -cr.tact the Automobile Manufacturers' Association indicating the desire of the Medical advisory Committee of the API to contact a similar group in the Automobile Manufacturers' Association. C. R. Miller, M. D. elaborated on the thought of the subcommittee for collecting a packet of medical articles on atmospheric pollution, jbe actions of the subcommittee regarding Dr. Goldblatt's recommendations for 3edical research in air pollution was discussed by Dr. Miller. Suggestions were made that the subcommittee reconsider Dr. Goldblatt's recommendations solely on the basis of the availability or absence of factual aedical knowledge as to the health aspects of air pollution which may be of concern to the petroleum industry. The Medical Advisory Committee and its subcommittees were not expected to render decisions in matters of economics and public relations. After much discussion, the following action was taken on the report of the Subcommittee on Atmospheric Pollutants. ACTION: It was regularly moved, seconded, and unanimously passed that the Medical Advisory Committee receive, without endorsement, the report of the Subcommittee on Atmospheric Pollutants The proposed expenditure of the $5,000 in the 1961 budget was discussed at length. ACTION: It was regularly moved, seconded, and passed, with one negative vote, that the budgetary recommendation of the Subcommittee on Atmospheric Pollutants be accepted. ACTION: It was regularly moved, seconded, and unanimously passed that the chairman of the Medical Advisory Committee request the members of this committee to send, in writing, to the chair man of the Subcommittee on Atmospheric Pollutants any suggestions which they have for research on the medical aspects of air pollution. If this has been done previously, it should be repeated at this time. The chairman of the Subcommittee on Atmospheric Pollutants should summarize these consents for transmittal to members of the Medical Advisory Conmittee and for consideration of his subconsnittee members. C. C9 - C]jg Aromatics Kieffer Davis, M. D., chairman of this subcommittee, presented his re port which is given in Appendix C. ACTION : It was regularly moved, seconded, and unanimously passed that the report be accepted. D. Certificate of Appreciation J. V/. Osborn, M. D. reported that this committee had not waft. A Certifi cate had been recommended at the i960 spring meeting for J. C. Ruddock, M. D. and had just been presented. API 07633 P K , Carcinogenicity R. E. Eckart, M. D., chairman of this subcommittee, presented his rewhich is given as Appendix D. ACTION: "* I t was r e g u la r ly moved, seconded, and unanim ously passed th a t t h is report he accepted. ? , Dermatology Leo J. Wade, M. D., chairman of this group, presented his report which is given as Appendix E. ACTION: It was regularly moved, seconded, and unanimously passed that ' this report be accepted. G. Epidem iology George M. Saunders, M. D., chairman of this subcommittee, gave his report vfcicb is included as Appendix F. ' ACTION: It was regularly moved, seconded, and unanimously passed that ' this report be accepted. H. Medical Policies and Administrative Practices Ralph F. Schneider, M. D. gave his report which is attached as Appendix G. ACTION : It was regularly moved, seconded, and unanimously passed that this report be accepted. I. Physical Agents G. H. Collings, M. D., chairman, gave his report which is attached as Appendix H. ACTION : It was regularly moved, seconded, and unanimously passed that this report be accepted. J. Specialty Petroleum Products C. H. Baylor, M. D., chairman, gave bis report which is attached as Appendix I. ACTION : It was regularly moved, seconded, and unanimously passed that this report be accepted. K. Toxicological Reviews In the absence of H. W. Gerarde, M. D., chairman of the Subcommittee on Toxicological Reviews, his report was read, and is given as Appendix J. ACTION : """ i t was r e g u la r ly moved, secon d ed , and unanimously passed t h a t th is report be accepted. API 07634 Jack Spence presented his report which is given as Appendix K. Who should do the study on lung cancer, in relation to the inhalation of oil mist, yaS discussed since the Subcommittee on Carcinogenicity has been discharged. It i yas agreed that this should be referred to the chairman of the Medical Advisory Committee for his assignment. ACTION : It was regularly moved, seconded, and unanimously passed that ' the report be accepted as amended by changing recommendation I number 3 to refer the need for study of lung cancer, in re- ` lation to the inhalation of oil mist, to the chairman of the Medical Advisory Committee instead of the chairman of the Subcommittee on Carcinogenicity. VI. REPORT OF LIAISON MEMBERS A. Smoke and Fumes Clark Miller, M. D. reported for J. C. Ruddock, M. D. who had attended a number of meetings of the Smoke and Fumes Committee of the Division of Refining. Clark Miller, M. D. agreed to report to the Stooke and Fumes Conmittee the Industrial Hygiene Subcommittee proposal that the Medical Advisory Committee, in cooperation with the anoke and Fumes Committee, review the desirability of giving financial support in the amount of $25,000 to the cooperative lead-in-air study being under taken by the U. S. Public Health Service along with certain participating industry groups. B. Labeling A. E. Dooley, chairman of the Interdivisional Committee on Labeling, reported on the activities of this group. His report is attached as Appendix L. He reported that on February 1, 1961, the Federal Hazardous Labeling Act for house hold goods goes into effect. An inter-association group, of which the API is a member, is working with the Department of Health, Education, and Welfare establish ing definitions which will apply to petroleum products. The inter-association group has requested that a toxicologist be assigned to help them. Dr. Horace Gerarde was appointed to work with Allan Dooley in his activity with the interassociation group working on the hazardous labeling act. C. First Aid Training T. K. Frank, M. D. reported on his liaison work with the Central Conmittee on Accident Prevention. D. Wax Conmittee R. E. Eckardt, M. D., chairman of the Advisory Conmittee to the Wax Research Project, reported on this group's activities. His report is given as Appendix M. E. Quarantine Service 0. M. Saunders, M. D., liaison with the Quarantine Service of the U. S. Public Health Service, gave his report which is attached as Appendix N. API 07635 F. Petroleua ?ood Additives L. E. Curtis, M. D., chairman of the Interdivisional Committee on petroleum Food Additives, reported on the activities of this group. A copy of his report, which he plans to give to the Medical and Health Committee, is attached as Appendix 0. VII. 1961 BUDGET Chairman Osborn reported that in the 1961 budget is an item for the activities of the Medical Advisory Committee in the amount of $0,500. This has been approved by the Budget and Review Committee, and the Executive Committee. It is subject to approval of the Board of Directors at their meeting tomorrow. Beginning January 1, 1961, the Medical Advisory Committee's budget will be on a calendar year basis. Therefore, monies for the 1962 budget should be submitted by each subcommittee on or before the spring meeting in 1961. VIII. NEW BUSINESS No new business was brought before the Medical Advisory Committee. IX. NEXT MEETING Chairman Osborn announced that the next meeting of the Medical Advisory Committee and subconmittees will be in the Denver Hilton Hotel, Denver, Colorado, April 6, T, and 8, 1961. E. 0. Mattocks, Reporter Approved: J. W. Osborn, M. D., Chairman API 07636