Document qE1dw3e5KV46n7ZXGaOw2aRn

j l ATED e t h y l c o mp a n y l imit e d ^Registered Office: THE ADELPHI, mDOV,WC 2 ylddress all communications untilJurther notice to - ARTILLERY HOUSE, ARTILLERY ROW; LORD OR, S.l JXrectors: N.A.GASS L-N.HAMILTON (o.S.A.) J.B.AU6 KESSLER (n CTHERUAn o $) G. LEGH JONES F. G. C. MORRIS R.W. SELLERS D. A.SHEPARO (U.S.AJ A.O. SINGLETON E. E.SOUBRY T.R.A.BEVAN fjfatoying) ABBEY 3974-7 ffctegmmS: ETWYI-TORT, SOWEST. LONDON OUR REF. ST/3/310 YOUR REF. 1st February 1945 Dr. R.Kehoe, University of Cincinnati, College of Liedicine, CIDGIDIIATI. Dear Bob, I enclose one copy of a report prepared by Dr. Cassells on his recent visit to Falmouth to investigate cases of alleged poisoning amongst personnel employed in tank cleaning operations. Enc,, ^ A* K/ vA Y 3">* , 'n |} / jiC'Tf' 4 HE 0021513 41 `` m-ciijEiiuaac At f a l mo u t h DgscaxprioR Og rnsurnm. lO C\2 O o tu he o ooVTOvf he tanks to be cleaned were: five underground tanks which had. contained leaded gasoline* Mos. 26, 24, 23 had held 87 octane fuel5 Ho*23 had held 100 ocfene fuel and Ho.27 had. held 100 and 150 octane fuel. The tanks were circular - 118 feet diameter z 20 feet high - 4,000 tons capacity, with supporting pillars at intervals. The bottom and sides'were of steel with a concrete ,lliningn along the bottom and for a height, of approximately three feet up the walls. The roof was of concrete* fahk Ho,23, which 1 entered, had a manhole 2-ft.l0--in, diameter in the roof, which was open, and by which one gained access by means of a perpendicular ladder to the floor of the tank. I understood 'that there were two manholes in the roof of each tank. Emptying of the fuel from the tanks was bsgdn on the 3.5th October .1948, and finished by the-10th Kovemher 1945* Cleaning on the first tank (Ho.26)was begun on the day after it was emo tied, but the other tanks had bean extracted (by fans in the access chamber sucking, through the two 10,f mains which had; been disconnected in the access chamber) wi.fch both manlids open for two weeks before cleaning began. The procedure in the case of tank Mo.26 was as follows. . On 12th November 1943 the Assistant Supervisor (33r. Thompson) N entered, the tank and removed the inverted suction pipe (4 drain) over the sump in order to make room for the rubber tube of the sludge pump, and also out in the lights by whi ch the work was to be carried on. He was in the tank for'about an hour and a half, and no one'else was in on that day. * fha men entered the following cay. wearing white overalls,-gum boots and gloves, and equipped wi th . blower-type helmets. She explosiveter gave three MIL readings on : this day - 1.3th November' 1945. The. blower-type helmets were worn l for the first two or three days during which the men cleaned the bank-bottom, using rubber squeegees about 3 feet long arm bass bristle brooms. As much as possible of the water and sludge on the tank bottom was sucked up by > the si udge pump from the water drain to - the sump in the access chamber, whence it flowed to the interceptor at the bottom of the site. file men stirred up the sludge with* the squeegees and brooms so-as to keep i t in suspension for 'the pump to take. *. 1 y The remainder which- the pump couldn* t take was. swept along in front of each man until there was sufficient to shovel into a bucket wi th a brass shovel* These buckets, when- filled, -660 were emptied into a heap on thg floor under, the panlid, and .when ' suffi ciend sludge had aeeumuXatediyy afcout ::7? bo.j8kewt :3 to be cleaned were:.five underground tanks .eh had contained leaded gasoline. $02.26, 24, 23 had held 87 octane fuel5 $0.25 had held 100 ocfeme fuel and $0.27 had held 100 and l^O octane fuel. Phe tanks v/ere ei vcular - 118 feet diameter x 20 feet high - 4,000 tons capacity, with supporting pillars at intervals. The bottom and sides"were of steel with a concrete nliningn along' the bottom and for a height of approximately three feet up the walls. Xhs roof was of concrete. i Panic Ko.23, which 1 entered, had a manhole 2-f t.-lO-in. diameter in the roof, which v/as open, and by which one gained access by means of a perpendicular ladder to the floor of the bank. 1 understood that there v/ero two manholes in the roof of each tank, ' Mptying of the fuel from the tanks was begiin on the > ;| l6th October I945, ' and finished by the 10th Hovaaber 1945* Cleaning* on' the first tank (Ho.26)was begun on the clay after it was emptied., ww but the other tanks had been extracted (by fans in the access chamber'sucking, through the two 1015 mains which had been -: disconnected in the access chamber) with both manlids open for w two week# before cleaning began. 1 She procedure in the case of tank ho.26 v/as as follows, f On 12th November 1945 the Assistant Supervisor (hr. Thompson) entered the tank and removed the inverted suction pipe (4n drain) over the sump in order to make room for the rubber tube of the sludge pump, and also out in the lights by which the work was to be carried on. He v/as in the tank for about an hour and a half, said no one'else was in on that day. The men entered the following cay. wearing white overalls, 'gum boots and gloves, and equipped with blower-type helmets. jfhe explosive ter gave three NIL readings on this day - 1.5th November 1945* The blower-type helmets were worn for the first two or three days during which the men. cleaned the tank-bottom, using rubber squeegees about 5 feet long and bass bristle brooms. As much as possible of the water and sludge on the tank bottom was sucked up by the si udge pump from the water drain to the sump in the access chamber, whence ife flowed to the interceptor at the bottom of .the site. fhe men stirred up the sludge with" the squeegees and brooma so-as to kee*p It in suspension for `the v pump to take. *. 1 ,Ihev ranainderjwhich-.the.' pump' couldn* b take was sweat along in front of each man unhi3.f there was sufficient to shovel into a bucket wi th-a brass shovel, fhese buckets, when filled, -were emptied into a heap on the floor under the manlid, and when sufficient'sludge had aecu.mu3.ated - about 7 to 8 cwfcs. - it was filled up into buckets, pulled up through the manlid, and buried about 2 feet deep in a trench some distance away. 1'hcr men were in the bank for four to five hours each day, and at the end of the day they had a bath provided before . changing into their oan clothes. The same cleaning procedure was adopted in the case of K .0021515 s 2 5=aeh texikf except that half way through the cleaning of the third tank (No.27) the sludge was siphoned from the water drain to the sump in the access chamber, instead of being pumped-, and - the .sludge was hosed and' swept, by squeegees into the water drain instead of being brushed*. This was done also in the case of Tanks Nos.24 and 23. " Blower type helmets were worn only for the first two days in the first two tanks. After they were discarded civilian type respirators were worn for 2 days and these were replaced later by box* respirators, service type, each man having two. One of the men was made responsible for cleaning the face pieces with 1ZAL at the end of each day. ... The following men 'were engaged in the work for varying periods of time under the supervision of Mr. ihA. iSOMPSOK:- Uv&s more or less in charge of the'squad from 13th November 1943 until he went off sick on Sysfc November 194-5, was then in charge and also during^ the absence of ir. Thompson from find to 27th December, end from 28th December to 7th January 1946, _,.r ^IllIGPKOGRAMilS _ The tanics were pot tom-cleaned in the following order: ~ 26, ^5, 27, 24, and 25 - ' lank No. 26 from 12th to 14th November inclusive. Ho. 25 from 15 th to T/th November, No. 27 from. 19 th to 24 th Novembers No.24 from 26th to 29th November. "-'i C ,. There was then * gap of a week when the man were not in ti were working on the valves. - y-emwing re~commenced on Tank No, 23 on 5th December, and :"2jri"70:0' _7n -kil the present time (8 th January 1946) with the ;p - , M :3;i1rljbri sernas week, when no work was done. The men were :in Tank ho, 23 at the time of my visit ~ 7;-h and '8 th =^.^p. be-.ng then engaged on. scraping the walls, hone of aave as yet been scraped. ................ K& 0021516'" ' * '-t / oa w.% j i `sJiiA ui.cU.i2 the sump in the access chamber, instead of being pumped, and iq sludge was hosed and swept by squeegees into the water drain instead of being brushed* 1`his v?as done also in the case of Tanks Hos.24 and 23. Blower type helmets were -com only ion the first two days in the first two tanks.. After they were discarded, civilian type respirators were worn for 2 days and these were replaced later by- box respirators, service fcyp e, eaen man having km * One of the men was made responsible for cleaning the face pieces with 12AL at the end of each day. The following were engaged In the vjork for varying periods of time under i;bo supervision of Hr. T.A. Ll}G&PfcpK;~ P was more or less in charge of the squad from IjHh novaliDer^dy until ho went off sick on 29 sh November I945, v/aa then in charge and also during; the absence of dr. Thera?soS^Q^oiu find to 27 th December, and from 2'Bth December to 2 th J jurmary .1946. The tonics were uoltom-clearned In the following order;- 26. 23, 27, 24, ana 2;j - Tank Bo. 26 from 12th to 14 tif No vender inclusive. Ho. 23 from 13th to .17ch November, Kuo. 27 from 19th to 24,th November:; do. 24 from 26th to 29 th November. life re was then .tt gap of & week ./Tien the man were not in the tanks, but were working on the valves. Gleaning re-commenced on lawk Ho.23 on 3th December*and has continued until the present time (8th January" 1946) with the exception of Christmas 0000, when no wonr was done. Th s men were still at work in Tank do * 2p at the time of my visit - 7 th and 8 th January 1946 - being than engaged on scraping the walls* Cone of the other* tanks nave as yet been scraped. The length of truft spent by each man inside the tanks is ;_;:i von in the accompanying table. According !:o statements by some of the men., there y/as :. small an one or two of tho tanks (bos, it), 25 ana possi bly 27) variously a user idea. *u 0 smell of api ri tw, Hi. smell of octane-',, !;no t petrol bat a scon to >. am ill, something like a doctor* s surgeryOne man (Chilli) said that when stirring up the sludge a small could be felt even through the hairnet, ana it gave rise to a taste in the mouth "like a poor applet liverythi/r- seems r-3.ve ;iom *ell until Drury reported sice on 25 th November lylf,, fc 11..) wed by W i. eboli 3 cn the - ol.lc wing K 0021517 5. day,30th November 1945. A statement by Dr.h.aS. Wright dated 8th December, 1945? was submitted in the case of WKKKfr giving influenzal enteritis as the cause of his incapacity for work (copy attached). Some time later in December, Drury suffered from depression, and developed mental symptoms. He was seen on January 3rd,l94o by Dr .Stanley Copeman of the Cornwall Mental Hospital, Sodmin, who considered him to be very ill mentally, and recommended his admission as a voluntary patient to the Mental Hospital. Nicholls stated that his doctor considered he was suffering from !Tn erves". i was informed of these circumstances by the Petroleum Board,London, ana arranged with Mr.Coles to visit Falmouth on Tuesday, 8th January 1946. 0021518 4 Se spent between 5 and 6 hours dally in the tanks, except Saturdays, when work stopped at 12 noon and he did not work on Sundays* He v/ore overalls, gumboots, treated gloves, and no headgear* 'Alien the gas content was high as shown by the explosimeter he wore a blower-type helmet - afterwards changing to a service respirator* He states that he worked several times for two hour spells wi thout any respirator at all,and that this happened in more .than one tank*. Baths were available at the end of each day's work, but he only had "a ;jolly good wash1' because he found the water too cold end the towels too wet. A week prior fco.doveiaber 2.8th 19-5 his doctor states that he had been sick one evening and stayed away from work the following day. There is no evidence of this absence in the time-Table given me by Mr. Thompson. : Apart from this he felt quite well, no headaches,no giddiness, appetite good and sleeping well. On Wednesday, 28th November 1945, he had diarrhoea and vomiting, and some flatulence^ he was perspiring and shaking and had difficulty in falling asleep, aid spent most of the night talking to his wife and smoking, tie was irritable and excitable, and unable to concentrate. He was seen by Ms doctor on the following day, and thought to be suffering from influenzal gasto enteritis. He spent 4 or 5 days in bed .and seemed to improve, although he was still not sleeping -well; He. couldn't fail asleep tin til .late on in the night, end his sleep was disturbed by dreams: ha attributed this happening to the & S; B tablets which he was taking for his influenza. ,,His wife;.states his hands fcwi fcched duping sleep*. ' .. y w~:., After 4 or 5 days he was sleeping a little better,but still not vrell. He felt depressed and as though something was pressing on his head. Ha felt he coul&M t ^oin in paying cards as usual wi til his family. On one occasion when on his way to' see the doctor Ms wife states his maimer was peculiar, .He was taking long strides in a great hurry, and Ms wife had to take his arm as he was unsteady on his feet - "going too quickly for his legs to carry him'1. He did everything in' a great hurry; e.g.,undressing for the doctor, and he shouted'instead of talking quietly as usual. , . . 0l?e - 29th December - he suddenly went stiff in his choir anu-Kep t saying strange things, ,, end quo tin# the Serin-* - rt4 *,-S A *v. r-> l-U4 v. ..*- * K F 002151 Hi story: Commenced, tank-cleaning on lyth November 19^5 and, being an experienced man, was more or less in charge of the squad under . , Mr.Thompson. ' He spent between 5 and 6 hours daily in the tanks, except Saturdays, when work stopped at 12 noon and he did not work on Sundays. Re wore overalls, gumboots,treated gloves, and no headgear. -Alien the gas content was high as shown by the explosimeter, he wore a blower-type helmet - afterwards changing to a service respirator. He states that he worked several times for two hour spells without any respirator at all,and that this happened in more .than one tank.. Baths were available at the end of each day*s work, but he only had a ^olly good wash" because he found the water too cold and the towels too wet, A week prior to November'28th 1945 his doctor states that he had been sick one evening and stayed away from work the following day. There is no evidence of this absence in the Time-Table given me by Mr. Thompson. \ Apart from this he felt quite well, no headaches,no giddiness, appetite good and sleeping well. On Wednesday, 28th November 19^5^ be had diarrhoea and vomiting, and some flatulence^ he was perspiring and shaking and had difficulty in falling asleep, and spent most of the night talking to his wife and smoking. He was irritable and excitable, and unable to concentrate. He was seen by his doctor on the following day, and thought to be suffering .from influenzal gas to enteritis. He spent or 5 days in bed and seemed, to improve, although he was stil-l not sleeping well. He. couldn* t fall asleep 'until late on in the night, and. his sleep was disturbed by dreams* he attributed this happening to the 11 MB tablets which he was taking for his influenza. His wife states his hands fcwi fcched during sleeo. After 4 or 5 days he was sleeping a little better,but still not well,, He felt depressed and as though, something was pressing on his head. He felt he couldn't join in paying cards as usual v/i til his family. On one occasion when'on his way to' see the doctor his wife states his manner was peculiar. .He. was taking long strides in a great hurry, and Ms.wife had to-*take his arm as he was unsteady on his feet - "going too quickly for his legs to carry Mm". He did everything in a great hurryi e. g.,undressing for the doctor, and he shouted ^instead of talking quietly as usual. o C\2 One day - 29th December - he suddenly went stiff in his chair and kept saying strange things, and quoting the Scriptures. His wife, 'who told me this, states that she-felt flabbergasted. He was quite normal quarter of an hour later. S1200 . -3X He has developed the habit'.of reading the Bible fairly frequently, and. likes to be alone when doing so. . He has lost between 1 and 2 stones weight since 26th November 1945. On J anuary 2nd 1946 he saw t .Stanley Coleman of the Cornwall Mental Hospi tM,-Bodmin, vi si ting psychi afcri s fc at Eruro Infirmary. At this time his wi fe states he was very nervous. diking quicfely(as described above) and his jaws working. On that, day. Dr. Colan thought him men bally vary ill vd tfc confusion ' and depression, and delusional ideas, and .recommended his admission to the Mental Hospital as a voluntary patient, or failing this, by certification. iix^inatipin^ l94o. I examined this man at his home on Iuesday,6th January He was quite po-operativs end talked, freely. Re wore an anxious look, and his.face was thin and hi s eyes rather staring. He was restless" while he talked wi ch various purposeless movements of his hands and arms and face muselos,and his articulation was not . always' clear, as though he eouidn1 t talk' quickly enough bo keep pace wi fch his thoughts. His colour was good. His pulse rate-was 48 per minutet his temperature 97--2F His blood pressure was 90/55- the Cranial nerves appeared normal. The pupillary reflexes were normal His abdominal reflexes were increased in all segments. His deep reflexes were all present and slightly increased. The plantar responses were flsxo 1`here was no tremor of the tongue nor of the hands,but hand movements were clumsy, slightly .spasmodic,' 'Muscular power in arms, and legs was good. Liuscle toils was also good, A blood film taken at tills time and stained later showed no. abnormal!' by. ,' .him. In conversation* he seemed to me to bear a grudge against his previous employers - Ihe Shell Refining and Marketing Company - and .blamed them on several counts:- (a) He considered he was unfairly treated at 8 tanlow. On his return from work on the South Coast to Stsnlov/ he felt that he was demo ted. . fie stated that he was fomerly a foreman, and when he complained of not getting back his job, he received ?!an insulting letter" from his manager, ' (o) * le stated that, without his knowledge, his subsistence 1. _ allowance was not paid-'him - while working in the-South, snd he only knew of_ i t when cheques whi ch ho gave. T/ere and*impression, and delusional ideas, and .recommended hi C* adifd ssion to-?IS& Mental Hospital as | volunbary patient, or failin this, by certification. ' naciSiiim I. examined this man at his home on iu-esday,btb January He was quite co-operative and talked freely. He wore an anxious look, and Ms.fe.ee was thin and hi s eyes rather staring. He was restless while he talked with various purposeless movements ox his hands and arms and face muscles,and his articulation was not always'clear, as though he'coition1 fc talk' quickly enough to keep pace with his thoughts. His colour was good. His pulse rate-was 4.6 per minute/* his temperature 97-2F. His blood pressure was 90/55* The Cranial nerves appeared normal. he pupillary reflexes were normal His abdominal reflexes were increased in all segments. Hi s deep reflexes v/era all present and slightly increased. The plantar responses were flexor Fnere was no tremor of the tongue nor of the hands,but hand movements were clumsy, slightly spasmodic.,' Muscular power in arms. and. legs y,*as good. Muscle tone was also good. f A blood film taken at this time and stained later showed no abnormal!ty. In conversation, he seemed to me to bear a grudge against Ms previous employers - Jhe Shell defining and Marketing Company - and blamed them on several counts;- (a) He considered he was unfairly treated at Stanley. On his return from work oh the South Coast to Steniov/ he felt that he was demoted. He stated, that he was former!;/ & foreman, and when-Ire' complained of not getting back his job, he received an insulting letter11 from his manager', ' - (b) * (c) He stated that, Avi thout hi 3 knowledge, his subsistence allowance was not paid him while working in the - South, end he only knew of 1t when cheques whieh he gave were returned ''Refer to Drawer11. One such cheque was sent to a woman who lives within half a mile of'his own home and he was Upset about what she taifhs Mink of him. He stated he had to sell fxirni ture to meet the cheques. \ He left a car behind in the South v/hen he returned to returned to Stanlow, and in his absence tyres,dynamo, batteries, etc., were stolen from it. He applied to Roman House fob petrol coupons to take the ear back to Sfcanlow and was asked for reasons why i t was necessary., nils disgusted him, since it was his car and ,fche KE 0021522 firm had no thing to do ivi th it, and he didn't reply co the letter. . While on the South Coast 3.0b he had tc> use a car, end v;as paid only 2fd. per mile, which did not cover running costs* .' Re had various other worries:- (a) He was financially embarrassed due, he states, to unemployment.', 0) Re lives in furnished apartments. His own house is let and he can't get the people out. (c) He accepted a new job and then didn't go to i t as promised. Re stated, that he couldn't raise the fare to go although it was a good job with a weekly wage of 8. to 9. id) His daughter's position worries him. She had an illigi tigiate baby to an American soldier who had promised, he states, to marry her, but was already married. This happening v/as a great shock to Mm, He is quite fond of the baby but is worried that it will have n6 legal claim to'i ts father's estate in U.S.A. As regards his dreams, he dreamt that ho was in a cage and couldn't get out, ... He dreamt ain that he was given complete custody of the child. He had one nightmare when he dreamt that all . kinds of octopus., were trying to catch him. He. fought them off, had to chop off some of their tentacles and. finally escaped. Ho 7-oke up very relieved that he had only been dr earning."- He still has difficulty in falling asleep but Kis feeling better every day". Re states he has never been ill in his life .before except for a touch of rheumatism while at Stanley-;. A sample of urine obtai?).3d at this time showed the following when analysed at the Courfc&uld Institute; Volume 200 mis. mg.lead in sample ,043 lig.lead per litre- .'213 Sp. Gravity 1.014 X0 f}0215?:> 1 OPINION :~ Ehis man, so far as we know, was quite well and in good health* up to 28th November 1943* Prom the 13th to the 28th November his occupation was one in which there is a known toxic (lead) hazard unless precautions are scrupulously observed. According to the man's grn statement he disregarded these precautions for a sufficient length of time to make it possible-for him to develop toxic symptoms. Exposure tp lead has occurred to the extent that lead is present in'a specimen of urine in a concentration of .215 mgms.per litre nearly six weeks after he stopped work. The nature of his illness on the 28th November 1945 is compatible with tetra ethyl lead poisoning: his condition on the 8fch January 194b was compatible with this diagnosis. On the other hand, Ms illness of the 28th November 1945 was diagnosed at that time as influenzal gastro enteritis, and his subsequent manic depressive state attributed to post influenzal depression. His financial end domestic worries may be considered to have aggravated his depression and to have contributed"'to his present mental illness. After ctue-consideration 1 cannot escape the conclusion that he has had the opportunity of contracting tetra ethy lead poisonipg ~ though it-i-s also reasonable to accept that his financial and domestic worries have played a part in determining the?; nature of his illness. 0021524 2 Aged 44 years 110,The Terrace,?enryn. Qlsbossi ' He commenced tank-deeming on 13bh November 1945, and worked on all four tanks (Eos.-26, 25, 27, 24) sludging the bottoms and pulling up the "buckets of sludge through the.manlid and burying them., ' ... z . He wore overalls, gum-boo ts .and fcrbated gloves. He wore 'a. bloVer-type helmet on first entering a tank while the smell of spirit was about. He states he never wore any other type of respirator. * * ' I-le states that he had itching of the face and nostrils while on the job, and aber he went home, and this occurred after helping to "carry Away the sludge. ' During the last week ho was at i-vork - he reported sick on 30th November 1943 - he felt sick while working". On several occasions he put hasfingers cown his throat.; in order to make himfielf vomit. During this same period of time ha had difficulty in falling asleep, sad had two or three very restless nights. He felt giddy and unsteady on his feet. Ho states that he lost weight fast during-the fortnight he was tank-cleaning, aha that where he was living he didn't get enough to eat. . "his appetite was good up to the last week he was working. He took ill on the 29th November 1945 - felt, cola and. shivery end had an. itching sensation inside the nostrils. Be. states that his doctor bold him he was suffering from ''nerves" although he himself says he did not feel nervous in himself while at work, bub he fancied he hoard sounds - someone talking or someone walking behind him. He continued to sleep badly for" 'a week or two after stopping work-- that i q for a month-or just over, in all. He had no dreams. Sxgjsi n afei on; * 1 examined this man on the'8th Januarjy 194.6' _. He was quite co-operative and expressed himself as anxious to start work again. ' Be was slow in his .speech and. did not strike me as a parfcieularly intelligent man. t He told me fcha'fc ha was how feeling fi t for work. He was sleeping well.* his appetite was goods he was now putting on weight again nicelyi. ' - , ..r k He occasionally feels an itching inside the nostrils still 0021525 History: Be coaaeneecl tank-cleaning on ILJth November 1945,and worked on all four banks (Bos.-26, 25, 27, 24) sludging the bottoms and pulling up the buckets of sludge through the.manlid ' and burying them. .. Me wore overalls, gum-boots .and treated gloves. He wore a blower-type helmet on first entering a tank while the smell of spirit was about. Me states lie never wore any. other type of respirator. . * Be states that he had itching of the face and nostrils while on the job, and aber he went home, and-this occurred after helping to'carry sway the sludge.f During the last week he was at work he reported' si ek on pQfch November 1945 - he felt sick while working; On several., occasions he put his - fingers down his throat* in order to make himSeif vomit, During this same period of tim-e'ha had difficulty in falling asleep, snd had two or-three vary restless nights. Be felt giddy and unsteady on his feet. Ho states that he lost weight fast during-the fortnight he was tank-cleaning, ahd that where he was living he dicin' t . get enough to eat. *Hfs appetite was good up to the last week he was working. Be took ill on 'the 29th November 1945 - felt cold and. shivery and had on. itching serisation inside the nostrils. Ee . states that his doctor told Mm he was suffering from' nerves?1 although he himself says he did not feel nervous in himself while at work, but he fancied-' he heard sounds - someone talking or someone walking behind him. He continued to, sleep badly for" a week or- two after stopping work - that i < for a month or just over, in all. Be had no dreams. nb^lng.fciont_^_ 2 examined this nan on the' 8th January 1946 ' lie was quite co-operative and expressed himself as anxious to start work again. ' Me was slow in his .speech snd. did not strike me as a-particularly intelligent man. > Be told me that ha was now feeling fi fc for work. He v;as sleeping well: his-appetite was goods he was now putting cn weight again niceiyi ;f ' ' > tie occasionally feels an itching inside the nostrils still file -pulse raterwas 63 per minute. Bis bloca pressure was 135/So. Ihe Cranial nerves appeared normal. .-The pupillary reflexes were normal: his abdominal Kr 0021526 ref3.exes were very brisk in all segments: deep reflexes were normal and the plan bar responses were flexor,". 9. Xiiere were no tremors. Muscle power and tone were good. A Dlooci film' taken at thi s time showed no abnormal! fcy when later stained. ' - L sample of urine was taken, and on analysis at the 'Court&ulc. Institute, it showed the- following:- - Volume 173 mis .. , hg/ieau in sample - ,0415 hg/lead perjlifcre., 240 Sp. Gravity' ' = ~ 1.018 '(Mr. 3.L Smi fell) . His doctor (Dr.ksia,. fregea House,Penxance) informed mo by . telephone that h 7 considered iiicholls showed an anxiety state .7hen" seen at the 'end of November 19<0 Oplnionf- I consider tins dan has had a moderate lead intoxication as evidenced by . fclia presence .of load in the urine in a cons strati on of . 240 ugns.por litre nearly six wears after his exposure ceased. .. His symptoms of nausea sue. sleeplessness,and his loss in weight am. laervasn are in keeping with this, condition. 1 eensieeroG Inch-oils fi t to resume work but advised the Supervisor at valueu :h to give him out of door work,where there wouic be no contact >xl th leaded arterial. I advised against his resuming tamr-cleanin;... 1 felt that haa this man' been core intelligent he v/ould have had further informal;.!on c,cive as regards his symptoms'. I made so attempt to elucidate information by direct questioning,- us 1 should not have known how much credence to give to the answers, but 1 felt that the little he had to say was trustworthy; ' * HE 0021527 10* Holland Villa,Ireverva, Buaock. Commenced tank cleaning lpth November 1945 and was in all four banks (Nos. 26,' 25, 27, 24). fie stakes that in bank 25 he dicnJfc wear a blower-type helmet but only a box respirator, and "that was where the trouble started'1. Ee cleaneu out 5 barrow loads of deposit from the sump in the access chamber of tank No.27 using a shovel. He wore no respirator at all while:doing thisi although "the smell of octane was* pretty strong"-. Eire fans were running all the time. //hat y;as left in the tank sump was also cleared out by shovelling the sludge into canvas buckets. ivhil shovelling out the sludge from the sump in the access chamber of tank No.24 wearing no respirators, the smell was strong, so they left it and went to work on the valves outside. After a week on the valves, work -was resumed on rank. 25 for two days, after which he reported sick on friciay,7th December 1945. lie returned to work on Iuesday,llth December,but did not go back to fcank-ele&ning. He states that for the first week or two on the tanks he slept badly. He .couldn* t fall asleep5 .when he did sleep it was broken and restless, and he began to" have nightmares again. He woitlci wake up with a start or a scream and sweating profusely. He can1 t remember his dreams. He used to have nightmares for a time after leaving the sea he was trapped in the ammunition magazine of a merchant cruiser, and suffered from nerves and loss of memory after this experience^ ha left the; sea in November 1943., and was not allowed to* sail again. He had been free of nightmares for at least a year and a half until he began tank-cleaning this time. On one day after, being in a tank- (? Dank 24) all morning, he developed, a tingling- and itching round nose,face,eyes and neck in the afternoon. On the same day he had sourness of the stomach, felt sick bub couldn't vomit, and when" he went home that night he took salt and water as an emetic. He finally vomited and felt much batter. His wife thought he had been drinking because of the smell of his breath - t1ai putrid smell1*. He has not felt ill apart from this day. His appetite has "been'good throughout. H/a h.-ip been s'leeoina all night again since the and KE~ 0021528 Hi s fcorvi v I_ Commenced tank cleaning 15th November 1945 and was in all four tanks (Nos.26, '25, 27, 24). He states that in tank 25 he dion't /rear a blov/er-type helmet but only a box respirator, - and "that was where the trouble star ted". He cleaned out 5 barrow loads of deposi t from the sump in the access chamber of tank No.27 using a shovel. He wore no respirator at all while: doing this, although ''the smell of octane was*pi*etty strong11-. The fans were running all the time. V/hat was left in .the tank sump was also cleared'out by shovelling the sludge into canvas buckets; while shovelling out the sludge from the sump in the access chamber of bank No.24 wearing no respirators* the smell was strong, so they le,t- i b and went to work on the valves outside, After a week on the valves, work was resumed on lank 25 for two days, after which he reported sick on Friday,7th December 1945. He returned to work on Tuesday, 11th December,but*did not go back to bank-cleaning. He states that'for the first week or two on the tanks he slept badly. He couldn't fall asleep* .when he did sleep it was broken and restless, and he began to have nightmares again. He would wake up with a'start or a scream and sweating profusely. He can't remember his dreams. He used to have nightmares for a time after leaving the sea - he was trapped.in the ammunition magazine of a merchant cruiser, and suffered from nerves and loss of memory after this experience* he left the sea in November 1941., and was not allowed to' sail again. Re had been free of nightmares for at least a y ear and a half until he began tank-cleaning this time. On'one day after, being in a tank (? Dank 24) all morning, he developed, a tingling and itching round nose,face,eyes and neck in the afternoon. On the same day he had sourness of the stomach, felt sick but couldn' t vomit, and when he went home that night he took salt, and water as an emetic. He finally vomited and felt much better. His wife thought he had been drinking because of the smell of hi 3 breath - na, putrid smell". * He has nob felt ill apart from this day. His appetite has been'good throughout. He has been sleeping all night again since the end of December - a fortnight after ceasing work on the tanks. fhere has been'no loss of weight. Sxaminafciont- He is an alert, in telli gen t man - not. ill. Normal outlook KIT 0021529 11. ^and quite co-operative. Be has a good colour. His pulse rate was $4 per minute. His blood pressure was ilp/65. Cranial nerves appeared normal. ^ Reflexes \vere all present and normal. Plantar responses were flexor. A. blood film., stained la ter, showed no abnormality. A specimen of urine, analysed in the Courtauld Insti tube, . showed the following:- Volume lig/lead in sample hg/'le&u. per litre Sp.Gravity - - 179 mis. - .0405 .225 1.021- (iir.H.E. Smi th) .Be is now quite fi t again. Opinion:- -' This man has had .a mild lead intoxication as shown by disturbed, and difficult sleep and the feeling of nausea. .. She concentration of lead in urine - .225 mga.per litre one month after all con tac b v.-i th lead has ceased, points to a hazardous exposure having occurred. fie should nob.be employed on work which involves any exposure to lead, however slight, for at least two months from the date of this-report, and then only if the lead concentration of the urine has reached a normal figure. j I ./ Kg- 0021530 ;4 s : 'I or were present in the tanks in a supervisory capacity. Since they experienced either mild symptoms or else none at all* I have grouped them together'in my report* and 1 shall only refer to individuals in cases where symptoms were present* or where working conditions call for comment. \ and have worked in all the tanks from lyth November 1945 up to the present'time* v/i th the exception of two weeks* one of which was spent on valves* and one week's holiday curing -Christmas week. Aged years. _ had difficulty in falling asleep for about a month. tie usually sleeps from 9,30 p.m. to 5.45.a.m. bub for this oeriod he- v;asn*' t dropping off to sleep 'till some'time between midnight and 4.a.m. eizen when he went to bed as early as 7. 30.p.m. which he did v/i th the'object of making up fox-lost sleep. He had dreams but nothing frightening or odd - he usually dreams now and then. After his we ex on valves and after Christmas 'week he began to sleep a lot better*and is now sleeping well again. Ax'.ter the first two days in lank No.27 he felt out of sorts -- not sleeping* a bad taste in his mouth (,!iike a poor apple") and a slightly sore throat. His appetite remained good all the way through end he states that he has lost no weight. He has had no headaehes*no giddiness-"or unsteadiness. '` .this man is a steady type of workman who- would obey orders unque'sticningly. .Be has had experience of lead blending* and in' this way he has been' examined by me on four previous occasions when his urine was also analysed for lead. 1 found no difference in CO in < his health on clinical examination* but the concentration of load in the urine was much higher. CV2 o A specimen of urine analysed at the Courbauld o' Institute gave the following results:- - w Volume - mg/lead in sample- 234.mis .041 fig/lead per litre-. Sp, Gravi ty - 3-75 . 1.015 (Mr. E. R. Bmi th) . A blood film shov/ed'no abnormal! ty. __ i ana' fl^were"a!^cr!ftigagea in. earner cleaning nr Were present in iw canks in a supervi sory capacity. Since they experienced either slid symptoms or else none at all, I have grouped them together in my report, and X shall only refer to individuals in cases where symptoms were present, or where working condi cions call for comment. 1 " . Iflj^fl^Hfehave worked in all the tanks from lyth November 1945 up t^xn^^Fesent time, wi th the exception of two weeks, one of which was spent on valves, and one week' s holiday curing -Christmas week. Aged 48 years. - : had difficulty in falling asleep.for about a month. He usually sleeps from 9*50 p.m, fco 5.45.a.si, but for this period he" wasn*'b dropping off to sleep ' bill sometime between midnight and 4.a.au sizen when-he went to bed as early as 7*30.p.m. which he did v/i th the'object of making up for1 lost sleep. He had dreams but nothing frightening or odd - he usually dreams now and then. After his week on valves and after Christmas 'week he began to sleep a lot be beer, and is now sleeping well again. After the first two days in Tank ho,27 he felt out 0 sores no t ;Din bad taste in his month (,!iike a poor apple") anc a sl i gh tiy so r e thro at. His appetite remained good all the way through and he states that he has lost no weight. He has had no headaches,no giddiness or unsteadiness. '1 rnis man is a steady type of workman who would obey orders unquestioningly, .Be has had experience of lead blending, and in this way he has been examined by me on four previous occasions when his urine was also analysed for lead. 1 found no difference in his health on clinical examination, but the concentration of load in the urine was much higher, A specimen of urine analysed at the Courfcauld Institute gave the following results:- Volume -. mg/lead in sample- !4g/lead per litre- Sp, Gravity - 2p4.mis .041 .175 1.015 (Mr. E. R. Smi th) . A blood film shov/ed'no abnormal! ty. : His pulse rate was 63 per minute. His blood.pressure was 105/70* There was no abnormality of the central nervous system. Opinion: This nan has had a mild, intoxication from which he has * i~K HF 0021532 . is a gooa;.recovery. Xhere would be no objection to nsinued employment in scraping the tanks whose bottoms have been cleaned, but he should, iiot.be employed in bottom-cleaning fresh tanks for at least two months from the date of this report, and. only then if the lead, concentration of the urine has diminished safcisfae toriiy. Aged 21. On'one occasion while in the first tank (Ho.26) when pumping in the access chamber - pumping sludge from tank strap to the smp in the access chamber - he did not wear Ms respirator and. felt giddy. He put his mash on. quickly and kept i t on the whole time after that. file tank at this time was being' exhausted of petrol vapour through the 10 K mains which had been disconnected in the access chamber,and there was probably a rather high concentration of x>^trol vapour in the air. / >: - This experience may have had the beneficial effect of impressing upon Mm the desirability of wearing Ms breathing apparatus. Certainly, apart from this temporary giddiness, Jennings appears to have been fib throughout the entire period. His appetite has been good and he has slept well from 10 p.m, to 6 a.m. every day. He experienced a few dreams ho saw his sister who clod a year ago rise up out of her coffin end come'back. He remembers, in another dream, fighting with someone who was using the handbasin in a part of the installation where he had no right to be. He doesn't remember any of the other dreams, but none of them was frightening. His pulse rate was 65 per minute. His blooo pressure was lph/75* .Che abdominal- reflexes were very brisk in'all segments, but the control nervous system showed no other abnormal! ty. A specimen of urine, analysed at the Courtauld institute showed the folioringi- Volume - Ug/ieaa in sample . - hg/laao. n.er litre - Spjiravi ty 420 mis .065 - . .230! 1.024 *. (Hr,chK.Smith) k blood film showed no abnohr&li by. ihis man has had exposure -to lead as evidenced by the conwentration of lead iir the urine, but it has hot been of sufficient intensity as to give rise to unequivocal symptoms of react intoxication. He is' fit and there is no objection bo his coninued employment in scraping'the tanks whose bottoms have been cleaned. He should not be employed on cleaning new tanks for at , least two months from the* date of this report,and then only if fchG-leae concentration of hi 0 urine has come within normal limi bs. ,. ,`h K(= 002163;; j DEER fAiflK CLEANERS., Aged 50* C,3CM*-3 PH supervised the cleaning of the tanks,and while presSi'it on the 'si te* for.most of the time, he did not spend s many hours inside the tanks. He was away from the site from 2nd to -27 th December and 'from the 26th December 1945 to *?th. uiu&ry 1946. ; he had. no symptoms attributable to lead poisoning. His pulse rate was 87 per minute. Sis blooa pressure was 135/75* a blood film showed no abnormal! by. A specimen of urine, analysed at the Courtauld Institute, showed the following:- - Volume Lig/leae in sample lig/lead per li bre Sp. Gravi ty 276 mis, .027 .098 X. 0 2 p (Mr.S.B.Smi fch) Q-o.iniion:-- i ______________ shows no signs or symptoms of lead intoxication, i'he concentration of lead in the urine points to exposure to lead, and is just short of the upper limit of safety (0.1 mg.per litre). The three mer agec, ,421 have all had a very much shorter ____ gg&-gll _ x tank cleaning C-tumbles spent two days on bottom cleaning in Tank Ho. 23. had done no bottom cleaning, only scraping. .... They were all quite lit on clirflcal examination. A sample of urine obtained from J .Hall was analysed at' the Courtaula Institute, and showed the following:- V Volume -.cV- 424 mis. !ig/lead, in sample '- . .0152 Itg/lead per litre . .0p6 * -Sp.Gravity 1 .010 (^r.E.R. Smi th) 1 did not expect to examine as many. as.nine men/' and 1 haci not enough bottles with mo to, obtain more than seven samples. 1 consider nowever that the sample obtained from J.Hall is probably typical ior tne group in ,mich i-have included him. - 1 took no blooc. films from this group because of a similar lack of suffice ent slides. - , ^ :UMwlARx i -- 15. ana probably lead poisoning of cleaning at Falmouth four of , them cer fcainly* > ave shown signs-and symptoms of tetra ethyl varying degree of intensity. The exposure< all five to the risk of intoxica.fcion . by lead is: shown by the cphcentral:! on of lead in the uri pe on anslysi fhe two men nipre severely affected _______ shovi a high lead urinary coneerUjrati on six 'weeks' after the last known exposure. One man flHHHBI moderately affected, shows a . similar concentration four wee!n^5n:er. Iwo man mildly affected show a slightly less but still, high concentration while remaining, at /work. DISCOSSIOfl. It is reasonable to assume that had higher urinary lead concentrations at" the time .they ceased ank-cleaning and - that these must have resulted from greater. exposure to lead in the course of their work, Fur ther,it would seem that they could only have experienced a' greater exposure through neglect of the precautions they were instructed to take" and which they stated they understood (see copy of. the form which they signed); ____ states that he aia fact, work vn thou fc any respirator on several occasions, states that he wore nothing, else than a blower-type he! appears to mean that no nob 1 so must have have reaj 'slised worked yd thout a the toxic-nature respirator at of the sludge times . Also he which he was may pullin- up out f the tank and burying, and he may have had some exposure from this. Matthews admits to clearing the sludge out of the sumps into a wheelbarrow wi thoub,any respirator being worn. - fhe other twq and assert that they never 'worked without some type^!^breabliin^procection at any time (with the exception of the very brief spell admitted to by Jennings r/hen he came giddy). Phey have experienced only the mildest of symptoms. 11.would seqm therefore that the incidence and the severity of illness have been more,or less in direct proportion to the degree of exposure. '\ lb should b$ noted that the early symptoms in these cases' were similar to those, of the men affected at Fareham. Nausea was, complained of by. t?ra of the men - felt sic-k bub couldn't vomit"; (cf.^HHWl one of the men put his fingers,down his throat and the other took salt and water as an emetic. One of the men began his illness with an attack of gasbro enteritis (cf^BBli during his week-end at home). Difficulty in falling asleep was a symptom in four cases, or else sleep was broken and restless and dreaming occurred. Two of the men wore more irritable ( _________________ them v/era anxious enough about themselves to stop work ,and cf.three of the Fareham men). 0021535 SCGGiSTIOtSi. 16, It would seeat desirable in the light of these occurrences to have some medical supervision of tenk-cleaners' wherever operations are being carried out. The doctor concerned - should be made aware of the nature of the. symptoms., and in this connection it should be emphasised that there are no blood changes, e.g., stippled cells, such* as occur in inorganic lead -poisoning. : };he doctor" concerned* should make himself'familiar with the . working -condi tions by entering .a...tank -Rearing all dee equipment ' worn by the men. ' li ' dll: The men should be. medically examined once a weak and'a record kept of - . ' Body height . f'y Pills Rate and fsmr.sr&ture Blood Pressure - ay Sleep - number of hours and ishether well or baoly; dreams*!- appetite - 'any- anorexia, nausea, -or gastro intestinal upset; number of bowel movements daily; wny bad taste.' General Condi tion - anxiety, nervousness, change ;in manner," tiredness, feeling of weakness, tremor,pallor. Analysis of urine for lead should be carried out, Ih:e absence from- work of any man should be reported immediately to the doctor; so ought any complaint of illness, 'however, trivi el it may seem,made by any man while at work. ; The type of man employed in tank-cleaning should 1 or carefully chosen.. He should be a steady workman,cl` moderate in tel ligence only who will .do* what he is told and who will put up with some inconvenience during his wo?jk -wi thout worrying too"much" ' hour it. ilany men object to' wearing an airline mask or a box respirator, or else remove it when . supervi si on is relaxed; others' jonffc mind it and can.be trusted to continue wearing it. K & ' 0021536 ;w- q':.-'-:;" She more intelligent typa of nan maybe too imaginative and may feel; stifled in. a respirator; ci he may chink t-iat the management is exaggerating the need for precautions, in doth cnesa cases ho tends to .neglect to do as he is bid. Ihe unintelligent man is also to be avoided. He may not trouble about the-correct fitting of his facepiece or understand twafc no must- replace it if it becomes contaminated; he may continue to v;ear contaminated clothing; he does nob understand the" reel hazard of his job anp. calls for more supervi si oh then can be riven him. ' uhttnraiucmlisloystreesdolSl-fasntoedthtssesefcehahnfahngttehoreosadfaotnf.rePeehxminas..emosnrg--p.'''akleininago;oc~ribh&asfcerhgrfl cvesehseah^Hofl&ilur-sl.datthlaebcoeoupni:dasr*=ei mdcaaenuratwitoihonons,,cawnwcjhnbode. ' kho" It would seeat desirable in the light of . these occurrences: to have some Medical supervision of tank-cleaners wherever operations are being carried out. The doctor concerned should be made aware of the nature of the symptoms, and in this connection it should be emphasised that there are no blood changes, s.g., stippled cells, such as occur in inorganic lead poisoning, file doctor concerned should make himself familiar with the working. -condi tions by entering a . tank wearing all the equipment worn by the men. The men should be. medically examined once a 'reek ana a record kept of - Body height . Pulse Bata and fempsrafcure Blood Pressure - ' Sleep - number of-hours and ^whether "well or badly; dreams. Apoetite - any anorexia, nausea, or gastro intestinal ' '.upset; number of bowel movements daily; any bad taste.' General Condi tion - anxiety, nervousness, change in manner, tiredness, feeling of weakness, tremor,pallor. Analysis of urine for lead should bo carried out, She absence from-vjork of any man should be reported isiusdiafceiy to the doctor; so ought any complaint of illness, 'however, trivial it may seem,made by. any. man while at work. 0 fhe typo .of man' employed. in tank-cleaning should j o carefully chosen,- fie-should be a steady workman,of moderate in tel ligence only who will do what he is told arid who will put up v.l th some inconvenience during his work without worrying too much 'baht it, llany men object to wearing an airline mask or a box respirator, or else remove it when .supervision is relaxed; others J bonk-t mind it and can be trusted to continue wearing it. H f: V :1 fhe lucre Intelligent type of man may be too imaginative and may feel, stifled in. a respirator; o* he may think that the Management is exaggerating the need for precautions. In ~ both- these cases he tends to neglect to do as lie Is bid. The twain belli gen fc man is also to be avoided. He may not trouble about the 'correct fi tt-ing of his facepiece or understand that ha must replace it if it becomes contaminated;- he may continue to wear confc&ainafeed clothing; he does*not understand the real hazard of his job anp. calls for more supervision then can be given 111 % ` h VIA -x r5?-~ hat|j:C;shoulcl be a men who- can be OOi, /f. * or tsu . S!|isMaHioSttlcSffeteS??Snne3;r0fSui , -ho tidily of the hours of uoc of each bos-rasp Mt tea r;, i fi.oe pieces are cleaned daily in sice, cue t_h__a_t t_h_e_#y arc replace,: A A contaminated.' He should'ensure that closn clo thins iiT avaluable 'hen required,and test the baths are taken. It snouic. be the duty of the Managscent bo provide utson clothing at sun table intervals and to provide warm baths, soap Cj.ean,cry towels 0 . Bathing snoulc. be carrig o out in Works time, half an hour' being aixoved for this purpose. HE 0021537 The greatest-;risk of lead poisoning seems to arise from cleaning thetank-battoms. During this operation, therefore, alr-Iine masks should be worn,'' &s they should he when cleaning out sumps containing sludge. For the later operations of scraping., box respirators would seem bo afford sufficient pro section,provided their period of useful life is not exceeded. The samples of scrapings taken from lank So.23 showed 21 parts per million organic lead and 1,1 moms.per litre of water in the s;::;iple(ldr. U.R. Smi bh) . Presumably the methods employed in tank-cleaning lav received careful consideration by all concerned, it is hoped the b this operation will continue to be the subject of study, ana that efforts, bo find'means of carrying it out more safely will continue to be mads. in the meantime i b seems as though safe working can only be achieved at the price of the most careful and thorough supervision - such supervision as may seem out of all proportion to the importance of .the type *of work, 'yet which is well .worth while if illness of a particularly ctistressing character is to be avoided. . (Sgti) C.A.K.OASSflLS, ii.2. KIT 0021538