Document qZ1aekno2nLMDxqyVoo057Nq

MEDICAL CONTROL OP OCCUPATIONAL LEAD EXPOSURE Pre-employment examination Complete throughout Careful history Previous occupations Present subjective picture by systems Careful physical examination Special attention (1) Gastro-enteric tract (2) Vascular system (5) Heuro-muscular Laboratory procedures Special attention to Blood Hemoglobin Differential leucocyte count Stippling Clinical urinalysis Lead analyses when previous exposure in doubt -? - Purposes Base line record Suiting workmah to job Elimination of definitely unfit Persons seriously exposed recently Persons with vascular disease Persons with hepatic disease Persons.with gastro-enteric sluggishness Periodic Re"examination - periodicity determined by conditions Interval History Importance of subjective symptoms Careful physical examination Unhurried Repetition of laboratory -study Blood - Stippling - hemoglobin Urine - Clinical examination Analytical examination if possible Necessary if exposure dangerous The importance of good records Medical data for study - medico-legal considerati Examination when required by illness History important in relation to physicians knowledge of plant Necessity of arrlvingfat a diagnosis, not merely convicting or excluding occupational factors Frequent necessity of consultation with other physicians KF 0008740 i -3- difficulties develop. Diagnostic Criteria in Relation to Lead Intoxication Lead Absorption Stippling of Erythrocytes Mean 339l8 per million erythrocytes Upper limit not far from 1000 - rare person higher Quantitative.information necessary Stippling and lead exposure abrupt changes significant Stippling and other factors Seasonal Anemia Other Lead Line Differentiation Bismuth Natural pigmentation Increased lead excretion KE 0003741 Lead Poisoning Actual illness characterized by (1) Gastro-enteric symptoms (2) Neuromuscular disturbance (3) Cerebral Involvement Associated with blood change (If no stippling, no intoxication) Sequellae Neuro-muscular Cerebral Hematopoetic ? AN EXPERIMENTAL STUDY OF LEAD ABSORPTION The normal Intake and output of lead Lead intake and output under conditions of experimentally induced lead exposure Immediate response to Increased intake Relation to industrial lead exposure Eventual response to increased intake Threshold of Intoxication not reached. Abnormal absorption and excretion without < Intoxication. Correspondence of blood and urinary levels to those seen In occupational lead exposure Comparison with results at H.R. plant.