Document qdYjJjnbbV5BMwzxQXL0w2OwK

FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1956 DOC#: API036 DOCUMENT DESCRIPTION: Minutes from Various Meetings and Associated Documents APPENDIX A TO .-iTNOTES CF 115T MAC MEETING "" X T FOR PUBLICATION MEMORANDUM OP MEETING OPERATING SUBCOMMITTEE April 22, 1956 The Warwick Philadelphia, Pennsylvania nifiSE FRESENT:. L. E. Curtis, M. D., Chairman V. C. Baird, M. D . , Vice Chairman P. D. Gassaway, M. D., Secretary Robert E. Eckardt, M. D. C. H. Hine, M. D. 3. B. Reeve, M. D. George M. Saunders, M. D. D. V. Stroop I SUBCOMMITTEE MEMBERSHIPS Those present discussed and agreed upon changes as follows: a) Existing Subcommittees l) Subcommittee on Atmospheric Pollutants Add T. B. Rendel as new member 2; Subcommittee on Economic Poisons Add M. N. Newquist, M. D. as new member 3) Subcommittee on Toxicological Reviews Substitute H. W. Gerarde, M. D. for Marshall Clinton, M. D. as chairman Substitute Kieffer Davis, M. D. for L. C. Beard, Jr. b) Hew Subcommittee Appoint a Subcommittee on Industrial Hygiene with membership as follows: P. D. Halley, Chairman E. K. Daniels A. E. Dooley J. W. Hammond A. C. Pabst L. E. Renes Jack Spence N. Van Hendricks API 07233 M. A. C. BROCHURE The : id D. V n tf the C. brochure was assigned to George M. caunders, III BUTGET ESTIMATES FOR 1957-1930 oi o After consideration of all proposals for expenditures during the fiscal t.-t y i 1957 . June 30, 1958, it was agreed that a solicitation oi $>75>C ary 1957 would be adequate for the continuation of the M. A. C. activitie D. Gassaway, M. D. Secretary E: u r t i s , M. D. airttan API 07234 t ArPJDIX 3 ;s cf 21st SAC Mss tins PROG?-1..'! 57? C !M1TT7EE i. 3. ?. Ikairran. "he Program Subcommittee met on April 21, 1956. Present were members .- - i" : , lir.der, 21 ar.ev, Saunders, the Chairman and guests. The first matter discussed was that of a medical round table session at _..a roil API meeting. It was moved by Dr. Saunders, seconded by Dr. Linder that the zzi~~es recommend that such meeting be held. The motion carried. In discussing for such meeting it was agreed that if the Medical Advisory Committee V-i"des in favor of such meeting, that the members of the Program Subcommittee are, .-'"cvir.g 'his meeting in Philadelphia, to forward to the subcommittee chairman '."Tested topics for the meeting and Chairman Reeve is to then select from these ''"Catted topics, the program for the Fall Round Table Session. Dr. Crcckshank called attention to the fact that the Medical Advisory ---ittee is not given recognition in the API booklet of organization and adminis--coicr.. This was referred to Dr. Curtis. The next matter discussed was that of an open medical session at the ..r.r.uai API meeting ir. the Fall. It was moved b y Dr. Osborn, seconded by Dr. Blarney .... zue program Subcommittee recommend that the Medical Advisory Committee hold an session at the Annual Meeting of the API in November, 1956. The motion rriei. In discussing a program for the proposed open session it was pointed out che purpose of such meeting should be primarily to inform and explain to the 'cr.-medical representatives, various aspects of health problems pertinent to the -ecroleun industry. It was agreed that the program should be so designed as to fj.fi11 this purpose. The following topics were discussed and are proposed for presentation o-, the cpen meeting: 1. Absenteeism: Dr. Saunders was appointed to obtain a speaker and to decide upon the title and general content of the talk. 2. Ionizing Radiation: Dr. Osborn was appointed to obtain a speaker and to decide upon the title and general content of the talk. 3. The Medical Program in a Petroleum Industry: One suggested title was "Why a Health Program in the Petroleum Industry?" The members of the Subcommittee are to contact Dr. Richard Walmer, Industrial Hygiene Foundation, to talk on this sub ject and if he is not available, to obtain another speaker. The final matter discussed was that of promoting attendance at this cpen Dr. Curtis suggested that each MAC member contact his own management to the meeting and that Mr. Staples be 'urged to inform other members of the --'--al and Health Committee of our objectives. API 07235 4 APPENDIX C To Minutes of 21so MAC Meeting REPORT CF AIR POLLUTION SUBCOMMITTEE CF MEDICAL ADVISORY COMMITTEE _________________' CF AMERICAN PETROLEUM INSTITUTS__________________ J. C. Ruidcck, M. D., Chai m a n Since the last meeting of the MAC, there has been two meetings of your committee, March 26, 1955 and April 22, 1956. Your committee has collected much literature concerning research develop ments as concerns Air Pollution. This literature has been mostly technical in character and those that affected human health have been distributed to the members of the subcommittee and some to the membership of the MAC. Close liaison has been carried on with such agencies as the Los Angeles =ncg Control District and Los Angeles Smog Foundation. Your committee has been continually advised of progress and conclusions as they develop in researches sponsored by the Western Oil and Gas Association. The conclusions adopted by your subcommittee are as follows: 1. The policies of the MAC, as stated in Appendix C of the Minutes of l6th Meeting of the MAC, September 10, 1952, are re-adopted. (Copy attached.) . 2. It was unanimously adopted that the MAC request $20,000 be allocated for the purpose of paying salaries and expenses in volved in collecting and critically evaluating all research programs in progress and contemplated in the future which might concern air pollutants and their effect on human health, individual and community. 3. It is recommended that the MAC, through its regular officers, approach the Automobile Manufacturers' Assocation to deter mine whether or not they are interested in furthering critical reviews of current and contemplated researches, particularly concerning those elements in smog that are caused or pre cipitated by automobile exhausts and how these may affect human health, both individual and community. API 07236 * t For Information Only - Net For Publication APPENDIX C To the Minutes of l6th Meeting of Medical Advisory Committee REPORT TO THE API MEDICAL ADVISORY COMMITTEE BY THE SUBCOMMITTEE ON ATMOSPHERIC POLLUTANTS September 10, 1952 Atmospheric pollution has today become a major challenge to scientists; to administrative officials and to the public. Important meetings have been held and more are scheduled. These include scientific meetings, industrial conferences, public gather ings, and official agency sessions offering information about air pollution, its sources, effect and control. Universities, foundations and industrial centers of re search are devoting more time to fundamental investigations meteorological studies and comparable research in adding knowledge of the characteristics of atmosphere. Scientific investigations overlap and points of difference occur when professional and techni cal viewpoints are multiple. Investigations involve engineers, chemists, toxicologists, biologists, meteorologists, bacteriologists physicists, botanists, physiologists, economists and physicians. One of the finest engineering investigations has been made under the auspices of The Western Oil and Gas Association, and quoting from the 3rd Interim Report by the Stanford Research Insti tute a pertinent paragraph as follows: 'Little is known about the exact effect of smog on human health. Reported experience of medical men in the area indicates that smog is detrimental to well-being. How serious a threat this may be has not been established. If it could be demonstrated by medical research that some ingredients of smog are harmful, a great impetus would be given to research leading to their specific elimination and, possibly, to further basic discoveries." We are primarily interested in air pollution in its rela tion to the petroleum industry. The petroleum industry has been responsible for certain of the elements that have to do with air pollution. These substances have their origin in the refining pro cesses or in the use and combustion of the finished product. Ihe petroleum industry has not been responsible for the air pollution nuisance in its entirety. This is a local problem and occurs only locally in relation to the amount of waste material from industrial and manufacturing plants as well as the waste material that is re leased. into the air in communities where there is a concentration f population, -- (garbage, refuse, incinerators, etc.). API 07237 I AFPUDIX G MAC Minutes Page 2 As physicians and members of the Medical Advisory Commit tee ar.d further, as members of the sub-committee on air pollution of the Medical Advisory Committee, it is apropos and pertinent at this time that an evaluation be made with regard to what approach should be made by the medical group concerning this problem of air pollu tion as it effects the oil industry. I have listed these as follows: 1. Medical science deals with physiological and toxicolo gical effects cn living human beings, or agricultural effects that might relate directly or indirectly to human health. This is in opposition to the exact science of chemistry, physics, and other types of technical groups. The effect of a substance on an inani mate object can be definitely measured. Whereas the same effect of that substance upon a human being is modified by many physiological laws and actions. One must not forget that in the living human being nature repairs damages that might occur. We, therefore, have two types of approaches from the medie ad standpoint. (a) Accute effect. When the physician knows the amount of the substance that a human being has been exposed to, then he can tell you what immediate effect it would have upon that human being and whether or not there would be any persisting residuals of the effect. (b) Chronic effect. It is only by exposure of an animal over a long period of time to minute quantities of sub stance "X" that the medical man may state what that effect may be. Is it harmful or is it not? Does it produce disease? Is it carcinogenic? What physiological changes occur in the animal to offset the continued exposure to such an element? 2. To determine physiological effect on an animal of any substance "X" there are basic factors which must be known. (a) The medium of exposure, - air, liquid or solid. (b) Is exposure made by inhalation, ingestion or contact? (c) The nature of the substance, namely, chemical formula and physical properties. I refer you again to the 3r<i Interim Report of the Stanford Research Institute wherein the conclusion and recommendations are made with regard to improvement of methods of identifying constituents of air pollutants. The Smoke and Fumes Committee has already proposed certain projects toward the development of ana lytical and identification methods, and any basic medical research might have to await the outcome of further investi gation along the lines recommended in such projects. API 07238 i-rixix : MAC Minutes t r-< Page 3 IN SUMMARY, the sub-committee cn air pollutants of the Medical .-.iviscry Committee feels that they should be kept continu ously advised of ail research work which have to do with the human physiological effects of air pollutants in relation to the community problem. The pharmacology of these substances, along with the physiological properties if requested may then be worked out by medical investigation. At the present time the sub-committee feels that no medi cal research under the auspices of the petroleum industry should be instigated-by them at this time. The sub-committee feels they should await the final outcome of such projects and investigations chat have been proposed or are already in the process of investi gation before undertaking any projects of their own. As stated in the minutes of the 15th meeting of the A.P.I. Medical Advisory Committee, "The subcommittee stands ready, if necessary, to render whatever service and assistance it can in those matters related to the physiologic effects of atmospheric pollution which it may be specifically requested to consider." (1) Nuisance values as concerns eye smarting, coughing and odors would be considered physiological effects. (2) Research has been underway for sometime concerning the effects of air pollutants on plant lift. It is conceivable that the effects of plants and animals, especially that are used for human consumption, - may be direct or indirect upon the human health. When such a problem arises the Medical Advisory Committee stands ready to advise, counsel, or continue any research investi gations along these lines. To investigate the harmful effects of air pollutants can be very definitely summarized in the following: (1) How much quanitatively of substance "X" is in the atmosphere? (2) What are the physiological effects immediate and after long time exposure? (3) What can be done medically to counteract immediate exposures or long time exposures by the medical profession? API 07239 4 APPENDIX D To Minutes of 21st MA.C Meeting REPORT CF THE C9 - Cl2 SUBCOMMITTEE C. H. Hine, M. D., Chairman Although funding of this project was instituted on 1 July, 1955, active investigation by the research group headed b y Dr. Nau did not commence until November. The initial phases of the investigation involved assembling of equipment needed for generating and monitoring atmospheres containing the toxicants and of chambers for exposure. Exposure of animals commenced in January 1956. At present, three groups cf animals are being exposed to 1000 and 2000 ppm of benzene and to 1CC0 ppm of O9 * aromatics. Three additional groups of animals have been assembled for exposure to 1C00 ppm of C9 - Cio> n-decane, C]_i - C j 2 . The experiment has not been underway for a sufficient time to permit the collection of significant data. It is our opinion that no pertinent data can be obtained for at least six months. This will necessitate continuation of the project during the next fiscal year. It appears that greater quantities of the C n - C]_2 fraction will be needed than was originally planned. Rather than attempt an additional fractionation of pooled stocks, it is recommended that this material be obtained by pooling the original C ^ - C i p f a c t i o n s with material of similar boiling range and aromatic content obtained from one of the participating companies. While there are a number of reports describing a possible relationship between leukemia and benzene exposure, a survey of the pertinent literature, carried out under the direction of Dr. Potts, failed to establish this. It was suggested by one of the members of the MAC that additional studies be carried out to evaluate the extent of liver damage produced b y the C9 - C32 fractions. The suggestion was discussed tut not adopted. RECOMMENDATIONS CF THE SUBCOMMITTEE The Subcommittee recommends that the present study be extended through the fiscal year 1956-1957 and that additional monies in the amount of $10,000 be solicited for support if needed during the year 1957-1958 Reports submitted by Dr. Nau and Dr. Potts are attached. API 07240 i D-2 PZFCRT TO ISMBERS CF THE STJBCCMMI1TZE CN C9 - Cl2 ARCMATICS D e scripticn of Exposure Chambers The exposure chanter shown in photograph No. b consists of three essential parts: (l) the Venturi nixing tube (2) surge chamber with diffuser plate (3) inner chamber for holding rat cages. These parts are constructed of galvanized sheet metal and galvanized hardware screen. The Venturi mixing tube receives the vapor or aerosol from the generators and mixes it with the inlet air. From the Venturi the air-vapor mixture is sucked into the surge chamber and diffused through the diffuser plate into the animal chamber. The outlet mixture of vapor and moisture from the exposed rats is exhausted to the outside atmosphere. A sampling port is provided in the approximate center of the chamber for sampling the air-vapor mixture to which the animals are actually exposed. The animals are housed in six cages constructed of inch mesh hardware screen. There are six rats per cage or a total of thirty-six per chamber. A two (2) foot square glass door is provided in the top of the chamber for placing or removing the caged rats. There are six cham bers for the project - three for the C9 - C 10 mixture and three for the C]_i C]_2 mixture. Concentrations of 500, 1000 and 2000 PPM of each mixture probably will be investigated at the same time. Three chambers are now (and have been) in operation Chamber: #1 - 1000 PPM Benzene #2 - 2000 PPM Benzene #3 - 2000 PPM C9 - C 1Q Thirty-six male white rats (6 rats per cage) are exposed in each chamber, seven hours per day, five days per week. The other three chambers are now ready to be started with Chamber: - 1000 PPM C9 - C 1Q #5 - 1000 PPM Normal Decane #6 - 1000 PPM C1X - C12 Thirty-six rats will be exposed in each chamber. The animals receive no feed or water while in the exposure chambers. They are fed and watered when the exposures end and the rats are put in other cages outside the exposure chambers. Operation of Chambers The operation of the chambers is as follows: API 07241 s - 2- 1. Air flew into chambers is measured by use of a thermo-anemometer ard a dry test gas meter. Hourly checks are mace by reading the in clined nanometer shown in photograph No. II, no. 2. A ccr.star.m and known quantity of benzene or Cn - Ciq is fed into the vaporizers by means of the infusion pump and ICO ml syringes, photograph I, re. 1 . 3. Daily or hourly sampling is done with the sampling set-up shown in photograph No. I, no. 5 h . At hourly intervals checks are made on the rats being exposed by viewing them through the glass door shown in photograph No. k . Atomizing of the material was found impractical. Calibration and Analyses of the Concentration of Vapor in the Chambers 1. 1CC0 PPM (3.19 rag per liter of air) of benzene The sample of vapor taken from vet test memer and is then absorbed absorbers connected in series using medium. the chamber is measured with a . in two pyrex 125 ml fritted glass redistilled methanol as the sampling The concentration of the sample is determined b y measuring the absorption of the benzene at 25^ millimicrons with the Beckman DU spec trophotometer. The specific gravity of benzene is taken as 0.880 and all calculation of PPM are corrected to 760 mm atmospheric pressure and 25C temperature. 2. 2000 PPM (6.38 mg per liter of air) benzene The sample of vapor taken from the chamber is measured with a wet test meter and is then absorbed in two pyrex 125 ml fritted glass absorbers connected in series using redistilled methanol as the sampling medium. The concentration of the sample is determined b y measuring the absorption of the benzene at 25^ millimicrons with the Beckman DU spectrophotometer. The specific gravity of benzene is taken as 0.880 and all calculation of PPM are corrected to 760 mm atmospheric pressure and 25C temperature. 3. 2000 PB! (IO.38 mg per liter) of C9 - The sample of vapor is absorbed in absolute ethanol and the concen tration determined at 266 millimicrons with the Beckman spectrophotometer. The specific gravity is taken as O.8U 5 75P/60F and the parts per million are calculated at 760 mm. and 25C, using a molecular weight of 127. Physiological effects observed grossly on rats exposed to - C ,q The rats exposed to 2000 PPM of C9 - ee *0 find the exposure extremely disagreeable. They exert every effort to es- API 07242 J - 3- cape. There is inflammation and irritation of che conjunctiva with swelling of one tissues, "arcotic effects appear early in nest an imals out tolerance no a given dosage seems to develop. A few animals become anesthetized and lose consciousness, Recovery, when removed tc fresh air, is rapid. After eighteen hours of exposure there was seme weight loss followed 'ey normal weight gains. As soon as they are removed from the exposure chambers they begin to "wash" their face and eyes. These animals appear to con sume more water than controls or than rats exposed to benzene (after removal from the chambers).- Their furs are moist with the condensate offering excellent opportunity for ingestion (by licking) and for skin absorption. Physiological Effects Observed Grossly on Rats Exposed to Benzene There is no visible effect of benzene on the rats in the chamber (at 1000 PPM). The only visible effect in the chamber at 2000 PPM is irritation to their eyes and nose. They tend to bury their heads and cover their faces as much as possible and occasionally show signs of trying to get away from the vapor. The fur does not appear to get moist. Blood Studies and Weigh" Changes No significant changes that the rats exposed to Cg these exposed to benzene or confirmed. have been observed thus far. It - C^q material bleed more freely than the control rats. This has appears than not been Attached Photographs Photograph #1 - Front view of exposure chamber showing 1 . infusion pump and 100 ml. syringes 2. fritted disc vaporizers 3* 3-way stopcocks and liquid reservoirs compressed air regulator 5. vapor sampling set-up 6. extra rat exposure cages Photograph 2. - Front view of exposure chamber showing ` 1 . sampling set-up 2. compressed air regulator 3. constant temperature bath U. inclined manometers API 07243 r .h . Phctcgrach =?2 (continued) 5. therncanencmeter port Photograph =3 - Vaporizer designed by Rieders and Hodes Photograph - Sketch of exposure chamber NCTE: Due to unforeseen events our work has not progressed as rapidly as we expected and hoped it would. We believe most obstacles have now been overcome. Respectfully submitted, CARL A. NAU API 07244 T D j SXFSRIME27TAL ANI'iAL IKDCSD LEUKEMIA In the review of the literature for the past thirty years, various hydro carbons have been incriminated in the induction of leukemia in experimental animals. ->e following group have been incriminated as factors of etiology in leukemia: Carcinogenic tar Methylcholar.threne 1-2 Benzpyrene 57 9,1 Dimethyl - 1,2 Benzanthracene 1 1:2:5:6-DiBenzanthracene ^3 3:^ - Benzpyrene 5 these compounds have been tested primarily on mice of various strains, some of which have spontaneous leukemic incidence, while others are of low incidence. In some of the more substantiated series, the hydrocarbons will induce leukemia in resistant strains and shorten the latent period in high Leukemic strains. 1 There are, however, strains that are entirely resistant to hydrocarbons, but are more susceptible to other leukcgemic agents, of which he most frequently mentioned are estrogens and ionizing radiation (x-alpha-beta rays). There are many related as well as unrelated complicat ing factors, most of which depend on the genetic stock of the mice involved. Various factors seem to act in a synergistic mode of action. Estrogens and x-ray are the mere frequently mentioned. 1,22 Other workers have reported factors such as dietary supplements of cystine and methionine. Along with hydrocarbons these have been reported to cause a great er incidence of spontaneously induced leukemia. Light is another factor that has ireen aentionecL, 2x other compounds have been mentioned which are indol, colchicine, and bile, ^>50 other workers have reported diets of amino-azo dyes producing leukemic-like state in mice. The modes of induction of most of these carcinogenic hydrocarbons have been varied]) topical applications, subcutaneous, intraspleenic, and gastric installations. 25,27 Few, if any, worker have used inhalations or some other physiological method of introducing suspected carcinogenic agents in experimental animals. Other experimental animals, in addition to rats and mice, that have been used are fowls such as chickens, 32,51 guinea pigs, 33_and a worker using guinea pigs has used beef liver preparations, 33 Several of the workers using rats have instilled intramedul lary carcinogenic tar. 53,51*-,55,5o As to the compound Benzene itself, workers disagree as to its carcinogenic effect. Some have reported the induction of leukemia in mice while others have been unable to confirm it. 10,lo,17,20,k8 As to the extent of the leukogemic effect of various hydrocarbons, one cannot say for sure how applicable data based on animal experiments is to man; how ever, a few scattered reports of leukemia subsequent to Benzene poisoning in man have been made. A P 1 07245 SUSPECTED ITICLCGIC FACTORS i D 7 (New England Journal of Medicine, 2L6:15:575*) Dameshek, in discussing the possibility of a real increase in leukemia, thought that such factors as radiation, benzol, benzol-ring drugs and arsenicals aight be responsible for this increase. He emphasized that radiologists, photo graphers, dye workers and gardeners are susceptible groups. (Dameshek, W. Is fsukemia increasing? BLOOD 2:101, 19^7) Hueper regarded benzol, radioactive substan ces and roentgen rays as established carcinogens of blood-forming organs. Mallory, Gall and Brickley reviewed 12 cases of leukemia with chronic benzol exposure up to 1939- (Mallory, T. B. Gall, E. A., and Brickley, W. J. Chronic exposure to benzene (benzol): pathologic results. J. INDUST. HYG. & TOXICOL. 21:355-93> (1939) According to a recent survey by Moeschlin, about 20 such cases are recorded in the literature. (Moeschlin, S. KLINIK UND THERAPIE der VERGIFTUNGEN. Stuttgart: G. Thieme (inpress) Skimkin and his associates suggested that the increas ing use of women in industries employing radiation and benzol might account for the higher proportion of females with leukemia found in their series today ae compared to that of former years. From an article entitled "Some Practical Aspects of Cancer Prevention (Concluded)", by Ernest L. Wynder, M. D. API 07246 J WCSUFZ TC RADIATION (Public Health Reports, 71:2:107) Vynder (Vyr.der, Z. L . : Some oractical aspects of cancer prevention. 3v England J. Med. 2^6: Up2-503, 533-546, and 573-582, March 27, April 3 and 10, -053.), in a discussion of ohe practical aspects of cancer prevention, reviewed the Evidence for the relationship between the development of leukemia and prior exposure -c radiation or to chemicals suspected of having leukemogenic properties. His evalua-icn of present knowledge of these factors was that "no good evidence was at hand" except with respect to radiation and possibly with respect to benzol. Winder's con tusion with regard to radiation was based, in part, on analyses by March and Ulrich 0f the mortality among radiologists from leukemia. For a 20-year period ending in 19U8, March (March, H. C.: Leukemia in radiologists in a 20 year period. Am. J. Med. Sc. 220: 282-286, Sept. 1950) computed ratios of deaths from leukemia to all deaths for radiologists (4.68 percent) and for nonradiolcgist physicians (o.51 percent). He concluded that the risk of death from leukemia among radiologists was 9 or 10 times that of nonradiologist physicians. Dublin and Spiegelman (Dublin,, L. I., and Spiegelman, M . : The longevity and mortali ty cf American physicians, I938-19U2. J.A.M.A. 13*: 1211-1215, Aug. 9 , 19^7) compared age-adjusted death rates from leukemia for male physicians (1 1 . k per 100,000) to the rate for the white male population (6.5) and found a ratio of 1.75. Later they found the number of deaths from leukemia among radiologists during 1938-^2 was "several times the number expected on the basis of the mortality experience of all male phy sicians". (Dublin, L. I., and Spiegelman, M . : Mortality of medical specialists, 1938-19^2. J.A.M.A. 137: 1519-152U, Aug. 21, 19U8) Peller (Peller, S.: Cancer in man. New York, International Universities Press, Inc., 1952, 556 pp.) cited age-standardized rates for mortality from cancer exclusive of leukemia and from leukemia for radiologists, all other physicians, and for all white American males of the same age. He concluded that the mortality from leukemia was 3*5 times greater for radiologists aged 35-7^ than for other physicians, and 8.5 times that of all white males of similar age. These ratios axe somewhat less than the estimates of March. It was his impression that part or all of the increase in the leukemia mortality took place at the expense of the total mortality from all cancer, including leukemia, though he was unable to confirm this from the data available. The fact that all persons, with even more prolonged exposure to radiation or to chemicals, do not develop leukemia (for example, not all radiologists die of leukemia) suggests that for those who do not succumb, some condition or conditions "necessary" to leukemogenesis are not operative. It has been frequently suggested nhat presence or absence of a hereditary predisposition might explain some of the vagaries of the behavior of the disease in a human population, that is, that a "cancer diathesis" might be a necessary condition for leukemogenesis. From an article entitled "Epidemiology of Leukemia", b y Gilcin F. Meadors, M. D. API 07247 i J-3 DISC ;ION Cn "he basis of the clinical, laboratory, and pathological findings there -3n be no icubt that this case must be classified as an erythro-leukaemic type of oraenia. Here the initial blood picture was that of a leukaemia of haemocytcblastic -'haracter later to assume the morphological characters of a mixed-type anaemia in which primitive cellular types were accompanied, on the one hand, b y a moderate 'ember of immature d e m e n t s of the myeloid series, and on the other, by a consider able proportion of immature elements of the red series, until a leucoerythrogenic ratio of 0.33 was reached. Regarded then as a mixed type, it would seem from its particular characteristics of special importance from the aetiological and pathoge netic points of view. Thus, it does not appear easy to escape an aetiological relation between the work in which the patient was engaged and the blood disease which led to his death. Such a view is supported by the finding that a short exposure -o benzene vapour, for example, in the case reported by Loeper, Fabre, and Boreau, ^piiG, which was in contact with benzene for only six months, a period approximately the same as that in our case, can be the determining factor in such a type of anaemia. Moreover, the time of action of the agent, regarded as the toxic cause of the disease, rust be assessed with great care (unless the period was extremely short), bearing- in mind the fundamental fact, admitted b y all writers on the subject, that the lighting up of such types of blood disorder requires a particular constitutional predisposi tion. Since, in addition to the inhalation of benzene vapour, the process renders possible that of chlorine and of the finely divided, powdered hexachlorocyclohexane, these also might be suspected in the aetiology of the disease. But hexachloro-cyclonexane has up till now not been found to be toxic to man and the syndrome of chronic poisoning is manifestly of an entirely different kind from that described. Only benzene can be seriously considered as the possible aetiological factor, and its aarked toxic effects are well demonstrated not only in the fatal case described but also in the symptoms experienced b y the other workers on the process and their haeaatological pictures. As benzene is recognized as a toxic cause of leukaemia the proposed attri bution to benzene of the form of blood disorder manifested in the present case appears to be reasonable in view of its erythro-leukaemic character. Examination of cases reported in the literature after that observed by Delore and Borgomano (1928) leads to the view that benzene leukaemia shows diverse clinical aspects and the reactive manifestations of the haemopoietic tissues are very variable. Careful evaluation, however, of the lesions of the haemopoietic organs produced by benzene suggests that, starting from the typical picture of aplastic anaemia, a whole series of intermediate blood abnormalities leading ultimately to leukaemia is found. Thus from the varied bleed pictures emanating from the toxic action of benzene, the erythro-leukaemic myelosis of our case may be held to result from it and to have developed a particular aspect as a consequence. What may be the cause of the diversity of toxic effects produced by benzene, possibly provocative of aplasia or a proliferative process in the bone marrow, and what constitutes its mode of action are entirely matters of opinion and may give rise to many hypotheses but facts are not yet available. API 07248 i D References: Delore, P., and Borgcnanc, C. (1923). J, Med. Lyon, 9, 227. Hess, V. (1935). Frankf. Z. Pathol> k j , 522 lignac, G.O.E. (1933). Klin. Wschr., 12, 109. ........... (1928). "Krankheitsforcbung", 6.97; (1930), 8, 391; (1932), 9,^0 Lceper, M . , Fabre, R., and Boreau (Mme.) (19^6). 130, 706. Bull. Acad. Med., Paris, Melander, B. (19^6). Svensk. kem. Tidskr., 58, 231. Penati, F., and Vigliani, E. C., (1938). Vili Congr. Internaz. per gli Infortuni e le Malattie del Lavoro, in "Rassegna di Medicina Industriale", 9, 3^5* Slade, R. E., (19^5). Endeavour, k, 1^8 From an article entitled "Erythro-Leukaemic Myelosis in Benzene Poisoning, by B. Galavotti and F. M. Trois!. API 07249 I Tv BIBLIOGRAPHY KIRSCHBAUM: "Journal of Lab and Clinical Medicine'1, 32, p.729 (19^7) 2. WHITE: "Journal of Nat. Cancer Institute", 2, pp. 95-97 (l94l). 3. HENSEAN: "Journal of Nat. Cancer Institute", 4, pp. 513-522 (1943-44). 1. FURTH, BARNES: "Cancer Research", 1, pp. 17-22 (1941) 5. BARNES, FURTH: "American Journal of Cancer", 30, p. 75, (1937). 6. PERRY, GINZTCN: "American Journal of Cancer", 29, (1937). 7 . MCRTCN, MIDER: "Science", 87, pp. 327-8 (1938). 0. BUNGLER, W., "Frankfurt Ztschi.f. Path.", 44, pp. 202-271,(1932). 9. WHITE, MIDER, HESTCN: "Journal of Nat. Cancer Institute", 3. pp. 453-4, (1943). 10. LIGNAC, G.O.E.,: "Klin. Wochenschrief", 12, pp. 109-110 (1933)* 1 1 . KIRSCHEAUM, KAPLAN: "Science", IOC, pp. 361-362, (1944). 12. FURTH, BOON: "Science", 98, pp. 138-9, (1943). 13. KENSHAW: "Radiology", 43, pp. 279-85, (1944). 14. MIXER: "Radiology", 50, pp. 476-80, (1948). 15. LAW: "Cancer Research", 1, pp. 564-70, (1941). 16. ENGELBRETH-HOLM: "Cancer Research", 1, pp. 102-8, (1941). 17. MORTON, MIDER: "Cancer Research", 1, pp. 95-8, (1941). 18. KIRSCHBAUM: "Cancer Research", 2, pp. 840-5, (1942). 19. NEILSCN, GORMSEN: "Cancer", 4, pp. 387-97, (1951). 20. KIRSCHBAUM, SHAPIRO, MIXER: "Cancer Research", 13, PP- 263-8, (1953). 21. MORTON, ET AL: "Cancer Research", 11, 7, PP- 559-51, (July, 1951). 22. ARENTSEN, HCGREFFE: "Acta Path. et. Bio. Scand.", 28, pp. 201-6, (1951) 23. NEILSCN, HCGREFFE: "Acta Pathologica et Microbologica Scandinavica". 33, pp. 368-380, (1953)- 25. SHAY, GRUZNSTEIN, MARX, GLAZER: "Cancer Research", 11, pp. 29-34, (1951). 26. McENDY, D. P., BOCN, FURTH: "Journal of Nat. Cancer Institute", 3, PP- 227-47 (1942). 27. SHAY, GRUENSTEIN, HARRIS, GLAZER: "Blood", 7, PP- 613-22, (1952). API 07250  O x; KAX1AU: Cancer Research", 1-, pp. ;4c-l, (1954). I-CrRLAN, KTR3CEBAUM: "Proc. See. Exper. Biology and Medicine", 55, PP- 2o2-2-:4, (1944). XIRSCH3AUM: "Yale Journal of Biloogy and Medicine", 17, PP 163-84, ( U 85). GARDNER AND DOUGHERTY: "Yale Journal of Biology and Medicine ", 17, PP 75-90. <2 Ei'j-EL: "Journal of Am. Vet. M. A.", 93, PP* 387-88, (1938)- 33. MEYER: "Am. Journal Path.", 24, pp. 835-53, (1948). 31*- COCK: "Am. Journal Cancer", 27, pp. 267-78, (1938). 35. FURTH AND FJRTH: "American Journal of Cancer", 34, PP* 169-83, (1938). 36. ANDERVONT, DUNN: "Journal of Nat. Cancer Institute", I k , pp. 329-39, (1953). *n FURTH: "Acta Radiogica Supplementum", ll6, pp. 469-76, (1954). ' JM 38. LAW: "Journal of Nao. Cancer Institute", 12, pp. 1119-26, (1952). 39- BETTONVILLE, FINNEGAN: "Medical Bulletin of St. Louis University", 5, p. 158, (1953). ci. KIRSCHBAUM, STRONG, GARDNER: "Proc. Soc. for Exper. Biology and Medicine", 45, P- 287, (19^0). k2. WIDMAN: "Leitschrift fur die gesamte experimentelle, medizin", (Berlin), 117, PP- 227-236, (1951). ^3. QUATTRIN: "Minerva Med.", 2, pp. 149-51, (Aug. 1946). 44. MERLINI: "Pathologica", (Genova), 31, pp. 1255-57, (1939)* 45. BERNARD: "Sang", 8, pp. 28-38, (193*0. ko. NAKAMURA: "Gann", (Tokyo), 44, pp. 2-3, (1953). b l . AVEZZA, TOMATIZ: "Archivio 0; Patologica E clinica medica", (Bologna), 30, 330-8, (1952). 48. BERGMAN: "Frankfurt Zeitschrift fur Pathologie", 47, pp. 522-35, (1935). 49 EERNARD: "Annals de Medicine," (Paris), 40, pp. 220-30, (1936). 50. BURGER: "Klin Wchnschr.", 16, pp. 334-337, (1936). 51. YUDINA: "Medichnig Zhurnal", (Ukraine), 7, pp. 819-835, (1937). 52. DESSY: "Minerva Med.", 2, pp. 359-62, (1937). 53. STCRTY: 'Archivos per le scienze mediche", 64, pp. 24-32, (1937). API 07251 r 1 i>-ij 51. "Sang' 1 1 "; :_p. 7A 9-53, (1 =37;- 55. "Eulletin oc. Franc de dermot et Syph", mL, pp. 1198-1527, (1937). 56. STORTI: "Klin Wchneschr.", 16, pp. 1062-35, (1937). 57. PIKCVSKI AND DOLJANSKI: "Harefuah:, (Palestine), ll, Xi (1938). 53. GROSS: "Acta Haemotoligica", 13, pp. 13-29, (1955)- 59. HOLM, PAULSEN: "Acta Path, et Midro S Cancl.", 21, p. V 72. 60. FURTH AND FURTH: "American Journal of Cancer", 28, 267-278, (1936). 61. BURROWS: "American Journal of Cancer", 27, pp. 267-78, (1936). 62. NIELSON: "Acta Pat. et Microbiol. Scand. Suppl. No. 78", (1918). 63. RANK-NIELSON: "British Journal of Cancer", 3, pp. 519-56. 61. HAMAGUTI, YOSIDA, HAZYO: "Jap. Journal M. Science", VIII, (1939). SPECIFIC REFERENCES TO MAN AND BENZENE LIGNAC, G.O.E.: "Klin. Wochenschrief", 12, pp. 109-10, (1-21-33). RICHCN, VERAN, GIRARD, DEVIN: "Rev. Med. de Narey", 66, pp. 3^9-358, (fc-15-38). FALCONER, E. H.: "Am. J. M. Sc.", 186, pp. 353-361, (Sept. 1933) GA1AV0LTI AND TROISI: "British J. Indust. Med.", 7, pp. 79-81, (April, 1950). PENATI, VIGLIANI: "Rassegna di Med. Appl. Lavoro Indust.", 9, pp. 31*5-61, (Oct. Dec. 1938). PERRUS, KISSEL, PIERQUIN: "Paris Med.", 1, pp. 533-538, (June 25, 1338). API 07252 t APPEHEIX E To Minutes of 21st MAC Meeting RZFCRT CF THE SUBCOMMITTEE OH CARCINOGENICITY to ;iCAI ATVI5CRY CCTiMITTEE CF THE AMERICAN FETROIZUM INSTITUI R. E. Eckardt, M. D., Chairman The original objectives of the carcinogenic work at the University of Cincinnati were to survey various refinery streams for their carcinogenic activity and to study the chemistry of these refinery streams, in an attempt to develop a physical-chemical method which might permit the prediction of their carcinogenic actions. In addition, epidemiological work was to be conducted in order to attempt to determine whether or not there had been introduced into the petroleum industry in recent years any new carcinogenic hazards. In the course of the experimental work which has teen conducted to date on the various carcinogenic streams in the refinery and the analysis of the composition of these streams, it appears that the original objectives of this work have been somewhat modified. It now appears that these objectives, other than the epidemiological work, are divided approximately as fellows: 1 . oG$ of the effort is devoted to attempts to isolate and identify the various carcinogens and to determine their contribution to carcinogenicity of the various refinery products. 2. The remaining i+0# of the effort, other than the epidemiological work, is devoted to an attempt to isolate and identify the accelerators and non-accelerators and to determine their contribution to carcinogenicity in the various refinery streams. In this respect, the work at The Kettering Laboratory appears today to be of a more fundamental nature than it was several years ago, and possibly more in line with some of the fundamental research being conducted b y other committees of the American Petroleum Institute. Thus, for instance, certain work being sponsored by the American Petroleum Institute is in an attempt to analyze the chemical composition of the various constituents of petroleum which contribute to the lubricating properties cf petroleum, and also to determine the nature and characteristics of various nitro gen-containing compounds and sulfur-containing compounds found in petroleum. The work The Kettering Laboratory does is devoted to isolating and determining the con tribution to carcinogenicity of various pure compounds found in petroleum. The Sub committee believes that this change in emphasis is, nonetheless, justified as suffi cient reason for the support of the work at The Kettering Laboratory. ' As evidence of the progress being made by The Kettering Laboratory on the isolation and identification of the various constituents of petroleum which contribute to its carcinogenicity, a manuscript, which is attached, has been submitted by The Kettering Laboratory which they propose to publish in a eaneer research publication. The Subcommittee has reviewed this manuscript and, with minor changes, recommends that it be published in the journal of choice of The Kettering Laboratory. The epidemiological work is continuing, but has met certain difficulties in attempting to develop the occupations which are involved in the petroleum industry. API 07253 ) eser. --lire a ^ii ^--<"* =-ideniolcgicai st C 09 'from the adzached ~ *z cr z Dr# ~h2.i r ths.~ zr. z b :. s z u iie s are net 5'" ' l i z z i e hope c f o f fe r in g in t! r t l*93UjvSa The 5uCCC -3 lt"9 5 re-er.d crses the im portance c: ical studies cut believes the tine has ccme to reorganize the ies either at Kettering Laboratory or elsewhere. Due to an artificiality in the budget situation .oh occurred ir. the oji-1955 budget, The lettering Laboratory is experiencing sene difficulty in remair.- within the budget this year. They have requested that a special appropriation cf $5,3CO be cade to its budget this year, in order tc correct this artificiality ,,hich has occurred on the past. The proposed budget for the interval July 1, 1957 - June 30, 1953 free The Kettering Laboratory is attached. The Subcomcittee cn Carcinogenicity recommends to the Medical Advisory Committee: 1. That the manuscript entitled, "Carcinogenesis cf the Shin. II. Accelerating, Promoting, and Preconditioning Effects of Aliphatic and Related carbons", by A. Wesley Horten, Dorothy T. Denman and Ruth Pierle Trcssett, be tv the Medical Advisory Committee and the Medical and Health Committee of the for publication in the periodical cf choice of The Kettering Laboratory. The Hydro cleared Beard ... 2. That an ad hoc ccntributicn of $5,300 be made to The Kettering Tboratory this year in order to meet an artificiality in its budget created in 195^-1955. . 3. That the Medical Advisory Committee solicit the participating companies for contributions to the work of the Subcommittee in the anaunt of $53,000 to be divided as follows: a. $ 15,000 for the epidemiological work b. $38,000 for the chemical and biological work at The Kettering Laboratory k . That the abstract submitted by Dr. Horton be cleared by the Medical Advisory Committee and forwarded to the Medical and Health Committee of the Board for their clearance for publication. ' V23/56 API 07254 APPENDIX F To Minutes of 21st MAC Meeting SUBCOMMITTEE CM ECONOMIC POISONS REPORT TO A.P.I. M.A.C. J. W. Osborn, M. D., Chairman The above committee met in the Rittenhcuse Room, Warwick Hotel, cr. Sunday, Arril 22, 1956 at 9:00 A. M. with the following subcommittee members present: Dr. J. W. Osborn, Chairman Dr. C. H. Hine Mr. J. W. Hammond, Appointed Secretary by the Chairman Sixteen others, including medical and technical advisor members cf the yA.C and guests, were present. The Chairman submits to the retort of that meeting: MAC, for its approval, the following I. Poison Control Centers The subcommittee voted to continue to circulate to Medical and Technical Advisers of the Medical Advisory Committee the latest list of poison control centers on a continuing basis as new centers are activated. I I . Kercsjne Poisoning Problem During a thorough discussion of this subject it was brought out that Dr. M. N. Nevquist, one of the three Representing M.A.C. Members on the A.P.I. Inter divisional Committee on Labeling, had a specific recommendation to rake to the M.A.C. regarding a Labeling and Educational Program for Kerosine Poisoning. The subcommittee voted to defer action until the subcommittee could meet with Dr. Nevquist and his group. Dr. Curtis, Chairman of the M.A.C, advised the subcommittee that the Operating Subcommittee meeting later in the day would consider appointing Dr. Nevquist to the Subcommittee on Economic Poisons which would result in consolidating responsibilities for furthering the kerosine poi soning problem under the Subcommittee on Economic Poisons. Dr. Osborn and Dr. Hine, following the appointment of Dr. Newquist to the subcommittee, met with him. These three, representing a quorum of those present, approve the following recommendations to the M.A.C.: l) The submission of the FROPOSED RECOMMENDATION FOR CONSIDERATION BY THE MEDICAL ADVISORY COMMITTEE API as contained in letter of April 23, 1956 (copy attached) to Mr. M. D. Gjerde, Chairman, Interdivisional Committee on Labeling, from Dr. L. E. Curtis, Chairman, M.A.C. API 07255 2) The submission of the ECPCSZD^LETTZR PCR CONSIDERATION 2Y TEE MAC dated April 23, l?5o, Subject: Kerosine Poisoning Among Chiidr n - Educational Program (copy attached) to Mr. D. I. Staples, Chairman of the Medical and Health Committee, rom Dr. 1. Z. Curtis, Chairman, M.A.C. The subcommittee approves any revisions in the above two proposed lette Curtis and/or Mr. Streep believe necessary for the sake of clarity and The Chairman moves that the M.A.C, approve this report. API 07256 April 23, 1956 PRCFC5ZD RECOMMENDATION FOR CONSIDERATION BY THE MILICAL ADVISORY COMMITTEE API Mr. M. D. Gjerde, Chairman Interdivisior.al Committee on Labeling API Standard Oil Company (Indiana) 910 South Michigan Avenue Chicago 80, Illinois Dear Sir: It is the recommendation of the Medical Ad visory Committee of the API that the Interdivisional Committee on Labeling should prepare an appropriate precautionary label for kerosine. For your information, a copy of my letter of to Mr. Staples, Chairman of the Medical and Health Committee of the Board, is attached. You will note that the MAC is in favor of an education al program including labeling as an aid in minimizing kerosine poisoning among children. Very truly yours, L. E. CURTIS, M.D., Chairman Medical Advisory Committee API API 07257 r ) April 23, 1956 FRCF05ED RECOMMENDATION FOR CONSIDERATION BY THE METICAL ADVISORY COMMITTEE API Mr. M. D. Gjerde, Chairman Interdivisional Committee on Labeling Standard Oil Company (Indiana) 910 South Michigan Avenue Chicago 80, Illinois . API Dear Sir: It is the recommendation of the Medical Ad visory Committee of the API that the Interdivisional Committee on Labeling should prepare an appropriate precautionary label for kerosine. For your information, a copy of my letter of to Mr. Staples, Chairman of the Medical and Health Committee of the Board, is attached. You will note that the MAC is in favor of an education al program including labeling as an aid in minimizing kerosine poisoning among children. Very truly yours, L. E. CURTIS, M.D., Chairman Medical Advisory Committee API API 07258 ) ETTZR FCR CCNSIZZRATICI? BY THE MAC - APRIL 23, 1956 Copies to Members KEROSINE POISONING AMONG CHILDREN EDUCATIONAL PROGRAM Mr. D. T. Staples Chairman of the Medical 1 Beard cf Directors, API Tide Water Associated Oil 79 New Montgomery Street San Francisco 20, Calif. Health Co. Committee Dear Sir: The Medical Advisory Committee of the API is seriously concerned over the increasing number of reports in medical jour nals, newspapers and magazines, of deaths among children from drinking kerosine. These reports show that kerosine is responsi ble for approximately 25 per cent of the accidental deaths from poisoning among children under 5 years of age in the U.S. (See Exhibit I). There is growing criticism, from various quarters, of the petroleum industry for not taking cooperative action towards solving the aforementioned problem. The Council on Pharmacy and Medical Association in its report in Medical Association for December 17; statement: Chemistry of the American the Journal of the American 1955; makes the following "In the absence of federal legislation to safeguard distribution of household articles, such as kerosene and other petroleum distillates that are serious offenders, consideration could be given to enactment of such legislation so as to protect the public. In addition, physicians and lay groups should work for appropriate state laws to strengthen the federal laws and to bring about correction of their special problems as found within a state. In this connection consideration could be given to a law restricting the sale of kerosene other than in a special container, which would prohibit the use of any other type of container. In addition, such con tainers should bear informative warnings as to the poisonous and combustible properties of kerosene and like substances. A suggested caution label is as follows: API 07259 ) T. Staples WASHING Kerosene is flanmable and nay produce dangerous explo sions. If it is swallowed, it nay cause fatal damage to the lungs. It should be kept out of the reach of children and should never be put in beverage bottles, glasses, or cups or left in unlabeled containers." The State Health Department of Arkansas has initiated an educational campaign to reach all persons concerned and particularly families using kerosine, petroleum distributors, physicians and other interested groups. (See Exhibit II). Dr. H.A. Carithers reports in the September 10, 1955 issue of the Journal of the American Medical Association concerning investiga tions that have been made on the kerosine hazard among children in the State of Florida. (See Exhibit III). Another report from Dr. A. Bradley Soule, Jr., of Burlington, Vermont, reveals that the same problem exists in their part of the country. Obviously, this is a nation-wide problem. The American Academy of Pediatrics is urgently recom mending that positive steps be taken in connection with this problem. Some organizations which are actively concerned with the poisoning problem in general and which would welcome coopera tion and support from the API to the extent of its interest in the matter are as follows: American Academy of Pediatrics American Medical Association American Public Health Association Health Departments (State and Local) National Safety Council State Medical Societies U.S. Public Health Service Since materials other than kerosine and petroleum dis tillates are also involved in the poisoning problem and since the principles of prevention apply generally to all toxic or poison ous materials, it would seem appropriate that some suitable organization other than the API should undertake to spearhead or coordinate an educational program for the prevention of accidental poisoning. CONCLUSIONS While the Medical Advisory Committee is recommending to che API Interdivisional Committee on Labeling that it prepare a API 07260 \ I -0- -- .5-3O suitable precautionary label for kercsine, it is the opinion of the Xeileal Advisory Committee "hat labeling aione is not the answer to the problem because the victims of kercsine poisoning are toe young to read. It is primarily a matter of educating the parents in the safe handling of kercsine so they do not leave it in cups, bottles or other containers readily accessible to small children, labeling is a part of the educational program for prevention of accidental poisoning. It is recognized that the problem is a continuing one and that an educational program will be most effective if it is directed towards all groups concerned and with their active par ticipation. The petroleum industry has an opportunity and a re sponsibility to participate in a constructive program towards eliminating the misuse of kerosine and ether petroleum distillates and thereby save lives. EECCKMENEATIONS CF THE MEDICAL ADVISORY COMMITTEE 1. That the API agree in principle to par ticipate in a broad educational program of which labeling shall be a part for the prevention of accidental poisoning to the extent of its interest in the subject. 2. That the role of the API in such an educational program be developed jointly by the MAC and other API committees inter ested in this subject in close collaboration with the API staff. 3. That no API funds be allocated at this time for such educational program. (A full report with findings and recom mendations will be submitted by the MAC to the Medical and Health Committee of the Board for their review and approval before any commitments are made or funds requested for support of an educational program). I would appreciate a reply at your early convenience as to the action of the Medical & Health Committee of the Board with respect to the above recommendations. Ve:y truly yours, API 07261 L. E. CURTIS, M.D., Chairman Medical Advisory Committee API ) J w Meet of meeting m a c s u b c o m m i t t e e o n p h y s i c a l , a g e n t s Lanscn Sianey, M. D., Chairman The significance of ncise and hearing loss in the petroleum industry was discussed. ?. D. Halley gave a special report of noise exposure in a refinery. Of 5,110 employees, 6,COO operating, approximately 3000 of this latter group were probably exposed to significant ncise, at one time or another. In the course of general discussion, it was indicated that obviously many persons in the petroleum industry (especially the crafts) are exposed to levels of noise which may be harm ful, although relatively fewer than in certain other industries. Instances were cited where suits had been brought for hearing losses. One plant initiated a hear ing program after an expensive case, realizing that they were vunerable without studies of exposure or pre-employment baseline audiograms. The possibility that suits might e.rise which could not be evaluated adequately at the present stage of knowledge in regards to the relationship between exposure and hearing loss and the difficulty in advising on definite cut off levels of allowable noise for new equip ment or instituting a program of worker protection points up the need for basic research in noise and its effects. The Subcommittee on Noise in Industry (Dr. Howard P. House, Chairman) through its research staff (Dr. Aram Glorig, Director) in Los Angeles is and has been the foremost organization in America engaged in this work. It is generally looked to for further development in the field. your committee had been asked to evaluate two requests from the Committee on Noise in Industry for API support. The first was for $5,000 to pay the entire cost of a project to evaluate the relationship between head injury and hearing loss. The second was for $30,000 to support part of a $100,000 annual budget for basic research in noise problems: 1. Evaluate relationships between long exposure to noise and hearing loss. 2. Establish relationship between speech intelligability and pure tone audiograms in determining disability due to impaired hearing. 3. Study effectiveness of ear protection. k. Provide data upon which to establish safe levels of noise exposure. 5. Evaluate auditory recovery following noise exposure. 6. Provide controlled methods of procedure for obtaining reliable data from industry. 7. Maintain a center for compiling and analyzing data. 8. Study of individual variations in susceptibility to noise. On the basis of the fact that the former proposal was of a highly specialized nature for the most part unrelated to the petroleum industry, it was voted not to recommend appropriation. In the case of the request for $30,000, it was noted that this was 1/3 of an annual budget to study a nationwide problem. Since petroleum employees constitute only 31> of the non-agricultural total, it was felt that the amount requested was not in proportion to the number of our people potentially effected. Therefore, this request, too, was voted down. However, your subcommittee felt that ncise levels and hearing loss were problems involving many persons in the industry for which there were not fully satisfactory answers. Therefore, on the basis of the previous discussion and the recognized importance of the work being performed by the Committee on Noise ia Industry, it was voted to recommend that the API should make available the sum of $5,000 in unrestricted funds API 07262 _3 . ) .sis while rch 'ey the foresail committee, this amount to be renewed on an annual need was apparent to us and the results of research significant. In order to further determine more specifically the extent of significant oi.se exposure in the petroleum industry, it was proposed that a relatively simple -ethed of making an area noise survey and enumerating those exposed be worked out cy the committee. This data sheet would he made available to MAC members who could ohen check their own organizations. This would be enlightening to these individuals `-"e survey and the total information would serve further to elucidate the r.dusory- wi de situat ic n . The Significance of Radiation Exposure in the Petroleum Industry - Including X-Ray and Varying Radiation The petroleum industry is one of the largest users of isotopes. While the use of the latter is controlled by AEC requirements, radium and x-ray are generally not supervised by the government. California and Kev York, however have passed regulatory lavs, New Jersey and Pennsylvania have them under consideration and the Federal government (AEC) and National Bureau of Standards have proposed :'r.odei" lavs to safeguard those working with these agents. Insofar as possible, they would leave detailed control to industry. A general discussion brought up the facts that hundreds of people in petroleum are potentially exposed. Control of x-ray and radium sources has been found to be lax in several instances. It was felt that the subcommittee could contribute to the understanding of its members and oo the safety of employees by making available information on the use of radio active materials in the oil industry and adequate methods for their control. Nathan Van Hendricks presented an excellent review paper entitled "Some Potential Sources of Radiation Exposures in the Petroleum Industry and Precautionary Programs", copies of which will be made available to members. API 07263 r \ / j* Ji/lX ~4. TT z Minutes Z i --- 3 -- ^ r* r 'TD . CF STBCCKMITTES :i-T TCMICOLOGICAL RSVI5W5 Marshall Clinton, M. D.; Chairman The Subcommittee cn Toxicological Reviews believes that the published toxicological reviews are losing some of their usefulness because of the fact that nest of the reviews are eight to ten years old and have not been brought up to date. It is unfortunately a fact that all of the reviews will lose ouch of their usefulness if even a few are discredited by reason of omission of newer data or inclusion of data which have subsequently been shown to be in error. It is therefore recommended that all of the reviews which have been published be critically reviewed by an authority outside of the petroleum industry, or revised or rewritten where indicated. Reviews on subjects which are now covered by the Manufacturing Chemists' Association, American Standards Association, or American Industrial Hygiene Association could be eliminated. It is recommended that the necessary review and revision be undertaken by or under the direction of a suitable authority, the necessary financial arrangements to be worked out between that authority and the Operating Committee. API 07264 To Minutes cf 1st l!A C Meeting RZFCRT CF THE SUBCOMMITTEE ON DERMATOLOGY Leo J. Wade, M. D., Chairman p: Dermatitis Survey April 23, 1956 The following members of the Joint Committee met at the Mellon Institute on March 28: Messrs. R. M. Landon, K. G. Mackenzie, D. G, Froudfoot, M. D. Gjerde, and Dr. L. Wade. Members of the Institute staff present included Doctors C. R. Walmer and D. Braun, and Mr. Schrenk. Attached is a copy of the report submitted by the staff. This was discussed at length by the members of the Joint Committee present, and no exception was taken to the general progress of the study. Dr. Braun felt that a final report could be made by September 1. He indicated further that data now present had stimulated M m to ask a number of questions which might be clarified only by an extension of the present study. The question of soliciting funds for a continuation of these studies was discussed. It was agreed that it was too early to decide whether or not it was desirable to continue these, or other studies. It was agreed, however, that a request for funds should be made in due course so that they could be collected if authorized b y the Board of Directors if a continued study was approved by the Medical Advisory Committee and the Lubrications Committee. API 07265 * U R I A L HY3IS:E FC UNTTIG II CF AMERICA, INC. Gelier. Institute, +-C0 Fifth Avenue Pittsture 13, ?a. March 28, 1956 Interim Report to American Petroleum Institute Re Dermatitis Survey In earlier progress reports, dated October 6, 1955 and January 16, 1956, were set forth the methods developed for planning, preparing and executing the study. The construction of the sample of industrial plants was described and the technique of collecting data was outlined. Some of the difficulties encountered in casing contact with the cooperating plants were mentioned. In addition, the most recent of these reports included the numerical and geographical distribution of pianos and employees constituting the sample, and noted the delay of approximately cr.e month in the original schedule, due to circumstances explained therein. Since the date of the last report, a considerable number of individual case data records have been received from the plants in the sample. All those dealing with cases arising prior to January 1, 1956, were considered only as a check on our methods and forms. Such records consisted of scattered reports covering 29 cases arising over a six-month period in eleven plants. In studying these reports, cur biostatisticians failed to discover evidence of fallacies or deficiencies, either in the forms which were designed or in the methods used in collecting the data. Beginning with January 1, 1956, reports of individual cases of dermatitis received from the cooperating plants have been recorded as received and then turned over to the biostatistician for coding of the information contained. A part of this information deals with a description of the lesions present and their location on the body. Although the cause of the dermatitis is also given, each data sheet will be studied to determine whether the type and location of lesions is consistent with the diagnosis given, and with the type of exposure noted. The plant data as collec ted on our form No. 1 for all plants in the study were turned over to the biostatis tician for coding and the preparation of the master information sheet regarding the sample. In this, the type of industry, number of employees, sex distribution, main categories of exposure and other pertinent information will be available. A record of the receipt of data from the plants indicates that for the first three months returns have been quite inconsistent. Some have reported regu larly but many have not. For this reason, a letter was sent to all participating plants thanking them for their cooperation to date and calling the attention of those who were delinquent of our failure to receive reports from them. As stated in the previous reports, contact was made with the health departments of the states in the geographic areas represented. As anticipated, the data from this source has proved unproductive. Some states failed to reply; at least ore has no data available, and the data from one state is obviously very incomplete. API 07266 ,0 ate? we have r.ct attempted to evaluate records potentially available from insurance companies ar.d from physicians in the private practice of industrial griatolcsy. The Bureau of Medicine and Surgery of the Department of the Navy receives -cr.thly from its r.cre than 100 installations, reports of all occupational dermatitis 5-eng about *00,000 military and civilian personnel. As nearly as possible, the causative agent in each case is noted. At a conference with Captain Sessions and ;onnander Siegel, the Bureau granted us permission to analyze this data for purposes cf comparison with figures from our selected sample of industrial plants. From a statistical standpoint, these figures cannot be lumped with the others, but they -.ill provide a valid and very useful comparison. It is understood that some of the >_vy installations lack ideal reporting, but very good reports can be expected on approximately 200,COO persons. These data will serve as a basis for comparison with those on about 125,000 people in our pilot study, of which perhaps 100,000 will be production workers. Discussion The progress of the study to date appears to be satisfactory in that the sample which was selected by random choice satisfies the statistical requirements of geographic and size distribution, covers a sufficient number of employees, and represents a broad category of exposures. Cooperation from these plants was excel lent when a personal visit was made. Although early reporting has been somewhat inconsistent, it is believed that the failure to receive reports will in most cases be shown to be due to the fact that no dermatitis was encountered for those periods. In any case, the reminder letter will probably produce results. We believe it has been confirmed that a study covering six months from the date of the visit was a wiser choice than any attempt to study the incidence of dermatitis in retrospect. Our earlier conviction that sufficient data could not be ob tained from state and local health departments seems likewise to have been justified. We expect only confirmatory data from insurance records and dermatologists' records but will include such as can be obtained. A very important and valuable source of comparative data will be obtained from the records of the Bureau of Medicine and Surgery of the Department of the Navy. At this 6tage of the study, the conclusion seems justified that meaningful information relative to the incidence of occupational dermatitis due to petroleum products will have been obtained. API 07267