Document vVKrx1wng1Jg9k2yQKrE65aZZ

Jana , iys LEAD KTOTPg simr Bcurra >o. 1 To tha jlwfein of tha Load Xndoatrlaa AuodtUan HEALTH KABTDtAKS B LEAS BS0S3UM In addrtaa with tha abort titla, dallrarad by fir. C. Richard VKlwar, HanaclnK Brtotor of tha Industrial Hyglans foundation, Flttabaxth, at tht imal Mtii of cnr Association In April, Included wocb that vaa worthy of ttrloot ooeddaratlon bp all who ara eonearnad with hit aobjact. rcr theta toe did not batr Sr. Valaar, td >. , at a rwlndtr to thoaa too did, bit paper baa baan reproduced and a odjjy la anoloaad. . Additional ooplaa art arallabla on raobaat. iy ;.,:> ' : ./ ' y.r^yv., - y^y.. ` - ' -?**' IXD06TSZU BOISE lb thoaa faoad with tha pretloa of lndoatrlal nolaa, tba alnglaobaat broad- * ride on lew Ear and Holaa* alao herewith, aaeurad throoch tha eeurteay of tha Ite- rtareh Cantor of tha 9bboo*dttae on Vole# in Induetry, Ill Xorth Brat Street, Lee Ancalae 26, California, wUl be of lnteraet. An excellent 2L-pa*a booklet with tha titla *Ooida for Conaarratlon of Earrlnc An Volaa,* la to ba had in quantity fro* tha aaaa organisation at Mil ooet. Vblla tha 11*1tad eopply laata, ein*la ooplaa will ba aant fro* thla offlea, without charts, on request. Uiat la ballarad to ba tha aoat eoqjrahonelTe and np-tO'date go thla subject la tha Sndoetrlal Volta Htaoal Juet pobllahad by tba Aaarlcan lndoatrlal Rjtlana Association. Thla 192-paf# rolune, wall indexed, la prlead at i?.5&. Coplaa d^oold ba ordarad fro* )tr, Oaorta 0. Clayton, Exacotlra Secretary oftbe AtUl^ti 11425 Errroet, Detroit 27, Klchltan Manfred Bowdltefc Mreotor of Haalth and Safety HEALTH KAPnTSAMCt HI LEAD TKDPSTKIESe C. Richard VilMr, K, D. Managing Diractor Industrial Hygiene foundation Halloa Institute,' fitteburgh, fe. Health Maintenance In ary Industry la ocntingant upon the practice of prereo- ; tire Medicine, and requires the nesting of problcM in tha precllnlcal* stage, the si lntnation of haiards before they can Inflict Injury or lllneas, and the teanwork . cf specialists in several professional fields. , The lead Industry offara a deaeic axsag>ls of the laportanee of thla ap^ j proach. In aany placea there land or lte cwpocnda are uaed there la potential ha- _ xardoua exporare, yet nost each lnduatrlea operate eafely by utilising effect!re control Manures. Toxicity la not eynocynoua vita batard where the Mdlcal, en gineering, and supervisory pereonnel work together to provide an affective oontrol ;; progress. &nrlronMntal factors and Mdlcal flpdlngs go hand In hand in datemining wtether an actual hasard axlata. Dlagnosla of lead poisoning la a cosg^lex procedure/ and cannot be baaed on eyif'toM alone, since theee can be Misleading unless differ- * _ entlated froe other disease entitles; nor can an occupational history of potential exposure be confining In itself. The txaninlng phyelclen met bare a detailed " knowledge of the Individual prooeaeea and operations end their potential basarda and ;requlrecants. Ha depends on the industrial hygienist for.an evaluation of the working ervlrornent and lrfomation on the Mgnltudo of exposure. Thla lnfomatloo and the occupational history, coupled with clinical findings and with accurate la boratory analyses, enable the physician to stake a proper diagnosis. The diagnosis. In turn, gives the engineer a basis for evaluating the effectiveness of control Msauree and pin-points areas where further steps Hit be taken. The sane Interrelationship of ectlvltlss anong the various specialists la the Industrial health flsld prevails not just there lead poisoning la concerned, but with other health hasarde as wall. -' |St? VC'1* And, as tha Director of Health and Safety of the Lead Industries Association recently pointed out, the health Mlntenance prograts In the lead Industries met so- ' .coapass Mrs than laad poisoning. In a breakdown cf hasarde other then lead to which ' workers In principal occupations involving lead nay beexposed, Mr. Bovdltch listed ' as nary as 10 health hasard* In certain operations. m Lead poisoning la, of course, of primary concern. Therefore, control of thla problan will be discussed to Illustrate the Ideal approach to health Mlntenance la Industry, Presented at tha JOth Annual Hasting, Lead lnduatrlea Association, 8t. Louis, Mo., April 15-16, 1?S . . _____ * ________ . . - . . C, Richard Vainer, K. S, 2- Health Maintenance la Lead Induatriee Patendninf Sources af Haxardous Exposures The probleo of lead poisoning met be studied from a rraj**r of distinct but related viewpoints. Since prevention la the goal, we need to know flret how lead la absorbed by the body end what the principal sources of lead exposure arw llk'ly to . be. The aala source of lead absorption In Industry 1* through inhalation at air* borne lead co^ouada. .^ .. The handling of lead co'q'ounds, then coa^poeed of oxide*, baalc carbonate, sulphates, elllcatee and arsenates, aay revolt la a lead haiard due to the lead doet disseminated Into the air dorlag each operations aa blasting, crushing, grinding, mlwing and aaadlag. .'*? load fumes becone a problem la such operatlona aa mtallalng, lead burning and anal ting aad reflalag at temperatures orer $OQC, Lead nlat my occur dorlag apray painting with palata containing a high land content. Absorption of load through the eJrln la the noat eerloua baxard connected with, the handling at undiluted eolutlons of tetraethyl lead in its mnofaotora aad la plant# where It la Mixed with gasoline, although this organic load ccwgxtand could al- oo produce haaardoue repore at room temperatures. *. fcreelght la fedaeerlag Dealgn ----- .T Vf^.f '^ .-rr It' .' - - !' - '-4'V . -.. - . %. t : V.,-. >.f . - ; ' *< -i '..' ..k ' -.-#> *vji'*r- 4' . :1&- %*t Control of health factora la aay typo ot Industry la mat offectlrely and economically eceospllahed by proper plant design. Anted with the knowledge of how an Industrial contaminant la taken Into the body and at thlch industrial operations > there la potential exposure, the engineer caa darise Means to eliminate the hazard ous situation or, there this la not entirely possible, to Incorporate control mea sures. In the Industrial hygiene and air pollution field studies which Industrial Hygiene Foundation bee been asked to conduct for lta member companies a definite and encouraging trend can be noted to make health protection an Integral part at opera tions. In one typical Instance the Foundation*# staff was asked by a primary metal producer to Incorporate Into the design of a new plant control of health hatard*. rrocaas equipment and plant layout and construction were redesigned to lillmlnate or Minimise hatardoue exposures. These changes lncreaeedth* coat of the plant, taVv provided firm basis on which to Institute end Maintain an affective hygiene con trol program quite beyond the practical poeslbllltles of the old plant. The Money expended on health Matures will be more than offset by savings la compensation coats and by more efficient production, assuring the company a better position la a highly eo*q>eUtlve Market, .'-M-.-.'- A Ideal aa it la to design adequate health measures into our plants at the f- tart, often we are faced with adapting controls to existing facilities. Hot only met contaminants be removed from the working environment but they must bo collected e to that they do out create a comnunity air pollution problem. On* of tho beat examples of the preventive approach in thia reapect la the eeaeanal air pollution eurrry which haa been conducted continuously by the Foundation for nor# than 20 year* for St. Joaeph Lead Company. These etudiea enable the company to appralae lta re* eponalblllt7 with resard to the eomunity air pollution problem, lhay alao aerve aa a baae line for corrective engineering sseasuree... A alallar approach was taken for a chemical company even before lta new plant waa built, and theae studies are continuing /early. Suppleaor.tlnj Engineering Control of Haaarda . i* Where exhaust ventilation cazuvot coepletely renova contaminants from the air before the/ reach tho worker, protective equipment and clothing ahould be employed. ReapIrator/ protective devicoa ahould not be considered a eubatltnte for control equipment, tut certalnl/ Aould be utilised aa a temporary expedient or during la* fre<jucnt maintenance operations. Occasionally It aa/ be Imperative to rotate worker* to reduce Individual exposure tine, but this la a poor substitute for actual control , and contradictory to the concept of health maintenance. , ' '.0'- Worker# should be adequately lnetructed and suparvlsed In the proper haadUi 9 of lead ccspounds and li^reesed with the Importance of good personal hygiene. pro-iJ*fc`-" per locker, ahowsr roon and lunch roon facilities Aould, of course, be provided.. Seedless to aa/, good housekeeping In the plant la essential alao, end swathe per*;;;- formed In mch a manner that dusts are picked up, net stirred up and rsdlsssmin ated.^:- 7he Preventive Hedlcal Program ,_v, . - '-.to -i' - 1R conjunction with the control measures for reducing exponre, It Is esaeo* tlal that a sound medical program be carried out with respect to the workers them- ^" selves. Even with the most efficient system of control, csees of lead poisonlrg could still occur unlaaa there Is strict medieel evpervlslcn and continuous education of employees. In addition, such supervision furnishes -the final evaluation of the effectiveness of th engineering measures. lbs basis for the preventive medical program Is the physical examination, the preplacement examination Includes a record of peet occupational history end pest medical history In addition to the actual examination Itself It assure* that an ; ' applicant will not be placed cc a JobOiieh would be hasardous In ths light of his present physical condition. Periodic examinations are particularly iaywrtant in the lead Industry, The/ serve not only to indicate absorption of lead but may uncover other diseases. Kedieel records are an essential part of the medical program and provide a valuable source of data for statistical analyses and evaluation and era also India* penelbl* in medicolegal action. [' The Clinical Diagnosis of lead Poisoning Certainly In the detection and diagnosis of lead poieonlng the clinical hlftory 1* n lrjortent first step. The physician's diegnoele wist b based on care ful nodical appraisal of tho whole patient. The typical symptom* of leed poisoning coulo actually be Indicative of other disorder*,. such a acute appendicitis. loo often vditn a patient believes be has boeo exposed tc lead'Cor.tcmlr>ants--when in reality his occupational hlatory in this reepect nay be negative---the eoncluslon nay be reached b7 e physician not familiar vlththe occupation or its htrends, that the physical finding* are attributable to his work. Rot only can each false conclusions result In medicolegal problems, but they delay proper treeteent of tbs patient's trus illness. ^ lbs Most frequent clinical picture of lead poisoning is ths gastrointestinal type, idiich Is characteriaed by intermittent ahriotrlnel pain, crops or colic. less frequent la ths neuromuscular type, which is characterised by weakness or petfeaps paralysis of extensor musclos of ths foresni and hand* lbs first step in the treatment of lsad poisoning is, efoouree, tharamoval of ths patient fro* further lead exposures. Ones s diagnosis of load poisooW has been definitely established, the physician can proceed with ths proper trsstasnt to relieve the specific symptoms in each ossa and to cope with ths disease lteelf*,, Environmental and Biological Keasurswewts To make a clear-cut diagnosis of lead poisoning the physician must b*v sup porting svidenca fro* anrlronnental measurements, laboratory tests and a conclusivs history of exposure. Quantitative dateruination of ths concentration of lead in the air at opera tions share there la potential exposure should be dons routinely by the Industrial hygienist. In air saxpling, consideration east be Riven to variable environmental fac tors. A knowledge of the principles Involved in both sailing and analytls is re quired and the choice of method* depends on ths situation and ths purpose. Different enpllnR proce&ires are used for collecting the three feme of alr-bome lead--vapor, funs and dust. The sotlrltisi of individual workers within an ares must bo taken in to account, since exposure can vary within a snail ares depending,on the nature of the work end the earner In which it is carried out. the duration and ths Intensity of ths exposure enter into the picture also. Biolngloal measurements of lead absorption by exposed workers should .bs a part of the periodic physical examination for workers in betardous operations. Tbs results can be helpful in arrivir* at a diagnosis. Blood or urine analyses nay be used tc supplement sir analysis to obtain a acre direct and precise aeature of leed absorption. Meticulous cars must be exer cised in obtaining a*l*rials for examination to avoid contamination of the sesplea. Q C. Richard Vainer, K. D. -5- B*lth Maintenance la Lead Industries The choice of the analytical method Itself depend* on the kind and miaber cf saaples to ba analysed, rang* of load concentration* antic ip*tad, and milability of equlp ant. The epectrograjhlc, tha chenlcal and tha polarographic method* each her* their Merita and thalr disadvantage*. Sufflcs to *ay bar* that *uch laboratory studies raqulr# a high degra* of knowledge and skill. Hie results saist ba proparly lnterpra1.. tad. for example, there 1* no speciflo level of lead concentration In tha blood la *lngl* tt which la diagnostically significant In Itself. However, concentrations In axoess of 0.08 Mg. par 100 grans cf tfaole blood ara considered to m within an , unaaf# rang*, and renoral fron exposure or improved control measure* should ba inetltutad. Value* within th* upper rarg* nay Indicate a causa and affect relationship between lead absorption and nonspecific symptomatology. Likewise, there la no specific level of urinary lead excretion tfclcfa can ba interpreted as Indicating lead poisoning. A value of 0.15 Mg. par liter la usually accepted as an upper safe Unit. However, concentrations considerably In excess of V- this have been found In the absence of aay significant evidence cf lead poisoning, and evidence cf lead polsonirg has existed in other case* despite concentrations be low this level. Again, single results do not have diagnostic assnlng* Repeated analyses, noting trends, and th* findings In a group of exposed persons reveal mo t s significant Information on tha Magnitude of exposures. This discussion la by no naans a cotpilete picture of the problem of lead poisoning In Industry or of tha health Maintenance program In general.*' X hope that , It has served to point out tha need for teaxwork aaeig Industrial health specialists *' 9 la all fields, and the fact that each group has a responsibility ifclch overlaps that In another area. These areas are* 1. evaluation of tha working environnent| - -V* A 'I'-fi*!. 2. -engineering control) 3. preventive nedeal pregrtaj It. analytical testa) j ~ 5. health otacation of employeetj 6, good housekeeping) and 7 good personal fay* ' fch glens. % s* Most Important of all la tha Interest and support of Management, without idileh the industrial health actiritlss cannot be welded together Into a positive health Maintenance progran. r; l if 3 HOW MUCH HEARING LOSS DOES INDUSTRY BUY? pc>n.AcoNT mco*os s h o w * YOUR ERl (US-COUMITTtt ON M ON c o n : AMUOON ACAPCMY O NOISE-INI ON ANY GIVtN OA DAY I OUT OF EVERY 4 WEN HAS IMPAIRED HEARING WHEN HIRED! ONLY PRE-PLACEMENT AUOIOMETRY III REVEAL THIS AND PROPERLY ALLOCATE ' RESPONSIBILITY THIS LOSS IS TEMPORARY-- it iii orrnvro ' . . . , . ' .S**; , WHY IS THIS IMPORTANT? TEMPORARY LOSS CONTAMIN ATES BASELINE AUDIOGRAM - ` AND MUST BE CONSIDERED BEFORE EVALUATING PER MANENT HEARING LOSS. RrSHAftCH CT7VTI * AUB-COMMIVn r ON NOISa IN INDCOrifcY III HOPTH WON.vn. MAC *T LOS ANOl.Ua 14, CALlf, * R AND NOISE ar c h c ent er IN *OViT*Y. or M COMMima ATION Of HtARINO f-j ,OQt AND OlOUUtYNGOLMV ED HEAR1NQ LOSS AFTl* YIAAS or 0** ! J____ 1 1 1 11- Ts! 1 f'l" L It $1 -- s ,1111 '#. ricnw ft -- MMiM l 1 a--*se* mr THit 1.0$* 1$ IHOIHIM TK*AIYVTlC MUMtl AMOOCX M IIMOnWVT HOW DO WE PREVENT NOISE-INDUCED HEARINQ LOSS? WEAR EAR PROTECTION EAR PLUGS - EAR MUFFS or BOTH IN COMBINATION AVtKACC DlfftWNCt IN (MCA*INC LOSS PROTECTION WILL NOT PREVENT COMMUNICATION IN NOISE PROTECTION WILL NOT CAUSE OISEASE OR INJURY TO THE EAR