Document wKYY6Y2qg5OvdgX6pLZd5Mrp3

May li-, 19b-0 Mr. D. A. Kohr, Pres. The Lowe Bros. Company k2li.. E.Third Street Dayton., Ohio Dear Mr. Kohrt . . My associates and I have discussed the questions which have arisen out of the visit which Mr. Gall and I paid your plant on April 5th, and although I am not prepared to propose detailed and concrete plans for the completion of all the work which',-., might be done in a comprehensive surveyof hygienic , conditions, 1 am ready to suggest the means of attack o n +-h e m a t t e r s w h i c h s e e m 3st important. By way of p r o f a c s l e t m e s a y t h a t i; ;he expense of a, survey were of n o e o n c e r n to y o u , a n d if [me were no object to us, we :> m i g h t & p n r o a c h t h e s t u d y ;' your plant:in a frankly ex p e Me:xxtal man: ;er, 'beginn: p at any point and proceeding : un.ti 1 - t h e p o s s i b i l i t i e s hi been exhausted. Such a pro- : cedure is, of course, imp-ssiolo. Therefore, I am disposed to study such definite hazards as are potentially in existence, and to leave other problems for future con sidration if and when they seem to justify study. In the latter category/ are the exposures to volatile solvents, which to me seem scarcely significant. A few observations will serve to determine -whether or not this impression is correct and these can go until a later date * .. . The: hazards which should be studied as promptly as possible,: in my opinion, are those which arise from dusts. Therefore I have selected the sites in which these dusts are present for first: considera tion. My recommendstions and estimates refer only to these areas and to the men who work within them. ' I list these below and note the numb e of men opposite each location which it seems desirable to examine. K f 0003745 2. - - f Location Number Employed Mixing room, 5th floor, Bldg.,1}, Small order dept. It-th flood, Bldg. 1| Receiving dept, various locations Maintenance dept. Advertising painting dept, 6th floor, Raw Material Handling, Varnish plant Mixing room, Lacquer plant Janitor, Lacquer plant . Bldg.! 10 3 2 11 6 1 3 1 Total 14i- Number to be Examined 10 5 ' 9 5* 3 1 31 35 * This includes the four men alternating in,, stone-dressings and one additional man of prolonged service* with the greatest and most prolonged exposure-: tp' silica 'Others might -be included if there is .. doubt on this score , . iS-55- At least 3 m@n ho have had the longest and most severe potential exposure to particulate material (paint) in air, as well ss to solvents, should be selected. If more are desired for any reason, they could be included at the start or later. . .It is, my opinloy o b serva - 7:tiphs.\-bf;yC6ndi-tlpn^:':'ini!'the- plant, that there is si.gg)ai Lieani exposure to lead in most of the areas listed above, s, I believe, is the greatest potential threat to your workmen. There are also exposures to certain ol^her metals which have to be given serious consideration, as.'.Zinc, and- Titanium. Considering the fact that there has been no medical supervision, I beli.eevve that the entire group of severely-exposed men should be examined. car::fully. Representative meri chosen from the othes areas of less severe exposure should be similarly examined. The examinations should cover their previous and present medical histories in detail, and physical examination should include careful tests of their nervous system. Laboratory, studies on each man should include (1) a clinical analysis of the urine for specific gravity, acidity, the presence of sugar and albumin, and in indicated cases, a microscopic examination for pathological cells or structures$ (2) examination of the blood for hemoglobin content, enumeration of red corpuscles, leucocytes, different types of leucocytes, reticulocytes, and stippled red corpuscles; and (J) analyses on the feces, urine and blood for their content of lead and certain other metals. The cost of the type of examination described above when figured in terms of the expenditures of time and materials by the laboratory staff will approximate $30.00 per man. It could not be less than $25*00 per man, without our making K F 0003746 3- - some actual contribution of our time and effort., unless we were to eliminate certain items Of work,'which,although not imperative, would be useful. (Vie intend making certain extra analyses of urine at our own expense in order to satisfy ourselves that we do not miss anything of importance. The other re regard as absolutely necessary for your information.) ; There are also certain areas in which exposure to silica may be significant, i.e. In the mixing rooms, the small order department, maintenance depart ment and the handling of raw materials. We believe these men should be checked, In addition to the examination described above, by stereoscopic x-ray examinations. About 20 men are Involved, and we can arrange to have these taken and read at a cost of #10.00 per man. This cost is very high as compared to the other costs, as for example, our own cost and charge for lead analyses,twhich are technically much more difficult . and time-consuming than x-ray examinations,of |500 per analysis. On the other hand this is a service we cannot provide in the laboratory, and it has to be done at a hospital, where the cost, while a little less than the standard charge, is, nevertheless, subject to very little reduction. On the basis of my selection of men for examination, which you may wish to modify by an In crease or decrease, the cost of the. clinical work can he 1, estimated as followst- .Clir.ical examination of workmen, Including all laboratory tests except x-ray and analysis for ' `.lead' and -other m e t a l s . ; ,'; . . . , - . : /.. \ 35 Bien at #15 *0u (2 hours cf technical work per man) . ,. ,#525t Analyses of blood, urine and feces for load and j certain other metals, (3 analyses per man at #5.00 I per analysis) . . . . . . - :O;:. '; //' '' : .* 35 men at #15.00 . . . .. . . . ... . . . . . . .... . . . . #5250 i X-Ray examinations . , : .- -, . , : j Extimated 20 men at f'lO.OC . . . . . . . . . . . . . . . #200. } 5; : ,/ .. " ' : ' , . :, , . .....; -- -- -- i Total for clinical work . . . . . . . . . , . . . . . . . . . $1250C ' ; ' ' - ' . . . ' ' ..' I.-.' ' -i" ' } Certain other men might be added to the group indicated above, by selecting representatives of ; various other departments, Some men, properly selected from : the grinding room would give information of the dangers, if any, In this type of work. The men who clean tubs and other equipment j on the Ij.th floor of Building No.2, might well be added, although . their exposure to dusts would not seem to be reat. Any additions i l ^ g'0003747 k- would Increase the expense accordingly. One means of reducing the expense per man would be to reduce the analytical work, The analyses on the blood could be eliminated with the least loss of necessary information If* on the other hand* the estimated expense per man is within the ex pected or feasible limits* this could well.be done to advantage since it contributes considerably to the accuracy of the estimates of exposure in a given case. An additional clinical Item* if desired* might well be the examination of the blood for serological evidence of syphilis. This is done routinely in some industrial plants and* therefore* may well, be considered. We have no v;lsh to urge it* since it Is not a part of our problem* but it could be done con veniently if desired. Dus t De terminal;I o n s . ' In addition to examinations of the men* it seems advisable to go it.to.,.the question of Exposure to dusts by a study of theconditions in the plant. This will provide a basis for the identification of the foci of exposure* and will point the way. to the application of .measures to- control..the exposure.. , We w o u l d .obtain samples of ,. the dust in known volumes o f .the air froTM the -various ,. . sites at -which dust is distributed lnto:the air. These y samples should be analysed for lead and other metals and for free silica. (Your raw siliceous materials must also be analysed for their free silica content.) Bust counts will also be required to measure the silica 'hazard* and petrographic (microscopic) studies of the dust must be made. Samples of dust from rafters and other undisturbed sites (and. from collector systems if any exist), ought to be taken for study* as evidence of the general character of the dust over a long period of time. This Is necessary, In view of the variability of the dust In the mixing room. . An estimate of the cost of this work is less precise than the foregoing estimates on the clinical work, for the reason that the amount: of work required to obtain the answer Is never entirely predictable. However a reasonable estimate can be based on the following break- d o w n ... . '.. . : K ^ 0003748 5 Sampling by electrostatic means, and analysing samples obtained from air in workrooms where dusts occur; ^V /"2 . o* Approximately I4.O samples at # 5.00 . . . . . . . . #200.00 I Analyses of indefinite number of materials for free silica . _ 1 Bor more than . .................. .. ................ 2 0 a00 Dust counts and petrographic examination of samples from air of workrooms; il' Approximately I4.O samples at $5.00 ................... 9-3 .ffj 200.00 Analysis for metals and silica and petrographic examination-of samples from rafters and other .undis turbed.areas '' - 20 to- -50 -samples at #5*00 to |8.00 per sample. . . . 214-0,00 Total . . ...................... .......... .. #660.00 Briefly to summarize pur sugges tions and proposal, we have every reason to believe that we can present you w i t h :a sound report on the hygienic status of ycur plant, with respect to dusts, through the clinical and technical studies outlined, at a total cost in round numbers of #1900.00. In the course of the clinical exami- . naiiions we will undoubtedly learn great deal about the significance of exposure of. -your men to volatile solvents, and , on this basis can outline any further work which may be indica- usd in that question. '. If this proposal is in reasonable agreement with your ideas as to the expense which could justifiably be incurred for such a purpose, I would suggest that we proceed promptly with preparations for the examination of the men, on the understanding that we are not to go beyond the limits of expen- : diture indicated above without consulting you further, and that our estimate is to be the maximal expenditure unless we should find come unforeseen situation which in our judgment and yours requires further study. Cordially yours RAX:is " '. - - Robert A. Kehoe, M.D. -, . K t O O 03749