Document wrDr2nwvZp9oRLBDqjgkZJ0e6

July 22, 1966 Messrs. G. F. Kirby J. C. Carter, Jr. H. E. Hesselberg R. A. Kehoe W. R. Perdue, Jr. G. Roush, Jr.'/ R. K. Scales A. Silverman C. C. Vogel F. P. Warne The attached material written in 19^7 may provide some "back ground on the Medical department. J.E.B. -00143 r -- 7947 The Medical Department of Ethyl Corporation cam* into existence in June of 1924, under condition* which/ antedating the origin of the Corporation itself* were to exert their lnfluenoe upon the for* and funotlone of medical activities of the Corporation throughout the years up to the present tin*. At that tine# the operations of General Motors Cheatioal Company in Dayton# Ohio* were just emerging frosi their early developmental state into the commercial e blending and distribution of an antiknock compound. Coincident with the increasing soale of these operations* the toxic properties of the constituents of the antiknock oompound gave first evidence of their true significance* when# without apparent warning, a group of workmen fell ill and two of them died with what is now recognizable as tetraethyl lead poisoning* This situation called for some combina tion of medical oar* for the slok men, and a thoroughgoing investiga tion of the disease from which they were suffering and the environmental and physiological conditions which gave rise to it. The present head of the Medical Department, Robert A. KehbeV a physician and a E-00144 physiologist in the University of Cincinnati Medical School* was neax at hand and known to Thomaa Mldgley* manager of General Motors Chemical Company, and was approached for advice and assistance* The time (May; being at the end of the academic year* it was possible* without delay, to undertake the proposed task. The work of the first summer, carried out in the Dayton plant, resulted in a clinical characterisation of tetraethyl lead poisoning, a preliminary and rough interpretation of the nature and the approximate order of magnitude of the hasards of handling tetraethyl lead and certain halogen carriers, and the develop ment of certain principles for the oontrol of the hasards. The care .t 2 f of the sick employee#, together with the medical selection and super vision of the personnel of the plant, represented a first responsi bility, vhicb on many days, especially at first, left little time for anything else. However-, as the conditions in the plant responded to the application of good engineering practices based upon the accumulating medical and physiological information, the uncertainties of the medical approach tended to disappear, the anxiety of the employees vas replaced by confidence in their security, and the time required for such work decreased in favor of greater experimental efforts. By the enc 01 fepteober of 1924 the situation appeared to be veil in hand. One could then viev the future of this phase of the industry vith reason able assurance, and could begin to take thought for the actual or potential hazards of its other aspects. From late in 1923 on, experimental vork on the most signi ficant problem of public health, - that of the contamination of the sir of streets, highways, and repair and storage establishments vith particulate lead compounds in the exhaust gas of motor vehicles -, had been under investigation at the Pittsburgh Experimental t tatlon of the U. i . Bureau of Mines, at the instigation of Midgley.-. rartici;a- tion in regular (monthly; conferences on this problem inducted the new medical consultant of General Motors Chemical Company into the consideration and practical appreciation of these problems, and prompted his to advise an extension of the experimental program of the Bureau of Mines to include the potential hazards of the slight but prolonged exposure to tetraethyl lead through contact with leaded gasoline and exposure to its vapors. This was initiated by means of animal E-00145 experimentation and carried out in rough. parallel with experiments conducted in the laboratories of General Motors Chemical Company by Kehoe, with the assistance of Graham Edgar and the technical research t 5. r staff of General Kotor* Chemical Company of which he was the head. A little later, Kehoe and Edgar expanded these experimental observations in to the field of commercial dietribution and use of leaded gasoline Ly undertaking study of the comparative lead exposure of unexpor.ed and exposed garage mechanics, drivers of cars, and filling station attendants. Iheforegoing aocount of the early medical and experimental work is of more than casual importance in the history of the Medical Department of the Corporation in that they lead up to an event of major importance associated with the date. Mt ay 20, 1^2f?. Chis date, referred to elsewhere in the annals of Ethyl Corporation, is that of a conference of prominent medical men, public health authorities, representatives of industry and labor and other interested persons, called by burgeon General Hugh Cunnings to consider the problem of public health presented by this industrial enterprise. The j.-zocetdings of this conference are recorded in detail in U. C. "ublic Health bulletin Ho. 158, and its conclusions need not be restated here. It is pertinent to note, however, that the conservative recommendations of this Conference were arrived at after s lengthy discussion in which highly emotional,'sometimes lurid, and wholly unsubstantiated state ments were tempered by the observations and fact* made available by the experimental work authorised and sponsored by the predecessors of Ethyl Corporation. Ihe effect of this crucial test of the practical merits of medical and toxicologic research, upon the executives anc medical advisors of the Corporation, was of the greatest moment in VvC o o a- establishing the character of future relationships of the Medical Department and its future medical and hygienic policies. As a part of his report of experimental vork to the Conference, Kehoe presented the incomplete results of clinical observations on garage mechanics, drivers of oars and filling station attendants, and the analytical results on rr 4. their excretion*. A full report of these results ves prepared shortly thereafter by Kehoe and Edgar and presented to the Board of Directors of Ethyl Corporation, rinoe, by that time, the Investige non of the i ublic Health fervice vas under way, these results vore not published until a considerably later date (J.A.M.A. 3j: 2j31, ,. ihe subsequent confirmation of these results, in part and officially, in the investigation of the Public Health fervice, and more validly and significantly by the later extensive investigations sponsored by 5 thyl Corporation in the Kettering Laboratory of Applied Physiology- in the University of Cincineti, served to establish the prestige of the Medical Department in the industry and among technical and medical people in related fields, thereby implementing its subsequent efforts to promote the broad hygienic program adopted by the Corporation, from the general medical and scientific viewpoint, moreover, this Conference and date have still greater significance, in that the data of Kehoe and Lugar, presented then, gave statement, for the first time, to certain facta as to the lead exposure, absorption and excretion of normal healthy Individuals in the American population. These facts, following their confirmation arid further elucidation, were destined to have e profound effect upon hygienic concepts and practices in the lead trades and in the community as a whole, with respect to the physiological significance of lead exposure. E-00147 January of 1^26, following upon the report of the investigation of the Public Health Service, saw the resumption of the connsercial operations of Ethyl Corporation and the organisation of the Medical Department. At that time the medical and hygienic program of the industry as a whole came actually to be centered in one group, namely, the Medical Department and the medioal research organization of Ethyl Corporation. This functional coordination of these activities at one r 5- place, essentially under one head and general program, has such significance in relation to the past history as veil as the probable future ci Ethyl Corporation that it deserves emphasis. Only by the force of unusual circumstances, among vhloh the initial deadly threat to the survival of the industry looms large, could have brought the three industrial group* engaged separately in, (1; the manufacture of the antiknock compound (Du Pontj, (2; the sale and distribution of the compound (Ethyl Corporation;, and (3; the manul'acturers and dis tributers of leaded gasoline ( a number of the oil companies,., under one professional influence. fihis came about largely by reason of a verbal agreement, on the part of Ethyl Corporation, with the United States Public Health Service, to implement a series of recommendations made by the Surgeon General of the United States Public Health Service, for the control of the hasards of the business. She fulfillment of tip/, agreement made it necessary for Ethyl Corporation to establish medical policies and procedures which under ordinary conditions would have been regarded as intrusions into the affairs of the manufacturers of the product .as well as the customers of the Corporation. Before long, however, there was general acceptance of the fact that the medi cal advisors of Ethyl Corporation alone, among those who might other wise exercise influence in these matters, had access to the informalien that was required to provide Intelligent hygienic guidance. In short, the facilities for medical and hygienic research made available by Ethyl Corporation then and expanded since from time to time ae required , have always constituted the cornerstone on which the wisdom and adequacy of medical policy and procedure for the control of the hazards of this industry have been based. One aspect of the f--ooi coordination referred to was accomplished through the multiple role of Kehoe, who, as a member of the medical faculty of the University of 6. unbiased research in this and ether phases of industrial health, vhlle acting as chief medical consultant tMedical Director; to Ethyl Corporation, and medical consultant, in relation to the manufacture oi tetraethyl lead, to Du font. The other factor in the application of one hygienic policy in the industry arose from the urgent need of controlling the manifest hazards of the operations involved in the mixing of the antiknock compound vith gasoline. The most careful consideration of tlis serious hygienic problem, on the part of execu tives and medical advisors of Ethyl Corporation, resulted in the development of a program vhereby the Corporation undertook to provide the medical and hygienic supervision of mixing plants and mixing personnel, and to set up, in detail, the regulations under vhioh this work vas to be done, This program involved the unique feature of lormal acceptance (by contract;, on the part of the refiners and distributors of gasoline, of medical regulations and instructions issued by Ethyl Corporation. The foregoing items of policy and procedure may appear to be given undue importance in this recital. Moreover, they may be suspected of attributing undue prominence to medical work and per sonnel. On the other hand the purpose of this history la to recount and explain the pact as a guide to the future, The emphasis, there fore, is upon ideas and principles arrived at largely through an interpretation of the acts and developments which grew out of the problems of the time and the compulsions of circumstances. E-00149 In the natter of developments, it may be remarked that the natural outgrowth of the principle of research as the basis of medical and hygienic practice in industry was the relationship between Ethyl Corporation and the Kettering Laboratory of Applied Physiology in the Medical College of the University of Cincinnati. The acceptance and * --... ^__ \ 7. the creation of this Laboratory and In ita development &s a responsible public source of medical and hygienic information. At the time o: v.he creation of the Laboratory, and since, other industrial organisations joined Ethyl Corporation in providing these facilities for the University of Cincinnati and in supporting the investigative pro^zam. however. Ethyl Corporation vas the prime mover in founding the Laboratory, as veil as its principal source of financial and moral support in ita developmental period. The staff of this Laboratory began its vork in the Physiology Department of the Medical College of the University of Cincinnati, late in ly25. Dr. Kehoe found it impossible to continue to absent himself from hia duties in the t University, and, at the same time, it had come to be apparent that -he investigative program,engaged in on behalf of Ethyl Corporation, lit ted into the public pattern of university activities. Accordingly equipment and such personnel as vere willing to do so, vere trans- ferred from th-eDsyton laboratories of Ethyl Corporation (in the General Motors Research Laboratory; to Cincinnati. The group so E_ Installed remained nominally in the employ,of Ethyl Corporation for a time as, a matter of convenience, and additions vere made to the stafl on that basis. Eventually, however, the policies of the Univer sity required that the research activities of this group be absorbed into the academic structure of the University of Cincinnati, and ell the individuals vere given formal appointments in the Department of Physiology of the Medical College. separate laboratory building soon came to be a necessity for carrying on the increasing volume of work on the problems of Ethyl Corporation and those of certain other industrial organisation*. Several of such organizations joined Ethyl Corporation in making a gift of funds to the University of Cincinnati , by. means of vhich a nev laboratory vas built, '.'his laboratory lecelveo its name, in honor of Mr. C. f . Kettering, on its completion and dedication in December of iy3>* Its activities have continued to expand until, in 1^41, a small addition to the building vae macs, through a further contribution by I.thyl Corporation, and in Is^J-hg this addition vas extended so as to double the size of the original building. The latter vas made possible by the contributions of about a score of large industrial organizations, vhich, vith Ethyl Corporalion, had supported the investigative program of the laboratory, through its encouragement and financial support of this enterprise. Ethyl Corporation has acquired access to experimental facilities for the systematic investigation of its ovn medical and hygienic problems, and at the same time has been actively instrumental in the development of a much needed center for industrial medical investigation and ti&ining. ihe peculiar responsibilities and activities of the Medical Department of Ethyl Corporation sIbo resulted in the creation and development of an allied organization devoted to the maintenance of the safety of all field operations in the rules Department of the Corporation. The origin, grovth and development cf this-organ!ration and of its functions represents a chapter, in itself, of great inter*, r-.. end importance in the history of the activities of Ethyl Corporation. Its somevhat unique character, guided, as it is in all matters oi hygienic policy, by the Medical Department, end yet administered and directed by sales executives, constitutes an example of the capacity of a rather large number of individuals to cooperate in single-minded devotion to an high purpose. The safety organization,managed vith great zeal and meticulous attention to detail for many years by C. L. Levis and nov under the capable direction of E. 0. Jones, had its E-OOl51 r 'j- f origin and its most important initial function in the work oi designing and maintaining field equipment for mixing 'rth^l'1 antiknock compound with gasoline* The pioneer in this work, vhen the ./le&ziu. type oi commercial operations oegan in 1^2j, vas E. M. Valters. Pen. the end of the first year of these operations he introduced '.he idea and designed the first equipment hy vhic:. pumps could be eliminated in the actual movement of the compound, and an "eductor", ac.ivfeit-o by a stream of gasoline, vas employed to drav the product from its container into the gasoline vith vhich it vap to be mixed. ;he adoption of this principle,, whereby contact of the concentrated material vith the moving parts of mechanical equipment could be avoided , and the product could be handled at reduced rather than elevated ;:tt> eures, has contributed incalculably to the simplicity and safety of the mixing operations, and has represented a fundamental contribution to the control of the hazards of this occupation. Walters, as ..ssisiani rales Manager of the Corporation, in vhich capacity he had many other responsibilities, continued to direct all the work related to mixing installations, maintaining a continued contact vith the Medical Department for advice and approval of specific plans and specifications for such equipment, until his untimely death,in Eecember of During his regime and largely through his initiation and design, the bulk type of mixing equipment (tenkcar-to-weigh tank;, now in use most widely, vas developed and introduced. This constituted a second fundamental step in securing the safety of these operations by the application of sound engineering. In later years the further design of mixing equipment, the engineering features of the operations, and the technical supervision of mixing plants passed through various stages of development, vith authority residing in various bands, and vith significant contributions made by various persons, all of whom 001 52 1 /. 'ihe responsibility of the latter lor final decision vith releience to the compatibility of proposed engineering procedures vith the ultimate safety of personnel concerned vith the trans.oj t oi the px-oducl and vith mixing operations, has never been a matter of question or controversy . from the organisational vievpoint, certain changes occurred from time to time, engineering and technical field super vision of mixing plants being first a function of the Sales Depai tmeni in collaboration vith the Medical Department, then beingtransferrec, ts to its responsible direction, to the Medical leparunent, and later returning to the fales Department, vhere it operates at present as an integrated part of a service organization to the customer's of the Corporation. She present stage of the organization became mandatory, partly because of the variety of the operations and the necessity oi their integration vith other field activities, but largely because of the emergence of an hazard vhich for a time required heroic efforts on the pert of the entire field staff of the Corporation for its control, 'ihis hazard - that associated vith the cleaning of gasoline storage tanks - nov recognized as the most serious of the occupational hazards .of -the industry, because of- the virtual universality of its geographic occurrence, and because of the difficulty of keeping it under observation, vas not anticipated originally by the Medical Department or by the technical personnel of the Corporation. It vas recognized for the first time and somewhat incompletely in 1 J2b, and regulations were issued by the Medical Department for its control, rhese regulations required modification, shortly after their initial issuance, in order- to cover the various features of the hazard as they came to light, but even after they reached their present satis factory state Us02 vith only slight changes in detail, since,, they were ineffectual because they were not alvays applied at a point -00153 ( .( 11 where a tank used for the storage of leaded gasoline was being cleaned. Ihe problem has been a difficult one, since it Is many sided. Involving , in some measure, all tra:isporting equipment for gasoline and all containers used in storing and handling leaded gasoline, in all ..arts ot the world. After a series of cases of poisoning, numbering mci e than one hundred among employees of American manufacturers and dis tributors of gasoline, of idiom more than a score died, it became apparent that steps had to be taken to bring this hazard under control, despite the reluctance, on the part of repres0 entatives of Ethyl Corporation, to extend their activities further into the operations of customer companies. In ly>5, following a series of meetings of executives of the Sales Department and representatives of the Medicai Department with various groups of the field staff, a program of observation and investigation was worked out, whereby, until further notice, the large proportion of the gasoline storage tanks in the United States and Canada, that were to be entered for cleaning, were to be observed by representatives of the Corporation during their cleaning. Samples of their water bottoms anc of scale and sludge veie to be obtained for examination, and detailed information concerning the previous use of the tanks was to be assembled for study. Vne plan of an integrated experimental study was worked out in advance through the collaboration of the Sales and Medical Departments, with the understanding that the Information was to be gathered in the field and furnished to the Medical Department. All of the samples were to be analysed and all of the results were to be correlated and interpreted in the Kettering Laboratory of Applied Physiology under the direction of the Assistant Medical Director of the Corporation, Dr. Vi. f . Mechle, who was also the Associate Director of the Laboratory. E-00154 f / Af ter many months of faithful and intelligent vcrk on the part of the field staff, and after further months of careful statistical study of the results, a report vas issued in 1^4J, vhich pointed clearly to the necessity of maintaining the intensive organized collaboration of field personnel of Ethyl Corporation in the tank-cleaning operations of customer companies, lhe history of this collaboration, and the developments that have followed further investigation of various aspects of this problem would take us far afield into a voluminous account of organizational and technical details. The basic facts, recounted as briefly as possible, will Berve to demonstrate the functional and historical association of field and service staii with the activities of the Medical Department, thereby illustrating tne point that industrial safety and hygiene in the hazardous chemical trades is largely, of necessity, and by its very nature, a medical matter vhich requires medical research and medical direction for its implementation. While the various activities of the Corporation were developing and expanding, the Medical Department grew in size and in the scope of its activities. The first year of business-after the investigation ol the Public Health Service, (ls*26;, can be said to be the actual beginning of planned commercial operations, and the first stage in the organization of & Medical Department, luring that yea* , and subsequently, additions were made to the traveling medical stafi with headquarters in Cincinnati, as the systematic examination and re-examination of an increasing number of mixing personnel in the refineries of customer ooapanles required. Hen of high calibre and of sound medical training were needed for this work, and despite the personal and professional difficulties associated with this unusual type of medical practice, such men were found and retained for pro- 00155 1> longed periods of time. This vas made possible because the executives ol the corporation vere villing to follow the policy required to .t certain unattractive qualities of much of the medical work. Members ol the staff of the Medical Department vere given opportunities and were encouraged to engage in other investigative and professional activities that vere not Incompatible with their responsibilities tc 1 thjl Corporation. By such means they vere spared the rigors cl continuous traveling and vere enabled to avoid a degree of isolation from other professional colleagues and activities, which would have made such a position unacceptable at any price to a veil trained and generally competent physician, through the operation of this policy the physicians of the Medical Department, as'a rule, have conducted their vork as virtually full-time (in the sense of continuous respon sibility; members of the staff and vith the benefits and privileges associated therewith, while engaged in restricted private medical practice or in organized investigative vork. feveral of them have- had formal membership in the medical faculty of the University cf Cincinnati, by virtue of their appointment- to the rtaff of the Kettering Laboratory. ~ " E-ooi56 Uhe first physician to be added to the medical staff vas Dr . Karl V. Kitzmiller (1926;. Ihe next, vlthln a fev months, vas in Dr. V. t . Maohle (1926), to be followed/ succession by Dr. : . L. Grudging ton and Dr. Lester V. Sanders (1927;# Dr. L. J. Schradin (1^2^,, and Er. Francis D . Heyroth (1942). Dr. Crudgington relinquished his duties in 19J4, in order to devote himself to the practice of obstetrics and to take up more extensive duties on the obstetrical staff of the Cincinnati General Hospital (the teaching hospital of the College of Medicine of the University of Cincinnati). Er. Machle, vho became Assistant Medical Director in 1936 vith headquarters in Cincinnati. ( 14. ( was on military leave i'tom October oi 1942 until October 1945, during vhicb he directed the 7J. S. Army Medica.l Feeearch Laboratory at lore Knox, Kentucky, he returned as head of the New \ork office of the Medical Department, taking this part of a new t unction of the Medical Department which will be referred to later. Dhe other members oi the medical staff as named above have continued their professional services on behalf of the Corporation. Dr. Kltzmlller has been Assistant Medical Director since 1946. Ihe original program of the Medical Department was concerned with the medical supervision of (1; members oi the field staff of Dthyl Corporation whose occupations involved actual or potential exposure to lead hazards, (2J members of the technical staff of Ithyl Corporation in research and testing laboratories, and (5, employees of customer companies in the United States and Canada engaged in mixing operations or in ether occupations which gave rice to hazardous expo sure to tetraethyl lead. !he physicians were also required to inves tigate reported cases of illness among garage mechanics, refinery personnel engaged in handling leaded gasoline, filling station E-ooii atiendants-and all other persons, including the drivers'-of automobiles, when any of such cases were thought or alleged to be due to exposure to leaded gasoline or to the exhaust gases of automobiles using leaded gasoline as a fuel. Medical representatives were also to consult with and advise refinery superintendents and other executives and technical personnel of customer companies on problems arising from their use of the antiknock compound, and to maintain such regular contact with regional and local representatives of customer companies as to be acquainted with their problems. This was facilitated greatly by the eventual development by Ethyl Corporation of a trained staff of regional and local representatives, whose relations with the personnel 15- A of customer companies, vhethei- in the promotion ol sales or In the t technical control of hazards, vere of great help to the phys clans, the technical supervision of mixing plants and the medical supervision oi the personnel vere coordinated effectively by an arrangement vhen.ry the doctor visited the plants in the company of t;:^ appropriate mc-iabei oi the field organisation. With the advent of a program of health and sickness bene: Its, provided by Uthyl Corporation for all of its employees, in l*;-, .he vork of the Medical Department vas expanded,to include'medical exami nations for all nev and prospective employees, ' c far as possible, these examinations vere carried out by traveling members of the medical staff. However, the geographic distribution of division offices, and the fact that the headquarters of the Medical Iepartment vas in Cincinnati and not Nev York or Detroit, made for inconvenience and delay in the performance of these examinations. lor this reason, a group of local medical consultants vas engaged to car-ry out pie-employ ment examinations of applicants for positions in Lthyl Corporati.cn vhen end as requested, and to report these to the Medical Department, these consultants vere located in Nev York, in relation to the Nev fork office and the Yonkers Laboratory, in Detroit, and in other cities in vhich there vere division offices. Members ci the Medical rtafi have maintained close professional contact vith these consultants, familiarizing them vith the relevant medical policies of the .or:ora tion, and integrating their vork vith that of the Medical Department. She foregoing development led to the advisability of furthex extension of the medical services of the Corporation to its employees, and paved the vay for the present program of medical service and, so to speak, medical maintenance. .-'Ians vere laid during the var, and E-00158 ( f 16* consummated as soon as possible after its close, ior providing not only pre-employment examinations for all employees, but also annual examinations, with somevhat limited opportunities ior certain types of medical advice in tbe interim. Shis required the development 01 a medical office in Kev York, and an extension oi the medical facili ties of the Detroit Laboratory. Dr. Machle took over the reoponsioili; j for this development in Kev 1'ork, and soon associated with himself an ofiice and laboratory staff of tvo persons and an assistant physician, I-r. Emil Beyer. At the same time, this group took over the responsi bility ior all personnel of Ethyl Corporation in the Kev England and Philadelphia area, and for mixing personnel of customer companies in that area. ihe Detroit Laboratory, under the medical supervision oi Dr. Senders as the visiting physician, had first acquired the sexvices oi a nurse for first aid and minor medical service to its stafi in lj?i.';. vith the adoption of the more comprehensive program of medical vork, it became advisable to engage the services of a physician tc visit the Laboratory daily and to set up and maintain a schedule oi J. periodic examinations. Dr. Carl/iprunk of Detroit assumed these duties, in vhich capacity he nov acts as assistant to ir. Sanders. At the end of the var it vas possible to augment the stall of traveling physicians so as to lighten the load of medical vork vhich had increased steadily during the var and of necessity had been assumed by the existing staff. Dr. Earl Doty vas appointed in this xole in 1*^5, first as assistant to Dr. Schradin, then as a stall member assigned to an area in vhich he assumed full responsibility for the medical supervision of personnel of both Ethyl Corporation a. and oil companies. F.-00159 While the augmented medical program vss being planned and { t 17- implemented, a new phase of medical work came into being, in that Ethyl Corporation took over the operation of its manufacturing plant in Beton rouge in feptember of ly45. It became necessary to organize a plant medical service, vithout delay. lortunately this was not as difficult as might have been expected, since the Medical Director of Ethyl Corporation, acting as a special medical consultant to E. 1. Du Pont do Nemours and Company, had had Intimate and continual fami liarity with the Baton Rouge plant and its personnel throughout the entire period of the existence of the plant. After a period during which the physioiane of the Du Pont medical staff remained at the plant to carry on the medical services as they had before. Dr. i oy C. A. Bock was appointed to head the Medical Staff at Baton -ouge. Dr. Villiam V. Cbrbett, formerly of the Du Pont organization, elected to remain, and other physicians were found to assist Dr. Bock i:: the work at Baton I ouge. She present medical service at Baton ..ouge, which will require some expansion when a new medical building has been completed, consists of four physicians. Dr. E. C. Harris having joined Dr. Bock and Dr. Corbett in November of 1946, and Dr. George D. licks having come in October of 1947. lh full staff cf the plant dispensary, in conformance with the requirements e: tne varied services, (formally approved by the American College of Surgeons) 1b made up of nurses, technicians in the clinical and X-Iay laboratories, and secretarial assistants; E-ooi6.o ihe beginning of commercial operations in Mexico .in 19>> required the appointment of a physician residing in and licensed in that country to supervise the mixing personnel of the gasoline distributing companies. Ihis was accomplished when Dr. V. J. Lynn agreed to undertake this work. Dr. Lynn died in November of lyJ7, and was succeeded by Lr Salvador Bermudez, who is associated with r ( 18. the f chocl of . ubllc Health In Mexico City. I-r. Bermudez maintains a close consulting relationship vith Mr. L. M. rhillips, vho represent a ? thyl Corporation commercially in Mexico, and sends reports frequently to the Medical firector. The activities of the Medical lepartment over the years, and its present function have been indicated in the preceding account. In ozder to summarise them and to demonstrate the functional pattern of the department as a vhole, a chart has been prepared and is attached, ivo additional features of the medloal activities mentioned in the chart as duties of the Medical director appear to require elaboration as history and as present policy. ihe occupational hazards involved in the conduct ol this business enterprise, and the Justified concern manifested by health authorities and by the public in relation to the effects ci tsure to lead compounds, have necessitated the maintenance of close and mutually frank relationships betveen the Medical :epartment of Ethyl Corporation and responsible public health officials. Such a liaison has been maintained vith the U. S. Public Health Service, and vhen Ethyl Corporation has extended its activities into other countries, the public health authorities have been consulted beforehand and put in possession of all the available information relating to occupational or public health. By such a policy, and by virtue of the systematic publication of the results of investigations carried out in a responsi ble institution of learning, the good faith of the Corporation has been shovn and its medical representatives have been accorded a respectful hearing. Indeed, on several occasions, their professional assistance has been sought in dealing vith problems of public and governmental E--OOl61 19. policy and procedure, in relation to this industry The conduct of the admittedly hazardous Corporation has been fraught vith more than an or means of defense against litigation based upon fal. of injury to the health and veil-being of persons occupations or merely represented in the general had been one of.the factors vhich has justified th program of hygienic research sponsored by the Corp j. t has been a duty of the Medical Department to ma detailed acquaintance vith all of the activities o vhich might, conceivably, result in medico-legal c true unfortunately, that very fev of the business Corporation fall outside this category. Conseque' Department has been required to enter into the dis" of policies and procedures vhich, ordinarily, voul strictly related to commercial matters. It haB had deliberately delegated to it by executives of the C exercise of vhich, under other circumstances, might arbitrary and dogmatic character. The point vhich and implemented, is that if the Medical Department fessional responsibility for the guidance of the Co of public policy related to health, - as it must un it must have minute and detailed knovledge of vh&t tatives of the Corporation and, in many instances. Corporation. It must also have an authority commen responsibility. This has translated itself into an relationship vhich is not common in American industi Medical Director has derived his authority directly of the Corporation.