Document yp8Gka6qpDrrQK4mzm2mpaM33

H-- September S, 1939 J Dr. Sidney McCurdy . S upervisor, Medical S ection I n d u s tr ia l Commission of Ohio Columbus, Ohio . ' Dear D octor McCurdy:-* 1 send y o u h e re w y j^ so a g ^ it ta rd ily rep o rt o f our examination of T his r e p o r t was d elay ed by reaso n o f my ab sen ce from th e c i t y on a b r i e f v a c a tio n . The a n a l y t i c a l r e s u l t s o b ta in e d a f te r exam ination had been com pleted were not in keeping w ith th e h is to ry and the p h y sical fin d in g s, as w ill be n o te d in th e r e p o r t . F or t h i s re a s o n my a s s o c ia te s con sid e re d I t unwise to forw ard th e re p o rt u n t i l X had re tu rn e d to examine them and to attem pt to ex p lain them. Concerning th ese a n a ly tic a l r e p o r t s , I may say t h a t i f th e y had n o t been done in t h i s la b o ra to ry and i f th e y had not been checked by two s e ts o f sam ples, I would be exceedingly s k e p tic a l o f t h e i r accuracy. As th e r e p o r t I n d ic a te s , we have n ev e r found bona f i d e r e s u l t s o f th e s o r t shown In t h i s mans u r in e ex cep t u n d er c o n d itio n s o f a c u te e x p o su re , and a lth o u g h X am n o t J u s t i f i e d In jumping to c o n c lu s io n s , X can n o t b u t su s p e c t t h a t some v e ry unusual ty p e o f le a d in ta k e o c c u rre d in t h e case o f t h i s man s h o r tly . b e fo re he ap p eared h e re f o r e x a m in a tio n . In some hundreds o f cases o f o ccupational lead exposure whleh have been stu d ied by us o v er a p e rio d o f y e a r s , we have n e v e r seen fig u re s : o f t h i s o rd e r of m agnitude even a f t e r a la p se o f a few weeks a f te r the ce ssa tio n o f exposure. I f is simply not reasonable nor se n sib le to a ttr ib u te these high r e s u lts to a moderate , le ad exposure which had been d isco n tin u ed tw e'y ears p re v io u s .` T h erefo re I an l e d to f e e l t h a t e i t h e r th e r e l a some u n u su a l en v iro n m en tal f a c t o r In t h i s case a t p r e s e n t o r e l s e we have been s u b je c te d to some i n t e n t i o n a l d e c e p tio n . O bviously one does not a r r iv e a t th e l a t t e r co n clu sio n on such evidence* I t I s , t h e r e f o r e , my f e e l in g t h a t t h i s man should be s tu d ie d fu rth e r In order to determ ine what has occurred In h is case. X have not f e l t th a t I was J u s t i f i e d In sen d in g f o r him f o r any fu rth e r study sin ce such a study could not be c a rrie d out adequately w ithout p u ttin g the claim ant In a h o sp ita l where he* co u ld be k e p t u n d er c lo s e o b se rv a tio n and where h is le ad Intake and output could be stu d ied over a sh o rt period* r 2 X th in k i t is a la s w orth m entioning in connection w ith th e re p o rt on th a t In an in te r v a l betw een two s e ta o f exam inations w hile he was in C in c in n a ti, he mad a l i t t l e to u r o f th e c i t y , from which he re tu rn e d somewhat flu sh ed o f fa c e , decidedly loquacious and sm elling stro n g ly o f alco h o lic beverages, the im b ib itio n of which he s to u tly denied. I t w ill be noted In th is connection th a t lie d escrib es him self as very nearly a to ta l ab stain er in h is h isto ry . In th e i n t e r e s t s o f f a i r n e s s , we have n o t s t r e s s e d th e p o in t of alcoholism in our re p o rt. There i s , however, ho q u e stio n th a t alcoholism has play ed a r o le in t h i s man*s p h y s ic a l s t a t e . I send herew ith our fee b i l l f o r o u r s e r v ic e s , and we s h a l l a w a it yo u r f u r t h e r i n s t r u c tio n s i f i t i s c o n s id e re d d e s ir a b le to make any more o b s e rv a tio n s on t h i s c la im a n t. Very tr u ly y o u rs, Robert' A. Keboe,''k'.lD. 0016892 r O.D. 12816 9-3-1939 For exam ination, diagnosia and recommendations in the case o f O.D. 12316 Complete p h y sical exam ination, c o n s istin g o f > physical exam ination, m icroscale blood exasina-- tlo n , (red ,w h ite and d if f e r e n tia l co u n ts, hemoglobin d eterm in atio n , count of s tip p le d ery th ro cy te s), c lin ic a l u rin a ly s is , m icroscopic exam ination o f u rin e , and analyses (5) on blood, u rin e and feces fo r th e ir lead c o n te n t.. . . . . 00 K fi 6689TI0 00 Ohip I n d u s t r i a l Commission Case. Sample of blood re c e iv e d November 2 , 1959. Bl oo d A n al y si s No. 39-&-5907 Grams - Ij,. 1 Mgs Pb/ lOQ gms - 0.075 Rep or t ed : November 7 # 1939 Ohio I n d u st r i al Com m ission Case. Bl ood san p l e #Ij. r ec ei v ed November 4., 1959 Bl oo d A n al y si s No. C-rams - 21. 8 Mgs Pb/ lOO gms- 0.08 ( Sp ect r o gr ap h i c) Mgs Pb/ lOO gms- 0 .0 7 ( D i t h i zo n e) Rep or t ed : November 15 , 1959 Repo* o f d lin ie s l. fs y e e tifa tle j* ' m o.i?* l a m s .idressi 1776 R* 93* 1 s t r e e t , C leveland# Ohio - % # i 53 9c$ o f Sbesaihatim* and S tdy O ctefcer 30# 1939 t 3v, 6# 1939* (So PVGV%OW Ffi-JKS^t lis te d 15# 1933}* Olaitsat reported t o C in cin n a ti <m October 3 0 , 1939* Was seen and aafeipie o f b io d and u rin e at t aitali* a f t e r which he w a s a d a itte d to Steccone H ospital# GXtften Amnuir* C incinnati* :cblo, She. c o lle c tio n o f f orth er * t & pt m o f teo reta a- in d ic a te d h erea fter* was began a t 6tO0 iVW October 30th ' . diaoa-.A aust 1939* when X aet x ml s m, h a s not horn b a tto ? o r orsa Sa bed 00 s s ta l i m o s o -ut has f e l t nimbi to work. Has bad o ccasio n ili is erately c e re re aM ofatnal cswnpc w ith d i ar r h oea* ilo t r a e oli o r o t h er su aU faet et l o M o f p iam ola. Qa itetardsy# October gStis, t & lim ln unusual oxnosur to cold developed iw t r s pain in rig h t dhouler which has continued stea d ily elnoc* Pstn 1 H a lte d to neighborhood o f jo in t and:ima been so- -sever as to prevent volimta^.isoviaeat' o f:ahoul&era, O onersl p h y s ic a l c o n d itio n 1 e s s e n t i a l l y tm changed opt f o r d i s a b i l i t y o f r i g h t 0b o u ld e r, A n te rio r and . p o s t e r i o r .c h e s t exottreion a re poosibl w ith o u t srnrked pain* th e d is a b ili ty b e in g m e t n s rk td In bdufetioh th e re a r e no sensory d is tu rb a n c e s in ` the a r s e o r hands* and th e m u sc u lar s tr e n g th o f forearm and v r l'a t i s good,, f a in doe n o t p re s e n t slo o p and when sh o u ld e r waa su p p o rted by ling* th e ayaptoa# r e le n te d s u f f i c ie n tly in 3day: to p e rm it s h a r in g , !lh@ le s io n I s b e lie v e d to bo au b - aroi.mi b u r s i t i s , . Sh# f a i n t p u n c ta te d e c e i t In th e l e f t lo w e r m o lar rs-*ion l a u n o lisngad'and th e r e l a same o s r g iim l d is c o lo r a tio n o f th e gun* p a r t i c u l a r l y o s th e l in g u a l a s p e c t o f t h e lo w er I n c is o r s , w hich, however* does not appear to be a. lead lin o * D iceontlnuanoe o f to o tli-b ru sh in g and o r a l hygisn f o r h day# mined no n o tic e a b le hang in th e d ep o sit * . tti# `i-r s y exam ination Creport attached) revealed a s lig h t in c re a so 1 p eribronchlel a c t in g but m nara so than might be a n tic ip a te d k% th e .patient:* age, fh i m & lnstion was requested In order t o :d eterain wttethwr or' n ot th e in d u s t r ia l le a d exposure la 1935 sig h t have been associated with considerable ex posure t o s i l i c e o u s dust c o n ta in in g lend, -which* I t was t e n t a t i v e l y believed# could have been retained as deposit, in th e lunge to be subsequently r e le a se d e v e r a long- p e rio d o f tin in to the. blood and lymph strea m * , - fit isrraye do n o t su g g est th.'tt -such d ep o sit ' e x i s t . . hs&sssssaL- m Ply p ysph* %0 losln acaip l tld i tin # 3*4/0 htm ites OftS&pJUQ- * 3KHMI O ther Inbornte r? fin d in g s were e s s e n tis lly negntir exoept fo r th e re s a lto o f analyse fo r load* which aro sftreii 'eeperately* 2 _ Sloo., 5 i2 sS L 2 sioe ' While %n tu * ba#pi*X p o tie a t' v$m *^d w ith t o i l e t :privilege*.*. a l l c lo th in g w w -provided i -Mm h p i t a l id` medication va lim ited to that prescribed hr tie, Srery sto o l passed vas c o lla o to ft as n in d iv id u a l mmpXn and m it u rin e voided during :th e week o f ob servation m a c o lle c t e d %n 2%*hoar aarl#* f r o s 6*00 P.H . to p ^ P.M* . D at e Cb t si n ed _______________ o et . 30t h * 1039 Hov* 2 How, % Hotu.ro o f i2i2M ~ Bl oo d O ct, O ct * O ct * 10 t h 30 0* 00 P . f , to % & % m .k . } \ it /V vet * 31 - o r . X How. 1 - o r . 2 3liQ lfm o r , 3 MOV, 3 o r , h h OV, % - Hv* OV, .-- ,'%r * 6 Urlnd if n O ct * 11, 10 10 0 m IToV,. !, 0^15 a s % v . 2* X 10 PH How, won 4?' "'0V, 5 *or. is f eces( d r iSSed ! 8 <* 15 Is Vallum r W eight ,.. xo on loo m I 'm oo head in H UUfwaai. 0*075 0*075 0*075 -P***. 1a-00 a reas 5 '_ 0*22 per Xitel* 0,2% * m . 1300 no 1190 oo 1X30 c lfo m 1500 m mm 0.20 * 0.23 * o*a * : o.a6 * 0,21 * 0.19 4 a 9 %*f tm m m 30*3 %#m9. 13*5 gn * 13*7 7*3 22*1 1 3 .d 0.18' .25*M o .tS 0 .5 2 0,2% 0.53 0*38 in * * * s ** s is a&t ir e # tS a J *# s#manl e * *5 n 0ho le a d cancer*tr& t io n in th e b lo o d simnl* i s c o n s is te n tly and uni f or ml y bore t he norm al and i s i ndi cat i ve at some recen t and continued lead exposure* since I t does not dim inish during th e p e r io d at th e o b s e rv a tio n s , Ohat 1 % I t I n- m>tvdue to & s in g le 1 dos o f ingetod load dssring *a #w day Iau4ft*tay- s>**id*8g t he o iw n in itio n . 'Tila co n c lu si n l v c r l f i c d by tito u rln o y y v a l e s cu fia n ffc foa&'ampias* ''T t & l . . j $T * g p f lir-O' 'i^ | lfr i ,::.fs|,'|||; '"1$ . o f w i o u sl y a? t a ln | | at | . n e t lo ti"en t.'i in 71 T, vj *": ']? .r t ' ~ ": v t 1.'n . 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