Document yrXoek9j6ddm7b29MRbNGLpnE

W ILLA RD M ACH LE, M. D. 610 PARK AVENUE NEWYORK 21. N. Y. 16 August 19U6 Dr. Aobert A. Kehoe Aettering Laboratory " College of Medicine University of Cincinnati Cincinnati 19 Ohio Dear Bob: Herewith report on S c ie n tific Products Company, Deacon F a lls, Connecticut Slides are being forwarded under separate cover. Cordially, illa rd Mac!le, M.B. 0009368 W I liA R D M ACH LE. M. D. 610 PARK AVENUE NEWYORK Et. N. Y. * 13 August I9I46 SCIENTIFIC PRODUCTS COMPANY Beacon F a lls Connecticut . Description of Plant The above company owned, by i s a small chemical company employing, four men. Since i t s beginnings in December 19h$> they have been en gaged in the manufacture of small lo ts of specii. chemicals among which have been organic mercurials (for a n tisep tics and fungicides) Cresol derivatives phenyl esters e t c .. The plant occupies a former p o lice barracks of fa ir quality construction, situated about f i f t y fe e t from Highway 8, in the v illa g e of Beacon F a lls, Cormecticut (near Waterbury). The inside working space i s about f i f t y by one hundred twenty-five fe e t with attached garage per rough sketch below. Floors of building of pine - concrete in garage. There is a dwelling (Dr. Bowles') above the main structure. O' KE 0009869 V entilation is lim ited to that from windows and such a ir as i s moved by a 300 c|m fan in the chemical hood, `i'here is an additional portable 300 c^fc fan which is in s ta lle d at times before an opened window, Entire system'i s haphazard and unre- la ted to any lo c a l needs. The chemical hood in the corner of the building is about three by s ix fe e t in table area* i s -provided wath windows and updraft only, and 'jTlow pattern i s such that heavy vapors w ill escape into the room. Vent from hood pan is in side of building and e fflu en t fr e e ly enters the resicenee apartment on the second flo o r. . Sewage disposal is d irect to the Naugatuck liv e r , a small stream of variable or stagnant flow, about_one hundred f i f t y fe e t away. There is no preliminary tre a t ment of w astes. '- ' Cleansing f a c i l i t i e s are lim ited to the sinks at the ends o f the chemical tables and. to a basin the W.C. enclosure, th is room also being used for storage of rubber aprons, s o ile d cloth in g, gloves, shoes and tow els. 2 . Character of Exposure . The follow ing m aterials were involved and are lis t e d in the probaole order of ' importance: a. Mercury dieth yl and i t s degradation products b. Mercuric, and mercurous mercury alkyl s a lt s .( A c., CO3, e t c .) T c. Mercurous and mercuric s a lts including Ac. C0 Oxides d. Degradation products of TEL. e . Benzol f . Mercury g. Other compounds 'which may r e su lt from reactions in the follow ing procedure: (The presence of gummy o ily mass at the end of the reaction suggests the presence of polymerization products of alkyl mercury compounds). About May 19h&> one case of 12 ca'Sfe o f pure TEL was acquired from r-thyl Corp. to be used as an alkyl carrier in the reaction for preparation of ethyimercuric acetate in syntaxes of 3-Me, 6-a lk y l, ethyimercuric, thiosodiumbenzoate. In the preparation of th is a n tise p tic , one gm mol TEL and l . i gm mol HgAc are reacted in anhydrous benzene. The f i r s t operation w^s begun on 3 August I 9I46. forking out doors, UOOml TEL were transferred fro-; the can to a beaker, gloves ana apron only being worn. There was no detectable odor or sp illa g e . The TEL was taken into the laboratory and added to 6L anhydrous benzene (under hood) and reaction started Q by addition of Hg Ac. The reaction went poorly at low reflu x temperature of 80 C and c r y sta lliz a tio n did not occur in four hours. Mixture was then filte r e d on laboratory table near open window and allowed to stand 36 hrs t i l l $ August, at which time i t was noted that the f i lt r a t e had turned salmon-red. The f ilt r a t e and ppt were then mixed and the benzene d is t ille d o ff (at 200mm Hg) and the r e s i due taken up in absolute EtOH (6L) and refluxed vigorously for 6 hours. Cn cool ing, a small y ie ld of needles was gotten. The mixture was then u is t ille d to h a lf (3L) volume when evidence of decomposition appeared in the shape of free mercury; mixture was then f ilt e r e d hot and again concentrated by d is t illa t io n to one-fourth origin al volume ( l i) There was further decomposition with more free mercury appearing. Mixture was then filte r e d and cooled with separation of a pasty, o ily mass with the characteriss of a super-cooled s o lid . Above procedure was carried out during -3th and 6th August. On 7th August, o ily mass was subjected to numerous t e s t s for id en tity - procedures occupying entire day - work stopping in evening because of pain from burns of hands of operators. Dir e c t expc s u r e w a s l h i t e d t o 3 employees in laboratory, Dr. a n d l ^ H H U H H f t Most'severe exnosure was that <57 who 1 /I - f ' owed operations throughout did the f ilt r a t io n s and t e s t s of residue and was most _ careless in handling. He cid not wear gloves at a l l tim es, ana there is good presumption that he handled so ile d fla sk s and la te r put hands in tniokol gloves in carrying out other operations. next in severity of exposure was ^ J J ^ w h o se work was lik e that of who was carefu l to avoid contact and inhalation and who has a considerable respect for the dangers of chemicals in general. had the le a s t exposure of the lo t - he measured out the TIL and in itia te d hie reaction - then departed. . Peak exposure of f H H v a n d kViednesday 7 August l$GO-1930 hrs. Sources of exposure were: a. Vapors of reaction mixture - e sp e c ia lly during decanting and filtr a tio n b. Skin contact with m aterial that had penetrated (perhaps) or been carried into gloves (1) D istribution and d iscrete character o f 'le sio n s suggests carriage of material into gloves. c. Dusts from sp illa g e on floors and equipment - ( 1) 'inis sp illa g e was much in evidence 1 d. Vapors and ousts from open Buchner funnels, beakers, ana tne evident gross deposits on outer surfaces of glassware from stoppage. e . Owing to the course of the efflu en t vapors from the hooa, there was secondary exposure of the occupants of the apartment on the upper story. This was lim ited to Hrs. (including 3/9 of a ch ild ), two infants ages 20 and 8 months resp ectiv ely , ana to Dr. Bodies when 'a t home'. Feed-back into the main laboratory space was also possible - th is point was, however, not checked. The p ollu tio n of the general air of the residence was seriou s, however, since during our. v i s i t there was pronounced ouor at various time in most of the rooms near the side of the hood and in the corridor. In the main laboratory space, the odors were quite strong and per s is te n t - th eir pattern of d istrib u tio n is indicated by the hatching in the sketch of the structure. (Cross-hatching = very strong) Oaors were not lik e those of TIL or degradation products, but strongly suggestive of alkyl mercury s a lts - no sneezing was produced. Must iness predominated. 3 Protective Measures a. Technique of handling was poor and housekeeping worse. Material was l e f t standing open on Chem desk #2 and s p i ll s of mixture on flo o rs and equipment not wiped or cleansed. .Dirty tow els, aprons and clothing were responsible for the odor in the washroom. b. Gloves ana aprons were in good condition but dirty c . Ko respirators are provided d. hashing f a c i l i t i e s (noted above) U. Recommendations a. Removal of residence from apartment and immediate cleanup of a l l product - to be buried. b. Purchase, rather than, manufacture* of t: e interm ediate, eth yl mercury acetate or: c. Isolation of operation - a separate building with concrete floor, ventilation and change room with shower. d. Redesign of chemical hood with b affle and extension of vent pipe. Hood to be cleansed statim. e. Provision of cleansing m aterial - kerosene, sulphury1 chloride, bleach e tc . f . Coating o f floors g. Treatment of wastes in sump - with proper trapping and d ilu tio n . h . .Provision of baths for treatment of glassware prior to washing. i . Construction of showers and separate lockers for clean and d irty clothing. . j . Procedure re impervious gloves . k. Canister masks in general laboratory - a ir lin e and canister in new building. l . Sampling control of a ir . . m. Routine medical check. CLINICAL DATA 13 August 191*6 Owner - manager - chemist Age 56 JiisWD (i*x) PROGENY 2 I&W .... PI See jo in t h istory of exposure. General symptoms began nito of 7 August with insomnia, c h ills and weakness and have p ersisted with s lig h t increase in sev er ity . Cutaneous lesio n s began with severe burning of fin g ers, n ite of 7 August, causing stoppage of work. This was followed by deep pain in 1*8 hrs when a w hite, cooked appearance of skin of terminal phalanges, both hands 'was noted. I n it ia lly applied heat, then soaium bicarbonate for 3 hrs, then eth yl alcohol, th a d ieth yl ether, then potassium iodide solu tion and f in a lly ice, water soaks which have been continued sin ce. The insomnia is attributed to the pain which has been continuous. Since 8 August, there has been poly uria and frequency - q 2h day and n it e . Appetite has been fa ir in past week - no nervousness, bad dreams, .weight lo s s , e tc . No fever, or sweats 'with c h i l l s . There were stabbing pains over spleen at times in past week. HI Three years,*.7 months medicine, PhD in chemistry, has done organic synthesis since age 25 with a l l types exposure. V/as poisoned by phenyl bromide in 1921* - mainly pulmonary symptoms. No unusual exposure to any se rie s - has done considerable work with organometallic compounds. PMH Usual childhood diseases including scarlatin a and diptheria. Shrapnel wound of face, heap and neck in 1917 liernioplasty 1928. Pneumonia 19*3 - 1* nays abed. FH Father died 58 Apoplexy. Mother died 73 N ep h ritis. 2 sib s Ivl SYSTEMIC REVIEW `. Gen Health always good - a very active worker C.R. NR GE Appetite generally good - l i t t l e breakfast - fa ir intake past week, constipation noted since 7 August 1*6 GU Nycturia and polyuria since 8 August, very cloudy urine noted on 9 August CHS Blind right eye since b irth . Glasses a l l tim es, questionable Skin Habits Social lie t Pers Hyg Vacc Allergy ir r ita b ility past five bays. NR t i l l PI Very irregular - works long hours with no relaxation , sport or diversion ' . A ctiv ity lim ited to business and tech n ical s o c ie t ie s . Home foods - w e ll balanced - 1 pt milk d a ily . Cocas alcohol. Heavy smoker - prefers coffee to water. Good but c a r e le ss. Smallpox Benzol vapors cause prompt headache. Sensitive to tomatoes. PHYSICAL EXAMINATION . Ht 70|" Wt 131 ( la s t record prior to PI) T 98.0 P 78 R 22 BP 125/76 ( la s t record 15 June 1|6 - 136/8U GA Skin Nodes bars byes Nose Mouth Throat Neck Thorax Heart Lungs Abdomen P elv is Joints Cr Nerv Reflexes Sensor Muscul Mental Emaciated,' pale, hyperactive - aggressive rather than anxious. General p a llo r. Severe corrosive burns volar aspect a l l fingers right hand and velar aspect f i r s t and second finger and thumb of l e f t hand to le v e l 3 and 2 phalanges - with s lig h t involvement dorsal su rfaces, (d istrib u tio n lik e that which would occur from the handling of glassw are). The sxin has a white, cooked app earance with a few blebs which contain bloody plasma, nesions extend thru en tire dermis in most of affected areas ana 'red in flamed tissu e i s exposed beneath opened bleb. There is slig h t lo c a l sw elling and l i t t l e area redness. Local circu lation appears unimpaired at th is tim e. NR NR R=L m iosis. Reflexes and LOM CK. Fundus examination unsatis factory. NR Gums NR. Pallor m.m. Teeth fa ir with many large f i l l i n g s and two permanent bridges. Slight redness anterior p illa rs NR . Surnmetrical - good expansion Tones s o ft but c le a r, regular B. S. inc vesicu la r - `normal NR Spleen not palpable, no tenderness, much gas in enteric tr a c t. i'jR . NR Normal - no tremor Normal a c tiv ity - equal Normal Symmetrical, good strength, marked myotatic ir r it a b ilit y . Coherent, w ell oriented, normal. Is a le r t hypomanic type. LABORATORY Hb D iff Urine 80 . Poly 61 Non-Seg I4. Lg Lymph 20.5Sm Lymph 13.>Iono 3 Lo 0 Baso 1 Myelo 3 Myeloblasts 2 Neg for Albumin and Sugar. pH 6.0 impr e s s io n 1. Seven corrosive burns of fingers Iron mercury s a lts 2. Mild in toxication from organic mercury compounds v- R2COI SI EKATI ONS . 1. To c a ll in from time to time re progress 2. Recheck in two weeks i f indicated 3. General therapy - sop orific, high flu id intake, r e s t, f u ll d ie t, e tc . li. Therapy for hands - Advised Dr. R ussell - procaine in je ctio n for pain, aspiration remainder of b leb s, debridement as indicated, control o f ' in fe c tio n . Discontinue soaking and tre a t dry or with ointment. 5 Samples blood and urine taken. Several blebs on fingers were aspirated and 0.3ml bloody plasma obtained fcr analysis Age 39 SEX Male . PI See jo in t h istory of exposure. Has had no general symptoms and has slep t vrell except for n ite of 7 August when was kept awake by pain from burns. Skin lesio n s started with intense pain in hands-and fingers which lasted for t h ir ty -s ix hours only. Twelve h urs after onset, a few small v e sic le s appeared on hands - these were opened, leaving raw fle sh beneath - most have e p ith e lia liz e d or crusted over. LOCAL EXAMINATION . There are several 1 x 2cm opened blebs and numerous small (few inn) lesio n s on skin of both hands. A few are beep - most su p erficia l and healing w ell . with minimal areas of reaction . On right forearm are several su p e rfic ia l reddened areas ( l x 3cm) with no gross destruction of skin or bleb formation. These suggest bromine or acid burns rather than le sio n s from m etallic s a lt s . RECOMMENDATION None - Samples blood and urine taken. Salesman Age 58 PI See jo in t h istory o f exposure. There have been no general symptoms except anorexia, which has been an occasional occurrence. No insomnia e tc . LOCAL EXAMINATION There i s one healed burn of skin of index finger and base of thumb of l e f t hand from contact with neck o f fla sk . I n it ia l symptom in few hours, as burning sensation - pain in 21+ hrs and bleb in 36 hrs. This was l e f t alone and dried and peeled in s ix days leaving dusky erythematous area. RECOMMENDATION None - Blood and urine sample s taken.