Document zQKnOw1aMj3peozG00Q8yQn0g

Uiuu> C'l/m-q INTERNATIONAL LBADZINO RBBBARCH OR CBANIZATION, INC. * $ U*0>0| AVlNUl. N#tV fO*C * r. wi IHI^h OM Iff-AOtO IAMB* COO* Blt CABwB AOt>**B* NTV**0 NfW OM # I IM June 20, 1967 - , >c. - v. -r'V' To: All Member* of th# Lead tovlrccarotal Health Ccaalttee R#1 Ui-115 gureelllaace of Population Lead Level* Attach*4 for your lnforaattoo i a copy of the alnute* of the >toy 31, 19$7 i ee 1104 of th* Subccmlttee 00 Surveillance of Population Lead!*rb la Of th* Lead Ldalaoo CccaItlee. V- Tog trill not* fro* r*<* 3 of tic attached alnute* that th# eubcooalttee prefer# that all ver* cn thla atudy be don* or uj>*nri**4 by a aIngle laetltutlce, and that the Kettering laboratory ha* bean aeleettd aa tha flrit choice to carry out thti wort. Accordingly, ICetterlcg la being Incited to preaeot a preliminary propoaal with estimated budget at the beat seating of the Lead Llalaoo Cgaaittee which la acLel*led for July Id, 1967. Alao attached for your lnforaattoo la a copy of the letter tram Prof. Vigilant of Xtlaa at lch we dlacueted at our laat lead tewlronwantel Health Caaaltle* Meeting 00 April 27, 19^7* Pleaae review the attached Material and aula It any craaamte and/or uggeetlooe you aay have prior to the July Id aeellsg. Very truly youre, JCBiaw attachment* Jaae* C. Bourn*1 i ijv: 'i* J ' -.i '_dJ ( He*tlng: >**y 31, i&J, Bom 2068, Health, Education 4 Votfr* South Bldg Tin*: 1:30 - *>: JO f.M. Preaent: E. T. Blcaojulat V. J. Caetrop R. I. Eckardt ft. J. M. Horton, Cbalrnan J*at* Rousaa (for D. 0. Tcvl*r) C. K. Ilmer (for J. H. Ludvig) 1. T>. dealrable period of tla* for air sanpllng t the verlcu* alt** chcata va* diseased. It vt agreed that caspltng should b# dee* at *aeb lt* for 1) - 1W Booth* la order to obtain material for a tnu* annual n**n. Frequently the data for th* flrt acr.th or tv *r defective and would be better dlerardc:!. Tola rbtalced tor toaevhat ion than th* n*d*d year vlll allow *uch adjuataant* to b* and* * 1 ly. 2. It vti afritl that tb* *axpllng of th* popult loo group* ahould b* don* on on* ocrlco during th* /tar la which th* air aaapllng la door. Th* qu*t'.eo of *a#oru*l varlatloo In blood laada as a f-ertln*nt prob.ra vat conald*r*d. Ur In* lead level* t*hd to rtaa In th* lata uiswr a* can b* *n In th* prolonged Individual espoaur* aludl** doft* If Dr. Keb.o*. *0 other published data on thl* problm appear to b* available eacep*. for on* ccament by Of- Rorlurht. Th* latter'a mter'.al show* a aeaeonal fluctuation In group Bean* of blood lead* taken In different aco'h*. However, th* hind* of people aaarpled. In earn lanth v-r* not unlfona, *0 that the apparent eeaicnal charM could be the reilt of coincidental grouping*, ln.hu*try probably ha* data to *nevr thl* q.*tlon, but ha* never tudll it frte* thl* point of view. t>r. IUho* kindly *uppll*3 data fru* Mt eifarlaental ubject* rfrr#1 to above. In lh** the blo<! leal h</* no eatot.Al varlatUvi even though the urtn* leal doe*. It va declled that th* obtaining of blood **urple frt* people thcrull be done vithln the * aenth In all of the *t rltle*. Thl* voull avoid any difficulty in the ab*en. of definitive Information on th# pr#*tvr* or aben<* 01 a total flue " avion in group naan* of blood lead l*v*la. fc- ` vt*rr f rI f >' S\; V2 t * N 492.01 ;n -2. -4 3 After the three city study It i found thet there vere several person* detected vlth blood or urine leed level* high enough to deterre first recheck end then further study of lesd exposure If required. Doing this Inter on va* svkvsrd. In future studlee persons having blood leed levels of JO y% or sore should be Idea11 fled a* promptly es possible, here their blood leed level rechecked, end. If it Is again elevated, be further Investigated es spproprlete. W. The problem of Including or excluding children la the study ves again considered. It Is agreed that children need core Investi gation but not In this study. The probleas of permission fre* parents, and noncoop* rati vsness aake then difficult to use. The previous decision to exclude children was confirmed. J. A suggestion to Include urine exanlcntlons for level of delta aalnolcvullnlc acid was considered. This arises principally from the correlations between blood lead and 8A1A shewn In recent work by Crasser. Ae above with the children problea, It was decided that the information Is desirable, but should be obtained In scae other setting. 6. A Suggestion was Bade that In choosing Individuals In the groups of people to stuly that person* who are part of each group for less than ooe year be excluded fro* the study. We are Interested In exposure states which are more or less steady) newcomer* are not appropriate for Inclusion. This suggestion was therefore adopted. 7* Xr. Zimmer discussed the quality control efforts which vere used In the three city study. He pointed out the considerable difficulties enccwnterel !o achieving and maintaining comparability between the three laboratories. There are also problems In keeping coctroi -I between technician* In the same laboratory. The fewer laboratories and technician* take part, the better. It was decided that *11 of the work in the forthcoming study on aercmetrlc and blood specimen should be done In one laboratory. A number of other incestloc* vere made) (a) epee lawns subaltted for quality control purposes should not te Identifiable by the laboratory If this can be arranged, (t>) bleed samples should be of sufficient site (?0 CC-) to permit accurate determinations, (<i) quality rnnlrol procedures should be set up and tried at realistic levels prior to the study, (d) trials for control and evaluation should be done by the technician who does the routine work, not by Ms superiors, sod (a) the laboratory . carrying out th* study should submit its quality control plan la detail ms part of the protocol. ly-t., tjqut1 w1si- -sakfpjwryi"j ir w m&mmjm ww - -. * -`.-i ^ 8, Mr. timer also stated that sons naterlal fron the three city study aercnetrle saaples 1* (till available 1a their laboratory. Tha laboratory vhlcb does the mv study can therefor* ba furnished air filters fron tha former study to analyse and to establish cooper-ability vlth those data. This la trua only for tb* seronetrle specimens) no blood specimens ara ava1labla. 9. Tha subccmlttee praftra that all of tha work on this study ba dona or supervised by a single Institution. It Is recognlied that local asslataaca vlll ba needed in tha selected cities In obtaining saaples and specimens, but tha study design, Its execution, tha laboratory vork, and tha analysis should all ba tha responsibility of a single Institution, and probably should ba tha direct raspooalblllty of as fee people aa possible. Tha subccsotltlee sa lac tad as its first choice to carry out this task Tha Kettering Laboratory of tha University of Cincinnati. Dr. Bortco mi authorised to contact tha Director of tha laboratory regarding their Interest * ^ j In doing this vork. If thay are interested a preliminary proposal' S.J vlth ell lasted budget should ba obtained for present*!loo to tha Lead Llaitoo Ccnaltlee at Its Beating In July. Tha Information Co tha opt Ira 1 site of population groups which vaa referred to to paragraph 9 of tha alnulea of tha January 12 Beating should ba obtained by Dr. Horton and furnished to The Kettering laboratory along vlth tha dec la tons contained In these and tha previous nlr.utct. 10. A latter fron Prof. Enrico Vigilant of Milan, Italy, to Don fouler, la attached. This vaa discussed sa s possible desirable Inclusion . ^ In the oev study, fron the Information given In the letter It vaa thought that this would add to tha study If the ea&s protocol eculd be followed exactly, and tha laboratory vork done her*. The Kettering Laboratory should also be asked to express an opinion cn tha deslr* ability of such an addition to tha atudy. Meanwhile, Mr. fovlar "l vlll obtain sore Information re data already on band la Milan. i L S Dr. Doo 0. Fowler Director of Health tod Safety Lead Industrie* Association 292 Kadi*00 Aveou* ]w fork 17 t H.T., 0.3.A. mj ia n o 10th Karch, 1967 VUtMIMAKI MMtt HMJ9 ICT/loe - tnt. j Do s t Dr. Fowler, I remeaber with pleasur* your visit to tbs Clinic* dl Uvoro of KilaA and our talks sbout tbs r***rch jolnj 0a 00 atmospheric 1**4 pollution *od occup*tion*l 1**4 poUoalnf. L*st ssonth 1 was in tbs 0.3.A. wher* I *ttnJ*4 th Annual He#tin* of th* American Ac*4*y of Occupational Hedlcln* in Jan Francisco. On that occasion I bad a loo* conversation with Dr. John Keller of tbs Awrlean Petroleun Insti tute. I told hue that vs have started a study on the oomal lead Mt*bolls* of tbs inhabitant* of Mll*n. from th* first data i have at hand, it seeses that th* inhabitant* of Kilan have * such higher lead intake than the urban population of nan/ torn* In th* U.3.A. Oar value* are about 0.3 at of lead per day, vhsrsa* th* oornal lead intake in th* States does not scea to exceed 0.4 s^/day. V* also nads aany asasureasnts of lead In th* air to assess th* pollution due to exhaust Cases iron automobiles. I asked Dr. Keller whether th* American Petroleum Insti tute or th* Lead Industries Association vould be interested in aiding this typ* of research work, which art unable to carry out properly with our own resources. Me told a* that th# Aaarlcan Petroleum Institute Is not allowed to five funds for aedical research outside the 0.3.A., but he felt sure that the* resesrch work v# have undertaken would be of Interest to the Lead Industrie#**' Association. He ssld the Association ni^ht be able to help our research project and cugjeeted me to fet in touch with you. So I aa taklnt th* liberty of writing to you to *k you whether yon think Lead Industries Association would be Interested In a study on ltad mla bel!** In a rather polluted European town like Kilan. I know that studies on this subject are ftoln* on In Los Anjelti, Cincinnati and Philadelphia. Th* comparison between th* eituation in kilan and that found 1a th* AaericaA cltlet would be Interacting, Juet because our fijurts see* to b* much hl(h*r than th* 1 =v.. "V j.' ' ' ' N 492.02 I - y>' :,&j C v:CA DEL LAVOKO 'LUIC! DEVOTO* SU N. American ones and, nevertheless, It does not sees u if tha inhabitants of Milan art suffering frca an/ degree of lead poisoning. If you think such a research project would be of an/ interest to the Lead Industries Association, I can send /ou a report of everythinx vs have already done and a project of that vo intend to do and vfcat assistance ve need to carry out our prograsae, I do not know whether you would also be interested in clinical lead poisoning. Every year, about fifty cates of clinical lead poisoning are adaltted to the Clinica del Lavoro, which provide very good naterial for the study of the various deleading procedures. Ac present, we are intercated in studying the deleading effect of verser-ate injected intrarasscularljr in doses of ICO cg/day versus the deleading effccc of tee conventional intravenous perfusion of 1-2 g. of vcrtcoate. The intrawscular injection is euch easier to perfors in all aabulaat cases and in workers exhibiting very early signs of pluahita Uit who have not given up working with lead. Ve are also interested in studying the decrease in the blood strua content of the enxyae ALt-dehydrase as an early sign of excessive lead absorption. It sees* to us that this is one of the very early signs of lead poisoning, which appears even before the rise in coproporphyria in the urine and the appearance of. stippled cells. If you ere at all Interested in the work we are doing at the noaeat on load absorption and lead poisoning, plcsse let ns know and I shill be happy to give you all the infonatioo we have. It would be very nice if we could start a collaboration with you and the Lead Industries Association. Vith best regards. a Tours sincerely. it. Enrico C. Vig^f Ini Vu^; .-i552v*f'