There is considerable debate as to the actual health risk associated with low level lead "poisoning" in adolescent populations.

Foreign to the human body, lead is a cumulative poison.

Another large investigation, this one on the subject of lead poison ing, was begun in the1 spring.of 1921 !

Two seals had died earlier this year and a third one just recently, reportedly from lead poisoning.

In that the basio lead oonee^fcratloo has appeared to be in the neighborhood of 1 mill i gras par 10 eubio cetera, while the brief periodic expoeure, during droaslng end shoveling la of the order of 2*5 to 3*0 csllllgraas per 10 cublo aeters* iiy experience In industry leads ne to believe that thla degree of exposure dace not indues sufficient lead absorption to cause lead poisoning* This conclusion la fully verified by the results obtained In the examination of 2 employees whose work has Involved daily exposure to such lead as is regularly distributed into the atmos* phere around the pot* Neither of the two workmen showed any cltnioel evidence of occupational lead absorption* Neither had a lead line, despite the presence of conditions in the nouth (pyorrhoea) uhloh are favorable to the development of lead doposlts in the guc tissue* Neither of then shoved any blood changes lanecsla or stippling) suggestive of lead absorption* Neither of them had abnormal quantities of load in their blood and urine* I&rrlt uyer had O.OU mg* per litar of urine, and 0*03 i*b por 100 .( rams of whole blood, wh*'e John Difcsler had 0*03 Tb per liter of urine and 0*033 g* i'b per 1^0 grams of whole blood* These or quite within the limits of values found In perfectly normal persons with no occupational exposure to lead compounds* 04410 I conclude, therefore, from the combination of these data, that the occupational conditions studied at this time are not such as to entail the risk of lead poisoning In werkaen* It Is also ny opinion that the conditions described as in sailstenos at the time of the plaintiff*s employment, while probably Invt Ivlng somewhat greater exposure then that which ooours at presant, were not sufficiently different In type or magnitude to Justify an opinion that lead poisoning would have resulted from tbs exposure* Good clinical evidence would be required, therefore, to convince me that tho plaintiff bad lead poisoning at the tire it was claimed that he had* By good ollnioal evidence I mean that characteristic symptoms, associated with lead line of the gums, perhaps, and certainly olth exoeaalve numbers of "stippled0 rod blood corpuscles, should have been present* The preaenee of ab normal quantities of lend in the urine or blood or In both at that ti-e, would have been convincing, while the lack of such evldenoe 13 a serious fault In the plaintIff*a olain* Returning to tho subject of "stippled" erythrocytes (red blood corpuscles} It is necessary to demonstrate the presence of abnormal numbers before signification can be attached to the phenomenon* "stippled" erythro cytes occur in the blood of normal persons up to ton or more por fifty microscopic fields, and they are found In increased numbera In a wide variety of conditions which have nothing whatever to do with lead absorption* Their presence, without reference to numbers, or without knowledge of other concomitant ohanges in the blood.

CORONERS VERDICT * Died as the result of peritonitis with obstruction of the JeJunua associated with chronic lead poisoning.

In that the basio lead oonee^fcratloo has appeared to be in the neighborhood of 1 mill i gras par 10 eubio cetera, while the brief periodic expoeure, during droaslng end shoveling la of the order of 2*5 to 3*0 csllllgraas per 10 cublo aeters* iiy experience In industry leads ne to believe that thla degree of exposure dace not indues sufficient lead absorption to cause lead poisoning* This conclusion la fully verified by the results obtained In the examination of 2 employees whose work has Involved daily exposure to such lead as is regularly distributed into the atmos* phere around the pot* Neither of the two workmen showed any cltnioel evidence of occupational lead absorption* Neither had a lead line, despite the presence of conditions in the nouth (pyorrhoea) uhloh are favorable to the development of lead doposlts in the guc tissue* Neither of then shoved any blood changes lanecsla or stippling) suggestive of lead absorption* Neither of them had abnormal quantities of load in their blood and urine* I&rrlt uyer had O.OU mg* per litar of urine, and 0*03 i*b por 100 .

' 1, The hazard of lead poisoning is present whenever men enter a stowage tank which has contained leaded gasoline.

Lead Poisoning D.

Ten cases of silicosis were reported and one each cf lead poisoning and radium poisoning.

The Health Department had a record of thirty-one cases of lead poisoning of children in 191*8, four of vrhon died.

However, instead of so doing, he refers to them as Important evidence of the likelihood that the patient had lead poisoning.

-2- It Is fairly apparent to me that Dr* Quaintance*s report Is the chief reason for the decision of the Commission, for Dr, Quaintance is very definite In his belief that the; patient had lead poisoning, and died of lead poisoning, and yet he comes out with the bizarre statement that there is no evidence that sorbed lead as a con sequence of his occupation* It is, of course, possible for a man to absorb lead from non-occupational sources but it is so improbable in the case of an adult that the Commission was right in not giving this statement much weight.

There are some veiy capable and well-informed people there, with specific reference to the problem of lead poisoning.

It is my impression that the use of x-rays for diagnosing lead poisoning has been performed mostly by pediatricians who have little knowledge of lead toxicology and who therefore tend to rely on a tool which they already have in their possession.