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HARVARD UNIVERSITY
SCHOOL OF PUBLIC HEALTH
DEPARTMENT OF PHYSIOLOGY
55 VAN DYKE STREET
BOSTON, MASSACHUSETTS
June 27, 1924.
Mr. Arthur Roeder,
United States Radium Corporation,
30 Church Street,
New York City.
Dear Mr. Roeder:
In regard to your letter of June 24, the points brought up
are all matters which we have either discussed with Mr. Viedt
or with yourself.
1. In regard to #1, in the case of a substance such as
radium which is deposited in bone there is no reason why, given
sufficiently long exposure and time for deposition, that bone
disease may not develop many years after exposure, provided
bacterial infection is permitted.
2. In regard to the second point, I doubt whether any
amount of investigation of other plants will bring out real
facts unless it is made discerningly. Let me illustrate.
Several years ago I was called in consultation on a very
important situation which proved to be manganese poisoning.
The condition was practically unknown in this country though
there were many users of manganese and millers of manganese
dioxide. Under protest from certain members of the Company
involved, protective measures were instituted. The condition
disappeared and after a short time\we published the details
of the disease we had observed. When we gave a thorough account
of the medical facts of the situation we at once got reports of
manganese poisoning from firms which had written us previously
that no such condition could exist in their works nor ever had
existed. They had had cases of manganese poisoning which had
been diagnosed as locomotor ataxia and ordinary types of nervous
disease, and they had not realized this until their attention
was called to the possibility of a new disease entity.
No amount of inquiry of a general nature will bring
information in regard to the incidence of bone necrosis in
other plants applying radium paint and handling radium unless the
request for information is accompanied by a thorough explanation
in medical terms of what has happened in your plant. When the
first cases of aplastic anemia due to radium occurred their
cause was not instantly appreciated, and it was only after five
fatalities had taken place that this phase of radium damage was
understood and workers with radium began to carry X-ray films
and pay attention to the warning they give.
-2-
3. We are aware of the fact that Mr. Bilstein, Dr. Lehman,
and Mr. Roth are at present still free from any such dangerous
experience as some of the girls have been unfortunate enough to
meet. We do not, however, regard this as an important matter of
evidence. In any situation involving industrial poisoning, unless
the poison in question is intolerably dangerous and quick in
action, individuals frequently heavily exposed can be pointed out
as apparent evidence that poisoning does not exist. Many times
in my experience I have been shown employees in lead plants who
have been there for many years and who are pointed to as conclusive
evidence that lead is practically not poisonous at all. We do
not know what it is that makes one person more susceptible to a
poison or drug than another, but we do know that given a situation
moderately dangerous -- and this is what you are dealing with --
occasionally individuals will be found who will succumb.
4. In regard to Mr. Viedt's point that trouble has occurred
mostly in individuals employed some time ago, it seems to me that
we simply have evidence that a long period of exposure is needed
in order to cause trouble. Miss Carlough, your most recent case,
was employed up until last Christmas and has failed progressively
since this time.
The situation we found at Waltham had little or no bearing
on the conditions in Orange because they had but three operators
at work and never, apparently, according to the account of their
superintendent, had a sufficient volume of dial work to keep the
same girls employed over long periods.
I would myself have the greatest interest in an investigation
of the situation presented by your principal competitor -- I think,
the Standard Chemical Company -- provided the investigation in
question was carried out by some one who would give the Company
in question full details of what caused the inquiry and what might
be discovered. Lacking such information I believe that even with
the frankest intentions the firm in question might reply in much
the same way as did some of the firms who first answered us in
regard to manganese. They might well have had instances of this
-3-
condition, but unless these instances fell in the hands of the
same group of physicians or dentists and unless they were
sufficiently concentrated to create definite notice there would
be no reason why the firm in question should know that damage
had been done. This is why I feel that inquiries made by the
New Jersey State Board of Health should be carried out through
medical men and not through the ordinary routine inquiries of a
health department, and it is even necessary in this case that
the medical men should have a very thorough acquaintance with
the situation before instituting their inquiry.
Very sincerely yours,
Cecil K. Drinker, M.D.
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"ocrText": "HARVARD UNIVERSITY\nSCHOOL OF PUBLIC HEALTH\nDEPARTMENT OF PHYSIOLOGY\n55 VAN DYKE STREET\nBOSTON, MASSACHUSETTS\nJune 27, 1924.\nMr. Arthur Roeder,\nUnited States Radium Corporation,\n30 Church Street,\nNew York City.\nDear Mr. Roeder:\nIn regard to your letter of June 24, the points brought up\nare all matters which we have either discussed with Mr. Viedt\nor with yourself.\n1. In regard to #1, in the case of a substance such as\nradium which is deposited in bone there is no reason why, given\nsufficiently long exposure and time for deposition, that bone\ndisease may not develop many years after exposure, provided\nbacterial infection is permitted.\n2. In regard to the second point, I doubt whether any\namount of investigation of other plants will bring out real\nfacts unless it is made discerningly. Let me illustrate.\nSeveral years ago I was called in consultation on a very\nimportant situation which proved to be manganese poisoning.\nThe condition was practically unknown in this country though\nthere were many users of manganese and millers of manganese\ndioxide. Under protest from certain members of the Company\ninvolved, protective measures were instituted. The condition\ndisappeared and after a short time\\we published the details\nof the disease we had observed. When we gave a thorough account\nof the medical facts of the situation we at once got reports of\nmanganese poisoning from firms which had written us previously\nthat no such condition could exist in their works nor ever had\nexisted. They had had cases of manganese poisoning which had\nbeen diagnosed as locomotor ataxia and ordinary types of nervous\ndisease, and they had not realized this until their attention\nwas called to the possibility of a new disease entity.\nNo amount of inquiry of a general nature will bring\ninformation in regard to the incidence of bone necrosis in\nother plants applying radium paint and handling radium unless the\nrequest for information is accompanied by a thorough explanation\nin medical terms of what has happened in your plant. When the\nfirst cases of aplastic anemia due to radium occurred their\ncause was not instantly appreciated, and it was only after five\nfatalities had taken place that this phase of radium damage was\nunderstood and workers with radium began to carry X-ray films\nand pay attention to the warning they give.\n-2-\n3. We are aware of the fact that Mr. Bilstein, Dr. Lehman,\nand Mr. Roth are at present still free from any such dangerous\nexperience as some of the girls have been unfortunate enough to\nmeet. We do not, however, regard this as an important matter of\nevidence. In any situation involving industrial poisoning, unless\nthe poison in question is intolerably dangerous and quick in\naction, individuals frequently heavily exposed can be pointed out\nas apparent evidence that poisoning does not exist. Many times\nin my experience I have been shown employees in lead plants who\nhave been there for many years and who are pointed to as conclusive\nevidence that lead is practically not poisonous at all. We do\nnot know what it is that makes one person more susceptible to a\npoison or drug than another, but we do know that given a situation\nmoderately dangerous -- and this is what you are dealing with --\noccasionally individuals will be found who will succumb.\n4. In regard to Mr. Viedt's point that trouble has occurred\nmostly in individuals employed some time ago, it seems to me that\nwe simply have evidence that a long period of exposure is needed\nin order to cause trouble. Miss Carlough, your most recent case,\nwas employed up until last Christmas and has failed progressively\nsince this time.\nThe situation we found at Waltham had little or no bearing\non the conditions in Orange because they had but three operators\nat work and never, apparently, according to the account of their\nsuperintendent, had a sufficient volume of dial work to keep the\nsame girls employed over long periods.\nI would myself have the greatest interest in an investigation\nof the situation presented by your principal competitor -- I think,\nthe Standard Chemical Company -- provided the investigation in\nquestion was carried out by some one who would give the Company\nin question full details of what caused the inquiry and what might\nbe discovered. Lacking such information I believe that even with\nthe frankest intentions the firm in question might reply in much\nthe same way as did some of the firms who first answered us in\nregard to manganese. They might well have had instances of this\n-3-\ncondition, but unless these instances fell in the hands of the\nsame group of physicians or dentists and unless they were\nsufficiently concentrated to create definite notice there would\nbe no reason why the firm in question should know that damage\nhad been done. This is why I feel that inquiries made by the\nNew Jersey State Board of Health should be carried out through\nmedical men and not through the ordinary routine inquiries of a\nhealth department, and it is even necessary in this case that\nthe medical men should have a very thorough acquaintance with\nthe situation before instituting their inquiry.\nVery sincerely yours,\nCecil K. Drinker, M.D."
}