81.

Nottbohm L. The supervisory physician in plants presenting lead hazards. Medizinische Welt. 1963; 44:224-228. (2596) [The author describes his work as an industrial physician in a battery plant in Germany. Preemployment medical examination is required by law. Men with previous or present Pb intoxication, tuberculosis, vascular, renal, metabolic or liver disease or ulcers and former prisoners of war who had acquired some sort of dystrophy, are considered unsuitable. As respirators re advocated for high levels of exposure, the men should have no nasal obstruction; mycotic skin troubles should also be watched for. The law prescribes a monthly supervision of battery workers, which includes a weight check and detailed blood and urine tests. Blood pressure is taken every 6 mo, X rays of the lungs every 2 yr. All laboratory tests have to be evaluated in comparison to previously obtained data. An increase of basophilic erythrocytes and coproporphyrin may occur in a new worker who after some time develops resistance to Pb so that intake and output of Pb become balanced. An evaluating scheme is shown in which 5 groups of subjects are classified on the basis of such tests as count of stippled cells, urinary porphyrin, Pb in blood, hemoglobin content and clinical symptoms; the classifications are: (1) no Pb absorption; (2) insignificant Pb absorption, (3) manifest but still not significant Pb absorption, (4) manifest Pb absorption, (5) incipient Pb intoxication. Another table shows the percentage distribution of Pb exposure in various work places. Preventive measures and education of the workers are discussed. For prophylactic purposes, vacations in a stimulating climate and administration of Mosatil are useful.

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