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LINDA HAWES CLEVER, M.D. v
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DEPARTMENT OF OCCUPATIONAL HEALTH VW

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October 21, 1980

Dr. Joshua Lederberg
President

The Rockefeller University
New York, New York 10021

Dear Josh:

It was with a sense of relief, exultation, and excitement
that I heard of your thoughts about establishing a center
for studying "untoward events" in the workplace. Rocke-
feller, because of its breadth, excellence, and objectivity
can have a tremendous impact in occupational medicine,
which is currently quite bereft of research thrusts and
valid data. Your center could look at at least two ap-
proaches. One would be to evaluate surprises; the other
would be more systematic. Surprises would include:

1. spills and other acute overdoses, ,
2. unusual syndromes (such as TMI trimelytic anhydride ),
see attached,

3. asthma,

4. exceptional sensitivity to common substances (for example,
I have seen a lead battery worker who has clear bone mar-
row and probably renal and GI toxicity when his leads are
in the sixty micrograms per deciliter range; most workers
aren't affected until their leads are eighty to one hun-
dred micrograms per deciliter,

P.O. BOX 7999, SAN FRANCISCO, CA 94120, CLAY AT BUCHANAN STREET, SAN FRANCISCO (415) 563-4321
Dr.

Joshua Lederberg

October 21, 1980
Page Two

5.

The

new processes which have unexpected side effects.

more systematic approach would be to evaluate the

metabolic effects by classes of chemicals depending, for
example, on current toxicologic information and/or volume
of use (for example, PCB, vinyl chloride).

A few caveats come to mind:

1.

If you do not have a functioning referral network,
which should include industry and labor, that would
need to be established.

Your center must be objective by union and management
standards or you could ignore the adversary, trench
warfare in the workplace and take the approach that
Rockefeller is above it all. But you must at least

_be acutely aware of labor/management issues.

Long-term follow-up of end-organ effects would be an
additional attraction to volunteers who might be willing
to have metabolic parameters evaluated. It might also
be, for example, that effects on an inducible enzyme
system might be permanent.

It would be most useful, of course, for you to know
what research is already going on at Mt. Sinai, Univer-
sity of Cinncinnati, UC Davis, in industry (DuPont,
Dow, Standard Oil).

Above all, be prepared for flack, in spite of your good
intentions. To some people, knowledge is dangerous
since they do not know the outcome of its acquisition.
It seems to me that ignorance is the source of even
more conflict, however.

Best wishes! And please let me know if I can help in any

way.

LHC:

Cordially,
Linda Hawes Clever, M. D.
Chairman
Department of Occupational
Health
BP

Enclosure