Dr. Robert Kehoe, Cars, Lead, and Smoke
Submitted By Elizabeth J. Kopras
Just as the mass production of cars got underway in the United States, Thomas Midgley, Jr. and Charles F. Kettering made a very lucrative discovery. They found that adding ethyl fluid to gasoline improved the antiknock properties of fuel, improved gas mileage, and made cars run more smoothly. Their company, General Motors (GM), knew this improved fuel would be in high demand, and estimated that profits would be over $60 million per year, in 1923 dollars. When several workers who handled the material became ill and died, GM faced the possibility of losing enormous potential profits. With the hopes of saving their product, the GM research team went to the University of Cincinnati for help. Dr. Marin H. Fischer, Chairman of the Department of Physiology, wasn’t interested in the project, but referred them to a young investigator in his department, Dr. Robert A. Kehoe, who had expertise in the reaction of heavy metals with tissue and cellular proteins. Dr. Kehoe, then an assistant professor, told Midgley that he didn’t have the faintest idea what the corporation should do, but… “If I had the right kind of laboratory with the right kind of people in it—chemists, physicists, engineers, and doctors—I think I could find out what you should do.” Prompted by the need for this type of interdisciplinary research to save their product, GM supported Dr. Kehoe’s efforts.
Using industry support, Dr. Kehoe built his interdisciplinary team. It was already known that high levels of lead, one component of the fuel, could cause adverse health effects similar to those reported for the new fuel. Dr. Kehoe and colleagues devised elaborate epidemiological investigations of the distribution and use of tetraethyl lead-containing gasoline by comparing the findings on filling station attendants and other exposed persons with similar groups handling gasoline that contained no tetraethyl lead. They proved that tetraethyl lead was the primary toxic agent in the ethyl fluid, and they proceeded to study the process of lead exposure and how it was distributed in the human body. Based on their findings, they developed precautions for handling ethyl fluid, and educational plans for workers in industry. This information was used to develop regulations for handling ethyl fluid, and enabled the GM Chemical Company to build equipment for safely blending the fuel, which let them keep producing this very profitable compound. It is significant to note that no case of tetraethyl lead poisoning was reported once Dr. Kehoe’s worker safety programs were put into place.
Having made a reputation for work on industrial lead compounds, the laboratory was besieged with requests to study other industrial problems. University of Cincinnati (UC) scientists performed extensive studies on methyl chloride, methyl bromide, and sulfur dioxide. The Frigidaire Corporation used these chemicals as refrigerants, but the company needed to understand the toxicity and safe handling of the chemicals after exposure to the refrigerants had caused several worker deaths. Once again, the first phase of the investigation was a careful survey of the health of the workers in the industry, a combination of epidemiology, clinical evaluation, occupational hygiene, chemistry, and engineering. Dr. Kehoe’s team implemented the concept of testing the chemicals in “worst case” conditions, such as while heated, under pressure, or mixed with other chemicals. According to his predecessor, Dr. Roy E. Albert,Dr. Kehoe was “one of the great pioneers in the field of occupational medicine. His great contribution was the realization that, in fact, there is a field of occupational medicine which requires research workers from many disciplines all working together to discover the ways in which things we use in industry and that enter the environment cause harm.” By the end of the decade, Ethyl Gasoline Corporation, DuPont, and Frigidaire Corporation jointly contributed $130,000 to build Dr. Kehoe’s dream laboratory at UC. This was the birth of the interdisciplinary research known today as “Toxicology” at UC, in the Kettering Laboratory of Applied Physiology.
The field of toxicology continued to be challenged by industrialization, the production of new chemical compounds, and toxicants of war. Kettering Laboratory was renovated in 1941 to support research important to the war effort, with the addition of a high-altitude chamber where anti-malarial drugs were studied to see if they affected World War II fliers. In support of this important war-related research, faculty of the Kettering Laboratory and Departments of Psychiatry and Medicine frequently served as research subjects as well as scientists. In 1948, a new wing was built using $640,000 in contributions from local industries that required the continued support of a multidisciplinary research team. Kettering Laboratory joined the Department of Preventative Medicine to create a new, interdisciplinary Department of Preventative Medicine and Industrial Health. The Laboratory was subdivided into six divisions: Preventive Medicine; Clinical Medicine; Toxicology; Forensic Pathology; Industrial Hygiene Technology; Biometrics; and Bibliographic Research, reflecting the disciplines of that time. Staff included physicians, physiologists, pathologists, toxicologists, chemists, engineers, epidemiologists, veterinarians, and a full time medical librarian. The war effort and industrialization produced effluents from aluminum, atomic energy, beryllium, magnesium, petroleum, steel, and other industries. Advances in the toxicity or safety of pesticides such as DDT, food additives and the newly developed plastics used to wrap and preserve food required further investigation to meet new requirements of the U.S. Food and Drug Administration and the World Health Organization.
Dr. Kehoe organized a program of graduate training in 1947 to meet the need for more scientists with the multidisciplinary expertise to investigate toxicological problems. He developed the Institute of Industrial Health, which included instructors from the Colleges of Law, Engineering and Business Administration, in addition to the Medical College. Dr. Kehoe actively pursued the goal of official recognition of the specialty of occupational medicine, serving as Chairman of the Interim Board of the American Medical Association Council on Medical Education and Hospital. When Occupational Medicine was officially recognized as a specialty by the American Board of Preventive Medicine in 1955, Dr. Kehoe served as the first Vice Chairman of this Board.
Kettering scientists were called upon to apply their interdisciplinary expertise to a variety of industrial and public health situations, including the first investigation to document the health impacts of air pollution in the United States. Donora, Pennsylvania, had a history of air pollution problems due to local industry including the Donora Zinc Works smelting operation. The plant owner had paid off legal claims as early as 1918, and regular air sampling had been in effect in the 1920s and 30s. In late October 1948, smog had settled over the town of 13,500, but they were accustomed to the fumes that assured them of work, progress, and prosperity. They had yet to experience a “temperature inversion,” an atmospheric condition where warm air from above traps the cooler air against the ground, causing the atmospheric toxicants to blanket the community. The stagnant pollutants took their greatest toll on Halloween night, in fog so dense that the high school football team had to abandon the pass. Seventeen people died in the space of twelve hours, and thousands more were left gasping for breath. A day later, a light rain fell and the suffocating conditions lifted as quickly and as mysteriously as they had descended. In search of “an independent and unbiased” study of the disaster, Dr. Clarence Mills, one of the medical school professors from Cincinnati, was brought in. Based on their previous experiences with industrial toxicants, Dr. Mills advised running a health-effects survey to establish the cause of the miasma and to understand what safeguards would be needed to protect the public in the future. Dr. Kehoe’s team was given the contract to investigate the smog, and to ascertain if the factory effluvium or the unprecedentedly heavy fog had been responsible for the deaths. For Dr. Kehoe and the U.S. Public Health Services the Donora survey was an opportunity to develop a new program, adapting the methods of industrial hygiene to address the public health threat of air pollution believed to be imminent in postwar industrialization, urbanization and population growth. Before the Donora smog, neither manufacturers nor public health professionals considered air pollution to be an urgent issue. The Donora Disaster was the starting point for federal clean air laws. President Harry Truman called for a national conference to address air pollution, and Congress eventually passed the nation’s first Clean Air Act in 1955.