. (1976). British Journal of Industrial Medicine, 33,[29][30][31][32][33][34][35]. Biochemical changes during the initial stages of industrial lead exposure. Biochemical measurements were carried out on 20 workers entering employment in a lead industry. Blood lead (Pb-B), urinary 8-aminolevulinic acid (ALA), and coproporphyrin (CP) levels were determined before entry and then at approximately weekly intervals for the first 12 weeks of employment. Levels of blood lead began to increase in all men within one week rising from an average pre-employment figure of about I 1 t,mol/l (22 ,ug/100 ml) to a value of about 2-9 ,umol/l (60 ,ug/100 ml) at three weeks. Subsequently there was only a small increase and Pb-B values levelled for the rest of the period. There was no increase in urinary ALA and CP in most subjects during the first two weeks; thereafter there was a variable pattern of excretion although three main groups of response could be discerned. Urinary ALA and CP changes related well to each other but their correlation with the characteristic increase in Pb-B fell into three categories of relationship. The major finding of the study was the very contrasting response shown by some individuals. This emphasized the need for a reasonably comprehensive biochemical screen during the early stages of employment in the lead industry in order to assess the individual biological response of a new employee to this environment. The measurement of Pb-B and urinary CP or ALA was advocated for this purpose.
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BRMSH 541 tives, usually poor palliatives at that, and in these circumstances any dosage carrying a 16% mortality rate is far too high. During 1959-61 1 treated well over a hundred cases with " thiotepa." Roughly one-third were given the high dosage (along with testosterone propionate) recommended by Whyte Watson and Turner,' the remainder receiving about half this dosage. This experience convinced me that maximal doses do more harm than good. Dr. Basil A. Stoll is right in stressing the harmful effects of injudicious chemotherapy.2 He writes of the " dangers of piling misery upon misery in the late cancer case."-I am, etc.,
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