Stegall v. St. Joseph Lead Co., 33824

Decision Date23 February 1971
Docket NumberNo. 33824,33824
Citation465 S.W.2d 855
PartiesLynn H. STEGALL, Respondent, v. ST. JOSEPH LEAD COMPANY, Appellant.
CourtMissouri Court of Appeals

Moser, Marsalek, Carpenter, Cleary, Jaeckel, Keaney & Brown, Joseph H. Mueller, St. Louis, W. Oliver Rasch, Edward J. Bust, Bonne Terre, for defendant-appellant.

John J. Larsen, Jack Randall, St. Louis, for plaintiff-respondent.

DOWD, Judge.

This is a workmen's compensation case involving a claim by an employee against his employer and self-insurer for the occupational disease of lead intoxication. The employer by its answer denied the claim. At the hearing before the Referee the employer admitted inter alia that the employee had been exposed to lead dust and fumes during his employment but denied the employee sustained lead intoxication.

The Referee found in favor of the employee and awarded him compensation for permanent partial disability of 5% of the body as a whole which amounts to $940.00 for lead intoxication. Both employee and employer made application to the Industrial Commission for review of this award with the employee contending that the award for permanent partial disability should be increased to 15% of the body as a whole and the employer contending that the award should be reversed. On review, the Industrial Commission affirmed the award of the Referee but increased the employee's permanent partial disability to 10% of the body as a whole.

On employer's appeal, the Circuit Court affirmed the final award of the Industrial Commission.

The employee testified at the hearing before the Referee as follows: He was 36 years old and had been employed by St. Joseph Lead Company for 12 years. In August of 1966 he had been working for about 5 years in the blast furnace department where the lead is smelted. His job was to charge the furnace with lead ore and lead welding and he was exposed to lead smoke. In August, 1966 he developed weakness, muscle cramps and stomach cramps. He was examined and treated for this condition by Dr. Emmett J. Senn, the plant doctor.

Dr. Senn took a blood count and told him the court was too high for him to be suffering from lead. He returned to the furnace work. He saw this doctor five or six times and about September 8, 1966 was given white pills. He was then transferred from the blast furnace department to yard work which is outside. After working in the yard for about three weeks, he had another blood test and was then told by his foreman to return to his job in the blast furnace. In July, 1967, he was transferred back to yard work for four weeks and was again taking the white pills. He was working in the blast furnace department at the time of the hearing.

Dr. Martin W. Davis examined him for the employer on January 26 and December 1, 1967. Dr. Harry Agress donducted an examination on behalf of the employee on July 18, 1967. His complaints to those doctors were that he had a lot of trouble with his joints, ankles, knees, fingers, elbows and occasionally trouble with his appetite. Some of the complaints which he had when he saw Dr. Senn had cleared up when he saw Doctors Davis and Agress, however, he still had 'joint trouble' and he tired quickly. His complaints at the hearing were 'all joints' and that he tired quicker than he should, his feet and hands get numb, and cramps in low part of the stomach.

On cross-examination, the employee stated that the trouble with his joints, appetite and stomach cramps developed about five months before August, 1966. Before going to Dr. Senn in September, 1966, he told his fellow workers about his symptoms. There were signs posted about the plant to the effect that muscular aches and pains, stomach cramps and loss of appetite are symptoms of lead poisoning. He was provided with a respirator which covers his nose and mouth. He wore it 89% of the time and wore it when he could see dust and smoke. He has lost no time from work from August, 1966 to the date of the hearing and his physical condition has remained the same for the year immediately preceding the hearing.

Dr. Agress' deposition was introduced for the employer. He confines his practice to internal medicine, specializing in hematology. An examination of a patient to determine if lead intoxication exists consists of a complete history, a physical examination, laboratory tests and an examination of the patient's records.

Dr. Agress' testimony was as follows. Common complaints of persons with lead intoxication involve the gastrointestinal system. Other common complaints are: cramping or pain in the abdomen, sometimes constipation; wague digestive disturbances and joint pains; and, complaints involving the central nervous system which involve headaches, insomnia and nervousness. There is another area of complaints usually related to blood counts and this complaint is usually one of weakness or ready fatigue.

He examined the employee on July 18, 1967 and obtained a lengthy history much of which is contained in the employee's testimony. The history includes the following information: The last time the employee saw Dr. Senn he was told he had lead poisoning. During the time he was assigned to the yard his joints got better and his ankle swelling diminished but when he went back on the blast furnace duty his joints stayed sore all the time. Since June, 1966 he felt sluggish and tired all the time. The sluggishness diminished during the period of yard work but became worse when he returned to the blast furnace. He made no complaints related to the gastrointestinal tract. He had headaches daily.

Dr. Agress' examination further showed: There was no lead line on the gums. The test for the red blood count and the white blood count showed them to be within normal limits. A reticulocyte count revealed 1.6 percent reticulocytes, an elevated count, some of which showed a very coarse basophilic stippling. A lead blood determination showed 74 micrograms of lead in 100 grams of blood. The average lead content of the blood of a normal person does not exceed 60 micrograms per 100 grams of blood.

Dr. Agress stated: 'My diagnosis is that Mr. Stegall had chronic lead intoxication. * * * My opinion is that Mr. Stegall's lead intoxication was a direct result of his employment at the St. Joseph Lead Company.' He stated his condition would either remain the same or may deteriorate. He was asked for his opinion as to the percentage of permanent partial disability the employee has sustained. He answered: 'In my impression, Mr. Stegall has a fifteen percent disability.'

On cross-examination, Dr. Agress testified that in his practice he had encountered about 15 cases of lead intoxication and in his opinion there are occasions when persons exposed to lead and who have symptoms of lead intoxication have fully and completely recovered. Based upon experiments performed by Dr. Kehoe, of the Kettering Institute in Cincinnati, an individual exposed to lead in excessive amounts and then put in a relatively lead-free environment will take a minimum of three times the length of time to get rid of the lead in time element as it did for the exposure, i.e., if he is exposed for two years it will take him over six years to get rid of the lead.

Dr. Agress further testified on re-cross examination:

'Q Your physical examination was basically normal, everything appeared to be normal? A Yes.

'Q And the laboratory examination, with the exception of the reticulocyte count and the blood lead level was normal? A Yes, sir.

'Q * * * You estimate his disability at the present time as fifteen percent? A Yes, sir.

'Q Doctor, would you say that in the event this man is removed from this environment that his disability might change? A Yes, sir.

'Q And might it lessen? A Yes, sir.

'MR. MUELLER: Would it be fair to say that even though his disability might lessen--would you be able to state now with any degree of medical certainty whether or not there would be any permanent damage to his system as a result of the lead that you say he now has? A There may or may not be.

'Q All right. By that do I understand you to say you can't tell? A Yes, sir.

'Q Is there any way anyone could measure at the present time--A No, sir.

'Q--at the present time what this man's condition or what injury, if any, there would be to his system as a result of exposure to lead that you found at the time of your examination? A This could only be an indirect assumption and this indirect assumption is based on the history of lead workers. It's been shown particularly in studies in Great Britain that men in occupations similar to Mr. Stegall have a lessened life expectancy and that this diminished life expectancy had been related either to the development of kidney trouble later in life or central nervous system disease, particularly involving blood vessels.

'Q Well, Doctor, it's not clearly understood, is it, what effect the lead has on the kidneys, would that be a fair statement or is that an incorrect statement? A The exact mechanism isn't understood but the fact lead can injure the kidneys is well documented.'

The testimony of Dr. Davis in behalf of employer was presented by deposition. He testified in part as follows: He has treated many cases of lead intoxication. Every human being has some lead in the system. There is some difference of opinion as to what amount is considered normal, but nowadays the opinion in that anything up to 0.07 milligrams per hundred grams of blood is within normal limits. Usually people who have absorbed lead have abdominal pains, cramping in nature, associated with very marked constipation. They also can develop a foot drop with paralysis to the extensor muscles of the foot. They can develop anemia and headaches. Some people tolerate lead better than others. Lead is distributed throughout the body, but it becomes deposited in the bones, which it...

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