Robert A. Kehoe

Robert Arthur Kehoe (/ˈkiːhoʊ/; November 18, 1893 – November 24, 1992) was an American toxicologist and a dominant figure in occupational health.^[1][2] Working on behalf of the lead industry (including the manufacturing of leaded gasoline and lead-acid batteries), Kehoe was the most powerful medically-trained proponent for the use of tetraethyllead as an additive in gasoline.^[3]

Robert Arthur Kehoe
Kehoe in the 1930s
Born	(1893-11-18)November 18, 1893 Georgetown, Ohio
Died	November 24, 1992(1992-11-24) (aged 99) Cincinnati
Education	Ohio State University
Alma mater	University of Cincinnati
Known for	Denying the toxicity of lead Advocating for tetraethyllead as an additive in gasoline "Kehoe Rule"
Spouse	Lucille Marshall
Scientific career
Fields	Toxicology, occupational health
Institutions	University of Cincinnati Kettering Laboratory of Applied Physiology (1930-1965)

Family and education

Kehoe was born in Georgetown, Ohio, on November 18, 1893, to Jeremiah and Jessie Kehoe.

Robert studied at Ohio State University. After his graduation at the University of Cincinnati (UC) medical school in 1920 he was a resident in pathology at the Cincinnati General Hospital.

Shortly after obtaining his M.D. he married Lucille Marshall.

Occupational health

When he was an instructor in the UC Department of Physiology in 1924, he was hired by Charles Kettering for General Motors (GM) to examine health issues related to the production of tetraethyllead (TEL). In 1925 Kehoe became the chief medical advisor of TEL maker Ethyl Corporation, a position he held until his retirement.^[4]

In 1930, he became the director of the newly created University of Cincinnati (UC) Kettering Laboratory of Applied Physiology, the first university-based laboratory devoted to toxicological problems peculiar to industry.^[5] The laboratory was funded by the stakeholder companies, GM, DuPont, and Ethyl Corporation.

At the Kettering Laboratory, Kehoe was commissioned by DuPont to produce a study with the goal of showing that the carcinogen 2-Naphthylamine, then widely used by DuPont and shown to produce cancer in nine out of ten employees exposed to it, was safe.^[6] Kehoe was named Professor of Industrial Medicine at UC and put together an interdisciplinary team to investigate occupational-health issues.

Kehoe performed industry-sponsored research that spanned decades.^[7] One of the people who was involved in this research was a co-author, Ivan F. Ferneau, who Kehoe said was administered potentially dangerous amounts of lead.^{[8][9][10][11]}

From at least 1948 though 1968, Kehoe was involved with the Electric Storage Battery Company (later ESB, Inc.) lead-acid battery factory in Crescentville^{[12][13][14][15][16][17][18][19][20]}

Advocacy of lead in gasoline

Working at the GM Research Laboratory at Dayton, Ohio, Charles F. Kettering and his assistant Thomas Midgley Jr. studied anti-knocking agents. In 1921, the team directed by Midgley discovered TEL's anti-knocking property, which would eliminate the knock in internal combustion engines, allowing them to be built with higher compression ratios. GM proceeded to file a patent for the use of TEL as an additive in gasoline. In August 1924, after Standard Oil of New Jersey discovered a lower-cost method to synthesize TEL, it teamed up with GM to establish the Ethyl Gasoline Corporation to produce TEL as a gasoline additive with the help of DuPont.^[21] Soon, workers at Ethyl plants fell ill and a number of them died from lead poisoning. Kettering hired Kehoe to develop protocols for the workers handling TEL. Kehoe soon became the main medical advocate for the position that the use of TEL in gasoline is safe and gained prominence as the industry's expert at government and public health hearings. As almost all research support concerning leaded gasoline came from industry, and most was channeled to him, he held "an almost complete monopoly" on data for half a century.^[22] Kehoe claimed that presence of lead in humans and other organisms was normal and that exposure to low lead levels was not harmful.^[23]

Although lead had been known to be highly toxic since antiquity,^[24] Kehoe’s beliefs were not seriously contested until after Clair Cameron Patterson’s publication in 1965.^[25] Patterson argued that global lead contamination was taking place and that it had started gradually with the Industrial Revolution but had been markedly accelerated once leaded gasoline had entered the market.^[22]

In a 1966 government hearing chaired by Senator Edmund Muskie, Kehoe stated that his laboratory "was the only source of new information (about lead exposure)" and "had wide influence (in the US and abroad) in shaping the point of view and activities... of those who are responsible for industrial and public hygiene".^[26]

Because leaded gasoline had been found "safe" by the U.S. Surgeon General in the 1920s (see below), and ambient lead had been "demonstrated" through Kehoe's work to not constitute a public health hazard over the succeeding decades, it took years for Patterson's findings to change the prevailing view of the toxicity of ambient lead. The validation of Patterson's refutation of Kehoe's research required new, more precise research by several others, but ultimately the medical/public health argument prevailed. Kehoe's work is now considered discredited. By 2014, a majority of countries had discontinued the use of leaded gasoline in automobiles. Yet leaded gasoline continues to be produced and used, for example, for private aviation in the United States.^[27]

The Surgeon General's review of gasoline lead and the Kehoe Rule

Yandell Henderson, Alice Hamilton^[28] and others raised doubts about the safety of tetraethyl lead early on. When the public became aware that workers at TEL plants had fallen ill and deaths had occurred, the Surgeon General, Dr. Hugh Smith Cumming, called for a conference, and TEL production was voluntarily suspended. At the conference, held May 20, 1925, the advocates of lead argued that the use of leaded gasoline raised public health issues that were novel.^[29] They also asked to be informed what their duty was, implying that they were not guilty of violating any rule because no rule had previously been established. Portraying their responsibility as a blank slate opened up the issue to be addressed by a new policy approach, and Dr. Kehoe provided the logic that would resolve the controversy by filling in that blank. In his testimony at the conference, Kehoe offered (speaking on behalf of the companies engaged in the Ethyl Gasoline enterprise) to discontinue the sale of gasoline containing lead "if it can be shown ... that an actual danger is had as a result..." But, he reasoned, if it could not be shown "on the basis of facts," a product this economically beneficial should not be "thrown into the discard on the basis of opinions." Kehoe's offer thus acted as a decision rule (hence, "the Kehoe Rule"), setting out a choice point and two alternative paths that could be followed, depending on what was shown as proof at that choice point.^[30]

The Kehoe Rule had two significant characteristics. First, it placed the burden of proof on the opponents of tetraethyl lead, who would have to show that use of TEL was unsafe if any constraint on its use were to be instituted.^[3] If the finding of fact was inconclusive and did not provide an uncontestable showing of proof, then TEL would be allowed. Second, it balanced the interest in protecting public health against the economic benefits of TEL, which the advocates of TEL had promised would be in the form of conservation of fuel. The alternative approach, the precautionary principle,^[31] would have required proof that TEL was safe before it could be used. While the Kehoe Paradigm^[3][32] (or Kehoe Rule)^[4][33] assumes that in the absence of clear evidence of risk, there is no risk of significance, the precautionary principle assumes that there is a possible risk until it is proved otherwise. Nriagu asserted that with the large investments by industry, the social and economic climate of the time, and the belief in progress, the outcome of the 1925 conference was preordained.^[3] TEL production resumed, and soon, leaded gasoline was commonly used. That there were alternatives to the use of TEL was falsely denied by the industry.^[32]

Application of the Kehoe Rule made it critical for the industry to fund and control the research in lead toxicity. That was done through the Kettering Laboratory, under Kehoe’s direction. The Kehoe Rule was beneficial to those engaged in the gasoline lead industry, as all that was necessary was to characterize any criticism as fraught with uncertainty. In the case of lead toxicity, Kehoe's laboratory dominated the scene for decades, attesting to the safety of leaded gasoline and deconstructing any criticism. The credibility of Kehoe's research was bolstered for decades by the support of the US Public Health Service and American Medical Association.^[4]

Using the Kehoe Rule, Ethyl Corporation was a winner in either situation: if its product was actually safe, Ethyl would be seen as a responsible party. If, however, its product was unsafe, it would take decades to demonstrate that with certainty. The process of getting to certainty could be prolonged by challenging the methods and results and calling for more data, and while it was going on the product would continue to generate profits.^[4] Kitman indicates that the strategy taken by the lead industry, referring to use of the Kehoe Rule, similarly "provided a model for the asbestos, tobacco, pesticide and nuclear power industries, and other(s)... for evading clear evidence that their products are harmful by hiding behind the mantle of scientific uncertainty."^[4] Kettering Laboratories under Kehoe's leadership also certified the safety of the fluorinated refrigerant, Freon, "another environmentally insensitive GM patent that would earn hundreds of millions before it was outlawed."^[4]

Death

Kehoe retired in 1965. He became Professor Emeritus of Occupational Medicine at the university upon his retirement.^[34] Kehoe Hall, part of the Kettering Lab Complex at the University of Cincinnati, was completed in 1963 and is named in his honor.^{[citation needed]} Kehoe wrote of having an illness in 1973.^[35] He died in Cincinnati in 1992 at the age of 99.

References

1. Kehoe, R. A. (1961). "Occupational medicine and public health". Public Health Reports. 76 (8): 645–9. doi:10.2307/4591234. JSTOR 4591234. PMC 1929660. PMID 13752196.
2. Ralph Buncher. . University of Cincinnati, UC College of Medicine. Archived from the original on 2014-05-22. Retrieved 2014-05-21.
3. Nriagu J.O. (August 1998). "Clair Patterson and Robert Kehoe's paradigm of "show me the data" on environmental lead poisoning". Environmental Research. 78 (2): 71–8. Bibcode:1998ER.....78...71N. doi:10.1006/enrs.1997.3808. PMID 9719610.
4. Jamie Lincoln Kitman (2000-03-20). "The Secret History of Lead". The Nation. Retrieved 2014-05-21.
5. "Guide to the Robert A. Kehoe Archival Collection". ead.ohiolink.edu.
6. Brown, Kate (2013). Plutopia: Nuclear Families, Atomic Cities, and the Great Soviet and American Plutonium Disasters. Oxford University Press. p. 51.
7. Kehoe, Robert A. (January 25, 1979). "Letter to Arthur M. Diamon" (PDF). Toxic Docs. Retrieved March 15, 2021. thirty-five years of the detailed study of the behavior of human subjects to whom lead was administered daily over the period of years; one group, to whom lead was administered by mouth for years, and a second, larger group, to whom lead was administered over considerable periods of time in the air they breathed in a respiratory chamber, on five days of the week.
8. Kehoe, Robert A. (April 3, 1943). "Letter to Dr. H. H. Schrenk" (PDF). Toxic Docs. Retrieved March 15, 2021. The third paper, "Exposure to Fluorides in Magnesium Founding and Its Significance* by Edward J . Largent, should also bear the name Ivan F. Ferneau.
9. Feldman, Robert G. (December 13, 1982). "Letter to Stanley Sulkes" (PDF). Toxic Docs. Retrieved March 15, 2021. Dr. Kehoe was able to give me the names of all the participants in that study but was uncertain of six individuals' current addresses. They are as follows: Floyd Creech, Steven Balog, Martin Riehle, Ivan Ferneau, Harvey Reed, and Donald Hayes
10. Feldman, Robert G. (December 21, 1982). "Letter to Ms. Mary Isenhour" (PDF). Toxic Docs. Retrieved March 15, 2021. I am sending you a copy of the letter and questionnaire that is being sent to all study participants.
11. Isenhour, Mary D. (December 28, 1982). "Letter to Patricia H. Travers" (PDF). Toxic Docs. Retrieved March 15, 2021. Dr. Kehoe wishes me to convey this to you concerning the Subject, Ivan Ferneau. He is one of the most important subjects because he was administered the largest dose of lead of all the subjects in the study. The dosage was stopped when Dr. Kehoe considered it to be potentially dangerous.
12. Kehoe, Robert A. (June 29, 1948). "Letter to the Electric Storage Battery Company". Toxic Docs. Retrieved April 2, 2020. The smelter building for the most part could only be described as incredibly dirty, poorly ventilated and generally lacking in any evidence of housekeeping.
13. Lanahan, Francis Benedict (January 16, 1948). "Letter to Robert A. Kehoe". Toxic Docs. Retrieved March 14, 2021. working steadily in the Pasting Department of our Crescentville plant since 1928 ... He complains of dizzy spells, weakness and constipation ... examination revealed an enlarged heart
14. Lanahan, Francis Benedict (January 21, 1948). "Letter to Robert A. Kehoe". Toxic Docs. Retrieved March 14, 2021. ...suffering from anorexia, diarrhea ... working steadily for the past six months in the Pasting Department ...
15. Lanahan, Francis Benedict (March 19, 1948). "Letter to Robert A. Kehoe". Toxic Docs. Retrieved March 14, 2021. ...abdominal colic, nausea, vomiting, and headache ... worked as a helper in the grey oxide department...
16. Lanahan, Francis Benedict (May 28, 1948). "Letter to Robert A. Kehoe". Toxic Docs. Retrieved March 14, 2021. ...feels sore over entire body ... annorexia (sic) ... insomnia ... abdominal colic, nausea and vomiting ... worked as a helper in the grey oxide department
17. Kehoe, Robert A. (June 14, 1948). "Letter to Sidney S. Goldman". Toxic Docs. Retrieved March 14, 2021. 100 micrograms per deciliter of lead in blood
18. Lanahan, Francis Benedict (November 15, 1948). "Proceedings of the Lead Industries Association Lead Hygiene Conference". Lead Industries Association. Retrieved March 14, 2021. Our air levels worry us. We have people getting sick.
19. Brieger, H. (May 31, 1949). "Letter to Robert A. Kehoe". Toxic Docs. Retrieved March 14, 2021. ...conditions at the Electric Storage Battery Company are so bad, as you know...
20. Kehoe, Robert A. (October 3, 1968). "Letter to William Pallies". Toxic Docs. Retrieved March 14, 2021. 100 micrograms per deciliter of lead in blood...No honest and competent expert witness can prevail against such testimony...
21. Alan P. Loeb, "Birth of the Kettering Doctrine: Fordism, Sloanism and Tetraethyl Lead," Business and Economic History, Vol. 24, No. 2, Fall 1995.
22. Herbert L. Needleman (1998). "Clair Patterson and Robert Kehoe: Two Views on Lead Toxicity". Environmental Research. 78 (2): 79–85. Bibcode:1998ER.....78...79N. doi:10.1006/enrs.1997.3807. PMID 9719611.
23. Kehoe RA (1953). "Experimental Studies on the Inhalation of Lead by Human Subjects" (PDF). Occupational Health. 12 (10): 161. PMID 14957352. Retrieved 2014-05-21.
24. Waldron, H. A. (1973). "Lead poisoning in the ancient world". Medical History. 17 (4): 391–9. doi:10.1017/s0025727300019013. PMC 1081502. PMID 4606720.
25. Patterson, C. C. (1965). "Contaminated and Natural Lead Environments of Man". Archives of Environmental Health. 11 (3): 344–60. doi:10.1080/00039896.1965.10664229. PMID 14334042.
26. Gerald Markowitz; David Rosner (2013-04-30). The Lead Wars: The Politics of Science and the Fate of America's Children. University of California Press, 2013. p. 39. ISBN 978-0-520-27325-2.
27. Zhang, Sarah. "Leaded Fuel Is a Thing of the Past—Unless You Fly a Private Plane". Mother Jones. Some 167,000 piston engine aircraft—about three-quarters of private planes in the United States—are still spewing lead into our air... Last June, the FAA finally created the Fuels Program Office to replace leaded avgas by 2018—24 years after it was banned in automobiles.
28. Rosner, D; Markowitz, G (1985). "A 'gift of God'?: The public health controversy over leaded gasoline during the 1920s". American Journal of Public Health. 75 (4): 344–52. doi:10.2105/ajph.75.4.344. PMC 1646253. PMID 2579591.
29. Alan P. Loeb, "Paradigms Lost: A Case Study Analysis of Models of Corporate Responsibility for the Environment," Business and Economic History, Vol. 28, No. 2, Winter 1999, at 95.
30. Loeb (1999)
31. Peterson, M (2007). "The precautionary principle should not be used as a basis for decision-making. Talking point on the precautionary principle". EMBO Reports. 8 (4): 305–8. doi:10.1038/sj.embor.7400947. PMC 1852769. PMID 17401402.
32. Kovarik W (2005). (PDF). International Journal of Occupational and Environmental Health. 11 (4): 384–397. doi:10.1179/oeh.2005.11.4.384. PMID 16350473. S2CID 44633845. Archived from the original (PDF) on 2014-07-11. Retrieved 2014-05-22.
33. Alan P. Loeb, "Birth of the Kehoe Rule: Implications of the Surgeon General's Review of Tetraethyl Lead, 1925-26," presented at the 1997 biennial meeting of the American Society for Environmental History, Baltimore, Maryland, March 7, 1997;a copy was provided to Nriagu, who cited it in his article.
34. . OhioLINK Finding Aid Repository. 2017. Archived from the original on September 14, 2018. Retrieved March 19, 2021.
35. Kehoe, Robert A. (June 7, 1973). "Letter to Kenneth L. Kuykendall" (PDF). Toxic Docs. Retrieved March 15, 2021. I have noted in certain of my reactions, from time to time, since my illness, mild indications of irritability and of irrelevant behavior, and I regret this very much, not only because of the effects which might result from my somewhat irrational behavior, but also because of the difficulties which might result between myself and persons who have had to deal with me on such occasion.