Document 0LJE8okRe27jrMgQk1j9b53BR

FILE NAME: Metropolitan Life (ML) DATE: 1952 DOC#: ML320 DOCUMENT DESCRIPTION: Dr. Lanza Disinformation Campaign; Other Conference Proceedings / i'b * AW*i4i'Lf-Kiii-' V' X I [ |W - ' 262 INDUSTRIAL HYGIENE AND OCCUPATIONAL MEDICINE July, 1950, a conference was held at Oxford dealing with cancer in relation to sociological and environmental factors other than occupation. Proceedings of this . conference have been published/1 t , v i . ABSTRACT OF DISCUSSION ,^ } D r. P aul Cartier, L'Annondation, Que., Canada: I have been asked to describe our experi ence at the Thetford Industrial G inic in Quebec, where we see men engaged in the asbestos- ; mining industry in Canada. Table 3 presents data on eight cases of primary cancer of the lung v which we have detected among 4,000 asbestos workers between 1940 and 1950. . -! In addition to those listed in the table, there was a case in which there was quite a definite^ clinical and radiological history of cancer of the lung but for which, unfortunately, no autopsy*.. IjM . 'the asbestos factor, ' : ' r",F " \ v' . ' *' ' '.:o; Is it not more logical to think that the same causal factor will produce the same type of P H tumor; and, therefore, why do we observe such a variety of malignant tumors? ' T able 3.-- Cases of Carcinoma of the Lungs Detected Among 4,000 Asbestos ..? .. .W o rk e rs W O r M S O ^ : . ^ ; , ~ - ... ' JlidUitlMtJyajph M 1ii} % fc-t I Ml Z w.c. Son 5 XOM A^lcnKinttot^^w ^ .'Brootbotenlc _ __ 'proscbogenle J (thoracotomy)- - Pleura! mcsothellom* * "Standard Nomenclature o t Olsoasca and Operations'' published by the American Medical Association (New Tork, The Blakiston Company, 1933) suggests (be term "mesothellal sarcoma." Vi-ijii; If for a moment we may assume that the asbestos fibers might produce a bronchogenic,car- J ^ ' / s ' cinoina in asbestotic < ` " ... .serve ,as evidence because 'exposure or without ............. As a last remark, it would appear necessary that any statistics on occupational, cancer. of ^he ^'.i ^ lung, to be conclusive, should indicate.the precise variety of lungcancer. M fr? Sil v; i>*;! \M -e r t'''jiliA, ./' .M r. E dward A. L ew, New York i,T h e'T eren c e in. the frequency of lung cancer m persons S ' m 'w ith asbestotic lungs as compared.'with the.iarge group o f silicotics*provided by coniosis Board seems impressive. However, one might wonder whether the two groups fadfaieen examined for cancer with equal care: I am impressed by the fact that when different groups lungs were studied by the same observer, Dr. Gloyne, the differences in frequency of lung cancer - were much less. If we restrict our attention solely to Dr. Gloyne's series, I am not sure that the differences are statistically significant . : Y - D r. A . J . L anza, New York : I think it is important to distinguish between cases of clinically recognizable and fatal lung cancer; oh onc'hand, and cases in which the diagnosis of lung cancer' has been made as more or less of an incidental finding at autopsy, on the other. The English claim for an association between lung cancer and asbestosis has been based, it seems to me, on data obtained from lungs that a pathologist has searched with a microscope. I wonder how many 51. Conference on Geographical Pathology and Demography of Cancer, J. Xat. Cancer Inst. 11:627-662. 1950. SMITH-BRITISH AXD EUROPEAS TUMOR PROBLEMS 263 cases of lung cancer would be found if lungs from any sort of population were subjected to the " ^ r t ^ a r d to Dr. Cartier's c,bery*as t * t of different ty p e s ^ lu n g fia s great variety of tumor types. If asbestos is carcinogenic, I ould of l ,, r a l mesothe- *** - - - i .. mm stj \ n i p lii silicosis and their i^ ijf e i& o tie f '- ;^ .th e r e f o r serve as Pneumoconiosis Board Dr. Gloyne's - reasonably satisfactory;,comrQi'3^WMff,MSa ^ "a .g ffi-i^ :controtgroup. .-;. ^ ^ : [ s d r f 9a ;b f'81 caassees of f the'tum or was --~J --* ^ * * * " " ' the bombing c in the gross. ... ............ ,r .. .. 1 '"**j:Wm " estroy^Jdurmg1'` ................................ -v- ' . . , . v , of lung cancer in relation to asbcstosis? .. ' s g ll *!T ^^PBIS^rvi Vt. m Sm & ii J ~K A vV 'y - mm M s k p y ,i -i* -.!i 2-.hr SEVENTH SARANAC SYMPOSIUM SEPTEMBER 22 TO SEPTEMBER 26 1952 65233 THE SARANAC LABORATORY of the Edward L. Trudeau Foundation Saranac Lake, New York s os i^SJZ=SSg=5; I V Foreword 4 The Saranac Symposiums, of which this session is the Seventh, have been organised periodically for the discussion of health problems pertaining to workers exposed by inhalation to industrial substances. The subjects to be discussed at the Seventh Saranac Sym posium will be limited but many have broad applica tion. The topics will not be restricted to individual companies or industries, nor will they concern only a single group such as the employer or the employee, the insurer or the insured. The problems to be considered involve a host of diverse interests -- engineering, medical, legal, administrative, social. A t the sym posium representatives of each of those groups and interests will have the opportunity to explore and discuss common problems with the objective that in dustrial health be improved. If that objective is at tained, the symposium will be a successful one. Participants in Program A mbersox, J. Burns, M .D,, Professor of M ediane, Columbi* University -- College of P d S, Visiting Physidan-in* Charge, Chest Service, Bellevue Hospital, Member, Board of Chest Consultants, Workman's Compensation Board of New York State, New York, N.Y. A ndrews, Earle T., Vice-President in Charge of Operations, Pennsylvania Glass Sand Corporation, Hancock, W . Va. BaETJER, A nna M., Sc.D., Associate Professor of Environ mental Medicine, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md. Barnako, Frank, Manager of Compensation and Safety, Bethlehem Steel Company, Bethlehem, Pa. Braun, Daniel C., M.D. Medical Director, Industrial Hy giene Foundation of America, Pittsburgh, Pa. .Bristol. Leonard J., M.D., Head, Department of Radiology, The Trudeau Foundation, Saranac Lake, N.Y. Cartier, Paul, M.D., Medical Director, Thetford Industrial Clinic, Thetford Mines, Quebec, Canada Connolly, W illiam L., Director of- Bureau of Labor Stand ards, U. S. Department of Labor, Washington, D. C. Donlox. M ary, Chairman, W orkman's Compensation Board of New York S u te, Albany, N.Y. _ D rinker. P hilip, Sc.D., Professor of Industrial Hygiene, Harvard University School, of Public Health, Boston, Mass. . Durkak. T homas M .t Assistant Director, The Saranac Lab oratory, Saranac Lake, N.Y. Eisenbud, M erril. Director, Health and Safety Division, U. S. Atomic Energy Commission, New York Opera tion's Office, New York. N.Y. . Fletcher. C harles M ., M.D., Director, Pneumoconiosis Research Unit, The Medical Research Council, Llandough Hospital, near Penarth, Cardiff, Wales, Senior Lecturer, Postgraduate School of M edianc, University of London, London, England Friedman, Louis, M .D., Friedman Diagnostic Clinic, Bir mingham, Ala. G entholts, A. J., Assistant Counsel, Republic Steel Cor poration, Cleveland, Ohio G reenblrc. Leonard. M.D., Director, Division of Industrial Hygiene and Safety Standards, New York State De partment of Labor, New York, N.Y. G recoire, Fernand, M.D., Medical Director, Institute, Montreal, Quebec, Canada C. # J) . Lavoisier -sw Hamlin. Lloyd E.. M D , Medical Director. American Brake Shoe Company, Chicago, Ul. . I Hardt, Harrtet L., M.D., Associate Physician. Occupational I Medical Qinic, Massachusetts General Hospital, Boston, Masa. H atch. T heodore F., School of Public Health, University of Pittsburgh, and Industrial Hygiene Foundation, Mellon Institute, Pittsburgh, Pa. HlLFINCER, M artin F., President, Associated Industries of New York State, Buffalo, N.Y. HlLL, James L., Commissioner, Workmen's Compensation _ Commission, State of Michigan, Lansing, Mich. \ H ueper. W . C.. M.D., Chief. Cancerigenic Reswrch Studies V Section, Cancer Control Branch, National Cancer Insti tute, National Institutes of Health, Bethesda, Md. H uc h -Jones. Philip, M.D., Senior Lecturer in Medicine, University College of the W est Indies, Mona bt. Andrews, Jamaica, B. W . I. Kalmykov. A ndrew, Assistant Manager, Casualty Depart ment, Association of Casualty and Surety Companies, New York, N.Y. Kuechle. B. E., Vice-President and Claims Manager, Etp- . ploye'rs Mutual Liability Insurance Co. of Wisconsin, Wausau, Wis. Lanza. A nthony J., M .D , Chairman, Institute of Industrial Medicine, New York University, BeUevue Medical Cen ter, New York, N.Y. Levin M orton L.. M .D , Assistant Commissioner forMetUcl Services. New York State Department of Health, Albany, N.Y. Lynch. Kenneth M., M.D. Professor o f Pathology and Dean, Medical College of the State of South Carolina, Charleston, S. C. M cCann. W illiam S., M.D., Professor of M ediane. U ni versity of Rochester, Physician-in-Chief, Strong Memorial Hospital, Rochester, N.Y. M cG ee. Lemuel C.. M.D.. Medical Director, Hercules Powder Company, Wilmington, Del. M ayer. Edgar. M.D., Clinical Professor of Industrial Medidne, New York University Postgraduate Medical School, Member. Board of Chest Consultants.W o rk m en ii Com* pensation Board of New York State, New York, N . i . M e r edith New , G eorge E,, Vice-President and General Attor Jersey Manufacturers' Casualty Insurance nLeoy.,, Trenton, N. J. 1 M er ew eth e r. E. R. a ., M .D , H. M. Senior Medical In j spector of Factories, Ministry of Labour and National Service, St. James Square, London, England Mider G. Burroughs. M.D.. Assodate Director in Charge of Research, National Cancer Institute, National Insti tutes of Health, Bethesda, Md. Motley H urley L.. M.D., Director, CardioRespiratory Laboratory, Jefferson Medical College Hospital. Barton Memorial Division, Philadelphia, Pa. O renstein. A. J.. M.D.. Chief Medical Officer. Rand Mines. Ltd-, Johannesburg. Union of South Africa Pratt, P hilip C., M.D., Assodate Pathologist, The Saranac Laboratory, Saranac Lake, N.Y. R hoads. C. P.. M.D., Director Memorial Center for Cancer and Allied Diseases, New York, N.Y. Sadourin Ivan. Queen's Counsel, Counsel to Quebec Asbes tos Producers Assodation, Montreal. Quebec, Canada Sander O A , M.D.. Assodate in Medidne, Marquette &AN University Medical School. Consultant in Industrial M edidne. Milwaukee. Wis. Shaver. C. G.. M.D. Superintendent. Niagara Peninsula Sanatorium, St. Catherines, O nttno, Canada Solandt. D onald. M .D , Professor of Physiology and of Physiological Hygiene, Faculty of Medxone, Toronto, Canada T hompson. M. W .. Treasurer and General Manager. Hall China Company. East Liverpool. Ohio T rudeau. Francis B , M.D.. President, Board of Trustee of the Trudeau Corporation, Saranac lake, N.x. U rbaK. E. C. J - Industrial Hygiene Engineer, The Saranac Laboratory, Saranac Lake, N.Y* _ Vorwald. A rthur J.. M .D , Director. The Trudeaui Found ation and The Saranac Laboratory, Saranac Lake. N.Y. W acner. R ichard, Manager, Casualty Department, Asso dation of Casualty and Surety Companies, New York, N.Y. W aring. James J , M .D , Professor of Medidne University of Colorado School of M edidne, Denver, Colo. " W ater' T heodore C , Counsel to Industrie Hygiene Foundation, Industrial Counsel. Mullikin, Stockbndge and W aters, Baltimore. Md. W hipple. Edward G,, M .D , Consultant Physidan. Strong '. Memorial Hospital. Member Board of Chest Consul.- ants, W orkmen's Compensation Board of New i otic State, Rochester. N.Y. W right. G eorce W ,, M.D , Head Department of Physi ology, The Trudeau Foundation. Saranac Lake, N . i . S' Notes -- Wednesday, September 24 9.00 A.M. -- 1OO P.M. IL. Pneumoconiosis and \ IrrtYvdvChonChairman: C. Pulmonary Cancer P. RHOADS, M.D. Philosophy of Biostatistics as Applied to Environmental Pulmonary Cancer Morton L. Levin, M.D. Discussion > f i General Review Discussion W . C. Hueper, M.D. ^Asbestos Miners Discussion - Paul Cartier, M.D. Asbestos Weavers Kenneth M. Lynch, M.D. Discussion, led by . w E. R. A. Merewether, M.D. Group Photograph Notes Wednesday, September 24 2:30 P.M. -- 5:30 P.M. Pneumoconiosis and Pulmonary Cancer (Continued) Chromate "Workers Discussion Anthony J. Lanza, M.D. . Experimental Pulmonary Cancer -- General Review ' . G. Burroughs Mider, M.D. Discussion Pulmonary Cancer in Experimental Exposures to Chromate Anna Baetjer, ScD. Discussion . Pulmonary Cancer in Experimental Exposures to Beryllium Arthur J. Vorwald, M.D. -r.- Thursday, September 25 2:30 P.M. -- 5:30 P.M. Workmen's Compensation -- Medical and Legal Aspects Chairman: M . W . T hom pson Concepts of Disability Under Workmen's Compensation Statutes Theodore C. Water Compensation for Disability and Death Re sulting from the Pneumoconioses George W . Wright, M.D. George. E. Meredith Martin. F. Hilfinger Discussion, led by Andrew Kaltnykow 7:30 P.M. Banquet -- Hotel Saranac Introduction of Guests -- Arthur J. Vorwald, M.D. ' I Remarks -- Francis B. Trudeau, M.D. Leroy U. Gardner Memorial Lecture Anthony J. Lanca, M.D. : Y 1*5 .'-rjTSj V-T_~Y -vS -L ^ Y7=3 Notes -- Thursday, September 25 j 9:00 A.M. -- 1:00 P.M. i Clinical Aspects of Pneumoconiosis Chairman: W illiam S. M cC ann*. M.D. Incidence of Clinically Manifest Diffuse Obstructive Emphysema Leonard J. Bristol, M.D. Discussion Pulmonary Function Studies in Men Exposed for Ten or More Tears to Inhalation of Asbestos Fibers . Fernand Grgoire, M.D. Discussion Maximum Ability for Physical W o r \ of Moderate Duration Correlated with Various Tests of Pulmonary Function George W . W right, M.D. Discussion CardiO'Circulatory Aspects of the Pneumo conioses William S. McCann, M.D. Discussion, led by James J. Waring, M.D. s Friday, 'September 26 9:00 A.M. -- 1:00 P.M. Viewpoints on Compensation for Pulmonary and Other Occupational Diseases C h a irm a n : Hon. M ary D oxtox The Functions and Value of Medical Boards and Medical Examiners in Controverted Compensation Cases Lemuel C. McGee, M.D. Board of Chest Consultant, W orkmen' Compensation Board, New York State .Edgar Mayer, M.D. J. Bums Amberson, M.D. Edward G. Whipple, M.D. ` A. J. Gentholts Discussion j, J i/l The Presentation of Medical Evidence in Controverted Compensation Cases Daniel C. Braun, M.D. Frank Bamako Ivan Sabourin Discussion Group Photograph 5 i 9 Friday, September 26 9 2:00 P.M. -- 5:30 P.M. t | . * * * Administration of Workmen's Compensation Laws as They Relate to the Pneumoconioses Moderator: THEODORE C. WATERS ; Panel Members: ; James L. Hill William L. Connolly . B. E. Keuchle ' Earle T. Andrews Lloyd E. Hamlin, M.D. Summary Workmen's Compensation Sessions Theodore C. Waters 1 1 Conclusion of the Symposium Summary of the Medical Sessions and Remarks Arthur J. Vorwald, M.D. 5 I Monday, September 22 9:00 A.M. Registration: John Black Room, The Saranac Laboratory 7 Church Street, Saranac Lake New York Early arrivals are requested to register on Sunday, September 21. 9:45 A.ML Address of Welcome ' Arthur J. Varwald, M.D. t I 10:00 A.M. -- 12:00 Noon Definitions and Clarification of Terms Pertaining to Pneumoconiosis Moderator: ARTHUR J. V orwaLD, M.D. Panel Members: Anthony J. Lanza, M.D. Leonard Greenburg, M.D. O. A. Sander, M.D. Richard Wagner Charles M. Fletcher, M.D. Discussion, led by s A. J. Orenstein, M.D. ; .s * r i--- - ',,c^-^LS-^z^ - j - - i - .:>*-^ --"^mL*^' ' . ' 2 =x- ; . ' ' - ', i -V Notes :-^s * | njoi-<i! -- - ^ tSSi&I Monday, September 22 2:00 P.M. -- .5:30 P M . The Inhalation of Certain Industrial Substances ` Chairman: T heodore F. H a tc h Brief Reviews Silica Asbestos Beryllium Bauxite Thom is M- Durkin Arthur J. Vorwald, M.D. jHairiet L. Hardy. M.D. ` _ C. G. Shaver, M.D. ' and Donald Solandt, M.D. Discussion N ew Synthetic Silicas Philip C. Pratt. M.D. T he Fate of Inhaled Particulates Merril Eisenbud Discussion, led by- Theodore F. Hatch 3 fe;-'^./*r^.-s--*=**"-??jj -''"-'--*--X'i*'----ii r-~~*j -- Notes -- 9:00 A.M. -- 1.00 P.M. Pneumoconiosis in Cool Miners Chairm an: P hilip D rinker, Sc.D. Industrial Hygiene Studies of Coal Miners in Tw o Geographical Areas in the United States E. C. J. Urban Discussion ' Radiological Classification Charles M. Fletcher, M.D. Discussion Pathology of Coal Workers' Pneumoconiosis A rthur J. Vorcvald, M .D. Discussion Epidemiology of Coal Workers' Pneumo coniosis in W ales Charles M. Fletcher. M D. s Discussion J J i 2:30 P.M. -- 5:30 P.M. Pneumoconiosis in Coal Miners (Continuad) " Chairmen : O. A. Sander. M.D. Pneumoconiosis in Coal Miners in Alabama Louis'Friedman, M.D. Discussion Pulmonary Punction Studies of Coal Mtiers in Pennsylvania and W est 'Virginia . Hurley L. Modey, M.D. Pulmonary Function Studies of Coal Miners in Wales Philip Hugh-Jones, M.D. Discussion s vp55T0H_RH0ASt f* Think yon, P o eto r K erew ether. Is th ere s eorr-.er.. about the Kerewether d isc u ssio n ? (R re s? o ..s-)* P oetor L e n a , I th in k you can make scste cem en t on t h i s . s v noc?oa LA51A: Kr. chairman, la d ie s and G ent.eren, before going in to t h i s b r i e f statem en t of nine on chrom ates, I would 111: to ik e s few consents on P o eto r K erew ether's o b se rv a tio n s. I was very nueh im pressed w ith whet P o eto r K ere- w ether s e id , end th e re i s no q u estio n b u t what e very c a r e f u l, p a in s ta k in g Job has been done in S re e t B r ita in or. the su b ject of trying to determine what the h a ta ri sign? b . in the asbestos industry w ith resp ect to career. There are Ju st a couple of cem en ts, I ' r not say in g on. way or the o th e r, t h a t i t nay or nay not ir.f.u en ce the incidence of cancer. I would ra ise a couple of points which I th in k 11 o f us n ig h t k .e ? in n in e , and which r.tgr p o .s lb ly have .o n . b e a rin g on the s i t u a t io n in England. Row, I have v i s i t e d , somewhat e r-ten siv ely . . t r . n early a l l the asbestos p la n ts of the m l ted S ta te s, and n in es and the m ills in Canada and have spent S uite a u o . t i n . th e re , end have epent . l e t of tin e review ing *" =*. d n e t le n s ego, ? - " v e r*1 d *"s v if c 3>5etC'r KeaM th S riith or* a s b e sto s , re a d in g h is f iin s * I fin d i t d irfieialt to believe th at cur cancer incidence ico n s tsb e sto s worker* conic be anything l ^ e as ie e g e * i t *eer.s to be in Engl end, because v n ile I'm Per fe c tly fre e to admit th a t w. m have missed cancer ^eeses which we should have n o t, on th e o th er hens, I c s . . '. * - ~ k we could have m issed a l l of then i f they had occu rred , in to the stn e a tte n d th a t ap p aren tly they do in Sngland. saw , th a t i . sim ply an e b .e rv a tio n of n in e . Of co u rse , i t i* tru e t h a t a* .eon a* the b u sin ess of the harm f u l e f f e c ts of asb estos once took h ole in tne ir e . -cs_ i d u stry , they did s ta r t to clear, up th e ir p lan ts and, while 1 w ouldn't say th a t a l l the asbestos plants- in the country were marvels of in d u s tria l hygiene p e rfe c tio n , never tn ele s s g re a t s trid e s have been made. and p a r tic u la r ly , fo r in s ta n c e , in the p la n t in D octor henneth Lynch's town in C h a rlo tte , South C a ro lin a , where th ey have done a very b e a u tif u l job, so th a t w ith the s n s ll number of people in the in d u s try , i t ' s obvious th a t we are never going to have th e c l i n i c a l experience w ith as b . s t e s i s t h a t w. have, f a in s ta n c e , w ith e i l i c o s i s . because th ere is not going to be the n a t e r i a l to v or'rf or.* sow, back of t h a t , th e re i s s t i l l one more q u est WE k .e .m T b it i s the n atu re o f the asb e sto s i t s e l f . Kow, when I f i r s t u sed to go to Canada, I u sed to b eer fre q u e n tly t h a t , u? th e re , th a t the Canadian asbestos vas le s s danaging than the kind they used in Engl and,I b e l i e , and I have put t h a t c o n te n t d o to what we n ig h t e a i l the n a tio n a l or l o c a l p a tr io tis m , you know, l i k e the r i v a l r y between tow ns, so th a t you so freq u en tly se e , b u t the f a c t remains the ^ san e , th a t in th is co u n try , we do use the a s b e sto s , m ostly th e a sb e sto s t h a t we g e t from Canada, and I b e lie v e , frcr. what I hear from our E nglish frie n d s , th a t a g re a t deal, i f not the major p a rt of the asbestos used in England, is Rhodesian asbestos, tfcieh i s quite d issim ilar in its con stru c tio n and in i t s form ation, i t s physical cn erac-eris t i c s , to the kind t h a t comes from T h etfo rd and from a sb e s to s In C*nad* Kow, t h a t nay have n o th in g to do with i t , and u? t i l two o r th ree y e a rs ago, I dism issed t h a t . I thcught h a t w a, ju s t p u r i l e , b u t sin ce w. have in the l a s t few years, learned th at d iffe ren t types of s ilic a , for instar. produce e n tir e ly d i s t i n c t p a th o lo g ic a l a f f e c t . I am begin n in g to wonder i f w. have n o t f a i l e d to pay s u f f i c ie n t a t te n tio n to the type o f asbestos which v a rie s even, as I inform ed, th ere 1 . a - n e e between the esbdstos the, 1 , mined in the town of A sbestos and the kind th a t is = - n o t f a r away in T h etfo rd , and y e t b o th of th e s e , in tu rn u i _____^ v-l o r 5 i S 2 .:--- w .t qui te d iffe r e n t fre n the esb estes th a t cene Trou Hno- d e sie , and p o s s ib lj = otoer ? ` rtS *** Vr l vLich ! not acquainted* _ t o i , h atin g in si tha l e s e v e 'te leareed^in th ilic e dust, I th in th a t i eonathlng ke th e u ld p a j ore a tte n tio n t o . Ko, I i=?-T r i l " p e i n t , b ecause I th in k i t =T * ' e gres*. desi nere . - n iie e a e e thar. ve h e been ine lin e d te g l i t . ^ Kov, _I .nave s__x_n__*-.* I* ehcve Js. u-xnariseo ny r e - ,, v - i . 'i T beetuse the tep ie o ehraae is gomarks bere very . _ ^ _. * <** v o bas cone * in s te be hehdled bp Heeter Ann* S e e .J e ., ~ experim ental verte in eeronee, . eni*. vhae*. ae nneo.r^e ^in tin a te kr.c*>- ledge o f i t froia t.n. a *, ,o.i-_n** eo.* vviiew than a do* The a v e ile b le e c i. d. e. nte iis. *--.v***-- cV- ~ " Vw!rjCS s de h e in ciden ce * f esneer c i th lunga ir. e n c e s s ^ - ^ vh et n ig h t be expeeted. Stpond t h is , ve de net es T- *= " a c r t de a l* , In te re st in chrone es e p e ssie le ce-cihe agent, v ith p a rticu la r resp ect te lung cencer. is cenpere t lSe e lp r e e e n t. Ine oo ff '.iicc iiaa lis- oesf one e f th le r g e s t ceree, preduelng eeapenies 4inti thr.*.ss ccoeuor...t. r*. sucp p lie s tbe inpetu. th e t s ta r te d I n te r e s.t ign +t evl4s. sauM- jteectt ein the U nitec S .^ e . t r c ib le fc rr., in s e ttin g or. fe th * 4p apprhensions to S and publ iashed in ttraee pr --- b li1cC H ealth R eports on A-*-** c ( " E ffo rts were oade to reduce exposure in chron-um p la n ts and more in te n s iv e m edical s e rv ic e vas inaugurated w ith a much more fre e use o f X-ray exam ination, and I ven tu re Doctor B e e tje r v i l l t e l l you o f her work ir. B e ltia o re w ith experim ental animals. Kov, Doctor 5 a e t j e r p u b lish e d a comprenensive paper on pulmonary carcinoma in chromate workers in the Archieves of In d u strial History in 195o ^ aov* th ere is not much'nore to say th a t vas not sa id in ner p a p e r. In a word*, as the saying goes, she coverea tne sub je c t from sou? to nuts* and as f a r as our question s ta te d along th a t lin e , goes. Bov, fo rtu n a te ly , during 1952, the D ivision cf Occupational Health of the T nited S tates f M . i t Health Service , v ith the assistance tad cooperation of the in d u stry , conducted a surrey e l the vncle ehrcr.e in d u stry . Through th e courtesy of Doctor Severs S. K ille r, ir. energe o i the D ivision of Occupational E e titn , I have bee., g.ven a copy o f the . d i d p o rtio n of th e ir ad r.iraU e re p o rt. Doctor M ille r vaa kind enough to she th a t av ailab le to ne s te n I asked h i i f he vas going to p re se n t h is findings here and he said no. The r e p o r t, however, is in the p re ss nov, and as i t w ill be p resen tly a v a ila b le , 1 w ill only fe fe r to i n a very b r i e f summary. I quote from tne P u ciic Hea^-a Ol *1# S ervice R eport: A ll s p e c ific causes of m o rta lity ia chror.e w orkers, the chrome workers had frequency r a te s th a t were n o t g r e a tly d if f e r e n t f t*or o th e r w orkers. However, cancer w ith a r a t e o f 7*1 compered w ith .7 stan d s out as aark ec-y in excess fo r chromate workers# For cancer of s ll s i t e s , th e a c tu a l number of deaths o f chrenate w orkers was approx im ately fo u r and a h a lf tin e s the number th a t would have been expected had the cancer ra te fo r a ll nales in tne United S ta te s p re v a ile d . Vher cancer of the re s p ir a to ry system was observed se p a ra te ly f o r chroaate w orkers, n e a rly tw enty-nine tin e s as many deaths as were expected were found. A ll o th er types of cancer f a i l e d to show ar. excess among chromate w orkers. I t i s obvious -- t h a t 's the end o f tne c.uooe -- i t is obvious th a t irjch re sear eh and experim entation re p a ir, to be done before ve c a t t a l k w ith co re essura--.ee of t u ! s itu a tio n . In the Beantime, the in d u s tr ia l p lan ts are b e ing cleaned up and in sene cases r . - b u l i t w its the hope end expectation of steadying th is tid e of cancer cases. Before leav in g th is to p ic . I again would lik e to Bake a p le a f o r the n o r. c a re fu l and p r e c i s , u s . and a sso c i a t i o n o f w ords. The evidence of the r e la tio n s h ip of ch.-one exposure and pulmonary cancer appears conclusive. This cancer o f the lungs in cu rate workers does not fo llo w , as fa r a . I can ..c e rta in , doe. not follow , nor is i t dependent upon a p re -e x istin g pneunonoconiosi th e re may n o t be any f a ls e co n clu si i a t i o n of th ese two te rn s as they are u ses in needing nr our program. Thank you. BY DOCTOR RHOADS: With very c h a r a c te r is tic p re c is io n , Doctor Ler.oa has la i d to r e s t any illu s io n s or questions th a t nig h t be ra is e d concerning the re la tio n of chrone to culronary cancer. Is th e re a consent on Doctor L an za's preser.tao---- ? BY DOSTO?- RIC2A?.DS0::: Who were the workers th a t were e f f e c t e r in th .s ? . BY DOCTOP- LA"2A: As f a r as I know now; I c a n 't t e l l ysu ? o s it* \e -y u n t i l I have had a chance to d ig e s t the ru c -ic .-.eautr. S er v ice r e p o r t , b u t you know these are s n a il p la n ts arc in s n a il p l a n t s , men s h i f t around, so th a t r .:t only do we not icnov what p a r tic u la r chrone substance cr wnac p a r tic u la r process in the nar.ufacture of chrcne is r e s p o n s iv e , i f i t i s a c a n c e r, o u.t. .w.e. aoo- n o . vu-.nov. ao--. touu c a n 't cepe no or. group o f men in th is departm ent or th a t greue o f men in t h a t departm ent, u n fo rtu n a te ly , we c a n 't do i t . *v P0CT03 RICHARDS: V e il, could we ay when does the exposure to chrome begin and when does it end in the process of tne h e A* re * *fmc of chrome? . ^ *. V.' v> ~ ET DOCTOR LAirZA: V e il, you would have to then. Rece.ved f.h.h&s PATE:. JUL 3 | )C7c Ve had, I th in z , the engineering p o rtio n of the Public Health Service repcr*., which w ill give the d e ta ils of the process, the dust stuo- ie s , and so fo rth , a t d iffe re n t stages a ll along the lin e , fror. the tin e they get th e ir ore out u n til i t is sn.ppec out of the plant* 'EY DOCTC-3 P.ICHAP.PS: W ell, th en , is th ere any hazard a f te r i t is shipped out of the plant? jyj^XTCR^LA^ZA: As f a r as I know, th ere has beer, no conplair.t ir o n any so u rc e , t u t th a t again i s s o u th in g ve d o n 't know. c y SQCTO?. RHOADS: Doctor Hueper has concent* yv t>0CT-03 HTZPZ?.: you asked the question wnether the n a te ria l shipped o a t of the p le a t w ill beeoae carcinogenic. There hve b e s t re p o rts fro a Germary t h a t sin e p ig a e s t wer-sers h sre developed carcinogen. The zinc c h ro sa te , the yellow d ie w ith which we sprey oar a irp la n e s ta d w ith which we sprey the o il teak s end o il pipe lin e s , i f yen see those b e a u tifu l b rig h t yellow eolors in the landscape of eur re f i n e r i e s , th e t- s sin e e h ro n e te . We are q u ite e b i t i n te r e s ts ; to f in d out whether the p a in te rs who sprayed the zinc BY DOCTQB RHOADS: . r `/ / r Doctor M erewetner, would 7 ` c o m en t on t ese r e - ra&rks? , gv pocTOB ^RSWSTjlsS^ I co u ld n 't comment on some of th e n , b u t I th in k I can p a r t i a l l y answer some of th e s e , s i r , ana I th in k Doc to r Knox can answer co n c lu siv ely one of them* F ir s t of a l l , I think Doctor Lanza is misinformed about the proportions of asb esto s used and where they are used in England* The o r ig in a l cases of a s b e s to s is , f i f t y y ears ago, were a l l Canadian asbestos* The e a r l i e s t a sb e s to s work in England was. e i t h e r se v e n ty -e ig h t o r eighty-tw o and th e re may have been some c r y s t a ll i n e f ib e r th en , b u t very q u ick ly the asb esto s tra d e co n c en trated on the w hite Canadian cry sta llin e* L a te r on, the Rhodesian a sb e sto s and the Rhodes ia n - the South A frican b lu e , and the t h i r d one which i s a ls o an iro n s i l i c a , the .a n a c ite , came i n . l?ow , of a l l of th ese, the anacite is d e fin ite ly the most b r ittle * I t n*s s h o rt f i b e r s , i t 's brown and i t 's got f ib e r s as -ong as t n a t (in d ic a tin g ) whereas the b e st Canadian spinning fib ers have onlv got fib e rs as long as th a t (in d ic a tin g ) ano the b e s t blue is about that* W ell, th ere i s no doubt about the d u stin ess of the am acite* That is the brown long fib e re d s t u f f , to such an e x ten t th a t i t 's very l i t t l e used today, so i t 's a t tne p e rio d where some o f these cases are concerned, 'or where the cases of a s b e sto s is occurred - some of my old frie n d G l y n n ' s cases o ccurred - th e re was a good deal of blue and S' O'" o u<j- i o ______________ i j 2 0 . _ OAT:_Jli. 3 , | c > a good deal of maacite used* M .L M ' Kov, I th in k d o cto r Knox w i l l be able to t e l l u s, in h is p la n t, which is the b ig g est in the country, what about the types of asbestos they use in th a t p a rtic u la r fa c to ry , and the - wnether they have had any carcinoma of the lung* Now, a b o u t the n ic k e l ca n cer, i t i s p e rfe c t-y c o rre c t th a t none of us think th a t n ick el carbon has any th in g to do w ith i t as such f o r the very sim ple reason t n a t - w e ll, one reaso n i s th a t n ic k e l carbon i s so to x ic th a t we should b u ild a fa c to ry in o rder to g e t the - in o rcer to g et the l i t t l e cancer, and of course, i t might act in t h a t p ro p o rtio n , then I should imagine a l o t more people would have been effected* D octor ignore or Doctor -organ ana nyse^f fee* th a t th e - th a t the re -b u ild in g of the old c a ^ c ire rs was th e c r u c ia l change in the m a tte r, though th e re was some o p eratio n in the c o n s titu tio n of th e m aterials which are sh ip p ed from P o rt Home in Canada. The d if f e r e n c e , as I know, because I saw i t b efo re and a fte rw a rd s, between the o ld and extrem ely dusty c a lc in c e rs and the modern b u ilc , i s enormous* T h e re fo re , th e re may be some hope in the fa c t th a t perhaps a lo t of hig dosage is necessary to pro duce some of these cancers* B Y doctor RHOADS: ( L' c c VJ- v V I sy /'o i . . t HUMBtR FC 752 >utmoi. A . J L a n z a titl*. A sbestos is ' Paper read before Fourth Conference etc. Rtfa.i --u0.V- _ _ | 2 p p | /1 952 of M c I n ty r e R e s e a r c h F o u n d , I on Silicos! . , c t i o of .i rbe..rosis on the bod y is b r i e f l y r e v i e w e d It is B r i r '^ U " ardtd o r e seriously in rent fhl . 1 r d Se4t= the B r i t t , h b e l i e v e it is w o r s e fo rom ,l b.0:;1" ' " d " t0 t " C' r ' * " * in Amer.cs cantor r " tt,, , b from asbestor.is is practically r.on-existent. G b a z 0z bd /w5 OATC ^ut^otr _Qr U ltew , OOMT-O asitaact iunr row orwcAt. I / eenffli Vt ;-u l t o . R . v ' %r \ asbestosis* Kh t Da. A. J . Lamm Q uirm aal Institute of Industrial Medicine Now York University Post-Graduate Medical School la opening my discussion of asbestosis I would like to say that while U has been presumably described by Herodotus in 410 B.G , the disease as wo now know it is very new. I t w u ftrstlreported In England in 1900 and a comprehensive report was made in that country by Dr. MorewcthSr (d u e l Medical Inspector of Factories) and Dr. Price in 1940. The lust cases in the United S te p were described by Lynch and Smith of Charlestop, South Carolina in 1940. During 1940 and 1941, Drs. Lanza and McConnell of the Metropolitan* Life Insurance Company conducted the first ftudy of Asbestosis in ths United States and Canada. This study included the mines in Canada and ntariy all the fabricating plants in the United States. The reports of this study wore published by the United States Public Health Service in IMS. Asbestosis, I would like to point out, is the only silicate dust capable of producing disability and death that does so to any marked or appreciable extent. The total number of persona involved in' the industry probably decs not exceed 12^00 sad as far as can bo borne out by clinical experience, tuberculosis is not a factor in this diseasaj Ever since the survey wee started in 1940 the industry has carried on strenuous measures to .contfol the dust in mine, mill and factory with a very marked degree of success. I t would seem, therefore!, there will never be available the clinical experirmce of asbestosis that has been a marked feature ef silicosis ip various industries throughout the world.I I would also like to point out that the explrieaoe with asbestosis in England appears to differ sharply with that In C au d a and the United State), The authorities in Great Britain regard asbestosis as a very, serious disease, much more so than ail costs, and they seem to be convinced that cancer bf ths * A payer rood Mori tki fourth Coolant* of Mct/iTYM RSARCB FOUNDATION ee SUenh, hold m Norooit, Quote, Jmmry ittk-JOtk, J9if, lungs is a Sequent sequela. This is not the experi ence in either Canada or ip the United S ta tu A great deal of information is available from the medical departments of the various industries that have for a long time maintained constant roentgeno- graphic examinations of asbestos workers which, coupled with the efforts a t dust control, may explain the difference in clinical findings. As far u we have been able to ascertain, there docs act seen to be . any undue prevalency of cancer among asbestos V workers in this country and, u some of the mince * and fabricating plants have been working extensive- *> ty for over thirty years, it would seem th at if cancer w u a frequent complication of exposure to as* bestos dust, this fact would have become evident long ago, especially u the medical supervision ef t` asbestos workers is both thorough and com ptehenv.: ' slue, I have, within the last couple e f months, spent several days with D r. Kenneth Smith in Asbestos reviewing a great many films covering a * ; period of a number of years and I understood him ' .* to say that be bad seen only one case of cancer of C the lu g s during tbattim n. D r. Chrtier a t Tbcttord ;t * b u found only a vary small number of casos of ' * cancer of the lungs in the asbestos clinic in Thetford. * I would Uke#to emphasise that none of us can afford to be tod dogmatic in discussing these oc- ,, upational diseases sad because the experience far ooe country indicates one set of results, it does not necessarily fellow that tha same results are to be found, in other countries. There am many dreum* environmental conditions th at may diffar markedly and, unless all these divergent factors are known, comparisons can bo mado only with tho greatest of caution. U is quite possible that the asbestos fibers themselves in various parts of the world may differ in their structure and com position and hence produce different pathological results when inhaled. We have recently learned to appreciate the Importance of this phase of dust disease of the lungs in connection with the effects of the inhalation of dJatomnceoui earth. Diato- -*01(04 d k ftl# ETttt T6. 6B .M 1 T 'd t inactous earth is chemically Identical with crystal* line silica, but the amorphous form of silici pro* producing pulmonary Abroeis will receive further 4^. tended study. duces q uiu a different pathology in the than does crystalline silica. In these dust the m atter of dosage also is important and unless the Tuberculosis does not appear to be a factor in seriousness of the exposure in terms of dust in the asbestosia and there is general agreement on this inspired air can be determined with some degree of accuracy, one cannot compare one set of both in Canada and the United Stales. Certainly there is nothing in the clinical observations! with another without running the risk of serious sbestos workers comparable to the experience with error, The m atter of asbestos as a carcinogenic g g f * Industrial workers exposed agent deserves, and will receive, continuing study both in Canada and the United States.1 In* dustrial physicians have been alerted to be on the lookout for lung cancer among orkjrs. Aluminum prophylaxis has not been tried in ths asbestos Industry. The m u lt of 4b* work of Smith. Some y ean ago the late Dr. Gardner o f , first ascribed the action of asbestos fibrosis id the lung to the larger particles rather than mAi|*n>dam. TU s is exactly opposite to the effect o S T X r e it has been demonstrated that the smaller I the particles the more active they are in producing pulmonary fibrosis. Dr. Gardner was also om ha opinion that the action of the asbestos fibers was mechanical rather than chemical which again Is in contradistinction to the action of silica. However, some of the persons who have studied asbesitsis are not in complete agreement with this and i , is probable that the factor of asbestoe particle sin in ^ t0 0 " d Published tt'TH O R A X in J im IM l indicates no-am elioration of i. expenmenul an im * as has tm . e v id e n t f To summsrise; H aad'jn head with contiauine effortt to control air borne dust in mine, miU and factory goes a well developed and thorough n H k at supervision of asbestoe workers, together with a research program involving not only animals, but also clinical studies InduSgpuim on* ary function evaluatioh tests (Saranac) on M * of asbestos workers showing rocsigcno* graphic evidence of W i I . id S ltm QatiAddH T6. B Q KWA