Document 2J9zzLdyvDp8ONgrbpNzGNBvN

FILE NAME: Metropolitan Life (ML) DATE: 1951 DOC#: ML165 DOCUMENT DESCRIPTION: Trip Report - Notes by Dr. Abrams on Visit to Santa Barbara, Dec 5,1951 - Diatomaceous Earth 4k Notes on Visit to Santa Barbara, December 5, 1951 - Diatomaceous Earth Vis i t made b y ; H. K. Abrams, M.D and V. D. David, M.O. Karrator; H. K. Abrams, M.D. Persona seen; Dr. Joseph T. Hardo, Health Officer, Santa Barbara County; Dr. Lauren F. Bushy, Director of Tuberculosis Control for Santa Barbara City and County Health Departments; Mr. Frank Harader, Executive Secretary, Santa Barbara County Tuberculosis Association; Dr. David M, Caldwell, Director of Tuberculosis Hospital, Santa Barbara County, Purpose of visit: To further explore the problem of diatoreaceous earth pneumo coniosis. Drs, Nardo a n d Bus h y ; Vie conferred briefly with Dr. Nardo, who was friendly to the idea of a further study of this problem to properly evaluate its importance. He referred us to Dr. Busby to work out details. 1 told Dr. Bushy that recent re-examination of this problem led us to believe that it was more Important than w e had hitherto thought. We were thinking Beriously of doing a state-wide, if not nation-wide, study of it. Dr. Bushy's first comment was, "It is about time you realized that." Dr. Bushy sees only the diatomaceous earth cases that happen to come into his X-ray clinics. He keeps a card file and X-ray film file arranged b y alphabet according to name of patient. Therefore it is not possible easily to pick out the cases of pneumoconiosis from the others. However, he has started segregating these cases in his card file but has not progressed very far since h e has several thousand cards. Mbrecrver, he is working only on the records as f a r back as about 194-6, when he took this job. His records also contain very little or no clinical or occupational history. They contain merely the name, age, and other identifying data and the clinical and X-ray diagnosis. He states that he keeps the histories "in his head." He has no statistical help in arranging his files and he would welcome assistance. I offered him the possibility of assigning for a limited period of time one or two of the Bureau personnel to set U p a proper filing system which would permit cross filing and easier access to the wealth of information which the records in this department have accumulated over the years. He would welcome such help and awaits a further contact from us. During the time we spent with him, approximately an hour, he was able to recall the following cases of pneumoconiosis from diatomaceous earth, entirely by memory. All of these people were exposed at the Johns-bknville Plant in Lompoc, TS PLAINTIFF 'S EXHIBIT '5-9 9 9 Max Romero - combined with tuberculosis. Now at the Santa Barbara County Sanatorium. Age AS in 1946 when diagnosed. Julio Becerra ~ Combined with tuberculosis. Was a patient at the sanitorium. Young wman. W. A. Snyder. UXi Mrs. Mary J. Vatkins r- Combined with tuberculosis. -Haw at the sanitorivm, Her exposure was in connection with sewing of bags at the Johns-Manville Company, Lompoc. Age 43. MET-0000371 TRIAL EXHIBIT _ 2 - q B Vincent Grossitmi - Combined with tuberculoBlB. at the eanitorium. -- Joe DeLira - Combined with tuberculosis. Nov said to be a tractor driver. Present location unknown. Age 37. Howard Downing, John Fagaragon. Donald Ashe - Worked as a chemist for one year at Johns-lfenville. Is now working with the Sea Bees, U.S. Navy, Port Hueaeme, California. He was diagnosed as an uncomplicated pneumo coniosis with linear fibrosis and emphysema, but no disability. This occurred a year or more ago. Young man. Victor Stradiotto - Now probably living in Lompoc. John C. Sells - Now said to be living in San Diego. Age 81, Frank Winters - Age 54- An electrician at the plant for 20 years. Now has diatomaceous earth pneumoconiosis. Dr. Anderson told i--* him "to leave" but Mr. Winters states, "This is the only skill I have. Where can I go now?" Melvin McCollum - Now a patient at the Tuberculosis Sanatorium with T combined tuberculosis, pneumoconiosis. Was diagnosed In 1947 at the age of 36. He was a foreman at the Johns- Manville Plant in Lompoc. Howard Vinn.- Combined with tuberculosis. Now at the sanitorium. Charles BatldLn - Has been at the sanitorium. He has a pneumoconiosis and possibly tuberculosis. Kenneth Main - Age 35 in 1947, when ho was diagnosed as an early case of pneumoconiosis. He may be still living at Lompoc. Leland Steffansen - Age 51 in 1950, when diagnosis was made of pneumo coniosis. John Tonelli - Age 35 in 1950, when diagnosed as pneumoconiosis. A. G. Rohlfsen - Age 59 in 1951, when diagnosed as pneumoconiosis. ______________ - Name of man not remembered by Dr. Busby. He was last living In San Diego and recently died. Dr. Busby understands his lungs were sent to Saranac recently. The following information was also given by Dr. Busby. The Great lakes Carbon Corporation, which is the second largest producer of diatomaceous earth, operates a quarrying plant about five miles west of Lompoc and they are also building a processing plant just outside of Lompoc, which may have already started operations. He stated that he is desirous of visiting these plants with us and would bo glad to drive us out in his car any time we could come out. (In the county,also, is another mining company, the product of which Dr. Busby is not familiar with, called the Airox Company, located in CasmaULa, Santa Barbara County. He also stated that he just recently picked up a case of silicosis in a man working at the water reclamation project tunnel at Goleta. The contractors are the Halverson Company. He states that the man also had a history of hard-rock mining.) 1. - 3 - There are five doctors practicing in Lompoc. Anderson, Heidges, and Duncan; and the newer ones are the former Johns-Manville Company physician, is still practicing. The older ones are; Holloway and Foley. Dr. Truax, living in Lompoc, but not Dr. Busby stated that he has talked with both Dr. Caldwell and Dr. Kupka concerning doing a mass X-ray survey in Santa Barbara County. He is in favor of it and states that Dr. Caldwell is very enthusiastic about it. There are now 30 beds vacant at the Tuberculosis Sanitoriiaa. Dr. Caldwell feels that there is more tuberculosis in the county needing care. Mr. Harader, of the Santa Barbara County Tuberculosis Association, is also very anxious to do such a survey. Visit with Mr. Harader. Executive Secretary, Santa Barbara County Tubercu losis Association. Mr. Harader also believes that the diatomaceous earth situation needs more attention. He is anxious to do a mass X-ray survey of the entire county to find not only cases of tuberculosis but also cases of pneumoconiosis. He states that the Tuberculosis Association does not own its own X-ray equipment but can rent the equipment from the Ventura County Association at the rate of about $50 a day. He will cooperate with us in any industrial study which we may desire. Visit with Dr. Caldwell. Director oif the Santa Barbara County Tuberculosis Hospital. We had lunch and about three hours with Dr. Caldwell in discussion of the diatomaceous earth problem. Dr. Caldwell came to the sanitorium in about 1946. <He stated that if he had never heard of diatomaceous earth he would most likely diagnose most of the cases he has seen as tuberculosis. It was his first impression that cases of tuberculosis which occurred in patients having pneumoconiosis did better with their tuberculosis than uncomplicated cases. However, he has since revised his first impression and feels that while the tuberculosis lesion on X-ray film seems to be modified by the presence of diatomaceous earth pneumoconiosis, the clinical course is not improved but is actually worsened. He proceeded to give us detailed histories and show us films of several cases now in the sanitorium. In general, these cases have been characterized by improvement while in the sanitorium but have all sooner or later returned to the sanitorium with hemoptysis, loss of weight and other symptoms. He now feels that the prognosis is poor. As in the case of Busby, the records of the Tuberculosis Sanitorium are also not in a state by which the pneumoconiosis cases can be picked out very easily. However, he told us of several cases that he has seen since 1946 and the clerk of the hospital was able to find the names of several others that she could remember since about 1943. However, the hospital was established in about 1930 and there are many records which have never been analyzed. Dr. Caldwell would be grateful for any statistical help we could give him in digging out the cases of pneumoconiosis and would help any person we could assign. He gave us the following names of patients who were diagnosed with diatomaceous earth pneumoconiosis which could be remembered since about 1943: Joe Delira, James Olivers, Juan Valdivia, Floyd Gillian, Antonio Orso, George Mello, JuLio Becerra, Melvin McCollum*, Ed Williams*, Charles Batkin, flax Romero*, Howard Winn*, Norberto hhgdaleno*, Mary J. Watkins. * Now a t S iin it o n u m . Williams is employed as maintenance man. - 4 - Of this number, five are at the present time patients in the sanitorium. Mr. B1 Williams was diagnosed as uncomplicated pneumoconiosis about four years 6 on a pre-employment examination when he applied for a job at the sanitorium as a janitorial worker. Because he needed money, he made a compromise and release settlement with the Johns-Manvi11e Company for $1,000 several years ago. The following four have combined tuberculosis and pneumoconiosis, end their course can be described as one of intermittent improvement and remission with a gradual down-hill course, They are Magdaleno, McCollum, Romero and Winn. Eliminating the duplications in names given by Busby and Caldwell, there are a total of 26 people with diatomaceous earth pneumoconiosis, with or without tuberculosis that were given to us by Caldwell and Busby. These cases date only from 1943 or later. A complete list of these names is attached. This list should be checked with the records of the Industrial Accident Commission. It was Dr. Caldwell's belief that Mr. Melvin McCollum had not made a claim and that his expenses at the hospital were being paid for by the Johns-Manville Company* He did not know definitely whether the others had made claims for compensation. Mr. Howard Winn first entered the sanitorium in 194&- He had worked at the Johns-Manville Company in Lompoc for eight years until May 1942. He has been told nothing by the company concerning his physical condition, even though they had done X-rays on him. He has both tuberculosis and pneumoconiosis. Dr. Caldwell showed me the minutes of the meeting of the Santa Barbara County General Hospital staff on December 14, 1950. They contained a report of a talk Dr. Anderson, the medical director of johns-Msnville Company in Lompoc, gave before the society on the subject of diatomaceous earth pneumoconiosis. The following quotes were taken from these minutes. 1. "All powders in their various Bteps can cause linear lesions. The progressive conglomerate lesions are probably due to crystabolite and trydimite, which do not nodulate as in silicosis. 2. "Diatomaceous earth pneumoconiosis symptoms are the same as the symptoms of silicosis, the difference being that diatomaceous earth pneumoconiosis causes disability and death, while silicosis causes disability only." 3. "These patients (diatomaceous earth) probably are more susceptible to tuberculosis (than those .with ordinary silicosis)." Action: 1. Statistical help to Busby and Caldwell to search out all cases of pneumoconiosis (both ordinary silicosis and dietoznaceous earth silicosis) and set up a better filing system. 2. Check all names given by above with Industrial Accident Commission compensation records. 3. Medical-engineering study of plants of Johns-Manville Company' and Great lakes Carbon Corporation in Lompoc area. - 5 4.. Check with Dr. Kupka res mass X-ray survey, Santa Barbara County. 5. Interview for occupational histoxy the patients.now at Santa Barbara County Tuberculosis Hospital and all others in area no longer employed at Johne-Manville Company, Herbert K, Abrams, M.D. Chief, Bureau of Adult Health 1/ December 11, 1951 HKA:mw * Names of Cases of Diatomaceous Earth Pneumoconiosis Given by Drs. Busby and Caldwell 12/5/51 Donald she Charles Batkin *T Jnllo Becerra 'jQJoe Delira Howard Downlng John Fagaragon Floyd Gi Ili atri T B Vincent Grossinni 7^ Norberto l&gdaleno S'k -. Kenneth Maln 1 Melvin He Co11um Sfly*. George Mello James Ctlivera Antonio Orso 1. G. Rohlfsen *filMax Staner . John C, Sells V. A. Snyder Leland Steffansen Victor Stradiotto '' John Tonelll Juan Valdivia T 6 Mary J. Vatkins Ed Villi ama f ( -J Howard Vino Frank Vinters i , >n