Document 2jKMnJMMRkkQZ9q6g5RVkNJQ7

1 1 IN THE CIRCUIT COURT TWENTIETH JUDICIAL CIRCUIT OF ILLINOIS 2 ST. CLAIR COUNTY 3 FRANCES E. KEHNER, et al. 4 Plaintiff, 5 vs. 6 MONSANTO COMPANY, 7 Defendant. ) ) )' ) ) No. ) ) ) ) 30-L-970 8 Before the HON. RICHARD P. GOLDENHERSH, Judge 9 10 11 ' REPORT OF PROCEEDINGS 12 JURY TRIAL 13 February 10, 1986 14 15 16 A P P E A R A N C E S : 17 MR. REX C A R R & MR. JERRY SEIGFREID, Attorneys at Law Appeared on Behalf of the Plaintiff. 18 19 MR. K E N N E T H R. H E I N E M A N & MR. JOSEPH MASSIF, A t t o r n e y s at Lav; 20 Appeared on Behalf of the Defendant. 21 22 23 MARSHA SCHNIPPER 24 Official Court Reporter PG LN 63 1 PG LN 31 20 31 24 37 22 40 11 69 6 80 14 82 4 84 4 84 16 12 22 [NgljOloxin 2/10 2#3#7,8-TCDD to tetrochlorodibenzodioxin# 2#3#7#8-TCDD in the work place :laim to have been exposed to A. Not NIEHS. The NIOSH commonly known as who told us about the of Chapter 17 of the book on discussed was chloracne and tfith respect to chloracne and or not acne is a hallmark of being the hallmark of being the hallmark of dioxin? A. That -- that's a dioxin registry# which was dioxin or TCDD. 0* How did dioxin registry# but dioxin in the environment# dioxin# and I was asked to do dioxin* It is a paper he has dioxin intoxication? A. Yes# dioxin intoxication? A. Well# dioxin intoxication# not LISTI COMPLETE 1 INDEX PAGE 2 DR. RAYMOND S U S KIN D .................................. DIRECT EXAMINATION BY MR. HEINEMAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 EXHIBITS Paqe ` Paqe 2 Identified Admitted i 3 EXHIBITS SUBMITTED ON BEHALF OF THE DEFENDANTS: i1 4 Defendant's Exhibit No.: i 5 1692 68 69' 5 1692A 70 72; 1692B 70 72! 7 1692C 70 72 1693 8 1694 80 102 1 1695 109 110' 9 1696 109 110' 1697 ' 109 110' 10 1698 109 110! 1699 113 n s: 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2 1 BE IT REMEMBERED AND CERTIFIED that heretofore, on 2 to-wxt: February 10, 1986, being one of the regular judicial 3 days of this Court, the matter as hereinbefore set forth came 4 on for hearing before the Hon o r a b l e R i c hard P. G o l d e n h e r s h , 1a 5 Judge in and for the Twentieth Judicial Circuit of the State I 6 of Illinois, Belleville, St. Clair County, Illinois, and theI 7 following was had of record, to-wit: j 8 9 ******* ! 10 II 11 (The following proceedings were had in open Court].) II 12 MR. HEINEMAN : Morning, Your Honor. The defense at 13 this time will interrupt the testimony of Dr. C ugell and call 14 Dr. Raymond R. Suskind to the stand. j 15 RAYMOND R. SUSKIND j I 16 being called on behalf of the defendant, having been first ; 17 duly sworn, testified as follows: 18 DIRECT EXAMINATION 19 BY MR. HEINEMAN: 20 Q. Would you state your name for the record please, 21 s i r . 22 A. My name is Raymond R. Suskind. ! I I ' 23 Q. And what is your date of birth, sir? 24 A. November 29, 1913. i J! 1 Q. And where were you born? ! 2 A. New York City. ; i 3 Q. N o w , Dr. Suskind, would you state b r i e f l y what your l 4 current employment is, sir? i 5 A. At the present time I am a d i rector emeritus of the 6 Institute of Environmental Health at the University of | i 7 Cincinnati. I retired from the position as the director ofi 8 that institute in September of last year. 9 Q. All right, sir. And immediately prior to your j j 10 retirement, Dr. Suskind, how long did you have the position! 11 of director of that institute? \1 j i 12 A. I was the director of that institute f r o m 1969 J J 13 until 1975 -- I'm sorry, 1985. ji | 14 Q. And I wonder if you would tell us your e ducational 15 background, sir, please? ! i 16 A. I went to college at Columbia University, and I j 17 received a bachelor of arts degree with a major in 13 chemistry. I went to medical school at the State U n i v e r s i t y 19 of New York, downstate medical center, and I interned at the i 20 Cincinnati General Hospital and had a residency in 21 dermatology at that hospital in 1944 to *46 and f rom '48 to 22 *50. j ! 23 Q. All right, sir. Nov/, with respect to the work at! i 24 Columbia University when did you receive your AB w i t h a major L 4 1 in chemistry? x1 2 A. In 1934. ! 3 Q. And did you do any work at the u n iversity followii ! 4 your graduation atColumbia? 5 A. No, I did not-. This was during the de p r e ss i o n ! 6 years, and I got a job in a laboratory devoted to the -- to1; 7 p olio myel i t i s at New York University. And I spent two yea: 8 there as a researchassistant. i i 9 Q. Did I understand you to say polio mye l i t i s ? ,j i 10 A Polio myelitis. It was actually the same | 11 laboratory in w hich Dr. Albert Sabin also got his start. i .! 12 Q. And the notoriety of Dr. Albert Sabin is what, si| 13 A. He's the man that developed the most e f f ective 14 polio myelitis vaccine, and as a result of that, the epidemj 15 polio myeli t i s has been eliminated p r a c tically all over the| ! 16 w o r l d . 17 Q. Now, did you have any opportunities to do any worl 18 overseas in terms of your studies, medical studies? 19 A. Yes, in 1937 I entered medical school at -- in 20 Edinboro and spent a year and a half there until the outbre [ 21 of World War II, and just before that outbreak I returned t! I 22 the United States, and since it was not possible to return ! 23 Edinboro, I entered an American medical school at the State! i f 24 U n i v e r s i t y in New York. 1 Q. Now, in your study of medicine, generally what were 2 the types of courses that you took? 3 A, Well, medical students have a rather formal 1 i ' i 4 curriculum, and the courses include the basic sciences such 5 as anatomy and physiology and biochemistry, pharmacology, 1 6 pathology, and the clinical subjects include internal II | 7 medicine, pediatrics, surgery, psychiatry, and the ! 8 specialties such as dermatology, ear, nose, and throat, 9 diseases of the e y e . | , 10 Q. Now, during that time was there any exposure to the 11 field of preve n t i v e medi c i n e ? i 12 A. Well, in -- at m e d ical school I had an opportunity 13 to be involved in a symposium in the field of ' occupational ji i 14 health and found that the field had a lot of u n answered 1 i 15 questions which were kind of important socially as well as J 16 medically. I atte n d e d sessions of the workmen's compensation 17 hearings and became att r a c t e d to the field at the time. 18 Q. Now., f oml l owing your g r aduation from medical schoo! 19 in 1943 you ment i o n e d that you did an .internship at the 20 U n i v e r s i t y o f -- at C i n c i n n a t i General Hospital, is that 21 right? 22 A. Right. 23 Q. And what sort of training did that entail, sir? 24 A. Well, that also included hospital experiences and 1 outpatient experiences in medicine and surgery and j 2 orthopedics and pediatrics and psychiatry and some of the ; 3 specialties like ear, nose, and throat and disease of the ; 4 eye. ! 5 Q. Now, at that -- following that training did you ! 6 elect to become a specialist in a particular field? i I 7 A. Well, I d e c ided b e c ause of a v a r i e t y of reasons -j- 8 one of them was that the field of dermatology was a very ! i i 9 useful one to be trained in, es p e c i a l l y if one was interest' i 10 in occupational illnesses, b e c ause at that time about 60 to' 11 70 percent in some states like Ne w York, 60 to 70 percent o!; 12 all occupational diseases were skin disease, so I thought i| j 13 would be a useful thing to do to receive my residency j 14 training in the field of skin diseases. i I 15 Q. That would be the science of dermatology? J 16 A. Right, that would be dermatology. ' 17 Q. Now, when did you undertake that training, sir? 18 A. I started in Octo b e r of 1944 and finished two 19 periods of training. This was during W o r l d War II and 20 instead of having yearly periods of training, there were ni I! 21 month periods without holiday, and I served until 1946 and ! 22 then went into the Armed Forces. ' After I came out I i 23 continued the residency. I finished the residency as well | 24 accepting a fellowship in pr e v e n t i v e medicine and industrial / 1 medicine. 2 Q. Now, Dr. Suskind, I've heard you use the term 3 preventive medicine, industrial medicine, and occupational 4 medicine. Can you define those for us please? 5 A. Well, p r e v e n t i v e m e d i c i n e is a field w h i c h deals ; 6 with the prevention of diseases and injury generally, and one 7 can get specialized training in preventive medicine following 8 medical school and following an internship. This was not my 9 intent. You can practice preventive medicine in specific 10 fields like in internal medi c i n e and p e diatrics and , 11 obstetrics, and you can certainly do it in a rather large way 12 in the field of o c cupational medicine, because one is largely 13 concerned in occupat i o n a l medicine not simply w i t h the 14 diagnosis of occupat i o n a l diseases, but the p r e v e n t i o n of ( 15 occupational d i s e a s e s . 16 Q. Now, in -- upon co m p l e t i o n of your residency ' i 17 training were you -- what was your first employment, sir? 18 A. My first em p l o y m e n t was that of an instructor in 19 the Department of Preventive Medicine .and*Industrial Health, i 20 which was located in the Kettering Laboratory, the same 21 department years after w a r d s I became the director of as well 22 as an appointment as an assistant professor in dermatology,, 23 so I had a joint a p p o intment in two departments. 24 My primary reason for returning to C i ncinnati after o 1 discharge from the Armed Forces was that it provided a rather 2 unique opportunity for me at least to develop a research 3 program in the toxicology of the skin, that is, to study how 4 toxic agents affect the skin, how they're absorbed and how 5 the skin reacts to it, w h i c h is the key to the p r e v e n t i o n of 6 occupational skin diseases and I had an opportunity to set up 7 a laboratory for the study of skin problems relating to . 8 environmental chemicals. 9 I was particularly interested in the reaction of 10 the sebaceous glands to chemical agents, and in 1948 w hen I 11 returned set up a laboratory to study the reaction of the 12 sebaceous glands to chemical agents. 13 Q. Now, would you define sebaceous glands? 14 A. A sebaceous gland is -- are the fat glands of the 15 skin. The glands that are atta c h e d to the hair follicle, and 16 the fat from these glands keep the skin flexible and smooth, 17 and as a matter of fact, they're an important organ of 18 defense of the skin against certain kinds of stresses such 19 as, for example, the fatty acids from t h e `sebaceous glands 20 will prevent infection, so that it's v e r y di f f i c u l t really to 21 infect the skin. The skin has to be damaged sever e l y for the 22 skin to become infected with bacteria, b e c ause of the fact 23 that there are these fatty acids secreted by the sebaceous 24 glands, which defend the skin against invasion by 1 micro-organisms. 2 Q. Now, Dr- Suskind, as I understand it, you had a 3 professorship in the Dermatology Department as well as the 4 Department of Preventive Medicine and Industrial Health? 5 A. Right, and that Department of Preventive Medicine 6 and Industrial Health eventually became the Institute of 7 Environmental Health and from 1962 to 1969 I held joint 8 appointments in both departments and'was also responsible for 9 teaching the residents in both occupational medicine and 10 dermatology. 11 Q. Nov/, at the University of Cincinnati, sir, you 12 m e n t i o n e d the teaching that you did. Did you do any clinical 13 work there as well? 14 A. Yes. From 1962 to 1969 I served in the 15 O c c u p a t i o n a l Health Clinic, which was at the K e t t e r i n g 16 Laboratory, as well as in the clinic and the hosp i t a l service 17 of the Department of Dermatology. 18 Q. Now, would you tell me the d i fference -- the jury 19 has heard quite a number of times reference to the K e t t e r i n g 20 Laboratory. How is that different from the U n i v e r s i t y of 21 Cincinnati Medical School, how are they related? 22 A. Well, the Institute of Environmental Heal t h is a 23 comprehens i ve . i n s t i t u t e devoted largely to research and 24 teaching in all aspects of environmental and o c c upational u 1 health. This is a department -- this is a department of the 2, College of Medicin e at the U n iversity of Cincinnati, one of 3 the largest departments of the College of Medicine and enjoys 4 the same status as the Department of Surgery or Department of 5 Medicine. It's uniqueness is that it has a large research 6 unit, and the research unit is located in the building called 7 the Kettering Laboratory. 8 Q. Now, from the University of Cincinnati did you go 9 to another medical school? 10 A. In 1962 I was invited to develop a new 11 e n v ironmental medicine research p r o gram at the U n i v e r s i t y of 12 Oreg o n in Portland, Oregon. They were interested in 13 deve l o p i n g a unit, and I went there as the head of the 14 Division of Environmental Medicine and set up a research 15 unit, in w hich we were engaged in studying the effects of 16 certain environmental agents on health, p a r t i c u l a r l y on the 17 skin, and it had to do with humidity as humidity and wetting 18 the skin affected absorption through the skin. We now know as 19 a result of that work that when you wet the skin, toxic 20 agents will go through much more readily through the skin. 21 We did a study of forest product workers. We did a 22 study of the photosensitizing, that is, the capab i l i t y of 23 chemical agents found in products to sensitize the skin to 24 sunlight, and we did some work on -- in that area as well. 1 Q. Did you do any study with respect to farm workers 2 while you were there at the University of Oregon? 3 A. Well, we had an opportunity to do some studies of 4 orchardists, workers who were involved in cherry picking and 5 there -- some of the migrant farm families which came up from 6 California to Oregon to pick the cherries developed problems 7 w h i c h we event u a l l y found out were due to the spraying of 8 lead arsenate on the cherries before they were picked, and 9 because the cherries were so lucious and edible, the pickers 10 a c t u a l l y ate the cherries that had the lead arsenate on it. 11 Q. And did you have any chance while at the Univer s i t y 12 of Oreg o n to work w i t h detergents and bacteria stats? 13 A. Well, w h e n I talked about photosen s i t iz i n g agents, 14 the agents that we were largely concerned with were agents 15 that were being incorporated into soaps and into detergents 16 to prevent the growth of bacteria. They're called 17 b a c t e r i o s t a ti c agents, and there were a series of them at 18 that time, the so-called salicylanilides and these were 19 b r o m i n a t e d salicylanilides, and the most active 20 p h o t o s e n s i t iz e r was an agent which was very commonly used, 21 and it was called tribromsalicylanilides, and we did a study 22 of a group of people who had become photosensitized to the 23 agent and some of these people became what are known as 24 pers i s t e n t light reactors even though they did not use the JLA 1 soap any longer or the detergent any longer, they still were 2 sensitive to sunlight. 3 Q. W ere these m a t e r i a l s in any c o m m o n l y sold or 4 commonly used soaps that the jurors might be familiar with? 5 A. Well, they aren't any longer- T h e y ' r e no longer 6 incorporated into consumer products, but at the time there 7 were products like Safeguard that had it in. it, L ifebuoy 8 soap. As a matter of fact, as a result of that study I was 9 asked by the government of Australia to come and look at a 10 problem that was d e v e l o p i n g there, and it was v e r y similar. 11 They were using soaps and de t e r g e n t s that had bromi n a t e d 12 salicylanilides in it, and people were d e v e l o p i n g sunlight 13 r e a c t i o n s . 14 Q. Now, following your time at the U n i v e r s i t y of 15 Oregon what did you then do? 16 A. Well, in 1969 I was invited -- even t hough Oregon 17 is a beautiful area of the world, and we loved it there -- I 18 was invited by the University of Cincinnati to become the 19 director of the now Institute of Envir o n m e n t al Health and 20 occupy the first endowed chair in that posi t i o n of the 21 director of the institute. 22 Q. W hat is an endowed chair, Dr. Suskind? 23 A. An endowed chair is a position, a chairma n s h i p of a 24 department positio n w h i c h is paid for by a grant or a gift, X and the interest on that gift or grant provides the income, 2 the complete income of the occupant of the chair. j't Q. All right. So that this -- the interest from this 4 grant was in essence paid your salary? 5 A. Yes, it was, and had paid my complete salary up 6 until I retired. 7 Q. And was this grant a p u b l i c or a private gift, what 3 sort of a thing was it? 9 A. W e 11, there was a foundation called the Schmidlapp 10 Foundation and the Schmidlapp F o u n d a t i o n in 1969 decided to 11 endov; a chair in e n vironmental health for the dire c t o r of the 12 department, and-as I indicated, I -- my income came from that 13 e n d o w m e n t . 14 Q. Nov;, if it weren't for an endowment of that kind 15 would you be then paid by the u n i v e r s i t y itself? 16 A. Yes, the u n iversity u s u ally has a salary for full 17 time faculty and, however, in m a n y of the departments, many 18 of the major departments and the basic science depa r t m e n t s 19 there are endowed chairs. In some instances the amount is 20 not sufficient to cover the salary, so the un i v e r s i t y pays 21 the rest. This un iversity is a state university, `so that the 22 monies for salaries also come from the state. 23 Q. H o w , in your posi t i o n as director of the Kettering 24 Laboratory what v;ere your duties? 1 A. My duties included de v e l o p i n g and a d m i n i s t r a t in g a 2 rather substantial research program in a variety of areas 3 involving environmental health problems as well as teaching 4 and as well as participating in the clinical activities of 5 the department, so I spent about 35 to 40 perc e n t of my time 6 in research administration and some of my own research and 7 about another 30 percent in teaching, w h i c h X still do, and 8 the rest of the time in clinical activities. 9 Q. All right. Now, when you say clinical activities, 10 what are you specifically referring to? 11 A. I mean seeing patients in the occupational health 12 clinical facility of the department, and I spent two to three 13 afternoons a week doing that, and I still do. 14 Q. And the teaching aspect, w h o m do you t e a c h at the 15 university? 16 A. Well, first of all, we have -- w ithin the 17 department we have graduate students, and there are about 70 18 graduate students, and they include physicians, PhD students 19 in toxicology, graduate students in industrial,hygiene, 20 graduate nursing students in occupational health, g r aduate 21 students in occupational safety and environmental 22 epidemiology and biostatistics. 23 I also have some respons i b i l it y to teach 24 undergraduate medical students, medi c a l students in their .LO X second year and medical students in their fourth .year, and 2 some of that teaching as well as the teaching of the 3 physicians who are graduate students or residents is carried 4 out within the clinical facility, so my two or three 5 afternoons a week are spent in seeing referral patients as 6 well as teaching the residents as well as medical students 7 who serve clerkships in the clinic. 8 Q. Do these students go on rounds w i t h you and 9 participate in the examination of patients? 10 A. They not only do that, but they a c t u a l l y help work 11 up the patient. T h e y take histories, they do the exam i n a t i o n 12 under my supervision. 13 Q. How, with respect to the research work that you 14 have done at the Kettering Institute or Ke t t e r i n g L a b o r a t o r y 15 would you describe for us generally what is the n ature of 16 that research? 17 A. Well, as I indicated, the research effort at the 18 Kettering Laboratory is a rather c omprehensive one. It 19 includes research efforts in the toxicity'of heavy metals 20 like lead and cad mium and selenium and arsenic. Right now 21 there are a substantial number of programs' d e v oted to the 22 study of the effects of lead as well as m e r c u r y on 23 experimental animals and also on human health. 24 The research program includes a research unit io 1 devoted to pulmonary problemsf a research unit devoted to 2 neurological problems or neurotoxicology, a research unit, 3 rather large one, devoted to the study of cancer, the 4 mechanism of the carcinogenesis or the induction of cancer. 5 This is largely done in animals. There's a research unit 6 devoted to clinical studies, in which populations are studied 7 in the field. There's a group studying or developing new 8 methods of the prevention of or the control of hazards. This 9 is the development of industrial hygiene methods. And 10 there's a research p r o gram in epidemiology and 11 biostatistics. So that as you can see it's a rather broad 12 program, and my job was to administrate that program and to 13 see that the investigators had a sufficient amount of support 14 for their efforts. 15 Q. I b e l iev e you mentioned that you did some personal 16 research, some research of your own within that context. 17 A. Yes. IS Q. W ould you describe that for us please? 19 A. Well, from 1969 on I have carried out a number of 20 studies, and they have included studies of the effects of 21 environments on a b sorption through the skin, that is, the 22 study of the effects of certain types of injury, injury by 23 chemical agents, injury by wetting and so on. 24 We also have done some studies on rubber workers. l/ 1 We did a large field study to determine the cause of a large 2 frequency or rather high frequency of skin problems in the 3 rubber industry. We have carried out, as the court has 4 heard, studies on the effects of working with 2,4,5-T, that 5 is, the m a n u f a c t u r e of 2,4,5-T on the health of workers. 6 Q. Now, w i t h respect to the clinical practice you say 7 you still do the clinical practice? 8 A. Yes, we do. > 9 Q. W h o m do you n o r m a l l y see in that context? Are they 10 your own p a t i e n t s or are they referred, what is the nature of 11 that practice? 12 A. Well, the departm e n t ' s clinical effort is largely a 13 tertiary care facility, that is, we don't see acute problems 14 as a rule. W e do see p r oblems that have b een seen by other 15 physicians, and the physicians want a consultation to 16 determine how to u n d e r s t a n d the problem which is not getting 17 any better perh a p s and how to treat the problem, and the 18 cases that we see, not only myself but others who are working 19 in the clinical facility, are referred b y `physicians, 20 referred by., the medi c a l departments of industries, referred 21 by unions, referred by workmen's compensation agencies of the 22 state as well as the federal worker's compensation office. 23 Q. Now, w i t h respect to the toxicology work that you 24 do, do you do that yourself? Iti 1 A. Well, the toxicologic efforts are very-.broad, as I 2 indicated, and they include work on lead and mercury and 3 cancer and a variety of things, and my job was to supervise 4 and to administrate. My own efforts, if youVre asking me 5 what my own efforts in the field of toxicology were, I think 6 I have already indicated that they involved human efforts, 7 human studies. We have done, for example, a study quite 8 recently on the toxicologic effects of certain rubber 9 additives. This was a spillover of the study we did in a 10 rubber tire plant to determine w h a t or how sensitizing, for 11 example, certain rubber additives were and for that we did a 12 study in guinea pigs. 13 Q. Mow, wit h respect to the types of teaching that you 14 do, the nature of the courses that you teach, could you give 15 us an idea of the kinds of subject matters that you do teach 16 these students? 17 A. Well, I have a seminar course whi c h I give. It's 18 called Persp e c t i v e s in Envir o n m e n t al Health, and what it does 19 is to a l low for an indepth d i scussion of some of the critical 20 problems in e n v iro n m e n t al health. For example, a review of 21 the toxic m e t a l s , w h i c h -- we discuss s o u r c e s , we discuss 22 processing, we discuss the utilization of these products as 23 well as the health problems w h i c h may ensue from the -- from 24 working w i t h metals, for example, or using products which 1 actually contain them. 2 We are not only concerned with products, we are 3 concerned with the other aspects of the environment which may 4 be contaminated by such products, air, water, food chain, and 5 so on. In addition to a discussion, indepth discussion of 6 the health issues involved in -- with metals, we discuss the 7 critical cancer causing agents that are -- that are emerging, 8 that are emerging. This is to keep the students up to date. 9 The seminar discusses immunotoxicology or the 10 immunologic aspects of environmental agents and the effects 11 of such agents through immunologic processes like asthma or 12 like allergic problems involving the skin. 13 We have -- this seminar also di s c u s s e s the problems 14 of energy sources and energy utilization, w h i c h m e a n s the 15 discussion of fossil fuels like p e t r o l e u m and coal and 16 shale. It's their origin, mining, the processing, the 17 refining and also utilization as w e 11 as nuclear sources of 18 energy and solar sources of energy and title sources of 19 energy and so on. 20 I also give lectures to th gra d u a t e students in 21 each of the special areas like toxicology, in w h i c h I will 22 discuss largely the toxicologic pro b l e m s as they affect the 23 skin and the mechanisms and patt e r n s of injury. Also discuss 24 these issues with the graduate students in industrial zu 1 hygiene. I participate in the general seminar given for the 2 whole department, which is a weekly seminar, in w h i c h the 3 whole department is involved. 4 Q. N o w , with respect to the -- you're t a l king about 5 energy sources and oils and lubricants and that soft of 6 thing. Do you look at the health effects of exposure to 7 those materials? 8 A. We start off by looking at the sources of the 9 energy, the coal that needs to be mined, the shale that needs 10 to be taken out of the earth, the nuclear, origins of nuclear 11 energy, the fuels that are used, and then we discuss how 12 these energy sources are processed, and then how they're 13 refined and then the materials that are used from these 14 sources by industries or by consumers and the h e a l t h hazard 15 aspects of them if there are any and what we know about them. 16 Q. I'd like to deal w ith your d e r m a t o l o g y 17 specialization for a moment. Are you boa r d certified, sir? 18 A. Yes, I am. 19 Q. And when did you achieve that c e r t i f i c a t i on ? 20 A. In 1949. 21 Q. How did youv become certified? 22 A. Well, one has to serve a period of training and by . 23 1949 I had already served the equivalent of three years of 24 training, and then at that time one took a w r i t t e n 21 1 examination and then had an oral examination, and following 2 that examination I got a certificate. 3 Q. All right. Now, you -- how m a n y times did you take 4 that examination? 5 A. I only took it once. 6 Q. And who did the certifying? 1 A. Well, there's an American Board of Dermatology, 8 which is a certifying board, and just like an American Board 9 of Internal Medicine or American Board of Surgery, these are 10 certifying boards that are maintained, and the c e r t i f i c a t i on 11 examination was given by members of the board. 12 Q. And those were written and' oral? 13 A. At that time they were w r i t t e n and oral, right. 14 Q. Now, are you a member or have you been a m ember in 15 any professional societies relating to the science of 16 dermatology? 17 A. Yes. I^'ve been a member of the A m e r i c a n A c a d e m y of 18 Dermatology, I've been a member of Society for Investigative 19 Dermatology, I was a member of the Board of D i r e c t o r s of that 20 society and a vice president of the society, and last year I 21 was a made an honorary member of that society. I'm also a 22 member of the American Dermatological Association. 23 Q. All right. Nov/, what is the nature of these 24 professional societies, what is it that they do? 1 A. Well, most professional societies are'organized to 2 enhance the level of knowledge and level of understanding of 3 the diseases that members of that specialty are confronted 4 with, so that the American Academy of Dermatology is largely 5 a large society that has an annual meeting devoted largely to 6 education. Th Society for Investigative Dermatology is a 7 society, as the title d e s c r i b e s , interested in research in 3 dermatology, and not only does it provide forums or fora for 9 the discussion of research in dermatology, but also provides, 1G and I had a hand in helping to develop fellowships for the 11 training of research dermatologists, so that the professional 12 societies are largely to enhance the status, enhance the 13 scientific and the professional status of the specialty. 14 Q. Do you have a n y ' r e l a t i o ns h i p with any societies or 15 foundations overseas? 16 A. Well, I have been made a honorary m ember of the 17 Japanese Dermatologic Association and a member, because of a 18 three m onth teaching -and consultation effort I did in Chile 19 in 1966 was made a honorary m ember of the'Chilean 20 D e r m atological Association. 21 Q. Do you have any appointments to committees or 22 councils in the field of dermatology? 23 A. Well, I have been a member of the -- m ember of the 24 Board of Directors of the Society of Investigative 23 1 Dermatology, but if you're asking about the a p p o i n t m e n t s ,to 2 councils, I have been a chairman of the Standards Advisory 3 Committee on skin hazards of OSHA and developed a report 4 after a year's work in that. 5 I was a member of the Board of Trustees of the 6 Dermatology Foundation. I was a chairman of the program 7 committee of the Academy of Dermatology and chairman of the 8 education evaluation committee of the American Academy of 9 Dermatology. 10 R ecently I was appoi n t e d a member of the 11 subcommittee on malignant melanoma of the Lawrence Livermore 12 National L a b o r a t o r y in Calif o r n i a and am serving currently on 13 that c o m m i t t e e . 14 Q. Nov/, w i t h respect to the Lawrence Livermore 15 appointment, what is the subcommittee on malignant melanoma, 16 what is that appo intment ail about? 17 A. Well, some years ago it was discovered that, the ! 18 employees of the Lawrence Livermore Laboratory, which is a 19 national laboratory, there was a -- there was a p parently an 20 increased frequency in a type of skin cancer, rather serious 21 skin cancer called melanoma, and the job of the committee 22 which was appointed is to see v/hether or not this frequency 23 is real, v/hether or not it's really greater than the people 24 living in the area or the State of California, and the 1 cormnittee of experts was assembled by the University of 2 California to look into it, and this is what w e ' r e now doing. 3 O. Now, what is the -- what is the nature of the work 4 that you're doing on that committee? W h o 's s e r v i n g , o n it and 5 6 A. The chairman of the committee is Dr. Arthur Upton, 7 who used to be the Director of the National Cancer Institute 3 and is now, the Director of the Institute of Environmental 9 Medicine at NYU. It's an institute very similar to the 10 Institute of Environmental Health at the U n i v e r s i t y of 11 C i n c i n n a t i . 12 And the other members of the board are the dean of 13 the School of Public Health at UCLA, Dr. B r e s l o w or Dr. 14 Sober, who's from Harvard and who's an expert on the 15 pathology and the clinical aspects of melanoma, a young man 15 from the National Institute of Environmental H ealth Sciences 17 whose work is largely the nature of environments .that may 18 result in injury or disease, t h a t 's industrial hygiene or 19 environmental hygiene, and then there-'is myself, v/ho I serve 20 in the capacity of an occupational physician who has done 21 research in populations who can study or knows what to look 22 for in the environment. For example, in this instance, the 23 laboratory's been in existence since 1952, so one would have 24 to determine what have they been doing in those various AO 1 laboratories since 1952- That's not been done, but it has to 2 be done. 3 Q. Now, wit h respect to the field of occu p a t i o n a l 4 medicine, when did you begin your involvement in that 5 specialty? 6 A- I really began the involvement when I became a 7 member of the faculty of the Kettering Laboratory and the 8 Department of Environmental Health back in 196 -- 1948, and I 9 have learned a great deal about occupational medicine and 10 o c cupational illnesses as a result of my work at the 11 K e t t e r i n g Laboratory, so that I've been involved in the study 12 of occupational illnesses and the source mech a n i s m s of 13 occup a t i o n a l illness since 1948. 14 Q. Some 38 years or so you been involved in that 15 field? 16 A. About that, yes. 17 Q. And when you began in this field, was there such a 18 thing as certification? 19 A. Mo, certification actually came later. As a matter 20 of f a c t , the certifying board, I t h i n k , gave its first 21 exami n a t i o n in the early fifties, it must have been '54, '55, 22 so that when I entered, there wasn't any certifying board. 23 However,.I have served on the residency review committee of 24 the A s s o c i a t i o n of American Medical Colleges and the AMA u 1 which ,,reviews curricula and experiences for training special 2 lists in occupational medicine, and in the last, oh, seven or 3 eight years I must have reviewed, site visited about six or 4 seven different residency programs. 5 I also have in the past served as a examiner for 6 the board. When oral examinations were given and they needed 7 examiners for that, I have been asked to be a examiner for 8 the board. 9 Q. Now what is that board, sir? 10 A. This is the American Board of Preventive Medicine, 11 w h i c h has a special area of occupational medicine, so it's a 12 subsp e c i a l t y of preventive medicine, but it's a certification 13 in occu p a t i o n a l medicine. 14 Q. So you give the exams for board ce r t i f i c a t i on in 15 that field? 16 A. Right. 17 Q. Nov/, with respect to the occupational m edicine 18 field, do you have any society memberships in that area? 19 A. I'm a member of the American Occupat i o n a l M e d i c i n e 20 A s s o c i a t i o n and member of the American Academy of 21 Occup a t i o n a l Medicine and have been a member of the Board of 22 Dire c t o r s of the American Occupational Medical. A s s o c i a t i o n on, 23 -- for two terms. 24 Q. What is the function of those particular societies? Ai 1 A. Like other profess i o n a l societies they-.-- their 2 main thrust is to enhance the level of education, the level 3 of u n d e r s t a n d i ng of the diseases covered by the spe c i a l t y or 4 the problems covered by the specialty. So that the American 5 O c c u p a t i o n a l Clinical Association, which is a v e r y large 6 body, not all of the people in it are certified, is to 1 provide short courses and symposia at its annual meeting to 8 -- again to increase the knowledge, understanding, and skills 9 of the occupational physician. 10 Q. Nov;, are you a member of any councils or committees 11 or have any appointments in that specialty of occupational 12 m e d i c i n e ? 13 A. Well, I serve as an -- as the representative of 14 o ccupational medicine on the editorial board of the A n nals of 15 Internal Medicine. I am on the Board of Dir e c t o r s of the 16 permanent commission or the International C o mmission of 17 O c c u p a t i o n a l Health, and I'm currently on that board. 18 I was a member of the -- of NIOSH's task force on 19 o c cupational surveillance and served about a year or two on 20 that, in that group. I have served both as a consultant in 21 o ccupational problems for both the A rmy as well as the Navy. 22 THE COURT: Mr. Heineman, is this a good point to 23 break for a short recess? 24 MR. HEINEMAN: Oh, yes, sir. O 1 THE COURT: W e 'll take a short recess at this time. 2 I would remind you, and this covers any other breaks we take 3 during the day that you're not to discuss this matter among 4 yourselves or with anyone outside the jury panel or as of yet 5 form any opinions or conclusions about the matters on trial. 6 Court's in a short recess. 7 (At this time a short recess was taken.) 8 9 (The following p r o c e e d i n g s were had in open Court.) 10 Q. Dr. Suskind, b e fore the break you were mentioning 11 that you had been on the N I OSH task force on occupational 12 health surveillance, sir? 13 A. Yes. 14 Q. And NIOSH is what, sir? 15 A. That's the National Institute of Occu p a t i o n a l 16 Safety and Health. This is the organization, national 17 organization, national a g e n c y w h i c h is responsible for 18 carrying out research and education in relation to 19 occupational illnesses and injuries. 20 Q. Now, further in c o nnection with the -- with your 21 specialty of occupational medicine, have you had any 22 relationship or co n s u l t a n c y with the Nat i o n a l Institute of 23 Environmental Health Sciences? 24 A. Yes, I have, a rather longsta n d i n g one. First of 1 all, the National Institute of Environmental Health Sciences ,2 provides the basic support for the Institute of Environmental 3 Health, It is a d e signated center of e n v i r o n m e n t al health 4 research sponsored by the NIEHS, ,National Institute of 5 Environmental Health Sciences, 6 I also served on a -- in 1975 served on a task 7 force for research planning in the environmental health 8 sciences. Every four or five years Congress asks the various 9 institutes to provide them with an update on what their needs 10 are, and in this instance there have been now three volumes 11 of research needs which the NIEHS has prov i d e d for Congress, 12 and I was even before I went to Cincinnati in 1969, I was on 13 a task force that developed such a program, but in '75 the 14 second task force was created, and I served as a m ember of 15 that task force and wrote and edited the docu m e n t w h i c h was 16 sent to Congress. 17 Q. That was with respect to needs or areas of research 18 that needed to be looked into? 19 A. What the task force did was to identify the state 20 of the science in environmental health, how m u c h do we know 21 about anything that we should be paying attention to, and 22 what are the current and future needs for study, current and 23 future needs for study. This would give Congress some idea 24 as to what the tax dollar will be supporting in environmental ou 1 health research and education for the next five years or so. 2 Q. Wow, when you said that the N I E H S has a connection 3 with the Environmental Health Center, you're referring to the 4 University of Cincinnati? 5 A. Yes, and there are -- there are now nine others 6 that are also designated environmental health research 7 centers. 3 Q. M o w , when you say designated, w hat do you m e a n by 9 that? 10 A. The National Institute of E n v i ronmental Health n Sciences as a result of an application that the university 12 makes for support of a large c o m prehensive program. The 13 application and its p r o gram are reviewed, and then it takes a 14 good while to do this, it takes over a year to do this. The 15 NIEHS with counsel then decides, yes, they will designate the 16 University of Cincinnati as one of- their c o m p r e h e n s i ve 17 environmental health research centers and support it so that 18 the core support of the Institute of E n v i r o n m e n t al H e alth now 19 and since 1965 in Cincinnati has been from the NIEHS. Matter 20 of fact, there was no NIEHS in 1965, but the Public Health 21 Service had an Office of E n v ironmental Health, and it was 22 only in 1969 that the NIEHS was created. 23 However, that's beside the point. The point is 24 though that government agencies like the NIEHS, National J JL 1 Insitute of Environmental Health Sciences, has now ten 2 different universities has research centers and the 3 U n i v e r s i t y of Cincinnati is one of them. 4 Q. And so these research projects that you were 5 telling the jury about a few minutes ago, these are then 6 funded by NIEHS? 7 A. The NIEHS supports the basic staff and basic 8 resources, but for specific projects, for specific projects 9 one can apply to the NIEHS, but it's not part of the center 10 grant. So that in addition to the NIEHS center grant which 11 we have, we may have seven or eight other project grants for 12 specific research projects. 13 Q. Then those are funded as well? 14 A. Those are funded as well, and what they do -- and 15 without the center we probably could not, we coul d n ' t get 16 these other grants, because we wouldn't have the f a cilities 17 or the staff. 18 Q. Now, in connection with NIEHS, sir, is there any 19 maintenance of a registry with respect to*people who have 20 been exposed or claim to have been exposed to dioxin? 21 A. That -- that's a registry which is main t a i n e d by 22 NIOSH. 23 Q. By NIOSH? 24 A. Not NIEHS. The NIOSH dioxin registry, w h i c h was I 1 started some years ago and is now directed by Marilyn 2 Fingerhut, is, I think, what you're referring to, but that's 3 NIOSH. Again I said that the NIOSH was responsible for 4 research and education about problems of the work place. 5 NIEHS is responsible for research in other environmental 6 areas and sometimes gets into the areas of the work place, 7 but it's usually not in the work place. 8 Q. N o w , with respect to the Environmental Prote c t i o n 9 Agency, do you have any -- have you had a relationship with 10 that agency? 11 A. Well, I been on a number of advisory committees. I 12 been on a National A c a d e m y of Sciences Committee to look into 13 the probl e m s of p o lycyclic aromatic*hydrocarbons or 14 polycyclic organic materials, and that project essentially 15 was sponsored by EPA, but carried out by the National Academy 16 of Sciences. I also served on a committee, it v/as a National 17 Air Q u a l i t y A d v i s o r y C o m m ittee for the EPA, so that v/hen the 13 EPA was reviewing the need to regulate air pollutants like 19 carbon monoxide or photochemical oxidants*or sulfur oxide, 20 this committee would review the documents that -- that 21 supported or were supposed to support the regulations which 22 were being considered. 23 Q. All right. Nov/, you mentioned earlier the Annals 24 of Internal M e d i c i n e . What is that publication, sir? 1 A. The A n n a l s of Internal Medicine is a ve.ry 2 well-known medical journal published by the American College 3 of Physicians, and I think that it's probably in circulation 4 it's second only to the Journal of the AMA insofar as 5 world-wide d i s t r i b u t i o n insofars circulation is concerned, 6 and my role on the editorial board was to serve as a peer 7 reviewer of articles submitted to the journal for publication 8 as well as to advise the journal on matters that concerned 9 occupational health. 10 Q. W h a t are the -- as a member of editorial board the 11 types of public, types of articles that are included in that 12 publication? 13 A. The types of articles include the whole range of 14 disease problems that are the -- that internal medicine 15 addresses, so it would include hematologic diseases or 16 diseases of the blood, diseases of the lungs, diseases of the 17 central nervous system, diseases of the kidney, a wide 18 variety of disease problems, which internists or specialists 19 in internal medic i n e would be interested in. 20 Q. Nov/, is this a p e er-reviewed journal? 21 A. Oh, yes. 22 0. All right. In terms of the peer review process 23 being on the editorial board do you get involved in that 24 process? Jfi 1 A. I do get referred to me articles that are being 2 considered for publication, and I have to read them and 3 appraise them and give an e v a l u a t i o n and finally w h e t h e r or 4 not the article is worthy of publication in that journal. 5 Q. All right. Now -- 6 A. What happens is that my review without name will go 7 back to the author, and sometimes the article is worth 8 publishing if they make c e r t a i n required revisions, and if 9 the revisions are made, and the author accepts the idea that 10 these these revisions ought to be made, then the a r t icle will 11 be published, and then sometimes, and this is true for all 12 peer-reviewed journals, they get articles which are not 13 qualified for publication. 14 Q. And so you are a peer reviewer? 15 A. Right. 16 Q. Is that right? W h a t are the factors that go into 17 that process to de c i d e w h e t h e r an article should be published 18 in a p e e r - r e v i e w ed journal? 19 A. Well, there are a set of criteria which the journal20 actually designates, originality, medical interest, whether 21 it's of strong medical interest, moderate or there's v e r y 22 little interest on the part of medical community in the 23 subject of the article. Looks at the adequacy of the 24 writing, w h e ther it's good English or not, and that sometimes JO 1 is a problem, whether the material is of value, but not 2 presented properly, and the peer reviewer can determine, yes, 3 it's of great value, this new information, but it's not 4 interpreted properly or presented properly, so that one looks 5 for originality, one looks for level of interest, one looks 6 for organization, one looks for adequacy of the writing and 7 then makes a judgment about w h e ther it's w o r t h p u b l i s h i n g in 8 the journal. 9 Q. Do you get involved in a d e t e r m i n a t i o n of the 10 merits of what's being presented, whether the c o n c l u s i o n s are 11 justified? 12 A. Yes, that's part of it, but I not only do peer 13 reviewing for that journal, but peer review for the Journal 14 of the AMA and the Journal of Inves t i g a t i ve D e r m a t o l o g y and 15 the Journal of the Ame r i c a n A c a d e m y of Dermato l o g y , so that 16 -- and it takes a lot of effort, beca u s e one does recognize 17 that it is a responsibility of the peer reviewer to be, to be 18 thorough about the review. 19 0. Now, I'd like to deal w i t h y o u r `toxico l o g y 20 background. What is the board -- is there a boa r d or a 21 governing group in the field of toxicology? 22 A. Well, up until 1978 there was no ce r t i f y i n g board 23 in toxicology, and several scholars in the field d e c ided that 24 it would be a good idea to d e v elop such a certification, JO 1 again to enhance the level of education, to enhance the level 2 of skills of the toxicologists who are going to be 3 responsible for making judgments about products, about 4 processes, about work places, and their efforts are going to 5 have an important role in regulatory decisions.* 6 In 1978 a group was brought together, and I was 7 asked to join that group to develop an examination, and this 8 is -- we spent two years developing this p r o g r a m of 9 examination, and the exam has been given now since 1980, and 10 I served on the board for five years, from 1978 to 1983, and 11 now the board is well on its way, and they are giving 12 examinations not only in the U nited States but overseas. 13 They give'the examinations in Great Brit a i n and G e r m a n y and 14 Australia and Mew Zealand. 15 Q. All right. Now, with respect to the field of 16 toxicology do you serve and have you served on other 17 committees or councils in that connection? 18 A. I have served on a few. I served as a m e m b e r of 19 the advisory panel on toxicology of the A m e r i c a n Medical 20 A ssociation from 1980 to 1985. I served' on the O h i o State 21 Agent Orange advisory committee from 1982 on. I served on 22 the Veterans Administration committee on h ealth related 23 effects of herbicides. This was a national committee, and I 24 was a consultant to the V A on Agent O range studies. o/ 1 Q. W i t h respect to the A M A panel on t o x i c o l o g y did you 2 have a specific project that you were involved in in that 3 connection? 4 A. Origina l l y the panels developed to a dvise the AMA 5 on a variety of toxicologic issues, but one issue appeared to 6 be very urgent at the time, and that's -- this was the Agent 7 Orange issue, and the panel was then asked to develop a state 8 of the science, a state of the knowledge that we had about 9 Agent Orange and its possible contaminants and look into the 10 e n v ironmental aspects of it, the t o x i cologic a s p ects of it in 11 animals, that is, at least the contami n a n t s or the m a t e r i a l s 12 that made up Agent Orange 2,4,-D and 2,4,5-T, and then 13 p a r t i c u l a r l y interested in the state of our kno w l e d g e about 14 the health effects of Agent Orange and v/hat studies were 15 being done, what studies should be done to develop critical 16 information about the effect of Agent O range on V i e t n a m 17 veterans or the effect of the materials that w e r e used in 18 Agent Orange on other populations. 19 Q. tlow, by the contaminants what parti c u l a r 20 c ontaminants were you referring to? 21 A. We were particu l a r l y concerned with 2,3,7,8 22 tetrach3.orodibenzo-para-dioxin commonly known as d ioxin or 23 T C D D . 24 Q. How did you get appointed, how did you get involved 1 in this particular project? A. Weil, I 5ra not altogether sure who recommended me, *3 but I got a call one day from the office of the council on * scientific affairs of the AHA asking me whether X would serve D on that toxicology committee, and they indicated, whoever 6 called me indicated what the need was and X had served years 7 ago on other AHA committees and found it a very useful 8 prof es a ion a 1 responsibility. 9 Q. -vho else was on this committee with you? 10 A. The committee was chaired by a phy s i c i a n 'who was i;l the dean at bright State U n i v e r s i t y Medical School named John 12 Belgian, and other members of the committee were the 13 toxicologist, 'Mendeli Kilgore from Davis, a physician 14 t oxicologist from Dayton named Kimura, ci p athologist from the 15 A fried Forces Institute of Pathology named Mel son Irey,- who J,Vi was very knowledgeable about the pathological aspects of 17 toxicology, and a man named Vestal, a toxicologist who had 18 been ---- I had known him from the U n iversity of Rochester 19 Center for Dnv.l ronnenta Health Research, who was at the time 20 of his appointment the Director of T o xicology of the General 21 iiOc.O 3.1). o o 0 Mov:, v;nat -- how di ci you r group f u11ct ion, what did 23 you do? 24 7\* re!']., we felt -- oh, yes, i `m sorry, there was a 1 secretar y v/ho v/as staff n ame d Rob e rt tineater, who v/as a very 2 knowledgeable, sch o l a r l y man v/ho put together references and r> even did some of the writing for us to look at, examine and 4 appraise before it went into any of the documents. urz I think the wa y we went about our affairs could 6 best be described by what we did to develop the latest issue 1 of a document on the health effects of Agent Orange. There 8 was one put out in 1381 and a second one in 1984, which was _o/. the revision- and what we did was literally to divide up the 10 responsibility, because there were representatives of a 11 variety of disciplines on that panel. Dr. Kilgore knew a 12 good deal about the envir o n m e n t al aspects and analytical 12 aspects of the Agent Orange components and their contaminants 14 like TCDD. 15 Dr. Vostal handled the toxicologic aspects, what 16 the state of knowl e d g e was about the effects of TCDD and 17 other related substances on animals, and Dr. Ximu.ru and I If. were really responsible for putting together the human health 19 effects materia] and. all the references, and vze submitted our 20 review to the whole committee. It was gone over very 21 carefully by the whole committee, and then we decided what 27 should go in that f irial cioeumen c . 23 0. M o w , now long clid th is comnit tee ope ra te ? 24 A . 7Jell r the corami11ee e >:1sted actual!v from 1380 to m1l* I cP iCD Q. And what m a t e r i a l s did the committee refer to in 3 order to reach the c o n c l u s i o n s that it e v entually expressed? 4 A. First of all, we went to the literature, and we had / 5 a good Informational backup including my own library of the 6 Institute of Environmental Health, and then we brought in a 7 series of consulta n t s to tell us about v/hat they knew of the 8 various studies that were going on and listed in the latest 9 edition of '84 is a list of those people, and they included 10 Renate Kimbrough, who w orked with the CDC, and it included 11 Marilyn Fingerhut, who told us about the d i oxin registry, but 12 particularly about her work on the soft tissue sarcoma issue, 13 what she had done up until that time and v/hat new knowledge 14 there was throughout the world as well as through the efforts "rr of CIQFH about clarifying the diagnostic issue with respect 16 to soft, tissue sarcoma. ^ 17 \1q had doctor -- the e p i demiologist at .Dow, whose 18 name escapes rae at the moment, but he told us about what Dow 19 was actuaily d o 1n g . Me had Sheila Hoar from the Matronal 20 Cancer Institute told us about the studies that the NCI was 21 Coring on effects of spraying and non-Vietnam community, for 22 e xai.r>1 e , among Kanaas f a r m e s that used 2 ,4,5-T years ago, 23 v/hat trie state of their h ealth was. 24 "s-'-bon Iry represented the Armed Forces Institute 1 of Pathology. Dr Shepherd from the VA came as a 2 consultant. Dr. Herlo, v/ho v/as a graduate student of mine f 3 but was the Director of the biostatistical unit at Seveso, 4 told us about v/hat new knowledge there v/as with respect to 5 the studies being carried out at Seveso. Those were some Of 6 the consultants. 7 Q. All right. Then having -- 8 A. The name of the -- I 'm s o r r y r if I can interrupt -- D the narae of the epidemiologist from Dov/ v/as Ralph Cook. I :m 10 sorry. 11 Q. Ilow, once you had gathered all of that .information 12 and searched the l i terature and had the consu l t a t i o ns what 13 did the committee then do? 14 the committee decided that all this material 15 should go into a document, w h i c h would be made available to 16 Arnerlean p h y s 1clans or any other p eople -that would like to 17 have a copy of this rev lev/. 18 0. And then is that when the responsibilities v;ere 19 d iff e re n iated as you des c r i b e d them?-' 20 A . oo, n o ? the re sp o n sibiiicies were d if f e re n t ra t so ao 21 the very beginning when we set out to develop this revised 22 document on he a 1th effects of Ag e n t 0 ra n g e r b u t lien a 11 o f 23 our indi' i.d u a w o rk v/as done t Jiis wa s ;jro u g ht t og e t he.r , 24 reviewed by- the committee as a whole and then edited and 1 published. 2 Q. All right. Was there any feedback? In other 3 v/ords, did you send it out to the people that had s poken to 4 you and consulted with you for further consultation? 5 A. Yes.- Individual sections that referred to the work 6 that was being carried out like at the National Cancer 7 Institute or at NIOSH and the update of the research at 8 Seveso, this was all reviewed by the consultants themselves. 9 Q. And then did you receive remarks back from them? 10 A. Yes, yes, and I think in most instances the 11 reporting was very accurate so that there vas v e r y little in 12 the way of correction. 13 Q. How does the procedure that you went t h r ough w ith 14 this AHA report on Agent Orange, how does that c o m pare to the 15 peer-review process which you have just d e s c r i b e d to the 16 jury? 17 A. Well, first of all, I have to e x p l a i n that the peer 18 rev lev/ process of an original article w h i c h is sub m i t t e d to a 19 journal is really very different than a review of an -- a 20 review of a review. The AMA's document was really an 21 informational review, and then a d i scussion of the state of 22 the science, of the state of knowledge and some -- and 23 conclusions based upon the state of the knowledge. 24 O. That was -- was that based in part on review of 1 other peer-reviewed articles? 2 A. It was based upon the collective information about 3 all of these various levels of research activity, 4 environmental and analytical toxicology, human health 5 effects, human health effects, and the information that was 6 gleaned from the articles was summarized in this document. 7 NoW/ I can't really tell you that all of the i 8 articles that we had looked at and quoted were peer-reviewed 9 adequately. I really don't know. Nobody can tell you that, 10 but most of the articles were published in p e e r - r e v i e w e d 11 j o u r n a l s . 12 Q. Now -- 13 A. Some of them actually were documents that came out 14 of national agencies and while documents that come out of 15 national agencies may not be peer-reviewed in the same sense 16 as we know it, but they usually are reviewed before they are 17 p u b l i s h e d . 18 Q. Now, you, sir, have written articles of your own, 19 have you not? 20 A. I have. 21 Q. And can you give us an idea of a p p r o x i m a t e l y how 22 many, let's say, peer-reviewed publications that-you have 23 written? 24 A. Tie11, I would -- I've never counted the number of 1 peer-reviewed articles, but most of the original publications 2 that I have submitted were peer-reviewed and published in 3 peer-reviewed journals like the Journal of Investigative 4 Dermatology, the Journal of Occupational Medicine, even the 5 state of the arts document on the environment and skin, which 6 I published in Environmental Health Perspectives, that's a 7 national, that's a journal of the NIEHS, that's also 3 peer-reviewed. 9 Q. So when you write an article, then someone, else is 10 peer reviewing it for the journal. 11 A. Yes, yes. 12 Q. You get back their comments? 13 A. Yes. 14 THE COURT: Is this -- before you get into a 15 specific article, is this a good point to break for lunch? 16 MR. HEINEMAN: Yes, sir. 17 THE COURT: We'll b r e a k 'at this time. We'll resume 18 again at 1:15. The admonishments that I gave you earlier 19 will a pply during this break also. Court's in recess for 20 lunch. 21 (At this time a short recess was taken.) 22 (At this time the following proceedings were had in 23 chambers out of the hearing of the,jury.) \ 24 THE COURT: Let the record indicate we're in 1 chambers outside the presence of the jury, and would you 2 please indicate for the record what days Dr. Suskind has told 3 us that he's available? 4 MR. HEINEMAN: The days he's available are -- other 5 than today, of course. 6 THE COURT: Sure, right. 7 MR. HEINEMAN: Thursday and Friday of this week. 8 THE COURT: 'That's the 13th and 14th? 9 MR. HEINEMAN: Right. .The 18th and 19th, the 25th 10 through the 28th, and the 3rd and 4th of March. Now, I'd 11 also note that he is also available on the days that have 12 been declared that there's no court, which is the 11th and 13 12th and 17th and 24th. 14 THE COURT: The 17th and 12th are court holidays, 15 and this building is closed down. Okay. And that's it? 16 He's not available past that is what you're telling me? 17 MR. HEINEMAN: That's what he's informed me. 18 THE COURT: How long is your direct going to be? 19 M R . H E I N E M A N : I will finish m y 'd i r e c t , I'm 20 assuming I'll finish my direct on-Friday of this'week. 21 THE COURT: So that would be -- you'd finish on the 22 14th, and w e 'd have the 18th and 19th. Where is he going to 23 be the 20th and 21st? 24 MR. HEINEMAN: In California at the U n iversity of *jto 1 California at a meeting of that committee that he described 2 this morning at the Lawrence Livermore Laboratories at the 3 University of California. 4 THE COURT: I'm assuming you've got a witness to put 5 in those two dates, the 20th and 21st. Can you get Dr. 6 Cugell back? 7 MR. HEINEMAN: I can assume so. I don't know, I 3 haven't addressed that point. 9 THE COURT: Mr. Carr, do you have anything to say? 10 MR. CARR: Yes, your Honor. The plaintiff would 11 object to Dr. Suskind not b e i n g ' b e i n g here on the 20th and 12 21st and some other witn e s s interposed. V7e`ve alre a d y got a 13 witness that has been interrupted for D r . Suskind to come 14 here. If you recall, Dr. Cugell testified for a couple of 15 days and has been pulled off now so that Dr. Suskind can come 16 o n . If Suskind isn't here on the 20th and 21st presumably 17 Dr. Kugeil will be put back on in the m iddle of m y cross iJ.nO e x a m ination of Dr. Suskind, and I submit, Your Honor, that I IS cannot develop a decent cross e x a m ination *for the benefit of 20 the jury to develop the p oints that need to be developed if 21 the c r o s s - e xaminat i o n is interrupted in this way by some 22 other witn e s s on direct examination. And Z would object to 23 taking Dr. Suskind off the stand for the purpose of him 24 attending a~ committee meeting in California. M/ 1 They must have known of this committee"meeting 2 prior to this time. They could have scheduled Dr. Suskind in 3 March or April or whenever t h e y -- or in January, whenever 4 they wanted to, and I would object to any -- to taking him 5 off the stand for the 20th and 21st and some other witness 6 coming on in his place. I think it's unfair to the 7 cross-examination that we're going to give. 8 THS COURT: Why can't he be here past the 4th. Q MR. HEINEMAN: I don't know that, Judge. That's 10 the date upon w hic h he says b e g i n n i n g the fifth he's got to 11 be off doing something else, and I don't honestly know what 12 it is as of the 4th or the 5th of March. 13 How, X might say that at the time that we scheduled 14 him during this period we were not aware of the additional 15 days off that had occurred, and, of course, the examination 16 of Dr. Cugell was unfor t u n a t e ly interrupted by, I think, 17 three days of juror illness as I'm informed. 18 THE COURT: Yeah, it was juror illness. 19 MR. HEI1TSMAN: Further I recall `p retty well, I 20 think, occasions when both Dr. S i lbergeld and Dr. C a r n o w were 21 away for a day or so in the midst of examination. I think it 22 was my cross-examination when that occurred. 23 THE COURT: Well, if I remember correctly, those 24 v?ere not where another witness was put in. I think those Li ij 1 were days that were off. 2 MR. HEINEMAN: W e l l , they weren't off until Dr. 3 Carnow couldn't be here, cause I remember one of those 4 specifically. He had to go to Boston or something for some 5 conference or meeting. How, we had not proposed, at least I 6 didn't propose to Mr. Carr to put a witness on during those 7 two days. I know that Musgrave talked to Mr. Carr about 8 that, and I don't know what the subject of that conversation 9 was. 10 MR. CARR: I have not been talked to about 11 anything. I just assumed you were going to put somebody on 12 during those two days. In e s s ence you're a sking the Court 13 shut down those two days then? 14 MR. H E I N E M A N : If you don't want some b o d y else in 15. the meantime. 16 MR. CARR: I sure d o n 11 . I think it would be 17 unfair to everybody to shut down for two days because he's 18 going to be in California at a com m i t t e e meeting. I think 19 they should nave scheduled him at a point in time w h e n they 20 wouldn't have to ask for a recess. We're going to end up with 21 two days, we're ending up w i t h three days this week, two days 22 next week. 23 MR. HEIWEMAN: W e i ] , if the Court please, I know 24 that, I'm informed that the 24th we're not on because Mr. 1 Carr has some other -- 2 MR. CARR: T h a t 1s exactly c o r r e c t . 3 MR. HEIMS MAM: -- Engagement that he has to '4 participate i n . 5 MR. CARR: I have to appear in the Appellate Court. 6 The courts have a little more authority in the judicial 1 system over a committee meeting in California. On HR. HHJNEHAM: Well, they ma y to you. 'but-- 9 MR. CARR: They do to the Court as well. 10 MR. HEINEMAN: I think that this m e e t i n g in n California is of the utmost importance to the witness. The 12 participation that Drs. Carnov; and S i lbergeid had, the court 13 days were called off w hen they c o u l d n 't be here. 14 MR. CARR: Well, I d o n 't know of any days when 15 Silbergeid was called. There may have been some. As far as 16 Carnow you have an advantage on me. I d o n 't recollect him 17 being gone during cross e x a m i n a t i o n -- one da y he .had -- 18 t h a t 's, when he had to testify in Congress about Bopal 19 i n c i d e n t . 20 HR. HE XHE,'IArJ: Well, I r eme mb e i: a t r ip t o B o st o n f 21 as I r e c a l l . 22 THE COURT: T 11at w a s the Bopal inc1d e n t , cause I 23 talked to -- that came about from C o n g ressman Blackmon 24 c a .1.1 1 ng me to get him off ior the tost i m o n y . 1 think that OU 1 was correct. Well, what about this? If you're going to 2 finish him -- of course, how long -- do you have any idea how 3 long Dr. Cugell is going to take, how much longer? 4 HR. CARR: I have no idea. It's their witness, 5 Judge. They just got two or three plaintiffs that they have 6 discussed, and if you recall, they gave us a long list of 7 plaintiffs that they're going to talk about. 8 THE COURT: 21 of them. 9 MR. CARR: Abnormal spirometers are only relatively 10 few, so I d o n 't see how -- there's only about five that have 11 an abnormal spirometer. I don't see hov? it can take v e r y 12 long for Cugell on direct examination^ 13 THE COURT: What I am thinking is perhaps we could 14 put Cugell in the week of the 17th, just the whole week after 15 cros s - e x a m i na t i o n is finished on the 14th, and then start up 16 w i t h Dr. Suskind the week of the 24th. 17 . HR. CARR: Then Cugell's cross-examination -- I 18 don't know how long they're going to put on Cugell, and 19 Cugell's cros s - e x a m i n a t i o n may be interrupted to start Dr. 20 Carnow's e x a m i n a t i o n -- I mean Suskind's cross-examination. 21 THE COURT: This is getting eraay. 22 HR. CARR: I don't know if 1 could keep it 23 s t r a i g h t . 24 THE COURT: This is that ongoing committee on the -- 1 this suspected exposure at Livermore Laboratory, right? 2 MR. HEINEMAH: Umhm. That's my understanding, 3 Judge. 4 THE COURT: T h at's what I remember. I 've got my 5 notes out in the courtroom, but my understanding, so this is 6 an ongoing committee meeting. Weil -- 7 MR. CARR: W hy can't Suskind be here in March? Why 8 can't you pull him off the stand, bring Cugell back, Cug.ell S can be the 13th and 14th and the following week and then 10 bring Suskind, and we get through with Cugell by the middle 11 of the week of the 25 or sometime during that week, we can 12 have Suskind then, and he can be here unlimited. 13 MR. MASSIF: You can put this on the record, but, 14 Judge, I have a recollection that he's gone someplace for two 15 m o n t h s . 16 MR. CARR: W ho? 17 MR. MASSIF: Suskind, right after this March date 18 that he's given us on a major thing that he's working on, a 19 project, and I can't recall exactly what the details were, 20 but I remember we had him scheduled before Christmas 21 originally, and things got -- because of Mrs, Melton's 22 illness, things got all pushed back and then he said wel.I, 23 I've got this win d o w from the 10th until March the date that 24 he gave us, and I can remember vaguely that after March he's 1 unavailable/ and I think it's for a significant period of 2 time, and I can't recall what it is, .but I think it's 3 something out of this a r e a , it's not in C i n c i n n a t i . He's 4 working someplace else. 5 THE COURT: He's actually engaged in a project 5 somewhere else. v7ell then, the only wa y we are going to 7 finish him is if we go the 20th and 21st and I'm sustaining 8 your o b j e c t i o n to that. That is the only way we can possibly 9 finish him. I remember the scope of what his testimony was 10 going to be. I have been served. I've gotten a copy of ' 11 various d i s c o v e r y matters co n c e r n i n g his te s t i m o n y and 12 looking at the history of this thing and the way witnesses go 13 in this trial there's no w a y in the world we'll finish this 14 otherwise if he ac t u a l l y hasto be out on a c o ntracted or 15 committed project on the 5thor the 6th or whenever it is, 16 the 5th; of March. That's the only wa y w e 're going to finish 17 him, so I will sustain your objection. 13 MR. HEINEMAR: Your Honor -- IS THE COURT: The d i f f e r e n c e with those other 20 situation when we shut down or whatever was we didn't have a 21 witness on the stand who had limitations as far as -- as far 22 as when the thing had to end, and life was a little easier as 23 far as d e a ling with that. If it weren't for the -- this 24 apparent commitmen t on the 5th and beyond, you know, this J 1 would be a lot easier to deal with, but under the 2 circumstances, I don^t see any other v;ay that we can finish 3 this witness with cross-examination and the inevitable 4 redirect and recross-examination that comes about with these 5 witnesses. 6 MR. HEINEMAN: Let me-- As said to you, I don't 7 know what this March thing is. If the court would like I'd 8 take a few minutes and go talk to him about it. 9 THE COURT: Why don't you talk to him at the recess 10 and report to me. 11 (The following proceedings were had in open Court.) 12 THE COURT: Okay. 13 Q. Dr. Suskind, one of the things I ne g l e c t e d to cover 14 with you this morning was at the time you were -- from 1969 15 untij. the time that you retired when you were at the 16 University of Cincinnati in the Kettering Laboratory, what 17 professorships did you hold w i t h the university? 18 A. I held a faculty a p p o i n t m e n t as full professor in 19 three departments. One, my major department, I was professor 20 of environmental health, and I also held appoint m e n t s in th 21 Department of Internal Medicine as* professor of internal 22 medicine as v/ell as professor of d e r m a t o i o g y , and I 23 participated in the a c tivities of those d e p a r t m e n t s to some 24 d e g r e e . D ft 1 Q. All right, sir. Now, just b e fore the lunch break 2 we had begun talking about your publications, and I don't -- 3 while I realize you've written many articles, I just want to 4 deal with a few. First of all, have you written on the 5 subject of human sebaceous glands? 6 A. Yes, I have, sir. 7 Q. And when 'was that? 8 A. Well, as I indicated earlier, when I came to S Cincinnati in 1948, I came w i t h the idea that I was. going to 10 establish a laboratory to do studies on the p h y s i o l o g y and 11 the chemistry of the skin, w hich would help expl a i n why the 12 skin reacts in certain 'ways and how it reacts, and I was 13 p articularly interested in the p r o blem of young p e o p l e with 14 acne vulgaris, juvenile acne, which is v e r y common, and 15 wanted to compare the reaction of the sebaceous glands in 16 juvenile acne to those that were caused by chem i c a l agents 17 such as causing chioracne, so that the first paper we did was 18 on a histochemicai, which means you take biopsies of the skin 19 of people who have normal skin, a v/ide age range, and then 20 you take biopsies of people with acne vulgaris, and then 21 biopsies of people that have chioracne, and you stain them 22 for certain chemical components like c h o l esterol and lipids, 23 like triglycerides and so on on and you d e t e r m i n e what the 24 difference is, what the difference b e t ween the normal skin of jo 1 certain age groups, especially adolescents and those who have 2 acne vulgaris, and even some adults have acne vulgaris as you 3 know. Then we compared those reactions or those 4 characteristics, chemical characteristics to the biopsies of 5 the first four people who were involved in a runav/ay reaction 6 involving trichlorophenol, and they had chloracne, severe 7 chloracne, and we did the same kinds of examinations of those 8 people. 9 Vie then followed this up -- this was 10 h i s t o c h e m i c a l l y , this was staining for chemicals, staining 11 for the characteristic chemicals and then we went ahead and 12 we did analytical measurements. A chemist p h y s i o l o g i s t named 13 Schmidt Nielsen joined me. Dr. Schmidt Niel s e n is now a 14 professor of physiology at Duke University, but he spent 15 several years with us, and he had just de v e l o p e d new 16 techniques to determine micro amounts,, very, v e r y small 17 amounts of lipids in tissues, which he had dev e l o p e d w hen he 18 was in Copenhagen, and he joined us, and he did some 19 analytical studies, not staining, but he actu a l l y m e asured 20 the amount of triglycerides and fatty acids within the 21 material that came out of the sebaceous o r i f i c e , came out of 22 the opening in the skin. 23 And the second paper in that series is about that. 24 O. Ail right. Mow, and what was the year w h e n those 1 papers were published? 2 A. These were published, I believe, in 1951, a gain in 3 the Journal of Investigative Dermatology. One -- they were 4 published in July of 1951. 5 Q. All right, sir. Now, did you have occasion to 6 publish in the areas of occupational skin problems? 7 A. Well, I had because of my interest in m e c h a n i s m s of 8 how and why skin reactions occur, which is really the basis 9 of understanding occupational skin disease, by the time, oh, 10 1958 arrived I had a fair amount of information w h i c h I had 11 gathered both myself and then through reading and published a 12 series of review articles, sort of state of the science of 13 occupational skin problems in the first, second, and third 14 issues of the Journal of Occupational Medicine. 15 The first article was on the mechanisms of 15 dermatological or skin response, and the second article had 17 to do with the patterns of response, the manner in w h i c h the. 18 I'm sorry, the second article v/as on methods of study, 19 methods of `evaiuat i o n , and the third article v/as on 20 diagnostic methods to clearly define what the origin of 21 occupational skin problems v/ere, and this v/as p u blished in 22 the Journal of Occupational Medicine beginning in J a n u a r y of 23 1959. 24 Q. Ail right, sir. Following that did you have an