Document 3Qpq9rD87NkMoMpv0JGNp7KXx

i \ \ b. /- It :). . . f': AmxticMB Joeraal r IrtuftrliJ Medldcw IIS7JM47 (1992) HISTORICAL PERSPECTIVES tH OCOOPATIOKAL MEWC1NE Wittenoom, Western Australia: A Modem Industrial Disaster A. V^rnam Mudk. uo, Nicholas H. tfe Kierit, MD, Jtfi L Ece&a, Michael S. T. Hobbs, opwt, Brucd K. Armstrong, ww, Lenore Laymofl, PhD, and 3*0*4* C. McHuWy, Kj MfKltr Wwor? af jballdeo, eflwatas atatdoted dteus, nriftfai dials, ^OTBMcaaW), Woe ufamw, ctaStoirte, n>ifntflnw, HtemMi, futt cancer GEOGRAPHY Wiamoorn is .raisorely located in Western Australia's north west, approximately 1,600 Km by road fmm Perth, approximately 320 Km from the coast, and 720 Km from the railhead at Mcekatharra, The rocks exposed in Winenoom Gw|e consist predominantly of qusruiies inusbeddfid with siliceous or cherty ironstone, (he deposits of cxoBdoiite being as* sociated with the ironstone. The bands ofcrocjdolite occur appoxktntely 25 feet apart, with the iewesvevnofosocidoltaavera&ag 2 Vf2 inches as Gn&ness and the upper oocidofitc vein occurring some 200 feet above the base erf the cliffs. >t DEPOSITS Q? BLUE ABBESTOS A considerable amount of fiber was available in the cliff faces and could be obtained without much difficulty at outcrops {Mina Department of W.A., 193$), initially it was considered doubtful that the tasrw '*vd\y> ofPtt veka wtwrtd permit the deposits to be worked economically by underground rtmhods. in i53S ihe State Mtamg' Brpneej reported tMin Department of W.A., 1939] that (he atxidoUte deposits had been worked by "'hand dressing*' only along theman ribbon of norma) containing long fibersin the lower horizon, The ironstone S*r Cfe*rtt Cue* HwjritiJ, KMtar, UftMera AuaraJu. AasaUt(K.WM1 Depevcei f PvtWHmU>. ofWeuera Aweal*.8etfau*Jj(N.MdR.. IX g.. M.S.T.H.), Seie( t Secwl toqwr*. MwOoea Uttvewry, Mecte* Q_L). - He*ftfe Ckp*nmew pi Wum Aeundi*. Perth. Avert* IJ.CM.i, UtwmuMd Agency for fcoauv* eeCttccr. t^on. ftstce (B.KjO AetearqKiMfeq^autDbi. A.*. Muft,icpimM ofte^uvo? Hofem, St> Chela Gftudno Hcai*i. Nedlandt. Waunt AesmlU 6C09, AnMii. A**psd tee f*,WicPM Aagsu >9, 199). t3 Wlky-Litf, Inc. 1 : > PLAINTIFF'S EXHIBIT II WV-04277- $??: v! ''Vsw, Yj <s^ II %?' f|; && X`:' l.\ S-... A WV-004277 j t WKienoen and Asbcsus W amount ofehrysotlie and smositc imported from Canada and South Africa (XuctaJ., 1985). CnOdOOUTE PRODUCTION The Production of Asbestos (a 1937, 14 tons ofcroctdoliw were produced from the Wittenoom area with a total value of 216. Is the following year. 55 tons valued u 3,170 were produced: but in S939 the total fell to only 24 tons, valued at 1,900, and is the following two yearsjust overone ton was produced. Production rapidly increased from 1943, when Australia Blue Asbestos Ltd. too*, over all the leases tad confinedtheiroperations to Wittenoom Gorge. By 1952. 3.000 toss of crockSotite per amtum were being pro duced and by 1957 this had increased to 11,000 ions per annum |Australia Blue Asbestos Limited,11958). This level of production was sustained until the Industry closed in 1966, Mining Practice The mitral mine and mill operated by Australian Blue Asbestos Ltd. f!948j were situated in Wittenoom Gorge. In 1957, a new mine and mill were opened In Colonial Gorge iABP, 1958] Initially, most ofthe ore was won from theupperseam, in order to allow, this to advance far enough ahead of the lower seam for safe extraction of the latter. The ore was delivered into a but and then erushed, first in a coarse crusher and next tn a fine crusher, after whkh it passed to an oil fired rotary drier. The fiber was cleaned and packed intojute sacks In 100 ft. loads. The whole 23 yeanof mining and milling was a process oftrial and error. The mining technique was fixed after five or so years of experimentation by British and American managers. Milling of the ore neverreached this point of stability. It was a simple dry mechanical process ofcrushing, grinding, and aspirating, but problems persisted in dust control, ventilation, adequate fiber purity, the etwemely abrasive host rock which made maintenance a huge task, and in the company's mining inex perience. The old mil!, which operated from 1943 to 1957, was poorly organized, while the new mill, which look overIn 1958, was better planned, with a bettersystem ofdost control. However, dostcontrol and fiberpurityremained problems throughout the life of the works. In the mid-1950s, the company experimented with a wet extraction method, but nothing caste of it. Dust Collection'andttusBrvmecn In the new mill, rotoclone dust collecting units were used for dust collection (Australia Blue Asbestos Limited, 1948; Major. 1968). The dust was saturated with water in the roroelones aid the sledge discharged to a pump which delivered it to a thickening tank. The heavy siudge settled out and was pumped to waste, while the clear water overflowed io atank, from which It wascirculated back throughtheplant. Hie plant was designed on the company's own experience. Canadian and South African plants were examined, butthe condition oftheore in the formeraad the labor conditions in the latter were so different that no direct application of this knowledge was possible. The mosteffic rent typesof machinery, basedon performance in the oM plant in Wiuenoom Gorge, were installed in the rww plant in Colonial Gorge. Only one adequate survey of dustiness was performed at Witrenooro. Thri was i } i fit Murk del. undertaken in 1966, to the final year of operation of the plant by es todustrial Hygieaist [Major, J968J. Ft&er levels higher than 1<X) Pm! 'ere measured in many parti ofthe plant, and subsequently pemtoted estimates of individual exposure of the 'oftforce to be made JArmstrong et aJ,, 19551 More recently, some of the original dust filters used by Major in his 1966 survey have been reexamined (Rogers. 1990). and the measurements were said to have underestimated the degree of exposure by 4'orders of magnitude.'' frierto these dust meawrenresu. crude ton!raetei readings had been carried out by the industry and the Mines Department ofWestern Australia. These readings usually exceeded measurement Smte of 1,000 particles per ee< In 1951. Western Australia having adopted a safe dost limit of 176 particles perec, the company was warned repeatedly d ifae CommissionerofPublic Health wrote to the UnderSecretary for Minesthat the"hasard fifomasbestosisconsiderablygreaterthan that from silica... we ban reason to believe that attention to this aspect ofmining operations i< Wtannoom has been inadequate in the part." In 1955, the Mines Inspector threatened to closethe mine. However, the works were not closed until the company itself tcok the decision in December 1966. Economies of the Industry The Government reserved all ground around the ADA Ieases from selection for croctdoliie mining by others and provided shipping subsidies to thecompany, but the asbestos indusuy was always economically marginal because of its inability to com pete with large reals producers In South Afoot and Canada. The company made a profit for only e few years between 1955 and I960, when it had a five-year export contract with Johns Manvlilc in the U.S.A, By the last year of its operation, it had accumulated losses of52,5 miUioB. Labor shortages, espe:alty ofskilled Aosualian miners and tradesmen, were continuous especiallyin the 1960s, when thenearby ires ote industry attracted many workers by offering better working conditions. Capital costs also rose, but marts prices did pot rise as anticipated. TOWNSHIP OF WrTTENOQM The original teetiement for the tube and mill m W&enoom Gorge was to die gotge hsetf, about one mb: from toe store. Astoe workforce grew, toe township trf Wlrtenoom was laid out and bulk at the entrance to Witmoom Gorge, about 12 km. north of the mine, la 1961, tos poputaooa of thedivision, which included Wioenoom js the town wheretoe -majority-ofpeople resided; coralgeti of6?l males anfl`W9 females. At toe toe ofclosure of (he mine to 1966, there were 1.46S males ard 421 females [Bureau of Census Statistics, 1971J. The township to 1958 contained 151 houses, a general sure,cafe, library, cinema, billiard room, hotel, teams courts, nee cousve, cricket tad football groavis, -jest oRkt. pedtoo ritofoo, tatpbad, Suae school, Catholic sebel, and kindergarten. A weekly baby cltofc operated and a doctorresided tothe towa. Singlemen wee accommodated to two-roomed hue, four men to each hut, and a ceatnj cafeteria was provided for tow use. Later, dorflaifcxy accommodation was also provided, Bowing. school, hospital, police station, water supply, and postoffice wereprovided by toe Government, and all other buSdings aod amenities were company projects. These was a Roman Catholic church in the town* ship, and Oturcbof England rl MctoodUl ctegy vxaredOMeanKWAh.Thcvoww shipenjoyed a regular air service by the MacRobertsoa Miller Airline Companyeach ` ? r r. ;v <y i Witieoeom and azbww TASIE I. OuratW f Eapteyaww f Austria* Use Aafacms CnpH>]'. 1M-|W ___ PrrtcU ofmptnvMOU tawtful 0 3-6 6-7 *-!Z > 12 4) ts 12 i 22 729 Tuesday, Thursday, and Saturday. and by a Dove Station Service aircraft each { Wednesday. Thursday, and Friday. Layman (198*1 has portrayed the to*n as ste reotypical ofthe usual mining town in only one respect: its isolation. Its community iartwateons we few and fragile, its trade txudaivn dwactemed by apathy and inactivity, evidenceofclass confta was infrequent- Virtually nochallengeexisted to company dominance i^i a company town. The workforce was nx militant and did not display much solidarity or oven class struggle, U was transient; less than one-quarterr stayed for longer than one year (Table I). Manyofthe workers were refugees from a depressed postwar Europe and were there only to earn wffteieot money to get a stan elsewhere. As a result, ail organized activities, such as trade unionism, political acunurt. and community otgaoiiaticn. west weak and sporadic. Owpfct *t poor working conditions, (to major strikes occurred. Collective activism to remedy griev ances was rare; s was not until 1965 that men living in the single men's quarters petitioned the Health Department to remedy their sub-Undart living conditions. "Hvc one community organization which did survive successfully w*s the Catholic church and convent school. The Government of Western Australia assisted in setting up the industry by providing die houses, as wed as transport subsidies. U cooeoraged people to go so Winenoom by projecting the town a* modern and a model for future development in remote areas. Wjttenoom was presumed as the largest inland town in,jbe north of State, with a stable and law-abiding community and a long and prosperous future. Tailings from the mill, rich in residua! crocUloIite, urere found Id be ideal foruse about the township for paving the roads, pukingareas, asd cbe like, and for reducing the dust and mud tnthe back-yards ofthe township's houses. From ihe middle 1960s. the Health Department of Western Australia tried to 009 dm compact? foam using Utese tailings and even proposed to Introduce a regulation coder the Health Act banning their use. The Minister for Mines preferred a course of obtaining the com pany's co-operation, but the use of tailings was not stopped until the mid- 1960s. the wdy exception being a permitted use when incorporated tn concrete and in the construction of a police station. There was a major mishap when, in the late 1960s or early 1970s, the then Government Department of Civil Aviation, without consuming anybody, used massive amounts of tailings on die airport tarmac. A Public Health Department Inspector noted in 1973: "Streets are sealed, but tn all ecrept one or two cases havs been made with mine tailings. Evidence ofunsealedtailings may be noted . on the sides of the roads. In the early days, it is obvious that people used tailings to * make driveways for their houses and some evert used them to cover garden areas: large areas covered by the tailings indude the front of the Wittencom Chib, the car park for the Club, the convent playground, the vehicle parking site near the Sure A * \ m mba school. and the tennis courts. The race course i$ completely covered by tailings and it i> interesting bow(be frhrtfs have becomepulverized and separated with rain to form concentrations in the hollow* made by hoof marts." THE WORKFORCE Between 1943 and 1966, some 6V00 reales and 500 females worked for Ausiraiiao Blue Asbestos Lid. at Wsaenown. The maxirewt wortioree at any or* Vune in the i960t was about 500* The crane was roe mostly on contract rates, rather than wages. Despite this, the company wat unable to wait skilled miners in Western Australia because Australian miners we no* prepared to wort continuously tn 42 inch slopes. As a consequence, the contfany turned to overseas recruitment of minat. I< recruited largely young and unskilled migrant labor, mostly from Italy, and brought them to '`Viitcnoom on two-yearcontracts, Others were recruiteddirectly off migrant ships w Bremantle (the port ofPerth) on sU-nwnih contracts, These men had no tradition of (nine wort or any idea of the conditions they faced. Many were Awfvaytd vrttfi 'hey saw the srtuaViws^but they were relatively powerless; they had ao money, no recognized skills, no common tradition with which to defend them* selves. Ofthe k>eal Australians who worted at Wiacnoom, many were itinerant and quickly moved on. Wort tn the null was also deemed unskilled, It was heavy, noisy, diny, and ho*. and few worted there (or long. Many Uit toe Lome as aooe, u the* eoniracts had been fulfilled and some Jeff sooner. Those who were forced to stay in WHtencom moved to the mine at the Ht opportunity. Most of the mill workers had heavy laboring jobs at different points is the milling process where they provided a back-up for an inadequate mechanical process. At eteend ofthe milling process, the baggers were doing the jut> widely regarded as the most intolerable In the mill. Workers responded to these oppressive working conditions leaving thejob. Turn over In the mill was continuous. What was found to be most intolerable was the amount of dust, Dt. {.C. McNutey bccarotthe. M*4MedicalCtfTwei vn W) andtasdescribed his experience visiting Winertoom personally: "Oo arrival f was met by a company official at the airport and taken on a tour of the mine and mill, i feti ai the time that b was chc dirties* mine and wti {badever seen,although (had no occupational health training. Bui by that time 1 had visited many surfaceandunderground workings in(he eastern^oldGelds.These.wore dumps ofasbestos allover^he-floornnd'suriaccs of themill andone'* clothing was rapidly soiled by contact with anysurface. Sunbeams showed heavy dust particles and visibility was reducedinsome areas. Aftercrushing, at the exit of (be underground mine high up on fire, face of (be gorge, (he ore os a rovingbek enuredthetop story ofthe mill, The fibtfwasheavily admixed with rock and "picker*" looped over (he belt, manually removing (he larger pieces of rod;. This was a very dasy area. As the belt awed down through the virions levels ofthe mill, smallerrocks were removed, fiberwas freed, andthendischarged fromahopper and bagged. Every operation in the nuU was associated with dud, even the fewsekeeping Sweeping up die floors was done dry and raised a great deal ofdust. The men at the bagging pfem simply stood over opart begs, which were filled from a chute. The floor was heavilycontaminated with clumps ofasbestosand youcouldsee is it, the men's clothing, hair, everywhere. At some Sage, either this year or subse quently when 1 was present, (he bagger* wore respirators, but these were of a very W&tt&Qooi *ftd AEhtgiw 741 simple, h|lf*rtce cartridge type. During tny visit, the maximum (empemurc rarely dropped below 1007 and it was obviously impossible to do reagoaabiy he**? wosfc 6-10 hours a day wearing sue* # respirator. They were obviously tll-ftrting sd ineffective axsyway. The dust was c*traded from the mil! end siropfy poured out above,roof levd vo flow tack u> 9* min staff offices. Azsfces uspectocreported dust feveis in the air measured oa the Isms outside (he Hal? (dikes would be enac tspubic in an underground mine. The duu emerged at (he same level as the main entrance lothe underground workings, anddust in the air entering had been measured at between 200and 305 particles percubiccentimeter, a level which was above what would** accepted v fee goldowang mdss&y. The underground workings were also fairly poorly ventilated and humid. The rock was parttailariy bard, had a high free silicacontent, water was not veryevident, and there was obviously a serious silicosis risk. Apart from a general shortage of water, management had difficulty with damp fit*jand, in fact, limited the use ofwaterand this cctvtribused tothe general dustiness of the pueft and mill. Oooke the mill, the waste material, the laftngs, and the material collected tn (he dust extractor system were simply dumped from hoppers onto the back of tryeks trt a cloud of dust and the trucks then driven up ro (he gorge over roadways laid with tailings to dump the ore. Vehicle oovemere over the roads raised a great deal ofdust. Airline pilots cUirrted they homed in on Wittenoem from considerable distances by sdcswtfyreg the Wue haze on the horiisn," Exposure Standards and Refutations In (he United Kingdom, official action to control exposure so asbestos was initiated rs I$30, basedon a 1926-1929 study ofMerewether and Price (Mwwefoar, 193QJ. which showed (tat ssfeestwis was an industrial disease and concluded that there w*s no substitute for dust control at source. The Asbestos Regulations (1931) were introduced and a scheme for compensation of workers developing asbeawuH was Instituted, The first recommendations for asbestos exposure control </> the United States were made in 1956 5Dret&$, 1936), following a study of 541 employees in four asbestostextile plants. The recommended airconcentration of S tnppef. asdetermined by the impinge/ technique and counted by light microscopy, was asubUstad. U 1946. the American Conference of Government! Industrial Hygienists adopted 5 mppcf as a threshold limit value, la New South Wales, the "Dreessen Standard'* Cwre the U S, had bean adopted by the Health Pcparwiew in foe measurement of asbestos in industry by 1936. The same standard wai adopted in regulations in Victoria in 1945* In 1956. the asbestos industry was declared adaAguffu&tode uadat ihs-Heath Act in 'Victoria. Hence, in the responsible tsurumenuljtks in Western Australis, knowledge of (ho harmful effects of aabcatos and the need (o control exposure existed dwirtg foe time (hat the Winenoom industry was operating. The National Health and Medical Research Council in Australia recommended an exposure level of5 mppef(30toil)forall asbestos in 1964. reducedthis to4mppcf <12 (/mi) in 1999, 4 f/ml in 1973, and 2 f/ml for chrysolite and aroosiie and 0.1 f/mi fot crocidoliie \n 19?4. However. ftvuern Australiadid not legislate obasbestos until ihe Pacwiex Ad Shops Act in 19)6. TUspons&ritiy for health and safely m foe mining industry was foe statutory responsibility offoe Mines Department, and i( was jealous ofthe interference by (he Public Health Department. UtcUUonto(he industry si Wmenoom, therefore. no legislative restrictions were over imposed. None of the i ii \ \ \ 'Ml Maskel L pyblished description* ^formation availableduring'stic I95EB u considered very relevant 10 what was ukiag place at Wittfooom. The liter*** discussed asbestos^ as a disease which occurred adet very tea^hj exposure vd fecA-A* sy t*$Avu& u*d progressionthat occurred afterthe veryshort butintenseexposures at Wiiieaoom. THE INCIDENCE OF DISEASE The youth of the workforce <57% were less than 30 years of age when fust employed and only 16% were aged 40 or aon) has had an important effect on the subsequent joetdeoee of asbcMos-related drteaaes, as many have survived M experi ence Q# onset ol diseases with long latent period, io 1946, (he Wtaeimm Mine Manage wrote to his head office describing (te fim known esbeslosit sc--a m*A called Oigoara (Hills, 1989). In die iuc year, the Mines Department Inspeao? deserbed the dust conditioas at Wfoaoent as "icaiftc." Two yean law, Os. Erie Saint, the Syiagdoctorfor the Pifcan, but fian&eriy from Newcastie-on-Tyrre, where he had acquired a knowledge ofoccupational king diseases, informed the Winecoom Mine nxaoageraect that asbestos was extremely dangerous and that men exposed ocwW tawrae\ d*si daaaac wMnn six months. He wrote to Sw Public Health De- panrocm in Perth predictingthat the Wtaenoom Mine would produce "the richest and most lethal cases of ssbestesis in (he wood's literature.'' In 1961. the first cases of raescjlbeljosm was detected among ex-Wiaenootfi vKvfcen {McNuky, 1962), By 1967. numerouscases ofasbestoseshad been described among Wmenoom workers (Eider, 1967] *nd the local council wis also warned that the tons ofasbestos tailings being spread around the township W control the red dust and mud could threaten even tourists. Mortality in the workforce ofWinsBoomhas been studied subsequently (Hofebi ct *1., 5980; Armstrong et a]., 1988). Bastfd os two different assumptions as to the vital status of subjects lost to follow up mortality ratios (SMR) have teeacaJc-a&ed.The ftrstassumed all those tostto follow upwerestffl alive upto ags 85, whereas thesecond censored sublets ai thedate they were iart known tobs alive Among the 6,505 men who were employed in the alroog and milling ofcroddota at Wincncora between 1943 and 1966. the SMR for a!) cause* of death as of Dc' cember 1980 was 0.96-1-53. There was statistically significant excess number of deathsfrom cancer, neoplasmsofthe trachea, brooebus, and tag (SMR l.60-2.64}, srtd neoplasms ofthe stomach (SMR 1.16-1.90); 32 deaths wennotedfiosomnlig- tuns mesofirttiwna. Excess moruHry alsoooasecd &om respiratory diseases, punk* ulariy pneumoconiosis (SMS IS, 1-25,5); infections, particularly tuberculosis (SMR 2.72-4.09), marital disorders, particularly alcoholism (SMR 3.16-4,87); digestive diseases, particularly peptic ulceration (SMR 1-S8-2-46) and cirrhosis of the live* <$MR 2.53-4.9<y, and k^onex wad pobo&sga, parficolarty nontransport accKkoU (SMS 1,62-2.36). The morality from psKumoeoskni* and fiws malignant taesatbe' lioma and the excess frfuarespiratory cancers. bet tot from stooaach neoplasms, war dependent oo time since fbsr exposure to croddoliv and on cumulative exposure. There was no increase in mortality from laryngeal cancer (SMR0.6S-i.09) or other neoplasms. As a result of the croetiolite industry m Weston Australia, tite incidence of malignant mcsotiwlioma has been greater a this state than io all bef states of Australia since the mid-1960s (Musk et ah, 1989) cod U one of the highest io fte I WTTensw and Attests* U3 wortrt Jde Klerk and Armstrong. 1991). Pleural mesotheliomas have accounted for pearly 90% f aU cases of mesothelioma in Australia. Up to the end of I9S6,22 of 94 cases of twdtgftantree&odwlsorostevttet* described as peritoneal inttie'Wtue* doom workforce coho) Jde Klerk et *1,, 1919a). As in 0Cher studies, tungcancerincidence hasappeared 10 increase itsewiy with tomalftbvt exposures crocidoitK \6c Klerk el a)., )9$9bJ. Smoking and rrockJoSric exposure have acred independently so* hence. mckipiieativcJy, in the production of lung cancer in a subgroup of the Wmenoom cohort ifl whom smoking information was obtained by mailed questionnaire |de Klerk esa!,. 1992). WGBBKHTY FftOW ASSESTOS-ftB-hTED DISEASES A study of the prevalence ofradiographic abnormality in the Winenoom work' force as of 1980 thawed dw undiagnosedndtographic changes compst&e wflh the presenceofashssros (small irregular Endows ofprofusion I/Oor greateron the 11.0 scale} were present rn approximately JS% of the workforce, especially those more htj\y exposed Xt> croc&oYne {Cookson ik. )986a). 77is Wfoenoom cohort has also permitted an cumulation ofthe natural history of asbestosis and ofbenign pleural disease to beconducted, the course ofpulmonary asbesto&is and its determinants were examined in 2$0 applicants for compensation from (he Wjetenoom workforce Seri*} chest X-rays, accrued ever more than three decades, were graded separately by two observers tcoQoiUtg to *e 1980 \l>Os sification of Radiographs of Pneumoconioses without knowledge ofexposure histo ries or compensation details, In 136 subjects whose median duration ofexposure was 3? months, radiographic asbcstosH appeared between 2--In years after initial expo sure and, usually, progressed continuously. Total exposure to asbestos and time horn first exposure to the appearance of definite radiographic ubestasis were significant dctrnn'manLs of the rwe of progression in profesioa of small opacities. Astesiosis in these subjects usually appeared to be progressive, evert 30 year^aftef exposure had ended JCookson al.. 1986b). No effect ofstroking on Use jnchtoree of asbestosis (as measured by a successful claim for compensation) can be demonstrated in the Wittenoom workforce Jde Klerk et al.. 2991), Minor benign pleural thickening, ax observed to plain, efecurad%ogra?hs ot vht Wiuenooro workers, has been shown to frequently progress i extent along (he lateral chest wall, but progression beyond 5 tarn in thickness b lesscommon {de Klerk et a),, 1989c). Pkurai plaques were *k sera to progttu beyond their kttia} thickness or extent. The onset of Neural thickening in the Wrtienoom worifofte.ificsBasedcoe.' iimrally frtnnih* time W* first exposure *nd also increased slightly with age. There * evidence * the fevei of toui cumulative exposure to crocidojjie was directly related ro (he rate ofonset of pleural ihichcniog m the period between 5 and 13 years after exposure to crocidolite. The raw ofprogression ofestablished pleural thickouttg was greatest m subjects who firat developed thickening soon after first exposure. and the relative rate of progression decreased slowly wjrh time from first signs of thick ening, there feeing no evidence of any progreu&Rwere da** (S ytare wfcw ernes. tn die Wutenoom workforce, the'rate of diffuse pleural thickening in relation to pleura! plaques has been greater than in other asbestos.exposed cohorts where the incidence of maligasw mesotheliomas lo*e ittiKerda) and Weft. 2990). Asbestos-related diseases, especially malignant mesothelioma, have also teen ] ! : j .1 ' ;,w. ? .. V. `wtfvv,, 744 Musk Mil. observed kt worim involved the Iraniport of Wiltsrvoom crcctdoiiw by road la Potra Sampson or Pori Hedtand, and by sea lo Fremantle and beyond (Armstrong tt *1.. tn*v PREDICTIONS FOR FUTURE DISEASE Predictions have ban made ofibe future incidence ofmalignant mesothelioma, bronchogenic earcmoma, and asbestos* kn the Wittesoom workforce using statistical models to fit the incidence of these disrates to December 1916 to age, duration and intensity of exposure, tits* mu first expopat, andotherexposure-related variables (de KJat et al,, 1989*3- Thecomberofnew e*t*.y ofmalignant mesothelioma ta the cohort of6405 malesand 410 females is expected so rise tot peak ofover 20 cates per year by the year 2010, with an exposed soul number ofup to 700 cases between 195? mid 2020, A total of abow 3,000 deaths from all causes Is expected during the same period. Mwcues oflungcaocerandasbcstosls areexpected locontinue attheir current rates ofabout 8 aad 17 cases peryear,respectively,before decliningafter the year 2000, iea&ag to totals of around 2QQ cases of lung cancer and 450 eases of asbestosis by the year 2020. COMPENSATION AND UTIQATTON As a result of its heavy dependence on the mining industry, initially gold RsAtng, to*Stated Wtsftm, AusualteVosbad aimg mtperascewfehtoe occurence ofpneatmoconitrtUandthe needforcompensation ofaffected workers. This need was first addteued the Wocfcera Compensation Act in 1925, which was subsequently revised to include racsotoeliora* in 1970 and lung cancer with heavy asbestos expo sure in 1954, TO date, 389 cases of asbestosis, 116 cases of acsochelioaa, and IS9 cases of lung cancer attributed to asbestos exposure among workers formerly em ployed by Australian Blue Asbestos Ud. have Hied. Modeled on tie British system of compensation, a noa-advmarial decision oneligibility is.made bya medical panel which, according legislation, consists of toe Mfre* Medial Officer for toe State, a physician from (he Penh Chest Clinic, aad a respiratory physician, who z& jointly and examine aBapfhauu* todetermine Ibe presenceofatom-related disease and the degree of disability which results from tots disease. The decision of the panel is bindiog on toe workers* campeesatfon insurers. Successful civil hugatioa ba* been osuefc more slowly achieved. Ibe first a*. srahnHomaca*eto**ed hottoag corrymy oFAEAvetvned is7977,'butthe patent died before his case came to court- The second attempt was made by a 51-ye-u-old woman who had been employed in an officeon the mine siteand who bad developed malignant pieoral oesotoe&om* In 1979. The judge lo tots case considered tost aegfigeace had not waned, but "sad misadventure.*' TV potest toed few hours after her appeal was to be beard and the case did otf proceed further. No further dvd ttUgwtea was undertaken fo? teotoe tea yun. Derag feix time, toe previously loose soda! aefwoto efex-Witteooom peoplebecame:cohesively organized as toe Asbestos Diseases Society ofWesera Australia. TV first asbesoris case was mounted by an inter-State law firm which specialized in personal injuries. TV platedIf la ton case was a mac who had worked a* Wiaezwom for six maths. He had had an open lung biopsy performed for diagnostic purposes tea year* earlier :-/ , ^v' .J * j Wfe/rom i*3 Asbestos , 745 which hadconfirmed the presence ofdiffuse intemitia) pulmonary fibrttsis, Hia was J the longest running civil litigation cue in the history of the Westers Australian r Supreme Court to that time. It was heard by singlejudge who did not appear to * comprehend the complexities ofmedical evidence and found that the plaintiffdid not haveae asbestos-causeddisease, The defense had questioned every pieceofexposure t history and medical evidence, even that which was not important locstsb&hiag that diffuse pulmonary fibrosis was not present (since this was conclusively shown by the open biopsy). Tie judge then concluded that the condition was instead `idiopathic (pulmonary fibrosis/' persuaded by the paucity ofasbestos bodies In the lung tissue and despite the exposure history. The so-caSed ''fourdogdefense" (Brofeur* 1946) I was asnd arid almost succeeded. The exposure history wasquestioned (wedim's own ' a dog). The cause of the man's disability was disputed; he had airway disease from smoking (we own a dog. but another dog bit him). The plaintiff should have worn a mask (he knew the dog was dangerous). If he had disease, be was not disabled (the. dog bit him. but didn't hurt bkn). Subsequent appeal t this case, however, held (he man to have a$be$o*is. and (he company to have been negligent. During these proceedings, a furthercase of mesothelioma washeatd by judge nd jury in the State ; of Victoria. The plaintiffwas awarded AirsiralUaS426&0by way ofcwnpensatio* and Australian $25,000 punitive damages against h'tt ex-employer for "reckless indifference (o the safety ofkg workers," In Western Australia, the nextcase kept the court sitting for ITI days when two patients with mesothelioma (one of whom died curingthe proceedings) we ulurutety sweecssfel wkk \Scit c&stt. Sirs*then, the employer has endeavored to settle cases out ofcourt. Up 10 June >0, 1990, * total of 336 cases had been settled. No cue of lung cancer has yci been conceded in the THE TOWNSPEOPLE it has been estimated that at least a further 5.000 people Kwd in the township of WineDoom (many as children), but did pot work in the reining, twilling, ot traasport of asbestos. These people are cuntnrly (he subjects of a further fomtal cohort mortality study (Hansen <wal,, I99IJ, as at feast IS cases ofmalignant mesothelioma have been recorded among them in the Western Australian Cancer Registry. FUTURE INTERVENTIONS The previous workforce of Wittenoom has been shown to be a group which '*% at increased risk ofdeveloping asbestos-induced malignancies, particularly lung can cer andmaligoancpleural mtsWtclwma/Btfwrseofthisihk,Intervention in (be form of dietary supplementation with vitamin A preparations has been initiated in (he ex-workers and ex-residents ofthe township. This project will explore two questions arising from epidemiological and laboratory evidence ofthe value ofbeta carotene or retinol in preventing the onset of malignancy, let the workforce cohort, beta carotene 30 mg daily will he compared with retinol 25,(CO units daily to determine ifone agent is superior jp she other. As a result of knowledge of the outcome ofsubjects who do not lake part in the project, a comparison group of subjects wfeo receive supplemen tary vitamin A in neither form will be available to serve as a comparison group. It is e5'knjied thai sufficient events will have occurred after five years lo demonstrate if one form of vitamin A is more effective titan (he other, and if neither form i* better : * '' ) -. * . ' i I < 746 Musk t at. than ta metNtrAion. Sr. fte echon td ea-res'idems, beta earner* JO mg is being compared with beta carotene 0.7S mg to deurmir* whether or not deficiency is causative or whether large inrau are preventive, CONCLUSION Wrflonoom has been described as Australia's greateat-ever industrial disaster, ' Controversy still surrounds (be future ofd* township ofWitusnooen and enondon has wstt*4 to the tawsaroieMal tisXs to people exposed to erocidoijte who have lived there or who have encountered Wroeooom crecidotfee elsewhere, iltece still remaim peat concern for the future of (he people who worked in Wincnoom. This concern extends 10 current workers a the iron on Industry is the Pitban region ofthe Saw In whore ic^vstK tocRctto&odegpotia appealspcosibtedorinsrrnTrisg operalions, and ccna&ly for workersengaged In the removal anddisposal of 0* vast ^uantiries of building products containing Wklenoom eroetetoihe. REFERENCES Araurec* hac. 4e Kte* NH> Hvtl AW, Kobta M-'TT (IMS); IMf *> *inen cwf ioUIsr el erusiMi* in Wesen AueMts. flri fcSJ-JX Anuson* GK. MustAW,SaksIE, wu)M,feW9 CC. linn,itHR, Btaodoft BS.ClvfcwHsMfc; O. WondwuS SC. Hobbs MST DWi): piWiaiottj nwtrgrum ttBttbe&otiu in W*Um AuAnlit-MedlAwt 141*6-6*. AttUtdiMi P Asbestos UnitedMk w.BeacemOorje, Waifze Anandin. Gaesel dttriptk{ opertuaM. AwenJUft GiveA^ese* Co. AusercJu* Blue Attested Linked(I9JW Re***osOpemiWBuWfaettowwCorpt.Waicre > iimtl> AuMtun She Attceos Co. Btodcw P "AjWih fadsary c* Tru). Tfcc Omptotc Nov Y*far fte^wu.*' Nsw Ye*t: PwtUswe. Bureau?Cau endSu6<cs (IPM*. Poputuk*. earf Ana, looi Ctewnaeat Aram and SutinioU DiwsrtW 1966 sod i?W. Bra atf Cmsa jmis&s. Ctnbem. Am<nii. Cookie* WO. fle Uwfc HH, Mub AW, Ameses*GK, GUtsyjj,HobbsM$TC(986ah Prevefeaceetf radktnpbkBbescsunerecidNteniaBoudBadknnWtanBoa. WewereAuBndi*. Bella* MeeHMJO-457. Cbotm WO.tfc Kkrt KH, AW.Uw), 8.tttt* W{IW6*k TV uamJ Muoey cT iitewwrt is feme goadedW *odaaof Waiwivi-m Qjey. An ten taepk DW OW94- * 998. de Kieik NK. Armoreoi BK (1992J: Tbe cpidesuolofy of sibcm* ad acaectehores. la Hawknao DW, Sulkta KG. WUubcr O. Log&s $LP Ms* "Maltja** u--" Ne* Yet: KsmJiptw Pp 22S-250, ^e40wt WH; AwttOfl^t..~>ua tCW,'Httbe KST <tWh,y. Nc6ateo at tewrc erasof Mbeiwoy. sUm4 disease raeni Ibnos a4w wHkf* f emciddrie Wwz* AusSaha fcM X Aus IS (.6)6-623. dc KlotNH, Amvoq 9K,Mud AW,KM)MS? 0985%};C4MWmi; (airfriim to uont elKp,quuwifilsl( wpeare wqecvfeUng twannoea Qm in Weoen.AaMQdia. hr I lad Mol r6in-SJ6. 4e (Uert NH.COotaeWOC, Mud A^W. AraBra BK, GLacy<l989e>i Nwwii tiaaty of^onl ftidtenani kReceafOBR (eewdoitie, G< 1B* Med66!>467. 4# KMNH,Mad: AW,Arams*ON. KofcMST09913:S*ia*,fcqwswe ineedMUtn.d tt* * nsieme onu^euce at* wbnuom. fie 3 M Med 4;>(2^(7, 0):etof.d.WC, 0>awk M. SfrradsTt. Mae 7H. BayesKR QTO>; ^ tnrfy nf M8aw . wtadn \tmik> kaWsOy. US. PebGc Healik fiaUede N, Ml. Efcte 109*7); Adasoecb te WeeMra AwmBii. Mol3 Asa 2579-13. : : ...i '.7  WftMeea> **d 1* 74? fena >. 4s XkA , Sate J. Mdl AW, Kottx MST: Osao^a^Ue rtaraaeriftis of fetm mirtrmi tf WtcaoBB. WowniAaoifli Ut4) *ue <ufrigaO. ' HibMO, Mafc AW (IWtgi ftasil Hast* es airtlnliii* *wtg> fare Wgaga Awgnd*. Bt fled Mai HitU B < )9}. "She Marts.1' Hie Mks&b Cb. f AuBmjii. Wort. MST, WgodwrfSO. hfej*, 6, Mad AW, ElderJB(19** 71*WteeefjdeMnaassss. tfrertettem, id other 'apfatf?Oast eene cagtfrt to niaieg serf sUBa* creertatoe let Waft i ii Aaurts. to Wapsr JC W*. "Bfclegka* Eftm of Mont Rhea". Lyo* Jbibb*. taut Agency ter Rittgeitfr to C**a. tARC $s> PuM Ns. 30. Lifttvo t (IWJ): Work sad -art**' trrp)g>a a WtoKrt I94J-I9C& CtBaaft KreJtt $*4 -. Uynuuv L (1992): A hurery of Mac iMm ftreeMrt*) hrtcsry Waaa*B to Wert* Auefrdie. Is KudOKA DW, Shift* KB. ***** &. La*M* SU> *4* `'MsUsm* hterteljtfco." N*r Vert KoRtopteeI* MS-327. hUfit O (1963): Artsas dut cpaa*e. Is U*>S C <*?. "RreecttiBigs of d* Rrs AArtahen P*eacneMMMtU CrtEererng, Sy<toey |Kt," Syrtoy; JeiMGaal Board, pp *67-74. Mrftahy K t 1M2K Maltgsw pfant innreMiim* Is u frtofiei verier. Mrt l Ass 2923-9R VWvra^M uwsoy. T%o (seaemceat pdtfauury ftroa end afer puiaref/y toTcBMu bj tumi mar.) k>d W/gke* t2rt98-J2.239-J5T M*a Oqatfvaew oJ fV.A. {l9Mj. Re?*n f * QepvuMM of Mass tv the Year <977. P**d Wm Stsyteet. Gnerniment Was*. Pert, Weesn Autnlto. MIMS Depends of W,a, (1979/ Report at te Departor. of Mtow fa fa Year IW8. Red Wei Stoipsoa, Oewraesos Rsmt, Pert, WrnrT Atowfa. MMh AW. ffeite fi, AoaSivtg BK. Rrt !M, Kkft HK, HoM* MST (J9W). IV tocrdeMe of wai'^nwi foeMSrtkAt Is Awa*14. I9OI9B0. Med t Abs ISa24Z^U4, IUen A) (`990>. Cenxr matrtry sod<>vadrttf. Bf J lad Mai 4?*U. Xi> Z. AATiSmag SK. BSunlHe Bj. Rogen ?H hM AW. SliJftk KB OKS). Ifert h tMrteJuj ri> md(gwtsws*9(hrtonuMtte9bsa.aa49(rtMs>s4>)iseaiedcssia Aeuri* MedlAus *43:1S5--1S1, A* * IS A'