Document 3e3ZbojXwGzxemZxq0OnQ9ox6

FILE NAME: ddZWZZdd DATE: DOC#:ATd DOCUMENT DESCRIPTION: WZZtZZZ WZZKZ, PR,OCEElJlNG8--40th Annual Convention ofj the InttJI"nati()nal iksocmtion oJj lndustrml Accident Boards and Commisswns~ Quebec, OJ~, October 3-7" 1954 Workmen's Co pe ation Problems 1954 BULLETIN 100 UNITED STATES DEPARTMEf<q;"T OF LABOR Jam~ P.. MiteheUt Secretary BUREAU OF UBOR STANDARDS Paul E.. Gu~k<e'. Di:teetOl' . ,,:, :"'; '" . . ,. "",. " :.,:' ;' ::.', ,",:'.:' .... :,:"',, ' ,,"'. i f':: ., .".:'.: :-.;.. :' ,: .;.,', "'::': <~' ," ,: :,-:: I ."rm.s B~M No. 180, rout. the proooooiilgs .of th~ 40th a.nnual oonvention of the mte.rnSf.tion.ru Aaoociation of Indu&trift<i Aooident :no~ and COl)1w O~oerno!bM~&-1w$h1le9h5M4.W$S held in Queooc1 Oantl.dal ~. ~ of the oonvt.mtion have ba~n prepared for publiootiou by the stall of the BurMu of Laobor Sknd~. <~l ''::''..::'',, ... ::''::::::;; ;l'.: 126 Oecupatioi.U.d Cancer Hazanis w. D. HUEP~ M. D.~ ChUf* ~ ~ ~~ ~ s. l~ IT. ~ 1:l~ ~~ W~i~ BDv. C. A~ Scope OooupataoruM cane.ey h~ards have plaguoo mankind for thoue~ (jf y~al'$y Undue ~pt)s'Ur~ 'i;.I) ~u, Qf ()l,Jf natural environment f:lU is solar l'~i~tion, or llUootiOllS with 'ttliwM worm~ Sdlistoooma h~m~r 'OOb1um~ hav~ df1ubtloosly b~en roopt.msible for the OOOU1'.mnoo of ean.tmm of tha exposed akin among outdoor w~Jfk~m &!nid of eMOO.r MM the MbJMootder runon.g farmem of th~ Nll~ vWl~y ~v!ID. during pl'{jhistorio :rOOtS timoo. Haw~vQ:f~ it W-M not until th~ ~v~n.t of rm,m~l'.u in.dugtl"i~ism $oOommae Hill ago tlu~t ooonp&tioDAl and indua.trY~l'elatoo ~gents have attained a.. p1'6an:Urum.t pooit.ion in tha human. canoor problem.. Not only aro occupational C:$I'cin~s thl$ only well dl'.'lfinoo. kxwwn. tumr e~~ of human e~l;neent but thmr numbal" and variety hava st%dHy mere. sin~ ~tt in 1175 fust l''6611~~twmdi t.ha (){;cW'r~.uoo Qf s-erob~ ~Moor anl{)llg dilinnay sewoope to thoir (}...'It:po:sure to soot, Our :real knowledge ~nd ~:pJ):rooiation of oooupationw. c:ane~!' proN dudng 3gen.t~ M phauom~na of m~~l"n in.-dUHitriali$m cia-too book oom.a 127 75 yearn with the dlsc<wflry nf the relation hi!ttween the o{,,cnrre.nce of skin c.a,ucer and an occupational exposure to c.oru. tar (fig. 1). The data given in the following tables (1 and la) briefly summwe the BeJioot a.dditiol1S to the information on oCl(}upatiQnal (lanCer ha~afds made ain'Ce that time. TMY llli1t the various chernicaI and physical flgeIlts 00 fay ret"'..ognized or strongly suspected as causes of CallDer in man, Th$y show, moreover, t,he different organs and tissues representing the target organs of the..~a agen~ and the number of (){~(5upation&l <e'.:aBuJ:swMer cba.y.~t.hs epmla.ced on record or known t.o have been recognized as 'I'.AJ3U 1.--0ceupational CanC&'1! RUf}rded if. t..~f! United Stat~>~ and FlJrd(f11, CIJ'4ntrie>~ up tJ! 1tf5e f I ; : I 1<~iiflt ! I, ~l~ f)tt;:~rjwr (JNaIluOmt>tll~llt:I(elIf,:Nmuomohlrlf~(}:f ~ i > In U$,A, 1m Edrop" ~~~~~~~~I'~~-----i~~-i~~~ olL._y_._,., ___ !v__ _v"" -,v,,i),,,v,.Ay.,iil ;.Y._.__ Y.1..... i y Arsenl~L~ ~ _____ ~ _____ ~ __________ ~J Skh:~.,~Y,~ y.,:' 7 i CoaHB.!") pl~)!!."Y ...."._.. ______ .. ",.+_Ao~_vy.,vy_~: 110 Pe{it'<ileum_,. __ _. _____ ____ ._.+ ... d<!~_.~_~v~: 70 i SLnig$.nleitoeitl,alr'La-n-d-~P-Qr.!vyl..f~f.in-...-_~_-_-..-.y..-.y.,-.-.-..l~vy.--..dd(~,l",.v.vy"..~~~-vy...-J:.- ... vy7 .j AC.rnetohsro~cteelo1eiLo_l_L_.__y-_._,.-, -__-_--q-_-... ___ -->-].!vy _._,tA'lt9:<~.~,,, _.,.,,,,_'''..))j'',Y,.Ay1.,ij Soot-c.a:rbon blacl!:. _____ . v._ __ v.1..... rl(~v ,.,: 1; Aroma.tic aminee__..,"'. ____ "._.,..,..,.,...,.".,.J mM1lkt' __ .)S~Um:H}Q I Roent,g~I!u ~nd mdimn..r$.di~tkm_ ~--\!!:'t~:,k~b.~vY~.e.m:l~L ~\ C:'} i .ti'l Al'OOnic. _________ . ~ ... y .... ~_." j;. LLj'(~mn~g_.>.""y"h .,, ) v .'.' " v 7, -i; ! 25 i aa,,1H6iO0! 29 i 1,900 j ~; ~,i '.tUV I20 \ 190 i 1,200 1 (?)1~ i.J ) 650 ~ 16 32 a,zoo S91I} 1,907 14 41 20 HH 1. (}OO CC?l) 29 I /; AChs"h:~~gt::-----".,.-.,.~-~~.,.) +--~O.vy: -vV---} "4....... ,=.----Y---------i".. ,;l<>~ :'~~~ :; )6~3~ "., .. l i>/ I >.SO if., ./{ioo,." ""'Ai I} 84 i iIIr ;i '11 "~~.3'(:..~e!YV"'.VAV'_'YVAY~"_' ___ '_"'yV~ i N'l.:m! H}', {'IO- {j 51 i it);'nsltl ~iWj~) ~ 51 .1 ss CQaltar,Pitch ___ .,-"~.,_u.u.u~u. __ tA~~l#N' __ "\ 0 _< Petroleum _. _________________ ._ ~!N:"d?~-vy:y 7 531 :33 Benzol ___ .. -----------------------1 L~~tl":~i~\~.a.,y.,i 11 1. ~O 3~ ; 42 .',vy_-< IwprapyL ______________ .,..,. _.... Id'Lw:~g-- qlAU'ynx ____ . < 1 i 4: 0() ii, 1 i ~ ,;,' 4: I ! (} ! =""A.~.U.Q&c,..l.V~ h tN~l sml.l!U B 1 U 6 m(!l...es___ ".: 9 9 C e~:mc&!$ .... . . . " . . . . - - - - ( 1i 1>. !.'..Y,. a-..~n l" 8:. 1 1 U $ . i ! '!) !; ...n. ! I :5 i..~~-~--;:-~Q~:y~~1.~~- TotaL~--~---==:~,~.~.~:.~J,~..,.yv.y.,-.yv1 ~~O I i 11,650 'Al>~~. ':. :;':: . ' ." .::':,' ' ..',. : :',' :.' 128 ,.:.:.:", .. '; -.--~:;:;~;~~Jwl'>.':.~~!I~~~~~n_,_~",:.~,Il~~~~,~,~~~ed wn.:l.:~:~::~~~~~ Ch~m~l~l)~l(l: ! fJoo~...< .." , t'nnli! -l Cool t.l<r (llf1dt~L.. IS1e Coo.l. Wtao (b!tuu..mm11rr....<)uU~)...) !m'2 t'o.ll tM ()mthrac!t~).vv.v> UUO i C<)sl tar (hlml'll)....v... ) lroil C~ti! <)Uu . ,. 1l.!Im2(! i~ !"!)t*,. .... $~m {~~"'<~$f,;m)... "....... : Oceup&tkmf>t i V(jll&~11lUm.~........-'l S.k~~l,.,,'v"v.'YA'V'-V; 1X~. 1Jut1!n....v v v}"."<l,)""<,,....vv<,,,l Po. ; l:;.:{gvv.....v..v.. "i.".Ali>.. <Y,'-v.A<'A,: Dt<, 1.K:l.WIlhBte".vv.vv.vv__ ; r.,m~? ." ... ,,, ... '''''i rIlI<>. ! {I'1:){'!l!l';'l>n................1j {;l(i.::l....." .. , .... " .......... i .f);), ;:~~;~~';;;i~:j ~~~ ~~~~~::::::.~~:~:::::~t:~::;::;.~. .~:~~:~~:~::j ~~: 1 ! ! !"~tr<sku.mlStill oolte.... 1001> ~~;~ll.d {lUu$r. !"v,,~h .. 'v"v",v' ",... ~ Do. ~:=: =~~;nJ ~:,; !~=~:::~:::::::~~L::~::;;. . .::. :.::~:::.:...,.1! ~:: +... Shw,,~ubd~tfng eCllll."..\ l!)t{l ; Wmon..v_............ OA~j}.; .. '''': ,......" .ot1. :a~n~.ul ......m ,.... .i H"~ j f3elore & Xlffl'I)P.'l.8.OO.llWxxHf'fmwK tW';W;"f Pp{fjj, I Ar(!fw~tic ~m1JJ{;~ {(lYll ll.!~, 1Ual!!:l~--""""--i ~~~<i<icr, ~rf.tt..II;{, ~=<i' i fJ~, 1! ! l ~1I11g. mWtme;'lmt-es). 'i ; fi>:r, ; I!!oPro~1tO!L ~......... 111il2 i \\"~~u. Snwt.h &. ~!llll~.~ NISiml sinuws, lM:rru:. r D!l, C.llruuIMM-filOfgrulill! ; I;:::i~~i~~;;;.. ~.:..~.: .:....I.:~~!!:;.~~::::::::::::J Me.;:~~\1!. .Ammelnlle,........1 ;: , 'l!l.1tl !!t:...........,...... ..1 AJ;h!!Sins .-v "., "..! lll..'i,'} Chromaw, ., ...... ll)..% N!$.el..................... !. 11l:l2 i ! il Ph1$i ~nto~ j Ultl:!l.vlalet ffid11l,ticn..... 1lS1i1m4 1 :i:l<*~\\$~1\.l'.8:'.:Ual.!iiiL "." lOO~ 1s&U~..,.v ........v j Llmg ................... ; jl,yr,er, <t Smlth !.. .! j 'Pfs:n ................,.\..... -<ii.e .................. ,; i f.lNnful1............... [ N!IlOal m~tty Md &1 ~ ; 1 !:lures. lung, l i ~ j {JaM........., ....... ; ::'!~;!l~., .... ,., . ,,,' ...,.1 j j ! :f<rleheuv v .........v.. !,..... <lf>...... ., .'. ,., ... i OOOllP~ti'~!J;il, Dc, Utn}. Dll. Do. Env!!'ol'.sne.",v.>l. OOOUptit!OOlhl, 1!lM j W~..............v.. ,~ ......,'1l1i;.... ,. , .. , ....... n! Med.icinal. l &:! llltll '!flen r~> 1%.Q~ -m("l,H'>\';alb~ tSf.$fil!X,j O\'!l)l.l.patkmr.!' i 1 :: ''rrOo'nl'l S1-:,<~n.rc-@. 1lmm 1 Xl~(\k" .............. , BDouna...." ...." ....,.: t.r~d}~!m!. :aM.\w.I:tha ~............ "'"""' ...........:.. ;SsUu~~oo&oOvV::l j' r l ".".1 11Sm?l) l nl!wHl-iJr<ig: &a~v .... f !itiT'4..............."".! %%'\ummtlunill. 1'~ ~k~ffil( WMd ,~j'JiJ Sl!:h)....." .... D'~. WtUiS~ 1 : JIl2(! l"KI~.. " . , ..".J lilood-f6!'m!!'lz ti~.su(<&.\ DJI). J23.! :tv'!'!~l'tl:,m1. .......... "'~f Xlml6."................... j D;>, : . .~~ . . . . . . . . . . . . . . .n '<...... ..........."'...... I t ~~~~~~~ How~'\{~:r: an indiscriminate accaptanef! ()f t,h~so figl'l:r~s aMB l"%flec.til1g th0 ae.tl.lal scope of the ot;:,mpatiol!.a;1 ernlC('l' hazards W>f)uld sN:iOtlBly be ffilsh:ading for the following reasons, Th~~ p:ri'gen~'# {)f oel;upati()na.l can.cer haUirds has. so far bmm established fnr 011l1y So few' work~r groups having o:mt!l.c,t \'\iltJ~ {):nEl or s.everal of t1.H.1 eare1llugml.ic, agon.t,g listed. '\,YhHe, for insta..llCO, it. is genol's..11y knO\vn 11mt workers nm- ploycd ihll g,as works il.nd ooa1 tar distill(>riCls Ol' engage.d in the dt\ilJling of petrol~lun 8tms .an<l having $kin anct respira.t,(H'Y con:tfl.ct 'with Ct,')it-l and pctrolt"um pikh a.nd ttl.l: show an l)xcessive Ihl..bilii<y to can-cer of the skin" .and frI>pa-rently fi1sQ~ of the lungl thHr{~ does not -0X15t any officia.l record of similar c.a.n.CBro'Us comr~1ica.tious among dedrode .......................wnrkem ..in ...cl.uminmn.. pr.o.ducfiml..pJaut!\ ..wh.nnrr..<e\....a.n. ..ex.p.oB.Un~.tn.. fumes........ , .: .: ' ", ': 1.29 fl'vm the el(l(~tr.odes (lonsisting (yf 8. mi,i;ure of coal tar, pitch) and petl'olE\-Uffi coke Bxists" Reliahlo information, however) is on hand that these WWOOrrkk{{))ffSS suffer from eanc~.rs of tJw skin at\d~ pns~iblyj also th~ respirat.()ry tract. The ~xtmlt of this exposure hazard may bB estiml.ttf.~d by' the faet that a.ppro:ximatdy twoRthirds (If n pound of electrode <!arbon is consumed for Moeh pound of m~tamc yJuminum prOdlW{!Ul of'whkh 800t OOO short tons Were c{msum~ in tho United St.ates in 1945. It is equally g,ignifknnt thAt ag'Mts whk~h h~a hean f(lpoorrtod to l~aVl-'1 camwu occupational Mnct>rs among workers of an industry of {)n~J eonntrYt do not MNU to ha\yo tlw same effect upon th.& \..orkers of an id(\l1til:tal industry of amtthcr country, if the available data would be SMt~pted J.l,t tbeir fM30 value. Since Cltl'cinogtHlS hehave in tb}!r iUl1ui1Jhent.al di8Nwc~produeing pl'c~p(\rt,iM lUikkl) patJwgen.!c mkro{)rga.n.is.ms~ there is no sound reason to assmne that carelrwgeM make any <list-.inc{,'t,itoionnlSs in th~ir activity or ~ffol.~tiveni)Sa fm: ,any nalional. reasons, In fact! it ca.n be SUOV.'1l that :Hwh scientifically inoom~ preh{msiblo <Hscropallcies al'\) mainly due to local differences of l'eport~ ing {){ oceupat-ional canoor C!Vl(~S. Thoe exist.onoe of an execssivc liability of gas houw l'i)tOrt. find eoke {Wen 'w'orkelr's to Ot1Met of (he lu~ has bc'cn reportf:,d from ..f~p!ws CanCt{la, and Eng.landl hut. not, from ally other country despito the fact t.hat t,he e:;qlosure conditions for workomrs employed in such opera~ tions n:rrce ideut,icul The OOCCCCUU11''ll''eennMM of an appredabie. llumb~J: of fU'St'tltlC canct}r~ of tobo s.kill among GOorl'mmanll users ofarsenit.fi,~ in~ secticicios 'WM p}o,CMl on r()cord during r~)Cellt years. If full cNdimce wouhl b~ givim to l'~'p(}rts 011 arsonic cau(wrs ohsnrv{!d in thu.r. Un.it-od Stat{!s, one would. he led t.o belio'VfJ that fltfSoniritls in our 'Part (d t,he world are carcinogenk for almost (lxdusivdy medicinal reaaSs0o1n'l--BB, Again~ it is had to assunw dutt i\.l'sSff,,))rr~Uirr.~la would .make 81.mh dig.. tiuctions. .A similar situation seems to exist e,onecming thl) eil.r~ cinogenicity of luoricating oils obtained from patmleum in di1f~;rent :parts Df the world, ~..uthough thcre were placed on reoord by English investigators during re('.ent years, several hundred casoo of skin can~ e<st'S due to o(".cnpatkmllJ couhv'.t 'tv1th luhricating olls,practic4tHy nothing is officially known .as it,.,)} the axi8tence of sllch industrial diseases from the c()untri(!s on this sid13 of the Athmtie. Onnfe) seems to be content with fittribuf..,ing h(~.r(~ tlw English olm~rvatlons to t.he 'Cn.rdnogerric action of shg,l~ oils, the larg~...gcw~ in<lustri~~l us~! of which was dilwontmtwd during t,he 192!Ys, and t.herefore e,anMt accIJunt for th~ more .recent Engli8h cancer C8.S00 obs{ll'v~d 1l,ffiOng spUllimnorn, nlOO}w,lllCSr CIl.g.,in(l~rs and oth~r workers hEr1."ing haa.d e~dusive ccoonn.~~ tact with lu.brkating and cooling oils of petroleum d0tl\"ation. . ';' .' ~ ': ,. ..' ". : ...,. ':. ::. ': , ',' :'" 130 1H9I5M4 MEETING OF IAIA.:BC It is worth noting in thh~ crmnection that during the hst 20 years? thffi'e hM be~.naf1 almost Mmplct-f} lack of puhlished additions tD the list of oceuJ>atkmal e.oal tatl piten attd Cl'oosok~ oil canee.rs of the skin from thoe United. States, although sm~h Callef.;fS ha,{(l heeJl obsm'ved and aal'l!:-t l"e!rcit'td !l,8 such in industrial records, and desphe the fn.et. tha.t the annual reports of the Chi,fl,f Inspector of F'actories of J~ng!.and ~md Walt>.s havt} mgul.arly list~~.t rwtiflca.tiorm nf guch lesions to the ~~t>nt of from 100 to 250 cases pCI' y(~8J" One may also reflect on th!lj fact tbat the last published fignres on an ooonpational c{Uwern in Arrwrican dye workers appearod in 1~rHj$S and listed les8 than 100 ea."lt's, m~currin.g among employees of one COinplffiy. During t,hc int.ervening 15 YI?ttU'S" the total number {~f snch eoo~s has ris>f!;n oov(~rat fold and no oHkial ctat,a hnse becomo aVil.ilable from any oi()f tha ot-.her compa.nies producing and. handling c.a.re.inog'tm1o aromaticamill8s used ill tbl} l)rnriuctkm of dyn~ and rubbDI' R.l1tioriciwts. In contrast, reMnnt, reports by English inv>o,:;tigatol's SUpn pDrted by t.hH English dH~mi(lil indust.ries have suppH{\d adequate figure.'5 1)0. t.he number, 1tlddenoo raN)s) and atta~k risks of bladder cancer anwng l';nglish d)~e a.nd ruhher workf.:'l's who had been eX'Pl:)s{)d t.o t,he same eardnogenk a,mms,t,ic aInines \vitnh which the G(wff;;ll..rrppi(o)nding worker grou.ps in this country hayve cccu:pati()l1ai contact. Finally) soma consicim'l\,tao!t must bo g1,\"tm t.o th~ t&.ct that tho genee1t'al population 'ba~ V'JXryingdogrO!){lS of Mntact, with S(ff'fw of th(l !;arcinoganie ag~nts through their presence in industrial wootoo released inttIn} th0 enYlronrmmtal air and bodies of wat,ar~ and entering subsequently tho 50il and the fauna a.nd flora living in such a poIllutad onvlrollDwnt. a.nd US{l{! in part for nutrit,ionaJ purposes. In the past, daims as to the {){~Ctll'r-8nN~ of so,.caU~tl ItnoighhQrhood>l CcAa,~es of CAneiH' have fUeiy been made. The well establisnad f(}l'm~r oceurrenc~ of a.t'S(!11lc. ean~.ers a,mong inhahitants of a Ge.rman region in. whkh thoe drinking WwaA.t.toor sU1>ply was p-l)lluted with arsenic frDm mine sla.g h{;aps r(~'prrsent$ the .first occurrence of this t,ype. Following the discovery of bladder cancer hazards among Gl:'rman dye work~rs> iL was asserted that all eIlVlrOB.melltal pIlaaum!" cOJJllttaammiinn!nJ.,~ tkm with cardnogi:nie at'ontl1tk amines was f{lsponsibl0 kkif the or production of hladdIlJr ean{mrs amoug IHmwns living in the vidnity of this plhannt.. While the, actual existence such cOlllddiittii(o)ns was deni(cd at, that tinw by Od,Wf inveat.igatol'$, the l'I.'l(:{mmt delnotlstl'atlon of tlneighborhood cas{:,sl! of berylliosis makes such claims appear as not, unreaoona,hle possibilities ~,inc{'l a, highly potent carcinogflu, such a.s bettHHl"phthytamine, lfl involvMl which might hn,v!~ rn:-odu>t;('d Buch ra~ult8 if the waste disposal and h()Usokeeping metthhi(o)ds of the plant were inaciequat', It is proba.ble that the future occ-urreo.ce of canc~rs of the hmg a.nd bone a..rnong individuals ,<vho livod D.{'a,f b~rylEu.m~---~-prmhrcingor!W0cessing plii.1tl.!:1 might l1Jrn.trrl'r-addithn:al u~vtd~lHY.;.oi " " ::',: : ~ ;.::: .,:: (.; ;.:, 131 or t~aneer hazards relat.ed 1.0 envimmnarltal plant pollution if bery1liurn and i~5 compounds are !mt only eQ,l'cinc!genic for raw .a.nd rabbits hut also for man. Sinillar con(iitiona of industria! a,t,rnosp!:wflC pollutirm exist arf.mnd arsenic aU1!;itorn, c..hrmnate ptociudng plants! carbon black fadorias Md on renneri0s1 as \'I{oli as uranium or~ mm~. The reCi\nt compensatJon daJ.lns advane.ed on the oasis of lUl rulf5gert oxistonea botwNm dga:rt'tte smoking and hmg eal1Mr also point to thf.l possibility of fi grt~att'f future impol't,a,.nc{} of Hw GompeMatinn aspects conneeted 'witll the O(!CUl'ren~ of can%1"S from industry~r~bted 80urc{!S, su{!h as exposu:re 1-0 careinogens contained in the exhaust fumes il'(Wn di!1Sd and gasullne enginest or preaent M additives 8.nd conftlminants in foodstuffs. It appears from t,lwsa eonsidel'ations that ther(' e.en hI? rw dmlbht t,hat the actual number oc(>'upational cancers is ooJu}ssllddeell''aably higher than the mnnh(ll' of cases placed on !'(l(~ord, H is of Sf)ltle interest1more(}Vi~.r1 that th{) numbt,l' of (:~es rMordod in lnedi~al journals is appreciahly highor than the numbtW of occupat.ional t~an{~et'S whkh. during tb~ last 20 YBars have come for dedsk!ll hbedinl'(\. compensation boaard':Ss be.. ~~ause compm15mti(m drums in many sm~h CMe5 have OOf.1fl set-t!oo. out of {X)Uft. 'Yith a few exx!cptlons, such a.') tho inddmwe 01 lung cafwer among Am~rkan ehromate m.antlIiecturens and among German amI Cz~choslovRkifi,n radioact.ive. om miners) of nasal sinus! In..rynx and lung tnnmmooTrSs armmg Americ:lu Isopropyl aJoohl)l mfmufMtnrors, amd of skin cance.r a.mong English ('i3&,1 tM' manuheturem an.d proj>(>~seNi no redliiaabhlhf-. information is availl'1ble (nl the incid!JllGl rate of OCG1.rpational cam~ers of the va.rlous types among diffurent occupational population. groups. B. SJX>.13,al Aspect.-s ofj Occu,~t.i(m. Cu.rf;("..ers A fair !md cOl1lp~lent adjudif~ation of cvmptmsatlon claims for eance~ allegedly cn.used hy oceupaJi(}naJ agents or conditions requires an ad~~.quitt,o km)cwl{ldgo of thoe spcdiI aspeets relM,/xl. t.o th.e I)f!}duct.ion and dcYek!l:mmnt of these ttuummOonf$~ and of t.he criteria. by which they may he distln~olshed from non~oc<3i.:l..patiumd environmental (nwdi~ cinal, <iiN.a.ry, eo~mot.ic) habitual) as weHIf at) Itsponta.neous" caneers. 1. Di;jiniti.on n.f thR :T1~ft'rrmm.. HO(;(.:upatirm.al (:at(r.t~'" .~ThQ U.~fm i(oc~ cllp.ll.tional cancoro is applied to malignant tumOn:l originating in indjvidHal~ rlnt'ing the ~XH1rnej and/or a.<s tJ1{l result nf dw r(~gular and usually prolo1Jgt.>d exorciw of c-e.rtain oceupat,ional Mtivitl(\$ entailing rontact withlIDme exog(lnous~ phY8icaI I ehemica! OrHJ.' p.arasitk agent, acting :in pro1)or intensity. O(,,f~up&.tiona1 can<*.rs thUs are eaused by &pecific agents or Nio!ogica.ily rolateri tn \\'-e11 defim:.d occup~~tional oonditiDns whkh form an integral part of the ordinary working enVirfHl.:ment. They differ through t,h.cse aspects from the accidental ........_....mQ~~MJ!..!~Ji()na..l .. e~ce~. \Y~llich.. l'~ult.JJ;9PJ..Qr fQ.llow 4P~P. .~qll~~. ~x.trAtl}r:-... . ,.', . ':. ;"'':,:."".' .,'. 132 l~M MEE'l'ING OF IAIABC acccident din.~y~ unfm't.~. eenl al sUliltained at work and being of ~ nonspet;:in~ natu.re. Otcu.patio (tnd ,'t> [a f 2. Typt.'$ a , .[ature oj ox nal vado1{lj; 01'gn.l caagne~n.trss whid~ are knnoo'Wwn Dnfr injury st,rongly Can'inO~!1l$.-Oce.llpationlM suspet~ted f~S having MUMd largely chemieals, lS ionf wthoerskeers who beeaml;\ exposed to tlwm are Som~ wen dennecL. are others consigt, of variahle of elhaermgeitals m1xtur~ fi group of oe.cupatiQnru cal'c cardnogenic second p{}unds;a of w ch of ehemiAesl fi~W bi POS5&.Si& nm:nht~r prOp(wtii~S, eom~ by their ionizing or h:wgtnsriasdeiao.mti.opnosfld chamctrir,ed of ag<:'HtS nonionil~ing ihsneaafneuvtcteetei<Odalnl1bSyorenvironmentn.l anadndwhcicohn, dmiAtaioynthsirwdhgicrhn.uptoisc rt.ain se MSDclation) rda.ted (j(~cupaJional a~e-.nts l'epr~ 8omet,in18~ b~ conditions) in rteiolantaiol ns t;o c eivnoorgaafln-ndseIswlsdt1<', dUtlatictj, go ogic, die{;>tttl'Y,esasnd nutri- ar \'!,'oirh par ol moro lo r. hl\vtl DDJ<r indjl'N~.t table ( Or21/)',!.n$ TAnu Z,~OCel+'fHlti(jnf!l CtJrtinogN~$--rM1r R1)uf~ jJf E;t'P<'~iwre muu:l! Their Tar-get ......................................."...~~.......................~ ~~.......................,..,........... ;<-N -~~......................""" ......I>......................~,.. Cl'l';~~:;~;:~~n&: ;'-"~"~"''''- G0l'l0r~ tY!J~ ~ $pwllk t:rl~ ; R()\'.t~ of ":>:Jl<s:l~iN 'I':;,l'!!(jt o)'jp'm ...~........N- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. , o . , - J. . . . ~~ ....... .... '''''~'''''l''''''-''''-~''''~'''''~~j~~'''M.,~~ ~ Or;\tanlC eh,,..,,1lnl Ml~omatm. :: ; l'h~!l3:.Qt,.........".,."...., , : CU~1:ll:(lUS, r<.'~plrr. . ,.A_ _ l:>"aS'l!y~lJ,.,") hnt',tot-. : l!!'OO'el!e lM,l!.>-I1s>pht1lylatnlM, l wry, : bent!: It!$p!rattl?')'', n1M(Hormh)g Hgani> j (h>~l~emh~. !mpho~t .: OO'ma, my(>!cIDa), .d,l~lkl,ll,,:4.>lltmt1iang<eldnitpah1N)lyl\l{l.tUalt(ltSl'<, j ~ Il'.ltol\:t!e: OllS, l>llmentlU'y, i IJrdO.";1t,\lml'l~o\tm~,Ot&jU:lHOlinl e(:rb)M Q!fl<5}, Coo!t "i tat W, l:<fill, lli~dl, soot, asp~\!!,tt, tl'tillil>tl! ,,\1, !H.~l!rn' : : CtlU>iW~,L .......... r " S'kin. <$p.e ott mmp. llIMR, l!~n.!l,.~ ; R(I."l.limitlt'YH,'",",,""l Lw~> I1 SS{~t~a!trrbg2BeitMlil"~}p>a~ i'l1tfu<\ ;Mil I.:l,,;ld ts>f ij Cutanoous ............, Skill. un l . Slmle i ~\Jl.d },\lIS1)!!',n r;\1._.",,: .. ,/11) j ................~ Do. ; : Pl}trol<l!l1'f! tuu.t.-'l. lubr!l.'t.tln~ I)U~ ,1!t'!!(!1 (J;il, ( Re:>pirnMy............ j j CuttmMuS ...............;j h'lfYl~. 1'I1;;Jll, i ! ellttlrlZ oil atiit I~)lllll), ~l"bt'n Zl'<:.'W<.>, hhwi6;. : Re:>l,lf'll;torY'--'-"-'''i 1,tlflf{. j tl$phslt, tar, ro~l', ~.ld<;; l j p..'J.rumn nit \ . i lAnimlMlIt!Pltis!M..m. t!i<C;..e.!l.!.)J.3.3.i.'l; AI.%w-'ptt'll:l<lll'.ly.l.o.i.l......,.y.""......... ."..,.,,.. \ ~"\.BJM\f<<.>)(.4,~,~,..,~,n,!l,(,o,$,-.H~.',<.?M,\: ~:1k(!.!\h.~15JnWl.li:\l'ym, h..mmtae;'. i i NielmL ........................}:. ..~~.(.<.:.1~<~Stl~L~~~.'.>"i'~"(" l ...... '."",, .......... : ... ,.... ",1 L'U'f1~~ NW$l~wH.y)nl\!lllhtnml, ! 0'" I '"1 ... ". 'i'""""".... A~~y<W>.m~atlm.."""'"",,,,..'".. .... :. l '" h.nll~. v ,,..~ ',1;'t't~~w.J WCmt)~IU': kmttlng-Wii1l,'tl<>n, I1II X ..:ta,j!l>tt<.>.u....".............................,.,.;:.C.l.}.'t.admn'\.t.'.l.~.~....._. _..... ".; ~ D/I}. f 'l:~liS@t:'\a..'.f.i.~.L....".v... :: CSMMkrnii<l.ll<,(I())tthh;;~ tjJ ~, ijll.&u!.)octl"ln;>tlint!!>l! {~pha. l ; C.l;JM0i~*." l i$IY!, hlood!\ltrf<.lug wgantl, j betr., and esmwamdm.tir<lll. ~ 'tiMl~~itrmf><".l.2.I...... _. ,. ," : : J:lltill, Cvnn~tl'\"e tiS!!ue, 'bll)!l~ i . : 1: it~$\l'.:nh(;r>"......vo : N~(;.lI;m.!.~I1l'J><!l021'1,'11>\\$, 1.......... __ ."".""..... ;.j !.. . . ~~{~'l!tk i;\~rP.$II.!S,'!~I~.. ~.~"""~ ~~ i ~IJ~IW!"~>.'W>m~ t~,m~t,)h~tlm. ~,,;'I 1"1<::"'~I,l<.'<: .." . t:'"<J~~<tlt~S<%":.,, l~~ "" ... ,: llooo. . . . . . .'.'. .:~.' .w'.__"~y~__~_~~., . . ',,:.w... .. :~(t'_ l:il.l.l..t.<.,:'1,.W...............~.> . . ....., .,, _ , ' ~. .; : " ~' ;" : .... : ; . ::. ~ ,,',' : . ':, :.,:.., ..,.::.: :.: In addition k) these estahHsh~d oecupatioual carcinogmm there are a number of potential hummeardnogens which hav~ heen shown. to elicit cltneers in f.lxp~rinu~ntal animals and to which workers become m:p{'!s~d during thci.r rt>gnw.r occupM,ional activities. Tlwsa po- tential agents \'lfhich also muat hi} consid!;n~:.d ill the adjudieatiml of oompensation claimsJ are listed in tables 3 and 4, .&~~tlt l' 1 T~~;()e'l.' :~j",'i;~~ I roumc~l1 ~~~~'-'-~~('''''''''''''''''''' ....................,........,.H".[...................................................~:..................................~ ...................."..........v................oY.'w."'.y,....y..y j, SIt!? llftllmor l-..- ............................ .. ~...-~~~--.-:~ 1" \ i - , . , . . . . . . . , . " . . , .. . . . T}'l)ll!H)'flmma-u ~ ~ ~ "'.l El!tro~n&"'" B~~"" ...,..... j ~'!!r,*nl"'14. .v.~ ~~i>UM".""j Mll..;lU!~tVN, Natumi..." .._........) .. ,..,... SYl~~hetl.<A....... .\ Lymph ll.<)d~. ...j Uwnl~ . . . . .,".,,! (::'Ut4~iiM~~ ...... ) z.'h'~~ "".,j l~"'t.,..,. '" ",] 1M'/ait. ",,) DmI;l;<<ttWW'y soddlttllVvl3, ()usmetildt.lg!1l4!t'nt,. Ca.ri3>~!l T-lltraehll>l:lulLj; :Lrrln'l'xe>r.p.h.y.J...il..s."v'....!~'OAtV'~"L."",.,",.,,, ..""'"Jj '!!.<k;hW>\w$<.Lpl.i.;:.... ;: It!.ju:;trJalI:KM~llt, j l I: i '1 : i : ; i 1 ; J)<'lgR'3Slng (,~nt. i 1)fs,,:);>aU!l1ill agane, ; ~ FlrM'~tinKlli<>lJl~ :o!{,;ni, ~ i Marnl!<wWN<. 'I i 1"N)ductillll e<Iff fl:ooll. j ({Ham !mnlgBlit. ! j Clllllccrr11>>ffol'r3m3l" ..........," ".(l>.>. ""AmV"" ... lj (iinr~~ll" .,.",... "i ! i '1'" ,........,' ; ! P~l{Nlt(-t{~!. ..... 1 ; ",',:: I ; , : Extmctl re llf SflliUll>s. M<>;.<*~, "",) J'vtnnwfM:tm'<', ,..1j An..,'tn<;t.k, i SoJ ~p.nt BAAd R)tirilcM'l~ of ,-'lb, re..'1.ttl~, ruhoor, W\'Il$j8, j If>dmf, alkl;,k>.ld~. i ln~dWni 01 1lIeq~t, !loof DD'Tl' id"j ! (~ftDi~(P"('h!() A,), d .. \ i ; , "i l '>". ,,,[ OrnL.w...... t- \ flil!isl:!, illeeBnnmg fiuJJdIi... , ~ P.rl1-:l:i.lasutlrcetiso.n ot ru-tflicW !tU!:"" R(,t .. ",..... M:al1~.~~tur&. f. . . &,>:ll/!lt>rlyl.U,!td"i! ~.h!(lr*-thBM>. i ~ordc acld..",......~~ . "'~ .. : ~~(~. ~ ~ l<m/i.!~~~;}~ :,.!. A ..... ; ..... A .... A.., ....... .. N .. ! i i I j r Tll!()nrr,j~ 11<.1 < 1 d(!.ri\!Ql,~~,~,!i>,:,;"v...... ~ t.>tllL""",.. trr~. p-1"ll~t.l~tylUtro i ,11>,~ijC... " .... "", ...... , ......... (D'\ll11..:i,, Lll<;w ." ........ j .... ,;h......... 1 tin). 1 m Dfet.hrknc f(!yooL.. "i' mmhl:t ... """,;., .. ~h>. . ,,,', i i ~: " :: ......... ( ..... , "Q;) .., . , .. y .. : , ....\"'.,<l,.,""'.v.,~ , ... '."" ",Mv" ,,; . ,,:. ""AI) ",,"" : : ""':!:;:::::" .. ,<1(,,,.,,.,, I!!S<l{,-tl.cIM. 1"00<1 C!mtamW:!i.tlt. wgteillent of toodmuff& (tl"lllts, win!!, oottoo, antt tM). Medlt'.il1&1 &jI;mt 'funnting &gent, Oltnl!l, fnlJt ~)~).wn;ll.tjl(~. M,dlo.l'Jll.l ilg1i.nt. Mamtjiwtl}r~, BwOOWnlfSf( ;;g<:,ut, Antlr!W~"" XnU~fmed!att ~:g~",;, '(1Jtl.l<,.3h,wture. s!}rwn~r >:ot II'l~qu~ !.lib, : ;' i M'ltll:vl8,u-d ! lel'lf!.>, wood ~tll!nl!, g!I2~, te~til(!-, 3lilphthil, ; SlI:!n ...., 'V"c ............ i Dl*!):l<'il(l~, ",y,,! ::>:h>:.l.~,." ...... : hnlllMtJlnt (t>J~), V~hicl~ of ~tfcld~Sf. !"' ; ; ; Derglua 1 ,,1 J tat. >1O0O0!t (>!l$ and ! . , d , c - . " . . . . . . . .) S'UI>!lut~met)U$ t:11~i!i;l<!i>~}~" b:~il~s~y,~lL, .. "'~ <>'f<Xls;~, ..... p~~, ...., .. ..1 M!lt!1lfI>~ttll)'}, Fnd. ! i~ tl:!su.-.!t 'I' I LUbrW3lJtS. 1 F18~e,.."''rr~~h j ;.. ,'{l:ll i lJ"'~t..." ...,t PlMtil.-i,mx!u{ill;;n, Petf~~!lew1<~l, I QlJ8. ~, W~~ i e'f:U'~XlSll'!-li1l~t()i:>:I!.:.l:"IS""".~".TM"C.I.).~.i.j.y...".,.,.'.i\ MlUlcl&.etut~. Fuel. ! 'I w~s, ......................................................... .......... ...... j .;. .......................~ j l.ubrlOOl'lt. -, ...... ~1',.<E:~t~~~~w~;;.)$.J;: " ," ,.", :.::: ': : " : ~. '. : ,':' 134 v~.....""...... .... __ ! 8t~ I '1'~~!..E!3:' I Sl!t'(;je~ ... Ty~ hum~lH<)ntM~ ~~ mmor Aw.mJ &t .,----~ ! ~_~,~j._~~m~~mi~"'~mm_m~m'j~~_"_' M m~mm_mmmm~'~'_m I ! Ught W w~ SF brtl.: al1b.~lib.Uc~!;luQ ~l>U'~nM"A...... &t ...." ...... '1'ertiWdyes. ll!r..tlt blUt\ FOF Mt! t\Qsrjl). ; ! Food a1MM ~mRtl~ .;ly<!<'!, ween FOl)" ! !; ! <v': n'Utt~y<!llt>W'_: t.!"~1"............) O~..........." .. '!-;t"n~" ... Food dr'" (r;rl,m(>. i i : l~&L ....v- .. : OMOlmfS rl~'ll, ! : , j i Fltl.r& ool!.lr. ,.L.... GMIl).13blme, poly&t'l3y\, ! au!.Jllllw,neuo.s.. : f'"nm.ii.<ti.L .... GOo.. ,..... i Fllm,ill:o!,!l', pl&lt!elndu&'ttkU &Wlllaa, 'P!llFWllde (UnyF' i .: i i :m~nll.factU!'e1md 'USM. ! : ! 1.00), 1mkeljt~ li;eefti.oonu, Wra'llpln!', m8:t&~iL ~l~~Ulyl mat'hBe< l ~ i j Medlelnsl a!l;el.lt. rfli>~, I I i i !! j ! :grmylllum..... , ...._"j Bone..........__ l?at.::.~l<a'.81 .. '> .... j Ri'>!}!}lt ...... : M~W ~!lcy, X.my tllM, ; ! i ~~Im~nt......: ~ae.... ''''''''.. M pUWlPhot maunu,t&et<are, i!Iel.em'u!33.."". ",. ,... . L." J l : i i i i L~'\"et, i.U:?1<R<l..,) 01'&............. \ ; ! i R~kq lrIlS3els. ii Atomil!enerl(}' pr()du~tlen, .:\'l';)"" ... B(lU oontru:mnaat, C!lMlting matter <:If glM:!!, ~'!u;n!re, patZlt, rut>t~'U', ! M!)tll.tll.lioss. ! i Rubwr a=lN~1'<1r. i ! ~ PJ)I)twl;,t.trll} r.PJl8.mtus. !i !r ~""I<;r!K~, 'I F~proofi.ng ~~11t 1i 1!. Co:bslt.........v......,. Slli1!mtauI:lCI1/J !i :: I t~..., l'&fii1t~$!'a.L" ... ,v.'i~.. ,... Moolclna.! a!lH.t. MeW!tllm'~ and platin!l. O<>l~tl"t: ma'!.t<)~. ~ ill..."". I.\ernm!re. JjflJn..., ,<ulbober, I I ii .. , :- :M:ooiclna.! ~tlt. _ _ _ ..........."...".,.,.~A.;.,.~,.....v ~...........,.,.~......................................~~"'..:~"""'..'"......... ............... ...................".,..,.,.".,...A.,................................. .. .. ........ ., ............... T.~m.. 4.-0wwcciinn(>QQfffiic Ohismiml$ EUmi~(Jteif. m l?twi~l)n.ment~l l1iH~~G>J. rr ............... . . (f/3.rC:iMQe~~ ...,...1..... ~i ,y.-,.........,.,.,.......'..""...y.No........~I'~,.....I'I'". ,."".M-'- HHVAW-~H......-'......A...ON..........~............,........M-'- 1 i " " J.~<e".<t f~"",!wf{J %'l100f )llfTjITS*i'!lle'taas:.- ,,SS~~**lleM~ .utelldeo'. 1.1% ~ : ; ...m__ ... "~'~~m_~~ --"1~mm~mm_t_~ "~~"r~~~~"mm~~~ Stfl'rl ~~."y"y .......... : t i ...!,... ""! ~.A{~il@).ll\M~1'l(P,'@tM,[ ! ; : j J v"",,; : j 1 :. 9ub~utl>lll>(lnlS .~ ~'m:".n~t{$j,., ,.,.'; tlsm&,.: ! SUD(lutlUH!QlllS OtiL. ..... ,.,,, tis~Uui!,! fl\t@i.~ral. ...... ; Blad.der......v !, .. " .. ,... ,....".",. Liver ~,,.., . ",""< ....'"'' ..,'" !Blramtt.. i Mil\:;'~.,."".,) i ,,(h,. '. Ha~........... D(J~,.,. ,< ) :e:'{s{<;l .. 't~H;{ss;!).i}i!li,l nl~~Y.!tit\\l"" ;: ~=i~!' I duct, < l. I l'lrr,-wt '.: i IAlu'tc&m;a, i R'1dnl\)l. j i ! . r,u!<g. ; .....,.I'................ .... ~ .................... , ,.,.," ......., , ,............,'.............................~.I'................~................................... ~ ~ isWni. 3, .Et?aluatiQ1/. of E1>-1Aence.-Fot th.G o8tablishmant of causltI r-~llt Hons between an. 6XPO$ur~ to t,nese a,gen,ts a.nd th~ s'lJbssqu~nJ. dY{llop~ mIDlt of a. eano~l' of an cootrpati()na[ gonesi~ and thereflJ!."e c(~mpensable lu\htr~~ the icllQwing prerequisites nmst be fuliilled: : :: '--:.' "'", ,;: ()CTOBE.R (r-MORNING 8E8!:UON 135 (a) Definite evid~.rwe must he available indicating that t.he claimant had f)f5Cupat,ional oontactwith anyone of t.he various .agents listed! that this cnntaet WftS I3ith~r of prohing~d na.t.ure exten.ding as a rule over periods of at, least 6 monthsil ,and was of adequate intensity for diniting a ca.nncerous response) accol'ciing t,o alW pi"~vious e}..l1urlenoo which might be availahle on this point. Single exposures may be considered to he effective if the casual agent consists of external ionizing radiation or the eX11OSUf.e mechanism favnors t.lw prmiu-ction of a careinogenic depot in the tissues from 'which a prolonged (,XpOSSlllre (If t.he host organism mayemme, (0) The route of exposure to oQr introduction of the carcinogenic agent in addit,fon to its specific chetnical properties and metabolic peculiarit.ies de.termine the site of tbh-e organ or tissues in which a. cancer is eJicited. Ther0iore, not .any (~ancerl but only cancers t)f specific sites are related to any particular carcinogenic .agent. (e) The t}-p6 of e~poour8 does not necd to be continuous or extend l!P to the time of appearaJ:1M of the c,ancer, hut. may be intermittent, In fact, any contact with the occupational carcinogenic agent may ha;v-e ceased many mOllths to Yl)ars or~ occasionally: evan deca.doo before the, cancer beooml3s manif~st. EffMtiy~ carcinogenic ez.."POS'Ufi}$ may bH sustainilil not only hy tb~ oJ'i:Hnary OlH~l':tt.tors employed in operations \vith occupational rarelrlogenic hll;zards~ but also by workers entering such operations on a transitory hasis, such as ~uperViS0r81 maint{ma.nc.e pOl'sonlwl! !(\pah'm('l1, ta'uck(~rs, loaders} yar(lmen, g,nda workkeers t"lmployod in rooms I,l,nd buihlings lntce-nrt the hazardous operalions, if hom,nkeeping and tiXhauSlt. disposal met.hods ate infl.d{\quate and envilxmUlI:mt.i!.l (:ontaminntinns result. (d) Octupational111e.dicfll SHgmafa.-Fo!l' the estf\bJishnH'nt. of eausal rdations between occupat,ionn.i cx:ro$U1'~S t,o el1fCtnog811s and suh- sequently appearing GI\.llC0['S1 it is of distinct value t.o analyzlej the medknl histm-y of l,llf:l nifl.lcte!.i poreons for funf!tional otr' anattoomm.ic dis(>.as(~ manifnststioIlS cli.ll,l'I!.Ctel'lt,ltl<; of a pathogenic action ,of the partieular carcinogen -allegedly involved. Sud!. 1l0lwarmerous and ()ften prl3psrat.ory Of pmcarwerous s),1xrptoms of etk,logie 3pccifk~it.y ad US $t-igm!~ta or bi~)Jogit~ fing01' lwiJ)t,~ suppordng not only thn adtlidity of a pr(\\'lously sustainNl spodfic CXpOSUl'i.', hut !llliso its <:;ft,usn.l rdationsl1ip to the cancoer present. Symptomatie manifestll.~ i,ions possessing sueh a s1gnifictmc~ are, for instance, chronic radiodormatitis, chronic htr dermatitis, ar-~enie dermatosis, t.'1tronic solar dermatitis) chronic radiation p~rio$titi$, a.sb~$t.osis of t.!w lung, and lhemukemoid react.ions after /Jxposme to ben7,t)1 and. ionit.ing ):,M!iat.iou, Chemical a.na,lys<l$ of tissues for the inm'iminated chemical also may so.cnet,lmes be 01 assis-taMe in establishing previous contact WitJl any ......m.spfK;ifhu.1cc.upatiOIJjj,] caminogens, 81wb. fl..'3 nrsm:liC"t J:;}J;n:f)Xl1il11Jl,.,.nuiekcl,..,..m............ radio8.ctJ.ve suhstances) and benzol. : :~ :-- . :" ...' :: " : :..: !' ',: :.,,; .... .... :..; ::... ': .... .i': 136 195M4 MEETING OIl' B1A..BC It is important1 howev~er! to note that both these procedures ar~ n.ot applicable for till 0{'.ctlpatlona1 cancceelr'Ss. Some of the carcinogens do not produce any etio!ogieruJy eharacteriati<l symptoms, in faects (;hey may not elicit any preliminary to:dc (11' othe.r disease phenomena des-ph,e a pe1'8istent and prolonged carcinogenic exposure. Thus, Cancers of the bladder in {lye and ruhber workers may devdQP in t.he absent:e of any preliminary local or general warning symptoms after more than one or two decades. of continuous, intermittt.nt1 01' discontinued exposuro to ~rtain carcinogenic aroITw,tic .a.rnines. There a1Bo does not exist any paralielisln between t.he toxie an!ijor irritative properties of any ehemical and it,,"5 potentia.l carc1rwgenic qualities, n{H's is thore 11 relationship hetween the <ic,lTc of (,Oxi0ity of any particular Cl1l'clnogml and its relatlvo cat'dnogenit~ pntorwy. (e) Ext~nsiv(-i ~xp~ri(mCfJ with OCCUPf1tittUtJ ~aucers indicates that there usually elapses a latent pCc-'.rfiloda of years) if not dee.ados, between the onset of e.xposul'e$ t<o a cj,l'~inogenic agent il.nd th~ app(iaril.JH:~e of the resulting cancer (t,aJ)le 5). It is for this reason most l.mlik!.11y t.hat an ocmlpationai cancers hecome ma.nifest within the first yes,!' follo'Ssing the inc~ptio!l of contant wit,}) 11 cl1l'Cinogt\nic f1gNI.t. In fact) CmlCl)l'S which make Uwh: appefiralAc<J during thB first th.l'O(1 yeiil.'S of oCl:~up.;1.hon in a 130ltrcinogcnic en;vironment, sh{}uld be subjected to severe scrutiny for v. .more prolH~lJle nonoccupational origin before t.lwy may he coulSidered from any occupational viewpoint. TA~Ll:'} 5,-Latt.cnt P/lrifJdl$ Qf Oc(':upa.iianat C'am:.en Orgl>l1 and agent jAVVII}}!!Zaff((ll)) llrmmii Ra.ul'-'3 fJf i [ Il<'lt/()d i:.ltmlt paerrAl""..::'! l-................... .. ~n~N ~~........,. A ~ ..................... A~~ll~;: , . j t M{3dwm!i.L .. - .. ~ .. ~~~~ __________________________ i i Occupati(maL_ ...... __ ~ _- -- ~- _- -- _.... _-- .. __ -- -- __ Tar._. ___ ~ ____________ - _.... _, ....... ~ .. _~_ >- ___ '" _ ... - - __ \ CreolSote oIL _________________________ ,___ ______ - ____ l ! MinenI a}L_.. _. ___ ~ _______________ .. ____ ......... ___ .. _.... Crude PUflJ,itlll oiL __________________________________ t 181 Year!l !1 !25 2()""~;; ",a 5f1-51 " 11).,.18 \ Y,ut1'$ 3..-lG 4-46 4-75 Solar l'adi~do~l." _---.--------------- ______ .. ______ i .X. -tl1dl.a.tl.otL.,..,.. ., _____ - ____ ~-- _________ .. __ - - - __ - - ___ ;~ 2f1-3Q 1 ~ ;~ f ! :: i i Lun~ A&bf.stQs._,,,, .... __ .. ______ ._ ________ - - ____ - __ '" _.. - _. t ]8 i -l Ohromates____ -- --.,-.,- -- --.- .--- -- _-- _.. -- __ ,... ',' .....,. TNaicrkfeulrat'e.as._r_b_o_n=v_L__.._____.,_.. -_-._--.."_'_-"-_'--"'_-_-_-"_'_-_-_____-_-___"_____--"-_-_______ 1l -- .... -"'-.-- "------ _-- _______ I I ono ~mg ra.".l;8,,+t.I'Oll___ -?~. 1 , 15 'I 22 16 l ~..,;~r-V0i1,J( ; 1.5~40 1-12 15-21 7-50 ~~~~~~ ~ 11-151 Aromatic a.!nines._._____ ___ -- - .. --_ -" -" ___ - .. _\ ,'",'",,'",',".."""",',""","''","'",_"m "'"_m m"mnnnn""m ~."w"""",",",, ..n." .. """ .. "."""""",..""""""""""" ""." .",." .....":::.,..",,:...::::::...'..:""".,,, '..~,-~~ 137 (j) A l)llcc..oosiul productiUll or cancers in experimental luumab: by the adminissttrraa.tilon of i:lJl.ypart.imdar chc'nueal or occup.a.tion.aJ agent, suppHlinngs weight.y support to 11 claim that &nwh 11 faetol' may havv(e~! an. id~ntlcal effect UPQIrt mmaa.t"t!l.1l espeeiw.ly if the rouk of expOSt1r'()1 the physiod&emic~l status of the agent during cl)ntach and t,h.e cancer produced in t~:\1>e>rimont'fll an)m.rt1s aI'/;> id,mth;a1 with tIw corresponding aspects in human cxpi)rionm~. HOWClVl:1l', because of the pronouncod spf)cies sp(:!Citlcit;v ofaxogenous carcinogen.ic a.gc'nts, (lVf1n positive experime.ntltl evidence provides merely strongly su~ges1 lve but not entirely cOlldus:in~ cvidNlC{\ as to the existonce of cardllogenie propl.~!' tics of such ag~mts for n1allo Onby human eXp()riNl{!~ givHS a deHnit.n and irrefutable anllSWeell' in SsuUddl lnf.H~1'8, nie (g) P!ttholor"fje and histologic edi!r:>Jwo is in g'N1N'al of only limited import.ancfe' in dw (lstah!i~h.llWHt of Hie oc{;upathmal Ntustltiou of eanem"!-!, ginm~ lwith(,t t]w dink!ll bPlHn-im- nor th~ g!'()~~ nrrpMl'ft,nC,~~ and histologie stnH'tUl'0 {)[ (5ltI1J~N'S are t1tiolng,v spm,jf}~< Howover, in SWOIlnDOO oceup~\ti{!ri~li t'llH(,I'l';; hhtolol,!icftHy 01' hbto(1hi:~miN.lly dMlH)H~ st~'n,htc m!.nir{~stat.i{H1s a,re pl'(~spnt, whkh gin~ CHHdut;i'n~ oOJr' sngg{)stivl} t'vidf'm~n as to tlwlr p~lrtkular t\dolog}>", The pre;!H~1H'(' of asiWSt08 hodies and a.sb('sto~<is in il hmg tti1{'l..'t:(>d h;\" NmC('l' pro1vii!(>s pnwtir.J:tl and $('ienWk pmof M to Hw f~hh{'l'lwtie odgin of sHneeh a pr!lmonary (;a.reino.tna. Of similnr (,flUSH] signifi(:'llll(>I.~ ,,\"ould he t-1H..~ (j(>mol1sil'Minn of chromlte dust hy htModwmie~1 mnt.hods and. h:'l irwinr\nl.tion of s('ctions of Hw hwf:': of afin individua.l with pulmonary carcinoma. The hisCZldH.unieat dertlOllt-ltmt ion Hi ttrsenic ill the skill ~dfected hy a. cardnoma r()pmsents another Hlusil'}ltion of the value of hist,(~togk sfttdie~ in the det(':rl'nh~fltiQn of t!w (~t,it)logy of a f~a.n('(ll', Likewise the preStmCc!~ of ~xLensinl cndaTt!iriii~ C'llang('f; in a fibl'()~;;p<1 suhcutaneous tissue (~(>l1u\'ining ft. (;-tl,f,(,lnorna 0O)J' RtU>eom~t would arouse the suspicion that X-rays or radioact i \~e efJC'rgy W1ts ('~wsaUY' fN;ponsible for thoe n:tn.lignllHt lesiol1, It appears froItH thc'soe {:oltsifipratious tlmt a (~(jmp!?tl)Ilt fLtUUel!. et'it1cat evaluation 4){ tiH~ 4:nttl'f< (~vidNW(' r(. lat.~d to i 1H1 Hxposur0 of OUw individl1al t.IH} symptomatie maJtifestat.ioll.s of tlw lH"c}-Htnttor,v period, the length of th<~ htktll" l>(}ri(!d) tho sit.t) (>f tho <',tl-l1C(\I', Sf.m(l hbist,rd.ogk ~)J' hist,ochnmie~tl {;h!trflet{~risties tJ,nd tht\ I].xist.tync,{~ of <''.{lrn~spondtng ob~ 'S0f\7 ations on eal1!?M prodnctioJ1 in oxrH~rim~:.ntal ftllimal.fl nskh~ frtorn ptlrtilwnt epirtemiolo~i() (tlhfttt,a n~pres{)nts the sdtmtific hal",is essential for meciieoiega.l cif)clSions in liHgtl.tions of aU('ged (H.'{'uIHtt1onal {:.!).l1(~N'~,. C. Compensation Laws or V?orkmf'll'S compt>ll.sation laws eniwted in various countries f\,nd state,:; revmtl a ren1!LrkaHe lack uniformity as to t.he types oft 0<;f;upat.ional carDilnlDgonic ~etlts! industrial opera.tions with el!.I'e!n.{;g'nnic .................... .... a..iio3$t:i=~:tii{)-"....................., . " .. , ..., ,............,..".".."..".".."..".,.'.".."..,..."..",'.". . '.,,';';' ::;":' :'. ~:'.: ::': . : :',. .,.... .',,"., .',.',..,... 138 hazards, and (~('ctlpationall)$,noors OOV(1l'NL As of Ocwber 1f If154, full (',overage laws applying t,o all kinds of ocenpationuJ dist~a."8S including cancers had been passed in 26 Statfls of the United Stat&s and th~ District of Columbia; ~ehedulo c()v~.:rage laws not alw'aY5 coveriug occupational cancers, or alnl typos., were in, forl~e in 20 Sta.tes ~nJ no oMupatioI1a.l dis('8)W laws had bean enacted a.t. that t,ime in :2 St.at.es (Mississippi ai.mndd. Wyontillg}. While workm,en~8 comp~.nsation la.wW-'Ss baMd on the. principle nf schedule (',overage may provide some d('.gre~ of compensation against disability !)'ud injuries resulting from occupatJonnl cafl(\(\l' hazards, such legal provisions. dt>siglled for the protMtkm t':lf workers arf;> t.otally inadeql.l.ate, if not. obsoiettt, in an ttra of a rapidly changing and ln~ er~!Wlng oc-cupational dist'tase panorama. Such static law's refloe('t a legal and sociologic sta.t~ of mind which is maladjusted to the dyxuunic 5tate of :modern industry. However, even the blankL'lt or goneral coverage (lompensation It\w whieh is $ufflOJent,Iy fiexih18 to include not only the pft'ssnt hut rJw MMly future oMupationttl Mncer hazards, usually has !l, st,fj,{;ute of limilatJons 'which is in.ad.oqun..tt~ for providing fair protN;tlon. under e.ertain .and !HHJJt too unu~ual (~ircum8tance:s m0ot with in occupa.tional eanGBr, Sinc,e oe.eupat1onnJ (l'anceeelr'Ss may hl}cl)I!1e Inn.nifest :n:l.tlnY YYCC::ff::JJ''SS aftor cessation. of (~xp()sure to oc:cupationa.l cl"!rcinogenic agents, a st.atutory time cla.use of from 6 montha t.o 6 yearl1 .may h.;) too Sh{fL't for OCCUPf~ tional Call(~;l1'S which mf>,Y appear after .a ionger period. It i('; advi:sable for this N'atHHl tt} a.djust a.HU exisHng laws in sueh a )"y"aay that. sme.h eYtmtuaHt.i~s are properly covered. In the workmen\! compl3'usat,ion !fnVS existing itnt most Sttlotes: eCl'ta.in groups of workers or empl()y~es, sud!. M (\S,Pee1!111y fann ilabboo1l' and domt~"tic S{',ryu.nt.sl !..t"e t<xduUNl ftom Cl)vcntge by the IIJ,\Y. Since farming as wdl ft.,,; hous(\W'!)tk have become and are increa~ingly h{~~ {',oming oc('upll.t.ious having cxtensivu contact with indust.rial prodllcts (pesticide::!, hcrhirkte~, synthetic rel't,ili3N'S, antisp!'Outing agl>tl1ts, hormonal fattening agents of live-stock, lubrl("g.nt.;:; tmd fud of fu,nn maehirwry, residual {jils fooJr:-" smudge pots, Boil impHH'N'S, antibiotiesl d("t~rgentsl wax.;):;" polishi,\'3) dry cbanjng agents), t,hete is 110 sOI.Uld scll.mtifie rt~uson for excluding memoors of 8ueh oceupntioYl.s from cov{)rage by t,he workrnen's compensation l!),ws and from adequate proN}ct"lon -R-g.atnst, Cf>,fleerS a,rising fmm f;.xposure to pot(lHtia1 and actu.aiocnupational carcinogenic agents. ..:,.": ;!: ;,:/ :;. ,",' : ,".' "" ;... ::. 139 Dfl. TlAAbbor Codes erul 5funddrtls Any attempt toward. ae.hieving an ad.equate oomPB!lsataon by nnan dal means for a canctirous condition acquired through contact with -occupat)tmat ag~n.ts not, on]y presents com~idN',ahl(', economic diificultk~ but is also of qucst.ionl1b1e human~ merit. While such a, :proc~{:ure is evid~ntly the hbest thl1t can hbe done after an occupational {~iinC(jr has haooma an acoomplished facts the wiser, more rational, and in tJll:l long run, mom eeonominal a.pproM.h to a rea"lonable c{}n~ trol of occupational can(,mr har,Mds lies olwi{)ualy in their pnwtmtio!A 'wht>,rev"'er tJlis is possible. This gmu can he Ilcrut'tve.d to a lal'gt~ dt.~grce by the en.forcement of pmpt~r work ~onditi()ns in op~r&tions in. which cancer hazards a.:xists 'So t,hat {eliitthher any oontfJ.(~t of workers with sueh agents is eliminated or fB(iuced to an ineffective level. As to the fundamental step for an ,accoTnpHshing sndl. a control of oceupatkmal cancer ha2~dB~ it would be wJdsfl,bl~ t,o havl!> all fM,toX'l{;ts, worKsh{xps, lahoratori(ls and ot.her estabEsh.tncn.ts prodUcing, handling or using known or snspected carcinogNllc ma:wriels to N'giste.:r with 8tato puhblic health find labotr' ~(>lldes. tfhis information would. provide the basis 1lo01r' establishing tJu.', 8upe.fvislon of plants by ht)alth and 1laabooo1r' agoocies and would (;ro.ate the proper maehiuol'Y for f[\~mma.riz'ing ma:na.g{;t'l'S of sBuueeh opera~ tions with t.lw pot.ent,ial eaminogenic properties of the .mootanCN;! ,and devlces used in t.h~ir ~t!lhblishmonts and with th.> methods and pr{) eMm'I'S hy which thf!>y might, be cm:1troUed or avoided, The rdativ'e ~ffcdheness of any medical, sanital'), and t.ctlm.ologie (~{mtrol measnres t.o he ad()pted e.an best he di't.{<rmlned by a.''3cf.>.rtaining th~ ec.hhaanngg'-{flSl; in t,he {)ooupa,tiona,l Ctl,nN.\t incidi.'<lH1(! a,YMulg t.h{1 Mt.al pop'tllation at ri~k occurring (luring 30nlC 10 t.o Sf) yefiI'S ahet their introduetim~. It is Hwn~fore di~$lr.fi.hl(1 t,htl.t proyi~h)U5 be made for lr'oOuuttiinndy recording all cane!:.!.' Ci!..~es occurring' iLn1{mg worker gtoUp8 ~1:<\:poSe{t to oecupaJion.al (1areinogens. An pr(\(;a.n.i~Hrous and {~arl.eN'OUS lesions ohserved among members of SHell groups should f()r this reMm:1, b{' made .llotifiahla 'ldth the St.ate h~alth llgf.mcy, All Pf'rROllS ha.ving know1fdge of those ('{amneeeers should be h~ld respons;ible for suceh r{~port ing. Thu tt.d6ption of ~m!;:h l""llleenSlltl'{>g n"pl'!~s{."nb. an importa;nt; step from ft puhlic lwalth viewpoints because ther~ ias e. growing uqt{krw~v to ddm'mine t,h.{~ etwiron.m()ntat {5amw.,s responsihle for significant chfl:nges in. th~ ineid0nce rates of several canccrs. A gmat deal of cinmmstant.iaJ amI rlin~et 8vidtmce incrnnll,atoo rec~nt changes in tihl;:. indusstt1ry'y--rroolat!!d en,ironmental hetors for th!~ startling and progrcssive iuerease in ItiJm lung (~anelr fmquNwy observed .: :, 140 1964 MEETING OF lAl!J3C an in aU iu"luatrialized counkies during the :past 50 years (graph 1). A similar, while not Ml marked, rise in mortality rates has ht~en ob8er\~~,d during the last, two dsc.ooes for cancers o:f t.he blood forming t,ii;lSUI"$~ esptJcially leulmmis.f:l/ for which the c.rude mortalit.y rate lnema,socl from lrAJ pt'<r W(l!OOO of the population in 1900 to 4.;1 pM 100/000 in 1944, TIlls d{lVl.tlopmcnt coinddc.s with it marbd lllCf'8ftSOU w:;e of ionizing radia.tion M weeHll M with ik ~idos.'pl't')oo indusuial and medicinal ~mIlioyme:nt of ch01:nic.als ha:dng dist.inct lwmatow:xie effect.s. COMPARATIVE TRENDS IN RESPIRATORY CANCER MORTALiTY ~924"1950 . :" . ' ".:' 44 ,:.:.: :', . . ': ': ., , ,.: . . .:' ~ :': 141 It also may be of significance that the, a.ge~specme~ total and age.. adjusted mortality rates per 100,000 population for skin cancel' in wbite males. and white females in the United States h!tve eho"ft>"n between 193(} and 1950 a marked shift in favor 'Of the younger age groups (table 6), W'hethm: s1.lch t:.hanges in the age distribution of skin. canC(lfS f:or both se:ltes may have resuited from tUn.! modern habit of sun ha,t,hing {H: a mOf6 intense erfvironmental, oceupatiQual and dietary cont,act; of tha gerwralpopulation 'liYith arsenicals, e'Orr vdth products of the coal tar and pntrolimm industry, remains at present a matter 01 speculation. For determining the pos.~ih1e ~aallllsaall signifi>canM of such fa.elol'S in. this de\"eloplnent, it ,<muM be necessary to asccrt,ain data Oil Oc(mrhltimlal> dietarYI environment.al and habitual oont,s,cts of thG affected individu~ls, their oomplexioll u.nd rMe~ and TAllliE 6.-A{lll-apll;;Cl'ftCs Tatlllj (J;~tl A(fNldju3tr..d MlJrt(J.lity lfuiml Per !()(J,(){}() hrpulation J{)T 15kin. CarU;{ff in Whit.-- l\fllle$ and While Femalefl, United States~ 19S0, 19-45, and 1950 i 1~ Wt>.l~t'.m>.>.!t':"~ .... ~~:~;Ml-;~~I:. h.,'M'Ht N~M~M W'i~t<} . . .~. . . . . . . ."....,~-r. . .--'N~ 'N~.; .~~~ '1. .'> ~ u!luer HL ~ _~ ~~~~ ~"~. ~_~. ~. ~"_. ~ ~~~~~_; 15-24.. ______ .... ______ ~______ .. '''..".."... __i 25-3L-- _____________________________ t 35-44 __ ___ - _____ ... ___ _. ___ . .. ____ .. _i 41HH_-. ______ ._. ___ ...... __ .......... _...... \ -1 55-54___ .. _.... ______ .. ___ .. _______ .. _.. __ ._[ 65-74 ... _,, ___ ~~ n"~" _~_~ __ ~_ ~ __ _ ... " __ .) 75-84__ .. ___ .. ___ .. ___ .. _____ .. __________ 85 and over____ .. _.. _________ .. __________ f ----_---._--------l Al!age~..... _.. - ....... _"-- .. _.... -_ .....- ...... _.. _.. j A,geadhl!}te-dl------- ... {). {)O::! .12; .22: .75 ': 2.5 8. 0 2:,.7 68. 2 < 1IM94..22 ; 3.3; 4.7' O. 08 i. .11 j .46 j j .85 j ~.! 1~', Od 1:::. ~! 52.:3 ! 172.4 i 3. 2 j 3.6\ O. 03 .34 .81 1. 4 2,7 ;}. 9 12. 8 32.6 77.5 Z.9 2,9 }i -1)2 ~ +209 j i +'76 +M +29 +11 -20 -55 t._-_._-j._ ......... .. ~ ~.....~ .,.,.,.,.......;.""' '?"'''............'''''''''"~l<''>' .. ..-.. 1 Wi'>lt~fu~ (~'~T~m mT~'"=~T~~ ~ Under l.'L __ .. _________________________ t 0.07 i __ ... _. ! 15---24. __ .. ___________ _____ _____ _____ i-OS ; ZlHH_______________________________ -i .231 .&i--4L .. _________ .. ______________ ____ ..! .63 1 4S-J)4 .. - _.. _._ .. -.... .,.,.._N_".~. i 55-M_________________________________ ~N_______ ._.. _____________________ .; 1.5; 3.8 1f 11.4 i 0,071 . r3 ,23! .55 j I 1,0 j ~U~ < 8.7 . I0,02 i .:n l .72 i 1. 2 1.8 8.6! 6.8! -11 + 1la8S +213 +118 +80 +21 -22 75-~4.. --.~---.- .. - ..-------,,- .. ---- ... -_.\ 44. 6 ~i 26,3 \ 18, S l ~2f; 85-t-_ .. __ .... _____ ___ _________ .... _....... j 162.. 7 132. '7 j 68.5 l -48 Anag~I'j- .. _.-_ .. ___ ...... _.. _.. _____________ i Ag'3 adjusted l _________________________ / Z,l } 2. {) , 2.{) 2.1 i 1 2. (} 1. {} rti.-"-,-..."..A,.,. ~_ .,y"....... n ....'-:-O.......... .....,..........-.I .............,.." ....:-~ ......................,......................................IY-..........."..,.......,.".................~ ',' .. . . :. ." :.: "" ,,' : ::.:...:.:.. '..: .': 142 195M4 MMEETING OF !.AIAlW on the locS\,tion of the CiUlOOl'S in the exposoJ Or une}.,,})osed part.s nf the skin ('Bite d.lstribut,ion). All such data, could readHy be ohtained for oe,eupationru. faetors if all occupational cancers would b(} made noWiahle, At the safne time this m{}a,s'Ure would be instrument.al in ascerta.i:hing to a much greater degroo than heretoforo the scope of occupational cancer hazards alind of the cancers resulting tuherefrom. The effO(lt,iveness or t,his pro- oodnre is strikingly iUustrated by a gra.ph (gri,l;ph 2) published several C{JT&~QUS CANCER IN RELATION TO OCCUPATION ~~NlH ~ THE.NUMeER OF CMS OF CUTANEOOS ~ ~~ ~ & FnlALSIN ~.WAt.S $se<:m.AWO NO'nFlEO ~y FROM I~U - 1'49 iNQ..USlV. 1<),..." .: '," :...... . ~ . '. '. 143 ye.ars ago by Henry in which he showed t.he 'Striking rise in the numher Qt eases of cut.aneous cardnoma in males and fBmaloo in England) WWaallBaSs and Se.ot.Jand attributable to (}(~(mpatioll~1 mrprumres tl) c.o8.1 tar~ pitch! shale oil and mineral oil after statuto!}'" notificati()JJ. w~mt int~ effecct in H:)2(l, Couelw;ie:m.s 1. The rapid deyl.?!opment ,of mQdern indl1st.ria1islH has heM a85!J~ ciat~d with the .appearanc(~ of man.y lWW occupationa.l health haM.rds of which those (Jtmsing cuncel~$ OC()UPY an impOl't.a.nJ position. 2. rrhe increasing rate at which occuput,ionru carcinogens have been disGov~red during recent decades s!Jgg~st.s a.hat (Djilly It f:rsction of the aetuaUy IfIxistiug iud tl'Skial !}ardtlogens is kn.own and that heretofnfO unknown and nmnwv o(l{~upatiollaI earcinogons may be added to tho prefffint indust<l:"h~l onvironment tlm)ugh the development and use of new -cbemicals and :production m{~thodB. 3. There is a. great deal of evidence indicating that only ft :rdat,iy~!y small friJ.Ction of thoe eancers Pl'OdUMd through Ixmtact with oe(~1)~ pational cArcinogens hJi,s bMn :rMOglli2.(~cl and/or placed on r~wo:t{L Bec$use of the est.~hlislwd wide5prea,d. industrial cOllta.et of large worker groups with known occupational carcinogens, the potentia seope of the occupational Cancer prnblmn evidently is. much larger than apparent from the re:pl.)l'ted numhnr of oenupathmfJ. eancer C'!t.~es and hazardous h:alustrial operat&Dr\Cs. 4. l\fctlicolcgal decisions in cOlnp~n$atiou procedures of occupatitmal cane~r claims 5001.11d be bl1Md on It compet(int an(l critical Hvaluatkm of the entiro eviderwo rolated to the {~~xxppomsmurre e<mciitions of the claimant) th~ presence: or absence and tho typ.e of allY (~tiology, specific symptomatic manif{'stahhoonngs ohsf;rv~d during Lh~ latent and dev{llop~ me-nt~l pe-dods of the Citnc!'!tfl the len~th of the latent p<loriod, tho site of the cancer, any specific hist.o1.og1{} and hist(}dlemi(~al eharacteri8tics} the pmtiuciiDn of corr('spooiling ta.ncerg in experimental animals by th~ incriminat~~d agent and pertinent epidemiologk data_ 5. Senhe-.dnule c.overage laws am inadequate for providing proper protection against OCQupstionai m),n(:!ll' bnz~l'dB hee~HlSti of the dynaxnie statB of modern ludustry n:.sulting in t.he const.ant addition of fnit''Ww chemkals and pl'~)~hwt.i(ll1 method~ which. ma.y eMnt,ait htltflt.(lf()re unknown occupational cancer hazards, The statute of limitations cont,ained in the g'1)fl'C'ral cov(,rtt.ge laws :reprm"cnw its main. dtl.:.ffeed in the fail' and aquitahla tl,1Iplieation of this type of workmen's cnmN panst\;t;it:m law to occupa.tiona.l cancer hazards. O. Since tb~ prevention of (}c~upat<ional can{~er hazards and n.ot, :Unf.md.aI ('.-Ol);lpe:r.mation for established {mcupatiollal cancerg appears ..............t>:Lb~~ tlw.mj)l'~~...~N1.~ihb .M\dhumamt m~th!)d of t!.i1cnpatio.nal f;~'W\.lf.. 144 195M4 MEETING OF IAIAB-C oontrol, lahl.}16 codes shotlld be properly adjusted and nnfore.Bd so as to eliminate or re&''')oflably eontain occupational caneer hazards in rnod~ ~rnin(lllstr1$S. 7. For ascertaining the aetual scope of the occupational cancer probkm and fm' th.{) inst.it:ution of adequate e.onkol ll::w!Wures~ it is essent.1al tnil,t oooupational Clillet~rs and pr~cancf:.WUS (~Qndit,ions art3 made llotitiahl('lwith local and State health and lab{}l' aut.horities. 8, A cmnprdwusivB study of occupational carac~.:r hazards will provide a sound hasis for an equally urgent inv-es!'igati{}n of t.h.e apparent extension of induslry-relaA:ect CAfl.,neoelr' h!\zards to large parts of t.he generaJ population, BU1I,.IOGRAPHY c. 1. lJl}r~J?l:iS, W. C' I Oceupatlo33llff!l.Jl Tmnors and AHled Discll.;:';Q!;, C. SI}t1tlgfield. llLf 1{l.t2~ p. 897, 'l1Hnn.a~, U0{'i'nt Del?e!Qptnents ill Euvlr(lnm~;ntal C~~lC'~fl A.. H0\Ai{'w. Ardl. PathoL In pres$.. A Methodntog.J for Envlronml.l'l1tal ~lld Om:mpationa,! Can~er Sntveys. PubL Health Tech. Monograph No. L U. S. Pllhllc HeaH.h 8~~rvJce. DepaFi... tMnt of Heat~h, .Edl1(~atinn and \VeJfar0, 1950, p. 37. 2. 'T1=tASfi: 0, V. M" OeC\!flt~tionru. Diooase Reporting. Uv B. Depn:rtm~mt of Hell,ltJl, Edtwation ai!d \Velfll.l'e, P'auMhL. Be.!th Servimn!} l'Bhl. ::\,,). 2Z88, l!)@, p,80. 3. S'f:&r?{R, L K, Reeeell1lt 'trends in Or.-cupatkmai Dj,,0ase Legislation, Cniivv-. .r., IJllHQ1~ BBiillllt. 18; No. tuiS, 1951, p. 80. 4, MOSOl~! O. G" ~nd bA'l.ENI'ORi\ S. l., State Conrpen8atory Pwvlsiow> for Occupational ni~~aseg. Bmoo.u of Mi.ln!N\M> !n(ot'llul,tkm Clt~(~lM '(1G1MM), lL Sfl, T.k*ll.rt.m.ent of the Interior, 1952, p. 125. 1), WA'f&RS, 'fff., Incillstr'ial Physiciu,n a.nrld \1,'orkmen~;; C!)ml)(l')Mtkm~Ctlrr!~llt Trendos in Compmmmmaatt..iiooll[ Legis!atkm, J. InotiBt. Pyg. and Toxi~ol, 31; 2.51~2,5.5, 194{}, 5, SWlH}(fU)!tT'l'lIlllll ON' LlIllOlBtAT:HJN PRn;t(:!l'I,~i;1 A R,~HQ"nal Appr(lAdl to Air PoilutinH u~gis!al.if.m, Manufacturing Chmnists' Assoc., 1952, p. 23. 7. TOUR,'I.X'(l!S./'<ll, F. J" Helllth <>f W()rktnen~ Appre-(lj&'uotl of Risks to \VhkkllJi Heal!.h of Wo.kmen Are E:1!:posed in Industry an P:rO"lince of Quebec, Cana<t M, A. J. 54~3&21 H~413. The .A.ccdident Preventioll Associations Under the Quebec '\lTorkn'lcn;s Compensation Law Lx H. 1'. CI,EnG~ Presidem. Qtl~ As-soci(atimt. Jor the PrmJenttm", Qf Industrial Accident$ Un the n;b8enee ofj Mr. Cle(l(!. kiIJ ~<l.alemmt WM read iJy J ..t1rmand l)~$r!!ch,l}r3. f,dce pr,l}8.id~nt, Quebec A~~bciaton jl..lr the Pn'tJi:mH(J?~ of Aedd"''ltsI I ,,,,ill out,line briefly the S('tup of t,h{\ \?n.riouB saftlty jtgfwelations> and later, being more falniliar with thl,i organization \\Vhb;h I represont I I shaH (~tl.d.ea.V'out to e1ahorat,e on ~ few of i!;.q mfljor pmmodonal .....................a~ti:vitiffl~,...w " . ", '" ' ~' : ,'... :':' . . :::: :.::" .. ; ,,', ...:...". ::' "", APPE}\""DD1IX C Oflidd Attendance at the Fortieth Annual Meeting of the Inten.nttional A@sociation of Industrial Aed,.. dent Boards and Commissions CANADA Alberta A. Fh.RMM~ M. B. E'I Commi&!lon~l"., ,\\rorkm{Jn.!~ Compen!lstkm Board, E~ ~onWn. Da. H. H. Hlell?lHJltNs Cl&iei Medica:l Om.em.', Workmen'5 ComP'!'-wmth::m Bosrd, EdmortWll. C. M, MAcr..:!lmD, Q. C" Chrurm$.u, W(~rkmtm's C(lmpe~&s3.ii*m lk,8.rd, EdllH)nkin. iJrn'i$'h OQl~iml)ilJ, .F. P. AR~ffUU.W, Sif!~retary, Worlnnen's ComImn!m:Mon BOArd, V~I1cQuver. A1MJ.lI B~u.:. Chrurm~n, WQrkmen's Comp~!lMMQu Eoard. Yancmtver. C. W. PruT01!A.RD) Commi&liQj)el"~ Workmen'a Compensation BOll.rd, Va.nwuver. ;"" ..m';tcls~ Q. t. COU,*UlY, Q. C,' CQro~ir>nez, Workmen's Compen$$.tion .3()a:ri1. W~n~ nipeg. P. V. E. JON~, Ami~tant to Q)mmiis..<!ione't', '\VQrkmeh'~ Oompeh!!$tion Boo.ro, Winnipeg. New Brun8?1.>iek A. A. C~ISftQL~, P~ident'i N~w Unmswick iwcident Pre~ntiM A!300ciat.iofl, MohcroYy'L!. It. G. JO()MHNS'rI'ON', Viee C!:uurn:um, Wot'kmen'a ConlpansaattiiooIIl Boa:rd, St. Jo1lm. J. A. LEBlliL.ANC. Claim!! Offu':er~ Workmen's C()mpen.rmtion Board. St. John. N <'1wJoundlm~d CLAlU:N'($ V. HANCOCE:, Commissioner, ,\VQrkmen'a Com~nM.t.l~)Tl Board. St,.. Johtl'a, 11(It'a &&<clttia'a. Aln'a:u~ P~l'ru&, Commiasim:H~.:t. Workmen's Compenae.tio!l BQardl Halli~, FlUNlt RowE, Chaaiill''ffffil!m, Workmao's Compensation Bceaalt"d! Halifax. Onla.~(J J ..F. C ..Ul$,EY, Vice Chairman, Workm.en'!} CompMMtion Boru-d, Toronto. MAAl!; DonDl)S, Oht~rl(> Fedef~tlQn of lsaoorl TOroltt.\}. F. Fr~C~AM, W(}1'kmen'g Compen&l.tion Bo&.rd, TOMl1tO. GEOROB GARROQW GREEBBN:f.l, Direc!.or, Fecleml Gove:mmetlL Emptoyeea Cmnpenea- tkm Brnlich, DepMtll;e~lt of I~b(.lr> Otta:wa. W. J. JOttNSl'ON, 'Workmen's Componsa,tlotl.. Boa.rd, 'I'monto. J. B. LANg, Department of La.boyt', Qttaw&" ---- -----~~~ :.' '.. ,- .:: .. ':.. "'.' .;' AppENDIX C 229 L. B. L~l't>Al1n~ Phy~kiid~ Div~ioo f>f lnr.h.u!t.ns.l Hygienes D~Imrt,ment of Health, Toronw. W1l.'UI l\fAOtACHLAN, Pre8id~!1t, Canad.i$n Ind'lUltrial Se.f~ty Conferences Toronw. V. C. Pll:.ELANf Di1'ect(}f, C&n&dian Branch of the L ls. 0., Ottawa. G. R. POOLE, Workmen's Compensation Board, Toronto. Al.l:.AN PORTE~ Department of Labor, Ottawa. A.. llollmaoN, Workmen's Compel'l.l!lB,tkm BOll,rd, Toronto. E. E.E.t Sl'AR:It(}W, Chairman: Workmeth C"Hnp!l;tn~tion B<~B.rd, Toronto. WARMN W. S&,TrEEAA-aNSs, Claims MMagel', Liberty Mutual Insurs.llCa Co" Toronto, Da. E.F.t C. Snmul, 'Worinnen'g Compensation Board, Toronto. Da.. B:aUCE YOUl'W, Director. Itehabilitatiol), Workmen's Compenaation Board, Toronto. Sl'EPflEN' BA~lNl Saf~ty Director, Queber. Iron &; Tiw.ni1.un Qm:po::ra!:.ims, Sorel. A. G. BJ\.1J.ACHEY, President, Quebec Metal Mining Assoeia.ti:on, Nomnda. w.DR. BE:R'1'RAND BELLEMAM. Woorkmmean'as Compensation Cmnmi2B1on, QuaMe. 1. BENN~1'f. Pri'$iden1i. Quebec Pulp &; Paper Sdety Association, QllhOOC. JAC-QUEa B!lRN,m~, Montreal. DB. L, A. Bnoclfu. Workmen's CompenaatlOll Commission, QueMc. JAC<:!Ul:$ CAS(}ftA1N, DeplI,rtment of Labor, Quebec. A. S, COOK, Secretary-Manager, Quebec Pulp & Papoer Safety Association, QuebeC', ,PA,l]t A. C001U>, Joiut M~~el'. Ql~ebec Indu~tr~l Accident Prevention Aooooia... tiout Quebec, A. Ih~J?'MAN COt~, Safety Director~ Canadian Car & Foundry CQ'l Ltd,. Montreal. J. AJl84hN!} D:e~aOC~EllUl, Yioo P.r~..!lid{mt, Que!nc Aseocmtion for t.:b.e Prevention ot Industrial Accidents, Queboo. J. Av DucKE'lT, Montreal, JJI;A.N D.lSBMl;u.)&f;, ah~wil1ig~n Wa.t.ef &: Power (Jo., Montre~l, PAm.. D~SJAIWINS. Assistant to President, Caagrain.& Charbonne.aut Monttrreeaalt, J. E, Dl()N~ WorkID9"n's Cempene&tkl!l CommiB8iMo>u~ QU(!MC. J, E. It. DEME~. Workmmeenn'S's Cmnpeusation CommmSit),11, Quebec, ,J, H. DE!"U!Ml, Commissioner, Workmen's Compensll,tion Commission, Qu~hec. JOSJ!ll'B D~LAGl), Wo:tkml?tn~s Compensation Commission, Queooc. HONO:RAllLE Mv 1. D'Ol'LEssrs. Qv C., Premier ot Quebec. AmHuE FOS1'E~, Viee Presi.den~1 Workmen's Compensation Commiooiof1, Quebec. H(ll\!{)~I\.:Ul"E ONESJ84El GA(G3NNO(!N, Minister of Finanee, Quebec. DR. GUS'l:'A.VE GIN"GRAS, Medical. Director, Rehahllitatkm Institute. Montrea!l. 'Wm.aa::AAM GG...u.ttAAGlttEEllaa, Montreal. S. G:RREEGGOORY, OhM Cl.8.ims Ag~nt" Call1l,dI~lj Nati<mal R~i!waya, MOnLl'Ml. JJllII!AN GGAAnnNNEE.AA.Uu, Workmen's Compensation Commission, Quehec. JOACMrIM GR:ENIE~, Q. C., Presid~nt, W~:tkmen's Compensation Commission, Quebec. Bl!laNARD C. llAMEt.s QU(lbe~ Power Co., Qu~bee, RUMLl'HE HAMErt., Vice Pre$id~.nt, C!a.t~olk Conference of Ls.bou::r, A!3be,,~~ HON. WrLFl'Ul.O HAISL, Msa..yor of Q~teboo. A. H. HOllfiH~lilRGE~, PresidMt, Quebec Metal Mines Accident Preven.tion Associa". tiQn, Namnda.. H. H. HHOOoU-GOHH,, Chier Claims Agent, CaMciian Pacilic Rrulw!l.Y, Montreal. LJ!!oPof,.I! HI)'B.8lWA's Sufe~y Director.. Quebec North Shore Paper Co./ Ba.ie Comeau. M. MAl'tC LL.AA.cCoOsB'l''lE'E, Edifice Cadillac, Montreal. MA11lUCll: L4l'l!lll~IElU:. Q1lobec Iron'& Titanium Corporation, SoorreeLt '" " " ' , ',' ".: :. ,:,': "'.,::':, "',, EU(JENE LAIWClfEtJ::.E, Secretruy GeMrsl, QtlebE3C Met.aJ Mining ASiiooiatioft, Queooc. Nom. J,.,..-l.IWCB:E:, \V(B'kmen's COlupen!3!ktion CommlMion, QUlJbee. DR. ARTllV'R LEl:OLBRC, Chief Medimt! Omne:t'l Workmen'g Compensation Commissu>n1 Quebec. D~. D. LElONAIW, Workmen's Com~nsation Commis.'Slon, Quebec. T. E. Lrnl:.E, Director, Qllebe{~ Met4tl Mining Assadatioll, Non.mOO. W. }~. MONTGmreay, Safety Director, KenMth n. 8. lloberison, Ltd., Montreal. Pa.ttJ:l?l'B MorH>';'tn~, Q, Cq C(}m,tni~k.ln~r! Wm'kmen's Compens~tlon Commission, MontrML J. A',l(!mN~H4 MOHEIIWY, Workmen's Compensation Oommission, Quebec-. JEAN' Pn~NtX, Ol'tllopedi!<t Tedm3e:ima, MontreaL ROMEO PAQ1JET, WOl'kmen'~ Compeulmtiofl. Oommi8.'!km, Quebec. DOONNAA:t' QUIMPSI Deputy MinisWr of Lab(}X's Deptu'itrmmt of Labor, Qlxehe". O. ANT, ROV8SlZAl;l, \Vorklnen'S\ Compt!n!la,tit>n Cormnis.~ion, QUe?:>M. F. Iv1. ROCllEhC>;k~, Commissioner, 'V(.rkmen's Compensation Cmnmisslon. Quebec. 1.)(\"\!'IwW ROIHlLt\:!tD, WorKmen's Compensa.tion C-ommlsslon, Quebee. EVASl:S'1'B R(lCllBTt'E. C(lmmi8&iom~t. Workmen'a Cmnpenaation Cmmnissio,::!, QU{loo(:. 1. 11. 8X.O,A-NE, S!Uf3ty Dlredor, Canadian johns-M'anviUe Co., Ltd., Asb~6tOS. W. H. SOUT.U~. Asslst.fmt to Mltm MlI,llJtgt!1', Canadian Jolms-ManviUe 00., Ltd., Asllilstos. Dn. O.HfHJ,E SrMMAARR.Oo, W!)!'km~n's Companslttkm Commissi.on, Q~leb<~c. DB. I<~. J, TounAN1X)O~l\.a, Dhislotl Qof Tndustria.! Hygiene, Montl"eaL D%, R A. Trractl'l:, President, Ind.ustrial M~diet~l AeBodf~tion, Mont.r~I~L CZJIH.R-D 'rR.ilMBLAY, Deputy lI.1lnlst(";),' 0{ Lltbof, n{~l>$.rtnmr,t (IIf Lllb(!r, ql1(~bell. L. P. l'~~ssnm. \Vorkmen's ('"ompensation Com.mission, Quebec, JACQUOES VERn.~A1JI,T. StlCc''rree!.ary, Wntkmet'l'a C~)mp(lnsat.iml CQnunission, QuehM, A. C. W.u.r.~tt, SuplJr:int.endcl1t (If Sa.fet.y, Crame Limited, Monttrreeaalt. a",PDR. R. E. L. WWAATTSSOON, MecliNil Dill'ed.or, Crane, Umit.ed, M<mtril!ll S", G~\laGE WHITE, Workmen's Compml~ll.th:m Commission, QUehec, Sas'ka.lcllewan M. D, TH(}MP$(}N, Com.missioIH~.t, Wodonen'~ CompcmSll.t.iOl} ]lJl1))MMd, 0. W. VAAUU,,&MJJ, Ohairman, Wmkm-en's Compensatioll Board, Regina. C. C. WUJ.l.A:M~~ M1niswr nf l:.abnr, Delll%r'tmeut oft Labo!r'. R~giM. Hegina. UNITED STATES Ala&omm J<OmE L. G(jJ,,~;MAN, lXr-ector, Depa~!'ment of Indu~tdal Rclations, Montgom~fY. .:'il'kan$@ G, L Gl'l.,\NT, Attorney, Unitod Mine \Y{)rlnm;, FOr!< Smit,tL {}, W, Ht)LM~lS. CnmmiRsi.oner, W(j~knHm'~ Comp!)llsation C01nmk..si(1), Ut,tle Roe!\:, A:RNOU> B. Snu~$, C(}mmit;$iOflet, \VO):kr.mw\l Compenaatkm COll.U!11ss!on, Little RoddLe Cm!i'r lhtAz[E*, Gu.anmtee Insurance Co,~ Log Angeles, l ... . ,. JOSB1>ll J. G.....l..U.~mml Man~er, St.!lo1.e !1~su:t.ne(> Fund, EUl'lingamv :~C~V~ l'-liiSi)x~u};Ttiii.iti~l{i.h. Ind!l!::td:n-! :\o6!aiiM' 'C<.ihiiiil#1j1i;@m'Vfli6{i1MO::" ! r '.'.:.:" :':,' . , ' , : ":;",,, .... ' :,.::.:..:. :'j::':, ',: .. ':. . .: 231 PA'Ul:< 8C~AR1US;~~)m~G. DJr~ct.ol", Departnmnt m ludJl!lt,riru R~lationl3, S!>,~ Frmm~co. 1)S-, :B:l:lR'l' $, Tig(~MAe, :Department 0(lE1 Emp!oyment., SB.cramento, R. 1M'.L. W1r4{l~. n(!p~rtmont Q{ Employment, Sacml~l~mtQ. Ct,lr;rtjd(j RAY 11. Bi?.A:N'r(AMA:N'~ Cha.irman, I~ldustr-i~l Co:mmission of CoJQr1>d.o~ D~nver, H.&JWLLII}) C. Tif~r,f"SO:{, f>itedor onf Cla.hnl3? SWtt~ Compen133.t,i'H\ In~nfalHe8 'Plmcl, Denveelr'. D. K COtl!:lHUr(, Ha;rt(ol'G Aeoinent &: Indemnity Co., Hartford. Av H. Gftafl, President, Toll Gfi.tH H'~}mw, h'<~r.Yt,nw?l, W. 8. M~:COlimcK. TIllu.{:; Aetns Ca.~lJilty &. ~tH(:t.Y Co" Hn,rl.fo'fcl, D/3llrUiatf] AlBsEL I{uw, Sppdat (\nw!!d, E. L du P,}!lt d{~ Nerm:Hl:tl> & COo,,!! 'Vilmingto<l, D:f. t J, ,MAGor.J,V'~, Mmnoc:t. Indw~tf!8,! Acciil,mt Hl>ll-d, Wyoming, JAMBS A, MnJ.J~, F:i'ffildMt., Indm':triat Aenld.mt Bo\\)'d, Wlllnillgtt,n, PQJ:~3} N. \Y4lt~lMl'!'(l':-;. I\1~mbe'f, ind11:>t1'la.1 Aceidel\t B{xrr<i. L<I,urel, D~'s!ritl of Cclu?nOia A~DREW J. BHumJ.~~, Mi!mbet, NatScmal Leg!al&iUv6 Commltt.oo. Amedc~:n Federlll,i(m of L~j;x;.r', FR,'\NK ,f~)re~mAm~:, As~<!el.ah~ Dl-:-ool,(ll' d Educ.aUotl'& Relleal'ch, Congrilsa of lndtl~tfittl ()rga.nll&~t1on)l< BlitJCZ A. Cll.IHl:-\:E, U. S. Dr:J)l!crtment of Labo!r. ~,\1;L E, (h~R::{ifE:) Seeret~t'y~Tt'{!aI\ul'et. IAIABC~ IUI, f), 1Xl~.artm~l1t of lAl,l:H)t. Dl:'< WWv. C. HV'~!'ZR, Chid,Emdronmel1tai Cancer SN;ti<m, Cfi.nmmKK Institut-B. Depilri,tm~rlt of Healtb. Education !!cend W~lfare, B{lt!1!~8da, Md, Hon, Aftnn.~R 1.<,6;!,t.'}Ol';. Unti{'l' S!lCr(~t,ary nf Lab!)!r', JOH~ Eo LA wnR. Ch~l.rman, Rrrrploy~~ Comp!ml>~t.1m! AJ3~l~~ lk.ard. UVA. 8, f.lr Uepars"mmt of Laho!',. ~1J\ta~B V> !~~~flNt;~r-:g!J..~ (jffi(t~~ tJ1~ S~~~)r~}t&ry<;a.Tt'~~~~o1~rt !A..l .~RC~ "C.. S~ Deval'tm~mt of Lltbm, WUJ.H.M McC.Am.~Y. Director, Bur~.a,u .of Employees' COln;xmMtkm, U, Bv Deptu'tme:nt of L&bal'. FSI\:-<:K ~l(lE~!>.<.y; U. 8, Depn.rtrnetlt ()f f..J3.bof. :F~AJ{t.'l':S C, 8M:l:m, U. 8. D!;Pl1.rtn<cr.t of LRhof. ROlU;!fi' "VfM,' HYNlNtl. Unftad Mine \VQt'~~rs W'0JJfffi.r<3 ~nd Retlrilment Fund. Fwrtdll JAMe CAM:~~O~. M,embet, Imlu!-<td,l\l COlrs.m.j"",>JQn~ T~!l..ah~~"~(\, R 1'. COt~M"'~. G{jnel'a.S Counool, Ind\.l.~trlai COlmn~~$ion. T~~U!l,h~" R,O!}KSY DUttHHIIAAl1IlIlCcSs, Dll:'ector. \Yorkmnn's COm})()R~t\Qn DlvI:llon, Industris.!. C!)rnmiSlSi.m~. T.aJl!i.h&ll>OO. Jm!<&Wl1 A. PARit1>, Or1laando, JAME<> T. VoceLLE, Chairmau, Incil1l'!trial Cm:nmission, Ta.l~l!cha.sSOOA Geargia IhrmAlm \\'. RB~l%8STT>, Se{lretary~Tre&lirilt. Boa.rd of \VOl:'krniln'Z CompennMMt,ii((llll"l, C~}l1ege P~~!d'tkA. W, K Buc:K~H'm, Memb~:r~ lloo.rd (if '\v\wkmM'''' C(tml?en~!I,t~ol:l; Atlanta.. '.: , . ...:. ~ :' , " laM/) (ft,xnQIU) .1. n(!!lP"llQQNN~, 17ef!iden~ :Na..tiQl:tw AMOcl#:tion ~r Selft !naurers, Lew-lleawn. B. W. O:t'Plmn~IM, Chatr:man~ InduBtrlM Accident BOMd, Botw, DAN ADAlIRR., Nationru SWi!ty Council, Chfl1go. H~Nlll' B~,HJfrnAN~ Superintendent, Cmnpensation Claims Departm~nt, Zurlth Q~uw.al Accident &. Ll/a.hiUty In~t3:r&nce Co., 11<d., Clal.cagn. Eu:tt- M. CJ..URlNl>O; Commfus3ionm.', t:ndu~.:rial Comml$.,lon1 Chicago, Fww.E. Fru.:nEft, Directo"!', Industrial Divi&ian. Nattonal AssOelAtion of Mutual C~ua!ty Cll))mmppaa.nnjj~~l Chicago. Mnl, l\h.~omRl W. G~IOW', Co\m~H on Indl.Wt:r:i$l HeAlth, A, M. A., Clii(($go, ES.t J. H1J)BlU,tA. N, Chairman, Industrial Commission, Ohicago, RaB~tn< S. RHOOWWEEl, Lumberm~n's Mutual Casualty Ct)'t Chicago. l), W, Johnstolnl, Corotniw.kltlel', Indu$trl~ ('...ommiasion, Chicago. :D011r'v MMlLwN 11, KMNBNBE:aa, Medie.al Services Miimm..~~lr'. Ost.(lrpiUar TrActor Co., Pe!)rl~ If. GRlN~ Mn,t.~~~ Nst,ionat SMety Cmm~n, Chil'.JlgO, lJooaaN MMOouUuUNN; Conrmi$ijjoner~ Xnd.!lstri~ CommmmiiSSlllll!:m1 Chhiiooaa.g{), Dr. CL T. Ot,si:rlll. ChairmAn, COmmlmltOO on WOl'km~.n1a Gompen~a.tion. lnd~!l'l- ttial Mediool ABBl)~iMion, C'hie$g()v J. A. :PAgiS:n~ww3S. lHin<)is Department of LB.hOf, Chio8&gG. 5.1. S:n:n~N2t Wt-stern El{letrie Co" Chi~o, PAm. S, WIS~., Amen($rt Mutu~ Alllill.ncet Chl~Q. In~U't't'~ ROOWWAAlID T. DBAA'mmAN, Gceners,'!l MMM&&..ggeer a.nd C<immel, I,Yfl(,.h Caa.J f)p~toOr$ Reejproeal AMOOtAtlon. Terre Haute. Dr. fAtv. K HARCOUR.'l', Ind-lamqwli::3. EMANU:lM, F. M~a, Hearing Memhel', Industria! Bt)Sl'd, Indiana-poollmis, lo~iEP~ P. MIi...LER, Chairrmw., Ianldduu~~ttrrjjiilll.l Boord. Indiimapolil!. C, H. G1U;;EN~Yt D$S MoOrianles, Deput.y lIeWm<~'.!. Commissioner, Ktl~.s Workrnen'a Com~.mmtio13 Servioo, ErfwAlID Cmm.Y, CommlsslokHlf, Offi.oa of Workmen's (X}mpensatlon CDommmm!i&s.-. akmer, Topeka.. At~llR1' M. :aoa!l~ EIsm:iner, Office of Workm~m'a CmnJ)f1t1aatlot1 CommilllltOMr, :K~~City, RJAUL>Pl"H J, 'rHoaN~. Ex$.cminel", Offi(~ of Workm~n'$ ComlIDusati-ol.) ('Arumi!!s10n(!r-~ ll~t>clii.mwn. SmE~ W:eltlB! Examiner$ Office at W(l~kmen'a Compensation Commia8ioMf, Pitt$burg. Ket~tu.tky PAAnmt. COM:BBS, Acting Cnrom:i!l!lioner, Depill.rtm>ent af Industria.} r~nkfort, IHI. W:O:UAMS. Attorney CeMl"al, Department of M!.OOl', Frrutldort. Re!e,M!)n~ ";"',' ::.' J(U~M' W. S.AlM)(J, I.awyer. Dtu!gor, Mfl!l. l\.f.~nEl>lNE BARM'ARD, lndustria.l Accident Commiooion. AUg\l5t4. COnn. M, J!jLTt Memberl Induatrial Aeeid~:nt Commlasion, Wa.wrville, JA.~ E. Mrrcl{$u" I~~'Yer, }3.ttng(}f. F. E. RWRA.RMON, Portland, Maf1/Ul1f,d MllLVW L. FmE, ChaitIrut.!l, lndustri&i Accident Commiaeion, Baltimore. Dr, JOHN' V. HOJ>lClN$, BtUMmor~. W. ALS!lR'l' ~:,fENCUlt<lJel, Commissioner. IndU$wl Accident Commleslon, B.alti~ m01'9. PAUL StEMl!l:R5t Jr. ManagefJ Compensation Department., Maryland Caaoolty Co., BaltimOl"$. IbuM R S~TE:a$ N~w Amaoord$.m Oasualty Co.$ B.ttl:tJn:u>re, I fMB(f,Clw,)t~ DR, A.J,;E'X4Nl>3l::a P. A1TXP:N, Chairman, Subcommittee on InduatrlaJ Remtiona, American Ooll!l:lg0 of SUl'gcot}$. Brooldio!l:l, Al,PRON&E S. BACSOROWSKl. Attorney, &.1em, DAVIln D. B.u<u. Emptoyern GrOl):ps Ilji,Jlmwl>OO, Bost..()n. THOIU.B lV. BS:)'IVE, Mmnooft Division of Industrial Accidents, BoBtnn. 1Itt. B. COOl'Eft, Director of Medical Rel.&tiona, American MutWIJ Liability In- auuw::e CQ,~ BostQn. E~o~*lI!l 1H1, Gu~oux, Chllirm.B.n, Divis.lon of Indus-trial A~)cidents, Boaton, F~*lt, E, O)O~. Di:reeror of &!If-Ina.urancej Divl!!totl, of Ind~llft.d$.l A~cident,a, B0o2oWton, BTANwoon l". lIA.NsoN, Assistant Vioo President, Liberty Mutuallrumrance CO'I Boortono. G, B. H.AlILAN, Vice Presiden:t, American Mutual Ua.bllity IOI3'ura.noo Co., Borltm., Juu!:s G. BAlll;><Zny, Atto:rney~ M~husetts Bonding and In.aun.nee Co" BooWton. M.ARc:EtL!.J. 1ft CKB~ }3oaton. M.un: F, HICID}!j Members Division of hulWltri$.l Accidents, B!)&t~n. :&IrM!l J. l{l)M)II'I)f,XMl!~ M~mOOl'. Diviai()ll of Indwtrml A~<:i>d~'Uta. B08tQn. EnW.AJ1D J. Mn:aPRYj AttomeJ'. RBMoottool1n. M.uty A, NOOONN.A&NN!j Boston. M.l$~r $1, ~"'"~, Oounijel. T.libel'ty Mutual Insur~n.ce Co,} ~n. J()6SlilPH A.SULLIlVAN. Ohief E:wmin~r~ Liberty Mutual lrulU:ranoo Co., Boston. Maws. EMMA. S. Tom!!....!'!'!', Past Presiden.t, IAIABC, Qumcy. Michi{jav, W. CCl, E.flIHtOI';, Manag!!>1', State Aedd.1nt, Fund, LM~ing, H ...n~T F, BIU~t~~. Sll~cin~n.dl2>tlt of Cla.lme, Sta.w Aceidlltnt Jl'und. La:nsing. WXl4;XAB4 E. DUCl:(ANAN, Chryasler Oorp., Detroit. C. E. CU01'RE:as, Fo.rd MotOr C'.c., Detroit. Jo.RN C. CatLI>E:a.s, Lincoln M~:roury DiviSion, Genem! Motors, Detroit. Bfl:. A. Co~r~.Av, AttQrney, St~t,.e Aeelnt Fund, Lan:sing, WIWAM I. I);g/,v:$lm. GChryy8s1ler Corporation, Iktroit. Onus,E, DURIO. Chryaler Corporation. Thltroit. JAW!l~ L. Hru., Buper\'laory Attoflley, W!)rkm~l:l's Ct)m.p'~mBb.U!)al ~(StlOtl, Ford Motor (Jo.,Detroit. . .... .a3.i!~~~l~ , ,;" , : . :, ; " , ' . <':', W. G. H~'l'Clfll:gl!!a, Compenm.tion SU!)!'v:i<lm-. Cbry:;ler Corpo:rraa-tHJoo?nl, D~trolto G~~M~ F.:. JmH1S(H-t, M$,MgM, iSmployw ~tviN)B l"kpa1't~\I.mt, Ford 'Mot.or Co., Dearhont. WX;.,tVM J. J!)~r..~, Laccee)y", Jones & DoooeUlle, Detroit. F. A. LtiX, St~ Attm,"l}~.yi WOfkm~:n.'1S Com~n&1.tlon Section, Ford Motor Co., Detroit. WAl):E H, M:(~GltEE., J~" Membm:, W(!rkmen':; Compl~1i5$,tior:. Commisslon, L,,'l.""~iug. W. R MAcGn~(Kl~} Vice Pre::ddent, Ml!lhigll.u MU.tU~A LiabiHty CQu., D~trolt. Bl:t>r..'f.A.MON MAltCUi3, lrepra~nting S~mllel B, HOrovttlS, Mw~kegnn. IbclM.M 11. Na~m~$, C~u?Y<l!~r CorpomUorl, Detroit. Routm'l:' L. O'Cll);':-':BU" Rot.he, Mm-eaton, Bohn & Ma}l~.y, D('troit. 1'nzono:n.m p, HY.\N, Ci:Hl.cll'lY!an, Worknwn's Compe.MiOt:ioll CQltlml8Skm" DiinmHomn- dale. RrcffAlw L ikH.\lJV1'~ Intern.atkm..al ReJlresetlb,tive, Oom~xmMtion r.kp~l,'tlmmt., UAW~GW, D<)tt,,rrooiL A. A. B~~M1T'l" Vh~.. President in Ctus:rb<e of Cl!l.lmS!, Carpnmt,e &~rvke, l!l('" Detroit. Flt~D S, WhlH"~, Attorn~y, Auto OWll~l'S ,l!l);UltMH~e C<~., LR.1!sing, 111 t1i!1HlS'(llll: M igg-sssipp-s S5iA\.M B. ALLKtO. O\)mm!.!';..'*:mel:'~ Wotkm~n'e. CommppeennSSll'ttio,l Commission, Ja.CklilOil. ,jjOmi'-HtN;> IAt, Ca.-AAWm, Chaih.!1.$ll, Workmel)'s Compew3l3.~1~>fl C,)mmssskm, ,}'!!.ek!\m~, M~uri Wl1"!,,f.HI1 n. lklWH, SH~"~il'int~ll<h~t!t, \Vol'bmm'13 Cmnpl.m13ati.o!1, Am~l'i~lt?\- A!';..'l(l(liar,(:d :rn~mfanoo ComplI:.uea, St, Louis, CUUAA::nnu:lS E. CA~S, Me-mbe~, !ndustdM Con~~llls.$km, Jeefff'eroon City. EA:R1. FA ORBBMfl', A;,,.L,,t-m.t plf'l)t~$or, St.v !<(B~il> Utl:ivtln~ty, ~t Il,<Q:mtti>', R. RORl'Jm:' CI)HN, /\t,t.orne:s:, KanAAS City. D W. E. F~:Bru..AXtl> l\f<;rm,ht:f, Illd:Uliltrlru COtnnl!8Si(lll, Jefnfeerson City. S~l!)XCl:'~ If, OI'''~S, Dit'Cctnr, Division Br Wt>tkmen'g ('A:.mpmtMt'im!, Jl~frernan Csty, 8 .ENHlN J, M~u,li:rr, ClmirffiM, h~dustriai COmml!!!!mn" J{3ff~Non City. Ml:m.f.~n,<t W. W. CAi3I'ER, Secretary, IndtiEtrlai Aeddell~ BQ~nj, Hekllu" Nww;;. JiJl'$f}!J WINWDN ELAN'N', Clhlllbh & SnnB, Mam~,gl;'!~, Fedem! Tll~l!mWN\ Gn., Riwrt Hmili>.), D~. H. B. B~HH{1?,R, New LM~ll. CAm, HorAl~II'l~M~N, C~Hnm~:3Sioner, D~partnwnt of Lahort &: Industry, Trenton. DA:mmL A. St'A1H, Director, Division.of Workmen'g Omnpenaat.imlx Depa.:rtment oOfl Labo!'.&: Inrluiltry, TroenMtotmll. New llfexiM E~f.lN'~%~I~ JO'l<ll"S, .~i3Sistant CornmiMion>er, 141.l:iot' ~nd Ind.ustrial Oomm-i"~'4$I)(l. S!!.nw, Fe. ":,'" ":.. . . . . . ,',',', :,:: :.:. :-'::.. ,,: }"tew :Vcrx, E'r1i1~~ R AI,D$~, Mb,afna~ng~geerr,, Ct~lm~;$o Sruety Depll.rtment, ~m'}'~Vru.~mrm 011 Co., Inc. New York, Loms AaBE1'l', Adtlary, Wood-ward & Pondl!ier, New York. FFLt DUDLll:T Bn:RAu, Dimctor, Coml'ensstion ,& 8iJ!ci:r~ A'i'nmem:; Loemuotive Co., Sd:mnectMY~ M1SS G~R'1'R!Jl}E CAYV'AANNAAlJGH, W{lrkm~m'l': Cnmp.ms~tloX! 'R(!t~:fd, Alhany, n.>..,ntONJ~ A, CAY~m::-r, Vke Prosiuetlt, :Fidelity & ClMlualty CO.r N~w Ym'k. OUV'El!: '1'. Ct.AYrnN, New York, Ml;1UmAJ.L. DAW!>(HII, P.Mt &-crctli.ry-'f~a.'int'('r, rAIAHCe, New York J. A, Dl!:N:&IlClt:l!;R1:$ SetreM.l'y-ComptroHt>I.', National CouncH on C;}:mpe:mmtkm ln~ttnmee, New York. aj>;:NJA*r~ :thSB!N, St!lte lmmr<l<!lce Fund, Ne,,: V{nrk. Mn~g Ma DDOoNmLoONN', Chainmw, Wor,knwn's Cmnpensa,tkm BnlU'd, New Y<.:,rk, ,r. R~U'}i lhra:s} United Stat{N'"l C~"'a<ttty C.o., N",w York. JOSE~fr DEAN E1HV,\:lW3, AttOl'W!1, Ntw York. IhcfrARJ} For-rarw,zR, 'WnQdwlinl &:: }\}udHlm" .Ae<,, \\jl'IC G. EARt,}?! :F'():;{, fk.t;retll,ty. C~"liU1ty .D1vl"lotl. Gkm;<; Falll'l Itl~lli'Kl)IX~ Co., Glem8 F~lb, D:n,L~OJ'Um) J., GOr.O"At'Klt. Natkma! Qhalrmat!, Ca:rdiac,m,;,l:~d.l3i!try C(!m~ mittee, American Heart ASSMisnon, New York. W.LM8 C, CO!IT!H. C. E" Director, rn~,H'it{~ for ilw Crlm}il~d fl.nd Di!!~hloo, New Y{)rk Ml:&'S JSANElTI.'E HAN1,ON, A~}(:i1>.k Enm<!lHi~t, Wodwwn'<, O>mpensatiof) BnOOMa, Now York. ALl"R:t!) Hil:1N'1'l~? Utntitt:!d St~[workers \)[ Amt'ril'ft, BI,lfi'.ah TW::OIK,*E H~:TSS3,~*,J<4, At.wm~~y, Nll.t.ion~i t\'l.-mt'istil)!', {;f Mtlti\M Cw.u.!.lty Coo., New York p, H, H V~l>!l~l:E~. A. C, F. bdu<,l rjes, },;{~W York. H.M. JAC~I>.{m, Manag:(\t, fnd\lst.l'lai Ih:alth Program.) Jo.lU!8 MhlWm(1 Corp., New Y.ork. A:~H~Rl1lW KALSIl'lKOW', New York, ED"&'1N D. I{YL.f.l. CQu.n:;eI, New York Com}~nsatlon blS!JI.'Ml(~(~ Rli'.ting '&iru-d, New Y~rk. M. L. L.<\SK~Wl$ru:, Wi)st{;mmfHltr!C CH., Ine., New Yrk, JOMN' 1\1, lVrcDQ~ALD, Di:tedor, W!)r,km~n'!i C!)m}wtlS.atkm, A"m)dat.~!d lwiIJ~h1~s of !'><ew York Stltt.1l, [nec" Al!)a.ny, Rl:m~.1t~ r:;, MA~'mM,l" Admlnbtm~ij{(l Depnty, \Vorknwn'~ C<.'lnt}X:llMtk>ll &ru-d, New Y~rk G1S0R~~ E. MMmm::,':ul.:,(W;.i>"N, Malll~>gter, \\\);tkWell'" Cmnpen!:le.!,l~>B .~ nl~hulty Ciaim~ Divl!!!011.Amerir.~Ul Sn:rel,y Co. N~w Yoorrkk. 1VhCcRRAEL J. MmtNfV, n~m~ra! Mana~~'('. AI'"o{'it~tim! of N.>w York Bt.AU< Muhm,{ C$m~ity COil., N~w York RAY J. O,HO..1'lY, Stat~ tm'HH'atl(~ Fund~ Koew Yor,k. M1iS~ M:t,<A.l1A'la'nan~~~~ PQJ..Jd<OV, 8cim;J?1>:tY, ttJhn~U~tA!ld 8t.cdworkefll of Anl{3rk~ Huffa.lo. Mr~s MAlt;; Pm.m8::~W, Hulfnlo. JAMl!:S J. RJ;;(L'-.N, Secwtfl.ry, TIlH1~ &1f-Il!Su.ror8 A&",,}(;,Ul.tlon, New York. R. V. RYAN, FldeH.ty &: C$SUlltt'Y Co. (!f N~w York, N{fW York, HENRY D, 8AYli<8, Genera.! M~magct, }N';{m~wYYoorrk Compell!3a.tk"nlnsurIHlc~ lmMt,ltntg BOm'd. New Y(jerk A. M, Bcma:l1M>t1Hl,))'l', !nsural}{leMa!l$.ge:t. Nati<miU Cmmdl <~3 Sta~ &3lfoln!lu:rera ABIIllooee\at.iO!l, New YYor,k, ,,', " 1H9IM MEETING OF IAIABC J.uma R. SmELDa) Attorney, AmeriCAo Telephone &, Telegraph Co., New York. Cntm Po !hiY'l'ttl!lr ClaiID.a Attol'ney~ New Ym:k T(llephne (h~ New Ym.-k. Wru.rAl( HN, ~(lLrl'1!l, A~Mi~t.e Attorney, SWte I.n~\I~c(! Pun.d, New York, $. H,3,aaT Ttg~NA!It, Att(lrn~y, UliiUld Stoolw()rk~a'S of Am{3rit)s( Buffalo. W~N C. TuclII>U, CouMcl, Utiicca Mut.uallnsumnoo Co., Utiicca. GEO. D. Wl!lLtS, Western Electr[c C<l., 1IMM.., New YOl;'k, N. Mj)oo-W W<l'O!)~, A~latiotl of CMualty &; Surety Cos' l New York. DDRR., M. WruJA~ Zucn:a, Dlre~Wf of Studies, Com.m.e;roe &: Industry A.&rocistion of NEiw York. New York, North Carolina J. W. BEAN, Comm!aal<lner1 !ndustrW COmml$S!l)n) &lelgh. N (Jrtk Dakow Orls IhlTAN'l', ChllJrmmll:Ul, Workmen's CompenMtlon BUU11'9Su. Biissmwnk. B. M, RTYAN, Member, Wol'kmtm'a C<lmpenaation Bureau, Bism.arok. ()h~ o H. D. BANOEM', Emil.e.E. W&iBon, Colnumbu$s., JACO~ CUY'fMAN, Secreta.ryTreMUl'er, Ohio cro Cou.ncil, Cl)l~mb~ .1, Mlo,mA~U!D,l;c~MQti, Vice Ohhairman, Industrial CommilSSion, Columbbuws. g, G. G<mlWOEl.t.&Rt Superintendent of (nru.ma~ Fa.rm Burteau MutuaJ Au.to Int:iU!1Wloe C-o., CQollu.mbus. W. O. H'\J.1'AN, Attorney. Squire, Sanders & Demp$ey, Clevehmd, M. HOt.L4.Nl) KRIrSsE, Director, Workmen's Com:p0ngati()n~ Frlgid&.!.re Dhdsion, Gene~l Mot.om, D~yt.Qn. JOoaHNN KKUm(t'EL, United Rubber WOl'k~l'S, Akrotnl. ttWHARO W. MOlmE. ChaJrman, Induat:rinl Comml8Sion, Columobus. CCHAAllUU..''EE$ F. Nt:1'l"t'E:a, R F, G()odrieh Co., Aknroon. Tuo.MAS M. HAARRMMAANN,,JJOOttlleeaa, Day. Cockley &; RIe.a:<,'ls, C~\'clMd. Oklahom.a Fun Auu!:n'I', IndU$triM Commil3aion. Okl!iliQJXlA City. MMA.uRtXx CCaaTThhDDEEmm..,, Indmtrla:l OmnniS!lto'll, Okla.homa. Cit,y. JUunDGGEE ALBlliR'l' O. RUlJN'l'. Industrial Commission, Oklahoma City. T<l'M G, 'MAaTlN. Cotnmissiouef. State Insurance Fmlo. Ok!allQma City, 6fo~ It. POW$lifl. Chif'$ Att-omey, Stt~W !mmrM1CI1! Fund. Oklahoma. City. &, J.SmUl!L4.Nl), IndU8t.:r:i~l Commission, Oklahoma City. OrefJfJ1'4 L. O. M!:NS, Memool:'J Industrial Aeciidll}nt Oommiseion~ SSaa}}l}m. WnJ:,u.~ A" CAAJu;...WA,BBAANN~ Chairm!l.n, lnduatrta,! AC(lideut Comm~on, &lem. P;mnlJlII~ania F. It. BAliNAlto, M~t~f, Compenee.tkm. ~nd Safety, Bethlehem Steel co,~ BElthlehem. FRAtUr K. B().&L~ Deputy Soof(ltary, Departmen.t of Labor and Industry, Har:rm. burg. A. C. CaammSS'l''lM'MA.tf, Chief Supervisor, lndcmnit.y Insll'I:Ulce Co. of North Amerriiccaa., PhhiilAAddeelpphi..aa. W. D. COULl!lYr Seerota'ry, Fif~ Assoeiu.t,ion of Philadelphia, Phllad~lphia., E. GWIU.J:AM, Ms,nag0r, St.ate Workmen's Itl.lUt'anoo Fundr HM'rll3l:mrg. R. M. HAR"'..ffll,U:N, ~ AM~~t t Ma~:r, Compena&tmn and S.a.faty, B~thI(!ham Steal 00,.. m~~lmm. ," .,' , ;. : ..... ..;,':; . : .. ,:', :/l::"} :., ::'" 237 RoaJl:m' 0, HERONI S!~peril~Wndenl. 'C<tmpeuaation Chl,im Department, AmerieM OasulUty Co., Reading. RUSSEL C. KE1S~1!., AMliztant M&nQger. St.aw Workmen~6 Iwm.mmoo Jl)}nd, HfJ,t'rllsburg. W..illl'llllt LImNN., &ere1:afy-TreMurer, N~tiotl~l Council oft StB.W Salf~:tru!~ A800ciatian, Philadelphia. JOHN L. N.I\..yyttii:lR, Director, BureAU cofl WOtkfllil}\tg Com~noo,tiOn, H~, F. Pltt't'CgAf!.D, Chief Safety IU13pect(lI'l State Workmen's Ins~~ ~ B~ burg. A. 5CmtO~Di:.ft, General AttornilY, P'ennaylv&nia Railroad CO'$ PbilaOOlprua. l)Avm M. WALPE, ~ret;.(ry, DeplUtmellt of Lillbol' &; Indm;t:ry~1I~bu.rg, P'wrl(J Ric(} Mies RA.Ql;)'EL.N,!(a. GUCNt,M(lmb(!T', Inn!1Btfiru Comml!S..'1ictl, 8&Mn. Juan.. EnUAltDO A, SAN'flA(l{), Actlla:ry, St!l.W Iusur!l.nce Fund, Sa.n Juan. Rhode 18land ANTONIO Drt PrNt'o. gl(~3c!~tive AEml~t CUfll.t.ive Cenwr, .D(l})~ment of La.bl)l\ Pl"ovit.ienoo. DR. JI.)e::NN E. DON~~Y, M.edkal Director, CurAtive Centef~ Department ofi Laboor, Proviiaaenoo. Stw.~h C'aroliM M.ISS F.Hl'tr CUY'l'ON~ COmmi8l!lOner, Induatdal G\)mmi$ion~ C<Jharnbi.a. JA'M~a J. R~H.>. Vice Chakmllul, Itlaustrillil Cmnmtssioll. Columhia. MI;lL H. S. T &1.'&. C(lJumhiQ. w. n, W.l!' P,um.ll.M. Co:mmii3Sion~r. Dep~ment. of LB.b<iI', NB.81wille. I~AUL A, :rHU..t-IP.I:!, 6at{}ty l'~nginem', DepIII:.rt,ment (If Lwahhooilff', N.aBb."Uk Dsw~y Wamu:, Direc~l'. Divi8ion. cli Workmen's Corn~llsa,tJon, Depftrtmetlt of LUabboor. NoohviUe. Da. Vv C, .BAl:f!.D. Ch.ief PltY!lieiftn. HUlnble OonH &: Refining Co., H1)mton, IRt, L. ECl~,&I[AN, Vir.e President, Petroleum Ca.sua.'lty Cov~ Houston. 14,11. F'l.:f1WEUo&N, Oba.innlll:.u, Ind(!~t;i~ Am,ldeut B(lard; Au,etin., F'illUX A, RRAA.nIEH., Pl.'ooidel1t; Petroimuu CMUruty Co., HOUlstcn. Virginia MRS. C. B. RrrC!f. Iticnm(ma. W. H. NIC!t.lELS, JR., Ch~it'm.!l.n, Dept~rtmeut Hri Workmml'a Compenaati1)ll. Riebmond. ~r@Mnutl)-n ~~:a It K~N~ulDr. Superv~or, lteh!l,hmtll.tim~ Cente.r. DepiSbrlment (If LabQl' $Xld lnduatr-les, Olympia. W Mt Virg~~tdt; Da. Joona'tN-t p, BB1lUUCCKK. Ohrul.'tnam. (){leupationlll DIB"'.a..'I~ Medi~19 Board, Chartestan. F:ru..N:KU~ W. KERN. Executive SeCl'etary, WOl'kmen's Com.pensation Fund, ChID'lootou. R,moLP.H: J. MtrRl'l,,*S'!tl', l~g!\J A88i..'It~nt. Workmen;e Compenaatil.},a Fund, Ch.aarrlleseton. .. qJJ!!::~~~~((11~.~.~~.. S!~~r~~.,q~~~1t~~..ii??~~))~~~~!!....JJ..YY::~~~~..~~!!''99~~~..~~HH...99~~~~..~~pp''~:~~.i(!.n..F.:tlI!.~~. 9.hh~~llaa22tt(o)n .W~~""m ,. :"" .... ':", ,....,.',.',.' ':;:. " ,.,;., . .: .. . :.'" , .. , W~~ ~~ I. HAroUO%~ Attorney, Milwtl,ukoo-. B/E, KJJl\\~, V'ioo ~dent~ Empl{<y~ MlJtt~> W~'OO~u. M~~l~L:ii<~~. ~t~t, Att1)1':MY t'~l3It~l? M~:n, J'.'E. ~l!lft. ~ tklttwe.l, Esllt~yem Muturu~ Ws'l.uM\l, ~y A. N~*. Dkootor~ Wm%ml?fIla Co:m:p@1l&iiorl, I~d~ ~ , Commi*,km, YbWA W~<i_ 0h~l:'m!w'~ lndu~ Cmmnimli{<u. Madfrotl. WWI}m~ W~ p, '~~'t. Me,n~i, W{~rkmat/& Com~n..~ti~n Cmnm.mal:ml~ Ch~"Y<Jw~ "::,:':,, , '",' '''. :..:. 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