Document 6wvB92zOmoQLJDDK3bBYaxRKg

FILE NAME: Metropolitan Life (ML) DATE: DOC#: ML DOCUMENT DESCRIPTION:>KZt^:D W ..., . i that such airline respirators were "on the market," he was fully aware that they cannot be worn except by a person who stands in one place as they have to be hooked up with a rubber tube to an air line. I doubt if they would be practical in a textile plant." Exhibit: "Questions Asked Dr. A. J. Lanza and His Answers Verbatim," forwarded by s. Williams to A. Fisher (August 29, 193.3). 3034. Asked whether the workers should be warned of the hazard in breathing no such warnings should - asbestos dust, Lanza responded that be given,_~especiaIIY .. in view of / fi the extraordinary legal situation" (presumably a reference J. to the recently settled asbestosis suits)~ ./ Exhibit: "Questions Asked Dr. A. J. Lanza and His Answers 'Verbatim,"' 'forwarded by S. Williams to A. Fisher (August 29, 1933). 3035. 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' : . . . .1- '..,. 1.' ...... " " ' " .. , :...,. .. ~~... I QUESTIONS ASKED DR. A. J. LANZA AND HIS ANSWERS VERBATUM Question No.1. Among eleven employees in the Textile department, all exposed to asbestos dust, one only wears a respirator, several on being questioned claim they cannot wear them continuously especially in hot weather. Should all employees be forced to wear these respirators whether subjected to much or little asbestos dust? Is any such difficulty experienced at the Manville N. J. J -M plant or other places of which you have knowledge? Answer: Respirators are not satisfactory. It is possible to construct a respirator which will filter out fine dust, but it would offer so much resistance to respiration that it could not be worn continuously on an eight hour shift. There are on the market small face mask respirators which are equipped with positive pressure and these are both satisfactory, efficient, and comfortable but they cannot be worn except by a person who stands in one place as they have to be hooked up with a rubber tube to an air line. I doubt if they would be practical in a textile plant. Question No.2. Do you agree with my recommendation that employees definitely be made aware of the fact that asbestos dust is hazardous to their health? My idea is that a poster be placed at one or more conspicuous places in the department, signed by the physician, stating that ~pe dust is injurious, advising the continuous use of respirators while at work and cleansing of hands before eating lunch and after work. Your comment on this please and particularly is there any additional advice that should be given? Answer: This is partially answered by No.1. I doubt if the hazard is sufficient to justify warning posters as might be used where lead, benzol or carbon monoxide are concerned. This is especially true in view of the extraordinary legal situation. If anything is said at all, ,;it would be better to make a general statement that the Company is taking steps to control the amount of dust in the air for general health purposes. Any action contemplated at Waukegan would probably be influenced by the experience at other plants of the Comp,apy. -2- Question No.3. Do you regard the findihg of asbestosis bodies in the sputum as pathogenesis of asbestosis? I have one employee with x-ray and physical findings pointing toward asbestosis but not suffi~aently definite that I can be positive as to whether or not she has asbestosis. However, every one of four or five specimens of sputum examined show typical asbestosis bodies. On the other hand, is it possible for a person to have asbestosis and not be able, with careful and thorough search to find asbestosis bodies in the sputum? Answer: The presence of asbestos bodies in the sputum only implies that the individual has been exposed to asbestos dust. I am not certain of the exact pathological significance. My impression is that the presence of asbestos bodies in the sputum indicate some definite lung pathology. I believe it' 'is quite possible for an individual to have asbestosis without asbestos bodies in the sputum. Question No.4. Are you of the opinion that the added information derived from stereoscopic films of the chest justified the procedure of taking a stereo on every case that is to be x-rayed? This is the conclusion I draw from Dr. Pancost's talk in Chicago. Do you consider it advisable and practical that an x-ray film be taken of every employee in the Waukegan J. M.plant who is exposed to asbestos or silica dust? To date I have x-rayed only those cases suspected, from history or physical findings, of having asbestosis of other lung pathology. Answer: Stereoscopic films are better than single films. They are also more expensive. In our work at the Picher Clinic, we used single films simply on account of the expense involved. You can diagnose silicosis or any other form of pneumoconiosis from a single flat film. On the other hand, you can probably get a more complete and accurate idea of the--exact condition of any given case from a stereo. If it is the intention to determine what may be the extent of pneumoconiosis among employees, obviously the only thing to do is to x-ray all of them and then correlate your findings with the length of exposure and nature of the job in order that you may get a fairly accurate idea of what the hazard is. -3- Question No.5. I have made a diagnosis of asbestosis on an employee who has been working in the card room of the textile department six years. This place is extremely dusty. He is not disabled. In my judgment the best disposition of such a case is to remove him from the dust and give him a job in some other part1lof the plant. From your remarks in Chicago I believe this was your advise as to the disposition of such cases. Answer: It is difficult to answer this question. I think it would depend upon the manls age, the nature of his work, his length of service, and other considerations which might have some bearing. If he is well along in years and shows no disability, it may be just as well to leave him alone. One of the difficulties and vexations in trying to deal with the problems of pneumoconiosis is that economic as well as production factors must be balanced against the medical factors. Question No.6. We have what seems to be an unfortunate situation existing in the fact that the asbestos textile department including looms, twisters, pools, etc. occupies one side or about half the width of a long building, the other side of which is occupied by the packing, brake lining and other departments in which there is very little dust. The card room, or most dusty part of the textile department is isolated by partition. Further isolation of the textile department involves considerable expense. Should or would you be guided by the dust counts and other observations in these adjoining departments? Answer: I think the answer to the situation outlined in this question is the control of dust in those processes that cause it. When everything possible has been done to accomplish this result, it may then be necessary to isolate or confine the dusty processes so as to avoid needless exposure or other employees not concerned in these processes. This is a situation that occurs in many different types of industrial hazard. It calls for nothing more than the application of common sense to the problem. RECOMMENDATIONS OF PLANT PHYSICIAN FOLLOWING EXAMINATION OF EMPLOYEES IN TEXTILE DEPARTMENT AND COMMENT BY DR:" A. J. LANZA 1. The provision of the best type of dust collection and exhaust ventilation equipment. Comment: By all means. /1 2. Personal respiratory protection of an adequate and approved type for every employee in this department. Comment: I do not know 3. Employees in the textile department should tactfully but definitely be made aware of the fact that work in asbestos dust is hazardous to their health. Every reasonable effort should be made to induce them to war respirators. They should be instructed in the necessity of thoroughly cleansing their hands before eating lunch and after work and provided with adequate facilities for doing this. Comment: I think this is out I at least' 'for the present. Personal cleanliness does not enter into this problem. 4. I advise rigid adherence to the factory manager's order that no employees we hired or rehired in this department without first being examined and approved by the plant physician and further that no employee be transferred to this department without first being approved by the physician. Comment: Absolutely correct. 5. I advise re-examination, as indicated, of all workers in asbestos dust and x-rays of any suspected cases. I consider the reexaminations and the continued study of this hazard and its effects of more importance than the first examination. From this point of view, the study of some of these cases may be considered complete. Comment: Entirely correct, with the understanding that no examination without an x-ray is worth anything in dealing with Pneumoconiosis. 6. I request, if possible and approved by Mr. Williams, contact with some authority on asbestosis who has x-ray films showing the condition. This for the purpose of comparative study of our suspected cases. Comment: We can probably help you in this if your company is willing. 7. My rejection of Marie Lutenski, made at the time of first examination, stands. Comment: This is outside of my knowledge. 8. I have deferred rejection or classification of Dwain o. Bell, first: because of the delicacy of the situation which might arise in connection with his case, and secondly: because it is generally believed that removal of a worker from the dust will not retard or affect the progress of the disease once it is established. Comment: Ditto. '. ..~~ " . ~., . ,'.-! .: -' ~ I. ~: 0 \ . , :0" -..... .~ _. . .... eo I. ,' - ~ " '., , ... . ... - ~ PLAIKTlFf'S PHIsrr 3917 \ General. Headquarters; Al.rJust 29, 1933. Personal & Cgntidential Mr. A. R. Fisher, Manager, Manville:Factoty ....ol~ r'~ 0-:- c:.m:;snCttS ASl<ID m. A. J. LANZA NfO HIS Aliswrns \'EREAIYM J<ot:tcaJrPI Attached is COW ~ by Mr. s office of questicns asked Dr. A. J. I.anza by cur lcx:al {i1ysician at Waukegan am his answers: also tr.e I'eCCIIlTlerrlations by our plant physician. I WOUld like to have yaJ turn this over to saneone ",'ho o::uld reviecN this cone::,-p:n:ien:e ard then go aver it yc::urself a.rrl writ.e me yOlr ~inir.n of it. ., 0 s. A. WILt..INi'S, cc - HI'. J. P. Y.ottcacp Wauke;Ful Factorj -iMJr k~ IS fa4 re,;5 i . ..... . .. .. ~\. '." "0 .......!' " ... .'... " , , ..,,". , . ' " ".~' .. ' Qt;"ESTICNS ~ m. A. J. I.ANZA AND HIS ANSWERS VDW\lUM Question No.1. ':" ~ .,.:.:,r :... .' -.0 '" :. , t. Azn::n; eleven erployees in the Textile depart:me.nt~ all exp=sed to asbestos dust, cne ally wears a respirator, several CIl l::eirq questioned cla.i.~ they cannot wear them c:x::nt..inuously especially in hot .\o1eather. , , ShcWd all errployees be force:! to wear these respirators lWhether subjected to DllCh or 1ittle asbe:stos dust? Is ~~ diffic:ulty experienca:l at the ~ille N.J. J-M plant or cther places Qf,lmic:h yc:u have }cnor,.Iledge? ' Ans;.."er!' ~irators. are rot satisfactory. It is p::ssible to ccnst.ruct a respirator loIhich Will filter 0Jt fine dust, b.lt it wc:W.d offer so DUCh resistance to respiratiCll that it cn.Ud n:1t be worn o:rn:inuoJsly a'l an eight' hour shift. 'Ihere are CI'l the Jnarket small face JDa.Sk respirators wen are ~ipped with p:::ISitive pressure arxi these are b:7th satisfact.orj, efficient, nd canfortable bJt they canrot be ~tn except by a person who stan:is in one 1ce as they have to be hooke::i ,up with a rubber tube to an air line. I .Jbt if they ~d be practical in a textile plant. ~...ions No, .2... " , Do yoJ agt-ee with JIrj rea::nuerdatiat that erployees definitely be made aware of the fact that asbe:stos dust is ha..zaI'dals to their health? My idea is that a p:6te.r be placed at 'me or nore cx:nspio.x:us places in the de- pa.rt::nent, signed by the }ilysician, stat.in;l that the dust is injuricus, advisin:;r the ~ use of respirators while at work an::i cleansi.rq of hanis before eat.i.n:1 lurch arx:l arter work. Yrur 0)1 .Ie It at this please ani partio.llarly is the.re arrJ additional advice that shc:ul.d be given? ,Ans".Jer: '!his is partially answered W No.1.' I doubt if the ha%ard is' sufficient to justity wam.il1; posb!rS as might be use::! \.bare lead, benzol or cari::on JZX:)nox.ide are o:n:::emed. 'Ibis.is especially ~ in view ~t the ' extraordinary legal. situaticn. -If anyt:hi.n; is said at all, it \.O.1ld 'be better to make a qeneral 5"tc\,tement that the Q:Dpany is ~ steps to cxrrt:rol the am:::unt of du!;t in tN! air for qenera.l health p.u:poses. 1uTf &ctim CI:C'lt.em- t_0/ t~\ows J 11 d (j)fi-It' ,,' {h~ ~:.' . : . ' . . . . . .. .". ,. O . . ; ' . : . i . -- ,'. ., '. , -2- i. . "> t. . . . . ": . . . . . . . . .. .,. ~4'" .... ' . ' .' ~ ~, . - 1!S ID ycu regard the firxi.i.rq pathogenesis of asbest,c,sis? of asbest,c,sis b:dies in the sp.rt:um .. "- .1' tcwa.n! I have a1e eaployee with x-ray an::l tbYsical as1:est.csis tut lX:It sufficiently definite that I firdin;s pointin; can be p::sitive as to whether :me.~ of or not .sputum e&xhaemh.i.anEsdasshbeewst,tcy,spiisc. alHaoswbeevset,rc, ,sfiNsebryx1Qi"e)se.ofonfot.Ihreoorthfievrehsaprde,ci- is it possible for a person mx:t 1:hcrcugh seardl to tin:1 to have asbesto!;i.s am net be able, asbesto!;is bx1ies in the sp.rl:um? . with careful Ans"...Ier: s:~ -' ~ ~ presence of asbestos irxtividual has been exposed to lxdies in the sp.rt:um mly ~lies that asbestos dust. I am not certain of the exact patholc::qic:al signific:an::l!.. My ilq>ressicn is that the presen.::e of asbestos lieve it lxxties in. the sp.rt:um .irxllcate sane definite is quite p:ssible for .an irdividual to have lurq pathol~. I asbestosis vithcut ~ asbestos lxxties in the sp..rt::um. ~onNo.4. Are yaJ of the cpinion that the adjed WOlT.\ation derived fI'Q':\ .oDsntr..eer~ veeors' ycocps aiscefittlah.rla.kst ioinsf Cttohheibccaeghxoe-.srat y.j.e.uds?t"ifi'lehdisthise tphroe=oe::hnl:rleusoifont.aIJddr,rqer..a.f sftret.r."."leO be taken to you a:nsider it edvisable arx:l of fNerj axployee in the waukegan practical J.M plant that an x-ray fili:1 \Who is exposed to asbestos or silica dust? fran history or }:hysical To date I have x-nyed ally those cases suspect.a:l, t.i.n::1i.rJ:;s, of hav.i.nq asbesto!;is of other lurq pathology .AnsI.er: llOt"e stereoso::pic fllins expensive.' In cur ~rk are better than single tilmS. at the Picher Clinic, we U5E!d '!hey are also sin;1le films sinply a1 ac:x:::o.mt of the expense involved. YO.l can d..iagnc:lse siliCXlSis or Mry you other form of }nl!tm c:x uiosis frdii a single flat fillll. can prt::bably get a JD:)re cx:tqJlete an:! accurate idea of on the the other harrl, exact cxniition of any 91ven case fran a stereo. . . ~osiI fsi tami s:rgt heea pi nl ot eyne te.si,a lc bt oV idceutselIymti:)nlee \What may te the extent cnly t:h..in; to do is to of x-ray all of them an::! then ""atureof the jc::b in c:crrelate yoJ1" order that yo..t f.i.n::1i.rJ:;s wi.th the lergth of exp:sure and may get a fairly aCOJrate idea of \.'hat e ha.zal:a is. . .. - . . . :~ ... ... ..:; \ :'" . .... ,o.,. . '. ' : . ~. " . e",. : . _:_: ..... ~".' . . . . . '., -3- JeSth:n No.5. , I bave ~ a diagn:::sis of asbestc:sis CI'l an enplajee who has been . worki.rq in the card ro:D of the textUe department six years. 'lhis plaO! is extrene.ly dusty.' ~ Jis rot diSabled. In;II';{.j~. the best d j SfClSi- tion of Stich a Case is to'I1!!lJ:1oI8 him fran the dust ard qive him a jc::b in scm! other part of the plant. FraIl yrur 1"eDarks in CUr:::zqo I believe this was your advise as' to the d ispositia1' of su:::h cases; . . .... t,o .... e' ... . ......... ...... ..... .-. :It is difficult to answer this question. I think it wculd i1epen:i lJPOn theman's ac;Je ~ . the .natUre .of 'his work, his lerqth of service, am other cx:nsideraticns 1.'h.ic::h might have SCIDe ~in;. If he is wI alon;J in years and sho..'S J'X) disability, it my ~~ust as well to leave him alone. ~ .~~...~ .dittiOl.l.ties aid vexat.3.Cns .t.n triin:1 to deal with the problems of ~osis is' tHat "iir5:'iianic as Well 'as prcx:hx:tial factors lZIlSt ~. balanced against the ~cal factcrs. O1estion No.6." . We have what seems to be an unfortunate situatiCl'l existirg in ~e fact that the asbestos textile department in:lu:tin:i lcx:ms, t:'Jisters, ?XX)ls, etc. occupies en! side or al:o..tt half the width of a long l:ui.ld.ir"q, e other side of which is cx:x:upied by the pac:Jd.n;, brake linirq am ot.i.er _c!part::lents in \o'h.i.c:h there is very little dust. The c:.a.ni rcan, or trOSt dus'ty part of the textile ~ is isolate:l by partition. further isolation of the text"-ile department involves considerable expense. ShaJ.ld or\ICW.d you be guided by the dust a:urrts am ether 'd::servaticns in these adjoin.i.rg depa.rt:nents? '. I t.h.ink the answer to the situatim outlined iJ1 this question is the control of dust in thc:se prccessesthat cause it. ~ everyth.i.n:1 possible has been dcne to acxxnplish this result, it may then be necessary to isolate or ccnfine the dusty prcx:esses so as to avoid needless exp:sure of other etrployees rot o::::n::emed in these pIocesses. ~ is a situatic:n that occurs in "J1.'Jimj different 1:yI:eS of :in::hJstrial ha.zaItl. It calls for not:h.irq mre tha.ri the at:Plicaticn ~f a liiil XI sense to the prc:blem. '. , .... " :,... . ... r , '.. . t ........ , : ... .', . " .. , ~CNS OF PUNl' mYSICIAN rotu:WIN:; l.HINATIQl OF !MPl.O'iEFS m 'lDClTIE IEPARIlimr AND CIHID1I' BY , ... ..... ' I'R. A. oJ.' L\NZA - ,_. . _. _. ...... " ... .. _~._ I" ,'. ..., __ . ' ,,,-- . .'. 1._ 0 'lhe,pt'O'{isi~ o(o~.l;est ~o~ot:'o~~~eCt+~ ~ ~~ ~ation equiptent. 0 ... -, ': _ _ 00 0 0 Cc:mnent: By all means. 2. Pe..~ respiratory protec:tial of an 2Idequate anj ~ type for ~very er.ployee in this de.par't:bmt. Cgtment: oJ; do not Jcrx:w. 3. 'Il:ployees in the textile depart:mIt.nt Shciwrti:Etoolyoliit~de!iiiltelY~be'" . mde awcu:e of the tact that work in a.sbestos dusl. is ha%atdous to their health. Every reasonable..effort shc:ul.dbe made .to ~ them .to war respirators. '!bey should be ~ in the necessity of thorcu;hly cleansirq their harrl.s before eatirq lundl an:! after wrk an:i provided with adequate facilities for doing this. Cgtme.'"lt: 0 I th.ink this is Olt, at least for the present. Perscnal cleanl.it)ess does not enter into this pIt:blem. -4. I advise rigid adhererx:e to the factory manager's order that no elrl'loyees !! hire::i or rehire:i in this deparbnent vithc:ut first being examined a.n::! awroved o the plant physician arx:l turther that no enployee be transferred to this depar:~!,t withoot first be~ awrovEd by the P'lysician. C~t: Absolutely (X)rrect. 5. I advise re-exmn:i.natia'l, as imfcated, of all wrlcers in asbestc.:s dust 0 0 0 am x-rays of arrt suspected cases. I"o::nsider the re-ex:aminations arrl the continued study of this hazard an:! its effects of mI'1! ~rt.a.rx::e than the first exa.r.dnation. Fran this point of viw, the st:u:ly of sane of these cases may be c:x::nsidered carp1ete. Q;xiUIe."lt: Entirely COll:e.."'t, with the un:3e.rstarl:1i that lXJ exam.ination wit.haJt an x-ray ..lS ~rth "."~ ,a;rr +...-...h...~6~;1 in deall'll; Wl'.th f~ iJC'mv o::rU,O.SlS. 0 6. I request, i f p:ssible ar.d ~ by Mr. Williams, ccntact with scr.e authority crl asbest:.csis \i'ho has x-ray films showirq the cx::niitioo. 'Ih.is for the PJrFOSe of cnrparative sb.x!y of Cllt" suspected cases. Cg:JTent: We can prcbably help yt:U in this if ywr o::upar1)" is willin;. 7. My rejectiQ'l of Marie I.utenski, made at the time of first examination, stands. 0 ';' Cgtpent: 'lhis is cutside of 'tt'fj kr'o.lled;1e. S. I have deferre::l rejection or classificaticn of 0Ja.iri o. Bell, first: be- cause of the delicacy of the situatiQ'l \t'hidl might arise in ccnnectioo with his case, a.n::l ~y; because i t is genera.l1-.y believed that rem:M1l of a 1IlOrXer fran the dust will rxrt: retanl or affect the PI03Ie:ss of the disease ax:e it is established. -:mnent: Oitto. 0  , . .. ".-:'.. ~'.' :: ~ ........,..~.\ "b"."1"1)'.: " . ls2"rN ~:'*,,! p,,} ..' na..-. ..... &.. i-'~- .... p', ~ -. , '-i . .t1.l.l..t I .. .. ' ... ~aa ~ ZL &. Z. 1..\11.& _ t.: I t'P"SC TB.", f. " ,h."etd u ........ " "'11 .... ~t... at ~ .... tU:taC "", ""rJ. "--- ~ ... ~ ~ lIS . . , ._ ... w.. - & ... e,l,.- . . n E! 0 1 "-- lit .-r Jl.-\ JIl,rU~ . . , . 1 ~ 1UIII ........ ,... tIIzII w.J..I ....,. \a ........... ~. .'1 ~i ta.1..I I ... _ ....... ~ 1\ z-:r-l.! ... r-cr .,..,. Wi \a .. 1._ ~ 1 "" '. " .... .. -- -"t . .. ..~. ;:~ ~~' par "-wq .,. . ': . -. .. , - . .... -. ,i- ~ . . . . ~ . ,, } '-. p. '"Jo . 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