Document 85nQQvGV4oekp4zM3Oe117L2o

ANNALS OF INDUSTRY Casualties Of The Workplace By Paul Brodeur Part V "The New Yorker" - November 26, 1973 Reprinted by permission; 1973 The New Yorker Magazine, Inc. DAVID JO* M.D. ASSISTANT McDlCAL QtRECTOR "UNITED STATES STEEL CORPORATION VOO*GRANT STREET---------- tatT&BUisfiMe'f'A. 15230 - ANNALJ OF -INDUSTRY - CASUALTIES OF THE WOKICPLACE V-A Ol/ETTION OF THE rATIENT'J RIGHTJ * URNISHED with incontrovert among asbestos-insulation workers in centimetre of air, and that after that Fible evidence that industrial'diseasc the United States was caused by lung was rampant in the Unite*! States, cancer; that almost one out of ten Congress passed tlie Occupational Sadfcea tlis among these men was caused by late tlie standard would he lowered to two fibres greater than five microns in length per cubic centimetre. (A five- ty ami Health Act f 19/0, authorizing mesothelioma, a rare cancer of tlie lin micron fibre can he seen only with a the Secretary f Labor to promulgate ings of the chest or abdomen, which microscope; a cubic centimetre of air is mandatory stanlarls for exposure to usually occurs many years after sonic, about a thimbleful; and in a normal toxic materials so that no employee even if slight, exposure t asbestos; tltat eight-hour working day a worker will would suffer dimintsk-d health or life another one out of ten deaths among hreatlie in and out about eight million expectancy as a result of his work cx- them was caused by asbestosis, which is cubic centimetres of air.) Since the new perience. This was a considerable scarring'of the lungs resulting from in- ruling would permit workers exposed to undertaking, since American work iialatinn of asbestos fibres; and that asbestos to inhale anil retain in their er* were being exposed to thousands of nearly half of these men w^rc dying of lungs as many as thirty milium asbestos toxic substances, and since federal some form of asbestos disease. Yet in fibres of all sizes in a working day, it standards, often inadequate, existed for spite of the fact tltat the insulation was considered grossly inadequate bv fewer than four hundred and fifty of workers constituted only a fraction of almost everyone who had been study ing them. Of all the industrial hazards, the total work force exposed to asbestos, the effects of exposure to the mineral. none had been studied more thoroughly a permanent standard for the mineral Indeed, during the previous six months, or had been proved to he more critical was not declared until June 6, 1972. a two-fibre standard had been urged than occupational exposure to asbestos. At tliat time. Secretary of Labor James upon Secretary Hodgson as a minimum Mortality studies conducted by Dr. D. Hodgson and Assistant Secretary' of requirement by Dr. Selikoff and otlier Irving J. Selikoff, the director of die Labor George C. Guenther, who was members of the independent medical Minim Sinai School of Medicine's En the director of the Department of La and scientific community, and by the vironmental Sciences Laboratory, and bor's Occupational Safety and Health A.F.L.-C.LO.'s Industrial Union De by Dr. E. Cuvier Hammond, vice- Administration, decided that until July partment--an organization represent president for epidemiology and statistics 1, 1976, workers could safely inhale air ing lahor unions with several million of the American Cancer Society, in containing five asbestos fibres greater members who had cither direct or in dicated that one out of every five deaths than five microns in length per cubic direct exposure t asbestos. (Dr. Scli- koff and tlie union people liad also urged tlie Secretary to require Work practices that would ultimately reduce asbestos exposure to almost zero.) In addition, tlie Department of Health, Education, and Welfare's National In stitute for Occupational Safety anil Health, or XIOSH--an organization set up under the 1970 Act to conduct medical research on industrial hazards and t*> provide the Secretary of Libor with criteria for setting new stainlords for toxic materials--had furnished Sec retary Hodgson with a careftillv re searched asbestos-criteria document rec ommending that a two-fibre standard go into effect within two years, and In forming him that such a standard was attainable with existing technology. Tlie XIOSII document stressed the fact that a two-fibre standard had ken rec ommended by the British Occupation.il Hygiene Society, and set hi tlie British [ns|K'ctorate of Factories--the Depart ment of Lilxir's English counterpart -- in 1968. Subsequently, XIdsn's recom mendation fora two-fibre standard m, upheld by a fivc-inau adtisort com mittee of Secretary HodosoiiV own choosing. "It is not known \v!:7t prompted Secretan' Hodg>on u* select tilt" hVi--fi!n^tandar(trfir"Wily lie de cided to disregard "data furuishtd in detniilogi>ts.showing tlint disease could | tl*e United States each year, and that occur ntt<he. five-fibre level of expisore, { ` there might be as many as a hundred and that even a iw>-fibre standard I thousand deaths a year from occupa- could be expected to prevent only the J tionally caused diseases. ticcurience of asbestos** and not the de { In spite of these appalling figures, velopment of asbestos-induced cancer, j is believed, however, that he' was .ring a middle gnnmd that he hoped would be acceptable to tile asbestos in dustry, which--basing its claims on in formation supplied hy a medical-in dustrial complex consisting in part of consultants and researchers whose work was supported financially hy various segments of the industry--had fought against the two-fibre standard on the ground that the cost of meeting it would drive many asbestos companies out of business and that the five-fibre standard was sufficient to protect the health of workers. In any case, the permanent standard for asbestos was the first ruling that the Secretary' had made under hk mandate 'to redefine occupatiorial-safety-and-hcnlth regula tions, so industry. Labor, and the indications that the federal government was less concerned about the physical health of workers than about the eco nomic health of industry appeared at around the same rime, when word got out that the Occupational Safety and Health Administration had hired Arthur D. Little, Inc., a researeh-andcnnsulring firm hased in Cambridge, Massachusetts, to perform an econom ic-impact study of the proposed twofibre standard for asbestos. There were a number of disturbing factors about Arthur D. Little's involvement. Not only was there no provision in the Oc cupational Safety- and Health Act re quiring the Department of Labor to Undertake a cost-benefit analysis before promulgating a health regulation hut the study was apparently initiated in re sponse to an executive policy handed- independent medical and scientific down hy President Nixon's Office of community viewed the ruling as an in dication of how diligent the federal gov Management and Budget--an organi zation notably well disposed toward big ernment would be in setting new stand business. In addition, it soon developed ards for other havardous substances. that even as Arthur D. Little was ne The reaction to Hodgson's ruling was strong. Sheldon W. Samuels, the di- gotiating a contract with the federal government to conduct a cost-benefit *" tor of Health, Safety, and Environ- analysis of the propised two-fibre ital Affairs for the Industrial Union - standard, it had urged Rnybcstos-Man- Department, declared tliat since titc hattan, Itic., a major producer of as Sccretary had failed to set a standard bestos products, to move a plant from that would adequately protect work Stratford, Connecticut, to Mexico; ers, the Industrial Union Deprtmcnt I would challenge his ruling in the where asbestos operations would be un hindered hy any regulations that might courts. Dr. Scliknff was quoted in the he established in the United States. Times as predicring that tens of thon- Moreover, when the reptrt of the Ar sands of workers exposed to asbestos thur I). Little study, which had been I would die unnecessarily early deaths directed by Dr. Donald \V. Meals, was i because of the inadequate regulations, | and that if the Occupational Safety released, shortly after Secretary Hodg son declared his controversial standard, | and Health Administration showed the it turned out that the firm had solicited [same disregard fur essential precautions "guess-estimates" on the biological ef jin setring standards for bther toxic fects of a five-fibre standard, as com stdistanccs the working pipulatinn of pared with a two-fihre standard, front the nation would face an unparalleled an eleven-man "expert health panel" disaster. As it happened, signs that the that included only one medical doctor disaster predicted hy. I)r. Seliknff was who had not been a paid consultant of, already at hand had appeared only a or whose investigations into - asbestos- few Weeks before, when the While related disease had not been supported House issued "The President's Report hy, some segment of the asbestos in on Occupational Safetv and Health," dustry, ami that it had --.dicited "t>ticss- describing what had Ik-vii done to carry stimates" on the economic impact of | out the provi-iuns of the 1970 Act in the respective standards from a panel the year since i: liatl been passed. Presi of twelve men representing various as de Nixon's report was addressed to bestos-producing companies and from < ;ress, and it contained a report a cnmmitlee of thirteen men represrnt- from the Secretary of flealth, Kducn- ing private shipbuilding companies. tion, and Welfare, Elliot L. Ridiaul- Small uunder, then, that the, A. ..D. sm, who told the President that recent Little report assured Secreiarv Hmlg- estimates indicated there were at least a Jive-fibre' stamlard^jfrtnld three hundred .mil ninetv thousand new adequately protect tile health of asbes caws of disalihnj indnstiial disease in tos worker^ and that a I u n-/ihiv Stnndard would inipise undue hardship on the asbestos industry ami on ship building companies. Alt this was simply nnotiivr indication of how much influ ence the medical-industrial complex liad acquired, and how deeply it had penetrated the workings of the govern ment. During the summer and early au tumn of 1972, moreover, it became known in medical circles that the Brit ish Occupational Hygiene Society's two-fihre standard, which liad been based on information supplied to the society by Dr. John F. Knox ami Dr. Stcpltcit Holmes, of the Turner Broth ers Asbestos Company, Ltd., of Roch dale, England, might be open t<> ques tion. New data published by Dr. Hilton j C. Lewinsolm, who had succeeded Dr.: Knox as chief medical officer of Tur-, ner Brothers, suggested that Dr. Knox and Dr. Holmes had furnished the so- ciety with information that appeared to | understate by as much ns 'tenfold the incidence of ashestosis among the j Turner Brothers workers they had Studied. The ramifications of tills dis closure were staggering, for, if the British two-fihre standard was medical ly and scientifically invalid, s*>, by ex tension, was the proposed two-fibre standard in the United States, which was not even to go into effect until 1976. In addirion to making an obvi ous mocker)- of Secretary Hodgson's five-fibre standard, this development presented the possibility that industry in- | fluence might have had an effect on of ficial medical considerations concerning the problem of occupational cxpistirc ,ti asbestos in England. By this time, there could hardly be any doubt that such influence was at work in the -United States. Indeed, the medicalindustrial complex in this country ap peared to he involved in nothing less1 than a blatant and jiervasive effort to _ suppress and ignore medical in forma-, tion concerning ashestos and other ha/.- [ ardous substances that were estimated to he killing a hundred thousand work- ! ers a tear,-and to prevent any effective enforcement of the Occupational Safe- tv and Health Act that might put an ; end to die slaughter. 1 T IN the middle of October of 1972, t went to Washington jo talk with ' Anthony Ma7.v:oi.-clii, the director of the Legislative Department of the Oil, Chemical, ami Atomic Workers filter- j - national Union, almtii yum- of the nth- ` < er heafth problems that were plaguing j T ' American workers.,,M:t7.-/.ncchi\-. union I [. Jiad fejTffse-nted emjfluvfes at the I'iit-- 1 Imrgli Cornhig~Corpira:ion's a-.liesto-- | _T tsittalon plan; in Tyler, *1 tMf, where )r.-Wflli:uvr M. Johnsun and !)". Jo~ cplt-K, \Vagnvr, of NiOSll's Divtim ? Field' Studies ami Clinical Investiatinns had fmind atrocious working and a critical health pntbJazzncchi considered the Tyfcf itiiaikin a prime example of how the ncdical-indtistribl complex had for ears ignored occupational-health data i-ith no interference (nun key indusrial-heahh officials at various levels of tate or federal government. At a press onference held in Washington in Febiinrv of 1972, he had harshly criti-j ized Pittsburgh Corning and its med;al consultant. Dr. i-ee B. Grant, for inuring t)e peril of workers at the facnry, and had been equally hitter in ondemning the Department of La w's Occupational Safety and Healtli Administration for failing to enforce t the Tyler pLmt even the grossly indequatc standard of twelve fibres per uhic centimetre which was in effect vhen the Administration' had cm- tictcd an inspection of the factory in no November of 19/1. Over the past etv years, during which Alazzocchi and its associates in the Legislative Departnent had been holding conferences for } acton- workers around the country, t hey had amassed and published, in a : er -if pamphlets entitled "Hazards n . industrial Environment," a great mount of information on the effects f chemicals and physical agents on the leahh of working men and women. In ;athering this information, they had ninpiled a large dossier of the names, filiations, ami activities of people who verc involved in occupational-health natters, and so were known to have `the book" on the medical-industrial omplex. I had Seen Mazzocchi at his prtss inference about the Tyler plant; a nonrh later I had encountered him (gain in Washington at the public (earing; on the proposed two-fibre tandani, which were held by the De railment of 1-ahiir; and in October, toping to learn more about the workng> of the medical-industrial complex n areas other than asbestos, I visited tim and his assistant, Stewn Wndka, it the onion offices there. A lazzocchi, i blunt-spoken man in his mitltlle'ortivs with uimtlv black hair, had hetn finch tin the go in the interval--flying lere id lln-ie aroinnl the country-- nil iKiki'd (iicil. "I nii'iv been Modting tlie Tyler plant, which in many ways is a perfect xaniplr of t!ie kinds nf problems we fan-,' lu- |o)il me. "Tiler had all the elements siippn-ssinn of n'cnpatinnal- Itvalth data, callousness on tlw pan of tfuisc in positions of rejjnoisiltility in in dustry and government, and danger not only for the workers hut also for their families and tlte community at large--ami yet yon could be hearing much-the same story about any number of factories in this country. You could he studying the Mobil Oil Corpora tion's refinery in Paulsboro, New Jer sey, or the Kawccki Berylco Industries factor)" in Hazleton, Pennsylvania, or any one of hundreds of other places where the health of workers either has been or is being needlessly endangered. I hardly know where to begin. In fact, I don't know where to begin. Steve, here, once stated the multiplicity of our problems by saying that members of our union don't get Mack lung, like coal miners, or brown lung, like cotton-tex tile workers, but rainbow lung, because they're exposed to so many toxic sub stances." "Let's stan with the Kawccki Berylco plant in Hazleton," I said. "I've already heard something about the situation iltcrc." Mazzocchi asked Wodka to pull out a file on KBI, as the company is known, and told me that tlte union had represented workers at the factory since the summer of 1969. "By August of 1970, it was apparent that much more information was needed concerning the hazards of beryllium, so the local union representatives initiated plans to hold a conference on the problem in mid-Oc tober," he said. "At that conference, the KBI workers told us that beryllium dust was ccntaminating the Hazleton plant, and that several deaths and cur rent cases oc lung disease among them were thought t he related to beryllium exposure." Mazzocchi went on to say that, armed with tape; of the confer ence, he travelled to Cambridge a fetedays later and met with Dr. Harriet L. Hardy, who was assistant medical di rector" in charge of the eneironment.-rf medical service at tlte Massachusetts Institute of Technology, an as.-oceue physician at Massachusetts General Hospital, and a renowned expert on beryllium poisoning. Up-m bearin'; the tapes. Dr. Hard) express-d concern about tlte reports of Conditions inside the Hazleton plant and pledged Iter as sistance in anal) zing urine samples of the workers there. "Shuttle thereafter, an insjvctor (nun the Department of Labor conducted a survei of the plant," Alazzocclti said. "The iitS|KCtion, which the I**cal had requested suite six- riaBfeearlier,. w;o stqtcrficial^fe-f put it troffllr. for example, no samples were taken to determine rbe amount of hen ilium dust ui the air. The in>;v un did indicate. However, that hotter \- Iiaust ventilation was require d, so ih.ii men would not have to wear respirators ut routine production jolt;. He aho criticized tlte plant for jvur hnusekeep- ing procedures and for using an n|vn lump fol" disposing of refill: contanti- nated with hen Ilium. The compant was given until February I, 1971, to ntrreci these conditions, hut a check with the Department of Labor in .March revealed that no followup in spection iud been performed. to de termine whether the company Itad complied." Alazzocclti asked Wndka to contin ue the ston" of the Hazleton plant, since lie had spent considerable time there in the fall of 1970 and the winter of 1971.' \Vodka--a man in his middle twenties, with brown eyes, curly hair, and a laconic manner--told me that he went to Hazleton in late November of 1970 to gather information on con ditions in the KBI plant, and returned on December Silt to attend a tmion- management hcnltlt-.-ind-safety meet ing. "When I questioned company of ficials on tlte unsafe procedures I had heard about, they offered to take me on a tour of the plant," Wndka said. "It proved to be an invaluable experience in assessing unsafe conditions, for al most everything I saw confirmed what the workers had told me. Inadequate ventilation equipment had allowed dust to pile up around machinery anti to blow throughout the plant. Another serious problem was the companies ex cessive reliance on tlw use of respira tors. Instead nf installing proper ven tilation equipment to reduce bervllium- tlust levels, the company had simply designated some of tile dustv sections of the plant as respirator areas. As a re sult, many workers were forced to wear respirators for long |kthkIs--a practice that Is.extremely difficult, if not downright impossible." ; A couple of days later, Wndka said, lie went to Cambridge to report what he had learned to Dr. flardt. "Site ^ol , it the phone imnirdiatch anti rounded ip a leant of hen Ilium spcciali-ts to help is out," he continued. "1 bet included ! Richard I. Chamberlin, an indnstri.il- htgicne engineer ai the Massachusetts ' fiislittite of Teclinoloiv, -wlto would simple Ivrt llitun-dtist levels in the plant : and study the ventilation sfMcni; l)r. (hit I). Stoeckle, an e\|vrt in in dustrial lung di-casc at .Massachusetts General Hospital; who would conduct a sv nip^oip .survey of :ljl workers: Dr. lfotnavotin-Kazentf, the chief of the piilnion.irv unit at Massarlniseits C>.-n- aniUL'.-Alfred L. Weber, a m*lit!gwt the Hazleton plant. Later, we teamed from the hospital, who would supervise tint in an annual screening program of a 'mass X-ray program ami read and KBI workers the Pennsylvania people interpret the results. When I returned Itad been using X-ray equipment that, t Washington, I drew up a Jet of according to Dr. Hardy, was inade oroposak for tlie next Hireling f the quate for detecting beryllium disease, union-management hcalth-aitd-safrty j luting hts telephone conversation with committee, on January 5, 1971- The Barer, Steve learned that the state had chief provisions were that bcrylliuin- taken beryllium-dust counts during its dnst keek in the plant he kept at or be inflections of the Hazleton plant. low the threshold limit value of two However, Baier told Steve that he con inicntgrams per cubic metre of air; that sidered the data confidential, and felt the union have the right to *bservc the that their release to the union would company's dust-monitoring operations damage the relationship between the and have access to the results; and that state and the company." the company finance a thorough indus Wodka said that he then went to trial-hygiene survey of the plant, to be Harrisburg to meet with Baier. "Dur conducted by the team of ing the meeting, _Baier and specialists designated by Dr. his staff admitted'that they Hardy, which Chamberlin had recently taken readings had--estimated could be ac of beryllium-dust levels in complished at a cost of about the Hazleton plant, and in t.wenty-one hundred dol some' sections they were ten lars." Mazzocchi continued the times the recommended standard," Wodka said. story by telling me that at the January "Baier assured me that each man in 5th meeting plant officials informed him these contaminated areas had been tolil that they were not prepared to deal to wear a respirator, but he also ack with such extensive proposals. "They nowledged that such protection shoutd said they would have to consult higher be used only for interim control. I authority in KBI," he said. "As things asked him why the State had not forced turned out, we weren't able to arrange tile company to comply with the recom another meeting with the KBI peo mended beryllium standard, and ho ple until March 1 Oth. In the meantime, told ntc that the KBI people were co urine samples were collected from five operating. When I again requested ac workers and sent to Dr. Hardy, who cess to the state's inspection reports, had them analyzed at M.I.T. by Baier promised that a copy of the most George W. Boylen, Jr., an expert in recent survey, which had been con industrial-hygiene chemistry. He found ducted in January, would be sent to varying amounts of beryllium in all the the company for transmittal to the samples, and both he and Dr. Hardy union." said they believed that beryllium would Mazzocchi then told me that at the not be present in the urine of men who March 10th meeting of the union- were exposed at or below the level of management health-and-safety com two microgratas per cubic metre of mittee, C. Dale Magnuson, the in air--the standard recommended by the dustrial-relations manager for Kill, American Conference of Governmen rejected the union's proposal for a sur tal Industrial Hygienists. As a result, vey of the plant by the team of in the union local voted unanimously that dustrial-hygiene experts that Dr. Hardy each of the two hundred and seventy- had assembled. "According to Magnti-' eight members working in the Hazle son, tiic company already had a good ton plant support the cost of our health industrial-hygiene department^ `anil* proposals by paying a dollar a month there was no need to bring in another surcharge on membership dues." group," Mazzochi said. "Wodka then Mazzocchi went on to tell me that asked the KBI people if the State of Wodka conducted an investigation of Pennsylvania had forwarded them a the State of Pennsylvania's role in en copy of its January inspection for trans forcing health regulations at the Hazle mittal t<> the union. They replied that ton plant. "It turned out that the state the lepnrt liari not entire in. When people had more data on die plant than Steve produced a letter from Baier stat nyonr else," Mazzocchi said. "The ing that the rc|xrt had been sent to quality of the data, however, was an them on March 5th, the KBI |H-ople other matter. When Steve telephoned admitted after all that they had re Edward Bairr, who was then director ceived the copy marked for transmittal of the state's Divirion of Occupational t^gffcjgjniori, hut su'd that they fg^-mr-- Health and is now the deputy director der no obligation to turn it over." of XIOSII, he was told that there had The only couiucrpri>|,,>s.iI made hv iwi c.-c f ^ tit.* k Uf * li.. \ 1 t fWl. meeting, Mazzocchi said, was that they Would give tile unimi a quarterly report of the coin|nny'$ monitoring data on beryllium-dust levels. "On April 29ih, wc went hack to Hazleton to get the first of these reports, taking along Chamberlin, from M.I.T., in a con' suiting capacity. At the meeting, the KBI.people were represented by Mag. nuson; Edmund Velten, one of their vice-presidents; and James Butler, the assistant to tlie president. The com pany's report showed only one area in the plant where there Were excessive levels of U-ryllmin dust. U|>on review ing the data, however, Chamberlin said that it was difficult for him to interpret the figures without knowing something aliout the Layout of the plant. Velten then suggested a'quick lour, to which we readily agreed. At the end of the tour,. Chamberlin said he had seen enough to convince him that the com pany's interpretation of its data on beryllium-dust levck did not give a true indication of the potential hazard in the plant. Then Steve produced copies of the January inspection conducted by the State of Pennsylvania's Division of Occupational Health, and two earlier state inspections of the plant as well, which Baier had finally decided to re lease the day before. The reports showed scrims viokitions of both state and federal beryllium standards in four specific areas of tile factory, going hack to 1969. At that point, Velten and the other KBI officials agreed to our key priiposnl time a union-designated in vestigation team he allowed to conduct industrial-hygiene and clinical surveys at the plant, and tluit tile costs he shared equally by KBI and the union. In May, we got tlie Pennsylvania peo ple to agree to take X-rays using equip ment adequate for the detection of beryllium disease of all the workers in the Hazleton plant, and to allow Dr. Weber to assist in the interpretation of I the X-rays. In mid-Scptemhcr, an in- f spection of the Hazleton plant condueted- by the Occupational Safetv and Health Allministration still showed ex cessive levels of beryllium dust. The Administration fined KBT six hundred dollars and gave it a month to clean things up. Then, in November of 1971, Dr. Ka'/.cini, who is one of the world's leading e\|*erts on the detection and diagnosis of l>ei\Ilium ili.-e.ise, con ducted a medical -iirvet of the I lazlcton workers. Dr. Kazcmi found that, out of jwci hundred and nineteen Work ers, twcnti-five had s\ mptoius |ios-illy ''ckiqaLfe- I'cry Ilium: di-case and trn of these men had limit abnormalities of such magnitude that they shouldn't h'lVf li.'i'o U'm 1'wt*. C,,,.'.- ill.-o foul ,if th.- haw- Iv.D ilcfiniult diagii'nK-l as having Ix.-r\ Ilium 3t<ca*. In atMiiinn, two, other men front *It* plant, u`ht ftutl been examined at Mas sachusetts General, were diagnosed -is sitfft-i <tijr front tin- disease." 'What happened a# a result f !*' line anti the date f<r cleaning tilings up?" I asked. Mazzne'hi gav.- a short, liar.sh laugh. "As of this date, inure than a year later, the Administration people haven't seen fit in make a.followup inspection of the Hazleton plant," lie told nte. "No dottht they asstime the KBI people have complied with their order. Sounds like Tyler all over again, doesn't AFTER a short coffer break, MaziX zocchi said, "Now let me tell you afiotit the Mobil refiner)' in PaulsItoro, which is just southwest of Cam den. It employs about a thousand workers, and it manufactures a whole spectrum of oil products, including heating oil, lubrication oil, gasoline, and aviation fuel. For a long time, mem bers of our Local S-S31 had been com plaining about health-and-safety condi tions there, and on October 11, 1971, we filed a complaint with Alfred Barden, acting regional administrator V Occupational Safety and Health . ministration in New York City, re questing an imminent-danger inspection of the facility. The petition presented Barden with a partial list of health haz ards at the refinery, including exposure to asbestos, sulphuric-acid fumes, phenol fumes, carbon-monoxide gas, tetraethyl lead, caustic soda, benzene, cumene, carbon tetrachloride, anti chlorine. Since tin.* Administration's regolattons pcrmit employees to request that a third party accompany its own representatives on walk-around inspections, tin- local asked for Steve \Vodka, who had assisted them in filing tin- complaint. The first immi nent-danger inspection began on Oc tober 15th, resumed on the 19lh, anti lasted through October 22ml, anil Steve's effect on it was soon evident. Even the iriS|>ectors remarked that he provided a valuahle extra Set of eyes during tlte walk-around. On the other hand, the Mobil jx-opte grew inen-asinglv irritated hv hi-, presence--so much so, in fact, that on October 22nd the plant manager mill Steve that he 1> 1 to have him removed from the " |>, ilS* T^S. >7 Wodka then tlescrilied some of the conditions that were discovered during the first part of the ins|vction oi the refinery. "We found workers installing ad'c-tiis insulation, similar m the prod uct. manufactured in tlie Tyler plant, on boiler* and pipes in various areas of the plant," he laid. "In the asbestos shop, where tlie insulation was cut to size, tlte men were wearing surgical- type paper masks provided by the com pany, which are virtually useless for protection against toxic dusts. More over, there was absolutely no ventila tion equipment in the cutring simp. Elsewhere in tlie refinery, we fnund places where men were being exposed to toluene [an aromatic compound similar to benzene], to excessive noise, to welding fumes, and to hydrogen-; sulphide gas--a highly toxic substance | that is given off in the sulphur plant, | where sulphur is removed from the ( crude ofl." '| Wodka went on tt> tell me tliat; when the inspection resumed, on No-; vember 8th, he was denied entry to the refinety. "I was told by John Kearney, the assistant regional admin-, istrator, that a decision had been made j to bar me fn>m accompanying tlie j walk-around any farther," Wodka; said. "As a result, I left the plant, | under protest. The inspections con-j tinued intermittently for several more , weeks, but their quality deteriorated,. for by giving management advance notice of the areas tltey wislied to tour, * the inspectors also gave management an j opportunity to reduce operations tliat t were generating harmful fumes and | dust. In this way, the Mobil people were able to dominate the inspection process. As a resuk, the imminent- danger inspection of tlie Paulsboro re finery was an almost total failure. 'Fake the problem of exposure to asbestos. The Administration failed to issue a citation for excessive asbestos dust, yet when Dr. SclikofF examined and X-raycd nineteen workers who were employed at the refinery as welders, pipc-cov- erers, boilermakers, ami brickkiyers, he fnund that more than" half of them showed X-ray abnormalities consistent with acbestosis. When the Administra- tion, on January 2S, 1972, issued eit.'f- tions t Mtthil, they carried with them fines totalling seventy-three luintlreil and fiftv dollars for three hundred and fift)-four safett-atul-health violations, or about twenti dollars )>er violation. Onlv twelve of the violations involved occupational-health standards, "ito of which was for an unsanitary water Cooler.* .Maz/cchi saitl that similar per formances hv the Occupational Safety anti Health Administration h:id uc- lyyryyl. in recent months at a chemical pWmtSti-Alalxaina ami at an nil rcThiery I in Kansas. ** i IteSe are just a few of the-many-instances in whicii the Adminfctnttioii lias failetl to enforce the provisions of the Occupational Safety and Health Act," lie said. "Bv the wav, did I tell ytni that when live Adminis tration jx-nple fiiietl KBI six humlreil dollars'for excessive beryllium tllist in tlie Hazleton plant they also fined the company the grand total of ,7v /lo/lnn for allowing footl to he eaten ami stored wlterc toxic materials were pres ent: That was just a few weeks after they fined Pittsburgh Corning the sum of two hundred anil ten dollars for socalled `nonserious violations' at the Tyler.nshestns plant. SucJi fines are ri diculous, of course, but the Administra tion people don't stop there. They ruh salt into the wound by being secretive with what, under Law, is public infor mation. We face delays and denials practically every time we ask them for copies tif citations, notice of pro|>o$ed penalties, and inspectors'. rejyirts of plant surveys. And, remember, we're trying to exercise tlie rights of our hundred anil eighty thousand-odd members through an extensive union hureaucracy. Imagine what the chances are for unorganized workers, who ac count for seventy-five per cent of the total labor force in this country!" At this point, I asked Mazzucchi if he had ever heard of Dr. Mitchell A. Xavtin, Assistant Health Commissioner for Cincinnati. "Yes, I've heard of him," Mnzzuechi replied. "Why do you ask:" "Because I understand he lias re cently voiced opposition to some pro posed city regulations that would ban the spraying of asbestos insulation in ' building construction.'' "We have a whole file on Dr. Zavnn," Mazzocclii said. "I'll have it Xeroxed for you; In 1969, the House Committee tin Government Operations wrote a report on Dr. Zavmi's activi ties will) regal'd to the No-Pest strip, manufactured hv the Shell Chemical Company, a division of the Shell Oil Company. According to the report. Dr. `/.avm had been a consultant to Shell Chemical during a >i\-vear peri od-- 196.1 to 1969--when lie was also a Consultant to the Department of A"- | riculture's Pesticides Regulation Dili- sion, which had registered the iii-ecti> it It* snip for use in restaurants ami homes. Duringc that time. Dr. /..no. n ;j comliieieil tests for the Company which j showed the Strips to lx- safe. When it teas demonstrated. Inter that tlie strips __ could leave unsafe chemical residues | 'll cspoge.1 food, the Deivirtmem of | -J Agriculture required that thee lx-ar a partment informed the Committee on Government Operations that it was re ferring questions of possible conflict of interest involving Dr. Zaron tr the Department of Justice. Nothing came of it, however." WHEN I left Mazzocchi't office, I was carrying a manila envelope that contained the flic on Dr. Zavon and copies of letters, petitions, inspec tions, and surveys relaring to KBI's Hazleton plant and Mobil's Paulsboro refiner}'. On rite plane back to New York; I read the report on Dr. Zavon, which substantiated what Mazzstcchi had told ine. (Later, I learned that in March of 1973 XIOSH awarded a contract for $203,873 to the Agatha Corporation--a private 'medical con sulting firm headed by Dr. Zavon-- for developing health criteria on car bon tetrachloride, chloroform, ethylene dichloride, methylene chloride, tetradilorocthylene, and 1, 1, 1-trichloro-. ethane, which can be synthesized from precursor chemicals obtained from pe troleum.) 1 also glanced through the annual stockholders' report put out by KBl in 1971. It was full of handsome photograplis and interesting statistics. It listed principal plants in Hazleton, Byertown, and Reading, Pennsylvania, and in Wenatchee, Washington. It listed company subdivisions and sub sidiaries in Boston; Springfield, Ore gon; Revere, Pennsylvania; Thnmaston, Connecticut; Yonkers, New York; and Palisades Park, New Jer sey. And it listed international opera tions in France, Germany, the Nether lands, and Great Britain. In a letter to the shareholders, dated March 2, 1972, and signed by Joseph C. AbeleS, cluirman of the board, and by Walter R. Lowry, president, there was this paragraph: No industrial enterprise today can af ford to ipiurt the entwine insistence upon clean air. clean water, and safe, healthful places of work as manifested in aniipoUutiuu ami job safety and health Iceislntiim. Considerations of environ mental quality which have prompted us to make stthstanti.il expenditures on eqnqtmeftt and staff to control pollution ami prtiinotr ttvcupational health have, in our view, assumed a permanent place in the conduct of :t hu-Iucss such as Kill's. We expect to continue to intcsf in envi ronmental quality to preserve the gains tt c have iitatlc and take advantage of im provement- in control ret liimlngy as they leciMiic available. A few tlavs Inter, in tlu: October 29, 1972, c'diliim of the / lim'.', I came across a store wriitcn l^^lfeipyr-llig- art which appeared under Titf"1ie:idKne "Lung-1b-c.i-c I'r<iblvtn I raced tu ' Beryllium Refinery, Plagues Hazlctortr Pa." Bigart's article began: In the grim year of 1956, when unem ployment in this worn-out coal town hov ered near 20 per cent and the region was one of the most depressed in Appalachia, there was general rejoicing when rite Chamher of Commerce enticed a beryl lium refining plant to settle four miles east of here. There was only one discordant voice. Dr. Herman H. Feissner, J r-, who has a tiny walk-up office over a store in near by Freeland, began cautioning his patients j that it might be dangerous to work at the ' plant. Nobody paid much attention. After saying tlut nine present or former employees of rhe plant were suffering from chronic berylliosis, which he described as "a rare disease that involves a slow but progressive-- and apparently irreversible--yeteriora- tion of the lungs," Bigart returned to the subject of Dr. Feissner: The tall, white-haired physician Was graduated from Lehigh University in 1928 and from Jefferson Medical Col lege, Philadelphia, in 1932. Now in his late sixties, he spends much of his time working with rrtardeJ children at the White Haven State School and Hospital. However, he still practices medicine and among his recent patients were sev eral beryllium refinery employees. "At least five," he said, had symptoms oi berylliosis. I)r. Feissner's first encounter with the beryllium industry came soon after Kawreki Kcrylco acquired an old Lehigh Valley Railroad machine shop and round- ! house a few miles east of Hazleton and began converting beryl ore into beryllium. Kawcvki Berylco is a major company in the specialty metals field, with sales total ling $70 million last veat. What disturbed Dr. Feissner was the knowledge that tile corporation's plant in Reading, Pa., had hren cited in several lawsuits charging negligence in exposing workers and nearby residents to unsafe levels of toxic dust. Dr. Feissner said hr was reproached by a local radiologist. Dr. Edgar L. Drssen, for "telling my patients a little tx> much about beryllium poisoning.- Dr. Drss'en was the leader of a Chamber of Commerce drive to bring new industry to Hazleton, a campaign so successful that unemployment is now down to 4.5 per cent. Dr. DcSScn confirmed that he had spo ken to I)r. Krissner. "He (Dr. hcissiter) u as telling people hcryllitim was a toxic material at a time the company teas hiring men, " Dr. Des- sen said. "I felt it tea- imlair lo people who tt noted work. Th- plant was dv- signetl under Atomic Energy Cuiunii-Mun speeilieatiuns to keep irritants out of the air. With stringent precautions, the men would he propei ly protected." Dr. De-sen sai,[_ he hail been a ditcetor oi Kawrcki llcrvlvo but did not -rand iur re-election tin- year. He -aid his.timc tins Weaken 'tip- with WI<tSr inalti-i v htrlruling the chairmanship' oT the American Col lege of Radiologytn-k hove on pnvn- mncomnM-t. a generic term lor lun; dis- eases caused by du>t. 'I'm aut'.miattcally suspn-t for haring been a director," Ur. l)t<xn HtJ. "but I consider myself a physician lir>t." anti seven other carcinogens," l>c_dcdared. letter in hi> s|>eech, Samuels remind ed Ids listeners that most of them worked for com|>.-mies that were mem When I Later made inquiries about bers of llic Unitvd States CltamlnT of Or. DeSSen, I learned tliat, in addition Commerce, the National Association of to being a former director of KBI, he Manufacturers, and similar groups. lutd been paid by the company for many " Read tin- record of llie recent Senate years to read and take X-rays of ent- and I louse oversight itearings of the |Joyces at tile Hazleton plant. committers mi small business and la iT)Y this time, I was beginning to understand how multiple and in bor," lie said. "Tlte Clumber sap that workers face no greater risk than slip|iing in a hath tub. I only wish the situ tricate were the reasons for the ap ation were confined t the greedy blus palling casualty rate in the nation's ter of such moral midgets. More seri workplaces, and how intertwined and ous is the subversion of government for pervasive were the activities of the profit. The National Asspcmtibn of medical-industrial complex, which was Manufacturers has a full-time repre apparently bent on perpetuating the sit sentative--office, plumes, even a gov uation. What seemed more and more ernment expense account--at the very incredible to me as the months passed, heart of the Occupational Safety and however, was how such a situation Health Administration operations. Po could he--indeed, was being--feder litical industry appointments arc now ated at the highest levels of the federal made at the lowest levels. Industry government. Then, in the second week standard-setting organizations, such as of November, Sheldon Samuels Sent me the American Society for Testing Ma a copy of a speech he had delivered be terials, are attempting to bypass the fore a joint session of the American standard-setting mechanisms . in the Society of Safety Engineers and the [ Occupational Safety and Health] National Safety Conference, in Chica Act. Industrial consultants dominate go, on November 1st. After referring the contract route the federal govern to Secretary Richardson's estimate of a ment lias taken in lieu of adequate hundred thousand deaths annually staff in its standard-setting operations." from occupational disease, Samuels ad Of particular interest to me was dressed himself to the very question that Samuels' claim that industrial con had been troubling me. sultants were receiving contracts that rite economics of the situation are in effect allowed them to usurp the very simple," Samuels said. "Nearly standartl-Setting provisions of the 1970 half of the male blue-collar work force Act--which had clearly intended tliat t> afflicted with chronic--and no doubt standards be developed and recom partly work-related--diseases tliat arc mended by N'lOSII and tlurn promul largely paid for bv the work gated and enforced by tile Oc er and the community as a cupational Safety and Health whole. Even if all of the iden Administratiim. I was already tifiable costs were placed on familiar with the activities of the employer, we cannot al Arthur D. Little, Inc., in ways he sure that it would not helping to set the questionable be cheaper for the employer m coni|>romi-H- standard fty as- replace dead workers than to best**s, ami a few days earlier I keep them alive. It mat even bail received in formation con- he profitable, if onl\ dollars and cents crrinii" anotlier industrial-cfi'nsultmg are counted. In the case of climaic oc firm under contract to the government, cupational disease, it mat be chea;>er for which hail attempted to play a similar nnv nation to sacrifice a life that has r*>lc. This bail occurred when Mazzoc- already achieved |>c.-ik prodtntivitv." chi called to suggest that I telephone Samuels went on u> so tliat in recent Dr. [i-annc M. Stellman, who is as months he had learned of at least four sistant tm occupational health to the plants ill which heta-ii.iplitlivlanuac anil president of the Oil, Chemical, and benzidine were used without proper Atomic Workcis, at ilu- union's head controls by employers well a war* tlici quarters, in Denver. "Ask her o* tell / probable death from cancer of a third \ von the -tore about lictr/.eiie," Ma'/.-l or more of the workers expoed to /ocelli said. - v__ I them. "Became its priorities are deter fMivn I called Dr. Stellman, she mined mi a crude rosi-liencfi; basis, t^Sial,. to Ivgin 'with, thrfS^betP hoWeter, the federal governon tit has /cnc- a colorless liquid --is produced refused to adopt standards f..- the-i as an integral part of refilling oil and gasoline. "It i>"pro!ulU bandit d h\ more than ;t thin) of the hundred and eighty thousand-odd members of the Oil, Chemical, and .Atomic Workers," she said. "And because benzene is also widely employed in the ruhlier, cement, and plastics industries, additional thou sands of workers come into contact with it there. The trouble with ben zene, as has long been known, i> that it is a noxious poison, whose fumes, when inhaled, can induce blood changes-- anemia and leukemia. Indeed, benzene is considered so dangerous that both the American National StantL-irds Institute and the International Labor Office, which is pan of the World Health Or ganization, have recommended tliat in any given volume of air, liquid, or solid material it should be present only in the ratio of ten parts per million--which comes to one-thousandth of one per cent--with a ceiling of twenty-five parts per million. The .American Con ference of Governmental Industrial Hygienists, however, has recommended a standard whereby benzene can bo present in a ratio of twentj-five parts per million, with a ceiling of fifty parts per million. I tell you all this as back ground to the fact that in order to de velop criteria for the establishment of an official federal standard for benzene a twenty-three-tliousand-dolLircontract from N'lOSH was awarded List May to George D. Clayton & Associates--an industrial-consulting firm in Southfield, Michigan." On October 10th, Dr. Stellman continued, Clayton & Associates called an informal meeting of a benzene com mittee it had established. The meering was held at the William Penn Hotel in Pittsburgh where the Industrial Health Foundation, Inc., was then I holding its annual conference. ".As a * member of the committee, I was in vited to attend," she said. "Clavton & Associates -called the meeting at that' time and place simply because Severn1 of the committee's members were at tending tile foundation's annual con ference. The idea was !> have us give our opinion of a preliminary draft of the document on lienzrne criteria tlu-v had prepared for XIOSH. In addition to Clayton, Robert G. Keenan, vice-pres ident and director of laboratories for Clayton & .A>sociatcs, who was tormerly head of the analytical lnlmratorics at the Bureau of .Occupational Safety and Health, and myself, the iih-hiIkts of the ctimmitlce included HnwaiH L. Kusnetz, who was formerly directin' of .the- Ifififtau's 1 )iyirirm-r.-rt Xcupati.mal Injury and DNSr-e Control and i> now I with the iiidii-.ti ial-lugiene d,paruuent | d the Shell Oil Company; Dr. Horace \\*; Gcrafile, who was formerly rhirf to.vlcologt'H at the F.o Research ami Engineering Company anil is now at Fairleigh I>ickinsn University, in New li-rxv; a representative >f the Man ` tilting Chemists .Association and , from the American Steel Institute; anl Louis Beliczky, the director if in dustrial hygiene for the United Ruh-j her, Cork, Linoleum, and Plastic Workers *>f America, who could not attend. When I read the preliminary' draft of the benzene document pre pared by Clayton & Associates, I was shocked to see titat ft was proposing a henzene standard identical to the one recommended by the Conference of `^Hygienists, which is two and a half rimes as high as the standard for ben zene recommended hy the American N'atiniia) Standards Institute and the International .Labor Office. I told the committee that there was no way labor could live with such a standard. After a whole day of arguing, I finally walked out of the meeting, took a plane to Washington, and told Sheldon Sam uels wliat was going on. Samuels promptly bulged a complaint with Dr. Marcus M. Key, the director of XIOSH, and, as a result, Clayton & Associates revised its preliminary document on benzene criteria, and has since recom- idcd the more stringent standard tor benzene of ten parts per million. The point is that the firm obviously called the Pittsburgh meeting in the hope of obtaining approval for a com promise standard for benzene which, while it might not adequately protect i workers against anemia and leukemia, would tun ruffle anyone's feathers." SINCE Dr. Stellman's account of how Clayton & Associates had han dled the XIOSH contract for developing criteria on benzene was closely followed by Sheldon Samuels' speech, 1 started to look into this aspect of the medicalindustrial complex by examining a hook entitled "xiosil Contract anil Research Agreements," which the De partment of Health, Education, anil Welfare had published in September of 1972. Without much difficulty, I de termined that out of a hundred and forty-eight contracts for research on occupational silett and health which XIOSII bail either let nr renewed ill the fiscal year 1972, eight had Iven auaril- '> Clatlon fc A-sociaieS. In addition tlte contrail for lu-nzciic, tin- firm had red it >d contracts for developing documents on criteria for toluene, chromic acid, and trichloroethylene; lor improtint: invthodoloo\ for moni toring lwat-stress standards; for writ ing a manual of"good industrial-hy giene practices fur metal welding and cutting; for setting up a haste course on particulate contaminants for presen tation at the college level; and for pub lishing the third edition of a Public Health Service manual entitled "The Industrial Environment--fts Evalua tion and Control." As I read through die listings, I no ticed that the project officer for the contracts awarded to Clayton & Asso ciates fur tlte development of criteria for benzene, toluene, chmmic acid, and trichloroethylene was Dr. Charles H. Powell, who..is XIOSIl's assistant director for Research aud Standards Development, at the Institute's head quarters, in Rockville, Maryland. Conridering Dr. Powell's position, this in it self did not appear to constitute anything out of die ordinary. Nor was it particu larly surprising that Dr. Powell was listed as project officer for fire out of seven other contracts let by XIOSH, for the development of criteria documents on mercury, sulphur dioxide and sul phuric acid, toluene diisocyanate, fi brous glass, cadmium, arsenic, and parathion. What did seem somewhat unusual, however; was the fact that four of the five contracts for which Dr. Powell was project officer had been awarded to the consulting firm of Tabershavv-CoojHT Associates, Inc., of Berkeley, California. (This firm had also received a fifth contract, for which Dr. Powell was not listed as project of ficer, for developing criteria on arse nic.) The first contract for which Dr. Powell was project officer was awarded to the Sequoia Group, also of Berkeley, for developing a parathion-crircria doc ument. The contract for a criteria docu ment on cadmium was awarded to the University of Cincinnati's College of Medicine. Thus, out of the eleven mostcrucially im|>ori:iiit contracts let hy XIOSH in-the fiscal-year 1972--those for the development of criteria designed to enable the federal government to Set specific stnndartls for hazardous sub stances--Dr. Powell was listed as proj ect officer, for four contracts, totalling $1 I 5,32X, that had been awarded to Clayton & As~ociaics, and for four con tracts, totalling $IS6,SSS, awarded to I ahershaw-CooJvr Associates. In view of the wa\ Chit ton Iv Associates had hnniDcil the bcnzeiic-ci'iu-rfa document in Pittsburgh, I found this a bit discon certing. And in view of the fact that Dr. U\ Clark Cooper, a partner in Talvrshaw-Conpcr Associates, h:ui published fctlflP-atesttJts of two studies mi eX|msure nu.<--glnss in separate 'Strides iii tile Atn> ii> m Iniluftri.il II i A - Station Journal, anil that both studies had been supjtorivd hy the National Insulation .Manufacturers Association, of which PPG Industries, the Ow ens-Coming Corporation, and Johns- Manville fall large producers of fibrous lass) either are or were members, I I found it downright eerie, especial ly when I recalled that the trail of the mcdK-aI-fndtist.ru! complex, which 1 hail been following for nine months started at the Tyler asbestos plant, which was owned bj- ilk- Pittsburgh Coming Corporation, a joint venture of. PPG Industries and the Corning Glass Works, which, in turn, had es tablished and still partly owns Owens* Coming. ' But if the labyrinth in which the medical-industrial complex operated now seemed to branch into a new net work of tunnels, a truly remarkable example of the elements making up this complex appeared in black and white several days later, when I received in the mail a copy of a book entitled "In dustrial Environmental Health: The' Worker and the Community," newly published by the Academic Press, of New York and London. The hook, whose frontispiece proclaimed that it was sponsored by the Industrial Health Foundation, Inc., identified its editor as "Lester V. Cralley, Environmental Health Services, Aluminum Company of America, Pittsburgh, Pennsylvania," and listed its associate editors as "Lewis - J. Cralley, National Institute for Oc cupational Safety ami Health, Cincin nati, Ohio-, George D. Clayton, George I). Clayton & Associates, Southfield, Michigan; and John A. Jurgiel, In dustrial Health Foundation, Inc., Pitts burgh, Pennsylvania." The real am apparent twill's in this editorial roste were startling, to say tin- least, and tlu-t went so many different wavs at once a to be almost too much to comprehend However^ after making a few tele, plume calls and toving with variou jiosribiliiies, I Caine up with a wav n looking at them which amounts to ; riddle-- ,--- \ The riddle begins with the f.tet that jLcstiTT^^Vallei, of the Aluminum Company of America, La twin brother of Dr. Lewis J. Ciallcv, hn in )9yH, while lie teas diicCl*o of the HuiVau of Occupational Safett anil'llcallli'- I)iii- j -ion of Kpideiniologv ami Special Serv ices, rejected a promised >to-l\ o( the biolooie.il effects ol coal Lir-pitch \olatiles_ on _ workers in the aluminum industry (co.il-tnr-piuJi vol.-nib s !>.in^^mcer-modneino .agents to wliii le _ thoiis:nn|{ *>( eoke-ovi-n noil.,is are" exposed j?nn die riinil tltat it wasn*>t rears without even respirator protec presented as an industry-wide study, an tion--but never evaluated in terms of action dial was reversed by tile new the incredible dtsease-and-rleath haz people-in XlOSit, .|v> 'j|>proved a study ard it posed for these men hr anyone in of tile effects of vod-tnr-|iitcl Volatiles the Division of Epidemiology and Spe ivn aluminum workers for the fiscal cial Services, including its director dur ' 1973, which study was tempnrori- ing this period, Dr. Lewis J. Cralley, iv . .iclvctl at XIOS 11 Itcadquartcrs when who, as associate editor of "Industrial siime aluminum-industry officials voiced Environmental Health: The Worker objections to not laving been cuusulted and the Community," wrote a section during die planning stages of the in of the hook entitled "Epidemiologic vestigation, an event tliat appeared to Studies of Occupational Disease," con re]>eat the previous action taken by taining a five-page chapter on asbestos Lewis J. Cralley. who, now retired that described in detail some studies of (nun government service, participated disease among asbestos workers con in writing up the health effects of ben ducted by Dr. John Knox and Dr. zene as a paid consultant to Clayton & Stephen Holmes, of the Turner Broth Associates, which k die firm that re ers Asbestos Company, who later fur ceived a hundred-and-sixty-thousand- nished the'British Occupational Hy diillar contract from XIOSH to produce v/ giene Society with data that appear to tiie third edition of "The Industrial En have underestimated hy as much as vironment--Its Evaluation and Con tenfold the incidence of asbestosis trol," not to he confused with "In among the Turner Brothers workers, dustrial Environmental Health: Tlie and by Dr. John Corbett McDonald, Worker and the Community," which of McGill University, in Montreal, was sponsored by the Industrial Health whose research on mortality among as Foundation, Inc., of Pittsburgh, where bestos miners and millers was financial George I). Clayton and Robert G. ly supported hy tlic Quebec Asbestos Keenan, of Cla} ton & Associates, called Mining Association, hut that failed to a meeting of tlic firm's committee on mention cither the study showing the benzene in order to propose an inap disastrous mortality experience of the propriate and later discredited com asbestos-insulation workers conducted promise standard for benzene, at the by Dr. Selikoff and Dr. Hammond or W 'el William Penn, on October 10, Dr. Cralley's oxvn unaccountably un 2, which was the vet}' time and completed study showing an appalling place of the annual meeting being held rate of death from asbestos disease Vby the Industrial Health Foundation, Inc., which employs John A. Jurgicl, among asbestos-textile workers, all of which, in turn, was accepted for publi an associate editor of "Industrial En- cation by his brother, Lester V. Cralley, . vironmental Health: The Worker and assistant director of Environmental , the Community," and also employs Dr. Health Services of the Aluminum Com Paul Gross, who, in addition to having pany of America, who is the editor of i testified for Johns-Manvflle in a num "Industrial Environmental Health:The ber of workmen's-coinpensatiun cases, Worker and the Community," which b the director of research laborato is the book that inspired tbr <jd;jle- ries of the Industrial Health founda tion, Inc., which is a new name for| the old Industrial Hygiene Foundation of America, Inc., the self-styled "asso SHORTLY before Thanksgiving, I telephoned Dr. Johnson, at XIOSH's Division of Field Studies and Clini ciation of industries for the advance cal Investigations, in Cincinnati,'and ment of healthful working conditions" asked him to tell me ahoot a survey that, entirely financed by industry, in that lie and some associates from tile cluding Johns-Manville, was retained division bail conducted in October at by Pittsburgh Corning in the summer the Allied Chemical Corporation's plant of 1963 to evaluate the n$hc$tos-dust in Buffalo. "We believe that there arc hazard at its newly acquired plant, in still some problems with the compam's Tyler, Texas, where, during the next benzidine operation, and that there are eight years, several more evaluations of major problems with its diehlnroheii/i- tile hazard were made, including two dine operation, which is a relatively by the Bureau <>f Occupational Health's o|>en system," Dr. Johnson said. " 1 he Division <>t K|)iiK minln"V and Special Allied Chemical |V.-ople have chosen to ices, which -bowed airborne ashes- treat diehlnriilx-nzidiiie, which has liven tos-ilust levels at tile Tvlcr plant to he proved to he eareinogeiiic in test ani grossly cpit of contiol, a fact that was mals, as a toxic substance--not as a not itlv not made known to the men potential human carcinogen, as has who wi.rkrd in the plant--- many of ^Srb^wrcoinii'tended 'In the Ijigjish, whom had inhaled a-liesiox dut for who say there is no known safe level <>f exposure to dicldurolvn/idine. and the I American Conference of Goicrnim tit- j al Industrial Hygienists-, wlm say that there should be an absolute minimal ex posure to tint chemical. For this rea son, We're pcirticidarU concerned about employees at tlie Butfalo plant. upiu> have liad past exposure to heta-naphthyLimine and benzidine, and wlm are currently being exposed in dichlorobenzidine. Incidentally, I liave just ounc back from North Haven, Con necticut, where I talked with industrial hygienists from the Upjohn Company. In 1962, the Upjohn peojile bought a plant in- North Haven that was owned by the Carwin Conipanv, which hail been a manufacturer of benzidine since the late nineteen-forties. The Upjohn people discontinued the benzidine opera tion in 1963, and their hygienists told us die other day that there had hern no problems among the workers. How ever, we then made a check at the Connecticut State Tumor' Registry, in ' Hartford, and discovered that there had already been six deaths from bladder cancer among workers employed at the old Carwin plant. For this reason, we are concerned hy the fact that one hun dred and seventy-one employees ( the plant, whose onset of exposure to ben zidine, dichlorohenzidinc, anti other aromatic amines occurred more than sixteen years ago, are no longer em ployed there, and are consequently not included in any existing program of medical surveillance." Dr. Johnson went on to tell me that on November 9th he had addressed a meeting of the National Tuberculosis and Respiratory Disease Ass>ciaaon, in Houston, where lie presented some new information concerning the men who worked at Pittsburgh Coming's asbestos plant in Tyler. "Losing data from Dr. Selikoff*s and Dr. Hammond's mortal ity stmly of the nine hundred am! thirty-three men who worked at the Union Asliesms it Rubber Company's Paterson, New Jersey, factory between 19+1 and 19+5, where exposures were similar to those incurred at Tyler, we now estimate that there will he be tween one hundred and two hundred . excess deaths from asbestos-related can- I cer among the eight hundred and nine ty-five men who worked at the Tiler plant," Dr. Johnson .yid. ("K.xCeSs deaths are deaths iieiond the numhei that the standard niortaliti table, would projeet.) "late l.i-c summer. I I Sent memorandum's to e.nious regional administrator, of t|,e Occup-.iiiouaL J _ Safety and Health A'dtiiini.ti'atioti. u;i- 1 in.i-lkr.- nnoi-j -o.'J -..U.----,.f ,.(|,ol +- asbesrns plant*-where f had iva-wi r>>" .u.pect that, heeau.' of d.u.i ii. had found buried in the files, there were problems of overexposure that should be mtougated. I have since been in* formed bp one f the assistant directors at .VIOSM' headquarters, however, that such memos could constitute an em barrassment to our director, Dr. Key, who is apparently anxious to maintain an image of XIOSH as a pure-research agency. In effect, I have been cau tioned against alerting the govern ment's enforcement agency to situation* where there might be a discase-anddcath hazard. "I now intend to leave XIOSH at the end o{ June, when my tour of duty with the government is over, because I've come to the conclu sion that I'll he better able to function as a medical doctor in some other at mosphere." I called Dr. Sclikoff in December and_ asked him to comment on Dr. Johnson's estimate of future mortality among the Tyler workers, and he told me that he thought the estimate would turn out to be too low. "It must be re membered that only thirty-one years have passed since the onset of exposure among the men who went to work at the Paterson factory," Dr. Sclikoff said, j "It must also be remembered that the excess risk of lung cancer in men ex- j posed to ashestos increases year by year, j For example, a man at twenty-five ears from onset of exposure has an in creased risk over a man at ten years from onset. This risk is greater at thirty years, and even greater at forty. . On the basis of the mortality study of the Paterson workers, I expect a dismal future for many of tile men who worked in tJie Tyler plant. In fact, I anticipate that there will be a hundred and fifty excess deaths among them . from lung cancer, fifty excess deaths , from mesothelioma, forty-five excess ' deaths front cancers of the colon, rec tum, stomadt, and esophagus, and fifty excess deaths front asbestems. In other words, almost three hundred, or rough ly a third, of these men will prohably die unnecessary early deaths." and Atomic Workers International tected, ami elicit, einion-Iy, went on to Union requesting that a zero leVcl of say that if tumors did occur they were exposure for ten carcinogens he set removed "long Itefore malignancy is through a temporary emergency stand expected t develop." Sam MaoCut- ard to he issued under the authority of clteott, corporate director for safety ami tlte Occupational Safety amt Health kee prevention of tlte Dow Chemical Act. A press release issued on the same Conqiany, said that tin* suggested day read, in part: standard would serve as a harassment Approximately 100,000 Am e r ic a n workers die each year as a result of occupational diseases. As more is learned about the orients of cancer, it becomes dear that thousands of worker' deaths are caused by exposure to carcinogenic chemicals in the workplace. The Health Research Group and the Oil, Chemical, .and Atomic Workers Union are thus petitioning the Depart ment of Labor to promulgate emergency temporary standards to eliminate human exposure to the following If) cancer-caus ing chemicals, in order to protect the lives and health of American workers: and would dilute present owiperarive efforts between industry and govern ment agencies. MacCutchettn went on to say tltat studies related to hts-chloroinetliyl ether were in progress, and tltat, because of their imjxirt.ancc and the impact they would linve, the chemi cal slHHtld he removed from considera tion until they were completed. Biscliloromcilirl ether was also much on tile minds of people at the Rohm and Haas Company, in'Philadelphia. Fred erick C. Mucscl, Jr., assistant secretary 2>AcetylaminoSuorene 4-Aminodiphenyl Benzidine and Its Salts Bis-Chloromethyl Ether Dichlorobenzidine and Its Salts 4-Dimethylaminoazobcnxene Beta-N aphthylamine 4-Nitrodiphenyl N-Nitrosodimethylamine Beta-Propiolactonc of the firm, said that exliaustive epide miological studies on the chemical were under way, and tltat his company ex pected results showing ano-effect level well above one part per billion. On May 3rd, having assessed the petition and the fifty written comments, the Administration issued an emergency temporary standard consisting of strict When I telephoned Dr. Johnson work practices regarding tlte manu toward the end of the month and in facture and use of fourteen carcinogens, quired about these developments, he in including bis-chlorontetliyl ether and formed me that on January 24th" he the nine others that had been listed in had called Dr. Albert J. Rosso, who is tlte petition. According to the Adminis associate industrial-hygiene physician at tration, workers were being exposed to the Buffalo office of tlte New York the fourteen chemicals, such exposure State Department of Labor's Division posed a grave danger to them, and the of Industrial Hygiene, and that Dr. emergency standard was necessary to Rosso had revealed that no followup protect their health until permanent inspection of the Allied Chemical plant Standards could Ik- promulgated six had been conducted hy the state since months hence, as the law required. the XIOSH survey in October, which Tlte subject of bis-chloromethyl showed that men worki.tg in the factory ether came to my attention again .in the were at risk because of exposure to ben middle of June, when Samuels sent me zidine and (lichlorohcnzidinr. On Feb a copy of an article entitled "Lung ruary 9th, tlte Assistant Secretary of Cancer in Chloronuthvl Methyl Ether Labor published a notice in the FrA- Workers," which had l>eeii puhlished rrnl Rrghtsr acknowledging receipt of in the May 2+th issue of the -Vnv Eng- l the petition on the ten carcinogens,jiful Innil Jinn unli-l .1/.Aifiiir hy three requesting additional information from Philadelphia pin sician---Dr. W. G. intcrc.-tcd parries. In response to tjic Figueroa, of the Germantown Dis- request, fifty written comments were DURING the early part of 1973, occupational-health problems be sides thitsc associated with ashestos gan to receive increasing public allcntion. On January 3rd, the Buffalo Ctmricr-hxpm carried an article stat received during the next few months. be Some of them were rather interesting. Dr. Harold Golv., the ditvrtur of medi cal-environmental affair.- fur the Amer ican Petroleum Institute, said that the ftetitinn should he denied, on ti\- ground ing that chemicals used at the Allied Chemical plant in Buffalo had k-en 'plicated in a du/cn recent caws of .neer, some .if them fatal, among workers in the factory. On December that the proposed rules te:e `"un realistic, technically unfeasible, and in consistent" and that "zeio tolerance is a philosophical Concept and an objective 29tli, a |>etitii>n had been filed with the Occupational Safety and Health Ad that is neither achievable nor. neces sary." The Beu/idine Task Force of ^gS^mltetic.C ) rgn uic'C.Tcmic.d'^Jjnw- ministration hy the Nader Health Re search Group am) the Oil, Chemical, facturcrs Association assvted that workers uerc brin^ a.l. <|u..:. It pro |H'ii-art and |[>pita!'s pulmonary-dis ease section; Dr, Robert Rasy.kowski, of Temple Unitersilt's School of Med icine; and Dr. William Weiss, of the Department of Medicine 'of Hahne mann Medical College. ( Hi>-rhlorotnctht I ethei i- a cuut.i ill ilia lit hr-product nceurriu'c with chemical reactions that take place in the production of cliiniometln I uietlul ether.) The ar ticle began In sn ill" that in 1962 the managentriit of a rlu-inical-manufac- tilting plant cmpluwn-.: alxuit HCn -thniK.iiitfoe&ikvrs "herwm-^ware that an \ci --iw .number of worker.- mi-- jh'i t` d of li.uin*. lun" c mciM ui o' he- reported in one area >( the plant,, ami turned i<* a chest consultant, who t'cciunmcndcd a program to establish tile degree of risk by semiannual screen ing." This screening program, which ^eluded chest X-rays, was in progress the next five years, the article saal, and during that time the plant manage ment "made a careful investigation of the wort histories in several men wltose lung cancers developed while they were working in the area under suspicion, and concluded that the only common denominator was exposure to chloro- methyl methy1 ether (CMME)." 1 What action, if any, the plant man- j agers took witli rcgartl to the conclu sion they had reached by 1967 remains a mystery, for the article continued: Management is as yet unable to pro vide exact information on the exposure of ;the employees to CM ME. Further in| terest that CMME could be a carcinogen was stimulated by... a 44-year-old man admitted to Germantown Dispensary and Hospital in December, 1971, because of cough and hemoptysis. A detailed occu pational history revealed that he was a chemical operator who had been exposed to CMME for 12 years. The patient scaled that 13 of his fellow workers had lung cancer, and he suspected that this was his diagnosis. All had worked as chemical operators in the same building of a local chemical plant, where the}* m:-d formalin, methanol, ami hydro-! ic actd in two 3800-liter kettles to | p.-slucc CMME. During the process fumes were often visible. To check for losses, the lids on the kettles were raised several times during each shift. The em ployees considered it a good day if the entire building had to be evacuated only three or four times per eight-hour shift because of noxious fumes. The article went on w say that when l retrospective investigation of the fnur:eei cases was made, by an examination >f hospital records and autopsy results iml by consultation with family phvsi:ians, it was determined that all tltv mm had indeed developed lung "can:cf; that their ace at diagnosis ranged rom thirty-three to fifty-five; that he exposure of thirteen of them to 3MME ranged from three to fourteen ears; and that thirteen of them had lied within twenty mouths of <liagnosi*>. The article concluded that the data Strongly suggest that an industrial nzard is associated with CMME." j At that point, I put down the article, .deplumed Samuels in Washington, ml asked him :f he knew which plant red to. . are/' he Said. "It's the Rohtn and Ians factory in Philadelphia." rXURlNG th winter, some signifi'--' cant chan-jes of (K-rsonnel took laci in the Department of l.alior. - which -were said to have been instituted under the direction of Charles \V. Col son, special counsel to the President. In January', George Guenther's, resigna tion as Assistant Secretary of Labor and director of the Occupational Safe ty and Health Administration was accepted by the White House--pre sumably because his performance Jiad received some highly publicized nega- * tive reactions from organized -labor, Guenther`Was replaced by John II. Slender, a former'vice-prwidem of the International Brotherhood uf Boiler makers, Imnshiphuildcrs, Blacksmiths, Forgets, and Helpers, who was also a former Republican state senator in Washington. Then, in February*, James 1). Hodgson, who had resigned, as Secretary of Labor to return to the Lockheed Aircraft Coqtoration as senior vice-president for corporate relations, was replaced by Peter J. Brennan, the president of the New York City* Build ing and Construction Trades Council, who had organized the OHiiucrdemnnstration of hardhat construction work ers that disrupted the student peace rally at City Hall in New York on May S, 1970. Early in March of this year, I learned from Samuels that President Nixon's Office of Management and Budget ltad plans for a reorganization of federal agencies which included a scheme for dismantling large pans of the Department of Health, Education, and Welfare and the Department of Labor, and merging them into a De partment of Economic Affairs. "There is considerable speculation that this shuffle may he attempted without the consent of Congress," Samuels said grimly. "If it takes place, ic will ef fectively do away with the separate roles that were envisioned for the Oc cupational Safety ami Health Adminis tration and KIOSK by the Congress when it wrote and passed the Occupa tional Safety and Health Act. It will* also help tt> sweep under the rug the whole nccopational-lK-alth scandal, we've been trying to expose." Since then, it scents, whatever plans the Office of Management and Budget hail in mind for H.E.W. and the De partment of Labor have been held in alk-yarice pending a resolution of the Watergate crisis. In Mav, however, XIOSll was transferred from If.LAM.V Health Services and Mental Health Administration (which was dissolved) to its Center for Disease Control, as part of a decision by H.E.W. to tv-. luce manjtower and reorganize health pro'^Rftmc.' Sottie. people 'saw this further downgrading of XIOSll, others a** -m attempt by H.E.W. to preserve some semblance of a preventive-medi cine program. In any case. Civil Serv ice regulations regarding seniority de prived KIOSK of more than fifty of its six hundred and fifty employees. Since it already lacked sufficient funds and manpower to keep tip with increased demands for research training, indusI try-wide safety-and-health studies, doc uments on criteria, and health-hazard evaluations, there were predictions of serious work hackings am! an attendant lowering of morale. In June, the con fusion surrounding the future of KIOSK and its operations was compounded by Secretary Brennan, who requested sup port from the Office of Management and Budget for merging KIOSK with the Department of Labor. Comment ing on the general situation in the middle of the month. Dr. Key, the KIOSK director, noted that all its ac tivities would have to be curtailed, and that "the health and safety of the American worker is not going to Ikprotected as much"--a rather chilling prediction in view of the fact that only the previous year Secretary Richardson had estimated that occupational disease killed a hundred thousand American workers each year. Meanwhile, on April 4-th, a hearing on the petition filed by the A.F.L.C.I.O.'s Industrial Union Department and five trade unions for review of the Secretary of Labor's five-fihre stand ard for exposure to asbestos dust had been held in the United States Court of Appeals for the District of Columbia Circuit. In a brief for the petitioners, - the Industrial Union Department nr: gued that the Occupational Safety and i Health Act had clearly required the Secretary to set a standard that would adequately protect the health of work ers. The Industrial Union Depart ment's case that the Secretary kid not done so was based largely upoii the in tegrity of -the KIOSK document on criteria for asbestos, which had recom mended that a two-fihre standard go into effect within two years. However, in the brief for the respondent--former ' Secretary Hodgson--there were two I documents of startling origin which de- j fended the Secretary's action in declar- ( ing a five-fibre standard for four more < rears. The first of these yas a nine- ] teeit-page single-spaced critique of the ` conclusions anil recnnuneinlatioits of tin- KIOSK criteria document, which bail lieett submitted to Dr. I'owcil, an assistant-director of KIOSK, on Janu ary II, 1972, by Dr. George W. VrightytfcJongtinur-ptmfrfonsuhnnr of Jblins-.UaTtville, who was then bead of medical research ai St. Luke's Ilo-|ia:il in CWcLth.i, and who testified later tlwt year in Ik-half of Johns-Manville (and against' the proposed two-fibre standard) at the Department of La bor's jmblic Iwaring*. Curiously, Dr. igltt's letter to Dr. Powell was .er submitted as port of the public record that lire Department of Labor was required to compile in order to establish a permanent' standard for as-, bestirs hut was only later submitted by Dr. Powell as an. extra-record state- mem solicited by Assistant Secretary of f^ibor Guenther in order to justify the Department's controversial decision to delay the imposition of a two-fibre standard for four years. The second letter in support of the government brief was an extra-record memorandum sent to Guenther by Dr. Key, tm May 30, 1972--three days before Guenther signed the contested standard for asbestos--which, in effect, disavowed critical portions of the criteria document that had been prepared by Dr. Key's own staff, and under his di rection. Dr. Key's memorandum to Guenther ended, "In summary, if your hearings and feasibility study indicate that a two-fibre-pcr-cuhic-centimetre level is not achievable until four years hence, I W'ould accept thk as a reasr-tble health stantlard." Dr. Key .d three safeguards to his accept ance of the higher standard, including; provisions that new plant construction , be designed to meet a two-fibre level; that plants and operations that had al ready achieved a two-fibre level be re quired to maintain it; and that an antismoking campaign be required for workers exposed to asbestos. As it turned out, none of these safeguards were incorporated in the standard promulgated by the Department of La bor. However, the government did make liberal use of Dr. Key's memo ten months Later, in its brief defending the Secretary of Labor from the peti tion brought against him by the unions. Tims did the director and an as sistant director of XI OSH take the' as tonishing step of compromising in cam era their own asbestos-criteria docu ment anti its recommended two-fibre standard, which Secretary Richard son had assured President Nix'on, less than a month he fore Dr. Key wrote hi> memo, was designed "to protect against ashestosis and a-hestos-mducvd c -r . . . and to he attainable with existing technology." Moreover, as justification for this extraordinary ad ministrative act. Dr. Powell clmse to rely on an opinion provided hv Dr. \\ right, the Johns-Manville consult ant ( tile compam '.vas later an a:nu in 1 curinr on the government side), and ' win* had died of asbvstosis, lung cancer, Dr. Key professed no qualms about gastro-intestinal cancer, and mesotheli feasibility data gathered by Arthur I). Little, Inc., a firm that not only liad relied mainly upon information solicited oma had once been employed at a small insulation plant in Tyler owned by Pittsburgh Coming?. from the asbestos industry, and from a : group tif medical doctors the vast ma jority of whom had conducted research : on asbestos disease tliat was financially ; nqipoitcd by the industry, hut also was ( It therefore appeared that only an unusual disaster--a drama of vast mag nitude--was likely to evoke the kind of public outrage that, as in the case of the war, would demand an end to the ttn- involved in a direct conflict of interest ! in behalf of the asbestos industry even . as it prepared to undertake its study. No one knows for sure what could have motivated Dr. Key to sign thk extraordinary memorandum, which turned out to have been written by Dr. Powell, but many pcople-assume tliat he was reacting to pressure from his necessaiy slaughter. As things turned out,, newspapers and televfcSori stations around the country were carrying sto ries about the possibility of just such a disaster--one that could affect the hundred thousand citizens of Duluth, Minnesota. Whether or not the Duluth situation proves to he truly catastrophic, it certainly scries to illustrate how a confreres in die Department of Labor, with which XIOSH might be merged. potential disaster can evolve without warning, and to suggest how other such As for the Industrial Union Depart ment's petition for review of die fivefibre standard, a final decision upon it is disasters are bound to occur in the future if steps are not taken to curb industry's indiscriminate use of the en still pending. Most observers feel, how vironment as a private sewer. The ever, that the fact that the integrity of the criteria document on asbestos lias been questioned by its primaiy author has dealt a Mow to the Industrial Un ion Department's case. Duluth story broke in the middle of June, when the Environmental Protection Agency announced that the public water system of the city, which derives its supply front Lake Superior, contained grossly excessive amounts of BY the Late spring of this yeac, I had long since come to the conclusion that there would he no quick end to the resistance of the medical-industrial complex to action that would amelio rate the plight of workers exposed to toxic substances, or, for that matter, to the capacity of many key government officials to react with timidity anti de ceit whenever they were required to make decisions regarding occupationalhealth problems which might run coun ter to the interests of the corporate giants that had been supplying money and manpower to political administra tions for decades. One of the chief dif ficulties in overcoming the traditional busmess-as-usual approach to industrial disease was simple that public opinion could not easily be aroused against the delayetl carnage occurring in the work place. In short, unlike the casualty fig ures of the Vietnam war, which fur years had been reported weekly from :: specific geographical area, specific or dramatic reporting of casualties from industrial disease could never he pro vided, for they were occurring vents after the onset of exposure to toxic sub stances and among men and women win* hail been working in literally tens of thousands of shops anil factories in State of the union. For example, mibuilil be likely to reincmhcP+iirTv -- years from now- that several hundred men in the bill country of Hast Texas ashcsti*s-like material. Upon further analysis, this turned out to be similar to amositc asbestos---the type that was liandlt-d in .the Paterson ami Tyler fac tories. The contamination of Lake Su perior with asbestos had evidently be gun in the middle fifties, when a new pruerss was developed for extracting iron from the tacnnitc-ore deposits in the nearby Mesahi Range. This process consisted in crushing the ore, grinding it in water , to a fine muddy sand, and magnetically separating the iron from the wet slurry. In 1956, the Reserve Mining Company--a threc-hundredantl-forty-million-tlollar subsidiary of AKMCO ami Republic Steel--began us ing the new process at its plant in Silver Hay, a town on the Lake about fifty miles northeast of Duluth, ami also began dumping, through pi]>cs and chute.-', thousands of tons of pulverized waste tailings into the lake each day. (At the same time, large quantities of mineral dost In-gan to be released into the ambient air through the .mokestacks of the plant.) lit the middle sixties, when the compam w.i.s dump ing sixty-seven thousand tons ,,f w.t-ti tailings into the lake each da\, a large green stain almost twenty square miles :n area was Spreading over the hike in the vicinity of Silvcr'llay- -a -Tam that xvafc-*bsug)tt for *--lnng time to l.c composed of algae whose growth v.a- stimiii.ited by the dumping of tli. tail- irrg>. In 19.69, mnccrncd about the con conduct a preliminary study and re dition of the wafer in the lake, the State port their findings to him within two of Minnesota went to court seeking to weeks. Since no studies had ever l>ecn enjoitj Reserve from the practice of performed on people wliose exposure to dumping. In the course .if the proceed asliestos was purely by ingestion. Dr. ings, it was established that the gnx-it Selikoff and Dr. Hammond, and Dr. " :n resulted not from algae but from William J. Nicholson, associate profes jht-Jcattering effect that was caused sor of community medicine at the hy sunlight shining on suspended par- Mount Sinai ScIhmiI of Medicine, and . tides. Then, in December of 1972. aho a member of the staff of its En (Suspecting that asbestos might be pres vironmental Sciences Laboratory, un ent in tlie taconite ore mined for pro dertook n> determine the presence of duction, officials of. the Minnesota Pnl- asbestos fibres in the tissues of such 1 lotion Control Agency commissioned people by comparing autopsy material two geologists--Stephen Burrell, of the from people who had lived all their University of Wisconsin, and James lives in Duluth with autopsy material Stout, of the University f Minne front asbestos workers who had been sota--tn undertake a study of the situ employed at the old Union Asbestos ation. Over the next seven months, & Rubber Company's faculty in,Pater Burrell took samples of ore at Reserve's son. Because workers at that plant-- Peter Mitchell Mine, and when Stout and other asbestos workers as well-- analyzed them, ashestos-type material were known to have incurred three turned out to constitute- about twenty times as much gastro-intestinal cancer per cent of the total. After the iron as people in the general population, the was separated from the ore, the waste projcct appeared to be an urgent one. tailings that were left, contained an Toward the end of June, Dr. Seli even greater percentage of this materi koff, Dr. Hammond, and Dr. Nichol al. Thus, since the dumping had begun, son informed Judge Lord that because it could be estimated that the waters of their initial studies showed that the au- the lake had been polluted not only tnpsy material from Duluth had been with about two hundred million tons prepared with formalin which had been of ore refuse but with tens of millions diluted with water from the Dulutli, of tons of asbestos-type minerals. Small water supply, the material was con wonder that when the Environmental taminated with asbestos to stairt with, :ection Agency--which had insti- and thus made its analysis very much ...cd its own suit against Reserve in more complicated. For this reason, a February of 1972--collected samples proper evaluation of the potential health of the public water supply of Duluth hazard to the residents of Duluth from and sent them t the Environmental drinking water contaminated with as- Sciences Laboratory of the Mount Si lK-sto> could not be made on short no nai School of Medicine, in June, to be tice but would take many months of analyzed they were found to contain painstaking study and evaluation. As a approximately a hundred result, the study contin times as much asbestos- ued through tlie summer type fibre by weight per and fall. litre as any other water Meanwhile, tlie suits samples that liad ever that had been brought been analyzed there. against Reserve by . Min During May, prelimi nesota and the E.P.A. hail nary results of tlie Bur been merged, and went trr . rell-Stout study were re trial on August 1st in ported to officials of the E.P.A., ill United States District Conn, with Washington, who, after mulling over Judge Lord presiding, and with the their implications and the possible ef Justice Department (acting in behalf of fects of - their public disclosure (in the E.P.A., and joined in its action hv cluding the |w>ssihilitv of panic anmug .Minnesota, Wi'consin, and Michigan, tlic citizens of Dulutli), funuMu-d the as well as hi rive environmental groups) information to the court, thus adding a mnieiuliiig that Reserve's di'charge of new dimension t the original suit. At laconite waste intu Lake Su|n-rior posed the suite time, the E.P.A. asked Dr. a threat public health ami should IhSelikoff anti Dr. Hammond to evaluate haitvd. IJec.iiise of the complcxitl of - n sixty days the jxisshilitl' of ad the i"iie> involved, most of the gnicrn- 's .< effects upon the health of the nietu's kei witnesses were not called citizen' of Duluth. Shortlv thereafter. to the stand until the e.-irli (i.ut "f United States District Court fudge September. One of the first of these was Miles D . I.ord, who was scheduled to Dr. who testified th.it hear tile Case against Reserve, feipwst- roiali sis i-P"Water"Samples from Duliiui ed I )r. SelikofF and 1)r, Hammond to shotenl t t thei .untamed veil larg' mounts of amphiboL- minerals, t Atn|t|iiholeS are a complex group of silicate minerals that chief!) contain magn.riuni, silicon, and iron. Included in the group are live different varieties of ashestos, including cmcidolitc and atuositc, both of which are known to have caused ashejitnsts, lung cancer, meso thelioma, and cancer of tlie gasiro-iiitestinal tract in workers who inhaled their fibres.) When asked Jhhv many ainphibulc fibres someone might ingest from drinking a quart of water from the |Nihlic water supply of Duluth. Dr. Nicholsiiii testified that his niialvsts showed that a quart of Dulutli water could contain anywhere from uventv inillion 10 a hundred million such fibres. Later" in his testimony,' Dr. Nicholson indicated- that Reserve's operations might also constitute a serious :iir-|xlhiiion (wizard, since his analysis of air samples taken in the. victilit) of the coinpany's plant in Silver Bay showed that they contained concentrations as high as eleven million antphihoK- fibres |H-r cubic metre of air. ( Am one breath ing such air could inhale more than one hundred million fibres in twentyfour iHiurs.) Basing his conclusions on the air and water samples he had ana lyzed, on his research on' people wlm had been occupationally exposed to as- I hestos, ami on his knowledge of other research into tlie biological effects of asbestos which showed that asbestos-in duced cancers usually took twentv years or more to develop, Dr. Nicholson stated that the situation resulting from Reserve's discharge of taconite waste constituted a serious puhlic-Jicaltli haz ard. "If we waited until wo saw the Iindies in the street, we would then he certain that there would he another thirty or forty years of mortality ex perience before us," Dr. Nicholson sod. "We would have built up a backlog of disease over which we would have little Control." He. Nicholson was followed on the witness stand Kv Dr. Harold L. Slewart, u ho hail In-en engaged in cancer lesiaivh for rhe United States Puhlic Health Seivice's National Canoe Jnstimie since 19.19, and who had been thief of palhologi at the Institute from 1954 until I960, when lie retired. J)r. Steiiatt lestiriid that ill Ills opinion tile amphihole liliies in thi. Dulutli water siipplt eonstiiut.il a carcinogen. `Dun gilt- it to the infants,'' he said. *D on giie it to lining children. This i~ a Caplive population. J he) tun null ing.'t ihe water, it's viriualh a food addiine. Lven thing tiiat's 'e.Hik.-d_ is cooked >n | ash.-stiform minerals]. All the she.tr .-uul thc-^ifflrrtecnses atuPTlw clothes l.iumh ied in ihe'Ti'hestos leaiei. It must- Ik- in the attuin-plicIV. It mtirt he ar.mnd. Tin- dryer jJut dries tile chillies in'the cellar must blow this out somewhere, I woolil assume. It's a carcinogen introduced through the ncstie water supply into the homes People." 1 oward the end of his di rect testimony, I>r. Stewart said that anybody who permits such a situa tion "must realize that he's condemn ing people to exposure to a carcinogen that may take their lives and probably will." After Dr. Stewart's apjrcarance, tle government called Dr. Arthur M. Danger, the chief mineralogist and head of the physical sciences section at the Mount Sinai Environmental Sci ences Laboratory, wlm testified tliat his analysis of fibres in samples of the Du luth water supply showed that lialf of them were of the amphibole variety, that approximately two pcr-ccnt were ttlentical with amosite asbestos, and that between four and five per cent were consistent with amosite: Dr. Langer also stated that almost half of the fibres found in the air samples taken in Silver Bay were cither identical to or con sistent with amosite asbestos in their chemical composition. Dr. Langer was followed to the stand hy Dr. Wagoner, of XtOSIt. A considerable portion of Wagoner's testimony wa devoted t. the excessive amosite-asbeitos dost concentrations that Dr. Johnson and others from die Division of Field Studies had found during tlieir survey of Pittsburgh Coming's Tyler plant, in October of 1971, and to the critical occupational-health situation that had existed there. During this testimony, it was brought out that previous surveys of the Tyler plant, which showed gmss abuses of good industrial-hygiene pracj tices at the factory as far hack as 1967, hail been conducted under the direction of Dr. Wagoner's predecessor at the division. Dr. Cralle) ; that Dr. Cralley had reported the results of his findings to Pittsburgh Corning hut tint, insofar as Wagoner knew, to any federal regu latory agency; ami tliat Dr. Cralley I was at present a consultant for Re serve. Dr. Wagoner was followed on the witness stand hv Dr. Sclikoff, wlm, dining four tlavs of testimony, pro ceeded to review the history of asbestos di-casc, the results of the major studies lie hiological effects of asbestos \. .ell hail been carried out during the, past forty jeans, and the results of. the studies lie and Dr. Hammond liad conductevl showing the disastrous mor tality exjx-rience of ashestns workers at the Tyler plant and at its predeces-or. tiie Union Asbestos & Rubber Coinpanv's factory in Paterson. Dr. SclP5 koif went on to describe some pre liminary findings of a Study he is con ducting of the relatives of men who had worked at the Paterson plant. He told lltc court that upon examining a hundred and fifteen people wlio had lived in the same house with workers at the plant (and who could, tltcre- fore, have been expv*cvl to asbestos'dust brought Imme on the workers' clothes), he found dm thirty-nine per cent showed X-ray abnormalities, most of them in the form of long scarring typi cally found among people who are oc cupationally exposed to asbestos. Dr, Sclikoff also testified thatJte felt it was -ihighly probable that -ingestion-of asbes ts fibres was responsible for the fact that he liad found a threefold increase in cancer of the gastrointestinal tract among the asbestos workers he had studied. In attempting to deny the govern ment's charges. Reserve contended tltat die fibres found in the Duluth water supply were not caused by its disposal of taconite waste into l-ike Superior, and tliat, in any case, the fibres were not of the same chemical type that had been found to cause cancer of the lungs and gastrointestinal tract among asbestos workers. However, Dr. Sclikotf testi fied that lie strongly believed, on die hasis of his experience ami upon evalua tion of all tlu- ilata lie had studied, that cancer was induced hy the "size and shape of tlu- panicles rather than their exact chemical composition." Later, when asked if lie lent an opinion as to whether or not the presence of nmpliibole fihres in the Duluth water sys tem constituted a health hazard, Dr. Selikoff replied licit lie thought it posed a distinct health hazard to the popula tion of Duluth and t other populations drinking or using such water. "We will not know whether or not these partjeular circumstances will cause cancer un til another twenty-five to thirty-five \ears have passed," Dr. Selikoff stated. "This is in mi opinion a form of Rus sian roulette, and l don't know where the Indict is located.'' Upon further ipiestioniiig. Dr. Selikoff testified tliat ashcsios levels measured ill tlw air at Silver il.tv, less than half a mile from two -ela-ils, vv-i-rc about ten tinns as "Teat as a-lx-tos levels measured near -.iies where :oJvmos in-ululion had been used in hiulding o mst ruction in New 'l oik City (a practice lianncd hv the city as ;i health hazard in February of .that t lie. aslvest* is levels igMStbaw Lay' vvviv about the highest environ mental k n k he had ever seen; and that people win* might he hri.ithing air containing such, coucctitrati.>nj were, in hi.s .pinion, risking the development of mesothelioma. At Judge laird's request, a tentatire list of witnesses whom the buyers for Reserve intended to call to the stand was furnished on September 28th. It contained the names anil affiliations of sixty-four men, who were listed ac cording to ten different categvnies of information about which they cindd lie expected to testify. Some of the names were familiar. They included Dr. Cral ley and Robert G. Keenan, of Clayton & Associates; Dr. Paul Gross; Dr. Stephen Holmes, now chief health physicist for the Turner Brothers As bestos Company; and Dr. John Cor bett McDonald, of McGill Univer sity-all of whom had figured in the riddle abuut the medical-industrial complex. Also listed were Dr. Donald W. Meals and three other members of Arthur D. Little, including Dr. Charles J. Kenslcr, the firm's senior vice-president in charge of operations; Dr. Leonard G. Bristol, director of Immur.obiological Research Labora tories of the Trudeau Institute, Inc., at Saranac Lake, which Johns-Manville has helped support for many years; and Dr. Hans Weill, professor of medi cine in the pulmonary-diseases section of the Tulane University School of Medicine, whose study of a>hcstnsis in j workers at a Johns-Manville cementproducts plant at Marrero, Louisiana, had been financially sup|H>rtcd by the Quebec Asbestos Mining Association, of which Johns-Manville is a leading member. Wiiatever the outcome of the trial, all those involved in tlw- Duluth affair, and especially the city's hundred thou sand residents, arc keeping their fingers crossed. On the face of it, the prcdica rnent would seem to he an incredibly absurd and hapless one for the people of any city in this country--the most liigh1 iv devetuped and technologically expert nation of the world--to he in. The major steel companies are anxious about it, because many of them have mine-' and mills in the Mcsahi Range, and the health of thousands of tlieir workers may letve been scriouflv jeopardized tluniicli c*x|nKure to aiK'Stos dust. Most anxious of all, however, are ARMCO and Republic Steel, for, as co-owners of Reserve, they might, if worst comes to wor.-t for the |K-ople of Duluth, lie sued under Minnesota lave. A> it_hap pens, lull- of the chief, medical consult ants for Republic Steely these days is . iioiic~*77{hcr than *TTr*. George W. Wright. Dr. Wright's value to Re- public Sh-i 1- in :ilc Duh.:h art air may prive in lv limited h\ the fact that while in llu-. - nice of fiilnis-Mantillc --tiu- world's largest producer of chrysulilc ashv~ts-- he lt~iified at the Di'H'irinu.lil of -r's [uililic hearings . amositc, uni chry smile, was, in his opinion, rcS)'"ti'ih!c t'nr tin- grossly ex cessive incidence of nnsoiheliotu.-i in the >lii<ly nf insulation ycorkcrs >'miinru-d by l)r. Sclikoff ami Dr. Ham* mninl. uring iiu- smuiur, while iu- D situatinn ill Duluth was making headlines across the country, the De partment- of Labor aiUIr.sseil itself to tile husincss of selling permanent stand ards-fur exjrositre to the f<Hirtveii chem ical carcinogens for which it liatl promulgated six-umniii temporary emergency stamlanls on May 3rd. As in the case of the asbestos standard a tear and a half before, the Secretary of Labor convened an advisory commit tee--tin- Standards Advisory Commit tee on Carcinogens--in order to avail himself of \\|ten advice on tin- prob lem. The committee was made up of fifteen members drawn (rum govern ment, labor, tin- independent medical and scientific community,-ami industry, and in August, it recommended t Sec- y lireiman that the |iermanettt s. .d.-inis incliule a strict |n-rmit sys tem, so that no company enuUI ntanufarture or use any of the fourteen car cinogens without first demonstrating its abilitv to handle the chemical in a manner that would avoid detectable exposure to am worker. "I bis recom mendation vainr about largely because of evidence presented to the advisory committee In Dr. Wagoner's Division of Field Studies and Clinical Investiga tions, which demonstrated that literally hundreds of factories across tile land were mamilaetiiiiiig and .using the chemicals with cither grossly ioadrquate or, in some cases, no controls for tinprotection of workers. fn Septemlier. when the Depart ment of l.aUir's Occupational Safety aud ilealtli Administration held public hearings on the promised si.uidaoL, iit Wasliingioii D.C., the recoin inciulnlioli of ihe ndyisory coinuiiiiee was dis counted by l.eo t ephnv, a special con sultant (or Organization Resources Counselors. Iiic. a concern repiv- min un major corporations, mam of w. . either inaiiuf.-ietiire ir in- uie or more of the carcinogens involved. Testifying-at the bearings on SeptemL-r I I ill, I'eplow declared that the recommendation merited verv little at tention, ami added. " J his is a subject for consideration In |>cuple of far more generalized ex|K-riencc than those wlnF were primarily toxicologists and Jiygienists that composed this committee." On Septvnthcr 14th, Teplmv's state ments were contradicted hy Dr. Ket, nf XIOStt, wlin on this uccasioit took a strung ami forthright stand on the matter of occtipatsui.il exposure to known carcinogens. "It is the firm con viction of SIOSII that tut evidence ex ists to scientifically conclude that any onc of the fourteen agents tinder consideratioxt t> nut carcinogenic in man," Dr. Key testified. "I make this presen tation as a concerned public-health of ficial in the spirit of fostering a better understanding of occupational carcino genesis ... and also in tltd spirit of en couraging a prudent approach to standards setting, so that we can profit from those lessons learned from expe rience with beta-naphthylamine and bis-chloromethyl ether. Such lessons, although advancing the state of knowl edge as far as experimental versus hu man carcinogenicity is concerned, were unfortunately done at the expense of the health of the American worker." On the same day, Samuels, of the Industrial Union Department, attacked the timing of the public hearings. "This hearing could have been held more than two years ago, when our depart ment and affiliates first questioned the exclusion of known carcinogens from the interim standards promulgated un der the Occupational Safety and Health Act," Samuels testified. "The conse-1 quence is that, as a result of two years of unjustifiable exp>sufe to carcino genic agents, regardless of anything done now, hundreds and perhaps thou sands of men anti women can be ex pected to experience agonizing death from cancer in the next two decades. Sir, in a truly civilized .society ur would bold personally responsible those who participated in this crime, both the callous political creatures and the can cer peddlers who bartered moral, ami statutory obligations. In a jusfsocietV they woulti now lie undergoing re habilitation in a |>cnal institution. In stead, they walk freely--some of them are or'have been in this room--as if evil is its own reward." Although Secretary lireiman and Assistant Secretary Stender Wetv re quired by law to announce the proimilgataui of permanent standards for tlie fourtcen carcinogens by November 3uI, that deadline pissed with no action tak en. However, on November Kill, Ge- Scamiell, the director of the OSsSqlalionaU-Safety and Hcalffi-'.Vtf- ministratiiio's Office of Standards, in formed fi.im.xls tiut ;he lieu it.nni.oil> would not include a |n unit system, which hail linn ivcommended In Sec retary Ureitnan's advisory committee, by NIOSII, and by the unions, so that the standards could Ik- effectively en forced under the 1970 Act. ff tin's proves to be the case, then once again, as in the case of the asbestos standard, a Secretary of Labor will have dis owned the recommendations, nf the memhers of his orvn advisory commit tee and of occupational-health experts from NIOSII. (In this instance, he will even have disowned the advice of the staff of the 1'resident's Council on Environmental Quality, who have also strongly iirgrd the necessity nf includ ing a permit system in the new stand ards.) Indeed, continuing the long busincss-as-usii.il approach of the fed eral government toward the crucial problem of industrial disease, lie will have set standards for known canecrproditcing substances which fail to ade quately protect the health and lives of yvorkers. eanwhile, there were some M new developments concerning Pittsburgh Coming's Tvler plant, which had provided the starting point for tny twcnty-oiyc-month investiga tion of the medical-industrial complex. In October, I received a copy of a re port entitled " l ylvr Asbestos Workers Study"--a project designed to conduct a medical followup of the Tyler work ers in the coming years--which had been drawn up by a newly- formed, nonprofit organization called the Texas Chest Foundation, with headquarters at tlw: Texas State Department of Health's East Texas Clu-st Hospital, in I tier. The idea for the project had been initiated by Dr. Johnson Lite ui the summer of 1972, and it had hcen developed since then by him and hy Dr. Wagoner; hy Richard A. Lcmeli, an epidemiologist in the Division of Field Studies and Clinical Investiga tions; by Dr. George A. Hurst, the superintendent of the Hast Texa: Chest Hospital; anil hy Dr. Selikoff. Upon making inquiries, I learned that these men had met in May and June of this year yiish Dr. Michael R. Spurn, the chief of the lung-cancer branch of the Department of Health, Education, and Welfare's National Cancer liisti;nict for the purpose of engendering in terest in and funding for the project. 1 also learned that ilmiiii; the . late pring and Kuimni-r.I^.iiii-n had. ntatiagedto trace tile- whereabouts of >i\ lionifred and nme'iv-fveo iif the i-ioht'l hundred .inif^ ninetv-five men | hail liccn employed at the J yler plant from November of 1954, when it opened, until Fehruary of 1972, when Pittsburgh Corning shut it down. In addition, I found out time on June 18th, Hr. Johnson had written Dr. Grant, medical director of I'PO In dustries and medical consultant to Pitts burgh Corning--who hud first ignored and then minimized the peril of the workers employed at the Tyler plant-- informing him of the prop,wed study and of the National Cancer Institute's interest in it. I talked with I-enien recently, and lie told me that in August of this year he decided to revisit the site of the old 1 Tyler plant, where the Imperial Amer ican Company now manufactures lawn furniture. "I had not been back to Tyler since January of 1972, when Steven Wodka and I visited the dumps where Pittsburgh Corning was dispos ing of asbestos waste," he told me. "Imagine my surprise when I discov ered that the soil with which the com pany had later covered them over had eroded, and tint loose wads of asbestos fibre were lying everywhere on the ground." Lcmcn went on to tell me that he had brought the matter to the attention of officials of the Texas State Department of Health and of the E.P.A. I Later learned that Pittsburgh Corning had been directed by the E.P.A. this past September to remedy the situation. The company then pro ceeded to re-cover the dumps with two feet of soil and with four inches of top soil, and to seed them with grass, at a total cost of some sixty thousand dol lars. The prudence of the E.P.A.'s ac tion was .reinforced by an article that appeared recently in the Annals of Occupational Ilyg'wnc. The article was entitled "Asbestos in the Work Place and the Community;" it was written by Dr. Muriel L. Ne-whouse, of die London School of Hygiene and Ttopi cal Medicine, who is well known for her studies of mesothelioma; and it in cluded the description of "a patient suf fering from a peritoneal mesothelioma [who] recalled playing with handfuls of asbestos on waste ground near a factory as a small hoy, some fort}' years before he develo|xal his tumour." As for the "Tyler Asbestos Workers Study," which is being considered for funding h\ the National Cancer In stitute (ami to which, as yet, Pitts burgh Corning lias not offered to mala any contribution), it says, under tin licading "Definition of the Problem": . lit 1972, approximately cijjlit hundred and seventy-live employees of a Tyler as bestos plant completed massive exposure ] to inhaled amositc asbestos fibres. Ap pruximately two hundred and ,<ixt]^f these employees will develop cancer, mainly bronchogenic carcinoma, and dir from this disease unless some type of successful intervention is undertaken. At present, of cnu.rse, no truly suc cessful intervention to combat the de velopment of lung cancer is known to the medical and scientific community, hut it is at least a hojx-ful sign that if the Natinnal Cancer Institute funds the project the 'I yler workers will mu be wholly uhandouctl to the awful peril they have been exposed to (ns have so many other asbestos workers in the United States), and that if in the next few-years some-kind* of successful in tervention is discovered some of these men-who might othe'rwise 'die nnnec- ily early deaths may he saved. - IORTLY before the Duluth story broke into the headlines, I received an announcement of the National SymJ j posium on Occupational Safety and i\f Health, which was to be held at the Carnegie Institution, in Washington, D.C., from June 4th to June 6th. Amung the listed sponsors of the sym posium were tlie Division of Industrial and Engineering Chemistry, the Amer ican Chemical Society, the Manu facturing Chemists Association, the National Safety Cnuncil's Chemical Section, XIOSH, and the Occupational Safety and Health Administration. Ac cording to the announcement. Session SL\ of the symposium, entitled "The Human Factor," would be co-chaircd hy Dr. Gram, who was scheduled to deliver some introductory remarks. More recently, I received a copy of tile October 3rd issue of Clhii.uiil IFctk, a publication put out by .McGraw Hill. It contained an article en titled "Health Programs Need First Aid," which described a meetini' of the Manufacturing Chemists Association, liehl in Atlanta during September. The article said tlutt "O.S.H.A., now in its third tear, Itatl issucJ its first perma nent health standards--for asbestos," and tlutt "ten or more substances will ave fx-rmnnent standards In the end f tin- tear, according to l.ce Grant, ledicat director of PPG Industries, vho moderated the discussion." The -rticle went on to state that "Grant ays O.S.II.A. will define a `healthful nvironmem' and take oilier -ups con vening iixiImhIs and sampling pro cedures in the work environment, medical examinations for ctnplmves, and prescribed work practices."' Although I was unahji^f< attend '''"Writer the National St ttt|XMiun'oii Oc-- cupaliorial Safetc and Health or tin Manufacturing Chemists Acuti.<it meeting, I bad bail a chance to see Dr. Grant preside over a similar gathering almost a year before. The tK.vasi.oi was the One Hundredth Annual Meetitiu of tlie American Public Health Associ ation, which was held in AtLouie Cite from November 12th through Novem ber 16th of 1972. At that time, nearly eight months had passed since [antes M. Biercr, the president of Pittsburgh Corning, telephoned ntc to say that he could nut give me permission to talk with Dr. Grant, or with any other Pittsburgh Corning cmplnvce, about the Tyler plant. During those eight months, I had gathered a good deal of information about Dr. Grant, ami it had made me all tie more curious to meet him. Therefore, when I received a copy of the official program of the American Public Health Association's meeting and raw that lie was scheduled to preside at two of its sessions, I de cided to attend, in the hope of talking with him. I arrived in Atlantic City on Sunday, November 12th, and went di rectly to a meeting of the American College of Preventive Medicine, which was being held in Ballrooms A.and B of the Holiday Inn anti was being pre sided over by I)r. Grant in bis capacity as tlie college's outgoing president. Upon reaching the doorway of the ballroom, I could sec half a dozen peo ple sitting on a platform at the front of the room, about twenty yards away. I asked a toting man standing in the doorway if lie knew which f them was Dr. Grant, and he pointed out the man sitting at far stage right--a lean blond man, with deep-set eyes and a promi nent nose, who looked to be in bis middle forties. However, when tlie ses sion ended, a few minutes later, and I advanced across tlie ballroom Hoot--to ward the platform, I realized that Dr. Grant was at least ten years older than I bad thought, and that it was bis blond liair --parted and cmilhed in the Hat collegiate style of twenty tears ago-- tlutt nutde him ap|vnr younger at a distance. \\ ben I reached the platform, I illtiodticed lilt Self to Dr. Grant, wln was standing above me, at approxi-j tliately kucc-tn-ciehall let el, and rv-j minded him that l had telephoned him] in March in the hi|>e of lx mi; able lot talk with him aNutr the Filer plant. I* also reminded him that at the time lie: hail refened me n> Bieur. who had - subwi|iicntli* ivluwd to "it, its- |vr- mi'siou to talk with am eutplmee ul ' the coufjetnc." -- .=- -- - ``I wonder if tln-fc im-ar U- ...ntc ; firHE&in the iksr--ifai or ;uo that-T ` multi talk ivhh ton " 1 sink % Dr. Grant appeared to hesitate. Then, glancing quickly over tin: ball room, which was emptying, lie shook his head. "I'm afraid I can't," he re plied. "In this instance, it's a question f the patient's rights.'' For a munient, I thought I liad not heard him correctly. Then it dawned in me that he was talking about the company. "Do you mean Pittsburgh Corning?" I said. "Why, yes," Dr. Grant replied. "If they don't want me to talk with you, tlicre's nothing I cm do." "But isn't the patient all those men w!k> worked in the Tvler plant?" I . asked. Dr. Grant straightened up and looked down Si me from his full height* on the platform. "Well, in the larger sehse, *rf course, that's probably true," he replied. "And now, if you'll excuse inc, I have some business to attend to." I stood at the platform ami watched Dr. Grant, who, as he moved away, put a cigar in his mouth, lit it, and ex haled a cloud of smoke into the air. A moment later, I saw him throw an arm in greeting around the shoul ders of a colleague. Then I turned away, anil found myself looking straight into the face of Anthony Mazzocchi, who, as it turned out, had been invited to speak at one of the conven tion's sessions on occupational health. "Did you hear that?" f asked him. "Did you hear what he said?" For a long time, Mazzocclii looked at me without a trace of expression on his face. Then, very slowlv, he nodded his head up and down. And then, just as slowly,.he'shimk it from side to side. --Paul BnoriF.fR {Tbit is the last of <i serifs of articles.) r