Document 8OQDNReNGn7Lry972EzMjYBbB

FILE NAME: Talc (TALC) DATE: 1990-1993 DOC#: TALC044 DOCUMENT DESCRIPTION: Medical Records with Biopsy Records HOUSE OF THE GOOD SAMARITAN Department of Laboratories W a te rto w n , NY 13601 315-785-4001 SURGICAL PATHOLOGY REPORT N am e Harmer, Dale Sex M D o c to r Loewen C lin ic a l D ia g n o sis solitary pulmonary nodule RUL Age 49 D ate R eceived D ate R e p o rte d Room Agu Feb. 14, 1990 Feb. 15, 1990 GROSS DESCRIPTION: A _ xhree right upper lobe biopsies, the larger 0.3 cm, B - Bronchial washings submitted for cell block. Gross & Microscopic Diagnosis: A - Mild chronic bronchitis and lung tissue with asbestos bodies, biopsies from right upper lobe, - i B - Negative for malignant cells, cell block of bronchial washings. -2 R ecord R oom No. 203243 G 00099432 Jove n G . K uan, M D, F.C .A .P . C h ie f P a th o lo g is t Pathology Report No. g_90-990 HealthScienceCenter State UniversityofNewfctoris Syracuse Centrai New York Occupational Health Clinical Center 550 Harrison Center-- Suite 300 Syracuse, New York 13202 (315) 473-6422 March 26, 1990 MEDICAL SUMMARY p a t i e n t n a m e s Dala Harmer DATE SEEN: January 11 1990 NOV 2 6 Dale Harmer was evaluated at tte Centra^ s - Health Clinical Center on January 'p York In the Spring of y1e9a8r8-otlhde talc patie mi nt ner imd from erwen G t oau vce o m pe a n y , o f-ffe reedd^pphhyyssiic^arl ^ e x a m^ i n a t i^ o n and was told at that time tha oatient, he was evaluated lungs "looked bad". re extensive pulmonary function further with an Jhe pulmonary function testing testing, and e. treadmill . j _ reduced FVC and FEV 1 with a included a spirometry which s t restrictive lung disease, normal FEV1/FVC ratio. Thi^suggests done at that Apparently no lung volumes or diffusion capacity sclerosis and time. The echo c a r d * " * ^ i f i c a n V o S t n o w gradient. % ej ection S S v S T ' l S ? unavailable to me. -- S bests are The patient has had compla^ ci|JlyS^ h ^ n^xertinghimself at approximately the past year# ?. ^ shortness of breath while wo?k or climbing stairs. He ^ e l h i n k s he is able walking at his own pace^ on ^ However he feels limited at wtoorkkeeapndupiswiatfhraoidt htheart ssQo^onh e wil 1 not Hbe4 iasbleabtloe dtoo hiassCjeonbd B id S b any wheezing. -. " Also over approximately the past two years the pata^ j f la^aStohaa nSS is occurring almost daily. ^ " ^ ^ ^ " ^ ^ s u a l l y l a s L sternal area and radiates to the 1 ft h 1 certain turning a few minutes. It seems to De oro g h blows hard during msoptiiroonmsetraincd toetshteirng.actTihveitpiaeisn is somettiimes eexxaacceerrboaatueeda byy pushing ? Dale Harmer on the chest wall. It is not ^ J ^ t e n t l y asso<^ 2 diaphoresis, or feelingsof1faintnessf ^ i T S S the patient was resting in bed. ^ The patient denies any hemoptysis - - ^ TM S^ - fovBrs. He has had about a r> To the patient's which the patient has net used for his chest pain. _ ' --ifirant onlv for an ulcer in 1985 The past medical history is ?? an<j sinus problems which the wSich is not tcurrently * * * f TM ^ h heioon outgrew. The only patient experienced as tonsillectomy when the patient was previous surgery has be is currently on no medications, around 8 years old. The ^atient^ ^ ^ # motor vehicle accident He denies any known allerg broken ribs. In addition, in and suffered a fractured spine ^ d moving machinery at the 1974 the patient's arm got caught w i * damage to his right upper Gouverneur Talc mll]r cr^USJ-ff a Toft tissue injury without bony arm. Apparently, this was a sot fracture. . . * ,, ,, m e a n t for coronary artery disease. s haf 3 s s t s i . r a r ^ ? s r i * -- heiith- .. i. 57 vears and up until a yur The patient has smoked fo^ the pas ^ Qne_half packs per day. ago was smoking betweenon- tobacco intake to almost nothing. For the past year he has cut.nx "^ ies in the past have included He drinks a few beers Pr ^ T e enjoys hunting he denies extensive hunting and fishing. Tho g at all outside of the hunting s signihcanl^potentiallsM^xic non-occupational exposures. The patient's occupational o n ^ d a S r ? fara.^From 1963 teenager and in variety of short-term jobs. He worked until 1969 the patient had a v a r ^ c y ^ d was involved in most of the for two years in an Agway f winrtino the feed, and feed feed mill activities lneludmg g croveton Paper Mill deUvery. He worked for two yearsJ ^ e T f o r a year at a Kraft running a perforating ' For one year he was employed, m a foods plant processing cheese-^r Qn bowliyng pins. The patient was Lowville factory putting 1 3" gb joe's 2 inc mine as an Iso employed for six months at the st. J underground mucker. Dale Harmer In 1969 t^he pat*.i4en+t. ,,w-e,,ntt ttoo work wojtk fror IntuerntahteiopnraelseTnatlch,e whhaesrebeheen remained for five years. initially the patient was employed employed by Souverneur Talc. ^ e l d several other as a driller in the .irinciudind driving a truck, in the mill relatively short term j less than one year as a packer, crushing department for ^ ^ . ' since moving to Gouverneur Talc and about five months on rPaf|* a milling operator at the No. in 1974, the with older machinery. The ore 3 mill. This mill is an older m u crushed, milled, packed, is brought up from underground a ^i supervising a variety and shipped. T h e Hi spends^^Almost Jll of his time in the of milling o p e r a t e s . He milling machinery. He mill and describes itsheowftoernk as contin 7 ^dUsJty apnodtepnotsisailbllyy wionrasdeeqouvaetre the last couple a utinel leaves work covered with dust, maintenance. The patiervc touu. y thick and covers He describes "bad^ nightshim completely . Prior 'to lea g ott whatever dust he can clQthes home and they are with an air hose. He wears n estimates that he has worn a laundered there. _ respirator approximately 7 time. The respirator is an air with dust cartridges. The purifying half"/ha | every 1 hour shift but when the dust is cartridges are changed every chance the cartridges two or etshpreeceiatlilmyes a shift. 1 TThhe^rreessppiirrator has neavnedr bteheen pfaotrimeanltlywefairts- tested. The conditions are a1 o i s ^ The mine safety hearing protection approxima y s 0% ^ inspections once or twice a i e L ^ c c S d S 1? ^ patient but he does not know the results of these evaluations. On physical examination t ^ ^ walf^?and Regular, age but in no acute *d _rggSUre 108/80. The HEENT exam respirations were 20, and bl P canal w h i 'h was blocked with was remarkable for a rig t cerumen. The left tympanic ane was normal. The patient was r*iciv coated. There was no edentulous and hia^ ^ _ J ^ ph^ denopyathy. on auscultation of cervical or suP ^ ^ i ^ g ^ ^ C 4 bases on inspiration. In the the lungs there halfway up the chest, whereas on ltehfet rliugnhgt thtehseey disappears a o o ^ ^ ^ofextthrea wheaayrtupsotuhned chest. On examination of th , ,. _-ii_> There was also a which may have been an S4 r a rd b st at the apex. The abdominal 1/6 systolic e j aarg0^ dg W i t h o u t "organomegaly or exam reveeied positive B . d a prostate which was about 2+ tenderness. Rectal exam snowea p The testes were enlarged and was dff"i Tberg was no occult blood or masses c^n S sS ^r limits. " >'i t h i n n 0 r,n a l * 4 Dale Harmer Additional testing ln5l^ ef a ^ u i i i i t a l c u m ^ f r e g a l e s and normal in the 1"J `^ s i g n i f i c a n t asymmetry between the ears, to 8k region. There was sign . A.1- ,,efiont'ls FVC was 3.38 L (78% or on pulmonary function testing toe P f m i / P V O f 82%, predicted), FEV1 was 2 J.7. ,i% of predicted). The chest x-ray, and an FEF 25-75 o f 3 markings in toe mid and lower lung rovealed diffuse interstitia 4j..i.ified in the right apex. An fields bilaterally. BUH " ^identified in toe right upper lung ill defined nGduTia' . 5* " on-oal=ified with ill defined borders. Bo S S i S S i i S w P t o n o r m a l i t i e s were noted. Because of toe possibility of ^ S o X referred to Dr. Gregory obtained by Dr. Loewen there York. On pulmonary function ity with a normal total lung , diminished iSonstrated on PIT. Dr. capacity. ObstructiveL ^ t ^ x -X y and a CT of toe chest. The LoSwen also .ftained a t o t fX y ^ thic]cenlng along c h lower chest x-ray identified are P findings noted was i s s s . S K sat " definite^alcificaticni was noted and malignancy was suspec . Dr. Loewen carried out endoscopy and histology of the biopsies taken a biopsies^and the bronchial for numerous ferruginou hial Abraham also reviewed the \rontoi Health Science Center in yr "erruginous bodies in the i 9 ThJ however, was remarkable Dr. Gerald aiVeolar lavage at the S m m d very hlgh numbers of c m p r bIsSSsIioOnN mAidU r e c o m m--e-n-d-a-t io n s * ^ and Sale Harmer's symptoms, physical pneumoconiosis ulmonary function testing a^e a i combined talcosis and S is most likely for approximately 20 years as asbestosis. The patient ha ^ at time according to his history a talc miner and miller. Dur g . of talc and other dusts which he was exposed to significa . ge describes exposure to the included Tremolite and ^s p c ially during the early Yar fibrous forms of these protetion has been w o n of his employment. ^ d e a r whether the cartridges significant amount of time bur whether they were appropriate used were of the appropriate type, respirator has never been fit f i f t h s exposure levels rea=^e d * t ient'f b f I c h i a l alveolar lavage tested. n bronchoscopy the p t to.contain very high numbers fluid and biopsy material was 1 Dale Hanner . e y s u r 9in0S n Sbe^'ntlyhlS T * =nsiatent it* asbestos fiber pneumoconiosis ? L a t X n a ? ^ T i ttat >* * * i contracted as a direct result nf h l c 1 9 disease and has been I miner and miner. * of hls *&*** working as a t a S malignancy? "hich * suspicious for 1 out the possibility o f a lung t ^ o r ^ K r e l o ? S ^ dSS not rule ' the patient must be followed ^ i i e ]?y Dr`Loewen enlarges an open lung biopsy will be noro/ anci, the nodule . evaluate it. if the nodull is not .to definitively : pneumoconiotic nodule as noted by D r i i e w e n . 1 13 MSt likely a o i t ^ h ^ 'i ? V ? pn* i^ a a k in g it ^ e ^ 'd T f f iS f lt ^ wi t h P a c V t y S V S S S i . functiorT t w t i w TM cof 3 ~ " i ? S that his symptoms a S d ^ to decreased J nse^.ently it is likely his occupational lung d X e a s e p f t X S T f bln 33 a result of ' him at increased risk of p r o g r e s s i o n ^ h?J s pneumoconiosis puts mmiallli.gnanBceycawuisteh oafny hfiusrtshyemrpteoxmpsosaunrde tfohodu1sts aatttthhet Xta/lc m1i*neasanodf exposure I would consider Mr. Harmer to f no further p1" ^ . " - ih e * patient's lun, disease *' s s s rz s z 2` * . * i'Oewen for the 3 - and pneumococcus. 4. The patient should locate a ^or pth the influenza __ local area who can bereiponsible^n^X p*?Ysician in his his medical care. resPons^ l e for coordinating all of ll m " questions regarding this report, please call me ML:lm I"' STATE OF NEW YORK ST. LAWRENCE COUNTY LEONARD GAUMES, etal I P la in tiffs , I R. T. VANDERBILT COMPANY, INC., GOUVERNEUR TALC COMPANY, INC., ST. JOE MINERALS CORP., and FLUOR CORP., J4 Index No. AFFIDAVIT STATE OF NEWYORK ) COUNTYO F ONONDAGA)SS: . I, Dale Harmer, being duly sworn, deposes and says: 1. I am one o f the plaintiffs in the lawsuits against R. T. Vanderbilt Company, Inc., Gouverneur Talc Company, Saint Joe Minerals Corp., and Fluor Corporation and I understand that R. T. Vanderbilt and Gouverneur Talc Company have made a motion to dismiss my action. I know that this affidavit will be used as a means of opposing that motion. SETRIGHT. C IA BO TTI 6. LON G S TR E E T - SYRACUSE. NEW YORK 2. My lawyers tell me that R. T. Vanderbilt and Gouverneur Talc Company deny that they ever made any misrepresentations to me concerning my health and deny that they concealed from me the true condition of my health. I have also been told that they deny that there is asbestos in the mines, and deny that they concealed from us the fact that there is asbestos in the mines. Those denials are false and I will explain how I know that from my own personal experience. 3. I am fifty-two years old and went to work for International Talc Company on October 6, , 1969 in the "open pit." Then, when Gouverneur Talc Company took over International Talc Company in 1974, Gouverneur Talc Company hired me. Therefore, since 1 9 6 9 ,1 have worked in and about the talc mines and pits owned first by International Talc Company and then by Gouverneur . Talc Company, which in turn, I am told, is owned and controlled by R. T. Vandeibilt Company. j j , iI i; i! I f I 4. With respect to the condition of my health, I want to say that every year the employees of International Talc Company and then Gouverneur Talc Company would undergo physical examinations by the plant doctor, which included chest x-rays. So for the approximately twenty years that I worked for International Talc Company and Gouverneur Talc Company, I had yearly chest x-rays and breathing tests performed by the plant doctors. Prior to 1989, I never once was told that there was anything wrong with my lungs or anything else. 5. Sometime after I filed a Workers Compensation claim, in November of 1989, my lawyers gave me copies of some medical reports they had received from Gouverneur Talc Company. 6. Included In the medical reports, there was a report by Dr. Dodd, the plant doctor back in 1979, dated October 10,1979, which stated: "Comparison with the previous exam of October 11. 1978, now reveals an increase of pulmonary markings throughout both lung fields, somewhat more accentuated in the right base." I am not a doctor, but it reads to me like something was going on way back then. I was not told by Dr. Dodd or any other doctor at that time that I had any lung or respiratory problems at all. Even when I began to feel sick, I wasn't told that I shouldn't work there anymore. 7. During the last part of 1989, I got to a point where I got tired going up and down stairs. I was spitting up a lot, and my lungs were feeling bad. Somewhere around the spring of 1 98 9 ,1had a physical examination by the plant doctor, who was then Dr. Fung. He talked to me after the physical examination. He told me that I had a heart murmur and he said that my lungs didn't look too good right then. Dr. Fung told me that I had a real small spot starting in my right upper lung, but it wasn't significant enough at the time to really do anything about it. He sent me down to the hospital for some tests and again said it wasn't serious enough to do anything about. He didn't tell me to stop working and I kept on working because I didn't know anything was wrong. 8. I kept getting worse and worse. Finally, my wife and I decided I better do something else and that is when I went to Dr. Lax, somewhere around January 1990. By that time, l was feeling pretty bad. Shortly after that, Dr. Lax diagnosed that I had lung cancer. I want to know why I wasn't told about Dr. Dodd's examination report of October 10,1979, which said I had some trouble "somewhat more accentuated in the right base," especially since that is where the lung cancer started. 9. My true physical condition was concealed from me, but, Q. E. Erdman's Inter-Office Memorandum was placed on the bulletin board. pu< up there for all of us employees to see, and we all saw it. (A copy Is attached to my statement, by my lawyer, and marked Exhibit A.) Please note the next to last sentence In the memorandum -Even though you shouldn't need to worry about getting cancer from our dust, you must respect the possibility of getting talcosis." My Information is that, at that point, several of the miners had developed cancer and since then several more of them have developed cancer, but on this memorandum, we have the manager of Gouvemeur Talc Company telling us we don't have to worry. . 10. I think, concerning my medical condition, they kept from me the true nature of It and they even tried to tell me them was nothing wrong. The manager. Mr. Erdman, even told us not to worry about getting cancer from the dust. It I had know that I was going to get s i* from being m the mines, I would have looked for other employment that was not so unsafe to my health. I relred on what the company was telling me and also what they were not telling me in making my determination to continue working in the mines. SETRiGHT. CIABOTT1 & LON GSTREET SYRACUSE. NEW YORK 11. Maybe the pay is not as good being a farmer or something like that, but at least you don't end up with lung cancer. 12. I have a few comments as far as this asbestos thing is concerned. Before OSHA came in, everybody talked about asbestos being in the mines and in some areas, there were more fibrous materials which we all called asbestos. After OSHA came in, we noticed that the word asbestos disappeared from management's vocabulary and they took a position with us, as well as with OSHA, as far as I know which is shown in Mr. Erdman's memorandum, attached as Exhibit A, in the first paragraph: "NIOSH knows these facts but is reluctant to recognize their earlier error in classing tremolite as an asbestos mineral that is not a cancer causing agent." and "but the weight of increasing evidence continues to indicate that our products are not causing abnormal amounts of cancer." 13. la m told by my lawyers, who have retained well known mineralogist, Dr. Arthur Rohl, who is fam iliar with our talc mines, and environmental pathologist, Dr. Jerrold Abraham, that there is no question that there is asbestos in the mines up here and it gets into the lungs of the miners and has been seen there by Dr. Abraham. SETRIGHT. ClABO TTt f t LONGSTREET - SYRACUSE. N E W YORK 14. 01 course, I have read, over the Iasi teen to twenty years, about the dangers of asbestos. All ot us miners up here were interested in that because, all along, we have been calling some of the products coming out ot the mines asbestos. Now, our employer and the company that owns our employer, are telling us that there isn't any asbestos up here. It anybody had ever told me what I have found out since we biought this lawsuit and my lawyers went out and hired experts, and If I had known then what they have said, I would have gotten out ot those mines years ago. The only reason why I kept working was because Qcuvemeur Talc Company and R. T. Vanderbilt kept telling me that there wasn't any asbestos in the mines. 15. I remember, a tew years ago, a gentlemen by the name ot Hugh Vanderbilt, a big wheel with R. T. Vanderbilt, came up to the mines and talked to a lot of us at the mine head. He told us that the government was claiming that there was asbestos m the mines and he said that we didn't have asbestos. He said he had a senator In h b back pocket and there weren't going to be any problems with our Jobs because he could appeal any finding that we did have asbestos tor years, so we wouldn't have to worry about our Jobs and there wasn't any asbestos up here anyway. 16. We miners and ex-mlners up here are a very close knit group. When we are working, we have to depend on each other so that each one does his lob and everybody is safer and better oft. know that none of them would have worked In those mines If they had known It was going to harm their health and especially It they had known that they were being exposed to asbestos. D a te d : Signed and Sworn to before me this Y M /to J . 1993 Dale Harmer Notary Public NotaryAPNuNbElicL, SBtaEteNoNfENTeTwYork Qualified in St. Lawrence C o u n ty . Commission Expires June 3 0 ,1 9 tf-> The State Insurance Fund 901 James Street Syracuse, Hew York 13203 Inj.t Exam.: Carrier #: WCB #: 11/01/89 Pulmonology Consultation 10/26/90 30999031-062 6891 5142 ATTN: Charmaine Hauff . Dear Ms. Hauff: Thank you for referring Dale Harmer to Riverfront Medical Services. with and evaluated him on October 26, 1990. 1 spoke HISTORY As you know, he is a 50-ryear-old, white male who on 6/1/90 underwent right thoracotomy and upper lobectomy for adenocarcinoma of the lung. Pathologic examination of resected lung material revealed not only the carcinoma, but also numerous ferruginous materials and asbestos bodies as well. Lung tissue was examined by Dr. Abraham who concluded that the lung showed focal interstitial fibrosis with associated asbestos and ferruginous bodies. In Dr. Abraham's opinion, these findings were "sufficient for a diagnosis of pulmonary talcosls and asbestosis." ADMINISTERED BY EMPIRE MEDICAL MANAGEMENT LTD. 03-06-91 03:50PM P04 flUG 06 '91 14s31 00T & fiSSOC. 5YK NT 4 * ^ RE: HARMER, DALE 2 4 PAST MEDICAL HISTORY He has a history of having been a significant cigarette smoker for many years. PHYSICAL EXAMINATION Physical examination reveals a 5'8" tall, pressure is 130/88. 152 1/2 pound male. Blood The examinee has a well-healed right thoracotomy incision with . a moderate degree of hyperinflation bilaterally. There are no wheezes, rhonchi or rales. Expiratory phase is only mildly prolonged. The balance of the physical examination is unremarkable. X-RAYS An x-ray taken in January of 1990 showed chronic obstructive as well as interstitial change and a nodular density in the right upper lobe which turned out to be an adenocarcinoma. A review of the examinee's chest x-ray supports the analysis provided above by Dr. Serle in January of this year, CPNCLUSlflH DIAGNOSIS: The question at hand is whether the patient suffers from occupational lung disease. This question mist be answered in the affirmative. Not only does he have biopsy-proven pulmonary fibrosis associated with asbestos and talc particles, he also has a carcinoma of the lung occurring in this setting. 08-06-91 03:50PM P03 HU'S <O 3 1 it-Ol W i <x t-iaauu. a m m ' RE: HARMER, DALE CAUSAL RELATIONSHIP: We may, therefore, conclude that the examinee's pneumoconiosis derives solely from his occupetionel dust exposures end that, given his smoking history, his carcinoma derives, in part, from his occupational exposure. As you may know, asbestos exposure and cigarette usage act synergistically to dramatically increase the risk of carcinoma. The risk of lung cancer in nonsmoking asbestos workers is not known for sure, but is felt to be very, very low. Indeed, finding a nonsmoking asbestos worker may be difficults the classic studies in this area referred only to asbestos workers who -never regularly smoked*. Additional studies have failed to take into account the presence of passive smoke and may be flawed by virtue of reliance on smoking histories which are notoriously misleading. What we can say is that if asbestos in and of itself operates as a carcinogen, it is very weak. The combination of cigarette usage and asbestos exposure is, however, known to be a very strong risk factor for the development of lung carcinoma. In 1990 it is accepted that if a carcinoma develops against a background of clinically or pathologically proven asbestosis, it can be assumed that asbestos exposure played a role in the development of this cancer. Certainly this is the case with Mr. Harmer who has asbestosis as suggested by x-ray and proven by biopsy. The absence of crackles on his lung exam does not mitigate against the diagnosis of asbestosis. Because Mr. Harmer has asbestosis, it can be concluded that his lung cancer derives in large measure from his asbestos exposure and also from his long-term usage of cigarettes. APPORTIONMENT: Apportionment of this contribution is very difficult but it is reasonable to conclude that 50% of the examinee's lung cancer risk derived from occupational exposure to asbestos. Thank you again for this referral. 08-06-91 03:50PM P02 RUG 06 '91 14!30 OOT & HSUC. 6YK NY ' RE; HARMER, DALE 4 "I certify and affirm that the foregoing report is true to the best of my knowledge, under the penalties of perjury," David J. Davin, M.D. Pulmonologist OJD/ss cc: Worker* Compensation Board {/itty. Michael Oot, 501 E. Washington St., Syracuse, NY 13202 Gregory Loewen, M.D., 830 Washington St., Watertown, NY 13601 Joseph Meyer, M.D., 826 Washingotn St., Suite 106, Watertown, NY 13601 Michael Lax, M.D.. 550 Harrison Center, Suite 300, Syracuse, NY 13202 03-06-91 03:50PM POI State UnivGi'sity of New Uork Health Science Center Syracuse C o lle g e o f M ed icin e Department of Pathology (315) 464-4750 FAX (315) 464-7130 June 27, 1990 Jovan G. Kuan, M.D. Pathologist The House of the Good Samaritan 830 Washington Street P.0. Box 517 Watertown, New York 13601 Re: Dale Harmer, S90-3467 My # JA90-34 Dear Dr. Kuan: Thank vou very much for sending the right upper lobectomy specimen from Mr h . J rtudy. .. requeued by Dr. Lo. ,nd Dr. L,x. I have sever assertions fro th. luns tissue, but apparently all of the prepared several possible, I would appreciate a slides of tumor for y file. I - enclosing too unstained sections representative of the lung tissue in the remaining lung. The lung shows focal honeycombing with mucus accumulation and epithelial metaplasia There is focal interstitial fibrosis and marked accumulation of strongly birfringent dust consistent with talc and numerous asbestos bodies s well as larger^ferruginous bodies which may be based'f - ^ o r other minerals. Mr. Harmer did relate verbally to me that he _-,i Wollastonite processing mill for several years. These findings are sufficient for a diagnosis of pulmonary talcosis and asbestosis. Studies to identify the types of fibers and other particles present in the lung tissue are underway and the results should be avail within a few weeks I hope. * "" Looking forward to hearing from you. Sincerely, Jerrold L. Abraham, M.D. Associate Professor and Director of Environmental and Occupational Pathology JLA/cd cc: Dr. Loewen Dr. Lax Colk-pi- I'l' Moilkiiu- (,,m m lll'tl !.. Ki-IWn- In ................ .. l.<lmain. I'nlivnl rcwKl K^ " rh' , t'nllfjic I'l , rmhiau- St.nl.vs Cnllvi-o ..I 1Iv-lih. Kcla.l IToU-s^ hk f O tk ui- Ilf Ninsinj: n I ,iv| N'l.mi' ^ ,,VI Sy. UHM-. N i University llnspiuK .