Document 8RpLEJNpe9j5Eq140MjNpMLpe

W. It. Curtner, 3-11 Fau^ Kotin, M.D., 1-04 June 4, I960 MEDICAL IMTORMA^ZOM FOR IS5URAMCB KEMENAL Thor* ara two alamanta to your raquaatr (or intonation that can ba usad to convince insurance cu^.lcrs tuac t..; riak ia inaurabla. Ona alscant ia the criieace the that asbeatoa-ralatad dlsuassa ara on tha declinn, and this part la diacuaaad in tha anoloaad docqpent which exar.4 asbestos-ralatad diaaaaaa in general and tha biological principlaa governing them and raviawa tha medical literature on diaaaaa incidence and Morbidity and aortaltty trends. Thia Material can ba given directly to lneurance oasgumies since it *s basxu to understanding asbestoa-related health risks. . The aeoond element coocarna data (roe Johns-Manvlile'a work experience and tha relationship of those data to workers* compensation and third-pe*ty cases. Thia part ia tha More difficult of tha two, and although you have bean very specific in tha quest!cba you have raised in your mmmo of May 5, 1980, many of thee cannot ba answered as precisely as you wish. Consequently Xw4H respond to your questions intMts or asbestos-related disease, explanation or this ana toe * basis (or tbs etatenant is Included in the separate document. However,- you also gak that the etataeent be quantified. Answers of this type would ba ears speculation and as ouch >/. fraught with dangers. Xn the Radical area the hagt we can > uo ia apeak in trends. I In 2(b) you ask whether *tha nuaber of lawsuits la directly rwea l1aktaeadmI taoa tahUea numbera. ikIna * oa ef cmacnmeams tAhWanSt arMraa meIda*iac1a9lly diaamgmnaomsmejdI v as being asbestos-associated.* There is no SUOh direct relationship for a number of reasons. Pirat, tha approach in third-party litigation appears to be that of class' action. Xn other words, cases may repreaaafc^eeveral people or large numbers of people who ware employed St the same placee; yet > not all thaaa individuals in the suit Will have asbestos- related disease. A related factor is the clearly doctsaented willingness on the part of-none lnauranca carriars to settle such cases for lesser monies than night be.at stake should a caas involving a disputed diagnosis proceed to trial. Tha ,-k. . ,_ ^ * ' -_A:* M. % Vv- H. R. Cuitna* -2- Juna 4. I960 vttdict in Im Angeles tort a jury awar44 a plaintiff -related disease a 1.2 ailllM dollar eewtla- geamrate whole new wave of spurious plains. -A? - fsound* there la d general trend toward suing for dlssaaas wbidi any. M sab--toa-rslateo out ter ths- nose part an not boosuso they baas a multiple etiology, swan leg thara ara a noOtr of fsotors that can oauss those diseases. This does sot apply to ashestoela oor entirely to nesothallona, hot it does apply to luap cnoer sod etadoat^lang diseases saoh<s o^iyasM fM kioMl^ta* `Uses ara.many cicnnrui eswes for gastrointestinal esaeep^a toll. If asbestos exposure dots play t cola in gsetroincnetlnal ears?*?, It tr *9 , Third, s Mhtc of* ossea represent stigmaf of exposure (pleural tfciekaninfj' pleural plsquat). Those otlgnata ere mrely signs of an Individual ' o having Bean exposed ashestoe; they ere not signs af disease. 1=7.. Sven though easy of the lawsuits we aee do not truly reflect Mhsihw-wUtf4 41' . this, dose no_d_ necessarily that- "the neater dt 0? cases diagnosed .at asbestos* related will ba ooi it itfh than in previous yeerii*. Thera la e. greatly the puhlio and in the Uedlcsl the of exeeeetve expoeure' to The through the national Cancer Institute, has undertaken its extensive educational oaapalgn durlma the past two ytcra to itfen both vorkars who oay hava baiir exposed to aab^stps in tho post end phyaiciene about possible health affecta. ' Thus* while awdlcel knowledge about uteatos hasards evolved" slowly, the locunalatod knowledge has beau disseminated rapidly during tho pest five years. As a result, war ari , seeing Has evidence that ashestos-relsted disease My be everdlegnoaed at this tine* *- Tour guestlooe shout *a decrease in the nuafcer <o( people erpnsed to ujvioin levels of fiber* can bo taken two ways* either that there has been e reduction In the nuafcer of ^ people working with asbestos or a reduction in exposure' - levels, z have no figures or even estimates of tho current, asbestos workforce, but X oan demonstrate a reduotioo, in 4 r* exposure levels at aabeetoe-using operations..,Xegloded the enclosed paper on asbestos, diseases la industrial JqrUgne.^' cats from representative JahsS' fcsnville fnilioM dhriag. ' the period 1969 to 1979, Whichvwry definitely sbov M'l W- ^ . : :f T progress in reducing levelg 0f\airborne fiber ih our plants and that wa ara wall undorttho^-ourreat TJ6HA atmtfiAtd of> fibera per cubic centlawntdd Of jpr fbaee reduotioha occurred not only in JnhpS thmville but throughout the * asbestos industry. The studies of Turner-Neva11 facilities^ in England, referred to in the paper, also dsnonstrate ouoh' reductions in expoaura levels.- '* -f f BE-1 M. R. Curtner -3- Jttno 4, I960 The r,at ** Un information you (MX in ita 2 (B) cannot be supplied* Xt ia impoeaible to provide MtlMttt along such lino*. In }(Ci yoatakabeottbe pro^edtlona or MtlMtw of future eabeatis ral tt^ Si3ea? figure* of future dinaasa baaad on tka NC1/R1SRS/UXCVB report on occupational eaooer are aatlraly uaevraortable. This la dlacuaaed In the enclosed paper* and ooplaa of J*' aebaiaeieps to 06HA on the estimates are Included* The data-in our response to Q&HA show that'sly a taall percentage of future disease caaaa can ha related to asbestos exposure. The estimate* by th3 federal Qovsrnwsnt have also been diluted by; leading epidemiologists and canoer rmeeskcoe*.*, == --- L-. " the editorial froa lancet end the letter by ?*r <-***< n**i v which are in the eeparate document. Pertinent to nay discussion of future satimat.es la cne tact ' that the population exposed in the peat bo heroic oonoentrationa of aebestoa fiber la progressively aging, and many have already died. A* aging of the exposed population, though, is e confounding factor In another tray, inanmuch aa disease categories such as cancer increase as a population ages* sod It ia virtually certain that for asbestos workers there will ; be an irreeietlblo tendency to escribe . these cancers to aebestoa exposure. . In answer to your question whether *tbe claims being received today are due to earlier exposures at such heavier doses**' the overail experience at J-K's newer plants certainly ; indicates a reduction in hazard. There were atill sons dusty^}obs in these locations, though* and in the early days of these operations, exposure nay.have been sufficient to produce sporadic cases of asbestos-related disease. Mtes coaparid wttlr the experience of other J-dplants operating , in thlliM'i and 1946*a* however* the attack rate la reduced by every Criterion. MOM information in this area will be available tbe..end of ftly or early August'vbea Dr. Gerald R. Chase completes hie hiodtatistlcal studies.1 1 trust this material will be useful to you-teu laty wfait - to discuss certain aspects with me in acre detail.' Vlhase . call if you have any questions. iMv katttH iWrt Oo., iM, . 0. Sou *0 goehdal** bflaad - t r> 1 floUwi*; Attestiss: Sr. V. T, Swwll*, BanajT p^la--rim. taol BtMrtMrt flaaa* wcji mr thanto for tta oniiil add officiant m r rac*nt Tiiii t hmr k. m liadM. \ ta ay MtM, X found that Z tad praised ta Mad you a () ^ Mttal loth ud iy dost eolloetor manufacturor* la tta tibltad Itataa. X at ' 4 aaoloolas such a *aapl* toftttar vita a latter flTls* pnrtimoat spool-. v floatlean* ' `,.v:. * y*- . V? .i1 . r* I. A* Jackson tad ocprassad aa interest la nan tlwlai syatna. Vo puretaood m far our asbestos tortllo plant fra Ablaftcn TortHo Machinery Marta of forth Abiofton, Massanhnsotta* Thotr salsa offloa M at Csltan Yovr*( Or--wills, South CarolIsa. Mo have also purchased several systaaa frca Bofftaa laiutrUi, Xmm Air AppUaaoa Bdvtslen, 103 fourth Avsnue fa* Teak, lav York, ; } **1' :* S.W'' Rmm lot If you Mad mtr fttrttar laforastlon on than too It--M. Tory truly yotn, J. Ooldflald Chlaf v ^-- tatlai, Teotllatlaf y" and Bust Control Section v * ; s"' \ \ ' V.. 1 * t * .i- ' *; .1