Document DDOByRNKnDG58wz7MVE7qbVvd
FILE NAME: Z/ZZZZ/
DATE: K
DOC#: /
DOCUMENT DESCRIPTION:>Z>Z,td hZZ>>Z&
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[ '.:~ 'v~~ (".~::t ~~i~~'! .:'.:':\...... -e't,~.(eti ~h~..! ,";.'3.nlJ?~L"~g ;:.').;- ~o'~ ::...~.:~:~.~ L~::~~ f~ .... ":-,'.. ~J,.;:'"~ ::-~.:.~.t~;'~6 to :"'..1;:".; ::::::.r:c:~~: ?.....<) -l~ ~!;.be!;)tf..)':;I1 ht~a.l~h e:i:::2--::: y F~~?.a.:'''!'d '!::Jy ~h.l! :;:~cc-~r.:~:":.e", ! ~7t]J. (l..t.t~~;?t:. ~~1 9.:"O)ti<it!! y~'tO~l :'tfit~ ::-:;;~~.t ~:l(;t:..~:"".~.'.t ;::n ~:'t.::
::e~.cl{,";~ ':::~ i~f..;t~~!l $;h~onc:icgy g:i'j~"!r$ ~;."'! th~ Z:~~tc:-:l:':+e ~nate:::"i~: ~:) t:~~
i.n~;1:,:,,~;,:~~~a::;,Q:-.. or ~~t.5i~~3.1 :;(ig~...Eic:J,..:-1:::~ ~~ ~... ig~c: :~~ l=d!Zc:~:::>/e<i ~y ~~.t~di;.7;-.!.l
p1"':l.c~~tit)~~ -;:"$" Pl~a..~ e b~a"Z' i~ :~.i~c th(.i;.~ t~e,~ e -.::;:~+:~n"~~T..~~ 3,~ ~ ~i.;hly
j~. J.g~~.. ~t~l ~~d ~t: L~ quit:!t ILLkk-eelly tha~ ot.b..e!:'::l ~Nq1:'~:~g i.n tbl1:. ':_~_~:ld !.Y..igh~ 1:ZlVv~ ~-i'Hbs !:z!!~~:a.ilt diiferens~ tnt':;!:'?1:~t:a.ti~:::z.s. ...
Fit"s::., t'~ i~ i.xr-?ozt.::l~t. t.o rec:o~l.1.tt:e t~at sinc~ t1j5 p,"'l'h~n. \:~'::..'!$ U%~:St fS'S,."I,~g-e$ft:o~ ~..~$ mad~ that .carcinoma of th,~ llun:f; r:-~:r b~ ~-3~O c.iat<~d \~;-!.th il.Sbeiit~:c;fi'$.,. th~ ~tte~. ~th t) t:~e (!t"..rl,:ler:.z;e ~jJ..PPQt"~.. ~~ t~t'i.~~
a!}~q~i~t~.0~ itlt thf! ~netii;:ai lit~rat.u.re hlillSs gr'AduaU~( inc;-~tlseC}" Fro"tE. ! '1 } ~ until Z\~'"::~:: ~A'i~~~~t:el y 1940 ~ ~o.e ti~~:rat'..~:C'e coS'..t~ in~d v~wi:;";'1<ll"ily C<:!.$ ~ r~~poit-:"i of l'.,;.z~g Cil.t!ce~ "in pz.t..i<tr:t:s <,'t7n.o also h<'itl a~tH~~tos'~s d~fr~'s:~-::~i~1t~Q :~1:: t!.\~tf';p~y.. DtU"iug- this p~~i.oclt ed1.tot:iu.l CGtr...,met1C i:L m~jo~ n1edt<:{l1
jOt..~:::"';.~.~$ ',:,,/z..~ >-;:..:::~t':.~/'~, ~t b-e~t . ir: $t:"?P-o~T c[t this :s.:}:;~~<:~ati::::':1( ~.-: .j :0
~:' ~5, .:.~,~ ~~:;<"~.i,"';..~.'~ f:;i !:..~~~ :\.n'tt~~lc~:t'~_ ':ffe<ii;..;'3.l A~S<'H.:.::...:;.ti.,;)t".. d.o~'.:;::.:~d ~.. :':J.:l:s~l r~t~::::~~':'$~~l.~ ~'lhi:. e: t~:e Brittsh ivi~d5c:al/;(1:'lZ"r#al .i~ -~t'~ e~i.tql"ii.: $~g;r::::$t~d the "~~'yssibUi~)~n that s;,,:::;cb,. .an 'Js~:nzia.tio':t f4ay e~~i.~t", Th..z li.~~tZlt~t.:,t -iu:t" OyJ' in~ tha:; t~~~~ contin~;.ed ~Q be c~~4~ i~~1 yartic.'Uia r-1V ':3 it V/;J S :) ~i1~ 5 1..\; ~ ~::;.(,.t.~~d :.~~~ ~;::;T.~e ~v;;.r~et"~ th~:.;t ~ilLt~c1'$'l$ a.ll':'s;'o ca"r"tied ,.e.n -eXC~:$1 T"tsk :fq~ th~
d:{s~holv...-.~(1t~v~,;:r~;"t't)>t~; ~tIot. o'-::f(~ l?ut..:""~'j~5e1n,,t"!};;.to..Vt:;t'"r)\1;.l3"n;t~~~<~J stc:C'ds<.5::.{air.tic::':1~t. "'t'if..'.+:v~-c~ h::.:tlt~~s"S...;{suyebt:$.,'etq:;;.->h~~:~.'nit(l):~:-:\, beI..~-..nnc
r:':.~g . ~~ :::'~"l;,!cl :.'!~ e t~lat the: ass o.ciat..~or:. oet:\"Te,;;:;~ lu,l1g ~;~ D.\; er :~Gd ;).&b~::. .:u ~i$ ~tv.:. ~~ ':-est ' ::<C~ ..'. ~bt:.:(1 and e~'(set'l~t.i.alL~r <:,("~~$tttut~>J. ~~,J.gg~"$t:::ct:. ..v;h~c:-: ,~,~,,'1,-),Is i!'.~,. ._. - ..~"y"~ t"o '3,~', "~~ ._..",_,,$.,. 0 t...., ~_.._... tL., ~n-")/" ~. n',(~e'S :.--~1'.J;ly . t,!.QI' U~ ,
~ PLAINTIFf'S
EXt-UUBSff
24
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; ,r(O[~ 19.:i:i t~71:::.~ ~?;:~ ..'~".:::r;"!~tet: ,19~9, ;:t t\.!l~,""bt"~t' of. :,e.vt(~\~!~
~.??e~r ~~ i~ .~;-:.~ liter.acll.re a.r"':'d~~~ $i::~.;: t~~~ e~ue5i'icrn: of thl~ '-.~$ocirt:t:'.J~~
~:;or:~~ ~at~~ e~ ";J~a.~; -$::~~\\ee::ttttllnn~~~~..al ~ \...:..,J~ C'tc-e :s ug-ges ~e.d t1-H1:: a sbestl1~ e~-:?oSt3~e itit amm::''::''11""-l.:> ::-'~!lclt~d tntl L.ll..,ng (!(l.:!:d:;6g~dc efi.ect:s. D"l:'~!~ thiil p':l.:-iiccd., U \,':;'5 ~';.:-t.b.er reported that "?l:&ymali,g,nittlt" histol.ogi<:; <:;hange~ ~'<fe):"~ teHll.H'S:
~::!. '-~s~s of. a.s>bC!s:to~is and !>e<;re':-.a1 r/:e,e:f:eferreenncc..eeii -,:-"e:t'~ ~.ad.~ i .. the c~~dc~L -::t~::-~~~,~ e t~ ~he <l.c:ce?ta.(1';;~ ~~~ (/<2:: ~:::-n~-ny of. th~ Ol..ssod,;.tit3ti betwe~~ hmg Ga~:::~~ ->.:-.d ~$.b~>$totlis for '::;O:":l.p~~HM'to~ ?\.t:t'POSle-s. Ir:. 1'14-7, an ~t~~r.',?C ',~~ ~ul.(~ t<:) C~r:1pa:ce p:re<t;;l..1.e:::tce 6 lurt~ canee!' ih>I:l,. \'7oJ:ke-::,s ~y5,'1g ...-lithb ~ st~~ st;:lS!S l.r..~ th<.:l e.:<:?e<:;:te>:l ~;.:.~her ~!'). th~ g &rt~r.u ~C?\J,at;'Qfl CO:T".3.~ t.:>
a~~~to?'S't.. + 7:"!.e:~e re~f...tlt.$ \~~~z. ~!Qt .:!oncl'J..st""l'e~ but a~ ~::-t....~e$.~ ecst l'U~1 cl.rtce:!'
~'"!~ ~.:,~cj~...:;:)i~ \~~~~ .::nJsp~c.t-e-"; ... Du~i~g t1~i~ pe-:-:ed,. the ~~c.enc~ ~::: f~~IO"Z' of. a :::~U::l~::' .'l.ssC)cie..ti.cn wa.$ ~t"g:hc.:.'r ,.t~o~ .. ::- '.3<:lt th<.'l ,-:t:n;<:>ei;;.ticn W{3'.J1~ s~.Dl h.~v~ :::~ b~ ~la.ssiii~d a.s u?)~~~ibl~1'...
.o rh~ cext t'elev<4t.~ tl.r;"ll..ee ??~~td"ioodd \vhich. t nha<,,f!f! sS d~.l:ct~d h l:;:-:Jz;:l.
19";'~ \).r:.ti! 1.955..: T:'1is perio-Q :,e~&Ii ~~~hen. Me:::'wethe z- ,. t-h~ Chief r~~'Pect:~r
of ?-<:..;;tol'ies :.~ the t:.l<+, published h15 a.cnuai .e?Q;;<1: \vitn t~~ ~i~::i~ t~"t
~a~~~~ {;Ifi t~ hmg: 01' pleura occu...'l':?l(l in 13% O! ln~ivhh.!.als !Ioouunnd6o ~o have
il$Qestosis a~ autop8y.
This (;om?i3.:n~cl. <.rifr.. <l. risk d 1.. ~'f;J in inclivlic"\!.ii.l$ odal 1:u. th;; .rQ'l!'~a.l of th~ A.Amm~:-:-iicC;a;l.-;;?-:,'
&>friitth. "'ili.::~.sb~ Abo, in 1~49, Mtldicl).L AS50ciil.t::on accepted
an edH tb a..$:s.ociation
betwe~n
(Hib<::'to~~$
a.\.~
!~~
c;a.nce;-.
A~ y01J. UZIcl.Qv.btedly kn6i:<1, t:h~ :fA ~1fA ilS th~ n:.t~}~t '>v1d",ly :n:<l.,l jO\ll."n<'>.l
Qn.er:!S.ht thls cotm,t.ry. lx~ :1.951, 01:Qyt1~ lO\.mc l~r, Ot
a~,Q~g. m~C:ic:)..l 9t'~ctll:t
1~div1du.al$ With <l>Jbe-.&tosis
had p,ttr-.. ona.;:y c~ncet:
h. an autopsy
lSft:-ie:1,
c;)n-
1::-~::1i::l.5 t:"I.~ 5r...ciitlgs of !vfe.riwe3.:':l,<:1;. Also. i3.::!'oucd ~hi!t !;im~. att~I~ti.;jn tr.u
cl.ir~i1t~cl to an i;;,crease io. tn(? t~tt!i4eo ttoh~mgaelne-t';r.at'atil opoIp~:u'la1t1l.j-nognc,<!":c,<g;~eh=t in~m?i~rft.<)i-iX:v'r{idn-~
,>3:.'.>.a:..l.i.s.)(w~f~i~.t;hp>.1..~tsin~;":t'l~1.t1o:;!l.dss.ss$..:)ddaaasttiioocuuo..m, p(ar.,r1e9d5t3! , Ha.-ri'Zt. H:ax-dy a.r -coll~ague$ pt.>.bli:i-ked
t:/l() c ..\ se: :-ep .:It'"1;:s in th~ lj,rt'1e~~!!altit:,J;Q;l~.t1y::<;-::~~.lmoef:a!tyit..~oduicitn:,,i:$: b,,t-;~ctah.u$tob.';~: 4t~::,-,'~~c:;!...c.J!;..;t~~r~.;t;:tl;.H~!.t
(~~ c:::.'.!,;al a.s:>o~~a.tiO:t:l ts highl'l Jv~~2. t of :.v~~d:i.~ine ~;.r;,.s: been \v!cl.ely
read by ?hy~icii$. ~s
spec:itl.li~'~41
it\ 1.~~~ r~""
a.!. rrtB:'ciicir.e. !t i~ alsQ of s-.:>me ic;~re$t>, bt).t: perhaps not enti"l:".aly r,:!"l~trall.t
to t::te ~=t-s~::l.~ -aiscu-$sh:m., t<.hat 1.n 195$ and. 1'154 tHe $ug,J-estion W~'fi mi!:.de that
,)t~~.1...<.:..t ~nd p~:dJ:on>e-a.\. m:;$otneUo.n\as J:'e~H~ctt"'~ty w~re a.ss<ld.ated <..nth e t'ep ..?~t!S' it.:pp~a.ri:ag in th~ G=!~m~ll. Ut~:r,l.t1,4'e. D'jtin~
a!lOo$;;(}S e).7C$'J.:re:, thes t?-:i.s ~i~rt.e p~~ioc.t I wcu1d.
<;rJndl;<ie
th,~t
t.he
~~t.HC;l3.l.
li'~r;l~m'e
mi.:;l"ht
l*Ml
~<.:
",e;,:.i~.:t to ~~e opici.orl i;ba~ l;he <i.:Sllocia.t.ioft, between <t-s-be.siosis il.nd hmg O;;~llceZ'
<!.r~~ now "9:::'ohable",
ltm-n 2,4 IYH3X
-----~---................-...,.......- , .
i._.,.. 'Z;n;.;.lly,
the
lalOt .time
~~r:iod
i!> 1'1~5 ~l::tt.it th~ ?-::eset'!-t. by Rich<1..l:d Don {tsbg the
J:'his
~O.$t
rhQ.se"ep'i:I.tdeC~PU~:l::oS-<g:Oi, .cb~t~enc.:nhr~wq~i.thes.th\l;!.?ptuobUtbcaa..t.ttiohn~~ ~o i.nv~*'tiga..te a, C1!.\),::lll.t a::l.lSCk
vaH,~
,~au.$ e"sfH:citi<:
mQorrttaality
$tUC'l eof ""'ot'~;e.::,.s with ddt:ned etnp~oye,*'$ of th.i$ il. s$-'bb~ SsttCCi5l
c:i.:.ttO:."l,
a
<?'mpl.Q~-:r:-,e'(t~ ~l' a. ~pec:i.flc @l;.l.nt.
B~ found. thhaait:
() <$eV'e1a?i~ lung
c~xti1~ t~<:to;:,:;:,~.~!h:l:a'l--abe:'at.'~-:Fs~::o)~f:jrtnh.(e!..~t:e.!e:llyert~eln?tou?tc'ViO!Sl.a.t.:t/lh.sce~n.rb.izs:H.dkeils,s~bg'~essttlo!$:i<!!,. thaA..::lstec;h,i~b
c;~nC$!t' than r
t'i::;k waed."i,t:oc.orn~i,~:;;:,i.eb.c:'i..Jltu~lttehoBsreitil;l1'hd.iv)i;<tle.1~itac.:.las.1wJhouor~i3.1. Lanc~; anti Atne7ic~n. d
t;)'$, J01..!:n.al
o<:}j
C~'!'i.eal
P<tthology
book on
a<::~e9tlYJ. thts a.u:;':cia.tian aass. d~.d the l!.'I.).tho'l:' ~ccupanor.:at ~~a:ciic;~e;-, Do:l,J..l,d Hw:ta:;r. r~
l.:ne ':n'(3H ',"7<::n1ci. ';;a
~res~gious
my ;~cgmt!t:.t
tb.~t
~t~e
tTH,
the' -causal its $oc:i;j..t.!.o~ G.a.-e 0& 'Cc\"(.~
$.ln.e:- t!.<i 1?!"~V8:~J:~ c:"' ':ld.e:t~~~ fl ...
Up to tbh-.e ~t'e~ec.t ti.."':;l*,
there (.;cn.ti,!l.-:"~s to b-e some d.iEe~~~e hmg <::anc~!" riissk s ~i:x.itl!:d
of
c?,idon
c.'-::,'l>l':C:.;\:!l!l':~S tbll: <:!}}llll..SSiitt::Ct))! of. wh~t.\e::" ~+At:.~ a.gbf!llEt:o~i~ or il> p:Ot!sent b
l:b.'.!
tthh<o)lsHe.
only
\.~ili
a..ssOO!!!!sst,"HI
e:-c-
to
l.ncltvidualt;
?:::-izn~:.-y
:-ea.sou !o-::
thi#
~c.'!'Z'tai::;lt")'
is because t:'h~ ~e..d~~~r.
z:d.ght: ~e ha.s.r..d. O~ r:'ito::'-
foWf$ua..~~bee.!3t:oT!.'l1i,s$ :~ ~h~.irgr.h.liy::ta..e-iaaortritiaab,bl,b~:~l!.t~hd.eawn lolcnhe le.3.uoot'':,::gh:<<!l!m.vea.Ua:'l,~, .a.rtd on l;he "ttbh.ee~~
ougb. hiztologic might desrend otn:.
s:ev'!'1:'al
d..Lu:it:l.aJ...
r-i3-dlog~'lJ.phlc
~oba.ble tha-t t
a.xJi ne le
phy: vto:l
siol
or
..ogic ((;;::;~:i:titeeti:':~',~,aa.. My ;a.$b~$t;os t!...-qo$Ul'e
jndgm'.ettt: ~t ?rreeSs\'llXnlt i.;>: ne~u!>a.t1' to :"esult. i~
that it i.;l ? a. detee;ta'bte
~~c:~u' ri:.:k
tor
developing
lung cape'!:;: lS -naa:oy !ib~oc~is
~Il~(sSbo~'a.~tdoQo$ssi...s,.).wt-.cio~hwi-sevle:ri.k~lty.he/;0e>?.t.'i<d;}l~:l-muc.::e:e ocfl,.iaJsnosee:scthcasnisg~msaoooy]f np.'ollltll:,,mmboeo-nclinically 0:::-
~;H.Hog:t$.phl.c:allT 3,?p.ar.~:nt~
1 h.ep~
thilJdbe1:.5ait:m i:$.
Iliiet'-w.. You
arbH:ra~y.
\'<",'liill of Cour$~ -ppredat~ r Would h~ .nto'!St: l?l<:.::;.s~,:l
~hat the: ti:m.e ?e.dod$ l:I:I<ikatee i\.boy~ ate ~~ o.isc:'Us~ :3.:'!.v ecldi these opill.iiooll11a with ycu.
o.l:"r
t~
?!,(l.'Iir.:h~
d.a~iibatiQn
wh.~n
"
P.\'i~nc
>:;<;;; } ..{r. Cu.y Gs.<'H:1elson )k. ~Qb<ltZ"'!: Merenells';
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?RODUCED
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