Document DMdYrB1952EQ9k5MoD0bRJp0o

f\ - 1--* t A * IVAN SABOURIN , Q.C. Akm MIUMMC, wotfc Dcem&er 3Cth, 1957. . Or. Daniel Braun, Industrial Hrgiene Foundation at America lac., Mellon Institute. 44GC F tiiii Areaue, PITTSBURG 13, Pa. Z>ear Dan:- ZST. tar Publication * I am enclosing a mlf-explanatory letter Iraca gee Smith and *osdsr, ti* a coadxmatkMi at- cation ot e-ran date, X you nminr amuses* __ cke-nyec (If 70a, at cooran, acre* wltb ftisvtlgfn jam ccarf*gucaioa. X hare spoken with OrJTrlaker vim aid Mien igkflasB wttb yon aOer car taUsahoam end ha told m S srmc Iftsly taw saatter voaAd W poctfishad ia Merck or AprlL .* _ -a" "5= issr^-*^ Jd7 Taary bee LI jeksm t boartxt* *U Cm la tit* if tains Jm crtratU^yals 1 perafrapfe at kls latter. * ; *> .-v- V VW-05643 Tjbin nv. Hith r.s EK % . .loHNS-MaNVI U.I-: (jOKIV) I\ATI ON * tat.nty tho i`.\>t HjirnKTu m hv:kt M%W YOWK Ki. S Y PLAINTIFF'S EXHIBIT /Z/MD _ December 30* 1957 Mr. Ivan Sabourin * St. Johns Qiebec Re: I.H.F. Survey Dear Ivan: f.' 'Hugh Jackson and I have roviswed the condensation of the survey which you sent us. We have noted deletion of all references to the association of asbestosis and lung cancer in this condensation. While we believe that this in formation is of great scientific value, we can understand the desire of the Q.A.K.A. to emphasize tho exposure of the asbestos miner and not the cases of asbestosis. We also are in agreement with the deletion of the reference to smoking and lung cancer. 9 It must be recognized, however, that this report will be subjected to criticism when published because all other authors today correlate lung cancer and cases of asbestosis. If we are to restrict this condensation to asbestos miners, greater emphasis should be placed on the choice of words ,used in defin ing tho cohort. The fact that all members of the cohort had 5 or kore years of exposure to asoestus should be reiterated. . Following' are comments on certain paragraphs of the condensation. Page 9 \ We believe the first sentence in paragraph 2 should read "Perhaps no one has written so extensively - - - -" Page 1U In the third sentence of paragraph 2 the definition of cohort should be expanded to emphasize tnat non-exposed personnel were not included in the sample. Tlus might be done by adding a sentence similar to the following: "Office and other non-exposed personnel, regardless of length of employment were not included in toe conort". Mage Id To further emphasise the exposure aspect of the miners the second sentence of paragraph 2 might read, "Ail workers with more than 5 years of ex posure were placed in one of three categories". It might be advisable to add another sentence at the end of this para graph, "As previously noted workers with no exposure were not included in the data". 00012128 s Puge ?3 In Ujc fourth sentence reference ix tnadu to "tho level of signifi cance". This phr.iao was explained dourly and thoroughly on Pages 23 to 2$ in the suction on Statistical Methods of Ihu original survey. llocnuse this whole suction wns dolctud in tho condensation vo fuel .it wight bo advisnhlo to explain by foot note the meaning of "tho $>5'1 level of significance"1. Vo feel that tho filth sentence slight be made stronger by the following change. "However* having found just 12 eases, wo are not above thic level, and thereforo the hypothesis that anbeutoc laincru do mit have a higher mortality iron lung cancer than doon tho general population cannot bo rejected". loge 111 The Cable in the centor of tho page ohovs a rate of 271 in tho Li5 - 5h age group. In the original survey thiu rate war. 27. lane 13 In the last sentence of the first paragraph wo would like to suggest the (substitution of the word "undertakou" for tho word "eon/niasionnd". in the second sentence of paragraph 3 vc would like to suggest that the elm/.unts of the cohort definition be repeated. "A cohort was defined as a group of aaLestoryaiucrs having at least $ years of exposure in the inti a try and who were in the industry during 1950* Only those, workers who met those criteria were in cluded in tho otudy". ~ Page 19 . ` ' In the last scntenco of paragrtph 1 wo would like to Mutest the dele tion of the pliraso "vuich havo been explained in sumo dotnil" since such explanation was deleted in the condensation. Ttjis publication should form tho basin for future'surveys and reports. i>r. Uraun should l>e i.ikod to establish the fneuovork of reporting for Doc turn Ui (linger and Cartier no that enrh year tho iitaturi of every u.i mber of the original cohort could Ivj ruport.ed to hhu I mliiiitrl 1 Hygiene Foundation and the continuin'; study be analysed by their expert:;. V.'e cannot emphasize thiu {mint too strongly VocMi;.u nowncre in the 111 ora turn today In there reported ti study which i: so valuable and wnlch nppt oximtuy this mngultudu. We agree with Doctors Corfior .tnd Uraun that a certain number of workers . prnbuhly have some anbostotlc llibmai:; which cannot 1m diagnosed by x-ray. Un fortunately, wo cannot take lung blopslus on all workers anti we havo no other mums oi juakinj; a diagnosis before thorn arc X-ray changes. Thereforo the animal study of all o.'.jwmhJ a she stun workers hecouuju incre.aaingLy important. .. h 'We foci that Dr. Uraun ami liis ntaff ro to 1*e V.3njfrn tula Ltd heartily 'for this very valuable contribution to our medical knnwledro. We trust' that thoir efforts wi 1JL b' rewarded in th-* near future by tho jmbliwyCton of this work in a recognised Journal. ,* Since/ yly, PRODUCED JM -83 H'U00012129i:.Mirr:l.li W. Sm j th, ; .1 "