Document EmvKxJ6dRjprwwNovLbMoNBm0

FILE NAME: Philip Carey (PC) DATE: 1954-1957 DOC#: PC011 DOCUMENT DESCRIPTION: Worker's Comp File of Len Hope  I Ga s b y , Ge r r y , Ca s e y , W e s t b r o o k , R e e d & H u g h e s A TTO R N EY S AT LAW * DAVID S C A S E Y *RICHARD F GERRY *D AV1cfS CA S EY , JR *T M ICHAEL R EED * MARCIA W H GH ES FREDERICK SCHENK ANN M. RICH ARDSO N RO BER T J. FRANCAVILLA J A M E S F CO LLIN S. IU DENNIS PAUL DORMAN GERSHON D GREENBLATT STEPH EN P PRENTICE MO L A U R E L S T R E E T SAN DIEGO, CALIFORNIA 92101-1486 (619) 238-1811 January 17, 1985 RICHARD D WESTBROOK VALLEJO OFFICE ISOO TENNESSEE STREET V A LLE JO , CALIFORNIA 9 4 5 9 0 (707) 5 3 7 * 2 0 7 0 MARSHALL ISLANDS OFFICE ROOM 205 P O S T O F F IC E BUILDING P O B O X ><41 M AJURO, M AR SH ALL ISLANDS 9 6 9 6 0 *A PR O FESSIO NAL CORPORATION Mr. Barry Castleman 1722 Linden Avenue Baltimore, Maryland 21217 Dear Mr. Castleman: Enclosed please find the copy of the Len Hope file, which is part of the Kenneth Lynch Documents. This is being sent to you as requested by Marcia W. Hughes. Very truly yours, MM:34l/l23psd Michael Montgomery Legal Assistant to MARCIA W. HUGHES NINE BROWN ENVELOPES WITH INFORMATION PERTAINING TO ASBESTOSIS 1. Reprints: Pulmonary Asbestosis II, Pulmonary Asbestosis Ills Carcinoma of Lung in Asbesto-Silicosis - Lynch & Smith Work Sheets - Lynch Asbestos Bodies in Sputum and Lung. - Lynch & Smith Effects of Inhalation of Asbestos Dust on the Lungs of Asbestos Workers By A. J. Lanza, McConnell, Fehnel A Review of Pneumoconiosis by Pancoast & Pendergrass Public Health Reports, Jan. 4, 1935 - Vol. 50, No. I The Occurrence of Pulmonary Fibrosis and Other Pulmonary Affections in Asbestos Workers - E.R.A. Merewether, M.D. Pulmonary Asbestosis: Report of a Case-Ralph D. Mills, M.D. Pulmonary Asbestosis: Wood, Lond, Gloyne and Leeds Pulmonary Asbestosis in its Clinical Aspects-Sir Thomas Oliver, M.D. ASBESTOSIS. Special Bulletin No. 42, Dept, of Labor, Pa. 2. Schulken Case, 1935 3. Carcinoma in Asbesto-Silicosis, Reprint No. Ill - Garvis, 1935. 4. Illustrations of Paper on the Asbestosis Body and Similar Objects in Lung, JAMA, June 1937. 5. Illustrations - Asbestosis, 1937. 6... "'ulmonary Asbestosis IV. The Asbestosis Body and Similar Objects in the Lung. March 1937 - Work Sheets. 7. Photos - Asbestosis - KML 8. Photographs of Asbestosis Slides, June 1937. 9. Films & Prints, 25237, Wm. Parnell and Paper No. V., Aug. 1939 JO H N W. C O W E LL (1BOI-I89S) STUART E. FLET C H E R LEE J. HERETH DAVID W. BACON COWELL a FLETCHER ATTORNEYS AND COUNSELLORS AT LAW 1109 E n q u ir e r B u i l d i n g 17 VINE S TR EET C incinnati 2. O hio February 5 1957 Dr. Kenneth M. Lynch, President Medical College of South Carolina 16 Lucas Street Charleston 16, South Carolina Re; Industrial Commission OD 79998 Len R. H o p e / d e c 'd. Mary Lee Hope, widow-claimant Dear Dr. Lynch; I have just received a copy of the official order of the Commission in the above matter allowing the claim. When I was in Columbus a week or so ago I firstlearned that the Commission was going to do so. I am enclosing a copy of the report of the Attorney-Examiner and also a copy of the Commission's order which adopted the report into its order. I want to thank you for your very kind cooperation in this matter, not only on behalf of myself but also on behalf of Mrs. Mary Lee Hope, the widow. As I wrote Dr. Princi, enclosing a copy of the report and order, this is an excellent example of cooperation between doctors and lawyers, and the important thing is it benefits the client, or, as in this case, the widow-claimant. As you can see from the Attorney-Examiner's report, your letter of October 30 1956, was sufficient, although I had sent them a copy of your letter of December 31 1956, prior to my going to the final hearing in Columbus on January 2lf, 1957* I thought you would be interested in the outcome of this case and, again, thank you for your invaluable aid. LJHiic Ends. Len R. Hope, Dec'd. Krs. Mary Lee Hope 5434 Sanson Street Philadelphia, Pennaylvanla 0. D.79993 The Philip Caroy Manufacturing Company, Jayne Avenue, Lockland, Ohio December 22, I951 September II4., 1952 Aebestoals f)0. C3 deaiual services 5359.00 APPEAL TO THE C0.!I3dI0N In accordance with the recent order of the commission this claim as submitted to tue Medical Aavlsory Board at Columbus on fecember 20, I953 for their review and opinion as requested oy the Commission It is found that in addition to the proof which *su previously cn record, the claimant for the attorney offered in evidence a letter, dated October 30, 1953, from Dr. Kenneth Lynch, in respect to the cause of death. Copies of tnis letter have been .naue and are now to be found <bn file After a careful review of proof on file, together with the agree ment of the attorneys and the additional medical reports given by Dr. Lynch and recently by Lr. Clark, too M e d e a l advisory Board have given a final opinion as follows; "After reviewing the entire file, and a letter in the possession of claimant's attorney, vuloh nas not previously been In tae file, ana whlcn was & letter fruu Dr. Lynch of t.a> University of oom.h Carolina, and after reviewing the x-rays, the Medleal Advisory Buurd concludes aa follows; That the claimant c .od of i.oart di&u&as secondary to chronic pulmonary fibrosis, that tae pulmonary fibrosis vus associated In chemical analysis witn one finalng of silicates characteristic of asoestoa similar to those found in the dust at uis place of employment and that his death therefore resulted from asbestosls." CONCLUSION: The opinion given oy the three Members of the Medical Advisory Board, together with the later opinions of Dr. Lynch and of Dr. Clark, now show a preponderance of proof in favor of tne allowance of thia death claim in accordance with the previous finding of the Commission to the effeot that the olaimant nsrein is the legal widow and that she is the only person dependent upon the decedent. It is now concluded that this death claim should oe allowed and that a death award should be granted in the amount of $9,000.00 in accordance with the law which was in effeot at toe time of death on September 14 1952* . . 0 79998 Leo R. Hopa, Deo'd. Mrs. Mary Laa Hopa, aidoa-claimant H.Ms JO 12- 28-56 RECOM'.tENDAT ION S That the order of January 15, 19?4* and any later orders w d c h disallowed this death alain, be oareby revoked and set aslue; that the Appeal to the Canalslion filed on July 12, 1951m be allowed to the extent of the following order: The Commission finds from recent medical reports no on file and the opinion of the toree tfeaoers of Medical Advisory Board on December 20, 1956 established taat the death of tae decedent herein on September U+ 1952, resulted from the disease of asbestosis contracted In the course of employment* It is now tne order of bus Commission that this death claim be allowed end that the statutory death award in the amount of $9*000.00 be granted to iai'j Lee hooe, ano is the legal widow and ho as holly dependent upon tne uecedent at tne time of death; that the balance on tss funeral bill in tne amount of $ 70.60 be paid to the Suadet Lawn Mortuary; tret tne previous expenses which have been paid in ennneotion with this claim and charged to the occupational disease surplus fund be now Charged to the expenses of this claim and to the risk of the Philip Caroy Mnnufs.cturing Company. Prepared by Harry E. MoKeever-JC Attorney Examiner Leoember 28, 1956 THE INDUSTRIAL COMMISSION OF OHIO Form C-IOA Employee: Len R. Hope, Dec'd. NOTICE OF FINDING Claimant: Mrs. Mary Lee Hope, Widow Claim No. O. D. 79998 Street & No. 5434 Sansom Street City Philadelphia, Pennsylvania Date of injury Deoemoer 22, 1951 Date of Death September ll+, 1952. Employer: The Philip Carey Manufacturing Co. Street and No. Wayne Avenue City Dockland, Ohio Manual No. 1852 Risk No. 1684 PREVIOUS AWARDS FOR COMPENSATION AND MEDICAL SERVICES Total Medical Services to date Amount $1+49.00 FINDING OF FACTS AND MINUTES On tni day the above numbered claim, tosether with the proof on file, was presented to the Commission, considered and a finding of facts made as follows: That said employe's injury was sustained in the course of employ ment, and at the time and in the manner alleged in tne application; that employe's employer was at the time of injury a subscriber to the State Insurance Fund; that 3aid injury was not purposely self-inflicted; that death resulted to said employe from the injruy described in the application, that the following persons were his dependents at the time of death* The claim, therefore, was allowed in accordance with the facts snown below, and order and authority granted to the Auditor for issuing warrants in payment of tne same according to the rules of the Commission. MEDICAL SERVICES Item Name re ss Amount Warrant No. Funeral Sunset Lawn Mortuary 2350 East 13th South City, $70.SO iNSATION Weeks 279-4/7 minus Rate 32.20 period Sept. 15-52 to Jan. 23-58 Amount $9000.00 Warrant No. Lee J. Hereth Present for Claimant Address James Hughes Present for Employer Address Daniel Mann for Attorney General This action was based upon the following motion made by Mr. Norse Heard by Mr. Horse, Mr. Dickerson, Mr. Blake:RR That the order of January 15, 1954, and any later orders which disallowed this death claim, be hereby revoked and set aside; tnat the Appeal to the commission filed on July 12, 1954 *>e allowed to the extent of the following order: The Commission finds from recent medical reports now on file and the opinion of the three Members of Medical Advisory Boadd on December 20, 1956, established that the death of the decedent herein on September 14, 1952, resulted from the dis ease of asbestosis contracted in the course of employment. It is now the order of the Commission that this death claim be allowed and that the statutory death award in the amount of $9>00.00 be granted to Mary Lee Hope, who is the legal widow and who was wholly dependent upon tne decedent at the time of death; that the balance on the funeral bill An the amount of $70.50 be paid to the Sunset Lawn Mortuary; that the previous expenses which have Deen paid in connection with this claim and charged to the Occupational Disease Surplus Fund be now charged to the expenses of this claim and to the Risk of Philip Carey Manufacturing Company. The motion was seconded by Mr. Blake and voted upon as follows; Mr. Morse, aye; Mr. Dickerson, aye;. Mr. Blake, aye. Date January 24, 19&7 s" cretary December 31, 1956 Hr. L. J. Hereth c/o Cowell & Fletcher 1109 Enquirer Building 617 Vine Street Cincinnati 2, Ohio Re: Industrial Commission OD 79998 Len R. Hope deceased Mary Lee Hope, widow claimant Dear Mr. Hereth: In response to your letter of December 21, 1956, I have reviewed my material and the records in the Len R. Hope case, and I wish to state that on the basis of the clinical findings, the medical history, the chest X-ray, the record of exposure to the inhalation of as bestos dust and the autopsy findings of fibrosis of the lungs consistent with the effects of such exposure, in my opinion this man died of chronic fibrosis of the lungs with consequent heart disability as a result of prolonged asbestos dust exposure. In a broad definition, that is chronic fibrous disease of the lungs resulting from the deposit of materials contained in the asbestos dust inhaled, a diagnosis of asbestosls is reasonable and justified. Very truly yours, KMLjnmk Kenneth M. lynch, M. D. President J O H N W. C O W E L L (1901-1983) STU A R T E. F L E T C H E R LEE J. HERCTH DAVID W. BACON COWELL & FLETCHER ATTORNEYS AND COUNSELLORS AT LAW 1109 E n q u ir e r B u il d in g 017 VINE STREET C incinnati 2, O hio Dec. 21, 1956 PHONES 1*0063 1*0064 Dr. Kenneth M. Lynch Professor of Pathology and President Medical College of South Carolina l6 Lucas St* Charleston, South Carolina Re: Industrial Commission OD 79998 Len R. Hope, deceased Mary Lee Hope, widow claimant Dear Dr. Lynch: We had another hearing yesterday before the Medical Board of Review of the Industrial Commission and your letter of October 30, 1958, was considered by the members* It seems pretty well settled now that the man had pulmonary fibrosis, or asbestosis, or whatever you choose to call it, but the question now is one of etiology, or history: in other words, what caused the condition* In view of this I am enclosing a copy of a letter written by Dr. Princi, which is self-explanatory, and I would like to know whether, in view of the work experience, you could be more certain as to the diagnosis and reports. In other words, v/ith this picture of the working conditions and environment, is there any question now of the cause of this man's death? An early reply will be appreciated. I also want to thank you for your previous co-operation in this matter and may I wish you a Merry Christmas and Happy New Year* Very truly yours, COWSLlT 5 LJH:ic CC: Dr. Prank Princi, Kettering Laboratory, Sdon &; Bethcsda, Cincinnati, Ohio P. 3. The enclosed report was made, of course, prior to the autopsy, analysis of samples of dust, and also his later reports. L. J. H May 21, 1951]. Mr. Harry E. Me Keever Attorney-Examiner, Legal Section Industrial Commission of Ohio Columbus 15, Ohio Dear Mr. McKeever: R OD 79998 At the request of Mr. Lee Hereth, I have reviewed the Industrial Commission's file in the case of Len R. Hope, deceased, a former employee of the Philip-Carey Manufacturing Company, Cincinnati, Ohio. The first report of the present illness in the file is that contained in the report of the Veterans Administration Hospital of. Salt Lake City, Utah, The patient was described as a 58 year old colored male who was first seen on 55-13-52* He had been perfectly well until one year prior to admission. At that time he developed paroxysms of non-productive cough which were followed by the development of external dyspnea six months after the onset of the cough. There was no history of weight change, no sputum, no hemoptysis, or night sweats. On admission the patient was dyspneic on slight exertion. There was a venous engorgement of the neck when the patient was in the sitting position. The fingers showed moderate clubbing and there was evidence of arteriosclerosis. The laboratory findings were non-specific. The chest examination showed fullness and decreased breath sounds at both lung bases and fine rales over the lower half of both lung fields posteriorly. On admission a diagnosis of hypertension with congestive heart failure was made. This was said to be on the b&sis of hypertension ahd chronic pulmonary disease, most likely asbestosis. The electrocardiogram showed evidence of left ventricular failure and was suggestive of cor pulmonale and digitalis effect when the patient was seen at the Cardiovascular Clinic at Salt Lake County General Hospital on September 12, 1953. At this time he had a productive cough with dyspnea on exertion, ankle edema and increasingweakness. No attempt was made to examine the sputum for asbestos bodies. The patient died'two days after being seen at the county hospital in Salt Lake City, On 5-18-54 I visited the philip-Carey Manufacturing Company where Mr. Hope had been employed from 4-25-28 to 12-22-51* An inspection trip was made with the plant superintendent through the areas in which Mr. Hope had worked during his period of employment. An examination of the employment records revealed that Mr. Hope had worked in the paper mill from June 1938 to August 1943 when he was transferred to the asbestos Mr. Harry E. McEeever - 2 - May 21, 1951} mill. His work consisted of emptying bags (most of them of burlap) of powdered asbestos into a hopper. The asbestos fiber was carried by a conveyor to the "beaters" where it was mixed with water and scrapped salvage. At the time of my visit the procedure had been changed so that a new type of hopper w P_s being used. This new adaptation was designed to reduce the amount of dust in the atmosphere but it had not been in use during the period of time that Mr. Hope had worked in that area. The work area consisted of a. large basement area with a high ceiling. The space was approximately 100 ft. by 200 ft. and about 20 ft. in height. In the far corner of the room (at ceiling level) was a ventilating fan which was not in operation. If it had been operating, it is not likely that it would have produced much exhaust action. An employee was emptying bags (at a rate of about 3I4.O per day) of asbestos fiber into a grilled hopper. The excess that spilled over was brushed in by hand. During this process a respirator was worn. When the hopper was loaded, the same employee would sweep the floor with a broom, but during this activity he did not wear his respirator. A considerable amount of fine dust was present in the air at all times and this dust was increased during manipulation of the bags. This was essentially the same job in which Mr. Hope had been employed except that he had unloaded the bags by hand from a chute and in this fashion had created more dust than was present during our visit. He had also emptied the bags into .an open hopper in a smaller and more confined space. The bags were then shaken out by hand. Questioning revealed that tnere was no supervision over the use of respirators in this procedure. The men them selves would change the filters when they deemed it necesssay (about every three days). Between changes, they would "blow out" the filters with an Air hose. An examination of the respirators at this time showed that the inside of the face piece was filled with asbestos fiber. Asbestos dust was piled in all the wall projections and rafters of tae room. The only report of a dust count that cogild be obtained is that which is found in the report of the Industrial Commission's investigator dated 12-3-53 in which it is said that a single dust count revealed a concentration of 2.8 million particles per cubic foot of asbestos fiber in the work area. a review" of the chest roetgenograms which were provided shows the following. A- PA of the cnest taken on 5-15~52 shows pulmonary fibrosis of a non-discrete character with an increase in bronchovascular markings and evidence of passive congestion. The heart is markedly enlarged. Oblique views at this time showed enlargement of both sides of the heart with marked enlargement of the right ventricle. The film taken on 5-19*52 shows reduction in heart size with a decrease in pulmonary congestion. The mottlsd areas of increased radio-opacity persist, however, and are extensive in the bases and scant in the apices. Mr. Harry E. McKeever - 3 ** May 21, 195^ Dlscussion. Despite the finding of arteriosclerosis ahd left heart failure, the presence of cor pulmonale and pulmonary fibrosis is apparent both in the clinical history and the laboratory findings despite the fact that; the latter are non-specific. Clinically, it would be expected that chronic pulmonary fibrosis would produce a terminal picture of cor pulmonale with passive congestion. It -would have been desiraole to have the sputum examined for asbestos bodies. Unfortunately, this was not done. The appearance of the X-rays, however, is definitely consistent with a nistory of ezposure to asbestos dust in quantities sufficient to have produced pulmonary fibrosis Although a ground-glass appearance is not seen, this is not necessarily typical of asbestosis. The most typical feature, which is present in these X-rays, is the fact that the pulmonary fibrosis, predominates in the bases and is scanty in the apices. Tne clearing of tne lung picture as seen in the X-rays taken on 5-19-52 further accentuates the fibrotic changes which are seen in the chest roentgenogram. The right oblique views demonstrate clearly the presence of right ventricular enlargement Prom the history it seems evident tnat this individual has had about lk years exposure to asbestos dust. Asbestosis is known to have occurred in persons who have had as little as seven years exposure. The amount and degree of exposure can be determined only roughly at this time and in retrospect since the one air analysis which is reported is in no way definite. There is no record of where the atmospheric sample was taken, during what period of operation it was taken, nor what the particle size of the fibers might have been. In addition, sampling just one time is not sufficient to establish the presence or absence of an exposure. The fact that it was not customary to exercise supervision over the wearing of masks indicates that masks probably were not worn faithfully. In addition, the history of blowing out the filters with an air hose makes one suspect that these filters were perhaps broken and certainly not efficient. Conslusion. On the basis of clinical findings, the medical history, the history of exposure and the laboratory findings, a diagnosis of cor pulmonale secondary to asbestosis is justified. 4 Very truly yours, ppjrms cc: Lee J. Eereth Prank Princi, M. D Latter-day S aints Hospital 32S 8TH AVENUE SAUT LAKE CITY 3. UTAH November 13th, 1956 Us-*^Lee J. Hereth, ./o Cowell & Fletcher, JL09| Enquirer Building olTvine Street, Cincinnati 2, Ohio. Rej^O h i o Industrial Commission, I J / No. QD79998 ^ . Len R. Hope, deceased. Mary Lee Hope, widow-claimant. Mr. Hereth: This is a response to your letter dated 23 October, 1956 with reference to letters of Dr. Frank Princi, 24 August, 1956 and Dr. Kenneth M. Lynch, 30 August, II 1 am in total agreement with the conclusion that pulmonary fibrosis was the underrytng factor in the demise of Len C. Hope. Dr. Princi *s finding of chemical substances in pulmonary tissue similar to those of the specific industrial atmosphere in question are of interest. The resultant conclusion implicating them in a specific role in the etiology of pulmonary fibrosis seems problematic. This involves a knowledge of ex perimental production of fibrosis as well as an analysis of a control population with reference to these specific substances. Quantitative factors are no doubt important considerations. .1 find myself unequipped to evaluate this case with reference to these factors. Let me hasten to say that I have no distinct conviction that these chemical agents, described by Dr. Princi, were not involved in the production of fibrosis. It seems that in view of the clinical history, the autopsy findings and chemical analysis, the burden of proof resides with disclaiming this as a case of pulmonary fibrosis related to chronic exposure to chemical substances, allied with the production of asbestos. Sincerely yours, Homer H. Clark, M.D, HHC/vhb ce: Frank Princi, M.D. Kenneth K. Lynch, M.D, October 30, 1956 Mr, Lee J, Hereth c/o Cowell is Fletcher 1109 Enquirer Building 617 Vine Street Cincinnati 2, Ohio Res Ohio Industrial Conmisslon No. 0D79998 Len R, Hope, deceased Mary Lee Hope, widow-claimant Dear Mr. Hereth: In response to your letter concerning the above case accompanied by a copy of the letter of August 24, 1956, from Dr, Frank Princi, Cincinnati, to Dr. R. B. Hudson, Bureau of Workman1b Compensation, Ohio, I am still prevented from making a clean-cut diagnosis of asbestosis in this case by reason of the lack of positive identification of the as bestos material or characteristic bodies that up to this time are accepted as necessary for the application of that term. At the same time I am in agreement with the opinion expressed by Dr. Frank Princi quoted as follows: "The presence of pulmonary fibrosis, however, and the history of exposure which is reported in the record combined with the finding of silicate material which is present frequently in many combinations of asbestos dust confirms my previous opinion that pulmonary fibrosis was the result of the inhalation of a foreign material during the course of this man's work. Consequently, whether we call this a case of asbestosis or of pul monary fibrosis caused by occupational exposure becomes a matter of individual interpretation," It appears that the questions which bother me in using the term asbestosis are really academic in this case, and that there is sufficient evidence that this man's disability from which he died was the product of the material to which he was exposed in his occupation. Dr. Princi identified Page 2 October 30, 1956 Mr. Lee J. Hereth diooside in the lung tissue submitted to him, but neither he nor I found the material familiar to each in establishing a diagnosis of asbestosls. In my report on June 3> 1955* on his case I said that the nature of the fibrosis found in this lung tissue was like that seen in asbestosls. Since the silicate found by Dr. Princi in the samples of dust where the the deceased worked and in the lung tissue, chrysotile in the former and diopside in the latter are among the com binations of such materials frequently found in asbestos dust, I believe that the demonstrated exposure and the nature of the fibrosis of the lung are sufficient to establish a diagnosis of fatal disease of the lung caused by inhalation exposure to which the deceased was subject, and that the term asbestosls may Justifiably be used if that is necessary in the legal applications that are required to establish this man's claim. Very truly yours, Kenneth M. Lynch, M. D. Professor of Pathology and President KMLiJch cc: Dr. Prank Princi Dr. Homer H. Clark JOHN W. C O W I U . S TU A R T E. F L E T C H E R LEE J. HERETH DAVID W. BACON JO H N M. SA YR E COWELL & FLETCHER Attorneys and Counsellors at L aw 1109 E n q uirer B uiloinq S17 VINE STREET Cincinnati 2, Ohio October 23, 1956 FHONES Dr. Kenneth M. Lynch Professor of Pathology and President of Medical College of South Carolina 16 Lucas St. Charleston l6, South Carolina Re; Ohio Industrial Commission No. OD79998 Len R. Hope, deceased Mary Lee Hope, widowyclaimant Dear Dr. Lynch; As you probably know, we represent the claimant in the above matter and we have a copy of your letter and pathology report of June 3, 1955 Subsequent to your report and analysis of the samples of dust where the deceased worked by Dr. Princi, of this city, disclosed that it consisted principally of chrysoiile,. a form of asbestos. The material that was found in the lun^, or tissue, submitted on June lij., 1955, showed the presence of diopsids. The former material is hydrated magnesium silicate; the latter material is calcium magnesium silicate. I am quoting from a report of Dr. Princi to Dr. Hudson, of the Medical Department of the Industrial Commission. Dr. Princi goes on to say than the following, in the same line: ''The presence of pulmonary fibrosis, however, and the history of exposure which is reported in the record combined with the finding of silicate material which is present frequently in many combinations of asbestos dust confirms my previous opinion that pulmonary fibrosis was the result of the inhalation of a foreign material during the course of -this man*s work. Consequently, whether we call this a case of asbestosis or of pulmonary fibrosis caused by occupational exposure becomes a matter of individual interpretation." According to your report of June 3, 1955, yu stated that you could not identify the condition as asbestosis in the absence of Asbestos bodies". Then you go on in your letter to say that perhaps Dr. Princi could identify asbestos itself in such an amount as would explain the fibrosis. 10/23/56 Dr. Lynch 2, I would like to know, at this time, whether, in view of Dr. princis subsequent report quoted above, you could now identify the condition as asbestosis. The Industrial Commission puts great reliance on your views on this matter and I would appreciate your cooperation at this time. I am sending a copy of this letter to Dr. Princi. LJH:ic CC: Dr. Prank Princi, Kettering Laboratory, Eden 8s Bethesda, Cincinnati, Ohio P.S. A copy of Dr. Princis report,- is full, is enclosed. (COPY) August 24, 1956 Dr R. 3 Hudson rJediftal Department Bureau of Woidanen*s Compensation Columbus 15* Ohio R e : OD 79993 Lon R. Hope, Bec'd Dear Doctor Hudson: In reply bo your lotter of August 10th concerning the sample o f dust from the Philip C a re y Manufacturing Company one can only conclude that the sanple of dust which ina forwarded to us on February 9 1)56 consisted principally of cnrysotile* a fora of asbestos The material that was found in the lung tissue submitted on 6-1ij.-55 showed the presence of diopsldo. The former material is hydrated magnesium silicate; the latter material la calcium magnesium silicate Whether the material submitted to us as a dust for analysis truly represented the exposure unueruou* by Ur Len R. Hope during his lifetime cannot be uddcrtainee at this time for obvious reasons The presence of pulmonary fibrosis* however* and the history of exposure which is roported in the record combined with the finding of a silicate naterial -.vhion is present frequently in many combinations of aeoestos dust confirms aiy previous opinion that pulmonary fibrosis was the result of the inhalation of a foreign nutrial during the course of this man*3 work. Consequently, ahethor we call this a case of asbestosia or of pulmonary fibrosis oapsed by occupational exposure beeones a matter of individual interpretation*. Yours Sincerely, FP:rma EC: L J , Herath Frank Primei, Y. D, January 3, 195 Dr. Prank Princi University of Cincinnati Cincinnati 19, Ohio Dear Dr. Princi: Your letter about the X-ray diffraction studies on the lungs of Len R. Hope and the asbestos now being used at the place where he was exposed is most interesting. You did not say whether this material is the same as that being used during his employment. I believe that we have some lungs from cases of asbestosls which have been preserved various lengths of time. Please let me know what would be the minimum amount of lung tissue needed, and I will ask Dr. Patton to see what we can send. Incidentally, I have had some correspondence with Dr. G. Nagelschmidt of the British Ministry of Fuel and Power, in which he has offered to carry out X-ray diffraction analyses on the asbestos dust which we are using in our animal experi ments. I have not sent him any material, and I wonder whether you could do this for us. In Dr. Nagelschmidt1s letter he says, "Asbestos does not give a particularly sharp diffraction pattern, but it can be used, and we have in fact had occasion to study a human alleged asbestosia lung in which we found traces of asbestos after various pre-treatments." tilth many thanks and best wishes, I am Sincerely yours, KML: Jch cc* Dr. M. F. Patton Kenneth M. Lynch, M. D. President and Professor of Pathology THE KETTERING LABORATORY COLLEGE OF MEDICINE-- EDEN AVENUE CINCINNATI 1. OHIO UNIVERSITY OF CINCINNATI DEPARTMENT OF PREVENTIVE MEDICINE AND INDUSTRIAL HEALTH CABLE ADDRESS: KETLAB. CINCINNATI TELEPHONE: CAriTOL 1414 December 28, 1955 Dr. Kenneth M. Lynch Professor of Pathology and President Medical College of South Carolina 16 Lucas street Charleston 16, South Carolina Dear Doctor Lynch: You will recall that on June 3rd, 1955 you reported to the Industrial Commission of Ohio your findings concerning the lungs of Len R. Hope who was said to have had a considerable exposure to asbestos. At that time it was your opinion that since asbestosis bodies could not be identified, this could not be called asbestosis although there was fibrosis of the lung. The opinion of our own pathologist was identical to your own. Since that time X-ray diffraction studies of this lung were done and the report of the analyst was as follows. "X-ray analysis of the lungs (ashed and washed with water to remove soluble salts) showed that both samples contained diopside (calcium magnesium silicate, CaMgSiaO s) and quartz (Si02 ). The concentration of quartz was 0.2.% in the right lung and 0.18$ in the left lung (dried basis). The X-ray diffraction patterns did not show lines of asbestos (hydrated magnesium silicate, 3Mg0.2Si0ft.2Ha0) Since this was a curious finding (namely, that we had an exposure to asbestos and yet no asbestos in the lung), we wondered about the material to which the patient had actually been exposed. Consequently, we obtained a sample of asbestos which is being used at the present time by the Philip-Carey Company and analyzed this sample. The report of the analyst was as follows. "An X-ray diffraction pattern of the dust showed the material to be principally chrysotile, a form of asbestos (hydrated magnesium silicate, 3Mg0.2Si0a .2He0) The dust also contained some gamma iron oxide (YFezOa) and 1 per cent quartz (SiOa ). The X-ray diffraction pattern of asbestos was not affected by heating the material to temperatures not exceeding 50C. and treating with water." /Dr. Kenneth M. Lynch - 2 - December 23, 1955 4 | These unusual findings have caused us to wonder if the material that W9 are calling diopside is present in other persons who are known to have had asbestosis, (You will recognize, of course, that the question is now purely academic.) and whether the diopside is an incidental finding or perhaps even the important factor in the production of fibrosis. I wonder, therefore, if you might have any autopsy material in which asbestosis is known to exist, and if it might be possible for you to provide us with such material for X-ray diffraction analysis, regardless of our findings, I think this might prove an interesting investigation. We would, of course, provide you with all the information we are able to obtain. In any event, I would be interested in having your comments on these suggestions. With best regards. Very sincerely, PP:rms /Prank princi, H.D.