Document J3mQxnnK6v7mJx98zn0ZB4NmB

( i Ever since the pronounced incrose m whose work is also frequently referred - the incidence of lung oncer a;nong nates as establishing a connection between ast . heome apparent, there have been attempts tests and cancer of the lung, reported to associate it with one or another of the 1931 that oncer of the lung was pres various dements in the. environment of in 14.15* of asbestosis cases examined man. The approach used by some workers him. In 1941, Nordmann and Sorg has been to suspect one or several sob* claimed to have produced lung oncer stences and then set about in an intensive mice .which they exposed to asbestos d search for tung-cancer among persons who Since 1951, additional cases of cancer have had any exposure to those materials. the long coexisting with asbestosis h - In this connection. Smith*9 writes: "The been reported, and, according to Hucpc tcndatcy of authors reporting the coinci about 100 such cases had been reported dental occurrence 'of primary lung cancer to 1955, As a result, an association betw with' silicosis or with any ether theoretical the two diseases appears to have been etiologic conditions, has been to emphasise cepted by many authors, and several writ the percentage relationship in extremely were using the term "asbestosis cancer** Is t ; t small series of oms, with control eases which are not in any way comparable.** It would seem inevitable that asbestos the lung. Wcrber,** in 1952, stated c goricaily that in 7$* to 17% of cases asbestosis, after a latent period of ab should come under scrutiny in this manner, ljd to 20 years, carcinoma becomes est . because prolonged exfosure to this material lished in the lung. is known to cause a specific type of pneu- On the other hand, not all authors . moconiosts, and because persons who show cepted this alleged association with this form of pneumoconiosis often come to reservation. Saupc** in 1939 reported t autopsy and provide a ready source of he had discovered no cases of lung or material for study. It was in this way that among 620 cases of asbestosis which reports of the simultaneous occurrence of had examined; and in 1942, Hoilcb ; lung oncer and asbestosis began to accu Angrist4* expressed the opinion that mulate after the report of a case by Lynch number of oses of asbestosis with li and Smith** in 1935. Within the next 10 oncer was too small for statistical eval years, about 15 additional cases were re tion. In 1947, Wegvlius" reported ported, and in 1954 Mcrewethcr M reviewed radiologicdly diagnosed oses of asbestc all doths from asbestosis recorded in Eng- among 476 workers in Finland, and fot i land since March, 1924. Lung cancer oc- no cases of lung cancer in this gre ^ jcurred in 16% of these eases. Gloyne,41 Goldblatt and Goldblatt in their section Accepted (or publication /an. 20. 195&. Mercwether's latest book,44 state: "But i TTuj stwtjr was ncwlc jaissibie thmujh a frant no stage in all these impressive researc (ram *W Quebec A*Uiu* Mininc As*ciaijon. was any clue obtained which might h MaEcI Dirrcttir (Dr. Rnun) and Statistiol CyMulUM (Mr. Tnan), Industrial KyotM FoundstiaQ. . offered any sup|*orr to the possibility < asbestos could act as a carcinogen. T> <9# *6 bn* r*r Tal' H0i*W ti IU M M_ M. . .. . _r S4 U Ol na aaa . ' ic lung and in* i as mediastinal na, oncer of the abscess of lung, * One other x-ray only. In ng four oses in mce is strongly TSs is a total of a* 10 **sus* j 4 that are .institute the Ker of the lung incc 1940. *e^ 59 years of rriveen 37 years ig span covered ntnimum of 14 7 years. Only 5 years of eroScven anwtic nation is availre pheing them worked in an ejory I. ij these proved n wt have in* rescnce of as* resent in nine, wo. Two path* its presence in the 19 proved not accom- sions whether there m lung oncer JryY\ Ct*A\ rr\tx^ I OFtW produced to EAGLE-PICHER* IN LITIGATION OEC 1934 A. U. A. AHCUMiS OP tXDVSTRl.U. UliAt and exposure to asbestos has been evident was tn< |N**i!}c to trace 15.1 of thr>e since the report in 1955 by Lynch and Smith the whole period, but 5771 ol the reman* of a case in which ling"oncer and asbes* 595$ were found to be still living in 1 tosts were both present As additional cases or later. Of the 187 known dead, eat in which the two diseases coexisted were of the lung was considered to have b Tea5WWb!y"pKrt-etr m'9~auu to be stron have . been--gmduanr..accepted. by many suggested in 5. , authors, although som: workers considered The members of the cohort were stuc the correlation to be itvonclusivc.jThc pres with respect to age, length of emptovnu ent studyjrasamdcrtaien snr-an cilortto`dc* a weighted average of their exposure. : Aammg*whcthcr 'ajjsaal relationship <fid, ^^^factryist-hetwcCTcxposuj^to^isbcstos and canegripf3ie lunr! ^ *-- their. smoking habits. It was found t 4675 were smokers within the definittoti that term as used in this study. Thirty- U ^Sincg^mostTcarlicT'ftudlcr 'had** been per cent of the cohort were more than 4,-liimted-rto* enum^^^t^jltmg'onctrs years of age, and thirty per cent had be *gfound in certainpieced"samples.-such :as* employed for longer than 20 years. Tin leases coming to autopsy or death certificate^ per cent had a weighted exposure wh ^' which asbesto& was mentioned.'tt*>as. placed them in the category of highest t .^^parcnOhat they eduil hot fulfill the*re? posure. repriftmotU ot an.'epidamologieal and* stafj The mortality rate for lung cancer, Ttistical "IprifdachTtd^e^ problem.-- 4rSKnfTt53y was,''`thatfore," designer1 ^h^`ffiert<p5r5nctr?f dis methods XUcf a prellmhui) *.i\i> iu ehplun. life availabitity of reliable information, data computed on the basis of nine "prove deaths among the cohort was 25J per 10 000. When the three "suspected** cases wc added, the "total" rate for the cohort rc to 33.3. The importance of the suspect were gathered on worters in the asbestos but unproved oses in determining the mines in Quebec, based on their medical rates has been reiterated because it is like records. A cohort was defined as a group that sueh cases would not be included of asbestos miners havng at .least five years the statistics for the general population at of exposure and who yere in the industry because they influence the results so mar m 1950. Data relative tntheir characteristics edly.__ were collected and thor status at the end of a six*ycar period of observation was de termined. In the case of those who had died, an exhaustive search of death certtf* thewnortal no^miyonPycrc^TwuK^gtK!pf e: posureto^^rdccrce^oCcxpwyrcTa^fa iotes and insurance records was carried out which presents ` strong' evidence' against tl m order to determine as nearly as possible carCTnoiTOiatY or a'sb&tOs:----- the exaet muse of desh. ^Mortality rates comparison of the experience among tl from lung cancer for th: general population asbestos miners with that of various^; of the Province of Qudxc and its various ments of the unexposed, eomparable popt counties and for the Daninion of Canada, lation shows that the observed number c as well as the United Sates were calculated deaths among the miners is not significant! from statistics collected m the appropriate places. Comparisons o: the rates obtained for asbestos workers ant* for the other popu lation groups 'were mate according to ac greater than the expected number..The rat for proved cases among the asbestos miner (25J per 100.000) compares well with th rate of 22.5 per 100.000 for the rest of th cepted statistical methods. Province, and. 20.$ per 100.000 for adu Records were obtain?! on 6091 persons males throughout the Dominion of CamtL- who fulfilled the enters of the cohort. It It ato compares satisfactorily with rate UWG CJXCER IX ASBESTOS MIXERS produced, to eagle-ficher 'HeT6W of 37.2,25J. and 2&0 obtained from iisrimo A Vtchmn. W.: Ki|crimnttal Aj4cm> sources for adult male* in the United State*. Schweiz. Etwhr. aHc. Path. 14 'MS-717, IVSl. ^i^7^jUK^^nauetubfrcom(ariaa,Vlt 7. Behrens, W, Jr.: Tlie Clinical- IWr : Patlsulugy of A4mms, Ztschr. Unfallmed. mijwpuM an^r that tjw world-wide t*pqfenced Acrnfakmnklc 4S:I2<MJ0 (June IS) 1951 yaf-peraom expoxdtoTtfbcytoi dtm^is notT I UcrUitigcr, W.s Increase of Late Can ^TorM-wiia respee^oTuHg cancer iten (hat ptscowPortu Dust liilulatwat. Mul K ^SPKrw^wednorwbtion: j87gl337.lJMi;g,*p>. 1J3J93L ____ ^ ihc counttc* rurrouwling the aj>beto<- 9. BercnMum, I.: Irritation and Carcinogen* producing area*. In which tt t* presumed Arch. Path. 38:D3244 (Oct) 1944. 10. lUtte: Asbestosis, Dntixle mcd. WdmK most of die asbestos miners five, have al 62:928-930 (June 5) 1936. most Identical mortality rates with those of It. Bobme, A: Results of Periodical Exami eight counties widely scattered through the lions of Workers in aa Asbestos Factory, Be Province* and are lower than those for the remainder of the Province, and much lower than the cate for Montreal Since 1940 there have been 19 cases in which the diagnosis of primary cancer of the lung may he considered to have been proved. Approximately half of these cases Stfikmc Forseh. 11:34, 195L II Bowles, O.: Asbestos-Milling. Market and Fabrication, Information Circular X& 64 U. S. Department of the Interior, Bureau Mmes, 1931. pp. 1-2& U Breslow, L; Hoagtm, L.; Rasmussen, and Abrams, H. H: Occupations and Ggarc Smoking `as Factors in Lung Cancer* Am. were associated with asbestosis. All but one Puh. Health. 44:171-181 (Feb.) 1934. died in the recognized "oncer-age" and at least one-third had only the tightest exjxysurc (Category I) to asbestos dust On the bai^^l^haiare^clieved to be complctejn?. reliable dattTltjSccnts fair to ^onciu^^lnt^the'asbestds^miners in the 14. Bristol, L. J.: Rorntgenologie Aspects Silicons and Asbestosis, A.M.A. Arch. Ind: Health ti:189-193 (March) 1951 11 Cancer of the Long: An Evaluation of Problem, Proceedings of the Scientific Sect* Annual Meeting, American Cancer Society. I* Xer. 3-4, 1951 Xrv York, American Can Province of Quebec do_aot-have a signtf- Society, Inc, 1951 wantlsvh^heg-doth-.ratelfrom lung oncer . thanTl^aanjUrabW segmentsTofthe general | population. _ [ i^mhcnTWTt.yhcTdoth from tung an^ePTtfthe areas contiguous-to^thc asbes- j tos QpcrattonSj4<ocnparabie to "that in areas 16. Cartier, P.: Asbestosis Oncer of the Lu in discussion on Smith, W. E: Survey of Sc Cutrcm British and European Studies of Occ tiortal Tumor, Problems, A.M.A. -Arch. Ind; Hyg. 5:262-361 1951 t7. Canter. P.: Some Ginicat Observations Asbestosis in Mine and Mil! Workers, A. M. r widc^Jcatiered throughout tKe*Province of Arch. Indust. Health 11:204*207 (March) V. ' .Qiicbec-jad^<?lp^rr^thairjn icmie urban ized SrSuTwitKin {he `Province. 11 Gerent, J.: Research into Pulmonary As! tests in Belgitsn, Arch, beiges me! SoctaJe 8:5 565 (Nov.) 195L - REFERENCES L Atari* Escobar, R_: Bronchia! Carcinoma: Review of 200 Cases. J. Internal. CotL Surgeons 26:375*379 (Sept.) 1956. 1 Alien, U. L.: Brcnehiogenic Carcinoma As sociated with Pneumonoconiosis: Report of 2 Cases. J. Indust. Hyg. 16-.346-347 (Nov.) 1934. 1 Cartier. P.: A Contribution to the StiaJv of Asbestosis. Arch. maL profess. 10:589-595. 1949. 4. Anderson. C S, and Dibtc. J. H.: Silicosis and Carcinoma of tie Lung, J. Hyg* 38:185*204 (March) 1938. 1 Baadrr. E W.: Abest<i. Deutsche med. Wehatchr. 65:407*406 (March 17) 19J9. 19. G>,ncs: Asbestosis and Silicosis, Brit. M 1:379* 1931. 20 Coffin. C. J.; Duryte. H. C; Sfaier. H. Pardee, H. E B, and Wymer, E L.: The E<T* of Tobacco Smoking. Panel Meeting. Bull. N York Acad. Sled. 32:133-156 (Feb.) 1956. 21. Cohart. E 31.: Lung Cancer and Econo Status. Cancer 8:1126-1129 (Nov.-Dce.) V 21 Cooke. W. E: Pulmonary Asbestosis. B M. J. 2:1024-1025 (Dec. 3) 1927. 23. Curetun. R.J. R.: Squamous Cell Carcinr Occurring in Aslstosis of the Lung. Brit. Cancer 2 J49-253 (Sept.) 1948. 24. Cutler. S. J.j Schnridemian. M. A.. CrcQtliouv, S. W.: Some Statistiol Coruid*