Document J72OkMNqMBKnrLmLv5RYoeB2

FILE NAME Philip Carey PC DATE 1979 Oct DOC PC046 DOCUMENT DESCRIPTION Legal - Deposition of Mancuso THE THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA A. BATTON E. MIDDLETON et ux A. POWERS ANN RYDEN et ux Executrix etc. HORNE et ux MILLER etc. M. WEBER ExecutriExxecutrix , etc. etc. etc. Plaintifs Plaintifs Plaintiffs Plaintiffs Plaintifs Plaintifs Plaintifs Plaintifs A. No. 79-6773 C. A. No. 78-592 ee C. A. No. 78-591 ee C. A. No. 77-644 A. A. No. 79-957 ee A. No. 78-1283 77-671 ee No. A. C. A. A. A. et et VS. Nae JOHNS MANVILLE PRODUCTS a CORPORATION a corporation et al Ne Defendants a i ee DEPOSITION DEPOSITION DEPOSITION DEPOSITION OF OF DR THOMAS THOMAS FRANCIS FRANCIS FRANCIS FRANCIS MANCUSO MANCUSO MANCUSO witness a witness way in behalf of the plaintiffs taken pursuant to the Federal Civil Procedure byand before Richard E. Powers a Registered :ua etdble Professional Reporter and a notary public in and for the Common- Common- ate wealth of Pennsylvania at the U. S. Post Office and Court House rrhant Bvylake Pittsburgh Pa on October 17 and 18 1979 Gnd foe mens a rd wa or et. eC foe OME RE ' a e 29 Dr. Mancuso Direct DR THOMAS FRANCIS MANCUSO a witness called in behalf of the plaintiffs plaintifs plaintiffs having been first duly sworn was examined and testified as follows DIRECT EXAMINATION BY MR HENDERSON 2 Would you state your name please A Thomas Francis Mancuso Q Where do you presently reside A Pittsburgh Pa Q . What is your profession A Physician Q By whom are you presently employed A University of Pittsburgh I'm employed as a research Is that at the Graduate School of Occupational 14 XX ^ Q A Health ~ Graduate School of Public Health Where did you attend medical school Dr. Mancuso Creighton University Omaha Nebraska What year did you graduate 1937 Following your graduation from Creighton Medica School in 1937 would you trace for us quich 30 Dr. Mancuso - Direct your vocational and professional activities have been to date A I spent five years in internships and residencies in eastern hospitals particularly at King's County Hospital Brooklyn New York At the time of the outbreak of the war I was assigned by Medical Procurement to an assignment to the Public Health Service in 1942 and I was assigned to the Division of Industrial Hygiene and I was sent to the State of Michigan as an industrial hygiene physician for one year Following that I became the director of the Y Division Division Division of Industrial Hygiene for the State of Oregon for two years that Following that I then became director of the Division of Industrial Hygiene for the State of Ohio and was director of the Division of Industrial Hygiene for the State of Ohio for 17 years After thatI became a professor was appointed research professor at the University of Pitsburgh Pitsburgh Pittsburgh Pittsburgh And you have been there since 19627 19627 That's right 2 Now you were subpoenaed were you not in connection with a case in the state court of California Dr. Mancuso a Direct Yes sir When was that subpoena served upon you The end of August And did that deposition which has been marked as Plaintiff Deposition Exhibit No. 1 MR LOCKS Plaintiff exhibit exhibit I'm scrry The subpoena which has been identified identified identified identified identified identified as Plaintiff's Exhibit 1 was that the subpoena which was served upon you in the latter latter part of August of 1979 3 Yes sir Did it call for a date on which you were to give a deposition Yes It was to be within the first week 7 1979 Did that deposition take place No. Were arrangements then made by me to deposition of you today Yes I was extremely busy at the time impossible for me to undertake that And what has been marked as Plaintiff's Plaintif's Plaintiff's Deposition I Exhibit No. 2 which is the subpoena subpoena I gave you the 32 other day would you identify that for me please 3 I have it here Do you have a copy of it Yes I do That is in the case of Robert A. Bayton versus Johns- Manville Products Corporation and others at Civil Action No. 79-677 te t ( Yes sir This is the document Did both of those exhibits , PlaintifPlaintiff's 's Deposition Deposition Deposition Exhibit Nos 1 and 2 indicate to go over and provide to us certain notes memoranda and the like in connection with your consultancy with Philip Carey Company in 1962 and 1963 bs ' \ Are those documents available for review ? a Dr. Mancuso I'm going going going going going to ask the court reporter Mr. Powers to hand you Deposition Exhibit Exhibit No. No. No. and 3 and and and ask if you can identify that Yes sir ThisThis is is a Curriculum Vitae my Curriculum is Vitae of Thomas F. Mancuso It identifies my professional career my professional offions and on the types of work and and positions positions that I have held and Dr. Mancuso - Direct my publications What is your birth date February 19 1912 How old are you A seven In connection with your Curriculum Vitae and particularly beginning at Page 2 what is the title title titletitle title of Page 2 and what follows Offices held iin n professional association Under that is a list of a whole series of professional associations in which I had been affiliated afiliated affiliated afiliated in in major major major major major capacity over the years starting in 1955 and continuing on to 1972 In connection with the second one indicated as quote Consultant to Surgeon General and so on would you tell us us what what what what that that that that is is ? A I was selected by the Surgeon General of the Public Health Service to undertake a special assignment on a national basis to undertake to determine the range and scope of the research necessary necessary necessary necessary necessary necesary necessary necesary to to determine determine determine determine determine determine detrmine determine determine the the the biological effects effects of of air pollution pollution That was in 1955 1955 1955 1955 , and and and this this this was was was an an extensive extensive extensive extensive extensive extensive extensive extensive extensive effort effort effort effort effort effort , and and I submitted submitted submit ed submitted submitted submitted submitted submit ed submitted submitted an internal report to the Surgeon General of the 34 United States Dropping down to the second below that beginning with Diplomate would you indicate what that is is for for for us A That means that I'm certified as a specialist in occupational medicine medicine By the way are you licensed to practice medicine in Yes sir I'm licensed to practice medicine in Pennsylvania New York and Nebraska and I have reciprocal arrangements with most other states If I might at this point I'd ask you to characterize what your specialty has been since you began your professional activities in 1942 in the State of Michigan Well concentration relating to the investigation and control of occupational diseases The primary objective was to identify the causative factors relative to the occupational diseases and determine the appropriate means for prevention and control Dropping down to the next one immediately below the one that you just described it shows that you were an officer in the American Conference of Governmental Dr. Mancuso - Direct Industrial Hygienists Would you tell us what that organization is Well title it has the the title title Governmental but actually it's governmental It's a professional organization of individuals who work with city state and federal who were involved directly or indirectly governments with the concernconcern concern of protecting -- investigating occupational diseases and instituting procedures for and control in their respective areas of prevention jurisdiction It is similar to any organization for example if you had people who were chemists in the government who join together or engineers This is that type of thing Would you read the next note the next several of those and indicate indicate indicate for us what offices and committees that you have served on and at what times with the ACGIH ACGIH or the American Conference of Governmental -- I Let me finish so the record will be clear -- Governmental Industrial Hygienists I was chairman of the Committee on Labeling c Toxic Substances and I was national chairman of of 36 Dr. Marcuso - Direct the American Conference of Governmental Industrial Hygienists What year was that 1958. And I was also chairman of the Committee on the Epidemiology of Occupational Diseases in '59 and 160 I was also chairman of the Committee on Industrial Case Studies on Occupational Diseases in - 1960-62 of the American Conference of Governmental Industrial Hygienists I note about -- it's it's it's fourth from the bottom -- that you were with the Environmental Health Studies section in 1960 to 1961. I ask you what that office included 2 Well that is a select group The system in the United States and in the National Institute of Health is to have a serieosf study sessions which consists of research scientists who are picked to review the research grants of other scientists throughout the country I was on that committee for 1960 and '63 and if you will look at the next page from '51 to '63 This meant in effect that the scientists throughout the United States that were submitting research applications relative to environmental effects and biological effects from environmental Dr. Mancuso - DiDirect rect causes that we would review the scientists applications to determine whether they had sufficient merit to determine whether they should be approved or not and I was on that particular select group Immediately below that what did that committee assignment include incluincludede Well this was a Committee on Industrial Case Studies on -- Excuse me I'm referring to Page 3 the the third third third third third committee assignment The Committee on on Asbestos Asbestos and Cancer of the International Union against Cancer this was a committee that I and DrDr.. Christopher Christopher Christopher Wagner and Dr. Smithers of England initiated in which we proposed and actually developed an international approach to research relative to cancer Dropping down if I might Dr. Mancuso to the title headed Items of Related Interest do you see that at the middle of Page 3 of your Curriculum Vitae of Yes sir MR POWER Let me interrupt you Would you ask him to give the dates dates dates dates dates becausebecause because because we we don't don't don't don't have have have have copies copies copies copies copies copies of of the the the matter matter matter matter matter matter that that that that you you you are are are 38 Dr. Mancuso - Direct dealing with Doctor would you indicate under the second award or category starting with National Carend Development dileadte Award what that was CO The National Career Development Award from the National Cancer Institute to me for research on long- term biological effects of the microchemical environment and studies in environmental cancer from 1962 to 1972 meant that there was an effort and program of the National Cancer Institute to select certain promising scientists in the country and to support their research at a university so that they could continue their research work I was one of those individuals that was selected and I was supported for ten years by the National Cancer Institute for that purpose And the one immediately below that the award from the ACGIH The National Award of Merit by the American Conference of Governmental Industrial Hygienists was for his substantial contributions to the methodology of investigation of incidence of chronic occupational disease disease disease disease disease disease disease disease and and and and for for for hishis outstanding administration  39 Dr. Mancuso - Direct governmental governmental industrial industrial industrial industrial hygiene agencies That was awarded April 26 1960. This was an award award that was given by that organization for unusual contributions and exceptional merit Noting Dr. Mancuso the next several pages up to and including Page 7 of your Curriculum Vitae is a list of those articles under the heading of Publications accurate Is that accurate Yes sir ms What comprises the heading Publications Well within that group of 82 it consists of not only my scientific publications but also includes progress reports and presentations before various . groups ; How many did you say Eighty Now for what period of time were you chief of the Division of Industrial Hygiene in the State of Ohio I note attached to your Curriculum Vitae are several pages of your outline and responsibilities or what I think most of us would refer to as a job description Would you indicate particularly what is 40 Dr. Mancuso - Direct included therein therein with particular reference to your consultancy with Philip Carey Manufacturing Company in 1962 and 1963 Well the professional skills described in this that relate to my position as chief of the Division of Industrial Hygiene are that I had extensive responsibility in the investigation of occupational diseases I was actually in charge of investiinvestigating gating occupational diseases for the whole State of Ohio of which there were approximately 12,000 manufacmanufacturing turing industries and at least least two million people exposed exposed to various culminations of chemicals and relationship is is to the investigatiinvestigation on of occupational diseases diseases diseases is is perhaps wall described on the second page in in which which which which I conducted field investigations of industries throughout the state for occupational disease problems I analyzed various records medical records in industry and I provided recommendations to industry relative to the identification and resolution of their problems I conducted industrial health diseases research relative to occupational diseadiseases ses of populations exposed to specific chemicals or groups 41 Dr. Mancuso - Direct of chemicals I identified and directed medical engineering and chemical research efforts to control toxic and causing substances I provided technical consultation to the industries to the physicians the companies both large and small and on the attachment probably which relates to the graphic description of my breakdown of that it shows that I was division chief and I had within my group three major units medical chemical and engineering And among those facets of the medical I was providing investigative work relative to occupational diseases plant medical programs conducting cancer studies plant studies And the engineering work was involved to the evaluation and control of toxic chemicals conduct of air sampling noise elimination hazard and so forth So it it was it really a combinatioonf effort which in industrial hygiene you have an disciplinary approach of the medical nursing chemical engineering focusing on a particular problem evaluating it and determining the appropriate means of control and making appropriate recommendations for -- 42 Dr. Mancuso - Direct their control of those occupational diseases I notice on the second page of the organizational chart which is entitled Division -- do you see that Yes sir Under that you have listed three different categories Yes sir I have What are they Well there's -Just indicate what they are if if you will Under Medical is Occupational Health Radiation and Air Pollution and under that category there is consultation epidemiology health education and direct services Underneath Consultation there are Occupational Diseases Plant Medical Programs Local Health Department Programs and under Epidemiology there are Cancer Studies Other Occupational Diseases and Plant Studies What is epidemiology Epidemiology Epidemiology is the science directed at trying to determine the common factors directed at trying to (( 43 Dr. Mancuso - Direct elicit the cause of a particular event and Public Health would be toward a disease or a health problem Is a shorthand way of saying that that that is a means by which a cause and effect relationship is established This is a scientific scientific approach approach approach approach approach to that direction Doctor if you would I'm referring to some period of time prior to the summer and early fall of 1962 and ask you to relate for us at what point in time and the means by which that interest arose and grew insofar as your investigation of asbestos diseases Well I had been conducting a study relative to asbestos I had been conducting a study of a plant manufacturing asbestos brake linings and this had been going on for several years and had developed findings relative to this in which there was higher rate for lung cancer and also mesotheliomas and I had at that particultair me conveyed that information to my colleagues or peers peers peers peers in in Europe Was there anyone in particular that suggested that you begin to investigate asbestos disease Yes there was Dr. Wilhelm C. Hueper who was chief of of the the the the Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Environmental Cancer Cancer Cancer Cancer Cancer Cancer Section Section Section Section Section Section Section of of Section the National Cancer Institute made that suggestion to me in 1955 44 Dr. Mancuso - Direct that he had come upon a series of lung cancer cases in this particular plant which I eventually studied Dr. Hueper suggested that I consider the study of asbestos and that I take such a study and I did MR PARLER We again ask that the witness when he is respondintgo the question give the dates of these events that he is relating 2 : - MR HENDERSON Did you hear 1955 MR PARLER I did It finally came in on that one BY MR HENDERSON 10 Dr. Mancuso I will ask Mr. Powers the court reporter to hand you what has been marked as Plaintiff Deposition Exhibit 4 and ask you to identify A This is a scientific paper that I published It is entitled Methodology in Industrial Health Studies The Cohort Approach with Special Reference to an Asbestos Company and the authors are Thomas F. F. Mancuso and Elizabeth J. Coulter Ph.D. It was submitted for publication July 19 1962 and it was published in February 1963 in the archives "ae of Environmental Environmental Health of the American Medical 45 Dr. Mancuso - Direct Association I had previously presented this report at a scientific meeting in February of 1961 at the American Academy of Occupational Health Q Who was the subject of that study A The asbestos exposure in plant manufacturing asbestos brake lining Is there any significance to the form of methodology that you utilized in connection with that study marked as Plaintiff Deposition Exhibit No. 4 Yes The study was unique not only relative to its observations pertaining to asbestos and cancer and the development of mesotheliomas but it was unique in the sense that this was the second time that I had utilized a method which I had developed using the Social Security record system in which it was possible to establish the population at risk the employees at risk at a given point in time many years before at any point in time since Social Security came into existence in 1937 '33 and '39 on and to use the intervening period of time to fulfill the latent period required for the development of cancer ) Consequently in this particular plant I was 46 Dr. Mancuso - Direct able to have Social Security identify the population at risk which they kept internally That information was not provided to me Only the information pertaining to deaths was provided to me and that made it possible then to trace this population of of all those individuals who were employed in 1938 and '39 follow them through to 1964 determine to 1960 in this first paper to determine who died and where they died and then eventually I obtained death certificates from which then I conducted the mortality study Then I proceeded from there to the pathological review the microscopic review of certain selected cases for which I had the fortunate help of Dr. Wilhelm C. Hueper What were your findings Dr. Mancuso The findings were that there was higher than expected rate of lung cancer and mesotheliomas occurring in the individuals who were exposed to asbestos This was considered a conservative estimate insomuch as the fact that the workers were not characterized by duration of employment It was any individual who had been employed at a specific point in time So consequently if there was a large number of people 47 Dr. Mancuso - Direct who were employed for short periods of time this would act as an averaging or dilution effect Explain what the averaging or dilution effect was Well if you are studying a population for example suppose that the more significan-t- suppose in this particular plant or any other occupational cancer study that you are conducting you find that the clustering of the cases requires that an individual have say five years of exposure that although they can occur with less than that suppose most of your cases appear that way Well if you have a plant population in which 1,000 of the individuals were employed for only one year and you haven't characterized your population by duration of employment naturally you are going to dilute or average the rate that you get Did you have occasion to participate in the conference arranged by Dr. Selikoff in October 1964 at the New York Academy of Science Yes sir I was on the Planning Committee Was there another meeting that went on immediately subsequent to that that that that meeting meeting meeting me ting meeting Yes sir There was a meeting of a Committee on 48 Dr. Mancuso - Direct Asbestos and Cancer of the International Union against Cancer in which I participated and arranged In connection with the background of those two conferences Dr. Mancuso I would first ask Mr. Powers to provide you Deposition Exhibits 5 through 11 and hand them to you at this time MR LOCKS Off the record Discussion off the record Dr. Mancuso you have before you what has been marked as Mancuso Deposition Exhibit 5 do you not Yes sir Would you identify that for us please This is is a letter letter from Dr. W. J. Smither is Works Medical Officer from England to Dr. Thomas F. Mancuso and it refers refers refers refers refers refers to le letters tters of January 2 and had January 8 which I had had written to him He expresses his appreciation of my letting him know of my findings He advises me of his findings like together with the same observations that Dr. WagWagnner er Wagner in South Africa was obtaining and he was referringreferring to his own research work which he hoped to publish 49 Dr. Mancuso ~ Direct Smither and Wagner Mesothelioma MR MEANEY What is the date of the letter THE WITNESS The date of the letter is January 16 1962 Who was Dr. Smither Dr. Smither was the medical officer of and he was associated with Cape Asbestos He was a major person in England and was coordinating the research work relative to asbestos and was one of the principal persons in England relative to asbestos Going on to Mancuso Deposition Exhibit 6 I'd ask you to identify that This is a letter from me to Dr. J. Smither What is the date The date is April 2 1963 and I am providing him with a reprint of the article that I had prepared relative to asbestos that he had inquired about last January Was that referred to earlier as your methodology report as Mancuso Deposition Exhibit ? Hueper was conducting the review of the slides relative  50 Dr. Mancuso - Direct to my study that I was continuing and I called his attention to the fact that my particular population that I was studying was only those employed at any time in '38 or '39 it could have been for one week one month or one year and this was therefore a conservative estimate and that Dr. Doll's work had emphasized the importance of duration of employment in his findings findings findings findings What is mesothelioma Doctor Mesothelioma is a cancer It's a devastating cancer There is no hope of recovering from this type of cancer Its name is derived because it comes from a particular cell called mesothelial cell That's why it is called mesothelioma It's a tumor of that type of cell which occurs in certain parts parts of of the body It can occur in the abdomen the lining lining lining lining lining of the body That's why you get mesothelioma of the peritoneum It occurs in the chest wall and on the outer lining of of the the the lung which is the pleura That's why you have pleural mesothelioma That's why it's called -- You said it kind of quickly I heard what pleura is is . What is the peritoneum 51 Dr. Mancuso - Direct The peritoneum is the surface lining surface above the intestines Now referring to Mancuso Deposition Exhibit No. 7 ? would you identify that for us please Yes sir This is a letter that I wrote to Dr. W. J. Smither at the Cape Insulation and Asbestos Products Company in Essex England What is the date The date is July 22 1963 and I advised him that the asbestos used in the study which I had conducted conducted was Chrysotile from Canada that this information came indirectly from Dr. O'Donnell who was the pathologist who had originally observed the large series of lung cancer cases with asbestosis in that particular community where the plant was located and that I could not get any information from the company direct The bottom of the letter relates to the fact that I suggested to him that I wanted to take this opportunity to suggsuggest est that some form of planned coordination be developed relative to asbestos research between the various countries and that an international committee be considered conconsidsered cionsidderedered considered considered considered considered considered for for this this purpose purpose pupurposr e pose that such coordination may be going on in England but 52 Dr. Mancuso - Direct this is not so in the United States In view of the international use of asbestos and the health and economic implications of this problem a common need exists for research and for an agreement on uniform control measures and safe practices MR SCHULTZ Now I believe that you are reading from a document are you not cD 2 | THE WITNESS Yes sir MR SCHULTZ I believe the document speaks for itself itself . I know that we are reserving all objections but I'm afraid that might be lost ge 7 1 forever if we we did did did not put on the record that he is readingreadingreading rearedadinig ng from the document I caution him Fh rd not to do that that he is to paraphrase To paraphrase the last paragraph of the letter I had proposed that an interinternationnal atiintoernational nal international committee committee committee committee committee committee committee committee committee be be set set set up up relative to the study of asbestos on a world basis a Was that suggestion ultimately reflected reflected reflected in that meetthi atntog ok place in New York following the meeting of the New York Academy of Science in October 1964 Yes This resulted in the meeting developing after fo. \ Dr. Mancuso - Direct the New York Academy of Science meeting but of course there was a meeting prior to that time in order to prepare for them Q Looking now at what has been marked as Mancuso Deposition Exhibit No. 6 I'd ask for you to review that and identify it for us please A This is a letter from Dr. Smither to Dr. Mancuso The essence of this letter refers to the information -- MR LOCKS Doctor give the date first A I'm sorry August 2 1963. He relates to his own cases and studies pertaining to mesothelioma hut he refers to his enthusiastic enthusiastic enthusiastic enthusiastic enthusiastic agreement agre ment agreement agreement agreement agreement agreement agreement agre ment of of the the the i id de ea a idea idea idea of of a planned coordination on an international basis He goes on to say that he is is active active active active active active as as the the the chairman he of asbestos research groups and he starts to list all the different organizations that he is affiliated with and he identifies individuals whom he also believes would be very much interested in an international approach relative to asbestos in cancer 0x Going on Doctor to Mancuso Deposition Exhibit No. 9 I ask you to review that quickly and and and identify identify identify identify identify identify identify identify that that that that for for for us please A This This This is is a let er letter letter letter letter letter by by me me to to Dr. Dr. J. Christopher Christopher Christopher Christopher Christopher Christopher Christopher Christopher Christopher Christopher Christopher Wagner Wagner Wagner Wagner Wagner Wagner at at 54 Dr. Mancuso - Direct Penarth in South Wales a letter to him referring again to the asbestos with Chrysotile from Canada and that I had also gotten confirmation from another source that the type of asbestos was Chrysotile and that I had made a recommendation to him that an international committee be established for coordination relative to asbestos Who is Dr. J. C. Wagner Dr. J. Christopher Wagner was the person who originally discovered in South Africa the mesotheliomas in relationship to asbestos to mesotheliomas He left South Africa and joined Dr. John Gilson and continued his research work in England What is the date of that letter July 22 1963 MR SCHULTZ Excuse me I thought that was the date of Exhibit No. 7 MR HENDERSON I think they are both the same MR DeLORENZO No. Exhibit 8 is -- MR LOCKS off the record for a second Discussion off the record Dr. Mancuso - Direct BY MR HENDERSON Q The dates of Plaintiff's Exhibits 7 and 9 are the same A Yes they are 10 That is July 22 1963. Moving to Mancuso Deposition Exhibit No. 10 Doctor I'd ask you to review and identify that for us please A This is a letter that I wrote dated March 17 1964 to Dr. Bernard Naylor Department of Pathology School of Medicine UniUniversity versity of Michigan Ann Arbor Michigan The essence of thithiss letter was to tell him that I had been in London in FebruaryFebruary February February of 1964 and that I had met with the Occupational Health Committee of the Medical Research Council I had presented befbefore ore the British Medical Research Council my findings relative to asbestos in cancer Dr. Naylor's findings relative to mesothelioma Dr. Selikoff's findings which he had provided to me in advance and asked me representing the United States to present his research work and in conjunction with the others there And I also advised him that we had planned a three and a half day meeting after the meeting in New  56 Dr. Mancuso - Direct York at the New York Academy of Science Meeting and the that this would be sponsored by the Committee Committee of of the International Union against Cancer and that I would keep him advised of it and I would hope that he would participate at an international level on this program When you referred to the Committee of the International Union against Cancer is that what we sometimes see as the UICC Yes sir It's the French UICC but it's the International Union against Cancer When you were in London in February 1964 could you give us a sampling of those individuals with whom you met and planned the session in New York the following October Yes sir I met with Dr. John Gilson who was chairman of the committee I met with Dr. Richard Doll I met with Dr. Christopher Wagner I met with Dr. Smither I believe Dr. Elmes from from from from Ireland was there I think Dr. Cremer from Africa was there Ian Webster as was Dr. Bohlig from Germany These would be those individuals who would be eventually participating in the term international committee work on research on asbestos _ Dr. Mancuso ~ Direct in cancer and they would be the ones who would be participating in the New New York Academy of Sciences Meeting which was going to be held in October of 1964 that year Dr. Mancuso in connection with Exhibits 5 through 10 first let me ask you about the letters that you sent Were those sent to the persons indicated on or about the date that the letter suggests Oh yes sir And those letters which you received from those individuals were they received by you on or about the date indicated With respect to the copies that are before you were you able to provide me with the originals When I refer to originals I mean the copies which you retained or the original letters which you received Yes sir I gave you all the originals and all my first copies You have that And those are before you now Yes sir Dr. Mancuso turning to Plaintiff Mancuso Deposition look Exhibit No. 11 would you look at that and identify it  58 Dr. Mancuso - Direct for the record for us please This is a publication a scientific document document document document document document document document called called called called called called , Working Group on Asbestos and Cancer It It consists consists consists consists consists consists consists consists of the report and recommendations of the working group convened under under under the thethe auspices auspices of the International International International International International International Union Union Union Union Union against Cancer . This represents represents represents the the the deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations deliberations and and and compilations compilations compilations compilations compilations compilations compilations compilations compilations compilations compilations compilations of the recom endations recommendations of the three conference that we had after the New York Academy of Science Meeting and these meetings were held October 22 and 23. They submitted the report for publication which I have have have have in in my hands here reprint Is that a of the the the publication publication publication publication publication publication publication publication ppuubblliiccaattiioonn publicationpupbulbliiccaattioinon ? Yes sir When and where was it published It was published August of 1965 in the Archives of Environmental Health of the American Medical Association Who arranged that meeting A I arranged it in the United States and Dr. Christopher Wagner coordinating with him in England Both of us 59 Dr. Mancuso - Direct together were the prime movers relative to this international committee international research program which we were developing I note that the first two pages and part of the third are confined to a list of participants participants participants Is that accurate Yes sir We listed each country and then we listed the names of the individuals individuals individuals individuals individuals individuals individuals individuals individuals individuals individuals individuals representing representing representing representing representing representing representing representing representing representing representing representing each country and also gave their addresses and the listing includes of course Australia Canada Finland France Germany Great Britian and Ireland Italy United States South Africa Specifically were Drs Wagner and Smither present Yes sir They are listed on Page 222 near the bottom of the page fourth from the bottom Dr. W. A. Smither Dr. J. C. Wagner Dr. Mancuso in light of the history of asbestos at that point in time what was the purpose of that meeting in October of 1964 in New York Well the extensive recognition of asbestosis was was known primarily primarily primarily of the work that was done in England and and some work done done done in in the the the United United United United United States States States States States States coe and Europe and the observations observations observations relative relative relative relative relative relative relative relative to to cancer cancer cancer cancer cancer cancer 60 Dr. Mancuso - Direct The point of the matter was to try to develop international cooperation and try to determine the ways and means if it was at all possible in which asbestos could be used safely for one thing whether changing the physics and chemistry of the asbestos product or the studies or research done relative to that might make it possible for thithiss particular might possible particular product to be used safely because we recognized how important it was And of course the other part was that we all recognize the problem of of observer observer observer variations variations variations among physicians only in the same country but in different diferent different countrcounti ries es and the idea was to try to develop a uniform type of interpretation uniform type of approach to the evaluation of problems For example the chemists and physicists in the sampling of the asbestos dusts or in the analysis and measurement the experimental experimental experimental pathologists in having determining the amount of the sample and having having having a uniform sample when he subjected the animals to this and the interpretation relative to chest rays This idea was to develop common factors and common means of interpretation and evaluation so that () 61 Dr. Mancuso - Direct we would move forward without duplication and save as much time as possible so that we could be as helpful as we could to see if we could use this product safely and of course to prevent and control the disease as much as possible Were you awaroef Dr. Doll's study in 1955 Yes of course I met Dr. Doll in February of 1964 and knew his work published in 1955 in which he had found that there was a fold increase relative to lung cancer among individuals who had been employed in asbestos plants who had been employed for I believe it was ten years or or more I think it was something like that Had there been any work earlier than that by any others suggesting that asbestos was a carcinogen MR PARNELL I object to the question as leading and suggesting an answer MR HENDERSON I'll withdraw the question Doctor was there any prior work before Dr. Doll's relative to the relationship of asbestos in cancer cancer cancer cancer cancer cancer ? MR PARNELL Same objection MR SCHULTO I object to the form of the 62 Dr. Mancuso - Direct established in 1965 or 1964 MR LOCKS One second For the record the prior objectiowans made by Mr. Parnell and and and the subsequent ones by both Mr. Parnell and Mr. Mr. Schultz If you could just throw out your last name it would make it a little easier Doctor MR SCHULTZ I'm sorry There was adequate information prior to 1955 and this related to a series of works by Nordmann by Merewether and a series of other other reports which go into the forties and into into the fifties fifties fifties Did you refer to Dr. Nordmann Yes I did MR HOOD I object to the last comment of counsel the form of of the comment MR LOCKS That is Mr. Hood Do you need some water Dr. Mancuso Yes I would like some Recess 63 Dr. Mancuso - Direct BY MR HENDERSON Dr. Mancuso , would you now provide provide us with the initial initial initial initial contact and other background information relative to the period of your retention as consulting corporate medical director with the Philip Carey Manufacturing Company starting sometime in the fall of 1962 MR VINES i question Objection to the form of the Go ahead I was chief of the Division of Industrial Hygiene for the State of Ohic and I had been frequently referred to as an individual individual individual individual individual individual individual who who who was was was an an expert expert expert expert expert expert on on occupational diseases relative to compensation cases Mr. John Cantlon who was a consulting actuary who handled compensation cases for different industries in the state knew me personally and knew me professionally and I told him of my research work that I was undertaking and had completed and was in process and what the findings findings were relative to the asbestos brake linings and I advised him of these particular findings of asbestos findings of lung cancer mesothelioma He advised me that one of his clients was a 64 Dr. Marcuso - Direct company that was engaged in the manufacture and sale of an asbestos product and the name of the company was Philip Carey and he thought it would be very helpful to the company if I would be willing to act as a consultant to the company in view view view view of of this increasing increasing national information that was developing aboutabout the the the the When was that met them in September Of what year of '62 Who were the particular Philip Carey Manufacturing Company employees with whom you either met initially or with whom you had had contact contact contact contact contact contact at at some some some some point point point point point during during during during during during the the the year or plus of your consultancy My initial contact was with Mr. Lou Pechstein who was the assistant secretary and Mr. L. Knippa who was the plant manager Mr. Karl Krieg who was the employee employee employee relations relations relations relations relations relations relations relations relations relations director director director director director director director director director and and and Mr. John John John John W. Humphrey I think it was who was the president of of the company and Mr. Fasold who was secretary of the company What was your proposal and agreement in connection with your role as consulting consulting consulting consulting consulting consulting consulting consulting corporate corporate corporate corporate corporate corporate corporate corporate corporate medical medical medical medical medical medical medical director director director director director director director My proposal was that of a corporate medical director as the medical director company The company had been engaged in the manufacture of asbestos products for several decades It was faced with a sericus medical problem which was now developing national attention The latent period of the developing of the cancer took many years Consequently the serious health effects would would would be be increasing increasing increasing increasing increasing increasing increasing They were faced with increasing liability They were faced with increainscreased ed increased responsibility all company and I I proposed thatthat that the resolution of ththeir eir problem would be to develop the necessary policies and and proceduresprocedures procedures procedures procedures procedures relative relative relative relative relative relative relative relative to to the the the manufacture and use of their particular particular particular particular particular particular particular particular particular particular product product product product product product product in industrial population but also to protect those who used the product and the general public had recommended that my approach would be one to -- 66 Dr. Mancuso - Direct develop these policies and procedures company because it would only be effective that way I knew from my experience as chief of the Division of Industrial Hygiene being consultant to many industries in the state both physicians and corporate medical directors directors directors directorsdirectors directors directors directors directors directors and and and executives executives executives executives executives executives executives executives executives executives that the only way that you could really bring about change in a company or corporation would be to work with top level to work with the executiveexecutivess of of those those those those those corporations corporations corporations corporations corporations corporations corporations corporations corporations corporations corporations corporations and and and and , consequently I felt that the only way that I could bring about the change and the development of convey the importance of this and they readily accepted and that was the way I carried it out I had had had of of course course course course course course , a certain certain certain certain certain certain certain degree degree degree degree degree degree of of profesional profesional profesional profesional profesional profesional profesional profesional profesional profesional profesional profesional type of national recognition and the only type of position that I would have considered actually would be in relationship to a company because it to me served as a professional opportunity unique opportunity experienced who as a person person was experienced experienced experienced in in in ( ) ( Dr. Mancuso - Direct public health and a specialist in occupational diseases to bring about the prevention and control of a major problem which would affect not only the industrial workers but also the users and also the public as whole So therefore therefore therefothereforre e I saw it as a way of implementing and bringing about a way of preventing and controlling what I considered to be a major problem Who were the users Well the users were everybody who bought and used the product This included not only the industrial users users users but everyone who used their product in any occupation insulation worker There was --o actually emphasized to the company that that this this this this was was was the the the time to develop a positive approach relative to the consumers This was the time to take leadership relative to this to devise safe practice manuals to devise ilustrated illustrated ventilation ventilation ventilation ventilation ventilation guides before the consumers or anyone who used that product so they could be able to use their product safely so that no serious health effects would occur and there would be no liability to the company L 63 Dr. Mancuso - Direct and Doctor I'm going to show you andand ask ask ask the the the reporter to hand you a copy of Plaintiff's Exhibit No. 12 and ask if you might identify that for us This is a letter dated September 8 It is a three MR LOCKS What year Doctor Sorry September 8 1962 from John T. Cantlon President to L. A. Pechstein Assistant Secretary of of the Philip Carey Manufacturing Manufacturing Manufacturing Company Carbon copy was made to me The nature of the letter relates to a meeting that was held in his office September 7 1952 relative to developmenotf an occupational health program It emphasizes to the company the importance of asbestos compensation claim It indicates the It It also also also also indicates indicates indicates indicates indicates indicates indicates indicates indicates the the increase increase increase increase increase increase increase increase increase in in liability liability liability liability liability liability liability liability liability and and and indicates also the cost that would occur from any particular case case case case . It then goes on on the second page that they they they recomended recomended recomended recommended recommended recommended recomended recommended recomended recomended recomended that this occupational health program be undertaken 2 Dr. Dr. Dr. Mancuso Mancuso Mancuso Mancuso Mancuso Mancuso , referring referring referring refer ing referring referring referring refering referring refering to to Page Page Page Page 1 of of Plaintif Plaintif Plaintiff Plaintif Plaintiff Plaintiff Plaintif Plaintif Plaintif Exhibit No. 12 I'd like to read couple couple couple couple couple couple couple couple couple small small small small small 69 Dr. Mancuso - Direct Direct Direct the portions of the lleettetr ter letter letter letter The The The The first first first first paragraph paragraph quote Dr. Thomas F. Mancuso and I discussed with you and your associates during our vivsisitit visit visit to your plant and office on September 7 1962 the various current and potential health problems and the need for a planned occupational health program on a company basis close quote Did I read that accurately Yes MR MR . PARNELL PARNELL PARNELL PARNELL PARNELL PARNELL PARNELL \ I object object object object object object to to the the the form form form form of of the the the itself My name is al Parnell Can we have a continuing continuing continuing continuing continuing continuing continuing continuing continuing continuing objection objection objection objection objection objection objection objection objection Mr. Mr. Henderson Henderson Henderson Henderson Henderson Henderson Henderson Henderson Henderson , if if you are to do that form of questioning so we don't going MR PARNELL Thank you Did I read that accurately Dr. Mancuso 10 MR VINES Mr. Henderson did you read the word occupational in that paragraph , Dr. Mancuso - Direct 70 ' MR VINES We object if you did not MR HENDERSON I hope I did I meant to The occupational health program is that what you are referring to MR VINES Yes MR HHE ENDERSON NDERSON I'm sorry That's the same phrase by the way that appears on the September 23 1963 document that we will refer to later on Is that what you meant MR MR . VINES VINES VINES VINES VINES Is Is this this this this on on the the record record record record record record ? MR HENDERSON Well it was your comment MR VINES I merely merely merely merely merely merely objecting objecting objecting objecting objecting objecting objecting objecting objecting and and and moving moving moving moving moving that your remark be stricken stricken stricken stricken stricken stricken stricken stricken . quote This has been further discussed between us and Dr. Mancuso and I now propose that he be made Consulting Medical Director for your company to advise and carry out broad occupational health and so 0. Did Did I read that portion portion portion of that that that that paragraph paragraph paragraph paragraph paragraph paragraph paragraph paragraph paragraph accurately acurately acurately accurately acurately acurately acurately accurately acurately ac urately ? Dr. Mancuso - Direct A Are those references to the September September September 8 1962 letter referred to as Mancuso Deposition Exhibit 12 consistent wiwith twithh that which you just testified to a moment ago MR CARPENTER Objection as to the form It's consistent in referring to the broad occupational health policies and the Consulting Medical Medical Medical Medical Medical Medical Medical Director Director Director Director Director Director Director Director and in relating to the concept of a company type of service 2 Doctor moving to Plaintiff DepositioDeposition n Deposition Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit No. No. 13 13 , you have before you now I trust a copy of of Plaintif Plaintif Plaintiff Plaintif Plaintiff Plaintif Plaintif Plaintif Plaintif Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit NNo. o. 13 do you not I'd I'd ask ask ask you you you to to indicate indicate indicate indicate indicate indicate indicate indicate what what what what indicate the the the date date date date of of that that that that letter letter letter letter letter is is you that first and tell us to whom it was sent by < whom it was sent and who received copies copies September 27 1962. It was a letter written by John T. Cantlon President President President President of John T. Cantlon and Associates It was written to Mr. L. A. Pechstein Assistant Director Director of of the Philip Philip Philip Carey Manufacturing Company Did Did you receive a copy of that ? that that that that that Dr. Mancuso - Direct Does it show that you received a copy Not on this first page Okay but your recollection is that you did receive a copy Yes MR CARPENTER question I object to the form of the ; MR HENDERSON I withdraw the question for Yes I certainly did I prepared the document How many pages comprise the attachment Three pages Doctor refrefering erring to Page 2 of the attachment atachment , which would be PaPagge e Page Exhibit 3 of of Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Deposition Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit 13 13 , I refer refer refer refer refer you you you to Roman numeral IV SubparagraSubparagraph ph b Do you see that and abstracts of reference sources on particular Dr. Mancuso chemicals chemicals recommended control control read that that accurately 73 quote the question question think think think with with earlier earlier earlier earlier earlier comment you have have have have with with Did that marked has been been been marked marked marked marked as Plaintiff Plaintif Plaintiff Plaintif Plaintif Plaintif identify identify identify identify identify identify identify the plant manager Company dated copy of of Knippa the Philip Carey Carey Carey Manufacturing Manufacturing 15 1963 carbon and sent a I carbon I carbon Pechstein Pechstein Pechstein Assistant Assistant Secretary of the Philip Carey Company With With With reference reference reference reference reference reference reference reference reference to to that that that letter letter letter letter letter and and and in particular paragraph Amer 8 Mine at cute ene me 00 74 Dr. Mancuso - Direct you had some quote latest With Mr. Louis Knippa and Mr. John W. Humphrey president of the company What did you indicate that you were going to do at that meeting I'm sending copies of the articles articles which related to the medical literature pertaining pertaining to the hazards concerning asbestos exposure exposure that was important to the company relative to their their industrial workers and and also to the adjoining population population the surrounding population What did you tell Mr. Humphrey Humphrey with respect to that discussion Well whenever I met with Mr. Mr. Humphrey my efforts were rather concise and broad that that I emphasized emphasized emphasized to him that that the company had been engaged engaged in the manufacturing of an asbestos product which was now -- which was have an accumulative medical medical medical medical medical medical and and liability liability that they had to institute immediate immediate range plans to control the problem that they they would have extensive undertake liability and that they ought ought to undertake measures for protection of the purchasers purchasers and users of the 00 75 Dr. Mancuso W Direct problem and that I would alert him to the current information relative to this problem problem problem problem problem with with with withwith this this this this asbestos because I happened to be deeply involved in it I also emphasized to him the fallacy of any company manufacturing an asbestos product product product relying upon the Truan report of the Industrial Hygiene Foundation which was sponsored by the asbestos industry because I told told him that the findings were broad and that the asbestos problem the cancer problem relative to asbestos was real that it would involved not go away that they were deeply in it and that this would takea major undertaking that this would require all serious consideration by his facilities whether they would be able to institute control measures Who were the purchasers and users Everybody who bought and used I didn't know who the purchasers and and and and and users were of the PhiPhilip lip Carey Company I had had had no no information information information information information information information information information information information relative relative relative relative relative relative relative relative to to that that that that had I knew that 76 DI Mancuso - scope scope It had been used used And I knew that other other other other other other industries had had had bought bought it it subcontractors had it of course other of of course I knew that insulation workers would be using the product Dr. Mancuso I will turn your attention now to Plaintiff Deposition Exhibit 15 and ask you if you might to identify plaintiff Deposition Exhibit 15 for us The label on this document is entitled Medical Literature Occupational Health Program The Philip Carey Manufacturing Company In ink it's marked 8/15/63 The imprint on John T. Cantlon & Associates Actuaries Is Plaintiff Exhibit 15 document a particular documentdocument document that that that you retained in your files since August 15 , 1963 Yes This is my personal Would you describe the outside of that deposition deposition deposition deposition deposition deposition deposition exhibit Well this exhibit is a bound bound bound volume a bound Dr. Mancuso - Direct it's a spiral document -- inside the document is a series of medical reports scientific reports pertaining to asbestos which I had selected which I believed to be important and were necessary to warn the company and to advise the company of the impact of asbestos both relative to the occupational exposures of asbestos inside the plant outside the plant and to the community at large and they consist of a series of documents which relate to accomplish that particular purpose It also details for the company and the responsible physicians the magnitude of the situation and the implications of the situation and their potential liability and and the serious health risks which would develop Dr. Mancuso how many medical articles are contained in Plaintiff Deposition Exhibit Exhibit Exhibit Exhibit Exhibit Exhibit 15 ? Deposition Seven Was that bound report sent to the Philip Philip Carey Manufacturing Company under the cover cover of of the letter dated August 15 163 to which it is referred in Plaintiff Exhibit 14 Yes it was sent to them but actually I had it in my c 78 Dr. Mancuso - Direct Direct Direct Direct Direct Direct hand at the time we were discussing with the various officials of the the company the contents of of this this this this document So that I made sure that the information that was within that I intended to inform them of that they were well aware of the nature and impact of the particular scientific documents that I had put together Thank you Doctor Referring now to the first article contained within Plaintiff Deposition Exhibit 15 would you tell us what that is please The first article is entitled Asbestos Exposure and Neoplasia by Dr. Irving J. Selikoff Dr. Jacob Churg and Dr. E. Cuyler Hammond And it was PhysiPhysicianscians on June 17 1963 at Atlantic City New Jersey By August 15 1963 was that article published in in the the the medical and scientific literature This was available This was presented on June 17 1963. I made it available ahead of time to the company It was not available in the scientific C 6 79 Dr. Mancuso ~- Direct journals Dr. Selikoff and I had been communicating to with each other and working together relative to our individual observations over a period of several years and he provided me with this copy in advance of the the publication MR PARNELL PARNELL PARNELL I object to the responsiveness of the answer Mr. Henderson 2 Was the paper latelaterr published A Yes sir - Who did did did the the the Selikoff Selikoff Selikof Selikof Selikoff Selikoff Selikof Selikof study study study study study include include include Dr. Mancuso A The Selikoff study included insulation workers They had the workers of the union members of the International Association of Heat and Frost and Insulation and Asbestos Workers and they comprised of these individuals in which he determined the cause of death and their relative -- the pattern of the cause of death and the excess risks So the answer is the asbestos -- what we refer to as insulation workers ,, What were the findings A The findings were principally that there was an excess of lung cancer death due to lung cancer among among 80 Dr. Mancuso - Direct the insulation workers approximately seven times that -- 6.9 or seven times that of the general population The second observation was that they had found mesotheliomas both pleural mesotheliomas and I believe peritoneal mesotheliomas which is a rare type of tumor which of course was excessive and the major finding of was course insulation workers were exposed to a minimum amount of asbestos and yet these individuals had developed an excess risk relative to lung cancer and mesothelioma mesothelioma mesothelioma mesothelioma mesothelioma mmeessootthehleilomiaoma And of course the report was also important in the sense that it involved the long latent pepriod eriod of exposed exposed exposed exposed exposed exposed exposed exposed to to asbestos asbestos asbestos asbestos asbestos asbestos asbestos asbestos and and and then then then then subsequently subsequently subsequently developing disease And this is very important because sometimes if one conducts a study where the cancer has a long latent period and if you make observations in too short a period of time you will underestimate the degree of risk What is the latent period Well the latent period is the term that we Use that describe describe describe -- there are various interpretations interpretations interpretations interpretations The The 81 Dr. Mancuso - Direct interpretation interpetaion interpretation I give give give give to to the the the latent latent latent latent latent latent latent period is the interval between the first exposure to the carcinogenic agent and the subsequent recognition of the development development development development development development development development of the cancer Now if the individual is alive that would be the point in time when the individual was exposed to the time that he was clinically observed to have the cancer If you don't know when the individual develops report to Philip Deposition Exhibit No 15 do you have that article A The title of Neoplasiums It's published December 3 1960. It was published in the British medical journal called tables tables tables tables tables tables included included included included included included included included on on the the the first first first first first page page page page of of came Crod 82 Dr. Mancuso - Direct Yes sir there's two The first Table 1 refers to the cases of asbestosis that relate to women Table 2 relates to the cases of asbestosis that relate to men Dropping down to Case No. 22 would you indicate what is listed under Type of Exposure MR SCHULTZ I object to the form of the question as leading and suggestive of an answer Well to the extent that it shows pipe lagger as type of exposure - : 7 MR SCHULTZ I further object to the ' ft question and move that the comments of counsel be stricken from the record We'll start all over again Referring to Case No. 22 what is the type of exposure indicated Pipe lagger MR SCHULTZ Same objection What is a pipe lagger A pipe lagger is the same work as an insulator or pipe coverer This term is interchangeable In some countries they call them pipe laggers in some countries they call them insulators Dropping down to Case 25 what is the occupation listed Dr. Mancuso - Direct there Asbestos lagger MR SCHULTZ I object to the form form of the question as leading and suggestive of an answer Asbestos lagger Is there any associated disease Yes Carcinoma of the lung Dropping down to Case 32 is there an indication of the type of exposure MR SCHULTZ I object to the form of the question as leading and suggestive of an answer The printed document shows boiler coverer as the type of exposure This woulbde the same as an insulation a worker and also the same as pipe lagger Is there any associated ~- MR CARPENTER I object to the answer I don't know if the doctor has any way of knowing that's the same thing Referring to the heading Associated Disease what is that with respect to -- Carcinoma of the lung MR SCHULTZ I object to the form of the question as leading and suggestive of an answer 84 ~~, Dr. Mancuso - Direct Doctor I'd appreciate it if you would pause briefly after he he finishes finishes his his his question so we can get our objections into the record Thank you Referring to Case No. 34 would you indicate what the type of exposure listed there is MR SCHULTZ Same objection Boiler coverer And is there an associated disease Carcinoma of the lung MR SCHULTZ Same objection With respect to Case 36 is there a type of exposure exposure indicated MR SCHULTZ Same objection Boiler coverer 0 Dr. Mancuso referring to the next article would you indicate what that is by whom it was written when and where it was published A The title of this article is called Diffuse Pleural Mesothelioma and Asbestos Exposure Exposure in the North Western Cape Province The authors are J. C. Wagner C. A. Sleggs and Paul Marchand It was published in in the the BritishBritish British Journal of Industrial Medicine 1960 CO 85 Dr. Mancuso - Direct Is that the same Dr. Wagner to whom we were referring earlier in your testimony testimony testimony ? Yes This is the same Dr. J. Christopher Wagner who made the observations in Africa relative to mesothelioma the same Dr. Wagner who joined with me in the development of the international program and effort committee on research on asbestos in cancer What were the findings of Dr. Wagner He found that a large series of cases of mesothelioma had occurred of pleural mesothelioma of individuals who were occupational cases They were resident They were individuals who were exposed outside of any working exposure and this was very important because the exposures d for two reasons -- were minimal and secondly it indicindicated aindicated ted the long latent period relative to the development of the subsequent disease mesothelioma Were there any occupationally exposed individuals who had contracted mesothelioma in that article Well he refers on Page 269 to four industrial cases Two of the patients were laggers lagging locomotive boilers and one was lagging steam pipes pipes pipes What is a lagger C 86 Dr. Mancuso - Direct fl A lagger is equivalent to an insulation worker and a boiler coverer Thank you Doctor before you now is Mancuso Plaintiff Deposition Exhibit Exhibit No. 16. I'd ask you to indicate the date of that exhibit what it is to whom it was sent by whom it was sent and who received copies The date is October 4 1962. It was sent by Mr. L. A. Pechstein Assistant Secretary of the Philip Carey Company It was sent to Dr. Thomas F. Mancuso Subject was Occupational Health Program Copies were sent to Mr. L. Knippa he was the Plant Manager Mr. C. Bedford he was the Assistant Plant Manager Mr. C. Krieg he was the Employee Relations Manager Mr. A. Brockmeyer and Mrs. V. A. Williams who was the nurse I don't know whether I got Bedford's ana Brockmeyer's positions interchanged but -Referring to the first paragraph of that letter would you paraphrase what that meant meant to you It says that they had confirmed the concept of the Occupational Health Program which had been outlined in the attachment of a letter letter letter letter letter letter September September September September September September September September September 27 1962 and they accepted the proposal -- 87 Dr. Mancuso - Direct Was the attachment to which you refer that three attachment you indicated that you had prepared Yes sir I believe you now have placed before you Dr. Mancuso what has been identified as Plaintif Plaintiff Mancuso Deposition Exhibit No. 17 and I ask you to identify that This is a lettletter er by me to Mr. L. Knippa Plant Manager of of the the Philip Philip Carey Company It is dated May 23 1963 and carbon copies were sent to Mr. L. A. Pechstein Assistant Secretary and Mr. Karl F. Krieg Personnel Manager Did you send that letter Dr. Mancuso Yes sir By May 1963 had any procedure been developed relative to reducing to writing previous meetings or conferences Yes A number of conferences I held with the various officials of the company individually and jointly and the procedure I adopted was to try to summarize the various points that I had made and to highlight these points in the forform m of a written document so that they would have something to refer to as we continued the progress in this particular area So I definitely 88 Dr. Mancuso - Direct adopted this parparticular ticular procedure I used it in a summary fashion because when I spoke to these individuals I not only provided them with the major points but gave them the details of it but at this time I provided a summary statement relative to the points I had made with them and provided the broad scope in broad terms What did the letter of May 23 1963 represent The letter represented in broad terms a recognition of the extensive serious medical problem that the company was faced with companywide in the manufacture and sale of its products and of course with its liability relative to the employees and to the users of its products and as well to the community at large the importance of trying to develop a constructive approach so that the company could sell and could use its particular product that it could sell its product safesafelly y SO in essence the proposal consisted of of identification of an awareness of the serious Foundation Foundation Foundation Foundation Foundation Foundation Foundation Foundation Foundation Foundation report report report report report report by by Braun Braun Braun Braun Braun & Truan Truan Truan Truan Truan and and and I emphasized emphasized emphasized emphasized emphasized emphasized emphasized emphasized emphasized emphasized 89 Dr. Mancuso - Direct the series of recommendations that they shoulshouldd undertake individually and in cooperation with other asbestos industries I told them of the importance of doing that type of work and I accepted accepted the positive approach relative to consumer guidance and assistance and outlined a whole series of steps that should be taken for that These steps included the recommendations relative to the establishment of safe practice manuals which contained illustrative ventilation control design for safe handling procedures procedures procedures procedures and safe data sheets so that the various dusts could be controlled and so that the consumers and the persons who used this particular product could use it safely safely safely safely safely And of course I emphasized emphasized empheasimzedphasized emphasized the importance of providing technical assistance to the consumers of their product and the purchasers of their product and I advised them the way to carry this out was to employ an industrial hygiene engineer who would develop and design the safe practice procedures who would evaluate and control the work procedures who would evaluate and and control the work procedures and exposures not only at that that that that plant but at each plant that 90 Dr. Mancuso - Direct the company had and at all of its operations including Canada I went on to describe the importance relative to air pollution control I went on to describe the importance of instituting protective measures relative to evaluating the health effects of any new products that the company was making and instituting this at the beginnibeginingng before before the release of any product And in essence all my efforts were trying to help the company to be able to utilize their product and to try to find a way in which it could could be done safely to protect the people who were buying and using it both inside and outside the plant and this was Was there any particular reason or reasons for your emphasis on the consumer uses in the outline of May 23 1963 Yes There was a combination of reasons relative to that I had already done my work relative to the asbestos brake lining study study I had already made available to the company the Keal Report which identified emphasized that minimum exposures would be identiidentified fied by pipefitters or boiler coverers who would develop an 91 eatn, oe Dr. Mancuso - Direct asbestosis or lung cancer I had identified the information that I had heard from Smither and from Selikoff and relative to their work in which Smither had identified that at a minimum exposure mesotheliomas could offer I had information from Selikoff long before he presented his information on June 13 1963 in New Jersey because we had been corresponding and I had written to him and he advised me of that work and I had found a case of an insulation worker with mesothelioma which I had identified in 1962 But the more striking and more important convincing point that I tried to get across with the Philip Carey Company was the practice that they were at risk in severe liability because they had the practice of being on national contracts in which the insulators would be put put on the Philip Carey payroll This was a national practice It had been going on for a large number of years I pointed out to the company the inadvisability of this I pointed out to them that this was an increase in liability that should shouldshould should should should be be discontinued discontinued discontinued discontinued discontinued discontinued discontinued discodntinuediscontinued and that it was very important that that that that control control control control control control control measures measures measures measures measures measures measures measures be be instituted instituted instituted instituted instituted instituted instituted instituted instituted instituted relative relative relative relative relative relative relative relative to to en at -- . Q A Q A Q 92 Dr. Mancuso ~- Direct insulation workers So these these combinations combinations of of mi mi nniimmu um m exposures were able to convey to the company the necessity of instituting control measures and safe practice procedures for minimal exposures to asbestos Dr. Mancuso I show you what has been identified as Plaintiff Mancuso Deposition Exhibit No. 18 and ask you to identify that please both in terms of date by whom sent to whom sent and the context of the document This is a letter from DrDr.. Irving J. Selikoff to Dr. Thomas F. Mancuso dated May 24 1962. He refers to the fact that I had written on March 6 1962 to Mr. Carl W. Sickles of the International Association of Heat and Frost Insulators and Asbestos Workers and that my letter to Mr. Sickles of that union had been referred to in March of 162 had been referred to Dr. Selikoff He then told me that he was -- Excuse me DI Mancuso Do you have a copy of the letter that you wrote to Mr. Sickles No I don't have that I couldn't fifind nd it What did you say to Mr. Sickles of the asbestos workers Well at the same time that I was conducting my study oO 93 Dr. Mancuso ~- Direct relative to the asbestos brake linings and had made the observations relative to the mesotheliomas I started to dig into the possibility of other cases of mesothelioma in the case of Ohio and I had uncovered other cases of mesothelioma and this particular case which was very clear was that an individual had been identified as an insulation worker So I wrote to the Internation Union trying to determine whether I might be able to get information information from them as to the length of time he was employed as an insulator and if if I could get their cooperation in providing information information information information information about the Insulation Workers Union but of course Dr. Selikoff was already engaged in working with that union in the the the development of that type of study Turning to Plaintiff Mancuso Deposition Exhibit No. 19 I'd ask you to identify that for us in terms of date by whom and to whom the document was sent and received This is a letter from Dr. Thomas F. Mancuso dated May 29 1962 to Dr. Irving J. Selikoff and this acknowledges the letter that he had sent to me cn May 24 in which I stated that I was pleased to know em 94 awe Dr. Mancuso - Direct that he was undertaking the studies relative to the insulation workers and I indicated that I hope that we will be getting together shortly and exchanging our information Next I show you what has been marked as Mancuso Plaintiff Plaintiff Plaintif Plaintiff Plaintiff Plaintif DeposiDeposition tion Exhibit No. 20 and ask you to describe and identify that document This is a letter from Dr. W. J. Smither Cape Insulation and Asbestos Products LLii mited mited dated April 23 1963 addressed addressed addressed to to Dr. T. F. Mancuso and the document refers to the fact that he had found a significant number of cases of mesotheliomian which the exposure was minimal and the lapse of of years before diagnosis was considerable He then goes on to discuss the different types of asbestos being used and the comments relative to other investigators in different parts of the world Dr. Mancuso what reaction resulted from the corporate officials to whom you presented the substance of of your your your May 23 1963 report identified as Plaintiff Deposition Deposition Deposition Exhibit 17 Deposition MR CARPENTER CARPENTCARPEE NTER R Objection Objection Objection to the form of that question unless you identify who you are 95 Dr. Mancuso - Direct talking about The vague form of that question what reaction of corporate officials I find objectionable To whom did you discuss the contents or substance of r the May 23 1963 report Mr. Lou Pechstein Mr. Knippa Mr. Krieg and I believe on some occasions Mr. Humphrey himself What was the individual and collective reaction to the contents of that report MR CARPENTER Objection to form MR PARNELL I object to the collective reaction Indicate for us what the reactions were in the manner that you can can can do it The manner was one of appreciation in the sense that they had had extensive liability practice relative to the use of of their Philip Carey insulators which was a practice that would only increase their liability liability liability and one in which they -- it was a sober type of reaction relative to their realization not only of their liability but the seriousness of the medical problems which had accumulated over several decades The seriousness related to the fact that 96 Dr. Mancuso - Direct individuals who had been exposed many years in the past would be developing lung cancer or serious other lung diseaseisn the succeeding years and that the potential relative to compensation claims and relative to Workmen's Compensation and relative to lawsuits would be very substantial So it was a question of appreciation relating to the the recoregcognition nition of any developing of the broad developing picture for them letting them be able to see the components so that they could visualize their role as an asbestos industry and their relationship with other asbestos industries and their role in the manufacture and sale of that product relating to industry and of course their buyers and consumers and users Who provided you with what you recognized to be the quote appreciation end quote of the problem What particular company officials The appreciation I would say would come from Mr. Pechstein and from Mr. Knippa and Mr. Krieg ad Dr. Mancuso I show you what has been marked as Plaintiff Mancuso Deposition Exhibit No. 21 and ask you to identify that in the same manner that you have Dr. Mancuso > Direct other exhibits This is a letter from Mr. John T. Cantlon President of the John T. Cantlon & Associates dated June 11 1963 marked Personal and Confidential sent to Mr. L. A. Pechstein Assistant Secretary of the Philip Carey Manufacturing Company It refers to the Occupational Health Program and says in effect that it was agreed and understood that the evaluation of the operations in the program that Dr. Mancuso had undertaken would be carried out by him and continued by him as a research project in his capacity as a professor at the University of Pittsburgh and it goes on to make the terms of the agreement What was the date of that < June 11 1963 Dr. Mancuso you now have before you what has been marked as plaintiff Mancuso Deposition Exhibit No. 22 and I'll ask you if you can identify that This is a bound document with a white label called The Philip Carey Manufacturing Company Occupational Health Program Thomas F. Mancuso M.D.M.P.H. September 23 1963. -- 98 Dr. Mancuso - Direct It had a green cover cover It has the imprint - the same green cover as in the previous document the August document and it's the same imprint John T. Cantlon & Associates Inc. Consulting Actuaries Columbus Ohio Did you have a meeting at sometime in September 1963 relative to the report that you have identified as Plaintiff Deposition Exhibit No. 22 =: Yes sir I did When was the meeting September 23 1963 Do you recall who was present Yes It was Mr. John Cantlon myself Mr. Lou Pechstein the Assistant Secretary Mr. Meisner the President of Engineering and Research and I believe either Mr. Knippa or Mr. Karl Krieg Tf think it was Mr. Knippa Would you describe descdescrribe desicribe be the essentiesentialsals of the September 23 1963 report report This is a document which followed the the the procedures procedures procedures procedures procedures procedures procedures procedures procedures procedures that that that that I had established to put into written form the various details details details details details details details and and and procedures procedures procedures procedures procedures proprocedcures eprocdeduresures and recommendations and details policies policies policies policies policies policies policies policies of of procedures procedures procedures procedures procedures procedures procedures that I had recommended It ' 99 Dr. Mancuso - Direct consists of 11 pages and it is divided into several groups relating to different types of questions the first question relating to the immediate long- range goals and this is an itemized in one two three four five six seven eight fashion nine ten eleven in which I identify all the means to identify the various chemicals and materials to which the workers and the general population and the users of the product would be exposed the means to evaluate and control them the necessity for setting up a identify the occupational risk at each of the plants affiliated with with with the the the Philip Carey Company including the Canadian minimining ng operations Then I reaffirmed in that particular facet of this particular document statements that I had already made on May 23 1963 in which I said that they should develop safe practice ventilation guides and safe practice procedures for their consumer use and to avoid compensation liability and liability by their consumers I identified then recommendations and I specified a whole series of recommendations of what the company vv Dr. Mancuso - Direct should do relative to hiring the technical staff to carry out these recommendations and particularly to hire a professional qualified hygiene engineer to carry out all the parts listed in Part , and also to carry out the environmental control procedures for the plant as well as the external the integration of the industrial occupational exposures and the air pollution problems Then I went on to the recommendations of conducting medical studies relative to the problems that may be associated with the sale of their products and their legal responsiblity and then I identified the questions that the consumers and the purchasers and the users would be asking relative to their asbestos product whether it would be safe or whether it would cause cancer or not that it was necessary for the company to be in a position to be able to answer those questions Then I go on in detail to cite illustrations of what may come on relative to the future and the desirability of what could be done I then emphasize again that the recommendations that I was making were really nothing more than the type of recommendations 101 Dr. Mancuso - Direct and program that any good experienced corporate medical director would carry out in his responsibility for a company to try to protect and help the company by identifying its risks not only to its employees but in the sale of its products and to undertake those policies and procedures to correct and prevent those things from happening I then also cited illustrations of information that could be obtained by studying the Plymouth plant the Canadian plant and then I also advised them about establishiestablishing ng a medical and engineering consultation service relative to theconsumers purchasers and users of their products I advised them very strongly to discontinue' their practice of putting on the Philip Carey payroll employees of the subcontractors who were the insulator I advised them to set up certain types of medical examinations I advised them to set up certain types of medical examinations I advised them to set up certain types of medical systems and detector systems I then of course accentuated the fact that they were faced with the realization that they had oN Dr. Mancuso - Direct accumulated the problem over several decades that they should give serious consideration whether they should relocate whether the magnitude and the extensive financial investment that would be required to control these problems might be of such a nature that they might consider relocating and in effect I really laid it on the line to them in detail and report that was the essence of this particular Discussion off the record On September 23 1963 did you provide the corporate officials of the Philip Carey Manufacturing Company whom you have identified earlier a copy of Plaintiff Deposition Exhibit No. 22 Mr. John Cantlon and myself jointly presented that to the officials We discussed the contents of the document And was the document provided to them The document was definitely provided to them because we went over it page by page paragraph by paragraph They asked certain types of questions certain questions that they had asked can't someone else do certain things I remember Why us Why But I tried to convince them of the importance ( O JUJ Dr. Mancuso - Direct of taking the leadership relative to this particular field and I thought that it would be a credit to the to exercise leadership relative to the company prevention and control so that the product could be us~ d We had luncheon We continued to discuss it during lunch and then we continued to discuss it . after lunch 0 Directing your attention Dr. Mancuso to Page 3 of the report I'm going to read Paragraphs 9 and 10 MR SCHULTZ Does Mr. Parnell's previous objections to reading from thedocuments still stand MR HENDERSON Yes BY MR HENDERSON Q 9. Evaluate and determine toxicological or harmful effects of company products or components under various conditions of use and as used in specific installations and occupations buildings industries et cetera by consumers 10. Develop safe practice ventilation guides with illustrative drawings as well as medical guidelines for distribution with sales for consumer protection and relations to avoid added 105 Dr. Mancuso - Direct health problems and proper guidance on ventilation controls for the company's products 4 Discontinue the practice of placing on Philip Carey's payroll employees of subcontractors in different areas of the country because of the occupational disease liability It has already been established by the recent study supported by the union that the union members have a high lung cancer rate Paragraph unnumbered It is highly unlikely that these installers exposed to asbestos over the years and generally continuing the same type of work will develop high lung cancer rates It is inadvisable to place the company in the position of defending against such claims and having such suits associated with Philip Carey Did I read those portions of Page 10 accurately Yes sir & To whom were you referring when you referred to consumers and Philip Carey payroll employees and subcontractors Well it's very clear that the whole category was for insulation workers It was a broad very clear and -- very 106 Dr. Mancuso - Direct Were there any discussions with any of the company officials relative to the implications of the called Braun report Would you repeat that question MR PARNELL I object to the form of the question MR HENDERSON Would you repeat the question MR PARNELL Would you try to rephrase it since you've got to repeat it anyway MR HENDERSON Going back to Page 6 Dr. Mancusoof the same document of September 23 1963 I refer to the top paragraph and I quote Internally within the companthye question has been raised as to why medical problems particularly relating to cancer and asbestos were not recognized before Actually they were recognized but the asbestos industry choice to ignore and deny their existence Evidence of this was as recent as the Industrial Hygiene Foundation Study sponsored by the Asbestos Industry at a cost of 40,000 which provided a basis for the companies to argue against this recognition of asbestos and lung cancer The 107 Dr. Mancuso - Direct report when properly analyzed had many weaknesses upon which the conclusion was drawn and these weaknesses have been recognized in scientific circles Did I read that paragraph accurately Yes sir With whom at the company level did you have conversation relative to the called Industry Hygiene Foundation Study . MR PARNELL I object to the form of the question Multiple objections MR LOCKS Excuse me For For that purpose for me would you state the reason for your objection to that last question MR PARNELL I don't believe that I have to state the reasons for for the objection MR LOCKS No but but if you are objecting to the form I just wonder so he can correct it He just said in the the last last question with whom in the company he talked to about that MR PARNELL That's not it Read the last question back Mr. Reporter including the the 108 Dr. Mancuso -- Direct quotation MR HENDERSON Let me phrase another question BY MR HENDERSON Q To whom Doctor in this corporate scheme did you refer or did you have conversation relative to that portion of your report outlined in that paragraph This was one of the first points that I had made with each official that I had contact with with the Philip Carey Company I not only said it once I said it many times I said it to each individual I said it specifically to Mr. Lou Pechstein the Assistant Secretary Mr. Knippa the Plant Manager Mr. Krieg the Employee Relations Manager It was also said to Mr. Humphrey the President It was also mentioned to Mr. Fasold the Secretary It was mentioned to every person that I had spoken to or had any contact with because I wanted to make sure that they were not operating under the illusion that they had a defense relative to a compensation case or against a lawsuit by the use of the Truan report and I made that quite clear What is the Truan report Dr. Mancuso - Direct refers to the document which The Truan report refrefers ers to the study conducted was in -- previously by the Industrial Hygiene Foundation ThiThiss is a This typographical error It isn't Industry Hygiene it's Industrial Hygiene It was a study that the asbestos industry in which they conducted the study and they supported with scientific findings which were not came up you Doctor I now show what has been marked as Plaintiff Deposition Exhibit No. 23 and ask you if you can identify that Would you identify plaintiff Mancuso Deposition Exhibit No. 23 This is a copy of my typed critique of the Braun- entitled An Epidemiology Study of Truan report Lung Cancer in Asbestos Miners which was published in the AMA Archives June 1958 I reviewed it It carries a caption Review by Thomas F. Mancuso M.D. Chief Division of Industrial Hygiene The date is November 18 1960 The document consists of -- I didn't number the pages It consists of 11 pages and it's structured in a way in which I make a comment relative to Dr. Mancuso - Direct excerpts from the statement that the Truan authors made in their document and then I make comments myself which highlights certain points they want to make and this goes in general fashion and then it gets down to specifics relative to the analysis of the data and why I interpreted that questionable nature of the way they conducted the analysis and questionable nature relative to the interpretation and other data on how they used their figures What was your conclusion with respect to the conclusions of the Truan report That instead of disproving it that they actually proved the relationship between asbestos and lung cancer Did you submit the review to anyone for for publication didn't submit it for publication but I submitted it to a colleague Dr. Herbert Stokingar I submitted it the same month in which I wrote it in November 1960. I sent it to Dr. Stokinger who was Chief Toxicologist of the Public Health Service of the Federal Government I notice on that first first page that there is a reference ee ee me er Dr. Mancuso - Direct to a report of Holleb 1942 Is that correct Yes I show you what has been marked as Plaintiff Mancuso Deposition Exhibit No. 24 and ask you to identify that This is a document a copy of an article authored by Herbert B. Holleb and Alfred Angrist entitled entitled Bronchiogenic Carcinoma in Association with : Pulmonary Asbestosis Report of Two Cases Where was that published I don't have it here but I think this was in the American Journal of Pathology and it was submitted for publication on May 19 1941 What were the diseases of the two persons case studies who were the subjects of Drs Holleb's and Angrist's report Asbestosis and lung cancer What were their occupations They were pipe coverers MR SCHULTZ I object to the form of the question You are asking him what was their occupation when in the report there is an indication for it Dr. Mancuso - Direct What were there occupations as listed in the article Pipe insulation workers Dr. Mancuso referring back to your Curriculum Vitae if you would which is Deposition Exhibit No. 3 would you indicate where if any place any further reference by you to the Truan report is located It's Item 39. My participation in the New York Academy of Sciences and my discussion of the cancer effects that included the critique of the BraunTruan report in summary fashion I show you what has been marked as Plaintiff Deposition Exhibit No. 25 and ask you if you can identify that This is a document from Dr. Irving J. Selikoff dated August 3 1964 to Dr. Thomas F. Mancuso saying Dear Tom and itemizing and providing to me in a whole series of paragraphs covering five pages totaling 18 items his criticism of the Braun report Dr. Selikoff made this available to me because he knew of my work in the analysis of the BraunTruan findings and he called to my attention a em em ee Yee mY et One er 0 -- oo Dr. Mancuso - Direct series of observations which I was not aware of which further weakened the Truan report For example in his first paragraph he cites the fact that -- he quotes a statement by Braun and Truan relative to Klotz saying that a certain number of lung cancers in a series of four in 478 cases of asbestosis where Dr. Selikoff pointed out that Braun had misquoted completely that there was no such document that what the paper really referred to was silicosis and carcinoma of the lung had nothing to do with asbestosis Then Dr. Selikoff MR PARNELL Tom I can'gto any further without -- he is now reading something that ha didn't author THE WITNESS I'm not reading MR HENDERSON He is paraphrasing a letter that he received from a colleague in August 1964 MR PARNELL Is Is that that that your position All right THE THE WITNESS I'm not reading it at all It would take me 15 minutes to read this ' 114 Dr. Mancuso Direct Direct - Direct Direct MR PARNELL Just as long as he is not reading I don't want him to do that MR SCHULTZ I'm sure the doctor would BY MR HENDERSON Q Go ahead Dactor Dr. Selikoff had identified in the letter certain 1 observations which he had an opportunity to make which I did not know of He had visited Canada He knew the distribution and the miles between -- the large distances from where the miners were and the hospitals and he contributed a number of observations which I was not aware of which lessened considerably my already -- which lessened considerably any credibility that the Truan report had and in fact he augmented and confirmed my observations but strengthened them Dr. Mancuso referring back now to various exhibits and maybe to save a moment I'll just indicate the ones With reference to DepositiDepositionon Exhibit 12 which is the letter to L. A. Pechstein from John A. Cantlon with a copy of you dated dated September September September September September September September September September 3 , 1952 1952 1952 , did did did you you you receive a copy of that that letter letter letter letter letter letter on on or or about about about about about September September September September September September September September September S 1962 115 om Dr. Mancuso - Direct Yes sir With respect toPlaintiff Deposition Exhibit 13 which is the letter from Mr. Cantlon to Mr. Pechstein with the three attachment did you receive a copy of that letter on or about or shortly after September 22 1962 Yes sir With respect to Plaintiff Deposition Exhibit 14 which is the letter to Mr. Knippa from you with copies to Messrs Krieg and Pechstein did you send that letter to Mr. Knippa on or about August 15 19632 Yes sir With respect to the bound report referenced Medical Literature Occupational Health Program The Philip Carey Manufacturing Company with pen date of 8/15/63 did you send that to Mr. Knippa on August 15 1963 at the time that the letter was sent Yes The staff I know transmitted it With reference to Plaintiff Exhibit 16 which is the letter dated October 4 1962 to you from Mr. Pechstein with with with with copies copies copies copies copies copies to to Mr. Mr. Knippa Sedford Krieg Brockmeyer and Ms. Williams did you receive that letter on or 116 * Dr. Mancuso - Direct shortly after October 4 1962 Yes sir With respect to the report of May 23 1963 directed to Mr. Knippa with copies to Messrs Pechstein and Krieg did you mail send that on or about May 23 1963 through the U.S. mails Yes sir With respect to the letteletterr from Dr. Selikoff to you dated May 24 1962 identified as Plaintiff Deposition Exhibit 18 did you receive that letter from Dr. Selikoff shortly after May 24 19527 Yes sir sir sir With respect to Plaintiff Deposition Exhibit 19 a copy of a letter to Dr. Selikoff from you did you send that letter to Dr. Selikoff on or about May 29 1962 Yes sir With respect to Plaintiff Deposition Exhibit 20 dated April 23 1963 from Dr. Smither to you did you receive that on or after or shortly after April 23 1963 from Dr. Smither Yes sir sir With respect to letter dated June 11 1963 from Mr. 117 Dr. Mancuso - Direct Cantlon to Mr. Pechstein with a copy to Dr. Mancuso identified as Plaintiff Deposition Exhibit 21 did of that document shortly after you receive a copy June 11 1963 Yes sir to Plaintiff Deposition Exhibit Exhibit No. 23 With respect the review of the Braun report dated November 18 1960 did you prepare that report on or about November 13 1960 Yes sir Selikoff With respect to the letter from Dr. to you dated August 8 1964 identified as Plaintiff Exhibit 25 did you receive that shortly after August 8 1964 Yes sir MR HENDERSON Let's break until three | o'clock MR VINES Does that finish the direct MR HENDERSON That finishes the direct Thereupon the deposition was recessed at 1:40 p.m. and resumed resumed resumed at p.m. 2:45 2:45 2:45 p.m. p.m. ) MR LOCKS I'm ready to to go go back on the record Everyone else if it's too late it's