Document JN61YOnq3o23oLJOMNMG2ddO2

FILE NAME Colonial Sugar Refinery CSR DATE 1958 Mar 12 DOC CSR131 DOCUMENT DESCRIPTION Letter to Doctor at Wooroloo State Sanitarium RE Individual Medical Report and Discussion of Clinical Asbestosis .DL JYCC . 12th March 1958 Dr. H. R. Elphick Medical Superintendent WOOROL.00 Kaczynski Kaczynski Dear Bob _ _OOOO in the on we. I was most interested I have looked up patient notes on rest case Pathology - Kenneth H. , in the A.K.1 Archives Patholec of Industrial Health 1955 Voliit P.185 - of Asbestosis describes 4 grains In the first numbers of asbestosis bodies are found in the alveoli This he says is an incidental finding In later stages asbestosis bodies are found with definite changes in the lung tissue Clinical Asbestosis - in the A.K.A. Archives of Industrial Health 1955 Vol.11 P.204 Paul Cartier maksa a survey of 4000 asbestos workers in Quebec Between 1945 and 1953 128 cases of asbestosis were discovered 40 of whom died Of the patho- 128 121 were diagnosed by ray and the other 7 on logical study only 1.8 diagnosis was not made in the films where changes if present at all were minimal Of the 40 deaths 6 were due to bronchogenic carcinous It is of intereat that in the other 3,000 employees only 7 died of bronchogenic carcinoma Of the 88 survivors with asbestosis 55 more able to work without discomfort Of the remaining 29 no good correlation between the degree of asbestosis and the clinical status was found the However in an article in the Graduate Journal of Medicine by H. Wyern 1949 Vol.35 P.635 in a survey of cases of asbestosis dyspnoea is quoted as a universal com plaint The author also mentions that sputus may be occasionally specked this is the only mention of haemoptysis that I have come across In this avera avg erae ge exposure to asbestos was - Males 16.2 years All cases 10.4 years to have In a survey of 53 cases 29 were found finger clubbing Also 33 of the 53 had an accentuated pulmonary 2nd sound pulmonary On the other hand Kenneth W. Smith in the A.X.A. Archives of Industrial Health 1955 Vol.12 P.195 states that there are no typical clinical feature of asbestosis and clubbing of the fingers is a rare finding Re states that nsteatos workers are not predisposed to intercurrent infections However when an acute pneumonitis develops in the presence of an established asbestotic fibrosis the infection is slow to heal relapses are frequent and the rotient may be more susceptible to subsequent pulmonary infections In an article Silicosis and Asbestosis - America America PLAINTIFF'S EXHIBIT 10321.0 10321.0 2 Journal of Surgery 1955 Tol.90 P.118 Sanders referring to asbestosis states that radioligically it needs to be distinguished from chronic passive congestion bronchiectasis polycythaenia polycythaenia mediastinus and infiltrating malignant metastisis from the . The best description of rays that I have read as yet 18 by L. J. Bristol A.M.A. Archives of Industrial Health 1955 Yol.11 P.193 in which he designates 3 stages Eta description infora father than states that the disease tends to follow a bilateral symmetrical configuration The Relationship of Cancer of the Lang.- 0 Futhology 1955 Editorials American Journal Clinical Vol.25 P.1388 The relationship relationship appears to . there appears to be Asbestosis cancer of the disease in Germany It toscancer of the lung of the lung and does not afversity of histological histological increased liability lung is a does appear thak cocupational cocupational limited the presence of asbestosis extend to exposure to asbestos without the existence of a pneumoconiosis resulting therefrom In the British Journal of Industrial Medicine 1955. Vol.12 P.81 by Richard Doll gives various percentages of lung cancer in cases of asbestonia 1949 - Merewether 31 out of 235 = 13 1951 - Glyone 17 "= ' 121 = 14 In Merewether's figures 17 of men and in Glymne's figures 19.5 of men with asbestosis had carcinoma of the lung All of the subjects in whom two diseases were associated had at least 9 years in conditions in which control of dust did not have to be undertaken 1.6 prior to 1931 in England He states that the association of the 2 conditions has not been found in any person taken into employment since that date This point is more significant when it is realised that between 1933 and 1953 incidences of lung cancer among men in the country at large increased six fold Apart from the clinical urgency it is important to establish whether or not this patient has a carcinoma of left mid the lung By this I mean that the shadow in the zone 1.e. a slowly resolving infection could be due to carcinoma of the lung and he has got the clubbing of the fingers There seems to be evidence that the later in of fairly recent origin and probably of fairly rapid progresa I rather tend to the opinion that this rapidity would be more in keeping with clubbing due to a carcinoma of the lung than that due to silicgets . If this patient has carcinoma of the lung we are left with the esbestos bodies and the inconclusive shadow at the right base to establish claim for asbestosis certainly might be well worth going ahead with under these circumstances but if we are certain that It the claim there is no carcinoma then me have a much sounder case for asbestosis I wonder 12 it would be of help if you could get specimen of sputum nd if you could send it down to Professor Tensellen with a view to having a search for carcinoma cells I do hope that these notes will be of assistance to dg ABSTES 234 would like to hear the outcome of your invest- aed this patient Thank . Yours sincerely oe RT AT OTT OF