Document Jro8348Qdz0YBdJ5eMGkBZNpr

FILE NAME: Celanese (CEL) DATE: 1974 May 23 DOC#: CEL013 DOCUMENT DESCRIPTION: Unpublished Conference Presentation Jotas-Monvtto OwMr.CMe<? amm-xm May 23, 1974 AstesTtfi Nr. Charlaa S. Laubly Calaaaa* Corporation S22 - 5th wanna Nov York, NT 10031 DaarMr. Laublys Mr. Mitsa askad mm to forward tba attachod to yon and aapraaa hit apologia* in tha dalay. Vary truly your*, Saoratary to N. 1. Maltaa Maaagar, Aoeldant Prawantion and Industrial Baalth Attaotuaast 100060.0 HIMA 27336 (ZAPS 1 - SIDS A) nmnwriOKAL shipyard health cowferehce LOS AVOIRS - DECEMBER 13-15, 1974 1 1 {- *dge, you mentioned the fact In the 1930's our cssss of lung cssocr began to ba soon among asbastoa workers, and this continued until tha matter was clearly settled by Btfr-fite; ta 195 in kin olaasic p*r. Dr. Doll, however, was unable to settle one question, and we are still stuck with it. Be found a good deal of lung cancer among these asbestos factory workers, hut he didn't know what the canoer threshold was. Be knew they had a great deal of e^osure but he didn't know whether it was 10,000 times more than was necessary to cause cancer or 1,000 times more or 100 times more or 10 times more. Be just dida't know. Be just knew that they were getting much more asbestos than they needed to prodoee canoer. We came along and we thought we might be able to answer that question, and we made a mistake. We began to study a group of asbestos workers that we thought had liit and intermittent exposure. Nay Z have the first slide please. M e t we did was to make a list of every asbestos insulation worker is the New York areai there were S32 of them on January 1, 1943. That gave us at least a 20 year period of follow-up, and knowing their ages in 1943 we calculated age, year and sex specific rates of through December 31, 1942. We found that whereas there should have been 203 deaths, there actually were 255. 100061.0 HNA 27337 2 - ad the excess v u limited largely to asbestosis, expected; cancer of gastrointestinal tract, a aodaat lacraaaa, three tines iacreaae only, unea^ected, and aa Dr. Doll has pointed out, cancer of the long, enthrothorasic cancer; whereas there ahould have been ( o r 7 canoere occurring, 45 actually did. Mow we were wrong, aa I say, because we too couldn't answer how inch of this caaoer resulted frost an exoess, a large excesa of over-exposure. We didn't know whether the asbestos insulation workers in Mew York were hawing 1,000 tines or 10,000 tines or 100 tines or 10 tines nore than they needed to be inflicted with this disease. So that in 19(4, we were in the sans position that Dr. Doll was in tan years previously. However, a good deal had been learned during the tine of the first report in 1935 by Dr. Lynch and the 19(0'a whan we began to find this, and tha nost inpertant thing that becana clear in those years was that as Ben Perris said yesterday, everything that happened with asbestos tended to take nore than 20 years to bacons evident. For enable, these data of a study of ours in Mew York where we looked at a thousand asbestos insulation workers, of the 725 with lees than 20 years iron onset of expeoure, seat had 1 X-rays and whan they were abnormal they tend to be sdalnally to. On the other hand, with nore than 20 years fron onset, the majority had abnormal X-rays and not infrequently the abnormality was considerable. The second important thing 1009*2.0 HNA 27338 3 we learned v u that the mssothelial surfaces not infrequently b*ca-- Involved and nobody raally knows why yet,as John Edf* has Just shown os, pleural plaques wart oo-- only seen not infrequently. This was vary extensive -- van fatal. Is soofa casas tha plaqoas sonatinas harms calcified, and thasa too obay tha twenty yaar rola. Of tha 735 with lass than 20 yaars fron onset, noat of than had a normal pleura on X-ray. Aftar that point, however, tha plaura was frequently abnormal with sithar fibroais or oaloification. X2 tha plaoral plaqoas wars largely on tha pariatal plaoral and so-- tinss tha plaora not only Showed fibrosis and calcification bat showed neoplasia -- in other words nasothallo-- . Thm, in our experience in any rata so far the-- have bean invariably fatal. Tha naaothalion of tha abdo-- n too of daring the early 19(0's beginning in 1950 and in 19(0*s hsc-- s apparently involved and in the exoallant papers of Snticknap and either tha frequency of saefa peritoneal involve-- nt was eaphaslsed. The diffassnaas again can be wall fle-- nstratad in any laperotosy. Za ear o-- stadias the laportanoe of tha nasothallo-- was so clearly seen in the 370 sorvivors of the original (32 group. On Janaery 1 19(3 oar prospect of observation through DeoaAar 31, 1971 has shown that long cancer, as ejected, is markedly increased whereas totally there should have bean IS deaths there were 1(1 -- twice as many asbestos works died as ware expected to die during that period, age, year and sax specific rates,of coarse. Mereas these should have 1.000*3-O HMfl 07220 bean 5 deaths of lung cancer, there were actually 42, bat interestingly as has boon just emphasised, tha mesotheliomas, pisoral and parltonaal, bogaa to bo s m s with lacreasing frequency. Tha same modest iacraasa la gastrointestinal cancer and, of ooorsa, deaths of asbestosls. We have pot on this slide oar entire experience with this lew York City groap front '43 through '71, and it's evident that in this particular group one out of every S deaths among these asbestos insulation workers has been due to broncbogenic oarcinoata. Bonewhere around one out of 20 deaths has been due to aesothelioaa , approximately one out of 10 to gastrointestinal canoer, and approximately one out of IS to asbestoeis. There was a possibility that the lew York experience was unique; therefore, we have undertaken a second study in which on January 1, 19(7, these are new data which have not yet been published. On January 1, 19(7, we registered every single union insulation worker in the oountry. There were 17,100 men in the union on that day. That's about a one*-third saapla or a one out of four sample of all the Insulation workers in the oountry. And we have followed then and theme data reflect what happened to the 17,(00 nan through DensahsT 31, 1971. And although it's a much younger group oontaining, ae X say, all na^iars of the union, even those who were In the union only a year or two or less, we had very snob the same results. There should have been age, year, and sex specific 44 deaths of bronchogenic oardaoan and 100964.0 HNA 27340 -5- 213 Actually occurred -- 77 aaaothalioaas,again, tha su m increase of gastrointestinal cancer and tha daaths of asbastosis. Ihase categorias accounted for tha total excess of sons 300 or so daaths in tha total group. Tha data whan broken down again confirmed what Or. Farris said yastarday that 20 yaars at laast 25 yaars, 30 yaars, 35 yaars must pass bafora tha clinical affacta ara seen bacaosa whan wa analysed oar group 4 lass than 30 yaars, 20 yaars and mote than 20 yaars, wa found that of tha 12,00 mtn who had Is m than 20 yaars from onsat of exposure tbara was a wary alight lncraasa in lung eanoar, scran expected and 22 occurred. Tha rata is thara but tha ntafeers ara small. Only a saall nunber of mesotheliomas, only fiva, wars saan, ate. On tha other hand, of tha 5,000 an aore than 20 yaars iron onset, thara ware 37 bronchogenic oardmonas expected and lfl occurred. Almost all of tha aaeothe* loses ware in this group, aore than 20 yaars from onset and tha daaths of asbastosis similarly ware so limited. Bow, at this tiaa wa analysed our data by duration fro onset and as you can sea hare, wa saw alaost no increase in branohoganio oarerfnomas leas than IS yaars from onsat. Indeed aost of the increase was seen 25 , 30 and 35 yaars from onset. These ara the ratios that you see and again Mnothslioma, only two eases ware saan in lass than 20 yaars frost onset and tha others oocurrad following that point. Bow at this tine, wa had now a good deal of information on what happens to asbestos insulation workers too. all, z think this morning wa heard tha phrase burst4--- ' 100666.D HNA 27341  Tvo boa&a burst laidat oux thinking. Tha firat omam fron Dr. Wagnar. Chria Wagnar raportad in 1960 that vbaraaa all of ua vara aaaing vary ( w aaaothalioaaa, va at Nt. Sinal itv thraa in 30 yaara roai 1930 to 1960. Ha raportad 47 caaaa of aaaothallona all la tha northvaatarn portioo of tha Capa Provinca, a placa aliara thara'a auch in tha aay of crocidolita ana and Billa, and in 4S of tha 477 tham had baan potantial aabaatoa oontact. Hall, thia vaa no aospriao. Ha had had a nofcar of raporta of aabaatoa and naaothalioa but vhat vaa intaraating vaa that in aany of thaaa paopla thara had baan no occopatiooal axpoaora. Thaaa vara paopla vho livad in tha houaahold of an aabaatoa vorfcar or along tha road along vhich tha donkay carta vara taking tha baga to tha Bill. Polloving thaaa data Mollay Havhooaa raportad in 1965 that aba lookad at tha hiatoriaa of intarviaving tha paopla of tha 76 caaaa of aaaothalioaa in tha filaa of a London hoapital. And rara anoogh, 31 oot of tha 76 had vorfcad vith aabaatoa. Pro tha 45 that had not, 9 had aiaply livad hooaabold of an aabaatoa vorfcar, and of tha 96 vho nalthar vorkad vith aabaatoa or livad vith aoaoona vho vith aabaatoa, 11 had aiaply livad vithia ooa-hal lia of an aabaatoa plant* Thia than raiaad for tha firat tino tha iaportanoa of "light axpoaora'. X rmally don't knov vhat "light* anana and X don't knov vhat "haavy" anana. Thia la anooght to caaaa aaaothalioaa. Dr. Liaban in Pannaylvania 100^ 4 . 0 HNA 27342 loofcad at tha nssothalioaws la tha filh* of tha stats aalth Dapartaant, and of tha 42 oaaaa thara, 20 had workad with aabacto. But of tha 22 who had not, sight had siaply livad in tha houaa in tha neighborhood within a ~ half nils of an asbaatoa plant and thxaa had livad in tha housahold of an asbaatoa wozfcar. At this point tha saoood boob burst and it was a quist ooaaant aada in that papar by Dr. Harrias who is hara with ua today, and looking at tha asbastos diaaaaa situation of tha Davsnport Dock yard, ha raportad that in addition to caaaa of nsothslioaa thara wara firs patianta with aabaatoaisi thara wara fira with nsothaliona at tha Davsnport Dock yard that ha knaw about. Wall, this as I say would causa a gnat stir, sapadally whan rapidly his obaamtions w a n oonfimd by othara in Britain-- Whitwall, HcBwan , Kapplaaton and otbars and alsawhara. Wow this raiaad tha question that wa a n diaeuaaing b a n at this wasting. Tha prohlaa of iadinct aspoeun aa I'wa hoard today a wary cuta phrasa "Dr Sispin's byatandar diaaaaa in shipyards", tha laportanco of this to wa o m bn dawonatntad ban. Wa in tha Daitad Statas had a m i l akipbuilding industry batwaan tba two world wan. Aa yon know, tba Britiah shipbuilding industry was motivated arotad 1931-1922. Wa did not begin to rabuild our shipbuilding industry until 1940. Wa oe^loyad around 75,000 ann at any ana t i n from 1922 to 1940. Whan tha shipbuilding industry ioon67.o HNA 27343 began again in full blossoa in 1940, ve want op to a vary uch largar ntnfeer, and this is a graph of thosa on tha aast coast, tha vast ooast, and, of ooorsa, tha golf coast, and tha Graat Lakes araa. We had also, starting around 42, 43, va bagan to eaploy a fair ntariaar of vonan id Or. Rieka told os yastardey that at tha yard that ha vas at thara aoastias raacfaad as asny as alsoet 1/3 of tha VO** foroa. Only 1 of 500 vas a pipa ooverer, vas an insolation worker. All tha othar tradas vara bars, but vhan you oonsidar vhat happened in tha hold of a ship, tha insolation worker vas obviously sorrouadad by all tha othar tradas, electridans, staan fittars, ate. Thara vas a hoga turnover during tha var, approdaately 1001 a year, and as a result, va had in this oouatzy 4H Billion people, any voaan, vbo worked at aoan tiaa or another in oor shipyards in World War II fro 1940*1945, reaching a a n d -- at tha and of 1943. Wall, is this a hasard? Wall, Z'll show you scan of our studies that are trying to get mama information on this. We first found out vhat hind of insulation these people used, and it vas aada by one o o ^ any, by and large. A Wavy spec 1a 1935, incidentally, with regard to tha question Of croddolita, tha asparianoa that Z1vs just shorn you has nothing whatsoever to do vith czocidolite which va didn't use in this country at all in insolation work, to tha a^arianoa of insolation workers has nothing to do vith croddolita. Ohtil around 1935, it was entirely ehryeotila. Wa began to use sow anoaita in 1935 100W68.0 HNA 27344 ad this increased rapidly in th 1940's and subsequently. It was tha Union Asbestos and Xubber Coapany that bagan to sake all of the insulation for the Wavy and tha other shipyards. And they vent into production in Patterson, lew Jersey in 1941, and they were very good. Aeaeaber the Aray-lfavyE and these were the aen. Thera were 933 aan employed in this factory at sosMtias between 1941 and 1945. We have followed every single ooe of these asn, and by the end of *71 as you can see we found that their experience was identical to the insulation workers. Lung cancer, 11 expected, 73 obeerved, aesothelioaa, gastrointestinal cancer and asbestoels. So that tha aeterials that were going into our shipyards were carcinogenic, we have now htaun proof in this regard. Indeed they ware quite carcinogenic, because we have analysed our group of aan working in this factory froe *41 to '45 by duration of exposure. One-third worked for less than three aonths, one-third worked froa 3 to 11 jnths. These ware short term jobs. Some of then worked for the suaasr and even went into the servioe after a few aonths in the factory and one-third worked nose than a year. The lung oaaoar rates were excessive even with less than three aonths of closure to the aaterials that ware then used in our shipyards in World War II. we got the wind up rather rapidly. The first case of aasothelioaa we saw was is the nan who invented this particular insulation notarial. Be died 100669.0 HIMA 27345 10- of nsaothallona. Ws got tha raoorda out but whan we inquired about him, his wifa vrota us about anothar tragedy, and this Was s tragedy that you sea on the seraaa now. This was his daughter, a young child who had never, of course, worked in the factory or any factory and she was found to have a pleural plaque not too well seen of calcified plaque. Three years later she developed aesothalioaa and died, and Mrs. X wrote us that her only contact with this particular insulation was that the chief engineer would bring hone the products proudly to show his faaily what he had invented and the hid had played with then on the dining rooa table. This is a meotheliona that we saw next. This was the Plant Manager. Kr. Shutt, in his previous X-ray had been nornal. Me than looked at to see how much of this notarial would be neoessary to cause nasotheliona or other canoers or other 'isease, osS I will now show you eons new data on this study la progress, of course, has not been published. We have now erssrlned 200 fanily aaabers of the nsn and wonan -- an worked in this factory during *41, '42. These are the wives and children who lived with then fran ad 0f period 1*41-1145, and this is our analysis of the first 115 eases we've seen. 'We have found that 401 have X-ray evideaoa of parenteral and/or pleural disease. These were einply fanily naabers of . people wbo worked in that factory. Wa have found it that wives, eons, daughter, aiblings, parent in about the aans proportion, to that it did not take nach of this particular dust of tide particular notarial of anoaite asbeatoa, and 100e70.0 HIMA 27346 -11 theee are the typical things we hart found as Dr. Bdge has shown you this ___ ^.plaque. -These.people art..__ , incidantal even /this ana. The ninjas! ashestosis vs found occasionally and the pleural plaques that you see here. This study is still in progress as I say. Vs have looked at it another way, and again, these data ha/e not been published. Z thought you sight be inteiastod in then. Zn the Me* fork city group vhen ve exaslned these people, the history vas obtained 4 whether or not they worked in shipyards. Nov these are all insulation workers. Approximately one-third never worked in a shipyard, one-thin! went up to two years, and one-third worked for 3 or 4 years in shipyards. How these were all people of the seas city and the seas union -- all insulation workers, and their lung canoar bates, their nasotheliona rates ware wary anch the sane. He have also looked at it another way. Za the National Survey we're doing from '47-*71 we haws analysed the Union's experience by whether or not the an were registered in locals in the aldwest, in the oeatral states, and presumably without any shipyard experience, and those registered in shipyard locals. There has been no difference in the rates of workman in shipyards or not in shipyards. Sow * we saw our first nasotheliona in a shipyard worker in 1944, Dr. Sdge saw his first one in 1944. Z think that Dr. Kerries reported that ho saw his first one in Davenport in 1944. Bow the British experience is about five, six, seven years before ours. They began their shipyard work about that length of tins before we did. Be didn't see very noeh in the way of shipyard nasotheliona tmt'1 the past year or two. Vow we're seeing one roughly jp^nti n LIMA -12- erooad c m every two vMki. I her* no idea how many there x bat it' omrwhere around in oar experience ftt this tine boat o m and two weeks and how nany thara ara in tha country wa don't know, i'll chow you c o m of our raoant eases to cloaa this praaantation. this is a an who worked -- these ara all nesothelioana. h nan who worked for two years in tha Brooklyn Vary Yards as an electrician, 1943. this is a young woman who worked for six weeks in the Hlnghan Shipyard in Boston while she was going to school. She was a oollege student. In response to patriotic appeal, she worked for six weeks at the llnghan Shipyard as a pipe ooverer. This is a nan who worked as an engineer for two years in Mayor Island in San rrancisco. This is a nan who worked as a sheet natal worker -- These ara all nesothsllonas -- at tha Bethlehem yard in the Mew York area. The next two cases I now have at Mt. Sinai. These are two patients that I left at the hospital whan I oaae out here. This is a young woenn, not a young women. She's <1 1 think -- Sally, Or. Cooper knows this patient well. She is the wife of a good friend of Dr. Cooper's, here in the ssoond row, if you want to know eons details about her. She was perfectly wall. She worked at Z. Hagnin in San Praadsoo. Several months ago, she underwent a routine store physical. Bn abnormal x-ray was found. She want to her private physician who did a _ _ _ _ _ _ and he cams 100672.0 HNA 27348 13- bacfc late bar coo# and ha told "Sally, X'va gatm m bad news-- thora la none problem" tad aha aid "Wall X know what I'ws got. I*we got aesotbelioaa", aho aaid. Sba told hi that for IS nontha, '43 to MS, aha hod worked at an Oakland, California shipyard and than want book to bar elarlcal work. And thia is har naaothaliona at tha praaant tins, and aha is now at Nt. Sinai in oor snperlaental chenotharapy program Another potiant wa now have in tha hospital is a wonan who navar hod any work of any kind othar than darical work. Sha dowwlopod a diaaaaa in 1S71. A biopsy was dona and pleural naaothaliona was found. Sha had no asbostos exposure. Chocking har history, however, sha was found to hart boon narriad in '42 to a nan who was a shoot natal workar at tha Sun Shipyard in Chostor, Pennsylvania. and For thoaa two yaors/sha washad his clotbas and sha doseribad coning boon with this whits dust over his elothas, which sha than washad, and this is har naaothaliona, and`she's now baginning to go down hill aftar a good portion of thass last II noaths or so. Ok,this was a nan that X sow thraa yaors ago. k 30 yaar old m m with this naaothaliona. X couldn't find out whara ho got his aabastos asposura baeausa at 30 years old whara dMbe gat it? Wa took a careful historyr of ooursa. la was born on tall Street, liwed there for a year and than nosed for 1< years to Wilson Street andtan ha got narriad. lis wife said "Wall, wa can't live around hare. We've 100673.0 HNA 27349 14 90t to mowe to riatbush/one of the nicer actions in av York at that tiaa and, in fact, sha insisted that ha gat a job, which ha did. Onder duress,he becaae a bookkeeper tad than for many years ha was perfectly wall notil ha developed this chest disaasa, and aesotheliana was found. One biopsy showed aapla asbestos to be present. So there was no question about his e^oeure. Indeed one * of the fibers was large enough for electron diffraction study and it proved to bo aaoeite. So he knew darn wall where ha got his asbestos fro. So got a 15 osnt nap of Saw York and that gave us the diagnosis. Bare was kail Street) hare was Wilson Street. That was across the way free the Brooklyn Wavy Yard, and ha got his asbestos in his uother's eras in 1140, 41, 42. These are the last two slide, and they give you the reason for our currant oonoezn. The age distribution of the workers in shipyards on the atlantic coast and the west coast was known in '41 and *42. We haven't got good data of '43 and *44, so we're extrapolating a bit. Of these 4% Billion nen and wonan who worked in owr shipyard froo *40 to '45, they're given their age distribution in '41 to '45. There are now sobwhere around three Billion Aaaricans alive who worked in our shipyards in World War IZ and who are now reaching the 30 year fro onset point, and we all feel that we are sitting ob the edge of a volcano. thank you very Bach. 100674.D HNA 27350 15- The asbestos worksrs .... X think X ought to introdoc nyaalf. Too ooght to know ne by now. X think after tho lent two doctors, Dr. Selikoff and tha doctor from England gars thair prasantatioos -- Xbair excellent prasantatioos '*J -- X would lika to answsr a littla bit to Dr. hall of his prasantation yaatarday. X would lika to say tha following in ragard to his very intarasting paper. toman numeral. XX-4, ha stated that tha Division of Occupational health and Pollution Control haa built up a reputation for impartiality. X think in his oaaa it's tins to bacaaa partial. I'n not critidiing Dr. hall, X'a criticising tha oonpany. X think it's tine they bacaaa partial. Tha aany health problaas they haws arising from lack of ooaaamication, to be biased on lack of nnaainnlcation and unaatia factory employer and eaployee relationships, and leek of job satisfaction. This, in ay opinion, la tha fault of both lower and upper supervision. Somewhere along tha line, if tha man are that -- and their aorala is that low, tha supervision is wrong. This is all X can say about this if tha morale is that low. X know we have many problems hare today and we've gone over many problems. Xiao in hia slide ha indicated no hasards involved for claan-op work. Exposed dry insulation on ceilings, the use of sprayed wet aabeetoe in group workers, tha cutting of aabeetoe sheets in open air and power operated hand asms in cabinets of no hasards. 100675.D HNA 27351 Z think aftar tha two pruaantationa thi* aorning, I think that m w c b i hat an awful lot to laarn and as was put so aptly by Dr. Salikoff this aorning, if I was a businass pant as z was in Tolado, Ohio for If yaars, if I was a businass agant in Australia, thara wouldn't ba ooa nan working in thoaa yards. Thosa gatas would ba blockad tight avary aorning. Z thank you for your tlas. 100676.0 HNA 27352 (Tap* 1 - Side B) 17 Could you repeat that plane? Tea, what ooamsnt would yon have to sake, and Z would like to aak Dr. Barries if he has seen any Navy people develop any of these syaptoaa who probably work around this stuff for years. x'think perhaps Dr. Barries will be able to answer that in great detail. He have studied the non-Iavy personnel. Z did aastion yesterday that all of the aesothalioaas that Z aaw at the Arsed Forces Institute of Pathology were in admirals. I didn't see ooe In a general, that's because tbs people who were not, Z saw their speciaena in 19C0 or so, 30 years before they were lieutenant junior grade, in the engine rooau The generah Z expect were having a good tlms on some of the aray posts. Dr. Barries, you care to field that? Thank you. Be are seeing asbestos disease in the Bevel personnel. But we have a problem, and z assuaa that you have the sane problem in your country that our Baval personnel retire young so that as we see from Dr. Selikoff's wonderful presentation, these diseases occur after a period of 20 years. Bo that by the tine the sen oomas to retire, he hasn't got any sipis of the disease, and they're ooourring after they taka tp other eaploynsot. So that they 1OOS77.0 HNA 27353 11- are usually forced to follow-up and ithis is so-- thing vt art looking into. I wonder as Z now have the microphone ubathar X could taka tha opportunity to ask Or. Salikoff if thara art now any advances in tha treatnsnt of aasothalioua, bacausa this seam to ba tha oat crucial point, JL X agraa with you# Dr. larrlas, this is probably tha moat important thing that wo now should ba looking to with aasotbeliosn. X think wa hart had enough diagnostic stadias# aoough epidemiological stadias, aoough statistical stadias. Wa know what our problem is. Wa haws to identify thoaa at risk and I'm not guita sura X know how to do this for tha 2>i or 1 million or 3 Billion poopla now aliws who worked in our shipyards in World War XZ. this is a problao that wa haws not apldsBiologically solved# but the question of tharapy arises. Mona of us have had any success but thara are m m hints that are beginning to occur. Braoad with sobs coafelned ohaootharaputie approaches# we have without question bean able to lengthen the duration of active life. One nan X think you knew hla wall -- id Xilasr. Local 12# the secretary of tha onion. Zt was a bad Onion to ba eneretapy of. lia predecessor# John Boglavitch died of pleural neeothaliona in 1M4, and then he was replaced by Id Kilner at s special election. Z don't know whether tha nan did him a favor . bet Id Kilner soon died # of nasothaliona also, and nobody has wanted to taka tha Jab siaoa. 100W7S.D HNA 27354 is And with chemotherapy h v u able to go back to work for a year and a half, What w had dona was to grow assothalioma oalla in call culture and than tact various battarlaa of chamotheraputic aganta against tha pacific call linas of tha spadfic patients. We had also grown this in hamster chaak poaches and had used tha sams approach. Ms are now with Or. Holland who has cosa to ns froa Boswell Park, has now begun a program of experimental cheaotharapy with some rary interesting maw drugs. One, for axaapla, that is specifically useful in tuaors that produce mooous on people polysacarides. We,,don't know whether this is going to ba affective hare. Thera is a reoent series froa Msaorial Hospital of peritoneal aesothalioaa, given full ebdoainal radiation, and seemed quite heroic, but they have five patients nowwbo have, ooa has gone 10 years and tha foer others have gone from 5 to 10 years, and they did not do their patients any harm. Z saw one patient with abdominal seeothelloae sent as froa Washington. Ha was ooa of tha aasowtives of Boys of Aaerica and ha had some abdominal trm b le. Me went into Georgetown Hospital. The next thing be knew after the operation was tha young intern came over to him and said "Whan have you worked with asbestos? " Ha said "Z almost fall out of tha bad." The intern had seen tha Ada. Zt was a peritoneal mesothelioma and, of oourse, he had worked when he was in Germany in 1121 with asbestos. 10067V.o HNA 27355 -20- Well, ha vat treated at Georgetown Boapital with fall IxVad nal radial therapy, and ha alto vat abla to lira thraa yaart which vat longer than oar paritonaal nesotheliooas 90. Thara la a poatibillty our ianaotherapy people, va hava than looking at thia alto, ara tailing ua that thay Might not ba abla to handle the huge amount of mssothellaam that'a praaant in a cheat or an ahilnman and thay hava taco-- andad that va oanaidar ooatoinad aurgical and immunological and/or chaaotherapotie approachaa ao that the canoar ohamotharapy might hava a chase* in tbaaa patianta. We ara alto engaged in a, aorry to give you ao many of thaee tharaputic approaches, bat va don't know which it going to work, and ao va ara trying all at the aamt tint. Wa have a vary active pxograi going based upon the observations of tehlipoolor in Germany with poly and oxide and siliea to tea whether va might ba abla to inaotiviata duet that ia already in tissue in long or in other tissues, and in the teat ttfce va ara wall abla now, va hava a variety of chemicals that oaa inactivate the surface of asbestos, tha various kinds of asbestos fibers stillting h-- illtic teat systems and other teat systems, and va ara now going into tha animal modal. This ia also a possible approach. So that va hava, va'ra looking at a mmber of different vtys of approaching thia and Z hava ay fingers crossed, z hope that ana or more of than ia going to bo abla to solve thia problem which otherwise, t**ra ia no solution 100600.D HIMA 27356 -21- Q. Dr. fcbnidt -- I h m two questions. Om , tine luring boon diagnosed, has asyoM op to nov reached the fir year lrl? Buster o m , mater two -- I* tter ay explanation as to why, ran on tlu nttr u p o i n n m m people seemingly are predisposed to aesothelioaa? A. tter* in a French paper which is unpublished, which was t presented at thair lioa Confarenc in Ju m . It waa a ooafereaoe on disaasaa of tha pleural in which o m of thair chasetherapy treated mesotheliomas has g o M fir* years. It was a rwry, rery long tunor. Eowerar, and I don't know whether you oould credit the chenotherapy with this beoauM sonatinas we see patients going three nanthe and a case of patients without any treatment last for three years and four years. So that I don't know how to asp.' sin this rrench report, and I're just given you tha report with regard to radialtherapy. We hare o m other case in our hospital in which full cteJt radial therapy was given following surgery to a doctor's wife A year and a half ago and so far her X-ray looks perfectly aocnal. to vs hare our fingers crossed knits. And why does relatively light exposure, United exposure produce this tuner? well, the csneer people, the carcinogenesis people, are fond of telling us thst the occurrence-of csneer is _________ event, that when you hare the initial turn around of noraal oalla into canceroua cells, Cron that 109081.D HNA 27357 -22- point on, they need do other energy eoaree fro the original carcinogenic agent. They are then off on their own and just proceed. So that what it neoaesary is enough to have a snail area becone canoer and fron than on la the initial cense has no relevanoa. Q. X'n Dr. Cooper iron Berkeley. Z agree with Dr. Selikoff 4 that we are facing a potentially very serious situation and regardless of what the incidenoa turnout to be the population involved here is so large that the total pzobloB in huaan eooooie and social tens is bound to be a serious one and Z feel that the shipyard workers were casualties of the war just as sonaooa who loot an are or leg or worse in cosfcet. The people of the shipyards There are no provisions for taking care of this situation. Our Worknen'a Compensation and other provisions very often will not apply and Z just wooder what kinds of steps are being taken, feat the possibilities are of approaching this thing la a way that will be fair to these individuals no natter whether there are 1,000 or 10,006. k. There is something being done and Z think we have at least in large part to thank Oeorgo Lawton for this. The lureau of Federal Eaployees Coapensation has agreed in the United Stetes, Z think this is within tht year, to consider 100682.0 HNA 27358 .-23- ltMlf the last eaployer of record for ay cm of neeotbeliona la which thalr last bstoc exposure was la World War ZZ la tha shipyards. Thors art oortaia criteria. Mesothelioma Boat bo proven, there should bars boon no othar asbastoo exposure sine that time, ate. But basically tha Wavy through tha Padaral Bureau of Xsployaas Compensation and hare * too, what to. Lawton said yesterday, Z haws found it to be true and no lawyer is necessary. That these people hare been given compensation by the Wavy. Z think that this has been a very humane act and a rery difficult situation. This, of oourse, is rather cold oomfort, Z agree with you, but its the best that has been dona and Z think the Wary deserves a good round of applause on this wary humane approach, aad Z think Oeorge Lawton, ia particular, deserves credit for this. Youag lady over here. Q. % question is this -- Does this ruling apply only to people who work ia tho U.S. levy yards or dooo it also apply to all of tho various people who work under contract for tha Maritime Commission, beoausa moat of tha work is dons ia private yards. 100003.D HNA 27359 . -24- A. (Selikoff) - I ax no expert on legal natters, perhaps Dr. lewton can tell os. A. (Lwtoo) - The Federal Employees Compensation applies only to federally eaployed workers. Contract eaployees voold fall nader a different coapensation. Does that answer your question? * There are other matures that have been attaapted. A year and a half ago we succeeded In haring Inserted In the OSKA-KOSI budget a special line appropriation for a msothaliom case finding registered. This its* was vetoed when the president vetoed that part of the budget. A second attempt was made by us to begin this work. Legislation has been Introduced. It's called skeletal legislation that Is to say, it is pet Into the hopper to be filled out later in hearings by Senator Hubert Husphrey, and tills bill will oall for a national register of all exposures as the beginning of the prooess of identifying these workers and trying to see that whatevsr ooasaalty resources exist are node available to the worker So, we're not sleeping on tide problem. (Selikbff) - There's anothsr evidence of vaitfulness that's ^ now in the works, and this Is again the idea of driving foroe o f A WwjBfitTITMtiri He has been the principal individual who has been trying to develop a now spproaeh to just such probleas. lie group has studied the population of the Obion Asbestos and Jtubber Oospany Flint in Tyler, Texas. 100084.0 HNA 27360 Bo m 00 people worked there fro 1954 through 1971. the pleat li now closed. Yet, here ve heve 900 people who were exposed to exactly this nateriai that we've been describing and what Is to happen to them. Dr. Wagoaar went to the Rational Cancer Institute some nine Months ago and proposed that the Rational Canoe r Institute fund a study of the chest hospital in Tyler, Texas to Make a register of every one of these 900 workers and follow then for the zest of their lives. The Cancer Control Division of the Rational Cancer Institute has taken this proposal and it Is sy understanding that Dr. Wagoner's efforts will be successful. We hope to hear about this in the next several weeks and this night set a pattern for problens like this that we will have I'm sure fro tins to tins. I'm no authority ln this particular field, in response to the young lady's question, but sane pleas bade In the gray natter here we're talking about sons legislation identified as white lung as we relate to the black lung In the ooal indestry. Wow far downstrean this la, Z really don't know. ha Dr. Belikoff Indicated and Shelley Banuela, Senator luaphrey has proposed s bill with Representative frelinghuysen and Senator Taft. Tha aost reoent one In regard to your quaatlon . about tho so-called white lung bill and X think the one that 1oees.o HNA 27361 AfXrCZO a vali u tha Asbasto Workars Zntarnational la going to back la apooacrad by Sanator Harriaon, William Javita, Jr., and Sanator William. Dow, Z undaratand Huaphray la villing to vithdraw hi bill andthay'ra 90109 to aakt thii bill a eoapanaation lsv raion. Zt'a going to bring tba banaflta qp to at laaat tha lavai of Longahoraaan'a Act of Washington, D.C., uhieh changad Octobar 1. Z for it total diastility/tas $1(7.00 a vaak and nov Z ballava it'i gooe up 25%. Bovavar, Z waat to tay tbla nuch and Z'11 raad a quota fron ona of tha nigasinas -- "fha alan haa aoundad and goaaa ubo aoundad it?" Ona indoatry and an Tha assodati-- ,yKational Znsulatlon Coatraotora Assodati-- ia tryiag to sonad aa alan. Zts Smentiva Diroctor, John Pollaci, haa vrlttan to oaa 30 indoatry assoelation mentina urging thsn to oarafully analysa tba bill and taka atapa to bava it -- andari, if naoaaaazy, to aaka it aera poverini. Thia bill if aoactad, aaid Pollaci, ili in our opinion bava a graatar iapaet on aaployers of OCA. Oaapita thia, norganited affort appears to ba nada to alart aployara to tba vary draatio provisi-- it oontaina. Ba'a alartad tba ADC, of ooursa, and thia bill alao prvidas for tha attornay faaa to ho ovar and abova aay settlenant or -- y ooapentati-- payanta. Zt'a going to ba quita a fight. Z think it'a ona that our Zntarnational vili ba backing. Z kno tba 'APL-CXO ia going to back it. Z'n auro tha inauranoa conpanlaa ili probably split on it. Z'n fairly a u n a lot of than vili baok tha bill but lt la going to ba our so-oallad ahita lung bill that va dodded to go for t our 1-- t oonvantion in Saptaabar. HNA 27362 27 Om sort, X think iron England. Q. Could X M k a o m coannnt and aak oaa question? Tha ona ooaaant la that we had a avail gas vask factory -- X think aovaona aakad about individual suacaptibillty -- Wa had a avail gaa vaak factory in at tba baginning of tha war which waa using thia blua aabaatoa frov Western Australia and thia esployed only uoavn for a pariod about a yaar packing this stuff into part of gaa vasks. Six of tbssa hava diad of vaaothaliova. tba thraa hava baan lost sight of. thia suggests to vs that there is no individual susceptibility required to account for this. You can have the right fiber in the right plaoa for long enough, you probably will get tha disease, that is ay ooavant. tha two questions that are part of Selikoff's breakdown on the associated lesions or narrinnvaa related to industries that described either fibrosis. Could you give us a brief convent on tha associated lesions with the van who develop eanoer and finally in regard to therapy -- has he any convents about the use of ICQ or _ _ _ _ _ A. (flvlikoff) - All of our insulation workers have autopsy have asbestoeis whatever else they have. They nay not have it on X-ray, but hiatologically there is always eove pulvonary fibrosis saoog these poepla. The shipyard aveotheliovee we've seen on x-ray frequently hava 10< * t 7 .o HNA 27363 ao svidaaoe o asbastosis. Thay aay or may not hava plaqu, but Usara is no association vith asbastois aseassarily. With regard to BOG va oursalves hve sot oaad this. zt oartaialy 1s a thought. lovever, va hava discusoed this vith our iassuaology group and thay ara looking at tha poasibility of varions 1-- unoloqical approachas. This is a vary activa field as va ail kaov at tha prasant tiaa vith regard to canoar sanageasat. Na'ra keepiag our fiagers eroassd that it von't 90 avay as soas of tha othar cancar vhich offarad graat proaise at first and thaa hava laft as still vorryiag about our problean. Wght as vall vind it upi oaa announcaasnt to aaks; oaa observation and Dr. Goldsaith vould lika to nata sosa cornants. fhoee of you vho hava not signad up for tha vorkshop, plaasa do. zt is a graat daal of iatarast. 100088.D HNA 27364 -21- Tk x 2 - tide x Blue u b u t o i -- I got loot oo the turn here. (that Bint asbestos any different than any otbar kind of aabaatoa or do you naan, just don't spray that bias staff? t. The qasstioas is -- Zs bios, any dlffarant than any othar kind of aabaatoa? A. Bloa aabaatoa is erocidolita asbastos which conns mainly fron Sooth Africa, though thorn ara sons dq^oeits in Australia, and it has diffarant propartias to aaosita or chrysotlla aabaatoa. q , Z'n going to aak Dr. Salikoff to connant in a nonsnt and tha raaaoo I was asking you tha quastion la this form and ha nay want to ask you sons questions, and Z know otbars will. But tha question, tbay built a hoga First National Bank in Portland raoantly and they sprayad all that steal work for 40 stories and for about a weak around there for four blocks around you walked around there and you ware walking oo white stuff, and Z thought oertainly the newspapers would gat wind of this and raise the question, but nobody did. fhe Bandar's Digest article was a little too far back there and you night want to oonasnt on that. Z don't know, Z assueo it's asbestos. Z see than still putting white and gray stuff on these steal buildings there in Portland. Z'n not absolutely sura what that stuff is, but you did talk about the spraying of this notarial and its problems. Z oan't help but feel that this stuff is still being used rather widely. Would you like 100689.D HNA 27365 -M- to ooement ob his rmrlci sad perhaps dialate s llttls sad ask him a question or two. A. Or. Wagner in Orest Britain is of the opinion that erocidolite asbestos is even more dangerous than amosite asbestos or ehrysotile asbestos. Stars hare, however, been no population studies which would indicate that this is so. Ssperlmental studies have shown that all types of asbestos have the property pretty much the same levels of producing the neoplasms. The United States' experience includes no erocidolite exposure. All of our data and other scientists in the United States have been based upon amosite and ehrysotile exposure. Z see no reason for treating erocidolite any differently than amosite or ehrysotile. or shall I put it the other vqr. Z see no reason for treating ehrysotile or amoeite any differently than ctocidolita, and in this* regard. Z am not optimistic at all. Z am not optimistic at all about cor ability to protect workers who are now coming into these trades based upon our current standards. Z'd like to translate some figures. The level of two fibers per oc imdlocfcas that there would be 2,000,000 fibers per ctfcic meter. Theee are fibers only longer than five microns in length. As was pointed out this morning , there may be anywhere from 90 to 99% sere fibers shorter than those five miorons in length, but if we would include only the long ones, 10Wo.o HNA 27366 -31 only those over five micron, two fibers per ce, s sen working in en staosphere contslning two fibers each oc would be working in en staosphere which has 2,000,000 fibers per cubic aster, vow, the working aen inhales soasthing around I cubic asters of air in an t-hour day, a aan actively at work. That aaans he would be inhaling, if the ataosphere contains! two fibers per oc, he would be inhaling If ,000,000 fibers longer than five microns and perhaps 100 tiaas that aaay shorter than five aicrons in each working day. Vow, we do not know what percentage of those inhaled are retained. There are soas studies by Bob Karris of Vorth Carolina, university of Borth Carolina, which soggests that soasthing around SOI are retained. Z know of no studies that would indicate that his aatheaatical node Is sad sons engineering scdels are neoassarily true. Bo any retain only 1 or 10% or 201, we don't really know at this point. Zn the absenoe of knowledge, Z think that precaution is doubly necessary. But whateWr, we are asking workers at the present tiaa to work in ataospheres in which they will Inhale 11,000,000 fibers in each working day of long ones and perhaps several billion of the saali ease, sad retain an unstudied proportion. Z have doubts whether this vodd protect anyone in the future. % doubts are based upon the fact that first of all those with very light exposure, as you pointed out, that only two of your in aeeothelioaas were/asbestos workers. The other SO were in the other trades. So that we have reason to believe that this will not protect workers in the future. Z have e second 100091.0 HNA 973R7 reason for having strong doubt*. They *r* based upon th* hictory of th* sotting of th asbestos standard. The *cbstos standard of 2 fibers per cc or S fibor* per ee or 4 fib*r* pr oe it based upon th* recoanendation of th* subcommittee on asbestos standard* of th* British Occupational Bygian* Bodaty. The British Occupational Hygisna Society net in 19, '7 and published its findings in 19. Thay vary wisely, in my opinion correctly, were very prudent in what they said. They said the data that ve have and the data that they have is another problem, another question, another story, but the data that they had they said referred only to chrysotile. They said ve know nothing about any other fiber because ve only have data with regards to chrysotile. Bo your workers are working with aaoslte - our workers are working with anosite and no standard is known for anosite. That's the first thing. Secondly, they said our data referred only to the prevention of asbestosis. Ve know nothing jv* have no data which would tell us what th* level should be for th* prevention of caaosr. mow, most asbestos workers who die don't die of asbestosis. In our series less than 20% of the enosea deaths were due to asbestosis. Tbs excess deaths are dee to lung oanoer, mesothelioma, gastrointestinal .oanoer. The standard of two fibers per oc them was designed and specifically stated by the British Occupational lygien* Society to refer only to th* prevention of asbestosis. 100692.0 HNA 27368 33- fha British Occupational Bygisns Society nada no clain that this standard vould pravant canear. Tat whan va imported thia standard across tha Atlantic, va forgot tha caution that tha British Occupational Bygieae Sociaty and va said' this is tha standard for asbastoa. lot that this is tha standard for tha pravantion of asbastoais but this is tha standard for asbastoa in ganaral. Thara is no publishad body of data that vould say that a standard * of two fibars par cc or li,000,000 fibars in a vesting day vill pravant canear. Thara aza no such data and vith so daagarous a situation vith such an important disaasa, vith Irreversible disaasa, vith daath of neoplasn, X subadt that not to taka avary possibla pracaution not to vait avarything on tha sida of tha vorkar is not nscsssarily going to pravant tha disaasa of daath of caaoar in tha futura. X agree that Dr. Selikoff nada a vary isportant point that thasa standards do safer to tha pravantion of asbastoais, and our regulations vara dravn up at tha tine vhan crocidolita asbastoa vas nor* closely asaodated vith nesothelioa* than tha other two varieties of asbestos. X still think they're not absolutely certain all tha degree of risk involved vith the different types of asbestos, and ve need to knov store about it. As far as our environaantal conditions are oonoarned in our ships our dust saapling teas are -* *- dispirited because they do not find asbestos fibars in tha air and X don't think I Motioned this in Wf talk that ve nov taka thousands of envirooMOtal nsasuranenta and fiber 100093.0 HNA 27369 concentrations. I know these art by tha light microscope bat it ia tha baat wa can do with a practical point of via*. Wa have brought about vary drastic reductions in aabaatoe concentrations, but Z agree that theee standards ware designed to pravant asbestosis, and it is unoertain about a standard for mesotheliona. Ara.there questions? % Q. Z have two questions. One, because of the precautionary assures that asbestos workers have to take, the plastic suits, they appear to be plastic, and the respirators and this type of thing, is there any compensation, shorter work hours or Monetary compensation for this? Second question you raised about the throw sway respirator, Z would like to have that question answered as to its effectiveness for asbestos filtering. Z believe that was your question. A. wall yes, thank you. the first point is that wa do pay the sea an extra rate for wearing the uncomfortable clothing. Zt is most uaoomfortable to do an l-hour day wearing an impervious suit, to wa pay then purely for wearing an unoomfortabla overall reepirator. The second question was, wee a question that Z posed. I an not sure - X do not know whether anybody has done any evaluation on this kind of thing on the effectiveness of these respirators. As far as Z know, they ara not approved by our Ministry, our Department of Ssployment, for protection egainst asbestos dust. lOoesa.D HNA 27370 q . X'a sort that they are not approved. Theca guys are wearing surgical Ith deferred for the Meant with your peralsaion. One question, X gathered ao-- where that aubliadnally you tend to have this type of work done eoaawhat in ieolation on the chip. Xa this oorreet? Yon don't nix a whole bunch of other cats in there with these chaps? Ho, this was always the problea that the aen would be in working conditions that you've seen now with all the other trades and the Havy in with them. Mowadays, we do not let the other trades go in until the asbestos work has been done and as we are not putting any asbestos back into our ships, this would be a aelf-liaiting problea. He isolate the workers as far as possible. Xa fact, it's gone so far that our son are very particular when they see a dusty condition, and they insist that we evaluate the dust and let then know what the dust is and what the oonoentrations are. X think this is good that people are aware of the hasards. 100*9 5 .0 34- June and July of loot year, Z spent five m k i 90109 through the nuclear coal stations in Groat Britain and Z c a m back to London to talk to thoa about what I'd learned, and Dr. Linoll apont all of ay tim not talking about nuclear problems but tailing me about what they wore doing with aaboatoa in the coal stations in . 110 major coal burning electrical stations in Ingland and Vales and they have a very special program that is all tuned up and in operation. Z haven't seen too much excitement about that within the States as yet. but Z simply mention that they felt that the nuclear problem was handled years ago. but the asbestos problem is very much with them. That's the reason Z asked about the spraying on the buildings and the question of its use in the community, but it appeared too me it is very widely need still. Q. Dr. Hoc ton. Z would like to know if you have in your studies of your memotheU ones -- if the experience of smoking was brought out in your study? JU lot very dearly, with the a s m problem that Dr. Idge mentioned thin morning, that lots of theme people die before we oould get to them. Ve have. Z think r six nonsmokers in amongst oor 55 but there's no clear relationship as far as Z oan see from the incidence or the prevalence of pleural___________in smoking habits as far aa Z can see. l00e*6.D H N A 27372 37 Q. Or. Selikoff caid once that tha inddanoa or the occurence of tha cancar in tha non-saokers ia axtraaaly lov -- la that corract -- alnost noc-axistsnt. Long cancers, othar canoers not toning oot to ba dornant - apparently with saokars and aoasaokars. Q. I would Ilka to aak thia of Dr. talikoff. ...... aa Dr. larriaa alao did, .. aa to whathar thara ara any indications of hypersusoeptibility or susoeptibillty to nasothalioM. Ara tha people at apodal risk? This was in your last slide. A. Z think that Dr. Barries is an to sonsthing. I think he's got a sense of soanthing. Ve had one asbestos worker ia Local 32 in lewark, a nan who developed a left pleural assothellona and died. Ba c a m into the trade ia 1321. Bis brother, three years younger cans into the trade ia 1331. this ia a father-son-brother-brother union. Toe can't get into this union, (laughter). Be cane into tha trade three years ia 1331 rather than 1321. Ba died three years later of a left pleural nseothsHoas. la worked ia tha seas conditions and Dr. Churg tells ns that ha cannot tell tha logical sections apart, they look identical. Bo that there is now soon suspicion on the basis of these clinical i^cessions that there nay be sons susceptibility factor. Bature is trying to tall os sonsthing. He are too dense so far to find out. "W.D HNA 27373 3S- Qi Z m i going to ask you a question on the praying of asbestos. Moat of tha formulations that contain asbaatoa are f to 151 asbaatoa thar ara sprayed by and large any citias and atatas have bannad tha spraying of asbaatoa. On tha othar hand* thay aubstituta aynthatic fibars that assantially hava tha aaaa foznolation and that gives us soon oonoazn. A* Letas anlarga on tha father-daughter, father-son syndrom in unions. Pazhaps tha unions will now wish to althsr hava thair duaghtars taka on tbaaa jda or alsa giva it to am m body alsa's kids. Tha first braakthrough X'va aaan bora wbara tha union fatbars nay not bring thair kids into tha union. Doctors do this also. Stay with no and an aqual rights don't gat axeitad. Zn/oiscussion here Z raoantly pointed out that a union nan rarely over brings thair daughters into the union, but one seas a great nany sons. So aqual opportunity hasn't really broken through, but perhaps with anosita and these things in the picture, they nay choose to nix. Ara there questions of tha speaker? Q. Or. Barries, Z had tha privilege of nesting with you tha othar day, and would you elaborate on that change .prooadura. It I followed you oorrectly, and oorreot na if Z'n wrong, tha worker oosm into tha locker roan area. a removed all these garnaats including his undargarnants and plaoad than in a locker. Be was issued other garnanta to put on, including tha ooveralls and the safety paraphernalia. looeve.D HNA 27374