Document KV2K61gpqR9zx6drqXRv2zor

FILE NAME Manville JMA DATE 1969 - 1977 DOC JMA402 DOCUMENT DESCRIPTION Memos & Report - Mesothelioma Meeting with Dr. George Wright CONFIDENTIAL 3026 February 19 1969 TO F. J. Solon Jr W. P. Raines qQ Carl Thompson -- Hill < & Knowlton RE TRANSCRIPT OF MEETING WITH DR GEORGE WRIGHT ON THE SUBJECT OF MESOTHELIOMA Attached is a copy of the transcript tape recording of our recent meeting the subject of mesothelioma that with we had made from the Dr. George Wright on Because of the rambling often ungrammatical nature of human conversation and because of the transcriber's unfamiliarity with the subject of asbestos and health you will find many confusing sentence constructions and many misspellings of familiar terms and names in this transcription Nevertheless I felt us to have a copy of that it would be of advantage for each the transcript to look over before our of next meeting with Dr. Wright Hopefully it will refresh our minds as to the events of our previous meeting some additional probing questions for and Dr. may very well spark Wright next time we gather At the very least it should help us avoid following paths already covered Once our meetings with Dr. Wright on the subjecotf mesothelioma are completed this transcription along with any others that may be prepared will be edited for the purpose of putting together a mesothelioma work with the subject in book that can serve as a handy guide in the future It should also be of great dealing assistance to Hill & Knowlton in the preparation of a mesothelioma background paper I need not remind you of the confidential nature of this transcription We would not want to in any way embarrass Dr. Wright who was very candid with us in his conversation especially in regard to the capabilities and motives of certain of his colleagues in the asbestos field Malt Matthew M. Swetonic JOHNS MANVILLE DR GEORGE WRIGHT ON MESO F.J.S. HOTED 1 I suggest we get rolling unclear and I further suggest that we get to the meat of the mesothelioma subject and I'm sure that's not going to be exhausted in 45 minutes but I think we had better stick to that one George as I expressed to you last time the thing that we're fundamentally after is this unclear in various places magazines and so forth seeing more and more of the use of the word mesothelioma and a lot of things being said about it and I think that we've simply got to get your think- ing so that we can put this into position papers and have it available for various uses that we - where we may find it nec- essary to put it to good use and we're not up to date on what's going on in meso and you've got all the information You've got the recent experiences on your trip and so on and we'd just like to have you expound in any direction you want to take DR GEORGE WRIGHT Okay VOICE Is that a fair statement of what we're after VOICE We hope to ultimately put it into some piece of paper and use it - VOICE But the Time Pesearcher would say phonetic what about this mesothelioma I hear about Mr. Rains We'd like to eventually have someone say Honey - we'll send it over to you Here it is here's what we're aiming for event- ually VOICE We wouldn't do that until you had seen it 2 VOICE No no of course not DR WRIGHT Well first of all I don't have to go back so far as to the very beginning People have some information Let's explore first the question that's constantly recurring and that is one is there such a thing as a mesothelioma And second is there full agreement on what meso- theliomas are when you meet them face to face In other words how uniform and how acceptable on the broad base - by that I mean throughout a country or throughout the word is the diagnosis of any single or any group of cases And I can say at the outset that there is no agreement whatsoever about this There are still those pathologists who say that a true mesothelioma namely something arising from the mesotheliom may not exist I would say if I had to give a weight to this I would say that such people are in an extraordinary minority but would remind you that Columbus was one of a small group also and that the facts are that this has not been settled to every one's satisfaction Quite apart from that is the question of criteria that will permit a uniform acceptance of a single case as being a mesothelioma This has been the subject of a considerable amount of discussion and still is In fact it is still one of the things to which the newly created Mesothelioma Group at the National Institute of Environmental Health Sciences is going to address itself I don't know whether you know about that committee 3 VOICE I know vaguely about it DR GEORGE WRIGHT I can tell you - VOICE Olsen phonetic heads it up doesn't he DR GEORGE WRIGHT Yes VOICE And he's got the registry center down there DR GEORGE WRIGHT It's going to be there and I have seen the Committee that he has appointed to more or less hand guide this and I don't know who all the pathologists will be but I have the other Committee and I don't think I'm at liberty to tell you who's on it because he may be forced by various pressures to change it a little bit before he's through or to add people to it VOICE Is that what came out of the Claire phonetic Conference called that ~ DR G. WRIGHT Yes Have you seen the minutes of VOICE No Sir I haven't DR G. WRIGHT Would you like to have them VOICE Could somebody run them off While we adjourn DR G. WRIGHT Sure it'll only be a few minutes VOICE If it's on this subject I think it would be very useful to have it right away DR G. WRIGHT Well if I give them to you you will have to know that these are confidential to some degree I'm sure they're not marked confidential leave them in the hands of other people and I'm sure you'll 4 VOICE But this you can get someone to photostat DR GEORGE WRIGHT I haven't read it myself VOICE Yes I think it would be very useful DR GEORGE WRIGHT But there will be constituted under Paul Colten's phonetic direction a group of pathologists and a group of others such as epidemiologists physicians etc. who are - cancer experts and so on who are going to look at this full problem and one of the things involved here is the matter of having some acceptable criteria that will categorize what a mesothelioma is This can be pointed up by indicating to you that in South Africa they have such a panel and they are looking through all of the material that has been alleged to be a mesophelioma in the past in whatever registries are available in South Africa and they are also looking at new material and out of the original group that were called mesothelioma by Herr Wagner phonetic roughly 25 have been considered to not be mesotheliomas by this new panel The information they gave me was that with the exception of one man whose name I could give you but I don't think it's important - there's one man on the panel who feels that mesotheliomas either don't occur - this is a pathologist or are extraordinarily rare and doesn't believe that those things that are being looked at in South Africa are mesotheliomas VOICE May I ask you a technical question Is this somewhat like the difference between epithelial and adinocarcinoma phonetic In the lung The question of where it originates DR GEORGE WRIGHT Yes to a large degree it's this because quite to my surprise Thompson phonetic agreed and surely he's a strong mesothelioma man VOICE Yes DR GEORGE WRIGHT Agree when I asked him whether or not it would be possible that what they now call a mesothelioma actually originates within the lung itself in the most distal part of the lung perhaps from an unclear membrane and simply grows to the outside and then appears as a mesothel- ioma VOICE mesothelial - Then when you take | the slides you get the DR GEORGE WRIGHT No you just get a tumor which is in the position of the mesothelium - VOICE Oh I see DR GEORGE WRIGHT And directly attached and located there and could look like a unclear kind of tumor which a mesothelium tumor can look like It is a category of tumors let's say that has some describible characteristics The real question is does it arise from the mesothelium or does it arise from the most distal parts of the lung but still within the lung Now this is - VOICE It pushes it way through DR GEORGE WRIGHT Now this is not a minor question because you have to ask yourself why as asbestos portal of entry 6 is the air tubes why is it that the tumor would originate in the mesophelium In the pleura and not in the lung itself It's much more readily understood if you say - ch well this tumor that now is being called a mesothelioma in fact a lung tumor that arises from within the lung and then you don't have the problem of getting the asbestos fiber to it- And in fact Corvin McDonald's group phonetic has said let's don't talk about mesothelioma Let's just talk about primary pleural tumors which simply means that the tumor is located at the level of the pleura VOICE Does this apply to the peritoneal mesothel- iomas too DR GEOPGE WRIGHT Sure you can say the same thing about the peritoneum as far as that's concerned TIED TO VOICE But not the type to the lung but to the - DR GEORGE WRIGHT To the gut VOICE To the gut yes In other words this is a stomach cancer - DR GEORGE WRIGHT Now in the gut it's not quite as easy to see how this could come about because the distance from the lining cells of the gut to the peritoneum is well quite a bit greater and you have to go across some pretty strong struct- ures such as muscle and so on VOICE Those are by far the minority cases aren't they - the DR GEORGE WRIGHT Well I don't know if you can say by far the minority They are in the minority 7 VOICE Yes yes DR WRIGHT Well all of this is to say that there is some disagreement in terms of categorizing a tumor that seems to occur with a greater than expected frequency in the periphery of the lung or on the surface of the lung and also invading the chest wall VOICE The reason that I brought up the adinal phonetic versus the epithelial - thing for the lung cancer is that this has been an important question in talking about the gross lung cancer - DR WRIGHT Sure that's right VOICE Whether the adinal phonetic carcinoma or the epidermoid carcinoma is always necessarily epidermoid - that may have come out of the gland and - DR WRIGHT Sure VOICE And broken through there DR WRIGHT And then you have the different kinds of tumor cells within the same tumor VOICE It's within that category of problem is it Can I - I mean can I think of it that way As a similar similar type problem that we're talking about where it originates DR WRIGHT The question is where did it originate VOICE Yes DR WRIGHT And if you think that it originated in the mesothelium it's called a mesothelioma LOICE Yes 8 DR WRIGHT If you think that it originates in the alvilar cells phonetic it'asn alvila cell carcinoma VOICE Yes DR WRIGHT Now you're in the lung category be- cause then the next step from an alvila cell carcinoma is a bronchiolar cell carcinoma These terms are used sometimes interchangeably Well I would just simply say that the current state is that there is not - well I'll put it more positively there is agreement that in some segments of the population there is a frequency of a tumor which can be called a malignant tumor in terms of its progressive and invasive character There's a greater frequency than should be in certain population groups the most striking of course was the population that lived the region from Preuska phonetic North through Creedman phonetic in what's called the Northwest Cape a province of South Africa VOICE There's no question of this being in the - I can't say it - mesothelioma group at the time it's found DR WRIGHT It is in the most distal part of the lung or in the covering of the lung VOICE : Yes DR WRIGHT One of the two It's almost impossible to get a tumor - by the time that you know that it's there if it hasn't gotten big enough to involve all of this VOICE Now most of our - what we think of as lung cancer usually manifests itself around the bifurcation 9 of the bronchi or - I said manifests not originates but this is in an opposite area DR WRIGHT Further out VOICE Yes DR WRIGHT Far out as you can get VOICE There are some who think that the major bronchus bronchi tumors may have originated farther away from the bronchus than they appear to at first DR WRIGHT I suppose that's possible VOICE Well - DR WRIGHT That's off our subject VOICE Yes but it is - what we're talking about is going in the other direction really DR WRIGHT Yes VOICE Yes DR WRIGHT Because when you come to the gut it's in a completely different league because here it is on the outer surface of the intestinal tract but you can still argue about where it originated VOICE Yes yes DR WRIGHT Well there are people are trying to develop acceptable criteria in South Africa They think that maybe they've had a fair meeting of the minds and in Great Britain I'm telling you that there's been a fair meeting of the minds In this country there is surely anything but a meeting of the minds because we've just begun to look at this 10 When you speak to somebody like Thompson about the fact that in certain rather unusual circumstances meso- thelioma doesn't appear to occur he says that such people just don't recognize mesophelioma VOICE huh DR WRIGHT And when you talk to other pathol- ogists in the world they say that's ridiculous We may argue whether it's a mesothelioma or not but you can at least know whether it's a tumor and in this category of people that I'm going to tell you about tumors have not been found Now as you know the high rate of occurrence was in a population that lived in the Northwest Cape in South Africa That was the be- ginning and this involved people who lived in the mines - worked in the mines rather and also people who did not work in the mines such as some of the women Nevertheless because it occurred with such great frequency and because there always is in the mind of any well- trained man the question of well why did it occur here and not seemingly elsewhere The obvious thing to look at was well what do these people do what goes on in their community that's different than in other communities So obviously the thought was well crycidilite phonetic mines are in this area and this seemingly kind of closed their minds it seems to me because there are other things peculiar to that area which were pointed out to me when I was in South Africa such as the fact 11 the Kalahari Desert lies just to the West and the sand from that area blow all through this region and if you were to take a look at the soil you might find that it had different trace metals although so far this is only being looked at not - we still don't have any information on it The reason this becomes important is that as of this present moment in the crycidilite mine area phonetic of the Northern - of the Northeast Transvaal which is many miles away in that crycidilite area phonetic as of this moment no cases of mesothelioma of any kind have been reported VOICE Now have they - you were talking first earlier about Wagner's work weren't you DR WRIGHT Yes * I mean has VOICE Had Wagner into the Transvaal i somebody gone in there looking for them as unclear might DR WRIGHT Wagner's data arose by reason of cases that were occurring in the tuberculosis hospital a receiving hospital that serviced the area and also by reason of the fact that he had access to the routine autopsy material in the pneumo- unclear research unit And the law over there is that any man who's worked as a miner when he dies it's the obligation of the doctor to obtain the heart and lungs of that man and ship them to the pneumo unclear research unit has all these from all over VOICE huh So Wagner | 12 DR WRIGHT And the pneumo unclear research unit gets has its continued this lungs from the work in the same way that it Transvaal just as well as we has get - it them from the Northwest Cape VOICE Wagner is in Pennard phonetic DR WRIGHT Now VOICE In Wales VOICE In fact he made mention - of the first draft of the background - VOICE Yes I remember that DR WRIGHT Now when I asked - of course this was a major question for me to ask of these guys and I've asked Young Webster phonetic who is in charge of the Pneumo unclear Research Unit and who is a pathologist who is on this panel and who is interested in mesothelioma and I've asked Lace Kramer phonetic who is the official who has to do with the determin- ing of whether or not a man is adjudged to have some illness arising out of his employmeanntd therefore could be taken out of his employment > they have a term for that that escapes me at the moment - I've asked both of these men is there any reason to believe that the collection of material or the mech- anism by which it would come to yours or to some other equally interested person's attention - is it any different in the North- west Cape than it would be in the Transvaal and they assure me that there is absolutelnyo difference That if the cases were in the North - Northeastern 13 part of the Transvaal coughing here - up around the fringe area - that they should have them and when you ask them how many cases they have they say they have at the most three You go to the mining people and say is this true The mine doctor says no we don't have any Those are not cases of mesothelia Let's just accept the idea that they do have two or three The number of people at risk in the area in general is so close to the number that are in the Northwest Cape that you ought to have them in the hundreds Now this may not be true just for crycidilite phonetic but we've got another one to talk about but before I go to the next one let me say this Then I asked Dr. Detroit phonetic who is the Industrial Hygiene Doctor for the state whether the duration of exposure and the history of exposure would have been substantially different in the Transvaal than in the Northwest Cape as far as crycidilite is concerned and he said that he thought not That there might have been a slightly heavier exposure in the Northwest Cape but that the practices for mining and milling and the exposure of the gener- al public were essentially the same in the two areas and that the duration of the exposure was essentially the same in the two areas So that if you were going to have any epidemic of mesotheliomas in that crycidilite area phonetic they should have them and they don't have them So I think it's reasonable 14 to raise the question as to why it was that crycidilite was picked on as being the cause of the mesotheliomas in the Northwest Cape Is there some other difference between the two areas Well other differences have not really been looked for accepted just been | that this is the thing It's VOICE Which is in effect that they felt they had found a whipping boy and they - DR WRIGHT Well they seem to have a fairly logical cause Now when you add to that in retrospect as you now take a look at what has been reported in other parts of the world you find that where crycidilite phonetic has been handled in the docks in England and in the textile plants that there is an unusual frequency of something called a mesothelioma so it may be more reasonable to think that crycidilite is involved in some way but only the crycidilite phonetic from the North- west Transvaal I mean - Northwest Cape and not the crycidilite - and so far I don't know of anyone who has come up with a popula- tion only exposed to crycidilite from the Transvaal where you don't find them Get an exposed group in England of this kind - this would be something that you'd like to find but I suspect you'll find that the users of crycidilite have bought it from both places VOICE Well the British have medical people have basically bought the idea of unclear mesotheliomas right 15 DR WRIGHT If there is such a thing as a meso- thelioma yes VOICE Just - there's no doubt they've got it in the factory regulations now DR WRIGHT Yes VOICE They're going to have precaution label apparently blue asbestos - | DR WRIGHT Yes they've bought the idea and they've now asked that you prove that this is not true VOICE Right DR WRIGHT which is not only - I'm just giving you - I don't think that you would find the majority of the men who are reasonably knowledgeable in South Africa who would say that crycidilite phonetic has nothing to do with it I'm just saying that you must raise some questions because the experience in the Transvaal is quite different Now I know that there'lble those - like Solikoff phonetic did to me the other day he'll say - but oh the exposure hasn't been nearly as long in the Transvaal and all I can come back and do is say - well I was told that it was And he says -oh no it wasn't Why argue that point VOICE Is there any basic difference in the people I mean one group isn't white and one group black or anything DR WRIGHT No. VOICE No real essential difference DR WRIGHT There's a mixture You have white miners 16 and black laborers and you have the blacks living in the area Now the exposure as far as that part of it is concerned which was of interest and which has been grabbed on runs as follows It's been alleged that the exposure of the women and those who were not actually working in the mill or under- ground has been rather light and this is - keeps creeping along with the idea that small exposures will be harmful elsewhere Well actually the exposures were really quite high for everybody The rugs in the area were made of crycidilite The mine that I visited in Creedman phonetic the manager said that up until they took measures the ground was blue and there was no vegetation for yards around the area hundreds of yards This was so true that they have now paved all their roads with macadam and they have covered their tailings piles either with big stones or with plastic sprayed it on and they have cleaned up the mill to the point where it's really very looking and they have trapped and filtered all of the air that they exhaust from the place so that they don't spew that out anymore and now the ground is nice brown sandy ground with plenty of vegetation growing on it So the exposure - and furthermore many of the women work and the babies were carried on their banks worked at hand carving and that's been done away with VOICE That's been done away with DR WRIGHT Yes there are no more women handcarving 17 only men VOICE You remember that - oh okay remember that DR WRIGHT The men don't carry the babies stopped about fifteen years ago - They VOICE That was the unclear that came out in the magazines showing some gal - DR WRIGHT That's against the law now Actually handcarving is frowned upon but it still does go on Well there's another very interesting thing and that is that there's a very substantial crycotile phonetic mine and mill in the fringe area or in the Transvaal area with many years history of production and And yet here's an just area as dirty as all from which as I the othe inrts he past say the Pneumo unclear Research speaks of three mesothelium - and the mines say none and the three that they have are not from the crycidolite mines or the crycotile mines phonetic They're from the amycyte mines phonetic VOICE In the same area DR WRIGHT In the same area So now you've got another little bit of indication that there is a place in the world where the opportunity to find mesotheliomas should be the same as it was in the Northwest Cape another place namely the Transvaal and yet they don't find them VOICE They do not find them in the Transvaal DR WRIGHT They do not find them in the Transvaal 18 in the crycidolite area or in the crycotile area phonetic There are alleged three cases in the amycyte area of- VOICE Of the Transvaal DR WRIGHT of the Transvaal Now amycyte phonetic came under question because first of all - VOICE Excuse me who says these are Thompson DR WRIGHT Pneumo unclear Research - VOICE Oh I see Okay DR WRIGHT So far has said that That's Ian Webster phonetic and just says that that's what they are doesn't know where the men there have worked for certainty because as you know the black laborer comes from all sorts of areas and there's a good possibility that black could have worked for a year or two over in the Northwest Cape and then gone to work subsequently in Transvaal These are some questions that I'm sure will come out in our discussions in Johannesburg VOICE Can you give us a roundhouse figure of how many they think they have found around the Northwest Cape Area At this point . Webster He came up with a fair > started looking in what Sixty DR WRIGHT Wagner VOICE VOICE Wagner Thirty two or thirty three VOICE Oh no It was over a hundred DR WRIGHT I think they're on the order now of 19 something like 180 VOICE 180 total VOICE Total cases VOICE Out of a possible what because - DR WRIGHT No one knows you have no denominator VOICE Are these women and men miners - DR WRIGHT Everybody miners blacks and women VOICE I suppose they do have details on their age and how long they could possibly have been exposed and so forth DR WRIGHT Many of them not because you can't get this retrospective - : VOICE Yes DR WRIGHT You can find that some of them were on the payroll of the mine but - and you know something about their age but really the blacks have very little in the way of vital statistics VOICE Well that's - DR WRIGHT The white miners yes they would have that and they would know something about the length of exposure and it isn't always forty years VOICE But it is interesting at any rate cause you've had some time to look for it looking for it I think Wagner reported in '60 and he must have found them a little bit before that so let's say ten years you've had to watch for this stuff 20 an awareness of it and theoretically everybody in that area at approximately the same exposure or duration of risk and yet relatively relatively few DR WRIGHT What you're getting at is whether there's an epidemic such as Thompson predicted VOICE Yes DR WRIGHT And this goes to what we were talking about a couple of months ago Webster is very adamant about this He just says there isn't going to be any epidemic VOICE Theoretically - DR WPIGHT There isn't going to be any not even theoretically They now have it by the year as I recall from 19 - the rate of discovery of cases from 1960 up till 1966 or 1967 and they're running very evenly 20 new cases a year There's been no great increase but - VOICE But theoretically you would have thought - DR WRIGHT If there was going to be an epidemic within six years you should see a very appreciable > it should have gone from 20 to 40 to 80 - VOICE Yes DR WRIGHT To 160. Webster said that that's just not going to happen They have that kind of information VOICE He doesn't know why it isn't going to happen I guess , because if he did - DR WRIGHT Well he doesn't think that they are minor exposures He thinks that you have to have a substantial 21 exposure to have it happen and secondly he doesn't think it's fiber alone VOICE Yes DR WRIGHT He thinks you have to have something plus fiber He doesn't know what it is VOICE That thing in itself could be one of the most significant - DR WRIGHT Well when you get around to asking him what the other thing is - VOICE I mean the figures - DR WRIGHT The numbers VOICE standable thing The numbers themselves are a good under- . DR WRIGHT Of course VOICE If this is only - if this is the rate going - on DR WRIGHT Not only that what's going to be very interesting and which they do not have and he says that he hopes to have it by the time of the conference I asked him well do you know whether or not the ones that your panel is turning down as mesotheliomas were the neighborhood cases Because if you speak to some of the men down there the approach has been in the past this on the part of Wagner and others If you had a tumor that looks like it might possibly be a mesothelioma and there's a history of any association of - in any way with the fiber ergo - it's a mesothelioma 22 That if you look without knowing anything about it it isn't always necessarily called a mesothelioma and 25 of them have been thrown out and the question is were those that were thrown out the ones that were neighborhood cases In other words they knew they lived in the unclear names area leaving behind only those who would actually have a working exposure which begins to be the case in England where if it wasn't a working exposure it's recognized that it was a very substantial exposure They don't know this because at the present moment because the panel is looking without knowing the exposure They don't want to know it and Ian said that as soon as they are finished with it then they will go back and get what the expos- ures were How it will turn out I don't know VOICE I don't want to - but you time is growing short I wonder if we could jump suddenly to the United States and what you know about it here and what we know about it maybe going back I don't know what your plan of development is DR WRIGHT Well I think that it would be better if I did it in a systematic way and did it again next week VOICE Right , very good DR WRIGHT I wouldn't know what I talked about the next time VOICE Okay DR WRIGHT Now amycyte phonetic is chemically and physically rather similar to crycotile phonetic It's closer - 23 I mean to crycydolite phonetic It's closer to crycydolite than it is to crycotile and obviously they wanted to take a hard look at it and it was just as dirty an operation both as regards the working place and the surrounding community I was there and it's only mined in one very small area around Pinge phonetic And the duration that is the number of years that amycyte phonetic has been being produced is equivalent to that so far as the living and recently dead population is concerned is equivalent to that of crycydolite phonetic so it's very striking to me that in this situation even though they had been striving very hard to find cases of mesotheliomas that the best they can come up with is three Now I'll come to the United States just for a moment because in - the only place where there has been a striking - that isn't quite right because we just double the number That's striking enough but the only place where a substantial number of mesotheliomas has been dis- closed is in the insulation workers Partly it's because none of the other groups has been looked at in the same way although this isn't completely true because if there was an epidemic of mesotheliomas it would make itself known in the crycotile phonetihacs Sepford Pegion been mined for striciy phonetic where years and where the doctors aren't so stupid but that if there were something very striking especially in retrospect and the doctors do know up 24 there about mesothelioma In retrospect they would say oh yes we've been wondering what those funny tumors are It just hasn't happened so far up there and it hasn't - unless we are happened to the same degree as in the textile industry but I don't think we can say anything about the textile industry But we can say something about the insulation industry because surely Selikoff phonetic has published that he has these mesotheliomas of the pleura and peritoneum Will everybody agree that they're mesotheliomas Well I suspect that they will not and one of the reasons I think that is - it's never happened elsewhere and secondly Church phonetic his own man has already said my hearing that when he looks at these tumors he finds as of the moment he can classify something like 26 varieties Well there aren't all that many so - each one must be classified almost differ- ently or 2 or 3 in any one classification So one really wonders is this really a homogeneous group That you can call mesophelioma Or is he talking about some other tumors And that is something for the future to tell think VOICE Have they gone to the registry now do you DR WRIGHT All these tumors will go to the registry VOICE Yes right DR WRIGHT All the past ones have gone and surely all the new ones 25 VOICE You mean all that Selikoff and Church phonetic have studied DR WRIGHT Well if Selikoff holds out then he's doing what he's asked others not to do VOICE Does he agree - as said at the mecting - DR WRIGHT He may decide to hold everything out when he learns that he's on the committee LAUGHTER DR WRIGHT find out about it That's neither here nor there . we'll VOICE Yes DR WRIGHT At any rate the interesting thing about insulation groups it is that the information group seems to be aware there is the greatest - and this is a group who certainly have been exposed to various kinds of fiber crycotile and amycyte phonetic as being the most abundant and some agreement that there may have been to some degree some crycydolite exposure although this has never been considered to be a characteristic fiber in in- sulation production but I guess that no one would be brave enough to say that there's been absolutely no crycydolite used VOICE Isn't there some in the spray that - DR WRIGHT Yes I think so A fellow up there said the other day that there was VOICE That's what I thought yes DR WRIGHT So there have been all three used VOICE Yes 26 DR WRIGHT But Selikoff phonetic is fond of saying - oh this is that in South Africa amycyte where there yet it's rather interesting is this very heavy amycyte exposure and where the same guys discovered the mesophelioma in the crycydolite they and I can understand why are not discovering it in the they might want to find some amycyte Well now before I leave South Africa let me tell you that first of all Thompson when I spoke to him said - vou see all these as- bestos bodies epidemic this can only mean that we're going to have an VOICE He said that to you again this trip DR WRIGHT Yes and I said - well why don't we have it and why don't they find all these And he said - well anyone who fails to find them doesn't recognize them and I said - Neuerman well how about phonetic who is the Finnish pathol- ogist olite who says there are phonetic and he no mesotheliomas associated with anthropsaid - Neuerman phonetic wouldn't know a mesothelioma if he saw it And I said - do you mean to tell me that he wouldn't even know that it was a tumor And he said - that's right Well when face this kind of a ment- ality it's somewhat like our friend up on Fifth Avenue the kind of guy that you'd just like to walk away from and it's because their mind is made up and they're going to find whatever it takes to fit the facts Thompson further said that asbestos fibers are so 27 ubiquitous that he had to give up his own experimental work because even in the distilled water he found asbestos fibers I didn't follow that up other than to raise my eyebrows - and say - I don't quite see how a fiber gets distilled over and he said well - with the electron microscope the water the distilled water is full of asbestos fibers Well mavbe they are down there because maybe he's got enough crycydolite sprayed around his laboratory to do that but at any rate when I said - well how about talcum powder and he had to allow that there was some fiber in talcum powder and I brought home some talcum powder fom the drugstore and it's got fibers in it I don't know what they are whether they're asbestos or talcum but I'm going to give some to Louis | Crowley phonetic and see -- Now back to the general area because as you know almost always you'll find some disagreements that don't appear on the surface and surely don't appear on the right unclear name Kramer and - he's in the Miners unclear Board and is the fellow who has to do with saying whether or not if a man has an injury if he deserves compensation and Ian Webster who is in charge of Pneumo unclear research in - both feel strongly that there is not going to be an epidemic that the public exposures other than in the immediate vicinity of a mine or a mill are negligible Webster even gave as an official pronouncement in 28 a letter that I that asbestos unclear pipe poses no does not hazard have it whatsoever that query having been made to him VOICE Whose going to get that letter DR WRIGHT Ian Webster VOICE You mentioned that December 17th DR WRIGHT I can't find it I'm still looking I may find it somewhere in my things I haven't been through them all VOICE Would you consider writing him and asking him to repeat it or would that be - DR WRIGHT I'll ask him when I'm down there VOICE VOICE the You mean next - in ~ I think discussion at our meeting was that you were going to give Jack the address and that you were going to write to him VOICE Yes DR WRIGHT Well I can give you the address - VOICE Is that work for me to do DR WRIGHT Of course You can just say that - have him put his view that it isn't a hazard VOICE You say that he wrote to some government - DR WRIGHT He did write to the government yes VOICE That's what I recall I want to get that address from you I don't think you had your address book that day as I recall 29 DR WRIGHT That's alright I could give you the telephone number VOICE And I was about to phone him DR WRIGHT Pneumoconiosis Research Unit phonetic Post Office Box 4788 Johannesburg - I guess it would be Union of South Africa | VOICE Very good DR WRIGHT You find that when you begin to talk around a little bit that there are some conflicting opinions and there are two people who represent asbestos producers crycydolite and amycyte people phonetic a radiologist and a pathologist both of whom feel very strongly that the mesothelioma situation has been grossly exaggerated The pathol- ogist is the one who raised the question as to whether there is such a thing as a mesothelioma He's the guy who got up in Dresden and said that these things they're calling mesotheliomas are predominantly metastatic lesions V^ ICE Yes DR WRIGHT As you know out of all of those meso- theliomas that have been reported in South Africa I think it's something under ten in which there's been a complete autopsy the bulk are just from the lung and heart things that are sent to the research unit or they are biopsy specimens VOICE So they don't even know that these are primaries 30 DR WRIGHT Well - VOICE Or he said - DR WRIGHT Well they think that they can look at them and tell that you see VOICE But he says that - DR WRIGHT But he said that they really need a complete autopsy When I say ten I might be in error but there are much fewer that they've had autopsy on than have not been autopsied I think they are stretching it a little but I do have and gee why didn't I give that to vou I have two things that he wrote the pathologist wrote - VOICE That the government unclear - DR WRIGHT That you really ought to have you'd have to make photostats of photostats Well VOICE We've done that VOICE Some of the stuff we've copied is unbeliev- unreadable able and unreal - DR.WRIGHT This is Bruckman phonetic who is the pathologist His answer to this fellow and that you won't have too much trouble copying This is the statement from the Scient- ific Research people Why don't you copy those off - meso- thelioma - this is by Hurwitz | VOICE Fine phonetic also a pathologist DR WRIGHT I've got two very good papers on the subject of that asbestos itself like Sydney Steele phonetic wrote 31 VOICE Oh DR WRIGHT You mean two written by others . Yes VOICE unclear regardless you would have some curiousity about why - whether these are metasticized or any- thing else why they were doing it in this peculiar place for this peculiar group of people I mean - DR WRIGHT Yes it's an unusual event VOICE Yes DR WRIGHT From a quantitative point of view it's clear that some people down there possibly those whose ox has been gored the heaviest look upon Wagner as an oppor- tunist of the first order a man whose judgment was not always sound because he was influenced by the great desire to promote himself with this mesothelioma thing They don't go so far as to say there's no problem but they say that the magnitude of it has been grossly exaggerated by him VOICE With a closed mind DR WRIGHT Well with a deliberate intent to find and to stretch the truth Now these are rather serious things to say VOICE They're not said openly DR WRIGHT They're not said openly and the other thing is that I suspect that Wagner like all other humans who find themselves in what they think is a situation of great interest who pursue it very very strongly and make some errors in terms of numbers and there's nothing wrong with that 32 providing in the end that it tends to balance itself out which is what it's doing I wouldn't attribute any malignant intent to what - to Wagner myself There are those down there who do VOICE Are you talking of Wagner or Thompson now DR WRIGHT Wagner VOICE Right DR WRIGHT Thompson I'm through with anything about him VOICE You already decided that one - saying DR WRIGHT Well I have nothing more to tell you about him but Wagner I think cannot be dismissed as being a dishonest man and being a fabricator That he may have been in error in enthusiasm I could readily understand him because I think many of us are and this should be taken into account and it may have something to do with what you might call the neighborhood or direct exposed people That he needs to continue to substantiate his posi- tion is probably also true There are some other oddities about it and that is that Wagner's sister is Ian Webster's wife and that makes Webster I think a little reluctant to criticize Wagner so that the fact that he does criticize him is to be taken into account That it's probably closer to what Hurwitz and the other man - VOICE Bruckman phonetic DR WRIGHT The pathologist say than maybe I would 33 like to believe I was shown a letter which contained in it a statement Please hurry up and find a case of mesothelioma from Tinge phonetic LAUGHTER And it was a letter from Wagner So this is the sort of kind of climate that should never go beyond this desk but which I must report to you because it goes to some understand- ing Now my considered judgment would be that it doesn't alter the basic things at all It might go to the quantitative end of it and it goes to of course his great desire to find the mesotheliomas in this other area so then you're forced to say well why in this area do you not find them since to all in- tents and purposes as far as the fiber exposure is concerned they are the same VOICE Yes DR WRIGHT So mavbe it isn't fiber at all or maybe it's fiber plus something that's peculiar in the Northwest Cape This he is not going to want to have to face anymore than I would have to want to face it after I had made such a todo about it Webster believes and possibly this is because of thinking along these lines that there must be something besides exposure to fiber and he currently says that he thinks that a previous inflammation of the pleura - he's gotten involved in the tuberculosis question quite heavily because he finds a high incidence of tuberculosis in the asbestos miners higher than in the quartz 34 exposed people Now the problem down there is of course that tuberculosis in the natives is as essentially as it was in our country about thirty years ago it's rampant very common and I don't know what other things might happen in those areas besides this exposure to asbestos fiber Ian is very careful doesn't say too much about it and is being very conservative but possibly he's led into some of these avenues because he would like to find an explanation that would help his brother off the hook I don't think I have anything else to say about South Africa mesothelioma and I think it's about the time that I ought to get the hell out of here VOICE Yes you should DR WRIGHT We'll talk about New York mesophelioma the next time What time do you have VOICE I have about four after three DR WRIGHT I'm going to try to get together with - next week I'm coming back and I'm going to try to meet Dr. McCann phonetic who is the doctor for General Dynamics and I'm going to look at some insulation settings with him - VOICE Very good thought - they just bought - DR WRIGHT They just bought -- VOICE VOICE Bought Asbestos unclear Corporation They wrote us for some information VOICE They already - 35 DR WRIGHT McCann VOICE No their Public Relations Department have already inquired for information from us which - which is a unique experience because no other company had that interest which I thought was good DR WRIGHT Fine get in touch with Hugh because Hugh is going to try to set that up for either Thursday or Friday of next week That's - that means that I'll be here either on the alternate day either Thursday or Friday - VOICE You'll be here those two days DR WRIGHT Yes I'm in Connecticut on Thursday and then I'll be here on Friday firm plans are - and versa so far as my e VOICE Then we could make a date DR WRIGHT Yes VOICE And drop you a note or whatever DR WRIGHT You're doing better by me than what poor old Bucher gets He gets it day after day doesn't he VOICE Who Oh Oh yes Sure does of afternoon would that be do you know Jack Morning DR WRIGHT would be out Well the day that I go to Connecticut VOICE It's out It's got to be the other day As you knowI get jammed up but I'll hold them both as long as I can DR WRIGHT Morning is probably better because on 36 a Friday I'd like to get out of here by noon if I can Friday evening is a son of a bitch to get out of here VOICE I know that prefer morning in any event so I'll . just put down - would VOICE Can I ask just one quickie that you're going to touch on I'm just curious as to your reaction Selikoff now says that he's - 10 of his deaths among insulation workers are mesothelioma is that high VOICE Pardon me VOICE We haven't gotten the others back VOICE Yes no they're still being done yes VOICE unclear along and just settle for one copy VOICE VOICE They were only planning one copy Excuse me Carl - I'm sorry VOICE VOICE That's alright That one out of ten of his insulation deaths insulation deaths now are mesopheliomas DR WRIGHT One out of ten I hadn't seen the figures but if he can tell you that VOICE Am I not right- I'm going on mentally - but I know we were shocked when we saw that DR WRIGHT Well 50 of his deaths are cancer VOICE Yes DR WRIGHT 10 of those are mesotheliomas 37 That's a very high frequency VOICE Yes 20 of those VOICE No no - he said 10 of the total deaths VOICE Total deaths and he says - 50 are cancer So that would mean 20 of cancer - yes high isn't it That's pretty damned DR WRIGHT 10 is very high VOICE Yes DR WRIGHT If they're all mesotheliomas VOICE Yes well | - to VOICE Well there's got to be somebody else trving VOICE - Yes well - we - Thompson do a - | guy's name were something different | VOICE Yes VOICE I wince every time - wish that VOICE I wince a little myself Of course he doesn't have the P and vinegar in his name that I have VOICE I know I know that DR WRIGHT Boy you ought to meet that guy VOICE I met him you know DR WRIGHT He's a bantam rooster isn't he VOICE He came right over into the middle of a group of us at Dresden and he'd say - okay here I am in the camp of the enemy That type - - 38 DR WRIGHT Oh he's very insulting I went all the way down to Capetown to visit him and he knew that he was the only guy and his opening remarks to me were - well you represent the industry don't you You'll whitewash them LAUGHTER VOICE Yes - well that's the tipoff you know guy who can think that way will operate for the record Any DR WRIGHT I said - oh I don't think so He said - oh yes - you fellows are all alike So I said - you can see who's on the committee and if you want to call somebody like Paul Colten phonetic and Marvin Krisher phonetic whitewashers - I think you need your head examined I handed it right back to him - without a smile I said - that's an insulting thing to say to somebody unless you know them better rooster VOICE He's a little - a short haired bantam That's what he is DR WRIGHT No I wouldn't take two minutes of that crap from him or from anybody else VOICE A bantam rooster type DR WRIGHT I haven't finished my report In fact I haven't started to dictate it yet on my South African trip VOICE Oh I thought that was done in fact I was going to ask you about a copy do DR WRIGHT No there were so many other things to VOICE You may shut it off - END OF SESSION 6623E MINUTES OF THE SEVENTEENTH MEETING OF THE SCIENTIFIC COMMITTEE OF THE INSTITUTE OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH The meeting was held in New Orleans March 15 and 16 1975 Louisiana Present were Dr. Dr. Dr. Dr. Dr. George W. Wright Ian Higgins Paul Kotin Marvin Kuschner Premysl V. Pelnar ** Dr. Michel Lesage Chairman Member Member Member Scientific Secretary Medical advisor QAMA Guests present during the first half day Dr. H. Weill Dr. M. Ziskind Tulane University Tulane University 1 Dr. Wright introduced Dr. M. Lesage who will serve as liaison between IOEH and QAMA In this function he replaces Dr. Karl Lindell who has retired from his advisory function with QAMA by the end of 1974 2 It was on behalf of Scientitic to Dr. Lindell for support to IOEH many unanimously resolved that Dr. Wright Committee write a letter of appreciation years of most valuable cooperation and ... / . . a) 2/1 Manviile To PAUL KOTIN M.D. ateh j From LOIS GAUL 161161 Internal Correspondence Date NOVEMBER 2 1977 Copies G. WRIGHT M.D. Subject MEETING WITH DR GAZE OCTOBER 31 1977 DR GEORGE WRIGHT AND DR OFFICE ON MONDAY OCTOBER MEETING BUT DR GAZE WAS WILLIAM R. PAUL MET WITH 31 1977. M. HARRIS WAS ACCOMPANIED BY G. MORGAN DR GAZE IN YOUR UNABLE TO ATTEND THE AND A MR TANNER DR CAZE STATED THAT HE WISHED TO DISCUSS THE OBJECTIVES AND ROLE OF THE INTERNATIONAL ASSOCIATION WHOSE JOB HE SAW AS ESSENTIALLY ONE OF PUBLIC RELATIONS AND OF PRESENTING INDUSTRY'S CASE IN THE BEST POSSIBLE WAY ALTHOUGH EVERY COUNTRY'S PROBLEMS WITH RESPECT TO ASBESTOS ARE SOMEWHAT DIFFERENT DR GAZE FEELS THEPE IS SUFFICIENT UNIFORMITY FOR A COORDINATED FFFORT THE AIM IS TO PRESENT INDUSTRY'S SIDE WITH MORE AUTHORITY AND PRECISION THAN HAS PEEN DONE UNTIL NOW DR GAZE ALSO STATED THAT COMPARED TO SELIKOFF AT THE JOHANNESBURG CONFERENCE INDUSTRY APPEARED CONFUSED AND MORE PREPARATION IS NEEDED TO ANSWER THE KINDS OF STATEMENTS SELIKOFF IS MAKING DR GAZE WAS SOMEWHAT CONCERNED THAT PARTICIPANTS AT THE JOHANNESBURG CONFERENCE CONFERENCE DID NOT QUESTION SEI.IKOFF AND SEEMED TO ACCEPT HIM AS AN AUTHORITY AUTHORITY . DR WPIGHT POINTED OUT THAT STATEMENTS ARE NOT CONTRADICTED AT SCIENTIFIC MEETINGS BECAUSE THEY ARE WEIGHED BY SELIKOFF'S PEERS AND SCIENTISTS PAMILIAR WITH FIELD KNOW VALUE OF WHAT HE IS SAYING DR WRIGHT AGREED THAT THE SCIENTIFIC WORLD HAS NOT PUT FORWARD A UNIFORM OR STRONG COMPETITIVE ATTITUDE TO COUNTER SELIKOFF HOWEVER AT SCIENTIFIC MEETINGS MOUNT SINAI IS AND PRESENTS REASONABLE CAREFUL IN DATA DR WHAT IS SAID STICKS TO WORK IT KNOWS WRICHT EMPHASIZED THAT NOT EVERY- THING SELIKOFF SAYS LEADS TO MISCHIEF THAT HE WAS REASONABLY CAPEFUL AT JOHANNESBURG THE PROBLEM IS THAT IN NONSCIENTIFIC MEETINGS SELIKOFF AND MOUNT SINAI REPRESENTATIVES ARE LOOSER IN THEIR INFERENCES BUT DR WRICHT IS NOT CERTAIN ABOUT WHAT CAN BE DONE WITH RESPECT TO KOPP'S STATEMENTS TO GOVERNMENT AGENCIES AND NEWS MEDIA DR HAS WRIGHT ALSO STATED THAT THE AGBESTOS INDUSTRY IN THE EPTEDEPTED STATES BEEN TREATED PRETTY FAIRLY PY GOVERNMENT PEGULATORY AGENCIES OVERALL ASBESTOS HAS NOT BEEN RANNED AND THERE IS NO TALK OF BANNING IT THE PRESS IS THE GREATEST DANCER AS FAR AS WHAT TO DO ABOUT THE SITUATION DR WRIGHT INDICATED THAT THE EUROPEANS GERMANS BELGIANS MUST BE BETTER PREPARED AND MUST DOCUMENT WITH NUMBERS IN THE LITERATURE THE ASSOCIATION SHOULD STRESS THIS DR WRIGHT THEN DISCUSSED LEPOUTRE'S BELGIAN DATA AS AN EXAMPLE STATING THAT FROM WHAT HE UNDERSTOOD THERE WAS NO FOLLOW ON PEOPLE WHO LEFT THE PLANT AND WITH MESOTHELIOMA SUCH FOLLOW IS MOST IMPORTANT HE KOPP D. -2- NOVEMBER 2 , 1977 ALSO HAD THE IMPRESSTON THAT DEATH CERTIFICATES ARE A PROBLEM IN AND FRANCE BUT THAT THESE ARE IMPORTANT FOR APPROPRIATE STUDIES BELGIUM DR GAZE THEN ASKED ABOUT THE THESIS THAT FIBER COATED WITH CEMENT IS INNOCUOUS DR WRIGHT MACHINING OF PIPE FOR REPLIED THAT HE DIDN'T BELIEVE IT EXAMPLE BUNDLES MAY BE FRACTURED THAT IN THE RELEASING FIBRILS NOT ON THE SURFACE ORIGINALLY AND WHICH THEREFORE MAY NOT BE COATED DR WRIGHT THEN DISCUSSED HIS RECENT WORK WITH KUSCHNER ON GLASS FIBERS AND THAT COMPARED TO ASBESTOS GLASS HAS LESS PROCLIVITY TC CAUSE FIBROSIS THE FEACTION IS QUALITATIVELY THE SAME FUT QUANTI- TATIVELY NOT LIKE ASBESTOS DR GAZE INQUIRED ABOUT WEILL'S STUDIES AND ASKED WHETHER DATA WERE CONCLUSIVE AND WHETHER THERE WERE ENOUGH CASES IN THE STATED THAT WEILL'S STUDY WAS A RELATIVELY SMALL ONE STUDY DR WRIGHT BUT THERE WAS AN EXCESS BRONCHOGENIC CANCER COMPARISONS USED LOUISIANA EXPERIENCE MORTALITY STATISTICS NOT U.S. AS AND MORBIDITY A WHOLE EXCESS CANCER WAS SUGGESTS A NOTED LEVEL ONLY THAT IN IS THE TWO HIGHEST CATEGORIES OF EXPOSUPE WHICH TOLERABLE WEILL STARTED WITH POPULATION THAT HAS A BETTER MORTALITY EXPERIENCE THAN LOUISIANA OVERALI WEILL'S GROUP THERE OF C SHEET WORKERS DID WAS A SMALI UNDETERMINED NOT REPRESENT A PURE CHRYSOTILE - EXPOSURE AMOUNT OF CROCIDOI IN THE PIPE PLANT THERE WAS OF COURSE MUCH MORE CROCIDOI AND THE CONTRAST OF THESE TWO POPULATIONS IS USEFUL UNFORTUNATELY THE NUMBER OF DEATHS IS SMALL ESPECIALLY IF AN ATTEMPT TO DIVIDE THEM INTO CATEGORIES OF SEVERITY OF EXPOSURE IS MADE IT IS MOST DIFFICULT TO ASSESS THE RESULTS AT THIS POINT DR GAZE MENTIONED THAT POBERT MURRAY BELIEVES HE TAS IDENTIFIED A CROUP OF WORKERS WITH ONLY CROCIDOLITE EXPOSURE THERE MAY BE A GROUP AMONG BATCHER BOX WORKERS ALSO AND SMITHER IS IN TOUCH WITH THIS GROUP TO VERIFY OTHERWISE THERE IS PROBABLY NO GROUP OF BLUE WORKERS OUTSIDE OF SOUTH AFRICA DR GAZE ALSO MENTIONED THAT HE HAS BEEN READING U.S. LITERATURE ON THE HIGHER CANCER RISK IN POPULATIONS RESIDING NEAP REFINERIES AND THAT THIS SITUATION MAY CONFOUND THE DATA IN NEW JERSEY DR WRIGHT STATED THAT HE TRIED TO POINT THIS OUT AT JOHANNESBURG INSULATION WORKERS HAVE A MORE DIVERSE EXPOSURE HISTORY THAN DO WORKERS IN ASBESTOS MINING AND MILLING AND THAT IT IS IMPORTANT TO ACCOUNT FOR 1 COMMUNITY EXPOSURE AND 2 OTHER OCCUPATIONAL EXPOSURE DR WRIGHT SAID HE WOULDN'T BE SURPRISED TO FIND THAT MANVILLE HAS TOTALLY DIFFERENT EXPERIENCE THAN ANY OTHER PLANT DR GAME FEMARKED THAT THE PROBLEMS IN THE U.S. ARF LARCELY FELATED TO GOVERNMENT AGENCIES ALSO UNIVERSITY UNIVERSITY RESEARCHERS AND THE MEDIA BUT IN EUROPE THESE FACTORS ARE COMPOUNDED BY TRADE UNIONS WHICH HAVE IMPOSED ALMOST A BAN ON THE USE OF ASBESTOS IN FACT THE TRADE UNION CONGRESS HAS RECOMMENDED THAT ASBESTOS USE BE FANNED TEN YEARS FROM NOW DR GAZE ASKED WHETHER ROBERT MURPAY WAS RIGHT MAN TO PEAD INTERNATIONAL INTERNATIONAL ASSOCIATION DF WRIGHT INDICATED THAT FROM HIS BRIEF MEETING WITH KATIN M.D. nies NOVEMBER 2 1977 THIKPAY IN JOHANNESBURG JOHANNESBURG JE GJERD HIM PERSONALITY PERSONALITY PERSONALITY WILL MURFAY BE ABLE TO CF NUMBERS FOR DOCUMENTATION AND TROGGET MURRAY CONVINCE EUROPLANS HAD AN OF THE ENGAGING NECESSITY DR GAZE ASKED WHY THERE WAS A FIGH INCIDENCE OF MESOTHELICMA IN THE C.K. IS THERE REALLY LESS MESO ELSEWHERE IN EUROPE OR HAS IT BEEN UN RECOGNIZED DR WRIGHT STATED THAT HE DOESN'T WORRY ABOUT THE DIAGNOSIS IN CERMANY IN THE U.S. THERE PROBABLY IS SOME FRIOR ON THE SIDE OF MESO DIAGNOSIS BUT THAT ANY ERRORS WOULD NOT AFFECT AFFECT EPIDEMIOLOGICAL DATA DR GAZE SUGGESTEL TEAT THE FACT THAT GERMANY WAS DEPRIVED OF ASBESTOS DURING TWO WORLD WAFS MAY ACCOUNT FOR THE DIFFFRENCE IN MORTALITY EXPERIENCE THE GERMAN ASBESTOS EXPERIENCE HAS BEEN IN PIPE AND ASBESTOS SHEET NOT PEALLY IN INSULATION DE WRIGHT SAID THERE IS A NEED TO SHOW THAT INSULATION EXPERIENCE IS NOT RELATED TO FIPE AND SHEET EXPERIENCE ONLY HANS WEILL IS LOOKING AT PIPE IN THE U.S. SO THE GERMAN PIPE EXPERIENCE SHOULD DE DOCUMENTED DR GAZE SAID HE SEES A NEED FOR SEVERAL LEVELS OF DETAILED PUBLIC INFORMATION ON ASBESTOS WHICH PRESENT FACTS IN A SIMPLE WAY IN SEVERAL LANGUAGES HE FEELS THAT AUDIOVISUAL AIDS BACKED UP EY 7. SMALL TEXTBOOK WOULL BE APPROPRIATE DR WRIGHT SUGGESTED THAT THE INFORMATION WOULD BEST BE COMPILED BY PEOPLE FREE OF DIRECT CONNECTION FORMED AND TO INDUSTRY AND THAT POSSIBLY THE INFORMATION THEN CONDENSED A SMALL COMMISSION BE TO CLEAR SIMPLE FROSE BY A PROFESSIONAL WRITER THE NEED IS TO EMPHASIZE THAT WHAT IS BEING SEEN TODAY IS A RESULT OF FAST EXPOSURES TEXT SHOULD INCLUDE PROS AND CONS OF SPECULATION MORE EMPHASIS THAN HERETOFORE SHOULD BE PUT ON THOSE POPULATIONS WHO HAVE BEEN EXPOSED TO ASBESTOS AT LOWER LEVELS AND WHO HAVE NO DEMONSTRABLE ILL EFFECTS 1.E. WRIGHT ALSO STATED THAT IMPORTANT FUTURE RESEARCH MAY EE IN LOOKING AT LUNG RESIDUES AND FINDING OUT WHAT THEY MEAN HOW DO RESEARCHERS GET CASES TO LOCK A ESPECIALLY HOUSEHOLD CASEST THE LOGISTICS OF SUCH RESEARCH APE DIFFICULT AND WOULD REQUIFE COOPERATION OF NUMEROUS ACENCIES INCLUDING LABOR UNIONS THE