Document LJaZ9VyXNZ3xjEMebNg4qGk5X

ihen 'T DEPARTMENT OF HEALTH, EDUCATION. AND WELFARE PUBLIC HEALTH SERVICE NATIONAL INSTITUTES OF HEALTH BETHESDA. MARYLAND 20014 MAY 05 iu/6 NATIONAL CANCER INSTITUTE 732 Blair Building Mr. Anthony Mazzocchi Director -Citizenship-Legislative Department ----- -Gil, Chemical and Atomic Workers International Union 1126 Sixteenth Street, NW Washington, D.C. 20036 Dear This is in response to your letter of February 26, 1976, which sum marized the points we discussed at our meeting of January 21. I have tried to respond to your statements in the order that they were given in your letter. Based on our meeting. Dr. Robert Wool ridge, Chief, Prevention Branch, Division of Cancer Control and Rehabilitation, and Project Officer of the Tyler contract, has been in touch with the Direc tors in Tyler at the Chest Hospital to raise these concerns and to findremedies to solve those which could be substantiated. Dr. Lee Grant, Medical Director, Pittsburgh Plate Glass Company, did contact the East Texas Chest Hospital regarding the Tyler Asbestos Workers' name lists and participation in the program. Dr. Hurst re fused Dr. Grant's request and sent him a letter to this effect. At tached is a copy of Dr. Hurst's letter dated December 9, 1975, to Dr. Grant. Medical care for chest diseases and smoking have been given to those asbestos workers who requested it from the East Texas Chest Hospital. The hospital medical staff has been giving advice on all other problems as well as various types of counselling on their current physical con dition. The East Texas Chest Hospital also assists in getting the workers into another hospital for special treatment and/or surgery. When the asbestos workers joined the medical demonstration program, lectures were given from an orientation module which explained in de- , tail all facets of the program. (See attached). The workers were told what to expect on the first and succeeding visits. They were informed Mr. Anthony Mazzocchi 2 that the first three or four visits would be at six-month intervals. At their first and each succeeding visit, the physical examination and the various procedures they could expect were discussed. Currently, the length of time between each physical examination is being reviewed. The date, length and type of exposure, and current laboratory and clinical findings and the physical conditions of each worker may alter the number and length of time between each medical examination for each person in the future. This will be reviewed on an annual basis and changes in time between examinations adjusted accordingly. All changes in procedures, time between examinations and any appointment changes are explained to the workers by a nurse and/or social worker. From September to December 1975 there were 250 plus outpatient visits by the asbestos workers for further diagnosis and treatment which were in addition to their regular scheduled visits. From December 1975 to the present, asbestos workers are coming into the outpatient clinic for ad ditional treatment at the rate of 25 or more each week. The social workers and nurses explain to each worker at the time of their examina tions that provisions are available for all of them to discuss the re sults of their physical examinations with a social worker, nurse or physician at any time it is convenient. In each case, the type of medi cal treatment administered is left to the discretion of the attending physician. Drugs prescribed by the physician are available free of charge at the hospital for those who cannot pay. Those who have insurance and/or medicare - medicaid, the hospital staff requests permission to use it. If the worker agrees, the hospital files for a claim; however, if the worker objects, the hospital then gives free treatment. The subject of attitude of the staff at the East Texas Chest Hospital and waiting times for worker examinations was reviewed with the Tyler Asbestos Program staff. When the asbestos worker leaves the asbestos program staff and enters the hospital for the last part of his clinical examinations, he is given a number and is put in line with the rest of the state hospital patients. The Superintendent of the hospital has been alerted and will implement different procedures in an attempt to remedy the situation. Since I talked with you in January, it seems that the best approach to deal with the medical situation in Tyler is to use the peer review mech anism to evaluate the effectiveness of the program there. As you know, DCCR is committed to the use of non-government experts to aid us in the objective assessment of our programs. Meanwhile, our staff will continue to monitor this contract and to assure that the best available professional practices are being used, including the points you raised. Dr. Wool ridge will and has used experts to assist him in these interim assessments. Such assessments are transmitted back to the Tyler staff with time for appropriate modification. By late summer or early fall, the DCCR Office Mr. Anthony Mazzocchi 3 of Committee and Review Activities will have worked out proper merit review procedures. The total Tyler program will be subjected to Merit Review by the DCCR Intervention Review Committee. To us this objective assessment will be of the most benefit to those of our greatest concern: the workers and others who were exposed to asbestos in Tyler, Texas. Your concerns, and ours, can, I believe, be resolved through the utiliza tion of the NIH peer review model. I very much appreciated our meeting and hope that I convey to you the very concern that DCCR has over the points you raised. Please keep in close touch. Let me know if you dis agree with this approach. Best personal regards. Si i rs Attachment Di, , M.D., Director Division of Cancer Control and Rehabilitation RobertJ. Wool r'idqo, D-Sc. George A. Hurst, M. D. Superintendent Cast Texas Chest Hospital Tyler, Texas 75701 __ Appropriate action __ Appropriate action, advise --1 Your information and file __ Your information, please return rr::*t a reply this office ~ Decem,ber 9, 1975 l') Grant, M. D. "..lical Director Pittsburgh Plato Glass Pfits burgh, Pennsylvanla Door Lee: IV.r.ior Spivey andv I have discussed our recent cor; versation v/ith you concerning j...rlici potion or v/orhers in the Tyler As bos ten rhors Program. Federal rc- c:; in'.sisnts concerning confidential i ty preclude ;\; iorso of the r.ar.os of inticr. In the program. Moreover, we believe that the intr.rcst or the program and the a-fieri to arc best served by continuing our currer, c emphasis on voluntary par- 11 c i j .a 11 on ^ ;y.w I 11 L i U V>< tM/inU George A. Hurst, M. D. Principal Inv e s Li<~ator <-;'* r.. W s'v, 'v I h a^ v*.' . t*- ' S-V*# >_ v -:.J : . , ,;r- r.vfT'F f ^ i ,V; 'K ?-4.il { t r5tV i.-r. P > '* *v, i 'X- . : v-