Document LppRJXknk0v2GZK1X8mawdx47

FILE NAME: Exxon (EXX) DATE: 1952 May 23 DOC#: EXX058 DOCUMENT DESCRIPTION: Conference Panel Discussion - Cancer Industry - Standard Oil Med Research Division m<MTHE COttECTIp^S S-18 M R e -ja -s a CANCER IN INDOSTRM, A PANEL DISCUSSION F RIMM AETERNOON MAY A i , AT CORNELL UNIVERSrrM MEDICAL COLLC-E . HELP STANDARD OIL W V . CO. MEDICAL RESEARCH DIVISION . <s? r- / --> ; ? /% r C f\K o m xa im J u s if iT A E t ia liXSCUSSlOS ' j j i KODSBASOS: Sttereon Bay, M0B,, j Bir&c'cor, Espirane Ccacar jj Pi'sY eation G lirto o f Meseorisi C enter PABII WMSEHS li Bohsi't e Pak&rclt FK0D 1; Birec&or* M edica! Hecoarch D iv s ic i S tan d ard O li DHVclopiaoat Ga0 ir W illiam S,, Maix&an6 Eh Do j K&tIona! A n ilin e Bt c c u ,, lle d i j O h m ic a! and Bye Corp fl! Z a ffa lo jj W illiam So Sm ith, MJ> j( A ssiotaat Professo? o f Industria! j| Keicino Hw York Enivereifcy P o st- M Graduata Medicai Schccl ;i Ax'thn? io Vory&ld* McB<> j; D irector* Tmde&u Foundation jj Sar&a&e lafe,v Noi ?tl Hold, cu F rid a y A fte rn o o n , May 231 Ij C ornell UaiYerBiljr Modica! Colica i | In co n n ec tio n w itii th j j AMSHICAH ACADEWT OF GOMFHfflSAffJOH MEDICI HC !| Couro e oa h MEDI CAI ASIECSfS QF WGPIIRBP 3 CQMIEHSMflOH ! Kay 1S23. 1952 I; ! ! 1 1 i[ v il n MEDICAI RSSEdRCF DIVISICI* BSS;> IsABOS&EOHlSS SVA5DAED OIL DBVaOBiiaE! CQMPAIY I ; im m 't M; ( ! "cr S ! m n>AP.T BTATOA&O OIL tiVm@SC680[: flOSIPAiir tm s u iM v a iw ii r ut x sx a a r aostn * b b u e e s m r-Y a* b , sokakjxj. 34,d 0 BE BATC MH48EBB AHD GUSSXS? She tiitS ? t h i s p a n el i s 11C areer i n Industry*1 Shat t i t l e covers a vsry wide ranget since I t Ineiudoa not only occupation#! caneerc* hut also non- ecavpaliouaX can cers in i n d u s t r i a l workers With h u t on& commentf 1 in te n d to d ism iss th e su b jec t o nosv-ccupntione 1 csacor in in d u s tr ia l w orkers and confine ssy rem arks to the s u b je c t o f o c c u p a tio n a l cancerc Ky comment on aans-ocoupationnl oaacer in in d u s tria l workers i s sim ply th a t in an in d u stry w ith a good medical department and m esta b lish e d program o f p erio d ic eseminations* an e x ce lle n t op p o rtu n ity fo r e a rly e sa e sr d e te c tio n preccm ts i t s e l f Kaay w orkers a re com pletely asym ptom atic a t th o tim e o f t h e i r p e rio d ic ex am in atio n s y e t more th a n 2/3 o f those examined have so p h y s ic a l d e fe c t which has re q u ire d r e f e r r a l back to t h e i r own p r iv a te p h y s ic ia n s fo r tre a tm e n t o r follawupo Among such de fa c te ,. n a t u r a l l y 5 n r s & few cancers and pre^ecAcerotis lesio n s Much h a s been w r itte n on th o s u b je c t o f o c c u p a tio n a l c an c e r w ith in th e p a c t 3 to h years Some o f t h i s h a s boon fa c t* end some o f i t teas been p u rs fancy* so th a t th e stu d en t o f th e su b je c t sometimes has g ro a t d i f f i c u l t y knowing ju s t what th e s i t u a t i o n i n re g a rd to t h i s problem r e a l l y i s . I t i s my i n t e n t t h i s a fte rn o o n to g iv e you a few f a c te which w i l l s t i c k w ith you end may h e lp to so lv e some o f the q u e stio n s you may have on the s u b je c t F ir s t o f a l l I ,?euld lik e to p o in t out th a t o ccu p atio n al cancer is not a now d lssn s . I t was f i r s t d e sc rib e d among chimney swoops in 1771 by S ir P e re lv a l F ett Although the c au sitlv e agent had not boon Id en tified * tha c lin ic a l observe^ t l e a s and c o r r e la tio n vri ih tho work h ic to r y d e f i n i t e l y i d e n t i f i e d t h i s o c cu p atio n &s a s s o c ia te d w ith su o c c u p a tio n a l cau ecr h&zsrd The hr.car A i n t h i s one* was f: a s s o c ia te d w ith c o n ta c t w ith th e ecot o f th e chluncy0s which* you w i l l remember* <=> 1 Musnv j>vsvxai o THE U N rV EK SITr OF TEXAS AT US1W j o snx a rlio trfaci oqj, *2!}. 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'P O s P *>* 0 41 4 op *T o t~ ( Vf H CSif b -VI 5 <94 1 5 C f*< P P ft <>* ici- O i THE UW VERSmr OF TEXAS AT AUSTIN i: . ~ -- : :......... ................. ...... ..................... " * ------------ --- goal tar & p it c h Gangers i s shglasd 1 FIRST GASES STUDIED X852 2o SO* CASES BBPQSTSD UP TO 19^2 m ss TEm ikoo 3,, TIPS TAH MOSS GABCltfOAEUIC S I TEHPEEATUSE v* PiilHCIH^ OGOUPATIOH 15 V -*l 8 BXCE OASES OGCOR a s . TAB 5 PRIBCIELE SITS OF CAHCKR UPPER LIMBS 6o AVERAGE EKFOSUBE 7 KOBTALITT Vi Fs- 8 I5GXDSHC3 AMOKS TAR VfOBSBES cif <> c> 9 AGE 2AHGS EDS MOST CASES 20*30 m as X5G$ VERI BIOS &}~8C SLIDE X m r , u rav fcR M i r u r fcAAS A l AUSJN iiisiis llllllll REVIEW OFGSOJALLGTAASRES&OPFITCCAHUCGEASHCCOSRYSESUIHSOUA.S1. 0-YR, PERIOD STUDIES) BY K5LXJ3S IH A CLEVEUHD PUST CASES SITE OF GAHCER MATERIAL PROCESS T HAKDS & ARMS GAS HOUSE PITCH CAIQGH OTG,, l EAR GAS HOUSE PITCH CAEROS HFS, l FACE GAS HOUSE PITCH CARBOH MFGo I LIP GAS HOUSE PITCH GAHBOD MiG, 1 FACE AHD HARDS GAS HOUSE PITCH careos u m ,, l WRIST GAS SOUSE PITCH CAHBOH MFOo X HAHD a SCROTUM GAS HOUSE PITCH GAS HOUSE PITCH GARBOS MFGo CAHBOE MFC* 3 LIP l SCROTUM 2 RASP COKE OYES PITCH COKE OVER PITCH TAR OIL CARROS MFC, DRY BATTER! MF0o LaMPBLAOK MFC, U FIRST CASKS REPORTED 2,, APPROXIMATE HO, GASES REPORTED 5,, BkIHGIPLS QGGUPaTXOH !sEE CASES OCCUE BiXHCXPGE SITE Q3? CASOSE 5-, STUDIES OF PLASTS IH FOLLQWXHG AREAS HEGATXYS HoY,0 BQSTOH, PITTS,, CHICAGO, MILWAUKEE6 PHILA, OCCUPATIQH MOLDES OS MIXER HOLDER HOLDER MOLDEE MOLDEE MXXER HOLDER MOLDEE HOLDERS & MIXERS SEAL MAKER LAMPBL&CX MAKERS 190? 50~100 HFO, PRODUCTS G0HTA1HXHG TAB UPPER LIMBS o oo d 29Q SLIDE 2 -rttfiuniversityor thxasatAustin KO $r le Oc *> SLIDE 3 SXEBRIMBHTAL STUDIES OH CAaClHOGjSHIC ACTIOS o r COAL TaR add p it c h " ---- -- ----------- -- ---------- ---- ------- 1 1 FIRST CAUSERS I I EXPISttHENTAL ANIMALS 3.315 I A 0 LATER STUDIES CONFXBM CARCINOGENIC ACTION ? S . SIGNIFICANCE ~ FIRST EXPER2HEHTAL CANCER PRODUCED BY KNOWS GHiSiXCAL 2,, ANIMALS IS WHICH CANCER HAS BESS PRODUCED MICE RABBITS BATS 3 , CARCINOGENIC POTENCY OF COAL TAR PRODUCTS, PITCH HIGH TEMPERATURE TAR* LOW TEMPERATURE TaR SHORTEST LATENCY PERIOD FOR TAR CaNCER IS MICE - 50 DAYS 5* SHORTEST LATENCY PERIOD FOR TAR CAHCER IN BABBITS - kf DAYS 6 . SHORTEST LATENCY PERIOD FOR TAR CAHCER JH RATS - 1*00 DAYS 7 EFFECT OF DURATION OF TABBING ON CANCER IN MICE DURATION OF TARRING t3 I MONTH | 2 MONTH S | 3 MONTH 1 k MONTH heow NUMBER OF MICE Ik 16 13 12 NUMBER OF CANCERS 1 0 3 129 tme u rw v B R s tj y u p j x a a $' a u s t o s 4 - o ** *J8i s 1^ * o 9 iy s* e 6 tv H 4 3 f*r O & 3 a !3 ZV s? t2 >* O c> ** & g E. tS ?3' O j C$" o 8 55 * b & o i3 Ci- a P-* O ^3 C> 13 7* crt1 p P- ctv.'*f $ o' M-4 *4 ?3 <** s O & ta a o p CPS s 5 O o v-1 ~* 1 & H <p <+ O \ Cv I $ & fell p a Cs ri* C o ' m a p> s~* Oo J?5 i ct> <r\ 3 i'Tl* VJl 5 P i-v ** a ? & P 1* 1(3 irt- r*"* H es 0 7 *3 \ 5 & ct is* 3 OJ >-> 3 0 S3 i-* ?a Ho o O 55 AO G9j O S3 L Q i Gf s a S MS ** o p- & ir.if. o a ft? e& s* O o c> eP a 0 .0 r~- *3 *> y; p O Pb {3 i p* w <3 r-% a CO cv I-* O S* H* H* o (rf *-} H0 C; as fo *P *s * aQ o ra o **> i~C < a fO f\ *3 o ET f o> <-} 0 -i p i T fi, ** pi er M> 3 O Ci" 13 i7s (iV*(t<*, P t3 CP <0j P- p S> e e**' 5-^ ct t o % -cj Po ir O 0 *-i P* ? ^3 Hp & 9& *** *v?i G> o i P* M e Cw-* **d S t* r? *4 h Pj i &g P. g P * 1& M H> f* pi. 3 i ?3 P* fu MO i** cot >tS H> H> Put Cy- 2 W P V* *-Sj a? S <~ t* ct jib *tr & p o r pc *3 4wt> r p #s p 3 ** 5 o *? 5 0 cr c<*< o 53 t- PP <p ^3 *ri M tr P <* Ha si C9 sj h& ><3 &> i-v *5 *"t H f-S o' g2 p F> S3 O Ms O i 1?1 s*f a ** P <3 Kj 5 *-^ W v^> a <s> >r4t O fS a o o m < 1 ifl O fe> P c* {ft '>i/5 (-* P ** o i i? <4+ VS f-1 "\y- P- o 2 g 5 & GS rt V 3 a sS H fs' p 53 i? o p. ? i o P & OU o J j O" Kff *- e O t t~i p* O 1 s* ir 5 e - 1 H* c f 3 f *3 o a 3 * p JsS O S cf S3 <r* ao O fa O O 3-* Wj S O .--^ g cf P &H 1* O f tp % -( {3 V Cfl S-* f H* H p eo &J Qra ef * c* a S3 * P* P* pi- fi cf 8 P p O P o w, H a- 0 ir O tf OO p r* cf o P * te* w T^ Or* O o ** 9 es <3 es ir & - s-rf ** O V"5 GX S 5-' s <>*r>* &p> <13 *3 P O a e S 3! O p *Ok P e p> 0 pj O i-i p a B t-r cS?" :c f* cf & g o 1 P i-* O w fj P cf O P p c- O1 t 3* ta er ? f P roa' tfir />* H 5JK P 0 O 0 C* ti *r P g P O H O <3 ? UD M 9 o>*f* f < f P* O* tO> a i3 > H O i 9 c t ? n 0 S3 e gP a * & fg 0o 01 & cf C P 1 0a i a P < & ta f o C> n t H* P J P* o ** f p o CS cf 0 < cf O o o o U P - d f a W -* a3 rto ** e* *i cf o ;r fS ft sr > o -A * e f f e$ *4 o C* H t3Jh- ir 3 1* 1 V* es & t-f $ r> o g> po s g* o MO f O s M o8 < *~P p* & sa > I <H5> a ** g o fJ r ta P h* S ' f "* K e* ** G * e& o V y << * o r> i-** fes P V fot c* 3 ni p rs li* Ci W <& Va * cf o tr^ O O f> c? Hi p Vi> S* o r<srr q EO 4* i">*>! P -u U O CJ a i e?> o (* ?-** H O P >* { o Hj &} ro fi P Ci 3-f* > P a -C <gB O p *< {x> *1 t N O sp H* P &* O& ^J5 o JS O- 15 M Vr*i* C* O PJ H 3r*~>* N Bti- X* m -f p .<E,> S^4> fef Sp a ri & fri '!-e TI,r TqTM.od 3^'A v i *qrttoj`5 i^ "T^aurrsatira su m ^ s 'Bti q, tm;'v oot ragwfrraKsmrertejasat* i OCORHJHOK 07 SE&LE OIL gajscer m m & M M > I r s T gases siju bsd Z a HOB GASES REPOSTEIS HP TO 1 ^ 2 W 'TtT WELL OVER 1500* 3 FRIHCPLK OCCUPATIOH IS WHIGH CASES OGCUH MULE SFXBHXKG 0 h * PBXHGXELS SITE OF GAHGER ~4 XHCIBESCB OF SCROTAL GAHGER AMDH MULE 3PISE3SS SGBOTUJ 25 GASES/ 1000/m s 6 b JOTRAOS EXPOSURE XQ~20 TEARS MORTALITY 20$ PSaGEHTAOE OF GASES WHICH ASS SOH-SCBDTAL QjJLa-jiSBj S L X B 3 4- i HB u N rv B R srrY o f t e x a s a t Au s t in 1 M M I OF PABATFII GASGSRS IH im iT iS D S M S Xo FIRST CASE REPORTED " ' ... ' 1 | 1310 2* APPROXIMATE TOTAL H0,, I CASES REPORTED 50 3 FRXICXFL3 OCCUPATION IH WHICH CASES OCCUR MSG PaEAITIA PEIHCIEuE SXTB OF GANGER scaomJ 5. ACE SA8&B FOR MOST CASES 50-60 N a AVERAGE EXPOSURE 5? NEGATIVE SnOBHGE 10-15 STUDIES OF 8 REFIHERIBS IH PA* NEGATIVE 1 |i.... CoCo-~J3$l sums 5 W i?V E8m ' OF Tf*$ AT M JS fft <5 \a 9 SLIM 6 M a th e r fcyps o f oecnp,viicua.l cancer which 1b w ell re c o g n ize d in th a t a s s o c ia te d w ith th e s u n n iu c tu re c-f c e r t a i n a n i l i n e dyoc* X do n o t in te n d to on. th in s u b je c t clao e Sr-, flc^uigan w ill undoubtedly d is c u s s t b l e in d e t a i l for you* I t need only ho s a id th a t rp eriisen tal evidence in d ic a te s th a t a n ilin e i a c t tHs c& rcinogoaio agsr.t h u t ru b b e r b e n z id in e and hsi&~aiaphtbylami`.H Another agent asso ciated w ith cancert e sp e c ia lly o f the skin, ie sunlight in work which re q u ire s th in d iv id u a l to he o u t- o f d o o rs a l l d ay } i t n ay w ell he considered as on occupational agent e R x illip ?.8 stu d ie s o f 1284 cases o f sk in cancer la & ie sa s H ospital c le a rly lllu r-tra tc s the Importance o f th is (S lid e 7) I t i s to be n o te d th a t about 60$ o f th e se s k in c a a c s rs o ccu rred among farm ers o r ran ch ers and t h e i r wives* Xke im portance o f thi o b s e rv a tio n I s treaisndous in the southern s ta te e * where- th e in c id e n c e o f s k in cancer has been s a id to be $Q tim es What i t i s i n th e Chicago a r e a . I t i s a ls o o f g r e a t Im portance i n tko d i f f e r e n t i a l diagnosis o f occupational cancer because so sary southern in d u s tria l workers have $aXl p e rs o n a l fa m e which keep them out in th e eua d u rin g p r a c t i c a l l y a l l t h e i r hour o f f th e job* Thus ih a q u e stio n may a r i s e w hether a p a r t i c u l a r ek in cancer 1b due to sun expo cure or to exposure to a carcinogen. In industry* In 1938 i t was re p o rte d from Germany th a t a h ig h in c id e n c e o f lung cancer had batm found among v o rk o rs in th e ohroiaium in d u stry * L i t t l e im portance m s a t tacked to t h i s enuouncomant u n t i l 1948 whan Me.chle & G regoriue r e p o rte d a s im ila r ia e rsc e a d In cid en ce o f lu n g can cer i n chrornate- workers I t new os eras- w ith o u t $&eslim t h a t some p la c e i n th e chrosium p ro d u cin g in d u s try such a h a za rd e x is t s , although to d a te I t has n ot been w ell id e n tifie d * A pparently :\i xa sons kind o f a S pecific exposure beesuea i f te c not y e t boon a s s o c ia te d w ith th e chroms p la tin g in d u s tr y * *cs> X O - -- js ufunw iH i r 'J r is x j w t /wisriwt FF tHW VSSnr O ? T83&*8 AT A fSW jfcVn w V n --- i r il ' '- ^ iM iWn W| . w . nffni i *+*-*r~*ifi~ -*r***t na. Hw m m w w w 'JJI I l WlWwMMW-- -- WWW . ! I 111JUCCCW ^l%i<WaaB-- ----llimnmgWu luiumi IUWU<l>1WlUl IIm aint UBBBOpai>WVWWrl l lOU.U..jt GHCKR OF THE SKIS IH TH U S (P H IL L IP S ) I 3 J- a o Cj SLIDE 7 F in a lly I would sim ply l i k e to m o tio n th a t la th o se v o rk a rs who develop ig b s^ te g is, th e r e 1 a ls o er. in c re a s e d in c id e n c e o f pulmonary cancer Exposure to g,st0Bto8 d u s t alon { w ithout th s appearance o f e s b s s to s ie does n o t seest to be associated w ith th e in creased incidence o f lung cancer I need only n sn tio n ra d ia tio n eanosf a t evidenced by akin cancers in ra d io lo g is ts and hone sarcomas la radio p a in te rs to re c a ll the carcinogenic hazards asso ciated w ith th ese occupations? I would l i k e now to show you a trasaa&ry e lid e o f acme o f th e more w e ll recognised oocup&tion&l cancers* (SLIDE 8) IhO s ig n if ic a n c e o f t h i s slid U s e i n th e much g r e a te r rauaber o f c a s e s re p o rte d fs m o th er countries* p rin c ip a lly England, th an re p o rted from the U nited S tates* .tilth th e x c e p tio n o f sh a le o il* where th e exposure does n o t occur in th e Uni te a S ta te si t h i s d if f e r e n c e hag been a t t r i b u t e d to two fa c to rs ? 1 ) th e g r e a te r per-' m&1 c le a n lin e s s end icrorovod w orking c o n d itio n s o f th e m a jo rity o f American workersc and 2) the lack o f a c e n tra l re p o rtin g agency fo r cancer in the U nited States* b u t i t s presence in England, In England, a i l cancer caese a re re p o rte d to the C h ief In s p e c to r o f K in s8 and F a c to rie s who p e r io d ic a l ly a n a ly s e s th e date, so ell ctad and c o r r e la te s i t w ith th e o c c u p a tio n a l h is to r y o f th e Individual Mo Such r e p o r tin g system a x is tc i n th e U n ited S ta te s and hence i t I s b e lie v e d by many b&psrto i n t h i s fie ld * th a t many o c c u p a tio n a l c an c e rs a re iaiscsc.e Shore I s on o th e r $$at t h a t t h i s olid eaptooiSQSo She d a ta gi^sm covey a p p ro x im a te ly a 20 y e ar f t r i e d * Thus th e number o f cases o f o ccu p atio n al cancer re p re se n ts but a em ail tra c tio n o f th e t o t a l number o f casco o f cancer which occur each year T his figur .N been e s tim a te d a s about am ~ ten th . o f on p erc en t You can th u s ge t h a t th e d e r a i l problem in term s of the to ta l cancer p ic tu re i s a r e la tiv e ly in s ig n ific a n t bhs* 3Sfonotholear fo r any eao in d u stry * th e problem can become a s ig n i f i c a n t one. 12 Mt4UNJv*s*MY UV 1>!AS AT AHSTJ T O PARA3OT M HD OIL SHALE OIL COAL IAH AHLHE DYS OCCUPATIONAL GAHCER *S. >2 OTHER CODHTHSS 193 0 >1500 33 >1568 100 ^50 TOTAL >255 >1500 > l 601 550 OaS S86&=A u SLIDE 8 i n c u r a v o u j i y W I tlA A S A.1 A S'ITN tjt- jtes-aq .teasreo x-suoT-Bd-nooo m s sa stft ?,^rq5, -B&o^'tr axt&% V SgSM 08 ^0a^3 SU^t3SSvE0Q ^JOTO "35 ^O) <} 255-80 OC$'T *29O q, t>^-9TP W'.. I i Mb UNSVKRSftY W TKXAS AT AUSTTN 1 !U~ t, t l I n d u s tr y i L I ($ a s r) $-- I y^.p.H oS , i H1 *v?3 3 i$ 'C CK 4 SUB 9 MCBTLXTT from cancer Irseld pas? th o u sa n d p a r y s a r -'.tuoi wipirw ~r. .-s Q m cm 7B THS OIL in b o tt p-sr Y09tr000 p^s* Ye** %=-~K I*, *$<8%vfSn Ci' # g & r 5 5 5 V, *H'rjr ffM' ^ -K 5 5 ^ $ ^ " ? 4'*f\,' I 4 n K i r p* .M.S !*j!iF !*2Sa d A J-'J- '>: I , s /. i* - j. -'. ifi e*/1-->. M IH* to < c*: 8< *t *r*n *>-* 1b-* < Ko CO M9 04-W lW*i<. ^ .r bis ' . i < n 1* * : f . ..:'-<?6LV:jC;= .f-,tt-: HP ! ft WMtt? ji| ,3r V -cJ ,\i, '* /. i OB-*-' sift & o j . .f w - * '* ,* '' * ' V M tfT fc 5'' * L>|jfl<ftOgg I n showing t h i s slid i s sim ply to indicates how m isle a d in g a s tu d y o f $ 8 typ mSi he# h o t u s * fo r in stase t&k th s ese o f th e r e f i n e r y re p re s e n te d th t h i r d bar* I t con "be seen t h a t th e in c id a o s o f can car o f a l l s i t e s i s n o t ^tg&lng when comparM w ith th e g e n e ra l p o p u la tio n # S im ila r ly th e in c id e n ce o f ' lung and kin can cer would h e no cause f o r concern v)im coxaparsd w ith th e !j^swnce fo r th e se s i t e s in th e g en eral popule-ton# X would p a r tic u la r ly lik e to ; * your a t t e n t i o n to th e figuro f o r s k in cancer# I t i s seen t h a t th e incl& enes w orkers i n th r e f i n e r y i s alm o st h a l f th a t i n th e g e n e ra l p o p u la tio n ^ h u t row llgips saiaino thee f ig u r e s more olcsXye ti (SUDS 11) :;th e in c id e n ce o f s k in cancel* i n th e g e n eral p o p n la tio n in th e age ran g es M & i s g iv e n In th e f i r s t two h a re l a th e n e x t b a r th e in c id e n c e o f skin. among a l l employsee in th r e f i n e r y i s g iren # However,, i n rev iew in g th e se H i t v as found th a t about i f } o f th e n ap p eared on th e s k in o f th e scrotum# Be of the previous lite ra tu r e references to occupational sc ro ta l cancer0 cur indos |||pSj>iciea was aroused and d e ta ile d stu d ie s were undertaken fh esa stu d io s in d icated f i l l th o se men. v o rk id i n one sm all a re a o f th e r e f in e r y fo r mor th a n 10 y e a re c j|jat* s more th e y a l l worked n t th o cam oh fo r more th a n te a y e ars# On t h i s I* th e n , i t i s goon th a t a v ery s i g n i f i c a n t in c ro a e e in th e in c id e n c e o f kin in t h i s s e le c te d group o f worker e x is ts * and th a t* th e re fo re s a d e f in ite itio n a l cancer e x is ts # Ae a r e s u l t o f ouch s tu d ie s i t was p o s s ib le to p in p o in t ^ e a r d and to introduce, th n e c e s s a ry p re c a u tio n s to e lim in a te i t # T h is th e n le a d s to th e 6fe oueetion* namely* wBow doe one a r r iv e a t th NUfelViV.SVXaXO ^felSOsis o f o c c u p a tio n a l c a n c e r? f} -h e annwer i s a d i f f i c u l t * b u t n o t an in su x - ^ f k k k l s one# F i r s t o f a l l th e lo c a tio n o f th e cancer mn% be determ ined* A ll M