Document Lxez3qx03GqVppZ4rwZ2NYQq

INDUSTRIAL. HYGIENE FOUNDATION OF AMERICA. INC MELLON INSTITUTE. AAOO FIFTH AVENUE Pittsburghi o. Pa. March i Memorandum on PROPOSED EPIDEMIOLOGICAL STUDY I PLAINTIFF'S |i EXHIBIT OF LUNG CANCER IN ASBESTOS WORKERS for the QUEBEC ASBESTOS MINING ASSOCIATION INTRODUCTION Report* of the occurrence of cancer of the lung in patiente with asbestods have been accumulating eince about 1935 (Lynch and Smith, Angrlet, Deemeulee et al, Cartier, Gloyne, Merewether, Keanaway and Kennaway, Doll, and other*), According to Hueper, such case* now total about a hundred* Many of the above authors refer to "asbestoeie cancer" of the lung, and claim to show a definite relationship between the two conditions* Up to the present time, all attempts at correlation appear to have been limited to lung cancer with aebeetoiie* although a connection between cancer and mere exposure to asbestos has been inferred.- Pub* Itched reports, together with the occurrence of some fifteen cases in the towns of Thetford Mines and Asbestos* led the industry to consult the Industrial Hygione Foundation regarding the possibility of a study having ; y Jr a/.J i 0437 MVOltM rOuNOiTIQh or iMCViCl INC -ita.orindam,. ,.'or the Q.A.W.A. 2. ai it* objective to prov* or disprove, if possible, 1. Whether there i* * relationship between asbestosl* end lung cancer, end 2. Whether e reUtionthip exist* between expoture to asbestos and lung cancer. It 1* believed that person* having any considerable exposure to asbestos should be Included in any study because, eventually, claims of lung caneer in this group will undoubtedly bo made. SOURCES OF INFORMATION During the week of February 20, 1956, a preliminary survey w of potential sources of information was made with the help of Dr. Kenneth W. Smith, Medical Director of Johns-ManviU* Corporation. Dr. Paul Cartier, Director of the Thetford Industrial Clinic; and Mr. Ivan Sabourin, General Couneel for the Quebec Asbcetos Mining Association. Conferences with representativee of the Health Department of the city of Montreal, the Deputy Minister of Health for the Province of Quebec, representatives of the Canadian Cancer Society, leading clinicians in the field, and many others indicated that considerable data relating to the general population of the Province can be obtained for purpoees of comparison with the popaletion group under study. Morbidity date, although limited, is potentially available from such sources as the hospitals In Montreal and Quebec city and some of the 15 cancer detection centers in the Province* Mortality figures, also subject to certaia limitations, are available through the Ministry of Health's Vital Statistics Department, headed by Dr, Paul PerfO< iNOuC'llAL MVGl*Nt *OuNCiT'ON O' AMERICA PNC. > Memor andum... for the U. . M. A, 3. Simultaneously, the various categories of Information relating to the asbestos workers were explored with Dr. Cartier at Thet/ord Mines and Dr. Granger at Asbestos, From these conferences, it was apparent that extensive and detailed information is obtainable with raspect to this group: \ 1. Medical data, including serial x-ray examinations of the chest, extend over a period of about 20 years, 2* In Asbestos, it will be possible to obtain, through insurance company records, information on the diagnoses and cause* of death among ^' the Insured workers. 3. Hospitals in Sherbrook and Arthabaska serve most of the people in Asbestos, and records in these institutions should be obtainable. 4. Finally, autopsy findings exist on most of the cases of lung cancer from the Theiford Mines area. * ` PRCPOSAL Obviously, several possibilities exist for a comparative statistical study between the asbestos worksrs and either the general population of the Province of Quebec or segments of that population having similar , cultural and ethnic characteristics. Careful consideration of the sources 0439 r AMfAiCA JA-C- Memorandum. ..for the U. A.M..A. . 4, tad kind of available Information and of it* probable reliability la con* sultation with bioetatietlclan* ha* lad to tba conclusion that a atudy of this problem la feasible and should raault in atAtlatiCAlly valid deduction*. The datall* of procedure. Including the decleion a* to which data should be utilised and In which order the available Information ehould be atudiad, mutt await more detailed investigation. However, it would appear from a review of copious notes assembled at the time of the preliminary survey that a reasonable starting point would bs an intra-industry study, selecting a group which entered the asbeetoe industry from iO to 10 years ago. Such a cohort of workers could then be followed according to their subse quent exposure to asbestos as wall as to the eubsequent development of asbestoeie. The precise incidence of lung cancer In the cohort would be determined by detailed study of the experience of these various groups as reflected In lneurance company records and careful analysis of the medical and x-ray examinations* This method would approximate as nearly ae poesible the controlled condition# of an actual experiment, and information derived therefrom ehould be of prime importance. The next logical procedure would be e comparison of the experionce among asbeetoe workers as determined by the previous phase and among the general population of the Province of Quebec or a suitable seg ment thereof. Our preliminary observations would strongly indicate that this phase would also be both foasible and meaningful. It would involve do* tailed atudy of morbidity data at hospital# in Megantic and Richmond counties, ` 0*Afi iNOutTHiti. or INC emoraridum. ., for the Q.A.bi.A, ( 5. ia Attbsbaska county and in Montreal and Quebec city. It would also re* quira car/ul investigation of the mortality rates developed ia the office of Dr. Parrot. Extensive individual checking of hospital records and death certificates and thorough follow-up of iedividuel cases wculd he necessary. The third and ultimate phase of the study would bo a comparison of data relating to morbidity and mortality as developed in the first two stages for the asbestos workers and the general population of Uuebec with similar statistics for the Uominioa of Canada and for the United Statea. It ia not anticipated that the statistics for Canada and the United states would be developed during the study since they are available through the public health servicea of both countries. The roost recent published fig* ures would be used and, if necessary, could be supplemented by figjrt* in possession of the respective national cancer societies. The coat of the proposed study will be *20, 000 (U. S. currency} including all travel expenses and the cost of preparing and printing the report. % 0441