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Dept, of Medicine & Environmental Health J.H. Spraul, M.D.-A2SB (2193) August 21, 1980 OTO W. C. Barnes, Or., M.D. D. L. Coleman, M.D.--. G. Roush, M.D. ' E. Tillman, M.D. Enclosed is a list of questions that I have been preparing to take to Dr. Wright in regard to the study project on asbestos workers in the Texas City Plant. This is a group of employees who were specifically identified as asbestos workers because of their work with insulation material. They may be more closely identified with this exposure than is warranted, but on the other hand, they're probably the only such a specific group that we have currently employed in Monsanto. The reason for their specific designation has to do with the union arrangements at Texas City. We may have similar groups that are not as clearly identified or are called by other names at some of the other plants. At any rate, this particular group seemed like an ideal one to use for a pilot study in looking for asbestos effects in a group of people dealing casually or otherwise with asbestos material. Any comments or additional questions you might have before I present these to Dr. Wright would be appreciated. Attachment /ab James H. Spraul, M.D 6113 21124 QUESTIONS FOR DR. WRIGHT 1. What is the significance of asymptomatic, late developing (after 20+ years) pleural asbestos changes? (a) Are they more prone to develop lung cancer (as opposed to asbestosis with parenchymal changes) than a normal individual? (b) How great a risk is mesothelioma for these people? .2 Should we continue to get periodic(? yearly or otherwise) x-rays on 3. How much other workup should be done? (With normal pulmonary function). Diffusion studies? Consults? etc. f/if ? .4 For whom do we continue surveillance after separation from Monsanto? e.g. If 10% of a group show changes? If anyone in a group shows changes? Vx___ -- "qU If there is bonafide asbestos exposure, even the minimal? Any age criteria? Any duration of exposure criteria? 5. Who should we have as a clinical consultant for individual cases in the Texas City area? yes .6 Is the film quality such that we need to make special arrange ments for repeat films for these people? -- 1, 7. They refer to asbestos-reinforced siding as "transite". They say that their industrial hygiene measurements (analyzed in St. Louis) were below the action level for asbestos. These measurements were made during sawing of this material. Is this consistant with what we would expect, or does this > situation need more study? ' .8 What is the experience with other large group designated as "insulators"? . / , f f- / J.H.S. 8/21/80 ? 6113 21125 HtyiHRWMtiiiifc MR***" '% isarto -NAV*- t.OC*TIO* fMONCI =* svijccr Dept, of Medicine & Environmental Health J.H. Spraul, M.D.-A2SB (2193) August 21, 1980 TO W. C. Barnes, Jr., M.D. D. L. Coleman, M.D. G. Roush, M.D. E. Tillman, M.D. Enclosed is a list of questions that I have been preparing to take to Dr. Wright in regard to the study project on asbestos workers in the Texas City Plant. This is a group of employees who were specifically identified as asbestos workers because of their work with insulation material. They may be more closely identified with this exposure than is warranted, but on the other hand, they're probably the only such a specific group that we have currently employed in Monsanto. The reason for their specific designation has to do with the union arrangements at Texas City. We may have similar groups that are not as clearly identified or are called by other names at some of the other plants. At any rate, this particular group seemed like an ideal one to use for a pilot study in looking for asbestos effects in a group of people dealing casually or otherwise with asbestos material. Any comments or additional questions you might have before I present these to Dr. Wright would be appreciated. Attachment /ab James H. Spraul, M.D. 6113 21126 QUESTIONS FOR DR. WRIGHT 1. What is the significance of asymptomatic, late developing (after 20+ years) pleural asbestos changes? (a) Are they more prone to develop lung cancer (as opposed to asbestosis with parenchymal changes) than a normal individual? (b) How great a risk is mesothelioma for these people? 2. Should we continue to get periodic(? yearly or otherwise) x-rays on 3. How much other workup should be done? (With normal pulmonary function). Diffusion studies? Consults? etc. 4. For whom do we continue surveillance after separation from Monsanto? e.g. If 10% of a group show changes? If anyone in a group shows changes? ^ i --' If there is bonafide asbestos exposure, even the minimal? Any age criteria? Any duration of exposure criteria? 5. Who should we have as a clinical consultant for individual cases in the Texas City area? 6. Is the film quality such that we need to make special arrange ments for repeat films for these people? 7. They refer to asbestos-reinforced siding as "transite". They say that their industrial hygiene measurements (analyzed in St. Louis) were below the action level for asbestos. These measurements were made during sawing of this material. Is this consistant with what we would expect, or does this situation need more study? 8. What is the experience with other large group designated as "insulators"?