Document MG5vL3YmRMOGG5L236Xn8MJbM
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------------- THE SECOND -----------ANNUAL REPORT
1--------------------- 0f the --------------------Department of Community Medicine
Mount Sinai School of Medicine of the
City University of New York
July 1, 1969 -June 30, 1970
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We wish to~`acknow 1 edge the support of the following foundations, corporations, unions, and government agencies who helped to make our program possible in this second development year. Their`generosity has given us the strength and encouragement - besides the tools - to meet the challenges that lie ahead.
Archdiocese of New York (His Eminence, Terence, Cardinal Cooke) Association for Aid co Crippled Children Chase Manhattan Bank Foundation City of New York, Board of Education City of New York, Department of Air Pollution City of New York, Department of Health City University of New York Commonwealth Fund Ernest and Mary Hayward Weir Foundation Euthanasia Educational Fund Field Foundation Health Research Council of New York City Hospital Insurance Plan of Greater New York
J International Association of Heat and Frost Insulators and
r Asbestos Workers [ Johns-ManviHe Foundation
Lavanburg-Corner House Fund Aaron and Rachel Meyer Foundation Milbank Memorial Fund National Fund for Med.ical Education
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New York City Community Trust New York Foundation
.- ' New York Metropolitan Regional Nodical Program New York Tuberculosis and Health Association Population Council Roman Meal Company Sears Roebuck Foundation Teachers College, Columbia University U.S. Department of Health, Education and Welfare
Health Services and Mental Health Administration "Model Cities" Program, Paterson, New Jersey National Communicable Disease Center National Institutes of Health Public Health Service i Social and Rehabilitation Service Van Ameringen Foundation
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INTRODUCTION
The Department's growth in its second development year ex ceeded projections. Recruitment of a talented, enthusiastic, com patible faculty and supporting staff was continued. Multidiscipline action steadily increased in teaching, research, service. Thanks to generous support from foundations, corporations, unions and government agencies, 32 programs were either initiated or further developed.
In every area, but that of service in particular, it might be said that the theme of our work was coalition: coalition with the people of East Harlem and Paterson communities; coalition with trades unions and the workers in their industries; coalition with our colleague clinical departments in the Mount Sinai Hospital,
Our relationship with the East Harlem community grew closer. We participated in activities of the East Harlem Health Council . and the East Harlem Triangle Association.~ In Paterson, New Jersey, our physicians, nurses, social workers, social scientists and
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economists worked successfully together with community people
on che pre_p_aration of a Model Cities' Ilea lilt I* Jan.
Ur. Selikoff and his environmental scientists worked with
groups from 10 different labor unions on problems of mutual in
terest and produced results important to the industrial community,
the nation, and indeed, the world, concerning environmental pol
lution. At che request of the Textile Workers Union of America,
they started a study-in-depth of byssinosis (growing hazard
among cotton workers) by giving lung tests to 350 union members
at their convention. In a study of car and asphalt use among roofing workers, they followed.almost 20,000 workmen.
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Collaboration with our clinical colleagues at che Mount
Sinai Hospital also made significant progress. Joint programs
were initiated with che departments of Obstetrics and Gynecology,
Pediatrics, Medicine, Surgery, Otolaryngology, Ophthalmology, and
Psychiatry. This cooperation was, in two instances, facilitated
by joint academic appointments: Dr. Peter Workman (Community
Medicine and Pediatrics) and Dr. Stanley Marinoff (Community
Medicine and Obstetrics and Gynecology.)
As will be seen in the Divisional Reports which follow, the
theme of coalition shona through each area of our work -- Nutrition
Health Care, Social Work, Behavioral Sciences, Health Economics.
Our research was aided by cooperation from, not only labor unions,
but .also many community groups, especially in East Harlem.
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W(Lli respect to Med fen1 Kduccii. ion, our prime academic com mitment, coJlaboration fins been consistently emphasized. Link-
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ages were strengthened with clinical departments on the one hand and academic departments of the University on die other, i It is our hope that, in the years to come, we can temper these links so lately forged, ever adding new ones, and so construct a chain to anchor us to the Community we seek to serve.
Kurt W. Deuschle, M.D. Lavanburg Professor and Chairman Department of Community Medicine
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MAJOR PROGRAMS INITIATED AND IN PROGRESS, 1569-1970
Program 1. East Harlem Drug Task Force 2. Student Training Program
3. Community Medicine Nutrition Programs 4. Impact of Medicaid and Medicare on
Former Welfare Clients 5. Research Program in Community Medicine 6. Heart Disease, Cancer, Stroke and
Related Diseases 7. East Harlem Health Survey 8. Development of Community Health
Monitoring System (Computerized Information Network for Community Health) 9. Nurse Practitioner Program in East Harlem 10. Community Medicine Biostatistics Program 11. Field Nutrition Study, Mississippi
12. Introduction to Medicine - A Develop mental Case History and Analysis
13. Asthma in the Ghetto
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Source of Funding Lavanburg Corner House Fund Department of Health, Education
and Welfare Department of K.E.W.
Department of H.E.W. Department of H.E.W. New York Metropolitan
Regional Medical Program Department of H.E.W.
Department of H.E.W.
Field Foundation and C.U.N.Y.
Chase Manhattan Bank Foundation Association for Aid to Cripple'
I Children
National Fund for Medical Educ New York Tuberculosis and ik-i1
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Program 14. Study of Abortion Attitudes in East
Harlem '
Source of Funding Population Council
15. Undergraduate Medical Curriculum
16. Paterson, N.J., Model Cities Project
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17. Perspectives on Death
18. Training Program: Medicine in Rural
Milbank Memorial Fund Model Cities Euthanasia Educational Fund
Areas
Sears-Roebuck Foundation
19. Health Careers Development Program (Student Health Opportunities
Ernest and Mary Hayward Weir Foundat. a
Program)
20. Development of Group Practice Program
New York Foundation
21. The Search and Service Concept: Amputees New York City Community Trust
22. Teaching Social Behavioral Sciences to Undergraduate Medical Students
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' Milbank Memorial Fund
23. Remodeling Health Care Systems in
East Harlem
Commonwealth Fund
24. Community Health Aide Training Program
Department of H.E.W.
25. Research Career Development
(Dr. A. Langer)
U.S. Public Health Service
26. Asbestos Exposure and Cancer in the
General Population
U.S.P.H.S.
27. Relation of Smoking to Neoplasia in
Asbestos Workers
U.S.P.H.S.
28. Asbestos Exposure-Risk in Defined
Human Populations
U.S.P.H.S.
29. Cancer in New York City Asbestos Workers Health Research Council of New
York City
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' Procrams
30. Asbestoa-(Air-pollution in New York City
31. Insulation Industry Hygiene Program
32. Biological Effects of Modified Inorganic Fibrous Microparticles
Source of Funding Department of Air Pollution of
New York City Johns-Manville Foundation and
International Assoc, of Heat and Frost Insulators and Asbestos Workers
Johns-Manville Foundation
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DIVISION OF ENVIRONMENTAL MEDICINE
Important reVnits concerning environmental pollution were produced
by the Division's investigations in 1969-1970, during which time research, teaching and service programs were all expanded.
Findings widely recognized as authoritative resulted from continuing study, led by Dr. I.J. f.elilcoff, Director of the Division, of hazards
associated with occupational exposure to asbestos. Almost 20,000 American workman were included in this research.
Studies were made of (a) caisson disease among 2,500 tunnel workers,
(b) the health effects of cotton textile dust exposure (byssinosis), (c)
the results of enzyme detergent inhalation among workmen in detergent fact
ories, and (d) tar and asphalt use among roofing workers (in which almost 20,000 workmen are being followed.)
Risks run by the community at large, owing to the dissemination of
occupational hazards were also investigated:
community exposure to asbestos du3t among family contacts of
asLcstos workers,
indirect occupational exposure among the 4,000,000 workmen in the
construction trades,
general asbestos air pollution in the community.
New epidemiological techniques, are being used in several studies
in cooperation with the American Cancer Society. Other studies are being
done together with the National Air Pollution Control Administration and
the City Department of Air Resources.
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Besides research into the human disease effects of exposure to environ
mental pollutants, basic research was also done. Dr. R.J. Schnitzer sought
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ways of altering asbestos to make it "safe" for humans to handle. Dr. J. chf
continued basic pathology studies, Dr. W.E. Smith animal experimentation. Dr. Suzuki pebiiehed basic electron microscopic observations.
Hew ground was broken in two areas. Dr. A.M. Langer led a team that
found fine inorganic particles in some cigars and cigar smoke; a Division
Croup, working with Dr. S. Berson, Chairman of the Department of Medicine,
discovered, circulating in the blood of enzyme detergent workers, antibodies to the enzyme material. They used a radio-immuno-assay technique developed
by Dr. Berson.
The Division's major efforts were supported by the U.S.P.H.S. Studies
were also undertaken with the cooperation of the National Air Pollution
Control Administration, the City Department of Air Resources, the Ford
Motor Company, National Insulation Contractors Association, and Johns-
Manville Corporation. Power station air pollution was reviewed with the
cooperation of the Consolidated Edison Co.
Among union groups with whom concerns of mutual interest were approached
were the Oil, Chemical and Atomic Workers Union, the International Chemical
Workers Union, the International Association of Heat and Frost Insulators and Asbestos Workers, the International Roofers Union, Painting Brotherhood,
Caisson Workers, Patrolmen's Benevolent Association, Steelworkers Union,
Utility Workers Union and Tile betters Union. In the Insulation Industry
Hygiene Research program Mount Sinai is cooperationg with the Asbestos
Workers Union, The Insulation Contractors, the Johns-Manville Corporation
and governmental agencies.
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Besides its research into the health effects of pollution, the Division
also recognizes a responsibility for seeking solutions to the hazards
identified. The Environmental Sciences Laboratory's scientists have come
to be recognized as a major resource, for this country and indeed, the
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world, in problems associated with pollution by fine inorganic particles. In this perspective, an International Course on Asbestosis was _iven _ *,
at the School, the world's first such course. It was attended by scientists from many countries. A second course ou "Occupational Health Hazards" will be given in 1971, for trade union officials responsible for occupational safety and health.
In the fail of 1969 a special group considered dust hazards in ship yards. It included representatives of the U.S. Navy, the civilian ship yards, material suppliers, labor union officials, governmental agencies and Mount Sinai scientists. Another group which reviewed the findings of fine inorganic particles in cigars, included representatives of the cigar industry, governmental agencies, and research institutions.
Scientists of the Division were asked to present information before governmental committees, on the Occupational Safety and Health Act of 1970 (later passed by Congress.) Division members also served on governmental advisory committees. Dr. Hammond was appointed to the National Advisory Council on Coal Workurs Pneumoconiosis (lung disease among coal miners). Dr. Selikoff (together with Dr. Marcus M. Key, Chief of the Bureau of Occupational Safety and Health, and Dr. W.H.K. Lee, Associate Director of the National Institute of Environmental Health Sciences) is acting as Co-Chairman in organizing an International Conference on Coal Workers Pneumoconiosis at the New York Academy of Sciences for the fall of 1971.
Other research initiated included investigation of trace mecals in polluted air, the automation of identification of such particles (in co operation v/itli the National Air Pollution Control Administration), hazards associated with oil mists and other inhalant difficulties among printing pressmen, .and new methods of treatment of mesothelioma (a form of cancer),
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WORLD'S FIRST COURSE ON ASBESTOSIS
Professor Rene Dubos speaks on Ecological Perspectives at luncheon session of the World's first course on asbestosis. Dr. Selikoff (white coat) is R of him.
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The Jeffrey asbestos mine of Canadian Johns-Manville Co., 100 miles east of Montreal, was visited by course participants. It is the world's largest as bestos mine and rv-ves the mineral in 200-ton trucks.
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in cooperation with Dr. P. Glade of Che Department of Pediatrics and Dr. S. Waxman and Dr. E. Greenspan of the Department of Medicine.
This varl'ecT"re.suarch effort forced tile basis for the Division's teaching program. Besides undergraduate training, it offered clcr::>lfpo and electives in various aspects of environmental medicine. Scientists of the Division taught in programs of the Institute of Health Sciences at Hunter College. Dr. Kingsley Kay developed the Master program in environmental studies at that Institute.
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