Document MJXQyawYJJVjxe1L3b9MYDon9

j.,. ^-j----r * ---ii-i - ."* -t --;- -"--* --*- - *................. * '^ i .< Environmental Causes of Cancer of the Lung Other Than Tobacco Smoke T7. C HUSPS2. ltD. Batbaada, Maryland c'&n |CFt* c- . - . , ~**|vV J ` r' ' s~ .*<v?+y i -*i.'rVq The recognized or stxontly suspected environmental causes cf canaw . of the respiratory system form an important segment of the environmental carcinogenic spectrum. L With one exception all so far known exogenous respiratorycartinotrens were discovered during the last 25 years (Table 2), that is, during the period in which a remarkable and progressive rise in the number and frequency of cancers of the lung was.observed in most industrialized coontriea (Fig. 1). * 3L The various respiratory carcinogens are more or less well defined chemical or physical agent? and/or are associated with distinct occupa tional activities engaged in by circumscribed workers groups (Table II). 3. The clinical, epidemiologic, pathologic and experimental observations related to these agents all of which act through the respiratory roots -i;/'!;.."' vf' '^1 I v1 rt TABLE l OCCUPATIONAL BESPHtATOBT CARCT.VOCSNS AND CANCE33 RECORDED CURING PAST 7S TEARS; T3E13 CAUSES, SITES AND NUMBERS LSO oCC : <O O0LJ ^yQ.2LHU** o x < Jr t: y~ < OzS_cLsU u.. O ! <+* ^ o~ S >> ^ j2s UJ t to cii5. Mat Araonio Asbaato# CEromataa NkW Coal Tar Patni'nim 00s IwptawiOa Bsiftaaetfva Cbairala andCtwo Laac Lane Lang NLaanngo and Nasal Sinoa Long Long sad Larynx Long Larynx Naaai SItraa Long Naaal Sinus TOTAL * mo 1934 1923 1933 1934 1934 Swtai1 UXJL mCi amO,fmMToTr^im,il Om TmI. 7 WV a 30 .93 113 74 S3 140 0M 34 0 51 0 53 7 33 51 53 40 1944 1 0 40 a0 1 4 4 1379 0 435 435 1931 3 9 3 133 1,015 1,142 ^%e.hTq``/ .." -1i * -- ^v-;-y . -;. >~4 . 5^; H .?| , -A'-'- ;,`3 -esrv. :,T 4 -'fy.-.r . . ;^j - vor---.. . * 3'"*^ "Sf*-** -' V :.a * &# '.ST*-r.V-;* Ci,.* >,< -- v- c 5^ 'UIfneMSg= gpy C3 1 SuTg. *T9 ;m/l^ ^ I o. _ > H CL t CO National CtMn In*t!tut*; National Inatitntr* of Health; Poblle Health Scm t; 17. 3. Dapai tnunt of Hralth, Education and tValfara. PtaMnUd at Sympo-iotn. 2iit Annual MtoUng. American Cellrja of Owst Fhy*WM, AllanUr-fltr, X-w Jcrwr, Juno 2. l?S3. Hr^nntri fr,wtt of tho VuJ, XXX* X*, A^u*>L i;i2i# 'OT(c. wi i,, : 1 \ ' ? ,i ('"bb"0020403 1 "> t -. 5 :'o i '- 1 ' _s -' ' :U r . -----------MWCj.'m'* : I---- ---.-..-o - `^ ; G ; 5 ....v.) - 2296 7 ^ ^ :*T _'yvt-/-.:' ... , vW,:*_*<=* ;tV ".i t 1 i*'t /.*>.'-r.!--'x^'* -- *- ---v<--r -**- v -,,,---.-,- *i^gj. j. J32. -r.fiWspf^sjigi - - -'. ` -! *. :---5Se$3 - COMPARATIVE RESP1RATOI MORTALITY MtttXS r/> srA^-i/fV", l * i feg2(K3 A* - r.i-psr?.' liBMi 1- " (NCkAMDtMNlS X g`i*5^r..ig " LV^^r, >WlTZCI>L.AfO 0)--------------- 1--------- --1-------------- 1--------------- 1-------------- 1-------------- 1-------------- IM4 Nil N)] lM N40 *4 ** FIGURE 1 TABLE If--SPECIFIC WORKER CROC PS WITH SPECIFIC RESPIRATORY CANCER HAZARDS AM WfW llwpiw Antal* Nanofacturora. kandlara, and war* of anonUal laaoctkidoa; organic rmaltar workon; Uxidomiata; ahaop dtp worfcar*; coppar amaitar nuikai* CknatMi Chromata manufacturara IneluUlnir plant aainttnanco worker*; chroma pnctnant handlora Nftkd Kkkai-aoppar matt* (Wliary wrrkm Iron Iron or* (hamatUa) minan } Radioactiv* Subatancoa Radioactive or* i pitchblende* muon: minam of nanrsdioactivo nr*a workinc in partiooeiive mne- l>opropyl Oil laoprvpyl alcohol manufneturera " I'imI Tar PtHnn Coke mn operator*; * hour* rotart worker* "* Pitnlnim Oil MUt* Poraflln preaaera; mulo (pinnera; (natal Utho worker* and drillar* | -" f- fc*tt#SaSl m i E** " "* i: Mi this docuiSent was not a record of NOTE: i; PfG INDUSTRIES, INC. DID NOT COME FROM IT'S FILES AMD CANNOT BE AUTHENTICATED RY PPG IN CASTRIES, INC.__________________ Mnr orooi/ic S 5'\civi j'i -j i, 209*7 ^ ;^SP3^s'"- - i^S^ausas?^' ;:v,> 7 ^iK* -* **.* m. ** *";; -v? -. . TarnWffal-tira LV --mj,. >MI^ f?3!3 i , -m*`.fe&J VO.W ,,. **^*5 k?^B9*I represent the only reliable footunl evidence available os the crusatloo of cancers In different parts of tb respiratory tract (Table 1X1). Although some occopstional, tnodicinal and experimental obatrra.Uon* suggest that pulmonary carcinogenesis may ensue after a non-respiratory contact eritb carcinogens, there exists no valid evidence incriminating hereditary or endogenous factors as primary causal agents of human lung cancer. ' Despite the feet that the total number of occupational pulmonary cancers on record is relatively small, the comparatively high cancer attack rates observed among tbe different worker groups etadled provide weighty evidence in favor of actual causal associations between an expoeure to the specific agents and tbe subsequent development of respiratory cancers (Table XV). The reported number of- cases of occupational respiratory cancers doubtlessly represent only e fraction of the total number which *`C? /si*** SgflW TABLX UI ENVIRONMENTAL LUNG CANCER SCORE BOARD TmW S^V-1 ---- t*m *-- -- -*- - *4 ij.f4i* :; f.*v -^r;- ,,-.* ' 'iC ur&H **T* **-**"r ***'***'/:j'/ &? 3^i?$t$o *_s*-T:T^ --- ss Ss <yy8o4*a2p. K 0.5 ,*c ok 2hr. fc z.< z 9 a! cj 'JH w)Q^-2 1 Sd.., *$ 5 21 # s . k<t r- *--a ^. -Xr.K jrfv/SsSj 3 SftzD = te<s 3=tfOo-f ^9aJS~3iioSt~cOja>o`O-.. `1-3 .k-Q-t CO i i111 ii Snwl> Asbestos Retrains Ckmetim X X X X Skin Nickel XX Iroe X 8 Satetaetoo 'X Skis . x Bane Scant. time Coen. Cmt IwpwiHl a XX X Poljrtyelio HyCwubm eaai tar, oot, pitch XX Skin PMreletne DwivsUvea ii ait XX Skin GmoIIm Dlooel engine Sxhauat G online Epoxidm X X ?X X ;x Tx X T xX ' X XX xX XX X Tx *t x .X x x Bone T Boeo. Conn, time Bom Coen.tiarae Bone X CoOftn tillQf Setat tieoue, etc. Skin Cnt ? tCa SUn Conn, time X1 X Skin . -- On . < BB 0020405 Vi NOT (3) \ 1 ' - 1 U- t 1 ^ * f t. 4 < *. ; : : 4m* j j i * ! * ' . ' i V,,- - * 1 . J NOT pn;v]^ r-- r- '"!/ r'.^ UUSVii- f nuivi i ru riu^C5 2S38 a o r- . '* '> *_ - * -4 - ' * . * . I -?':>.^r.. -v:- -. .*,?* --i, f* - ; l/-t>a. fLt w.-it-v' -Tv.t.'-'---""" .;_ V "., *v;r^7. '*. r 'Zl\- '*P,* - ' TABLE IV RESPIRATORY CANCER ATTACK RATES IT ENVIRONMENTAL CARCINOGENS *` Ammatk hydraearfeeea: Coal Lang Patralanm oil* Lang J*^?1** * * Ala* rfot wAS* Dm&m AttMk SMM MaBrMw*aw .*a 1FwuMaa - 500:100.000 43% ------ 5000:100,000 55% ___ ------ Carbon and oilteon palyman: Itoprayyi B Pinnurl 1 ainoam } Larynx J Lose IQ:l?9 uu ____ (normal 64) 134-20% aabeetoaia autapaiad (0444% normal) Motote: Arsenic Nldcal Long Long * * Name j ' Paranasal 1 him [ Lang | 320:100,000 574:100,000 ____ (4*X normal) <20* ____ normal) 145.7 mnlaa (104 normal) 144433 Ieatstryg radiation: Radioaetin* ana Long ------ ------ (5040% ad all daatha) occurred. Some of the lung cancers were certainly mistaken for tubercu losis, pulmonary abscesses, silicosis, asbestosis, siderosis or other forms of chronic pulmonary disease. Another portion of these tumors was recog nised as of occupational origin but not made a matter of public record, while a third fraction developed in workers many years sfter they had left the hazardous occupation and when the causal relations to their previously sustained exposures had been obscured by the passage of time (Table V. Page 156). , - The almost exclusive occurrence of occupational long cancers in male E pis^ fc rate fe* TV * s jr iifc-.y svv.-a'.j 2 * v i4 Li 1 TABLE Vt LATENT PERIODS OP ENVIRONMENTAL RESPIRATORY CANCERS Aihaatna Ormnata* KkW Tar turn *a Isopropyl U tanking radiation Lam 9mMS 1* 15 22 14 35-35 LrmasbsubE 15-44 6-47 4-30 -S3 __a 7-60 Nm*4IWIIhm 11wM1 PMM4 ItaaW --* -- *-- 11 3-24 -- 10 4-14 25 15-33 . HIS DOCUMENT WAS NOT A RECORD MQTp PG iNDCrSTTfis, INC. DID NOT COME FROfl rs FILES ANS CANNOT BE AUTHENTinA rhjhQJ~ X PPG INDuS'l'IWUyiWL HifO* C? 1 SL2S20W61 *' 's 1'2S59 iLt_. IL lSfV>^'T4 C SSU^y. * M?tt; ;:..v N "-'''-A ' V'-^^g=as*^a^^gB?asaa^iaag^fe^a^t8aSaagS^ae>A^as5 --TtCrfUZC^Tr `"~~.~&*T*'t`^' ***'' * **"r*W* **."-fr'Wt*'' --*"jn ~'f "** ** XiiTrvi^1'- **" iiV'nniii'fc* w>. i r^... J *\ * v-isSSa "'rfg *. a , r : workers ft in good agreement with the fast that stales ate preicmlnaBtfr employed la occupations having long cancer hazards. One of the known exoepdons la this respect are the lung esnesre found in. female asbestos workers. Tbs male-female ratio of lung cancers among workers with asbotcaia cancer of the lung la for this reason at the low level of 23:1* Indicating that with aa equalization of the degree of .exposure there CANCER Or LUNG. 1921*30 MALES AfitS 15 amo OVlt Achai nwtility peront of that opectcSfreathcdistnautMn tf population by *ge and dm ofdistrict r?0 70 - tj - too - MJ - 1)0 I<1 Counties indudme CourSf Berwighs :;^s * ^--w+*-"M,- .* -**525 *& -*1 'v^a t&Si . f ? r ts- st fc* m '$ St ^ 41 r- S` *--$v i;L-r? Sb g*& 9<i. 8t; i!j **< "rc, -- ;JUSMTREINET3, WINACS. DNIDO|j^RECORD~QF-- *G._VnE.^ - -- INDUSTRIES, INC. fJ) ' S. AND CANNOT BE AUTHENTICATED 9/ M* , J fJ3n1/Tfrl*. T* ? ;; ;' Pi P ^,. ^----' S900 *en mi ....... an *- ---- Ayi .'P'i ', '-- - ri.. f `-j i .' ; .! W > -- ' ' , .'weed: `---- J *->*--c~ .* -.. u THIS DOCUMENT WAS NOT A RECORD OF PPG INDUSTRIES, INC. DID NOT COME FROM IT'S FILES AND CANNOT BE AUTHENTICATED BY PPG INDUSTRIE^ f.? r 3 `i \j i NOT ; wv fi. :*** ?-"*^v_3r`-* . .j-p:anwf ft ^>:.? W*f` _'^.^v --r V'-**r*-r>^' --- l^i f**t'!s'-.K"^--i'' aas*fi^--'- *p<i>^Mr;-*ri^,fitr<vyri-i -^*J*,^f -t 'w->.'^ ^++^?s*\*ta-+y i-^wMa 'fc>-si7,":,JTj>-*'ftia mi a*1"w-A^^sJ aT~ir-^A. fcW^ti.rw^^^:i_?iL_ J-j~Lj *T '"T- **">*{ A^rr-- ~~~'r."itv'"'. hv. -. .' * *' - -,.m *<-wjiS '''< - v* _ *.*i ..* ;-V ".-- TAStC vu ; amotocic mpcs or cccupatkwal ksspiiutoiit cakccss <fl Tar fu Nldal Chraoioa Astertos SadieaetiTe Caw A Peat MUd hadtoactfrs Cue A Dost 1--yopji oa r, Loag Log Loag Loag ' Laog Mam and Nasal Steaa Nam and Nasal Siaos Nam and Nasal Shuts fliiwwica vras mat* C immiafai niM Ccnknm-- NC?im,,m-- r . -- 4 --. -- 3 S '-- U I-- Ss -- 4 14 T 1 S-- 1 33 _ _ Maa ---- 4-- develop* a tendency toward an equalization of liability to lone cancer. Several types of industrial Inng cancers, such as thosa caused by radlo- activs substances, ebroms pigments, and coal tar fumes, show a definite shift into younger age groups than those'observed in cancan of the lung ' K Utw) r 100,000, uou: 17-JO u-14 JK?qp S3 wM'WiV -SJ tS&'-iZBgJ?} K ^ ' ; T l -'- f^iMS .Ip document was not a regord of PPtilNDUSTRIES, INC. -DID NOT COME FROM ITi&iFlLES ANDnCANNOT BE AUTHENTICATED PG INDUSTRIES, INC. ncuits i ton?* ~ liV : U< * M0` ' ff T~i *r 7 BB^0020408 | bw. ?-e^J -- ,J ^^<1 2901 fCfc'* *. v*- -1 fr-Sr i~ f v-j ;*wrSj of cryptocvnotic origin, bat characteristic of cancan cf oceapotfetal etiology* Cacupational respiratory eaneer* moreover have lost latent periods like other cancers of known industrial or environmental Origin (Table VI). The relatively massive exposure to carcinogens- not Infrequently prevailins under occupational conditions may perhaps oceount for tbs fact that a multiecstrie genesis of several types of occupational', long cancer. La, ftVfrw*s cancer and radioactive cancer, is net infrequently observed. Pulmonary fibnw&a associated with silicosis in radioactive ore miners or with siderosls in hematite miners seems to decresse the individual liability to cancerous developments in the lungs thus affected. While many occupa tional lung cancers are of squamous ceil type, many others display an iamature or round ceil type or exhibit glandular structures- In fact, several different histologic types of cancers may occasionally ocean in the mam tumor mass (Table VII). Thus, no special histologic type seems to have any flxad relation to any specific causal factor. Occupational respira tory cancers critically studied exhibit a general symptomatic pattern common to and characteristic of environmental cancan. 4. Many of the agents incriminated in occupational respiratory carcino genesis, such as srsenieals, radioactive substances, coal tar and petroleum oils, had previously been known as important causes of Occupational and medidnai.canceri of the skin developing usually upon cutaneous exposure. Since the mucosa of the respiratory tract may be considered as an inverted, but specialised entoderms! extension of 'the ectodermal outer lining of the RESPIRATORY SYSTEM CANCER DEATH RATES BY AGE AND SEX 9WtaPopuictlon.Urbon Stofas-end Rurd States?United Slates, 1949 * "*3 *' * . , *vp ,co^ o> j a\& /y^i / /msuLtuu* // \ .* IMI '1^^0020U09 J cm***, roua so 40 m i-m >%m *ov. 90 *0 ASX 70 omnwei.wd M*H #4* swe% 90\ *** MItoteots.'Mtoslt,oii wgliuesetigtt*egtoHqMWfr>anH, .FIGURE 4 note: NOTCO,Vi!;-isCh'i 2302 xivrgz 'isriri-aiwS .' . ~--m; -j i sate*: ^Sss^sSixii ' ` V 'y; - ' t . v* * ^*''T * > . . ". :J-.r ' i;^C.:- - A `,. *V l/* * ,r . J-/y *:vf. ' * *; - ? *>* "V . ` * ' >'" > . . -, ......... ....>' ..... .TAILS Via .v - THS TCB* TABLE Of DtSCOVSfttXS Of OCCOTATTOMAt CASCCSS BM. OU_ Ojj*a !w : Chamkalat Organic 1771 Pott SUa (Sciataai) Occepotlooal Cool Tur (Lignite) 1*79 Volksuuui Skia OCMptfCtflMl . Coal Tar (Bituminous) im DutUa SUa OocopstlnoU Coal Tar (Anthracite) 1910 Zwai* SUa Ooavpatioaal Cool Tar (Foam*)* 1930 Kaushata Lmc Oocopatlosal Cnomci 00 1930 O'Danoraa Skia Oecopdtioaai Anthracene Oil 1900 Ollvw SUa Psrufin OS (Shaia Oil) BU U7( SUa a OmputiooMl AMa SttU Coka ISM DorriHoaad SUa * Gammim OiBtpitlfHJ Putratouin FusOa OU 1910 Sduuaborf Skin Pohidouia Lubrkatine HaUar OU 1930 SUa OMpikiMil ' Shalt Labricattas OU 1910 Wilson SUa Oocapotioaai --1 V 1930 Dolor* and BsriatM Blood Famine Oonpatioaoi TISStMM . Armada Amina* (Dyo Baba . IfttWwUAtM) 1S9S Bladdar. Uzvtsr Occapotioaol SUdnay leoprayyi Oil Mustard Car foomicals; laorgaaic Arseafe AsSeetos CbnauM "'Mk&al Physical Armat Ultraviolet Badlatiea tfmmfgoa Radiation Badiaocdva Snbatancsa 1940 Bala and Hooper Masai Slansaa, Larynx Loaf 1333 Yamaii*, Hirote Lane A MiyamUhi 1033 Park 1807 Hutchinson 1930 Soupe 1933 Lynch A Smith ' i3S "PJ5I 1933 GroaXoil SUa Skia N > Lane Lane Lane Masai Cavity A Siaosaa. Lane 1894 Unna 1903 1900 1911 1933 1179 1933 1933 frioboa Wyaa Van Jayie. Schwarts A wa SMauwk Back Haertine A Hhm MeNe-.L Ward A Willis La*wy 1931 Martland SUa SUa Skia Stood Fonaine Ttaoooo Booo Lane Skia Btoad Formine Tiasuoa Bono Oeeapaboaat Oeeopational OocapoUooal OceupatMosi Occupationml Occapotiuoai Oeoopotioaal Environmental Occupational Modkiaal Occupational Madiciaal TSSPBST-- Occupation Occupational Occupational tr- ?-' 'v;..1 E^vs^-tv,!; IS' t 0JI?V;r3s5Ts ^ i i t ;W^y ,, rrrv^->? gC^JS^T^=f-?x.:.3 &fc?-j' ?*%] ?rgXKwr:- -v-J9 ,,v*lsr! .Jgf L"V#~ ,, tH_ K&fc" .. ------- s SS,,ES' ,NC'DID "or cTM' TMO4F 3 AUTHntiFRtOel3\ \I0TE: ( 8> 3903 KrsS>& LX,, ` NOT COwjf;;D?,; TPs 10 -' r-ygi ;, ' " ;I ` - ^ 'y^ - j - V-'i * , >.rjy - '';- '*: " * 1f TABLE IX luxg cancss death jute per um tbaths op all causes :-V . foa SEVEN ft) INDUSTRIAL OROUPS at OHIO, /> r. v 1MT AMONG isos MALE GANGS* DEATHS ^'v; (XAMCUSO) . , f -Y- r.';'-- . .<f*l* Xts-cssyrSa*ir'!Si>:",jJt rA 1 i i A IrsaasdaM TnupmulM Aerteaitarr XsUar and plaadcs Itres. clay, giaat watal tOaiag oad qaanyiag TOTAL Lit LSI QA3 Ui 9M US US LTS K j. t*\"- * ijifcii'75 , " ** * < # " body, the devalopment of cancan from these structures following a respira tory contact with the mentioned exogenous carcinogens appears to be a phenomenon in Una with previous experience (Tabte VIII). 5. Although the existing factual data on occupational respiratory car cinogens are. at present limited to relatively restricted worker groups and apply torn comparatively small number of cancers of the respiratory organs, a considerable amount of circumstantial evidence suggests that identical or similar respiratory cancer hazards may prevail for much larger worker groups having occupational contacts with the known carcinogens. Epidemi ologic studies on lung cancer death rates made in this country and Europe have shown the existence of marked variations in the liability to lung cancer for different large occupational groups (Table IX). Some of them revealed a definitely excessive frequency of pulmonary cancer (Table X. XL and XII) as well as of cutaneous cancer. The possible significance of these observa tions in terms of occupational lung cancer hazards la evident from the fact that there are over 5,000,000 employed in American industries sustain ing various degrees of exposure to combustion, distillation and cracking products of coal, petroleum and other carbonaceous matter (soot, carbon (Cmtimmmd mm pmm tSS} E3SK *'C. v-r'- vr-^v - FTMi'v^i; "Svs**33 I r ESk*-' fs|&?ss*r*a if i TABLE X * LimO CANCER FREQUENCY AMONG OPERATING AND MON-OPERATING RAILROAD WORKERS H\ OLmpmmmMCIbNm1m9 VtmUmm CllfWl HfutmA OporeUwi itmfKaJdrI MClHiHmmui^ i hiw Ut Cfim Ha, hrCM Ha. feCMl Nfc Put Coat A 1>40-1950 a 24 8.1 5 17 *, rsm B 1S3S-1M9 m 59 57 IS 14 20 29 P*** ww* four time* u many nen-operntinir RR worWrr* in on* company "** **> *!* ftpiwtiilnl train pvraonnol, round hou> anJ tmk worker*. 7"bb' P02M11 Tm DQOTfNT WAS 'NOT A RECORD OF PPG INDUsSzFS, INC. DID NOT COME FROM IT'S FILES. AM) CANNOT BE AUTHENTICATED BY PPG INPaSIBIRS,, Utf! .. fv'OTE; i o) 2904 .'l .xv __ ' y:jy i'.-- ----- Vi W; i--. i [:*.. '* ' S. v ..... - '*i' _ .* ' 's3U -- PV-^'srS; .. . iiJr * , ^ .- . v* ` " ,.-'"*.Vr'f-' fe*i'X'Vl.s*.Cii'^*9'>v':r m' |p8^l -A B. - * **** - * -Jw 4 . : . . * . table a OCCUPATIONAL CMCM WITH AN EXCESSIVE LCNO CANCSS WCOTENC* .* nawi-irw. , .MoSiltalwtefOriliaw te-bte . , Mitalworfcm. woidare, grimkrt and polisbtre, wtro toa Wan. tool and din Makars, foundry owtov ` mstal monlders. laiba Natal dust. lubricating ofl mist Bontt Xennaway and Kaaaaway; Tumor and Oto; XuaQar: Dublin and Vana, Wyndar and Crabami McLauxblin; Sroainw at ai. `<atMf||nnasettettem Tobacco dust, tosoctfaidoa, Ssyfarth; Borst; Kcnnarray; sfr; Voraiuys, 4 . Brinkwann Engtnosrs. mechanics, Motal dusC soot, mtcMutefa. pfaaabara, ate. hibrfaattng oil. BSCC* 1M4 A 1953: C&laapln; Tumor and Graco; Musllsr; Wyndar and Graham Matal pigments, coal tar BECC 1944; MuoOor; dyas, carbon black, asphalt Dublin and Vano; ^ulton; : valuta, aotooata, rehicies (laoqnon, racias Wyndar and Greham synthetic jUaattes) Tar wothsis. road owkiil, aapbaltaia. pavienre, ihkm, patent foal o( Often, fumaeo mas, foundry laborers, xaare,ote. Tar and pitch fumee M9d d09t, MOt } Saanaoray and Zsnnavuy; rulton; BZCC 1953 Bagia. trsr-Gmarai (1933); KitdV(hliB 1 4 . p% '^Hr t *Fi ^22 Sp w?m&4 5s *Baport at tbo Bxttbh Empire Casern Campaign. WV V ***J? -j ii.yl -43 table xn luwo cxkcex mobtautt or several counties or montaka 1047-1943 (LULL AND WAIXACH) * late kten izmTM Coppor SflMUtf&g1 Copnsr MU* r.i.iii y>ui 21 31 UlU Hate 9B -304 Cum Calk tate Mate M 04 145.7 0 ST 3 39 2ft 334 14 UI 34 I-**? ^SS* r>n.ri~ 1*= Copnor MlnW^ Avkiltut 30 1 5 0 3S 399 12.7 . 34 1 n . 4. 04 444 134 * 54 0 iaa muimim croon ooath na tor lunr csnctr among trims mawo ui un Mar* Unitnd Staten in 1947 U 104 par 100.000 population. IN wnrkora ompleyod in eopxprr or* mmilnnlxlakfcf and smelting ianh*aJln dust and ffuummooa of MMIkil tOtlUlntd in tH# on a>nwd4 *tvW* u-M-dJ aa*t a* bhiyA* aaimxIt Mvwsttaa-p.irmodiliuicctt dduurfiinngc tthina "SSW"<*a anmitfeg iDGUN i MT W*S not * . (10) 1 BB^0020412"7 ^f^>c'M1!!0LrE' NOTE: T!!S3 -.' A T ? > *= W'Sf'^X'swig.'W B'f'pPG |H rI nyiurCr^I.r. e 2905 'WjA' **JtWeV.-.i.T~;v.-r--.3a^ te '*'? J *.- *3 `<VVw*- ''-yU^" jrtl* :^ t*y - ' * t ; > ^ ,v v. TABLE XCn LUNO CANCER XORTAUTT RATES IN AUSTRIA TER LStt ORATES (J. HEB81CS AND R. NSUBOLO) . \ - *------------------ tel Uahm * tana m aj 74 .' Ote 00400-1400400 IAS 314 AO ate 20,000 eo^xto 1R4 324 U Reet of Austria 104 174 2.7 ' !*>??* &2535| *-^l. 1>*.V04N| -%-^g 1 -`14 ,' 4 ' , t. * * " TABLE XTV * CANCER Or TEE LUNG AND LARYNX ENGLAND AND WALES 1040-1049 (XZNNAWAY AND XENNAWAY) Tn< Cnna Greeter London Cater Retouch Other Urban Disfe-icta Rani DUtrict* * t t--eC*e*W MaaiacOwBnil" a*a 100 Mill 100 139 137 ISO 1M 239 1U InwsOw Bwjj11 Ou M* 100 100 12S u nia 170 42 P t \ 4 TABU IV STANDARDIZED HORTAUTT RATIOS* TOR LUNG CANCSR XORTAUTT OT SELECTED SITES IN URBAN AND RURAL COUNTIES OT OHIO. WHITE HALES, 3544 TEARS (XANCUSO, Th. T. SUfiTARLANS. X. X. AND TORTERITELD, J. D.) pt--nwtmei.e1 Las, 1047.10S1 1224 S14 <04 ?'-T*'T:-Vf`atfe^; *IW Ohwwiil Death* .* 100 Expected Dntlu --HetrepoUta* County: Countic* with cite ef lOUfiOO r am la IMS (tl per. cent arbu), ***Utea County: Countir, wick cite wick population* h*caeca 50,000 earf 100,000 la I960 (Mi per cent urban). ***Rari County: Ceuntie* with eumawnite with poouUtion* belew 50400'hi JtM. (41.4 per cent urbaa), eompruisc T9 ceuate. XJjTi3HIS docume^I "fD^j;0Ar "j?S J-jl ftl S^NOT BE AUTHENWAT^^, (in .> J-S ,n 1 ,^9bV PPG INDUS'*1^ iNCl wear-------- hit> ;'* i t <- **Wtefw, V'*l ' S;-t NUI COME fK0,w r,; u ITS j_CB^0020413' J 2906 -`V_~ r^w - ______ .'V V ;*.~*V* ' - i. ' ' .- Vj frt WP <iip >* *< ^'j^J IT14 ; -*** ,-k*. j - *._ - . ' . .- -*,* ,i>-, :'. .;: \v'"v- `v"-" ' -.. ;: *'V ,'t. ? -a*y- -*v '* `"V. * ,, r m ,, j .- ' "- , ?"T' > ' "' >..a^.*ias^. J4|- v >.--/,- ' -.. -- *'!. ;/: , ':..>. - ,.v - -" - ' +**4 ' -55^44 d'! -*'-* "f^:-:r.;.r ..'. TASLS SVI vv UJXB CAKCES DEATH BATTS IK S3 STATES OT TSS UNITED CTATE9 04 -. ..; 0(1940 AND 1343 *.:i~V;- IV . ` -*** " r -.-;> '**-, , CRUDE DEATH KATES FEE 10QJM > * WDUETRIAUZXD STATES r. j v >; >. .*.*** *' . Cb--rtfart < 1M* u BUmoU u MaryW u Uiwirtiwta IM HlcUcaa AT Nrr Haapahlr* 7A Ktw Jc**y AT Ntr Till 1AX OUt AO hmylwait * A7 SMt Taland AT IM ' .-: Ui` AS -A A4 IAS M ioa 4 , AT 1U u A4 ta STATES WITH REGIONAL INDUSTRIALIZATION mm Florida Hlawwiri Maataaa Kobraaka IM AS AS TA IOlO AT iaa TA AS M At AO *- mm ^lakaaaa AGRICULTURAL STATES *1 1*M AO Arhaaaaa AS Nw Mexico AS North Carolina A1 North Dakota AS Onto* A1 Sooth Carolina AS Waahiaftati U Wyla AS IMO A1 A4 AO A9 a A1 AS AT AS AS J tr'T i zm. S.Trl r. ftitMgjg P& hxr Tit doath rate* far til* year 1948 w*r* taken from-**Tb* Amtrina Cantor Stritty, Im_ 1949. Cancer Death Rair* fur each Suu in the Cnitrd State* by Sita" (3); thcao ; for tho jrtu 1940 ware produced by the National Office of Vital Statutica. rSMlS * mot a'RECORD of (131 THIS. DC^^ ^DID NOT COME FROM t \ > in IBSES, INU. PITP'SG)flLE?Wc0an^nWo b^e IT'S f nuTE: Trim nr.ri! 2907 BY ppG IN' Hot On,;.} r- f wtiic i ; i' i_B^0020^t4-J i VHa-'t-T------- * r.-:s^rvsvr-$a c'v,;vv . ir-yrX'itH'i.'7" table xvn - v -'ao '> iSSi: I|?^ ' LUNG CANCER "MORTALITY AND POPULATION DENSITY (STOCKS) "' :' ;-:*W=.J "ENGLAND ' ' . --' . -.'I v < * Creep* of idjiwat towns with eatr 200.000 ottooM dwsOiagst . Landes sad Sobsrfcsa Area........ . #4 . iso * 134 Lhwrpoel and Suburban Am........._____ ; Lands sad Suburban Area__________ -1*0 to 133 V-, . ,>y *>, ftiBiM with 124400 occupied derailing*-- 133 Newssatte sad Gafsthead with *7,000 oeeupwd i U > of ( towns with 50400 t> 85400 occupied dwelling*.--- Ul Ajgiagate # 3 tmi with 40400 to 80,000 occupied dwnQini tor i af IX lawn with 30,000 to 40,000 occupied dwelling*-- 104 i ed 13 towwa with 30,000 to 30,000 occupied dwelling*,..... 100 > 30 towns with tsss than 20,000 occupied dwelling*--------- SO TABLE xvm INCIDENCE or RESPIXATORY CANCER, 1937 AN 134T morbidity rates.for nine metropolitan centers, by sex PER 100400 POPULATION* "^wsniS .TJ55<s3iF42^*i ** -'MT~1^**i*!a^3 .-l*X*-iR > Breachas sad Lose Attests New Orleans baltea Btmlnghaas Dearer Sea Ymacuca (bttesce Pittsburgh K53* Uf]wt Attests N* Oriesss bails* ibraungbaa Denesr iaa Francisco Chicago Ptrtaovrch Detroit tssr * Swai* tint 1MT Nmmi t*r tMT 6.0 1X4 14 TF 400 24 *94 ' ' 'i'll1 394 19* 24 44 50 i 204 jjl 29.0 392 04 A4 1100 XI 174 o 1*4 320 24 34 90 xi 114 9.1 214 141 A2 XI 93 X0 144 15.0 344 130 34 XI 109 94 204 1X3 294 122 A4 to 03 94 1X0 9.7 2X1 109 44 54 12 74 1X0 12.6 33.0 134 24 XT 443 74 194 1.4 A0 1*0 04 04 04 XO 114 144 32 0.4 14 150 5.0 7.0 34 54 00 14 0.4 73 24 2.1 1.4 A0 190 0.0 14 . 0.7 .2.9 2.0 A1 105 0.0 04 ... 1f 04 20 44 U 90 04 04 300 2.4 A0 6,7 7.0 4 0.4 0.0 50 34 27 4.4 9.0 92 0.4 04 100 2.4 A4 X* -X4 S3 0.4 04 --2S 24 24 207 174 455 233 124 112 105 114 150 122 30 zl ' 271 122 92 < S3 79 `*1% THtS PPG INDUSTfi irSfltSi BY PtfQ`7) *Blau tries Section, National Cancer Institwu. NT WAS NOT A Reg. CAW^t N0TCTM SSWh6< toll. I --nns n Tt. I j n }i' ' ' J"."' lil/r;! T DID I 7BB 0020415 2908 cbm dV: > 'C DfCUUtt or PXOOUCTTOH or CAHCX2-RXLATZD CBXM1CXL3 IN THI1JHTTZD STATCS a* *ru*n*.**--* <B*kH*SiiSgSiw^rwm. WlW 4TMML* MrTMkl-.MHO'KOUUCUtMlfTX toaa(* 1-------- h nctntxs THIS DOCUMENT WAS NOT- A RECORD .Of _ PPG INDUSTRIES, INC. OID ; ;0T COME FFfqfjlj ( r ITS FILES AND CANNOT BE AUTHENTICATE# _ BY PPG INDUSTRIES, INC. . . |*jQ j .> j_SB_Q02Q4t6~T * :Xw+-** j$ ^^SSlpiWMsa . -v ^ j..> "X- ^yTM ' V*** *' '"t i pr. k - * V i-.\; '-'''iV #.'Z:-1T~- - X ' ."*, "v:.;.-'^ *\ V-? / >. ;v- X; * / `-i ?i ' *`V 1 * , v tX " ' ^ .T*"'* ` * "_ S1sss` ^V*'iIaf *** *.''> . -*:V.??5. \-'V`vT"c*' ''.*-''- ~: ' t- * - .r;::#* v^ v ' * > Hag'535E33 J, - TAJOJIXa . ' X-.-- i- A20MAT1C HTOROCAgBON* ESTIHATja) IK OKSJtXKtTTE aXUPtSS Of - ffrgaf. EXHAUST WITH VARTING LOAD AND ENGINE REVOLUTICK ; ' SPEED WITH FUEL INJECTION XKZPTICtEKCT : r <P. KOTIN) J Pi* f>**?*3s**$4*. AgS Jfc*wf.',iNS JSS H I3g2p$Sa jif EH *vw ~T. IVJ ^5g **. -V**.- <?*4}. A#; 4i<.pA-. v 3 * .- ^ . ? ~.-?vaS" * <-** - `jMSB,,m ~`2*%kWf 58 - * + ,m t O--WI mnt :;Lms IMS 0 _____ 1/4 Coaprenias Bslsw 1/S CofBpfwnioA Biinn 3/4 CewpTSMrtnn ! 4/4 Cwpwniw Raicu* ISM 0 Crwipn--kin Rsissse ' 1/4 CsmpreHtea Rri---- 1/S Cwpwelw SsIssm - S/4 Compr--tlftn Rslssss 4/4 CottipfiulM (lllkil 140S - Caqiprswisa Rriwn 1/4 CMBpnssloa Rstssss 1^1 CwaptMiluw Ssissss S/4 Coeprwin IUIssm 4/4 Cawprewtew Rsissss Emsi LSI ten &S4 ISM 2200 tos T 4a sss 1913 in m 220 734 S2Z CTO. * 23 74 173* 440 429 .0 STS 4SS 414 0 64 70 237 3M ?maS 144 446 TTS 1220 STS 47 437 432 1706 SO 73 1373 393 1627 -s^; TnmM s0 aa . 134 S3 010 473 ' 1S0S 400 7S 4J a 34 m 137 330 330 070 944 0 30 0 It Ma 1071 077 044 MS Mifki, tar fumes tad dust, pitch and asphalt dust and fumes, lubricating OU; -So' 0ui -Sor* o< OCJ w fT=' Uq:J- oOux) and catting oil mists and' fogs, engine exhausts); over 2,000,000 with contact to metal fumes, vapors and dusts; and many thousands of others inhaling for occupational reasons other occupational carcinogens, such as arsenicsla, asbestos and radioactive materials. C. Since some of the recognized occupational respiratory agents have been found among the local and/or general air pollutants particularly of < p 5 urban and industrialized are* ;, people living and working in such regions t P ^ sortsIn beyond any doubt an attenuated form of exposure to these carcino- z o m.d gens. While inhalation contact with chromium compounds (chromite ore, o ~ chromates, chrome pigments), beryllium compounds, arsenicmls and asbes* So- (/> toe ia nmally of local character and depends upon the release of specific ^ " < S rtBoeats by certain industrial plants or the use of certain chemicals for apodal purposes (pesticides, antirusting agents), respiratory exposure to other carcinogens air pollutants, such as polycyclic hydrocarbons contained ^ < P is soot, exhaust fumes of gasoline and diesel engines and fumes from 2 uj " Industrial furnaces, oxidized unsaturated aliphatic hydocarbons from O z d ^ evaporated or non-combusted gasoline acted upon by atmospheric oxidants, S3 C3 tJ) radioactive matter, is of more or less generalized nature. 4X-- a. 0 r. U* 2r Although 00,under these the atmospheric concentrations of carcinogens encountered conditions are considerably below those prevailing with occu 'NOTEyTH'" liOTCObicria )' I BB 00 20417 7 29X0 WtSRW I f' --i,..' T--: BWRONMEOTAI. CP UW IH FORMER CHROMATE ^WORKERS - it >" I ^ - j t V- . Eiv-y^i Tjr. *?bj . * : . "'** ! *- !; ] -' -- v v; .- 7-t or1*4 *o**t _ ... .............. ........ , MWIg awkhwot. -ontmJWc--"""fT AMOHAOAlATtHTPCWOO Of 4 YCAAS OR - ao work"3 0^ a- ` :'s& > *45 TABLX V * TRENDS IN SE^J^^SFACTORS (Mlad Ste* 19C04933 B u. s: a 9o o'E o< o-2w p2 uOw o: o x < ho t9 tOz O2,, u4CDi o-pH5 <>^,;02 (/)- > Z 2 til 5 Pw> <' Qx riGUXB SA NOTE: T' ` ; (t> \ [M j- CUcI i- I i'.vOi ! 1 C i ' " -- "CO .-J *J,-- ii ;;/! . ... I vvr^ >' o ,',r co 1 J Vt,. 2911 s*: z j '&>**9'S*illmglr^ ?0szz%t:U ,_*------------------- 3zLl............. P1*,.<.v*iV^-fr;t*e.'svrV?;-~>j- r| r'?^l-%?'*zf:*-.: I V ' V `> (.>Sr>. KT- > **:>. T' ,* ,1 -- - ^ v - * - **' ., 1*t*-** '>.'*% i 4 As - ;>. .y .. _ . . ***>.* _ - ^ - V<S ' * * ViTe'- * " c' ` * TABLE XX V - AROMATIC HYDROCARBONS ESTIMATED Of ONE-MINUTE SAMPLES 0T" CUSOUNS EXHAUST WITH VARYING ENGINE REVOLUTION SPEED* - ' , ' - *(P. K--OTIN) .. ana h--i . elmra--s i to Vi.-na.rmWl * MO 225 2SS 120 23S IS* ` 1000 *** ms si 177 10* - 1500 sen MS 33 SO M -'* zooo are 14* . 40. . * 73 ST. zsoo 34* 127 XS to ' m - 3040 w .2* 11 a u SSOO it s 10 30 is "^OS'Lut|' Q .<^5 o- Oc.Z " 8 . V?.2! * ^5 zo 2 -urgj .U-2a *" UJ( pstlontl exposures, numerous epidemiologic observations on the geographi cal distribution of lung cancer suggest that they ere nevertheless carcinogenicaHy effective. In fact, the first observations on an appreciable rise In the frequency of long career were reported from the highly industrialized cities of densely populated Saxony daring the first two decades of this century. Some years later it was found that high lung cancer rates existed for the. population of the industrialized territory of the Huhr valley, while they wart below average for the agricultural region of the Main valley. '. A similarly irregular distribution pattern -f hug cancer frequency raiee was recently established for urbsn-industrialized and rural regions at Austria, England and tbs United States (Table XIII, XIV, XV, XVI: Pig. 2, Fig; S). There is moreover evidence from England and the United States showing that in general the lung cancer death rates increase with ths size of the community and. the population density (Table XVII) and therefore display a certain amount of parallelism between these two factors and the presumptive degree of air pollution. However, definite exceptions to this rule have also been noted indicating that the quality at air pollutants may play a role and/or that additional, still unknown environmental factors may be active in controlling. lung cancer attack . rates, on a local level (Table XVIII). It is finally noteworthy that this urban-rural distribution pattern of lung cancer death rates conforms with the increased exposure of urban populations to known environmental in* duatry-rslated carcinogens and their progressively increased use and pro duction particularly in urban areas (Tables XIX. XX; Figs. 4. 5. 5A). CONCLUSIONS L Hie evidence presented definitely establishes the fact that some well defined exogenous physical and chemical agents are causally involved in the production of occupational cancers of the respiratory system of members of certain restricted worker groups. . 2. Since epidemiologic studies of various large worker groups and of the ..383 a^ .2L_ >'' h a. t oj NOTE: T;--' ' NOT < t?) 1 BB 0020419 1 2912 . v-'r\ ?-rwr3cMfv^.f-; r-I-V.i^lr^rVJ mmT'H-.-.y Si :??. -J- A1- S tf SSJ- O,.^ r- owSof2i-. cc o -- :sf y^l tP u> QI Q- t_ > K O. t CO membership of special occupations have shown marlcad dilfsrsnces In thefr. loss: cancer death rate* and In view of the fact that excessive lone cacccf ' death rates have been found in- occupational troops with occupational. exposure to known industrial respiratory carcinogens, it, is likely that fa>* doairy-raUted factors account for a much larger number of lung cancers *-- than that on record. 3, The demonstration of recognized environmental respiratory carefwv ' fens In the atmosphere especially of urban areas and ofconsistently and markedly higher long cancer death rates for urban populations ever rural populations strongly suggests that industry-related air pollutants may play a causal role in the causation of lung cancer and its recent consider able increase in frequency in practically all industrialized countries. 4. "While occupational and industry-related carcinogenic air pollutants seam to play an important role in the causation of lung cancer and its recent increase in frequency, it is obvious that they are not the only factors responsible for pubnonary.cardnogenesis. & Beeearch on the etiology of lung cancer therefore should be conducted on a broad basis, including not only inhalants but also agents entering the body through non-respiratory routes. XXSUM2M . 1. La evidencia que se presents deftnidamento asienta el hecho de qoe . alguaoe agentes exogenos, flsieos y qulmicos determinados, influyen causalmenta en la prodoceidn de eincerea ocupaoionales del aparato rtspiratorio en dertoa grupos limitados de trabajadores. 2. Pueato que los estudios epidemioldgicos de varios grasdes grupos de trabajadores han moatrado notables diferenciaa en la frecuencia de las moertes por cancer del pulmdn. eh vista de que se ha- encontrado excesias proporciones de muertes por cancer del pulrodn en grupos de trabajsdoree que debido a sus ocupaciones sufren exposicidn a substaneias cardnoginicas respiratorias industriales. es posible que los factores en rela tion con la Industria tengan mucho mayor miraero de eincerea en su haber de k> qua ae concede. 8. La demoatraddn de la existenda de cartindgenos respiratorios en la atadafera espedahnente de areas urbanas con mucho mayor proporddn de muertes por cincer que en Us dress rurales, fuertemente sugiere que hay polocidn de sire por las industries que pue de desempeiUr un papel causal ea el cincer dd pulmon y su aumento redente en priticamente todos loe patses industrializados. 4. SI'bias los sgentes cartinogenicos que polueionan el sir* en los ua bientsa industriales profesionales parecen deaempenar un papel important* en la genesis del cancer y en su redente aumento de frecuencia. es obvio que no son los responsables unicos de U carcinogenesis pulmonar. 5. La investigation sobre U etiologia del cancer del pulmon por tanto debe condudrse sobre una base amplla que incluya no solo los agentes inhaUdos sino tumbien aqueUba que ingresan en el organismo por otraa vias ademaa de Us respiratorias. NOTE: Th'rS HO NOTCOMtFfiL',liV < iI" 1i ! "j BB 00204 20^^ 2313 m Vy.-'- Vv,V'4f_WT^ g -* .H^:^/^jpf'wLiy Y* ~ >*r rt.'agrfV3u*ra-gT*ry ~ -i^.------ nr. ^51 N. \~Zz**'` j**r.t*t gcHtvwoLosiracwr . ^v>7*V-`V ;<irj,''V" " ' " -'v-' ' ~ ; -jf1r`i'-*'-'T'iTvT,'' LDie vorgebrsehten Fnn daw einige kiar Before stetlen absehllesend die Tabosto tsaxsr abgegrenzte axogene physikaliscb* und cftaalscfta . *-<^ ` , *T. ."S A Krtfta tmicbUch beteiligt slnd M der Entstehungdes B*ruh'*n}>*ex dee .. ?j$*rr2*-T~~ ^+_r y.w<W~-**--***^>?iC! t1-- '-- jiTSfar^^1 kv*-. .Jf'uiKj? - Bespirattonstrmktes tob Angehftrigvn bestbnmtertescbrknkter Benf** greppen. ; *? ^- .. - ^-, ; 2. Naehdem epldemiologische tJnUrsochungvn vonversebiedengreesett Bembgruppen und von Angebbrigen ipexieller Befitfe aaagwproebep* Differeescn ergeben habcn hinsichtlkh flier SterbUrhltaitaslffer as Lnr?g _s..' J"*-`~*fV, '*"1 cnkrebe,. and im HInbUck auf di Tatsache, das* flbernsladff* SUrbJicb-' ksitariffera an Lungenkrehs bei Berufsgruppen gefundea warden mit be* ruflkher'Ejcpoeition aaf bekannte IndustrieUe carcinogen* Staffs der AU mungsorgaae* 1st es wahrscheiniich, daaa aaf die Industrie so bexichende . Faktoren far else vie! grbssers Zahl von Lungenkrebsen verentwortllcb .;*.?:'?*''*'*---**1*0 * alsd ala die Qbwliefert 1st. 3. Der Naehweis von anerkannten, dureh die Umgebong heriingtra car- dnogenen Stoffen da Respiretionstraktes in der Atmosphere besonden to attdtiaeben Bereiehen und von gieichmisaig and ausfespracben bObertn StarbUcbkeltsxiffern an Lungenkrebs unter der sttdtischen Bevdlkcrtag gtgenQber der UndlichwJ BavdUcerung legt die Vermutung nabe dasa die fVP. *ft*3 im Zaaamaenhang mit der Industrie ateherden LuftreninreLnigungen tine onichiiehe Rolle spielen kOnnten fflr das Zastandeko&naen des Lamgen- krebeea und seine kOrzllche betrichtliche Hiuftgkeitszunahme in praktisch r .*-.- 4 4 alien indostrialisierten Lindern. 4. Wkhrend berufsbedingte und sufdie Industrie bezOgiiebe eardnogene L&ftveronreinigungen cine bedeutende Roll# zu spielen scheinen far das Zsatasdekommen des Lungenkrebses und seine jOngste Hinflgkeitszn- nahme, liegt es auf der Hand, dasa dies nicht die sineigen, fUr das Zu- standekoramen von Lungvnkiebs vermntwortlicben Faktoren sind. 5. Forschungen Qber die Aetiologie des Lungenkrebses mOssen daber TM auf breiter Basts ausgefQhrt warden upd nicht nor inhaJierbare Stoffe einsebliessen, sondern such solche iBestandteile, die in den KSrpcr auf anderem Wege als Qber die Atmung cindringen. --(O' ~ ve* o , 1 $$33 A-; r --- -- >"*J C'i ` i '^pTousTR'ES` * mm 7370020421,1 NOTE: IfTEDT:1 WOT CG.ME (it) 2914