Document MM2QJ3zno4e594535eRk4zoJa

EB- 23-01 5 07:18P FROM: TO: 161E !20 INDUSTRIAL CARCINOGENESIS AND TOXICOLOGY creening, suction and bagging to the dust of the dried separated fibrous fflcate, in which all the cases of asbestosis developed. Among (ho 22 cases asbestous found by'radiography and confirmed post-mortem, there was mentio i of any cases of cancer of the lungs. More clinical and occupalonal dau on these cases would havo been desirable. On the basis of the iewh^re, 1 or 2 cases of lung cancer would have been expected. 3n the experimental side Carrier implies that his clinical data are confirmed >y exposui e of pnimals to the two kinds of dust. Cartier nakes two statements of considerable interest as to the severity >f asbesto is among his miners. (1) Dur ng hjs 3 years of clinical observation (more than 10,000 complete nodical animations) no worker has died of uncomplicated asbestosis under :he age of SO years, even after 20-30 years' severe exposure to asbestos dust; nor has h< seen among asbestosis cases as severe cyanosis or dyspnoea as thatiseen n asthmatics, lung cancer or advanced tuberculous cases. From, this'he cc Deludes that pure asbestosis is not as severe a diseuse as it is considered in Great Britain and elsewhere where manufacturing processes are carrlecj out with the separated asbestos. (2) Pure asbaiosit, often even radiologically very advanced, is found among workers who show no clinical signs, no diminution of respiratory function ajtd can without discomfort carry out their habitual tasks. The claipn by Cartier amounts to this, that asbestosis as usually described is really a mixed disease, complicated by cardiopathies and even tuberculosis, and that " pure " asbestosis as seen by him is by no moans a severe condition. Having been in close association with such notable authorities as Gardner and Vorwald, these statements cannot be ignored because of relatively short experience of the industry. It may be that Cartier considers a life of 60 years amply sufficient for the relatively few cases who develop the disease severely enough to die from it. He does not, however, in this paper give the popula tions at risk so that we cannot calculate essential data It may be relevant to his thesis that the population around the Thetford mines is almost entirely pependenl upon them for their " gagne-pain. ". Cartier's second statement is, however, borne out by the case of Franchini and Canepa. It will be recalled that whereas the general view in Great Britain is {that the symptomatic picture is more severe in asbestosis than in silicosis, tjic reverse view is held in America. The long period of absence of sytpptom^r has, been known for many years, but the diminution m vital capacity demonstrable even when the worker is perhaps unwilling to admit any respiratory abnormality. As was pointed out over 20 years ago by Mcrcwether and Price (1930) and Mereweihoc (1930), the worker is inclined to attribute his discomforts to causes other than his work. A more normal case history is that given by Luton, Champeix and Faure (1951) who describe what is suited to be tho first case of asbestosis reported in France This was a man aged 62 years who, having worked for 11 years P:9'13 iV-an. asbestos dot) [ir) complained ofj Radiographically W pies until he died^ find; diffuse fibrog bodies with giant ce "T Dust particles wei jlo mention Is mai bscount the posab uimonary tissues.!! _iWe have been at f ievidence in the lit hurt a verbal attrib; hyg'fi.brotic effects^ Harp " insoluble '3 " Jtg/Clegg and | of Gardner,i Dungs of rabbits tc {fibres. Gardner a nentioned, with ai innocuous, big pai from those of silica Nevertheless, King Ifjmall (2-5 v) pa "brous tissue teas Jails with hypeq of'giaTit-cell react ay enough to i fger;fibres (I5.t geiriapped by a., ted'the asbestos' JjSmg, Clegg at somewhat acdlul "`^arable to, if Bthie.lung doe Sfrespect or s ^insufflated,' Land fail to; S6fX>utonam JErged into^i %ry/,brkers,:t pngupM ^effects feVf' $ i**\'*fl