Document MxK8wgJyGxjO51V194jwo0g7

ANNALS OF INDUSTRY Casualties Of The Workplace By Paul Brodeux'' P^1 "The New Yorker j Reprinted by permission; (g) 1973 The New Yorker Magazine, Inc. DAVID JOE SMITH. M.O. _ _____ ASSISTANT MEDICAL DIRECTOR - ____UNrrED STATES^STEEL CORPORATISM _ BOO ORAN? street ~ 3 MTTSBOROH. Pa. Iktso ___ CA5UALTIEJ 0F THE VORKPLACE lll-JOME CONFLICTS OF INTEREST HEN the Pittsburgh Coming concept at NIOSH by showing how the WCorporation shut down its as organization could active))* carry out bestos-insulation plant in Ty the primary mission assigned to it by ler, Texas, in February of 1972, Citodnigdress in the Occupational Safety so because of determined and coura and Health Act of 1970--that of geous action taken by Dr. WSKam M. preventing occupational dacase. In ad Johnson and Dr. Joseph K. Wagoner, dition, they had helped to crack the who had joined-the Division of Field cornerstone of the medical-industrial Studies and CHnical Investigations of complex of company doctors and in the Department of Health,* Education, dustry consultants,' whose triangular and Welfare's National Institute for structure had come to rest largely upon Occupational Safety and Health in the an unspoken alliance with a number ^summer of 1971. Shortly after coming of key occupational-health officials at - to the division as its chief medical offi- various levels of state and federal, gov --cer. Dr. Johnsun discovered data show ernment. ing grossly excessive and dangerous lev For several years, Mazzocchi had els of asbestos dust in the Tyler plant-- been gathering evidence to show that data that had been buried in the files of industrial disease was rampant in the Dr. Lews J. Cralley, the former direc United States and that knowledge of tor of the division, for years. Dr. John it was being suppressed by the medicalson and Dr. Wagoner, the new di industrial complex, and since the situa rector, set out to make sure that this tion at the Tyler plant provided a information would be properly dissem quintessential example of the workings inated and used to benefit the workers, of this complex, he decided to draw whtise terrible jeopardy from ashestosis public attention to it. In the mean (pulmonary scarring resulting from the time, he and Sheldon W. Samuels, inhalation of asbestos fibres), lung can who is the director of Health, Safety, cer, mesothelioma, and other malignant and Environmental Affairs for the tumors it described. By daring to re lease the -government's dust counts at the Tyler factor)' to Anthony Mazzocchi and Steven Wodka, of the Oil, Chemical, and Atomic Workers Inter national Union; by expressing tlieir concern to Dr. Lee B. Grant, the med ical consultant to Pittsburgh Corning, for the plight of the men who worked in the plant; by inspecting the factory and writing a report stating that a criti cal occupational-health situation existed tltcrc; and by insisting to their superiors in the National Insiiuite for Occupa tional.Safety and Health-:--or NlOSH-- that action must be taken to remedy it, and that pressure be hrooght to hear upon Secretary of Labor James i). 1 lodgson to promulgate a safe standard for industrial exposure to asbestos, l)r. Johnson and J)r. Wagoner had dune something almost unheard of in the annals of occu|ialional medicine in rite United States: They had taken steps to force the federal government from its nation of self-imposed neutrality and had placed the well-being of workers before the self-interest of industry. In so doing, not only had they become apostates against the old policy of suppressing iKTiijeitional-health data tie were embarrassing to industry hut tliey'-'*'' had also introduced a revolutionary new A.FX.-C.I.O.'s Industrial Union Dcprtment, had aroused the concern of other trade-uninn leaders over the as bestos haxard, and had Keen urging Secretary Hodgson to declare an emer gency standard for occup.'ionnal expo sure to asbestos of two asbestos fibres per cubic centimetre of air, which would replace the totally inadequate jwelve-fihre standard then in effect. The unions were strongly supported in this effort by Dr. Irving J. Selikoff, who is the director of the Mount Sinai School of Medicine's Environmental Sciences Laboratory and 'a pioneer in the field of modem asbestos epidemi ology. However, in spite of the fact that Dr. Selikoff and Dr. E. Cuyler Ham mond, vice-president for epidemiology and statistics of the American Cancer Society, had provided indisputable ev idence that one out of five asbestosinsulation workers was dying of lung cancer and that almost half of these men were dying of some form of asbes tos-related disease. Secretary Hodgson, apparently searching for some middle ground that might be satisfactory to  4)011* .industry and. labor,.declared a ' temporary emergency^ standardof tfhirc*i,' fibinrdeiscapteiorncutbhicatcetnhteimgeotrvee.!rAnmfeunr-t Jvras seeking a compromise between the well-being of the nation's asbestos ;{workers and the interests of industry me late in Norcmber of 1971, when jk Department of Labor's Occupa tional Safety and Health Administra tion, which has.the responsibility of en forcing the ptuvuions of the 1970 Act, inspected the .Tyler plant as a result of . Dr. Johnson's report that a critical oe> cupatamaidtealth situation existed there. Although major deficiencies in the fac tory's ventilation system constituted se rious violations of the Act--those like ly to result-in disability or.death--the Administration chose to consider them . nonserious and fined Pittsburgh Com ing just two hundred, and ten dollars.. At the same time, it gave the company a deadline for making extensive im provements in die ventilation system-- 1 improvements that were considered too cosdy by Pittsburgh Coming's nun- . ageis, who decided to shut the plant. . All this provided a tense buildup for the public hearings that the Occupa tional Safety and Health Administra tion was required by law to hold as pan of the process of replacing the tempo rary emergency standard for asbestos xth a permanent standard. Since the nnanent standard for asbestos was to be the Administration's first ruling under its mandate to redefine occupa tional-health regulations, industry and labor were prepared to look upon the ruling as an indication of whether the Administration would be determined or lenient in setting new standards for other hazardous substances. Thus, tlie public hearings on asbestos, which were scheduled for the middle of March, loomed as a crucial cuntest between the independent medical and scientific com munity, most of wlmse numbers were backing labor's demand for a two-fibre standard, and that part of the medicalindustrial complex supported by the as bestos industry, whose members were preparing testimony to contend that a five-fibre standard was adequate to pro tect workers. In weighing the evidence and deciding upon a safe level of expo sure, the Administration obviously needed to approach the problem impar tially. The way things stood, however, the Administration's impartiality was "en to question, because of its previous lure to enforce even the inadequate j twelve-fibre standard at the Tyler plant j k and at hundreds of other factories across ] % tile land. Sjieaking at a press confer-, .retire in Washington, D.C., on Fcbruary ,10,^1972,'- Mazzbiechi. condemned ^-thit failure as bitterly a* he did the bla. tarn disregard shown by the managen of Pittsburgh Coming and its'medi cal consultant. Dr. Grant, who, he claimed, had for yean known about and ignored the cxrearrc dust in the i Tyler plant and the awful peril it held for the workers. During the first week in March,.I _ spent several-days in Tyler talking with men who had been employed ait the plant and with other people who were involved in the situation that had de veloped there. Shortly after I returned to New York, I arranged to fly to Cin cinnati and spend a day with Dr. Johnson and Dr. Wagoner. I also tele phoned Dr. Grant, who^ in addition to being the medical consultant to Pitts burgh Coming, is the medical director of PPG Industries .(formerly known as the Pittsburgh Plate Glass Company), which, together with the Coming Glass Works, had established Pittsburgh Coming. When I reached him, at his office at PPG Industries, in Pittsburgh, I asked him if he could spare an hour or so. to talk with me about the Tyler plant. Dr. Grant was extremely cor dial, but he declined to give me an interview unless I first obtained the permission of James H. Bicrer, the president of Pittsburgh Coming. I then called Bicrer, and he, too, was very cordial, but was somewhat hesitant re garding my request. He said that he would have to look into the matter be fore giving me permission to talk with Dr. Grant. `Til get back to you as soon as possible," he said. On Monday, March 13th, I'took a morning flight to Cincinnati, and ar rived at the offices of the XIOSH Di vision of Field Studies and Clinical In vestigations shortly before noon. Dr. Johnson turned out to be a tall, pale, bespectacled man of thirty-one, with a quiet way;of speaking and a serious de meanor. His boss. Dr. Wagoner, "was a boyish-looking blue-eyed man of thir ty-six; like Johnson, he iT extremely y>ft-spoken, hilt his manner is more in tense. I had a lot of questions for them bout the survey they had conducted at lie Tyler plant, in October of 1971, nil hi the time, we had finislkrd with hese we were in the middle of lunch t a ncarb) restaurant. At tliat point, I dd them something about my recent rip to Tyler, and how I liad met sevral men who had become ill and top|K-d working in the plant even lielore it was shut down. When I finislied String them my unprcsskin^jrfc.thcse{ men, . Dr.';Johnson put down, his fork arid shook hit head. :*5"As you know. Dr. SclikojfF arid Dr. Hammond hare conducted a study of the momfity experience of nine hun dred and thirty-three men who worked between 1941 and 1945 at the Union Ashestu* & Rubber Company's plant in Paterean, New Jersey, which was tinpredecessor- factory to tlic one in Tyler," he said. "Because of their find.trigVWe'rt awfully depressed about dir. future of'many of the eight hundred arid ninety-fire then wlib worked"at the Tyler plant during the seventeen year* k was in operation. And what is even more depressing is that the Paterson and Tyler tragedies are being repeated over and over, from one end of this country to the other.. Last summer, as Joe and I were unearthing the environmental data on Tyler, we came across some mortality data on men who had worked in asbestos-textile plants throughout the United States. Like the Tyler data, this information had been accumulating willy-nilly in the division for years, arid, incredible as it may sound, no one had seen fit to do anything about it. Just from the most cursory look at those I data, almost anyone would know there- had been a tragedy of immense propor tions in many, if not all, of those fac tories. Why, the men working in them were dying of asbestnsis and cor pul monale--a form of heart failure tliat often accompanies the disease--right on the job! Men in their fifties! And some only in their forties! Recently, Joe and I pulled together the figures on just one of those plants and analyzed them. It manufactures asbestos-textile, friction, and packing products, predominantly from chrysotile asbestos, and tltat's in teresting, because the segment of the asbestos industry that mines and uses this particular variety of asbestos has. been trying to claim tliat chrysolite is not as biologically harmful as otlier types of asbestos, including amosite, which was the type the Tyler men worked with. Between January 1, 194ft, and December 31, 1962, tliirty: three hundred and sixtv-seven men and ! women worked in the clirvsntile-asbcs! tos plant, and, using the data that we - found in the files, and inure tliat we developed, we made a followup stud} i of them from the time tlu-ir employ; incut ceased until January of 196S`. As j of that date, twenti-four hundred and I eighty-one of these workers were known i to be alive, six hundred and fiftv-fi\c were ktmwir to have died,-ami tuaihundred and thirtv^one amid not -he * traced. Death certificates were ohuiinedfiir six hundred and tweim -six of the > dead. According ti the standard mortaliiv tables, there should have been ap proximately five liuiuJrvd and twentyseven deaths among these thirty-three hundred and >u.\ty-seven people instead c six hundred and fiftj'-fivc. Of tlie .Cess of a hundred and twenty-eight deaths, the vast majority--one hun dred, to he exact-*'-were caused by dis eases of the cardiopulmonary system. Approximately nineteen deaths frttm lung cancer were t be expected, but there were actually forty-six. Scventytwu deaths occurred fnun chronic lung disease, mostly ashestosis, whereas there sluHthl have been only about thirty. five. Two-hundred and thirty-nine 'of I the workers died of heart disease--j many with cor pulmonale and con-; gestive heart failure--as opposed to two jhundred and two expected deaths from these causes. Among- the eighty-1 three other deaths whose causes were I known, sixteen resulted frura malig nancies of the lymphatic and blood systems." I)r. Wagoner told me that -he and Dr. Johnson had also evaluated the distribution of the cardiopulmonary deaths according to the elapsed time since termination of employment. "We did. this partly to shed- light on the-con sequences of a common practice in the -hcstos industry, as well as in many >cr industries, of using respirators in iftc absence of strict. environmental . controls," he-said. "Our findings tell "a depressing story. The majority of the lung-cancer and ashestosis `deaths oc curred within five years of termination of employment. In fact, foortcen of the forty-six lung-cancer deaths occurred within six months of termination of employment, and the average age of those fourteen people was only fiftythree ami a half. And of the forty-one ashestosis deaths. (Iiat occurred whliin five years after termination of employ ment, a majority took place within the first year, including seventeen. deaths lltat iiappenetl within' six mom Its, at an average age of fifty-four." Dr. Johnson hroke in to say, "Which means that a lot, if not most, of these jx-oph- Itad advanced lung disease, ma lignant or mminalignnnt, even as tlk-y were working. S'ow, wliat kind "of medical program did that factor)' have, to allow men to hi- dying of pulmonary disease tight on tin- johV' Dr. Wagoner then continm-d, "'luring our medical survey "f ilk- ler plant, we found that almost fifty ]x-r cent of the men with ten or- more years of employment showed X-ray pulmonary-function, and clinical find ings ctinsistent with ashestosis. 'Ilk- routine use of respirators, which arc often difficult to breathe through, in such a population of men is extremely hazardous, because it puts them at an excess risk of cardiojKilmonary death. For that reason, the Secretary of La bur's Advisor)* Committee on the As bestos Standard, of which I am a mem ber, has recommended that the use of respirators during periods of excessive asbestos dust he preceded by strict medi cal evaluation." I had heard previously of the exist ence of the- Advtsoty Committee on the Asbestos Standard, and when we returned tu^thc offices at NIOSH, I asked Dr. Wagoner to tell me about it He explained that the committee was part of a'long arid complicated proce dure by which criteria are' developed for the recommendation of occupa tional-health standards. "The primary source of medical evidence and infor mation about asbestos was provided in the NIOSH asbestos-criteria document, which I helped to write," Dr. Wagoner said.' "This document included a critical evaluation of all known research on asbestos disease and a recommended Standard based on this evaluation, and k was sent to Secretary Hodgson on February 1st. The document recom mends that airborne asbestos dust be controlled so that no worker is ex posed over an eight-liour working day to an average of more than two fibres greater than-five microns in length per cubic centimetre of air. It proposes that the two-fibre standard become effective two years after its promulgation, in order to permit manufacturers of as bestos products to install the necessary engineering controls, and that in the meantime die temporal)- emergency standard of'five fibres remain in effect. It urges that medical surveillance, including periodic pulmonary-function tests and X-rays, be required for all workers exposed to more titan one as bestos fibre per cubic centimetre of air, and that these examinations be con ducted at the employer's expense. It also recommends that warning labels be affixed to containers of raw asbestos and to finished asbestos products stating that asbestos is llarmful, that it may cause delayed lung injury, including ashestosis and cancer, that its dust should not he intuited, and that it should be used only with adequate ventilation ami approved respiratory delicts." Dr. Wagoner went on to tell me that in proposing a permanent two-fibre standard for asbestos dust Ik- and tKej other authoii of the KIOSK document gave .greaj^weiglit to the fact thnfcj jihad been recommended in 1968 by the British Occupational Hygiene Society and hail been adopted by Her Majesty's Inspectorate of Fac tories the same year. "However, wo took care to point nut that the British standard was designed only to reduce the early signs f ashestosis, and not to prevent asbestos-induced cancer, which may occur after exposure to levels of asbestos dust that are low enough to prevent lung scarring," he added. Continuing, Dr. Wagoner siid that the Advisory Committee on the Asbes tos Standard had been set up hy Secre tary Hodgson two months before, in January, to provide additional evidence and information as to what the perma nent standard should be. "The com mittee .has five members, represent ing industry, labor, government, 'and the independent medical ami scientific community," Dr. Wagoner said. "In addition to me, it includes Isaac tH. Weaver, corporate director for environ mental control of Raybestos-Manfiat- tan, Inc.; Andrew Haas, the president of the International Association of Heat and Frost. Insulators and Asbestos Workers; Jack Baliff, the chief engi neer of the Division of Industrial Hy giene of the State of New York's De partment of Labor; and Edwin Hyatt, of- the University of California's Los Alamos Scientific Laboratory, who is the chairman. We held meetings in Wash ington for five days in February, and, by majority Vote, we supported the rwo- fihrc standard and all the recommenda tions of the NIOSH criteria document. In fact, in certain areas wc made rec ommendations to the Secretary of La bor tliat were even stronger than thos'- of the criteria document. For example as I said, wc recommended that befor. respirators could be issued to workei for any reason, each worker must have a complete physical examination to de termine whether he could wear a res pirator without endangering hits health We took this action to avoid the recur rence of conditions like those at Tyler, where respirators were slapped ontc men who already liad pulmonary prob lems as a result of exposure to as bestos." * That night,' I had-dinner with Dr. Johnson and his wife, who fired, With their two children, in an apartment in the .suburbs of Cincinnati. I had been told that Dr. Johnson was fulfilling his military obligation hy serving with K'lOSII, and as he was driving me to my hotel Liter in the evening T asked him if he intended'to'.remain there when his two-yeai* \tmir.Yof duty ..was over. .'- few moments,''Dr. Johnson. . was silynt; then he shook his head and said , he.^lnea)5jr. didn't`.know. .**!' am gn-a'tlr troubled bv the qurttion ot re- \IWlb are ffnCT&Ker in industry nr in jivjL'nmmit, iaoftd now B"at 1 sett tacca with tnc problem nt defining llUsrifTirofaiJuiialli lAr the next thirty Tear* or to. I'm afraid of becoming frustrated andfatiguctlui thgjSSjlrand nt nccomuiljg part of the hhiic of'how things arc none tn huge bureaucracy. YOU ice, the war things are set up in occupational health these days, it's all too easy for a man to look at the welter of problems awaiting solution, .to re alize the lack of any real intention on the part of many people in government and in industry to take any significant action, to'remedy them, and to Say. to himself, 'Well, I can't do anything on my own, so I might just as well sit hack and fit into the mold.' " But you did do.something about it," I said. "You and Dr. Wagoner did something that could be the beginning of turning the whole thing around." "Yes, we did something," Dr. John son replied quietly. "But will they let us keep on doing it? " .ession of the Department of Labor's ; public hearings on the-proposed perma nent standard for occupational exposure to asbestos. They were lield in a large conference room in the Interdepart mental Auditorium, at Twelfth Street ] and Constitution Avenue, and when I j arrived there, shortly after nine o'clock, j tile place was filling up with some hun- dred-odd representatives of industry, labor, government, and the independ ent medical amt scientific community. The morning wa< given over to scheduling and rescheduling appear ances of people wishing to give testi mony during tlie rest of tile week, and this complicated husness was accomplisltcd with wit and dispatch by Arthur M. Goldberg, a diminutive, bearded man, wlio was a hearing examiner for the Department of Lalxir. After Gold berg had arranged the agenda for the four days of hearings, a tall man in his early forties, with dark hair and white sideburns, got to lus feet, introduced ] himself as Bradley Walls, and said he iresemed the Asliestos Information . .xsociatimi of North America. "We have a number of questions asking for rulings from you, Mr. Goldberg," Itc said. "I preface tlicm by saying that, in light of the number of witnesses, we concur with you that ernss-exami- : nation might delay the hearings beyond . i our endurance and poaublyyours, and - N'iyhidy(m,-;'aststant professor of ootn- that if clarifying questions be required ,\-A imiinity- medieine'at'' the Mount Sinai ' they best come from you, sir. Secondly, ' , 'l: ScIkioI of Medicine and a niemher of tin- we would like your- ruling on your '. Mount. Sinai' Environmental Sciences position with regard to physical evi , Laboratory; I)r. Maxwell Borow, a dence, either living or photographic. thoracic surgeon from Bound Brook, We would prefer that it not be pre New Jersey; which k near Manville; sented, inasmuch as we do not think it would be helpful to this hearing." Jacob dayman, administrative director of the Iridltstrial Union Department; With a puzzled frown, Goldberg in quired, "May I ask what you mean?" CoKn Kent;. Joseph Mondrone, jirvri. denf of Local. 800 of tfic Paper-makers' "Either basket cases nr X-rays," union hi Manville; Robert Klinger, Walk said, with a grin. "We feel that Local 800's Vice-president and the their introduction would turn die hear- I chairman of its Health and Safety ings mtq a circus." | Committee; Daniel Marihorakt, a mem "The only thing' I can say now is ber of the local; and Marshall Smith, that evidence must be submitted in : the. local's international representative. duplicate," Goldberg said dryly. Samuels got the press conference Walls grinned agafti. "Thank you, - under way by reminding his listeners sir," he replied. "We will accept that." : that it had long been known that the When Mr. Walls sat down, a slight inhalation of asbestos dust`could scar man in his early thirties rose at the rear ! and destroy the lungs. "For the past of the room and, in a voice full of emo thirty yean, asbestos has been a proven tion, introduced himself as Colin D. cause of cancer of the lungs, and of the Neal, the administrative assistant to the stomach and intestine* of tlic workers president <>f the United Papermakers j who breathe it," he went on. "Usually, and Paperworkcrt Union, which repre exposure over a long peritid of time k sents twenty-one hundred workers at . necessary to produce asbestos-related the Johns-Manvillc Corporation's as-, disease, but there it now evidence that hestut plant.in Manville, New Jersey. even a single day of breathing large "Sir, the* United Papermakers arid amounts of asbestos' dust will harm the Papcrworkers would like to express our lungs. Contamination in the commu indignation at Mr. Walls' characteriza nity, especially in the homes of asbestos tion of those who may suffer the ef workers, has been shown to cause can fects, of asbestos-dust disease as liaskct cer in women and children who have cafes^* " he said. "Using `his termi never been in a'n- asbestos factory. In nology, however, we have a `hasket deed, no one who has been or wlto is case' we would like to present to you being exposed k safe from the effects of sometime today." asbestos, and tens of thousands of work- Goldberg looked at Neal and nodded ers and their families may already have slightly. Then he said, in a quiet, voice, had their lives shortened hy exjxisurc to "We will liear all witnesses who are asbestos dust." presented, sir," and adjourned for Samuels went on to sav that the de- lunch. . vdopment of safe methods of working On my way out, I encountered Shel with asbestos had been hampered for don Samuels, of the A.F.L.-C.I.O.'s j rats hy the- efforts of management to Industrial Union Department, whom I hide the facts' about asbestos disease, to liad previously met and talked with on suppress government and private studies several occasions. Samuels, a stocky man of the subject, and to prevent state job- in his middle forties, is ordinarily mild- safety agencies faun taking effective mannered, but he was now flushed with action. He then declared the tempo anger. Wlien I asked hitff to explain rary emergency standard of "five fihres what had happened between Walls and per cubic centimetre of air to lx- totally Neal, he shook hk head grimly. "We're inadequate. "The Industrial Union De luilding a piess conference at the Hotel partment will recommend at the hear Wasliington in a few minutes," he said. ings thk week that a standard of two "Come on over anil you'll find out." asbestos fibres per cubic centimetre of I lie press conference was condueied air go into effect within six mouths, by tile Industrial Union Department in and that within two tears the standard onjunction with the United I'ajx-r- lx- lowered to one fibre |x-r cubic centi nakers and l'a|x-rworkers, and was nl- metre," he su'd. "Moremer, since con ended hy a dozen or so journalists stant monitoring of fibre levels in lion- roin various newspapers and magn- deeds of plants is obviously impossible,, .incs and hy a Metromedia television we are calling for-thc installation- of ig^mera team. Seated from ^fyoo-riglu. . .engineering coqtrolmind work pniciieti. tPfristd a long table at the front of the designed to bring nslx-stos exposures /oom were Samuels; Dr. William J. ultimate!!* to a zero level." --; i '.-.Samuels srhen- introduced Clayman, j who'. ha* hern ;'withv the ^ Industrial I | Union Department since ft*' formaDon, [in 1956, and'had' been it* administra- ' J live director since 1960. Clayman,' a soft-spoken man in hi* middle sixties, spent a fifetiiric in the labor movc- ..rt-nt, first a*. a. steelworker, then as a member of the Ohio state fcgklature fighting for improved worfcmcn'scompensation taws, and, just before joining the Industrial Union Depart ment, as secretary-treasurer of the Congress of Industrial Organizations in Ohio. Speaking in measured tones, Clayman told his audience that * the . press Vonfcrcnce had been called to < bring to public attention what might ; well he the most devastating environ mental disaster yet perpetrated hy any ' industrial'nation. "Today, millions of American workers, their families, and their neighbors may be exposed to toxic concentrations of asbestos," Clayman said. "God only knows how many thousands of workers have died; and how many will die or he terribly sick, because of the routine way this country has dealt with the problem of occupa- i tional exposure to asbestos for so many _ years. We -cannot* bring dead workers back to life or prevent pain king since experienced, hut we can and must mg an end to this inexcusable en.onmenial crime of huge proportions that afflicts workers ami totally un aware victims in the plant community." Dr. Borow was then introduced, and lie described tltc cases of malignant mesothelioma that he and his associates at the Somerset Hospital, in Somerville, New Jersey, liad begun to find in 1964, and Said licit he liad witnessed a sharp rise in the incidence of the disease since then. He quoted from a letter he liad written on Octoher 12, I 1967, to Marsliall Smith, then presi dent of the Papermnkcrs', Local SOO. "Hie letter stated licit Dr. Borow and his assoccites were planning an exhibit ' on the rising incidence of mesotltelioma in tlu* Manville area, which they hat! Imped in dismay in 1968 at four major nu-dical conventions throughout the ; country and at various hospitals in New | Jersey, hut that, though tlleV liad apr ! plied to forty different sources for j funding, they had been unable to ob tain money for this piiqnise. "We were told frankly that local industry would > sup|mri this project for fear of upting tin* Jolins-.Manville Corpora tion," tin- letter continued. -`Johns- Manville themselves, after six weeks of d liberation, refused Mipjxirt, as lliey Were not ready to acknowledge tile \ a*.^K*i.niou between asliestosis and imso- l| ;sJ'.jr* thcKoma." Dtv Borow's letter' fo Smith concluded by wking thc'union to pro . tnris is obviously' not the major protv lem among' asbestos workers. Cancer vide the three 'thousand' dollars that would be 'necessary to assemble 'and transport the exhibit, and after he had finished, reading it Dr. Borow said that the Union had supplied the money and the exhibit had been widely' displayed. Dr. Borow then introduced Daniel Marihorski, a patient in whom he had discovered an abdominal qaesotheKusna a few months' earlier. 'Madbcrrski, a gaunt man in (its middle fifties, told the is the major problem. Cancer accounts for .seventy-five per cent of tlic excess deaths among the asbestos-insulation workers studied by Dr. Sclikoff and Dr. Hammond, and this asbestos-cancer hazard is not appropriately covered by the proposed asbestos standard." Dr, Nicholson went on to say that no knowledge now existed of a safe work ing level at exposure to asbestos which would prevent the occurrence of can- audience with calm and dignity that he had contracted mesothelioma while working for Johns-Manville, and that he hoped his personal misfortune would ; cer, and he urged that asbestos not he used in the workplace except with ap proved techniques and methods de signed to remove asbestos dust from the encourage government officials to act promptly so that it would tfot be shared working environment. "There R evi dence that a standard of two fibres per by other workers. cubic' centimetre of air will be inade quate for the prevention of asbestos dis- THE hearings lutd begun hy the time I had had some lunch and ease," he said. "The recently measured long-term exposure of the asbestos-in returned to the conference room. As I sulation workers, whose disastrous dis- took a seat, I saw that Macihorski and ' rase experience has been documented Dr. Borow had been giving testimony by Dr. SelikoJF and Dr. Hammond, at a witness table at the front of the was approximately three fibres per room--to the right of Goldberg, the cubic centimetre, even prior to the im hearing examiner, and directly opposite plementation uf improved control a cross-examination panel consisting of measures.'* - * Nicholas DcGregnrio, an attorney with Another of the afternoon's witnesses ; the Department of Labor's Office of was Dr. Sidney Wolfe, who is the di ; the Solicitor, and Gerald Scanncll, act rector of Ralph Nader's Health Re ing director of the Occupational Safety' search Group and a former medical and Health Administration's Office of researcher on the staff of the National Standards. Toward the end.of his re Institutes of Health. Dr. Wolfe testi marks, Dr. Borow said tltat lie had fied that "if workers were guinea pigs now encountered fifty-two cases of and asbestos were a food additive, the mesothelioma in the Manville area, and Delaney Clause of the Food and Drug that all the victims of the disease had Act [which prevents the introduction worked for Johns-Manville with the, into the marketplace of any substance exception of two, who had simply lived known to cause cancer in test animals] in die community. would have mandated the elimination Dr. Borow and Macihorski wen? of this carcinogenic dust from the en 1 followed at the witness tahlc hy Dr. vironment bmg ago. However, in Nicholson, of the Mount Sinai En 1972, twelve years after the publica vironmental Sciences Laboratory, who tion of data allowing the relationship began his testimony by stating that the between asbestos exposure and meso- health experience of American asbestos thclioniain humans, and at a time workers could be described only as a when there are now hundreds of rases national tragedy. Referring to a mor of this cancer in workers exposed to tality study Dr. Sclikoff and Dr. Ham asbestos, the slaughter continues. Under mond had made of insulation workers these circumstances,- regulations which in the Newark-New York area. Dr. do not ultimately reduce the fibre count Nicholson reminded his listeners that <i rero fail to comply with the Oeeu- two in ten of those men had died of itional Safety and Health Act of lung cancer, one in ten of gastroin 970, which clearly states that `no vm- testinal cancer, nearl) one in ten of oyec will suffer diminished health, mesothelioma, one in ten of other can inrrinnni ca|vicity, or^Iife ex|x*ctanc\ cers, and almost one in ten of aslies- a result of his work experience.' " tosis. "Past standards are not an ap l)r. Wolfe was succeeded at the uit- propriate -reference in setting a new ess table hy Anthony Maw/ocelii, wlm permanent standard for- occupational ax accompanied by his assistant', Steven' exposure to asbestos, simply because all Vodka, and who stated the position nT SjjFstandards were conceived ^oly for lie Oil. Chemical, and Atomic Wurk- tne"' piifpitse' of preventing ashestnsis," Dr. Nicholson continued. "But ashes-1 rs -lntcniationuI Utiioit in blunt lan~ guage. "The pnijmsed f.alxir 1 )r|>:irt-_|- ment standard for exjKisurc to asbestos dust is a very sad document," lie saki. "It serves to confirm what many mem- bers of our international union already Hear--that the [Occupational Safety v* Health] Administration is frivolous v the health and rights of working people." Mazzncchi went on to say that there were far more pcsiple ex posed to asbestos in tin: workplace than one was usual})* led to believc^ "The often quoted Labor Department figure of two hundred "thousand workers isn't conservative, it's ridiculous," he declared.."In our international union, which represents one hundred and eighty thousand workers in the oil, chemical, and atomic-energy industries alone, almost every shop and plant uses asbestos in one form or another. For i example, in a major oil refinery on the-; East Coast--Mobil Oil in Paubboro, ! New Jersey--asbestos has captured our concern as the single most serious in dustrial-health hazard in- that facility. We had nineteen workers who handle : asbestos-insulation materials in that re- i finery examined by Dr. Irving SelikofF, | of the Mount Sinai School of Mcdi- | cine. Dr. SelikofTs tests revealed a very serious occupational-health problem re sulting from their exposure to asbestos. Now our concern b that two to three 1 'red other workers--pipefitters, bu^rmakers, welders, bricklayers, and others who work in and around this in sulation--may also have been overex posed. Asbestos turns up in the most unexpected situations. Recently, I was touring a plant in nordtern New Jersey where Presume antifreeze is made. At one point in the tour, I caught a com pletely unprotected worker dumping i asbestos into a vat of antifreeze. He told me that aslicstos is what gives Presume its anti-leak quality. If that was an unexpected situation, then what . has been our experience in- a primary asbestos plant--for example, one that . manufactures asbestos-insulation prod. ucts? Up until recently, the Q.C.A.W. [Oil, Chemical, and Atomic Work! ers International Union] represented workers at the Pittsburgh Corning Cor poration's asbestos plant in Tyler, ' Texas. Thb plant was the sister to the ; Union Asbestos & Rubber Company's factory in Paterson, New Jersey, where Dr. Selikoff conducted his now famous . mortality study tif antositc-asbcstos v ers. At the Paterson plant, Dr. &_-off found tiiat total deaths -were more than twice the numltcr "antici, pated, and now .at the Tyler plant rite National -Institute .-for Occupational Safety and Health lias already found ; tiiat seven otit of eighteen workers with ten or more years of employment meet at least three of four criteria for asbesioris. Worse yet, H.E.W. studies of the plant dating back to 1967 have found grossly excessive lcveb of asbestos dust throughout the plant. While thb par ticular factory employed only sixty or so people at its peak, the turnover was such that nearly' nine hundred men had worked there fur varying periods of rime from 1954 to 1972. The story of Tyler b sadly filled with episodes of corporate indifference and governmen tal secrecy." /Mazzocchl went on to say that, be cause even very small quantities of asbestos were known to cause cancer, the union was recommending that exposure to asbestos ultimately be, reduced to zero by* the enforcement of strict equipment-performance stand ards. "All manufacturing, mainte nance, and other industrial and con struction processes using asbestos must be reengineered so that they perform at zero exposure," he declared. "\Ve pro pose that industry be put on notice, as soon as posable, that within six months ' of the effective dateof thb stand*rd, no worker shall be exposed to more, than two fibres per cubic centimetre of air; that within two years thb level sliall be reduced to one fibre; and that within three years of June of 1972 zero ex posure shall he the law. As for respi rators, they should be audiorhrxd only when the employer has a definite abate ment plan to reduce tile exposure to as bestos through engineering means. The oilier situation in which respirators would be allowed b wlierc there b no feasible technology for controlling as bestos dust." Mazzocclii added that the Occupational Safety and Health 'Administration's proposed standard on medical examinations tif asbestos work ers would truly allow the fox to guard the chickens. "'Hie rtn-diyal communi ty, like many tidier professional groups ut this ctmntry, has physicians that in dustry can rely on to ilcny valid qccii- patHiiml-disease claims of workers." -fie said. "Theiefoit?,'. Wi1 recommend that workers lie .allowed to have annual physical examination^ performed on them by .doctors of their own cltoicc, hut at the employer's expense. Further more,'the records of these examinations should not Ik* sent to the employer bill to a central record-keeping faefity at NtOStl, wlicre such records could be kejit intact and confidential. NIOSI1 . would then send each employer an :in.. nual statistical summary on the exami- f all lib employees. It hatisKn. ir *M-cxjirichce,Vm case after; ensty '<5 that as sooii ias ntanagi-mciit finds oitt Ilow badly it has injured the health of . a worker, management docs its host to get rid of him. Thus these records need to be kept intact for at least forty years." Mazznccbi concluded by de claring that a deficient standard for protection from the hazards of asbestos would legislate sickness and an early death for thousands of people. "Faced with thb prospect, I would seek no new rule at all, rather than he held responsi' ble for tlic awes'of asbestos disease that will surface thirty yean from no.w," he said. One of the final witnesses of the aft. emoon was Alex Kuzmulc, a governor of the Asbestos Textile Institute-- which in 1964 had sent a letter to the New York Academy of Sciences urging : caution in the public discussion of medi cal research into asbestos disease ip or der "to avoid providing the bask for possibly damaging and misleading news stories." Kuzmuk now testified that the Asbestos Textile Institute was opposed to the KIOSH criteria document and to' tlic recommendations of tie Secretary of laibor's Advisory Committee on rite Asbestos Standard. "Wc find tint even the five-fibre standard b not feasible for us," Ik said. "Indeed, it will price - .American-made ashestos-textfle protlI ucts right nut of the world and do- ; mestic markets, with the result that imports from nations where workers = are under no such protection will flood the couutiy. Wc feel tiiat tlw proposed j. standard's based upon incomplete studj' ies and tiiat new evaluations arc ncctlI ctl. Pending more comprehensive suitlj ies, we respectfully urge the Secretary of Labor to reconsider the establishment of asliestos standards, to reinstate the - threshold limit value for asbestos dust ; at twelve fibres per cubic centimetre, and to provide for representation of the Asliestos Textile Institute on future advisory and study committees." WHEN Goldlierg recessed the first day's session, I Hew hack to New York, wlierc business kepi me during the second day of the hearings. 'Fhe day after tiiat---Thursday, March 16th--I tnlik an- early plane to Wash ington to. he present for wluit GohlIk-rg had referred to previously in the ' proceedings as the Joltns-Manville ' "scenario." The conference room of the InterdejKirtinental Auditorium was aliimst full wlu-n I arrived, just hefore 9 A.M., and the hearings got under way ' prinnjitly, with John H. Johe, Jiluis^ Manviilc's cxecittive.'vice-jiroiilent. for : <ijkrations, rilling -tlowii at die/witness: "..j- (abTc^uil- stating tliafdtc ashosf<ts^in~ . dustry liad first supported research.un (uvntk-s, .it tlie Saranac Lalmratory of t)ie Trudeau Foundation, in Saranac 1-nke, Si-\v York, and was at present >upponing such research at itwrc than half a dozen medical sclvnils in the V d States and Canada. He went on to ...y tint ahlHHigh the ashesto* in dustry recognized its rc^mnshtUty to .uipjiort the intent of the Occupational Safety and Health Act, there was no credible evidence demonstrating the necessity for a standard lower than five . fibres per cubic centimetre of air. Jnhc was' followed by Or. George W. Wright, a.longtime pan! medical con sultant for Johns-Manvilic, who was also director of medical research'of the Department of Medicine of St. Luke's Hospital in Cleveland. Dr. Wright be- : gan his testimony h\ saying that-hc had : been cunducting research on asbestdris since 1939, first as a member of the Saranac Laboratory of the Trudeau Foundation and then, since 1953, at St. Luke's HuqWul. After reviewing the various standards, for occupational ,ex posure to asbestos that had been in ef fect over the years, Dr. Wright told the hearings that no evidence had been found to^indicate that, the present as bestos standard should be changed. "Moreover, since I believe that the fiv--fibre standard will certainly pre s' ashestosk, I am in complete dis agreement with the NIOSH criteria document with respect to its expressed opinion that the data relating asbestos exposure to biological reaction are in adequate to establish a meaningful standard at this time," lie said. "While the evidence may not he as far-reach ing as wc would like, it is scientifically valid, and adequate to support as a first approximation tlx- opinion that the pres ent standard of five fibres per cubic centimetre should not he lowered, but left as it is." According to Dr. Wrigh't, a recent Study conducted by Dr. Jdui Cor bett McDonald, of tlie Department of Epidemiology and Health of McGill University, in Montreal, furnished j strong support for -not lowering tlie asbestos standard below five fibres per cubic centimetre of air' and proof titat-nK-sotitcliomn was virtually absent in people who were excised only to chrysoule asbestos---a type of the min eral that accounts fur ninety-five per cer- of the world's production, and the t\ dtat Johiis-Mnnvfllo mines, uses, anti sells alnmst exclusively. "Mcsotlielioma appears to he predominant-: ly linked with exposure to crocidplilc or anrorite," Dr. Wright declared. "Tliercfnrc, both'nf lliese types of as- Ix-stos should be. controlled more strin- then criticized certain aspects of Dr. SelikofTs and Dr. Hammond's mor tality studies of the asbestos-insulation workers; the studies did not include adequate control populations, he said, and the incidence of mesothelioma among these workers was caused not by their exposure to chtysotilc but by their dual exposure to chrysotile and amorice. He ended by reiterating his support Af the fivfc-fibre standard, be muse, as- he put it,-"tins is a correct standard and constitute* a level of ex posure tfuit will protect against the de velopment of asbestosk and broncho genic cancer." Thus far in the hearings, there had been very little cross-examination, but when Dr. Wright concluded his re marks a number of people made it known dut they had questions to ask and points to make concerning his testi mony. Among them was Nicholas DeGregorio, of the Department of Labor, who pointed out with somexsperity that he had never heard tlic validity of Dr. SelikofTs and Dr. Hammond's study of the asbcstns-insulation workers ques tioned by any of the leading epidemi ologists in the field. After a short recess, tlic Jnlms-Manville testimony continued with tlte ap pearance at the witness table of Dr. Thomas H. Davison, wlw introduced himself as the medical director of the corporation. Dr. Davison's testimony was very' brief, and was -chiefly con cerned with his objections to the' pro posed frequency of medical examina tions for asbestos workers. When he competed his remarks, he was suc ceeded at the witness table by Edmund M. Fenner, the corporation's director of environmental control. Fenner testij fied that Johns-Manvilic had worked diligently to lower dust levels in all its plants. He also criticized the two-fibre standard promised in the document, on tlte ground tliat adequate monitoriugand dust-sampling equipment was not available to measure such a level. Then Dr. Fred L. Puiidsack, joltns- Mattvillc's vice-president for research and development, came to the witness table. "Pcrlui|is nowhere else in the as bestos standards lieiilg considered Otdsiv k the ojipominitv to bring almut had diariges so dearly evident as it k in some of tlie projmsed label require ments," Dr. l'ttndsack said. "If these tahel requirements are adopted in their proposed form, they will in our opinion destroy large amounts of'the industry at^dmtiuaie.thiHisniids of jolts^yir,PundsacIT. vveht on to declare tlijt warning labels heed only indicate that nrecautinnan- strrw should b<- taken need not contain terrifying language, such as the word "cancer." He pointed out that asbestos is not an acutely toxic chemical or drug that reacts within minutes nr hours, nor is it an explosive, nor can it he absorbed through the skin. "Therefore, the application of frighten ing labels to ashesto* is inappropriate," he said. "Instead, wc. recommend that a caution or wanting label with the fol lowing type of text be used on bags or containers of asbestos fibre: 'Caution-- This hag contains chtysotilc asbestos fi- hne. Inhalation of asbestos in excessive quantities over long periods of time mat- tie harmful. If proper dust control can not he provided, respirators approved by the. United States Bureau of Mines for protection against pneumoconiosis-pro ducing dusts should be wont.' " When Dr. Pundsack finished his remarks, there was an hour's recess for lunch. .The first afternoon witness was Henry B.Morena, senior vice-president for die industrial and international divi sions of Johns-Manville, who said that the company's dust-control programs had already cost twenty million dollars. "For us to achieve a standard of two fibres per. cubic centimetre would re quire capital .expenditures of twelve I million dollars, and additional operat- ; mg costs of five million dollars per year," Moreno declared. "It would amply not he economically feasible to cjicrate at this level in five of our plants, which, if closed down, would put sixteen hundred employees out of work. This and similar closings across the country would have a substantial effect upon the nation's economy, and would result in higher costs reflected all across the hoard. In addition, Japan Taiwan, India, other Asian countries and nations in South America woulc come on strong and flood the Ameri can market with asbestos products. Foi these reasons, wc believe that it would he nothing"'less than complete social irresponsibility to adopt a two-fibre standard for occupational exposure to asbestos without stronger medical evi dence tlian that which presently exists." ; When questioned hy_])r. Nicholson, Moreno,- like Dr. AVright before him, ,. sought <o place-ciirysotflc asbestos above suspicion as it cause of mesothelioma, and, like Dr. Wright, he implicated amoshe. Moreno declared that from 1930 until 1960 all hlgh-tcmpcrature- insulation materials contained amosite, tliat since I960 there had been a trend away from amosite, and that far. the past ,,fivg._ycars almost.no amoshe had been used.. _ ./. ' . 'i'V. i Knowing that. Johns-Manrille ha'd long been attempting' to absolve clm's- 7. site asbestos fur the occurrence of tneso- . points not in my written submission, in tiiclinma, and tliat most members of t order to clarify my' position here," l)r. the independent medical and scientific , McDonald continued. "The first point community considered such efforts to he ! is that I am a full-time .employee at self-serving, I was not surprised to hear | McGill University, and an independent Dr. Nicholson strongly question More- J research worker. 1 do not work, nor tr 'xHit his statement that anwrite a$- am I associated, with any asbestos pro K j had been a major constituent of ducer or manufacturer. The research I insulation materials between 1930 arid shall he describing is supfmrted by 1960. Later, I learned tliat Dr. Nklw)- grants, not to me hut to McGill Uni son reinforced this refutation by tend versity, from a number of sources-- ing an addendum to Goldberg on the Institute of Occupational and En March. 24th for. inclusion.in the record vironmental Health, the Canadian gov of the 1tearings. Dr. Nicholson's ac- j ernment, the British Medical Research companying letter referred Goldberg to | Council, aiul the United States Public two tables of information he had in- { .'Health Service. I am not here to sup eluded in his addendum. The first table, ; port the testimony or position of Johns- which listed the quantity' of asbestos j Manvillc or any uther body affected by used in die manufacture of insulation j the proposed regulations." , materials in the United States between Dr. McDonald went 'on' t quote at 1920 and 1965, had been furnished by j length from a report entitled "The Dr. Pundsack himself to Dr. Selikoff Health of Chrysorilc Asbestos Mine for presentation at the Fourth Interna- ! and Mill Workers of Quebec," which tfortid Pneumoconiosis Conference of ' he and some colleagues were preparing the International Labor Office, held for publication in the near future. Dr. in Bucharest, on September 29, 1971. 'McDonald said that he and his associ The second table, compiled from the United Sum Muuridt Yutrbookt, ates had begun an epidemiological study of miners and millers in 1966, using listed imports of amnritc asbestos into records of the Quebec asbestos-mining the United States' during those same companies to identify'all persons known yean. Since a comparison of die two 'to lave worked in fhe industry since tables showed that only a few hundred its inception, in 1878. He explained tons of amositc was imported each year that the mortality aspect of the study between 1920 and 1940, and that this : was limited to those men who liad a nt was only a small fraction of the worked for a month or more, and who tot amount of asbestos used in the ' manufacture of insulation materials were bom between 1891 and 1920, adding that he and his colleagues liad during tlut period. Dr. Nicholson already published an initial analysis of 'pointed out, "clearly, amorite could 'have been only a minor constituent of ' insulation material until World War II," and even through 1950 "it could only represent a small fraction of the the mortality experience of these work ers. Dr. McDonald then said that about eighty-seven per cent of the II,-- 572 persons included in the mortality study liad been traced- hy the end of ' asbestos used in non-marine commercial and industrial insulation, if one con December, 1969, amt that 3,270 of them liad died. "Cancer of the lung siders the extensive use in shipbuilding." Dr. Nicholson concluded his letter-by calling Goldberg's attention to a table' showing tliat the disease experience (in cluding mesothelioma) of shipyard in- *' sulation workers was not significantly, different from tlie disease experience of non-shipyard insulation 'workers. "It is not possible to assign an important role to amorite in die insulation workers' ! experience," lie wrote. sltowcd a rising death rate with in creasing dust exposure, particularly in tile two highest dust-exposure groups," lie continued. "Of one hundred and thirty-four deaths from respiratory cancer, tliere were five from pleural mesothelioma. These cases, lunecver, sitowed no clear rekuionship wTtli dtisi ' exposure." . . Later iji. firs presentation, Dr. Mc Donald assessed tlie .results of his mor tality study hy declaring tliat the num AFTER Dr. Nicholson's cross-cx- amiualiou of Moreno, the seat.at ber of excess dentils related to asbestos exptisure among the workers he h:ul in tile witness table was taken by I)r. Me- . vestigated prohahly constituted mi more Donald, who stated at the outset tliat than two per cent of the total of 3,270 Iw s a professor of epidemiology and dentils; tlwt most of these deaths were die cliairntan of the Dc|iartment of | caused hy lung cancer and piteumo- Epidemiology and Health of McGill ; coniosis . (hy which Ik* presumably University, and tliat he liad sjiecialized ;j in cjmlcmiulugy for .twenty-four years. ri.t: asbestos**); and that almost all excess asbestos-related ^Seatlis "I would now like to add cite or;twci ^cctirred anfong workers employed in tlK highest du$t-cx|x>sure categories. After pointing out that die death rates from cancer and niesodtclinma among die ch rysotile-asbestos miners and mill ers he had studied were very low com pared with die dcadi rates front those diseases found among die insulation workers studied hy. Ir. Selikoff and Dr. Hammond, Dr. McDonald con cluded that only high levels of exposure to chiysoiSc asbestos during mining and mflHng'operations had an apprecia ble effect on mortality. Dr. McDonald ended his presentation by further-con cluding, from die findings of his study, that a reasonable standard for chiysotOc mines and mills would be some where between five and nine fibres per cubic centimetre. When Dr. McDonald finished his testimony, lie was questioned at some length by Dr. Nicholson and by DeGregorio. Dr. Nicholson's questioning elicited a statement from Dr. McDon ald that in a previously published re port on mortality among the Quebec asbestos miners and millers, he had concluded that among those workers in his cohort who were exposed to the highest level of chrysotile dust the in cidence of lung cancer was five rimes that of the workers exposed to the lowest lcveL He also obtained an ad mission from Dr. McDonald that his recommendation of a standard of be tween five and. nine fibres was based upon a 'total of only thirty-two fibre counts made in mines - and mills of Quebec iii the summer of 1971. DcGregorio, too, asked Dr. McDonald a scries of pointed questions about the sci entific Validity' of his study. He ei pressed open skepticism of I)r. McDor aid's ability to substantiate the accurac of clttysorile-expusurc levels tliat work ers were exposed to during the nine teen-fifties and the nineteen-sixties. He also obtained an admission' from him that not all the effects of whatever ex posures there may have been were ob served-directly hy Dr. McDonald and his associates--through, for example, the examination of autopsy material-- f but tliat they liad been uiiscrvcd by oth er people and recorded by them in re ports and death certificates, which he and his associates had then included in their study as valid. I .was not surprised to hear Dr. McDonald questioned in this manner, for several members of the independent medical and scientific -community bad ; previously expressed grave reservations ! to me about-the acctiraq- of tlie con; elusions ;hc and his. colleagues--had .! drawtiriitsi report^uLdit-iFotudy which liad appeared- in June of :1971, tii-VoI; ' fluffy-'-: -umc XXII of the Archivet of EtnAron~ mmini it,-tilth, under the title "Mur- tality .in the Chnsntilc Asbestos Mines and Mills of Quelicc." Some people had pointed out tltat many, if not most, of 'the workers studied by Dr. McDonald 'd have had little or no exposure In ~...>ornc asbestos fibres, because they had worked in <i|>en-.nir pits, extracting asbestos in wet-mck form. Others de plored the fact tltat Dr. McDonald and his associates had conducted very little pathological review* such as the exami nation of autopsy material and lung-tis sue slides, in arriving at' their conclu sions. Still others pointed out that niiKty per cent of the lung cancers and meso theliomas found in insulation workers occurred twenty years or more after die onset of exposure to asbestos--as, for example, in the cases of men who'began working with asbestos at the age of twenty, and who died of cancer at 1 fifty--and that by omitting persons bom before 1891 Dr. McDonald and his associates had excluded from their calculations precisely the people who might be expected to show the effects of asbestos inhalation. (It was as if in studying the total occurrence of gray hair one refused to look at anyone born more than fort}' or fifty ycart ago.) In -addition, a number of people pointed < that by including only deaths that irred twenty years or less after the -onset of exposure, Dr. McDonald had perforce diluted the major disease effect of asbestos in his study. Perhaps the most telling criticism of Dr. McDon ald's study, however, was made in a letter sent to Dr. Selikoff on Januaty 7, 1972, by Herbert Scidman, who is chief of statistic.-il analysis in the De partment of Epidemiology and Statistics of the American Cancer Society. Seidman's critique was included in the ad dendum for the liearing record that was submitted by Dr. Nicholson. It de scribed some of Dr. McDonald's meth ods of computing death rates as Milladvised." It pointed out the lack of consideration that Dr. McDonald and his associates had given, to the impor tance of the long latency period m the development of asbestos tumors, and it described the methodojqgy used in the study to asara separately the impor tance of cumulative dust exposure and ' duration of exposure in.relation to lurig cancer as "inappropriate," because of it'~ "paucity tif basic data." In condu- , Scidman wrote, "I think that the lata have been collected fairly well but analysed quite poorly." As a layman, I had little way of judging the scientific validity of D^ McDonald's work except through theji ' 1 observations of tliose members of the independent medical community who had communicated their opinions of it to me. However, I had brought with me to the hearings a copy of Volume XXII of the Archivn of EtnarottmcHt*l Hrfilth, containing Dr. McDonald's article on mortality among the chryso lite-asbestos miners and millers of Que bec, which had been sent to me some months .earlier by William P- Raines, a .vice-president and director of public affairs for Johns-Manville. {Since Dr. McDonald had referred to this mor tality study during the course of his testimony, and since anyone attend ing the public hearings had the right to cross-examine witnesses, including members of the press, I decided to ask him some questions about it. After re ceiving permission from Goldberg to address Dr. McDonald, I reminded him that in his opening remarks he had declared that all his research had been performed independently. "That is correct," Dr. McDonald replied. "All things arc relative." I then reminded Dr. McDonald that John Jobe, the executive vicepresident for -operations of JohntManvillc, had testified at the morning session that his company was supporting research on asbestos disease, and asked him if that was research other than what he had performed. "I guess what Mr. Jobe is referring to is the fact that Johns-Manville; to gether- with other mining companies, helps support the Institute of Occupa tional and Environmental Health, which is a granting body that receives research applications, and which there fore indirectly supports our research," Dr. McDonald replied. "Now, it is a very indirect relationship." I then pointed out to Dr. McDonald tliat at tlte end of his article in the Archives of Euwonmrntnl Health, a credit was listed in small type: "This work was undertaken with the assist ance of a grant from the Institute of Occupational and Environmental Health of the Quebec Asbestos Mining Association." "That is correct," Dr. McDonald said. With tltat, I took my seat. Dr. Mc. Donald liad just indirectly admitted tliat Johns-Manville, together with other asbestos-mining companies, sup ported the Institute <if Occupational and Environmental Health, and tliat the institute, in turn, had helped sup port fiis study. Moreover, the credits afcthe end of his article, which listed no fn5ntti: support otlier than tlfifcsupr plied by the institute, had given the full nnd correct title of this organization-- tile Institute of Occupational ami En vironmental Health of the Quebec Asbest< Mining Association. It seemed unnecessary to point out to the repre sentatives of industry, labor, govern ment, and the independent medical and scientific community who were gath ered in the conference room something tliat many of them already knew--that Joluu-Manville is, and for the past quarter of a century has been, the dominant member of the Quebec As bestos'Mining Association. When {tic hearings were adjourned that afternoon, Ivan. Sabourin, former attorney forthc Quebec Asbestos Min ing Association, came up to me and introduced himself. We talked briefly, and then I took a plane hack to New 'York. I had never`met Sabourin be fore, but I remembered reading some thing about him in .connection with McGill University in a copy of the minutes of a 1965 meeting of the As bestos Textile Institute. The following day, I took tlte minutes from my files and read them again. They informed me that a meeting was held on June 4, 1965, at the Motel Le Provence, in Thetfiird Mines, Canada, and thjry quoted Sabourin as raying that a recent article associating asbestos and cancer in the Journal of thr Americah Medical Aitocifitiou was not convincing, and expressing regret over the adverse pub licity tliat resulted from such articles. Sabourin tlien told the meeting tliat the Quebec Asbestos Mining Association . wished to study respiratory diseases re lated to chrysolite asbestos, and that it was seeking "alliance with some uni versity, such as McGill, for example, so tliat authoritative background for |ihlicity can he had." According -to tlte minutes, the next qleaker at the meeting was Dr. Le\vis_ J. Cralley, of tlie United States Public j Health Service, "who for the past sev eral years has been supervising the ex-; tensive environmental study of asbestos employees in textile plants in the U-SA." I)r. Cralley told the meeting that "tlie study was going well," that the Public Health Service was now ex- ^ lending its work into other asbestos in- j lliistriet, and that "the `results to date I certainly justify the program and its : furtlicr. expansion." Dr. Cralley did not elaborate mi what these results had been, nor, for that matter, did lie ever see fit to officially Warn any segment of tlie asbestos industry, least of all the workers, that the daw he was collect-, ing showed that "men employed in as- -- hestos factories aerate file Lind-were gg k-Tfgt^Jviscd. tu-griwwly'rxci'ssivo levels .5" of asbestos dusty and that excess mnr- y lality Ircyn -asbestos disease among down of many asbestos-manufacturing Had been given the Distinguished Serv workers in asbestos-textile factories had plants, with an attendant loss of jobs ice Award of the Health Physics So reached tragic proportions. (Indeed, and an influx of foreign asbestos-prod ciety.) Holaday addressed himself at six years passed before Dr. Johnson and Dr. Wagoner unearthed the data ucts into the United States. Repre sentatives of labor unions n the other the hearings to the problem of how best to control asbestos dust: buried in Dr. Oralley's files and under- hand, urged that the safety and health The use of procedural standards, by ( to do something to rectify the ap- of workers be placed ahead of any eco which I mean regulations requiring the pu..mg situation they discovered.) In this connection, I fotind it interesting to note that out of the jcventy-odd people nomic considerations, that the two-fibre standard be adopted, and that efforts be made to reduce occupational expo use of specified methods of treating and packing material, and work rules that re duce dust production and dispersion, ts die. best means of preventing overexposure* listed in the minutes as attending the sure to asbestos to zero. In a way, to harmful substances, ft is. based upon 965 meeting of the Asbestos Textile much of this testimony tended to be the knowledge that certain operations and nstitute, Dr. Ctallcy was the only invitee from any government, and the only one who did not represent an as misleading, for the hearings on the as bestos standard had become far more than just a disagreement between in processes will release contaminant* in die work area vales* they are controlled. It is also known from experience that certain control measures will markedly reduce or bestos company or a related organiza dustry -and labor over whether the- eliminate these emustuns. Therefore, the tion. At the same time, I also reread a paper sent to roe tome months before standard should he five or-two fibres. The introduction--hy Dr. Sehkoff and his associates at the Mount-Sinai En- prudent course is to require that control procedures be instituted without waiting for information obtained by air samples and dust counts to demonstrate that con by Johns-Manville, which gave a his ,, Yimnraenttl Sciences Laboratory, by tamination has, in fact, occurred. tory of the company's health-research programs. Referring to Dr. Mc, Donald's study of tlie Quebec asbestos miners and millers, the paper had this to say: tficauthors of the KIOSK criteria docu ment, and hy the Secretary of Labor's Advisory Committee on the Asbestos Standard--of proposals for perform ance standards that would a priori re duce dust levels in the manufacturing The second piece of testimony that I found of special interest was delivered on the final day of the hearings by Sheldon Samuels. He began by saying that there were certain advantages in This study is being funded "by the Insti and installation of asbestos products fay appearing at tlie end of the prolonged tute of Occupational and Environmental Health, the scientific research arm of the Quebec Asbestos Mining Association QAMA). As mentioned before, Johnstianville is a principal member of the requiring the use of proper equipment, efficient exhaust and ventilation sys. terns, and safe .work practices was.of crucial importance, /or the carrying out hearings. "As you know, Mr. Gold berg, I did not plan it that way, but it has provided me with an important overview, which I intend to exploit;" QAMA. The Institute of Occupational of perforinance standards would obvi he declared. "The baric issue before us and Environmental Health plays a vital role in the Johns-Manvfllc health re s' 4] effort. Besides allocating QAMA ( , for research projects, the sevenman .scientific advisory, committee of the ously put the horse before the cart, where it belonged. In short, effective jierformance standards would be bound to lessen the importance of and reliance was made crystal dear at your prehearing conference, when Mr. Walls, of the Asbestos Information Associa tion, attempted to prevent Daniel Institute aim reviews, requests J-M re-, ceivea from scientists and scientific or ganizations for money to conduct re search in the asbestos/health field. upon the laborious and time-consuming process of taking air samples and count ing asbestos fibres beneath a microscope in order to determine whether the as Maciborski from being heard, and re ferred to him. in a disgustingly unmen tionable manner. Daniel Maciborski did' not ask to be heard at these-hearings The paper then listed the chairman bestos standard was being complied tfor dramatic effect. He was trying to of tlic Institute's seven-man scientific with. Thus, performance standards tel! you that more than tlie company's advisory committee as I)r. George W. would go a long way toward obviating admittedly advanced environmental- Wright, Director of Medical Research, the kind of cooperation between indus control and medical-surveillance pro St. Luke's Hospital, Cleveland, Ohio.I DID not return to Wellington for I tlu- final day of the hearings, but during the following week,' (hanks to Gcrshoii Fisliliein, editor of the Oc, Health (S Safety Letter, and as a result of reading the Oecufatiotud Safety 6r Health Reporter, a ncwslct-' ter published by the Bureau of Nationnl Affairs, Inc., I was aide to keep abreast of most of the testimony tliat had becti delivered, during the two days of liear- try and government that in factories such as Pittsburgh Coming's Tyler plant had for so many years reduced the-taking of air samples and the count ing of asbestos particles and fihres to a farce of tragic proportions and fatal consequences. I wo pieces of testimony delivered, it the sessions I liad missed were of (articular interest to me in this res(R-ct, * a few days after the hearings were concluded I obtained full texts from tlic men who liad presented them: The grams were needed to reduce the risk to other workers. The issue before us is whether human life can be traded off in tlie marketplace, and wliether work ers must really face death on'the job." ' Saimtels continued his testimony hy urging tlie adoption of performance standards tltat would require equip ment and work practices designed for zero emission of. asbestos. "For a sixmonth transitional period the Industrial Union Department recommends a twofibre level," he said. "Within two years, ings I missed. By and large, this testi mony can true to form, in that it re flected the lieliefs and self-interest of tin-*- wIk delivered it.' Representatives ii e asbestos .industry, on tile orte' ' Itand, stated Hint an asbestos standanl first was given on the second day by Duncan A. Holnday, research associate professor at tlie Miami Sinai Environ mental Sciences Laboratory and for merly a senior industrial-hygiene en gineer with tlie United States Public this level shnnld lie lowered to one fibre per cubic centimetre of air, and, ulti mately, there should be a tent exposure to asbestos dost." Samuels also urged tlie adoption atld strengthening of the JCfOSlf recommendations, for labelling of two fihres (K-r culiic centimetre of air Health Service, w(tcrc he had been asbestiisj for_ monitoring airborne asbes citlter could not lie achieved technically or would Ik- prohibitive, in .ciist, arid tliat it would surely result in';the shutting i | >l< 'n developing' standards ..uranium miners ngSttfiS- ;' } i'. radiation exposure. (For this work,'he tos dusty for conducting periodic medical examinations of-asbestos workers, arid ?or.;guaraiUei,ing' that VhefTefonls 1C  such- examinations be the property of M*<int Sinai ScIhkiI of Medicine's ping department, where dust levels the employee, anl not the employer. Paterson Asbestos Control Program, *% were considerably lower dun on the "Must important of all, any employee where Dorothy Perron and several * production lines, because of a belief-- who Lacks confidence in the judgment' aides (among them Shirley S. Levine. widely held at the time--that the lungs of a physician who is directly responsible Kayla Margoles, and Charles Nolan 1 . of hfack people were somehow more 'to the employer should have the right have been working since 1968 to trace susceptible to dust than the lungs of choose anotltcr source of medical the nine hundred and thirty-three nu-n whites. w.. vice," Samuels declared, adding that who had worked for at least a year be While I was in Paterson, I called Daniel Mariborski had passed a medi tween 1941 and 19+5 at the Union Thomas Callahan, of Waldwick, New cal examination provided hy a Johds- Asbestos & Rubber Company's plant Jersey, who had been a foreman in Manville physician only a few weeks there. I learned that, pressed hy its in charge of tlie asbestos-block depart before his own physician had diagnosed surance company, Union Asbestos had ment of the Paterson plant. Callahan him as suffering from terminal meso paid its workers five cents an hour extra had been sent to Tyler in October of thelioma- * .. to wear respirators, and had threatened 1954 to help tot up machinery for the in editorials published in the plant news new factory tliat Union Asbestos was MOST of the members of the inde pendent medical and scientific paper to fire them if they refused. I also discovered that the workers had community with whom I spoke seemed lodged numemus complaints about the opening there and that was Later pur chased by Pittsburgh Coming. "I stayed a couple of months in Tyler, pleased by what had taken place at the respirators, saying that they'were diffi and then I. was sent to the Union As hearings, and thought it likely that a . cult to breathe through. Indeed, some bestos -pfant.in Bloomington, Illinois, two-fibre level would he adopted by the Occupational Safety and Health of. the men had complained that, unahlc^to work with the.respirators, they where I worked for the next eight years," Callahan told me. "As far as Administration as a permanent stand had coated their nostrils with Vaseline I was' concerned, our biggest prob ard for occupational exposure to asbes tos. Their optimism was based largely upon the reasoning that except for the testimony of Dr. Wright and Dr. McDonald--neither of whom could he considered completely independent medical researchers--the asbesfos in dustry had set forth no real' data to refute the conclusions and recommen dations of the KIOSH criteria docur~ -u and the Secretary of Labor's . kory Committee on the Asbestos Standard. Mazzncchi, Samuels, and other union people, however, expressed a skepticism concerning the Depart ment of Labor's motives and intent which was based upon long and bitter experience. In any event, once the hearings were concluded, nobody in volved in the matter could do much hut wait until June 6th, when, having presumably weighed all the evidence, the Department of Labor was required hy law to promulgate a permanent standard for asbestos. On Monday morning, March 20th, I received a long-distance call from James Bicrer, the president of Pitts burgh Corning. Bicrer started out by apologizing for not getting back to me sooner concerning -my Tequcst to inter view Dr. Grant about the Tyler plant. Then he told me that, upon .the advice i of legal counsel--because of the recent ! bearings in Washington and on ac- - count of possible litigation inherent in the Tyler situation--Pittsburgh Com- i inr -ttuld nut audiorizc me to conduct | ai .erview with I)r. Grant, or, for 'that matter, with, anyone else in Its employ. During the first wrek of April, I drove out to Paterson, New Jersey, arid spent a day at the offices of the and drunk large- quantities of milk in an attempt to protect their respiratory tracts from the irritating amounts of airborne asbestos dust that filled the plant. (Obviously, such measures were pitiful protection against the pervasive nature of asbestos fibres, -for when Dr. Seliknff and I)r. Hammond conducted their study of mortality among the men wlm had worked in the plant, theyj found a gross number of excess deaths resulting from asbestosk, lung cancer, mesntlielinma, and other malignant tu mors. Moreover,.- tlur asbestos-disease hazard extended far beyond, workers directly involved in the production of insulation materials. For example, Ru dolph Wild, the engineer who had de veloped the product manufactured in the Paterson and Tyler plants, died of mesothelioma. He ntay Itavc-itad ample occupational exposure to asbestos, but Ilk daughter also died of mesothelioma, and her only known exposure to as- iicstos'liad occurred when As a child she .Iwd pfayed with samples of asbestos- products her father Iiad brought home from work. In addition to the engineer and hk daughter, Robert E. Cryor, who had been manager of the Paterson plant between 1941 and 1944, died of mesothelioma in April of 1970.) Dur ing my- visit to tin- Paterson Asbestos Control Program, I Went -through nearly fifty separate reports of medical examinations conducted by the corn-. (Kiny's physician which citlier told of abnormal lung X-rays or contained such notations as `Thk man k a pxir risk" and 111 his man should nut he put into a dusty area." tltj^Krirtg the. .war f also discovered all blacks hiiHfctt -_ ^ tlie Union Asbestos plant .in Patenum lem was health. I always wore a respi-' rator at Paterson, at Tyler, and up in Bloomington, and on one occasion I discharged a man who refused to wear his. A. lot of men hated to wear them, you know. None of them seemed to understand the hazard.? - Callahan went on to tell me that he felt that the Union Asbestos people had been concerned about the safety and health of the workers in the Pntcrson plant. "The company doctor X-raycd all the men continually to detect asbes tosk, and, once he suspected .it, he would always tell a fellow to get him self a job out-of-doors," Callahan said. "In addition, the company used to pay its workers an extra five cents an hour to wear their masks, but the men were human beings, you see, and a lot of them wouldn't conform to regulations. Believe me, the company did every thing it could in those days, hut there was. no way it could improve the ven tilation system. In any case, We were a lot more humane than uther jieople in the business.T remember going one day in the early fifties with Edward Shu man--he was then the general man ager of the plant--to sec some Johnsr ManviUe people, in New York. We asked them if dicy knew of any way we ' could, improve ihc dust situation in ur factory. ; My ' Goil, they 'were' brutal bastards! Why, they practically laughed in our faces! They told iisAhat workmen's-compensatkm payments were tlie same for death as for disability, fn ef fect, they told us to let the men work thcmsrlvft to death! Afterward, wv went to the Metropolitan.Life Insprance people. Only one jdoctor over .there JutcSr anything^alxHtf* asbestoskiHe told us that the only solution was to( were automatically assigned to the ship spot iiearly and toll tin- guv to run for lits-Iifc. We did our Ik-m, you under stand, hue a lot of the men wouldn't wear their respirators, and nor engi, livers told us it was imjxissihli- to im-. |>r- -r the ventilation." next day, I dropped by the , J- Mount Sinai Environmental Sci ences Laboratory to see wliat progress i Dr. Scliko/jF and Dr. Haminond had ' made in their investigation into the 1 mortality experience of the Paterson workers. Dr. SelilcofF told me that as of December 31, 1971, Mrs. Perron and her associates had been able to I trace eight hundred and seventy-seven juf the nine hundred and thirty-three {men who had worked at tltc Paterjson plant during the war years. "It was a remarkable job of detective work, and Charles Nolan in particular has been inervdihly adept at tracking down then who appeared to have dropped from right," Dr. SelikofF said. "On the basis of the standard mortality tables. Dr. Hammond has calculated that in a normal population of that me, two hundred and ninety-nine dcatlts were to be expected. Instead, . there were four hundred and eightyfour. As with the studies we conduct ed of the asbestos-insulation workers, tl ason for the excess dcatlis-L-cight( hu..urcd and eighty-five, in this oasc-Vwas not Jiard to come by. There shodld liavc been about fifty deaths from can cer of all sites. Instead, there were a hundred and forty-three. Only eleven of tlie men could have been expected to die of lung cancer, hut there were actually seventy-three--a rate that is almost seven times as high as that of the gen eral population. And though virtually none of these workers could have been expected to die of mesothelioma ac cording- to the mortality 'tables for the general population, there were seven deaths from the disease. Moreover, in this group of men the death rate from cancers of the stomach, colon, and csopltagus were twice as high as they should Imve been. And though none of tile men could itavc been expected to die of asbestosis, twenty-seven of them did." When I asked Dr. SelikofF how Ite felt these statistics for the Paterson workers applied to the eight hundred and ninety-five men who had worked at Tyler factory between 1954 arid 19,^, he shook his head. "T can nnlv say tliat for the younger men--tltose wlto could lie expected to live' from . twenty to'`fifty years after their first exposure to asliestos-y-the future looks awfully ds-ui.-d," lie replied. Dr. SelikofF then told me that in staiulards in genenil, for I whole 1971 Local 800 of the United Paper- heartedly concur with it." makers and Paperwnrkers Union had "I tend to think of number stand asked him and Dr. Hammond to rc- ards in this way," Dr. Nicholson said. ' view the medical histories of its mem "A standard verified as two fibres per bers .to help evaluate-the effectiveness cuhic centimetre of air or five fibres per of Johns-ManwUe's dust-control meas cubic centimetre of air sounds fairly in ures at its Manville plant. uWc have nocuous. .However, it is well to remem since completed this study, which, sad- ber that a worker may inltalc eight lr, serves to corroborate our previous cubic metres, or eight million cubic cen findings," he said, adding that he timetres, of air in a working day. Leav wuuki call Dr. Nicholson in and let ing aside the fact that there' arc many him describe the actual results, since he mote -fibres .smaller than fire .microns iiad headed the field team that devel in length in any' environment contain oped the information. ing airborne asbestos dust, a five-fibte- Dr. Nicholson told me that out of per-cubic-ccntimetrc standard thus be a total of three thousand and seven eoi- comes, in terms of a man's lungs, a . ployees at the Manville complex of forty-millioii-fibre-a-day standard, and factories he. Dr. ScKkoff, and Dr. Ham by die same token the .proposed two- mond had decided to review die histo fibre standard would allow a worker ries of the six hundred "and' eighty-nine to inhale sixteen million fibres a day. production workers who were actively This, you see, is why wc testified at the at work on January 1,1959, and had by hearings in favor of performance stand that time lad at least twenty years* ex ards designed not only to control as posure to asbestos. "We studied the mor bestos emissions but to reduce them as tality experience of these men from dose as possible to zero." - January 1, 1959, until December 31, . When Dr. Nicholson had concluded, 1971," Dr. Nicholson said. "Unhap I asked Dr. SelikofF to tell me about pily, the results were at least as depress the recent development that had caused ing as those for the Newark-New York him to wonder whether the Depart asbestos-insulation workers.and for the ment of Labor would promulgate the men employed in the Paterson plant.' proposed two-fibre standard. By way Using standard mortality tables of the of reply, he handed me a set of docu National Center for Health Statistics, ments that included a page with this Dr. Hammond calculated that one heading: hundred and thirty-four dcatiis were to he expected in this group of people. In stead, there were a hundred and nine ty-nine." Enclosure A' Expert Judgmentsi Asbestos Medical & Industrial Hygiene Dr. Nicholson went on to say that the reasons for this large number, of Beneath this was a request: "Return at toon as possible to Arthur D. Little, excess deaths among the Johns-Manvflle workers were, unfortunately, all too familiar. "Only eight deaths from lung cancer should have occurred, luc., 35 Acorn Pari, Cambridge, Massachusetts, 02140. Retain a eof\ for reference during Phase II." Be neath the request was* a space for th< buttlierc were twenty-seven," he told me. "And tluuigh no deaths from name and affiliation of the person ti whom the documents were sent, am mesothelioma could normally be ex pected, there were fifteen. Cancers of beneath that, under the words "Expo sure-Response Judgments," was a tabl tlie stomach, colon, and rectum lucre of boxes licit asked the recipient to esti two and a half times what they should mate wluit might he the incidence *i liavc been. In addition, tluuigh yirtttally no deaths from ashestoris would liavc been expected among the general pripulation, twenty-four of the Jidtns-Man- asbestosis, lung cancer, and inesothe lioina in a hundred workers after forr years of exposure, on the basis of an eight-hour working day, to two, five, villc employees died of this disease.*'. When I asked Dr. SelikofF if. he tluiught it likely that the proposed twofihre level would he adopted hy the Department of Lahor as a permanent standard for occu(>ational exposure to friwtos, he shrugged. "I have no idea," lie replied. "Tliere has been a . Mtainge development in tlie past week ' me to-wonder, hut before I - tSfy-nw-abiHit it'Td liki'I)r.:NSwdfiin .-to" give-you Iris'' outlook <in 'number twelve, and thirty asbestos fihres per cubic -Centimetre of air. Dr. SelikofF had filled in tile boxes, and these were his estimates: At two fihres per cubic Centimetre, fifty-five of a hun dred workers would contract asbestosis, twelve of -a. hundred would develop King- cancer, and four of a hundred would he afllicted with mesothelioma. -i : At five fibres per cubic centimetre' (has\ ing^hB^judgtnettrSTTT--'ft-hat -had ` hap^ pened t< the -asbestos-insulatton wiirk- ers)_ eighty-five of a hundred would develop asiiestosts, twenty of a hundred . Would contract lung cancer, and seven of a hundred would develop mesotheli oma. Dr. Selikoff'* estimates were, of course, higher for workers exposed to wclve fibres |>er cuhic centimetre of air, and for workers exposed to thirty fibres he estimated that ninety-five of a hundred would be afflicted with as bestos*, twenty of a hundred would he afflicted with lung cancer, and five of a hundred would develop mesotheli oma. The reason Dr. Selikoff estimated fewer mesothelioma* at the highest lev el of exposure to asbestos dust was simpl)' that previous studies had indi cated that there would he more early death* fount asbestosis -af such,levels, and tliat fewer individuals V/oulU," therefore, survive long enough to de velop mesothelioma. 7*hc Arthur D. Little Piiase I ques tionnaire also asked for a judgment on how frequently asbestos workers should he examined, and it stated that all the estimates and judgments solicited would be synthesized and included in a Phase II questionnaire, which would he 'sent out Liter. The front page of .the questionnaire, which was .headed "Health & Asbestos, Phase I Judg ments, Background,"explained what the Arthur D. Little people ltad in mind: The formulation of public policy for euping with an occupational hazard such S* asbestos will necessarily rely upon judg ment until a great deal more research evi dence is availahlc than now exists. In par ticular, judgment concerning the relation ship between exposure and response will he implicit in health standards for asbestos established by the Occupational Safety nd Health Administration in the near future. But judgments, possibly different ones, on the same issue will be implicit in the response of labor and of industry to the proposed standards. As long as judg ments on the response to exposure rela tionship arc implicit rather than explic it and as long as groups affected by the standard lack needed data to buttress their judgments, protracted conflicts are in evitable and difficult to resolve. Moreover, the absence of a clearly defined and credible set of judgments makes it difficult, if not impossible, to identify the various costs and benefits associated with policies or redudng (he hazard. This is so because *he benefits of candidate standards de pend upon projections of lives saved or jUncsses eliminated at various exposure levels. So crucial a matter should not de pend. upon implicit judgment or even the .explicit view of a single expert. We are to a search for a consensus that will .e explicit and credible the necessary judgments on tlte exjvosure-response rela tionship fur axbcstux.'Such a consensus is uught through the participation df l^to 15 qualified experts whose judgments will he obtained, combined, and refined in a systematic way--a variant of tile Delphi process tbst has been used extensively to apply expertise to important issues not i} open to analysis. When I told Dr. Selikoff that I liad never heard of the Delphi process, and asked him what it meant, he sitook his head and smiled. "I've never heard of sc, either," he said. "But I'm pretty sure I knowwhat it means. It means guess work. And what's the point of guessing about the biological effects of aihcitu* when mortality studies of asbestos workers-have already shown exactly what the effect has been?" Dr. ScHkoff now handed me a letter be had written on April 3rd to Mrs. Sonja T. Strong, of Arthur D. Little, Inc* concerning the Phase I question naire. -Regarding the effectiveness of dust-counting as a method of insuring safe working conditions. Dr. Selikoff wrote: As matters now stand, meager use of performance standard* seems to be in tended. In this case, nothing in our experi ence indicate* that die threshold lunic values listed in your questionnaire will provide any effective safeguard against the occurrence of disease. An obvious rejoinder might be: "Yes, but what if they were enforced? How much disease might then occur?" JPoIlowmp. you into this never-never land, in which one-tenth of die workmen wear personal samplers on their coveralls and I the rest of us are at the phase microscopes in the laboratory, the results would still not be very much different, although per haps somewhat better, since peak ex cursions would not necessarily bave been engineered out. I have previously commented on the sorry state our nuclear-reactor industry would be in if radiation control had de pended upon "threshold limit value" rather dun engineering criteria. Can you imagine such regulation depending upon an army of inspectors with Geiger counters ? After describing some of the data de veloped in his studies of asbestos dis-1 case. Dr. Selikpff told Mrs. Strong that at'was impossible to answer with : any degree of accuracy the questions pmed by her firm. He wcnt"on'to point out that the weight of medical and scientific evidence concerning. <lic occurrence of mesothelioma in non- occupational circumstances, such as in families of asbestne workers and in peo ple firing in the vicinity of asbestos fac tories, bore heavily on the advisability of reaching a level of exposure as dose to zero as possible. "The numerous in stances of mcsotlirikima among work men presumably exposed to asbestos as a result of indirect occupational expos- ufc in shipyards, even in the absence of fibre counts thirty years ago, strongly . 1 to.asbcstus disease at lowlevcls of p-xjfcisure,"- his letter continued. ""Lit- | crally hundreds of cases of mcsotltclio- m.i are now known to have occurred in such circumstances." When I hail finished reading the let ter, I asked Dr. Selikoff why the Ar thur D. Little com|iany should lie so liciting exposure-response judgments at - this time. "It is my understanding that A. D. Little has been awarded a contract by the Occupational Safety anil Health Admntittration to formulate a con sensus regarding exposure-response for asbestos disease," Dr. Selikoff replied. "But the XIOSH criteria document, and the Advisory Committee on the Asbestos Standard have' already cov ered this ground hy reviewing all the literature concerning asbestos disease," I said. "Not to mention, the testimony given during four days of public bear.mgs. "True enough," Dr. Selikoff re plied. "However, the A. D. Little peo ple appear to have been specifically charged with determining the econom ic impact of the proposed permanent standard for occupational exposure to asbestos." "Then why a questionnaire focussed solely upon medical judgments?" I asked.. "That is a question I have been ask ing myself," Dr. Selikoff said dryly. "I don't know the answer. If you find out, please tell me." DURING the next few days, I made dozens of telephone calls to people in various agencies of the De partment of Health, Education, and Welfare, in the independent medical community, and in a number of labor unions, trying to ascertain wltat lay b hind the involvement of Arthur 1 Little, Inc., in the process of promt, gating a permanent standard for occ pational exposure to asbestos. The pe< pie I .spoke with at XIOSH were dea; ly unliappy over tile fact tliat a priva consulting firm had been asked, in e feet, to duplicate (if not amend) i the space of a few weeks all the effcit that over a period of years ltad gon into the assessments, conclusions, and recommendations, of tlie XIOSH docu ment. "Look," one of .them told. me. "Ouy recommendation for a two-fihre' siahdard-.ffnd our conclusion that it ts technically feasible were upheld by the Secretary of Labor's own Advisory I Committee on the Asbest<>s Stanilard. However,. A. D. Little is up to some-' tiling that Has no letsis in science and no: specific authorization in the Occh-; pniioual Safety ahd 'lleahh-Act. ItV fryteg to fontra-eiuwnsos for ultatir s-imetunes ^called the `socially-accepN- mill,- iiJt' involved ui <ccu|i:itKut;il ex. |uisurc *tu liuz.-irdnus substances. In otlii'r words, it's trying to determine lime much society is or should be, willing to pay to avoid the loss of lives. dations we made at the public hearings, and nt to participate in the A. 1)^ Little economic-impact study. We have good reasons for believing that the A. D. Little peuplc were 'brought into *" The Act, Imwever, clearly states that j ch employer shall furnish to each i the standard-setting process not just to satisfy the Office of Management and ... his employees employment and a > place of employment which are free ! from recognized hazards tltat are caus- ` ing or are likely to cause death or scri- oils-physical liann to his employees.- " Budget hut tn justify the asbestos in dustry's position. We have learned, for - example, that in the economic-feasibility part of their study the A. I). Little peo ple are relying almost entirely on guess- When I called.Sheldon Samuels, at estimates from the aslu-stns industry-- tlic Industrial Union Department, particularly from the shipbuilding in imwever, I was able to gain a new dustry, in which the government has an perspective nri the matter. "The whale .enormous stake." concept of economic-impact studies, as I asked Samuels if he was aware they now exist, began back in 1968 that the A. D. Little study was also with tiic President's Task Force on seeking medical judgments on the in- Government Reorganization, which * odeitbe of ashesrus disease. ' was headed by Roy L. Ash," Samuels "Indeed I am," he replied. "In fact, told me. "The Ash commission called just the other day I heard that A. D. {or an assessment of all government Little's so-called panel of medical ex- programs in terms of their effective |iera is loaded with doriors who are or ness, and this has since been nude by have'been connected with the asbestos the Nixon Administration's Office of industry'. It'll he interesting to tee this Management and Budget through a meter when the final report of the study whole series of cost-benefit analyses comes out." that are conducted under the guise of environmental-impact studies. The present A. 1). Little study lias some ex tremely serious ramifications. Congress IN the second week of May, I visited Dr. SelikoiF again and asked if he knew of any further developments in to the contrary, and throwing its Oc- the involvement of Arthur. D. Little in -<ation.il Safety and Health Act to the standard-setting process. He told | winds, the executive branch of gov me that the firm had sent him the ernment lias derided on its own that Phase II questionnaire of its economic- tile cost to the employer of meeting impact study. He also showed me a any new occupational-health standard letter he had written on May 9th to . ' must fall within an economic Tange Dr. Meals. The letter said, in part, "I that is acceptable to industry. The ma have carefully considered the asbestos jor point, of course, is the government's -data- forms sent me and am returning order of priorities in the? wluile mat ter. I mean, how in the name of God them to you unanswered. To have completed them, in my opinion, would can a serious, in-depth cost-benefit only contribute further to an inappro study of tltc proposed asliestos stand priate exercise; my original misgivings ard fail to assess as one of its first pri (see my letter of April 3, 1972) arc orities the cost to the worker and tltc now amplified." In conclusion, Dr. . wluile community of the i tcrrihle "in SclikofF told Dr. Meals that the meth cidence of asbestos disease? " odology upon which the A. D. Little When I asked Samuels if the In study was based "could lead to serious dustrial Union Department had heard misconceptions and misdirected advice." from the Arthur D.' Little people, he The following morning, I tele add me tliat two representatives of the firm liad visited him the previous week.- phoned Samuels to.find out if he had any new information about the Arthur "A Dr. Donald W. Meals and an en D. Little study, and' lie said lie did. . gineer qient a wluile day here," Sam "Have ycni looked at your- mail to-1 uels said. "They indicated tliat they day?" he asked. liad lieeii brought into the picture to mediate between labor and industry,' I told hint tliat I had not yet had time' to do so. and to o.uue up with a staniLird for i- ivitinnal exposure to ashestns tliat. . . "Well, see if there's a letter from me." - v .1 make everybody loppy, and tltey asked for our help. I hiring tin* [etst few days, I {Killed the mem bers of our ad-dnic Committee on the AsIk-sois Hazard, anil we linve'dcciiletl to stand firm on the recommen I went through the envelopes on my desk and saw dial there was. . "Well, open r up and talk to. me i later," Samuels said. "You aren't going J - ; ::j3iprKeyc whai's inside.". -jh rises'- ` 'ipfflffa*' 1ringing up;. I ojienedSanui.V letter and pulled out three document? tliat had been stapled together. The first was a press release fur A loml.n, May 8th, sent out hy the Connecticut Development Comniissiim, in Hartford. The second was a letter written on May 4th hy Mark !'VtiiI*erg, manag ing director of the Commission, to jack Cawthorne, executive director of the National Association of Suite Develnp- . mem 'Agencies; in Washington, D.C. The third document was a letter writ ten on Arthur D. Little stationery on January' 2S, 1972, by one John L. , Kent! The letter from Fcinhcrg to ' Cawthorne read: DusJack: We have learned that a Massachusetts- based consulting firm, Arthur D. Little Inc, is attempting to sell a Connecticut manufacturer on moving its plant to Mex ico. That information in itself is not star tling, but what is startling is the fact that Arthur D. Little Inc. has a consulting con tract from the U.S. Department of Labor to measure the impact of'the standards betgg. set for the asbestos industry under the recently enacted Occupational Safety . and Health Act. And the company which : Arthur D. Little is ttying to move from Connecticut to Mexico is also in the asbesto* industry. Thus tt appears to me that at the tame time as Arthur D. Little it car- tying out a federal contract dealing with the asbestos industry and its pnddetns, 1 Arthur D. Little is also attempting to take one of our companies in that tame indus try to A1e.xico. This activity by Arthur D. Little in my opinion looks like a Trojan horse which I feel is highly improper. On the one hand, Arthur D. Little is accepting federal funds and on the other hand, it is attempting t help Mexico attract a firm directly in. volved in the federal project. Further more, it is shocking to me that a Nevv England consulting company which has so frequently put forth the doctrine of hclp; ing economic development here would j "raid" a company in our state. As you J know, wc are certainly advocates of com: petition, free enterprise, .and profit, but 1 when a consultant presumably making a ; profit with federal dollars is at the same . time attempting to take jobs away from our state and out of the country, it is a most serious matter. I do not know what other companies in other states are being approached as our company was, and I feel strongly that the , development directors of the other states ' sImiuIJ bewarned about this Trojan-lmrse , operation which certainly seems to be i against the best interest of the people in ! the various states which may have simitar ! situations. This operation In- Arthur I). iyittlc also serins to hr coijtrary to all the . efforts which we state <U*vrlu|iiiiritt direc tors arc making in cooperation ith the , G.S. Ciovermnrnt to improve the natiooal balance of payments and the economic de velopment of our individual states. Therefore. 1 am enclosing, for your u*r,, the copy of the letter-on Arthur-U.-Littlc HE stationery which was sent to the Connect!-JHI cuFSSnpany being 'Valued.*' I have takeirfv? out the company name and address inJjV- order to avuid embarrassment fur the firm. I stnmcif tup you to tend a bulletin to . aO our member* alerting them to this seri ous problem aa soon aa possible. Sincerely yours,. Mark Fukbbrc Manafnnf Director i PS. You don't suppose there could be a 1 relationship between the health and safety atandarda Arthur D. Little aeta and the eucceta of effort* to relocate American at- beatoa companie* to Mexico? i After several phone calls, I learned that the corporation Anhur 1). Little had attempted to relocate in Mexico was Raybestos-Manhattan, Inc., whose factmy in Stratford, Connecticut, is a ma jor producer of ashestnc hralce linings, clutch facings, and gaskets. A few ..-weeks later, when I was abje to ex amine' * copy of Arthiir D. Little's first report to the Department of Labor, which was entitled "Impact of Pro posed OS.HA. Standard .for Asbes tos," I saw listed among its panel of experts John H Marsh, who is the director of planning for RaybestosManhattan, and who had testified at the puhlic hearings in Washington against the KIOSH recommendation re quiring warning labels on asbestos prod ucts. Meanwhile, I had discovered that the asbestos industry was taking a hard look at the feasibility of moving some of its plants and facilities to Taiwan and Korea, where, presumably, it could operate unhindered by occupational-' safety-and-hcalth regulations. It was already becoming dear, however, that hy involving Anhur D. Little, Inc., in tlie standard-setting process, the De partment of Labor was attempting to counter the recommendations of the KIOSH criteria document, of the Secre tary of Labor's Advisory Committee on the Asbestos Standard, and ofohe members of the independent medical and scientific community who had testi-. fied at the public hearings. It was also becoming clear Iww deeply the medi cal-industrial complex had succeeded in penetrating the workings of the gov ernment in matters relating to the pre vention of industrial disease. --Paul Broijeur ( Tkit it ike third mf trriet / trliclrt.)