Document N26prE921kKEJO4aN1LOn5YgD

i^VU^UJ^OVScU U Saudi 1 Corporate DIVISION Trumbull LOCATION February 21, 1978 SUBJECT: Corporate Policy Concerning the Reading and Interpretation of Chest Radiographs Several years ago a blind round robin reading of X-ray films was conducted between Manheim, Stratford and North Charleston. The correlation was very poor and it was apparent that it would not he possible to make a meaningful comparison of health effects in one plant versus another with such wide variations and. interpretations. For the past two years. X-ray films of Manheim employees have been read and interpreted by a team of experts at the Pulmonary Disease Section of Tulane University School of Medicine. To achieve consistent readings throughout the corporation, we wish to extend this service to ether R/M plants. We realize you may have an agreement or contractual arrangements with a local radiologist and will, therefore, be guided by you with respect to timing and . arrangements. The mechanics of the Manheim arrangements are that batches of 20 new X-ray films, together with all previous films of each individual, are dispatched to Tulane as they accumulate. If the current film is questionable, Dr. Weill or one of his associates will review as many of the previous films as are necessary to confirm whether changes have taken place. Dr. Lewinsohn will send directly to Dr. Goodman samples of X-ray film readings and an explanation of the classification used. The head of the Pulmonary Disease Section, Dr. Hans Weill, Is recognized internationally as an expert on pulmonary diseases includ ing, of course, asbestos related diseases. He has served as consultant to many industries and has conducted extensive morbidity and mortality studies of asbestos workers. He was engaged last month 24 878 G cn G. Ferrucci 2 rv-' by the Irish. Development Authority in connection with environmental questions raised by residents of Cork County opposed the operation of R/M disc brake pad plant. A Curriculum Vitae is enclosed for your Information. Please let me know if you have any questions. /as Enclosure CC: R. M. Gordon H. C. Lewinsohn J. F. Maclachlan ohn H. Marsh MW o 02115 Raybestos ijVianhaitan Corporate rrumbuli V / / i> - Hr-. M. W. Oliver March 2, 1976 SUBJECT: Proposed Reporting on Charleston X-ray Films by Tulane University Every person exposed to asbestos should have an annual chest X-ray as part of the medical surveillance program. It is also advisable to extend this procedure to all employees on site, both office staff and plant personnel. The proposal is that the latest chest X-ray film and all previous films available be sent to Tulane University for reporting. At Manheim employees are X-rayed annually on the date of hire or nearest convenient date and when approximately 20-25 films have accumulated, they are sent for reporting in the envelopes con taining each individual's series of previous films. There is usually a time lag of 3-^ weeks before the films and reports are returned. ' 1/ Reports are sent to the plant physician. If an abnormality is noted which appears to require urgent investigation and treatment, Tulane will telephone the result to the plant physician so that he can take immediate action. The plant physician may call Drs. Weill, Jones or Ziskind at any time regarding their interpretation of a particular film and will receive their help and advice. I am attaching hereto two sample reports and a summary of the coding of a batch of twenty films read in February. When the films have been reported, a copy of the report is also forwarded to me at Trumbull as well as the entire batch of films. I review the films and report on them according to the ILO U/C International Classification of Radiographs for Pneumoconioses. My interest is non-clinical and my purpose is to attempt to assess, on an epidemiologic basis, the present state of affairs with regard to X-ray changes. A copy of my reading is sent to the plant physician and to Tulane University. The plant physician, upon receipt of the Tulane University report, will inform 1/^ the individual of the result and will then take whatever action is necessary to investigate suspected abnormalities. The X-rays will be read at Tulane by Drs. Weill, Jones and Ziskind. The charge ^ will initially be $10.00 per person for review, of the entire package of films in the case of long term employees. It is suggested that a local radiologist report on pre-employment chest X-rays ^ and that this not be sent to Tulane until the annual repeat film has been taken. MWQ 02100 R M-2 it wil. t h e n cost $10.00 for the Weill wha t he proposes to cha rge as I celi eve there then ought (i^cfT^as I hear from him. initial reading. I an waiting to hear frcn Dr. for the annual review after the initial reading be a price reduction. I will let you know as I hone the above information will be of value to you. When you have considered the points made in this memorandum, please do not hesitate to call me to discuss any problems in connection with it. / 3-S attachment CC: Mr. J. H. Marsh Hilton C. Lewinschn MYVQ 02101 ti1k\ Ezinnzrzzz ASBESTOS INFORMATION ASSOCIATION 1745 Jefferson Oavis Highway. Crystal Square 4. Suite 509 Arlington. Virginia 22202 (703) 979-1150 9 August 1978 MEMORANDUM FOE: Merle rs SUBJECT: Plant Physicians Conference In accordance with the expression of interest at our last direc tors meeting preliminary arrangements have been made to conduct a Plant Physicians Conference on the campus of Tulane University, New Orleans, November 9-10. Structured presentations are planned the full day of Thursday, November 9. Informal workshops on areas of special interest will be held the morning of Friday, November 10. Participants would be free to return to their homes Friday afternoon. Objective of the conference will be to provide medical directors and plant physicians responsible for medical surveillance of asbestos exposed workers with a review and discussion in a number of areas of concern including: asbestos related health effects; guidelines for medical examinations; diagnostic techniques with emphasis on chest roentgenography and pulmonary function; physician responsibility on reporting of abnormal findings; and aspects of compensation as concerns the physician. Time will be allocated for discussion of additional matters that may be raised by conference attendees. Participating companies will be responsible for transportation, hotel and meal expenses for those physicians they sponsor. The Association's medical consultant, Dr^_Kans Weill, will be in charge of the conference and will arrange for appropriate discussion leaders. Dr. Paul Kotin, Senior Vice President, Health Safety and Environment, Johns-Manville Corporation and Dr. Hilton Lewir.sohn, Corporate Medical Director, Raybestcs-Manhattan have kindly agreed to assist Dr. Weill. I have asked vice president, John Marsh, to serve as the Association's coordinator for the conference. It is necessary to obtain a definite indication of conference atten dance. Please complete the enclosed form and return to Bob Mereness not later than August 31. A detailed program and additional infor mation with regard to arrangements will be forwarded to your designee with copy to you in due course. I think all of us in AIA/NA concur that a plant physicians conference is now most timely and important. T. A. Dougherty President Enclosure MWO 02120 Dr. H. C. Lewir.sohn Trnnbu LI L North Charleston, S.C. March 21, 1978 Tulane University's X-ray Program Reference your letter of March 7, 1978, to me, under above subject. We will start collecting our x-rays on annual physicals con ducted after April 1, 1978 and when we have collected twenty to twentyfive films, we will mail them to the following address: Tulane University School of Medicine New Orleans, LA 70112 Attention: Robert N. Jones, M.D. Department of Medicine Pulmonary Diseases Section 1700 Perdido Street We have discussed with Dr. Goodman the question of Dr. Jones visiting Charleston to arrange the protocol, and, in our opinion, this is not necessary at this time. If situations arise that would necessi tate such a visit, it could be arranged at that time. We are attaching the procedures we will follow both here in North Charleston, S.C. and Marshville, N.C. If you have any comments or questions relative to the above, please contact me. MWO :MF ccs: Messrs G. Ferrucci J. H. Marsh (Trumbull) J. L. Goodman, M.D. J. E. Greene, M.D. (Marshville) LA W O 02155 /(? -a- /<s y t-riAy w ^uvjCl^G:C(cJ^(DK] OIVISION ,p<J LOCATION TOs Messrs. IX. M. Gordon W. S. Simpson SUBJECT: Bad Science, Politics and Califano G. Ferrucci - n. Charleston M- xcff.y- ---- September 21, 1978 The remarks of Secretary of HEW Califano before the AFL-CIO National Conference on Occupational Safety and Health on September 11, concerning the incidence of occupationally caused cancer, represents a glaring example of the use of "bad science" for political purposes. The document on which Califano based his remarks "Estimates of the Fraction of Cancers in the United States Related to Occupational Factors" contain unsupported assumptions concerning the numbers of persons exposed to asbestos, the degree of exposure in the past, present and future, and invalid extrapolations of mortality rates derived from studies of a limited number of highly exposed asbestos insulation workers. The document was prepared by the National Cancer Institute, the National Institute of Environmental Health Sciences and the National Institute for Occupational Safety and Health. It is known that at least one of the scientists who contributed to the study has demanded that his name be removed from the list of contributors unless changes are made. A copy of the document was obtained by the AIA/NA on Tuesday night and reviewed by the Executive Committee with the assistance of Dr. Weill. A more thorough study is now underway Joy Dr. Weill and other scientific advisors to the Association. Upon completion of the review, a statement win be prepared tor transmittal to Secretary Califano and distribution to members. It is expected there will be severe criticism of Secretary Califano for making public statements based on scientific data that has not been subjected to peer review and that the study itself will be largely discredited. You will be aavi ed of further developments. /as John H. Marsh CC: Management B-card Environmenta 1 Affairs Coordinators A. R. Brauer D. L. Juhl H. C. Lewins ohn J. 0. Pearsc:n G. E. Quandt J. T. Traino I. H. Weaver MW Q 01282 CORPORATE HEADQUARTERS TOO OAKVIEW ORIVE. I HUMBUIL, CONNECTICUT 06U. USA. (203) 371-OIC1 HILTON C LEWINSQHN, MB.. BCh.. D.l H lumkuhatc mcojcal Diftccion October 5, 1978 Hans beill, MM'. Department of Medicine Pulmonary Diseases Section Tulane University School of Medicine 1700 PcrdLdo Street .Mew Orleans, LX 70112 Dear Hans: A problem has arisen at our North Charleston plant -where Dr. McLaughlin is having difficulty deciding on how best to serve our employees' interests because of apparently conflicting interpretations of the same x-rays by your unit and the radiologist in Charleston. Further more, as you will see from the attached correspondence, the findings of the chest physician do not agree with those of your unit with regard to interpretation of x-rays (in this particular case). Dr. McLaughlin, who has very recently been appointed as the full-time Medical Director in Charleston, has to rely upon the advice received from chest specialists and radiologists. Prior to his appointment. Dr. Joseph Goodman had seen many of the current employees, and based upon consultations with the chest specialists and radiologists in Charleston, had informed these employees about their state of health in the light of the opinion expressed by those specialists. Dr. McLaughlin now finds himself in a difficult position when there is a conflict of specialist opinion and in order to enable him to do his iob needs to lave the matter speedily resolved. I would like to suggest that Dr. McLaughlin and Dr. Goodman convene a meeting in Charleston as speedily as possible and that you. Dr. Jones and i Jttenpt to sort out the confusion with the help of the Charleston physicians. I would be grateful if you could treat this as a matter of some urgency' and let me know as soon as possible when such a meeting could be held. Please give one or two alternative dates so that we can try to get all the parties involved around the table. Best wishes Yours sincerely Hilton C. Lewmsohn OCT c September 21, 1972 Hans Weill, H.D. Tulane University School of Medicine Departrrient of Medicine 1^30 Tulane Avenue New Orleans, Louisiana 70112 Dear Doctor Veill: Thank you for taking tine fror. your busy schedule to discuss c methods of screening asoestcs exposed construction workers. It was a most delightful and stimulating day. After I have had an opportunity to discuss with nr/ Management the screening methods which evolved frotr our discussions I will be back in touch with you. Carmel Vagp.enspack very promptly forwarded the additional questionnaire which I requested. Sincerely, Jon L. Kcozen, M.D. JLK:mgs ( \ 002085 //H LAW OFFICES OF Rogers, Field, Gentry, Benjam in < Robertson CLAY C. ROGERS LMAN FIELD REED O. GENTRY JAMES W. BENJAMIN JACK 0. ROBERTSON GENE C. m C R Ri5 MORR'S m . KBOSS REGGIE C.G-FFin CECIL L.CAU.KINS GARY E. LOW E j O H N C.CC2AD SIS- S-A2 - SO 3 I 600 EAST IIth STREET Kansas City, Missouri 64106 October 1, 1973 Mr. Talmadge Neece The Travelers Insurance Company One Tower Square Hartford, Connecticut Mr. W. Rollins Heath Johns-Manville Greenwood Plaza Denver, Colorado ' RE: Borel vs. Fibreboard Paper Products Corporation, et al Travelers File No. B-2778189 L/A 1/19/69 Gentlemen: Enclosed please find copy of letter I have this day written to George Weller on our strong desire that application be made for certiorari to the Supreme Court of the United States, and that the mandate of the Fifth Circuit be stayed in the event of an adverse decision from the Fifth Circuit, so that we can get 90 days lead time to pi'epare uur nation al posture. I think that both of you gentlemen should write a letter to Tucker and to Pate specifically instructing them to see to it that this time is secured by the appropriate motions I have outlined in my letter to Weller and them. Last Friday, my secretary sent to Talmadge Neece a Xerox copy of the Borel Opinion which I was shocked to find had not been forwarded to him from Texas. I likewise sent to him my 18 pages of suggestions which I had sent to Weller to aid in the preparation of a motion for rehearing. I am sure that Pate or Tucker have forwarded the motion of the TRA 037490 0BT2100638 Page 2 Texas lawyers for a rehearing to Heath, but I am enclos ing a copy of these two motions to Talmadge because they probably didn't send them to him. When I talked to Talmadge on the telephone last Friday September 28 he indicated that he had talked to Rollie at some length and this was his first news of the adverse Borel decision. I filled Talmadge in on the trip that you and I took to Beaumont, Rollie, for the office conference with George Weller, et al on Monday the 17th of September. I also discussed the plan that you and I had considered on our trip from Houston to Beaumont of having another national conference of all Travelers trial attorneys in asbestosis cases now pending, in the Johns-Manville head quarters in Denver some time in November. I would like to outline the following points with respect to such conference: (1) It should be held either Friday November 9 through Saturday noon November 10, or Friday November 16 through Saturday noon November 17. (2) The attorneys from 1-fe.ssachusetts, Tennessee, Kentucky Ohio, Illinois, Minnesota, Washington and California should all be specifically invited to attend by both Talmadge and Rollie so as to insure their presence. It perhaps would be desirable to at least invite Pate from Texas (maybe Tucker also). (3) We should send out an advance packet of materials for study, urging the attendees to bring them to the conference and consisting of the following: (a) A Xerox copy of the Borel opinion. (b) A reprint of the Fleicher-Drinker medical report of 1945. BIT 21 00639 TRA 037491 Page 3 Cc) A reprint of the Marr studies of 1962. (d) A reprint of the basic Selikoff paper which appeared in the New York Academy of Science report of 1965. (e) The blue-backed latest study of Dr. George Wright which was distributed at the Cleveland conference. (f) A roster of the names of the prospective attendees so that each lawyer will know in advance who his colleagues are going to be at the conference. (4) If possible, it would help to have Dick Carter as well as Rollie Heath and his assistant. I would like the con ference attendees to meet Parker, the general counsel and McKinney, the vice president. (5) Perhaps Rollie could preside, but if he is not willing to do so, I would be agreeable to preside. (6) Dr. Hans Weil from Tulane University should be invited to attend. I do not think it is necessary to have Dr. George Wright again, it being more important that our trial lawyers meet Weil and talk with him because he will be available to a certain extent to testify in individual trials. (7) I would like to present to the conference an analysis of the Borel opinion and then outline how our cases henceforth should be defended in light of the Borel opinion. (8) The conferees will consist of experienced trial lawyers who should be encouraged to challenge, comment upon and enlarge upon my outlining of trial strategy. (9) Each trial lawyer from each separate area should be asked to report on the status, including readiness for trial and potential trial dates of the litigation under his control. He should also be asked to present in brief outline form the type of case involved, whether a death case, whether involving simply asbestosis or also mesothelioma or bronchogenic cancer or any other differing medical allegations or contentions. SBT2100640 TRA 037492 Page 4 (10) We should discuss ways and means to make sure that the Interrogatory Answer posture of Johns-Manville is consistent throughout the United States. This is a somewhat thorny problem which I know Dick Carter has struggled with for many months. (11) Vfe should also perhaps discuss specifically pretrial defensive investigation techniques, both on the medical and factual side. As you know, we have had two such conferences, the first being in Houston and the later one being in Cleveland. Hotel accommodations must be anticipated as well as conference meeting area. We have selected Denver because it now seems most central for the attendees when one takes into account we have cases in Washington and California. It may be that we would want to start with cocktails and a dinner on Thursday night where the conferees would all get acquainted with each other and then begin the conference Friday morning and plan for a second dinner with cocktails Friday night, and work towards an adjournment by Saturday noon. I would like your specific views on these details because I am not sure what accommodations are available there in Denver. Notice should go out fairly soon to the conference attendees because they are all busy trial men. I had thought to also include in this letter a somewhat de tailed rationale of the strategy we should now proceed to develop in the handling of these cases in light of the Borel opinion, but I will let that await a future letter because this one is already too long and I think we should get the plans for the conference off the ground right away. 112100641 TRA 037493 Page 5 I would be pleased to receive your comments about the conference and its planning as soon as conveniently possible. With best regards, Yours very truly, LF/peg SIT 21 00642 TRA 037494 tilid ASBESTOS INFORMATION ASSOCIATION 1745 Jefferson Davis Highway, Crystal Square 4, Suite 509 Arlington, Virginia 22202 (703) 979-T150 9 August 1978 MEMORANDUM FOR: Membe rs SUBJECT: Plant Physicians Conference In accordance with the expression of interest at our last direc tors meeting preliminary arrangements have been made to conduct a Plant Physicians Conference on the campus of Tulane University/ New Orleans, November 9-10. Structured presentations are planned the full day of Thursday, November 9. Informal workshops on areas of special interest will be held the morning of Friday, November 10. Participants would be free to return to their homes Friday afternoon. Objective of the conference will be to provide medical directors and plant physicians responsible for medical surveillance of asbestos exposed workers with a review and discussion in a number of areas of concern including; asbestos related health effects; guidelines for medical examinations; diagnostic techniques with emphasis on chest roentgenography and pulmonary function; physician responsibility on reporting of abnormal findings; and aspects of compensation as concerns the physician. Time will be allocated for discussion of additional matters that may be raised by conference attendees. Participating companies will be responsible for transportation, hotel and meal expenses for those physicians they sponsor. The Association's medical consultant, Dr. Mans Weill, will be in . charge of the conference and will arrange for appropriate discussion leaders. Dr. Paul Kotin, Senior Vice President, Health Safety and Environment, Johns-Manvilie Corporation and Dr. Hilton Lewinsohn, Corporate Medical Director, Raybestos-Manhattan have kindly agreed to assist Dr. Weill. I have asked vice president, John Marsh, to serve as the Association's coordinator for the conference. It is necessary to obtain a definite indication of conference atten dance. Please complete the enclosed form and return to Bob Mereness not later than August 31. A detailed program and additional infor mation with regard to arrangements will be forwarded to your designee with copy to you in due course. I think all of us in AIA/NA concur that a plant physicians conference is now most timely and important. T. A. Dougherty President Enclosure M.WO 02120