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FILE NAME Corning OC DATE 1964 Oct DOC OC173 DOCUMENT DESCRIPTION Agenda and Abstracts - Conference on Biological Effects of Asbestos . . . a eh mee ' . . oc . ' te o we . 4 - gg ig 3 . eee . - . Fy a . wee 2 0, 8h - 3 vers . + avers :.oF ea oo <> . : f". -. 3 nn ~ s --@ , f al e s oo e < . ue epteSt . Ped roe . . om | coe a re. . . . + \o ne DRRITE tye Fretg yet . ome ; Ce - ~! Cie be toy e . PO oye et tig POY et " OSE tO LESS yodge Vie a er. Sy nx oPELS) reer oo OER 7 Say os tet . PAC . . . te ze 7a wer a ae ee - wer ~ wer CAo Se . . e ~ . - . - . CONFERENC.E.* oy te . we, Oo BIOLOGICAL EFFECTS OF ASBESTOS Monday October 19 Tuesday October 20 and Wednesday October 21 1964 THE NEW YORK ACADEMY OF SCIENCES SECTION OF BIOLOGICAL AND MEDICAL SCIENCES 2 East Sixty Street . New York N. Y. 10021 The evening session on October 20 will be held at the Academy Building eee ALL OTHER SESSIONS WILL BE HELD AT . The Waldorf Park Avenue at 50th Street New York Y. This program . oe will aorvo da a . 6 tp . +, - on, Nicker af admission and le montransferabia  * aa 7 . vet wm tg re - . . n oA Do . . Sarde ar : 4 Rae at . . Te ae ~ are taeade Saat? deh ot eh, te rahe Nee los De tur J 4 Preface of the Conference In the four decades during which there has been acceptance of potential hazards associated with exposure to asbestos solutions of to the problems involved have been elusive asbestasobesstioss is remains largely a rearguard holding action once the diffuse interstitial fibrosis is established Prophylactic . measures are hampered by difficulties in early diagnosis including the long latent period often noted between onset of exposure and assolated Ad clinical change which indicate that neo- . Hard wop data have been accumulating the with asbestos exposure especially those of plasia at this time lung are perhaps the most important industrial cancers This importance has been emphasized by the recent stimulating studies of South African and British investigators demonstrating the significant incidence of pleural and peritoneal tumors associated with asbestos exposure and by the knowledge that the various neoplasms might follow exposure of limited duration and intensity in- adequate to result in significant asbestosis ; There have been effective advances in dust control techniques Bo accomplished by diligent ingenious and expensive engineering However application of these procedures has been hampered by a the rapid growth of asbestos utilization sometimes under circum- pS:ae stances in which exposure has been obscure or unrecognized More- 3 over community and indirect occupational exposure may occur the scope and importance of such asbestos air ollution are at pre- a sent uncertain but their potential significance has attracted atten- Wea, aGeeo<Se matie > oe Ty ce tion the stimulus and back- The foregoing sober inventory provided ground for this Conference The Scientific Council of the Academy considered that the interdisciplinary nature of the problem involving such distinct fields as experimental pathology applied physiology 4 and industrial hygiene could best be served oncology epidemiology by a broad conference of investigators in the biological sciences Gilson particular and those in allied fields In October 1963 visits were made by Dr. Selikoff on behalf of the centers to investigate the feasibility Academy to several European British and potential scope of such a conference In of the Medical studies were reviewed with Dr. C. Director Research Council Pneumoconiosis Research Unit The cooperation of Dr. H. Heimann of the Division of Occupational Health of the United States Public Health Service focilitated a survey of current work in this country + et, 7 1 . 3d4, abe eo5 aa fet* > w The Academy was fortunate in securing the advice of a Conference Committee which encompassed the major areas involved Its members themselves actively concerned with the problem net January 6 1964 in New York The preliminary design of a meeting then formulated was refined during the succeeding months by the Committee with the assistance of active investigators in many parts of the world and by July 1964 the Conference program was com pleted It is the hope of fertile one and will problem the Academy that this Conference lead to decisive findings on this , will be a important Eunice Thomas Miner ~ . Executive Director July 17 1964 The New York Academy of Sciences ORGANIZING COMMITTEE Irving J. Selikoff Cochairman The Mount Sinai Hospital New York N. Y. . Jacob Churg . Cochairman The Mount Sinai Hospital New York Y. W. Clark Cooper School of Public Health University of California Berkeley Calif John C. Gilson Pneumoconiosis Research Unit Medical Research Council Penarth Glamorgan Wales E. Cuyler Hammond American Cancer Society New York Y. Thomas F. Mancuso Graduate School of Public Health University of Pittsburgh Pittsburgh Pa E. Lynn Schall William E. Smith Occupational Health Program New Jersey State Department of Health Trenton N. J. Health Research Institute Fairleigh DickinSoo University Madison N. J. _ - ~. - t ^' . 7 . ry e , 172 . of ... A Nee  ; Cc te 8 . . ae sf . . e ^' Conference Cochairmen I. J. Selikoff and J. Churg Mount Sinai Hospital New York N. Y. PROGRAM ta ; ; : - o, MONDAY OCTOBER 19 1964 Session Choirman H. J. Magnuson Institute of Industrial Health University of Michigan Ann Arbor Mich 9:00 A.M. - d Greetings from the Academy - Gabriel G. Nahas Chairman Section of Biological and Medical Sciences The New York Academy of Sciences College of Physicians and Surgeons Columbia University New York N. Y. Opening Remarks - I. J. Selikoff The Mount Sinai Hospital New York Y. ASBESTOS MATERIALS IN MODERN TECHNOLOGY _, Session Cochairman P. H. Riordon . Asbestos Corporation ~imited . Thetford Mines Quebec The Geology Occurrences and Major Uses of Asbestos W. Hendry Canadian Manville Ltd. Asbestos Quebec Physical and Molecular Structure of Asbestos - R. Gaze The Cape Asbestos Company Ltd. Asbestosis Research Council London England _ LIVING TISSUE AND MINERAL MATER MATER PROBLEMS OF PATHOGENESIS Session Cochairman 1. Webster Pneumoconiosis Research Unit Johannesburg South Africa IDENTIFICATION PROBLEMS OF IDENTIFICATION OF ASBESTOS IN HUMAN TISSUE PANEL DISCUSSION MODERATOR P. Gross Industrial Hygiene Foundation } ittsburgh , Pa fd ee ce . ! fee nae tte rte, wobes te, . oy . rs, ee bat or _ . . tr rg? . KR . KR Paes oP rst we ch . Lat sa lity : 4 Tee nd 4 yu. Bp r, 3 wert pir if pt Wes fF: * 2 Pies vs 4 - cet . = Tush i 4 pet F , i . eee - e oee oe ee oT . yw tte 4 ? Identification by Fluorescent Dye Staining and Electronically Activated Oxygen Ashing C. Berkley and J. Churg The <"- Mount Sinai Hospital New York Y. EF L. Identification of the Several Varieties of Asbestos Fibers in Human Lung Tissue - A. Vorwald Wayne State University _. soe College of Medicine Detroit Mich ayia Dust Content and Composition in Lungs with Asbestosis G. Nagelschmidt Safety in Mines Research Establishment 37, x Sheffield England 3 EXPERIMENTAL ASBESTOSIS PANEL DISCUSSION 2 MODERATOR J. C. Wagner Medical Research Council Pneumo- coniosis Rescorch Unit Glamorgan Wales . Asbestos Dust Deposition and Retention in Animals C. i? Wagner and J. W. Skidmore M.R.C. Pneumoconiosis Research - Unit Glamorgan Wales Experimental Asbestosis with Three Types of Fibers Impor- . tance of Particle Size - J. Mills and P. F. Asbestosis ~. Research Council University of Reading Reading England (cy 7 . Electron Microscopic Studies of Asbestosis in Man Ani- j.,,. 3} iy mals - J. M. G. Davies As stosis Research Council Uni- wey . ' versity of Cambridge Cambridge England at Rheumatoid Factor in Serum of Individuals Exposed to Asbestos B. Pernis and E. C. Vigliani University of Milan Milan Italy and 1. J. Selikoff The Mount Sinai Hospital New York Y. _ Ls Observations on the Pathogenesis of Asbestosis E. C. Vigliani and B. Pernis University of Milan Milan Italy + yh 12:30 P.M. Luncheon Session Chairman J. H. Sterner Eastman Kodak Company Rochester N. Y. yt a YAT AAS we Mae th Sane - HUMAN EXPOSURE TO ASBESTOS ASBESTOSIS IN INDUSTRIAL POPULATIONS hangkes 20t Session Cochairman J. C. Gilson M.R.C. Pneumoconiosis Research Unit Glamorgan Glamorgan Wales Wales a FENN 47 te wa: 2:00 P.M. Asbestosis in the United Kingdom - J. McVittie Ministry of Pensions and National Insurance London England bees & sow tavs ansa4 e Sa EN, PTT OTT IV TI IO EL, SIE PT ED idee ne 7 : ct wee ee eR s SE = ay 7 7 te te @ N - % . os . _ a . ar rh 1. S 7 te 1 ge 00148 re We i 6 ALS Asbestosis Among Insulation Selikoff J. Churg and E. Workers the United States I. met C. Hammond The Mount Sinai New York N. Hospital eats Mortality Rates Among Asbestos States - P. Enterline U. Products Workers in the United C. Public Health / Service Washington ba Secular Changes in Asbestosis in Geet Smither Asbestosis an Asbestos Factory - W. J. pany Ltd. London EnRgelsaenardch Council The Cape Asbestos Com- 9 . SMAL eats | HUMAN EXPOSURE TO I tes ASBESTOS COMMUNITY STUDIES it a -9~ Session Cochairman J. Higginson eS 4 University of Kansas School of Medicine eter Kansas City Kan J Yer + Occupational and Nonoccupational Exposure yy C. Huaper National Cancer Institute Bethesda M todAsbestos- H. 3 . Prevalence of Asbestos Bodies in son University of CapeTown TowAun topSsoyutChaAsferisca- J.C. Thom- Asbestosis Geographical and Africa - G. K. Sluis Environmental Studies in South burg South Africa Cremer Pneumoconiosis Bureau Johannes- Pleural Plaques and Asbestos Further Observations on Endemic Nonoccupational and other Noncupational Asbestosis - R. Central Hospital Tampere Finland Kiviluoto Tampere Session Chairman ) . Wolfsie United States Rubber Company New York Y. U.S.P.H.S. 8:00 P.M. - Session Cochairman L. Cralley Occupational Health Research and ~ Training Facility Cincinnati Ohio Inhalation of Fibrous Dusts - V. Timbrell coniosis Research Unit Glamorgan Wales M.R.C. Pneumo- Comparison of Impinger and Membrane Filter uating Air Samples in Techniques for Eval- Occupational Asbestos Plants - H. E. Ayer Division of Health U. Public Health Service Developments in Washington C. Dust Sampling and Counting Techniques in the Asbestos Industry - S. Holmes Asbestosis Turner Brothers Asbestos Research Council Company Ltd. Rochdale England MY, Nf * }8 are ES Soe s - TAN PRET BE ERLE CNL A AHS EE EIN TO FO ser Stet FOU FN OE LY Ve rae Oe reeeeen than Nhat Mtn tr Sone li aha o seit ad Svakom Svakom Dust Measuremenatnsd Monitoring in the Asbestos Industry C. G. Addingley Asbestosis Research Council British Belting and Asbestos Ltd. Yorkshire England | Measurement of Airborn Asbestos Dust by Instruments Measuring Belting Different Parameters A. Roach London School of Hygiene and se Topical Medicine University of London London England <-> Discussion opened by T. Hatch University of Pittsburgh Pitts- burgh Pa s TUESDAY OCTOBER 20 1964 Session Chairman Harriet L. Hardy Massachusetts Institute of Technology Cambridge Mass DUST AND STANDARDS YY 9.00 A.M. - CONTROLS THY, nb Present Threshold Limit Valce in the U. A for Asbestos Dust A: oy A Critique- E. L. Scholl Occupational Health Program New > Jersey State Department of Health Trenton N. J. Economics of Dust Control D. W. Hills Asbestosis Research Council Turner Brothers Asbestos Company Ltd. Rochdale Eng- land aad +e . Session Cochairman L. Silverman School of Public Health Harvard University Boston Mass PULMONARY ASBESTOSIS Radiological Classification of Pulmonary Asbestosis H. Bohlig Municipal Hospital L^...densheidGermany Roentgenological Studies of Pleural Calcification in Asbestosis- I at Ri 1. J. Selikoff The Mount Sinai Hospital New York Y. Spent Differential Diagnosis in the Pathology of Asbestosis - J. Gough Welsh National School of Medicine Cardiff Wales Roentgenological Correlations in Pulmonary Asbes Oke tosis in the United Kingdom and South Africa - K. F. W. Hinson Brompton Hospital and J. C. McVittie Ministry of Pensions and National Insurance London England G. K. Sluis Cremer and C. P. Theron I neumoconiosis Bureau Johannesburg South Africa Disscussion opened by P. Cartier Thetford Industrial Clinic Thet- EB ford Mines Quebec and I. Webster Pneumoconiosis Research Unit Johannesburg South Africa SREY Fs 176 % 2 ? pte - . . te Se Hae ASE . * s se . ye 3 aos Pope att yoo get hes . ore sos . - a a aa tog ate he im _ 00148 ro + o Cae 2 . eas . fi ne nm % < ow taes Fe , . @ Tom on Wal 4 > ow ee PULMONARY FUNCTION IN ASBESTOSIS PANEL DISCUSSION MODERATOR G. L. Leathart University of Newcastle Newcastle --< England Pulmonary Function in Asbestosis Serial Tests Prospective Study - M. Bader R. Bader and The Mount Sinai Hospital York Y. in Long Tera A. Tierstein Routine Lung Function Studies of 830 bestos Processing Factory - R. Hunt Council British Belting and Asbestos land Employees in an AsAsbestosis Research Ltd. Yorkshire Eng- The Discriminant Value of Pulmonary Function Tests in Asbestosis M. L. Thomson W. J. Smither Marie Pelzer and M. Hills London School of Hygiene and Tropical Medicine University of London London and The Cape Asbestos Com- pany Barking Essex England Whittenberger Discussion opened by J. L. Harvard University Boston Mass School of Public Health 12:30 P.M. - Lunchcon Session Chairman W. C. Cooper School of Public Health University of California a Berkeley Calif ASBESTOS AND NEOPLASIA EXPERIMENTAL Session Cochairman Katherine R. Boucot * Woman's Medical College of Pennsylvania Philadelphia Pa 2:00 P.M. - Studies of Carcinogenesis of Asbestos Fibers and Their Natural Oils - J. S. Harington and F. J. C. Roe Chester Beatty Research Institute Royal Cancer Hospital London England Preparation of Asbestos Fibers for Experimental Use M. S. Badollet Health Research Institute Fairleigh Dickinson University Madison N. J. and W. A. Gantt Occupational Health Program N. J. State Department of Health Trenton N. J. Tests for Carcinogenicity of Asbestos - W. E. Smith and Llonas Miller Health Research Institute Fairleigh Dickinson University Madison N. J. Tests for Effect of Asbestos on Benzo 8 Pyrene Carcinogenesis . Ne Oe Oe TTEtE eds aaa . oy we. ee | ar ote Ce tte * Bae or E Et vale sree Me ee te Sara ae LIE Re tae NN a - eM a ESET CONS Pied we 2 Seal tM a et te 3 = ome. i os ve . ot " Se i. Y oe wo Te ~*s . a Ce ee Va ee e q . _ - vio. . m : . of toe . : rae . tong 7 ae are ry . Pa a aye. ae - owe 7 ES - . y . SG Sewer wee Sa Mee Sy te i A pape 4 to ee . Tegtat : & Keeae aacarAca, heal - ives m ct nr . e*eay er vat , z Cy . ee b - ma:s a g ' Mer. N > . ses oe 3 fart Be . 2. 93 45 a } lf L : s ~ e ^' .S fiw orn we. Orr Arar a a ' 5 oe an a eens . Lo. t ato yy b.: > ws <~: ae eer . cole , f.: Bey Ea eh on: . . - 7 oF ae <ida Ms eieitt. os 4g : vues ae. oO . Het oa a a aad 4 | ee a y- Carn . : ws o id ee y ae, * . x ; e on . ae . ' $0 BoYo] * : 6 ae i923 Reaee ad . ? . Sate ek Ae oe: eww ice . ze as bas ws i as - o8 . b. "y fe bee 9 o CETLAS ence, es ~ : oe - tee sot std Sweet ot fade. ox * vt 1G . Je wg dy . i 19 ment ee"get doen 6 lie n omy oe ry Jo ~ e . . * - 8 + . meee = om o* wy . aon . eee * ge - Fe ae my 1 el ine: ee +e - Pat e at ony . . oad _te epi . ve : ow % . q Sequelae of Asbestos Dust Exposure - J. C. Wagner M.R.C. Pneumoconiosis Research Unit Glamorgan Wales Changing Hazards of Asbestos Dust Expsure- J. C. Gilson Pneumocnois M.R.C. Pneumoconoiosis Research Unit Glamorgan Wales Multiple Factors Factors Relation to Neoplasia Among Asbestos Workers - E. C. Hammond The Mount Sinai Hospital New York Y. PANEL DISCUSSION % a 4 x e al fa is Moderator H. Heimann Division of Occupational Health U. S. Public Health Service Washington C. x Z z The Section of Diological and Medical Sciences provides con- -%, ferences for active workers in the special fields of biology and = medicine * This conference may be attended by interested Members of Academy all physicians research scientists and science and fi ical students as well as those invited to participate SA 8 3 SECTION OF BIOLOGICAL AND MEDICAL SCIENCES a .t Preston L. Perlman Gabriel G. Nahar Chairman Chair Fy a. ft: a: tye v: * : X pA ard e .. ao is & + 3 . , , BTOLOG Ia; EFFIITS oF AS532570S ASBESTOS SEOLGGY, OcuAF ners AC MICK AFRESTOS AFRESTOS MAJOR AFRESTOS ty OW, Eerary Canadas ay Eendry Asbestos The wineret Quebec Canadian Canadian Johns Quebec barely Manville Position, Pivcxenes Isto tus troea divided The mineral asbestos may fibrous fibrous silicates into groups divided phiboles position con- position pazely paroxenes chrysotile , and including verying verying crocidalite including emosite trezolite anthophyllite phiboles phiboles chrysotile crocidalite : trezolite trezolite trezolite chrysotile . The rock serpentine actinolite alteration alteration product anthophyllite types rock chrysotile peridotite which mag ultrabasic alteration product Crocidolites such dunite metamorphosed peridotite alteration alteration lizestone occur metamorphosed metamorphosed ferruginous Crocidolites sium lizestone lizestone Crocidolites Crocidolites and bdanded ironstones siliceous ferruginous bande ironstones iron crystallise metamorphosed rich termed banded ironstones silica termed magnesium $ anthophyllite anthophyllite occur Concentrations strut rocks schists turaldeformation limestones and linestones linestones linestones Concentrations these minerals are where where where are are has four, deformation Total of production production ess. broad annual million million dollars approximately approximately present varieties chrysotile world However approximately produced varieties Rhodesia Approximately and ampsite produced and Southern Rhodesia produce remaining 11 countries countries % production manufactured Exist, There hundreds hundreds importent for asbestos asbestos indispensable ingredient produce would of asbestos asbestos constitutes indispensable constitutes indispensable indispensable manufactured which is chrysotile many greatest asbestos crocidelite the consist products asbestos both zenufactured most counctrioesuntries the world shingles and others largest chrysotile crocido- Frodesia, Approximately CERY cease Ie meny manufacture of as- tp world consist it of as asbestos estestos floor language language the almost every country world the world world world involved involved one more is iivolve SESSION SESSION 1 ver PAPER 2 a THE PHYSICAL AND MOLECULAR STRUCTURE of ASBESTCS SECSTON 1, PAPER 2 The Cape Asbestos Company Ltd. Company Company Ltd. having fibrous Asbestos Asbestos is A different Asbestos generic bere applied they may classified different way but member this classified CEFYSTILE WEITE ingement ingement 1 . Se.entine The of groups CEFYSTILE Sey hydrated hydrated silicate formule 3160 3160 specific gravity chemical 29102 ; specific usually are may length length diameter much shorter brucite diameter hexsgozel Upca and are some 150 to 400 diameter Crystal structure hexsgozel hexsgozel sheets hydroxide magnesium scrolls form upca tubes like layer octagonal magnesium magnesium magnesium sheets Sitica 2. this Astestos group are = Astestos Astestos Astestos AGEISTOS Sodium 0203 OLIVE FILE AGEISTOS ferroso ferroso ferric 0203 FILE 05102 FePaary 0203 05102 gravity gravity uu p p " comerly 05102 distinct diameter length Sind Solid fibres usually usually between 500 in diameter Crocidolite comerly distinct Blze blue color resistance acids al and chemicals . Ppto 2" or 5.5Fe0 85:02 Crocidolite Naat 3Fe> specific regnesium regnesium silicate chemicals formula formula formula 11.50 .50 820 specific specific common 3.45 ; ebemical 820 The Stres gravity gravity up more Stres Stres are solid being about 1000 diameter Whitish faws color Anthophyllite acid and chemical in diameter resistance resistance 1900 amphiboles Tremolite and epecific Anthophyllite AGRIBOLES amphiboles and Actinolite may Anthophyllite Tremolite also de but little Sur encountered encountered commercial encountered encountered the fibres structure the strength strength strength Structure crystal Tystal Crystal leyers or fibres Harray. narrow narrow narrow narrow e=phiboles from arrangement from an octanedral octanedral octanedral arrangement 1 arrancetent of hiboles i farlos-cxr4e Tremolite much lower tensile e-ca crystal structure structure amphiboles besed upan of either either of formed strip units cf the Wetsinterlocked OF <ltherSESSION SESSION unes SESSION THE on C. Berkley Berkley Chung Chung E. with York Y. Berktey, The Hospital TISKE The Churg, W. RB. Sith ens r Mount Slices Ecspital, New ae J. York, Selikers N, Y. SESSION PAFIR 3 individuaclontinued A puzber of new techniques techniques are described which enable 1 the tagging of individual fibers with chromes in vay for a period of at least one month end 2 facilitate the detection of othervise invisible individual asbestos fibers and mineral particulates by electronic ashing of sections These fibers in absence of techniques techniques individuel situ situ after asbestos techniques were shortly asbestos asbestos designed for use a in experimental studies in animals to locate respiratory exposure and b in human biopsy or autopsy specimens in the Localization Localizton Localization by electronic ashing has proven highly satisfactory Variations in technical factors for correlation correlation allow ot asbestos demonstrated demonstrated bodiesbodies are of fiber location with histological also described The advantages of structures Studies of the effect of asting the concomitant use of phase microscopy vere The results of the fluorochromes experiments raise the question question of mechanical fixation of peri- culate carciigens in tissue as well as the adsorption and concentration concentration of dilute carcinogenic agents mS ; SESSION 1 PAPER 4 IDENTIFICATION OF THE SEVERAL VARIETIES OF ASBESTOS FIBERS IN HUMAN LUNG TISSUE ty A. Vor . Wayne State University Detroit Mich Abstract not received 5016E CEZEFVATIONS ON THE DUST CONTENT AND COMPOSITION IN LUNGS WITH ABESIOSIS MADE DURING WORK ON COAL MIERE PLEUMOCONIOSIS . by Safety in Mines G. Research Regelschide Regelschide EstablishmeEnsttablishment Suffield England In the course of studies made at of various types of lung dust diseases tians have been rede lungs with esbestosis the and premiosis Sheffield Laboratory of S.M.R.E. mainly of of coal esbestosis during the last workers a few 15 years observa- After a remey litereture chrystile rocidolite methods of isolating and identifying different types of ashes- ) be discussed Pesults will be presested for Fazel which were studied about 20 lungs with asbestosis obtained from the London Pretosevere years ago The types of esbestos which had caused the are not known and several types may bave been involved Preliminary data will be given for of estestosis estestosis lungs mon types cooperation tentative Wherees main lungs with exposure to single with the Freoconiosis Research Unit conclusion is the following of Estestes obtained from of South Africa in the doconiosis of coel and miners and in in the classical lungs and silicosis is co severity of fibrosis average average a this does positive clear positive not appear correlation betwees enunt to be the case in asbestosis of dust This 548- perhaps acid gests that products of dissolution polysilicic cause the fibrosis the suggest that scluble than in lungs crocidolite chrysotile is more soluble than crocidolite and amosite The may data also be less wie La rare ASBESTOS DUST DEPOSITION AND RETENTION IN ANIMALS SESSION 1 PAFER 6 M.R.C. by J. W. Sudore and J. C. Wagner Prezzocomosis Research Unit Glamorgan Wales has pietral dusting experiments it has been established on histological fibrogenic properties of different types of asbestos Following varieties of asbestos dust and silice into rats it has grounds that there Following Following the intra- been shown that it is possible pleural zesotheliomas with chrysotile amosite and silica The crocidelite amount of dust incculated into examination to be greatly in excess of the these animalswas 20 This appeared by extent found in the majority of human cases histological of pleural mesothelio8 Following the experiences of human cases in South Africa it was expected that the mesotheliomas would occur in animals dusting experiments inoculated with rocidalite In an attempt to clarify the position a series of It whether the dvesairrablie ous inhalation method was desirable therfore therefore therefore therefore therefore therefore therefore therefore therefore , to to produce as in the lungs of rats by an experimental inhalation types of asbestos were retained and bad method by which a move amount of dust In addition it was secessary to mov a similar histological distribution Groups of powdered less rats have been exposed to which served as a control dust clouds airborne inert and of chrysotile crocidelite amosite or insoluble insoluble fibrous dust Reasonably Reasonably constant and equal weight concentration of dust in the serodynamic range which could reach the pulmonary regions 149 BEOLOGICAL EFFECTS OF A ESTOS SESSIOSESSNION 1 PAPER 6 of the lung were maintained for each the rats being exposed for 7 hours a dust cloud The day on 5 days of inhalation extended over a each week To observe any continued period of six veens differential elimina- tice rate the rets from each gical sections were obtained ence to its silica costeat group vere killed 1 and 52 days from each rat lung 29 and days after the weight of dust the end of exposure histolo retained determined by refer- The findings of this experiment will be discussed EXPERIMENTAL ASBESTOSIS WITH FOUR TYPES OF FIERES by J. Mill6 University of Reading Reading England SESSION 1 PAPER The changes in the lungs of 49 rats exposed to 87.196 Holt Mills & Young J.Path & East 15. 87.196 cells were prominent followed by diffuse fibrosis but no asbestos bodies It was concluded that fine chrystile dust have already been described = The dust caused focal lesions in which gient Finely divided dust was seen seen the rat lungs asbestos dust could produce estestosis in in the rat Lung changes after exposing 66 geinee gs to four types of asbestos are now described chryso- tile 27 crocidalite 17 Emosite 12 and 20 anthophylite Duration of exposure Animals 3 to 120 days after first total exposure was 3 days varied from exposure to or 78 days 3 to 78 deys dust The same long Animals were killed at intervals term results were obtained extending from unether the the After 3 days exposureexposure asbestos dust could be surrounding alveoli and there was en exudate ducts found in the distal ends of mononuclear cells and of alveolar nitinuclear and in giant cells which was most evident in the terminal bronchioles which have Asbestos iron with an iron containing material with fibrosis alve spaces and alvecier in the size end number of estestos been identified vallsvalls generalized bodies Asbestos bodies efter 14 days follows 1.e. asbestos fibres coated Thereafter cell expiate extends and there is a steady increase The dust seep in the lungs consists chiefly of very finely divided particles and evidence be presented which suggests that these are more active in the production of lung fibrosis then larger particles which produce asbestos bodies v12 the It is extremely difficult to control the spread of asbestos dust throughoutthroughout the laboratory en^/ the guinea pig lung is very sensitive to the inhalation of small amounts of this dust In spite of the fact that experimental animals vere exposed to the dust in sealed chembers smell amounts of dust gained access to the enital room and any of the untreated guinea pigs developed interstitial pneumora8 snoe lan af MICROSCOPE STUDIES OF ASBESTCSIS IN MAN AND ANIMALS SESSION 1 PAPER 8 by a J. G. M. Devis . University of Cambridge Cambridge England In this paper are reported the results of some microscope observations on the effect particular q asbestos dust on Guineepig and Human lung material In asbestos bodies found sity by the method of in this material was examined The guinee pigs pigs Holt and Young 1960 The human lung material the fine structure structure of the were dusted at Feeding Univerwas taken as a biopsy from en asbestos worker who had been exposed to asbestos dust for over twenty years Guines pigs treated with asbestos dust developed several pathological changes in their lungs These included alvesler walls the formation ofnodular giant cell lesions interstitial preumonie became infiltrated with dust carrying macrophages macrophages and complete lung inwhich the consolidation and fibrosis in some areas macrophages Giant cells appeared to be formed by the evidence to suggest that these macrophages can aggregation of dust undergo conversion carrying to fibroblasts and there is Although the se- quence of events could not be followed in one human lung specimer the same pathological pathological pathological lesions were present as found in the guinea pig lungs namely codular giant cell lesions interstitial interstitial poetoni and lung consolidation When asbestos bodies were found in either either either guinea or probably usually consisted of fine granuler material that that that is probably pigs & in layers of varying density and occasionally in guinea human lungs their coating material ferritin This material can be deposited the outermost layer exhibits fibrous fibrous fibrous segmentation dif erent rather than a premier structure Asbestos body appeared to be due to two different processes In one the segmented appearance resulted from the deposition uneves of deposition deposition the costing material in seperate globules and in the other it was produced by the splitting splitting splitting of a previously previously smooth coat -4- 150 RHEUMATOID FACTOR IN SERUM OF INDIVIDUALS EXPOSED TO ASESICS by B. Fernis and E. C. Vigliani University of Milan Milan Italy and I. J. Selikoff The Mount Sinai Hospital New York N. Y. Abstract not received OBSERVATIONS ON THE PATHOGENESIS OF ASEISTOSIS by E. C. Vigliani and University University of Milan B. Pernis Milan Italy SESSION 1 PAFER 17 Abstract not received ASBESTOSIS IN GREAT BRITAIN SESSION 2 PAPER 1 . C. McVitie Ministry of Pensions and National Insurance London England A whole new literature relating to asbestos appeared in Great Britain between 1927 and The Report by Merewether and Price in 1930 of asbestos18 It was made clear that the was outstanding and principal principal safeguard safeguard established against the the ill occupational effects dust on the lungs was to be found in improved ventilation and dust supresion suppression 4 compensateble disease Initial and periodical examination of workers veve stituted and specific instructions were issued regarding exhaust 1932 origin etc. Case fanding arises in two ways from the applications for compensation under the under the Industrial Injuries Act probably the only source of information give the number of cases diegnosed posed between 1955 and 1963. These They numbers numbers resulting from clinical radiolgical radiological end pathological effects of asbestosis and mortality are . ate erent examinations and from disease are described applications and morbidity Hability to background the value diagnostic criteria other pulmonary and of periodical exam- : ASFESTOSIS AMONG INSULATION WCFLERS IN THE UNITED STATES by I. J. Selikoff J. Churg and E. C. Emood The Mount Sinai Hospital New York N. Y. SESSION 2 PAFER 2 . large scale studies of asbestosis in the past have been restricted to workers employed in astestos textile factories This was true both of the important basic investigations of Merevether in Great Britain 363 employees and of Dreessen and his colleagues in the United States employee)s There have been scattered reports of pulmonary asbestosis and its complications in workers ex- posed to asbestos in industries other than textile However the absence of satisfactory epidemic- logical date has zade it difficult to assess the risk of such exposure Yet such assessment is likely likely that asbestos textile workers now represent only a minority of those only reported here were concerned with 1,522 members of the International Insulators Insulators and Asbestos Workers in the New New Jersey Metropolitan area & units of insulation workers This study included every individual who was a member of this union December ch 31 ze 1942 vere or who joined by December 31 1962 dead on January 1 1963 43 have died since Each death has been studied 1,258 were alive 1,117 were examined 89.9 including 130 of 169 no longer working is the trade and 95 of zade zade the 1,026 working members Clinical redigical redigical and pulmonary function examinations were 1 Frevalence of asbestosis orset of exposure Correlation of radiological abnormality with lapsed time from 151 -BIOLOGICAL EFFECTS OF ASEESTOS Time lapsed from onset onset of Exposure 40+ years ** 30-39 11 20-29 10-19 " 0-9 Number Examined 121 194 346 ; 0 7 5.84 25 12.9 27.2 212 55.98 310 89.5 + RADIOLOGICAL RADIOLOGICAL RADIOLOGICAL RADIOLOGICAL ABNORMALITY Grade SESSION SESSION 2 PAPER 2 continued continued ) ABNORMALITY Asbestosis 94.2451 1 35 =e 20 94.24 102 10 87.14 72.8 9 4.24) 36 0 10.4 ) 1,117 1,117 1 123 2 Analysis of 307 consecutive deaths among among asbestos insulation vorkers January 1 123 - August 31 1964 Carcinoma Carcinoma of lung Mesotheliom G. I. Cercinoma > Other Other Geoplasms Asbestosis All other causes To be further reported by Dr. Hamend Hamend pulmonary Presence of asbestosis on Histological examination of lung parenchyms parenchyms of 39 consecutive insulation workers LMONARY FIEROSIS 1 With lung CA pleural mesothelioma Now (^') i 2 3 iG fe) 5 L 9 2 All other 23 Q 10 67 25 39 fe) 13 25 It is concluded that pulmonary asbestosis is a significant risk of insulation workers in the United States at this time Addendum Adequacy of sem Total U.S. Total N.Y. Examined Membership LAHFIAW 1963 ----+--- 14,803 N.J. Membership IAFFLAW 1963 > 1,255 1,217 However these data do not include the following insulation workers 2 unken insulation workers . 2 Maintenence insuletics workers 3 Sprayed insulation workers 4 . Insulation work as part of other other trades burner and boiler repair railroad sheetmmeetaltal leborers leborers etc. shipbuilding 5 Insulation Insulation workers in other unions lengshoremen ara lengshoremen shipbuilding shipbuilding SESSION 2 PAFEF 3 MORTALITY RATERSATES AMONG AGEESTOSAGEESTOS PRODUCTS WOFJERSWOFJERS IN THE UNITED STATES by P. Enterline Enterline U. 5. Public Health Service Washington D.C. Abstract not received SECULAR CHANGES IN ASEESTOSIS IN AN ASEESTOS FACTORY by W. J. Sither The Cape Asbestos Company Ltd. London England SESSION 2 PAFER 4 A in the east end of Londos has bees bees manufacturing asbestos products for over 50 years factory factory 1930 workers from this have been the subject of many many independent studies by various Since clinicians cliniciclianicniancsslinicians and researchers The clinical clinical findings findings findings findings reported in four previous publications are four publications pared with a series of 2 Dev cases presented presented fofror the first time in this paper of these time diagnosed diagnosed 12 after the last exposure Changes Changes in type lengthof exposure in signs diagnostic symptoms in diagnostic diagnostic techniques techniques and in evaluation of pessionable disability disability are noted over conwas and the disease disease compensation average years since the becambeecame subject subject to compensation There There has beez a s 'eady increase in the pucker of years of exposure required to prodice certifiable certifiable disability from 7 years to 17 years As some signs and symptoms symptoms considered characteristic characteristic by earlier earlier writers have become others have have gained prominence . Search for the classical xray picture picture has gives place to less common attempts to 152152 BIOLOGICAL EFFECTES FFECTS OF ASBESTOS ASBESTOS . SESSION 2 4 PAFIR continued demonstrate significant changes in a chronological series of films Puinonery function studies technique became an important technique in in diagnosis and assessment of disability In a small group of 10 cases with 10 controls matched for age sex and length of exposure have the evidence for the influence of pulmonery infection has inconclusive proved The changes in pathology of asbestosis are noted by comparing the CL workers from the same factory In 1949 Wyers published two series of Erten reports in 115 cases of asbestosis at findings death The present series of 71 mortems since 1957 shows much less frequency of tuberculosis as a complication but increased occurrence of malignancy of the lungs Emphysema has become less common Prizory melignency of the pleura and peritoneum occurs with a frequency unsuspected in the earlier reports The mean age at death has risen from 40.8 to 57.3 lengthened years lengthened one from year 6.4 to before 10.9 post years fortezfortez The longest interval The average duration of the disease between last exposure and dismosis hes is 38 OCCUPATIONAL OCCUPATIONAL AND OCCUPATIONAL W. C. Sueger National Cancer Institute EXPOSITES TO Bethes^s ASEESTCS ASE STCS 2 SESSION 2 PAPER 5 oN 50 hes The enormous rise in the production and industrial use of asbestos asbestos during the past years variety resulted in videned exposure to asbestos dust for a greatly increased s^berand variety markedly workers Some of them moreover sustain such contacts incidentally either when being employed in various cepecities in operations where products are processed used or handled or when asbestos working in plant areas inwhich an environmental environmental pollution of the air with asbestos exists The berm asbestos ful effects of such growing exposures to during the past two decades are reflected not only reports in of on the occurrence of asbestosis and asbestos ric sinag ncer in a variety of Estestos but also in the fact that such reports in such observations were zede only recently and of countries on the and of asbes- number and variety of exposed workers the States tos cancers among them is most this Cabada one being the principal and the It is for this reason that regrettably regrettably pies these aspects of asbestos production in Canadian mizes production and National Cancer Institute of Canada wes not adhered to yielded The dominated venture which highly controversial negative results contact with asbestos are employed in the asbestos mining respiratory girnoduupsstreixepsoseidn tthoeresppirratoory duction and commercial use of asbestos cement and plaster and their secondary products in the and application of asbestos for insulating purposes and production processing of asbestos its its manufacture into textiles Protection of estestos workerws orkers asbestos cocupational health bezer^s releted to respiratory and cutaneous contact with asbestos by compensation laws are in mary countries and States more or less defective and therefore , inadequate inadequate inadequate rR SESSION 2 PAPER 6 ASBESTOS AND THE UREAN DWELLER by J. G. Themse University of Cape Town Medical School Cape Town South Africa The extent of inhalation of asbestos fitres by urban dwellers was investigated by counting astes- over the age of consecutive subjects tos bodies in smears from the lung bases from 500 autopsies in subjects and 25 in Cape Town South Africa 500 in Miami Florida . The results were silar in the two cities the showed and no less than 30 of the males and 20 of females astestos bodies In 80 of the posiand were regarded as tive cases the bodies were scally were not associated with pulmonary changes the result of contamination of the atmosphere In 6 of the males the bodies were numerous urban and vere presumably of occupational origin to move dovevards by gravity before asbestos The tendency for fibres too long to be phagocytosed and small doses can have a phagocytosed they become asbestos bodies leads to concentration concentration at the lung bases in concentration urbear ir coantsembinaetisontos cumulative effect An increase in the amount of urber air contemination contemination conteminactionontemination would seem inevitable and of its virtual indestructi- asbestos view of the increasing consumption and diversity of uses of basal bility and en increase in asbestosis is suggested as a possible future development & & mesothelioma of pleure and peritoneum an Nimited basal asbestosismay be associated with malignant urtas forecast in this tumour is the main ground for regarding asbestos as a potential increase the finding of abundent asbestos todles in the lung bases hazard While that view is conjectural the occupational hazard from asbestos 16 of in 27 of the mele hospital population ggests that realized greater and more diversified that is at present the effects of a relatively new developreat The nain object of this work is to draw attention to an : . 153 -- ow ew BIOLOGICAL EFFECTS OF ASBESTOS . SESSION , costintel the videspread use of asbestos in cities and to stimulate the obtaining of comparable other parts of the world to establish the lizes of urban asbestos inhalation of today enable us to detect increases in the future fPaitie f SESSION 2 PAPER , ASBESTOSIS IN SOUTH AFRICA CERTAIN GEOGRAPHICAL AND ENVIRONMENTAL CONSIDERATIONS Miners Medical Bureau by G. K. Cremer Department of Mines Johannesburg South Africa Two major asbestos mining areas occur in South Africa one in the North West Cape the other in . the Northern Transvaal These arees are 300 miles apart por and there is little exchange of lation emong them pleural Available evidence indicates that the high prevalence of pleural mesothelioma in the North West Cape does not occur in the Northern Transvaal Although the population at risk in the Northern Transvaal is appreciably smaller that West Cage this cannot account for the absence of the phenomeson there especially as in the medical medical facilities are of equal standard in the two areas . Mineralogical differences in the two arees occur but are of obscure significance The history intensity intensity of pprorducotiodn puroductcion tion and environmental pollution resulting from mining activitactiviities es appear to run parallel in the two arees Dust levels in the mines and mills were higher in the North West Cape throughout Medical epidemiological the period for which recorded messurements are available epidemiological investigations indicate a higher prevalence of asbestos bodies is the sput of random aree This applies of inhabitents of the North West Cape Asbestos area that is the Irensveal both the industrially exposed people and the neighbourhood population The prevalence asbestos fibres in the sputum was rezerkably similar for all groups in both 27825. The significance of these findings is discussed Radiological observations on random samples of the the populations strongly suggest the occur- rence of asbestosis Cape.Post Cape.Post titem son industrially exposed persons indicate greater prevalence in the two areas sore so in the North West or severity of asbestosis in the North West Cape industrially despite the dustier conditions None of explains satisfactorily the absence of mesotheliomas mesotheliomas of the pleura PLAQUES AND ON EXTEMIC AND : FURTHE OPSERVATIONS OCUPATIONAL OCUPATIONAOL COCUPATIOCNAL UPATIONAL AASSBEBSETOSSASITBESSTOSOIS SIS SESSION 2 PAPER 6 Tampere Central Hospital Tampere Finland . . Sene hundred ceses of pleural calcification of the type characteristically seen among asbestos workers were found in people not employed in the mining industry but who lived in an ares sear two asbestos ines in Eastern Finland These may be called cases of endemic asbestosis regardless of the type or degree of pulmonary reaction or fibrosis . Radiological and clinical sis were not present in most of these cases of pleural pleural calcification Since ezdemic asbestosis in 1960 sco-- pulzczery function function tests have been performed signs of pulmonary fibro- the first report of on these cases and will be briefly outlined The incidence of pulmonary cancer in Finnish men is very high especially in eastern parts of the country being six times cancer has been observed higher than that in Norwey in 23 cases by the author Coincidence of endemic asbestosis and pulmonary The problem of establishing a causal relationship between asbestosis and pulmonary or pleural malignancies will be discussed Over the past 15 months 77 simile ceses of pleural calcification Lave been found in routine chest exeminations at the Roentgen department of Tempere Central Hospital in central Finland where there are rt asbestos rines The etiological problems in these cases will be discussed with parti- cular reference to asbestos and other dusts As asbestos dust is indestructible and insoluble brief exposures may result in pleural or pulmonary fibrosis many years later In typical cases of parietal pleural calcifications the roentgen diagnosis is calcification of the pleural plaques takes place the diagnosis is difficult Some easy but before roentgen diagnose tic observations will be presented INHALATION OF FLEROUS DUSTS SESSION PAPER 1 M.R.C. V. Tickrell Pneumoconiosis Research Unit Glamorges Wales 2101CGICAL EFFECTS OF ASBESTOS . SESSION3 PAFEF 1 continued continued Asbestos fibres 50 microns and longer are found in alveoli whereas few of the particles of sear sphericalshape present have diameters greater than 10 microns here is inconsistency here as the effectiveness of to deposit perticles depends on shape and sedimentation each of the two mechanisms respiratory in the upper respiratory density as well as tract cize tract is For a and inertial precipitation operating determined by particle felling speed vhion vhion fibre it is the diameter and not the length which mairly determines falling speed Asbestos fibres can be long and yet be so fine that deep pene- tration of the respiratory system becomes possible . . Measurements of falling speed diameter and length on glass fibres chosen for their exact sy indrical form have provided the relationships between these perefcters For a given diameter in- creasing the diameter ratio from 1 to 10 results in a fourfold increase in the felling speed For higher length diametderiameter ratios the falling speed is proportional to the square of the diaceter and almost independent of the length Results of similar measurements on the less uniform fibres of anosite chrysotile and crocidalite show the same tendencies The felling speed of an asbestos fibre for example 3 merons in diameter 300 microns long is comparable to that of a unit density sphere 10 microns in diameter diameter The possibility of long fires penetrating to the pulmonary of their capture in fine airways The rate of capture by virtue places where it is likely to be significent for exemple on the calculated space has decessitated consideration of length has been for nasal heirs and at breaching of airway Some espects of dust sampling asbestos particles are discussed in the paper FEEF TECHNIQUES A COMPARISON OF DEINGER AND MMEENNGGRRAANNEE FILTER TECHNIQUETSECHNIQUES MENGRIANNE FOR EVALUAZING AIR SAFLES ASBESTOS PLANTS by SESSION 3 PAPER 2 Ayer E. J. R. Lynch and J. B. Fanney Public Health Service Division of Occupational Health Cincinnati Ohio the threshold by inginger concentrations in value in textile that the is fiber are the determinations astestos comprise study of the asbestos handling by and membrane impinger determine the relationship between determine relationship filtersfilters transparentized filters microscope thethe spite ofresults large they variances associated yield was developed . Is with each of these counting general cre fibers were with associated relationships counting in carding operations then in other and impinger count the count of fibers longer then operation in this peper Tentative results sugesting threshold limit are also presented and discussed of respirable dust are briefly discussed . DEVELOPMENTS IN DUST SAMPLINGAID COUNTING TECHNIQUES IN THE ASSISTOS INDUSTRY by S. Scizes Turner Brothers Asbestos Co. Ltd. Rochisle England SESSION 3 FPAPER 3 Due to the fibrous nature of estestos dust the sampling and analysis of factory atmospheres in industry the asbestos presented continus tigation over the industry has past 20 years special problems which have been the subject of continus lovesfirst by the individual manufacturing companies and later as part research program of on the a sound of the Asbestosis Research Council The aim of this vere has been to egr^'s reliable method of sampling end counting which will enable true comparisons to be made conditions between dust This paper traces at different processes triefly the developmentdevelopment long running thermal precipitator and membrane methods are discussed and reasons are given given to membrane filters suitable for dry counting counting are and in differednt ifferent factories of sampling and counting methods leading up to the filter techniques The relative zerits these twe of show why the membrane filteris now preferred Colored white delibed delibed as well as the more usual sembraces which can be cleared for vet counting Results uring the two systems are compared A description is given of the microscopic microscopic techniques used in sample counting and attention is drawn to the difficulties which can arise arise due to the crystalline nature of asbestos dust One result of this is that care must be taken in choosing a liquid of suitable refractive index to clear the Dembrane and a number of such liquids are mentioned mentioned Prief reference is madteo recent work work in dispersion use can be made of the dispersion dispersion which by clearing staining technique the membrane with a liquid in viewing the sale In of high this way is possible that the individual componentcsomponents of samples containing mixed asbestos dusts Zay be identified fess 155 C BIOLOGICAL EFFECTS OF ASEESTOS SESSION 3 PAPER DUST MEAELPEMENTSMEALPEMNTS AND MONITORING IN THE ASBESTOS EDUSTRY by C. G. Addingley British Felting and Asbestos Ltd. Yorkshire England The commonly used methods for estimating atmospheric asbestos dust concentrations involve the collection of a sample followed by a count under the microscope These methods are slow and laborious and involve skilled or trained operatives In consequence it has always been difficult and generally impossible to carry out sufficient tests to give reliable results The big fluctuations of conceptr asbestos tion which may occur at one test position in an vork room gravate the difficulties A good deal of attention has recently been paid to Tyndelleseter methods of motoring factory atmospheres more especially at the other end of the pollution scale the monitoring of dust free atzospheres for medical photographic and electronic work The Asbestosis Research Councilin England has done a good deel of work on theuse of light Instra scattering methods Recently work has been carried out on the Royce Perticle Counter Royed California ments Inc. Merlo Park California very smell cell which accepts one This particle works on the light scattering at a time and a pulse height principle but by virtue of a discriminating and counting system it is capable of counting and sizing particles The results obtained over a period of 7 months in en estestes period a comparison has been made of its figures with those of the factory are described During this membrane filter Remarkably good agreement has been found with It is believed that factory without the very this instrument a large large cost of trained continuous continuous survey can be maintained microscopists microscopists Deeded to carry out much Burveys by the commonly useud sed used zethods Moreover since a dust figure can be obtained high concentrations occurring occurring occurring occurring for very short periods which might otherwise be overlocked may elso discovered MEASURING LISTIRET ASERSTOS LISTIRET DUST BY INSTRUMENTS PARAMETERS S. A. Roach University of London London England Abstract not received .t PRESENT THRESHOLD 17KXT VALUE IN THE U.S.A. A CRITIQUE FOR ASBESTOS DUST : by E. L. Schall Department New Jersey State of Health Trenton N. J. 1 SESSION 4 PAPIR Asbestos is a generic term applying to a number of mineral silicates that are incombustible in eir and cat be separated into filatests filatests That exposure to asbestos is associated with development or potentially disabling pneumoniosis of m.p.p.c.f. The present threshold limit value of relates to the prevention of asbestosis zental Industrial Hygienists following a man has been amply demonstrated by industrial experience millions of particles per cubic foot of air Thisvelue was adopted by the American Conference of Govern- recomendation by Ireessez Dells Edvards Miller and Hygienists Sayers after a study of doubtful cases of 541 employees in three asbestos textile plants using chrysotile were found in those exposed to dust concentrations Only 3 5 m.p.p.c.f. pneumoconiosis under whereas numerous marked cases were found above 5 c.p.p.c.f. Evaluation is made of the conditions of the studyby Ireesses and his colleagues and the applicability of a standard derived under such specific conditions to current industrial use . wet ECONOMICS OF DUST CONTROL Turner Brothers by D. W. Hills Asbestos Co. Ltd. Rochdale England SESSION 4 PAPER 2 ^ brief historial introduction is given about conditions in the U.K. asbestos textile industry in the late 1920's and early 1930's reference is made the 1931 conference between employers and the Home Office that resulted in a code of practice being established for dust suppression in asbestos tex- suppression tile factories Details are given of the various methods used for dust control in the Companies fat- tories together with the cost of these measures Some figures are also gives for the cost of dust improving contral at the Cape Asbestos Co. Ltd's new Amosite Mill at Ferge Current vork on dust control is discussed together with the part nov played in this by the Asbestosis Research Council * -10 = BIOLOGICAL EFFECTS OF ASEBETOS SESSION 4 PAPER 3 RADIOLOGICAL CLASSITICATION OF PULMONARY ASBESTOSIS by B. Behing Municipal Municipal Municipal Hospital Lidensheid Germacy Every classification is imperfect evez more sc regarding asbestosis The classifications now in use are not ently changing quite identical stegesof which they but mairly divide the radiological appearances into three flu- especielly the second is illogically defined and not to be produced efficiently Because the national differentiation between the compensation rules only only a mere radio- logical classification can be takes into consideration for international agreement The fact of this conference taking place at all proves that sew international agreements about a practicable classi- fication for pulmonary asbestosis disseminated shadows and that the also are decessery If experts egree that linear opacities are radiological appearances of prescolioses can be only either disseminated or squared opacities it would seem expropriate to adopt these two kinds of appearances as tasefor new clessification Doing so considerable approximation to Sydney already reproducibility cations Sydney 1950 Geneva 1958 would be gained as well For intensifying the the existing classifi- of intensifying reproducibility the rayfilm and on the other band enlarging the distinctness of the codified ray findings enlarging symbol we suggest not to use the unalterable symbol L Geneva 1955 but to introduce another f for linear patterns chiefly occurring in asbestosis and to combine it with the quantitative cate- gories for small opacities Geneva 1955 The large opacities might be charecterized by the symbol A for beginning confluence andby B and C for opacities having longer diszeter them 5 cm The additional symbols Genevs 1956 would bear welcome for further accomodation of the findingsfindings code to individual locel or national peculiarities Extensive reconstruction of the radiological appear- ances even without the film in question would be whez suggested It possible is unimportant whether this proposition attained be international agreement should be attained is adopted or not which would it is exceedingly important really practiceble that some #ec2 RCENTSENDLOGICAL STUTES OF PLEURAL SESSION 4 PAPER 4 CALCIFICATION IN ASETOSIS by I. J. Selikoff The Mount Sinai Hospital New York N. Y. Although scattered instances of pleural caleffication Viglient these were considered coincidental or ignored negative findings of A.R. Smith in 1952 had been acted 25 years ago Gloyne Such evaluation was strengthened by the pleural Recently attention bas again been called to the association of exposure to asbestos under industrial conditions Jacob Bohlig Miller and calcification with following environmental community exposure Kiviluoto Data are presented here which demostrate that pleural celcification is frequently found among asbestos calcification countries present 1. insulation workers in industriel and suggest that countries at Acalysis was made of the results of asbestosis is perhaps the most common cause of pleural especially when such calcification is bilateral ray exeminations of 1,117 asbestos insulation workers see SelikofSf elikoff Churg and Hammond this conference Asbestos Pleural Cecification on Ray Examination of 1,117 lepsed time from No. Asbestos Insulation Workers calcification calcification onset of exposure Exemiped Extent of calcification : 0 1 2 3 40+ years 121 51 37 20 13 " 30-39 194 127 ks 15 6 } 20-29 21 10-19 77 379 65.4 67 5 89.6 37- 5 34.58 0 0 10.4 0 a) 1 0-9 346 1,117 98.9 % 340 ) 1.1 1.1 i) Data is presented are of importance importance importance importance 2. Almost half especially noted in indicate that both total exposare in years and lapsed time from onset of exposure with the latter probably of greater consequence of the instances of calcification were bilateral 73 of 150 This tendency more extensive calcification 29 of 35 Grade 2 and 19 of 19 Grade 3 When radiologically unilateral the left side was more commonly involved 49 than the right 28 3 Illustrations will be given of the variable location of plaques diaphragm costal anterior and posterior mediastinal pericardial apical interlobar fissures their appearance and radiolo- gical demonstration -11- 157 AS355IOS to two single higher petetration petetration petetration SESSION 4 PATER L continued continued ) ray maneuvers which have been found valuable oblique oblique kilovoltages Both were routinely used in addition to the DIFFERENTIAL DIAGNOSIS IN THE PATHOLOGY OF ASHESTCSIS Welsh National by J. Cough School of Medicine Cardiff Wales The study is besed on workers in the manufacture manufacture or use of asbestos products It does not include asbestos miners is with there may be a mixture of silicosis and asbestosis asbestosis The differential dis is considered under three main headings i. The distinction between 20 The distinction betwe n asbest and other forms of diffuse fibrosis asbestosis and pneocoriosis due to other silicates 3. The distinction between asbestos bodies and haemosiderosis of elastic tissue which may mic asbestosis l. The fibrosis in asbestosis is often diffuse and associated with toneycomb cystic lung The dis- tribution of the fibrosis is helpful in distinguishing from other causes of honeycomb lung such as diffuse systemic sclerosis eosinophilic granuloza and idiopathic fibrosis Whole lung sections are of value in the differentiation When the asbestosis in the form of massive fibrosis the possibility of other diseases 2 The distinction as of preuzme or silicosis should be borne preuzme from preumoconiosis due to tale mica in mind and kaslip difficult but asbestos are in in which soze fibres present taloosis in~-rtant astestos bodies haemosiderosis of haeamonsidderin rusting rusting with haemosiderin haemosiderin occurs in pulmonary bypertension bypertension interstitial bazorrhage and is unrelated to occupation called elastosis bodibes odies It is also proposed proposed that should included under suck es spicules of of the currently coal used term be curious bodies proposedsimilar bodies similar to the geseric came estes- RADIOLOGICAL COFFELATIONS UNITED KINGDOM ANI REPUBLIC SESSION 4 PAPER 6 J.C. England K. F. W. Einson Brompton Hospital London Novistie Ministry of Pensions and National InsurancLe ondon London C. C. P. Theron G. K. Crezer and J. C. Wagner Pneumoconiosis Bureau Johannesburg South Africa . clas ification rediological Kingdom United classification classification Africa radiological rediological charges charges encountered in asbestosis bas been designed by modify- classification for Preumoconiosis This has been used by a panel of South will be Africa on radiological discussed material drawn from both countries . applied to two series of reys one from diagnosis of astestosis had been confirmed . differences betwees the United Kingdom and South discussed radiological classification classification follows The radiological classification is en extesSymbols comes to the two have the same definitions Additional followed shadows - the coarse variety is defined as those of greater than 1 m.m. indicate extent in the same degrees as for nodulation changes + W indicate diaphragmatic iastinal chest wall and respectively Calcified pleural thickenings are recorded separately in vidth ' fissures are- additional symbolsappearances suggestive suggestive of pleural mesothelioma tranchial tranchial carcinoma the additional symbols and added to the the the definitive definitive definitive definitive definitive definitive definitive definitive definitive preuzetom0 changes Cables will be contained in the published procedings proceedings proceedings . Fe. -12- 158 Be ae ee ee we PULMONARFYUNCTION IN ASBESTOSIS Boot ea wy Part SERIAL TESTS IN LONS TEEM PROSPECTIVE SIUZY M. S. Bader R. A. Seder A. S. Tierstein and I. J. Selikoff The Mount Sinal Sospital New York N. Y. factory Ten years ago a group of 17 actively employed asbestos radiologically and by nears of pulmonary function tests The plant workers was evaluated clinically in which the men were employ discontinued further discontinued discontinued operations at this time therefore they had no asbestos exposure exposure industrial Nevertheless they were maintained under observatics to study the naturel history of established established pulmonary disease uncomplicated by further exposure Annual clinical radiological function studies were undertaken as well as management of intercurrent radiological and pulmonary illnesses During the baseline studies pulmonary function examinations whenabnormal revealed the classic especially exercise the decrease findings of raxis alveolar capillary block sym^/rche uniform cepacity decreased arterial oxygen saturation in lung volumes on well preserved preserved p002 values and decreased diffusing capacity Byperventilation at rest and exercise occurred in more them belf the cases and while dead space ventilation was increased alverlar ventilation WES so increased The most sensitive index of impeired function was arterial oxygen sature Slight reduction at rest ves found in six and reduction below 92 was found in balf the vormes on exercise Foor correlation existed between impaired function and intimacy and duration of exposure Better but still not parallel correlation was found with rediographic findings The employment serial evaluations were made in terms of rey progression developmest or vorsening of dyspnea on exertion and further measurements of pulmonery Motion observations limited Follow observations were 1 zen are dead 2 of lung cancer by complications of the disease being studied 1 of pleural mesothelioma 2 of gastric carcinoma 2 of puimscalepuimscale 2 follow end pulmonary asbestosis cor ^ en^e ene live 1 following resection With this Mnitation long term radiological features Original Original and 1 of myocardial infarction of lung cancer results are described with correlation with observations on pulmonary compliance and pulmonary clinical resistance in these zes are discussed with relation to vital capacity sexinus breathing capacity ROUTEE LUNG FUNCTION SILIIS SILIIS ON 630 EMPLOYEES AN ASBESTOS PALCISSING FACTORY by Rose Bunt British Belting and Asbestos Ltd. Yorkshire England SISSION 4 PAFIS 6 this Routine work in field was started in July 1960 in an asbestos textile plent in the North of England The aim was to create a set of coral figures for lung compartment volumes gas transfer factor coefficients 90 mixing indices ventilation on exercise and forced breething capacities The subjects used in these tests vere volunteers of both sexes in varying age and stature groups from departments other than those processing asbestos These results were the analysed statistic- ally and the regression formulae obtained applied to the results of men and vonen vorking in sone- exposed duled and exposed clinical occupations The conclusions drawn from these in each case Pulmonary function tests results were eligned with the were also used as a screed to prevent withfindings people lungimpairment from taking work in departments where asbestos dust was pre- pre- up veient Some difficulties were encountered is the beginning both in subject response and sampling sampling sampling technique technique but there were overcoze end this paper deals in the main withthe technique and obtained significant significant over the past 3 years The evidence points significant to a significant significant decrease in ges transfer and vital capacity beforbeforee any radiological or clinical signs are evident The work continues as a routine test procedure carried out in the firm's medical centre Approximately eight people are examined each day the intention being to examine all soneiled and year exposed personnel once a at least A zodified bolding sempling andmore often if technique is used their results give ceuse for concern andis described is the paper ' XXX Parr erErs : SESSION 4 PAPER 9 THE DISCRIMINANT VALUE OF PULMONARY FUNCTION TESTS IN ASBESTOSIS by M. L. Thomson Marie Pelzer and W. J. Smither London School of Hygiene and Tropical Medicine and Cape Insulation and Asbestos Products Ltd. London England A clinical radiographic and pulmonary function evaluatica has asbestos factory certified as having asbestosis and on a further 9 rudicgreptic The clinical and rudicgreptic thors without knowledge of assessments vere zade using a 2 or 4 the pulmonary pulmonary function results Of the clinical features radiography dyspnoes and reles have been made on exposed but point scale the greatest 19 workers in an uncertified workers by one of the au- discriminating discriminating 159 eee we eee ee ie 55510 4 PAPER continued indicating that the Pneumoconiosie Board vas mainly relying on these features in certifying workers and this were in agreement with a group of experts who were askedto rank a in they clinical features according their value in diagnosing and assessing the degree of asbestosis standardizing to After standardizing standardizing the results where necessary against body size the discriminating ability ability discriminating of the pulmonary function tests has been assessed using the criterion of certification Inspiratory capacitaynd vital capacity were found to have the best discriminant power followed by diffusing capacity As expected the ratios residual volume / total lung capacity and forced expiratory volume F.E.V. ) / vital capacity and the pulmonary capillary blood volume had negligible discrimicent power The airway conductance by body plethysmograph peak flow rate and F.E.V. have been measured on a further group of 16 certified asbestos vorkers and a control group of 15 workers not directly exposed exposed control to asbestos group and the Although conductance showed a vide scatter same as that of a further normal group of 22 the mear ves similar to that of staff of this School and this the in spite of the universe reduction in lung volume and evidence of bronchial inflammation in meny of the esbestosis patients It is inferred that in these patients the bronchi do not participate in the - shrinkage of the lung parenchyma possibly because of a strong force exerted radially outwards on the the surrounding fibrous lung The peak flow correlated more highly than F.E.V with con- and appeared to be the more valuable of the two simpler tests for assessing bronchial patency ' tt ape te SESSION 5 PAFIF 1 STUDIES OF CARCINOGENESIS OF ASEESTOS FIBERS AND THEIR NATURAL OILS by J. S. Harington and F.J.C. Roe Royal Cancer Hospital Hospital London England two esbestos Shree types of asbestos are used industrielly emosite crocidclite and chrysetile The first nature of these not the third appreciable amounts of nature oils The three types of but contein native esbestos free emcsite and free crecidolite and the oils derived from site and crocidalite crocidalite tested being for carcinogenicity is rets and rice thefibers by subcutaneous injection after 525- pension in saline and the cils by repented application to the skin Asbestos is often treasported or stored in Jute secks and the oil from the jute fibers is absorbed to an appreciable extent by all three types of asbestos Samples of Jute cil are being tested for carcinogenic and carcinogemis activity on House skin Other possibilities of contamination of asbestos with carcinogenic materialS are also being investigated It is hoped that these investigations will lead to a clearer definition of the carcinogenic hazards ment of suitable systems in greater detail associated with to exposure asbestos and which the mechanisms of carcinogenesis by at the same time to the asbestos can be studied develop- in At 6 that present the following possible mechanisms are under consideration hydrocartons due to thperesence of carcinogenic polycyclic hydrocartons or other natural or contaminat198 9615 organic materials in the natural or hydrocartons b that it due to the of tertatt detals and complexes in asbestos Several metal presence complexes especially those conteining iron have been shown to induce cancer and several metals lead including chromium nickel etc. are carcinogenic in their own right chromium nickel and have been found in chrysotile Appreciable excunts of c there is an Oppenheizer Effect that is cancer induced by the prolonged residence in the tissues by chemically material incapable of being removed phagocytosis more intriguing features of estestos carcinogenesis is the fact that in the case of pleural peritoneal mesotheliomata the cancers develop at sites remote from those exposed Special studies being made therefore on the migration of inhaled or injected asbestos asbestos fibers in ex- perimental animals woe CHEMICAL STUDIES OF ASHESTOS Royal ty J. 5. Herington Cancer Hospital London England SESSION 5 PAFER 2 1 The natural oils and other organic matter associated with crocidclite and amosite asbestos have preliminarily been preliminarily examined by various techniques from both types of oil have been identified techniques A number of polycyclic aromatic hydrocerboss The yelds of oil chiained after extraction of fibers with suitable solvents under defined com- ditions range from 0.03 to 14 for both types of asbestos Mass extraction of large amounts of exosite asbestos and crocidclite gave yields crocidolite than on azosite of 0.3 300 though there .011 may be gm fiber More oil considerable variation from appears to be present on one type of asbestos to anther and within any one semple There are also indications that crocidelite oil differs it co- position from aposite oil -14 | 160 BIOLOGICAL EFFECTS OF ASBESTOS SESSION 5 PAFER 2 continued In addition to the oils naturally associated with certain types of asasbebstos estos secondary contas- izeting oils may sometimes be found Experiments have shown that asbestos fibers day absorb up % of jute oil from the jute sacks in which the asbestos is commonly stored or transported Trase amounts of polycyclic aromatic hydrocarbons vere found in samples of jute oil and at least one sample { ves shown to possess promoting activity after tests on the mouse skin In some cases oil emulsions are added intentionally to fibers to facilitate processing . Since the biological activity of asbestos may be due at least in part to the metal complex nature of its structure analyses for iron in asbestos and other minerals vere carried out Corre- activity lations are being sought between the content of ferrous and ferric irto and the biological activity of different minerals Spectrographic analyses have shown the presence in chrysotile of relatively concentrations of chromium and nickel both of which are recognized as carcinogenically active High As part of this project the elution of metals by serm under defined experimental conditions ' has been investigated Methods for the identification of asbestos fibers in histological preparations and tissues have . been developed ward PREPARATION OF ASBESTOS FIBERS FOR EXPERIMENTAL S. Hadellet Fairleigh Dickinson University W. A. Gantt State Department of Health Asbestos in its natural state in the form of cre contains iepurities impurities may be part of the vall rock or occluded , layers of asbestos iepurities or emredded in the crystal asbestos effects of biological molecule To ash this 1/32 visible pieces rotating series ntalning ntalning 2 the tributions were obtained Samples The slurry was filtered through air dried This prearation by estimation of several specific Sous other methods for Flenior method has advantages action it can be stopped at is & finction of time of grinding Fibers prepared by this es reported elsewhere at this them along the fater planes with with scissors scissors scissors fc ae ter lengths lengths lengths to a Waring was half blender was mun until di - in ranges below prepared funnel washed with then hydrocarbon content of the material as measured which are two fold intervals and sales hydrocarbons in a sample of amosite mills fiberizers and disintegrators The at allows the operator to observe the grinding quickly withdrawn for size measurement Size grinding method have been conference injected wean irae into : hamsters and rats by Smith and Miller . SESSION 5 PAPER 4 TESTS FOR CARCINOGENICITY OF ASBESTOS by W. E. Smith and Lonas Miller Fairleigh Dickinson University Medison N. J. intrapleural Asbestos samples were prepared from water slurries with a rotary knife according to a retard described described by BadchBadchllet et and Gents in a preceding paper at this conference paper Soft chrystile chrystile one harsh chrysotile ore and a commercial seyle of arosite vere processed to average fiber lengths average 67 , 18 18 microns respectively seyle Single injection was made into the right chest of golden Syrian hamsters 15 animals animals per sample Each injection contained 25 cess. of sample sus- pended 0.5 cc of 0.97 sodi Extensive granulomatous and intrathoracic tumors were found of amosite No tumors have yet been animals are still through 3 serial chloride fibrous pleural in 2 harsters at adhesions resulted 244 days and 355 days other hamsters at 419 and 527 days given the sample of soft tumors shoved local invasion and generations of new bosts in which it generations each treatment group Large respectively after injection intention of harsh chrysotile chrystile chrystile In each group sex- distant getesteses Che was solid solid solid solid tuncr masses up to In other experiments 180 hamsters and 270 rats bave been given weekly or injections of four types of asbestos prepared by the rotary knife knife method soft amosate and crocidclite in suspending medium saline Pneumonia chrystile tumors have been found in animals thus far examined A majority of animals in biweekly intratracheal chrysatile hars and fabrisis but no these intratracheal tests are still living " -15- 6 ASBESTOS BIOLOGICAL EFFECTS OF TESTS FOR EFFECT OF ASBESTOS ON PINIO PYRENE . GENESIS IN THE RESPIRATORY TRACT ty Lopes Miller and W. E. Smith Fairleigh Dickinson University Madison N. J. SESSION 5 PAFIP 5 CARCINO- Studies by by others associate asbestos with pulmonary carcinomas and pleural mesotheliomas in man In a separate paper at this Conference we reported pleural mesotheliomas in hamsterhsamsters foll intre- pleural injection of harsh chrysotile or commercial azosite Intratracheal exposures with various types have of asbestos however however however vere designed falled of animal sperient sperient sperient reported ExperimEexpnertimsents now reported increase inc^flence inc^flence inc^flence inc^flence to peculiarly of pulmonary carcinomas promotion thus far to test of action of to injectioninjecstions elagat Rumors Rumors hypothesis that some carcinogen sucking peculiarly exposed through Benzo pyrene was selected as a type of carcinogen present in cigaret e cigarette cigarette smoke It vas inhalation as - Tween 60 and administered to hamsters in in 25 veeks with and without chrystile in veekly intratracheal intratracheal intratracheal injections injections injections injections of to a total of 12.5 hamsters divided divided iintno to 5 zestzestzest epidermoid carcinomas were zaizzaizzaiz Fourte n Fourteen Fourteen Fourten treatment were were intervals umors umors groups of 10 andzels each Nineteen Nineteen Nineteen bronchi The first of these tumors was Fourteen enimals enimals died sacrificed et were found in 3 mostly from treatment up to 214 days of 5 hamsters treated carcinomas traches found in the the larynxlarynx in an animal that died 173 accidents before that day In those examined beqween with benzo pyrene alcae days days efter start start of test days Remaining Remaining Remaining Remaining animals animals diei or the 173rd 173rd 173rd 173rd and day four were founfd ofouunndd in hamsters treated with pyrene plus treated with with chrysotile alone in 8 treated with cchhrysrotilye sotile There the suspending vezeTween t te er rs s ters 10 untreated ccs or without without examination examination revealed revealed revealed treated with with benzo with weekly intratracheal intratracheal injections of benzo prese to e total Inhemsters Inhemsters Inhemsters sacrificed 224040 days after start of of this test treated with jyrene alone and 6 twtrs twtrs twtrs in6 : : BRBRONCHIALOBNRONCCHIHALIBRONCHAIAL BLRONCHIAL CARCINOMACARCINOMA Labour Bucheren London London London Great Britain Britain Britain by by by Medical Branch of E.M. Factory death certificates certificates of thesethese dying dying with withwith arrangement arrangement theRegistrar for England England Wales and for Scotland copies of the information routinely Prench tion is certificates relating relating to certain causes of death are routinely sent to Medical and from from from cases information has been obtained It is believed are recognizerdecorgeniczoedgnized during life and that followfinogllowing Great Britain death death death from high a high high proportion proportion proportion of of whatever cause cause this condi condi = rerecordedcorded of the death certificate ofter after autopsy confirmation ExaminationExamination Examination of the deathdeath certificates is considered to be a reasonably accurate means of determining determining determining the number of deaths from asbestosis and also any related pathology found at autopsy Earlier studies of this Factories for 19-7 1954 and type were published published is the Annual Report of the Chief Inspector Inspector of 1945. These earlier studies indicated an apparent association association between the presence of asbestosis and the finding of a thoracic tumour AlthoughAlthough Although such an association association had been postulated some years before 1917 it is believed occasion first occasion when this finding had been related to a that the sizeable study reported in that group The proportion year was the so affected appeared to be increasing in the more recent studies appeUapred 584 thus Up to the end of obtained and the 1963 annual death certificates recording of such certificates are totals proportion also recording a currently continued disproportionately the total number theratic so that tumour has also in both sexes over 50 per cent of males the presence of asbestosis asbestosis have teen currently increasing to increase disproportionately dying with asbestoris The present disproportionately have elso a Decplass Evenwhen viewed against the steadily rising incidence of lung cancer in the population population as a whole there seems little doubt that this increase is a real one NEOPLASIA AMONG INSULATION WORKERS IN THE UNITED STATES SPECIAL REFERENCE TO ABDOMINAL NEOPLASIA by E. C. Hammond I. J. Selfkoff and J. Churg Mount Sinai Hospital New York N. Y. WITH SESSION SESSION 5 PAPIR 7 meters This investigation has been concerned with 1,522 of the of the Asbestos Workers Union I.A.H.F.I. & A.W. A.F.L.-C.I.C. and a zember of these locals on December 31 1942 632 or who joined to New hes York metropolitan area included every ze vho December 31 1962 590 Locals vas -16- 162 BITLOGICALEFFECTS OF ASPECTOS SESSION 5 PAPER 7 : continued Detailed occupational and personal datawere obtained from 1,117 men of the 1,255who were alive on January 1 1963 who were examined Union records were available for similar analysis for those zen those zen who were dead 264 or who failed to appear for examination 141 43 zen have died since the onset of the study lung expected Wehave previously demonstrated using specispecf ific ic death rates in a prospective prospective study of 255 consecutive deaths among this group of men 1963-1962 1963-1962 that total deaths were increased increased observed 295 expected 204 as were deaths caused by cancer of and pleura observed 45 expected 7 and sto- mach and colon observed 29 expected 10 report We nowAugust an analysis of the 307 consecutive deaths among these insulation workers January 307 CONSECUTIVE DEATHS ANCING Cancer of the lung . G.I. Cancer Esophagus Stozach Rectum Mesothelioma Fleura Mesotheliome peritoneu Other neoplasms Bladder Generelized Generelized pharynx Neck Pancreas Asbestosis Pulzosary infection Pulmonary tuberculosis Cardiovascular All other causes 1,522 ASBESTOS INSULATION 26 1943-62 43 1963-64 42 11 30 1 5 023 11 18 320 320 20 3 023 023 137 137 137 1220A S 1220A ",, " " " 1220A ",, " " " 1220A ",, " " " 1220A _ 12 5 7 00077 4 00077 104 00077 LO 00077 264 00077 WORKERS 1943-64 TOTAL 53 35 4 5 27 27 7 L ae 41 307 We have bees particularlyinterested in analysis of those deaths due to abdominal neo- plasms G.I. tract and peritone For a variety of reasons accuracy of diagnosis of such ce plasms is often insecure In 2/5 of the 49 such deaths analysis of all available data shoved the diagnosis to be presumptive ized abdominal abdominal abdominal abdominal abdominal abdominal abdominal abdominal abdominal cancer 6 of this especially only was true 7) Therefore Therefore it is possible more cotton then the of 307 deaths deaths deaths recorded of stomach cancer 5 of 13 and generalthat peritoneal resotheliomaresothelioma may be eves among In addition to the peoplesia the recorded deaths there are 3 zes alive with kissa nep- Fleszs 1 lungcancer 1 pleural and 1 peritoneal mesothelita as well as one apparently cured of tongue cancer one of cepcer the of the color and three three three following successful resection of localized lung cancer found in this survey SESSION 5 PAFER 8 ANALYSIS COHORT ANALYSIS OF CHANGES IN INCIDENCE OF BRONCHIAL CARCINOMA . IN A TEXTILE ASBESTOS FACTORY by Brothers J. F. Knox Turner Brothers Brothers Asbestos Co. Ltd. R. 5. Doll M.R.C. Statistical Research Un Rochdale England London England and Ar association between asbestos asbestos dust inhalation and puttionary fibrosis was first recorded in Great Britain at the the turn of the century but untilfurthefr urther cases were reported 20 years later no official action action was taken on prevention A vey of the asbestos industry in Great Britain was carried out by members of the Factory Department of the before Parliament in 1930. In a sample of 363 workers Home Office in 1925-23 pulmonary fibrosis was and a found Report leid is greatest pro- portion in those employed for 20 years and upwards asbestos textile industry These workers were principally employed in the Following the submission of this to Parliament dust Report to reduce industry examinatiRoegnulsations examinations emission in manufacturingprocesesprocesses . Arrangements Arrangements of new entrants to the industry ent riodic . Regulations were examinations were imposed in 1931 in order also instituted instituted for medical thereafter Workers found to be suffering from disebility due to ppulmonaryulmpulomonanryary ffibrosis ibrosis received compensation and might might be suspended suspended fromfurther employment in the industry Coroners Coroners Coroners vere instructed to inquire into the causes of death of workers in the asbestos bees affected by their industry who had been suspendedsuspended for disability or who vere likely to have employment Necropsies vere performed in west of these cases and material for employment study study study upwards Among association tosis thereby thereby accumulated In & mortalitymortality study study of workers employeedmployed for 20 years and upwards was was responsible for a considerable considerable proportion the workers in one factory observed Lung cancer 10 of this excess A study of excess mortality association with astesa group of workers from the same factory excess of lung lung cancer exposed since the regulations shows shows a reduction in mortality rate without -17- 163 te ee eget ae Spee ee om f BIOLOGICAL EFFECTS OF ASEASRESRSIIOOSS ASERSIOS ASERSIOS FESSION FESSION FESSION 5 PAZES TULNDMARY NEOPLASIA AMORU DRESDEN ASBESTOS WORKERS by G. Jacob Krankenhaus Leninstrabe Karl Marx Stadt G.D.R. and M. Anspach Institute of Occupational Health Dresden G.D.R. who In are the district or have been of the Silikoseerhebungsstelle exposed to asbestos dust are at Dresden 2,645 persons 1124 women present under medical observation 1521 Dea present At suspected 432 cases of of this disease are 151 of those persons who asbestosis also under vere under of varying degree are registered observation medical control have died in 121 in addition 21 cases cases the cause of death could be escertaienscertaineed esdcertained Amongthose asbestos workers A survey of persons ill of asbestosis failure vas the e cause of death A3000 only relatively few cases of lung cancer have been observed to the present to the positively ascertained causes of death is given withwith special reference to b be -e - plasie of the respiratory tract the pleura the peritoneum and turers of other areas gastro- intestinal tract a.o. The characteristics of lung given Data is given concerning cancer and the serosal tumors the time of exposure to dust found in the Dresden autopsies are latent period sex age lung latent localization histology .0 is Comparison made between lung cancer among tica Discrepancies between our data and that in the other asbestos workers and that of the total total popula- publicaties on the same subjecatre pointed out and considered Perticuler observations as to the question of the accumulated accumulated occurrences of pleura mesothelioma in the surroundings of the Dresden asbestos works are presented THE RELATIONSHIP OF EXPOSURE TO AGEESTOS AND PLTURAL MALIGNANCY IN BELFAST Queen's by P. C. Elmes and 0. L. Wade University Belfast Northern Ireland SESSION SESSISOESSNION 5 , PAPEPRAPER 10 10 the the past 14 years 42 cases of pleural mesothelioma have been proved in Belfast derived total population of about 3/4 million A positive history of exposure to astestos at work obtained in 32 of the cases compared with only 9 of 12 matched matched controls bodies were total compared Asbestos found in the the the lungs of 66 of petients with mesothelioma of the pleure 20 of patients with carcinoma disease frequency of the tronchus and in 20.5 of patients dying of malignant The of finding asbestos in the lung is higher 21 in dydiyinngg of malignme alingnetnt disdiseese eese between 60 and 69 maend bodies started industry between 1905 1915 that in the 50-59 age group who started group Between 1906 and 1923 over 1,000 tons a year of boiler composition was inte Belfect compared menufactured taining materials with raw and 600 tons a menufactured year at other times Imports remeined at between 50 and of other 200 tons forms until of asbesatsboesstos cca- 1939 and since then has risen to over 1,700 toas per year in 1960 There is no evidence of environmental exposure from the industries using asbestos in Belfast patients but a positive history of exposure pleutralhe with asbestos fibres in the lungs can only be The latent obtained for quarters of period for the development of pleural after exposure zay be up to 40 years so that increasing numbers of cases arising who die malignancy from exposure which has already occurred can be expected for many years to come imported SESSION 5 PAPER 11 ASSOCIATION OF PULMONARY NEOPLASMSWITH ASBESTOS EXPOSURE IN NORTHERN ITALY ~ by C. Vigliani University of Milan Milan Italy G. Mottura University of Turin Turin Italy and P. Maraczana National Institute of Occupational Diseases Lombardy Italy Abstract not received SESSION 6 EPIDEMIOLOGY OF ASSOCIATION FROM DISTUSE SITUIES EVIDENCE MESOTHELIAL TUMOURS IN SOUTH AFRICA AND THE UNITED by OF AN KINGDOM J. C. Wagner M.R.C. Poeumoconiosis Research Unit Glamorgan Wales PAPER 1 -38- BIOLOGICAL EFFECTS OF ASBESTOS SESSION ( PAPER 2 An association between asbestosis and pulmonary malignancy is now generally caocnctepitneuded More incidence recent investigations have shown that there is an increased incidence of pleural and peritoneal peritoneal n615- thelices occurring in people occupationally or environmentally environmentally exposed to asbestos dust In sire of these cases the exposure has been extremely slight and and and not sufficient to produce the histological features of asbestosis The only painological evidence of exposure exposure has been the presence of asbestos bodies or fibres in the air spaces In South Africa more confirmed histologically Nearly all these Serer are majority of thesepeople wereemployedin the asbestos that then 100 seses of this confined_to_one_aspen have been confined_to_ne_aspen area confined_to_one_aspen confined_to_one_aspen confined_to_one_aspen confined_to_one_asp n ori ttuurirnig ng confined_to_one_aspen confined_to_one_aspen confined_to_one_aspen The industry Chezical_ipvesti-Chezical_ipvesti- Chezical_ipvesti- gations haveshow that oils containing carcinogenic bydrocarbons are present naturally in this per- ticuler type of asbestos At present the incidence units exposure being investigated in Britain of diffuse mesotheliomes associated associated Thoracic surgery and pathology pathology of these tunqurs have been approached and an attempt is being zele to find out how have been exposed to asbestos dust The investigation is only pertly complete and cases have been discovered in Britain as were observed in South Africa Details of dust is have resoris zery of these cases so far as many = - these Eritish investigations will be givet at the papers that follow Tases the association is mainly between_estestosbetween_estestos exposure a terked feature of thesethese Tases " and _ tee and it will be resotheliomas " 4 seen that as in South Africa and asbestosis is often not SESSION PAPIIN 2 EPIDEMIOLOGY OF MESOTHELIAL TUMOURS IN THE LONDON AFEA London School of Hygiene and Tropical Medicine London England Two groups of patients whoheve attended a large bospital in the East End of london have to determine determine their exposure to asbestos first or consisted of 53 patients in when . In all but 7 pest occupational diagnosis of mesothelioma and dinestic Histories the was peritoneal in origio in 62 pleural The earliest 10 of the series died before 1950. 55 of the males and 427 of The interval between first exposure and development of terminal years zeen 37 years second group consisted of 76 patients of the same hospitamlatched by sex and date those traced in the first series been of of those sufferite from resotheliomata had been exposed to asbestos as compared to 11.87 astestos exposure th group Three main types of exposure were recognized textiles infulating materials and other products to dust brought boze by relatives working with asbestos employment of inlaggers festories manufacturing laggers or insulators and those employed in factory work and four whose relatives were working with asbestos opened in 1913 andwas until recent years a teevy user could be traced worked with this type of asbestos were employed at one factory This factory of crocidclite all these those recoris , Among the 36 patients with mesotheliomate with no positive occupational history and no relatives living at home who worked SSeectcot ryory 5 of the of the control with asbestos there series also lived in were Li who lived within half a mile of an asbestos the same area The difference in the proportion of patients in the two series is statistically significant Seika CRITERIA FOR THE DIAGNOSIS MESOTHELIAL TUMOURS SESSION 6 PAPER 3 W.T.E.McCaughey Queen's University Belfast Northern Ireland , The criteria for the diagnosis of diffuse mesothelial tumour are at present imprecise and the security of the diagnosis often depends more on the degree of certainty with which retestatic tumour cat be excluded that on any specific quality of the mesothelioma for The gross Retestetic appearances of the diffuse carcinome to duplicate the mesothelic are not extensive cheet specific It is uncommon however serosal infiltration which is es- pecially characteristic of the diffuse pleural zesothelicza The diffuse mesothelize vs remarkable structural variation histriogically The most specific is structure a mixed one resembling that of a tiated papillary or tubular pattern in carcinosarcoma which the cells The commonly commonly observed well differen- are cubridal or flattered 16 also un- likely to be confused with metastatic tumour form closely resembling that is highly specific if the growth is known to be diffuse Several other types the presence of clefts lined by tumour cells and the disposition of solitary spheroidal interstices of dense colleges are also thought to be highly distinctive The diagnostic azy of these patterns is greatly enhanced if they are associated with one another It must be BITLOGICAL EFFECTS OF ASBESTOS SESSION recognized that sore otherwise acceptable mesotheliomas are histologically indisting other malignant growths If the diagnosis diagnosis should should be satisfied of diffuse mesothelioma 1. A thorough autopsy is to be accepted vithout reservation two main criteria should have excluded alternative sources of tumour or extra have pinpointed any serosal site where there is the leest suspicion of a neoplasz primary 2. The microscopic structure of the tumour should be consistent with a mesothelial derivation and permit certain differentiation from tumours arising in any tissue or organ which might ofhave a prizery besplasz grossly Another less rigorous requirement is that the behaviour should in gath conform within reasonable limits with that of previously proven exeles and harboured the gath particular show a clear predilection to spread along the serose membrane SISSION 6 HISTOLOGICAL CHARACTERISTICS OF MESOTHELIOMA ASSOCIATED WITH ASHISIUS by J. Chur The Mount Sinai Hospital New York N. Y. 5. Mocites Mdlesex General Hospital New BrunswickN. Y. and S. Rosen Armed Forces Institute of Fathology Washington D. C. PAFEN 4 Abstract not received ' MESOTHELIAL TUMORS IN SCUTE AFFRICA PATHOLOGY AND EXPERIMENTAL PATHOLOGY Preumcconiosis Research by Iam Webster Unit Johannesburg South Africa SESSION 6 PAPER The pathology pleureandperitoneum hundred of turcurs affecting and twenty such tuners af ecting the in peritoneum South Africa as mesotheliomata Eighty of the tumors were diagnosed diagnosed suggestive of mesothelioma descriced Oce retzeved pleural biopsy specimen These results as the final diagnosis of the patient well as the exfoliative cytological findings are correlatedwith The relationship thoracic relationship surgical units been associatedwith pati^dts malignant the lungs in of some of these tumors to pleural plaques is gested tuners in the pathological specimens from two tuberculosis hospitals and the Miners Miners Medical Bureau shows that the majority of the patients have the northern from the different part of the Cape Province The incidence of different asbestos areas of South Africa is given malignant tumors of . Animal experiments including those in which estestes was incculated intrapleurally are described Ina few of these tumors resembling resembling a zescthelioza have developed but such tutors have not been found in animals exposed to an asbestos asbestos dust cloud ASBESTOS A BIOPSY SERIES MESOTHELIOMATA AND ATTEMPTS TO IDENTIFY ASBESTOS WITHIN SOME OF THETINOURS by D. O'B Ecurihane London Hospital Medical School London England SESSION 6 PAFER 6 Abstract not received PLEURAL MESOTHELIAL TUMOURS AND EXPOSURE TO ASEESTOS ty W. Glyn Owen Broadgreen Hospital Liverpool England England DUST SESSION 6 PAFER 7 , An attempt to demonstrate association between asbestos exposure and diffuse mesothelioma vas made by study of recorded samples of mesothelions in the Merseyside area of North West Engle~ Thirty cases were considered All had malignant disease of the pleura Review of clinical histories and autopsy Desothelione was thought Evidence of records was followed by reassessment of histological steriel Diagnosis of only accepted where Histological appearances vere to be characteristic asbestos expture was sought by microscopic examination oflung tissue for asbestos bodies and by occupational histories obtained from patients or their relatives relatives Results Seventeen cases were selected as true exemples of diffuse resothelioma 16 pleural 1 peritoneal Other diegatses include secondary carcinize 7 fibrosarcina 3 and uncertain 3 Evidence of asbestos exposure vas obtained in 14 82 of the 17 Desothelioma cases None of the other 13 patients was known to have handled asbestos -20 166 166 PIOLOGICAL EFFECTS OF ASLISTOS . SESSION 6 PAPER 7 continued) Asbestos in Lung Tissue Asbestos bodies were scanty in nearly all positive specimens They vere detected are easily in smears of lung juice No esbestos bodies were seen withis tumour tissue Pulmonary fibrosis was minimal nc patient bad been considered to have pulmonary asbestosi6 Occupational Histories 17 helica cases Of those giving history of asbestos expess~ 5 were lacters employed by firms of insulation engineers and 2 were boiler takers building Two patients employed by Backware manufacturers handled old sacks which had contained asbestos Only 2 patients had worked in asbestos factories One patient gave history of close environmental exposure having worked in the offices of concrete manufacturers using asbestos cement Five gave inconclusive histories Asbestos bodies were present in the lungs of two of these Each of the other 3 patients had worked in places where they may have handled asbestos but there vas no direct evidence 1 boiler maker 1 ship repairers apprentice 1 dock railway labourer General Information Sixteen cut of 17 mesothelioma pete ats have died Average age was 58 years There interval from were 12 ep and 5 first exposure to vozes length development of of exposure ranged from 5 to 43 years tumour was 13 years Interval from end Shortest of exposure to development of succur from a few months to 40 years No attempt was made to ascertain types of asbestos fibre used and DC approach was made to industrial firms or other employers penn ree SESSION 7 PAPER 1 TRENDS IN THE HEALTH OF THE ASHESTOS WORKER by Kenneth W. Smith Manville Corporation Manville N. J. What is an asbestos worker As attempt is made to define the type of vork which would pro- perly classify There are an asbestos worker three main types of Exposure to multiple toxic dusts asbestos fibers in commercial use is discussed today They are different physically Rogically Should the and chemically and produce disease entities which Workers in many parts of the world are exposed to health experience of a group using only chrysotile are different chemically and radioone or another type of asbestos fiber be compared with that of a group using only ampsite or crocidolite The importance of the geographical location of the astestos d^'posit is important ssuchuch as chrose nickel radioactivity etc. associated with some deposits and Are other not others importantt importantt Population characteristics are discussed Disease incidence in a stable isolated population is compared with that of an urban floating population The there be associatioonf other diseases with the an association of a particular disease presence with the of the asbestos fiber is discussed Should asbestos fiber when there is no asbestotic fibrosis present oe fi SESSION 7 PAPER 2 PROBLEMS AND PERSPECTIVES PERSPECTIVES - THE SEQUELAE OF EXPOSURE TO ASBESTOS DUST . by J. C. Wegner Pneumoconiosis Research Unit Glamorgan Wales tion have some The and sequelse of the results exposure of their to asbestos dust include the inhalation of the fibres subsequent retention During this conference a number their deposi- of these fac been clarified and those problems most urgently requiring investigation defined In this paper of the salient features are summarized and certain facets illustrated and aspects in need of further investigation emphasized Logical explanations have been gives for the presence of long asbestos fibres in the maller air spaces Experimental evidence has been given to show that there is a difference in the retention of various types of asbestos The formation of the esbestos body has been described and the signi ficance of these bodies and fibres in sputum assessed The anatomical site at which the lesions of including asbestosis originate has been defined and the progression of the disease demonstrated in experimental anizels The variation of the effect of different forms of asbestos fibre is most clearly illustrated in the monkey and the rabbit The previous concepts of the significant particle size and the solubility of the respirable dust have been serious challenged However the exact rechasms of the pathogenesis of the discase is still unimeve and the migration of asbestos fibres including the ultramicroscopic from the respiratory tract requires much further study The malignant neoplasms associated with exposure to asbestos dust have been discussed On current evidence the earlier view that carcinomata of the lung occur in cases with a significant degree of asbestosis is fully supported but information is still required to confirm that there is Do correlation between exposure per se and these tumours More information is needed on the assselation of these tumours with different types of fibre Mesotheliomas of the pleura and peritoneum we neg eR a ee ee OMT FT g BICLOGITAL EFFECTS OF ASBESTOS . SESSION 7 PAPER associated to be continue with exposure to crocidolite dust however there are some cases of these tumoure la which there is evidence to suggest the implication of chrysotile and anthophyllite Therefore there is a real need for comparative surveys in all the asbestos producing areas In addition a suggestion has been made that tumours of the intestinal tract may be a further sequela of asbestos dust exposure and evidence of this and other malignancies should be sought tile pleural izoculations in experimental animals bave shown and ever silica can produce pleural mesotheliomas The high that crocidolite azosite chrysoincidence in these experimental conditions can cante in these be explained in part by the site of deposition and the high tumours of the cils naturally adsorbed onto the crocidolite dosage fibres used The signifiis being assessed It has become obvious that in this work and in the investigation of the biological effects of astes- tos itself there is a need for a joint effort by the experimental biologist mineralogist and chemist chemist PROBLEMS AND PERSPECTIVES SESSION 7 PAFER THE CHANGING HAZARDS OF EXPOSURE EXPOSURE TO ASBESTOS DUST . by J. C. Gilson M.R.C. Pneumoconiosis Research Unit Glamorgan Wales suggested that heavy exposure to asbestos dust could produce fatel have predicted that the diversity of its effects in man vould be so years later a whole conference devoted to the subject hazards of exposure to asbestos dust has features in comes with other improvements in one ares - the result of vigorous control action by simultaneously with an extension of the baterds elsewhere as new uses of the . the worker The hazards of fibrosis for the asbestos textile worker appear to be much workers are often not adequately protected Do other groups of workers ex- of the material need closer inspection prognosis a definite diagnosis of asbestosis has beer made is poor Cas never methods of functional enslysis of the lungs provide the leans of detecting abnormality in the individual or even in disease the group so that action can be taken has been established There is a most in time to prevent further derage before a progressive striking contrast between the detailed quantitative knowledge now available about the natural history of ecalvorkers pneumoconiosis which can be used is prevention and the absence of such information in asbestosis Will prospective studies of asbestos worders be established to remedy this The striking feature of this conference is the new evidence showing that not only is there a high risk of bronchial carcinoma in those with asbestosis but that other types of tumour occur in the lungs and elsewhere in these exposed to the dust and that these tumours develop in the absence of asbestosis in the lungs and spretimes after a mall exposure but always with a long or very long delay The evidence in man indicates that the type of fibre to which the individual is exposed - a long neglected aspect of this whole problem L is of great importance in the develdevelopmentopdevelmopmentent of these The changing pattern of hazard can be sumrized thus In the early days zen vorking in unC Dtrolled conditions developed asbestosis within a few years and died young often of its complications peria or and premonia tuberculosis improved the As factory conditions altered and the control onset of the disease ves delayed and the late and treatment of tuberculosis effects of fibrosis such as brontziectasis bronchitis and cor pulmonale were more common Still more recently the workers who have developed only moderate degrees of asbestosis have survived long enough to develop the associated bronomiel carcinoma In addition and unexpectedly we are at this time seeing the late effects of exposure to certain types of asbestos occasionally only environmental which were insuf- ficient to pridice appreciable lung fibrosis but have after a delay of 40 or more years led reso- thelial tumours in the pleura and elsewhere These cases date from their discovery emphasizes the the time need when the industry was a small fraction of its present size and to eliminate all unnecessary exposure to asbestos dust in the future But even if this was achieved at once we may anticipate an increased incidence of tumours from exposures during World War II when dust control was inevitably less good There is an urgent need to measure quantitatively the magnitude of the risk for different types fibre so that if the risk is very different as appears probable the safest material can be used the future fee SESSION 7 PAPER 4 MULTIPLE FACTORS IN RELATION TO NEOPLASIA AMONG ASBESTOS WORKERS The Mount E. Sinai by C. Hemod Hospital New York N.Y. Abstract not received -22- 168 NOTES ON PREPARATION OF MAITUSCRIPTSMAITUSCRIPTS MAITUSCRIPTS The Academy's Editorial Division has already mailed out notices to the senior authors listed in the program for this conference informing them of the deadline for the submission of zanuscripts to be published in the conference monograph senior authors who did not receive such a notice or who will have problems zeeting the announced deadline are asked to contact the Editor at the Academy building Included with this advance notice were a set of Instructions to Authors and a special an- nouncement regarding size of zanuscripts and extra charges to authors bring It may be helpful however to out at this time following points regarding the preparation of manuscripts Manuscripts Manuscripts should be typewritten on white bond paper paper paper double spaced throughout -- -- including references Fiure cations foot- footfoot- foot- potes etc. Submit only the original copy References All references listed ences can be Instructions set up either for numericaly to Authors numerically numerical y numerical y numericaly numerical y numerically numerically further used references must be cited in the reference # 1 being the first reference cited in the text Refer- alphabeticaly alphabetically see the Academy's the numerical system is ascending numerical order Art Work illustrations If possible please avoid submitting sized tables or For example photographs or other artwork that are con- siderably larger than the usual 8 x 11 size must be so drestically re- duced to fit our page size as to often eliminate a good deal of detail Remember too that words numbers or letters within any Figure illustra- tion should be large enough so that if reduction is necessary such voris numbers or letters will still be legible Note to Foreian Authors All material except references to foreign publications must be in English This requirement includes table titles and column headings and any interior information within a Figue illustra- tion have Authors who at any time any tion of their manuscripts should feel Academy questions regarding free to contact the the preparaEditor at the