Document O1yppXd4zebk2j1xmb9r81L2M
FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY021
DOCUMENT DESCRIPTION: Transcript of Presentation by Dr. Merewether with Discussion
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BY DOCTOR RHQAb-1 t
W ill th e m e e tin g p le a s e come to o rd e r? You w i l l
rem em ber t h a t we w ere f o r c e d b y th e d e la y s t a r t i n g t h i s
m orning, to p u t over D octor K erew ether's paper to the f i r s t
one on th e program th is a ftsrn e o : * I t
t h e r e f o r e , ray
h o n o r t o in tr o d u c e E . R. A. K e re w e th e r, S e n io r M e d ic a l I n
s p e c t o r o f F fu;3or *3, A d m i n i s t r a t o r o f L a b o r an d A l l i e d
S e rv ic e , London, I -gland* D o cto r M erew ethor*
j
BY DOCTOR uSTEWETKS?.* D octor R hoads, L acies and Gentlem en*
I I sac g r o a t - i
ly honored to be in v ite d to a tte n d th is e ru d ite n estin g w hich h a s now, b y v i r t u e o f 'the d iv e rs e and in s p ir e d w ork o f jay o l d f r i e n d , th e l a t a D o c to r LsRoy G a r d n e r ,a n d D o c to r j
Vorwald, become an In te r n a tio n a l event*
i
How, o n ly a f o o lh a r d y c r i m i n a l w o u ld s p e a k a f t e r jI
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th e no a t s tim u la tin g p a p e rs o f th i3 m orning, b u t 1*11 o n - j
d e a v o r t o do my b e s t , an d I s h a l l n o t d e t a i n you lo n g *
A il I have b een a b le to do in th e s n o rt tim e
;
a v a i l a b l e i s to bx*i 3 up to d a t e o u r m o r t a l i t y a n d p a t h o - :
lo g i c a l d a ta on t h i s m atte:: and la y thorn b e fo re you i n tn e ;
c o n f id e n t hop t h a t :.f th e r e i s an e x p la n a tio n o f them , and 1
t h e r e -e d e d u c t io n s t o fca draw n fro m th ere, I s h e l l o b t a i n
them d u rin g th i s co n fe re n c e *
'
F ra n k ly , I'm p u zzled and d is tu rb e d a t the p o s s i
b i l i t y w hich may em erge, n o t on ly in c o n n e c tio n w ith th e
TAKES I'lSM PAGE 397,
Coetor Ehoads, Lading aud Gaatlssssm X as* greatly honored
to b in vited to att*Bd th is nsdite cting viMch fcss osar, tgr
virtu o f th divers aad iasplrad work o f old frl&ad, t-iia
Xdt Ecstcr LsBoy G-rfeer, sd Dootor forwsld, bse*s aa
iutaync-t-icrsal eYstvfc,
Bob, caly a feelusrdjr e.?iain*l soald speak eft? tbs isost
tttiaulat&sg papaya o f th is aorrdisg, t t I 'l l 8deaver to do sgr
I's g t, read I s h a ll s o t d e ta in yoa Xsag* All. I L. fcosn sKLs to do ia lisa elcrfc tlE astdX&t-Xs i s to
up to data cur m ortality pad y 'lielegical fe ta ca tk i t t * r
fisd la y thssa hofor .yoa ia tho cssfld o o t lisp t!iat i f tto rs i s
aa explKiatioa o f that, ad tbsr as* deductions to to daras &ca
ibs I ;M 1 obtain
darlag th is coafsy&a*
?sakly, I !a pfe?4 a4 d is '- ^ ta d a t tka p o s s ib ility
F5*y ss3.`-y*j a o t csnly i a cosnootisa td/tti # 2
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q u e stio n o f an a tio lo g ie a l re la tio n s h ip betw een cancor of $28 lu n g an d a s b e s to s * b u t a l s o b e tw e e n c s jo c c r o f t b s lu n g
and o th e r lo c a l ilx .r ss# I n 191$, I made a n o te o f th e d e a th s from a s b e s -
to s is , asb esto s la w ith tu b e rc u lo sis and e ith e r o f chase
*
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w ith a ls o canoor o f the lun g , re c o rd e d in th e U nited King- j
dcm fro m 19d t o 19U-7* I p l& co d a lo n g s id e thorn f o r com-- ; p a r i s e n , th e c o r r e s p o n d in g d& ta we h a v e fro m s i l i c o s i s and e&Jioer o f th e lung* These w ars f a c t u a l d a ta w hich sp eak f o r them selves in s o f a r as they go* l t 1 a tto m p tsd to sales j d e d u ctio n s s in c e I f e l t th e a s b e s to s is d e a th s were too few j
{ f o r th e p u rp o se * I hav e now b r o u g h t th e s e f i g u r e s up to
date*
The c o rre s p o n d in g f i g u r e s f o r s i l i c o s i s doa'fiha
csuoxmt t o s e v e r a l th o u s a n d 3* They Ksre, I t h i n k , su ffic 3 ix * ."
l y la r g e to show t h a t th e r e i s no e t i o l o g i c a l r e la tio n s h ip j
b e tw e e n s i l i c o s i s end c a n c e r u .' th e lu n g a n d i n t h i s Im j f o r t i f i e d by th e d a t a p ro d u c e d b y th S o u th A f r ic a n e x p o r ts *j I w ill n o t weary you, th e re fo ro , w ith the ad d itio n s in tns !
l u s t th ro e nd a q ^ rfc o r y e a rs to cu r s i l i c o s i s fig u re s . j !
B r i e f l y t h e r e f o r e , o u r la te r , v f i g u r e s a r e r-oc orchid
d ea th s from a sb e sto s is , asbo& tc3i3 w ith tu b a rc u lo c ' ~, o r | e ith e r com plicated w ith can csr of the lu n g , w ith cancer, j a r e 306 . I am e x c l u d in g to n o f th e s e w h ere t h e r e i s a l s o
ca n c a r o f s i t e s o th e r t in th e Ixm -s Our n e t f ig u r e s a r e , ;
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fchar-i- iV 9, 296 do a 1 3 an d o f t h a s e f o r t y - e i g h t o r 1 6 .2
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p e r c e n t w ar a s s o c to d w ith c a n c e r o f th e l u n g . 57his
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show3 an in c r a a s e i.-o a a 13*2 p e r c e n t d is c l o s e d by our
e a r l i e r f ig u r e s . T his moans t h a t , os raora d e a th s fro a !
a s b o n t0 3 i3 coma to h an d , th a c u m u la tiv e p e re o n to g e o f
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d a a th a w ith c o m p lic a tin g c a n c e r o f th e lu n g i s r i s i n g r&t-li&ij
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than f a llin g .
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How, wh&ro do we go to fro m h a r e ? A ro th o s e f i g - j
urea s u f f ic ie n t to in d ic a te a c au sal r e la tio n s h ip batw een j i
th e r e t e n t i o n o f a s b e s to s d u s t i n the lu n g s and su b se q u e n t; ji
can cer o f the lu n g ? The sm all numbers c e r t a in l y d ic ta te
c a u tio n . ..ev o i th el9 sa, th ey r e p r e s e n t th e g r e a t m a jo rity
o f th e d e a th s from a s b e ^ to s is vaJ.ch have oco'U TSd in th a
U n ite d Kingdom d u rin g th e p e s t q u a r t e r o f a c e n tu r y .
Hcwadays, i ..cause o f th e g r e a t ly inert->sed a w are
ness o f w o rk ers, d o cto rs and o th e rs In tha neighborhood o f j
a sb e sto s p la n ts , o f th a d is e a s e , because o f th e duty o f
|
C o ro n e r* to i n v e s t i g a t e w ith a u to p s y a n d t o r e p o r t to ray d o -
portenant, dvatl-a suspoctw d to be due to o c c u p a tio n a l d i e - j
e a s e , w h a te v e r i t xnay b e , t h e c c n tp o n s a tio n b e n e f i t s a c c r u - i
in g to c ases o f pneum oconiosis, th e sya te a o f fa c to ry 'r. - .
/v i- Dgi o d i c a l ch9clc-ut> o f th a d e a t h c e r t l f i c a te * 1
o r o v id a d by th e R e g i s t r a ; C-5t a r s i , and f o r o t h e r r e a s o n s , '
i t i s l i k e l y tha*. very few d eath s from a s b e s to s i s escap e 1
n o tice
T h e re fo r , w i t h c o n f id e n c e , I th i n k we co n s a y th a t th e fig u re ? p o in t to the n e c e s s ity fo r th e c o lle c tio n o f s im ila r d a ta from o th e r com m unities w ith an a s b e s to s is h azard , so th a t by weans of s t a t i s t i c a l exam ination o f the I
g l o b a l f i g u r e s so o b t a i n e d , we c a n a e t t l a th e q u e s t i o n o f ij
w hether cancer o f th e lung is an a d d itio n a l r i s k o f asbesgtos exp o su res
iI Now, I s h o u l d iio n tio n h e r o t h a t th e f i g u r e s in U n ite d Kingdom, t h a t th e s e f ig u r e s in c lu d e a l l o f tb a a . b e c a u a e th e y come t o a , so t h a t we rr. <t n o t ad d u p e x e s s s fig u re s and - the X fig u re s and Y fig u re s and Z figuros# and th in k th a t they *re a l l ad< i onal can os o f asboato.tlc* w ith efti'clnom a o f th e lu n g , One c a n add u p , o f ccurs * d if f e r e n t c o u n trie s , b u t one roust be v ery c a re fu l adding up o r d u p l i c a t i n g t h e s a n e c a s e s i n th e s a n e c o u n trie s !# T h ire is a n o th e r p o in t th a t was b ro u g h t up th is morn l e g , t h a t th e p o p u la tio n r i s k o f a s b e s to s i s c-calX re la tiv e ly to o th e r Indus trio s and i t flu c tu a te s# A b rin g s a g reat in c re a se of people, because obviotrsly, th e re i s a g r e a t demand f o r h ig h c la s s a s b e s to s I n s u la ti on f o r u sa i n w ar s h ip s an d o th e r t ^ ; e s o f w ork, and t. .en i t d ro p s o f f a g a in , so th a t o n e c o u ld no vox* r e a l l y g e t a p o p u la t io n , l fo r in s ts n e o , to w hich one eoul i r e la te a p a rticu la r ca se | OJj a s b e s t o s i s , assu m ing t h a t a s b e s t o r i s a f a c t o r i n t h i s ;
;sr.
k O lm'
j;
How, a n o t h e r t h i n g i s th e r e v e r s e w h^ch I t h i n k j
ij h a s g o t to be b r o u g h t i n m in d , i n t o m in d , t h a t whan one i s j
j1 c o n sid e rin g a h a z a rd in an in d u s try and one w an ts, a s the J
i!
I
f s t a t i s t i c i a n s alw ays do w ant, som ething lik e a w o rld popu- j
j lafelon b efo re th ey give us anything very s a tis f a c to r y about! j
the m a tte r, th a t you - you say th a t, f o r a l l p u rp o ses, the
|!!| p o p u l a t i o n o f a n i n d u s t r y i s s a y tw o h u n d re d th o u s a n d , y o u r
!i v e r y r i s k may b e o s t i n th e m ass o f th o p o p u la tio n *
1:
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That o ccu rs, fo r in stan ce, in coal carbon tra d e ,
j]
j! w hore I t r i a d a n urabar o f y e a r s a g o , a r e l a t i v e l y s m a l l
i! p o r t i o n o f p e o p le e x p o s e d t o t a r o r t a r r y v a p o r s , an d
!!
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fi th e y * ri> l o s t i n t h e w h o le p o p u l a t i o n o f th e t r a d e , b u t
j when you l i m i t th a n to th e p e o p le who a r e e x p o s e d to t a r
jj a n d t a r r y v a p o r s , y o u f i n d tl ie r e i s s i x Waxes th e r i s k o f
|| c u ta n e o u s `c a n c e r I n o t h e r w o rd s , th e r i s k w as l o s t i n t h e
r o v e r a l l num bers a a a u a o d to b e a t 2jis k
ii
And, i t i s soma tilin g l i k e t h a t i n th e a s b e s to s
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|i tr a d e * A l o t o f p e o p le d o n 't }: ->.v e much o x c o s u r e to a s h e s - I
!!
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{I t o s a t a l l * How, as f a r a s th e r a t e i n a s b e s t o s , I h a v e n ' t :
i; g o t i n t o t h a t y e t , b u t f o ll o w i n g a r e m a r k made t h i s m orning,!
; I w i l l try and do so*
i.
Then Doc t e r Lynch d id c a y , w h at i3 th e d e g re e o f ;
a s b e s t o s i s * Now, a l l t h e s e p e o p le h a v e b o o n a n t o p s l e d and
a l l o f thorn ddea p r i m a r i l y o f a s h e s t o s i s , w h e th e r th e y had
tu b ercle or cancar la ..
iiQ S, 4-
D o c to r O p p sh h a im er, h a s - who h a s dona some e x p e r im e n ta l
work w ith c e llo p h a n e w rapped aro u n d h in g e s , w hich may b a a
p o in te r to th is fa c to r i f i t is m a te ria l. Thank you.
BY DC .'TOR RH0.1338
Thank you, D octor M orew etber.
!
I s th o ro a comment j
a b o u t th e K o rsw e th e r d i s c u s s i o n ? (No r e s p o n s e ) .
Doe to r L an za, I h in k you c a n make seme ccisusmt ;
on t h i s .
BY DODTOR L W ZkS I lr . C hairm en, L a d ie s and Gentlo r s e n , b e f o r e s oiR S
in to t h i s b r i e f s ta te m e n t o f mine on c h ro m a te s, I w ould lilx si
to make a few comments on D o cto r K e re * e th e r s b a o rv a tio a a . J
I was v e ry much im p ressed w ith w hat D o cto r H ere --
m oth er s a id ., and fchore i s no q u e s tio n b u t u h a t a v ery
c a r e fu l, p a in s ta k in g Job has been dona in G re a t B r ita in on
th e s u b je c t o f tr y in g to d eterm in e w hat th.o h a z a rd m ig h t b e
in the asb esto s in d u stry w ith re sp e c t to c a n c e r.
J
T h ere a r e j u 3 t a c o u p le o f c o i w o n t s , I sm n o t s a y
ing cas Jay o r the o th e r, th a t I t nay o r nay n o t in flu e n c e th e in c id e n c e o f c a n c e r . I v?oi;l d r a i s e a c o u p le o f p o i n t s j
vb? oh I th in k a l l o f us m ight keep in r in d , ana w hich m igh t i
I
p o s s ib ly have some b e a r in g on th o s i t u a t i o n i n Engl:., - i.
1
How, I have v i s i t e d , somewhat e x t e n s i v e l y , I t h in k ,
n e a r ly a l l the a s b e s t o s p l a n t s o f th e U n it e d i t o s , a.**d th e
m ines and the r a ill3 in Canada and have span q u ite a l o t o f
tin s th e re , and havo sp e n t a l o t o f tim e rev iew in g ." lia s , ! i
and n o t long ago, ep en t s e v e ra l days w ith D octor K enneth
S m ith on a s b e s to s , re a d in g h is f ilm s ,
I fin d i t d if f ic u lt to b e lie v e th a t our cancer
in c id s n c a among a s b e s to s vfo rk ers c o u ld be a n y th in g l i k e a s i
la rg e as i t seams to be in E ngland, because w h ile I a p a r - j I
f a e t l y f r e e to a d m it t h a t we may h av e m in se d c a n c e r c a s; i I
v h i ' h wc s h o u ld h a v e n o t , on t h e o t h e r h a n d , I d o n 't t h i n k j
wo c o u ld h av e m is s e d a l l o f t u i f th e y h a d o c c u r r e d . I n t o
th e same e x te n t t h a t a p p a re n tly th e y do in E n g lan d ,
Sow# t h a t i s bim p ly an o b s e r v a t i o n o f m in e . Of
c o u rs e , i t is true t h a t as soon as th e b u s in e s s o f th e burs**
r u l e f f e c t s o f a s b e s to s once to o k h o ld in th e Am erican i n
d u stry , they d id s t a r t to clean up th s ir p la n ts and, w hile
I w ouldn't aay th a t a l l the a sb e sto s p la n ts in th e c o u n try
were m arvels o f in d u s tr ia l hygiene p e rfe c tio n , n ev erth e
l e s s grs" fc s t r i d e a h a v e b e e n m ade, and p a r t i c u l a r l y , f o r
in s ta n c e , in th e p l a n t in D o cto r K enneth Lynch' s town in
C h a rlo tte , South C a ro lin a , whore th ey have done a very
b e a u tif u l job, so th a t w ith the sm all number o f p eople in
th e i n d u s t r y , i t ' a o b v io u s t h a t we * ro n e v e r g o in g to h a v e |
th e c l i n i c a l e x p e r i e n c e w ith a s b o a l o s l s t h a t we h a v e , fear i
in sta n c e , w ith s ilic o s is , because th ere is not going to be
th e m a te r ia l to work on*
:
Now, b a c k o f t h a t , tL h re i s s t i l l one m ore q u e s t i o n
M l.
T h a t i s th e n a t u r e o f th e a s b e s t o s i t s e l f . Now, whr-n I
j
f i r s t u sed to go to Canada, X u sed to h e a r fre q u e n tly th a t, i
u p t h e r e , t h a t th e C a n a d ia n a s b e s t o s was l e s s d am ag in g th a n jI
i
th e Kind, th e y u se d i n E n g la n d , I b e l i e v e , and I h av e p u t
j
i
t h a t com m ent down to w h a t we m ig h t c a l l th e n a t i o n a l o r
}
lo c a l p a trio tis m , you know, lik e th e r iv a l r y betw een tow ns,
so th a t you so fre q u e n tly se e , b u t the f a c t reiaalns the
sam e, t h a t i n t h i s c o u n t r y , we do vise th e a s b e s t o s , m o s tly
t h e a s b e s t o s t h a t wo g e t fro m C an ad a , a n d I b e l i e v e , fro m
w hat I h e a r from our E n g li.h frie r, 's , th a t a g ro a t da s i ,
i f n o t th e m a jo r p a r t o f th e a s b e s t o s v~ : d i n E n g la n d , i s
illtO desian a s b e s to s , which i s q u ite di a s im ila r in i t s co n - ,
s tru e tio n and in i t s form ation, i t s p h y sical c h a ra c te rise I
t i c s , to th e k in d th a t comes from T h e tfo rd and from a sb e s
to s in Canada*
How, t h a t may have n o th in g to do w ith i t , and up
u n t i l two o r th re e y e a rs ag o , I d is m is s e d th a t* I th o u g h t
t h a t w as j u s t p u r i l e , b u t s i n c e we h av e i n th e y o a ra , leecn o d th a t d iffe re n t typos o f s i l i c a , produce e n tire ly d is tin c t p ath o lo g ical e ffe c t,
l a s t few
j
i
fo r insteneej
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I cm b e g i n
n i n g to w o n d e r i f we h av e n o t f a i l e d t o p a y s u f f i c i e n t a t
te n tio n to th e ty p e o f ashes- .3 w hich v a r io s ev en , as I s |
i
in fo rm ed , th e re i s a d if f e nee betw een the a sb e sto s th a t ;
i i s m ined in th e town o f A sb esto s and th e k in d t h a t i s m inedj
n o t f a r away in T h a tfo rd , ar y e t b o th o f th e s e , i n tu r n ,
!j.0 8 <
a r e q u it d i f f e r e n t from th e a s b e s to s t h a t come fro m Rno-
desifc.j and p o s s ib ly from o th e r p a r ts of th e wor: d w ith
w h ic h I'm n o t a c q u a in te d *
And, h av in g in mind the le s s o n w e've le a rn e d in
th e s i l i c a d u s t, I t h i n k t h a t i s some a i n g p e rh a p s t h a t we j
s h o u ld p a y more a t t e n t i o n t o . Now, I Jim p ly r a i s e t h a t
|
p o in t, b e c a u se I th in k i t may have a g r e a t d e a l more s i g - j
n i f i c a n c a th a n wa have b o e n i n c l i n e d to g iv e i t . How, I have s u n m a riz e d - I h av e sum m arised
j rs ^
m ark s h a r e v*?y b r i e f l y , b e c a u s e th e *'-opio o f chx-m e i s g o in g t o b e h a n d le d by D o c to r Anna B a e t j e r , who h a s done th e
ex p erim en tal work in chrom e, and has a more in tim a te knew-
lodge o f i t from t h a t p o in t o f view titan I d o .
|
fho a v a ila b le evidence is th a t chrom ate w orkers j
do have an in c id en ce o f c a n c e r o f th e lu n g s in ejw sss o f j
w h a t m ig h t b e x p e c te d . B eyond t h i s , we do n o t a e y a t Imcw.
a g reat d eal.
j
I n te r e s t in chrome as a ; s a ib le c a rc in ' ;-eaie
|
a g e n t, w ith p a r tic u la r re s p e c t to lung e& noar, ocam era I
liv e ly r e c e n t . She o f f i c i a l s o f one o f th e la r g e s t ckrcaa j
p ro d u c in g co m p an,ies i n tt-hviiiso c ^uunnt^r yv a3Uu"n -o 1l-i e d th e its p o tu s jj
*t t a t s t a r t e d i n t o * . . * t o t o l .
In to . O nltod 6 t o t . j
th e ir W r .h .M lo n . to ta n g ib le font., in . . t t t o s
t n . s t a t i s t i c a l au r-w j conO uctbd b j H .c h la and G rag o rlu a, Q
-"b lld h o d in t o . P u b lic H ealth R eport.. on A up.st 27th,
{ __ _____________ __ ]t09*_._j
I
E f f o r ts wore made to re d u c e ex p o su re In chromium p la n ts and more in te n s iv e m ed ical s e rv ic e was in a u g u ra te d w ith a much more f r o s u se o f X -ray e x a m in a tio n , ar I v en tu re D octor B a o tje r w ill t e l l you of h e r .ork in B altim ore
w ith ex p erim en tal anim als* How, D o c to r B a e t j e r p u b l i s h e d a com p reh en sive
paper on pulm onary carcinom a in chrom ate w orkers in the A c h i e v e s o f Industrial H i s t o r y i n 1 9 5 0 , and up t o now, there is not much m ore t o s a y t h a t w as n o t s a i d i n h e r p a p s r* i n a w o rd , aa th e s a y in g g o e s , nhe c o v w s d th e h * a e * .fr o m so u p t o n u ts * a n d a s f a r a s o u r q u e s t i o n s t a t e d
along t h a t l i n e , goes* How. f o r t u n a t e l y , d u r in g 1 9 5 2 , th e D i v i s i o n ox
O c c u p a tio n a l H e a l t h o f th e U n ite d S t a t e s Public Health
Sorvlc ,
U a a s l s t - w * an d c o o p e r a t i o n o f
^
in d u s try , conducted a su rv ey o f th e w hole chrome in d u s try .
Through the c o u r t e s y o f D o c to r C v a rd S. M i l l a r , i n ccj* &
o f th e D iv isio n o f O ccupational H ealth , I have been given
a eopp ' the m e d ic a l p o r t i o n of i' Jr a d m ir a b le v if : r.
D o c to r A i l l s r w as ki?ad t*no.th t o ' -'.3 I iih^n I fish o d him I f 3he was g o i n s t o p r
b e r a and. ha -said no. f 1 X'o xr fc^ j_xi'.t3 v r , i s ill f
i t w i l l b a prostsnfcxw. . - i v a li a b le , I w i l l o n ly 'r e f e r i i t
in a vary b r ie f
I b u o to f *'<" 5 te
E , *i a *
j10,_
S erv ice R eport* A ll s p e c ific causes of m o rta lity in chrome I
w o rk e rs , th e chroma w o rk e rs h ah fre q u e n c y r a t e s t h a t wrers
n o t g re a tly d if f e r e n t from o th e r w orkers. However, can cer
w ith a r a t e o f 7 1 com pared w ith .7 s ta n d s o u t as m a rk e d ly
i n e x c e s s f o r chroiiv -,e w o r k e r s . F o r c a n c e r o f a l l s i t e s ,
th e a c t u a l num ber o f d e a t h s < :* chrom ate w o r k e r s was a p p r o x
im a te ly fo u r end a h a l f tim es the number th a t w ould have
b een ex p ected had th e can c er r a t fo r a l l m ales in th e
U n ite d S ta te s p r e v a i le d . When cane o r o f th e ro sp ir& tc-ry
sy a tarn was o b s e rv e d s e p a r a t e l y f o r curom ats w o rk e rs, n e a r l y ]
tw e n ty -n in e tim e s as many d e a th s as were e j e c t e d w a rs
jjJcund. A ll o th e r ty p e s o f c a n c e r f a i l e d to show an e x c e ss
among ehrom ato w o rk e rs.
j
I t 5.3 o b v io u s -- t h a t ' s th e en d o f t h e q r.o ie -- |
i t is obvious th a t much r e s e a rc h and e x p o rira e n ta tio n ra m a in I
bo b e done b e f o r e we c a n t a l k w ith iaore a s s u r a n c e o f t h i s jj
s itu a tio n . l a the ao an tiaje, the in d u s tria l p la n ts a re b a - j
3_rig c le a n e d u p and I n ecwie c a s e s r - b u i l t w ith th e hope a n d
ex p ectatio n o f steadying th is tid e of cancer oases*
B e f o r e l e a v i n g t h i s t o p i c , I a g a i n w o u ld Ilk fc -
r.isico a pw@a
i sna rior*e c& p eriil and p i^ a c isd u s o a n d \s?soo~ j
ia tio n of w ords. ?ho evidence
the r e la tio n s h ip of chrome
exposure and pulm onary c?.ncar appears c o n c lu siv e . ibis
;
c a n c e r o f th s lu n g s In chrome w orkers dees n o t fo llo w , as j
fa r as " cen a s c e rta in , does not follow , n o r is I t dependent
411,
upon a p r e - e x is tin g pneum onoconiosia. I m ention th is so th a t th a re may n o t be any f a ls e co n clu sio n s drawn from the assoc^ i a t i o n o f th o s e two te rra s as th e y a r e use-:: i n h e a d in g up
our program . Thank you*
!
BY DOCTOR RHOADSt
!
W ith v ery c h a r a c te r is tic p re c is io n , D octor Lanza j
has l a i d to r e s t any illu s io n s o r q u estio n s th a . m ight be j
r a i s e d c o n c e r n in g t h e r e l a t i o n o f c'r ome to p u lm o n ary c a n c e r .
Is th e r e a comment on D o cto r L a n z a 's p r e s e n ta tio n ?
j
BY D0CT03 RICgiiBDiO??> ho were th e w orkers th a t were e ffe c te d in th is ?
13y rJJCTOH LAKTJli As f a r as I know now* I c a n 't t a l l y o u p o s i t i v e l y |
u n til I have had a chance to d ig e st tha P u b lic H ealth S er
v i c e r e p o r t , b u t y o u know th o s e a r e s m a ll Pl a n t s r^ d i a
n l& n ts, min s h i f t aro u n d , so th a t i
(h a t p a r t i c u l a r ohrom e subf>l;nnce o r :g i n th e m.anufact--s?3 o f 0 -IT*OIVia i s :
'sib lo , i f i t
i s a , i c a r , b u t wo do n o t know o r y o u 0 g ro u p o f n o n i n t h i s d e p a r tm o n t o r t h a t r-oup o f ^ n i n
t h a t d e p a r t m e n t , u n f o r t u n a t e l y , we c a n ' t do i t .
rV -DOC-TOR S I CEASPS: W e ll, con I d wa ?.uy
t o r u end when d ess i t and m
von d' th e j.
ba exposure to chrome o ess of the h andl ing
of c-frome?
I
EY DOCTOR LANZAS WoXl, y o u w o u ld h a v e to t '_ n .
We h a d , I t h i n k ,
the en gineering p o rtio n of the P u b lic H ealth S ervice re p o rt,
w hich w ill give the d e ta ils o f the p ro c e ss, the d u st s tu d
ie s , and so fo rth , a t d iffe re n t sta g e , a l l along the lin e ,
from the tin e th ey g e t th e ir ore o u t u n ti l i t i s shipped
o u t o f the p la n t.
j
SY DOCTOR RICHARDS: W ell, then- is th e re any h azard a f te r i t is
shipped out of the p la n t?
by dogtor lamza:
I
As f - r a s I know, th e r e h a s b e e n no o o ju p la in t ffv '4
any s o u r c e , b u t t h a t a g a i n i s sons ti l i n g w d o n t k e sw .
BY DOoTOR RHOADS! D o cto r Kuoper h as comment.
BY DOCTOR
X
You a s k e d th e q u e s tio n w h eth er th e s a a te r ia l '
shipped o u t of th e p la n t w ill become c a rc in o g e n ic . T :.,ro ;
have b een r e p o r ts from Germany t h a t z in c p ig n -m t u e rk o rs j
have d ev elo p ed c a rc in o g e ,.. The z in c ch ro m ate, lb s y ello w j
d i e w i t h w h ich we s p r a y o u r a i r p l a n e s a n d w ith w h ic h we
!
sp ray the o i l tanka and o i l p ip e li n e s , i f you see cnoca
b e a u t i f u l b r i g h t y e llo w c o l o r s i r th e la n d s c a p e o f our- r e
f i n e r i e s , t h a t ' s z in c c h r o m a te . We a r e q u i t e a b i t i r . t e r e s \
to f i n d o u t w h eth er th e p a i n t e r s who s p ra y e d th e z in c
Mh
ch ro n ata on our a irp la n e s d u rin g th e la s t war have In c re a s od c a n c e r i n c id e n c e . We d o n 't know t h a t . They < n u t b e
tr a c e d , bub i t soems to b e .
BY DOCTOR VICKSHSt
(
In reg ard to th e p revious q u estio n , I m ight soy i
th a t in th e chrome in d u s tr y , w o rk ers are ex p o sed to ch ro m a ^
i n one way o r a n o th e r e l l th e way th r o u g h th e p l a n t . Scsne *
o f y o u r w orkers a re exposed to chromium, and soma to
h e x a v e liu a a l l through th e co sratio v
BY.DOCTOR RHOA P j:
*
^ You c a n 't p in down any p a r t i c u l a r s to p o r form of
chrom ium ?
by r o c Toa .yxcvKn^:
"
i!o, , vror! M
M ill J a w * ,<
13 !
. . . ram . * . t tw r . -1 *
l a a " tcT"
or
d r t M M * *> < * * * 811 "
-- *
by f-OC?Q?
*
W ould you c a r e t o comment on te a s^lac ehx ornate
o b se rv a tio n , D octor V c-xarai
gy
1/M : 'oS
i'Oa
v/iT ' ..aTOR TV'OAIW}: " ....... " x.3 t h e r e f u v h t o r comment?
D octor B ro tjo r?
BY D'l ?OR In the 1' te r a tu r e , th e re have been re p o rte d , ^
U lll. ;
already in the lite r a tu r e , a hundred and th irty -fo u r cases j
th a t a re a lre a d y on re c o rd . Of th a t number o f cases of lung c a n c e r, th e re w ere a hundred and tv m ty -o n e of tnoae a re in the chrom ate p ro d u cin g in d u s tr y ; te n a re in th e chrome pigm ent in d u s try , th a t is where they are m anufacturing th e z in c chrom ate p ig m e n ts, and th e v a r y in g , th e le a d chroisjace p ig m e n ts , and o n l two h av e I b e a n a b le to f i n d r e p o r t e d
in th e l i t e r a t u r e , among p e o p le who u s e chrom ium .
sJe h a d one c a s e i B a l tim o r e i n a oJirome p l a t e r , f
b u t lie was a ls o exposed to many o th e r s u b s ta n c e s , end
I
th e re i s one r e p o r te d i n th e l i t e r a t u r e who s p ra y e d a acorn-
ittm o r s p r a y e d w ith chrom ium p a i n t . W h e tn e r i t was o p r y
p a in tin g or n o t was n o t s t a t e d . So t h a t , alfco g et -r, o f
the one hundred end th i r ty - f o u r c a s e s , th e re a re a huiutrod
'TV-*tr.tO Ol*
CLOOVitS fclictt/ CiX*& -5-H Co.13 Ciii
i
du ein g o r chrome pigm ent p ro d u cin g Indus tr y , and only tw o, J
so f a r , in th e chrome u ao rs#
!
T h e re a r e a few o t h e r p o i n t s , i f I may add a i ow .
p o i n t s t o t h i s , i f D o c to r L a n z a w i l l f o r g i v e me f o r a d d in g :
o n to h i s p a p e r . I d o n 't Know w e a th e r he g o t o v e r th e p o in t*
to y o u uti&w W"
v5i, i , i n t o r e s t i n g l y e n o u rn , an y
c a n c e r o f th e s k i n i n chrom ,ue w o r k e r s , n o r h av e we o v e r
had any can cer of tne n a sa l seep
e v e n U: --ugh a l a r g e
p e rc e n ta g e o f th e s e wor.-cers have p e r f o r c t i o f h .s n a s a l
3cep tun,
JO Sj
T hare a re some f ig u r e s t h a t n ig h t i n t e r e s t you
c o n c e r n in g th e d u r a t i o n >f th e e x p o s u re o f t h e s e p e o p le
j
u n t i l th e y g e t c a n c e r. Kay I show one s lid e ? T h is m ig h t
i n t e r e s t you to show the d i s t r i b u t i o n o f th e se c a se s by
length of exposure. If you ju s t focus your a tte n tio n , bo- j
ce ' ' * d o n '* bavo much tim e , on t h i s column and th e ra n g e j
you w ill see th a t th e av erag e age i s f if ty - tw o y e a r s , and
he ra n g e was from t h i r t y - o n e to s e v e n ty two o f t h e s e c a s e s
t.,a t ha e been rep o rted In th e lite r a tu r e ,
^he d u ra tio n of exposure i3 the in te re s tin g thins; i h e re , and i t v a rie s from fo u rto fo rty -se v e n y e a rs , Those ! men have b een ex p o sed to chrom ium , b e fo re th e y d ev e lo p e d t h e i r c a n c e r . The i n t e r v a l b e tw e e n i n i t i a l e x p o s u re -and th e d, agnosia o f can cer was ap p ro x im ately the sam e, b e c a u se once i t la - about seventeen, and the range is fo u r to f o r t, --aeven.
in e n
.se n rhe and. o f ex p o su re and th e d in g n o --
a i a o f c a n c e r i s a l s o J - . i a r o a t i n g . I t show s t h a t i n a or
th e c a n c e r s a y d ev elo p many y e a rs a f t e r th e en d at
the ex p o su re. The in te r v a l b etw een d ia g n o sis and death i s ,
as in a l l c a se s o f lu n g c a n c e r, en average o f a very sh o re perio d of tin e*
r*any oi w i s s a
a i.u ic h we h av e h a d and w h ic h
we h av e s t u d i e d , h a v e cone to o u r d i s p e n s a r y c la im in g t h a t
tn a ir symptoms, t h e i r se v e re sym ptom s, d i d n 't b e g i.i r m t ll
two wooke b e f o r e th e y c a n , to th e c l i n i c , a n d th e y c o u ld th en b e d iag n o sed as h av in g lu n g c a n c e r. The c l in ic a l sy n p toa and the p ath o lo g y a rc no d if f e r e n t in th e cb ro m at. w orkera, ae f a r ae . have been a b le to d e te m ia e . th an In | m ug cancer of eth er o r ig in .. I ` blnk thoae are the p rin - j
c ip l p oillts*
,
BY DOCTOR V-. '1E7 i
|
, t r a ise s the q u e stio n . D octor B a e tje r , o f o s - |
eyBp t e a a t l c on c a n c e r w h ic h e l n p l y n e a n a no q * M O r o f '
a b le to th e lu n g e . Wht b re n g h t th e e e p a tle n to to th e
lln ic syiaotoias to th e ltm g f
BY l^GIOR q AgftTETU
|
U o, ccao cam s w i t h lu n g sym p tom s, p a in i n ths>
j
c h e a t* Bovm o f th o p a t i e n t s I h av o r e a d , r?jaa wi Xu ^ j
toxas ro fo r & b le to th e a ie t a s t i s e s *
1
i
DgCYOR P.r ~\DS
1
la th eref u r th e r comment ont h i s 7
j
'
!
PY DOCTOR f-YT?Kt
i
D octor L an za,a g a in commented on D octor
j
,, & r ' i d is c u s s io n , a a b o .t o .i e , end t u * * *> |
ch ro m a te s i t u a t i o n . I w onder i f I Jay c a l l f o r a l i t ,..o j
~
i
, iJi<a d i s c u s s i o n o f th e u s b o s t o s i s p r o b l w u
A t the end o f th e m orning s e s s i o n , a q u e s tio n was
b r o u g h t v.p a s to a s s o c ,i a t. i,o n o_*f* "lwuivnmgt pt-'a-nncceerr wi t h tli#
b e a t o s i 8. S h o r t ly b e f o r e D o c to r G ly n n 's d e a th , I had
--r
tso voofca boforo thoy cano to tho e l ia l s , & nt tfe* could
t ^ a bo diagnosed as having Ithg csaeor. Eho c lin ic a l
C7^ taa and tho pathology oro no d lffo rm t in th ohrssaato
workers, aa fa r ao vo h&vo boon oblo to datsraino, thsn In
lung cansar of othor origina. cipal poiata*
I think tfcoso as* tho prin !
;r
ra^3s3 tho Quoation, 3top Eaofcj?, or *
on ^ .p ar a& ieh s i i ^ l y - s no oyssptccjs r#f& r
Sfco la s g a # WJs&fc
i l l s p a t l o n t o t o hm
o lla i- a * yyg>fcsa t o tfe -p a g f
?
B 4 S f 5K3*
S o, ssa oaao w ith l o i s ey r-p ta s# jm ia i n th #
? a * s t , don o f th o p a t i o s 1 l u a r s e d , out w ith ay-p.
t%;;s r a f o p e b lo to th 9 trltStSfeiosa*
BX...-H y
tJC.t
l a fear f a r t h e r o*ioat on t h i s t 3X .M g01
A t t e a rvi e f th* '.si-r!ir;g a s s . - i c n , a Q tto a tio s *ias
b v o u ^ t V :ia to a f t c o e l a t i a n o f lu n g -.*.,}r w jfii t d a a
Of
'( f
''J~'~
o f c.sbo3t5-la* S h o r tly t s f o r a o c d e a t h , I h *4
an o p p o r tu n ity to v i s i t him and lo a m sm o o th in g o f th o ma
t e r i a l t h a t ha i ad a s s e m b le d . Ho h a d s e v e n te e n c a s e s i n w hich th e re had bean c o -e x is te n t carcinom a and a s b e s to s is | in th e lu n g s . I n h is s e r i e s , th e re was no r e l a t i o n th a t could be d e te c te d betw een the degree of a s b e s to s is and th e prosonoo or absenc- o f can cer, o r the degree of asb esto s!*
end f ig h t o f can cer. Now, h i s s e r i e s came from a p l a n t t h a t u s e d th e
R hodesian b lu e a sb e sto s w hich, as D octor Lanaa has p o in te d o u t, ha c e r ta in c h a r a c te r i s t ic s th a t s ro d if f e r e n t from the C an ad ian a s b e s to s . It # a more b r i t t l e f i b e r and, t h e r e f o r e , g i v e s r i s e t o more d u s t . H ow ever, i t '-'as uy u n d e r s ta n d i n g t h a t some o f th e c a s e s d e s c r i b e d Ua C-r--t B r ita in , had had exposure to the Canadian w hite a sb e sto s.
I won -,jf i f any o f o u r c o l l s ag u es from o v e rs e a s
who a r e i n th e room , m ig h t c a r e to commont o n t h a t ?
I would l i k e a ls o , to make one f u r th e r p o in t in
connection w ith a m a tte r th a t b o -; D octor
and D octor
Hhoads brought o u t, and th a t is fee experim ent of n a tu re ,
where one m y vary oirew sotcnooa end see i f th a t has m y*
th in g to do w ith a phenomenon ti* * has b een o b se rv e d . The
q u o stio .; o f exposure to n ic k e l, w hich was b ro u g h t up t h i s
m o rn in g , i s ^ ;c t h i n s t h a t I have b e e n a s k e d abov.t by s * r * T -
?.l in d iv id u a ls o v e r th e lu n c h h o u r.
;
I re c e n tly had an cpportur.' ty to v i s i t w ith Eoc - *
JOZ*.;-
a a o p p o i-tu n ifcy t o v i s i t bdsa a n d ls*u-n s c r t h i n s o r th n a t e r i a l t i t ho h a d a sse m b le d * Ha h a d s e v e n t e e n aooo i n y h i c h t h e .-3 h a d b o o n _o - e x i s t e n i c a ro in a m a a n d a s b e s t o s i a in th e lungs* I n h ia s e r ie s , th aro was no r e la tio n th a t co u ld bo da too to d betw een tho degroa o f ashesfeouio and th e
"-resenee o r absence o f cancer#
2>;. :iew, h i s s e r i e s cane f r - 'a a p l a n t t h a t w.oed he
Rh.-xiffslsa b lu e a sb eflb o a w M e b , a s Doe b a r L a n sa haa po,- sd
out, M s eert& ln cfcaraotoris*ia th at ore o iffe r m t
ih e csa a d iw a-fttb esfcw u I t s a mere b r i t t l e f i b e r end,
th e re fo re * g Iv es r i s e to a c re dust* uowovor, i t
^
\mfi-P2te n d in g t h a t come o f th e e** d o a w ib e d in G re a t _
,, ...
- - Had s y -n o s u r a to t h e C a n a d ia n w h i t e esb**w se 2 wonder i f any o f ar.e c lls a g a o s from o versea s
Ho ? i n th e ro o m , i s > t e re t o e o s a s e a t o n i h a t f
:--: ; ~ ...,-,. ,' . -, . ,T. ^ Y' d " " tii h'-h^.-v-g i - ^
Ht --^ ' *-!-':A^ :
'vyi.' * fc...,.. ,L. *
-
:^ * j
^ .. ^ ,-: -5-^ {*/j vAA:^1 j 'fH lcH v^is li^C't.yHt up tii.:*25 i
.-n'r.*.?*, Id 0: :a t} iin g ih i t I h.iv bon a a k ^ d Hbou by
s i in 'iiv id u u ls o v e r th e lih-.ch huur* r ---r o .n tly had an oppui*tuxti ly to v i s i t - w i t h D o cto r
Amora who w as f o r m a l ly n e d i c a l o f f i c e r ' op th a p l a n t i n W ald , w hara th e se n a s a l sin u s tum ors had bean o b serv ed , and I piso v i s i t e d D o c to r M organ who i s th a K a d ic a l O f f i c e r th e r e a t
tha p re se n t tia a . Thay b o th s t a t e d t h a t th e wan uho h a s d e v e lo p ad
th e n a s a l s in u s tum ors w ere n o t n a n who h a d b e e n ^ p l o y e d in th e p a r t o f th e p la n t w hore th e re Blight b e exposure to n ic k e l e a rto n e l. and they w ere, f o r th a t v m m , very r a l u c t a u i t to b e l i e v e t h a t th e n i c k e l c a r b o n e l w as ft f a c t o r in the n asal sinus tu to rs th a t had bean observed.
Thay f u r t h e r p o in te d o u t t h a t tr*e tu c o ra t a a t h ad ^
o c c u r r e d w e re i n n e n who ' nre *>< e x p o s e d t o t h e c a l c i n s r a ^ n * t is th e o rea w ith the - th a t s in c e 192k , when th e e e l - j
c i M M v o r . r 4 0 ls n d , , - j S* - * =`" c31- C " j
n s ,, a l t i m u I n n * a M p lo y a a n * I n t)j I n A u v r , *"
j
t& cn
o n ly . n b . M a . 4 * t o 1 9 ^ . * ' i `" a a s o t"a j
th a t th ere i s an in sta n c e w hich f u l f i l l s th e atipw la*i-* j
vl,at -...-ire r a i so d t h i s jao rrd n g a s to w h e th e r -an M r e r i a e n * |
n f r.a tu ro m ig h t b e p e r i o d ^ h ic h would h -v o h e w in g ca |
tha q u e stio n of an o c c u p a tio n a l l u r d in ka way o f a
j
r ' !> e o ir& to ry t r a c t c a r c i n o u a .
,
pqo V13 j
__ ______ _______ ,______ _____ _____________ ___ ___ _____
A s o r ^ vlio Wias f & ira a rly r a d i c a l o f f i c e r f o r th o p l a n t i n tfal4|
vhor t h * s s n a s a l g irm a t u n e r s h a d b#n o b sarT o d * c a d 1 ffiXasa
v isite d Baator Morgan who Is
Hadiesl Officer thr *fc
th e p a s s a n t tjjae*
/ a
S*ay both 0 ta ted th a t th e s-i*ho 4a developed
.'.*,?y*r.^ 3 ?>l g iisu s t-%ass>s*3 v e r e n o t ?.<aa w as n a d t o e a oxp..c/fcd
i n t h e p a r t o f t&s p l a t w h ere fehoyo ssig h t fc* e r a s u r e
nickel carbea*l and thsy vara* far that roaaon* very ro*
- , lu fr& n u t t o baA iev th&u
tilc) 3 l carooafpi -sss a f.cr i a
d
^ s a ` 1-! s in u s iusaors t h a t had b e e n cba^rvad*
Shay fn?tbv p o in ted o u t th a t, th e tu to rs th a t he-i |
A-.tj
I
e e su i're d ra re in non t-rho J* been exposed t a ^ h a iois?as4
tbs&*s^&5e**Xv - * J 5 **1
X:x;xs5i!WKS*?fer^
i ^ v a n o t e= a M taor th e !
xtstsaX aiistta i n n<m v h o sa s ^ l e y s o a t i n t b s ' ' lu s t e y _b~3
t-skea. 'f t "os o n ly xhotf'.f.ifcjii. t o XV-;*t r
AvC/vX A \.^iT
? A3U&~'ihs' h
i.3 ^ s*-,
no
0 -1^---f **'+ -'-- l - T O 'c h ...cxld 1 I,--*.-v,^^ia^.cn ;
*V ..*..u eatiuii 'ax'"iii e-uov
: *
..r?~- . m-:-ti --r \
'^i'X'?r- 5ji*?- *'-?*
iu^vLjJS
.
-"or i i
D octor K orevothor* would you ccseisuit on bhsao i >
risirksf
>'ir ' . ' ' n r . O O
9
M l*
I c o u l d n 't constant on soma o f them , b u t I th in k
I can p a r t i a l l y an sw er some o f t h e s e , s i r , and I th in k Doc
to r Knox can answ er c o n c lu s iv e ly one o f thema F ir s t o f a l l , I th in k D octor Lansa is m isinform ed
about the p ro p o rtio n s of asb e sto s u se d and where they are u s e d in E n g la n d . The o r i g i n a l c a s e s o f a s b e s t o a i s , f i f t y y ears ago, were a l l C h a d ia n a e b s a to s . The a a r l l s s t asbas-1 to s work in E ngland was e ith o r s e v e n ty -e ig h t o r e ig h t? -tw o an d t h e r e may h a v e b e a n some c r y s t a l l i n e f i b e r t h a n , b u t vary q u ic k -/ th e a sb e sto s tra d e c o n c e n tra te d on th e wait
Canadian c r y s ta llin e . L a te r on, th e Rhodesian asb asto 3 and the Rhodes
ia n - th e South A frican b lu e , and the th ir d one w hich is
a l s o an i r o n s i l i c a , t h e e n a c t t o , came i n . Ho-v, o f a l l o f
th e se , the s a c i t a is d e fin ite ly the moat b r i t t l e . I t has
-Mi'-
s h o r t f i b e r s , i t ' s brow n an d i t ' s g o t f i b e r s a s lb-=> 's
( I n d i .-.ting) w h e re a s t h e b a s t C a n a d ia n s p i n n i n g f i b e r s J
only b lu e
g o t f lb a r a as lo n g as th a t ( in d ic a tin g ) nnd t -- o a s t (
is about th a t.
|
V e il, tv a la no d o u b t ab o u t th e d u s tin e s s o f tM
s m a c ite . T h a t i s th e brown lo n g flbsrsd stuff, bo s u c h an
ax t m t that it's very littla u.ed today, so it's at the p e i - o d w here some of th o s e c a s e s are onco.i-ned, or w hore
c*sas of aabe3 t0 3 i8 occurred -
o f -V a- ir>i*n<i
mean's cases occurred - there was a good a l of blue and
k2C.
a good deal o f tanaclta used*
!I
Now, I t h i n k D o c to r Knox w i l l be a b l e to s e l l u s ,
in h i 3 p la n t, w hich is the b ig g e s t in th e c o u n try , what
about the types of asbestos they use in th a t p a rtic u la r fa c
to ry , and the --w hether they have had any c sr cinem a of the
lung*
*
Now, a b o u t th e n i c k e l c a n c e r , i t i s p e r f e c t l y
c o rre c t th a t none o f us th in k th a t n ic k e l carbon has any*
th in g to do w ith i t a s such f o r th e very sirsp la re a s o n th a t
- w e ll, one ro&son is th a t n ic k e l carbon is so to x ic th a t
a sh o u ld b u ild a fa c to r y in o rd e r to g e t th e - in o rd er
to g o t tiie l i t t l e can c er, and o f co u rse, i t raight uot in
tbu't p ro p o rtio n , th e n I sh o u ld im agine a l o t more p so p la
w o u ld h av e b e a n e f f c feed*
,
i
D o c to r Amore o r D o c to r M organ an d ja y s e lf f s e l
Ij
t h a t th e - t h a t th r - b u ild in g o f th e o ld c a l c i n o r s was I
t-feo c r u c i a l ch an g e i n th e n a t t e r , th o u g h t l r - r a wan o&ae
o p e r a tio n in th e c o n s t i t u t i o n o f th e n a t e r i a l s i>hiJa o re
a h ip p ..d fro m F o r t Home i n C anada* Tho d i f f e r e n c e * a s I
j|
know, because I saw i t b e fo re and a fts rw a rd s , betw osn th e !
o ld and ex trem al? d u sty c a lc in c e ra and the n o d era b u ild , I I
i s enorm ous * t h e r e f o r a , th e re way b e ene hope i n ''ho
j
I
f a c t th a t p erh ap s a l o t o f Uig dosego is n e c e ssa ry to o ro - !
dues so :r o f
ran cars*
1
l> 1 I
.< l r v .1 X
;
n
l t.
" CO tI" ' Kn0:' h e r * f * m <= to < , < * * * on
f
* " W - P - ..) .
ji; SO SSgQR mimmwr*,
A ppan*,,tly * t.
f
W*H. I can f in is h i t i f ha w ont.
f by DOCTOR PK0AE3J
I1
|
dont you?
I MX--BOCTOR
.
I f l . n M f 3C" ,SS *" f ^
on .n it
danu-ad
f ^ i : r a ,m su iy
f
> - UOM t a t t a t f M t a , . I d o n ' t t h i n * th e y u a e
j
a t a n , and * y . ,, had a ^
of
of 0M ca
:
X a i . one n ig h * e ,p .o t . Or c o m -,., n o t a l l ,
Of CSn03I rtf* f-V-aa -I.,
e o'o-.a,,
1
GV9n i r
i s du o r a sso c ia te d -^th
e- ; . ^ 1 *, a u s t be In c lu d e d In th e l l 9 t th a t wa hav9# b3_
causa th ere m i.t have been an ordinary o e o rr e . of cancori
. I " 1 ^ qU ltS
- * --
o r aeboatos* !
i
_ ,, . , ** * " * >a9tnm th a t 1 *** " 1 th D eoton E a t . I
; fcaa.
d ,ta " ^
* no,..,d no t h , d a ta
J
T h at?3 tho ocr-
- o n ce o f d a n c e r o f th e luno* a t h<s
p la n t*
i-ow, fro m 1932 to i o u ^ ^
t
L ' 5 l , th o y h a v e had e x a c t l y
n tD^ " X 1V CaQCei** F o r t u m , c o l y , D o c to r Knox
" " n<>t " 791b ^
toe ^ o ^ ' t i o a which would on ab le
o ith a r hLu o r anyone e ls e t 38v
............. ._ __ ____
" "*`3
*, . tn a t was an c ~ c e s;
1
U22....
of casco.
th . kind f t"t i s t l o s '
"9 |
?r o o o n to d t o s t a t i s t i c i a n s , t h a t m d c thorn l . h H a t tk sy j
i l d ha? a p s y c h ia tr is t*
' ^OCfOR,RHOABS t
j
"
Vary proper sta tem en t. I'm s u r e . I s th e n . fu r - |
* ,* comment on our q u e stio n s o f chromate or n lc S .1 T
j
(l*o r e s p o n s e ).
|
So H d ln a ts e . 4 th e se c o n c lu s iv e t o p i c s . Vo
,U 1 o r o v o ld to th e popor by G. B r r . 0 >. l d . R e c t o r o f c ta , . r Hoaoorott, X . t l o n l Cantor I n s t i t u t e . D octor
H id e. - on E aporim sntal PulmoMT? C ancer.
-jWfX ^'^ .YUW *>!JT.'.r/'-T-I* (D o c to r M id ar r o o d, a p .ro p c u o a
81*a Wn.5vCXI 2*3 C^Jl
f il a w ith the S6?aaM L aboratory)
BY
RYOiBSi
C e r ta in ly a very com prehensive d is s e r t a t io n on
th is cu b 'cct. I t . m e t unfortunate to suspend those or
pari'-,"- inv3 a t VtuHj.ss aa i-foc-3 Of r a d ic a l s c i e n c e . I a* nC" u
- -S.H
c o r r e l a t i o n c\* c l i n i c a l e b -
fo re s te d t o h e a r a a v o c u f a a tn e com -
s e d a tio n and epidem iological studxos. ^ -
1 . , v
n _ i, >!? ..h ** sxsw to 3 d h-.ru. r e f e r e n c e t o th e s e r x a l wo.-*, wh--h -
0P . M m ight ho . . . r o t e d ,n -h at .I n c . I t h a s n 't appocro
JOto TIV rOOTO? io d r h :
t has
... * 3
-- -- -- __ ___ ____________ -_____________ ___ ______________ ){2?:
on Lung P athology F ollow ing the In h a la tio n o f R ad io activ o
S e r i a l s , A b s t r a c t o f F e d e r a t i o n P r o c e e d i n g s , Page 3 6 0 , 1 9 *4.9 .i
BY DOCTOR RHOADS:
j
|
Thank you. v e ry much in d e e d . I know many w o u ld b | 1)
i n t e r e s t e d i n t h i s r e f e r e n c e . I m ig h t a ls o p o in t oixt a g a in ;
in drfens o f th e to b a c c o s t u d i e s , t h a t th e r e has b een sesaa j
in c r e a s e i n c a n c e r among women. F u rth e rm o re , much o f th j
Imom'i c a n c e r o f women, may bo a d in o - c a r c in o m a , com pared t o
carcinogenic
How, y o u 'r e u s e d t o th e t o m a l l e g e d i n c r e a s e , .in |
jnan a s n o t s e r i o u s l y m e a n t. Do we n o t a g r e e t h a t th e i n - >
cr;-~:ce i s r s a l f
p;V
hiTT
I th in k you and I can, D octor Rhoads; I th in k
D o c to r L e v in wlTC J o i n vis, b u t t h e r e a r e s t i l l some d i e -- n o r d a who w j~>1 n o t*
O'MTOR h. hiT"*S**:
!
Fuis very .in o re s tin g p ap er is open fo r d is c u s - !
c io n now*
!
V. Y. DOCJQ.R h'PTbDh *l :
*
I y o u ia l i k e to a s k Doc t o r M id ar a Q u a s tio n . You; r e f e r r e d to '.-ae e i f a c t o f c o a l d u s t on th e in c id e n c e o f
c a n c e r and you made th e s ta te r a e n t, I b e lie v e , th a t you d id
n o t tilin g i t bad any e f f e c t, p a r tic u la r e f f e c t, - yon the
i n c i d e n c e o f c a n c e r Now, we h av e s e e n -- o r s o n sv h in g to
JiZlu.
that a fr e e t W ill you r e -s ta te - w ill you r a -s ta te your
remark on t h a t , Lor K iu e r ?
BY DOCTOR MIDST;
'
I d o n 't know i f I c a n ; a l l I s a id was t h a t th e !
m ere - o r w h at I m e t a t to s a y was t h a t th e m ere p ro sen e of
la rg o q u a n titie s o f co al d u st in the lunge of m iners over
the y ears has ap p are n tly n o t been as o c ia to d w ith any con
s id e ra b le freq u en cy o f pulm onarycan cer*
j
BY JK)C_T`QR FHlkDI'AF:
I
That*a the p o in t# W ell, now, I w anted to aak you a q u e s ti o n # Do y o u 1 :u w h e th e r o r n o t i t a c t u a l l y h a s
e s ta b lis h e d tao in h it ion o r lias p re v e n te d the in c id e n c e
o f c a n c e r i n tn e s e i n d i v i d u a l a , b e c a u s e i n c o r own g r o u p , w4
have boon im p ro s s s d w ith th a f a c t th a t we h a v e s e e n v e r y
few ca ses o f pulm onary caroluiom in c o a l m in e rs, and w ith
re sp e c t to the incidence of the d ise a se in th e r e s t of our
h o s p ita l population#
PV tvv**fi,
Vt TJ"-.\` ~~.kT.>'.v 11, corns t o t h in k o f i t ,
;i
i
I th in k D o c to r F ink* e l *s
experim ents w ill b eer out th a t c o n te n tio n , though I have ro i
o p `I n i on on . i t i^yael.-' ,,
!
BY D-OCr CR HHnAD3;
{
,, Oil g i i o us y o u r f i ,u m 38 on t h a t ?
BY DOCTOR KRf-
'
1
Out o f t h r e e th o u sa n d 02.50s , we h a v e o n l y h a d f i v e
. ... ...
i<
C
!i
I:
____________ J t2 5 .- .
caeaa oi carcinom a and I ju s t s e n t one case to D octor Vorw a ld t h a t we 'r-. n o t e v e n s u r e i s c a r c in o m a . BY DOCTOR VCIliiALD t
And I'm s o r r y t o say D o c to r V orwald h a s n 't exam ine! d th e s e c tio n s y e t so I c a n 't comment*
by doctor m m z r n s t I t ' s n o t l i k e l y t h a t w e 'r e m is s in g i t , b o cairn & we
do e x t e n s i v e d i a g n o s t i c s t u d i o s a n d , i n v ie w o f y o u r com m en t, I th o u g h t p e rh a p s y o u m ig h t h a v e some o th e r Ix u o rm a-
tl o n on th e stu d ie s*
by DOCTOR EEOAPSt
I th in k some o r t h i s m ig h t b e o l e r i f l h d f u r t h e r J
th re e thousand cases o f w hat? BY DOCTOR Fnir.CilAMt
Throe thousand c ts c s o f c o a l m iners pneum ocoaiosi
BY POPTOR RHOAJDS: In ^salesT
BY DOCTOR FRXESY&Ht IJo, in Alabama} I th o u g h t you s a id Kayo C lin ic ,
i n K-'.yo, an d we o n ly h a v e e i t h e r 1 u r o r f x v o c a s e s * B1 DOCTOR LYFCHs
T h a t's c lin ic a lly , D -"to r?
BY DOCTCH FBIE^YAHX P a th o lo g ic a l d i- g n o s is , and a f i f t h ca se is in
dab a to . '--o'r a n o t s u r e i t ' s a c a rc in o m a o r n o t , b ec&u-so
U.26.1.
K o t o r Y o rv e ld i s one o f th o s e to e x p r e s s an o p i n io n .
3Y DOCTOR RHOADS: Th.n i f I may sum m arize, in th ro e th o u san d a u to p -
d ied inc....victuals
BY DOCTOR FgXEOyAK:
, ^
thou3and d i n l e a l e s s e ., th o se In vh lo h |
M. h a ve hoen a b le t o e . t s b l l a h . d e f i n i t e h la s n o e le o f s c In one o f the lo n g , we hr ;e o n ly b e e n a b le to p r o v e I t In o n rzery , and the autopsy ta b le In fo u r or f iv e o a s e s .
ip jr r B s.('Tpmsra SFSAKKBi So m ost o f you r m iner a chew o r smoke?
*3Y rf;CT03
?
They 0.0 o v a r y t h in,<sy*
y ei l .
l o t w>.*n -.t.ny co se w i f ttha a jlogbI t^h e y*
tWh e yJ smoko chaw; they
an aw fu l smoke; tliy
d rin k , they sat a l l ao:,ts o f r oda
UNrCr NTI PIE DJ5PEAK3 R S T)o th a y osok as much?
BY TYpCTf.-R F R T iO V J X * y e l l , v s ask in ou r s o c i a l h i s t o r y , wo a s k the
amount o f c i g a r e t t e sm o-aing Wev.-syv dAon onrr* ce ii^ba r s a o k i s r o r v'jbaoco, w hatever typ e o f tobacco they u s e , ana I iw u ^ .e
,o x a d ho sa fa to say th e* t n . M W ag , o v a l m inor would
smolt .e tween t b r e a q u a r t e r s and one and a q u a r t e r pac*>
nr c ig a r e tte s a day*
hZ i i
D octor M lder
on the3<> i n t r c t l n 8 |
marks Y TVtfiTOR MIDSHS
!
I _
'
i n w h at ago group M l th e se th ro o th o u san d Ih d -
.v id u als f a l l , d id you aay?
Y BOO TOR FglEPMAN.t
.
Y o u 're
a s k. in g
w,a
ess
ia s
lloott;
0o 1f
qi u e s t i o n s
and I
hatfen!t
. .
4-'.oa -v r u n - t h e o l d e s t c o a l
'I'-p p i-ed s t a t i s t i c s on i t , o u t t., y
, a in s r vhora I to o k
w. r of, I
is eig h ty -six
of
^
u orQ M-ri,, n 1 1 va ta k e n c s r o o f a s a c o a l
age and th s youngest one
A
,, ..round tw en ty -fo u r o r W e n ty -fiTM , to you I
M , o r o t - I h , n o t ta k e n ( * . s t a t i s t i c a l h n t l y t l s , o u t
t h a t 's i-ctighly th e e.read *
Y BOCT'OR MIB3H*
.
------
tv,at has been b ro u g a- i
!H his b r i n g s up th e a u b je c * u a a t
|
,
, . * ,, an adeouata fram e of re fe re n c e t
acp f o r e to d a y a n d t h a t 1 - an a w *
_ J
r r - n c o r l a a p o p u l a t i o n , vn-Jt-asor
f o r Jadgic-S th e in c id e n c e o f c - n e a r i -- **
,
, ?t i s axe - s a l v e , lo w e r tu-.a i-u .-
iiic-nar th an norm al j ;
C a r t n i n l y , v:s h a v e n o t h a d a d e q u a te s ta n d a r e s o f .
!
<n th e u a e t , C*n you h - a r no b a c k th o ro ?
" e have not had adequate stan d u ras of
.
- - * t . Tn th e U n ite d S t a t e s a t l e a s t , a u to p sy s t a -
,,
-, *
t< on o r d-coopni-e*
W e tlc s o u te r . r e la tiv e ly , U pro . t-o n o
s ia tio tU s ta p l, th a t cancer l >t
The u s e o f " 0 ' ," u l , J
, ,
,..u i th a t any be d eb atab le.
c u 'i'a D ie . ><' s---*
0 aac ei now is
I
J j-B'81
r e p o rta b le b y law or by r e g u la tio in tw e n ty -e ig h t o f those
U n ite d s t a t e s and the d i s t r i c t o f C o lu m b ia , &nd A la sk a #
BY DOCTOR RHOADS:
A fte r death?
BY DOCTOR MIDEP. t Ho, cancer#
I t w ould seem p r a c t ic a l thon to de
r iv e ta b les o f ineidancas o f anatom ical typ es o f m alignant
neoplasm s in r e la t io n to b o th age and sox f o r tho p r in c ip a l i
types vo *re in te re s te d in and from these c a lc u la te the o s - I
paeted occurrence o f cancer o f
ce various types in e ls e - i
a b le p o p u la t io n s i n w h ich we a r e in t a r e a tod#
Now, th e m eth o d f o r t h a t was d e v i s e d b y g n r t i s
and, t o th e b o a t o f a y k n o w le d g e , i t w as f i r s t p u b l i s h e d
o f a l l p la c e s l a th e American J o u rn a l o f O b s te tr ic s and
/.-.ec o lo g y , in 19'j.b# Tho Kev Y o rk S t a t e D spc.r tenant o f
H eal t h , l.'uvo u g h i t s Bi.A.jl *3\i o f C a n c e r C o n t r o l , I t h i n k
la r g e ly duo to th o e f f o r t s o f D o c to r L&vin, b a r
such
t a b l e s f o r th e y e a r 19h5 to th e y e a r 19ij.7# I uomoz* I f h a j w o u ld l i k e to o C iiM n t on t h i s ty p e o f s ta n c h e d o f .. ' h ^ a e a j
w h ic h s i g h t im p ro v e o u r c r i t e r i a f o r s a y in g t h a t this occu- :
p a t i o n a l o.: t l i i s e n v iro n , ;e n ln l g ro u p h e 3 o r h a s n o t m i n - j
c r e a s e d i n c i d e n c e i n c-vincex1#
;
pv wOOBCP a'HOA'C3:
D octor L ev in , you a lrea d y "towed one such r e f e r -
once in your s lid e th is loom ing#
I
B.v Y DOCT-OR LSVIK:
}i
Y es, I was going to ask fa c to r Friedman i f he would
mind t o l l i n g u s how lo n g ha had b een p r a c t i c i n g m e d ic in e ?
BY DOCTOR FRIEDtty?:
I have been p r a c tic in g m ed icin e s in c e 19lpl*
1
BY DOCTOR LEVIN: T h at's a period of ob servation o f ton years?
BY D O C T O R hN:
j
!
Less than th a t, because I h a v e n 't p r a c tic e d to j
make a l i v i n g s in c e
o r l|6*
j
BY DOCTOR T,7IIIS
I d on ' t ih - '-.i t h a t ' s p a r t i c u l a r l y p e r t in e n t * In I
*
i
a p eriod o f tan p oors, you wouldn' t b a ^ observed your three
thousand c a se s fo r r.oro than a f r a c t io n o f th o ir l i f e span*
How, i f you o b serv ed th r e e "Uousand x ia lo a , a c c o r d in g t o th e !
;ablos D octor M lder was ta lk in g ab o u t, sc:, r d in g to o u r d a ta i
h a t come from a l l th e h o s p i t a l s , l a b o r a t o r i e s an d p h y s ic - j
i
.an s p r a c t i c i n g n s d i e i n s i n Few Y ork S t a t e th ro u g h o u t t h e i r |
.ifs span, in our th ree thousand c a se s, i f they had n e ith e r!
re n o r l o s s lu n g c a n c e r th a n w e re : j a c t e d , t h e r e s h o u d l i
bo F lir t y c e re s*
j
How, I f you a l s o w a t c h e d them f o r te n y e a r s , i t ' s;
q u ite p o n e ib le th a t you baorvad Ju st a l o t o f the iv.'^csl
in c id - n c a o f lu n g c a n c e r i n th r e e thox- und n o n . Of o o u r - a ,
i f we know u h a t t h e a ge o f t h e go p e o p l e wore when you f i r s t
k30.
saw tto m , and o f c o u r s e . w hat to o a s e s woro whan you l a s t
thorn. w . co u ld use th . t a b l e . thr.t D octor
- a re
f e r r in g to and S U . you s o u t h i n g a l i t t l e b i t store r e f in e d .
I tilin g i t ' s a bind o f ob servation th a t you oan not oani
0,, a s f a r a . I t g o e s . I s w o rth f o llo w in g up n o r . p r e c i s e ly
and nay a c t u a ll y l e a d t o s o u t h i n g th a t i s a n o r , p r o d . .
j . n. a . i i i^v.q t a b le s are av& Il& bls 1? j
typo o f d ata, you c a n 't t a l l , -* airyoso would l i k e them; you can have them.
BY D O C 'P O H ^ S S S S .* ' t e t me comment o n e* more on t h is
terrib ly
4 - |j
OUS h a b it o f tr y in g to term s t a t i s t i c s on h o sp ita l p op ola- j
fclon, and 1 r e a lly do f e e l - I r e p u te d Doctor F r i e d a to r ;
I t y esterd a y , b u t he apparently Is L i t . unre , n t * .
j
D octor C oc-h ran s, - tI cvMadd <a3ae.siccir-i.bjwe to y*ou a aux-vay
+y-a Hiiondda V a lle y l a th-.t Doctor Cocbrene m cone In Mo ,
nouae * where he has r.-raysd a cocp leto . * * c o m
i t y . HOW, I t - a s v a r y I n t e r e s t i n g i n the s o u r s , o f t h a t i
X -ra y s u rv e y w,-sas.ry-va., v., jy*-rAa v * d o v e r n m a
m ~
',
e X- ,, J h o r s , I'm e e r r y I h a v en -1 g o t th e d e t a i l e d f i b r e s h ~ '
b u t they" 11 b e a v a i l a b l e f o r th e r e c o r d - he * X * * a e i a le q
p ic k up on th e T ,-riy a s i n g l e ". o f p u la o n h -y t - *
suseng th a t w h ole p o p u la t io n , a lth o u g h bo b id p i * " t ':0
m t r .t h o r .c t c - v * . t you - -h a t bo you c a l l - a n .
p a in s?
14-31-
K diasfcln& l p ain s?
BY EOO?QR FLSTCRSB? Two te rra s , y o u know, i t ' s a s t o n i s h i n g .
iOU F*5*-
i t up, b n o t a s in g le nooplaera, b u t w ith In a y ear of th a
s u r v e y , t h e r e had b e a n a g a i n -- - !ra q u o t i n g fro m w m o r j -- th e re had been fo u r deaths from th a t neoplasm in th a t group
How, we s h a l l have a c t u a l f i g u r e s f o r th e a c t u a l m o r t a l i t y
f r o E n e o o l& s a on t h i s a c t u a l g ro u p o f m in e r s e x te n d in g c>>er
th e y e a r s , w ith a c c u r a t e ago .`i s t r i b u t i o n , and I th in * c we
Should be a b le to g iv e a f a i r answer to the e f f e c t of c o a l
d u st on the in cid en ce o f neoplasm in th a t grou p .
Tn th e a o e n w h ilo , X th in k t h a t P r o f e s s o r (scugh* s
*--
j
e x p o r ie n c e * w ith an enormous e x p e r ie n c e o f p o s t mortem
?n c o a l t-sinsvrs i n South, W a le s, he t h in k s t h a t t h e r e i s no
i n f l u e n c e a t a l l o f c o a l d u s t on n e o p l a s m s . He 3533 d :u3t j a s many n eop l& cas i n m in e r s a s in n o n -m in o r s. But X don* a j
c a y any g r e a t e r r e s p e c t t o t h a t ..y th e e v id e n c e fro m th e j
p o s t mortem departm ent than I do to D o cto r F riedm an.
j
BY DOCTOR RHOADS
j
Doc ior Friedm an?
BY DODTCrr` F? IB[YAH*
,
I want D o cto r F le tc h e r to know I d id le a r n y e c - !
to r d a y , and th a t to d a y I d i d n ' t make any d e f i n i t e c o n c lu s io n .
t -,3 mo.. ; i y a s k in g a q u e s t i o n . I d o n ' t t h in k you s h o u ld
have rep ro v ed ne a gain to d a y .
I!
BY DOCTOR VORKAXjD:
j
D uring vary re c e n t m onths, y ears r e a l ly , I have j
becom e i n c r e a s i n g l y d i s t r e s s e d b y e f f o r t s o f s o a o who i n
c rim in a te a d u st w hich has been in h a le d in to th e lu n g , de
p o s ite d in a l l a re a s o f the lu n g , w hich n ig h t be soon aa
j p r e s e n t i n an a r e a o f m a lig n a n c y a s th e c a u s a t i o n f o r t h a t i
m alignancy, I r e f e r s p e c if ic a lly to the a sb e sto s body w hich
o c c u r s i n tum or3 dove'.' .<ping i n t h e lu n g , an d X s h o u ld 11--
to have sorzeono comssmt upon th e v a l i d i t y o f t h a t s o r t o f
r e f e r e n c e o r n o t, D octor M ider n ay li k e to oousaent*
t;?Y
>?P0 /V; -3 5
j
>ctor H lder?
ii
i
BY DOCTOR h;XIS3ll
I
Doc t o r H ifier do-3 sn* t l i k e to corstsu'fc o n th a t * b u t j
i t seems to k th a t i t ' s your p o ssib le
probably your
heps, th a t r t o f argum ent, and n o t s u s c e p tib le to s c ie n
t i f i c p r o o f o r r o p u t a ::'-on; i t ' s a s t a t e o f m in d , i s i t n o t?
X .J^-223J?Jr 1M*
D o cto r Lev .-a?
i
PY DOCTOR XTiVXIII
i
Coming b a ck . o D o c to r H id e r *s v e r y I n t e r e s t i n g |
*coar, I wonder i f you w ould m ind cnisnenting on t h is o n e s - t io n w h ic h n ay b e tm. ir In v ie w o f th e f a c t s r e g a r d in g ; iper e n ta l pulmonary neoplasm s in anim als such as ta e
mouse, what j u s t if ic a t io n cou ld you educe fo r d r y in g any
1i i
i
i
i j
c o n c lu sio n s whatsoever- re g a rd in g th e e f f e c t , p ro or con, o f
v a r io u s a g e n ts in th e n o u s e , i n w hat way w ould t h a t have
any boar \g on the naoplsatn i n th e man, in viow o f the
narked d iffe re n c e s th a t you have?
EY DOCTOR RgOAfS l T ver's i s a qim-afclon f o r you*
EY DOCTOR l-'I'DTR: I t sfcer.aB to me a b o u t 'ha o n ly i n f o r m a t i o n t h a t we j
can o b ta in fro m th e hour.a and man, in r e l a t i o n to men, i s ;
t h a t inform -,, .ion M c h -:.s a f f o r d e d u s b a s i c f a c t o r s o f I n
f orr-t-vtier. . a c& rcLaogsnc-2 .13 a n d i s cb.-pH e a t e d i n ssoate aoas*i
i
tiro bv w biat l i t t l e we know a b o u t c a r c i n o g e n e s i s i n th e h u - j
*
i
nan sp e c ie s and in o th e rspecies*
j
la g o n o ral, w ith seas very d e fin ite ex cep tio n s, comp g rab He a p p r o a c h e s i n n a n a n d i n th e mouse h a v e l a d t o
j J
co m p arab le r e s u l t s * b'e z v i s t roaveiaber t h a t th e e x p e r im e n ta l j
c a n c e r a p p r o p.eSa eajssa o u t o f t h e c l i n i c a n d t h a t , a s f a r a s j
*
i
we know t o d a y ,t h e r e seem t o b o o n ly f i v e u n a d u l t e r a t e d
j
s u b s ta n c e s vki-ch a r e c a p a b le o f c a u s in g c a n c e r i n man t n a t !
we know o f , X- r " j u l t r a - v i o l e t -
IjiS '& Z I l& p fcZ stiJL & i+ O
^ O
recen tly,
--*. -C-<.V o f r ic;so agar t-s i s .-Jr*/^ ->wU u u ^ .
3.CY>c \2 fcit& t3Vi. tl - 3 * t o pro dono on p la in i n oxper n hnl rvnlr-.Pls,
>r more t y p e s o f n e o rugh one ca n n o t d i f f a j
e n t i a t e fro m one s p e c ie s to e-notnar d i r e c t l y w ith o u t same
_________________ ______
___ ____________ _____
_ ____h3k_ ;
evidence th a t th is is one, I do th i k th a t the study of
pulm onary tum ors in th e mouse and o f o th e r tum ors in o th e r
species hava c o n trib u ted to our b a sic fa c u lty - our caaio
fa c tu a l in fo rm atio n as to w hat to expect in search in g fo r
human carcinom as#
I w ish D octor S m ith w ould i n t s r j o c t some rem arks
here# do I .
i knows a g r e a t d e a l more a b o u t th i s s i t u a t i o n th a n !
13Y_DOOIOH f.MX-ra:
I th in k th e d if f e r e n c e i s th a t I d o n 't know any
th in g about it# Id lik e to cay f e a t the re fe re n c e D octor
j
Rhoads aeked f o r and v ery p ro p e rly c a lle d to your a tte n tio n ,
th a t is th e a b s tr a c t by L ithgcw and PinkeX , d e sc rib in g
tum ors in the lu n g s > 1 an im als th a t have been allow ed to
in h ale ra d io a c tiv e serum . I s an a b s tra c t th a t I have - that!
t read c are fu lly i a d c o u l d n ' t u n d e r s t a n d .
I b eliev e i f y o n j j
lo o k i t u p , y o u may e n c o u n te r th e crane d i f f i c u l t y , so I
I
w ro te t o D o c to r L ith g o w a n d h a r e p l i e d t h a t - I a s k e d D ue-toir
L ithgow i f ho rcseant t h a t h a h a d , i n f a c t , g o t t e n tum ors und
i f so , w hat s o r t o f tum ors he got# H o r e p lie d th a t ho d id j
morn t h a t ha h ad g o tte n tum ors and th a t they wore ep id erm o id
carcinom as*
I
Now, ife ic a h e was t a l k i n g a b o u t a m a t t e r -1 p a t h --
o lo g y an d n o t a &. a t i f l t i c a l q u e s t i o n , I was i n c l i n e . t o
accept what ha sa id ns 'a c t, and I tn in k iu stao ^a as an
4-
a v i ^ - n c a t h a t t h i s i s on et I do t h i n k t h a t fch s tu d y c f
puLuc-n&ry tvtaors l a th s mouao an d o f o t h s r tiaao ra i n o th e r
sp acio a have confeributod to our b a s ic fa c u lty our b a s is
fa c tu a l inform ation as to w hat to espoct in search in g fo r
huraen carcinom as#-
I w ish D octor f a i t h w ould i n t e r j e c t some reaauSsa
hors# do l .
Ho knows a g r e a t d e a l rsora ".b o u t t h i s s i t u a t i o n t h a a j
I t h i n k t h e d i f f e r e n c e i s h.&t I & on*t know 6 a ?
,
/
'
tiiag a b o u t i t # 2 d l i k e t o s a y t h a t fcfea r a f e r e n o e D o c to r
Kh-iads fefektd f o r
-
-1&srtr i s td a \n b str a ct b y ^ t t e - ^ s n d F ia k a l* d e s c r ib in g
tu-uors in the
o f anX;nul3 t h a t ha?o b e e n aS-Xcrsd t o
...
. , . \ c&Ji / '
iruj& ie r R C u . o a e t i i s #tn a b s t r a c t SKSSSSJ^h^^** t h a t
X r -- -1
iypZl'\xciv-fildn* t u n d e r s ta n d # X b o l i o v o i f y o u
l o o k i t up# yo '^y < o ^ u n ter t h e stso d i f f i c u l t y * c-e- X i_u
w rote to D octor llvkg---tf
ha r e p l i e d t h a t - X --akod r .?
/
\
:
r .is h g e 'a i f h a t s c i- it t h a t hsN^ad* i n f a c t , g o t t s n turKv.a *udj
i f go# w h a t s o r 's o f tvn-ors h e '-.t# Ho r e p l i e d th a t ho d i d j
,
/
\
*
'
ioean t-nat ho h`!,i gotten tuora an.4 that they wore Si'ilo;:-.-.ivxd
\
Ciw^^hOEi&S,
i-cw y-cir.
~tn;3--hn^Aco.gy
. a y ; ; ; * :>v rtf y;;Vk?-
v-s* ' i s r iic a l -qua-*ti.uny._X. u .n?<
1*^*5-< . i
a.-*ti-4 - u s .'*ublr#~ufcd I t h i n k i t s t a i -'3 n s a n
M 5.
! e x tra o rd in a rily im portant advance, because i t re p re s e n ts,
| in a a fa r as I know, th e f i r s t ex p erim en tal su ccess in p ro
: ducing in anim als the type o f carcinom a th a t form s & re a lly
; m ajor segm ent o f the lu n g can cer problem in man, and as f a r
j as commenting on th a t g e n e ra l problem g o es, I th in k th a t j
jj we a r e r .i g h t t h e r e f a c e d w ith a v e ry im p o r ta n t comment on |
\
i
i i t , i n t h a t h o r s we a r e t a l k i n g a b o u t an e x p e r i m e n t w h ich j
j is so re c e n t th a t i t is in lite r a tu r e only in a b s tr a c t form |
I end y e t the s t a t i s t i c i a n s t e l l us and the c lin ic ia n s have j
p
!
lo n g knownt h a t lu a g c a n c d r h a s becom ep e rh a p s th e exits tend-? j
; i n g c l l n a l p ro b le m i n m a les* We a r e f a c e d w ith a r e a l a m
j a se rio u s s itu a tio n , pad as f a r as our a b ility to study
{
!!
!
t h a t s i t u a t i o n e x p e r im e n ta lly g o e s , we h av ev e ry l i t t l e
J
j
e x p e r i e n c e t o g u id e u s and l a s t we u r g e n t l y n e e d m ore stn &
; io a o f suspected carcinogens by is o la tio n techniques*
ji 3Y DOGTOR BHOADf:
I
j!
I
;
V e il, t h a t 's cn a r b i t r a r y s tafcoiuunt, D o c to r. I I
ji
!
[ would li k e to ,w ith a l l d e feren c e to D octor H id e r, you r o - j
i
!
|| f e r r e d to t h e f i v e c a r e in o g e n s w h ic h h a v e i n c l u d e d m en, a l i i
P h a v in g Oiovn a c t i v i t y i n th e e x p e r i m e n t a l a n i m a l s . D id you;
y o u rs e x f n o t q u e s tio n th e an im a l e x p o r J-msnts w ith a r s e n ic ? ! !. jjy DOCTOR D lX iP i
Oh, excuse ms, t h a t 's rig h t*
; ;v 'r 0 C 0 t
Are t h e r e o t h e r c o m e n t s ? (h o r e s p o n s e ) . Ti' no t j
\
th e n wo wiT . p ro c o a d w ith th e n e x t p a p e r . D o c to r Anna
|
B a e tje r , Pulmonary C ancer in E x p erim en tal E xposures to
,
Chromium. B Y DOCTOR BAE7.TF.R:
Ch- d o n 't you w an t to g iv e theia a l i t t l o A fte r a l l , they d o n 't a l l have ru b b er rin g s lik e I
rest do.
j
i
f^ ra t?
i
j
BY DOCTOR RHOADS t
!
She says th e y d o n 't a l l h a v e r u b b e r r i n g s l i n e ,
she does, so d o n 't you want to give than tn s r e s t p e rio d . ,
i
W e 'll w ill take a sh o rt re c e ss th--n.
\
.
i
(R e e e ss fro m l4.sE0 t o lj.:t5 ? H .)*
|
BY DOCTOR RHOADSt
!
W i ll you ta k e y o u r s e a t s , p l e a s e , so we c a n go wn |
w ith t h e p ro g ra m . 1 1 1 you p l e a s e >o s e a t e d ; M ill y< Dl 6 e a e be as& tad so t h a t D octor B a e tje r can b o h e a rd t C--.-t-L.--n, w i l l y o u p le a s e be s e a te d ? Our n e x t s p e a k e r w ould Xi-to
bs h e a rd and w e'd lik e to h o a r hor* W i ll th e m e e tin g p i e a s o come to o r d e r ,
'one n e x t
p an o r i s by D octor Anna B a e tje r , A sso c ia te P ro fe s s o r, Entro ru aen tal M edicine, Johns-H opkins "-hool. She w ill d is cus 3 pulm onary c a n c e r i n r a l a t i - ' . to expo stirs to cure ,.atO
Doct-.-r B a e t j e r .
BY DOCTOR B ASTJER: Boct .r R hoads, L adies ana G entlem en:
I--rst of
a l l , I 'm g o in g to h av e to ju , i f y why I s h o u ld sto o p t o ao