Document QgXqdkL3od9rnw6pnVpXQoMm5

FILE NAME: National Gypsum (NG) DATE: 1967 Apr 4 DOC#: NG020 DOCUMENT DESCRIPTION: Letter to A. Bianco, LA Medical School in Response to Questions RE Asbestos and Health Effects from Dr. Wright eSaint o L ukh-s Hospital .ftL ffl.iU u Cl.,A 113H S h ak er B o u l ev a r d C leveland . O hio 44104 April 4, 1967 August R. Bianco Box S02 Louisiana State University Medical School 1542. Tulane Avenue New Orleans, Louisiana 70112 Dear Mr. Bianco: I am afraid you have been somewhat mislead because I, am not the "medical officer" for the National Gypsum Company. I do examine their pre-employment and other chest films and I do act as a consultant for the company on some matters having to do with the health of workers. I also have a very strong interest in the general problems of what might be termed the "health effects of asbestos fiber" and hence, I am happy to make some comments about your questions, arranged in the order that you asked them. . .1 do not'know of any controls required by the Federal-^. Government since most of this sort of thing is the respon sibility at the present time of each state* A very con siderable amount of work is being done by the U- S* Public Health Service in Cincinnati having to d.o with learning more about the exposure pattern to asbestos fiber in industry, but as yet no specific recommendations in regard to this have been formulated. I v/ould suggest that you consult your own state industrial hygiene officials in regard to what the Louisiana . requirements with respect to asbestos fiber might be. - In those large corporations that have something called a "medical officer" there is also usually a department of industrial hygiene* The medical officer in conjunction withthe industrial hygiene department usually assumes the responsibility for the health matters of the worker in that spe- _ cific industry. One of the j'obs would be to exert every effort'.--:."' possible to see to it that specified controls are observed. `"T With respect to some materials and gases, the requirements inTTLvgeneral throughout the United States are well enforced blit with respect to others, this is not always the case. With 44853 V C O A u g u s t R. B ia n c o -21 April 4, 1967 regard to asbestos fiber, I would say that in general such controls as have been suggested have not always been rigidly enforced. Many plants--and I cite- amongst these the National Gypsum Company--havo taken groat efforts to provide a working environment where both free crystalline silica and asbestos fiber exposure is controlled within the limits suggested by the specific state the plant might be in. I would suggest that vou might want to write to Mr. Frank Zimr.icruan, (Director of Safety, National Gypsum Company, 325 Delaware Avenue, Buffalo, New York 1-1202) about the specific controls in effect in the Now Orleans Plant- I would also suggest that you might write to Dr. Lewis Cralley (Director of Epidemiology and Field Studios, U. S- Public Health Service, Bureau of State Services, 1014 Broadway, Cincinnati, Ohio 45202) who is currently in charge of a very comprehensive program studying the environ ment in the various industries where asbestos fiber is used. There are few if any reliable data on the incidence or prevalence of "pulmonary asbestosis" in any current working population in the United States. Completely reliable figures with respect to this natter are not available anywhere in the 'world- The reason underlying this is that the diagnosis of "pulmonary asbestosis" is one of those things' that is not universally agreed upon during life or even at autopsy* The spectrum runs all the way from a diagnosis of asbestosis made by simply finding one or two asbestos bodies in the lung to requirements that extensive changes- in the x-ray must be recog nized before the diagnosis can be made- In my opinion the best that can be said is that there is a disease which results from the interaction of human lung tissue and asbestos fiber and something is also known about the pattern both anatomically and clinically. However, a definite statement that asbestosis is present in a particular person is often moot. Some con ferences on this subject are to bo hold in the near future. That the incidence of carcinoma of the lung and of meso thelioma is higher in some populations of persons having other stigmata of pulmonary asbestosis has been reported on what would appear to be reasonably acceptable data. There is still some disagreement as to whether or not the incidence of lung cancer or mesothelioma is higher than to be expected in the group of persons who have been exposed rather heavily to asbestos fiber over a period of many years but who do not *have stigmata of pulmonary asbestosis. Insofar as data in the -VVS51 Aut'Ust R. Bianco April 4, 1967 Urniud States i^ O'nccrncu, thfix; is not--l'> my know!edge-any c o m j >1o to 1y accepL.ibl o lady on populations oi manufac turing p 1an is us im; a sbus lo? fiber. There would appear to be a higher than cxpoc lod incidence of lung cancer in insulation workers under certain specific circumstances- A considerable study ox' a population of asbestos miners and mil.1workc rs (refining) carried out in a group of chrysotilo producers failed to show any unusual frequency of lung cancer- It is apparent that there is every reason to make a careful study of the role that asbestos fiber may play in lung cancer and mesothelioma, but 1 do not believe that we are in any position as of today to indicate what this role i5 under the many diverse existing circumstances. One area of groat importanco has not been questioned by you. I refer here to the fact that'asbestos" is a generic ter'1! and embraces a family of fibrous materials which chemi cally and physically are quite different, one iron the other. Sub-fanilies, as for example chrysotile, aciosite, crocidolite, and anthophylite are major groupings which vary greatly in their chemical and physical makeup. It is of intere.st that in some areas where the exposure has been to chrysotile only, the investigators have been unable to show any relationship between exposure to fiber and an unusual incidence of lung cancer or mesothelioma whereas in some areas where crocidolito is usedf the relationship seems to bo quite striking. It is imperative, therefore, that at out-set you adopt the practice of referring to specific materials rather than to the general term asbestos- One of the great problems in attempting to learn the true role of these materials from a cancer point of view--and I might add also from a fibroccnetic point ox view--is that in many circumstances there are mixed exposures and there are relatively few largo population groups that have been exposed solely to one or the other varieties- I would also call your attention to the fact that the occurrence of pleural plaques--both calcified and non-calcifiedoccurs with unusual frequency in certain populations having varied exposures to asbestos fiber and the problem of specific kinds of fiber plagues us here also. Enclosed is a photostat of a rather good review article recently published by John Gilson, M-D., and in which he 41S55 o -A - A -t k. Bianco April 4 19A7 c.i i= attention to some or the points raised in the a bove common ls V.'ith best v:i?h e Sincorel y. vou r s , -: George W. << "r right, M.D. Hood, Medical Research Department CvP:::ka x Enclosure *44856