Document VjR4djMzOBYrLxMw7Qj7zMVOK

>/ 'tft 7->49t AflCA COWC 114 c TAST TEXAS TUBERCULOSIS HOSPITAL BOX 2003 TYLER 75701 A UNIT OF tHt TEXAS STATE DEPARTMENT of HEALT February 3, 1967 Lee B. Grant, M. I). Medical Director Pittsburgh Plate Glass Company One Gateway Center Pittsburgh, Pennsylvania 15222 Dear Dr. Crant: Enclosed you will find a request for Grant-In-Aid, Protocol and related information on the proposed asbestosis survey. % The budget figure was computed in the following manner: supplies and telephone - 5210, radiographs and pulmonary function tests on 52 uorkers$1010, professional services; physicians, technicians and secretarial assistance - $2250, administrative overhead - $700 making a total of $4200. All of us involved in this project are already salaried employees. We propose, therefore, to use the majority of this money to purchase equipment for our Pulmonary Function Laboratory. The references to tuberculosis were inserted at the suggestion of our Central Office in Austin in order to obviate any possible objection from legislators. After we receive your approval of this project, we will proceed to get a Collins single breath carbon monoxide diffusion apparatus and perfect our technique (with the supervision of Dr. Cushing). It would probably be mid April or the first of May before v/e are ready to begin Che project and ue would hope to finish it as soon as possible. Any suggestions or comments that you might have would be appreciated. Sincerely yours. GAU:vp enc. IT'S FILES AND wamn.w ~ , PX PPG INDUSTRIES, INC.- George A. Hurst, M. D. Clinical Director | Bjf 0 023559__J / 3653 REQUEST FOR ClUM.'T-IIi-AlD TO: Pittsburgh Plate Class Company One Gateway Center Pittsburgh, Pennsylvania 15222 Attention: Lee B. Grant, M. D. TITLE: Clinical and Laboratory Evaluation of Workers Exposed to Asbestos fibers , BUDGET REQUESTED: $4200 PRINCIPAL INVESTIGATOR: Ccorge A. Hurst, M. D. Clinical Director East Texas Tuberculosis Hospital Box 2003 Tyler, Texas - . Fred H. Y. Liu, M. D. Box 2003 Tyler, Texas ~ * * * CHECK TO BE MADE TO: Ivan Cushing, H. D. Box 2003 Tyler, Texas East Texas Tuberculosis Hospital CHECK TO BE SECT TO: Sam Toppormnn, M.D. Superintendent East Texas Tuberculosis Hospital Box 2003 , Tyler, Texas AIM OF PROPOSAL: a This project is designed to assess the extent and degree of pulmonary involvement in workers exposed to low concentrations of amosite, an asbestos fiber. Observations will also be made concerning any recog nizable relationship between the inhalation of asbestosfiber and pul monary tuberculosis. r-xoho of T V'A5^kot JSTR1E5,. INC* 1_BB_0Q 23560 l 4C54 (. f r METHOD OF PROCEUUUH: See attached protocol and form:: BUDGET: See letter AGREEMENT: Pittsburgh Plate Glass Company agrees to pay $4200 to East Texas Tuberculosis Hospital for the conduct of this investi gation and stipulates, as donor, that these grant funds are to he used solely at the discretion of the Superintendent of the East Texas Tuberculosis Hospital in the support of any expense which he deems necessary in connection with the research program at the East Texas Tuberculosis Hospital. ' -.EJ ..J kf) George A. Hurst, It. U. Clinical Director Lee B. Crant, M. 0. Medical Director Pittsburgh Plate Gla Robert B. Skinner, M. D. Director, Tuberculosis Hospitals Albert C. Randall, M. D. Director, Tuberculosis Control Division James E. Peavy, M. D. Commissioner of Health VS RLESAND CANNOT BE AUTHENTICATED SV PPG INDUSTRIES, INC. | BB 0023561 | sess / PROTOCOL CLINICAL AND LABORATORY EVALUATION OF WORKERS EXPOSED TO ASBESTOS FIBERS BACKGROUND: Inhalation of dust containing asbestos fibers may cause a crippling form of pulmonary fibrosis which usually does not appear until many years after Initial exposure. (1) Amosite is mined in South Africa. These fibers, with a mean diameter of 0,5 micron, arc larger chan Canadian asbestos fibers and tend to settle out more rapidly from the atmosphere. Th* diagnosis can be suspected when history of exposure is associated with one or more of the following: a) abnormal pulmonary function studies, specifically reduction in pulmonary diffusing capacity. (1,2) This is the hallmark of asbestosis and often prucedes definite changes in the radiograph or discernible physical signs, b) radiographic changes consisting of fine diffuse mottling in both bases, c) phy sical signs such as crepitant rales, clubbing and labored breathing. The last 2 signs occur late in the disease. Although'the relationship of asbestosis and tuber culosis has hot been emphasized, this project will investigate any potential co existence of these 2 conditions. ; a* METHODS OF PROCEDURE: Approximately 52 workers exposed to amosite fibers in a pipe insulation manufacturing firm* will be studied at the East Texas Tuberculosis Hospital. Each employee will be administered a questionnaire on respiratory symptoms (Form 1) by one of the investigators. This questionnaire was used by Ferris and Anderson in-a ^ survey of chronic respiratory disease in a .New Hampshire town. (3) It is similar to ^ / questionnaires used extensively in Great Britain. (4,5) A brief physical will be done ' ! and findings recorded in the first part of Form II. The following, laboratory tests will be done and recorded in the appropriate place on Form II, The.forced vital capacity (FVC) and the 0.5 second and 1 second i forced expiratory volume (FEV) will be calculated from spirograms obtained with the I Stead Wells Spirometer. The mcah of 3 tracings will be utilized and volumes will be corrected to body temperature and pressure saturated (BTrS). Nomogram for pre dicting FVC and FEV will be taken from the Veterans Administration-Army Cooperative Study of Pulmonary Function by Kory, Callahan, Boren and Syner. (6) The MEC will be performed utilizing the Stead Wells Spirometer. The mean of 3 tests which should check within 5 liters will be recorded. The prediction formula will be calculated, according to the method of Motley. (7) The residual volume will be determined by the helium closed circuit method utilizing the -Collins helium residual volume apparatus and single breath carbon mono xide diffusing capacity unit with a 13.5 liter respirometcr. This method has been described by Motley, (d) *. The single breath carbon monoxide diffusing capacity will be done with the above mentioned apparatus by the method of Consolazio, Johnson and Pccora. (9) Arterial pC>2, pH and pC02, before and after exercise will be done only in those cases which show low diffusing capacity. Radiometer A.ME equipment with a Clarke electrode will be empioyed in the above named determinations. Antero posterior and lateral radiographs of the chest will be taken and read by 2 of the investigators independently. Comparison will be made with earlier pre employment films. * I'iCtsburgh-Corning Corporation, Owencown, Texas IT'S FILES AND CANNOT BE AUTHENTICAIE BY PPG INDUSTRIES, INC. j BB 0023562 1 (c <s7 BIBLIOGRAPHY (1) Williams, R. , and Wugh-Joncs, P.: The Significance of lung function changes in asbestosis, Thorax, 1960, 15, 109. (2) Thomson, M, L. and McCrath, M. W., Smither, W. J., Shepherd, J.M.: Some anomalies in the measurement of pulmonary diffusion in asbestosis and chronic bronchitis with emphysema, Clin. Sci., 1961, 21, 1. (3) Perris, B. G., and Anderson, D. 0.: The prevalence of chronic respiratory disease in a New Hampshire Town, Amcr. Rev. Resp. Uis., 1962, 86, 165. (A) Higgcns, I. T. T.: Respiratory symptoms bronchitis and ventilatory capacity in a random sample of an agricultural population, Brit. Med. J., 1957, 2, 1198. (5) Fletcher, C. M., Elmes, P. C., Fairbaim, A. S., and Wood, C. II,: The signi ficance of respiratory symptoms and chc diagnosis of chronic bronchitis in a working population, Brit. Med, J., 1959, 2, 257. (6) Kory, R. C., Callahan, R., Boren, II. G., Syuer, J. C.: The veterans admini stration-army cooperative study of pulmonary function 1. Clinical spirometry in normal men, Amer. J. Med., 1961, 30, 243. (7) Motley, II. L.: Clinical pulmonary physiology II. Detection of early lung function changes in industrial exposure, Indust. Med., 1953, 22, 267. (S) Motley, H. L.: Comparison of a simple helium closed circuit method with the oxygen open circuit method for measuring residual air, Amer. Rev. Tubcrc. and Pula. Di*., 1957, 76,. 601. (9) Consolazio, C. F., Johnson, R. ., Pecora, L. J.: Physiological measurements of metabolic functions in man, 1963, 239. (McCraw Hill Book Company). O CO Ed H lTT c: C. t.. 1 . ;-C C^ THIS DOCUMENT WAS NOT A RECOr PPG INDUSTRiES, INC. DID not COME T S FILES AND CANNOT BE AUTHENTir BY PPG INDUSTRIES, INC. 'C 4057 / I BB 0023563 J u c o FORM I *' QUESTIONNAIRE OM RESPIRATORY SYMPTOMS Name................................................... .......................Sex............. Race.........Race of Birch. Address.................... ...................................................... ...................................... ............ .. Dace of questionnaire....................................... T- ': COUGH Do you usually have a cough?............................................................................... Do you cough at all on getting up, or first thing in Che morn ing.......................................................................................... In winter? In summer? Do you go oncoughingduring the day or at night: In winter? & In summer? PHLECM Do you usually bring up phlegm from your chest (not from the or ;first thing in the morning:. In winter? In summer? Do you continue to bring up any phlegm during the day............................................................................ In winter? In summer? Whet color is this phlegm: (a) always clear white, gray, or blackish? (Check (b) before recording) (b) occasionally yellow or green, at least in parts?............. (c) usually yullow or green?.................................................. ............... (d) don't know................................................................................................ How long have you had this cough and/or phlegm. .I.oss than 3 years? 3 years or marc?* Do you get bouts of (increased) cough and phlegm last ing (or at least 3 weekn each winter?................................... - If yes:.................. ..........................................Last 3 winters only? THIS DOCUMENT WAS NOT A RECORD OF PPG INDUSTRIES, INC. DID NOT COME FROM IT'S FILES AND CANNOT BE AUTHENTICATED BY PPG INDUSTRIES, INC. More than 3 winters? "----" Yes/No Yes/No Yes/Ho Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yas/No Yes/Ho 4253 bIVT'Sppg^^st"C' "nc.ENAUTTHCE0NMT1ECTMATMM ^ ir^avc you ever coughed up blood?. If yes: When was this'(Years of becurruncc). llov much? (greatest amount)......... Yes/Ho WHEEZING - w j Does your chest ever sound wheezy or whistling? *. " - ,. . e .1 i . (If no: check: not even when you have a cold?) If yes:...................... ...............................Only with colds? Yes/N _____ Occasionally (apart from colds?) ______ Most days or nights? ______ TIGHTNESS }oes your chest ever feel tight or your breaching become difficult? '* Yes/No If Yes:............................. ............................Only with colds? Other occasions specify _____ ______ BREATHLESSNESS Are you troubled by shortness of breath?.......................................... .. Yes/No (If No: check: Not even on hurrying on level or walking up a slight hill?) If disabled by a neurological or muscle-skeletal disease put . "disabled" here... If Yes: Do you have to walk slower than people of your age on the level because of breathlessness?........ ................................ Yes/No If Yea: Do you ever liave to atop for breach when walking at your own paca on the level?............. ........................................................... Yes/No If Yes: Do you have to stop for breath after walking about 100 yards (or after a few minutes) on the level?.......................... ................... If Yes: Are you too breathless to leave the house or breathless on undressing?...................................................... ..................... .................. Yes/No Yes/Ko COLDS If you get a cold, docs it usually go to your chest?...................... . .. Yes/No 4 NASAL CATARRH J^Bb" 0Q23 565*J Apart from colds do you usually have a stuffy nose or catarrh at the ^Sd back of your nose?..........................In winter? In summer7^ Yea/No Yes/No WEATHER >nJ)o<> the weather affect your chest?............................................ Yts/No If yes: What sort of weather?............................................ ...Fog-mist Damp-wet Yes/No Yes/No Cold Yes/No Heat Yes/No Does any other sort of weather affect your chest? (Specify)............ Yes/No Does this weather: make you wheeze?........................................ Yes/No - Increase cough or phlegm?..................... Yas/No make you more breathless?......... .. Yes/No have any other effect on your chest (Specify)....... Yes/No CHEST ILLNESSES During the past 3 years have you had a chest illness which has kept you off work. Indoors at home or in bed?......................................................... .. Yes/No (If No: check: Not even "flu"?) (If Yes: Give details of each illness. If doctor not seen put "none" in first column.) Doctor's Diagnosis Duration In Days Year Incr. cough Yes/No Incr. phi Yes/No * V . 1 . * > - if . . . ' * *-# **+ -av , 't - , ; ,. ... O O UQj fOc? O to*.r o-ur Or R iJ I, oo O S' * Q i-^u W f M $ CO b- ~~ s: o /5 w "<: k;=./ aP. %?>*; F ILLNESSES. If more than three attacks put "recurrent" after age at first attack. Have you ever bad: Pulmonary Tb. Pneumonia Each age of occurrence Yes/No......... Yes/No......... * Bronchial Asthma....... If Yea: Age started. l Age stopped. Pleurisy Bronchitis Sinusitis - Yes/No......... ......... 58 Yes/No......... Ycs/No......... Still present?....Yes/No Hurt trauhlt................ Details.__ _______ ... 4C60 / T BB 0023566 1 SMOKING ' Do you smoke?............................................................................................................................ Yes/No If No: Hove you ever smoked?..................................................................................... Yes/No If Yes: Now Changes in Past 10 Years Cigarette* per week............................................ ................................................................................................ 0x- tobacco/weck (handrolled).................... ................................. ,..................... .. Ox. tobocco/ueek (pipe)................................. ........................................................... .......................... Cigars/week. ......................................................... ..................................................................................... Age started regular cigarette smoking.. .................... Age started regular plpe/clgar sac Age stopped regular cigarette smoking.. .................... Age stopped regular pipe/cigar sac If smoking stopped or raduced give reason............................................ cOCCUPATION low long hove you been employed at Pittsburgh Corning? Do you work la a dusty atmosphere? _____________ Yes/No t PPflVlnUS OCCUPATTOH Dates Ages Kesldenca i \iv S v v ^. b i i v i i } ' I*--J U i >L i_S Materials Handled Actual Occupation Cl bl G -- - * "s "enst rrJ s" FILES^AN^CANNOT Bt^AUTHENTJCAi ED f PPG INDUSTRIES, INC. 002 3561--j 52S1 / PHYSICAL FTM EXTREHETIES '.ORATORY Ventilatory Studio* Predicted FVC FEV 0.5 aec THIS DOCUMENT WAS NOT A RECORD OF PPG INDUSTRIES, INC. DID NOT COME FROM IT'S FILES.AND CANNOT BE AUTHENTICATED BY PPG INDUSTRIES, INC.