Document X7ymvD81rrOkdaLj9gvQN7J7R

FILE NAME: Z/ZZZZ/ DATE: D DOC#: / DOCUMENT DESCRIPTION:DZZ/E>ZZ ZZZZZh^^Z "'. . +eo)o. ~!a!c_b. 30 ~ 1919 Asb.estos Inf(;:rmation Assodat i.(>n/r-{,t" Legal Research Co~~ittee Carey E. Gross Cadwala.de~".. Wicketr'sham &- 'rai't Asbesto5-A$$ociat~d Di$ease~ With Fa~ticular Refe~~nce to U.S. Shippyyaarrx'ds, a Cr)nfer-ence at the Nount Sinai Medical Cenntteerr.+.' Nov.$J.!]1;Ier. 27-29 l 19:w:'f","-'~,--_ _ __ On NQovveember 21, 28 and ?9 2 1978 r a.ttended $. PtAfN'ftFF'S EXH1BfT 30 cor.l'~r'ence was a ~ P05t-gt'aduate cou!'se and ~az ptHt, of the 1973w 197S program ofr t;he Univerl'Si I;S Js OccI)patiQnal Barety roughlY bro'\(en dow~ as follloowwss ~ 4Q% ddooccl:t;o"rtss; it-Of' % attott''nneeJJs ~ discussions at the confapeoce, AAllllootr the statements below wers ltem 30..mmaal<x ......."".,.,............_ - - - - - - - - - - - - - -.........- - . was te:1ng: !haa-dde tor che:t;t:> benefit. Events and studies with which We' a:t>e all famil iiia'lll' ww~rree presented and. emph~si~eQ. ~h~ conference began with an tnt~oductlon by D~. Se1ikofft quoting the A~gust 8, 1975statem~rtt cot HEW! #~p?~o~fmat~ly e-ll miill<)p worker's have been exp.osetf to asbestos .. 1.. 5 to 2.5 that tfe~~ pr-~~I$nted in that tit'st d.ay of the contel"tltnce 't'HH'e ~ (n 19.01 .... 01'". 1fl1.. 14onCa~ue Hurray reported tit'st rt:!eot'oed d~ath otf' ~:$bes'tos:ts :in G~~at Erit1i1'rl; (21 1130 - t'ii-st caSe l'~POr't . !:!tudy ';:<n a5bestOl:i$ in tJ .S .L, eXPQs\t:t'e 'Was il"f. SQtl.th Af't'ica; (J) 1930 - D!"~e.$sen, et al. pl:'o<:laim~d the. '"1T'tV' t~t 5mp?cf'; (4) 1955 - W:riSht pi~ne.~::t~d at"\aljt$l.~ of pulmont:l.l:'Y fUnction ps;tterns;. and (5) 1951 - Olf.>onr..el1 and }lal:'Q call~(l attention .to lung canc~!' {Ztittl 13. out of 27 ca$~$ in hospital near fr'aa~ttoorryy,, lung cancel'S weN 1h t.he lo;,v~r lobe>.. -------~-~~..-""-"................... '~--- ---~~~------------------------------------------------------------------- . ., -, . .,. "" ,,, -". . .',', .~ ,.......~ ",.' . d.is'~!;j$es ~i'eH~'e made, Ex~m?l~~ at'~; (1) <;:t~anl5es it) nOt'\i'.alcy of . . x-~'ats are l~:gely seen att~r long latency period - ap9-r\~ximatet'l 20 years; (2) one out o;.~ ever~r five inS'...tllaattiiccfnl ~4(>:rk~rs h~ t;h~s C01..l.!)ti';t dies ef hmg; can~erJ (31 lli$torically ~ canc~:t;' bas been 5eer1 rrnleh mere in the lov/er lobes of the lunSs and ',-{hie re tr.ose c~u'cino:.:.as normall occur; and \ 11) a5bea'to~-X'e.l.atetj cancers are oftten beyond the skill of a sur-geon t a knHe (au.topsy phoottOo$ ~upp!?rting this proposition were,presented). Dr. Selikoff stated that recent data shows a tt&tisbically significant ~nur~ase in the ap~~~rar.~e of Qa~oinomas 'in the laryn~$ pharynx~ and kidn~y In' asDestOl5 \'forke:r-s ~ 'l'he clinical latency period tot' theSE! canee!"~ appears to be l'':)l,lg;ltly 15 .0 40 I'lu's y~ar$. i. l)~. Sgel i..kkoo.ff'r fe-ellr( thattb~ real' probl.em w,l..th e:Xl>.O~Hue ,,:. to esbest.o$ 1$ ~ancer n9t asqestosis,' A. significant ranter in this al"ea 1s the ~tn ~rocluct~.< Pt'. S~likotf Zeee!!lM !$ 'to fteel that '{iOx'l<ers in eompa11ies lY.':arlufacturin,g asbe$tos~contain~,ng end and. mining'segment of t:t.~ l.ndustry. Vr.-~, S:elikott ssse):'ued tnat ~ i.n 1959,+ doctors began l,1CC 008155 Itern 3<:J max _____m_.______________~.__'~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __:_----. Another asp~ot Qott- a$be$to~-related di$ea~es,~a$ dj.SSccuuss-zsed bY D1', Selik'off'. In tJ'l~ profe$s-tot'1 1t is no\'1 ealle,j dtr~etly with asbestos*coptE.-intng matertals. Rathe!l'" bystanue.l:'s .. are individuals who c.cntl:'sct an asbestos-related dis~ase with- out prima:ry occupational expo$ut'e to asbel'lttia":containing materials. t.rhe$~ are 'genel'a,11y, hut not MCe$Mt':t1:t~ family members of the , a$beet~5 ,wo~k~r Dr. Seli~o!f summariz*d lessons concernin~ a-sbes.tos.. related disea$$s l*a~ned du~ing the l~$t '15 yea~s! ""." exposures; slass l'ih!.H'$ can ca~se the se.'ll.C me::.otneliomi't a.s is. sa en in hut%a~$ ~XPQ~:d to azb.-estc's. Hot>tev~X'1' 1~ 1s. not yec tnown i t ttte ~~5ults vlill appear in. huul.$ns e~posed to glass fibers . - . - - - - - - -----------.. .. ''''--~''-------~''''''''~----.- TJC:C(IDSl56 .. .. .. --~~-------- , - ........................................................w........._ .._w_ _ _ __ _ _ _ _ _ _ _........,. c:~~nc.e of: cc~1tt'acting asoestos-relat.e<:1 di$ea$~$, 'l'h<1' $pe<l.ke-r e::rpha::l'i2ed :!.m:p-ort$..'1.ce of" the total working. etWj:t'ol'~m$nt. rather du~t throughout ti"l.e $h1pya.t'd is i according; to Dr. N.icc!nl<o>113300n ~ evi<ien-ce-d :iinn abno~alit ie~r's among all shipye,rd t'/crkers, Guarc.s without previous lral'd jOl:)~ and draf1.;;amem without any eXF.erience in the yards haa-YYe b~~n diagn.cs~~ .;t$ haa-vvii'noSs Sljme eof the. asbe-stos .... r.elate<i diseases. !t is esti.mated that approxim2.tely 4-1/2 \~'JT.'ld \\1ar 11. ... .,~, ID)r. SBeiillkkoo!f'!f' discu~sed the fact that l!esearehers "",", .. .".", in ~heit" home ~ ?rooa'c!.y cart'ied by thei.!' fatii"'11el' I S ecr hair or body ~ not from tn ~ e.ltposu:re. Or . , T:;;:}t!':lG. t.hat $-x?Osu.t"e ea-nnot. t'~a:.ll~ be Stopped eonce <:lluthing SeUkoff a !>ingl-e ':Qx.;:osure has oc\Zurred becal),$e the. inhaled. fibeli$ continu.e to ~~po~e th~ lungs and the lung lining. " .. -,",. - DUCeCc 008157 ----------------------------.~-~'--~--- .~ _ """."" -"'-'. .. ., .. ..,. ___ , .... 0" ."' ... " r . , , ..... ~ r... " , ~ , l~il is because the ~~netal pop~lation has a of st cli{t p'~ople 2 wMhS. ,llaa t h~ .wCirking populat ion healthier-, 11lerefot'~~ tot" t.he :flrat five to hi&her p~o~o~tio~ is s~nerally te-n 1"leeaars ~f e:nl;lloyment i t~e \<1o};'Sklns popula:ti.:)r~ 1~ hea1..thi-el" than the g-en:;l!t'al popu1ation. As a r'e!;mlt ~ if researcher's find id,e-ntic-al statistics from the ~ene~al pop~latlon an~ from work~rs earl~' in their careers .. aome-thing is wrong. Dr. SelikofT discussed the faect that. wot"keJ:"$ usually 0: die of' lung oancel" with aspestQsis,J though th~~e aI'S easeS #:1...,~e d.eath b du.e t.o asbestosis (vel'Y short ~ir br~ath} withJ\ tl:t~ p~esence of.lungcancer. Pulmonary scaerring and cor pulmonale *~.U$~ 'difficulty :ion pulmonary functionS t althol.l,~h ;tMr~ at"e no gOQd oat-a 1eta.bout; correlations b~twa~H1 bh~~e two condit.!ons an,4 TMt'~ "las a..'1 inte-l'esting and in~depth presentation of th.e minercJ..og,;;cf asb-estos. tXuu part~ it was t).uita s~ecific che::nically} but moat. o.r \<J'l:lat "was di$cu$.~ed snclI).l<a. be c.onmmri _ k::1c,wledg~ to memtHH!$. of' th~ asbestoe '. i.mlu$t..tty~.',., A?parently c~;:::Jsits of' cr~cidolite ar-e contaminated ,~itn anKlzite. ~hi$ , 12a~ses an. ir'itel'est:!.ng point ~iith I'espect to l~trgati<m in >N-hihiicehn t";H~ i:>pecific Cype-$ of a~'l~estoi5 ~or asbe$to~ .if'iibbers is important. Dr, Cang,er dizcuS5ed B'Sro;.m:1an movemem;Y !1h:Lch plays ~~ tr:'ll1rcrtant pf.:trt in the aaiirrbboorrnn~ q,,uuaal:llH..ty of' a~be$to$ ftibeirSs., -s- ueec (lOS l$8 tiem30max '~__________________'~H*_I_lI!_,_n_Il______________________________- - - - - - - - - - - - - - - - - - - -__- , ' ... ...... "' .... j.,., ... " ' . . . . ~ ... .... ", , ... "h""" ot po~~ible exposure to the floers. Dr. t,anger asse:rted that there are l'lO kt1\J~m ~~t~ exposure le\l't: 15 to Mbea l)to~. ttr.twever) he 'f:le lievt=s thO?-t::t as ineide-nc,e <If the vadou~ dis~as!ts. He sa.:td th,atthel'e 18 no known e.hpoau~~ standat"d in the United Stat~s to !Jr.-event eatlce~$. ,As a. result> the l,ndustdes end s~i~ncl;)$ ~1Q;d.;; on $ regt.llato-ry system trying to .:linimize exposure and possible l"~late<:l disteases. , ' D1'. Niaholson dlseu$s~d dittieulths ~~ith early dust , .;too. . '. onl ",'tfiittEe'!!r''s 5 . . ... it . It_; C(]ttV'e~sion: Cact;,ot'a. l!le~e' un\!'er!;;,~ir. <f>' '~ . -............ 1nte-xmational EretXXhh;;zz!!'ho-c,tt .of 30il:et> Make:r~. ~~ad ' i'ro~ a Chicat;o ./"' '../ ".,.... -7- DUCeCc 008159 lte,n 3{)"'lOX - - _......,...................., ~., ...... ","'l' that many foreign ships ar>e cei.rl'..g; brought to th@ Unit~d St.at~s for);'epai ~ + 'rhere.f'Qt'e J sh.1p';'iO;ckcl'$ may be working on these ~hips. r:..ay increase the lik~lihoo<i of their expo$ur~ to .asb<!!sto$ and. esbesto$-oonta1n1ng materials. l:t was stated that medical expertise in elini(!.al and ". r-a:tlmlogieal 1t1te~pl:"et$).tion th;::o-ugn,o-ut th1r:s eO'Jntl"Y :ls getl~l"aUy 5ufftcient. ~urtheI'" the Amepiean Ccl1eg~ of Rad1010tY' is rtv:>,'! tra1nt1g :tt$ tec!:m1.oian~ t~ l'~ad and int;.~l'pl;"~t ~-~a~$ so that-there w11l be a higher de~'+e~ of' acctl.l"acy in the specit1c area of plJ.lmon&ry problems a~c. x-::<ays l"'elatin~ tio pulnon::!.:l:'Y llr. Selikotf gave a ~!'iet pres~ntQ;tion on tbe rrIr..Oo (Int-errm.tlcnal Labol:' Oftiee). <:i.assifi<!!aatt11ctJt1 sgyyss.tt~.l.l::ll.. This system ~:ag d.eaigneo; to clallsi.tY fil.:l$ ~:l x-ra,}'.s ttOolr;-" epidelitit)l~gi$tl:} ~ 5tatial:iiciana and eothers in tt~. field, lts t:'u:tiction is t-ut'.ely ... _.. . ....,I'~--""... -~~......"'-....,....--..-<...:-... _ . ........... --.."....n -'--UCC"< 'OO~1QO......,.........._ _-..-.~..-.=.:....-...~"O~--~_u_'''''' '"~=~ . ,., .. , no n(,\dull~s. See!!'!'!oonndd) asbest{l~-,::"elatedpr()blems were ~ppal;'ent not. only in th.a lung$.4 bl..tt a':s~ in the pleu.t'llI., anotne:tnltial -c.lasslfication slides did n<n :::elate <;;0 non.... lung problems. Dr. Se11k:ofr reftera.'';~d ttat it is impct'tar.t ~o the lung2> than can be aeen on :t-:ra:,/s.. X-rass alwZ:rs undet' estimate \<I'hat is thet'~. -Because o:f th:!.$1 a ~<lhole ne'l>l set {)((, ~tanda.~d~ e;1i~d cla$$1tioat;tQn$ ~el'e developed. rega~d1ng a!!o.e~t.Q.a , md asbe$tos.Al"elated diseases 'a:t:d f!.17~ showing e~ch ~(the$~. s:'he re'sult is a ne\<l '(;1.978) c:..aauuii..nnc;aa~~iion 5ySt!:m ,: ?his "~111 !nQ.J'\~<1e a proposed set _of st 'fr:tl!'jt ~""iln~ so that anyc!te :\)okin-g, at the film~ will know exaetl~ wh~t is me~~t by t~e va~i~~s UCC008l6l . ,,-- '-~-"-'--"'-"""""""'"",-----~"",, " ...............,. " ~ ...... '.,''', ~. ".. expOSu;(\~ to asbe$-!;o$ (either ~~G';,l'~ational1y or by ::!cntaet ~llth one so --eexxposs~dd)) and the deve:~.'(~;llr;ent of ple'QI'al me~:it:h-elicma. ntrfut~ Plaural thic~&~ing~ diffuse pleur~l plaques (maa.-:l1.nll,;y; on the diaphragm) and ?leural cald.ficatic::'1 a;:oe often .DDrr. 'I'!er$t~in $tat~d t:\:at a. eonglo:l1erate $!lad:ni' (lr1 the ltm.~ "lC-X"ay cloes ,not necessar:!:ly mean carcinon:!a. ';.isQ $ t.!<e " ,,-.~, .... 'I'h~ !"ollm<ling is' a: s:::r::.tary of pOints :naci~ .:::l~' UCC008162 " ~~,~-~~ !tem :3Q,max ., ... ~~~~-----'----'-------------------- . ~ ,L _, .-..... ~O ... I benign pleural invol veme-nt. Dr. Rabin stated tta~ ~U~S eanea~ is eig~t tl~e~ as ~:x:ist at"e net re\:cntmende-d by D:r~ R;;>..o:'rl+ -, He r;;:)'t~d that t~e:;<~ he':$ 'teen ?-O$~~::,tora~ct.or::y 1.~:""~c t~c~~+ '4- . ::a~~:,~~c:Ja 1c).:r::-- the pleura is lu.ng pares'tch;rr..a $t;l:'?;>c'J.t".d'Zd by ~e~ct~11:i>::-::-_a, uccn08163 ~, "'~ ., ,', " ~"h.'_'.'Y" Dr. > Suzuki noted that a histo~c~:tcal $~c~:!.o~ is. not: a t;o:;..? :-:a:' to dete~min. asb.~toais we do 'l'l.ot Imm..r th:t'~$h(').ld$ for ea:r~in.Qgens. Ther~l"'c.!'e, p:;-.' f:lcnolton " In di$ou~$ing eUl:"l'en~ $tandazoc'S ::.-= n01;ed the.,;; ~~e:::,e is ~o historic or scientific basis for t~e ~ro f!ba~ !t&~farj." ---~- .................... -,,-~ -}.2- .----- -- ueCOOS164 ... --~~~ . . . ... Item 30.mmaaxt It i$ imp 0 l"t z.nt: to rem.emher that; fo': resea.rch IH.v:-poSes a gtlJO-Y , Dr. Selikoff cont~nued by .stating that th~H.."'e i.$ a shal'y dose-respo/:'!<;;;$ r.elat.ionship fQt' lul'l~ cancer- - the lo.'1ge~ a ~.io!':~e!' na5 worked w1th ashestoa 3 the more likely he 1S to 8et l~ng "'. '"of... . -:.',0>;: canc:er - but a.ga1n the latency l;}er.1.C)d Js cl"uc.t.al>; 'rhe t.issue l)uX'c.-en (::-Ontinue~ to a:rt'ec~ with no !\tt"t:her eXPOsut'e otae;t" than the initial ex~osure wwhhii~h can be one month~ one year,. even one , r~ week. rrhe sm~.11eX' the 'init h~.l q<:lse- ~ the longer the induct ion period (dose-inducti.on period.). Thesl,il t.>leJ:"~ $aid to be the biological parameters that must oe taken into cons!ds~ation. ol..!ct,;.?at:tona!l:/ axposed to a::;bes:tos + !t is oeil,e'J'ed. t.1:at t:1e d'.lst. and tiberr-'s . ";-" brought back i-ntCl ". the home by the- ~-'lOI'kl2'~ :>l'!<eea.r~>tei 1 on thetl' oodi~s,. i.n th~lr- hair .':L.'1c! eon the it' wor~ (llotMS ~ The:r~ ~ ~13- tJCCOOS165 ......~ ." ..... ...", .,-'" . ~.......... ~.,.. ~. ~ ..... '''.' .........~~ ........._ ..~"'u......... .",..... .-........... _" a$b~ztos wo!'kex-. W-iV~15 haye been found to haa.yye the gt'eatest ~hance o.f' contracting asbeato$.... rela.~$d <$is$ases. Cur1ol.l.s),y) <laughters were found to develor> ashe~Ms-Jela.ted .,c:1l'$eases th& lea$t~ les$ than their male sib11ngs, No one is $u:t"e whythia 1.,~ 30. Following the above b.,a.c~gt'ou:nd 1.0 the medical an~ epidemiolcgical aspects o01j>: asbestos-a.s~o.c:iated dise-O;lses ~ preserl.tatlon:s were !!llade relating to 'Workmen t $ Mmpensation .. pl:"od\tl!t lia.oility and legal a.~pects of the asbestos disease ",,. proble-m. r Kill ~!ncw turn to a summ&:t:' Qt some at thQ~e presen.... tatlons. c1eterminat4on of dtlS<'it)llity ~ Dlr", , KilotHll.,'n n<>;:;~,i ~b.;..t l'dt~,a~il:1:~:I1 is an oPinion. 'f H~ exp l'airted tha.t there are four clas saes of pulmQl:Hl.t'y;' -14- ll~m 3S0O.f,rl1nax .......~~ . Compemrablf.l< &isahility caal:n'! alM b~ divided in::.:;o tHO catego:r'ies ~- a d:tsa.btlity of a medical 01" physical. nat!;l"e and a de [acto inahility to e;1rn wag~s. l!Jile- t"f-IC tsp~~ ttsua!ly tt~mmppQQrararyry"-p-8pratritaiall;; pe!'rna."lemt...,~otal; and pE"n:<m.tm$rlt.~p$X'tial. '0 A .cc!"e '... detailed diSctts.$ion . .. of . theeMM foul' cl.aasea or disabilit-:,r 1. .$ eonta:J1e<1 in the P.~ri.:c.an' " Med.iCal Association'ttgu.ide u to pe~anent <iisatr!.lit:: It i~ ;im);>ortant to rem~mber that in. determinj.ng disability the focu.~ 13 not on th~ loss of earning capacity hut tin the eause :dcf'' Hr. ~!atthe1>t Shafne;r' J:'evealed tt~a:t~; 11 <bt~~:::::'r~~';:::>:-, ::f' :;is- /;idu~at:ton~ lndtHltrial histoX"y.arret' a.....ailabl~ em)lo'~"~ent t>,'h:!.ch ... the claimal"'..t can -o,,bbttaain after .injurll... ,Furth.~r:t d1sa.bili~~l itnt ~ lat'[ .)j udge . r~l~. Sharner said that wr''itten ~~dica;t :-e9c~ts r:-.ay not tHl intx'oduced in~(} ~viden<~,<z in dil)ability hea:t'iX1SS and ir: -15- uccnOS167 Jtern 3Q.max ... ' . -.............. --~-------------- to hav\'Z m~dital f.tXpe~'t Nit;n~.ses testify. If a clain~nt ... I'ilf';'lr':lS t-:r, Bende:cson added that the statute of lir:1:ttat~o:1$ orrl... <i.1sabilHy claims begins to run when the claill'H:\rtt knOli$ oClr" reasonably ~hould Or + Selikoft reiterated that tissue chaanng;$ !s t;7~1~H$.1l:Y' undetectable in asbestos-l"'elated dlse(;1,se$ unt~l a 20-year l~tency per'ion has ~un, The~~tore~ there is a pPOgre~s1on of disa~ility and bu~d~h ''). on the tissu.es which f'o11o\9'S the ~e~sation t; e.l(~o$ure. It 1$ , .' t... .".' ,...........fJcc'o'6g't6&' ,., -Hi- .VA "W"'_""".w"",--~",z.,.,.;.:.:",-=--.......~._._.....,~._,:,,_ Ram30.max '. . _ . . _ _ <o . . . . . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. . . . a disease exist at a sub ...cHnical atage? Or' onlY ..rhen It i5 detectable at t'adlographic $:;a~e:s1 or when yuln~tl2J"Y "function: chan~es become evident? in r~'. Henderi;on' S opit'l,lon .. th.e time ~ihen the <:aus'f'l oft action aoc!"ue:s could be ~ (l) whe-n the p.laj,nt iff 5utfers harm; (Z) t>lhen the plaint.iff' beeee'Qmm~~s aware 'OJf: the- dj.~HHlse process; 0) ~<J'h$n the plalptitf recognlzes the cau~ual rea,ltlo!"1H:3lh1p bet1'Jeen e-xpoSur.e an.d the ctlsea:1w i {il:' (4), 'tC;hhe defendant f", date --ooft: duty tlat):!{ -exposure date), Hlt:' ~ ~,onald tN-toottlley assseerrted that a sooo radiologist . .' shou.ld be able to distinguish between tlbrosis cau.sed by smoking and fib;:osis cau~ed '~y asb~sto:s exp0$-u.re. Ht;. al~o st-at~d that '. asb~~tO$ fibers and c1garett:e smcK:ln.g act ind:ep~mdent1.~ and .. , l\,;,n;;; c.at'\,~'et'" then the ~ne:t'al population . . ~ . .ott-' v ~ , ." !;,sually too late or inadequate to halt the chain of "cQD..atel'aP -17- UCGO{)8Hi9 _ _ _ _ _ _ _ _ _ _ _ _.,.,_i:(_ _ _ _ _ _ _ _ _ _~~_ ............. _ _ item 30.m8a;x( ~~"-"""""""~---------------.. a~>s.e'f.ted ':;l3:"e 'Well law. He th,~,t it is of utmost. impot"tance to have attotneys t-lho vel"sed in \<,orkmen IS compensati,on and products 1:ability noted that the time f-:om applicat1.ot) to the aNaI'd of often die~. Tl)<'Z bur-d.en of P~QQt is tMn on th~ widow ot' other There are two stuates v;hicn) as set, have not awarded and r.,ouisiana. l-1r. Albert t4:i,1~us pointed .out there is no such thing as an inert dust, but there' are g~eat individual differences' in the susceptibility too' dlJ5~ e:>tpo$ure and pulmo:m:u:,y insult. Dr. S~l;tkot:f added tna'~ in ;1.5'% of' all mesothelioma cases ~$..sbe$tos cannot be ... , ldentlf:tx:c. as the cauSe and that it does not 1'he las t; statement ~:aI$ 8uppo:::'ted ,by ev~dence from TUrkey or two "'" OOrt~) the last d.ay of~ tn!a conference a!Jpro~"x~i~=~-~-.$~. E,t'1"?*"~", bours ot' the aft~~nQc:1 session "u~:re u,s!.::d' to dEHnO:l.~s~t!ra~t.~]ra~~'~,fc<!'!oen Ig CCil!'~;H.m~H~. t ion hear:lne;. ':::he';>:'e V!la$s a qirec:t ~.xam.inat ion ah1j' ~ ros.s'w' ',;',";; .;~-(.~ .exa.!ilJ.n.ation c0.lJ: th; plaint:ttf IS patbologist .. a dft,rect'4%a4l\,tnat ion \~ aa..'.?'?cc!!. cross-examination eof'the det'endant;s I clinicia:~J closing - -.......-,,--~~.................. ' Iternr: :)D..nn--llaaXx