Document YD111NLyXjgmpjwdVpV756xJD

January 23, 1987 MEMO TO: J. E. GuUck FROM: Martin E. Powara, Otto P. Prauaa l? SUBJECT: PROPOSED PROGRAM OF FILLING NEED FOR )KEW AND ACCURATE BERYLLIUM HEALTH AND SAFETY LITERATURE Tha Naad j The nadical and industrial hygiene Information on beryllium la largely obaoleta and Inaccurate. With the exception Of la relatively few document such aa Eiaenbud'a 1984 paper on the Beryllium Regia try, the literature on beryllium published In the laat twenty yeara haa been vajry damaging. The literature la constantly being ciped. Either to our doctors at medical meetings in rebuttal of the Brush experience, pr| by potential customers as the cause of their unwillingness to use our product. Federal Government regulatory agencies such as OSHA end EPA publish much of this material and than in the ebtence of good date, cite theae erroneoue ;docum tnta to support regulatory activities that are harmful and expensive to Brut he The Solution Whet le needed to coabet this eituetion iJ 4 complete, accurate and wall written textbook on beryllitm health and safety*. 1 It will have to be financed by Brush (or Brush and NCR?) and the bulk of the ;Vork done by Marty Powers and Otto Prauaa. To be fully accepted and credible, however, it will have to be published under tha auspices of aoma noc-for-prpfic organisation such aa a university or medical group. We estimate the project would coat about $50,000 and take two years to complete. In addition to the book, we should have a number of medical papers pub lished in prestigious medical books. In order to'have these papers published timely enough to be used aa up-to-date references jifor tha book, one would have to begin their preparation without further delay. !' This is also Important ' becauae aavaral papers should be written in coaqttyorahip wich reknowned secondary author who, in general, require additional time for their review and approval. I | , i A priority list and time table needs to be jujbablished since it will be impossible to prepare all necessary publicationj ajt onca. A suggested sequence follows: ! 1 i '( 1. "Summary of a Diagnostic Workshop on Chrbnic Beryllium Disease (CBD)" will contain the new an$ much more reliable criteria. Theee will take out the gueaiwdrk, prevent false positive diagnoses and allow us to det^Rfine tha presence of CBD wich at least' 9St accuracy. ; f, E 00 7041 3 J. E. Gulick 2- January 23, 1987 We have been Invited to submit chi piper to the inter national journal "Sarcoidosis", which addresses all chest physician* interested in (renuloaatous luhg disease These represent the very group likely to show the greatest interest in the application of the immune test via bronchioalveolar lavage (BAL). Coauthors would be Drs* Rossaan (University of Pennsylvania), Saltinl (National Institute of Health), Jpnes-Villi an (UK), Buhl (W, Germany), Zauai/Nagai (Japan) and Dr VsnOrdstrand. Brush Wellaan would have to coordinate the effort I The total preparation time would be approximately 10 weeks because of the required inter-author correspondence. Deadline should be set for June 1, 1987. I 2. "New Criteria in Che Diagnosis of ChronicjBeryllium Disease** should be published in the Journal of Occupational Medicine. The paper would give a review of all previously used diagnostic tests and their shortcomings and focus on the favorable experience with the BAL-immune teat This journal reaches a broader readership among occupational health physicians and its editor, Dr. Lloyd Tapper, has assured us of a spot in the May or June iasue. This would be particularly valuable in view of the planned DOE screening program which ahould be finalised by March or April of this year. Dr. Milton Rossaaa should be the primary iuthor for this paper, but the main work would have to be done byj 0. Preuss. i Completion time: 4-6 weeks. I 3. "A Critical Review of the Recent Literature Associating Beryllium with Increased Lung Cancer Rates." The present NIOSH study is at least one more year away from completion and the full acceptance of its putcome, whether positive or negative, might easily take another year. Meanwhile, the infamous Haneuso, Wagoner and Infante studies continue to be quoted as positive evidencej> For that reason, a summarised review of these papers, which, would point out their shortcomings and submit the reviewing author's opinion to peer review, could be very effective in'counter-acting \ this. It would also provide useful information for the. book. Preferably, the primary authors should be bra. HacMshon and Roth. However, most of the work on this piper would have to be done by Brush Wellman. | ! Completion time: 6-8 weeks. | E0070MIH [ J. E. Cullck -3- January 23, 1987 4. "Skin Effaces of Beryllium and Beryllium Compounds. Review and Follow-up on 330 Beryllium Workers.'* This paper would be base placed in the same journal or in the Archives for Dermatology. Ibis paper is urgently needed to disspell the any and still printed misconceptions and reassure that injuries caused by solid beryllium compounds heal without complications and do not require any special attention. Primary authors should be Drs. Markham and Preuss and the preparation would require 4-6 weeks. 5. "Epidemiological Aspects of Chronic Beryllium Disease. 46 Years Experience of a Major Beryllium Producer." This paper should discuss our case experience with emphasis on the special circumstances leading to excessive exposures and the eventual development of CBD cases end the efficacy of the adopted TLV. This information la of great importance to beryllium users in view of three fairly recent publications Incorrectly claiming the occurrence of disease with exposures below 2 ug/m^. The argument, if Aver accepted in court, would have a severe adverse effect on Brush. The flaws in these papers are quite obvious and should be Included in the discussion. The principal authors would be Tom Markham and Otto Preuss. Completion time: 3-4 weeks. 6. "Allergic Alveolitis from Exposure to Beryllium Fluoride". This paper would report two subacute, reversible cases which should clarify old controversies, i.e., Is the acute berylliosis so independent disease entity or the first stage of the same disease? In addition, since both cases were followed In great detail at the Rational Institute of Health, the accumulated data will enable us to better understand some of the immune mechanisms Involved in beryllium disease. Principal authors: Otto Preuss and Tom Markham. Completion time: 4-6 weeks. t00?0Hl5 J. E. Gulick. -4- Januery 23, 1987 7. "Health Effect* of Beryllium Compound* - k Monograph." Ue have been invited to submit and edit material on beryllium by the publisher of a veil known monograph series dealing with Occupational Medicine topics. The issue would contain abbreviated chapters containing Information from the Individual publications listed above. It would be a short version of the medical section of the textbook. The advantages for such a "compendium" would be twofoldi a) It would be published much faster than the beryllium textbook and thus available sooner to the occupational medicine practitioner in need of readily accsssable information. b) Sinca the individual chapters are reviewed by <" the editorial board, the monograph could also be used as reference for the book. Editors and contributors would be Tom Markham and 0. Preuse with additional contributions by Drs. Rossman, Saltini, Reeves, Sargent, Barna, Elsenbud and VanOrdstrand. Completion tlmei 12-16 weeks. MBP/0PP:ls cc: D. Davis, T. Markham E0070M I6