Document YjRaB5G7D2q8JmLxNgX0qLgXE

/<> 'A PLAINTIFF'S EXHIBIT I confident; l COPY (Original ir. long nunc) North Beighton Lowerfold Rochdale, Lancs.' Eh gland December 3, 1953 Dear Dr. Smith:. It we6 kind of you to send greetings and the paper on occupational cancer per John Beattie. I have read it with great interest. I am afraid that I am over due with information which I promised to let you have last year. Vhen I returned home I went through all my documents relating to carcinoma of the lung and asbestosis and found as usual - that there were some gaps to be made good. I did a search for the missing information through coroners' files and other places and felt in. May in a position to approach Richard Doll with my figures. As expected they were not complete enough about the population at ridi and we decided to concentrate on men who had been in the industry for 20 vrs. or more. Ve would have liked the 10 & 15 yr.. groups but while we knew the numbers we did .not know the fate of all these in detail as the war.years were included and there was a considerable dispersion of workers. After an interview and some correspondence he has just reported on this 20 yr. group. 1his was a group of 114 men with 11 carcinomas of the lung and asbestosis. All who had died in the group - 39 - bad been autopsied so the infoi7nation was-fairly complete. - Doll has concluded that (1) the data collected are adequate for testing whether prolonged and heavy exposure to asbestos dust predisposed to lung cancer on grounds of completeness and size. (2) that asbestosis is, in fact, associated with a heavy risk of development of lung cancer & (3) that the risk to which men are exposed - if over 20 yrs. or more in conditions which have in the past obtained in the industry - is of the order of ten times that to which members of the general public (men) are subject. The appropriate table isJ Cause of Death Lxpected No. of Deaths Pul. TB 1.0 Cancer of lung All other respiratory .3 i & cardiovascular diseases 7.0 All other cancer 2.3 All other causes 5.0 TOTAL 16.1 Actual Deaths 1* 11 21 4 2 39 One of the persons with lung cancer also had pul. tuberculosis. This is Just the summary and I will let you have the whole thing later. There are many interesting qualifying facts about the whole matter which I have gathered and a certain amount of information showing that the 'T\H a From Dr. Knox trend is being reversed. I do not think that tfifi-milder type of esbestosi we now see will produce carcinoma in this volume. A survey in xxr five years from now will demonstrate the truth or otherwise of this .view. I have not yet discussed this information with my directors 60 I hope you will consider it confidential as far as publication is concerned. I hope to write this up but a little period must elapse before I can find time - I am still in general practicel I hear that you have got the other paper from John Beattie. It was not as polished as I would have liked .but the material is quite interesting I think. We worked on it on a final hectic week-end visit which John paid to me and it bears traces of the rush of those days. I wonder i it has proved acceptable to the publishers and if so when is it likely to appear. The British industrial medical group meets in July next in Manchester end I wonder if it will be in print by then. Your family will be growing fast. The lively boy will probably be livelier than ever and the little baby who slept so peacefully through my Sunday afternoon visit is probably a match for him now. May I 6end my respects to your wife who was so kind to me on my visit to you. My wife joins me in sending Christmas Greetings to you all and hope that in your future wanderings you may pay a visit .to Rochdale and stsy with us. By the wsy Dr. Lanza looked us up one day and had a look around. Prof. R. E. Lane came with him. It war hig first visit to us and they both seemed interested in what they saw. ^ e are in the throes of a major development plan at the Turner Work6 end and hope this will finally solve our dust problem. We propose to do quite a bit of oiling of fibre as well as damping and will use non-carcinogenic oil. (This is al6o a cotton mule spinning area and I have seen many epitheliomata of the scrotum in my time). If you have managed to read this length you have done well & I will not prolong the agony, All the best, fa,John F. Knox ^ /J . (signed)