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FILE NAME Insulation Contractors & Distributors ICD DATE 1968 Oct DOC ICD006 DOCUMENT DESCRIPTION Occupational Health Program from Western States Asbestos Health Plan 18-2008 03P FROM TO 15105599970 4/35 THE WESTERN STATES ASBESTOS HEALTH PLAN OCCUPATIONAL HEALTH PROGRAM L , "On WESTERN STATES CONFERENCE OF ASBESTOS WORKERS ASSOCIATED INSULATION CONTRACTORS OF THE WESTERN STATES OCTOBER 31 1968 18-2008 03P FROM TO 15105599970 5/35 THE OCCUPATIONAL HEALTH PROGRAM FOR WESTERN STATES ASBESTOS HEALTH PLAN Irving R. Tabershaw M.D. W. Clark Cooper M.D. J. LeRoy Balzer X.S. Tabershaw Associates 2180 Milvia Street Berkeley California 94704 18-2008 03P FROM TO 15105599970 6/35 Trustees of the Western States Asbestos Health Plan meeting in Seattle Washington on October this program and entered into an agreement for its implementation 31 1968 approved with br Tabershaw The Trustees meeting in San Francisco on March 10 1969 authorized that copies be made available for general distribution BOARD OF TRUSTEES WESTERN STATES ASBESTOS HEALTH PLAN Western States Conference of Asbestos Workers Frank Calegory Earl B. Kirkland Don A Brun~ r Eduard T. Lontz Associated Insulation Contractors of the Western States Donald Bradshaw Kenneth M. McCaffree A. D. Schionerer LeLand E. Sweetser  18-2008 03P FROM TO 15105599970 P 7/35 fi OCCUPATIONAL HEALTH PROGRAM PROGRAM FOR THE WESTERN STATES ASBESTOS HEALTH PLAN I. Introduction 11 Distribution of Western Asbestos A. Area Covered B. Local Unions in Area Workers III IV Present Health Activities A. Health and Welfare Plans B. Environmental Control F. Summary Workmen's Compensation VI Recommended Program A. Medical Program - General 3. Industrial Hygiene Program - General Medical Examinations A. Content B. Frequency , C. Site D. Cost E Supervision F. Records VII VIII Industrial Hygiene Relationships with Interested Groups A. Trustees of Health and Welfare Plans B. Trustees of Local Health and Welfare G. Contractors D. Insulating Workers E. Physicians F. Industrial Hygienists G. Others IX Summary 18-2008 06 04P FROM = aegl? AN fs war IIT TO 15105599970 P 8/35 Fae ee eS oe = = tBaso as Metis ty CONFERCASBETOSWORKESBY COVERD STAES VESTERN AREA VESTERN OF 18-2008 04P FROM TO 15105599970 P 9/35 OCCUPATIONAL HEALTH PROGRAM for Asbestos Workers and Insulating Contractors of the Western States Irving R. Tabershaw M.D. W. Clark Cooper H.D. and J. LeRoy Balzer M.S. October 31 1968 INTRODUCTION The establishment in 1966 of a supplemental Health and Welfare Fund for Occupational Health and Research by the Associated Insulation Contractors of the Western States and the Western States Conference of Asbestos Workers has made it possible to begin a coordinated program to prevent occupational disease in the insulating trade The need for such a program has been increasingly apparent Insulating workers are subject to a number of specific hazards in their trade the major ones arising from inhalable dusts in the fabrication application finishing and tearing out of various insulating materials Knowledge has been steadily accumulated as to methods of reducing exposures to dusts and to detect disease in men already affected Work in the trade is stable but frequent changes in work site and jobs multiple mployers and a widely scattered work force make conventional medical surveillance and industrial hygiene difficult to apply A coordinated program is timely All insulating workers in the area Teceive medical care through health and welfare plans jointly supported by labor and management The increasing age of the work force and of medical care are producing insvitable strains upon health welrfiasriengancdoats pension funds At the same time available knowledge on the prevention diagnosis and treatment of asbestos disease is not being applied Leadership in both employer and labor groups is concerned dot only about the personal effects of preventable illness but also about the ultimate effects on industry They are therefore seeking effective and practical means of developing and applying modern occupational health practices under the particular conditions of their trade . In the development of the present proposal we have 1 reviewed all current health and welfare plans in the Western States with emphasis upoo preventive medicine and industrial bygiene 2 considered the basic components of medical and enviromental surveillance 3 made specific recommendations upon such medical and enviromental programs and 4 reviewed the suitability and availability of local medical and environmental health resources with specific recommendations where appropriate 18-2008 05P05P FROM : TO 15105599970 P 10/35 . Area Covered DISTRIBUTION OF WESTERN ASBESTOS WORKERS The geographical area represented in the western Asbestos Workers covers California States Conference of Colorado Nevada Wyoming Utah Oregon Washington Idaho Montana Arizona New counties Texas six western Mexico except six eastern there are nearly 2,200 2,200 counties only and Alaska In these 13 those Insulating workers The approximate States presently working within the jurisdiction of distribution of their Table I serves to illustrate the problem of local as shown in and environmental program providing a supervised medical Travellers working temporarily out of jurisdiction of their locals increase the construction is total numbers in the active areas where TABLE I - Insulating Workers in Western States Approximate ARIZONA NEVADA Phoenix _ Tucson for Total f73 ---73 we for State ~- . - - - ALASKA 38 Las Vegas 135 35 - - ~ _ Reno 16 - 11 Toral for State - - = 46 97 Anchorage 97 Total -- . 2 _ o 2 LL 00/00 00/00 . CALIFORNIA NEW MEXICO Albuquerque Roswell ^ arlsbad 76 76 76 - ~ 11 11 a 50 , , , , Orange Los Angeles & 5 - 400+ Farmington Total for 76 State | - - - 1 2 3% San Diego 45 - 60 MONTANA . eo Riverside MONTANA - Total San Fernando 45 . Ventura SB 5 Bakersfield # nu. Total ee ek 144 East Bay Pecins San Francisco Stockton 16 16 16 016 -~ + - - . 35 7 13 7 522+ 260 50 40 6 82 Billings J onlon eT onlon . OREGON Portland Total 36 . -~--+ ~~... 144 TEXAS El Paso Total 76 - -ee- . ~~ ee 50 50 Sacramento Redding Chico Fres^o Total -- Total for COLORADO COLORADO 16 - ~ 16 - 16 - - 416 ~~ 2-2 LL State -_. 50 4 2 15 427 = 949+ UTAH UTAHSalt Lake City 69 -Total - WASHINGTON Seattle & Tacoma # - Spokane State ) Spokane 082 - for _ ~ _ 84 84 13664 200 ~~ DDuernavnegro 28 Total for 28 ~--~~State -.. IDAHO 150 2 152 WYOMING Cheyenne & Laramic 28 6 Western Wyoming Total for State 069 -10 -~+-- 16 Boise 069 - & Idaho Falls N. Idaho 69 2 2 182 Total for State - 2 . 6 10 26 18-2008 05P FROM TO 15105599970 11/35 Local Unions in Area a ! Table 11 are listed the locals Heat and Frost Insulators and Asbestos the Western Conference of the International'Association International'Association of Workers within the area covered by Members of the Associated Insulation do not negotiate directly with all of the Contractors in Colorado for example are Contractors of the Western States unions in the Western Conference in the Midwest Association TABLE II Local Asbestos Workers Unions in Western States Local Number Headquarters No. of Men Health & Welfare Periodic Contribution ray Other Locals in Same 6 W Plan 5 Los Angeles Calif 522 0.210 yes 69,73,76,135 _ 7 Seattle Washington 134 20 RO 82,97 016 San Francisco Calif 427 30 yes 020 = Long Beach Calif ~~ -- - " 28 Denver Colorado 1,52 16 no 29 Hunters Point Calif <== 836 Portland Oregon 244 25c aa 62 Bremerton Washington --- J 69 Salt Lake City Utah 94 21 yes 73,76,135 70 73 = Mare Island Calif Phoenix Arizona 1 93 -- 21 yes 5,69,76,235 876 Albuquerque N.M. 106 21c yes 5,69,73,135 5,69,73,135 882 Spokane Washington 66 ' 97 Anchorage Alaska 78 135 Las Vegas Nevada 46 _ ae 20 20c 21 no ---- yes 7,97 7,82 5,69,73,76 Starred locals are in U.S. Naval Shipyards which were not included in the present review 18-2008 05P FROM TO 15105599970 12/35 Health & Welfare Plans There are five health and welfare plans operating within the western states 1 Los Angeles California The Heat and Frost Insulators and Asbestos Workers Health and Welfare Fund provides medical and life insurance benefits to locals 5 69 73 76 and 135. Operative since 1952 in Los Angeles 1954 in Phoenix and Tucson 1955 in Salt Lake City 1964 in Las Vegas and 1966 in Albuquerque and El Paso this plan is currently financed by a 21c per hour contribution It provides medical expenses and hospital benefits for occupational diseases to members and dependents accident and sickness weekly benefits for occupational and occupational injury or sickness and life insurance benefits Dental expenses are not covered Specific provision is made for an annual chest film performed by a number of designated radiologists the cost not to exceed 15 This is not totalled in the maximum amount of permissible benefits There is also a special provision for payment of medical benefits of up to 500 in a month period for asbestosis or silicosis if for any reason the member is not entitled to receive workmen's compensation The insurance cartier for the plan is Occidental Life Insurance Company of California ; : The provision of a voluntary annual chest film is the beginning of a medical surveillance program for members of locals 5 69 73 76 and 135 A list of 34 approved radiologists who have agreed to take films for the Fund was set up in 1966. All are certified There are 21 in greater Los Angeles and San Diego two each in Tucson Bakersfield and Albuquerque and 1 each in Santa Barbara Riverside San Diego Salt Lake City Boise and El Paso Anteroposterior and lateral films are taken The radiologist completes a form for the Administrator of the Health and Welfare Fund indicating whether or not the films show any abnormality for which further treament or medical advice is advisable This must accompany request for payment payment TABLE III Participation in the program has been as follows as of September 11 1965 Local 5 No. in Local 5ZO No. of Films Taken 214 7 Having Films 23 X Reported Positive 13 # 69 94 53 56 OZ L. $ 73 93 38 41 % : # 76 206 9 BZ Oz , # 135 35 9 25 3Z * Any abnormality requiring further study not necessarily asbestosis. We have no information on the conditions which led to request for further examination or medical care 18-2008 06P FROM TO 15105599970 13/35 2 Seattle Washington The Insulation and Asbestos Workers Welfare Trust of Seattle provides life insurance benefits for accidental death and dismemberment and loss of time for occupational disease medical care and hospital expense benefits to members and dependents of local 7 Seattle and Tacoma local 82 Spokane and Billings and local 97 Anchorage Occupational diseases are excluded from benefits if covered by workmen's compensation Diagnostic check examinations not incident to or necessary for the diagnosis of a sickness or accidental injury are expressly excluded if paid out of insurance The monthly contribution is 20 The insurance carrier is New York Life Insurance Company 3 San Francisco California The Health and Welfare Plan of local 16 has been in operation since 1951 and now provides benefits for about 440 active and 30 retired members Medical care hospital benefits and lost- time benefits are provided through Blue Cross and life insurance coverage is by Standard Insurance Company of Portland Oregon The program is supported by a 30 per hour contribution Since 1957 the health and welfare fund has provided annual chest films on a voluntary basis to all members paying at first 10 now 12 to any of several designated radiologists for the service 16.50 if two films are taken This is separate from the insurance program with chest film fees being billed directly to the Administrator of the Health and Welfare Fund who also receives the films and interpretations During the first year of the program pulmonary function tests were performed on about 166 men these were discontinued because of expense Over a e period of 10 years nearly 2000 films have been taken in 390 men and have provided excellent serial evidence changes Expansion of the program to include annual screening examinations is under consideration 4 Denver Colorado Local 28 with 156 members has had a health and velfare program since about 1952. It is financed by a contribution of 16 an hour with California Western Life Insurance Company as the insurance carrier It is a cash indemnity program and does not permit periodic examinations in absence of illness There have been films taken on a voluntary basis by the local tuberculosis program but union officials do not know the extent of participation 5 Portland Oregon The Health and Welfare Plan of local 36 provides hospital medical and surgical benefits through a choice either of direct benefits from the Kaiser Foundation or cash benefits through International Health and Life Insurance Co. of Portland Life accidental death and dismemberment weekly income dental benefits and major medical coverage under Kaiser Foundation are underwritten by Bankers Life Company of Des Moines Iowa The foregoing are paid for by a hour contribution Laboratory or other expenses involved in periodic examinations are provided under the Kaiser plan but not under the IHA coverage which pays only for necessary ray and laboratory procedures incident to the diagnosis or treatment of occupational injuries or illness Dental coverage is for 50 of covered charges in excess of a 15 per annum deductible 18-2008 06P FROM TO 15105599970 P 14/35 Portland has authorization for a periodic examination program and has negotiating during the past two years for its implementation The Portland Health Department out of a total of local participated in a program carried out by the State on March 8 1968 during which 100 members were examined about 145. Examinations included 70 mon chest films vital capacity and forced expiratory measurements Enviromental Control No comprehensive industrial hygiene activities are evident In Portland Seattle and Spokane through management agreement approved respirators are being supplied to all insulators Fitting and maintenance are each man's responsibility Also some individual contractors make approved respirators available Nearly all contractors supply some form disposable respirators More fundamental aspects of industrial housekeeping improving work practices are promoted hygiene such as ventilation not being systematically In Oregon the advice of the State Health Department has been requested by local 36 and recommendations are pending to reduce dust levels with -emphasis on marine construction Summary of Current Preventive Efforts Preventing occupational disease in an industry requires knowledge of potential and actual hazards surveillance and control of the work coordinated with surveillance of the worker's health and medical -- -- Industrial Evziene Responsibility for control measures in the entire construction industry has been unclear In the insulating trade efforts have so far been inadequate and industrial hygiene programs bave been difficult to organize supervise and regulate Protection against dust exposures has been far down in the list of priorities In the western states organized efforts to control dust are rarely evident except in Novy installat~,,ONS Individual contractors provide some exceptions Respirator programs are uneven and wearing them in dusty atmospheres is only occasionally obligatory Because of the increased effort of breathing with most approved respirators and the variations in their effectiveness in keeping out fibers choice of respirator is important and requires expert advice Equally important are fitting and maintenance there are no effective programs for this even in areas where respirators are furnished 18-2008 06P FROM TO 15105599970 15/35 -7- Medical Surveillance All members are protected against routine and major medical expenses for themselves and their dependents with variations in completeness It is not the purpose of this report to compare or evaluate medical coverage as such There is in all locals a consciousness of the need for improved preventive programs These have been difficult to provide in the context of existing insurance programs and in the absence of any one employer having a large enough proportion of the work force to provide occupational health services Periodic chest films although highly desirable are not enough in themselves to establish physical status of the worker Their value is further reduced when rays are taken by many different radiologists using different criteria unrelated to clinical histories working experience and knowledge of the insulators environment Private physicians see too few men with common working experience to deal consistently with their problems arising out of asbestos exposure WORKMEN'S COMPENSATION Although a separate study would be required to cover workmen's compensation provisions within the 13 States of the Western Conference information supplied in Table IV shows the important variations in the 14 jurisdictions involved thirteen States and United States Goverment Equally important are the interpretations applied within the various jurisdictions There are differences in benefits for medical care temporary total disability permanent partial disability permanent total disability and death provisions for waiver of compensation subsequent , injury funds in all jurisdictions except Nevada provisions for extraterritoriality allocation of costs to lost employer or prorating over all employers considered to be contributory to disease The U.S. Deparment of Labor lest year financed a study of the problems of compensation in berylliosis and asbestos disease This study by the firm of Woodward and Fondiller in New York City has not yet been released 18-20 TABLE IV - Compensation in the Weatorn States EMPLOYER TO INSURE THROUGH EMPLOYERS 07P JURISDICTION TYPE OF LAW STATE FUND PRIVATE COMPANY SELF EXEMPT WHO EMPLOYED FENER THAN COVERAGE SUBSEQUENT SUBSEQUENT INJURY FUND FROM Alaska Compulsory No Yes Yes Full Yes 36 Arizona Compulsoty Competitive Yes a Schedule Yes California Colorado Ideho Montana Compulsory Elective Compulsory Elective Competitive Yes Competitive Yea Competitive Yes Competitive Yes Yes Yes. Yes Yes Full Yea Schedule Yes Schedule Yea Schedule Yes _ Nevada New Mexico Oregon ---- -- Compulsory Exclusive Exclusive No No Elective No Yea Yea Compulsory Exclusive No No Elective Ho Yea No Full Na 32 =g~ Schedule Yes Full Yes 45 Schedule Yes Utah Compulsory Competitive Yea Yes Full Yes Washington Compulsory - Exclusive No No Full Yes USA FECA Wyoming Compulsory Appropriation No No Compulsory Exclusive No No Full Yea Schedule,, Yes Footnote Figures 36 11 etc. under coverage indicate number of conditions listed in schedule TO 15097 P 16/35 18-200818-2008 06 : 07P FROM : TO 15105599970 17/35 RECOMMENDED PROGRAM The needs of the insulating industry and its workers can best be met by a coordinated occupational health program responsive to both management and labor through the trustees of the participating health and welfare plans In such a program the Medical Advisor of the Occupational Health conformity with guidelines approved by the Plan of the Western States in trustees would coordinate and supervise medical and industrial hygiene activities as follows I. Medical Program A. Negotiate with appropriate clinics or physicians in each major area to perform periodic examinations on members B. Establish content of such examinations C. Establish frequency of such examinations D. Maintain central file of medical abstracts on members E. Maintain central file of duplicate chest films on members F. Periodically provide the trustees contractors and union members with statistical evaluation of physical health status of membership without revealing individual company or member's name G. Provide m^'dical information on asbestos diseases and other occupational health problems to participating clinics and physicians personal physicians radiologists and pathologists with particular emphasis on diagnostic criteria and on relative hazard or safety of work environment H. Work directly with local radiologists and pathologists to improve differential diagnosis of asbestos diseases I. Advise trustees upon workmen's compensation aspects of asbestosis and other asbestos diseases J. Provide health educational material for distribution to contractors local unions and members K. Maintain close liaison with members of the medical profession Interested in and responsible for the health of the insulator L. Keep informed on worldwide research as it pertains to the detection prevention and treatment of medical problems important to insulating workers and translate this information into appropriate action II Industrial Hygiene Program A. Develop manuels of hygienic practice with the help of the for organized health consideration by and safety committees trustees and by local in each area union leaders and contractors oro! 18-2008 07P FROM TO 15105599970 18/35 -10- B. Develop educational material for distribution by local bealth and safety committees C. Recommend local industrial hygiene resources and act as intermediaries in acquainting them with the needs of the industry and in interpreting their findings to management and labor D. Maintain liaison with research throughout the United States and the world relating to the improvement of , work enviroment of the insulating worker the A guiding principle in the foregoing would be that the medical findings in individual are to be held in confidence between him and his physician any for its release Medical information unless he has given his written consent in the files of the Medical Advisor will be handled in this way The periodic medical examination would not be expected to interfere with each man having his own personal physician Dust counts or other environmental findings identifying individu^l jobs or contractor would not be released without appropriate clearances by those involved MEDICAL EXAMINATIONS Content It is impossible to begin a program of this kind without of the health status of the work force and without periodic vo knowledge revaluation of the health status of the individual union members The following examination is recommended for all men at the start of the program and upon beginning employment 1. Medical history 2 Occupational history 3 General physical examination 4 Chest roentgenogram postercanterior and lateral S$. Pulmonary function ~- 8. Forced vital capacity b Forced expiratory volume 1 second c Diffusing capacity if available in area 6 Blood analyses sugar uric acid SCOT cholesterol 7 Electrocardiogram 8. Urinalysis 9. Collection of sputum sample 10. Audiogram test of hearing 11. Tonometry to detect glaucoma Frequency There is no need to repeat such an examination every year for every man Our present recommendation is that all men with 20 or more annually those with years since joining the trade should have examinattihoonsse with less than 10 10 to 20 years should have them every two years in the trade should have them every three years unless there are years special indications Table V indicates the current distribution of workers of since joining the trade in 5 major locala in terms years 18-2008 08P FROM TO 15105599970 19/35 -11- TABLE V Distribution of Asbestos Workers in Five Major Locals Based on Years Since Entering Trade Local 05 07 16 36 082 10 or less 123 23 25 16 134 312 29 227 29 172 10-20 220 42 69 452 115 271 . 30 23Z 57 33 Over 20 183 352 60 392 178 42 74 56 85 50 Total 526 100 154 100 427 100 133 100 171 100 340 24 491 35Z 580 41 1411 100 that the examinations be done by one Site and Costs It is physician or clinic in each important major area using forms prescribed by the clinics in the Health Plan Discussions with representative Occupational examination as outlined would cost about 50 areas have indicated that an negotiation and perhaps local as of 1968 This would involve individual of some parts of the examination Scheduling examinations : . modifications would release funds for special two or three years in some members every studies indicated for others Health and welfare funds should appropriate the examination program funda equivalent to 50 per member to cover Supervision The Medical Advisor would supply participating clinics the currently accepted criteria for the diagnosis with specific information on of asbestosis and systems for classification of chest roentgenograms films for radiologists to review would be circulated to Repr^'sentative apprise them of diagnostic criteria in each area would be kept advised of inforSmaitmiiolnarolny tphaethpoaltohgoilsotgsic diagnosis of asbestosis with the aim discouraging either over- or diagnosis current of chest film and a summary of each member's Medical Records A duplicate in the office of the Medical Advisor record would be kept on file staff would be available medical with the consent of the man examined The medical in difficult for consulcation or to suggest appropriate consultation diagnostic situations 18-2008 08P FROM TO 15105599970 P 20/35 -12- INDUSTRIAL HYGIENE Although asbestos has been the major concern that has forced consideration of improved industrial hygiene in the insulating industry an industrial hygiene program must consider other insulating materials such as fibrous glass Proper use of solvents and control of noise heat humidity and accidents are all within the scope of a complete trial hygiene program Nevertheless initial emphasis must be upon dust control through ventilation good housekeeping proper work practices and use of effective and comfortable respirators under appropriate circumstances To carry out the foregoing in specific terms is recommended that a code of hygienic practices be adopted in each local area with the advice of the Medical Advisor and his staff and the help of a local health and safety committee Such practices should be consistent with recommendations at the national level and in accord with changes in technology as related to materials packaging tools respirator developments etc. Industrial hygiene resources in each area will be located and conducted by the Medical Advisor and his staff Latest equipment for measuring fibrous dust exposures will be demonstrated Literature on environmental evaluation in the trade would be made available to local industrial hygienists Periodic visits will be made to each problems Upon request of contractors in surveys would be carried out area to review environmental participating plans special RELATIONSHIPS WITH INTERESTED GROUPS In carrying out the foregoing roles the following principles would govern communications with various interested parties I. Trustees of the Western States Occupational Health Plan The Trustees are responsible for expenditure of funds of the Western States Occupational Health Plan They must approve the plans and contemplated relationships under discussion They would receive periodic reports on the preventive program efforts and periodically evaluate its progress and course II Trustees of Local Health and Welfare Plans. Under guidelines of the general plan the Medical Advisor and his staff would work with trustees or designated administrators of participating local health and welfare plans in the implementation of preventive medical or industrial hygiene activities The role of the trustees would include A. Advice in negotiation with local physicians or medical clinics for periodic physical examinations 18-2008 08P FROM TO 15105599970 21/35 -13- B. Review and evaluation of periodic reports on the extent of participation by union membership and statistical data on findings without identification of individuals by name Cc, Providing and approving specific suggestions for industrial bygiene practices D. Suggesting contacts with local pathologists radiologists industrial hygienists as needed III Contractors | A. Associated Insulation Contractors of the Western States 1. Would be regarded as source of information on general problems and needs of the insulating contractor 2 Would periodically receive information on preventive medical and industrial hygiene efforts 3 Would receive scientific and educational material on the control of hazards in the insulating trade 4 Would be apprised in advance of possible recommendations for industrial hygiene that might prove unduly expensive or burdensome . 5. Would be kept advised on compensation legislation B. Individual contractors in addition 1. Would receive interpretation of environmental findings made by local industrial hygienists 2. When feasible would be given assistance in industrial byglene surveys with specific recommendations 3. Would receive detailed environmental data relating to their individual work sites names of contractors or identifiable jobs would not be made public without written consent of the contractor involved IV Insulating Workers A. International Union - There would be full cooperation with educational and research efforts of the international union subject only to restrictions on confidentiality of information Western Conference 1. Would receive periodic reports on the status of preventive medical efforts and industrial hygiene efforts 2. Would receive scientific and educational material on the control of hazards in the trade 3. Would be kept advised on trends in compensation 18-2008 08P FROM TO 15105599970 P 22/35 -14- C. Local Unions - Would receive foregoing information as it pertained to the local union D. Individual Asbestos Workers 1. Each man would receive a letter describing the new program 2 Follow letters describing local implementation would be sent by local Health and Welfare Plan ; 3, Would receive a report of the result of each examination in general terms with specific recommendations as needed 4. Would receive through union channels periodic information on health protection including hazards from smoking 5. Would have the advice of the Medical Advisor when requested through union channels or through his own physician V. Physicians A. Designated local physician or clinic - The clinic or physician chosen to perform physical examinations in each area would do it with the understanding that certain minimm studies will be done and that a standardized summary with duplicate AP chest film will be sent to the Medical Advisor Professional communications relating to individual medical examinations would be between the Medical Advisor and the examining clinic with release to others only upon written consent of the worker en B. Personal physicians - If the worker's personal physician were somes other than the one doing the periodic examination it is expected that this physician would receive a summary copy of the foregoing examination he would be urged to keep the Medical Advisor informed of medical events of importance to his patient C. Radiologists pathologists etc. * Summaries of current literature classification of films and lung disease as related to asbestosis would be sent periodically to radiologists and pathologists likely to be seen by asbestos workers VI Industrial Hygienists and Others Interested in Occupational Health A. State and local industrial hygiene departments - The Medical Advisor would write each of the foregoing informing him of the Occupational Health Plan and enclosing literature on current practices and sources for consultation B. Articles would be written in technical and trade journals describing the existence of the plan and its operations 18-2008 09P FROM TO 15105599970 23/35 -15- SUMMARY After review of 1 che medical and industrial hygiene needs of the insulating industry in the Western states 2 the distribution of insulators and contractors 3 the current health and welfare plans and environmental control efforts and 4 available medical and environmental resources a regional occupational health program is suggested with the objective of improving and coordinating efforts to control occupational disease and thereby lessen the human and economic effects of preventable illness in the insulating trade , I. A permanent Medical Advisor should be appointed to work with the Western Conference of Insulating Workers and the Associated Insulating.Contractors Insulating.Contractors of the Western States to develop and carry out medical policies II The Medical Advisor would be responsible to the Trustees of the Western States Occupational Health Plan and would work with trustees of local health and welfare plans in the improvement and implementatioonf preventive health activities III The asbestos workers and contractors would support through local health and welfare programs or special e assessment periodic physical examinations of all members with content and frequency based upon recommendations of the Medical Advisor Such examinations should be performed in each local area by a clinic or physician chosen by the local health and welfare plan with the advice of the Medical Advisor we Ptere Estimated cost of initial and periodic examination is a 50 per man per annum as of 1968 ees VI Abstracts of periodic examinations and duplicate chest nmewat films would sent to the Medical Advisor's central file VII The Medical Advisor and his staff would prepare for distribution health education material local VIII Each local area would be urged to form a health and safety comittee with labor and management representatives to supervise local environmental controls nee oem aie 18-2008 09P FROM TO 15105599970 24/35 -16- IX The Medical Advisor and his staff would prepare detailed industrial hygiene information and in cooperation with local health and safety committees develop local educational and enforcement programs The Medical Advisor and his staff would provide liaison with national programs working toward improved occupational health for the industry . 18-2008 10P FROM TO 15105599970 P 25/35 WESTERN STATES ASBESTOS HEALTH FUND MINUTES OF MEETING of BOARD OF TRUSTEES October 1969 Holiday Inn Salt Lake City Utah The meeting of the Board of Trustees of the Western States Asbestos Asbestos Health Plan was called to order by the Chairman Frank Calegory at 9:30 am on October 16 in the Holiday Inn at Salt Lake City Utah Those present were as follows . FOR THE EMPLOYER FOR THE UNION K. M. McCaffres Don Bradshaw A. D. Schinnerer Lee Sweetser Frank Calegory Don Bruner Earl Kirkland Ed Lontz In addition Administrator Glen medical consultants Dr. Irving Balzer Slaughter Tabershaw Legal Counsel Phil Smith Dr. Clark Cooper and Mr. and the LeRoy passed It was moved seconded and that t^<mmimites of the meating of July 10 be approved as written distributed The Administrator presented his Operations Report It was noted that commitments to the Trust were 45,250 and that expenses to date had amounted to 38,772 Cash on hand was in excess of 14,000 Thus the expected surplus as of October 31 was between 7,000 and 8,000 These funds were sufficient to carry the program on its present basis until December 31 It was noved seconded and passed that the Operations Report of the Administrator be accepted It was moved seconded and passed that the checks issued by the Finance Committes since seconded last meeting of the Trustees approved The Chairman noted that the item on retirement and disability benefits scheduled for discussion in connection with the health plan had been considered by the Trustees of the pension plan on the preceding day and no further discussion was necessary at this point Administrator Slaughter asked that the minutes show that the increase in con- tributions on August 1 1969 was to be held in separate accounting and the 2 for operations of the Occupational Health Plan be shown in a separate report BALZER 18-2008 10P FROM TO 15105599970 P 26/35 Western October States Asbestos 16 1969 Health Plan Minutes 2 The report of the medical consultants was then asked for Dr. Tabershaw Dr. Cooper and Mr. Balzer presented details of their activities since the last meeting Dr. Cooper had attended a meeting in Japan shich concerned the area of lung diseases and which he did in connection with other business Ha reported that unfortunately there were no real breakthroughs in the field of scientific knowledge Hr Balzer reported some of his work on the testing of masks Unfortunately there were no new products at this meeting to report He demonstrated the use of a plastic bag in the use of mixing various kinds of materials Tabershaw pointed out that there was considerable Congressional action directed towards the construction industry for the control of noise silicosis and asbestosis Dr. Tabershaw then gave the written report of their activities indicating a number of examinations of persons have been completed in Portland and Seattle He gave a brief statistical breakdown on the consequence of exams in Seattle These were discussed by the Board Attention was given to the status of the examining program in other areas The Trustees of the Health and Welfare Fund in Southern California and the southern States have yet to approve the expenditures specifically to cover the examinations under the Occupational Health Plan Accordingly no examinations have taken place in Utah Arizona New Mexico or Southern California Dr. Tabershaw reported progress in developing contacts in Los Angeles and San Francisco with respect to carrying out these examinations if and when funds became available A review was made of the various prices being charged for the exams through out the Western States Dr. Tabershaw was specifically instructed to go ahead and set up clinics and comections in California since Locals 5 and 16 | have now joined the Occupational Health Plan Dr. Tabershaw talked briefly about the problem of referrals to them and from other physicians and of referrals by them to family physicians He discussed the problem of the Workmen's Compensation law as these differ from state to state and indicated that their organization was reviewing this in terms of the problem related to to the health plan He also reported on general communications from and to the Conference to contractors and others Dr. Tabershaw then turned to a discussion of the industrial hygiene program Mr. Balzer demonstrated paper coveralls and discussed some of the problems in their use He reported the technical symposium at the Puget Sound Naval Shipyard where they were attempting to implement some of the recommendations which the Tabershaw Associates had previously presented to the Trustees for discussion There was discussion of the development of a mobile and industrial hygiene presented lab which could be used by the health plan Dr. Cooper also a syllabus for the seminar program that is being scheduled for the various BALZER 18-2008 10P FROM TO 15105599970 27/35 ~~ are da Western States Asbestos Health Plan Minutes October 16 1969 3 areas to discuss the problems related to industrial hygiene attention to the fact that publications would be occurring in every couple of months on activities which they were doing He also called the IDCNA Outlook It was agreed to send 150 copies of the Occupational IDCNA headquarters at the Mountain Shadows resort at bution to the delegates at that convention Health Flan to Scottsdale for the distri- The attention of the Trustees was turned to the budget Dr. Tabershaw briefly 10,000 cutlined the perscanal office travel and program costs plus potential expenditurs of some 10,000 as capital costs for a mobile laboratory These 70,000 totalled in excess of 70,000 The Trustees felt on the basis of their present experience that this was a hudget larger than could be accommodated by the Occupational Health Plan After further discussion of the matter it was moved seconded and passed that the Trustees extend the present arrange- Tabershaw ments with Associates for two months at 2,750 per month an additional zant o2f ,000 for travel and with the intent expressed to plus agree to extand the contrent for one year and accordingly to direct Tabershaw- Cooper Associates to prepare a budget and program of effort in the range of 60,000 There being no further items for discussion at this time it was moved seconded and passed that the meeting adjourn at 11:55 a.m. Respectfully submitted Kenneth M. Mouffree Secretary BALZER 18-2008 10P FROM TO 15105599970 28/35 WESTERN STATES ASBESTOS OCCUPATIONAL HEALTH PLAN OPERATIONS REPORT November 1969 I. TRUST FUND BALANCE AS OF OCTOBER 31 1969 BALANCE OCTOBER 31 31 1969 II INCOME $ 9,795.39 Employer contributions revd in August September III DISBURSEMENTS A. Administration Glen Slaughter and Associates October B. Other 2,744.61 10,815.13 13,559.74 $ 153.14 IV v I. R. Tabershaw H. D. Trustee expense NET TO TRUST FUND 2.750.00 102.93 102.93 NEW TRUST FUND BALANCE AS OF NOVEMBER 30 1969 TRUST BALANCE NOVEMBER NOVEMBER 30 1969 1969 Savings Account Checking Acct 20,529.00 180.00 180.00 $ 3,006.07 10,553.67 10,553.67 10,553.67 20,349.08 20,349.08 20,349.08 20,349.06 20,349.06 COMMITMENTS Professional Service 19 months TOTAL 23,750.00 23,750.00 23,750.00 Plus 18,000.00 18,000.00 Expenses Addtl 2,000 10/16/69 TOTAL $ 9,000.00 $2,000.00 52,750.00 52,750.00 TO DATE 22,500,00 15,000.00 -0- 37,500.00 37,500.00 DISBURSEMENTS TO DATE 22,500.00 15,000.00 7,348.85 44,848,86 44,848,86 44,848,86 BALZER 18-2008 11P FROM TO 15105599970 P 29/35 FROM GLEN SLAUGHTER AND ASSOCIATES TO WESTERN STATES ASBESTOS HRALTH PLAN Statement for Month Ending November 30 1969 OPERATING CHARGES I. Management Fee No Contributions Contributions Contributions II Reimbursement of Gen Adm Coats Incurred ) Direct Charges Mone 7 Shate of Pooled Operating Charges 3 3/4 App hours @ 7,65 III Heimbursement of Data Processing Costs ^ ncurrad Machine Time . PERSONNEL 56.00 Programming Operator Key Punch ^ Clerical Du 40.16 Supplica Cards Paper Supervision rated nQ2 12.02 101.18 IF TOTAL OPERATING CHARGES 28.69 28.69 136.87 BALZER 18-2008 11P FROM TO 15105599970 P 30/35 WESTERN STATES ASBESTOS OCCUPATIONAL HEALTH PLAN OPERATIONS REPORT December 1969 I. TRUST FUND BALANCE AS OF NOVEMBER 30 1969 II INCOME 20,349.06 20,349.06 Employer contributions revd In October will show on January report III DISBURSEMENTS -0- A. Administration Glen Slaughter and Associates November B. Other $ 138.87 I. R. Tabershaw M. D. Don Bruner stamps Transfer to checking account 3.525.51 90.00 100.00 IV NET FROM TRUST FUND NEW TRUST FUND BALANCE AS OF DECEMBER 31 1969 TRUST BALANCE BALANCE DECEMBER 31 1969 - $ 3.852.48 16,496.58 16,496.58 Savings Account Checking Account 16.396.58 100.00 16,496.58 16,496.58 COMMITMENTS TOTAL TO DATE Professional Service 19 months 23,750.00 Plus 18,000.00 18,000.00 Expenses $ 9,000.00 Addtl 2,000 10/16/69 $ 2,000.00 TOTAL 52,750.00 23,750,00 23,750,00 16,500.00 16,500.00 $_~0- 40,250.00 40,250.00 DISBURSEMENTS TO DATE 23,750.00 16,500.00 16,500.00 $8.124.47 48,379.47 BALZER 18-2008 11P FROM TO 15105599970 P 31/35 FROM GLEN SLAUGHTAENRD ASSOCIATES TO WESTERN STATES ASBESTOS HEALTH PLAN Statement for Month Ending December 1969 OPERATING CHARGES I. Management Fee % of 16,127.40 * 161.27 1 of 10,815.13 S. S. 108.15 269.42 II Reimbursement of Gen. Adm Costs Incurred 1 Direct Charges None 2 Share of Pooled Operating Charges 4 App Hrs @ 7,36 = 29.44 29.44 III Reimbursement of Data Processing Costs Incurred Machine Time PERSONNEL Programming Operator Key Punch & Clerical Supplies Carda . Paper Supervision rated 16.50 20- 11.04 .20 .30 8.51 IV TOTAL OPERATING CHARGES 29.44 . 31.55 330.41 BALZER 18-2008 11P FROM TO 15105599970 P 32/35 WESTERN STATES ASBESTOS OCCUPATIONAL HEALTH PLAN OPERATIONS REPORT January 1970 I. TRUST FUND BALANCE AS OF DECEMBER 31. 1969 II INCOME Employer contributions revd in October III DISBURSEMENTS A. Administration Glen Slaughter and Associates December B. Other I. R. Tabarshaw N. IV NET TO TRUST FUND V. NEW TRUST FUND BALANCE AS OF JANUARY 21 1970 TRUST BALANCE JANUARY JANUARY 21 1970 1970 1970 Savings Account Checking Account 29,318.16 29,318.16 100.00 16,496.59 16,127.40 $ 330.41 2,875.41 $ 3,205.87 12,921.58 29,418.16 29,418.16 29,418.16 Professional Service 19 months Plus 18,000.00 Expensas Addtl 2,000 10/16/69 TOTAL COMMITMENTS TOTAL TO DATE 23,750.00 23,750.00 18,000.00 18,000.00 $ 9,000.00 $ 2,000.00 52,760.00 23,750.00 18,000.00 a a: 41,750.00 DISBURSEMENTS TO DATE ' 23,750.00 18,500,00 18,500,00 : 9.499.88 51,749.88 BALZER 18-2008 11P FROM TO 15105599970 33/35 FROM TO GLEN SLAUGHTER AND ASSOCIATES WESTERN STATES ASBESTOS HEALTH FUND Statement for Month Ending January 1970 OPERATING CHARGES I. II Management Fee Ba is - % of November 21,377.02 21,377.02 / of Navambos / 19,967,149,9647,44 : Jecamber Reimbursement of Gen. Adm Costs Incurred 106.89 106.89 99.84 99.84 206.73 206.73 1 Direct Charges Fostmaster - Oakland Ck No. 1286 Date 1/22/70 Amount = 2.00 2.02.000 2 Share of Pooled Operating Charges Gen. Ad~-n 18 hrs @ 7.49 134.82 134.82 III Reimbursement of Data Processing Costs Incurred Gen. Adm Machine Time 93.05 PERSONNEL Programming Clerical Operator Key Punch & Clerical 135.19 Supplies Cards Paper Supervision rated 1.60 4.95 4.95 29.35 264.14 264.14 IV TOTAL OPERATING CHARGES 136.82 136.82 , 264.12644.14 607.69 607.69 BALZER 18-2008 12P FROM TO 15105599970 P 34/35 CHECKS ISSUED BY FINANCE COMMITTEE SINCE OCTOBER 1959 WESTERN STATES ASBESTOS HEALTH PLAN OCTOBER 1969 Glen Slaughter & Associates` September Touche Ross & Company 1968 Audit & Tax Returns I R. Tabershaw M. D. Fae & Expensen E. B. Kirkland Meeting Expense F. Calegory " , D. Bruner " Ed Lontz 17 -- L. E. Sweetzer = K. M. McCaffree n A. D. Schinnerer H D. Bradshaw t " NOV^ NIER1969 PVhoiidl Smith Meeting Expense Alan Slaughter & Associates October I. R. Tabershaw M. D. Fee Holiday Inn Trustee Meeting DECEMBER 1969 Glen Slaughter & Associates November I R. Tabershaw H. D. Fee & Travel Don Bruner Local 5 Three Rolla Stamps @ .00 JANUARY 1970 Void Glen Slaughter & Associates December 51 52 TOTAL AMOUNT el $ 253.94 750.00 3,325,98 35.00 5.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 35.00 153.14 2,750.00 67.93 138.87 3,525.61 90.00 2,875.41 330.41 agen 330.41 330.41 14,574.24 BALZER 18-2008 12P FROM TO 15105599970 35/35 WESTERN STATES ASBESTOS OCCUPATIONAL HEALTH PLAN TRUSTEES MEETING February 18 1970 Sir Francis Drake Hotel San Francisco Calif AGENDA Roll ikinutes Administrators Reports OperaSttaiteomenntss Report Authorization Authorization of Disbursements Disbursements Report ProposedTabershaw Cooper Report of & Program Budget Report of activities since October Fleeting Luncheon Disability 6. Benefits Benefits Plan of Question oBefnefitswhich Trust Actorney's Report 7. Other Business Estemet ) file file file Fanch _ ic . later foe Aval Aval BALZER