Document b54eyMjeb34nL3VqvNXXwaoK6

FILE NAME: Asten Hill (AH) DATE: 1956 May 1 DOC#: AH022 DOCUMENT DESCRIPTION: Memo and Unpublished Report / ~ . _ ^ y 1 , .1 9 5 6 M r, M yrll G. Shaw, E ccra tiry A cbealoo T on tila Institute ' ' c /o P hilad elp h ia T em ilB Institute) SchooL houee .Dona Philadelphia 44, P a,- - .D ear M s , -Chaw: -I'*--h:YS:~ v " T.-' VV ^ --** V- :.y- -I "wish to a c k n o w le d g e and thanb you fo r y o u r l e t t e r oi A p r il 26 and tho w ritten au th ority to con d u ct.th a p r e lim in a r y .survey for your Institute. ~ ' v . . ...... A . . ,.. '` '".T h e and o f Last w o a k D r . E m c n had th e o p p o r tu n ity o i v isitin g -th a A rtcn H ill C om pany, K o iib cy -M n ttlB o n C om pany and the A m e r ic a n A s b e s t o s T c u t ilo C o m p a n y . ' Ha will a r r a n g e a t an e a r ly date to v is it w ith tha "rem ainder co m p a n ies, p o lio w in g theae v isit* we w ill prepare a report and form al prospectus fo r a m ore com p re h e n siv e ep id e m io lo g ic stu d y. If you have any q u estio n e -regarding thl* w ork, wo w ould be p le a s e d to have yon con tact us.-. .. _ ... .. ".r/.- r\: "T -'; J:.V: - -'/a 's i n c e r e l y y o u r s , CRY? :ds cc: D. R .H olm cfl C . 'R ic h a r d 'rV alm or, M .D . - M anaging D irecto r HD r t f t n o n n o H VU i L i \ L ;u ; ; F A .v R iC -. irs;c N.iglL.l.C'N 1M SI IT WT C. U.UOC.' n n n A V E N U E P i T V b b u A G n H-. P a. lay L, "06 M t m o r a n d u m "on P i - i u P O o E D Z P l D h 'b i 1C LOGICAL. S T U D Y C F DUNG CANCEIt IN ASBESTOS WORKERS ior the ASBESTOS TEXTILE INSTITUTE INTRODUCTION T h e r a p i d l y . i n c r e a s i n g in c id e n c e of c a n c e r of the lung hue b e c o m e a m e t i e r ci c o n c e r n to i n v e s t i g a t o r t in a ll b r a n c h e i of hes*.th as well as to the g e n e ra l public. Although it would a p p e a r to be inevitable that s o m e c a s e w oulc d ev e io p in any r o u p of w o r k e r s , ita o c c u r r e n c e in p e r s o n s w ho a l s o h a d a i b e s t o t i s h a s b e e n s p e c i f i c a l l y n o t e d by a n u m b e r of a u t h o r s o v e r the p a s t tw en ty y e a r s . ( .Lynch and S m ith , A n g ris t, D o tm c u le s et al, C a r tie r , Gloyne, M c r c w c t h i : , K erm aw ay anu K-cnnaway, Doll, a n d o t h e r * . ) K u u p c r , of the .Nationa: C i n t e r Lnutitulc, U . a . P u b li c Health, b e r v i c e , h a s sta te d that c t a o s of iur.g c a n c e r a u p c r im p o e d uoor. s t b e i l o t i n n o - n u m b e r about .00. *-ike f.iany of th e -a b o v e u u t n o r t , H u e p c r r e f e r s to " a s b e s t o i * c a n c e r of the lung anc c l a i m s a d efin ite r e la t io n s h i p betw een tho Iwo con d itio n * . Although m o st of the a tte m p ts at c o r re la tio n i . i e n i o r i n c i u i a . . , i o r d 1 1 a. h a v e b e e n l i m i t e d l o l un g c i a c e r a d s i i i l u j i . - , a c o n n e c i i v n -viii. nvero expo are to i i b o ii y fiber-unu a u s th e s been in fe rre d . fh u re fo r e , it now a p p i x r j th at when iting c i n c e r o c c u r u in an w o r k e r , .it m a y bo l o o k e d upon .a i n o c c u p a t i o n a l d i s e a s e by l o m e Vi o r k m c n * C o m p o a < i l i o n i J o i r d i . B c c s o je oi thco c o n sid e ra tio n s and m o tivated by a d e s ire to d eterm in e the true facts, the A sb esto s .Textile Institute, through its Air Hygiene C o m m ittee, approaciieG Industrial Hygiene Foundation r e g a r d i n g the f e a s i b i l i t y .of a s t a t i s t i c a l a_nJ e p i d e m i o l o g i c a l s tu d y haying as its objective to pro v e or d isprove, ii p o ssib le, W hether liu r e iu.a relationship between iung c i n c c r u s d .asbosvosis, and 2 . W h e th e r a r e la t io n s h i p c x in ti b e tw e e n Ion,; c a n c e r arid any c o n a ic u ra b .e e x p o s u r e to a s b e s tu s fib e r a n a d u st. The r e p r e seutatiYC s ui the A ir Hygiene C o m m itte e pointed out t h a t only tu'O to t h r o e t h o u s a n d e m p l o y e e s w e r e e n g a g e d in t e x t i l e p r o duction and b e c a u s e of this rc ativ ely s m a ll n u m b e r, it was felt that a p re lim in a ry su rv e y should be u n d erta k en to find the extent and reliability of data b efo re slating Cefinitcly that ih e l a r g e r tuJy would he p ra c tic a l ii-.d p r o d u c t i v e . AHD 0 0 0 2 9 1 0 1/<Vm o r a n d u m . . . l o r A T I 3. b U i_.T b C r P ri i _LMlNA A Y b `J K V Y '.During th e w e e k s of A p r i l Z 3 a n c a*iay ; ,'bU., v i s i t * w e r e m a d e t o s e v e n m e m b e r p l a n t s o f t h e A s b e s t o s T e x t i l e : Lr.eLi. - l e une. c o n f e r e n c e s w e r e h o l d w ith r e p r c a e n t a t i v e a of m a n a g e m e ;.t a t e a c h . In s o m e c a s e s , t h e r e w as also an o p p o rtu n ity to m e e t the p h y s ic ia n io r the pianl. The p u rp o se was to d e te rm in e the extent'arid availability o f m e d i c a l r o c o r d s a n d e m p l o y m e n t r e c o r d s , a n d t h e p e r i o d o t i m e c o v e r e d by t h e m . T o t a l e m p l o y m e n t as. w e ll a s the n u m b e r o f thOi;e e n g a g e d in t e x t i l e m a r u a i a c t u r m g -wax n a c e r t a i n o < i a n d a t t e n t i o n w a s g i v e n to the rela tiv e e x p o su re of e m p lo y ee s in d iffe re n t op eratio n s. At the s a m e t i m e , i n q u i r y w a s m a d e r e g a r d i n g Lite i n s u r a n c e r e c u r d s which m ig ht be useful in fixing the c a u s e s of d eath s am ong the em ployed group. E a c h plan t w as q u e s tio n e d r e g a r d i n g .the n u m b o r of know n c u e s of a s be to s is an d of lung c a n c e r , if a n y . It c a n be a s s u m e d w ith o u t i n v e s t i g atio n th-U o f f ic ia l s o u r c e s of v ita l s t a t i s t i c s a s they ap p ly to the g e n e r a l population e x ist in all of the lo c a tio n s with w hich we a re c o n c e rn e d . As a r e s u l t of this p r e l i m i n a r y s u r v e y , it is appa i r u t that c o n sid erab le in fo rm a tio n ib av ailab le o r o b tain ab le with re sp ect to the lex'.ile w o rk e rs and to o th e rs with p otc-uial e x p o su re ; Foi ex a m p le , 1. ? r e - e m p lo y m e n t r e c o r d s e x m a t all p l a n t ., in m o s t for a c o n s i d e r a b l e n u m b e r of y u a n . . P e r i o d i c x - r a y . of the c h e s t a r c m a d e at ail but one plant. AMD 0 0 0 2 9 1 ' 1 . m o .A" - t ar n. . . i ' r A T I 4. 3. of rripiuynritint can be Ltudioc for pe.-;.ec v^^-yirt" from six to 56 y e a r s . 4. All the plant* except one have a preup life h i u r a i i c e p ro g ra m . w hich u o c l d p r o v i d e -data on c a u s e s of d e a t h . 5. A utopsy p ro to co ls a re av ailab le on-at leas: a lim iiec n u m ber of lun^ c a n c e r c u e . It w o u ld e c c m that at le a s t 1300 te x t i le w o r k e r s h av e b e e n em p lo y ed u n d e r o b se rv a b le conditions for p e rio d s sufficiently lend to t.jv*c a t o t a l o f n o l e s s t h a n 5 , 0 0 0 p e r - . n - y u a r * . r ' r o m a L a c t s l i c a l put..! of view , this s h o u ld be an a d e q u a te b a s i s on which to preo.ict with >0% a c c u r a c y , p r o v i d i n g the p l a n t i n c i d e n c e i s a c t u a l l y h i g h e r t h a n t h a t in the g e n e r a l p o p u l a t i o n , lr. a d d i t i o n , t h i s s tu d y w o u ld be c o n s i d e r a b l y e n h a n c e d b y v i r t u e of the f a c t t h a t c o m p a r a b l e i n f o r m a t i o n w ill be a.t hand fro m a s i m il a r titudy to be mado- for the a s b e s to s m ining in d u stry . A e s u l t f r o m t h e l a t t e r -jc111 p r o v i d e e x t r e m e l y v a l u u b c c o n f i r m a t o r y evidence for d id o clio iu draw n from, the p r e t t n t m aterial. h* K u P o i A c - C trrc -fu l-c e n s id e r a t i o n of th e type a i d probabLc_reJ.iability. of --.v a t l a b l e d a t a p e r m t U t h e c o n c l u w i o n t h a t a s t u d y of t h i s p r o b l . - m in t h e a s b e s t o s t e x t i l e i n d u s t r y i* f e a s i b l e , anu s h o u l d r e o u l t i.t s t a t i s t i c a l l y vaiid deduction*. AHD 0 0 0 2 9 1 2 ' a n , . . f<n /.T 1 ; c v : : r a l m e t h o d - of >ppr-ri.ch :vjjw lltv it. Jciv * ;_ , a fi-ial ch o ice of m e th o u should depend upon m u r e c-.-tailec clu b ; of the data, w h i c h t h e p r c l i m m r y s-j> v e y h a s s h o w n l u ; . d s l . i:. hov'cvcr, it is l . i a t a-i L a r ^ c *. p o a s i o l e a O: o u p u ; : o u o r r o f a o r k e r a w h o e r . l t r e d t h a i n s i u s t r y a t a j p c c i i i c u a n i h e .e l e c t e d a n d fo llo w ed , t h r o u g h t h e u s e of c x in tin ^ r e c o r d s . l h e i n c i d e n c e c l u i b c a - lo s i e in th is r c u p s h o u ld be d e t e r m i n e d by a iu d y ln ^ the r c n u i l u oi the p e rio d ic e x a m in a tio n s , a n d incidence of lun^ c a n c e r tiircu.'h r e c o r d s of the in su ra n c e e a r n e r a and official vital s ta tis tic s . T his m ethod .would ;i_pproach the c o n d i t i o n s of a c o n t r o l l e d e x p e r i m e n t u n e t h e in - i o r s u u o n cvc r i v e d w o u l d b e of r e a r i m p o r t a n c e . f o l l o w i n g t h i s , a c o m p a r i s o n of the r a l e s fa u n a in Lais Oroup of w o r k e r s and'1the in c id e n c e m the u n c r a l p o p u la tio n a-ouic be i r a u c , i - x p c r i e n c i i o r i r i c n t i of the g e n e r a l p o p u l a t i o n ( s e l e c t e d u a . to e l i m i n a t e b i a s a o a n d c o n t r o l v a r i a b l e s ) -would be o b t a i n e d f r o m s t u d y of O f f i c i a l YLtal u t a t i s t i c j r e c o r d s s n o f r o m p u b l i s h e d r e p u r t s i t 6 a r c i r . ^ i n c i d e n c e of c a n c e r 01 the i e n 0 , it i s , of c o u r s e , n e c e s s a r y to p l a c e considerable relian ce upon ucsih certificates rc^a.-uin^ the w u 0 ;;o n i, but in m o s t b o r d e r l i n e crises it should be pOw.ihie to refine inc d ata uy m o r e t r t L n i ' l V 4 " i e ' i r d i . i t' w o u l d be h e l p f u l , -w.lso, i f - t h e s i o j p u n d e r s t u d y c o t d u Oc e n l a r g e d by t h e i n c l u s i o n 01 - u r k e r t .vho a r e e x p o s e d Lu a s b e s t o s f i b e r a n a d u s t e v e n m o u ,, h t h e y a r c not e m p l o y e d in the. t e x t i l e d c p r tr u e r ,! . It lu o u r u n o e r s t a n d i n g t h a t in s o m e of th e c o m p a n i e s .tin nrwvJQi  i *ur 4 4 1 ^Cto 44 14 4 C A^JU J Ui t 441 Ci4 si C 4 <1 I 4. . ' 4 #44444 44 4 4>4_ J Ui 4444 . 4 4 U T C i 4,1 i;i j c i i i r o i ; -vUi^iw .'ic 1 t h e v u - l i ^ t y u i t h e a t ----y . `I a i i t y p e oi . ' i r v t y cL-. 4 0 4 4 i i ^ n e t c u i : - u - . c u t a i i u t . a . - a . /.; .a o f . h e - v u r 1. a i t o r y , r u t i i c i i : O L o ; i t| -.id i:i*uraaC(i c u a p u f l ) ea-psif-Loncc a thc-y r c i a . i t . to ..ii - a r k . : rt. p .- c u c i'iL iy e m p l o y e d , ...j# w c i . -- - t h u o c :io O n ^ c i c U l y s O y t c li.it - a o i c r 114} 1 . . I a 4*a a v i t i l a b l c * -it i ao 41 ui rc exam ica-tiO ii of i.i& u rm ice co n .p ao i/ i t c t r d s i n a l i d e ath c.aini*. c-ith f o l i o - - u p in t a c k d an o h i .in ch i n c u r a a p u i i i b i o c u - a o . i.i .addition., it u u u c c ^ c c i # * r y L-- l u u j v i t 4.1 #4 C 4 . c m a r c c u - t u ^ f o r -lie r c * i i in .4h i c o *lie v i c i c - . p l a n t . * . 1 1 c. k c n i e e , T L a l a c i o o u a c u i i - a D c - n c t r , a i t n o u . 0 h an u. 1 c a u u t * r a p i d l y , * - t u i c c a i p . r i U v c l y l o w , a a d La. t h i s r e a s o n , t U c r i i i no o u b s l i l u t e l u r Liu; t y p o o i a p p . - a a c h ou.Lii.iitd i f irie a .il- ir.^iuJ r c u i t i . sir u iu uu o b t - t h i u d . It i* a n t i c i p a t e d t h a t U10 i i e l u w o r k i o r - - c h a a t u s iy . t o u l u c o n * urn v - p p r u . 'U . a i a i c l y i u nr* o a t h , i m j a o a l y a i * oi th e t i a t i ., - a n y r j c c c . - a r y r e v i c - v , uwo p r c p i r i . n u : ) o i th e 1 e - p a r t , a n - i u b . U i o r i u .1 # u i.io i.L .h a . O n t i i ; b d a i s , c o * t oi t h e -jLuc./ 1 L - U u n a i i u a ! , i / , 5 C y , i n c l a h n 3 t r a v e l a n a c e l - o f - s o c k e t v.' vp d i u S , AHD 0 0 0 2 9 1 4 i s O i x t : i ;:v was diet.* ted by i X J on May 6, 1y 5 o for p o s s i b l e i a t u r e r e f e r e n c e re A s oe si os f ox t :: c in..t i tute C.iic L-;a'.ior.3 arid L o g i c on W h i c h a P r o s p e c t u s to the A soeslu.- Textile bislitute May be B ased . . . . The p re lim in a ry su rv e y of the seven m e m b e r com panies .j '. A s b e s t o s T e x t i l e i n s t i t u t e r e v e a l s t h a t a p p r o x i m a t e l y 1831 e m p lo y e e s a r e e x p o se d to a s b e s to s in the m a n u fa c tu rin g of t e x tile s .- In the sa m e co m p an ie s, th e re a re 7547 em ployees total. 'Jr.u.-notedly, th e re a re som e in addition to the textile w o rk e rs who i: i vv e x p o s u r e t o a s b e s t o s . T h e f i g u r e s f o r e a c h c o m p a n y a r e t a b u l a t e d in t h e f i i c . ( T a b l e 1). E m p l o y m e n t r e c o r d s of t h e v a r i o u s p l a n t s e x t e n d o v e r v a r y i n g t i m e s ' a n d t h e s e a r e a l s o t a b u l a t e d m T a b l e 1. M u l t i p l y i n g the n u m b e r of " e x p o s e d " e m p l o y e e s by the n u m b e r of y e a r s i c r w hich r e c o r d s e x is t in Ine s a m e c o m p a n y , we a r r i v e a: 51,435 m a n y e a r of o b s e r v e d e x p o s u r e . O b v i o u s l y , not all of the p r e s e n t e x p o s e d " e m p l o y e e s h a v e b e e n e m p l o y e d for the. p e r i o d c o v e rev: by e m p l o y m e n t r e c o r d s an d it wiji be n e c e s s a r y to ch e ck the r e c o r d s for actual exposure lim es. H o w i'u -r, u we cons.id.-r only those em oloycd at p re s e n t, a n d m u l t i p l y a f i g u r e r e p r e s e n t i n g t h e r e c o r d e d e m p l o y m e n t -- />.' J 10 -.-cars, we a r r i v e at a tigure of 15,525. This m ay serv e as a p o . i .-1oi r b e n c h m a r k oj m a n - y e a r s nf e x p o j u r e i n t h e >rc.-.cnt p o u u i a t i o n . AHD 0 0 0 2 9 1 5 A c c o rd in g to tables for the d e t e r m in a tio n of s a m p le size (C utler, et al, A m e ric a n Journal of P ublic H ealth, Sept. 1954), a 93% a s s u r a n c e can be obtained with 12 ,5 0 0 p e r s o n - y e a r s of o b se rv a tio n (if the plant ra te is th re e tim e s as high as the g en eral population). .............. \ R e fe rrin g to the idea e x p re s s e d above th at th ere m a y be o t h e r e m p l o y e e s w ith c o n s id e r a b le e x p o s u r e in t h e s e s a m e c o m p a n ie s , it would enhance the study c o n sid e ra b ly i f a ll su c h em p lo y e e s could be included. Since the entire com pany holds m e m b e rs h ip in ATI, ' we ca n see no r e a s o n why r e c o r d s on th ese e m p lo y e e s should not be included. A dm ittedly, a study covering only two or three thousand em ployees will be on the b o rd erlin e of v alidity. This is especially tr u e s i n c e our p r e l i m i n a r y s u r v e y i n d i c a t e d t h a t only 86 c a s e s of a s b e s to s is and th ree cases of lung c a n cer w e re a d m itte d by our con tacts at the tim e of that s u rv e y . T h e r e a r e two c o n s i d e r a t i o n s w hich m a y m a k e this p ictu re m e re fav o rab le. The f i r s t is that the actual survey probably will reveal m any m o re c a ses of both asb e sto sis and lung c a n c e r . The second is that this s m a l l s u r v e y will be g re a tly e n h a n c e d w hen it is c o n s id e r e d along with the l a r g e r s u r v e y c o n t e m plated for the QAMA. i. Asteri H ill M anufacturing Company, P h ila d e lp h ia , r n . C o n ta c t: Mr. D. R. H olm es, G enera] S u p e r in te n d e n t Pre-em ploym ent e x a m in a tio n s a r e made on a l l em ployees b e fo re p la c e m e n t. P r i o r t o J u ly , 1955, t h e s e _e x a m in a tio n s v e rs mads by Dr. Maxwell W hite a t h i s o f f i c e . S in c e t h a t tim e th e y have been made a t Woman's M edical C o lle g e . Dr. W h ite 's examina tio n s a re f i l e d a t th e o f f ic e o f th e company and dote back to 19t6. Records p r io r to th a t d ate are incom plete. P e rio d ic e x a m in atio n s, in c lu d in g p h y s ic a l exam ination and c h est x -ra y a re done y e a riy on a l l em ployees. O c c a s io n a lly , how ever, th e x -ra y is o v e rlo o k e d . Timed v i t a l c a p a c ity and flu o ro s c o p y a r e a ls o in c lu d e d . The x - ra y (11 by l u ) i s made a t Woman's M e d ic a l C o lle g e and th e p h y s ic a l i s done by Dr. White a t th e p la n t. Records a re r e ta in e d a t th e p la n t. These records a re f a i r l y com plete as f a r back as 1950 In 1919 th e y were l o s t d u rin g moving and p r i o r t h e r e t o a r e s p o t t y e x c e p t f o r 1913 2nd 1916. Group l i f e in s u ra n c e c o v e rs a l l em ployees a f t e r 90 d a y s; has been in e f f e c t s in c e 1935; and i s u n d e r w r i t t e n by C o n n e c tic u t G e n e ra l L ife In su ra n c e Company, mroad anc C h e stn u t S t r e e t s , P h ila d e lp h ia , where a l l re c o rd s a re a v a il a b le in c lu d in g cause o f d e a th . The com pany's e x p e rie n c e r a t i n g i s norm al or b e tt e r . They pay no e x tra premium f o r o c c u p a tio n a l h a ta r d . I exam ined sp ecim en s o f each ty p e o f e x a m in a tio n and r e c o r d . The rre-p l.icem en t exam ination i s m inim al, very sk e tc h y , and not signed by th e ; h y s i c i a n . T here i s a r e p o r t from Woman's M ed ical C o lle g e on th e y e a r l y x -ray and v i t a l c a p a c ity stu d y . There a re, in a d d itio n , numerous in d iv id u a l re i.o rts from D r. Thecdos on in d iv id u a l c a se s o f a s b e s to s is . I o b tain ed a m im eographed copy o f th e r o u t i n e ex a m in at Lon .lone a t Woman's M e d ic a l C o lle g e nOS L-l Lai* t*rv n n f t ? O l 7 . n o s p i t a l r o c o r d s f o r a l l c a se s o f p o s s ib l e a s b e s t o s i s . H r. Holmes was u n ab le t o f in d t h i s r e p o r t b u t w i l l fo rw a rd , i t t o m e. He does have a f i l e o f h a l f y e a rly r e p o r ts on a sm all group o f a s b e s t o t i c s . This f i l e a ls o c o n ta in s one autopsy re p o rt. T o t a l em ployees i n t h i s p l a n t e q u a ls 3A-6, 313 o f w hich a re f a c t o r y em p lo y ees. Of t h e l a t t e r -263 a r e c o n s id e r e d t o work u n d e r c o n d itio n s o f ex p o su re t o a s b e s to s f i b e r and d u s t . As o f t h i s d a te th e r e a re 21 known c a se s o f a s b e s t o s i s ( a l l t h r e e s t a g e s ) . One c a s e o f lu n g c a n c e r i s known t o have o c c u rre d o v e r a p e r io d o f 25 y e a r s t h a t t h e company h a s been i n b u s i n e s s . T his -was a n i g h t s u p e r i n te n d e n t, age 1 7 , em ployed 20 y e a r s , who d ie d 8 /3 0 /5 2 . 2. A m erican'A sbestos T e x tile C orporation C o n ta c t: H r. Weber, Vice P re sid e n t and G eneral Manager Pre-remployment ex am in atio n s a r e made on a l l em ployees o v er th e p a st th re e y e a rs . They are perform ed by D r. Z. Myers, N orristow n, P a ., a t h is o ffic e . Records are kept th e re ; r e p o r ts , only, are f ile d in th e p la n t. .X -ray s a re made by D r. Tomkins in N o rris to w n . P e r io d ic e x a m in a tio n s, y e a r ly , in clu d in g p h y sic a l and x -ra y , have been perform ed fo r f iv e y ears on everybody, in c lu d in g o f f i c e w o rk e rs . . They a r e made by t h e same tvro p h y s i c i a n s . ^Deployment re c o rd s ex ten d o v e r s i x y e a rs o f o p e ra tio n o f t h i s c o r p o r a ti o n . Some e m p lo y e es, how ever, h av e been h e re 25 o r 26 y e a r s . Under th e p re d e c e s s o r' s com panies ( P h ila d e lp h ia A sbestos Company) (American A sbestos Company), employment re c o rd s e x ist, on th e s e p eo p le b u t no m ed ic al r e c o r d s . There is no group l i f e in su ra n c e p la n . V ita l s t a t i s t i c s w ill have to be obtained from th e p u b lic re c o rd s. --tm T o ta l employment eq u als H I , o f which 8 are o f fic e w o rk ers. Of the rem aining 103, 20 work in th e m anagement, shop, s t e e l wool m an u factu re, e t c . , and a re n o t exposed to a s b e s t o s . S3 re m a in in g f a c t o r y w o rk ers a r e e x p o se d , cf Kiich approxim ately LI are fem ales. A.HD 0002913 DEPARTMENT OF PREVENTATIVE MED TOIME WOMAN'S MEDICAL COLLEGE HOSPITAL _ Philadelphia, Pa. PLAN II PREPLACEMENT AND PERIODIC SCREENING EXAMINATIONS 2. History -- medical a ad work. 2. Physical examination. 3. Chest roentgenegram* (miniature photofluorogram). 4. Timed vital capacity (pulmonary function test) on men engaged in dusty -work or v.rhose chest films suggest abnormality. * * * * .* 5. Vision tests (near and far acuities).. ' 6. Urine tests (albumin and sugar). ' 7. Report of findings to individual and his personal physician. S. Report of employability to employer. In instances in which persons are found to be unemployable, appoint ments vith these persons v.rill be made by the Dept, of Preventative Medicine, the situation will be explained and indicated steps for correction outlined. Emphasis will be placed on the good fortune of the individual in having applied for a job at a place where health inventories on applicants are paid for by the Company. 9. Reports to managment on health maintenance examinations will be confined to group reports unless infectious disease is discovered anc the individuals infected re fuse proper steps so that there may be a menace to fellow employees. .. Charge: $15.00 *'?he Miniature film will be developed while the balance of the examination is conducted. If any abnormality is noted, a 1L x 17 film and fluoroscopy will be or dered (to be done by Dr. Jacob Vastine). The charge for this additional service will be $5-00 Ai-in Cin fi o a 1 a V '. _ ; _ _ A A t'T .A :. A , i _ /A A y A ^ '^ j ", '~*'l ^ ............*. T " > -'y r " / / : ' " ' .' ' f _AA-.. _S _ y A A -c.e--\. ' r *~w f-- ^ a>-^ --=/ ^ J- ;-. * *" _ _.___ ______ ______ . h '- A - l. A A *-- A c x t - ^ - i . . A ? S K * .. ..... _.. . jCi t * ^ A ? '-/ > s s s ................ / ' A s-, :.Tt?*/; H -r/*: __ y /'? '.V t r-.-- --* .-/ _ ^ ^ _ C A * }'1 v y y/ j : ' j >y ,'i /-- -j ^ / ' ' . -?a /- M y y, ________ ( . . z 1 >----' _ -A A s Ay __ __ "j ] _______ ______ _ _ __ // '?/-s. <(- ~ CL-?/i/ -* tsS *vv.-'-/'* - ^ . . . . _ (i? / ``v ii -\. / *' ^ ^ _<r^---L "A**->j \?x . j < i A f A '* '. / / / i \' J (K' L ' C C ^ c^r> G S / l e --j.--t -\-c-*C ____ s i Y { -*- --- / - ~m\.**-- * 7 ~ / ? /- i\ . jZ Z ^ Z Y st, _>?-- / -><r. " " :' 7 "Z'/^':-: ^ _ -x^- n 7^_3j-- - \r/Z/`Z c" ^ Vi"-~b /sS_i Ss~--sj---~Z/-'(-.i----/^----/C-g-. --. >~,c. -- -, / ~L 7 - - / *_ v V-' ~ ^ _/'Z1? - u ____ /<r Z )/Y .r -S - . _ _ / Z ^ . 0 //-C`` A wi. J / >* *77 -- --^ y---'---- -C --------- <?- i ^ '^-- ^ y ^ / - ^ w / s // U r y ^ - Z . . J Z '-- i s Z u <r' c~^Z ..< , Z z - s Y c Z y / J X ~ - T- -y--ZL-cZ./cr~i 3/3 ^ ; ,.. y - ,. / : .X > li1 J & T -/: 3 13 _ - _ . - '. . . ^ '^ > _ , / l * { -i - > - 3 ''' Z " J * ___ ^ _ 7y > Ts-Z l Z 'Z - S / Y <-' _j ___ .X'<,7n--J 'J - 3 / l ^ ~ / f f i ^~' f y Z . Z t 'z Y ,<~ y/? ` `'S '' _-- f i ' ^ 3 ' y ~~,~y '*''*'/*'*"*' / a, L 'f /' iy / ^-- <r. / u ^ _.S i / C ' y ' *7` /" " 7 , ; ^ V U '. .. : r S `~ r r jr ..._ Z ? 3 ____ f r i t i - Z ' ^ 'v ^-j . -- 1. ( C U ' 3.^ . ..... '/ ?.r/i'*' - ' 7 ,`y i* Z - '-J y S . '' Z i - y / y . , -. .7-