Document bBoy7kk0262NdLVnQyeL7NEno

TRIP TO MONTREAL, ASBESTOS, THETTOED MIME?, 2UEEEC October l6-9ctober 21, 1944 PPRP03E To explore the reasons for the high tuberculosis mortality rate in Thetford Mines; To confer with the operators of the asbestos mines In Thetford concerning the establishment of an industrial health clinic in Thetford Mines; To visit Group policyholders in Montreal with Mr, Perry and Mr, Fehnel, Mr, Pebnel to make industrial hygiene survey of Asbestos mills in Asbestos and Thetford, SIGNIFICANT DEVELOPMENTS AND OBSERVATIONS He tuberculosis and asbestosls 1, Provincial Health Department to provide us with age-specific mortality rates for tuberculosis by sex for past eight years in Thetford, Asbestos and six comparable communities in addition to Dominion and Provincial rates, 2, Dr. Burnette to secure data for us on health services, character of population and living conditions in the communities for which mortality drta is being secured* 3, Local physicians and nuns at Thetford Mines hospital believe asbestos d6t contributes to tuberculosis, 4, Thetford hospital, built in 1930, has 150 beds---75 devoted to tubercu losis, Excellent, modern surgical equipment and basal metabolism apparatus, 7-ray machine 100 milliamperes and 20 years old. No EKG. About 50 tuberculosis patients in the hospital, about 50 percent male. 5, Tbetford has 115,000 health budget. County pays 10 percent, Provincial government pays the rest. One full-time health officer. Dr. Blais, and five part- time nurses are employed. Hollow-up on tuberculosis is poor. The nurses lack adequate training. Dr. Foley, the Provincial Epidemiologist, thinks there are 10 unknown cases for every known open case (he Insists that the unknowns are not open cases). 6, Dr. Slrou, the physician in charge of the Thetford Mines hospital ^ tuberculosis service, believes asbestosls causes tuberculosis although, according to Mr. gabourin, he has written and publicly stated the contrary. 7, Living conditions in Thetford have Improved in recent years. Mr. Fehnel, who visited Ihetford in 1930 and 1935, observed the improvement. Miss Chess, the Metropolitan Nurse, finds homes in Thetford better than home6 in parts of Cuebec City. 8. Asbestos companies in Thetford have no health information on their workmen. Only data nay be on ASfl claim forms, -2- 9* Is Johnson's Company's new mill a common tin drinking cup is still used. This was observed and reported by Mr. Tehnel in 1935. 10. In Johns-Hanville plant health service has been maintained for years vith Dr. Stevenson la charge. Dr. Smith ha9 just been employed to assist him. Dr. Smith wap-elth the-Aluminum Company of Canada on foreign service. There is a small but fairly well-equipped hospital and health records on employees extending over a period of years. It is hoped to enlarge the hospital facilities soon and install newer x-ray equipment. It was recommended that a new machine bar-at least 300 oilliaoperes and preferably 500 in order to secure adequate chest films for asbestosis* 11. In Asbestos. Dr. Smith said the incidence of tuberculosis appeared to be in the young women employed in the weaving and spinning mill. Operations are very dusty. Personal hygiene, living habits, and nutrition of these girls in his, opinion, were poor. Plans are under way to have a nutritionist demonstrate proper lunches and the preparation of other meals. Mr. UcGair was interested in securing all the heulth education materials of the Metropolitan which might help in this industrial situation. New ventilating equipment is being installed in the spin ning and weaving section. The electrostatic preciritator which collects the dust^- , from the various operations is working about 75 percent efficiently, mainly because' the increased tempo of operations is overloading it. 12. At our suggestion, the three managers of asbestos mines in Thetford agreed to Invite the laboratory man from Dr* Tourangeau's Industrial hygiene department in the Provincial Health Department to visit Thetford and work alongside Mr. Pehnel in making dust collections. This invitation was extended by Mr. Sabourin, legal representative of the Asbestos Producers Association, to Dr. Tourangeau when we called on the latter in Quebec. 13. We suggested that the effort be made to have the Compensation Commission Insist that x-rays, taken to demonstratevosbestoais, be made by a standard technique and that, if possible, diagnostic criteria be established. Mr. labourin thought it would be possible to have a committee on asbestosis made up of Canadian and American medical authorities meetiln Montreal and formulate such standards. Be also believed a clinical symposium on asbestosis could be arranged, to which practicing physicians in communities near the asbestos industry would be encour aged to attend by paying one-half of their expenses. Dr. Gardner and Dr. Lanza were authorities mentioned to speak at this symposium and for membership on the Committee on Asbestosis. Re Industrial Health Clinic in Thetford 1. The establishment of a clinic is a legal requirement In the asbestos industry. The government has recently ruled to allow the industry to establish Its own health service. 2. Three companies have agreed to spend about $60,000 to establish the clinic. 3. The position of full-time industrial physician will be offered to nr. Paul Cartier whom I met and interviewed in Montreal. If he accepts he will start at once to plan his program and secure ecralrment. _ G 06W -3- 4. Clinic will be onerated by a committee cononsed r>f the three managers. I suggested that the physician be & center of this committee. 5 Dr. Cartier, or whoever la appointed to the n^aiti^n, will have freedom and ?1000 yearly for orofessignal study and travel. he Visita in Montreal 1. Radio Comoratl~n of Canada It a. Dr. Kaufman critical of K.L.I. Medical Fxaminers on A&H follow-up. |l This criticism has teen passed on to Dr. Btirnette (see Exhibit A). b. Abnormally hig claim rate In radio-assembly section where there are 90 percent females. Causes--neurasthenia, weakness, fatigue, anemia. c. At Mr. ^ehnel's recommendati'n, ventilating hoods have beer, provided on operations involving soldering.' he wm make recheck survey. 2. Charles F. Prosat and Co. a. Planning health service for employees, rent Dr. Lozinsky, Director of Research and in charge of developing service, description of service for small plant (Exhibit B). b. Observed several working locations where dust end drug concentration in atmosphere might be hazard, (Mr. Pehnel arranged to visit and sake survey.) 3* Congress of Industrial Physicians This is a group of about 25 physician? employed In industry around Montreal. Dr. Graham hoas, of National Breweries, Is president. Mr. Pehnel and I spoke to this group on the work of the Industrial Hygiene Bureau and some postwar problems in Industrial medicine. Dr. Ross would like Metropolitan industrial hygiene literature which would be appropriate for these physicians. (Dr. Burnette has been informed.) -4- INDIVIDUALS MET DURING TRIP Radio Corporation of Canada Ur. Deacon, the nee President Mir. UcCallum, Personnel Director Dr, Kaufman, Medical Director h'r.^Eousseau, Safety Director Charles':'!. Trosst and Company ^liot S. 'rosst, President Ur. Sheen, Plant Manager Dr. Loxinsky, Director of Research Asbestos Cpro-ratlon Ur.. Robert Steele, President, Montreal Ur. Alfred Penhale, Manager, Thetford Montreal Anti-Tuberculosis League Dr. Paul Cartier National Breweries Dr. Graham Ross, Medical Director Aluminum Company of Canada Dr. Bildfell, Medical Director Asbestos Producers Association of Cuebee Mr. Ivan Sabourln Mr. Sabourin made arrangements with the three operators in Thetford Mines and with the Johns-Manville Plant In Asbestos for us to inspect and make dust surreys. He also took us In hi6 car on the trip from Montreal to Asbestos to Thetford to Quebec, and back to Montreal, and assisted us In meeting officials In the Provincial Health Deportment in Quebec City. Johns-Manville Mr. H. K. Sherry, Manager Ur. UcGaw, Director of Industrial Relations Dr. Stevenson, Medical Director Dr. Smith, Assistant to Dr. Stevenson Johnson^ Company Ur. Andrew Johnson, President Bell Mines Ur. 0. c* Smith, President Dr. Sirou, practicing physician in Thetford Ulnes 0693 Miss Chess, Metropolitan Nurse, and in addition the Sisters in charge of the hospital In Thetford and a number of the Plant Superintendents and Engineers in the four mines which were inspected. - 5- Quebec Health Department Paul Parrot, Statistician A. R. Foley, Provincial IpideEiologist Jean Gregoire, Deputy Minister of Health and Welfare Jules Gilbert, Director of Health Education - F. JTourongeau, Director of Industrial Hygiene Coamunltles for Which Information on Tuberculosis Mortality and Health Conditions Is Being Obtained CMcoutini Cap de Madeleine St* Jean St. Hyacinths Rlmouelci Valleyfield Asbestos Thetford EXHIBIT A October 25, 1944 Dr. Norman L> Burnette Assistant Secretary Canadian Head Office Dear Nnrmant *our questionnaire regarding community health services and living conditions, which you planned to send to the Nurses in communities in which we are making the tuberculosis mortality study, reached me today. I think it covers everything we talked about Saturday and should give us the necessary information. If it seems necessary and we are in doubt about conditions it may be possible ''or me to make an inspection visit later on. T assume from your letter that y'u can secure the information from a trusted source known to you in Rimouski. If you are in doubt about a source in Asbestos, I believe T can secure this information through Dr. Smith, the assistant to Dr. Stevenson at Canadian Johna-Manvtlle in Asbestos. I have several questions which I did not lake up with you on Saturday which relate to my visit, (l) Dr. Graham Ross, Medical Director of National Breweries, Montreal, was interested in our industrial health material. He has about 25 physicians in his professional organisation which he and Dr. Bildfell, Medical Director of Aluminum Company of Canada, are organising. He could use 25 conies of appropriate literature for these men. Do you have supplies of our Industrial Health Series and do you wish to supcly Dr. Hoss with them? (2) l!r. c. M. McGaw, In charge of Industrial Relations of Canadian Johns-Manville, Asbestos, Que., is Interested In having health education material for educational work with their employees In Asbestos. They have become quite active In safety education and now want to turn to health education. He wanted to be supplied with the health education material which we have available. Do you have liter ature you can send hlmf If not, what do you wish done! I might also mention that Mr. McGaw raised the question about nursing service. He said that the Impression had been given them that they would have nursing service when the insurance was purchased. I explained that we provide nursing service where It Is available and thut would not necessarily follow the contract. You perhaps know the background of this and you may wish to say something to him. In connection with the nursing service, I gave Miss Chess the names of the maagers of the two mines we insure in Thetford, Mr. 0, C. Smith of the Bell Mines, and Mr. Andrew Johnson, of Johnson's Mine. She is planning to call on them this week. O) Mr, Ivan Sabourin is also Interested in Metropolitan heulth liter ature. I shall arrange to put him on the Statistical Bulletin mailing-list,but am in doubt as to what you prefer to do about other health literature, ' Would J 0693 Dr. Norman fcumette -2- October 25* 1944 you prefer to 3end him material in which you think he would be interested through the Head Office or would you wish us to do so? While T was at RCA In Canada I met Dr. 'raufman, Mr. MeCallim, and Hr. Rousseau; Medical Director, Personnel Director, and Safety Director respectively. Their claim rate, as you know, is running currently around 40 per 1,000, according to data which they have at hand. Peak was reached during August, which was more than twice this rate, I believe./pr Raufman does not believe that these Claims are all for legitimate 11.ness. He is particularly critical of the part played by the Company Medical Examiners In claim administration. He said they were poorly trained for their work and their follow-up visits did not aid in the control of malingering. He stated that the Company should employ laboratory diagnostic tests such as blood examination, x-rays, etc., to check up on vague diagnoses submitted by attending physicians. The predominant diagnoses are neurasthenia, weakness, anemia, etc., and occur among the female employees, particularly in the radio assembly department, which has about 90 percent females. Tn Asbestos Or. Stevenson, who is the Johns-Manville physician, is also Medical Examiner for the Company. He mentioned that employees were abusing their A&H insurance* He has talked with local Physicians about.theirslgning of certificates and their excuse is that they are accommodating the patients. One of the attending physicians suggested that the Company print in bold letters on the form, which is given to the attending physician to fill out, that the insurance is not intended in cover vacations, rest periods, etc. 1 did not know whether this comes within your province, but I thought that T would pass it on to you to do whatever you see fit. Sincerely yours. George M. Rbeatley, M.D. Assistant Medical Director .! 0694