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FILE NAME Newspaper & Magazine Articles NMA DATE 1974 Oct 27 DOC NMA093 DOCUMENT DESCRIPTION NYT - The Hidden Plague By Alan AndersoJrn. NewYork Times Current file Oct 27 1974 ProQuest Historical Newspapers The New York Times 1851-2002 1851-2002 1851-2002 pg Even the families of some workers are endangered by occupational diseases The hidden plague Daughter victim of a lung tumor associated with exposure to Imagine this in your history books In October 1974 amid much fanfare a revolu- ___ tionary process burst upon the typewriter industry . when a research engineer for the Teletouch Corpo- . ration finally invented the ribbonless typewriter He found that type blocks made of the metal pantalonium could burn an imprint into specially treated paper obviating the need for ribbons and cutting manufacturing costs by 8 per cent The @ following spring a mysterious epidemic arose country throughout the characterized by shortness of breath chest pains insomnia dizziness and in seven to 10 days pulmonary failure and death Amid the chaos epidemiologists sleuths m who trace the origin of disease outbreaks . above foe in PatersonN. J. fae found that the victims were all typists secretaries journalists and others writers Investigating who had used the chemistry new the of the typetyping was process they discovered that each time a letter asbestos was seared onto paper traces of a volatile petro- chemical were released into air Tests demonstrated that this chemical caused irreversible lung changes in laboratory animals after a lag time of several B weeks and in humans after several months A na- tional furor ensued during which the officers of the typewriter company went to jail and the inventor himself was kept in protective seclusion After a trial that dragged on for two years the officers were all acquitted No laws could be found regulating nonconsumable chemicals Unfortunately there is at least as much reality N as fantasy in this tale The realityis that more than J 100,000 persons die annually of occupational dis- eases according to the President's Report on Occupational Safety and Health of 1972 and \ 390,000 more contract disabling occupational diseases The fantasy is that such statistics make Alan Anderson Jr. is a freelance writer who specializes in scientific and medical subjects Reproduced with permission of the copyright owner Further reproduction prohibited without permission asbestos is when treated by father father Irving Selikoff It returning from his any impression on the public The carnage occurs in slow motion hidden behind the walls of the several million workplaces of this country's 89 million workers Most chronic especially cancer not become apparent for many years after first exposure The victims often die at home long after becoming too sick to work when death comes it does not appear to be related It's like a major war notes winning biologist George Wald The casualties however aren't fighting but just trying to make a living The enemies are largely unidentified hidden among the 50,000 or so chemicals currently in use by industry The Government regulates the use of only about 450 which have in haphazard fashion proved dangerous to man Even for this small group which include asbestos uranium mercury and other now obvious health threats there is no rational system for setting maximum exposure levels Each year another 3,000 new substances are introduced whose effect upon humans is untested Belatedly and often by accident epidemiologists are discovering that many of them cause cancer both in experimental animals and in humans The World Health Organization estimates that at least 75 to 85 per cent of all cancers are triggered by environmental agents such as industrial chemicals Since World War II the variety of these agents has increased dramatically in what might be considered a second industrial revolution based largely upon a bewildering variety of plastics and other petroleum chemicals These chewm heni thec y caa usel cans cer typically require 20 to 40 years to produce tumor growth Significantly industrialized nations such as the United States are now passing the year mark from the beginning of the great plastics boom of the nineteen This correlation was brought home in frightening fashion earlier this year by the revelation that vinyl chloride a simple petrochemical byproduct used to make the plastic polyvinyl chloride is carcinogenic or cancer ing Breathing air contaminated with small amounts that Mrs. Van Zile Asbestos of vinyl chloride VC causes after a long latency period an extremely rare form of liver cancer which is invariably fatal VC was the first of the scale chemical materials that were in- troduced by the petrocih nduestm ryiafc teratl he war says Dr. Irving Selikoff of the Mt. Sinai College of Medicine in New York Because of the long latency period of occupational cancers we are just seeing the first deaths to be caused by VC There are going to be many more Selikoff who has earned an international repu- tation for his role in exploring and publicizing the carcinogenic nature of asbestos has rather suddenly found himself at the center of a dozen or so occupational investigations of unprece- dented scale He has created under the title of the Environmental Sciences Laboratory a medical cenoft soe rtsrcee nted red conhs is i owd n ce onsr ide- rable reputation anda brilliant team of occupational epidemiologists In a field traditionally short on both funds and prestige Selikoff has secured mil- lions of dollars in Federal grants and the open admiration of other health researchers He's at the center of the action says a colleague He both pushes and pulls his team with the relentless energy of a man confronting a mountain of un- finished business We have a backlog of unin- vestigated health threats from as far back as the nineteen says the year Selikoff Which do we take first old problems like mine dust and lead or the new chemicals like vinyl chloride We hardly know where to begin In both the diversity of its talent and sophistication of its technology the lab itself is unique in the United States and probably in the world the only comparable facility is the Pneumoconiosis Re- search Unit of Great Britain's Medical Research Council Selikoff's team includes six clinical physicians six field epidemiologists one industrial hygienist two pulmonary physiologists and 15 mineralogists The mineralogy lab headed by Dr. Arthur Langer is crucial to Selikoff's operation Pinpointing the source of mineral threats Asbestos habit miner likely His His work work aannddthe smoking such as asbestos and talc is possible only after precise identoficrf ystai l fc ibea rs t foui nd io n tn he Jungs Langer's analysis of complex crystals may be called for as legal evidence as in the recent trial involving a Minnesota iron refinery accused of lumping asbestos fibers into Lake Superior A typical Selikoff investigation begins with a suggestion of danger from a labor leader concerned about working conditions or from ani- mal studies with a certain chemical The next step is to find a high group that has been ex- posed to the threat example members of a union local who worked with vinyl chloride be- tween 25 and 20 years ago If the investigators are able to obtain lists of names they then attempt a sample trace trying to find 10 per cent of the working group If this proves reasonably easy they follow with a little R. as a Selikoff investigator puts it explaining to workers why they must conduct the tedious interrogations physical exams and pulmonary tests Then a physiancd i a faienld epide arem assi igno ed l to to he g casi e as nd t the study branches into two parts 1 a mortality sur- vey to determine the cause of death of those who have died and 2 a clinical study to examine all those still alive The process commonly takes several years and follow studies continue indefi- nitely he procedure was dramatically accelerated in the vionf y vinl yl beca bothubes caue se it threatens so many thousands of workers and because the evidence against it burst so suddenly into the open We had to drop every- thing we were doing when vinyl chloride hit recalled a bleary member of Selikoff's team a few months ago Rarely has a case been proven so quickly and precisely in the notoriously imprecise field of epidemiology On Jan. 22 1974 the B. F. Goodrich Chemical Company broke the news that since September 1971 three of its employes in a chloride plant in Louisville Ky had died of angiosaofrtcheolmivaer For such a rare disease -in 30,000 consecutive au- Continued on Page 23 Reproduced with permission of the copyright owner Further reproduction prohibited without permission Continued from Page 21 topsies at Bronx Veterans Administration Hospital no cases appeared was a miniepidemic In a crisis atmosphere the Department of Labor held hearings Feb. 15 and heard more bad news from Dr. Cesare Maltoni director of the Institute of Oncology at the University of Bologna Maltoni for more than a year had been inducing cancer in rodents by using low levels of vinyl chloride 250 parts per million lower than that found in some working condi- angiosarcoma has been induced by only 50 p.p.m. and lower dosages are being tried It is obvious says Selikoff that no threshold yet exists he National Insti- tute for Occupational Safety and Health N.IO.S.H. has been keeping tabs on VC deaths which now stand at 27. Re- corded cases are growing not only in number but also in kind At first all deaths were detected among the 6,500 workers directly involved in the manufacture of the vinyl- chloride gas or its conversion into plastic resin polyvinyl chloride PVC More recently however deaths have been reported further along the line Materials used in fireproofing such clothing as children's pajamas often required by law may combine with urine and prespiration to give off causing fumes La among workers who make some of the thousands of derivative consumer products One angiosarcoma victim had loaded VC in pressurized cans for use as a spray propellant another made PVC dictabelts still another wrapped electrical wires in PVC Six men who made plastic floor tiles in Germany have precursor symptoms of angiosarcoma A woman in Niagara Falls who since the end of World War II lived four blocks downwind of a PVC plant has died of a liver cancer Many other plants exude measurable amounts of VC and the Environmental Protection Ad- that escape into the atmos- phere each year Further evidence has implicated VC in other cancers and in birth malformations I suspect said J. William Lloyd of N.IO.S.H. that this is going to be the occupatidoinseaasle of the century Were vinyl chloride a more exotic chemical whose use could easily be limited the problem might be manageable Unfortunately VC has until recently been used widely as an aerosol propellant for hair sprays garden pesticides and other sprays and PVC is the second most widely used plastic after polyethylene in the country fashioned into food wrappers blood bags water pipes toys dentures shower curtains phonograph records furniture coverings and thousands of other products In 1973 some 5.3 billion pounds of VC gas were produced al- most all for conversion to plastic The importance of PVC production according to Albert C. Clark of the Manu- nents fabricated from this plastic The most disturbing aspect of the VC scandal is that the chemical has tradi- tionally been regarded as in- ert and innocuous there is no regulatory mechanism to test this false assumption vinyl chloride is that as in the case of the fictitious typing ingredient the prosecution had an open case against it In epidemiology causes and effects easily blend invisibly into the forest of health statistics Had VC caused a more common disease such as lung cancer it might never have been caught It is extremely difficult to prove anything in this field says Dr. Selikoff We suspected that asbestos causes lung cancer for 30 years before we were able to prove it with laboratory animals We still are not sure how cigarette smoke produces | cancer We think it is benzapyrene but the average roofing worker inhales as much benzapyrene from tar fumes as may be obtained by smoking about 700 cigarettes a day You would think they would be falling off the roofs with lung cancer but they're not Every problem has to be done The social consequencaerse too impotro t allaownat ny assumptions There is no substitute for leather epidemiology leather epidemiology VC You can't start with a group of people and wait for them to get sick he began In the case of both angiosar of tc he lio ver m and a me- sothelioma of to the preWs e ce all n thit s a mar groc up th hat e marcs hes together through time Reproduced with permission of the copyright owner Further reproduction prohibited without permission koff calls it leather epidemiology At the Paterson asbestos plant a lot of the workers were blacks from Co- lumbia and Camden S. C. many of them related But to find them you had to know their street names If you go asking about George Smith you may get a few guesses if you ask for Streaky you're more likely to get him right away ... If someolinme ps or squints or has three eyes it makes it easier to find him of course but you'd be amazed at how many lost people we get in the end When I read stories in the paper about som lookie ng fo or an loste sis- ter from Czechoslovakia I get tempted to try to find her I know I could do it in a min- ute but I just don't have any spare minutes Another seasoned tracer functions monitored at Dr. Irving Selikoff's laboratory son case often cited as a classic model of epidemiologi- cal sleuthing Several years ago Dr. Selikoff studied the mortality experience of 933 men who had worked between 1941 and 1945 at the Union work force with a nonmobile population What we would really like is a group of workers who stay in one job for 35 years and then retire in their home town on a pension More commonly there is a Mrs. Sylvia Blustein Every trace is done differently I'm tracing 900 men who built the third tube of the Lincoln Tunnel including movie actor Warren Beatty but he's compressed Asbestos Rubber Company U.N.A.R.C.O. in Paterson N.J. comparing their health histories between 1960 and 1971 with standard mortality tables During that period 47 deaths would have been ex; instead there were 105. Two or three deaths from lung cancer would have been expected there were 25 Deaths from cancer of the stomach colon and rectum were three times the expected figures We're extending this tinued who seem to be at risk exa wem havep foul nd te hat even the asbeofsat sbeosts os workers are endangered by dust brought home on the workers clothing hair or car We've examti he n fame ilid es of 210 of these men and found that 38.4 per cent of lot of movement Workers| sis from breatrohckipanrtgi- typically try a job for six cles I found one of them disaa nd p thep n de isaa pper ar Then we have to track them down staront ly i witnh g an address that may be 20 years da oft dae te Tracing these people is through a letter he'd sent from Vienna asking the post master in LivingsMtanoonr N.Y. where he had lived for money and saying he was moving to Argentina Well kind of like doing a crossword the post master told me about puzzle Each person you find it and I found the man's name in an Argentpihnonee book at the New York Public or up at the penitentiary he's Library Every wao s n vee ry helpful on that case The only uncooperative group is the - Social Security Administra- tion They have a small staff and say tney can't be both- ered If they would help us we'd save a lot of time and money I'm telling you I'd al- most be willing to have an af- fair with the head of it if that would belp Selikoff got into this fastmoving business offices without walls or doors re- semble a newsr who ereotm he air crawc ithk tipl s onefas st- This is quite high and reprepro a bb ig l proeblm em Now we are moving out into the neighbao rourndhtoheoPadterson plant to see what effect he next day I called ---- Mrs. day Shirley Levine a smiling energetic former breaking epidemics and clues for the through his expie n tr horat cici dis seae ses A Yor Nek w Ye orkr er he gradCol fru ommCb olui mba ia Univer- sity and earned his M.D. at Royal Colleges Scotland He problem is like a pyramid We move from the apex which is the highest exposure group downward to those who explo owes r u expr osue re When we stop finding deaths we stop moving downward The ideal cohort Dr. Andwee nt r on s is ao stan ble . days has proven invaluable A lot of this work is literally knocking on doors said Mrs. Levine That's why Dr. Seli- interned at Newark Beth Is- rael Hospital and first came to suspect the insidinaotuurse of occupational diseases when some of his chest patientisn Patwe herr e heshao s bn een associated with Barnert Me- morial Hospital since 1947 showed an alarming incidence of asbestosis lung cancer Reproduced with permission of the copyright owner Further reproduction prohibited without permission pecting the dark significance - and indiscriminataever liyn talcum abra andsai brv asie ve soaps Compounds responsible for permanent press cloth such as organophosphataensd mercury are highly toxic if released When furniture padded with foam rubber urethane is burned by a dropped cigarette or another heat source it gives off poisonous hydrogen fumes and a nerve gas used in World War 1 of industry began turning more and more to labor leaders in carr outy hisimin ssg ion of building and following cohorts of workers After a slow start labor leaders began to realize the extent of such industrimeanl- aces as asbestos and to so- licit the help of independent health researchers Today Selikoff's group is cooperat- ing with the unions of firemen who breath toxic fumes given off by burning plastipacinsters who breathe a variety of toxic fungai ndcfuingd ice ids es roofers who breathe benza- printing pressmen who breathe such golventass ben knoz wn te o can use e leukemia in man textile workers who get brown lung or byssfi ron m io nhas lini g cs otton dust sandblastwerhso parrot ck i parc ticl lese whs ich cause silicosis typographers who breathe lead and other trace metals wall tapers and floor workers who breathe asbes andtso o osn The Mt. Sinai team is con- tinuing to trace several co- horts of asbestaonsd vinyl- chloride workers moving down the pyrafm romiprdimary workers to those who fashion consumer products to the consumers themselves pyr dowa n tm he pi yrad mid in this way takes time and there is as yet little hard inforonmtha ret atsitoocon n- sumers Vinyl chloride has been used for years as a aerosol propellant for such proasd haiu r spc rayt inss ecticides and room deodorants One of the most worrisome disco is v thae t tr oxii c le evs els of the gas can accumulatinedoors after less than a minute's spray Equally ominous are the 3,000 or so products in which asbestos is used he most recent health menace to emerge- and it is emerging farther down the pyramid than either asbestos or VC did at first fibrous glass First introdiunc1e93d6 and known under the trade name fibrous glass has traditionally been considered biologically in- nocuous During the postwar chemical boom when the stuff found almost universal application as insulating ma- terial and was also woven into proo clotf h the e fid bers were large enough about three milloi r moiln liotnth hs s of a meter in diameter to be trapped by the upper respira- tory tract Then in the nine- sixties industry realized damagedWhen damaged and human Early the jamas often requibyreladw may comwib th i urin ne pe er- spiration or other acids to give off carcinogenic fumes Talc composed of harmful silica partii s uc sedlwe idesly nature carcinogenic . animals Any fibers So far in- dustry's response to the threat has been to ignore it by say- with of the Further copyright owner reproduction prohibited ing there is no demonstrated health hazard Of course these small fibers have only been in use for about 10 years and on the basis of our ex- perience with occupational cancers we would not expect any disease to have appeared yet Even with asbestos lung scarring doesn't show up for at least 10 years If supposedly inert substances such as vinyl chloride asbestos and fibrous glass can cause cancer what is the effect of working in an atmosphere laden with chemicals _known to be highly reactive and volatile Some oil refin- eries for example turn out more than 5,000 petrochemical products many of which find their way into humans In general says Selikoff with a shake of the finger chemicals are used in industry because they are chemical- ly active This means they tend to be biologically active as well Anything that reacts with our lungs isn't going to do us any good elikoff is particularly upset at the apparently accelerating effect of exposure to two or more toxic chemicals I have a theory he announced one day in his office It is that most human cancers are caused by multiple factors If this is true it could be that cancer is produced by very low levels of several carcinogens even though any one by itself would have no effect We have already shown with Dr. E. Cuyler Hammond of the American Cancer Society that in the case of asbestos work- ers two carcinogens are more than twice as bad as one Asbestos workers who smoke cigarettes get lung cancer at a rate eight times higher than smokers who do not work with asbestos and 92 times higher than people who neither smoke nor work with asbestos In the case of refinery workers or urban dwellers who breathe city air the combinations may be much more complicated Even when such health workers as Selikoff find their way through the complications to achieve a chemical indict- ment a maze of complications remains It is not easy to induce or even coerce industry to give up a profitable process or to spend money on filtration systems Although industry has come a long way since the days of sweatshops and child labor management is still loathe to accept outside intervention in plant processes " think in- dustry is changing says Selikoff but there are still some bad actors around He is being diplomatic One of our biggest problems says Henry Anderson is that the plants won't let us see their health records Industry will say the records are private or they have disappeared and we have to rely upon the unions for almost all of our information The best recent example of industry's attitude has been the decision by the Pittsburgh Corpora- tion to shut a polluting as- bestos plant in Tyler Tex rather than clean it up a story relentlessly documented in Paul Brodeur's book Ex- pendable Americans Viking Compass Even today the Manville Corporation the free world's largest producer of asbestos output in the Soviet Union is somewhat higher than in the U.S. seeks to dilute the impact of Selikoff's findings which have shown for 10 years the carci- nogenicity of even very low levels of asbestos dust Dr. Selikoff is very often held up as the one authority in asbestos research said a Manville spokesman recently I think that in the industry and in the field you will find there are a lot of others The two names of- fered by the spokesman were those of J. Corbett MacDonald of McGill University whose work has long been supported by the asbestos industry and - George Wright who is an employe of Manville Both men have consistently sought to play down the threat posed by asbestos to the 200,000 workers presently exposed to it and the 800,000 who have been exposed in the past The role of the Government in the war against occupational cancer dates only from April 1971 when the Occupational Safety and Health Act went into effect The act created the Occupational Safety and Health Administration O.S.H.A. to guarantee a safe and healthful workplace for all workers and set up N.L.O.S.H. which is charged with researching health problems and recommending safe- ty standards The effectiveness of these measures has already been blunted by lack of funding There are so few health inspectors that at the rate they were able to visit the nation's workplaces during the first eight months of the act they would need 230 years to inspect them all O.S.H.A.'s enforcement of health rules has Continued on Page 32 with permission the Further owner copyright reproduction prohibited withoutpermision The World Health Organization esti- mates that 75 to 85 per cent of all cancers are triggered by environ- mental agents such as industrial chemicals Since 1945 these agents have increased dramatically Conti fronm u Pagee d 28 been fines less than vigorous for violations have averaged a mere 18 so far When death comes it is seldom linked with occupation - in any records Getting sick an amount any business isn't enough declares Dr. Su- would rather pay than contest and many would no doubt rather pay than comply san Daum who is now studying byssami ongnteo xtis lei wors k- ers with the Mt. Sinal team with the regulation they are Government and industry charged with violating Selikoff himself is limited as an industrial researcher to making his data available to say you have to be able to count the bod in ti he e strs eet They don't take into account the workers who lose their O.S.H.A. and the unions and health who are forced to re- else will convert tire early who die young The textile partiics upalrtaicrullaryly hard deal with becauseit is difficult to prove mortality The enforcement situation in general says Sheldon Samuels from byssinosis It is not hard to prove sickness but that doesn't have the same impact as a stack of bodies of theC.LO.'s Industrial An increasing number of | Union Departmenits putrid Even so industry has bat- scientists in this field are beginning to reach a common - tled vigorously against the conclusion If occupational act and against strict con- health standards are to be trols of asbestos and other health threats As of the be- raised the workers themselves must raise them Until recent- ginning of 1974 there were | 76 bills before Congress to amend the act and three to of epidemiology in favor of repeal In her forthcoming the more obvious issues of book Muscle and Blood wages hours and vacations Dutton Rachel Scott describes labor's disillusionment with the law quoting an arti- cle by Bob Kason editor of a Teamster publication Within O.S.H.A. itself there has been no sense of mission or dedi- Now however a number of unions led by the Oil Chem- ical and Atomic Workers are turning aggressively to independent medical experts such as Selikoff supplying them with the union lists that make cation to the implementation of the act on behalf of the workers it was intended to cohort studies possible and teaching their members to collect air samples and other data protect Rather there is a in the workplace steady and prevailing attitude in the top echelons that shows priority compassion for prob- lems and inconveniences of Toward this end Drs Daum and Jeanne Stellman a physical chemist have written a volume titled Work Is Dan- management If 100,000 typists died on the job within a week of each other it would be impossible to ignore the imminent danger of occupational disease As indicated however most industrially gerous to Your Health Pantheon designed to translate the relevant medicine biology and industrial hygiene into the English that people use every day and to explain the operation of such essential tools as sampling devices Selikoff himself is firm in the caused illnesses develop not in one week but over many conviction that workers must learn to save themselves years at an imperceptible People who work in a factory pace The victim is slowly rendered unable to work through conditions typically described by company doctors as asthma or tuberculosis or in a mill can see what is going on around them better than we can he says Our mission is to help them clean it up of the copyright owner Further without