Document evdML0a6JEgvrDk5aYNDqoge

FILE NAME: Saranac (SAR) DATE: 1947 Aug 4 DOC#: SAR103 DOCUMENT DESCRIPTION: Letter to Dr. Lanza from J.P. Woodard RE Work on Dr. Gardner's Report 1 /# * V, 1 % 7 ";O T E u { v _ a __ j Or. A. J. Lansa aearepelitaa Life Insurance Ceopeiy Hew Tork, "ev Tortc Dear Sr. Laasa* Ten eantionad in our telephone conversation today that you had hoc a harra to review the notarial that Jr. Lynch has ssopiled from 'Sr, Uordnar'a notes a results of asbestos dusting testa at barauac. Zou also said you fait Or. Lynch had dona a good job la putting tbs notarial together and that you ars rending it alba" to Or. Voruald at Daranae, idx> nertiooed that be would like to has* a further ecoference with Lr. Lynch to see ldwther infonsiiian developed in the last few oaths not contained In Dr. Gardner's notes would la any way charge the conclusions that isd been arrived at. In tlsf of the ur?e *cy of jotting the naterial In flii&l ohapo praoftly, it la te be hoped that Dr. Voreeld and Dr. Lynch eas bold their discussion an thia aterial a* soon a possible. If there la way quoad lor of coet Involved. 1 ai^-fat segresi tii-t Jr. Lyre:. <y> to Jarsr.ee at our exponas ri^ht sway, wnich would offar the opportunity Smr both you and Dr. Vdrwald to rowlse this setter with M e . Xoa orrtlon ed that yaw would fy*> In W**ch with Dr. lynch rirtt eoaoy and see If be can arrange for a trip to .aranee to bring this to a conclusion. l-mtbmpm this will tie is with your trip to Jtranao on dtgust 15. at <Cilah tine 11 throe of you al^ht bo together and bo able to brine about a oors speedy coxlJaien. v8 you know, other eaaps_i.se are also involved in supporting tho oarenas tests and ve o'-.ill, of course, aobelt to thaoi any data Mr reports before pdhl lca&lon. If fc.c-aa in anything that wo can do to help, will yea pises* lot a s taov. Y 7 truly years. Blind eei L. C. Hart Yandirsr Broiej * L B. Flaher C. V. Itlto A. S. Klserhast J. P, M u d &^W^* #' .*****,---ZJ-.&-- .rj"U. COPY SUMMARY OF FINDINGS A. Various forms of asbestos fibres produce typical fibrosis In the lungs of some animals. B. Fibrosis Is produced by the mechanical and not the chemical action of the fibre. C. Fibrosis is produced by the long fibres (20-50 microns) and not by the short fibres (under 20 microns). D. Asbe3tosis was produced in an a taosphere with a total dust count of 138 M.P.P.C.F. of which only 0.6i were 10 microns or longer. E. As the concentration of long fibres in the air is in creased, the fibrosis develops in a shorter time. F. Fibrosis will not progress after removal from dost to normal air. 0. Asbestosls bodies are formed around fibres to prevent further irritation. B. Aluminum therapy is useless in asbestosls. 1. Asbestos dust causes no significant change in the course of pulmonary tuberculosis. COPY 1 COMMENTS 1. Tissue and anunal susceptibility was noted in the experiments. Individual susceptibility to the dust among our employees has been noted for many years. 2. We always have believed that the action of the dust was mechanical and not chemical. If there was an added chemical effect, I believe that we would see countless cases of asbestosis because we have had hundreds of men exposed to high concentrations of dust. 3. The theory of the action only by long fibres of 20-50 microns is, at first, hard to accept because: (a) I personally have heard the late Dr. Gardner say that probably the most dangerous lengths of fibre for *he production of asbestosis are those of 5 to 15 microns in <engtt (b) In Dr. Gardner's letter to Mr. Sabourin of ^ab.23,1944, he states: "I believe that the true hazard in asbestos plants Is proportional to the amount of small, individual u p c rushed fibres in the atmosphere. I sttspeet tha t tfter~ reason only one sees n c t x e or no typical asbestosis in the mines and mills Is because there Is probably too little such fibre in the air of these plants. Conversely the reason for the typical disease in the fabricating plants is the fact that the processes there open the bundles of asbestos fibres and tear them into lengths short enough to be inhaXecTin dangerous quantities?. (c) In the U.S. Public Health Bulletin #241 entitled "A Study of Asbestosis in the Asbestos Textile Industry* it is stated that the medium length of fibres range from 7 to 16 microns in the plants studied. Dust counts around the mixing pickers and cards showed the lowest percentage of fibre and the shortest lengths of fibre and it was among these men (pickers and carders) that the greatest number of asbestosis cases occurred. However, in spite of these three statements, I would prefer to believe in the action only of the long fibres and accept these recent Saranac findings because: 1 - The dust counts in our mills show 65% - 80Jt of the fibres " are 5 microns or less in length and rarely ljt are 20 microns or longer, and we have relatively few asbestosis cases. IX - Toe recent Saranac studies have shown that asbestosis will develop in an atmosphere of 138 M.P.P.C.F. total count of which only 0.6% were fibres longer than 10 microns. We have had many areas in our mills where such counts could have been found. - 2- Ilf - Saranac Mso has shown that, logically, as the concentration of long fibres is Increased, Bore fibrosis develops. The_fibre deposits ln__the Thetford area are of longer fibre than the'Xs'bestos deposits Although there is no data"'today, w"e'ight assuae that the dust in the Thetford Mills has a higher percentage of tne longer fibres than that in the Asbestos Mills. Tnis wrlght u r m n n t in part for the gfcaygrjnsuber of aoSsstools cases seen in the Thetford Plants. iV - The relatively small number of asbestosis cases occurring in the asbestos mines and mills as compared with the textile plants might be due in part to the percentage of fibres in the industrial atisosphere. Dust counts in various textile plants show up to 2b% fibre while counts in our mills show only fibre. 4. That the fibrosis of asbestosis will not progress after removal of the animal from dust to normal air can easily be believed. I have seen many men who, when transferred to ncn-dusty jobs, have improved physically and whose x-rays have shown no progression. 5. We always have believed that the asbestosis bodies are not evidence of disease, but simply the fact that fibre has been inhaled and the body has shown defensive action in an effort to neutralize the irritation. 6. 1 still believe that asbestos dust will not aggravate a pre-existing tuberculosis; also that the course of tuberculosis will not be altered in a man who has worked for several years in our wills as long as be has no x-ray evidence of asbestosis. However, at the moment I can neither accept nor deny the statement that asbestosis has no effect on superimposed tuberculosis. The Saranac experiments have shown that asbestos is not an Inert dust like gypsum, nor is it a very active dust like quartz. They have shown that concurrent asbestosis and tuberculosis produce more fibrosis than does either disase alone. Also it has been shown that tubercle bacilli have been found in the asbestotic fibrosis which is not the usual site for this infection. These experiments have shown that there may be some connection between non-tuberculous infection and asbestosis. I believe that this is a fact for, although I do not think our mill workers have more respiratory complaints than the average man, I have seen several cases where pneumonia has developed on a pre-existing asbestosis. Such cases are extremely difficult to treat, show a very slow recovery and considerable fibrosis in the x-ray. The local doc tors have stated that pneumonia in an employee who has worked for any years in the dust often has a fatal termination. In view of the probable detrimental effect of asbestosis on superim posed pneumonia, I believe that the relationship of tuberculosis developing on a well-established asbestosis should have further : study. Although this relationship has not been shown in the recent ex- ! perimeats, my opinions vast be neutral until more cases of the disease among our employees have been studied. / COPY Recommendations 1 - The air In the Asbestos and Tfcatford plants should be sampled and studied for fibre lmgths, and these findings correlated with the experimental and human studies at -crannc. II - Asbestosis can be controlled if:- (a) Every effort is made to lower the dust concentra tion in the working area of the employee, and (b) transfers to non-dusty Jobs are affected before any disability develops, probably as soon as there are significant x-ray changes. Ill- Tuberculosis would not be a problem if:- (a) Every active case is Isolated and not allowed to work; (b} non-dusty Jobs are found for apparently arrested cases; (c) routine case finding, examination of all contacts,etc. (an adequate tuberculous control program) was carried out. IV - We should have an opinion,from the Saranac Laboratory on the associa'tlon of asbestosis and cancer. There is a world-wide effort to find the cause and cure for cancer. The medical literature is full of suggested causes and asbestos has been mentioned as a very definite possible cause. Although in actual p ractice we have seen no_cases of cancer of the lung aBSngf'our employees^ asbestos is an irritant and as such might some role in the development of carcinoma. An expert opinion on this relationship would be worth while.