Document jgda9J236ad3XBEKO4KN7eMmp
FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY022
DOCUMENT DESCRIPTION: Transcript of Presentation by Dr. Baetjer, Followed by Discussion
TM SS FS2i PM S hi*'*, o
J
P'iv te r Fhs&Sa, Jadties ad (tastl&MM F i r s t o f a l l , I* goi&ij
t-3 .vs t3
t*by I dssiild i-i-oop to 2a
a n im a l e x p e rim e n ts an d why i t 's w o rth w h ile a t l e a s t why I
thought i t w ight be w orthw hile. A ctu ally , I thought I 'd
alrsad y done a good enough s ta t is tic a l and epidem iological
stu d y so th a t I had p ro v ed , along w ith D octor M achia and j
now th e P u b lic H e a lth S e r v ic e t h a t ch ro m ato a do p ro d u c e o r
a t le a s t are a f a c to r in the production o f lung canear in !
m an. A t l e a s t , my e p i d e m io l o g ic a l s tu d y p a s s o d o u r s t a t i c - j i
t i c s and epidam iolo. '.cal departm ent and I defy evan D octor j
L e v in fco is ,.? t h a t d i d n ' t c o n t a in a l l th e q u i r k s t h a t a
s t a t i s t i c i a n eon s u g g e s t f i r s t , so now I 'm g o in g to t o l l yon
rb o u t th ese anim al experim ents*
!
'fe f e l t t h a t i f we c o u ld o s a ib l y r e p r o d u c e t h i s
c o n d i t i o n i n a n i m a l s , t h e n we w ould h av e a b a s i s t o s t a r t
to sfcu-ly th e hang-os i n th e tic s u o a t h a t r e s u l t when a
a ire p ls im b s te n o a , i f y o u c o u ld p r o v e i t , e& usos c*aneer* *Jo j i
a ls o hoped th a t we c o u ld t e l l e x a c tly w hich subaten.ee was j
th e c a r c i n o g e n i c a g e n t i n th o s e human e x p o s u re # i f wo e o u l a j
re p ro d u c e i t i n an ' ia lo * Tlvfc th a n - so t h a t we th o u g h t t t ,
was w e ll w o rth u h ile s o t t i n g up a l a r g e p r o j e c t to s tu d y 'v3j
e f f e c t s o f chromlv-i-i cc-. iponnda on a n im a ls *
|
This work was su p p o rted vpry g en ero u sly by th e |
n atio n al
I- 't i t v . f o end h o s b o o n a p r o j e c t i n w h ich j
D e c v e r L o u n j o f t h a TJ?v. J d S t& ta s P u b lic R a a l t h d o r v ic e * t
D epartm ent of p a th o lo g y , and Mr. Udaa on o u r s t a f f , hr-re j
parfclcip ted w ith no*
:
__ J U 0 . .
I w ould l i k e to d i v i d e ray p r e s e n t a t i o n i n t o th r o #
p arts: F irs t, lung cancer in - our analysis
j oniaval e x p e r im e n ts on o u r e f f o r t s t o p ro d u o e t anim als; seco n d ly , our r e s u lts o f our anim al
j o f two c a s e s o f humans who h av e boon ex p o sed i
to chrom ates, and a eoarpariaon o f th a t w ith th e ra u n its
j
th a t have boon re p o rte d in th e l i t e r a t u r e ; th ir d ly , as tim e j
p e r m i t s , I r . : n i t h ax .ard a . u o s a o r two aa to why o r 3iOw t h i
I
chrom ium mi _'h t a c t ., an d w h ic h s u b s t a n c e -- n o , Im n o t g o - iI
.Ing to g u e s s t h a t , b e c a u s e I oan* t -- I m ig h t comse&nfc on j
w hat ehroaU ta m ight p o s s ib ly do to t i s s u e s , and I flig h t
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sp e c u la te aa to w hich su b sta n c e m ight p o s s ib ly be re s p o n s ib le ,
|
Taking f i r s t th a n o u r a n in a l e x p e ria e n ts , in the j
l i t e r a t u r e , th e re a re o n ly a few s tu d io s w hich r e p o r t th e j
e f f e c ts o f ohro-olua compounds o r a tte m p ts to produoe can c er i
w ith chromium compounds* L ttkanin ex p o sed s e v e n te e n an im als
'
i
i n a p?. a t f o r e i g h t m onths* He g o t s o n e q u i t e -af had
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i
p a t h o l r :?.<?al c h a n g e s i n t h e lu n g s o f th e a n i n a l o , b u t h e
:
d id n o t fio.ni.ion c u n c o r, and th e d e s c r i p t i o n o f th e p n W jlo g y
does not resem ble cancer*
DcoVjV i - h l p k t r..,
th e ir e a n h re /n tto o r
' t h o c h r o m i t e o r i n t o e v i:--; !.> L'U - ^*41b l e .i d e e
t h a t t h e r e w a s .0 i n . x '!;9 1r> t h a 9.)S :vefua e oi.t3
o f V: 83 I ;l i 0 3 * F u r t h * i - i - i o r o , h a .r'*~. . i n d
t th i
-
l, LL.i' : 'i i t s o u s t i n t r a v e n o u s l y i n t Q ,^ j ^ a l s b i d !
th e af f a c t o f me ta c h ro m a tin In th e p r due tio n
'm g tu m o rs *
-i--
The t h i r d p a p e r w hich I th in k i s w o rth m en tio n in g
is a paper, by S hi.. ; in w hich he im p lan ted in to the tr o
c h a n t e r o f a n i m a ls , a few a n im a ls , m e t a l l i c chrom ium . He
re o e rte d th a t a f te r fo u r y e a rs, one anim al developed a lung
c a l c o r w h ich w: ; a c a r c i n . . . a s a rc o m a , t h a t one end p o e s i- ^
h ly a second bone cancer s c a r r e d a t the s ite of the i- ? la n j
ta tio n .
j
She o t h e r w ork t h a t h a s b e e n r e p o r t e d i n t a s s.L*~ \
o r a tu r e h a s b e e n n o t w o rth a n y th in g , b e c a u s e i t 1ms J a v o i v ^ o n ly one o r .two o r t o r e e anirf-axa T*h''-awt *faa wuafc was i n in :;
l i t a , it u i '3 .
i
Today you h e a r d Boofcor tw p** say th a t he Had b een
fehlo to p ro d u ce th r e e lu n g c a n c e rs *n a,ven i a ta "ch ro m ite o r e . Such voa th e background in w hich we p a r te d .
Our o ^ o r i n e a t a have b e e n o f mueh g r e a t e r ~ aSn i -
t u d s th e n an y o f t h o s e w n ic h 1 AV9 repo*, t - d . *'ja l l , w ith re g a rd to th e ch ara cto r o f th e anim als u s e d . y e us'- m ice and r a t a , th r e , s t r a i n s o f cs** _ s u s c e p t i b l e i n b r e d s t r a i n , th a A s -d'-iln
s t been h e a rin g ab o u t; secondly, a Sw iss * tr a in
"*
a
,,- -
`
~ j
a taedsrataly h ig h Incidence of spontaneous luhg and t h i r d l y , th e CO-57 in b r e d s t r a i n whi- 1 has v
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low in c id e n c e o f sp o n ta n e o u s lu n g tu m o rs. Tha o t h .r tJP " ,
3nd 3p8 c i e s o f a n im a ls w n ic h we h a v e u s e a so f a r r e .. -M ;
and i n t h a t , we u s e d a n ix e d b r e e d , a s i n g l e s t r * i r
-t h n a
b een in o u r la b o r a to r y f o r many y e a r s . So laueh f o r th e ty ? e
o f anim als* i-fn a t a b o u t th e ty p o o f o x p o s u r a ?
Ws u s e d , i n th e
f i r s t p i ? i n h a l a t i o n expomur* ov er p e rio d s o f fo u r h o u rs
p a r day xW f iv e c a y s p a r *?sek f o r s h o r t e r lo n g e r p e r -
io ia of axposure up to te a l i f e te rn of tales end r a ts in
so n a c a s e s . T h a se e n is a a ls w a re p u t i n ft d u s t efc&aber &nd
th u s . vo."sd b y I n h a l a t i o n * S he s e c o n d m e th o d o f o x p e s u r s
r>-at w-
-d *?a i n t r a - t r a c h e a l ir ; o o e u lf tt io n s w ith die
t a r i a l . Tho&i* w ars g iv e n r e p e a t e d l y i n sales a n d i n r a t s *
m i9 th ir d tjp o o f m a te r ia l w hich we u s e d , th e t h i r d n o th e d
o f ex p o su re t h a t we u ao d was by i n t r a p l e u r a l i n a c t i o n ,
f h a f o u r t h ty p e o f e x p o s u r e t h a t we ir> ed was in t r a v e n o u s
in je c tio n of isA terlal* H e x t, w ith re._ r d t o th e ty p e o f s a t e r - ^ l n a ie h
ko \tsed* a w is h e d to j?r. p r o d u c e i n c-nr
cos.-- -*r
cor-M tlons e x a c tly as c lo s e ly , s im ila r, to th a t co n d itio n
w hich e x is ts in th e chrom ate chem ical aanuia-' b u rin % p la n ts t
hhsra th o se eftses o f lu n g co n cu r have o c c u rre d . ha a c ^ sa !
o f th e p l e a t s w h ic h h a s b e a n m oot c o o p e r a tiv e and b-zs j
supplied us w ith m a teria l and the n n aly als o f ow r,a t* ri* ls,;
i n o v a ry i n s t a n c e i n w h ic h wo h av e co n e to th&ra. 'Tie m a t e r i a l w h ich we u s e d i n th s o u s t ensm oer
was a r :ed d u s t. I have p u r on th e b o a rd h a r e , i f J ou can 't h a a r in the back, p le a se say so - I have put on th e
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HOT, w i t h r s E rd t o t h * *nL'i a l * &nd t i - ' l r 3^ 0 , ` | u sed a c o n c e n tra tio n w hich w e. ju s t below the la th -t
a p o i n t . Vo t r i e d t o g e t a s h ig h . c .c e n t r a t i o o a . p o s -
. I b i . . soae o f the e n ta s is , h e.e v e r , died, because of th . t o * l o i t 7 o f th e m a t e r ia l or f o r o t h e r .U w u r r ln s in f e c t i o n s <jr o th er reason #, and t h . r e s u lt s w hich 1 w t to rep o rt on tu^ n ic e are lim ite d to those which su rvived to ns p oin t w-a. e
v;o k i l l e d th o s u Tci>
A spariaeata w hich wore o n lf in h a la tio n
and
1 v +-a wxva t4*nVtafc iaX JU
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a a i c a l s v h ic h s u r v i v e d one y e a r s a d w k l l l o d th * T i n a l
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l e t which evu-vi^ d to a two-yr ?** V* conelw toa * * * '
th - i n t t r a t a , th o s e w h ic h d i e d th a n a f t a r on* p x * "if
sviAs*
So z-cioh. fox* th a s a t o r i a l a &d th e ty p o o f - i n th a isico experim ent w hich you ha* . -i-a'. i
f r e a D o c to r H id e * . wo d id s p o n ta n e o u s e x p e r t e e n t e ,
!
-
th a a n in a ls wore k i l l e d , o a a x ia ln e * th e
t-ha I& eid an c* o f ip e n ta n a o u s t u t o r s o r t u t o r s tim t.
a
v i s i f c l a o n th a s u r f a c e . We a u - i s ^ d a l l a n i E d i a , . a r- . - 4.v.,,ce. T o h V t ra o o J? 1: t o you b a o a u s o xx'*
n o t y e t stu d ie d thon p a th o lo g ic a lly
"S13 fc iiin a ls wore k i l l o d a t v w - 0 3 '-S ^tu h d .
!f h i3 was jIi-w-,t-*re"mw^guT-v7y -i-**ii t-'aa n le a b a c c u s o o f ^ :'i3
<i
anc '.jo u a n to d to d o t a r a i n e w h v tn e r ;
.__ n n o o a re d s a r l i o r i n o u r c h ro m a te a r - 'a s l s * : a t o / e
tuaa tu m o rs
i
I ] __ W*s-*k#-
d l d i n t h e c o n t r o l s . We k i l l e d th e a n i m a l s , t h e r e f o r e , a t j
v a r io u s I n t e r v a l s . We to o k o u t t h e l u n g s , c o u n te d th e
|
nuitb&r o f tu to r s on th e s u r f a c e o f th e lu n g s and a l s o made j
s p ra ts , J iif jto lo g ic H l s e c t i o n s , I s h o u ld say # o f t h e s e tvuao. .t j
fo r confirm ation o f tfcoir p a th o lo g y . A ll o th e r abnorm al c o n d itio n s of the lungs were a lso se c tio n e d end stu d ie d by
| J
th e p a t h o l o g i s t s . A l l o t h e r o r g a n s wr o x tta ta e d an d w h e re j
iii&ra was ny e v id e n c e o f o tL a r ty p o s o f is a lig n a n o ie a in I o th e r tissu es# th ey were also se c tio n e d f o r h is to lo g ic a l j
dssain& tion*
i|
fhe anim als were than coaparod w ith re g a rd , i n th e
a,s3 o f th e c iio c , w ith r e g a r d t o th e num ber o f a n im a ls w h ic h
su rv iv e d , w hich had pulm onary tum ors on th e s u rfa c e , th e rorsber o f cr tho p o rcontag o , th a t la the p ercen tag e o f s a l * ,
s a l s w ith t u t o r s , th av e ra g e num ber o f t a ra p e r nems, 1 th e esurly o r l a t a o n s e t o f tu m o rs , th e p ro s : nice o f raili/i*-..- ;
;aa D o c to r H id a r h a .3 a u i d , y o u g a t o i t >o ;co.ay v*a.<iy.ra * i t h th e c a r c in o g e n s # We d a t e r a i n e d , th o re s . o r , tn e p a r -- j
son^-ge w ith s ra ltip le tum or*, c o h e r e d the c o n tro ls and
:o rl
also v itk re g a rd to o th e r ty p e s o f lu n g pa ,,o lcg y
end othuP typea o f m alig n an cies#
Oaa th in g I f o r g o t , t o s a y w h ic h i a te p o r t - a n t,
!
Uiau i s th a t ,o h ad to n a i n t a i n o u r w e ig h t g a in if c a r ex
p e ria e n ta l h ie s to be . n il v a le n t o f the con to o l m ice, to oe
e a u i v a l e n t to th e e x p e r im e n ta l m ic e , Lac-:n is e i t h as t o e n
____ 445*.
shown t h a t c a l o r i e I n ta k e may e f f e c t th a in c id e n c e o f lu n g j
turaors. A ll o f our M ice, th e re fo re , ware w eiguod and th e |
c o n t r o l s * d i e t was r e s t r i c t e d so t h a t i t was - th e w e ig h t j
g a in s trora equal*
j
- i f t e i . t i l l e d c u r a n im a ls , isa d s th e s e c t i o n s '
and s tu d ie d the by p a th o lo g y , we th en eo,spared tho e z p s r - `
In e n te le and the c o n tro ls in th e se v a rio u s m ethods th a t I ;
Imvo s a id . la a d d itio n , we an a ly se d th e lungs f o r th a p r o s -
enc f c h ro ra iu a t o h e a u r a t h a t we w a re g e t t i n g c h r e a i a a !
i n t o th e lu n g t i s s u e * So rvmoh f o r cxir rae-t'h.-d'a*
j |
about th e r e s u lts of o u r anim alexperim ents* I
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I
J I n th a -ice x p o rh a s a ts , a l t o g e t h e r , we u s a d l a r g o n tjsib e rs j
o f Mice su ch th a t a t c a r t a i n - a t th e d a te o f k i l l i n g , ye
ii -d a L'1-' l a a l l o f o u r t w e n t y - f i v e ex p y rim nte o f a b o u t |
s ix te e n nnndrod m iss . T his y ie ld e d us d a ta which vs co u ld |
h - s a t 3 t a t 3 t i c a l l y * Tho - in re g a rd to tho in c id e n c e o f |
i..a g w^torw, t a s i r ago a t o n s e t, th e a v e ra g e num ber o f tu- j
n o ra and th e c h a r a c te r o f th o fem ora, th e re was e s s e n t i a l l y !
no d iffo rsa c in tho c o n tr o l groups as com pared w ith t h e i r i
- xn t.ue .^ a r in e n td l g ro u p s as c o o p ere d w ith t h e i r re sp o e -,-
tiv e co n tro ls*
j
r e s u l t s , th e re f o r e , o f tha mice ex p erim en t a I
w iin re g a rd t o th e in c id e n c e o f pulm onary tu n e rs , was on th e
who , n e sr& tiv e , --Th=e--e el o
nr>-j~ dji*i i t d ' 09 oavwoen t n e 1
cicen ce o f c ,ier m a lig n a n c ie s in tho raic , b atwov-i th a
j! ii
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. , -i ,, i,nA th a c o n t r o l s *
experim ent-.la *nd
how ever, we fo u ad
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th e o th e r p ath o lo g y , however,
,
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w '8* ' 4 * " * B l" , oa 'I n to tto r-to ry reactio n ,
to tr.ri.u M i a * i* . . ^ t c r j reactio n ,
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tu t m
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only a clx g b t T 6 _
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tie, le a s e !> W - r a . .
roduoed o n ly U SW j
T i r r i t a t i o n oa . a
intravenous erporlr.cn .
I - ^- t h . ^
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- 1 c h r o m e p ro v .4 1
nine . ^ 1 - j
unch .core to te r e e tto g .
^ m W 1 m 1 , of ta , alv eo lar
a c u te , te c n ic e ! " * `
fu r th e r on th le . 'o o eau ..
l ,t l l a l lung, 1 can ro e repo,
-
\ ... a , . ,, ,, t y e t b o o n read., b y * p a t b o l o g i e t .
t h a t a t m * 1-aB a 1
i n looted In trav e n -
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,, in o la n n a to ry re a c tio n in the lu=S
0" 1?' l * - ' * " 4 * * " ^ ` ! V , ;, to . h ig h pore .
tfae e n t o . 1 . , T hus, th e Klnol lr r l M t ln t, ond by to r - j
! chrenato pro v ed , oy to r . "
. , honl and to tr a -;
,
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. . . very I r r lf W - * iu -
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t v,s
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in h a la t io n group of - t
W the ^ .
r a t a x p e r ir ^ n c w . , , , a i o t ,3 n u m b e r.
j s ta rte d the :
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U n fo rtu n a te ly,
.
- ....1
kkl* t
w h a d a l a r g e num ber o f d e a t h s , e o t h i n th i n t r a - t r a c h e a l j
and in the in h a la tio n group o f r a t s . Tha in tra -fc ra c h a a l
a n im a ls d i e d so r a p i d l y we w are f o r c e d t o k i l l t h a n a t an
age o f f o r t y - e i g h t w eeks, find e x c e p t f o r th e i r r i t a t i v e
ch an g e s, th e re was n o th in g s ig n if i c a n t* The gro u p in th e
i n h a l a t i o n c h a m b e r, w h ich a s e x p o s e d to ' h m ix ed d u s t , j
how ever, d id show one p o s s ib ly i n t e r e s t! . - f e a tu r e .
I
T hjse aniai& ls - th e re w ars f i f t y - e i g h t th a t s u r - j
v i v s d a p e r i o d o f s i x t y "e i g h t to o n e h u n d r e d and one w o ek s *
i n th e d u s t c h am b er. T h o se r a t s , whan th e y w ere oxf-mJ;
i
show ed, o u t o f th e t o t a l f i f t y - e i g h t , t h r e e d e f i n i t e ofts&a
o f ly x 'p h o $sarcoma and two p o s s i b l e c a s e s o f lyicphos a rc c n n #
Of th o se lyiaphosarco/ca cr-^oa, one ap p eared to bo p rim a rily
; i th e l u n g , on p o s s i b l y p r i m a r i l y i n t h e lu n g an d one was
secondary* 3a had ;if ty c o n tro l anim als l o f t , b u t fo rtu n a te -j
l y , U9 had i n o u r l a b o r : 'ory a l a r g o nvrabaz* o f s t o c k s n i -- j
|
m ala o f th e saw s a g o , s&xno s t r a i n , same d i e t , as c u r c o n t r o l
a n i m a l s . T h e r e f o r e , we w a a b le to i n c r e a s e o a r c o n t r o l j
group to th re e hundred and f i f t y - s i x sn in a j.s, liv in g on th e .
o r t o th e asm a g e as th e e x p e r i m e n t a l g r o u p , and p r o p o r - 1
t i o n n t o l y k i l l e d .-t th e s a n e age p e r i o d . Of t-. -> tlsa?**-
h u n d re d an d f i f t y - s i x , ve h- ? f i v e a n im a la w h ic h sh e jd
m a lig n a n c ie s , none o f them wore in th e lu n g and none o f
them involved, th e lu n g t i s s u e .
i
I f you ta k e the p e rce n tag e, th e re fo re , o f spar- ;
im en tal a n im a ls, which had m a lig n a n c ie s, as In th e e x p e rt- i
|
m ental as compared w ith the c o n tro ls , and c a lc u la te th e
i
d iffe re n c e s, divided by the stan d ard area o f d iffe re n c e s, j
u s in g y& tea C o r r e c t i o n s , b e c a u s e we a r e d e a l i n g w ith rsu s- j
b ars under te n , you fin d th a t th e X over siesta v alu e, using,
t-liree experim ental!* and n o t in c lu d in g tn e two q u e s tie n a b le s ,
t h r o x p o rin a n ta ls and f i v e c o n t r o l m a lig n o i c is s , you come
o u t t o an X o v e r s i g n s v* ' u e o f 2 .4 * I f yc** .Toali: n a n c ie s w h ich e f f e c t th e l u n g t i s s u e i n
i " co n tro ls,
tla-ee anim als as cosrparod w ith zero in the ex pariasentale*
y o u ccaae o u t t o an X o v e r s i g a a v a l u e o f 3*5 < so * T his shows th a t they a r e , a c c o rd in g t o s t a t i s t i c a l
f ig u r e s , s t a t i s t i c a l l y s ig n if i c a n t* B ut I 'm n o t going so
say anything on th re e anim als, no m atter what th e fig u re s
show, i d o n 't l i k e d -awing any c o n c lu sio n s on j u s t th ro e
^iiirc&ls. T h a t d o o an t go r i g h t , a o , a s a r e s ' " t , we a r e r e p e a t i n g th e e x p e r im e n t i f we c a n r e p e a t i t , an d we hope I
t h a t we w i l l b o a b le to k e e p t h e r a t e in l a r g e r n u * * -ra to |
f '3 n , !'fc
bc-r t h i s t i n e , so t h a t a do n o t i^avo --,tlf ,
d e a th s tuid we w i l l h av e m ors .-.t t h e e n d , w hop w
|
ba ab le to co n firm i t . A t th e p r e s e n t tin ? ., I would n o t j
a ay we ha. p ro v a n a n y th in g a t a l l , b u t wo h a v e a su g g e stiv e ^
le a d , as in d ic a te d , th a t we m ight re. a t th e e x p e rim e n t. The r a t s , th e r e f o r e , showed :hat ty p e o f r e a c tio n .
Tho m ice snowed E s s e n t i a l l y n e g a tiv e . So much fo r o u r a n i
n a l experim ents# The second p a r t o f our work h as J u s t begun and >
t h a t I s t h a t we a r e now a n a l y z in g t i s s u e f o r chrom ium .
j
l^h o n ev ar we can p e r s u a d e anybody to 1 s t u s know t h a t th e y j
h a v e one o f th o s e n a n who h a d worke< I n th e c h ro m a te c h o n - |
l e a l p ro d u cin g Indus t r y , w ith w hich Is com ing up e i th e r :
f o r a u to p s y o r f o r p n o iu u o n o cto ay , we im m e d ia te ly s a y , x a t !
ua h av e s o n s o f th e t i s s u e # To d a t e , we h a v e g o t to n tw o .
Cna was a body t h a t was d i s i n t e r r e d , and >? a
man who h a d h ad a y e a r and a h a l f o f e x p o s u r e , w h ic h waa
bsrstJJiated two y e a r s b e f o r e h is d e a th , who d i d n o t d i e o f
l u n g earse *r# The o t h e r i s a c a se t h a t qsjsio i n t o vr h o s -
p i t f i l , a co u p le o f w eeks ego f c r - w ith symptoms o f o h e s t
pain# They diag n o sed i t as . .Oaonary carcinom a, o p e ra te d
w ith in two w eeks, th e men h a d , t h e r e f o r e , b is e x p o su re
j
to some tim e v itv h 'n a m onth o f th e fcirse we g o t th > t i s s u e j
fo r an aly sis. 1 3d l i k e , t h e r e f o r e , t o show you the r e s u l t s o f
o u r two c a s e s and to com pare th o se w ith th e r e s u l t s o f th e o th e r ans / s w hich a re o n ly fo u r, t h a t have toon re p o rte d
in the lite r a tu r e #
i
F i r s t o r a l l , I m is 'u t, i n th e Iw^S* a n a l y s i s ***
I cdglit t a l l you w hat norm al re s u lts have been re p o rte d . .
in alm ost a l l ty p o s o f norm al tis s u e in tra c e d amoungs* B. W arren B enz, many y e a r s a g o , showed th a t tum ors j u s t taken from th e autc y room o r from th e o p a ra tin g room , many o f them showed tr a c e s o f chrom ium , b u t d id d iffa rs s n fc l-j a te V ween b e n ig n and e. U g n a n t, p r o s e n t in sem e, b e n ig n , J i n s c a e m a lig n a n t , acme b e n i g n ; p r e s e n t i n o t h e r s , o f b o t h j typos* They could n o t d e c ic . on any p o s s ib le fu n c tio n of j
cliroiitinzai n th o s e c a se s*
j
Chromium a ls o a p p e a re d i n o f - o r t i s s u e s o f norm al I
p e o p l e . I t a p p e a r s ecmetim .* i n th e v i n e , sc s a e tlr-^ s in j
t h s b lo o d * 4s f a r aa I h a v e b e e n a b l ' to make o\ifc, v?e h a d 5
~
1
no id ea th a t i t has any p h y sio lo g ic a l fu n ctio n * fh u s, X j
p u t i n t h e f i r s t t a b l e , a fv r e s u l t s . A l l r i g h t , i f *sa J
could have tho ta b '
!
i
Thosa aro th e a n a ly se s t h a t Lave been re p o rte d * i \
I m ig h t spy th e o t h e r p e o p le who hstv r e p o r t e d thee c a s e s , j
wV'ich i s l-iancuso an d E u e p e r and U ni tad. S t a t e s .p u b lic t -iSd h i
S erv ice, th is reproeonts fo u r cases and our lung case, oars i
r - in term s cf f r e s h tis s u e -- our d is in te r r e d body we
j
o o u ld n * t co m p are, b e c a u s e , o f c o u r s e , v.s <-oui.d o n ly 0.0 i t
i n &.ou, so t h a t t h i s r e p r e s e n t s o u r c a ox" th e r.-ia * - ; i
t h i r t y y e a r s e x p o s u re who j u 3 t came to o p e r a t i o n f o r p ;-m e
ns c tomy. Now, t h e r e a r e a c o u p le o f th i n g s t h a t i n t e r e s t
in g and t h a t ' s why I 'm t a k i n g y o u r tim e to show y o u the se
f ir u r o s * In th e f i r s t p la c e , th e chromium, th e chromium in |
w
i
the lu n g tis s u e Is r e la tiv e ly h ig h as compared w ith what ha^
h sa n r e p o r te d to o c c u r in one o r two norm al e a s e s Of p o r*
haps g re a te r in t e r e s t, because you ex p ect th is in the ch ro
ma to w o r k e r s , a n d by c h ro m a te w o r k e r s , I mean a lw a y s p e o p le
in th e chromium ch em ical m a n u fa ctu rin g in d u s tr y , n o t p eo p le
u s in g chretsium s, i t i s r e l a t i v e l y h ig h . You would e x p e c t
t h a t , b" ; n o t i c e v a fo u n d a h ig h in c id e n c e o f chrom ium .In j
y o u r lu n g tu m o r, b u t th e r e e r a two c a s e s on r e c o r d i n w h ich j . i
th e re was no chromium in th e lu n g tum or in chrom ate w orker I
although o th e r people have also found, in o th e r c a se s, a
h ig h Inc id s ,.ce* You w i l l n o tic e t h a t bloody in o u r chrom ate w ork
e r s , c o n ta in s chromium, b u t c h ie f ly lo c a te d in th e r e d blood
v e s s e l s # .1*11 c o r e b a c k to t h a t I n a rscsio n t. H uch l o s e
1n '"ho plAiT,'i. The o t h e r p o i n t t h a t i s c i n t e r e s t i n t h i s j
ta b le is th a t th e re are canoe o f chrom ate w o rk ers, and th i s |
re p re s e n ts a la rg e num ber, a la rg e s e r ie s o f H ancuao's and ;
E u sp ar* a w o rk , i n w h ic h t h e r e w ere a n u m b e r, i n n.-.-.;h t h e r e
vas
l u t e l y no chromium d e t e c t a b l e i n txie u r i n e , I
;
m u st ^:>y wo c o u l d n 't b e l i e v e t h a t when we >3aw i t i n th e l i t *
a r a t o j'B , *fc v n e n we g o t t h i s c a s e t h e o t h e r d a y , he
no
chrc.">iicm d e t e c t a b l e b y o u r m eth o d s i n th e u r i n e e i t a v * ,
So much f o r th e d i s t r i b u t i o n i n t o s t t i s s u e , . .>
The n e x t s lid e shows th e d is tr i b u tio n by lo b e of
_________ ____ _ ___________________ __________________ _ tlaa lung* in o u r two c a s e s , e x p re s s e d a s iaierogrttfaa
k& * ]_
I J
of
j
chromium p e r te n grama o f ash# In th e r i g h t u p p er lo b e , j I
w hore i n t h i s - t i l l s was th e c a s e t h a t came f o r p n e u a o - |
nectoray, th is is the cancer case, th is is the lu n g cancer j
case* '
found a trem endously h ig h v alu e of chromium in th e j
lu n g where the can c er was loc& tod* Here Is th e ca n c e r w hich
shews tw enty thousand m lcrogram s, th e im m odiate su rro u n d in g j
a r e a was f if t y - n i n e thousand} th e o th e r lo b e s w ere shown j
here# th a t in
T h is n a n '' id a r i g h t pneum onectom y*
|
i
A n o n -'u .n cero u s c jse i s shown ho re * You w ill sa j
*
|
b o th o f th e se c a s e s , th e re is more chromium in th e j
u p p e r lo b e* H ueper and H&ncuso a l s o fo u n d t h a t in one o f
t h e i r p a p e rs , b u t one o f th e German p a p e rs fo u n d more in
th e lo w e r lo b e , I don *t know w h e th e r t h a t was tr u e # Ye
found a h ig h e r chromium d e p o s it w nere th e c a n c e r was p re se n
-
on a o f th o Carman p a p e r s c la im s t h a t was n o t t r u e i n '->ne i
|
o f th e ir cases*
;
However, t h i s g iv e s y o u some id e a o f th o m arked
a r e a o f l i s t r i b u t l o n * I n l i n e w i t h D o c to r *< --t t * s comments j
y e s to rd a y t h a t you o u g h t to do v-ie w hole lu n g , I su b m it
;
o r I m ight say th a t th o se tis s u e s were done p a r gram o f w et
w e ig h t , p a r g r s , i o f d r y w e ig h t, p e r gram o f a s h , so t h a t we <
h a v e ta k e n i n t o a c c o u n t, on o u r r- t r i b u t l o n , a l l th e p o s
s ib le fa c to rs o f in f e c tio n and o th e r su b seq u en t p a th o lo g ic a l
change a which m igtc e f f e c t the w e ith t o f o u r t i s s u e .
i? 3
T h erefo re,w e have c e rta in ver; le fin ita d is tr ib
u tio n , v ery marked v a r ia tio n s in the d is tr i b u tio n o f our
chromium ti s s u e . Our an im al ti s s u e s a l l show ed, lu n g
t i s s u e a l s o show ed, chrom ium o f a b o u t on t e n t h &3 much aa
we g o t i n th e h u sian s. So much f o r t h a t p a r t * I th in k I have one m inute m ore, perhaps, is tn a t
r i g h t , i n w hich I m ight s p e c u la te j u s t us w e ll, so te a t
I o n t p u t my f o o t i n i t . T h ere a r e two t h i n g s I d I l k a
to ta lk about* r $ sp 0&3 1o o
One i s , w hat I s th e m a t e r i a l w h ich m ig h t h e j j
j
'D octor Euepor in d ic a te d to you t h i s n a m in g t h a t j
ho hc.w-r*at I t m ig h t b e c h r o m ite d u s t , an d y o u
S;!S>
hore H u t i t m ight ha th is r a to r i ? ! >U ioh i s q u it a ia e o lu b l^
I would lil:o to c a l l your ,-ttaafcio n to tt* H o t th a t th e | U n ite d S ta t e s h a b ile H e a lth S e rv ic e made a s tu d y o f a p la n *
w hich us c h ro m ite , t h a t i s th e chrome ir o n o r e , -nd In
w hich th e c o n c e n tra tio n ?. found m th e atm o sp h ere o f th e
p la n t* The mort* i.ty re c o rd s o f th a t p la n t sn a re d no h ig h e r ir.-.Ide= ce o f hm*; c a n c e r th a n i n th a p o p u la tio n a s a w h o le , s o t h a t .0 h a v e , on th e one h e r i , D o c to r h - le p e r a ; ex p erim en ts, on the o th e r, the U nited S tite * P u b lic H e a lth |
Sax-vice f i e l d 3 tu d y .
|
The U n ited S ta te s P u b lic H ealth S e rv ic e has s a g - :
&oafc3d t h a t t h i s m a to r in i w h ic h i s th e w a t e r - i n s o l u b l e ,
a c i d - s o l u b l e m a t e r i a l , may b e r e s p o n s i b l e I d r th e lu n g
1+5!+ .
c a n c e r s . They, - t h i s ia o n ly a s u g g e s tio n , th e y have no r e ^ l p ro o f. They aay th a t in - in E n g lan d , i n t h i s co u n try , in moat o f our p la n ts her , th is In term ed iate p ro d u ct is ra -w o rk sd . In tha E n g lis h p la n ts . I t is not ro-wcsritod. 'fhera has n o t been a h ig h in c id e n c e o f lung c a n c sr ro p o rts d in th a E n g lish p la n ts . Therefor , they th in k i t w ight ba 1 because th is is n o t re-w orked and thus the exposure to th i s
m alarial is le s s . I a h o u lt1 l i k e to comment on t h a t &ad s a y t^ a s I
MV* bean to ld by th a chrom ate in d u s try th a t th e re U a
p l a n t i n Germany w h ich d o e . n o t r e w o r k t h i s m a t e r i a l , w*iy
h93 e x a c tly com parable f e a tu r e , to th e E n g lish p ro c e s s , andj
Uiay hair h a d lu n g c a n c e r . I f . on o f th a Gwm an p l a n t s |
w h ere some o f t h e s e c a s e , earn* * * . So i t may c r may n o t j
h a t h a t m a t e r i a l . We h a v e a e m a il
of i t a ^ a y a in j
the p la n t in the a i r .
j
The m a jo rity o f w o rk ers, in c lu d in g D octor re'.
hava th o u g h t t h a t th e h e x a v a le n t chrom atos e r e th e rc >n- j
s : 1 f a c t o r . They a r e i n s o l u b l e , i t i s to u e . * n iy
j
H at. r - I moan th ey a re w a t e r - s o l u b l e , i t is t r u e , aud - j
b u t, how ever, th ey ere v e ry c o r r o s iv e , they are hignxy
.lin in g a g e n ts, becauso Of th e ir h e x e v a la a t form , and tm s j
*t o y a r e m a t e r i a l s w h ic h you w ould e x p e c t t o c a u s e a
re a c tio n in the lu n g s. T h e r e f o r e , wa c a n n o t sa y w h at th e m a t e r i a l i a ,
b e c a u s e we d o n 't know* You c- ta k e y o u r c h o ic e * Your
i
guess is alm ost as good as rains. The l a s t p o in t t b i t I w ould l i k e to make is* w hat
happens to chromium when i t ' s ta k e n in to th e lu n g ? I d o n 't
know a t a l l . I have no id e a , b u t I w ould l i k e to b r i e f l y
t e l l you s-jme v a r y i n t e r e s t i n g e x p e r im e n ts t h a t h a v e b een
dona a t H arvard by Bray and S te rlin g * They showed th a t i f
you i n j e c t r a d io a c tiv e a n t i b i o t i c h e x a v a le n t chromium intra<-
variously in tv an im als, th e m fcerial passes im m ediately in to
th e ra d blood c e l ls and combinea w ith the g lo b in p r o te in
o f t-ha h m o r l o b i n . The t r i v a l e n t chrom ium on th e o t h e r
h an d , does n o t p e n e tr a te th e ra d b lo o d c e l l xsambrim/ I t
i s , how ever, i f th o ro d c e l l s a re h&wolyzad and th e hasio-
g lo b ln i s l i b e r a t e d , i t w i l l t o n com bine w ith th g lo b in
f r a c t i o n . I f you i n j e c t th o t r l v a i e n t t o r n , i t w i l l how
e v e r , comb in o w i t h th o b lo o d p r o t e i n s . On th e b a s i s o f t h i s , i t h a s
| oen su g g ested th a t j
p o s s ib ly the f a i l u r e to f i n d chromium in th e u r i n s , in some|
e a s e s , may b e due t o th e f a c t t h a t th e chrom ium , a l th o u g h |
i t ' s p r e s e n t i n th e b lo o d , may b e bou n d to a p r o t e i n m o le- .
cule and thus too la rg e to pass through th e gloroular cap
s u le . Nobody knows w hat happens to cnroraiuu. tank Indus tr y doo
r e a c tio n betw een chromium and p r o te i n s . I t is known th a t ch ro m S 'i becomes com bined w ith the p r o te in s , b u t even unasr
kSo. |
o r In th e ta n k in d u s tr y , p e o p le d o n 't knew w h e th e r i t o o a-
b ia ^ s w ith th e c a rb o x y l c r th e amino group# So t h a t we who a r e d e a l ng w ith t i s s u e a t an
e n t i r y pc. s m ortem , w h ic h e x i s t s i n the b o d y , and who a r e j d eal! 3 w ith liv e m a te ria l and not other m a te ria l, are even h a rd e r p re s s e d to d eterm in e w hat happens to th e chromium. 7sa-y l i t t l e wo. : h a s b e e n d o n e on th e e f f e c t s o f chrom ium j on enzyme system s# I do n o t th in k i t y ie ld s enough o f I n - j
te r e s t to th is group to review it*
j
Jn evrm ary -h e n , I w ould sa y th a t we have atfcompt*.
od a n in a l ex p erim en ts w hich have y ie ld e d us alm o st no r e - j s u i t s , in lin o w ith - as D octor W ide* s a le , o r i n lin e w ith r.a s t o f th e o th e r e x p e rim e n ts, we havo n o t b e e n u o ls to re p ro d u c e in th e s e two s p e c ie s o f a n im a ls, th a ty p e o f c a n
c e r t h a t we f i n d i n h u s a n s . We a r e h o p in g , b y o u r a n a l y s e s , e v e n tu a lly , to have sonsth in g o f the d is tr ib u tio n o f j chromium and w hat ta k e s p la e e . She r e m i t s , th e r e f o r e , havej n o t y i e l d e d ,3 a n y t h in g t o r e a l l y c o n t r i b u t e to th e sum o f j
c v r k^oylod^o on th is su b ject*
|
l ' 1 aus s )
i
X Y D O C T O R BXQAPS :
!
We c a n c e r t a i n l y a l l c o n g r a t u l a t e D o c to r B a o t y jr I
and the P u b lic H ealth S erv ice on a most com prehensive and c o n c l u s i v e s tu d y . I w o u ld lik e to ask one o r two q u e s tio n f o r r;y own i n t e r e s t . I presum e - c o u ld you t e l l us w h at
-- 457*.~
method was u se d in m easu rin g th e ehrom iun?
|
BY DOCTOR BASTJSa t Y eah , we !
vised a m ethod - w e ll, t h a t 's one o f th e g r e a t re a s o n s why i t ' s b e e n e x tre m e ly d i f f i c u l t t o a n a ly z e t i s s u e f o r chromium, i s b e c a u s e m ost o f th e m e th o d s a r e n o t g o o d , 'i a
have t h - i n th e m ethod su g g e ste d by Gam*ny,imd have made a
number o f m o d ific a tio n s f o r w hich we a re v ery g r a t e f u l to
i
D octor Euo^er fo r th e ir h elp in ti lls .
j
'
I
The m a te r ia l is w et a s h e d , i s n o t p r o c e s s e d , the !
hexav; l e n t chrcsiium i3 red u ced to th e t r i v a l a n t chrou.ua# j I
I t is then f u r th e r ashed in a m u ffle oven* I t - l a o rd e r |
to g o t r i d o f th e i r o n w h ich i tn e ccsmoll e a t i n g f s e v o r . ----d
which is th e vary d i f f i c u l t f a c t o r , b ecau se you g o t your chromium b e i n g c a r r i e d down, w i t h th e i r o n , we t r y t o *eep i t i n a t r i v a l o n t , we k eep i t i n a t r i v a L e n t fo rm and p r e
c ip ita te the iro n o u t w ith bro m in e. XTioxi we p r e c i p i t a t e o u t th e i r o n a n d , a t d ie 2Si"
tin e th e n , b rin g the m a te ria l b ack to a h a x av a lo n t form ,
jh e n , fo llo w ins? t h a t , h a v in g i t b a c k i n th e h e x a v & la n t
we d e te rm in e c o l o r w ith th e b r o m in e .
BY DOCTOR RFC * 3 : Do i assum e th a t. ih s
l c o n t r a t t on o f d u s t m--
c lo v e d w ith has ar. ..;a l s was a b o u t t h a t a c h ie v e d i n t h e p la n
or higher?
y e l l , nobody knows what th e c o n c e n tra tio n was In
th e p l a n t s a t th e tim e th e s e men g o t t h . r e x p o s u re . The
co n cen tratio n s th a t nave been m easured by th e public H ealth
S e rv ic e a re in th e ra n g e t h a t o c c u r when they made t h e i r
summary, and w hich u e have b een a b le to lo a n on f o r th e
j
Tew m easurem ents t h a t h av e b e e n r.ad e i n ro c o n y e a r s , and j
th e y a r e semew hat co m p arab le to o u r s .
j
Our c o n c e n tra tio n s fo r th e m ice ex p erim en ts were |
t e n t! r i e s th e maximum a llo w a b le c o n c e n tr a ti o n ; T or th e r a t :
e x p o r im e n b s , th e y w e re tw e n ty ti m e s th e maximum a llo w a b le i
_
i
c o n c e n tra tio n . They h e lp e d to r e p r e s e n t th e wixinrug f o r *
t h e nimals, i n f a c t we k i l l e d a l o t o f teem by t r y i n g t o j
g o t them up j u s t t o t h e maximum l e v e l s I t 1*?, th e re fe re e # |
c o m p a ra b le and h i g h e r th a n t h e p l a n t s now have* -it i s
;
I
low er th an - by f a r , than th e p la n ts in the old days* Jh j
th e o ld d a y s , i t w e n t l e s s th a n o n e t o n . - o f a mi* `..morula '
p e r c u b i c m o to r o f s i r up t o f i f t y m i l l i g r a m s re p o - A l~u i
th e l i t e r a t u r e * Me w o re w o rk in g i n th e r a n g e s o f a b o u t onei
to two to th ro e *
BY EQOfOH P.BOADS;
:
There i s a q u e stio n b o ra th a t bothorc a a .a l i t t l e
l> it, and b o th e rs D o cto r M idor a l i t t l e , I suppose. You were w orking w ith an im als th a t had gh enough cone antra-: ton
to be f a i r l y s ic k i n many i n s t a n c e s , I tak e i t ?
_____________ ___________ ___ - ....-............. ..... ___ _____ ________________ 459.
Y eah, o n ly we c u t I t down to th e p o i n t w here th e y did survive* BY DOCTOR RHOADS:
You c u t i c down to th e p o in t w here i t w o u ld n 't Imp a i r th e h e a l t h ? BY DOCTOR DAETJ.gR;
I 'e c u t i t down t o w h ere th e y w o u ld s u r v iv e * BY DOCTOR RHOADS :
T i i t im pair th e ir grow th? BY_ LOOTOR rETJTR:
I n 12;; i n h a l a t i c " c h a m b e rs , th e y w ere a b s o l u t e l y lo w e r, i n seme groups t-hsy w are o n ly lo w e r, i n seme g ro u p s they were s lig h t ly low er* BY 300TOR RHOADSI
Vlas th e c a l o r i c i n t a k e c u t way down?
The w e ig h t w a s n 't dovm too much*
BY DOCTOR RHOADS:
You s a id you c u t i t down?
BY .DOCTOR PBEi'XYR:
Y3s , i t was o u t down*
BY DOCTOR KTD2R: r h o re v a r a some m ore p a t h o l o g i c a l c h a n g e s a t t a r
th an th e neoplasm ir. th o se anim als?
3Y DOCTOR B ABITTR
r\ 46C, ;
Y ss, th e re wsro more* The I n h a la tio n mice showed v a r y n a r k e d d if f s r e n c e * The infc. -.a tio n r a t s d id ahow a higlji e r degree o f Inflam m atory re a c tio n * In the in tr a - tr a c h e a l, t h e r e , o r c o u r s e , we ware u s i n g d e f i n i t s l y m e a su re d d o se s t o p u t i n , an d t h e r e we h a d g o t t e n m a ria d f i b r o s i s w ith a t e l e c t a s i s I n th e m ioe when we i n j e c t e d th e m ixed d u s t. T h a t , a t th e p o in t whore i t was i n j e c t e d , so t h a t we know ve w ere g e t t i n g i t down i n , b u t - an d th o s e a n i m a ls , th e w eig h t g a in was n o t to o d i f f e r e n t from th e c o n tro ls * BY FOOTOH RHOADS ;
How, I 'm a f r a i d I m is s e d y o u r g ro u p t h r e e o f m ioa barium chrom ate anim als* BY S OCfOB BAETJYR:
They showed no d iffa rrn .e e a t a l l , e zsepfc th sy w are s lig h t ly - s lig h t i r r i t a t i o n , s lig h tly n o ra , b u t not* s t a t i s t i c i a n s would n ev er c o n s id e r i t to m a tte r* 3Y DOCTOR Th'TOA-'PZSt
D octor L bhsa, co u ld you ccsaum t on th is work? BY DOCTOR LAHZAt
Ko* BY DOCTOR RY0AD3:
The p ap er Is open fc-r g e n e ra l d isv ,oaion* BY DOCTOR ia.Q C 'YBRt
D octor B a e tje ^ , in y o u r ex p erim en ts, the le sio n s com parable to n a s a l p e r f o r a t i o n s , n a s a l seepturn, you moan
t M>1. !
th a t i s a lm o st u n iv e r s a l in to e human e x p e rie n c e ?
j
BY DOCTOR BAETJEH:
|
T h e re was n o th in g i n th e r a t s o r m ic e , we a r e
!
|
now d o in g r a b b i t s , an d we a r e now g e t t i n g n a s a l p e r f o r a t i o n !
o f the r a b b i t s , we d i d n 't h a v e i t i n th e m ic e . We h a d n o j
evidence of any m alignancies there*
Jl jVj>i VriX
*
|
T h ere was one o th e r t h i n g , t h e r e was a r e c e n t
j
case r e p o r t in w hich l i v e r damage was a lle g e d In a - in a j
w orker u s in g c h ro m a te , I th i n k in a man em ployed in a p l a t - j
Ing in d u stry , and it a also been a lle g e d , I th in k , th a t
|
re n a l le s io n s have been cau g h t* C ould you comment on t h a t J |
on e ith e r li v e r o r kidney le sio n s?
m DOCTOR BABTJEH:
y hav n o t s t u d i e d -- o u r p a t h o l o g i s t - a s a
i m a t t e r ' 'o f f a c t , .d h a d no p a t h o l o g i s t on th e p r o j e c t f o r S
I
a y e a r , b e c a u s e h e }: is b e a n i l l , ao t h a t -the o t h e r f e a t u r e s I
h av e n o t b o o n s tu d ie d * 'Jo h a v e thorn, so I w ould n o t l i k e j
to comment* I n th e l i t e r a t u r e - I hav e n a v e r fo u n d any
i
i
d e s c rip tio n in th e l i t e r a t u r e th a t chromium c ru se s any
j
a lv e r damage* That does n o t seem to be c h a r a c te r is tic *
;
dors a rc many r e p o r ts in th e l i t e r a t u r e , of an iia a l c x p e r i - j
mants in w hich th e chrom ates have b een in je c te d and .J.ch .
have cau sed kid ay damage* D o cto r R ie g le r has done some o f 1
those D octor liuoper has done some; he can p erhaps answ er
. U6 2
your q u e s tio n b e t to r th a n I*
BY DOCTOR ,,HUS?gR: W ith r s f s r a n e e to l i v e r dam ages, refer* to th e
J o u r n a l o f th e A m erican M ed ical A s s o c i a t i o n , I t h i n k I t 13
p u b l i s h e d i n Kew Y o rk , L i v e r Damage a f t e r E x p o su re t o
Chrornate*
BY DOCTOR BAKTJEBt I 5d l i k e to sa y w ith r e g a r d t o t h
[ pa p u r , my con-4
K ent ab o u t i t , i f i t 's w orth a n y th in g , and i t p ro b ab ly is r .`
ia t h a t I thought i t was an ex trem ely weak case f o r chr o -a ru
They bod one case o f l i v e r damage i n a chromium I n d u s tr y , \
end, th o ra fo re , tin y say ihrosium cau ses it* Thty had fo u r j
perso n a w orking n ear th e re th a t had s lig h t chsng 'a iriivhe j i
li v e r te s t , b u t no o th e r changes w hatsoever* I t seemed to j
no t h a t p aper was e x tre m e ly poor*
)i
gYjnOC'Bc-d
*
!
I should lik e to r e fe r b ack to a statessant D octor j
B & e tjo r mads in r-sfo ren o e to f o e t o r L u is a is p a p e r She
;
s ta te d th a t the p a .u o lo g y in th o se ca se s of chrom ate c & rs i- ;
r.oraa w as i r` . n t i c a l to t h a t fo u n d i n th e gc-rclon v a r i e t y c a r - '
ciao isa* I t h i n k , to p a t h o l o g i s t s e n d c l i n i c i a n a , thmfc th e
lu n g c a rc in o m a i a u n e s s e n t i a l i n a g r e a t many c a s e s , end
w ith L in d b e rg 's s tu d y oti tbs g e n e s la o f carc in o m a, th e r e havo t s e n r-u..ny ch an g es i n ru-ny p o r t i o n - o f th e b r o n c h i a l e p i -
th e l i i : n * Some p e o p l e , in d e e d , assum e t h a t t h i s u n i c ^ n t r * !
---
C hirac to r is an argument a g a in st th e iraportanoe of inhaled carcinogens. I d o n 't th in k th a t's n e c e ssa rily so , but I w ould l i k e to know i f in th o se ch ro m ate c a rc in o m a , th a r e are m u ltic e n tric tum ors or is th e re rmta p la s ia , or pern&ps carcinom a in s ig h t, to be r e a s s u r in g th a t i n t h i s type w hich seams to b e so d e f in i te l y r e l a t e d , i f th e re w ore demons t r a t i o r o f a f f e c ts on the whole b ro n c h ia l tre e #
BY 1-CGTOR B i g .?-' Z* \-3 f a r a s I know, D o c to r Eueper c a n p r o b a b ly
m su o r t h i s q u e s t i o n from 'h e c a s e h i s t o r i e s the.;. I re a d , th ey wu-e lo c a lis e d . There ware s ix ty - e ig h t p ercent i n th e r i g h t b r o n c h i a l t r e e , a n d t h e r e s t i n ?.,/ a o r j.e s , *&* I th i n k t h e German eer?-ea was s i x t y p e r c e n t i n on r i g n t b r o n c h i a l t r e e * The - a l l th e e c a s e s have b o o n l o c a l i s e d and s re n o t d istrib u ted throughout the b r o n c h ia l tic''?*
'HY f BY
KUBhiT-^D T !/ero thare exten sive stu d io s o f
No, there were n o t , f-J f a r as I
the bronchial know*
.tr-i
i 1
BY DOCTOR P b ^ D S t " iri anvona e l s e an sw e r th e q u e s t i o n , v e r y e x t e n
s iv e s t u d i e s b e in g made o f th e c h a n g e s i n tl a e b r o n c h i e l n e c ro s is in g e n e r a lj have you d a ta on t h a t p o in t , D octor
Kueper?
I cou ld n 't t e ll you that#
BY DOCTOR RHOADSS
B oas anyone h a v e in f o r m a tio n ? I t h i n k a **y im
p o rtan t point has been ra ise d here certain ly #
BY..DOCTOR BA.E-T.JEH i
I d o n 't th in k any r e s u lts have been p u b lish ed on
the re s u lts th a t I have seen#
BY PhlvOR ItYaSVIgTSgR t Could I a sk , s i r , w hether D octor E s a tje r has any
cases o f is o la te d carcinom a, in th e low er lo b e s? P ro fe sso r
G ro s s , when I saw b i a a b o u t s e v e n y e a r s a g o , s a i d he h ad b*?4
a few ca se ? os one or m ore anyw ay, t h a t h a d n o th in g t o do i
w ith th e bronchi, the node bronchi#
BY DOCTOR Bi HP-TSRt A ll o f iuy c a s e s w ere c o n csr-n ad w i t h d e f i n i t e l y
b ro n c h o g e n ic , e x c e p t one i n w hich we h ad a p l e u r a l c a n c e r
in a d d itio n t o th a b ro n ch o g e n ic o n e, end i t was of a d i f f e r s
o a t ty p o , so i t viaa n o t a p p a r e n t l y r e l a t e d to i t # 14o had |
acme in th e lo w er lo b e , u t as f a r a s I know, th e y -dare a l l j
r e l a t e d to to o l a r g e r b r o n c h i# jlfc 3r u s t , s o a c c o r d in g to j
th e p a th o lo g y r e p o r t t h a t a p p e a r s on Wie h i a tc r y #
b Y. doctor D" O.*T31
|
Are th e r e f u r t h e r q u e s tio n ? on th e clicks q u e s tio n ?
f
(llo r e s p o n s e ) . I f n o t , we w i l l p a s s to th e l a s t paper*,
;
t h a t o f o u r h o s t , D o c to r V orw ald, who w i l l d is c u s s h i s
