Document jmLYv7JXOnkoZ2G0qbDyBLea5

Organization Resources Counselors, !nc. 1660 L Street, N. W. Suito 212 Washington, D. C. (202) 872-1080 Cable Address: orescon March 5, 1974 oJxh^ijamCEiVEO ^8 ,S74 MEDICAL Div. Memorandum To: Attached address list From: Wayne T. The enclosed letter from Dr. Laurence H. Ballou, Medical Director at Firestone Tire and Rubber Company, dated February 22 and its attached enclosure is being forwarded to you with Dr. Ballou's knowledge and approval. The enclosure has its origin in the many discussions which have taken place regarding polyvinyl chloride which came into the general broader discussions the latter part of January. The concept of an industry wide medical examination is of course not one limited solely to VC/PVC workers. In many different combined or singular applications the procedure has a relevancy to many occupational exposures. This is being forwarded to you at this time solely for information. It may well be that at a future date we should give it further 11 consideration. I am quite certain that Dr. Ballou would welcome an expression from you of any reaction you may have to the enclosure VVC 000006480 ORC OCCUPATIONAL SAFETY AND HEALTH STANDARDS GROUP MEDICAL REPRESENTATIVES Dr. Ernest M. Dixon Corporate Director Environmental Medicine Allied Chemical Corporation Dr. Miles 0. Colwell Vice President, Health & Environment Aluminum Company of America Dr. Ray Yerg Director of Medicine, and Safety American Can Company Health Corporate Medical Director Celanese Corporation Dr. R. L. Lembke Medical Director Continental Oil Dr. R. W. McBurney Medical Director T. R. Evans Research Center Diamond Shamrock Corporation Dr. Howard E. Everson Associate Director, Safety and Environment D-iamond Shamrock Corporation Dr. William L. Sutton Director Health, Safety & Security Eastman Kodak Corporation Dr. D. L. Block Medical Director Ford Motor Company Dr.C. A. Johnson Director, Occupational Safety and Health The Goodyear Tire & Rubber Co. Dr. Richard Henderson Director, Environmental Hygiene & Toxicology Olin Corporation K. D. McMurrain, Jr., M.D. Medical Director The Procter & Gamble Company Dr. John Welsh Medical Director Union Carbide Corporation J. N. Gallivan, M.D. Director, Health & Safety United Aircraft Corporation J. W. Whitworth, M.D. Medical Director Westpoint Pepperell VVC 000006481 < rmfiANl/AlinN M ',011111:1 ( Qumm i Mir, ihuj____m m I ..............---------------------------- - Eae Vlvectom Ifltae ? Rubber Coraparoy HAfWEY S. P J fVE STON FOUNOfA AKHON , OHIO 44377 February 22, 197l*- Maurice Johnson, II. D; The B. F. Goodrich Company 5'00 South Main Street Akron, Oil hlj-318 Bear Maury: In 'thinking about the ideas presented at the Tuesday night committoo mooting, the Task Forco mooting on Wednesday, and my subsequent t ine -with a MIOSK team of investigators who visited our Pottstown plant on Thursday, I get the increasing feeling of the need for urgency in getting some sort of inchistrywida ongoing study started. if 7/e don't do it, either NI0S1I or the Mount Sinai (IUD) sponsored group 7/ill. Your company took the initiative in the AOL study, the MCA mounted the Tabershaw-Cooper study, and your company has been most exemplary in its public spirited efforts to inform everyone of the hazard of VC as soon as it was learned. I v/ould like to see the PVC industry retain the initiative for once and offer a method of study that uoxfid so -well fill the needs of all concerned that 210 parallel studies -would be mounted by other interested groups. I claim no particular authorship for the following proposal. It seemed to have evolved over the past feu days and there are probably many badly tho\ight-out portions, but I think it would fill the need as 1 see it and-would avoid or sidestep many criticisms of other schemes, and be much better than going our separate ways. I am forwarding copie s of this letter and the attached to the physicians named on this committee in MCA's communication of January 30, 197^. Sincerely, LHB:rf Attachment eotome rfbur Symbol of Quality _L_xi Laurenq'e II. Ballou, M.D. Medical Director VVC 000006482 % .X..-.. . February 22, 1971* INmJ2VRYYJIDF iimopCAL KXAMIRATIOTT PROCKDIIRF. ^OR VC/PVC VIORXRRS \ A private or iinivers.ity-bascd investigative body, hereinafter called "the Registry" would design a history questionnaire, physical examination form, laboratory, X-ray and "other studies" protocol and put this up in an examination packet with instructions. A unit charge for each packet would be made to each company whether it bought one, one hundred, or one thousand packets. The company uou.ld contract to pay their local doctor to follow the instructions and do the cxa5.1ina.tion as outlined. YJhcn all examinations were completed, the packet would be returned to the Registry where the reports would be assessed by someone who wculu soon become very export at evaluating the findings. The Registry would then advise the company an to the risk factor of its employees, what should bo done In followup, and what in general could be told the employee. The data from this examination and the expert's evaluation would then go into a data, bank and a tickle system would operate to be sure that follow-up investigative reports were reviewed by the Registry. When the time came for the next periodic examination, the computer would inform the subscriber that it was time to order more packets. These are the bare essentials of the plan. In the following paragraphs I have tried to clarify some points and answer certain objections that occur. The Registry examination would be the basic examination. It would be updated and revised as now studies proved their worth and others fell by the wayside. Subscribing to the Registry examination would not preclude any company from adding any studies that ehey wanted to pursue but would ensure each company, large or small, of an exam protocol which was acceptable in scope and designed to protect its workers as well as the state of the knowledge allowed. The unit fee for the packet would in effect po.y for one year's subscription to the service for one employee and would ensure for the Registry adequate monitoring Returns for its efforts. It would l)o a pay-as-you-go scheme for each company and would assure them, for a relatively small unit price, the advice and counsel of the best experts in tJiis new field. t VVC 000006483 2 The threat of government surveillance in lieu of the Registry membership would keep i*:ost of the industry as subscribers as long as the study was felt to be necessary. The Registry would keep government agencies informed of the general nature of the findings and would report all cases as suspicions developed. The Registry as an entity would not investigate death certificates in a retrospective study, nor would it mount any prospective study, but it would gradually evolve trends that could bo given to qualified epidemiologists for study. The selection of a qualified group to develop and run the Registry would ensure credibility and trust from government and labors in fact, it night be conceivable that both govern ment and labor be invited to have observers on the board of directors of the Registry. The examination packets sent out by the Registry could contain a blood rumpling mailing kit from one of those contract laboratories that arc currently soliciting us. The volume of business that would be assured from an industrywide registry system would assure us of getting just about what we wanted in the way of liver function tests without having to have a lot of tag-aiong superfluous tests that usually come as part of a commercial or hospital ShA-12. The packet could be designed so that the examining physician or the medical department of each company could extract a copy of each section before the papers were sent on to the Registry. It would also be do ;i 0ned to give feedback and advice to the patient's private pp hysician if such were desired by the employee, The design of the examination would be such that much of the examination would be such that much of the examination could be on palpati form of instrumentation can equal to the personal and direct attention of even an average physician. Yet tho use of a single Registry interpretation would assure Industry of a consistent evaluation for each of its member company's employees regardless of tho quality of their local medical facilities because all tricky' or difficult interpretation would be done centrally leaving only a clear-cut, well-planned physical examination to be done by the local practitioner. I do not want to imply any distrust of the local physician. I VVC 000006484 -3- just want to point out that it is often hard to arouse the neccs.,:ory interest or expertise from a buoy doctor who lias been finked by some small company to examine thoir employees for "the PVCUTS C' Disease.n1~> i c i\ > r> f~\ It ReceivingTin.-'m' ir'i tvf pr* ood/I instructions( iif'V'MirT!"! iMif< ao nd aC) simple kit would ease the local burden and assure industry of relatively good and consistent result, regardless of local facilities, interest, or motivation. A packet examination originating from one source would also ensure the most rapid Inclusion of new procedures or the elimination of sections that experience taught us to be useless. The board of directors of the Registry would have to make sure they had direct input from exports in the fields of cancer, bcnarolcgy, liver disease, and epidemiology so as to keep the examination always pertinent. The Registry would serve as a designer and updater of the best type of ongoing examination, it would store information, it would give advice to each, company, it would ensure uniformity and regularity, and it would disseminate valuable preventive medical information. In short* it would do for the industry in an impersonal and objective way what each company would otherwise have to do and not do well. In my discussion with the I7I0SII team on Thursday, I began to get the very distinct impression that they weren't going to be able to wait very long for any private group to slowly deliberate itself towards a recommendation. If no one came forward within two or three weeks, then UIOSII would feel that it was their responsibility to set the medical criteria so all industry could get started on their individual programs. LIIBsrf Copies: Laurence H. Ballou, M.D. Dr. C. U. Dernehl - Union CarbideDr. C. A. Johnson - Goodyear Dr. R. V7. McBurney - Diamond Shamrock Dr. George Roush, Jr. - Monsanto Dr. Ernest II. Dixon - Allied Chemical Dr. D. P. Duffield - ICI VVC 000006485