Document jmvKNe7aXk35Y2QnQZjLr4Lry

on ; ) I A 0 0 7 I fiif X CMFUWTZAL bcitoi Qae. March 19. 1949. George K. Footer Tha report on experlnental aabeatoala has baan re al avad. Tho experlMnta nd resulting ooncluaiona are aumariaed In tha attaehad report, to which Z have added ay own oo--anti and roeonaondatlona. Tha recoaaandationa are for tha industry aa a whole. Several pointa need farther clarification; when theae hare been diacusaed with the Saranac people Z ahall auboit another report. KVS/h.n. taneth 1. ttalth, 1.0. PLAINTIFFS EXHIBIT 'M' mxu> > 4 COPT ) I <1 .JO/ ^ AM or .TttMIflP A. Various forma of asbestoa fibres produce typleal flbroala In tba lungs of sons aalnela. B. flbroala la produced by tba asctmnlcil and not tba ehaalcal action of tbo fibre. C. flbroala la produced by tba lone flbraa (20-50 alcrona) and not by tba abort flbraa (under 20 alcrona). D. Asbestoals was produood la an a taoapbora with a total duat count of 138 l.f.P.C.f. of which only 0.6% vara 10 alcrona or leaser. B. Aa the concentration of long flbraa In tba air la In creased. tba flbroala develops In a ahorter tine. f. flbroala will not profroaa after renewal fron duat to noraal air. Q. Aabeatoela bodies are foraed around flbraa to prevent further Irritation. H. Alunlnun therapy la useless in asbestosls. Z. Asbestos duat causes no significant change In the course of pulaonary tuberculosis. i I 1. Tissue and muimI susceptibility vat noted 1b the axperlaents. Individual susceptibility to tba duat aaong our eaployees baa baan notad Ibr aany yaara. 2. Wa always have baliarad that tba aetioii of tha duat vaa aechanlcal and not chealcal. If thara vaa an addJ ebonleal affaet, I believe that oa would aaa countless eaaaa of asbestosls bacauaa va have bad bundrada of aan axpoaad to high eoneantrationa of duat. 3. Tha thaory of tba action only by Ions flbraa of 20-50 aicrona ls9 at first, bard to accept bacauaa: (a) I paraonally have heard tba lata Or. Gardner aay that probably tba aost dangerous lengths of fibre for tha of aabaatoaia are thoaa of 5 to 15 aicrona (b) In Or. Gardner*a latter to Mr. 8abourin of feb.23,1944* ha atatea: "I believe that tba true haaard in aabeatoa planta ia proportional to tha aaount of aaa11 f individual uncruahed flbraa in tba ataoepbere. I adlpeai that thereason only one All little or no typical aabaatoaia In tha alnaa and ailla ia because thara la probablv too little such fibre in tba air of tbaaa planta. Convaraaly tha raaaon for tha typical dlaaaaa in tba fabrlcatlnf plants la tha fact that tba prooeaaes there open tha bundlea of aabeatoa flbraa and tear than into lanatha lfiort wntth to be inhale3~ln danseroua quantltiaaV. (c) in tha 0.8. Public Health Bulletin #2U entitled a Study of Aabaatoaia in tha Aabeatoa Textile Industry" it la stated that tha nadlun lanfth of flbraa rants frow 7 to 16 nicrona in tba plants studied. Duat counts around tha aixliif pickers and cards showed tha lowest percentage of fibre and the shortest lengths of fibre and it was anong these own (pickers and carders) that the greatest nuaber of asbastosla eases occurred. However, in spite of these threw stateaants, I would prefer to believe in tha action only of the long fibres and accept these recent Saranac findings because: X - Tha duat counts in our ailla show 65Jf - 90% of tba fibres are 5 aicrona or less in length and rarely 1% are 20 aicrona or longer, and we have relatively few aabaatoaia eaaaa. IT - The recent Saranac studies have shown that aabaatoaia will develop in an ataospbere of 13S M.P.F.C.F. total count of which only 0.60 were fibres longer than 10 aicrona. Ve have had aany areas in our Bills where such counts could have been found. : I A - 0 0 / -i -2- TTT - Saranac Mso lu show that, logically, as the concentration of lone fibres is laemiid, sort fibrosis develops. The fibre deposits In tbs Thstford srss srs o-f iloocncsr fibre than the ASbestos coposii. Although fbara is no dots Ho9ay, we"eiglit assum tbst the dust In tbs Thstford mils has s hifher psrcsntsfs of tbs longer flbros than tbst in tbs Asbestos Mills. TfciLnlghi-eccount lajtsrt^for thegreaper nuabor_pf__tiboatosla ossos seen In the TBACrord Plants. ' iV - The relatively saall number of ssbestosls esses occurring In the asbestos sines end Hills as compared with the textile plants nlfbt be due In part to the percentage of fibres In the Industrial ataosphere. Oust counts In various textile plants sbov up to 26 fibre eblle counts In our mils shoe only 4Jfibre. 4. That the fibrosis of ssbestosls mil not progress after rMoval of the anlaal froo dust to nomal sir esn easily be believed. X have seen many sen who, when transferred to noa-dusty Jobs, have improved physically and whose x-rays have shown no progression. 5. We always have believed that the asbeetoals bodies are not evldeneo of disease, but sinply the fact that fibre has been Inhaled and the body has shown defensive action la an effort to neutralise the irritation. 6. X still believe that asbestos dust mil not aggravate a pre-existing tuberculosis; also that the eourse of' tuberculosis mil not be altered in a nan who has worked for several years In our mils as long as he has no x-ray evldwee of ssbestosls. Bowever, at the / noasnt I can neither accept nor deny the statement that ssbestosls has no effect on superlaposed tuberculosis. The Saranac experiments have shown that asbestos is not an Inert* dust like gypsua, nor Is It a very active dust like quarts. Ttafr have shown that concurrent asbeatosls and tuberculosis produce aore fibrosis than does either dlaase alone. Also It has been shown that tubercle bacilli have been found la the asbestotlc fibrosis which is not the usual site for this Infection. These cxpcrlaonts have shown that there nay be sons connection between non-tuberculons infection md ssbestosls. X believe that this Is a fact for, although X do not think our will workers have aore respiratory coaplalnts than the average nan# Z hevt seen several cases where pneuaaola has developed on a pre-existing ssbestosls. 8ueh cases are extrmely difficult to treat, show a vers alow 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 detrlawifcal effect of ssbestosls on superinposed pneumonia, X believe the*, the relationship of tuberculosis developing on a well-established ssbestosls should have further study. Although this relationship has not been shown in the recent as perlaents, ay opinions oust be neutral until aore cases of the dlseas aaong our employees have been studied. 'i *: i ) I A > 0 0 / S SSZ1 1 - Tbw sir in the Asbestos and Thetford plants should bs sanpled and studlad for flbrs lmgths, and tbsss flndlnfs eorrslatad with tba experlnental and huaan studios at Saranac. II - Asbostosls can bo controlled Ifi(a) Every effort Is nsdo to lover the dust concentra tios In the working area of the onployee, and (b) transfers to non-dust7 Jobe are effected before any disability develops, probably os soon as there are significant x-ray changes. Ill- Tuberculosis would not be a problen 1ft(ft) Every active ease is Isolated nod not allowed to work; (b) non-duety Jobs are found for apparently arrested cases; (c) routine ease finding, crawl nation of all contacts,etc. (an adequate tuberculous control prograa) was carried out. IV - re shouldhave an qplnlon.fron the.Saranac Laboratory on the association of'asbestosls and cancer. There Is a world-wide effort to find the cause and cure for cancer. The nodical literature Is full of suggested causes and asbestos has been nentloned as a very definite possible cause. Although In actual practice we have seen_no j*ases_of cancer of the lung affbng our enployees^ asbestos Is an Irritant and as such night jfcy sons role In the devolopnont of carelnona. An expert opinion on this relationship would be worth while.