Document jy7086dqONK17rLgjx3x2ZdzO

FILE NAME Corning OC DATE 1979 Apr 12 DOC OC371 DOCUMENT DESCRIPTION Memo RE Asbestos Related Disease RF PLAINTIFF'S EXHIBIT K.625 BY OCF OWENS C^ NING FIBERGLAS company correspondence 10 L. W. Saxby - 27 | from J. L. Konzen M.D. - 11 subject ASBESTOS RELATED DISEASE dale = April 12 1979 CC D. M. Phillips - 26 R. A. Yudkin - 27 J. F. Vyverberg - New York This correspondence is in response to a request to define asbestosis the effect of smoking on asbestosis mesothelioma of the lung cancer of the lung mesothelioma of the peritoneum the effect of cigarette smoking and asbestos exposure on cancer of the lung and the effecotf cigarette smoking on mesothelioma of the lung ASBESTOSIS tens o Asbestosis is a result of over exposure to airborne asbestos fiber It begins as an inflammation of the air sacs alveoli of the lungs The air sacs where air exchange between the lung and blood stream takes place The first change in asbestosis is an inflammation of these air sacs and the final air conducting channels respiratory bronchioles we which lead into the air sacs This inflammation leads to thickening of the walls of the air sacs and eventual laying down of scar tissue between weme the air sacs interstitial fibrosis As the scarring progresses it e involves the network of blood vessels which surround the air sacs eventually obliterating some of them This leads to increased resistance to blood flow through the lungs and causes the right side of the heart to enlarge and eventually fail cor pulmonale In summary the basic lesion in asbestosis is a blocking of air movement from the air sac into the blood which is then complicated by hindered blood flow through the lungs Death caused by asbestosis is frequently a result of the heart failure cor pulmonale ASBESTOSIS AND SMOKING The process of asbestosis as described above also takes place in the smoker In addition the smoke can cause bronchitis which is an inflammation of the air conducting systems taking air to the alveoli This can lead to a thickening of the wall of the air conducting systems a change in the wall's architecture including the loss of cilia Cilia are hair projections from the cell which aid in clearing foreign material from the respiratory tract Smoking causes these cilia to be less active and in severe cases to be destroyed Further smoking can actually affect the walls of the air sacs so that they dilate some of them breaking down to form larger chambers which in turn results in loss of elastic tissue in the lungs this damage to the air sacs and elastic tissue is emphysema 02 419 0933 oto Peery 7? . emt Warmed o/rder Doutera up / ahia up /winy We We We L. W. Saxby 2 April 12. 1979 enavece BY OCT The emphysema combined with the asbestosis is additive in damaging the lung MESOTHELIOMA Mesothelioma is a rare malignant tumor which can occur from natural causes but is seen in over exposed asbestos workers with marked frequency At this time it has not been possible to determine a dose response how much asbestos for how long a time for mesothelioma doubt that such a response does exist However there is little The mesothelioma is a malignant tumor of the envelope covering the lung pleura It is believed that the asbestos fiber somehow migrates to the pleural surface of the lung to cause the malignant change in the pleura A mesothelioma does not usually invade far into to distant sites in the body metastasize It rapid damage by literally encompassing the lung venting its functioning the lung nor does it travel causes its devastating in a straight jacket pre- CANOF CTHEELURNG Cancer of the lung affects the air conducting systems bronchi by causing malignant changes in its surface cells or at other times affecting more distant structures such as the lung sacs Asbestos and smoking in some unknown manner work together as carcniogens causing cancer of the lung in far greater proportion of the exposed asbestos worker than in either a smoking asbestos exposed individual or a smoker not exposed to asbestos PERITONEAL MESOTHELIOMA Under the microscope a peritoneal mesothelioma looks exactly like a pleural mesothelioma This is because the peritoneum which is the envelope lining the abdominal cavity is derived from the same embryonic tissue as the pleura At the present time there is a continuing controversy as to how the asbestos comes into contact with the peritoneum Some people feel that it migrates from the lungs by a route yet to be determined Others feel that the asbestos is cleared from the lung by the normal lung clearing mechanism which clears any foreign material involves the unconscious movement of the foreign material into the throat followed by swallowing of the material without the individual being aware of it travels down through the GI tract and passes through the walls of the intestine to damage the peritoneum MESOTHELIOMA PRODUCTION AND CIGARETTE SMOKING . . At this time there is no demonstrated link between cigarette smoking and mesothelioma production in either asbestos exposed or in asbestos exposed individuals 02 419 0934 L. . Saxby 3 BY CCT April 12 1970 If you have any questions or comments concerning these definitions and explanations please let me know JLK jgb N N N N N NOTE Attached are questions and answers developed by Dr. D. J. Billmater Billmater as a result of his briefing of the Berlin plant workers following Mr. Califano's statement in April 1978 concerning past asbestos exposure we s Ut ' Cubes Luse GILG SRCOLeED 02 419 0935 FINAL DRAFT 11-28-78 QUESTIONS AND ANSWERS CONCERNING ASBESTOS e ene ate Prepared by D. J. Billmater M.D. after question and answer order sessions at the Corning Fiberglas Berlin New Jersey oo Plant me tourt's chia chia cupenswith Eight sessions were held May 10-12 1978. Dr. Billmaier we was present at the request of Richard S. Hite Plant Manager atfordOe ee . In addition to Dr. Billmaier and Mr. Hite participants in the sessions included W. Russ Warmath Personnel Director Barbara Neill R.N. plant nurse John P. McNally M.D plant physician and a majority of the hourly and salary , work force 02 419 0936 -1- BY OCE Introductory Remarks Several reports have appeared in news- papers and on television recently concerning the health effects of working with asbestos These reports are a result of actions taken by Joseph Califano the Secretary of Health Education and Welfare It is important to understand why Mr. Califano took such action He made the following statements in his official press release As part of my responsibility to promote and protect the public health I am today announcing several steps to inform doctors workers and others about the increased health effects of asbestos exposure | newra The actions I am announcing today with respect to asbestos are i Couce based on a number of factors but two of the most important are the number of individuals affected who are unaware of the risk Lhin and the fact that asbestos is one of the most dangerous and insidious substances in the workplace WIL AAN Given the numbers of unaware individuals affected and the serious risks involved it is imparative that HEW protect STOP the health of our citizens Anyone at Corning Berlin Plant who has worked with asbestos should know that they have worked with it In 1971 Paul Scheuerle the plant manager talked with employees about health effects of asbestos using information given to him by Dr. Jon Konzen the Corporate Medical Director ; The newspaper articles greatly increased the awareness of the Berlin Plant employees to the health problems of working with asbestos The newspaper articles may also have contained information which the employees were not previously aware of Questions and Answers Many employees raised the same question at each session however some questions were asked at only one or two sessions The following questions and answers represent an attempt to summarize the main questions which were asked and answers which were given 02 419 0937 Note There are two very similar words Asbestos is a fibrous mineral Asbestosis is the specific disease which is caused by the mineral asbestos These words should not be confused QUESTION What diseases will asbestos cause ANSWER Asbestos will cause asbestosis It causes people to have a greater than normal chance of getting lung cancer Intestinal cancer and mesothelioma mesothelioma Iku~-rvoe QUESTION Does asbestos in the lungs always cause disease oo ANSWER Asbestos in the lungs most often does not cause Court's symptoms of disease The more asbestos there is in the lungs aidys which depends how long the person worked with asbestos and this how much asbestos was in the air he breathed will determine of witharab the chances of having disease Also people are different arab from another and the same amount asbestos exposure A Doctors Ob might cause disease in one person but not in another person m have examined the lungs of people who live in cities CPe and found that many of them have small amounts of asbestos in their lungs This probably comes from automobile brake linings or other asbestos products Those people do not have any unusual types or amounts of lung disease QUESTION What is asbestosis . ANSWER Asbestosis is a condiction of scarring of the lungs caused by asbestos Normally the lungs are soft and spongy If the lungs get scarred from asbestos they do not expand as well so not enough air can get into the lungs Also this scarring may keep oxygen from getting through the air sacks of the lungs into the blood 02 419 0938 _ 7 7 . -3- BY OCF QUESTION Why does asbestos cause asbestosis ANSWER A very simple explanation is that asbestos fibers are small enough and fine enough to get way down into the Tung When such fibers do get into the lung they scratch or irritate the inside of the lungs and the cells in the oo lung form scar tissue . mateg A little more scientific answer is that there are certain types of cells macrophage which normally eat up foreign materials and protect the lungs When a long thin fiber of asbestos gets into the lungs the cell tries to eat the Metmdan fiber but instead the fiber spears the cell and kills ft Fve When other cells come to help they are also killed As - a result of this process scar tissue is formed cepruineConse' enia Can a chest ray show asbestos fibers in the Spe. QUESTION QUESTION with lungs acorPebta ANSWER HO A doctor cannot see asbestos fibers on an ray bo film sees shadows of the lungs and looks for changes caused by asbestos Very early changes may be difficult to distinguish from the shadows in a normal lung Later changes may be very specific for asbestosis At times the doctor may find shadows indicating other types of disease in the heart or lungs not due to asbestos QUESTION Is a chest ray to look for asbestosis different from other chest rays ANSWER Almost all chest rays are taken so the doctor can mainly look for disease in the lungs but also to look for some disease in the heart This is the kind of chest ray that Berlin Plant employees have been getting and the kind a person would get if he went to his own doctor or a hospital If the doctor were especially concerned about heart disease or if he wanted to look for a broken rib he might ask for a different kind of chest ray 02 419 0939 BY OCT QUESTION Does getting a chest ray cause harmful exposure to radiation ANSWER and from a person and will Everybody gets background radiation from the sun other materials around them The amount of radiation gets from a chest ray is small compared to this not cause any bad health effects QUESTION How does a doctor make a diagnosis of asbestosis together ANSWER The doctor puts information about a person From his work history of asbestos exposure the chest ray ~ results lung function tests and physical examination sedov especially listening to the lungs for certain breathing sounds If the doctor finds certain things abnormal in court'scourt's these areas he can make a diagnosis of asbestosis this QUESTION What are the symptoms of asbestosis acordteith ANSWER Any disease of the lungs including asbestosis may cause cough and shortness of breath It would be unusual for asbestosis to cause chest pain Oftentimes the effects of asbestos on the lungs can be found by medical testing before a person has any symptoms Rather than worrying about symptoms the employee should discuss his concerns with the plant physician QUESTION How does a doctor determine the amount of > disability disability ANSWER Doctors Gansler and Wright have written out standards to judge the amount of lung disability Archives of Environmental Health February 1966 The dactor uses these standards and based on person's symptoms chest ray lung function tests and capability for working or There exercising he determines the amount of disability is an element of judgement in this determination and one physician's opinion may be different from another The Gansler and Wright criteria were set up as an effort to be fair and to get doctors to agree as much as possible 02 419 0940 - BY OCT QUESTION Will the percent disability get worse much and how fast How ANSWER Once asbestos gets the lung it does not get out The disease caused by asbestos will not get better and may get worse How much or how fast this will happen cannot be predicted for any individual but does depend in general on the amount of asbestos and length of time the person has been exposed People may have diseases other than asbestosis for instance chitis due to smoking If a person has symptoms due to Ordes these other diseases and they can be cured or helped for instance by stopping smoking or treating lung infections Courta a person could get better The doctor cannot predict how much disability any one this individual will have nor can he predict how fast the with disability will progress Some people and we would expect that most people at the Berlin Plant will have a relatively As slow progression of their disease based on the types and amounts of exposure they have had QUESTION : How can a person have % disability ANSWER Even if asbestos causes scarring in the lungs and the doctor diagnoses asbestosis based on history chest ray lung function tests and listening to the lungs the lungs have a great deal of reserve capacity Until this reserve capacitiys used up a person could have no symptoms and be able to work or exercise normally QUESTION What is cancer ANSWER Cancer occurs when one part or tissue of the body for instance lung bone skin intestine etc. produces an abnormal type and amount of cells A lot of abnorma cells grow out of control as if the shut off mechanism is not working 02 419 0941 - . ~~ BY OCF -7- ' QUESTION Will I get intestinal cancer ANSWER Again there is no way to predict who will or who will not get cancer The chances of getting intestinal cancer are somewhat greater in asbestos workers with high exposures compared to asbestos workers QUESTION What is mesothelioma mesothelioma ANSWER Mesothelioma is a rare cancer of the lining of the armat lung or the lining of the intestine . Courto QUESTION What about the family of an asbestos worker or people this living around asbestos plants can they get any diseases from asbestos with ANSWER Whether or not an individual gets asbestosis lung atogason cancer or intestinal cancer from asbestos is related to how high an exposure he had and how long he worked with it It is extremely unlikely that any family member would have a high enough exposure to asbestos to get any of these diseases from that exposure The newspaper article mentioned that family members could get diseases What the newspaper article was talking about was mesothelioma Family members do have a much higher chance of getting mesothelioma However since mesothelioma is such a rare tumor it is extremely unlikely that any family member of a Berlin plant worker would get mesothelioma For instance the normal amount of mesothelioma might be one case among 2 million persons but among families of asbestos workers there might be one case in 200,000 persons QUESTION Does asbestosis lead to lung cancer ANSWER There is an increased risk of lung cancer in workers exposed to asbestos Although asbestosis indicates exposure to asbestos a person with asbestosis does not necessarily have any greater chance of getting lung cancer than a fellow worker exposed to asbestos but without asbestosis 2,0 -. 02 419 0943 BY OCF QUESTION QUESTION Can of the skin asbestos get into the body through the pores ANSWER No it cannot Asbestos can cause asbestos warts and asbestos warts will not turn into cancer QUESTION Can asbestos get into the blood ANSWER Asbestos fibers may be small enough to get into the Tung and very complicated research has shown that a few fibers may be small enough to get from the lung to the blood DEGE Such fibers do not have an affect on the health of the worker & Lowel QUESTION Can asbestos damage the heart sh28 the with AthNeSWlEuRng Atsobgeesttosoxycgaenncafursoem lungaidrisienatsoe thTehebodhyearttiswsourekss wiItfh a person has heart disease and asbestosis the one condition tics may make the other condition worse In some cases severe lung scarring from asbestos can make the heart work harder Asbestos will not get into the heart and directly damage the heart not will asbestos cause hardening of the arteries or heart attacks QUESTION What kind of medical tests should be done if a . person has worked with asbestos What good are these tests ANSWER The following are useful in detecting early effects of asbestos 1. Chest ray This can detect lung scarring from asbestos It may help to detect lung cancer early which may then be able to be cured by surgery 2. Spirometry or breathing test This tests how much air the lungs can hold and how fast a person can blow out his air Like the chest ray it may find disease other than disease due to asbestos 02 419 0944 3. Tests for hidden blood in stool Cancer in the intestine may give off very small amounts of blood which a person wouldn't recognize A special test can be done to look for this hidden blood If a test is positive it does not mean a person has cancer but the person needs further tests 4. Rectal Examination Most cancers of the large bowels occur near the rectum and these tumors could be found by a rectal examination QUESTION Why did diseases caused by it take so asbestos long to learn about the ews, ANSWER Asbestos began to be used widely in the late 1800's - The first article about asbestos disease was written in 1910 cours Not much was known about asbestos even in the early 1960's In 1964 the government Bureau of Occupational Safety and ABse Health published a book which said about asbestos ... Conflicting opinions and differences in reports make it difficult to confirm or deny conclusively a causal ... " relationship between asbestosis and cancer of the lung or extrapulmonary tissues However there is increasing evidence to suggest that such a relationship exists The real concern for asbestos began in the late 1960's A large reason for the delay was that diseases caused by asbestos take 15 25 or 35 years to develop QUESTION Will the things we are working with now cause . disease or cancer 30 to 40 years from now " ANSWER The chemicals and substances used now have been around a long time and have been studied extensively They do not have the bad effects that asbestos has Silics is a batch material which can cause lung scarring but not cancer Workers should wear respirators while working with batch materials 02 419 0945 DY OCF -10- The Rayon used in batch is a manmade fiber It is too large to get into the lungs and therefore cannot cause any disease QUESTION Is it bad to breathe dusts ANSWER There are different kinds of dusts Dusts which cause scarring or bad effects in the lungs are called toxic dusts lungs Dusts which do not cause bad effects or lung scarring scarring are called nuisance dusts For instance limestone is calcium carbonate a dust which can cause an irritation of the eyes nose and throat However if it is small enough to be breathed into the the body can break it down Calcium is a part of normal bone and carbonate is like the carbon dioxide which you breath out bret In order to be breathed in the dust must be small enough to - get into the lungs The average human hair a fiber is 65 Lour microns in diameter Ch16 Dusts which are round or almost round must be less than 10 with microns in diameter to be breathed in particle of dust Fibers must be less diameter to be breathed in This is a very small than 3 microns in agordbus A Fiber is a particle which is three times longer than it is in diameter In order to cause bad health effects the fiber must be even thinner less than one micron and very long Asbestos fibers are this size fiberglass and rayon are not QUESTION Is there a danger from the asbestos in the walls and in the ceilings ANSWER The asbestos in these locations generally is covered up and stays there However it will not stay forever If renovation or construction work is done and the asbestos containing material needs to be ripped out respirators and proper protective clothing must be worn and proper procedures for tearout cleanup and disposal of this material must be followed 02 419 0946