Document mBqgE89Kx41xwJBGdno5DL8Y4

;/EXHIBIT . NO. - uuirr L. HYGIENE FOUNDATION OF AMERICA. INC. MELLON INSTITUTE. i400 FIFTH AVENUE Pittsburgh ta. Pa. MARKED FOR IDENTIFICATION FILED IN EVIDENCE Michael E. Kunz Clerk hi*rch 16, 1956 Memorandum on )POSID EPIDEMIOLOGICAL STUDY m CANCrR IN ASBESTOS WORKERS /or the QUEBEC ASBESTOS MINING ASSOCIATION # INTRODUCTION Report* of the occurrence of cancer of the lung In patients with a*be*to*ls hive been Accumulating line# About 1935 (Lynch And Smith, Angrist, Doemeulo* at al, Cartier, Gloyne, Merewethar, XnnaawAy And Kean*way, Doll, And other*). According to Hueper, each cAeas now toted About e hundred. Many of the Above Author* refer to "Aebestoels cancer" of the lung, and claim to show a definite relatiooehip between the two conditioae. Up to the present time, *11 Attempt* At correlation Appeer to have been limited to lung ciacer with asbest-osia, Although a connection between cancer and mere exposure to A*beatoa ha* been inferred.. Pub* lished report*, together with the occurrence of acme fifteen easts in the towa* of Thetford Mines and /sbestos, led the industry to consult the Industrial Hygiene iuundation regarding ths possibility of a study having t-CEf*C ^OUM^ATION Or AME-ICA. IKC. M-cno rand urn. .. for the Q. A. W, A. Wy -- 2, as it* objective to prove or disprove, if possible, 1. WLathor there l a relationship between asbestosla and lung cancer, and 2. Whether a relationship exists between exposure to asbestos and lung cancer. It is believed that persons bavin) any considerable exposure to asbestos should be included In any study because, eventually, claims of lung can- csr In this group will undoubtedly b mads, SOURCES Of INFORMATION During th weak of February 20, 1956, a preliminary survey of potential sources of Information -was made with the belp of Dr. Kenneth V, Smith, Medical Director of Johns-Manvilie Corporation, Dr. Paul Cartier, Director of the Tbetfurd Industrial Clinic; aad Mr. Ivan Sabourin, General Counsel for the Quebec Asbestoe Mining Association. Conferences with representative* of the Health Department of the city of Montreal, tha Deputy Minister of Health for the Province of Quebec, representativee of the Cansdlm Cancer 5ociety, loading clinicians in the field, and many Others indicated that considerable data relating to the general population of the Province can be obtained for purpose* of comparison with the popu lation group under study. Morbidity data, although limited, it potentially available from such sources as the hospitals in Montreal and Quebec city and some of the 13 cancer detection centers in tbs Provinca. Mortality figures, also s uujsct to certain limitations, are available through the Ministry of Health's Vital Statistics Department, headed by Dr. Paul Parrot. . htoicnc ^ounoation or amcwica. ihc. - M*morwdum.,.for th Q./>.M. A, 3. Simultaneously, th* various categories of information relating to tin asbestos workers war* explored with Or. Cartier at Tbetford Mines and Or. Granger at A*b*to*. From the** conferences, it wti apparent that extensive and detailed information 1* obtainable with respect to this group: 1. Medical data, including aerial x-ray examination* of th* chest, extend over a period of about 20 years. 2. In Asbestos, it will be possible to obtain, through Insurance company records, information on th* diagnoses and causes of death among the insured workers. 3. Hospitals In Sherbrook and Arthabaska serve most of the people in Asbostos, and records in these institutions should be obtainable, 4. Finally, autopsy findings exist on most of the casee of lung cancer from the Thetiord Mine* area. PROPOSAL Obviously, several possibllitl*s exist for a comparative statistical study between the asbestoe workers and either the general population of the Province of Quebec or segments of that population having similar cultural and ethnic characteristics. Careful consideration of th* sources f*MOwlTI*tAU HTOICNl 'FOUNOaTION Or AMIItICA. INC. * Ucmorandum... for the Q.A.M.A. 4. *nd kind of available information and of its probable reliability la con sultation with blostatisticisA* has ltd to the conclusion that a study of this problem is feasible and should result in statistically valid deductions. The details of procedure. Including lh decision as to which data should bo utilized and in which order the available Information should be studied, e .must await more detailed investigation. However, it would appear from a review of copious notes assembled at the time of the preliminary survey that a reasonable starting point would be an ln.tra-Industry study, selecting a group which entered the asbestos industry from 10 to 20 years ago. Such a cohort of workers could then be followed according to their subse quent exposure to asbestos as well as to the subsequent development of aibeeloaie. The precise incidence of lung esneer in the cohort would be determined by detailed study of the experience of those various groups as reflected In Insurance company records and careful analysis of the medical and x-ray examinations. This method would approximate as nearly as < possible the controlled conditions of an actual experiment, and Information derived therefrom should be of prime importance. The next logics! procedure would W a comperieoo of the expertact among asbestos workers as determined by the previous phase and among the general population of the Province of Quebee or s suitable seg ment thereof. Our preliminary observations would strongly indicate that this phase would also be both feasible and meaningful. It would involve de tailed study of morbidity Cain at hospitals in kfejanlle and Richmond counties, . Jp*OliT r % MtOifNC fOUNOATlON O' AWfWlCX INC. * icmormdumi f0r th* QeA#MeA# 5. la Arthabaska county and in Montreal and Ouebec city. It would alio re quire careful investigation of the mortality rate* developed la the office of Dr. Parvot. Extensive individual checking of hospital record* and death certificates and thorough follow-up of individual cases would be accessary. 0 The third and ultimate phase of the study would be a comparison " of data relating to morbidity and mortality as developed la the first two tases for the asbestos workers and the general population of Quebec with similar statistics for the dominion of Canada and for the United States. It is not anticipated that the statistics for Canada and the United States would be developed during the study since they are available through the public health services of both countries. The most recent published fig* ures would be used and, Lf necessary, could be supplemented by figurep la possession of the respective national cancer societies. The coet of the proposed study will be 120,000 (U. 5. currency} including all travel expenses and the cost of preparing and printing the report