Document mpE6maLq5pR2VBDJoZL7Yv3GB

FILE NAME Industrial Hygiene Foundation IHF DATE 1941-1957 DOC IHF040 DOCUMENT DESCRIPTION Proposal and Memos in Response to an Epidemiological Study of Lung Cancer in Asbestos Workers for the Quebec Asbestos Mining Association ; COPY oy 8 INDUSTRIAL HYGIENE FOUNDATION OF AMERICA INC MELLON INSTITUTE 4400 FIFTH AVENUE Pittsburgh 13. Pa March 16 1956 Memorandum on PROPOSED EPIDEMIOLOGICAL STUDY OF LUNG CANCER IN ASBESTOS WORKERS for the QUEBEC ASBESTOS MINING ASSOCIATION ; INTRODUCTION Reports of the occurrence of cancer of the lung in patients with asbestosis have been accumulating since about 1935 Lynch and Smith Angrist Desmoules et al Cartier Gloyne Merewether Kennaway and Kennaway Doll and others According to Hueper such cases now total about a hundred Many of the above authors refer to asbestosis cancer of the lung and claim to show a definite relationship between the two conditions Up to the present time all attempts at correlation appear to have been limited to lung cancer with asbestosis although a connection between cancer and mere exposure to asbestos has been inferred Published reports together with the occurrence of some fifteen cases in the towns of Thetford Mines and Asbestos led the industry to consult the Industrial Hygiene Foundation regarding the possibility of a study having ~ 7 7 JETRIAL HYGIENE HYGIENE FOUNDATION OF AMERICA INC capes - Memorandum the M. ~ 2 Led , as its objective to prove or disprove if possible 1. Whether there is a relationship between asbestosis and lung cancer and 2. Whether a relationship exists between exposure to asbestos and lung cancer It is believed that persons having any considerable exposure to asbestsasbests should be included in any study because eventually claims of lung cancer in this group will undoubtedly be made SOURCES OF INFORMATION During the week of February 20 1956 a preliminary survey of potential sources of information was made with the help of Dr. Kenneth W. Smith Medical Director of Manville Corporation Dr. Paul Cartier Director of the Thetford Industrial Clinic and Mr. Ivan Sabourin General Counsel for the Quebec Asbestos Mining Association Conferences with representatives of the Health Departmenotf the city of Montreal the Deputy Minister of Health for the Province of Quebec representatives of the Canadian Cancer Society leading clinicians in the field and many others indicated that considerable data relating to the general population of the Province can be obtained for purposes of comparison with the popu- lation group under study Morbidity data although limited is potentially available from such sources as the hospitals in Montreal and Quebec city and some of the 13 cancer detection centers in the Province Mortality figures also subject to certain limitations are available through the Ministry of Health's Vital Statistics Department headed by Dr. Paul Parrot  STRIAL STRIAL HYGIENE FOUNDATION OF AMERICA INC Memorandum ... for the M. 3 Simultaneously the various categories of information relating to the asbestos workers were explored with Dr. Cartier at Thetford Mines and Dr. Granger at Asbestos From these conferences that extensive and detailed information is obtainable with it was apparent respect to this group \ 1. Medical data including serial ray examinations of the chest extend over a period of about 20 years 2. In Asbestos it will be possible to obtain through insurance company records information on the diagnoses and causes of death among the insured workers 3. Hospitals in Sherbrook and Arthabaska serve most of the people in Asbestos and records in these institutions should be obtainable 4. Finally autopsy findings exist on most of the cases of lung cancer from the Thetford Mines area PROPOSAL PROPOSAL Obviously several possibilities exist for a comparative statistical study between the asbestos 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 the sources DUSTRIAL HYGIENE FOUNDATION OF AMERICA INC . a 7 Memorandum the M. 4, . and kind of available information and of its probable reliability in con- sultation with biostatisticians has led to the conclusion that a study of this problem is feasible and should resuit in statistically valid deductions The details of procedure including the decision as to which data should be utilized and in which order the available information should be studied 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 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 subsequent exposure to asbestos as well as to the subsequent development of asbestosis The precise incidence of lung cancer in the cohort would be determined by detailed study of the experience of these various groups as reflected in insurance company records and careful analysis of the medical and 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 logical procedure would be a comparison of the experi- ence among asbestos workers as determined by the previous phase and among the general population of the Province of Quebec or a suitable segment thereof Our preliminary observations would strongly indicate that this phase would also be both feasible and meaningful It would involve detailed study of morbidity data at hospitals in Megantic and Richmond counties STRIAL HYGIENE FOUNDATION OF AMERICA INC in Arthabaska county and in Montreal and Quebec city It would also re- quire careful investigation of the mortality rates developed in the office of Dr. Parrot Extensive individual checking of hospital records and death certificates and thorough follow of individual cases would be necessary The third and ultimate phase of the study would be a comparison of data relating to morbidity and mortality as developed in the first two stages 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 figures would be used and if necessary could be supplemented by figures in possession of the respective national cancer societies The cost of the proposed study will be 320,000 U. S. currency including all travel expenses and the cost of preparing and printing the report n\ JoHNS MANVILLE GORPORATION TWENTY TWO LAST FORTEETH FORTEETH STREAZT NEW YORK NY EXECUTIVE EXCUTIVE EXECUTIVE OPE 4 eg wae wa. ay ~! Pern eer ene Santa ..venue ..venue ..venue ns , Detisvunia Det isivunia Dettisivunia oe ahon ic ths On the voby 1 Issue Vol 12 No. Brest Chanel Chanel an article article Item 968 17 locis - which appears to be of interest to no Pewee 10 to a par written in French but translated into fer gad sa in the ritish Journal of industrial ledicne ledicine onder 12 you could supply be with three copies of his article etting them Yours ver iruly , director of J romel .olicies October 6 19 Mr. Vandiver Brown General Manville Corporation 2 E. 40th St. New York N. Y. Counsel Dear Mr. Browns This is a memorandum following up our recent conversation regarding the possibilities of a mail emmpaign for new members for Industrial Hygiene Foundation The day before I saw you I had a long discussion on this subject with the McGraw people This reputable organization offers a direct mail service as one of its activities ens maintains accurate lists in connection with the publishing of its numerous journals in different lines of industry . David F. Board Sales Manager of the company's virect mail division sug- gests a utilite one of their best lists which is composed of 1,0.0 presidents of industrial concerns employing more than 1,000 persons He recommended this as a test mailing and strongly advised us to have the letters go out on the stationery and over the signature of the president of one of our member companies which commands the res pect of industry generally and whose president is well known und well regarded In looking over our membership list Mr. Board suggested that Mr. Lewis H. Brown could be an ideal choice The plan would work like thiss We would draft a letter to submit to Mr. Brown for his approval and for any revisions he might care to meko und obtain permission to send this letter out on his company's stationery and over his signature he would tuy the 1,000 letterhends and envelopes from your company and McGraw would have the letters signed by one of their expert permen who duplicates signatures ucsurately If agreeable Mr. Brown's secretary could furnish us with a list of those presidents which he addresses by first name so that if any of these appear on the McGraw list a modification can be made in the salutation Mr. Brown's secretary could turn over the replies to us and we could handle the resulting correspondence from here explaining that they had voen referred to us by Mr. Browne There is nothing now or revolutionary about this procedure The McGrawHill people are using this technique technique regularly I believe I showed you such a letter on the stationery and over the signature of the president of a large rubber company As & matter of fact you may recall that we have used this plan from time to time on a miller scale with trustees of the Foundation Foundation signing letters we prepared and send- ing thom on their own stationery This is simply approaching the subject on a larger scale than would be possible without outside assistance There are many indiostions that the time is ripe for s vigorous push for new membera As a matter of fact @ hai hoped to let some promotional mestures started surlier in the year but the project was delayed by the legal procedure of changing our nume There would have been no point in making a big membership push under the old name when a change was pending . s 4 Meer River Brown ss... . Oct , 1911 Now of course if the Foundation were a commercial commercial enterprise or conservation conser conservation v conservata ion w tie on would not consider such a request But the facts facts are that this Foundation is a combined scientific research and service institution for protecting the health of workers is probably probably one of the most cited constructive and progressive undertakings which industry has ever launched As has been pointed out many times this Foundation represents the type of industrial leadership and voluntary action which makes the American system work and which serves the cause for governmental governmentaalgents and policemen Because of this we are hopeful that Mr. Brown will make the contribution of lending his name in an effort effort to bring this Foundation and its work to the forceful attention of top industrial management so that it may derive the support it deserves It memo We advance of have me present is not likely that I will be in New York in the near future hence this would like to get action on our annual meeting November 12 the proposal so as to start this mailing in 1O 3 n the other hand if you care to the project to Mr. Brown personally I will be glad to make a special trip to do so Your assistance will be very much appreciated oe Sincerely yours JIM John F. McMahon Executive Secretary ony Memorandum e Prospective Members j Lever Brothers Company former member We can point to no specific instance in which we could be of service to this company but assume that they could benefit from access to our files of general information on hygiene medicine and toxicology as well as the publications and the meetings We have had correspondence on general subjects with Dr. John J. Poutas Medical Director Minnesota Mining & Manufacturing Company In December 1952. Dr. C. M. King Treasurer requested the Transactions of our meeting and stated that they were particularly interested in the advisability of maintaining a medical director in their employ He received complete information from Dr. Walmer but nothing further was heard from them In 1944 Mr. E. C. Schleh Manager of Personnel Research had requested Medical Series Bulletin No. 4 entitled Sick Absenteeism in Industry Its Extent Its Causes and Control Prior inquiries dealt with absenteeism Olin Industries Inc. In April 1954 this company through Mr. Richard S. Reed requested information on problems of the older worker and statistics relating age to accidents In July 1953 Mr. Fletcher wrote to J. M. Olin President inviting them to membership No reply to this invitation was received Richfield Oil Corporation to Dr. The annual meeting issue of the Industrial Hygiene Digest was sent Leach Assistant Medical Director in January 1953. No other cor- respondence Our wide experience with other oil companies including an ex- tensive industrial hygiene survey for Standard Oil of New Jersey a complete medical survey for Sun Oil and some studies for the American Petroleum Institute should be of interest to Richfield There has been no correspondence between the Foundation and Warner Corporation Illinois Central Railroad Union Oil Company of California Mewes Br hv ale i" E7 D ote RagH e D LN ly Wy A tray, atfhe ah 4, tee Sue Awash Goyal ie. 7b BE Ra di e y,yeeae tees 3 8 oat Ben : ; : nt, An : oan nas ware . a fe Bh August 23 1957 Mr. Hugh M. Jackson Manager Industrial Health Program Corporation Manville 22 East 40th Street New York 16 New York Dear Hugh regarding letter Thank you for your tember meeting of the ATI ; of August 19 the Sep- . As a matter of fact having completed the literature search it is apparent to us that the possibility of an association between lung cancer and asbestosis is much more likely to exist in asbestos factories _ than in mining operations For example of 99 cases which had been reported up to 1955 at least 80 appear to have accurred in asbestos workers other than miners A number were women and the occupations given carder lagger pipe were weaver spinner etc. mattress maker bagger coverer type of Two specific articles which mention the exposure the job that by Doll and that by Isselbacher Seventeen cases studied by Gloyne and 31 reported by Merewether as well as thres mentioned by Harrison and one each by Cureton and Owen occurred in England If my information is correct there is no mining of asbestos in England and these must all have been workers in contile or similar jobs In this country the ten cases reported were apparently all in textile workers The first case reported in 1935 by Lynch and Smith was a weaver in an asbestos factory for 21 years Isselbacher's cases involved a contractor's asbestos helper engaged in cutting and sawing mill board and sorter in an asbestos Mr. Hugh M. Jackson -2- August 23 1957 The QAMA study is in the final stages which are of course the slowest All of the statistical analysis has been completed and the ' report is 99 written What remains is mainly minor revisions typing . the manuscript and proofing It should go to the print shop by the end of this month I hope this supplies you with what you need for the meeting If there is anything further please let me know and I will try to get it to you in time Sincerely yours DCB Enclosure Daniel C. Braun M.D. Medical Director References 1. Doll R. Mortality from Lung Cancer in Asbestos Workers 2. Isselbacher K. .; Klaus .; and Hardy H. .: Asbestosis and Bronchogenic Carcinoma Am J. Med 15 721-732 November 1953 3. Doll .: Bronchial Carcinoma Incidence and Aetiology Milroy 585-590 Sept. 12 1953 1 gee E. F. Aba September 23 1948 Mr. J.P. Woodard Director of Personnel Policies Manville Corporation 22 East 40th St. New York 16 N.Y. Dear Mr. Woodard We have made a copy of the French article Asbestosis and Pulmonary Tuberculosis as it appears in the British Journal of Industrial Medicine for April 1948. You will note that this is an abstract of the French article but is longer than the abstract which we published in the Industrial Hygiene Digest We have been unable to locate the full name and address of the French publication Paris I suggest that you G.K. Stechert & Co. 31 E. It is simply identified can probably secure this 10th St. New York N.Y. ar fem Hop article through Another source for foreign publications is the H.W. Wilson Co. , 950 University Ave. New York H.T. Finally in case you wish to write to the British Journal of Industrial Medicine their address is British Medical Assoc Tavistock Square W.C. 1 London England Very truly yours Boe, John F. McMahon Managing Director Some Remarks on Asbestosis Quelques considerations sur l'amiantose l'amiantose ) Rousseau L. 1947 Sem Hop Paris 23 1811 Experimental Asbestosis Pathognomonic Value of the Asbestos Body - Amiantose experimentale Valeur pathognomonique du Corps d'Amiante Giroux M. 1947 Sem Hop Paris 23 1814 Desmoules pulmonaire Asbestosis and Pulmonary Tuberculosis Amiantose et tuberculose H. Giroux M. and Richard P. 1947 Sam Hop Paris 23 Asbestosis and Cancer of the Lung Amiantose et cancers Desmoulos R. Rousseau L. Giroux M. and Birois A. Paris 23 1820 pulmonaires 1947 Sem Hop These four papers come from Quebec Canada where several workers in the asbestos mines have been studied . The Quebec school disagrees with the statements of Gardner that pneumoconiosis due to asbestosis is not an important factor in the production and progress of pulmonary tuberculosis and that the presence of asbestos bodies in the sputum has no value in the diagnosis of asbestosis Rousseau gives the brief descriptions of four patients some of whom are also reported in following papers One had worked in the asbestos industry for 18 years and experienced respiratory symptoms only during the last three He complained of cough and an asthma- like dyspnea Asbestos bodies were found in his sputum but no tubercle bacilli Radiography is said to have shown a ground appearance in his lungs unfortunately the illustration is too poor to demonstrate this This is the only case seen at this diagnosis hospital in which it has been possible to make a of asbestosis during life Another patient who had been exposed to asbestos dust for 25 years and who died from some unrelated cause showed no clinical or radiological signs of any abnormality in his lungs during life Giroux exposed guinea rabbits and a dog to crude asbestos dust in a chamber daily for several months The rabbits killed after periods of from three to 12-1 months had no asbestosis and no asbestos bodies The dog showed no lesions after 10 months exposure only the guinea showed lesions in the lungs and asbestos bodies In these animals he traces the stages of formation of asbestos bodies fibres reaching the alveoli are rapidly covered by phagocytic cells ~ e . 2 + movement of the fibres results in microscopic dleeding from damaged alveolar valls the haemoglobin haemoglobin haemoglobin from the liberated red cells is taken up by the phagocytes which already enclose the asbestos fibres Subcutaneous or intratesticular injections into guinea of suspensions of asbestos in olive oil resulted in the production of granulomatous lesions but no asbestos bodies When however the suspension vas injected into an area into which 1 ml of blood had been injected immediately before asbestos bodies were found after a month He considers that the presence of asbestos bodies in sputum has significance pince it implies tissue damage in the lungs Desmoules Giroux and Richard report a patient aged 44 years in whose family there was no history of tuberculosis He had worked as a bagger of asbestos for 20 years after 10 years he began to experience dyspnea on effort accompanied by cough and expectoration He became more severely ill some nine months before his death which was due to tuberculosis and asbestosis The authors argue that the asbestosis preceded and paved the way for the tuberculosis , but admit that they have no proof of this The association of tuberculosis and asbestosis is generally admitted in Britain but is doubtful in the United States Desmeules Rousseau Giroux and Birois record brief details of two patients who had asbestosis and cancer of the lung The claim that carcinoma of the lung with asbestosis has been recorded before in only one case cannot be allowed Nor will there be general agreement with the statement that silicosis is admitted to play an important part in the pathogenesis of pulmonary carcinoma carcinoma ) --- Taken directly from British Industrial Medicine Vol p 100 April 1948 Journal of 5 No. 2