Document p2gz14ge5pjn1D6qaGzzMvD6j

JK/ED V . 16th October, 1952* Ibt Seventh 8ar-- Syapoait-- Sept--her 22nd to 26th 1952. Eh* Seventh. Saras** Sjrwpoaiua took a* lta sufejoet "the diaeuesl-- of baalth probla-- pertaining to worker* axpoaod by inhalation to industrial r&staacea*. It was attended by error 200 paople end vaa representative of UaiTeraity interest#, research foundation* of Canada and th* 0.3. , O.S. federal and atata labour depaxtnenta, tnauraaow istezests and legal authorities. fren tha Psswooonlocia Bessarab Unit of thokediael Raaaarcb Council at Cardiff ean* Dr. C. fletehsr and Dr. HuWcn*a. Dr. KJLJu Kirwattar vaa praaant representing tba British Ministry of Labour. Therb vara several diatlngudahad indlTiduala firea Canada, South Afirloa and tha U.S. who attended in their private oapaoltlo* and a largo group of interested aedloal nan who famed the bulk of the sail--ow at th* nestings. On th* first day a aaaalon as devoted to an att--pt by gw-- speaker* to suggest a definition of the tern ps--tocnloala. there saa auoh dlaouaaion on this subject but no manlatty vaa adaiered, and it saa resolved that a --all oanxittee be famed to att--pt the daflnltixn in a nenner vhloh vould satisfy both legal caid nodical opinion. the lack at an agreed definition did not prevent tha fljnpasiua tran ocntlsulng lta dal fberatlona and each spankrr need the word in bis oaa aanae. to tha average listener pneu--wanted s jelled a disability arising prinarily aa a result of dost inhalation, and char--tarlaed by breethleasresa to a greater r leaser degree. The pneiawoonioala of ooal adnexa received a shale days ' oonalderation vlth British snd A--rle-- contributor*. Zt was obrloua that the acre careful studl-- had be-- aada in Britain and that Brltiahv4sa* obtained acre acceptance fren the audience. Itinera pneuanoontnaia is only slowly achieving nwogiltlon aa -- entity separate fren sillooals in the Q.S. end there axe assy interests gypsen! to the acceptance of this view ever there. Zt saa obvious first the great interest shorn in this subject that it is attracting widespread attention all over the world and that than will be rayerousslons ft-- this aetivity in all pol--xy bat diesee--. Tha large tuber of worker* enployed and the Isolation of --any of the area# of oo*l production enable good cpldofaological studies to be dons. In JE^Bay work the British have defined new Radiological Standards both aa regards th* queli^r of the fllas end the effiLdanay of the Radiologists who Interpret then. The-- have be-- --da the sdijeots of statistical analysis. finality, has not be-- reached but the --runt at work done has paused -- awakening of interest in the subject and a universal questioning la the adnds of the-- who try and interpret the shadow graph in to--a of physical incapacity or pathological process. V Eton the Cardiff Unit c--e -- ixpeort--t study -- puZaonaz7 filiation by Dr. Hugh^anes. Shis work la being p"nnd in tha U.S. and Canada. One had tha inpreaalon that while auoh work bad 'be-- don* in th* 3tat-- it vaa less oonolusiv* th-- the work don* hare. This la a line of study with great potentialities but it 4a still cn a research basis. Already, however, in Canada and thd Q.S. a litigant aay support his oaa* - especially if it is weak radialoginally cad oh--leal ly, - with a functional report. It was t Continued. n/Tn 'i o-o oT to 2 tt^**4!**1 toy Dr. HugJWcnes that Zoos of fuootico breathlessness ia tbs cardinal oaaplaiat of the ptmienooplotlo and that the fcnotioeal study is aa attenpt to evaluate this toy laatnatwutal nathoda. 7n Canada ease the first functional studies on nan exposed for tea years or boss to asbestos dust toy Or. P, Cregoire ear' the Lavoisier InstitutO/of Montreal. These sere Inn stairs tout did. not do acre than relate the obvious truth that a sea vith tozeathlesaness vhiafa saa truly related to loss of elasticity la his lungs Cron fibrosis eould toe shorn to hare a poor pulacnaxy fraction liTtri--ntny. This invasion of the physiologist Into the pnsaoocBlctio field Is a developaant to be satched vrith interest. She siAJeet of pnouuocnlosln end puLsonsry osaoer eas conaliWred froathe angle ef the ohrowate, toerylllm and asbestos industries. Zt eas sllotsd a days consideration. There saa a ` gstersl statistical revise of this s^Jeet toy Dr. M. Levin of the I.X. State Deparfiawt of Health which eas first class. This lecture, sfaieh eas illustrated toy about thirty glides lasted half aa hour and eas dellarersd toe rapidly to report la detail. full study eill he possible shea the proceedings are later polished. Zt unearned the statistical aetboda toy ehieh enrixa--ntal treads ooald toe Judged frae the piiiHibsd vital statistics and be pointed eat mny incmslstsncee in the published sort. The esse against the cigarette oould net he regarded se proved ehile it saa oertadaly suggestive. Ksny ether anvlrsaMntal factors suah ss tar reeds, soot, and ftaas ftrae the ooebustlcn of ells and petrol eese ocnsidcro feqpertant. Dr. Buapsr ef the Vatlonsl Cancer Institute spoke of the ssbestce Industry eith ausplnlnn. He used the ptddlshed fLguree of ethers and as all axe agreed that these are tnocncluatre sad fallaeloas he eus xrtatols te do sore than, record hie iepresalcn that asbestoses the rteeseeiTy prerequisite far the association vrith eexoiacna, that the prssuas of ssbestos fibre In the section, vs proof of erpusure and that asbestos sorters as a olaas vexe not sueesptlhle to earedacna of the lmg. Br* Paul Cartier teas Thetford Minna gave hie paper on pulaonaxy censer effecting ssbestos He eas good --"-^e* to give as eoplss of his tshlse ehtah ere included vrith this report. Is fkr as this study goes no relationship eith oarcinons eas dananatratsd la the asbestos sorters of the Thetford area or the eases of asbestosle oocun-ing la the eining era*. I eould prefer the opinlai ef s British Medical Statistician an these figures before m--ltting itself a the subject of this paper. Incidentally the figures given refer to 53 autopelsd voxtara out of 300 eho hare died in the tea year period stated. Ft Psxtt f the Sansao Laboratory otoeerved that Ih the WMBtioeed rrmher ef large aeea tor hi* shoeing Mbeitrmi sad rurmirtnee the grseth vrsa related to the large bronchi. Prcfessor Lynch, Profesaor of Pathology In the Medical College of the State ef South Carolina xoportsd that he had seen his first case ef aasooistinn ef aabcstosla d earoinona in 193V (first tonhdals ease 1952), end that ha bad seen 5 oases (&) altogether In k6 lmgs eisirinsd. His final rnsvert sag that the evidan* supports suspicion and that the available inforaatian dose net allay -p<<*'" Be aention ess usds of the cxperlaaata noe pmneoling an aloe in the attaapt to shew a causal relationship between pulacnaxy ti--ura and asbestos dust inhalation. Dr. Merssether opened a discussion an this sdsjeot with a reiteration of his previous stationta vrith meant nuueal additions of oases reported. His Continued. n/M-1 n-0017 3 failure to sir* a yardstick other then the silicosis autopeied gmip u adversely eoeaeanted upon, tad his failure to prodaos mmbers of sorting population at risk failed to oonvisoo the Sjwpoolua that hla eerie* sa* ether thmi a aeleeted group of cheat oeaea shoe* death sea investigated microscopically. ia la roll 1sema to us the group asbestos sorters cn aboa autopay la mde la selective la that only the nbjeots aho die Of heart failure, acute and chronic thoracic iafectioa tad other groups likely to reveal a relationship aith asbestosis szo regularly autopslcd. The surgical group of deaths, the trmaaatio deaths cad the obviously nco-aabestotlo ferae ere seldom Remitted to pnot aurtea exairlnation cad their number la aiknoon. Ihllo at Serene* Lake I act Da, Va. X. Sadth of the Department of Zadootrlal Medicine Foot Graduate Medina! School of lr lexk Dai-varsity. Se la the secretary of the Cwnoor Preventive Cosmlttce of the 0.3JU aad he expressed great interest la aqr figure* relating to the population at risk la ffmtMele during the past tmnty-teo year* aad the atmbers of long earslnaeeta reoexdsd. As the subject of pulmonary eerolama la almost of headline iatereat at tba mommit ead every avenue, industrial or ethenrlse, la being explored la search of olnea, the Admission of the etatlatical material shlcfa I have eolleoted to a oanpetent medical statlstlolea veuld, eeea to be a aattar of urganay, Z eee able to help Or. T* Smith to a fuller appreciation of the nethod of oolleotlng atatirtice on aabeartoeia over here* TMa erne a subject vfcich had greatly pooled him ebsn he visited this owntry la 1315 in qpest of each 21a foil report la included la the Fnooeedi-nga of the Csaoer Preveattro Caealttee a eopy of uhleh la attached* Ttx, (MLth la a much reapectad authority on the euhjeot of Industrial Ameer la the C.SJL. end la la a position to miadt to hla OonittM acj iafoxawtian of Tales la field sooeuezlly revealing the eouxoa. Xt mould be possible to mice through Mm a ^ eontrfbutiaa of value am the cAJeot of aabeetoela end *an**r evem though pchlteatlfln ten delayed pending fuller study ef the materiel m the tardiness of the usual channels. C liVic.l On the nheei iwl side ef the study ef pneueoecnleeia ee sere reminded by a sotnd physician, Dr. T.3. McCann, Professor ef Medicine ia the Uuivexslty of Rochester M.T. that the erawrintng doctor oould sake hla ocntzlbutlaa end should bo the central figure in this field. Me eas the oo-onilnator of the various Inatnnantal studlee ead eealA best assess them. Dr. MeCem brought the Symposia* back to nodical phlloeoshleal ooueepte elth ell the poser of a persuasive speaker cad a gifted ead obviously beloved ^jslaiexu be reminded the neeting that the heart also lived in the eheet* The aspects were discussed on the day. These naturally had reference to the practices currant In the Q.3JL vfasre there sere great legalist!* dlffaranoea beteeea the States. The value of Msdlool Boards as aeeeeeors u salntalned by ease grwpa ead equally dlatruated by others aho do not Uks to see either the ecatera or the Insurers laterest subjected to a tribunal vtthmit appeal. It vaa mainly a reoord of ilfferaneea of State usage, of ocnfllot of Federal and State interests, aad of the degree to shlah politic* eon invade the laduetrial Ufa of a democratic state* It eas aotseurthy that the layers spoke with greater prealaten aad assurance than the doctors aho must have souided sect tfiaeianttnoany vague to the lesyen. Their of nodical tana - already In dispute among the doctors - seem to indloato that the legal meaning of these see in no dtaftt vith Continued. \ l \\ n/!q n - 00172 -k- Xa his ocnalading resort* to the Syaposita Dxw A* J enreld emaerated the points of grm--nt nd difference efaich bod oaerged and stressod tha Tlae of rash joint do! fherotiana to oil the interested parties* Ha hod boon in ottaodeaoe for tha fall period at over? cession rad bad shorn an adaiTable tolerance cad foxbaoraaoa as veil as qualities of leadership* t, 7* Xaox* \ \ \ o.^q- i o---tt(n? SZXZSAI. EBtAHM, la nob a gathering of people a* occurred at Saxenao Lake it vaa natural for there to be aaob private ocnteot between various interested parties. Za the man abctrus* and detached eaimtlfio wort it oould b* appreciated that seat of the worker* proamt vara of Mgh status and that tbair views vara sot eoloured by political, insurance or labour actives. For tho rast ahooa interest aaialy centred axomd the applications of these principle* it vaa obvious that opinions vara coloured by affairs. Za tha field of oeal slnlng where vast mafcexs ara oaq^layad and powerful intaraats ara la oonfllct thara vara tfaoaa vbe adbsltted that thair Tisva had v aado than unpopular tad others again aho had profited greatly fro* these elashs*. Za ao field vae there mean obscurity* aore vagueness in all phase* of its dissuasion both in public end private than in the field of asbestosls. Bare ve enter a territory shore the following propositions sees to apply. I. thara are no gmerally aooeptad clinical standards for different degress of tha condition. 2* Xo agreed pathological standard* on autopay arterial. J. Xo agreed standards of inpaiment of pulmonary fraction. Km Xo vital statistic* prirtlahed giving comprehensive information* 5. Xo aooepted X-ray standard*. (Pi* P2 i4 il i2 e7* tha thaoratioal standards but th*y are not agreed in particular instance* and do not oorrelat* with 1. 2 *r 3). < Xo kneeledge of susoeptihl* types. 7. gelationship with loot olearly defined. Com view sftich prevail* in Bonhdala ha* not. oving to ladk of pahllahed data, oven boon oonaidared al share. t. Tact* an tha m*jeet of esbestosls as between fibres of different origin are not agreed. 9m the terit on tha axparinental tniaal 1* agreed as of saae valna a* a guide, bt there la no rsiifoxni^r in tha application of this vert to Industry. 10. British figure*, which ar* *o*tly Xarewethor4*, hew bem eo amh at varloao* vith iaarlcan experience that swan when elucidation is attempted by their author hlaself no oorrelatian is evident. IX, Differing dust oomt practice* her* and in 0.3*1. greatly Increase our difficulty in judging safe Torts dust concentration*. 12. Xhe leak of oaepnhanaive study of autopay aaterial, as regards the awomt end. range of fibre else it oontaina, prevmta a link up being node between hums md cxperiamtal asbestosls. Za yMilto it vaa stated by Dr, Toreeld epeelring under the ohainienahip of Dr. Hatch at tha Mellon Institute that tha nueber of people at risk In the U.3.A. to inhalation at asbestos duet la Ccntiniidl Q -- 1 H- ^ 0 T 7 1 2- industry was 1*500. Dr. Lansa la private agreed with this but others* notably Dr. I. ikLth of the J.-tL. Corporation* Dr. Hooper ini Dr. w. 5. adtb oanslfler that the zaabar sight bo la th* region of 55*000. This largo diwergsao* Boat bo due to a ocnfllct of Interest. Than are no scheduled areas* as re know then* la tbs U.SJU and bo Fneinwocniosis Boards ecndayting regular owlnations. Th* P.B. *s wore arltlcad far not pub! ishlng their standards and despite assurances trm Dr. Karoosthar that the British Standards were Juet. fair and medically orisnnmnos ones* which worked all the bottar la practice froe set being fully or publioally defined* questioners st Sazanss wore far frw satisfied. (Xereewtber's final retort to a nan oho asked a question an these lines three tines oss *1 think you sre haring Just as such difficulty la ftasdng your question as Z an haring la answering it*. This oas eossidered s olatslo riposte and got the biggest laugh of Ihe mating). la regard* th# ptfellcatlcn of the Saranac work on hussa ssbeotasls I reoaired ovnsire replies. It is possible that nook ef the aatorlsl used has eons free sirring areas sad olll net bs fully applicable here. Is single institution la lurries has bad assess- te a large and rspressatstlrs amnt of pathological notarial sad asst people lasa bearlly on the wort of Qlayns she is widely patted both with sod without soknmlodgnoat. Vs Wests surreys an the populations of say ashestoo works tar soapsrisen with Kererether*s original report had been dons. Sre X. Smith of the Cerp. had oontanplstod this but bad not get uonl to it yet, so re were tsahla to oonpars notes on this sAJco*. The experlano* aeons mirerasl of tho sffsot on the worker ef s diagnosis of asbestos!*. ill are agreed that it is bod and ems to affsot bin both physically and payohalogioaUy. Zt is the one point at onanislty at British and iaorlcaa dootora an this sofejest. The best Inform< Works Doctor whoa I net was mdochtadOy Drw X. SkrLth ef the Corporation. Els srpexisne* extends orei" both irinlng aad Industrial tortile pninnaaas Zt was through an inritatlm flun bln that I was able to inspect th* Works at Asbestos aad I was fortunate In barring hln as a golds before bs takes up Ms nar appolntaoat as the first chief K.0* of th* J.-d. Carp, with heedquarters in Wow lark. Os ths si&Jeet of dost oountlng I found tbs ststssants ssds ary erwrfaelng. The Cresaberg hsith nrthod gsnerelly used Is a wwtnwtbod. I bsre nsds technical details of this nrthod awailahls to Xre- Dawson sad Dr. Holms In our Research Departmnt. Xr. Dawsoi will report- on its corral ail onship - if say - with our Thsxaal Precipitator nsthod. In ths absonoo of nrthod* to n goat In the air at th* Works th* known risk must be aassesed as accurately * nodera nethods allow. Method* of dust eraouatlon can only be Judged sdsctifloally hy the nest careful dust oountlng nethods. these do not appear to be praotlaed la the ttaited States or Canada In a routine way. P Know. i f)A q -Til- 00 I