Document pBppOK5p2M1p5zY8G3anw0oV7
FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY019
DOCUMENT DESCRIPTION: Transcript of Presentation by Dr. Cartier, Followed by Discussion
TAKES FEQM P/.GS
M asters of th la Sysipoaiwa* Sot being a s t a t i s t i c i a n , n e ith e r an epidem iologist, I don't t& ial I ehoold have aeoaptsd to pro-i.-sat t h i s paper, bat I th in k , to azousa s y s e lf i I gay tSv.t t h is s t a t is t ic s and s e a t o f tb a papers I m pressntixsg hae bass srirloifad by pour s t a t i s t i c i a n in M ontreal and Hooter P h illip s , o f f ic ia l a ta tla tlela a fo r H-atioaal (baser In s titu te s i Canada in Tsrento, so X v '-^Xd lik e th a t tSsssa fe/ts xpeits taka the rsapcasiM liigr o f te a statem ents X n ig h t oawsnee.
So I Kis lovit.su to p ra s s u t th is pap***' ea tfee paXasnoxy oanear in -ft eabsstoe sdatng laS aetxy, c a t on cocosmt o f aay z>paial. q u alifica tio n # only because I feagpan to be in eharge o f a c lin ic vMch te a , as a p rlaary f emotion, to Miporvice th e p ris a ry condition of fo u r thousand asbastoa is ta s rs , euoh a grcnip c f atrsAvfl o fferin g
m.
BY DOCTOR RHOADS1 The n e x t p a p er on th e Symposium
paper already d iscu ssed by Doctor Hueper.
concerns the I f we c o u ld
j
j
have j
a l i t t - o q u ie t , i t would oa vary h o lp f u l f o r th o se who are j
p r e s e n t in g p a p ers# D o cto r Hueper has ask ed to commant on
D o cto r D rin k er*s rem a rk s. I t h in k we m u st d e f e r t h i s u n t i l !
we can g a t th e p a p e r s under w ay.
i
I v J11, th e r e fo r e , in trod u ce the paper on asb es
to s saining L Boa to r C 'r tia r # Dec tor C a rtier#
BY P0CT03 r.rsTTJX li
j
Hombor-a o f t h i s Tyisposium: N ot b e in g a a t a t i s - J
t ic la n , n eith er an e p id e m io lo g ist, I don't th in k I should j
have accepted to p resen t th is paper, b u t I think, to excuse J
n sy se lf, I sh ou ld say th a t t h is s t a t i s t i c s and raoat o f the J
p a p ers I sun p r e s e n t in g have boon r e v ie w e d by you r s t a t i s - j
t i c i a n in M on ire*\1 and D o cto r P h i l l i p s , o f f i c i a l s t a t i s t i c i a n
f o r ID -io n a l Cm. ,a r I n s t i t u t e o f Canada in T o r o n to , so I I I!
w ould l i k e t h a t th o s e two e x "n a r t s take th e r e s p o n s i b i l i t y [|
i
o f the statem ents I n ig h t advance#
j
So I a -c i n v i t e d to p r e s e n t t h i 3 >.; -r on th e
j
pulm onary c ^ ic a r in. th e a s b e s t o s m in in g in d u s t r y , n o t on ;
a c c o v a t o f -"^y r c i a i i a i . u i c a exon,
;a ca u ss I hupp aa ;
to oo in charge o f a c l i n i c w hich h a s, as a primary fu n c
t io n , to s u o o r v is e too primary c o n d itio n o f fou r '.ous end
a s h e s t 03 m in e r s, such a group o f e n tr a n ts o f f e r in g an
o u tsta n d in g m e ta llu rg ic a l ? tudy of cancer of the lu n g in
re la tio n to asbestos fib e rs
any o th e r r e la te d f ib e r s . ; j
In the o rig in of m inos, s ix d if f e r e n t com panies j
a r e d o in g a s b e s to s m ir in g opex'a t i o n a , so f o r m ore th- "
;
e ig h ty y e a r s , and sin c e 19^5# th e se com panies have o rg a n - j
izod the Thooford I n d u s tr ia l C lin ic w hich h as, as a p r i - j 1
mary aim , to f u l f i l l a program o f I n d u s tr ia l h y g ie n e ,
j
m ainly m edical and w ith d u st c o n tro l p ro v is io n s .
I
I In 1950, the concept o f an in h a la tio n o f aab as- j
to 3 f ib e r s end pulm onary c a n c e r was m entioned by many in - j
V 98tf g a t o r s an d i t was a t t h a t n o r e n t t h a t .-ha M e d ic a l
|
A d v is o r o r th e u o b ee A; '.>estos M in in g A s s o c ' t i o n , saw a d
v a n ta g e s f o r th e QB-ployoes an d th e e m p lo y e rs , to r e e o m e n d j
a company in v e s tig a tio n composed o f an e p id e m io lo g ic a l and
ex p arise n tal study.
T h is iepoi't i s p a r t o f t h i s s tu d y *
j
p i Th i t f o r a In d u s t r i a l C li n ic h a s b e e n i n o p e r-- j
a t I o n o n ly tu n e s I 9I4.6 , an d we h a v e r a d i c a l r c o r d s on fiv ;
thousand fifty -tw o em ployees, b u t th is surv ey is b ased only |
on r a a thousand nin e hundred f if ty - s e v e n w orkers having j
w orked i n th e in d u s tr y from two t o s i x . / y e a r s . A bout one j
thousand em ployees havo been r e je c te d from tills survey b o -
M ,, , 9 i hay have n o t worked lo n g enough, o r b ecau se tisey
'nava w o rk ed i n dr T e r e n t I n d u s t r i a l vr a d e s b e f o r e . B e fo re p r e s e n t i n g fcha f ix 's t t a b l e , I t h i n k I t '' a
183.
w orthw hile to aay th a t the la b o r tu rn -o v er in the asb esto s j
in d u s try i s one o f the lo w est in a l l the in d u stry in Cana da* n ean in g th a t th e s ta b le p o p u la tio n i s w orking in cur a in e and m oaning, a ls o , th a t in many a s p e c ts , i t i s e a s ie r
to stu d y and more re p re s e n ta tiv e # The f i r s t s l i d e p le a s e #
So as I m en tio n ed , t h i s
T a b le Number 1 shows th e age g ro u p d i s t r i b u t i o n o f th e
j
group stu d y and I d o n ' t th in k i t n eed s any comments e x c e p t j
to say th a t th e average aga o f o u r em ployees i s t h i r t y -
f i v e , a b o u t two y e a r s o l d e r th a n t h e a#-. r a g e f o r th o g e n e ? - j
a l i n d u s t r i a l p o p u l a t i o n , ->nd t h i s ta b l a w i l l snow ax so
j
t h a t 1 ,5 7 7 men a r e in c lu d e d i n th e age gro u p fro m f o r t y t o j -- u o v e r, in th e group wlisro th e in c id e n c e o f can c e r i s
more g oner si# Second -- r ?xt ta b le , please#
T his table* i n d i
c a t e s '''h e number o f y o u rs s p e n t i n t h e a s h e s c o s '~V-^ d u s trv by the to ta l number o f em ployees surveyed# Of courses
t h i s ta b lo is n o t as s ig n i f i c a n t as would be a ta b le i a d i -
e a t i n g th e s p e c i f i c .xp Xi'-e o f tb s so <unp1o y e a s , bn t a f t- o r
ItlfSXiy &'b dipIj-3 i t ll3.3
sd la p o r x i b l e t o - to ad d t.o re th e r i
th e : ./.'f o r e n t y e a r a s p e n t i n d i f f e r e n t c o n e * u itr a tic n o f f i b e r s , to w h h -h m o st o f th e em p lo y 003 *>**s-y t*>r- r\ '
and I th in k as a rem ark to o , i t is wovt.hM la to
t l - t two th o u s a n d , i m h u n d re d h a v e s p e u - more th a n te n
ye-ix-s in th e a3bos 3 in d u s tr y #
2& u
N ext ta b ! a , p le f^ e * The fo llo w in g ta b le shows a
c la s s if ic a tio n o f v ario u s exposures in the a sb e sto s m ining j
Indus tr y . R e a lise th a t th is c la s s if ic a tio n could be d is
c u sse d f o r many h o u rs , and p r e s e n t many q u a r r e l s , b u t I
t h i n k n o v e r t h o l e a s t h a t we n e e d , f o r many p u r p o s e s , we n o s d
a job c la s s if ic a tio n , even f o r the e 'o eu re asp e c t o r f o r
r e s e a r c h , so a f t e r we w ere s t a t i o n o d w ith o u r e n g in e e r *
|
we to o k th e a v e ra g e o f a l l th e d u s t s u r v e y made i n t h e m in - j i
in g i n d u s t r y and we d a c id e d j u s t to draw t-hi- t a b l e , an d
t h i s t a b l e hs.s a l s o , X d o n * t know i f i t i s o b je c tiv e a d
v a n ta g e , b u t h a s th e a d v a n ta g e o_ c o r r e l a t i n g w ivn o u r c-a.se j
of aobostosls* X want to s ta te th a t a l l the casos o f a s b e s to s is
h a v e b e lo n g e d - h a v e voxfcc; i n s h o p s , u n d e r t h a t r u l e , I d a |
s o r r y , i n t h e lo w e r g r o u p , a n d o u r jzm M y. eg w orked o v e n j
fre m two t o f o r t y --f i v e y- * r s i n t n a t .cn-1 o f s x p e s u r o ,
j
nov't^r d sv ex o ^o d s n a o b o s c o e ie -?hion a fo u n d b y p a t h o lo g ie s ^
or
d o lo g ists o r by experim ents, to be of m j sequence^
.aziy msd i e d se q u e n c e * T h is fe e b le , a s y o u may s e e , p r e s e n t s m i l l i o n r - r
t i d e s p a r c u b ic f o o t and ha p e rc e n t-ag e ox' f i b e r c o u n t*
S h is l a c ary im p o r ta n t, b-scauze from o x p e ria n c e to e ;~ -s r --
i n c , i t seems th a t th e f i b e r is tho o n ly p& thologi. o!
a g e n t , r o c k d r.a t n o t b e i n g - n o t b a i n .g r e p r o d u c e d in. !*ny
c uc.--r.3u s , p u lm o n ary f i b r e d a I t-M r \ i , o n ly Uil s rd w tit
I ______ 385*. .
n e e d me f u r t h a r e x p l a n a t i o n , b e c a u s e you s e e t h a t i s n o t :
c le a r* Evan th is m ight seem a l i t t l e le s s c o n c e n tra te d , j
b u t ju s t, th e seme we p u t i n t h i s w h o le g r o u p , b e c a u s e on j
fee gro u n d , dry wor^ and th e g r iz z ly man a re w orking lo n g e r*
tfcsy a re w o rk in g In more c o n s ta n t c o n c e n tra tio n , o f f i b e r s , ;
and I n t h e t h i r d p l a c e , b e c a u s e we h av e fo u n d a few e x c a p - j
t i o n a l c a s e s o f a a b e s tc i s I n t h a t g r o u p . S o , p lo & se r s - fj
member `oho c a t e g o r i e s , 0, 1, 2, 3$ 4 an<^ 5 b e c a u s e i n th e j
coming ta b l e s , th e y m ig h t h elp you to u n d e rs ta n d them .
j
The fo llo w in g ta b le s in te n d to In d ic a te in d ic sn o e j
o r p rev alen ce o f pulm onary can cer in d if f i d e n t groups o f i
asb esto s w orkers In com parison to d if f e r e n t c o n tro l groups*
The ta sk o f s e le c tin g s ig n if ic a n t c o n tro l group has b een ,
in th is c a so , as everyw here, very d if f i c u lt* ifs w ould have
w ished to be ab le to fin d a group In th e p ro v in ce o f uo-
b e c , a group In any o th e r com parative - com parable in c u s- j
t r i a l gSoup, b u t i t was im p o ssib le f o r th e fo llo w in g roesonjj
th a t in no o th e r in d u s tria l cit-ioa in Province Quebec, so j
l a r g o a p r o p o r t i o n o f th e a d u l t p o p 'o l a t i o n i s f o l l o w e d
|
m edically so c lo se ly , because I th in k I should m ention to j I
you th a t about th irty -th . - about th ir ty p e rc e n t of the ;
a d u lt p o p u la tio n in T h alfo rd are w orking in tho m inos, b eing
tk a o n ly i n d u s t r y , so we c a n ' t h a v e a v a r y c l o s e su p ax -v iso o :
o f th e fu n c tio n o f tho - o f the c o n d itio n o f tho lu n g s*
y t r i e d , w ith th e mass s u r v e y , to da t a c t a com-
36 6 .
p a ra b le su rv ey g ro u p , b u t I d o n ' t th in k i t was o r i s pos-- j
s ib ls , because in th e P rovince o f Quebec, very few a d u lts j
o v er f i f t y y e a rs o f age a re ta k in g aav& ntage o f th e mass
i
s u r v e y . As a m a t t e r o f f a c t , th e m ass s u r v e y made i n T h a t- j
fo rd p in es in 1950 by the P ro v in c ia l D epartm ent of H ealth , j
d id not d e ta c t a s in g le ease o f pulm onary c a n c e r, e ith e r in j
"ha g e n e r ic o p e r a t io n o r In f c r t e e a m in o ra who h av o b een j
X -rayed, so having not succeeded in s alec tin g a good con" j
t r o l g ro u p f o r th e r e a s o n j u s t m e n tio n e d , wo h a v e d o e id e d j )
to m ice coic-.-arativo stu d y o f in c id e n c e o f th e pulm onary
cancer in d if f e r e n t groups o f a sb e sto s w o rk ers, which c m
b e s tu d io d w ith th e same m ethods and w h ich , a t th e sa se I
t i r e s , w o u ld p r e s e n t s u f f i c i e n t c h a r a c t e r i s t i c s t o b ^*4 * n lfieaat*
Jj
The n e x t ta b le , p le a s e . This ta b le in d ic a te s, th e i
p rev alen ce o f pulm onary to degree and le n g th of shows th e p rev alen ce of
cancer according to d o g ro e exposure and by age: This
J 01 l*ngtuty
l.-ibie
pulm onary c a n c e r in th e &roup w ich j
sev ere e x p o su re , t h a t 's th i s g ro u p , and t h i s i s more or la s s ;
a ecu': r o l gcuup*
,i
T h i s , we have s i x c a s e s o f p u lm o n ary - o f p r im a r y i
Tsulraon&ry c a n c e r and f o u r c a c ^ s , i n f a c t , i n th o * oup en ~ 1
po5od end t h i s , o f c o u rse , th e number b n in g s m a lle r, i t
j
g av e us a h ig h e r i n c i d e n c e , b u t i f we p ls o ta k e t h a t , t e
have to adm it th a t th is d iffe re n c e in in c id en ce is n o t, h as :
____
t I
no s t a t i s t i c a l v;'-'-ue, b e c a u se I t l a n o t more o r e q u a l to
tw ice the secondary cond itio n *
N ext, p le ase * T his ta b le was made a t th e sug
g e s t i o n o f D o c to r P r a t t , who was i n t e r e s t e d to know th e eom i
p a r a t i v e in c id e n c e i n g ro u p o f e m p lo y e e , o f em p lo y ees who
have been exposed to a s ig n ific a n t degree o f exposure.
C a te g o ry 3 , J4. a n d , g iv e n a s l o s s - a s cne y e a r , an d as
a con' o l g ro u p , wo t. :e th e g ro u p o f em p lo y ees w ith any j
k in d o f e x p o su re , b u t o f th e C a te g o rie s 1 , - 0 , 1 and 2 * j
l
D octor P r a tt had in r `a d , In su g g estin g th a t
j
i ta b le , th a t tha fa c to r exposure to sever 0 co n ce n tratio n o f i
aa^esto s fo r any le n g th o f tim e m ight be as s ig n ific a n t as J
th e f - ; to r a f o s s to s is i t s e l f , m eaning th a t i f th ere i s a
p o ssib le cau sal re la tio n s h ip , the in h a la tio n o f s u ffic ie n t
d o s a g e o f a s b e s t o s f i b e r s '/s ig h t b e a s im p o r ta n t a s th e f a s - j i
t o r a s b e s t c . i l s i t s e l f a n d a t th e same ti m e , I th i n k wa have j
th e two e x tre m e s*
j
I n t h e p r e v io u s e l i d e , wo h a v e r u n w ith s e v e r e j
i
e x p o s u re , th e in c id e n c e o f c a n c e r , pulm onary c a n c e r i n man |
v th sev ere e x p o su re, and In th is - In th is ta b le , we have |
men In th e group 2 w ith v e ry l i g h t o r v ery l i t t l e exposure ;
b u t w ith s u f f ic ie n t dosage o f - o f dust*
I
Next ta b le , p le a s e . This ta b le In d ic a te s the
p rev alen ce o f pulm onary c a n c e r In a s e r ie s o f f if ty - th r e e
au to m ated a s b e s to s w o rk e rs . T h is a n a l y s i s , a l t . gh n o t a s
3-33.
Im p o rtan t as th a t o r D octor M erewether o f G re a t B r i t a i n , j
i s b a s e d on q u i t e a s i m i l a r b a s i s and I woulc t h i n k t i i a t j
th is group is le s s s e le c tiv e , because th a t is no s e c tio n j
a t a l l . T h a t *a a l l th e c a s e s we m e a n t t o a u to p s y a f t e r
j
1 - from f if te e n y ears and over in th e in d u s try . A gain h e r e ,j
the d iffe re n c e is not as b ig as i t lo o k s, because a f ta r
u s in g - u s i n g th e stan d aiv * t h e r e , w came t o a d i f f e r e n c e j
o f a b o u t o n ly .5 betw een th e two c ro u p s , th e g ro u p w ith
j
i
a sb e sto a is and group w ith - w ithout a sb e sto sis#
j
I can n o t an sw er why th e r e i s l e e s c a s e s o f c a n - j
c a r i n t h e a s h e s t o t i e g r o u p , b u t I t h i n k t h a t i f we c o u ld j
j
h a v e a u to p s y on e v e ry .m p lo y ee who h ap p en s to d i e , we m ig a tj
g o t e i t h e r a d i f f e r e n t p i c t u r e o f maybe an i n d i r e c t eacpl-ia*-j
a tio n *
Ilext ta b le , p le a s e . Ib is ta b le was made f o r th e
pu rp o se o f knowing i f th e r a t i o betw een th e num ber o f c a n
c e r cl. ith s o u ts id e and th e pulm onary can c er d e a th s was
gcsauwhat d i f f e r e n t from th e r a t i o o b se rv e d i n a few o th e r
c o n tro l groups* F ir s t, I th in k i t should be m entioned
th a t n in e ty p ercen t of the esses f o r the C ity o f M ontreal
an d a h u n d re d p e r c e n t o f th e c a s e s f o r `-he C ity o f T h a t -
fo rd M inas, are a u to p sie d , are p o st m crtun e a se s, so th a t
i s uhy I say i t i s d i f f i c u l t to c ` 're.
woi ch or o p o r t i o n f o r th e P r o v in c e
C lb
f o r tJio xb e v in c e o f $\ibG, th e st-i i a t i
I d o n 't Jav la
rt if'
rt^V.
9*j
e p i d e m i o l o g i s t a t th e sam e tim e t o l d me t h a t l a s s th a n t e n | I
pe reerr':' &re p o st-m o rte m c a s e s , so t h i s m ig h t b s n o t corn--
p a ra b la to a la r g e e x te n t, b u t I th in k i f th e r e was any
s ig n if ic a n c e , we sh o u ld e x p e c t to have a b ig g e r v a r ia tio n
in the percentages* N ext, ta b le , p le a s e .
In s te a d o f com paring the
annual p re v a le n c e on in c id e n c e o f pulm onary can c er in the
p o p u la tio n of T h atfo rd H inas w ith the in cid en ce in o th e r
c o n tro l groups, D octor P h illip s from the fcnlional Cuncor j
I n s t i t u t e o f Canada has su g g e ste d to work th is num ber, th is j !
ta b le , w hich i s baaed on th e f a c t th a t D octor D onning has j
found i n a random p o p u la tio n o f ls.8,833, an an n u al in e id e n o e j I
o f sev en cases fox1 each hundred ousand o f p o p u la tio n ,
j
g iv en a y e a r expectancy o f seventy*
1
i On t h a t b a s i s , T h e t f o r d H in e s , w h ic h i 3 a v e r a g e j
p op u lation o f 15,00 0 f o r the l a s t tan y e a rs , should have j
tu n ea: :-s h o t - -.an - t w e n t y - f i v e c a s e s o f p u lm o n a ry c a r e e r # j
(md th e a c tu a l p re v a le n c e f o r te n y e a r s , t h i s ta n y o r s , j
th e a c tu a l p rev alen ce is nine cases* In H o n traal, w ith
i t exp CO >ncj o f s i x ,
I n s , 0.3 you 0 ^ 0 , 1
i wor thw hile to
;
'lit, in a t e c o r h u n d re d th o u s a n d o f p o p u l a t i o n v afisS cA ij
the d 0/ , .
;...nd i n 1 9 5 0 , i t h a s r e a c h e d 1 2 . 0 .
3 a c u -4i--
In c o n c lu sio n , th is p ap er h a s n 't b een, by any
j
means, tho in te n tio n to b rin g th e f in a l answer to the p ro b lem o f th e f i n a l re ttio n betw een th e in h a la tio n o f a s b e s -
I b e r s and. th e d e v e lo p m e n t o f p u lm o n ary c rn ic e r, o u t X
th in k th a t th i - incom plete stu d y , I m ust a d m it, may have
found one o f the m ost r e p r e s e n ta tiv e groups o f a s b e s to s
wo: k e r s , b e l i e v i n g t h a t th e d a t a c o l l e c t e d i n T h o tf o r d
j
K inea do n o t
to in d ic a te a caused, r e la tio n s h ip , and j
th a t i f i t be so , th a t the d a ta do n o t c o r r e la te th e d a ta o f D octor K erow ether in G reat B r ita in * Thank you*
(A pplause)*
B Y I.--DITlO--1C" T O tie r of
R' R H O A D S * I'm cu rio u s to observe
th e mass su rv ey em ployed
the rem ark o f in h is group,
i| Dos to r C a r- j
i did not ro -
vcal any p a tie n ts w ith e a rly pulm onary caneor* I m ust
p rssu ita th a t th e mass su rv ey was n o t s u f f i c i e n t l y l a r g e , j
so i f th is m eans, a f te r a l l , fo r p ic k in g up a d ise a se w hich| i
i s t r e a t a b l e and i n many in s ta n c e s c in ? a b le , may n o t have
bsen su fficien t* Ija also v e ry c u rio u s ab o u t th e f i f t y - t h r e e
a u t o u s l e d i n d i v i d u a l s o f whom t a n h a d p u lm o n ary o x c o r * I th o u g h t th ey wore a u to p s ia d V c>iuaa i t was t l x , . 1 th e y m h av e h ad pu.lnon.aiy c a n c er* I t was >t a r o u t i n e a u tc p ay?
BY DCCTOR CAR "1R: ho*
BY DOCTOR HP.PADSt spa th e re any q u e stio n s on th is p ap er?
391*4
i
i
(No r a - |
sponca). Of co u rse , the im p lic a tio n . j c la a r th a t th e re ls | no danger o f pulmo n ary c a n c e r from th e w o rk ers in th is p a r-j
tic u ls r group, and perhaps you are rig h t* I t appears to j m t h a t a s b e s t o s i s i s a v e ry h e a l t h y a i l m e n t a s f a r as c a n - !
c a r i s c o n c e r n e d . `I h a r s seem s to V-e no d i s c u s s i o n . I
1Y DOCTOR PLATTS: liy name i s f l a t t o fro r- K irk a a n L-ake. I t s o s -
s e n t i d i l y a g o ld m in in g d i s t r i c t , lJ-3 now h a v e an a s b e s t o s m ine i n th e Town o f B a n v ille n e a r M ad iso n . I d l i k e to auk
t th e d o c to r vh& t h i s f i r s t s ig n s - I moan V' h a s n o th i n g t o j do w ith c a n c e r - b u t tthat he lo o k s f o r f o r in d ic a tio n s o f
tro u b le frem asb esto s?
BY EOp."CP.. RH.Cl.p 3 : Tlio q u e s t i o n i s , w hat a r e th e f i r s t i n d i c a t i o n s
o f tro u b le from a sb e sto s exposure* Can you answ er t h a t ,
S ecto r? BY '.DOCTOR CAHT irH x
I don't think there
5.3 an y s p e c i f i c
ji I symptoms ox* j
n2 r.c tu a l'.T chX'jiges In th e - i f th e f i b r o s i s i s e x te n - :
s iv o e n o u g h , t h a t i s d y sp n ea -xud c y s tu o s is , o n th a e x t j d c ^ c o , b u t * '.at i s , fo r a a b e s to a is , in ay e x p e rie n c e , s# have Jiad about; - I can m e n tio n , we ' -ve n in e ty - e i g h t e a s e s o f as., j s t o s i s i n o u r group and o n ly th e g ro u p w ith laarkad
592.!
e x p o s u re an d ns&ny - f o r many y e a r s , -nd many t i n e s whean
th e y s t a r t to re a c h f i f t y - f i v e and o v er, th o y ^ re more
d y s p n o a c , emd I t h i n k th e m a in t h i n g , th e r e s i s t a n c e to i t ,
th e y Boom to d ie m ore
va& rs w ith o u t much o f " th e y go down th e h i l l
r a p i d l y or. a th e y r e a c h f i f t y , s o v e n ty
j any d is e a s e , W ithin a few m onths, j
I
very ra p id ly ,
|
BY DOCTOR RHOADS t
I
*?bat do they d ie o f?
BY DOCTOR CAaTTSZi; 'rfc.ov A le , soma fro m c a r d i a c an d fro m g e n e r a l i s e d |
m is c e lla n e o tr d is e a s e s , and sons from b rc n c M o c fcasis, 'out I don't th in k , in ay experience, there is any sp ecia l p ic
t u r e e x c e p t t h a t in a few , i n two o r th r e e m o n th s, th e y go
down voxy r a p i d l y ,
m doctor duo id s *
fo e to r V orvald w ould 7 ik e to comment*
j
BY I>tO?OR VCFisALD:
!
I * d l i k e t o ccn raen t j u s t a b i t , kJa h a t e b e a n a a i
couraging D octor C a rtie r to continue or p -rau e ti-.J study j
i n rhv r-.i or d, V;a 0*0 pro-
miolcgic al sur\ay i n a
. the min k g o f ash (y-y.j '.03
Of c o u r s e , I t h i n k you r e a l i s s a -oeCxior C U=.rs d i f f i c u l -
ord, Kh3ra ha ; .'St, r a i y
n , a;Lia ye d e b a tod how tlxa
332m
incidence of cancer in his exposed p o p u latio n in T hatford
m ig h t h e i d e n t i f i e d , a n d we have u g g s s t a d , a s h e d i d , r e - \
view al o f th e c h e st Roentgenogram s, of a l l th e se c a se s, thej
hoantgenogram s having been taken d u rin g the l a s t p e rio d o f ;
f if te e n y e a rs . A dm ittedly though, th e re w ill be a number
o f c a s e s o f p u lm o n a ry c a n c e r m is s e d b y t h a t m e th o d , We *
have co n sid e re d sputum exam ination o f a la rg e p o p u la tio n
*uoh a s t h a t , b u t a t th e moment, t h e b e s t v c a n do was
su rv e y and s budy th e efcost R oentg^ nog razss o f t h i s ra rg *
a e r i e s o f in d iv id u a ls 'jtpooad to a s p o o ls ! in d u s tr y ,
^vtr
Ol .,t
-----i i*t
rr>V- ' * *-ui w '- v .-A *
* m .vm****r mj<.
And you d id n o t p ic k up any o>ncer, 1 ta k e i t ,
so doing?
gy EOSTOR CARTIER: Oh, yoa, from th e X -ray ,
j
j | j 1 | i ] I<
1 j
in i i) ` i
BY DOCTOR FKOABS:
A*A"v/A'.t y o u r surv& y? !i
3 Y tor ci.m 'j m t
i
Y es - n o , n o t from no.2 3 s u r v e y ; *11 th e c n s o s h a v e
*bc 6n *-o te c to d i r th a c l i E i c ,
;
3YD0C
Y-; 1.'Vi.-- - ,
I im a 11 tf. l a p u z s lo d ab o u t t h i s , Th i 3 cam. b a a ;
v a ry i n10r a s t i n g to p i c . You ;ux'f n a s s s u r v e y d i d n 1t do i t ;
h u t th .o r e v ie w o f F" an tg sr.o g ram s 'r-h .jn \uietx i iid iv ld u Mls
:
ao u lied fc r icedical care?
_ 3 9 iu l
BY DOCTOR CARTIERS No, t h a t ' s a r o u t i n e e x a m in a tio n a t t h e c l in ic #
BY .DOCTOR RHOADS: How d o e s t h a t d i f f e r fro m th e mass s u r v e y ?
BY DOCTOR CARTIERt
I t h i n k I t d i f f e r s i n t h a t vhe p e o p le o v e r f i f t y
i
y e a rs o f age do n o t ta. 3 advantage o f th e mass su rv e y , b u t |
a t the c l i n i c , a l l th e c a se s have been d e te c te d a t tuo
j
c l i n i c a n d a f t e r t h a t t h e y h a v e b e e n f o llo w e d tip , a n d we
have t>" o a se s o f p o s t m ortem .
BY DOCTOR.RHOADSl
T h is i n d i c a t e s w h at we h a v e r e f e r r e d to b e f o r e i n j
a number o f d is c u s s io n s a t t h i s p o in t , t h a t somehow tno naaij
i
survey dosan't cone through to the a c tu a l d e te c tio n sad use j
:*f fcha d e t e c t i o n f a c i l i t y In b r i n g i n g th e p a t i e n t I n t o
icsdic.! h a n d s a y.4&ys#
Any f u r t h e r d i s c u s s i o n ? (Ho r e s p o n s e ) # I f n o t , j
we *11 p r o c e e d to th e n e x t , ap o r# *
J Eoc t o r K enneth. L y n ch , ?.s
d
i
y ou 'mow, I s f r o f e - o r o f p a th o lo g y an d Loan a t th e i 'a o l c a l j
Co*1oge o f S o u th C aro lin a D o c to r Lynch
!
f y _p o cloh ir r m n t
\
(D octor Lynch re a d a p rep ared papwr w hicn is on ;
f i l e a t the Saranac Laboratory )
I
r%i~ 'r-.r-. -i riwvs P --0 :
.
Thank y o u , D o c to r L y n ch , f o r a v e ry o r d e r l y an d '
m S N FROM PASS 394. rcftc* s m , Sc-cter I^ach, f&r a w ry oz&iriy and
o 3.9$.
I n ta r o a tin g p r e s e n ta tio n . I hoped to b e a b le to make a p e r t i n e n t c c r s o n t , b u t D o c to r Lynch d is p o s e d o f t h a t i n t> .'3!
l a s t p a r t of the ^ k . I g a th e r th e re is no c o rre la tio n
betw een th e e x te n t o f a sb e sto sia in your s e rie s and the
o ccu rr ence o f r.aoplas oic change?
BY DOCTOR LYHCHt In our s c r ie s , D octor Rhoads, the throe c a se s,
now, rom ejabar th o r e a r e o n ly t h r e e * o c c u r r e d i n a d v an c ed
eases o f a s b e o to s is , n o t in Liinor c o n d itio n s where you
n e r s l y ranks & d ia g n o s is b e c a u se th e a s b e s to s i s jnight h e
p re s e n t*
BY TKXiTm REOAY3:
I I.jould e ,iic th o s e who a r e g o in g o u t i f th e y
j
w o u ld n 't mind w a itin g . n t il
take the photographs in ju s t; f
a faw m in u te s * D o c to r V o ru a ld , w e 'r e a n x io u s fcc ^ e s p a l l s *
p-ossib: 3 h are fo r the photograph*
;
Is th e re o th e r d iscu ssio n on D octor Lunch's
I h*3ar n o d is c u s s io n * D o c to r V orw ald an d I o o th f ^ e l , w-** * m u s e o f th e tirrse atvd th e n e e d f o r ta k in g th e photc.gr-apn, ;
we h a d o a s t poa tp o n e D o c to r H erewe t h i r ' a pap o r u n t i l a f i o r t
I lUiC-h, i,*vy v.or V o rw eld , do you c o re to s p a r k a b o u t t i p h o to g ra p h ?
BY DOCTOR VOYYALP : Y0 3 , wo w o u ld l i k e to ta k e a p h o to g ra p h o f th e
aro u p a s we a r e s e a t e d hex e . l a th e p h o to g r a p h e r r r r o ?
' J: $ `
(:io re s p o n s e )#
3
How, i f th o s e o f you who a r e I n >:ke b a c k , c o u ld
y o u cone f o r w a r d so t h a t we can r e a l l y g e t a p i c t u r e # T h ere a re a l o t o f s e a t s up fo rw ard and i t w i l l o n ly ta k e a fow
m inutes# I m ight aay th a t the photographer w ill p r in t
th o s e p i c t u r e s an d y o u may buy one fro m h im I f you s o w is h ; on th e b u l l s t i n b o a r u o u ts id e w i l l b e a p a p e r r- .e r e you m ight Indicates w hether you want one or a dozen#
(PhotOgTi /as ta k e n , a f t e r w hich th s m eetin g
was a d jo u rn e d # C o se . ->n r e c o n v e n e d a t 2x37 P . M)#
BiBIZMOCOHIOSIS AliD P U L K O K A R Y C A S C S R ^ C o n tin u e d ) 2 i > 0 to j
f'
5x30 ?#i-u i
Chromato W orkers
i
AnLIaony J . L an za, H D#
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D iscussion
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E x p e rim e n ta l Pulm onary "'aaeer - G en e ra l Hoviow
!
0# B u rro u g h s W id er, M# D
;
D iscussion
|
pwlraor a r y Choicer In B x p a r J - .u n ta l E x p o s u r e s t o C-hrcc.a to j
Aijiia. E a e t ^ a r , ScD#
j
D is emission
:
?um-i-vm-vy C -racor in E x p e r im e n ta l E x p o s u re s t o EM ?ylilon
A r th u r J . V o r s a ld , H D#
*' '
D iscu& aion.