Document rxpay62paJq6EzzMMy1Le52mq

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 s 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 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 inferred Pub- lished 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 ~ * JSTRIAL HYGIENE HYGIENE FOUNDATION OF AMERICA INC ance Memorandum ... for the Q. A.M.A. A.M.A. A.M.A. o ~ a 2 al , 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 asbestos 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 a _ USTRIAL USTRIAL USTRIAL HYGIENE FOUNDATION OF AMERICA INC Memorandum ... for the M. 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 it was apparent obtainable that extensive and detailed information is with respect to this group \ N\ 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 SE Oe ee map E e e NDUSTRIAL . a a HYGIENE FOUNDATION OF AMERICA INC ee 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 result 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 subse- quent 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 seg- ment 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 n, cpa cece TER ne RE EER OLN ARE ME TT RR ES AMMO NNO RE rumen 6TRIAL HYGIENE FOUNDATION OF AMERICA INC Memorandum for the A M. 5 y < 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 20,000 U. S. currency including all travel expenses and the cost of preparing and printing the report EXECUTIVE EXECUTIVE OFF MaNVILLE GORPORATION TWENTTWYENTY TWO LAST FORTIETFORH TIETH STREET NEW YORK 16 NY NY 13 13 etsivunia in the ,, ,, issue Vol 12 No. 8 of the mustrial tothe, rest Soon la an article Item o 988 entitled sbestosis onary Dubormlocis which appears to be of interest to 4 us Bade ew Was Qo lami) written in French but translated into Vo ali in the ritish Journal of laiustrial Redicne Redicine 1 wonder (2 on could supply me with three copies of his article director of romel .olicies 4 RETIRE Heo hy mee eb oe tem ne ota, ape nant wee October 6 19 Mr. Vandiver Brown General Counsel Manville Corporation New York N. Y. Dear Mr. Brown This is a memorandum following up our recent conversation regarding the possibilities of a mail campaign for new members for Industrial Hygiene Foundation The day before I saw you I had a long discussion on this subject with the McGraw Hill people This reputable organization offers a direct mail service as one of its activities and maintains accurate lists in connection with the publishing of its numerous journals in different lines of industry David F. Beard Sales Manager of the company's wirect mail division suggests we utilize 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 and 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 this We would draft a letter to submit to Mr. Brown for his approval and for any revisions he might care to make and obtain permission to send this letter out on his company's stationery and over his signature he would buy the 1,000 letterheads and envelopes from your company and McGraw would have the letters signed by one of their expert permen who duplicates signatures accur atoly 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 secretery could turn over the replies to us and we could handle the resulting correspondence from here explaining that they had been referred to us by Mr. Brown There is nothing new 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 e mutter of fact you may recall that we have used this plan from time to time on a smaller scale with trustees of the Founustion Founustion signing letters we prepared and send- ing them on their own stationery This is simply approaching the subject on a larger scale than would be possible without outside assistance There are many indications that the time is ripe for vigorous push for new members As a matter of fact @ had hoped to let some promotional mesures started earlier in the your but the project was delayed by the legal procedure of changing our n'me There would have been no point in making a big membership push under the old name when a change was pending . Caan al *~e ~y . Mver Mver Brown wen awe e October October October 6 1911 1911 Now of course if the Found tion were a commercial commercial enterprise or controvercontroverssiation iconatrotveirsioatinon we would not consider such a request But the facts facts are that this Foundation combined scientific research and service institution for protecting the health of constructive and progressive workers is probably one of undertakings which industry the hever hever most hever sighted 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 removes the cause for governmental edicts and policeman Because of this we are hoped that Mr. Brown will make the contribution of lending his name in en efort to bring this Foundation and its work to the forceful attention of top industrial Mengement Mengement so that it may derive the support it deserves this nemo in advance to have ne It is not likely that I will be in New York in the near future hence We would like to get action on the proposal so as to start this mailing of our annual Besting November 12-13 On the other hand if you care present the project to Mr. Brown personally will be glad to make a special trip to do so Your assistance will be very much appreciated be Sincerely yours JIM F. McMahon Executive Secretary ony Memorandum Re Prospective Members 2 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 Cluses Cluses 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 extensive 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 , ; } de atte iia teak ri tes ee . Seer laidigietime 8 OS : hab ee WEE ae , , tae Re ee August 23 1957 Mr. Hugh M. Jackson Manager Industrial Health Program Corporation Johns 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- having completed literature . As a matter of fact the 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 exampleof 99 cases which had been re- ported up to 1955 at least 80 appear to have occurredinasbestos workers other than miners A number were women and the occupations given lagger pipe were weaver carder mattress maker spinner etc. bagger coverer of that Two specific articles which mention the type exposure and the job that by Doll and that by Isselbacher al2 Seventeen cases studied by Gloyne and 31 reported by Merewether as well as three 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 engaged asbestos helper mill in cutting and sawing 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 proofing to . the manuscript and this month go It should the print shop by the end of 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 ee References 1. Doll .: Mortality from Lung Cancer in Asbestos Workers 2. Isselbacher K. .; Klaus H and Hardy H. .: Asbestosis and Bronchogenic Carcinoma Am J. Med 15 721-732 November , 1953 Incidence Actiology 3. Doll .: Bronchial Carcinoma and Milroy Lectures abridged Brit M. J. 2 521-527 Sept. 5 1953 tee i J. M Aba September 23 1948 Mr. J.P. Woodard Director of Personnel Policies Manville Corporation 22 East 40th St. New York 16 H.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.E. Stechert & Co. 31 E. It is simply identified can probably secure this 10th St. New York N.Y. as Sem Hop article through Another source for foreign publications is the H.W. Wilson Co. , 950 New York N.Y. University Ave. 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 JFM 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 Desmeules Asbestosis and Pulmonary Tuberculosis Amiantose et tuberculose pulmonaire N. Giroux M. and Richard P. 1947 Sem Hop Paris 23 Asbestosis and Cancer of the Lung Amiantose et cancers Desmoules 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 res- piratory symptoms only during the last three He complained of cough and an asthmalike 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 s con 2 _ movement of the fibres results in microscopic bleeding from damaged alveolar walls the 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 Desmoules Rousseau Giroux and Sirois 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 ) coe Taken directly from British Industrial Medicine Vol p 100 April 1948 Journal of 5 No. 2