Document vVZEpQB5rEOxLBkjdZz6gXknY

FILE NAME: Rogers Corporation (ROG) DATE: 1968 Oct 12 DOC#: ROG039 DOCUMENT DESCRIPTION: New Yorker Article - The Magic Mineral  T I53911115 A REPORTER. A T LA R G E THE. MAGIC MINERAL by Pavl Brodeur REPRINTED from TH E N E V YORKER hme of OCTOBER 12, 1968 T I53911116 TH E M A G IC M INERAL BACK in the nineteen-twenties, , when the word "ASUESTOS" frequently appeared in large block Jotters on the fireproof drop cur tains that closed off the proscenium openings of theatre stages, it was cuslomaty in certain ports of the country for youngsters attending Snturdaymatinic performances of *'Charleys Aunt'* or "The Vagabond King*' or "Mrs. Wiggs of the Cabbage Patch" to greet the raising of the asbestos cur tain with the chant "Alt school hoys cat stewed tomatoes on Saturday* " This was not, of course, an exercise in mnemonics but an expression of youth ful exuberance, and, to a lesser extent, perhaps, a reflection of the tendency in an era. celebrated for parochialism and flippancy to dismiss strange and exotic substances with jokes. Among older people, h was certainly common knowl edge that asbestos was noncombimiblc, for when "Joe and Asbestos-- the syndicated comic strip about horse rac ing'--first appeared in the Baltimore Surtf in 1925, the ftsblebuy named As bestos explained to the readership that be had acquired bis ndd monikrr be cause "no matter how hot my tips arc, they'll never hum a hole in your pock ^ 00^." Such knowledge was hardly universal, however, for it was also true that a popular put-on n the flapper age consisted of solemnly assuring a susceptible theatre companion that the funny-looking word on (he curtain meant " Welcome" in Latin. T he fart of the matter is tliat although asbestos wot linked one way or another in the public mind with fireproof theatre cur tains, many people thought its name was a trademark, few people knew that it was being utilized in a wide variety of inductrial products, only n handful id medical resenrrhers were Just thru be ginning tu sthprct (lui it wax ufftv ling the health of the workers who handled it, and virtually ntt one had nnv idea (hat it svilititi one day pmve tu he one of the most imjmrtaat indiKtritl causes of cancer in the world. ASBESTOS, which cornea from tlu* T k Greek adjective tiafJiirm, tnranfrig focxtmgtikhablt* or timjiirnclmhlt', it a broad tern) embracing a number *d /limits silicate minrr.ib thul are found in practically every country in the world. According tn geologists, chryctu tile ashes**-- a variety f the mineral that account* fr iitnrty-five per cent f die world's production--haa its origin millions of years ago, when subterra nean upheavals pruvnli-il fractalr* in serpentine rock which were m irtraied by water heated iu the ra n k s interior. Soltsequently, thc wnM-rs tlKwlved some f the serpentine, ami as the mluturns cnolcd, fibrous silicate cratals began to grow within the fractures. The two other major varieties of as bestos--cmctdolhe and nmusitc--orig inated through jurniewh.ir difiniiit dynamic and thermal pmeewt in inrt.t* morphir ruck, nmf their fibres thmigli tiinihtr to ciuywtflc, pwwt* ililTrrrnt strucuiral and chemical proper tie*. Al though Jt/iMvn to atari at curly ux ikt* Stone Agrt when it was used in pot tery, asbestos wax mnMdcrcd a novelty until the bite righteen-teventict, when k begnn tu be mined on a commenid has. Suite then, ft has achieved c/mr- T153911117 mous industrial importance because of its unique and astonishing physicalprop* ernes I t appears to be highly combusti ble, yet it can withstand the fiercest heat. I t seems as perishable as grass, but by virtue of being almost immune to the forces of corrosion and decay under almost every condition of temperature and moisture (and of being resistant as well to the action of most acids, alkalies, and other chemicals) it is just about indestructible. I t looks extremely frag ile, yet its fibres have a tensile strength equal to that of piano wire. Apparent ly as light and feather}* as thistle- or eiderdown, it is actually as heavy and dense as the rock from which ic & extracted. In one sense, then, it is a fibre of stone. In another seme, how ever, it is a mmeralogical vegetable whose fibres are so soft and flexible that they can be carded, spun, and woven as easily as fibres of cotton or flax. Asbestos is the only mineral that can be woven into cloth, and its fibrous structure is, if anything, even more amazing than its remarkable ability to withstand heat. In fact, if it were not for the electron microscope, the extent to which asbestosis fibrouswould be dif ficult to believe, for there are approxi mately a mtUkm individual fibrils lying side by side in a linear inch of chrysotile asbestos, whereas only thirty-night hun dred glass fibrils, such as those found in various insulation materials, or six hun dred and thirty human hairs can be aligned along die same distance. More over, in addition to their extreme fine ness, high tensile strength, unusual flex ibility,spinnability,and resistance to heat and the elements, asbestos fibres pos sess great powers to adsorb and 10 filter. Small wonder, then, that when asbestos, which had been known to die ancients as " the magic mineral/' was, In effect, rediscovered less than a hun dred years ago in the age of industrial expansion, it was put to work. Since that time, the demand for asbestos lias risen almost as fast as die stuff could be mined from die earth and milled from its host rock. In 1879, when die world's first commercial as bestos mine was opened at Thcriord, in the Province of Quebec, only three hundred tons of the mineral was pro duced. By 1910, annual world produc tion had jumped to thirty thousand tons: by the middle thirties, it had in creased to five hundred thousand tons) and today the total output & more than four million tons a year. Up until a few years ago, asbestos was often called " the mineral of a thou sand uses'1 by those who sold it, but this label has become obsolete, especial ly in the United States, where it is estimated that asbestos may have as many as three thousand different in dustrial applications. T he United States is die largest consumer of asbestos in the world, importing nearly a million tons a year mostly chrysotile from Canada, and ance fully ninety-five per cent of this amount is used in combination with other raw materi als--such as Portland cement, asphalt, and vinyl and other plastics--asbestos is present as an invisible and anonymous ingredient in a myriad of Industrial products, many of which are never identified as concatnmg asbestos even though it may constitute up to fifty per cent of their content. Tiie asbestos-cement industry, which is the principal consumer of the min eral, makes shingles for roofing and siding, sheets for exterior and Interior walk, insulation board, clapboard, cas ings for electric motors, pipes to carry water, sewage, and gas, and numerous other products. Asbestos textiles are used not only in fireproof theatre cur tains but also in lagging and other in sulating wrapping, in conveyor belting and safety clothing, in pot holders, ironing-board coven, draperies, rugs, and motion-picture screens, as filters in tural steel, and of undcrctMthty* sprayed gas masks and in the processing of fruit on autwnuhtte bodies. juices, acids, beer, and medicines, and As a result of these multiple and in mafibag^ prison-cell padding, air miscellaneous applications, asbestos hat plane fittings, stove and lamp wicks, become practically ubiquitous in mod sparkplugs, and fire hose. The electri- em society. There i<not an uittomoHlc, cal-cquipmcnt industry has depended afrpionc, train, dun, mAxle, nr engine for years on asbestos yarn anti tape h r of any sort that dins not contain as insulating conductors ranging front bestos in some form ur ntlirr, and it . fine-gauge wire to heavy cable, and has found its way into literally rvrty woven asbestos friction materials-- building, facto!?, fittmc, and farm such as brake linings and clutch fac across the land. Anil, hi'cnusc in mi- ings--are found in curs, trucks, trac Mtsctiiv fibres are eminently rcspir.ildr, tor^ power shovels, hoists, and other asbestos has aim found fft way bm* the industrial machines, as tire asbestes- lungs of man, where, by remainmg jn dnth packings, seals, and gaskets. As indestructible ns it dors in nature, it van bestos papers and felts are used for wreak terrible havoc. roofing, for piano padding, far lining stoves, heaters, filing cabinets, military helmets, and the mufflers and hoods of automobiles, and they also ore found THE advene bitdngical rffret* of asbestos were oftwrved as early us the first century hy thr Greek gw/ft* In armored cars, carpets, and car rapher Strnbu and hy the Unman nat tridges, and as boiler jackets and radi uralist Pliny the Elder, both of whom ator covers. Asbestos millboard, which mentioned in posting a stchiien nf the is a heavier version of asbestos paper, lungs in slaves whose occupation was is used for acoustical ceilings as plas to weave asbestos into cloth. Strain) terboard and fireproof walibonrd, and and Pliny were catting attention for flic in electric switch boxes, safe, table first time in history to n dfccatc tli.it pads, stove mats, ovens, and dry kilns. would one day be known ax tidiest'*-* Vinyl and asphalt floor tiles cortarn sis--a form nf pncumocnniibK (thr anywhere from thirty to fifty per cent, general term far all dost duraws of the by weight; of short asbestos fibres, and lungs) caused hy thr intial.iuon of fine the floor-tie industry has become the fibres and particles of xdirWtK--hue the seemd-hrgest user of the mineral. ancients were much tun awed hy (be Since the development of pbett- magic uf the mineral iu hr *.inc*rnrd oi-furmaldehydc resins in 1909, as with the pmribifity that it might con bestos lias been used in large quantities stitute a health hazard. Indu'd, tlirir as a reinforcement and filler by the attitude toward aihfMus sometimes bor plastics Industry, and today there arc dered on veneration. StruWu and Plu countless plastic products (hat contain tarch noted that the "pei'pcnnd" wnfe asbestos, ranging from frying-pan han used in the xtcrcJ and inrMiuguitiiit- dles to rocket nose cones. Asbestos is hle lamp* af thr Wild virgins wrri* also an ingredient of many paints and ntwdr of iishcsm., /md Pliny dfttrilnl sealants, of compounds used for nif asbestos doth, which laid hern used coating and road building, of putties, for centuries in crcimtium, as the utrr caulking, and other crack fillers, of and costly "funeral doss nf kinp*" ft d a p used for pnttrip and sculpture, of was gciicrully assumed in nncimt times artificial snow, of plaster and stucco, of dial nsbrstfis was of vegetable origin-- fireproof insulation sprayed on struc Pliny called it "iututrt ti m m " and chn sccond-ccntury Greek topographer Pausanhs referred to it as "the only linen that is not consumed by fire"-- and this misconception endured for centuries. (Only a few years ago, a major shareholder of an English as bestos company who was visiting the source til its supplies in South Africa asked the resident manager where the plantations were.) The Romans were especially impressed by the fact that when cloth made of asbestos was ex posed to flame it always came out whiter than before---lienee the Latin word for asbestos, amw/i/w, meaning unpolluted or undefiled--and they are said to have cleaned asbestos dinner napkins hy tossing them into the fire. T he use of asbestos in Europe ap pears to have diminished greatly during the Dark Ages, although h is said that the Emperor Charlemagne convinced some warrior guests from a rival king dom that he possessed magic powers hy throwing on asbestos tablecloth into the fire and then withdrawing it, un scathed, from the flames. In the latter part of the thirteenth century, when the indefatigable Venetian traveller Mar co Palo was traversing a pari of Si beria then known as the Great Em pire of Tartary, he was shown some doth that would not burn, and was told by hi? T artar hosts that it was made from salamander** wooL Too wily to be taken in by a story like that, Marco examined the material carefully and, after making some inquiries, learned that there was a mineral in the mountains of the district that con tained threads like those of wool. In 1720, asbestos deposits were discovered in the Ural Mountains, and forty years later a factory was built to manu facture asbestos products. Because the known uses of the mineral were few and the demand was limited, this first commercial attempt to revive the longdannam asbestos industry was a failure, TI53911118 but the second attempt, which took place slightly more than a century Utcr, succeeded beyopd the wildest dreams of its backers. As a residr, the fact that asbestos could produce lung disease, which liad been forgotten since Strabo and Hmy first recorded it around die time of Christ, soon manifested itself again. Modem knowledge of asbestosis dates from the year 3900, when a post mortem examination was performed by Dr. H. Montagu Murray, a physician in London1* Charing Croc Hospital, on the body of a thirty-three-ycar-old man who had worked for fourteen years in an ashesros-textile factory. Tire patient, found to have been suffering from severe pulmonary fibrosis, which js scarring of the lungs, had been the last survivor of a group af ten men wlui were working in the carding room of the factory in 1886, and ace D r. Murray found spicules of asbestos in die lung tissues at autopsy, he was able to establish a presumptive connection between the man's occupation and the disease that killed him. A few yean later, an inspector in the Department of Labor at Caen, whose name was Auribault, reported the results of what was undoubtedly the first study af mortality among asbestos Workers. Ac cording to Aurihault, whose account appeared in the Bulletin d t VInfection Hu Trov/iil ct H rrffygiini ItiHuitricllc, an asbestos-weaving mill bad been established in 1890 at Condc-surKnireau, in Calvados, and during its first five years of operation, when there was no artificial ventilation and tle employees were heavily exposed to dim from die looms, fifty of them died* Moreover, the director of the fac tory, who had previously owned a cutton mill at Gotmevfilc, in Marcchc, had recruited seventeen workers from his former staff, of whom sixteen were wiped, out by what Aurfbault, who was not a physician, mistakenly described as chaftcorfe--a pneumoconiosis common among stonecutters. Unfortunately, neither Murray nor Aunbaulc realised the importance of their findings. Testifying before a De woman patient who had started work ing at the age uf thirteen in an asbestostextfle factory in which them was rut provision /or the removal af dust* By 1917. after thirteen years of cxniourc, she had been coughing and In bad partmental Committee on Compensa health, and from then on her attend tion for Industrial Diseases, in 1906, ance at work had been intermittent he- Murray said, "One hears, generally causr of shortness of breath and lassi* speaking, that considerable trouble is tude. The autopsy showed extensive now taken to prevent the inhalation of dust, and so the disease isnot su likely to occur as heretofore/1a.td the conclud pulmonary fibrosis and dense strands uf abnormal fibrous tissue connecting tlie lungs and the pleural membranes sur ing recommendation of Aurihault's re rounding them, lit addition, Cooke port was simply that people under noted the presence of solid yelliwish- eighteen years of age should nut be al brown particles, which he called "curi lowed to work in dusty conditions. Be ous bodies," in the areas tif fibrush, cause of ignorance about the cause of "We have never won anything parallel the disease, and became It manifested to (his in pncumuccmiusis due to other itself slowly and insidiously over a pe dusts, nur hnvc wc been able to find riod of from ten to twenty years or such occurrence in literature,*1 he de more, asbestosis was probably more of clared, and he added, ^Wc cannot ten than not misdiagnosed in the early think there is any reasnnable doubt that part of the century os pulmonary tu the particles in the lung art the heavy, berculosis, silicosis, or fibrosing pneu brittle, iron-containing fragments of as monia. In addition, coyness an the part bestos fibre," of industry, timidity on the part of la Cooke's discovery, which was pub bor, and obtusencss on the part of the lished in the BrttUh Medical Journal of medical profession often combined to July 26, 1924, and republished in make early invesiigatioro into the health 1927, provided the point of departure of asbestos workers meaningless. As a for a scientific journey that startrd pi result, even though the asbestos indus an apparently straightforward path nf try was growing very rapidly in all the occupational hygiene and that has since industrialized countries of the world, branched out anu> epidemiology, on almost: nothing wasdone to control dust cology, physical chemhtiy, physiology, levels in asbestos factories, and almost and experimental pathptogjr. As a re no medical information on asbestosis sult of studies made between 1927 was gathered during the quarter of a and 193 J, o whole literature relating to century that followed the disclosures of asbestosIj appeared in Great Britain, Murray and Aurihault--although as which included cHninl and X-ray find bestos workers wtre probably dying ings, descriptions of the histology of the like fifes of it. disease, and the hypothesis (sunn widely I t was 1924 before the first clear accepted) that the strangc-boking yel case of death due to asbesiosis ap lowish-brown bodies noticed bv Cooke peared in medical literature. In that were asbestos fibres that had been al year, Dr. W . E. Cooke, an English tered by the reaction of lung tissue, and physician, who gave the disease its cuatcil with a colloidal substance rich name, performed a post-mortem ex in iron. In fact, Cooke's "curimis amination on a thirty-three-year-old bodies*1proved to he so abundant In the T153911119 lungs of autopsia) asbestos workers, many of which contained literally bil lions of them, that they quick)/came to be called `'asbestos bodies" T he most important investigation of this period was conducted by Dr. E. R A. Mercwcther, a medical in spector for the Factory Department of the British Home Office. Between 1923 and 1929, he examined three hundred and sixty-three asbestos-textile workers out of an estimated total of twenty-two hundred asbestos workers employed in Great Britain at the rime, and found that ninety-five, or slightly more than twenty-five per cent, showed evidence of suffering from pulmonary fibrosis. He also demonstrated that the inci dence of fibrosis increased ht direct pro portion to the number of years of ex posure, reaching eighty-one per cent in the group of workers who had been employed in the industry fr twenty years or more. As a result of Merewether's report, fttrfeincflt passed leg islation in 1931 that made asbestosis a compensable disease, required improved methods of exhaust ventilation and dust suppression in asbestos-textile factories, and instituted periodical medical exami nations for workers engaged in par ticularly dusty processes in the asbestostextile industry. After this promising burst of activity, however, progress ui the field of asbes toses was depressing^ slow, for, as things turned out, the doctors had only begun to scratch the surface of a prob lem of bewildering complexity. Many investigators assumed that the new reg ulations would prove effective m con trolling the disease, thus failing to ap preciate the fact (hat, once inhaled, asbestos, which is virtuallyindestruetihle, continues to react within the lungs for a lifetime, and to heed the warning of Mercwcther, who, when asked if two years of exposure was sufficient to cause asbestosis in a young girl, replied, "Yes, if she lives long enough." Moreover, techniquesof dustsampling were primi tive and inaccurate, and dust levels varied so greatly--not only from fac tory to factory but from area to area within a given factory-- that fe would have been almost impossible to establish criteria upon which to recommend a safe level of exposure. But as time went by, the generally lowered dust levels that did result from the regula tions of 1931 appeared to be slowing down the attack rate of the disease, at least in Great Britain, and the life ex pectancy o f the average asbestos-textile worker was further increased by the advent of antibiotics, which drastically reduced the death rate from infectious pulmonary diseases that often had to be feared as a complication of asbestos. The totally unforeseeable consequence of all this was that asbestos workers, in stead of dying of asbestos, began living long enough to develop asbestos-in duced cancer. The first published suggestion of an association between asbestos and ma lignant disease was made in 1935 by D r. Kenneth M . Lynch, professor of pathology at the Medical College of South Carolina, who described the case of a fifty-seven-ycar-oid asbestosweaver who died of asbestos and in whose lungs cancer was also found. Because the regulations o f 1931 required Brit ish coroners to conduct autopsies on men who had been suspended from work with asbestos on account of pul monary disability or when their length of service rendered it likely that their occupation was a contributory cause of death, pathologists in Britain were able to investigate the suggested link between asbestosis and lung cancer much more easily than their counterpars in the United States, where few states had w orkm en's compensation laws covering dust diseases, and where there were no specific regulations re quiring post-mortem examinations of group of henvijy rxpusrd worker en asbestos workers. The British investi gaged in malting asbestos textiles. The gations were not made die subject <tf tnntble was that very few studtea had official comment until 1949, however, been made of the tens of thnusutdi of when D r. Mcreweihtr, who was then workers engaged in either branches of Chief Inspector of Factories, published the industry, which was then rxpainl- a review of data that had been accum ing at an enurmnus rate all over the ulated from 1924 to 1946, which re world, so that no one really hat! any vealed that lung cancer was present way of knowing whether there was In thirty-one out of two hundred and any danger from moderate nr light thirty-five deaths that were caused by occupational exposure'--or, for that asbestosis or m which asbestosis was matter, from indirect, nun-t'ccitrcttwmri found at autopsy. This was an inci exposure. Such studies were tinurr wyy dence of slightly mure than thirteen in a number of countries, hawevrr, and per cent; and Merewcthcr found it when the results began to appear, in the highly significant, for lung cancer, ac lute fifties, it became evident that the cording to its incidence in the general hazard posed to man by asbestos JwJ population, should only have been pres once again been underestimated, ent in approximately one per cent of the The most dramatic development was cases. A t the tone, no fomtal claim of the discovery of an assocutiutt between an association between the two diseases exposure to asbestos and mestithelhtmnf was made, but during the next few an almost always malignant tumor of years an increasing amount of evidence the pleura, which ri the delicate mem began to establish one Then, in 1955, brane that encases the lungs, nr of the Dr. Bichard S. DoS, director of the perituntum, a simitar membrane that Statistical Research Unit of the Britttil lines the abdominal cavity. Previously, Medical Research Council, completed mesuthriioma had been su rare that it a study of a hundred and thirteen con was considered a pathological riir/osity. secutive autopsies of men with more It was found in only one out id than twenty years of exposure in a every ten thousand autopsies, it wai large asbestos-textile factory, which not listed in most medical hooks, and showed that the extent to. which they ft was not even ended separately fn Use had raked lung cancer over the whole World Health Organization's Interna- period was eleven times as great a tto/iai Classification uf D efeat, fn that of men in the general population 1956 and 1957, however, rixtrrit cmrs of England and Wales. From then of this rare turnur--tantamount to an on, many doctors were convinced that epidemic--were diagnosed a t the Pnru- a carnal relationship between asbestos moconfofr Research Unit in Johan exposure and lung cancer had been nesburg, South Africa, by a pathologist demonstrated, although almost no part turned J , Christopher Wagner. Twit of the vast asbestos industry other circumstances led D r. Wagner and acknowledged the relationship nr found his associates to suggest (hat ashretfit it advisable to aid the independent re might play smt part in the mytfeqntw searchers who were investigating it. outbreak: asbestos iradies had hem found at autnfay in the lungs of the A T this point, many epidemiologists very first case, and tea nf (he rates had concluded that the hazards had come from a huspiul to wltirii to human health presented by asbestos patients suspected of suffering ir*m were limited to chft relatively small tuhrrcubsfe were referred fmm it "053911120 large crocidolite-ashcstos mining area. A t the beginning this hypothesis seemed rather tenuous, far none of the sixteen patients who suffered from mesothelioma had ever worked in as bestos mines or milts. Wkhin a shun period, however eases of mesothelioma began to crop op elsewhere in South Africa, and when Wagner and hfeasso ciates discovered that rhe father of one of their new mesothelioma patients had been the manager of on asbestos mine, and that the patient had pUycd around the mine and on the adjacent dumps as a cJttid, they undertook to reinvestigate the sixteen original cases and to ob tain detailed life histories in all future cases. By the end of 1961, they had diagnosed a total of eighty-seven mesotheliomas of the pJcura and two mesotheliomas of the peritoneum. Only twelve uf the cases proved to have had industrial exposure to asbestos, hut all the rest came from the. arid, windswept region of the Cape asbestos fields, where they could easily have sus tained exposure simply by living in the vicinity of ashestos mills and dumps. A particularly striking case was that of a woman who was born in a town on the ashestos fields, Jcfc the region at the age uf live, and died of a pleural mesathelioma at the age of fifty-seven. -Detailed questioning about her chQdhood re vealed that she had attended a kinder garten near an asbestos dump and that she and her playmates (two of whom also died of mesothelioma) used to en joy sliding down the dump on their way home from school. Another exam ple was provided by the youngest pa tient of die series--a man who died at the age of ewewy-one. He had been exposed to asbestos from the age of six weeks until he was weaned--a period during which his mother took him along with her when she went to work at &cobbing rite, which Isa place where asbestos is separated from its host rock. Even among those patients who had worked m asbestos mines, the actual exposure appeared to have been slight, for In most costs die lungs showed no evidence of asbestosts but only a. few as hestos bodies and fibres in the air spaces. From this, Wagner drew the chilling conclusion that mesothelioma might re sult from an exposure to ashestos dust that was considerably less than elute needed to produce fibrosis--the condi tion that had always been considered es sentia! for the development of asbestos lung cancer. (In some areas of Smith Africa, occupational exposure to ashestos dust was so heavy, however, that fi brosis of the lungs was almost certain ly killing people before cancer could develop. According tt D r. G. W . H. Schcpers, a native of South Africa who Is now director nf the Bureau of Lab oratories in the Department nf Health in Washington, D.C., condiriuns *>f industrial hygiene in the asbestos mines and factories were often " deplorable." In 1949, when Schepers was sent into cite northeastern Transvaal to make the first official radiological and clinical survey of the ashestos industry' for ilie South African government, he found barefoot Bantu children spending their days inride large jute shipping hags, where they were forced by overseers . armed with whips to trample down 1 Huffy amorite asbestos ns it come cas cading over their heads into the bag?. ; Schepers found that a number of these ( children had developed ashestons with cor pulmonale--right-sided heart fail ure, which often accompanies the dis ease--before the age of twelve, and he has said that he would be very sur prised if any of them had lived long enough to develop cither lung cancer ) or roesotftehoinj.) Tn 1960, the year that Wagner pub lished the first of his disturbing reports about mesothelioma, there were two additional developments that caused grave concern among scientists invests- lifetime, might well be a major cause . gating the asbestos problem. One of of the beratnm of avfctvtos fust* diem occurred in Finland, where Dr. Thomson reminded h colleagues that, t Katmo KtviltiotOj a mdiofogt, fiad compared to a half-life of twenty-eight been surveying the general population years for strontium 90, rite half-lift nf ( for tubtitufoss; he detected deposits asbestos fibre was an infinity of years, < oi calcium on the pleura, which had and he concluded that, because nf the previously been seen almost exclusive* continuous disintegration of aslicstm [ ly in asbestos workers, In four Jum- products such as brake lining, floor I red and ninety-nine out of sixty-three tUes, and moling material, n<* well as i hundred and twelve neop!e (mostly the demolition uf Imiidtngy cnMffMif{ farmers and their wivrs) who lived in a numerous other ashestos product* as county where asbestos had been mined bestos was constantly finding As w.iy andmfijedfor manyyears,and /jopleuraJ into the amufcpherr as nn rvrriitting calcifications in seventy-one hundred contaminant. He cvrn went tn fur as m and one people who lived in a neigh predict that in future t!n*aik.<, the ;u*- boring county where there was no as cumulation uf asbestos Irt urban ureas bestos industty. The other development ltd inexorably tn higher cuncuntmiiuM took place back in South Africa, where of asbestos fibres in the lungs nf urban Dr. J. G. Thomson, professor of pa dwellers, atbestos-indueed neoplasms thology at the Medical School of the would rival cigarcitr-imJuved lung can University of Cape Town, was exam cer as a cause nf death. ining lung-fluid smears from five hun As might be expected, the disclosures dred consecutive autopsies to determine made by Wagner, Kfvfiuoto, nml the extent to which the ordinary urban Thomson provided a powerful stimulus dweller was exposed to the inhalation for further investigate nf the prob of asbestos} he found asbestos bodies in lem of asbestos exposure. During the twenty-five per cent of die total. next few years, a hum for mesariurlio- Thomson's discovery astonished the masnnd asbestos bodies was undertaken medical world, for up until that time by pathologists all over the world. no one suspected that asbestos bodies Thomson' observations were con might be present in the lungs of people firmed by studies made in Miami, in Y/ho did not work i asbestos mines London, and m Belfast, while in Ktf-- or factories. He pointed out, however, burgh ashestnj bodies wore found in tin* that there had been a tremendous in lungs of frty-rix of a hundred con crease In the use of ashestos throughout secutive autopsies at Bre&bytrrian-Ui- the world over rife previous twenty verrity Hospital. And Wagner's find years---three million tons were market ings were corroborated by investiga ed in I960--and that asbestos was be tions that associated mesothelioma with ing incorporated into an increasing exposure tu osbestm in half a iliiycn number and variety of industrial prod cities in Europe and flic United Stoics. ucts with Which the ordinary urban Perhaps the mmt striking vuttfirnmtrnn dweller came into Intimate daily con of VVagnerV dm* came from London, tact. He alto suggested that the air of tvhm* Dr. Morid L. Nwhmisi' .mu city streets was a likely source uf as- Dr. Hilda Thompson, of the Depart tiesto* exposure, and that the average ment uf O tcup.tteal Health at the motor vehicle, which wears out three nr Lonvlun School uf Uygfrnr nnd Tropi four sets of asbestos brake linings and ca! Mcdhinr, investigated the life hfe. one or two asbestos clutch facings in its mritai nf scvcrny-six caws <d meutiir- TI53911121 lioma (hat had been confirmed by au topsy or biopsy in London Hospital. T o no one's surprise, thirty-one of the seventy-six patients had -worked with asbestos, but eleven of those who had died had simply lived within half a mile of an asbestos factory, and nine others--seven women and two men-- were relatives of asbestos workers. Mate of these women had washed their husbands' work clothes regularly. The investigators learned chat one of the husband.*, a docker, had come home "white whh asbestos" every evening for three or four years, and that his wife had brushed him dawn. Both of the men In this group, when boys of eight or nine years, had had sis ters who worked in asbestos-textile foetones. One of the sisters had been employed as a spinner from 1925 to 1936, and had died of asbtstosis in 194-7, at which time it was determined at nn inquest that ' rshe used to return from work with dust on her clothes," Her brother, who had apparently sus tained no other exposure to asbestos in his lifetime, died in 1956 of a pleural mesothelioma. Further corroboration uf Wagner's findings came from southeastern Penn sylvania, where D r. Ja n Lichen, then head of the Djvisiun of Occupational Health at the State Department of Health, in Harrisburg, investigated the backgrounds of forty-two people who had died of mesothelioma between 195S and 1963. O f the forty-two pa tients, ten proved to have had definite uccujutiunal exposure to asbestos, three were nelarim of asbesror workers, eight either lived o r were employed in the vicinity of an asbestos factor)*} and ten others were discovered to have had at least some minor exposure to the min eral. T h e ten people with minor exposure included a self-employed maker o f Swiss chccsc who used a fivehundred-gallon boiler covered with asbestos insulation that flaked off on contact, ft salesman -who had mixed and applied asbestos-cement insulation to boilers in hrs home, and a fourteenyear-old boy who at one time had helped hfs father saw up and install plasterboard during an extensive re modelling of their house. From an epidemiological point of view, the investigations that tended to support (he findings of W agner and Thomson were weak, because they Jacked a defined population as a base against which the data could be meas ured, O n the other hand, die presence of asbestos bodies in the lungs of Such a large percentage of consecutive autop sies in so many widely distributed dries of the world was sufficient to indicate that asbestos fibres were probably being inhaled hy a majority of urban dwell ers everywhere, and the association between asbestos and mesothelioma was striking enough to suggest that a history of exposure to the mineral was likely to be found whenever a positive diagnosis of the tumor was made. A sa result, epidemiologists were forced to revise their idea that asbestos was only an industrial hazard, and to give serious consideration to Thom son's prediction that it might prove to be dangerous for untold numbers of unsuspecting people in the general community. IN October of 1964, in order to re view flte data collected in the past and to discuss the problems awaiting solution in the future, the New York Academy o f Sciences sponsored an in ternational Conference on the Biologi cal Effects of Asbestos, a t the WaldorfAstoria. T h e conference enabled more than four hundred scientists from all over the world to discuss the immensely complicated epidemiological and clinical problems that had appeared in the forty years since D r. Cooke de scribed the first clear case of asbestos!?, And what there was scarcely seemed to and its planning was largely the work indicate that it would pmv* h* hr of one of its co-chairmen, Dr. Irving much f a problem" As things turned J . Selikoff, who is bead of the Divi out, he changed his mind. In 1954, sion of Environmental Medicine at all seventeen men from the Paterson the City University's Mount Sinai factory were able-bodied am! ivnrl> J School of Medicine, director of its ing. By 1961, however, six of them Environmental Sciences Laboratory were dead, and twisty only six of tftrtn <j ( and a pioneer in the field of modern are alive. O f the eleven who iliVd, asbestos epidemiology. four wcr<< victims of lung cancer, three Like many of his colleagues at the of other cancers, one of mtuithcllnain, conference, Dr, SelDcoff became inter and two of arftcftnw. O f die she who ested in asbestos in a roundabout way. arc still alive, two arc disabled hi'amsc A native of New York City, h* in of respiratory insufficiency caused hy terned at Belli Israel Hospital in New fibrosis of the lungs, iiml urte has re ark) did his pathology at Mount Sinai, covered from surgery for caitrcrs of where he has been a member of the the lung and larvnx. Dr. Krliknff staff since 1947; and became a chest shook his head in describing tin* fate physician at the Sea View Hospital on of these patients, hm as early m 1961 Staten Island, specializing in tubercu their ranks had been thinned out sm losis. In 1951, he participated in the drastically that, ns he said, "I wav basic research on uonuzid--the anti forced to the awful realization of whit* biotic drug that, by effectively killing could happen (u me who were occu tubercle bacilli, has provided a cure fur pationally expired to asbestoj/1 After tuberculosis--for which he received the company that owned the factory the American Public Health Associa said it was unable to make its employ tion's Albert Lasker Award in Medi ment records available, he wrote to cine. In 1953, Dr. Sdikoff founded a several other large nshei.tr manufac medical clinic in Paterson, New Jersey, turers in the United Stairs, tmfiiirtng where, by chancy seventeen o f hi% about the health experiences in their early patients were men referred for plants, and was unable to tAttain iii- chest-doease consultations who worked formation from any of them. Mean in a local factory that hnd been mak while, he and D r. Jacob Chttrg, chief ing asbestos-insulation materials since pathologist a t Barncrt Memorial Hos | 1940. W hen die factory dosed down pital, in Paterwm, who had been find in 1954, the seventeen men went into ing asbestos and lung cancer in a ' other work, and at that point D r. Scli- large number of workers from the Pat koff derided to continue hit observa erson factory, took their data to D r. tion of these patients with X -ray ex Eojcfic P. Handle, Commissioner uf aminations and pulmonary-function the New Jersey State Department f tests in order to determine die history Health, and D r. Handle applied to tlw and the natural course of asbestosis in United States Public Health Service for men who would not be subjected to funds to undertake a study uf the Pat further exposure. erson factor)* and tn make a uatrwolr A t the time, D r. Sdikoff was chiefly survey to determine how many (UMplr interested in aibescoss because, as he were being occupationally exposed to lias explained, " I was still unconvinced mhrstus. However, the request W11 of the relationship between asbestos and denird for hick of m m ircu. tong cancer. There wasn't much data, Since D r. SelikoiT already knew that I T I men who had worked in the factoiy die tool) which occurred in hospitals, that made insulation materials were <1y- In the next phase of the study, Dr. fog <if asbestos and lung cancer at Sel/koff and D r. Churg were joined an alarming rate, he considered that by D r. . Cuylcr Hammond, Vice- men who were installing such materials President for Epidemiology and Sta- might also risk disease, and early in ustics of the American Cancer Society, 1962 lie made contact with officials of who had participated in an analysis of New York Local 12 and Newark Lo- rhe medical effects of the atomic ex eat 32 of the International Association plosions that devastated Hiroshima and of Heat and Frost Insulators and As- Nagasaki, in 194-5, and whose large- hestos Workers. The asbestos insulators scale epidemiological studies of more itad been trying for years to interest than a million men nnd women pro- doctors and various government agen- vxkd a major basts Cor die conclusions ries in (heir medical problems, so they drawn m the 1964 Surgeon General's were only too glad to cooperate, and report on the effects of cigarette smok- urged D r. ScJikoff to make a study ui ing. Since previous studira had sug- depth of the effects of asbestos expo- gested that lug o n cer associated with sure among their members. asbestos seldom develops until twenty During the next six months, Dr. years after initial exposure to asbestos Sclikoff and his administrative assistant, dust, D r. SeKknff and D r. Hammond Mrs. Janet S. KaJftnburgh, pored decided to Emit their Best report to the through the unions1 records and com- six hundred and thirty-two men who (died a fist of the names and address*? were on the union rolls as of Decem- of the six hundred and thirty-two men ber 31, 1942. Taking the men's ages who had hecn members of either of the into consideration, D r. SeKkoffand D r. metropolitan locals on December 31, Hammond then set about comparing 1942, and of the eight hundred and the number and causes of death among ninety men who had joined between them with those of the general male then and December 31, 1962. From population in the United States. The die unions' employment records, they results were depressing. According to obtained detailed work histories of the the standard mortality tables, two hun- tntal membership of fifteen hundred dred and dire deaths could have been and twenty-two men, including data expected among the six hundred and on their withdrawal from work for thirty-two workers. Instead, there other employment, war service, retire- were two hundred and fifty-five, not ment, or illness. This enabled (hem to counting seven men who had died bc- cnlruiate the onset and duration of ex- fore incurring twenty years of e x posure to asbestos for each worker, sure--an excess of twenty-five per cent. Records of the unions' health and vvei- The reason for the excess was not hard fare funds provided them with the dates to find. T he fact that twelve of the and places of death of the two hundred deaths were attributed to asbestos was and sixty-two workers who had died not particularly surprising, but only six. between I942r.i.i 1962, and copies of or seven deaths from cancer of the lung, the death certificates of all hut one of pleura, or trachea were to he expected, them were obtained. In addition, at)- whereas (here were forty-five. And tepsy protocols, histological specimens, where nine or ten gastrointestinal can- and hospital records were reviewed cers were to be expected there were by D r. ScJikoff and Dr. Churg in actually twenty-nine. Since the lung- those deaths (approximately one-half of cancer death rate was known to bo more than ten times as high among cigarette smokers as among non-smokers, Dr. Selikoff and Dr. Hammond realized that they would havc to take the smoking habits of the asbestos-insulation workers into account if their findings were to have any validity. Ic was, of course, impossible for them to ascertain this with accuracy in the cases of the two hundred and fiftyfive men who had died, so, for purposes of calculation, ihey assumed that all six hundred and thirty-two men had smoked a pack or more of cigarettes cadi day, and they demonstrated that even if this had been die case it would have produced a lung-cancer death rate only three and a half times that nf (he general male population. Cigarette smoking, therefore, could not explain the fact that in this group of asbestosinsulation workers the rate of death from lung cancer was seven times die expected rate. Because of its objectivity, its scope, and its thoroughness, this study conducted by Drs. Selikoff, Churg, and Hammond had a great impact on the medical community when it was published, m the spring of 1964, in the Journal of the American Medical Assedation, and when it was delivered hcforc the Conference on the Btological Effects of Asbestos due October, I t was the first study ever made that had tzken a large enough group of asbestos workers from a point for enough back in time and followed (hem long enough to determine unequivocally what their health experience had been. Unlike .*1most all the previous investigations, which simply indicated that there was ara association between asbestos nnd various kinds of cancer, it was based upon the incidence of disease within a defined population, and thus answered a fundamental epidemiological question of how many cancers had developed ouc of how many persons exposed, In doing sn, it furnished the first foccin* trnvenibfc evidence that industrial rxptistirc to asbestos was hazardumj it established sound methodology for future studies; and it marked n turning point in the views held by doctors nnd health /fiends armind the World* T N thr autumn ul 1962, D r. Mi* i - koff-- using dnnaiiom from private sources nnd a grant awarded by the Health Research Cutmril erf New York City, headed hy Dr. Gturgc S. Mmch-- had set up Informal clinics at union halls in New York nnd Newark and started giring X-ray examinations, pulmonary-function tests, and trim! tests to the m em bers of the two asbestos workers' Imali. During the next year, fie examined eleven hundred nnd seventeen wiirkcra, nnd he n1s*< queuiunrd them chccly about their milking liul'ttx, the kinds of ranUrmls they used, and (he rund* tions tinder which they worked. " The insulation workers, on intelligent and highly killed group id craftsmen, pa* ticntly educated me concerning their trade/1 he nnee said. " I learned that they had had comparatively light nnd intermittent cxptruirc as aehestui work era go, because they often worked uut- ol-donrs on construction jirujrcU, and because- most o te mstertah they used had an asbestos content of less (han fif- teen per cent. I afar found out how their problems had been neglected, Most of them had never seen a fcrfwr inspector in their live*, and only a handful could remember seeing anyone make a dmt-lcvd count in ilie areas where they were at work," Dr. Reli k*>ff alto learned that aUliougli sunn* of the workers knew they ran a risk of developing njbcUttfifl ^(whirl? they usually referred tu as almost none of them had any idea (hat (hey also risked cancer because nf their ic- cupatfon. As things turned out, lie T153911122 TI53911123 found radiological evidence of asbcsto> would have been normal, but twenty- sir in fully half of the eleven hundred eight occurred, and where the actuarial and seventeen men. The extent of the tables predicted only two gastrointes fibrosis varied directly with the dura* tinal caneen diere were eight. An un tion of exposure. O f three hundred and expectedly sharp rise in the number of forty-six men whose exposure had be mesotheliomas was observed. In the gun less than ten years before, only ten earlier study, there had been only four per cent showed any abnormality, and in two hundred and fifty-five deaths; of three hundred and seventy-nine men between 1963 and 1968, however, who had been exposed for between ten thirteen of these rare tumors were and nineteen years more than half still found in a hundred and thirteen deaths. had normal X-rays; fn neither group D r. Selikoff suspects that the latent was there any discernible evidence of period for mesothelioma may be longer cancer. On the other hand, Dr. Selikoff than that for either asbestos's o r lung found that among three hundred and cancer, hut so far he regards the heavy nincty-nvo men with more than twen increase of mesothelioma among the ty years of exposure three hundred and insulation workers as something of a thirty-nine had developed asbestos, mystery. which had by that time become mod D r. Selikoff and Dr. Hammond erate or extensive in more than fifty found special significance in the fact per cent of the cases; he also found that that all twenty-eight bronchogenic eleven of the men had developed can carcinomas occurred among asbestos cers of the lung or pleura. workers who smoked cigarettes regu Aided by yearly grants from the larly. None were found among eighty- Health Research Council, Dr. SeU- seven men who never smoked ciga koff has maintained a dose watch on rettes. D r. Selikoff and D r. Hammond the asbestos workers1 health) paying have reservations about these data, particular attention to those men with which suggest that asbestos workers more than twenty years of exposure by who smoke cigarettes are ninety times examining them once nr twice a year. more likely to die of lung cancer than As a result, he has been able to detect men who neither work with asbestos symptoms of illness in many of the men nor smoke, because they are based much earlier than they might have been upon the experience of a relatively detected and to (serve with great ac small number of people. They do con curacy the mortalfey experience o f the clude from it, however, chat an im three hundred and seventy whom he portant co-carcinogentc effect exists be found in 1963 to be survivors of the tween asbestos exposure and cigarette original six hundred and thirty-two smoking, and in a recent article pub members of the union in 1942. I t con lished in the Journal o f the American tinues to he disastrous. Between Janu Medical A troaiton they recommend ary of 1963 and March of 1968, fifty " that asbestos exposure be minimized, deaths would normally have been ex that asbestos workers who do not smoke pected to occur among these snen. In should never start, and that those now stead, there were a hundred and thir smoking should stop immediately." It teen. Fifteen of them were caused by has been suggested in some quarters asbestos, and, as with the earlier that asbestos fibres, which are known study, the rest of the excess turned out to he highly adsorbent as well as vir to be caused by cancer of various kinds. tually indestructible, may retain the Tw o or three bronchogenic cancers substance known as benzo (a] pyrene from dgarette smoke for long periods of time in lung tissue, thus tending to produce lung cancer by a synergistic effect. No one knows forsure, however, and D f. Selikoff will nothazard a guess about the matter until more informa tion is gathered. He expresses certainty about the effects of asbestos exposure only when he has epidemiological proof. He knows, for example, that one out of every five asbestos-insulation work ers who die in the New York-New Jersey metropolitan area dies of lung csneer, and that almost half of the three hundred and sixty-eight deaths he has recorded among these men in the past twenty-five years have been caused by cancer of one type or another. Last March, citing these figures before a House subcommittee on labor, he warned that "if they are projected to the country as a whole, 2nd if no im provement in the health hazards these men face is achieved, we may look for ward to perhaps six thousand deaths from lung cancer and to perhaps fifteen thousand deaths from cancer In genera! among men in this tingle asbestos trade alone." Considering that the total membership of the Internationa) As sociation of Heat and Frost Insulators and Asbestos Workers is only eighteen thousand men, and that there are about tile same number of non-union asbestos workers, his prediction has staggering imputations. I RECENTLY spent several days with D r. Selikoff in the Environ mental Sdences Laboratory at Mount Sinai, where he has assembled a team of thirty men and women to work on various aspects of the asbestos problem. T he rooms include laboratories for his tology, pathology, electron microscopy, chemistry, and mineralogy, and among the imposing array of equipment they contain an election microprobe that is capable of identifying particles of in finitesimal size. Dr. Scliknfl's office is large and modern. Its walk arc lined with shelves and cabinets containing hundreds of bound volumes of research papers and reports on asbestos, and nt one end arc a large conference tablet and a blackboard. The place gives an Immediate impression of rather cold efficiency, but this b tempered to a great degree by die affability of the di rector. As we talked) Dr. Selikoff, a large, soft-spoken man in his early fifties, was frequently interrupted by telephone calls and by questions from staff members, but he generally re sumed--often with an enthusiastic " Where were wc?M--and rattled v tf statistics about asbestos disease the way some baseball fanatics recite the tutting averages of big-lcague ballplayer*. On the day of my first visit, however, lie received a cal) from a doctor in New Jersey who informed him that a lung cancer had just been diagnosed In an other of the insulation workers. Dr. Selikoff told the physician that the pa tient's last X-rays showed moderate asbestosis, that he had had mors than twenty years of exposure, and that he smoked a pack of cigarettes a day. When he hung up the phone, he was visibly upset, and fell silent. A few moments Inter, he told me that be had taken more calls like that than he cared to remember. **2 don't relish the rule of Cassandra, but I fed we've got to fnrge ahead on this problem as quickly a$ possible,*' he said. "There are ah>ur thirty-six thousand insulation work ers--union and min-union--in tin* United States. AH in all, including as bestos-textile worker* :tn*l people en gaged in manufacturing other asbest* products, there arc prubsbly mote than a hundred thousand workers who arc regularly and directly exposed. The hazard would be serious enough if thh were the only group at risk, but it's ob vious that the problem extends further, TI53911124 simply because floating- asbestos fibres do wait for the results of the tile-setter not respect job classifications. Dr. Wil- study, however, because the problem is lam H. Stewart who is the Surgeon too urgent. We're initiating a whole General of the United States, told the cluster of studies designed to provide House subcommittee that the asbesto- information on whether environmental insulation workers are probably sharing asbestos pollution carries a risk for the their exposure to some extent with general population* A t the same time, more than three and a half million by analyzing the ripples, wc can deterother construction workers--steam fit- mine which rocks thrown into the pond ters, electricians, welders, carpenters, make the biggest splash. By thus ironworkers, plumbers, masons, tfie set- identifying the sources of contamina reis, snd the like--who arc employed tian, appropriate control measures will on the same projects, often in die same become feasible. O ur plan of attack is room or general area, and who there- to discover where asbestos-associated fore must be inhaling the same dusts.*1 diseases may occur, and to control the Because of their concern with the sources in such a way as to eliminate possible effects of such indirect occupa- them as a hazard. I t must be a team tionol exposure. D r. SelikofF and his effort, of course, including cpidtmiolassistants have spent months compiling agists, baric scientists, engineers, public ise names, addresses, and! work his- health officials, and industry and labor." tones of twelve hundred tile setters. One of Dr. Sclikoff's studies will *xthrcc thousand roofing workers, and amine the possible health problems three thousand tunnel, foundation, and arising from interrupted exposure by caisson workers in the Men* Vork tracing thirteen hundred and sixty- metropolitan area. They plan to seven men who worked at the asbestosexamine these men for possible health insulation plant in Paterson--closed problems as they did tlie insulation down in 1954-- where Dr. Sclikoff's workers, and to determine whether first seventeen patients were employed, they have significant indirect occupa- Another will look into the matter of rional exposure, and, if they do, wheth- neighborhood exposure by tracing and er it is associated with risk of asbestos ^ Investigating the health experience of disease. ``We will study defined pop- seventy-five hundred people who lived ulations that have been selected in within a half-mile radius of the plant leans nf what appear to be dimihdhmg in 1942. " The question of neighborlevels of exposure to a known risk," hood exposure was emphasized as a rc~ Dr. Selikoff told me. "ft's as if a rock suit of the mesotheliomas discovered had been thrown into a pond and by Christopher Wagner in Smith Afriwc're watching how far the ripples ex- c, and later by Molly Newhmtse and tend. Since the pond in our case is the Hilda Thompson in London and by general community, you can see how Jan Lieben in Pennsylvania,'* D r. difficult the epidemiological detective Sclikoff told me* "Since current evjwork will be. If we discover, for ex- deuce suggests that the tumor rarely ample, that the rile setters run a rig- occurs without a history of exposure to fiificant risk of developing asbestos dts- asbestos, epidemiologists consider it a a$c--and there are some preliminary `markeri disease, and we'll be looking indications that they might--then we for it when we trace the medical hismust look into the question of fibre fell- tory of the people in Paterson. Inci<iut from the construction rices where dentally, there's one preliminary indithey're employed. W e're not going to cation dial leads us to suspect we may find it. In 19S5, the proprietor of a junk yard next to die Paterson insula tion plant died of a pleural tumor.'* A third study in Dr. SdikoJPs cluster will aim at the protection of rela tives of asbestos workers. As in the case of neighborhood exposure, pre vious investigators of this group had no population base against which to meas ure the occurrence of the disease they discovered. Dr. SelikofF, however, has a definitely established group to work with. It is composed of the wives and children of all the insulation workers, and their health problems trill br care fully scrutinized, especially for evidence of mesothelioma. In D r. Selikofif's opin ion, this study will be of tremendous importance, because in subjects have been far removed from direct exposure. "If the fcmttics of insulation workers turn nut to be in trouble, the implica tions will be very serious indeed," he said. "On the other hand, if we find no trouble among them--and this is my hope--we'll be on safer ground. Our observations will also enable us to recommend whether special facilities should be provided so that insulation workers can change their work clothes before going home to their families." With the aid of a grant from the United States Public Health Service, D r. ScfifcofF and fits associates are cun. rcntly conducting an investigation that covers an even wider range, by study ing samples of lung tissue from three thousand consecutive autopsies that have been performed at three different hospitals in New York City and trac ing the work histories of each of the dead people. So far, theyhave examined two thousand lung samples, and have found ariiestos bodies in nearly half of them. According to D r. Victor Baden, a hotologist ac the Environmental Sci ences Laboratory, from one to five or more asbestos bodies are found in fifty per cent of the tissue slides he examines, Since each slide It composed nf seven sections that together rrpreccrrt Jrw than one half-million(h of an entire lung, ami since it U widely assumed that asbestos bodies are evenly distrib uted throughout a hmg, the finding <ri just one of them can be projected < mean that half a million may be pres ent. Dr. Scltkoff and his fellow-epide miologist* do not knmv whether the relatively small amount of ashed* mm' being inhaled by the general public var- ries a risk of inducing mesothelioma, * whether the presence of what appear in be asbestos bodies in the lungs ui many people fa die general population repre sents a serious public-health problem. Nor do they know whether relatively light inhalation of ashruos w avuvitted with a special lung-cancer rik in cigar ette smokers. "Ac present, w r simply have no way of telling what titc dnxdisensc relationship' air," Dr. SelikofF said. "Is it better to have breathed in only fifty asbestos fibres than fifty thousand or fifty mifliutri Docs each fibre have the potential of musing :<cell with which it comes in miacr In tutu cancerous? The answers to these im mensely complicated ouetrit>s will have to come from epidemiology over a lung period nf time. An eightfold increaw in asbestosproduction over tile lust tiiifty yean, would appear to make tt likely that asbrstos cancers will Increase, hut only the future will tell. Remember that current cases uf mesothelioma must be associated with mhafaffrft that took place twenty, thirty, or mure year ago, when world consumptioit of as bestos was nnly abuut five hundred thmivnnd tons .* year, nml that the neoplasm* nssociatrd with tudxp'a pro duction nf over feur mtlltu tons a year xvill not br evident until the nine teen-nineties. Moreover, we have found that all varieties nf asbestos fibres appear to be implicated in mesu* TI53911125 thclloma, and nut just crocdolte, as are employed in the food and pharma some a t us Jmd hoped following Wago ceutical industries, but we have no in ner's observations m South Africa. The formation chat this carries a disease problem would have been simple if potential. W hat troubles me is that on))* one variety of asbestos had been relatively few people are aware of the related to this tumor. Control proce b e t that it can be dangerous to Inhale dures could have been narrowly fo asbestos. Hot long ago, we discovered cussed. As it is, however, a control pro that children in a number of kinder gram will have to be concerned with gartens In Hew York, California, and asbestos in general." other states were being allowed to mix I asked D r. Selikoff if be thought raw asbestos with water to make a that asbestos air pollution was respon cheap form of play dough. W e have sible for the occurrence of asbestos also learned that the powders in. some bodies in die lungs of people m the children's cosmetics kits and in certain general population, and he replied that powder-water-mix jewelry kits con although there was relatively little tain asbestos, in addition, within the direct confirmation, he felt it was at pasr couple of years two different least partly responsible. Pointing out thoracic surgeons have published ar again that direct and indirect occupa ticles in leading medical journals which tional exposure were much more com advocate the sprinkling of asbestos mon than had been suspected, especially on surgical incisions in order to pro in the construction and shipbuilding mote die adhesion and healing of industries, he went cm to say, "The tissue. This is very had advice. Why, possible sources of environmental con Dr. William E. Smith, who con tamination are numerous. Mining ducts animal studies at Fairletgh Dick and milling operations, manufacturing inson University, has readily induced processes, and the delivery and storage mesotheliomas in hamsters hy injec of finished products constitute Just one tions of asbestos fibres into their pleural part of it. T he constant use of asbestos cavities! " materials in the construction industry is D r. Selikoff went on to say that he another, and the destruction and de- understands full well that asbestos is an terinrattnn at asbestos products in the extremely valuable material, and that community at large constitutes a third. it has become essential in modern There's no question in my mind that industrial society. "W e epidemiologists unsuspecting people are being exposed recognise and study its dangers so that to small quantities of fibres from such we may devise ways of minimizing or sources as torn ironing-board covers avoiding them," he said. "Improve and pot holders, and who knows how ments in the practice of industrial hy much asbestos is inhaled by hobbyists giene are needed to eliminate unneces engaged in do-it-yourself projects sary exposure among asbestos workers around the house--like sawing Up wall- and men in other building trades, and hoard, miring crack-filler compounds, awareness of the potential risks of en insulating pipes with asbestos materials, vironmental contamination is needed and repairing furnaces and bofleis with until our studies indicate just how far asbestos cements? I agree with those out into the general population the who suggest that small numbers of fi problem extends. All I can say is that bres may he liberated item many prod the public should be made aware of the ucts in widespread use, such as asbestos- problem, and chat no one, particularly ccmtnt pipe and asbestos filters, which children and young people, should be unduly exposed. After all, today's chil dren are almost certainly inhaling more asbestos than their parents did, and we now know that if a person inhales sig nificant amounts of asbestos dust, he carries a burden that will provide a la tent potential for the development of cancer for the rest of his life. Here's an example I'll never forget. A couple of years ago, just after Cuylcr Hammond, Jack Churg, and I published an article about asbestos and mesothelioma in the New England Journal of Medicine, 1 received a phone call from a doctor in Massachusetts who said that when he read the piece he immediately told his forty-three-year-old wife about it, be cause her sister had died of mesothelio ma the year before. 'Imagine my hor ror,' this physician Went on, 'when my wife proceeded to tell me chat in 1943, while she and her sister were students in college, they had responded to a pa triotic appeal and spent six weeks in a shipyard insulating pipes in destroyer escorts.' " Dr. Selikoff paused, " Two sisters with six weeks of exposure in 1943," he murmured. "Twenty-three years later, one of them dies of meso thelioma. And today, the other one--- the doctor's wife--is being examined every few months to keep crack of somesuspiaotis-looioflg shadows on her X-rays." AS I was arriving at the EnvironJTX mental Sciences Laboratory one day, I happened to notice a newspaper dipping tacked up on a bulletin board near the entrance. The story, which was from the Times of September Z, 1967, starred out as follows; "The scene looked wintry on Madison Ave nue, between 57th and 58th Streets, yesterday. Flurries of what seemed to be snowflakes fell on the area from between the 25th and 30th flours of the General Motors Budding, which is nearing completion on the rite of the former Savoy Plaza Hotel,11 The article went on to say that residents of the neighborhood find complained to the contractor, and that one of the project engineers bad explained that the white flakes were fallout from fireproofing material that was bring sprayed nn the structural steel girders, beams, and decks of the fifty-story skyscraper. According to the T im a , the engineer would not identify the in stilating material, which wav bring ap plied with spray guns, "because I don't want to read newspaper storks about how wc are messing up city strcetF." He was abo quoted as saying, "Tfui is a job condition all over the city**1The last paragraph of the article read, "The city's Buddings Department said that it had not received any complaints nbcut eh* Mfldhon Avenue Wnvf.di.' The department said the use of tar paulins was required for spraying up eratinns in construction wttrk to pretent inconvenience to ncighbarhuuds." Beneath the article was this typed notation: "Examined in our laboratory, the material was found to contain amorphous glass fibres (presumably 'rock wool'), and chrysolite asbestos, I t is known that other sprayed insula tion materials contain amusicc asbestos plus rock won), while still others con tain asbesto.* fibres alimc." When 1 asked Dr. Selikoff about the bulletin-board items, he said that the mineralogist in die laboratory, Dr. A r thur M . Longer, hud odlccted a sam ple of die material and identified its contents by means nf electron diffrac tion and electrun microscopy, and with the aid nf the electron micrqprohe. Then lie went to a shelf and tok down a small glass jar that contained a grayish wad uf fihrnirt-funking stuff, about the size of a half dollar. " This is the mmole Dr. Lancer brought back and. analyzed," he told me. "i t comes from a type of insulation material that 7153911123 is about twenty-five per cent asbestos, m en slide a large rectangular container and in clifs tiny wad alone there arc from a pickup truck and carjy it into a literally billions of fibres O f course, building. T he container was full nf the Snowfall* those people saw and white pnwdcr, some of which was be complained about was not w hat may ing blown away by the wind, and the have been hazardous. W hat may have men's clothes were covered with white been hazardous was what they couldn't dust. W hen T looked into the truck, I see--an untold number of sub-micro-' saw half a dozen large paper sacks la scnpic and highly respirable particles. belled "Fireproof Piaster." O ne nf the T he `snowfall* was a perfect ex workmen returned for his tools, and I ample of how asbestos gets into the asked him f the plaster contained av ambient air, and that engineer was beans. "Sure," he replied. "T hat's right when he said it*s a job condition v/liat makes ic fireproof." all over the city* You'll sec die same I walked on to the com er of Sixth material floating down from many Avenue, where a forty-four-story office other ImOding projects in town. It's budding had been under construction sprayed on by men in the Plasterers for several months. D uring that period, and Cement Masons Union. Inciden I liad passed the huiJding nearly ever)' tally, as far as I know, no one has ever day, but now, for the fiist tne, I made a study uf their health.** looked up and scrutinized it carefully. I t was a blustery day, filled with in About halfway up its side, I saw some timations of the season's changing, and tarpaulins biUovving in the wind. Above when I left the hospital I took a Fifth the tarpaulins, the steel girders and Avenue bus downtown. I sat hy a win beams were reddish browns between dow, and was looking idly out a t peo the tarpaulins and the ground, however, ple strolling along the sidewalks when they had been sprayed with asbestos in the bus came to a stop in die upper sulation, which clung to diem like gray Forties beside a dump truck parked in frosting. T hen, all n t once, I saw wads front nf a small office budding that was of the same gray stuff (idling out of die being gutted. Several workmen were area that bad lieen curtained off by the carrying canvas sacks of refuse across tarpaulins. Some of die pieces were car the sidewalk and heaving them up to a ried away on die wind* others that tall, well-built: Negro who stood in the were heavier came tumbling down rear of the truck, emptying the sacks at around me. O ne fell on die sidewalka t his feet. As lie did, clouds of dust rose my feet. I picked it up, crumbled it be into the air nrnund him. Some of it tween my fingers, and saw dozens of showered the window beside me. I t ap tiny fibres float away. I t was the same peared to be ordinary cement dust, but color and texture as the material that then I saw that the pOc of debris on D r. Selikoff had shown me half an which the man was standing contained hour before. T h e sidewalk was covered broken pieces of acoustics? panelling with it, and even ns I stood there more and walihrard, both of which often of it came showering down. A woman contain asbestos, and lengths of pipe hurrying to make the light with a coated with crumbling white insulation friend brushed some of? die sleeve of materia! that looked very much like her coat, and said, "W hat the devil is asbestos. this stuff?" I watched her cross the When I got of? the bus, I walked, avenue, and a w asbestos insulation west along Forty-fourth Street. Half Mowing over the pavement like thistle way down the block, I saw two work- down across a field. T he wind was southerly, and most of the asbutos Was w*vcHfag north, in the direction of Mount Sinai Hospital, where Dr. SeJiJcoff and his associates are st follow ing (be uail D r. Cooke set our on in 192*. B ut I was not thinking about D r. S e to f f or the difficulties nf rpf- demiulngy jst i wa$ thinJwtfl about the children who play in Ccntr Park every day and nbuiit all the other children who live in this city and breathe to air. --Paul B nootus