Document wqeK8knZYZBGyzkB2GMGZD1O6

July 11. 1972 ' ; or;;'' ... right, f t. 7 Head, . : edical /leacarch Division Saint Luke's Hospital 11311 Shaker Boulevard Cleveland, riuo 4110 1 Thank you for your letter of July 27th. I am happy to respond to your questions and comments concerning our grant renewal proposal sub mitted to you last month. A? you indicated, we consider the mortality study to be an important i n -'L of cur investigation and, therefore, are anxious to begin this phase at L ! i:' ["i 1 . ' 1 though 'vc would hop to Unv significant information by the cud of the ,:> irt* grant year, as you know tracing approximately 8,000 workers i- tc H>n ami time-consun bng and it may not be possible to complete this study by that time. i am cure that your long experience in all aspects of this type nf research leads you to conclude along with us that things never go as quickly as one would like, and I think our group has been fortunate in having collected and and analysed as much data as v/e have by the middle of the third year of the study. Tn you will remember, another segment of this investigation which was included in the original proposal and outlined again in my most recent cona.r.'T.ication :.s th<" prospective follow-up of a defined cohort of workers who \-'u- b-.vf complete evaluations beginning in the coming year and thereafter at tiu w v.-nr intervals. As you know, very little longitudinal information of this sort is available in either the asbestos cement or other asbestos products i. ;!`!?tric3. IMs cohort has been defined to include those workers who were /of the ages of 45 and 59 (incorrectly indicated ao 40 and 59 in my letter to you of Jun~ 20) at the start of the study and in order to assure that we will have at least 300 workers to be followed, the total number included in this group is 415. Lf thm total population for the cohort study, 354 will be eligible for study during 1973 or in the coming grant year. It is not certain how many of these individuals will bo able and willing to participate but. hopefully, together with the group eligible for follow-up study in 1974, the cohort will be larger Dr. Ceor/_;o V. if'Ixt - n <y c than the minimum 300 desired. The x-ray cost for these follow-up studies was probaLly under-estimated at T>2, 000 (T>10. 00 per FPA for 200 workers). Slight shifting of budgoi: it' vill nlic-.v for x-rays on workers recruited for the rr,Mr tr i.r , - i v o ~ Of you can appreciate, the number of worker; i .) ' o 'K : ire the coming year will justify ti c pulmonary function t .'ch'Uui_| n .-'l;-r; ; two nr fkr as. technicians will actually be doing these field studies so that covering t'>c cost of one of these individuals through this grant seems appropriate. The mobile pulmonary function unit has, in fact, just arrived in New Orleans and will be tested and calibrated during the next six weeks. Ac you suggested. It will make the studies of plant employees much more efficient .n .it 1 :s6 loss of time for the worker which is anticipated to be mi,perhaps 43 at the outside, and which comparer O V ;t!; the half ky previously required in the laboratory. Y e appreciate , ;i:.i'hUngnocs to allow the unexpended stun of 35, COO from the current year's grant to be applied toward the purchase of this equipment and van. I share your interest in the initial readings of the 70 control subjects on whom ::-rn.ys were obtained and was also surprised that so little radiographic abnormality in regard to irregular opacities was found. The Gilson readings "i'.l be '/ailable soon end should shed additional light, on this subject. Ve bad ' 'pv] *c> h -vc ;nvc controls bv this lir.it- but our X-ray department has been luce t';-- '.-ip ::.-, out in offering these films to persons in their department without cardiorespiratory disease. V. e will renew our efforts in the coming year to c nlar gc the contr ol group. You will be pleased to know, however, that the age distribution of this group is similar to the exposed population studied. I would be happy to have yourveview of these films at any time, should your schedule permit. The amount requested for investigator's travel is essentially to cover th r- < - r.%|it;,isivc trips anticipated for the coming year, primarily for my trawl for the presentations in Lyon and London on the results of our study. A dutiomlLv, i. have Lem asked to present a paper on respiratory changes in ,.i;-d:.for am. :: i worker'' as nart of a symposium chaired by Keith Morgan on oeronntio' '1 lung disease at the American College of Chest Physicians in Denver in late f -cfcolmr. Margaret Dcckiakc is also participating in this session. One of the itomu which I listed in my June letter was our plan to u'dy>.e tk*' rviatioiiship of pulmonary function and total dust exposure in order to arrive at, information which, hopefully, will be helpful in answering the question which you raise concerning a sensitive pulmonary function method (s) which will be of greater use than the cheat x-ray in the detection of early changes I ,'r. George Wright - 1 age 3 V associated with asbestos exposure. Certainly, one of the ways of looking at pulmonary function ansi oxpos.urc is the one which you suggest where groups with smula.r crpoaure" arc divided by whether or not they have radiographic abnormalities. he will make every effort to do this, assuming that there are enough individuals in each category to make the results meaningful, et any rate, this question is, of course, uppermost in our minds and it has simply not been possible to do all the analyses at once. I hope that most of the information which you require is included in this letter, but if there arc further items which should be clarified or expanded r <. rhrpr Ike heat way to do this would be to discuss these items by telephone at y ;ur convenience. gain, let me express my thanks to you for your support : ml as si stance and, particularly, for bringing up these matters which are likcl to need clarification in the deliberations of your committee. Vv ith best regards, ' flincerely yours. rnv/j I-lana Weill, M. D.