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FILE NAME: Ford (FD) DATE: 1966 DOC#: FD054 DOCUMENT DESCRIPTION: AIHA Bulletin, Produced by Ford - Asbestos Bioeffects Research for Industry < . -5 PLAINTIFF'S EXHIBI INDUSTRIAL HYGIENE FOUNDATION OF AM ERICA, Inc. JOEFFECTS RESEARCH OR INDUSTRY Medic*) Series, Bulletin No. 1) 4400 Fifth Avenue Pittsburgh. Pennsylvtma 1966 8005 1492 PRODUCED BY FORD FOREWORD During the p ast y ear, a num ber of industrial m aterial* have come under attack in public news m edia as a re su lt of heightened public in te re st in the environ m ent. The potential of such m aterials to adversely affect the health of the general population through environm ental contam ination has been raised . One such m aterial is asb esto s. T here have been a rtic le s in the pro fes sional lite ra tu re 1,2 and in the lay p r e s s 3 which p resen t highly exaggerated views of the nature and extent of the potential problem . P rom pt c ritic ism has followed pointing to erroneous in terp retatio n of existing fact* and publication of m isinfor m ation. * "^ At the suggestion of sev eral of its m em b ers, Industiial Hygiene Founda tion held a m eeting on Ju ly 19. 1966 to su m m arise what industry is doing to develop inform ation to p ro te c t the health of its em ployees and the public from potential environm ental h azard. Such inform ation should be of considerable value to all those responsible for planning of environm ental and occupational health research , w hether in industry, u n iv ersities or governm ent. It is appropriate th at Industrial Hygiene Foundation, a nonprofit research a s s o c ia tio n of in d u s trie s fo r ad vancem ent of h ealth co n se rv a tio n in m a tte rs r e lated to in d u stry 's o p eratio n s, products and w astes, should a s s is t in development of national environm ental and occupational health research to help insure that in d u s try 's n eed s a r e p ro v id e d fo r at a ll sta g e s of p ro g ra m developm ent. 1. T hom son, J . C . and C ra v e s . W .M . "A sb e sto s a s an U rban A ir C ontam inant. " A rch. P ath, 81:456, May 1966. 2. Thom son. J .C . and G rav es. W .M . "A sbestosis in Urban Populations. ' JAMA 196:732-733. M ay 1966. 3. A nonym ous. " A sb e sto s: A w aiting 'T r i a l '. " C hem . W eek, p . 32, Sept. 10, 1966. 4. C ro s s , P . L e tte r to E d ito r "T o d ay 's P re ssin g Q uestion--How Safe is Urban A ir." A rch. P ath . 82:195. Aug. 1966. 5. deT reville, R .T .P . L etter to E ditor. A rch. P ath, (to be published) 6. C ro ss, P . L etter to E d ito r. JAMA, (to be published) 7. H ackney, R . L e tte r to E d ito r. C hem . W eek. p. 7, O ct, 8, 1966. 8. Brown. M. C. L etter to E ditor. Ibid. 9. E d ito rial Note (following re fs . 7 and 8). Ibid. h 8005 U 9 3 PRODUCED BY FORD 1 Subject; S um m ary of Weed and Plan fo r A sbestos R esearch The purpose of this session of the Industrial Hygiene Foundation M anagem ent Planning M eeting, held in the Hunt Room of the W ebster Hall H otel on Ju ly 19, w as (1) to h elp develop a b e tte r concept of the a sb e s to s in dustry's environm ental and occupational health research needs and what is being done to m e e t th em and (2) to provide the U. S. Public H ealth Service Surgeon G eneral with a sum m ary re p o rt and any recom m endations which may be developed from the m eeting to aid in setting, clarifying, and reaching sound and realistic health conservation goals in the national interest. The m eeting was sponsored by the Foundation's Policy and P lan ning Com m ittee. Those attending the meeting w ere: Name Bowman, H. M. Colwell, M .O . C ralley, !.. J. Davison, E. K. deTreville, R. T. P. Edwards, F.H . G rant, L. B. Gross, Paul Hatch, T .F . H asard, W .G. M inard, David Schrenk, H. H. Smith, F .W . Smith, K.W . Smyth, H. F . W right, G.W . Company T hiokol's R eaction M otors Division Aluminum Compsny of A m erica U .S . Public Health Service D avison Sand fc G rav el Company M anaging D ire c to r of 1HF Owens-Com ing Fiberglas Corporation Pittsburgh P late G lass Company D ire c to r of 1HF R esearch L ab oratory U niversity of Pittsburgh O w ens-Illinois G lass Company U niversity of Pittsburgh S ecretary, IHF Board of T rustees Mine Safety Appliances Company Johns-M anville Corporation M ellon Institute St. Luke's Hospital 8005 U 9 4 PRODUCED BY FORD 5 2 M r. Bowman opened the m eeting and asked D r. deTrevllle to conduct the sessio n on A sbestos. D r. d eT rev ille. who had asked sev eral oi those p resen t to be prep ared to discuss th e ir a re a s of special in terest and research needs, firs t called on D r. G eorge W. W right to rep o rt briefly on his activities of the p ast y e a r in behalf of th e Quebec A sb esto s M ining A ssociation (QAMA). D r. W right said that he had been aw are of in d u stry 's in te re st in asbestos since about 1940. a s a re s u lt of h is w ork at Saranac L aboratory for QAMA. At th a t tim e no question w as ra ise d co n cerning p o ssib le m alignancy. At a m eeting in Antigua in 1965. QAMA ex p ressed its intention to le a rn . "W hat is known, what we need to know, and what is unknown" concerning the bioeffccts of asbestos. Concerning what is known. D r. W right listed the following scientists who w ere p re sen t in A ntiguai D r. John B eattie Cam bridge, England D r. H. Bohlig L udenscheid. W. G erm any Dr. Paul C artier Thetiord M ines, Quebec D r. A. Claass D r. John C. Gilson P en arth . G lam organ. Wales D r. Roger G rainger A sbestos. Quebec Dr. Fernand G regoire M ontreal, Quebec Dr. Paul Gross P ittsb u rg h , Pa, D r. L. J. Cralley C incinnati, Ohio D r. A. J. deV illiers Ottawa, O ntario D r. Roland Guy C artierv ille, Quebec P rof. A. Houberechts Has seit, Belgium 8005 1495 PRODUCED BY FORD * *1. 3. D r. J . C. McDonald M ontreal, Quebec D r. A rthur J . Vorwald D etroit, M ichigan D r. Leo Noro Helsinki, Finland Dr. J. C. Wagner Penarth, G lam organ, W ales D r. Sherm an S. Pinto Tacoma, W ashington D r. George W. W right Cleveland, Ohio Prof, Paul Sadoul Nancy, France D r. K. W. Smith New York, New York D r. J . A. Vidal M ontreal, Quebec D r. Philip Enterline M ontreal, Quebec D r. Philippe Duval Noranda, Quebec D r. Eugene Pendergrass Philadelphia, Pa. P rof. E. C. Vigliani Milan, Italy M r. K. W. N elson Salt Lake City, Utah In the c o u rs e of th e QAMA M eeting, m uch of "w hat is known" w as review ed and discussed. D r. W right found the m eeting very valuable from a personal standpoint, chiefly regarding discussions of the very pertinent questions,"W hat we need to know" and "what is unknown." F o r example, he stated that the word "asb esto s" is as general a te rm as "b acteria" and th at it is not possible to tra n sla te data from one type to another. The types vary with origin and chem ical com position and alm ost never exist in a "pure" form . It is very difficult to categorise an exposure en v iro n m en t because of the need to capture, identify, recognise, and quantitate the m a te ria l we now call "a sb e sto s". D uring p ro cessin g , asb esto s, which is not indestructible, m ay undergo dissolution or change in form. Is the m ateria) redissem inated identical to the original, or does it differ? D r. W right indicated that it had been sobering to realise the extent to which asbestos is distributed in various lo rm t in the general population. 8005 1496 PRODUCED BY FORD 4. and we m ust have b etter knowledge of w here asbestos m ay com e into contact w ith humane and b etter reco g n ise any adverse bioeffects which m ay have re s u lte d . P r . deT reville next aeked if P r . Kenneth W. Smith had any com m ents concerning the A sbestos T extile In stitu te program . P r. Smith related that the A sbestos Textile Institute is cooperating in an extensive investiga tion w ith the a sb e sto s te x tile in d u stry by the U. S. Public H ealth Service under the direction of P r . Lew is J . C ralley. The ATI has felt the im pact of adverse criticism in the form of p re ss releases, radio, and television ap p earan ces concerning a s b e s to s . A side fro m knowing the facts concerning the tru e effects of asbestos upon m an, the industry must be increasingly concerned with p re se rv a tio n of its m a rk e ts as a m a tte r of survival. All the individual company can do to help solve this pressing problem is to provide funds, environm ents, and individuals for study. The basic re se a rc h needs w ill have to be "farm ed out", but studies a r e alread y being conducted on in su latio n w o rk ers on the W est C oast and in the M idw est. In C anada, Johns-M anville Company is studying a ll in su la tion w orkers who have p e rm its, and this study has governm ent approval. The ATI. as m entioned, is co o p eratin g in an extensive survey by the U. S. Public Health Service, D ivision of O ccupational Health. The National Insulation M anufacturers A ssociation is vitally in terested in developing inform ation to pass on to insu lato r em ployer groups. As he has pointed out repeatedly, D r. Smith feels that the prim ary need is b etter definition of a sb e s to s exposure, especially im portant in epidem iological stu d ies. What is an asb esto s w orker? In this regard 8005 149? PRODUCED BY FORD 't 5. he aaid, the looae thinking concerning aabeetos exposure was dem onstrated recen tly in Pennsylvania when the o ccu rren ce of m esotheliom a in a th re e - year old child was attributed to the fa th e r's working in industry under the union category of an asbestos w orker. A ctually, this union category title covers many individuals who have no occupational exposure to asbestos. At th is point D r. deT reville called on D r. Lewis J . C ralley to p ro vide a b rie f re p o rt on U .S . Public H ealth S e rv ice, D ivision of Occupational Health plans. D r. C ralley sta te d that he would like to cover briefly th re e areas of U .S. Public Health S ervice, Division of Occupational Health in terest. (1) A prospective longitudinal epidem iological study is now under way in four industry exposure categories: (a) A sbestos textiles (b) A sb esto s fric tio n pro d u cts (c) A sbestos cem ent products id) A sb esto s in su latin g m a te ria ls The aim is to cover at le a st 2500 w orkers in each category with a wide range of exposure from office to production w orker and with b u ilt-in co n tro ls. Exposures are being defined in detail including factors other than asbestos. In addition, the past h isto ry of plants regarding asbestos exposure is being reco rd ed in an attem pt to develop retro sp ectiv e studies designed to com pli m ent those of a prospective n atu re. D etailed inform ation on each w orker is being developed using a questionnaire approach, which includes occupations, hobbies, and sm oking h isto ry . These studies will be c a rrie d out over the 8005 1498 PRODUCED BY FORD 6. lifetim e of these individual* w hether o r not they stay in the industry. At in te r val* a follow -up w ill be m ad e using B u reau of Old Age and S u rv iv o r's in su ran ce re c o rd s and State D epartm ent of H ealth death reco rd s from w hicha trend of causes of death w ill be developed fo r each group. A designated num ber in each group will have periodic m edical follow -ups to e sta b lish health p ro files. While the p ro spective study itse lf w ill req u ire 25-30 y e a rs of w o rk ers' experience, it m ay be possible to recognize tren d s as early as 5-10 years from the tim e of the base line study. (2) C o n cu rren tly , a study w ill be m ade of the lungs of individuals in the cohorts who died of can cer. This w ill include com plete m ineral analysis of tra c e m etals including nickel, cobalt, chrom ium , etc. In this regard, individuals w ill be categ o rized into two g ro u p s-- those having significant exposure before mid 1940 and those en terin g exposure a fte r this period. T ech nology has changed m ark ed ly since th e 1930's, and contam inant fines of asb esto s have been re d u ced 307 o r m o r e . E x p o su re of w o rk e rs is g e n e ra lly no lo n ger m a ssiv e . Data collected should help provide insight in understanding past and present w orker health experience. (3) The U. S. Public H ealth S erv ice is also very in terested in identi fying the various types of pulm onary ferruginous bodies that have been observed in a num ber of persons coming to autopsy in hospitals in urban a re a s . P or ex a m p le , ta lc h a s b een found to co n tain about 10% fib e rs . In veiw of th e w ide sp read use of talc in co sm etics, e tc ., could som e of the ferruginous bodies be from this source? A lso, just what does the presence of these bodies mean? A U .S . Public H ealth S erv ice re c o rd s study begun by D r. Philip E n ter line is designed to d etect con trastin g d ifferen ces in tren d s in causes of death of w o rk e rs in different a sb e s to s product c o h o rts. The im portance of K nox's and 8005 1499 PRODUCED BY FORD 7. D oll's study is th at early data indicates that industrial hygiene control of dust exposures w ill reduce the incidence of lung can cer in a sb esto s w o rk ers. D r. deTreville then requested D r. G ross to provide a detailed d es cription ol IH F's Fibrous Dust R esearch P roposal. D r. G ro ss sa id th a t Thomson*** h a s found th a t about 30% of th e people th at had died in hospitals in Capetown (500 consecutive autopsies) h ad " a s b e sto s b o d ies" in the lu n g s. T he sa m e author*12 34* had found a s im ila r prevalence of "asbestos bodies" among the hospital deaths in M iami, Florida. C auna. T otten and G ro ss* 2 * exam ined th e lungs of 100 n o n -se le c te d h o sp ital deaths fo r which autopsy p e rm issio n had been obtained and found that 40% of th ese had "asbestos bodies" in th eir lungs. Ian Webster*** recently reported a 47% prevalence in Johannesburg. There is, at present, a reasonable doubt that "asbestos bodies" are specific indicators of the inhalation of asb esto s fib ers. Such bodies have been found in coal m in e rs and talc w orkers w here they have been called (1) T hom son, J . G . , et a l. A sb esto s a s M odern U rban H azard . S. A ir. M ed. J . 37:77-81. 1963. (2) Thom son, J . G . , et a l. A sbestos as an U rban A ir Contam inant. A rch Pathol. 81*58-464. May 1966. (3) Cauna, D zidra; T otten. R obert S . : and G ro ss, P aul. A sbestos Bodies in Human Dungs at Autopsy. JAMA 193:371-373, May 3, 1965. (4) W ebster, lan. R eport of p ro g re ss quoted in the Annual Report of the Pneum oconiosis R esearch Unit of the South A frican Council for Scientific and Industrial R esearch , 1965. 8005 1500 PRODUCED BY FORD B. "p s e u d o -a sb e sto s b o d ie s ." R e c e n tly D a v is(5) end Collet*6* have d e m o n stra te d the intracellular developm ent of "asbestos bodie" secondary to amorphous m aterial. A sbesto occupie an anom alous position in it ability to produce lung dam age, causing diffuse fibrosi and possibly also lung cancer. It is anom a lous inasm uch as no other silic a te has been shown to possess this ability. The fib ro sis encountered in ta lc o sis is lim ited to the trem o lite v a rie ty , which is a sb e sto s-lik e . On the o th er band, the pneum oconiosis associated with the mining of m ica (another silicate) has not been investigated experim entally, and the fibrogenic activity of the du sts coexisting with the m ica has not been evaluated. Other silicates may evoke either m inim a) or relatively slight inflam m atory changes, and a re incapable of producing lung cancer. Inasm uch as certain polycyclic hydrocarbons and trace m etals known to be potent cancer-producing agents have been dem onstrated in asb esto s, particu larly nickel, chrom ium and bennopyrene, the possibility exists that the tra c e m etals a n d /o r the polycyclic hydrocarbons may be solely responsible for the observed pathogenicity. This p o ssib ility is supported by two findings: 1. The re p o rt of B raun and Truan*^* which indicated that the p rev a lence of lung cancer among Canadian asbestos m iners was no g re a te r than that of the gen eral population. T his w as in c o n tra st to the re p o rt of Doll ( 8) (5) D av is. J .M .G . E le c tro n -M ic ro s c o p e S tudies of A sb e sto sis in Man and A nim als. Ann. N .Y . A cad. S cie. 132:98-1)1. 1963. (6) C o lle t, A . P e rs o n a l C o m m u n icatio n , 1963. (7) B rau n , Daniel C . and T ru a n , T . D avid. An E pidem iological Study of Dung C an cer in A sb e sto s M in e rs . AMA A rc h . lnd. H ealth )J :6 3 4 -6 5 3 , June 1956. (B) D oll, R. M o rta lity fro m Dung C a n c e r in A sb esto s W o rk e rs. B rit. J. lnd. H ealth 12:81, 1955. 8005 1501 PRODUCED BY FORD 9. which indicated a g reatly in creased ris k of long cancer among B ritish w orkers exposed to asbestos dust while fabricating the asb esto s. 2. In a recen t investigation in the lab o rato ry of the In d u strial Hygiene F o u n d atio n , lung c a n c e rs w ere found in r a t s exposed fo r 18 m onths to high c o n c e n tra tio n s of c h ry s o tile d u s t . (9) B ecau se ra ts exposed to c h ry so tile dust by other investigators failed to develop lung can cer, th ere is a good probability that the chrysotile dust that produced lung cancer was significantly different from that which did not have this effect. It is possible that this difference is caused by a coating of nickel steel alloy applied to the asbestos dust particles during the continuous ham m er m illing p ro cess used for ren d erin g the dust re sp ira b le . This m ethod has not been used by previous inv estig ato rs. Nickel has been found capable of producing lung cancer in tra c e am ounts. Although asbestos and glass are both silic a te s, the in dustrial health experience with w o rk ers of these two m a te ria ls has been vastly different. No pulm onary d isease has been reported in w orkers exposed to glass dust. N ev erth eless, the dust of filam entous glass has been labeled as highly dangerous in the lay p re s s by association with asb esto s. It is a fact that although the effect of flake glass dust on the lungs of anim als has been rep o rted , no sim ila r study has been m ade of the dust of filam entous glass which does not have an associated resin or filler. It is proposed to examine the response of anim als' lungs to different inorganic fibrous m aterials of contrasting chem ical com position, and to c h a ra c te rise the differences and sim ila ritie s in the resp o n se. (9) G ro s s . P . and d e T re v ille . R . T . P . E x p erim en tal A sb esto s is : Studies on the P ro g r e s s iv e n e s s of the P u lm o n ary F ib ro s is C aused by C hrysotile D ust. To be published. 3005 1502 PRODUCED BY FORD 10. . It is also proposed to investigate the influence of trace m inerals and polycyclic hydrocarbons ( i . e . , benzopyrene) associated with chrysotile ore o r the subsequent p ro c e ssin g on the lo n g -te rm resp o n se of the lung to the dust. A nother objective of th is phase is to obtain definitive data on the long term effect of dust derived from filam entous glass upon the lungs. Three v arieties of sucb glass dust will be investigated: 1. with the phenol-form aldehyde-type of binder . 2. with the binders used in tex tiles 3. without binder In addition, a co m p arativ e study of the th ree m ain types of asbestos dust (chrysotile, am osite and crocidolite) is proposed to attem pt to pinpoint the cause of biological activ ity -- i.e . , w hether due to silicates j t r i t or the a sso c ia te d tra c e m etals o r h y d ro carb o n s. P o sitiv e findings would be a basis for identifying any possible health hazards and for suggesting specific engineering or other process controls to elim inate such hazards. 1. The follow ing fib ro u s m a te ria ls w ill be re d u c e d to re s p ira b le p a rtic le size (<3p) and w ill be injected in am ounts of 3.5 m g. to 30 mg. as aqueous suspensions: 1. chrysotile dust (prepared by m illing in W right m ill and with dem o n strated carcinogenic potential) 2. chrysotile dust (unm illed synthetic)* 3. alum inum nitride 4. tricalcium phosphate (filam entous) 5. fibrous glass a. with phenol-form aldehyde-type binder b. with binder used for textiles c. without binder 6. m agnesium hydroxide (brucite) 7. m ineral wool 6. zinc oxide (filam entous) * Synthetic chrysotile has been p rep ared a t Mellon Institute by D r. William G ranquist. E lectron photom icrographs show the ch aracteristic tubular crystals. 8005 1503 PRODUCED RY FORD 5 n. These m aterial w ill be injected intra t rad ically into ham atera under eth er aneatheaia. P revious experience ha a demon trated that aabeatoa bodiea w ill form in reaponae to chryaotile duat w ithin five month. The anim al w ill th e re fo re be held fo r aix month and then kilted . Abeto bodiea w ill be ought in lung juice aa well aa in the lung tia su e s. The lung w ill be expanded w ith buffered fo rm alin under a head of 10 c m . of w a te r. Block rem oved fro m th e a e lung w ill be aectioned a t 6 u a fte r p a ra ffin im p reg n atio n . T heae se ctio n w ill be atained by d iffe re n t method and photographed aequentially to provide mean for atudying m ore com pletely the ti*ue reaction to theae various m aterial. Search fo r the so-called asbestos bodies will be m ade using routinely stained sections, and sections stained for iron. In addition, unstained cleared sections will be exam ined under d ark -field conditions for asb esto s bodies. The la tte r glow when exam ined in th is m an n er. The difference in tissue reactio n betw een the synthetic chry so tile dust and that which is known to be fibrogenic as w ell as carcinogenic will point to the contrib u tio n to pathogenicity m ad e by one o r m o re of the v a rio u s trace substance which m ay be asso ciated w ith chrysotile asbestos dust as a result of processing. The development of "asbestos b o d ies." better term ed Ferruginous bodies, to dusts other than asb esto s would point to the non-specificty of these stru c tu re s and to the d esirab ility of collecting such "asbestos bodies" from human lungs in o rder to subject them to electron-probe analysis. Such 8005 1504 PRODUCED BY FORT 13. 111. B ecau se of the in te r e s t of s num ber of com panies in biologic investigations sim ilar to those planned for chrysotile asbestos, but using instead, am osite and crocidolite, an additional investigation is proposed to be undertaken concurrently. As in the proposal dealing with chrysotile asb e sto s, the purpose of this supplem ental, co ncurrent investigation is to attem pt to pinpoint the cause of the biologic activity of all three m ain types of asbestos dusts: w hether this lies in the silic a te s per s e , in the associated tra c e m etals, o r in the associated h y d rocarbons. Because neither am osite nor crocidolite is available as a pure synthetic m a te ria l, the investigation proposed for these two types of asbestos is n ecessarily different from that proposed for chrysotile. N ev erth eless, in o rd er to m ake the investigation com plete, it is desirab le to include also chrysotile in the new investigation since different m ethods a re involved. Inasm uch a s the biologic activ ity of a sb e sto s se e m s to have two com ponents: (a) in fla m m a to ry -- re sp o n sib le for a s b e s to s is , and (b) n e o . p la s tic -- responsible for lung cancer and m esotheliom a, it is advisable to investigate both of them . This can readily be accom plished within the four year span contem plated for this investigation. In order to determ ine whether the biologic activity of asbestos re s id e s in the s ilic a te , in the asso ciated tra c e m e ta ls , or in the associated hydrocarbons, attem pts will be m ade to rem ove the trace m etals and the hydrocarbons from th eir respective silicates and to com pare the biologic activities of such "purified" asbestos sam ples from which these associated m aterials have been rem oved. 8005 1506 PRODUCED BY FORD