Document xjn90xovgN4paxY7753jY6Vg

i.u.un . SU.1. of letter of Or. H.C. Lseimsafca ad Or. S. Hoiaes to Or. l.J. Sellkoff. July 13, 1973. Document* A. Hi. Saltkc.'f .in... , .. the Aaarlcu Industrial Hygleoe Coatraac% May 31, 1973, as recorded and transcribed by undisclosed aouroas sad subeitted by Dr. Lewlatoha and Holass. 9. Coealttea on Hygiene Standards of tbs British Occupational Hygiene Society. Ann. Occup. Hyg. 11:47-69, I960. C. H.C. Laainaohn. Tha ted leal Surveillance of Asbestos Vorfcers. Bey. 8oc. Haaltb J. 93:69-77, 1973. 0. C. Bar- . Hygiena Standards -- Theory sac Application, lyea, Oct. 3, 1973, Paper 33. s. 6. Holme*. Criteria for Enviroonental Oats sad Bases of Threshold Limit Value* -- Environmental Data la Industry. Lyoa, Oct. 9, 1973, Paper 30. Co--ant* 1(a) ireference to a--bored paragraphs La Lowlnaoha Holmes' letter). d The paper "...was mot Intended to Justify or verify the BOB standard." Noehere did 1 say it van so intended. 1(b) "1110 results presented la HCL's paper earn preliminary results." It Is possible that you elll have further findings but at the tine of my presentation only those sere available that you had published, and defined la your paper as follows: "Figure* 3 and 3 Ulu*trate the Incidence of radiological changes, in ten years exposure groups, la 970 males sad 317 females exposed to asbestos. In the previous report* it van shown that radiological abnormality was dependent upon exposure, age and smoking habits but that exposure appeared Ik Uie most important staple factor." (Document C, pg. 74.) 1(e) Tou argue that It was clearly stated la your Discussion that "From the information currently available only tentative opinion* can ho expressed." I fall to see the relevance of the implied complaint. Nowhere did I quote your opinions. I van interested only in your data. ENVirtONMENTAL SCIENCES LABORATORY MOUNT SIN. I 1(a) You atata that tha populations reportsd by bn sad IQ vara not identical nor vara "the vary large majority" "cvsca to both survey*." I vould be interested la data ta support ihu assertion, vlth reference to tta aaaletmt catacorlcs specifically referred to br aa la av preaoatatlo*. i.a., these 10-19, 30-29 and 30-39 years I t, sad ra- produced la ay tables (see 3(a)). These vara the vklch radiological changes vara seen, sad ta ifelcb rale lld, (Docuaeat 1, fT 'r'-- 11. > The thrust of ay dlacussloa, and tha ooetraat ta tdiich I pointed, bora on tha individuals x-rayad by hot (Oacanaat I, p. S3) la X9M. All of these individuals vara at least Id years iron onset and, unless no longer vorklag at Turner ran, vara In the 1970 groups x-rayed by yon. Do yon nontend they vara not? If so, please explain. I made no issue of individuals 40* years fron onset, nor sere they Included in the grsph (eea S) sine# they bad bogus before 1933, **d were not Included la Dr. Knex*9 report. 2(b) Insofar as you would have preferred that I had designated tha additional individuals x-rayad by you aa "gaallty control and research staff" ratbsr than "office vorfcers" 1 eaa only plead tha shorthand of aa exteeporsneona presentation designed to fit s United tine allotaent. Incidentally, ay axperis with U.8. research staff# la that they do spend n of tine la offices. 3(a) You conplsin that I stated that Knox mportad on 913 aaa with at laast 10 years exposure. Yon nlsgaote an. My earn: "Dr. Knox had exaalnsd only aea la -- that Is, the production areas, 113*, Included sll enployees...." (Document A, p. 10.) The flgnre 913 vss given to cospare a production area groep vlth tha larger population (1,2*7) x-rmyed by yon. In ststenant ana made by aa that such s nunbar vsa la the 10 year or aver groups (Docunent A, p. 8.) Indeed, ay references to Dr. Knox's findings earn specific sad exact, since I shoved s slide vhlch presented the precise data , ,contained in the tables In the paper published la *868 (Docunent 9 p. 51) sad sttrlbutsd to Dr. Knox (Doeuneat 9 p. 54). Oroup 1 Years --Pl0>*d to15302530- Baber exposed 99 73 29 48 ___8 flbres/caJ 11 11 to 27 Z-Xsy changes 0 1 3 3 _1 811 7 3 Crip 2 fears <sp 1 r-4 101320.'1 30- Nunbe r e xp<' 22 20 10 20 _7 70 tlbera/cm 3.3 3.5 tu .o X-kay changes 0 0 0 1 _0 1 tables from which this slide was abstracted follow: Van employ4 l1520-- 2550- Hrtai maedarda for chryvula Number <<^ad 54 71 9 44 4 Geove I Man tun pwu* cm* (aa* Noe 1) M0 M0 10 940 ftVTVCW* (m Sota 7) II II r Rhercm II 7 M 2 Basal rake 1 1 4 8 1 1 `4 X-ray chaaca 1 2 1 1 Yaws 10-- 15201510- Member axpoaad 22 20 10 10 7 Oeewe 2 Mm flonewniM* paniate/oe* (ms Noa 1) lyo/os' (m* No<a D 165 15 165 1*5 o to 0 40 Rhonchi 1 5 2 1 1 Ba-d r*' 0 0 X-ray civirpM :0 0 My *xct extemporaneous consents were: In the departments where the dust counts were 10 to 13 fibers per cc, of the large number of workers there employed, 7 showed some x-ray abnormality which could have been asbestosls. On the other hand, of 70 or 80 people working at 3 to 4 fibers per cc, only one was reported to have an abnormal r-ray." (Document A, p. 8.) -4- 1 The designations "10 to 15 fibers par ec" aad 3 to 4 fibers par cc" were derived t r - ('r. Carry's tabla In 1972 f Don--a t 0, p. 11). Ha glv.-a thca a* 10.9 to 13.2 flbsrs/ca* sad 3.4 to 4.1 flbers/ca . j believe ay reference la accurate. 3(b) My uaa of the pnraee "...could bava baas ashesteals" (Don--at A, p. 8) based upon tha colusn heading is tbs 1944 paper (Dociaent B, Tables 1 and 2, p. S3), "X-Ray changes possibly aabastotic," and tharafora taans aotlraly faithful. 3(e) and 4(a) You all! note, too; that ay tablet listed 290'aas with sere than 10 years, exactly as reported la 1944. These ere compared ltb tha rasults la these aorkers x-rayed by you in tha saaa general employment categories, l.a., 30-29 years, 30-39 years, -10 years" troa first employment." Ibis Is adalttedly not absolutely identical with your prsdsossser Dr. Knox's " years aaployad" but, If anything, your employment categories (years fro* first employment") could not have re flected -tore than Or. Knox'a ("years employed"). It could have been u,s (if aooe worker* had periods out of eork), but net >--. Therefore, if my-thiii*, >our x-rays should hsv# shown less disease than Dr. Knox's, by employment category. 4(b) You coaplaln that the tarn "asbestosis" arms used on tbs graph. Ibis eord ass used by Kaos etuis you used tbo torn "pulnonary fibrosis." a tharafora had tbs option of using either. Per haps yo alght sdrlse ne If you think 1 ass Incorrect la ueiag Dr. Knox's "asbestosls," sad it you bollsae It Is stretching things to so label your "pulnonary fibrosis," sbsn yen describe such x-ray findings Is eorkers anploysd la an asbestos fsetory for 20, 30, 40 or acre years. I seen to rensnbsr as old English saying, to the offset that circumstantial saldeaee Is aery strong, as whan one finds fish In tbs nllk. 5 You say that you did not sttsnpt to calculate fiber yaars/cc. I did not say you had. I did shoe a graph prepared by Dr. Willlan J. Nicholson of our Laboratory coapsring your x-ray findings with Dr. Knox's using an overall average cumulative exposure for tha entire population. Tha exposure experience ass not taken out of thin air but aas derived froa tbo vary complete Turner Bros, dust data analysis preseated by Ur. C. Berry in Lyon on October 2, 1972 (Document D). These data wars given as the latest available. Unfortunately, you did not pre sent coapaiaole results la your osm paper -- as sould have liked to have assn then. lbs asbestos exposures used on the graph In ay presentation sere estlasted as folloes: The dust levels reported by Berry (Docuaent 0, p. 11) and presented at Lyon served as the basis for estimating cumula tive exposures prior to 6,30,66. To each of these Integrated exposures was added 22.5 flbors/cc-ycars, which was obtained by avrraging the dust level lata listed In Table 4. page 37, f Decuman t B tor the flberlilng, cardiac Md depart- neats aad aultlplying by 4.5 year*. Tea year average exposure* eere obtained by averaging the data la appropriate I year a*U gorlea, weighted by the niabr ot een working In iwwd. Baeauea e bad ao way of aaaoclating observed x-ray changes with In dividuals In high aad low 10 year eaposur# categories and ta order to be as conservative as possible, the dust exposures aaslgaed to groups ot workers were those of the highest ex posed workers although 1/3 to 1/2 of the individuals repre sented by each point were exposed at levels 1/3 leas. The estimates oi tae niakewr ul Individuals affected ware also as conservstlve ss possible. All questionable parenchymal x-ray changes snd all pleural changes not consistent with asbestosls were considered as negatlvs. As oan be seen by conparlng the graph with your figures t and 3, our conservative approach has reaultod in the graph aborning Ians x-ray abnormality than do your figures. X mould appreciate either reworked or nee dust data ta go with your x-ray reaulta and will then prepare another graph, la the naantine, we win have ta uaa dust data presented from Tun-r Bros, by Dr. Kolass la 1323 tSocunenv B, p. 57) and by Mr. Berry in 1973 (Oociesnnt 0). I. glnce Dr. Knox included In his recorded x-ray changes pleural abaormSlitlas as well as parenchymal disease. It any well be that there were even fewer than B cases, of those ha reported, with only pulmonary flbrenia. The 19*1 paper deep net aaks this clear. If this were ao, thee the contrast with year 1970 "pulnonary fibrosis" category would be ewes greater aad the discrepancy even more pesxllng, since me coshered all el Dr. Knox's "possibly asbestotic" x-ray changes (Poo--at B, p. 55) with your nore limited category "pulnonary fibrosis." A further point is In order. The BOMS paper la 1BBB was eoscerned with earliest evidence of disease resultlag from asbestos exposure. (Document B, p. 50.) Indeed, it deemed It advantsgeous to so consider basal rales since these onuld occur before x-ray change. You state you used "the U.1.C.C./1LD classification" (nislabeled; it in the 1LO U/C classification!) to analyse your radiological findings. Tour appropriate nan of this international x-ray claaalfication system rather than a personal one has surely allowed you to approach the goal ot the BOMS coralttee. the uae of "the earliest demonstrable effect* on the lung due to asbestos," as the criterion for "aebeetosia." 1 believe your reoorded x-ray findings (Pocueent C, figures 2 and 3, p. 74) are likely to be accurate, aad the reported presence of parenchymal and plaural abnormalities "consistent with* asbestosls to refloct what actually exists among eerfcers at tbe Turner Bros. Asbestos Co., Ltd. 7. Basal rales. I Mds no reference to basal rales since your paper did not report on these (Document C, pp. 74-75) and 6 r . i .;n of 1 ' --Kn i .nd ib70 - he<lnsohn was thus not possible. I- a :ic .1 i . n. . . ' a; . . < o pare K-1 ary f unc t ion f lndi: ^ j !ii r rr-i.. . .-J l, j ou but not by Knox (Document C, P P. -i 'j) . 8(a) also see 4lo) hid > - r.a-e an/ cases recorded by you as "pulmonary fibrosis" lid rot fnt t!:.ne lens tic asbestotic Interstitial f ar.isis if they later care to pos two,? dio) . . j. .. ^ fact that the number of cases of ashestosis : r. 100s among 33!i employe** (r.en and women) e* po.-fi for lu y-ars or -ore sir.ee 19J3 in Rochdale and still was :. : 2* (..e. i cases) as conpa red with llerewether1 s finding of M.l". (l.g. met) aaoo.g 133 workers exposed 10 .i ic. or r.- .n : a.-<- industry in 1929. This lower ln- ci : r i js ' "J ; pile ,itr.e tact that the Pneumoconiosis L'.i':- ire better equipped to diagnose ssbestosls than Vler.-et:. r -is. 1 c h . -1 . - i e no reference to this observation of yours (C ..1..J . n. - a-e - C, Triple II, p. 71). since It was such * a.,.. r-< e -- w ' -> - r -4 1 r/> - - te . u . .- - j-- - * .* * * a * w-.Ms att r.ti r. t: Th- i r.eurncor. i&s i s i.nei c.t>i were re- cases fir -t iu -r nr! .n 1j' - "ere-ethcr ' s data gave the result* of a study of the p-- a! ->'. re of asbestosts among a group of worker. : n I '.'.j. One u.u r. ; coni tse annual incidence of s dice a- e , - t th its prevalence, (Vour Table II follows.) riw rain of 41A-iioii <u.:t amd Mtrrutthtr". Taau II >W) d,otne4 m 7944 (u* aa > pn*r m eaa^and with She data at MmmtLi* Ate. of yeart 1C-U 15-19 20-U 4 OvTf TOTAL Pnja-.xn IMS Ate./ cmmi Sf*1 Torot S', 49 139 i 16 24 t* J s 14 a 14 ** 234 in 333 4 Grout bttUtnta % 6)2 Ml 1-30 1 12 Casa or Assuiws 2937 A`. of taut 1 1 Gnu? tmerdtact 7. 0*4 0-71 1 ) 3 0 IfJO Gnat tttidtaea 7. 321 13-6 *09 26-2 You voice d*nplc-jure that the contents oi a private correspondence" were communicated. I hardly thir-.h that a paper published in the Royal Soc'rty of Health Journal is "private correspondence." I requested that v-i'i scnc rc numbers to translate the figures and you did: nv references were then mp.de only to what you reported in your published paper. You did send me r.c-v dita (concerning pulmonary function abnorr.alities ar.d relation o( r-ray abno.-r.ali t les to froklr.g that were given m a paper by you at S.I fori) but I made no reference to these data since, while 1 had *!.< - ,.nd i l>- you had r.ade bib i iocra.ih ica l reference to the-. ([jo. u.'1-.it C. T. : r nee 'C, p. 77), thev h ..! not yet appeared in print an 1 r. . d t): r` not reidLl t: tv them. fiii U nr r 7 You suggest that the information la being used "to launch what urae te be a political campaign in the U.S.A. a1med at discrediting <>"r Uygteaa Standard f r asbestos," l note you sent your letter to the Asbesto* Information Association of north Aaertca. In contrast, ajr aaalyala wai given In an invited paper to a scientific society (the A.C.C.I.H.), before > rs, and av.uiabir for discussion and for preseatatloa ot alternate views, If such be held. i