Document zQ64QMQYqwDxXkKkV8GDkJM0B

800936 Hugh .Jackson and I have reviewed the condensation of the survey which you sent us. We liave noted deletion of all references to the association of nr.ios Los is ana lung cancer in this condensation. While wo believe that this in formation is of groat scientific value, we can understand the desire of the Q.A.K.A. to emphasize tho exposure of the aobestos miner and not the cases of futbentosis. We also are in agreement with the deletion of the reference to smoking and lung cancer. It must be recognized, however, that this report will be subjected to criticism when publir-ned because all other authors today corrclnto lung cancer ana cases of asbestos in. If w are to restrict this condensation to asbestos miners, greater emphasis should bo placed on tho choice of words .used in defin ing the* coiiort. The fact tiiat all members of the cohort had 5 or inore years of exposure to asbestos snould bo reiterated. Following are comments on certain paragraphs of the condensation. I Fage * '. ' Wo believe the first sentence in paragraph 2 should read "Pcrlutps no one nao written so uxtenaively I age Hi In the third sentence of paragraph 2 the definition of cohort should be t.'xpniMicd to empnnsi zc tnat non-exposed personnol were nut included in tho sample. This mi pi it oe done by anding a suntunca similar to tho following: "Office and other nun-exposed porsomml, regardless of length of employment wore not ineludud in LMc coiiort". I^gc_ KJ To further emphasize the expoauro aspect of Uio miners tho second sentence.of paragraph ? might rend, "All workers with more tnan 5 yuarG of ex posure wore placed in one of throe categories". It mik'ht bo advisable to add another sentence at the end of this para graph, "An previously noted workers with no oxposuro wore not included in tho data". 300937 In t./ie Court.!i sentence refri mice is mado Co "the F'iX Icv.'l of ."ignifirmico''. Thic phrase wa:; tvitiln inud dourly and thoroughly im I'a;;vs 2.1 In L*1! in l-l<0 unction on Slnl j :;t.icn l Methods of tho original ourvoy. Hccnnue this whole r.uclion mbs dnlcted in tho condensation fit. ini.ht bo advisable to explain \<y routno U: the meaning of "thu VxX level of ;iignificancs". Wo fool Dint tho fifth sentence might be made strongerby the following changa. "However, having found just 12 cases, wo arc not ubove this level, and Uicreforo Die hypothesis that .i/ibeatoc miners do not have a higher mortality from . lung cancer than doas tha general population cannot be rojoctcd". kage Ul Tho table in the cantor of tho page ohowa a rate of 271 in tho US - SU aye group. In the original survey thiu rate was 27. 1'agv lifl In the last sentence of the first paragraph wo vnuld like to suggest the aubstitution of the word "undertaken" for the word "commissioned". 1j thu second .sentence of paragraph j ve would like to suggest that tho elaiMtnls of the cohort definition bs repeated. "A cohort was defined as a group of asbestos miners having at least $ years oC exposure in the indbtry and who were in Die industry during 19S0. Only those workers who met these criteria were in cluded in thu study". ^a>jc hp * In Die last sentence of paragr.'pb 1 wo would liku to suggest the dele tion of the pltraso "vnich have beon explained in some detail" since such explanation was deleted in the condensation. Tnis publication should form the baaiu for future' surveys and reports. Ur. hr.*iun should be asked to establish the framework of reporting for Doctors Grainger and Cartier so that each year tho atatus of every member of the original cohort could be roported to tho Industrial Hygiene Foundation and the continuing study be analysed by their experts. Vie cannot emphusiv.e this point too atrongly bocfiwsn nowncrc in the litoraturo today is there roported a study which in so valuable and which approximates this magnitude. ` We ngruu with Doctors (lirt-ior and Uraun tliat a curtain number of workers probably have .io.uo onbeslotic (`.ihrusls which cannot bo d.iagnosud by x-ray. Unw fortiiu.itcly, wo cannot t-ixe lung blopsios on all workers and we hnvo new other means ol making a diagnosis before thoru are x-ray changes. Therefore the annual study of all exposed asbestos workers bucomoa Increasingly important. Wc foci that Dr. P.raun and his staff nro to be congratulated heartily Cur this very y&lunblo contribution to our medical knowledpu. Ve tnast tliat thoir i:JJurts will bo rewarded in the near future by the publication of this work in a rwcogni aed journal.. Sincuroly,