Document zoV0gRgMDpvOngR6aLX9B2mD6

FILE NAME: Metropolitan Life (ML) DATE: 1944 Feb 28 DOC#: ML093 DOCUMENT DESCRIPTION: Letter to Ivan Sabourin from Dr. Gardner RE Study Documenting High Levels of Asbestosis and Low Levels of Tuberculosis in an Asbestos Fabricating plant Titles Authors. Receivers Sabourin Conents: NI have just now completed a review of 125 films for an asbestos fabricating plant in another state, in this plant the amount of severity of the asbestosis on the first examination in 1930 was well marked, approximately 40% of the group showing definite X-ray evidence of the disease ... A second examination was made upon 67 of the original group after an interval of five years during which they remained at work* How the incidence of asbestos [sicl had increased to 6|% but tbs tuberculosis rate had fallen to 2.9%. A third examination was dome on 57 of the original group who still remained In employment after a further interval of 3 to 4 years; ih this group the incidence of asbestosis was over 80% and that for tuberculosis only 3.5%. N F o b -a ry 2$, 1944. Daar hr. Smbourini I hswo you r lottor of XftfcCBl3L22 ****** fo r bo-- sn ta -- -- tho relationship botwoon aabostoala and susceptibility to tuboroulosla Tbia qua*tion cannot bo aaaworod doolalwoly fran a atod/ of /oat sort-- atrial alono. hediaol problo-- of this naturo oro avail/ solrod oa tho baala of probabilities and It la this attar of probabilltleo -- vhleb vo aaod furthor arldanco in tho caao of taberouloala associated with aaboatoala. arowottaor la hia "Be-- road-- oa Aaboatoala" Taborolo 1er-- bor aad Decsaber, 1933 and Janar/, 1934) adadta that *the data oa tho aabjoet aro -- cor" Bo reporta that of 374 worfcora vhllo at work, oal/ 4 ahovod alfaa of aotlro tuberculosis -- d that tho Brltlah 8illooala and laboatoa lodleal Board la ita flrat perlodla oraalnation of workers la thia Industr/ found oal/ ono oaao of aaboatoala aad taboroaloala la ,1512 ax-- lnatlona. On tho othor hand tho Bagllah post aort-- notorial Iat that tins rowsoled 35.7J of tho eaaoa oooilcotod by tabor-- Ioala (ube-- uontly ho appears to hare fo-- d aoro -- a-- If Dr. KLddoll la oo* rootl/ lafbzaod) la tho publleatlon oltod -- oosthor oa-- ladaai *Tho orldoneo therefore. polata to tho hypothesis that at present tho added risk than la workers exposed to froo slllea) rlraloat aaa- air# lafootlona will aa la tho general papulation, eaua# do*thj lossor onoa will result la -- ro wldoaproad fibrosis thaa woold -- poor la oosoo -- coast tho go-- ral population aad alight lafootlona, la oa-- on with m m j other offootio-- , aro llkoly to proolpltato 4oath la uses of M^ff***1 aobostosis whoro tho/ wouldn't do so la tho go-- 1 population" tho undorsoorlag la srl-- but 1 ag(rTOoOo w ltfc th a so n o - PR O D U C ED S/< hoa Dr. Berevethor was la this oo-- try last yaar ha rialtod -- for sororal da/a and wo spout asat of our tlao dls-- sslBg tl Be still aeeopts our oacperlnontal work whioh prow-- that there-1 % no spoelflo roscoptlblllt/ to tuboroulosla laduaod by asbe*tosla mam hs,llho oursolwoa, la oaxloua to aee-- lato oo-- orotiro atatlatl-- fro ports of tho world to ostobllsh tho go-- 1 allirlosl npsrli / (2 ) As I iadlestsd la my last lsttsr tbs Quebec sapsrlcos , is net yet analysedj there is only sn impres*Ion tbet eg* 9f__tle asbestos soriesrs die of tuberculosis without teJdaf into eesewnt the * excessive prov i so es of such infection ahuig the population oJTthe \ Prorlflgji. This impression needs werlflestlan by careful analysis of morbidity and Mortality statlstlen Tolleoted from the explores# of tho asbestos industry, from their ftmllles not exposed to asbestos dust and fro* other eossotttts in the Prorlnce of Quebec. 8oeh data should then be coeipared with sisdlar statistics for asbestos workers la other countries. If there Is a specific occupational predisposition to tuber culosis it will be cone apparent on such analysos just ss it has for silicosis. Wherever silicosis is being created, the high Mortality fro ` tuberculosis cannot be hidden. I do not believe that there la mach tuberculosis asbestos workers In the United States and suspect that the ss oart!!ty frosi this cans# in la probably due to the low 1' of industrial worker nas'Influenced tho p itrate enough tuberculosis u t t | asbestos corker* to U. 8. P u bUe Ssalth Service Study of Asbestosls in the Tortile Industry in Borth Carolina, (Bulletin 2A1), issued 1a 193 hardly Mentioned tuberculosis, dlsnlsslMf tbs subject with the jm page 51 that there were only 2 cases of active, pulnonary " __ in the group" (541 employees). Shull, (Radiology *7. Be. 3, 279-292 1936) examined 71 of 100 eases discharged from the plants who Public Health Service aade its study 15 months later snd foond 8 complicated by tuberculosis of slight to moderate extent but only 2 motive. Those two subsequently died of this cause mid in 2 infection later became active. Shall states in his conclusions "eebestosls does not predispose to tuberculosis.* `although he does not say sn, that tho A cases of active dl 541 workassn represented accumulated disabilities when tbs pregram as inaugurated. Donnelly (J. Ind. Urg and Tex. Id, 222-228i1936) also sTsntuail 151 discharged esgilcym reported by anil. Bo gives more details on the cam One of then had uorkad in the asbastes industry for 5 others 15 -- h a , The remain1st 2 had unrfead 6 amt 1 and their Infecti erne might dust. Se points out, that an industrial smalaysss la i higher than in ePhoeters, (j. Zhd. Hyg snd Tax., 18, 1934 the ether reporters. In his comelesions ho states, activating er aggravating affect of asbestos dust or asbewtoel* or tuberculosis m m ;observed.* Plaally I believe Z told you that I ^rsalf, bad just re turned from Berth Curelins share Z had renamed sheet films of same 109 employees of tho local asbestos industry snd sev only ana that shamed any indication of adult type pulmonary tuberculosis. This was complete' PRODUCED S / C / M / t e ^ > Ivan Sabourin (3) Fabruary 28, 1944 healed. i commented on th* fact to th# box*# of th# Fedical 3oard of th# 8tat* Industrial Commission with who* I waa conferring and th* Chairman, Dr. Festal, told m* that tuberculosis was a rare firsdinf amonf aabastoa worksrs although coamon enough in other industrial workers in thwir stat*. It would therefore, app*ar that in forth Carolina asbestos!* doss not favor or predispose to tubwrculosis I have Just now complatad a review of 125 films for an asbostos fabricating plant in another state. In this of ..T.rlty of th. ..b.3ts.t* on th. rir.tjxMln.tion In 1930 ... . . U Mrt.4, .pproxlJMt.ly 40* of th. group `in* of the disease. leverthelees, th* total adult type 'jjj was only 5*j four of th*s* eases ocurr*d in parsons with asbstosis and 2 of tha w*r* consid*rd probably active. A tacond examination waa amda upon 67 of th* original group aftar an Interval of 5 yaars during ^ c\ S * L I #?hintiblieSosis low tha inoid*nca of asbastos had increased to 62* but *u^ riroil# rata had fallen to 2.9*. A third Lamination ** * H Starval original group who still r*main*d in employment aft* flf'Si S1 3 to a years; In this group th* inoidene# of asb*stosi# 'was Op -t that for tuberculosis only 3.5*. In spit* of ??24ta*usuall s*v*r* asb*3tosis th* tub*roulosis rat* r**ain*d within th* 11*1 found in Amarioan industrial populations. The bebavior of th* tub*rculosia in th*s* unusual. For exaapl* on* man, a spinnar for 13 yaara, waa 31 jr whan first examined. Ha had at that tima an *arly reaction and evidence of old tuberculosis An tha top of , \ n t_D suocaading axaminations his dust raaotion itaadily inoraasad . . . first stsio a.ba.tosis 9 yaars aftar ha was first swan. Hi however, remained apparently uninfluenced. Host o f aiJitos in th* sam* manner. Th*s* people had already been dust for periods of 3 to 18 or mor* years w h e n r e l r s g i i * and th* three subsequent examinations during the following 9 yaars gx us a good opportunity to follow what night have developed. * " __ o? ?ubculMl. pp.ir.d- If It hd not by tht tla. th. eh*. w r . not very great that they would later. After they left the asbestos industry w* do not what happens! to most of the* but on a Xaw thsr# ar* Shid that indicate the cause of death. Two died of t*5* TM ^ * 1*! -5"* At had hia infection when he was examined in 1930 at th* aga of 50. A that time he had an early asbestosis after o^i0 evldance of associated chronic tuberculosis. He wae _ ..ond -bleh h. did .nd dl.d of hi. Infection .bout 1 I^^.bl!tl. 4 q mged 32 had been a weaver for 12 year and had first stag* a but no avidanca of tubarculosis at th* tima. Ha laft his Job PRODUCED S/C/M/MS ^ q g T Ivan Sabourln U) February 26, 1944 first exaatnatlon for reasons not stated. Thraa years latar ha was reported to have died of tubarouloaia in a aenitorium. Such caaaa could oacur anywhere. It la possible that if va had follow-ups on more of thaaa caaaa aftar they laft tha asbaatoa industry we would find aora persona who subaaquantly contracted tuberculosis and died of It. How ever, tha evidence now available indicates no such tendency. .experiments, contrary to those upon silicosis, disclose no theoretical |reasons for suspecting that asbestosis creates any special susceptl- I bility to the tubercle bacillus of Koch. I aa beconing aora and more convinced that that the ,high tuberculosis rates reported in English autopsy statistics are due ; to causes other than occupation. I believe that the sane aust hold / true in Quebec where the amount of severity of the asbestos dust reaction fla very much less than it is in tha fabricating plants in the United > 'States. X believe X have covered the other points raised in your letter and will therefore not prolong this dlsousslon further. ery truly yours, Leroy 0. Gardner, M. D. Director LUOiRH ec to Mr. Tandiver lroeu n 'i' --- < J/M /M