We do not recommend that any part of this note is quoted out of context or distributed separately, since this could lead to misunderstandings.

It is postulated that fish meal, an ingredient in some rodent chow, may contain FC and thus lead to the PFOS found in untreated rats.

Outcome of Discusssions. which will lead to the index. 2.

The second is dominated by mycobacterial infection leading to death (1987-1990) ("infectious" period).

Contract work regarding the installation or removal of containing products d Any other construction work performed by employees of contractors where incident to such work asbestos containing products were disturbed installed replaced or used in any fashion whatsoever ANSWER Objection is made to this interrogatory on the grounds that is overly broad unduly burdensome and requires information for period of time INCO has employed various an unlimited who may have hired subcontractors general contractors over the years to perform the tasks outlined above INCO INCO would not have been in contractual privity with those therefore could not identify all contractors that performed thceonttarsakcstoorustliannedd above INCO further objects to this interrogatory on the grounds that it is not reasonably calculated to lead to the discovery of admissible evidence waiving these objections and specifically subject thereto INCO is Without contractors besides those identified by the plaintiffs and INCO unaware of has verified whether those contractors not yet nature of the work INCO is performed work at INCO and if so the will continuing its investigation in this regard and supplement this response as necessary a See objection and answer above b See objection and answer above C.

Intuitively, it can also be seen dial the other (wo ("the product anti how it is used") lend themselves to evaluation by lesls lh.il can lead lo laiily specific but Inoadly applicable results, l oi llicsc reasons "cnviionincnl will be considered lust.

**'*-*************** + ***********-**************************** + ************Tlierijc)dlcr*****iItt PRINTED BY 2020 U073763 MCCREEDY, R L. 636-1824 94/07/06 11:07:21 ***************************************************************************** From: U060561 --MDDECD Date and time 07/06/94 11:05:50 XVY1" _______ - ~~ /f-'S ^ - rtTi'or^CL /^CAU^ From: To: NAME: U060561 <U060561@MDVAX@MRGATE@MARN06> U073763OIBMQ JULY 6, 1994 GEORGE MACKEY ******** WARNING THIS DOCUMENT IS 17 PAGES *********** BOB ANDREWS CC: RON MCCREEDY **B*O**B**R*O*U*S*E* WARNING THE ENCLOSED DOCUMENT WHEN PRINTED WILL BE AT LEAST 17 PAGES LONG||||||||||| ENCLOSED IS THE ABSTRACTS THAT I MENTIONED IN OUR PHONE CONVERSATION THIS AM.

minutes PIPE RESOURCE ORGANIZATION Hyatt Regency Dallas/Fort Worth Airport Dallas, Texas East Tower Thursday August 29, 1991 8:00 a.m.

R-S86-1-0-16 PINAL SCREENING SITE INSPECTION REPORT.

"Off-the-Job Safety" Routine dosimetry results for the month were: < PEL Number Percent > PEL Percent VCH Lead Total Particulates 85 100.0 7 87.5 2 100.0 0 1 0 Monthly Injury Summary Inlurv Class Department Maintenance First degree bum of left hand (palm and fingers).

In Phase I, the US has the lead on nine chemicals.

Changes that occur during the evolution of a typical colorectal carcinoma Schematlc reDresentationof a model of tumor progression in which indepenoent steps are required. leading to the activation of at least one protooncogene couoled with the successive loss of several tumor suppressor genes Adapted from Varmus and Weinberg (61 early H P C responding to IL-3 a n d GM- CSF exhibit extensive overlap.

Several starting point should be an internal health types of quantitative occupational exposure TNO Nutrition and Food Research Institute, Division of Toxicology,Zeist, T h e Netherlands based occupational exposure limit-that is, the maximum dose to be absorbed without leading to adverse systemic effects.

All urban areas in Louisiana except Monroe have respiratory cancer mortality rates above the US average (Fig 1), in contrast to colorectal cancer which exceeds the US rate in only one metropolitan area (Fig 2) even though colorectal cancer is the second leading cause of cancer death in Louisiana.

DE COSTER ET AL In 1987 at the age of 55 yrs the patient was admitted to the hospital with symptoms of fever dyspnoea and purulent sputum There was also a significant weight loss 38 kg body weight for 1.65 m Chest radiographs showed a progression of the large opacity in the right upper lobe and cavitations of both upper lobes predominating in the left upper lobe fig 1b Pulmonary function tests showed a deterioration of the spirometric values FVC 1.4 L 35 pred FEV 6 L 21 pred residual volume RV 4.0 L 190 pred and CO 11 pred The sedimentation rate reached 107 mm and the white blood cell count 10 cells Arterial blood gas examination disclo- sed severe hypoxaemia arterial oxygen tension Pa 49 kPa 37 mmHg Sputum smears for bacteria and acid bacilli were negative Clavulanic acid + amoxy- cillin had no effect on the fever but the patient recovered after antibiotic treatment of 10 days duration with trimoxazole In 1988 the patient was once more admitted because of fever and chest pain A chest radiograph showed a hy- droaenic level in the right upper lobe Blood cultures were negative and there were no pathogens detected in the sputum Oral antibiotherapy with trimoxazole was administrated for 3 days followed by cefuroxime One year later he was again admitted to the hospital with the same symptoms chest radiographs showing a progres- sion of the cavitary lesions At that time the sputum culture yielded 20 colonies of Mycobacterium xenopi but was negative for Mycobacte- Hum tuberculosis Oral rifampicin 600 day and,, Isoniazid INH 300 day were mitiated However because M. xenopi was resistant to INH it was replaced by ofloxacin 400 mg day ,, Four months later the patient was admitted for the last time because his condition had deteriorated He develo- ped severe renal failure anaemia leucocytosis and shock Despite intensive care the patient died a few days later Discussion The fust period 1977 198o7f this patient's disease is dominated by the diagnosis and the compensation for tale pneumoconiosis occupational period The second is dominated by mycobacterial infection leading to death 1987-1990 infectious period Knowing the diagno- SIS of M xenopi infection it is difficult to define its exact onset On the radiograph from 1983 it is possible that the right upper lobe opacity already corresponds to an infectious process Nevertheless the discussion will con- sider two phases in the patient's evolution the talc pneumoconiosis and the M xenopi infection and the possible relationship between them Talc pneumoconiosis in an uncommon pneumoconio- sis which classically requires a long duration of exposure to a high concentration of dust 2 3 Cigarette smoke appeals to increase the risk of developing this disease In the present case the prolonged exposure to high levels of respirable talc particles together with the presence of diffuse bilateral small rounded opacities on chest radiographs is compatible with the diagnosis of talcosis 2 3 BAL confirmed the retention of a very high concentration of talc particles The clinical and radiological data were compatible with previous descriptions of pneumoconiosis in exposed workers so that ro lung biopsies were taken The Belgian Occupational Disease Fund agreed to recognize and compensate this disease Large opacities are also described in talcosis and the abnormalities in the right upper lobe on the chest radiograph from 1983 were also considered as a part of the pneumoconiosis However the fact that this lesion was unilateral should have been considered as atypical This underscores the problem of differential diagrosis of lung opacities appearing in pneumoconiolic subjects subjects usually considered as coniotic masses without any complementary investigations Furthermore there was a clear progression of the bilateral small opacities No prior exposure to other mineral dust had been detected and even if a few tremolite asbestos fibres were found in BAL there were no evident signs of asbestosis no pleural plaques on thickening no evidence of interstitial fibrosis The fact that the asbestos type was tremolite suggests suggests a possible geological contamination of talc 1 It is actually admitted that M xenopi can bc pathogenic for humans and lead to severe disease but lung diseases due to this mycobacterial species are rare Underlying existing pulmonary diseases such as pulmonary tuberculosis chronic bronchitis emphysema bronchiectasis interstitial pulmonary fibrosis lung carcinorna and sarcoidosis are predisposing factors forM xenoni infection 4 6 Diagnostic criteria exist for identifying pulmonary disease where M xenopi is considered to be a pathogen including repeated positive cultures an abnormal chest roentgenogram consistent with mycobacterial infection and absence of other pathogens in the sputum 4 6 Various radiographic manifestations of M xchopi infection are described from multiple nodular shadows to Cavitary lesions 7 The clinical and radiological evolution of our patient since 1987 is consistent with a chronic lung infection by mycobacteria M xenopi was found twice in sputum cultures whereas M tuberculosis was never detected and could be excluded Therefore accord- ing to mycobacteriological and roentgenographic criteria it is obvious that the patient died from destructive lung infection by M xenopi There are only a few cases described in the literature in which lung disease caused by M xenopi led to death 4 5 7 As far as we know this is the first case report of the association of talc pneumoconiosis and lung infection by M xenopi Even if the succession of these two uncom- mon diseases in an individual case could be purely coincidental this seems unlikely and several clues suggest that the presence of talcosts predisposed to the secondary infection by M xenopi A parallel situation occurs in sili- cosis another pneumoconiosis which is a known predisposing condition for tuberculosis or even nontuberculous mycobacterial disease 8,9 8,9 The increased susceptibility to these other diseases could be explained by impaired function of macrophages due to sihca 10 11 Alveolar macrophages are important in the defence against mycobacteria not only through their phagocytic and bactericidal activities but also through the amplitication of the host defence by the release of cytokines interleukin IL and tumour necrosis factor TNF 12 In the case of talc pneumoconiosis in which macrophages are overloaded by tale particles is conceivable that these activities can be impaned ATYPICAL MYCOBACTEeriosis in TALC PNEUMOCONIOSIS 1759 In conclusion this case study suggests that lung infection by mycobacteria at least M xenopi can complicate talc pneumoconiosis In such a situation it sho