WEBVTT NOTE Machine transcript of the film's sound; not yet checked. 1 00:00:11.630 --> 00:00:17.030 Dr. Kotin, in connection with the last question that Mr. 2 00:00:17.130 --> 00:00:22.550 Motley asked you about when you were aware that asbestos was a 3 00:00:22.550 --> 00:00:24.890 carcinogen or caused cancer, 4 00:00:25.150 --> 00:00:29.470 under what circumstances were you aware that it could cause cancer in 1955? 5 00:00:30.270 --> 00:00:35.270 By the published work of Professor Dowell and his associates who examined the group 6 00:00:35.270 --> 00:00:38.050 of textile workers in the United Kingdom. 7 00:00:38.050 --> 00:00:39.050 them. 8 00:00:39.190 --> 00:00:44.710 Was there any evidence in 1955 that insulation workers or shipyard workers 9 00:00:44.710 --> 00:00:47.210 were at risk to 10 00:00:47.210 --> 00:00:48.210 cancer? 11 00:00:47.690 --> 00:00:49.930 The only population that 12 00:00:49.930 --> 00:00:55.830 was studied was the textile 13 00:00:55.830 --> 00:00:57.590 workers and the only conclusions that 14 00:00:57.590 --> 00:01:00.090 could be drawn were those applicable to textile workers. 15 00:01:00.430 --> 00:01:04.350 Why could you not extrapolate from the textile workers to the insulation workers? 16 00:01:04.350 --> 00:01:09.950 Well, I think there's sort of a universal principle in analyzing medical 17 00:01:09.950 --> 00:01:15.430 data that the individual populations have characteristics special to them, 18 00:01:15.510 --> 00:01:21.330 both in terms of their exposure, both in terms of their environment, and 19 00:01:21.330 --> 00:01:26.470 as Dr. Selikoff has written, as many, many have written, 20 00:01:26.470 --> 00:01:32.330 that the extrapolation requires a comparability of what you're 21 00:01:32.330 --> 00:01:34.010 trying to what you have to compare 22 00:01:34.570 --> 00:01:39.130 to that which you are trying to compare it with and if you don't have that commonality 23 00:01:39.790 --> 00:01:45.490 then it's a flawed comparison dr mr motley asked you about 24 00:01:45.490 --> 00:01:48.750 a study made by dr Dreessen in 1938 25 00:01:48.750 --> 00:01:52.190 1938, and specifically whether or not Dr. 26 00:01:52.350 --> 00:01:57.860 Dreessen, in counting the dust to which the 27 00:01:57.860 --> 00:02:03.140 workers in that textile mill were exposed, counted all of the particles or just the asbestos 28 00:02:03.140 --> 00:02:04.140 particles. 29 00:02:04.460 --> 00:02:06.080 Do you recall those questions? 30 00:02:06.240 --> 00:02:07.240 I do. 31 00:02:06.700 --> 00:02:09.720 In what work environment was the Dreessen study made? 32 00:02:10.060 --> 00:02:15.500 In a textile environment where the exposure was incidental to the manufacturing 33 00:02:15.500 --> 00:02:17.100 of asbestos textiles. 34 00:02:18.540 --> 00:02:24.440 And do you draw any conclusions from that as to the amount of 35 00:02:24.440 --> 00:02:26.160 asbestos that he was measuring? 36 00:02:26.500 --> 00:02:32.360 Yes, that virtually the total dust that he was 37 00:02:32.360 --> 00:02:36.380 measuring was equatable with total asbestos. 38 00:02:36.380 --> 00:02:42.000 There were obviously some cotton in the dust as well, but it was a work exposure in 39 00:02:42.000 --> 00:02:43.240 which not 40 00:02:43.240 --> 00:02:46.380 not only I, but the entire world that 41 00:02:46.380 --> 00:02:51.000 was addressing the issue of the dust in the workplace studied 42 00:02:51.000 --> 00:02:54.140 by Dr. Driessen, as being considered 43 00:02:54.140 --> 00:02:57.680 asbestos exposure, 44 00:02:58.660 --> 00:03:01.220 asbestos particles in the five million particles 45 00:03:01.220 --> 00:03:02.220 per cubic foot. 46 00:03:02.360 --> 00:03:06.680 For in fact, if you look at the publications of Dr. 47 00:03:06.840 --> 00:03:07.840 Selikoff, 48 00:03:07.420 --> 00:03:13.640 off publications of keepers the publications of Dr. 49 00:03:13.840 --> 00:03:16.040 Hardy as far as the American Conference 50 00:03:16.040 --> 00:03:21.120 of Government industrial hygienists were concerned they all use the same five 51 00:03:21.120 --> 00:03:22.120 million particles 52 00:03:21.980 --> 00:03:27.940 per cubic foot and the interpretation was that they were dealing with five million particles 53 00:03:28.920 --> 00:03:35.220 found in the workplace of asbestos textile workers how does that compare with the 54 00:03:35.220 --> 00:03:39.060 the Fleischer-Drinker study in 1946. 55 00:03:39.680 --> 00:03:45.400 Well, I think one can further verify, in fact, make indelible the fact 56 00:03:45.400 --> 00:03:47.960 that the five million 57 00:03:47.960 --> 00:03:53.760 particles per cubic foot are treated by all involved and were treated by all involved 58 00:03:53.760 --> 00:03:59.340 as being an asbestos exposure by the fact that Dr. 59 00:04:00.880 --> 00:04:02.880 Fleischer and his associates felt 60 00:04:02.880 --> 00:04:07.940 it necessary to separate the 61 00:04:07.940 --> 00:04:11.120 asbestos component of the dust they measured. 62 00:04:11.260 --> 00:04:13.100 They were not measuring an 63 00:04:13.100 --> 00:04:18.860 asbestos operation. They were measuring an operation in which insulation 64 00:04:18.860 --> 00:04:22.240 was the focal 65 00:04:22.240 --> 00:04:27.700 point of exposure in a highly complex environment so that to 66 00:04:27.700 --> 00:04:30.740 give their data the precision that they 67 00:04:30.740 --> 00:04:36.620 wanted it to have, they measured total dust and then, as they have done 68 00:04:36.620 --> 00:04:37.620 in a table in 69 00:04:37.360 --> 00:04:43.300 their paper, they had a table in which they put down 70 00:04:43.300 --> 00:04:45.280 that component of the total dust 71 00:04:45.690 --> 00:04:47.540 which was asbestos. 72 00:04:47.780 --> 00:04:51.560 Now it's clear that Dr. 73 00:04:51.660 --> 00:04:56.700 Driessen had at least the competency in his associates that Dr. 74 00:04:56.700 --> 00:05:00.920 Dr. Fleischer and Dr. Drinker had, and they were satisfied that they didn't have to 75 00:05:00.920 --> 00:05:03.540 do that for the textile operation in 76 00:05:03.540 --> 00:05:05.400 contrast to the Fleischer-Drinker study. 77 00:05:08.780 --> 00:05:12.580 Dr. Do you have an opinion as to whether or not the 78 00:05:14.920 --> 00:05:19.980 results of the Fleischer-Drinker study were interpreted by the medical community as 79 00:05:19.980 --> 00:05:21.460 to be within the then 80 00:05:21.460 --> 00:05:23.740 threshold limit value for asbestos? 81 00:05:23.740 --> 00:05:29.360 Let me make that perfectly clear, that five million particle 82 00:05:29.360 --> 00:05:31.560 determination after it was 83 00:05:32.100 --> 00:05:37.840 made and concluded by Dr. Driessen was not put in some archives and then forgotten. 84 00:05:38.080 --> 00:05:39.480 It was under constant review. 85 00:05:39.800 --> 00:05:45.780 It was part of a whole array of workplace standards that were reviewed annually. 86 00:05:45.780 --> 00:05:51.280 annually, and the persistence of the 5 million particle 87 00:05:51.280 --> 00:05:56.220 standard or level through the years 88 00:05:56.220 --> 00:06:01.400 and years was not the result of any calculated omission, 89 00:06:01.500 --> 00:06:04.660 because in fact the group of the 90 00:06:04.660 --> 00:06:10.060 American Conference of Government and Industrial Hygienists annually meet to review threshold 91 00:06:10.060 --> 00:06:14.040 limit values, so that it was a studied omission. 92 00:06:14.040 --> 00:06:19.620 They felt that it was unnecessary to change, and in fact, when the 93 00:06:19.620 --> 00:06:25.580 1964 conference was held and new data were presented, they did, in fact, 94 00:06:25.580 --> 00:06:31.480 change so that it isn't neglect that was 95 00:06:31.480 --> 00:06:34.420 responsible for the persistence of the five-million pardons. 96 00:06:34.500 --> 00:06:38.280 It was just scientific judgment that there was no data to challenge it. 97 00:06:38.620 --> 00:06:40.660 Object to the responsibility of the question. 98 00:06:40.920 --> 00:06:42.000 Dr. Kodman. 99 00:06:42.000 --> 00:06:45.620 answer. You were asked by Mr. 100 00:06:45.660 --> 00:06:49.300 Motley on cross-examination that if the asbestos 101 00:06:49.300 --> 00:06:53.500 industry knew that exposures above five million particles per cubic foot were 102 00:06:53.500 --> 00:06:59.240 dangerous, would you agree that they should have advised any users of 103 00:06:59.240 --> 00:07:03.780 products which contained asbestos to avoid levels of exposure above five 104 00:07:03.780 --> 00:07:09.820 million particles per cubic foot? Yeah, where that likelihood of exposure did 105 00:07:09.820 --> 00:07:11.020 did exist, but in fact. 106 00:07:11.340 --> 00:07:12.980 Let me ask you, under what circumstances 107 00:07:13.520 --> 00:07:15.140 should that notice have been given? 108 00:07:15.400 --> 00:07:18.640 Well, the likelihood of that exposure should exist. 109 00:07:19.780 --> 00:07:23.220 For example, I would judge 70, I don't know. 110 00:07:23.360 --> 00:07:25.980 There are certain people in this room, certainly my watch, 111 00:07:26.620 --> 00:07:28.980 has with it some radioactive material 112 00:07:28.980 --> 00:07:31.740 so that in the middle of the night I can look at my watch. 113 00:07:32.320 --> 00:07:35.900 Now, there's no question that radioactive material is 114 00:07:35.900 --> 00:07:37.980 potentially a hazardous agent. 115 00:07:39.320 --> 00:07:45.280 Yet, there is no notice on my watch that my carrying it 116 00:07:45.280 --> 00:07:46.840 carries any calculated risk. 117 00:07:47.100 --> 00:07:51.380 In fact, it doesn't, even though it has perhaps the most hazardous agent known in 118 00:07:51.380 --> 00:07:52.600 the environment, radiation. 119 00:07:53.000 --> 00:07:57.900 And the reason it doesn't have it is because it is untenable to believe that any 120 00:07:57.900 --> 00:07:58.920 hazard is going to come. 121 00:07:58.980 --> 00:08:01.180 Well, I think that's the philosophy behind all warning. 122 00:08:01.180 --> 00:08:07.160 So that on a package of Anacin, forgive 123 00:08:07.160 --> 00:08:12.980 me, American home products, which contains phenacetin, there is no notice 124 00:08:12.980 --> 00:08:17.320 that phenacetin, technically 125 00:08:17.320 --> 00:08:22.240 saying not important, phenacetin, is associated with, 126 00:08:22.320 --> 00:08:27.420 in the literature, with an increased risk to development of kidney cancer. 127 00:08:27.420 --> 00:08:33.340 what it says on a package of medicine containing this drug 128 00:08:33.340 --> 00:08:38.350 is warning use only 129 00:08:38.350 --> 00:08:43.850 as directed so that the quality the content 130 00:08:43.850 --> 00:08:50.270 the need for any kind of a label 131 00:08:50.270 --> 00:08:54.050 warning or whatever you want to call it is directly related to the specific 132 00:08:54.050 --> 00:09:00.130 situation and that's how in fact the federal government operates or in fact 133 00:09:00.130 --> 00:09:05.630 an automobile a potentially lethal agent potentially it's lethal to tens of 134 00:09:05.630 --> 00:09:09.130 thousands of people on the highway there's no sticker on your windshield 135 00:09:09.130 --> 00:09:15.170 next to the one that says use unleaded gas only that says you're dealing with a 136 00:09:15.170 --> 00:09:17.490 a potentially lethal agent. 137 00:09:18.190 --> 00:09:20.930 Object to the response to this question, I have the answer. 138 00:09:21.450 --> 00:09:26.330 Did Dr. Selikoff in 1964 establish that insulation workers 139 00:09:26.330 --> 00:09:28.690 were exposed to more than 5 million particles? 140 00:09:28.770 --> 00:09:31.890 Not at all. The 5 million particles was not an issue. 141 00:09:31.990 --> 00:09:35.470 I think all of the studies indicated that the insulation workers 142 00:09:35.470 --> 00:09:39.750 at the studies in the field of industrial hygiene 143 00:09:39.750 --> 00:09:44.150 were not exposed to an excess of 5 million particles. 144 00:09:44.150 --> 00:09:49.230 The real issue was, and is to this day, the 145 00:09:49.230 --> 00:09:54.150 level of science in 1938, which concluded 146 00:09:54.150 --> 00:09:56.750 that five million particles was a safe level of exposure. 147 00:09:57.330 --> 00:10:03.230 Dr. Selikoff showed that the level of science was inadequate in terms of 148 00:10:03.230 --> 00:10:04.230 what he had learned 149 00:10:04.050 --> 00:10:05.710 almost two decades later. 150 00:10:06.610 --> 00:10:12.090 So that, again I would reiterate, the issue is not that there were 151 00:10:12.090 --> 00:10:13.090 exposures above the 152 00:10:13.090 --> 00:10:17.230 5 million particle level. It was just that the level of knowledge 153 00:10:17.230 --> 00:10:22.830 in 1938 was superseded 154 00:10:22.830 --> 00:10:28.770 by a level of knowledge in 1964, which said that 5 million particle level 155 00:10:28.770 --> 00:10:29.930 was wrong. And 156 00:10:29.930 --> 00:10:34.870 this is again acknowledged as intrinsic to the establishment of all threshold limit values. 157 00:10:35.230 --> 00:10:39.950 This is why the ACGIH meets every year. This is why OSHA continually, 158 00:10:40.370 --> 00:10:41.910 as it states in 159 00:10:41.910 --> 00:10:43.910 in its documents published in the Federal Register, 160 00:10:44.090 --> 00:10:47.470 in every standard that it sets, it 161 00:10:47.470 --> 00:10:49.710 emphasizes the fact that the standard is 162 00:10:49.710 --> 00:10:50.990 subject to revision. 163 00:10:51.310 --> 00:10:53.690 The Secretary of Labor testifies that. 164 00:10:54.350 --> 00:10:56.030 Revision upward, because it might 165 00:10:56.030 --> 00:10:58.610 have been too conservative, or revision downward, 166 00:10:59.070 --> 00:11:00.450 if it might have been too liberal, 167 00:11:00.650 --> 00:11:03.250 on the basis of knowledge that is accumulated 168 00:11:03.710 --> 00:11:06.530 with the march of science, advancing knowledge. 169 00:11:06.790 --> 00:11:08.270 Excuse me, I object to your responsiveness. 170 00:11:08.410 --> 00:11:09.430 Can we take one second? 171 00:11:11.910 --> 00:11:13.090 Will you cut the tape for us, please? 172 00:11:21.080 --> 00:11:25.440 Dr. Kotin, on your direct examination, 173 00:11:25.820 --> 00:11:27.680 I asked you about smoking and its effect 174 00:11:27.680 --> 00:11:30.860 on the lungs' susceptibility to asbestosis. 175 00:11:31.220 --> 00:11:34.060 Does smoking have any relationship to asbestosis? 176 00:11:34.360 --> 00:11:37.640 Yes, it has a relationship that is 177 00:11:37.640 --> 00:11:41.400 manifest in the disease itself from its earliest time. 178 00:11:42.000 --> 00:11:44.720 You asked if it has any relation to susceptibility. 179 00:11:44.840 --> 00:11:46.480 I answered then and would answer now 180 00:11:46.480 --> 00:11:50.660 that I'm unaware of any convincing evidence that smoking is related to 181 00:11:50.660 --> 00:11:55.320 susceptibility to asbestosis but from the moment that you get your earliest 182 00:11:55.320 --> 00:12:01.480 changes then clearly the worst thing you can do is continue to smoke because while 183 00:12:01.480 --> 00:12:07.480 as I say the data in relation to susceptibility almost have the opposite 184 00:12:07.480 --> 00:12:12.820 implication once the disease is there and that is everybody's data shows that 185 00:12:12.820 --> 00:12:17.040 if you are a smoker even with the mildest form of asbestosis certainly with severe 186 00:12:17.040 --> 00:12:18.040 forms of 187 00:12:17.640 --> 00:12:23.360 asbestosis you are sicker you are more prone to to the symptoms associated 188 00:12:23.360 --> 00:12:24.500 with interfered 189 00:12:24.930 --> 00:12:30.820 lung function you are more prone to infection and basically uh your death 190 00:12:30.820 --> 00:12:31.820 rates are higher 191 00:12:32.090 --> 00:12:37.840 check the responses dr Kotin uh mr motley in his cross-examination 192 00:12:39.040 --> 00:12:44.740 I want to ask you about some figures that Dr. Selikoff had reported in his recent 193 00:12:44.740 --> 00:12:50.680 book about causes of death in insulation 194 00:12:50.680 --> 00:12:56.680 workers, and he made the statement that Dr. Selikoff's figure showed that 12 195 00:12:56.680 --> 00:13:02.580 % of insulators die of asbestosis, that 23% of them die of lung cancer, 196 00:13:02.700 --> 00:13:06.400 and that 11% of them die of mesothelioma. Are those correct statements? 197 00:13:06.400 --> 00:13:12.220 No, the correct statement is that of insulator workers who die, the causes 198 00:13:12.220 --> 00:13:14.000 of death are, 199 00:13:14.260 --> 00:13:17.900 in fact, the percentages that Dr. Selikoff cited in his study. 200 00:13:18.160 --> 00:13:20.800 They are special to Dr. Selikoff's study. 201 00:13:21.240 --> 00:13:26.360 They are specific to the time he reported the study for, in fact, 202 00:13:26.520 --> 00:13:28.460 causes of death, not 203 00:13:28.460 --> 00:13:30.040 not only of insulators but of everybody, 204 00:13:30.540 --> 00:13:36.700 varies with the passage of time on the basis of the changes 205 00:13:36.700 --> 00:13:38.820 in the environment, if you will, on the basis 206 00:13:38.820 --> 00:13:40.520 of natural catastrophes. 207 00:13:40.720 --> 00:13:43.320 In other words, the causes of death in 1975, 208 00:13:43.740 --> 00:13:47.320 a non-hurricane year, the percentage of death 209 00:13:47.320 --> 00:13:50.660 due to the hurricane would be a lot different in a hurricane 210 00:13:50.660 --> 00:13:54.020 area than they would be in 1976 if there were no hurricane. 211 00:13:54.180 --> 00:13:56.720 What Dr. Selikoff meant was that at his time, 212 00:13:57.760 --> 00:14:02.220 Counting the deaths in his population, that percentage died from 213 00:14:02.220 --> 00:14:05.380 asbestosis, lung cancer, and measles. 214 00:14:05.740 --> 00:14:10.840 In fact, as Dr. Selikoff's data shows, and as the data from the National Institute 215 00:14:10.840 --> 00:14:12.760 of Occupational Safety and Health show, 216 00:14:13.080 --> 00:14:17.520 that asbestos-related diseases fall into three categories. 217 00:14:18.980 --> 00:14:21.240 Asbestosis is a declining disease. 218 00:14:21.240 --> 00:14:26.600 And, in fact, Dr. Robbins testified so before Congressman Miller's committee 219 00:14:26.600 --> 00:14:29.580 in June or July of this year. 220 00:14:30.500 --> 00:14:35.080 And asbestosis is a disease on the wane. 221 00:14:35.280 --> 00:14:39.960 So clearly the causes of death, the next time Dr. Selikoff follows this population 222 00:14:39.960 --> 00:14:46.160 in relation to asbestos, asbestosis will show a different percentage. 223 00:14:46.900 --> 00:14:52.880 Now, the 17,000 plus people that are in Dr. 224 00:14:53.140 --> 00:14:59.100 Selikoff's study, the 14%, the percentages 225 00:14:59.100 --> 00:15:00.360 don't apply to them. 226 00:15:00.500 --> 00:15:04.240 That would be absolutely, well, 227 00:15:06.220 --> 00:15:08.580 I'm trying to find the right word. 228 00:15:08.680 --> 00:15:11.080 It's so completely outlandish. 229 00:15:12.940 --> 00:15:18.580 the 9% applied to the percentage of those that died in fact 230 00:15:18.580 --> 00:15:20.440 the reason the US government puts 231 00:15:20.440 --> 00:15:26.340 out every year death rates for different diseases is that they change every year 232 00:15:26.340 --> 00:15:27.340 and if you go back 233 00:15:27.080 --> 00:15:31.480 over the years you'll find that they change positions for many many years it was pneumonia 234 00:15:32.300 --> 00:15:36.660 typhoid and infectious diseases more recently heart disease moved into first place 235 00:15:36.660 --> 00:15:37.660 and then 236 00:15:37.640 --> 00:15:39.700 and cancer was third, it became second, 237 00:15:39.800 --> 00:15:42.420 and then stroke changed place, perhaps, 238 00:15:42.700 --> 00:15:44.280 with another form of disease. 239 00:15:44.420 --> 00:15:45.500 The point I'm trying to make is 240 00:15:45.500 --> 00:15:48.040 that the causes of death vary, 241 00:15:49.660 --> 00:15:53.640 and this is as factual as any of the law of gravity, 242 00:15:53.760 --> 00:15:54.760 if you will. 243 00:15:54.380 --> 00:15:55.380 All right. 244 00:15:55.140 --> 00:15:58.420 So that to assume that Dr. 245 00:16:00.270 --> 00:16:01.270 Selikoff's data 246 00:16:00.910 --> 00:16:03.170 has any relevance, and he'd be the first to admit that, 247 00:16:03.230 --> 00:16:06.590 beyond his population at that time, 248 00:16:06.590 --> 00:16:11.450 and it related only to the number of people dying during the period he studied not 249 00:16:11.450 --> 00:16:13.930 the total population at risk the 250 00:16:13.930 --> 00:16:16.370 17,000 it does not mean that 12 251 00:16:16.370 --> 00:16:19.850 Speech and the responsiveness in the end. 252 00:16:19.950 --> 00:16:24.030 It does not mean that 12% of all insulation workers are going to die of asbestosis 253 00:16:24.030 --> 00:16:25.030 does it 254 00:16:25.450 --> 00:16:29.350 Directly form it very very positively does not mean that 255 00:16:30.190 --> 00:16:36.950 Dr. Mr. Motley, in his cross-examination, inquired of you as to whether or not epidemiology 256 00:16:36.950 --> 00:16:42.610 was a known science in the 30s, and if techniques 257 00:16:42.610 --> 00:16:45.050 to evaluate the incidence of disease were 258 00:16:45.050 --> 00:16:50.770 available in the 30s, and animal experimentation was going on in the 20s and 30s, 259 00:16:50.790 --> 00:16:52.790 and you indicated 260 00:16:52.790 --> 00:16:58.640 that they were let me ask you if those if that 261 00:16:58.640 --> 00:17:00.280 knowledge was available to you 262 00:17:00.280 --> 00:17:05.740 at that time why did it take until 1964 to find out whether 263 00:17:05.740 --> 00:17:06.780 insulators were at 264 00:17:06.780 --> 00:17:12.160 risk to asbestos disease basically the 265 00:17:12.160 --> 00:17:16.340 discipline of epidemiology the the the 266 00:17:16.340 --> 00:17:21.680 discipline of animal experimentation was of course known in those days 267 00:17:21.680 --> 00:17:22.900 but it was 268 00:17:22.900 --> 00:17:26.340 was known at a level consistent with the state of knowledge 269 00:17:26.340 --> 00:17:27.340 at the time. 270 00:17:27.720 --> 00:17:30.980 In fact, the epidemiology in those days 271 00:17:30.980 --> 00:17:35.020 was purely and exclusively acute disease epidemiology. 272 00:17:35.180 --> 00:17:36.180 What do you mean, acute? 273 00:17:36.200 --> 00:17:38.020 Diseases that we traditionally know, 274 00:17:38.220 --> 00:17:42.200 that we classify acute, diphtheria, pneumonia, 275 00:17:42.600 --> 00:17:44.920 whooping cough, diseases that come in a short time. 276 00:17:45.480 --> 00:17:47.760 Now, the science of epidemiology, 277 00:17:47.760 --> 00:17:50.080 just as the science of mechanics, is a constant. 278 00:17:50.200 --> 00:17:51.300 The principles are the same. 279 00:17:51.960 --> 00:17:57.540 The principles that allowed Mr. Ford to build a Model T early in the century, 280 00:17:57.740 --> 00:18:00.940 the mechanics, the engineering, the technology, the physical laws, 281 00:18:01.840 --> 00:18:06.800 were no different than the technology that allowed us to put a man on the moon in 282 00:18:06.800 --> 00:18:08.020 the 1970s. 283 00:18:08.040 --> 00:18:13.060 Yet there's no way Mr. Ford, in inventing his automobile, 284 00:18:14.240 --> 00:18:16.820 had the body of knowledge to put a man on the moon. 285 00:18:16.980 --> 00:18:18.780 And the same thing applies to this. 286 00:18:18.780 --> 00:18:23.560 In fact, acute disease epidemiology is so different than chronic disease 287 00:18:23.560 --> 00:18:25.340 epidemiology for a lot of reasons. 288 00:18:25.860 --> 00:18:30.240 First of all, as I say, acute disease epidemiology is usually associated with 289 00:18:30.240 --> 00:18:31.680 infectious disease, one cause. 290 00:18:31.980 --> 00:18:34.540 Only the diphtheria germ can cause diphtheria. 291 00:18:34.600 --> 00:18:37.480 Only the tuberculosis bacillus can cause tuberculosis. 292 00:18:37.820 --> 00:18:39.540 I'm sorry, doctor, just a minute. 293 00:18:41.240 --> 00:18:42.240 I'm sorry. 294 00:18:42.460 --> 00:18:43.740 Okay, fine. 295 00:18:43.740 --> 00:18:49.380 But basically acute disease deals for the most part with a single cause in a single disease 296 00:18:49.380 --> 00:18:55.040 In a very short period of time between exposure to the agent and the appearance of 297 00:18:55.040 --> 00:18:56.040 the disease 298 00:18:56.200 --> 00:18:58.540 Chronic disease involves many many things 299 00:18:59.260 --> 00:19:02.960 Not only in relation to lung disease, but in relation to others you hear how 300 00:19:02.960 --> 00:19:05.400 nutrition is a factor in chronic disease 301 00:19:05.400 --> 00:19:11.080 You hear about how in case of lung disease smoking might be a factor childhood 302 00:19:11.080 --> 00:19:14.000 childhood, diseases of the lung, and so on and so forth. 303 00:19:15.180 --> 00:19:19.780 In fact, I know for a fact that there was no 304 00:19:19.780 --> 00:19:24.040 chronic disease epidemiology in the government 305 00:19:24.040 --> 00:19:29.300 because the Epidemiologic Intelligence Service, the EIS in Atlanta, which has a 306 00:19:29.300 --> 00:19:30.300 long and distinguished 307 00:19:30.040 --> 00:19:35.280 history, was until the middle 60s exclusively an acute disease 308 00:19:35.280 --> 00:19:37.620 epidemiology program because 309 00:19:37.620 --> 00:19:39.460 because with your money and mine as taxpayers, 310 00:19:40.140 --> 00:19:43.140 I was part of the group that set up the program 311 00:19:43.140 --> 00:19:47.340 which gave birth to the chronic disease epidemiology aspect. 312 00:19:47.800 --> 00:19:50.860 So while the, in answer to your question, 313 00:19:51.560 --> 00:19:55.920 the disciplines were there, 314 00:19:56.040 --> 00:19:58.100 the categorical approaches were there, 315 00:19:58.700 --> 00:20:00.840 but the level of knowledge was such 316 00:20:01.700 --> 00:20:05.900 that it was useful for what, at that time, 317 00:20:05.900 --> 00:20:12.160 And above all, there was no need identified at that time for a chronic disease epidemiology 318 00:20:12.160 --> 00:20:18.160 for a special type of animal domiciliary care for the type of experiments that 319 00:20:18.160 --> 00:20:19.160 we can now do. 320 00:20:20.060 --> 00:20:24.800 Dr. Kotin, Mr. Motley, in his cross- examination, 321 00:20:24.940 --> 00:20:28.020 read to you from some correspondence 322 00:20:28.020 --> 00:20:33.770 correspondence from the Philip Carey Manufacturing 323 00:20:33.770 --> 00:20:37.150 Company that related to the publication of 324 00:20:37.150 --> 00:20:40.230 a safe practice manual in 1963. 325 00:20:43.670 --> 00:20:48.990 And you indicated that you were not aware of any safe practice manuals at 326 00:20:48.990 --> 00:20:50.350 that time. 327 00:20:50.770 --> 00:20:54.570 Were other methods of disseminating knowledge used? 328 00:20:54.570 --> 00:20:57.830 Excuse me, I object to the form of the question if you're suggesting that Philip 329 00:20:57.830 --> 00:20:59.810 Carey distributed 330 00:20:59.810 --> 00:21:02.930 anything because they've admitted in their answers in their argumentaries no warning 331 00:21:02.930 --> 00:21:04.550 labels were put on until 1972. 332 00:21:05.170 --> 00:21:10.030 My question was not addressed to that because your questions were not addressed 333 00:21:10.030 --> 00:21:11.030 to that. 334 00:21:10.510 --> 00:21:14.910 You undertook to extrapolate, if I can use that word, from Philip Carey's correspondence 335 00:21:14.910 --> 00:21:20.590 to the industry, and my question relates now to what Johns-Manville was doing at 336 00:21:20.590 --> 00:21:21.590 the time. 337 00:21:21.030 --> 00:21:23.110 I object to the form of the question. 338 00:21:23.730 --> 00:21:24.730 Go ahead, Doctor. 339 00:21:24.690 --> 00:21:25.690 Dr. Excuse me, sir. 340 00:21:25.330 --> 00:21:26.330 Excuse me, sir. 341 00:21:25.990 --> 00:21:31.030 I object to a misstatement in the objection that one way is what I'm carrying, that is, 342 00:21:31.030 --> 00:21:34.830 don't carry asbestos in its products after 1969. 343 00:21:35.670 --> 00:21:39.040 Mr. Go ahead, Doctor. 344 00:21:39.680 --> 00:21:41.020 Do you recall the question? 345 00:21:41.320 --> 00:21:42.320 Dr. Would you repeat it, please? 346 00:21:42.240 --> 00:21:43.240 Mr. Yes. 347 00:21:42.400 --> 00:21:47.820 My question was were there other methods than manuals for 348 00:21:47.820 --> 00:21:49.360 disseminating information about 349 00:21:49.940 --> 00:21:50.940 asbestos? 350 00:21:50.580 --> 00:21:51.580 Dr. Yes. 351 00:21:54.320 --> 00:21:58.120 Intrinsic to every operation was a work practice procedure. 352 00:21:58.520 --> 00:22:00.720 And included in this work practice procedure 353 00:22:01.360 --> 00:22:03.340 were all of the elements of the program. 354 00:22:04.000 --> 00:22:08.760 And part of it, of course, was worker protection and safety. 355 00:22:09.640 --> 00:22:13.440 So that a specific manual, I did not see. 356 00:22:13.540 --> 00:22:18.620 But basically, the programs for control 357 00:22:18.620 --> 00:22:20.420 in the broadest sense 358 00:22:20.420 --> 00:22:25.660 were ongoing and not only were they ongoing within the corporation 359 00:22:25.660 --> 00:22:28.920 but the 360 00:22:32.610 --> 00:22:38.270 dissemination of this information also took place so that the 361 00:22:38.270 --> 00:22:40.650 efforts on the 362 00:22:40.650 --> 00:22:45.710 part of the company on the part of the 363 00:22:45.710 --> 00:22:50.330 education of the users of the products 364 00:22:50.330 --> 00:22:54.270 was ongoing in 365 00:22:56.250 --> 00:23:02.550 the 30s and 40s clearly as well as because it was intrinsic to the very nature 366 00:23:02.550 --> 00:23:08.350 of the manufacturing process and then there was a special program in 367 00:23:08.350 --> 00:23:11.190 which the circumstances 368 00:23:11.190 --> 00:23:17.470 for occupational health and safety were included. 369 00:23:19.730 --> 00:23:24.310 Mr. Motley, let's strike that, please. 370 00:23:25.810 --> 00:23:31.470 You mentioned education as far as the consumer of the product was concerned. 371 00:23:32.310 --> 00:23:36.050 What educational efforts were made by Johns-Manville 372 00:23:36.050 --> 00:23:40.470 with respect to the consumers of its insulation products? 373 00:23:40.470 --> 00:23:41.470 The 374 00:23:40.930 --> 00:23:47.910 education 375 00:23:47.910 --> 00:23:52.210 for the insulation industry was 376 00:23:52.210 --> 00:23:55.970 non-existent because the evidence 377 00:23:55.970 --> 00:24:02.770 at the time was that insulation was, as was concluded by Dr. 378 00:24:02.970 --> 00:24:06.150 Fleischer and Rinker, a non-hazardous 379 00:24:06.150 --> 00:24:11.390 industry. So that education was at that time 380 00:24:11.390 --> 00:24:16.350 committed to those areas where a hazard was 381 00:24:16.350 --> 00:24:21.950 recognized as existing. Do you recall when some 382 00:24:21.950 --> 00:24:24.770 information was disseminated to the 383 00:24:24.770 --> 00:24:31.730 insulation trade? In 1964, subsequent to the identification of a hazard and the erroneousness 384 00:24:31.730 --> 00:24:35.290 of the 5 million particle per cubic foot standard 385 00:24:35.290 --> 00:24:37.730 in terms of its adequacy. 386 00:24:38.210 --> 00:24:41.670 Now, Dr. 387 00:24:42.310 --> 00:24:45.610 Mr. Motley asked you about dust counts 388 00:24:45.610 --> 00:24:50.810 specifically at the Waukegan plant 389 00:24:50.810 --> 00:24:53.950 of Johns-Manville in 1951. 390 00:24:54.050 --> 00:24:57.510 You indicated you were not aware of any dust counts 391 00:24:57.510 --> 00:24:59.690 taken at that plant in 1951. 392 00:25:00.290 --> 00:25:04.490 Were you aware of dust counts generally being made in the Johns-Manville plants? 393 00:25:04.730 --> 00:25:09.710 Yes. I can't remember whether any were taken in 1951 in Waukegan, 394 00:25:09.750 --> 00:25:13.150 and if you were to ask me again, I would again have to answer I was unaware of any. 395 00:25:13.470 --> 00:25:16.150 But were there dust counts taken? Of course there were. 396 00:25:16.230 --> 00:25:22.000 In fact, the whole business of industrial 397 00:25:22.000 --> 00:25:23.940 hygiene measurements, 398 00:25:24.280 --> 00:25:28.720 the science of industrial hygiene, was really born and developed in industry. 399 00:25:28.720 --> 00:25:34.240 industry. To this day, the federal government and regulatory agencies use 400 00:25:34.240 --> 00:25:36.160 techniques, obviously 401 00:25:36.470 --> 00:25:42.040 with the 1979 precision and so on, that had their fundamental principles 402 00:25:42.040 --> 00:25:43.380 evolved by industry. 403 00:25:44.900 --> 00:25:50.500 There was no place industry could turn to where they could really get the substantive 404 00:25:50.500 --> 00:25:55.000 need for industrial hygiene measurements that they required. 405 00:25:55.320 --> 00:25:56.320 They couldn't get them from 406 00:25:56.180 --> 00:26:00.740 from government, they couldn't get them from academia, so they did them themselves. 407 00:26:01.260 --> 00:26:05.940 And to this day, the leading edge of industrial hygiene measurements 408 00:26:05.940 --> 00:26:10.800 are either jointly generated 409 00:26:10.800 --> 00:26:16.500 by industry and government, industry, labor and government, 410 00:26:16.660 --> 00:26:18.260 by industry itself. 411 00:26:18.540 --> 00:26:24.420 Certainly the government generates independently techniques as well, but all you 412 00:26:24.420 --> 00:26:25.420 have to do 413 00:26:24.820 --> 00:26:29.180 is go to the scientific literature and see the in the world of industrial hygiene 414 00:26:29.180 --> 00:26:30.360 publications in 415 00:26:30.360 --> 00:26:35.920 which co-authors by articles on the science of industrial hygiene are co- authored 416 00:26:35.920 --> 00:26:36.920 by people from 417 00:26:36.580 --> 00:26:42.540 academia and industry by people from government and academia and so 418 00:26:42.540 --> 00:26:45.780 on so that industrial hygiene 419 00:26:45.780 --> 00:26:51.340 Hygiene is a well-established, pre-1951 420 00:26:51.340 --> 00:26:55.400 endeavor of industry. 421 00:26:57.840 --> 00:27:02.440 Dr. Kotin, Mr. Motley asked you at some length about a 422 00:27:02.440 --> 00:27:06.360 report prepared by Mr. 423 00:27:06.640 --> 00:27:11.460 Hemeon of the Industrial Health Foundation in 1947 424 00:27:11.460 --> 00:27:14.460 in 1947, and stated 425 00:27:17.310 --> 00:27:21.130 that that report had been presented to the Asbestos Textile Institute 426 00:27:21.130 --> 00:27:24.210 and the recommendations of it turned down. 427 00:27:24.730 --> 00:27:30.130 Does that, in your opinion, have a significant impact on the development of 428 00:27:30.130 --> 00:27:31.830 knowledge as 429 00:27:31.830 --> 00:27:34.230 far as asbestos risk is concerned? 430 00:27:34.510 --> 00:27:40.050 Well, I wasn't at that Asbestos Textile Institute meeting, so I can't say what went 431 00:27:40.050 --> 00:27:41.050 on, but 432 00:27:40.390 --> 00:27:43.730 but what I can do is give you the realities at the time. 433 00:27:44.410 --> 00:27:46.290 Whatever Mr. Hemeon recommended, 434 00:27:47.750 --> 00:27:53.030 if he were under the illusion that he was coming into a wasteland 435 00:27:53.030 --> 00:27:56.210 where industrial hygiene measurements were never taken, he was wrong. 436 00:27:57.190 --> 00:28:00.110 And in fact, Johns-Manville, as the record clearly shows, 437 00:28:00.150 --> 00:28:01.890 was doing industrial hygiene measurements. 438 00:28:02.750 --> 00:28:05.810 I think that if Mr. Hemeon had recommended 439 00:28:05.810 --> 00:28:09.110 that industrial hygiene measurements were not to be done, 440 00:28:10.010 --> 00:28:15.510 his recommendations would have been as ignored as they were apparently, 441 00:28:15.810 --> 00:28:17.470 recommending that something 442 00:28:17.470 --> 00:28:22.310 be done. In other words, the world of industrial hygiene was not waiting for Mr. 443 00:28:22.350 --> 00:28:23.350 Hemeon to come 444 00:28:22.970 --> 00:28:26.430 along and say you should start measuring concentrations in the workplace. 445 00:28:26.890 --> 00:28:27.890 This was 446 00:28:27.590 --> 00:28:32.930 being done beforehand, it was an ongoing thing, it was developing, so that 447 00:28:32.930 --> 00:28:36.790 again what the facts and 448 00:28:36.790 --> 00:28:39.370 And the record is relative to Mr. Hemeon's relationship 449 00:28:39.370 --> 00:28:40.970 with the American Textile Institute 450 00:28:41.490 --> 00:28:42.850 is one thing that the record states. 451 00:28:42.970 --> 00:28:44.430 And I need not comment on it. 452 00:28:44.430 --> 00:28:47.270 But I can comment very clearly, and I think responsibly, 453 00:28:47.350 --> 00:28:49.690 on what the state of industrial hygiene was at the time. 454 00:28:49.970 --> 00:28:50.970 SPEAKER 1. 455 00:28:50.130 --> 00:28:51.130 Object to responsibility. 456 00:28:51.510 --> 00:28:52.510 SPEAKER 2. 457 00:28:51.630 --> 00:28:52.630 SPEAKER 1. 458 00:28:51.730 --> 00:28:55.950 Dr. Kotin, how does that relate to your earlier testimony 459 00:28:55.950 --> 00:28:59.370 that the field of occupational medicine 460 00:28:59.370 --> 00:29:03.530 was virtually deserted during this period of time 461 00:29:04.070 --> 00:29:05.070 or nonexistent? 462 00:29:04.930 --> 00:29:09.390 Dr. Well, all 463 00:29:10.990 --> 00:29:16.750 I can say is that if I were convinced 464 00:29:16.750 --> 00:29:19.670 that the field of occupational 465 00:29:19.670 --> 00:29:25.150 medicine was a virtually non-existing thing 466 00:29:25.150 --> 00:29:30.010 at the time of my prior testimony, what was 467 00:29:30.010 --> 00:29:35.090 then etched perhaps in wood is now or engraved in wood is etched in concrete 468 00:29:35.090 --> 00:29:40.530 clearly whether it's 469 00:29:40.530 --> 00:29:46.330 with the former or present assistant secretary of labor ferocious whether it's with 470 00:29:46.330 --> 00:29:47.330 the former 471 00:29:46.810 --> 00:29:52.790 or assistant assistant secretary of hew for science and 472 00:29:52.790 --> 00:29:55.350 health whether it's with the former 473 00:29:55.350 --> 00:29:59.030 or the present director of the national institute of occupational safety and health 474 00:29:59.030 --> 00:30:01.630 the query what 475 00:30:01.630 --> 00:30:06.870 What was the state of occupational health in the 1940s, in the 40s, immediately 476 00:30:06.870 --> 00:30:08.230 post-World War II? 477 00:30:09.490 --> 00:30:15.210 The responses uniformly and consistently were variations on non 478 00:30:15.210 --> 00:30:19.590 -existent, disgraceful, negligent, abominable. 479 00:30:20.910 --> 00:30:26.650 And again, I mention these people very specifically so that these opinions can be verified. 480 00:30:26.650 --> 00:30:31.990 But in a way that I would have no control over in this 481 00:30:31.990 --> 00:30:37.230 month of November 1979, the American 482 00:30:37.230 --> 00:30:42.510 Board of Preventive Medicine, the people that teach occupational health, came out 483 00:30:42.510 --> 00:30:43.510 with its 484 00:30:42.890 --> 00:30:48.850 report and analysis of the situation historically in terms of the 485 00:30:48.850 --> 00:30:50.250 teaching of occupational health 486 00:30:50.720 --> 00:30:51.720 and medicine. 487 00:30:51.470 --> 00:30:57.470 Dr. Kotin, is the report that you just referred to reported in the 488 00:30:57.470 --> 00:31:00.270 Occupational Health and Safety Letter of November 8, 1979? 489 00:31:00.790 --> 00:31:01.790 It is. 490 00:31:01.250 --> 00:31:03.630 Let me hand you a copy of that letter and a report. 491 00:31:03.830 --> 00:31:04.830 Sure. 492 00:31:25.180 --> 00:31:27.840 After four days, her fingers are getting a little stiff. 493 00:31:40.120 --> 00:31:42.220 I'm just talking about the first paragraph there. 494 00:31:42.240 --> 00:31:43.900 You can read it off. 495 00:32:11.920 --> 00:32:14.680 Dr. I've handed you a newsletter 496 00:32:14.680 --> 00:32:15.960 that reports on that 497 00:32:18.820 --> 00:32:24.240 report of the teachers of preventive medicine and I'll ask you and would you 498 00:32:24.240 --> 00:32:29.400 comment on that please and yes what it shows the report itself has the 499 00:32:29.400 --> 00:32:33.360 headline survey sites inadequacies of occupational health training in medical 500 00:32:47.450 --> 00:32:53.350 Now, Dr. Kotin, before we took a short break, I asked you if 501 00:32:53.350 --> 00:32:56.210 the report of the teachers 502 00:32:56.210 --> 00:33:02.090 of preventing medicine had been published or an account of it in the Occupational Safety 503 00:33:02.090 --> 00:33:03.090 and Health Newsletter. 504 00:33:03.210 --> 00:33:04.210 Yes, sir. 505 00:33:03.670 --> 00:33:08.050 Would you tell the court and jury what that report contained? 506 00:33:08.350 --> 00:33:13.270 Yeah, well, it says the survey cites inadequacies of occupational health training 507 00:33:13.270 --> 00:33:14.270 in medical schools. 508 00:33:14.950 --> 00:33:19.230 A survey sponsored by the Association of Teachers of Preventive Medicine has 509 00:33:19.230 --> 00:33:22.450 confirmed what everyone has known all along, 510 00:33:22.630 --> 00:33:27.770 namely that occupational medicine is grossly neglected in the curriculum of the 511 00:33:27.770 --> 00:33:28.950 nation's medical schools, 512 00:33:28.990 --> 00:33:33.210 contributing to the shortage of occupational physicians generally. 513 00:33:33.670 --> 00:33:38.050 The questionnaire survey was conducted among 112 U.S. 514 00:33:38.070 --> 00:33:39.070 medical schools 515 00:33:38.750 --> 00:33:43.970 to determine the content and format of occupational health instruction during the 516 00:33:43.970 --> 00:33:48.050 1977-1978 academic year. 517 00:33:49.210 --> 00:33:55.130 Only 46 or 50 percent of the 92 responding institutions specifically taught 518 00:33:55.130 --> 00:33:56.290 occupational health, 519 00:33:56.390 --> 00:34:01.730 and only 28, 30 percent required in their curriculum, usually in the 520 00:34:01.730 --> 00:34:02.730 preclinical years. 521 00:34:03.970 --> 00:34:09.630 Among those 28, the median required curriculum time was 4 hours, 522 00:34:09.870 --> 00:34:12.730 and that was for the 4 years in the medical school. 523 00:34:13.270 --> 00:34:19.170 Doctor, does that status of occupational medicine also find 524 00:34:19.170 --> 00:34:22.690 support in other literature? 525 00:34:22.850 --> 00:34:29.810 And I would refer you particularly to a book called Crisis in the Workplace by Dr. 526 00:34:30.010 --> 00:34:32.330 Ashford at Massachusetts Institute of Technology. 527 00:34:32.330 --> 00:34:33.330 Mr. May I say a question? 528 00:34:33.530 --> 00:34:34.530 Mr. Sure. 529 00:34:34.830 --> 00:34:36.090 Would you show it to Mr. Motley? 530 00:34:36.410 --> 00:34:41.680 Mr. Thank you. 531 00:34:41.820 --> 00:34:42.820 I'm sorry. 532 00:34:42.160 --> 00:34:43.620 Yeah, you're as tied up as I am. 533 00:34:43.720 --> 00:34:47.560 I was going to do it, but I have the wire attached to me. 534 00:34:48.720 --> 00:34:49.720 Mr. Come 535 00:34:59.370 --> 00:35:00.370 make his day. 536 00:35:00.250 --> 00:35:04.150 Mr. I can't move. 537 00:35:05.170 --> 00:35:06.170 Thank you. 538 00:35:06.530 --> 00:35:07.530 Yes, sir. 539 00:35:07.030 --> 00:35:08.030 This... 540 00:35:10.660 --> 00:35:11.900 Mr. Excuse me. 541 00:35:11.920 --> 00:35:12.920 Are we on the tape? 542 00:35:12.960 --> 00:35:13.960 Mr. Yes, sir. 543 00:35:13.540 --> 00:35:14.540 Mr. All right. 544 00:35:14.440 --> 00:35:20.240 This is a book entitled Crisis in the Workplace by Nicholas Ashford from MIT, 545 00:35:20.380 --> 00:35:22.080 funded by the Ford Foundation. 546 00:35:22.700 --> 00:35:25.700 And one of the chapters is devoted to manpower problems. 547 00:35:26.740 --> 00:35:32.640 The part that I think verifies what we've just heard from the most authoritative 548 00:35:32.640 --> 00:35:34.180 source, the teachers of the material. 549 00:35:35.740 --> 00:35:37.740 This book was published in 1976. 550 00:35:37.740 --> 00:35:43.440 In 1976, it is estimated that only 12 medical schools include health, 551 00:35:43.580 --> 00:35:46.340 occupational health, in their curriculum. 552 00:35:46.560 --> 00:35:50.900 According to Dr. Henry Howe of the Department of Occupational Health of the 553 00:35:50.900 --> 00:35:52.160 American Medical Association, 554 00:35:52.950 --> 00:35:57.500 there are seven educational institutions with AMA-approved two-year residency 555 00:35:57.500 --> 00:35:59.240 programs in occupational medicine. 556 00:35:59.830 --> 00:36:01.760 This again refers to the 70s. 557 00:36:01.860 --> 00:36:06.820 An additional 25 residency programs are conducted by industrial firms. 558 00:36:07.740 --> 00:36:12.320 And industrial firms, I would comment, are not in the business of conducting 559 00:36:12.320 --> 00:36:13.360 residency programs. 560 00:36:13.500 --> 00:36:15.820 It's just that there aren't any available anywhere else. 561 00:36:16.280 --> 00:36:21.980 Between 25 and 50 physicians complete training in occupational medicine each year, 562 00:36:22.610 --> 00:36:26.640 barely sufficient to staff a dozen corporation medical programs. 563 00:36:27.600 --> 00:36:31.800 Dr. Kotin, Mr. Motley asked you a number of questions on your cross-examination 564 00:36:31.800 --> 00:36:34.120 about the status of occupational. 565 00:36:34.120 --> 00:36:38.660 Excuse me, we took a break a second ago, and you'd asked a question previous to 566 00:36:38.660 --> 00:36:39.860 that, not objected to the form. 567 00:36:39.980 --> 00:36:42.880 I didn't object to the form when you came back, but objected to the form in 568 00:36:42.880 --> 00:36:45.540 response to that question and answer. 569 00:36:46.300 --> 00:36:51.580 Dr. Kotin, Mr. Motley asked you on your cross-examination a number of questions 570 00:36:51.580 --> 00:36:57.580 about the status of occupational medicine in the medical schools 571 00:36:57.580 --> 00:36:58.580 at that time. 572 00:36:58.320 --> 00:36:59.320 Do you recall that? 573 00:36:58.800 --> 00:36:59.800 Yes, sir. 574 00:36:59.140 --> 00:37:04.460 He also asked you a number of questions on cross-examination about your involvement 575 00:37:04.460 --> 00:37:07.420 with asbestos and asbestos research. 576 00:37:08.100 --> 00:37:12.100 Will you tell the court and jury, please, what the Institute for Occupational and 577 00:37:12.100 --> 00:37:14.580 Environmental Health of the QAMA is? 578 00:37:14.580 --> 00:37:21.200 Yes, it is an institute located in Montreal, which 579 00:37:21.340 --> 00:37:27.060 is an independent institute staffed by 580 00:37:27.060 --> 00:37:28.960 a medical director 581 00:37:29.280 --> 00:37:32.400 with an advisory board, an international advisory board, 582 00:37:34.000 --> 00:37:37.580 which devotes all of its scientific efforts 583 00:37:37.580 --> 00:37:43.140 to the world of asbestos in the area of health 584 00:37:43.140 --> 00:37:47.040 and safety and environmental considerations. 585 00:37:47.580 --> 00:37:49.340 Have you been a member of that board? 586 00:37:49.660 --> 00:37:52.260 Yes, I was invited to be a member of that board. 587 00:37:52.360 --> 00:37:57.680 I think it was 1965, along with the board had already been in existence. 588 00:37:58.180 --> 00:38:04.560 But it is interesting that the board, scientific advisory board, was chaired by Dr. 589 00:38:04.720 --> 00:38:05.720 George Wright. 590 00:38:05.340 --> 00:38:11.340 Its membership included Dr. Fernand Gregoire of the province of 591 00:38:11.340 --> 00:38:16.660 Quebec, who was the chief physician for the Workers' Compensation Board 592 00:38:16.660 --> 00:38:20.420 of the province of Quebec, 593 00:38:21.320 --> 00:38:26.960 Professor Ian Higgins of the University of Michigan, who is sort of recognized 594 00:38:26.960 --> 00:38:32.420 as the dean of chronic disease epidemiologists in chest diseases, 595 00:38:32.420 --> 00:38:38.000 diseases, having been responsible for a major part of the epidemiologic 596 00:38:38.000 --> 00:38:39.840 program in science 597 00:38:39.840 --> 00:38:43.180 that was used in relation to the development of the Black Lung Act. 598 00:38:44.120 --> 00:38:48.900 His studies in Nashua, New Hampshire and Berlin on air pollution, 599 00:38:49.140 --> 00:38:52.180 chronic disease epidemiology 600 00:38:52.180 --> 00:38:53.980 is the standard in the field. 601 00:38:55.000 --> 00:38:59.580 Professor Marvin Kushner, who was professor of pathology and dean of the School of Medicine 602 00:38:59.580 --> 00:39:03.840 at Stony Brook campus of the State University of New York was on the board. 603 00:39:04.440 --> 00:39:09.660 As I say, I was invited to be on the board, and the board periodically meets, 604 00:39:10.520 --> 00:39:16.820 grants funds to academic institutions, and in general reviews in an ongoing way 605 00:39:16.820 --> 00:39:22.840 the world of asbestos in the world, in the areas of occupational and 606 00:39:22.840 --> 00:39:28.840 environmental factors doctor how long did 607 00:39:28.840 --> 00:39:30.640 you remain on that board well I 608 00:39:30.640 --> 00:39:34.760 remain on that board until I went to work for Johns-Manville because the 609 00:39:34.760 --> 00:39:40.180 board has a set of I guess bylaws you call them which preclude a 610 00:39:40.180 --> 00:39:42.260 person in any 611 00:39:42.260 --> 00:39:46.960 way related to a person employed by a corporation 612 00:39:46.960 --> 00:39:51.200 from being on the board 613 00:39:52.420 --> 00:39:57.840 Dr., in the course of your professional career, have you attended and 614 00:39:57.840 --> 00:40:03.100 participated in conferences 615 00:40:03.100 --> 00:40:04.300 on asbestos? 616 00:40:04.760 --> 00:40:06.000 Yeah, it's interesting. 617 00:40:06.160 --> 00:40:09.760 I kept asking myself, how could I have forgotten this when Mr. 618 00:40:09.800 --> 00:40:11.080 Motley was asking me questions? 619 00:40:11.220 --> 00:40:16.760 But it just goes to show you forget things that are very much, 620 00:40:16.840 --> 00:40:18.940 at a given moment, perhaps 621 00:40:18.940 --> 00:40:24.500 important and even helpful to yourself. In 1967 I was at the 622 00:40:24.500 --> 00:40:25.500 Antigua conference 623 00:40:26.180 --> 00:40:29.300 on asbestos sponsored by the IOEH. 624 00:40:29.620 --> 00:40:31.940 This was an international conference with 625 00:40:31.940 --> 00:40:37.900 representatives from I don't know how many countries but certainly there 626 00:40:37.900 --> 00:40:42.840 wasn't any major worker in the field who did not attend. 627 00:40:43.320 --> 00:40:44.720 Certainly the Mount Sinai 628 00:40:44.720 --> 00:40:49.620 group was there, the pneumoconiosis research unit from England was there, and 629 00:40:49.620 --> 00:40:51.780 it again 630 00:40:51.780 --> 00:40:55.100 addressed the problem of asbestos-related health problems. 631 00:40:55.400 --> 00:41:01.160 In 1979, there have been references in the past to the conferences 632 00:41:01.160 --> 00:41:02.160 held in the Union 633 00:41:02.020 --> 00:41:05.240 of South Africa in relation to asbestos. 634 00:41:05.300 --> 00:41:06.300 They've been held- 635 00:41:06.240 --> 00:41:07.580 Mr. 1979 or- 636 00:41:07.580 --> 00:41:08.780 Mr. 1969, I beg your pardon. 637 00:41:08.780 --> 00:41:12.720 In 1969, about every 10 years, the 638 00:41:12.720 --> 00:41:18.280 Department of Labor, the Department of Mines, and the Department of 639 00:41:18.280 --> 00:41:20.320 Environment, I guess that's what they're called, 640 00:41:20.380 --> 00:41:26.240 and the Union of South Africa has had a world, an international conference on asbestos. 641 00:41:27.120 --> 00:41:33.020 And in 1969 was the follow-up of the 1959 one, and I was 642 00:41:33.020 --> 00:41:34.160 invited to attend that. 643 00:41:34.160 --> 00:41:38.840 I would emphasize that both in 69 and 67 644 00:41:38.840 --> 00:41:43.900 there's no way I could have dreamed let alone thought of 645 00:41:43.900 --> 00:41:49.100 that I would ultimately be coming to work for Johns-Manville I was working for the government 646 00:41:49.100 --> 00:41:54.620 at the time quite clearly I went at government expense and I went as 647 00:41:54.620 --> 00:41:58.860 as an expert in the field 648 00:42:00.280 --> 00:42:05.300 by virtue of my designation and responsibilities in the government. 649 00:42:05.580 --> 00:42:10.680 Dr. Kotin, within the past few years, have you been nominated for the position of 650 00:42:10.680 --> 00:42:13.740 Dean of the College of Medicine at the Medical University of South Carolina? 651 00:42:14.080 --> 00:42:20.080 Indeed I have. I was honored to be nominated for the deanship and 652 00:42:20.080 --> 00:42:21.920 it was in 1975. 653 00:42:21.920 --> 00:42:27.420 It was just a year after I had come to Johns-Manville, I didn't feel that I could 654 00:42:27.420 --> 00:42:28.420 with any 655 00:42:28.100 --> 00:42:34.000 degree of a responsibility run out on a commitment that I had made 656 00:42:34.000 --> 00:42:35.800 that was tacit that I would 657 00:42:35.800 --> 00:42:38.460 stick around to at least get a program launched. 658 00:42:38.700 --> 00:42:43.840 But that was just one of many, I might say, that have periodically come during the course 659 00:42:43.840 --> 00:42:44.840 of the years. 660 00:42:44.580 --> 00:42:45.580 Thank you, Dr. Kotin. 661 00:42:45.640 --> 00:42:46.640 That's all. 662 00:42:45.820 --> 00:42:50.160 Can I have about 30 minutes and we can probably shorten this? 663 00:42:50.160 --> 00:42:52.320 How about in the journey until 11.15? 664 00:42:52.580 --> 00:42:53.580 What time is it right now? 665 00:42:53.620 --> 00:42:54.640 About 7 minutes to 11. 666 00:42:54.820 --> 00:42:55.820 11.30. 667 00:42:55.620 --> 00:42:56.680 How about 11.30? 668 00:42:56.720 --> 00:42:57.720 11.30. 669 00:42:57.280 --> 00:42:58.420 I'll give you the extra time. 670 00:42:58.640 --> 00:43:01.000 The more time I get, the less time it'll take. 671 00:43:01.340 --> 00:43:02.340 I'm for that. 672 00:43:09.120 --> 00:43:10.120 You ready? 673 00:43:13.300 --> 00:43:14.300 Technicians are ready? 674 00:43:32.500 --> 00:43:33.500 It's all ready. 675 00:43:33.940 --> 00:43:34.940 Ready? 676 00:43:35.980 --> 00:43:39.740 Now, Dr. Kotin, did I understand you correctly to say, sir, 677 00:43:39.740 --> 00:43:44.520 that excuse me let me state for the record I think I already did it but 678 00:43:44.520 --> 00:43:48.560 these are all subject to my objections previously stated I believe we agreed to 679 00:43:48.560 --> 00:43:54.180 that. Doctor did I understand you to tell the jury that there were asbestos 680 00:43:54.180 --> 00:44:00.640 conferences of an international scope in South Africa in the 1930 decade? 681 00:44:01.600 --> 00:44:02.600 I can't 682 00:44:02.380 --> 00:44:07.660 be sure of that but certainly in the 1960 and in the 1950 there was. 683 00:44:07.720 --> 00:44:08.720 Yes sir in 684 00:44:08.060 --> 00:44:11.640 In fact, there was a conference in Johannesburg in 1934, wasn't there? 685 00:44:11.740 --> 00:44:12.740 Could very well be. 686 00:44:12.740 --> 00:44:15.060 And there was another one in 1939, wasn't there, sir? 687 00:44:15.620 --> 00:44:16.620 Yes, sir. 688 00:44:16.240 --> 00:44:18.100 And there was one in 1949, wasn't there? 689 00:44:18.140 --> 00:44:19.640 There were a series of conferences, yes. 690 00:44:19.880 --> 00:44:21.800 And there was one in 1959, wasn't there? 691 00:44:22.680 --> 00:44:24.420 The doctor just said there was one in 1959. 692 00:44:24.540 --> 00:44:25.540 1959, yes. 693 00:44:25.320 --> 00:44:26.320 1959. 694 00:44:25.940 --> 00:44:28.540 And, in fact, doctor, at the 1959 conference, 695 00:44:29.360 --> 00:44:32.800 insulation workers and asbestos disease were discussed, weren't they? 696 00:44:32.920 --> 00:44:34.040 I'd like to see the program. 697 00:44:34.280 --> 00:44:35.280 All right, sir. 698 00:44:34.580 --> 00:44:35.900 I'll be glad to let you see it. 699 00:44:36.720 --> 00:44:37.780 Would you mark this, please? 700 00:45:03.290 --> 00:45:09.250 Now, Doctor, before I ask you any specific questions about the 1959 conference 701 00:45:09.250 --> 00:45:10.250 that was 702 00:45:09.830 --> 00:45:15.030 held in South Africa in 1959 and included a discussion of asbestos diseases, let me 703 00:45:15.030 --> 00:45:16.650 ask you if you recognize any of these names. 704 00:45:17.290 --> 00:45:20.650 Did you know a Dr. Gough, G-O-U-G-H, from Great Britain? 705 00:45:21.190 --> 00:45:22.870 I knew Dr. Gough. 706 00:45:22.890 --> 00:45:23.890 He is now dead. 707 00:45:23.810 --> 00:45:24.810 Yes, sir. 708 00:45:24.430 --> 00:45:27.170 But at the time, he was a leader in the field of dust diseases. 709 00:45:27.170 --> 00:45:28.170 What? 710 00:45:27.590 --> 00:45:30.770 He was a recognized worker in the field, yes, sir. 711 00:45:30.770 --> 00:45:35.370 And you knew Dr. Michael John, M-I-E-K-L- E-J-O-H-N, did you not, sir? 712 00:45:35.450 --> 00:45:36.490 Dr. Michael John, yes. 713 00:45:36.530 --> 00:45:37.690 Michael John, I'm sorry, sir. 714 00:45:37.790 --> 00:45:40.570 And, of course, you knew Dr. Hurwitz. Did you know Dr. Hurwitz? 715 00:45:40.750 --> 00:45:42.150 No, I did not know Dr. Hurwitz. 716 00:45:42.390 --> 00:45:45.590 Were you at the New York Academy of Sciences meeting in 1964? 717 00:45:46.030 --> 00:45:47.870 I think we discussed that. 718 00:45:48.270 --> 00:45:49.310 That's right. You weren't there, though. 719 00:45:49.350 --> 00:45:50.350 That's right. 720 00:45:50.490 --> 00:45:53.010 You knew who Dr. Sleggs was, didn't you, sir? 721 00:45:53.190 --> 00:45:58.650 Yes, he was a co-publisher with Dr. Wagner on his scientific 722 00:45:58.650 --> 00:46:00.030 publication, some of them. 723 00:46:00.070 --> 00:46:01.070 Yes, sir. 724 00:46:00.770 --> 00:46:04.630 Right. In fact, he was a co-author on the mesothelioma publication, was he not? 725 00:46:04.670 --> 00:46:05.670 He was, yes, sir. 726 00:46:05.730 --> 00:46:09.150 And I believe we discussed before that in his mesothelioma study, 727 00:46:09.310 --> 00:46:11.110 there were several insulation workers, weren't there? 728 00:46:11.210 --> 00:46:13.890 As I recall, we did discuss that, yes, sir. 729 00:46:14.050 --> 00:46:15.730 And that was in 1959, wasn't it? 730 00:46:15.770 --> 00:46:18.490 Yes, sir, just about the time that there were suspicions 731 00:46:18.490 --> 00:46:21.570 that maybe insulation workers were not protected 732 00:46:21.570 --> 00:46:24.690 by the 5 million particle per cubic foot standard, yes, sir. 733 00:46:24.910 --> 00:46:25.910 1959. 734 00:46:25.990 --> 00:46:28.950 Well, that's when the studies were, suspicions were beginning to arise. 735 00:46:28.950 --> 00:46:34.590 And Dr. Vorwald, he was the director of the Saranac Laboratory for a period of 736 00:46:34.590 --> 00:46:35.590 time, wasn't he? 737 00:46:35.270 --> 00:46:36.270 Yes, sir. 738 00:46:35.770 --> 00:46:40.370 And he conducted experiments with asbestos in the 1940s and early 1950s. 739 00:46:40.430 --> 00:46:41.430 As I recall... 740 00:46:41.430 --> 00:46:42.810 I'm going to object to these questions. 741 00:46:42.930 --> 00:46:47.050 These are all things that you went into with these very individuals on cross- examination. 742 00:46:47.050 --> 00:46:49.010 They were not the subject of redirecting. 743 00:46:49.030 --> 00:46:50.030 I think it's improper cross. 744 00:46:50.370 --> 00:46:54.650 And Dr. Wagner, or as we would say in South Carolina, Wagner... 745 00:46:54.650 --> 00:46:56.250 We say that in Denver as well. 746 00:46:56.250 --> 00:47:02.230 Right. He was an author of the mesothelioma study in 1960, 747 00:47:02.450 --> 00:47:06.910 which convinced you that mesothelioma was a disease associated with asbestos. 748 00:47:06.990 --> 00:47:09.610 Excessive asbestos exposure, yes, sir. 749 00:47:09.710 --> 00:47:15.510 Now, doctor, I'm going to hand you a copy which we'll identify at a later time, 750 00:47:15.710 --> 00:47:20.810 which is a portion of the proceedings of the pneumoconiosis conference held at the 751 00:47:20.810 --> 00:47:25.530 University of Witten-Waterstrand, Johannesburg, February 1959. 752 00:47:27.250 --> 00:47:29.870 We're going to have to... Thank you. 753 00:47:30.850 --> 00:47:35.030 Let me ask you first of all, sir, have you ever had an opportunity prior to today 754 00:47:35.030 --> 00:47:36.050 to review the 755 00:47:36.930 --> 00:47:40.710 proceedings of the 1959 conference in South Africa? 756 00:47:40.870 --> 00:47:44.290 I have an objection to the question. The report is not complete. 757 00:47:44.370 --> 00:47:45.370 It's very, 758 00:47:45.130 --> 00:47:46.970 very incomplete as a matter of fact. 759 00:47:47.110 --> 00:47:48.110 Yes, sir. 760 00:47:47.950 --> 00:47:52.310 In fact, the volume... Have you ever seen the proceedings before, doctor? 761 00:47:52.430 --> 00:47:54.470 Well, I've seen... I don't remember if this was the year, but sure, 762 00:47:54.470 --> 00:47:56.490 I'm pretty sure I've seen Proceedings of Pneumoconiosis Conference. 763 00:47:56.830 --> 00:47:59.610 Pretty thick book, thicker than that one that's sitting on your desk right now, 764 00:47:59.650 --> 00:48:00.650 isn't it? 765 00:47:59.990 --> 00:48:01.850 Well, it's a big book, yes. 766 00:48:01.990 --> 00:48:03.850 Yes, all right. Would you take a look at that, sir? 767 00:48:03.970 --> 00:48:04.970 Yes, sir. 768 00:48:04.450 --> 00:48:08.510 All right, and if you want to take a second to review it, I'd call your attention, 769 00:48:08.690 --> 00:48:09.690 sir, to 770 00:48:10.090 --> 00:48:15.410 certain portions of it. You're welcome to read the first several pages if you'd like. 771 00:48:15.570 --> 00:48:16.570 Would you like 772 00:48:16.190 --> 00:48:20.710 to cut the tape while he looks at it? Mr. Hood, do you have any objection to us 773 00:48:20.710 --> 00:48:21.710 cutting the tape 774 00:48:23.850 --> 00:48:25.170 Dr. Now, 775 00:48:31.980 --> 00:48:35.760 Doctor, isn't it a fact that Dr. Goff, at a discussion among the doctors, 776 00:48:35.840 --> 00:48:41.260 including Dr. Vorwald, Dr. Bodnar, and Dr. Sleggs, reported on cases of 777 00:48:41.260 --> 00:48:42.260 asbestosis in 778 00:48:42.260 --> 00:48:45.460 people who did insulation work at that conference in 1959? 779 00:48:45.960 --> 00:48:49.580 Dr. Yes, but there's nothing in here to suggest what their prior work history was, 780 00:48:49.660 --> 00:48:56.220 so that indeed, as Dr. Goff said, asbestosis is sometimes found in building demolishers 781 00:48:56.220 --> 00:48:59.640 who have been stripping asbestos insulation. Yes, and do you know that insulation 782 00:48:59.640 --> 00:49:01.040 workers in 1959 783 00:49:01.040 --> 00:49:05.000 from time to time had to rip old insulation off the buildings? 784 00:49:05.400 --> 00:49:07.520 I guess they did, he said so. All right. 785 00:49:07.740 --> 00:49:11.460 Now, Doctor, did you finish your answer? No, I think. 786 00:49:11.500 --> 00:49:13.820 What were you going to say? I was just going to say that 787 00:49:16.400 --> 00:49:21.920 a generally recognized principle is that in ascribing any kind of an occupational disease 788 00:49:21.920 --> 00:49:25.140 through an occupational situation, you need an occupational history. 789 00:49:25.240 --> 00:49:26.240 I don't 790 00:49:25.640 --> 00:49:30.300 know what these people did beforehand. Now, at least at the time that Dr. 791 00:49:30.420 --> 00:49:31.420 Goff 792 00:49:30.660 --> 00:49:33.860 was interested in them, they were doing insulation work. Isn't that right, Doctor? 793 00:49:34.080 --> 00:49:39.060 That is what Dr. Goff said, yes. Now, when you attended the 1967 and 1969 794 00:49:40.060 --> 00:49:43.980 asbestos conferences, did you present a paper on asbestos disease? No, sir. 795 00:49:44.040 --> 00:49:45.040 I 796 00:49:44.160 --> 00:49:48.180 discussed many, many papers. Well, you weren't invited there to present a paper 797 00:49:48.180 --> 00:49:51.520 on asbestos disease, were you, Doctor? As I recall, most of the papers that were 798 00:49:51.520 --> 00:49:53.060 were given were people who were invited 799 00:49:53.060 --> 00:49:55.320 and were given the opportunity to present or not. 800 00:49:56.380 --> 00:49:58.820 I, as the proceedings of the conference 801 00:49:59.340 --> 00:50:01.960 would show, if there are proceedings of the discussion, 802 00:50:02.200 --> 00:50:05.080 would show that I, much as you're quoting discussion now, 803 00:50:05.200 --> 00:50:08.120 I note that you're quoting not the scientific paper, 804 00:50:08.220 --> 00:50:10.340 but you're quoting Dr. Goff as part of a discussion, 805 00:50:10.540 --> 00:50:14.120 no less than Dr. Goff discussed in 1959 806 00:50:14.460 --> 00:50:15.980 that I discussed in 1969. 807 00:50:16.060 --> 00:50:18.720 And you're telling the jury that if I present you 808 00:50:18.720 --> 00:50:22.800 with a copy of the transcript of the proceedings in 1967. 809 00:50:23.340 --> 00:50:25.340 Dr. Paul Kotin's name's going to be on 810 00:50:25.340 --> 00:50:29.640 there. Well I don't know that there are a transcript of the full proceedings but if 811 00:50:29.640 --> 00:50:31.200 there are Dr. Paul 812 00:50:31.200 --> 00:50:34.340 Kotin's name is going to be his name's going to be on there if there's a transcript 813 00:50:34.340 --> 00:50:35.500 of it. All right 814 00:50:36.620 --> 00:50:43.760 now doctor you're not suggesting to this jury are you sir that there weren't any epidemiologic 815 00:50:43.760 --> 00:50:49.280 studies as you have defined it in the dust the trade industries 816 00:50:49.280 --> 00:50:50.920 in the 1920s 817 00:50:50.920 --> 00:50:56.120 are you know what I'm suggesting is that the epidemiologic studies 818 00:50:56.120 --> 00:50:59.520 of a population 819 00:50:59.520 --> 00:51:05.300 in those days were undertaken under these state-of-the-art at that time yes 820 00:51:05.300 --> 00:51:10.220 and in a case like silicosis where there were many epidemiologic studies were 821 00:51:10.220 --> 00:51:15.560 that were done they were done very very in 822 00:51:15.560 --> 00:51:18.640 circumspect populations you were 823 00:51:18.640 --> 00:51:22.820 dealing with the disease which at that time was exceedingly well characterized 824 00:51:24.100 --> 00:51:29.440 that so that as I say the state of the art and the thing you're studying would 825 00:51:29.440 --> 00:51:32.980 determine the effectiveness of an epidemiologic study well there were 826 00:51:32.980 --> 00:51:37.060 studies made in the 1920s and you didn't mean to suggest to this jury by talking 827 00:51:37.060 --> 00:51:41.760 about Atlanta in 1965 that there weren't any studies now what I was telling no 828 00:51:42.200 --> 00:51:48.200 let me tell you what I was telling thank you it wasn't what I was trying to tell 829 00:51:48.200 --> 00:51:53.040 him sir it's what I was telling him that as far as chronic disease epidemiology 830 00:51:53.040 --> 00:51:58.980 was concerned it was a facet of epidemiology 831 00:51:58.980 --> 00:52:03.580 that was as part of the 832 00:52:03.580 --> 00:52:09.960 government program in epidemiology finally recognized as a stepchild as it were and the 833 00:52:09.960 --> 00:52:15.860 epidemiologic service added a chronic disease epidemiology dimension to it i would submit 834 00:52:15.860 --> 00:52:20.400 that that is probably a very very accurate assessment of what the state of the art 835 00:52:20.400 --> 00:52:21.400 was doctor 836 00:52:21.970 --> 00:52:26.660 the united states public health service conducted dozens of epidemiologic studies 837 00:52:26.660 --> 00:52:32.320 of industries in the 1910s 1920s and 1930s of desk 838 00:52:32.320 --> 00:52:35.580 diseases did they not they examined lots 839 00:52:35.580 --> 00:52:40.660 of populations yes sir dr. Dreessen study in 1938 was an epidemiologic study the 840 00:52:40.660 --> 00:52:41.660 asbestos industry 841 00:52:41.420 --> 00:52:46.100 and it's one that was rather unique and special at the time and dr. 842 00:52:46.280 --> 00:52:47.660 lands that did an epidemiologic 843 00:52:47.660 --> 00:52:52.400 study in 1935 for the asbestos oh sure there were they were done all I was trying 844 00:52:52.400 --> 00:52:53.400 to say is that 845 00:52:53.200 --> 00:52:57.220 they were unique they were special it was not the situation that we have at present 846 00:52:57.220 --> 00:52:58.220 right and they 847 00:52:58.040 --> 00:53:02.640 were related to a specific instance and dr fulton did an epidemiologic study in 848 00:53:02.640 --> 00:53:04.100 1938 in pennsylvania 849 00:53:04.100 --> 00:53:09.840 of asbestos facilities didn't he looked at the populations yes sir and dr Hemeon in 850 00:53:09.840 --> 00:53:11.200 1947 in his 851 00:53:11.200 --> 00:53:14.780 study did an epidemiologic study did well there were different qualities 852 00:53:14.780 --> 00:53:16.080 populations were examined 853 00:53:16.080 --> 00:53:21.380 yes asbestos workers were yes but let me tell you and perhaps the one of the best 854 00:53:21.380 --> 00:53:22.380 things that could 855 00:53:21.980 --> 00:53:24.760 could be done would be to have, as a witness, 856 00:53:24.920 --> 00:53:26.440 a professional epidemiologist. 857 00:53:27.740 --> 00:53:32.020 And let him evaluate the status of chronic disease 858 00:53:32.540 --> 00:53:33.540 epidemiology. 859 00:53:33.240 --> 00:53:36.120 And you and I, neither one of us are epidemiologists, 860 00:53:36.180 --> 00:53:37.180 although you know a lot more than I do. 861 00:53:37.120 --> 00:53:41.500 I would submit that we're in different ballparks 862 00:53:41.500 --> 00:53:43.880 in terms of our appreciation of epidemiology, 863 00:53:43.880 --> 00:53:45.780 as we are in our appreciation of the law. 864 00:53:45.840 --> 00:53:46.840 Yes, sir. 865 00:53:46.260 --> 00:53:47.740 We're indeed the . 866 00:53:48.260 --> 00:53:51.460 Now, doctor, with respect to the threshold limit value 867 00:53:51.460 --> 00:53:57.340 for asbestos you're not suggesting to this jury that there wasn't any criticism 868 00:53:57.340 --> 00:53:58.680 of the threshold 869 00:53:58.680 --> 00:54:04.480 limit value for asbestos prior to dr selikoff coming along in 1964 are you quite 870 00:54:04.480 --> 00:54:05.480 the contrary 871 00:54:05.100 --> 00:54:11.060 i was telling you that that basically all threshold limit 872 00:54:11.060 --> 00:54:13.840 values carry with them the 873 00:54:14.760 --> 00:54:19.120 clear understanding that they should be looked at constantly and evaluated because 874 00:54:19.120 --> 00:54:20.120 of the fact that 875 00:54:19.880 --> 00:54:25.000 new knowledge is coming along all the time so that i wouldn't know how you define 876 00:54:25.000 --> 00:54:26.460 criticism would i 877 00:54:27.020 --> 00:54:30.920 say that people are looking at them we're looking at threshold limited values today 878 00:54:31.600 --> 00:54:37.260 for things unrelated to asbestos purely on the basis of the ongoing evaluation 879 00:54:37.260 --> 00:54:38.280 all right sir 880 00:54:38.760 --> 00:54:43.800 now did you know who vandiver brown was sir yes i was told who he was i didn't know 881 00:54:43.800 --> 00:54:44.800 him well tell 882 00:54:44.460 --> 00:54:46.580 Tell the jury who you were told Vandiver Brown was. 883 00:54:46.580 --> 00:54:50.120 He was, I believe, a vice president of Johns-Manville Corporation. 884 00:54:50.240 --> 00:54:51.240 Johns-Manville Corporation. 885 00:54:51.420 --> 00:54:54.640 Now, have you ever seen anything that Mr. Brown might have written about the 886 00:54:54.640 --> 00:54:57.740 threshold limit value for asbestos back in the 1940s? 887 00:54:58.040 --> 00:54:59.380 I believe he was an attorney. 888 00:54:59.680 --> 00:55:02.160 Yes, and he was also secretary of the corporation, right? 889 00:55:02.180 --> 00:55:03.180 Yeah. 890 00:55:02.820 --> 00:55:04.680 Well, I haven't. 891 00:55:04.680 --> 00:55:07.340 Certainly not in anything that's an authoritative text. 892 00:55:07.340 --> 00:55:12.900 Next, I suspect his knowledge of threshold limit values in the scientific area would 893 00:55:12.900 --> 00:55:17.100 be equivalent to my having any kind of an opinion, which I do not, sir, as to the validity 894 00:55:17.100 --> 00:55:19.560 of your objecting or this council objecting. 895 00:55:19.620 --> 00:55:20.620 It's not his field. 896 00:55:20.540 --> 00:55:24.780 So really what he says about a threshold limit value in advance, I think I would 897 00:55:24.780 --> 00:55:26.280 have some 898 00:55:26.280 --> 00:55:29.240 very serious question as to whether he's entitled to an opinion. 899 00:55:29.420 --> 00:55:32.360 Like you, you admitted you're not an expert in these areas. 900 00:55:32.680 --> 00:55:35.440 I suspect he was probably even less of an expert. 901 00:55:35.440 --> 00:55:39.900 Less of an extra. Now, are you familiar with the Saranac Symposium, sir? 902 00:55:40.120 --> 00:55:41.980 You know I am. Some of you, some not. 903 00:55:42.120 --> 00:55:44.520 Do you know whether or not one was held in 1947? 904 00:55:45.000 --> 00:55:49.320 If I can be shown a program for 1947, I will agree that there was one. 905 00:55:49.420 --> 00:55:50.420 Yes, sir. 906 00:55:50.060 --> 00:55:53.840 Do you know whether or not Johns Mammel sent Mr. Vandiver Brown to that particular 907 00:55:53.840 --> 00:55:55.380 symposium to present a paper? 908 00:55:55.600 --> 00:55:57.540 I would like to see the proceedings, and I can't. 909 00:55:58.520 --> 00:55:59.560 We'll mark it later. 910 00:56:01.540 --> 00:56:03.100 Oh, I wish we'd done it before.