Dr. Kenneth W. Smith to George K. Foster Reviewing the Saranac Asbestosis Report (1948)

A confidential memo of March 19, 1948, from Dr. Kenneth W. Smith, the doctor at Canadian Johns-Manville's operations in Asbestos, Quebec, to George K. Foster, sending his review of the Saranac Laboratory's report on experimental asbestosis. Smith summarizes the animal findings (fibrosis came from the long fibers, and asbestosis developed in dust where only a small share was long fiber), compares them with conditions in J-M's mills, and adds recommendations for the industry. The last asks Saranac for an opinion on asbestosis and cancer: asbestos "has been mentioned as a very definite possible cause," and although Smith had seen no lung cancer among J-M's employees, it "might play some role in the development of carcinoma."

What it shows

Smith accepted the Saranac findings partly because they fit his own mills, where he thought conditions like those that produced asbestosis in the animals "could have been found." He recommended that asbestosis be controlled by lowering dust and by transferring men to non-dusty jobs "probably as soon as there are significant x-ray changes." He also reported that pneumonia in men with asbestosis was "extremely difficult to treat" and that local doctors said it often ended in death in a man who had worked many years in the dust. In March 1948, then, J-M's own doctor in Quebec was asking for an expert opinion on cancer. Seven months later, when the full Saranac report reached the sponsors, Vandiver Brown proposed removing its references to tumors (Brown's memorandum of October 1948).

In Johns-Manville's chronology

Johns-Manville's own chronology of what the company knew describes this document as follows:

A report dated 3/19/48 (no copy available), by Dr. Wright and Dr. Gregoire (a post-graduate student at Saranac assisting Dr. Wright) apparently details the visit of these doctors to Asbestos where they toured the mill to observe working conditions and to review the x-rays of certain Canadian J-M employees.

The men selected for the study were picked by Drs. Smith and Cartier after they conducted a review of physical examinations of all employees given in 1947 and divided this group into those with dust exposure and those without dust exposure. No criteria is mentioned regarding what they consider to be no exposure. The x-rays of those men who had been exposed were then reviewed by Drs. Smith and Cartier.

In a letter dated 7/6/48 to Dr. Cartier, Dr. Smith states that based upon the decisions made at a QAMA meeting and at I. Sabourin's insistence, it was made to appear that the selection of the men for the study was done by the Compensation Board rather than the company. According to Dr. Smith "we never have let anyone know that this company (J-M) had anything to do with the scheme; we are merely co-operating with Dr. Vidal and the Board to the best of our ability. Mr. Sabourin insisted on this point and we have adhered to this decision implicitly. Even the head of the union here thinks that Dr. Vidal selected the men for examination and that all I did was to help him out."

Several letters dated 9/6/48 and 7/28/49 from G. Foster and C. McGaw discuss how widely the test results should be published. The original plan was for the results to remain with the companies and for the study to be submitted to all interested companies for approval before publication. Later, it was decided that the information should be made available to the public. Dr. Smith reported the subjects' inquiries about the results of their exams. The extant correspondence does not include any statements indicating that the men were informed of the results; however, the correspondence from Dr. Smith indicates that he anticipated that they would be informed.

On 12/4/48, a meeting was held in the Saranac lab to discuss the results of the tests. Among other results, it was found that: oxygen unsaturation in arterial blood could appear before x-ray evidence of fibrosis; fibrosis does not lead to emphysema; and asbestosis can cause a total physical incapacity to work. The report recommended tests for oxygen unsaturation to be carried out in men with significant dust exposure and early x-ray fibrosis, transfers for those men with x-ray changes and oxygen unsaturation, and more efficient methods of dust control.

On 1/4/49, Dr. Wright wrote to I. Sabourin requesting an additional 24 men from Asbestos and Thetford for the study; however, this additional effort was delayed because J-M did not want to send more men to Saranac until things settled down after a strike.

The testing of six additional men was completed in February, 1951. In July, 1951, Dr. Wright presented a paper, described by Dr. Smith in a letter to I. Sabourin of 7/23/51, to be "considering the results of his examination of our men" at a QAMA meeting at Murray Bay. In a letter of 7/16/51, Dr. Smith wrote Dr. Wright requesting a meeting in Quebec with Dr. Wright and Dr. Cartier "to discuss questions which might arise after the presentation of your paper."

Editor's note: J-M's description is built around a March 19, 1948 report by Drs. Wright and Gregoire, Dr. Smith's July 6, 1948 letter to Dr. Cartier, letters from Foster and McGaw, and a December 4, 1948 meeting at Saranac; none of these is in this file. The March 19, 1948 paper here is Dr. Smith's memo to George K. Foster reviewing the Saranac report on experimental asbestosis.