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R. J. Sexton to C. U. Dernehl Transmitting the Asbestos Workers Health Hazard Survey Form (1973)

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Internal correspondence from the Institute Plant medical director sending physicians a copy of the 'Asbestos Workers Health Hazard Survey' form (UCC-512-MD-4) that he had developed, following a meeting in New Orleans. The enclosed form has questionnaire sections on work history, personal health history and smoking history, plus a physical examination, X-ray report and industrial hygiene exposure sampling record section.

Author
R. J. Sexton, M.D. (Plant Medical Director)
Published by
Union Carbide Corporation, Chemicals and Plastics, Institute Plant, Medical Department - Plant 512
Series
Union Carbide documents, UC-3928
Date
February 15, 1973
Number
Bates UCC 014439 to UCC 014441
Library no.
ACL Doc 18567 · asbestosclaims.law/library/18567
Rights
A document from asbestos litigation, published for research and historical study.

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Read online Download the PDF Document UC-3928 · 4 pages · 153 KB

What the document holds

  • Page 1: Letter from R. J. Sexton, M.D., to C. U. Dernehl, M.D., 15 Feb 1973, transmitting the survey form
  • Page 2: Form UCC-512-MD-4, questionnaire on work history, personal health history and smoking history
  • Page 3: Form continuation: physical examination, laboratory, X-ray report, physician's examination and exposure sampling record

People and organizations

From R. J. Sexton, M.D. (Plant Medical Director) to C. U. Dernehl, M.D. (270 Park Avenue, New York).

Pages on our site about what this document covers: Industrial Hygiene · West Virginia Asbestos Exposure Sites: Worksites, Industries, and Trust Coverage.

About this copy

This is document UC-3928 of the Union Carbide documents, documents produced and used as evidence in asbestos lawsuits against Union Carbide, 4 pages. Production numbers UCC 014439 to UCC 014441.

Cite this document

“R. J. Sexton to C. U. Dernehl Transmitting the Asbestos Workers Health Hazard Survey Form.” February 15, 1973. Union Carbide documents, UC-3928, Bates UCC 014439 to UCC 014441. Union Carbide Corporation, Chemicals and Plastics, Institute Plant, Medical Department - Plant 512. AsbestosClaims.Law Library, ACL Doc 18567. https://asbestosclaims.law/library/18567.

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