Dr. Daniel C. Braun to H. M. Jackson Sending Lung Cancer Literature for the Asbestos Textile Industry (1956)

A two-page letter of December 6, 1956, from Dr. Daniel C. Braun, medical director of the Industrial Hygiene Foundation, to Hugh M. Jackson, manager of J-M's industrial health program, with two of the articles it discusses. Braun had promised Jackson, after talking about "the status of the ATI study," material for a coming Asbestos Textile Institute meeting. He summarizes a 1953 review linking asbestos with bronchogenic carcinoma in 13.3 percent of reported cases, Richard Doll's 1955 study of 18 lung cancers among 105 autopsies of asbestos workers, and a writer who found it "more and more difficult to absolve asbestos" as a cause of lung cancer and expected compensation claims to grow. He hopes it will help in "enlightening the representatives of the textile industry" and promises more "ammunition" as he finds it.

What it shows

The "ATI study" was the Industrial Hygiene Foundation's proposed study of lung cancer in asbestos textile workers, on which the institute's members could not agree. Jackson had asked for the medical literature on asbestos and lung cancer, and by the end of 1956 J-M's industrial health manager had in hand a summary of the published evidence that asbestos workers developed lung cancer, together with the British autopsy study behind it.

About this copy

Braun's letter and the 1953 Isselbacher, Klaus and Hardy article are shown here. Richard Doll's 1955 article in the British Journal of Industrial Medicine is still under copyright in the United States, so it is left out of this copy; it can be read free on PubMed Central. The letter is also published, with its scan, as Motley 1,000 document 91.

In Johns-Manville's chronology

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

Letter from Dr. Daniel C. Braun, Medical Director of IHF to H.M. Jackson, Manager of J-M Industrial Health program dated 12/6/56. Pursuant to Jackson's request, Dr. Braun sent Jackson information available in the literature on asbestos and cancer. Braun discusses an article in the American Journal of Medicine for 11/53 by Isselbacher, Klaus and Hardy entitled "Asbestosis and Bronchogenic Carcinoma." Isselbacher, Klaus and Hardy reviewed cases in the literature and concluded that asbestos is associated with bronchogenic carcinoma in 13.3% of the cases cited in the literature. The occupation of most of the 20 cases studied was asbestos textile worker, except for 4 pipe coverers (insulation workers).

Dr. Braun also mentions an article by Doyle entitled "Mortality from Lung Cancer in Asbestos Workers," British Journal of Industrial Medicine, 4/55, which presents data on 18 cases of lung cancer diagnosed in autopsy among 105 consecutive autopsies of asbestos textile workers in "a large asbestos works." Fifteen of the 18 had asbestosis and three did not.

Dr. Braun also mentions an article by L.W. Smith entitled "Pneumoconiosis and Lung Cancer" in the Compensation Medicine Journal, November 1949, which states that "the American and English figures correspond so closely that it becomes more and more difficult to absolve asbestos as a potential factor in the development of pulmonary cancer."

Smith quotes a recent editorial in the JAMA: "As the available evidence shows that the occurrence of cancer of the lung is related to pulmonary asbestosis and is not merely a possible sequel of exposure to asbestos dust" and states that "claims for compensation will become of increasing frequency due to the general increase of carcinoma of the lung." Dr. Braun hopes that the above information will be helpful to Jackson in enlightening the representatives of the textile industry. "We will continue to send 'ammunitions' as we uncover it."

Dr. Braun also mentions that Dr. H.C. Hinshaw and Dr. L.H. Garland in their new book Diseases of the Chest state that "exposure occurs in industrial plants where asbestos products are fabricated and among those who install insulating materials. The spinning and weaving of asbestos in combination with other textiles also results in exposure."

Editor's note: J-M's description names the British author "Doyle." Braun's letter and the enclosed article are by Richard Doll.