Dr. Joseph A. Smith to Dr. Kenneth W. Smith on Dr. Selikoff's Proposed Passaic County Asbestosis Study (1961)

A short letter of August 8, 1961, from Dr. Joseph A. Smith, superintendent and medical director of the New Jersey State Sanatorium for Chest Diseases, to Dr. Kenneth W. Smith, Johns-Manville's medical director. Following up "our conversation the other day regarding cancer in asbestos," he enclosed an outline of a proposed study of asbestosis in Passaic County, New Jersey, and a nurses' report of a July 26 meeting with Dr. Irving Selikoff, asking that the material be kept confidential if it was new to Kenneth Smith. The outline said there was "a lack of awareness" among doctors, industry, health officials and the public of "the injurious effects of inhalation of asbestos dust."

What it shows

The meeting report, written by two nurses, Mrs. King and Ann Talamo, records Dr. Selikoff saying that Barnert Memorial Hospital in Paterson, with only 125 beds, had seen six deaths from asbestosis in ten years, and that two of his 71 patients with severe asbestosis had died of lung cancer. He cited British figures on lung cancer among asbestosis patients and Dr. Thomas Mancuso's Public Health Service study, and said Dr. Harold Magnuson of the Public Health Service had asked the asbestos industry to support research and would back the work if industry did not. The nurses noted that Selikoff had "never been so forceful" about going ahead "regardless of help." The copy sent to J-M carries handwritten notes beside the study plan, including "Eliminate" next to the assumption that there is a "safe" concentration of asbestos dust, and "Too broad" beside the list of objectives; the writer is not identified. The letter shows that J-M's medical director was told of Selikoff's planned work in 1961, two years before it was published (see Selikoff, Churg and Hammond's 1963 paper).

About this copy

The letter's routing box shows the initials KWS and CLS, probably Dr. Kenneth W. Smith and C. L. Sheckler of J-M's industrial hygiene staff. The handwritten notes may be by one of them, but that is a guess.

In Johns-Manville's chronology

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

Dr. Joseph Smith (Superintendent & Medical Director, State of N.J.) sends to Dr. Kenneth Smith, 8/8/61, a report of a meeting in which a proposed pulmonary asbestosis study of workers in Passaic County was discussed. (A separate report describing the proposed study is also enclosed.)

Dr. J. Smith writes that he is sending these materials because they are relevant to a conversation he and Dr. K. Smith had the other day regarding "cancer in [sic] asbestos." Dr. J. Smith asks that if Dr. K. Smith is unfamiliar with this proposed study, that he treat the information as confidential.

The description of the proposed study, prepared by Ann Tolomec (NJTHA), states that there is a lack of awareness about the injurious effects of inhaling asbestos, and it is felt that research in this area is needed. Passaic County, because of the large amount of asbestos used by industry there, is particularly suitable for research on this subject.

The objectives of the study are: (1) to determine the prevalence of asbestosis in industries using asbestos in Passaic County, (2) to determine the incidence of lung cancer and other lung diseases in this group, and (3) to establish a safe concentration of asbestos dust as a preventive measure.

The report of the meeting concerning the proposed study indicates that the meeting took place on 7/26/61. The participants were Drs. Selikoff, Chung (pathologist, Barnert Hospital), Sachs (Health Officer, Metropolitan Health District); Schall (Coordinator, Occupational Health Program); King and Tolomec (NJTHA).

Dr. Selikoff opened the discussion by stating that in Great Britain there were 49 deaths due to lung cancer in 250 asbestosis patients, and that Dr. Thomas Mancuso (University of Pittsburgh) performed a study which "confirmed the Great Britain finding of intra peritoneal cancer lining of abdomen] in addition to lung cancer." Dr. Selikoff reported that two issues need to be considered -individual exposure to asbestos, and the clinical hazard peculiar to asbestos inhalation, which is cancer.

Dr. Selikoff indicated that he met with Dr. Harold Magnuson (USPHS) who is eager to do some studies in this field. Dr. Magnuson recently met with representatives of the asbestos industry and asked for their support to undertake a similar study. Dr. Magnuson said that he would be willing to help plan the Passaic County study. Dr. Selikoff stated that he plans to proceed with the following: (1) make up a list of plants in which asbestos is used in great quantity (need not be confined to Passaic County) and (2) perform X-ray surveys.

Dr. Selikoff said that the following basic research is needed: (1) chemical analysis of sputa, (2) pulmonary function pattern which will pick up asbestosis, and (3) other lab studies. Dr. Selikoff said that he would approach unions and the asbestos industry for support. He hopes the NJTHA and SHD will offer support, but he plans to proceed with the project whether he gets help or not.

"Dr. Selikoff, although he has always been enthusiastic about projects, has never been so forceful in his statements about doing the project regardless of help. This may be due to the encouragement he got from Dr. Magnuson."

Editor's note: J-M's description names the pathologist "Dr. Chung" and the nurse "Ann Tolomec." The meeting report names the pathologist as Jack Churg, M.D., of Barnert Memorial Hospital, and on a faint copy the nurse's name reads "Ann Talamo."