Dr. Kenneth W. Smith to H. M. Jackson and C. M. McGaw on Dr. Wright's Findings Without X-Ray Evidence (1950)

Two short letters from Dr. Kenneth W. Smith, medical director of Canadian Johns-Manville at Asbestos, Quebec. On December 19, 1950, he told H. M. Jackson at J-M headquarters that Dr. Wright's report on the Quebec mine and mill workers might be delayed, because Wright had found evidence of a breathing abnormality with little or nothing to be seen on the X-ray and wanted to be certain before publishing. In January 1951 he told C. M. McGaw that he had already pointed out that "such findings might change our whole examination program and seriously affect the field of compensation," and asked the company to approve Wright's request to re-examine eight men, two from Thetford and six from Asbestos, at the Quebec Asbestos Mining Association's expense.

What it shows

Quebec compensation for asbestosis depended on a typical X-ray pattern. Wright's work suggested that men could have asbestosis that the X-ray did not show, and Smith saw at once what that would mean for J-M's examinations and its compensation costs. He nevertheless supported the further tests, writing that their results "can be of vital importance to this Company." Lanza was gathering the British view on X-ray diagnosis at the same time (Sutherland to Lanza).

About this copy

The letter to McGaw appears to be the same letter that is filed with McGaw's January 1951 note on the industrial hygiene minutes. Its day is hard to read (January 17 or 18).

In Johns-Manville's chronology

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

On 12/19/50, Dr. Smith wrote to H. Jackson that Dr. Wright's report on the Canadian mine and mill workers might be delayed due to the need for additional research on his findings, because he had found evidence of a physiological abnormality with little or nothing to be seen on the x-ray.

In a letter to Drs. Smith and Cartier on 1/8/51, Dr. Wright said that "eight of the men who, to our belief, show insufficient x-ray evidence to warrant classification as definite asbestosis (by X-ray) nevertheless show pathologically incomplete saturation of their arterial blood during exercise." He went on to explain that if this were established, then the importance of using x-rays to establish a diagnosis of asbestosis would be put in a "different light." Dr. Smith wrote to C. McGaw on 1/18/51, that these findings "might change our whole examination program and seriously affect the field of compensation."

J. Woodard wrote Dr. Smith in January, 1951, inquiring about this theory and mentioned that Dr. Sutherland (London, England) considered this theory "entirely untenable." Dr. Smith wrote an angry letter in response to J. Woodard on 2/7/51. He felt his integrity has been questioned regarding the issue of whether or not he had correctly reported that workers in England had been compensated for total disability from asbestosis in the absence of an x-ray pattern considered to be typical of asbestosis.

Dr. Smith explained that as early as 12/7/45, he had reported (he does not state to whom) that the Saranac doctors had found that oxygen unsaturation in arterial blood could be one of the earliest signs of lung fibrosis and could appear before x-ray evidence of fibrosis, thus making it possible "to have asbestotic fibrosis without x-ray evidence and probably without functional disability."

He went on to explain that in February 1949, he attended the Compensation Board hearing for Allaire v. Asbestos Corporation. Conversations with those in attendance especially Dr. Bellemare, led him to believe that group would try to change the compensation law so that a typical x-ray pattern was not necessary for a diagnosis of asbestos. Dr. Smith subsequently learned that a J-M employee, Cyprien Frachette, was to be used as a test case. Regarding Dr. Sutherland's recent statements to Dr. Lanza denouncing the truth of this theory, Dr. Smith pointed to a 1941 article by Hanes Hanneson ln Tubercle entitled "A Case of Pulmonary Asbestos is Accompanied by Tuberculosis" in which Dr. Sutherland was cited for his assistance in reviewing the article.

A reply letter from J. Woodard dated 2/20/51 clarified that it was not his intent to try to discredit what Dr. Smith had reported, but to learn about the development of opinion in Canada concerning the role x-ray evidence plays in the determination of disability and asbestosis.

Editor's note: Only Dr. Smith's letters of December 19, 1950, and January 1951 are in this file. Dr. Wright's letter of January 8, 1951, Woodard's January letter, Smith's reply of February 7, 1951, and Woodard's letter of February 20, 1951, which the chronology also describes, are not in this file.