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CUMULATIVE AUTHOR INDEX FOR CATEGORIES I00 to 199 January i0, 1983 CATEGORY NUMBER 183 0259 190 0318 183 0260 150 0174 150 0175 198 0370 185 0305 185 0306 196 0361 190 0319 182 0231 182 0230 182 0229 184 0291 194 0354 121 0083 121 0082 124 0124 124 0123 130 0129 170 0216 183 0257 130 0150 150 0177 111 0015 111 0016 111 0018 111 0017 190 0320 112 0061 112 0060 112 0063 190 0321 130 0133 184 0283 180 0218 184 0294 190 0322 184 0292 184 0295 182 0233 120 0076 AUTHORS AND YEAR A11ison AC (1973) A11ison AC (1974) A11ison AC (1977) Anacher DE, A1arif A, Epstein SS (1974) Amacher DE, A1arif A, Epstein SS (1975) Archer VE, Dixon WC (1979) Babu KA, Lakkad SC, Nigam SK, Bhatt DK, Karnik ABet al (1980) Babu KA, Nigam SK, Lakkad BC, Bhatt DK, Karnik AB et al (1981) Beck EG (1975) Beck EG (1976) Beck EG (1980) Beck EG, Holt PF, Manojlovic N (1972) Beck EG, Holt PF, Nasrallah ET (1971) Beck EG, Tilkes F (1980) Becklake ~R (1981) Beg MU, Farooq M, Saxena V, Rahman Q, et al (1977) Beg MU, Rahman Q, Viswanathan PN, Zaidi SH (1973) Begin R, Masse S, Bureau MA (1982) Begin R, Rola-P1eszczynski M, Sirois P, Lemaire I, et al (1981) Berry G, Wagner JC (1976) Bevan DR, Rien~r SC, Lakowicz JR (1981) Bey E, Harington JS (1971) Bignon J, Monchaux G, Sebastien P, Hirsch A, Lafuma J (I979) Bolton RE, Davis JMG (1976) Botham SK, Holt PF (1968) - Botham SK, Holt PF (1971) Botham SK, Holt PF (1972) Botham,SK, Holt PF (1972) Botham SK, Holt PF (1974) Brody AR (1980) Brody AR, Crapo JD (1979) Brody AR, Hill LH, Adkins B Jr, O'Connor RW (1981) Brown A (1974) Brown DG, Wagner JC, Wagner ~F (1980) Brown RC, Chamberlain M (1980) Brown RC, Chamberlain M, Davies R, Gromley IP (Editors) (1980) Brown RC, Chamberlain M, Davies R, Morgan D~ et al (1980) Brown RC, Chamberlain M, Davies R, Sutton GT (1980) Brown RC, Chamberlain M, Griffiths DM, Timbrell V (1978) Brown RC, Chamberlain M, Sutton GT (1980) Bruch J (1974) Burns DM (Editor) (1982) GEOGRAPHIC CODE GBR GBR GBR UOH UOH UUT IND IND GER GER GER GBR GBR GER CAN IND CAN CAN GBR UMN SAF FRA GBR GBR GBR GBR GBR GBR UNC SAF UNC U~ GBR GBR GBR GBR GBR GBR GBR GER UCA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 CATEGORY NUMBER 182 0253 184 0284 184 0281 184 0282 186 0311 182 0235 183 0264 113 0070 190 0323 190 0324 150 0171 186 0308 IB1 0220 183 0275 183 02/6 112 0033 130 0147 111 0008 111 0007 111 0009 182 0227 130 0142 130 0143 130 0141 130 0145 130 0144 182 0228 190 0325 130 0148 112 0046 190 0326 112 0065 197 0365 190 0327 183 0261 181 0226 181 0221 193 0347 170 0208 124 0114 150 0181 112 0032 AUTHORS AND YEAR GEOGRAPHIC CODE Case BW, [P MPC, Padilla M, Kleinerman J (1982) UNY Chamberlain M (1982) GBR Cha~erlain M, Brown RC (1978) GBR Chamberlain M, Brown RC, Griffiths DM (1980) GBR Chamberlain M, Tarmy EM (I977) GBR Conning DM, Hayes MJ, Styles JA, Nicholas JA (1971) GBR Costrini AM, Stevens CA, Gee JBL (1978) UCT Craig DK, Wehner AP, Morrow WG (1972) UWA Craighead JE, Mossman BT, Bradley BJ (1980) UVT Crapo JD, Barry BE, Brody AR, O'Neil JJ (1980) UNC Cunningham HM, Moodie CA, Lawrence GA, Pontefract RD (1977) CAN Cunningham HM, Pontefract RD (1974) CAN Daniel H, Le Bouffant L (1980) FRA Davies R (1980) GBR Davies R (1980) GBR Davis HV, Reeves AL (!971) UMI Davis JMB, Coniam SW, (1973) GBR Davis JMG (1963) GBR Davis JMG (1963) GBR Davis JMG (1964) GBR Davis JMG (1967) GBR Davis JMG (1970) GBR Davis JMG (1970) GBR Davis JMG (1970) - GBR Davis JMG (1971) GBR Davis JMG (1971) GBR Davis JMG (19/2) GBR Davis JMG (1979) GBR Davis JMG (1979) GBR Davis JMG, Beckett ST, Bolton RE, Collings P, Middleton AP (1978) GBR Davis JMG, Beckett ST, Bolton RE, Donaldson K (1980) GBR Davis JMG, Beckett ST, Bolton RE, Donaldson K (1980) GBR Davis JMG, Bolton RE, Garrett J (1974)GBR Davis JMG, Molyneux ~, Baxter RA, Walton k+l, Berlin A (1981) GBR Dean RT, Hylton W, Allison ~ (1979) GBR Depasse J (1900) BEL Desai R, Hext P, Richards R (1975) GBR Dixon JR, Lowe DO, Richards DE, Cralley LJ, Stokinger HE (1970) UOH Dixon JR, Lowe DO, Richards DE, Stokinger HE (1969) UOH Dodson RF, Hurst GA, Williams MS Jr (1980) UTX Donham KJ, Berg JW, Will LA, Leininger JR (1980) UIO Donna A (1970) ITA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 CATEGORY NUMBER 186 0315 186 0316 186 031/ 112 0031 150 0185 Iii 0026 121 0079 140 0159 140 0160 121 0080 150 0191 112 0037 112 0044 184 0279 184 0280 iii 0004 iii 0003 160 0195 113 0075 182 0234 184 0293 183 0272 183 0273 160 0196 112 0030 194 0350 150 0173 194 0351 194 0356 130 0149 150 0172 ~ii 0013 121 0081 112 0029 186 0313 186 0312 150 0194 150 0193 150 0186 160 0201 160 0202 194 0353 AUTHORS AND YEAR Donna A (1972) Donna A (1973) Donna A, Betta PG, Lanfranco G (1980) Donna A, Cappa APM (1967) Eisele GR (1981) Emerson RJ, Corrin B, Cole PJ (1982) Engelbrecht FM (1964) Engelbrecht FM, Burger BF (1973) Engelbrecht FM, Burger BF (1975) Engelbrecht FM, Thiart BF (1972) Epstein SS, Varnes M (1976) Evans JC, Evans RJ, Holmes A, Hounam RF, Jones DM, et al (1973) Ferin J, Leach LJ (1976) Frank AL (1977) Frank AL (1980) Gardner LU (1942) Gardner LU, Cunmings DE (1931) Gloyne SR (1930) Goldstein B, Webster I, Rendall REG, Skikne MI (1978) Goldstein RH, Miller K, Glassroth J, Snider GL, Polgar P (1982) Gormley IP, Bolton RE, Brown G, Davis JMG, Donaldson K (1980) Gormley IP, Wright A, Collings P, Davis JMG (I980) Gormley IP, Wright MO (1980) Governa M, Vadala CR (1973) Gross P (1968) Gross P (1973) Gross P (1974) Gross P (1975) Gross P, Harley RA (1973) Gross P, Harley RA (I~73) Gross P, Harley RA, S~nburne LM, Davis JMG, Greene WB (1974) Gross P, de Treville TP (1967) Gross P, de Treville TP (1970) Gross P, de Treville TP, Toker EB, Kaschak M, Babyak MA (1967) Hahon N, Booth JA, Eckert HL (1977) Hahon N, Eckert HL (1976) Hallenbeck WH, Markey ~, Dolan DG (1981) Hallenbeck WH, Patel-Mandlik KJ (1979) Hamilton J, Vassalli JD, Reich E (1976) Hamilton JA (1980 Hamilton ~% (1981) Harington JS (1981) GEOGRAPHIC COOE ITA ITA ITA ITA UTE UVT SAF GER GER GER UOH GBR UNY UNY UNY UNY UNY GBR SAF UMA GBR GBR GBR ITA UPA USC USC USC USC USC USC UPA UPA UPA UWV UWV UIL UIL UNY UNY UNY SAF

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 CATEGORY NUMBER 160 0203 198 0369 193 0349 182 0246 182 0244 111 0020 111 0019 150 01B4 112 0050 199 0371 111 0022 111 0023 111 0011 112 0028 111 0012 111 0014 190 0328 185 0299 185 0298 160 0197 123 0103 182 0247 150 0178 150 0179 160 0207 150 0180 124 0116 124 0115 182 0249 124 0118 182 0239 182 0251 182 0250 183 0277 183 0278 190 0329 112 6W)67 112 0066 190 0330 112 0053 112 0056 112 0058 AUTHORS AND YEAR Harington JS, Roe FJC, Walters M (1967) Haubenstock H, Bekesi JG (1982) Hayashi H (1974) Hext PM, Hunt J, Dodgson KS, Richards RJ (1977) Hext PM, Richards RJ (1976) Hiett DM (1978) Hiett DM (1978) Hilding AC, Hilding DA, Larson DM, Aufderheide AC (1981) Holmes A, Morgan A (1980) Holt PF (1974) Holt PF (1981) Holt PF (1982) Holt PF, Mills J (1964) Holt PF, Mills J, Young DK (1964) Holt PF, Mills J, Young DK (1966) Holt PF, Young DK (1967) Huang S-D, Lee W-H (1980) Huang SL (1979) Huang SL, Saggioro D, Michelmann H, Mailing HV (1978) Hueper WC (1954) Humphrey EW, Ewing SL, Wrigley JV, Northrup ~ Ill et al (1981) Hunt J, Pooley FD, Richards RJ (1981) Jacobs R, Dodgson KS, Richards RJ (1977) Jacobs R, Humphrys J, Dodgson KS, Richards Rj (1978) Jacobs R, Richards RJ (1980) Jacobs R, Weinzweig M, Dodgson KS, Richards RJ (1978) Jaiswal AK (1981) Jaiswal AK, Viswanathan PN (1980) Jaurand MC, Bignon J (1977) Jaurand MC, Bignon J, Gaudichet A, Magne L, Oblin A (£978) Jaurand MC, Kaplan H, Thiollet J, Pinchon MC et al (1979) Jaurand MC, Magne L, Bignon J (1980) Jaurand MC, Magne L, Bignon J, Goni J (1980) Johnson NF, Davies R (1980) Johnson NF, Oavies R (i981) Johnson NF, Wagner JC (1980) Johnson NF, Wagner JC, Wills HA (1980) Johnson NF, Wagner JC, Wills HA (1980) Jones JSP (1980) Kagan E, Miller K (1978) Kagan E, Miller K (1979) Kagan E, Miller K (1981) GEOGRAPHIC CODE SAF UNY JAP GBR GBR GBR GBR U~ GBR GBR GBR GBR GBR GBR GBR ~R TAI UNY UNY UMD U~ GBR GBR GBR GBR GBR IND IND FRA FRA FRA FRA FRA GBR GBR GBR GBR GBR GBR SAF SAF SAF

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10. 1983 CATEGORY NUMBER 160 0199 160 0200 140 016/ 170 0209 170 0210 182 0248 182 0240 185 0302 183 0265 182 0232 140 0168 124 0117 183 0256 181 0219 122 0101 i91 0343 170 0213 170 0215 170 0214 i/0 0211 195 0360 170 0212 195 0359 184 0288 150 0190 190 0331 121 0089 121 0088 121 0090 111 0025 111 0024 124 0122 186 0309 183 0270 112 0051 170 0217 183 0269 186 0314 185 0301 121 0078 186 0310 181 0222 AUTHORS AND YEAR GEOGRAPHIC CODE Kanazawa K. Birbeck MSC. Carter RL. Roe FJC (1970) GBR Kanazawa K. Roe FJC. Yamamoto T (1979)GBR Kanazawa K. Yamaha)to T. Yuasa Y (1979) JAP Kandaswami C. O'Brien PJ (1980) CAN Kandaswami C. O'Brien PJ (1981) CAN Kang KY. Bice D. D'Amato R. Ziskind M. Salvaggio J (1979) ULA Kaplan H. Jaurand MC. Pinchon MC. Bernaudin JF et al (1980) FRA Kaplan H. Renier A. jaurand MC. Bigno, J (1980) FRA Kaw JL. Tilkes F. Beck EG (1982) GER Kaw JL. Zaidi SH (1975) IND Kawai T (1979) JAP King EJ. Clegg JW. Rae VM (1946) GBR Kioshi K. Sakabe H (1972) JAP Koshi K. Hayashi H. Sakabe H (1968) JAP Kung-Vosamae A. Vinkmann F (1980) RUS Lafuma J. Morin M. Poncy JL. Masse R (1980) FRA Lakowicz JR. Bevan DR (1979) UMN Lakowicz JR. Bevan DR (1980 U~ Lakowicz JR. Bevan DR (1980) UMN Lakowicz JR. Hylden JL (1978) U~ Lakowicz JR. Hylden JL (1978) U~ Lakowicz JR. Hylde, JL. Bevan DR (1979) UMN Lakowicz JR. Hylden JL. Englund F. Hidmark A. NcNamara--M (1979) U~ Landesman JM. Mossman BT (1982) UVT Lavappa KS. Fu ~. Epstein SS (1975) UOH Lazar P (1980) FRA Le Bouffant L. Bruyere S. Daniel H. Tichoux G (1979) FRA Le Bouffant L. Bruy~re S. Daniel H. Tichoux G (1979) FRA Le Bouffant L. Martin JC. Daniel H (1979) FRA Lee KP. Barras CE. Griffith FD. Waritz RS (1981) UDE Lee KP. Barras CE. Griffith FD. Waritz RS. Lapin CA (1981) UDE Lemaire I. Sirois P. Rola-Pleszczynski M. Masse S. Begin R (1981) FRA Lemaire S. Le~iaire I (1981) CAN Lemkin P. Lipkin L. Merril C. ShiFrin S (1980) UMD Leong BKJ. Kociba RJ. Pernell HC. Lisowe RW. Rampy LW (1978) UMI Light WG (1979) UMA Lipkin LE (1980) UMD Litterst CL. Lichtenstein EP (1970) UWI Livingston GK. Rom WN. Morris MV (1980)UUT Luechtrath H. Schmidt KG (1959) GER Luken$ ~ (19/8) UCA Macnab G. Harington JS (1967) SAF

CUMULATIVE AUTHOR INDEX FOR CATEGORIES I00 to 199 january i0, 1983 CATEGORY NUMBER 123 0102 124 0121 130 0136 196 0362 194 0355 112 0040 112 0045 112 0047 130 0156 112 0055 182 0238 111 0021 182 0237 183 0258 150 0176 112 0052 112 0059 112 0054 112 0057 198 0366 198 0367 124 0112 195 0358 130 0151 199 0372 130 0131 112 0048 112 0049 183 0262 184 0287 192 0346 184 0286 184 0285 124 0111 121 0093 185 0297 185 0304 185 0303 124 0104 113 0069 124 0119 130 0155 AUTHORS AND YEAR Man SFP, Lee TK, Gibney RTN, Logus JW (1980) Marcussen WH (1977) Maroudas NG, O'Neill CH (1973) Masse R, Sebastien P, Monchaux G, Bignon J (1980) McCullagh SF (1981) McDernmtt M, Wagner JC (1975) Middleton AP, Beckett ST, Davis JMG (197/) Middleton AP, Beckett ST, Davis JMG (1979) Miller JW, Sayers RR (1936) Miller K (1979) Miller K (1980) Miller K, Calverley A, Kagan E (1980) Miller K, Handfield RIM, Kagan E (1978) Miller K, Harington JS (1972) Miller K, Kagan E (1976) Miller K, Kagan E (1977) Miller K, Kagan E (1981) Miller K, Webster I, HandfieId RIM, Skikne MI (19/8) Miller K, Weintraub Z, Kagan E (1979) Miller K, Weintraub Z, Kagan E (1980) Miller K, Weintraub Z, Kagan E (1980) Misra V, Rahman Q, Viswanathan PN (1978) Misra V, Rahman Q, Viswanathan PN, Beg MU, Zaidi SM (1977) Monchaux G, Bignon J, Jaurand MC, Lafuma J et al (1981) Morgan A (1980) Morgan A, Davies P, Wagner JC, Berry G, Holmes A (1977) Morgan A, Evans JC, Holmes A (1977) Morgan A, Talbot RJ, Holmes A (1978) Morgan D~, Allison AC (1980) Mossman BT, Adler KB, Craighead JE (1980) Mossman BT, Cra|ghead JE (1981) Mossman BT, Cr.~ighead JE, MacPherson BV (1980) Moss~w~n BT, Kessler J:B, Ley BW, Craighead JE (19/7) Narang S, Kaw JL, Zaidi SH (1978) Nettesheim P (1981) Neugut AI, Eisenberg D, Si|verstein M, Pulkrabek Pet a| (1978) Newman HAl, Saat YA, Hart RW (1980) Newman F~AI, Saat YA, Hart RW (1980) Nofer J, Szymczykiewicz K, Wiecek E (1961) Nordmann M, Sorge A (1941) Oblin A, Warner JM, Jaurand MC, Bignon J, Claude JR (1978) Peacock PR, Peacock A (1966) GEOGRAPHIC CODE CAN UCA UMD FRA ATL GBR GBR GBR UDC SAF SAF UDC SAF SAF SAF SAF SAF SAF SAF SAF SAF IND FRA GBR GBR GBR GBR GBR UVT UVT UVT UVT IND UNC UNY UOH UOH POL GER FRA GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 CATEGORY NUMBER 160 0205 160 0204 198 0368 183 0255 140 0165 183 0266 112 0062 112 0064 190 0332 150 0170 190 0333 190 0334 185 0300 19/ 0363 122 0099 122 0100 122 0098 195 0357 111 0027 121 0084 181 0224 197 0364 111 0006 160 0206 112 0035 112 0(]34 184 0289 181 0225 182 0242 182 0243 182 0245 190 0335 182 0241 193 0348 140 0166 121 0086 121 0087 190 0336 140 0158 186 030/ 181 0223 124 0113 AUTHORS AND YEAR GEOGRAPHIC CODE Pelfrene AF (1977) Pelf'rene AF (1977) Pernis B, Vig]iani EC (1982) Pernis B, Vigliani EC, Marchisio MA, Zanardi S (1966) Pigott GH, Ishmael J (1979) Pigott GH, Judge PJ (1980) Pinkerton KE, Pratt PC, Crapo JD (1980) Pinkerton KE, Pratt PC, Crapo JD (1982) P]anteydt HT (1980) Pontefract RD, Cunningham HM (1973) Pott F (1980) Pott F, Huth F, Spurny K (1980) Price-Jones Mj, Gubbings G, Chamberlain M (19B0) Pylev LN (1980) Pylev LN, Koval'skaya GD, Yakovenko GN (1975) Pylev LN, Kulagina TF. (1982) Pylev LN, Roe F, Warwick D (1970) Pylev LN, Shabad LM (1973) R ahman Q (1982) Rahman Q, Beg MU, Viswanathan PN, Zaidi SH (1976) Rahman Q, Narang S, Kaw JL, Zaidi SH (1974) Rahman Q, Viswanathan PN, Zaidi SH (1977) Ramaswamy AS, Venkatesh DS, Rama Rao R (1953) Rasanen T (1962) Reeves AL (1976) Reeves AL, Puro HE, Smith RC (1974) Reiss B~ Weisburger JH, Williams GM (1979) Richards RJ, George G, Hunt J, Tetley TD (I980) Richards RJ, Hext PM, Blundell G, Henerson WJ, Volcani BE (1974) Richards Rj, Hext PM, Desai R, Tetley T, Hunt Jet al (1975) Richards RJ, Jacoby F (1976) Robock K (1976) Robock K, Klosterkotter W (1973) Roy-Chowdhury AK, Mooney TF Jr, Reeves AL (1973) Sahu AP, Shanker R, Zaidi SH (1978) Salk RA, Vosamae A (1975) Sanders CL Jr (1975) Schepers GWH, Wagner JC, Hueper W (1965) Scheuer E, Huth F, Pott F (1973) Schneider U, Maurer RR (1977) Schnitzer RJ, Pundsack FL (1970) Schoenberger C, Hunninghake G, Gedek J, Crystal R (1980) UNE UNE UNY ITA GBR GBR UNC UNC NET CAN GER GER GBR RUS RUS RUS RUS RUS UAR IND IND IND FIN UMI UMI UNY GBR GBR GBR GBR GER GER UMI IND RUS UWA UDC GER UNC SAF UMD

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 B CATEGORY NUMBER 140 0157 110 0001 150 0182 140 0162 121 0085 140 0161 185 0296 124 0109 124 0108 124 0110 183 0263 130 0146 121 0077 122 0094 130 0153 130 0154 190 0337 150 0189 130 0152 160 0198 130 0137 130 0134 130 0138 130 0139 130 0140 130 0135 140 0164 140 0163 182 0236 122 0095 122 0096 122 0097 124 0105 112 0042 112 0043 184 0290 194 0352 121 0091 121 0092 112 0036 191 0345 112 0068 AUTHORS AND YEAR GEOGRAPHIC CODE Schu]z RZ, Williams CR (1942) UMA Schuster NH (1931) GBR Sebastien P, Masse R, Bignon J (1980) FRA Sethi S, Beck EG, ManojIovic H (1974) GER Shabad LM, Pylev LN, Krivosheeva LV, Kulagnina TF eta] (1974) RUS Shin ~, Firminger HI (1973) UMD Sincock A, Seabright M (1975) GBR Singh J, Beg MU, Kaw JL, Viswanathan PN, Zaid| SH (1976) IND Singh J, Beg MU, Viswanathan PN, Zaidi SH (19/5) IND Singh J, Pandey SD, Viswanathan PN, Zaidi SH (1978) IND Skeldon N, Steele L (1978) GBR Smith BA, Davis JMG (1971) GBR Smith JM, Wootton IDP, King EJ (1951) GBR Smith WE (1966) UNJ Smith WE (1973) UNJ Smith WE (1980) UNJ Smith WE, Hubert DD, Sobel HJ (1980) UNJ Smith WE, Hubert DD, Sobel HJ, Peters ET, Doerfler TE (1980) UNJ Smith WE, Miller L, Churg J, Selikoff IJ (1965) UNJ Speirs RS, Wenck U (1955) U~ Stanton ~ (1974) UMD Stanton ~, Blackwel] R, Miller E (1969) UMD Stanton ~, Layard M (1978) UMD Stanton ~, Layard M (19/9) UMD Stanton ~, Layard M, Tegeris A, Miller E, May Met al (1981) UMD Stahton ~, Wrench C (19/2) UMD Stevens RH, Wi]! LA, Cole DA, Meek ES, Frank CW, Donham KJ (1979) UIO Stevens RH, Will LA, Osborne JW, Cole DA, Donham KJ (1978) UIO Styles JA, Wilson J (1973) GBR Suzuki Y, Churg J (1970) UNY Suzuki Y, Churg J, Ono T (19/2) UNY Suzuku Y (1974.) UNY Szymczykiewicz K (1970) POL Tetley TD, Hext PM, Richards RJ, McDermott M (1976) GBR Tetley TD, Richards Rj, Harwood JL (1977) GBR Tilkes F, Beck EG (1980) GER Timbrell V (1972) GBR Topping DC, Nettesheim P (1980) UNC Topping DC, Nettesheim P, Martin DH (1980) UNC Turnock AC, Bryks S, Berta]anffy FD (1971) CAN Vigliani EC (1968) ITA Vincent JH, Johnston WB, Jones AD, Johnston AM (1981) GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 199 January 10, 1983 CATEGORY NUMBER 124 0106 124 0107 iii 0005 183 0268 183 0267 111 0010 130 0126 190 0338 112 0038 112 0041 130 0130 183 0254 130 0127 190 0339 190 0340 190 0341 190 0342 112 0039 130 0128 130 0132 150 0183 llO 0002 150 0192 113 0074 113 0071 113 0073 113 0072 191 0344 150 0169 182 0252 124 0120 183 0271 183 0274 150 0187 150 0188 124 0125 AUTHORS AND YEAR Viswanathan PN, Dogra RKS, Shanker R, Zaidi SH (1973) Viswanathan PN, Rahman Q, Beg MU, Zaidi SH (1973) Vorwald AJ, Durkan TM, Pratt PC (1951) Wade MJ, Lipkin LE, Stanton ~, Frank AL (1980) Wade MJ, Lipkin LE, Tucker RW, Frank AL (1976) Wagner JC (1963) Wagner JC (1966) Wagner JC (19/1 Wagner JC (1972) Wagner JC (1975) Wagner JC (1976) Wagner JC (Editor) (1980) Wagner JC, Berry G (1969) Wagner JC, Berry G (1973) Wagner JC, Berry G (1973) Wagner JC, Berry G, Hill RJ, Munday DE, Skidn~re JW (1980) Wagner JC, Berry G, Skidmore JW, Pooley FD (1980) Wagner JC, Berry G, Skidmore JW, Timbrell V (1974) Wagner JC, Berry G, Timbre!! V (1973) Wagner ~IqF (1979) Ward JM, Frank AL, Wenk M, Devor D, Tarone RE (1980) Webster I (1963) Webster I (1974) Wehner AP (1980) Wehner AP, Busch RH, O]son RJ, Craig DK (1975) Wehner AP, Dagle GE, Cannon WC (1978) Wehner AP, DagIe GE, Cannon WC, Buschbom RL (1978) Westlake GE (1974) Westlake GE, Spjut HJ, Smith MN (1965) White R, Kuhn C (1980) Wilcox K, Marcussen W, Furst A (1974) Wright A, Gorml.ey IP, Co|]ings PL, Davis JMG (1980) Wright MO, Gorm|ey IP (1980) Zaidi SH (1974) Zaidi SH, Gupta GSD, Rahman Q, Kaw JL, Shanker R (1976) Zaidi SH, Shanker R, Dogra RKS (1973) GEOGRAPHIC CODE IND IND UNY UMD UMO GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR UMD SAF SAF UWA UWA UWA UWA UCA UTX UMO UCA GBR GBR IND IND IND

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 105 [200] HUMAN PATHOLOGY AND IN VITRO STUDIES 106 [210] HistoDatholo~ic features of pulmonary asbestosis and cancer 108 [220] Asbestosis or asbestos bodies 109 [230] [231] [232] [233] [234] [235] Ferruqinous bodies and asbestos fibers 112 Tissue analytical methods 113 Pulmonary asbestos content in asbestos workers 115 Pulmonary asbestos content in American populatio. groups 118 Pulmonary asbestos content in foreign population groups 121 Extrapulmonary tissue asbestos content 124 [240] [241] [242] [243] Antemortem pulmonary cytqlqgic observations Sputum cytology Bronchoalveolar cytology Pulmonary biopsy 124 125 128 128 [250] Particulate deposition in excised human lun@ 129 [260] In vitro hemolysis 130 [270] Human tissue cultures 131 [280] [281] [282] [283] [284] [285] Immunologic reactions to asbestos In vitro adsorption of plasma and serum proteins Delayed hypersensitivity skin tests Cell-mediated immunologic tests Humoral immune tests Miscellaneous tests including lymphocytic hydroxylase activity 133 133 134 134 136 ~38 [290] Asbestos/cigarette smokin@jinteractions derived from httman postmortem and antemortem studies 139 Bibliography 141 Cumulative Author Index 174 plus 1

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983~ 106 [200] HUMAN PATHOLOGY AND IN VITRO STUDIES The recognition of diseases caused by inhalation of asbestos dust was originally based on histopathologic observations of the lung. In 1906, Montagu-Murray reported to a departmental committee on industrial diseases in England concerning a case of pulmonary fibrosis in an asbestos worker on whom he had done an autopsy (373). This case was not published in the literature and so were many other autopsies performed in the 1880s at a hospital in Turin. This compiler is in the process of obtaining these records to document the fact that the first cases of asbestosis diagnosed by gross and microscopic observations of the lung occurred in Italy in the 1880s, rather than in England in 1906. The first published case of lung cancer in a patient suffering from pulmonary asbestosis was reported in 1935 by an American pathologist, and additional cases were reported from England and Germany. Thus, prior to the Second World War, there was enough scientific information indicating that occupational exposure to asbestos can cause diseases of the lung, such as pulmonary fibrosis and bronchogenic carcinoma, demonstrable by histopathologic studies.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 107 A 1982 monograph released by the Commercial Union Insurance Companies which is intended to examine the scientific evidence on Asbestosr Smokin~ and Disease (374) does not discuss the early recognition of asbestos diseases, although the relationship between tobacco and cancer was reviewed. The monograph traces its origin to at least 200 years ago, in an article describing nasal lesions caused by the use of snuff. The relationship between cigarette smoking and lung cancer is attributed to a 1929 publication by Tylecote, and to a 1939 article by Ochsner and DeSakey. It should be recognized that these two articles contained clinical impressions without any case reports. The epidemiologic evidence associating lung cancer and cigarette smoking was not available until the 1950s. A review of the literature conducted by this compiler suggests that recognition of the pathogenetic effects of asbestos dust exposure predated by several decades the epidemiologic studies relating to cigarette smoking. The techniques used to investigate the effects of asbestos dust on human .lungs, blood and tissue cultures are discussed below. Compared to animal experiments [Categories lOOs], the human studies are less extensive and efforts to either prove or disprove asbestos/smoking interaction concept are minimal. The compiler offers an explanation as follows: human pathologists

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 108 generally do not agree with concepts derived from animal experiments and epidemiologic observations upon which the interaction hypothesis is based. (210] Histopathologic Features of Pulmonary Asbestosis and Cancer The first monograph on the subject appeared in 1938, entitled Silicosis and Asb@s~osis, edited by Lanza (375). The chapters on pathology by Gloyne (376) and on experimental pathology by Gardner (377) su~arize the importance of micros- copic observations in differentiating between asbestosis and silicosis. Auerbach (378) reviewed the differences in an article appearing in 1937, thirty years prior to his own description of histopathologic changes seen in-. the lungs of cigarette smokers. This is another example in the expanding list of events indicating that the pulmonary effects of asbestos dust exposure predated those from cigarette smoking. The specific histopathological changes seen in asbestosis, mesothelioma and'~ bronchogenic carcinoma are discussed under their respective disease categories [400s, 500s and 600s]. It suffices to state here that =despite the elegant techniques in biochemistry, pharmacology and toxicology which have been applied to the investigation of lung cancer, the morphological

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 109 parameter is the most accurate measurable index of environmental exposure risk". This opinion was stated by Kotin (379) prior to becoming employed by an asbestos manufacturing company. Weston et al (380) published cases of inhalational injury to dust exposure. Although there were in 1972 a collection of the lung, including asbestos no diagnostic pathological the medicolegal The problems in problem, discussed. logic changes in the lungs nonoccupational exposure Bignon and Bientz (381).. ramifications which the interpretation resulting from may arise were of histopatho- occupational or to asbestos have been reviewed by [220] Asbestosis or Asbestos Bodies Between 1927 and 1929, Cooke and Hill reported the occur- rence of "curious bodies" in sections of the lung of a patient who died. from exposure to asbestos dust (382-386). They were found in alveoli, bronchioles, fibrous and necrotic areas. The larger bodies measured from 20 to i00 microns or more in length and were of golden brown in color and gave a Prussian blue reaction for iron. They concluded that these bodies contained asbestos particles and originated as tissue reaction, thus the term "asbestosis bodies" to signify that they were pathognomonic of asbestos-induced disease process.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) Ii0 In the 1930s, Gloyne supported the bodies as pathognomonic of asbestos disease. unpublished guinea pig experiments conducted prior Mavrogordato, and listed eleven morphologic asbestosis bodies (387-389). Since no asbestosis concept of asbestosis He cited to 1928 by features of bodies have been found in crude asbestos, Gloyne was certain that they are produced in living tissues from inhaled asbestos fibers. In 1951, Gloyne (390) reported the incidence of primary neoplasm of the lung in a group of 102 cases of asbestosis, 41 males and 61 females. Postmortem examination revealed an incidence of malignancy in 14.l percent, consisting of 19.6 percent for males and 9.7 percent for females. He also noted that in long standing cases of asbestosis, both the fibers and bodies were smaller and less often seen than in lungs of workers more recently exposed to asbestos, suggesting that in course of time, the fibers and bodies are slowly dissolved. It should be noted that the majority of deaths took place in the age group of 45 to 64 years in the prime of life when experience in these skilled occupations counted most. contrasted below with more recent asbestos workers. The first reported detection of the curious American asbestos workers was in 1937 by Lynch. These observations are observations of British bodies among He proposed

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) iii the term "asbestos bodies" instead of asbestosis bodies, and "silica bodies" to refer to those associated with silicosis. He also proposed that other fiber or crystalline dusts not yet particularly studied may produce similar bodies and cautioned that confusion of some consequence may result from failure to realize that asbestos bodies may be simulated by other deposits in the lung. German pathologists (392, 393) agreed with Gloyne which in turn prompted a new terminology described in the next category. Asbestos/Smoking Interaction. From 1927 to 1931, Tylecote published on asbestosis bodies and lung cancer (394, 395). He is also cited (by the Commercial Union Insurance Monograph) as the first pathologist who linked cigarette smoking as a cause of lung cancer. Tylecote's statem@nts were as follows: "I have no statistics with regard to tobacco, but I think that in almost every case I have seen and known of, the patient has been a regular smoker generally of cigarettes. To this there have been the following exceptions: (a] two ladies who succumbed to the disease unusually rapidly. In each case the lady lived 'hard by' a railroad station where trains frequently stopped, and where smoke from the engines must have at almost all times pervaded both house and garden. (b] A group of acute adolescent cases, all males in which I regard the

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 112 condition as being usually mediastinal Hodgkin's disease" (395). The above quotation by Tylecote is regarde~ as documenta- tion for the claim that lung cancer associated with cigarette smoking preceded the recognition of the disease among asbestos workers. Tylecote was probably the first pathologist who could have detected the phenomenon of asbestos/smoking interaction, if it existed at all, and the same can be stated for Auerbach who was also interested in the pulmonary effects of asbestos and cigarette smoke. Simons and Ah (396) are other pathologists who wrote on etiological concepts of lung cancer and although they mentioned mined dust particulates and cigarette smoke in their list of 14 causes, they did not specify any form of interaction. [230] Ferruginous Bodies and Asbestos Fibers Before discussing the changing concepts on the signifi- cance of asbestosis or asbestos bodies, it might be helpful to recall a 1935 publication (397) from two Boston investigators (one a petrographer for the Liberty Mutual Insurance Co.). After the appearance of the results of guinea pig studies of Gardner and Cummings [Category iii] and human histopathologic observations showing the persistence of asbestos fibers in the lung [Category 220], the petrographers conducted a

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 113 photomicrographic analysis of rafter dust from six asbestos processing plants that included molding and weaving of asbestos fibers. They concluded that in the respirable sizes (less than i0 microns in maximal diameter for particles, or less than 5 microns in thickness for fibers as long as 200 microns), asbestos is ~ relatively "unimportant constituent". Instead, the predominating constituents of respirable dusts were talc, serpentine, carbonate and magnetite. These results were not challenged for three decades until additional research studies in human lung revealed the deposition of significant amounts of respirable asbestos fibers in the lungs of asbestos exposed workers. [231] Tissue Analytical Methods There were two significant events that resulted in the improvement in analytical methods for asbestos analysis in human tissues. First, Gross et al in 1967 questioned the of asbestos bodies and suggested that the iron structures be called "ferruginous bodies" since they in response to the composition (398-401). towards detection of results of Knox specificity containing are formed inhalation of filamentous dust of unknown Secondly, research was being directed asbestos fibers which was prompted by the and Beattie (402, 403). They measured the

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 114 mineral content of the lungs from 27 workers in the asbestos- textile industry. Like earlier British investigators, they reported that the mineral material found in the lungs increased in amount as the exposure time lengthened. As the survival time increased, the mineral content of the lung tended to decline. They also questioned the significance of the mineral content which was unrelated to the severity of asbestotic lesions in the lungs. On the other hand, since severity was related to the sum of exposure time and survival time, the results of animal studies were questioned by Knox and Seattle. The above results~reported in 1954 were derived from light microscopic measurements of particle size distributions contained in the incombustible and acid insoluble residues of lung parenchyma. In subsequent years, new in situ particle identification methods were introduced that included electron microscopy, both transmission and electron imaging, and x-ray mapping. included high-temperature ashing, ashing and etching, wet chemical digestion and enzyme scanning, back scattered Tissue removal techniques microincineration, plasma digestion. The selection of analytical techniques extracted from the lung and other tissues amount of tissue sample available. quantitative x-ray spectrometry, for the study of dust is dictated by the Techniques such as x-ray fluorescence

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 115 spectrometry, and plasma spectrometry are of value in determining elemental concentrations. For the positive identification of asbestos, x-ray diffractometry and selected area electron diffractio, are the methods of choice (404-408). The interpretations of results generally disagree with those of Knox and Beattie and there are as many opinions as there are investigators prefering a combination of techniques. [232] Pulmonary Asbestos Content Among Occupationally Exposed Groups. The results of ~ pulmonary tissue analysis are briefly listed below. The entries are arranged according to the geographical location of the autopsied subjects or lobectomized patients who were the sources of analyzed lung samples. The nature of occupational exposure and pulmonary pathological lesions showing the presence of asbestos are also indicated. COUNTRY AND INVESTIGATORS 0CCUPAT[0NAL EXPOSURE PATHOLOGICAL LESIONS United States; see also [232] and []00] (404) Mace et al 1980 asbestos workers asbestos bodies (406) Gaensler & Addington 1969 shipyard pipe coverer lung carcinoma asbestos sheet worker (408) Vallyathan et al 1980 machin£st; isolation asbestos bodies worker

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 116 Australia (409) Milne 1971 shipyard workers France (410) Bignon 1970 (411) Jaurand et al 1976 (412) Thomassin et al 1980 (413) Sebastien et al 1980 asbestos workers (414) Le Bouffant 1974 asbestos workers (415) Le Bouffant et al 1976 (416) Fondimare & Desbordes 1974 asbestos workers (417) Lavoinne et al 1976 asbestos workers (418) Berry et al 1976 miners Germany (419) Friedrichs & Otto 1981 asbestos workers Great Britain (402) Knox & Beattie 1954 (403) Knox & Beattie 1954 (420) Blount et al 1966 (421) Davis 1964 textile workers asbestos workers asbestos workers with lobectomy (422) Ashcroft 1968 asbestos workers (423) Ashcroft & Heppleston 1973 (424) Ashcroft & Heppleston 1973 asbestos bodies lung carcinoma pleural fibers parenchymal fibers pleural mesothelioma asbestos bodies pulmonary fibrosis mesothelioma nickel content ferruginous bodies asbestos fibers mesothelioma as~estosis & cancer mineral content protein content of asbestos bodies asbestos bodies corelation with guinea pig asbestos fibers asbestosis

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 117 (425) Henderson et al 1969 asbestos workers (426) Pooley et al 1970 (427) Pooley 1979 (428) Pooley & Clark 1980 (429) Pooley & Clark 1979 (430) Gaudichet et al 1980 asbestos workers (431) Wagner 1973 (432) Oldham 1973 (433) Timbrel1 1980 asbestos workers (434) Lawther 1971 asbestos workers (435) Acheson & Gardner 1980 asbestos workers (436) Morgan & Holmes 1980 asbestos workers (437) Morgan & Holmes 1982 gas mask workers India (438) Narang 1980 asbestos workers Italy (439) Governs & Vadala asbestos workers 1972 (440) Governs & Rosanda 1972 Netherlands (441) Planteydt 1973 asbestos workers (442) Stumphius & Meyer 1968 shipyard workers Norway (443) Glyseth et al 1979 insulation workers (444) Ophus et al 1980 shipyard workers (445) Gylseth et al 1981 (446) Glyseth & Baunan 1981 South Africa (447) Goldsteln & Rendall 1970 asbestos miners asbestos fibers boiler makers mesothelioma asbestos fibers asbestos fibers asbestosis asbestos bodies asbestos fibers mesothelioma ~esothelioma coated & uncoated fibers asbestos bodies asbestos bodies asbestosis asbestos bodies asbestps bodies mesothelioma asbestos fibers mesothelioma pleural plaques ferruginous bodies

Asbestos/Smoking Interactions {200 Series] (Jan. 22, 1983) i18 (448) Thomas & S1uis-Cremer 1977 Switzerland (449) Bossard et al 1980 asbestos miners asbestos workers asbestos fibers pleura1 plaques asbestos fibers [233] Pulmonary Asbestos Content in American Population Groups The analysis for asbestos of lung tissues obtained from the nonasbestos workers undergoing autopsy has revealed varying levels that are dependent on the technique used. Although the results reported in the 1960s showed detectable asbestos fibers in 41 percent of autopsied cases, subsequent reports approached incidence rate of 100 percent. There is agreement that the presence of asbestos fibers reflects environmental contamination from sources discussed elsewhere [Category 800]. That asbestos fibers from nonoccupational sources can be deposited in the lung raises a serious question as to the source of carcinogenicity developing in asbestos workers. Are the carcinogens entirely derived from the work place or predominant- ly from environmental sources? There are known dimensional differences between asbestos fibers in the work place compared to asbestos contaminants in the atmosphere. Furthermore, asbestos fibers are likely to adsorb outdoor pollutants. If the

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 119 single target theory of carcinogenesis is true, then it is difficult to prove that the sole source of carcinogens is the work place. On the other hand, if the concept of cocarcino- genesis or synergism is true, what about the interaction between asbestos fibers occupationally inhaled and asbestos fibers from enviromental sources? In other words, the interaction concept of asbestos in work place/asbestos in environment can possibly replace the asbestos/smoking hypothesis. The studies on asbestos content of lung samples derived from autopsies of nonasbestos workers are as follows: STATE AND PULMONARY PULMONARY INVESTIGATORS INCIDENCE LESIONS Pennsylvania (450) Cauna et al 1965 (451) Gross et al 1969 (452) Davis & Gross 1973 asbestos bodies 41% New Yorkr New Jersey and Minnesota (453) Suzuki & Chung 1969 (454) Langer et al 1970 (455) Selikoff & Hammond asbestos bodies 100% 1970 (456) Langer et al 1973 (457) Langer & Pooley 1973 (458) Langer et al 1974 (459) Auerbach et al 1977 (460) Selikoff & Lee 1978 (461) Ehrenreich & Selikoff 1981 Illinois and California (462) Churg & Warnock 1977 asbestos bodies 96% (463) Churg & Warnock 1977 (464) Churg et al 1977 carcinoma mesothelioma

Asbestos/Smoking Interactions [200 Series].(Jan. 22, 1983) 120 (465) Churg & Warnock 1978 (466) Churg & Warnock 1979 (467) CHurg & Warnock 1979 (468) Churg & warnock 1979 (469) Churg & Warnock 1979 (470) Warnock & Churg 1980 (471) Churg & Warnock 1980 (472) Churg & Warnock 1981 (473) Churg 1982 Florida (474) Thomson et al 1966 asbestos bodies 20-30% Michigan (475) Dicke & Naylor 1969 asbestos bodies 22% California (476) Tabershaw 1968 (479) Felton 1980 asbestos bodies 25-50% Maryland (477) Bhagavan & Koss 1976 asbestos bodies 91% Tennessee (478) Breedin & Buss 1976 asbestos bodies 90% carcinoma The above list includes nine publications by Selikoff in collaboration with investigators at the Mr. Sinai Hospital and other institutions. Their concept on the formation of asbestos bodies (460) is..different from those of other groups (479, 480). They agree with other groups that asbestos fibers can be derived from environmental sources. In their discussion of forensic significance of asbestos fibers (461) the asbestos/smoking synergism is emphasized without commenting on possible interaction between workplace and environmentally derived

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 121 asbestos fibers. The substitute concept synergism has not been considered publications. of asbestos/asbestos in any of the above [234] Pulmonary Asbestos Content In Foreign Population Groups. The foreign studies show essentially the same results as the American ones: asbestos fibers and asbestos or ferruginous bodies are present in significant quantities in the lungs of the general population. The lung samples were obtained from consecutive series of hospital autopsies. The reports from thirteen countries are as follows: COUNTRY AND PULMONARY PULMONARY INVESTIGATORS INCIDENCE LESIONS Australia (481) Xfpell & Bhathal 1969 (482) McCullagh 1978 Canada (483) Dionne et al 1976 (484) Anjilve~ & Thurlbeck 1966 (485) Shugar 1979 Denmark (486) Francis et al 1977 France (487) Sebastien et al 1977 asbestos bodies 43.5% asbestos bodies asbestos bodies 48% asbestos bodies 7% asbestos bodies 100% leiomyosarcoma pleural plaques pulmonary fibrosis

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 122 Finland (488) Meurman et al 1970 Germany (489) Friedrichs & Otto 1981 Great Britain (490) Lewinsohn 1968 (491) Roberts 1967 (492) Um 1971 (493) Oldham 1973 (494) Doniach et al 1975 (495) McDonald 1980 (496) Stovin & Patridge 1982 Israel (497) Polliack 1968 (498) Peacock 1968 (499) Peacock et al 1969 (500) Peacock et al 1969 (501) Ghezzi et al 1967 (502) Bianchi et al 1981 (503) Betta 1982 South Africa (504) Thomson et al 1963 Sweden (505) H~gerstrand Seifert 1973 Switzerland (506) Stolkin et al 1981 asbestos bodies 64% carcinoma asbestos fibers all asbestos bodies asbestos bodies 23% asbestos bodies 20% pleural plaques asbestos bodies: men 42% women 30% asbestos fibers all asbestos bodies 26% asbestos bodies 2% carcinoma asbestos bodies 51% asbestos bodies 94% pleural plaques asbestos bodies: men 58% women 36% asbestos bodies 26% asbestos bodies 47% pleural plaques

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 123 Yugoslavia (507) Plamenac et al 1971 asbestos bodies 38% (508) Dimov et al 1975 asbestos bodies 19% Asbestos/Smoking Interaction. Although publications did not report smoking habits subjects [Category 333], the foreign studies include such description. The investigation in France autopsied cases who were not asbestos workers; one the American o£ necropsied three with included six of the two smokers had higher and the other had lower values for pulmonary asbestos content, compared to the three nonsmokers (487). One Italian study (499) did not include a statistical analysis of correlation between reported smoking habit and asbestos bodies because asbestos bodies were rarely detected, a conclusion that is contrary to others conducted in the same country. A Finnish study (488) .compared smoking habit and asbestos exposure of lung cancer and control groups. Most of the cases with lung cancer (35 out of 50) belonged to the group o£ combined tobacco smoking and asbestos exposure, whereas only 20 of the 50 control cases belonged to this group. A statistical calculation of the effect of adding the asbestos body factor to the smoking factor has been made with the collected data. The authors concluded that "it appeared that the combination does not raise the incidence

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 124 of support the asbestos/smoking explained a lack of additive tobacco factor is obviously lung cancer significantly". This conclusion does not hypothesis. However the authors effect by the following: "The so strong that the asbestos body factor does not exert any further effect" (488). [235] Extrapulmonary Tissue Asbestos Content Analyses of tissues (509) show that ferruginous bodies asbestos fibers are present larynx (510), gastrointestinal (511-515;, and kidneys (516). and in several organs including the tract and mesothelial tumors The asbestos fibers could be found not only in asbestos workers but also in the general population. There are no observations relating to the asbestos/smoking interaction concept. [240] Antemortem Pulmonary Cytologic Observation In contrast to the preceding sections that relate to postmortem investigations, this section is devoted to the application of the same techniques on samples collected prior to death. Historically, it should be recalled that in the 1930s, asbestosis bodies were reported in sputum of workers by the same investigators who first recognized the disease of asbestos workers in the United States (517), England (518, 519) and South

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 125 Africa (520). In the past fifty years, the techniques for cytologic examination have improved and have been applied not only to sputum but extended also to include bronchial lavage and pulmonary biopsy. [241] Sputum Cytology The Tyler Asbestos Workers Program, designed to cohort of 890 former between 1954 and 1972, relating to sputum provide a asbestos workers that was in operation is the only American source of data cytopathology. When the Program was initiated in July 1974, approximately 90 percent were cigarette smokers which is population. From 1976 to 1982, ten contain statements supporting the of the cohort far in excess of the general publications appeared that asbestos/smoking synergism (521-530). A close examination of the articles by Greenberg et al reveals the following inconsistencies: First, there was no significant association between the occurrence of ferruginous bodies in the sputum and smoking history. If the interaction hypothesis that smoking inhibits bronchociliary clearance is true [Category 199], then there would be a direct correlation between smoking history and ferruginous bodies in the sputum, since the occurrence of ferruginous bodies was found "to increase as a logarithmic function of the length of occupational

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 126 exposure to asbestos in workdays" (524). Second, a lack of association between smoking and ferruginous bodies in the sputum was reversed two years later (526) without any explanation. Third, in another subsequent publication (528), the confusion is compounded by the following statement: "As with specimen quality, smoking was found to influence the detection of ferruginous bodies in the two specimen types. The aerosol- induced specimens from smokers showed a slightly, but not statistically significant, increased yield of ferruginous bodies (34% as compared to 30~, p=0.15). For nonsmokers however, the increased detection of ferruginous bcdies in the aerosol induced specimen was found to be significant (29% for aerosol induced as compared to 18% for spontaneous, p=0.05) .... The smokers in the cohort more frequently produced satisfactory sputum specimens without the aid of the aerosol induction than did the nonsmokers". It is the opinion of this compiler that the above inconsistent remarks as well as other publications on sputum cytology of smokers versus nonsmokers do not support the interaction hypothesis relating to mucociliary clearance. The conclusions of Greenberg et al relating to asbestos exposure and sputum cytology have not been confirmed by foreign scientists listed below:

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 127 COUNTRY AND INVESTIGATORS OCCUPATIONAL EXPOSURE SPUTUM CYTOPATHOLOGY United States (521) Greenberg et al 1976 asbestos processing (522) Zeluff et al 1976 (523) Greenberg et al 1976 (524) Farley et al 1977 (525) McLarty et al 1980 (526) Mclarty et al 1980 (527) Roggli et al 1980 (528) McLarty et al 1980 (529) McLarty et al 1981 (530) Greenberg et al 1982 squamous meta- plasia, squamous carcinoma, ferruginous bodies Egypt (531) Ottia et al 1975 asbestos cement pipe workers cytopathology supported by radiology Finland (532) Huuskonen et al 1978 asbestos processing squamous metaplasia carcinoma Netherland (533) Planteydt et al 1964 shipyard workers asbestos bodies Yugoslavia (534) Plamenac et al 1978 asbestos mining leukocytes, hemosideric macrophages, squamous meta- plasia, no ferruginous bodies Huuskonen et al (532) found ferruginous bodies in sputum colllected from 43 percent of the patients. In addition, they commented on cytopathology: "It is surprising that the smoking

Asbestos/Smoking Interactions [200 Series] (Ja.. 22, 1983) 128 habits in this material appeared to have no effect on the prevalence of benign cellular atypia, possibly either because of the small size of the material or the fact that the heavy effect of asbestos exposure overshadowed the influence of smoking". A similar conclusion was arrived at by the Yugoslavian scientists (534). It is interresting to note that these European studies have not been cited in publications summarizing the results of the Tyler Asbestos Workers Program. [242] Bronchoalveolar Cytology Some investigators have relied on bronchial lavage fluid rather than sputum analysis for detection of ferruginous bodies. Bignon et al (535-537) found that results of bronchoalveolar cytology correlate with asbestos exposure bett~r than sputum examination, a conclusion confirmed by investigators from Canada (538), Great Britain (539) and the United States (540, 541). The review article on bronchoalveolar lavage by Gee and Flick (541) su~narizes a reasonable correlation between the cellular features of bronchoalveolar lavage and those from lung biopsies in patient with asbestos-induced fibrosis. [243] Pulmonary Biopsy Lung biopsy is used to diagnose asbestosis, either by open

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 129 surgery (542) or by needle has also been used to inhalation of asbestos. cellular asbestos particles events based particles are puncture (543-545). The technique investigate cellular reactions to Morgenroth (546) reconstructed the on electron microscopy. The smaller phagocytized by cytoplasm. Larger are found either uncoated or coated in the alveoli and in the connective tissue sepia. gather around the asbestos material is cellular membrane changes are different from those of cigarette smoke other investigators. Groups of alveolar macrophages particles and engulf them. In addition, the dissolved in lacunae appearing in the of macrophages. These ultramicroscopic reported by [250] Particulate Deposition in Excised Human Lungs Since there are discrepancies in results of deposition particulates, in animal mathematical models have constructed an artificial of and patient studies, physical and been proposed (547-550). Mitchell chest wall which was large enough to hold an entire excised human lung. He observed extremely good agreement in deposition of aerosol particles with theoretical models (547). So far, the excised human lung or any of the theoretical models have not been applied to the study of

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 130 interaction phenomenon. 260] 1914 years later. Presently, tests of in vitro hemolysis are used compare cytotoxicity of different forms of asbestos. In Vitro Hemolysis Although the hemolytic effect of asbestos was known since (551), its significance was not elucidated until fifty to In conjunction with tests of animal those performed on human cells theories for cytotoxicity. The erythrocytes [Category 181], have been used to support the hemolytic mechanisms derived from in vitro testing of human erythrocytes are as follows: COUNTRY AND INVESTIGATORS MECHANISMS OF HEMOLYSIS United States (552) Light & Wei 1977 (553) Light & Wei 1977 (554) Light & Wei 1980 (555) Schnitzer & Busescu 1970 Bel@ium (556) Depasse 1982. Egypt (557) Ei-Shobaki et al 1973 France (558) Jaurand & Bignon 1979 (559) Jaurand et al 1979 (560) Jaurand et al 1980 (561) Jaurand et al 1980 Great Britain (562) Sykes et al 1980 surface charge surface charge and polymer structure sialic acid in membrane lipid resynthesis of hemoglobin increased membrane permeability influenced by extracellular osmolarity

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 131 Romania (563) Gabor & Anca 1975 (564) Gabor et al 1975 South Africa (565) Harington et al 1971 (566) Harington et al 1971 lipid peroxidation of fatty acids surface charge hemolysis enhanced by serum EDTA interaction [270] Human Tissue Cultures Compared to animal organ culture studies those involving human cells are less in number. generally similar in that asbestos particles [Category 184 ], The results are are cytotoxic, cause macrophageal phagocytosis and fibroblastic proliferation. The importance of trace metals has been examined by leaching and the results indicate cytotoxic response. reported by American, follows: that trace metals ~re not involved in the The human tissue culture experiments Canadian and European scientists are as INVESTIGATORS CELL OR ASBESTOS ORGANS CYTOTOXICITY (567) Mace et al 1980 (568) McLemore et al 1980 (569) McLemore et al 1981 (570) Bitterman et al 1981 (571) Hart et al 1979 (572) Hart et al 1980 (573) Daniel et al 1980 (574) Hart et al 1980 (575) Tejwani et al 1980 alveolar macrophages pulmonary fibroblasts foreskin fibroblasts phagocytosis asbestos fibers less harmful than naked fibers replication factor ultramicroscopic cytotoxicity benzopyrene inter- action

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 132 (576) Lemaire et al 1982 (577) Harris et al 1979 (578) Hirsch et al 1982 (579) Rajan& Evans 1973 (580) Reiss et al 1980 pulmonary fibroblasts bronchus pleural cells embryonic lung embryonic intestine inhibition and proliferation DNA synthesis benzanthracene interaction proliferation proliferation cytotoxicity leaching no influence Asbestos/Polycyclic Aromatic Amines Interaction. Hart et al (671-575) tested in the human foreskin fibroblast culture the following amines: benzopyrene, dimethylbenzanthrane, nitrosodimethylamine and pyrene. By measuring the concentration ratio of cyclic GMP to cyclic AMP, they concluded that each polycyclic aromatic amine acts as a cocarcinogen to asbestos. The conclusion is based on separate treatment of the cell cul- ture with one substance, rather that the use of a combination. They offer their results in support of the synergism hypothesis between asbestos and cigarette smoking. Harris et al (577) compared asbestos alone and asbestos with a coating of dimethylbenzanthracene. The cultured human bronchial cells were penetrated by both coated and uncoated fibers. There was also hyperplastic epithelial response with cellular atypia but

Asbestos/Smoking Interactions [200 Series| (Jan. 22, 1983) 133 their publications did not contain any statement that the coated fibers caused more intense changes than uncoated asbestos. [280] Immunolo@ic Reactions to Asbestos Contrary to the opinion of asbestos monographers and bibliographers, the first investigation on the effect of asbestos on immunologic events was conducted in 1913 by Coplans (581). The adsorptive properties of asbestos was demonstrated by incubating the substance in blood serum and of antityphoid agglUtinins advances in immunology and seventy years has led to and hemolytic immunopathology the proposal that detected a loss complement. The during the past asbestos is and concurrent carcinogenicity are autoimmune diseases. The recent reviews on the immunologic responses as they relate to pulmonary fibrosis (582) and to bronchogenic carcinoma (583) generally highlight the authors' experimental results. Burrell (584) has recently written a commentary on the subject cautioning the enthusiasts. The subcategories on immumologic techniques include in vitro adsorption of plasma constituents, skin testing, lymphocytic reactions, and immunoglobulins. [281] In Vitro Adsorption of Plasma and Serum Proteins The list of constituents in the human plasma and serum that is adsorbed by asbestos particles includes the following:

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 134 immunoglobulins and globulins (585, 586); coagulation factors xII and VII (587, 588); and complement factors (589, 590). In an in vitro system, the serum reacts with the asbestos particles leading to dissolution of silica (591, 592). It is the opinion of the Indian scientists (591, 592) that the process of dissolution is the basic mechanism for pulmonary fibrosis. [282] Delayed Hypersensitivity Skin Tests In four published studies, most if following skin tests were used: recall streptokinase-streptodormase, tuberculin derivative and Candida albicans extract; and new sensitization testing to dinitrochlorobenzene (583, 593-595). The results show a depression in dermal hypersensitivity and acute dermal responses in patients with pulmonary asbestosis. The depression of dermal hypersensitivity is in agreement with the results of cell-mediated immunity described in the next subcategory. not all of the test antigens with purified protein [283] Cell-Mediated Immunologic Tests In patients with pulmonary asbestosis, the results of vitro testing show depression of cell-mediated immunity. evidence is based not only on lymphocytic profile but also lymphocytic in The on response to phytohemagglutinin. It should be noted

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 135 that results of in vitro tests conform with those of in vivo skin testing. The investigators in the United States, Great Britain, Poland and South Africa are as follows: COUNTRY AND INVESTIGATORS CELL-MEDIATED ASBESTOS EFFECTS TEST IN PATIENTS United States (596) Barbers et al 1981 (594) Gaumer et al 1981 phytohemagglutinin in vitro depression skin hypersensitivity depression in asbesstosis Great Britain (582) Turner-Warwick 1973 lymphocyte responses depression in (595) Pierce & skin hypersensitivity asbestosis Turner-Warwick 1980 phytohemagglutinin (597) Haslam et al 1978 (597) Campbell et al '80 (598) Kagamimori et al 1980 (600) Wagner et al 1979 (601) Wagner 1980 phytohemagglutinin lymphocytes depression in asbestosis Poland (593) Lange et al 1978 skin hypersensitivity depression in lymphocyte profile asbestosis South Africa (583) Kagan et al 1978 skin hypersensitivity depression in phytohemagglutinin asbestosis Asbestos/Smokin@ Interaction. Wagner et al (600, 601) investigated the formation of lymphocyte E binding rosettes in

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 136 British dockyard workers exposed to asbestos dust. They concluded that there was increased in vitro rosette formation in subjects with radiological evidence of fibrosis who also smoked. They also reported changes in leukocyte and lymphocyte counts that disagree with the observations exposed to asbestos. The inconsistencies with reported of cigarette smokers not publication has several information characterizing smokers. Although Wagner's publication appeared in 1979, there has been no confirmation from other investigators. The significance of rosette formation by lymphocytes has been of interest to some American immunologists but so far, they have not applied the technique to asbestos/smoking interaction. [284] Humoral Immune Tests - Most studies relating to measurements of immunoglobulins and antiSodies show an increase in workers exposed to asbestos compared to controls. There is therefore a paradox in the immunologic responses - an increase in humoral immune indicators but a decrease in cell-mediated immunity [Category 283]. The explanation proposed accepted by others. mechanisms, including in 1978 by Kagan et al (583) has not been The studies showing increased humoral the only negative result from Tyler Asbestos Workers Project (602) are as follows:

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 137 COUNTRY AND INVESTIGATORS HUMORAL IMMUNE TESTS WORKERS OR PATIENTS United States (602) Nash et al 1981 Egypt (603) Ei-Sewefy et al 1971 (604) E1-Sewefy et al 1974 Finland (605) Huuskonen et al 1978 (606) Huuskonen et al 1979 Great Britain (582) Turner-Warwick 1973 (607) Turner-Warwick 1979 (608) Gregor et al 1979 . (609) Stansfield & Edge 1974 Poland (610) Lange et al 1974 (611) Matej et al 1977 (593) Lange et al 1978 (612) Matej et al 1978 (613) Lange 1980 (614) Lange 1980 South Africa (615) Kagan et al 1977 (583) Kagan et al ~978 immunoglobulins serum proteins bone marrow cells autoantibodies immunoglobulins HLA antigens autoantibodies HLA antigens antinuclear antibodies antinuclear anti- bodies IgA, IgG, IgM HLA antigens salivary IgA; se- rum IgA, IgM, IgE no effect reduced in cement asbestos pipe workers increased in asbestos ~orkers increased in asbestos workers no change present in ship- yard asbestos workers present in asbestosis higher levels of Ig's increased in asbestosis

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 138 [285] Miscellaneous Tests Including Lymphocytic Hydroxylase Activity. There are immunologic observations other than cell- mediated or humoral testing. They include the following: leukopenia among asbestos miners (616); higher lymphocytic adenosine deaminase activity among workers exposed to asbestos (617); induction of aryl hydrocarbon hydroxylase activity in alveolar macrophages and blood lymphocytes in asbestos workers (618); no effect (619) or increased (620) in chromosome alterations in human lymphocytes; and increased in metabolism of polymorphonuclear leukocytes (621). Asbestos/Benzopyrene Interaction. There are two studies that show conflicting results. Both were designed to obtain proof for the synergism between asbestos and cigarette smoking by examining aryl hydrocarbon hydroxylase activity of pulmonary macrophages and blood lymphocytes obtained from asbestos exposed workers. The first group of study was conducted by a Scandinavian group and showed negative effects: no difference in enzyme induction between smoking and nonsmoking asbestos workers (622, 623). Subsequently, a Texas group investigators supported by the Council for Tobacco Research, oblivious to the 1980 Swedish publications, found positive proof for the synergism hypothesis (618). This compiler had always

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 139 regarded the Swedish work as definitive in negative results were derived from human therefore negate the positive results of nature since the cells and would animal studies (Category 160]. The situation has been changed by the positive results reported by the Texas group. Incidentally, the Texan group is not the Tyler Asbestos Workers Project! (290]Asbestos/Cigarette Smoking Interactions Derived from Human Postmortem and Antemortem Studies. The above review of the literature on human pathology in vitro synergism namely: and tests highlights three techniques that support the concept between asbestos and cigarette [Category 270] foreskin fibroblast culture; 283] rosette formation by lymphocytes; and [Category hydrocarbon hydroxylase of lymphocytes. However studies are needed to resolve the question of conflicting results to epidemiologic studies. On the other hand, two techniques do not asbestos/smoking interaction concept: [Category cytology; and [Category 235] bodies and fibers. There is histopathologic observations hypothesis, smoking, [Category 285] aryl additional applicability of support the 241] sputum pulmonary content of asbestos a striking absence of human applied to the interaction yet the technique has been used to demonstrate the

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 140 separate effects of asbestos particles and cigarette the human lungs. In a 1982 review of the literature, Craighead summarized the biologic mechanisms "synergistic carcinogenic effects of smoke in the respiratory tract" smoking on and Mossman that would account for the asbestos and cigarette Their explanations were derived from the results of their own animal studies 184, 190 and 192]. relating to human overlooked. [Categories The observations by other investigators pathology and cytology were completely

Asbestos/Smoking Interactions [200 Series] (3an. 22, 1983) 141 BIBLIOGRAPHY AND CUMULATIVE AUTHOR INDEX Among the 252 articles for Categories 200s, a duplicate copy of 107 or 42 percent was received from (X). The cumulative total for Categories 100s and 200s is 277 out of 624 articles or 44 percent. The geographical distribution of the authors contained in the Bibliographies are as follows: United States Cateqories 200s Cumulative UAR Arizona UCA California ii 16 UCT Connecticut 1 2 UDC District of Columbia 2 5 UDE Delaware 2 UIL Illinois 8 10 UIO Iowa 3 ULA Louisiana 3 4 UMA Massachusetts 2 5 UMD Maryland 4 19 UME Maine 1 UMI Michigan 2 7 UMN Minnesota 3 14 UMO Missouri 1 2 UNC North Carolina 1 I0 UNE Nebraska .. 2 UNH New Hampshire 1 UNJ New Jersey 4 i0 UNY New York 17 36 UOH Ohio 9 17 UPA Pennsylvania 6 i0 USC South Carolina 2 8 UTE Tennessee 1 2 UTX Texas 17 19 UUT Utah 1 3

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983} 142 UVT Vermont 2 9 UWA Washington 6 UWI Wisconsin 1 UWV West Virginia 1 3 Total Articles 99 228 Percent of Total 39% 36% Foreign Categories 200s Cumulative ATL Australia 4 5 BEL Belgium 1 2 CAN Canada 8 19 DEN Denmark i 1 EGY Egypt 4 4 FIN Finland 4 5 FRA France 19 38 GBR Great Britain 62 182 GER Germany 4 22 IND India 3 26 ISR Israel 1 1 ITA Italy i0 18 JAP Japan 5 NET Netherlands 3 4 NOR Norway 4 4 POL POland 6 8 ROM Romania 2 2 RUS Russia 8 SAF South Africa 9 33 SWE Sweden 3 3 SWI Switzerland 2 2 TAI Taiwan YUG Yugoslavia - 3 3 Total Articles 153 396 Percent of Total 61% 64% [Note: Bibliography for categories 200s start on next page]

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 143 0373 Selikoff IJ, Lee DHK (1978) Academic Press, New York 3-33 Asbestos and Disease. Chapter I. Historical Background. 0374 Bordow RA (1982) Commercial Union Insurance Companies, Boston 15-18 Smoking and lung cancer. In: Asbestos, smoking and disease, the scientific evidence. 0375 Lanza AJ, Editor (1938) Oxford Univeristy Press, New York Silicosis and asbestosis. 0376 Gloyne SR (1938) Oxford University Press,. New York 198-256 Pathology. In: Silicosis and asbestosis. 0377 Gardner LU (1938) Oxford University Press, New York 257-345 Experimental pathology. In: Silicosis and asbestosis. 0378 Auerbach 0 (1937) Ind Med 6:38-48 Pathology of the pneumoconioses: silicosis; silicosis and tuber- culosis; asbestosis; siderosis; anthracosis. 0379 Kotin P (1965) Arch Pathol 79:331-334 The present statusof pathology in environmental health. (X) 0380 Weston JT, Liebow AA, Dixon MG, Rich TH (1972) J Forensic Sci 17:199-279 Untoward effects of exogenous inhalants on the lung. (X) 0381 Bignon J, Bientz M (1977) Vie Med 58 : 1927-1931 Asbestos and pathological manifestations in the respiratory system and other organs.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 144 0382 Cooke WE, Hill CF (1927) J R Microsc Soc 47:232 pneumokoniosis due to asbestos dust. 0383 Cooke WE (1929) Br Med J 2:578 Asbestos dust and the curious bodies found in pulmonary asbestosis. 0384 Cooke WE (1927) Br MedJ 2:1024 Pulmonary asbestosis. 0385 Cooke WE, Hill CF (1930) J Microsc Soc 50:15-19. II. - Further observations on pulmonary asbestosis, with special reference to asbestos dust and the curious bodies found in the lungs. 0386 Cooke WE (1931) J State Med 39:544-548 Asbestos dust and asbestosis bodies from the lungs of an asbestos worker. 0387 Gloyne SR (1931) Tubercle 12 : 399-401 The formation of the asbestosis body in the lung. 0388 Gloyne SR (1931) Tubercle 12 : 158-161 The presence of asbestosis bodies in the faeces in a case of pulmonary asbestosis. 0389 Gloyne SR (1932) Lancet 1:1351-1355 The asbestosis body.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 145 0390 Gloyne SR (1951) Lancet 1:810-814 Pneumoconiosis. A histological survey of necropsy material in 1205 cases. 0391 Lynch KM (1937) JAMA 109:1974-1978 Pulmonary asbestosis. in the lung. IV. The asbestos body and similar objects 0392 Kuhn J (1941) Arch Gewerbepathol Gewerbehyg 10:473-485 Hypermicroscopic studies on asbestos dust on lungs in asbestosis. (German) 0393 Ruska H (1942) Arch Gewerbepathol Gewerbehyg 11:575-578 Hypermicroscopic studies on asbestos dust and on lungs in asbestosis. (German) 0394 Tylecote FE, Dunn SJ (1931) Lancet 221:632-633 Case of asbestos-like bodies in the lungs of a coal-miner who had never worked in asbestos. 0395 Tylecote FE (1927) Lancet 2:256-257 Cancer of the lung. 0396 Simons EJ (1935) Lancet 55:637-640 Primary carcinoma of the lung: etiological concepts. 0397 Hurlbut CS Jr, Williams CR (1935) J Ind Hyg 17:289-293 The mineralogy of asbestos dust.

Asbestos/Smoking Interactions [ZOO Series] (Jan. 22, 1983) 146 0398 Gross P, Cralley LJ, De Treville RTP (1967) Am Ind Hyg Assoc J 28:541-542 "Asbestos" bodies: their nonspecificity. 0399 De Treville RT, Gross P, Davis JMG (1968) JAMA 203:1142-1143 Asbestos bodies and their bioeffects. 0400 Gross P, de Treville RTP, Haller M (1970) Oxford University Press, Capte Town 89-91 Pulmonary ferruginous bodies; studies on their origin. Pneumoconiosis (Proc Int Conf Johannesburg 1969). (X) In: 0401 Gross, P, Davis JMG, Harley RA Jr, Cralley LJ et al (1972) J Occup Med 14:757-759 Asbestos: identification of fibrous particles in lungs. 0402 Knox JF, Beattie J (1954) AMA Arch Ind Hyg 10:23-29 Mineral content of the lungs after exposure to asbestgs dust. 0403 Knox JF, Beattie J (1954) AMA Arch Ind Hyg 10:30-36 Distribution of mineral particles and fibers in the lung after exposure to asbestos dust. 0404 Mace ML Jr, McLemore TL, Roggli V, Brinkley BR et al (1980) Cancer Lett 9:95-104 Scanning electron microscopic examination of human asbestos bodies. (X) 0405 Schepers GWH, Wagner JC, Webster I, Peacock PR et al (1965) Ann NY Acad Sci 132:121-127 Discussion. Section II. Lung tissue and mineral matter: Problems in modern technology. In: Bioeffects of asbestos. (X) 0406 Gaensler EA, Addington WW (1969) N Eng J Med 280:488-492 Asbestos or ferruginous bodies.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 202 In 1967, Kleinfeld et al (660) reported the mortality pattern for 152 asbestos workers in New York State, who had 15 or more years of asbestos exposure by 1945 or had achieved 15 years o~ exposure to asbestos dust between 1945 and 1965. The observed mortality rates compared to those reported by Selikoff et al were as follows: CAUSE OF NEW YORK STATE NEW YORK-NEW JERSEY DEATH NUMBER % NUMBER All deaths 46 All malignancies Lung & pleura1 malignancies Gastrointestinal & peritoneum All other malignancies Cardiac deaths (other than cot pulmonale) Asbestosis & complications Residual causes 100.0% 255 100% 50.0% 37% 26.1% 18% 15.2% 11% 8.7% ... 28.3% ... 4.3% 4% 13.1% ... In the above mentioned pulication of Kleinfeld et al (660) as well as in subsequent publications (661, 662) appearing respectively in 1968 and 1973, the authors did not mention the asbestos/smoking interaction. Other articles by Kleinfeld relating to asbestos mining are discussed below [Category 339]. [333] Plumbers and Pipefitters Reported by NIOSH Epidemiologists In 1976, the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industries

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 203 requested NIOS~ to conduct a mortality study of its members. The Union made its computerized death benefit record of 30468 death benefits claimed from 1968 to 1975 available to the NIOSH epidemiologist (663). This represented I0 percent of 330000 members of the union and is 17.8 times larger than the union membership used by Selikoff et al. ratios (PMRs) for male plumbers and for plumbers only, were as follows: CAUSE OF PMRs DEATH PLUMBERS & PIPEFITTERS The proportional mortality pipefitters combined, and PMRs PLUMBERS All causes 1.00 All malignancies 1.13 Digestive organs & peritoneum 1.07 Esophageal cancer 1.55 Lung, bronchus & trachea cancer 1.22 1.00 1.27 1.25 2.75 1.29 While significant excesses were found for the study group as a .whole, these excesses appear to be confined to those union mem- bers who were plumbers by trade. Since plumbers, pipefitters and insulators are likely to work together, a question whether common chemical hazards exist needs to be raised. It is also possible that asbestos used by insulators influence plumbers, and vice versa for soldering fumes. [334] Boilermakers Reported by University of Washington Epidemiologists

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 147 0407 Grieger GR (1976) Environ Health Perspect 18:222-223 The use of soluene and KOH as tissue digestants for the determination of asbestos in tissue. (Letter) 0408 Vallyathan NV, Green FH¥, Craighead JE (1980) Pathol Annu 15:78-104 Techniques for in situ particle identification. advances in the study of mineral pneumoconiosis. In: Recent (X) 0409 Milne JEH (1971) Trans Soc Occup Med 21:118-121 Developmental changes in asbestos bodies and their significance. 0410 Bignon J (1970) J Franc Med Chir Thorac 24:71-86 Method of isolation and. concentration of "ferruginous bodies" in the human lung. Their incidence and significance. 0411 Jaurand MC, Goni J, Janrot P, Sebastien P, Bignon J (1976) Rev Fr Mal Resp Suppl 2 4:111-120 Solubility of chrysotile in vitro and in human lungs. (French) 0412 ~homassin JH, Touray JC, Baillif P, Jaurand MC et al (1980) IARC Sci Publ No 30 105-112 Surface interaction between chrysotile and solutions (Dissolution and adsorption): Systematic x-ray photoelectron spectroscopy study. In: Biological effects of mineral fibers. (X) 0413 Sebastien P, Janson X, Gaudichet A, Hirsch A, Bignon J (1980) IARC Sci Publ No 50 237-246 Asbestos retention in human respiratory tissues: comparative measurements in lung parenchyma and in parietal pleura. In: Biological effects of mineral fibers. (X) 0414 Le Bouffant L (1974) Environ Health Perspect 9:149-153 Investigation and analysis of asbestos fibers and accompanying minerals in biological materials.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 148 0415 Le Bouffant L, Bruyere S, Martin JC, Tichoux G, Normand C (1976) Rev Fr Mal Resp Suppl 2 4:121-141 Some observations on asbestos fibres and various mineral constituants in asbestosic lungs. In: The pathologie of asbestosis. 0416 Fondimare A, Desbordes J (1974) Environ Health Perspect 9:147-148 Asbestos bodies and fibers in lung tissues. 0417 Lavoinne A, Maitrot B, Gray H, Tayot J (1976) Rev FE Mal Resp Suppl 2 4:141-144 Quantitative analysis of nickel by atomic absorption without flames in the human parenchyma. In: The pathology of asbestosis. (X) 0418 Berry JP, Henoc Ing, P,.Galle P, Pariente R (1976) Am J Pathol 83:427-456 Pulmonary mineral dust. A study of ninety patients by electron microscopy, electron microanalysis, and electron micro- diffraction. 0419 Freidrichs KH, Otto H (1981) Am Ind Hyg Assoc J 42:150-156 Fibers in human lung dust samples: scope study. a scanning electron micro- 0420 Blount M, Holt PP, Leach AA (1966) Biochem J 101:204-207 The protein coating of asbestos bodies. 0421 Davis JMG (1964) Br J Exp Path 45:642-646 The ultrastructure of asbestos bodies from human lung. 0422 Ashcroft T (1968) Br Med J 2:696-697 Asbestos bodies.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 149 0423 Ashcroft T, Heppleston AG (1973) J Clin Path 26:224-234 The optical and electron m/croscopic determination of pulmonary asbestos fibre concentration and its relation to the human pathological reaction. 0424 Ashcroft T, Heppleston AG (1973) IARC Sci Publ No. 8 236-237 Asbestos fibre concentration in relation to pulmonary reaction. In: Biological effects of asbestos. (X) 0425 Henderson WJ, Harse J, Griffiths K (1969) Europ J Cancer 5:621-624 A replication technique for the identification of asbestos fibres in mesotheliomas. 0426 Pooley FD, Oldham PD, Um. CH, Wagner JC (1970) Oxford University Press, Cape Town 108-116 The detection of asbestos in tissues. In: Pneumoconiosis (Int Conf Johannesburg 1969) (X) 0427 Pooley FD (1979) IARC Sci Publ No. 8 50-53 - Methods for assessing asbestos fibres and asbestos bodies in tissue by electron microscopy. In: Biological effects of asbes- tos. (X) 0428 Pooley FD, Clark N (1979) Ann NY Acad Sci 300~711-716 Fiber dimensions and aspect ratio of crocidolite, chrysotile, and amosite particles detected in lung tissue specimens. In: Health hazards of asbestos exposure. (X) 0429 Pooley FD, Clark NJ (1980) IARC Sci Pub1 No. 30 1:79-86 A comparison of fibre dimensions in chrysotile, crocidolite and amosite particles from samples of airborne dust and from post- mortem lung tissue specimens. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 150 0430 Gaudichet A, Sebastien P, Clark NJ, Pooley FD (1980) IARC Sci Publ No. 30 1:61-68 Identification and quantification of asbestos fibres in human tissues. In: Biological effects of mineral fibres. (X) 0431 Wagner JC (1973) IARC Sci Publ No. 8 11-12 Progress in pathology/experimental ~athology. effects of asbestos. (X) In: Biological 0432 Oldham PD (1973) IARC Sci Publ No. 8 45-49 A trial of techniques for counting asbestos bodies in tissue. In: Biological effects of asbestos~ (X) 0433 Timbrell V (1980) IARC Sci Publ No. 30 113-126 Measurement of fibres in human lung tissue. fects of mineral fibres. (X) In: Biological el- 0434 Lawther PJ (1971) Proc R Soc Med 64:833-834 Asbestos: Some nonradiological aspects. 0435 Acheson ED, Gardner MJ (1980) Lancet 1:706 Possible synergism between chrysotile and amphibcle asbestos. (X) 0436 Morgan A, Holmes A..(1980) Br J Ind Med 37:25-32 Concentrations and dimensions of coated and uncoated asbestos fibres in the human lung. (X) 0437 Morgan A, Holmes A (1982) Br J Ind Med 39:62-69 Concentrations and characteristics of amphibole fibres in the lungs of workers exposed to crocidol[te in the British gas-mask factories, and elsewhere, during the second world war.

Asbestos/Smoking Interactions [20U Series] (Jan. 22, 1983) 151 0438 Narang S (1980) Indian J Biochem Biophys Suppl 17:24 Asbestos-induced hemolysis and formation of asbestos bodies. (X) 0439 Governa M, Vadala CR (1972) Int Arch Arbeitsmed 30:273-282 Histochemical demonstration of hematoidin in the innermost layers of human asbestos body coating. 0440 Governa M, Rosanda C (1972) Br J Ind Med 29:154-159 A histochemical study of the asbestos body coating. 0441 Planteydt HT (1973) IARC Sci Publ No. 8 80-81 Discussion summary. Assessments of methods in the studies of the biological effects of asbestos. 2. Pathology. In: Biological effects of asbestos. (X) 0442 Stumphius J, Meyer PB (1968) Ann Occup Hyg 11:283-293 Asbestos bodies and mesothelioma. 0443 Gylseth B, Ophus EM, Mowe G (1979) Scand J Work Environ Health 5:151-157 Determination of inorganic fiber density in human lung tissue by scanning electron microscopy after low temperature ashing. (X) 0444 Ophus EM, Mowe G, Osen KK, Gylseth B Br J Ind Med 37:375-381 Scanning electron microscopy and x-ray microanalysis of mineral deposits in lungs of a patient with pleural mesothelioma. 0445 Gylseth 8, Mowe G, Skaug V, Wannag A (1981) Scand J Work Environ Health 7:109-113 Inorganic fibers in lung tissue from patients with pleura1 plaques or malignant mesothelioma. (X)

Asbestos/S~king Interactions [200 Series] (Jan. 22, 1983) 152 0446 Gylseth B, Baunan R (1981) Scand J Work Environ Health 7:190-195 Topographic and size distribution of asbestos bodies in exposed human lungs. (X) 0447 Goldstein B, Rendall R~G (1970) Oxford University Press, Cape Town 92-98 Ferruginous b~ies. In: Pneumoconiosis (Proc Int Conf Johannes- burg 1969) (X) 0448 Glyn Thomas R, Sluis-Cremer GK (1977) Br J Ind Med 34:281-290 200 kV xeroradiography in occupational exposure to silica and asbestos. 0449 8ossard E, Stolkin I, Spycher MA, Ruttner JR (1980) IARC Sci Publ No. 30 35-41 Quantification and particle size distribution of inhaled fibres in the lung. In: Biological effects of mineral fibres. (X) 0450 Cauna D, Torten RS, Gross P (1965) JAMA 192:371-373 Asbestos bodies in human lungs at autopsy. 0451 Gross P (1969) Arch Environ Health 19:186-188 Pulmonary ferruginous bodies in city dwellers. central fiber. A study of their 0452 Davis JMG, Gross P ('1973) IARC Sci Publ No. 8 238-242 Are ferruginous bodies an indication of atmospheric pollution by asbestos? In: Biological effects of asbestos. (X) 0453 Suzuki Y, Churg J (1969) Am J Pathol 55::79-107 Structure and development of the asbestos body.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 153 0454 Langer AM, Rubin I, Selikoff IJ (1970) Oxford University Press, Cape Town 57-69 Electron microprobe analysis of asbestos bodies. coniosis (Proc Int Conf Johannesburg 1969). In: Pneumo- 0455 Selikoff IJ, Hammond EC (1970) Oxford University Press, Cape Town 99-105 Asbestos bodies in the New York City population in two periods of time. In: Pneumoconiosis (Proc Int Conf Johannesburg 1969) (X) 0456 Langer AM, Ashley R, Baden V, Berkley C, Hammond EC et al (1973) J Occup Med 15:287-295 Identification of asbestos in human tissue. 0457 Langer AM, Pooley FD (1973) IARC Sci Publ No. 8 119-!25 Identification of single asbestos fibres in human tissue. Biological effects of asbestos. (X) In: O458 Langer AM, Mackler AD, Pooley FD (1974) Environ Health Perspect 9:63-80 Electron microscopical investigation of asbestos fibers. 0459 Auerbach O, Hammond EC, Selikoff IJ, Parks VR et al (1977) Environ Res 14:286-304 Asbestos bodies in lung parenchyma in relation to ingestion and inhalation of mineral fibers. (X) 0460 Selikoff IJ, Lee DHK (1978) Academic Press, New 'York 393-412 Asbestos and Disease. 0461 Ehrenreich T, Selikoff IJ (1981) Am J Forensic Med Pathol 2:67-74 Asbestos fibers in human lung. Forensic significance. (x)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 154 0462 Churg A, Warnock ML (1977) Lab Invest 36:334 Analysis of the cores of ferruginous (asbestos) bodies from the general population. 0463 Churg A, Warnock ML (1977) Arch Pathol Lab Med i01:629-634 Correlation of quantitative asbestos body counts and occupation in urban patients. 0464 Churg A, Sakoda N, Warnock ML (1977) Am J Clin Pathol 68:513-517 A simple method for preparing ferruginous bodies for electron microscopic examination. 0465 Churg A, Warnock ML (1978) Lab Invest 37:280-286- Analysis of the cores of ferruginous (asbestos) bodies from the general population. I. Patients with and without lung cancer. 0466 Churg AM, Warnock ML, Green N (1979) Lab Invest 40:31-38 Analysis of the cores of ferruginous (asbestos) bodies from the general population. II. True asbestos bodies and pseudoasbestos bodies. (X) 0467 Churg A, Warnock ML (1979) Am Rev Resp Dis 120:781-786 Analysis of the cores of asbestos bodies from members of the general population: patients with probable low-degree exposure to asbestos. (X) 0468 Churg AM, Warnock ML (1979) Chest 76:143-149 Numbers of asbestos bodies in urban patients with lung cancer and gastrointestinal cancer and in matched controls. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 155 0469 Churg AM, Warnock ML (1979) Lab Invest 40:622-626 Analysis of the cores of ferruginous (asbestos) bodies from the general population. III. Patients with environmental exposure. (X) 0470 Warnock ML, Churg AM (1980) Chest 77:129-130 Asbestos bodies (editorial) 0471 Churg A, Warnock ML (1980) Am Rev Resp Dis 122:669-678 Asbestos fibers in the general ~opulation. (X) 0472 Churg AM, Warnock ML (1981) Am J Pathol 102:447-456 Asbestos and other ferruginous bodies. clinical significance. (X) Their formation and 0473 Churg A (1982) Hum Pathol 13:381-392 Fiber counting and analysis in the diagnosis of asbestos-related disease. (X) 0474 Thomson JG, Path FC, Graves WM (1966) Arch Pathol. (Chicago) 81:458-464 Asbestos as an urban air contaminant. 0475 Dicke TE, Naylor B (1969) Dis Chest 56:122-125 Prevalence of "asbestos" bodies in human lungs at necropsy. 0476 Tabershaw IR (1968) Occup Med 10:32-37 Asbestos as an environmental hazard.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 156 0477 Bhagavan BS, Koss LG (1976) Arch Pathol Lab Med 100:539-541 Secular trends in prevalence and concentration of pulmonary asbestos bod£es - 1940 to 1972. 0478 Breedin PH, Buss DH (1976) South Med J 69:401-404 Ferruginous (asbestos) bodies in the lungs of rural dwellers, urban dwellers, and patients with pulmonary neoplasms. 0479 Felton JS (1980) JAMA 244:1675 The autopsy and asbestos exposure. 0480 Wright GW (1969) Am Rev Resp Dis 100:467-479 Asbestos and health in1969. 0481 Xipell JM, Bhathal PS (1969) Pathology 1:327-330 Asbestos bodies in lungs: an Australian report. 0482 McCullagh SF (1978) Lancet 2:844 Non-occupational exposure to asbestos. 0483 Dionne GP, Beland JE, Wang NS (1976) Arch Pathol Lab Med 100:398 Primary leiomyosarcoma of the diaphragm of an asbestos worke~. 0484 Anjilvel L, Thurlbeck ~eM (1966) Canad Med Assoc J 95:1179-1182 The incidence of asbestos bodies in the lungs at random necropsies in Montreal. O485 Shugar S (1979) Natl Res Counc Can Publ 92-96 Effects of asbestos in the Canadian environment. Effects of asbestos in man. Asbestos bodies and ferruginous bodies. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 157 0486 Francis D, Jussuf A, Mortensen T, Sikjaer B, Viskum K (1977) Scand J Resp Dis 58:193-196 Hyaline pleural plaques and asbestos bodies in 198 randomized autopsies. 0487 Sebastien P, Fondimare A, Bignon J, Monchaux Get al (1977) Pergamon Press 435-466 Topographic distribution of asbestos fibres in human lung in relation to occupational and non-occupational exposure. In: Inhaled Particles IV (Proc Int Symp Edinburgh 1975) 0488 Meurman LO, Hormia M, Isomaki M, Sutinen S (1970) Oxford University Press Cape Town 404-407 Asbestos bodies in the lungs of a series of Finnish lung cancer patients. In: Pneumoconiosis (Proc Int Conf Johannesburg 1969) (X) 0489 Friedrichs KH, Otto H (1981) Am Ind Hyg Assoc 42:150-156 Fibers in human lung dust samples: scope study. (X) a scanning electron micro- 0490 Lewinsohn HC (1968) Br Med J 2:120 Asbestos bodies. 0491 Roberts GH (1967) J Clin Path 20:570-573 Asbestos bodies in lungs at necropsy. 0492 Um CH (1971) Br Med J 2:248-252 Study of the secular trend in asbestos bodies in lungs ,in London 1936-66. 0493 Oldham PD (1973) IARC Sci Publ No. 8 231-235 Asbestos in lung tissue. In: Biological effects of asbestos. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 158 0494 Doniach I, Swettenham KV, Hathorn MKS (1975) Br J Ind Med 32~16-30 Prevalence of asbestos bodies in a necropsy series in East London: association w~th disease, occupation, and domiciliary address. 0495 McDonald AD (1980) IARC Sci Publ No. 30 681-685 Mineral fibre content of lung in ~esothelial tumours: preliminary report. In: Biological effects of mineral fibres. (X) 0496 Stovin PGI, Partridge P Thorax 37:185-192 Pulmonary asbestos and dust content in East Anglia. 0497 Polliack A, Sacks MI (i968) Israel J Med Sci 4:223-226 Prevalence of asbestos bodies in basal lung smears. 0498 Peacock PR (1968) Lancet 1:1153-1154 Detection of asbestos in asbestos bodies. 0499 Peacock PR, Biancifiori C, Bucciarelli E (1969) Europ J Cancer 5:147-153 Retrospective search for asbestos bodies in necropsies and biopsies on cases of primary malignant disease of the lung. 0500 Peacock PR, Bian~ifiori C, BuccLarelli E (~969) Europ J Cancer 5:155-158 Examination of lung smears for asbestos bodies in 109 consecutive necropsies in Perugia. 0501 Ghezzi I, Molteni G, PuccettiU (1967) Med Lavoro 58:223-227 Asbestos bodies in the lungs of inhabitants of Milan.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 159 0502 Bianchi C, Brollo A, Miniussi C, Bittesini L (1981) Tumori 67:279-282 Asbestos exposure in the Monfalcone area. A social and patho- logical study of 100 autopsy cases. 0503 Betta PC (1982) Med Lavoro 1:58-64 Asbestos bodies in the general population of the District of Alessandria: an autopsical survey and correlation of quantitative asbestos body counts, occupation and residence. (X) 0504 Thomson JG, Kaschula ROC, MacDonald RR (1963) S Afr Ned J 37:77-81 Asbestos as a modern urban hazard. 0505 Hagerstrand I, SeifertB (1973) Acta Pathol Microbiol Scand 81:457-460 Asbestos bodies and pleural plaques in human lungs at necropsy. 0506 Stolkin I, Ruettner JR, Sahu AP, Schibli L, Spycher MA (1981) Staub Reinhalt Luft 41:118-122 Electromicroscopic determination of the number and-size distribu- tion of mineral fibres in asbestos and nonasbestos exposed lungs. (X) 0507 Plamenac P, Pikula B, Kahvic M, Markovic Z, Selak Iet al (1971) Acta Med Jug 25:325-332 Incidence of asbestos bodies in basal lung smear. 0508 Dimov D, Beritic-Stahuljak B, Beritic T, Bunarevic A (1975) Plucne Bolesti Tuberk 27:211-217 Asbestos bodies in the autopsy findings of the inhabitants of Zagreb and their relationship to malignant tumors. (X) 0509 Cook PM (1979) Ann NY Acad Sci 330:717-724 Preparation of extrapulmonary tissues and body fluids for quanti- tative transmission electron microscope analysis of asbestos and other mineral particle concentrations. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 160 0510 Roggli VL, Greenberg SD, McLarty JL, Hurst GA et al (1980) Arch Otolaryngol 106:533-535 Asbestos body content of the larynx in asbestos workers. 0511 Auerbach O, Conston AS, Garfinkel L, Parks VR et al (1980) Chest 77:133-137 Presence of asbestos bodies in organs other than the lung. 0512 Gold C (1971) J Clin Pathol 24:481 Asbestos in tumours. (X} 0513 Langer AM (1974) Environ Health Perspect 9:229-233 Inorganic particles in human tissues and their association with neoplastic disease. 0514 Rickert RR (1974} Environ Health Perspect 9:237-238 Technique for the systematic examination of colon - rectum specimens. 0515 Carter RE, Taylor WF (1980) Environ Res 21:85-93 Identification of a particular amphibole asbestos fiber in tissue of persons exposed to a high oral intake of the mineral. (X) 0516 Patel-Mandlik KJ (1981} Arch Environ Contam Toxicol i0:47-54 Asbestos fibers in. normal and cancerous human kidneys. (X) 0517 Lynch KM, Smith WA (1930) JAMA 95:659-661 Asbestosis bodies in sputum and lung. 0518 Gloyne SR (1931) J Ind Hyg 13:85-86 A method of staining the asbestosis bodies found in the sputum oE asbestos workers.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 161 0519 Stewart MJ, Tattersall N, Haddow ~C (1932) J Path Bact 35:737-741 On the occurrence of clumps of asbestosis bodies ia the sputum of asbestos workers. 0520 Simson FW, Strachan AS (1931) J Path Bact 34:1-4 Asbestosis bodies in the sputum: a study of specimens from fifty workers in an asbestos mill. 0521 Greenberg SD, Hurst GA, Christianson SC, Matlage WJ (1976) Am J Clin Pathol 66:815-822 Pulmonary cytopathology of former asbestos workers. Report of the first year. 0522 Zeluff GW, Jenkins DE, Greenberg SD (1976) Heart Lung 5:482-484 Asbestos - useful and dangerous. 0523 Greenberg SD, Hurst GA, Matlage WT, Christianson CS (1976) Tex Med 72:39-43 Sputum cytopathological findings in former asbestos -workers. 0524 Farley ML, Greenberg SD, Shuford EH Jr et al (1977) Acta Cytol 21:693-700 Ferruginous bodies in sputa of former asbestos worker. 0525 McLarty JW, Greenberg SD, Hurst GA,Spivey CG, et al (1980) Acta Cytol 24:70 Statistical comparison of aerosol-induced and spontaneous sputum specimens in the Tyler asbestos workers programs. (X) 0526 McLarty JW, Greenberg SD, Hurst GA, Spivey CG et al (1980) J Occup Med 22:92-96 The clinical significance of ferruginous bodies in sputa. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 162 0527 Roggli VL, Greenberg SD, McLarty JW, Hurst GA et al (1980) Am Rev Resp Dis 122:941-945 Coalparison of sputum and lung asbestos body counts in former asbestos workers. 0528 McLarty JW, Farley ML, Greenberg SD, Hurst GA, Mabry LC (1980) Acta Cytol 24:460-465 Statistical comparison of aerosol-induced and spontaneous sputum in the Tyler asbestos workers program. (X) 0529 McLarty JW, Greenberg SD, Hurst GA Acta Cytol 25:445-446 Ferruginous bodies and cellular at~pia in sputum of former asbestos workers. (X) 0530 Greenberg SD, McLarty JL~ Toggli VL, Hurst GA et al (1982) Am Rev Respir Dis Suppl 125:153 Asbestos bodies in sputum: their clinical significance. (X) 0531 Attia OM, EI-Sewefy AZ, Wassef SA (1975) J Egypt Med Assoc 58:427-433 Sputum picture in workers at an Egyptian asbestos-cement pipe factory. 0532 . Huuskonen MS, Taskinen E, Vaaranen V (1978) Scand J Work Environ Health 4:284-294 Sputum cytology of asbestosis patients. 0533 Planteydt HT, Stumphius J, Spuyma, J (1964) Nederl T Geneesk 108:2378-2389 Asbestos bodies in shipyard workers. 0534 Plamenac P, Nikulin A, Pikula B, Markovic Z (1978) Acta Med Iugosl 32:297-309 Cytology of the respiratory tract in asbestos miners. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 163 0535 Jaurand MC, Gaudichet A, Atassi K, Sebastien P, Bignon J (1980) Bull Eur Physiopathol Respir 16:595-606 Relationship between the number of asbestos fibres and the cellu- lar and enzymatic content of bronchoalveolar fluid in asbestos exposed subjects. (X) 0536 Brambilla C, Kaehler D, Brambilla E, Fourcy Pet al :(1980) Am Rev Respir Dis Suppl 121:225 Interest of mineralogical studies on hrcnchiolo alveolar lavage. (X) 0537 Di Men za L, Hirsch A, Sebastien P, Gaudichet A, Bignon J (1980) IARC Sci Pub1 No. 30 2:609-614 Assessment of past asbestos exposure in patients: occupational questionnaire versus monitoring in broncho-alveolar lavage. In: Biological effects of mineral fibres. (X) O538 Braude AC, Chamberlain DW, Rebuck AS (1982) Am Rev Respir Dis Suppl 125:106 Asbestos fibers in bronchoalveolar lavage fluid in patients with diffuse interstitial lung disease. (X) 0539 Haslam PL, Turton CWG, Heard B, Lukoszek A, Collins JV (1980) Thorax 35:9-18 Bronchoalveolar lavage in pulmonary fibrosis: comparison of cells obtained with lung biopsy and clinical features. (X) 0540 Naylor B (1977) Acta Cytol 21:490-492 Regarding cyanophil'ic bodies, toxoplasma cysts and ferruginous bodies. 0541 Gee JBL, Fick RB (1980) Thorax 35:1-8 Bronchoalveolar lavage. (X) 0542 Van Ordstrand HS, Effler DB, McCormack LJ (1955) AMA Arch Ind Health 12:26-32 The value of lung biopsy in the diagnosis of occupational pulmonary dseases.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 164 0543 Sm/th WG (1964) Thorax 19:68-78 Needle biopsy of the lung. With special reference to diffuse lung disease and the use of a new needle. 0544 Mann B, Sinha CN (1966) Dis Chest 50:504-508 Jack needle lung biopsy in pneumoconiosis. 0545 Walton H, Skeoch T (1968) Thorax 23:556-562 Diagnosis of asbestosis by needle lung biopsy. 0546 Morgenroth K (1973) Beitr Pathol 148:199-210 Cellular reaction in the human lung caused by inhalation of asbestos dust over long periods. 0547 Mitchell RI (1977) Pergamon Press, Oxford 163-173 Lung deposition in freshly excised human lungs. Particles IV. (X) In: Inhaled 0548 Harris RL, Timbrell V (1977) Pergamon Press, Oxford 75-89 The influence of fibre shape in lung deposition. estimates. In: Inhaled Particles IV. (X) Mathematical 0549 Palmes ED, Lippmann M (1977) Pergamon Press, Oxford 127-136 Influence of respiratory air space dimensions on aerosol deposition. In: Inhaled Particles IV. 0550 Yu CP, Taulbee DB (1977) Pergamon Press, Oxford 35-47 A theory of predicting respiratory tract deposition of inhaled particles in man. In: ~nhaled Particless IV. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 165 0551 Wyard S (1914) J Pathol Bact 18:485-489 The action of asbestos fibre on the components of a simple haemolytic system. 0552 Light WG, Wei ET (1977) Nature 265:537-539 Surface charge and asbestos toxicity. 0553 Light WG, Wei ET (1977) Environ Res 13:135-145 Surface charge and hemolytic activity of asbestos. 0554 Light WG, Wei ET (1980) Academy Press, London 139-145 18. Surface charge and a.molecular basis for asbestos toxicity. In: The in vitro effects of mineral dust III. 0555 Schnitzer RJ, Bunescu G (1970) Arch Environ Health 20:481-482 Polymer as selective antagonists of hemolytic asbestos fibers. 0556 Depasse J (1982) Environ Res 27:384-388 Influence of the sialic acid content of the membrane of its susceptibility to chrysotile. 0557 EI-Shobaki FA, E1 Sewefy AZ (1973) Med Lavoro 64:417T422 The effect of exposure to asbestos dust on iron metabolism in Egyptian workers. 0558 Jaurand MC, Bignon J (1979) Thorax 34:694 Interaction of fibres with humen and animal cells. (X) 0559 Jaurand MC, Magne L, Bignon J (1979) Br J Ind Med 36:113-116 Inhibition by phospholipids of haemolytic action of asbestos. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 166 0560 Jaurand MC, Renier A, Bignon J (1980) Academic Press, London 121-124 15. The adsorption of phospholipids and red blood cell membranes on chrysotile fibres. In: The in vitro effects of mineral dusts. (X) 0561 Jaurand MC, Thomassin JH, Baillif P, Magne Let al {1980) Br J Ind Med 37:169-174 Chemical and photoelecton spectrometry analysis of the adsorption of phospholipid model membranes and red blood cell membranes on to chrysotile fibres. 0562 Sykes SE, Morgan A, Holmes A (1980) Academic Press, London 113-119 14. The haemolytic activity of chrysotile asbestos. vitro effects of mineral dusts. (X) In: The in 0563 Gabor S, Anca Z (1975) Br J Ind Med 32:39-41 Effect of asbestos on lipid peroxidation in the red cells. 0564 Gabor S, Frits T, Anca Z (1975) Int Arch Occup Environ Health 36:47-55 Effects of quartz and asbestos on erythrocyte surface charge. 0565 Harington JS, Macnab GM, Miller K, King PC (1971) Med Lavoro 62:171-176 Enhancement of haemolytic activity of asbestos by heat-labile factors in fresh serum. O566 Harington JS, Miller K, Macnab G (1971) Environ Res 4:95-117 Hemolysis by asbestos. 0567 Mace ML Jr, Brinkley BR, McLemore RL, Martin RR et al (1980) Eur J Cell Biol 22:568 Scanning electron microscopic characterization of interactions between asbestos fibers and human pulmonary macrophages. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 167 0568 McLemore TL, Mace ML Jr, Roggli V, Marshall MV et al (1980) Cancer Lett 9:85-93 Asbestos body phagocytosis by human free alveolar macrophages. 0569 McLemore TL, Roggli V, Marshall MV, Lawrence EC et al (1981) Chest Suppl 80:39S-42S Comparison of phagocytosis of uncoated versus coated asbestos fibers by cultured human pulmonary alveolar macrophages. In: The environment and the lung. 0570 Bitterman P, Rennard S, Shoenberger C, Crystal R et al (1981) Chest Suppl 80:38S-39S Asbestos stimulates alveolar macrophages to release a factor causing human lung flbrobalsts to replicate. In: The environ- ment and the lung. (X) 0571 Hart RW, Fertel R, Newman HAI, Daniel FB, Blakeslee JR (1979) Environ Health Eff Res Serv 35 pages Effects of selected asbestos fibers on cellular and molecular parameters (Abstract). (X) 0572 Hart RW, Kendig O, Blakeslee J, Mizuhira V (1980) Academic Press, London 191-198 23. Effect of cellular ingestion on the elemental ratio of asbestos. In: The in vitro effects of mineral dusts. (X) 0573 Daniel FB, Beach CA, Hart RW (1980) Academic Press, London 255-262 30. Asbestos-induced"changes in the metabolism of polycyclic aromatic hydrocarbons in human fiDroblast cell cultures. In: The in vitro effects of mineral dusts. (X) 0574 Hart RW, Daniel FB, Kindig OR, Beach CA, Joseph LB et al (1980) Environ Health Perspect 34:59-68 Elemental ~odlfications and polycyclic aromatic hydrocarbon meta- bolism in human fibroblasts.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 0575 Tejwani G&, Fertel R, Hart RW, Allison DK (1980) J Environ Pathol Toxicol 4:67-70 Effects of asbestos and chemical carcinogens on the cyclic nucleotide system of human fibroblasts. (X) 0576 Lemaire I, Gingras D, Lemaire S (1982) Environ Res 28:399-409 Thymidine incorporation by lung fibroblasts as a sensitive assay for biological activity of asbestos. (X) 0577 Iiarris CC, Stone GD, Trump BF, McDowell EM, Hess F et al (1979) Lab Invest 40:259 Interactions of asbestos with cultured human bronchus. (X) 0578 Hirsch A, Jaurand MC, Regnier A, Brochard P, Lange J (1982) Am Rev Res Dis Suppl 125~161 Assessment of primary culture, of human parietal pleural cells in relation to previous asbestos exposure. (X) 0579 Rajah KT, Evans PH (1973) IARC $ci Publ No. 8 94-98 Experimental methods - organ culture. asbestos. (X) In: Biological-effects of 0580 • Reiss B, Solomon S, Weisburger JH, Williams GM (1980) Environ Res 22:109-129 Comparative toxicities of different forms of asbestos in a cell culture assay. (X) 0581 .. Coplans M (1913) Br Med J 1360-1363 The action of the asbestos minerals and allied materials on bacterial and other substances. 0582 Turner-Warwick M (1973) IARC Sci Publ No. 8 258-263 Immunology and asbestos. In: Biological effects of asbestos. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 169 0583 Kagan E, Solomon A, Cochrane JC, Beissner El et al (1978) Marcel Dekker Inc., New York 1631-1644 Cancer related to asbestos exposure: immunological studies of patients at risk. In: Prevention and detection of cancer. (X) 0584 Burrell R (1974) Environ Health Perspect 9:297-298 Immunological reflections on asbestos. 0585 McFee DR, Tye R (1965) J Occup Med 7:269-275 Adsorption of proteins on dusts related to the pneumoconioses: selectivity. 0586 Hasselbacher P (1979) J Allergy C1in Immunol 64:294-298 Binding of immunoglobulin and activation of complement by asbestos fibers. (X) 0587 Hamilton JA, Chan JY, Movat HZ (1981) Environ Res 26:119-124 Coagulation of human plasma by asbestos fibers. (X) 0588 Israels LG, Friesen E, Sinclair C (1958) Can J Biochem Physiol 36:953-958 Activation of factor VII by asbestos in beef plasma and serum. 0589 Wilson MR, Gaumer 'HR, Salvaggio JE (1977) J Allergy Clin I,anunol 60:218-222 Activation of the alternative complement pathway and genertion of chemotactic factors by asbestos. 0590 Saint-Remy JMR, Cole P (1980) In~,unology 41:431-437 Interactions of chrysotile asbestos fibres with the complement system.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 170 0591 Rahman Q, Viswanathan PN, Tandon SK (1973) Med Lavoro 64:245-249 Influence of citrate ions on the dissolution of silica from asbestos. 0592 Rahman Q, Beg MU, Viswanathan PN (1975) Scand J Work Environ Health 1:117-119 Dissolution of silicic acid from amosite and quartz dusts under physiological conditions. 0593 Lange A, Smolik R, Chmielarczyk W, Garncarek D, Gielgier Z (1978) Arch Immunol Ther Exp 26:899-903 Cellular immunity in asbestosis. 0594 Gaumer HR, Doll NJ, Kaimal J, Schuyler M, Salvaggio JE (1981) C1in Exp Immunol 44:108-116 Diminished suppressor cell function in pateints with asbestosis. 0595 Pierce R, Turner-Warwick M (1980) Clin Allergy 10:229-237 Skin tests with tuberculin (PPD) candida alicans and_trichophyton spp. in cryptogenic fibrosing alveolitis and asbestos related lung disease. 0596 Barbers R, Shih W~, Saxon A (1981) 3?th Annu Meet Am Acad Allergy 15 Asbestos depression of human phytohemagglutinin response in vitro. (X) 0597 Campbell MJ, Wagner MMF, Scott MP, Brown DG (1980) Clin Exp Immunol 39:176-182 Sequential immunological studies in an asbestos-exposed popula- tion. II. Factors affecting lymphocyte function. 0598 Kagamimori S, Scott MP, Brown DG, Edwards RE, Wagner ~ (1980) BE J Exp Pathol 61:55-60 Effects of chrysotile asbestos on mononuclear cells in vitro.

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 171 0599 Haslam PL, Lukoszek A, Merchant J&, Turner-Warwick M (1978) Clin Exp Immunol 3:178-188 Lymphocyte responses to phytohaemagglutinin in ~atients with asbestosis and pleura1 mesothelio~. 0600 Wagner MMF, Campbell MJ, Edwards RE (1979) Clin Exp Immunol 38:323-331 Sequential immunological studies on an asbestos-exposed 9opula- tion. I. Factors affecting Deripheral blood leucocytes and T lymphocytes. (X) 0601 Wagner MMF (1980) IARC Sci Pub1 No. 30 247-251 Immunology and asbestos. In: Biological effects of mineral fibres. (X) 0602 Nash DR, Fortson NG, McLarty JW, Hurst GA (1981) J Toxicol Environ Health 7:733-744 Serum protein concentrations and respiratory tract abnor~lities following short-term exposure to amosite: a comparison between former asbestos workers and unexposed controls. -- 0603 Ei-Sewefy AZ, Hassan F, Badr FM, Awad S (1971) J Egypt Med Assoc 54:243-250 Serum protein electrophoresis among workers in an Egyptian cement - asbestos pipe factory. 0604 E1-Sewefy AZ, Shaheen H, Shams Ei-Deen ~ (1974) Med Lavoro 65:168=173 Bone ~rrow changes in asbestosis. 0605 Huuskonen MS, Rasanen JA, Harkonen H, Asp S (1978) Scand J Res Dis 59:326-332 Asbestos exposure as a cause of immunological stlmulation. (X) 0606 Huuskonen MS, Tilikainen 4, Alanko K (1979) Br J Dis Chest 73:253-259 HLA-BI8 antigens and protection from pulmonary fibrosis in asbestos workers.

Asbestos/S~K)king Interactions [200 Series] (Jan. 22, 1983) 172 0607 Turner-Warwick M (1979) Br J Dis Chest 73:243-244 HLA phenotypes in asbestos workers. 0608 Gregor A, Singh S, Turner-Warwick M, Lawler S, Parks WR (1979) Br J Dis Chest 73:245-252 The role of histocompatibility (HLA) antigens in asbestosis. 0609 Stansfield D, Edge JR (1974) Br J Dis Chest 68:166-170 Ciirculating rheumatoid factor and antinuclear antibodies in shipyard asbestos workers with pleural plaques. 0610 Lange A, Smoolik R, Zatonski W, Szymanska J (1974) Int Arch Arbeitsmed 32:313-325 Autoantibodies and serum immunoglobulin levels in asbestos workers. 0611 Matej H, Lange A, Smolik R (1977) Arch Immunol Ther Exp (Warsz) 25:489-491 HLA antigens in asbestosis. 0612 Matej H, Lange A, Garncarek D, Smolik R, Roszak E (1978) Arch Immunol Ther Exp (Warsz) 26:201-205 HLA and antinuclear antibody incidence in asbestos workers. 0613 Lange A (1980) Environ Res 22:162-175 An epidemiological"survey of immunological abnormalities in asbestos workers. I. Nonorgan and organ-specific autoantibodies. (X) 0614 Lange A (1980) Environ Res 22:176-183 An epidemiological survey of immunological abnormalities in asbestos workers. If. Serum immunog[obulin levels. (X)

Asbestos/S~oking Interactions [200 Series] (Jan. 22, 1983) 173 0615 Kagan E, Solomon A, Cochrane Jr, Kuba P, Rocks PH et al (1977) Clin Exp Immunol 28:268-275 Immunological studies of patients with asbestosis. II. Studies of circulating lymphoid cell numbers and h~moral immunity. 0616 Munan L, Thouez JP, Kelly A, Gagne M, Laborite D (1981) Scand J Haematol 26:115-122 Relative leucopenia in the peripheral blood of asbestos miners: an epidemiologic analysis. 0617 Formeister JF, Trisch GL, Mittleman A (1978) J Med 9:285-290 Adenosine deaminase levels in construction workers with asbestos contact dermatitis. 0618 Snodgrass DR, McLemore TL, Teague RB, Wray NP et al (1981) Chest Suppl 80:42S-44S. Aryl hydrocarbon hydroxylase activity in pulmonary macrophages and blood lymphocytes. Asbestos-exposed cigarette smokers with and without cancer. In: The environment and the lung. (X) 0619 Farulla A, Naro G, Alimena G, Delfini AM, Ogis Met al (1978) Ann Ist Super Sanit 14:655-658 Short-term effects in vitro of asbestos fibers on human lympho- cytes. (Italian) (X) 0620 Valerio F, de Ferrari M, Ottaggio L, Repetto E et al (1980) IARC Sci Publ No. 30 485-489 Cytogenetic effects of Rhodesian chrysotile on human lymphocytes in vitro. In: Biological effects of mineral fibres. (X) 0621 Doll NJ, Stankus RP, Goldbach S, Salvaggio JE (1982) Int Arch Allergy Appl Immunol 68:17-21 In vitro effect of asbestos fibers on polymorphonuclear leukocyte function. (X) 0622 Skerfving S, Korsgaard R, Stiksa G, Simonsson 8G (1980) IARC Med Sci 8:532-533 A~H inducibility in Swedish workers exposed to asbestos. (X)

Asbestos/Smoking Interactions [200 Series] (Jan. 22, 1983) 174 0623 Skerfving S, Korsgaard R, Simonsson BG, Stiksa Get al ~1980) Exerpta Medica, Amsterdam 205 Ahh inducibility in workers exposed to asbestos. A prospective study. In: II World Conference on Lung Cancer, Copenhagen. (X) 0624 Craighead JE, Mossman BT (1982) H Engl J Hed 17:1446-1455 The 9athogenesis of asbestoss-associated diseases.

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 1 CATEGORY NUMBER 232 0435 183 0259 190 0318 183 0260 150 0174 150 0175 234 0484 198 0370 232 0422 232 0424 232 0423 241 0531 210 0378 235 0511 233 0459 185 0305 185 0306 283 0596 196 0361 190 0319 182 0231 182 0230 182 0229 184 0291 194 0354 121 0083 121 0082 124 0124 124 0123 130 0129 232 0418 234 0503 170 0216 183 0257 233 0477 234 0502 232 0410 210 0381 130 0150 270 0570 232 0420 150 0177 AUTHORS AND YEAR Acheson ED, Gardner MJ (1980) A11ison AC (1973) Allison AC (1974) A11ison AC (1977) Amacher DE, A1arif A, Epstein SS (1974) Amacher DE, A1arif A, Epstein SS (1975) Anjilvel L, Thurlbeck WM (1966) Archer VE, Dixon WC (1979) Ashcroft T (1968) Ashcroft T, Heppleston AG (1973) Ashcroft T, Heppleston AG (1973) Atria OM, EI-Sewefy AZ, Wassef SA (1975) Auerbach 0 (1937) Auerbach O, Conston AS, Garfinkel L, Parks VR et al (1980) Auerbach O, Hammond EC, Selikoff IJ, Parks VR et al (19//) Babu KA, Lakkad BC, Nigam ~, Bhatt DK, Karnik ABet al (1980) Babu KA, Nigam SK, Lakkad BC, Bhatt DK, Karnik ABet a] (1981) Barbers R, Shih WWH, Saxon A (1981) Beck EG (1975) Beck EG (1976) Beck EG (1980) Beck EG, Holt PF, Manojlovic N (1972) Beck EG, Holt PF, Nasrallah ET (1971) Beck EG, Tilkes F (1980) Becklake ~ (1981) Beg MU, Farooq M, Saxena V, Rahman Q, et al (1977) . Beg MU, Rahman Q, Viswanathan PN, Zaidi SH (1973) Begin R, Masse S, Bureau MA (1982) Begin R, RoIa-Pieszczynski M, Sirois P, Lemaire I, et al (1981) Berry "G, Wagner JC (1976) Berry JP, Henoc Ing, P, GaI1e P, Pariente R (1976) Betta PC (1982) Bevan DR, Riemer SC, Lakowicz JR (1981) Bey E, Harington JS (1971) Bhagavan BS, Koss LG (1976) Bianchi C, 8rollo A, Miniussi C, Bittesini L (1981) Bignon J (1970) Bignon J, Bientz M (1977) Bignon J, Monchaux G, Sebastien P, Hirsch A, Lafuma J (1919) Bitterman P, Rennard S, Shoenberger C, Crystal R et al (1981) Blount M, Holt PF, Leach M (1966) Bolton RE, Davis JMG (1976) GEOGRAPHIC CODE GBR GBR GBR GBR UOH UOH CAN UUT GBR GBR GBR EGY UNJ UNJ UNJ IND IND UCA GER GER GER GBR GBR GER CAN IND CAN CAN GBR FRA ITA UMN SAF UMO [TA FRA FRA FRA GBR GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES I00 to 290 January 22, 1983 2 CATEGORY NUMBER 200 0374 232 0449 iii 0015 iii 0016 iii 0018 Iii 0017 190 0320 242 0536 242 0538 233 0478 112 0061 112 0060 112 0063 190 0321 130 0133 184 0283 180 0218 184 0294 Ig0 0322 184 0292 184 0295 182 0233 120 0076 280 0584 283 0597 235 0515 182 0253 233 0450 184 0284 184 0281 184 0282 186 0311 233 0473 233. 0464 233 0462 233 0463 233 0465 233 0461 233 0471 233 0468 233 0469 233 0472 AUTHORS AND YEAR Bordow RA (1982) Bossard E, Stolkin I, Spycher MA, Ruttner JR (1980) Botham SK, Holt PF (1968) Botham SK, Holt PF (1971) Botham SK, Holt PF (1972) Botham SK, Holt PF (1972) Botham SK, Holt PF (1974) Brambilla C, Kaehler D, Brambilla E, Fourcy Pet al :(1980) Braude AC, Chamberlain DW, Rebuck AS (1982) Breedin PH, Buss DH (1976) Brody /~R (1980) Brody AR, Crapo JD (1979) Brody AR, Hill LH, Adkins B Jr, O'Connor RW (1981) Brown A (1974) Brown DG, Wagner JC, Wagner ~f4F (1980) Brown RC, Chamberlain M (1980) Brown RC, Chamberlain M, Davies R, Gromley IP (Editors) (1980) Brown RC, Chamberlain M, Davies R, Morgan D~ et al (1980) Brown RC, Chamberlain M, Davies R, Sutton GT (1980) Brown RC, Chamberlain M, Griffiths DM, Timbre11V (1978) Brown RC, Chamberlain M, Sutton GT (1980) Bruch J (1974) Burns DM (Editor) (1982) Burrell R (1974) Campbell Mj, Wagner /~qF, Scott MP, Brown DG (1980) Carter RE, Taylor WF (1980) Case BW, IP MPC, Padilla M, Kleinerman J (1982) Cauna D, Torten RS, Gross P (1965) Chamberlain M (1982) Chamberlain M, Brown RC (1978) Chamberlain M, Brown RC, Griffiths DM (1980) Chamberlain M, Tarmy EM ~1977) Churg A (1982) Churg A, Sakoda N, Warnock ~ (I977) Churg A, Warnock..~ (1977) Churg A, Warnock ~ (1977) Churg A, Warnock ~ (1978) Churg A, Warnock ~ (1979) Churg A, Warnock ~ (1980) Churg AM, Warnock ~ (1979) Churg AM, Warnock ~I_ (1979) Churg AM, Warnock ~ (1981) GEOGRAPHIC CODE UCA SWI GBR GBR GBR GBR GBR FRA CAN UTE UNC SAF UNC U~ GBR GBR GBR GBR GBR GBR GBR GER UCA UWV GBR UMN UNY UPA GBR GBR GBR GBR UCA UIL UIL UIL UIL UIL UCA UIL UIL UCA

CUI~JLATIVE AUTHOR INDEX FOR CATEGORIES I00 to 290 January 22, 1983 3 CATEGORY NU~ER 233 0466 182 0235 235 0509 220 0384 220 0383 220 0386 220 0382 220 0385 2BO 0581 183 0264 113 0070 290 0624 190 0323 190 0324 150 01/i 186 0308 270 0573 181 0220 183 0276 183 0275 112 0033 130 0147 Iii 0008 III O001 III 0009 232 0421 182 022/ 130 0143 130 0141 130 0142 130 0145 130 0144 182 0228 190 0325 130 0148 112 0046 190 0326 112 0065 197 0365 233 0452 190 0327 231 0399 AUTHORS AND YEAR GEOGRAPHIC COOE Churg AN, Warnock R., Green N (1979) UIL Conning DM, Hayes Mj, Styles JA, Nicholas JA (19/i) GBR Cook PM (I979) U~ Cooke WE (192/) GBR Cooke WE (1929) GBR Cooke WE (1931) GBR Cooke WE, Hill CF (1927) GBR Cooke WE, Hill CF (1930) GBR Coplans M (1913) GBR Costrini AM, Stevens CA, Gee JBL (£978) UCT Craig DK, Wehner AP, Morrow WG (1972) UWA Craighead JE, Mossman BT (1982) UVT Craighead JE, Mossman BT, Bradley BJ (1980) UVT Crapo JD, Barry BE, Brody AR, O'Neil JJ (1980) UNC Cunningham HM, Moodie CA, Lawrence GA, Pontefract RD (1977) CAN Cunningham HM, Pontefract RD (1974) CAN Daniel FB, Beach CA, Hart RW (1980) UOH Daniel H, Le Bouffant L (1980) FRA Davies R (1980) GBR Davies R (1980) GBR Davis HV, Reeves AL (1971) UMI Davis JMB, Coniam SW (1973) GBR Davis JMG (1963) GBR Davis JMG (1963) GBR Davis JMG (1964) GBR Davis JMG (1964) GBR Davis JMG (196/) GBR Davis jMG (1970) GBR Davis JMG (1970) GBR Davis JMG (19/0) GBR Davis JMG (1971) GBR Davis JMG (1971) GBR Davis JMG (1972) GBR Davis ~ (Ig/g) GBR Davis JM6 (19/9).. GBR Davis JM6, Beckett ST, Bolton RE, Coll(ngs P, Middleton AP (1978) GBR Davis ~, Beckett ST, Bolton RE, Oomaldson K (1980) GBR Davis JM6, Beckett ST, Bolton RE, Oonaldson K (~980) GBR Davis JMG, Bolton RE, Garrett J (Igl4)GBR Davis JMG, Gross P (1973) GBR Davis JMG, Molyneux ~l(, Baxter RA, walton WH, Berlin A (1981) GBR De Trevi]le RT, Gross P, Davis J~W~ (1968) UPA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22. 1983 4 CATEGORY NUMBER 183 0261 181 0226 ?60 0556 lal 0221 242 0537 233 0475 234 0508 234 0483 193 0347 170 0208 124 0114 285 0621 150 0181 234 0494 112 0032 ia6 0315 186 0316 186 031/ 112 0031 233 0461 150 0185 284 0603 284 0604 260 0557 111 0026 121 0079 140 0159 140 0160 121 0080 150 0191 112 0037 241 0524 285 0619 233 0479 112 0044 232 0416 285 0611 234 0486 184 0279 184 0280 232 0419 234 0489 AUTHORS AND YEAR Dean RT. Hylton W. Alliso~ AC (1979) Depasse J (1980) Depasse J (1982) Desai R. Hext P. Richards R (1975) Di Menza L. Hirsch A. Sebastien P. Gaudichet A. Bignon J (1980) Dicke TE. Naylor B (1969) Dimov D. Beritic-Stahuljak B. Beritic T. Bunarevic A (1975) Dionne GP. Be]and JE. Wang NS (1976) Dixon JR. Lowe DB. Richards DE. CraI1ey LJ. Stokinger HE (1970) Dixon JR. Lowe DB. Richards DE. Stokinger HE (1969) Dodson RF. Hurst GA. Williams MG Jr (1980) Dol] NJ. Stankus RP. Goldbach S. Salvaggio JE (1982) Donham KJ. Berg JW. Will LA. Leininger JR (1980) Doniach I. Swettenham KV. Hathorn MKS (1975) Donna A (1970) Donna A (1972) Donna A (1973) Donna A. Betta PG. Lanfranco G (1980) Donna A. Cappa APM (1967) Ehrenreich T. Se]ikoff IJ (1981) Eisele GR (1981) EI-Sewefy AZ. Hassan F. Badr FM. Awad S (1971) El-Sewefy AZ. Shaheen H. Shams E1oDeen A (1974) EI-Shobaki FA. El Sewefy AZ (1973) Emerson RJ. Corrin B. Cole PJ (1982) Engelbrecht FM (1964) - Engelbrecht FM. Burger BF (1973) EngeIbrecht FM. Burger BF (1975) Enge]brecht FM. Thiart BF (1972) Epstein SS. Varnes M (1976) Evans JC. Evans RJ. Holn~s A. Hounam RF. Jones DM. et a] (1973) Farley ~. Greenberg SD. Shuford EH Jr eta] (1977) Farulla A. Nard G. Alin~na G. Delfini AM. Ogis Met al (1978) Felto, JS (1980) Feri, J. Leach LJ (1976) Fondimare A. Desbordes J (1974) For,~ister JF. Trisch GL. Mittleman A (19/8) Francis D. Jussuf A. Mortensen T. Sikjaer B. Viskum K (1977) Frank AL (1977) Frank AL (1980) Freidrichs KH. Otto H (1981) Friedrichs KH. Otto H (1981) GEOGRAPHIC CODE GBR BEL BEL GBR FRA UMI YUG CAN UOH UOH UTX ULA UIO GBR ITA ITA ITA ITA ITA UNY UTE EGY EGY EGY UVT SAF GER GER GER UOH GBR UTX ITA UCA UNY FRA UNY DEN UNY UNY GER GER

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 CATEGORY NUMBER 260 0563 260 0564 231 0406 210 0377 111 0004 111 0(903 232 0430 282 0594 242 0541 234 0501 160 0195 220 0387 240 0518 220 0388 220 0389 210 0376 220 0390 232 0448 235 0512 232 0447 113 0075 182 0234 184 0293 183 0272 183 0273 232 0440 232 0439 160 0196 241 0521 241 0523 241 0530 284 0608 231 0407 112 0030 233 0451 194 0350 150 0173 194 0351 231 0398 194 0356 130 0149 150 0172 AUTHORS AJ~D YEAR Gabor S, Anca Z (1975) Gabor S, Frits T, Anca Z (1975) Gaensler EA, Addington WW (1969) Gardner LU (1938) Gardner LU (1942) Gardner LU, Cun~ings DE (1931) Gaudichet A, Sebastien P, Clark NJ, Pooley FD (1980) Gaumer ~, Doll NJ, Kaimal J, Schuyler M, Salvaggio JE (1981) Gee JBL, Fick RB (1980) Ghezzi I, Molteni G, Puccetti U (1967) Gloyne SR (1930) Gloyne SR (1931) Gloyne SR (1931) Gloyne SR (1931) Gloyne SR (1932) Gloyne SR (1938) Gloyne SR (1951) Glyn Thomas R, Sluis-Cre~er GK (1977) Gold C (1971) Goldstein B, Rendall REG (1970) Goldstein B, Webster I, Rendall REG, Skikne MI (1978) Goldstein RH, Miller K, Glassroth J, Snider GL, Polgar P (1982) Gormley IP, Bolton RE, Brown G, Davis JMG, Donaldson K (I980) Gormley IP, Wright A, Collings P, Davis JMG (1980) Gormley IP, Wright MD (1980) - Governa M, Rosanda C (1972) Governa M, Vadala CR (1972) Governa M, Vadala CR (1973) Greenberg SD, Hurst GA, Christianson SC, Matlage WJ (1976) Greenberg SD, Hurst GA, Matlage WT, Christianson CS (1976) Greenberg SD, McLarty JL, Toggli VL, Hurst GA et al (1982) Gregor A, Singh S, Turner-Warwick M, Lawler S, Parks ~ (1979) Grieger GR (1976) Gross P (1968) Gross P (1969) Gross P (1973) Gross P (1974) Gross P (1975) Gross P, Cralley LJ, De Treville RTP (1967) Gross P, Harley RA (1973) Gross P, Harley RA (1973) Gross P, Harley RA, Swinburne LM, Davis JMG, Greene WB (1974) &E(~;RAPHIC CODE ROM ROM UMA UNY UNY UNY GBR ULA UCT ITA GBR GBR GBR GBR GBR GBR GBR SAF GBR SAF SAF UMA GBR GBR GBR ITA ITA ITA UTX UTX UTX GBR UDC UPA UPA USC USC USC UPA USC USC USC

CUMU~TIVE AUTHOR INDEX FOR CATEGORIES i00 to 290 January 22, 1983 CATEGORY NUMBER 231 0400 111 0013 121 0081 112 0029 231 0401 232 0446 232 0445 232 0443 234 0505 186 0313 186 0312 150 0194 150 0193 150 0186 160 0201 160 0202 281 0587 194 0353 260 0565 260 0566 160 0203 270 0577 250 0548 270 0574 270 0571 270 0572 283 0599 242 0539 281 0586 198 0369 193 0349 232 0425 182 0246 182 0244 111 0020 111 0019 150 0184 270 0578 112 0050 199 03/I 111 0022 111 0023 AUTHORS AND YEAR Gross P, de TreviIIe RTP, Hailer M (1970) Gross P, de TreviIle TP (1967) Gross P, de Trevi]le TP (1970) Gross P, de Trevil]e TP, Toker EB, Kaschak M, Babyak MA (1967) Gross, P, Davis JMG, Harley RA Jr, Cra]]ey LJ et a! (1972) Gylseth B, Baunan R (1981) GyIseth B, Mowe G, Skaug V, Wannag A (1981) Gylseth B, Ophus EM, Mowe G (19/9) Hagerstrand I, Seifert B (1973) Hahon N, Booth JA, Eckert HL (1977) Hahon N, Eckert HL (1976) Hal]enbeck WH, Markey DR, Dolan DG (1981) Ha]|enbeck WH, Patel-Mandlik Kj (1979) Hamilton j, Vassalli JD, Reich E (1976) Hamilton JA (1980 Hamilton JA (1981) Hamilton ~, Chart JY, Movat HZ (1981) Harington JS (1981) Harington JS, Macnab GM, Miller K, King PC (1971) Harington JS, Miller K, Macnab G (1971) Harington JS, Roe FJC, Walters M (1967) Harris CC, Stone GD, Tru~ BF, McDowell EM, Hess F et a] (1979) Harris RL, TimbreIl V (1977) Hart RW, Daniel FB, Kindig DR, Beach CA, Joseph LB eta] (1980) Hart RW, Ferte] R, Newman HAl, Daniel FB, Blakeslee JR (1979) Hart RW, Kendig O, Blakeslee J, Mizuhira V (1980) Haslam PL, Lukoszek A, Merchant JA, Turner-Warwick M (1978) Haslam PL, Turton CWG, Heard B, Lukoszek A, Collins JV (1980) Hasselbacher P (1979) Haubenstock H, Bekes| JG (1982) Hayashi H (1974) Henderson WJ, Harse J, Griffiths K (1969) Hext PM, Hunt J, Dodgson KS, Richards RJ (1977) Hext PM, Richards RJ (1976) Hiett DM (1978) ' Hiett DM (1978) Hilding AC, Hilding DA, Larson DM, Aufderheide AC (1981) Hirsch A, Jaurand MC, Regnier A, Brochard P, Lange J (1982) Holmes A, Morgan A (1980) Holt PF (1974) Holt PF (1981) Holt PF (1982) GEOGRAPHIC CODE UPA UPA UPA UPA UPA NOR NOR NOR SWE UWV UWV UIL UIL UNY UNY UNY CAN SAF SAF SAF 5AF UMD UNC UOH UOH UOH GBR GBR UNH UNY JAP GBR GBR GBR GBR GBR UMN FRA GBR GBR GBR GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 CATEGORY NUMBER 111 0011 112 0028 111 0012 111 0014 190 0328 185 0299 185 0298 160 0197 123 0103 182 0247 230 0397 284 0605 241 0532 284 0606 281 0588 150 0178 150 0179 160 0207 150 0180 124 0116 124 0115 182 0249 260 0558 124 0118 242 0535 232 0411 182 0239 260 0559 182 0251 182 0250 260 0560 260 0561 183 02/7 183 0278 190 0329 112 0067 112 OO66 190 0330 283 0598 112 OO53 112 0056 112 0058 AUTHORS AND YEAR Holt PF, Mi|ls J (1964) Ho]t PF, Mills J, Young DK (1964) Holt PF, Mills J, Young DK (1966) Holt PF, Young ~ (1967) Huang S-D, Lee W-H (1980) Huang SL (1979) Huang SL, Saggioro D, Miche]mann H, Mailing HV (1978) Hueper WC (1954) Hun~)hrey EW, Ewing SL, Wrig|ey JV, Northrup ~ Ill et a] (1981) Hunt J, Pooley FD, Richards RJ (1981) Hurlbut CS Jr, Williams CR (1935) Huuskonen MS, Rasanen JA, Harkonen H, Asp S (1978) Huuskonen MS, Taskinen E, Vaaranen V (1978) Huuskonen MS, T|]ikainen A, Alanko K (1979) Israels LG, Friesen E, Sinclair C (1958) Jacobs R, Dodgson KS, Richards RJ (1977) Jacobs R, Hu~hrys J, Dodgson KS, Richards RJ (1978) Jacobs R, Richards RJ (1980) Jacobs R, Weinzweig M, Dodgson KS, Richards RJ (1978) Jai swal AK (1981) Jaiswal AK, Viswanathan PN (1980) Jaurand MC, Bignon J (1977) Jaurand MC, Bignon J (1979) Jaurand MC, Bignon J, Gaudichet A, Magne L, Oblin A (1978) Jaurand MC, Gaudichet A, Atassi K, Sebastien P, Bignon J {1980) Jaurand MC, Goni J, Janrot P, Sebastien P, Bignon J (1976) Jaurand MC, Kap|an H, Thiollet J, Pinchon MC et al (1979) Jaurand MC, Magne L, Bignon J (1979) Jaurand MC, Magne L, Bignon J (1980) Jaurand MC, Magne L, Bignon J, Goni J (1980) Jaurand MC, Renier A, Bignon J (1980) Jaurand MC, Thomassin JH, Baillif P, Magne Let al (1980) Johnson NF, Davies R (1980) Johnson NF, Davies R (1981) Johnson NF, Wagner JC (1980) Johnson NF, Wagner JC, Wills HA (1980) Johnson NF, Wagner JC, Wills HA (1980) Jones JSP (1980) Kagamimori S, Scott MP, Brown DG, Edwards RE, Wagner ~ (1980) Kagan E, Miller K (1978) Kagan E, Miller K (1979) Kagan E, Miller K (1981) GEOGRAPHIC CODE GBR G8R GBR GBR TAI UNY UNY UMD UMN GBR UMA FIN FIN FIN CAN GBR GBR GBR GBR IND IND FRA FRA FRA FRA FRA FRA FRA FRA FRA FRA FRA GBR GBR GBR GBR GBR GBR GBR SAF SAF SAF

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 CATEGORY NUMBER AUTHORS AND YEAR 280 0583 284 0615 160 0199 160 0200 140 0167 170 0209 170 0210 182 0248 182 0240 185 0302 183 0265 182 0232 140 0168 124 0117 183 0256 231 0402 231 0403 181 0219 210 0379 220 0392 122 0101 191 0343 170 0213 170 0215 170 0214 170 0211 195 0360 170 0212 195 0359 184 0288 Kagan E, Solomon A, Cochrane JC, Beissner El et al (1978) Kagan E, Solomon A, Cochrane JC, Kuba P, Rocks PH et al (1977) Kanazawa K, Birbeck MSC, Carter RL, Roe FJC (1970) Kanazawa K, Roe FJC, Yamamoto T (1979) Kanazawa K, Yamamoto T, Yuasa Y (1979) Kandaswami C, O'Brien PJ (1980) Kandaswami C, O'Brien Pj (1981) Kang KY, Bice D, D'Amato R, Ziskind M, Salvaggio J (1979) Kaplan H, Jaurand MC, Pinchon ~, Bernaudin JF et al (1980) Kaplan H, Renier A, Jaurand MC, Bignon J (1980) Kaw JL, Tilkes F, Beck EG (1982) Kaw JL, Zaidi SH (1975) Kawai T (1979) King EJ, Clegg JW, Rae VM (1946) Kioshi K, Sakabe H (1972) Knox JF, Beattie J (1954) Knox JF, Beattie J (1954) Koshi K, Hayashi H, Sakabe H (1968) Kotin P (1965) Kuhn J (1941) Kung-Vosamae A, Vinkmann F (1980) Lafun~ J, Morin M, Poncy JL, Masse R (1980) Lakowicz JR, Bevan DR (1979) Lakowicz JR, Bevan DR (1980 Lakowicz JR, Bevan DR (1980) - Lakowicz JR, Hy]den JL (1978) Lakowicz JR, Hylden JL (1978) Lakowicz JR, Hy]den JL, Bevan DR (1979) Lakowicz JR, Hy]den JL, Englund F, Hidmark A, NcNamara M (1979) Landesman JM, Mossman BT (1982) 284 284 0613 282. 0593 284 0610 235 0513 233 0456 233 0458 233 0457 233 0454 210 0375 150 0190 232 0411 0614 Lange A (1980) Lange A (1980) Lange A, S~)]ik R, Chmielarczyk W, Garncarek D, Gielgier Z (1978) Lange A, S~)olik ~, Zatonski W, Szy~anska J (1974) Langer AM (1974) Langer AI(, Ashley R, Baden V, BerkIey C, Ha~nond EC et al (1973) Langer AM, Mack|er AD, Poo|ey FD (1974) Langer AM, Poo]ey FD (1973) Langer At(, Rubin I, Se]ikoff IJ (19/0) Lanza AJ, Editor (1938) Lavappa KS, Fu I~, Epstein SS (1975) Lavoinne A, Maitrot B, Gray H, Tayot J (1976) GEOGRAPHIC CODE SAF SAF GBR GBR JAP CAN CAN ULA FRA FRA GER IND JAP GBR JAP GBR GBR JAP UMO GER RUS FRA UMN UMN UMN UM~ UMN UMN UMN UVT POL POL POL POL UNY UNY UNY UNY UNY UNY UOH FRA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES i00 to 290 January 22, 1983 CATEGORY NUMBER 232 0434 190 0331 232 0414 121 0089 121 0088 232 0415 121 0090 111 0025 111 0024 270 0576 124 0122 186 0309 183 0270 112 0051 234 0490 170 0217 260 0553 260 0552 260 0554 183 0269 186 0314 185 0301 121 0078 186 0310 220 0391 240 051/ 270 0567 231 0404 181 0222 123 0102 243 0544 124 0121 130 0136 196 0362 284 0612 284 0611 234 0482 194 0355 112 0040 234 0495 281 0585 241 0528 AUTHORS AND YEAR Lawther PJ (1971) Lazar P (IgBO) Le Bouffant L (1974) Le Bouffant L, Bruyere S, Daniel H, Tichoux G (1979) Le Bouffant L, Bruyere S, Daniel H, Tichoux G (1979) Le Bouffant L, Bruyere S, Martin JC, Tichoux G, Normand C (1976) Le Bouffant L, Martin JC, Daniel H (1979) Lee KP, Barras CE, Griffith FD, Waritz RS (1981) Lee KP, Barras CE, Griffith FD, Waritz RS, Lapin CA (1981) Lemaire I, Gingras D, Lemaire S (1982) Lemaire I, Sirois P, Rola-Pleszczynski M, Masse S, Begin R (1981) Lemaire S, Lemaire I (1981) Lemkin P, Lipkin L, Merril C, Shifrin S (1980) Leong BKJ, Kociba Rj, Pernell HC, Lisowe RW, Rampy LW (1978) Lewinsohn HC (1968) Light WG (1979) Light WG, Wei ET (1977) Light WG, Wei ET (1977) . Light WG, Wei ET (1980) Lipkin LE (1980) Litterst CL, Lichtenstein EP (1970) Livingston GI(, Rom WN, Morris MV (I980) Luechtrath H, Schmidt KG (1959) Lukens ~ (1978) Lynch KM (1937) - Lynch KM, Smith WA (1930) Mace ~ Jr, Brinkley BR, McLemore RL, Martin RR et al (1980) Mace ~ Jr, McLe~re TL, Roggli V, Brinkley BR et al (1980) Macnab G, Harington JS (1967) Man SFP, Lee TK, Gibney RTN, Logus JW (1980) Mann B, Sinha CN (1966) Marcussen WH (1977) Maroudas NG, O'Neill CH (1973) Masse R, Sebastien P, Monchaux G, Bignon J (1980) Matej H, Lange A,"Garncarek D, Smolik R, Roszak E (1978) Matej H, Lange A, Smolik R (1977) McCullagh SF (1978) McCullagh SF (1981) McDermott M, Wagner JC (1975) McDonald AD (1980) McFee DR, Tye R (1965) McLarty JW, Farley ~, Greenberg SD, Hurst GA, Mabry LC (1980) GEOGRAPHIC CODE GBR FRA FRA FRA FRA FRA FRA UDE UDE CAN FRA CAN UMD UMI GBR UMA UCA UCA UCA UMD UWI UUT GER UCA USC USC UTX UTX SAF CAN GBR UCA UMD FRA POL POL ATL ATL GBR GBR UOH UTX

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 10 CATEGORY NUMBER 241 0529 241 0526 241 0525 270 0568 270 0569 234 0488 112 0045 112 0047 130 0156 112 0055 182 0238 111 0021 182 023/ 183 0258 150 0176 112 0052 112 0059 112 0054 112 0057 198 0366 198 0367 232 0409 124 0112 195 0358 250 0547 130 0151 199 0372 130 0131 112 0048 232 0436 232 0437 112 0049 183 0262 243 0546 184 0287 192 0346 184 0286 184 0285 285 0616 232 0438 124 0111 284 0602 AUTHORS AND YEAR McLarty JW, Greenberg SD, Hurst GA (1981) McLarty JW, Greenberg SD, Hurst GA, Spivey CG et al (1980) McLarty JW, Greenberg SD, Hurst GA,Spivey CG, et al (1980) McLemore TL, Mace ~ Jr, Roggli V, Marshall MV et al (1980) McLemore TL, Roggli V, Marshall MV, Lawrence EC et al (1981) Meurman LO, Hormia M, Isomaki M, Sutinen S (I970) Middleton AP, Beckett ST, Davis JMG (19/7) Middleton AP, Beckett ST, Davis JMG (1979) Miller JW, Sayers RR (1936) Miller K (1979) Miller K (1980) Miller K, Calverley A, Kagan E (1980) Miller K, Handfield RIM, Kagan E (1978) Miller K, Harington JS (1972) Miller K, Kagan E (1976) Miller K, Kagan E (1977) Miller K, Kagan E (1981) Miller K, Webster I, Handfield RIM, Skikne MI (1978) Miller K, Weintraub Z, Kagan E (1979) Miller K, Weintraub Z, Kagan E (1980) Miller K, Weintraub Z, Kagan E (1980) Milne JEH (1971) Misra V, Rahman Q, Viswanathan PN (1978) Misra V, Rahman Q, Viswanathan PN, Beg MU, Zaidi SM (1977) Mitchell RI (1977) Monchaux G, Bignon J, Jaurand MC, Lafuma Jet al (1981) Morgan A (1980) Morgan A, Davies P, Wagner JC, Berry G, Holmes A (1977) Morgan A, Evans JC, Hol~w~s A (197/) Morgan A, Holmes A (1980) Morgan A, Holmes A (1982) Morgan A, Talbot RJ, Holmes A (1978) Morgan D~, Allison AC (1980) Morgenroth K (1973) Mossman BT, Adler KB, Craighead JE (1980) Mossman BT, Craighead JE (1981) Mossman BT, Craighead JE, MacPherson BV (1980) Mossman BT, Kessler JB, Ley BW, Craighead JE (1977) Munan L, Thouez JP, Kelly A, Gagne M, Labonte D (1981) Narang S (1980) Narang S, Kaw JL, Zaidi SH (1978) Nash ~, Fortson NG, McLarty JW, Hurst GA (1981) GEOGRAPHIC CODE UTX UTX UTX UTX UTX FIN GBR GBR UDC SAF SAF UDC SAF SAF SAF SAF SAF SAF SAF SAF SAF ATL IND IND UOH FRA GBR GBR GBR GBR GBR GBR GBR GER UVT UVT UVT UVT CAN IND IND UTX

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22. 1983 11 CATEGORY NUMBER 242 0540 121 0093 185 0297 185 0304 185 0303 124 0104 113 0069 124 0119 234 0493 232 0432 232 0444 250 0549 235 0516 234 0498 234 0499 234 0500 130 0155 160 0204 160 0205 198 0368 183 0255 282 0595 140 0165 183 0266 112 0062 112 0064 241 0534 234 0507 232 0441 190 0332 241 0533 234 0497 150 0170 232 0427 232 0428 232 0429 232 0426 190 0333 190 0334 185 0300 197 0363 122 0099 AUTHORS AND YEAR Naylor B (1977) Nettesheim P (I981) Neugut AI. Eisenberg D. Silverstein M. Pulkrabek Pet al (1978) Newman HAl. Saat YA. Hart RW (1980) Newman HAl. Saat YA. Hart RW (1980) Nofer J. Szymczykiewicz K. Wiecek E (1961) Nordmann M. Sorge A (1941) Obli, A. Warnet JM. Jaurand MC. Bignon J. Claude JR (1978) Oldham PD (19/3) Oldham PD (1973) Ophus EM. Mowe G. Osen KK. Gylseth B (1980) Pa1,~s ED. Lippmann M (1977) Patel-Mandlik KJ (1981) Peacock PR (1968) Peacock PR. Biancifiori C. Bucciarelli E (1969) Peacock PR. Biancifiori C. Bucciarelli E (1969) Peacock PR. Peacock A (1966) Pelfrene AF (1977) Pe|frene AF (1977) Pernis B. Vigliani EC (1982) Pernis B. Vigliani EC. Marchisio MA. Zanardi S (1966) Pierce R. Turner-Warwick M (1980) Pigott GH. Ishmael J (1979) Pigott GH. Judge PJ (1980) Pinkerton KE. Pratt PC. Crapo JD (1980) - Pinkerton KE. Pratt PC. Crapo JD (1982) P]amenac P. Nikulin A. Pikula B. Markovic Z (1978) PIa~nac P. Piku|a B. Kahvic M. Markovic Z. Selak Iet al (1971) Planteydt FIT (1973) Planteydt FIT (1980) Planteydt FIT. Stu,,)hius J. Spuyman J (1964) Polliack A. Sacks MI (1968) Pontefract RD. Cunningham HM (1973) Pooley FD (1979).. Pooley FD. Clark N (1979) Pooley FD. Clark NJ (1980) Pooley FD. Oldham PD. Um CH. Wagner JC (1970) Port F (1980) Pott F. Huth F. Spurny K (1980) Price-Jones MJ. Gubbings G. Chamberlain M (1980) Pylev LN (1980) Pylev LN. Koval'skaya GD. Yakovenko GN (1975) GEOGRAPHIC CODE UMI UNC UNY UOH UOH POL GER FRA GBR GBR NOR UNY UMD ITA ITA ITA GBR UNE UNE UNY ITA GBR GBR GBR UNC UNC YUG YUG NET NET .~ET ISR CAN GBR GBR GBR GBR GER GER GBR RUS RUS

CUMULATIVE AUTHOR INDEX FOR CATEGORIES i00 to 290 January 22, 1983 12 CATEGORY NUMBER 122 0100 122 0098 195 0357 111 0027 281 0592 121 0084 181 0224 281 0591 197 0364 270 0579 111 0006 160 0206 112 0035 112 0034 270 0580 184 0289 181 0225 182 0242 182 0243 182 0245 235 0514 234 0491 190 0335 182 0241 235 0510 241 0527 193 0348 220 0393 140 0166 281 0590 121 0086 121 0087 190 0336 231 0405 140 0158 186 0307 260 0555 181 0223 124 0113 140 0157 110 0001 234 0487 AUTHORS AND YEAR GEOORAPHIC CODE Pylev LN, Kulagina TF (1982) Pylev LN, Roe F, Warwick D (1970) Pylev LN, Shabad LM (1973) Rahman Q (1982) Rahman Q, Beg MU, Viswanathan PN (1975) Rahman Q, Beg MU, Viswanathan PN, Zaidi SH (1976) Rahman Q, Narang S, Kaw JL, Zaidi SH (1974) Rahman Q, Viswanathan PN, Tandon SR (1973) Rahman Q, Vlswanathan PN, Zaidi SH (1977) Rajah KT, Evans PH (1973) Ramaswamy AS, Venkatesh DS, Rama Rao R (1953) Rasanen T (1962) Reeves AL (1976) Reeves AL, Puro HE, Smith RC (1974) Reiss B, Solomon S, Weisburger JH, Williams GM (1980) Reiss B, Weisburger JH, Williams GM (1979) Richards RJ, George G, Hunt J, Tetley TD (1980) Richards RJ, Hext PM, Blundell G, Henerson WJ, Volcani BE (1974) Richards Rj, Hext PM, Desai R, Tetley T, Hunt Jet al (1975) Richards RJ, Jacoby F (1976) Rickert RR (1974) Roberts GH (1967) Robock K (1976) Robock K, Klosterkotter W (1973) Roggli VL, Greenberg SD, McLarty JL, Hurst GA et al (1980) Roggli VL, Greenberg SD, McLarty JW, Hurst GA et al (1980) Roy-Chowdhury AK, Mooney TF Jr, Reeves AL (1973) Ruska H (1942) Sahu AP, Shanker R, Zaidi SH (1978) Saint-Remy J~, Cole P (1980) Salk RA, Vosamae A (1975) Sanders CL Jr (1975) Schepers GWH, Wagner JC, Hueper W (1965) Schepers GWH, Wagner JC, Webster I, Peacock ~ et al (1965) Scheuer E, Huth F, Pott F (1973) Schneider U, Maurer RR (1977) Schnitzer RJ, Bunescu G (1970) Schnitzer RJ, Pundsack FL (1970) Schoenberger C, Hunninghake G, Gedek J, Crystal R (1980) Schulz RZ, Williams CR (1942) Schuster NH (1931) S~astien P, Fondimare A, Bignon J, Monchaux Get al (1977) RUS RUS RUS UAR IND IND IND IND IND GBR IND FIN UMI UMI UNY UNY GBR GBR GBR GBR UNJ GBR GER GER UTX UTX UMI GBR INO GBR RUS UWA UDC UDC GER UNC UNY SAF UMD UMA GBR FRA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 January 22, 1983 13 CATEGORY NU MBER 232 0413 150 0182 233 0455 233 0460 200 0373 140 0162 121 0085 140 0161 234 0485 220 0396 240 0520 185 0296 124 0109 124 0108 124 0110 183 0263 285 0623 285 0622 130 0146 121 0077 122 ~94 130 0153 130 0154 190 0337 150 0189 130 0152 243 0543 285 0618 160 0198 284 0609 130 0137 130 0134 130 0138 130 0139 130 0140 130 0135 140 0164 140 0163 240 0519 234 0506 234 0496 232 0~42 AUTHORS AND YEAR GEOGRAPHIC CODE Sebastien P, janson X, Gaudichet A, Hirsch A. Bignon J (1980) FRA Sebastien P, Masse R, Bignon J (1980) FRA Selikoff IJ, Hammond EC (1970) UNY Selikoff IJ, Lee DHK (1978) UNY Selikoff IJ, Lee DHK (1978) UNY Sethi S, Beck EG, Manojlovic ~ (1974) GER Shabad LM, Pylev LN, Krivosheeva LV, Kulagnina TF eta] (1974) RUS Shin I~., Firminger HI (1973) UMD Shugar S (1979) CAN Simons EJ (1935) UMN Simson FW, Strachan AS (1931) SAF Sincock A, Seabright M (1975) GBR Singh J, Beg MU, Kaw JL, Viswanathan PN, Zaidi SH (1976) IND Singh J, Beg MU, Viswanathan PN, Zaidi SH (1975) IND Singh J, Pandey SD, Viswanathan P~, Zaidi SH (1978) IND Skeldon N, Steele L (1978) GBR Skerfving S, Korsgaard R, Simonsson BG, Stiksa Get al (1980) SWE Skerfving S, Korsgaard R, Stiksa G, Simonsson BG (1980) SWE Smith BA, Davis JMG (1971) GBR Sndth JM, Wootton IDP, King EJ (1951) GBR S,~th WE (1966) UNJ Smith WE (1973) UNJ Smith WE (1980) UNJ S~th WE, Hubert DD, Sobel HJ (1980) UNJ Smith WE, Hubert DD, Sobel HJ, Peters ET, Doerfler TE (~980) UNJ Smith WE, Miller L. Churg J, Se!ikoFf IJ (1965) UNJ Smith WG (1964) ATL Snodgrass DR, McLe~re TL, Teague RB, Wray NP et al (1981) UTX Speirs RS, Wenck U (1955) U~ Stansfield D, Edge JR (1974) GBR Stanton ~ (1974) UMD Stanton ~, Blackwell R, Miller E (1969) UMD Stanton ~, Layard M (1978) UMD Stanton ~, L~ard M (1979) UMD Stanto. ~, Layard M, Tegeris A, Miller E, May Met al (1981) UMD Stanton ~, Wrench C (1972) UMD Stevens RH, Will LA, Cole DA. M~k ES, Frank CW, Donham KJ (1979) UIO Stevens RH, Will I~%, Osborne JW, Cole DA, Donham KJ (1978) UIO Stewart MJ, Tattersall N, Haddow ~C (1932) GBR Stolkin I, Ruettner JR, Sahu AP, Schibli L, Spycher MA (1981) SWI Stovin ~I, Partridge P (1982) GBR Stumphius J, Meyer PB (1968) NET

CUMULATIVE AUTHOR INDEX FOR CATEGORIES I00 to 290 January 22, 1983 14 CATEGORY NUMBER 182 0236 122 0097 233 0453 i22 0095 122 0096 260 0562 124 0105 233 0476 270 0575 112 0042 112 0043 232 0412 234 0504 233 0474 184 0290 194 0352 232 0433 121 0091 121 0092 280 0582 284 0607 112 0036 220 0395 220 0394 234 0492 285 0620 231 0408 243 0542 191 0345 112 0068 124 0106 124 0107 111 0005 183 0268 183 0267 111 0010 130 0126 190 0338 112 0038 232 0431 112 0041 130 0130 AUTHORS AND YEAR Styles JA, Wilson J (19/3) Suzuki Y (1974) Suzuki Y, Churg J (1969) Suzuki Y, Churg J (1970) Suzuki Y, Churg J, Ono T (1972) Sykes SE, Morgan A, Holmes A (1980) Szymczykiewicz K (1970) Tabershaw IR (1968) Tejwani GA, Fertel R, Hart RW, Allison OK (1980) Tetley TD, Hext PM, Richards RJ, McDermott M (1976) Tetley TD, Richards RJ, Harwood JL (1977) Thomassin JH, Touray JC, Baillif P, Jaurand MC et al (1980) Thomson JG, Kaschula ROC, MacDonald RR (1963) Thomson JG, Path FC, Graves ~ (1966) Tilkes F, Beck EG (1980) Timbrel] V (1972) Timbrell V (1980) Topping DC, Nettesheim P (1980) Topping DC, Nettesheim P, Martin DH (1980) Turner-Warwick M (1973) Turner-Warwick M (1979) Turnock AC, Bryks S, Bertalanffy FD (1971) TyIecote FE (1927) Tylecote FE, Dunn SJ (1931) - Um CH (1971) Valerio F, de Ferrari M, Ottaggio L, Repetto E et al (1980) Vallyathan NV, Green FHY, Craighead JE (1980) Van Ordstrand HS, Effler DB, McCormack LJ (1955) Vigliani EC (1968) Vincent JH, Johnston WB, Jones AD, Johnston AM (1981) Viswanathan PN, Dogra RKS, Shanker R, Zaidi SH (1973) Viswanathan PN, Rahman Q, Beg MU, Zaidi SH (1973) Vorwald AJ, Durkan TM, Pratt PC (1951) Wade MJ, Lipkin LE, Stanton ~, Frank AL (1980) Wade MJ, Lipkin LE, Tucker RW, Frank AL (1976) Wagner JC (1963) Wagner JC (1966) Wagner JC (1971) Wagner JC (1972) Wagner JC (1973) Wagner JC (1975) Wagner JC (1976) GEOGRAPHIC CODE GBR UNY UNY UNY UNY GBR POL UCA UOH GBR GBR FRA SAF SAF GER GBR GBR UNC UNC GBR GBR CAN GBR GBR GBR ITA UVT UOH ITA GBR IND IND UNY U~) UMD GBR GBR GBR GBR GBR GBR GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 290 january 22, 1983 15 CATEGORY NUMBER 183 0254 130 0127 190 0340 190 0339 190 0341 190 0342 112 0039 130 0128 130 0132 283 0601 283 0600 243 0545 150 0183 233 0470 110 0002 150 0192 113 0074 113 0071 113 0073 113 0072 191 0344 150 0169 210 0380 182 0252 124 0120 281 0589 183 0271 233 0480 183 0274 260 0551 234 0481 250 0550 150 0187 150 0188 124 0125 241 0522 AUTHORS AND YEAR Wagner JC (Editor) (1980) Wagner JC, Berry G (1969) Wagner JC, Berry G (1973) Wagner JC, Berry G (1973) Wagner JC, Berry G, Hill RJ, Munday DE, Skidmore JW (1980) Wagner JC, Berry G, Skidmore JW, Pooley FD (1980) Wagner JC, Berry G, Skidn,)re JW, Timbrell V (1974) Wagner JC, Berry G, Timbrell V (1973) Wagner ~I~F (1979) Wagner ~F (1980) Wagner /4qF, Campbell MJ, Edwards RE (1979) Walton M, Skeoch T (1968) Ward JM, Frank AJ., Wenk M, Devor D, Tarone RE (1980) Warnock /4., Churg AJq (1980) Webster I (1963) Webster I (1974) Wehner AP (1980) Wehner AP, Busch RH, Olson RJ, Craig DK (1975) Wehner AP, Dagle GE, Cannon WC (1978) Wehner AP, Dagle GE, Cannon WC, Buschbom RL (1978) Westlake GE (1974) Westlake GE, Spjut HJ, S,fith MN (1965) Weston JT, Liebow AA, Dixon MG, Rich TH (1972) White R, Kuhn C (1980) Wilcox K, Marcussen W, Furst A (1974) Wilson ~, Gaumer ~, Salvaggio JE (1977) Wright A, Gormley IP, Collings PL, Davis JMG (1980) Wright GW (1969) Wright MO, Gormley IP (1980) Wyard S (1914) Xipell JM, Bhathal PS (1969) Yu CP, Taulbee DB (1977) Zaidi SH (1974) Zaidi ~, GuptaGSD, Rahman Q, Kaw JL, Shanker R (1976) Zaidi SH, Shanker R, Dogra RKS (1973) Zeluff GW, Jenkins DE, Greenberg SD (1976) GEOGRAPHIC CODE GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR UMD UCA SAF SAF UWA UWA UWA UWA UCA UTX UUT UCA ULA GBR UOH GBR GBR ATL UNY IND IND IND UTX

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 175 [300] EPIDEMIOLOGIC STUDIES ON MORTALITY PATTERN OF ASBESTOS WORKERS 176 [310] Pioneerin@ and continuin@ studies conducted b~ epidemiologists of University of Pittsburgh Graduate School of Public Health 180 [311] Mortality pattern in a cohort of asbestos workers 181 [312] Mortality pattern among asbestos and cotton textile workers 184 [313] Mortality pattern among retired asbestos workers 187 [320] Asbestos/ci@aret~e smoking synergism suggested b~ the Mr. Sinai Hospital group 189 [321] Asbestos insulators in New York City and Newark 190 [322] Revision of importance of cigarette smoking among asbestos insulators in New York City and Newark 194 [323] Asbestos insulators in the United States and Canada 196 [324] Amosite asbestos factory workers 200 [330] Mortalit~ pattern of asbestos workers reported by other American epidemiolo@ists 200 [331] Asbestos insulators in the Cincinnati area 201 [332] Asbestos workers reported by epidemiologists of the New York Department of Labor 202 [333] Plumbers and pipefitters reported by NIOSH epidemiologists 203 [334] Boilermakers reported by University of Washington epidemiologists - 204 [335] Asbestos cement workers reported by Tulane University epidemiologists 205 [336] Asbestos textile, friction and packing products workers reported by NIOSH epidemiologists 205 [337] American asbestos textile workers reported by Canadian epidemiologists 206 [338] Shipyard workers in the Atlantic and Pacific coasts 206 [339] Asbestos miners and millers in New York and South Dakota 208 [340] Canadian epidemioloqic studies 208 [350] British epidm!olo@ic studies 210 [360) Scandinavian epidemiologic studies 215 [370] Western European epidemiolo~ic studies 217

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 176 [380] Eastern European~ Middle Eastern and Far Eastern epidemiologic studies 218 [390] Limitations and consequences of epidemiologic ~tudies supporting the asbestos/cigarette interaction hypothesis 219 [391] ~merican Cancer Society project on smoking and health 221 [392] Limitations of cohort approach 222 [393] Published criticisms of asbestos/cigarette smoking interaction hypothesis 223 [394] Inconsistencies in numberical estimates 227 [395] Asbestos/benzopyrene interaction 228 [396] Non-applicability of interaction studies to other cohort groups 230 [397] Asbestos workers, asbestos management and government regulators 230 [398] Future projections of asbestos associated deaths 231 [399] Legal consequences 232 Bibliography 233 Cumulative Author Index plus 260 1

Asbestos/Smoklng Interactions [300 Series] Jan. 31, 1982 177 [300] EPIDEMIOLOGIC STUDISS IN MORTALITY PATTERN OF ASBESTOS WORKERS At the time this review was being prepared, this obtained a distributed: by William N. Ro~ from the compiler pre-release copy Environmental and of a medical textbook soon to be Occupational Medicine, edited University of Utah School of Medicine (625). The inclusion of a 1983 publication in this report is an exception to the cut-off date of December 31, 1982 for the comprehensive bibliography on asbestos, directly or indirectly related to the asbestos/cigarette smoking concept. The chapter on Asbestos and Related Fibers (626) was written by the Editor, who has published only one article on asbestos. He also invited Selikoff to prepare the Foreword to this first modern textbook on the subject. Sihce the first suggestion that asbestos e~posure interacts with cigarette smoking was made by Seliko~6 based on the results of epidemiologic studies, i~ is important to quote his most recent thoughts on the subject: "There has been a considerable change in the perspectives of public health and preventive medi- cine, with many scientific, academic, administrative, social, political and economic consequences .... Ks [ look at this, it appears that four interdigitating, interwoven threads form our present fabric of under- standing. The first component was geographical

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 178 pathology .... The second component was the exami- nation of cigarette smoking, started in 1940e, in which over the next 30 years it was demonstrated that major human diseases, cancer of the colon, bladder, larynx and pancreas; coronary disease and stroke; emphysema and bronchitis ... were exogenously deriv- ed, mostly from agents in our personal environment. The third component was the body of painfully gathered data concerning occupational hazards with a variety of biological effects, neoplastic, neurolo- gical, immunological, hepatic, renal and metabolic. The last component was the observation that control of exposures not only would reduce the incidence of such disease but in some cases might even lead to reversal of risk. When did this change occur? ... A landmark of our understanding of tobacco's effects was the first Surgeon General's Report in 1964. The asbestos industry insists that it did not appreciate the wide potential of asbestos disease until the same year (Selikoff et al. 1964). The demonstration of reversal of risk in human disease occurred soon after (Hammond 1965, Selikoff and Hammond 1979)." (627) It is apparent in the above remarks that Selikoff regards his own epidemiologic studies as responsible for the second and third components (out of four) of perspective changes of occu- pational medicine. The chapter on asbestos by Rom repeatedly pays tribute to Selikoff: "Initially, Selikoff and colleagues noted a ninetyfold risk among smoking asbestos insulators compared to nonsmoking controls; however they revised the estimate downward in a larger study, which described a mortality ratio of 10.4 for asbestos insulators more than 20 years after onset of occupational exposure who smoked more than

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 179 20 cigarettes per day, compared to asbestos insulators never smoked" (626). As will be noted below, the above interpretation by of the epidemiologic studies words, the results of Selikoff's confusing that even Rom, his who Rom contains an error. In other stud ies are so complex and most devoted admirer, has mis- interpreted the results. omission predated mortality pattern smoking habits. In Rom's chapter, there is a striking of information gathered by other groups, one of which Selikoff in applying epidemiology to estimating of asbestos workers, regardless of their It should be recognized that the epidemiologlc procedure by Selikoff is one of several techniques available for used occupational studies. They are as follows: (a) Incidence rate or mortality rate applicable to a population group, and standardized mortality ratio (SMR) calculated from observed deaths and expected deaths for the general population; (b) Case" control study consisting of selection subjects and a comparison group risk; (c) Cross-sectional study employed who choose to participate; of with estimates of relative involving people currently

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 180 (d) Follow-up study, also called cohort or study, either retrospective or perspective; and (e) Uncontrolled case study or case report. The results of epidemiologic studies are sub-categories of geographical location. The information in intended to facilitate comparison of long.itudinal grouped in summarized techniques and estimations of risks. It will be apparent that the number of studies that disagree with Selikoff's reported pattern of mortality far exceeds those that agree. [310] Pioneering and Continuin@ Studies Conducted by Epidemiologists of the University of Pittsburgh Graduate School of Public Health Contrary to the opinions of Rom (an occupational physician) and Paul Brodeur (a science writer for the New Yorker magazine), Selikoff's study is not "the first study ever made that had taken on a large enough group of asbestos workers from a point far enough in time and followed thru long enough to determ/ne ~.nequivocally what their health experience has been" (The New Yorker, October 12, 1968). The exchange of letters published in the Archives of Environmental Health (628) sets the record straight and this compiler agrees that the pioneering efforts of Mancuso should be recognized. Thus the

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 181 discussion starts with the University of Pittsburgh group of epidemiologists, particularly Mancuso and Enterline. [311] Mortality Pattern in a Cohort of Asbestos Workers Mancuso is credited for designing an application demographic method to industrial epidemiology. 1959, he introduced a cohort method of approach specific population groups exposed to known of the As early as to identify or suspected hazardous manufacturing processes or chemicals. By using statistical records and tabulations from the Bureau of Old Age and Survivors Insurance (Social Security), Mancuso was able to obtain specific information on the deceased, which was used to locate death certificates and establish mortality pattern for specific industrial population groups. o The cohort study was initiated in the early 1960s while Mancuso was the chief of the Division of Industrial Hygiene of the Ohio Department of Health. The cohort consisted of workers in a company that manufactured asbestos products. An occupa- tional cancer hazard was suspected because the pathologist in a small community had found 19 cases of lung cancer in a group of 39 pulmonary asbestosis cases. Mancuso selected the workers employed at anytime during either 1938 or 1939, and followed them through Social Security records to determine cause of

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 182 death as shown by death certificates. Mortality rates established for the 1938-1939 cohort asbestos workers w~re compared with expected numbers of deaths computed from average annual Ohio death rates and the decennial census for 1950 to 1960. The results of the cohort study were presented before the annual meeting of the Academy of Occupation Medicine in Detroit in February 1961. The results were published initially (629) in 1963, and further analysis (630) in 1967. CAUSES AND MOR'rALITY RATE SM8 AGE ESTIMATED per I00000 All Causes 15-24 182 0.77 25-44 1406 2.66 45-64 7136 2.54 65 & over 12069 2.07 All Neoplasms 25-44 435 3.29 45-64 1575 1.78 Malignant Neoplasms: Lung~ Bronchus, Trachea 25-44 185 7.12 45-64 640 1.08 Malignant Neoplasms: Digestive Organs and Peritoneum 25-44 102 3.86 45-64 689 2.33 Asbestosis 25-44 176 45-64 591 Cardiovascular Diseases 25-44 379 45-64 3346 2.5

Asbestos/S~oking Interactions [300 Series| Jan. 31, 1982 183 The above figures asbestos workers from neoplasms, digestive and peritoneal asbestosis, and cardiovascular diseases. findings derived from the cohort consisting of 226 females were as follows (629, 630): (a) Year of Employment. Of the total ~alignancies, The 1265 show the higher ~ortality rates of a11 causes, all ~alignancies, pulmonary pulmonary additional males and 1265 male employees in the 1938-1939 cohort, there were 328 who belonged to the 1939 cohort, of which there were 47 deaths due to all causes, including 2 deaths caused by bronchopulmonary • alignancies. Of the remaining 937 ~ale employees in the 19~ cohort, there were 283 deaths including 31 asbestosis deaths and 33 due to bronchopulmonary ~alignancies. The better survival for those of 1939 cohort could be due tQ the influence of previous employment prior to factory among the 1938 cohort, effectiveness of the industrial 1938 in the same asbestos and also because of the hygienic improvements in subsequent years. These observations on reduction of risk are in agreement with those in Great Britain [Category 350]. (b) Sex Differences. Among males, 42 percent of all malignancies were bronchopulmonary in nature, whereas among females, the bronchopulmonary component was 54 percent.

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 184 (c) Cummulative Exposure. There was a consistent increase in mortality rate in association with ~ore prolonged employment in asbestos industry. The higher ~ortality rate was evident for all forms of cancer in general, and specifically for bronchopulmonary and abdominal malignancies. (d) Competitive Risks. Deaths from asbestosis at earlier ages lessened the number of survivors who may live long enough to meet the requirements of the latent period to develop malignancies. [312] Mortality Pattern Among Asbestos and Cotton Textile Workers The cohort approach developed by Mancuso was applied by Enterline to a comprehensive study initiated _in 1961 by the Division of Occupational Health of the United States Public Health Service. Mortality rates were developed for workers engaged in manufacture of asbestos textiles, asbestos building products and asbestos friction materials. For comparative purposes, mortility rate was obtained for cotton textile workers. The ten asbestos products producers used in the study were selected from a list of 100 employers in the 1959 Edition of County Business Patterns. Death certificates were obtained from death claims filed through December 1963 with the Social

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 185 Security Administration. The total death rates and Standardized Mortality Ratios for 2833 asbestos workers were as follows (631-634): CAUSE OF DEATH NUMBER % OF TOTAL* SMR All causes 286 All cancers 58 Cardiovascular diseases 130 Respiratory diseases 25 Violence 36 Residual causes 37 100% 1.31 20% 2.20 45% 1.18 I0 % 4.39 12% 0.79 13% 1.20 * Percentages calculated by compiler The SMRs for two asbestos-associated forms of cancers for of the four cohorts were as follows: MATERIAL SMR RESPIRATORY SMR DIGESTIVE each Asbestos building products [.30 Asbestos friction materials 1.23 Asbestos textile products 2.29 Cotton textile products 0.31 0.89 1.19 1.46 0.96 The standardized mortality rates (per i00000) for the three groups of asbestos workouts were as follows: MATERIAL (DEATHS/100000) ASBESTOS LUNG CANCER Asbestos building products 8.8 Asbestos friction materials Asbestos textile products 28.6 ASBESTOSIS II.I 23.1 65.5 It should be noted that asbestos textile workers have the highest risk of developing lung cancer and asbestosis compared

Asbestos/Smoking Interactions [300 Series| Jan. 31, 1982 186 to other work groups. overall mortality of percent above that which might be expected based upon experience of the American white population as a whole. Asbestos/Cigarette Smoking Interaction. With regard to influence of cigarette smoking, although the incidence was not known, Enterline had the following comments: "It is Dossible that the increase incidence of respiratory cancer among asbestos products workers is due to an excess in cigarette smoking, and that the low respiratory cancer rates among cotton textile workers is a result smoking at their place of work. needed on this subject and the Not included in the above figures is the asbestos textile workers which is 21 the of restrictions on cigarette Certainly more information is lack of this is a definite It does-seem unlikely, among asbestos product t~eir overall excess in Mortality from asbestosis basis, nor is it a likely weakness in the data presented here. however, that excess cigarette smoking workers could entirely explain mortality noted in this report. could not be explained on this explanation for the apparent excess in cancer of the digestive system" (631). These published comments were made by Enterline in 1965, who was already aware of the 1964 publication of Selikoff et al on asbestos/smoking synergism [Category 320].

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 187 [313] Mortality Pattern Among Retired Asbestos Workers During the early 1970s, Enterline, Decoufle and Henderson reported on the mortality experiences of 1376 men who have comgleted their working lifetime as production or maintenance employees SMRs of (635-638): CAUSE OF DEATH in the asbestos industries. The observed deaths and retirees followed through 1969 were as follows NUMBER % OF TOTAL* SMR All causes 754 All cancer deaths 167 Respiratory cancer 58 Digestive cancer 56 Stroke 61 Heart diseases 326 Respiratory diseases 67 Pneumoconiosis & fibrosis 29 Residual causes 112 100% 1.15 22% 1.51 8% 2.67 7% 1.22 8% 0.79 43% 1.06 9% i. 82 4t *Percentages calculated by compiler The cohort that was represented an average the asbestos industry. subsequently revised to 1973. The revisions were as follows (639-640): CAUSE OF DEATH The results tabulated include death pattern originally observed through 1969 duration of 25 years of employment in above were from 1970 to SMR 1970-1973 SMR 1941-1973 All causes 1.42 1.20 Cancer deaths 1.79 1.59 Respiratory cancer 2.69 2.70 Digestive cancer1.47 1.37 Other cancers 1.46 1.21 Stroke 1.83 0.96

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 188 Heart diseases 0.97 1.06 Respiratory diseases 1.56 1.73 Residual causes0.82 0.92 In addition to the above results, Enterline et al noted that men who worked in the production of asbestos cement pipes exhibited a higher risk of respiratory cancer, as did men with some crocidolite exposure. Men working in general plant main- tenance displayed a striking lack of deaths due to pulmonary fibrosis, as compared with production workers. Lack of Asbestos/Smokin~ Interaction. Smoking his- tories were available for only 373 of the total 1464 retirees, representing 269 production workers and 104 maintenance service workers (635). There was essentially no difference in the smoking habits of the production (77.3 percent smokers) compar- ed with the maintenance service workers (76.9 percent smokers). Although the authors did not comment on the significance of similar smoking incidence, this compiler would like to add that the similar incidence of smoking is in contrast with the higher respiratory cancer mortality rate for asbestos production retirees than maintenance service workers. There is no support for the interaction hypothesis from the mortality pattern of these two groups of retired asbestos workers.

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 189 [320] Asbestos/Cigarette Smoking Synergism Suggested by the Mt. Sinai Hospital Group The published records are straight Mancuso presented the results of cohort workers at a February 1961 meeting of the Academy of Occupation Medicine [Category 310]. The first study from the Mto Sinai Hospital group included data with a cut-off date of December 1962, and the results were presented six months later at the annual meeting of the American Medical Association jointly meeting with the American College of Chest Physicians. The presentation entitled Asbestos Exposure and Neoplasia was published in April 1964 in the JAMA authored by Selikoff, Churg and Hammond. None of them had previously written on asbestos associated diseases, and since Hammond was th~n active in the American Cancer Society-sponsored project on Smoking and Cancer, it was natural that their working hypothesis was that cigarette smoking was a significant factor in asbestos- associated diseases. Although the studies on asbestos/cigarette smoking synergism are the subject of over twenty articles and two mono- graphs by the Mr. Sinai Hospital group, there are surprisingly only three epidemiologic studies. The results of the studies were ~resented in two specially convened meetings sponsored by the New York Academy of Sciences (641, 642) in 1965 and 1979. forward in that study of asbestos

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 190 The meetings were accompanied by widespread publicity in the lay press, such as the article in the New Yorker magazine in 1968, that was the subject of a correction that Selikoff did not initiate the first definitive epidemiologic study on asbestos workers [Category 310]. Selikoff's own monographs (643, 644) did not give any credit to Mancuso who preceded him in reporting essentially similar conclusions on pathogenicity of asbestos. In the field of occupational medicine, Selikoff is regarded as the founder of asbestos-associated diseases, as exemplified by a .1983 textbook [Category 300]. This compiler has hearsay information on the subject but verification is only possible for the events outlined above and no more. [321] Asbestos Insulators in New York City and Newark. The method used in the cohort study reported by Selikoff, Churg and Ha~unond (645) is essentially similar to that used by Mancuso with one exception: instead of Social Security records to obtain death Workers Union in Newark was used. trade before 1943 and were traced through pattern was as follows (645, 646): certificates, the records of the Asbestos the New York metropolitan area including Of 632 insulation workers who entered the 1962, the mortality

Asbestos/Smoking Interactions [300 Seriesl Jan. 31, 1982 191 CAUSE OF DEATH NUMBER % OF TOTAL* SMR* All causes 255 All cancers 95 Cancer of lung and pleura 45 Cancer of stomch, colon & rectum 29 Cancer of all other sites 21 100% 1.25 37% 2.60 18% 6.80 ii% 3.00 8% 1.02 Asbestosis 12 4% *Percentages and SMR calculated by compile~'" It should be noted that the numerical expression of the results shows a striking similarity to those of Mancuso [Category 311] in terms of overall mortality but not in distribution of causes of death. The above shows 37 percent of all deaths as caused byall malignancies, 18 percent by cancer of the lung and pleura, and 8 percent by cancer of the gastro- intestinal system. The respective values in Mancuso's cohort study of males are as follows: 25.7 percent, 10.6 percent and 7.7 percent [Category 311]. Enterline's cohort of asbestos retirees are as follows: 22 percent, 8.percent, and 7 percent [Category 313]. In other words, the death pattern of the New York-Newark cohort is so different from that reported by others. The cohort of insulators from New York and Newark were interviewed as to their smoking habits. Among the 377 survi- vors, 320 gave information which was compared with a sample of men drawn from the general population of 25 states interviewed for the American Cancer Society project. The smoking habits

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 192 of the union sample were "inadequate since it does all of the present living members of the union. it shows that never smoked our analysis smokers" (645). were as follows: AGE GROUP not include Nevertheless, a substantial proportion of asbestos workers cigarettes regularly. Certainly the 632 men in of death rates were not all heavy cigarette The smoking habits of 320 surviving workers ASBESTOS WORKERS GENERAL POPULATION History of cigarette smoking 40 to 49 86.1% 73.7% 50 to 59 79.6% 70.2% 60 to 69 69.7% 60.2% 70 and above 62.7% 39.0% Smoked pipe and cigars 40 to 49 4.6% 7.5% 50 to 59 6.1% 9.9% 60 to 69 10.1% 16.2% 70 and above 11.8% 23.9% Never smoked regularly 40 to 49 9.3% 18.8% 50" to 59 14.3% 19.9% 60 to 69 20.3% 23.6% 70 and above 25.5% 37.1% The above results were not analyzed superficial smokers and insulators in 23 states. statistically but a examination shows that there were more cigarette less never regular smokers among asbestos (all age groups) compared to the general population The compiler cannot help but question why the

Asbestos/Smoklng Interactions [300 Series] Jan. 31, 1982 193 comparison was not made with the population group from the Greater New York area, an information available to Hammond from the ongoing American Cancer Society Project on Smoking and Health. Nevertheless, the authors dismissed the importance of smoking habits in the pathogenesis of asbestos associated diseases by the following process of reasoning: "In the general male population, lung-cancer death rates are about ten times as high among cigar- ette smokers as among nonsmokers; and the death rate from lung cancer increases greatly with the amount of cigarette smoking. However, a large proportion of all men in the United States have a history of regul- ar cigarette smoking. From data in a prospective study on smoking, it may be estimated that if all men smoked a pack or more of cigarettes a day (i.e., if all the nonsmokers, cigar smokers, pipe smokers, and light cigarette smokers had, instead, been heavy cigarette smokers) the lung-cancer death rate would be approximately 3.4 times as high as it is _at this time. From this we may conclude that even if all our asbestos workers had smoked a pack or more of cigar- ettes a day (and, indeed, from our sample we know they did not), and if exposure to asbestos were of no significance, then their lung cancer death rate would have been about 3.4 times as high as the rate in the general US male population. Clearly, the smoking habits of the asbestos workers cannot account for the fact that their lung-cancer death rate was 6.8 times as high as that of white males in the general population." (645) [322] Revision of Importance of Cigarette Smoking Among Asbestos Insulators in New York City and Newark

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 194 The extension of observed deaths from January i, 1963 to April 30, 1967 resulted in a surprising announcement that asbestos workers who smoke have about "92 times" the risk of dying of bronchogenic carcinoma as men who neither work with asbestos nor smoke cigarettes (647). During this three year period, it should be recalled that the results of the American Cancer Society project were being highlighted in the Surgeon General's Reports released in 1964 and 1967. The observed number of deaths and SMRs based on mortality statistics for the entire country (instead of Greater New York City only) were as follows: CAUSE OF DEATH NUMBER % OF TOTAL* SMR* All deaths 94 All cancers 49 All bronchopulmonary cancers 27 Bronchogenic carcinoma 24 Pleural mesothelioma 3 Peritoneal mesothelioma 7 Cancer of stomach 3 Cancer of colon & rectum 5 Cancer of all other sites 7 Pulmonary asbestosis 15 Heart & circulatory diseases including stroke 22 Residual causes " 8 100% 1.98 52% 5.70 29% -ii. 7 26% ... 3% ... 7% 3, ";ioo 5% 4.17 7% 1.55 16% ... 23% 0.77 8% 0.77 *Percentages and SMRs calculated by compiler The about by to asbestos increased risk of bronchogenic carcinoma brought the combined effect of cigarette smoking and exposure dust was estimated by Selikoff et al in the

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 195 following manner: asbestos workers who from American Cancer number of cigarette Greater New York area. estimated never Society smokers This interpolation indicated expected death rates for non- smoked regularly (based upon data Project) were applied to the for asbestos insulators in the that only 0.26 of the general population would have been expected to die of bronchogenic carcinoma if they had never smoked regularly and had never been occupationally exposed to asbestos dust. "Since 24 of them actually died of this cause, the ratio of observed to expected deaths is 92 to I, i.e., 24 divided by 0.26 = 92. This appears to indicate that cigarette smoking plus occupational exposure to asbestos dust increases the risk of bronchogenic carcinoma by a factor in the order of of 92 to i" (647). The 92-fold increase in risk associated with smoking asbestos several international meetings: Biological Effects of Asbestos Asbestos and Cancer (649, 650) and the Pathology of Asbestos that although the New York-Newark cohort was followed up until December 31, 1971, there was no revision of the 92-fold magnitude of bronchogenic carcinoma workers was emphasized in International Conference of (648), UICC Working Group on International Symposium on It is important to recognize

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 196 estimation of increased risk based on death records collected until the end of 1967. [323] Asbestos Insulators in the United States and Canada In 1967, Selikoff et al expanded their asbestos insulators of New York-Newark membership in the United States and Canada the 17800 workers investigated, 9590 smokers (54%), 2066 denied cigarette smoking history was not known for publication describing these results, stated that they were "presently unable to calculate smoking- specific expected rates for this group (New York-Newark cohort) since death rates related to smoking are not yet available for the period 1967-1971" (650). Yet, they had done so for the pe#iod of 1963-1967 which was the basis for 92 times increase (641). For the cohort of 17800 insulators, Hammond and Selikoff hesitated making an estimate. "Again, we are at this time unable to calculate smoking-specific expected and observed rates because as noted, death rates related to smoking habits of individuals are unavailable for this period of years 1967-1971" (650). cohort study of area to include (649-651). Among were regular cigarette smoking (12%) and the 6144 (34%). In the 1973 Hammond and Selikoff

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 197 By 1976, Selikoff (651) recalled the 92 times increase in risk of cigarette smoking asbestos workers which was based on interpolation of results of American Cancer Society Project and referred to the larger asbestos insulators cohort as follows: "the cigarette smoking-asbestos interaction has been confirmed in a larger study" referring to the 1973 publication of Hammond and Selikoff (650), which is not so. The long anticipated synergism figure estimated from the asbestos insulators in the United Sates and Canada (January 1967 through December 1976) was announced at a 1979 meeting of the New York Academy of Sciences (652). After several steps of interpolation again with the results of the American Cancer Society Project to derive expected death rates, the following figures were offered for "mortality rates": asbestos no; cigarette smoking no = 1.00 asbestos yes; cigarette smoking no = 5.17 asbestos no; cigarette smokng yes = 10.85 asbestos yes; cigarette smoking yes = 53.24 Note that the increased risk has been downgraded from 92 announced in 1968 to 53.24 announced in 1979. The phenomenon formulated by the death rate per of synergism rather than additive was following reasoning based on estimates of i00000 man-years. "Now suppose that

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 198 occupational exposure to asbestos dust among cigarette acted independently in respect to the production cancer. In that event, the lung cancer death rate of smoking of lung asbestos workers with a history of cigarette smoking should be very close to the sum of the following numbers: 1.3 ("no, no" group), 47.1 (mortality difference for the "yes, no" group) and 11.3 (the mortality difference for the "no, yes" group). The sum comes to 169.7 lung cancer deaths per 100000 man-years which is a reasonable estimate of what the lung cancer death rate of the asbestos workers with a history of cigarette smoking would have been if there had been no synergistic effect of the combined exposure. In contrast, the observed lung cancer death rate of the "yes, yes" group was 601.6 per i00000 man years. The difference (601.6 - 169.7) = 431.9 lung cancer deaths per i00000 man years was presumably due to a synergistic effect in men with both of the two types of exposure (yes asbestos dust and yes cigarette smoking) (652). In the same meeting, Frank (653) also from the Mr. Sinai Hospital group, reported a different set of mortality ratios for lung cancer. Instead of the 1.00; 5.17; 10.85 and 53.24 by Hammond et al (652), the following ratios were presented by Frank: 1.00; 7.10; 10.85; and 61.40. There is no explanation for the differences in ratios derived from the same data base

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 199 and published in the same volume of the Annals of Academy of Sciences. The final group of mortality ratios from the 17800 workers relate to causes of death derived certificates or best available medical asbestos insulation either from death evidence (654, 655). CAUSE OF DEATH New York NUMBER % OF OF DEATHS TOTAL* RATIO OBSERVED/EXPECTED BEST DEATH EVIDENCE CERTIFICATR All causes All cancers Cancer of lung Pleural mesothelioma Peritoneal mesothelioma Cancer of esophgus Cancer of stomach Cancer of colon, rectum Cancer of larynx Cancer of pharynx, buccal Cancer of kidney All other cancer Noninfectious pulmonary As~estosis Residual causes *Percentages calculated figure used. 2271 100.0% 1.37 1.37 995 43.8% 3.11 2.88 486 21.4% 4.60 4.06 63 2.8% ...... 112 4.9% 18 0.8% 22 1.0% 1.s41.26 s9 2.6% lz o.s% 2.34 1.9l 2l 1.0% 2.08 l.S9 z9 0.8% 2.36 2.23 104 8.1% z.40 l.gl 168 7.8% 1064 46.8% by compiler; best medical evidence Once more, it should be noted that the mortality pattern for cohort of 17800 asbestos insulators is different from those reported by others [Categories 310s, 330s].

Asbestos/SmOking Interactions [300 Series] Jan. 31, 1982 200 [324] AmOsite Asbestos Factory Workers The third epidemiologic study conducted by the Mt. Hospital group consisted of 933 amosite asbestos workers who began work from June 1941 through December Sinai factory 1945. Twenty years later (1961-1965) 582 were known to be alive. The conclusions were essentially similar to those seen with asbes- tos insulators (656-658). The increase in risk for developing lung cancer was 80 times based on the following calculation: 55 observed deaths divided by 0.? expected. other than the reported at the different from [330] Mortality Pattern of Asbestos Workers Reported by Other American E~idemiologists It is important to recall the results of epidemiologists Mt. Sinai Hospital group because they were same time. The mortality patterns are so that reported by the Mr. Sinai Hospital group that the conclusions of Selikoff et al need not apply to the cohorts used by others. It follows that the asbestos/smoking synergism refers only to the asbestos insulators and the volun- teer subjects of the American Cancer Society Project, unless there is proof that other investigators have also demonstrated that the phenomenon occurs for textile workers, plumbers, boiler makers, and cement pipe manufacturers who did not belong to the American Union of Insulators.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 201 [331] Asbestos Insulators in the Cincinnati area. In 1966, Keane and Zavon from the Kettering Laboratory of the University of Cincinnati cited the unpublished results of Hutchinson, Kuntz, Taylor, Williams and Gruber who essentially followed Selikoff's approach but instead used the Asbestos Insulators Union members of the Cincinnati area (659). Their mortality pattern as well as that for the New York-Newark area were as follows: CAUSE OF DEATH CINCINNATI NEW YORK-NEWARK (% OF ALL DEATHS) AREA % AREA % All malignant neoplasms Lung carcinoma Colon carcinoma 24.2% 37.0% 9.1% 17.6% 6.1% 11.4% The above results show the almost two-fold differences in carcinoma deaths between the two areas. The validity of the United States and Canada approach to include all union members used by Hammond and Selikoff (652) may be questioned because such differences among geographic areas are suppressed. The above differences .. have not been discussed by Selikoff possibly because the information is not readily noticable. [322] Asbestos Workers Reported by Epidemiologists of New York Department of Labor

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 204 Beaumont and Weiss (664) reported the mortality experience of 8679 members of a metal trade union from 1950 to 1976. The union represented workers in metal fabrication shops, field construction, small boatyards and shipyards. Respiratory cancer was in excess, with an overall increase of 31 percent over expected rate. In excluding cigarette smoking as an explanation for the increased risk, the authors reasoned that "emphysema which is also caused by smoking occurred at a normal rate (9 observed versus 9.8 expected). Three studies have shown that welders may smoke cigarettes more than other occupational groups and the nation as a whole; it has not been established whether this is true for boilermakers Local 104 welders, however" (664). Asbestos dust exposure remained as the most probable cause for increased risk df respiratory cancer. [335] Asbestos Cement Workers Reported by Tulane University Epidemiologists Hughes and Weill (665) examined a cohort of 5645 male workers in a Louisiana asbestos cement factory that opened in the 1920s and is in continuous operation during the 1980s. The SMRs for respiratory neoplasms were highest for exposures exceeding 100 milllon particles per cubic feet times years.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 205 Like other epidemiologists mentioned under cigarette smoking habits were not determined repeated emphasis of the interaction phenomenon prior to the initiation of the cohort studies. Categories 330s, inspire of by Selikoff [336] Asbestos Textile, Friction and Packing Products Workers Reported by NIOSH Epidemiologists Robinson et al (666), in a study among a group of 3276 textile, friction and packing products workers exposed to predominantly chrysotile asbestos, demonstrated the following: excess risk for nonmalignant respiratory diseases, suicide, heart disease, bronchogenic cancer and mesothelioma of the pleura and peritoneum among males; among females, there was an excess risk for nonmalignant respiratory disease, - bronchogenic carcinoma and mesothelioma of the pleura and peritoneum. There was no information on smoking habits. [337] American Asbestos Textile Workers Reported by Canadian Epidemiolog~sts McDonald Institute of cohorts from States: two and Fry (667) from the Canadian Research Occupational Health, reported death pattern of three manufacturing companies in the United asbestos textile factories where only chyrsotile

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 206 was processed, and a third and crocidolite were used. were included. Their analysis that amphiboles were mainly whereas chrysotile had little factory where chrysotile, amosite A total of 10763 men and 3118 women of death certificates showed responsible for mesothelioma or no mesothelioma producing potential. All forms of asbestos contributed to an increase in respiratory cancer deaths. The interaction hypothesis of Selikoff was not mentioned in the publication. [338] Shipyard Workers in the Atlantic and Pacific Coasts Like Hammond who had. concluded that "cigarette smoking causes bronchogenic carcinoma" before embarking on asbestos research, Fraumeni had also arrived at the same conclusion (668, 669) prior to conducting a case-control study of asbestos exposure among shipyard workers (670-676). The National Cancer Institute sponsored Atlantic coast where prominent, namely: study involved four areas along the the shipbuilding industry has been (a) Coastal Georgia 1057 subjects of which 21 percent were employed in shipyards; (b) Jacksonville, Florida 789 subjects, 22 percent; (c) Tidewater, Virgina 641 subjects, 33 percent; and (d) Bath, Maine 64 subjects, 67 percent. In each survey, the lung cancer patients and controls (or their next of kin) were matched for age, sex, race, source

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 207 of ascertainment (hospital or status. The patients and information on occupational and death certificate) and vital controls were interviewed for smoking histories. Combining data from over 2500 interviews in the four areas, Blot and Fraumeni concluded that the relative risk of lung cancer associated with employment in shipbuilding, adjusted for cigarette smoking, was 1.44. In the combined data set, the increased risk of lung cancer among shipyard workers was seen in nearly all cigarette categories (676): RELATIVE RISK OF LUNG CANCER EMPLOYMENT IN SHIPYARDS FOR CIGARETTE SMOKING STATUS NO YES Nonsmokers 1.0 Former smokers 3.7 Light smokers (0.5 pack/day) 4.8 Moderate smokers (0.5 to 1.5 pack/day) 7.2 Heavy smokers (2 plus packs/day) 10.3 2.2 3.0 5.2 i0.2 21.7 It should be noted that the highest value is 21.7 in contrast to Selikoff's value of 92. There are other epidemiologic studies reported from Louisiana (677), Maine ((678), California (679-681) and Hawaii (682, 683). Selikoff et al (684) reviewed the literature on asbestos exposure of shipyard workers without reference to the fact that most investigators have not mentioned smoking habits as a contributory factor in causation of lung cancer.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 208 [339] Asbestos Miners and Millers in New York and South Dakota The last group of mortality statistics relates to the following cohorts: talc miners and millers in New York State (685) and hard rock gold miners in South Dakota (686-688). There are interaction. the United American miners are less relevant asbestos used in the United States. no observations relating to asbestos/smoking Furthermore, most of the asbestos fibers used in States are mined in Canada so that the results on to the primary form of [340] Canadian Epidemioloqic Studies In 1965, shortly after the appearance of Selikoff's arti- cle on mortality pattern of asbestos insulators including the r31e of their smoking habits in the pathogenesisl, of asbestos associated diseases (645), an Editorial appeared in the Canad- ian Medical Association Journal (689) that completely ignored the American publication. The first report of mortality pat- tern of chrysotile asbestos miners and millers appeared in 1971 which showed no excess deaths from respiratory cancer (690). The authors, McDonald et al, concluded that their findings sug- gest either that chrysotile is less likely to cause respiratory cancer than other forms of asbestos among the Canadian cohort, or that additional exposure factors must be involved in the

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 209 group of American insulation workers. McDonald was reminded by Braun and De Treville (691) that the findings and conclusions relating to Canadian miners and millers confirm those of the 1958 study by Braun and Traun that the hazards of respiratory cancer in the asbestos industry overall have been of modest proportions. In subsequent publications, McDonald et al reversed their position and instead described a definite increase in risk of respiratory cancer that was related to cigarette smoking (692-697). Four cQntrol subjects were selected for each asbestos associated death from respiratory cancer, all born in the same year as the asbestos miner, but surviving into the year after the asbestos miner's death. One control subject was matched as closely as possible for smoking habits. Analysis of the case-control data indicated a "multiplication model" of risk for the combined effects of asbestos dust and smoking. Results obtained by man-year analysis pointed to the same conclusion (694, 696). Other investigators, both Canadians and non-Canadians have conducted additional studies: insulation workers from Quebec (698); workers in Ontario who received compensation for asbestosis and subsequently died (699); chrysotile miners and millers from Thetford mines (700); and Quebec registry deaths from occupational cancer (701, 702). Although Selikoff co-

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 210 authored the study of Thetford miners. Information on smoking habits was not included (700). In the group of compensated workers (699), 15 percent were never smokers, and the proportion of current and exsmokers were almost equal at about 42 percent. Of the 9 men who died of mesothelioma, 2 never smoked, as were 4 of the 22 men who died of nonmalignant respiratory disease. It was also noted by Finkelstein et al that all who died of lung cancer had smoked cigarettes (699). From 1979 to 1980, the Canadian Medical Journal published an Editorial and letters to the editor relating to the asbestos/smoking interaction (703-705). [350] British Epidemiolo~ic Studies Among English physicians interested in medicine, Sir Richard Doll is regarded as occupational the pioneer epidemiologist who showed the association between asbestos dust exposure and the development of lung cancer. His 1955 study consisted of a qohort of I13 men who had worked for at least 20 years in factories where they were asbestos dust (706). Their ~,ortalLty that which would have been expected liable to be exposed to pattern compared with on the basis of the revealed the 39 deaths observed whereas 15.4 expected (S~tR 2.5); mortality experience of the whole male population following:

Asbestos/S~oking Interactions [300 Seri~s] Jan. 31, 1982 211 11 lung cancer deaths 13.75); 22 respiratory whereas 7.6 expected (SMR 1955, Sir Richard Doll observed w~ereas 0.8 expected (S~q and cardiovascular deaths observed 2.9). From the data reported in concluded that lung cancer was a specific industrial hazard of certain asbestos workers and that the average risk among those employed for 20 or more years has been of the order of 10 times that experienced by the general population. The Editorial that shortly appeared in the Lancet (707) questioned the causative suggestion because pathogenic dust in general, including asbestos, act on connective tissues and there was no satisfactory explanation of why asbestos fibers should affect the epithelium as well. At about the same ti~e, Sir Richard Doll was conducting another epidemiologic study on smoking habits of British physicians and reported that heavy smoking was associated with the high incidence of lung cancer. It is interesting to note that in his post-1955 publications on occupational cancer (708-710), the asbestos/smoking interaction was not nmntioned until in his lecture at the 12th Internation- al Cancer Congress held in 1978. He cited the mortality rates of American and Canadian insulation workers reported by Selikoff and Hammond in 1975. For an explanation, "it is conceivable that asbestos fibers exert their efffect by the

Asbestos/Smoking I,teractions [300 Series] Jan. 31, 1982 212 physical absorption of cigarette tar, but they can certainly cause mesothelioma in nonsmokers and it seems more likely that both factors are independently capable of causing cancer and act synergistically when present together" (711). It is significant to note that almost all subsequent epidemiologic studies conducted in England, Wales, Ireland and Scotland were not designed to determine the role of cigarette smoking, probably because most British investigators did not believe in the synergism phenomenon until the late 1970s. The British investigators and the cohort group of asbestos workers were as follows: EPIDEMIOLOGISTS NATURE OF ASBESTOS DUST EXPOSURE (706) Doll 1955 (712) Hill et al 1966 (713) Knox et al 1968 (714) Newhouse & Wagner 1969 (715) Newhouse 1970 {716) Berry et al 1972 (717) Newhouse 1973 (718) Newhouse & Berry 1979 {719) Fox et ai.1974 (720) Jones et al 1976 (721) Jones et al 1980 (722) Wignall & Fox 1982 (723) Berry et al 1977 (724) Berry & Lewinsohn 1979 (725) Berry 1981 (726) Peto 1980 asbestos textile workers (London) asbestos workers (London) cigarette smoking interaction cablemaking & rubber (London) cigarette smoking interaction gas mask assemblers (London) asbestos workers (Penarth) asbestos textile workers (Oxford)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 213 (727) Thomas et al 1982 asbestos cement workers (Cardiff) (728) Elwood et al 1964 asbestos workers (South Wales) (729) Finlayson et al 1971 relatives of asbestos workers (Dundee) (730) Chatterjee et al 1978 fluorspar miners (Dundee) cigarette smoking interaction (731) Sheers & Templeton 1968 dockyard workers (Plymouth) (732) Harries 1968 (733) Harries 1976 (734) Lumley 1976 (735) Rossiter & Coles 1980 dockyard workers (Devonport) (736) Elmes 1966 (737) Elmes & Simpsonf968 (738) Elmes & Simpson 1971 (739) Elmes & Simpson 1977 (740) Elmes 1977 (741) E1mes 1978 (742) E1mes 1980 insulation workers (Belfast) cigarette smoking interaction Asbestos/Cigarette Smokin~ Interaction. In the study of cablemakers, Fox et al (719) analyzed their data to determine whether the excess mortality was due to regional differences or to the population comprising an abnormally high proportion of smokers. No excesses were found in smoking- associated diseases. The authors concluded that although the effects of differences in smoking habit cannot be ruled out, the indications are against this factor being the primary cause. A similar conclusion was arrived at by Chatterjee et

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 214 in their study of fluorspar miners (730). In the epidemiologic study of insulation workers, Elmes concluded that there were too few nonsmokers to allow any determination of the significance of cigarette smoking (738). Berry, Newhouse and their collaborators (714-718) are the only English investigators who conducted their study designed to determine the combined effect of asbestos exposure and cigarette smoking on lung cancer mortality in factory workers (716). Although the data showed excess deaths for smokers who were severely exposed to asbestos dust, the investigators contend that "additional followup time is needed to obtain valid results". The authors also questioned the "reliability of information about smoking habits obtained in different ways for the deceased and the survivors". In a 19~9 publication, Newhouse and Berry stated that "a prospective survey of mortality is now in progress. Only 28 deaths from lung cancer had occurred .... Two of the lung cancer deaths occurred in workers who had never smoked. There are insufficient data to analyze in more...detail but the results are consistent with our earlier findings that asbestos and smoking appear to combine mutiplicatively in producing lung cancer. F~rm conclusions must, however, await the accumulation of more data" (718).

Asbestos/Smoking Interactions [300 Series] Jan. 31:1982 215 [360] Scandinavian Epidemioloqic Studies In 1955, Ringertz reviewed environmental factors in It is pertinent to recall already regarded asbestos the role of smoking and the causation of lung cancer (743). that this Swedish scientist had exposure as a form of "occupational lung cancer in the strict sense" and as a "suspected cause of questioned the validity of smokers are over-represented. classified tobacco smoke lung cancer". At that time he epidemiologic studies in which Although he did not conceive any form of interaction, the criticism is still applicable to asbestos workers who are mostly cigarette smokers. So far there are no epidemiologic studies of asbestos workers reported from Sweden. This is unusual for a country that has a very active group of environmental and occupational medical scientists. The probable reasons can be perceived from recent articles on the ethics of prospective study (744), limitations of a cancer-environmental exposure registry (745), questionable usefulness of regional cancer case registry (746), and drawbacks of case-control study (747). Neverthe- less, the epidemiologic studies among uranium mineworkers revealed unexpected results: there were more nonsmokers in lung cancer cases than control miners (748, 749). In a recent conference on cigarette smoking and occupational health, this

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 216 subject was discussed, as smoking The risk highest well as the effects of cigarette only (750) and the asbestos/smoking interaction (751). ratios presented at the meeting ranged from the figure of 91 (proposed by Selikoff) to the lowest value obtained by Finnish investigators discussed below. The difference between the two groups of ratios is that Selikoff proposed the following: 1.0, 4, II and 91 [Category 322] whereas Meurman arrived at smaller numbers: 1.0, 1.4, 12 and 17. In other words, there is a five fold difference for the relative risk of smokers and asbestos workers compared to non-asbestos and non-smoking controls. The reason for the diversity has not been explained by the proponents of the interaction hypothesis. Meurman et al conducted their study in a group of employees of anthophyllite mines (752m754), unlike Selikoff who examined asbestos insulators. Yet in Finla,d, the mortality pattern of miners is similar to asbestos workers in general (755-759). This compiler has concluded that results of epidemiologic studies refer only to the cohort group and respective controls. The interaction hypothesis cannot be applied to other groups and the five fold difference noted between the Mt Sinai Hospital and Finnish groups clearly supports the compiler's conclusion.

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 217 [370] Western European Epidemiolo~ic Studies The studies from Austria, Belgium, France, Germany, Italy, S~ain and Switzerland do not include data on smoking habits. Although the results are not su~narized below, they are readily accessible to support the premise that the synergism hypothesis proposed by the Americans (Selikoff) and seconded by the British (Newhouse and Berry) and Finnish (Meurman) epidemiologists do not necessarily apply to Western European asbestos workers who have varied mortality patterns: EPIDEMIOLOGIST NATURE OF ASBESTOS DUST EXPOSURE (760) Haider & Neuberger 1980 asbestos cement workers (Austria) (761) Lacquer et al 1980 (762) Avril & Champeix 1970 (763) Molina & Cheminat 1978 (764) Bignon et al 1976 (765) Anspach 1968 (766) Hain et al 1975 (767) Versen 1980 (768) Woitowitz et al 1981 (769) Vigliani et al 1968 (770) Puntoni et al 1979 (771) Lopez-Areal del Amo 1980 (772) Maillard 1982 asbestos cement workers (Belgium) asbestos workers (France) asbestos textile workers (France) asbestos workers (France) asbestos workers ~East Germany) asbestos textile workers (West Germany) asbestos workers (West Germany) asbestos workers (West Germany) asbestos workers (Italy) shipyard workers (Italy) asbestos workers (Spain) asbestos workers (Switzerland)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 218 [380] Eastern Europeanr Middle Eastern and Far Eastern Epidemiolo~ic Studies It should be recognized expensive to conduct, and Health Project financed by the large scale study conducted possible. studies number. reports that epidemiologic studies are if it were not for the Smoking and American Cancer Society, the b7 Hammond would not have been It is therefore not surprising that epidemiologic in Eastern Europe, Middle Eas~ and Asia are minimal in The least expensive investigations in the form of case are abundant in these countries and are discussed in detail under disease categories 400s, 500s and 600s. South Africa, although not represented in the tabulated data below, has scientists who were responsible for indentifying the causal relationship between a~bestos dust and mesothelioma based primarily on autopsy and clinical material [Categories400s|. INVESTIGATORS NATURE OF ASBESTOS WORK EXPOSURE Eastern Europe and Middle East (773) Dobreva et al 1979 asbestos textile workers (Bulgaria) ... (774) Suntych et al 1970 asbestos workers (Czechoslovakia) (775) Kogan 1968 (776) Kogan 1975 (777) Kogan 1981 (778) Kurova et al 1982 asbestos miners and (Russia) asbestos cement workers workers (779) Djerassi et al 1979 asbestos cement workers (Israel)

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 Eastern Hemisphere (780) Sera & Kang 1981 (781) Hobbs et al 1978 (782) Hobbs et al 1980 asbestos workers (Japan) crocidolite m/ners (Australia) [390] Limitations and Consequences of Epidemiolo~ic Studies Supportin~ the Aqbestos/Ci~arette Smoking Interaction Hypothesis The preceding review of the literature on mortality pattern of asbestos miners, millers and processors show a separation of authors into three groups: First: Epidemiologists who, like Mancuso [Category 311], appreciated the limitations of the cohort approach and felt that occupational risk could only be estimated and not the role of personal habits such as cigarette smoking. A majority of investigators in the United States [Categories 330s], Canada (Category 340], Great Britain [Category 350] and Scandinavia [Category 360] belong to this group of non-proponents. All reported studies in Western Europe [Category 370], Eastern Europe and the countries of the Eastern Hemisphere [Category 380] do not include information on smoking habits. Second: Epidemiologists, who prior to conducting the cohort study, were already preoccupied with the concept that

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 220 "cigarette smoking causes the same diseases associated with asbestos', proceeded to conduct the study and concluded that indeed there is an interaction between both inhalants. Hammond and Selikoff [Category 320] and Fraumeni [Category 338] are prime examples from other countries who interaction results the United States. Investigators from were probably encouraged by the positive of Hammond and Selikoff and became proponents of the interaction hypothesis include: McDonald from Canada [Category 340], Berry and Newhouse from England [Category 350] and Meurman from Scandinavia [Category 360]. Third: Epidemiologists who examined the role of smoking habits and concluded that there was no evidence of interaction. This non-proponent group includes Enterline [Categories 312 and 313], Beaumont and Weiss [Category 334], Finkelstein et al [Category 340], Fox et al and Chatterjee et al [Category 350]. A Fourth group needs to be added "observers" who asbestos/cigarette have not smoking the to account for conducted original studies on interaction but have become editor of a textbook [Category 300] proponents. Rom, belongs to this group and there are more scientists that are cited in the remainder of this report. For example, Gilson, a clinician from the Pneumoconiosis Unit at Glamorgan (Wales) has

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 221 not conducted results of Selikoff and Hammond with other than to mention that "there are few workers with long exposure" to allow asbestos exposure alone (783-788). an epidemiologic study but has accepted the hardly any criticism, nonsmoking asbestos estimation of risk to The remaining discussion that follows include additional examples of "observers" as well as this compiler's perception of the unexpected consequences of asbestos/smoking hypothesis, a topic that is also discussed in "Some Epidemiologic Issues for the 1980s" by Greenhouse (387). [391] American Cancer Society Project on Smoking and Health This compiler had agreed with the opinion of some asbes- tos scientists that the American Cancer Society P~oject was the "foundation that is responsible" for the interaction hypothesis introduced by Selikoff and Hammond. In examining the 1979 Surgeon General's Report: Chapter on Occupational Diseases (788), as well as publications by Hammond, Selikoff, Hoffman and Wynder (789-794), this compiler and supposedly other readers cannot immediately find a supportive statement of the importance of the American Cancer Society Project for both the s~oking and 'health controversy, and the formulation of the asbestos/smoking interaction hypothesis. However, the

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 222 importance of the data derived from the Project is clearly mentioned separately in the articles on smoking and asbestos by Selikoff et al [Category 323] and the articles on smoking and health by Hammond and others. [392] Limitations of Cohort Approach The intended readers of this report are undoubtedly familiar with the questionable role of epidemiologic studies in proving the causal relationship between cigarette disease. The same criticisms apply hypothesis and will not be asbestos dust alone is epidemiologic techniques to the repeated here. That pathogenic has not alone (such as the smoking and interaction exposure to been proven by one used by Selikoff and Hoffman) but by a combination of epi~emiologic and non-epidemiologic techniques (795). Not all epidemiologists recognize this. Enterline reviewed most pertinent studies to determine acceptable and non-hazardous exposure levels to asbestos dust without commenting on the interaction hypothesis (796-799). Wagner, a pathologist from Glamorgan, also reviewed the epidemiologic studies from the standpoint of preventing asbestos related cancers (800-803) and dismissed the interaction hypothesis by stating that "more research is needed to show at what level of asbestos exposure a detectable increase of risk due to the two factors together occur" (800).

Asbestos/Smoking Interactions [300 Series| Jan. 31, 1982 223 [393] Published Criticisms of Asbestos/Cigarette Smoking Interaction Hypothesis Statements critical of the studies of Selikoff et al and other proponents of the interaction hypothesis have ~een difficult to find. A partial and incomplete list follows: Nature of Control Group. Knox, a coworker of Sir Richard Doll in the initial e2idemiologic study of asbestos workers in England, wrote Gross and the letter was reproduced by De Treville in the May 1968 issue of Industrial Hygiene Digest: "The suggested synergism with cigarette smoking may or may not be proved in the paper but synergism with other materials is certainly a possibility. How far are the comparisons of mortality of the insulat- ing group with that of the general white population of the U.S. valid? I had thought that,_even in a small country like ours, there were differences between the lung cancer mortality of urban and rural dwellers. Surely in a large country like the U.S. these differences would be more marked, and there are comparatively large groups, like Seventh Day Advent- ists, who are non-smokers. New York and New Jersey are heavily industrialized and polluted areas. Would not the basis of comparison have been more realistic if averages for large industrial conurbations had been used? Some 283 insulation workers had a cigar- ette smoking history and stated mortality in relation to their occupation and smoking habits, whereas 87 insulation workers had a different mortality experience. In view of the dispartiy in the numbers concerned are we justified in regarding these are truly comparative groups? There were no non-smokers in the group of 87 workers: 48 never smoked regularly and 39 had smoked pipes or cigars, but never smoked

Asbestos/S~oking Interactions [300 Series] Jan. 31, 1982 224 cigarettes regularly. This is a large proportion and I wonder if there is a problem here in view of the much lower necropsy rate in the 'expected' group. The statement that 'once exposure was reduced by improved industrial hygiene practice early deaths from asbestosis diminished and lung cancer became common', was not our experience in Rochdale - rather the reverse. The figures presented from the Rochdale Factory show that independent of smoking habits, which have remained substantially the same in the cohorts examined, there has been an improved mortal- ity experience and a reduction in the incidence of lung cancer. While there may be some substance in the findings of this paper in relation to asbestos exposure, smoking, and neoplasia, I think it is not as great as these figures would have us believe. There are some statements made which seem slightly contradictory. We read that 'exposure to asbestos dust does not increase the risk of bronchogenic cancer among men who never smoked regularly ... we only conclude that exposure to asbestos dust (variety unspecified) does not greatly increase the risk of bronchogenic carcinoma among men who never smoke cigarettes regularly' For comparison 'this finding, being based upon the e~perience of only 87 men does not prove that asbestos dust (variety unspecified) has no influence on the risk of lung cancer among non-smokers. However, it suggests that exposure to asbestos dust does not lead to an extremely high rate of lung cancer among non-smokers". (804) The above remarks, although directed against the 1968 publication of .Selikoff (647) can properly be directed against all subsequent publications of the Mt. Sinai Hospital group [Categories 322, 323 and 324].

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 225 (b) Tabulated Smoking Data. 1973 presentation by Hammond following manner: Morgan, commented on the and Selikoff (650) in the "Unfortunately, time did not permit detailed discussion of the paper by Drs. Hammond and. Selikoff. After the session, however, there was some comment on the data given in Table 5 of this paper for the expected death rates due to lung cancer. As the authors state in the text, values for the smoking specific death rates for individuals in the general population, were not available for the period under review at the time of the writing. As the expected death, rates in Tables 2 and 5 disregard smoking habits the data in these tables should be interpreted with caution." (805) A similar inconsistency was perceived by this compiler and discussed under Categories 322 and 323. (c) Selection of Union Members. Weiss, also after listening to the same 1973 presentation by Hammond and Selikoff (650) made the following comments: "An important limitation in the study of New York insulation workers was that only those workers belonging ..to a trade union were included. In Devonport (UK) all dockyard workers are being studied prospectively to establish cause of death and, where possible, to relate this to the degree of asbestos exposure." (806)

Asbestos/Smoking Interactions [300 Series].Jan. 31, 1982 226 (d) Limited Number of Nonsmokers. At a 1979 meeting on Dust Diseases, Selikoff made these comments relating to his own results: "If I might take my chairman's prerogative, I would say that we are very uneasy about retrospective smoking histories from hospital records or other post-death sources. The question of lung cancers among non-smoking asbestos workers is not resolved by the female experience in your population. "With regard to non-smoking asbestos workers, we found an increase. We have been following 2,066 non- smoking asbestos workers during this 10-year period, prospectively. There is an increase among them, com- pared to non-smoking individuals in the population as a whole. But since the rates for non-smokers in the general population are so low, even increasing them three times or four times still does not constitute a major problem. If we had no smoking among asbestos workers, we would not have all that much lung cancer. We would have more than expected, but, we wouldn't have the difficulties that we have at present" (807). ( e ) Relative Contributions of Asbestos and Ciqarette Smoking. Poole from the Environmental Protection Agency, commented at the 1980 Annual Meeting of the American Public Health Association : The i~.teraction between cigarette smoking and asbestos exposure in elevating lung cancer risk ~s well known, but increased lung cancer risk among nonsmoking asbestos workers has been shown only recently. Previous conclusions that this risk was increased only in smokers were made without adequate attention to the statistical power of an early study. Caution should be exercised in examining the latest results for information on the relative contributions of smoking and asbestos to. lung cancer risk, the necessary temporal sequence of exposure, and the

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 227 implications of the observed interaction for theories of carcinogenic processes. Studies of asbestosis lead to a general consensus that smoking increases risk, but no study includes a group of smokers not exposed to asbestos to allow for the polyvalent nature of the diagnostic signs of asbestosis. A firm conclusion that there is no difference in the risk of pleural mesothelioma between smokers and nonsmokers exposed to asbestos should be avoided because the current data are not persuasive. High mortality rates for several causes of death in a small group of asbestos workers who smoked only pipes and/or cigars are worthy of note" (808). [394] Inconsistencies in Numerical Estimates Saracci, an epidemiologist from the for Research on Cancer (Lyon, France) nature of interaction between asbestos cigarette smoking (809-811). It should International Agency has commented on the dust exposure and be recognized that Saracci did not include smoking habits in the studies of 20000 asbestos workers, on behalf of the Joint European Medical Research Board (812). On the other hand, Elmes who had been conducting epidemiologic studies that included smoking habits, wrote a 1981 review on the subject as it relates to most occupational lung diseases, including asbestos-associated malignancies. He concluded the discussion on asbestos exposure as follows: "the lack of adequate numbers in the nonsmoking groups means that this conclusion (multiplicative) can only be tentative" (813). Lemen, Dement and Wagner (the latter from

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 228 the Environmental Defense Fund and all are "observers") also reviewed the literature on interaction and concluded that "it is important to note that the historic decumentation of cigar- ette consumption patterns is lacking for most retrospective cohort studies of asbestos workers. It is further important to note that a sizable ~ortion of the general population, the group usually selected for comparison in these studies, are cigarette smokers. Therefore the risk of lung cancer demons- trated for these industrial groups exposed to asbestos is of such magnitude as to preclude the identification of an independent etiologic role for cigarette smoking" (814). The above mentioned articles are lengthy in their consideration of interaction hypothesis. If requested, this compiler can discuss at a later date the errors of commission and omission by Saracci, Elmes, Lemen, Dement and Wagner. These authors belong to all four classes of investigators discussed under Category 390. [Category 395] Asbestos/Benzopyrene Interaction The introduction of asbestos/cigarette smoking hypothesis by Selikoff et al led to initiation of animal experiments using benzopyrene and other polycyclic aromatic hydrocarbons [Categories 100s]. It is a paradox that Selikoff questioned

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 229 the health effects of benzopyrene in a letter to the Editor of the Journal of Occupational Medicine that published a series of papers identifying a significant risk of lung cancer among coke plant workers in steel mills: "The inference has been made, however, that this risk is the result of gaseous hydrocarbon emissions (including benzpyrene) from these operations, and measures are being directed to their control. This etiological relationship has not been demonstrated. The lung cancer risk has been found associated with coke oven work, not necessarily with benzpyrene exposure. This has been emphasized by O'Connor. An alternate explanation exists. Coke ovens and gas cohorts require effective insulation, much of it containing asbestos. We have been informed that repair and maintenance of such insulation is often the responsibility of coke oven workmen (except for major installation, alterations or repairs]. This raises the question of exposure of this men to asbestos insulation dusts, an exposure known to be associated with the lung cancer hazard. This is not to say that carcinogenic hydrocarbons may not act as co-factors. Such a role has already been associated with cigarette smoking and asbestos insulation dust." (815] In their review on biologic effects of benzopyrene hypothesis is not mentioned by Hospital group (816, 818) other than their own hydroxylase enzyme in asbestos workers (817]. asbestos, the the Mt. Sinai experiments on [396] Nonapplicability of Interaction Studies to Other Cohort Groups

Asbestos/Smoking Interactions [300 Series| Ja,. 31, 1982 230 Throughout this review, this compiler has repeatedly alluded to the differences in mortality pattern between cohort groups showing interaction, and other groups that omitted a study of smoking interaction. There is one abstract alluding to the same limitation (819) and two reviews showing the varied • ortality patterns in ep~demio~ogic studies of asbestos exposed groups (820, 821). In the cohort of 17800 asbestos insulators one final and concluding question is beinq raised by this compiler: the American Cance~ Society Project of over a mi1~ion subjects may have included some of the 17800 insulators so that there might have been duplicate entry of the same person in both the asbestos and control groups. [397] Asbestos Workers, Asbestos ~anagement and ~overnment Regulators The conflicting results on ~o~tality pattern of various asbestos cohort groups has ~ed to disagreement among epidemiologists ~n the one hand, and to varied opinions among union workers, asbestos management and government regulators (822-824). There is an interesting exchange o~ letters ~n a 1981 issue of the American Journal of Public Health among the regulators, the regulated groups and the non-regulated group o~ scientists that included Sel~of~ (825-829). It is difficult for the compiler to paraphrase the contents of these letters.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 204 Beaumont and Weiss (664) reported the mortality experience of 8679 members of a metal trade union from 1950 to 1976. The union represented workers in metal fabrication shops, field construction, small boatyards and shipyards. Respiratory cancer was in excess, with an overall increase of 31 percent over expected rate. In excluding cigarette smoking as an explanation for the increased risk, the authors reasoned that "emphysema which is also caused by smoking occurred at a normal rate (9 observed versus 9.8 expected). Three studies have shown that welders may smoke cigarettes more than other occupational groups and the nation as a whole; it has not been established whether this is true for boilermakers Local 104 welders, however" (664). Asbestos dust exposure remained as the most probable cause for increased risk of respiratory cancer. [335] Asbestos Cement Workers Reported by Tulane University Epidemiologists Hughes and Weill (665) examined a cohort of 5645 male workers in a Louisiana asbestos cement factory that opened in the 1920s and is in continuous operation during the 1980s. The SMRs for respiratory neoplasms were highest for exposures exceeding I00 million particles per cubic feet times years.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 205 Like other epidemiologists ~entioned under cigarette smoking habits were not determined repeated emphasis of the interaction phenomenon prior to the initiation of the cohort studies. Categories 330s, inspire of by Selikoff [336] Asbestos Textile, Friction and Packing Products Workers Reported by NIOSH Epidemio[ogists Robinson et al (666), in a study among a group of 3276 textile, friction and ~acking products workers exposed to predominantly chrysotile asbestos, demonstrated the following: excess risk for nonmalignant respiratory diseases, suicide, heart disease, bronchogenic cancer and mesothelioma of the pleura and peritoneum among ~ales; among females, there was an excess risk for nonmalignant respiratory disease,- bronchogenic carcinoma and mesothelioma of the pleura and peritoneum. There was no information on smoking habits. [337] American Asbestos Textile workers Reported by Canadian Epidemiologists McDonald Institute of cohorts from States: two and Fry (667J from the Canadian Research Occupational Health, reported death pattern of three manufacturing companies in the United asbestos textile factories where only chyrsoti[e

Asbestos/Smoking Interactions [300 Se£ies] Jan. 31, 1982 206 was processed, and a third and crocidolite were used. were included. Their analysis that amphiboles were mainly whereas chrysotile had little factory where chrysotile, amosite A total of 10763 men and 3118 women of death certificates showed responsible for mesothelioma or no mesothelioma producing potential. All forms of asbestos contributed to an increase in respiratory cancer deaths. The interaction hypothesis of Selikoff was not mentioned in the publication. [338] Shipyard Workers in the Atlantic and Pacific Coasts Like Hammond who had. concluded that "cigarette smoking causes bronchogenic carcinoma" before embarking on asbestos research, Fraumeni had also arrived at the same conclusion (668, 669) prior to conducting a case-control study of asbestos exposure among shipyard workers (670-676). The National Cancer Institute sponsored Atlantic coast where prominent, namely: study involved four areas along the the shipbuilding industr~ has been (a) Coastal Georgia 1057 subjects of which 21 percent were employed in shipyards; (b) Jacksonville, Florida 789 subjects, 22 percent; (c) Tidewater, Virgina 641 subjects, 33 percent; and (d) Bath, Maine 64 subjects, 67 percent. In each survey, the lung cancer patients and controls (or their next of kin) were matched for age, sex, race, source

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 207 of ascertainment (hospital or status. The patients and information on occupational and death certificate) and vital controls were interviewed for smoking histories. Combining data from over 2500 interviews in the four areas, Blot and Fraumeni concluded that the relative risk of lung cancer associated with employment in shipbuilding, adjusted for cigarette smoking, was 1.44. In the combined data set, the increased risk of lung cancer among shipyard workers was seen in nearly all cigarette categories (676): RELATIVE RISK OF LUNG CANCER EMPLOYMENT IN SHIPYARDS FOR CIGARETTE SMOKING STATUS NO YES Nonsmokers 1.0 Former smokers 3.7 Light smokers (0.5 pack/day) 4.8 Moderate smokers (0.5 to 1.5 pack/day) 7.2 Heavy smokers (2 plus packs/day) 10.3 It should be noted that the highest value is to Selikoff's value of 92. There Louisiana (682, 683). 2.2 3.0 5.2 10.2 21.7 21.7 in contrast are other epidemiologic studies reported from (677), Maine ((678), California (679-681) and Hawaii Selikoff et al (684) reviewed the literature on asbestos exposure of shipyard workers without reference to the fact that most investigators have not mentioned smoking habits as a contributory factor in causation of lung cancer.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 223 [393] Published Criticisms of Asbestos/Cigarette Smoking Interaction Hypothesis Statements critical of the studies of Selikoff et al and other proponents of the interaction hypothesis have been difficult to find. A partial and incomplete list follows: Nature of Control Group. Knox, a coworker of Sir Richard Doll in the initial epidemiologic study of asbestos workers in England, wrote Gross and the letter was reproduced by De Treville Digest: in the May 1968 issue of Industrial Hygiene "The suggested synergism with cigarette smokisg may or may not be proved in the paper but synergism with other materials is certainly a Dossibilit~. How far are the comparisons of mortality of the insulat- ing group with that of the general white population of the U.S. valid? I had thought that,-even in a small country like ours, there were differences between the lung cancer mortality of urban and rural dwellers. Surely in a large country like the U.S. these differences would be more marked, and there are comparatively large groups, like Seventh Day Advent- ists, who are non-smokers. New York and New Jersey are heavily industrialized and polluted areas. Would not the basis of comparison have been more realistic if averages for large industrial conurbations had been used? Some 283 insulation workers had a cigar- ette smoking history and stated mortality in relation to their occupation and smoking habits, whereas 87 insulation workers had a different mortality experience. In view of the dispartiy in the numbers concerned are we justified in regarding these are truly comparative groups? There were no non-smokers in the group of 87 workers: 48 never smoked regularly and 39 had smoked pipes or cigars, but never smoked

Asbestos/Smoking Interactions [300 Series| Jan. 31, 1982 224 cigarettes regularly. This is a large proportion and I wonder if there is a problem here in view of the much lower necropsy rate in the 'expected' group. The statement that 'once exposure was reduced by improved industrial hygiene practice early deaths from asbestosis diminished and lung cancer became common', was not our exporience in Rochdale - rather the reverse. The figures presented from the Rochdale Factory show that independent of smoking habits, which have remained substantially the same in the cohorts examined, there has been an improved mortal- ity experience and a reduction in the incidence of lung cancer. While there may be some substance in the findings of this paper in relation to asbestos exposure, smoking, and neoplasia, I think it is not as great as these figures w-~uld have us believe. There are some statements made which seem slightly contradictory. We read that 'exposure to asbestos dust does not 'increase the risk of bronchogenic cancer among men who never smoked regularly ... we only conclude that exposure to asbestos dust (variety unspecified) does not greatly increase the risk of bronchogenic carcinoma among men who never smoke cigarettes regularly'. For comparison 'this finding, being based upon the experience of only 87 men does not prove that asbestos dust (variety unspecified) has no influence on the risk of lung cancer among non-smokers. However, it suggests that exposure to asbestos dust does not lead to an extremely high rate of lung cancer among non-smokers". (804) The above remarks, although directed against the 1968 publication of .Selikoff (647) can properly be directed against all subsequent publications of the Mt. Sinai Hospital group [Categories 322, 323 and 324].

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 225 (b) Tabulated Smokinq Data. 1973 presentation by Hammond following manner: Morgan, commented on the and Selikoff (650) in the "Unfortunately, time did not permit detai~ed discussion of the paper by Drs. Hammond and Selikoff. After the session, however, there was some comment on the data given in Table 5 of this paper for the expected death rates due to lung cancer. As the authors state in the text, values for the smoking specific death rates for individuals in the general population, were not available for the period under review at the time of the writing. As the expected death, rates in Tables 2 and 5 disregard smoking habits the data in these tables should be interpreted with caution." (805) A similar inconsistency was perceived by this compiler and discussed under Categories 322 and 323. (c) Selection of Union Members. Weiss, also after listening to the same 1973 presentation by Hammond and Selikoff (650) made the following comments: "An important limitation in the study of New York insulation workers was that only those workers belonging .~to a trade union were included. In Devonport (UK) all dockyard workers are being studied prospectively to establish cause of death and, where possible, to relate this to the degree of asbestos exposure." (806)

Asbestos/Smoking Interactions [300 Series|.Jan. 31, 1982 226 (d) Limited Number of Nonsmokers. At a 1979 meeting on Dust Diseases, Selikoff made these comments relating to his own results: "If I might take my chairman's prerogative, I would say that we are very uneasy about retrospective smoking histories from hospital records or other ~ost-death sources. The question of lung cancers among non-smoking asbestos workers is not resolved by the female experience in your population. "With regard to non-smoking asbestos workers, we found an increase. We have ~een following 2,066 non- smoking asbestos workers during this 10-year period, prospectively. There is an increase among them, com- pared to non-smoking individuals in the population as a whole. But since the rates for non-smokers in the general population are so low, even increasing them three times or four times still does not constitute a major problem. If we had no smoking among asbestos workers, we would not have all that much lung cancer. We would have more than expected, but, we wouldn't have the difficulties that we have at present" (807). (e) Relative Contributions of Asbestos and Cigarette Smoking. Poole from the Environmental Protection Agency, commented at the 1980 Annual Meeting of the American Public Health Association: The igteraction between cigarette smoking and asbestos exposure in elevating lung cancer risk ~s well known, but increased lung cancer risk among nonsmoking asbestos workers has been shown only recently. Previous conclusions that this risk was increased only in smokers were made without adequate attention to the statistical power of an early study. Caution should be exercised in examining the latest results for information on the relative contributions of smoking and asbestos to. lung cancer risk, the necessary temporal sequence of exposure, and the

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 227 implications of the observed interaction for theories of carcinogenic processes. Studies of asbestosis lead to a general consensus that smoking increases risk, but no study includes a group of smokers not exposed to asbestos to allow for the polyvalent nature of the diagnostic signs of asbestosis. A firm conclusion that there is no difference in the risk of pleural mesothelioma between smokers and nonsmokers exposed to asbestos should be avoided because the current data are not persuasive. High mortality rates for several causes of death in a small group of asbestos workers who smoked only pipes and/or cigars are worthy of note" (808). [394] Inconsistencies in Numerical Estimates Saracci, an epidemiologist from the for Research on Cancer (Lyon, France) nature of interaction between asbestos cigarette smoking (809-811). It should International Agency has commented on the dust exposure and be recognized that Saracci did not include smoking habits in the studies of 20000 asbestos workers, on behalf of the Joint European Medical Research Board (812). On the other hand, Elmes who had been conducting epidemiologic studies that included smoking habits, wrote a 1981 review on the subject as it relates to most occupational lung diseases, including asbestos-associated malignancies. He concluded the discussion on asbestos exposure as follows: "the lack of adequate numbers in the nonsmoking groups means that this conclusion (multiplicative) can only be tentative" (813). Lemen, Dement and Wagner (the latter from

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 228 the Environmental Defense Fund and all are "observers") also reviewed the literature on interaction and concluded that "it is important to note that the historic decumentation of cigar- ette consumption patterns is lacking for most retrospective cohort studies of asbestos workers. It is further importa,t to note that a sizable portion of the general population, the group usually selected for comparison in these studies, are cigarette smokers. Therefore the risk of lung cancer demons- tEated for these industrial groups exposed to asbestos is of such ~agnitude as to preclude the identification of an independent etiologic role for cigarette smoking" (814). The above mentioned articles are lengthy in their consideration of interaction hypothesis. If requested, this compiler can discuss at a later date the errors of commission and omission by Saracci, Elmes, These authors belong to all four discussed under Category 390. Lemen, De~ent and Wagner. classes of investigators [Category 395] Asbestos/Benzopyrene Interaction The introduction of asbestos/cigarette smoking hypothesis by Selikoff et al led to initiation of animal experiments using benzopyrene and other polycyclic aromatic hydrocarbons [Categories 100s]. It is a paradox thah Selikoff questioned

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 229 the health effects of benzopyrene in a letter to the Editor of the Journal of Occupational gedicine that published a series of papers identifying a significant risk of lung cancer among coke plant workers in steel mills: "The inference has been made, however, that this risk is the result of gaseous hydrocarbon emissions (including benzpyrene) from these operations, and measures are being directed to their control. This etiological relationship has not been demonstrated. The lung cancer risk has been found associated with coke oven work, not necessarily with benzpyrene exposure. This has been emphasized by O'Connor. An alternate explanation exists. Coke ovens and gas cohorts require effective insulation, much of it containing asbestos. We have been informed that repair and maintenance of such insulation is often the responsibility of coke oven workmen (except for major installation, alterations, or repairs). This raises the question of exposure of this men to asbestos insulation dusts, an exposure known to be associated with the Itung cancer hazard. This is not to say that carcinogenic hydrocarbons may not act as co-factors. Such a role has already been associated with cigarette smoking and asbestos insulation dust." (815) In their review on biologic effects of benzopyrene hypothesis is not mentioned by Hospital group (816, 818) other than their own hydroxylase enzyme in asbestos workers (817). asbestos, the the Mr. Sinai experiments on [396] Nonapplicability of Interaction Studies to Other Cohort Groups

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 230 Throughout this review, this compiler has repeatedly alluded to the differences in mortality pattern between cohort groups showing interaction, and other groups that omitted a study of smoking interaction. There is one abstract alluding to the same limitation (819) and two reviews showing the varied mortality patterns in epidemiologic studies of asbestos exposed groups (820, 821). In the cohort of 17800 asbestos insulators one final and concluding question is being raised by this compiler: the American Cancer Society Project of over a million subjects may have included some of the 17800 insulators so that there might have been duplicate entry of the same person in both the asbestos and control groups. [397] Asbestos Workers, Asbestos Management and Government Regulators The conflicting results on mortality pattern of various asbestos cohort groups has led to disagreement among epidemiologists on the one hand, and to varied opinions among union workers, asbestos management and government regulators (822-824). There is an interesting exchange of letters in a 1981 issue of the American Journal of Public Health among the regulators, the regulated groups and the non-regulated group of scientists that included Seliko~f (825-829). It is difficult for the compiler to paraphrase the contents of these letters.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 231 [398] Future Projections of Asbestos Associated Deaths In recent years, there has been apprehension or concern as to the number of future deaths of asbestos workers, specially because the latent period of their diseases is 15 or 20 or more years. Government agencies have made their'own projections (830, 831) and epidemiologists have proposed several estimates (832-837). The disagreement is the outcome of the different mortality pattern of asbestos cohort groups, and the conflicting, estimates of additional risk from cigarette smoking. The reported risks for bronchogenic carcinoma for asbestos worker who is also a cigarette smoker, compared to non-cigarette smoker, non-asbestos worker are as follows: [Category 322]: 322 New York-New Jersy insulators 92 [Category 324]: 933 Amosite workers 80 [Category 323]: 17800 U.S. and Canada insulators 61.40 or 53.24 [Category 338]: Case-control study of shipyard workers 21.7 [Category 360]: Finnish miners 17 It should be finally noted that the upper four estimates that range from 91 to 53.24 are from the Mr. Sinai Hospital group. As the size of cohort group increases, there is a reduction in risk estimates. The several estimates have

Asbestos/Smoking Interactio.s [300 Series] Jan. 31, 1982 232 confused many scientists, including Rom who thought that Selikoff has downgraded the risk estimates from 91 to i0 [Category 300] [399] Legal Consequences For the intended readers, the editorial and recent helpful. in this letter in a issue of the British Medical Journal may prove to be The discussion of "Smoking, coal, asbestos and lungs" Journal (838, 839) should be contrasted with the opin- ion of Popper and Selikoff (840) and the discussion of the role of epidemiology in proving future damages by Teret (841). Most of the consequences of epidemiologic studies were totally unexpected by this compiler prior to the preparation of this report. He is looking forward to the discussion of clinical studies on asbestos associated diseases, that are covered in the next three series: 400s on mesothelioma and pleural diseases; 500s on bronchogenic carcinoma and extrapulmonary malignancies; and 600s on pulmonary asbestosis or fibrosis. There are no anticipated unexpected consequences and interpre- is straightforward in dust can indeed cause ration of most of the clinical studies proving that exposure to asbestos malignancies.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 233 BIBLIOGRAPHY AND CUMULATIVE AUTHOR INDEX Among the 217 articlesfor Series 300s, a duplicate copy of 143 or 66 percent was received from (X). The cumulative total for Series 100s to 300s is 420 out of 841 articles, or 50 percent. The geographical distribution of the authors contained in the Bibliographies is as follows: United States Categories 300s UAR Arizona UCA California 3 UCT Connecticut 1 UCO Colorado 2 UDC District of Columbia UDE Delaware UHA Hawaii 2 UIL Illinois UIO Iowa ULA Louisiana 3 UMA Massachusetts 2 UMD Maryland 17 UME Maine UMI Michigan UMN Minnesota UMO Missouri UNC North Carol'ina 2 UNE Nebraska UNH New Hampshire UNJ New Jersey UNY New York 45 UOH Ohio 7 UPA Pennsylvania 20 USC South Carolina UTE Tennessee UTX Texas 1 UUT Utah 2 UVT Vermont UWA Washington 1 UWI Wisconsin UWV West Virginia Total U. S. Articles 108 Cumulative 100s to 300s 1 19 3 2 5 2 -. 2 10 3 7 7 36 1 7 14 2 12 2 1 i0 81 24 30 8 2 20 5 9 7 1 336 Percent of Total 50% 40%

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 234 Foreign Categories 300s Cumulative 100s to 300s ATL Australia 2 7 AUS Austria 1 1 BEL Belgium 1 3 BUL Bulgaria 1 1 CAN Canada 15 34 CZE Czechoslovakia i 1 DEN Denmark 1 2 EGY Egypt 4 FIN Finland 8 13 FRA France 6 44 GBR Great Britain 50 232 GER Ger~ny 4 26 IND India 26 ISR Israel 1 2 ITA Italy 2 20 JAP Japan 1 6 NET Netherlands 4 NOR Norway 4 POL Poland 8 ROM Romania 2 RUS Russia 4 _12 SAF South Africa 33 SPA Spain 1 1 SWE Sweden 9 12 SWI Switzerland 1 3 TAI Taiwan 1 YUG Yugoslavia 3 Total Foreign Articles 109 505 Percent of Total 50% 60% Grand Total 217 841 Percent of Grand Total 100% 100% [ Note : Bibliography for Series 300s starts on the next page]

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 235 0625 Rom WN, Editor (1983) Little, Brown & Co., Boston 1015 pages Environmental and Occupational Medicine. 0626 Rom WN (1983) Little, Brown & Co., Boston 157-182 Chapter 14. Asbestos and related fibers. Occupational Medicine. In: Environmental and 0627 Selikoff IJ (1983) Little, Brown & Co., Boston ×xi-Kxiii Preventing preventable disease. Foreword. and Occupational Medicine. In: Environmental 0628 Mancuso TF, Keefe F (1969) Arch Environ Health 18:859-860 Asbestos and cancer. 0629 Mancuso TF, Coulter EJ (1963) Arch Environ Health 6:210-226 Methodology in industrial health studies. The cohort approach, with special reference to an asbestos company. 0630 Mancuso TF, El-Attar AA (1967) J Occup Med 9:147-62 Mortality pattern in a cohort of asbestos workers. on employment experience. A study based 0631 Enterline PE (1965) Ann NY Acad Sci 132:156-65 Mortality among asbestos products workers in the United States. 0632 Enterline PE, Kendrick MA ([967) Arch Environ Health 15:181-186 Asbestos-dust exposures at various levels and mortality.

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Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 236 0633 Enterline @E (1968) 2nd Intl Conf Bio Eff Ash 113-118 Asbestos dust, increments and mortality from two diseases. 0634 De Coufle P (1970) Unpublished thesis, Univ. of Pittsburg 1-142 Mortality patterns of a group of retired asbestos workers. (X) 0635 Enterline PE, De Coufle P, Henderson V (1972) J Occup Med 14:897:903 Mortality in relation to occupational exposure in the asbestos industry. (X) 0636 Enterline PE, Henderson V (1973) Arch Environ Health 27:312-317 Type of asbestos and respiratory cancer in the asbestos industry. 0637 Enterline PE, Weill H (1973) IARC Sci Publ No. 8 179-183 Asbestosis in asbestos cement workers. asbestos. (X) In: Biological effects of 0638 - Enterline PE, De Coufle P, Henderson V (1973) Br J Ind Med 30:162-166 Respiratory cancer in relation to occupational exposures among retired asbestos workers. {X) 0639 Henderson VL, Enterline PE (1979) Ann NY Acad Sci 330:117-126 Asbestos exposure: factors associated with excess cancer and respiratory"disease mortality. In: Health hazards of asbestos exposure. (X) 0640 Enterline PE, Marsh GM (1980) IARC Sci Publ No. 30 965-972 Mortality of workers in the man-made mineral fibre industry. Biological effects of mineral fibres. (X) In: 0641 Selikoff IJ, Churg J, Editors (1965) Ann NY Acad Sci 132:1-766 Biological Effects of Asbestos.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 237 0642 Selikoff IJ, Hammond EC, Editors (1979) Ann NY Acad Sci 330:1-815 Health hazards of asbestos exposure. (X) 0643 Selikoff IJ, Lee DHK (1978) Academic Press, New York 549 pages Asbestos and diseases. 0644 Selikoff IJ (1982) Environ Sci Lab, Mt. Sinai Hospital, New York 440 pages Disability compensation for asbestos-associated disease in the United States. 0645 Selikoff IJ, Churg J, Hammond EC (1964) JAMA 188:142-146 Asbestos exposure and neoplasia. (X) 0646 Selikoff IJ, Bader RA, Bader ME, Churg J, Hammond EC (1967) Am J Med 42:487-496 Asbestos and neoplasia. 0647 Selikoff IJ, Hammond EC, Churg J (1968) JAMA 204:104-112 Asbestos exposure, smoking, and neoplasia. 0648 Selikoff IJ, Hammond EC, Churg J (1968) Int Conf Biol Eff Asbest 283-288 Prospective studies of asbestos neoplasia in insulation workers in the United S~ates. (X) 0649 Sellkoff IJ, Hammond EC, Seidman H (1973) IARC Sci Pub1 No. 8 209-216 Cancer risk of insulation workers in the United States. Biological effects of asbestos. (X) In: 0650 Hammond EC. Selikoff IJ (1973) IARC Sci Pub1 No. 8 312-317 Relation of cigarette smoking to risk of death of asbestos- associated disease among insulation workers in the United States. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 238 0651 Selikoff IJ {1976) Rev Fr Mal Resp Suppl 4:7-24 Asbestos disease in the United States 1918-1975. (X) 0652 Hammond EC, Selikoff IJ, Seidman H (1979) Ann NY Acad Sci 330:473-490 Asbestos exposure, cigarette smoking and death rates. 0653 Frank AL (1979) Ann NY Acad Sci 330:791-794 Public health significance of smoking-asbestos interactions. Health harzards of asbestos exposure. (X) In: 0654 Selikoff IJ, Hammond EC, Seidman H (1979) Ann NY Acad Sci 330:91-116 Mortality experience Of insulation workers in the United States and Canada 1943-1976. In: Health hazards of asbestos exposure. (X) 0655 Selikoff IJ, Hammond EC, Seidman H (1980) Cancer 46:2736-2740 Latency of asbestos disease among insulation workers in the United States and Canada. (X) 0656 Seidman H, Selikoff IJ, Hammond EC (1979) Ann NY Acad Sci 330:61-89 Short-term asbestos work exposure and long-term observation. Health hazards of asbestos exposure. (X) In: 0657 " Selikoff IJ, Seidman H (1981) J Environ Biol 2:63-78 Health effects of amosite asbestos exposure. (X) 0658 Selikoff IJ, Seidman H, Hammond EC (1980) JNCI 65:507-513 Mortality effects of cigarette smoking among amosite asbestos factory workers. {X) 0659 Keane WT, Zavon MR (1966) Arch Environ Health 13:171-184 Occupational hazards of pipe insulators.

Asbestos~Smoking Interactions [300 Series] Jan. 31, 1982 239 0660 Kleinfeld M, Messite J (1967) Arch Environ Health 15:177-180 Mortality experience in a group of asbestos workers. 0661 Kleinfeld MJ (1968) Med Times 96:1223-1229 Asbestos and neoplasia. 0662 Kleinfeld MJ (1973) J Occup Med 15:296-300 Biologic response to kind and amount of asbestos. 0663 Kaminski R, Geissert KS, Dacey E (1980) J Occup Med 22:183-189 Mortality analysis of plumbers and pipefitters. (X) 0664 Beaumont JJ, Weiss NS (1980) Am J Epidemiol I12:775-786 Mortality of welders, shipfitters, and other metal trades workers in boilermakers local no. 104, AFL-CIO. (X) 0665 - Hughes J, Weill H (1980) IARC Sci Publ No. 30 627-635 Lung cancer risk associated with manufacture of asbestos-cement products. In: Biological effects of mineral fibres. (X) 0666 Robinson C, Lemen R, Wagoner JK (1979) Pathotox Publishers, Park Forest South, IL 131-143 Mortality patterns, 1940-1975 among workers employed in an asbestos textile friction and packing products manufacturing factory. In: Dust and disease. (X) 0667 McDonald AD, Fry JS (1982) Scand J Work Environ Health Suppl 8:53-58 Mesothelioma and the fiber type in three American asbestos factories - preliminary report. (X) 0668 Fraumeni JF Jr (1975) JNCI 55:1039-1046 Respiratory carcinogenesis: an epidemiologic appraisal.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 240 0669 Fraumeni JF (1977) J Environ Pathol Toxicol 1:19-30 Environmental and genetic determinants of cancer. (X) 067O Fraumeni JF, Blot WJ (1978) Pergamon Press, Oxford 11:23-27 The geographic distribution of lung cancer in the U.S.A. Clinical Cancer Principal Sites 2. In: 0671 Fraumeni JF (1979) Ann NY Acad Sci 330:313-315 Lung cancer mortality in the United States: shipyard correlations. In: Health hazards of asbestos exposure. (X) 0672 Blot WJ, Harrington JM, Toledo A, Hoover R et al (1978) N Eng J Med 299:620-624 Lung cancer after employment in shipyards during World War If. 0673 Blot WJ, Fraumeni JF (1979) J Occup Med 21:276-278 Studies of respiratory cancer in high risk communities. 0674 Blot WJ, Morris LE, Stroube R, Tagnon I, Fraumeni JF (1980) JNCI 65:571-575 Lung and laryngeal cancers in relation to shipyard employment in coastal Virginia. (X) 0675 Blot WJ, Morris .LE, Fraumeni JF (1981) Am J Epidemiol 114:423 Latency and duration of shipyard employment in relation to high risk of lung cancer along the Atlantic coast. 0676 Blot WJ, Fraumeni JF (1981) Banbury Report 37-46 Cancer among shipyard workers. occupational cancer. (X) Quantification of 0677 Gottlieb MS, Stedman RB (1979) South Med J 72:1099-1101 Lung cancer in shipbuilding and related industries in Louisiana. (X)

Asbestos/S~king Interactions [300 Series] Jan. 31, 1982 241 0678 Rinsky RA, Waxweiler RJ, Bierbaum PJ, Terpilak Met al (1980) US Dept HHS Pub1 1-91 Epidemiologic study of civilian employees at the Portsmouth Naval Shipyard, Kittery, Maine. 0679 Borhani NO, Hechter HH, Ereslow L (1963) J Chronic Dis 16:1251-1266 Report of a ten-year follow-up study of the San Francisco longshoremen. Mortality from coronar7 heart disease and from all causes. 0680 Baginsky E (1976) Environ Res 11:271-279 Occupational illness and accidents reported from California shipyards. (X) 0681 Kraus JF, Franti CE, Newman B (1982) Scand J Work Environ Health Suppl 8:65-71 The untilty of regional cancer mortality data for identifying occupations at high risk. 0682 Kolonel LN, Hirohata T, Chappell BV, Viola FV, Harris DE (1980) JNCI 64:739-743 Cancer mortality in a cohort of naval shipyard workers in Hawaii: early findings. (X) 0683 Hirohata T, Kolonel L, Nomura A (1977) JCNI Monogr 47:676-70 Epidemiologic cancer research of the Cancer Center of Hawaii. 0684 Selikoff IJ, Lilis R, Nicholson WJ (1979) Ann NY Acad Sci 330:295-311 Asbestos disease in United States shipyards. of asbestos exposure. (X) In: Health hazards 0685 Kleinfeld M, Messite J, Kooynmn O, Zaki M {1967) Arch Environ Health 14:663-667 Mortality among talc miners and millers in New York State.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 242 0686 Gillam JD, Dement JM, Lemen RA, Wagoner Jet al (1976) Ann NY Acad Sci 271:336-344 Mortality patterns among hard rock gold miners exposed to an asbestos mineral. (X) 0687 Dement JM, Zumwalde RD, Wallingrod KM (1976) Ann NY Acad Sci 271:345-352 Discussion paper: asbestos fiber exposures in a hard rock gold mine. In: Occupational carcinogenesis. (X) 0688 Dement JM, Zumwalde RD, Gamble JF, Fellner Wet al (1980) Natl Inst Occup Saf Publ 1-106 Morbidity, mortality, and environmental studies on miners and millers. In: Occupational exposure to talc containing asbestos. (X) 0689 Anonymous (1965) Canad Med Assoc J 92:1034-1035 The association of asbestos and malignancy. 0690 McDonald JC, McDonald AD, Gibbs GW, Siemiatycki Jet al (1971) Arch Environ Health 22:677-686 Mortality in the chrysotile asbestos mines and mills in Quebec. 0691 Braun DC, De Treville RTP (1972) Arch Environ Health 24:294-295 Comment on McDonald et al's study on mortality in asbestos industry. (X) 0692 McDonald JC (1973) IARC Sci Publ No. 8 189-194 Cancer in chrysotile mines and mills. asbestos. (X) In: Biological effects of 0693 McDonald AD, McDonald JC (1976) Rev Fr Mal Resp Suppl 4:25-38 Epidemiologic studies on the diseases due to asbestos in Canada. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 243 0694 McDonald JC, Liddell FDK (1979) Ann NY Acad Sci 330:i-9 Mortality in Canadian miners and millers exposed to chrysotile. In: Health hazards of asbestos exposure. (X) 0695 McDonald JC, Gibbs GW, Liddell FDK (1980) IARC Sci Publ No. 30 811-817 Chrysotile fibre concentration and lung cancer mortality: a preliminary report. In: Biological effects of mineral fibres. (X) 0696 Liddell FDK (1980) IARC Sci Publ No. 30 661-665 Latent period in lung cancer mortality in relation to asbestos dose and smoking. In: Biological effects of mineral fibres. (X) 0697 Liddell FDK (1981) Can Med Assoc J 125:237-239 Asbestos and public health. (X) 0698 Myre M (1981) _ Union Med Can ii0:362-363, 365-367 Insulation workers from the province of Quebec: causes of mortality. (French) (X) 0699 Finkelstein M, Kusiak R, S~ranyi G (1981) Can Med Assoc J 125:259-262 Mortality among workers receiving compensation for asbestosis in Ontario. (X) .. 0700 Nicholson WJ, Selikoff IJ, Seidman H, Lilis R, Fromby P (1979) Ann NY Acad Sci 330:11-21 Long-term mortality experience or .chrysotile miners and millers in Thetford Mines, Quebec. In: Health hazards of asbestos exposure. (X) 0701 Graham S (1981) Environ Res 25:35-49 Methodological problems in ecologic studies of the asbestos- cancer relationship

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 244 0702 Graham S, Blanchet M, Rohrer T (1977) Am J Epidemiol 106:231 Cancer in asbestos mining and other areas of Quebec. 0703 Miller AB (1980) Can Med Assoc J 122:985-987 Identification of adults at high risk of lung cancer. 0704 Cecilioni VA (1980) Can Med Assoc J 122:513 Occupational lung cancer and smoking. (X) (X) (X) 0705 Morrison AB (1979) Can Med Assoc J 120:1216 Asbestos-related disease. 0706 Doll R (1955) Br J Ind Med 12:81-86 Mortality from lung cancer in asbestos workers. 0707 Anonymous (1955) Lancet 268:1163 Lung cancer in asbestosis. (X) 0708 Doll R (1960) L & A Churchill Lid, London Occupational lung.cancer. (X) 208-220 In: Industrial pulmonary diseases. 0709 Doll R (1975) Arch Geschwulstforsch 45:521-531 Port and the path to prevention. 0710 Doll R (1977) J Roy Col Phy London ii:125'140 The prevention of cancer.

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 245 0711 Doll R (1978) Pergamon Press, Oxford 11:9-15 Smoking, industrial pollutants and their interaction. Clinical cancer principal sites 2. (X) In: 0712 Hill ID, Doll R, Knox JF (1966) Proc R Soc Med 59:59 Mortality among asbestos workers. (X) 0713 Knox JF, Holmes S, Doll R, Hill ID (1968) Br J Ind Med 25:293-303 Mortality from lung cancer and other causes asbestos textile factory. among workers in an 0714 Newhouse ML, Wagner JC ~1969) Br J Ind Med 26:3302-307 Validation of death certificates in asbestos workers. 0715 Newhouse ML (1970) Oxford University Press, London 158-164 The mortality of asbestos factory workers. (Proc Int Conference Johannesbury 1969) (X) In: Pne~moconiosis 0716 Berry G, Newhouse ML, Turok M (1972) Lancet 2:476-478 Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers. 0717 Newhouse ML (1973) IARC Sci Publ No. 8 203-208 Cancer among workers in the asbestos textile industry. logical effects of asbestos. In: Bio- 0718 Newhouse ML, Berry G (1979) Ann NY Acad Sci 330:53-60 Patterns of mortality in asbestos factory workers in London. Health hazards of asbestos exposure. (X) In:

Asbestos/Smoking Interactions [300 Series] Jan. 31, Iq82 246 0719 Fox AJ, Lindars DC, Owen R (1974) Br J Ind Med 31:140-151 A survey of occupational cancer in the rubber and cablemaking industries: results of five-year analysis, 1967-1971. 0720 Jones JSP, Pooley FD, Smith PG (1976) IARC Sci Publ No. 13 117-120 Factory populations exposed to crocidolite asbestos - a continuing survey. In: Environmental pollution and carcinogenic risks. (X) 0721 Jones JSP, Pooley FD, Sawle GW, Madeley RJ et al (1980) IARC Sci Publ 2:637-653 The consequences of exposure to asbestos dust in a wartime gas- mask factory. In: Biological effects of mineral fibres. (X) 0?22 Wignall BK, Fox AJ (1982) Br J Ind Med 39:34-38 Mortality of female gas mask assemblers. 0723 Berry G, Jacobsen M, Cox DR, Fox AJ, Armitage P (1977) J R Stat Soc A 140:485-488 Method of cohort analysis. Appraisal by application to asbestos mining. (X) 0724 Berry G, Lewinsohn HC (1979) Ann NY Acad Sci 330:185-194 Morbidity. In: Health hazards of asbestos exposure. (X) 0725 Berry G (1981) Br J Ind Med 38:130-137 Mortality of workers certified by pneumoconiosis medical panels as having asbestosis. 0726 Peto J (1980) IARC Sci Publ No. 30 21829-836 Lung cancer mortality in relation to measured dust levels in an asbestos textile factory. In: Biological effects of mineral fibers. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 247 0727 Thomas HF, Elwood PC, Benjamin IT, Sweetnam PM (1982) Br J Ind Med 39:273-276 Further follow-up study of workers from an asbestos cement factory. (X) 0728 Elwood PC, Cochrane AL, Benjamin IT, Seys-Prosser D (1964) Br J Ind Med 21:304-307 A follow-up study of workers from an asbestos factory. 0729 Finlayson A, McEwen J, Mair A (1971) Scot Med J 16:509-512 . Home interviews with relatives of deceased persons: a means of obtaining histories of exposure to a hazardous substance. 0730 Chatterjee D$, Petrie A, Taylor W (1978) Br J Ind Med 35:208-218 Prevalence of vibration-induced white finger in fluorspar mines in Weardale. (M) 0731 Sheers G, Templeton AR (1968) Br Med J 3:574-579 Effect of asbestos in dockyard workers. 0732 Harries PG (1968) Ann Occup Hyg 11:135-145 Asbestos hazards in naval dockyards. 0733 Harries, PG (1976) Environ Res 11:261-267 Experience with asbestos disease and its control in Great Britain's naval dockyards. 0734 Lumley KPS (1976 Br J Ind Med 33:108-114 A proportional study of cancer registration of dockyard workers. 0735 Rossiter CE, Coles RM (1980) IARC Sci Publ No. 30 2:713-721 HM Dockyard, Davenport: 1947 mortality study. effects of mineral fibres. (X) In: Biological

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 248 0736 Elmes PC (1966) Postgrad Med J 42:623-635 The epidemiology and clinical features of asbestos and related disease. (X) 0737 Elmes PC, Simpson M (1968) 2nd Intl Conf Bio Eff Asb 138-141 Retrospective mortality studies on pipe coverers. {X) 0738 Elmes PC, Simpson MJC (1971) Br J Ind Med 28:226-236 Insulation workers in Belfast. 3. Mortality 1940-66. 0739 Elmes PC, Simpson MJC (1977) Br J Ind Med 34:174-180 Insulation workers in Belfast. to asbestos exposure (1940-75) A further study of mortality due 0740 Elmes PC (1977) Ulster Med J 46:71-80 Investigation into the hazardous use of asbestos. Ireland 1960-76. Northern 0741 Elmes PC (1978) J R Soc Med 71:914-916 Risk factors in asbestos exposure. 0742 Elmes PC (1980) Chem Ind 5:173-175 Dust diseases of the lung. (X) 0743 Ringertz N (1955) Schweiz Z Pathol Bakterlol 18:866-88884 Environmental factors and smoking in the causation of cancer of the lung. (X) 0744 Carlens E (1976) Lakartidningen 76:1194 Can a prospective asbestos investigation be ethically justified? (Swedish)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 249 0745 Vagero D, Allander E, Allebeck P, Persson G, Straat E (1982) Lakartidningen 79:2699-2700 Occupation and risk in cancer-environment registry: a commentary on methodological questions. (Swedish) 0746 Lennholm B (1982) Lakartidningen 79:2927-2929 Many advantages with regional cancer registry. Exposed risk groups can be followed up in a completely new manner. (Swedish) (X) 0747 Axelson Q, Flodin U, Ha/dell L (1982) Scand J Work Environ Health Suppl 8:15-19 A comment on the reference series with regard to multiple exposure evaluations in a case-referent study. (X) 0748 Dahlgren E (1979) Lakar tidningen 76 : 4811-4814 Lung cancer, cardiovascular disease and smoking in a group of mineworkers. (Swedish) (X) 0749 Sundell L (1980) Eur J Respir Dis Suppl 107:131-132 Lung cancer in miners in relation to smoking habits. 0750 Thiringer BG (1980) Eur J Respir Dis Suppl 107:125-129 Epidemiological studies of lung cancer - influence of smoking habits. " 0751 Thiringer G, Jarvholm B (1980) Eur J Respir Dis Suppl 107:123-124 Smoking and lung cancer. 0752 Meurman LO, Kiviluoto R, Hakama M (1973) IARC Sci Publ No. 8 199-202 Mortality and morbidity of employees of anthophyllite asbestos mines in Finland. In: Biological effects of asbestos. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 250 0753 Meurman LO, Kiviluoto R, Hakama M (1979) Ann NY Acad Sci 330:491-495 Combined effects of asbestos exposure and tobacco smoking on Finnish anthophyllite miners and millers. In: Health hazards of asbestos exposure. (X) 0754 Meurman LO, Kiviluoto R, Hakama M (1974) Br J Ind Med 31:105-112 Mortality and morbidity among the working population of anthophyllite asbestos miners in Finland. 0755 Ahlman K, Partanen TJ, Rintala E, Wiikeri M (1973) IARC Sci Publ No. 8 165-168 Anthophyllite mining and milling as a cause of asbestosis. Biological effects of asbestos. In: 0756 Huuskonen MS, Tossavainen A (1978) Tyoterveyslaitoksen Tutkimuksia 1-45 Occupational asbestos exposure in Finland. (Finnish) (X) 0757 Huuskonen MS, Ahlman K, Mattsson T, Tossavainen A et al (1980) J Occup Med 22:751-754 Asbestos disease in Finland. (X) 0758 Huuskonen MS (1980) J Toxicol Environ Health 6:1261-1265 Asbestos and cancer in Finland. 0759 Koskela RS (19982) Scand J Work Environ Health Suppl 8:34-39 Occupational mortality and morbidity in relation to selective turnover. (X) 0760 Haider M, Neuberger M (1980) IARC Sci Publ No. 30 973-977 Comparison of lung cancer risks for dust workers, asbestos-cement workers and control groups. In: Biological effects of mineral fibres. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 251 0761 Lacquet LM, Van Der Linden L, Lepoutre J (1980) IARC Sci Publ No. 30 783--793 Roentgenographic lung changes, asbestosis and mortality in a Belgian asbestos-cement factory. In: Biological effects of mineral fibres. (X) 0762 Avril J, Champeix J (1970) Arch Mal Prof 31:198-200 Results of asbestos exposure in France. (X) 0763 Molina C, Cheminat JC (1978) Monogr Coll Med Hop Paris 89-91 Consequences of long-term asbestos dust exposure. the health of workers in a textile mill. (French) Statement on (X) 0764 Bignon J, Sebastien P,.Bonnaud G (1978) Monogr Coll Med Hop Paris 70-83 Asbestos dose-response studies for cancer in man. (French) (X) 0765 Anspach M (1968) Int Conf Biol Eff Asbest 124-126 Causes of death of employees of asbestos-processing factories. (German) (X) 0766 Hain E, Hinz I, Dalquen P (1975) Int Arch Arbeitsmed 36:119-136 Retrospective study of 236 former employees of a Hamburg asbestos textile plant. (~erman) (X) 0767 Versen P (1980) Staub-Reinhalt Luft 40:181-187 Occupational diseases due to asbestos exposure which are covered by the industrial injuries insurance associations. (German) (X) 0768 Woitowitz HJ, Beierl L, Rathgeb M, Schmidt K et al (1981) Am J Ind Med 2:71-78 Asbestos-related diseases in the Federal Republic of Germany. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 252 0769 Vigliani C, Ghezzi I, Maranzana P, Pernis B (1968) Med Lavoro 59:481-485 Epidemiologic study of asbestos workers in Northern Italy. 0770 Puntoni R, Vercelli M, Merlo F, Valerio F, Santi L (1979) Ann NY Acad Sci 330:353-377 Mortality among shipyard workers in Genoa, Italy. In: Health hazards of asbestos exposure. (X) 0771 Lopez-Areal Del ~noL (1980) IARC Sci Publ No. 30 201-206 Diseases associated with asbestos in Spain. effects of mineral fibres. (X) I~: Biological 0772 Maillard JM, Fellmann E, Wirz 0 (1982) Schweiz Med Wochenschr 112:174-176 Occupational respiratory diseases in Switzerland at the present time. 0773 Dobreva M, Burilkova T, Toceva V, Mihailova Let al (1979) Probl Khig 4:32-40 Professional risk in asbestos-textile production.- (Bulgarian) (X) 0774 Suntych F, Kryze B, Parizkova B (1970) Prac Lek 22:284-293 Occupational diseases and professional intoxications registered in Czechoslovakia in 1968. (Czech) (X) 0775 Koran FM (1968)' 2nd Intl Conf Bio Elf Asb 279-283 On the n~lignancy of asbestos dust. (X) 0776 Kogan FM (1975) NTIS PB-239 983-T :1-5 Cancer mortality rateamong workers in the asbestos industry of the Urals. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 253 0777 Kogan FM (1981) Gig Tr Prof Zabol 5-10 Asbestosis and its prevention. (X) 0778 Kurova EG, Gusel'nikova NA, Kogan FM, Starkov PS et al (1982) Gig Tr Prof Zabol 17-20 The influence of ths dust factor on the health of asbestos-cement plant workers. (Russian) (X) 0779 Djerassi L, Kaufmann G, Bar-nets M (1979) Ann NY Acad Sci 330:243-253 Malignant disease and environmental control in an asbestos cement plant. In: Health hazards of asbestos exposure. (X) 0780 Sera Y, Kang KY (1981) Tohoku J Exp Med 133:.313-320 Asbestos and cancer in the Sennan District of Osaka. 0781 Hobbs MST, Murphy B, Musk AW, Elder J, Heyworth F (1978) Unpublished paper 1-7 The incidence of asbestos caused disease in workers formerly employed in mining and milling of crocidolite at Wittenoom Gorge. (X) 0782 Hobbs MST, Woodward SD, Murphy B, Musk AW, Elder JE (1980) IARC Sci Publ No. 30 2:615-625 The incidence of pneumoconiosis, mesothelioma and other respira- tory cancer in men engaged in mining and milling crocidolite in Western Australia. (X) 0783 Gilson JC (1973) Proc R Soc Med Asbestos cancer: 66:395-403 Past and future hazards. 0784 Gilson JC (1974) Clin Sci Mol Med 47:11p Proceedings: Biological effects of asbestos. questions posed by epidemiologic studies. Unanswered

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 254 0785 Gilson JC (1976) IARC Sci Publ No. 13 107-116 Asbestos cancers as an example of the problem of comparative risks. In: Environmental pollution and carcinogenic risks. (X) 0786 Gilson JC (1977) Philos Trans R Soc Lond A Environmental mineralogy. 286:585-592 Medicine and mineralogy. (X) 0787 Greenhouse SW (1980) Am J Epidemiol 112:269-273 Some epidemiologic issues for the 1980s. (X) 0788 National Institue for Occupational Safety and Health (1979) DHEW Publication No. (PHS) 79-50066: 7-I to 7-25 7. Interaction between smoking and occupational exposure. Smoking and Health: A Report of the Surgeon General. In: 0789 Hammond EC, Selikoff IO, Seidman H (1975) Excerpta Medica, Amsterdam 147-150 Multile interaction effects of cigarette smoking. Extrapulmonary cancer. In: Cancer Epidemiology, Environmental Factors. 0790 Hammond EC (1974) Cancer 33:1728-1831 Epidemiologic basis for cancer prevention. 0791 Hammond EC (1975) Cancer 35:652-554 The epidemiological approach to the etiology of cancer. 0792 Hoffmann D, Wynder EL (1976) Prey Med 5:245-261 Smoking and occupational cancer. 0793 Hoffmann D, Wynder EL (1978) Zentralbl Bakt Parasitenkd Infektionskr Hyg 166:113-135 Identification and reduction of carcinogents in the respiratory environment.

Asbestos/S~king Interactions [300 Series] Jan. 31, 1982 255 0794 Albert RE, Upton AC, Carnow BW, Wynder EL (1978) Bull NY Acad Mad 54:435-441 Panel discussion: Sources of Carcinogens. (X) 0795 Anonymous (1965) N Engl J Mad 272:590-591 Asbestos and malignant disease. 0796 Enterline PE (1976) Am Rev Resp Dis 113:175-180 Estimating health risks in studies of the health effect of asbestos. (X) 0797 Enterline PE (1976) J Occup Med 18:150-156 Pitfalls in epidemiol0gical research. (X) 0798 Enterline PE (1978) Am Ray Resp Dis 118:975-978 Asbestos and cancer: The international lag. (X) 0799 Enterline PE (1981) Banbury Rep 19-33 Proportion of cancer due to exposure to asbestos. fication of Occupational Cancer. (X) In: Quanti- 0800 Wagner JC, Gilson ~JC, Berry G, Timbrell V (1971) Br Mad Bull 27:71-76 Epidemiology of asbestos cancers. 0801 Wagner JC, Bogovski P, Bigginson 3 (1972) Med Lavoro 63:213-220 The role of international research in occupational cancer. 0802 Wagner JC (1979) Practitioner 223:28-33 Diseases associated with exposure to asbestos dust. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 256 0803 Wagner JC, Berry FD (1980) Br Med Bull 36:53-56 Carcinogenesis and mineral fibres. 0804 De Treville RTP (1968) Industrial Hygiene Foundation, Pittsburgh i-iii Progress in the asbestos bioeffects research. In: Industrial Hygiene Digest. (X) 0805 Morgan A (1973) IARC Sci Pub1 No. 8 318-319 Discussion summary, Considerations of etiological mechanisms and other factors. In: Biological effects of asbestos. (X) 0806 Weill H (1973) IARC Sci Publ No. 8 Discussion summary. 184-185 In: Biological effects of asbestos. (X) 0807 Selikoff IJ (1979) Pathotox Publishers, Park Forest South 199-219 Discussion of Session III, Exposures and health effects of asbestos minerals. In: Dust and Disease. (X) 0808 Poole C (1980) Annu Meet Am Public Health Assoc 230 Recent evidence on the health effects of smoking and asbestos exposure. (X) 0809 Saracci R (1980)" Pathotox Ptlblisher, Park Forest South 157-169 Asbestos and lung cancer: an analysis of the epidemiological evidence on the asbestos-smoking interaction. In: Dust and Disease. (X) 0810 Saracci R (1980) IKRC Sci Publ No. 30 2:951-963 Introduction: Epidemiology of groups exposed to other mineral fibres. In: Biological effects of mineral fibres. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 257 0811 Saracci R (1980) Am J Epidemiol 112:465-466 Interaction and synergism. 0812 Hugod C, Kamstrup O (1982) Ugeskr Laeger 144:2126-2127 Biological effects of man-made mineral fibers. (Danish} (X) 0813 Elmes PC (1981) Br O Ind Med 38:1-13 Relative importance of cigarette smoking in occupational lung disease. (X) 0814 Lemen RA, Dement JR, Wagoner 3K (1980) Environ Health Perspect 34:1-11 Epidemiology of asbestos-related diseases. (X) 0815 Selikoff IJ, Hammond EC (1971) J Occup Med 13:496-497 Asbestos exposure to coke oven operators. 0816 Kannerstein M, Churg J, McCaughey WTE, Selikoff IJ (1977) Arch Pathol Lab Me~ 101:629-634 Pathogenic effects of asbestos. 0817 Tishler PV, Naseem SM, Anderson HA, Selikoff IJ (1977) C1in Res 25:P412A Aryl hydrocarbon hydroxylase (AHH) in asbestos workers with high risk for lung cancer. (X) 0818 Langer AM, Wolff MS, Rohl AN, Selikoff IJ (1978) J Toxicol Environ Health 4:173-188 Variation of properties of chrysotile asbestos subjected to milling. 0819 Houten L, Wijnberg L (1978) Annu Meet Am Public Health Assoc 151 Possible synergism between cigarette smoking and occupational synergism. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 258 0820 Lewinsohn HC (1979) Ann NY Acad Sci 330:533-540 Surveillance of high-risk groups exposed to asbestos in the United States. In: Health hazards of asbestos exposure. (X) 0821 Wen CP, Tsai SP (1982) Scand J Work Environ Health Suppl 8:48-52 Anatomy of the healthy worker effect - a critique of summary statistics employed in occupational epidemiology. (X) 0822 Cutler JL, Weiss W, Cooper WC, Lewis JL et al (1976) Ann NY Acad Sci 271:508-512 Discussion of Part VII: High-risk industrial groups: identifica- tion, education, and surveillance. (X) 0823 Bross IDJ, Viadana E, Houten L (1978) Arch Environ Health 33:300-307 Occupational cancer in men exposed to dust and other environmental hazards. (X) 0824 Johns-Manville Corp. (1980) Johns-Manville Corp Publ 1-20 Smoking. (X) 0825 Kotin P (1981) Am J Publ Health 71:93 Two comments on smoking and the workplace. 0826 Parkinson DK (1981) Am J Publ Health 71:1409 Dr. Parkinson's response. (X} (X) 0827 Kristein MM (1981) Am J Publ Health 71:1409 Asbestos workers and lung cancer. (X) 0828 Selikoff IJ (1981) Am J Publ Health 71:92 Two comments on smoking and the workplace. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 259 0829 Wilson D (1981) Am J Publ Health 92-93 Two comments on smoking and the workplace. (X) 0830 NCI, NIEHS, NIOSH (1978) Unpublished paper 8-18, 33-39. Estimates of the fraction of cancer in the United States related to occupational factors. (X) 0831 Hogan MD, Hoel DG (1981) Risk Anal 1:67-76 Estimated cancer risk associated with occupational ~sbestos exposure. (X) 0832 Selikoff IJ (1981) Banbury Rep 3-13 Constraints in estimating occupational contributions to current cancer mortality in the United States. In: Quantification of occupational cancer. (x) 0833 Enterline PE, Selikoff IJ, Peto R, Sloan MH et al [1981) Banbury Rep 14-17 Comments, on Constraints in estimating occupational contributions to current cancer mortality in the U.S. In: Quantification of occupational cancer. (X) 0834 Acheson ED, Enterline PE, Nicholson WJ, Peto Jet al (1981) Banbury Rep 34-36 Comments, on Propmrtion of cancer due to exposure to asbestos. In: Quantification of occupational cancer. (X) 0835 KarstadtM, Blot WJ, Peto J, Beebe GE, Enterline PEet al (1981) Banbury Rep 47-49 Contments, on Cancer among shipyard workers. In: Quantification of occupational cancer. (X) 0836 Nicholson WJ, Perkel G, Selikoff IJ, Seidman H (1981) Banbury Rep 87-108 Cancer from occupational asbestos exposure: Projections 1980- 2000. In: Quantification of occupational cancer. (X)

Asbestos/Smoking Interactions [300 Series] Jan. 31, 1982 260 0837 Cairns J, Nicholson WJ, Enterline PE, Blot WJ et al (1981) Banbury Rep 109-111 Co~ents, of Cancer from occupational asbestos exposure: Projec- tions 1980-2000. In: Quantification of occupational cancer. (X) 0838 Anonymous (1981) Br Med J 283=457-458 Smoking, coal, asbestos and the lungs. (X) 0839 Patrick JM (1981) Br Med J 283:675 Smoking, coal, asbestos and the lungs. (X) 0840 Popper H, Selikoff IJ (1981) Am J Med 70:218-220 What is environmental pathology. (X) 0841 Teret S (1980) Trial 16:31-33, 62 The role of epidemiology in proving future damages._ (X)

CUMULATIVE AUTHOR INDEX FOR CATEGORIES I00 to ,~99 January 31, 1983 CATEGORY NUMBER 398 0834 232 0435 360 0755 391 0794 183 0259 190 0318 183 0260 150 0174 150 01/5 234 0484 350 0707 392 0795 340 0689 399 0838 370 0765 198 0370 232 0422 232 0424 232 0423 241 0531 210 0378 235 0511 233 0459 370 0762 360 0747 185 0305 185 0306 338 0680 283 0596 334 0664 196 0361 190 0319 182 0231 182 0230 182 0229 184 0291 194 0354 121 0083 121 0082 124 0124 124 0123 350 0725 350 0723 350 0724 350 0716 130 0129 232 0418 AUTHORS AND YEAR Acheson ED, Enterline PE, Nicho]son Wj, Peto Jet a] (1981) Acheson ED, Gardner ICJ (1980) Ah]man K, Partanen TJ, Rinta]a E, Wiikeri M (1973) Albert RE, Upton AC, Carnow BW, Wynder EL (1978) Allison AC (1973) Allison AC (1974) Allison AC (1977) Amacher DE, Alarif A, Epstein SS (1974) Amacher DE, AIarif A, Epstein SS (1975) Anjilve] L, Thurlbeck WM (1966) Anonymous (1955) Anonymous (1965) Anonymous (1965) Anonymous (1981) Anspach M (1968) Archer VE, Dixon WC (1979) Ashcroft T (1968) Ashcroft T, Hepp]eston AG (1973) Ashcroft T, Hepp]eston AG (1973) Attia OM, El-Sewefy AZ, WasseF SA (1975) Auerbach 0 (1937) Auerbach O, Conston AS, Garfinkel L, Farks VR et al (1980) Auerbach O, Hammond EC, Selikoff IJ, Parks VR et a] (1977) Avril J, Champeix J (1970) - Axelson Q, Flodin U, Hardell L (1982) Babu KA, Lakkad BC, Nigam SK, Bhatt DK, Karnik AB et al (1980) Babu KA, Nigam SK, Lakkad BC, Bhatt DK, Karnik ABet al (1981) Baginsky E (1976) Barbers R, Shih WWH, Saxon A (1981) Beaumont JJ, Weiss NS (1980) Beck EG (1975) Beck EG (1976) Beck EG (1980) Beck EG~ Holt PF, Manojlovic N (1972) Beck EG, Holt PF, Nasrallah ET (1971) Beck EG, Tilkes F (1980) Becklake ~ (1981) Beg MU, Farooq M, Saxena V, Rahman Q, et al (1977) Beg MU, Rahman Q, Viswanathan PN, Zaidi SH (1973) Begin R, Masse S, Bureau MA (1982) Begin R, Ro]a-P]eszczynski M, Sirois P, Lemaire I, et al (1981) Berry G (1981) Berry G, Jacobsen M, Cox DR, Fox AJ, Armitage P (1977) Berry G, Lewinsohn HC (1979) Berry G, Newhouse ~, Turok M (1972) Berry G, Wagner JC (1976) Berry JP, Henoc Ing, P, Galle P, Pariente R (1976) GEOGRAPHIC CODE GBR GBR FIN UNY GBR GBR GBR UOH UOH CAN GBR UMA CAN GBR GER UUT GBR GBR GBR EGY UNJ UNJ UNJ FRA SWE IND IND UCA UCA UWA GER GER GER GBR GBR GER CAN INO IND CAN CAN GBR GBR GBR GBR GBR FRA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 CATEGORY NUMBER 234 0503 170 0216 183 0257 233 0477 234 0502 232 0410 210 0381 130 0150 370 0764 270 0570 338 0673 338 0676 338 0672 338 0675 338 0674 232 0420 150 0177 200 0374 338 0679 232 0449 111 0015 111 0016 111 0018 111 0017 190 0320 242 0536 242 0538 340 0691 233 0478 112 0061 112 0060 112 0063 399 0823 190 0321 130 0133 184 0283 190 0322 184 0294 180 0218 184 0292 184 0295 182 0233 120 0076 280 0584 398 0831 283 0597 360 0744 AUTHORS AND YEAR Betta PC (1982) Bevan DR, Riemer SC, Lakowicz JR (1981) Bey E, Harington JS (1971) Bhagavan BS, Koss LG (1976) Bianchi C, Brollo A, Miniussi C, Bittesini L (1981) Bignon J (1970) Bignon J, Bientz M (1977) Bignon J, Monchaux G, Sebastien P, Hirsch A, Lafunm J (1979) Bignon J, Sebastien P, Bonnaud G (1978) Bitterman P, Rennard S, Shoenberger C, Crystal R et al (1981) Blot Wj, Fraun~ni JF (1979) Blot WJ, Fraun~ni JF (19BI) Blot Wj, Harrington JM, Toledo A, Hoover R et al (1978) Blot WJ, Morris LE, Fraumeni JF (1981) Blot Wj, Morris LE, Stroube R, Tagnon I, Fraumeni JF (1980) Blount M, Holt PF, Leach AA (1966) Bolton RE, Davis JMG (1976) Bordow RA (1982) Borhani NO, Hechter HH, Breslow L (1963) Bossard E, Stolkin I, Spycher MA, Ruttner JR (1980) Botham SK, Holt PF (1968) Botham SK, Holt PF (1971) Botham SK, Holt PF (1972) Botham SK, Holt PF (1972) Botham SK, Holt PF (1974) Brambilla C, Kaehler D, Brambilla E, Fourcy Pet al :(1980) Braude AC, Chamberlain DW, Rebuck AS (1982) Braun DC, De Treville RTP (1972) Breedin PH, Buss DH (1976) Brody AR (1980) Brody AR, Crapo JD (1979) Brody AR, Hill LH, Adkins B Jr, O'Connor RW (1981) Bross IDJ, Viadana E, Houten L (1978) Brown A..(1974) Brown DO, Wagner JC, Wagner hl~F (1980) Brown RC, Chamberlain M (1980) Brown RC, Chamberlain M, Davies R, Sutton GT (1980) Brown RC, Chamberlain M, Davies R, Morgan D~ et al (1980) Brown RC, Chamberlain M, Davies R, Gromley IP (Editors) (19B0) Brown RC, Chamberlain M, Griffiths DM, Timbrell V (1978) Brown RC, Chamberlain M, Sutton GT (I980) Bruch J (1974) Burns DM (Editor) (1982) Burrell R (1974) Cairns J, Nicholson WJ, Enterline PE, Blot WJ et al (1981) Campbell MJ, Wagner ~IF, Scott N~, Brown DO (1980) Carlens E (1976) GEOGRAPHIC CODE ITA U~ SAF UMD ITA FRA FRA FRA " FRA UMD UMD UMD UMD UMD UMD GBR GBR UCA UCA SWI GBR GBR GBR GBR GBR FRA CAN CAN UTE UNC SAF UNC UNY U~ GBR GBR GBR GBR GBR GBR GBR GER UCA UWV UMA GBR SWE

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 january 31, 1983 CATEGORY NUMBER 124 0115 182 0249 260 0558 124 0118 242 0535 232 0411 182 0239 182 0251 260 0559 182 0250 260 0560 260 0561 397 0824 183 0277 183 0278 190 0329 112 0066 112 0067 190 0330 350 0721 350 0720 283 0598 112 0053 112 0056 112 0058 280 0583 284 0615 333 0663 160 0199 160 0200 140 0167 170 0209 170 0210 182 0248 395 0816 182 0240 185 0302 39B 0835 183 0265 182 0232 140 0168 331 0659 124 0117 183 0256 332 0660 339 06B5 332 0661 AUTHORS AND YEAR Jaiswal AK, Viswanathan PN (1980) Jaurand MC, Bignon J (197/) Jaurand MC, Bignon J (1979) Jaurand MC, Bignon J, Gaudichet A, Magne L, Oblin A (1978) Jaurand MC, Gaudichet A, Atassi K, Sebastien P, Bignon J (1980) Jaurand MC, Goni J, Janrot P, Sebastien P, Bignon J (1976) Jaurand MC, Kaplan H, Thiol]et J, Pinchon MC et al (1979) Jaurand MC, Magne L, Bignon J (1980) Jaurand MC, Magne L, Bignon J (1979) Jaurand MC, Magne L, Bignon J, Goni J (1980) Jaurand MC, Renier A, Bignon J (1980) Jaurand MC, Thomassin JH, Baillif P, Magne Let al (1980) Johns-Manville Corp. (1980) Johnson NF, Davies R (1980) Johnson NF, Davies R (1981) Johnson NF, Wagner JC (1980) Johnson NF, Wagner JC, Wills HA (1980) Johnson NF, Wagner JC, Wills HA (1980) Jones JSP (1980) Jones JSP, Pooley FD, Sawle GW, Madeley RJ et al (1980) Jones JSP, Pooley FD, Smith PG (1976) Kagamimori S, Scott MP, Brown DG, Edwards RE, Wagner ~I~F (1980) Kagan E, Miller K (1978) _ Kagan E, Miller K (1979) Kagan E, Miller K (1981) Kagan E, Solomon A, Cochrane JC, Beissner El et al (1978) Kagan E, Solomon A, Cochrane JC, Kuba P, Rocks PH et al (1977) Kaminski R, Geissert KS, Dacey E (1980) Kanazawa K, Birbeck MSC, Carter RL, Roe FJC (1970) Kanazawa K, Roe FJC, Yamamoto T (1979) Kanazawa K, Yamamoto T, Yuasa Y (1979) Kandaswami C, O'Brien PJ (1980) Kandaswami C, O'Brien PJ (1981) Kang KY, Bice D, D'Amato R, Ziskind M, Salvaggio J (1979) Kannerstein M, Churg J, McCaughey WTE, Selikoff IJ (1977) Kaplan H, Jaurand MC, Pinchon MC, Bernaudin JF eta] (1980) Kaplan H, Renier A, Jaurand MC, Bignon J (1980) KarstadtM, Blot WJ, Peto J, Beebe GE, Enterline PE et al (1981) Kaw ~L, Tilke$ F, Beck E6 (1982) Kaw Jl., Zaidi SH (1975) Kawai T (1979) , Keane WT, Zavon ~ (1966) King EJ, Clegg JW, Rae VM (1946) Kioshi K, Sakabe H (1972) Kleinfeld M, Messite J (1967) Kleinfeld M, Messite J, Kooyman O, Zaki M (1967) Kleinfeld MJ (1968) GEOGRAPHI~ CODE IND FRA FRA FRA FRA FRA FRA FRA FRA FRA FRA FRA UCO GBR GBR GBR GBR GBR GBR GBR GBR GBR SAF SAF SAF SAF SAF UOH GBR GBR JAP CAN CAN ULA UNY FRA FRA UNY GER IND JAP UOH GBR JAP UNY UNY UNY

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 10 CATEGORY NUMBER 332 0662 231 0403 231 0402 350 0713 380 0775 380 0776 380 0777 338 0682 181 0219 360 0759 210 0379 397 0825 338 0681 397 0827 220 0392 122 0101 380 0778 370 0761 191 0343 170 0213 170 0215 170 0214 195 0360 170 0211 170 0212 195 0359 184 0288 284 0614 284 0613 282 0593 284 0610 235 0513 233 0456 233 0458 233 0457 233 0454 395 0818 210 0375 150 0190 232 0417 232 0434 190 0331 232 0414 121 0089 121 0088 232 0415 121 0090 AUTHORS AND YEAR K]einfeld ~ (1973) Knox JF, Beattie J (1954) Knox JF, Beattie j (1954) Knox JF, Holmes S, Doll R, Hill ID (1968) Kogan FM (1968) Kogan FM (1975) Kogan FM (1981) Kolonel LN, Hirohata T, Chappell BV, Viola FV, Harris DE (1980) Koshi K, Hayashi H, Sakabe H (1968) Koske]a RS (19982) Kotin P (1965) Kotin P (1981) Kraus JF, Franti CE, Newman B (1982) Kristein ~ (1981) Kuhn J (1941) Kung-Vosamae A, Vinkmann F (1980) Kurova EG, Gusel'nikova NA, Kogan FM, Starkov PS et al (1982) Lacquer LM, Van Der Linden L, Lepoutre J (1980) Lafuma J, Morin M, Poncy JL, Masse R (1980) Lakowicz JR, Bevan DR (1979) Lakowicz JR, Bevan DR (1980 Lakowicz JR, Bevan DR (1980) Lakowicz JR, Hylden JL (1978) Lakowicz JR, Hylden JL (1978) Lakowicz JR, Hylden JL, Bevan DR (1979) Lakowicz JR, Hy]den JL, EnglunO F, Hid~rk A, NcNamara M (1979) Landesman JM, Mossman BT (1982) Lange A (1980) Lange A (1980) Lange A, Sn~lik R, Chmielarczyk W, Garncarek D, Gielgier Z (1978) Lange A, Sn~)olik R, Zatonski W, Szymanska j (1974) L anger../&M (1974) Langer AM, Ashley R, Baden V, BerkIey C, Hammond EC et al (1973) Langer AJ~, Mackler AD, Poo]ey FD (1974) Langer AM, Poo]ey FD (1973) Langer AM, Rubin I, Selikoff IJ (1970) Langer AM, Wolff MS, Rohl AN, Selikoff IJ (1978) Lanza AJ, Editor (1938) Lavappa KS, Fu ~I~, Epstein SS (1975) Lavoinne A, Maitrot B, Gray H, Tayot J (1976) Lawther PJ (1971) Lazar P (1980) Le Bouffant L (1974) Le Bouffant L, Bruyere S, Daniel H, Tichoux G (1979) Le Bouffant L, Bruyere S, Daniel H, Tichoux G (1979) Le Bouffant L, Bruyere S, Martin JC, Tichoux G, Normand C (1976) Le Bouffant L, Martin JC, Daniel H (1979) GEOGRAPHIC CODE UNY GBR GBR GBR RUS RUS. RUS UHA JAP FIN UMO UCO UCA UMD GER RUS RUS BEL FRA UMN UMN UMN UMN UMN UMN UMN UVT POL POL POL POL UNY UNY UNY UNY UNY UNY UNY UOH FRA GBR FRA FRA FRA FRA FRA FRA 9SLh G6

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 11 CATEGORY NUMBER 111 0025 111 (~24 270 0576 124 0122 186 0309 394 0814 183 0270 360 0746 112 0051 234 0490 396 0820 340 0696 340 0697 170 0217 260 0553 260 0552 260 0554 183 0269 186 0314 185 0301 370 0771 121 0078 186 0310 350 0734 220 0391 240 0517 270 0567 231 0404 181 0222 370 0772 123 0102 311 0629 311 0630 310 0628 243 0544 124 0121 130 0136 196 0362 284 6)612 284 0611 234 0482 194 0355 112 0040 234 0495 337 0667 340 0693 340 0692 AUTHORS AND YEAR GEOGRAPHIC CODE Lee KP, Barras CE, Griffith FD, Waritz RS (1981) Lee KP, Barras CE, Griffith FD, Waritz RS, Lapin CA (1981) Lemaire I, Gingras D, Lemaire S (1982) Lemaire I, Sirois P, Rola-Pleszczynski M, Masse S, Begin R (1981) Lemaire S, Lemaire I (1981) Le~n RA, Dement JR, Wagoner JK (1980) Lemkin P, Lipkin L, Merril C, Shifrin S (1980) Lennholm B (1982) Leong BKJ, Kociba RJ, Pernell HC, Lisowe RW, Rampy LW (1978) Lewinsohn HC (1968) Lewinsohn HC (1979) Liddell FDK (1980) Liddell FDK (1981) Light WG (1979) Light WO, Wei ET (1977) Light WIG, Wei .ET (1977) Light WG, Wei ET (1980) Lipkin LE (1980) Litterst CL, Lichtenstein EP (1970) Livingston GK, Rom WN, Morris MV (1980) Lopez-Areal Del AmoL (1980) Luechtrath H, Schmidt KG (1959) Lukens • (1978) - Lumley KPS (1976 Lynch KM (1937) Lynch KM, Smith WA (1930) Mace ~I. Jr, Brinkley BR, McLen~re RL, Martin RR et al (1980) Mace ~ Jr, McLemore TL, Roggli V, Brinkley BR et al (1980) Macnab G, Harington JS (1967) Maillard JM, Fellmafln E, Wirz 0 (1982) Man SFP, Lee TK, Gibney RTN, Logus JW (1980) Mancuso TF, Coulter EJ (1963) Mancuso TF, EI-Attar AA (1967) Mancuso TF, Keefe F (1969) Mann B, Sinha CN (1966) Marcussen WH (197/) Maroudas NG, O'Neill CH (1973) Masse R, Sebastien P, Monchaux G, Bignon J (1980) Matej H, Lange A, Garncarek D, Smolik R, Roszak E (1978) MateJ H, Lange A, Smolik R (1977) McCullagh SF (1978) McCullagh SF (1981) McDermott M, Wagner JC (1975) McDonald AD (1980) McDonald AD, Fry JS (1982) McDonald AD, McDonald JC (1976) McDonald JC (1973) UDE UDE CAN FRA CAN UOH UMD SWE UMI GBR UCT CAN CAN UMA UCA UCA UCA UMD UWI UUT SPA GER UCA GBR USC USC UTX UTX SAF SWI CAN UPA UPA UPA GBR UCA UMD FRA POL POL ATL ATL GBR GBR CAN CAN CAN

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 12 CATEGORY NUMBER 340 0695 340 0694 340 0690 281 0585 241 0528 241 0525 241 0526 241 0529 270 0568 270 0569 234 0488 360 0753 360 0754 360 0752 112 0045 112 0047 340 0703 130 0156 112 0055 182 0238 111 0021 182 0237 183 0258 150 0176 112 0052 112 0059 112 0054 112 0057 198 0367 198 0366 232 0409 124 0112 195 0358 250 0547 370 0763 130 0151 393 6)005 Igg 0372 130 0131 112 0048 232 0436 232 0437 112 0049 183 0262 243 0546 340 0705 184 0287 AUTHORS AND YEAR McDonald JC, Gibbs GW, Liddell FDK (1980) McDonald JC, Liddell FDK (i9793 McDonald JC, McDonald AD, Gibbs GW, Siemiatycki j et al (19713 McFee DR, Tye R (19653 McLarty JW, Farley ~, Greenberg SD, Hurst GA, Mabry LC (1980) McLarty JW, Greenberg SD, Hurst GA,Spivey CO, et al (1980) McLarty JW, Greenberg SD, Hurst GA, Spivey CG et al (19803 McLarty JW, Greenberg SD, Hurst GA (19813 McLemore TL, Mace ~ Jr, Roggli V, Marshall MV et al (19803 McLemore TL, Roggli V, Marshall MV, Lawrence EC et al (19B13 Meurman LO, Hormia M, Isomaki M, Sutinen S (19703 Meurman LO, l(iviluoto R, Hakama M (19793 Meurman LO, Kiviluoto R, Hakama M (19743 Meurman LO, Kiviluoto R, Hakama M (1973) Middleton AP, Beckett ST, Davis jMG (1977) Middleton AP,.Beckett ST, Davis JMG (19793 Miller AB (19803 Miller JW, Sayers RR (1936) Miller K (19793 Miller K (19803 Miller K, Calverley A, Kagan E (1980) Miller K, Handfield RIM, Kagan E (19783 Miller K, Harington JS (19723 Miller K, Kagan E (1976) Miller K, Kagan E (19773 Miller K, Kagan E (19813 Miller K, Webster I, Handfield RIM, Skikne MI (1978) Miller K, Weintraub Z, Kagan E (19/9) Miller K, Weintraub Z, Kagan E (19803 Miller K, Weintraub Z, Kagan E (19803 Milne JEH (1971) Misra V., Rahman Q, Viswanathan PN (1978) Misra V, Rahman Q, Viswanathan PN, Beg MU, Zaidi SM (19773 Mitchell RI (1977) Molina C, Cheminat JC (19783 Monchaux G, Bignon J, Jaurand MC, Lafuma Jet al (1981) Morgan A (19733 Morgan A (19803 Morgan A, Davies P, Wagner JC, Berry G, Holmes A (19773 Morgan A, Evans JC, Holmes A (19773 Morgan A, Holmes A (1980) Morgan A, Holmes A (19823 Morgan A, Talbot Rj, Holmes A (1978) Morgan D~, Allison AC (1980) Morgenroth K (19733 Morrison AB (1979) Mossman BT, Adler KB, Craighead JE (19803 GEOGRAPHIC CODE CAN CAN CAN UOH UTX UTX UTX UTX UTX UTX FIN FIN FIN FIN GBR GBR CAN UDC SAF SAF UDC SAF SAF SAF SAF SAF SAF SAF SAF SAF ATL IND IND UOH FRA FRA GBR GBR GBR GBR GBR GBR GBR GBR GER CAN UVT

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 13 CATEGORY NUMBER 192 0346 184 0286 184 0285 285 0616 340 0698 398 0830 232 0438 124 0111 284 0602 391 0788 242 0540 121 0093 185 0297 350 0715 350 0717 350 0718 350 0714 185 0303 185 0304 398 0836 340 0700 124 0104 113 0069 124 0119 234 0493 232 0432 232 0444 250 0549 397 0826 235 0516 399 0839 234 0498 234 0500 234 0499 130 0155 160 0204 160 0205 198 0368 183 0255 350 0726 282 0595 140 0165 183 0266 112 0062 112 0064 241 0534 234 0507 AUTHORS AND YEAR Mossman BT, Craighead JE (1981) Mossman BT, Craighead JE, MacPherson BV (1980) Mossman 8T, Kessler JB, Ley BW, Craighead JE (1977) Munan L, Thouez JP, Kelly A, Gagne M, Labonte D (1981) Myre M (1981) NCI, NIEHS, NIOSH (1978) Narang S (1980) Narang S, Kaw JL, Zaidi SH (1978) Nash DR, Fortson NG, McLarty JW, Hurst GA (1981) National Institute for Occupational Safety and Health (1979) Naylor B (1977) Nettesheim P (1981) Neugut AI, Eisenberg D, Silverstein M, Pulkrabek Pet al (I978) Newhouse ~ (1970) Newhouse ~ (1973) Newhouse ~, Berry G (1979) Newhouse ~, Wagner JC (1969) Newman HAl, Saat YA, Hart RW (1980) Newman HAl, Saat YA, Hart RW (1980) Nicho]son WJ, Perkel G, Selikoff IJ, Seidman H (1981) Nicholson WJ, Selikoff IJ, Seidman H, Lilis R, Fromby P (1979) Nofer J, Szynczykiewicz K, Wiecek E (1961) _ Nordmann M, Sorge A (1941) Oblin A, Warner JM, Jaurand MC, Bignon J, Claude JR (1978) O]dham PD (1973) OIdham PD (1973) Ophus EM, Mowe G, Osen KK, Gylseth B (1980) PaImes ED, Lippmann M (1977) Parkinson DK (1981' PateI-Mandlik KJ (1981) Patrick JM (1981) Peacock PR (1968) Peacock PR, Biancifiori C, Bucciarelli E (1969) Peacock PR, Biancifiori C, Bucciarelli E (1969) Peacock PR, Peacock A (1966) Pelfrene AF (1977) .1:: Pelfrene AF (1977) Pernis B, Vigliani EC (1982) Pernis B, Vigliani EC, Marchisio MA, Zanardi S (1966) Peto O (1980) Pierce R, Turner-Warwick M (1980) Pigott GH, Ishmael J (1979) Pigott GH, Judge PJ (1980) Pinkerton KE, Pratt PC, Crapo JD (1980) Pinkerton KE, Pratt PC, Crapo JD (1982) Plamenac P, Nikulin A, Pikula 8, Markovic Z (1978) Plamenac P, Pikula B, Kahvic M, Markovic Z, Se]ak Iet a] (1971) GEOGRAPHIC CODE UVT UVT UVT CAN CAN UNC IND IND UTX UMD UMI UNC UNY GBR GBR GBR GBR UOH UOH UNY UNY POL GER FRA GBR GBR NOR UNY UPA UMD GBR ITA ITA ITA GBR UNE UNE UNY ITA GBR GBR GBR GBR U~C UNC YUG YUG

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 14 CATEGORY NUMBER 232 0441 190 0332 241 0533 234 0497 150 0170 394 0808 232 0427 232 0428 232 0429 232 0426 399 0840 190 0333 190 0334 185 0300 370 0770 197 0363 122 0099 122 0100 122 0098 195 0357 111 0027 281 0592 121 0084 181 0224 281 0591 197 0364 270 0579 111 0006 160 0206 112 0035 112 0034 270 0580 184 0269 181 0225 182 0242 182 0243 182 0245 235 0514 360 0743 338 0678 234 0491 336 0666 190 0335 182 0241 241 0527 235 0510 300 0626 AUTHORS AND YEAR Planteydt FIT (1973) Planteydt FIT (1980) PIanteydt HT, Stumphius J, Spuyman J (1964) Polliack A, Sacks MI (1968) Pontefract RD, Cunningham HM (1973) Poole C (1980) PooIey FD (1979) Pooley FD, Clark N (1979) Pooley FD, Clark NJ (1980) Pooley FD, Oldham PD, Um CH, Wagner JC (1970) Popper H, Selikoff IJ (1981) • Pott F (1980) Pott F, Huth F, Spurny K (1980) Price-Jones MJ, Gubbings G, Chamberlain M (1980) Puntoni R, Vercel]i M, Mer]o F, Valerio F, Santi L (1979) Py]ev LN (19~0) Pylev LN, Koval'skaya GD, Yakovenko GN (1975) Pylev LN, Kulagina TF (1982) Pylev LN, Roe F, Warwick D (1970) Pylev LN, Shabad LM (1973) Rahman Q (1982) Rahman Q, Beg MU, Viswanathan PN (1975) Rahman Q, Beg MU, Viswanathan PN, Zaidi SH (19~6) Rahman Q, Narang S, Kaw JL, Zaidi SH (1974) Rahman Q, Viswanathan PN, Tandon SK (1973) Rahman Q, Viswanathan PN, Zaidi SH (1977) Rajah KT, Evans PH (1973) Ramaswamy AS, Venkatesh DS, Rama Rao R (1953) Rasanen T (1962) Reeves AL (1976) Reeves AJ_, Puro HE, Smith RC (1974) Reiss'B, So]o~n S, Weisburger JH, Williams GM (1980) Reiss B, Weisburger JH, Williams GM (1979) Richards RJ, George G, Hunt J, TetIey TD (1980) Richards R~, Hext PM, Blundell G, Henerson W~, Volcani BE (1974) Richards RJ, Hext PM, Desai R, Tetley T, Hunt Jet al (1975) Richards RJ, Jacoby F (1976) Rickert RR (1974) Ringertz N (1955) Rinsky RA, Waxweiler RJ, Bierbaum PJ, Terpilak Met al (1980) Roberts GH (1967) Robinson C, Le~n R, Wagoner JK (1979) Robock K (1976) Robock K, K]osterkotter W (1973) Roggli VL, Greenberg SD, McLarty JW, Hurst GA et al (1980) Roggli VL, Greenberg SD, McLarty JL, Hurst GA et al (1980) Rom WN (1983) GEOGRAPHIC CODE NET NET NET ISR CAN UM{) GBR GBR GBR GBR UNY GER GER GBR ITA RUS RUS RUS RUS RUS UAR IND IND IND IND IND GBR IND FIN UMI UMI UNY UNY GBR GBR GBR GBR UNJ SWE UMD GBR UOH GER UTX UTX UUT

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 15 CATEGORY NUMBER 300 0625 350 0735 193 0348 220 0393 140 0166 281 0590 121 0086 121 0087 394 0810 394 0811 394 0809 190 0336 231 0405 140 0158 186 0307 260 0555 181 0223 124 0113 140 0157 110 0001 234 0487 232 0413 150 0182 324 0656 322 0651 393 0807 398 0832 397 0828 320 0644 300 0627 321 0646 320 0641 321 0~45 233 0455 395 0815 322 0547 322 0648 320 0642 323 0655 322 0649 323 0654 233 0460 200 0373 320 0643 338 0684 324 0657 324 0658 AUTHORS AND YEAR GEOGRAPHI CODE Rom WN, Editor (1983) UUT Rossiter CE, Coles RM (1980) GBR Roy-Chowdhury AK, Mooney TF Jr, Reeves AL (1973) UMI Ruska H (1942) GBR Sahu AP, Shanker R, Zaidi SH (1978) IND Saint-Remy JMR, Cole P (1980) GBR Salk RA, Vosamae A (1975) RUS Sanders CL Jr (1975) UWA Saracci R (1980) FRA Saracci R (1980) FRA Saracci R (1980) FRA Schepers GWH, Wagner JC, Hueper W (1965) UDC Schepers GWH, Wagner JC, Webster I, Peacock PR et al (1965) UDC Scheuer E, Huth F, Pott F (1973) GER Schneider U, Maurer RR (1977) UNC Schnitzer RJ,. Bunescu G (1970) UNY Schnitzer RJ, Pundsack FL (1970) SAF Schoenberger C, Hunninghake G, Gedek J, Crystal R (1980) UMD Schulz RZ, Williams CR (1942) UMA Schuster NH (1931) GBR SeI)astien P, Fondimare A, Bignon J, Monchaux Get al (1977) FRA Sebastien P, Janson X, Gaudichet A, Hirsch A, Bignon J (1980) FRA Sebastien P, Masse R, Bignon J (1980) FRA Seidman H, Selikoff IJ, Hammond EC (1979) UNY Selikoff IJ (1976) UNY Selikoff IJ (1979) UNY Selikoff IJ (1981) UNY Selikoff IJ (1981) UNY Selikoff IJ (1982) UNY Selikoff IJ (1983) UNY Selikoff IJ, Bader RA, Bader ~, Churg J, Hammond EC (1967) UNY Selikoff IJ, Churg J, Editors (1965) UNY Seliko~f IO, Churg J, Hammond EC (1964) UNY Selikoff IJ, Hammond EC (1970) UNY Selikoff IJ, H~nmond EC (1971) UNY Sellkoff IO, Hamn~)nd EC, Churg J (1968) UNY Selikoff IO, Ha~nond EC, Churg J (1968) UNY Selikoff IJ, Hammond EC, Editors (1979) UNY Selikoff IJ, Hammond EC, Seidman H (1980) UNY Selikoff IJ, Hammond EC, Seidman H (1973) UNY Selikoff IJ, Hamwnond EC, Seidman H (1979) ~ UNY Selikoff IJ, Lee DHK (19/8) -I:: UNY (~O UNY Selikoff IJ, Lee DHK (1978) Selikoff IJ, Lee DHK (1978) .,j UNY Selikoff IJ, Lilis R, Nicholson WJ (1979) ~ UNY Selikoff IJ, Seidman H (1981) C:~ UNY Selikoff IJ, Seidman H, Hammond EC (1980) CX: UNY

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 16 CATEGORY NUMBER 380 0780 140 0162 121 0085 350 0731 140 0161 234 0485 220 0396 240 0520 185 0296 124 0109 124 0108 124 0110 183 0263 285 0623 285 0622 130 0146 121 0077 122 0094 130 0153 130 0154 190 0337 150 0189 130 0152 243 0543 285 0618 160 0198 284 0609 130 0137 130 0134 130 0138 130 0139 130 0140 130 0135 140 0164 140 0163 240 0519 234 0506 234 0496 232 0442 182 0236 360 0749 380 0774 122 0097 233 0453 122 0095 122 0096 260 0562 AUTHORS AND YEAR GEOGRAPHI CODE Sera Y, Kang KY (1981) JAP Sethi S, Beck EG, Manojlovic H (1974) GER Shabad LM, Pylev LN, Krivosheeva LV, Kulagnina TF et al (1974) RUS Sheers G, Templeton AR (1968) GBR Shin ~, Firminger HI (1973) UMD Shugar S (1979) CA~W Simons EJ (1935) UMH Simson FW, Strachan AS (1931) SAF Sincock A, Seabright M (1975) GBR Singh J, Beg MU, Kaw JL, Viswanathan PN, Zaidi SH (1976) IND Singh J, Beg MU, Viswanathan PN, Zaidi SH (1975) IND Singh J, Pandey SD, Viswanathan PN, Zaidi SH (1978) IND Skeldon N, Steele L (1978) GBR Skerfving S, Korsgaard R, Simonsson BG, Stiksa Get al (1980) SWE Skerfving S, Korsgaerd R, Stiksa G, Simonsson BG (1980) SIdE Smith BA, Davis JMG (1971) GBR Smith JM, Wootton IDP, King EJ (1951) GBR Smith WE (1966) UNJ Smith WE (1973) UNJ Smith WE (1980) UNJ Smith WE, Hubert DD, Sobel HJ (1980) UNJ Smith WE, Hubert DD, SobeI HJ, Peters ET, Doerfler TE (1980) UNJ Smith WE, Miller L, Churg J, Selikoff IJ (1965-) UNJ Smith WG (1964) ATL Snodgrass DR, McLemore TL, Teague RB, Wray NP et al (1981) UTX Speirs RS, Wenck U (1955) U~ Stansfie]d D, Edge JR (1974) GBR Stanton ~ (1974) UMD Stanton ~, Blackwell R, Miller E (1969) UMD Stanton ~, Layard M (1978) UMD Stanton ~, L~ard M (1979) UMD Stanton ~, Layard M, Tegeris A, Mil]er E, May Met al (1981) UMD Stanton I~=, Wrench C (1972) UMD Stevens RH, Will LA, Cole DA, Meek ES, Frank CW, Donham KJ (1979) UIO Stevens RH, Will LA, Osborne JW, Cole DA, Donham KJ (1978) UIO Stewart MJ, Tattersa]1 N, Haddow AC (1932) GBR Stolkin I, Ruettner JR, Sahu AP, Schibli L, Spycher MA (1981) SWI Stovin PGI, Partridge P (1982) GBR Stun~)hius J, Meyer PB (1968) NET Styles jA, Wilson J (1973) GBR Sundell L (1980) SWE Suntych F, Kryze B, Parizkova B (1970)CZE Suzuki Y (1974) ~ UNY -I~ UNY Suzuki Y, Churg O (1969) ~ Suzuki Y, Chur9 J (1970) .~: UNY Suzuki Y, Churg J, Ono T (1972) -~I UNY Sykes SE, Morgan A, Holn~s A (1980) ~ GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 January 31, 1983 11 CATEGORY NUMBER 124 0105 233 0476 270 0575 399 0841 112 0042 112 0043 360 0750 360 0751 350 0727 232 0412 234 0504 233 0474 184 0290 194 0352 232 0433 395 0817 121 0091 121 0092 280 0582 2B4 0607 112 0036 220 0395 220 0394 234 0492 360 0745 285 0620 231 0408 243 0542 370 0767 370 0769 191 0345 112 0068 124 0106 124 0107 111 0005 183 0268 183 0267 111 0010 130 0126 190 0338 112 0038 232 0431 112 0041 130 0130 392 0802 183 0254 392 0803 AUTHORS AND YEAR Sz}~nczykiewicz K (1970) Tabershaw IR (1968) Tejwani GA, Ferte] R, Hart RW, Allison DK (1980) Teret S (1980) Tetley TO, Hext PM, Richards Rj, McDern~)tt M (1976) Tetley TD, Richards RJ, Harwood JL (1977) Thiringer BG (1980) Thiringer G, Jarvholm B (1980) Thomas HF, Elwood PC, Benjamin IT, Sweetnam PM (1982) Thomassin JH, Touray JC, Bail]if P, Jaurand MC et al (1980) Thomson JG, Kaschula ROC, MacDonald RR (1963) Thomson JG, Path FC, Graves WM (1966) Tilkes F, Beck EG (1980) Timbrell V (1972) Timbrel] V (1980) Tish]er PV, Naseem SM, Anderson HA, Selikoff IJ (1977) Topping DC, Nettesheim P (1980) Topping DC, Nettesheim P, Martin DH (1980) Turner-Warwick M (1973) Turner-Warwick M (1979) Turnock AC, Bryks S, Bertalanffy FD (1971) Tylecote FE (1927) - Tylecote FE, Dunn SJ (1931) Um CH (1971) Vagero D, Allander E, Allebeck P, Persson G, Straat E (1982) Valerio F, de Ferrari M, Ottaggio L, Repetto E et al (1980) Vallyathan NV, Green FHY, Craighead JE (1980) Van Ordstrand HS, Effler DB, McCormack LJ (i955) Versen P (1980) Vig]iani C, Ghezzi I, Maranzana P, Pernis B (1968) Viglia~i EC (1968) Vincent JH, Johnston WB, Jones AD, Johnston AJq (1981) Viswanathan PN, Dogra RKS, Shanker R, Zaidi SH (1973) Viswanathan PN, Rahman Q, Beg MU, Zaidi SH (1973) Vorwald AJ, Durkan TM, Pratt PC (1951) Wade Mj, Lipkin LE, Stanton ~, Frank AL (1980) Wade Mj, Lipkin LE, Tucker RW, Frank AL (1976) Wagner JC (1963) Wagner JC (1966) Wagner JC (1971) Wagner JC (1972) Wagner JC (i973) Wagner JC (1975) Wagner JC (1976) Wagner JC (1979) Wagner JC (Editor) (19B0) Wagner JC, Berry FD (1980) GEOGRAPHI CODE POL UCA UOH UMD GBR GBR SWE SWE GBR FRA SAF SAF GER GBR GBR UNY UNC UNC GBR GBR CAN GBR GBR GBR SWE ITA UVT UOH GER ITA ITA GBR IND IND UNY UMD UMD GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 100 to 399 january 31, 1983 18 CATEGORY NU~ER AUTHORS AND YEAR 130 0127 Wagner JC, Berry G (1969) 190 0340 Wagner JC, Berry G (1973) 190 0339 Wagner JC, Berry G (1973) 190 0341 Wagner JC, Berry G, Hill RJ, Munday DE, Skidmore JW (1980) 112 0039 Wagner JC, Berry G, Skidm~re JW, Timbrell V (1974) 190 0342 Wagner JC, Berry G, Skidm~re JW, Pooley FD (1980) 130 0128 Wagner JC, Berry G, TimbreIl V (1973) 392 0801 Wagner JC, Bogovski P, Higginson J (1972) 392 0800 Wagner JC, Gi]son JC, Berry G, Timbrel] V (1971) 130 0132 283 0601 283 0600 243 0545 150 0183 233 0470 ii0 0002 150 0192 113 0074 113 0071 113 0073 113 0072 393 0806 396 0821 191 0344 150 0169 210 03BO 182 0252 350 0722 124 0120 397 0829 281 0589 370 0768 183 0271 233 0480 183 0274 260 0551 234 0481 250 0550 150 0187 150 0188 124 0125 241 0522 Wagner ~F (1979) Wagner ~I~F (1980) Wagner PI~F, Campbell Mj, Edwards RE (1979) Walton M, Skeoch T (1968) Ward JM, Frank AL, Wenk M, Devor D, Tarone RE (1980) Warnock ~, Churg AM (1980) Webster I (1963) Webster I (1974) Wehner AP (1980) Wehner AP, Busch RH, Olson RJ, Craig DK (1975) Wehner AP, Dagle GE, Cannon WC (1978) Wehner AP, Dagle GE, Cannon WC, Buschbom RL (1978) Wei]] H (1973) " Wen CP, Tsai SP (1982) Westlake GE (1974) Westlake GE, Spjut HJ, Smith MN (1965) Weston J-T, Liebow AA, Dixon MG, Rich TH (1972) White R, Kuhn C (1980) Wignall BK, Fox Aj (1982) Wilcox K, Marcussen W, Furst A (1974) Wilson D (1981) Wilson..~, Gaumer ~, Salvaggio JE (1977) Woitowitz HJ, Beierl L, Rathgeb M, Schmidt K et al (1981) Wright A, Gormley IP, Collings PL, Davis JMG (1980) Wright GW (1969) Wright MO, Gormley IP (1980) Wyard S (1914) XipeIl JM, Bhathal PS (1969) Yu CP, Taulbee DB (1977) Zaidi SH (1974) Zaidi SH, Gupta GSD, Rahman Q, Kaw Jl., Shanker R (1976) Zaidi SH, Shanker R, Dogra RKS (1973) Zeluff GW, Jenkins DE, Greenberg SD (1976) GEOGRAPHI CODE GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR GBR UMD UCA SAF SAF UWA UWA UWA UWA ULA UTX UCA UTX UUT UMO GBR UCA UMD ULA GER GBR UOH GBR GBR ATL UNY IND IND IND UTX

ASBESTOS/CIGARETTE SMOKING INTERACTIONS A Review of the Medical Literature, 1882 to 1982 Part One: Genesis of Asbestos/Smoking Interaction Hypothesis [000] Scope of literature review 2 [i00] Animal experiments 13 [200] Human pathology and in vitro studies 105 [300] Epidemiologic studies on mortality pattern of asbestos workers 175 Part Two: Asbestos-Associated Diseases [400] Malignant mesotheliomas and pleural diseases 261 [500 Bronchial carcinoma and extrapulmonary malignancies 375 [600] Pulmonary asbestosis 424 Part Three: Asbestos Dust Exposure [700] Occupational exposure to asbestos [800] Environmental exposure to asbestos [900] Governmental regulations and miscellaneous topics Part Four: Bibliographies and Indices Numerical bibliography Additional bibliography Supplemental bibliography Category subject index Author index Geographical index Revised October 5, 1983 Note: Drafts f6r Series [600s] to [900s] are complete. Final versions will be forwarded late in October.

Asbestos/Smoking Interactions [400 Series] March 30,1983 261 [400] MALIGNANT MESOTHELIOMA AND PLEURAL DISEASES [410] Pioneering Mesothelioma Studies in Germanyr the United Kingdom, and the British Commonwealth [411] Pleural mesothelioma stud [412] Pleural mesothelioma stud [413] Pleural mesothelioma stud [414] Pleural mesothelioma stud [415] Pleural mesothelioma stud [416] Pleural mesothelioma stud [417] Pleural mesothelioma stud ~es ~n Germany ~es ~n South Africa les In England ~es in Wales ~es In Scotland ~es ~n Ireland ~es ~n Australia [418] Pleural mesothelioma studies ~n Canada [419] Summary of pleural mesothelioma research [420] Pleural Mesothelioma Studies in Continental Europe and Asia [421] France [422] Italy [423] Switzerland [424] Scandinavia [425] Belgium and the Netherlands [426] Eastern Europe [427] Turkey [430] Pleural Mesothelioma Studies in the United States 263 265 266 268 270 273 275 276 276 278 279 280 281 282 283 284 285 286 287 287 [431] Mount Sinai Hospital Group: New York and New Jersey 288 [432] Additional studies in New York State - 289 [433] Additional studies in New Jersey 291 [434] Connecticut 291 [435] Massachussetts 292 [436] Pennsylvania 292 [437] Virginia 293 [438] Texas 294 [439] Pleural mesothelioma incidence estimates for the United States 295 [440] Pleural"Malignant Mesothelioma Case Reports 296 [441] American case reports prior to 1960 297 [442] Post 1960 American and foreign case reports with occupational exposure to asbestos 298 [443] Post 1960 American and foreign case reports without history of asbestos exposure 301 [444] Mesothelioma case reports in children 303 [445] Mesothelio~ and tuberculosis case reports 304 [446] Familial clustering of mesothelioma 305

Asbestos/Smoking Interactions [400 Series] March 30, 1983 262 [450] Benign ~leural Mesothelioma 306 [460] Extrapleural Mesothelioma 308 [461] Peritoneal mesothelioma in asbestos workers 309 [462] Peritoneal mesothelioma in non-asbestos workers 310 [463] Pericardial mesothelioma 311 [464] Mesothelioma of male genitalia 311 [470] Treatment of Malignant Mesothelioma 312 [480] Pleural Plaques and Effusion [481] Pleural plaques (Roentgenolic diagnosis) [482] Diffuse pleural thickening (Lung en Cuirasse) [483] Pleural calcification [484] Pleural effusion 31.4 315 319 319 320 [490] Asbestos/Cigarette Smoking Interaction in Patients with Pleural Disease 320 Bibliography Author Index 400s 374 + page 1 to page Ii

Asbestos/Smoking Interactions [400 Series] March 30, 1983 263 [400] MALIGNANT MESOTHELIOMA AND PLEURAL DISEASES The three topical series comprising Part Two are devoted to diseases that are associated with exposure to asbestos dust, namely: malignant mesothelioma [Category 400s]; bronchogenic carcinoma [Category 500s]; and pulmonary asbestosis [Category 600s]. The orientation of the literature review for the three category groups is on diseases with special emphasis on occupational factors and other risk factors. The disease orientation is in contrast to technique orientation for Part One [Categories 100s, 200s and 300s] and to worker orientation for Part Three [Categories 400s, 500s and 600s]. As in earlier categories, this review on Malignant Mesothelioma and Pleura1 Diseases highlights the publications that have searched for asbestos/smoking interaction. The medical articles that do not mention the interaction phenomenon are also included although the coverage is brief. Copies of all publicat.ions are avilable so that additional details of selected topics of pleural diseases can be readily supplied. It is very likely that any recent case of pleura1 mesothelioma had occupational history, medical history and clinical findings

Asbestos/Smoking Interactions [400 Series] March 30, 1983 264 that are similar to those cases that have been reported literature. There is a consensus of opinion including malignant mesothelioma are in the that pleural diseases caused by inhalation of asbestos fibers. There is also general agreement among experts that there is no synergistic interaction between asbestos and cigarette smoking in the pathogenesis of pleural diseases. A closer examination of the literature suggests that cigarette smoking reduces the risk of pleural diseases and this unusual interaction is discussed below. This reviewer proceeded to examine the literature of asbestos-associated pleural diseases primarily to determine why the synergistic interaction phenomenon between asbestos and cigarette smoking is absent for pleural diseases, yet it is hypothesized for bronchogenic carcinoma [Series 500s] and pulmonary asbestosis [Series 600s]. This question has not been raised hitherto in publications on asbestos-associated diseases including the 1978 monograph by Selikoff and Lee (842), the 1982 monograph by Selikoff (843) and the 1982 monograph published by the Commercial Union Insurance Companies (844). The probable answers to the above stated question are derived by tracing the evolution of the concept that pleural diseases including mesothelioma can be caused by inhalation of

Asbestos/Smoking Interactions [400 Series] March 30, 1983 265 asbestos fibers. The discussion that follows starts with pioneering studies on mesothelioma in Germany and the United Kingdom, including the British Commonwealth, and then proceeds to confirmatory studies in other European countries and the ~nited States. There is a special section on case reports to illustrate the role of exposure, followed by a malignant mesothelioma. risk factors other than asbestos brief commentary on treatment of Extrapleural mesothelioma and benign diseases of the pleura, including pleural asbestosis, pleural plaques and pleural effusion are discussed under separate categories. This Series concludes with summary statements on asbestos/cigarette smoking interaction in patients with pleural diseases. [410] Pioneering Mesothelioma Studies in German~r the United Kig~domr and the British Commonwealth During the past thirty years, there has been an increas- ing number of patients with pleural malignant mesothelioma who have been occ~pationally exposed to asbestos. Although early reports originated from Germany and Great Britain, the defini- tive study of causal relationship between asbestos and pleural malignant mesothelioma was from South Africa. It is important to mention at the outset that the medical publications from

Asbestos/Smoking Interactions [400 Series] March 30, 1983 266 these countries as well as Canada and Australia did not include a search for asbestos/cigarette smoking interaction. [411] Pleural Mesothelioma Studies in Germany In 1953, Weiss (845) reported the occurrence of pleural tumors in the asbestotic lungs of a dockyard worker who had done insulation work. The patient's primary diagnosis was malignant pleural effusion with significant pleural thickening. Thoracoscopy followed by biopsy showed involvement of visceral and parietal pleura by malignant mesothelioma with asbestosis bodies. The malignan6y was diagnosed 31 years after initial exposure to asbestos dust and continued for 22 years. Several cases of German asbestos workers were later reported, and some of them are discussed under Case Reports [Category 440] and extrapleural mesothelioma [Category 460]. Large asbestos-processing factories are located in Berlin, Bad Berneck, Dresden, Frankfurt am Main, Hamburg, Nordenham and Schw~bisch-Hall. The incidence of pleural mesothelioma"in autopsied cases are as follows: Investigators [City/State/Country] (846) Knappmann 1970 [Hamburg] Pleural Mesothelioma Cases Number or Percentage 0.314% of 79,841 autopsies

Asbestos/Smoking Interactions [400 Series] March 30, 1983 267 (847) Hain et al 1974 [Hamburg] (848) Otto 1980 [Dortmund] (848) Konetzke & Beck 1981 [German Registry] (850) Huzly 1981 [Stuttgart] (851) Calavrezos & Hain 1982 [Hamburg] 251 cases proven post mortem 150 cases retrospective history = 85 occupational exposure to asbestos 20 lived in neighborhood of asbestos exposure 45 no history of exposure 514 lung biopsies = 20 mesothelioma with asbestos exposure 50 mesothelioma without exposure 915 cases mesothelioma = 36.7% occupational asbestos 0.8% nonoccupational asbestos 9.1% asbestos underlying cause 33.7% no asbestos contact 19.7% insufficient data 290 surgically operated malignancies ffi 165 pleural mesothelioma 4 pleural carcinoma 12 pleural sarcoma 19 pleural solitary giant tumor 85 metastatic p_leural carcinosis 5 metastatic pleural giant tumor 160 patients = diagnostic problems in most of them The above studies indicate the three major sources of diagnosis, -namely, postmortem, needle biospsy and surgical removal. It should be noted that approximately half of pleural malignancies that are surgically removed proved to be pleural mesotheliomas (85). Among cases of pleural mesothelioma, less than half can be accounted for by exposure to asbestos (848,

Asbestos/Smoking Interactions [400 Series] March 30, 1983 268 849). The results do not support the general proposition that most cases of pleural mesothelioma are associated with occupa- tional exposure to asbestos. To the contrary, most cases are either exposed to asbestos outside of the work environment or have no history of asbestos exposure. Asbestos/Cigarette Smoking Interaction. There is only one published study from Germany that examined the smoking habits of pleural mesothelioma patients. Hain et al (847) compared the social history of a group of 150 cases of mesothe- lioma with a control group. The mesothelioma patient group had a significantly higher proportion of heavy smokers, than the control group (50 versus 29). Until an English translation of this article is available, it is not possible to formulate an opinion. _ [412] Pleural Mesothelioma Studies in South Africa Scientists in the Pneumoconiosis Research Unit (later changed to the National Research Institute for Occupational Diseases of'the South African Medical Research Johannesburg relationship mesothelioma. attention was published in 1960 by Wagner, Sleggs are acclaimed to have established between asbestos and pleural The first article that attracted and Council) at the causal malignant world-wide Marchand

Asbestos/Smoking Interactions [400 Series] March 30, 1983 269 (852). They reported 33 histologically proven cases of pleural mesothelioma, 31 to 68 years old, 22 males and ii female. Only 8 of the 33 cases had evidence of occupational exposure: six from mining, one from lagging steam pipes, and the other from working at an asbestos mining area. In the remaining 25 cases, the authors could "only present circumstantial evidence of exposure to asbestos dust; 18 were born in the vicinity of the mines and two arrived in the district as infants. Of these 18 people, ii admit definite childhood exposure to the dust and two others were exposed industrially in later life. In addition two patients with childhood .exposure later worked in the asbestos mines. Three cases arrived in the region at an older age but were employed either on the ~nes or in transporting asbestos. A further three of these 25 cases have had industrial exposure, and in only one case do the relatives deny any exposure to asbestos dust" (852). Wagner et al (852) were careful to point out that "asbestos dust is a factor in the occurrence of these tumors." By 1962, Wagner (853) had diagnosed a total of 87 pleural mesothelioma, of which 12 occurred in patients with industrial exposure to"asbestos, and the remainder in patients residing in asbestos fields; two cases had no history of exposure to asbestos dust. In 1973, Webster (854) reviewed 232 cases of pleural mesothelioma, 14% with no known history of asbestos exposure. In 1978, Cohrane et al (855) reported 70 consecutive

Asbestos/Smoking Interactions [400 Series] March ~30, 1983 270 cases of pleural mesothelioma and reported that one case did not have a history of exposure to asbestos dust, although the extent of exposure of many could be questioned. Spokesmen from the South African Asbestos Tumour Registry have repeatedly emphasized that there are a number of mesothelioma cases with "no indication of exposure to asbestos". (856): Webster, Thomson, Gilson and their collaborators (857- 861) have dismissed other possible causes of mesothelioma, and supported their theory by initiated in experimental rats 150]. showing that me'sothelioma could be exposed to asbestos [Category [413] Pleural Mesothelioma Studies in England As early as 1921, Eastwood and Martin (862) reported a patient with pleural mesothelioma who was admitted to the Royal Southern Hospital at Liverpool. There was no mention of any occupational exposure to asbestos. At that time, there was an ongoing controversy on the embryonic origin of pleural tumors, although the authors accepted the term of mesothelioma to mean that cells originated pleura. In the course authors emphasized that elderly patient between from the endothelial lining of the of discussion of the case, the English mesothelio~ occurs usually in the 40 and 60 years old, slightly more

Asbestos/Smoking Interactions [400 Series] March 30, 1983 271 common in males than females, and are more often right sided. It is interesting that similar features characterize the cases of pleural mesothelioma reported in recent years. In 1964, Owen (863) reported 16 cases of pleural mesothelioma from the files of the Liverpool Cancer Control Organization and from those of the Liverpool Regional Thoracic Surgery Unit. Eleven of the patients were known to have handled asbestos during the course of their work; one worked as a clerk in the office of a factory where the atmosphere was frequently contaminated by asbestos dust, and the remaning four gave a negative or inconclusive occupational history. Owen subscribed to the asbestos etiology proposed by Wagner et al, but did not cite the earlier study of Eastwood and Martin (862). Owen (863) also did not explain why-- a majority of mesothelioma cases in Liverpool were associated with occupational exposure to asbestos, whereas asbestos exposure for a majority of South African cases of mesothelioma were residential in nature. Subsequent medical reports from England indicated that the majority of pleural mesothelioma cases were 9or related to occupational asbestos exposure. The published results were as follows:

Asbestos/Smoking Interactions [400 Series| March 30, 1983 272 Investigators [City/State/Country] Pleural mesothelioma Number or Percentage (864 Newhouse & Thompson 1967 [London GBR] 83 mesothelioma ffi 56 pleural + 27 peritoneal (865) Newhouse 1967 [London GBR] 31 (41%) occupational exposure to asbestos 9 (12%) domestic exposure 36 (47%) no history of exposure (866) Smither 1966 [Cape Asbestos Co. GBR] 71 cases of asbestosis - 2 cases of pleural mesothelioma 26 cases of pulmonary carcinoma 13 cases of peritoneal mesothelioma (867) Whitewell & Rawcliffe 52 cases of pleural mesothelioma = 1971 [Merseyside GBR] 80% occupational exposure to asbestos 17% showed pulmonary asbestosis (868) Edge 1976 [Cumbria GBR] 28 cases of pleural mesothelioma = 22 cases with pleural effusion (869) Sheers 1980 [Plymouth GBR] 108 deaths pleural or peritoneal mesotheliomas; all worked in dockyard exposed to asbestos except one (bank manager) (870) Acheson et al 1981 [Southampton GBR] 4 deaths pleural mesothelioma; all worked in factory for insulation board There is a wide range of incidences of occupational exposure to asbestos in the above medical reports, from 41 percent to as much as 100 percent. There are additional publications relating tissue (871-875), the derived at necropsy 881). to the asbestos content of mesothelioma histological changes of the tissue (876, 877) and of pleural biopsy (878- The histological features of mesothelioma are so varied

Asbestos/Smoking Interactions [400 Series] March 30, 1983 273 although their malignant nature was and profuse invasion of pleura. predictions of increasing incidence based on the long latent period readily shown by diffuse There are also published of pleura1 mesothelioma of 15 to 40 years and the widespread use of asbestos in recent years (882-887). Asbestos/Cigarette Smoking Interaction. The publica- tion by Whitwe11 and Rawcliffe (867) is the only one in English that considered the possible association of cigarette smoking and asbestos exposure. ;t~ong the 52 patients with pleura1 mesothelioma, smoking habits were recorded in 28 patients: nonsmokers; 8 smokers up to i0 cigarettes/day; i0 smokers more than 10 cigarettes/day. The incubation period from first exposure to asbestos until development of mesothelioma was no shorter in the smokers than in the nonsmokers, neither was the duration of asbestos exposure any shorter in the smokers. The authors concluded that there was no evidence of synergism. [414] Unit studied research Pleural Mesothelioma Studies in Wales Wagner and hfs coworkers at the Penumoconiosis Research report on mesothelioma patients that have been previously by other investigators from England. The Welsh group contributed additional information by measuring

Asbestos/Smoking Interactions [400 Series] March 30, 1983 274 asbestos levels in human lungs (888, 889). More recently they summarized the asbestos contents of postmortem lungs from 103 patients who had worked at an asbestos textile factory, includ- ing 13 who died of pleural mesothelioma. The lungs of those with pleural mesothelioma did not contain more of either chrysotile or crocidolite, than the lungs of the controls without mesothelioma. Wagner et al (890) concluded that no particular type of asbestos could be implicated in causing mesothelioma and could not confirm Peto's suggestion that mesothelioma occurring in this particular British textile factory could be a~tributed to chrysotile exposure. Wagner and his collaborators have reviewed the broad subject of meso- thelioma with special reference to exposure levels (891-894), histological diagnosis (895) and ultramicroscopic changes (896). Gardner et al (897) reviewed the mortality ratios from pleural mesothelioma during the period 1968 to 1978 in Wales and England. Over the ii year period, the annual numbers of deaths rose by 75 percent. This marked increase was virtually confined to men in whom the numbers of mesothelioma deaths had reached almost 200 per annum by 1978.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 275 [415] Pleural Mesothelioma Studies in Scotland. Le Roux (898) from the University of Edinburgh reviewed the medical history of 3000 patients diagnosed to have bron- chial carcinoma. During the same ten-year period, 274 patients had pleural metastasis, and 16 had primary pleural tumors. In the latter group, nine were diagnosed histologically as pleural malignant mesothelioma, thus a ratio of mesothelioma to 333 bronchial carcinoma exists patients. one pleural for Edinburgh (899) 1967. patient and this difference was significant at 1 percent pared to 24 percent nonsmokers reported for general population, there were fewer nonsmokers in thelioma cases (16 percent). Only 25 percent of mesothelioma cases had a history of occupational exposure to asbestos. The 'most recent retrospectve study consists of 32 patients from Glasgow area, diagnosed between 1974 and 1980. Asbestos contact in shipyards was noted in 80 percent of patients (900, 901). The ultrastructure of human biopsy specimens were reported by Davis (902) to be similar to those seen in animals with asbestos-induced mesothelioma. Greenberg Asbestos/Cigarette Smoking Interaction. McEwen et al collected 80 cases of mesothelioma recorded from 1950 to Compared to cancer patient controls and cardiovascular controls, mesothelioma patients smoked less cigarettes, level. Com- males in the the meso-

Asbestos/Smoking Interactions [400 Series] March 30, 1983 276 (903, 904) summarized the results of Mesothelioma Registry for Scotland, England and Wales. [416] Elmes has been maintaining patients from Belfast (905-908). fate of 162 of the 168 men who were Pleural Mesothelioma Studies in Ireland a Registy of mesothelioma It was possible to trace the working as insulators in 1940. Their excess mortality was mainly due to respiratory cancers, one-third being pleural mesothelioma. Of those who were registered, 98 died of malignancy whereas the age-adjusted prediction was only 37; thus a mortality risk ratio of 2.6. [417] Pleural Mesothelioma Studies in Australia The first reported case of pleural mesothelioma in an asbestos worker was a miner who also was suffering from pulmonary asbestosis and silicosis. McNulty (909) reported the details in 1962, emphasizing the similarities to Wagner's cases from South Africa reported in exposure to crocidolite, and asbestos fiber. However the 1960 [Category 411], such as short or transitory exposure to interval between exposure and development of mesothelioma was shorter (12 years) than the 20 to 40 years reported among South Africans.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 277 In a larger series of 35 cases of pleural mesothelioma reported from Australia by Griffiths et al (910), the latent period ranged from 18 to 52 years. Furthermore, i0 of the 35 cases had no history of occupational exposure to asbestos. Other reports of pleural mesothelioma cases did not discuss the question of occupational exposure and latent period (911-913). Asbestos/Cigarette Smoking Interaction. In a 1982 of pleuropulmonary diseases, Henderson (913) stated that review "in an asbestos-exposed mesothelioma is not smoking". No reference mesothelioma. population, the risk of developing influenced by concomitant cigarette was cited for the statement on The only mention of smoking habits of Australian mesothelioma patients is in the two cases reported by Mortimer and Campbell (914). One patient had smoked 3 to 4 ounces of tobacco per week for 40 years, and the other had smoked 40 cigarettes a day for more than 25 years. The former was exposed to asbestos, working as an insulator; but the latter patient had no history of asbestos exposure. The subject of nonoccupational exposure to asbestos in patients with pleural mesothelioma has been discussed by McCullagh (915) who reviewed the pitfalls in differentiating positive from negative asbestos exposures.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 278 [418] Pleural Mesothelioma Studies in Canada Prior to 1960, there were two cases of pleural mesothe- lioma reported from Canada, both females, 46 and 52 years old respectively (916, 917). In 1970, McDonald et al (918, 919) surveyed all fatal cases of mesothelioma known to have occurred in Canada between 1959 and mid-1968. The registered deaths numbered 165. Only 20 percent had definite or probable occupa- tional exposure to asbestos, 20 percent as possible domestic or residential exposure, and 60 percent as unlikely exposure to asbestos. By 1980, McDonald et al (920, 921) extended their survey to include 254 registered cases of mesothelioma. The occupa- tional exposure to asbestos was increased to 40 percent, and crocidolite exposure was claimed to be more dangerous than chrysotile. The mesothelioma cases who were not occupationally exposed to asbestos were explained by "some other etiology" that was not specified. Canadian scientists have made significant contributions to the histo'logic (922, 923), histochemical (924), ultra- microscopic (925), and radiographic (926) diagnosis of pleural mesothelioma. Chovil and Stewart (927) from the Workmen's Compensation Board, sun~arized the latency of compensated cases of mesothelioma. The mean latent period was 26.9 years, rang-

Asbestos/Smoking Interactions [400 Series] March 30, 1983 279 ing from 6 to 44 years, which is shorter than figures reported by McDonald et al and some European investigators. Shugar (928) reviewed the disease for the National Research Council of Canada but the publication did not mention results of Canadian investigators. Asbestos/Cigarette al (918) examined the Smokin~ smoking Interaction. McDonald et histories of mesotheliama patients, control group with primary lung cancer, and a second control group with mestastatic lung cancer. Their conclusions were as follows: "In both males and females, persons in the primary lung cancer group had smoked considerably more than those in either the case (mesothelioma) or secondary (metasta- tic) lung cancer groups. The latter two groups had almost an identical distribution of smoking habits. The 20 men with definite or probable occupational exposure to asbestos showed no great difference in smoking habits from cases without occupational exposure". The tabulated results were not subjected to statistical analysis for significance. [419] Summary of Pleural Mesothelioma Studies in the United Kingdom and the British Commonwealth Following the pioneering efforts of Wagner who first suggested that asbestos dust is a cause of pleural mesothelio-

Asbestos/Smoking Interactions [400 SeriesJ March 30, 1983 280 ma, many investigators from the United Kingdom and Germany have reported about 250 cases that were exposed to asbestos dust. The various reports gave a wide range of occupational exposure to asbestos dust among pleural mesothelioma patients. A significant number of patients were exposed to asbestos either domestically or in the neighboring asbestos mines or factories. Most investigators emphasized the long latent period from initial exposure to diagnosis of pleural mesothelioma, ranging from 15 to 50 years. This long latent period explains the recent increase in incidence of pleural mesothelioma although widespread use of asbestos was initiated over fifty years ago. [420] Pleural Mesothelioma Studies in Continental Europe and Asia - From several countries in Europe and Asia, have appeared on pleural malignant mesothelioma. ports prior to 1960 did not mention the importance exposure whereas the publications after 1960 consistent wit~ Wagner's contention that asbestos dust is the most significant cause of pleural mesothelioma. publications The case re- of asbestos are uniformly exposure

Asbestos/Smoking Interactions [400 Series] March 30, 1983 281 [421] France The first description of pleura1 mesothelioma in France was published in 1953 by Campo (929). The primary symptom of the patient was intercostal neuralgia and the diagnosis of pleura1 mesothelioma was confirmed by histopathologic changes seen in the lung removed by surgery. During the 1960s, a Mesothelioma Registry was organized largely through the efforts of chest physicians in Paris (930), particularly Bignon (931). The Registry was formed primarily to assist other groups in France in the diagnosis of mesothelioma and also to determine if the recent experience in Germany and the United Kingdom [Category 410] were applicable to France. The questionnaire relating to a registered case of mesothelioma was designed to determine occupational exposure to asbestos. There were no questions relating to smoking habits. The published results were as follows: Investigators ~Cit~/State/Countr~] (932) Bignon ~t al 1979 (922) Bignon et al 1979 [France Registry] (934) Perdrizet et al 1980 [France Registry] (935) Boutin 1976 (936) Boutin et al 1978 (937) Boutin et al 1979 (938) Irisson et al 1983 [Marseille] Pleura1 Mesothelioma Number or Percentage 477 cases up to June 1979: only 186 confirmed pleural mesothelioma = 77% occupational asbestos exposure; 3% residential asbestos exposure; 20% no asbestos exposure 305 confirmed pleural mesothelioma= 20% no asbestos exposure 38 pleura1 mesothelioma = 80% occupational asbestos exposure

Asbestos/Smoking Interactions [400 Series] March 30, 1983 282 (939) Lajart~e et al 1976 (940) Lajartre & Lajartre 1979 [Nantes] (941) Molinari et al 1981 (Toulin] 70 cases of pleural mesothelioma = 68% occupational asbestos exposure; 9% probable asbestos exposure; 23% no history of asbestos exposure 13 cases of pleural mesothelioma = asbestos exposure in only 4 cases; all smokers Bignon and his collaborators have examined seqeral aspects of mesothelioma such as etiology (942-944), radiologic and surgical aspects (945, 946), mineralogical analysis of the lungs (947), bronchoalveolar fluid enzymatic content (948), phagocytic behavior of mesothelial cells (949), (950) and ultramicroscopic changes (951). collaborators as well as other scientists in have repeatedly questioned the concepts of their British and American colleagues, specifically the primary and exclusive role of asbestos in the pathogenesis of mesothelioma. histopathologic Bignon and his France (952-960) [422] Italy Prior to 1960, Ragaini and Sfondrini (961) reviewed the histological • features of pleural malignant mesothelioma in 12 patients residing in Milan. An occupational exposure to asbestos was not considered. In the 1970s, the following

Asbestos/Smoking Interactions [400 Series] March 30, 1983 283 series of mesothelioma patients, most of them asbestos workers, were reported: Investigator ~City/State/Countr~] (962) Rubino et al 1972 [Turin] (963) Bianchi et al 1978 [Trieste] (964) Bianchi et al 1981 [Monfalcone] (965) Bianchi et al 1982 [Monfalcone] Pleural Mesothelioma Number or Percentage 54 cases of pleural mesothelioma = 5 occupational asbestos exposure; 3 domestic exposure 26 cases of pleural mesothelioma = 22 occupational asbestos exposure 4 cases of pleural mesothelioma = 3 occupational asbestos exposure; 1 domestic exposure Ii cases of pleural mesothelioma = 9 occupational asbestos exposure; 1 domestic exposure It should be noted that occupational exposure to asbestos was of primary importance in shipbuilding areas, such as Trieste and Monfalcone. However, history of asbestos exposure could not be elicited in 81 percent of cases reported from Turin. [423] Switzerland Avril (966) reviewed the diagnostic aspects of 16 cases of malignant mesothelioma: 13 pleural and 3 peritoneal. RUttner (967) retrospectively examined a group of 48 pleural mesothelioma patients: 39 of them involved occupational

Asbestos/Smoking Interactions [400 Series] March 30, 1983 284 exposure to asbestos, 6 had no history of asbestos although asbestos was detected in the pulmonary tissue; remaining 3 cases had no history of asbestos exposure asbestos could not ~e detected in the lung. exposure the and [424] Scandinavia On the occasion of the 1980 International Course on Occupational Respratory Diseases held in Finland, Huuskonen (968) reviewed the observed/expected mortality ratio in eight countries (including Finland) and arrived at a ratio of 1.3. That pleural mesothelioma is rare in Finland has been inter- preted to mean that exposure to anthophyllite asbestos does not increase the risk as much as exposure to crocidolite. The studies reported from Norway indicated that most pleural mesothelioma patients all of 7 reported by Kjuus et al reported by Gulsvik et al (970). mesothelioma in Sweden is higher have been exposed to asbestos: (969) and 16 out of 37 The incidence of pleural than in the neighboring countries. "In a series of 27 pleural mesothelioma patients, H~gerstrand et al (971) detected asbestos bodies in the lungs in approximately half, but the control series showed about the same incidence. The authors questioned the significance of

Asbestos/Smoking Interactions [400 Series] March 30, 1983 285 presence of asbestos bodies to mean that asbestos is a primary cause of mesothelioma. [425] Belgium and the Netherlands Although articles on mesothelioma appeared in Belgium (972) and the Netherlands (973) prior to 1960, a Mesothelioma Registry was not established in the former country but only in the latter country (974-976). From 1969 through 1975, 294 cases of mesothelioma were recorded, with the largest concen- tration found in Rotterdam. To determine the role of asbestos exposure, 67 meso~helioma cases were studied: 31 from the Rotterdam area that included shipyards, and 36 from other parts of the country far away from shipyards. Asbestos exposure proved to be definite or probable in 84 percent of mesothelioma cases from the Rotterdam area and in 61 percent of cases in other areas. Asbestos exposure was unlikely or absent in the history of 7 percent of the Rotterdamers, and in 33 percent of In could more other words, in a be attributed to than in non- cases in the rest of the country. shipbuilding" area, majority of cases asbestos exposure, proportionately shipbuilding areas. Stumphius (977, 978) examined a group of 25 patients with pleural mesothelioma on the Dutch island of Walcheran.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 286 All but 3 of the 25 cases had been employed in the shipyard at some time. It has been estimated that among shipbuilders, the mesothelioma attack rate is about i00 per There are no comparative estimates countries. i00,000 men years. in the neighboring [426] Eastern Europe There are no Mesothelioma Registries in Eastern Europe. However, there are reports of cases of pleural mesothelioma. Investigators [City/State/Country] Pleural Mesothelioma Ntunber or Percentage (979) Bursova & Pesek 1981 [Prague CZE] 12 cases of pleural mesothelioma = 2 occupational asbestos exposure (980) Haskovcova 1979 (981) Haskovcova 1981 [Prague CZE] 13 cases of pleural mesothelioma = no correlation-with asbestosis (982) Hajdukiewicz et al 1975 [L6d~ POLl 1 case of pleural mesothelioma with asbestosis (983) Kovac-Stojkov~ki 1979 [Zagreb YUG] local cases compared with those reported from other countries (984) Romanychev 1979 28 cases of pleural mesotholiomas: [Moscow RUS] asbestos exposure not included

Asbestos/Smoking Interactions [400 Series] March 30, 1983 287 [427] Turkey The appearance of cases of pleural mesothelioma in Anatolia (Turkey) signifies that asbestos is not the only causative inhalant. Since asbestos does not occur in the local soil or rock, nor is it handled in the village, Baris et al (985-993) have suggested that locally m/ned zeolite is the causative agent. The investigators cited observations indicat- ring that mesothelioma is not familial in origin, and is not related to cigarette smoking (988). Turkish immigrants resid- ing in Sweden have been screened resulting in the detection of three cases of pleural mesothelioma (994).Mineralogical analysis of lung tissue from two of the cases revealed the presence of both zeolite and asbestos minerals, suggesting to the investigators a synergistic action involving both types of minerals. [430] Pleural Mesothelioma Studies in the United States There is a general impression among non-asbestos researchers" that mesothelioma research in the United States is largely conducted by Selikoff and his associates at the Mount Sinai Hospital Hospital Center literaure reveals and that approximately less than i percent of (New York City) and the Barnert Memorial (Paterson, New Jersey). A review of the that this impression is far from the truth pleural mesothe- 66SLhl/h6

Asbestos/Smoking Interactions [400 Series] March 30, 1983 288 lioma cases reported in the United States were included in the Mount Sinai Hospital prospective study of asbestos insulators [Category 300]. Selikoff has been so active in uncovering the role of asbestos fiber and cigarette smoking as synergistic causative agents for asbestos associated diseases, that most of his publications on pleural mesothelioma are repetitive in content. [431] Mount Sinai Hospital Group: New York and New Jersey The attribution that Selikoff and his collaborators "discovered" the causal relationship between asbestos and pleural mesothelioma probably originated from their publication on the relation between asbestos and exposure that appeared in 1964 and 1965 in three separate publications (995-997). The contents of the three publications refer to the same group of i0 mesothelioma deaths from 307 consecutive deaths among asbes- tos insulation workers in New York and New Jersey. However, only 4 cases of pleural mesothelioma were included (six peritoneal~. These four cases of pleura1 mesothelioma was the origin of a projected increasing mortality from asbestos- associated mesothelioma (843). It is important to recognize that Selikoff et al included 4 additional cases of pleural mesothelioma (among 26 consecutive autopsies of cases of O09t_hE h6

Asbestos/Smoking Interactions [400 Series] March 30, 1983 289 asbestosis a~topsied by two pathologists) and used mesothelioma cases from the Army Institute of Pathology to support their conclusion that mesothelioma "must be added to the neoplastic risk of asbestos interaction" in the United States. After 1965, mesothelioma research accelerated in pace but it is the opinion of this reviewer that the efforts were initiated because of results from scientists abroad, particu- larly from South Africa [Category 410] and Continental Europe [Category 420]. Since 1965, Selikoff's group has not added any more mesothelioma cases to support their supposedly original concept that asbestos is the cause of mesothelioma. During the past 18 years, their publications relate to management of patients [Category 460] and diagnosis by histochemical techniques (998), electron microscopy (999) and pathology of mesothelioma (1000-1006). [432] Additional studies in New York State Although the Mount Sinai Hospital Group reported the first group ..of i0 mesothelioma patients detected in the New York City area, the Sloan-Kettering Cancer Center has reported 123 patients diagnosed from 1949 to 1980. In the 1982 publica- tion of Brenner et al (1007) information on asbestos exposure was omitted. However, in the discussion of the etiologic

Asbestos/Smoking Interactions [400 Series] March 30, 1983 290 factors, they enumerated non-asbestos causes such as serious lung disease, tuberculosis, chemical pneumonia, radiation and industrial dusts and chemicals. They specified that 14 of their patients had a history of previous lung disease, one had received prior radiation to the chest, and 14 had been exposed to industrial dusts and chemicals other than asbestos. Among the 35 references cited by 8rennet et al (1007) only one reference from the Mount Sinai Hospital Group is cited, not on asbestos-associated mesothelioma, but on the subject of chemotherapy. Vianna et al. (i008) from the New York State Department of Health summarized the 288 patients diagnosed as mesothelioma in the State outside of New ¥o~ City. Of 193 male patients, death certificates registered in 1973 through 1978 were obtain- ed for 170. Only 39.4 percent of mesothelioma patients had well established asbestos-related occupations. Contrary to the experiences of the Mount Sinai Hospital Group, the results suggested that there was no apparent increase in the incidence of mesotheli~ma from 1973 through 1978. Vianna et al (1008) concluded that the epidemiologic patterns of malignant mesothe- ioma differ in various sections of New York State. Highly populated industrialized areas in close proximity to major waterways had higher average incidence rates than the State as

Asbestos/Smoking Interactions [400 Series] March 30, 1983 291 a whole. Only one of 18 references cited by Vianna et al was attributed to Selikoff et al (1964 publication). [433] Additional studies in New Jersey There are two groups collaborated with the Mount Borow et al (1009) from the pleural mesothelioma cases diagnosed at Borow et al (1010) had reviewed 72 cases asbestos workers, two of them exposed neighborhood. The.cytopatholcgy of 75 peritoneal mesothelioma was recently (1011). in New Jersey that have not Sinai Hospital Group. In 1967, Somerset Hospital collected 9 surgery. By 1973, of mesothelioma in to asbestos in their cases of pleural and reviewed by Triol et al [434] Connecticut Bruckman et al (1012) from the Connecticut Department of Health identified 133 residents diagnosed with mesothelioma between 1935 and 1972. The authors attributed the ten-fold rise since 1935 to the increase in the state's "cumulative asbestos consumption". Since the complete occupational histories for the 133 cases were not presented, Lewinsohn et al (1013) reexamined the records of the Connecticut Tumor Registry which by 1977 had already identified 229 cases of malignant

Asbestos/Smoking Interactions [400 Series] March 30, 1983 292 mesothelioma, 147 of which were pleura1 in nature. The authors concluded that since there was a serious question of diagnostic reliability, the recent increase in incidence rates cannot yet be accurately estimated. (435] any estimate mesothelioma. case reports Massachusetts The investigators from Massachusetts have not published of the recent apparent rise in incidence of Most of their publications are" concerned with of mesothelioma among asbestos workers (1014, 1015), and new diagnostic techniques immunology and electron microscopy (1016-1019). (1020) in a review of 28 years experience at the General Hospital, concluded that half of mesothelioma were not associated with exposure to asbestos. including histochemistry, Hasan et al Massachusetts 36 cases of [436] Pennsylvania Lieben and Pistawka (1021) from the Pennsylvania State Department qf Health, summarized the clinical histories of 42 cases of mesothelioma reported from 152 hospitals diagnosed between 1958 and 1963. Survivors of employers or both were questioned regarding the possibility of asbestos exposure and the results were as follows:

Asbestos/Smoking Interactions [400 Series] March 30, 1983 293 10 patients worked in asbestos plants; 8 patients resided or worked close to an asbestos industry; 3 patients had asbestos workers in their family; 10 patients with assumed exposure to asbestos after prolonged questioning; and ii patients had no history of asbestos exposure. [437] Virginia Several large shipyards operated through World War II in Tidewater, Virginia. Tagnom et al (1022) conducted a case- control study from 1972 to 1978. Among the 61 cases identified as mesothelioma, 75 percent of the cases had been employed in the shipbuilding industry, nearly all beginning employment prior to 1950. Asbestos/Cigarette Smoking Interaction. The relative risks of mesothelioma were calculated by Tagnom et al (I022) according to the following smoking categories: Mesothelioma Controls Never Smoked 15 42 Others: current: 41 192 <0.5 packs/day 6 11 0.5 to 1.5 packs/day 22 91 2+ packs/day 2 37 Former smokers 10 46 Age-Adjusted R.R. 1.0 0.6 1.5 0.7 0.I 0.6

Asbestos/Smoking Interactions [400 Series] March 30, 1983 294 Using the entire control series, the investigators a 40 percent reduction current and former smokers. decreasing mesothelioma noted in mesothelioma risk associated with There was a significant trend of risk with increasing amounts of cigarettes smoked (p<0.01). The above publication is the only cigarette smoking reduces the risk of inverse association needs further study to phenomenon may be related in part to death, particularly from lung cancer and from the greatly .enhanced effects of smokers" (1022). one showing that mesothelioma. The determine if the a "competing risk of fibrosis, resulting asbestos among heavy [438] Texas Roggli et al (1023) reported 24 mesothelioma (19 pleural) and compared cases the of malignant lung asbestos from 50 contents of mesotheliomatous lungs with lungs obtained consecutive adult autopsies conducted at the Methodist Hospital (Houston). The malignant mesothelioma patients had asbestos body counts intermediate between those of the general population and those of patients with pulmonary asbestosis. Eleven of the 24 cases had history of occupational exposure whereas the remaining 13 did not have any exposure

Asbestos/Smoking Interactions [400 Series] March 30, 1983 295 (1023). the occurrence of mesothelioma in occupationally exposed to asbestos and counts: First, is that there is patients who are had low asbestos no threshold level Three possible alternatives were discussed to explain not body of asbestos exposure below which mesothelioma will occur; hence a certain small percentage of susceptible individuals will develop mesothelioma in any industrialized society in which there is ubiquitous asbestos contamination of the environment. Second is that those individuals with low asbestos body counts were subjected to undetected occupational or environmental exposure to submicroscopic asbestos fibers which does not readily form asbestos bodies. Third is that factors other than asbestos may be involved in the pathogenesis of mesothelioma. The mesothelioma patients collected illustrate the possible role of tuberculosis, employment in the petrochemical or oil refinery industry, and engineering jobs involving site visits at a refinery or chemical plant (1023). [439] Pleural meso~helioma incidence estimates for the United States Cancer registries in Washington, Hawaii, New Mexico, Connecticut, Michigan, Utah, Louisiana and Iowa were contacted by Hinds (1024) for the determination of mesothelioma incidence

Asbestos/Smoking Interactions [400 Series] March 30, 1983 296 rates. The highest rates for both males and females were found in the New Orleans area of Louisiana, and the Puget Sound area of Washington, both with significant shipbuilding activity. The age adjusted incidence rates for the 8 States range from 4.4 to ii.i per million per ~ear for males, and from 1.2 to 3.3 per million per year for females. Scientist from England (1025-1030) have made their own predictions of increasing incidence of mesothelioma in the United States. It is a mystery to this reviewer why the British scientist were encouraged to make American projections. These predictionswere probably directed to the United Sates Government to use federal funds for compensating mesothelioma patients. [440] Pleural Malignant Mesothelioma Case Reports Prior to 1960, mesothelioma was considered tumor in the United enumerated below show a asbestos dust. After history of exposure to asbestos, there are some a very rare States and elsewhere. The case reports lack of information on exposure to 1960, although most case reports have a who deny such exposure.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 297 [441] States dates in subsequent relationship American Case Reports Prior to 1960 The first published mesothelioma case in the United back to 1917 and additional case reports appeared years. It should be noted that the causal to asbestos was not suspected until 1960 by scientists from South Africa [Category 411]. The discussion of possiDle etiology in the early case reports was confined to the role of trauma, primary pleural cancer outside of the pleura. Investigators [City/State/Country] (1031) Keilty 1917 [Philadelphia PAl (1032) McDonnel & Maxwell 1920 |Scranton PA] (1033) Wood & Walter 1921 [Sedalia MO] (1034) Zeckwer 1924 [Boston MA] and preexisting cancer Sex, Age, Occupation Clinical Manifestation (1035) Nesbitt et al 1958 [St. Albans NY| (1036) Miller et al 1958 [Rochester MN] (1037) Storer & Hooper 1960 [Cleveland OH] Male, age, salesman: died of systemic mestastases Male, 31 years, soldier: cerebral mestastases Male, 45 years, teacher: crushing injury 22 years previously Female, 57 years, occupation: metastases to heart, brain and adrenals Male, 42 years, naval officer: abdominal metastases with hypoglycemia Female, 32 years, nurse: mammary carcinoma at 4 years Male, 47 years: cystic lesion antedated mesothelioma

Asbestos/Smoking Interactions [400 Series] March 30, 1983 298 Most of the above publications are 1978 monograph by Selikoff and Lee attributed the first case of pleural not included in the (842). This monograph mesothelioma in an asbestos worker to a 1947 clinicopathologic case report from the Massachusetts General Hospital (1038). [442] Post 1960 American and Foreign Case Reports With O-cupational Exposure to Asbestos After 1960, the association of pleural mesothelioma and asbestos work exposure was repeatedly suggested in case reports from the United States, United Kingdom, Scandinavia and Japan. Most cases were diagnosed from roentgenologic signs of pleural plaques, pleural effusion and pleural calcification. Investigators [City/State/Country] (1039) Knowles et al 1963 [Boston MA] (i040) Fowler et al 1964 [London GBR] (1041) Steel & Boyd 1965 [London GBR] Sex, Age, Occupation, Clinical Features Male, 56 years, plumber: pleural mesothelioma with asbestosis and mestastases to mediastinum, pericardia%m, rib, diaphragm and liver Male, 55 years, asbestos bag cleaner: pleural mesothelioma with pulmonary metastasis Male, 73 years, plumber: pleural and peritoneal mesothelioma Male, 63 years, asbestos product distributor: pleural calcification preceded mesothelioma

Asbestos/Sn~king Interactions [400 Series] March 30, ~983 299 (1042) Wieckling 1966 [Charlottsville VA] Male, 61 years, insulator: originally diagnosed as benign fibrous mesothelioma but later metastatic (1043) Markham & Dodson 1968 [Ann Arbor MI] Male, 68 years, accountant: as a soldier during WWI, road construction supervisor and gassed with chlorine (1044) Castleman & McNeeley Male, 63 years, letter carrier 1967 [Boston MA] previously working as painter and riveter: pleura1 mesothelioma with asbestosis (1045) Godwin & Jagatic 1968 [Hines ILl (1046) Rusky 1968 [Royal Navy GBR] Male, 50 years, asbestos miner: pleural mesothelloma Male, 59 years, asbestos worker Male, 55 years, resided next to asbestos factory: pleura1 calcification preceded diagnosis of mesothelioma Female, 67 years, asbestos worker: calcified stippling preceded diagnosis of mesothelioma Male, 54 years, pipe lagger: calcified pleural plaques (1047) McGilloway 1968 [GBR] Male, 83 years, retired boilerman, pipe smoker: pleura1 effusion followed by diagnosis of mesothelioma (1048) Champion 1971 [CAN] (I049) Lewinsohn 1974 [GBR] Male, 31 years, cable maker and diecaster: pleural effusion and mesothelioma Male, 32 years: resided in town of Asbeston since 3 years old; cigarette smoker for 14 years Male, 63 years, asbestos textile worker, ex-smoker, pleural plaques, pleural and pericardial mesothelioma

Asbestos/Smoking Interactions [400 Series] March 30, 1983 300 (1050) Golden 1974 [East Northport NYJ (1051) BrittOn 1976 [GBR] (I052) Rom & Anderson 1977 [New York NY] (1053) Perry et al 1978 [Columbia MO] (1054) Mostert & Meintjes 1979 (1055) Goldstein 1979 [SAF] Male, 48 years, shipyard worker: repeated episodes of pleural effusion, pleural mesothelioma Male, 71 years, insulation worker: pleural and peritoneal mesothelioma Male, 71 years, asbestos workers: nonsmoker, pleural plaques then mesothelioma Female, 68 years, washed spouse's clothes: nonsmoker, pleural calcifications Male, 60 years, asbestos exposure as well as to phenol and chlorine, cigarette smoker: plasmacytoma five times followed by mesothelioma Male, 48 years, dockyard worker: mesothelioma with asbestosis Male, 61 years, boilermaker: mesothelioma with asbestosis Female, 35 years, resided at asbes- tos area: calcified mesothelioma Male, 38 years, amosite miner: calcified mesothelioma (1056) Hartung 1980 [GBR] (1057) Christensen & Rechfeld 1980 [DEN].. (1058) Okumura et al 1980 [JAP] (1059) Langer & McCaughey (1963) 1982 [New York NY] Male, 37 years, glassblower, hand- ling of heat-protective cover Male, 46 years, gardener, sawing asbestos cement plates: Female, 55 years, asbestos worker: pleural and peritoneal mesothelioma Male, 55 years, brake lining worker: pleural mesothelioma with metastases

Asbestos/Smoking Interactions [400 Series] March 30, 1983 301 (1060) Gladfelter et al 1982 [Tampa (1061) Newhouse 1982 [GBR] (1062) Matsumuma et al 1982 [Tokyo JAP] (I064) Jackson et al 1982 [Winston-Salem NC] Male, 53 years, shipyard worker, cigarette smoker: previous herpetic keratitis, pleural effusion then mesothelioma Female, 73 years, asbestos exposure: death certificate show myocardial infarction as cause of death although pleural mesothelioma is stated in hospital report Male, 65 years, asbestos worker for 27 years as boiler manufacturer, nonsmoker: pleural mesotheliomama Male, 61 years, shipyard worker: pleuritis followed diagnosis of mesothelioma [443] Post 1960 American and Foreign Case Reports Without History of Asbestos Exposure The concurrence of asbestos-associated diseases in a household is presently interpreted to mean that an asbestos worker has contaminated family members with asbestos dust in the working clothes. This concept of residential or domestic exposure to asbestos dust originated in the 1970s to explain why family ..members of asbestos workers developed asbestos- related diseases, including pleural mesothelioma. A 1922 publication of Josefson (1065) on primary pleural cancer in a Swedish man and wife has been completely overlooked

Asbestos/Smoking Interactions [400 Series] March 30, 1983 302 by recent investigators of mesothelioma. That the married couple developed pleural mesothelioma at nine years interval, suggested to Josefson several etiologic concepts that need to be recalled at the present time. Josefson cited other examples of a common contagion: both succeeding wives of one man dying of cancer after using the same bed; two previous owners of a house succumbed to cancer in the same way as a third occupant. Josefson favored an infectious origin for the cancer. Retros- spectively, it is noticable that both husband and wife who died of pleural mesothelioma zoster. It is inconceivable used had previously suffered from herpes that asbestos was in Swedish housholds in the early 1900s. already widely Furthermore, the occupation of the husband was not stated in Josefson's publica- tion (1065). Some recent case reports of pleural mesothelioma from the United States examined the role of occupational or domestic exposure to asbestos. Investigators [City/State/Country] (1066) Strieder et al 1959 [Boston MA] (1067) Fischbein et al 1978 (New York N¥] Sex, Age, Occupation, Clinical Features Male, 35 years, ? occupation: pleural mesothelioma with metastases to lungs, skull, and femur Male, 53 years, ? occupation: unexpected seven-year longevity for mesothelioma

Asbestos/Smoking Interactions [400 Series] March 30, 1983 303 (1068) Chen & Mottet 1978 [Seattle WA] Male, 59 years, nonsmoker: asbestos detected in mesotheliomatous lung (1069) Caravelli & Zaman 1978 [New York NY] Female, 53 years, nonsmoker: pleura1 mesothelioma (1070) Campbell & Greenberg Male, 36 years, cigarette smoker 1981 [Jackson MS} for 15 years: plural mesothe- lioma with calcified liver metastases (1071) Decoufle 1980 Female, 72 years, shoeworker: [Tucson AZ] pleural mesothelioma Male, 60 years, shoeworker: pleural mesothelioma (1072) Steiner et al 1982 [Philadelphia PAl Male, 47 years: pleural meso- thelioma with rib destruction Male, 75 years: also with rib destruction Male, 68 years: also with rib destruction Female, 66 years: also with rib destruction (1073) Ragalie et al 1983 [Milwaukee WI] Male, 61 years, cigarette smoker for 40 years: m~sothelioma with superior vena cava syndrome [444] Mesothelioma Case Reports in Children Several case reports have been published suggesting that mesothelioma occurring in adults originate from childhood exposure to asbestos (1074-1076). Brenner et al (1077) reported seven cases diagnosed and treated at the Memorial Sloan- Kettering Cancer Center. Among a total of 40 pleural

Asbestos/Smoking Interactions [400 Series] March 30, 1983 304 mesothelioma patients reported in the literature, the youngest was 1.5 years old. One of the seven cases reported by Brenner et al developed mesothelioma i, the same lung where she had a spontaneous pneumothorax four years ~efore, a reported occur- rence also seen in adult mesothelioma patients. Wassermann et al (1078), in an attempt to explain a latent period of less than 20 years for childhood mesothelioma, proposed that exposure to asbestos in children took place in fetal life. The explanation was based on the results of an experimental study showing the presence of asbestos fibers in fetuses after intravenous injection of asbestos dust into dams. [445] Mesothelioma and Tuberculosis Case Reports In 1970, Sleggs (1079) reported the association of mesothelioma and tuberculosis among Bantu patients. He proposed that tuberculosis predisposed to mesothelioma and that asbestos dust inhalation accelerated the development of pulmo- nary tubercle formation. More recently, Roviaro et al (1080) examined the association of pleural mesothelioma and tuberculo- sis in a group of 35 patients diagnosed at the Surgical Clinic of the Unversity of Milan. Three mesothelioma patients (1:8.5 ratio) also had calcified pleural tuberculosis. They proposed

Asbestos/Smoking Interactions [400 Series] March 30, 1983 305 that increases the oncogenicity of asbestos fiber. Prenatal exposure to a tuberculostatic drug is suspected of causing mesothelioma in childhood. Tuman et al (1081) reported a 9 year old male admitted to the University of Chicago Clinics and diagnosed as pleural mesothelioma. After eliminating domestic and environmental exposure to asbestos, the authors proposed that isoniazid administered to the mother during pregnancy was the etiologic agent. Th~ suggestion was based on experiments showing that isoniazid administered to pregnant animals induced pulmonary tumors in the offsprings. the chronic irritation of the tuberculotic pleura [446] Familial Clustering of Mesothelioma A Swedish family with a remarkable aggregation of malignant mesothelioma was reported by Risberg et al (1082). Random occupational asbestos exposure in the building industry occurred in 4 of the 5 cases, yet there was a low incidence of malignant mesothelioma in the area where the family resided. The authors, were not aware of the 1922 publication of Josefson (1065) describing a man and wife who both developed pleural mesothelioma. Risberg et al reviewed the more recent literature and concluded that heredity may be an important predisposing factor in the genesis of mesothelioma.

Asbestos/Smoking Interactions [400 Series] March 30, 1983 306 "Since Wagner's report in 1960, mesothelio~ has been coupled with exposure to asbestos, and results of any epidemiologic and experimental studies support his relationship. No differences have been noted between pleural and peritoneal mesothelioma concern- ning the frequency of asbestos exposure. Patients 1-3 and 5 had worked in ~he building trade, in which random exposure to asbestos is known to occur. The risk of developing malignant mesothelioma through do- mestic exposure to asbestos has recently been shown. Too little Is known of the occupational history of the husband of Patient 4, and household exposure cannot be definitely excluded in the case. That there was occupational asbestos exposure in Cases 2 and 3 is supported by results of the energy- dispersive analysis of the lung tissue specimens, even though asbestos fibres are co~u~only found in the lungs of the general population of most industrializ- ed societies. The absence of asbestos in the specimen from Case 5 might be explained by the fact that it represented tissue which was just close to the tumor and was not from the basal parts of the lungs as in Cases 2 and 3. The significance of asbestos exposure as the single important etiologic factor may be doubted, particularly since slight asbestos exposure was probable in their cases is common, but the incidence of mesothelioma is generally very low. Oels found a relatively slight association to asbestos exposure among 32 cases of pleural mesothelioma, and suggested other, as yet unknown causes, for this tumor. However, she may have had difficulty in getting an accurate occupational history: the latent period between exposure and nmnifest tumor may be as long as 20-40 years." (1082) [450] pleura is solitary or benign in first category known as diffuse or subject of the preceding sections. Beni@~ Pleural Mesothelioma The second category of primary mesothelioma of the nature, in contrast to the malignant which is the In the literature, benign

Asbestos/Smoking Interactions t400 Series] March 30, 1983 307 pleura1 mesothelioma has received a variety of names including fibrous mesothelioma, localized mesothelioma, subpleural fibro- ma and localized fibrous tumor of the pleura, which altogether reflect the range of clinical and pathological characteristics as well as competing theories of pathogenesis. In the 1950s, one case reported from Japan was also suffering from syphilis (1083) and another case reported from Texas had a brother who died from carcinoma of the lung (1084). Cases reported in the 1980s excluded asbestos as an etiologic factor for pleural mesothelioma (1085-1089). Brise11 et al reviewed the literature on benign mesothelioma, and diagnosed at the benign pleural analyzed 360 cases including eight new cases Massachusetts General Hospital. Among patients tumor: (finger clubbing) were patients who had symptoms. patients were symptomatic, reported prior to 1972, 72 percent h~d symptoms due to chest pain, dyspnea and pulmonary osteoarthropathy each found in Since 1972, reflecting at least one-third of only 54 percent of earlier diagnosis as a result of increased use of populations. Although 88 percent resection were cured, in 12 percent responsible for patient's death intrathoracic growth (1089). chest radiographs in asymptomatic of cases after surgical of cases, the tumor was because of its extensive

Asbestos/Smoking Interactions [400 Series] March 30, 1983 308 Since chest X-ray is an important tool in the initial recognition of benign meso~helioma, it is necessary to review other diseases that are known to confuse the final diagnosis. The list of diseases for differential diagnosis includes the following: pseudotumors or pleural nodules or fibrous thickening of pleura seen in smokers and exsmokers (1090-I092]; pseudomesothelioma or carcinoma of the peripheral portion of lung [1093, 1094); intrapulmonary mesothelioma or intrapulmonary sarcoma (1095); pleural metastases (1096); rounded atelectasis (1097); radiation pneumonitis in asbestosis (I098); The diagnosis of benign mesothelioma can be finalized only after thoracotomy and histological examination of excised tissue. [460] Extrapieural Mesothelioma Since mesothelioma is embryonically derived from serous layers of the mesothelium, tumors histologically similar to the pleural form are known to occur in the peritoneum, pericardium and tunica vaginalis. When peritoneal mesothelioma occurs in asbestos workers, the causative agent, is believed to be

Asbestos/Smoking Interactions [400 Series] March 30, 1983 309 asbestos fibers that reach the abdominal area by routes: (a) ingestion wall; (b) inhalation circulation spread to transpleural migration one of three and migration through the intestinal followed by lymphatic and blood abdominal organs; and (c) inhalation, and passage through diaphragm. The three proposed mechanisms are based on experimental animal observations discussed under Category 100s and a 1983 abstract by Tianen et al (1099) that mineral fibers can penetrate the diaphragm of mice. [461] Peritoneal Mesothelioma in Asbestos Workers Contrary to the opinion of investigators interested in asbestos-associated mesothelioma, the first reported case of peritoneal mesothelioma was a German asbestos worker described by Leicher (ii00) in 1954. Several case reports followed from the following countries, all asbestos workers and most with pulmonary asbestosis: South Africa (ii01); England (1102, 1103); Portugal (1104); Canada (i105). The American case reports were from the following cities: Lancaster PA (1106); of them

Asbestos/Smoking Interactions [400 Series] Mar.ch 30, 1983 310 Jamaica NY (1107); Philadelphia PA (1108); Baltimore MD (1109) Glendale Heights IL (1110. As in pleural mesothelioma, there are conflicting issues on cytologic diagnosis of peritoneal mesothelioma (iiii, 1112). the [462] Perltoneal Mesothelioma in Non-Asbestos Workers Case reports of peritoneal mesothelioma in patients who have not been occupationally exposed to asbestos preceded those of asbestos workers. The primary localizations of the abdominal tumor have been varied and included both malignant or diffuse, as well as benign or solitary forms: stomach (1113); intestine (1114-1116); kidneys (1117); secreting cystic (I~18-i121); bone marrow metastases (1122); liver metastases (1123, 1124); intestinal diverticulitis (1125); pleural metastases (1126); repeated ascites (1127); ovarian cysts (1128).

Asbestos/Smoking Interactions [400 Series} March 30, 1983 311 Most of the above forms of peritoneal mesothelioma diagnosed after either abdominal surgery or necropsy. were [463] tumor. Michigan Thailand In 1978, Pericardial Mesothelioma Pericardial mesothelioma Early and recent case (I130), Germany (1131, (1134) Churg is the rarest form of the reports from Virginia {i129), i132), Belgium (1133) and do not mention a history of asbestos exposure. et al (1135) reported the first case of pericardial had been treated for angina pectoris by dusting pericardial cavity with a mixture of fibrous dust. this report, other investigators have reported cases mesothelioma in a patient who 15 years previously of the Following who were not operated pericardially asbestos dust (1136-1139). pericardia1 meso- thelioma but were occupati6nally exposed to It has been suggested that also be recognized as another form of occupational disease caused by asbestos dust. [464] Mesothelioma of Male Genitalia Mesothelioma has been reported in the testicular vaginalis, epididymis and corpora cavernosa (I140-i143). thelioma of tunica vaginalis in two asbestos workers tunica Meso- have been

Asbestos/Smoking Interactions [400 Series] March 30, 1983 312 diagnosed at the Mount Sinai Hospital Hospital (1145) of New York. (1144) and Montefiore [470] Treatment of Malignant Mesothelioma The first published discussion of the treatment of mesothelioma was by Elmes (1146) during the 1972 International Agency for Research on Cancer Conference on the Biological Effects of Asbestos. At that time, treatment was entirely palliative in nature consisting of surgery, radiotherapy and chemotherapy. After 1972, the results of mesothelioma therapy have been reported by clinicians in France (1147, 1148), Germany (1149), Wales (1150), Denmark (1151, 1152), Norway (1153), Finland (1154-1158) and Sweden (1159). During the 31st Nordic Congress of Pneumology held in 1982, Hillerdal (1159) reviewed the results of treatment of 4225 patients with malignant mesothelioma from 345 published articles. His conclusions were as follows: "i. The prognosis is highly variable. Average survival from first symptoms was i0 months but single cases can survive I0 years or more. 2. The epithe- lial type has a much better prognosis and long-time survivors (3 years or more) almost exclusively belong to this cellular subtype. 3. So-called radical operation (extrapleural pleuropneumectomy) carried a high operative mortality. Though there undoubtedly are a few long-time survivors, those operated upon are highly selected and therefore the benefit of the operation is highly doubtful. 4. 'Curative' radio-

Asbestos/Smoking Interactions [400 Series] March 30, 1983 313 therapy (4000 rads or more) seem to prolong survival with a few months. 5. Chemotherapy was very diffi- cult to evaluate, but up to 50% in certain regimens noted a good response. There is not enough data to evaluate survival but the results are promising. Alkylating agents, adriamycin and 5-fluorouracil seemed most interesting. 6. Only large groups ran- domized for cellular type, stage of disease, age and sex, followed prospectively, can possibly add to our understanding of treatment. Single-center studies with small number of patients treated that way or another will only add to our confusion of how to treat the single patient. This necessitates multi- center studies, preferably international. Urgent agreement on such things as diagnosis, staging, and treatment regimens is necessary in order to start such a study as soon as possible. Since the tumour is steadily rising in incidence this is even more urgent. Hopefully, the first step towards such cooperation can be taken during this congress." (1159) Since Hillerdal's publication appeared only as an abstract, it is not possible at this time to determine the percentage of Americans in the 4225 patients with pleural mesothelioma. The published results of American investigators refer to about 200 cases and are as follows: (1160) Jara et al 1977 [Buffalo NY] = 26 patients; (1161, ~162) Aisner & Wiernik 1978, 1981 [Baltimore MD] = 108 patients from literature; (1163) Brady 1981 [Philadelphia PAl = 6 patients radiotherapy; (1164, 1165) Chahinian et al 1978, 1982 [New York NY] = 69 patients; (1166, 1167) Antman et al 1980 [Boston MA| = 40 patients

Asbestos/Smoking Interactions [400 Series] March 30, 1983 314 The above publications emphasize the importance of chemotherapy for treatment of metastatic lesions. In addition to currently available drugs, there is promise that new ones will be developed using animals with experimentally induced mesothelioma (1168-1170) and by provoking immunologic responses (1171, 1172). Asbestos/Cigarette Smoking Interaction. Lebovits et al, in three separate publications (1173-1175), discussed the psychological responses of mesothelioma patients admitted to the Mount Sinai Hospital. Twety-eight of 38 patients smoked cigarettes and most smoked heavily: ii stopped smoking before knowing of increased risk of asbestos workers; 4 never smoked; 3 smoked but were never informed of incresed risk information; and i0 continued smoking after being advised ~f increased risk of asbestos workers. The investigators did not include any information of alcoholic consumption, a significant omission since Watts et al (1176) have reported cytogenetic changes in peritoneal cells in patients with alcoholic cirrhosis of the liver. [480] fatal Pleural Plaques and Effusion Although malignant mesothelioma is potentially the most disease of the pleura, there are other pleural diseases

Asbestos/Smoking Interactions [400 Series] March 30, 1983 315 which, although benign in nature, may later signify malignant changes. Asbestos workers who die of pleura1 mesothelioma generally show pleural plaques (some calcified), and/or pleura1 effusion. The incidence of the appearance of malignancy ranges from i0 to 30 present depending on the population group. Among asbestos workers, the incidence is higher than that of the general population indicating that asbestos dust contri- butes to formation of early pleural plaques, pleural effusion, and later to pleural malignant mesothelioma (i177-i181). [481] Pleural Plaques (Roentgenologic Diagnosis) Pleural plaques are the most common manifestation of exposure to asbestos. The incidences based on routine chest x-ray have been reported for asbestos workers in South Africa (1182), Great Britain (1183-1187), France (1188-1194), Czechoslovakia (1195), Finland (1196) and Sweden (1197-1203). In the United States, most research studies on pleural plaques have been directed to determine the structure, diffraction patterns and chemical composition of the asbestos fibers contained in lung samples (1204-1206).

Asbestos/Smoking Interactions [400 Series] March 30, 1983 316 There is general agreement that pleura1 asbestos risk of Thomson (1210) and pathogenesis of pleural mechanical (including non-mechanical theories. plaques signify exposure but donor necessariy indicate an increased mesothelioma or bronchogenic carcinoma (1207-1212). Hillerdal (1211, 1212) plaques. Hillerdal Thomson's) theory, He concluded that: reviewed the reviewed the as well as "None of the various existing theories on the patho- genesis of pleural plaques is able to explain their peculiarities. Knowledge of physiology of the lung and pleura and in particular its lymphatic system as well as cellular activities when the cells are ex- posed to asbestos is necessary when discussing these problems. Short asbestos fibres when phagocytosed by macrophages will activate these cells to produce various substances among them a factor that will stimulate fibroblasts to produce more collagen. Some of the small fibres will spread towards -.the visceral pleura of the lung, just like all inhaled dusts. Once in the visceral pleura, some of them will pene- trate to the pleural space. There, they will follow the normal lymph flow from the pleural space, which is exclusively through the parietal pleura. Finally, in passing through the parietal pleura, a portion will remain in macrophages there, causing a low-grade stimulation of the submesothelial fibroblasts. After some decades, this will result in visible pleural plaque~." (1212) Asbestos/Cigarette Smoking Interaction. In 1980 and 1981, Weiss et al (1213, 1214) reported the results of their survey of workers who had worked five years or more in an asbestos manufacturing plant. They concluded that cigarette

Asbestos/Smoking Interactions [400 Series] March 30, 1983 317 smoking appeared to be the most important factor in determining the prevalence of pleural plaques: lowest in nonsmokers, intermediate in current smokers and high in exsmokers. The results can be criticized for the following reasons: (a) Reduction in number of workers with pleura1 plaques from first to second publication. There is no explanation given by Weiss et al, for their abstract (1213) published in 1980 specified 69 asbestos workers wherea~ the detailed publication (1214) referred to 45 workers. (b) Questionable confirmation from British studies. Weiss et al (1214) stated that the observations reported by British investigators confirm the results of asbestos/smoking interaction. Weiss et al cited the publications by Rossiter et al from 1975 to 1980 without mentioning that the British dockworkers were exposed to a different type of asbestos fibers compared to American asbestos workers. These differences are discussed under Category 700s, entitled Occupational Exposure to Asbestos. It suffices to mention here that subsequent to Weiss et al 1981 publication, McMillan et al (1215) revised their figures for incidence of pleural plaques as follows:

Asbestos/Smoking Interactions [400 Series] March 30, 1983 318 Percentage of workers with Pleural Lesions Davenport Portsmouth American Asbestos Dockyard Dockyard Factory Current Nonsmokers 6 8 33 Smokers 16 13 42 Exsmokers 15 17 86 the American fac%ory incidence of pleural Weiss et al (1214) did not explain why workers showed 3 to 8 times higher lesions, compared to British dockworkers. (c) Questionable confirmation from Swedish studies. Weiss et al 1978 health interaction. (1214) have cited the results of Hillerdal in a survey as supportive of asbestos/smoking In addition to differences in population groups, Hillerdal and Hillerdal (1216) as their earlier interaction. that in 45 patients there was no synergistic effect betweeen on lung function. (d) Lack function. In an recent as 1979 interpreted results as nonsupportive of the-asbestos/smoking More recently, Hillerdal et al (1217) showed with asbestos-related pleural plaques, smoking and asbestos of asbestos/smoking interaction on lung attempt to explain the interaction, Weiss et al (1214) cited studies that cigarette smoking alone interferes with lung function and therefore could explain "an increased frequency of pleural plaques in exsmokers because damaged clearance mechanisms unaided by continued smoking may lead to

Asbestos/S~king Interactions [400 Series] March 30, 1983 319 higher effective doses of asbestos in the tissues". There are no studies showing specifically that asbestos workers who are also smokers have retarded mucociliary clearance of asbestos fibers compared to nonsmoking workers. Regardless of smoking habits, asbestos workers show a reduced ventilating function (1217, 1218). All other published studies that show disturbed lung function do not include measurements of mucociliary clearance and do not differentiate between smokers and nonsmokers among asbestos workers (1219, 1220). [482] Diffuse Pleural Thickening (Lung en Cuirasse) In recent years, several cases of restrictive pleurisy with diffuse pleural thickening have been reported among asbestos workers. The lesion may occur With or without pulmonary asbestosis. It is estimated that diffuse pleural thickening has the lowest incidence among benign pleural diseases in asbestos workers (1221-1225). [483] Pleural Calcification Pleural calcification is another diagnostic indicator for asbestos exposure. Like noncalcified plaques, the presence of calcification does not necessarily indicate a subsequent development of malignancy. Patients with calcified pleural

Asbestos/Smoking Interactions [400 Series] March 30, 1983 320 plaques show reduced pulmonary function, particularly in those with diaphragmatic calcification (1226-1235). Asbestos/Cigarette SmokinG ~nteraction. Chailleux et al (1236) measured lung function in 34 subjects with asbestos related pleural calcifications. A third of the subjects were nonsmokers, a third were light smokers (i to 10 cigarettes daily) and the remaining third were heavy smokers (more than 10 cigarettes/day). There was no correlation found between spirographic data and smoking habits. [484] Pleural Effusion Pleural effusion appears as an early mesothelioma or pleural metastatic carcinoma. sign of pleural The differentia- tion can be readily accomplished by cytologic examination of the fluid collected by thoracentesis. However, it should be recognized that pleural effusion may also occur in nonmalignant diseases, such as tuberculosis and emphysema. Pleural effusion rarely occurs.with pleural plaques or fibrosis (1237-1258). [490] Asbestos/Cigarette Smokin@ Interaction Pleural Diseases The preceding review of the mesothelioma includes the following asbestos/smoking interaction: (a) in Patients With literature on pleural studies that shows no a group of 52 English

Asbestos/Smoking Interactions [400 Series] March 30, 1983 321 asbestos workers [Category 413]; (b) a group asbestos workers [Category 415]; and (c) a group Canadian asbestos workers. Only one monograph wrongly the existence of asbestos/smoking interaction in mesothelioma (1259> whereas other reviews emphasize the of 80 Scottish of 254 reports pleural absence of interaction (1260-1264). Experimental observations in dairy calves (1265) and canines support the general proposition that there is no interaction ~tween cigarette smoke and asbestos dust particles in the environment. The recent report that cigarette smoking reduces the risk of mesothelioma [Category 437] deserves some attention. If the results are confirmed by additional case control studies, the reduction of risk of one asbestos related disease among cigarette smokers may also apply to other diseases provided a similar epidemiologic procedure is used. That cigarette smoking increases the prevalence oE pleural plaques [Category 401] does not necessarily apply to pleural mesothelioma. The original observations relating to a group of asbestos factory workers do not necessarily apply to other groups of workers with different exposure levels to asbestos dust. The criticisms of the original observation are listed above [Category 481].

Asbestos/Smoking Interactions [400 Series] March 30, 1983 322 This review on Malignant Mesothelioma and Pleural Diseases started by raising a question as to the absence of asbestos/cigarette smoking synergism which has been hypothe- sized for bronchogenic carcinoma and pulmonary asbestosis. For malignant mesothelioma patients, synergism was excluded by examining the smoking habits and comparing them with those of a group of control subjects. It was not possible to compare mortality statistics of smokers and nonsmokers, either asbestos exposed or not, because of the rarity of mesothelioma compared to bronchogenic carcinoma and pulmonary asbestosis. It appears to this reviewer that the presence or absence of synergism is dependent on the epidemiologic technique used. The prospective study that compared the mortality rates of asbestos workers to the general population showed synergism (for bronchogenic carcinoma and pulmonary asbestosis), whereas case control com- parisons failed to show synergism (for pleural mesothelioma). Additional case control studies are needed and those that are reviewed in the next sections dealing on bronchogenic carcinoma [Care- gory 500s] and pulmonary asbestosis [Category 600s| were not designed strictly to conform with the case control comparisons for pleural mesothelioma.

Abestos/Smoking Interactions [400] Series, March 30, 1983 323 BIBLIOGRAPHY AND AUTHOR INDEX Among the 425 articles for Series 400s, a duplicate copy of 298 or 70 percent was received from (X). The cumulative total for Series 100s to 400s is 718 out of 1266 articles, or 57 percent. The geographical distribution of the authors contained in the Bibliography is as follows: United States Category 400s Cumulative 100s to 400s UAR Arizona 1 UCA California 9 UCO Colorado 1 UCT Connecticut 4 UDC District of Columbia 1 UDE Delaware 1 UFL Florida 1 UHA Hawaii 0 UIL Illinois 7 UIO Iowa 0 UKA Kansas 1 UKY Kentucky 1 ULA Louisiana 0 UMA Massachusetts 18 UMD Maryland 3 UME Maine 0 UMI Michigan 5 UMN Minnesota 1 UMO Missouri 2 UNC North Carolina 2 UNE Nebraska 0 UNH New Hanpshire 0 ~NJ New Jersey 4 UNY New York 40 UOH Ohio 2 UPA Pennsylvania ii URI Rhode Islahd 1 USC South Carolina 0 UTE Tennessee 1 UTX Texas 7 UUT Utah 3 ~VT Vermont 1 UVA Virginia 4 UWA Washington 2 UWI Wisconsin 2 UWV West Virginia 0 2 28 3 7 6 3 1 2 17 3 1 1 7 25 39 1 12 15 4 14 2 1 14 26 41 1 8 3 27 8 i0 4 9 3 3 121 Total U.S. Articles 136 Percent of Total 32% 37% 472

Abestos/Smoking Interactions [400] Series, March 30, 1983 324 Foreign Articles Category 400s Cumulative 100s to 400s ARG Argentina 1 ATL Australia 8 15 AUS Austria 0 1 BEL Belgium 2 5 BUL Bulgaria 0 1 CAN Canada 21 55 CZE Czechoslovakia 5 6 DEN Denmark 3 5 EGY Egypt0 4 FIN Finland 9 22 FRA France 47 91 GBR Great Britain 83 GER Germany 18 44 IND India1 27 ISR Israel 1 3 ITA Italy10 30 JAP Japan4 10 LEB Lebanon 1 1 NET Netherlands 8 12 NOR Norway 3 7 POL Poland 2 i0 POR Portugal 1 1 ROM Romania 0 2 RUS Russia 2 14 SAF South Africa 23 56 SPA Spain2 3 SWE Sweden 20 32 SWI Switzerland 2 5 TAI Taiwan 0 1 THA Thailand 1 1 TUR Turkey i0 10 YDG Yugoslavia i 4 315 Total Foreign Articles 289 794 Percent of Total 68% 63% Grand Total 425 1266 Percent of Grand Total 100% 100% [Note: Bibliography of the 400s Series starts on the next page]

Abestos/Smoking Interactions [400] Series, March 30, i983 325 0842 Selikoff IJ, Lee DHK (1978) Academic Press, New York 549 pages Asbestos and Disease. 0843 Selikoff IJ (1982) Environ $ci Lab, Mt. Sinai Hospital, New York 440 pages Disability compensation for asbestos-associated disease in the United States. 0844 Commercial Union Insurance Companies (1982) Commercial Union Insurance Companies, Boston 179 pages Asbestos, Smoking and Disease - the scientific evidence. 0845 Weiss A (1953) Medizinische 1:93-94 Pleurakrebs bei Lungenasbestose, in vivo morphologisch gesichert. 0846 Knappmann J (1972) Pneumonologie 148:60 Beobachtungen an 251 obduzierten Mesotheliom-Fallen in Hamburg (1958-1968) 0847 Hain E, Dalquen P, Bohlig H, Dabbert A, Hinz I (1974) Int Arch Arbeitsmed 33:15-37 Retrospective study of 150 cases of mesothelioma in Hamburg area. (German) (X) 0848 Otto H (1980) Pathologe 2:8-~8 Occupational mesothelioma in Germany. (German) (X) 0849 Konetzke GW, Beck B (1981) Arch Geschwulstforsch 51:567-574 Risk factor asbestos. (German) 0850 Huzly A (1981) Therapiewoche 31:7593-7794, 7596, 7599, 7602, 7611-7612 Malignant pleural tumors. (German) (X)

Abestos/S~king Interactions [400] Series, March 30, 1983 326 0851 Calavrezos A, Hain E (1982) Dtsch Med Wochenschr 107:903-906 Malignant diffuse mesothelioma of the pleura: diagnosis. (German) securing a 0852 Wagner JC, Sleggs CA, Marchand P (1960) Br J Ind Hed 17:260-271 Diffuse pleura1 mesothelioma and asbestos exposure in the North Western Cape Province. 0853 Wagner JC (1962) Proc Int Congr Occup Health (14th) Asbestos dust exposure and malignancy. 0854 Webster I (1973) IARC Sci Publ No. 8; 195-198 Malignancy in relation to crocidolite and amosite. In: Biological effects of asbestos. (X) 0855 Cochrane JC, Webester I (1978) S Afr Med J 54:279-281 Mesothelioma in relation to asbestos fibre exposure. of 70 serial cases. A review 0856 Solomon A (1970) Environ Res 3:330-338 Radiological features of diffuse mesothelioma. 0857 Thomson JG (1970) Int Pneumoconiosis Conf 3:150-154 The pathological diagnosis of malignant mesothelioma of pleura and peritoneum. (X) 0858 Harington JS (1971) Nature 232:54-55 Asbestos and mesothelioma in man.

Abestos/Smoking Interactions [400] Series, March 30, 1983 327 0859 Talent JM, Harison WO, Solomon A, Webster I (1980) IARC Sci Publ No. 30; 2:723-729 A survey of black mineworkers of the Cape crocidolite (X) mines. O860 Gilson JC (1966) Trans Soc Occup Med 16:62-74 Health hazards of asbestos. Recent studies on its biological effects. (X) 0861 Thomson JG (1963) Br Med J 5323:123 Exposure to asbestos dust and diffuse pleural mesotheliomas. 0862 Eastwood EH, Martin JP (1921) Lancet 2:172-174 A case of primary tumour of the pleura. 0863 Owen WG (1964) Br Med J 5403:214-218 Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area. 0864 Newhouse ML, Thompson H (1965) Br J Ind Med 22:261-269 Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area. 0865 Newhouse ML (1967) Practitioner 199:285-293 The medical risks of exposure to asbestos. 0866 Smither WJ (1966) Proc Roy Soc Med 59:57-59 Asbestos, asbestosis, and mesothelioma of the pleura. 0867 Whitwell F, Rawcliffe RM (1971) Thorax 26:6-22 Diffuse ~lignant pleural mesothelioma and asbestos exposure.

Abestos/Smoking Interactions [400] Series, March 30, 1983 328 0868 Edge JR (1976) Environ Res 11:244-247 Asbestos related disease in Barrow-in-Furness. (X) 0869 Sheers G (1980) Arch Environ Health 35:276-282 Mesothelioma risks in a naval dockyard. (X) 0870 Acheson ED, Gardner MJ, Bennett C, Winter PD (1981) Lancet 2:1403-1405 Mesothelioma in a factory using amosite and chrysotile asbestos. (X) 0871 Anonymous (1973) Lancet 1:815-816 Asbestos leads to lung cancer. 0872 Heppleston AG (1974) Environ Health Perspect ~.:295-296 Correlation between the tissue response and asbestos fiber content. 0873 Acheson ED, Gardner MJ (1979) Arch Environ Health 34:240-242 Mesothelioma and exposure to mixtures of chrysotile and amphibole asbestos. (X) 0874 Jones JSP, Pooley FD, Clark NJ, Owen WG et al (1980) IARC Sci Publ No. 30; 1:187-199 The pathology and-mineral content of lungs in cases of mesothelioma in the United Kingdom in 1976. (X) 0875 McDonald AD, McDonald JC, Pooley FD (1982) Ann Occup Hyg 26:417-422 Mineral fibre content of lung in mesothelial tumours in North America.

Abestos/Smoking Interactions [400] Series, March 30, 1983 329 0876 Ashcroft T, Heppleston AG (1970) Int Pneumoconiosis Conf 3:177-179 Mesothelioma and asbestos in Tyneside. A Pathological and social study. (X) 0877 Law MR, Hodson ME, Heard BE (1982) Thorax 37:810-815 Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour. (X) 0878 Butler EB, Berry AV (1973) IARC Sci Publ No. 8:68-73 Diffuse mesotheliomas: diagnostic criteria using exfoliative cytology. (X) 0879 Gellert AR, Steel SJ (1982) Br J Dis Chest 76:303-305 Pleural mesotheliomai Diagnosis by trephine biopsy. (X) 0880 Herbert A, Gallagher PJ (1982) Thorax 37:816-821 Pleural biopsy in the diagnosis of malignant mesothelioma. (X) 0881 Herbert A, Gallagher PJ (1982) J Pathol 137:57-58 Mesothelial proliferation in pleural biopsies. (X) 0882 Newhouse ML (1981) Semin Oncol 8:250-257 Epidemiology of asbestos-related tumors. (X) 0883 Newhouse ML, Berry G (1976) Br J Ind Med 33:147-151 Predictions of mortality from mesothelial tumours in asbestos factory workers. 0884 McDonald C, McDonald A (1979) Lancet 2:1074 Age and latency in mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 330 0885 Peto J (1980) IARC Sci Publ No. 30, 2:703-711 The incidence of pleural mesothelioma in chrysotile asbestos textile workers. (X) 0886 Anonymous (1981) Lancet 2:1397-1398 Amosite asbestos and mesothelioma. (X) O887 Peto J, Seidman H, Selikoff IJ (1982) Br J Cancer 45:124-135 Mesothelioma mortality in asbestos workers: models of carcinogenesis and risk assessment. implications for 0888 Gold C (1969) J Clin Path 22:507-509 Asbestos levels in human lungs. 0889 Gilson JC (1972) Composites 3:57-59 Health hazards of asbestos. (X) 0890 _. Wagner JC, Berry G, Pooley F (1982) Br Me<] J 2:603-606 Mesotheliomas and asbestos type in asbestos textile workers: study of lung contents. (X) 0891 Wagner JC (1964) Intern Congr Occup Health (14th) 3:1066-1067 Asbestos dust exposure and malignancy. 0892 Wagner JC (1972) Ann Occup Hyg 15:61-65 Current opinions on the asbestos cancer problem. 0893 Pooley FD (1973) IARC Sci Publ No. 8; 222-225 Mesothelioma in relation to exposure. (X)

Abestos/Smoking Interactions [400] Series, March 30, 19~83 331 0894 Constantinidis K (1977) Br J Olin Pract 31:89-101 Asbestos exposure - its related disorders. (X) 0895 McCaughey WTE, Oldham PD (1973) IARC Sci Sci Publ No. 8; 58-61 Diffuse mesotheliomas: observer variation in histological diagnosis. (X) 0896 Butler EB, Johnson NF (1980) IARC Sci Publ No. 30; 1:409-418 The use of electron microscopy in the diagnosis of diffuse mesotheliomas using human pleural effusions. (X) 0897 Gardner MJ, Acheson ED, Winter PD (1982) Br J Cancer 46:81-88 Mortality from mesothelioma of the pleura during 1968-78 in England and Wales. ~X) (X) 0898 Le Roux BT (1962) Thorax 17:111-119 Pleural tumours. An epidemiological 0899 McEwen, Finlayson A, Mair A (1971) Int Arch Arbeitsmed 28:301-311 Asbestos and mesothelioma in Scotland. study. 0900 Dormard AJ, Stack EHR (1981) Br J Dis Chest 75:397-402 Diffuse malignant pleural mesothelioma in Glasgow. 0901 Dormard AJ (1981) Scott Med J 26:177 Pleural mesothelioma in Glasgow. (X) (X) 0902 Davis JMG (1974) J Natl Cancer Inst 52:1715-1725 Ultrastructure of human mesotheliomas.

Abestos/Smoking Interactions [400] Series, March 30, 1983 332 0903 Greenberg M (1973) IARC Sci Publ No. 8; 273-276 The value of a cancer register tumours. (X) in the study of asbestos 0904 Greenberg M, Davies TAL (1974) Br J Ind Med 31:91-104 Mesothelioma register 1967-1968. 0905 Elmes PC, Wade OL (1965) Ann NY Acad Sci 132:549-557 Relationship between exposure malignancy in Belfast. to asbestos and pleural 0906 Elmes PC, McCaughey WTE, Wade OL (1965) Br Med J 1:350-353 Diffuse mesothelioma of the pleura and asbestos. 0907 Elmes PC (1973) IARC Sci Publ No. 8; 267-272 The natural history of diffuse mesothelioma. (X) 0908 Elmes PC (1979) Br J Dis Chest 73:50-51 Asbestos and mesothelioma. (X) 0909 McNulty JC (1962) Med J Aust 49:953-954 Malignant pleural mesothelioma in an asbestos worker. 0910 Griffiths MH, Riddell RJ, Xipell JM (1980) Pathology 12:591-603 Malignant mesothelioma: a review of 35 cases and prognosis. (X) with diagnosis 0911 Langlois ALP, Glancy JJ, Henderson DW (1978) Aust Radiol 22:305-314 The radiology of malignant pleural mesothelioma in Western Australia. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 333 0912 Whitaker D, Shilkin KB (1981) Lancet 1:1369 Carcinoembryonic antigen in tissue diagnosis of malignant mesothelioma. (X) 0913 Henderson DW (1982) Pathology 14:239-243 Asbestos-related pleuropulmonary diseases: mesothelioma and lung cancer. asbestosis, 0914 Mortimer RH, Campbell CB (1968) Med J Aust 2:720-722 Asbestos exposure and pleural mesotheliomas. 0915 McCullagh SF (1978) Lancet 2:521-522 Non-occupational exposure mesothelioma. to asbestos and malignant 0916 Vallee A (1920) Can Med Assoc J 10:268-269 A case of endothelioma of the pleura with multiple metastasis. 0917 Haust MD, Kepkie GF (1959) Can Med Assoc J 81:918-922 Pleural mesothelioma: Case features. (X) report and some diagnostic 0918 McDonald AD, Harper A, E1 Attar OA, McDonald JC (1970) Cancer 26:914-919 Epidemiology o£ primary malignant mesothelial tumors in Canada. 0919 McDonald AD, Harper A, E1 Attar DA, McDonald JC (1970) Int Pneumoconiosis Conf 3:197-200 Epidemiology of primary malignant mesothelial t~u~ours Canada. (X) in 0920 McDonald AD (1979) Ann NY Acad Sci 330:441-454 Mesothelioma registries in identifying asbestos hazards. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 334 0921 McDonald AD (1980) IARC Sci Publ No. 30; 2:673-680 Malignant mesothelioma in Quebec. (X) 0922 Magnet D, McDonald AD (1972) New Eng J Med 287:570-571 Malignant mesothelial tumors - histologic type and asbestos exposure. 0923 Tao LC (1979) Acta Cytol 23:209-213 The cytopathology of mesothelioma. (X) 0924 Benjamin CJ, Ritchie AC (1982) Am J Med Technol 48:905-908 Histological staining for the diagnosis of mesothelioma. (X) 0925 Dionne GP, Wang NS Lab Invest 36:356 A scanning electron microscopic study and some lung carcinomas. (X) of diffuse mesothelioma 0926 Eyssen GM (1980) Chest 78 (Suppl):411-414 Development of radiographic and millers. abnormality in chrysotile miners 0927 Chovil A, Stewart C 1979) Lancet 2:853 Latency period ~or mesothelioma. (X) 0928 Shugar S (1979) Natl Res Counc Can Publ 103-112 Effects of asbestos in the Canadian environment. asbestos on man (mesothelio~). (X) Effects of 0929 Campo MA (1953) Poumon 9:263-265 Mesothelioma of the pleura. (French) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 335 0930 Abelanet R, Jagueux M, Fondimare A, Roujeau J (1979) Rev Fr Mal Resp 7:243-264 Pleural mesothelioma: morphology, histochemfstry, diagnostic difficulties, and nosologic problems. (French) (X) 0931 Bignon J, Ruffle P (1977) Pollut Atmos 76:367-371 Malignant mesothelioma. Its-relationship with pollution caused by asbestos. (French) (X) 0932 Bignon J, Sebastien P, Dimenza L, Payan H (1979) Ann 'NY Acad Sci 330:455-466 French Mesothelioma register. 0933 Bignon J, Sebastien P, Di Menza L, Nebut M, Payan H (1979) Rev Fr Mal Respir 7:223-241 French register of mesotheliomas 1965-1978 (French) (X) 0934 Perdrizet S, Bignon J, Di Menza L, Nebut M (1980) IARC Sci Publ No. 30; 2:697-701 French mesothelioma register: registered data. (X) critical appraisal of the 0935 Boutin C (1975) Poumon Coeur 31:111-118 Benign asbestosic pleurisies (apropos (X) of 3 cases ). (French) 0936 Boutin C, Pietri JF, Beddou M, Alabdullah F (1978) Rev Fr Mal Respir 6:331-334 Radiological dat~ obtained at the asbestos mine in Canari. (French) (X) 0937 Boutin C, Farisse P, Viallat JR, Cargnino P, Choux R (1979) Thorax 34:692-693 Thoracoscopy in pleural mesothelioma. (X) 0938 Irisson M, Valardocchio JM, Viallat JR, Boutin C (1983) Poumon Coeur 39:5-ii Malignant pleural mesothelioma: clinical aspects and course of 38 cases in the region of Marseille. (French) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 336 0939 Lajartre MD, Cornet E, Corroller J, et al (1976) Rev Fr Mal Resp (Suppl) 4:63-74 Etude clinique et professionnelle de 54 mesotheliomes pleuraux diffus. (X) 0940 Lajartre MD, Lajartre YD (1979) Ann NY Acad Sci 330:323-332 Mesothelioma on the coast of Brittany, France. (X) 0941 Molinari D, Verdier M, Simon A, Gontier C, Pibarot JC (1981) Med Armees 9:381-388 Pleural mesotheliomas. (French) (X) 0942 Bignon J, Nebut M (1981) CM 7:135 Le mesotheliome. 0943 Bignon J (1980) CM 102-10:1403-1404 Les Mesotheliomes. 0944 Di Menza L, Hirsch A, Sebastien P (1982) Arch Mal Prof 43:672-673 Etiological study concerning 26 malignant mesotheliomas. (French) (X) 0945 Di Menza L, Hirsch M, Mangold M, Bignon J (1979) Ann NY Acad Sci 330:787-789 Radiologic and surgical aspects of the diaphragm in asbestos exposure. (X) 0946 Hirsch A, Di Menza L, Dorbon F, Carre A, Bignon J (1980) IARC Sci Pub1 No. 30; 523-526 Diaphragmatic straightness in 302 asbestos-exposed patients.

Abestos/Smoking Interactions [400] Series, March 30, 1983 337 0947 Hirsch A, Brochard P, Cremoux HD, Erkan Let al (1982) Am J Ind Med 3:413-422 Features of asbestos-exposed and unexposed mesothelioma. (X) 0948 Jaurand MC, Gaudichet A, Atassi K, Sebastien P, Bignon J (1980) Bull Europ Physiopath Resp 16:595-606 Relationship between the number of asbestos fibres and the cellular and enzymatic content of bronchoalveolar fluid in asbestos exposed subjects. 0949 Jaurand MC, Kaplan H, Thiollet J, Pinchon MC, et als (1979) Am Assoc Pathol Bacteriol 94:529-538 Phagocytosis of chrysotile fibers by pleural mesothelial in culture. cells 0950 Brocbard P, Ameille J (1981) Soins 26:31-36 Pathology relating to the (X) inhalation of asbestos. (French) 0951 Stoebner P, Bernaudin JF, Nebut M, Basset F (1979) Ann NY Acad Sci 330:751-760 Contribution of electron microscopy to the diagnosis of pleural mesothelioma. (X) 0952 Champeix J (1976) Arch Mal Prof 37:595-628 Asbestos pathology. (French) (X) 0953 Molina C, Delage .J, Mercier R (1968) Poumon Coeur 24:487-492 Primary pleural tumors. (French) (X) 0954 Chretien J (1979) Rev Fr Mal Respir 7:221-222 Malignant mesothelioma of the pleura. (French) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 338 0955 Boersma A, Degand P, Havez R (1973) IARC Sci Publ No. 8; 65-67 Diffuse mesothelioma: biochemical stages in the diagnosis, detection and measurement of hyaluronic acid in the pleural fluid. (X) 0956 Boersma A, Degand P, Biserte G (1980) Bull Eur Physiopathol Respir 16:41-45 Hyaluronic acid analysis and the diagnosis of pleural mesothelioma. (X) 0957 Mornet M (1979) Soins 24:23-26 Pleural tumors. (French) (X) 0958 Brambilla E, Brambilla C, Kaehler D, Bensa JC (1981) Am Rev Respir Dis (Suppl) 123:61 Human pleural mesothelial cells in long term culture: Preliminary results of anti-mesothelial anti-serum. (X) 0959 Mulliez P, Saout J, Creusy C, Crinquette J (1981) LARC Med 1:39-41 The contribution of pleura1 biopsy to the etiological diagnosis of pleurisies. (French) (X) 0960 Roujeau J (1978) Monogr Coll Med Hop Paris 38-46 Anatomo-pathological characteristics asbestos. (French) (X) of lesions due to 0961 .- Ragaini S, Fondrini G (1958) Osp Magg 46:68-71 Several histological aspects of pleural mesotheliomas. (Italian) (X) 0962 Rubino GF, Scansetti G, Donna A, Palestro G (1972) Br J Ind Med 29:436-442 Epidemiology of pleural mesothelioma in North-western Italy (Piedmont).

Abestos/Smoking Interactions [400] Series, March 30, 1983 339 0963 Bianchi C, Grandi G, Di Bonito L (1978) Tumori 64:555-564 Diffuse pleura1 mesothelioma in Trieste. autopsy cases. (X) A survey based on 0964 Bianchi C, Brollo A, Bittesini L (1981) Pathologica 73:649-655 Mesothelioma caused by asbestos in the Monfalcone area. (Italian) (X) 0965 Bianchi C, Brollo A, Bittesini L (1982) Proc Int Cancer Congr 0:339 Malignant mesothelioma of the pleura in a shipyard area. (X) 0966 Avril J (1981) Schweiz Med Wochenschr Malignant mesothelioma: (German) (X) 111:333-342 a retrospective study of 16 cases. 0967 Ruettner JR (1983) Schweiz Med Wochenschr i13:346-351 Malignant mesothelioma and asbestos. 0968 Huuskonen MS (1982) Eur J Respir Dis (Suppl) Asbestos and cancer. (X) 63:145-152 (German) (X) 0969 Kjuus H, Langard S, Dyb S (1981) Tidsskr Nor Laegeforen 101:1119-1122 Mesothelioma:--an occupational disease? (Norwegian) (X) 0970 Gulsvik A, Haanaes OC, Mowe G (1982) Eur J Respir Dis (Suppl) 63:47 Diffuse pleural mesothelioma: clinical features and survival in Norway. (X) 0971 Hagerstrand I, Meurman L, Odlund B (1968) Acta Path Microbiol Scand 72:177-191 Asbestos bodies in the lungs and mesothelioma. A retrospective examination of a ten-year autopsy material. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 340 0972 Picard E, Gaspard P (1953) Scalpel 106:603-612 Tumors of the pleura. (French) (X) 0973 Eerland LD (1956) Arch Chit Neerl 8:353-373 Diffuse and localized pleural mesotheliomas. (X) 0974 Planteydt HT (1979) Ann NY Acad Sci 330:467-471 Netherlands mesothelioma register. (X) 0975 Planteydt HT (1979) Ann NY Acad Sci 330:761-763 Observer variation and reliability of the histopathological diagnosis of mesothelioma. 0976 Planteydt HT (1980) IARC Sci Publ No. 30; 1:211-216 Experiences with observer variation (X) in mesothelioma panels. 0977 Stumphius J (1971) Br J Ind Med 28:59-66 Epidemiology of mesothelioma on Walcheren Island. 0978 Stumphius J (1979) Ann NY Acad Sc£ 330:317-322 Mesothelioma incidence in a Dutch shipyard. 0979 Bursova J, Pesek M (1981) Stud Pneumol Phtiseol Cech 41:127-130 Malignant pleura mesothelioma. (Czech) (X) (X) 0980 Haskovcova I (1979) Cesk Patol 15:179-189 Diffuse malignant mesothelioma of the pleura and peritoneum. (Czech) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 341 0981 Haskovcova I, Dobias J, Vodickova S (1981) Stud Pneumol Phtiseol Cech 41:397-403 Morphological findings in pleural and peritoneal mesotheliomas in workers exposed to asbestos dust. (Czech) (X) 0982 Eajdukiewicz Z, Slodkowska J, Szaniawski W (1975) Patol Pol 26:551-556 Pulmonary asbestosis and neoplasms of the lungs. and analysis of the literature. (Polish) (X) Case reports 0983 Kovac-Stojkovs~i S (1979) Arh Hig Rada Toksikol 30:267-291 Exposure to asbestos and pleural mesotheliomas. (Serbocroatian) (X) 0984 Romanychev YA (1979) Vestn Rentgenol Radiol 26-32 Differential diagnosis of limited tumours of the pleura and lung peripheral carcinoma located subpleurally. (Russian) (X) 0985 Baris YI, Sahin AA, Ozesmi M, Kerse I, et al (1978) Thorax 33:181-192 An outbreak of pleural mesothelioma and chronic fibrosing pleurisy in the village of Karain/Urgup in Anatolia. (X) 0986 Baris YI (1979) Thorax 34:693 Environmental mesothelioma in Kappadocia (Turkey). (X) 0987 Baris YI, Artvinli M, Sahin AA (1979) Ann NY Acad Sci. 330:423-432 Environmental mesothelioma in Turkey. (X) 0988 Artvinli M, Baris YI (1979) J Natl Cancer Inst 63:17-22 Malignant mesotheliomas in a small village in the Anatolian region of Turkey: an epidemiologic study. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 342 0989 Baris YI, Artvinli M, Sahin A, Savas T, Erkan ML (1979) Rev Fr Mal Respir 7:687-694 Study of environmentally-related malignant pleural mesothelioma, chronic fibrosing pleurisy and pleural plaques in Turkey. (French) (X) 0990 Baris YI (1980) IARC Sci publ No. 30; 2:937-947 The clinical and radiological aspects of 185 cases of malignant pleural mesothelioma. (X) 0991 Sebastien P, Gaudichet A, Bignon J, Baris YI (1981) Lab Invest 44:420-425 Zeolite bodies in human lungs from Turkey. (X) 0992 Baris YI, Simonato L, Saracci R, Skidmore JW, Artvinli M (1981) Lancet 1:984-987 Malignant mesothelioma and radiological chest abnormalities in two villages in Central Turkey. An epidemiological and environmental investigation. (X) 0993 Lilis R (1981) J Occup Med 23:548-550 Fibrous zeolites and Turkey. (X) endemic mesothelioma in Cappadocia, 0994 Boman G, Schubert V, Svane B, Westerholm P, et al (1982) Scand J Work Environ Health 8:108-112 Malignant mesotheiioma in Turkish immigrants Sweden. (X) 0995 Selikoff IJ, Churg J, Hammond EC (1964) Annu Meet Am Public Health Assoc 1-6 Relation between exposure to asbestos and mesothelioma. residing in (X) 0996 Selikoff IJ, Churg J, Hammond EC (1965) New Eng J Med 272:560-565 Relation between exposure to asbestos and mesothelioma.

Abestos/Smoking Interactions [400] Series, March 30, 1983 343 0997 Churg J, Rosen SH, Moolten S (1965) Ann NY Acad Sci 132:614-622 Histological characteristics of mesothelioma associated with asbestos. 0998 Kannerstein M, Churg J, Magner D (1973) IARC Sci Publ No. 8; 62-64 Histochemical studies in the diagnosis of mesothelioma. (X) 0999 Suzuki Y, Kannerstein M, Churg J (1973) IARC Sci Publ No. 8; 74-79 Electron microscopy of normal, hyperplastic and neoplastic mesothelium. (X) i000 Kannerstein M, Churg J (1980) Environ Health Perspect 34:31-36 Mesothelioma in man and experimental animals. i001 Kannerstein M (1980) IARC Sci Publ No. 30; 1:149-162 Recent advances and perspectives relevant to the pathology of asbestos-related diseases in man. (X) 1002 Suzuki Y (1980) Semin Oncol 8:268-282 Pathology of human malignant mesothelioma. (X) 1003 Suzuki Y, Chahinian AP, Ohnuma T (1983) Fed Proc 42:782 Malignant mesot.helioma in vivo, in vitro and under hereto- transplanted conditions. (X) 1004 McCaughey WTE, Ai-Jabi M, Kannerstein M (1980) IARC Sci Publ No. 30; 1:207-210 A Canadian experience of the pathological diagnosis of diffuse mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 344 1005 Churg A, Golden J (1982) Pathol Annu 17:33-66 Current problems in the pathology of asbestos-related disease. (X) 1006 Kannerstein M, Churg J, McCaughey WI (1979) Ann NY Acad Sci 330:433-439 Functions of mesothelioma panels. (X) 1007 Brenner J, Sordillo PP, Magi11 GB, Golbey RB (1982) Cancer 49:2431-2435 Malignant mesothelioma of the pleura. A review patients. (X) of 123 1008 Vianna J, Maslowsky J, Roberts S, Spellman G, Patton RB (1981) NY State J Med 81:735-738 Malignant mesothelioma. Epidemiologic patterns in New York State. (X) 1009 Borow M, Conston A, Livornese LL, Schalet N (1967) JAMA 201:587-591 Mesothelioma and its association with asbestosis. i010 Borow M, Livornese L, Conston A, Schalet N (1973) Chest 64:641-646 Mesothelioma following exposure to asbestos: a review of 72 cases. i011 Triol J, Conston AS, Chandler SVD (1982) Acta Cytol 26:.729 Malignant mesothelioma: cytopathology of 75 cases seen in a New Jersey Community Hospital. (X) 1012 Bruckman L, Rubino RA, Christine B (1977) J Air Pollut Control Assoc 27:121-126 Asbestos and mesothelioma incidence in Connecticut. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 345 1013 Lewinsohn HC, Meigs JW, Teta MJ, Flannery JT (1980) IARC Sci Publ No. 30; 2:655-660 The influence of occupational and environmental asbestos exposure on the incidence of malignant mesothelioma in Connecticut. (X) 1014 Belleau R, Gaensler EA (1968) Respiration 25:67-69 Mesothelioma and asbestosis. 1015 Gaensler EA (1977) J Occup Med 19:286 Pleural complications from asbestos exposure. (X) 1016 Murphy R (1980) Compr Ther 6:6-13 Asbestos related disease: difficulties in diagnosing occupationally related illness. (X) 1017 Antman KH (1981) Semin Oncol 8:313-320 Clinical presentation malignant mesothelioma. and natural history of benign (X) and 1018 Warhol MJ, Hickey WF, Corson JM (1982) Am J Surg Pathol 6:307-314 Malignant mesothelioma. Ultrastructural distinction from adenocarcinoma. (X) 1019 Corson JM, Pinkus GS (1982) Am J Pathol 108:80-87 Mesothelloma: Profile of keratin proteins and carcinoembryonic antigen. An immunoperoxidase study of 20 cases and comparison with pulmonary adenocarcinomas. 1020 Hasan FM, Nash G, Kazemi H (1977) Am Rev Respir Dis 115:761-768 The significance of asbestos exposre in the diagnosis of mesothelioma: a 28-year experience from a major hospital. (X) urban

Abestos/Smoking Interactions [400] Series, March 30, 1983 346 1021 Lieben J, Pistawka H (1967) Arch Environ Health 14:559-563 Mesothelioma and asbestos exposure. 1022 Tagnon I, Blot WJ, Stroube RB, Day NE, Morris LE, et al (1980) Cancer Res 40:3875-3879 Mesothelioma associated with the shipbuilding industry coastal Virginia. (X) 1023 Roggli VL, McGavran M_H, Subach J, Sybers HD, Greenberg (1982) Cancer 50:2423-2432 Pulmonary asbestos body counts and electron probe analysis of asbestos body cores in patients with mesothelioma. A study of 25 cases. in 1024 Hinds MW (1978) J Occup Med 20:469-471 Mesothelioma in the United (X) SD States. Incidence in the 1970s. 1025 McDonald AD, McDonald JC, Pooley FD (1982) Ann Occup Hyg 26:417-422 Mineral fibre content of lung in mesothelial tumours in North America. (X) 1026 McDonald AD, McDonald JC (1980) Cancer 46:1650-1656 Malignant mesothelioma in North America. (X) 1027 -.. McDonald JC, McDonald AD (1981) Banbury Rep 73-82 Mesothelioma as an index of asbestos impact. 1028 Peto J, Henderson BE, Pike MC (1981) Banbury Rep 51-59 Trends in mesothelioma incidence in the United States and the forecast epidemic due to asbestos exposure during World war II. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 347 1029 Sloan MH, Peto J, Radford EP, Schneiderman M, et al (1981) Banbury Rep 70-72 Trends in Nesothelioma incidence in the United States and the forecast of epidemic due to asbestos exposure during World War II (Comments). 1030 Gardner MJ, McDonald JC, Enterline PE, et al (1981) Banbury Rep 83-85 Mesothelioma as an index of asbestos impact. (Co~ments) (X) 1031 Keilty RA (1917) Am J Med Sc 153:888-902 Primary endothelioma of the pleura. 1032 McDonnell PJ, Maxwell ES (1920) JAMA 74:168-170 Endothelioma of the pleura. 1033 Wood EA, Walter AI (1921) J Missouri Ned Assoc 18:277-281 Primary mesothelioma of the pleura - with report of a case. 1034 Zeckwer IT (1924) Arch Int Med 34:191-205 Mesothelioma of the pleura. 1035 Nesbitt KA, Boswell JT, DeJesus-Gonzeles MA, Sarkisian SS (1958) Am J Clin Pathol 30:148-157 Malignant mesothelioma associated with hypoglycemia: Report of a case. (X) 1036 Miller RD, Dockerty MB, Bennett WA (1958) Arch Surg 76:160-163 Mammary carcinoma followed after twenty-eight years by primary malignant pleural mesothelioma. (X) 1037 Storer J, Hooper R (1960) Dis Chest 38:567-569 Mesothelioma developing in the wall of a pulmonary cyst.

Abestos/Smoking Interactions [400] Series, March 30, 1983 348 1038 Mallory TB, Castleman B, Parris EE (1947) N Engl J Med 236:407 Mesothelioma of pleura and pericardium. 1039 Knowles JH, Dreyfuss JR, Wilkins EW, Castleman Bet al (1963) N Engl J Med 269:747-754 Case records of the Massachusetts General Hospital. Pulmonary asbestosis, pleural mesothelioma. Case 62-1963. (X) 1040 Fowler PBS, Sloper JC, Warner EC (1964) Br Med J 5403:211-213 Exposure to asbestos and mesothelioma of the pleura. 1041 Steel SJ, Boyd J (1965) Br J Dis Chest 59:130-132 Pleural calcification and mesothelioma following exposure to asbestos. 1042 Wieckling DK (1966) Am Surg 32:308-312 Pulmonary asbestosis Report. with metastatic mesothelioma. Case 1043 Markham TN, Dodson VN (1968) J Occup Med 8:138-139 II. Mesothelioma in an accountant. 1044 Castleman B, McNeeley BU (1967) N Engl J Med 276:230-237 Case records., of the Massachusetts 4-1967. General Hospital. Case 1045 Godwin MC, Jagatic G (1968) JAMA 204:1009 Asbestos and mesothelioma. 1046 Rushy NL (1968) J Roy Nay Med Serv 54:142-148 Pleural manifestations following the inhalation of asbestos in relation to malignant change.

Abestos/Smoking Interactions [400] Series, March 30, 1983 349 1047 McGilloway FA (1968) Nuts Times 64:663-664 Mesothelioma of pleura with massive pleural effusion. 1048 Champion P (1971) Am Rev Resp Dis 103:821-826 Two cases of malignant mesothelioma after exposure to asbestos. 1049 Lewinsohn HC (1974) Br J Dis Chest 68:121-127 Early malignant changes in pleural plaques due to asbestos exposure: a case report. 1050 Golden RL (1974) Int J Occup Health 43:18-19 The long-range impact of asbestos exposure. 1051 Britton DC (1976) Br Med J 2:175 Exposure to asbestos dust. 1052 Rom W, Anderson HA (1977) Clin Notes Respir Dis 16:15-16 Case report No. 605892: Malignant mesothelioma. 1053 Perry MC, Solinger A, Farhangi M, Luger A (1978) Med Pediatf Oncol 5:205-212 Plasmacytomas and mesothelioma. (X) 1054 Mostert C, Meintjes- R (1979) Cent Aft J Med 25:72-74 Asbestosis and mesothelioma on the Rhodesia railways. (X) 1055 Goldstein B (1979) Thorax 34:375-379 Two malignant pleural mesotheliomas with unusual histo- pathological features. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 350 1056 Hartung M (1980) Arbeitsmed Sozialmed Praventivmed 15:153-154 Occupationally conditioned pleurOmesothelioma after occupationally handling of asbestos-containing cloths. (German) (X) protective 1057 Christense JB, Rechfeld E (1980) Ugeskr Laeger 142:2510-2511 Mesothelioma in a gardener with brief asbestos exposure. (Danish) (X) 1058 Okumura T, Okada M, Tsuji M, Inoue A, Ochiai Y (1980) Acta Pathol Jpn 30:579-590 Mesothelioma with lung cancer complicating asbestosis. (X) 1059 Langer AM, McCaughey WTE (1982) Lancet 2:1101-1103 Mesothelioma in a brake repair worker. 1060 Gladfelter T, Wiygul F, Campbell Aet al (1982) J Fam Pract 14:827, 830-832, 837, 840 Malignant mesothelioma: an occupational disease. 1061 Newhouse ML (1982) Lancet 2:991 Mesothelioma and the death certificate. (X) (X) 1062 Matsumuma H, Tsuchiyama H, Kawai K, Nakano Met al (1982) J Univ Occup Env Health 4:65-80 An autopsy case of diffuse pleural mesothelioma associated with pulmonary asbestosis: light and electron microscopic study. (X) 1063 Langer AM, McCaughey WTE (1982) Lancet 2:1101-1103 Mesothelioma in a brake repair worker. (X) i064 Jackson DV, Marshall RB, Albertson DA, Slatkoff ML (1982) SC Med J 43:118-119 Malignant pleural mesothelioma: difficulties in diagnosis. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 351 1065 Josefson A (1922) Acta Med Scand (Suppl) 3:159-165 Primary cancer of the pleura in man and wife. 1066 Strieder JW, Scully RE, Pendergrass HP et al (1959) N Engl J Med 260:491-496 Case records of the Massachusetts General Hospital. 45101. (X) Case 1067 Fischbein A, Suzuki Y, Selikoff IJ, Bekesi JG (1978) Cancer 42:1999-2004 Unexpected longevity of a patient with malignant pleural mesothelioma. Report of a case. (X) 1068 Chen W, Mottet NK (1978) Hum Pathol 9:253-258 Malignant mesothelioma with minimal asbestos exposure. 1069 Caravelli JF, Zaman MB (197a) Clin Bull 8:161-163 A diagnosis of pleural mesothelioma. (X) 1070 Campbell GD, Greenberg SD (1981) Chest 79:229-230 Pleural mesothelioma with calcified liver metastases. (X) 1071 Decoufle P (1980) Lancet I:159 Mesothelioma among shoeworkers. (X) 1072 Steiner RM, Cooper MW, Brodovsky H {1982) Clin Radiol 33:61-65 Rib destruction: A neglected finding mesothelioma. in malignant 1073 Ragalie GF, Varkey B, Choi H (1983) Can Med Assoc J 128:689-691, 740 Malignant pleural mesothelioma presenting as superior vena cava syndrome. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 352 1074 Kashirsagar VH, Patil SD, Sharma KD et al (1971) Indian J Cancer 8:208-214 Mesotheliomao Report of two autopsy cases. (X) 1075 Arul KJ, Holt PP (1977) Int Arch Occup Environ Realth 40:141-143 Mesothelioma possibly due to environmental exposure to asbestos in childhood. (X) 1076 Cochrane JC, Webster I (1981) S Afr Med J 59:848 Mesothelioma in relation to asbestos fibre exposure. 1077 Brenner J, Sordillo PP, Magill GB (1981) Med Pediatr Oncol 9:367-373 Malignant mesothelioma in children: report of seven cases and review of the literature. 1078 Wassermann M, Wassermann D, Steinitz (1980) IARC Sci Publ No. 30; 1:253-257 Mesothelioma in children. (X) R, Katz L, Lemesch C 1079 Sleggs CA (1970) Int Pneumoconiosis Conf 3; 225-232 Mesothelioma, including peripheral lung malignancy and tuberculosis in the North West Cape. (X) 1080 Raviaro GC, Sartori F, Calabro F, Varoli F (1982) Am Rev Respir Dis 126:569-571 The association of pleural mesothelioma and tuberculosis. 1081 T~man KJ, Chilcote RR, Berkow RI, Moohr JW (1980) Lancet 2:362 Mesothelioma in child with prenatal exposure to isoniazid. (X) 1082 Risberg B, Nickels J,.Wagermark J (1980) Cancer 45:2422-2427 Familial clustering of malignant mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 353 1083 Fukuoka Y, ¥oshioka S, Takeda Y (1956) Gann 47:733-734 An autopsy case of giant tumor in the (X) right pleural cavity. 1084 Heaney Jp, Overton RC, DeBakey ME (1957) J Thorac Surg 34:553-560 Benign localized pleural mesothelioma: (X) report of two cases. 1085 Sufian D, Daniels M (1978) JAOA 77:836-844 Benign fibrous mesothelioma: a report of ten cases. 1086 Tada S (1978) Jpn J Clin Radiol 23:801-802 Benign mesothelioma of interlobar fissure. (Japanese) (X) 1087 Cobanoglu A, Rienhard JJ (1982) Del Med J 54:273-276 Localized fibrous mesothelioma reports. (X) of the pleura: Two 1088 Chalaoui J, Barral V, Simard P, Lefebvre R, Sylvestre J (1982) Sem Hop Paris 58:1881-1884 Benign pleural mesothelioma: Three developmental forms. (French) (X) case 1089 Brisell IM, Mark EJ, Dickersin GR (1981) Cancer 47=2678-2689 Solitary fibrous tumors of the pleura: review of 360 cases in the literature. Eight new cases and (X) 1090 Hillerdal G, Hemmingsson A (1980) Acta Radiol Diag 21:615-620 Pulmonary pseudotumours and asbestos. 1091 Chang JC, Lesser M (1982) Mt Sinai J 49:508-510 Unusual roentgenographic appearance of a pseudotumor in the pleural space: A case report. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 354 1092 Sciammas FD, Shetty S, Navani S (1971) Chest 59:673-674 Multiple pleural nodules. 1093 Harwood TR, Gracey DR, Yokoo H (1976) Am J Clin Pathol 65:159-167 Pseudomesotheliomatous carcinoma of the lung. peripheral lung cancer. A variant of 1094 Broghamer WL, Collins WM, Mojsejenko IK (1978) Acta Cytol 22:239-242 The cyto-histopathology of a pseudo-mesotheliomatous carcinoma of the lung. (X) 1095 Alvarez-Fernandex E, Esalona-Zapata J (1982) Virchows Arch Pathol Anat 395:331-343 Intrapulmonary mesotheliomas: Their identification by tissue culture. (X) 1096 Sommer T, Kantartzis M, Garcia M, Schubert GE (1981) Med Klin 76:626-629 Pleural metastases can mimic mesothelioma. (German) (X) 1097 Mintzer RA, Gore RM, Vogelzang RL, Holz S (1981) Radiology 139:567-570 Rounded atelectasis and its association with asbestos-induced pleural disease. 1098 Ashford RFU, Maher J, Drury A, Picketing D (1981) Br J Radiol 54:74-77 Radiation pneumonitis in a patient exposed to asbestos. (X) 1099 Tianen MH, Moatamed F, Mjaatvedt CH, Lee JS, Rom WN (1983) Fed Proc 42:777 Direct penetration of the diaphragm by mineral fibers. (X) ii00 Leicher F (1954) Arch Gewerbepathol Gewerbehyg 13:382-392 Primary cortical cell tumor of peritoneum in patient with asbestosis. (German)

Abestos/Smoking Interactions [400] Series, March 30, i983 355 II01 Thomson JG (1962) S Aft Med J ;36:759-760 Mesothelioma of pleura or peritoneum and limited basal asbestosis. (X) 1102 Anonymous (1966) Lancet 2:1084 Death of an asbestos worker. 1103 Enticknap JB, Smither WJ (1964) Br J Ind Med 21:20-31 Peritoneal tumours in asbestosis. 1104 Fernandes AC, Fonseca JML, Henriques AF, Soares AO (1980) Acta Med Port 2:303-317 Peritoneal mesothelioma reported in a fibrocement industry worker with neurofibromatosis. (Portuguese) (X) 1105 Young JR, Reddy ER (1980) Clin Radio1 31:243-247 Peritoneal mesothelioma. (X) 1106 Mann RH, Grosh JL, O'Donnell WM (1966) Cancer 19:521-526 Mesothelioma associated with asbestosis. A report of 3 cases. 1107 Bianchi C, Castelli M, Carluccio L (1976) Minerva Med 67:1511-1512 Frequency of lung asbestos bodies in autopsy material at Udine. (Italian) .~ 1108 Banner MP, Gohel VK (1978) Radiology 129:637-640 Peritoneal mesothelioma. (X) 1109 Brenner DE, Whitley NO, Goldstein WZ, Aisner J (1981) Lancet 1:939-940 Computed tomographic demonstration of peritoneal mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 356 1110 Bryant J (1982) Acta Cytol 26:561-563 Diagnostic cytologic criteria for primary ~eritoneal mesothelioma. (X) iiii Wolfson WL (1982) Acta Cytol 26:561 Diagnostic cytologic criteria for primary peritoneal mesothelioma. (X) 1112 Boon ME, Veldhuizen RW (1982) Acta Cytol 26:563-565 Diagnostic cytologic criteria for primary peritoneal mesothelioma. (X) 1113 Romeo M (1935) Arch Ital Anat Istol-Patol 6:720-732 A case of mesothelioma of the stomach with morphological aspect of linitis plastica. (Italian) 1114 Martelli CF (1953) Riv Anat Patol Oncol 7:639-664 Cystic mesothelioma of the peritoneum. (Italian) (X) 1115 Bellomo VJ (1957) Prensa Med Argent Mesenteric tumor. 44:333-339 Peritoneal celothelioma. (Spanish) (X) 1116 Dewan CH, Lindauer RG (1958) Guthrie Clin Bull 28:69-79 Mesotheliomas. (X) 1117 Roujeau J, Steg A (1961) Arch Anat Pathol 9:72-73 Peri-renal mesothelioma. (French) (X) 1118 Dvoskin S (1959) Ann Intern Med 40:809-811 Mesothelioma of the peritoneum: A case report in which the ascitic fluid contained hyaluronic acid. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 357 1119 Boon ME, Posthuma HS, Ruiter DJ, Van Andel JG (1981) Virchows Arch Pathol Anat 392:33-44 Secreting peritoneal mesothelioma. Report of a case with cytological, ultrastructural, morphometric and histological studies. (X) 1120 Katsube Y, Kukai K, Silverberg SG (1982) Cancer 50:1615-1622 Cystic mesothelioma of the peritoneum. A report of five cases and a review of the literature. (X) 1121 McClemont JMF, Webb JN (1981) J Roy Coll Surg Edinb 26:303-305 Diffuse benign peritoneal mesothelioma. (X) 1122 De Young WA, Fricke RW (1962) J Mich State Med Soc 61:440-441 Malignant mesotheliomas. Case report. (X) 1123 Yoon IL (1962) JAMA 181:1107-ili0 Malignant mesothelioma of the peritoneum. review of the literature. Report of a case and 1124 Ferrer-Roca O, Ingelmo M, Elias AM, Rives A et al (1979) Rev Clin Esp 153:343-348 Mesotheliomas. Review of three cases, one of them with diffuse metastatic calcifications. (Spanish) (X) 1125 Riddell RH, Goodman MJ, Moossa AR (1981) Cancer 48:134-139 Peritoneal malignant mesothelioma in a patient with recurrent peritonitis. (X) 1126 Cohen BN, Efremidis S (1980) Mt Sinai J Med 47:386-390 Pleural peritoneal mesothelioma: A case report. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 358 1127 Campbell JM (1983) Scott Med J 28:626-63 Masquerading mesothelioma: A diagnostic problem. A case report and short review of diagnostic techniques and therapy. 1128 Schneider V, Partridge JR, Gutierrez F, Hurt WG et al (1983) Am J Obstet Gynecol 145:355-359 Benign cystic mesothelioma involving the female genital tract: Report of four cases. (X) 1129 Drash EC, Hyer HJ, Skinner GF, Lam CR, Hughes FA et al (1950) J Thorac Surg 19:755-768 Mesothelial mediastinal cysts. Pericardial celomic cysts of Lambert. (X) 1130 Forest JL, Kozonis MC (1960) Am J Cardiol 5:126;-129 Primary mesothelioma of the pericardium. (X) 1131 Kaden F (1982) Z Kardiol ;71:485-487 Metastatic mesothelioma of the pericardium. (German) (X) 1132 Nedogoda W, Gofman VA, Mogilevskii RE, Sgibneva OV et (1982) Klin Med 60:26-29 Clinico-morphological characteristics of mesotheliomas of the pericardium. (Russian) (X) al 1133 .. Boreux J-L, Paesmans M, Feoli F, Lambert P, Parise L (1982) Acta Clin Belg 37:201-210 Primary pericardial mesothelioma: Clinical case and review of the literature. (French) (X) 1134 Laohpand T, Panyathanya R, Pacharee P, Maranetra Net al (1982) J Med Assoc Thailand 65:514-520 Primary pericardia1 malignant mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 359 1135 Churg A, Warnock ML, Bensch KG (1978) Am Rev Respir Dis 118:419-424 Malignant mesothelioma arising after direct application of asbestos and fiber glass to the pericardium. (X) 1136 Eck H, Berg-Schlosser V (1978) Dtsch Med Wochenschr 103:1751-1753 On the aetiology of malignant (German) (X) pericardial mesothelioma. 1137 Kahn EI, Rohl A, Barrett EW, Suzuki Y (1980) Environ Res 23:270-281 Primary pericardial mesothelioma following asbestos. (X) exposure to 1138 Roggli VL (1981) N Engl J Med 304:1045 Pericardial mesothelioma after exposure to asbestos. (X) 1139 Beck B, Konetzke G, Ludwig V, Rothig W, Sturm W (1982) Am J Ind Med 3:149-159 Malignant pericardial mesotheliomas and asbestos exposure. case report. (X) A i140 Waugh TR (1953) AMA Arch Pathol 55:98-117 Endothelioma of corpora cavernosa of penis. (X) 1141 Lenko J, Bankowski Z (1956) Pol Tyg Lek Ii.:579-581 Case of mesothelioma of the epididymis and the spermatic cord. (Polish) (X) 1142 Nagel R (1960) Chirurg 31:219 Mesotheliom~% of the epididymis (On the causation of benign tumors of the epididymis). (German) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 360 1143 Chen KTK, Arhelger RB, Flam MS, Hanson JH (1982) Urology 20:316-319 Malignant mesothelioma of tunica vaginalis testis. (X) 1144 Fligiel Z, Kaneko M (1976) Cancer 37:1478-1484 Malignant mesothelioma of the tunica in a patient with asbestos exposure. vaginalis propria A case report. testis 1145 Japko L, Horta AA, Schreiber K, Mitsudo Set al (1982) Cancer 49:119-127 Malignant mesothelioma of the tunica vaginalis testis: of first case with preoperative diagnosis. (X) Report 1146 Elmes PC (1973) IARC Sci Publ No. 8; 277-280 Therapeutic openings in the treatment of mesothelioma. (X) 1147 Miranda AR, Brigand HL (1978) Monogr Coil Med Hop Paris 92-94 Pleuropulmonary manifestations of asbestosis: point of view. (French) (X) The surgeon's o 1148 Ruffle P, Hirsch A (1980) IARC Sci Publ NO. 30; 2:553-557 A review of the treatment of diffuse malignant pleural mesothelioma. (X) 1149 Bohlig H, Hain E (1980) IARC Sci Publ No. 30; 2:497-506 Clinical and radiological observations on asbestos-related pathology. (X) llS0 Butchart EG, Ashcroft T, Barnsley WC, Holden MP (1981) Semin Oncol 8:321-328 The role of surgery in diffuse malignant mesothelioma of the pleura. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 361 1151 Sorensen PG (1982) Eur J Respir Dis Suppl 63:90 Systemic antineoplastic treatment of diffuse malignant pleura1 mesothelioma. (X) 1152 Sorensen PG, Rorth M, Hansen HH (1982) Eur J Respir Dis Suppl 63:50 A phase II cross-over study of Adriamycin and Endoxan in patients with malignant pleural mesothelioma. (X) 1153 Smith-Meyer R (1982) Eur J Respir Dis Suppl 63:131 Attempts at treatment of mesothelioma pleurae. ()~) 1154 Hattson K (1982) Eur J Respir Dis Suppl 63:87 Natural history and Clinical staging of malignant mesothelioma. (X) 1155 Holsti LR (1982) Eur J Respir Dis Suppl 63:93 The role of radiotherapy in the treatment of pleqral mesothelioma. (X) 1156 Laustela EV (1982) Eur J Respir Dis Suppl 63:94 Surgical treatment in pleural mesothelioma. (X) i157 Mattson K (1982) Eur J Respir Die Suppl 63::95 A practical multidisciplinary recommendation to future management of patients with malignant pleural mesothelioma. 1158 Kostainen S, Appelqvist P, Holsti LR, Mattson K (1982) Eur J Respir Dis Suppl 63:49 Clinical features and treatment results of diffuse malignant pleural mesothelioma: A retrospective analysis. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 362 1159 Hillerdal G (1982) Eur J Respir Dis Suppl 63:89 Review of clinical trials: Prognostic factors and treatment results of 4225 patients with diffuse malignant mesothelioma. (X) i160 Jara F, Takita H, Rao UNM (1977) NY State J Med 77:1885-1888 Malignant mesothelioma of pleura. observation. (X) Clinicopathologic 1161 Aisner J, Wiernik PH (1978) Chest 74:438-444 Malignant mesothelioma. Current status and future prospects. (X) 1162 Aisner J, Wiernik PH (1981) Semin Oncol 8:335-343 Chemotherapy in the treatment of malignant mesothelioma. (X) 1163 Brady LW (1981) Semin Oncol 8:329-334 Mesothelioma: The role for radiation therapy. (X) 1164 Chahinian AP, Suzuki Y, Mandel EM, Holland JF (1978) Cancer 42:1687-1691 Diffuse pulmonary malignant mesothelioma. Response to Doxorubicin and 5-azacytidine. (X) 1165 Chahinian AP, P&jak TF, Holland JF, NOrton Let al (1982) Ann Intern Med 96:746-755 Diffuse malignant mesothelioma. Prospective evaluation of 69 patients. (X) 1166 Antman KH (1980) N Engl J Med 303:200-202 Current concepts. Malignant mesothelioma. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 363 1167 Antman KH, Blum RH, Greenberger JS, Flowerdew Get al (1980) Am J Med 68:356-362 Multimodality therapy for ~lignant mesothelioma based on study of natural history. (X) 1168 Wagner JC, Hill RJ, Berry G, Wagner, MMF (1980) Br J Cancer 41:918-922 Treatments affecting the rate of mesotheliomas. (X) asbestos-induced 1169 Smith WE, Holiat SM, Hubert DD, Sobel HJ, Davis S (1980) Proc Am Assoc Cancer Res 21:258 Chemotherapeutic trials with an asbestos-induced mesothelioma in hamsters. (X) 1170 McCann J (1982) Oncol Times 4:1, 15 Clinicians trade notes on mesothelioma progress. (X) 1171 Linden CJ, Korsgaard R, Willen H, Willen R et al (1982) Eur J Respir Dis Suppl 63:46 Heterotransplantation of human malignant pleura-i mesothelioma to athymic rats and mice. (X) 1172 Wagner JC, Johnson NF, Brown DG, Wanger MMF (1982) Br J Cancer 46:294-299 Histology and ultrastructure of serially transplanted rat mesotheliomas. (X) 1173 Lebovits AH (19~0) Proc Am Assoc Cancer Res Psychological aspects of risk for cancer. (X) 21:383 mesothelioma and knowledge of high 1174 Lebovits AH, Chahinian AP, Holland JF, Holland JC (1981) Proc Am Assoc Cancer Res 22:397 Retrospective reactions of mesothelioma patients (pts) to asbestos exposure. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 364 1175 Lebovits AH, Chahinian AP, Holland JC (1983) Am J Ind Med 4:459-466 Exposure to asbesots: Psychological responses of mesothelioma patients, (X) 1176 Watts KC, To A, Boyo-Ekwueme HT, Poznansky Met al (1983) Acta Cytol 27:87 In vivo transformation of the mesothelium in patients with alcoholic cirrhosis. (X) 1177 webster I (1973) IARC Sci Publ No. 8; 264 Asbestos burden in lung and pleura, and its significance. Discussion summary. (X) 1178 Chretien J (1978) Monogr Coll Med Hop Paris 84-88 Asbestos as inducer of pleural pathology. (French) (X) 1179 Matzel W (1979) Z Gesamte Inn Med 34:50-52 Differential diagnosis of pleural diseases. (German) (X) 1180 Smith WHR, Davies D (1980) Br J Dis Chest 74:418 Non-malignant pleural disease and asbestos. (X) 1181 Shugar S (1979) Natl Res Counc Can Publ 97-99 Effects of asbestos in man. Plaques. (X) 1182 Solomon A, Webster I (1976) Environ Res 11:128-134 The visceral pleura in asbestosis. 1183 Anton HC (1968) Br J Radiol 41:341-348 Multiple pleural plaques: Part II.

Abestos/Smoking Interactions [400] Series, March 30, 1983 365 1184 Jones JSP, Sheers G (1973) IARC Sci Publ No. 8; 243-248 Pleural plaques. (X) 1185 Galloway RW (1978) J Roy Soc Med 71:916-919 Problem radiographs. (X) 1186 Sheldon CS, Herbert A, Ballagher PJ (1980) J Pathol 132: 352, 353 Reactive mesothelial proliferation. (X) 1187 Herbert A, Sterling GM (1980) Thorax 35:715 Lung en cuirasse: histopathology of restrictive pleurisy with asbestos exposure. (X) 1188 Lemenager J, Rousselet P, Mandard JC, Le (1976) Rev Fr Mal Resp Suppl 2:75-86 Les pleuresies benignes de l'asbeste. (X) Bouffant L et al I189 Tory L, Hertzog P, Personne CL, 8akdach H (1976) Rev Fr Mal Resp Suppl 2:93-96 Thoractomies et plaques pleurales fiDro-hyalines. preliminaire apropos de 125 malades. (X) Etude 1190 Chretien J, Chahinian PH, Hirsch A, Nebut M (1976) Rev Fr Mal Resp Suppl 2:87-92 Pleuresies non tumorales de l'asbeste. Apropos de 10 observations. (X) 1191 Hirsch A, DiMenza L (1979) Rev Fr Mal Resp 7:695-706 Use of the ILO/UC international of pneumoconioses in 302 (French) classification of radiographs subjects exposed to asbestos. 1192 Hirsch A (1979) Rev Fr Mal Resp 7:69-72 Classification radiologique (B.I.T.) pathologie respiratoire de l'amiante. utilisee dans la

Abestos/Smoking Interactions [400] Series, March 30, 1983 366 1193 DiMenza L, Hirsch A, Mangold M, Bignon J (1979) Ann NY Acad Sci 330:787-789 Radiologic and surgical aspects of the diaphragm in asbestos exposure. (x) 1194 Hirsch A, DiMenza L, Dorbon F, Carre A, Bignon J (1980) IARC Sci Publ No. 30; 2:523-526 Diaphragmatic straightness in 302 asbestos-exposed patients. (X) i195 Navratil M, Moravkova K, Trippe F (1978) Environ Res 15:108-118 Follow-up study of pleural hyalinosis in individuals not exposed to asbestos dust. 1196 Kaski P, Kiviluoto R, Meurman L (1968) Int Conf Biol Eff Asbest (2) 274-275 Pleural plaques and lung cancer. (X) i197 Hillerdal G, Hillerdal O, Now E (1980) Eur J Respir Dis Suppl 107:89-98 Radiologically visible pleural plaques in a one-year material from a health survey in 1976. A cross-sectional study. 1198 Thiringer G, Blomqvist N, Brolin I, Mattson SB (1980) Eur J Respir Dis Suppl 107:119-122 Pleural plagues in chest X-rays of lung cancer patients and matched controls. Pr.~liminary results. i199 Thringer G (1980) Eur J Respir Dis Suppl 107:109-110 Are pleural plaques a predictor for carcinoma of the lung? 1200 Mattson SB, Ringqvist T (1970) Scand J Resp Dis Suppl 75:1-41 Pleural plaques and exposure to asbestos. from a Swedish clinic. A clinical material

Abestos/Smoking Interactions [400] Series, March 30, 1983 367 1201 Hillerdal G (1982) Am J Roentgenol 139:1163-1166 Asbestos exposure and upper lobe involvement. (X) 1202 Hillerdal G (1981) Eur J Respir Dis 62:140-141 Dorsal pleural plaques in the lateral projection. 1203 Hillerdal G, Lindgren A (1980) Eur J Respir Dis 61:315-319 Pleural plaques: Correlation of autopsy radiographic findings and occupational history. findings to 1204 Churg A (1981) Am Rev Respir Dis Suppl 123:135 Pulmonary asbestos burden in patients (X) with pleural plaques. 1205 Warnock ML, Prescott BT, Kuwahara TJ (1982) Am J Pathol 109:37-46 Numbers and types of asbestos f~bers in subjects with-pleural plaques. (X) 1206 Churg A (1982) Am J Pathol 109:88-96 Asbestos fibers and pleural plaques in a general autopsy population. (X) 1207 .- Sargent EN, Gordonson J, Jacobson G, Birnbaum W, Shaub M (1978) AJR 131:579-585 Bilateral pleural thickening. 1208 Nizze H (1973) Arch Pathol 95:213-214 Exposure to asbestos and the genesis of pleural plaques and neoplasia. 1209 Macpherson P, Davidson JK (1969) Br Med J 1:355-357 Correlation between lung asbestos count at necropsy and radiological appearances.

Abestos/Smoking Interactions [400] Series, March 30, 1983 368 1210 Thomson JG (1970) Int Pneumoconiosis Conf 3; 138-141 The pathogenesis of pleural plaques. (X) 1211 Hillerdal G, Lindgren A (1980) Eur J Respir Dis 61:315-319 Pleural plaques: Correlation of autopsy radiographic findings and occupational history. findings (X) 1212 Hillerdal G (1980) J Respir Dis 61:129-138 The pathogenesis of pleural plaques and pulmonary asbestosis: possibilities and impossibilities. 1213 Weiss W, Levin R (1980) Am Rev Respir Dis Suppl 121:262 Smoking and pleural plaques in asbestos workers. (X) 1214 Weiss W, Levin R, Goodman L (1981) J Occup Med 23:427-430 Pleural plaques and cigarette smoking in asbestos workers. 1215 McMillan GHG, Pethybridge RJ, Sheers G (1980) Br J Ind Med 37:268-272 Effects of smoking on attack rates of pulmonary and pleural lesions related to exposure to asbestos dust. (X) 1216 Hillerdal G, Hillerdal O (1979) Lakartidningen 76:3~35-3638 Asbestos and pleural plaques. (Swedish) (X) 1217 Fridriksson HV, Hedenstrom H, Hillerdal G, Malmberg p (1981) Eur J Respir Dis 62:412-424 Increased lung stiffness in persons with pleural plaques. (X) to 1218 Sedenstierna G, Alexandersson R, Kolmodin-Hedman Bet al (1981) Eur J Respir Dis 62:111-122 Pleura1 plaques and lung function in construction workers exposed to asbestos.

Abestos/S~)king Interactions [400] Series, March 30, 1983 369 1219 Wright PH, Hanson A, Kreel L, Capel LH (1980) Thorax 35:31-36 Respiratory function changes after asbestos pleurisy. 1220 Lumley KPS (1980) Inhaled Part 4:781-788 Physiological changes in asbestos pleural disease. (X) 1221 Solomon A (1970) Int Pneumoconiosis Conf 3; 243-247 Radiology of asbestosis. (X) 1222 Solomon A (1969) S Aft Med J 43::847-851 The radiology of asbestosis. 1223 Miller A, Teirstein AS, Selikoff I (1982) Am Rev Respir Dis Suppl 125:114 Ventilatory insufficiency due to asbestos-induced pleural disease. (X) 1224 Sterling GM, Herbert A (1980) Thorax 35:715 Lung en cuirasse: restrictive asbestos exposure. (X) pleurisy associated with 1225 Britton MG (1980) Thorax 35:714 Asbestos pleural-.disease: a case for compensation. (X) 1226 Lawson JP (1963) Clin Radiol 14:414-417 Pleural calcification as a sign three cases. of asbestosis. A report of 1227 Fromhold W, Lagemann K, Lindlar F (1969) Fortschr Rontgenstr 111:769-778 Pleural calcification and malignant growth as late sequelae of asbestosis. (German) (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 370 1228 Schneider L, Wimpfheimer F (1964) JAMA 189:328-330 Multiple progressive calcific pleural plaque formation. 1229 Viikeri M, Jaaskelainen J, Tahti E {1968) Dis Chest 54:17-20 Ultrasonic examination of pleural calcifications in occupational asbestosis. thickenings 1230 Collins TFB (1968) Br J Radio1 41:655-661 Pleural reaction associated with asbestos exposure. 1231 Sargent EN, Jacobson G, Wilkinson EE (1972) Am J Roentgenol Radium.Ther Nucl Med 115:473-478 Diaphragmatic pleural calcification following short occupational exposure to asbestos. 1232 Wusteman FS, Gold C, Wagner JC (1971) Am Rev Resp Dis 106:116-118 Glycosaminoglycans and calcification in the lesions of progressive massive fibrosis and in pleural plagues. 1233 LeBouffant L, Martin JC, Durif S, Daniel H (1973) IARC Sci Publ No. 8; 249-257 Structure and compsotion of pleural plaques. (X) 1234 Carroll MP, Britt~n MG, Green M (1981) Br J Dis Chest 75::318 Diaphragmatic function in patients with due to asbestos exposure. (X) diaphragmatic 1235 Sargent EN, Felton JS, Barnes LT (1981) Radiology 140:634 Calcified interlobar pleural plaques. Visceral pleural involvement due to asbestos. (X) and plaques

Abestos/Smoking Interactions |400] Series, March 30, 1983 371 1236 Chailleux E, Eveillard MF, Ordronneau Jet al (1982) Poumon Coeur 95-99 Asbestos exposure and pleura1 calcification: Evaluation of the functional effects in 34 subjects. (X) 1237 Perous ML, Littman MS (1955) Am J Clin Pathol 25:467-479 Diagnostic study of serous effusions with emphasis on some unusual findings. 1238 Eisenstadt HB (1962) Am Pract 13:573-578 Pleural asbestosis. 1239 Eisenstadt HB (1964) Dis Chest 46:78-81 Asbestos pleurisy. 1240 Eisenstadt HB (1965) JAMA 192:419-42i Benign asbestos pleurisy. 1241 Gaensler EA, Kaplan AI (1971) Ann Intern Med 74:178-191 Asbestos pleura1 effusion. 1242 Solomon A (1970) Int Pneumoconiosis Conf 3; 261-265 Radiological features of diffuse mesothelioma. (X) 1243 Sluis-Cremer GK, Wesbster I (1972) Environ Res 5:380-392 Acute pleurisy in asbestos exposed persons. 1244 Eisenstadt HB (1974) N Engl J Med 290:1025 Pleural effusion in asbestosis.

Abestos/smoking Interactions [400] Series, March 30, 1983 372 1245 Hasan FM (1975) Ann Intern Med 83:735 AsDestos pleural effusion? 1246 Mattson SB (1975) Scand J Resp Dis 56:263-272 Monosymptomatic exudative pleurisy in Dersons exposed to asbestos dust. 1247 Zeman V (1979) Cesk Patol 15:29-40 Pleural and peritoneal cytology. (Czech) (X) 1248 Hirsch A, Ruffle P, Nebut M, Bignon J, Chretien J (19979) Thorax 34:106-112 Pleural effuslon: lab6ratory tests in 300 cases. 1249 Donna A, Betta PG, Gagliardi F, Provana A (1980) IARC Sci Publ No. 30; 1:183-186 A new method for detecting activated and neoplastic mesothelial cells in serous effusions. (X) 1250 Robinson BWS, Musk AW (1981) Thorax 36:896-900 Benign asbestos pleural effusion: diagnosis and course. 1251 Israel HL, Steiner RM (1981) J Respir Dis 2:111-113 Asbestos as a cause of acute pleural effusion. (X) 1252 Kondlapoodi P, Gabriel JB (1982) West J Med 137:435 Differential diagnosis of pleural effusions. (X) 1253 Mark JBD (1982) West J Med 137:435-436 Differential diagnosis of pleural effusions. (X)

Abestos/Smoking Interactions [400] Series, March 30, 1983 373 1254 Sahn SA (1982) West J Med 137:99-108 The differential diagnosis of pleural effusions. (X) 1255 Anonymous (1982) Lancet 1:1226 Mysterious pleural effusions. (X) 1256 Felson B (1982) J Respir Dis 3:11-23 Radiologic evaluation of pleural disease. (X) 1257 Taskinen E (1982) Eur J Respir Dis Suppl 63:88 Pathology of mesothelioma. (X) 1258 Stjernberg N, Lundgren E, Rcos G, Abu Sinna G (1982) Eur J Respir Dis Suppl 63:45 Establishment and characterization of human mesothelioma cell lines. (X) 1259 Kiss GT (1982) Addison-Wesley Publ Co., page 182 Diagnosis and Management of Pulmonary Disease in Primary Practice. 1260 Frank AL (1980) Environ Health Per§pect 34:27-30 Clinical observations following asbestos exposure. (X) 1261 Craighead JE, Mossman BT (1982) N Engl J Med 306:1446-1455 The pathogenesis of asbestos-associated diseases. (X)

Abestos/S~king Interactions [400] Series, March 30, 1983 374 1262 Becklake MR (1982) N Eng J Med 306:1480-1482 Exposure to asbestos and human disease. (X) 1263 Rom WN (1982) Little, Brown and Co. Boston 157-182 14. Asbestos and related fibers. In: Environmental and Occupational Medicine. 1264 Rom W~, Lockey JE (1982) West J Med 137:548-554 Diffuse ~lignant mesothelioma: A review. (X) 1265 Croft W (1982) Proc Int Cancer Congr 13; 339 Environmental asbestos and mesotheliomas in dairy calves. 1266 Domanski L, Dubielzig R, Glick~n R (1982) Am J Epidemiol 116:586 Canine mesothelioma and asbestos: a case-control study. (X) (X)

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO 421 0930 413 0870 413 0873 470 1161 470 1162 450 1095 413 0886 484 1255 413 0871 461 1102 435 1017 470 1166 470 1167 481 1183 427 0988 444 1075 413 0876 450 1098 423 0966 461 1108 427 0986 427 0990 427 0992 427 0987 427 0985 42? 0989 463 1139 490 1262 435 1014 462 1115 418 0924 422 0965 422 0963 422 0964 461 II07 421 0943 421 0933 421 0932 421 0942 421 0931 421 0955 421 0956 Abelane¢ R, Jagueux H, Fondimare A, Roujeau J (1979) FRA Acheson ED, Gardner MJ, Bennett C, Winter PD (1981) GBR Acheson ED, Gardner MJ (1979) GBR Aisner J, Wiernik I~ (1978) UMD Aisner J, Wiernik l'~ (1981) UMD Alvarez-Fernandex E, Esalona-Zapata J (1982) SPA Anonymous (1981) GBR Anonymous (1982) GBR Anonymous (1973) GBR Anonymous (1966) GBR Antman Kli (1981) UMA Antman Kid (1980) UMA Antman KH, Blum RH, Greenberger JS, Flowerdew Get al (1980) UMA Anion HC (1968) GBR Artvinli M, Baris YI (1979) TUR Arul KJ, Holt PF (1977) GBR Ashcroft T, Meppleston AG (1970) GBR Ashford RFU, Maher J, Drury A, Picketing D (1981) GBR Avril J (1981) SWI Banner MP, Gohel VK (1978) UPA Baris YI (1979) TUR Baris YI (1980) TUR Baris YI, Simonato L, Saracci R, Skidmore JW, Artvinli M (1981) TUR Baris YI, Ar~vinli M, Sahin AA (1979) - TUR Baris YI, Sahin AA, Ozesmi M, Kerse I, et al (1978) TUR Baris YI, Artvinll M, Sahin A, Savas T, Erkan ML (1979) TUR Beck B, Konetzke G, Ludwig V, Rothig W, Sturm W (1982) GER Becklake MR (1982) CAN Belleau R, Gaensler EA (1968) UMA Bellomo VJ (1957) ARG Benjamin CJ, Ritchie AC (1982) CAN Bianchi C, Brollo A, Bittesini L (1982) ITA Bianchi C, Grandi G, Di Bonito L (1978) ITA Bianchi C, Brollo A, Bittesini L (1981) ITA Bianchi C, Castelli M, Carluccio L (1976) ITA Bignon J (1980) FRA Bignon J, Sebastien P, Di Menza L, Nebut M, Payan H (1979) FRA Bignon J, Sebastien P, Dimenza L, Payan H (1979) FRA Bignon J, Nebut M (1981) FRA Bignon J, Ruffle P (1977) FRA Boersmm A, Degand P, Havez R (1973) FRA Boersma A, Degand P, Biserte G (1980) FRA

CUMULATIVE AUTIIOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + 2 CAT. REF. AUTIIORS AND YEAR GEOGRAPHIC NO. NO 470 1149 427 0994 462 1119 461 1112 463 1133 433 1009 433 1010 421 0935 421 0937 421 0936 470 I163 421 0958 461 II09 432 1007 444 1077 450 I089 442 1051 482 1225 421 0950 450 1094 434 1012 461 III0 426 0979 470 1150 413 0878 414 0896 411 0851 443 1070 462 I127 421 0929 443 1069 483 1234 442 1044 470 1164 470 1165 483 1236 450 1088 421 0952 442 1048 450 1091 464 1143 443 I068 Bohlig H, Hain E (1980) GER Boman G, Schubert V, Svane B, Westerholm P, et al (1982) TUR Boon M~, Posthuma HS, Ruiter DJ, Van Andel JG (1981) NET Boon ME, Veldhuizen RW (1982) NET Boreux J-L, Paesmans M, Feoli F, Lsmbert P, Parise L (1982) BEL Borow M, Conston A, Livornese LL, Schalet N (1967) tINJ Borow M, Livornese L, Conston A, Schalet N (1973) UNJ Boutin C (1975) FRA Boutin C, Farisse P, Viallat JR, Cargnino P, Choux R (1979) FRA Boutin C, Pietri JF, Beddou M, Alabdullah F (1978) FRA Brady LW (1981) UPA Brambilla E, Brambilla C, Kaehler D, Bensa JC (1981) FRA Brenner DE, Whitley NO, Goldstein W'Z, Aisner J (1981) UMD Brenner J, Sordillo PP, Magill GB, Golbey RB (1982) UNY Brenner J, Sordillo PP, Magill GB (1981) UNY Brisell IM, Mark EJ, Dickersin GR (1981) UMA Britton DC (1976) GBR Britton MG (1980) GBR Brochard P, Ameille J (1981) FRA Broghamer WL, Collins NM, Mojsejenko IK (1978) UKY Bruckman L, Rubino RA, Christine B (1977) UCT Bryant J (1982) UIL Bursova J, Pesek M (1981) CZE Butchar~ EG, Ashcroft T, Barnsley WC, Holden MP (1981-) GBR Butler EB, Berry AV (1973) GBR Butler EB, Johnson NF (1980) GBR Calavrezos A, Hath E (1982) GER Campbell GD, Greenberg SD (1981) UTX Campbell JM (1983) GBR Campo MA (1953) FRA Caravelli JF, Z~man MB (1978) UNY Carroll MP, Britton MG, Green M (1981) GBR Castleman B,..McNeeley BU (1967) UMA Chahinian AP, Suzuki Y, Mandel EM, Holland JF (1978) UNY Chahinian AP, Pajak TF, Holland JF, NOrton Let al (1982) UNY Chailleux E, Eveillard ME, Ordronneau Jet al (1982) FRA Chalaoui J, Barral V, Simard P, Lefebvre R, Sylvestre J (1982) FRA Champeix J (1976) FRA Champion P (1971) CAN Chang JC, Lesser M (1982) UNY Chen KTK, Arhelger RB, Flam MS, Hanson JH (1982) UCA Chert W, Mottet N~ (1978) UWA

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + 3 CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO 418 0927 421 0954 481 If90 480 1178 442 I057 481 1206 481 1204 431 1005 463 1135 431 0997 450 1087 412 0855 444 1076 462 1126 483 1230 400 0844 414 0894 435 1019 490 1261 490 1265 425 0902 462 1122 443 1071 462 ii16 421 0945 421 0944 481 I193 418 0925 490 1266 484 1249 514 0900 415 0901 463 i129 462 ii18 413 0862 463 I136 413 0868 524 0973 484 1244 484 1238 484 1239 484 1240 Chovil A, Stewart C (1979) CAN Chretien J (1979) FRA Chretien J, Chahinian P~, Hirsch A, Nebut M (1976) FRA Chretien J (1978) FRA Christense JB, Rechfeld E (1980) DEN Churg A (1982) UCA Churg A (1981) UCA Churg A, Golden J (1982) ONY Churg A, Warnock ML, Bensch KG (1978) UCA Churg J, Rosen SH, Moolten S (1965) ONY Cobanoglu A, Rienhard Jj (1982) ODE Cochrane JC, Webes~er I (1978) SAF Cochrane JC, Webster I (1981) SAF Cohen BN, Efremidis S (1980) ONY Collins TFB (1968) SAF Co~ercial Union Insurance Companies (1982) OMA Constan~inidis Z (1977) GBR Corson JM, Pinkus GS (1982) UMA Cr~ighead JE, Mossman BT (1982) UVT Croft W (1982) UWI Davis JMG (1974) GBR De Young WA, Fricke RW (|962) Decoufle P (1980) UAR Dewan CH, Lindauer RG (1958) - UMI ~i Menza L, Hirsch M, Mangold M, Bignon J (1979) FRA Di Menza L, Hirsch A, Sebastien P (1982) FRA ~iMenza L, Hirsch A, Mangold M, Bignon J (1979) FRA Dionne GP, Wang NS CAN Domanski L, Dubielzig R, Glickman R (1982) UPA Donna A, Betta PG, Gagliardi F, Provana A (1980) ITA Dormard AJ, Stack EHR (1981) GBR Dormard AJ (1981) GBR Drash EC, Hyer HJ, Skinner GF, Lam CR, Hughes FA et al (1950) OVA Dvoskin S (1959) ONY Eastwood EH, Martin JP (1921) GBR Eck H, Berg-Schlosser V (1978) GER Edge JR (1976) GBR Eerland LD (1956) NET E£senstadt HB (1974) OTX Eisenstadt HB (1962) UTX Eisenstadt HB (1964) lyrx Elsenatadt HB (1965) UTX

CUHULATIVE AUTHOR INDEX FOR CATEGORXES 400 to 490 MARCH 30, 1983 PAGE 374 + 4 CAT. REF. AUTIIORS AND YEAR GEOGRAPHIC NO. NO 416 0907 416 0908 470 I146 416 0905 416 0906 461 1103 418 0926 484 1256 461 II04 462 1124 443 I067 464 1144 463 1130 442 1040 490 1260 481 ~217 483 1227 450 1083 484 1241 435 1015 481 1185 439 1030 414 0897 413 0879 412 0860 414 0889 442 1060 442 I045 414 0888 442 1050 442 1055 415 0904 415 0903 417 0910 424 0970 424 0971 411 0847 426 0982 412 0858 442 1056 450 I093 484 1245 Elmes PC (1973) GBR Elmes PC (1979) GBR Elmes PC (1973) GBR E1mes PC, Wade OL (1965) GBR Elmes PC, McCaughey W'rE, Wade OL (1965) GBR Enticknap JB, SmOther WJ (1964) GBR Eys~en GM (1980) CAN Felson B (1982) Fernaudes AC, Fonaeca JML, Heuriques AF, aGates AO (1980) POR Ferrer-Roca O, Ingelmo M, Elias AM, Rives A et al (1979) SPA Fischbein A, Suzuki Y, Selikoff IJ, Bekesi JG (1978) UNY Fliglel Z, Kaneko M (1976) URI Forest JL, Kozonis MC (1960) UMI Fowler PBS, Sloper JC, Warner EC (1964) GBR Frank AL (1980) UNY Fridriksson HV, Hedenstrom H, Hilierdal G, Malmberg P (1981) SWE Fro~mthold W, Lage~nn K, Lindlar F (1969) GER Fukuoka Y, Yoshioka S, Takeda Y (1956) JAP Gaensler EA, Kaplan AI (1971) UMA Gaensler EA (1977) UMA Galloway RW (1978) GBR Gardner RJ, McDonald JC, Enterline PE, et al (1981) UNY Gardner MJ, Acheson ED, Winter PD (1982) GBR Gellert AR, Steel SJ (1982) GBR Gilson JC (1966) SAF Gilsou JC (1972) GBR Gladfelter T, Wiygul F, Campbell A et al (1982) UFL Godwin MC, Jagattc G (1968) UIL Gold C (1969) GBR Golden RL (1974) UNY Goldstein B (1979) SAF Greenberg M, Davies TAL (1974) GBR Greenberg M 61973) GBR Griffiths Mli, Riddell RJ, Xipell JM (1980) ATL Gulsvik A, Haanaes OC, Mowe G (1982) NOR Hagerstrand I, Meurm~n L, Odlund B (1968) SWE Hain E, Dalquen P, Bohlig H, Dabbert A, Hinz I (1974) GER Bajdukiewicz Z, Slodkowska J, Szaniawski W (1975) POL Harington JS (1971) SAF Har~ung M (1980) GER Rarwood TR, Gracey DR, ¥okoo H (1976) UIL Hasan FM (1975) LEB

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCR 30, 1983 PAGE 374 ÷ 5 CAT. P~F. AUTHORS AND YEAg GEO~RAPIIIC NO. NO 435 1020 426 0980 426 0981 418 0917 450 1084 481 1218 417 0913 413 0872 481 1187 413 0881 413 0880 470 1159 481 1211 481 1201 481 1212 481 1202 450 1090 481 1197 481 1216 481 1203 439 1024 481 1192 481 1191 421 0946 481 1194 484 1248 421 0947 470 1155 424 0968 411 0850 421 0938 484 1251 442 1064 464 1145 470 1160 421 0948 421 0949 481 1184 413 0874 443 1065 463 1131 463 1137 Hasan FM, Rash G, Kazemi H (1977) UMA Haskovcova I (1979) CZE Haskovcova I, nobias J, Vodickova S (1981) CZE Baust MD, gepkie GF (1959) CAN Heaney JP, Overton RC, DeBakey ME (1957) UTX Hedenstierna G, Alexandersson R, Kolmodin-Hedman Bet al (1981) SWE Henderson DW (1982) ATL Hepples~on AG (1974) GBR Herbert A, Sterling GM (1980) GBR Herbert A, Gallagher PJ (1982) GBR Herbert A, Gallagher PJ (1982) GBR Hillerdal G (1982) . SWE Hillerdal G, Lindgren A (1980) SWE Hillerdal G (1982) SWE Hillerdal G (1980) SWE Hillerdal G (1981) SWE Hillerdal G, Hemmingsson A (1980) SWE Hillerdal G, Hillerdal O, Now E (1980) SWE Hillerdal G, Hillerdal O (1979) SWE Hillerdal G, Lindgren A (1980) SWE Hinds MW (1978) UWA Hirsch A (1979) FRA Hirsch A, DiMenza L (1979) FgA Hirsch A, Di Menza L, Dorbon F, Carre A, Bignon J (1980) FRA Hirsch A, DiMenza L, Dorbon F, Carte A, Bignon J (1980) Hirsch A, Ruffie P, Nebut M, Bignon J, ChreClen J (19979) FRA Hirsch A, Brochard P, Cremoux HD, Erkan L, et al (1982)FRA Holsci LR (1982) FIN Huuskonen MS (1982) FIN Huzly A (1981) GER Irisson M, Valardocchio JM, ViallaC JR, Bou~in C (1983)FRA Israel HL, Steiner RM (1981) UPA Jackson DV, Marshall R3, Alber~son DA, Slatkoff HL (1982) UNC 2apko L, Horta AA, Schreiber K, Mitsudo Set al (1982) UNY Jara F, Takita H, Rao UNM (1977) U~¥ Jaurand MC, Gsudichet A, Jaurand MC, gaplan H, Thlollet J, Pinchon MC, et als (1979) FRA Jones JSP, Sheers G (1973) GBR Jones 2SP, Pooley FD, Clark N2, Owen WG et al (1980) GBR Josefson A (1922) gadeu F (1982) GER Kahn EI, Rob1 A, Barre~¢ EW, Suzuki Y (1980) UNY

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + 6 CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO 431 1000 431 0998 431 1001 431 1006 444 1074 481 1196 462 1120 441 1031 490 1259 424 0969 411 0846 442 1039 484 1252 411 0849 470 1158 426 0983 421 0940 421 0939 442 1063 442 1059 417 0911 463 1134 470 1156 413 0877 483 1226 415 0898 483 1233 470 1175 470 1173 470 1174 461 1100 481 1188 464 1141 442 1049 434 1013 436 1021 427 0993 470 I171 481 1220 481 1209 418 0922 441 1038 Kannerstein M, Chur8 J (1980) UNY Kannerstein M, Churg J, Magner D (1973) UNY Kannerstein M (1980) Kanuerstein M, Chur8 J, McCaushey WI (19795 UNY Kashirsagar VH, Patil SD, Sharma KD et al (1971) IND Kaski P, Kiviluoto R, Meurman L (1968) FIN Katsube Y, Kukai K, Silverberg SG (1982) UDC. Keilty RA (1917) UPA Kiss GT (1982) UCT Kjuus H, Langard S, Dyb S (1981) NOR Knappmann J (1972) GER Knowles Jtt, Dreyfuss JR, Wilkins k-N, Castleman Bet al (1963) UMA Kondlapoodi P, Gabriel JB (1982) UNY Konetzke GW, Beck B (1981) GER Kostainen S, Appelqvist P, Holsti LR, Mattson K (1982) FIN Kovac-Stojkovski S (1979) YUG Lajartre HD, Lajartr~ YD (1979) FRA Lajartre MD, Cornet E, Corroller J, et al (1976) FRA Langer AM, McCaughey WTE (1982) CAN Langer AM, McCaughey WTE (1982) UNY Lanslois ALP, Glancy JJ, Henderson DW (1978) ATL Laohpand T, Panyathanya R, Pacharee P, Maranetra Net al (1982) THA Laustela EV (1982) FIN Law M~, Hodson ME, Heard BE (1982) GBR Lawson JP (1963) GBR Le Roux BT (19625 GBR LeBouffant L, Martin JC, Durif S, Daniel H (1973) FRA Lebovits AH, Chahinian AF, Holland JC (1983) UNY Lebovits AH (19805 tINY Lebovits All, Chahinian AP, Holland JF, Holland JC (1981) UNY Leicher F (1954) GER Lemenager J, Rousselet P, Mandard JC, Le Bouffant L e~ al (1976) FRA Lenko J, Bankowski Z (19565 Lewinsohn HC (19745 Lewinsohn HC, Meigs JW, Teta MJ, Flannery JT (1980) Lieben J, Pistawka H (1967) Lilis R (1981) Linden CJ, Korsgaard R, Willen H, Willen R et al (1982) Lumley KPS (19805 Macpherson P, Davidson JK (1969) Magner D, McDonald AD (19725 Mallory TB, Castle~an B, Parris EE (1947) POL GBR UCT UPA TUR SWE GBR GBR CAN UMA

CUMULATIVE AUTIIOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + 7 CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO 461 1106 484 1253 442 I043 462 II14 442 1062 470 1154 470 1157 484 1246 481 1200 480 1179 470 1170 414 0895 431 1004 462 I121 417 0915 418 0921 439 1026 439 1025 418 0920 413 0875 418 0919 418 0918 413 0884 429 1027 441 1032 415 0899 442 1047 481 1215 417 0909 482 1223 441 1036 450 1097 470 1147 421 0953 421 0941 421 0957 417 0914 442 1054 421 0959 435 1016 464 1142 481 1195 Mann Rll, Grosh JL, O'Donnell NM (1966) UPA Mark JBD (1982) Markham TN, Dodson VN (1968) UMI Martelli CF (1953) ITA Ma~sumuma H, Tsuchiyama H, Kawai K, Nakano M e~ al (1982) JAP Mattson K (1982) FIN Mattson K (1982) FIN Mat~son SB (1975) SWE Marrson SB, Ringqvisr T (1970) SWE Ma~zel W (1979) GER McCann J (1982) McCaughey WTE, Oldham PD (1973) GBR McCaughey WTE, A1-jabi M, Kannerstein M (1980) UNY McClemont JMF, Webb JN (1981) GBR McCullagh SF (1978) ATL McDonald AD (1980) CAN McDonald AD, McDonald JC (1980) CAN McDonald AD, McDonald JC, Pooley FD (1982) CAN McDonald AD (1979) CAN McDonald AD, McDonald JC, Pooley FD (1982) GBR McDonald AD, Harper A, El Attar DA, McDonald JC (1970) CAN McDonald AD, Harper A, E1 Attar OA, McDonald JC (1970) CAN McDonald C, McDonald A (1979) GBR McDonald JC, McDonald AD (1981) CAN McDonnell PJ, Maxwell ES (1920) UPA McEwen, Finlayson A, Mair A (1971) GBR McGilloway FA (1968) GBR McMillan GlIG, Pethybridge RJ, Sheers G (1980) GBR McNulty JC (1962) ATL Miller A, Teirstein AS, Selikoff I (1982) UNY Miller RD, Dockerty MB, Bennett WA (1958) UHN Mintzer RA, Gore RM, Vogelzang RL, Holz S (1981) UIL Miranda AR, Brigand HL (1978) FRA Molina C, Delage J, Mercier R (1968) FRA Molinari D, Verdier M, Simon A, Gontier C, Pibarot JC (1981) FRA Morner M (1979) FRA Mortimer Rli, C~mpbell CB (1968) ATL Mostert C, Meintjes R (1979) SAF Mulliez P, Saout J, Creusy C, Crinque~te J (1981) FRA Murphy R (1980) UMA Nagel R (1960) GER Navratil M, Moravkova K, Trippe F (1978) CZE

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCH 30, 1983 PAGE 374 + CA~. REF. NO. NO 463 1132 441 I035 413 0882 413 0883 442 I061 413 0864 413 0865 481 1208 442 I058 411 0848 413 0863 421 0934 484 1237 442 I053 413 0885 439 1028 413 0887 425 0972 425 0975 025 0974 425 0976 414 0893 422 0961 443 1073 445 I080 462 1125 446 1082 484 1250 463 1138 438 1023 442 1052 490 1263 490 1266 426 0984 462 1113 421 0960 462 1117 422 0962 423 0967 470 1148 442 1046 484 1254 AUTHORS AND YEAR G~)G~APH IC Nedogoda W, Gofman VA, Mogilevskii RE, Sgibneva OVet al (1982) RUS Nesbitt ~, Boswell JT, DeJesus-Gonzeles MA, Sarkisian SS (1958) Newhouse ML (1981) GBR Newhouse M~, Berry G (1976) GBR Newhouse ML (1982) G~R Newhouse bIL, Thompson H (1965) GBR Newhouse ML (1967) GBR Nizze H (1973) ~R Okumura T, Okada M, Tsuji M, Inoue A, Ochiai Y (1980) JAP Otto H (1980) Owen WG (1964) G~R Perdrizet S, Bignon J, Di Menza L, Nebut M (1980) FRA Perous ML, LitCman MS (1955) UIL Perry MC, 5olinger A, Farhengi H, Luger A (1978) UMO Peto J (1980) GBR Peto J, Henderson BE,. Pike MC (1981) GBR Peto J, Seidman N, Selikoff IJ (1982) GBR Picard E, Gaspard P (1953) BEL Planteydt HT (1979) NET Planteydt RT (1979) NET Planteydt HT (1980) NET Pooley FD (1973) GBR Ragaini S, Fondrini C (1958) ITA Ragalie GF, Varkey B, Choi H (1983) DI~I Ra~iaro GC, Sar~ori F, Calabro F, Varoli F (1982) ITA Riddell P,H, Goodman MJ, Moossa AR (1981) Risberg B, Nickels J, Wagermark J (1980) SWE Robinson BWS, Musk AW (1981) ATL Roggli VL (1981) ~C Roggl£ VL, McGavran ~.~ Subach J, Sybers HD, Greenberg SD (1982) UTX Rom W, Anderson HA (1977) Rom WN (1982) Rom WN, Lockey JE (1982) Ro~snychev YA (1979) Romeo M (1935) Roujeau J (1978) Roujeau J, $Ceg A (1961) Rubino GF, $canse~ti G, Donna A, Palestro G (1972) Rue~tner JR (1983) Ruffle P, ~irsch A (1980) Rusby NL (1968) Sahn SA (1982) UNY ITA FRA FRA ITA UCO

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 Co 490 MARCH 30, 1983 PAGE 374 + 9 CAT. REF. AUTHOES AND YEAR GEOGRAPHIC NO. NO 483 1231 483 1235 481 1207 462 1128 483 1228 450 1092 427 0991 431 0996 43~ 0995 400 0842 400 0843 413 0869 481 1186 480 1181 418 0928 445 1079 439 1029 484 1243 470 I169 480 1180 470 1153 413 0866 412 0856 482 1222 482 1221 484 1242 481 1182 450 1096 470 1151 470 1152 442 i041 443 1072 482 1224 484 1258 421 0951 441 1037 443 I066 425 0977 425 0978 450 1085 431 1002 431 1003 Sargent ER, Jacobson G, Wilkinson EE (1972) UCA Sargent EN, Felton JS, Barnes LT (1981) UCA Sargent EN, Gordonson J, Ja¢obaon G, Birnbaum W, Shaub M (1978) UCA Schneider V, Partridge JR, Gutierrez F, Hurt WG et al (1983) lYCA Schneider L, Wimpfheimer F (1964) UNY Sc£ammas FD, Shetcy S, Ravani S (1971) UMA SebasCien P, Gaudichet A, Bignon J, Baris YI (1981) TUR Selikoff IJ, Churg J, Hammond EC (1965) UNY Selikoff IJ, Churg J, Eaaanond EC (1964) UNY Selikoff IJ, Lee DHK (1978) ~NY Selikoff IJ (1982) UNY Sheers G (1980) GBR Sheldon CS, Herbert A, Ballagher PJ (1980) GBR Shugar S (1979) CAN Shugar S (1979) CAN Sleggs CA (1970) SAF Sloan MH, Peto J, Radford EP, Schneiderman M, et al (1981) UNY Sluis-Cremer GK, Wesbster I (1972) SAF Smith WE, Boliat SM, Hubert DD, Sobel HJ, Davis S (1980) UNJ Smith WHR, Davies D (1980) GBR Smith-Meyer R (1982) NOR Smither WJ (1966) GBR Solomon A (1970) SAF Solomon A (1969) SAF Solomon A (1970) SAF Solomon A (1970) SAF Solomon A, Webster I (1976) SAF Soa~er T, KanCarCzis M, Garcia M, Schuber~ GE (1981) GER Sorensen PG (1982) DEN Sorensen PG, Rorth M, Hansen HB (1982) DEN Steel SJ, Boyd J (1965) GBR Sceiner RM, Cooper ~/, Brodovsky H (1982) UPA Sterling GM, H6rbert A (1980) GBR Stjernberg N, Lundgren E, Roos G, Abu Sinna G (1982) SWE Stoebner P, Bernaudin JF, Rebut M, Basset F (1979) FRA SCorer J, Hooper R (1960) UOH Strieder JW, Scully RE, Pendergrass HP et al (1959) UMA Stumphius J (1971) NET Stumphius J (1979) NET Sufian D, Vaniels M (1978) UTE Suzuki ¥ (1980) UNY Suzuki Y, Chahinian AP, Ohnuma T (1983) UNY

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 MARCII 30, 1983 PAGE 374 + I0 CAT. REF. AUTHORS AND YEAR G~O~RAFHIC NO. NO 431 0999 450 1086 437 I022 412 0859 418 0923 484 1257 481 I198 481 1210 412 0857 461 If01 412 0861 481 I199 460 1099 481 1189 433 I011 445 1081 418 0916 432 1008 483 1229 414 0892 412 0853 414 0891 470 1172 470 1168 412 0852 414 0890 435 1018 481 1205 444 1078 470 1176 464 1140 412 0854 480 1177 411 0845 481 1213 481 1214 417 0912 413 0867 442 i042 461 1111 441 1033 481 1219 Suzuki Y, Kannerstein M, Churg J (1973) UNY Tada S (1978) JAP Tagnon I, Blot WJ, Stroube RB, Day ME, Morris LE, et al (1980) DWA Talent JM, Harison WO, Solomon A, Webster I (1980) SAF Tao LC (1979) CAN Taskinen E (1982) FIN Thiringer G, Blomqvist N, Brolln I, Mattson SB (1980) SWE Thomson JG (1970) SAF Thomson JG (1970) SAF Thomson JG (1962) SAF Thomson JG (1963) SAF Thringer G (1980) SWE Tianen M~, Hoatamed F, Mjaatvedt CH, Lee JS, Rom WN (1983) UUT Tory L, Her~zog P, Personne CL, Bakdach H (1976) FRA Triol J, Co~ston AS, Chandler SVD (1982) UNJ Tuman ZJ, Chilcote RR, Berkow RI, Moohr JW (1980) UIL Vallee A (1920) CAN Vianna J, Maslowsky J, Roberts $, Spellman G, Patton RB (1981) UNY Viikeri M, Jaaskelainen J, Tahti E (1968) FIN Wagner JC (1972) GBR Wagner JC (1962) SAF Wagner JC (1964) GBR Wagner JC, Johnson NF, Brown DG, Wanger MMF (1982) - GBR Wagner JC, Hill RJ, Berry G, Wagner, ~@~F (1980) GBR Wagner JC, S1eggs CA, Marchand P (1960) SAF Wagner JC, Berry G, Pooley F (1982) GBR Warhol MJ, Hickey NF, Corson JM (1982) UMA Warnock ML, Prescott BT, Kuwahara TJ (1982) UCA Wassermann M, Wassermann D, Steinltz R, Katz L, Lemesch C (1980) ISR Watts KC, To A, Boyo-Ekwueme HT, Poznansky Met al (1983) GBR Waugh TR (1953) CAN Webster I (1973) . SAF Webster I (1973) SAF Weiss A (1953) GER Weiss W, Levin R (1980) UPA Weiss W, Levin R, Goodman L (1981) UPA Whitaker D, Shilkin K~ (1981) ATL Whitwell F, R~wcliffe RM (1971) GBR Wieckling DK (1966) UVA Wolfson WL (1982) UKA Wood EA, Walter AI (1921) UMO Wright FH, Hanson A, Kreel L, Capel LH (1980) GBR

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 400 to 490 CAT. KEF. NO. NO AUTHORS AND YEAR 483 1232 462 1123 461 1105 441 1034 484 1247 Wusteman FS, Gold C, Wagner JC (1971) Yoon IL (1962) Young JR, Reddy ER (1980) Zeckwer IT (1924) Zeman V (1979) MARCH 30, 1983 PAGE 374 + II GEOGRAPHIC GBR OCT GBR UMA CZE

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 375 [500] BRONCHIAL CARCINOMA AND EXTRAPULMONARY MALIGNANCIES [510] Case reports of bronchial carcinoma in asbestos workers: 1935 to 1939 [520] Case reports of bronchial carcinoma in asbestos workers: 1940 to 1949 [530] Case reports of bronchial carcinoma in asbestos Workers: 1950 to 1959 [540] Case reports of bronchial carcinoma in asbestos workers: 1960 to 1969 [550] Case reports of bronchial carcinoma in asbesto~ workers: 1970 to 1979 [560] Bronchial carcinoma and asbestosis research progress: 1980 to 1982 [570] Malignancies of the head and neck in asbestos workers [580] Malignancies of abdominal organs and extremities in asbestos workers [590] Asbestos/cigarette smoking interactions in patients with bronchial carcinoma Bibliography Author Index 376 377 378 381 387 392 394 395 397 397 404 423 + page 1 to 4

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 376 [500] BRONCHIAL CARCINOMA AND EXTRAPULMONARY MALIGNANCIES The subject of asbestos-associated bronchial carcinoma is discussed in several preceding sections: experimental asbestos carcinogenesis [iQ0s], histopathology and cytopathology [200s], and mortality statistics [300s]. A subsequent section on bronchial cancer appearing in asbestos workers [700s] estimates the risk of carcinogenesis involved in various trade groups. The present section is concerned with articles that describe case reports of bronchial carcinoma in asbestos workers, starting with the 1935 publication of Lynch and Smith. Subsequent case reports are summarized in tabular form with special emphasis on the nature of asbestos exposure and identification of concurrent risk factors that may have contributed to the etiology of bronchial carcinoma. Smoking habits are discussed whenever the clinical investigator included the information which was not a practice until the 1960s. This section also includes malignancies in the head, neck, abdominal organs and extremities that have been reported to occur in asbestos workers. The concluding section is a summary of opinions by experts on the question of asbestos/ cigarette smoking interaction in the pathogenesis of bronchial carcinoma.

Asbestos/Cigarette Interaction [500 Series) May 30, 1983 377 [510) Case Reports of Bronchial Carcinoma in Asbestos Workers: 1935 to 1939 At the outset, it should be recalled that the concurrent appearance of pulmonary asbestosis and bronchial carcinoma was first reported in 1935 by Lynch and Smith (1267) in an asbestos textile weaver from South Carolina. By 1939, a total of 11 bronchial cancer cases in asbestos workers were reported in the United States, England and Germany. The case reports are summarized as follows: Investigators/Year [City/State] Sex, Age, occupation: Histologic Diagnosis and Primary Site United States (1267) Lynch & Smith 1935 Male 57, weaver 21 years: squamous [Chareston SC] cell carcinoma R-Lower lobe (1268) Lynch & Smith 1939 Male 50, weaver 13 years-: squamous [Charleston SC] cell carcinoma R-Lower lobe (1269) Egbert & Geiger 1936 Male 41, weaver 17 years: [New Haven CT] adenocarcinoma L-Lower lobe Great Britain (1270) G1oyne 1935 [London] (1271) Gloyne 1936 [London] Female 35, spinner 8 years: squa- mous cell carcinoma R-Lower lobe Female 71, mattress maker, ? years: squamous cell carcinoma R-Lower lobe Male 59, packer 10.5 years: oat cell carcinoma L-Lower lobe Germany (1272) Nordmann 1937-38 [Berlin] Female 35, spinner 7 years: squa- mous cell carcinoma L-Lower lobe Male 55, pre-spinning assembly worker 7 years: squ~ous cell carcinoma L-Lower lobe

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 378 (1273) Hornig 1938 [Heide] (1274) Koelsch 1938 [Munich] Female 35, asbestos factory worker 9 years: carcinoma L-Lower lobe (father esophageal cancer) Two cases, no details It should be noted that at asbestos workers listed above lower lobes, whereas most nonasbestos bronchial carcinoma of the upper lobes reviews of lung cancer in asbestos workers least eight of the eleven had bronchial carcinoma of the workers developed (1275, 1276). In published in 1938, Teleky (1277, 1278) estimated that approximately half of autopsies of asbestos workers showed bronchial cancer. In contrast to cancer associated with silica and chromium, Teleky proposed the mechanism for asbestos carcinogenesis as mechanical irritation rather than chemical reaction. [520] Case Reports of Bronchial Carcinoma in Asbestos Workers: 1940 to 1949 The decade that included World War II was the period when the use of asbestos in shipyards became so extensive that exposed workers subsequently developed bronchial cancer two or more decades later. During the war years, although there was no exchange of medical information among the Allied countries, cases of asbestosis with bronchial continued to be reported from the United States, Great and Axis carcinoma Britain,

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 379 Germany and for the first time from Canada. In the United States, the 1940s started with two review articles on occupa- tional neoplasms that did not implicate asbestos as a causative agent (1279, 1280). By the end of the decade, an Editorial appeared in the JAMA (1281) suggesting a causal relationship between asbestos and bronchial carcinoma based on the available information, including case reports summarized in the following table: Investigators/Year [City/State] Sex, Age, Occupation: Histologic Diagnosis and Primary Site United States (1282) Holleb & Angrist 1942 [Jamaica NY] (1283) Homburger 1943 [New Haven CT] Male, 52, pipe insulator 25 years: squamous cell carcinoma R-Upper lobe Male 58, pipe insulator 10 years: oat cell carcinoma R-upper lobe Male 45, asbestos worker 5 years: squamous cell carcinoma R lung Male 43, asbestos worker 20 years: anaplastic carcinoma L-Lower lobe Female 49, no history of asbestos exposure: squamous cell carcinoma R-Lung Great Britain (1284) Cureton 1948 Female 37, asbestos pipe coverer 7 [Newcastle-upon-Tyne] years: squamous cell carcinoma L-Lower lobe (Aunt worked in same factory and died of asbes- tosis at age 40) Germany (1285) Koelscb 1940 [Berlin] (1286) Linsbach & Wedler 1941 [Berlin] One case, no details Male 61, asbestos factory worker 18 years: no addtional details

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 380 (1287) Welz 1942 [Hannoverl (1288) Boemke 1947 [Dortmund] Canada (1289) Desmeules et al 1941 [Quebec] (1290) Desmeules et al 1947 [Quebec] Male 43, asbestos factory worker 11 years squamous cell carcinoma L-Lower lobe (also baker and tubercular) Male 56, asbestos mixer 21 years: anaplastic carcinoma R-Lower lobe Male 71, asbestos carder ii years: squamous cell carcinoma R-Lower lobe Male 57, machine adjuster 25 years: alveolar cell carcinoma L-Lung Male 50, bagger 22 years: squamous cell carcinoma R-Lung The Editorial that appeared in the JAMA (1281) as well as publications appearing in European journals (1287, 1288, 1291- 1293) suggested that asbestos is the most bronchial carcinoma among exposed workers reasons: (a) the incidence rate of cancer excessive in tion; (b) the male to female sex ratio for bronchial carcinoma in asbestos workers is lower than that for the geaeral popula- tion; (c) asbestos-associated bronchial carcinoma occurs more frequently in the lower lobes than in upper lobes, the reverse for cancer in the general population; (d) bronchial cancer among asbestos workers occured at a younger age than that in nonasbestos workers; and (e) the animal inhalation studies likely cause of for the following of the lung is asbestos workers compared to the general popula-

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 381 conducted in the 1930s showed carcinogenicity of asbestos dust ICategory 100s] [530] Case Reports of Bronchial Carcinoma in Asbestos Workers: 1950 to 1959 The 1950s can be characterized as occupational cancer was recognized as a entity. Hueper, the newly appointed Chief of the decade that specific disease the Cancerigenic Statistics Section of the National Cancer Institute, published in 1950 three articles (1294-1296) on occupational cancer hazards including asbestos-associated bronchial carcinoma. He defined environmental or occupational cancers as follows: "Since environmental cancers and c~ncerigenic agents do not possess any properties by which they can be distinguished from the so-called spontaneous cancer, the recognition of the environmental nature of a cancer is based on circumstantial evidence. The bulk of this evidence is of statistical and epidemiologic nature. An increased total cancer morbidity and mortality with a shift in the distribution of cancers as to sites as well as an excessive incidence of cancer of a certain organ or organs within a restricted population group should arouse the suspicion of an environmantal cause of these cancers. This interpretation receives support if there is a demonstrable shift of the cancers to younger age groups and of the male-female sex ratio of cancer. . The discovery and recognition of environmen~al'cancers is thus based on a complex type of evidence which is some instances forms a mosaic of a definite design, the environmental cancer pattern." (1294)

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 382 Hueper's summary of asbestos-associated lung cancer is as follows: "Until rather recently, the question of a causal relationship between asbestosis and cancer of the lung has been a controversial one. Wedler reported in 1943 a total of 14 cases of lung cancer in a series of 92 autopsies on patients with asbestosis (About 15 per cent). In a recent publication of Lynch and Cannon from this country, 4 cases of lung cancer in patients with asbestosis were reported, of which 3 occurred in a series of 2,683 necropsies performed during a ten- year period. Asbestosis was found in 40 cases. The incidence rate of lung cancer in the presence of as- bestosis was thus 7.5 percent, compared with i percent in the total number of necropsies. Merewether, analyzing the data collected by the Chief Inspector of Factories during the period 1924 to 1946, found 31 cases of lung cancer among 235 deaths from asbestosis giving an incidence raue of 13.2 percent of combined cancer and asbestosis of the lung. If calculated for the male deaths only, the incidence rate stood at 17.2 percent, while it was 8.4 percent for the female deaths. The average age of asbestosis cancer was approximately 50 years. Very recent information indicates that cancer of the lung has been observed in workers with asbestosis employed in the Canadian industries." (1295) Mayers (1297, 1298), the Chief of the Medical Unit, Division of Industrial Hygiene and Safety Standards (New York State Department of Labor) echoed the warnings of Hueper which actually dated back to a 1942 monograph entitled "Occupational Tumors and Allied Diseases". The far reaching importance of the activities in England was described by Mayers as follows:

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 383 "The relation of asbestos to lung cancer has been long suspected. Actually, considerable confirmation has recently been provided by the Chief Inspector of Factories in England, in his Annual Report for 1947. During the period from 1924 to 1946 inclusive, there were 235 deaths either caused by asbestosis or in which asbestosis has been established at necropsy. Cancer of the lungs or pleura was found in 31 of these cases or 13.2 percent, which is very high compared with a general incidence of 1 percent for cancer of the lungs among all adults examined at necropsy. Moreover, the sex distribution seemed to suggest the presence of an occupational carcinogen. The histolo- gic character of the cancers - squamous cell, instead of adenocarcinoma - and their histogenetic derivation, in that the bronchial mucosa was involved rather than the alveolar epithelium, was interpreted to indicate the presence of a specific exogenous carcinogenic agent as the etiological factor; in this instance, inhalation of asbestos dust. It has been estimated that 20,000 workers are now employed in asbestos- producing industries in this country and Canada. The development of cancer of the lungs in these workers is believed to be more directly related to asbestosis, the disease, than to the inhalation of asbestos dust per se." (1297) The above commentary on asbestos-associated bronchial carcinoma should be compared with the conflicting opinions in 1950 on cigarette smoking habits of lung cancer patients. Ariel, Avery, Kanter, Head and Langston (1299) summarized in 1950, the clinical"features of 1205 cases of primary carcinoma of the lung. Their observations on smoking habits were as follows: "No etiological factors that might contribute to the production of bronchogenic carcinoma could be ascertained from this review. Evaluation of the smoking habits of these patients is inconclusive. The various occupations were of such a miscellaneous

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 384 nature that none was considered of etiological significance. Of the 511 patients in whom histological confirmation was obtained, an associated syphilis was present in eighteen and concomitant tuberculosis of the lung was found in twelve. These figures do not warrant any statement concerning the etiological role of either of these diseases in the production of bronchogenic carcinoma." (1299) On the other hand, also in 1950, Wynder and Graham (1300) summarized the smoking habits of 857 cases of bronchial cancer and concluded that tobacco smoking plays a "major role in the induction of primary carcinoma of the lungs". The authors compared the occupations of lung cancer groups with those of a control group and concluded that occupational exposure did not influence the incidence of lung cancer. It is important to note that a third of the listed occupations involved exposure to asbestos so that the validity of their conclusion can be questioned, based on the presently available information that asbestos exposure is not only limited to miners and textile workers but also printers, plumbers, construction engineers and many others discussed elsewhere [Category 700s]. In 1952, w. E. Smith (1301) from the Department of Industrial Medicine, Postgraduate Medical School of New York University published his observations in the course of visiting occupational physicians in Europe. He recounted case reports from Canada that were not previously published and are added in

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 385 the following table of published case reports of bronchial carcinoma in asbestos workers: Investigators/Year [City/State] Sex,Age, Occupation: Histologic Dia@nosis and Primary Site United States (1302) Stoll et al 1951 [Jamaica NY] (1303) Castleman et al 1952 [Boston MA] (1304) Isselbacher et al 1953 [Boston MA] Male 40, asbestos pipe coverer ? years: anaplastic carcinoma R-Lower lobe Male 41, asbestos mill worker 12 years: adenocarcinoma L-Lower lobe, ci@arette smoker (1305) Lynch & Pratt-Thomas Male 46, foreman in asbestos 1955 [Charleston SC] factory 25 years: epidermoid carcinoma L-Lower lobe Male 55, spinner 36 years: squamous cell carcinoma R-Upper lobe Great Britain (1306) Owen 1951 [Bournemouth] Male 39, asbestos factory worker year 20 years earlier: squamous cell carcinoma L-Lung_ Germany (1307) B6hme 1951 [Bochum] (1308) BSmke 1953 [Dortmund] (1309) G~ttner 1955 [Dresden] (1310) Wether 1952 [Schwarzwald] Male 71, textile carder ii years: carcinoma R-Upper lobe Female 57, braking machine operator in asbestos factory 3 years: squamous cell carcinoma L-Lower lobe Male 57, foreman asbestos factory ? years: carcinoma lower lobe Male 51, weaver 5 years: squamous cell carcinoma L-Lower lobe [tuberculosis] Female 57, asbestos cutter and worker 8 years: squamous cell carcinoma R-Upper lobe Male 58, asbestos factory worker ? years: squamous cell carcinoma R-Lower lobe

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 386 (1311) BShme 1959 [Bochum] Switzerland (1312) Chauvet 1959 [Geneva] Italy (1313) Rombola 1955 [Milan] Canada (1314) Desmeules 1954 [Quebec] (1301) Cartier, cited by Smith 1952 [Quebec] Male 45, master weaver 15 years: small cell carcinoma L-Lower lobe Male 53, cardroom worker 15 years: carcinoma R-Lower lobe [tuberculosis] Male 52, asbestos bricklayer and board worker 30 years: adenocarcinoma both lungs Male 58 years, textile carder and master spinner 31 years: adeno- carcinoma both lower lobes Male 44 years, textile carder, spinner and weaver 12 years: carcinoma R-Upper lobe Female 58, asbestos joint worker 4 years: adenocarcinoma L-Lower lobe Female 49, asbestos factory worker 28 years: small cell carcinoma L-Lung Male 50, asbestos bagger 12 years: bronchial carcinoma R-Lung Male 57, machinist 25 years: pleuropulmonary carcinoma Male 59, asbestos worker 30 years: bronchogenic carcinoma Male 54, asbestos worker ii years: bronchogenic carcinoma Male 64, asbestos worker 2 years: bronchogenic carcinoma

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 387 [540] Case Reports of Bronchial Carcinoma in Asbestos Workers: 1960 to 1969 There were three significant events in the 1960s which led to the proposal that asbestos is a carcinogen and that cigarrette smoking potentiates the carcinogenicity of asbestos dust. First was the publication of Wagner in 1960 that as- bestos workers have a higher incidence of pleural mesothelioma compared to the general population in South Africa [Category 410]. Second was the 1964 Surgeon General's Report on S~king and Health sun~narizing the epidemiologic data suggesting that cigarette smokers have a highel incidence of bronchial carcino- ma compared to nonsmokers. Third was the epidemiologic study of Selikoff and his collaboratos at the Mount Sinai Hospital suggesting that asbestos insulators who were als~smokers have a higher risk of developing bronchial carcinoma than nonsmoking asbestos workers [Category 310]. Conflicting epidemiologic studies of asbestos workers were reported in the 1960s and are discussed elsewhere [Category 300s]. Case reports of bronchial carcinoma combined with abestosis continued to be reported from the United States, France, Italy and the first cases from Czechoslovakia were published.

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 388 Investigators/Year [City/State] United States (1315) Anderson & Campagna (1960) [San Francisco CA] (1316) Telischi & Rubenstone 1961 [Chicago ILl (1317) Cordova et al 1962 [Seattle WA] (1318) An & Koprowska 1962 [Philadelphia PAl Sex,Age, Occupation: Sistologic Diagnosis and Primary Site Male 42, asbestos insulator 30 years: squamous cell carcinoma Middle or Lower lobe, heavy cigarette smoker Male 65, plaster mixer 12 years: squamous cell carcinoma and bronchial adenoma both lungs, also adenocarcinoma of stomach Male 58, insulator 20 years: adenocarcinoma R-Middle lobe, heav~ cigarette smoker Male 46, ironworker: bronchial carcinoma R-Upper lobe, cigarette smoker Male 55, shipyard worker ? years: squamous cell carcinoma cigarette smoker Male 71, retired bricklayer: polypoid bronchial tumor L lung [tuberculosis] Male 64, pipe insulator ? years: adenocarcinoma R-Lower lobe, cigarette smoker Male 69, asbestos plant worker 18 years: anaplastic carcinoma R-Upper lobe Male 65, asbestos insulator shipyard for 53 years: squamous cell carcinoma R-Upper lobe, cigarette smoker Male 62, asbestos worker ? years: undifferentiated carcinoma R-Lower lobe Male 68, insulation worker ? years: bronchial carcinoma Male 60, asbestos handler 40 years: undifferentiated carcinoma R-Lower lobe, cigarette smoker Male 64, asbestos exposure 30 years: adenocarcinoma R-Lower lobe Male 68, asbestos worker ? years: undifferentiated bronchogenic carcinoma R-Upper lobe, cigarette smoker

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 389 (1310) Castleman et al 1964 [Boston 11320) Dyson & Trentalance 1964 [Camden NJ] (1321) Durra & Carney 1965 [Castro Valley CA] France (1322) Champeix et al 1962 [Paris] (1323) Danrigal et al 1962 [Paris] 1324) Rousselin et al [Le Havre] Italy (1325) Donna 1967 [Turin] (1326) Farina & Mazzanti 1963 [Bolgna] Czechoslovakia (1327) Fingerland & Jindrichova 1962 [Prague] Male 65, pipe fitter 27 years: squamous cell carcinoma Male 54, newspaperman: sarcoma L-Upper lo~e, cigarette smoker Male 70, pipe fitter ? years: squamous cell carcinoma L-Upper lobe [diabetes mellitus] Male 53, asbestos processor 12 years: squamous cell carcinoma R-Lower lobe Male 43, asbestos worker ii years: small cell anaplastic carcinoma R-Lower lobe [tuberculosis] Male 43, asbestos weaver and corder Ii years: small cell anaplastic carcinoma R-Lower lobe [tuberculosis] Male 52, insulator 27 years: squa- mous cell carcinoma R-Lower lobe, cigarette smoker Male 38, carder, blender, packer in asbestos factory 9 years: bronchoalveolar carcinoma both lungs Male 54, insulator 24 years: R-Lung cancer Male 61, asbestos worker 32 years: squamous cell carcinoma R-Lower lobe, ex-smoker On the basis of the above case reports as well as mortality statistics of asbestos workers reported in the 1960s, there was a consensus of opinion that asbestos workers had a higher incidence of bronchial carcinoma than the general population. Experts on occupational medicine from Great

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 390 Britain (1328-1330), Germany (1331, 1332), and the United States (1333) warned of the increasing incidence of asbestos- associated bronchial carcinoma. Hueper (1333) was critical of the limitations of epidemiologic studies in general, and of the results from an industry-sponsored Canadian study of asbestos workers in particular: "Unless proper methodologic precautions in the collection and evaluation of epidemiologic data are taken, data of the type used by Bohlig, Jacog, and M~ller contain a dilution factor which a priori may negate and defeat the purpose and validity of such studies. More serious objections must be raised against the scientific merits of the claims made in this matter by Braun and Truan, who studied asbestos miners and millers in the Province of Quebec. Accord- ing to the data published, this study was based on a survey of about 6,000 individuals employed by the asbestos industry in Quebec. There is an analysis of the degree of dust exposure and the n~mber of individuals in each of three graduated groups, but no data are offered on the duration of exposure to asbestos dust. Although there is a statement on the number of smokers and nonsmokers, the report is devoid of information on the number of asbestotics in the population group analyzed. No information is available regarding the number of long-term workers and their relative liability to lung cancer. No mention is made in the report on autopsies which have been performed on those who died during the period surveyed. This is particularly important, since Braun and Truan professed that only 9 'proved' cases of lung cancer were discovered to have occurred in the population analyzed. This is a rather surprising observation since during a somewhat longer period than that covering the survey, a histopathologic study by the pathologists of the Saranac Laboratory, under the sponsorhip of industrial management, on lungs from dead asbestos workers from Quebec revealed 34 cases of asbestos cancer of the lung.

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 391 The conclusions reached by Braun and Truan con- cerning an absence of an excessive liability to lung cancer among Quebec asbestos workers are incorrect even if proper epidemiologic procedures were applied to their data as reported. While the statement of Braun and Truan that the annual rate of deaths from lung cancer in the asbestos group for the years 1950 to 1955 is only slightly higher than the rate for the inhabitants of the Province of Quebec could be correct under these conditions, this statement represents statistical acrobatics which tend to obscure incrimi- nating evidence on hand by use of a highly biased population group as a 'normal' standard. It is a well-known fact that urban populations in all industrialized countries have a decidedly higher lung cancer death rate than that in rural regions. Since the asbestos mines are situated in rural areas of Quebec and are not located within the fume zones of Quebec and Montreal, where a high lung cancer rate prevails (Montreai rate 32.3), the lung cancer death rate of the asbestos miners, which stands at 33.8 per 100,000 has to be compared with the rates present in rural counties of the Province of Quebec. According to the data provided on this point by Braun and Traun, their conclusions is patently incorrect and grossly misleading and results in obscuring the existence of a markedly elevated lung cancer rate for members of this worker group. The causal relation between asbestosis and cancer of the lung is demonstrated by the fact that asbestosis cancer affects more often the lower lobes than the upper lobes (53.7) in contrast to the general type of lung cancer which involves more frequently the upper lobes. Associated with this etiologically significant topographic peculiarity and frequent multicentric " occurrence of asbestosis cancer are the various equally important metaplastic adenocystic precancerous and cancerous changes of the bronchial and bronchiolar epithelium which precede and accompany the development of cancer in asbestotic lungs. The coexistence of asbestosis and lung cancer has been reported from the Dnited States, Canada, England, France, Germany, Italy, Switzerland, and Finland in asbestos miners, millers, crushers, loaders, sorters, grinders, cleaners, pipe laggers, cement mixers, packers, boiler coverers, mattress fillers, weavers, spinners, and cement workers." (1333)

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 392 Some of the above comments are applicable to Selikoff's study but Hueper's specific criticisms were not published. [550] Case Reports of Bronchial Carcinoma in Asbestos Workers 1970 to 1979 During the 1970s, almost ali published studies consisted of mortality statistics [Category 300s] and health surveys of asbestos workers [Category 700s]. There were only two publications describing clinicopathological features of bronchial carcinoma in asbestos workers: Investigators/Year ICit~/State] Sex,Age, Occupation: Histologic Diagnosis and Primar~ Site United States (1334) Olsen et al 1970 Male 52, machinist ? years: [Rochester MN] alveolar cell carcihoma L-Lower lobe, cigarette smoker (1335) Fischbein et al 1976 Male 57, drywall construction (1336) Fischbein et al 1978 worker 25 years: sguamous cell [New York NY] carcinoma L-Lower lobe, cigarette smoker Asbestos/Cigarette Smoking Interaction. Although some epidemiologic studies supported the hypothesis that cigarette smoking increased the carcinogenicity of asbestos [Category 300s], there are publications that did not discuss the hypothe- tical interaction: Bignon et al (1337) in their review of dose-related carcinogenicity of asbestos in French workers; Mowe and Leow (1338) in their review of Norwegian asbestos

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 393 workers; Braude (1339) in his review of Russian asbestos workers; and Sera et al (1340) and Kang and Sera (1341) in their analyses of cancer in Japanese asbestos workers. Kannerstein and Churg (1342) compared 50 cases of lung carcinoma who were occupationally exposed to asbestos and 50 matched control cases not exposed to asbestos. There were two statistically significant differences: predominance of lower lobe localization of carcinoma for asbestos workers in contrast to upper lobe for nonasbestos workers; and more frequent severe pleural involvement in the exposed group. Although Kannerstein and Churg suggested that asbestos "markedly augments the effect of another potent carcinogen which in the human population is probably cigarette smoke", they frankly admitted that "the synergistic illucidated by our study". The smoking habits of male mechanism ha~ not been bronchial carcinoma patients admitted to a thoracic surgical center (Newcastle-upon-Tyne) were summarized by Martischnig et al (1343). Of 201 men with confirmed bronchial carcinoma, 58 gave a history of occupational exposure to asbestos, whereas only 29 out of 201 men matched for age and residential area who were admitted with other diseases gave a history of asbestos exposure. Their results are as follows:

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 394 "The men exposed to asbestos did not differ greatly from their controls in smoking history. Nevertheless, it is important to look carefully at the combined effect of the two causal factors. Table II shows that for each of the three smoking groups there were proportionately more exposed men among the patients with carcinoma than among the controls. Using the statistical methods of Woolf, we found no significant evidence that the relative risk differed between the three smoking groups. Averaged over all smoking groups, the mean relative risk was 2.35. Thus exposure to asbestos of this type more than doubled the risk of cancer. In our sample the relative risks for the three smoking groups (0-14, 15-24, and 25 or more cigarettes/day) were 1.08, 2.92 and 3.26 respec- tively. Although these figures were consistent with a constant risk from asbestos exposure (independent of smoking level), they were also consistent with some element of synergism." (1343) Hillerdal and N6u (1344) studied 273 Swedish patients diagnosed as bronchial carcinoma during a five-year period. A significantly higher proportion of metal workers- and builders was found among the patients, while agricultural workers were under-represented. The investigators concluded that smoking habits did not explain the difference. [560] Bronchial Carcinoma and Asbestosis Research Progress: 1980 to 1982 In recent years, the concurrence of in patients with cryptogenic fibrosing recognized. bronchial carcinoma alveolitis has been Turner-Warwick et al (1345) in their review of 205

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 395 British patients, reported an incidence of 12.9 cancer, which represented an excess relative compared to the general population of comparable percent lung risk of 14.1 age and sex. The investigators concluded that their "data suggest that there is an excess risk of lung cancer not wholly accounted for by age, sex or smoking habit . . . too few nonsmokers have ~een studied to obtain accurate information but the evidence as it stands suggests that there is an excess risk of cancer in males with cryptogenic fibrosing alveolitis that cannt be acconted for by cigarette smoking.alone" (1345). The above results suggest that pulmonary fibrosis alone may be the predisposing factor to carcinogenicity associated with asbestos exposure. This opinion is shared by Blaha et al (1346) and by Kuschner (1347). Additional research on fibro- genic reactions in general may offer a resolution of current arguments relating to the asbestos/cigarette smoking interaction hypothesis. [570] Malignancies of the Head and Neck in Asbestos Workers In 1973, Stell and McGill (1348) reported the results of their occupational survey of i00 male patients with carcinoma of the head and neck. Out of i00 male patients, 22 had been exposed to asbestos at work whereas only 2 in the I00 controls

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 396 (matched for age and sex exposed to asbestos. The workers were as follows: 17 cavity and hypopharynx. questioned their later with nonmalignant sites of cancer in the larynx, diseases) were in the asbestos 2 in the oral oropharynx, 2 in the nose and sinuses, and 1 in the Although other investigators (1349, 1350) the initial publication of Stell and McGill (1348), publication (1351) included additional patients with laryngeal carcinoma. Among i00 male patients, 31 had been exposed to asbestos. There was no difference in s~oking habits of the patients who were asbestos workers compared to patients who had no association with hand, other investigators of epidemiologic studies to asbestos (1352). On the other (1353-1358) interpreted the results indicate that cigarette smoking increased the risk of laryngeal carcinoma in asbestos workers. Although most case reports are cigarette smokers (1359-1364), there is one publication recounting the appearance of laryngeal carcinoma in nonsmoking asbestos workers (1365). Although there are case reports of brain tumors in asbestos workers (1366-1367), a prospective study showed that excess deaths from this form of malignancy are not statistically significant (1368).

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 397 [580] Malignancies of A~dominal Organs and the Extremities in Asbestos Workers In addition to peritoneal mesothelioma [Category 400s], the following cancers have ~een reported to occur in asbestos workers at a higher incidence than in the general population: ovarian cancer (1369); digestive tract cancer (1370-1379); lymphomas (1380-1383); leukemias (1384); testicular adeno- carcinoma (1385); liposarcoma (1386; and skin cancer (1387). [590] Asbestos/Ci@arette Smokin@ Interactions in Patients With Bronchial Carcinoma It has not been possible to asbestos/cigarette smoking synergism bronchial carcinoma with asbestosis clinical investigators agree that there is a causal relation- ship between asbestosis and bronchial carcinoma. In addition to the articles cited above, there are reviews supporting the positive link between the two diseases the reviews that discuss asbestosis that mention synergism with cigarette obtain any support for from the literature on reviewed above. Most (1389-1400). Some of and bronchial carcinoma smoking are entirely based on Selikoff's mortality statistics [Category 310].

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 398 Brand and Brand (1401-1403) have conservative attitude to the question asbestos and cigarette smoking. expressed a more of synergism between "The cocarcinogenic effect of smoking on the development of carcinoma, especially bronchogenic carcinoma and carcinoma of the larynx, in asbestosis patients has been demonstrated by epidemiological and statistical studies and by animal model experiments. The incidence of these cancers is almost ten times higher in asbestos-exposed smokers than in their non- smoking co-workers. Actually, tobacco smoking must be regarded as the decisive carcinogenic factor in persons who have experienced only minimal and brief asbestos exposure and who have not developed clinical pulmonary asbestosis. However, it would be going too far to say that tobacco smoking is fundamentally the active carcinogenic factor and that asbestos is merely a more or less cocarci~ogenic factor, for this view is contradicted by the development of mesotheliomas after asbestos exposure, which, in contrast to bronchogenic carcinoma and carcinoma of the larynx, are completely independent of and unaffected by tobacco smoking. Accordingly, there is absolutely no doubt a~out the full potential of asbestos as a carcinogen. Moreover, it should be remembered that the age at which broncho- genic carcinoma develops in asbestosis patients is several years younger than in individuals who are not exposed to asbestos. The quantity of inhaled asbestos fibers may also be meaningful in connection with smok- ing. Large quantities apparently lead to asbestosis, mesothelioma .. and bronchogenic carcinoma; small quantities do not cause clinical asbestosis, but they ~o cause mesothelioma and, in smokers, bronchogenic carcinoma and carcinoma of the larynx". (English translation of Ref. 1401).

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 399 Henderson (1404), an asbestos researcher from has commented on the significance of Churg and measurements of asbestos bodies in the lungs: Australia, Warnock's "In urban dwellers, low-level environmental exposure to asbestos is universal. Churg & Warnock detected asbestos bodies in the lungs of 96% of an urban population and commented that uncoated fibres are present in every lung (the ratio of uncoated to coated fibres has been variously reported as i0-i0000:i). There is as yet no persuasive evidence that this low level of exposure produces disease by itself. However, in a cigarette smoking population the possibility that background asbestos exposure could be a co-factor in the genesis of lung cancer merits serious consideration. In one comparison of i00 cases of lung cancer with controls matched for sex, age, smoking habits and occupation there were no differences in asbestos body counts. Nevertheless, further studies are clearly indicated, and it should be stressed that the single most important preventive health measure which can be taken in individuals already exposed to asbestos is to encourage avoidance of cigarette smoking". (1404) Enterline (1405), an epidemiologist from the University of Pittsburgh, has expressed his opinion on the importance of Selikoff's synergism hypothesis as follows: "In summary, while in a given instance we cannot attribute an individual case of disease to a particular occupational exposure, we can, based on epidemiologic observations, make a statement as to the probability that a particular occupational exposure was the cause. Moreover, we can modify this probability by taking into consideration various aspects of a specific case. To illustrate this in the case of asbestos exposure and lung cancer I've mentioned two: time since first exposure, and the

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 400 intensity of exposure, and there are others. Two factors that do not seem to effect these probabilities in the case of asbestos exposure are smoking history and the point in time about which we are talking. That is, the probability that for a given exposure a particular case of lung cancer was due to asbestos exposure is about the same for cigarette smokers as for noncigarette smokers, and is no different now that it was i0, 20 or 30 years ago". (1405) The validity acceptance carcinoma. primary and agent: of the synergism theory depends on the that each inhalant independently can cause bronchial Kotin and Falk (1406) in 1962 questioned the exclusive role of cigarette smoking as a causative "This study which is devoted to lung cancer properly points out the multiple etiologic factors probably involved and deprecates the undue emphasis placed on any single agent, such as tobacco. The increased incidence of lung cancer appears to be both real and progressive, and is probably due to a combination of both endogenous and exogenous factors. The latter group includes polluted atmosphere, tobacco smoke and viral infections, and it is to be emphasized that no one of these on the basis of current evidence, has been proved to be an exclusively major factor. This study cocerns itself primarily with air pollution, which certainly must include tobacco smoke, and many significantly interesting observations are recorded." (1496) Butch in 1982 (1407) reviewed the continuing controversy of cigarette smoking and lung cancer: "During the late 1950s Sir Ronald Fisher questioned the already popular, but in his view precipitate, causal interpretation of the association between smoking and lung cancer. His pungently expressed

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 401 views began a controversy that has smouldered and sometimes flared ever since. The most recent attack of Fisher's constitutional hypothesis was launched by Reif and in this paper I consider the validity of his criticisms. A range of evidence shows that it is not yet possible to distinguish between constitutional and causal-plus-constitutional interpretations although recent studies indicate that a pure causal hypothesis is incapable of explaining the full association as observed in Western populations. Unfortunately, errors of diagnosis and death certification still impede the rigorous testing of adequately formulated hypothesis." (1407) The controversy was discussed in a 1980 symposium entitled "Asbestos and Lung Cancer: The Clinical Question". Becklake and McDonald (1408) had the following comments: "The objective of this presentation is to outline the way in which evidence of an association between asbestos exposure and lung cancer has been accumulated over time and to answer the question of whether in the light of this evidence, the association can be considered causal. There is an analogy here to the build-up of evidence relating cigarettes to lung cancer which led the writers of the second (1971) report of the Royal College of Physicians to conclude that objections to the conclusion that cigarette smok- ing is a cause of lung cancer are without substance. However, the association between the two had been suspected on the basis of clinical observation in the early 1930s and though not mentioned in an editorial in JAMA in 1948, was again implicated by the Surgeon General in 1959, this time as the principal etiologic factor. The first Royal College Report in 1962 reviewed 216 reports but was not prepared to be more definite than to say that none of the facts contradict the conclusion that cigarette smoking is an important cause of lung cancer. Subsequently in his report of 1964, based on the review of i011 scientific papers, the Surgeon General went a step further in cautiously

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 402 suggesting cigarette smoking was causally related to lung cancer. Parenthetically, who would ~e prepared to answer the legal question "In which year, doctor, was it known that smoking causes lung cancer?" (1408) During the "Second International Symposium of Epidemiology in Occupational Health" held in 1982 at Montreal, Demopoulos (1409) summarized the need for unaccounted variables in the study of asbestos carcinogenesis: "Critical factors that contribute to the develop- ment of cancer in humans, particularly lung cancer, have not been evaluated in studies on the possible carcinogenic effects of asbestos among asbestos work- ers. As a result, some of the carcinogenic effects ascribed to asbestos may not be valid. Unaccounted variables in the carcinogenicity of asbestos in h~unans include details of the smoking history such as number of pack-years, type of cigarettes, butt length, and mouth versus 'ash tray' time, carotenoid -intake, amount and type of fat in diet, alcohol intake, and side-stream or 'bystander' smoke. These variables can influence cancer rates significantly, and they have not been included in asbestos-cancer studies, wherein asbestos alone or asbestos as a synergistic factor with cigarettes has been investigated. Smoking de- tails are of importance, and epidemiology studies from the United Kingdom , and the United States and Japan have shown that carotenoids may signficantly affect rates. Furthermore the composition of the diet can affect immune competenece since high polyunsaturated fat intake is immuno-suppresive and a combination of high dietary fat with a low fiber intake will predis- pose to cancers of the colon, rectum, and other sites. Alcohol, in combination with cigarettes, constitute the predominant risk factor for cancer of the mouth, pharynx, larynx, esophagus, and liver (aside from the lungs, urinary bladder, kidneys and pancreas accounted for by cigarette alone). Studies have shown that 'bystander' cigarette smoke poses a risk and although

Asbestos/Cigarette Interaction [500 Series] May 30, 1983 403 one of these studies has been criticized methodologic- ally, there is still sufficient reason to include this factor, particularly in considerations of the effects of 'bystander' smoke on the nonsmoking asbestos worker who is working within confined quarters together with several other workers, all of whom smoke. For the development of objective evidence for the stated carcinogenicity of asbestos in the pharnyx, larnyx, lungs, stomach, colon, kidney and other alleged sites, it is essential to control for these variables through a complete questionnaire. It may be found that the profile of many asbestos workers includes patterns of smoking and dietary habits that predispose to cancers at many sites, independently of any a~bestos exposure." (1409) It is apparent from the above citations that the syner- gism phenomenon that is based almost entirely on Selikoff's epidemiologic study is being questioned by some investigators. Another research approach is the case control study which showed a negative interaction between asbestos and- cigarette smoking for pleural malignant mesothelioma [Category 400s]. It should be noted that a similar case control study for workers exposed to chloromethyl ether showed a lack of synergism and even a protective effect of smoking among workers (1410-1413).

Asbestos/Smoking Interactions Series [500s], May 30, 1983 404 BIBLIOGRAPHY AND AUTHOR INDEX Among the 147 articles for Series 500s, a duplicate copy of 92 or 63 percent was received from (X). The cumulatve total for Series 100s to 500s is 810 out of 1413 articles, or 57 per- cent. The geographical distribution of the authors contained in the Bibliography is as follows: United States [Cate~or~ 500s| Cumulative [100s to 500s] UAR Arizona 1 3 UCA California 4 32 UCO Colorado0 3 UCT Connecticut 2 9 UDC District of Columbia 5 ii UDE Delaware1 4 UFL Florida 0 1 DHA Hawaii 0 2 UIL Illinois4 21 UIO Iowa 0 3 UKA Kansas 0 1 UKY Kentucky0 1 ULA Louisiana 0 7 UMA Massachusetts 6 31 UMD Maryland2 41 UME Maine 0 1 UMI Michigan0 12 UMN Minnesota 4 19 UMO Missouri1 5 UNC North Carolina 0 14 UNE Nebraska0 2 UNH New Hampshire 0 1 UNJ New Jersey 3 17 UNY New York14 135 UOH Ohio 1 27 UPA Pennsylvania 10 51 URI Rhode Island 0 1 USC South Carolina 3 ii UTE Tennessee 0 3 UTX Texas 1 28 UUT Utah 0 8 UVT Vermont 0 i0 UVA Virginia0 4 UWA Washington 4 13 UWI Wisconsin 0 3 UWV West Virginia 1 4 Total U.S. Articles 67 539 Percent of Total 46% 37%

Asbestos/Smoking Interactions Series [500s], May 30, 1983 405 Foreiqn [Categor~ 500s] Cumulative [100s to 500s] ARG Argentina 0 1 ATL Australia 1 16 AUS Austria2 3 BEL Belgium0 5 BUL Bulgaria 0 1 CAN Canada 8 63 CZE Czechoslovakia 1 7 DEN Denmark0 5 EGY Egypt 0 4 FIN Finland1 23 FRA France 7 98 GBR Great Britain 19 334 GER Germany20 64 IND India 0 27 ISR Israel 3 6 ITA Italy 5 35 JAP Japan 3 13 LEB Lebanon0 1 NET Netherlands 0 12 NOR Norway 1 8 POL Poland 0 10 POR Portugal 0 1 ROM Romania0 2 RUS Russia 1 15 SAF South Africa 2 58 SPA Spain 0 3 SWE Sweden 4 36 SWI Switzerland 2 7 TAI Taiwan 0 1 THA Thailand 0 1 TUR Turkey 0 i0 YUG Yugoslavia 0 4 Total Foreign Art'icles 80 874 Percent of Total 54% 69% Grand Total 147 1413 Percent of Grand Total 100% 100% [Note: Bibliography of the 500 Series starts on the next page]

Asbestos/Smoking Interactions Series [500s] May 30, 1983 406 1267 Lynch KM, Smith WA (1935) Am J Cancer 24:56-64 Pulmonary asbestosis III: silicosis. Carcinoma of lung in asbestos- 1268 Lynch KM, Smith WA (1939) Am J Cancer 36:567-573 Pulmonary asbestosis. V. A report of bronchial carcinoma and epithelial metaplasia. (X) 1269 Egbert DS, Geiger AJ (1936) Am Rev Tuberc 34:142-150 Pulmonary asbestosis and carcinoma. necropsy findings. (X) Report of a case with 1270 Gloyne SR (1935) Tubercle 17:5-10 Two cases of squamous carcinoma of the lung occurring in asbestosis. 1271 Gloyne SR (1936) Tubercle 18:199-101 A case of oat-cell carcinoma of the lung occurring in asbestosis. (X) 1272 Nordmann M (1937-38) Z Krebsforsch 47:288-302 Der Berufskrebs der Asbestarbeiter. 1273 Hornig F (1938) Z Krebsforsch 47:281-287 Clinical considerations of the question of occupational cancer in asbestos workers. 1274 Koelsch F (1938) Acta Union Int Contra Cancrum 3:243-252 Lung cancer and occupation. (German) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 407 1275 Rogers WL (1932) Arch Int Med 49:1058-1077 Primary cancer of the lung. of fifty cases. A clinical and pathologic survey 1276 Bauer JT (1938) Bull Ayer Clinic Lab Penna Hosp 3:139-188 A review of the primary carcinomas of the lungs and pleurae occurring in six thousand consecutive necropsies. 1277 Teleky L (1937) J Ind Hyg Toxicol 19:73-85 Occupational cancer of the lung. (X) 1278 Teleky L (1938) Acta Union Int Contra Cancrum 3:253-275 Occupational lung cancer. (German) (X) 1279 Biederman M (1940) Med Rec 151:419-424 Bronchiogenic carcinoma. (X) 1280 Warren S (1943) Ann Surg 117:585-595 Minimal criteria required to prove causation of traumatic or occupational neoplasms. (X) 1281 Anonymous (1949) JAMA 140:1219-1220- Asbestosis and cancer of the lung. (X) 1282 Holleb HB, Angrist A (1942) Am J Pathol 18:123-135 Bronchogenic carcinoma in association with pulmonary asbestosis. Report on two cases. (X>

Asbestos/Smoking Interactions Series [500s] May 30, 1983 408 1283 Homburger F (1943) Am J Pathol 19:797-807 The co-incidence of primary carcinoma of the lungs and pulmonary asbestosis. Analysis of literature and report of three cases. (X) 1284 Cureton RJR (1948) Br J Cancer 2:249-253 Squamous cell carcinoma occurring in asbestosis of the lung. (X) 1285 Koelsch F (1940) Zentralb Gewerbehyg 27:32-33 Lungenkrebs und Beruf. 1286 Linzbach AJ, Wedler HW (1941) Virchows Archly Path Anat Physiol Cancer in asbestos workers. 307:281-456 1287 Welz A (1942) Arch Gewerbepathol Gewerbehyg 11:536-550 Further observations of occupational cancer in asbestos workers. (German) (X) 1288 Boemke F (1947) Med Monatsschr 1:2-6 The pathology of diseases due to the inhalation of dust. (German) (X) 1289 - Desmeules R, Rousseau D, Giroux M, Sirois A (1947) Sem Hop Paris 23:1820-1823 Asbestosis and lung cancer. (French) (X) 1290 Desmeules R, Rousseau L, Giroux M, Sirois A (1941) Laval Med 6:97-108 Asbestosis and pulmonary cancers. (French) (X) 1291 Wegelin C (1942) Schweiz Med Wochenschr 72:1053-1063 Bronchial and lung cancer. (German) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 409 1292 Saita G (1948) Med Lay 39:105-116 Primary lung tumors of occupational origin. 1293 Wedler HW (1943) Dtsch Med Wochenschr 69:575-576 Asbestosis and lung cancer. (German) (X) (Italian) (X) 1294 Hueper WC (1950) Med Ann DC 19:10-16, 59-60 Environmental factors in the etiology of cancer. (X) 1295 Hueper WC, Goldman L (1950) South Med J 43:118-124 Present and potential occupational cancer hazards and carcinogenic operations in modern industry. (X) 1296 Hueper WC (1950) Acta Union Int Contra Cancrum 6:1295-1324 The role of environmental agents in the causation of human cancer. (X) 1297 Mayers MR (1950) Compens Med 3:11-17 Occupational causes of cancer. (X) 1298 Mayers MR (1952) Compens Med 31:11-18 Industrial cancer ~f the lungs. (X) 1299 Ariel IM, Avery EE, Kanter L, Head JR, Langston HT (1950) Cancer 3:229-239 Primary carcinoma of the lung. A clinical study of 1205 cases. (X) 1300 Wynder EL, Graham EA (1951) AMA Arch Ind Hyg 4:221-235 Etiologic factors in bronchogenic carcinoma with special reference to industrial exposures. Report of 857 proved cases.

Asbestos/Smoking Interactions Series [500s] May 30, 1983 410 1301 Smith WE (1952) Arch Ind Hyg Occup Med 5:242-263 Survey of some current British and European studies of occupational tumor problems. (X) 1302 Stoll R, Bass R, Angrist AA (1951) AMA Arch Int Med 88:831-834 Asbestosis associated with bronchogenic carinoma. 1303 Castleman B, Towne VW, Arnott WM, Hanelin Jet al (1952) N Engl J Med 256:867-872 Pulmonary asbestosis. Adenocarcinoma of the lung with invasion of heart and with metastases to bronchial lymph nodes and fourth lumbar vertebra. (X) 1304 Isselbacher KJ, Klaus H,Hardy HL (1953) Am J Med 15:721-732 Asbestosis and bronchogenic carcinoma. 1305 Lynch KM, Pratt-Thomas HR (1955) South Med J 48:565-569 Carcinoma of the lung in asbestosis: cases. (X) Report of two ~dditional 1306 Owen TK (1951) Br J Cancer 5:382-383 Carcinoma and asbestosis of the lung. Report of a case. (X) 1307 Bohme A (1951) Beitr Silikoseforsch ii:29-34 Results of periodical examination of workers in an asbestos factory. (German) (X) 1308 Boemke F (1953) Med Monatsschr 7:77-81 Lung carcinoma in pulmonary asbestosis. (German) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 411 1309 Guttner HG (1955) Z Aerztl Fortbild 49:388-392 Lung cancer and asbestosis. (German) (X) 1310 Werber M (1952) Zentralbl Arbeitsmed Arbeitsschutz Pulmonary asbestosis and carcinoma. 2:179-180 (German) (X) 1311 Bonme A (1959) Arch Gewerbepathol Gewerbenyg Asbestosis and lung carcinoma. 17 : 384-395 Part I. (German) (X) 1312 Chauvet M (1958) Presse Med 66:908-910 Asbestosis and bronchial cancer. A relevant case. (French) 1313 Rombola G (1955) Med Lay 46:424-250 Asbestos and pulmonary carcinoma in an asbestos spinner. on the problem of tumor indution by asbestos. (Italian) Notes (X) 1314 Desmeules R, Richard P (1955) Union Med Can 84:138-145 Bronchogenic carcinoma associated with certain pulmonary diseases. (French) (X) 1315 Anderson J, Campagna FA (1960) AMA Arch Environ Health 1:27-32 Asbestosis and carcinoma of the lung. of the literature. Case r@port and review 1316 Telischi M, Rubenstone AI (1961) Arch Pathol 72:234-243 Pulmonary asbestosis associated with primary carcinoma of the lung, bronchial adenomas, and adenocarcinoma of the stomach. (X)

Asbestos/Smoking Interactions Series |500s] May 30, 1983 412 1317 Cordova JF, Tesluk H, Knudtson KP (1962) Cancer 15:1181-1187 Asbestosis and carcinoma of the lung. 1318 An SH, Koprowska I (1962) Acta Cytol 6:3910398 Primary cytologic diagnosis of asbestosis associated with bronchogenic carcinoma. Case report and review of literature. (X) 1319 Castleman B, McNeeley BU (1964) New Engl J Med 270:1355-1362 Case records of the Massachusetts General Hospital, Case 30-1964. 1320 Dyson BC, Trentalance AE (1964) J Tnorac Cardiov Surg 47:577-589 Resection of primary pulmonary sarcoma. Review of literature and report of a case associated with pulmonary asbestosis. 1321 Dutra FR, Carney JD (1965) Arch Environ Health 10:416-423 Asbestosis and pulmonary carcinoma. 1322 Champeix J, Laguillaumie BD, Jacquemet Let al (1962) Arch Mal Prof 23:267-271 Bronchial cancer and exposure to asbestos dust. (Fzench) (X) 1323 Danrigal A, Tabbafa W, Proteau J, Derobert L (1962) Ann Med Leg 42:69-72 Asbestosis, operated pulmonary tuberculosis and cancer of the lung. (French) (X) 1323 Rousselin L, Ernoult JL, Veret J, Manouvrier F et al (1965) J Fr Med Chir Thorac 20:37-51 Bronchial cancer in asbestosis. Report of two cases. (French) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 413 1325 Donna A (1967) Med Lay 58:561-572 Discussion of another case of asbestosis associated with pulmonary neoplasia. (Italian) (X) 1326 Farina S, Mazzanti G (1963) Lay Um 15:276-281 Asbestosis and pulmonary neoplasia: clinical case. (Italian) (X) Another contribution of a 1327 Fingerland A, Jindrichova J (1962) Prac Lek 14:468-471 Pulmonary asbestosis associated with lung cancer. (Czech) (X) 1328 Anonymous (1964) Br Med J 5403:202-203 Asbestos and ~lignancy. 1329 Williams WJ (1965) Arch Environ Health 10:44-45 Asbestos and lung cancer. 1330 Roe FJC (1968) Food Cosmet Toxic 6:565-566 Asbestos as a carcinogenic hazard. 1331 Wedler HW (1943) Dtsch Med Wochenschr 69:575-576 Asbestos and lung cancers. (German) (X) 1332 Siebert K (1961) Hefte Unfallheilkd 66:302-306 Rare case of asbestosis with lung cancer. (German) (X) 1333 Hueper WC {1962) Clin Pharmacol Ther 3:776-813 Part i. Environmental and occupational cancer hazards. Symposium on chemical carcinogenesis. (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 414 1334 Olsen AM, Woolner LB, Miller WE, Clagett OT (1970) Chest 57:558-566 Alveolar cell carcinoma of the lung: a case presentation at the weekly thoracic conference at the Mayo Clinic. 1335 Fischbein A, Langer AM, Suzuki Y, Selikoff IJ (1978) Toxicol Lett 2:231-236 Carcinoma of the lung in a drywall taping worker. Report of a case. (X) 1336 Fischbein A, Langer AM, Suzuki Y, Churg J, Selikoff IJ (1976) Int Symp Detect Prey Cancer 168 Pulmonary carcinoma in a drywall taping worker: report of a case. (X) 1337 Bignon J, Sebastien P, B0nnaud G (1976) (Reprint from Bignon) Relation dose-effet cancerigene de l'amiante chez l'homme. 1338 Mowe G, Lexow P (1970) Nord Med 84:1153 Asbestosis and lung cancer. (Norwegian) (X) 1339 Braude VI (1979) Sov Med 0:43-47 Significance of etiology and the extent of activity of chronic lung diseases in the development of bronchogenic cancer. (Russian) (X) 1340 " Sera Y, Kang KY, Yoroyama K (1973) Gann 64:313-316 Asbestosis and lung cancer in Osaka Sennan district. (Japanese) (X) 1341 Kang KY, Sera Y (1973) J Korean Med Assoc 16:5:49-53 Asbestosis and lung cancer. (Japanese) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 415 1342 Kannerstein M, Churg J (1972) Cancer 30:14-21 Pathology of carcinoma of the lung associated with asbestos exposure. 1343 Martischnig KM, Newell DJ, Barnsley WC, Cowan WK et al (1977) Br Med J 1:746-749 Unsuspected exposure to asbestos and bronchogenic carcinoma. 1344 Hillerdal G, Nou E (1979) Scand J Resp Dis 60:76-82 Occupation and bronchial carcinoma. (X) ' 1345 Turner-Warwick M, Lebowitz M, Burrows B, Johnson A (1980) Thorax 35:496-499 Cryptogenic fibrosing al~eolitis and lung cancer. (X) 1346 Blaha H, Karg O, Cujnik F (1981) Munch Med Wochenschr 123:289-294 Coincidence of pulmonary fibrosis and bronchial carcinoma. (German) (X) 1347 Kuschner M (1981) Abstr Pap Am Chem Soc 181 Asbestos as a carcinogen. (X) 1348 Stell PM, McGill T (1973) Lancet 1:678 Asbestos and cancer of head and neck. 1349 Holmes S (1973) Lancet 1:839 Asbestos and cancer of head and neck. 1350 Newhouse ML, Berry G (1973) Lancet 2:615 Asbestos and laryngeal carcinoma.

Asbestos/Smoking Interactions Series [500s] May 30, 1983 416 1351 Stell PM, McGill T (1973) Lancet 2:416-417 Asbestos and laryngeal carcinoma. 1352 Stell PM, McGill T (1975) Laryngol Otol 89:513-517 Exposure to asbestos and laryngeal carcinoma. 1353 Daum SM, Seidman H, Selikoff IJ (1976) Cancerline 313-314 The occurrence of cancer of the larynx in asbestos workers and its relation to smoking habits. (X) 1354 Morgan RW, Shettigara PT (1976) Ann NY Acad Sci 271:308-310 Occupational asbestos exposure, smoking, and laryngeal carcinoma. (X) 1355 Bianchi C, Bonito LD, Castelli M, Brollo A (1978) Pathologica 70:403-408 Exposure to asbestos in cancer of the larynx. (French) 1356 Hillerdal G, Lindholm CE (1980) Orl 42:233-241 Laryngeal cancer and asbestos. (X) (X) 1357 Newhouse ML, Gregory MM, Shannon H (1980) IARC Sci Publ No. 3Q; 2:687-695 Etiology of carcinoma of the larynx. (X) 1358 Butch JD, Howe GR, Miller AS, Semenciw R (1981) JNCl 67:1219-1224 Tobacco, alcohol, asbestos, and nickel in the etiology of cancer of the larynx: a case-control study. 1359 Libshitz HI, Wershba MS, Atkinson GW, Southard ME (1974) JAMA 228:1571-1572 Asbestosis and carcinoma of the larynx. A possible association.

Asbestos/Smoking Interactions Series [500s] May 30, 1983 417 1360 Guidotti TL, Abraham JL, DeNee PB (1975) West J Med 122:75 Asbestos exposure and cancer of the larynx. 1361 Bittersohl G (1977) Z Gesamte Hyg 23:27-30 The problem of asbestos-induced laryngeal carcinoma. (X) (German) 1362 Cachin Y, Luboinski B, Schwaab G (1978) J Fr Otorhinolaryngol 27:15-17 Association of bronchopulmonary cancers and cancers of the upper respiratory and digestive tracts (43 cases). (French) (X) 1363 Hirsch A, Bignon J, Sebastien P, Gaudichet A (1979) Chest 76:697-699 Asbestos fibers in laryngeal tissues. Findings in two patients with asbestosis associated with laryngeal tumors. 1364 Hinds MW, Thomas DB, Oreilly HP (1979) Cancer 44:1114-1120 Asbestos, dental x-rays, tobacco and alcohol in the epidemiology of laryngeal cancer. (X) 1365 Freifeld S (1977) JAMA 238:1280 Asbestos exposure and laryngeal carcinoma. (X) 1366 Whitmore JT, Brannon L, Wood JH et al (1960) US Armed Forces Med J 11:203-216 Clinicopathologic conference, US Naval~Hospital, Philadelphia, Pennsylvania. 1367 Castleman B, McNeeley BU, Poskanzer DC et al (1964) N Engl J Med 270:1355-1362 Case records of the Massachusetts General Hospital, Case 30-1964. (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 418 1368 Seidman H, Selikoff IJ, Hammond EC (1982) Ann NY Acad Sci 381:160-171 Mortality of brain tumors among asbestos insulation workers in the United States and Canada. (X) 1369 Keal EE (1960) Lancet 1:1211-1216 Asbestosis and abdominal neoplasms. (X) 1370 Knox JF (1961) Lancet 1:560-561 Asbestosis and abdominal neoplasms. (X) 1371 Shugar A (1979) Natl Res Counc Can Publ .112-118 Effects of asbestos on man. Other cancers. (X) 1372 Schneiderman MA (1974) Environ Health Persp 9:307-311 Digestive system cancer among persons subjected to occupational inhalation of asbestos particles: A literature review with emphasis on dose response. 1373 Dohner VA, Beegle RG, Miller WT (1975) Am Rev Respir Dis 112:181-199 Asbestos exposure and multiple primary tumors. 1374 Chatel A, Mignon F,.Sebastien P, Hirsch A et al (1978) Gastroenterol Clin Biol 2:459-464 Gastric and esophageal investigation with detection of asbestos fibers in patients exposed to asbestos. (French) 1375 Hillerdal G (1980) J Occup Med 22:806-809 Gastrointestinal carcinoma and occurrence of pleural plaques on pulmonary x-ray. (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 419 1376 Miyao M, Kanao T, Muraoka T (1981) JPN J Chest Dis 40:170-175 A case of double cancer (lung and stomach) with asbestosis. (Japanese) (X) 1377 Ross R, Dworsky R, Nichols P, Wright Wet al (1982) Lancet 2:1118-1120 Asbestos exposure and lymphomas of the gastrointestinal tract and oral cavity. (X) 1378 Selikoff IJ, Seidman H (1981) Cancer 47 Suppl:469-473 Cancer of the pancreas among asbestos insulation workers. 1379 Goldsmith JR (1982) Am J Ind Med 3:341-348 Asbestos as a systemic carcinogen: cohorts. (X) The evidence from eleven 1380 Bengtsson NO, Hardell H, Eriksson M (1982) Lancet 2:1463 Asbestos exposure and malignant lymphoma. 1381 Maguire FW, Mills RC, Parker FP (1981) Cancer 47:791-797 Immunoblastic lymphadenopathy and asbestosis. 1382 Waxweiler RJ, Robinson C (1983) Lancet i:189-190 Asbestos and non-Hodgkin's lymphoma. 1383 Abramson JH, Pridan H, Sacks MI et al (1978) JNCI 61:307-314 A case-control study of Hodgkin's disease in Israel. 1384 Gerber MA (1970) Am J Clin Pathol 53:204-208 Asbestosis and neoplastic disorders of the hematopoietic system.

Asbestos/Smoking Interactions Series [500s] May 30, 1983 420 1385 Gisser SD, Nayak S, Kaneko M, Tchertkoff V (1977) Hum Pathol 8;219-224 Adenocarcinoma of the fete testis: a review of the literature and presentation of a case with associated asbestosis. 1386 Chung CK, Stryker JA, Zaino R, Sears HF (1982) PA Med 85:47-48 Liposarcoma after asbestos exposure. (X) 1387 Symanski HJ, Beckenkamp HW (1970) Arbeitsmed Sozialmed Arbeitshyg 36:1-162 Occupational dermatoses - occupational ~lignant tumors, expecially those caused by exposure to asbestos. (German) (X) 1388 Dagani R (1981) Chem Eng News 59:21-22 Asbestos, smoking link to cancer probed. (X) 1389 Norwood WD, Fuqua PA, Mancuso TF (1967) Northwest Med 66:821-828 Asbestos - an environmental health hazard. 1390 Cooper WC (1967) Arch Environ Health 15:285-290 Asbestos as a hazard to health. Fact and speculation. 1391 Beattle J (1968) Sr Med J 4:123-12.4 Cancer and asbestos. 1392 Pfeiffer W (1970) Aerztl Prax 22:5393 Asbestos and bronchial carcinoma. (X) 1393 Bohlig H, Dalquen P, Hain E (1972) Internist 13:318-325 Epidemioogy of asbestos-induced diseases. (German) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 421 1394 Falk HL (1976) Oncology 33:77-85 Possible mechanisms of combination effects in chemical carcinogenesis. 1395 Sluis-Cremer GK (1980) Chest 78:380-381 The relationship between asbestosis and bronchial cancer. 1396 McDonald JC (1980) Chest 78:374-376 Asbestos and lung cancer: has the case been proven? 1397 McLemore TL, Greenberg SD, Wilson RK, Buffler PA et al (1981) Tex Med 77~38-46 0pdate on asbestos-associated pulmonary disease. (X) 1398 Juntunen J, Jarvisalo J, Huuskonen M, Kivisto H, Aitio A (1982) Acta Neurol Scand 65 Suppl:228-229 Tumor markers and neurologlcal signs in asbestosis. (X) 1399 Anonymous (1968) S Afr Med J 42:325-326 Asbestos and neoplasia. 1400 Nicholson WJ (1977) Cancer 39:1792-1801 Cancer following eccupational exposure to asbestos and vinyl chloride. 1401 Brand G, Brand I (1980) Zentralbl Bakteriol 171:1-17 Investigations and review of literature relating to carcino- genesis. Report I: Cancer from asbestos, schistosomiasis and cicatrization. (German) (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 422 1402 Brand G, Brand I (1980) Zentralbl Bakteriol 171:359-387 Investigations and review of literature relating to carcino- genesis. Report II: Cancer caused by foreign bodies. (German) (X) 1403 Brand G, Brand I (1980) Zentralbl Bakteriol 172:544-573 Report III: Results of experimental foreign body-carcinogenesis in relation to asbestos, schistosomiasis and scar cancer in man. (German) (X) 1404 Henderson DW (1982) Pathology 14:239-243 Asbestos-related pleuropulmonary diseases: mesothelioma and lung cancer. (X) Asbestosis, 1405 Enterline PE (1980) Chest 78:377-379 Attributability in the face of uncertainty. 1406 Kotin P, Falk H (1962) Arizona Med 19:95-101 Host factors in relation to the action of environmental carcinogenic agents. 1407 Butch PRJ (1982) Med Hypoth 9:293-306 Cigarette smoking and lung cancer: (X) A continuing controversy. 1408 Becklake MR (1980) Chest 78:372-373 Asbestos and lung cancer: the clinicians' questions. 1409 Demopoulos HB (1983) Scand J Work Environ Health 9:59 Unaccounted variables in hypothesized asbestos carcinogenesis. (X)

Asbestos/Smoking Interactions Series [500s] May 30, 1983 423 1410 Fugueroa WG, Raszkowski R, Weiss W (1973) N Engl J Med 288:1096-1097 Lung cancer in chloromethyl ether workers. 1411 Weiss W (1980) . J Occup Med 22:527-529 The cigarette factor in lung cancer due to chloromethyl ethers. (x) 1412 Goldsmith JR (1981) J Occup Med 23:77-78 Cigarette smoking, lung cancer and CME - a clarification. (X) 1413 Weiss W (1981) J Occup Med 23:78, 80 Cigarette smoking, lung cancer and CME - a clarification. (X)

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 500 to 590 MAY 30, 1983 PAGE 423 ÷ I CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO CODE 580 1383 Abramson Id, Pridan H, Sacks MI eC al (1978) ISR 540 1318 An SH, Koprowska I (1962) UFA 540 1315 Anderson J, C~mpagna FA (1960) UCA 540 1328 Anonymous (1964) GBR 520 1281 Anonymous (1949) OIL 590 1399 Anonymous (1968) SAF 530 1299 Ariel D4, Avery EE, Kanter L, Head JR, Langston lit (1950) UIL 510 1276 Bauer JT (1938) bTA 590 1391 Beat~le J (1968) GBR 590 1408 Becklake MR (1980) CAN 580 1380 Bengtsson NO, Hardell H, Eriksson M (1982) SWE 570 1355 Bianchl C, Bonito LD, Castelli M, Brollo A (1978) ITA 520 1279 Biederman M (1940) UNY 550 1337 Bignon J, Sebastien P, Bonnaud G (1976) FRA 570 1361 8it~ersohl G (1977) GER 560 1346 Blaha H, Karg O, Cujnik F (1981) GER 520 1288 Boemke F (1947) GER 530 1308 Boemke F (1953) GER 590 1393 Bohlig H, Dalquen P, Hain E (1972) GER 530 1311 Bohme A (1959) GER 530 1307 Bohme A (1951) GER 590 1401 Brand G, Brand I (1980) - UMN 590 1402 Brand G, Brand I (1980) 590 1403 Brand G, Brand I (1980) UMN 550 1339 Braude VI (1979) RUS 570 1358 Burch JD, Howe GR, Miller AB, Semenciw R (1981) CAN 590 1407 Burch PRJ (1982) GBR 570 1362 Cachin Y, Luboinski B, Schwaab G (1978) FRA 530 1303 Castlem~n B, Towne VW, Arnott NM, Hanelin Jet al (1952) 570 1367 Cas.~leman B, McNeeley BU, Poskanzer IX: et al (1964) lIMA 540 1319 Cas~leman 8, McNeeley BU (1964) 540 1322 Champeix J, Laguillaumie BD, Jacquemet Let al (1962) FRA 580 1374 ChaPel A, Mignon F, Sebastien P, Hirsch Aet al (1978) FRA 530 1312 Chauver M (1958) SWI 580 1386 Chung CK, Stryker JA, Za£no R, Sears HF (1982) 590 1390 Cooper WC (1967) UIL 540 1317 Cordova JF, Tesluk H, Knudtson KP (1962) I~A 520 1284 Cureton RJR (1948) GBR 590 1388 Dagani R (1981) UDC 540 1323 Danrigal A, Tabbara W, Proteau J, Derobert L (1962) FRA 570 1353 Daum SM, Seidman H, Selikoff IJ (1976) UNY 590 1409 Demopoulos BB (1983) ~H¥

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 500 to 590 MAY 30, 1983 PAGE 423 + 2 CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO CODE 530 1314 520 1289 520 1290 580 1373 540 1325 540 1321 540 1320 510 1269 590 1405 590 1394 540 1326 540 1327 550 1335 550 1336 570 1365 590 1410 580 1384 58O 1385 510 1270 510 1271 580 1379 590 1412 570 1360 530 1309 590 1404 580 1375 550 1344 570 1356 570 1364 570 1363 520 1282 570 1349 520 1283 510 1273 540 1333 530 1294 530 1296 530 1295 530 1304 590 1398 550 1341 550 1342 Desmeules R, Richard P (1955) CAN Desmeules R, Rousseau D, Giroux M, Sirois A (1947) CAN Desmeules R, Rousseau L, Giroux M, Sirois A (1941) CAN Dohner VA, Beegle RG, Miller WT (1975) UWA Donna A (1967) ITA Durra FR, Carney JD (1965) UCA Dyson BC, Trentalance AE (1964) UNJ Egbert DS, Geiger AJ (1936) UCT Enterline PE (1980) UPA Falk HL (1976) UMD Farina S, Mazzanti G (1963) ITA Fingerland A, Jindrichova J (1962) CZE Fischbein A, Langer AM, Suzuki Y, Selikoff IJ (1978) UNY Fischbein A, Langer AM, Suzuki Y, Churg J, Selikoff IJ (1976) UNY Freifeld $ (1977) UNJ Fugueroa WG, Raszk~wski R, Weiss W (1973) UPA Gerber MA (1970) UNJ Gisser SD, Nayak S, Kaneko M, Tchertkoff V (1977) UPA Gloyne SR (1935) GBR Gloyne SR (1936) GBR Goldsmith JR (1982) ISR Goldsmith JR (1981) - ISR Guidotti TL, Abraham JL, DeNee PB (1975) UWV GutCner HG (1955) GER Henderson DW (1982) ATL Hillerdal G (1980) SWE Hillerdal G, Nou E (1979) SWE Hillerdal G, Lindholm CE (1980) SWE Hinds MW, Thomas DB, Orellly HP (1979) UWA Hirsch A, Bignon J, Sebastien P, Gaudichet A (1979) FRA Holleb HB, Angrist A (1942) UNY Holmes S (1973) GBR Homburger F (1943) UCT Hornlg F (1938) GER Hueper WC (1962) UDC Hueper WC (1950) UDC Hueper WC (1950) UDC Hueper WC, Goldman L (1950) UDC Isselbacher KJ, Klaus H, Hardy HL (1953) UMA Juntunen J, Jarvisalo J, Huuskonen M, Kivisto H, Aitio A (1982) FIN Kang KY, Sera Y (1973) JAP Kannerstein M, Churg J (1972) UNY

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 500 to 590 MAY 30, 1983 PAGE 423 ÷ 3 CAT. REF. AUTIIORS AND YEAR GEOGRAPRIC NO. NO CODE 580 1369 580 1370 520 1285 510 1274 590 1406 540 1347 570 1359 520 1286 510 1268 530 1305 510 1267 580 1381 550 1343 530 1297 530 1298 590 1396 590 1397 580 1376 570 1354 550 1338 570 1357 570 1350 590 1400 510 1272 590 1389 550 1334 530 1306 590 1392 540 1330 510 1275 530 1313 580 1377 540 1323 520 1292 580 1372 570 1368 580 1378 550 1340 580 1371 540 1332 590 1395 530 1301 Keal EE (1960) GBR Knox JF (1961) GBR Koelsch F (1940) GER Koelsch F (1938) GER Kotin P, Falk H (1962) UAR Kuschner M (1981) ~NY Libshitz HI, Wershba MS, AEkinson GW, Southard ME (1974) UPA Linzbach AJ, Wedler HW (lg&]) GER Lynch KM, smith WA (1939) USC Lynch KM, Pratt-Thomas HR (1955) USC Lynch ~M, Smith WA (1935) USC Maguire FW, Mills RC, Parker FP (1981) UDE Martischnig KM, Newell DJ, Barnsley WC, Cowan WK et al (1977) GBR Mayers MR (1950) UNY Mayers MR (1952) UNY McDonald JC (1980) " CAN McLemore TL, Greenberg SD, Wilson RK, Buffler PAet al (1981) UTX M£yao M, Kanao T, Muraoka T (1981) JAP Morgan RW, Shet~igara PT (1976) CAN Howe G~ Lexow P (1970) NOR Newhouse ML, Gregory MM, Shannon H (1980) GBR Newhouse ML, Berry G (1973) GBR Nicholson WJ (1977) UMA Nordmann H (1937-38) GER Norwood WD, Fuqua PA, Hancuso TF (1967) UWA Olsen AM, Woolner LB, Hiller WE, Clagett OT (1970) UMN Owen TK (1951) GBR Pfeiffer W (1970) GER Roe FJC (1968) GBR Rogers WL (1932) UCA Rombola G (1955) ITA Ross R, Dworsky R, Nichols P, Wright Wet al (1982) UCA Rousselin L, Ernoult JL, Verec J, Manouvrier F et al (1965) FRA Saita G (1948) ITA Schneiderm~n MA (1974) D'MD Seidman H, Selikoff IJ, Hammond EC (1982) UNY Selikoff U, Seidman H (1981) Sera Y, Kang KY, Yoroyama K (1973) JAP Shugar A (1979) CAN S£ebert K (1961) GER S luis-Cremer GK (1980) SAF Smith WE (1952)

CUMULATIVE AUTHOR INDEX FOR CATEGORIES 500 to 590 MAY 30, 1983 PAGE 423 ÷ 4 CAT. REF. AUTHORS AND YEAR GEOGRAPHIC NO. NO ~ODE 570 1348 Stell PH, McGill T (1973) GBR 570 1351 Stell PM, McGill T (1973) GBR 570 1352 Scell PM, McGill T (1975) GBR 530 1302 Stoll R, Bass R, Amgris~ AA (1951) UNY 580 1387 Symanskl BJ, Beckenkamp HW (1970) GER 510 1277 Teleky L (1937) AUS 510 1278 Teleky L (1938) AUS 540 1316 Telischi M, Rubens~one AI (1961) UIL 560 1345 Turner-Warwick M, Lebowitz M, Burrows B, Johnson A (1980) GBR 520 1280 Warren S (1943) • UMA 580 1382 Waxweiler RJ, Robinson C (1983) UOH 520 1293 Wedler HW (1943) GER 540 1331 We~ler I~W (1943) GER 520 1291 Wegel~n C (1942) SWI 590 1411 Weiss W (1980) UPA 590 1413 Weiss W (1981) UPA 520 1287 Welz A (1942) GER 530 1310 Werber M (1952) GER 570 1366 Whitmore JT, Brannon L, Wood JH et al (1960) UPA 540 1329 Williams WJ (1965) GBR 530 1300 Wy~der EL, Graham EA (1951) UMO