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PRIVILIGED AND CONFIDENTIAL ATTORNEY'S WORK PRODUCT February 25, 1989 ASIA ETS CONSULTANTS PROJECT I. Thailand A. Professor Malinee Wongphanich, M.D. Occupational Health Department Faculty of Public Health Mahidol University Current President, Asian Association of Occupational Health (AAOH) George Leslie (GL) met with Dr. Malinee Wongphanich (MW) on Monday, February 13 in Bangkok. According to GL, she was very gracious and helpful. She provided him with the names of certain scientists whom she recommended we see in connection with the ETS Project. Most of these individuals, however, are from countries that are not now priority markets -- i.e., Singapore, Malaysia and Indonesia. ML agreed to serve on the technical committee for the 1990 Lisbon Conference on "Indoor Air Quality and Ventilation in Warm Climates." The AAOH will be a joint sponsor of the Lisbon Conference. MW began her three-year term as President of the AAOH last November. At the expiration of her term, MW will host in Bangkok a regional conference (held once every three years) for which she asked GL to organize a session on indoor air pollution. MW informed GL of an upcoming conference in Thailand on occupational health scheduled for the last week in May. It will be attended by several Japanese and Australians. In addition, ML mentioned a joint Thai-Austrian conference this fall on air pollution and mass psychogenic effects, which may be of substantial interest to us. MW will be attending the WHO Occupational Health meeting from April 17 to 21 in Geneva. There, MW will introduce GL to the WHO Chairman for Occupational Health from Japan and the ILO Chairman for Occupational Health from Singapore. Following the Geneva WHO meeting, GL invited MW to London for a meeting of the Lisbon Conference technical committee on April 24. GL will copy me on a letter he is writing to MW confirming the above.

MW also mentioned that the Secretary of the AAOH is a deputy director of the Bangkok Metropolitan Authority. He evidently wants to do some pollution monitoring in Bangkok. They would need funding and equipment but could easily site the equipment and furnish the labor. We may want to keep this in mind for the longer term. MW is an importnat contact for us to cultivate given her regional stature and extensive network of friends in the Asian scientific community. Assisting her also secures our continued good relations with the AAOH. II. The Philippines A. The Manila Conference The conference was the 11th National Congress of the Philippine Occupational & Industrial Medical Association, Inc. (POIMA). The theme of the conference was "Industrial Peace Thru Occupational Health Care." The conference resembled more a convention than a scientific conference. It lasted for two days, during which only a very few substantive presentations were made. None of the topics were particularly rigorous, with the exception of the presentation by Fengsheng He on occupational solvents. Included in the program were discussions of medical services in small, medium and large industries, a report on a Japanese workshop by Dr. Reverente, and other various topics. GL and I spent all our time at the conference meeting with Drs. Reverente and. He. B. Dr. Beneto Reverente, Jr., M.D. WHO Occupational Health Panel Ex-President, AAOH (1.982-85) Lecturer, University of the Philippines Philippine Refining Co. (Unilever) GL and I had a very productive meeting with Dr. Reverente. He already is on the technical committee for the Lisbon Conference. We discussed the ETS Project with him, initially with an eye toward identifying others who might be interested in the project. It became apparent in the course of the conversation that Dr. Reverente himself was interested in working with us. We discussed the issue of ETS and health and gave him a literature packet. Neither GL nor I has any serious doubt that Dr. Reverente ultimately will join us. He will not be able to review the packet for two weeks and then will require a week or two to review it

at his leisure. We informed him that we will pay his normal consulting rate for the approximately two days that we suggested will be necessary to digest the material fully. Dr. Reverente will bill GL for his time. When asked about others in the Philippines who might be appropriate consultants, Dr. Reverente offered the name of a friend, Professor Lina Somera of the College of Public Health at the University of the Philippines. We were unable to meet with her. However, Dr. Reverente seemed to have little doubt that she would join us. He asked GL and me for --,an extra copy of the literature packet to deliver to her and he agreed to inform her t e nature of the project. Both GL and I will follow up with letters. Dr. Reverente is our most senior consultant to date. He is clinically qualified and, more importantly, has more connections throughout Asia and the rest of the world than anyone else we saw. His English is, not surprisingly, excellent and he has a serious though warm personality. Excepting the fact that he is from the Philippines -- and not, for example, Japan -- Dr. Reverente has all the earmarks of a team leader for Asia. C. Professor Fengsheng He Director, Institute of Occupational Medicine Chinese Academy of Preventive Medicine Beijing ARIA paid for Dr. He to attend the Manila Conference. She does not know, however, the ultimate source of these funds. Our discussions with Dr. He were limited to the Lisbon Conference. We did not attempt to recruit her for the ETS Project. According to GL, she is the most eminent toxicologist in China and her published work is recognized internationally. Dr. He is likely to become the next President of the AAOH. Her current research focuses on volatile vapors and is funded at least in part by the petrochemical industry. GL asked Dr. He to serve on the technical committee for the Lisbon Conference. She agreed to do so. She is coming to England for the 5th World Congress on Toxicology to be held in Brighton in July, at which she will receive an award and present a paper. She will stay on in London after the conference to discuss the Lisbon meeting. We will have to handle Dr. He carefully. For the mid to long term, she is both an important avenue into the scientific community in China and a key link to the AAOH over the next 5 years.

D. Dr. Marilyn Go Pediatrician Manila GL and I met Dr. Go s.erendipitously. She is the wife of Dr. William Go, a surgeon at Valenzuela Hospital at which GL has a contact. He brought his wife along out of the belief that this project involved research in which she might be interested. As a young surgeon, Dr. William Go is quite busy and cannot spare any time for consulting. Hoping not to disappoint us, he kindly offered the services of his wife. We were not able to find out a great deal about her, other than that she is a medically qualified pediatrician with an interest in research. We gave her a copy of the ETS packet and asked her to review it. GL and I will follow up with letters. Dr. Marilyn Go may be useful to us as a way to break into the pediatrics community in Asia. She is quite young and would not carry much weight herself. Although it appears that we already have two high caliber consultants in the Philippines, we perhaps should encourage her to attend a pediatrics conference on our behalf and make some contacts. III. Korea A. Dr. Jung Koo Roh Director, Toxicology Research Center KRICT Deajeon According to GL, Dr. Roh founded toxicology in Korea. He runs a team of approximately 40 scientists at the only contract toxicology center in Asia outside of Japan. He is fairly young for this role. GL worked with Dr. Roh as a U.N. sponsored scientist on loan to KRICT two years ago. As a result, GL knows a number of the scientists at the toxicology center in addition to Dr. Roh. Although GL has said that Dr. Roh can be enigmatic at times, our meeting with him went extremely well. As with Dr. Reverente, Dr. Roh expressed a personal interest in working with us, as well as a willingness to open other Korean doors for us. We gave him a copy of the ETS packet after discussing the issue in general. He will of course review it but this should be no more than a formality. At this stage, Dr. Roh is on the team. He also has agreed to accompany us to meet with other Korean scientists on our next trip, which should be invaluable. According to GL, Dr. Roh knows all the major players in the medical-scientific community in Korea. Dr. Roh will be attending the Toxicology Congress in Brighton in July.

Both GL and I will follow up with letters. B. Dr. Kuy San Cho Dean of Catholic University Medical School Seoul Dr. Cho was Vice-President of the AAOH during Dr. Reverente's term. MW also mentioned Cho's name to GL. Despite these personal introductions, Dr. Cho was a reluctant conversationalist. GL tried to get him to join the technical committee for the Lisbon Conference but Dr. Cho was unenthused. He first questioned the value of a conference devoted to indoor as opposed to outdoor air pollution. Without directly declining the offer, he merely said he would look for an alternative participant from the medical school. GL raised the issue of ETS but was met with little more than a blank stare. Consequently, we did not press the issue. We left on extremely cordial terms with Dr. Cho (he insisted on paying for lunch) but did not get to first base with him. GL will correspond with him concerning the Lisbon Conference but he is out of the question as an ETS consultant. Given that Dr. Roh should pave our way next time, this should not present a problem. IV. Hong Kong A. Dr. Alun McIntyre Director, Consultants in Environmental Sciences (Asia) Ltd. (CES) We received Dr. Mclntyre's name from Professor Roger Perry, with whom McIntyre studied at Imperial College. Since last June, Dr. McIntyre has directed a consulting firm consisting of four environmental scientists assisted by about 20 engineers. CES is connected with Balfours International (Asia). Dr. McIntyre was quite friendly and responsive. We discussed the ETS Project and in particular our desire to recruit a number of consultants from different disciplines. He is an expert on most kinds of pollution and has a special interest in air pollution. After discussing the sources of air pollution in Hong Kong and some of his upcoming projects, I invited him to attend the ACVA Conference in Hong Kong tentatively scheduled for April 14. He agreed to do so.

Dr. McIntyre can be useful in our efforts to place ETS in the larger context of indoor air pollution. As he agreed, much of the indoor pollution in places like Hong Kong comes from outside sources, notably from vehicle and industrial emissions. He is well-spoken and may be able to play an active role in the debate in Hong Kong. Because he is not a health scientist °, we did not give Dr. McIntyre the ETS packet. He showed us the proceedings from the December Polmet 88 Conference on pollution in the urban environment. We copied the relevant section on air pollution from the table of contents. We have his CV and a list of publications. Dr. McIntyre's normal daily consulting fee is HK$800. We should plan to compensate him for attending the ACVA Converence, although I do not believe he expects to be compensated. This should get our relationship off on a good footing. B. Dr. Sarah Liao EHS Consultants Ltd. Dr. McIntyre gave us the name of Dr. Liao, whom he engages for some of his projects. She has a Ph.D. in occupational health from the Department of Community Medicine at the University of Hong Kong, where she continues to lecture. She is also a close personal friend of Linda Koo. Dr. Liao started her consulting firm last year and has a staff of 5. GL and I had an extremely positive meeting with her. Her current specialty is asbestos. Interestingly, she is married to the Postmaster General in Hong Kong and is presumably well-connected politically. Dr. Liao has undertaken some office safety audits for BAT in the past. She has declined offers to consult on smoking ahd health, however, more for pragmatic than philosophical reasons. Dr. Liao does work for both private industry and government in Hong Kong and wants to retain that balance. She appears to have great integrity and objectivity as a scientist and criticizes the health lobby for its inquisitorial tactics and scientific bias. Judith Mackay is not objective and not credible, according to Dr. Liao. She also stated that T.H. Lam, who co-authored the COSH survey with Stuart Donnan^is a "jerk." ~ Dr. Liao expressed the view that ETS may be a "contributing factor" in lung cancer. She is willing, however, to examine the issue on its merits. Given her specialty and her practical aversion to tobacco-funded work, however, it is unlikely that she can act as a consultant. At the same time, I would not write her off completely. At the very least, she can and has agreed to screen potential candidates. In the virulently anti-smoking atmosphere

prevailing here, this is critical if we are to avoid compromising the project. Dr. Liao advised that in order to recruit high-level scientists, the funding must come from industries in addition to tobacco. Dr. Liao has heard of ACVA and accepted our invitation to attend the ACVA Conference. Her rate is the same as Dr. Mclntyre's, HK$800 per day. Both GL and I will follow up with letters. It will be interesting to hear her views on ETS after she has read the packet. C. Dr. Linda C. Koo Department of Community Medicine University of Hong Kong GL and I met with Dr. Koo for over three hours. She has an extremely attractive and sparkling personality and is utterly Americanized. Dr. Koo spent 17 years in U.S. schools, including Berkeley, where she received her Ph.D. GL asked Dr. Koo to serve on the technical committee for the Lisbon Conference and to give a paper, both of which she agreed to do. Her current research focuses on oxides of nitrogen and respiratory disease. In the course of our conversation, we talked about quite a few things. On the subject of lung cancer in Chinese women, Dr. Koo believes it is principally caused by dietary factors. Interestingly, Dr. Koo is finding that light smokers have a lower risk of lung cancer than never-smokers. GL confirmed that this result also has been found by Richard Doll. The only consistent results Dr. Koo has seen with respect to ETS is an increased risk of infection in young children. The illnesses that have been attributed to ETS are, in her view, caused by cross-infection. Dr. Koo talked of the "victimization" practiced by the health lobby. In this environment, no one wants to stick their neck out, and no scientist will accept money from the tobacco industry. For these reasons, she does not believe that an objective and positive debate on ETS is possible in Hong Kong. Dr. Koo informed us that Judith Mackay is now calling passive smoking "respiratory rape." What scientist wants to aid and abet rape?

GL and I assured Dr. Koo that we did not wish to estrange her further from the anti-smoking lobby. We did ask her if she would be willing to talk to our consultants about the epidemiology of ETS. They would benefit enormously from her expertise. She indicated a willingness to help us in a private capacity. We can follow this up later and allow her an opportunity to back down if she likes. According to Dr. Liao, Dr. Koo has tenure. In the context of discussing sexual discrimination in the department, Dr. Koo noted that women like herself have not been promoted. GL is planning to arrange a dinner between Drs. Koo, Liao and Francis Roe in April during the ACVA Conference. Dr. Koo gave us the name of a consultant whom we may wish to contact. Of course, we would not use her name. Dr. S.Y. So Rm. 603, Melbourne Plaza 33 Queen's Road Central Hong Kong Tel: 5-8453838