Motion-Secondary: HAROLD KOEPKE et al VS. FORD MOTOR COMPANY et al

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Joseph Satterley, Esq, (C.S.B. # 286890) ELECTRONICALLY
Ted W. Pelletier, Esq. (C.S.B. # 172938)

Julianna Rivera, Esq. (C.S.B. # 290955) FILED
JRivera@kazanlaw.com Superior Court of California,
KAZAN, McCLAIN, SATTERLEY & GREENWOOD County of San Francisco

A Professional Law Corporation JUN 04 2014
Jack London Market Clerk of the Court

55 Harrison Street, Suite 400 BY: VANESSA WU
Oakland, California 94607 Deputy Clerk

Telephone: (510) 302-1000
Facsimile: (510) 835-4913

Attorneys for Plaintiffs
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN FRANCISCO

HAROLD KOEPKE and NANCY KARIDIS- Case No. CGC13276217
KOEPKE,
Assigned For AH Purposes To:
Plaintiffs, Hon. Teri L. Jackson, Dept. 503

vs. DECLARATION OF DR. DAVID
EGILMAN, M.D., M.P.H., IN SUPPORT
OF PLAINTIFES’ OPPOSITION TO
DEFENDANTS’ MOTIONS FOR

FORD MOTOR COMPANY, et al.,

Defendants. SUMMARY
JUDGMENT/ADIUDICATION
Action Filed: December 3, 2013

I, David Egilman, declare as follows:

1. 1am an adult over the age of 18 years and am not a party fo this lawsuit. [ have
personal knowledge of the facts set forth in this declaration, except for such facts that have been
made known to me in forming an opinion, in which case each such fact is of a type on which
professionals in my field reasonably rely in forming such opinions. The facts stated in this
declaration that are within my personal knowledge are true. If asked, ] could and would testify
competently to the truth of each fact and opinion asserted within this declaration, as well as to the

foundation for each such fact and opinion.

1312022.1Kazan, McClain, Satterley & Greenwood

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Jack London Mazket

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Background and Qualifications

2. I am a medical doctor and Clinical Professor of Family Medicine at Brown
University. I am board certified in Internal Medicine and Preventive-Cccupational Medicine. My
curriculum vita sets forth more fully my qualifications, a true and correct copy of which is
attached as Exhibit 1 hereto and incorporated fully herein by reference

3. I received a Bachelor of Science from Brown University in Molecular Biology in
1974. [received a medical degree from Brown University in 1978. 1 completed a three-year
medical residency in Internal Medicine at Strong Memorial Hospital in Rochester, New York, in
1981. [completed a three-year training program in epidemiology, called the National Institutes of
Health Epidemiology Training Program, in 1984, As part of this program, I completed a Master's
in Public Health at the Harvard School of Public Health. At Harvard, I studied epidemiology,
statistics and occupational medicine, industrial hygiene, warnings and occupational and
environmental law. I completed a third residency in preventive medicine in 1994.

4. I served two years at the National Institute for Occupational Safety & Health
(NIOSH), designing and conducting small and large epidemiologic studies. I was responsible for
interpreting and implementing aspects of the OSHA act of 1971.

5. Since 1978, | have published a variety of letters and medical articles on the issues
that relate to the manner in which cause-effect determinations are made in medicine (the
epistemology of medicine). I have discussed the nermal, accepted process of causal determination
in medicine in several peer-reviewed articles. In addition, these ideas were accepted for
presentation and were presented at the American Public Health Association meetings in 1984, I
have also studied, taught, and published articles on the history of medical ethics and the duty to
warn. I have taught and done research on the history of the development of medical and corporate
ethics during the 20th century. I have on two occasions, testified before congressional committees
on the issue of medical ethics and corporate responsibility. My testimony concerned the history of
informed consent. In addition, I have published two papers on the topic of the history of the

development of medical ethics.Kazan, McClain, Satterley & Greenwood

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6. For the past twenty-six years, | have taught various courses at Brown University,
including one called the Development of Medical and Scientific Knowledge in the 20th Century.
This course deals specifically with the issues outlined in this report: the history of the development
of knowledge of the health effects of asbestos including corporate knowledge, the history of the
development of government regulations on occupational and environmental safety, and the history
of the development of product warnings. My views on medical epistemology have been cited by
the Massachusetts Supreme Court and been adopted by the Wyoming Supreme Court. I have also
published on these topics. 1 served as guest faculty, at the Appellate Judges Seminar Series, on
issues related to medical epistemology and the Daubert decision. I have testified on the issues
discussed in this report in over one hundred cases over the past 16 years. 1 have also testified
twice before Congressional subcommittees.

7. My qualifications and opinions are also based in part on my clinical experience and
awareness of the ways that normal physicians in normal medical practice make decisions about
causal relationships that affect patients’ lives every day. Much of my time is devoted to direct
patient care and consulting for corporations. J served as an expert on state of the art issues at the
request of both injured workers and companies.

8. In the course of doing research, publishing peer reviewed papers, my corporate
consulting in occupational and environmental health and teaching courses, I base my opinions on
the following sources of information:

a. Review of medical literature
i. Medical journal articles
ii. Medical meetings
iii. Medical textbooks
iv. In order to review medical literature, I conducted computer searches
of several different databases including:
a) Index Medicus
(2) NIOSHtic
(3) EPAKazan, McClain, Satterley & Greenwood

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(4) Cancer Lit
6) MedLine
v. In addition, my staff or 1] reviewed each issus of Index Medicus from
1910 through 1966. (Index Medicus was computerized from 1964 forward and was reviewed by
computer following this.)
b. Review of corporate documents
i, Thave reviewed corporate documents from several asbestos
corporations and their insurers. Most of these documents were exhibits in toxic tort litigation and
were supplied as part of the discovery process. In addition, | have visited several corporate
document repositories to review corporate documents that are available as part of the discovery
process, including memoranda.
ii. Company meetings and correspondence

iii. Internal company medical studies

iv. Information from workers’ compensation insurance companies
v. Workers Compensation Claims
vi. Warnings labels and warnings policies
C Visits and reviews of libraries
i. General publications
ii. Trade publications
iii. Public libraries’ general information
iv. Special research collections in libraries
Vv. Organizational and Association Minutes and Documents

()} ACGIH (American Conference of Governmental industrial
Hygienists}

(2) Manufacturing Chemists Association (MCA or CMA)

(3) American Petroleum Institute (APD

(4) ~~ Railroads

(5) AEC and DOE Health & Safety PoliciesKazan, McClain, Satterley & Greenwood

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(6) THF (Industrial Hygiene Foundation)

(7) National Safety Council (NSC)

(8) Asbestos Textile Institute (ATD

(9) Friction Materials Standards Institute (FMSD

(10) Quebec Asbestos Mining Association (QAMA)

(11) Thermal Insulation Manufacturers Association (TIMA,
MIMA or NIMA}

(12) Gypsum Products Association

vi. Special libraries and collections
() Vorwald Archives
(2) Saranac Lake Laboratories
(3) Drinker Collection at the Harvard School of Public Health
(4) Mellon Institute Documents
d. Interviews or deposition reviews of historical figures.
i, Corporate personnel
ii. Product users
iii. Kenneth Smith
iv. Gerrit Schepers
v. Harriet Hardy
vi. Clark Cooper
vii. Mort Com
viii. Bill Burgess
ix. E. Lynn Schall
x. Thomas Mancuso
xi, Industrial Hygiene Personnel
e Interviews and/or medica! examinations of workers

fi Lhave been qualified in state and federal court to testify about:

Development and implementation of occupational exposure limitsKazan, McClain, Satterley & Greenwood

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Jack London Market

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ii. History of industrial hygienic practices

iii. Occupational health and safety standards throughout the century

iv, Warnings

v. Comparison between differing corporate approaches to health and
safety problems and public health standards relating to these
problems

vi. Epidemiology generally and the significance and proper
interpretation of epidemiologic studies

vii. General causation of asbestos diseases

viii. Specific causation of asbestos diseases

9. T have studied the medical literature pertaining te occupational and non-
occupational asbestos exposure and all of the disease inherent to such exposure including pleural
abnormalities, asbestosis, lung cancer, gastro-intestinal cancer and mesothelioma. I have also
reviewed articles relating to the evolution of medical knowledge of asbestos-related conditions.

10. [have reached the conclusions stated below to a reasonable degree of medical
probability based on my review of the medical and scientific literature and based on my years of
training and clinical experience.

11. Thave performed an evaluation of asbestos brake manufacturing at the GM Inland
division, Dayton Ohio.

12. have served as a consultant to several brake manufacturing companies.

13. I will rely on the information in the articles and publications I have authored, which
are listed in my most current Curriculum Vitae, a true and correct copy of which is attached hereto
as Exhibit 1, and incorporated fully by reference herein, as well as the articles cited in those
articles and publications to the extent they inform my opinions as set forth below.

Asbestos State of the Art
14. As more fully set forth below, I have formed the following conclusions based on

my studies and research.vv
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15. Health hazards from asbestos exposure were identified in the 1890s. During this
time, the Lady Inspectors of Factories in Great Britain noted that individuals working with
asbestos were suffering various lung injuries. {See “Annual Report of the Chief Inspector of
Factors and Workshops for the Year 1898,” London, HM Stationery Ofc., 1899; “Annual Report
of the Chief Inspector of Factors and Workshops for the Year 1899," London, HM Stationery
Ofe., 1900.]

16. As early as the 1920s, the term “asbestosis” was used to describe pulmonary
fibrosis caused by asbestos exposure. Asbestos was recognized as a disabling and potentially fatal
disease. Case reports in Great Britain and the United States detailed asbestos in various workers.
[See, e.g., Cooke, W.E., Fibrosis of the Lungs Due to the inhalation af Asbestos Dust (huly 26,
1924) 2 British Medical J. 147; Pancoast, H.K., et al., A Review of Our Present Knowledge of
Pneumoconiosis, Based Upon Roentgenologic Studies, with Notes on the Pathology of the
Condition (Nov. 1925) 14 Am. J. of Roentgenology and Radium Therapy 381-423; Cooke, W.E.,
Pulmonary Asbestosis (Dec. 23, 1927) 2 British Medical J. 1024-1027; Oliver, T., Clinical Aspects
of Pulmonary Asbestosis (Dec. 3, 1927) 2 British Medical J. 1026-1027; Pulmonary Asbestosis
(1927) 89 JAMA 2285; Pulmonary Asbestosis (1928) 90 JAMA 119-120; Willams, C.L., “Report
of the Medical Officer of Health for the Year 1929,” England, Barking Town Urban District
Council, 1930.]

17. By the 1940s, it became known and recognized that asbestos exposure could
cause pulmonary cancers.

a In the late 1930s, case reports were published addressing the relationship
between asbestos and cancer. [See, e.g., Gloyne, S.R., The Morbid Anatomy and Histology of
Asbestosis (August 1933) 14 Tubercle 550-558; Lynch, K.M., et al., Pulmonary Asbestosis II:
Carcinoma of the Lung in Asbestosis-Silicosis (1935) 24 American J. Cancer 56-64; Nordmann,
M., Der Berufkrebs der Asbestarbeiter (1938) 47 Z. Krebsforsch 288-302; Homing, F., Clinical
Considerations on the Question of Industrial Cancer of Asbestos Workers (1938) 47 Z.

Krebsforsch 281-287; Vorwald, A.J., et al., Paeumoconiosis and Pulmonary Carcinoma (1938) 14Kazan, McClain, Satterley & Greenwood

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American J. of Pathology 49-57; Lynch, K.M., et al., Pulmonary Ashestosis ¥: A Report of
Bronchial Carcinoma and Epithelial Metaplasia (1939) 36 American J. of Cancer 567-574.]

b. In the 1940s, asbestos carcinogenicity was noted in reviews in fields of
industrial medicine, cancer research and pneumoconiosis. [See, e.g., Hueper, W.C., Occupational
Tumors and Allied Diseases (1942); Holleb, H.B., et al., Bronchiogenic Carcinoma in Association
with Pulmonary Asbestosis (1942) 18 American J. Pathology 123-132; Hueper, W.E., Cancer in
its Relation to Occupation and Environment (Jan. 1943) 25 Bulletin of the American Society for
the Control of Cancer, Inc. 63-69; Homburger, F., The Coincidence of Primary Carcinoma of the
Lungs and Pulmonary Asbestosis (1943) 19 American J. of Pathology 797-807, Tabershaw, LR.,
et al., Industrial Hygiene in 1944 (1944) 231 New England J. Medicine 706-716; Hueper, W.C.,
Industrial Management and Occupational Cancer (1946) 131 JAMA 738-741; Hueper, W.C.,
Significance of Industrial Cancer in the Problem of Cancer (1946) 2 Occupational Medicine 190-
200; Kennaway, E.L., et al., A Further Study of the Incidence of Cancer of the Lung and Larynx
(1947) 1 British J. Cancer 260-298; Doig, E.T., Other Lung Diseases Due to Dust (1949) 25
Postgraduate Medical J. 639-649.]

18. During the 1950s, mesothelioma was recognized as a separate cancer that could be
caused by asbestos exposure. [See ¢.g., Weiss, A., Pleural Cancer in Patients with Pulmonary
Asbestosis Morphologically Confirmed In Vivo (1953) 3 Medizinsche 93-94; Bonser, G., et al.,
Occupational Cancer of the Urinary Bladder in Dyestuffs Operatives and of the Lung in Asbestos
Textile Workers and Iron-Ore Miners (Feb. 1955) 25 American J. of Clinical Pathology 126-134;
Braun, D. et al., 47 Epidemiological Study of Lung Cancer in Asbestos Miners (June 1958) 17
AMA Archives of Industrial Health 634-652; Eisenstadt, H.B., et al., Primary Malignant
Mesothelioma of the Pleura (Nov. 1960) 80 Journal-Lancet 511-514; Wagner, L.C., et al., Diffuse
Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province (1960) 17
British J. Industrial Medicine 260-271; Selikoff, 1.J., et al., Asbestos Exposure and Neoplasia
(April 6, 1964) 188 JAMA 22-26.]

19. In addition, during the 1940s and 1950s, it was recognized that individuals who

worked with asbestos materials, as well as those who did not work directly with asbestos productsKazan, McClain, Sattetley & Greenwood

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but only had relatively brief or intermittent exposures to asbestos products, could develop fatal
asbestos diseases. [See e.g., Merewether, E.R.A., et al., “Report on Effects of Asbestos Dust on
the Lungs and Dust Suppression in the Asbestos Industry” (1930} Londen, HM Stationery Ofc.;
Ellman, P., Pulmonary Asbestosis: Its Clinical, Radiological, and Pathological Features, and
Associated Risk of Tuberculous Infection (July 1933) 15 J. of Industrial Hygiene 165-183, Wood,
W.B., et al., Pulmonary Asbestosis: A Review of One Hundred Cases (Dec. 22, 1934) 2 Journal-
Lancet 1383-1385; Dorland, W.AN., et al., The American IHustrated Medical Dictionary (17th
Ed., 1937); Holleb, H.B., et al., Bronchiogenic Carcinoma in Association with Pulmonary
Asbestosis (1942) 18 American J. of Pathology 123-131; Kennaway, E.L., et al., 4 Further Study
of Cancer of the Lung and Larynx (1947) 1 British J. of Cancer 260-298; Sander, O.A., Asbestosis
as Differentiated from Other Pneumoconioses (1955) 11 AMA Archives of Industrial Health 208-
211; Stoll, R., et al., Asbestosis Associated With Bronchogenic Carcinoma (1951) 88 AMA
Archives of Internal Medicine 831-834; Eisenstadt, H.B., et al, Primary Malignant Mesothelioma
of the Pleura (Nov. 1960) 80 Journal-Lancet 511-514.]

20. In the United States, companies first developed and sold woven asbestos friction
materials around the turn of the twentieth century. In the carly 1920s companies began to
manufacture and promote molded brake linings and by 1940, virtually every automobile was
equipped with them. A decade later, companies began to switch to disc (metallic/non-asbestos)
brakes, and by 1975 virtually all newly manufactured U.S. cars contained front disc brakes.
However, drums continued to be used on rear brakes. Manufacturers used chrysotile asbestos for
brake linings almost exclusively because amphibole asbestos tended to score the brake drums,
decreasing their useful life. Asbestos constituted 30 to 70 percent of the brake linings. Virtually
all brake linings sold in the US on drums contained asbestos until the mid-1980s.

21. It was well established in the literature of the 1940s, 1950s, and 1960s that workers
manufacturing, grinding, and repairing automotive brakes were at risk of developing asbestos

disease. The following tables summarize the key points from a selection of these articles:Kazan, McClain, Satterley & Greenwood

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BRAKE LINING MANUFACTURE

Date itati Findings

1930 | REPORT ON (a) Brake and Clutch Linings.
EFFECTS OF Before impregnated, the dry asbestos cloth, known as “grey,”
ASBESTOS may be calendered at squaring rolls and in all cases the coils are
DUST ON THE __ | eased out to separate them a little, so ensuring thorough treatment
LUNGS and by the liquid. A little dust is produced in these operations but
DUST insufficient to render special precautionary measures necessary.
SUPPRESSION __ | Other preparatory work on “grey” arises in the making of special
IN THE linings. Lengths of cloth are lightly hammered to ring shape, in
ASBESTOS templates, then cut with chisel or shears and the radial edges sewn
INDUSTRY

together at a wire-stitching machine, as used in book-binding.
Dust occurs in hammering and stitching. A canepied bench fitted
with localized exhaust arrangements might be provided and the
machine placed under exhaust draught.

Dry impregnated material is shaped and finished mainly by
power-driven machines, e.g. knives, circular and guillotine,
cutting presses, hydraulic squeezing presses and band saws.
Cutting and sawing expose ends of wire and leave rough edges;
trimming and smoothing, done on grinding wheels and finishers,
are necessary to obtain exact size and finish. All the operations,
except squeezing, produce waste, and dust is created in some. The
dust is heavy and sticky and less likely to fly about than dry
asbestos dust. The amount is considerable at sawing and grinding
machines and localized exhaust draught, to remove it, has been
applied—in some cases with much success—and is always
necessary.

Inverted hoods are fitted at band saws, just below the tables,
the dust being drawn through the small opening in the table
guides. A powerful draught is essential.

Grinding and finishing wheels include, in addition to ordinary
single-disc machines, two-disc and vertical spindle segmental
grinders, used for flat linings. The hoods by which the draught is
applied fo all these types are similar to those applied to the same
machines when used for metal grinding. The position is similar as
regards finishers, a hood being fitted in line with and at the back of
the band. A baffle plate to prevent dust being carried past the hood
by the high linear speed of the band is a necessary addition.

Special linings and anti-friction bushes are molded from
disintegrated impregnated waste. Some dust is created in the filling
of molds and efficient localized exhaust draught may be necessary.
The articles are shaped and finished as just described. Bushes are
turned and bored in lathes, with production of waste and dust, but
exhaust draught is not at present applied though possibly necessary.

10Kazan, McClain, Satterley & Greenwood

A Professional Law Corporation
+ 55 Harrison Street, Suite 400 + Oakland, California 94607

Jack London Market

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» Fax: (510) 835-4913,

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Ce NW

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1935

ndings

High prevalence of asbestosis among workers with “more than 3

Lanza,
McConnell, years of employment in the industry” at five plants including one
Fehbnel. “Effects of | where molded brake band and clutch friction materials were
inhalation of manufactured.
asbestos dust on
the lungs of
asbestos workers”
Publ. Health, Rep.
50:1-12

1935 Fulton, et al. Report of 25 percent prevalence of asbestosis among selected
Asbestosis. workers at four asbestos fabricating plants, including three where
Harrisburg, Penn.: | brake linings were manufactured.
Dept of Labor and
Industry,
Commonwealth of
Penn.

1939 | George, A.W., Documents asbestosis in brake lining manufacturing workers since
R.D Leonard. “An | 1928, with compensation. Explains that the asbestosis cases seen by
X-ray study of the | Hawes (New Engl. J. Med. 216:162-165, 1937) were brake lining
lungs of workmen | manufacturing workers. Discusses switch from dry to wet methods
in the asbestos of processing.
industry covering
a period of ten
years” Radiology
33:196-209

1940 Stone, M.J. Asbestosis in 148 brake-lining manufacturing workers seen by Drs.
“Clinical Studies | Stone and Hawes.
in asbestosis”
Amer. Rev.
Tuberc, 41: 12-21

1940 | Stone, MJ. Asbestosis in 148 brake-lining manufacturing workers seen by Drs.
“Studies in Stone and Hawes.

asbestosis.” Dis.
Chest. 6: 170-171

GRINDING AND DRILLING BRAKE LININGS — EARLY PAPERS

itation

Osborn. Forty-
Ninth Report of the
State Department
of Health, State of
Conn, Public
Document No. 25,
Hartford, CT. pp.
507-514

indin .
Describes the grinding of molded asbestos brake and clutch
parts under varying degrees of local exhaust ventilation. Total
dust counts ranged from 0.6 to 17 MPPCF. The need for dust
sampling and analysis to evaluate these exposures was stressed,
as the visual appearance of the worst grinding exposure was
unremarkable.

1935

Memorandum on
the Industrial
Diseases of
Silicosis and
Asbestosis.
London: H.M.
Stationery Ofc

Lists under “Industries and Processes in which asbestosis
occurs...the sawing, grinding, and turning in the dry state of
articles composed wholly or partly of asbestos such as motor car
brake and clutch linings...”

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Date

Citation

dings. 8

Use and servicing of brake products produced exposures greatly

1939 | Case, L.B. “Air
Hygiene Studies.” | exceeding permissible Hmits.

General Motors

1940 | Brachmann, Clinical and X-ray examination showed asbestosis in nearly all
“Asbestosis in workers employed 5 years or more as grinders and drillers of
grinders and brake linings.
drillers of brake
bands”

Arbeitsschutz 172-
174

1941 | Brachmann. Clinical and X-ray examination showed asbestosis in nearly ail
Abstract in workers employed 5 years or more as grinders and drillers of
“Abstracts” brake linings.
supplement to J.

Indust. Hyg. Tox.
23:76-77.

Feb. | Castrop, V.J.“Fume | By General Motors industrial hygienist. Section on asbestos noted

1948 | and dust exposure” | that brake lining grinding and “surfacing” operations were
Nat. Safety News. | equipped with local exhaust ventilation Systems.

1957 | Thomas, D.L.G. The following occupations (involve asbestosis hazards)...sawing,
“Pneumokoniosis cutting and finishing any product containing asbestos—for
in Victorian. example, drake linings, asbestos sheeting, and various insulating
Industry” Med. J. materials...

Australia 1:75-77

1963 | Patty, F.A. Written by former director of Industrial Hygiene Dept., General
Industrial Hygiene | Motors.
and Toxicology,
ne York: dd “The sawing, filing, drilling, and grinding of brake linings is

mlerscience ( 0944 ordinarily wel! controlled... It is desirable in asbestos exposures
ed.) pp. ~ to keep the dust count down to 5 million particles, or less, per
cubic foot.of air.”

1968 | Lynch, JR. “The dust produced by the abrading operations in asbestos
“Brake Lining friction product factories (figure 1) contains free asbestos fibers
Decomposition that are similar to those in industries where cancer is known to
Products” National | be in excess.”

Center for Urban .
and Industrial

Health Vol. 18 No.

12

1969 | Hickish, D.E.and | Paper presented at conference held at the Central Office of Ford

Knight, K.L. Motor Company.

“Exposure to

Asbestos During “Our environmental studies have not included maintenance
Maintenance” procedures which involve the filing or grinding of brake lining
Ann. Oce. Hyg material, and we would envisage that these would give rise to

Vol. 13 pp.17-21

considerably increased air contamination by chrysotile asbestos,
with the attendant need for strict precautions to prevent the
inhalation of fibres.”Kazan, McClain, Satterley & Greenwood

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COMPENSATION

oe Finding: See

1965 | McVittie, J.C. Describing the occupations of workers diagnosed with asbestosis
“Asbestosis in (and compensated for disability) in the years 1955-1963, he lists
Great Britain” “brake lining” workers with an average of 14 years’ exposure.
Ann. NY Acad.
Sci. 132:129-138

1979 | Smither. Updates McVittie’s figures through 1969, showing that the
“Surveillance of four U.K. Pneumoconiosis Panels diagnosed 10 cases of
High-Risk Groups | asbestosis in “brake fining” workers in the years 1963-1969.
— A Survey of.
Asbestos Workers:
The Present
Position in the
UK” Ann. NY
Acad. Sci. 330:
525-532

ASBESTOS AIR POLLUTION HAZARD FROM BRAKE WEAR

"1963

Thomson, J.G.,
R.O.C. Kaschula,
and R.R.
MacDonald.
“Asbestos as a
Modern Urban
Hazard,” S. Afr.
Med. J_37:77-81

S- ee :
Expresses fear of public cancer hazard from asbestos released into
the air of cities by brake wear.

Products,” J. Air.
Pollut. Contr.
Assoc. 18:824-826

1963 | “Pulmonary Editorial expresses similar concerns to Thomson’s.
Asbestosis,” S.
Afr. Med. J.
37:629-630

1968 | Lynch, J.L. Electron micrograph showed no free fibers in accumulated
“Brake lining brake drum dust. Testing was then done on dust released by
Decomposition braking, using equipment of a brake lining manufacturer. The

apparatus permitted simulation of stopping using complete
brake assemblies.

In all but a few tests the automobile drum brake linings showed
less than 1% free fiber in the decomposition product... In those
tests where a significant mass of free fiber was released, the
temperature was in an extremely high range for the lining in
question as evidenced by the rapid drop in the coefficient of
friction...(Qinder which conditions the brakes would have
failed)... Similar results were obtained in the bus and truck drum
brake tests...

REMAINING CHRONOLOGY OF PAPERS RELATING TO ASBESTOS

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HAZARD IN BRAKE REPAIR (through 1985)

Citation:

Hueper, W.C. Lists brake linings under, “operations and products with contact to
“Carcinogens in | asbestos for producers, processors, users, consumers, residents.”

the Human Lists as a population with occupational and environmental
Environment,” exposure, in italics, “brake linings producers.”
Arch. Path,
71:237-267

1965 Hueper, W.C. Table lists “garage attendants” under the heading of groups
“Occupational occupationally exposed to asbestos and lists brake linings as a
and Non- source of general environmental asbestos exposure.
occupational
Exposures to
Asbestos,” Ann.
N.Y. Acad. Sci.
1.32:184-195

July A Preliminary The index card for document no. 3071 at the Institute for

1968 Investigation.” —_| Occupational and Environmental Health, library of the Quebec
Indust, ee Asbestos Mining Association in Montreal, recorded the authors’

‘oundation—

Report for summary: “Brake-drum dust has evoked a pulmonary response
Johns-Manville. | Which suggests that this dust is biologically ‘inert.’ Brake-drum
Unpublished. dust is capable of producing ferruginous bodies in the lungs of
hamsters that are indistinguishable from asbestos bodies.”
Handwritten on the card are the phrases, “Not to circulate!” and
“Scientific Committee only.” The library is now part of the
Asbestos Institute in Montreal.

1969 Gross, P. and (O)f the 6 ferruginous bodies isolated from hamster lungs injected

R.T.P. de with brake drum dust, all gave an electron diffraction pattern
Treville. characteristic of chrysotile; this, in spite of the relative paucity of
“Pulmonary fibers in the dust by optical microscopy and the negative X-ray

Ferruginous diffraction pattern of the powder. These 6 ferruginous bodies
bodies/Studies were, therefore, asbestos bodies.

on Their Origin,
Pneumaconiosis
Proceedings’ of
the International
Conference
Johannesburg.
HLA. Shapiro,
Ed. Cape Town,
South Africa:
Oxford
University
Press, 1970,

1969 Sullivan, R.J. Refers to Newhouse and Thompson's report of mesothelioma “in a
and Y.C. mechanic.”

Athanassiadis.
Preliminary Air
Pollution Survey
of Asbestos.

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Litton Systems,

Inc. report
prepared for the
National Air
Pollution
Control
Administration,
p.32
1970 McDonald, A.D. | In a retrospective review of the potential asbestos exposures of
etal. a series of mesothelioma patients in Canada,
“Epidemiology
of Primary “Men employed in... the installation of brake linings...were
Malignant responsible for most of the excess of cases over controls.”
Mesothelial
Tumors in In a tabulation of the “occupations classified under definite or
Canada.” Cancer | probable exposure to asbestos,” are 2] cases of mesothelioma,
26:914-919 including 2 who did “brake lining installation” and ene more
who worked in brake lining manufacture. This study attributes
the main risk of mesothelioma to asbestos exposure in
manufacturing and product use, as opposed to the mining of
chrysotile asbestos. Funded by Quebec Asbestos Mining
Association
1970 Smither, W.J. The medical advisor to Cape Asbestos opens with discussion
“Asbestos and about the different mineral varieties of asbestos, then notes that all
Asbestosis.” “current” friction materials contain 50% chrysotile asbestos. This
Annals of figure he expected to gradually decline to as little as 30%.
Occupational
Hygiene. 13: 3-
5.
1970 Hickish, D.E. This paper contains data on the asbestos dust exposure of brake
and K.L. Knight. | mechanics reported by the Medical Services of Ford of Britain.
“Exposure to The first car servicing tests were done using Cortina and Anglia

Asbestos During
Brake
Maintenance.”
Annals of
Occupational
Hygiene. 13: 17-
21.

vehicles, which presumably had smailer brakes than American
cars of this era. Sampling was done in the dust cloud generated
by blow-out of the accumulated dust in brake drums. This
yielded an average value of 2.55 fibers per cc of air. Other tests
were done beside the car when the repairs were in progress,
yielding somewhat lower values averaging 1.25 ffec, Personal
samples were also taken, to get the best measure of the workers’
actual exposure to airborne asbestos. The average exposure
during brake servicing was 0.68 ffec.

Truck brakes generated more dust. Sampling was done in an
adjacent bay and two bays away from the service bay where
brake repairs were performed. The values recorded were lower
in these bystander locations. The bystander fiber counts ranged
from 0.17 to 0.49 fice in the mornings, during which time only
15-2 hours was devoted to brake cleaning. Personal sampling
for mechanics doing track brake repair showed concentrations

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Date.

| Findings

of 7.09 fcc, declining to 0.08 afier cleaning and averaging 1.75
ficc over the time sampling interval. The duration of this
interval could easily have been adjusted to yield an average
value on either side of the new British asbestos standard, 2 fcc.
Even clutch repair in the adjacent bay was recorded as 2.25 fee
“during cleaning.” Samples from bays adjacent to truck brake
repair showed 0.79 fice as a time-averaged exposure (for
cleaning and a post-cleaning combined interval}. The authors
conceded, “personal exposures in the vicinity (of truck brake
repair) do exceed the standard.”

Holmes, of Turner & Newall, who found chrysotile asbestos
present at up to 1% in it, analyzed brake drum dust. The
authors advised safeguards during brake repairs:

“It is however recommended that care should be exercised
during brake cleaning fo avoid inhalation of dust produced,
and the development of cleaning procedures that would
reduce air contamination is desirable.” [emphasis added]

They also noted that their studies did not include sampling
during such procedures as “filing or grinding brake lining,” but
they assumed that these were hazardous processes “with the
attendant need for strict precautions to prevent the inhalation of
fibers.”

1970 Hatch, D. Representative of Ferodo, a manufacturer. Begins with history
“Possible on the development of friction products and the technical role of
Alternatives to | asbestos in the products. For brake linings the author said,
Asbestos as a “there is no substitute for asbestos which would not result in a
Friction deterioration of performance and strength.” For disc brake pads
Material.” the picture was brighter:

Annals of

eeu ational 5 “(It cannot be said that the use of asbestos in disc brake pads

oO **°" | remains a technical necessity, and it is in this field of friction
materials that some departure from resin-asbestos based
composites could occur in the next few years on technical and
performance grounds.”
On the subject of clutches, he said the spider clutch being used
in the U.S. for “heavy duty manual shift gear boxes” could use
asbestos-free materials such as sintered metals or ceramic-metal
composites.

1970 Bentley, M.L. A working group of the ARC’s Environmental Control
“Control of the | Committee was devoted to friction products. Constituent
Use of Asbestos- | members were Small and Parkes (now part of Cape Industries),
Containing Ferodo, and Mintex. “The Group (which has been formed
Fr iction recently) is concerned with the users of friction materials...in
Materials.” the replacement and service field.”

Annals of.

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ndings

Oceupational
Hygiene. 13: 31-
32.

Bentley also said the ARC work group on friction materials was
preparing “two codes of practice for users of asbestos based
friction materials which will be used by (ARC). One of these is
for ... the guidance of those engaged in servicing brakes and
clutches.”

He called the codes of practice “Notes of Guidance.”

1970

Lee, G.L.
“Removing
Dusts from
Brake
Assemblies
During Vehicle
Servicing
Alternative
Cleaning
Methods.”
Annals of
Occupational
Hygiene. 13:
33-36.

The author worked for the auto manufacturer British Leland.
He noted that a technique for cleaning brakes that would reduce
dust emissions would also involve an increase in time and effort
involved (hence an increase in cost}. He commented:

“When viewed under normal lighting conditions, the result of
applying a compressed-air line to remove brake dusts is very
dramatic.”

Lee provided data (Konimeter sampling) in units one can
convert for comparison with the old asbestos TLV. He showed
that at the beginning of brake blow-out, there were 5000 brake
dust particles per 5 cubic centimeters of air; this declined within
minutes to 586 particles per 5 cc. Converting the units of these
measurements to millions of particles per cubic foot of air:

Ci cu. ft. 28,317 ce},

5000 particles/Scc = 28.3 Million particles/ou. ft, (MPPCF)
580 particles/Sce = 3.3 MPPCF

Though it was only for brief periods of exposure that these high
values were measured, it is still conceivable that the exposures
would be kept high in a shop where numerous and continuous
brake repairs were being done. The old TLV for asbestos
exposure was 5 MPPCF, and it applied to dusts containing
asbestos fibers (i.¢., all particles were counted, not just the
asbestos fraction of the particles). So peak exposure levels
would have exceeded 5 MPPCF in brake repair although daily-
average exposures were unlikely to have been that high in most
shops, according to this report.

For 5-minute samples fibers only,

«.. Asbestos fibers counted on membrane filter samples gave a
concentration on the order of 3-5 fibers/cc.”

A “modified technique” for cleaning brakes used a portable
vacuum unit to extract dust raised by brushing out the
brake dust with a paintbrush. Damp rag wiping followed.

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Chicago, pp.65-
74

Date ___{ Citation see _
airborne particle counts, and no fibers were detected in the
airborne dust samples.

1970 Knight, K.L. Notes that when the brake dust is blown off with a compressed
and D.IE. air hose, the dust cloud in which the operator works is
Hickish. “proportionate in size to the drum assembly being cleaned.”
“Investigations
into Alternative | Vacuum funnel and vacuum brush cleaning methods were
Forms of tested. The peak exposures for both of these were way below
Control for Dust | that observed for “blow-off’- 1.04 fice for the funnel, 0.57 fice
Generated for the brush, and 87 fice for blow-off. The vacuum brush
During the method was preferred for its ease of use as well as the lowering
Cleaning of of exposures.
Brake
Assemblies and
Drums.” Arnals
of Occupational
Hygiene. 13:
37-39,
1970 Asbestos. This report on asbestos air pollution notes that “an appreciable
Washington, percentage (1-3%)” of the asbestos in brake linings survives the
D.C.: National heat of friction and remains as fibrous asbestos.
Academy of
Sciences,
1971, p.22
1971 Oels, H.C, et al. | One mesothelioma patient with a history of “probable
“Diffuse occupational exposure to asbestos” was a “service station
Malignant operator.”
Mesothelioma
of the Pleura: A
Review of 37
Cases,” Chest
60: 564-570.
April, Harwood, C.F. “(A)n estimate is presented which indicates that the asbestos
1972 “Asbestos Air emission from brake linings is significant.”
Pollution
Resulting from | He assumes that 1% of brake dust is asbestos fiber, that 80% of
the Wear of this dust is emitted and 20% remains lodged within the brake
Brake Linings,” system,
Supplementary | This paper contain a several-page discussion, “Alternatives to
powes Supplied Asbestos,” in which sintered metals, ceramic metal, fiberglass,
to the Attendees | and sealed systems are discussed.
of Seminar on
Asbestos, “ : . wos
Llinois Institute ‘At the present time, no alternative to asbesios containing
of Technology friction products is developed to the stage of finesse required by
Research the industry. It is difficult to believe that modern technology
Institute, can not overcome the problems presented by the use of

alternates.”

This was a several-day seminar attended by a number of
indi entatives and thi © (BC

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Citation

Article on asbestos begins with description of some mechanics

June 8, Newman, B.
1972 “Perilous blowing dust out of brake parts:
Particles,” Wall
Street J. “What the mechanics don’t seem to know—like thousands of
other mechanics—is that the brown dust is dangerous, And ifa
mechanic breathes in enough dust from worn out linings it
could eventually kill him.”

1972 Moertel, C.G. Explaining that mesothelioma is caused by asbestos, he says,
“Peritoneal “particularly vulnerable occupations are ... brake lining
Mesothelioma,” | installation...”

Gastroenterolog
y 63:346-350

Feb. Control “In the course of servicing and overhauling motor vehicle brakes

1973 Techniques for | and manual clutches, the accumulated asbestos-containing dust is
Asbestos Air frequently dislodged from drums and housings by directing a
Pollutants. compressed air jet against the deposits.” Expressed concern over
Research environmental air pollution.

Triangle Park,
N.C. U.S.
Environmental
Protection
Agency Office
of Air and
Water
Programs, pp. 3-
48 and 3-49.

1973 Boillat, M.A. English summary:
and M. Lob.

“Risk of “Thirty-nine workers with the job of replacing automobile brake

Asbestosis linings (asbestos) have been investigated. The working

among Workers | conditions and clinical findings, including radiology and

Replacing spirometric studies, are discussed. In view of the comparatively

Brake Linings,” brief exposure during the working day, the maximum

Schweiz. Med. permissible concentration of asbestos fibers, according to the

Wodi. norms indicated by American health workers, does not appear

103:1354-1359 to be exceeded. No cases of asbestosis were detected, but in

. * | one instance the diagnosis is open to discussion. Despite the

satisfactory outcome of this study, periodic examinations of
workers in this type of occupation are indicated.”
Subjects of the study averaged only 8 years of brake repair
experience at % to 2 hours per day of work, Fiber concen-
trations from drilling holes for rivets and grinding ranged up to
29.2 fice; four of nine measurements ex

May 14- | Jacko, M.G., Tests of brake wear emissions from braking showed 14.4 percent

18, 1973 | R.T. DuCharme, | of tofal car asbestos emissions were “retained in brake” of test
and JIL vehicle. The corresponding figure for trucks was 9.2%. The
Somers. “Brake | Overall figure for all vehicles in U.S. was 11.2% brake retention.
and Clutch
Emissions
Generated

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Citation

during Vehicle
Operation.”
Society of
Automotive
Eng. meeting,
Detroit.

1973 Davis, J.M., and | Automobile brake lining dust was provided by Turner & Newall
S.W. Coniam. from a test vehicle. The dust produced “very smal} granulomas
“Experimental and little fibrosis” when injected into the pleural cavities of
Studies on the mice. No mesotheliomas were induced. Designed to be a three-
Effects of year study. Mice “lost” after initial findings reported and never
Heated completed. Repeat study that was recommended was never
Chrysotile and conducted. (Personal communication JMG Davis) The study
‘Automobile was terminated after only one year, and was sponsored by the

oe Asbestosis Research Council.
Brake Lining
Dust Injected
into the Body
Cavities of
Mice,” Exper.
Molec, Pathol.
19:339-353.

1974 Greenberg, M. Lists “Industry or Job Title in 167 ‘Definite’ Mesotheliomas with
and T.A. Lloyd- | Definite Occupational Exposure to Asbestos’—includes one
Davies. “motor mechanic.”

“Mesothelioma
Register 1967-
68,” Brit, J. Ind.
Med. 31:91-104.

Aug. 8, | Lloyd, JW. Reports on July 21, 1975 NIOSH meeting with industry, labor,

1975 “Dear and academic attendees to discuss brake repair asbestos hazards.
Colleague...” Data generated by the Mt. Sinai Environmental Sciences
Hazard Alert Laboratory included 1} blowout of automobile drum brakes, 2)

letter, National
Institute for
Occupational
Safety and
Health,
Rockville, MD.

grinding used truck brake linings, and 3) beveling new truck
brake linings. “Average peak asbestos air concentrations for
these three activities based on personal samples taken within 10
feet of the operation were, respectively, 10.5, 3.75, and 37.3
fibers (greater than 5 microns in length)” per cc. of air.

“The present findings indicate that enough asbestos is preserved
to produce significant exposures during certain brake servicing
procedures.”

Earlier reports of mesothelioma among persons with jobs
involving automobile brake servicing were cited. NIOSH
estimated that 833,535 auto mechanics, 67,679 garage workers,
and 6,657 (original and rebuilding) manufacturing employees
made up a workforce “potentially exposed to asbestos.”

“Recommended (interim) Procedures for Asbestos Brake and

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3
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‘indings:

Clutch Servicing” were attached. These procedures included: 1)
posting signs in the work area warning people not to stay there
unless their work required it (“ ... May Cause Asbestosis and
Cancer”); 2) use of industrial vacuum cleaners (with high
efficiency filters) for removing dust from brakes; 3) use of
respirators; 4) use of local exhaust ventilation and high
efficiency dust collection on grinding machines; 5) adherence to
OSHA asbestos regulations’ provisions regarding special

e TOOMS.,

Aug.15, | “HEW Warns of | Summarizes the NIOSH alert notice (previous item).

1975 Asbestos
Hazard in Work
with Brake
Linings,

Spackling
Mixtures,” Wall
Street J.

1976 Menck, H.R. This study on occupation and lung cancer rates in California
and B.E. shows a statistically significant Standard Mortality Ratio (146,
Henderson, meaning 46 percent higher than expected) for “Auto Repair”
“Occupational | workers. This figure is based on eight deaths from lung cancer
Differences in in the years 1972-1973.

Rates of Lung
Cancer,” J.
Occup. Med.
78:797-801.

1976 Alste, J., D. Chrysotile asbestos fibers from new and worn brake linings and
Watson, and J. from the air near a freeway were examined by electron
Bogg. microscopy and electron diffraction. The major effect of braking
“Airborne appears to be in separating bundles of fibers and reducing their
Asbestos in the | average length but not altering their crystal structure. The
Vicinity of a majority of particles had a maximum linear dimension of 2
Freeway,” microns or less.

Atmos. Environ.
10:583-589.

1976 Rohl, A.N., Unaltered chrysotile asbestos was found in garage air samples
A.M. Langer, and brake drum dust. “(E)xposure of garage mechanics during
MS. Wolff, and | brake lining maintenance and repair show that fiber
J. Weisman. concentrations frequently in excess of regulated limits are
“Asbestos common.” (Optical microscopy}

Exposure during

B rake Lining Blowing out automobile brake dram dust yielded exposures of

Manenanee 6.6 to 29.8. f/ce with measurable exposure 50-75 feet away.

on sepalr, Some of the other data had been summarized in the NIOSH
nviron.

‘Research alert of Aug. 8, 1975.

72:110-128.

Electron microscopy showed most of the fibers were too small
to be seen by optical microscopes. The authors warned that
exposure to these very small and numerous asbestos fibers
could have adverse effects.

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1976 Lorimer, W.V. | Tabulates exposures previously measured by others, includes
et al., “Asbestos | their own data in great detail for all types of brake work.
Exposure of
Brake Repair Clinical study of 90 men with ten or more years of brake repair
Workers in the | work and no other history of occupational exposure to asbestos.
United Sfates,” Most of the general mechanics examined did brake lining more

OUR STHAT J.

Med 43:207. than once weekly.

218. Parenchymal fibrosis was seen on X-ray in 18 (20%) and
pleural thickening in 5 (6%). Those who started work before
1946 had twice the prevalence of abnormal X-rays as those
starting in