Dr. Schepers Responds to Dr. Case Regarding Personal Motives, State of the Art, and Canadian Workers Comp System
1. Dr. Case asked why Dr. Schepers has testified only for mesothelioma victims in asbestos lawsuits.
Dr. Schepers' Answer: Thanks for your inquiry about why I have testified only for "plaintiffs" during the vast asbestos litigation since 1978. The answer is rather simple: it would be rather unscrupulous for any doctor to say in one court room that mesothelioma was caused by chrysotile asbestos and then in the next court room to deny this. Most witnesses in this asbestos litigation receive monetary compensation and if they switch readily from one side to another there is considerable basis for suspicion that they do so for the sake of the money. A doctor like me sometimes gets asked to testify in court rooms whether tumors are mesothelioma or carcinomata. For such a doctor there can be only one diagnosis at a time as he can use but one set of criteria that are persuasive to him. I suppose that if a doctor is a little wonky on knowledge that he may wobble in various directions, and if he is very skillful at keeping his conscience and intellect well separated this will help too.
A second reason why I have in the past often been required to appear in court rooms is to recount historical facts that are personally known to me, as I have dealt with both asbestosis and mesothelioma problems since the mid 1930ties, and almost entirely until 1978 in the capacity of contracting consultant to industries and government agencies. As knowledge acquired in this manner is the essence of the punitive damages issues relating to any asbestos disease claims it would be downright stupid of a lawyer defending an industry to invite me to come help destroy his defense. Canadians do not have this problem as they do not have a tort litigation law there, at least did not when last I did research for Quebec Asbestos interests.
2. Dr. Case asks why Dr. Schepers did not publish his data regarding the incidence of mesothelioma cases from Quebec back in the early 1950s.
Dr. Schepers: You wish to know why I did not "publish" the data concerning the cancer cases on file at the Saranac Laboratory in 1950. I did, but this "publication" was of course limited to the South African Government and my report was immediately placed under seal and shortly after confiscated by the chief attorney for the Asbestos Producers Association. Prior to 1949 I made a study of the asbestos mines and mills of the Eastern Transvaal plus Swaziland as a result of which twelve mesothelioma cases were found among the employees. The industries were shut down for about ten years. In a number of court rooms I have in the past been taunted by defense attorneys with questions: "Why did you not publish" your question merely echos these taunts.
I was under orders never to divulge any information gained through my government employment, the fine for so doing being 10 years hard labor imprisonment plus the monetary equivalent of a $100,000 fine. In 1964 I mentioned something about theses 12 cases at the New York Academy of Science Meeting, as I was out of reach of South Africa's Government having become an American Citizen, but I was promptly sued by the owners of those industries using South African Law.
3. Dr. Case disputes the timing of the first publications on the relationship between asbestos and mesothelioma.
Dr. Schepers: Your inquiry also is concerned over when pleural mesothelioma first was written about. I now am pretty remote from library facilities, but the first case I recall, was published by Dr. Simson in 1929 in the Annals of the South African Institute for Medical Research. Dr. Simson was one of the pathologists I worked and trained with in the 1930ties. He and Dr. Strachan and Dr. Mavrogordato had a specific task assigned to them by the Institute to study the pathology of chrysotile asbestos mined in the Eastern Transvaal. I served as medical assistant to them while at medical school there. Then they all died one after the other and this research with them, the more so as we were involved with the War against the Germans and Italians from 1939 onward. The Swaziland chrysotile Mine also was brought to a standstill as its cable car system to convey ore to Barberton had been contracted out to Germans and this could not be corrected until after war ended in 1945.
Following Dr. Simpson's paper there was very large series of cases analyzed by Drs Klemperer and Rabin in 1931-332. Most of these cases were benign mesothelioma, which had been known about for decades previously. As I recall this was mainly a literature review study.
In 1935 Dr. Gloyne of London mentioned one case of pleural malignancy. He did not use the name mesothelioma. Then in 1939 (?) Meyer and Chaffee described how to differentiate mesothelioma from other neoplasmata through the use of the Periodic Acid Schiff technique. To do this they must have had access at Sloan Kettering to mesothelioma tissue. As Dr. Stewart then was pathologist there and also a consultant to Raybestos Manhattan, he may have helped them get the tissues. In 1942 there was a related study published on this topic by Murray and Stout. The latter had by then succeeded Stewart as the Chief of the Pathology Laboratory at Sloan Kettering. Before this there was a publication by a Dr. Desmeules from Quebec on two cases among asbestos workers. That was in 1940 as I recall. Whether he used the term "pleural mesothelioma" specifically I cannot recall now, but you may be able to have this verified if you know French. I do recollect that a Dr. Teutchlander in 1943 used the mesothelioma terminology.
In Court Rooms I have formerly been taunted by the defense lawyers over the fact that although I identified 12 cases of mesothelioma in South Africa in 1949, I did not publish their materials on crocidolite mesothelioma in 1959. There is a not so subtle explanation for this. I was a federal government employee and subject to the restrictions imposed thereby. The three authors by contrast had nothing to with SA Government. Dr. Sleggs was a physician in the Kimberly Hospital to which the 70 cases were referred. Dr. Marchand was the surgeon who dissected out the tumors and Dr. Wagner was a postgraduate student working up a thesis for an M.D. degree. You may also be interested to know that these three authors whom you credit with having definitively proven that asbestos can cause this rather horrible type of neoplasm reserved their attributions on causality to only 39 of the 70 cases. Before they made this etiological assessment, there had already been 39 papers written (up to 1959) on malignant pleural mesothelioma in asbestos workers. My own mention of the etiology was in a textbook in 1959.
Dr. Schepers: What is Burden of Proof in Canada for Compensation?
It would be of interest to me to discover whether Canadians now compensate asbestos workers for developing malignant pleural mesothelioma and whether they consider mere exposure as sufficient presumptive proof or still require that victims first develop asbestosis. As you seem to be familiar with the situation up there I would be interested to discover. In former years attribution was stultified by lack of clinically demonstrable asbestosis and later by lack of chrysotile fiber burdens above a theoretical background level. As I have never managed to see a chrysotile asbestos fiber in tissues (other than by use of transmission electron micrography above 20K. plus electron diffraction analysis) I wonder how many malignant mesothelioma which those Canadians encounter as "background- uncaused by anything cases" have been completely studied by true experts using all the technology available.
The chrysotile fiber is so thin and transparent that it is extremely difficult to see. How was it proven that none of the many women in Canada who died of peritoneal mesotheliomas harbored chrysotile fibers, considering that there are many papers from Canadian authors describing background asbestos in great abundance up there? Something fiercely contradictory.
Sincerely,
GWHS
** POSTED NOVEMBER 30, 1998 **