Monday, July 05, 2004

Dr. Thomas Mancuso 1912 - 2004

Guarding the health of workers exposed to toxic chemicals is not an easy task. Before regulations can be issued -- even before workers can be warned about the health effects of the chemicals they are working with -- someone has to do the scientific research to determine what effect the chemicals are having on workers.

Determining the effect of a single chemical out of all of the exposures a worker has during his or her lifetime is a difficult, expensive and lenghty task even under the best of circumstances. Such research is rarely welcomed by chemical manufacturers. So on top of the difficult science, such research is often discouraged -- and the researchers harassed, presecuted and de-funded -- by the industries that manufacture and use the chemicals, and the research institutions that are beholden to them. It takes not only compassion and great intellect, but also extraordinary courage to conduct such research and publish the findings -- especially when those findings can threaten the profit margins and "good will" of major industries.

Dr. Thomas Mancuso not only cared enough about workers to do that research, but also had the courage to stand up to the powerful forces that wanted to silence him. Mancuso died yesterday at the age of 92. George Washington University Professor David Michaels sent out the notice today Mancuso's death and included the following exerpts from the presentation of the American Public Health Association Occupational Safety and Health Section's Alice Hamilton Award given to Dr. Mancuso at the APHA's 130th Annual Meeting, November 12, 2002, in Philadelphia:
Sir Isaac Newton wrote "If I have seen further, it is because I stand on the shoulders of giants". We are here today to honor Dr. Thomas Mancuso, one of the true giants of occupational safety and health. As chief of the State of Ohio's Division of Industrial Hygiene from 1945 to 1962, and then as a professor at the University of Pittsburgh School of Public Health, Dr. Mancuso did pioneering studies of workers exposed to aromatic amines, asbestos, chromium, beryllium and a host of other toxins.

In 1969 and 1970, Dr. Mancuso published two studies showing elevated rates of lung cancer among beryllium-exposed workers in an Ohio beryllium facility. Further analysis by NIOSH epidemiologists of Mancuso's cohort confirmed the findings. These studies were very controversial - the beryllium industry hired some big name epidemiologists, as well as a PR firm, to publicly refute Mancuso. And they were successful for a while - it's a long ugly story, but Brush Wellman, in collaboration with DOD and DOE got OSHA to withdraw its newly proposed beryllium standard. But as you'll hear several times today, history proved Tom right; a study by NIOSH epidemiologists published 2 years ago found excess lung cancer at a different beryllium plant. And finally, two years ago, the National Toxicology Program voted to put beryllium in the category of "Known Human Carcinogen.".

A similar tale can be told for chromium. Tom first published a study showing excess risk of lung cancer from hexavalent chromium in the 1950s. Recently a group at Johns Hopkins found similar results at a Baltimore chromium facility, but Tom's study remains one of the foundations for the attempt currently underway by Public Citizen and the PACE International Union, to force OSHA to recognize the risk of lung cancer associated with chromium and to strengthen their standard.

Tom published ground-braking work on the risk of asbestos-related disease, especially mesothelioma, among railroad repair workers.

He did a very important analysis of aromatic amine exposure and bladder cancer in the 1950s and then another set of studies on cancer risks among OHIO rubber workers in the 1960s. It was Dr. Mancuso who advised the United Rubber Workers to set up an industry-wide epidemiology program which originally funded by half cent per hour negotiated contribution by all rubber workers. As a result, Harvard and UNC were hired to do a series of important studies on causes of disease and death among rubber workers.

As important as the results of these studies were, perhaps even more important were Tom's methods. Long before occupational epidemiology was taught in schools of public health, Tom Mancuso was inventing the methods we now take for granted. He conducted the first cohort mortality studies on occupational cohorts in the US. He was the first researcher to use the Social Security system to trace workers, pioneering the cohort follow-up study.

In 1962, he joined the faculty of the School of Public Health at the University of Pittsburgh, and in 1965, was awarded a contract by the Atomic Energy Commission (AEC) to conduct a massive (500,000 person) study of the health effects of radiation among workers employed in the nation's nuclear weapons complex.

In 1974, the AEC put pressure on Dr. Mancuso to repudiate findings by another researcher of increased cancer risk among workers at the AEC's Hanford facility. Although his own preliminary findings did not support that conclusion, Mancuso refused to endorse an AEC press release disputing the other study because his findings were only preliminary. As result, his funding was terminated. Dr. Mancuso continued his data analyses, and eventually published two important papers documenting excess cancer risk at Hanford. But the AEC and then the DOE hounded him, and cut short his career.

For many years Dr. Mancuso served as medical consultant to the International Association of Machinists, answering in The Machinist workers' questions about toxic exposures. These answers where compiled into the book Help for the Working Wounded, published by the IAM in 1976 and was distributed to thousands of members of that union.

Dr. Mancuso turned 90 this year. He has never stopped trying to contribute to the health of American workers, and the prevention of occupational illness.
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