Pushing for asbestosis study cost doctor his job

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Pushing for asbestosis study cost doctor his job

Postby Webmaster » February 25th, 2005, 9:07 am

Pushing for asbestosis study cost doctor his job
'These miners were desperate'

Thursday, June 22, 2000

By ANDREW SCHNEIDER
SEATTLE POST-INTELLIGENCER SENIOR NATIONAL CORRESPONDENT

Dr. George Wineburgh stood up for sick and dying New York miners whose suffering was being ignored by most of the medical community. For his efforts he was fired from his job and ostracized by doctors in two counties.

Wineburgh practiced at New York City's largest hospital for 16 years before moving, with new wife and four Labrador retrievers, up to the peaceful upstate New York in March 1982. He was eager to start his new job as the radiologist at Ogdensburg's Barton Hepburn Hospital.

"I thought this was going to be a piece of cake, you know, no stress, a handful of cases, a great change from the big city," he recalls. "Boy was I wrong."

It didn't take long before the skills Wineburgh gained becoming a board-certified radiologist started generating questions within the pile of X-rays waiting on his desk each morning. The films were from the patients examined overnight, usually for assorted trauma, aches and pains and heart problems.

Among the cracked ribs, bruised kidneys and clogged arteries, Wineburgh was finding something unexpected: the distinctive shadow of a lung damaged by asbestosis.

"I kept seeing four, five, six cases every single week, week after week, classic asbestosis," Wineburgh says.

He questioned the other doctors.

"All the clinicians that I asked said, 'Ah, they're just smokers. Yeah, they're miners, but they're all smokers. That's the reason, so we don't mess with them,'" he says.

Wineburgh was sure that what he was seeing was asbestosis.

"It's distinctive," he says. "If you know what you're looking for, there's no way to confuse it with something else. Asbestosis is one of 14 (X-ray) findings that is unique, that can be one thing and nothing else."

By the end of three months, he had X-rays from 50 patients in which he diagnosed asbestosis.

Other doctors still insisted it was emphysema from smoking, and claimed they had the pulmonary function tests -- the amount of air a lung can hold -- to prove it.

"But the numbers were all wrong, completely opposite of what they should have been," Wineburgh says. "Emphysema is called an obstructive lung disease and the lungs are over-expanded. With asbestosis the lungs are small -- restrictive lung disease -- completely opposite numbers. There should be no confusion."

He was uncomfortable about what was going on.

"I didn't like it. It smelled. Nobody wanted to stand up for the miners, nobody was being clinically objective. It was like they were under the thumb of the mining company," the 55-year-old specialist recalls.

As the numbers increased, so did his frustration.

"These miners were desperate," he says. "They weren't getting any better, and they weren't getting any answers. Some were dying. Doctors were telling them to stop smoking, but some of them never smoked."

Wineburgh asked the unions for help.

"They were supposed to stick up for the miners," he says. "But they said they had been told that if they raised a stink, demanded that the safety regulations be followed, management said they would close down the mines. So they too did nothing. Just breathe in, breathe out, and keep working."

Then Wineburgh sent the 50 cases to the state health department.

"Most of these guys are out of the mines. Asbestosis is a reportable disease. You guys have got the authority," he told them. "So here you are."

The state shipped the X-rays to the Selikoff Institute for Occupational Medicine in New York City. There, a specialist confirmed that Wineburgh was right in almost all of the cases.

Then the health department contracted with Wineburgh to lead the examination of all the X-rays taken between April 1982 and March 1983 at six hospitals in a two-county area of people 40 years old and older.

About 22,000 films of 9,442 patients were examined. Wineburgh and his team found chest abnormalities in 500 patients. Those X-rays were evaluated by what the health department called "an internationally recognized" expert.

She found that 71 percent of the X-rays of Wineburgh's 500 "were indeed consistent with chest abnormalities indicative of asbestos exposure," says Dr. Edward Fitzgerald, who co-wrote the state's report and is assistant director of the bureau of environmental and occupational epidemiology.

Lengthy interviews were conducted to pin down work histories. The largest number of the patients who had diseased lungs worked in talc mining or milling. The next highest group afflicted were workers from the paper mills, which used large amounts of talc, the report said.

Thomas DiCerbo, the associate director of the New York's Division of Occupational Health, said the state "jumped in immediately."

To address concerns that asbestosis was being undiagnosed or misdiagnosed, he says, his department sent physicians upstate to meet with the medical societies and local physicians "to alert them to what they should be looking for."

"The owners of the mine agreed to talk to us, and we explained our concerns," DiCerbo said, but he declined to discuss whether his department thought there was asbestos in the mine's talc.

For his efforts, Wineburgh lost his job.

"My contract with the hospital was canceled three days before it was to be renewed," he says. "Most of the medical community thought I was a trouble-making traitor. Working with the Health Department of New York State to try to get help for hundreds of miners made me a traitor to the physicians of two counties."

Wineburgh is not alone in being ostracized for trying to help miners exposed to asbestos.

Radiologists in Libby, Mont., who first raised the alarm that vermiculite miners at a now-closed W.R. Grace and Co. mine had asbestosis, left town soon after. Another specialist in Northern Minnesota told the state about finding asbestosis and other respiratory disease in taconite miners in the Iron Range. He soon moved his practice to another state.

Wineburgh is now practicing in the Midwest.

"Finding those sick New York miners changed my life." he says. "I'm a lot poorer now. I have to work a lot harder then I should at my age. Would I stick my neck out again for those guys? Of course. That's how medicine should be practiced."

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P-I reporter Lise Olsen contributed to this report.

http://seattlepi.nwsource.com/uncivilaction/doc222.shtml
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