Document 1gMrp7MOgVdwgyY5MR99yQy5a

MORTALITY EXPERIENCE OF INSULATION WORKERS IN THE UNITED STATES and Canada, 1943-1976* Irving J. Selikoff Environmental Sciences Laboratory Mount Sinai School of Medicine The City University of New York New York, New York 10029 E. Cuyler Hammond and Herbert Seidman Department of Epidemiology and Statistics American Cancer Society New York, New York 10017 In 1964, we reported data concerning the mortality experience of a cohort of asbestos insulation workers in the New York-New Jersey metropolitan area 1943 1962 1 Significant increases in deaths of lung cancer, mesothelioma, gastrointestinal cancer and asbestosis were found. Findings were limited to observation of only 632 mep, .however. On January I, 1967, a larger cohort was enrolled for prospective observation and included all 17,800 men on the rolls of the insulation workers' union (International Association of Heat and Frost Insulators and Asbestos Workers. AFL-CIO, CLC) in the United States and Canada on that day. This second cohort included the survivors of the original 632 New York-New Jersey men. Observation has been maintained and an interval report of deaths in this group since January 1, 1967 has been made.! The present analysis details findings among these men through December 3 I, 1976. Asbestos Insulation in the United States Asbestos, as a mixture ST fiber and sodium silicate, was first used as an insulation material in 1866 and as asbestos cement about 1870. Magnesia with asbestos as a binder soon followed and air-cell covering, using corregated asbestos paper, was introduced in 1 898 . The first union of insulation workers in the United Stales was formed in New York City in 1883 under a charter issued by the Knights of Labor (predecessor of the American Federation of Labor), as `The Salamander Association of Boiler and Pipe Fehers.'' The present union of insulation workers in this country as chartered by the AFL in 1910, as the International Association of Heat hnd Frost Insulators and Asbestos Workers, by the amalgamation of the Salamanders Association of New York 'uh other independent locals throughout the country. Members of this union are insulation workers, primarily employed in the building trades doing construction insulation work but also employed as insulation workers in refineries, industrial plants, 'This study was supported fcv grams from the American Cancer Society (R-S3), the National Institute for Occupational Safety and Health (0H0O320) and the National Institute of Environ mental Health Sciences (ES00928) of the U.S. Department of Health. Education and Welfare, are the Health Research Council of the City of New York (L/12'2). 91 0071-8923/79/0330-0091 St 75/0 C 1979, NYAS . 7- -- ; ^* .w,f. *-..j* '**. r . .*, - W ..." - . ; mm* .* ' >V.V ' -- . ' "S/ Cu-J*&.+ wv. 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S. 9 --. u o Wo- -5o <>-js <c"J 5 * vUi 3 * 1 'w e 2 2: S " !S2|.S 2v* e a '5eo O ^ > E .ioy3E ^ 0 ! I ~ 2 u - ! 2 oi-g <j y illli"3 v> 9 -- C i W ** s Is 8 S ' c-- u _ 'I * 3 ^J-5 --J ' VI < 5? -! lS<ii '3 if C *<3 , "9 <Jii Cfl 73 VI H X> rm= n > v. 3 e EC w s< c VI 2 -M O 5 o . ss e m 01 E S a. w -X > 5 J 9 u 0 yu n VI '3V<aI so ^ Ty3 _>% c .=* w *5 2 3 C 73 C y .2 .= s C VI 2 - 0 /= & - X " S3 2 ,5U IS _OCQ `ccwuy y9 90 V9I " vf 5 0S9ey0O c 3w ' o u _1 x < s i4 < o < C .2 2 u - Table I Expected ano Observed Deaths of Selected Causes Among 632 Nfw' Yorx-New Jersey asbestos Insulation Workers First Employed Before January I. 1943, ano 833 Workers First Employed January I, 1943-December 31, 1962, Orserved from ______ _________________________ January I, 1943 or Date of First Employment-Decemier 31, 1976 Leu than 20 Years from First Exposure to: Chrysolite only before 1943. plus amositc after 1943 Chrysolite and amosite Number of Men in Category Man-ycart of Observation 323 1,970 833 13.320 Deaths from Selected Causes Less than 20 Years from First Exposure to Possible Amositc and/or Chrysolite Asbestos Exposure^ Lung Cancer Exp* Obs. Mesothelioma t Obs. Rate per 1000 Man-years Noninfectious Pulmonary Diseases. Total Exp* Obs. Asbestosist Obs. Rate per 1000 Man-vcan 0.2 0 0 0 0.1 0 0 1.1 2 0 0 0.3 0 0 0 0 TRaiej Rre not ivailable. but these hive been rare causes of death in the general population, t Amositc insulation materials were first introduced shortly before and during World War II. > a -o< >3< o 0a0 o' 3 P Table 9 ' Expected and Observed Deaths of Selected Causes among 631 New York-New Jersey Asbestos Insulation Workers First Employed Before January I, 1943, and 833 Workers First Employed January 1. 1943-December 31, 1962. ................... _ Observed from January 1, 1943 or Date of First Employmem-December 31. 1976 ----- ----- --- .............. ....... ......... g - - ------- : - -- _!L'.J . Deaths of Selected Causes 20-34 Years from Onset of Exposure ,J ^ 2. r~ First Exposure Number of Men in Category Man-years of Observation Lung Cancer Exp* Obs. Mesothelioma! Obv Rate per (000 Man-years Noninfectious Pulmonary Diseases, Total Exp* Obs. Asbestosist Obs. Rale per 1000 Man-years a 7 c* iefore 1943 1943-1952 1953-1962 1963-1969 1970-1976 Total 1941-1962 1943-1952 1953-1962 1963-1969 1970-1976 Total CO I 523 393 3253 2430 \.\ 9 1 \ 4 11 4 0.31 0.7 0 0 1 65 0.7 3 2 0* 0 82 H 154 418 0.3 5 i 2.39 0.1 i i 1.42 O , 32 162 0.2 1 i 6.17 0.1 0 0 0 r>o = 561 6263 3.0 26 7 M2 16 ' 4 3 * 0.48 -J C _ -- -- -- -- -- -- ---- -- VJD t -- -- -- ---- -- -- ---- -- ro 258 596 0.2 2 1 1.68 0.1 i 1 1.68 c* 515 2685 1.6 6 n 0.37 0.5 6 5 1.86 CO s 323 3281 1.8 8 3 0.91 0.6 7 6 1.83 - rr r. Expected deaths are based upon white male age-specific U S. death rates of ihe US National Center for Health Statistics, 1949-1976. Rates for 1941-1948 were extrapolated from rates for 1949-1955. . Rates are not available, but these hue been rare causes of death in the general population. --. _* ^i - J; *3 ^ - s Zvcs o2. rt ">^ 2 2^3 It i -?.s s * jj*c. 1 O Jn 2 > v * ~ 2 J> -uA _^_ 3 <JO"nT O s* -33 3^<* U -^S -a - 5aJ>) H-->- M jj 2 * C 9 >y "99 J-3 U f * p; ~:* Cflo " 5 |jj 3 1 11 - i3 2n oj 3 .1 2-5 = o >\ o > -Ow 35y --"-- . 3 1' ` -J5 ra~* C * s.-s 9 5 on O -3 , "5 V <-"* U S .3^ o -o c *J3 Cn S-n''"-- S 2 * o o a. o 3 s u Jo* 9 39 *--9 u 8. M| eb J-5H J i* If. ~G C/5 .5 o 33*5 u *Su _^ 2y ?--v o--=- ;*^ 00 3 s 2 ft y t-E-S a^ Z '_o 3V <j -- :i c orso /. -- 2 -9 o 3 is ` - b z Do 9 33v z * Q -* 2 * Z 9 5 > =5 = 3- oo *5 38 ?lf^3< AZ r 9 2 < -*s> v-sr vv-, -->r a9d v*O> 9 nt <0 ,I 2* ^ _ J IN (S N - '"' O il c. c 23 *<wrJt *-3r* ^ ^ M O - --. r*i O' * -* -- <** -- : ' JS *3 > 9 ^2 IS M ^ O 52 5 i * > i ^o ^--> o- -- r. -- r~ -- -- so r.' V so" W o oo -- . 3J u 5a J S3 =-J3i 2 j1 ;I liirll* i"o3. 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" 3 a u *|S aco 5-s &_ -- Ou.0-aXo0o2 ^*a. 25 c y " g-u S' 9-8 sl31 * 2 S ^ a 00 ; .= < 5 cn -3OJ ary r- v\CM 30 d- u 0 >, . -uo . u < 51 > o1 2 'O ij 2a 8-' Z 9 z 9 U. i n-- 'a^ho rch^-* <r--* 'i--0n vNinMN Vo1->1I -S U -5 2 cU n SA < 0 l< su ^ VNrt-IN'rt-% -s O v r< -- lI ^r* ^OOoOo--r-rrN -- 11^ ^i ^T-f^0/[-^I'Nr0*>IXN^rN*)Q*8vsJrhN'V^0p^O.--^'rViNO----Nn 9IN>aO0o ^^^os^0|k^ro>'ro|>,0',^ . <> -/r\N(i(vNiOni-lo\TONvViiv>ortJ^)N-oOr'r,^*099,rt,r3 =< M*0 ^y/ 28 ^< =1 i: 5! JS3 !i ul t Aq x iSU-'O ; *OOn 5 ?*r -= o o su -(0 < o* JZ u "9 c e >y '5> *^ -5 2S -2 04 6 3 i X s oo 2 5 -5 0 O a at u *.=5 s* e 1 -: " 00 JS .5 *3 .2 ^ ^ 0O4 Ok ^ <= 5 3 S 5y * >. co o "2 u jz v n S _ao Eo S. 0,u3-`oC-g =s U- 'S0. 0>. O 3C 3 Qw JnJ k-m "-- <0 c A. 0 0 90 "2 -- x-* c ^a > Z J2 c fc 2 U *w 'r9t 0 a -- sMlfl y O rr rN o 3*1 1$ = = Sf^ u c 00 . ^ E oJ: ! 04 O i * 5 = * 5L g *y5 5u 5y ofN Wo >cS Cc y -2O5 TS 0+^^-iSCo J= " -3 - J-.- j; I; I 5 *3 a 5 8. " 8. - 2 ^ 3 J - 5 3 e<-s --6u _u----_i -w yUr^*->45\. j*-5 >9 cOwe- u~j<jj ^y3 wr-s vo c g H ^ "3 S 0 2 ~ za 3 -2 u *'S k V ggo &^ 2M ^. g ^ M g ^ _c 0 2 0 = ? 5 % 2 *^94 - "3 9>3 2 .8 "^.| = a --0 as UI fl - 6 J --j 5 c 0 c -a <-- o - 9 `C 5yX ya .22y00y 3 V ^u *< 0 C ., u u 0 3 2-1 oHb- f^o 00- u VM> c v uw o - I|588 3H O 23C %-^ f*4 00 y- S - o o 3 O 5 ^*-- c -O Sw 2 00 .?; a ic 2 E >0 -- M3 --s ^ Do J rO*.. 9>^59* r'M>**su* >0 oe v2 IU K< O0s a 9 --* H s wQs <3 aaVI < 1Z< 9<< 3 r-' Z< O 9 uO Z < Z O w < 3 ^ r- ^ SO IN ^ Ow w >n n.. 4 3 ^s 1|1js. s Z2 o< Ift CM cn r- <V1 o H</> D 2 3S?i!,.s3`5S = r 3 ~ u = .2 " c 5 3 H-- - i_ >n='5^`5 Ic Sc*.-J&S w9 a23y aa 3, -7--i.?to i..S* I_ o != 2>-3s ;i = l|-is"-3 sl! = *_u == 1.5 = S so 3 "J ^ i J: *; C 13 S n -> - 'S " 5 _ *= = 3^">'2:/,=`3 2 ~ = J3 - . -O " J = z_ * V 2 ^ C TT _ 3-- U "^ --3 -i 3. i2 -5 3 s.. 5 * z* ~--==j 1 ~ 3 a a - _ ? < S = 3 > " S -3 ct"i" E | = - v* -J k_ U f VI ^ 3 - - r y a ) 5 V j issl-9 y 2 y .1 = 5-3^ g w'> --= O3 o5 a 3 s .= `-531.. -cc3 ;I I1 2a .--2- 0 -- a co a o -- ^3 u li ! M > 2 -- "3 -- w -- <i ^ u " u = x3 cc yH -c" =._c 2- * .s s * c90 2* 23 = a ao 25J V *3 < a C V * jutij u3-- --c s "e -5 no <= o U " -w "- 2 2 5 3 Jj 3 5- * c - fi 1A A * e 9 nw W -- u* 3 o 3 . 2 . o3- -- 2 11 i co. aoS2'.-"55=2 e o S ^ a > z 3 *> Ii -------O--------- , ,^-s I *r >--A\ V>\ <S4 jo V--i | ill >2 = s z l 5**3 5O H 2> _o zzI2 24z *< <a iI " '-j VS > r ao 9--k -- -- 'Oa) -- 0^0*00 If -w --_o * * c - ill = -! 1 S3J. 6 .5 c !E| 2 S^. c 5 g. 3 3 3 g U: ?y HOO o.-iaj--o- -- --;via -i^5 25? ?^ c ,, w 2..S ^ 33 ill .3!2 . 2Z *-- ' z~ 83^2 -. > 3 J5 *o w 5u -- rz lei 2 z ^]aT fi.G u-|d 2 a Z2 a C" -s u c ^ ` c SO w i ny 3 s =- 5 l U SI 2* < 2 S o 90 - UtJZ V - ne -5 a C -C 1 -- ? <j w 2 ^ w 6. o s J*o 4 ^ s -- y -- >\ s3-*-o=ayH2 2 s; s 2 tv 3? iK-v : C.' ^ =o O3 =0 30 - 0 J5 -3 H^ 1 3 >. = 2j=.3s>*. S3 a^ ?.= 3 * sit3t = a^ >. ^ a< __ -3 -o -- 3 3 wn . w -A M: " c* y ' 2 3 >>y j rt O y 9. u -- SO = i sg s I =y . o > "3 V! * S a C. a3 y -- ^9 yo Sc-UiJS 53 -S2 sSEju.r-- t.2fl !2 a o2 2 U U 90 O a5 c 3 O a.! S -3 >* ^ -- gc 2 S. 1U3 1 ^5 a < H. sz V 2 . js y ,y r - O ^2 i! 2 '2 2L! uO TO -- J H y 5o g -- cc ?3.5 o 'S a -- ^ a_ *--a u SO , u a >- 5J'` 90-3 O U_ o J?c.Sc a S eaq >^ > 2 c - -a y ij wai *a v* s oa "--O a *-o----J---i" u SO ao ao c .2 .2 - y a a r -a w *c Jt-gi"g*eo- 5 | > c -c 5 3H 3-S d a a. a 'w 3 =A 2. 5S *3 j= 2Smj.2 c . u c -* 3 . PS . t 5O u U. _n* Mfl ... 2? c 3j * *" y . 2- O 2 = C - aIA O. > 83 5 -i | .c c" _-3 -33 8 *2 o y -.2 S' u ti= -= ij*o2 i = S- a ^s >2 w3 -- y .a ^ oo a rt ^^ > -- V! " -- O^- c 3 O -= -az 2 ^*s sc vyi 2a; a vi < 32 ^ - >5 y w 3 n -2 -S S y * y .2 M j X E . -a 5 f- S3 J^J c -5-S 8. Ow3 >C a ?-2 - c* y -5 o "a C o c -CC* >y vy* CL U __ 5u = ?w ; n c S _ (- g 5 . a-- Q.= JZ I g sl a y 0cHo u q.,2 IlIJs o -O o - c I > ^u * 5 -- W o j: . n= juz. j--: *3 I 8 e rf 329 ; 3. O 3 ' I. ts VI Id S 00 ~-- >> c Si3 ; a d" 3 2 !a w _ Ui -- ; * J i- 5 ?,* J J3 o- 3 u 52 " *A VaI 3y --- !2 5 y js a .= 5 f= -r -- acl-a u -*33 ?.*2 3 J- `c ^ = o .^ *~ y- 2 u s ? - | a 3> = .11 5 u .c -s -Oc 00 2 o . " - ca y ux <* 2 <3 2 O O5r JI*i U yC 3 .2 c- om w vi c a y -- -- a yo ^o 2e -- r2 & vi -3 -2 c c y sis O !J -- - a -d -o =a s I >5 =3 > OO c o .. o -= a s; -o : y v* 3 * 2 *3 2 2 V* O o ^2 - 3 5^ y c yH w y c 3> s^52.CiCL!L U2 H "9 s^ Z y 2 00 i'ly .2 > T3 3 ^ 2 ^" c o 51 .0 a *-- *0 2 1-25 -- o. e c vi *0 2 - 3 c Oao 5 - '* l.-e A i-2 a5 2 , c O C3 a ,1 aT y j fw --O > g -.Q2 - eu *cl=*J'5g a cl y < 5 = - s0 ~ 3 -- CE : t-S <s o *e -o= - i: y* 5y o v -5 5 af >^* wy itr 3c. -k. 3 U 3 " * * -s S= ) 5 " O'---"" i.rH 5 2 ? 2-- --.VI Jj3i :v i o u t -- .2 c 3 c > 3 M a -= ; .-2 ^ = uio^oc _ = - n^ ---- 3~ S3 3is C3. 9 a-j- T*J> - ^ Z !? y 2 y 5S3 "C *" O -say a n ^5 5 *j ^ a -a i e oo vi o ac 51 li - r i' 5i" ; '5 :U1= = =: 3=^|' nA C S - 3 ^5 i S s JJ 1 8-2 2 o 'z *a =w i * a .^2- >0? c " C 4> c J .33 .c= c- sJ u vl a 2 3 5 --aw 5 ^0 sa _ a - 3 u* a 3 ya g 3.a ay if a -- o 13 - i yo S 2 -- ---- y o*2 ha T? o >o S ^ 00 TJ .Sit 3a yy a -yc ^c 22U T3 <V*I y eg o a <75 5 *" yc y5 C I a e -o -e aa 3 2 CI y vi a it -a y ** 4= *a w 2H Om ZZ ay 0-* o 2ye v a *U 111 . y , a o_ 2 3 o i w 2 S -- 5 it -s .? ^ isa^ass-i2S5 S' 2 - 2*o _>o* > .2 *2 2 '2 CL *0 -- ' 13 2 J 3 -. -5 5E i TJ ,M u a uj r C jo y .1. -- c c CUv. y u .9.2 rf ay -- y js J li 5 5: a <-- _* H - ^ so, A 00 - 5o ^-c e a a -- a y rz y = g 2* co y XS >5 -O 2 o .V2I y -c y.. a JL " JS y 1-S' 5y i* y . . ^ .s -- &"3 -- 2 c -- 2 o c *" 00 o .c c --vi ^^ - - a .'S fti >S--C -yo yC y > ^ it 3 Jj J S z < y y .c --, ". y = -3 * ^ a ^ H 1 z 0-3 J H yO 2 o 3 ;u!S*-. *23i!. *J X3 < CL O y2 c S y'o 5 ? 5 2 a -2 O 5 ^ y 'Oc 3Q.gc^5h'5i z ; y o " rf -a -3 3 8.S o *u *2 u 2 2 : y> --o yc O !"H U ^25 -- 00 c J - y y Q. 3 c 00 c - 5 6. II o*?'" ' -o .? a * * a = 0.1 s c o --; w > _00 c c 5 > - .= !.= j s. o i g * c .r .lua * 3<2 r y 2 > 3 3 =S s> 7: 3 u 3 "p < Z >s u~ 3 s3 .=y o 0 i-fiO u;; '-So = >k s.&'-f= -o .a2 S ^ Ml L u 'yJ y -- 3 ^e. , .5 O c As ^ M cv. 2-- - ^ w .= W 2 y> o e j3 8 <2 =*11cl x < ^ u .2 . y > vi eoy E VI ** y tj 5-y 2 2,-8y CL vi * J . c 3--0 zrt ya y y c 3 y aJ ss.3 2 .2? -- VI y U " = =-s| = S| k 5 - i - 5 2 c S5 j * 'so,sa"l^-;SSgu O- e* < !ne J?E22i;cV3 g r- a * 5-3 2 - V-3-- U=T o i 6-.= 3--3 "= 2jf-S J 3 3O C0 *-> -.z -<= -j o *5 o => v so = SE2 " -i y wo ~ ,, 3s .1 -s 15 4- r oS*j.G5'*1"cfwl!,w|4SSg|s--U 3j<* ---v r4* r 4 2 2 * X O M ^ -- -1 o -x5-wS4g1i"wS 1c J* *^ i^'Ow~;jn"_Z * - ; c3 , *P ^ 'A ---. e. 2 -3* M* -= - 3 S O = Si. 2 2 -= c s 2 3 5 S. so ________ ,,_ _ 27 _ 'i 5s _-2 5:1=32E5 ;5r=. 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B e , O ^^w ,,w 2 o ; 3 v2l .5: ^*t: '<^ ^ e: ^w 3w V O is 2^w N-3 -c s. z.P os r^- SuOw^M 5ceHf: -v 3w ?* . i o 0 U =u -i* T3 2 JS e 1 S U2 0^G y 8e ,_ -r] -i-S f -f 3 S 5* 53 3i S -a *2 sSi 3 S z D =< < r - - I] 1 as D S O o* * ^ ^ o ^ o ^ : 2^SS --. z Zu JIfi Zz z o r s; cr O^ V 2O d!/> z z-- v> ? 2 "" z o a S o z *c ; < AA < UJ < 2 3i -<a 8 z = * 'O <c .. oz ,' 2 S 2a -- II << *2 SI 5I x u > aZ < 2 i -- uo. 3 a ^D 3a Z o oy isV - 30 ^ n |3f z= = -- <0--N4 30 -- *oO^r r--^0*4 e. 1 i 11 'll yC 2 C c c g o *%% tj--^i c .s u 3 31 __!__I___S__3" 3 ? S' t ? 00000^5 -- 21 "2 SssBSSII 15. 2 e c c c c^c w c (j , <=* 5 l in Csi <n r-- 2 co 2 5 o 3S 00 2< 04 jxz i %2 = 2v* < -- 9s J 1* U5 u< X^ az ^1 < li^na Silt 1 - a rZ <s c90 43! O 3e 3 ev> w M XeA a0VI. Z c .. 9 2 --O-- a 2 .2 11 1-- 3u 30 _ ** xc -?^5*2.aOS2 -ct 2* c0*2V>cK'o>-sww 1 JZ w <*0* <-3J Tw3 2 '2 5 CL w ox ** 2 2 -S a E = 3E;j 5 o J -a e. S a = 1c ^ JIZ.S u/3 w: *22 ^w 3 siT o S u _o ^ *3 cP r -- Js ~ j si ov 5 5 c .2 .e1r3t _c3 ^ uaJ ^3u 3 c s 1 j p .2 *z -- o US >1 -5 o 5.5 a .! _o .=: 3 - E1 >> >* S . EI Ol * *e 0 " c rroi! >= 5o 00 s Ie rj .i E.2 i'.S: -- uu v; O- C y u jD it -F = 5 w 5;sm n II .5 -e fy o~ is. u0u* . --- --* w. 3. "3|*.-2J"= -o > - ~ ' u i 2 O rN ! i 3o J2 - ,_- J? Sv I'S * ee o * 0c0 'rr--Oo- c 2X - p . u^ (J1 "o _v, *e3 <kJ. 42 S u= -* * 3 -- 2 -=u 3 Cl `-.--3SO522A s--n<=ij-j-<io2k. -3'vSr-u*s*j mw --CO>\ ua u-2ao 2* E2 S.2 ^ 3 S cE3 3 o* .52 a< 2*3 iS y cA Cl s9 " .2 r; >od ~ r; s? . CO .H c 0 : co *5 H 2 n J2H o* : ?>. w !i - c w C o c*u >w>u ' o -O .2 u ^c coi3 3w ~_ S -- "QX. -- o3 . ' S3*3 e Ji-sS C si' - .3 u5 [ 8 5 :. (^j Juj 'A w .2 Q. U o 3 O,,,,y o- Z . fl > i 2U ' .2 jg -- *rr o 00 a o SlU Cu q z -c d9 w a s5 M O =-- , ,1 l-i-8 5 J3 a T3 2 " C sa *" 1^1 . Q. Oc wI 5 oC 6 ^c 5 o V} Q C 2 2-- 22 ^ ^ 2 - J= a 2go i"3 siis^ --o .^ vc a .*?= 00 li 5^3 . <0C ----T03 O OO X_ 3 o < 11 O -5 g s a I Jca*. v< c * -- .'"CS3, /JJJ--Z .2 iA -- e i * t a -o H !L* o8 UD = *3 5 '5 ~ lO <5 0 a 2 ^o 35 z a.d3 <2 3 5g LII _J l3Sl) A AS * | E 3 G.Q "3 ' i: - trt - o >v &s.S. 8 *5 a = 1- Table 16 Deaths Amonc 17,800 asbestos Insulation Workers in the United States and Canaoa Januabv 1, 1967-December 31, 1976. Analysis by Duration from Onset or Employment Toul Men Man-years of Observation Before 20 Years from Onset 12.683 89.462 Observed Ratio o/e 20 or More Years from Onset 12.051 77.391 Observed Ratio o/e Underlying Cause of Death Toul deaths, all causes Cancer, all sites Cancer of lung Pleural mesothelioma Peritoneal mesothelioma Mesothelioma, n.o-s. Cancer of esophagus Cancer of stomach Cancer of colon-rectum Cancer of larynx Cancer of pharynx, buccal . Cancer of kidney All other cancer . Noninfcctious pulmonary diseases, toul Asbestosts All other causes _____ Expected* 282.9 42.6 11.9 t t. t 0.6 1.5 4.1 0.4 1.3 l.l 21.7 5.2 t 235.1 (BE) 325 83 36 2 3 0 1 l 4 2 3 3 28 8 8 234 (DC) 325 77 32 2 0 1 1 0 4 2 2 3 30 11 2 237 (BE) 1.15 1.95 3.03 -- -- -- -- -- -- -- --- w -- 1.29 1--.54 1.00 (DC) 1.15 1.81 2.69 -- -- -- -- -- -- -- -- -- 1.38 2.12 -- 1.01 Expected* ' 1376.0 277.1 93.7 t t t 6.5 12.7 34.0 4.3 8.8 7.0 110.1 53.8 t I04S.1 (BE) 1946 912 450 61 109 0 17 21 55 9 18 16 156 204 160 830 (DC) 1946 845 397 23 24 54 17 18 54 7 14 15 222 177 76 924 (BE) 1.41 3.29 4.80 . __ -- -- 2.64 1.65 1.62 2.09 2.05 2.29 1.42 3.78 -- 0.79 (DC) 1.4) 3.05 4.24 __ -- 2.64 1.42 1.59 1.63 1.59 2.14 2.02 3.28 -- 0.88 `Expected deaths are based upon white male age-specific U-S. death rates of the US. National Center for Health Sutisiics, 1967-1976. Rates arc not available, but these have been rare causes of death in the general population. (BE)'. Best evidence. Number of deaths categarixed after review of best available information (autopsy, surgical, clinical). (DC) . Number of deaths as recorded from death certificate information only. t ablx i/ Deaths amonc 17,800 Asbestos Insulation Workers in United States and Canada. January i, (967-December 21, 1976. Analysis by Duration from Onset of Employment Lung Cincer Pleural Mesothelioma Peritoneal Mesothelioma Duration from Onsel (Years) <10 10-14' 15-19 20-24 25-29 30-34 35-39 40-44 45 - ` Number of Men 8.190 9.063 9.948 8.887 6.596 3.547 2.020 1.108 1.448 Person-ycm of Observation 26,393 29.003 34.066 31.268 20.657 1 1.598 5.403 3.160 5.305 Eap.` 0.7 2.7 8.5 17.0 21.0 18 4 1 1.5 81 17.8 Observed (BE) (DC) 00 75 29 27 59 57 105 96 112 103 65 57 40 131 69 53 Ratio o/e (BE) (DC) 2.55 1.82 3.40 3.17 3.48 3.36 500 4 58 6.08 5.59 5 68 4.98 4.93 3.82 3.89 2.98 Number (BE) (DC) 0 0 t 6 13 9 15 4 14 No./1000 Personvears (BE) 0 0 0.06 0.19 0.63 0.78 2.78 1.27 2.64 Number (BE) (DC) 00 00 .3 0 32 19 3 23 6 19 5 16 3 29 5 No./IOOO Personvears (BE) 0 0 0.09 0.10 0.92 1.98 3.52 5 06 5 47 `Expected deaths are based upon hite male age-specific L1 S. death rales of the U S. National Center for Health Statistics. 1967-1976 Smoking habits not taken into account. (BE): Best evidence Number of deaths categorized after revie* of best avaitabie information (autopsy, surgical, clinical). (DC): Number of deaths as recorded from death certificate information only. CO *3 g J{ o' ^ -3 -= u -3 =-oC 2 3 .S g j3 5->4 -" 3-> = 2 = = 5 " = s' `g 5 " - : ;3 5 3 u" y --* c j> C2 S 2.2 w --ft ./ " .2 ,, C . g o. o-- - - wc. _r_ ilf: - ., -a w o ^ = 2= 2 .% 3 i -= -3 o s y = ^2 1>J <L.2 2 a <2 5 .9 5- 3 - - 3 2 3 3" .= *233 o " "22 - ---- -- c e > s 5>2 S- 4 .2 ^- 32 " > n 3 "5> c -: 2 i'.f 7 .5 - 23 -a o 33 c o /* *= ii 2 * = ^ r- = L 5- i : u= o -D ?3 -= * ^ve - - 3H _o 5 .2 3 3 .4 'J J 1 -- ^ J* C o 2 .d * ~ -1 ^ |-2 J2j.? ^ 2 a ft .2 C JK 1 23 2 -a 2 C J! = -a u g = e 3 r2 5wX2 ^^ * w If ^ U -- 3 >>y a - u S -- ji - -3 O '1 V3J u UfC S 2 g3 2- 9S S .2 <= 5 5 2 s = Z 1 ?3 SI i-s-3 1 it = -J 5 o * S2 -JJi r SO y C v * *- = = 3 5 C w 2 "3^ ^ s -S C. u >, n * ^ a y -- o S %. s.3 xc y- g .O - '- w u_ *- 5? I*3- e u *-- O jz .. Zz 5g il 3 z >* 275 * .o= ^n xs .2 ow 53 i-J-o-JuSaJ* <j -- 8-S ;-- e o J |' coc u 'ft ^ oo 2.5 B _ 9 8 -S.! S (J c v -- U JS 2' 3 5 S - | J^>,-J=- =:s J-a a s pi 5-3 -~J5 u ^ : oS - C 3 13-2 _ Sju 3 S"5= 3 2. -5 yw 3* 60 U 1. 3 C C -- .> ao 5 1.5^8^ 2 5 w * -z .2vl 3 n * -s % Ji SLa -if jo _ *&= ^" -3 3 " ** j 5 < ao^^ao^C-- C,,0^ -- M73 ai l2 -z r* | 'j ~ =i dc /l < i22 2O X 3 522 . < -> z \ 1 r - < - 5 > r- p* S ^ - : O s 5a: << Z>2 <4 ^22 SI: :2z< ht^ .K>= :m3J 1: 29*7 4o !32 di i s =3 i.3al3 5 1 Si --u o ^Z St -9 <0 <*N | J j /\ ri fS'NNIN'rt -- -- K*l O' *r ^ *<3 --. <-9 O 3 ^ <s rvi -- o -- Ci -- 3^ r ^ r** ^*9 r-* ao O O -- r*( -- o <-7 ^4 -- <4% 30 f-\ 1 o N 30 t e--+ '--O d< S 'I VI = ^ C 3 2 2 JZ y1 3 JJ = g. " J ^ "5 = `5 2S3 ri ^ s i ^ .2 yr 2 -35 -- Jv 2" 111 5 3 * y y2w ^ p- ^ 30 . O " ** " --. i-9 rs* -T o UO* Z.s y30 -*3j "T- -a -s: C^ fS *U i 5^ 3 . oO y y 5 "-- JC & -3 ?? 332 7c3 23 5 c 812 * w-- `3 = Sf o = J5 = 5 3Sor x 2 2. o 33 ^ ooo .>.= O I 8 S _ __ c. -o i 'j; J3 0-5 o 3 "3'o ? IS .1 - 3 5 -= W-- c xs w ; s: 2 3 a 3 3 ycu* uu c c7u- fucul ricuv <cy w-- II-I C oa. C- 2 U U O O UU OOU <. ill2 = * ^ a " 2i! -9 -ua --*"ua --3s -- m u -ear si Zaz y ^ ay'j as a 2 co in a CM cr> r--! CSi z s' i zS co z a" J5 a0 3 (M mM U V> 4o r- y 0 xO -z >2 5< 1J <O 53 u< z < o 2 < O--rs'o.or^'C'rV *N <-< go O <- O O f-* i^ o ao oe w*> -- -- 00009 -- rsi -- .. >ooooo^o<oo OO -- O 7 <i P P O f oo -- -- ~o -- -- o -- -7r*3sON 00-*"<"9INipip<^pj *'9#PPiAf900' O'Op-VdpsivvrNob -- -- rs#-\ps-- -- -- e y .2 Sf 33 5 " * S; ^ .= ii. 3a 3-- ,2. "a = || WO sm S%i *s G J2i,* <vi ^ v ^ 51 w *3 --IN(9N_(S 11 . S i ~z 52 -- rii,9n(NM7(s C z ? 5-i| 2o^ uo " > .F ^ O -r O T O Sw7--T*d7'oV1*o7OT'^*2o v"* -- > -r ^ ^ = 5 y. *5 -w* o~ -a ji 13 i 4-0 -S2 2 555 - d " z "5 J -- 3 =J -U Ha 2O 3^ o a. 3 s? b 30 uc *-> o c *jr u y jz -e s'-? <8 e-- oc ^ " c 33 .2 _- c H ^ j! *h v - 32 y c --y o = --y w3 >n`G a 5 S3 s = 3 ^2 u 00 98 c - >s e*c 3 " ^ -- y ' JS "X vO'Ji c5= ^ -<J 88 -- < a a D Oc ^ 7 3 3 73 5 3 fl * o O /wf y 2 Hf S * jc oco j*-a> 3 *_a3o .2 c X 5 "= t 2-2 : " 3' 5o_ c--" fla w *r ---2 : 2 ij - " j= u" --55 o3 0 o2 -75 " v. 5 g = . " s 3 J a o- 2 a C J -3 Ifo v* S "? -- e `C c oo. Oc ow JU: o ua xy uu o 3. ou goo-ar _; 0O -^2 *:-0* -o 0 o _2 'r 2 ISjI 5' o> O 3-,S5 T? ;o8o^ i"d 5 r > t 2 -w ou5 yay >ouy3a. 'SSoJjSl'! =o s= 2- 3r j- i-3 in -2.-d "E'-=E?>gi o 8 x-'5a *" 3 "3 | s -^ " i=hr"'s Zo 5 84,3Ssi'5"5cO! S>Jo2iSa.sS.5|go?r--..S2gS^-| 5 or **; S 2tJ3yaO<^;o-- . .r: 3 S' 2 -- ^ o15 = *:ii33 o c2 Ui H= < (J O z < z o H < o p ^. * " y vs V3 w ^ta*. jsS^ a55 a-5-s s-.-sg * .. g'g 2 3j|i s * 5 u yCj > ^ ^3 3 C T 5 * " c3 *rt-_r,?2. ^o wo >.--= z X <j * --e... SoS j; V5 - 3r,i;'-pogi*! !eZ = ^u_ -^w .-' "un eo " vi 2 - =53'S3i2s?-_ --'J *j --yNu ,C<-* 3w ^-- --e -^r VO3 ux 2 .S = c = J2 .2 " _ --, C. Cl c. %3 z 3c. 8c vSc |I 3 g ^ - 50 M ? S 3^1 5 = r* o 3 --o SS 5na S 2.x .2 . 2u *-> "3 J--Z /'J\ s *-- '3 w i J = -3 3 2V 3.1-2 in 0=1 5 i * * 5; -*>== =i .iy 2 i- JvS jo a 40 * j -o y if = H - = .i * ^ T; " .--2 ->> = 2.2. i7.22 a. o ^y il yi -- o/i ---- _v 3* y-3 ** u3 2* C -y . y = - v-- y 2 = ^5 u* 'S - -3 ^ Hi- * r-i Vo | u 2 J i -5 4>i.. -3-- J.- <-- O sJ 3i == ~ s -2 5-^ = 2 2 S' 2 I '5 r s ss u A : ;5 c =-- * u -- 5J 3y* ---- j .32 r* * V! 3 J Z *J 2 w 3 = 2 5 jS " 5-- S 2 a 3 -3 - r?; _ "3 22 - y a> - - -s c _ c -3 2 -2 2 y $ J3 2 a f'jf-V- a EhM "5 3 O " 3y EM 5 o2^ r C y -* 3 J5.2 *5 3 o .2 u" i\\i^ 3 J3 OM2 y y ** j u >- 5 - -S =y - -'* "o v y oo2 5 .a y y y *j ^ m ifi-- C E i3 5iB r3i * 5 = 3 = *5 21 = *l = S "3 V 3 535,J:i2f|Z J! O * 3 __ y a 3 y . **3 y =*-=*53 c y g ..= ara J*r>f 1 -5 J c - o i : o > 5 >* W z i2 y - ^ "3 = * 5f "s2 *2 y vi is' > ll / ' bw3-V. s 1 =3 .5ra 0y0 "_3y 3 5 ?J 3= C 3 4 41 ? '*4? 4 a -z 2 ?!0 = - ?y _> r--t '3 -* cV5I w .2 c.2 * E f* =s* Sy-o13 3-1 2 L -= T=3 . 3 3=2 = 5 ss,.n a -53*2 C 3z = c n %>-?, v jz 2 ^ i . --2: va 0^2 ' 1: 2 *13 5D0 ^- = w w J: i ,ir*a 3V 3 ^35 = j ^ e~ Jii: ' f N ""W5 J J5>S j{2 -^ s E ! j-i -E 5 ^ - 1! * ~ -- c U 'o- r- =o 2. j J-? 3 i>.3rj -- ra 2. C2 3 *3 *5 >n - yi -3 - -SZ3 - 2 5. . ; o j; i -Is 90 - ?* --3 a ^OO290-yer3 ^> /y* e y/> y ui < 'o 3 > --> y o30 n y > = 3 .3^2 s^~ 5=2 S 4 j=o $ c3. 3 E S o3^- 2E 5 2 W i'o 9 5 o if -- 3" > & c^ y ^=5 u 52 ~n taen >s *y * ^O- = 3 dS |? I -- 2 y = V . C. a > - -- n 3 15 - v 2 c 0 *= *= 3 =; y i i -2 = *- -- rr .s 25 I f* > .-- T9 5j.r :-3.5 Q c 53 "^ 2 S c- y I i g Z i jf 2 iP? 35 3S tils - 'J ^__ rs / wO " -/5 o r -Ui s= Vy? -3y w= I2> SB 3 2 3 11-3 z y;"3 =2 < O 2Z*y y v_ C _ 20 a, --S !--" Sc -1-5 2 il 1 I g l-il'l 3 32 = -- 2 V) -3 ! S = M: C > I'E. y0i a sftl* 3 in S 3" <J2 o3 3 fc- N 3-- hi >-23 -- s i> 5 c > -* 2 ii|;! 11'5 32 o -- ^ w ~ S w. U 01 >. su id . 2 3 2 .2 z2 8 _ 3 y* C i -- *9 - *5^-3 uC a O Ji ra v: .3; Jo 2H ^ -S rt'0 O a ~ vi vi 2 "5 CO-a 5<S 3 o| c c '3 cCc ^ = .2 -2 1 2 a3 3-3= e^Uo = yJ--s '2Z=--r3s o a. ^n -o= U> My *U- n c "=b J"h. --a w3S ts O . Si E l>i- ^ T9 y 90 2 s rs -o S 13 e o 3-5 1 -- yc C Mi 1Z 2 <yj ^ s *J cw o3Cs. --y** E 5 S &5 > < : ao if 3 ^ <* ^ i 3851 ^-5 >> u u T3 1 n Uc3Jr a-o 5s 52E 2 M . J2 a j* y= Qc , 1. 3 y-- < f ' : s"3 y .J 7 -- js u 5 e f - cJd .ti.22 C. a a a *a a . -- 9A CoO -c !_ S.l-5 f -3 = = :3cy 1 a = a r'- a O 15 . ; 3 iCf. 73 5 '.; cfelo ^Q0 cT9 .-25 ;; 50 5 *roj .2> -W3 ^"tl .g2. U ; C O-- ll ~y a: o y. .11 a--2 ?s -- c. c .5 r ; f u a. a J_ .y o a " aS y3 >y C -3 o 3 2 " 3 - 3 - o 5 K-?. -2 V fj 2 v 3 y 2 -- MW9* ^v* .-*y3 r y 3 o -i-s ?g *85^lls^ - 46S0 XE3 h. j*2gs & Z dL 'a X. g ?2 %y M- ^ .22 ,1 s23s a =f > 3 ~3 "T T9 M -y - =t nC .S -- 23 aO 7 = a C 853 ._2 op $ Ku u 5. 2^ a 5 -0'oo 2. o 3 a . 5^ a = 5 - a a= 5.1! a x 5 a S T9 2: O o >. u = ? =y - -- e- _5 *3a *i^ E.E A *5 3 2E. 2E y W .. 2. 3 *y 2? o T9 , -32 , *3 5 : wo 3> ^ _- 3 !J " >"3 7. u 5?a3|'l".|^ 2=3 I 3 5 r1 a : ,, 'i 4 1 j.?,* Si a: Cl 2 cc y y *3 ` c / c " o " " = a3 j31 = Z -t y - ;; s. 90 . rINv| S -- .32 ?2 90 *= if -3 --*> -- .c >% y s .y2 -j -i 3 3 iS a *3 O Cc ^ 3 .i 2 ^ ? _ =_ .== A 2a E *5 3 5^ t- - "3 s ^ S. f9 o if m* ^ - T9 33 rj ;3 ya a = _32 G3^22" erac(J J! c * Sa3 'V 3a U (-<n 5.^ ** ui 3 .12 1 o -aaCfl.Sa SS26Z.201S > q ~i c' O fpyl sis o?"E- Pr ?*_* Su w If2 = 5 4 32 3 s -g * y 7 C M2 2* c .J c 3 3 n - -5 > E ^ c 2 yy. .S c i "5 ^ 2 g* JJ 3S 33 a 90 : S SL: 3u1 111 8 2.1H Qw = 1 S -5 '= 5^= _ > U " . c e2 o- 3 - C-- > c "o y ---- _ c .= oja -- u X Z -3 Wl >>(J u o 2 90 c 3 a co 5 3 y o i3- -- a) --3 o -a -- 3 3 C O ) ,, 3 ^6 y eo > 5 .. y -- o s S > y S. E= ^ _. -- 2 '5 k y s Ti 5V 2S'"u3 '= s.153 3 i8! 12 nit i e f iz 5 i$ 3 O ;s H3 1 = 8.O II si 2 82 fl Hi 11 3i l53 l1;E * TS c Eu (9 73 if .. - 3 < <y w ^ u u . u 0 3 > c*15s 18 E j= - -- o P .2 s fo J P c <a -- co a2 -3 ^ .2 8 a "* .o = * u cn 3 W"2 3P. "2 "* 5o -S C C0 y S`o 2 2 -- C u UUQ su 3= G | ?-3 g3 ._ " - 2 = " v 0 2. 3 3 k. ^* . *= =* ^ U y u o' E >J5 >s 5 <9 = t* y -- *3 y ; ys A -- T9 a **:= ysn 2 co y g. y 3-5= c ^>,2C -c- JCZL "P il 2 *o e -- ' y v 55 vi 3 a-a a 20 -- o"-- -- * .2 ,o o?.o 1 3 1J i y o J= = vi <9 dE _ >. M >* 3 a O s: e "" 1wy5 ** *3? Q. > w >> C--Q (9 w O e .s 'T o y "5 cm > 3H k. ^ - j *S >N >% s : c O c= v. -- O V -3 y ;5 s - 13O 2*,2x a -U 8 o wy )Z - ? y 3t S ^ -a .12 3 - *0 2. 2 u y0oM *!=-- y 2 -3 a a -5 5 o X. y a 2 a c60 PUi ow =_ 51 -c _ o iz _ __= J D 3 -2 si c J{ -a my ^ ^ rn .a a s - 60 2> c 2 2 ?3= y -S'0 J- c - y --J9 - --S - eJ id - 2 3 s .= c 2 <n o o . ^- x a vi 0* 5 'o >L . .9^ 3 Cl (>j 5e <9 y = 1 C o X U ^ C 2 o c 13 5^ eEg {f - s2 U o s? v? .3 X n r " --r *-33 c vi ^-cow -.= a5 > y^ >_> 2a -ax 2 E5 d 5 3 :aa "5l. sc -:u y -O S-g as a vi g.3 -xMrz vi = c ---. > - 3* -* GC* --.S=3 3 7" Er rt y oVI O -3 cu s9o0"T9 60 .c y a= *a co -- w 90 "O *3 O a ^< ^ y -= --C 2 uua--1y25I i -8 ~ij5 S e .a 35os 2-^ 'r3k* C -- y *o = a y y y --^ o a -- 10 r r-s aa w-- -r. yy --_* -n -"E v o <n gC -3 u>I \ O -P c 2 21 a^ 2 |3 a &y yxy >S y O *" ^ o (= i^ u y c i-l O2 yy'Ts 'C- --2 - u* - - *--2 ,Ws ujf y 5-3 U*Jrnc^3-3300-0. 3 ** Jw? -O. *90 y y yw 3.--= >1 ~2m i "3 S * x yU -g 1 - 2 y k. e a ^ ,1 - 1 3 i S - it m t( u Ov 3> f^i .e-- c9 scz = ji. 3 E ry O-2 5y-*y o " w^ -y >1 a y -s" .= -- a sy y *= jaa a 5 >1 >.:o a w *2 *= 3vi.-- JJj "a T9 32 .a y y = CC a Observed m onalily among (his cohort was compared w ith an expected m ortality based on the experience o f the entire United States white male population living at the same ages and time periods as the retired population under study. The modified life table method, described in detail in un earlier report, was used for computing the expected number of deaths.* Inclusion o f disabled retirees improves coitt|>arabilily with the 10 to CM a% r* CM CD r h-- t 6A /-V f<tj 'St <5 w- %0 A H < A</ VO = > -- u. 2^S 0"H <QZ - z O' i <2 55 X^ U< V) V) 0 HI ts 9 Jj xa -ju A < * cu 3 -e . -g S , Z -2 -5 -- ^ 8 -- c. < z ^ .2 ?5 -s 2^32*55 55 a* .2 ^ -i 5^ 3 8 ?i^ 2 i >5 e -1a ia^1~ i1 = = 5-13 . ^ "2 Z J c 02 51 2 '> > H fMi3* 3 ? 5 ? g 3 38e* a n 0 ** o'-S-i- o = = 5 3 Ji < V 3-- SwO- J9* ~wd. .-2 s 'ii 9 as 2.3-2 -S'- v '> ri ;- ^ Uj s '^ -3 > _v fj -c *t 3 c 5 ^ = c " a "3 * ^ Crj.-33 S-S _ "--3 '-5/I --s 0 .5 C - y 11 v iO 33|s% 3r. -O0 3J z >s- jz ^ X'Lw2 y i " "" -3 1 2- s S ^ " 5 I * so' >* c , "V3 1 u x) 3. jz -S^.2.^2 - O 11 v w^ ^ O c5 u _* 5 7-35 5.. 2JS? r--<t ^ ^-- O V <_ U - *J > 9* oe "w3 * * *2 s = V t 5 e* y O & 7 m > VX *1 ^ 5V w i5 '"32 _ --^-- >* 'c=- U -5 --. ^-n * --** wv 3 H j:|U >o*** tw_ a"S5 3 J> -Q _ 3 rt _ = 5 3S-= y 3 2.Sj2 U ^ 0 .y s_ 1u ' S' o 8c 2 c3 r8 >1c."*M> 1 O3 . i* 5 * * -y5 *-3g 5 " 3 11 -.3--C 33w 73 > 3C5 3 J -Z -- j ; ^ :*3 51- 1 3 20 ,, H ;r< : r-- --w Cw tw, wy t.riy 33 5 i- .Z Z' -3 "3 j .3* t ^ ' y ~03 53^ *--- cfj ?i3 w U 3 ~ 3 >1 :3 y ^ --5-~u3 nu *3 c v>uS3 ^n -3 t 3-- Cy y r*\ >S --^ J4JI SocC ^rti^3yvc5c 3 ec i S5 II uU C Si^ !-:? II 5|| O v O f3 | irt u >^ 33 J.2 -- -5 ,2 = ? .b 2 s'Z o* jn uUw3o v 3u .S*-- ru :"oc o .r J B. g x .2 -- 3 c y ^> > -- 3 -M O jj * "3 "o W>* >Ji .o2 ^ c. 2 c= > v5 - = M~V 1 Xuw i " *2 2- g j = C V rX S* 2I ? 2 * ? 2 E rj --C3 -- u - *r\ -S " ** >, C<1 -J> z >> y = A A >s . _ 03 -- s'is ! ^ " a = i - y> -a 3 Oso 2 * B -S 1-3 S : J? -3 C J-E rj T3 2 .> ? s5 ' 3 l : -5 ! a S-^ -s i ^ i/ -- c ! y u *- -a 3 ^UC "--^3 E5*.s 3 5o i B i 11 i ? :12 V 'i ~y n- U -- O* uW >i --> c 4 * u -O c5 *| o *5 'i 3S y o O p *" JS -- w ^ ft ^5^ J *' B 2 J < .ir y 2 ll, j c. -3 s -_hru3*. u* y 2 .,, r-> : s = = - 53 T--Z .5e va^ 'vJ --j 3 < > ^ ii"B-o & i S 5 3 3 i *--o aa 2 5 2 S05 g 2^1 88 J3 S3 tii g , o _5V5* 2it - II tfs 3 13 g C - (C = ^.^2 _Z. -3 W & u 3 B> j{ ->.8o ^,3- o 2 Si`CSo = * i; f 3yy^2s si ii -s I 2^ 2 S^i o J5 3 S o ! *0 7* J= a - a * u 3 .2 a e aa 2, - *2 11 I 3 I ,`5 * Ji 0 *2 -Jl 8f i-| f 3 II 5 >> 5 a a1 K2 X^ oS wU p^ IS: xT S -O--v o. "Cft 0 0g .3sC --^^J3S fo V -S a ^5 8 =: H S 2 1 aa 2M 3 .3? a E -5 = a 2. a *z = 111 3 < _ "7 0 -' ^ (=il5*-S2 r045.2^ = 3' "If >- c: ) -/i c cl '3 - --I 5 a * 52 Hi <1 5 ! 1 fj v j* "o t ? jj 3i8 If * <% *6 o i: oe > Z 2. - 2 2 -- .1 g c --*.- g* =2 iii fj ^ *0 1 C 'O .2 Is 1 i Ca 2l u c "3 48 Jj u^ ca Sf 3 2 3w % 4 V3 I5 a^ ^ i o aaa.. > St H< w> 3 i: o > * JJ u X *-t Z-- 3 = 8 3 ?o e 21 VI Cal 3o ?U <5> V z * o 2: d 52 ---uauc . 3-..^2 2 8 -S..S .25??,vn7" Q3C a'*. i *9 J i _5 1: 25 3 z -- -- U d VS cx32 << IO (A :z <3 z S >0 . 5 < ^ . 15 jjjja- 9P 5 "S i e ; ^ ^ L"! = Jo u a. - ='!;=; xo 5 :0- 2c sc/>' O *3 . <1 >s zee. ---s4<- :<y z 1 z co 2 X- . sc * . V 30 '5 < Ma*ai 3z iO '*/> - >* to ^ > s PN , ] 3(J *a 5<--I *i i2*--" wO ' mw I 15 aS U '"i * l"|< 5T ? 3 ^ y? " -! o s1 11.X11 ga.amc* rJu _-^ E-s~i (3 = > 5 s-s ^ m- 23 Pi$ = :. ;3a2 < 50 ! 2U 2 r. aj >2 'J >3 J C VJ ^ 'j W .u** ^x*^^. --O, - < .2 -N < 2 j= O. v *3 ^ *9 Ul< 3-9-fC 71 * uCj 3>!3 iijjji . -i X < - p*" . 07 -. 2 - c y ";- :<;3^ :; : uU ^ -1 ^ *C fii -- -- --, - 3a a b:T: vi r* --^ O x 7) A i< Z .5 x 7) U. : - 7; 'Z : ? x-- r ?z _ -> c -- 0 .= ^ x -3 O a x :2:S e 7i < ;-<-c < X 7 '.2 - 2=7 .0-5 w^j a- S>V -3 f ^ ^:.3S w e -- C. a- -- d y) ::> </) 4 y z e y3 0^ Ii X --= < ! vi --^ O -- r*