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of AAnnEaEpTippoitsddeeesmnsitoollatoo. ggiitcche MMooCrrhtteaamlolliiittryye SSttPuuldadynyt of Employees at the Chemolite Plant LJLaeecooknn'aasrr.dd MMM..andSSecclhh,uummaaMnn,,EM..AD0.. Jack S. Mandel, M.P.H.~ 5 Eptantology Associates Epidemiology Associates 373.3c3C FFeebbrruuasreyy,, 11998800 1229 EExxhhiibbiitt 1229 State of Minnesota v. 3M Co., Court File No. 27-CV-10-28862 11222299..00000011 33MMAA0000663388777755 An An Epidentologle Epidemiologic MMoorcttaalliittyy SSttuuddyy ooff EEmmppllooyyeeeess aatt tthhee CChheenmoolliittee PPllaanntt tatroduction Introduction AA rreettrroossppeeccttiivvee ccoohhoorrtt mmoorrttaalliittyy ssttuuddyy ooff eemmppllooyyeeeess aatt tthhee CChheemmoolliittee PPllaanntt iinn CCoottttaaggee GGrroovvee,, MMiinnnneessoottaa wwaass ccoonndduucctteedd.. AAllll eemmppllooyyeeeess wwhhoo hhaadd wwoorrkkeedd aatt lleeaasstt ssiixx mmoonntthhss aatt tthhee PPllaanntt wweerree iinncclluuddeedd iinn tchhee ssttuuddyy.. TThhee bbaassiicc oobbjjeeccttiivveess ooff tthhee ssttuuddyy wweerree ttwwooffoolldd:: i1.. TToo ddeetteerrmaitnnee wwhheetthheerr tthhee mmoorrttaalliittyy eexxppeerriieennccee ooff eemmppllooyyeeeess aatt tthhee CChheesmoolliittee PPllaanntt wwaass ssiiggnniiffiiccaannttllyy ddiiffffeerreenntt ffrroomm tthhaatt eexxppeecctteedd ilnn aa Ppooppuullaattiioonn ggrroouupp ooff tthhiiss ddeemmooggrraapphhiicc ccoommppoossiittiioonn.. 22.. TToo ddeetteerrnmiinnee wwhheetthheerr tthhee mmoorrttaalliittyy eexxppeerriieennccee ooff eemmppllooyyeeeess iinn tthhee CChheemnitccaall DDiivviissiioonn ooff tthhee CChheemmoolliittee PPllaanntt wwaass ssiiggnniiffiiccaannttllyy ddiiffffeerreenntt ffrroomn tthhaatt eexxppeecctteedd.. MHeotthhooddss AAlLlL eemmppllooyyeeee rreeccoorrddss ffoorr aallll ddilvvi~ssiioonngs ooff tthhee CChheemmoolliittee PPllaannt aarree ssttoorreedd iinn aa cceennttrraall llooccaattiioonn ((PPeerrssoonnnneell OOffffiiccee)).. TThhee ppeerrssoonnnneell rreeccoorrddkkeeeeppiinngg ssyyss-cteemn hhaass bbeeeenn ddeessiiggnneedd ssoo tthhaatt ccoommpplleettee rreeccoorrddss hhaavvee bbeeeenn mmaaiinnttaaiinneedd oonn aallll eemappllooyyeeeess wwhhoo eevveerr wwoorrkkeedd aatt tthhee CChheemmoolliittee PPllaanntt.. TThheessee rreeccoorrddss aarree aallssoo mmaaiinnttaaiinneedd ffoorr eemmppllooyyeeeess wwhhoo ttrraannssffeerr wwiitthhiinn tthhee 3IMM CCoorrppoorraattiioonn.. TThhuuss,, iinn ccoonnssttrruuccttiinngg tthhee ssttuuddyy ccoohhoorrtt iitt wwaass aassssuummeedd tthhaattaa ccoommpplleettee rroosstteerr ccoouulldd be be aasssseemnbblleedd ooff aallll eemmppllooyyeeeess wwhhoo eevveerr wwoorrkkeedd aatt tthhee CChheemmoolliitcee PPllaanntt ssiinnccee iittss opentng in 1947. opening in 1947. AA ccaarreeffuull rreevviieeww ooff tthhee ppeerrssoonnnneell rreeccoorrddss iinnddiiccaatteedd tthhaatt aa ttootraall ooff 44221188 h1a3dd bbeeeenn eemmppllooyyeedd aatt CChheemmoolliittee ffoorr ssoommee ppeerriioodd ooff ttiimmee ssiinnccee 11994477.. OF Of tthheessee,, 33668888 wweerree eemmppllooyyeedd ffoorr aatt lleeaasstt 66 mmoonntthhss.. TThhiiss ggeroouupp ccoommpprriisseedd 11222299..00000022 33MMAA0000663388777766 a he baste conan for sat. the basic cohort for study. : IInnffoorrmmaattiioonn wwaass aabbssttrraacctteedd ffrroomm ppeerrssoonnnneell rreeccoorrddss.. IInn mmaannyy iinn-- ET ---- stances a number of records existed for a given employee and these records sere stored fa diferent areas in the personel office. Nevertheless, were stored in different areas in the personnel office. Nevertheless, 411 sources of inforestion were ascertained and the appropriate daca a].l sources of information were ascertained and the appropriate data secacted. abstracted. For cach tndiutdual he following fnfornation was coded onto Fortra For each individual the following information was coded onto Fortra~ coding sheets: [-- Employee number vaneName ratress . Address Seinghons ser Telephone number Sostal corey ster Social security number sorSex 3 strendate Birthdate -- Marital status Date of first employment at Chanolite Date of first employment at Chemolite Dace of Last seployment at Gheneiice Date of last employment at Chemolite A Period of employment in the Chemical Division Status (current, cetired, deceased, disabled, latdofe, Status (current, retired, deceased, disabled, laidoff, . Sranatereed, terminated, seam not stated wnt transferre~ terminated, reason not stated and retuened 0 schost) returned to schoo!) SE -- Date of death (if noted on record) Area transterced to (5 noted on record) Area transferred to (if noted on record) Fo each of the 3688 enployess, two computer cards were punched wih For each of the 3688 employees, two computer cards were punched with the tnforsacton senttoned ove. the information mentioned above. : # computer tava Testing the name, ssetal security mnber and Birches of A computer tape listing the name, social security number and bir~hdate of 11222299..00000033 33MMAA0000663388777777 1a!1 bbuutt tthhee ccuurrrreenntt eemmppllooyyeeeess wwaass ddeevveellooppeedd aanndd sseenntt ttoo tthhee SSoocciiaall SSeeccuurriittyy AAddnmiinniissttrraattiioonn ((SSSSAA)) ttoo aasscceerrttaaiinn tthhoossee iinnddiivviidduuaallss wwhhoo hhaadd died during the pertod of study (1947 = 1978). dieJ during the period of study (1947 - 1978). AA ttoottaall ooff 118800 ddeeaatthhss wweerree aasscceerrttaaiinneedd ffrroomm SSSSAA rreeccoorrddss.. FFoorr eeaacchh death the state of last residence, the state of last employment, of the death the state of last residence, the state of last employment, or the ssttaattee ffrroomm wwhhiicchh tthhee bbeenneeffLitt wwaass fFiilleedd aalloonngg wwiitthh tthhee ddaattee ooff ddeeaatthh was listed. This information vas used to obtain a copy of the death was listed. This information was used to obtain a copy of the death ~ cceerrttiiffiiccaattee ffoorr eeaacchh ddeecceeddeenntt.. UUnnffoorrttuunnaatteellyy,, ssiinnccee tthhee mmoosstt vviittaall ppiieeccee ooff iinnffoorrmaaattiioonn -- ssttaattee iinn wwhhiicchh tthhee ddeeaatthh ooccccuurrreedd -= wwaass nnoott pprroo-- vided by the SSA, acquisition for all death certificates was a formldable vided by the SSA, acquisition for all death certificates was a formidable task. task. FFoorr tthhoossee ddeeaatthhss ffoorr wwhhiicchh aa ddeeaatthh cceerrttiiffiiccaattee wwaass nmoott aavvaaiillaabbllee ffrroomm tthhee ssttaattee ooff llaasstt rreessiiddeennccee,, tthhee ssttaattee ooff llaasstt eemmppllooyymmeenntt,, oorr tthhee ssttaattee ffrroomm wwhhiicchh tthhee bbeenneeffiitt wwaass ffiilleedd,, aa sseeaarrcchh uwaass mmaaddee iinn MMiinnnneessoottaa uussiinngg tthhee MMiinnnneessoottaa HHeeaalltthh DDeeppaarrttmmeenntt''ss ccoommmmuullaattiivvee mmiiccrrooffiicchhee ddeeaatthh iinnddeexx 11996622 =- 11997788 aanndd tthhee ddeeaatthh rreeccoorrddss pprriioorr ttoo 11996622.. IInnffoorrmmaattiioonn ((nnaammee,, ssoocciiaall sseeccuurriittyy nnuummbbeerr,, bbiirrtthhddaatsee,, ddaattee ooff ddeeaatthh)) oonn aallll ddeeaatthhss ffoorr wwhhiicchh t[hhee ddeeaatthh cceerrtciiffiiccaattee wwaass nnoott aaccqquuiirreedd bbyy aannyy ooff tthhee aabboovvee mmeennttiioonneedd mmeetthhooddss wwaass sseenntt ttoo tthhee WWiissccoonnssiinn HHeeaalltthh DDeeppaarrttmmeenntt ttoo ddeetteerrmmiinnee iiff aa ddeeaatthh cceerrttiiffiiccaattee wwaass oonn ffiillee iinn tthheefirr rreeccoorrddss.. Utilizing these procedures, 168 of the 180 (93.3%) death certificates Utilizing these procedures, 168 of the 180 (93.3%) death certificates wweerree aaccqquuiirreedd.. IInnffoorrmmaattiioonn oonn tthhee rreemmasilnniinngg ttwweellvvee wwiitthh aa rreeqquueesstt ffoorr aa ccooppyy ooff tthhee ddeeaatthh cceerrttiiffiiccaattee wwaass sseenntt ttoo eevveerryy ssttaattee hheeaalltthh ddeeppaarrttmmeenntt eexxcceepptt MMiinnnneessoottaa,, WWiissccoonnssiinn aanndd NNeeww YYoorrkk.. MMiinnnneessoottaa aanndd WWiissccoonnssiinn wweerree eexxcclluuddeedd ssiinnccee tthheeilrr rreeccoorrddss hhaadd aallrreeaaddyy bbeeeenn rreevviieewveedd.. NNeeww YYoorrkk wwaass eexxcclluuddeedd ssiinnccee tthheeyy rreeqquuiirree tthhee bboorroouugghh Linn wwhhiicchh tthhee ddeeaatthh ooccccuurrrreedd ttoo 11222299..00000044 33MMAA0000663388777788 . aJsscceerrttaailnn tthhee ddeeaatthh cceerrttiif[iiccaattee.. HHoowweevveerr,, iIff aannyy ooff tthhee ttwweellvvee ddeeaatthh cceerr-- Ctiiffiiccaatteess treemmaaiinn oouuttssttaannddiinngg aafftteerr aa sseeaarrcchh bbyy aallll ootthheerr ssttaattee hheeaalltthh deparenents, then an attempt will be made to access New York vital records departments, then an attempt will be made to access New York vital records. TThhee ddeeaatthh cceerrttiiffiiccaatteess wweerree ccooddeedd bbyy aa pprrooffeessssiioonnaall nnoossoollooggiisstt aacc-- ccoorrddiiangg ttoo tthhee IInntteerrnnaattiioonnaall CCllaassssiiffiiccaattiioonn oo.ff DDiisseeaasseess ((II..CC..DD..)),, EEiigghhtthh RReevviissiioonn.. AAllll iinnffoorrmmaattiioonn iinn tthhee ccaauussee ooff ddeeaatthh sseeccttiioonn ooff tthhee ddeeaatthh cceerrttiiffiiccaattee wwaass ccooddeedd.. TThhiiss iinncclluuddeedd tthhee uunnddeerrllyyiinngg ccaauussee ooff ddeeaatthh,, iinm-- sediate cause of death, conditions related to the immediate cause of death mediate cause of death, conditions related to the immediate cause of death ((rreeffeerrrreedd ttoo oonn tthhee ddeeaatthh cceerrttiiffiiccaattee aass ""aass aa ccoonnsseeqquueennccee ooff"" oorr ""dduuee ttoo"")),, and other significant conditions. These codes along with the individual's and other significant conditions. These codes along with the individual's name and soctal security number (to facilitate linking these data to the main nsme and social security number (to facilitate linking these data to the main file) were transferred onto Fortran coding sheets and keypunched. file) were transferred onto Fortran coding sheets and keypunched. In addition to {dentifying the deaths, SSA reported that for 485 members In addition to identifying the deaths~ SSA reported that for 485 members of the study cohort nobenefics were currently belng pald. This meant that of the study cohort no benefits were currently being paid. This meant that 3 SSA could not esphatically state whether these individuals were dead or SSA could not emphatically state whether these individuals were dead or aalliivvee.. HHoowweevveerr,, ppuubblliisshheedd rreeppoorrttss ((sseeee ffoorr eexxaammppllee WWaanngg,, HH.. aanndd MMaaccMMaahhoonn,, B., J. Oceup. Med. 21, 745, 1979) have stated that the ascertainment of mor- J. Occup. Med., 21, 745, 1979) have stated that the ascertainment of mor- tality by SSA is virtually complete and that additional follow up on in- tality by SSA is virtually complete and that additional follow up on in- dtviduals for whoa no information 1s available from SSA records 1s unnecces- dividuals for whom no information is available from SSA records is unnecces- ssaarryy.. NNeevveerrtthheelleessss,, iinn oorrddeerr ttoo bbee aabbssoolluutteellyy cceerrtaalinn tthhaatt aallll ddeeaatthhss wweerree aasscceerrttaaiinneedd,, eevveerryy eeffffoorrtt uwaass mmaaddee tthhrroouugghh eexxtteennssiivvee ttrraacciinngg eeffffoorrttss ttnn .i~ntceerrmaiinnee tthhee ccuurrrreenntt ssttaattuuss ooff tthheessee 448855 uunnaaccccoo~unntteedH f~oorr ssttuuddyy mmeemmhbeerrss.. TThhee ssttaattuuss ooff vviirrttuuaallllyy aallll ooff tthheessee ppeeooppllee wwaass ddeetteerrnmiinneedd iinn tthhiiss wwaayy.. MMeetthhoodd ooff AAnnaallyyssiiss TThhee mmeetthhoodd ooff aannaallyyssitss iiss bbaasseedd oonn aa ccoommppaarriissoonn ooff tthhee oobbsseerrvveedd ttoo eexxppeecctteedd ddeeaatthh rraatteess ssppeecciiffiicc ffoorr ccaauussee,, aaggee,, ttiimmee,, sseexx aanndd rraaccee.. TThhee 11222299..00000055 33MMAA0000663388777799 e etihol In~,t]~ocJ is is describad described in in detail detail tn Yonson, in Monson, RR..,, AAnnaallyyssiiss ooff rreellaattiivvee ssuurrvviivvaall and proportional mortality, Comp. Biosed. Res., 7, 325-332, 1974. ~nd proportional mortality, Comp. Biomed. Res.~ 7, 325-332, 1974. the '[he output output fron from this this analysis analysis provides provides tthhee oobbsseerrvveedd aanndd eexxppeecctteedd number number of of deaths, deaths, tthhee rraattiioo ooff oobbsseerrvveedd ttoo eexxppeecctteedd ((SSbH~R)),, aanndd tthhee uuppppeerr and Lower 95% confidence Limits. and lower 95% confidence limits. The The 95% 95% confidence confidence lLiimmiittss aarree ddeeffiinneedd aass ffoolllloowwss:: sover vate = w= @ a - vo Lossf{TA) IE UUppppeerr LLiimatit =: UutL =:i((~ Blr)(()1l -= 1/98) i/9(~1) ++ 1 1..969/36VT/3B~H)3)) 7/E2 Vere Where 0 = observed nusber of deaths 0 = observed number of deaths E E = = expected expected musber number ooff ddeeaatthhss Resuics Results Boni those who worked at Chaneitee for ste ox sore months 0,600) sere Records Records on on 4,218 4,218 eemnppllooyyeeeess wweerree rreevviieewweedd aanndd aabbssttrraacctteedd ((fTaabbllee 1i)).. Only those who worked at Chemolite for six or more months (3,688) were included tn the mortality followup. included in the mortality follow~ap. UF the 180 known deaths, 168 (93.31) death certificates were obtained. Or the 180 known deaths, 168 (93.3%) death certificates were obtained. There There were were 159 159 male male ddeeaatthhss aanndd 2211ffeemmaallee ddeeaatthhss.. Table Table 2 2 presents presents the the results results ffoorr CChheemmoolliittee PPllaanntt mmaallee semmppllooyyeeesss.. Overall, Overall, the the number number of of deaths deaths ((114499)) wwaass ssiiggnniiffiiccaannttllyy lLeessss tthhaann eexxppeecctteedd (208.3). (208.3). This This ""ddeaftiiceitte"" wwaass pprriimmaarriillyy dduuee ttoo tchhee lloowveerr tthhaann eexxppeecctteedd ausber number of of ddeeaatthhss fErrooms ddiisseeaasseess ooff tthhee cciirrccuullaattoorryy ssyysstteemm aanndd aallll eexxtteerrnnaall causes of death. causes of death. TThhee aobbsseerrvveedd--ttoo--eexxppeecctteadd rraattiioo ffoorr ccaanncceerr ddeeaatthhss wwaass 1.0, 1.0, tndicattng indicating no no ddiissppaarriittyy bbeettwueeesnn tthhee nmuumsbbeerr ooff ddeeaatthhss oobbsseerrvveedd aanndd tthhee susber expected. number expected. The The anly only 0O//E2 rraattiiooss wwhhiicchh eexxcceeeeddeedd 11..00 wweerree ffoorr ddeeaatthhss due due to to asthna asthma (2.8) (2.8) and and motor motor vehicle vehicle aaccectiddeennttss ((i1.1i)).. HHoowweevveerr,, nneelicthheerr -i even even aapppprrooaacchheedd ssttaattiissttiiccaall ssiiggnniiffiiccaannccee.. 1122299..00000068 33MMAA0000663388778800 fable l'able I1.. EEppiiddeemnioollooggJliuecly;MMoorr1tt9aa78lliitt=yyDeSSctteuumddbyyeroo,ff CC1hh9e7e9mmoolliittee PPllaanntt July," 1978 - December, 1979 RReeccoorrddss AAbbssctrraacctteedd NNuummbbeerr SSttuuddiieedd NNuummbbeerr ooff DDeeaatthhss DDeeaatthh CCeerrttiiffiiccaatteess AAnnaallyyzzeedd 428 4,218 3,688 3,688 118800 168 168 ((44..99%%)) + 11222299..00000077 33MMAA0000663388778811 . T'l'aabhllce 22.. RReessuullttss ooff CMCaaaluuesssee,--SSppeeCcchtieffmiioccliMtMoeorrttPaalllaniitttyy (AA3nnaa6llyymssoiinssths) Males, Chemolite Plant (2 6 months) eI Cause 0oEf DDeEathE cee 114400 -- MMaalliiggnnaannLt NNeeooppllaassmmss 000000 -- AALlLl IInnffeeccttiivvee aanndd PPaarraassiittiicc DDiisseeaasseess Tuberculosis Tuberculosis 224400 -- AAlllleerrggitce,, EEnnddooccrriinnee,, MMeettaabb..,, NNuuttrr.. DDiisseeaasseess DDiiaabbeetteess MMeelllliittuuss 332200 -- AAllll DDiisseeaasseess ooff NNeerrvvoouuss SSyyss.. && SSeennssee OOrrggaannss 339900 -- AAlLlL DDiisseeaasseess ooff CCiirrccuullaattoorryy SSyysstteemm CChhrroonntiec RRhheeuummaattiicc HHeeaarrtt DDiisseeaassee AArrcteerriioosscclleerroottiicc HH..DD..,, IInnccl!.. CCHHDD ALL Vascular Lestons of CNS All Vascular Lesions of CNS 446600 =- AAllll RReessppiirraattoorryy DDiisseeaasseess AAlLlL PPnneeuumsoonntiaa si EaEpmphhyysseenmsa Asthna Asthma 5720 = ALL Diseases of Digestive System 520 - All Diseases of Digestive System ALL All Gastric Gastric and and DDuuooddeennaall UUllcceerr CCiirrcrhhoossitss ooff LLiivveerr 880000 -= AALlLl fExtteerrnnaall CCaauusseess ooff DDeeaatthh ALL Acetdents All Accidents MMoottoo\rr VVeehhiiccllee AAccccitddeennttss SuStuicctiddee AAlLlL CCaauusseess ooff DDeeaatthh 0 E o0//6E LLLL___uULL 3 37 wa 37.1 Lo 1.0 7.7 11.33 11 22.s5 113 i 1.3 4.4 0.0 22.33 .88 0.0 4a.s5 3 34 9 22 23 23.84 .9 .2 2.6 7 a 26 2 2.8 .7 .I 2.6 2 2 24.9 2.4 .9 a .i 33.a1 664 883..00 8.8 .6.6 <<L1o.O0 1I 262.6 4.4 0.0 22.22 50 61.4 8 6 11 50 61.4 .8 .6 i.I " 4 s8.5ss.5 a.1i 11.22 66 88.99 2 3s 12 203.5 i 2.0 14 i .4 7.7 3.3 1L.s5 6 a 2a .6 .I 5.0 22.81 2..5 8.0.0 152..88 2.8 .0 15.8 1 124 6 2 12 7 12.4 .6 .2 1.2 113.8 1.3 .8 0.0 44.a4 "nes a1 14 7.6 .5 .I 1.4 2299 4499..00 6.6 4.4 .8.8 224 B33e.4 .77 4.4 L> 1o.0 20 20 183 18.3 Li.i186.6 Le 1.6 511s 2 12 5 i0.I .5 .2 1.2 we 149 220088.33 .77 .66 .8.8 11222299..00000088 33MMAA0000663388778822 . fable). Tabl e 3. RReessuullttss ooffMaCClaaeuusss.ee--SSppCeehcceiisFfoilicicteMMoorrPttlaaalnlititcyy(5AAnn6aallmyyossniitsshs) Males. CCahnecmeorlite Plant (3 6 months) Cancer insSCaIusEe LofEIDeath sorre meel OleBrUeL l ALL Maligasnt Neoplasms All Malignant Neoplasms CCaanncceerr ooff DDiiggeessttiivvee OOrrggaannss & PPeecriittoonneeusmm 150 - Cancer of Esophagus 150 - Cancer of Esophagus 151 - Cancer of Stomach 151 - Cancer of Stomach 153 - Cancer of Large Intestine 153 - Cancer of Large Intestine 154 - Cancer of Rectua 154 - Cancer of Rectum 157 = Cancer of Pancreas 157 - Cancer of Pancreas CCaanncceerr ooff RReessppiirraattoorryy SSyysstteenm 161 - Cancer of Larynx 161 - Cancer of Larynx $172 + cancer of Skin 162 - ALI Cancer of Lung (Peta. Sec.) 162 - All Cancer of Lung (Prim. &Sec.) ~!72 - Cancer of Skin 185 - Cancer of Prostate 185 - Cancer of Prostate 186 - Cancer of Testis 186 - Cancer of Testis 189 - Cancer of Kidusy 189 - Cancer of Kidney 191 - Cancer of Brain & Other CNS 191 - Cancer of Brain & Other CNS ALL Lymphopotetic Cancer All Lymphopoietic Cancer 201 - Hodgins Disease 201 - Hodgkins Disease 208 - Cancer of Lyphatic Tissue 208 - Cancer of Ly~nphatic Tissue wa 10 9 13 37 37.1 1.0 .7 1.3 9 9.0 10.3 1.0 .5 11.99 9 9.0 18 13 0 I .8 1.3 .0 7.1" 11s 1 1.6 6.6 0.0 33.55 33292.9 I1.1i 2.2 33.a1 110 Lo 0 se i 1.0 1.0 .0 5.6 2 1s 11a 39 2 1.9 i.i .I 3.9 3 ms 9 12.5 9a .7 .3 16 1.4 1s Le 0 1100.77 i .5 1.9 .0 11s 0 se sous 8 11.8 I i.I 7 3 13 .7 .3 1.3 .9 .0 5.0 2 wo 20 2 73 2 1.0 2.0 .2 7.3 17 Ls 0 88.33 I .7 1.5 .0 1 10 10 0 56 i 1.0 i.O .0 5.6 2 Le nla 39 2 1.9 i.I .i 3.9 so 8 2 20 4 5.0 .8 .2 2.0 : Ll Le 2 6s 2 i.i 1.9 .2 6.8 2 9 22 3 80 2 .9 2.2 .3 8.0 158 other Digestive 1 119558 O1t11herDefDtiageedstiSvteees 1i 119995 MIaIlIls.DefiNneeopdl.SitWeisthouit Specif. of Site 6 199 Malig. Neopl. Without Specif. of Site 11222299..00000099 33MMAA0000663388778833 Ifnn TTaabbllee 33,, tthhee 3377 ccaanncceerr deaths deaths are are distributed distributed by by site. site. Nene of None of the results were significant. the results were significant. Tables 4 and 5 present results for deaths among men who were esploy- Tables 4 and 5 present results for deaths among men who were employ- ed for at least six months fn the Chealcal Division of the Chemolite Plast. ed for at least six months in the Chemical Division of the Chemolite Plant. Overall, the observed number of deaths (55) was less than expected (66.1. Overall, the observed number of~ deaths (55) Was less than expected (66.1).~,.....~.~ This uss mainly the result of the lower than expected number of deaths This was ~mainly the result.0f the iowe~ than expected number~-of deaths + fron diseases of the circulatory system. The highest O/E ratio, 9.2, from diseases ~ the circulatory system. ~:~The highest O/E ratio, 9.2, i occurced for deaths due to asthma. However, this ratio, based on only a 4 occurred for deaths due to asthma. However, this ratio, based on only single death in the 21 year study period, vas not statistically significant. single death in the 21 year study period, was not statistically significant. A total of 13 cancer deaths occured among the Chentcal Diviston male A total of 13 cancer deaths occurred among the Chemical Division male employees. This was approximately the nusber expected (11.2). Although employees. This was approximately the number expected (11.2). Although the 0/2 ratio for a nusber of cancer sites exceeded one, nonewere statisti the 0/E ratio for a number of cancer sites exceeded one, none were statisti- cally significant. cally significant. B presenat 10 abte 6. to maor departures fro expected vase noted fn chess AA ddiissttrriibbuuttiioonn ooff tthhee 1199 oobbsseerrvveedd ddeeaatthhss aammoonngg ffeemmaallee eemmppllooyyeeeess iiss presented in Table 6. No major departures from expected were noted in these cents. results. Discussion Discussion The Lower than expected mortality Crea all causes is often found in The lower than expected mortality from all causes is often found in studies of occupational cohorts. This reflects "the healthy worker" effect. studies of occupational cohorts. This reflects "the healthy worker" effect. Generally, tndividuals who are disabled or chronically 11 are excluded from Generally, individuals who are disabled or chronically ill are excluded from certain work situations, particularly those requiring considerable physical certain work situations, particularly those requlring considerable physical activity. Thus,eaployee cohorts compared to the general population general activity. Thus, employee cohorts compared to the general population general- 1y have more favorable morality outcomes, particularly for younger employees. ly have more favorable mortality outcomes, particularly for younger employees. To compensate for this effect the data could be reviesed with an 0/5 ratio of To compensate for this effect the data could be reviewed with an 0/E ratio of t dittarence beceen observed and expected deaths. Reviewing the daca with Less than 1, (pechaps .9 Ls appropriate) considered equivalent to no less than i, (perhaps .9 is appropriate) considered equivalent to no difference between observed and expected deaths. Reviewing the data with 1122229..00001100 33MMAA0000663388778844 h Table 4. Tab [e 4. RReessNuualllttusss.ooff CCChaaeuumssieecaSSlppeeccDiiiffviiiccsiMoMoonrr[tGaa6lliittMyyontAAhnnsaa)llyyssiiss Males. chemical Division @6 Months) ooCCaasusee ooff DDeeaathh 140 140 - - Holtznant Malignant NNeeooppllaassmmss 20240 - - AAlllleecrsgiicc,, EEnnddooccrriinnee,, MMeettaabb..,, NNuottre.. DDiisseeaasseess Diabetes Diabetes NMeelllltietuuss 320 320 - - AAlLlL DDiisseeaasseess ooff NNeerrvvoouuss SSyyss,. & & SSeennssee OOrrggaannss 390 390 - - ALL All DDiisseeaasseess ooff CCiirrccuullaattoorryy SSyysstteemm Artertosclerottc Arteriosclerotic HH..DD.. IInnccll.. GCHHDD 460 460 - - AALlLl RReessppiirraattoorryy DDiisseeaasseess JITE-- Asthma Al! Pneumonia Asthma 552200 -- AALllL DDiisseeaasseess ooff DDiiggeessttiivvee SSyysstteemn B cAALloLlrnGGoaassstttsersiecofaaninddveDDruuooddeennaall UUllcceerr Cirrhosis of Liver 800 800 = - ALL All Iexxtteerrnnaall CCaauusseess ooff bDeeaacthh ALL Acetdents HAoltlorAcVceihdiecnltes Accidents Suede Motor Vehicle Accidents Suicide AALlLl CCaauusseess ooff DDeeaatthh 0 0 = E o0m/E uLuL wUmL Lome 13 11.2 2 11 1s 2 i.i I .9 1.8 I .8 w3 16 24.3 Wome 14 17.9 4 27 4 2.7 zo 2 I.I 1a I .I 526 539 Tw 5 3.9 i .4 3 2.4 no1s1 14 o18w.s1 512 70 12.5 29 ss7.0 2 3.6 12 6 9 1.2 .6 1.9 1.9.2 1.9 .2 6.8 11 0 es6.8 i.I .O 6.5 13.0 7.0 1.3 .0 7.0 2 4 1a .7 .4 I.I 8 4 1a .fl .4 1.3 1s 4 as 1.5 .4 3.9 Ls 2 er 1.9 .2 6.7 sz a sa 9.2 .1 51.1 13 a aa 13 a4 a0 1.3 .4 3.0 26 0 ws 2.6 .0 14.5 1.3 .3 3.7 8 4 13 .8 .4 1.3 10 so 17 1.0 .5 1.7 13 6 24 1.3 .6 2.4 6 a 20 .6 .I 2.0 ss e186 11 55 66.1 .8 .6 I.i i 11222299..00001111 33MMAA0000663388778855 ? Tfaabbltee 55.. RReessMuualllttesss.ooff CCChaaeuumssieec--aSSlppeeccDiiiffviiiccsiMoMnoorrtt(aa3ll6iittMyoyntAAhnnsaa)llyyssitss Males. CCahnecmeircal Division (~6 Months) Cancer CauCsauese ooff DDeeaatthh ok E or O/E LwL wUL 114400 - - MMaalliiggnnaanntt NNeeooppllaassamss 113B 111.22 11.22 6.6 11.99 CCaanncceerr ooff DDiiggeessttiivvee OOrrggaannss & PPeerriittoonneeuusm 33 22.66 I1.1I .22 33.33 CCaanncceerr ooff EEssoopphhaagguuss 1I 2.2 44.d4 a.i 2246.s5 CCaanncceerr ooff LLaarrggee IInntteessttiinnee 1I S.9 121.2 .00 66.66 CCaanncceerr ooff PPaannccrreeaass 1 1 6.6 11.88 0.0 1100.22 CCaanncceerr ooff RReessppiirraattoorryy SSyysstteemm 44 33.17 i1.1I 3.3 22.8 CCaanncceerr ooff LLaarryynnxx i 1 2.2 6e.7 1.3 I 3 37.3 CCaanncceerr ooff LLuunngg ((PPrriimn.. &&SSeecc,.)) 3 3 s3.5 .99 2.2 22.s5 3 cCaanncceerr ooff SSkkiinn 11 4.4 272.7 0.O B15.a1 CCaanncceerr ooff PPrroossttaattee 1 1 .33 393.9 a.i 221.s8 CCaanncceerr ooff TTeessttiiss 11 .33 44.00 .ai 222a.1 199 - Malis. Neopl. Wiehout Specification of Sie = 3 199 - Malig, Neopl. Without Specification of Site - 3 11222299..00001122 33MMAA0000663388778866 i Table 6. Specific Causes of Death Table 6. FeSmpaelceisf.ic CChauesneoslitoef DPelaatnth (36 months) Females. Chemolite Plant (36 months) 009 Ddiiaarrrrhheeaall disease disease 009 0 EE 1 " 1 .4 162 Malt. neopl. of lung 162 Malig. neopl, of lung 1 i i 1 172 vali. neopl. of skin 172 Malig. neopl, of skin~ 1 2 i .2 174 174 MMaalliigg.. nneeooppll,. ooff bbrreeaasstt 2 2.5 2 2.5 18 Malte. neopl. of ovary 183 Malig. neopl, of ovary 1 8 i .8 191 Malis. neocpl. of brata 191 Malig. neopl, of brai~ 1 " i .4 402 Hypercenstve 1.0. 402 Hypertensive H.D. 410 Acute MI. 410 Acute M,I. 412 Chronte Tachentc H.D. 412 Chronic Ischemie H.D. T 1 1 " 7.5 7.5 427 Sympecasttc HD. 2 427 Symptomatic H.D. 3 472 Influenza Influenza wwiitthh ootthheerr rreesspp.. mmaanniiffeessttaattiioonnss 472 1 1 1 i 493 aschaa 493 Asthma 1 EY 1 .i 812 Car accident with other car 812 Car accident with other car 819 CCaarr aaccce.. ooff uunnssppeecciiffiieedd nnaattuurree 819 v 1s 1 1.5 Total 19 Total 19 11222299..00001133 33MMAA0000663388778877 e 2 null hypothesis of .9 would not substantially alter the conclusions. a null hypothesis of .9 would not substantially alter the conclusions. Geet te on or th co san or ton eres tes te DDeeaattihlss ffoorr UU..SS.. wwhhiit~ee mnaalleess aanndd ffeemmaalleess wweerree uusseedd ttoo ddeerriivvee eexxppeecctteedd vvaalluueess.. AA mmoorree aapppprroopprriiaattee ccoommppaarriissoonn ppooppuullaattiioonn mmiigghhtt hhaavvee bbeeeenn ddeeaatthhss ffoorr tthhee ccoouunnttiieess itnn wwhhiicchh tthhee eemmppllooyyeeeess rreessiiddeedd,, nnaammeellyy DDaakkoottaa,, RRaammsseeyy aanndd WWaasshhiinnggttoonn iinn MMiinnnneessoottaa aanndd PPlieerrccee aanndd SStt.. CCrrooiixx iinn WWiissccoonnssiinn.. TThheerree aarree ttwwoo mmaajjoorr pprroobblleemmss wwiitthh uussiinngg ddaattaa ffrroomm tthheessee ccoouunnttiieess ttoo ddeerriivvee eexxppeecctteedd vvaalluueess.. FFiirrsstt,, aage-g-sseeexx-- rraaccee aanndd ccaauussee ssppeecciiffiicc ddeeaatthh rraatteess aarree nnoott aavvaaiillaabbllee bbyy ccoouunnttyy ffoorr ppeerriiooddss bbaacckk ttoo tthhee llaattee 11994400''ss.. SSeeccoonndd,, iLFf ssuucchh rraatteess ccoouulldd bbee ddeerriivveedd ffrroomm tthhee bbaassiicc ddaattaa,, tthhee rreellaattiivveellyy ssmmaallll ppooppuullaattiioonn bbaasseesa wwoouulldd rreessuulltt iinn hhiigghhllyy uunnssttaabbllee rraatteess.. OOnnee ssttrraatteeggyy ffoorrcocnosnisiddeerriinnggggeeooggrraapphhiicc ddiiffffeerreenncceess tinnmmoorrttaalliittyy iiss ttoo eexxaanmtinnee aavvaaiillaabbllee ddaattaa ffoorr tthhee ccoouunnttiieess ooff iinntteerreesstt iinn rreellaattiioonn ttoo tthhee UUnniitteedd SSttaatteess rraatteess.. FFoorr ccaanncceerr,, aaggee aaddjjuusstteedd ddeeaatthh rraatteess aarree aavvaaitllaabbllee bbyy ccoouunnttyy ffoorr tthhee ppeerriioodd 11995500--6699.. TThheessee ddaattaa wweerree eexxaammiinneedd ffoorr tthhee aabboovvee mmeennttlioonneedd ccoouunnttiieess aanndd compared to the rates for the United States. For those cancer sites where the the rraattee wuaass bbaasseedd oonn aann aavveerraaggee ooff aact lleeaasstt oonnee ddeeaatthh ppeerr yyeeaarr tthhee oonnllyy notable notable ddiiffffeerreennccee bbeettwweeeenn tthhee rraatteess ffoorr tthhee 55 ccoouunnttiieess aanndd tthhee UU..SS..~ wwaass foorr lLuunngg ccaanncceerr wwhheerree tthhee aaggee--aaddjjuusstteedd rraattee wwaass aapppprreeccitaabbllyy lloowweerr ifnn 44 ooff the the 55 ccoouunnttiieess tthhaann finn tthhee UU..SS.. aass aa wwhhoollee ((tthhee rraattee ffoorr RRaammsseeyy ccoouunnttyy aapppprrooxxiinmaatteedd tthhee UU..SS.. rraattee)).. TThhee O0//EE rraattioo ffoorr lluunngg ccaanncceerr wwaass lleessss tthhaann 11..00.. TThhiiss i{ss aann uunnddeerreessttiimaaattee ooff tthhee SSMR~ i1ff ccaallccuullaatteedd uussiinngg ccoouunnttyy rraatteess.. HHoowweevveerr,, rree--ccaallccuullaattiinngg tthhee SSMVRR uussiinngg ccoouunnttyy ddaattaa ttoo ddeerriivvee eexxppeecctteedd vvaalluueess wvoouulldd pprroobbaabbllyy rreessuulltt iinn aann SSMH~R ooff aabboouutt 11..55,, whhiicchh wwoouulldd nmoott bbee ssttaattiissttiiccaallllyy ssiiggantit[iiccaanntt.. AAlltthhoouusghh tthhee rreessuullttss ooff tthhiiss aannaallyyssitss rreevveeaalleedd nmoo ssiiggnniiffiiccaanntt ffiinnddiinngsg,sa,a nnuumabbeerr ooff SS~R''ss,, ppaarrttiiccuullaarrllyy ffoorr tthhee ccaanncceerrss,, ddiidd eexxcceeeedd oonnee.. .TThhuuss,, ccoonnttiinnuueedd 1 ssuurrvveeiillllaannccee ffoorr mmoorrttaalliittyy i1ss ww~arrrr~anntteedd.. 11222299..00001144 33MMAA0000663388778888 ? AAss ooff tthhee wwrriittiinngg.ooff tthhiiss rreeppoorrtt ((FFeebbrruuaarryy 2266,, 11998800)) iinnffoorrmmaattiioonn oonn tthhee 1122 ddeecceeaasseedd ssctuuddyy mmeemmbbeerrss wwhhoossee ddeeaatthh cceerrttiiffiiccaatteess wweerree nnoott aavvaaiillaabbllee aatt tthhee ttiimmee tthhee ddaattaa wwaass aannaallyyzzeedd iiss aass ffoolllloowwss:: 2 dtieedd iinn sseerrvviiccee,, oonnee iinnVViieettnnaamm aanndd oonnee iinn KKoorreeaa 4 died died ffrrooam ccaarrddiioovvaassccuullaarr ddiisseeaassee i 2 ddiieedd fFrroomm ccaanncceerr 1 ddieedd rfroonm iInnjjuurriieess ssuussttaaitneedd finn aann aaiirrppllaannee ccrraasshh 3 cause cause of of ddeeaatthh uunnkknnoowwnn ((22 ooff tthheessee ddeeaatthhs ooccccuurrrreedd aammoonngg eemmppllooyyeeeess wwhhoo wwoorrkkeedd aatt CChheemmoolliittee ffoorr lleessss than than 6 6 mmoonntthhss)) Feon From the the aabboovvee ddiissttrriibbuuttiioonn ooff ddeeaatthhss,, iict ifas oobbvviioouuss tthhaatt tthhee aaddddiftciioo~n ooff tthheessee ddeeaatthhss ttoo tthhee aannaallyysseess pprreesseenntteedd iinn tthhiiss rreeppoorrtt ddooeess 1 rot not aalltteerr tthhee ccoonncclluussiioonnss. 11222299..00001155 33MMAA0000663388778899