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WALL STREET JOURNAL, April 14, 1981 Copied for D. L. Engle D. H. Glenn Medical Sleuths Fear of Toxic Materials Creates More Demand For Epidemiologists Dow Chemical Study Seeks Link Between 24 Deaths And Work at Texas Plant A Tedious, Frustrating Trail By Georgette Jasen j Staff Reporter of Tub Wau Strut ^Journal It reads like a detective story. Twenty-four men from a small area oa the Texas Gulf Coast are mysteriously dead of a rare disease, brain cancer. Investiga tors hare silted through thousands of pages of evidence 1 and talked wtth people vka might know something about the case, hot so far they don't know what caused the dis ease. One theory holds that the deaths an related to the men's work: All 24 were * ployed at a Dow Chemical Co. plant In Pro*port. The detectives are epidemiologists, nmtNcal specialists who study the csuses of dfo. .ease in people. A typical team might Indute physicians, some of whom have doctoraus In public health; non-physicians wtth grsdtate degrees In public health; nonoloftofo (specialists In classifying diseases!: stsUM- clans, and clerk* . Epidemiologist*. si* in demand mam than ever thesedays. As the public becorere more aware of health problem* caused bp toxic substance* pressure has Increased ae corporations and 'government agenda R- show that prodwcts sad. working coredtlea are safe. . t. A Household WordT Dow, for example, has more than a doa people working In epidemiology: la the Mo lMto it had one. Denise deMsn. s Beverly Hills-based recruiter for health Kleneoi job*, says requests for epWemWogtsti hove increased st least fourfold In the pest three years. `Now people can spell It" she say* Today epidemMogtst* are Involved In downs of major Investigations. Both govern ment and corporate teams are working on the Dow case. Union Carbide Corp. workers In Texas are the subject of t similar bnlecaacer study. Monsanto Co. recently studied its employes who may have been exposed * dioxin, 3 contaminant found In some herbi cides oir'-.iii- the chemical Industry, tpUendafogtca: methods are being used to seek s Itah between tampons'and toxic shock syndrome. "There will be even more studies," predict! Ralph R. Cook, Dow's chief epWemtotogfeL "The public it asking more-sopblsticsMd questions." Providing the answers is costly. A ptayM- clan with s doctorate in public health caa earn about 570,000 In industry- Union Car bide says Its brain-cancer study will cam QM.MS. Dow speads more than Oft midka a year tor reaearefe a health, safety sad tfa eavtmameai. Too Costly for Small Companies And the outlays are rising, to the potat at which some smaller chemical companies may be hard pressed. "There will be tre mendous distortions In the chemical indus try." says Etcyl Blair, Dow s vice president for health and environmental sciences. "Small companies that don't have the re sources will be shut out." The case of the 24 Dow workers in Texas illustrates how much time, effort and money are consumed in epidemiological studies, and how the inherent imprecision can lead two groups to draw different conclusions la a single situation. It began in November 1978. when a, worker at Union Carbide's plant not tar from Dow's was diagnosed as having brain : cancer. He knew two other workers at the : plant who had died of brain tumors, and he called the Occupational Safety and Health > Administration's regional office In Ckar 1 Lake City. Texas, wondering if the disease ; could be related to working at the plant. OSHA's regional office quickly turned up two other brain-cancer deaths of Carbide workers, and later the total of cases discov ered was 13-ironically not including the worker who approached OSHA. since hi* cancer began la another pan of his body. OSHA and Union Carbide are Jointly lnveattgating those cases. But while searching for brain-caacar deaths among Carbide workers, OSHA R vestigatorx discovered the similar death! among workers at the Dow Chemical piaat in the same area. Twice the Risk OSHA compared the ratio of b'aln-caacer deaths among Dow workers with the ratio of such deaths In Brazoria County, where the Dow plant is located. It concluded that Dow workers faced twice-as much risk of oon- tractlng the disease as other people. \ Dow. which has a larger and more estab lished epidemiology staff than Carbide, quickly did itv own study. In two weeks K ; checked the work histories and conclude that there wasn't any link between the chemicals they worked with and their dR ease. It also said that when adjusted for the age sf-lhe workers, the number of deaths Is the plant wasn't much out of line with h- Uona! avenges. it could be years before the Issue Is re solved. Based on the preUmi,,ary data, gov ernment researchers remain convinced that the brain cancers are work related; com pany officials still think they aren't OSHA and Dow agreed to conduct a mere thorough Investigation, which has been run ning for about a year: data-gathering should be completed by this summer. About UN empioyes-a random 5" sample of the more than 40,000 men (women don't contract the disease nearly as often) who have worked at the Dow plant since It opened In 1940-are being studied. The two teams will share data but write separate reports. It's by no means certain they will agree. There are Indications that the two sides pi*ire rare to Pnge to. t'oion* I l" V V- UCC 097235 WALL STREET JOURNAL, April 14,1981 Page 1. Medical Sleuths: Demand Is Increasing For Epidemiologists Continued From First Page don't trust each other. "Some government studies are fishing expeditions." says Perry Gehrtng. a Dow vice president. "They find anything they can catch." On the government side, Victor Alexan der, an OSHA physician, says. "We encour age companies to do all the epidemiology they like. We also have an obligation to do the best Job we can. We might want to look Into things they don't." Questioned directly, however, both deny there's any mistrust. Just legitimate differences In methodology. "It depends on how you slice up the Infor mation," says J. William Lloyd, an OSHA epidemiologist. Epidemiology Isn't an exact science. Peo ple, unlike laboratory animals, are exposed to many substances every day. and It's often difficult to Isolate the harmful ones. "It's ex asperating," jays Irving J. Setikoff. a pro fessor of environmental medicine at Mount Sinai School of Medicine in New York. "There are no Instant answers." And a study of cancer deaths Is always difficult To begin with, there's still a lot to learn about the disease. Although It's widely agreed that environmental (acton contrib ute to most cancers, there are clearly other causes, too: Not all smokers contract lung cancer, for example. Current research seem* to Indicate that several factors worki tog together my sharply increase the risk. ; For example, asbestos workers who smoke develop cancer at a far higher rate than 1 either smokers who don't work with asbes tos or asbestos workers who don't smoke. Because cancer sometimes takes 20 to 30 years to develop, it's nearly impossible to knew al the substances the victims were expoMd Ml As Dow's Dr. Cook says. "The Ideal thing would be to Implant a monitor in the right buttock at birth." Brain cancer presents still further prob lems, Because it Is rare-an estimated four case* a year per 100,000 population-Invest! gators have few cases to work with. A single statistical error can affect results. What's more, brain cancer is frequently misdi agnosed. All of this means that a study tike Dow's takes a long time, even though it Involves only a 5% sample. And, unlike a criminal in vestigation, the work Isn't dramatic or glamorous. Dr. Cook says, "Things come In like the tide. It's dealing with paper." Even the simplest tasks are frustrating, Personnel records at Dow are filed alpha betically. It would be easier for epidemiolo gists II they were arranged by date of em ployment or by department-that way work ers who were hired at a particular time or who worked In a particular department could be reviewed separately. When the study started, there were no indexes. Many records are on microfiche, requiring re searchers to spend hours reading enlarge ments on machines. It takes a major effort Just to determine how many former workers have died and the causes. Investigators say they now know whether nearly all of the sample Is alive or dead; it wasn't easy to find out even that. Reviewing personnel records for date and cause of death and death certificates from three counties surrounding the plant was Just the beginning, A list of names was sent to the Social Se curity Administration In Washington to find out whether a death claim had been filed or where retirement benefits were being sent The names of than stlfi missing were sent to the Texas motorvehicles bureau. Govern ment agencies can ask the Internal Revenue Service for a last known address, ind there are high-school and college alumni records and checka of local telephone books. "It's shoe-leather epidemiology." says Dr. Cook. Investigators may never know what workers were breathing and handling hi the plant Before the Occupational Safety and Health Act wia pained In 1970, few compa nies measured or analysed chemicals in the workplace. Protective equipment if it was available, wasn't always wont "The compa nies don't know, nobody knows," says Mount Sinai's Dr. Sellkoft "Our Inadequacies of the past are coming home to roost" Even wort histories don't always help. Building names and numbers have changed. as have manufacturing processes and Job ti tles. The Dow plant is one of the largest In the world. Hundreds of chemicals are made there, and others are used In the manufac turing process. "Even If you know someone worked in an ethylene plant for 10 years, you may not he able to tell It he was an op erator In an air-conditioned control room or a production person sloshing around in the stuff," says Gordon Reeve, an epidemiolo gist with the National Institute of Occupa tional Safety and Health. Workers did slosh around In chemicals In the early days of the plant. "Back in the 1950s, you went In with your hands and washed tools, clothes and parts in carbon tetrachloride," recalls O.D. Kenemore, pres ident of the Freeport Metal Trades Council, an association of unions, who worked ss a pipefitter In the plant "They wouldn't let a drop of It on the floor now." Carbon tetra chloride, once a commonly used denting fluid, has been shown to cause cancer in laboratory animals. Working conditions have changed so much in fact, that epidemiologists concede that even If there was a problem years ago, It may no longer exist They continue to be concerned, however, because so many work ers still could face health problems caused by previous exposures, or a cancer-causing substance could remain. "The real potential danger Is that there's a chemical In the plant that no one sus pects." says Dr. Alexander, the OSHA epi demiologist "We won't see the benefits of Improved controls until the turn of the cen tury." 'SPECIALISTS IN OCEAN| AND AIR CARGO INSURANCE Unmatched Service Loweet Possible Retee Feat Claim Settlement Representing the moat reiiebie old line companies Internationally . 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