Document 3J2EDozDm56RnzVVNrayVg1Ky

Epidemiological Surveillance Report An Updated Mortality Study of Chevron's Port Arthur Refinery, 1937-1987 Epidemiology and Biostatistics Chevron Medicaf Staff October 1994 TR94-016 AN UPDATED MORTALITY STUDY OF CHEVRON'S PORT ARTHUR REFINERY, 1937-1987 (TR94-G16) Kenneth P. Satin Leslie A. Yuan Olio Wong William J. Bailey Kimberly L. Newton Chi-Pang Wen Timothy G. Bagg Laura L, Harmon October 1994 ACKNOWLEDGMENT The authors wish to thank Anita Ross for her work in coding and coordinating the quality assurance procedures for the causes of death. We also wish to thank Tom Mach, Diane Steeley, and Odessa Williams for their assistance in performing the cause of death quality assurance. Table of Contents EXECUTIVE' SUMMARY. . .......................... ;. INTRODUCTION METHODS AND MATERIALS'............................. RESULTS. ...... . ............. Descriptive Statistics............................................... Mortality Analyses for the Total Cohort ...... Mortality Analyses Stratified by Race and Sex. . . Mortality Analyses by Length of Employment. , . Mortality Analyses by Interval Since Hire ....... Mortality Analyses by Period ofHire. ....... Mortality Analyses by Pay Status............................. Analyses of Lymphatic and Hematopoietic Cancers DISCUSSION. ......................................., ......... CONCLUSION REFERENCES . TABLES 1987 Update .. 1 ,1 J- ........ 3 ....... 4 6.................. .. .. . .............. ... . 6 .................... 7 ....... .. 8 ....................... 9 .9 10 , 14 . .15 Epidemiology <& Biosiatisilcs EXECUTIVE SUMMARY In 1980, the Gulf Oil Corporation began publishing a series of epidemiologic reports on the mortality of current and former employees working at the Port Arthur refinery. The Port Arthur study group consisted of more than 16,000 refinery workers, and their mortality experience was observed from 1937 to 1978. Subsequently, additional employees, who were hired after 1978 and worked for at least one day at the refinery, were enrolled in the study. The expanded, cohort consists of 1.7,844 Gulf employees who had worked at the Port Arthur refinery anytime between January 1, 1937 and December 31,1983. Following the merger of Gulf and Chevron in 1985, the data were transferred to the Medical Department at Chevron. The vital, status of the expanded cohort has been updated from, the end of the original study period (January 1, 1978) through December 31,1987. A total, of 6,799 deaths were identified. Cause-specific standardized mortality ratios (SMRs) were calculated for the entire cohort as well as for various subcohorts. Cause-specific mortality data were also analyzed by length of employment, interval, since hire, period of hire and pay status. Tests for trend were also performed. In general, the results of the updated study demonstrated a favorable mortality experience for the Port Arthur employees as compared to the general populations of Texas or the United States . The overall mortality of the Port Arthur employees was about 7% less than the expected when compared to the Texas general, population, and about 10% less than the expected when compared the U.S. general population. More than 50 causes of death were examined, and 18 disease categories showed, statistically significant deficits among the Port Arthur refinery workers. These categories included, among others, cancer of the biliary tract and liver, lymphosarcoma and reticulosarcoma, chronic lymphocytic leukemia, cerebrovascular disease, heart disease, non- Epidemiolog)' & Biostatistics ..........................--......................................................... -----------------------------------:--------------------------- 1987 Update malignant respiratory disease, and external causes of death (e.g.. accidents and injuries). For many additional disease categories, mortality among the Port Arthur refinery employees was similar to that of the Texas general population. These categories included all cancers, cancer ofthe digestive organs, cancer of the respiratory system, prostate cancer, kidney cancer, bladder cancer, malignant melanoma of the skin, cancer of the central nervous system, non-Hodgkin's lymphoma, multiple myeloma, several types of leukemia, soft-tissue sarcoma, pulmonary fibrosis, and mesothelioma. On the other hand, a few statistically significant mortality excesses were also found. As reported previously in the original study, a statistically significant excess of bone cancer was observed. However, no exposure-response relationship was evident front the length of employment analysis. As discussed in the original study, the bone cancer excess likely represented an artifact of the eighth revision of the International Classification of Diseases, Mortality from benign brain tumor was border-line significant when compared to the Texas general population, but not to the U.S. general population. Analysis by length of employment did not reveal any exposure-response relationship. As such, it was unlikely that the border-line significant finding was related to employment at the refinery. Furthermore, for malignant tumors of the central nervous system (including brain cancer), the mortality of the Port Arthur refinery employees was similar- to the expected. Among the male employees, 8 deaths were coded as acute lymphocytic leukemia, whereas 3.08 deaths were expected. The resultant SMR of 259,6 was statistically significant. Conversely, mortality form chrome lymphocytic leukemia was significantly less than the expected (3 observed vs. 10.04 expected, SMRA29.9). Based on the length of employment analysis, no exposure-response relationship was detected for acute lymphocytic leukemia. Several possible explanations for the acute lymphocytic leukemia excess were offered, but no Epidemiology & B'ioslalistics Port Arthur Mortality' Study definite conclusion could be made. No other refineries have reported an increase of acute lymphocytic leukemia. The excess of acute lymphocytic leukemia at the Port Arthur refiner}' was limited to employees hired before 1.950, In summary, the results of the updated study demonstrated a favorable mortality experience for the Port Arthur refiner}' employees as compared to the Texas general population or the U.S, general population. Most causes of death showed either a similar mortality or a significant deficit.among the refinery employees "when, compared to the general population. Only a few causes of death showed statistically significant elevations. Further analyses by length of employment, trends over time, potential misciassification due to nosology rules, and likelihood of exposure given, pay status job classifications did not support a conclusion that these increases resulted from employment at the refinery. Epidemiology & Biostatislics Hi Port Arthur Mortality Study INTRODUCTION In 1980, the Gulf Oil Corporation began publishing a series of epidemiologic reports on the mortality of current and former employees working at the Port Arthur refinery along the Texas Gulf Coast (Tabershaw Occupational Medicine Associates. 1980; Tsai et al,, 1983; Wen et al., 1980, 198 la,b,c, 1983, 1984a,b,e,d, 1985.1986), The Port Arthur cohort consisted of more than 16,000 refinery workers, and their mortality experience was observed from 1937 to 1978. The results ofthese studies were generally favorable in that the overall mortality rate, and most cause-specific mortality rates, were lower than that of the general population. For the entire cohort, statistically significant deficits in mortality' were observed for all causes, digestive cancer, esophageal cancer, rectal cancer, liver cancer, bladder cancer, lymphosarcoma and reticulosarcoma, heart disease, respiratory disease and several other iron-malignant diseases. On the other hand, a statistically significant excess of bone cancer for the cohort was reported. However, a review of the actual causes of death of the cases indicated that the excess was likely an artifact stemming from the coding rules of the 8th revision ofthe International Classification ofDiseases (ICD), which was used to code causes, of death in the cohort, The present study represents an update to the cohort of Port Arthur refinery employees. Ten additional years of follow-up have accrued since the original full cohort mortality assessment. The update should, result In more precise estimates of mortality risk, and provide an opportunity for additional detailed analyses forsome causes ofdeath. METHODS AND MATERIALS The original cohort, as defined by Wm et a). (1980), consisted of employees who worked at least one day at the Port Arthur refinery between January' 1, 1937 and January 1, 1978. Subsequently, additional employees, who were hired after 1978 and worked for at least one day at the refinery, were enrolled in the study (Wen et al., 1984a). Following the merger of Gulf and Chevron in 1985, the data were transferred to the Medical Department at Chevron. The vital status of the expanded cohort has been updated from the end ofthe original study period (December 31, 1978) through December 31, 1987. As noted above, Gulf continued adding to the cohort employees who began working after 1978. Based on a review ofthe data, we concluded that 1983 was the last year new hires were systematically identified and included in the cohort. Thus, the expanded cohort consists of Gulf employees who had Epidemiology* & Biostafisiicx 1987 Update worked at the Port Arthur refinery anytime between January 1, 1937 and December 31, 1983. Sources for vital status determination of the expanded cohort included Gulfs personnel and annuitant record systems., the Texas Department of Motor Vehicles, the Social Security Administration, and the National Death Index. Detailed descriptions of methodological issues in the stu dy are presented in a separate technical appendix. These issues include: study' population enumeration, vital status update procedures, employment status update procedures, data quality review, and quality assurance procedures for cause of death coding. The updated cohort consists of 17,844 individuals of which 6,799 had died as of the end ofthe study (December 3 L, 1.987). For.347 deceased cohort members (5,1% of all deaths) no death certificates could be found, but. the dates of death, were known. These deaths were included only in the.'"all causes of death" category' of the mortality analysis. Mortality analysis was based on cause-specific standardized mortality ratios (SMRs), which are ratios of the number of observed deaths to the number of expected deaths. The number of expected deaths is calculated by applying mortality rates from a reference population to the. person-years of observation in the cohort, and is adjusted fox age.,, sex, calendar period and race. As the reference, we used general Texas population rates. We considered using the rates for the counties where most Port. Arthur refinety employees live as a reference. However, because these county populations, were relatively small, we felt their rates would be too variable (unstable).and thus unreliable to use as reference rates. Since most other refinery studies are- based on a comparison to the U.S. general population, we also carried out one analysis for the entire cohort using the U.S. general population as the reference. The OCMAP program (Marsh and Preninger, 1980} was used to perform fee mortality analyses. Because of the a priori interest in cancers of the lymphatic and hematopoietic tissues and the previous leukemia cell-type analysis by Wen et al. (1984a), we conducted additional analyses for celltype specific leukemias, non-Hodgkin's lymphoma, and multiple myeloma for the male cohort members. Age-specific leukemia cell-type mortality rates for U.S. white males for the period 1969-77 derived by Selvin etaJ. (1983) were used in the calculation. For non-Hodgkin's lymphoma and multiple myeloma, age-specific mortality rates for U.S. white males, 1950-1980, compiled by the National Cancer Institute were used (Pickle et al., 1987). Since no similar rates were available for non-white males, these rates were used for the entire male subcohort. The following SMR analyses were performed on the cohort: total cohort, subcohorts stratified by sex and race, length of employment, interval since hire, period ofhire, and pay status. The rationale for Epidemiology & Biostatisiics. 2 jPort Arthur Mortality Stud)' these analyses is as follows. Length of emp loyment serves as an indirect measure for potentia l refinery exposures. An increasing trend in mortality by length of employment supports an exposure-response relationship between refinery employment and mortality risk but, by itself, does not mean the relationship is necessarily one of cause and effect Conversely, the absence of a trend (or a decreasing trend) argues against an association between work and the risk of death. interval since hire analysis follows from the observation that chronic diseases typically require a sufficiently long period (latency) after exposure to develop and become clinically apparent. In mortality studies, interval since hire is used as a surrogate for latency to permit examination of disease (mortality) in relation to the elapsed time since "exposure" First occurred. With regard to period of hire, several investigators (Wen ct at, 1986, Rtnsky et al., 1981; Meinhardt et al, 1982; Bond et aL, 1985). have reported adverse health effects for workers hired during the second world war period (approximately 1940-1945). They also reported that those hired before, after, or during the war years likely experienced different exposure intensities (e.g,, higher before 1940 and lower after 1945) and exposure durations (e.g., longer before 1940 and shorter in the 1940 to 1945 period). These differences in exposure resulted from improved engineering controls and personal protective equipment, as well as lowering of regulatory exposure standards. Thus, stratification oiv period of hire prov ides a means of assessing time-related exposure risks. Finally, analysis by pay status provides another Indirect way to assess the effects ofpotential' refinery' exposures. The presumption here is that hourly employees were/are more likely to be exposed to higher concentrations of refinery chemicals than salaried workers due to the nature oftheir respective jobs. . Statistical tests for trend were conducted across length of employment strata using the method described by Breslow and Day (1987). The result ofthe trend test is expressed in terms of x2 with one degree of freedom (1 df). RESULTS Descriptive. Statistics The 17,844 cohort members accrued a total of 526,386.7 person-years of observation. Eightynine percent (12,608) of the cohort members are males and among them 79% are white (Table 1), Of the Epidemiology & Biostatistics 3 1987 Update females, nearly 89% are white. As ofthe end ofthe study period, 38% of the cohort, was deceased. Death certificates were obtained for 95% of the decedents. The duration of employment at the refinery ranged from 3 days to 54.6 years with the median duration being 12.4 years for males and 1.8 years for females (Table 2). Most cohort members have been followed for a considerable time, For males, the median interval since hire was 35.6 years while that for females was 31.9 years ('fable 3). Table 4 shows the distributions for age at death and year of death. The median age at death was 66.6 years. Approximately 60% of the deaths occurred in the 1970s and 1980s. Only 20% ofthe deaths were reported before 1950. Mortality' Analyses for the Total Cohort Using Texas death rates as the reference, about 7% fewer deaths were observed than expected (Table 5), The resulting SMR, 92,7, was statistically significant1. Ofthe 56 cause of death categories analyzed, 17 additional categories showed statistically significant deficits. These, categories include., among others, cancer of the biliary tract and. liver, lymphosarcoma.and reticuiosarcoma, cerebrovascular disease, heart disease, non-malignant respirator)'- disease, and external causes of death (e,,g,, accidents and injuries). On the other hand, a few significant mortality' excesses were found. As reported previously in the original cohort, a significant SMR for bone cancer was observed fSMR=207.8, 95% Cl: 110.6 355.3). A significant excess was also observed for the category^ ^benign and unspecified neoplasms""" (SMR=194,9, 95% Cl: 129,5-281,7). Although many different sites are included in this category, 17 of the 28 deaths in this category' involved the brain, In the U.S, general population, approximately 68% of the deaths in this broad category are brain tumors (Environmental Health Associates, 1983), Applying 68% to the expected number of 14.4 in Table 5, an estimate of 9,8 deaths from benign brain tumor could be expected. The corresponding SMR was estimated to be approximately 173.5 (17 observed/9.8 expected; 95% Cl: 100.8-277.6), border-line significant Because of the use of asbestos at the refinery in the past, we also examined mortality from causes known to be associated with the substance. With respect to malignant diseases, asbestos is a known cause of both lung cancer and mesothelioma. Table 5 shows that lung cancer was not elevated ! Note: Throughout this report, "significant"' means "statistically significant" and the two terms are used interchangeably. ------- Epidemiology & Biostatisiics 4 Port Arthur Mortality Study (SMR=92.9, 95% Cl: 83.4-101.2). Regarding mesothelioma, the eighth revision ofthe ICD, used to code all deaths in the study, does not recognize a single code for this disease. Instead, depending on die wording on the death certificate, mesothelioma could be coded as a malignant respiratory cancer (1CD codes 162.1, 163, 163.0, or 163.9), a malignant neoplasm without specification of site (ICD codes 199,199.0. or 199.1), ora benign respiratory disease (ICD codes 212.3,212.4, or 228), Death certificates with any of these codes as either the underlying or contributing cause of death were manually reviewed to identify all mesotheliomas (malignant, or benign). Six deaths were coded as a malignant mesothelioma. Agespecific malignant mesothelioma mortality rates were not available for either the general U.S. or Texas populations. However, since malignant mesothelioma is a rapidly fatal disease, national age-specific incidence rates for 1975-79 were used to estimate the expected number ofmalignant mesothelioma deaths (Connelly et al, 1987). These rates were derived from data in the SEER (Surveillance, Epidemiology, and. End Results) Program, based on microscopically confirmed diagnoses. Mesotheliomas specified as benign were excluded from the SEER rates. For the Port Arthur cohort:, 5,9 malignant mesothelioma deaths would have been expected. The resultant SMR was 101.7 (95% Cl: 37.3-221.6) which was not statistically significant. In addition, 3 deaths were coded as benign mesothelioma. Benign or localized mesothelioma is not. associated with exposure to asbestos (Amman and Corson, 1985; Briselli. et alr, 1981), Asbestosis is the term for pulmonary fibrosis caused by exposure to asbestos, or, more correctly, in persons with a documented history of occupational exposure to asbestos. A. thorough review of all death certificates in the study did not reveal any w ith the underlying cause of death as asbestosis (ICD 515.2), although ten deaths were due to pulmonary fibrosis (ICD 51.5.x- 517.x). These 10 deaths did not represent an increase in the occurence of generalized pulmonary fibrosis: the expected number of deaths in the study is 28.6 yielding an SMR of 35.0 (95% Cl: 16.8-64.4). The expected number is based on unpublished data from the National Center for Health Statistics for the general U.S. population. The analysis presented in Table 5 was based on mortality rates for Texas. Since most refinery studies are based on a comparison to the U.S. general population, an additional analysis For the entire cohort based on U.S. death rates was carried out (Table 6). In general, the results were similar to those based on Texas death rates. Several additional significant deficits were observed (e.g., cancer of digestive organs and peritoneum, esophageal cancer, rectal cancer, bladder cancer). Furthermore, the SMR for benign and unspecified neoplasms was no longer statistically significant. In particular, for benign brain tumor, the number of expected deaths was estimated to be 12.9. and the corresponding SMR was 131.7 (95% Cl: 76.5-210.7). All other analyses in this report were based on Texas death, rates, unless otherwise specified. ------Epidemiology & Biostatistics 5 Mortality Analyses Stratified by Race and Sex 1987 Update White males accounted for 71% of the entire cohort. Therefore, their mortality experience generally paralleled that of the .entire cohort (Table 7). Hie-overall SMR was significantly lower than expected (SMR- 96.6), while the same causes showing significantly elevated SMRs for the entire cohort, plus hypertension without heart -disease (SMR-167.3), were also significantly elevated for the white males, A few additional significant mortality deficits were observed for white males, including cancer of digestive organs and peritoneum (SMR=86.5), esophageal cancer (SMR=51,6), bladder cancer (SMR=55.9), rectal cancer (SMR=:59.8), and rheumatic heart disease (SMR=50.3). The analysis for non-white males, based on 3,247 individuals and over 88,000 person-years of follow-up. also showed a significant deficit in overall mortality (SMR=78,4) (Table 8), No causespecific SMRs were significantly elevated for non-white males. On the other hand, significant deficits were reported for cancer ofthe large intestine,,, lung cancer, all heart: disease, non-malignant respiratory disease, and external causes of death. Among the 1,778 white females in. the cohort, 267 deaths were observed, yielding an SMR of 111.3, which was not statistically significant (Table 9), Two causes showed significant elevations; all malignant neoplasms (89 observed, SMR=126.5)and benign and unspecified neoplasms (4 observed, $MR=42G.5). The increase in all malignant neoplasms was driven by cancers ofthe large intestine, lung, and breast. Although each of these showed an elevated SMR, none were statistically significant. No analyses are presented for non-white females because only 10 deaths were observed among the 211 women in this subcohort. The causes of death were: malignant neoplasms (2), heart disease (3), non-malignant respiratory disease (1), external causes (I), and other causes (3). With so few deaths for any single cause of death category, death rates are unstable and comparisons to a reference population would not be meaningful. Mortality Analyses by Length of Employment Table 10 presents mortality analysis by length of employment for the entire cohort. Mortality from all causes combined showed a significantly decreasing trend by length of employment (x^dfi , df=32.2, p=O.OQOO). Four cause-specific SMRs were significantly elevated in the 20-29 year stratum but\ no trend with length of employment was observed: stomach cancer (SMR=156.7; x^mici ^-0.49, p=0.4825), lymphatic and hematopoietic tissue (SMR=152.6; x^endo dfrO.49, p=0.4854), leukemia (S.MR=222.7; x2<reiOdff=L76* P=O.1840), and hypertension with heart disease (SMR=214,3; x2b-,,io df)=3.23, p-0,0721). Three other cause-specific SMRs showed a significant excess in the 30+ year group Epidemiology? Biostatistics 6 Port Arthur Mortality Study but only hypertension without heart disease demonstrated a positive trend: cervical cancer (SMR=888.6: n=3 observed deaths -- no treed test performed), benign and unspecified neoplasms (SMR=~257.9; %2trend(i df==1 .25, p=0,2636) , and hypertension without heart disease (SMR=T97.9; (1 <^=9,95, p=0.G016), Because bone cancer had a significantly elevated SMR in the entire cohort analysis, we performed a trend test on it as well even though no SMR in any ofthe strata was .significantly elevated in the length of employment analysis. The result indicated ho trend was present (x2teIlti{1 d{)-0,21, p=0.6473). Length of employment analyses were also performed for the 3 major sex-race subcohorts (Tables 11-13). The results for white males (Table 11) paralleled those for the entire cohort although the category ''all heart disease" revealed a significantly elevated SMR in the 10-19 year stratum. The trend test, however, was not significant (x^eatpi p=0,7951). Among non-white males (Table 12), the SMR for kidney cancer was significantly elevated in the less than one year stratum which resulted in a significant inverse trend .(x2teCttd(ld{)=5.36, p-0.0206). Diabetes was also significantly elevated among non-white males in the 30 or more years stratum; this resulted in a positive trend (x^d l1()=4.89, p"0,027l). Because of the much smaller number of deaths for most other causes in the sex-race subcohorts, the length of employment, analyses were not very informative, Mortality Analyses'by Interval Since Hire Table 14 shows numerous cause of death categories, both cancers and non-cancers, with significant deficits in various intervals since hire. No significantly elevated SMRs were found for any cause in employees with an interval since hire less than 30 years. Several cause of death categories showed significantly elevated SMRs after at least a 30-year interval of time, but none had a positive trend with length of employment: all malignant neoplasms (x2traidu dfj=3-823 p=0.0506; borderline significant inverse trend), cancers ofthe stomach (x^smKi df)=0.49, p=0.482S), central nervous system (x2fis:ndOdf)=0`00P=()-9873)=bone (x2im,d(i<if)=0.21, p=0.6473), benign and unspecified neoplasms (x2w,,d<i ^=1.25, p=0.2636), hypertension with heart disease (x\e!1d o ao=3.23, p=0.072), and suicides (x\.ejld df)=0J5, p=0.6965). Subcohort analyses by interval since hire for white males yielded results similar to those of the entire cohort (Table 15), Among non-white males, significantly elevated SMRs were found for diabetes mellitus in the 40+ year stratum (Table 16), and a positive trend was seen with length of employment (rtrendy df)=4.89, p=0.0271). In white females, the categories all causes, all malignant neoplasms, and cancer of the digestive organs and peritoneum had significantly elevated SMRs in the strata with at least 30 years since hire (Table 17). However, no trends with length of employment were seen (all causes: vCtmuKi.dir'O-Ql, p=0.9230` all malignant neoplasms: x2tfd(i<ia"Q.23, p=0.6345; digestive cancers: x2trc,,d(i Epidemiology A Biostatistics 7 1987 Update do=0.11, p=0.7378). Cancer of the bladder and other urinary organs was also significantly elevated but this occurred only in the less than 10 years stratum and was based on a single death. Mortality Analyses by Period of Hire Table 18 shows that the total person-years of follow-up for the cohort were evenly spread across the three period-of-hire strata: before 1940, 1940 to 1945, and in or after 1945. The distribution of deaths, however, was. skewed toward the earlier hire periods with more than half occurring in those hired prior to 1940, The table also shows that a higher percentage of women (18.5%) were hired in the 1940 to 1945 period (the war years) as compared to either the earlier period (3.2%) or the later period (8.9%). Across sex-race groups, employees hired in the 1940 to 1945 period workedat the refinery for a.median of 0.9 year versus 30,7 years in the pro-1.940 group and 8,3 years for those hired in or after 1945, Also, the median interval since hire (to the earliest ofdeath, loss to follow-up, or the end ofthe study period) generally exceeded. 40 years for cohort members hired prior to 1945. For those hired in or after 1945, the median interval since hire was 29.2,16,1, and 17.3 years for white males, non-white males, and. white females, respectively. SMRs by period of hire are shown in Tables 1,9-22. For the entire cohort (Table 19), significant deficits in the all causes of death category were found for the before 1940 stratum (SMRTM91.7) and the in. or after 1945 stratum. (SJVIR=77.7),, The SMR (101.6) was close to expected for those hired between 1940 and 1945 (the war years). Fourteen and 1.3 additional causes of death showed significant deficits in the before 1940 and hired after 1945 strata, respectively. These compare to a total of 6 causes in the 1940 to 1945 stratum. Three causes were significantly elevated in the before 1940 stratum: Hodgkin's disease (SMR=205.2), benign and unspecified neoplasms (SMR= 218,8), and hypertension without heart disease (SMR=145.9):, None of these were significantly elevated in the other period of hire strata, No significantly elevated causes were found in the 1940 to 1945 stratum, while kidney cancer was the sole significantly increased cause of death among employees hired in or after 1945 (SMR=225,1), The subcohort analysis by period of hire for white males is shown in Table 20, The results are similar to the before 1940 period except the increase in Hodgkin's disease is no longer significant. For the 1940 to 1945 group, the categories of all causes and pancreatic cancer were significantly elevated. No causes of death were significantly elevated among employees hired in or after 1945, although kidney cancer was greater than expected. For non-white males significant SMR deficits were observed in all the period-of-hire strata Epidemiology <6 Biostatisiics 8 Port Arthur Mortality Study (Table 21). The only significantly elevated SMR was for Hodgkin's disease in the before 1940 stratum (SMR= 445.1). Based on two deaths, the category benign/unspecified neoplasms was significantly elevated among white females hired in or after 1945 (Table 22). This was the only significant finding for the white female subcohort. Mortality Analyses by Pay Status The percentage oftotal time worked as a salaried employee was classified into one of seven categories: 0:, 10,25, 50, 75, 90, and 100 percent. The original designations made by Wen et al. (1983) were carried forward in the current, update. Table 23 shows that 82,3% of the cohort members spent all their time as hourly employees, and they accounted for 87.2% ofdie deaths. On the-other hand, only 12.7% ofthe cohort members spent at least 90% time of their employment as salaried employees, and they accounted for only 6.7% of the deaths. The pay status of 70 individuals (0.4%) was unknown, and they were excluded from the mortality analysis by pay status. Three strata were formed for the mortality analysis: employment strictly hourly, employment at least 90% salaried, and all other.combinations of hourly and salaried employment. The SMR results for the entire cohort by pay status are shown in Table 24. The overall SMR for each stratum. was significantly less than 100, but the magnitude of the deficit increased with increasing time spent as a salaried worker. Hourly workers showed significantly elevated SMRs for the causes ail malignant neoplasms (SMR= 106.3) and bone cancer (SMR"228,7). Based on only four deaths,Xpenigti/unspecrfied iieoplasmy^vere significantly elevated in the mixed hourly-salaried group (SMR=433.1). Among salaried workers, significant elevations were found for the benign/unspecified neoplasms (SMR= 365.8) and hypertension without heart disease (SMR-375.7), but these were based onjust a few deaths each: 5 and 8 deaths, respectively. Analyses ofLymphatic and Hematopoietic Cancers The set of rates we used in the OCMAP program does not provide analyses for cell-type specific leukemias, non-Hodgkin's lymphoma, or multiple myeloma. Therefore, separate analyses on these lymphatic and hematopoietic cancers for all males were carried out. There were non-significant deficits for acute myelogenous leukemia (SMR=62,7, 95% Cl: 30.1-115.3), chronic myelogenous leukemia (SMR=84,4, 95% Cl: 3 LOT83.6), non-Hodgkin's lymphoma (SMR=7L0, 95% Cl: 47.9-101.4), and .multiple myeloma (SMR=98.0, 95% Q: 59.0-153.0) (Table 25). A significant excess was observed for acute lymphocytic leukemia (SMRTM259.6,9.5% Cl: 112.1-511.5), whereas a significant deficit was ---- Epidemiology & Biosiatislics 9 reported for chronic lymphocytic leukemia (SMR=29.9, 95% Cl: 6.2-87.3), m? Update All of the acute lymphocytic leukemia deaths occurred in white males who were hired prior to 1955 (Table 26). Two employees were older than 50 when, they were hired at the refinery while two other employees worked at the refinery' for less than 5 years (0.5 and 4, respectively), A trend analysis by length of employment for these deaths was also carried, out. Because ofthe small number of deaths, only three categories were used. SMRs in all three categories were elevated, but no individual SMR was significant (Table 27). A formal test indicated that there was no positive trend by length of employment. (X^ao ^0.23^=0.6333). DISCUSSION Comparisons of this .1.987 update of the Port Arthur Refinery cohort to earlier published reports indicated that the updated results were consistent with earlier ones published on the cohort. The cohort showed a generally more favorable mortality* experience than the general population. For example, the cohort experienced significant mortality deficits from all causes combined, all heart diseases combined, non-malignant respiratory disease, and external causes. Similar to the previous reports, bone cancer was significantly elevated for the cohort as a whole. A detailed discussion ofthe bone cancer excess can be found in two previous reports (Tabershaw Occupational Medicine Associates, 1980; Wen et al., 1983), A review of the actual causes listed on the death certificates indicated that several deaths were due to tumors of epithelial tissue (carcinomas) rather than sarcomas, i.e., they were not tumors of bone tissue (mesenchymal tissue) per se, but rather metastatic tumors from other sites (epithelial tissue). As such, these cancers reflect coding misciassifications derived from coding rules in the eighth revision of ICD, the basis for all cause of death coding In former and current mortality analyses. Had the ninth revision ofthe ICD been used instead, the bone tumors of epithelial origins would not have been considered primary bone cancers. Thus, the bone cancer excess can be considered an artifact stemming from the coding rules for th.c eighth revision of ICD codes. Furthermore, there was no exposure-response relationship between bone cancer and length of employment. This observation also argues against the bone cancer excess being occupationally related. Most of the deaths in the significantly elevatechfaenign/unspecified neoplasm category were benign brain tumors. The estimated SMR for benign brain tumor based on Texas death rates was border Epidemiolog)' & Biostatistics 10 Pori Arthur Mortality Study line significant (SMR= 173.5, 95%. Cl: 300,8-277.6). Using the U.S. general population, the SMR.was reduced to 131,7 (95% Cl: 76.5-210,7), and was no longer statistically significant. Analysis by length of employment did not reveal any trend. For malignant tumors of the central nervous system, the observed number-of deaths was similar to the expected, and the corresponding SMR ( 117.7) was not significant. In a previous report on brain tumors in the Port Arthur refinery cohort, Wen et al. (1981b) discussed the problems associated with diagnostic errors of brain tumors. Errors occur more frequently among inaccessible tumors such as those that occur in the liver, brain, or pancreas. Furthermore, liver and brain are two organs of the body known for their propensity of being metastatic cancer sites (Falk, 1982; Shoenberg, 1982), In fact, in the original study Wen et al. (1981b) identified 6 cases with likely incorrect diagnosis. A potential over-reporting of brain tumors in. occupational groups as a result of diagnostic sensitivity bias has also been reported in several previous investigations (Greenwald et ah, 1981, Wong et al,, 1986; Wong and Whorton, 1993). Our ceil type analysis of leukemia deaths followed the previous work by Wen et al. (1984a), who reported no excess in myelogenous leukemia, but found elevated lymphocytic leukemias in employees who worked 20 to 29 years at the refinery. However, their analysis did not distinguish between, acute and chronic lymphocytic leukemias. A. comparable analysis in this update yielded no increase in either acute and chronic lymphocytic leukemias combined (11 observed deaths, 13.0 expected) or acute and chronic myelogenous leukemias combined (16 observed, 23,0 expected). However, a significant increase in acute lymphocytic leukemia (ALL) was found (SMR=259.6; 8 observed deaths, 3 expected), . Conversely, the SMR for chronic lymphocytic leukemia (CLL) showed a significant deficit (SMR=29.9; 3 observed deaths, 10 expected). The ALL excess coupled with a deficit of CLL could be important In the interpretation of these results. From a diagnostic perspective, historically it might have been, difficult to distinguish between patients with CLL and those with ALL (Wintrobe et al., 1981). This difficulty would likely have prevailed during a large portion ofthe cohort follow-up period. The observations that half (26/52) of the leukemia death certificates for white males did not report the cell type (as was the case for 3 of the 4 leukemia deaths in non-white males), coupled with the fact that combined ALL and CLL death categories yielded an SMR not significantly different from expected (i.e., 100), lend some credence to the possibility of diagnostic difficulty and hence, misclassification with respect to recording the cause of death. Further examination of the 8 ALL deaths revealed that 5 occurred in Jefferson County, Texas, while an. additional two occurred in other Texas counties and one in California (Table 27), The observation that 5 ofthe 8 deaths occurred in the same Texas county also supports the possibility that the ALL increase is an artifact stemming from, a local diagnostic bias. Ifeven one ALL case was the result Epidemiology & Biosialistics 198? Update ofmisdiagnosis, the ALL SMR would not have been statistically significant, in this regard it is noteworthy that one of the ALL death certificates listed the cause of death as "Alymphatic leukemia" [sic]. As this is not a generally recognized diagnosis, we sought outside advise on its meaning. Acute lymphocytic leukemia and acute myelogenous leukemia were the most common interpretations. Although strictly speaking we could not determine the cell type of this cancer, we nevertheless coded it as acute lymphocytic leukemia in our analysis. We also examined the work histories for the ALL cases. However,, because of the lack of specificity and nonstandardized way the information was recorded for cohort members during the early time periods covered by the study, no additional insight regarding possible occupational associations could be gleaned from this review. Potential for exposure to benzene or benzene-containing mixtures exists at every petroleum refinery. Under conditions of high concentration and long duration, benzene is recognized as a human ' leukemogen. However, only acute myelogenous leukemia has been linked to benzene exposure. No epidemiologic study has demonstrated an association between exposure to benzene and acute lymphocytic leukemia. Similarly, no other petroleum refinery study has reported an increase of ALL (Wong and Raabe, 1994). Based on a meta-analysis of a combined cohort of more than 208,000 petroleum workers, in the United Kingdom and the United States, including Port Arthur, the ALL SMR. was 114(95%: Cl 78-161) (Wong and Raabe, 1994). Removing the Port Arthur data from tlierneta- analysis, the ALL SMR became 96. Thus, the finding from the Port Arthur refinery was not consistent with other studies of refinery workers, with similar exposures. . The likely spurious nature ofthe ALL finding in the Port Arthur cohort is further supported by the lack of an exposure-response relationship based on length of employment analysis. In addition, with most of the deaths occurring in employees hired before 1950, acute lymphocytic leukemia does not appear to be a problem in more recently hired employees. The objective ofthe length of employment analysis was to determine ifthere was a consistent upward trend in the exposure-response relationship, which we wouid consider important in our interpretation of potential causality. Hypertension without heart disease and diabetes were the only causes to show positive trends, but in neither case was the trend strictly increasing. Instead, each trend was solely due to an increase in the longest length of employment stratum while no trend was apparent across the other strata. In addition, the period of hire analysis showed that the increases in hypertension and diabetes were limited to employees hired prior to 1945. This suggests if occupational exposures did contribute to these deaths, the exposure is not affecting employees hired after 1945. Lastly, the increase in hypertension was also limited to salaried workers whose potential refinery exposures were likely to Epidemiology & Biostaiistics 12 Part Arthur Mortality Study have been briefer and less intense than hourly workers, In general, several significant cause-specific mortality deficits as well as elevations were noted in individual length of employment strata. Apart from the two causes of death discussed above, no consistent pattern was detected for any cause of death, and the observed deficits as well ,as elevations were likely statistical artifacts. Because of the large number of SMRs calculated for various causes of death, length of employment categories and sex-race subcohorts, some of the SMRs might have been statistically significant as a result of chance. With the large number of strata, the number of deaths in some of the individual strata might he small* and the corresponding individual SMRs might not be reliable. As such, for length of employment analysis, only trends in the data and not individual SMRs were emphasized. As in the length, of employment analyses, several individual strata m the interval since hire analyses showed significant mortality deficits and elevations. Among causes with significant elevations, trend analyses with, respect to length of employment, did not indicate the presence of positive trends with the exception of diabetes in non-white males, Diabetes is not generally associated with employment in the petroleum refining industry. For example, we found only a single report of a significant elevation (Rushton and Alderson, 1981). Lastly, the increase in the Port Arthur cohort was driven by employees hired prior to 1945 which suggests that employees hired during that time period might have had unusually high rates of Intrinsic metabolic disorders. In. general, the interval since hire analyses* as well as those based on period of hire and pay status did not reveal any major new findings. These analyses were also affected by the same issues discussed, above in conjunction with length of employment analysis. For period of hire, the updated results are in agreement with earlier accounts of the cohort (Wen et al., 1986) regarding differences among employees hired in the 1940 to 1945 period versus other times: women were more likely to be hired, employees tended to work at the refinery for a very short period* and overall, the healthy worker effect was. not apparent. Primarily because ofthe short employment duration, significant elevations occurring only in the subcohort hired in the 1940 to 1945 period should not be given much weight, because for these employees, the opportunity for exposures was much greater outside of the Port Arthur refinery than while they were employed there. Kidney cancer was the only significantly elevated cause of death among total cohort members hired after 1945 (.12 observed, SMR-225,1) and ten of the twelve deaths occurred, in persons hired between 1946 and 1951. This type of cancer has been the focus of considerable scientific research, both in animals and humans, stemming from an initial study which found an excess of kidney tumors in male rats following chronic exposure to wholly vaporized gasoline (MacFarland et al., 1984). Subsequent Epidemiology & Bwsiatistics 13 1987 Update. toxico logic research has been critical of this finding's relevance to humans (Swenberg, 1993). Similarly, a recent review of the epidemiologic evidence found that most studies do not support a link between gasoline exposure and kidney cancer (McLaughlin, 1993). More specifically, several recently completed studies among petroleum refinery and distribution workers exposed to gasoline failed to identify a significantly increased risk for kidney cancer (Rushton, 1993; Schnatter et ah, 1993; Wong et ah, 1993; and Poole et ah, 1993). These observations, together with the fact that no increase was found prior to 1945, suggested that kidney cancer deaths occurring between 1945 and 1951 most likely represented a random cluster, and were not related to employment at the refinery. It should he pointed out that there were several limitations in the study, most of which are typical of historical cohort mortality studies of industrial populations. First, death certificates for 5% ofthe deaths identified could not be retrieved. While these deaths were included in the all causes combined analyses, some cause-specific SMRs might have been affected (underestimated) because ofthese missing death certificates. Second, the vital status of 6.5% ofthe males and 31.1% ofthe females in the cohort: was unknown. This missing information might have affected some of the results, especially for women in the study. Third, being a mortality study, this investigation inherited the problems associated with death certificates (e,g., diagnostic accuracy, comparability' ofICD codes over time). In particular, the use of the eighth revision oflCD was problematic in analyzing bone cancer. Fourth, some analyses were potentially affected by the limited availability of reference rates, for comparison. For example, for specific lymphatic and hematopoietic cancers, rates for white males were used for all males. Furthermore, certain mortality rates were not available for the entire observation period. Fifth, although the Port Arthur refinery' cohort was probably one of the largest data sets in the petroleum industry, for some causes, the number of deaths was relatively small. For these causes, some results might not be statistically' stable or reliable. Finally, the interpretation of the results is limited by the absence of quantitative exposure data. Because ofthis, we relied on indirect measures of exposure: length of employment, period ofhire, and pay status. Although this is a common practice in occupational epidemiologic studies, the use of surrogates may result in misclassifying employees with respect to possible exposures which could result in some SMRs being underestimated. CONCLUSION In .summary', the results of the updated study demonstrated a favorable mortality experience for the Port Arthur refinery employees as compared to the Texas general population or the U.S. general population. Most causes of death showed either a similar mortality or a statistically significant deficit among the refinery employees when compared to the general population.. Only a few causes of death ------Epidemiology & Biostaiistics 14 Pari Arthur MortalityStudy showed statistically significant elevations. Further analyses by length-of employment, trends over time, potential misclassification due to nosology rules, and likelihood of exposure given pay status job classifications did not support a conclusion that these increases resulted from employment at the refiner}'. Epidemiology & Biosiatistics 15 REFERENCES 198? Update Animan KH and Corson IM (19.85), Benign aid malignant pleural mesothelioma. Clinics in Chest Medicine 6(1): 127-40. Bond GG, Reeve GR, Oh MG and Waxweiler'RJ (1985).; Mortality among a sample of chemical company employees. Am J Ind Med 7:109-21. Breslow NE and Day NE (1987): Statistical Methods in Cancer Research. Volume II - The Design and Analysis ofCohort Studies. 1ARC Scientific Publications No. 82, International Agency for Research on Cancer, Lyon. Briselli M, Mark EJ, and Dickersin GR (1981), Solitary fibrous tumors of the pleura: Eight new cases arid review of 360 cases hi the. literature. Cancer 47:2678-89. Connelly RR, Spirtas R, Myers MIL et al. (.1.987): Demographic patterns for mesothelioma in the United States. J Natl Cancer Inst 78(6): 10.53-60. Environmental Health Associates (1983): Cause-specific mortality among employees at the Chevron. Richmond and El Segundo Refineries., Report submitted to the Standard Oil Company of California. Falk H (1982). "Liver" in Cancer Epidemiology and Prevention, eds: D Schottenfeld and IF Fraumeni. WB Saunders Co. Philadelphia, p 668. GreenwaldP, Friedlander BR. LawerenceCE, etal, (1981): Diagnostic sensitivity bias -- ati epidemiologic explanation for an apparent brain tumor excess. J Occup Med 23(10):690-94. MacFarland HN, Ulrich CE, Holdsworth CE, Kitchen DN, HalliWell. WH, and. Bum, SC (1984). A chronic inhalation study of unleaded gasoline vapor. J Amer College Toxicol 3:231-248. McLaughlin JK (1993). Renal Call Cancer and Exposure to Gasoline: A review. Environ Health Perspec Suppl 101 (Supplement 6): 111-114. Marsh GM and Preriinger M (1980). OCMAP: A user-oriented occupational cohort mortality analysts program. Aril Stat 34:254. Meinhardi TJ, Lemeen RA, Crandall MS and Young RJ (1982). Environmental epidemiologic investigation of the styrene-hutadiene rubber industry. Scand J Work Environ Health 8:250-59. Pickle LW, Mason TJ, Howard N, etal. (1987). Atlas ofU.S. Cancer Mortality among Whites: 1.950 1980. DHHS Publication NO. (NIH) 87-2900. Poole C, Dreyer NA, Satterfield MH, Levin L, and Rothman KJ (1993). Kidney cancer and hydrocarbon exposures among petroleum refinery workers. Environ Health Perspect 101 (Suppl 6):53-62. Rinsky RA, Young RJ, Smith AB, et al. (1981). Leukemia in benzene workers. Am J Ind Med 2:217-45. ---- Epidemiology tii Biostatistics 16 Port Arthur Mortality Study Rushton L, (1993). A 39-year follow-up ofU.K. oil refinery and distribution center studies: results for kidney cancer and leukemia. Environ Health Perspeet 101 (Suppl 6):77-84. Rushton L and Alderson MR (1981). An epidemiological survey of eight oil refineries in Britain. Brit J Indust Medicine 38:225-234. Schnatter AR, Katz AM, Nicoiich MI, and Theriault G (1993). A retrospective mortality study among Canadian marketing and distribution workers. Environ Health Perspeet 101 (Suppl 6) 85-99, Schoenberg BS (1982). "Nervous System" in Cancer Epidemiology and Prevention, eds: D Schottenfeld and JF Fraumeni, WB Saunders Co. Philadelphia, p 968, Selvin S, Levin LL Merrill DW and Winkelstein W (1983): Selected epidemiologic observations of cellspecific leukemia mortality in the United States, 1969-19.77, Am J Epidemiol 117(2): 140-52. Swenberg JA (1993). ^-Globulin nephropathy: Review ofthe cellular and molecular mechanisms involved and their implications for human risk assessment. Environ Health Perspcc Suppl 101. (Supplement 6): 39-44, Taberhaw Occupational Medicine Associates, P.A. (1980): An historical prospective mortality study of workers potentially exposed to benzene and the lubricating-solveut units of the Gulf Port Arthur Refinery. Report presented to the Gulf Oil Company. Tsai SP, Wen CP. Weiss NS, et al (1983): Retrospective mortality and medical surveillance studies of workers in benzene areas of refineries. J Occup Med 25:685-92, Wen CP, Wong O, Tsai SP, and Gibson RL (1980): Epidemiology of refinery workers with solventrelated exposures. Gulf Oil Corporation. Presented at the 11th Conference on Environmental. Toxicology, .Dayton, OH. Wen CP, Tsai SP, McCellan WA, and Gibson RL (1981a): Retrospective cohort study of refinery workers. Gulf Oil Corporation. Presented at the Occupational Health Epidemiology Section, APHA Annual Meeting. Los Angeles. CA, Wen CP, Tsai SP, and Gibson RL (1981b): A report on brain tumors from a retrospective cohort study of refinery workers, Ann NY Acad Sci 381: 130-38. Wen CP, Tsai SP, Weiss NS, etal. (1981c): A population-based cohort study of brain tumor mortality among oil. refinery workers with a discussion of methodological issues of.SMR and PMR. in Banbury Report No. 9: Quantification ofOccupational Cancer, pp. 41.3-32. Wen CP, Tsai SP, McCellan WA, and Gibson RL (1983): Long-term mortality study of oil refinery workers. I. Mortality of hourly and salaried workers. Am J Epidemiol 118: 526-42. Wen CP, Tsai SP, Gibson RL, and McCellan WA (1.984a): Long-term mortality study' of oil refinery workers. II, Comparison of the active, the terminated and the retired workers. J Occup Med. 26:11:8-27. Epidemiology'& Biostatistics 17 1987 Update Wen CP, Tsai SP, Weiss NS, et al (1984b): Result oriented medical information system; an alternative to the conventional approach. J Occup Med 26:386-91. Wen CP, Tsai SP, Moffitt K, Bondy M, Runion H, and Gibson RL (1984c): Leukemia among oil. refinery workers and residents in the surrounding communities. Gulf Oil Corporation. Wen CP, Tsai SP, Moffitt K, Bondy M, Runion H, and Gibson R1 (I984d): Epidemiologic studies ofthe role of gasoline exposure (hydrocarbon) in kidney cancer risk. In Mehlman MA, ed. Advances in Modern Environmental Toxicology, VoJ VII Renal effects ofpetroleum hydrocarbons, pp. 245-5 Wen CP, Tsai SP, Gibson RL, et al (1985): Long-term mortality study of oil refinery workers. IV. Exposure to lubricating-dewaxing solvents, including methyl ethyl ketone (MEK). J Natl Cancer Inst 74:11-1*. ~ Wen CP, Tsai SP. Weiss NS, and Gibson RL (1.986); Long-term mortality study ofoil refinery workers. V. Comparison of workers hired before, during, and after World War II (1940-1945) with a discussion of the impact of study designs on cohort results. Am J tod Med 9:171-180. Wintrobe MM, Lee GR, Boggs DR, et al. (1981): Clinical ffematolog}>, (Eighth edition). Lea & Febiger, Philadelphia, p 151.4, Wong O, Morgan RW, Bailey WJ, Swencicki RE, Claxton K and Kheifets L (1986): Am epidemiological study of petroleum refinery workers. Br J Ind Med 43 :6-17. Wong O and Whorton MD (1993): Diagnostic bias in occupational epidemiologic studies: an example based on the vinyl chloride literature. Am J Ind Med 24:251-256. Wong O, Harris F, and Smith TJ (3993). Health effects of gasoline exposure. II. Mortality patterns of distribution workers in the United States. Environ Health Perspeet 101 (Suppl 6):63-76, Wong O and Raabe GK (1994): Cell-type specific Leukemia analyses in a combined cohort of mare than 208,000 petroleum workers in the United States and the United Kingdom. Submitted for publication. Epidemiology & Biosiatistics 18 Table 1 Demographic and Vital Status Characteristics for All Cohort Members Port Arthur Refinery Update, 1937--1987 Male Female TOTAL Population Size (%) Person-Years of Follow-up Year of Birth Distribution < 1900 ' 1900-1909 1910-1919 1920-1929 1930-1939 1940-1949 1950-1959 1960-1969 Age1 Distribution Average P50 P33 Range Race Distribution White White Assumed White Non--White Black Assumed Black Hispanic Native American Asian Unknown Vital Status (as of 12/31/87) Alive Dead3 Unknown 15855 (89) 474875 1989 (11) 51512 15.5% 15.6 21,2 20.8 9.2 7.1 9.7 1.0 . 1.7 6,1 22.2 43.2 7.0 8.1 11.1 0.6 49.4 yrs 52.7 80,6 16.4-104.72 33.6 27.5 67.6 15.4-92.6 79.0% 0.5 17.0 0.1 1.5 0,1 Q.l 1.7 52.4% 41.1 6.5 88.6 0.8 5.8 0.1 1.3 Q.l 0.1 3.3 55.0 13,9 31.14 17844 (100) 526387 13,9 14.5 21,3 23.3 8.9 7.2 9.9 0.9 47.7 48,0 80,2 15.4-104.7 80.1 0.5 15.7 G..1 1.5 0,1 0.1 1.9 . 52,7 38.1 9.2 Age at earliest of: time of death, loss to follow-up, or end of study (13/31/87), Note: F^g, refers to the 50th percentile (median) and 95 refers to the 85th percentile. ~ The dates used to calculate the age were verified for accuracy by checking against the hard -copy work hiS'Lory and S-IEOIC. The dates were correct. There are males in the cohort who were born iti the late 1600s and lived more than 100 years. Death certificates. obtained for 0455 (952) dcdent.s Of the women with an unknown vital status, over 88% had retired, terminated, or had been transferred on or before 12(31/60 making tracing nearly impassible. In fact, almost <m~fchird wr lest to folio*?--up during the period 1940-19^5. Table 2 Employment Characteristics for All Cohort Members Port Arthur Refinery Update, 1937-1987 Male (n15.855) Female(n&1989) TOTAL(n-17844) Employment Duration < 1 year 1-9 10-19 20-29 > 30 22.2% 23,6 14., 7 10.3 29.3 Average Pbc P95 Range 16.7 yrs 12 .. 4; 41.3 3 days-54.6 years1 41.3 40.3 9,7 4,0 4.7 5.8 1.8 29.2 3 days-44.7 years 24.3' 2S.4 14,1 9.6 26.6 15.5 10.2 40.8 3 days-54.6 years 1There are males in the cohort whose length of employment exceeded SO years. The date of hire and the date of termination were checked for these males. The dates were correct according to personnel records. Table 3 Time of Hire Characteristics for All Cohort Members Port Arthur Refinery Update, 1937--1987 Male (n--1585 5 ) Female(n~l989) T0TAL(rri.7844>1 Interval Since Hire1 < 10 years 10-19 20-29 30-39 > 40 10.2% 15.5 9.9 24.6 .39.8 Average 1*50 P95 Range 33.2 yes 35.6 58.1 3 days-77.5 years 29.6 11.3 6,5 16.0 36.7 26.3 31.9 47.3 3 days-7 2.0 years 12,3 15.0 9.5 .23.6 39,5 32.4 35.4 57.5 3 -days--77.3 ; Year of Hire 1900-1909 1910-1919 1920-1929 1930-1939 1940-1949 1950-1959 1960-1969 1970-1979 1980-1987 0.5% 5.3 15.9 9.9 34.S 14.7 4.0 13.0 2,2 0.0 0,2 1.9 6.9 61.7 7.7 3,5 15.4 2.6 0.4 4.7 14.3 9,6 37.6 13.9 3.9 13,3 2,3 Age at Hire < 20 years 20-29 30-39 40-49 > 50 18.4% 59.7 16,7 4,4 0,8 32.7 51.7 12.9 2.4 0.3 .20.0 58,8 16,2 4.2 0.8 1 Interval since initial hire is the period between hire date and the earlier of date of death, date of last contact, or end of study. Table 4 Time of Death Characteristics for All Cohort Members Port Arthur Refinery Update, 1937--1987 Age at Death <29 years 30-39 40-49 50-59 60-69 > 70 Average Age (yrs) ^50 Year of Death 1930-1939 1940-1949 1950-1959 1960-1969 1970-1979 1980-1987 Male(n--6522) Female(n-277) 1.6% 3.5 8.3 18.6 27.7 40.2 65.3 66,7 1.0% 6.8 12.9 21.0 31.0 27.3 1.1 4.7 11.2 23,1 30.3 29.6 62.9 63,5 0.4 1.4 6.5 9.4 30.0 .52,3 TOTAL (n-6799) 1-6 3.5 8.4 18.8 27.8 39.8 65.2 66.6 1.0 6.6 12.6 20.5 31.0 28.3 Table 5 Cause Specific SMRs for ALL COHORTMEMBERS Port Arthur Refinery Update, 1937--1987 Expected Deaths Based on TEXAS DEATH RATES No. ofPersotis.atRisk = 17,844 Person-Years -- 526,386.7 CAUSE OF DEATH <ICDA 8th REVISION CODES) Observed Expected SMR 95% Confidence Interval Lower Upper All Causes ofDeath Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs &. Peritoneum Cancer ofEsophagus Cancer of Stomach Cancer of Large Intestine Cancer ofRectum Cancer ofBiliary Passages & Liver Cancer ofPancreas Cancer ofRespiratory System Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer ofBladder and Other Urinary Organs Malignant Melanoma of Skin Cancer ofEye Cancer of Central Nervous Svstern Cancer ofThyroid & Other Endocrme Glands Cancer ofBone Cancer ofAll Lymphatic, Haematopoietic Tissue lymphosarcoma & Rciiculosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Benign Neoplasms/Necplasnis of Unspecified Nature Diabetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endoeard Dis,; Other Myocard. Insuff, Hypertension, with Heart Disease Hypertension vy/o Heart Disease Non--malignant Respiratory Disease Influenza &. Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis ofLiver Nephritis & Nephrosis All External Causes ofDeath Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes ofDeath Unknown Causes (In All Causes Category Only) 6799 33 1482 . 36 377 23 95 117 26 13 94 448 423 .22 7 3 5 126 5 40 25 21 2 39 7 13 138 13 18 57 50 28 1Q7 502 .2534 32 1994 44 72 32 346 132 101 21 72 8 28 79 50 547 367 169 198 111 69 684 347 7336.0 38.7 1444.3 40.9 371.7 34,1 80.2 106.4 26,3 31,0 80.8 485.5 459.8 17.6 6,7 4.2 5.3 131.0 6,3 31.3 34:8 18.7 1.0 33.1 4.6 6.3 131.7 .23.0 12.7 55.9 40.1 14.4 101.2 600.5 2784.9 36.7 2283.3 81,6 63,7 29.9 469.4 199.7 137.8 24.5 102.5 10.7 37.0 121,9 51.6 759.3 467.9 239.6 229.1 118,2 137.8 833.1 92.7 ** 85.2 102.6 87.9 101.4 .67,5 118.5 110.0 98.8 41,9 ** 116.4 92,3 92,0 125.4 104,2 71.5 93.7 96.2 79.0 127.9 71.9 112.2 191.7 117.7 151,3 207.8 * 104,8 56:5 * 141.3 102,0 124,7 194.9 ** 105,7 83,6 91,0 ** 87.1 87.3 ** 54,0 ** 113.0 107.2 73.7 ** 66.1 ** 73.3 ** 85.7 70.2 ** 74.8 75.6 64,8 ** 96.9 72.0 ** 78.4 ** 70.5 ** 86.4 *' .93,9 50.1 ** 82.1 ** 90.5 58.6 97.4 61.6 91.4 42.8 95.9 90.9 64,5 22.3 94.1 83.9 83.4 78.6 41.9 14.7 30.4 80.1 25,6 91.4 46.5 69.5 23,2 83.7 60.8 110.6 88.0 30.1 83,7 77.3 92.6 129.5 86.7 76.4 87.5 59.6 83.5 39.2 88.4 73.3 66.1 55.3 59.7 53.1 54.9 32.3 50.3 51.3 71.9 66.1 70.6 60.3 74.8 77.2 39.0 76.1 94.9 119.6 108.0 121.8 112.2 101.3 144.9 131.8 144.8 71.6 142,4 101.2 101,2 189,8 214,7 208.8 218.5 114.5 184.3 174.2 106.1 171.5 692.5 160.9 311.8 355.3 123.8 96.5 223.3 132.2 164.5 281.7 127.8 91.2 94.6 123,0 91.2 72.4 142.3 151.3 81.9 78.4 89.1 131.0 88.4 147,4 109.3 80.8 127.7 78.3 86.9 82.0 99.3 113.1 63.4 88,5 * SIGNIFICANT'AT 5%, LEVEL ** SIGNIFICANTAT 1% LEVEL Tabic 6 Cause Specific SMRs for ALL COHORT MEMBERS .Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on US DEATH RATES No, of Persons at Risk ~ 17,844 Person--Years *= 526,386.7 CAUSE OF DEATH (ICDA 8th REVISION CODES) Observed Expected SMR All Causes of Death Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Inte-stine Cancer of Rectum Cancer of Biliary Passages Sc, Liver Cancer of Pancreas Cancer of Respiratory System. Cancer of Bronchus, Trachea, Lung Cancer of Breast AU Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancar of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer -of Rye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer oiBona Cancer of AH Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticnlosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Mellitus Cerebrovascular Disease AH Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis,; Other Myocard, Insuff Hypertension with Heart Disease Hypertension w/o Heart Disease Noii-malignant Respirator)' Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephri tis & Nephrosis. All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category Only) 6799 33 1482 36 377 23. 95 117 26 13 94 448 423 22 7 3 5 126 5 40 25 21 2 39 7 13 138 13 18 57 50 28 107 502 2534 32 1994 44 72 32 346 132 101 21 72 8 28 79 50 547 367 169 198 111 69 684 347 7541.1 41.3 1528.6 410 435.9 44.5 92.5 1343 43.5 26.6 80.6 482.2 454.2 21.0 7,0 4.2 6.4 136,4 6.9 32.7 44.7 14.7 LI 35.2 5.1 6.6 135.6 25.4 14.2 510 41.1 18.9 115.9 584.4 3008.5 63.6 2650.5 .62.2 74.6 32.5 494.7 215.2 132.9 21.9 98.5 11.9 45.2 160.5 49.2 .657.8 410.0 190.3 220,0. 120.0 96.2 768:2 90.2 ** 79.9 97.0 80.0 86.5 ** 51.6 ** 102:7 87.1 59.8 48.8 ** i 16.7 92,9 93,1 104.8 99,9 70.9 78.7 92.4 72.5 122.4 519 **. 142.7 175.3 110.8 137.8 198.4 * 101.8 51.2 * 127.1 .103.7 121.7 148.4 92.3 85.9 ** 84.2 .**. 50.3 ** 75.2 ** 70.8 * 96,5 98.3 69.9 * 61.3 ** 76.0 ** 96.0 73.1 ** 67.0 61,9 ** 4$;2 **' 101.6 83.2 ** 89.5 * 88.8 90,0 92,571*7 ** 89.0 ** . * SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL 95% Confidence Interval Lower Upper 88.0 55.0 92.1 56,0 78.0 32.7 83.1 72.0 39.1 26.0 94,3 84.5 84.5 65.7 40.1 14.6 25.5 77.0 23.5 87.5 36,2 88,4 21.2 78.8 55.4 105.6 85.5 27.3 75.3 78.6 90.3 98.6 75.7 7.8.6 81.0 34.4 72.0 51.4 75.5 67.3 62,8 51.3 61.9 59.4 57,2 28.9 41.2 39.0 75.4 76.3 80.6 75.9 77.9 76.1 55.8 82.5 92.3 112.2 102.0 110,8 95.7 77.5 125.6 104.4 S7.7 83.4 142.8 101.9 102.4 158.7 205.8 207.2 183,6 110.0 169.1 166.7 82.5 218.2 633.3 151.5 2S3.9 339.3 120.3 87.6 200.9 134.4 160.4 214.4 111.6 93.8 87.6 71.1 78.6 95.0 121.5 138.8 77.7 72.7 92.3 146.8 92.1 132.0 89.5 61.3 133.9 90.4 99,2 103.3 103.4 111,4 90.8 90.0 Table 7 Cause Specific SMRs for WHITEMALES Port Arthur Refinery Update, 1937--1987 Expected Deaths Based on TEXAS DEATH RATES No. ofPersons at Risk = 12,608 Person-Years -- 386,469,8 CAUSE OF DEATH (ICDA 8th REVISION CODES) Observed Expected AH Causes ofDeath Tuberculosis AM Malignant Neoplasms Cancer ofBuccal Cavity & Pharynx Cancer ofDigestive Organs & Peritoneum Cancer ofEsophagus Cancer of Stomach Cancer ofLarge Intestine Cancer ofRectum Cancer of Biliary Passages & Liver Cancer ofPancreas Cancer ofRespiratory System Cancer ofBronchus, Trachea, Lung Cancer ofBreast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer ofProstate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer ofBladder and Other Urinary Organs Malignant Melanoma of Skin Cancer ofEve Cancer of Centra! Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer ofBone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Rcticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer ofAH Other Lymphopoietic Tissue Benign Neoplasms/Neqplasms ofUnspecified Nature Diabetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis,; Other Myocard. Insuff, Hypertension with Heart Disease Hypertension w/o Heart Disease Non--malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes ofDeath Unknown Causes (In AM Causes Category Only) 5180 22 1096 27 271 11 58 90 22 no 73 352 333 0 0 0 0 90 4 27 17 21 2 32 6 10 113 9 14 52 38 17 70 349 2026 24 1649 23 42 24 264 91 92 19 68 5 2.1 65 29 433 295 137 158 96 42 520 244 5362.4 26.0 1045,5 31,1 258.4 19.6 50,8 79,1 19,2 21.2 59.7 373.1 353.9 1.1 0.0 0.0 0.0 86,8 4.8 25,2 26.4 16.9 0.9 28.1 3..7 4.6 101.1 18.5 10.2 44.2 28.2 9.8 69.7 400.3 2128.7 27.6 1816,8 58.6 32.4 14.4 364.5 142.9 115.8 20.5 89,7 6.4 28.7 96.2 29.5 534.1 347.7 180.4 168.1 105.1 55.4 580.5 SIGNIFICANTAT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL SMR 96.6 * 84.5 104.8 86,9 104.9 56.2 114.1 113.8 114.5 47.3 * 122.4 94.3 94.1 ------- ---- -- ------ 103.7 84.3 107.2 64.5 124.1 219.8 114.0 163.7 217.2 * 111,7 48.8 * 137.4 117.6 134.6 172.7 * 100.4 87.2 ** 95.2 * 87.0 90.8 ** 39.3 ** 129.6 167.3 *' 72.4 ** 63.7 ** 79.5 * 92.8 7S.8 * 77.6 73.1 .67.6 ** 98.4 81.1 ** 84.9 ** 76.0 ** 94.0 91.3 75.9 89.6 * 95% Confidence Interval Lower Upper 94.0 53.0 98.7 57.3 92.8 28.1 86.7 91.5 71.7 22.7 95.9 84.7 84.3 0,0 -- ------ 83.4 23.0 70.7 37.6 76,8 26.6 78.0 60.1 304,1 92,1 22.3 75.1 87.8 95.2 300,6 78.3 78.3 91,1 55.8 86.4 24,9 93.4 107.2 64.0 51,3 64.1 55.8 58,9 25.2 45,3 52.2 65.9 73.6 75.4 63.8 79.9 74.0 54,7 82.0 . 99.3 128.0 111.2 126,4 118.2 100.6 147.5 139.9 173.3 86,9 153.9 104.7 104.8 327.1 -- ------- 127.5 215.8 156.0 103.2 189.7 794.0 160.9 356.4 399.4 134,4 92.6 230.5 154.2 184.7 276.6 126.9 96.8 99.4 129.5 95.3 58.9 175.1 248.9 81.7 78.2 97.5 144.9 96.1 381-2 111.8 86.1 141,3 89.1 95,1 89.8 109.8 111.3 102.6 97.6 Table 8 Cause Specific .SMRs for NGN--WHITE MALES Port Arthur Refinery Update. 1937-1987 Expected Deaths Based bn TEXAS DEATH RATES No. of Persons at IRisk -- 3,247 Person-- Years. = 88,404,7 CAUSE OF DEATH (ICDA 8th REVISION CODES) Observed Expected SMR 95% Confidence Interval Lower Upper All Causes ofDeath Tuberculosis AM Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer ofLarge Intestine Cancer ofRectum Cancer ofBiiiaiy Passages & Liver Cancer ofPancreas Cancer ofRespiratory System Cancer ofBronchus, Trachea, Lung Cancer ofBreast All Uterine Cancers (Females only) Cancer ofCervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer ofProstate (Males only) Cancer ofTestes and Other Male Genital Organs Cancer ofKidney Cancer ofBladder and Other Urinary Organs Malignant Melanoma of Skin Cancer ofEve Cancer of Central Nervous System Caticer ofThyroid & Other Endocrine; Glands Cancer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Rcticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer ofAll Other Lymphopoietic Tissue Benign Neoplasms/Necplasms ofUnspecified Nature Diabetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis.; Other Myoeard, Lnsuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non--malignant Respiratory Disease. Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer ofStomach & Duodenum Cirrhosis ofLiver Nephritis & Nephrosis All External Causes ofDeath Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes AJ1 Other Causes ofDeath Unknown Causes (in All Causes Category Only) 1342 11 295 7 86 11 35 18 1 3 17 80 75 1 0 0 0 36 i 10 7 0 0 4 0 2 20 3 4- 4 9 7 31 137 441. 7 297 20 29 8 71 35 9 2 4 3 7 11 21 93 S9 23 36 9 .25 132 77 1710.8 11.6 323.8 8.8 97,6 13,9 27.1 2LG 6.0 8.3 17.8 100.5 94.5 0.6 0.0 0.0 0.0 44.2 1.6 5.0 7.8 0.6 0.1 2.9 0.6 1.4 24.1 3.4 2.0 9.0 9,6 3.5 24.6 170,8 582.3 6.5 412.1 19.4 28.8 14.6 91,0 50.8 19.0 3.5 11.1 3,7 7.5 20.0 20.2 204,0 107.0 51.6 55.5 8.6 79.8 215.8 78.4 ** 94,7 91.1 79.6 88.1 79.4 129,3 85.8 16.7 * 36.2 .95,7 79.6 * 79.4 * 179.2 -- --------- 81.4 63.1 202.3 90.3 -- -- 140.1 "--- 146.0 83.1 88.4 200.5 44.3 93.4 201,6 125.8 77.5 ** 75.7 ** 108.3 72.1 ** 103.3 100.6 54.7 78,1 * 69.0 * 47,3 * 57,9 36.2 * 81.5 94,0 55.0 * 104.2 45.6 ** 55.1 ** 44.6 ** 64.9 ** 105.0 31.3 ** 61.2 ** . . 74,3 473 81.0 32.0 70.5 39.7 90.0 50.8 0.4 7.5 55.7 63.1 62.5 4,5 -- -- 57.0 1.6 96.9 36.3 0.0 0.0 38.2 0,0 17J 50.8 .18.2 54,6 12,1 42,7 81.0 85.5 65,0 68,8 43.5 64.1 63,1 67.4 23,6 61.0 48.0 21.6 7.0 9.9 16.8 37.8 27.4 64.5 36.8 42.0 28.3 45.5 4S..0 20.3 51,2 82.8 169.4 102.1 164.1 108.8 142.1 179.8 135.6 93.2 105.8 153.2 99.1 99.5 998.5. -- -- 112.8 351.8 371.7 186,1 578,6 4759.6 358.7 614.1 527.3 128.4 258.4 513.4 113.4 177.4 415,4 178.6 91.6 83.1 223.1 80.8 159.5 144.5 107.7 98.5 95.9 89.9 209.2 92.7 238.3 193.6 98.4 159.3 55.9 71.1 66,9 89.8 199.2 46.2 72.6 * SIGNIFICANT AT5%, LEVEL; ** SIGNIFICANTAT Wo LEVEL Table 9 Cause Specific SMRs for WHHEFEMALES Port Arthur Refinery Update, 1937--1987 Expected Deaths Based on TEXAS DEA'Il I RATES No. ofPetsons at Risk = 1,778 Person-Years =s 47,910.7 CAUSE OF DEATH (ICDA 8th REVISION CODES) Observed Expected SMR Ail Causes ofDeath ` Tuberculosis All Malignant Neoplasms Cancer ofBuccal Cavity & Pharynx Cancer ofDigestive Organs & Peritoneum Cancer ofEsophagus Cancer ofStomach Cancer ofLarge Intestine Cancer of Rectum Cancer of Biliary' Passages & Liver Cancer ofPancreas Cancer ofRespiratory System Cancer of Bronchus, Trachea, Lung Cancer ofBreast All Uterine Cancers (Females only) . Cancer of Cervix Uteri (Females only) Cancer of OtherFemale Genital Organs Cancer ofProstate (Males only) Cancer ofTestes and Other Male Genital Organs Cancer ofKidney Cancer ofBladder and Other Urinary Organs Malignant Melanoma ofSkin. Cancer ofEye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Rcticulosarcoma. Hodgkins Disease Leukemia & Aleukemia Cancer ofAll Other Lymphopoietic Tissue Benign Neoplasms/Neoplasms ofUnspecified Nature Diabetes Meliitvs Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard Dis.; Other Myocard.lnsuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non--malignant Respiratory Disease Influe.ma & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema. Asthma Ulcer ofStomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes ofDeath Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes ofDeath Unknown. Causes (In All Causes Category Only) 267 239.8 111.3 0 1.0 -- 89 70.3 126.5 * 2 1.0 198.5 20 14.6 137.4 1 0.6 175.8 2 .2.1 97.3 9 SJ 152.2 3 1.0 291.3 0 1.5 -- 4 3*1 129.1 15 11.3 132.6 IS 10.9 137.1 20 15,0 133.7 7 6.0 117.4 .3 3.7 80.4 5 5.1 98.7 0 0.0 -------- 0 0.0 -------- 3 1.1 2775 i 0.6 165.9 0 1.2. ------0 0.1 ------- 3 2.1 140.2 1 0.3 294.4 1 0.3 386.1 5 6,2 80.7 .1 1.1 87.4 0 0.5 ------- 1 2,5 40.7 3 2.1 145,6 4 1.0 420,5 * .6 6.0 100,4 16 20.6 77,5 54 66,5 96.3 1 2,5 39,9 45 49.7 90.6 1 3.3 30,4 1 1.9 51,8 0 0.7 -- 10 13.1 76,1 5 5.6 89.7 0 2.9 ------ 0 0.6 ------- 0 1.7 -- 0 0.5 -- -- -- 0 0.8 3 5.3 56.3 0 1.7 ---- 20 19.4 103.1 n 12.3 97.6 9 7.3 123.8 3 5.1 58.8 6 4.5 134,8 2 1.8 108.8 29 33.2 87,4 26 * SIGNIFICANT AT5%, LEVEL; ** SIGNIFICANT ATI% LEVEL 95% Confidence Interval tower Upper 98.4 0.0 101.6 24.0 83:9 4.4 11.8 69.6 60.1 0.0 35,2 74.2 76,7 81,7 47.2 16.6 32.0 -- ----- - 57.3 4.1 0.0 0,0 28,9 7,4 9.7 26.2 2,2 0.0 1.0 30.0 114.6 36.8 44.3 74.1 1.0 66.1 0.8 1.3 0.0 36.5 29.1 0.0 0.0 0.0 0.0 0.0 11.6 0.0 63.0 50.4 56.6 12.1 49.5 13.2 58.5 125.5 368.6 155.7 717.1 212.2 979.8 351.3 288.8 851.4 244.5 330.6 218.7 226.2 206.5 241,8 234.9 230,3 -- ------ 810.9 924.5 320.9 6659.8 409.6 1640.4 2151.5 188.3 487.3 691.0 226.7 425.4 1076.8 218.5 125.9 122.9 222.4 121.3 169.2 288.6 561.2 140.0 209.3 128.5 669.3 211.5 743.4 458.8 164.4 217,6 159.3 170.4 235.0 171.8 293,5 393.1 125,5 Table 10 Cause Specific SM Rs for ALL COHORT MEMBERS Stratified by Length of Employment Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES CAUSE OF DEATH (ICDA 3th REVISION CODES) Alt Causes of Death Tut>efcuiosk All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx. Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Oncer ot Biliary hissages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Brdtiehus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Carreer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer ot Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer ofAil Other Lymphopoietic Tissue <lyear Observed SMR 1-9 years Observed SMR 1346 5 305 11 67 8 13 19 2 3 20 104 101 6 2 0 2 14 1 9 3 5 0 12 1 2 25 3 3 8 11 ms ** 82.9 1.14,7 * 148.9 108.5 136.4 116.3 99.7 46.7 52.2 142,2 109.0 111.0 83.3 74.0 86.9 88.3 75.9 147.9 59.6 1.17,6 -------- 1.54.3 109-4 181.6 100.5 68.6 HOT 79.0 143.4 1135 9 242 4 56 t 11 18 3 2 18 77 72 11 1 0 2 12 1 6 5 4 0 6 2 3 23 3 5 5 10 95.8 136.7 102.4 61.7 98.9 35.0 98.8 107.8 76,7 38.5 146,8 94.8 93.3 197.7 43.1 115.8 80.0 57.7 115,1 111.3 103.1 -- 86.1 242.2 271.1 99.0 75-4 170.5 52.4 147.3 10-19 years Observed SMR 20-29 years Observed SMR. 30+years Observed SMR 784 87.2 ** 7 111.2 144 88.3 4 82.6 32 74.1 3 78.2 8 77.9 10 87.8 5 159,9 0-- 5 55,0 52 99.0 49 98.9 1 61.9 0 ------ 0 0 10 76.6 2 182.7 4 .110.2 2 52.3 4 154,7 0 ~-------4 87.1 1 166.8 2 244.8 10 61.1 2 64.7 l 47.3 5 73.6 2 45.9 1167 6 270 7 81 3 27 23 5 4 19 59 57 1 2 1 0 25. 0 7 4 2 1 6 0 3 33 3 4 21 5 87.0 ** 73.2 1.12,6 92.2 11.9.8 50.2 156.7 * 134.1 100.6 86.0 135.8 78,5 80.9 * 65.6 360.7 3_1_6_.2 109.8 ----- . 134,2 64,4 67.2 413.8 113.3 -- 242.9 152.6 * 72-1 185.1 222.7 **. 85.5 2367 6 521 10 141 7 36 47 11 4 32 156 144 3 2 2 1 65 1 14 11 6 .1 11 3 3 47 2 5 18 22 (continued) 88,2 ** 51.6 96.6 68.5 98.9 55.3 118.6 111.6 109,8 33.0 * 102.0 86.1 83.9 182,8 437.8 888.6 * 249.5 101.1 79.3 125.9 72.3 119.5 264.6 1.29.4 204.7 150.3 103.0 26,9 * 176.8 90.2 1427 Table 10 continued Cause Specific SMRs for ALL COHORTMEMBERS Stratified by Length of Employment CAUSE OF DEATH (ICDA Sib REVISION CODES) < 1 year Observed SMR 1-9 years Observed SMR 10--19 years Observed SMR 20-29 years Observed SMR 30+ years Observed SMR Benign .NeoplasmVNeopiasnis of Unspecified Nature Diabetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Dh-ease Chronic Endocard, Dis.t Other Myosard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non-malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis erf Liver Nephritis & Nephrosis All Externa! Causes of Death Accidents Motor Vehicle Accidents AH Other Accidents Suicides Homicides. & Other External Causes Ali Other Causes of Death Unknown Causes (In All Causes Category Only) 3 108.8 12 69-6 hi 80.9 439 100.8 3. 40.4 359 101.7 3 22 3 ** 7 76.9 1 218 82 113.7 25 92.7 26 127:6 3 87.9 22 .145.0 1 58.6 5 89.7 23 85.1 6 76.4 138 81.8. * 80 '77.2 * 39 69.2 * 41 86,3 32 117.3 26 86.2 115 85.4 151 4 17 55 357 3 293 1 .6 2 55 23 IS 0 14 1 .5 ' 14 8 153 104 50 54 24. 25 108 106 148.3 104.2 75.1 * 91.5 41.0 94.6 8.2 61.5 42.9 85.0 87,8 86,1 -- 112.9 52.4 92.5 57.7 91.8 70.1 * 81.2 * 70.0 *'* 94.7 80.0 49,8 ** 83.1 4 216.6 11 90,7 49 73.3 * 281 86.0 * 5 84.9 213 78.8 ** 9 110:3 5 65.9 5 106.5 48 91,5 22 94.6 10 63.1 1 35.8 7 62.0 .2 125.2 5 94.2 3 17.1 ** 7 97.8 77 5^.1 ** 51 66.0 ** 19 47.6 ** 32 85.5 14 73.1 12 45.3 ** 82 83.7 61 5 207.2 19 107.4 113 90.6 449 83.6 ** 8 119.3 347 76.6 " 16 134.8 26 214.3 **' 4 61.4 47 56.1 ** 20 50.1 ** 16 60.6 * 6 121.29 46.6 * 1. 46.5 2 25,1 * 12 52.4 * 9 91.6 76 66.6 ** 61 84.7 30 87.8 31. 82.0 12 63.7 3 17.2 ** 133 88.0 22 12 48 224 1008 13 782 15 28 20 114 42 34 n 20 3 11 27 20 103 71 31 40 29 3 246 7 257.9 ** 127,0 86.1 * 92.0 ** 138.4 87,1 ** 41.8 * 111.3 197.9 ** 58.1 ** 50.4 ** 58.8 ** 105.1 45,1 ** 90.1 86.1 88.6 110.7 806 * 81.6 82.1 810 1.26.4 223 ** 77.0 ** * SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANTAT 1 LEVEL # SIGNIFICANT DEFICITAT 5% LEVEL OBSERVED DEATHS = 0, SMRNQT CALCULATED, CAUSE OF DEATH (1CDA 8th REVISION CODES) Ail Causes of Death Tuberculosis Alt Malignant. Neoplasms Cancer ofBuccal Cavity & Pharynx Oncer ofDigestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Tung Qtncer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer ofOther Female Genital Organs Oncer ofPrestate (Males only) Cancer ofTestes and Other Male Genital Organs Cancer ofKidney Cancer ofBladderand Other Urinary Organs Malignant Melanoma of Skirt Cancer ofEye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Gmcer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer ofAll Other Lymphopoietic Tissue Table 11 Causa Specific SMRs for WHITE MALES Strati tied by Length ofEmployment PortArthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES < 1 year Observed SMR 1-9 years Observed SMR 1073 4 225 10 45 3 6 14 1 3 17 84 82 C G 0 0 13 1 4 3 5 0 12 1 1 17 1 3 7 6 115.2 ** 95.3 114,8 * 173.2 100.7 80.1 77.4 99.0 30.9 74.9 159.1 110.1 ,112.7 -- -- ---- -- 107.7 88.5 80,4 74.8 135,9 ------- 189.2 145,6 121.2 88.4 28,8 138.5 87.8 106.6 802 102,6 5 133.2 163 105.5 2 44,7 35 99.7 l 35.0 5 79.3 13 117.8 2 77.8 1 32.4 11 134.4 58 100.3 53 96.2 0 ---0 ------- 0-- 0-- 10 109.4 1 71$ 2 51.6 4 129.4 4 118.7 0 ------ 3 54.0 1 170.9 3 402.8 18 109.7 1 34.4 S 228.7 5 72.3 7 158.9 10--19 years Observed. SMR 20-29 years Observed SMR 30+ years Observed SMR 582 92.0 * 5 127.4 106 91.1 3 84.2 23 79.4 1 48.4 5 81.6 7 82.9 5 229.0 0 4 60.7 42 101.6 40 105.4 0 ____ 0-- 0-- 0 ____ 5 60.7 i 125.4 3 105;5 2 72.1 4 163.2 0 ------ , 2 50.2 1 202.8 2 335.7 6 43.1 2 81.5 0 ------ 4 74.5 0 --- 911 91.3 3 52.5 203 114.7 6 mi 55 115.1 1 29.9 14 123.8 17 129.0 .5. 134.8 3 94.2 15 142.6 42 72.7 * 41 755 0 ____ 0 _____ 0-- 0 ____ 20 129.2 0 ____ * 7 165.4 2 42.1 2 72.1 1 471.6 6 128.6 0-- 3 313.5 31 182.1 ** 3 87.6 4 223.5 19 246.3 ** 5 122.6 1812 5 399 6 113 5 28 39 9 3 26 126 117 0 0 0 0 42 1 11 6 6 i 9 3 1 41 2 2 17 20 89.8 ** 59.7 99.3 52.1 110.9 66.3 145.0 120.8 119.7 34,6 109.8 .89.3 87.5 ___ ____ ___ 1003 123.5 119.0 53.1 137.2 287.1 119.5 245.4 67,5 114.0 32.3 83.9 104,6 179.7 * (continued) Table 11 continued Gtuse.Specific SMRs for WHITE MAIMS Stratified by Length ofEmployment CAUSE OF DEATH (ICDA 3th REVISION CODES) < lyear Observed SMR 1-9 years Observed SMR 10--19 years Observed SM R 20-29 years Observed SMR 304" years Observed SMR Benign Neoplasms/Neopiasms of UnspecificdNature Diabetes Mellilus Cerebrovascular Disease Ail Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endoeard. Dis.; Other Myocard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease . Non --malignant Respiratory Disease Influenza & Pneumonia . Bronchitis. Emphysema, Asthma. Bronchitis Emphysema Asthma Ulcer of Stomach. & Duodenum Cirrhosis of Liver Nephritis & Nephrosis Alt Externa! Causes of Death Accidents Motor Vehicle Accidents Ail OtherAccidents Suicides Homicides & Other External Causes All Other Causes ofDeath Unknown Causes (In AH Causes Category Ottly) 0 _____ TO 83.7 4S 86.4 369 105.5 2 36.9 310 10S.6 3 9.9 ** 5 97.0 1 50.8 67 117.6 19 95.6 24 140.5 3 104.5 20 150.3 1 100.9 4 91.0 19 89.9 6 122.1 111 88,3 68 83-5. 34 76.3 34 91.5 27 113.4 16 110.1 91 93.1 121 2 121.3 14 1431 33 80.5 278 101.2 3 61.1 236 1015 0 ------- ## 4 99.5 2 123.4 35 78.4 33 81.1 13 98.9 0-- 12 118.3 1 1.191 3 8.1.5 10 581 4 9L3 1.17 810 * 82 89.3 40 76,7 42 10S.2 20 78.9 IS 80.7 65 80.6 71 4 328.6 5 61.4 28 61.6 * 227 93.4 2 45.2 174 82.7 * 5 86,4 3 90.8 5 289.9 35 90.6 1.5 97.8 8 63.0 .1 44.7 7 72;3 0-- 4 105.6 2 15.0 ** 4 104.9 60 68.7 * 40 72,0 * 13 44-8 ** 27 101.4 12 69.8 8 8S.0 65 991 32 3 182.4 13 103.1 88 102.2 364 87.7 * 6 114.4 288 79.2 ** 12 143:3 16 248.9 2 61.1 34 52.0 ** 12 4iA ** 13 58.0 * 4 96.4 9 53.0 0-- 1 15.8 * 12. 64.2 7 124.2 61 74.0 * 48 89,3 25 971 23 52.2 a 63.0 2 29.3 105 98.0 15 8 233.4 * 28 1029 1S5 86.3 788 931 * 11 145.2 641 89.1 ** 5 18.9 ** 14 103,6 14 243.0 93 58.6 ** 32 51.1 ** 34 67,4 * 11 122,0 20 50,5 ** 3 128.7 9 85.6 22 85.3 8 74,6 84 87.6 57 87.5 25 86.7 32 87.9 26 12.2.0 1 16.7 * 194 84.5 * 5 * SIGNIFf CANTAT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL ## SIGNIFICANT DEFICITAT 1% LEVEL OBSERVED DEATHS = G, SMRNOT CALCULATED. Table 12 Cause Specifics SMRs for NON--WHITE-MALES Stratified by Length of Employment Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES CAUSE OF DEATH (ICDA 8th REVISION CODES) Ail Causes oF Death tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer o[ St6m&di Cancer of Large Intestine Cancer <>[ Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Lutig Cancer ofBreast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of OtherFemale Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladderand Other Urinary Orgas Malignant Melanoma ofSkin Cancer of Eve Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Oncer-of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma fe Reticulosarcoraa Hodgkins Disease Leukemia & Aleukemia Cancer ofAll Other Lymphopoietic Tissue < 1 year Observed SMR 1-9 years Observed SMR 10--19 years Observed SMR 20-29 years Observed $b1R 30+ years Observed. SMR 170 87.8 240 75.2 ** 178 714 ** 227 71.9 527 82.8 ** 1 72.8. 4 168.3 2 8S.6 3 124.5 1 31,3 43 112.7 47 810 33 81.8 58 103.0 114 86.6 ,1 85.9 1 59.7 1 81.2 0 ------- ## 4 133.4 13 119.7 16 95.9 7 54.2 23 126.7 27 69.2 4 216,6 1 37.8 1 116.3 2 77.6 '* 2 39.6 5 195.1 6 146.0 3 76.4 13 229.2 8 74.0 2 82.3 0 2 53.8 0 ------ - 2 82.5 0 --- -- 4 121.1 0 ------- 4 8 87,8 1 41.9 0 i 6L8 0 1 76.6 1 30.5 2 93.1 6 .196.5 0 3 96.1 6 81.9 12 87.7 12 61.5 9 77.8 .17 103,0 30 76.5 12 92,9 12 65,3 8 74,2 16 104,2 27 72,9 0 -------0 ------ - 0 ----- 0 ---- -- 1 1018.8 0-- 0-- 0-- 0 0 0 ------0-- 0 --T -- 0-- 0 ------- # 0-- 0 ------0-- 0 -----" 0-- 1 25.4 0-- 2 34.2 0-- 5 103.6 1 329.0 5 68.6 ** 0-- 23 1.025 0-- 4 635.8 ** 3 308.5 0-- 0-- 0-- 0-- 1 143.7 0 ----0-- 0-- 2 145.1. 0-- 2 113.1 5 147.5 0 0 0 ------- . 0-- 0 ------- ## 0-- 0 0-- d-- 1 149.9 0 0-- 1 239.3 0-- 0 0 ------- # 0 -------- 0 ---- -- 2 236.0 0-- 2 406.0 3 102.7 1 245.5 0 --0-- 2 180.2 5 107.1 2 289.3 .0 -- 0-- 3 177.9 4 119.7 0-- 1 251.1 1 82.7 % 165.1 2 49.8 0 "---- 0 2 134.9 0-- 6 65.9 0-- 3 723.0 * 1 28.7 2 49.2 (continued) Table 12conftoucd Cause Specific SMRs for HON-WHITE MALES Stratified by Length of Employment CAUSE. OF DEATH (ICDA 8th REVISION CODES) Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Mellilus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard.Dis.; Other Mvocard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non --malignant Respiratory' Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents Ail OtherAccidents Suicides Homicides & Other External Causes All Oilier Causes of Death Unknown Causes (InAll Games Category Only) < 1 year Observed SMR 1-9 years Observed SMR 10-19 years Observed SMR 20-29 years Observed SMR i 237.8 2 73.7 11 69.2 46 76.6 1 115.6 32 78.4 1 47.1 2 64.3 0-- 11 112.7 5 99.0 2 99,3 0 ~---- 2 180.8. 0 1 1174 2 0 __6_6_.4_ 21 62.0 * 9 54.4 3 35,6 6 73:8 3 216.3 9 61,5 1.1 48.1 ** 20 0 _____ i 22.9 16 66.8 61 0 71.4 ** -- 45 76.7 1 31,1 2 40.4 0 --- 16 101.5 8 96.0 1. 0 --60.3 2 0 --116.4 2 137.8 3 58.8 4 109.4 23 40,1 ** 13 54.4 ** 5 43,2 * 8 66.3 1 34.5 9 29.6 ** 28 75.0 22 0 _____ 5 145.9 17 72.0 49 62.8 ** 3 246.9 34 61.1 ** 4 185.6 2 4S.9 0-- 12 93,8 6 80.5 2 69.2 0. -- ,--0 ---+- 2 280.8 1 69.4 1 27.1 3 94,1 13 31.5 ** S 38.9 ** 3 29,3 * 5 48,3 1 63.4 4 23.7 ** 16 54.2 ** 26 2 293.3 6 137.8 24 68 7.1 63.3 1 79.9 49 59.6 4 133,9 9 166.4 2 63.8 12 n.2 7 69.6 3 8.L1 2 269.6 0 ----- 1. 149.8 1 0 --65 2 50 13 42.6 11 63.1 4 49.8 7 74.6 1 84 1 9.5 27 67 6 * SIGNIFICANTAT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL # SIGNIFICANT DEFICITAT 5% LEVEL OBSERVED DEATHS = 0, SMR NOT CALCULATED. ## SIGNIFICANT DEFICITAT 1% LEVEL. OBSERVED DEATHS = 0, -SMR NOT GALOJIATED. 30+ years Observed SMR 4 349.4 17 173.9 * 68 88.8 208 87.3 * 2 120.9 133 78.4 ** M 1125 14 124.3 6 142 20 S5.9 ** 9 45.3 * 0 0 ~~-- ,, 0 -----# 0 ---- - 2 92.4 5 113.9 12 168.4 19 611 * 14 66.1 6 69.2 g 64 3 1967 2 269 9 50 58.3 ** 1 CAUSE OF DEATH (ICDA 8th REVISION CODES) All Causes of Death Tuberculosis AH Malignant Neoplasms Cancer 01 Buccal Cav'tiy & Pharynx Queer ofDigestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Respiratory' System Cancer of Bronchus, Trachea, Lung Cancer ofBreast All Llteriue Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer ofOther Female Genital Organs Cancer ofProstate (Males only) Cancer ofTestes and Other Male Genital Organs Cancer of Kidney Cancer ofBladderand Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Queer ofCentral Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer ofAH Lymphatic, Haematopoietic Tissue Lymphosarcoma & Rettculosafcoma Hodgkins Disease Leukema & Aleukemia Cancer ofAll Other LymphopoieticTsssu Table 13 Cause SpeoificSMRs for WHITTS FEMALES Stratified by Length of Employment PortArthur Refinery Update^ .1937-1987 Expected Deaths Based on TEXAS DEATH RATES < 1 year Observed SMR JOT 105.4 0-- 36 1173 0-- 9 152.2 1 407.7 2 244.9 3 124.9 1 242.1 0-- 1 73.3 7 131,7 7 136.0 6 89.2 2 79.1 a *** ** SB 2 89.6 c-- a-- i 214.9 0 ------(i -- 0 --0-- 0 ---- 1 925.9 5 189.8 1 0 -2-0--6-.-7-- 1 97.3 3 335.8 1-9 years Observed SMR 87 119.2 0 ---- -- 31 139.8 1 320.9 5 115.2 0 -----_ 0 ---- 3 170.5 i 324.8 0-- i 109.4 7 195.7 7 202.3 9 185.6 1 51.1 0 -----2 125.2 0-- 0 1 302.2 1 587.5 0-- 0 2 279.7 1 926.9 0 ------- 0-- 0-- 0 -------1 0-- 0-- 10--19 years Observed SivtR 20-29 years Observed SMR 30+ years Observed SMR 24 123.1 0-- 5 84.4 0-- 2 161.3 0-- 0 ---- -- 1 205.0 0 ---- 0 -------' 1 402.1 1 126.5 1 131.5 1 76.4 0 ---- -- 0 0 0 ---- -- 0 0-- 0-- 0-- 0-- 1 547.3 0-- 0 --0 *--* 0 Q ---- 0-- 0-- 29 108.4 0-- 9 146.0 1 1145,0 3 186.8 0-- 0 ------- . 2 304,6 0-- 0-- 1 295.6 0-- 0: ----rsa. 1 86.3 2 395.7 1 349.2 0 ~---- 0 0-- 0-- 0-- 0-- 0 .... 0 0-- 0 ---- ~~ 0-- 0-- 0-- 0 0-- 26 0 8 0 1 0 0 0 1 0 0 0 0 3 2 2 i 0 0 i0 0 0 0 0 0 0 0 0 0 0 105.1 --148.3 -- 68.7 ------ ,, ----- ,, ---- -- 997.5 -- -- ,------ 328.4 562.2 1142.2 * 277.5 --- - -- 1041.9 -- ---------- --- "=----- -- -- '-------- -- (continued) Table 13 continued Cause Spedfic SMRs for WHITE FEMALES Stratified by Length of Employment CAUSE OF DEATH (ICDA Stb REVISION CODES) < 1 year Observed SMR Benign Neoplasms/Neoplasms of UnspecifiedNalure Diabetes Melliius Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard, Dis.; Oilier Myocard, Irtsuff. Hypertension with Heart Disease Hypertension w7o Heart Disease Non--malignant Respiratory Disease Influenza & .Pneumonia Bronchitis Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes ofDeath Accidents Motor Vehicle Accidents All OtherAccidents Suicides Homicides & Other External Causes All Other Causes ol Death Unknown Causes (In All Causes Category Only) 2 490.1 0 -- ---- s 72.2 24 99.1 0 ----- 17 9S.6 1 82.0 0-- 0 ~~ ~ . 4 76.5 i 51.0 0-- 0 ---- TM 0-- 0 -- *""" 0 2 80.9 0 6 70.0 3 56.1 2 61.1 1 47.4 2 98.2 1 121.9 1.2 90.8 10 SIGNIFICANTAT 5%, LEVEL; ** SIGN1FICANTAT1% LEVEL 1--9 years Observed SMR 10--19 years Observed SMR 20-29y ears Observed SMR 2 642,9 2 .112,6 5 87,7 10 53.9 * 0-- 6 44,0 * 0-- 0 0-- 4 102.3 2 1.24.5 0-- 0-- 0 0 ------- 0 ------ 1 56.7 0 ---- 8. 110.8 4 89.5 3 108.3 1 57.8 3 176.4 1 135.0 13 126.1 11 0 ,__ 1 201.8 4 234.6 5 96.3 0-- 5 124.7 0-- 0 ---- 0 i 101.8 .i 231.4 0 ------- 0 ------- 0-- 0 ---- -- 0-- .0 -- 0 4 238.7 3 288,0 3 490.0 * 0-- 1 251.6 0 ------- 1 38.1 3 0 _____ 0-- 1 31.1 14 149.2 1 504.4 10 136.7 0-- 1 375.6 0-- 1 65.7 .1 524.1 0-- 0-- 0-- 0 0 ----0-- 0-- z 174.2 2 240.4 .1. 261.2 1 221.1 0 0 1 27.4 1 30+ years Observed SMR 0 3 472.1 1 324 11 120.4 0-- 7 97.7 0 --;---0-- 0 "------ 0-- 0 0-- 0 0 ------0 ------- 0-- 0-- 0 --- 0 ------- 0-- 0 0 -----0-- Cl -- 2 58.9 1 Table 14 Cause Specific SMRs for ALL COHORT MEMBERS Stratified by Years Since Hired Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES CAUSE OF DEATH (ICDA 8th REVISION CODES) All Causes ofDeath Tuberculosis Ail Malignant Neoplasms Cancer of Buccal Cavity & Pharynx: Cancer of Digestive Organs & Peritoneum Cancer ot Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer ot1 liiliary Passages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Luflg Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer os Other Female Genital Organs Cancer of Prostate (Males only) Cancer, of Testes and Other Male Genital Organs Cancer of Kidney Gtnoer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer ofEye Cancer of Central Nervous System Cancer oniiyfdd& Other Endocrine Glands Cancer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticuiosarcoma Hodgkins Disease Leukemia & Aleukemia Catioer ofAil Other Lymphopoietic Tissue < 10 years Observed SMR 10" 19 years Observed SMR 20-29 years Observed SMR 30-39 years Observed SMR. 40+ years Observed SMR 269 76.2 ** 7 226.0 26 71.7 1 108.3 5 58:6 0-- 0 ---- 1 46.1 I 135.8 0-- 3 236.1 6 93.4 6 102.9 I 115.0 0 ---- -0 -------: 0-- 2 352.S 0-- 1 128.1 1 232.1 1 64,1 0 ;------0 .------- - 1 419,8 1 164.9 3 42,2 0 -------0-- 3 91.4 0-- 567 83.2 s!s 7 97.9 87 84.5 4 112.4 IS 65.3 0 -------L 7 90.2 7 115.4 1 46.4 0-- 3 56,1 22. 76,5 20 74.9 1. 44.5 1 69.5 0 --0 -------- 1 31.9 2 138:2 4 160.8 1 55.4 2 72.2 0-- 4 80.9 1 177.1 2 2602 14 105.5 1 33,8 5 183.5 6 109.5 2 94.9 1128 7 247 9 71 5 20 15 5 6 19 65 61 5 0 0 1 11 2 7 2 4 1 7 1 1 24 4 4 8 8 SL9 m 71.4 92.6 97.8 100.1 70.8 113.8 90.3 96.8 120.3 12219 70.2 ** 70.0 ** 104.9 ------ 70.1 86.0 166:9 108.6 37.7 92,6 410.0 83.8 9?.7 69.4 96.7 73,3 125:9 79.8 130.1 1949 8 483 10 122 8 37 34 3 z 32 156 148 9 3 1 2 .25 1 14 5 6 0 18 2 8 44 6 6 19 13 96.8 82.2 107.2 73.7 105.7 66.7 152.4 * 106.3 37.8 30.4 ` 124.5 94.2 94.1 149.3 173.5 109.1. 102:7 75.3 91.7 137.3 50.3 120,6 _____ 184,2 * 145.8 454.1 ** 119.5 90,8 221.9 127.1 103.7. 2886 4 639 12 161 10 31 60 16 4 37 199 188 6 3 2 2 87 0 14 16 8 1 10 2 1 53 2 3 21 27 (continued) 99.1 44.7 108.7 * 87,7 107.8 82.2 110.2 1210 154.9 28.4 ** 112,1 103.7 102,8 165.0 312.6 502.1 180.0 1070 123.2 92,4 157.2 280.6 1321 1458 59.6 1060 29,8 130.1 94.9 145.2 Table 14 continued Cause Specific SMRs forALL COHORTMEMBERS Stratified by Years Since Hired CAUSE OP DEATH (ICDASlh REVISION CODES) < 10 years Observed SMR 10-19 years Observed SMR 20-29 years Observed SMR 30-39 years Observed SMR 40+ yrars Observed SMR Benign Neoplasms/Neoptasms of Unspecified Nature Diabetes Meiitius Cerebrovascular Disease AH Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis,; Other Myocard, Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non--malignant Respiratory Disease Influenza & Pneumonia' Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Uicer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis AJ1 External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes AH Other Causes of Death Unknown Causes (In AH Causes Category Only) 1 104.3 1 27.6 6 54.1 33 53.7 ** 0-- 25 52.0 ** 1 87,9 G 1 67.8 7 66.2 4 67.1 1 37.9 0-- G t 121.8 2 113.4 2 30.2 3 84.3. 103 57.1 ** 67 63.7 ** 32 49-8 ** 35 84.4 11 54.0 * 25 56.1 ** 21 62.4 * 56 4 242.5 5 58.5 28 75.8 164 76.4 ** 1 14.6 * 141 77.7 ** '5 168.6 3 59,3 2 45.1 19 66.9 9 60.6 6 64.2 0-- 4 71.1. 2 119.2 0 ------- # 4 21.8 ** 6 95.6 126 72.3 ** 92 91,4 42 77.2 50 107.9 14 56.1 * 20 53.0 ** 45 66.4 ** 70 3 101.9 12 66.2 64 67.2 ** 397 75.1 ** 9 95.4 332 73.3 ** 11 167.5 12 111.8 2 29.7 43 6.1.5 ** 21 68.1 , 13 49.9 ** 3 63.3 10 53.6 4 0-- 2 22.8 * 21 58,2 ** 9 91.5 117 68.6 ** 77 74.2 ** 41 77:5 36 70.7 4 31 106.1 9 30.6 ** 98 69.4 ** 106 10 259.6 * 37 127.5 126 80.4 * 765 95.010 109.2 606 91.3 * 16 81.6' 30 159.5 * U 154.2 95 76.4 ** 33 69.6 * 34 84.5 7 97.7 24 79.6 3 99.9 11 110.5 3i 84.0 11 90.8 104 79.4 *' 73 87.1 31 78,3 42 94.9 20 80.0 11 61.6 177 80.0 ** 80 10 52 278 1175 12 890 ll 27 16 182 65 47 11 34 2 13 21 21 97 58 23 35 35 4 343 35 201,6 124.2 92.6 100.0 153.0 .95.0 21.5 ** 98.0 158.5 77.1 *+ 64.6 ** 78.9 104.7 72.5 74.0 113.7 87.8 105.9 93.9 77.9 8C.7 75.9 187.1 ** 48.8 92.9 * SIGNIFICANTAT 5%, LEVEL: ** SIGNIFICANTAT 1% LEVEL .# SIGNIFICANT DEFICITAT 5% LEVEL OBSERVED DEATHS = 0, SMR NOT CALCULATED. CAUSE OF DEATH (ICDA 8th REVISION CODES) Ail Causes of Death Tuberculosis Alt Malignant Neoplasms Cancer ofBucca! Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Oncer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Gmcer of Respiratory System Cancer oE Bronchus, Trachea, Lung Cancer o Breast Ail Uterine Cancers (Femaies only) Cancer of Cervix Uteri (Females only) Cancer ofOtherFemale Genital Organs Cancer of Prostate (Males only) Cancer ofTestes and Other Male Genital Organs Cancer crfKidney Cancer of Bladderand Other Urinary Organs Malignant Melanoma ofSkin Cancer ofEye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer ofAll Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Table 15 Cause Specific SMRs for WHITE MALES Stra tified by Years Since Hired PortArthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES < 10 years Observed SMR 212 9.1.4 4 2183 21 84.0 1 154.7 5 90.9 0 0 1 70-6 1 212.4 o --3 318.9 5 105.5 5 115,5 0-- 0-- 0 ------0-- 2 556.6 0 !------0-- 0-- 1 70.6 0-- 0-- 1 537,9 1 235.3 3 56,2 0-- 0-- 3 120.2 0-- 10-19 years Observed SMR 443 94.8 5 114:1 69 95.8 4 160.5 15 81.6 0 ---- 5 1033 7 157.6 X 67.2 0 2 50.2 19 86.5 18 87.8 0 ---- -0-- 0-- 0-- 1 50.2 1 87.8 2 105.7 1 80.8 2 80.1 0-- 2 47.6 1 220.2 2 356.0 12 118.7 1 42.9 4 191.i 5 117.3 2 139.6 20--29 years Observed SMR 30-39 years Observed SMR 40+ years Observed SMR 879 88.8 ** 4 61.9 180 94.9 7 103.8 47 98,0 2 54.2 9 82.4 9 72,8 4 107.4 5 155.5 17 149.3 53 74.9 * 50 74.8 * 0-- 0-- 0 --0 ----6 72:6 2 234.1 5 97,3 2 52.1 4 103.4 1 487.6 6 84.6 i 1.15.6 i 92.7 20 104.9 3 69.0 4 158.2 8 100.9 5 117.3 1464 6 352 7 93 5 24 29 -3 3 24 115 108 0 0 0 0 19 1 u 3 6 0 15 1 6 35. 3 4 17 11 99.9 88.2 109.4 68.4 117.6 74.4 156.3 * 123.9 51.9 45.7 128.1 91.7 90:7 ------- - ---- --- -- 87.4 145.1 1.34.3 40.S 1.34.4 ---- -- 184.4 * 95.1 465.6 "* 125.7 57.1 182.8 145.7 126.1 .2182 3 474 8 111 4 20 44 13 2 27 160 152 0 0 0 0 62 0 9 11 8 1 9 2 0 43 2 2 19 20 (continued) 98.8 45.8 108.5 729 103.3 51.9 110.0 ms 167.5 19.7 ** 109.8 106.5 106.2 -- '------ : ------- 113.9 ------- ` 95.6 80.9 171.2 306.9 .137.7 180.5 ------ . 110.9 36.0 101.0 106.3 149.8 Table 15 continued Cause Specific SMRs for WHITE MALES Stratified by Years Since Hired CAUSE OF DEATH (ICDA 8th REVISION CODES) Benign Neoplasms/Neoplasms of Unspecified Nature. Diabetes Mallitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart. Disease Chronic Endocard. Dis.; Other Mvocard. Insult Hypertension with Heart Disease Hypertension w/o Heart Disease Non-malignant RespiratoryDisease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer ofStomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis Ail External Causes of Death Accidents Motor Vehicle Accidents All OtherAccidents Suicides Homicides & Other Externa! Causes AH Other Causes o Death Unknown Causes (In.All Causes Category Only) < 10 years Observed SMR 10-19 years Observed SMR 20-29 years Observed SMR 30-39 years Observed SMR 40+ years Observed SMR 0 ____ 1 44.4 4 64.5 29 66.6 * 0-- 24 64.3 * 0 ---0-- 1. 235.5 4 67.9 2 618 1 63,4 0 ---- 0 ------- 1 365.9 1 84.2 2. 48.2 2 102.4 86 71,5 ** 58 73.0 * 28 56,6 ** 30 98.6 9. 52.8 19 116.8 n 56.0 46 4 404.2 4 71.3 20 94.9 140 87.6 1 20.0 123 8S.7 3 166.4 1 55.2 2 150.1 13 71.4 7 82.2 3 43.5 0 >------3 63.3 0-- 0-- 4 29.9 ** 4 123.2 95 80.6 * 72 97.4 32 79,4 40 118.6 10 45,6 ** 13 9L3 34 79.6 49 2 106.8 8 6S.3 45 78.2 328 81.2 ** 5 70.7 281 78.2 ** 8 176.1 9 186.2 2 76.5 30 59.1 ** 13 65,7 ii 51,9 * 2 52,9 9 56.2 0 0 ------- ##. 20 70.0 7 138.1 . 95 7S.3 * 61 79.6 34 86.4 27 72.3 29 110.3 5 39,8 * 77 80.9 81 5 186.6 25 129.6 88 88.0 620 101.7 9 128.2 510 .97.7 9 65.1 17 177.7 * 7 195.8 72 75.2 * 19 57.7 * 32 94.9 6 101.5 24 92.0 2 102.1. 9 113.1 20 66.6 6 89.8, 81 84.3 59 9S.6 '25 84,4 34 105.6 18 79,3 4 47,8 126 82.3 * 47 6 .162.7 32 105.6 192 89.1 909 99.7 9 146.7 711 94.2 3 7.9 ** 15 95.4 12 187,4 145 74,8 ** 50 63,7 ** 45 85.9 11 1196 32 76.4 2 104.3 11 116.4 19 94.8 10 79.9 76 96.7 45 80,5 18 83,1 27 78,4 30 .175.2 l 25.5 272 100.8 21 * SIGNIFICANTATS*, LEVEL; ** SIGNIFICANTAT \% LEVEL ## SIGNIFICANT DEFICITAT 1% LEVEL OBSERVED DEATHS 0, SMRNQT CALCULATED.. CAUSE OF DEATH (ICDA 8th REVISION CODES) All Causes of Death Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectuni Cancer of Biliary Passages & Liver Cancer ofPancreas Cancer of Respiratory System Cancer of Bronchus. Trachea, Lung Cancer of Breast All Uterine Cancels (Females only) Cancer of Cervix Uteri (Females only) Cancer of OtherFemale Genital Orssans Cancer of Prestate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladderand Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of AH Lymphatic, Haematopoietic Tissue Lymphosarcoma &. Reticulosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Table 16 Cause Specific SMRs for NON-WHITE MALES Stratified by Years Since Hired PortArthurRefinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH .RATES < 10 years Observed SMR 10-19 years Observed SMR 20-29 years Observed SMR 30-39 years Observed SMR 40+ years Observed SMR 46 44.1 3.' 285.5 2 26.9 * 0 -----0-- 0 0 -------0-- 0 0 ---- -- 0 0 - --- 0 0-- 0 -------- 0 0 -----0-- 0 ~~~ 1 490.6 0 0-- 0-- 0 ---- - 0 0-- 0 ------- 0 ---- 0-- 0 ------- 0 `------ .109 58.0 2 83.5 35 65.7 0 3 38.3 0 ------ 2 76.5 0-- 0 ---- --0-- 1 85.8 3 47.8 2 34.9 0-- 0-- 0-- 0 ------ 0 ------1 325.2 2 38.9.9 0 -- " "" 0-- 0 1 247,9 0-- 0 ---2 83.2 0-- 1 203.1 1 113.7 0 --- 211 63.1 ** 3 97.4 54 90.4 1 45.0 21 106,8 3 92.9 it 180.1 4 133.6 0-- 1 67.8 2 58.3 12 60.9 11 60.2 0 ---- 0 0-- 0 ---- -- 5 110.6 0 2 185.7 0-- 0-- Q ---- -0-- 0-- 0-- 4 90.9 1 128.6 0 ---- 0-- 3 194.2 374 81.2 * 2 72.1 92 90.9 3 103.2 23 75.8 3 59.9 il 134.7 3. 48,9 0 0 ------- 6 106.8 31 88.5 31 93.8 1 686,6 0 ------0-- 0-- 6 52.4 0 .---- -- 2 128.3 2 87.4 0 0-- 2 217.7 0-- 1 248.0 5 74.3 2 207.2 2 496.4 1 40.4 0-- 602 1 132 3' 39 5 11 11 1 2 8 34 31 0 0 0 0 25 0 3 5 0 0 I 0 1 9 0 i 2 6 (continued) 96,543.1 99.6 123.3 104,6 116.7 1M4 108.1 43.6 58.3 109.7 89.4 85.9 -- -- -- 93.0 ---- -- 188.1 143.6 ------- 153,8 -- 258.3 97.1 -- 375.7 55.5 134.S Tabic 16 continued Cause Specific SM Rs for NON -WHITE MAIZES Stratified by Years Since Hired CAUSE OF DEATH (ICDASth REVISION CODES) Benign Neaplasms/Neoplastns of Unspecitied Nature Diabetes Meliiius Cerebrovascular Disease Alt Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis.; Other Myocard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non--malignant Respiratory Disease Influenza & Pneumonia Bronchitis Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Yehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unkncwft Causes {In AH Causes Category Only) < 10 years Observed SMR 10-19 years Observed SMR 20-29 years Observed SMR 30-39 years Observed SMR 40+ years Observed SMR 0_ 0 -----2 48.4 4 25.0 * 0-- 1 10.1 ** 1 249.0 0-- 0-- 3 75.0 2 85.9 0 0-- 0 ----- ^ 0 -----1 190.7 0-- I 72.9 12 21.9 * * 5 22.0 ** 2 15.9 ** 3 29.5 * 1 42.6 6 21.9 ** id 95,5 8 0. 1. 7 22 0 16 2 2 0 6 2 3 0 1 2 0 0 2 26 17 7 10 2 7 9 19 41.8 49.9 43.7 ** -- 45.4 ** 194.7 65.0 -r-TM -- 65.5 34.8 137.2 -- 124.9 262.0 -- ------- # 73.4 50.3 ** 70.8 56.5 85.9 103.0 30.6 ** 433 ** 1 12.1.1 3 66.8 16 419 ** 62 54.9 ** 4 242.8 44 51.8 ** 3 166.2 3 54.1 0# 12 71.2 8 80.8 2 47.3 1 120.0 l 43.1 0-- 2 103.7 1 17.6 * 2 46.0 18 4i.fi ** 13 54.2 * 5 43.0 8 65.0 2 123.0 3 18.4 ** 16 40.7 ** 21 3 337.2 10 538.0 32 65.2 * 1.22 72,4 ** 0 S2 67.7 ** 7 148.7 12 143.1 4 120,4 18 75.6 10 78.3 2 37.2 1 96.4 0-- 1 1.124 2 113.9 8 160.7 5 101.8 18 58.4 * 12 62.0 4 46.1 8 74.9 0-- 6 66.0 36 63.0 ** 22 3 285.3 17 180.0 * 80 105.0 231 98.6 3 228.6 154 95.6 7 61.3 12 111.3 4 316.5 32 86.2 13 65.0 2 31.7 0 2 45.1 0 ------2. 113.8 2 64.5 11 161.9 i9 83.8 12 71,0 5 79.5 7 65.7 4 308,9 3 726 61 69.2 ** 7 * SIGNIFICANTAT 5%, LEVEL; ** SIGNIFICANTAT Wc LEVEL # SIGNIFICANT DEFICITAT 5% LEVEL OBSERVED DEATHS = 0, SMR NOT CALCULATED. CAUSE OF DEATH (ICDASlh REVISION CODES) AH Causes ofDeath Tuberculosis All Malignant Neoplasms Cancer ofBuccal Cavity & Pharynx Oncer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Gancer of Biliary Passages & Liver Cancer of Rrncreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Lung Cancer ofBreast All Uterine Cancers (Females only) Gancer of Cervix Uteri (Females only) Cancer ofOther Female Genital Organs Cancer ofProstate (Males only) Cancer oETestes and Other Male Genital Organs Cancer ofKidney Cancer ofBladderand Other Urinary Organs Malignant Melanoma of Skin Ca ncer of Eye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer ofAH Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticuiosarooma Hodgkins Disease Leukemia &. Aleukemia Cancer ofAll Other Lymphopoietic Tissue Table 17 Cause Specific SMBs for WHITE FEMALES Stratified by Years Since Hired Fort Arthur Refinery Update, 1937--1987 Expected Deaths Based on TEXAS DEATH RATES < 10 years Observed SMR 10-19 years Observed SMR 10 74.2 0-- 3 911 0 ---- -0-- 0-- 0 -------0-- 0-- 0-- 0-- i 581.7 1 658.3 l 152.6 0 0-- 0-- 0-- 0 0 ---- -- 1 7821.6 * 0-- 0-- 0 ------ 0-- 0 ---- 0-- 0 0 ---- ^ 0-- 0-- 15 63,9 0 ---- -- 3 40.0 0-- 0 ---- 0 --*-- 0-- 0-- 0-- 0-- 0. ---- 0~ 0-- 1 5.1,5 1 77.3 0 ----0-- 0-- 0 ---- -0-- 0-- 0 ---- 0-- 1 303.8 0 ---- - 0-- 0-- 0-- Cl -- 0-- 0-- 20--29 years Observed SMR 30-39 years Observed SMR 40+ years Observed SMR 36 7S.0 0 ------1. 13 79.9 1 448.6 3 97,7 0 ------ " Q-- 2 1693 1 41-1.2 0-- 0 -- ---0-- 0 ------ , 5 118.7 0-- 0-- 1 73.5 0-- 0 0-- 0-- 0-- 0-- 1 175.8 0 ---- -0-- 0-- 0 ---- -Q ---- - 0-- C) -- 107 130.6 ** 0-- 37 1.42.6 0-- 6 106,7 0-- i 284.2 2 86.5 0-- 0 --TM 2 159.7 9 178.6 9. 184.2 7 .1324 3 194.0 i 122.9 2 107.1 0-- 0 1 235.1 0-- 0-- 0-- 1 142.2 1 893,9 1 1536.4 4 186.4 1 260.9 0-- 1 129.6 2 226.8 99 0 33 1 11 1 0 5 % 0 2 5 5 6 3 2 -2 0 0 2 0 0 0 0 0 0 1 0 0 0 1 (continued) 135,8 ** -- 190.0 ** 380.1 263.1 * 643.0 -- 278.7 795.0 -- 197.1 140.7 144.3 21.0.3 362.5 590.0 191.5 -- 5916 -- -- -- -- ---- -- 623 -- -- ------135,7 Table .^continued Cause Specific SMRs for WHITE FEMALES Stratified by Years Since Hired CAUSE OF DEATH (ICDA Bth REVISION CODES) < 10 years Observed SMR Benign Ncoplasms/Neoplasnts of Unspecified Nature Diabetes MeUitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischeniic Heart Disease Chronic Endocard/Dis.: Other MyocardL Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non- malignant Respiratory Disease Influenza Sl Pneumonia Bronchitis Emphysemas Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis . AO External Causes of Death Accidents Motor Vchicle Accidents AH Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death. Unknown Causes (InAH Causes Category Only) i 1015,6 0 0-- 0-- 0-- 0-- 0-- 0 ------------ - 0-- 0-- 0-- 0 --0-- 0 0 --"-- 0-- 0-- .0 -- 4. 92.0 3 111-7 2 100.3 I 138.5 I 111.9 0-- 0 -------2 SIGNIFICANTAT 5%, LEVEL; ** SIGNIFICANTAT Wo LEVEL 10-19 years Observed $MR 0 __ ___ __ 0-- 1 65.0 2 56.1 0-- 2 85.8 0-- 0 0 --- -- 0 -------0 0-- 0-- 0. -- 0 0-- 0-- 0-- S- 115.1 3 119.5 3 182,1 0-- 2 186.9 0-- 2 53.8 2 20-29 years Observed SMR 0 1 82.4 3 7S.0 6 56.3 0-- 6 73.3 0-- 0 ------------ ; 0-- 1 47.4 0 -----------0 ------- 0-- 0 ------------1 0-- 0-- 0-- 0-- 4 81.0 3 98,7 2 10J.4 1 82.0 0-- 1 217.8 4 64.7 4 30-39 years Observed SMR 2 753.7 2 89.7 6 85.2 22 89.4 1 151.5 13 68.5 0-- 1 142.9 0 -------5 109.7 4 244.3 0 _________ 0 ~~-------0-- 0 0-- 3 164.1 0 --5 129.2 2- 77.5 2 156.5 0 ;-- -------2 2X6.2 1 293.9 14 136.7 11 40+ years Observed SMR i 497.2 3 162,6 6 77.8 34 128,9 0 24 122.8 1 51.6 0 ---- 0-- 4 79.6 1 48.6 C) 0 0 0 0 ------------0 0 2 105.7 1 67.3 0-- 1 102.9 1 352.7 0 -----------9 87.9 7 Table 18 Employment Characteristics for All Cohort Members By Period, of Hire Port Arthur Refinery Update, 1937-1987 < 1940 n=JS.184) 1940-1945(n=5Q29) > 1945 (n=7631) Person-Years {%} Ho, Deaths {%} Percent Women 17 82S7.4 (33.9) 3827 (56.3) 3.2 Employment Duration Total Cohort Average P5e White Males Average PSo Non-White Males Average P50 white Females Average Pso Nan-White Females Average P50 (yrs) 2 S.. 8 30..7 27.2 31.3 27.8 31.1 13.5 8,1 18.3 9.6 interval Since Hire Total cohort Average Pso White Males Average ^SCI Non-White Males Average (yrs 5 White Females Average P50 Non-White Females Average Pbd 44.5 48 .1 44.9 48,4 43,6 46 -.9 39,1 4 8.6 46.6 51,3 170389.4 (32.4) .2191 (32,2) 18.5 177730.0 (33.8) 781 (11.6) 8.9 8.5 0.9 9.4 0.9 10.5 .1,7 3.7 0,6 2.6 1.2 12.3 8 .,3 13.1 8,7 12,6 9.9 6.5 3.9 7,3 7.6 33.9 41.1 35.1 41.3 3 2.. 9 39.6 3.0.5 42.4 26.6 36.7 23.3 21.9 25,0 29,2. 19.3 16.1 20.1 17 - 3 13.0 10.9 Table 19 Cause Specific SMRs for ALL COHORT MEMBERS by Period of Hire Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES Hired Before 01/01/1940 N=5,184 Hired Between 01/01/1940 & 12/31/1945 N-5,029 Hired After 12/31/1945 N=7,631 CAUSE OF DEATH (ICDA 8th REVISION CODES) AH Cause s of Death Tuberculosis A!! Malignant Neoplasms ' Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biiiary Passages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Lung Cancer of Breast Ali Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate {Ma les only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Haematopoietic Tissue Lymphosarcoma & Retjculosarcoma Hodgkins Disease I-eutcemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endoeard. Dis.; Other Myoeard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Not) -malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category Only) Hired < 1940 Observed SMR Hired 1940--1945 Observed SMR Hired > 1945 Observed SMR 3827 2.1 791 18 218 10 60 69 20 8 46 230 214 5 4 3 % 91 1. 16 20 9 2 13 3 8 76 6 12 32 26 16 73 358 1503 22 1170 38 54 28 199 81 60 14 41 5 21 31 34 206 147 66 81 45 14 414 132 91.7 ** 90.6 103,9 83/2 102,9 58.8 118.0 118.4 129.0 50.5 * 102.4 98.2 97.2 133.4 257.8 340.9 187,9 101.0 35.9 102.7 89.4 114.1 298.7 95.5 127.6 225.3 110.8 48.7 205.2 * 105:2 130.4 218.8 ** 127.5 87.5 * 89.2 ** 118.0 83.0 ** 81.7 145,9 * 147.9 68.3 ** 61.8 ** 66,5 ** 84,3 60.6 ** 80.8 90.2 61.5 ** iio.i 70.4 ** 77.4 ** 73.6 * 80,7 97,0 35.9 ** 85.6 ** 2191 10 505 11 114 7 22 37 5 4 36 172 165 12 3 0 3 33 2 12 4 5 0 19 2 3 39 4 5 15 15 6 26 110 774 8 623 4 15 3 129 45 35 6 26 3 7 32 14 194 115 51 64. 45 34 193 188 101.6 90.7 106.6 83.6 99.6 fiOA 101.2 108.4 64.2 37.5 * 140.0 101.1 101.8 115.2 75.9 -----89.7 96.4 .109,8 115.9 40.5 82.4 -------, ' 160.2 134.4 167,5 93.1 54.6 122.6 88.6 110,4 128.3 84,0 73.2 ** 96.8 65.3 96.8 15 9 ** 82.4 36,6 95.9 88.0 91.8 93.5 91,5 95.6 68.5 76.7 93.7 85.4 * 82.2 * 70.7 ` 93:9 125.0 85.4 80.0 ** 781 J"] ** 2 44.2 1.86 88.9 7 113.9 45 99.1 6 J09.6 13 172.1 11 78.6 1 33,1 1 22.0 12 118.5 46 .56.7 ** 44 56.7 ** 5 147.7 0 0-- 0 ----- 2 30.3 2 116.0 12 225.1 * 1 39.5 7 146.9 0-- 7 91.5 2 254.5 2 218.7 23 108.3 3 88,4 1 35.5 10 117.7 9 137.5 6 252.5 8 61.7 34 83.1 257 85.3 * 2 34.2 201 87.4 2 20:4 ** 3 35.2 1 36.7 18 41.3 ** 6 34.4 ** 6 63.1 1 68.1 5 77.4 0 -- ~~~ 0-- 16 53.8 ** 2 34.6 147 61.4 ** 105 76..1 ** 52 66.8 ** S3 87.5 .21 58.6 * 'll 35.6 ** 77 71:2 ** 27 SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% LEVEL Tabie 20 Cause Specific SMRs for WHITE MALES by Period of Hire Port Arthur Refinery Update* 1937-1987 Expected Deaths Based os TEXAS DEATH RATES Hired Before 01/01/1940 N=3,959 Hired Between 01/01/1940 & 12/31/1945 N=3,243 Hired After 12/31/1943 N=5,406 CAUSE OF DEATH (ICDA 8th REVISION CODES) Hired < 1940 Observed SMR Hired 1940-1945 Observed SMR Hired > 1945 Observed SMR All Causes of Death Tuberculosis AH Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of AH Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticuiosarcema Hodgkins Disease Leukemia <& Ateulcamra Cancer of All Other Lymphopoietic Tissue Benign Neoplasms/Neoplasms o f Unspecified Nature Diabetes Mellitus Cerebrovascular- Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endoeard. Dis.; Other Myoeard. Jnsuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non -malignant Respiratory Disease influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis Aii External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes Al! Other Causes of Death Unknown Causes (In All Causes Category Only) 2948 14 60S 12 163 6 39 52 19 6 37 191 178 0 0 0 0 64 1 12 14 9 2 11 3 6 63 5 8 29 21 12 48 253 1204 16 .973 22 31 21 156 57 57 13 40 4 17 26 20 163 115 52 63 40 8 324 82 93.9 ** 85.3 106,2 69.3 107.1 57.1 119.0 115.2 164,6 52.2 107.9 102.0 101.0 -- J------------ 106.6 53.1 93.2 80.8 323.2 332.4 90.3 150.9 221.9 115.9 49.1 165.1 115.7 147.5 229.9 * 116.4 89.2 91.9 ** 10S.3 85.7 ** 63.9 * 156.8 * 212.1 ** 66,7 ** 58.4 * 73.3 * 91.7 66,2 ** 96.7 90.6 62.0 * 110.1 77.1 ** 81.0 * 76.4 85.0 93.6 57.5 93.5 1640 6 356 10 78 4 10 28 3 3 28 126 120 0 0 0 0 25 2 7 3 5 0 14 2 2 31 2 5 15 9 2 16 72 616 6 509 1 9 2 95 30 30 6 23 1 4 23 8 154 95 45 50 38 21 146 140 109.3 ** 87.6 110.8 104,9 104,5 64.3 76.7 118.9 55.8 44.8 156,6 * 100.6 100.5 -- -- -- "----------- - 112.6 150.0 88.1 41.9 96,8 -- 148.6 187.4 161.6 102.8 36.3 164.6 119.4 99.2 67,7 81.4 78.4 * 104.3 70.3 102.1 5.8 ** 106.6 58.9 95.5 87.8 98,0 116.8 95,8 61.0 53.9 73.9 100.1 101,1 95.8 87.6 104,1 123.0 146.1 91.7 592 2 132 5 30 1 9 10 0 1 8 35 35 0 0 0 0 1 1 8 0 7 0 7 1 2 19 2 i 8 8 36 24 206 2 167 0 2 1. 13 4 5 0 5 0 0 16 1 116 '85 40 45 18 13 50 22 81.7 ** 72.3 87.1 118.3 95.4 35.4 180.0 96.1 -------- 33.7 106.7 57.7 ** 60.1 ** -- -- 22.0 65.4 183.7 -- 157.5 108.0 164.3 301,4 114.5 72.2 43.4 121.3 162.2 180,0 68.0 96.6 90.1 47.0 91.0 ##------------47.6 94.8 42.0 ** 35.8 * 69.6 ---------- 93.9 -- -- 69.2 30.2 68.1 ** 79.8 * 65.7 ** 98.0 57.2 * 48.0 '* 66.9 ** * SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% LEVEL ## SIGNIFICANT DEFICIT AT 1% LEVEL. OBSERVED DEATHS = 0, SMR NOT CALCULATED Tabic 21 Causa Specific SMRs for NON-WHITE MALES by Period of Hire Port Arthur Refinery Update,. 1937-1987 Expected Deaths Based on TEXAS DEATH RATES Hired Before 01/01/1940 N= 1,045 Hired Between 01/01/1940 & 12/31/194.1 N = 821 Hired After 12/31/1945 N= 1,381 CAUSE OF DEATH (ICDA 8th REVISION CODES) Hired < 1940 Observed SMR Hired 1940- 1.945 Observed SMR Hired > 1945 Observed SMR All Causes of Death Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum , Cancer ofEsophagus Cancer of Stomach Cancer of Larse Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Respira tory System Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Omcers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Bye Cancer of Central Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Haematopoietic Tissue Lymphosarcoma & Ralicuiosarcoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Ti ssue Benign Neoptasms/Neoplasms of Unspecified Nature Diabetes Meilitus Cerebrovascular Disease All Hear t Disease Rheumatic Heart Disease Ischemic Heart Disease ChronicEndocard, Dis,; Other Myocard, insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non-malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach Sc Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category Only) 805 83.3 ** 7 107.0 163 94.0 5 122.1 50 90.2 3 47.4 21 120,2 14 121.8 1 27.3 2 50.2 & 81,7 38 84.3 35 83,2 0-- 0 ----- --- 0-- 0 ---------27 89.6 0-- 3 121.9 6 124.5 0 ----- --0 ----- 2 183.0 0-- 2 255.8 13 101.5 1 53.4 4 445.1 * 3 62.6 5 95.5 3 160.8 21 148.9 98 83.7 281 S0.3 ** 6 1803 184 72.0 ** 16 146,1 23 140.1 n* 80.2 40 74.6 22 69.8 3 26.0 ** 1 43.5 1 14.5 * 1 51,6. 4 93.4 5 65.7 14 115,0 37 47.4 ** 28 61,3 ** 11 53.5 * 17 67,8 3 94.4 6 24.2 ** 84 65.9 ** 41 399 78.7 ** 4 113.8 98 92.4 1 33.9 26 85.1 3 60.4 12 162.0 4 58.6 0-- 1 33.5 6 103.0 35 94.2 34 96.9 1 645.3 0 ------- 0-- 0-- 8 66.5 0 --------4 234.7 0 ---- 0 -------- 0 --------' 2 191.9 0 0-- 4 51.3 1 91.4 0-- 0-- 3 95.4 3 274.4 9 121.2 30 64.5 f 117 69.3 ** 1 48.5 83 71.4 ** 2 33.1 5: 59.1 1 22,9 27 100.7 12 87.0 5 88,6 0 "---- 3 91.7 2 172.3 3 130.8 6 86.2 6 102.9 31 49.3 ** 16 48.0 ** 3 18.4 ** 13 76.3 4 167.0 11 45,4 ** 30 48.9 **. 34 * SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% LEVEL ## SIGNIFICANT DEFICIT AT 1% LEVEL. OBSERVED DEATHS = G, SMR NOT CALCULATED 138 58.2 ** 0 ------- 34 76.9 1 57.3 10 86,1 5. 1.96.5 2 90.9 0 *-------- 0 --------- 0 """" 3 139.3 7 38.4 ** 6 347 ** 0-- 0 '--------0-- Q. -- 1 48.5 1 516,1 3 384.1 1 169,8 0 0 -------- 0 ----- 0 ------ 0-- 3 86.8 1 235.2 0-- 1 71.5 1 80.0 1 194.8 1 3:2.1 9 67.7 43 67.7 ** 0-- 30 74.4 2 84.6 i. 25.4 0-- 4 37.9 * 1 18.3 1 54.3 1 445.7 0 ------ 0-- 0-- 0 --------- ## 1 46.7 25 39.6 ** 15 53.5 * 9 61.2 6 44.9 * .2 66.6 8 26.0 ** 18 66.9 2 Tabic 22 Cause Speeific.SMR.s for WHITE FEMALES by Period of Hire Port Arthur Refinery Update, 1937-1987 Expected Deaths Based on TEXAS DEATH RATES Hired Before 01/01/1940 N= 166 Hired Between 01/01/1940 & 12/31/1945 N= 932 Hired After 12/31/1945 H 680 CAUSE OF DEATH (ICDA 8th REVISION CODES) Hired < 1940 Observed SMR Hired 1940-1945 Qbserved SMR Hired > 1945 Observed SMR. All Causes of Death Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity' & Pharynx Cancer of Dige stive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Re.spirs.lnry System Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Cent ral Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of AH Lymphatic. Haematopoietic Tissue Lymphosarcoma & Reliculosareoma Hodgkins Disease Leukemia & Aleukemia Cancer of All Other Lymphopoietic Tissue Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Meliitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis.; Other Myocard. Insuff. Hypertension with Heart Disease Hypertension w/b Heart Disease Non -malignant Respiratory Disease Influenza & Pneumonia Bronchitis. Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes AH Other Causes of Death Unknown Causes (In All Causes Category Only) n 120.2 148 103.3 0 ---- - 0 20 146.2 50 112.0 1 519.9 0 -------- 5 139.5 10 112.2 :t 817.2 0 ------- 0 ------- - 0 ----- 3 2G6.0 5 138.2 0 ------ - 2 310.9 0 -- 0 :------- 1 135.2 7 103.6 1 59.2 li 145.2 1 61.9 u 149.9 5 201.7 10 103,8 4 316.8 3 414.2 3 81.3 0-- 2 207.9 0 *------0-- 3 92.4 0-- 0-- 1 449.4 0-- 0-- G --- : 0-- 0 ------- - 1 146.1 i 284.1 0-- 0-- 3 217.3 0 *------ 0 --- 1 648,4 0 ------- 4 104.3 0 0 " --" 1 141.2 0-- 0 0 -------- - 0 ------- 3 226,9 1 530.0 1 168.8 4 260.8 1 27.8 7 961 8 71.9 17 81.6 39 102.3 0-- 1 63.2 12 73.3 29 103.3 0 -----0-- 1 51,7 1 89.5 0 ----- 0 -- 2 59.2 7 88.2 1 55.5 3 97.7 0 ----- 0-- 0-- 0-- 0 ----------- 0-- 0-- 0-- 0-- 0 -------- 0 -- . 3 85,8. 0-- 0-- 6 210.9 9 78.4 4 195.4 4 55.2 3 300.3 3 69.7 1 94.4 1 33.4 2 416.0 0-- 3 111.7 2 192.8 6 72.7 16 81.3 9 14 47 128.3 0-- 19 158.0 1 646.3 5 242.4 0 -- ---2 659.2 1 118.9 1 699.0 0 -" 1 233.9 3 146.7 3 151.1 5 175.8 0-- 0-- 0 0-- 0-- 1 574,2 0-- 0-- 0 0-- 1 1712.9 0-- 1 93.4 0 0 ------- , 1 224.1 0-- 2 1176.9 * 1 118.5 1 44.8 8 105.9 0-- 4 76.5 0-- 0-- 0-- 1 54.7 1 142.5 0-- 0-- 0-- 0' -- 0 0 ------0-- 5 98.6 4 133.1 3 152.4 1 95.0 1 77.9 0-- 7 13.10 3 SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% LEVEL Table 23 Distribution of Hourly and Salaried Workers AH Cohort Members Port Arthur Refinery Update, 1937-1987 Percent Time Salaried No. Employees c%j 0 (=100? Hourly) 25 50 75 90 100 Unknown 14691 316 298 207 271 1991 70 (82.3) ( 1.8) ( 1.7) ( 1.2) ( 1.5) (11,2) ( 0.4) _________No. Deaths (%) 5926 (87.2) 147 ( 2.2) 144 ( 2.1) 92 ( 1.4) 109 ( 1.6) 346 C 5.1) 35 ( 0.5) Table 24 Cause Specific' SMRs for ALL COHORT MEMBERS by Pay Stalus+ Port Arthur Refinery Update, 1937--1987 Expected Deaths Based on TEXAS DEATH RATES Hourly N= 14,691 .25-75% Salaried N=82i 90-100% Salaried N=2,262 CAUSE OF DEATH (ICDA 8th REVISION CODES) All Causes of Death Tuberculosis All Malignant Neoplasms Cancer of Buccal Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Cancer of Bsoiphagus Cancer of Stomach Cancer ofLarge Intestine Cancer of Rectum Cancer of Biliary Passages & Liver Cancer of Pancreas Cancer of Resp iratory System. Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Central Nervons System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Haematopoietic Tissue Lymphosarcoma & Reticuiosarcoma Hodgkins Disease Inke.mia &. Aleukemia Cancer ofAll Other Lymphopoietic Tissue Benign NeoplasmsiNeoplasms of Unspecified Nature Diahetes Mellitus Cerebrovascular Disease All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease Chronic Endocard. Dis.; Other Mvocard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non -malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category Only) Hourly Observed SMR 25-75% Salaried Observed SMR 90-100% Salaried Observed SMR 5926 32 1284 30 323 22 84 98 19 -12 79 404 381 14 5 1 .5 104 5 36 22 18 1 33 6 12 115 7 14 51 43 19 91 431 2188 27 1704 41 66 21 311 113 93 19 68 6 23 .68 48 492 324 153 171 101 67 587 331 96.5 ** 97.0 106,3 * 87.0 103,3 75.1 123.2 111.0 86.2 46.0 ** 116.6 98.8 98.4 116.2 118.0 37.6 140.0 93.4 93.3 138.1 75.2 1184 116.6 120.8 157.4 228.7 * 104.9 36.5 ** 131.8 110.0 128.4 15S.8 108.1 85.7 '* 93.9 ** 88.2 89.3 ** 60.9 121:6 81.5 79.4 ** 67.7 ** 80.6 * 92.8 79.4 66.1 73.8 67.0 ** 109.4 77.1 ** 82.6 ** 76.3 ** 88,9 103.8 56.4 ** 84.3 ** 383 76.4 ** 0-- 87 88.4 3 104.8 24 96.3 1 49.0 5 99.3 1.1 147.0 4 220.7 0-- 3 53.3 20 58.4 * 19 58.6 * 0-- 1 6.94.6 1 1151.3 0 ---8 89,6 0-- 3 .133.1 2 78,7 0 1 1241.8 A3 129.0 0-- 0-- 9 98,1. 3 IS3.7 1 117.3 2 50.0 3 111,5 4 433.1 * 7 104.3 37 92.8 148 74.3 ** 2 80.8 119 71.0 * * 2 33.2 2 56.4 2 126.3 19 54.7 ** 8 57.4 6 56.2 2 105.5 2 24.4 * 2 308,2 4 150.7 5 61.0 2 65.5 23 52.3 ** IS 63.5 7 49.1 11 77.8 4 50.0 1 18.6 38 68.3 * 7 455 jj 7 ** 1 344 101 79,4 1 3 89.9 30 96.5 0 ------ 6 98.5 8 81.4 3 133.5 i 37.5 12 176.2 20 50-5 ** 19 50.4 ** 8 161.5 1 43.7 1 70.2 0 ------8 89.0 0 ------1 36.2 1 37.0 3 146.8 0-- 3 89.5 1 214.7 1 183.6 14 .116.3 3 144.3 3 2484 4 77.8 4 111.0 5 365.8 * 8 84.3 30 59.0 ** 186 80.0 ** 3 87.3 163 85.6 * 1 13.5 * 4 77.9 8 375.7 ** 15 384 ** 10 59.0 2 18.2 ** 0 ------2 24.6 * 0-- 1 33.8 6 51.5 0 --------# 30 41.2 ** 23 51.5 ** 9 384 ** 14 664 6 48.0 1 7.8 ** 55 74.6 * 9 + See text for definition of pay status. * SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% .LEVEL # SIGNIFICANT DEFICITAT 5% LEVEL. OBSERVED DEATHS-0, SMR NOT CALCULATED. Table 25 Lymphatic and Hematopoietic Tissue Cancers by Cell Type All Males Port Arthur Refinery Update, 1937-1987 Observed Deaths Expected Deaths1 SMR (95% Confidence Limits) AML (205.Q)3 10 15.945 62.7 ( 30,1 - 115.3) CML (205.1) ALL (204,0) 6 8 7.113. 3.082 84,4 259.6* ( 31.0 - 183.6) (112,1 -511.5) CLL (204.1) 3 10.044 29.9* ( 6,2- 87.3) NHL (200,202) 30 42.233 71.0 ( 4.7.9 -101.4) MM (203) 19 19.390 98.0 ( 59.0-153.0) 1 = Expected number of deaths based on rates for white males regardless ofrace (from Selvin et at. 1983) 2 - N umbers in parentheses arc codes for the International Classification of Diseases (ICD). 8th Revision * = p<Q.05 ' Abbreviations: AML = Acute Myeloid Leukemia CML = Chronic Myeloid Leukemia ALL * Acute Lymphatic Leukemia CLL - Chronic Lymphatic Leukemia NHL = Non-Hodgkin's Lymphoma MM = Multiple Myeloma . Table 26 Selected Characteristics ofDecedents1 with Underlying Cause of Death Due to Acute Lymphatic Leukemia Port Arthur Refinery Update, 1937-1987 Year of ID Hire Age at Hire Year Employ't Years Year of Terminated Worked Death Age at Death Interval Since Hire A 1910 32 .1940 29.5 1940 62 29.5 B 1924 29 1959 34.8 1972 77 47.6 C 1936 22 1957 20.9 1957 43 . 20.9 D 1943 54 1954 11.1 1962 72 19.0 E 1944 43 1944 0.5 1983 82 39.2 F 1945 62 1956 10.7 1956 73 10.7 G 1949 27 1975 26.7 1975 53 ' 26.7 H 1953 22 1957 4.0 1961 30 8,4 1 All decedents were white males Note: Seven ofthe eight ALL deaths occurred in Texas. Employees A, C, D, F, and G died in Jefferson County. Employees B and E died in Taylor and Nacogodoches counties, respectively. Employee H died in San Diego, California. Table 27 Length, of Employment Trend Analysis for Deaths Due to Acute Lymphatic Leukemia Port Arthur Refinery Update, 1937-1987 <10 Employment Duration Strata (yrs) ' 10-19 20+ Avg Employment Duration (yrs) 2.5 Observed Deaths Expected Deaths 2 1.25 SMR SMR 95% Cl 160.0 19.4-578.0 CM square (trend): 0.23. p= 0.6333 14.4 2 0.39 512.8 62.1-1652.5 33.0 4 1.45 275.9 75.2-706.3