Document 3NMXmR4jbmaZ56b9pRJEj9w1x

224 1 N0. 90-3696 2 NORMAN W. ELLIS, * 14TH JUDICIAL DISTRICT COURT 3 ET AL 4 VS. * PARISH OF CALCASIEU 5 INSURANCE COMPANY OF 6 NORTH AMERICA, ET AL * STATE OF LOUISIANA 7 8 9 CONTINUED DEPOSITION OF 10 11 OTTO WONG, ScD., F.A.C.E. 12 13 VOLUME II OF II 14 December 20, 1991 15 901 Lakeshore Drive, Suite 836 16 Lake Charles, Louisiana 17 18 19 20 Reported by: 21 JAMES G. ELLIS, CSR 22 Nell McCallum & Associates, Inc. 23 2615 Calder, Suite 111 24 Beaumont, Texas 77702 25 (409) 838-0333 NELL MC CALLUM 3 ASSOCIATES, INC. 225 1 INDEX PAGE APPEARANCES 226 4 STIPULATIONS 227 5 EXAMINATION BY MR. HYDE 228 6 7 (ALL EXHIBITS WERE MARKED IN VOLUME I OF II) 8 9 CERTIFIED QUESTIONS (NONE) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 NELL MC CALLUM & ASSOCIATES, INC. 226 1 APPEARANCES: 2 For the Plaintiffs: 3 MR. J. KEITH HYDE 4 of the Law Firm of 5 Herschel L. Hobson 6 2190 Harrison Street 7 Beaumont, Texas 77701 8 9 For the Defendant Lloyd's of London: 10 MS. BARBARA L. ARRAS . 11 of the Law Firm of 12 Phelps, Dunbar, Marks, Claverie & Sims 13 Texaco Center 14 400 Poydras Street 15 New Orleans, Louisiana 70130-3245 16 17 For the Defendant Insurance Company of 18 North America: 19 MR. WILLIAM T. McCALL 20 of the Law Firm of 21 Guillory & McCall 22 901 Lakeshore Drive, Suite 836 23 P. 0. Drawer 1607 24 Lake Charles, Louisiana 70602-1607 25 NELL MC CALLUM & ASSOCIATES, INC. 227 1 Continued Deposition via telephone of 2 OTTO WONG, ScD., F.A.C.E., called by Plaintiffs on 3 December 20, 1991, at 901 Lakeshore Drive, 4 Suite 836, Lake Charles, Louisiana, at 10:00 a.m., 5 before JAMES G. ELLIS, CSR, Texas No. 3004, in and 6 for the State of Texas, pursuant to notice and the 7 following stipulations: 8 THE REPORTER: Are we going to 9 have all the same agreements? 10 MR. McCALL: Yes. . 11 MR. HYDE: Right. 12 (THIS DEPOSITION IS BEING TAKEN 13 PURSUANT TO NOTICE AND THE LOUISIANA 14 RULES OF CIVIL PROCEDURE, AND IS TO BE 15 READ AND SIGNED BY THE WITNESS) 16 17 18 19 20 21 22 23 24 25 NELL MC CALLUM & ASSOCIATES, INC. 228 1 OTTO WONG, ScD., F.A.C.E., 2 having been previously duly sworn, testified as 3 follows, to-wit: 4 EXAMINATION BY MR. HYDE: 5 Q. Dr. Wong,, have you done any more 6 research since the last time you and I talked in 7 the deposition relative to this case? 8 A. No. 9 Q. Have you looked at any other documents 10 at all concerning benzene and epidemioJogy or 11 toxicology relative to this case since the last 12 time we talked? 13 A. No. 14 Q. Where are you presently located right 15 now? 16 A. Right now? In my office. 17 Q. Is there anybody else in your office? 18 A. No. 19 Q. When we last talked, we were discussing 20 Mr. Lilly. And we were talking about his level of 21 benzene exposure, whatever those levels were. Do 22 you recall that discussion? 23 A. No. 24 Q. Okay. I think I had asked you -- and 25 we'll pick it up right here -- for purposes of NELL MC CALLUM 8 ASSOCIATES, INC. 229 1 your opinions in this case, what levels of benzene 2 exposure did you assume Mr. Lilly to have relative 3 to his work at the Cities Service refinery located 4 in Calcasieu Parish during the time when he was 5 either a boilermaker or a lab technician or a 6 laborer. And can you tell me what those benzene 7 levels were? 8 A. I do not have specific information on 9 his exposure. At least I cannot quantify that. 10 The information I have at this point i.s his 11 general job titles. And I -- what I have done is, 12 I tried to equate that with what's out in the 13 literature in terms of job tasks and job functions. 14 Q. What levels did you then assume as it 15 concerns his benzene exposure based on the 16 literature that you reviewed? 17 A. I would think his exposure would be 18 similar to maintenance people in industry. 19 Q. What was that exposure level? Do you 20 have any quantification at all? 21 A. I do not have any quantification at this 22 point, no. 23 Q. Now, have you reviewed any of the 24 industrial hygiene monitoring information for 25 boilermakers who worked at the Cities Service NELL MC CALLUM 3 ASSOCIATES. INC. 230 1 refinery at any point in time? 2 A. I don't recall off the top of my head. 3 I did review Nancy Culver's report. I don't 4 remember whether there was any specific exposure 5 information for boilermakers. 6 Q. So, as it stands here today, assuming 7 that Nancy Culver's report does not contain 8 industrial hygiene monitoring results for 9 boilermakers, then you have not seen any of the 10 benzene monitoring results for boilerm.akers at the 11 Cities Service refinery? 12 A. That would be correct. 13 Q. Now, what was your estimation of 14 Mr. Lilly's level of exposure to butadiene 15 relative to his work at the Cities Service 16 refinery? 17 A. I would give you a similar answer. 18 Q. And what would that answer be? 19 A. And that is, I do not have specific 20 information on his exposure. 21 MR. McCALL: Are you talking about 22 quantification, Counsel? 23 THE WITNESS: Right. I cannot 24 quantify that. 25 NELL MC CALLUM do ASSOCIATES, INC. 231 1 BY MR. HYDE: 2 Q. Are you able to quantify boilermakers', 3 in general, exposure to butadiene at a refinery? 4 A. No. 5 Q. Have you ever seen any literature 6 indicating boilermakers' exposure to butadiene at 7 a refinery? 8 A. I haven't done that yet, no. 9 Q. Have you ever seen any literature or 10 reviewed any documents that would indi.cate what a 11 boilermaker's or a laborer's exposure to butadiene 12 would be in a butadiene manufacturing plant? 13 A. I don't recall that. 14 Q. Do you know how long of a period of time 15 Mr. Lilly was exposed to butadiene? 16 A. I have some information on the duration 17 of employment, but I do not have any specific 18 information on exactly how long he was or was not 19 exposed to butadiene. 20 Q. Is that information you need before you 21 can completely render an opinion in this case? 22 A. I would like to have that information; 23 but there is an overriding issue there, yes. And 24 that is, is there any relationship at all between 25 exposure to butadiene and non-Hodgkin's lymphoma. NELL MC CALLUM 8 ASSOCIATES, INC. 232 1 Q. What is your opinion as it concerns the 2 exposure of an individual to butadiene and the 3 disease non-Hodgkin's lymphoma in that same 4 person? MR. McCALL: Counsel, let me enter 6 an objection as to the form of the 7 question because I'm not sure. Are you 8 talking about a causal relationship 9 between butadiene and NHL? You used the 10 term "exposure." Are you talking about 11 levels of exposure, or are you talking 12 about relationship between the chemical 13 butadiene and the disease? 14 BY MR. HYDE: 15 Q. Can you answer my question, Dr. Wong? 16 A. Can you explain the question in more 17 detail? Can you rephrase the question maybe? 18 Q. Let me start off generally. As an 19 epidemiologist, do you consider that there is an 20 association between individuals exposed to 21 butadiene and the disease non-Hodgkin's lymphoma? 22 A. I would say no, there is no association 23 at this point, not based on criteria that 24 epidemiologists use to determine an association or 25 relationship. NELL MC CALLUM & ASSOCIATES, INC. 233 1 Q. What is that criteria that an 2 epidemiologist would utilize relative to opining 3 that there is an association between a chemical 4 and a disease? 5 A. Well, the data has to satisfy a number 6 of requirements. And that would include 7 significant -- you know, statistical significance 8 of the association. The association has to be 9 strong in terms of, you know, the measure of risk, 10 whether it's standardized mortality ratio or 11 relative risk. 12 Another criteria is, he need to have a 13 positive dose response relationship. In other 14 words, the higher the exposure, the higher the 15 risk of the disease. 16 And we also need to be specific in terms 17 of exposure, make sure that there is no confounding 18 or bias in the data. 19 The relationship also needs to be 20 consistent in terms of you should find similar 21 results from different studies insofar as 22 different locations. 23 THE REPORTER: A little louder, 24 Doctor. 25 A. I just said that the relationship had to NELL MC CALLUM & ASSOCIATES, INC. 234 1 be consistent in terms of studies performed in 2 different locations. And you also have to satisfy 3 certain latency requirements. 4 Those are the things that we need to 5 consider in determining whether there is a causal 6 relationship or not. 7 BY MR. HYDE: 8 Q. As it concerns the chemical butadiene, 9 what is your understanding relative to the latency 10 period from exposure to the onset of malignant 11 disease as reported by researchers such as 12 Genevieve Matanoski? 13 A. Well, it doesn't really apply, because I 14 do not think there is a relationship between 15 exposure and the disease. And that being the 16 case, you know, it's not proper to label a 17 latency. Latency is when you have determined that 18 there is a relationship between exposure and a 19 disease. But in this case I do not think that 20 part has been established. 21 MS. ARRAS: I'd like to just 22 clarify something for the record here. 23 Keith, are we talking -- I thought your 24 last question was about malignancy in 25 general as opposed to specifically NELL MC CALLUM 3 ASSOCIATES, INC. 235 1 non-Hodgkin's lymphoma. Is that 2 MR. HYDE: Malignancy in general. 3 MS. ARRAS: Okay. I just wanted 4 to clarify that in my own mind. 5 BY MR. HYDE: 6 Q. Assume, Doctor, that butadiene does 7 cause non-Hodgkin's lymphoma. Would there be 8 anything about the latency period between any of 9 the four Plaintiffs' exposure in this case and the 10 ultimate diagnosis of disease that you would find 11 incorrect as an epidemiologist? 12 A. Even assuming that, I would not be able 13 to give you an answer today for a number of 14 reasons. I do not know at this point exactly when 15 the first exposure to butadiene occurred in each 16 of the Plaintiffs. And I need that information. 17 It may be in the materials that the attorneys have 18 provided to me. But I did not look for that 19 information when I formed my opinion. 20 Number two, I need to go back to some of 21 the butadiene studies and look at what kind of 22 latencies those studies would have, assuming that 23 there is a relationship. 24 So, I haven't done neither one of those 25 things. So, I cannot give you an answer today. NELL MC CALLUM 8 ASSOCIATES. INC. 236 1 Q. Okay. Now, as it concerns -- you 2 indicated first exposure. Is it also important 3 that that last exposure be considered relative to 4 latency period and the onset of malignant disease? 5 A. In general, I would say no, because 6 "latency" in epidemiology is defined as the time 7 between first exposure and appearance of a 8 disease, the first symptom of a disease or 9 subsequent death of -- due to that disease. 10 MS. ARRAS: Dr. Wong, we missed a 11 part there. You said it was the time 12 between first exposure and 13 THE WITNESS: The appearance or 14 symptoms or a disease 15 MS. ARRAS: Okay. 16 MS. ARRAS: -- or subsequent death 17 due to that disease. 18 BY MR. HYDE: 19 Q. What do you typically find as it 20 concerns a latency period as it relates to 21 exposure to benzene and ultimate causation of 22 malignant disease such as AML? What do you 23 consider the appropriate latency period? 24 MR. McCALL: Benzene and AML? 25 MR. HYDE: Yes. NELL MC CALLUM & ASSOCIATES, INC. 237 1 A. There is another thing we need to 2 consider. And that is how high the exposure was. 3 In general, there is an inverse relationship 4 between the level of exposure and the duration or 5 the length of latency. In other words, the higher 6 the exposure, the shorter the latency. And the 7 reverse is also true. Given very low exposure of 8 a carcinogen, the latency would be very, very long. 9 In this country, among chemical workers, 10 latency between AML and exposure to benzene, I 11 would say, would be around 20-some years. 12 BY MR. HYDE: 13 Q. Have you seen any epidemiological 14 studies that would indicate an increased incidence 15 of non-Hodgkin's lymphoma in a work force that was 16 was exposed to butadiene? 17 MR. McCALL: Let me object to the 18 form of the question without further 19 elaboration of "increased incidence" 20 BY MR. HYDE: 21 Q. You may answer 22 MR. McCALL: -- as being vague. 23 A. Did you say "incidence"? 24 BY MR. HYDE: 25 Q Yes. NELL MC CALLUM 8 ASSOCIATES, INC. 238 1 A. I'm not aware of any study that would '2 actually look at incidence of non-Hodgkin's 3 lymphoma at all. 4 Q. Are you aware of any epidemiologic study 5 that would indicate an increased risk of 6 non-Hodgkin's lymphoma from workers exposed to 7 1,3-butadiene? 8 MS. ARRAS: I'm going to object to 9 the form. 10 A. When you say "increased risk-," how do 11 you measure that? In terms of mortality, in terms 12 of morbidity, in terms of incidence, or what? 13 BY MR. HYDE: 14 Q. Any one of those, mortality, morbidity, 15 or incidence. 16 A. Okay. There are couple of mortality 17 studies on workers exposed to butadiene. And some 18 of those studies have found isolated increases of 19 mortality due to certain components of 20 non-Hodgkin's lymphoma. 21 Q. What are the names of those studies? 22 A. Give me a minute and let me look at my 23 file. 24 I am looking at a paper written by 25 Jerry Ott. It should be-in the folder labeled NELL MC CALLUM 8 ASSOCIATES, INC. 239 1 "Butadienen in the exhibit. '2 Q. Other than Dr. Ott's study, are there 3 any other studies that would indicate an increased 4 mortality from workers exposed to 1,3-butadiene? 5 A. Let me clarify that 6 MS. ARRAS: Just a moment. I'd '7 like to object. You mean mortality in 8 terms of all deaths? That's what you're 9 saying, from all causes in workers 10 exposed to butadiene? . 11 BY MR. HYDE: 12 Q. And let me limit that question -- and let 13 me start over. 14 Are there any other studies, other than 15 Dr. Ott's, that indicate an increased mortality in 16 workers from non-Hodgkin's lymphoma who were 17 exposed to the chemical 1,3-butadiene? 18 A. Well, let me clarify that first. The 19 paper that I just referred you to by Dr. Ott is 20 not a study done by Dr. Ott. Dr. Ott wrote a 21 review article, a very in-depth analysis of the 22 data out in the literature. So, it's not a study, 23 per se. I just want to clarify that point. 24 Q. Okay. Can you now answer my question, 25 though? Are there any studies that you kn-ow of NELL MC CALLUM S ASSOCIATES. INC. 240 1 that indicate an increased mortality as a result 2 of individuals acquiring the disease non-Hodgkin's 3 lymphoma wherein those workers were exposed to the 4 chemical 1,3-butadiene? 5 A. Given that the article by Ott is not a 6 study itself, but rather a summary of all the 7 studies out there, I don't think your question is 8 appropriate, and I cannot answer your question, 9 because that paper by Ott includes all the studies 10 already. 11 Q. Well -- and I'm asking you, which of the 12 studies that were reviewed by Dr. Ott found an 13 increased incidence of non-Hodgkin's lymphoma in 14 workers exposed to the chemical 1,3-butadiene? 15 MS. ARRAS: Keith, are you asking 16 him to review the article and tell you 17 right now, or else testify from his own 18 recollection as to the individual 19 references in the Ott paper? 20 MR. HYDE: Whatever he's capable 21 of doing. 22 A. There are three studies included in 23 Dr. Ott's article. And out of the three, the 24 study done by Dr. Divine indicates that 25 lymphosarcoma -- there was an increase of NELL MC CALLUM 8 ASSOCIATES, INC. 241 1 lymphosarcoma. That is part of the non-Hodgkin's 2 lymphoma. 3 On the other hand, the second component 4 of non-Hodgkin's lymphoma, and that is under the 5 category of other lymphatic tissue cancer. There 6 was no increase. 7 So, all I can answer at this point is, 8 Dr. Divine found an increase in part of the 9 non-Hodgkin's lymphoma in her study. 10 BY MR. HYDE: 11 Q. Did Dr. Matanoski, in any of the studies 12 that she coordinated or conducted, find an 13 increased incidence of workers with non-Hodgkin's 14 lymphoma for those workers exposed to 15 1,3-butadiene? 16 MS. ARRAS: We object to the form 17 in the sense that there's no foundation 18 laid as to who Dr. Matanoski is. I 19 don't know that we've established that 20 Dr. Wong, on the record, knows 21 Dr. Matanoski or of her work. 22 BY MR. HYDE: 23 Q. You may answer, Doctor. 24 A. Well, I am looking at Dr. Ott's 25 article. I have it in front of me. And I am NELL MC CALLUM & ASSOCIATES, INC. 242 1 looking at a table summarizing all the results of 2 different studies, including Dr. Matanoski's. And 3 based on that table, I don't see any increase of 4 lymphosarcoma. There was a very small, 5 non-significant increase of other lymphatic tissue 6 cancer. But that is not of any significance at 7 all. 8 Q. Do you know Dr. Ott? 9 A. Do I know him? 10 Q. Yes. 11 A. Yes. 12 Q. How do you know him? 13 A. He is an epidemiologist. I am an 14 epidemiologist. And we run into each other quite 15 often at meetings. He used to work for Dow 16 Chemical, as well as Union Carbide. And I'm sure 17 did some studies that I have done for the Chemical 18 Manufacturers Association that either Dow or Union 19 Carbide might have been participants in those 20 studies. And I might have run into him at some of 21 those meetings. 22 Q. As we sit here today, as an 23 epidemiologist, do you consider 1,3-butadiene to 24 be a carcinogen? 25 MS. ARRAS: I'm going to object to NELL MC CALLUM 8 ASSOCIATES, INC. 243 1 the form. Do you mean in humans? 2 BY MR. HYDE: 3 Q. You may answer. 4 MR. McCALL: Object to the form as 5 vague. 6 A. You mean humans? 7 BY MR. HYDE: 8 Q. Okay. As an epidemiologist, do you 9 consider 1,3-butadiene to be a human carcinogen? 10 A. Not based on the data we have at hand. 11 Q. Then I take it you disagree with IARC 12 relative to their classification of butadiene as a 13 probable human carcinogen? 14 A. I haven't looked at IARC's conclusion; 15 so I cannot answer your question. 16 Q. Are you familiar with the Collegium 17 Ramazzini? 18 A. I've heard about that. I have heard 19 about that. 20 Q. Of course, you know who Dr. Selikoff is? 21 A. Yes. 22 Q. Are you aware that the Collegium 23 Ramazzini has indicated that butadiene is a strong 24 carcinogen in humans? 25 A. I don't. NELL MC CALLUM a ASSOCIATES, INC. 244 1 Q. Do you know whether or not OSHA 2 considers 1,3-butadiene to be a human carcinogen? 3 MR. McCALL: Counsel, we're 4 talking about today? 5 MR. HYDE: Today. 6 A. I don't know what OSHA thinks about the 7 chemical. 8 BY MR. HYDE: 9 Q. Did Mr. Lilly have a family history of 10 cancer? _ 11 A. Not that I'm aware of. 12 Q. Do you consider Mr. Lilly's family 13 history, if he had one, of any significance 14 relative to his non-Hodgkin's lymphoma -- family 15 history cancer, that is, if he had one? 16 A. Yes. There have been studies indicating 17 a relationship between family history of cancer 18 and an increased risk of non-Hodgkin's lymphoma. 19 Q. What are the names of those studies? 20 A. The study done by Cartwright in 1988. 21 And also a project done by Dr. McDonald in 1987. 22 Q. Were there any other risk factors that 23 you identified relative to Mr. Lilly and his 24 non-Hodgkin's lymphoma? 25 MS. ARRAS: I'm going to object to NELL MC CALLUM & ASSOCIATES, INC. 245 1 that form as being vague. 2 MR. McCALL: Right. 3 A. Could you repeat a question one more 4 time? 5 BY MR. HYDE: 6 Q. Sure. Have you identified any other 7 other risk factors for Mr. Lilly relative to the 8 causation of his non-Hodgkin's lymphoma, other 9 than what you have already spoken about? 10 A. I'm confused, because I said that as of 11 now, I'm not aware of any family history of cancer 12 in his case. And your question is, "Is there any 13 other risk factors?" Are you implying -- are you 14 telling me that he has a family history of 15 cancer 16 Q. No. 17 A. -- because 18 Q. Let me rephrase that. Do you know of 19 any risk factors that Mr. Lilly has that may have 20 caused his non-Hodgkin's lymphoma? 21 A. Two come into my mind right now. One is 22 smoking, cigarette smoking. And the other one is 23 his exposure to a farm or working on a farm. 24 Q. How long did little Mr. Lilly work on a 25 farm? NELL MC CALLUM & ASSOCIATES, INC. 246 1 A. I don't recall at this minute. 2 According to the notes that I have, he grew up on 3 a farm; and he also worked on a farm, as well. 4 But I don't know exactly how long at this point. 5 I may have to go back and retrieve that 6 information to answer your question. 7 Q. What type of products were raised on the 8 farm or farms where Mr. Lilly worked? 9 MR. McCALL: You mean crops? 10 BY MR. HYDE: 11 Q. Crops. 12 A. I don't recall the details at this 13 point. 14 Q. Do you know whether or not Mr. Lilly 15 ever. used any pesticides or herbicides relative to 16 any of the farm work he may have performed? 17 A. I don't know at this point. 18 Q. Can you say here today that more 19 probably than not Mr. Lilly's farm work was a 20 cause or a contributing cause of his non-Hodgkin's 21 lymphoma? 22 A. Certainly it's a risk factor. I cannot 23 quantify, you know, the probability of causation 24 at this point. 25 Q. Are you saying that his farm work NELL MC CALLUM 8 ASSOCIATES, INC. 247 1 contributed more probably than not to the 2 causation of his non-Hodgkin's lymphoma? 3 A. I guess I have to ask you what you mean 4 by "more likely than not.' What does that mean? 5 Q. Over 50 percent sure. Are you over 6 50 percent sure that Mr. Lilly's farming work 7 caused or contributed to causing his non-Hodgkin's 8 lymphoma? 9 A. I haven't 10 MR. McCALL: At the present time? 11 A. I haven't done any detailed calculation 12 in terms of his probability of causation due to 13 farming. So, I cannot answer your question. All 14 I can tell you today is, farming would be a risk 15 factor in his case. 16 BY MR. HYDE: 17 Q. Can you say more probably than not 18 A. I already told you, I cannot do that 19 today. 20 Q. Well, I'm talking on a different subject 21 now. 22 Can you say more probably than not that 23 Mr. Lilly's cigarette smoking caused or 24 contributed to causing his non-Hodgkin's lymphoma? 25 A. I would say yes, given that there is a NEIL MC CALLUM 8 ASSOCIATES, INC. 248 1 very strong risk associated with cigarette smoking 2 and non-Hodgkin's lymphoma. I would say yes. And 3 given his very heavy smoking history. 4 Q. What is your understanding of his 5 smoking history? Can you give me a pack-year? 6 A. I cannot give you a pack-year. I can 7 give a range. Based on the information I have, 8 his history was anywhere between 79 to 106 9 pack-years. He started smoking when he was age 10 14 and continued to 67 year old. _ 11 Q. The fact that Mr. Lilly is a black man, 12 would you consider that to be a risk factor 13 relative to his development of non-Hodgkin's 14 lymphoma? 15 A. I'm not so sure I understand your 16 question. 17 Q. Does race play any role as a risk factor 18 in Mr. Lilly's development of non-Hodgkin's 19 lymphoma? 20 MR. McCALL: Again, Keith, you're 21 asking his opinion as an epidemiologist? 22 MR. HYDE: Yes. 23 A. I guess I still don't quite understand 24 your question. Just being alive, you know, is a 25 risk factor for developing different kinds of NELL MC CALLUM 8 ASSOCIATES, INC. 249 1 diseases. But if you ask me whether -- based on 2 vital status of this country, whether blacks have 3 a higher risk of non-Hodgkin's lymphoma or not, 4 the answer is no, because both black and white 5 have more or less the same risks. 6 Have I answered your question? 7 BY MR. HYDE: 8 Q. Yes. 9 And what is your understanding of 10 Mr. Lilly's diagnosis? What is the disease he 11 has? 12 MS. ARRAS: I'm going to object to 13 the form. You mean, what disease does 14 Dr. Wong believe that Mr. Lilly has? 15 BY MR. HYDE: 16 Q. Okay. Let me rephrase it. What disease 17 do you believe that Mr. Lilly has? 18 A. Based on the information provided to me, 19 my understanding is that he has T-cell 20 non-Hodgkin's lymphoma. 21 Q. What is your understanding of 22 Mr. Talbott's disease? What's the diagnosis? 23 A. Non-Hodgkin's lymphoma, 24 well-differentiated diffuse lymphoma. 25 Q. What is your understanding as to the NELL MC CALLUM & ASSOCIATES, INC. 250 1 diagnosis of Mr. LeBlanc? 2 A. Poorly differentiated diffuse lymphoma. 3 Q. What is your understanding as to 4 Mr. Ellis' diagnosis? 5 A. Well-differentiated diffuse lymphoma. 6 Q. And certainly as an epidemiologist, you 7 have no reason to question any of these diagnoses; 8 am I right? 9 A. I said no. Well, you asked a double 10 negative question, I think. Maybe you. can ask 11 me 12 Q. Okay. I'm going to ask the question 13 again because, evidently, we didn't hear you say 14 you say "no." And then I said, "Is that correct?" 15 And that would make it a double negative. So, 16 let's start it over one more time. 17 As an epidemiologist, do you have any 18 reason to disagree with any of the diagnoses 19 associated with the four Plaintiffs? 20 A. No, I do not. 21 Q. What is your understanding of 22 Mr. Talbott's occupation? 23 A. He worked as a pipe fitter, as well as a 24 welder. 25 Q. Do you know what a pipe fitter does in a NELL MC CALLUM & ASSOCIATES, INC. 251 1 refinery, those kinds of tasks that he would 2 perform? 3 A. I would say think to replace all kinds 4 of pipes, you know, rip out insulation material, 5 go over the old pipes or fix it, and put the 6 insulation back on again. 7 Q. And what assumptions did you make 8 relative to Mr. Talbott's benzene exposure during 9 the time period when Mr. Talbott was a pipe fitter 10 or a welder? 11 A. Well, again, my assumption is that his 12 exposure would be similar to maintenance people in 13 the industry. 14 Q. So, it's going to be your assumption 15 that Mr. Talbott would have the same level of 16 benzene exposure as a pipe fitter at Exxon or 17 Shell; is that correct? 18 MS. ARRAS: I'm going to object to 19 the form in the sense that he didn't say 20 "same," he said it would be similar 21 MR. McCALL: To the industry. 22 MS. ARRAS: -- to the industry. 23 A. I cannot -- I don't think it's 24 appropriate to identify two specific companies. 25 What I have done is -- you know, I assume that his NELL MC CALLUM 3 ASSOCIATES, INC. 252 1 exposure would be similar to maintenance people in 2 the entire industry. 3 BY MR. HYDE: 4 Q. But you have no information that would 5 indicate that the Cities Service refinery and the 6 respective exposures to pipe fitters at that 7 facility would in any way be the same as pipe 8 fitters throughout the refining industry? 9 MS. ARRAS: I'm going to object to 10 the form because you haven't quantified 11 or stated what the exposure would be to. 12 BY MR. HYDE: 13 Q. To benzene. 14 A. I do not have specific information to 15 indicate whether you would be similar or you would 16 not be similar. But based on my experience in the 17 industry -- you know, I have done quite a few 18 studies at different refineries -- I would say that 19 overall, there may be some small differences. But 20 in general, the order of magnitude of exposure 21 would be the same across the industry. 22 Q. If Mr. Talbott used benzene to clean his 23 work tools at the Cities Service refinery -- or 24 rather, I want you to assume this with me. And 25 let me start over. NELL MC CALLUM 8 ASSOCIATES, INC. 253 1 Assume that Mr. Talbott used benzene to 2 wash his tools at the Cities Service refinery, 3 could that have led to a different level of 4 benzene exposure as compared to a pipe fitter at 5 Exxon wherein those pipe fitters would not have 6 been allowed to use benzene to clean their tools? 7 Do you see any difference in the, the exposure 8 levels. 9 MR. McCALL: Dr. Wong, let me 10 object to the form of the question 11 insofar as the hypothetical. The 12 foundation for the assumption in the 13 hypothetical has not been established 14 into evidence, and we object to it. 15 MS. ARRAS: I object 16 MR. McCALL: I further add, what 17 the level of benzene was, whether it 18 was -- what amount or quantification of 19 benzene was in your assumption, Counsel, 20 was being used to wash tools, I think 21 that's vague and objectionable also as 22 to form. 23 BY MR. HYDE: 24 Q. You may answer the question, Dr. Wong. 25 A. Did they object to it? NELL MC CALLUM 8 ASSOCIATES, INC. 254 1 Q. Yeah, they objected. But you can't. 2 A. Again, I think your question is more 3 specific than what I have told you. I did not say 4 that -- I did not use Exxon in my assumption. I 5 said that his exposure would be similar to 6 maintenance people in the industry, overall. 7 ` If you can rephrase the question without 8 making a reference to a specific company, then 9 maybe I can answer your question. 10 Q. Assume that other refineries. did not let 11 their employees wash their tools with benzene. 12 And assume that Mr. Talbott washed his tools with 13 benzene at the Cities Service refinery. Do you 14 see any difference in the level of exposure to 15 benzene based on the information I just gave you? 16 MR. McCALL: Same objection. 17 A. You want me to assume that at other 18 refineries, people do not -- employees do not wash 19 their tools with benzene? 20 BY MR. HYDE: 21 Q. Yes. 22 A. You want me to assume that? 23 Q. Yes. 24 A. Well, number one, I want to tell you, 25 that is a very unrealistic assumption. But if it NELL MC CALLUM 3 ASSOCIATES, INC. 255 1 does, then, in general, if you compare someone who 2 washed tools with benzene to someone who does not 3 do that, I would assume that there would be some 4 additional exposure in the first case through the 5 dermal route. 6 Q. Wouldn't there also be an increased 7 exposure through inhalation as it pertains to 8 benzene exposure? 9 A. Everything being equal, there may be 10 some, yes. 11 Q. Did you participate in any API 12 epidemiological study wherein Sloan-Kettering 13 participated in that same study? 14 MS. ARRAS: I'm going to object. 15 You haven't established who 16 Sloan-Kettering is. 17 A. I'm not sure I understand your question. 18 BY MR. HYDE: 19 Q. Have you ever participated in any API 20 study wherein in the Sloan-Kettering Laboratory 21 also participated? 22 A. I still don't understand your question. 23 You mean, I worked with Sloan-Kettering in a study 24 sponsored by API? 25 Q. Yes. NELL MC CALLUM 3 ASSOCIATES, INC. 256 1 A. No, I have never worked with 2 Sloan-Kettering. 3 Q. Are you familiar with any API 4 epidemiological study conducted by 5 Sloan-Kettering? 6 A. I'm aware of one -- I don't know whether 7 you would call it a study or not -- but one program 8 sponsored by API, run by the Memorial 9 Sloan-Kettering Cancer Center. 10 Q. Do you know whether the Cities Service 11 facility in Calcasieu Parish participated in that 12 study? 13 A. There was a large number of participants 14 in that program. And I don't know whether Cities 15 Service was in there or not. I cannot answer that 16 question. 17 Q. Would you recommend as an epidemiologist 18 that a company such as Cities Service participate 19 in epidemiological studies where possible? 20 MR. McCALL: Let me object to the 21 form of the question, Keith, insofar 22 as -- I think you're going beyond the 23 scope of this man's testimony that is 24 going to be produced at trial. 25 NELL MC CALLUM & ASSOCIATES. INC. 257 1 BY MR. HYDE: 2 Q. You may answer. 3 A. I think it's too general a question to 4 give you any meaningful answer. We've got to know 5 what kind of concern, you know, Cities Service may 6 or may not have and whether they have any 7 suggestion or indication based on the literature 8 out there, that whether the chemicals, you know, 9 that Cities Service has would or would not pose 10 any hazards. I mean, I just cannot answer your 11 general question. 12 BY MR. HYDE: 13 Q. Well, obviously, you know that benzene 14 was present at the Cities Service refinery in some 15 concentrations ever since that refinery was 16 built. You will agree with that, won't you? 17 A. There would be some -- I assume, you 18 know, there would be some benzene there, yes. 19 Q. And if there was benzene at the Cities 20 Service refinery since the 1940's and fifties and 21 people were possibly exposed to that benzene, 22 wouldn't you agree with me that it's a prudent 23 practice for that company to participate in 24 epidemiological studies whenever it's possible? 25 MR. McCALL: Let me object to the NELL MC CALLUM & ASSOCIATES. INC. 258 1 form of the question. Again, you're 2 calling for -- I think it gets into the 3 medical area and occupational medicine 4 beyond the expertise of this witness, 5 and it's objectionable as to form. 6 MS. ARRAS: I'm also objecting as 7 to the time period in that you're 8 suggesting that in the forties and 9 fifties is the time that the benzene was 10 first used, under your hypothetical, at 11 that facility, that they should have 12 participated in epidemiological 13 studies. 14 BY MR. HYDE: 15 Q. You can answer the question. 16 A. Well, I'm not so sure that in the 17 forties or fifties that we knew benzene would 18 cause AML. 19 Q. Well, my question was, if they knew 20 that -- if Cities Service knew that in the forties 21 and fifties benzene was present and they had the 22 capability of participating in an epidemiological 23 study in the late seventies, shouldn't Cities 24 Service have participated in that study? 25 MR. McCALL: Objection, again, as NELL MC CALLUM 8 ASSOCIATES, INC. 259 1 to form of the question. It's assuming 2 facts that's not in evidence, your facts 3 for your hypothetical, Keith, until 4 they're established. You say that they 5 knew. And I object to that. 6 BY MR. HYDE: 7 Q. You can answer the question. 8 A. I don't have enough information to 9 answer your question. You know, even if you want 10 to do a study, you know, anywhere, you've got to 11 look at what kind of records you have to see 12 whether you have sufficient data to participate in 13 the study. It's not something that someone can 14 say, "Yes, I want to participate in the study" 15 and, therefore, you are in the study. You have to 16 go through some kind of a data quality assessment, 17 or what we call feasibility analysis, just to look 18 at what kind of data you have, see whether it's 19 meaningful to participate in the study or not. 20 So, I think you are somewhat 21 over-simplifying the issue. 22 Q. So, what you're telling me is that they 23 need to do a study to determine if they need to 24 participate in a study; is that right 25 A. I don't-know whether you need to do a NELL MC CALLUM d ASSOCIATES. INC. 260 1 study or not. Sometimes you -- it's very simple 2 to go look at your records and say, say, "We just 3 have no data to contribute to such a study." In 4 other cases, you may have to hire an epidemiologist 5 to come in and look at your data. So, the 6 situation is, you know, very different from case 7 to case. 8 Q. Have you seen any indication that Cities 9 Service ever employed an epidemiologist, either as 10 an employee or as a consultant contractor? 11 MR. McCALL: Are we talking about 12 Cities Service Lake Charles operations, 13 Keith, or Cities Service Company in 14 general? 15 MR. HYDE: Either one. 16 A. I don't have any information to answer 17 your question. 18 BY MR. HYDE: 19 Q. Have you reviewed any of the mortality 20 or morbidity statistics associated with the Cities 21 Service refinery located in Calcasieu Parish? 22 MS. ARRAS: I'm going to object to 23 an assumption that that data exists for 24 him to review. 25 A. Not that I know of. NELL MC CALLUM 3 ASSOCIATES, INC. 261 1 BY MR. HYDE: 2 Q. If that data, being morbidity and 3 mortality information, does exist, is that 4 information the type of information that you would 5 like to have relative to the formations of your 6 opinions in this matter? 7 'A. If there is such information, of course, 8 I would like to take a look. 9 Q. Have you asked the attorneys whether or 10 not any morbidity or mortality statistics exist? 11 A. I have not asked that. 12 Q. Why didn't you ask them? 13 A. Well, the petroleum industry -- you know, 14 the health community of the petroleum industry is 15 rather small. If Cities Service had sponsored a 16 study, I would think that I would know about it. 17 Q. But if they have morbidity and mortality 18 statistics that have not ever before been analyzed 19 by an epidemiologist, wouldn't you like to see 20 that information before rendering an opinion in 21 this case? 22 A. I don't see how they can collect 23 meaningful morbidity or mortality statistics 24 without any help from the epidemiologists. I just 25 cannot envision that. NELL MC CALLUM & ASSOCIATES. INC. 262 1 Q. I want to try to group this next 2 question such that I don't have to ask 50 more 3 questions. 4 A. Okay. 5 Q. Would it be fair to say that as it 6 concerns Misters Talbott, LeBlanc, and Ellis, that 7 as to their respective benzene, butadiene, and 8 ethylene oxide exposures out at Calcasieu Parish, 9 you have no numerical data that you have relied 10 upon specifically for their exposures .to those 11 chemicals; is that correct? 12 MR. McCALL: Counsel, data out of 13 Calcasieu Parish is what you're saying? 14 MR. HYDE: Yes. 15 A. Your question is so are long that by the 16 time you get to the end of it, I lost track of the 17 first part. Would you please repeat it one more 18 time? 19 BY MR. HYDE: 20 Q. Okay. As it concerns Mr. Talbott, 21 Mr. LeBlanc, and Mr. Ellis, do you have any 22 specific exposure data indicating their exposure 23 levels to benzene, butadiene, or ethylene oxide? 24 A. No, I do not have specific information 25 on quantitative exposure of this -- of these NELL MC CALLUM 8 ASSOCIATES, INC. 263 1 Plaintiffs. 2 Q. What are you relying upon relative to 3 characterizing Misters Talbott's LeBlanc's, and 4 Ellis' exposure levels to benzene, butadiene, and 5 ethylene oxide? 6 A. Based on their job functions, based on 7 their job titles in their employment history. 8 Q. As we sit here today, can you give me 9 any of those exposure levels that you have assumed? 10 A. As I said, I cannot give you a 11 quantitative exposure level for any of these 12 Plaintiffs. 13 Q. What document can I look at or which 14 document can you refer me to that would represent 15 these individuals' exposures to benzene, 16 butadiene, and ethylene oxide? 17 MS. ARRAS: I'm going to object to 18 the form of the question as being vague. 19 A. I'm not so sure I understand your 20 question. 21 BY MR. HYDE: 22 Q. Okay. What document can you refer me 23 to, or documents can you refer me to, that you 24 believe would reflect representative exposure 25 levels for the Plaintiffs relative to benzene, NELL MC CALLUM & ASSOCIATES, INC. 264 1 butadiene, or ethylene oxide? 2 MS. ARRAS: That's as clear as a 3 bell. 4 MS. ARRAS: What? 5 MR. McCALL: That question. It 6 was. 7 MS. ARRAS: It was a bell? 8 MR. HYDE: Clear as a bell. 9 MS. ARRAS: No, it wasn't clear as 10 a bell. I'm going to object because 11 when you say "represent their exposure 12 levels," you mean is that where you 13 would go to find information about their 14 exposure? I mean, what Dr. Wong relied 15 on 16 MR. HYDE: I want to know 17 MS. ARRAS: -- I don't know 18 MR. HYDE: -- what documents he has 19 used to assume their exposure levels. 20 MS. ARRAS: That was not the 21 question. 22 MR. HYDE: That was the question. 23 MS. ARRAS: No. 24 A. I told you, I could not determine 25 exposure level, per se, of these individuals. All NELL MC CALLUM & ASSOCIATES, INC. 265 1 I can say is, their exposure would be similar to 2 maintenance people in the industry. 3 BY MR. HYDE: 4 Q. What risk factors have you identified 5 relative to causing Mr. Talbott's non-Hodgkin's 6 lymphoma? 7 MS. ARRAS: That hasn't been asked 8 and answered? 9 MR. HYDE: No. 10 A. For Talbott? 11 BY MR. HYDE: 12 Q. For Talbott. 13 A. He has some exposure to a farm or 14 farming because he grew up on a farm. He also 15 worked on farm, as well. So, I would say that's 16 one of the possibilities. 17 Q. Okay. Can you say more likely than not 18 that Mr. Talbott's work on a farm caused or 19 contributed to causing his non-Hodgkin's 20 lymphoma? 21 A. I don't have detailed information on how 22 long he was exposed to a farm or farming. So, at 23 this point I cannot answer your question. 24 Q. What .other risk factors have you 25 identified for Mr. Talbott relative to his NELL MC CALLUM & ASSOCIATES, INC. 266 1 non-Hodgkin's lymphoma? 2 A. Well, smoking is another possibility. 3 Q. Okay. What is your understanding of 4 Mr. Talbott's smoking history? 5 A. He started smoking when he was 12 and 6 quit when he was 42. 7 Q. Do you have a pack-year history for him? 8 A. According to my notes, he had a history 9 of 15 pack-years. 10 Q. What is your opinion relative to 11 Mr. Talbott's smoking history, whether or not that 12 smoking history caused or contributed to causing 13 his non-Hodgkin's lymphoma? 14 A. Certainly it's a risk factor. I have 15 not determined, you know, how much weight I would 16 give to that smoking history. 17 Q. Can you say more probably than not that 18 his smoking caused his non-Hodgkin's lymphoma? 19 We're talking about Mr. Talbott. 20 MR. McCALL: At the present time? 21 A. I cannot give you an answer today. 22 BY MR. HYDE: 23 Q. Were there any other risk factors for 24 Mr. Talbott relative to his non-Hodgkin's 25 lymphoma? NELL MC CALLUM & ASSOCIATES, INC. 267 1 A. Just being alive, just being part of the 2 general population. Everyone would have 3 background risks of non-Hodgkin's lymphoma. And, 4 also, age is a risk factor. I mean, that applies 5 to everybody. 6 Q. What risk factors have you identified 7 for Mr. LeBlanc relative to causing his 8 non-Hodgkin's lymphoma? 9 A. Again, he had some exposure to a farm, 10 although the information that I have at this point 11 is very sketchy. I don't even know whether he 12 grew up on a farm or not. But certainly he had 13 some exposure to a farm or farming. So, that 14 would be one of the risk factors. 15 The other one is his substantial smoking 16 history. He had a history of more than 43 17 pack-years. And, also, he started when he was 18 very young, age 16. Started smoking at age 16. 19 So, I would say those two would 20 definitely be risk factors for him. 21 Q. Any others, any other risk factors for 22 Mr. LeBlanc relative to his non-Hodgkin's 23 lymphoma? 24 A. There was some information on his 25 employment between 1951 and 1957 that he .did some NELL MC CALLUM 8 ASSOCIATES, INC. 268 1 sulphur pumping. And it depends on whether that 2 would have any ionizing radiation or not. That 3 may be another risk factor. 4 Q. What kind of pumping was that? 5 A. Sulphur. 6 Q. Do you consider radiation to be a risk 7 factor relative to non-Hodgkin's lymphoma? 8 A. Oh, yes. There are quite a few studies 9 linking ionizing radiation to an increased risk of 10 non-Hodgkin's lymphoma. 11 Q. Do you know the mechanism in the body of 12 how radiation affects the bone marrow or lymphatic 13 system which ultimately leads to non-Hodgkin's 14 lymphoma? Do you know that mechanism? 15 A. No, I don't. 16 Q. As we sit here today, can you say more 17 probably than not that Mr. LeBlanc's work pumping 18 sulphur was a cause or a contributing cause of his 19 non-Hodgkin's lymphoma? 20 A. I have not formed an opinion on that 21 issue yet simply because I do not know enough 22 about the exposure there. 23 Q. As we sit here today, can you say more 24 probably than not that Mr. LeBlanc's work on the 25 farm was a cause or contributing cause to his HELL MC CALLUM 8 ASSOCIATES, INC. 269 1 non-Hodgkin's lymphoma? 2 A. Well, definitely it's a risk factor. 3 But I cannot quantify that answer because at this 4 point I do not have sufficient information on his 5 exposure to a farm or farming. 6 Q. As we sit here today, can you say more 7 probably than not that Mr. LeBlanc's history of 8 smoking was a cause or a contributing cause to his 9 non-Hodgkin's lymphoma? 10 A. Well, given his very substantial smoking 11 history, I would definitely say that, at the 12 minimum, it would be a contributing factor. 13 Q. But as to farming and radiation, you 14 cannot say more probably than not that those two 15 activities contributed or caused his non-Hodgkin's 16 lymphoma? 17 A. I just do not have sufficient 18 information on exposures to those two at this 19 point to form a quantitative opinion. 20 Q. What information do you need? 21 A. I would like to know how high the 22 radiation was, if possible, to determine whether 23 there's a substantial exposure or not. And at 24 this point I do not even know how long he was 25 exposed to a farm or farming. NELL MC CALLUM & ASSOCIATES, INC. 270 1 Q. Without that information, you won't be 2 able to render an opinion relative to those two 3 risk factors and the causation of Mr. LeBlanc's 4 non-Hodgkin's lymphoma? 5 A. No, that's not exactly what I said. I 6 said I cannot give you a quantitative opinion that 7 without any doubt those two would be risk factors. 8 I cannot quantify. I cannot give you a 9 probability of causation. 10 Q. What risk factors have you identified 11 relative to Mr. Ellis and his non-Hodgkin's 12 lymphoma? 13 A. Smoking, for sure. 14 (PAUSE) 15 THE WITNESS: Are you guys waiting 16 for me, or am I waiting 17 MS. ARRAS: Yeah, we're waiting 18 for you 19 MR. HYDE: Yeah, we're waiting for 20 you. 21 MS. ARRAS: -- to finish with the 22 question. 23 THE WITNESS: I was waiting for 24 you. 25 A. I said smoking would be one of the risk NELL MC CALLUM & ASSOCIATES. INC. 271 1 factors. 2 BY MR. HYDE: 3 Q. Are there any others? 4 A. I was waiting for that question. 5 Family history would be another. 6 Q. Excuse me? 7 A. Family history. 8 Q. What is your understanding of Mr. Ellis' 9 family's history of cancer? 10 A. His mother had cancer. 11 Q. What kind of cancer? 12 A. I do not know whether I have that 13 information, or I did not put down in my notes. I 14 may not have that information. 15 Q. Well, if Mr. Ellis' mother had breast 16 cancer, how would that affect your opinion 17 relative to Mr. Ellis' non-Hodgkin's lymphoma? 18 A. It would, because based on 19 epidemiological study, it really doesn't matter 20 what kind of cancer. As long as there is a family 21 history of cancer, there is an increased risk. 22 Q. Okay. Now, what study document or 23 reference book would I find that would support the 24 statement you just gave relative to family history 25 of cancer and non-Hodgkin's lymphoma? NELL MC CALLUM & ASSOCIATES. INC. 272 1 A. I think you asked this question early 2 this morning. But I'm happy to repeat it one more 3 time. And that would be the study done by 4 Cartwright in 1988. And the second one was done 5 by McDonald in 1987. 6 Q. Are there any other studies? 7 A. Those are the two that I rely on. 8 Q. Other than his mother possibly having 9 cancer, or had cancer, were there any other family 10 members of Mr. Ellis who had cancer? . 11 A. Not that I'm aware of. 12 Q. So, is it your opinion that just because 13 his mother may have had cancer, then that would 14 have been a cause or a contributing cause to his 15 acquisition of non-Hodgkin's lymphoma? 16 A. It would be at least a contributing 17 factor, yes. 18 Q. Can you say more probably than not that 19 Mr. Ellis' family history of cancer was a cause or 20 a contributing cause to his non-Hodgkin's lymphoma? 21 MR. McCALL: As we sit here today? 22 MR. HYDE: (Nodding) 23 A. I would say it's -- at a minimum, it 24 would be a contributing cause. 25 HELL MC CALLUM & ASSOCIATES, INC. 273 1 BY MR. HYDE: 2 Q. And you can say that more probably than 3 not? 4 A. Oh, yeah. 5 Q. And that's based on knowledge that 6 possibly his mother may have had cancer? 7 A. Yes. 8 Q. Are there any other facts that support 9 your opinion relative to Mr. Ellis' family history 10 of cancer? 11 A. Could you repeat the last question? 12 Q. Do you have any other facts that support 13 your opinion as to Mr. Ellis' family history of 14 cancer, other than his mother may have had cancer? 15 A. The two studies that I rely on? I 16 mean, that's -- I'm not so sure I understand your 17 question. 18 Q. Well, if it is shown that his mother 19 didn't have cancer, how would that affect your 20 opinion? 21 A. Family history would not play any role 22 in his case. 23 Q. Well, I guess, how do you know that his 24 mother had cancer? 25 A. That was based than information provided NELL MC CALLUM 8 ASSOCIATES, INC. 274 1 to me, documents provided to me. 2 Q. What is your understanding of his 3 smoking history? 4 A. He smoked between 60 to 90 pack-years, 5 and he started at age 18. So, that's a very, very 6 heavy history of smoking. 7 Q. Can you say more probably than not that 8 Mr. Ellis' smoking was a cause or a contributing 9 cause of his non-Hodgkin's lymphoma? 10 A. Given his heavy history of smoking, I 11 would say yes. 12 Q. Have you identified any other risk 13 factors associated with Mr. Ellis and his 14 non-Hodgkin's lymphoma, other than smoking and 15 family history of cancer? 16 A. There was some information that he was 17 in Hiroshima in 1946 for just one day. And I 18 don't know what he was exposed to. I guess -- you 19 know, we are talking about radiation as a result 20 of the atomic bomb. I do not know the exact 21 timing, and I don't know what kind of -- what 22 level of ionizing radiation he was exposed to as a 23 result of his one day being there. But certainly 24 that would be a possibility. 25 Q. A possibility? NELL MC CALLUM 3 ASSOCIATES. INC. 275 1 A. Right. 2 Q. Can you say more probably than not that 3 Mr. Ellis' one day in 1946 in Hiroshima was a 4 cause or a contributing cause to his non-Hodgkin's 5 lymphoma? 6 A. I cannot give you an answer without 7 knowing how much exposure there was when he was 8 there. 9 Q. Any other risk factors associated with 10 Mr. Ellis and his non-Hodgkin's lymphoma? 11 A. No, other than, again, you know, being 12 part of a general population, you know, age and so 13 on, he would experience certain background level 14 risks. 15 Q. What is the incidence of non-Hodgkin's 16 lymphoma in the general population? 17 A. Did you say "incidence"? 18 Q. Morbidity, mortality, incidence, 19 whatever. 20 A. Okay. I don't have my hands on 21 incidence data right away. But I do have 22 information on mortality. Let me look. 23 MR. HYDE: Could you get me a fax 24 of whatever he's looking at? 25 A. I'm looking at the exhibit that I had NELL MC CALLUM 8 ASSOCIATES, INC. 276 1 prepared. How should I refer that here -- in 2 Exhibit 3A. There's some tables as some graphs 3 that I have. Do you want to look at that? 4 BY MR. HYDE: 5 Q. That's okay. I'll just -- I know that 6 it's there and the court reporter has it. In the 7 interest of time, I won't go thumbing through it. 8 But go ahead and tell me what the number is. 9 A. I'll give you an answer. In his age 10 group -- and that is, you know, around 60 years 11 old -- in this country I would say is around 20 per 12 100,000 people per year. A little bit over 20 per 13 100,000 per year. 14 MR. HYDE: Why don't we take a 15 five-minute break or a ten-minute break, 16 and we'll call you -- I guess we can call 17 him right back, in ten minutes? 18 MS. ARRAS: Okay. Is that all 19 right, Dr. Wong? 20 THE WITNESS: Yeah. So, we'll 21 hang up. And you guys will call again 22 after about ten minutes? 23 MR. HYDE: Right. 24 THE WITNESS: Okay. 25 (BRIEF RECESS) NELL MC CALLUM &C ASSOCIATES, INC. 277 1 BY MR. HYDE: 2 Q. Dr. Wong, are you familiar with the 3 Toxic Substances Control Act of 1976? 4 A. No. 5 Q. "No"? 6 A. "No." 7 Q. I take it you have never heard of 8 Section 8(C) or 8(E) of that act, have you? 9 A. Section 8(E)? 10 Q. Or 8(C). 11 A. No. 12 Q. Now, do you have any opinion as to 13 whether any of the Plaintiffs who were working in 14 1948 or 1949 or 1950 at the Cities Service complex 15 in Calcasieu Parish, whether those individuals, I 16 think particularly Mr. Talbott and Mr. Lilly 17 whether they were exposed to more benzene in 1948 18 as compared to the year 1949? 19 A. I don't have that specific information, 20 no. 21 Q. Do you have an opinion as to whether 22 butadiene can cause acute lymphocytic leukemia? 23 A. I have not looked into that for this 24 case. 25 Q. Well, do you have an opinion generally, NELL MC CALLUM & ASSOCIATES, INC. 278 1 as an epidemiologist? 2 A. Nobody else asked me that question 3 before. 4 Q. Do you have an opinion as to whether 5 benzene can cause chronic myelogenous leukemia? 6 MS. ARRAS: Benzene? 7 MR. HYDE: (Nodding) 8 A. What was the leukemia that you said? 9 BY MR. HYDE: 10 Q. CML, chronic myelogenous leukemia. 11 A. No, I have not looked at that, either. 12 Q. Do you have an opinion whether benzene 13 can cause chronic lymphocytic leukemia? 14 A. I'm sorry. Did you say -- let's go back 15 to the previous question. I think I misunderstood 16 your question. Would you please repeat it so that 17 I can give an answer on CML? 18 Q. Do you have an opinion as an 19 epidemiologist whether benzene can cause chronic 20 myelogenous leukemia? 21 A. Yes, I have an opinion. I'm sorry. I 22 misunderstood your question. 23 Q. What is your opinion? 24 A My opinion is there is no relationship 25 . between the two. NELL MC CALLUM 3 ASSOCIATES, INC. 279 1 Q. Just so we are certain -- I don't want to 2 miss one -- do you have an opinion as to whether 3 benzene can cause chronic lymphocytic leukemia? 4 A. Yes, I have an opinion. 5 Q. What is your opinion? 6 A. There is no relationship. 7 Q. Do you have an opinion as to whether 8 benzene can cause multiple myeloma? 9 A. That one I have not looked at. 10 Q. Do you have an opinion as to. whether 11 benzene can cause Hodgkin's lymphoma, or Hodgkin's 12 disease? 13 A. Hodgkin's disease? I have not looked at 14 that, either. 15 Q. Do you have an opinion as to whether 16 benzene can cause hairy-cell leukemia? 17 A. I'd have to go back and look at the ICD 18 coding to see what 19 Q. Do you have an opinion as to whether 20 benzene can cause pancytopenia? 21 A. I haven't looked at that. 22 Q. Do you have an opinion as to whether 23 benzene can cause polycythemia vera? 24 A. I have not looked at that, either. 25 Q. Do you have an opinion as to whether HELL MC CALLUM & ASSOCIATES, INC. 280 1 benzene can cause thrombocytopenia purpura? 2 A. I have not looked at that. 3 Q. Do you have an opinion whether benzene 4 can cause aplastic anemia? 5 A. I think there is some studies that 6 indicate at high enough level there is an 7 increased risk. 8 Q. Do you have an opinion whether benzene 9 can cause causes acute myelogenous leukemia? 10 A. Acute myelogenous leukemia 11 Q. Yes. 12 A. At high enough exposure and long enough 13 exposure, yes. 14 Q. Okay. What is high enough exposure? 15 A. I think we can combine the two, 16 intensity of exposure and duration of exposure 17 into something what we call cumulative exposure in 18 terms of ppm years. My opinion is that if the 19 exposure is higher than 60 ppm years, that would 20 be an increased risk of AML. 21 Q. Now, what reference can you point me to 22 that would support your opinion that an exposure 23 level of 60 ppm years -- or exposure history of 24 60 ppm years would cause an increased risk of 25 acquiring AML from benzene exposure? NELL MC CALLUM 14 ASSAMATFS INr: 281 1 A. Dr. Rensky's study. 2 Q. Okay. What diseases do you associate 3 with exposure to ethylene oxide? 4 A. Can you be more specific than that? 5 Q. Okay. Well, do you have an opinion as 6 to whether ethylene oxide causes any malignant 7 diseases? 8 MS. ARRAS: I'm going to object 9 A. In the sense that it would increase the 10 risks -- _ 11 BY MR. HYDE: 12 Q. Yes. 13 A. -- above and beyond the background risks? 14 Q. Yes. 15 MS. ARRAS: Let me object. This 16 is in human or animals or what? 17 MR. HYDE: Humans. 18 A. Are you referring the question to humans? 19 BY MR. HYDE: 20 Q. Yes. 21 A. Okay. There is no increased risk in any 22 malignancies that we can associate with ethylene 23 oxide exposure. 24 Q. During our first part of this 25 deposition, did you say that you had a study or a NELL MC CALLUM a ASSOCIATES, INC. 282 1 paper, something such as that, that indicated that 2 exposure to ethylene oxide resulted in an 3 increased incidence or mortality of non-Hodgkin's 4 lymphoma in your study population? 5 A. I know what you are referring to, but I 6 cannot agree with your statement because it's not 7 accurate. What I said was that in my study, I did 8 find a statistical increase of non-Hodgkin's 9 lymphoma in about half of the study, the male 10 members of the study, but not in female. 11 But I did not say that that was 12 associated with ethylene oxide, per se. Finding 13 an increase in a population is only part of the 14 overall risk identification or risk assessment 15 process. 16 When you look at the dose response 17 relationship, you don't find any. And, therefore, 18 I do not associate the statistical increase in 19 non-Hodgkin's lymphoma in the study with exposure 20 to ethylene oxide. 21 Q. What kind of work was involved in -- you 22 know, I'm talking about the work of the workers 23 who were studied as it concerns your ethylene 24 oxide, non-Hodgkin's lymphoma study. Was it 25 sterilization workers, something such as that? NELL MC CALLUM & ASSOCIATES. INC. 283 1 A. Yes. 2 Q. And what was the relative risk or SMR or 3 whatever you used for that study? What was the 4 numerical number? 5 A. For what? 6 Q. For an increased incidence of 7 non-Hodgkin's lymphoma. 8 A. Well, I have calculated several SMR's 9 for different groups within the study. Which one 10 do you want? 11 Q. Give all of them to me that you can. I 12 mean, I don't have the study in front of me. I 13 mean, if you can summarize it, tell me how you've 14 done it, that would be fine. 15 A. Okay. Overall, for the entire study, 16 the SMR was one forty-one; and it was not 17 statistically significant. Among the males, the 18 SMR for non-Hodgkin's lymphoma in the study was 19 two forty-seven. And that was statistically 20 significant. 21 But on the other hand, for females in 22 that study, which account for more than 50 percent 23 of the population in the study, the non-Hodgkin's 24 lymphoma SMR was only thirty-one. And that was 25 very low. NELL MC CALLUM 8 ASSOCIATES. INC. 284 1 And, also, when we look at the data, 2 length of employment, we do not see any upward 3 trend. In other words, the longer the exposure 4 let me start over again. 5 In other words, longer exposure was not 6 associated with a higher risk. And based on that, 7 as well as the consistency in the data between 8 male and female, I conclude that the significant 9 increase in male was not related to the 10 occupational exposure to ethylene oxide. 11 (DISCUSSION OFF THE RECORD) 12 BY MR. HYDE: 13 Q. Dr. Wong, based on the SMR of 14 two forty-seven for male workers exposed to 15 ethylene oxide who developed non-Hodgkin's 16 lymphoma, what conclusions did you draw as a 17 result of those study results? 18 MS. ARRAS: With respect to what? 19 BY MR. HYDE: 20 Q. Let me start that over. 21 From the study where you found an SMR of 22 two forty-seven relative to non-Hodgkin's lymphoma 23 and workers in the sterilization industry that you 24 studied, what conclusions did you draw relative to 25 the causation of the non-Hodgkin's lymphoma? NELL MC CALLUM 8 ASSOCIATES, INC. 285 1 MS. ARRAS: I am going to object 2 to the question on two bases; one, it 3 mischaracterizes or fails to state that 4 the 2.47 applied to males only. And, 5 secondly, it's vague, too general. 6 BY MR. HYDE: 7 Q. You can answer, Doctor. 8 A. As I said, when I looked at the entire 9 study, not just on -- not just looking at the 10 males, but both the males and the females, as well 11 as, most importantly, the dose response analysis, 12 I come to the conclusion that the statistical 13 increase in the male cannot be attributed to the 14 occupational exposure. 15 Q. What could it be contributed to, then? 16 A. I don't know at this point. In my paper 17 1 make a number of suggestions. And one of them 18 is that perhaps some of those cases could have 19 been related to AIDS. That's certainly a 20 possibility, because we've only seen an increase 21 in the male, but not in the female. We know that 22 a lot of the AIDS patients will eventually die 23 from non-Hodgkin's lymphoma. 24 Now, I do not have specific information, 25 lifestyle information in my study. And, NELL MC CALLUM 8 ASSOCIATES, INC. 286 1 therefore, that would be only a suggestion. 2 Q. Who funded your study, this ethylene 3 oxide study? 4 A. The study was funded by the Health 5 Industry Manufacturers Association. 6 Q. So, these were manufacturers who 7 manufacture hospital equipment such as sterilizers 8 and such; is that correct? 9 A. No. Most of the members of that 10 association are health-care products companies. 11 Q. Such as -12 A. Such as Johnson & Johnson, Upjohn -- you 13 know, companies that manufacture medical care 14 products. 15 Q. How much money did ENSR Health Sciences 16 or Applied -- your company, Applied Health 17 Services, how much did y'all receive for 18 conducting this study? 19 A. Oh, the study was done when I was at 20 ENSR Health Sciences. So personally, I did not, 21 and my company, Applied Health Sciences, have not 22 received any funding for that project because that 23 was done, was completed. 24 Q. How much did ENSR Health Sciences 25 receive? NELL MC CALLUM do ASSOCIATES, INC. 287 1 A. I think the overall budget over five or 2 six years would be around $400,000 or so, in that 3 neighborhood. 4 Q. Do you know how IARC classifies ethylene 5 oxide -6 MS. ARRAS: I'm going to object to 7 the form. 8 BY MR. HYDE: 9 Q. -- relative to its carcinogenicity? 10 A. No, I don't. 11 Q. Do you know whether or not OSHA 12 considers ethylene oxide to be a carcinogen? 13 A. I don't 14 MS. ARRAS: Object to the form. 15 A. No. 16 BY MR. HYDE: 17 Q. You don't know? 18 A. No, I don't know. 19 Q. Do you know whether the EPA, 20 Environmental Protection Agency, considers 21 ethylene oxide to be a carcinogen? 22 A. I don't know, either. 23 MS. ARRAS: Object to the form. 24 BY MR. HYDE: 25 Q. You indicated that you're continuing NELL MC CALLUM 3 ASSOCIATES, INC. 288 1 work on the distribution workers study for the API 2 relative to distribution or products containing, I 3 guess, benzene or petroleum products. You're 4 still doing work, aren't you, in that project? 5 A. Yes. 6 Q. And you presented your first draft of 7 that study in October? 8 A. I presented the preliminary analysis at 9 the International Symposium back in November, yes. 10 Q. And now, after presenting your 11 preliminary analysis, you're going back to rewrite 12 part of that paper; is that correct? 13 A. Well, at this point we do have a draft 14 report. And based on some of the questions raised 15 at the symposium, I'm doing some minor revision of 16 the report, you know, making things a little bit 17 clearer in places that it was not clear. 18 And at the same time, we are also doing 19 some additional analysis independent of the 20 symposium, you know. That was something that we 21 were prepared to do anyway, even before the 22 symposium. 23 Q. Have you been told to change that 24 report? 25 A. I'm not so sure I understand the NELL MC CALLUM S ASSOCIATES, INC. 289 1 question. Told by whom? 2 Q. By anyone at the API. 3 A. No, sir. 4 Q. Have you been pressured to change the 5 report at all by anyone from the API? 6 A. No, sir. 7 Q. Or any member of the API? 8 A. No, sir. 9 Q. Was that preliminary analysis and report 10 available to the public? We're talking about the 11 API study there. 12 A. I think the decision is API's and not 13 mine, because at this point, as I said, I have 14 submitted a draft report to API. And what kind of 15 release API wants to have of the report is API's 16 decision. Once when the report is finalized, then 17 I would think I would be able to send copies out, 18 you know, when people request that. But not at 19 this point, because I'm still working on the 20 revision of the report. 21 Q. How long ago did you complete this 22 preliminary analysis of the distribution workers 23 for the API? 24 A. Probably a few days before the 25 symposium. It was either the end of October or NELL MC CALLUM 8 ASSOCIATES, INC. 290 1 beginning of November. 2 Q. Obviously, you don't plan to testify as 3 to what units out at Cities Service complex did or 4 did not contain benzene, ethylene oxide, or 5 butadiene; am I correct? 6 A. Not to my understanding. 7 Q. Well, are you planning to testify as to 8 which units at the Cities Service complex 9 contained benzene, butadiene, or ethylene oxide? 10 MR. McCALL: Counsel, my 11 understanding, he's been given the 12 Culver reports. Independent of that 13 knowledge? 14 MR. HYDE: Yes. 15 MR. McCALL: I want to point that 16 out 17 MR. HYDE: I want to know, is he 18 going to testify as to which units at 19 the Cities Service complex had benzene, 20 butadiene, or ethylene oxide? 21 MS. ARRAS: I'd also like to 22 qualify. You mean independent of 23 whether their names -- if it was a 24 butadiene unit, obviously, it would 25 contain butadiene. You mean something NELL MC CALLUM de ASSOCIATES, INC. 291 1 beyond that? 2 MR. HYDE: Yes. 3 MR. McCALL: He's not a process 4 engineer. 5 BY MR. HYDE: 6 Q. Are you there? 7 A. I don't believe I'm asked to do that. 8 (PAUSE) 9 A. Hello. Are you there? 10 MR. McCALL: Dr. Wong, he's 11 reviewing his notes right now. We're 12 still here. Bear with us for a second, 13 please. 14 BY MR. HYDE: 15 Q. Dr. Wong, do you plan on doing any more 16 work in this case prior to the trial that starts 17 on January 13th? 18 A. I would think so. 19 Q. What do you think you're going to do? 20 A. I probably will go back and look at some 21 of the materials, you know, some of things that 22 you raised, and probably try to organize my 23 thoughts, you know, how to, you know, present some 24 of the scientific information to the jury. And 25 also depends on whether the attorneys would send NELL MC CALLUM A ASSOCIATES, INC. 292 1 me additional materials to review or pose 2 additional questions for me to research. 3 MR. McCALL: Counsel, we'll 4 certainly notify you if Dr. Wong's 5 opinion as an epidemiologist on the lack 6 of medical causation between the 7 chemicals in this case and the NHL 8 changes in any way. We'll certainly 9 notify you of that and make it 10 available. _ 11 MR. HYDE: Pass the witness. 12 MR. McCALL: No questions at this, 13 time, Dr. Wong. 14 THE WITNESS: That's it? 15 MS. ARRAS: That's it. 16 (DEPOSITION CONCLUDED AT 1:35 P.M.) 17 18 19 20 21 22 23 24 25 NELL MC CALLUM & ASSOCIATES, INC.