Document 3O3mBewyK51rMYJ2QDwnen8J

102 Summary While the dangers of asbestos have been well recognized for over five decades, the industry was able to largely ignore or suppress these until studies in the 1950s by Doll in England and by SelikofI in the U.S. (sponsored by the asbestos insulators union) es tablished the relationship between asbestos and asbestosis and cancers at various sites. Since then the industry has employed scientific expertise to advocate its position in professional journals and to successfully resist and prevent effective government regula tions. With an estimated 8 to 11 million workers having been ex posed since World War 11, the toll of asbestos occupational dis ease and cancer is now reaching epidemic proportions. Workers have begun to exercise legal initiatives, including third-party and medical malpractice suits, resulting in multimillion dollar awards. Concerns are also mounting on the dangers to the public from "low-level" asbestos contamination of air and water and from as bestos-containing consumer products such as hair dryers. As the realization is dawning that asbestos is too expensive in terms of disease and death to continue using, the industry is be ginning to develop the strategies of relocating in lesser developed countries and promoting the use of fiberglass as an asbestos sub stitute in the United States. There are serious unresolved ques tions as to the dangers of fiberglass and there are possibilities that it may be no less hazardous than asbestos. The massive human toll taken by asbestos is probably the single most important incentive to the development of coherent national policies recognizing preventive medicine as a major future compo nent in the delivery of health care. Vinyl Chloride One of the most common pejoralives applied to modern times is "the plastic age." And just as age-old natural materials like wood. The Workplace: Case Studies 103 glass, and metal have been replaced by cheaper synthetic plastics, this seems to imply, so has the value of our lifestyle been degraded. Many things we now touch or use daily are made of plastic. Yet the plastic transformation of our society has only taken place over the last forty years. The consequences to society of its plasticization, in terms both of high energy and health costs, have only recently been appreciated. One of the major costs is from cancer.1 Manufacture Plastics are the leading product of the modern petrochemical in dustry. This era of plastics dawned in the 1930s with the realiza tion that petroleum was the cheapest and simplest starting mate rial for the synthesis of the vast array of organic chemicals now used by modern industry. Petroleum then gradually replaced coal, which had been previously used for this purpose, and is now al most the exclusive basis of the organic chemical industry. Vinyl chloride (VC) lies at the heart of the plastics industry. VC was first discovered in 1837. Large-scale production, how ever, did not start until the 1930s, when it was synthesized from chlorine and ethylene, largely for the manufacture of synthetic rubber.* Production levels increased rapidly after World War II at a rate of 15 percent per year, reaching a total of about 7 billion pounds this year. VC is a simple chemical consisting of a small single molecular unit (a monomer) which is normally a gas but can be shipped and stored as a liquid under pressure. VC reacts under conditions of heat and pressure and in the presence of plasticizing chemicals to form large molecular chains (polymers) of polyvinyl chloride (PVC) resins. The polymerization of the VC monomer never proceeds to completion, but always .leaves some unreacted VC en trapped in the PVC resin. Depending on the production process, this unreacted VC has concentrations ranging as high as 8,000 parts per million (ppm).* This residual VC can be dissolved oui of the polymer or released by heating it.1 PVC resins are molded, injected, and extruded in the fabrica tion of a wide array of plastic products. These include pltoiso- o I 23942002 BFG28705 ir- -- - - - 'hi,:., ..U .J 'I..L. t. 101 TIIE POLITICS OF CANCER graph records, wire and cable insulation, floor coverings, garden lior.c, furniture, upholstery fabrics, car bodies, coating of fabrics and wallpaper, cnntaiii'.-rs, hollies, and food wrappings. It is dillicult to gel an accurate count of the number of U.S. workers involved in all the various stages of PVC production. There are about seventeen VC manufacturing plants, employing about a thousand workers, and forty PVC plants, employing about six thousand workers.5 There are no figures available, however, on the number of fabricating plants or on the number of their employees. These must run into the hundreds of thousands. Suppression by the Industry of Data on the Carcinogenicity of Vinyl Chloride In May, 1970, an Italian toxicologist. Pier Luigi Viola (employed by Solvar Manufacturing Corporation), reported at an interna tional cancer congress in Houston, Texas, that long-term inter mittent exposure of a small group of rats to 3 percent of VC in air (30,000 ppm) resulted in the production of cancers in a wide range of organs.* This fu st report on the carcinogenicity of VC created little im pact because Viola had claimed that the type of tumors induced were peculiar to rats and without human significance, and also be cause of the very high levels of VC to which the rats were ex posed. In fact, Viola had induced tumors at much lower concen trations, extending down to less than 5,000 ppm. These facts were discussed in detail at a Manufacturing Chemists Association meet ing in November, 1971, where it was concluded that they should not l>c published, as this would otherwise "lead to serious prob lems with regard to the vinyl chloride monomer and resin industry . . . and force an industrial upheaval via new' laws or strict inter pretation of pollution and occupational health laws."7 Union Car bide further expressed its concerns that in view of the large stake it had in "areas most likely to be affected, such as food, food packaging, fiber and aerosols [it] would be seriously hurl by arbi trary or panic-induced government restrictions." I*iior to this, thereJiaJ.anQmjmtlwJrccn-wo-stuclics-in-lhg-blasti s intiii .lry on the pos*d'jc_carciim^niciiy_Qf_V_C^-aUhoiigh-tons of thousands of workers the world over had been exposed to it for The Workplace: Case Studies 105 ovcrj]uee_ilecadcs-and-aL-4east-6vft-fatnl-cases-'oHivef-cancer had occurred in VC/PVC workers prior to 19.70.11 Disturbed by Viola's public report, a consortium of giant European chemical industries, led by Italy's semi-govcrnmcntal Montedison, anil with contributions from British, Belgian, and French firms, financed a major study initiated in July, 1971, by Cesare Maltoui of the Bologna Cancer Institute.** An extensive series of tests were con ducted in which adult, infant, and pregnant mice, rats, and hamsters were exposed to VC in inhalation chambers at concen trations ranging from the relatively low 50 ppm level to the toxic 100,000 ppm (10 percent) level. RvlateJ972| Malumi^hatLn confirmed and extended Viola's results. Vc was shown to be a polldnMSrPHo|UKI"ifi3tftilfi]glITf!ff8'iypWt*liver cancer (called an giosarcoma), as well as more common liver cancers (hepatomas) and cancers of other organs, including kidney, brain, and lung. The cancers were subsequently found even at the lowest level then tested, 50 ppm. The overall tumor incidence was concentrationdependent, with higher doses increasing the incidence and rate of development of the cancers.10 In October, 1972, (he Manufacturing Chemists Association, the major trade association of the U.S. chemical industry, entered into an agreement with the European consortium to share their infor mation, but not to disclose it without prior consent.11 In January, 1973, the U.S. industry representatives visited Maltoni and were given full details of his experimental studies. The Manufacturing Chemists Association (and Maltoni) subsequently failed to dis close this information, in spite of the fact that NIOSH, in the same month, had publicly requested all available data on the toxic effects of VC. In March, 1973, the Manufacturing Chemists Asso ciation recommended to NIOSH a precautionary label for VC that made no reference to toxic or carcinogenic effects on animals or humans. Four months later, however, representatives of the Manufac turing Chemists Association met in secret with Marcus Key, then Director of NlOSIl and now Professor of Occupational Medicine at the University of Texas, Houston, and a small group of his sen- * An additional reason for initialing these tests, revealed by Maltoni in 1975, was Itis hitherto undisclosed finding in 196V of malignant cells (of a large cell adenocarciuontalous type not seen in smokers) in the sputum of VC/PVC workers, suggestive of early lung cancer or pre-cancerous changes. I 23942003 BFG28706 106 the rouncs or cancer ior stalf. Tl<cy were informed that Maltoni had induced tumors in rats exposed to VC levels of 250 ppm. At one stage of the meetin!', mi industry representative, V. K. Rowe of Dow Chemical Company, adjourned to a separate office for a private meeting with Key.12 Rowe subsequently commented that "this private dis cussion of the carcinogen problem was worth the whole effort." Finally, industry concluded that as a result of a meeting "(he chances of precipitous action by NIOSH on VC was materially lessened. NIOSH did not appear to want to alienate a cooperative industry or they did not want to know too much unpublished data." In March, 1973, following complaints of an unpleasant taste, Schenley Distillers found 10-20 ppm levels of VC in their liquors sold in l*VC bottles. On the basis of these findings, and still knowing nothing about the carcinogenicity data, FDA then banned the use of these liquor bottles. In December, 1973, the Society of Plastics Industry, the plastics industry trade associa tion, provided the FDA with data on migration of VC from PVC containers to food, but made no reference to problems of car cinogenicity. On January 22, 1974, B. F. Goodrich announced that since ^1971 three PVC workers in their Louisville, Kentucky, plant had died of angiosarcoma of the liver. On that same day, the Manu facturing Chemists Association revealed the by now fifteenmonth-old Maltoni data to NIOSII. According to a recent special committee report of the American Association for Advancement of Science, the Manufacturing Chemists Association "appears to have deliberately deceived NIOSH regarding the true facts. . . . Because of the suppression of these data, tens of thousands of workers were exposed without warning, for perhaps some two years, to toxic concentrations of vinyl chloride."' Distortion by the Industry of Data on the Carcinogenicity of Vinyl Chloride TP'* first published case reports of angiosarcoma of the liver in VC/PVC workers generated an intensive epidemiological investi- f'i The Workplace: Care Sltalic.i 107 galion of cancer mortality in the industry in several counhies. A British Petroleum Corporation study, published in Lancer in 1975, claimed that the longer one worked in a VC plant, the less was the risk of getting cancer.'4 Closer examination by NIOSII, however, questioned the interpretation of the English data. Ex pected death rates in workers exposed to VC for fifteen or more years were artificially reduced, and rates in workers with lesser ex posures were artificially inflated. Re-analysis of the data by NIOSH, using standard methods, showed a clear excess of mortal ity from ail causes and all cancers, including digestive system and lung cancers, besides angiosarcoma of the liver (Table 5.3). Exaggeration by the Industry of the Costs of Regulating Occupational Exposure to VC As information on the carcinogenicity of VC began to surface, OSHA was prodded into action. On April 5, 1974, OSHA re duced permissible exposure levels froRP3WJ fJjliH lb1 A new <?!Hdrgency standard ot Wppm" Uttdfelf piWIlffil? fltffH MUDI1 Jlltl'DidepeiKieht 'scientist' "Mb'Iffsisted that the new standard was too high for safety, on May 10, 1974, OSHA proposed a VC standard "at no detectable level" (in the range of 0 to 1 ppm) to be achieved by the use of engineering controls, rather than worker use of respirators. Faced with strenuous industry opposition and alarming economic impact analyses, OSHA did not proceed to .adopt this standard, but on October 4, 1978, instead issued the more lenient final 1 ppm standard.1* Even at that time, however, it had been shown that exposure of small numbers of rats to 5 ppm VC induced an increased incidence of cancer, and there was no evidence then (or now) of any safe exposure level for VC, or indeed to any other carcinogen,t Nevertheless, industry objected strongly to the "no detectable level" proposal on the grounds that it was unnecessary, too expen sive, and beyond their compliance capability. To bolster these claims, contracts were given out by the Society of the Plastics In- 1 Later studies by Maltoni and others demonstrated carcinogenic effects, in cluding breast cancer, in rodents following inhalation of VC at levels as low as I ppm. J /i w ncl O to 00 -oJ -o rnmmmwmmmmsm JOS THE POLITICS OP CANCER Table 5.3 Comparison of Caines of Dealli in VC Workers /.'( /)//< </ by Hritish Petroleum (HP) and Recalculated by NIOSH Canso of Death, Reported by 1)1* ami Recalculated by NIOSH Standard Mortality Ratios* for Workers Exposed to VC for Varying Times Years of Exposure 9 or less 10-14 15 or more All causes BP NIOSH All cancers Bl* NIOSH Digestive system cancer BP NIOSH Lung cancer BP NIOSH 112 107 61 79 137 353 123 58 73 86 76 428 106 47 121 75 62 702 129 101 62 90 133 366 Source: I. K. Wagoner. P. P. Infante, and R. Saracci, "Vinyl Chloride and Mortality." Lancet 2 (1975): 19-1-95. * Values greater than 100 indicate excessive deaths relative to expected population values. duslry, Inc. to Arthur D. Little, Inc., of Cambridge, Massa chusetts. Also, OSHA gave out a contract to Foster D. Snell, a di vision of Booz, Allen and Hamilton, for the purpose of estimating the economic impact of the new standard. The consulting firms l-icdictcd costs as high as $90 billion and losses up to 2.2 million j.ihs. persuasive arguments in the depressed economic climate of 1974. However, these estimates were shown by the subsequent expericncc of the plastics industry to be gross exaggeralions.1 * In spite of massive industry lobbying and pressures, OSHA stood fit m on the new I ppm standard, which was passed on April 1, 1975. 1 he Society of the Plastics Industry then petitioned the 2nd Cir cuit Corn I of Appeals to review the 1 ppm final OSHA standard staling: The Workplace: Case Studies 109 The evidence clearly demonstrates that the Standard is simply beyond the compliance of the industry. . . . The general increase in raw materials costs (an unavoidable result of this Standard), and the costs of monitoring, respiratory protection, medical sur veillance and record keeping all militate against the likelihood that the bulk of this segment of the industry would be able to survive economically. The evidence is clear (that these various industries) would at the very least suffer economic disaster if not close down completely. Within one year, the VC/PVC manufacturing industry had suc cessfully met the new standard, and without any major economic dislocation or plant shutdowns. B. F. Goodrich, one of the in dustry giants, redesigned its manufacturing technology to^eiiclose Vu .manufacturing and handling processes and plug possible sources ofleaks. Additionally, a "stripping" process was developed to reduce levels of the unreactecTVC monomer TiTthe PVC resin and~to decrease VC~loss~in~tTie process. The initial capital costs of the compliance technology were only $34 million. Contrary to the estimates of the industry consulting firms, B. F. Goodrich found that the new clean-up technology actually cut labor costs and could be profitably leased. (In spite of this, B. F. Goodrich increased the price of its PVC products in 1976, claiming higher production costs and blaming these on regulatory standards.) The experience of Union Carbide is similar. In late 1975, R. N. Wheeler, a senior technical official expressed surprise as to how unexpectedly easy it had been for his company to comply with the 1 ppm standard. However, earlier intercompany reports had documented the economic advantages of compliance through re covering and recycling VC which would have otherwise been discharged into the environment. Estimates of the economic im pact of compliance had ignored the major costs to industry from losses of VC gas, with resulting air pollution of the plant and adjacent community. They had also ignored or discounted the major costs to society, both direct and indirect, from failure to regulate, with resulting VC-induced disease. Finally, these esti mates did not reflect the emergence of a small and boomin'* in dustry manufacturing the monitoring equipment now required to meet OSHA regulations. 'A cd . T1 :O , to 00 *=! 00 110 run roi iTics or cancur It is clear dial, despite uniform and overwhelming protestations and prophecies to the contrary, the industry had no major difficulty in meeting tlie I ppm standard. It is also clear that the industry is ll<uiiishiiig with high production, strong demand, growing capacity, and steady prices. The slump in the PVC market in 1974 and 1975, reflecting the 1973 oil embargo and a general pattern of recession, has been replaced by a boom, well recognized in chemical trade publications since 1976. (See for instance, Chemical and Engineering News, July 24, 1978, p. 12, and September 4, 1978, p. 13.) Cancer and Other Diseases Due to VC Long before the 1974 reports of angiosarcoma in VC/PVC workers. VC was known to be toxic to experimental animnls and to humans at relatively high concentrations. Studies on experi mental animals in the early 1960s, by Dow Chemical Company and others, established that VC induced toxic effects in the liver and kidney at concentrations as low as 500 ppm, then the U.S. oc cupational standard.17 At higher levels skin and bone abnor malities were also noted. Acute toxic effects, such as headaches, disorientation, dizziness, drowsiness, and loss of consciousness had been noted in VC/PVC workers as long ago as 1949.' In the same year, the Russian scientific literature reported the occurrence of chronic gastritis, hepatitis, and skin lesions from VC exposure. In 1957 there ap peared the first report of a new occupational disease among vinyl plastic workers called acroosteolysis, characterized by a thicken in'? or clubbing of the fingers and toes, spasmodic contraction of the blood vessels, painful bone changes, and arthritis of the knuckles Additional cases of acroosteolysis have since been noted from plastic plants all over the world. By 1966, it was rec ognized that liver damage, hepatitis and cirrhosis, was common among VC/PVC workers and in some cases occurred after only one or two years of employment. Since 1974, seven independent retrospective epidemiological studies have identified over seventy deaths from angiosarcoma of v, The Workplace: Case Studies III the liver in VC/PVC plants in the United States and elsewhere.t While most have involved polymerization workers, others have occurred in workers exposed to lower concentrations of VC, in cluding four cases in PVC fabricating plants, where PVC levels were probably below 10 ppm. Cancers at various other sites in cluding the lung, brain, kidney, and digestive tract, besides lymphomas and leukaemias, have also been found in VC/PVC workers.* The lung cancers were mainly of a type (adenocar cinoma and undifferentiated large-cell) not generally associated with smoking, and were found in workers engaged in a wide range of VC/PVC operations, including PVC milling and packaging. While the occupational exposures preceding these various cancers have generally ranged from thirteen to twenty years, there have been four reports of liver angiosarcoma following less than six years of exposure. The true incidence of VC/PVC cancers in ex posed workers is still unknown, because of considerations of la tency, and also because of the ever-increasing number of cancers reported in organs other than the liver, which can no longer be considered the exclusive or even predominant site of VC/PVC-induced cancers.1* It should be noted that the wide range of VC cancers found in workers is, in general, similar to the types and distribution of cancers induced in animal tests. Despite the growing evidence of chronic human disease and the many thousands of workers at risk worldwide, the industry failed for more than thirty years to undertake any carcinogenicity tests in animals. Such tests could as easily have detected the car cinogenic effects of VC in the 1940s as they eventually did in the 1970s. There are still elements of the academic community who mini i mize the risks of VC exposure. A recent brochure from the Uni versity of Louisville's Vinyl Chloride Project, a multiniillion dol- I t At least seven fatal easel of primary carcinoma of the liver, subsequently diagnosed as angiosarcoma, hail been recognized in VC/PVC workers be fore 1970. Six of these cases occurred in the United Slates between 1961 and 1968. and the other in Sweden. * An excessive incidence of brain tumors (gliobastoma inulliforme) has been noted among VC workers in Union Carbide and Monsanto plants in Texas City, Texas, and is now being investigated by OSItA and NIOSII. There have been ten deaths from the brain tumor among workers at the Carbide plant since 1962. I 23942005 * 'fwztuiKi4mm .vr-1'-r '-cv"> *UJtiL'i <' Uka, 11?. THE POUTICS OK CANCER l.ii NCI-fuiukd program for the prevention and detection of VC-induced occupational cancer and other diseases, states: The low incidence of cancer development among people with prolonged exposure to vinyl chloride is a reflection of the body's ability to remove the chemical agent safely without developing can cel. Some individuals do not have this capability and develop cancer after years of exposure.20 . The brochure makes DQ_referonee-trrthe-faet-that-the-preserrt*ap, parent "low incidence of fVCl cancer" may sirnply.xcltect-its-U>ng intcncy period. Additionally, the independence of this University project has been questioned following recent disclosure of its re ceipt of undisclosed support from the Manufacturing Chemists Association.! Xn 00 O to oo -J o SO Cancer and Other Diseases Due to P VC While in the past concerns have focused on VC itself as the major toxic and carcinogenic agent to VC/PVC workers, there is grow ing realization of other serious hazards posed by PVC dust to far greater numbers of workers in operations involving the packaging and milling of PVC, and its fabrication into innumerable plastic products. These hazards most probably reflect the presence of unreacted VC entrapped at concentrations up to about 1 percent (10,000 ppm) in the PVC resin or products, and which can be released by their healing or processing, or can be dissolved from inhaled PVC dust by tissue fluids. Additionally, VC gas can be absorbed on PVC or on other dusts which may act as inert car- fixperimcntal studies have shown that inhalation of PVC dust or its instillation into the lungs of rodents can induce acute inflam mation followed by chronic granulomatous changes. Similarly, a wide range of abnormalities has been recognized in the lungs of workers exposed to PVC dust in a variety of operations involving begging and packaging of PVC resins and their fabrication of PVC 1 I liis a.is iiiliniual at an NC I site visit meeting at the University of Louis ville on September 26 and 27, 1977. The Workplace: Case Studies 113 products, where dust levels have been found to range as high as 20 mg/m*, and where the dust may be so fine that most is in haled deep into the lungs. The lung abnormalities reported include reduction of lung function, radiological changes, and chronic lung disease (pneumoconiosis). "Meat-wrapper's asthma" is a pos sibly related problem well recognized among supermarket and wholesale meat workers who, in packaging cuts of meat, use a "hot wire" or "cool rod" to cut and seal the sheet of Saran Wrapt of other PVC plastic film used for wrapping.I11 In the cut ting process, particularly when high temperatures are used, irritant fumes, including hydrochloric acid, are given off. White the in dustry has readily ascribed the asthma to such irritants, it is not yet known whether there are any carcinogenic hazards posed by unreacted VC, or other related carcinogenic agents, such as vinylidene chloride, which may be liberated from the plastic film by the heat cutting. More ominous than the inflammatory lung changes, an excess frequency of cancer deaths has been reported in four retrospective epidemiological studies of workers predominantly exposed to PVC dust.13 These include lung cancer (of the same type as de scribed in VC workers), and cancers of the urinary tract, digestive system, and lymphatic system. . . Public Exposure to VC The public and the regulatory agencies are now beginning to real ize that what goes on in a plant often affects the health of those living nearby in the community. The closer you live to a plant manufacturing VC or PVC or fabricating PVC products, the more VC you are likely to breathe. EPA has estimated that 4.6 million people live within five mites of VC/PVC plants.** No estimates are available for the presumably greater number of people living near the uncounted PVC fabricating plants scattered over the country. Measurements by EPA in 1974 and 1975 indicated that in 90 percent of cases, VC levels in the vicinity of VC/PVC I Saran Wrap, a product of Dow Chemical, is a co-polymer of VC and the related vinylidcne chloride, which has recently also been shown to be car cinogenic in rodents, inducing angiosarcoma of the liver in addition to oilier cancers. I 23342006 J | 4 THE POLITICS OF CANCER s plants were below 1 ppm; EPA estimated that average exposure iriT "'>fl'lA v.ithin a five-mile radius would be about 17 parts per billion (pph). Higher levels, however, were found in 10 percent of com munities sampled--33 ppnt at a distance of one-third of a mile from the center of one plant. EPA also estimated that VC/PVC plants were losing 220 mil lion pounds of VC into the air annually, mainly from PVC plants. These considerations, together with reports of excess birth defects in Ohio women living near VC/PVC plants, prompted EPA in October, 1976, to propose regulating VC as a "hazardous air pol lutant" and to limit plant emissions to 10 ppm. These regulations would be expected to reduce VC emissions by about 95 percent of previous levels and to reduce community exposure by a similar amount. However, no regulations have yet been developed for plants fabricating PVC products nor for municipal incinerators, which discharge VC into the air from thermal processing and combustion of plastic products, respectively. The results of a June, 1977, EPA investigation of an elemen tary school in Saugus, California, located across the road from Keysor-Century Corporation, which manufactures PVC and pho nograph records, arc disturbing.*4 Levels as high as 2.8 ppm VC have been measured in the air in classrooms. This heavy contami nation largely results from VC losses during tank car unloading at the plant in the night. The occurrence of VC disease in the general population has been suggested by preliminary findings of an incidence of 18 con genital malformations per 1,000 live births in women living in three Ohio communities near PVC plants, in comparison with an incidence of 10.5 per 1,000 in those living at a distance." Most of these malformations were of the brain. In addition, an excessive number of brain tumors in adult males were found in those com munities near the PVC plants. A similar excess of birth defects over a period from 1966 to 1974, has been recently noted in Sha- winignn, Quebec, where a large VC/PVC plant is located.*" Moie rctcnily, five cases of angiosarcoma of the liver have been reported in women who have lived for prolonged periods close to VC polymerizing or I'VC fat (icaiing plants, and who have never worked in these plants or t een erpo'.ol to other carcinogens known to induce angiosarcoma (such us arsenic or thorium dioxide). !! The Workplace: Care Stmlier 115 These various effects have been associated with the detection of VC in the air of communities adjacent to VC/PVC plants. Another way in which thc_public_has.-bcen exposed, to.VC is from aerosol propellants in consumer products. 5.yclt_as_iiisccli- cides, hair~sprays, disinfectams1_^nrOurnilure_polishes.JLJiPA studies show that during use _g.f_hfl'r_Pr ipsoa-t sprays, nsora breathed VC In the 100 to 400 ppm range. After much prodding, the FDA banned the use of VC as a propellant in cosmetic prod- _ uctiTTnciujing hair sprays. However, the FDA did not consider the matter serious enough to order a recall of VC-containing products soThaCIhe~publlc~c6iiia' avoRrfurt)ier~exposure. The Health Research Group eventually pried out from the 'FDA the brand names of hair sprays that used VC as a propellant, identi fying Clairol as a top selling product. According to a recent sur vey by Consumer Product Safety Commission staff, no new con sumer products containing VC have been manufactured since 1974, and no VC-containing products remain on the market in 1978. The FDA also showed reluctance in moving against the use of PVC containers for food products, although it was aware that unreacted VC was leached out of the container walls by the foods or fluids inside. By 1974 the FDA knewjhat VC levels as high as 9 ppm had been found in vegetable oils sold in rigid PVC containers." High levels were aisolfouri3 irfoifierTVC-packaged products, including beverages and cosmetics. Whife^the'FDA^pro- posed a ban on the use of rigid PVC containers for food products tmd^ beverages, the use of PVC. film. for. wrappingjoods_is_still sanctioned*! Extensive research is now being done by industry with the ob ject of reducing VC levels in PVC products, especially those in tended for food packaging and medical applications.*' However, as indicated in a recent trade journal article, the prospects of suc cess seem slim: ' At present conventional devolatilizing techniques cannot be success fully offered to PVC. ... It cannot be expected, however, lhat a completely monomer-free PVC resin will be a commercial reality in the near future." I 0 0 ZbGZZ 'AidLi 116 TIIE POLITICS OF CANCER Summary Vinyl chloride (VC) is a simple gaseous chemical which can be polymerized to form a wealth of plastic materials. Despite recog nition for several decades of a wide range of chronic toxic effects in animals and exposed workers, it was not until 1970 that the carcinogenicity of VC was first established experimentally. A con sortium of European plastics manufacturers then funded further carcinogenicity testing of VC which confirmed and extended the earlier findings. These results, which were shared with the Manu facturing Chemists Association, remained unpublished for over eighteen months until the announcement by B. F. Goodrich in January, 1974, of the occurrence of three fatal cases of an ex tremely rare cancer, angiosarcoma of the liver, among its VC/PVC workers. On the same day, the Manufacturing Chemists Association revealed the results of tests showing VC to be a po tent carcinogen in rodents, inducing angiosarcoma of the liver and a wide range of cancers at other sites at exposures of SO ppm and below. In the absence of available information on the carcinogenicity of VC iii animals, its effects in exposed workers were only finally recognized because of the occurrence of the three rare angiosar comas of the liver. Had VC only induced lung cancer, its car cinogenicity would in all probability have remained unrecognized or ascribed to smoking. The present occupational standard of 1 ppm was promulgated a by OSHA in spite of estimates by industry of grossly exaggerated O costs and unemployment. While the standard affords some degree to of protection to workers in VC/PVC plants, it is clearly excessive. oo Furthermore, it docs not protect the greater number of workers in -4 PVC packaging and fabricating plants, nor does it prevent expo sures to VC of the public-at-large, particularly those living in the vicinity of VC/PVC plants, with attendant risks of cancer and also possibly birth defects. Quite apart from VC itself, there has been recent recognition of The Workplace: Case Studies 117 the carcinogenic hazards of exposure to PVC dusts in a wide range of operations involving bagging and packaging of PVC resins, and their formulation into innumerable plastic products. My own company is very conscientious and careful about the chemicals we use in the manufacturing process. Ellington M. Beavers, Medical Director and Vice President, Rohm & Haas Company, 1974. Bischloromethylether It is surprising how quickly the scandals of yesterday become to day's respectable textbook classics. A standard 1975 medical text. Occupational Medicine, contains the following matter-of-fact ac count of the discovery of bischloromethylether (BCME) as a po tent human carcinogen: [Dr. William Figueroa] reported on lung cancer found in chloromethylmethylether workers and suggested another occupational haz ard that increases the risk of lung cancer. They surveyed and studied a chemical manufacturing plant with approximately 2,000 em ployees where periodic chest X-ray surveys had been carried out for many years. In 1962, management became aware that an excessive number of workers suspected of having lung cancer were reported in one area of the plant, and promptly engaged consulting services to identify and resolve what appeared to be a serious problem.1 Claims of "prompt" action by this company, Rohm and Haas (R&H), one of the world's dozen largest chemical inanulactiuing companies, have often been reiterated in the medical literature. The facts prove the contrary. As shown, among others, by Phila- I 23942008 23942009 BFG28712 5f,4 REFERENCES IS. I*, kiiim an.l O. k. Chase, "Comments on `Mortality Patterns Among Hard Rook Gold Miners Exposed loan Asbestifonn Mincral' and `Asbestos F iber Exposures in a Flard Rock Gold Mine'," Jolms-Mauville Corp., Health and Safety Department (Denver, Colo., iy7o). 19. J. K. Wagoner, et al., ``Comments on `Critique of Mortality Pat terns among Hard Rock Gold Miners Exposed to an Asbestiform Mineral' and `Asbestos Fiber Exposures in a Hard Rock Gold Mine"' (Washington, D.C.: National Institute of Occupational Siilcly anil Ucultli, 1976). 20. 1. F. Finl.lea to Assistant Secretary for Health, "Evaluation of Data on Health Effects of Asbestos Exposure and Revised RecomncndcJ Niiineric.il Environmental Limits," December IS, 1976. 21. I*. A. Greene, "OSHA Serves a Corporate Client, Ignoring Asbes tos in Vanderbilt Industrial Talc" (Washington, D.C.: Public Citi zen Health Research Group, 1976). 22. Ibid., p. 18. 23. Occupational Safety and Health Review Commission, Docket 10757 OSI11) 20, 947, June 28, 1976. 24. Inlet national Agency for Research on Cancer, Asbestos, IARC Monogtaphs on the Evaluation of Carcinogenic Risks of Chemi cals to Man, vol. 14 (Lyon, France, 1977). This is the best availa ble summary on the carcinogenicity of asbestos. 25. H. Weinstein, "Did Industry Suppress Asbestos Data? Dangers Apparently Long Known," Lot Angeles Times, October 23, 1978. 26. Kotelebuk, "Asbestos Research." 27. A. l.anza, "Effects of Asbestos Dust on the Lungs," Public Health Reports 50 (1935), p. 1. 28. K. VV. Smith, "industrial Hygiene--Survey of Man in a Dusty Area," unpublished Johns-Manvillc Report, 1949. 29. The Louisville Trust Company, Administrator of the Estate of William Virgil Sampson vs. Johns-Manville Corporation, Jefferson Circuit Court, Common Pleas Branch, Seventh Division, Deposi tion of Kenneth W. Smith, April 21, 1976, pp. 63-64. 30. f. J. S.dikoff, J. Clitirg, and E. C. Hammond, "Asbestos Exposure and Neoplasia," Journal American Medical Association 188 (I9ti4), pp. 22-26; I. J. SclikolT, J. Churg, and E. C. Hammond, "The Ocean cnee of Asbestosis Among Insulation Workers in the United States," Annals New York Academy of Sciences 132 (1965), pp 139- 55. 31. Minutes Asbestos Textile Institute Meetings, June 6, 1963 (Air Hygiene Committee), and October 8, 1964 (Air Hygiene Commit tee). 32. Minutes General Meeting Asbestos Textile Institute, February 4, 1971. 33. S.lil i.ff, Clitirg, and Hammond, "Asbestos Exposure and Neopla sia," and "Asbestosis in Insulation Workers." REFERENCES 565 34. J. C. Wagner, C. A. Sleggs, and P. Marcltand, "Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province," Brit. J. hid. Med. 17 (I960), pp. 260-71. 35. W. Nicholson, Ml. Sinai School of Medicine, New York, quoted in Brodeur, Expendable Americans, p. 172. 36. R. Nader and R. Harris, "Don't Drink the Water, Don't Breathe the Air," Environmental Action, September 15, 1973; E. W. Law less, Technology and Social Shock (New Brunswick, N.J.: Rutgers University Press, 1977), pp. 288-307. 37. T. Temple, "Protecting Lake Superior," EPA Journal 4 (1978), pp. 5-9. Contains a chronological summary of the Reserve Min ing case. 38. Selikoff, "Cancer Risks of Asbestos Exposure"; Nicholson, "Occu pational and Environmental Standards for Asbestos"; IARC, As bestos. 39. Nicholson, "Occupational and Environmental Standards for As bestos"; IARC, Asbestos. 40. D. L. Uayliss et al., "Mortality Patterns among Fibrous Glass Pro duction Workers," in Saffiotti and Wagoner, eds.. Occupational Carcinogenesis, pp. 324-35. 41. P. Kotin, New Times, November 25, 1977. 42. B. Castleman (1733 Riggs Place, N.W., Washington, D.C. 20009), "The Export of Hazardous Factories to Developing Na tions," Congressional Record, June 29, 1978. Vinyl Chloride 1 I. J. Selikoff and E. C. Hammond, eds., Toxicity of Vinyl Chloride-Polyvinyl Chloride, Annals of the New York Academy of Sciences, vol. 246 (New York, 1975). Proceedings of a confer ence on vinyl chloride with papers by most of the world's VC researchers, and with a detailed bibliography. 2. Environmental Protection Agency, "Scientific and Technical Assessment Report (STAR) on Vinyl Chloride and Polyvinyl Chloride," EPA-600/6-75-004 (Washington, D C.. June, 1975). 3. Ibid. 4. Ibid.; H. R. Simonds, Handbook of Plastics, 2nd ed. (Princeton, N.J.: D. Van Nostrand, 1949); E. A. Boetther and B. Weiss, "An Analytic System for Identifying the Volatile Pyrolysis Products of Plastics," American Industrial Hygiene Association Journal 28 (1967), pp. 535-40; E. A. Boettner, EPA Report 670/2-73/049, July, 1973. J. EPA, "Report on Vinyl Chloride and Polyvinyl Chloride." 6. P. L. Viola, "Cancerogenic Effect of Vinyl Chloride" (abstract),. 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