Document 4v9z4qX9mpnbMLLvkNnJJekxV
Epidemiological Surveillance Report
An Updated Mortality Study of Chevron's Port Arthur Refinery, 193.7-t987
Epidemiology and Biostatistics Chevron Medical Staff October 1994
TR94-016
AN UPDATED MORTALITY STUDY OF CHEVRON'S PORT ARTHUR REFINERY~ 1937'I987 (TR94-016)
Kenneth P. Satin Leslie A. Yuan
Otto Wong William J. Bailey Kimberly L. Newton
Chi=Pang Wen Timothy G~ Dagg Laura L. Harmon
October t 994
ACKNO'vVLED GMENT
"I-he authors wish to tha~k Anita Ross for her work in coding and coordinating t:he quality assurance procedures tbr ~he causes of death. We also wish to thank Tom iMach, Diane Steeley,
and Odessa Williams ~br their assistance in performir~g the.cause of death quality assurance.
']'able of Contems
1987 Upda~
EXECUTIVE S~MARY ............. ..........
,,., .. ..........
~ ..... i
INTRODUCTION ................... ......................
" .......
1
METHODS AND M2a2I'ERIALS ................ .... , ~ . , : , , ,.. , ....: ......
i
RESULTS
3
Descriptive Statistics ...... ; ....... ....................... Moi~ality Analyses for the Total Cohm~ . . .......... Mortality Analyses Stratified by Race and Sex ........................... Mortality Ana!yses by Length of.Emp!oyment, ..................... Mortality Analyses by Inte~al Since Hire : . . . .................
Mortatikv Anaiyses by Period of Hire .... ....... Mortality Analyses by Pay .SLams ................................ Analyses of Lymphatic and Hematopoietic Cancers
DISCUSSION ..... , ............. .... , ......... , ............ , . ,. ..... 10 CONCLUSION ................................................
t4
REFERENCES ............
: . .... : .............................
15
TABLES
E~CUTIVE SUMMARY
In 1980, the GuK Oil Corporation began publishing a series of epidemiologic reports on tI~e mortaIity of et~rrent and former employees working at tll.e Po~ Arthur refinery. The Pori Arthur study ~oup consisted: of more than 16,..000 re.fine~y workers, and: tt~eir mortality experience was observed from 1937 m 1978. Subsequently, additional employees, who were hired after ~978 and worked for at least one day at the relinery., were enrolled in the study. The expanded, cohort consists of 17,844 Gulfemployee~ who had wo.rked at the Port Arthur refiner3," anytime between January 1, 1937:and December 3 t; t 983. Following the merger of Gulf and Chevron in 1985, the data were transferred to the. Medical Department at Chevron.
The vital status of the expanded cohort has been updated from. tl~e end of'the original study period (Janum~y 1:, 1978) through December 31, 1987. A to~. of 6.,799 deaths were identified. Cause-specific standardized mortality ratios (SM]Ls) were calculated for the entire cohort as well as for various subcohorts. Causevspecific mortaI~ty data were also analyzed by length of employment, interval, since hire, period of hire and pay status. Tests for trend were also performed.
in general, the re.suits of the updated study demonstrated a favorable mortality, experience :tbr the Port Arthur employees as compared ~o the general populations of Texas o:r fl~e 'UNreal States. The overall mortality of the Port Arthur employees was about 7% tess than the expected when compared to the Texas general population, and about 10% less than the expected when compared the U.S. general populati.on.
More than 50 causes of death were examined, and 18 disease categories showed statistically significant deficits among the Port Arthur refinery workers. These categories included, among others, cancer of the bi]iary tract and liver, lymphosarcoma and reticulosarcoma, chronic lymphocytic le~emia, cerebrovasculm" disease, heart disease, non-
~ Epidemiology & B~ostatistics
t987 Update
malignant respiratory disease,, and external causes of death (e.g., accidents and injuries),
For n~any additional disease categories, mortality among the Port Arthur refinery employees was similar to that of the Texas general population. These. categories included all cancers, cancer of the diges6ve organs, cancer oftt~e respiratory System, prostate cancer, kidney cancer, bladder cancer, malignant melanoma of the skin, cancer of the central nervous system, non-Hodgkiffs ly:mphoma, multiple :myetoma, several ~pes of leukemia, soft'tissue sarcoma, puhnonary fibrosis, and mcsothelioma.
On the other hand, a few statistically significant mortality excesses were also fc~tmd. As reported previously inthe original smdy,.a statistically significant excess of bone cancer was observed, However, no exposure-response relationship was evident from the length, of employment analysis. As dlsetlssed in the original study, :the bone cancer excess Iikely represented an artifact of the eighth revision of the International Classification of Diseases.
Mortality from benign brain tumor was border-line significant ~vher~ compared~o the Texas general population; but not to the ~LJ.S. general population, Analysis 'by length of employment did not reveal any exposure-response relatio~ship. As such, it was oa~l~kely that the bo.rder-iine significant timing was relatedto, employment at the refinery. Furthermore., for malignant tumors of the central nervous system (including brain cancer), the mortality of the Port Arthur rcfinc~3' employees was similm" to the expected.
Among the male employees, 8 deaths were coded as acute lymphocytic leukemia, whereas 3.08 deaths were expected. The resultant SMR of 259,6 was statis~ica!!y signiificant. Conversely, mortality fc~ma cttro~tic lymphocylicleukemia was significm~tly less thma the expected (3 observed vs. 10.04 expected, S/VIR=29.9). Based on the length of employment analysis, no exposure-respo.ase retationsNp was detected for acute lymphocytic leukemia. Several possible explanations for the acute lymphocytic leukemia excess were offered, butno
~ .Epidemiology & B~ostqtistics
ii
Port Arthttr MorialiO~ Study
definite conclusion could be made. No other refineries have reported an increase of acute lymphocytic leukemia. The excess of acute lymphocytic leukemia at the Port Arthur refinery was limited to employees hired before !.950,
In surmnary, theresults of the updated stttdy demonstrated a favorabte mortality experience for the Port Arthur refirtery employees as compared to the Texas general population or the U.S. general population. Most causes of death showed either a similar mortality or a sig~ificant cleficit.mnong the ~efmery employees When. compared to the general population. Only a few causes of death showed statistically si.gni~cant elevations. Further analyses by length of employment, trends over time, potential misclassification due to noso.togy rules, and likelihood of exposure given, pay status job classifications did not support a Conclusion that these increases resulted from employment at Ne refinery.
~ Epidemiology & Biostattstics
iii
Port Arthur Mortality Stud.v
INTRODUCTION
In 1980, the Gulf Oil Corporatio!a began publishing a series of epidemiologie reports on the mortali _ty.of current and former employees working at.the Port Arthur refinery along the Texas Gulf Coast (Tabershaw Occupational Medicine Associates, 198.0; Tsai et al., 1983.; Wen etal., 1980, 1981a,b,e, 1983, 1984a,b,c,d, 1985, 1986). The Port Arthur cohort eonslsted of more than 16,000 refine~' workers, and their mortali~ experience was observed tom 1937 to 1978.
The results offllese studies were generally favorable in that tla.e overall mortalityrate, and most cause-specific mortality rates, were lower than that of the.general population. For the entire cohort, statistically significant deficits in m0rtatit3, were observed for all causes, digestive cancer, esophageal cancer, rectal cancer, liver cancer, bladder cancer, lymphosarcoma mad reticulosarcoma, heart disease, respiratot3r disease .and se~,,eral other r~on-malignat~t diseases. On the other hand, a statistically significant excess of bone cancer for the cohort was reported. However, a review of the actual causes of death of the cases indicated thatthe excess was likely an artii~et stemming from the coding ru|es of the 8th revision of the International Classification of Diseases (ICD), which was used to code causes of death in the cohort,.
The presen~ study represents an update to the c~hort of Port Arthur refiner~ employees. Ten additional years of foilow-up have accrued since the original full cohortmortali~ assessment. The update should, result in more preciseestimates of mortality risk, and provide zn opportunit), f~r additional detailed analyses forsome causes of death,
METHODS AND MATERIALS
The original cohort, as defined by Wen eta!. (]980), consisted of employees who worked at least one day at the Port Arthur refinery between January 1, 1937 and January t, 1978. Subsequently, additional employees, who were hired after t978 and worked for at least one day at the fernery, were enrolled in the study (Wen et at., 1984a). Following the merger of Gulf and Chevron in 1985, the .data were ta'ansferred to [he MedicaI Department at Chevron. The vital status of the expanded cohort has been updated from the end of~he original study period (December 31, 1978) through December 31, 1987.
As noted above, Gulfeontinued adding to the cotmrt employees who began working after 1978, Based on a review of the data, we cor~c.luded that t983 was the last year new hires were systematically identified and included in the cohort. Thus, theexpanded cohort consists of Gulf employees who had
worked at the Port Arthur refinery ~n~ime bet~veen JanuaD~ 1, 1937 and December 3 t~ ~ 983~
Sources for vital status determination of the expanded cohort included Gulf's personnel and annuitant record systems., the Texas Department of Motor Vehicles, the Social SecuriD" Administration, and the National Death Index. Detailed deseriptlons ofmethodologieal issues in the study are presented in a separate technical appendix. These issues include: study population.enumeration, vital status update procedures, employment status update procedures, data quality review, and quali~ assurance procedures for cause of death ending.
The updated cohort consists of 17,844 individuals ofwl~ieh.6,799 had d~ed. as of the end of~he study (December 31, 1997). For. 347 deceased cohortmembers (5.1% of all deaths) no death certificates could be found, but. the dates of.death.-were known. These deaths were included only in the"all causes of death" category of the mortality analys~s.
Mortality analysis was based on cause;specific standardized .mortality ratios (SMRs), whMa are
ratios of the number of observed deaths to the nt~mber of expected deaths, The number of expected deaths is calculated by applying mortality rates from a reference population to the person-years of observation in the cohort, and is adjusted for age,. sex,. calendar period and race. As the reference, we used general Texas population rates. We considered using t!~e rates for the counties where most Port Arthur refinery employees live as a reference..Howe~er, becausethese county populations. were relatively small, we felt their rates would be too variable (unstable) and thus 'unreliable to use as reference rates. Since most other ref}nery studies are based on a comparisonto the U.S. genera[ population, we also carried out one analysis tbr :the entire cohort using the U.S. general population a.s the ret~rence. The OCMAP program (Marsti and Preninger, 1980) was used to perform fl~e mortality analyses.
Because of the a priori interest in cancers of the lymphatic and hematopoietic tissues and the previous leukemia cell-type analysis by Wen et al. (1984a), we conducted additional analyses for celltype specific leukemias, non-HMgk~n's lymphoma~ and multiplemyeloma tbr the male cohor~ members. Age-specific leukemiacelt-type mortality rates for U.S. white males for theperiod 1969-77 derived by Setvin et al. (] 983) were used in the calculatiom For non~Hodgkin's lymphoma and multiple rayet0ma, age-specific mortality rates for U,S. white males~ 1950-1980, compiled bythe National Cancer Institute were used (Piclde et al, t987). Since no similar rates were available for non-white males, these rates were used for the entire male subohort.
The following SMR analyses were performedon the cohort: total cohort, subcohorts stratified by sex and race, length of employment, interval since hire, period of hire, and pay status~ The rationale for
~ EpidemiologY & B iostatistics ~
2
Po~t Artk~ur Mortali~ Stu~i
these analyses is as follows. Length ofen!ployment sepces as an indirect measure thr potentiN refiner3., exposures. An increasing trend in mortality by length of employment supports an exposure-response relationship between refinery employment and nmrtality risk but, by itself; does not mean the relationship is necessarily.one of cause and effect. Conversely, the absence of a trend (or a decreasing trend) .argues agalrtst an -association between work mad the risl~ of death.
Interat since hire analysis follows from. the observation that chronic diseases typicaIly require a sufficiently Tong period (latency) after exposure te develop and become clinically apparent., In mortality studies, interval since hire is used as a surrogate for latency to permit examination of disease (mortality.) in relation to the elapsed time since "exposttre" first occurred.
With regard to period of hire~ seyeral investigators (Wen et aL, 1.986, Rinsky et ai~, I981; Meinhardt etaL, 1982; Bond etal,, 1985)ihave reported ~dverse health offcots for workers hirec~ during the secoM world war period (apwoximately 1940-1945). They also reported that those hired betbre, after, or during the war years likely experienced differem exposure intensities (e,g,, higher :before 1940 and lower after 1945) and exposure d~trations (e,g-, longer before 1940 and shorter in the 1940 to 1.945 period). These differences in exposure resulted from improved engineering controls and personal protective equipment, as well as ~owering ofregttlatory exposure standards. Tlius, Strati.fieatioa on, period of hire provides a means of assessing time-related exposure-risks.
Finally, analysis by pay status provides another indirect way to assess the effects ofpotentia.! refine~, exposures. The presumption here is that hourly employees were/are more likely to be exposed to higher concentrations of refinery chemicals than salaried workers due to the nature of their a'espective
jobs.
Statistical lests tbr trend were conducted across length of employment strata using.the method described by Breslow and Day (1987). The result of the trend test is expressed ~n terms of Z: with one degree of freedom (1 df).
RESULTS
Descriptive. Statistics
The 17,844 cohort members accrued a total of 526,386.7 person~years.of observation. Eightyninepercent (12,608) of She cohort :m embers are males and am ong them 79% are white (TaN e i.), Of the
~ .Ep~demiotogy & Biostattstic~
females, nearly 89% are white. As of the cad of the .study" period, 38% of the cohort was deceased. Death certificates were obtained for 95% of the decedents.
The duration of employment at the refiners' ranged from 3 days to 54.6 yearswi~h the median duration being 12.4 years for males and 1.8 years t~br females (Table 2). Most cohort membera have been followed for a considerable time, For males, the medim~ interval since hire was 35.6 years while tl~atfbr females was 31.9 years (]Able
Table 4 shows the distributions for age at death andyear ofdeatta. The median age at death was 66.6 years. Approximately 60% of the deathsoccurred in the 1970s and t 980s: Onty 20% ofthe deaths were reported before 1950.
Mortal~i~, Analyses for the Total Cohort
Using Texas death rates as fl~e reference, about 7% fewer deaths were observed than expected (Table 5:). The resulting SMR, 92~7, was statistic~ilty signifieantL Of the 56-cause of death categories analyzed, 17 additional:c~tegories showed statistically significant deficits. These.categories include, among others, cancer of the biliary tract and. liver, lymphosarc~ma.and reticulosarc0ma, cerebrovascular disease, heart disease, non-malignant respiratoB~ disease, and external causes of de~th (e.g,, accidents and injuries)~
On the other hand, a few significant mortality excesses were found, As reported previously in the original cohort, a significant SMR for bone cancer was observed (SMR=_207.8,.95~ CI: .355.3). A slgnificant excess was also observed for the catego~beni~;n ,'rod unspecified neoptasms'W~_ (SMR=194.9, 95% CI: t29,5'28f :7). AlthOi~gh mm~y different sites a~e included in this c~y, i 7 of ~he 28 deaths in this category involvedthe brain. In the U.S. general population, approximately 68% of the deaths in this broad category are brain tumors (Environmental Health Associates, 1983). Applyi:ng 68% to the expected number of t4.4 in Table 5, an estimate of 9.8 deaths .from benign brain tumor could be expected. The correspondi~g SMR was estimated to be approximately 173.5 (17 obset~ed/9~8 .expected; 95% CI: 100.8-277.6)~ border-line significant.
Because of the use of asbestos at the refiner?, in the past, we also examined mortality from causes known to be associated with the substance. With respect m malignant diseases, asbestos is a known cause of both lung cancer and mesothelioma. Table 5 shows that lung cancer was not elevated
Note: Throughout ~_his report, "significant" means "statistically significant" and the two terms are used iffterchangeably.
~ Epidemiology & Biostat~atics
4.
Porl Arthur Moriatity SnMy
(SMR=92,9, 95% :CI: 83.4-101.2),
Regarding mesothelioma, 'the eighth revision of the ICD, used to code ail deaths in.the stud),, does not recognize a single code for this disease. Instead, depending on .tim wording on the death certificate, mesothelioma could be coded as a malignant respiratory cm~cer (ICD codes 162.1, 163, 1630, or 163 ~9), a matignant neoplasm with.out specification of site (ICD codes 199, 199;0, or 199A), or a benign respiratory disease (ICD codes 212.3, 212.4~ or 228), Death certificates with any of these codes as either the under!ying or contributing caus~e of death were manually reviewed to identify all mesotheliomas (malignantor benign). Six deaths were .coded as a malignant mesothetioma. Agespecific malignant mesothelioma mortafi .W rates were not available for either the general U.S; or Texas
populations. However, since malignant mesothelioma is a rapidly fatal disease, national age-specifiC incidence rates for t975-79 were ~sed to estimatelhe expected number of malignant mesothelioma deaths (Connelly et al., 1987). ~ese rates were derived from data in the SEER (Survei|ian~e, Epidemiology, and. End Results) Program, based o.n microscopically confinrted diagnoses, Mesotheli.omas specified as benign were excluded from the SEER .rates. For the Port Arthur cohort, 5,9 malignant mesothetioma deaths would have been expected, The resultant SMR was 101;7 (95% CI: 37.3-22t.6) which was t3ot statistically significant. In addition, 3 deaths were co~ed as benign mesotheiioma. Benign or localized mesothelioma is not. associated wifla exposure to asbestos (Antman and Corson, 1985; Briselii et al, I981,),
Asbestosis is the term for pulmonary fibrosis caused by exposure to asbestos, or, more co:rrectly, in persons with a documented history of oecupatirr-nal exposure to asbestos, A thorough review of all death certificates in :the study did not reveal a~y with the underlying cause-of death as asbestosis (ICD 515.2)., alflaough ten deafhs were dueto pulr~ot~ary fibrosis (!CD 5t5.x.- 517.x). These 10 dearies did not represent an increase in the occurence of generalized pulmonary fibrosis: the expected number of deaths in the study is 28.6 yielding an SMR of 35.0 (95% Ct: 16.8-64,.4). Theexpected n:umber is based or~ unpublished data from the National Center for Heatth Statistics for the general U.S. population.
The analysis presented in Table 5 was based on mortality rates for Texas: Since most refiner),
studies are based on a comparison to the U.S, general population, m~ additional analysis for the entire cohort based on U..S. death rates was carried out (Table 6). In general, the results were similar to those
based on Texas death rates. Several additional s~gnificant deficits were Observed (e.g., cancer' of digestive organs and peritoneum, esophageal cancer, rectal cancer, bladder cancer). Furthermore, the
SMR for benign and unspecified neoplasms was no longer statistically significant. In particular, for benign brain tumor, the number of expected deaths was estimated to be 12~9, and the corresponding SMR was 131.7 (95% Ct: 76.5-210.7). All other analyses in this report were based on Texas death rates, unless otherwise specified.
~ Epidemiotogy & Biostatistics
~
Mortality Analyses Stratified by Race and Sex
White males accounted for 7 ~ % of the entire cohort. Therefore, their mortal iLv experience
generally paralleled that of the entire cohort (Table 7). The overall SMR was significantly lower than expected (SMR= 96.6), while the same causes shoMng significantly elevated SMRs for the .entire cohort, plus hypertension without heart disease (SM-R-q 67.3)~ were also significantly elevated for the white males. A t~w additional significant mortali~, deficits were observed for white males, including cancer of digestive orgm~s and peritoneum (SMR=86.5), esophageal cancer (SMR=51.6), bladder cancer (SMR=55.9), rectal cancer (SMR=59.8), and rheumatic heart disease. (SMR=503).
The analysis for non-white males, based on 3,247 individuals and over 88,000 person-years of follow-up, also showed a signNeant deficit in overall mortality (SMR=78.4) (Table 8), No .causespecific SMRs were significantly elevated for non-white males. On the other hand, significant defici,ts were reported for cancer of the large ~ntestit~.e, tung cancer, all heart: disease, non-malignant respiratory disease, and external causes of death.
Among the 1,778 white female~ in. fhe cohort, 267 deaths were obse~ed, ~yielding an SMR cff 1 i 1.3, which was not Statistically Significan~ (Table 9). Two causes showed sig~ificant ele~,'ations: al! malignant neoplasms (89 observed, SMR=126.5) amd benign and unspecified neoplasms (4 observed, SMR=420.5). The increase in NI malignant neoplasms was driven by cancers of the large ~ntestine, lung, and breast. Althougla each of these Showed an elevated SMI~, none were statistically significant.
No analyses are presented for non-white females because onlly 10 deaths were observed among the 2 t I women.in fhis.subeohort. The causes of death .were: malignant neoplasms (2), hem,t disease (3), non-malignant respiratory disease (1)~ external causes (t), and other causes (3). With so few deaths for any single cause of death category, deathrates are unstable and comparisons to a reference population would not be meaningful.
Mortality Analyses by Length of Employment
Table 10.presents mortality analysis by length of employment for the entire cohort, Mortality from all causes combined showed a significantly decreasing trend by length of emptoymeat (~,a~ , a0=32~2, p=0.0000), Four cause-specific SMRs were significantly elevated in the 20~29 year stratum but', no trend with length of employment was observed: stomach cancer (SMR= 156.7; X~,a p=0,4825), lymphatic and hematopoietic tis sue (SMR=t 52.6; X,~,,~,a (~ ~o=0,49, p=0.4854), leukemia (SMR=222,7; ~(~ a~=1,76, p=0.1840), and hypertension with heart disease (SMR=214,3; a0=3.23, p=0,0721), Three other cause-specific SMRs showed a significant excess in the 30+ year group
~ Epidemiolog)' & Biostatistics ....
6
Port ArehuJ Mortalit~ Study
but only hypectension without heart disease ,demonstrated a positive trend: cervical cancer (SMR=SgS.6; n=3 observed deaths -- no trend test performed), benign and unspecified neoplasms (SMR=257,9; ar~=l.25, p=0,2636), and hypertensi0~t without heart disease (SMR=197,9; z-~.~ ~ ~=9,95,
Because bone cancer had a significantly elevated SMR in the entire cohort analysis, we performed a ~rend test on it as well even though no SMR in any of the strata was significantly eIevated in the length of employment analysis. The result indicated no trend ~vas present (~z~,,~ (~ ~=0,2 i, p=0,6473).
Length of employment analyses were also performed for the 3 major sex-race subcahorts (Tables 1 l-! 3). The results for white males (Table 1~ 1)paralleled those for the entire cohort although the catego~ "all heart disease" revealed a significantlyetevated SMR in the 10-19 year stratum. The trend test, however~ was not significant (~;~-~,d 0 ~0=0'07~ p=0.7951). Among non,white .males .(Tabl.e I:2)~ SMR for kidney cancer was significantly elevated in the less than one year stratum which resulted in a si~i~cant i~werse trend(x"~,,a(~rU5.36, p=0.0206). :Diabetes was also significantly elevated zmong non-white males in the 30 or more years strattma;.flfis resulted in a positive trend (z~,d(.~ 19=0.027t). Because &the much smaller number of deaths for :most other causes in the sex-race subcohorts, the length of employment.analy~esv~'ere not ~very informative~
Mortality Ar~alyses by Interval Since Hke
Table 14 shows numerous cause of death categories,, both cancers and non-cancers, with. significant deficits in various intervals since hire..N0 significantly elevated :SMRs were found for .any cause i~n employees with an interval since Nre less than 30 years. Several cause of death categories showed significantly elevated SMRs after at. least a 30-year interval of time, but none had a positive trend with len~h of employment: all malignant neoplasms (Z"~,,~ (~ a~=3.82, p=0.0506; borderline signiIicant inverse trend), cancers ofthe stomach (Zz~,,,ao ~0=0.49, p=0.4825), central nervous system (z"t~,e o a0=0"00, p=0.9873), bone (~,.a o ~0=0"21, p---0.6473), benign and unspecified .neoplasm s (z"~,~ a~=1.25, p=0.2636), hypertension wi~h heart disease (x"~,a(~ a0--3.2a, p=0.072), and suicides " a0=0, i 5, p=0.6965).
Subcohort analyses by interval since hi.re for M~te males yielded results s~milar to those of the
entire cohort(Table 15). Among non-white males, significantly elevated SMRs were found for diabetes mellitus in the 40+ year stratum (Table t6), and a positive trend was seen With lenffth ofemptoymer~t
(z'-~.a ~ ~=4.89, p=0.0271). In white females, the categories all causes, all malignant neoplasms, and cancer of the digestive organs and peritoneum had significantly elevated SMRs in the 'strata with at least 30 years since hire (Table 17). However, no trends with length of empfoyment were seen (all causes: X'~,~ o. ~o-0"01., p=0.9230; all malignant neoplasms: ~ ~,~ 0 ~-0.2~, p=0.634.5; digestive cancers: z~,~ 0
~ Epidemiotogy & Biostatistix .........
7
1987 .Updale
a0=O..11, p=0.7378), Cancer of the bladder and ot~er urinary organs was also significantly elevated but this occurred only in the less than 10 years stratum and was based on a. singIe death.
Mortality Analyses by Period of Hire
Table 18 show's that the total person-years of follow-up for the cohortwere evenfy spread across the three period-0f-hire strata: before 1.940, 1940 to 1945,.and in or after 1945. The distribution of deaths, however, was Skewed toward fl~e earlier hire periods with more than half occurring in those hired .prior to 1940. Tile table also Shows thata higher percentage of women (18.5%) were hired in the 11940 to 1945 period (the war years) as compared to either the .earlier period (3.2%) or the later period .(8.9%). Across sex-race groups, employees hi.red in the 1940to 1945 period worked.at the refiner), for a:median of 0.9 year versus 30.7 years in the pre-i.940 group and 8.3 years for those hired in or after 19~t5. Also, the median interval since hire (to the earliest ofdeath, loss to follow-t~p, :or ~e end of the stud)" period) generally exceeded. 40 years for cohort: members txired prior to 1945. For those hired in. or after 1945~ the median interval since hire was 29~2, .16.1, and 17.3 years for white males, non-white m.ales~ and white fema]es~ respectix~ety.
SIVIRs by period of hire are shown in Tables 19-22. For the entire cohort .(Table 19), significant deficits in tile all causes of death category were fom~d f0.r the before 1940 stratum. (SMR~91.7)m~d the in or after 1945 stratum (SMR=77.7)~ The SMR (101.6) was close m expected for those hired between 11940 and 1945 (the war years)~ Fourteen and t.3 additional causes of death showed significan~ deficits in tile beibre 1940 and hired after 1945 strata, respectively. These compare te atotal of 6 causes ia~ :the 1940 to 1945 stratum.
Three causes were significantly elevated ia~ the before 1940 stratum: Hodgkin's disease (SMR=205.2), benign and unspecified neoplasms (SMR= 2t8.8), and hypertension without heart disease (SMR=145.9), None of these were si.gnificantly elevated ~n the other pe6od of hire strata. No significamly elevated causes were found inthe 1940 to 1945 stratum, while k~dney cancer was the sole significantly increased cause of death among employees hired in or after t 945 (SMR=225.1).
The subcohort analysis by period of hire for white males is shown in Table 20. The results are Similar to the before t940 period except the increase in Hodgkin's disease is no longer significant. For the 1940 to 1945 group, the categories ofalt causes and pancreatic cancer were significantly elevated. No causes of death were significantly elevated among employees hired in or after 1945, although kidney cancer was greater than expected,
For non-white males significant SMR deficits were observed in all the period-of-hire strata
~ Epidemiotogy & BiostatiStics
(Table 21). The only significantly elevated SMR was for Hodgkiffs disease in the before 1940 stratum ($]~R= 445.
Based c;n two deaths, the categor3, ben~gnhanspecified neoplasms was significantly elevated among white females hired in or after 1945 (Table. 22). This wasthe onty.~ significant finding for the white .female subcohort.
Mortality Analyses by Pay Status
The percentage of total time worked as a salaried employee was classified into one of seven categories: 0, 10, 25, 50, 75, 90, and 100 percent. The original designations made by Wen eta[. (1983) were carried forward :in the c~rrent update. Table 23 shows that 82.3% of the eoh.ort members spent all
their time as hourly employees, and they accounted for 87.2% office deaths. On theother hand, o1~ly 12.7% of the cohort members spent at least 90% time oftheir employment: as salaried employees, and they accounted for only 6.7% of the.deaths. The pay statt~s of 70 individuals (0.4%) was unkr~own., and they were exch~ded from the mortally analysis by pay status.
Three strata Were formed for the mortality analysis: employment s~ictly hourly, employment at least 90% salaried, and all other.coml~in~tio~s of tmur!y and salaried employment. The SMR results fer
the entire cohort by pay status are shown in Table 24. The overall SMR for each stratum was significantly less than I00; but the magnitude of the deficit increased with increasing time spea~t as a salaried worker. Hourly workers Showed significantly elevated SMRs for the causes all malignant
neoplasms (SMR=106.3) and bone cmacer (8MR=22817)~ :Based on .only four deaths,~e!fign/unsoeclified aaeop_lasm~/?/vere significantly elevated .in the mixed hourly-salaried group (SMR--433.t }. Among
s~_a_ried wo__rkers, S~gnificant elevations were f0nnd for the be.ai~n]unsoecified neopla_sms (SMR= 365.8) and hypertension without heart disease (SMR=375.7), but these were based on just a t~w deathseach: 5
and 8 deaths, respectively.
Analyses of Lymphatic m~d Hematopoietic Cancers
The set of rates we used in the OCMAP program does not provide analyses for ceil-type specific
leukemias, non-Hodgkin's lymphoma, or multiple myeloma. Therefore, separate analyses on these lymphatic and hematopoietic cancers ~br all males were carried out. There were non-significant deficits for acute myelogenous leukemia (SMR=62.7, 95% CI: 3 0.1-115.3), chronic myelogenous .leUkemia (SM'R=84.4, 95% CI: 3 L0-I83,6), non-Hodgkin's lymphoma (SMR=71.0, 95% CI: 47.9-101.4), and multiplemyeioma (SMR=g8.0,. 95% el: 59.0-153.0) (Table 25). A significant excess was observed for acute lymphocytic leukemia. (SMR=259~6, 95% C.I: 112.1-511 ..5), whereas a significant deficit was
~ Npidemiology & Biostat~stics
9
reported for chronic lymphocytic leukemia (SMR=29.9, 95% CI: 6.2-87.3).
All of the acute lymphocytic teukemia deaths occurred in white males who were hired prior ~o 1955 (Table 26). Two employees were older than 50 when they were hired .at the refinery, while two other employees worked at the refinery for less than 5 years (0.5 and 4, respectively). A trend analysis by length of employment for these deaths was also carried, out. Because of the small number of deaths, only three categories were used. SMRs in all three categories were elevated, butno in4ividual 8MR was significant (Table 27). A formal test indicated that there was no positive trend by Ion.grit of employment. (;~2u~ (~ ~0=0.23, p=0~6333),
DISCUSSION
Comparisons of this 1987 update of the Port Arthur Refinery cohort to ea/'fier published reports indicated that the updated results were consistent with eaxt~er ones published on the cohort. Tile cohort showed a generally more favorable mortality experience than the general population. For example, the cohort exper{enced significant mortality deficits from all causes combined, all heart diseases combined, non-malignant respiratory disease, and externa~ causes.
Similar to ~e previous reports, ibone cancer was .significantly elevated for the cohort as a whole. A detailed discussion of the bone cancer excess c.an be found in two previous reports (Tabershaw Occupational Medfcine Associates, i980; Wen etal., 1983). A review of the actual causes Iiated on "the death certificates indicated fhat several deaths were due to tumors of epithelial tissue (carcinomas):rather than sarcomas, i.e., they were :not tumors ofbone tissue (mesenchymal tissue)per se, but rather metastatic tumors from other sites (ep:ithelial tissue). As such, these cancers reflect coding misctassifications derived from coding rules in the e~ghth rewsmn .of tC , the basis for all cause of death coding in former and current mortality analyses. Had the ninth revision of the ICD been used :instea& the bone tumors of epithelial origins would not have been considered primary bone cancers. Thus, ~e bone cancer excess can be considered an artifact stemming from the coding rules for the eighth revision of ICD codes. Furthermore, there was no exposure,response.relationship between bone cancer and length of employment. This Observation also argues against the bone cancer excess beh~g occupationally related.
Most of the deaths in the significantly eieva_te~n/unspecified neoi3tasm caNgory were benign brain tumors. The estimated SMR for benign brain tumor based on Texas death rates was border-
~ Epidemiology & Biostatistis
Port Ardour Mortality Stud.},
Iine significant (.SlvIR=t 73,5, 95% CI: 100.8-27%6). Using the U.S. general population,~ the SMR was reduced to 131.7 (95% CI: 76,5-210,7), and was no Ionger statistically significant. Analysts by length of employment did not reveal any :trend. For mafignant tumors of the central nervous system, the observed number of deaths was similar to the expected, and the corresponding SMR (I 17.7) was not sig~ificam. In a previous report on brMn tumors in the Port Arthur refinery cohort, VC-e~a et al, (1981b) discussed the problems associated with diagnostic errors.of brain tumors. Errors occur more frequently among inaccessible tumors such as those that occur in the 1Ner, brain~ or pancreas. Furthermore, liver and brain are two organs of the body knovcn fbr their propensity of being metastatic cancer sites (Falk, 1982; Shoenberg, 1982). In fact, in.the original study Wen et al. (1981b) identified 6 cases with likely incorrect diagnosis. A potential over-reporting of brain tumors in occupational groups as a result of diagnostic sensitivity bias has also been reported in several previous }nvestigations (Greem,cald et al., 1981; Wong et al., 1986; Wong and Whorton, 1.993).
Our cell type analysis of leukemia deaths ~btlowed the previous work by Wen et al: (1.984a), who reported no excess in myelogenous leukemia, but found elevated lymphocytic leukemias in employees who worked 20 to 29 years atthe refine~. However, their analysis did not distinguish between, acute and chronic lymphocytic leukemias..A comparable analysis in this update yielded no increase in either acute
and chronic ~ymphocytic teukemias combined (t 1 observed deaths, 13,0 expected) or acute and chronic myelogenous leukemias combined (i6 obse[ved, 23.0 expected). However, a significant i~crease in acute lymphocytic leukemia (ALL)was found (8MR=259.6; 8 observed deaths, 3 expected). Conversely, ~he SMR for chronic lymphocytic leukemia (CLL) showed a significant deficit (SMR=29.9;
3 observed deaths, 10 expected).
The ALL excess coupled with a deficit of CLL could be importaltt in the interpretation of these results.. From a diagnostic perspective, historically it might have been. difficult to distinguish between patients with CLL and ~hose wi.~h ALL (Wilatrobe.et al., 1981). This difficulty would likety have
prevailed during a large portion of the cohort fbtlcrw-up period. The observations that half (26/52) of the leukemia death certificates tbr white males did not report the cell t3'pe (as was the case t~br 3 ofthe 4 leukemia deaths in non-white males), coupled wifl~ the fact that combined ALL and CLL death categories yielded an SMR not significantly different from expected (i.e,, t 00), tend some credence to the possibility of diagnostic difficulty and hence, misclassification with respect to recording the cause of death.
Further examination of the 8 ALL deaths revealed that 5 occurred in .Jefferson Count.', Texas, while an additiona~ two occurred in other Texas counties and one in California (Table 2-7). The observa~:ion th,qt 5 of the 8 deaths occurred in the same Texas count3, also supports the possibility that the
ALL increase is an artifact stemming from a local diagnostic bias. If even one ALL case was the result
~ Epidemiology & Bioslatistics
"
II
i 9,~7 ~Jpdate,
ofmisdiagnosis, the AEL SMR would not have been statistically significant. In this regard i~ is noteworthy ~/hat one of the ALL death certificates ~isted the cause of death as "Alymphatic leukemia~' [sic]. As this is not a ge~era[ly reco~ized diagnosis, we sought outside advise o.n its mear~ing. Acute lymphocytic leukemia and acute myetogencrus leukemia were the most common interpretations, Although strictly speaking we could not determi~te the cell type of this cancer, we nevertheles~ coded it as acute l)anphocytic leukemia in our ana!ysis.
We also examined the work histories for the ALL cases. However, becauseof the lack of specificity and nonstandardized way ~he information was recorded for cohort members during the early time periods covered by~he study, no additional insight regarding possible occupational, associations could be gleaned from this review.
Potential for exposure to benzene or benzene-containh~g mixtures exists at evew petr0Ieum refinery. Ur~der conditions of high concentration and long duration~ benzene is recognized as z h.uman leukemogen,. However, only acute myefoge.nous leukemia has been linked to benzene exposure. No epidemiologic study has demo~strated an association between exposure to benzene and acute lymphocytic .leukemia. Similarly, no c~.l~er petroleum re~net3~ study has reported an increase of ALL (Wong and Raabe, 1994). Based ona recta.analysis of a :combined cohort.of.more than 208,000 petroleum workers in th.e United Kingdom and tl~e U~ited States, including Po~t A:t~tlmr, the ALL SMR was 114 (95%: CI 78-161)(Wong mad Raabe, !994). Removing fl~e Port Arthur data from the.rectaanalysis, the ALL SMR b~came 96.; Thus, the finding from the Port Arthur refine~ was not consistent with other studies of reflne~ workers.with similar exposures.
The likely spurious nature of:~he ALL findi~g in fhe Port Arthur cohort is further supported by the lack of an exposure-response relationship based on length of employment analysis. In addition, with most of the deaths occurring in employees t~ired belbre 1950, acute lymphocytic leukemia does not appear to be a problem in more recently hired employees.
The objective of the len~h of employment analysis was to determine if there was a consistent
upward trend in the exposure-response relationship, which we would consider important in our interpretation of potential causality, Hypertension without heart disease and diabetes were the only
causes to show positive trends, but in neither case was the trend strictly increasing. Instead, each trend was solely due to an incr, ease in the longest length of employment stratum while no tread was apparent across fide other strata: In addition, ~e period of hire analysis showed that the increases in ibypertension and diabetes were limited to emNoyees ihired prior to 1~45. This suggests if occupational exposures did contribute to these deaths, the-exposure is n,ot affecting employees hired after 1945. Lastly, the ~ncrease in hypertension was also limited to salaried workers whose potential refinery exposures were likely to
~ Epidemiology & Biostatistic
12
Part Arlttur Moriality Study
have been briefer and less intense than hour|y workers~
tn general, several significant cause-specific mortality deficits as well as :elevations were noted in individual length of employment :strata. Apart from the two causes of death discussed above, no consistent pattern was detected for any cause of death, and the observed deficits as wetl ,as ele,.,ations were likely statistioal artifacts. Because of the large number of SMRs calculated for various causes of death~ length of employment categories and sex,race subeo.horts, some of the SIVIRs might have been statistically significant as a result of chance. With the large number of strata, the number of deaths in some of the individual strata might be sm~ll, and the corresponding indMdual SMRs .might not be reliable. As such, for length of employment analysis, only trends in the data and not individual SMRs
were emphasized.
.As in the lengh of employmen~ analyses, several individual strata in the interva.! since hire analyses showed significant mortality defici~ts and elevations..Among causes with. significant elevations,
trend analyses with. respect to length of emp.~oyment, did not indicate the presence of positive trends with the exception of diabetes i~a non.~vA~ite males. Diabetes is not ge~eralty assoeiatecl with employment in the petroleum refining industry. For example, we found only a single report of a significant elevation (Rushton and Alderson, 1981). Lastly, the increase in the Port Arthur cohort was driven, by employees hired prior to 1945 which suggests that ~mployee~ hired dm~ing, that time period might have had unusually high rates of intrinsic metabolic d~sorders.
In general, the~nterval since hire analyses, as Well as those.based on period of hire and pay status did not reveal any major new findings, These analyses were also affected by the same issues discussed. above in eonjunctlon with length of employment analysis, For period of hire, the. updated results are in agreementwith earlier accounts of the cohort (We,~ et at., 1986) regarding differences among employees hired in the 1940 to 1945 period versus other times: women were more like|y to be hired, employees tended to work at the refiner3, lbr a very sliort period, and overall, the healthy worker effect was. not apparent. Primarily because of the short employment duration, significant elevations occurring only in the subcohort hired in the 1940 to 1945 period sho;uld not be given much weight, because for ~hese employees, the opportunity for exposures was much greater, outside .0f the Port Arthur refinery than while they were employed there.
Kidney cancer was the oniy significantly elevated cause of death among total cohort members hired after 1945 (I2 observed, SMR=225.1) and ten of the twelve deaths occurred in persons hired between 1946 and t951. This t-ype of cancer has been the focus of considerable scientific research, both in animals and humans, stemming.from an initiaI study which found an excess of kidney tumors in male rats following chronic exposure m wtml[y vaporized gasoline (MacFafland et at., 1984). Subsequent
~ Epidemiology & Biostattsties
"
t3
1987 Update
toxicologic researc.h has been critical of this finding's relevance to humans (Swenberg, 19931). Simil:arly~ a recent review ofthe epidemiologic evidence found that most studies do not support a link between gasoline exposure and kidney cancer (McLaughlin, 1993). More specifically, several recently compIeted studies among petroleum refinery and distribution workers exposed to gasoline failed to identi~' a significantly increased risk for kidney cancer (Rushton, 1993; S~hnatter et al.~ 1993; Wong etal, 1993; and Poole etal., 1993) These observations, together with the fact that no increase was found prior to 1945, suggested that kidney cancer deaths occurring bet~veen 1945 and 1951 most likely represented a random cluster, and were not related to employmeni at the refinery,
It should be pointed out ~hat t'herewere several limitations in the study; most of wliicl~.are typical of historical cohort mortaii~, studies taf ind.t~strial populations~ First, death certificates for 5% of the deaths identified could not be .retrieve& While these deaths were included in the all causes coml,~ined analyses, some cat,so-specific SMRs might ihave been affected (underestimated) because ofthese missing death certificates. Second, the vital s~ams o~ 65% of the males and 31.I% of the females in the eolmrt was unknow~a. This missing information might have affected some .of the results, especially for women in the study. Third, being a mortality study, this investigation inherited the problems associated with death certificates (e,g., diagnostic accuracy, comparabi!i~ of tCD codes over time), in particular, the use of the eighth revision of ICD was problematic in analyzing bone cancer. Fourth, some analyses were ipotent~ally affected by the limited avaiiabili'ty of reference rates, for comparison. For example, for specific lymphatic and hematopoietic cancers, rates for white males were used for all males. Furthermore, certain mortality rates were not avaiIablefor the entire observation period. Fifth, although the Port Arthur refinery cohort was probably one of the largest data sets in the petroleum industry, for some causes, the number of deaths was relatively small. For these causes, some results might not be statisti:cally stable or reliable. Finally, ~he interpretation of the results is limited by the absence of quantitative exposure data. Bec~au" se ofthis,.we relied on indirect measures of exposure: length of employment, period of hire, and pay status. Although this is a common practice in occupational epidemio!ogic studies, the use of surrogates may result in misciassifying e~nployees with respect to possible.exposures which could :result ira some SMRs being underestimated.
CONCLU SION
In summar3', the results :of the updated study demonstrated a favorable mortali .ty experience for the Port Arthur refinery employees as compared to the Texas general population or the U.S. general population. Most causes of death showed Mflaer a similar mortality or a statistically significant deficit among the refiner); employees when compared to ~he general population. Only a 4(~W causes ~f death
~, Epidemiofogy & Biostatia'tics
14
t~ ort ,4rthur Mortality Study
showed statistically significant elevations. Further analyses by lengh of employment, trends over time, potential misclassification due to nosotogy .rules, and likelihood of exposure given pay status jcrb classifications did not support a-conclusion -that these increases resulted from employment at the refiner3:.
-- Epidemio[ogy & B+ostat+stics ++ +
15
REFERENCES
1987 Update
Antmaaa KH and Corson 3M (1985). Benign and malignmat pleural mesothelioma. Clinics in Chest Medicine 6(t): 127-40.
Bond GG~ Reeve GR, Oh MG and Wax~veilerRJ (1985)~: IVlortality among a sample of chemleal company employees. Am J Ind Med 7: t 09-21.
Bres!ow NE and Day NE (i987): Stat~s#cal Methods in Cance~ Research. I~'ohtme H-- The De~ign and Analysis oAt'Cohort Studies. tARC Scientific Pnbli~ations No. 82. International Agency forReseareh on Cancer~.Lyon.
Briselli M, Mark E J, and Dickers~n GR (198t)~ Sofitary fibrous tumors of thepleura: Eight new cases arid review of 360 cases in the :!jterattrre. ~ancer 47:2678-89~
Conne]ly RR, Spirtas R, Myers MH, et ai. (1.987): Demographic patterns for mesoflM~oma in th.e United States. JNatl Cancer Inst 78(6): 1053-60.
Environmental Health Assoeiates (1983): Cause-;speeifie mortality among employees at the Chevron. Richmond and El Segundo Refineries.~ Report submitted to the Standard Oil .Company of Cafifornia.
Falk H (1982). "Liver" in Cancer Epidemiololo, and.Prevention, eds: D Schottenfeld and JF Fraumeni. ~,q3 Saunders Co. Philadelphia. p 668.
Greenwald P, Friedlander BR, Lawerence CE, et aL (1981): Diagnostic sensitivi .~. bias -- an epidemiologic explanation for an apparent brain tumor excess. J Oocup Meal 23(I 0):690-94.
MacFarland/-IN, UMch CE, Hotdsworth CE, .Kitchen DN, HalliWell WH, and Bum, SC (1984). A chronic inhalation study of unleaded.gasoline vapor. J Amer College Toxicol 3:23 t-248.
McLaugb/lin JK (1993). Renal Call. Cancer and Exposure to Gasoline: A review, Environ Health Perspec Suppl 101 (Supplement 6): 111-lt4.
Marsh GMI and Pre.ninger M (J980). OCMAP: A t~ser*ofiented occupational c0hor~ mor~atity analysi.s program. Am Stat 34:254.
Meinhardt T J, Lemeen RA, Crandalt MS and Young RJ (1982). Environmental epidemiologic investi.gatlort of the styrene-butadiene rubber indu~ry. Stand J Work Environ Health 8:250~59,
Pickle LW, Mason TJ, Howard N, .etak (1987)~ Atlas of U.S. Cancer Mortality among Whites: t:95:0t980. D~S Publication NO. ~H) 8742900.
Poole C, Dreyer NA, Satterfield MH, Levin L, and Rothman KJ (1993). Kidney cancer and hydrocarbon exposures among petroleum refinery workers. Environ ttealth Perspect 101 (SuppI 6):53-62.
Rinsky RA, Young RJ, Smith AB, et al. (1981). Leukemia in benzene workers. Am J Ind Med 2:217-45.
~ Epidemiotog~, & Biosta~isti~s
16
Port Arthur Mortality Stud):
Rushton L, (1993). A 39-year folIow-up of U.K. oil refinery and distribution center studies: results for kidney cancer and leukemia. Environ Health Perspect 101 (Suppl 6):77-84.
Rushmn L and Alderson MTR (1,98t). ,An epidemiological survey of eight oil refineries in Britain. Brk J Indust Medicine 3 8:225-234,
Schnatter AR, Katz AM, Nicalich MJ, and Thefiault G (1993). A retrospective mo~n~ality study among Canadian marketing and distribution workers. Environ Health Perspect 101 (Suppl 6) 85-99.
Schoenberg BS (1982). "Nervous System" in Cancer Epidemiology and Prevention. eds: D Schottenfeld and JF Fraumeni. WB Saunders Co, Philadelphia, p 968,
Setvin S, Levin LI, Merrill DW and Winkelstein W (1983): Selected epidemi01ogic Observations of. cellspecific leukemia mortality in the Uni.ted States, 1969-19.77, Am J Epidemic! 117(2): 140-52.
Swenberg JA (1993). ~-Globulin nephropathy: Review of the cellular and molecular mechanisms involved and fl~eir implications for hm~an risk assessment. Environ Health Perspee Sttppl 10l. (Supplement 6): 39-44.
Taberhaw Occupational Med Mne Associates, P.A. (1980): An historical prospective mortality .study of workers potentially exposed to benzene and the lubricating-solvent units of the Gulf Port Arthur Refinery. Report presented t~ the Gulf Oil Company.
Tsai SP, Wen CP, Weiss NS, et al (1983): Retrospective mortality and medical surveil|ance studies of workers in benzene areas of refineries.. J Occup Med 25:685-92.
Wen CP, Wong O, Tsai SP, and Gibson RL (1980): EpidemiolOgy of refinery workers with. solventrelated exposures. Gulf Oil Corporation~ Presented at tt~e 1 lth Conference on Environmental. Toxicology, Dayton, OH.
Wen CP, Tsai SP, McCellan WA: and Gibson RL (1981a): Retrospective cohort study of refinery workers. GulfOil Corporation. Presented at the Occupational ttealth Epidemiotogy Section., APt.L& Annual .Meeting, Los Angeles, CA.
Wen CP, Tsai SP, and Gibson RL (1981b): A report on brain tumors from a retrospective cohort study of refinery workers, Ann NY Acad Set 381: 130-38.
Wen CP, Tsai SP, Weiss NS,..et al. (198tc): A population-based cohort study of brain tumor mortaIity among oil refinery workers with a discussion of methodological issues of SMR and PMR. in BanbutT )~eport No. 9: Quantification of Occupational Cancer, pp~ 413-32.
Wen CP, Tsai SP, McCeltan WA, and Gibson RL (1983.): Long-term mortality study of oil refinery workers. I. Mortality of hourly and salaried workers. Am J EpidemioI 1 t8: 526-42.
Wen CP, Tsai SP, Gibson RL, and McCellan WA (1984a): Long-term mortality ~tudy ofoil refinery workers. II. Comparison of the active, the terminated ~nd Ne retired workers. J Occup Meal 2(i: 118-27~
~ Epidemiolo~, & Bioslatistics,
17
1987 Update
Wen CP, Tsai SP, Weiss NS, et al (1984b): Result oriented medical information system: an alternative to the cotwentional approach~. J Occup Med 26:386-91.
Wen CP, Tsai SP, Moffitt K, Bond), M, Rurtion H, and Gibson RL (1984c): Leukemia among oil refinery workers and residents in the surroundS~g commun.Sties. GuIfOil Corporation.
Wen CP, Tsai SP, Moffitt K, Bondy M, Runlon H, and Gibson R1 (1984d): Epidemiologic studies of the role of gasoline exposure (hydrocarbon) in kidney cancer risk. In Mehlman MA, ed. Advances in ~odern Environmental Toxicology, Vot VII Renal effects of petroleum hydrocarbons, pp~ 245-5
Wen CP, Tsai SP, Gibson RL, et al (i985): Long-term mortality study of oil refinery workers. IV. Exposure to lubricating-dewaxing solvents including methyl ethyl ketone (MEK).. J Natl Cancer Inst 74:11-18.
Wen CP, 'I'sai SP, Weiss NS, and Gibson IlL (1986): Long-term mo~lity study ofoit refinery workers. V. Comparison of workers hired before, during, and after "World War II (l.940-t945) with a discussion of the impact of study designs on cohort re.suits. Am. J Ind:Med 9:171-180.
Wintrobe M'M, Lee GR, Boggs DR, etal. (1981): CTiniccd HernatotogI,, (Eighth edition). Lea & Feblger, Philadelphim p 151.4.
Wong O, Morgan RW, Bailey WJ, Swencicki RE; Claxton K and Kheifets L (1986): Am epidemiological study of petroleum refine .ry workers~ Br J Ind Med 43:6-1.7.
Wong O and Whorton MD (1993): Diagnostic bias in occupational epidemiologic studies: an .example based on the vinyl chloride literature. Am JInd.Med 24:251-256.
Wong O, Harris F, and :Smith T J: (t 993). Health effects of gasoline exposure. II. MortaliW pattems of distribution workers in the United States, Environ Health PerspeCt 10t (Suppl 6):63-76~
Wong O and Raabe GK (1994): Ceil-13,pe specific Leukemia anaIyses in a combined cohort of more than 208,000 petroleum workers .in the United States and the United Kingdom. Submitted t~r publication.
~ El~ideraiolog~, & Bioslati~tica
] t~
Table 1 Demographic and Vital Status .Characteristics forAll ,~ohor~ Members
Port Arthur Refinery Update, 1937-1987
Male
Female
TOTAL
Population Size (%)
Person-Years of FollowTup
Year of Birth Distribution < 1900 1900-1909 1910-1919 1920--1929 1930--1939 1940--194.9 1950-.1959 1960--1969
Age~ Distribution Average
p~ p~ Range
~ce Distribution White
White Assumed White Nan-White Black Assumed Black Hispanic Native ~meriean Asian Unknown
Vital Status (as of I~/31/87) Alive Dead~ Unknown
15855 (89)
474875
15~5% 15.6 21..2 20.8
9~2 7.1 9.7 1.0
49.4 yrs 52.7 ~0,6 16.4,104.7~
1989 (11)
51512
I~7 6.1 22.2 43.2 2.0 8.1 ii.I 0.6
33.6 ~7.5 67.6 15.4-92.6
79~0% 0.5
17~0 0,i 1.5 0~I O.l I~7
52.4% 41,1
6.5
88.6 0.8
5.8 0.i !.3 0.I 0~i 3~3
55~0 13.9 31.I~
526387
14.5 21~B 25.3
8~9 7.2 9.9 0.9
47.7 48.0 80~2 15.4-I04.7
80~I 0.5
~5.7 0~.i 1.5 0.i 0~I 1.9
52,7 38.1
9.2
AK~ at earllest of: time of deabh, loss to follow--~p, .or end of study (~3/31187). Note: P~0' refers to the 5Oth percentile~median) and ~95 refer~ Do the SSth percentile.
The dates used to ~alculabe the abe were verifie~ for accuracy by Che~kng againsZ ~be hard ~opy work
and lived ,!ore than I00 years.
Of ~he women wi~h:as ~%knownviLal st~tu~ ov'er88Zhsd red,red, t~rmina~d, or ha~ beentransferre~ on or
Table 2 Employment Characteristics for All Cohort Members
Port A~thur Refinery Update, 1937-1987
Male(~n=15855)
Female(n=lgS9)
~0TAL(n=IT~44)
Employment Duratio~ < I yea~
10-1.9 20-29
22.2'%
14,.7 10.3
41~3
9~7 4.0
24~3
14,1 9.6
Average
Ps~ P~ Range
16,7
12..41
~1,3 3 da~54,6 years~
I.S 29.~ 3 days-44.:7 years
~0~2 40.8 3 days-~54.6 year~s
~There ar~ males in the cohort whoselength of employment exceeded 50 years The date of hire and the date of termination were checked for thes~ males. The dates were correct according to persorunel records.
Table 13 Time of Hire Gharac=erls~cs for All Gohor~ Members
Port Arthur Refinery Update, 1937-1987
Male(n=15855)
Femaie(n=1989)
TOTAL(n=I7844)
Interval Since HireI < i0 years 10-19 2.0-29 30-39 ~ 40
10.2% 1'5.5
19,9 24,6 .3.9.8
Average
Ps0 Pg5 Range
33,2 yrs 35.6 58,1 3 days-77.5 years
29.6 11.3
6~5 16.0 36.7
26.3 31.9 47.3 3 days-72.0 years
12~3 15,0
9,5 23,6 39.5
32.4 35.4 57,5 3 .days--77o5 years
Year of Hire 1900-1909 1910-1919 1920-1929 1930--1939 1940--1949 1950--1959 1960--1969 1970-1979 1980-1987
0.5% 5.3
151,9 9.9
34.5 i~.~
4.10 13.0
2~2
0.0 0~2 I~9 6.9 61.7 7~? 3,5 15.4 2.6
0.4 4.7 14,3 9~6 37~6 13~9 3,9 13.~3 2~3
Age at Hire < 20 years 20-29 30-39 40~49
~ 50
18,4% 59.7 I~ ~ 7 4.4
O. 8
32.7 51.7 12~ 9
2.4 O, 3
20.0 58.8 16 ..2
4~ 2. O. 8
~Interval since initial hire is the period Between hire date and the earlierof date of death, date of last contact, or end of study~
Table 4 Time of Death Characteristics for All Cohort Members
Port Arthur Refinery Update, 1937-1987
Age. at Death _< 129 years 30-39 40-49 50-59 60-69 _> 70
Average Age (yrs)
Year of Death 1930-1939 1940-1949 1950-1959 1960-1969 1970-1979 1980-1987
Male(n=6522>
Female(n=277)
1.6% 35
18.6 27 ~ 7 40~2
i.I 4.7 ii ,..2 23..1 30,3
1.0%
12.19 21.0 31.0 27~3
0.4 1.4 6.5
30.0
TOTAL(n=6799)
3.5 8.4 .27.8 39..8
6.6 20.5 31.0 2.8.3
Table 5 Cause Specific SMRs for ALL COI-'IORTMJ~dBERS
Port Arthur Refinery Update, 1.937-1987 tL~pected Deatlas B~sed on TE)k~S DEATH tlA'IES
No, of Personsat Risk = 17,844 Person-Years = 526fl86.7
CRUSE OF DEATH, ([CDA 8,~h REVISION CODEN)
Observed F~'peeted
SMR
All Causes of Death Tubercuto,~is
All Malignant NeopIasms Cancer of Bucc~l Cavity & PhaD~a~ Cancer of Digestive Orgm~s & Peritoneum
Cancer of Esophagus Cancer of St~a~aaeh Cancer of Large Intes{inc Cancer of Rectum
Cancer of Biliary P~ssages & Liver Cancer ol'Panereas Cancer of Respiratory Systera
Cancer of Bronchus, 'IYaehea, Lung Cancer of Breast
.All Uterine Cancers (Females only) Cancer of Cervix Uteri (Feraales only) Cancer of Other.Female Genital.Organs
Cancer of Prostate (Males only) Cancer o.f Testes and Other Male GeniP~ Organs
Cancer of Kidney Cancer of Bladder and Other Urinary Organs
Malignant Melanoma of Skin Cancer of Eye
Cancer of Central .Nervous System
CancerofBone
Cancer of All L3maph.afie~ Haematopoietic Tissue Lymphosarc~na & Refieulosarcoma Hodgk'ins Disease Leukemia & Aleukemia
Cancer of All Other Lymphupoietic Tissue
Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Metlitus Cerebrcreascut ar Disc ase
All Heart Disease Rheumatic Heart Disease Ischemic Heart Disease
Chmrfic Endoearct Dis.; Other Myocard, InSuf[~ ttyper tension with Heart Disease
Hypertension ~v/o Heart Disease
Non-mNignant Restfiratory Disease Influenzz & Pneumonia Bronchitis, Emphysema, Astshraa
Bronchitis Emphysema Asthma
Ulcer of Stomach & Duodenum Cirrh~is of Liver
Nephritis & Nephrosis
All F, xternal Causes of Death Accidents /rioter Vehicle Accidents
All Other Accidents Suicides
Homiddes & Other External Causes All Other Causes of Death
Llnkn,-~n Causes (In All Causes Category Only)
6799
33 1482
36 377
23 95
i17 26 i3
94 448
42.3 .22
7 3 5
126
5 40
2.5
2i 2
39 7
t3 !38 13
18
57 50 28
107 502
:2534 32
1994
44
72 32
346 132 101
21 72
8 28
79 50 547 367
1.69 198
111 69 684
347
7336.0 382
14443
40.9 371.7 34j
80.2
106.4 .26,3
.31.0 80,8
485,5 459.8
17,6
6;7 4,2 5.3
13L0
6.3 31.3 34~8
18.7
1.0 33.1 4.6
6.3 t31.7 23.0
12~7
55.9 40.1
!4.4 101.2 600,5
:2784,9
36.7 2283.3
8L6
63;7 29.9
469.4 i99.7 13Z8
24.5 102.5
103 37.0
121,9 51,5 759.3
467.9
239.6 229.1 i18,2 137,8
833,1
92:7 **
.85,2 102,6
87.9
101.4 67,5
ll&5 I10.0
98.8 41,9 ** 116.4
92,3
92,0 .125.4
104.2 71,5
93.7 9&2
79.0 127.9
71.9 .112.2
191;7 117.7
1513 20Z8 *
104,8 56:5 * 141,3
102;0 124,7
194.9 ** 105~7
8&6 ** 91,0 **
87.1 87,3 **
5&0 ** 113.0
107.2 7K7 *~
6G1 ** 73.3 ** 85.7
70.2 ** 74.8
75,6 64.8 **
96.9
72,0 ** 78.4 ** 70.5 **
86.4 *" 93,9 50A **
82.1 **
* SIGNIFICANTAT5%, LEVEI~ ** StGNIFtCANTAT t% LEVEL
95% Confidence Interval
Lower
Upper
.c~5 5&6 97.4
6t.6
91.4 42.8 95.9 90.9
64.5
22.3 94,1 832
-83.4 78.6 1.9
14.7 30,4
80.1 25.6
91.4 46.5
69.5 23.2
83.7 60,8 110.6
88,0
3&/ 83,7
77.3 92,6 129,5
86.7 76.4
87.5 59.6 83,5
39.2
88,4 73.3
66.1 55.3 59.7
53.1 54:9
32.3 50.3 513
7L9 66.t 70.6
60.3 74.8
77.2 39.0
76,1
94.9 119.6
108.0 12L8
112.2 10.1.3
144.9 131.8
144,8
71.6 t42.4 101.2
101.2 189,8
214,7 208,,8 218.5
114.5
184.,3 I74.2
106.i 171.5
692.5 160.9
311.8 355,3 t23,8
96.5 223.3
132.2 164.5 281.7
127.8 9t.2
94.6
123.0 91.2 72.4
142.3
151.3 81..9
78.4 89.1.
131.0 88.4
t47,4 109.3
80.8 127.7
78.3 86.9 82.0
99.3 I13,,i 63.4
88,5
Table 6 Cause Spec fieSMRs for ALL COHORT MEMBERS
Port ArthUr Refinery Update, 1937-1987 ~E,xpeeted D=aths Based on US DEATIt RATES
NO. of Persons at :Risk= 17,844 Person-Years -~ 526,386.7
CAUSE OF DEATH (ICDA 8th REV[StON CODES)
Observed
Expected
SMR
All Causes of Death
Tuberculosis All Malignant Neoplasms
Cancer of Buecal Cavity & Phary~tx Cancer of Digestive Organs & Peritoneum
Cancer of Esophagus
Cancer of Stomach
Cancer of Large Intestine Cancer of Rectum Cancer of Biliary Passages & Liver
Cancer of Pancreas Cancer of Respiratory System Cancer of Bronchus, Trachea. Lnng. Cancer of Breast
All Uterine Cancers (Females only) Cancer o[ Cervix Uteri (Females only) Cancer of Other Female Genital Organs
Cancer of Prostate (/vlales only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs
Malignant Melanoma of Skin Cancer nf F, ye Cancer of Central Nervous System Cancer of Thyroid & UtherEndocrine Glands
Cancer of All Lymphatic, Haematopoietie ~tfssee .Lymphosarcoma & Reticule.sarcoma tIodgkins Disease Leukemia & Aleukemia Cancer el All Other Lymphopoietie ~ssue
Benign Neoplasms/Neoplagm~ of Unspeeifled Nature Diabetes Mellitus Cerebrovaseul~ Disease All Heart Disease
Rhe~matio Heart Disease Ischemie Heart Disease Chronic Endocztrd, Dis;; Other Myoe~rd, In~uff. Hypertension .wit.h Heart Disease Hypertension wlo Heart Disease Null- malignam Respirator)' D~oase Influe:nza & Pneumonia
Bronchitis, E~physema, Asthma BroncMtis Emphysema Asthma Ulcer of Stomach & D?aodenum Cirrhosis of Liver
Nephritis & Nephrosis All External Causes of Death
Accidents Motor Vehicle Accidents All Other Accidents Suieides
HomicSdes & Other External Causes All Other Causes or Death
Unknown Causes On All Causes Calegory Only)
6799 33
1482 36
377 23 95 117 26
13 94 448 423 22
7 3
~
t26
5
40 25 21
2 39
7
13 i38 13 18 57
50 28 107
502 253d
32 i994
44 72
32 34.6 132 lOi 2i 72
8 28 79 50 547
367 169 198 111 69 684
347
7541.1
4t.3 i528,6
45.0
435,9 44.5 :92.5 134.3 43.5
26.6 80,6 482.2 454~2
21.0 7.0' :4,2
~.4
.t36A
6.9
32.7 443 14.7
!.,I 35,2
5:I
6,6 " t35,6 25,4
1.4,2 55 0 41.1 ~19 i 15,9
584.4 300K5
63~6
2650.5 .62.2
74,6 32,5 -'194,7 215:2 I32.9 21.9 98.5
ii29 45.2 1605 49.2 1657.8
410:0 190.3 Z20.0. :120.0
96.2 768:2
90~2 ** 79,9 97,0
80.0 86.5 51,6 * 102:'7
8%t 59~8
48,8 *'*' i16.7 92~9 93;i
10~ :8 99,9 70~9
78.7
92A
7~.5
1224 55.9 142,7
1.75:3 110.8
~37.8
198.4 *" 101.8 51,2 *
I271 .!03:7
112t,7 ~48~4
92,3 85.9 ** 84.2 50.3 **
75,2 ** 70,8 *
96.5 9823 69.9 ** '61.3 **
76.0 96,0
73~t ~ 67;0 6L9 ** 49~2
10L6 83.2 ~
89.5 ~ 88,8 90.0 92,5.
71.7 ** 89;0 **
SIGNIFICANT AT 5%, LEVEL; ** StGNIFICANTAT i% LEVEL
95% Confidence Interval
I~ower
Upper
88:0
55~0 92.1 56,0 78,0 32.7
83,1 72,0 39.i 26.0
94,3 84.5 84,5 64(5L.71
14.6 25.5 77.0 23.5
87:5 36.2 88,4 2L2 78.8
55A :105.6 85:5 27.3 75.3 78,6
9013 98.6 75;7
7~8.6 8t:,0 34.4
72.0 5I:A 75,5
:67.3 :62:~8 5t,.3 ~:1~9 59.4 57.2
289
~i,2
39,0 75,4 76.3
80.6 75.9 77.9 76,t 55.8
82,5
92.3 112.2 10Z.0
110,8 95.7 77~5 125.6
i04.4 87.7 83.4
142.8 10L9
102.4
158:7 205.8 207.2 183,6 110.0
169.1 1663 82.5 218.2 6333 151.5 283.9
339.3 120.3 87,6 200.9 134,4
160A.
214,4 11.1,6
93.8 87.6 7tA 78.6 95 0
121,5 1382 77,7 72.7 92,3 146,8
92,1 132.0
s9.5
61.3
133.9 90.4
99.2 1033 103.4 II1A
90.8 96,0
Table 7 Cause Sp~ckfic SMRs f~r VCHITE~ Port Arthur.Refi~e~ Upd~e, 1937-1987 ~?ecmd Deaths B~ed ~n "I~S D~'~ ~'~
No. 0fPersong at Risk = 12,608 Person~Ye~rs = 386,469~8
CAUSE OF DEATH (ICDA 8th.~SION CODES)
Obse~ed Expected
SMR
All Causes of Death Tuberculosis
AII Malignant Neoplasms Cancer of Buccat Cavity & Pharynx Cancer of Digestive Organs & PerJtc~eura
Caneer of Esophagus Cancer of Stomach
Ca~cer of Large Intcztine Cancer of Rectum
Cancer of Bi~iary Passages & Liver Cancer of Pa:nereas Cancer of Respiratory System
Cancer of Bromhus, Trachea, Lung Cancer of Breast
All Uterine Cancers (Females :Only)
Cancer of Cervix Uteri (Females only) Cancer of Other Female Ge.aital Organs
Cancer of Prostate (Males only) Cancer of Testes and Other Male Genital Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs
Matignanl Me, lanomz of Skin~ Cancer of Eye
Cancer of Central Nervous.System Coa~eer of Thyroid & Other Endorse Crla~ds
Cancer of Bone Cancer of All Lymphatic, itaematopoiefic Tissue
Lymphosareoma & Retlcutosar~oma Hodgldns Disease
I~ukemia & Aleukeraia Cancer of All Other Lymphopoietie Tissue
Benign N~oplasm.qNeoplasms ofUnspedfied Nat~re Diabetes Mellitus Cerebrc~,ascular Disease
All Heart Disease
Rheumatic He'art Diseme Isehemic Heart Disease
Chrorfic Endoear& Dis.; Other Myoem& Insuff,
Hypertension with Heart Disease Hypertension w/o Heart Disease
Non-malignant Respiratory Disezuse
Bronctiitis, :Emphysema, Asthma
Bronchitis Fanphyzema
Asthma Ulcer of Stomach & Duodenum
Cirrhosis of Livcr Nephritis &.Nephrosis
All Extema] Cauls of Death Accidents Motor Vehicle Accidents
All Other Accidents Suicides
Homiddes & Other External Causes All Other Causes of Death
Unlm~ Causes (In All Causes C.ategory Only)
5t80
22 1096
27 271
11
58 90 22
I0 73
352 333
0
O
0
90
~
27 17 21
2
32 6
10
1t3 9
~4 52 38
~7 70
3~9 2026
24 1649
Z3
42 24
"264
91 ~2 19
68 5
21 65
2,9 433 295
137 158 96
42
520 244:
5362.4 26.0
I045,5
3i.i 2.58.4
19,6
50.8 79.1
19.2 21.2 59,7
373,1 353.9
i.i
~0.0
:0.0
86.8
4.8
25,2 2@4
16:9 0.9 2&1
.~..7 4~6
lOLl 18
1G2 44,2 28,2
9,8
69,7 400.3
2i28,7
2Z6 1816,8
58.6.
32.4
14,4
364.5 142.9 115,8
20.5 89,7
6,4 28.7 96.2
.29,5 534.1 347,7
.180.4
168,1 105.I.
55A 580:5
96.6 * 84.5 :104.8 86,9 104.9 56.2 114.1 1t3,8 i14,5 47.3 * i22,4 94.3 94.1 ----
~~~
103,7
84.3
107.2 64.5 124A 2t9.8 tt4.0 t63:7 217,2 * 1t13 K8 * 137.4 117,6 i34,6 172.7 * 100.4 8%2 ** 95:2 * 87,0 90.8 ** 39.3 ** 129,6 267.3 * 72,4 ** 63.7 ** 79,5 * 92.8 75:8 * 77.6 73.1 .67.6 ** 98.4 81.1 ** 84.9 ** 76.0 ** 94.0 9t.3 75.9 89.6 *
* SIGNIFICANTAT 5%, ~. ~VEI~ ** SiGNIFI~ AT 1% LEVEl+
95% Confidence Interval
Lower
Upper
94.0 99.3
53:0 128.0 98.7 111.2 57.3 126,4 92.8 118:2 28,1 100.6 86,7 147.5 91.5 139,9 7L7 173,3 2Z7 86,9 95.9 t53.9 84.7 104.7 84.3 104.8 0~0 327.1
83A
23.0 70,7
37.6
76,8 26.6 78,0
60.1 304.]
92,I 22.3 75.I
87.8 95.2
t00,6 78,3 78.3
91,1 55,8
86,4 24..9
93~4
107,2 64.0
51.3 64.1
55.8 58.9
25.2
45,3 5212 65.9
73.6 75.4
63.8 79.9 74.0
54.7
82.0
127,5
215~8
156:0 103:2
I89.7 794~0
160.9 356.4 399,4
.134..4 92..6 9_,,30.5
154,2 1.84.7
276* 6
126,9 96,8 99.4
129.5 95.3 58.9
175.1
248.9 81.7
78.2 97.5 144.9
96.~
181.2 111.8 86.1
141.3 89.1
95.I 89_8
109.8 11L5 10Z6
9%6
TaNc 8 Cause Specific SMRs or NON-WI-ItTE MALES
:Po~ A~hur Refinery Upd~e, t937-1987 ~p~tod D~atl~ B~d On ~ DN~I ~
No. ofPersc~ns atRisk = 3,247 Person-Years = 88,404,7
CAUSE OF DEATH (ICAgA 8th REVISION CODES)
Observed Expected
SIVlR
AJ! Causes of Death Tuberculosis
All Malignant Neopla~s Cancer of Buccal Cavity & Pharyr~
Cancer of Digestive Organs & PerJtonet~m Cancer of Esophagms
Cancer of Stomach
Cancer of Rectum Caneerof Bitiary Passage~ & L~ver Cancer of P'a-zqc're as
Cancer of Respiratory System
Cancer of Bronchus, "IYaehea, Lung Cancer of Brezst
Atl Uterine Cancers ('tTema]esonly) Cancer of C~v~ix Uteri (Females on!y) Cancer of Other Female Genital Organs
Cancer of Prostate (Males.only) Cromer of Testes and Other Mate Genital Organs Cancer of Kidney
Cancer of Bladder and Other Urinary Organs Malignznt Melanoma of Sk2n
Cmaeer of Eve Cancer of Central Nervous System C~ee~ of Thyroid & Other Endoerkae
Cancer of Bone
Cancer of All Lymphatic, Haematopoletie Tissue Lymphosareoma & l~,etioulosareoma I'~[odgkins Disease
Leukemia & Aleul~mia
Cancer of All Other Lya-upholxoi~tic Tissue Benign Neopl asms/Neoplazras of Unspecified Nature
?Diabetes Md!itus Cerebrcrcascu/ar Disease All Heart Dizease
Rheumatic Heart Disease Isehemie Heart Dise~e
C'hrorfie Endocarck Dis.; Other Myoeard, Hypertension with Heart Dis ease
~ypertension wlo Heart Disease .Non-malignant Respiratory Disee~e,
Influe.nz~ & Pneumonia
Bronchitis, Emphysema, Asttu:~a Br.onehifis
Emphysema Asthma Ulcer of Stomach & Duodenum
Cirrhosis of Liver Nephritis & Nephro~is
All External Causes of Death Aceidentz
Motor Vehicle Acc~deats All Other Accidents Suicides
Homiddes & Other/~xtemal Causes
All Olher Causes of Death Unkm~ Causes (ln All Causes Categca7 Only)
1342 1t 295 7 86 11 35 18 t 3 17: 80 7:5
1 0 0 0 36 1 10 .7 .0 0
4 0 2
3 44 9 '7 ,31 137 441. 7 297 20 29 8 71 35 9 2
4 3 7
II 21 93 59 Z3 36 9 7_5
132 77
1710.8 1t,6
8.8 97..6 13.9 27.1 21-0
i7.8 ~09~5 94.5
0,6
0.0 0.0 44.2 1.6 5.0 7-8 0.6 0.1 2.9 0,6 L4
3.4 2.0 9.0 9,6 3.5 24.6 176.8 582.3 6.5 412.1 19.4 28.8 14.6 9L0 50.8 i9.0 3.5 liA 3.7 7_5 20~0 20 204.0 1.07.0 51,6 55:5 8.6 79.8 215,8
94,7 91,1 79.6 88:1 79.4 129,3 85.8 I6.7 * 3622 95.7 79,6 * 79,4 *~ 3[79.2
81.4 63.1 202.1 90.3
140.1
i46.0 83.1 88.4 200.5 44.3 93.4 20i;6 1Z%8 77.5 ** 75.7 ** 108.3 72.1 ** 103;3 100.6 54.7
69,0 * 47.3 * 5Z9 36.2* 81;5 94,0 55.0 * 104.2 45,6 ** 55.i ** 44~6 **
1.05.0 31.3 ** 61.2 **
* SIGNIbTCANT AT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL
95% Confidence Interval
Lower
Upper
74~3 82.8 4723 169.4 8t.0 102.1. 32.0 164.1
70.5 I08.8 39.7 i42. i 90,0 179.:8 50.8 ~3.5.6 0,4 93:2
'7.5 105,8 55~7 t53.~ 63.1 99,J 62.5 99.5
45 998.5.
57.0 1~6
96,9
36.3 0.0 0,0
38,2
0,0 17.7
50.8 18,2 54,6
12:1 42,7
8t,0
85.5 65,0
68,8 43,5 64.t
63,1 67.4
23~6 6i ~0 48.0 21.6
%0
9.9 16.8 3Z8
:27,4 64.5
36.8 42.0
28.3 45.5 4g..0
20,3
51.2
112.8 351.8 371.7
186,1 578.6 4759.6
358.7
614.1 527.3
i28,4 2.58.4 513,4
113.,4 177,,4 41i4
i7&6 9I ~6
83,I 2Z3,1
80.8 159,5
144.5 107.7 98,5
95.9 89.9 209.2
92.7 23&3
193.6 98.4 159.3
55,9
7~.1 66.9
89.8 199.2 46.2
72.6
Table 9 Cavtse Specific SMI-ls ~br WrdgIE ~
Port Arthur Refinery Update, 1937- t987 ~p~ot~d D~a~m B~d on ~8 D~I~q
No. of Persons at Risk = 1,778 Person-Years = 47,910,7
CAUSE OF DEATH (ICDA 8th REVISION CODF_S)
Observed F_~g~ected
SMR
Adl Causes of Death
TubercUlosis All Malignant Neoptas.vns
Cancer ofBuecat Cav'ity & Ph~ Cancer of Digestive Organs & Peritoneum
Cancer of E~ophagus Cancer of Stomach Cancer of I.arge Intestine
Cancer of Rectum Cancer of BRiary Passage, & Liver
Cancer of Pancreas Cancer of Res:piratory System Cancer of Bronchus,.'lYaehea, Lung
Cancer of Breast All Uterine Cancers (.Females ordy).
Cancer of Cervix Uteri (Females o~ly) Cancer of etherFern sde Genita/Organs
~Caneer of Prostate (Males only) Cancer of Testes and Other Male Genital Organ.s
Cancer of Kichae5' Cancer of Bladder and Other Urinary Organs
Malignanl Melannma of Skin Cancer of Eye Cancer of Cenlral Nervous System
Cancer of Thyroid & Other Endocrhae. Cancer of Bone
Cancer of All Lymphatic, Haematopoletic Tissue Lymphosarcoma & Rctieulo~arcoma.
Hodgkins Dksease
Leukemia & Aleukeania Cancer of AU Other Lymphopoictic Tis.~ue Benign Neoplasms/Neoplasms of Unspecified N~ture
Diabetes Mel|ims Cerebrova~eular Dise~e
All Heart Dise~e Rheumatic Heart Disease Isehemic Heart Disease
Chronic Endoeard, Dis.; Ot~er Myocard.. In~Uff. Hypertension with Heart Disease
Hypertension w/o H~art Disease
Non-malignant Respirntory Dise~,ce Influea~..~ & Pneumonia
Bronchitis, ~physema,.Asthraa
Bronchitis Emphysema. Asthraa
Ulcer ofStomaeh & Duodenum Cirrhesis of Liver
Nephritis & Nepbxosis All External Causes of Death Accidents
MoIor Vehicle Aecide~kg
All Other Accidents
Suicides
Homicides & Other External Causes All Other Causes of De~th Unknown Causes (in All Causes Category.
26'7
0 89
2 20
1 2 9
3
0 .4 ~5
15 20
7 .3 5
0 0
3 i
0 0
3
1 1 5
.1. 0
t 3
4. :6 16
64 1
45
1
t 0 10
5 0
0 0
0 0
3 0
20 12
9
3 6 2
29 26
239.8 1,0
70.3 1.0 14.6 0,6
5.9 1.0 i.5
I0,9
6,0 3;7 5.1 0.0 0.0 LI 026 1.2. 0.1 2.1 0.3 0.3 6.2
0;5 2,5 2.I 1.0
2G6 665 25 49~7 3.3
i.9
13A 5~6 2,9 0.6 L7 0.5 0,8 5.3 L7 19.4 12.3 7.3 5:t 4.5 1.8 33.2
111,3
126,5 198,5 137.4 175.8
152.2 29!,3
t29.1 t32.6 13Z1 133.7 117.4 80,4 9817
27725 165/9
140.2 294.4 386.1 80,7 87.4
40.7 145;6 420,5 * 100,4 77,5 96,3 39,9 90~6 30.4 51.8
76,1 89,7
56/3
t03.1 97.6 i23,8 58.8 134,8 I08.8 8Z4
* SIGNI~CANT AT5%, LEVEI.g ** SIGNIFICANT AT 1% LEVEL
95% Confidence Interval
Dower
Upper
98,4
0.0 10t.6 24.0
83:9 4,4 11.8
69.6 60.1
0.0 35,2 74,2
76,,7 81,7
47.2 16,6 32,0
125.5
368.6: 155.7 717.1
212,2 979.8
351.3 288,8
851..4 244,5 330.6
2t8.7 22@2 206.5
24L8 234.9
230;3
57,3
4,1 0,0
0,0
28.9 7,4 9~7
26,2 Z2 0.0
1,0 30,0
114.6 36,8 44.3
74.1
LO 66,t
0.8 1.3 0.0
36.5
29.1 0.0 0~0
0.0 0.0
0,0 11.6
0.0 63.0 50,4
56.6 t2.t 49~5
13.2
58.5
810,9
924.5
320.9 6659.8
409.6 1640,4 2151.5
I88.3 48%3
691.0
226.7 425.4
1076.8
218.5 125,9
122,9 222.4 121.3
169.2 288.6
561.2 140.0
209.3 128.5 669.3
211~5 743.4
458.8 164,4
21Z6 t59.3 170.4
235.0
171.8 293,5 393A
125.5
Table 10
Gause Specific SMP, s for ALL COHORT MEMBERS Stratified by Length of Employment PortArthur Refinery Update, 1937-I.987
F~xpeded Death~ Based on TEXA..q DF.A'IH RATES
CAUSE OF DEATH (ICDA 8th REVISION CODES)
All Causes of Death
All Maligr~att Neoplasms Cancer of Bull Cauity & Caner of Digestiw Organs & Perit~eum ~n~r of Esop~gus C~ncer o~ grouch Cm~r of Large Intestine C~r or" Rectum ~n~r or" Bil~aD' ~s~ges & Liver (~a~r of Pan~,s ~n~r of Respi~t~ry System ~n~r of Be~ehu~ Tmeh~, Lung Caner o~ Br~st All Uterine Can~s ff~ma]es only) Caner of Ce~Lx Uteri ~e:mles only) ~n~r of Other Female ~ni~l Or~ns ~an~r of Prorate (~les one) C~n~r of Testes and Other Male C~nita! Organs Caner of ~dney ~n~r of Bladder and Other Uti~D" Malignant Melano~l of Skhx ~r or Eye Garter of C~ntml Ne~ons System Caner of ~yr6d & Other Endocrine. Caner of Bone Gan~:r of All LympKati~ ~hen~topoietie~ss~e Lymph~rm~ & Hod#ins Disuse Leuk~m~ & A]euk~mia ~n~r of All Or.her Lymph~oieti~
< t year Observed SMR
1-9 years Obsewed SMR
1346 t09.8. ~* 5 82.9
305 114o7 *
11 148,9 67 108,5
8 136.4
t3 i16,3
I9 99.7 2 4&7
3 52;2
20 142;2 tO4 109.0 1OI ttL0
6 83,3 2 74~0
0 --2 86.9
14 88,3
1 75.9 9 147.9 3 59,6
5 117:,6
0 ...... 12 1.54,3
1 109.4 2 181.6
25 100.5
3 68,6
3 110,7 8 79,0
!! ~43:4
1135 9
242 4
56 2 11 18 3 2 I8 77 72 11 i
0 .... 2 i2 t 6. 5 4 0 6 2 3 23 3 5 5 10
95,8 t36,7 1ff2-4 6L7 98.9 35~0 98,8
107;8 76,7 38.5 ~46.8 94,8 93.3 :197.7 43.1
115,8 80,0 57,7 115,1 1i,1,3 103,1 --86,1 242.2 271.1 99,0 75,5t 170,5 52,4 i47,3
10- t9 years O1Merved SMR
20-29 years Observed SMR
30+ Observed ~MR
784 87,2 ~ 7 111.2,
144 88,3
4 82,0
32 74:1 3 '78,2
8 77..9
10 87.8
5 159.9 0 --5 55.0
52 9%0 49 98.9
1 61,9 0 ---
0 ---
0 10 76.6
2 18Z7 4 110.2
2 52.3 4 154,7 0 -~ - 4 87,1.
1 16~.8 2 244.8 10 61..1
2 64~7
1 4%3 5 73,6 2 45.9
II67 87.0 ~ 6: 73,2
270 tt2.6
7 92.2 81 119,8
3 ~0.2 27 156.7 * 23 134,i
5 100,6 ~ 86.0 19 135.8 59 78.5 57 80.9 1 * 65.6 2 360,7 1 3162
25. I(N.8
O" -- 7 134..2 4. 64.4 2 67,2 1 413.8 6 1t3.3 0 --3 2t2.9 33 15Z6 ~ 3 72,i 4 185.1 21 222-7 ** 5 85,5
2367 6
521: 10 141
7 36
il 4 32 156 144 3 2 2
65 I
14
6 I.
3 47
2 5 18 22
(contlnued)
88,2 51,.6 96,6
685 98,9 553 118.6 11t,6 t.09,8 33:0 102,0
862 83.9 i82.8 437,8 8886 249.5 101.i 79,3 125.9 72.3 119,5 264,6 129A ~04,7
I50.3 103.0 26,9 176.8 90,2 142.7
'Fable 10contlnuod Cause Spet~fie SM1L~ for ALL COHORT MEMBERS Stratified by Longth o1~ Employment
CAUSE (IF DEA~I~t (ICDA 8th REVISION CODES)
Observed SMR
1-9 7~rs Observed SMR
10-19 years Observe,] SMR
20-29years Observed SMR
30+ years Observed SMR
Benlga Neop!asms/Neophsms of Unspecified Nature Diabetes Metlitus Cerebrovaseu h r Di~ase All Heart D~sease Rhmtmat~e H~.rt Disuse I~ehemie I'I~rt Disease Chronic E~d~rd, Dis,; O~mr My~rd. InsufL Hypertension with H~rt Disuse Hypertension ~;~o H~rt Disuse
Non- malisnant Re~piratou, Dis~se In~uen~ & Pneum~fia Bronchi6~ Empl~,sema, Asth~ Bronchitis Emp~ema ~thma Ui~r el Sto~eh & Duodmmm Cirrhosis of Liver Nephritis & Nephrosis All E~erml ~uses o~ Death Ac~dents
Motor VehiCle A~idents All Other A~deats Suiddes i.t0midd~ & Other E~erm[ ~useg
All Other Czuses el D~th Unkn~n ~uses (In All ~ums ~tego~ Only)
3 108.8 12 69.6
6i 80.9 439 100.8
3. 40.4 359 10L7
3 22.3 ** 7 76.9
1 25,8 82 1.13.7 Z5 ~.7
26 t27:6
3 87.9
22 t45.0 1. 58~6 5 89.7
23 86,1
6 76.4 138 81.8. * 80 77.2 * 39 69,2 ~
4.1 86,3 32 117,3 26 ~,2 ti5 85A
t51
4 148.3
4 216.6
17 10,4.2
il 91t,7
55 75.1 * 357 91.5
49 73:3 :28.I 86.0 *
3 41,(}
5 84,9
'293 94.6
213 78,8
1 8.2 **
9 110;3
.6 61.5 2 42.9
5 :65.9 _5 106;5
55 85.0
48 91,5
23 87
22 94~6
15 86t
10
0 ---
i 3L8
14 112,9 1 52.4
7 62,0 2 125.2
5 92.5 14 57.7 *
5 94.2 3 17,1
8 153
91.8 70,1 ~"
7 97.8 77 59A **
104 8ii *
5t 66~0 **
50 70~0
54 943 32
85.5
24. 80.0
14 731
25 49,8 **
12 43 **
108 83.1 lfgi
82 83.7 61
5 207.2
i9 107.4
11.3 90.6
449 83.6 **
8 119.3
347 76.6 "**
t6 26
i34.8 214.3 ~*'
4 61.4
47 56.i **
20 501 **
1~ 60,6 '
6 121.2.'
9 46.6 *
1.
2. !2
~6.5 25.1
~
52.4 #
9 91.6 76 66.6 ~*
61 84.7
30 BZ8
31. 82.0
'1.2 63,7
3 17.2 "*
133 88.0
22
12 48 22~ 1,008 t3
782 15 28 20 114 42
3 II
20 3 11
27
20 t03 71 31 40 29
3 246
7
257,9 127.0 86.1 92.0 138,4 87,1 41,8 111.3 t97.9
58,I 50,4 58.8 105.I 45.1 90,1 86.1 88.6 110.7 8(t6 81.6
81,0 1.26.4 2213 77.0
* SIGNW.tC/~NTAT 5%, LEVEL; ** SIGNIFtcANTAT lge LEVEL # SIGNIFIGSNT DEFICITAT 5% LEVEL OBSERVED DFATHS = 0~ SMRNOT CALCULATED,
CAUSE OF DEAq~ (ICDA 8th REVISION CODES)
All Causes o[Death Tubereu]osb All tvlkalignznt Neoplasms
Cancer o[Bu~l ~vlkv & P~W~x Cancer of Digestlve Organs & Pedt~eum Caner of Esop~gus
~n~r o~ Respimto~ ~stom C~e ~ Bronehu~ Tmoh~,:Lung C~n~r o[ Br~ t All Uterine C~n~rs (Females only) Cm~r of Ce~ Uteri (Fen~le~ only) ~n~r 0fOlher F%mate ~ni~l Organs (~n~r ofPr~tate (~[es oMy) Caner of Testes and Other Mab C~.i~t Organs Caner of~d~ey Caner oBladderand Other Uri~ Or~ns Malignant M~lan~m o[ Skia Caner of Eye Caa~r of ~nlmt Ne~o'tm System Caner o~hyroid & Other Endocrine Glauds Caner of Bone Cz~r of All L3~uplmti~ Haenmtopoielle
Hodgkh*s Disease .Leukem~ & Aienkem~ C~r of All Other Lymph~oielb
Table 11 Cau,~ Sp~fie SivlRs for WHYIE I~I.,ES Stmti fled by Length of Employment
PortArthur Refinery Update. i937-1987 Expected Deaths Based on 't'EXASI DEATH' RATES
< I year Observed SMR
1-9 years Ob~ewed SMR
I073 115.2 **
4 95.3 225 ii4.8 *
10 i73,2
45 lfY3~7
3 80:1
6 77.4 14 9933
i 3E9
3 74,9
17 t59,1
84 II0.I 82 112,7
(3 --(1 ---
802 102,6
5 131.2 i63 105,5
2 44,7
35 99,7
I 35,0 5 79.3
I~ 117.8 2 77.8
I 32A 11 134.4 58 i00.3
53 96.2
0
0
1;3 1 4 3
5 0 12
l
l
1.7 1
3 '7 6
107.7 88.5 80;4 74.8 135,9 --189,2
145,6
12L2 8&4
2&8
13~.5 87.8 1(36.6
10 109,4 I 71,9 ~2 51.6 4 129.4 4 118~7 0 --~ 3 54.0
1 1.70.9
3 4~.8 18 109.7
I 34~4
5 228.7
5 72.3 7 158,9
10-I~ years Observed SMR
20-29 years Observed: SMR
30+ y~ars Observed SMR
582 9Z0 i 5 127.4
i06 9t.l 3 8,2 23 79A t 48,4 5 8L6 7 "82,9 5 2291) 0 ...... 4 6~,7 42 1GL6
40 lOi4 0 0
5 60.7 1 12,6.4 3 105~5 2 72,1 ~ 16~.2 0 2 50.2 ~ 20L8 2 33i7 6 4~.i 2 8L5 0 ~ 74.5 0 - --
91! 3
203 6 55
t 14. 17 .5
3 15 42 4! 0
0 .... 0
20 0 7 2 2 I 6 0 3
31 3 ~ 19 5
91,3 *~ 52.5 ii4,7 1~.1
I15.1
29,9 123,8 129,0 1-3.4,8 9i.2 142,6 7Z7 ~ 755
1812 5
399 6
113 5 28
39
9 3 26 126 117 0
0
t29.2
--165.4 42.1 72,i 471.,6 t28.6 ---
313.5 t82.1 ** 87.6 223.5 246.3 ** I22,6
42
1i 6 6
9 3 1. 4i 2 2 17 20
(coniinued)
59.7 99.3 52.t 110.9 66,3 i4!0 120.8 i19~7 34~6 1.09.8 .89,3 87.5
123.5 119.0 51.1 127,2 287.i 119.5 ~.4 676 114,0 32.3 83.9 lfM~6 i79.7 *
Table 11 continu*d Cause.Stx.~oit'ie SMRs for WHITE MALES Stratified b3,Length of Employment
CAUSE OF DEATH (ICDA 8th REVISION CODES)
Benign Necrplasms,~eop[asms of UmpecifiedNature Diabetes Mellitus Cerebrovaseuhr AII Heart Disease Rhenmatlc H~rt Isehemio Heart Disease '
Chronic Endo,'ard. Dis.; Other IVtyoc,~rd. ][nsui% Hypertemion wltli Heart Disease Hypertension w]o Heart Disease Noa-ma|ignant Resplraiory Disease tnflueo.za & Fnemuorfia Bronchitis Empt6~m~, .A~thrm. Bronehlf~s Empl~,sema A~thma U]~r of Sto~eh. & Du~do n urn Cirrhosis of Liver Nephritis & Nephr~is All ~xter~l Causes of Death A~fidents
Motor Vehicle A~idea~ At! OtherA~ideats
Homlcide~ & Othw E~ermt ~1 Other ~uses of Death Unknown ~ums (In All ~auses ~tego~" Only)
< lyear Observed SMR
i-9 ymrs Observed SMR
t0-19 years observed SMR
20-29 years Observed SMR
30+ years Observed SMR
O --I0 83.7
,I5 86.4 369 105.5
2 36.9 310 105.6
I 9.9 ** 5 9L0
i 50.8 67 it7.6
I9 95.6
24 t40.5 3 t04.5 20 !50.3
1 lifO.9
4 9i.0 19 89.9
6 122.1 IIi 88,3
68 83.5 34 76,3 3.4 91,5
27 113.4
16 i10.1. 91 93.1.
121
2, 121.3 I4 143.1
33 805
278 101,2 3 6t,1
236 t02;5
0 --- ##
4 99.5
2 123.4 35 78,4
1.3 8i,1
13 98,9 0 -- 1.2 118.3
.t
1 1.19:t
3 81.5 10 58.1
4 91;3 1.17 82.0 *
82 89.3
40 76,7 42 t05.2
20 78.9
15 80.7
65 80.6 7.1
4. 32~,6 5 61.4 28 67.6 * 227 93.4 2 45.2 174 82.7 * 5 86~4 3 90.8 5 289.9 35 90.6 15 97,8
.63~0 4~.7 7 72,3
4 105~6 2 15~0 ** 4 104,9 60 68.7 **
72,0 ~ '4+8 ** 27 10L4 t2 69.8 8 85.0 65 99.1 32
3 182.4
13 1103.1 88 102,2
364 87.7 *
6 lI4A
288 79.2
12 1433 16 248.9 ~*
2 6t.[ 34 52.0 *
12 41.4"*
i3 58.0 * 4 86.4 9 53.0
0 1 15.8 ~ 12 64.2
7 t24,2
61 74.0 48 89,3 L'~ 97.1
23 82,2 ti 63.0 2 29.3 1.05 98.0
15
8 233,4 * 28 10Z9
155 863 788 93,1 *
11 i~5,2
64i 89.1 **
5 18:9 ** t4 103,6
i4 243.0 ** 93 58.6 **
32 51.1 **
34 6Zl * ti 122,0
20 5(1.5 **
3 128,7 9 85,6
22 85,3
8 74,6 84 87.6
57 87.5
25 86,7
32 87.9 26 122.0
1 16,7 *
194 84.5 *
5
* SIGN1FICANTAT 5%, LEVEL; ** SIGNIFIC-ANTAT t% LEVEL ## SIGN/I;ICANT DEFICrFAT i% LEVEL OBSERVED DEATHS = O~ SMRNOT C.ALCUI~TED.
CAUSE O~ DIL-~TH (ICDA 8th REVISION CODES)
AI! C~uses o~ Death 'r~bereulosis All Maligmnt Neoplasmg Cancer of Buccal Cavity & Plm~
Caner of Digestive Organ~ & Perit~eum ~n~r o~ Esop~gus
~n~r o[ Re~tum
Caner of ~ncr~s Caner of R~pi:mlo~ System Czneer of Broachug Troche% Lm~g ~ncer All Uterine C~m~rs ~emales only) C~n~r o~ ~ Uteri (Fe~tes only) Caner of OtherFemale Genial Or~ns C~n~r o[ Pr~tate (~les only) Cancer o~Test~s and, Olher Male ~.~ital Organs Ca~r of Kidney Caner of Bladderand Other Ur[~ Or~ns Malignant M~lano~ organ C~n~r o~ ~o ~r og Cemml Ne~ous System ~t~r of'Ihyr~d & Other Endocrine Glands Caner o~ Bone Caner otAli Lymplm/i~ ~eamtOpoietio ~s~ue Lympho~ & Retlculo~r~ Hodgkins Disease Leukemh & Ale~kemla C~n~r o[`AlI Other Lymphopolefic ~ssue
C.altse Spcifio SMR~ ['or NON-.WHITE MALES Stratified by Length of Empkr~mem Port Arthar Refinery Update, 1937" 1987
Expected Deaths Based o~ TEXAS DF.ATH RATES
< I year Observed gMR
1-9 years Observed SMR
]0-19 years Observed SMR
20-29 years Ol~erv~d SMF.
30+ years ONeeved SMR
170 l
43 1
13 4
5 2 0 .... 0 2 12 120 0 0 o .... I 0 4
0 0
0 O O
O 3 1 0
0 2
87,8 72.8 112,7 86.9 i19,7 216.6 195A 82,3
-- 98,1 87.7 92,9 -------
25.4 --635.,8 ** ----------
102.7 245.5 -- -- 180.2
240 75.2 ** 4 168.3 47 82.0 1 59.7 I6 95,9 1 37.8 6 146,0 2 53.8 [! ---1 61.8 6 196.5 12 61,5 12 63 1 t018.8 0 0 --0 --2 34.2 0 - -3 3(k8.5 0 0 0 ----1 149.9 0 .... 0 --5 I07.t 2 289.3 0 O
3 177.9
I78 2 33 1 7 2 3 2 0 0 0 .... 9 8 0 o
0 0 5 I I 0 0
0 l 0 0 4 0 t 1
2
72.4 ** 88,6 8L8 81.2 54.'2 116.3 76.4 82.5 ----~-
7Z8 742 --------103.6 32%0 143.7
239,3 ----i19.7 --251.1 82,7 166.I
227 3 58
0 23 ~ i3
4 Q 1 3 17 16 0 0 0 0 5 0 .... 0 2 0 0 0 0 0 2 0
0 2 0
71.9 124.5 103.0 -- - ## t26.7 77.6 "~ 229,2 121.t. ---- # 76.6 96.1 1.03.0 104,2
---# --68.6 "~
145,1
--- ## --- # ----49.8 ----134.9
527 1
114 4
27 2 ~ 8 1 1 6
30 27
23
2 5
2 0 2 6 0 3 1 2
(continued)
82.8 3t,3 86.6 t33.4 69.2 39.6 74.0 87.8 41.9 30.5 8L9 76.5 72,9
102.5
113.1 147.5
236.0
406.0 65.9
723,0 28.7 49.2
Table 12contlnued C~a u~e Stmeifie SMRs for NON-~v~q:IITE Mt~,LES ,Stratified by Length of Employment
CAUSE. OF DEATH (ICDA 8th REVISION CODES)
Benign Neoplasms/Neoplasms of Unspecified Nature Diabetes Mellitus Cerebrovascuktr Di.~ease All Heart Disease
~eumatie H~rt Disuse Isdmmi~ Heart Di~ase Chronio Endo~rd.Dis.; Other Mv~rd. I~suf ~ypertension ~xfith ['I~r t Dis~e t-~pertenslon w/o H=rt Disease N~n ~mali~ant ResplratoD, Disuse
Erone~iti~ Emp~sema, ~thnm Bronchitis Emp~,sema Asthma Ul~r of Sto~md~ & Da~Menum Cirrhosis of L~er Nephritis & Nephrogig All E~ermi ~uses of Death Ac~fdents MOtor Vehicle Ac~dents All Other A~denls Sui~des Homicides & Other Exterml ~uses ~1 Other Causes o~De~th Unkne~n ~huae~ OnAll Cremes ~tego~, Oniy)
< t year Observed SMR
1-9 yatrs Observed SMR
10-19 ~'ears Observed SMR
20-29 years Observed SMR
30+ years O~erved SMR
1 23Z8
2 73.7 tI 69,2 46 76,6
1 115,6
32 78.4 ] 47.1
2 64,3
0
It 112.7 5 99.0
2 99.3 0 ----
2 180.8. 0 - ~1 117;4
2 66.4
0 --21 62.0 "
9 54.4
3 35,6
6 73:8 3 216.;3
9 61,5
I1 48.I **
20
0 --1 22,9
16 66,8
61 71,4 **
0 45 76,7
1 3I.t
2 40,4
0 -16 101.5 8 96.0
2 60,3
0 --2 I1~5,,$
0
2 137.8. 3 58,8 4 109,4 23 40.t ** I3 5aA '** 5 43.2 *
8 66.3
1 34,5
9 29,6 **
28 75,0
22
0 --5 IZ~5.9 1.7 72,0 49 62,8 ** 3 246,9 34 61.i ** 4 185.6 2 48.9
0 --12 93-8 6 80.5
2 69.2
f) .... 0 -- -2 280.8 1 69.4 t 27.I 3 94;1 13 3t.5 ** 8 38.9 ** 3 29.3 * 5 48,3 1 63,4 4 23,7 ** 16 5~.2 ** 26
2 293.3 I37~8 68
71 63,3 1 79.9
49 59.6 4 133,9 9 166:4 2 63~8
7 69.6 :3 2 269.6 0 1. 149,8 1 65
0
50 13 42,6 II 63.1
49.8
7 74.6 1 8 1 9.5
27 ~7
6
4 39A t7 I739 68 88.8 208 87.3
2 120,9 133 78.4 10 11Z5
t24.3 6 1~2 "20 55.~ 9 45.3
0
92.4 5 113.9 t2 168,4
6t.1 t4 66,1 6 69.2
64 3. 196:7
2 26.9 50 58.3
t
* SIGNIFICANTAT 5%, LEVEL; ** SIGNIFI CANTAT t% LEVEL
# SIGNIFICANT DEFICtTAT 5% LEVEL, OBSERVED DEA, THS = 0, SMP, NOT CALCULATED, ## SIGNIFICANT DEFICIT.AT 1% LEVEL. OBSERVED D~',ATHS = 0, SMR NOT CALCULATF~D.
CAUSE OF DEATI-I (ICDA 8th REVISION CODES)
All Causes of Death Tuberculosis All Malignant Neoplasms Cancer o Buecal Czvity & Pharyr*x
(L~ncer of Digestive Organs & Perlt,:meum Cancer of Esophagus
Cancer of Large Cancer of Rectum Cancer of BilhD, Passages & Liver Cancer of Par~creas Cancer of Respiratory System (hncer of Bronchus, Trachea, Cancer of Breast All Uterine Cancers (Females ort[y) Cancer of Cervix Uteri (Females otlty) (Lancer o[Other Female C-e,n.ital Organs Cancer o[Pmstate (Males only) Cancer of Te~te~ and Other Mate Genital Organs Cancer of Kidney Cancer of Bladderand Other Urh~7 Organs Malignant Melanonm of Skin Crater of Eye Cancer of Central Nervous System (Tmfcer of ThTroid & Other Endocrine Glands Cancer o~ Bone Cancer of All Lympbatic~ Haematopolefic Lymphomrcoma & Retleulosarcoma Hodgkin,~ Disease Leakemh & Ale~kemia Cancer o[Al[ Other LymphopoietieTissUe
Table 13
Cause SpecifiSMRs for WI-lI'l~ FEMALES Stratified by Length of Employment Port Arthur Refinery Update~ 1.937- t987
Expected Deaths Based on "IEXAS DF_ATtt RATES
< 1 year
Observed SMR
i0i i05.4 0 36 117.3 0 9 152.2 t 4073 2 241~9 3 t24.9 1 242.t
o ---
I 7B~3 7 t.31~7 7 t36,0 6 89~2 2 7911 0 ~=2 89.6 0 .....
1 214.9 {} ..... 0 --0 ~-0 0 .... 1 9ZS.9
1 206,7 O --1 ffL3 3 3352
I-9 years
Observed SMR
87 llg,2 0 --.7 3I. 139,8 1 320.9 5 115,2 0 --0 ~~= 3 170.5 1 32,8
0
1 I09A 7 1.95.7 7 202,3 9 1.85,6 I 51.1 0 --2 125.2 0 ---
1 302,2 1. 587.5 0 --0 --2 279.7 i 92G9 0 - --
0 0 0 0 ---
10-19 year~
Observed ~MR
24 123,1 0 5 84.4 0 2 161.3 0 0 1 205.0 0
0
I 1265 1 13[,5 I 76.4 0 -0 --0 0
0 .... 0 0 0 .... 1 54Z3 0 - -0-
0 --0 ~-.0 0'
20-29 years Observed
30+ years Observed SMR
108,4 0 9 146.0 I 1145,0
186.8 0 0 2 304.6
0 295.6
0 86.3
2 395.7 349.2
0
0 0 0 0 0 0 0 0 0 0 0 0
26 105.1 0 8 t48.3 0 683 0 0 0 99715
0
3 328.4 2 562.2
11421 277.5
0
0
i I041.9 0 0 .0 0
0 0 0 0 0 0
(continued)
Table I3 eontlnu..d Cause Spec~fieSMEs for WHITE FEMALES Stratified by ILength of Employment
CAUSE OF DtLck'IIq (ICDA gth REVISION CODES)
Benign Neoplasms/Neopl~sins of UmpeoifiedNatu~:e Diabetes Mellitus Cerebro~seuhr Di~eaze All Heart Disease Rheumatic. H~rt Dise~e
~emie IIeart Dis~a~ Chronic Endt~td, Dis;; Odter Myomrd. tmuff~ Hyperien~on with Heart ~sease " !typerten~ion ~qo H~rt Disease Non- mallguant Re~pirai.o~ DiseaSe h~.fl uenz~ & .Pn eumt~ia Bronchiti~ Empl~e~, Asthn~a Bronchi~i~ Emp~sema Asthma Ul~r of S~o~ch & DuodenUm Cirrhosis o[ Liver ~ephritis & N~phr0sis ~l ~terml ~uses of~ath ~ciden~ Motor Vehic[~ A~ident~ All Other A~idents Sui6des Homi~des & O~her Exter~ Czus~ All Other (~uses of Death Unkn~ Causes (In All Causes ~Xtego~ Only)
< 1 y~r Observed SMR
2 490.t 0 - -5 72.2
24 99.1 0 ----
17 96.6 t 82.0
0 ~ 1 0 ....
0 0 0 0 .... 2 0 6 3 2 1 2 1 12 10
--7&5 51.0
--~ -----
80.9 --~.0 56.! 61.1 47.4 98~2 121.9 ~,8
~ SIGNIFICANTAT 5%, LEVEL; ** SIGN1FICANTAT 1% LEVEL
1.-9 y~ars O~erved SMR
I~-19 ~'ears Observed SMR
2 642,9
2 112,6
5 10
87.7 53.9
~
0
6 44.0 '
0 ---
0 .... 4 -2 0 0 .... O .... 0 0 1 0 8 4 ~3 1 3 I 13 II.
1.0~3 1.2~.5
--56.7
t10.8 89.5 ~,3 57.8 t76.4 135.0 I26.i
0 --~ 20].8 ~ 234.,6 5 96;3 0 5 12&7 0
0 ~-1 101.,8
O .... O --0 0 ....
.0 - - 0 .... 4 3 28~,0 3 490~0 0 I 0 .... 1 381 3
20-29 years Observed SMR.
0 0 1. 14 1, 10 0
I
0 .... t 1
---
3M 1492 504.4 136.7
375.6
65.7 124.1
0 ---
0 0 --0 ---
2, ~742 2 2#0.4 I. 26i,2 t 22! 1 9 --O --~ 1 27.4 I
30+ yt~rs
Observed ,qMR
0 3 472,1 t 3Zl ii 120.4 07 97.7 0 0 --0 0 0
0
0 --0 0 0 ..... 0 --0 0 ..... 0 --0 .... 2 58,9 1
CLAUSE OF DEATH (ICDA &h REVISION CODES)
All Gauses of Death
Caner of Bull CarRy & ~n~r of Digestive Orsans & Perit~eum ~n~r of Esop~us
C~n~r of Large Intestine
C~n~r o~ BillaB, ~s~g~ & Liver C~n~r of Caner of R~pirato~' Syste~
Caner of Br~st All Uterine ~n~s ~ema[es only) ~n~r of CewLx Uteri ~eml~ only) (hn~r of Other FemaM ~nital.Or~ns C~n~r of Prorate (~[e~ only) ~n~r. of T~teS and Othe~ Male ~nital Caner 0f Kidney Caner of B~dder and Oth~ Urim~ Or~ns Malignant Melanoam of Skin Gm~r of Eye ~n~r o[ ~mtml Ne~ous Syslem ~ n~r of'Ihyr~d & Other Endo=in~ Glands C~:n~r of Bone Caner ofAtl Lymp~tM Hae~topoielie Lympho~ra~m & Retieuto~r~ Hodgki~s D~s~ase Leukem~x & Aleuk.emla
C~n~r o[Atl Old.or Lymph~oietie
qhble 14
Cause Specifle SMRs for ALL COHORT MEMBERS Stratified by Years Since Hired Port Arthur Refinery Update, 1937-i987
Expected De~ths Based on TEXAS DEA~IH RATES
< 10 years
O~erved SMR
269 76.2 ** 7 226.0 26 71,7 1 t08.3 5 58:6 0 --0 --1 46.1 I 135.8 0 --3 2~.i 6 93.4 6 lC0_,9 I 115.0 0 --0 --0 --2 352.5
0 .... 1 128A 1 232,1 1 64,1, 0 ..... 0 ...... 1 419,8 1 164,9 3 42,2
0 --0 .... 3 9t,4
0
10~ 19 year~
Observed .SMR
367 83,2 ~ 7 97,9
87 84,5' 4 t12A 18 65,3 0 7 90.2 ~ tIf4 1 46,4 0 --3 56;I
22 76,5 20 74.~
1 44.5 1 69,5 0 ....
'0 - - 1 31,9 2 138;2 4. 160.8 1 515,4. 2 72.2 0 ......... 4 80,9 :1 177.1 2 260,2 t4 t05,5 1 33,8 5 183.5 6 I09.5 2 94,9
20-29 years Observed ~MR
1128. 7
247 9
7t 5 20 i5 5 6 19 65 61 5 0 0
11 2 7 2 ~ 1 7 1 1 24 4 4 8 8
81.9 71,4 9z6 97~8
70,8 113~8 90.3 96.8 120~3 12Z9 70.2 70,0 104,9 ---
86.0 166~9 108.6 37,7 9Z6 41~.0 83,8 9~,7 69.4 96.7
12!9 79,8 130.i
30-39 years Observed SMR.
40+ years Observed ~MR
1949 8
483
122 8
37 34 3 3 32. 156 1~8 9 3 1 2 25. 1 14 5 .6 0 18
8 44 6 6 19 ~3
96,8 82.2 t07.2 73.7 105.7 66.7 152.4 i136.3 37,8 30.4 124.5 ~4.2 94.i 149.3 173.5 109,1. lfE:7 75,3 91,7 ].37.3 50,3 120,6
184;2
145,8 454.1 11.9.5 90Z 221!) 127.i
2886 4
639 12 161 10
16 4
199 188
6 3
87
1.6 8 I. 10
53
3 21 27
(continued)
993 44.7 t08,7 * 87,7 i07.8 82.2 1102 121.0 t54,9 28.4 ** 112,1 103.7 t02,8 t65.0 312.6 502:i t80.0 107,0
123.2 92,4 t57.2 ~0.6 132.1 !,45.8 59.6 106,6 39,8 130.1 94.9 145,2
Table 14 o0nfiaaed Cause Specific SMRs forALL COHORTMEMBERS Stratiffed by Years Since Hired
CAUSB OF DIL'%TH (ICDA 8th REVISION CODES)
Beaign Neopiasms/Neop~asms of Unspecified Nature Diabetes Meilit us Cerebro~,aseuhr D~sease All Heart .Disuse Rhe~tmatie I.[~rt Disuse Isehemle Iteart Disease ~ronJc Endo~rd. Dis,; Oiber Myomrd. Inmff, Hyper~nsion with H~rt ~sease Hypertension ~v/0 H~rt Di~eage Non-malignant R~plratou" Disease
Emp~sema A~Ilima U~r o[ Stmmeh & Duodenum Cirrhosis of Liver Nephritis & Nephrosis AJ] E~erml Causes of Death ~ddents Minor V~hiole A~dm~tz All Other A~id6ntz Sui~des H.omiddes & Other F~terml (~us~ At1 Other C~ns~ of D~th Un[m~n Causes (.ln All ~uses C~tego~ Only)
< 10 ),ears Observed SMR
10-19 years Observed SMR
20-29 years Ob,~rved SMR
30-39 year~ Observed SMR
i 104.3 1 27.6 6 5~.1 33 53.7 ~ 0 -- ~ 52.0 *~ 1 87,9 0 -- ~ 1 6Z8 7 66.2
~ 1 12L8 2 113A 2 3D.2 ~ 84.3 103 57.1 ** 67 63.7 ** ~2 49,8 ** 35 84.4 11 54,0 * 25 56A ** 21 62,4 * 56
4 ~w~12,5 5 585 28 75,8 164 ?6,4 ** 1 14,6 * 14t 77,7 ** "5 168 3 59~3 2 45.1 19 66.9 9 60,6 6 64,2 0 --4 71,1. 2 119.2, 0 ---# 4 21,8 ** 6 96 126 72.3 ** 92 91,4
4~ 77~ 50 107.9 ].4 56.I * 20 53.0 ** 45 66.4 ** 7O
3 10],9 12 66,2 64 67.2 397 75.1. **
9 95,4 332 733 11 167.5 12 111.8
2 29:7
21 t3 49.9 ** 3 63.3 10 53.6 *
2 22.8 21 5&2
9 9L5 117 68.6 77 74,2 .** 41 77;5 36 70.7 31, 106.1
9 30.6 98 :69,4 ** 106
10 259.6 37 I27,5 126 80,4 765 9i010 109.2' 606 913 16 8L6 30 159.5
154.2 9~ 76.4 33 69.6 34 845
7 97.7 79.6 99.9 1t0.5
3i 84.0 90,8 79.4
73 87.1 783
42 94,9 80.0 6L6
177 80.0 80
StGNIFICANTA'][' 5%, LEVEL~ ** SIGNIFICANTAT 1% LE EVL SIGNIFICANT D[~F1CiTAT 5% LEVEL OBSERVED DEATHS = 0 SMR NOT CALCUI2ViED,
40+ years Observed SMR
I0 52 278 H75 ~2 890
16
65
II ~4
2
21 21 9~ 58
35 35
4 343 35
201,6 124.2 92.6 100.0 1.53,0 .95.0 21.5 ** 98.0 158.5 77A ** 64,6 78;9 104.7 72.5 74.0 t13.7
8Z8 t09 93.9 7Z9 80,7 75.9 187.,I, ** 48.8 92,9
CAUSE OF DEATH (ICDA 8th REVISION CODES),
Tuberculosis All.Maiigmnt Neoptasms Cancer of Buccal Cavity & Pha~nx
Cancer of Digestive Organs & Peritoneum Cancer o[ Esophagus Ca1~eer o[ S;tomacb C~cer of l.xtrg~ Intestine Cancer O[ Rectum Cn'oeer of Biliary t:~smge~ & Liter Cancer o~ Patiereas Canoer of Respiratory System Cancer o[ Br0nchU~ ]~chea, Lung Cancer of Breast All Uterine Cance~s (Females only) Cancer of Cervix Uteri (Females only) Cancer ofOtherFemale Gerfital Organs Cancer of ProsLate (Males tin!y) Cancer of Testes a~d Other Mal~ Genital Or~a~i~ Cancer otKidney Cancer of Bladderand Other Urhmry Orffms Malignant MeB.o~ of Skin Cancer of Eye Cancer of Centre! Nervous System Cancer of'/'hyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Uaematopoiefio EsSUe Lymphosarcoma & Retieulosarcoma Hodgkins Disease Leukemh & Aleukemia Cancer of Alt Other Lymphopoletic'Hssue
Table
Cause Spedfie SMRS for WHI.qE MALES Stratified by Years Since Hired PortArthut Refinery Upchte, 1937-t987
Expected Deaths Based oa TEXAg DEATH RATES
< I0 years Observed SMR
212 91.4 4 21.8,3
21 84.0 1 i 5~ ~7 5 90.9 0 ---0 --~1 70.6 1 21L4
3 5 5 0
0
0 0 2 0 0 0 I 0 0 .... 1 1 3 0 0 3 0 ....
31K9 10515 ti5,5
---
556,6 ~----
7,3,6 ---
537,9 235.3 56,2
-- 1.2,3.2
10-19 years Observed SMR
20-29 years Observed SMR
30-39yearn Observed SMR
40+ years O~erved SMR
443 94~8 5 114:1
69 95.8 4 " 160.5 15 8L6 0 --5 I03,3 7 157.6 I 67,2
2 50,2 i9 86,5 18 87,8
0
0 0
0 --1 50,2 1 87,8 2 105.7 1 80.8 2 80.1 0 --2 47,6 i 220,2 2 356,0 12 1183 1 42.9 4 191.i 5 117,3" 2 139,6
6
879 88.8 ** 4 6L9
180 94.9 7 103:8
47 98.0 2 54.2 82A 9 72,8 4 107.4
155,5 i7 14.9.3 53 74.9 * 50 74~8 *
0 0
6 T2:6 2 23'L1 5 973
5Lt 4 103,4
487.6 84.6 1 116 9Z7 20 104.9 3 69.0 4 t58.2 8 104).9 5 ItZ3
t454 99.9
6 8K2 352 :109~4
7 68.4 93 1t7.6
: 5 74.4
24. 156,3 *
29 123.9 :3 51.9
3 45.7 24 128,1 115 91,7
108 90~7
2182 3
474 8
4 20
t3 2 27 160 152
0 ---
0
0 .... 19
1 I1 3 6
0 15
I 6 35 3
4 17 11
87.4. 145,1 1.34.3 40.5 11 1.34.4 ---18,1,4 * 95.1 465.6 ** 125,7 57:1 "
182.8 145.7 I26.1
0 62
0
8
2 0 43 2, 2 19 20
(continued)
98.8 45,8
7;!9 t03.3 51.9 t10.0
!17.5
t67.5 192 ** 109.8 106.5 106,2
1t3.9
95.6 80.9 171.2 306,9 137.7 180.5
110,9 36.0 t01.0 106.3 149,8
Table 15 Cordinucd f,'~tme Specific SMRs for WHFIE M&LES StmtiSed by Years Sittc~ Hired
CAUSE OF DEATH (ICDA 8th tLEVISION CODES)
Benisn Neoplasms/Neop|asms of Unspecified Nalure Diabetes Mellitus Cerebrow~scuhr Disease All Heart Disease Rh.~umatie H~rt Disease
Chronic Endooard.Dis.: Other ~vomrd. tnsuff. Hyper~ion with Heart Disuse Hypertension w/o H~rt Disea~ Non.~ mali~ant Respirato~ Disuse tnflUe~ & Pneumonia Bronehiti~ Em.pI~ema, ~h~ Bron~ifiz Emp~sema
Ul~r of Sto~mch & Duodenum Ci~hosis ~[ Liver Nephritis & Nephr~i~ All ~ert~l ~uses of Death Aeddents
MotorVehide A~dents All OtherA~dents SuMd~ Homicides & Other E~erml Cmus~ All Oilier Causes o[Death Unkn~n C~u.se~ (InAlt ~uses C~tego~ Only)
< 10 years Observed SMR
10-19 years Obsewed SMR
20-29 years Observed SMR
30-39 years Obscta,ed SMR
40+ years Observed SMR
0 --1 44.4 4 645
29 66.6 *
0 --24 64,3 ~
0 -- - -
0 I 235.5 4 67.9
2 6t.8
I 63A o ....
o
1 365.9 ~ 84.2 2 48.2
2 102.4
86 71.5 ** 58 73.0 *
28 56,6 **
30 98.6 9 52.8
19 116,8 11 56.0
46
4 404.2 * 4 71.3 20 94.9 1.40 87.6 I 20,0 123 85.7 3 166.4 3. 55.2 2 150.1 13 71A. 7 82.2 3 43.5 0 3 63.3 0 --0 4 29.9 ** 4 1232. 95 80.6 ~ 72 97.4 32 79A 40 118.6 t0 45,6 ** I3 91;3 3~ 79.6 49
2 106.8
8 65.3
45 78.2
328 81.2 ** 5 70.7
281 7&2 ** 8 1"76.1
9 186.2
2 76.5 30 59.I ~ 13 65.7 tt 51.9 *
2 52.9 9 56.2
0
0 20 70.0
7 138.1
95
61 7K6 34 86.4 27 72.3
29 110.3
5 3%8 * 77 80.9
81
186.6 129,6
88 88.0
620 101.7 9 128,2
510 97.7
65.1 177.7 '7 195.8 72 75.2
19 57.7
94.9
6 ~OL5
~4 92,0
2 t(YIA.
1t3,1
2O 66.6
6 89.8.
84.3
195.6
25 84,4
34 I05.6
79,3
4 47;8
n6 82;3
47
162.7
t05,6
192 89,1
909 99.7
9 I46,7
7t~ 941
3 7.9 ** 15 95.4 12 t87,4
145 74,8 **
50 63:7 **
45 85.9 tl 119,6
32 76.4
2 104.3
t16.4
19 94.8
10 79,9 76. 96.7
45 80,5
18 83,1
78,4 30 175,2 **
1 2.5.5
2"/2 100.8
21
* SIGNIFtCANTAT5%, LEVEL: ** SIONIFICANTAT 1%LEVEL ## SIGNIFICANT DEFICITAT t% LEVEL OBSERVED DEATHS = 0, SMKNOT f,Td~CULATED.
(~kUSE OF DEATH (ICDA 8th REV]SION CODES)
All Causes of Death Tuberculosis
Czn~r o~ Digestive Organs& Peritoneum Caner of Esop~gus (~n~r of Sto~di Czn~r of ~rg Iatestine (~n~r of Rectum Caner of Bilia~ Pas~gos & Liwr Caner of IXa~tcr~s (~nmr of Respl.mt~ ~tem ~n~r of Bronchu~ Troche, Lufig Caner o.f Breast All Uterln~ C~n~s ~emales only) Cancer of C~ Uteri (Fe~le~ only) Caner ofOflmrFemale ~niml Organs ~hn~r of Prorate (~[es only) Garter ofl~tes and Other Male ~nital Organs ~m~r of Kidney Caner o[ Bladderand Other Uri~ Or~m Malignant M~iano~ of Skin Caner of Eye Caner of C=~tmt Ne,vous System ~r of ~yrdd & Other Endocri.no Glands Garter of Bone Caner ogAtl Lymp~ti ~ae~topoletle 'tissue Lympho~r~ & Reficulomr~n~ Hodgk~ns Disea~ Leukemh & Ale~em~a Cancer of Alt Other Lymph~oietio ~sue
T~N~ 16 Cause Specific SMRs for NON-.WHI?EE MALES Stratified ~ Y~rs Sin~ Hired
Port Ar tlmr P, efine~/Up~te, 1937-1987 Expected D~aths ~ed o~ ~S D~ ~S
years Observed ~MR
iO- 19 years Observed SMR
20-29 3~ears Obsewed gMR
46 44.1 ** 3' 285,5 2 26,9 * 0 --0 --0 .... 0 -- 0 --0 ---
0 ---
0 -- 0 ..... 0 - ~ -0 ..... 0 --0~ 0 --0
0 77~- -1 490.6 0 ---
0 --0 .... 0 ..... 0 0 .... 0 .... .
0
0 0 .... 0 ---
t09 58.0 '* 2 83.5 I5 65.7 O --3 38.3 0 -- --2 76.5 0 -- - -
0 --0 --1 85.8 3 47,8 2 34,9 0 ---0 0 ---
0 ~0 1 325,2 2 389,9 0 -.-O --O --1 247,9 0
0 2 83,2
0
1 203.1 1 113.7 0 -~-
211. 3 97,4.
54 90,4 1 45.0
21 106.8 3 92.9
1i 180.1 4 133~6
0
I 67.8 2 58.3 12 60:9 t 1 '60.2 0 --~ 0 0 --0 --5 110.6 0 .... 2 185.7
O ....
0
0 0 ..... 0 --4, 90.9 i 128.6 0 -0 3 194.2
30-39 year~ Observed SM R
40+ years Observed SMR
374 81,2 * 2 72,I 92, 90,9 3 103.2 23 75.8 3 59.9 It 134,7 3 48+9
6 106.8 31 88,5 3t 93.8
1 .686,6 0
602 96,5. 1 43,1
132 99.6
3 123,3
39 104,6 5 116.7
II 116,4 1i 108,1
i 43,6
Z 583 8 109,7 34. 89.4 31 859
6 52,4
2 128.3
2 87.4
25 03.0
3 188.1 5 t.43.6
2 217.7 0
1 248.0 5 74,3
2
2 496.4 1 40.4
1 0 1 9 0 I
2
6
(continued)
153,8
258.3 97.1
375.7
s5.S
t34.8
T~tbIe 16 c~ntlnued Cause Spedfie SMI~ for NON-WH.I~ MALES Stratified by Years Since Hired
(V~,USE OF DEATH (ICDA 8th REVISION CODES)
< 10 7ears Observed SMR
10-19 year~ Observed 8MR
20-29 years Observed SMR
30-39 year~ Obsgrved SMR
Benign Neopl~,~ms/Neoplasms ofUmpeeified Natx~te Diabetes Meliitus Cerebro~as~uhr Dhe~se All Heart Disease
Rheumatic Hmrt Disease Is~h~mie H~t Dheas~ ~ron~e Endo~M. Dis.; edger Myo~M, tnsuff. Hypertenfion with Heart ~sease H)gertenslon w[o ~rt Dis~e Non-malignant Respirato~ Disease Infiuen~ & Pneumoni~
Bronchitis E~p~sema
~l~r of Sio~m~ & Duodenum Cirrhosis of Liver Nephritis & Nephrc~is All Ex~erml ~useS of D~th
Motor VehMo A~dents All Other A~de~s Sui6des Bomiddes & Other ~atermt Caus~ All Other Causes of Death Unknt~v~ ~auses (In All Causea Cate8o~, Only)
0 .... 0 .....
2 48,4 4 25.0 ** 0 ---
1 10.t **
1 249.0
0 - --
0 3 75,0 12 85,9
0 ....
0 ....
0 0 --1 i90.7 0 ----
1 72,9 12 2t.9 **
5 22,0 *~
2 15.9 ** 3 29.5 *
1 42.6
6 21.9 **
i0 95:,5 8
0. --1. 41.8 7 49,9 22 43.7 ** 0 I6 45.4 ~* 2 194,7 2 65.0 0. -~ 6 65,5 2 34(8 3 137,2 ~ --1 I24,9 2 202.0 0 0 .... # 2 73.4 26 50.3 ** 17 70.8 7 56,5 10 85,9 2 103,0 7 30,6 ** 9 43,3 ** 19
12iA, 3 66,8
16 47,9
62 54,9 4 242,8
5i,8
3 166,2 3 54.1 0~
7L2
8 80,8
2 47,3 120,0
:43.1
0 2 103,7 1 17.6
2 46.0
18 13 541 5 43.0
8 65.0
2 123,0 3 18.4 16 40.7 2t
3 337,2 10 ~38,0
32 65,2
122 724
0
~2 67.7
7 148.7 12 1431
4 120,4
18 75.6 10 78,3
2 37.2 1 96.4. 0
t.t2,4
2 113,9
8 160,7
5 101.8
58,4 62.0
4 46.1.
8 74.9
0 6 66.0
36 63,0
22
* SIGNtFICANTAT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL # SIGNIFIC~\NT DEFICITAT 5% LgVEL OBSERVED DEA'H-IS = 0~ SMR NOT CALCULATED,
40+ y~,'ars
Observed SMR
3 285.3 i7 180.0 80 1.05.0 231. 98,6
3 228.6 154 95.6
7 61.3 ~2 t11:3 4 tt6.5 3~ 86.2 t3 65.0 2 31.7 0
45.I 0 2 ti3.8 2 64.5 I1 161.9 i9 83.8 I2 71,0 5 79.5 7 65,7 4 3O8,9 3 726 6t 69,2 7
-C~.USE OF DEA~I (ICDASth REVISION CODES)
All Causes o[Death Tuberculosis
All Maligr~an~ NeopIasms (.~r~eer of Bueeal Cavil" & Pharyrlx Cznce~ of Digestive Organ~ & Periton.eu~ Caneer of Esophagus Cancer of Sto~mch Cancer of Large Intestine Cancer of I~ectum Cancer o~ Billary Pas~ges & Liver Cancer ~ Pancreas Cancer of RespimloD, System Cancer of Bronohus, Trachea, Lung Cancer of Breast All Liter-Joe Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital Organs Cancer of Prostate (Males otfly) Cancel offFegtes and Other Male ~nital Organs Cancer of Kidney Cancer o['Bladderand Other Urirary Or~ns Malignan~ Melanoma of Skin Cancer of Eye Cancer of Central Nervous System Caner of Thyroid & Othe~ Endocri.nc GIa~ds Cancer of Bone Qtncer 0fAll Lymphatic, I{aematopoletie q~issue Lympho~reo~m & Reticulosarco~t Irlodgkin~ Disease Leukemh & Aleskemla Cancer o[AII Other iLymphopoietic q3ssue
Table 17 Cause Specific SMRs lot WHI~ FEM,~LES Stratified by Years Sinoe Hired
Fort Arthttr Refinery Op~hte~ 1937-1987
Rxpeeted Deaths Based on 1EXAS DEATH RATES
< t0 years Otr~erved SMR
10 7~.2 3 92,1.
10-19 years. Observed SMR
t 58~.7 1 6583 1 152,6
1 7821.6
20~29 years Observed SMR
75.0 799 44&6 97i7 16~3 41&2
llS.7 73.5
t76,8
30--39 years Observed SMR
40+ years Observed SMR
i0'~ i3&6
37 ].4Z6 0 6 106;7
284.2 2 86.5
0
178.6 184.2 7 I32.1 3 194.0 122/9 2 107.1
33 190.0 ** 1. 380.1
11 26&1 ** i 643,0
5 27&7 Z 79~.0
2 i97.1 5 14&7 5 144,3 6 21.0.3 3 362.5 2 590.0 {2 t915
1 235.1 0
0 l 142.2 1 893,9 1. 1536.4 4 I86,4 1 260,9 0 1 i29.6 2 226.8
2 0 0 0
I
i
(continued)
595,6
67.3 ~35,7
"[hble iTconti~aed Cause Specific SMRs for WHFIE FEMALES Stratified by Years Since Hired
CAUSE OF DEA'IH (ICDA 8th REVISION CODES)
< 10 years Observed SMR
Benign Neoplasms/Ne0p[asn)s of Unspecified Nature Diabetes N[ellitus Cerebrovascuhr Disease All Heart Dis~ Rheumalle H~rt Disuse Is~hemie H~art Disuse
Chronic Endo~rd, Dis[: Other My~rd, Insuff[ Hypertension with H~rt Disease Ityper~nsion w[o H~rt Di~ Non - maligner Re~plramu Disuse
Emp~'~ema ,~thma Ul~r of Stonmch & Duodenum Grrhosis of Liver Nephritis & Nephr~is All ~terml Czus~ of Death
Motor VohMe A~idents All Othe~ A~i.de~tts Sulddes Homiddos & Other ~r~l Caus~ AII Othe~ Causes of.Death Unkn~n Caus~ (It~All Czuses Ca~go~ Only)
1 1015,6 0 --0 --0 .... 0 0 --0 0
0 ---
0
0 ===
0 --0 --~ 0 0 0 .0 4. 92.0 3 11L7 2 100;3 1 138,5 I 1I1.9 0 0 2
* SIGNIFICANTAT 5%, LEVEq.; ** SIGNtFICANTAT i% LEVEL
10- I9 years
Observed SMR
0 0 1 65,0 2 56,1. 0 .... 2 85,8 0 --0 ---
0 ---
0 0 0 .... 0. .0 .... 0 0 .... 0 5: 115.1 3 119.5 3 182,1 0 2 186,9 0 2 53,8 2
20-29 years
Observed SMR
0 -. - 1 82;4 3 79,0 6 0 --6 73.3 0
~
0 --0 t3 --0 ---. 0 ....
0 0
81.0 3 9817 2 1(~.4 1 82,0 0 t 217.8 4 64,7 4
30-39 years
Observed S~IR
2 753.7 2 89,7 6 85.2 22 89.4 t 1.51,5
13 68.5
142,9
5 I09~7 '4 244,3
3 164.1
5 129,2 2. 77.5 2 i56.5 0 2 2.16,2 1 2933 1.4 136,7 ll
40+ years Observed SMR
i 497.2 3 162,6 6 77,8 34 128:9 24 1~,8 ~ 51,6
4 79,6 I 48,6
2 105.7 I 67,3 I 102.9
352,7 9 87,9 7
Table 18 Employment Characteristics for All Cohort Members
By Period of.~i~e
Port Arthur Refinery Update, 1937-1987
< 1940(n=5184}
Person-Years (%) ~o. Deaths (%) Percent Women
I78257.4 (33.9) 3827 ~(56.3) 3.2
Employment Duration Total Cohort Average
Ps0 White Males
Average
Ps~ Non-White Males
Average
Ps~ White Females
Average p~ Non-White Females Average ps~
26.,8 30..7
27,2 31.3
27.8 31.1
13.5 8.1
~8.3 9~6
interval Since Hire (yrs) Total Cohort Average
Ps~ White Males
Average p~ Non-White Males Average p~. White Females Average
Pso Non-White Females
Average
Ps0
44.5 48,1
44,9 48~4
43.6 46~9
39.1 48.6
~6~6 51,3
!940-1945 (n=5029)
_> 1945
170389~4 (32..4) 2191 (32.2) 18.5
177730.0 (33. 781 8.9
8.5 0.9
9.4 0~9
10.5
3.7 0~6
2,6 I.~
12~3 8,~3
13,1
12~6
6,5 3,9 7,3 7.6
33.,9 41,1
35.1 41.3
32~9 39.6
3.0.5 42.4
26.6 36.7
21.9
29.2
19.3 16,1
20.1 17.3
13.0 10.9
Table 19 Cause Specific SMRs for ALL COHORT MEMBERS by Period of Hire
Por~ Arthur Relirtery Update, 1937-i987 Expected De, ath~ ]]used on TEXAS DEATH RATES
Hired Before 01/01/1940 N=5,184 Hired Between 01/0111940 & 1.2f3111945 N=5,029 Hired After 12/31/I945 N=7,631
CAUSE OF DEATH (ICDA 8th REVISION CODES)
Hired < 1940
Observed
SMR
Hired 1940-1945
Observed
SMR
Hired > 1945
Observed
SMR
All Causes of Death Tuberculosis All Malignant Neoplasms
Cancer of Bucca! Cavity & Pharynx Cancer of Digestive Organs & Peritoneum Caaee.r of ]~sophagu~ Canoe r o f Stomach Cancer of Large Intestine Caneer of Ree turn Cancer of Biliary Passages.& Liver Cancer of Pancreas Cancer of Respiratory Sy~teni Cancer of Bronchus, Trachea, Lung Cancer of Breast All Uterine Cancers (Females only) Cancer of Cervix Uteri (Femailes only) Cancer of Other Female Genital Organs Cancer of Prostate (Ma, lcs on|y) Cancer of Testes and Other Male Genital Organ~ Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Ca ncer of C~ntrat Nervous System Cancer of Thyroid & Other Endocrine Glands Can~er of Bone C,~neer of All Lyre phzfie, l-lacmatopoiefie Tissue Lympbosarcoma & Reticulosarcoma
Hodgki~s Disease I~nkemia & Aleukemia Cancer of All Other L)~phopoiefic Tissue
Benign Neoplasms/Neoplasms of Unspecified Nature Diabete.~ lvfellit~s Cerebrovaseutar Disease All Heart Disease Rheumatic Heart Disease
tschem~c Heart Disease Chronic Endoeard. Dis.; Other Myoear& Insuff. Hypertension wi~h Hea.a Disease I-typertension w/o Heart Disease. Non-malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma
Bronchitis Emphysema Asthma
Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosis All External Causes of Death Accidents
Motor Vehicle _Accidents All Other Accidents Suicides Homicides & Other F..~ternal Causes
All Other Causes of Death Unknown Causes (In All Causes Category Only)
3827 2t 791 lg
218 10 60.
69 20 8 46 230 214
5 4
3 2
91 1. 16: 20 9 2 13 3
8 76 6 t2 32 26
16 73 358. 1503 22 1170 38 54 28 199 81 60 i4
41 5
2t
31 34 206 147 66 8! 45 14 414 I32
91.7 ** 90.6 103.9 83:2 102..9 58.8 118.0 118/4 129.0
5~.5 * 102.4 98.2 97.2 133.4 257.8 340.9 187:9 101.0 35.9 102.7 89.4 114,1 298.7 95.5 I27~6
225.3 110.8 48.7
205.2 * 105:2 130,4 218.8 ** 127.5 87.5 * 89,2 ** 118,0 83.0 ** 81.7 145,9 * 147.9 68.3 ** 61,8 ** 66;5 ** 84,3 60;6 ** 80.8
90.2 61:5 ** 110.1 70,4 ** 77.,4 ** 73,6 * 80.7 97,0 35.9 ** 85.6 **
219I 10 505 11 ~14 7 22 37 5 4 36 1.72 165 12 3 0 3 33 2 12 4 5 0 19 2 3 39 4 5 15 15 6 26 ,1.10 774 8 623
~ 15
3 129 45 35
6 26
3 7 32 14 194.
115 51 64. 45 34 193 I88
101.6 90.7 106.6 83;6 99:6 fi0.4 101;2
t08.4 6,t.2
37.5 * M0,0 10L1 10L8 1t5.2 75~9 ---~ 89.7 96.4 109,8
115.9 40,5 82.4 - -~ 160.2 134.4 167.5 93A 54,6 122.6 88,6 110.4 128.3 84.0 73.2 ** 96,8 65,3 96,8
15.9 ** 82,4 36,6 95.9 88;0 91.8 93.5 91,5 95.6 68:5 76.7 93.7 85.4
82,2 '* 70.7 '* 93:9 125.0 85.4 80,0 **
78I 77/7 2 44,2
1.86 88.9 7 113.9
45 99.1 6 ~09.fi 13 172.1 tt 78.6 1 33.~ 1 22.0
12 118,5 46 5&7 ** 44 5~.7 **
5 1.47.7 0 -0 -- 0 2 30.3 2 116.0 12 225.t * t 39.5 7 1.46~9 0 7 91.5 2 254.5 2 21:8.7 23 1.08.3 3 88,4 1 35;5 10 117.7 9 137.5 6 252.5 8 61.7 34 83,1 257 85.3 * 2 34.2 201 87.4 2 20:4 ** 3 35.2 1 36,7 18 41.3 6 34,4 6 63.1 1 6&l 5 77.4 0 -- --
0 16 53.8. ** 2 34.6
105 76.1 ** 52 66;8 ** 53 87.5 21 58.6 *
77 71;2 27
* SIGNIla'ICANT AT 5%, LEVEL; ** SIGNIFICANTAT 1% LEVEL-
Table 20
Cause Specific SMRs. for WI-IIq[E MALESby Period ofHire
Pot~ Arthur Refinery Update~ 1937-1987 "-~E~peoted Deaths Ba~d oat Tt~XA$ DEATH RA'FES
Hired Betbre 0t/01/1940 N=3,959
Hired Betwee~ 01/01/1.940 & 12/3.t/1945 N=3,243
Hired After i2/3ili945 N =5,406
CAUSE OF DEATH (ICDA 8th REVISION CODES)
Hired < 1940
Observed
SMR
Hired t940-I945
Observed
SMR
Hired > 1945
Observed
SMR
All Causes of Death Tuberculosis All Malignant Neoplasms
Cancer of Bue~al Cavity & Pharynx Cancer o1~ Digestive Organs & Peritoneum Cancer of Esophagus Cancer of Stomach Cancer of Large Intestine Canoer of P,e~tum Cancer of Biliary Passages & Liver Cancer of Pancrer~s Cancer of Respiratory System Caneer of Bronchus, Trachea, Lung
Cancer o Breast All Utorino Cancers (Females only) Cancer of Cervix Uteri (Females only) Cancer of Other Female Genital .Organs Cancer of Prostate (Males only) Cancer of Testes and Other Male Geni*al Organs Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye C~neer of Central Nervous System Cancer of Th],xoid & Other Endocrine Glands Cancer of Bone Caneer of All L},mphatie., Hnematnpoletle "Dssue
Lymphosarcoma & Retieulosaroma Hodgklns Disease Leukemia & Alenkemia Cancer of All Other Lymphopoietic T~ssue Benign Neoplasms/Neoplasms o.[ Unspecified Nmt~re Diabetes blellit u s Cerebrmra~ular' Disease All Heart Disease Rhe, umatle Heart Disease I~hemie Heart Disease Chronic Endoeard. Dis,; Other Myoeard. Insuff. Hypertension with Heart Disease Hypertension w]o Heart Disease Non - malignant RespiratoryDisease Influenza & P~eumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephriti~ & Nephros~s ,,adl External Causes of Death
Accidents Motor Vehicle Accidents All Olher Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category Only)
2948 14 608 I2 163 6 39 52 19 6 37 19t 178
0:
93.9 **
85.3 106,2 69.3 107,1 57L1 119.0 115.2 164.6 52.2 107.9 1fl2.0
i01.0
64
1 12
14 9 2 il 3: 6 63 5 8 29 21 12 48 253 1204 I6 973 22
31 21 i56 57 57 i3 40
4
17
26 20 163
115 52 63 40 8
324
82
106,6 53A 93.2
80.8 t23.2 332.4 90,3 150.9
22L9 115.9 49.t 165. t 115.7 147,5
229.9 * 116.4 89.2 91,9 ** 108,3 853 ** 63.9 * 156.8 * 212.1 ** 66;7 ** 58.4 ** 73.t * 91.7 66.2 ** 96.7 90.6 62X1 * 110.1 77,1 **
81.0 * 76.4 85.0 93.6 57.5
93.5
1640 6
356 10 78 4
I0
28 3 3
28 126 120
0
109.3 ** 87.6 II0.8 104,9 104~5 64.3 76.7 118.9 55,g
44.8 156,6 * 100,6 100.5 ---
0 --25 112 2 150.0 7 88.1
3 4!.9 5 96.8 0 --14 I48.6 2 187.4 2 16L6
31 l~,B 2 36.3 5 164.6 15 119.4 9 99,2 2 6Z7 16 81.4
72 78,4 * 616 104;3
6 70.3 509 102,1
I 5.8 ** 9 106;6 2 58.9 95 95.5 N 87.8 ~ 9&O 6 116.8 23 9f8 1 6i,0 4 53.9 23 73.9 8 t00,t 154 t01.1 95 95.8 45 87.6 50 104A 38 123,0 2t 146.1 146 91,7 140
592 81.7 2 72,3
132 87,1 5 1~8.3 30 95.4 1 35,4
9 180.0
I0 96, t
0
t 33.7
8 106.7 35 57,7 35 60.1
0
0 1 1 8
0 7 0 7 1 2 19 2, 1 8 8 3 6 24.
206 2
167 0 .....
2 1
22.0 65;4 I83.7
--t57.5 -~108~0 1~.3 301,4 114.5 72.2
43~4 121.3 162.2
180,0
96.6 90.1 47L0 91.0
## 47.6
4 35.8 5 69.6 0 ~ -5 93.9 0 --0 --16 69.2 1. 30,2 116 68,1
40 65.7 45 98,0
13
22
* SIGNIFICANT AT 5~%, LEVEL; ** StGNIFIC..~NT AT 1% LEVEL ## SIGNIFICANT DEFICIT AT t% LEVEL~ OBSER VED DEATHS = 0, SMR NOT CALCULATED
"l%~blc 21 Cause Specific SMRs for NON-~VH [I~ MALES by Period of Hire
Por~ Arthur Ratinery Update. 1_937-1987
01/01/1940 N= L045 Hk~d Betwe~ 01/01/1940 & ~/31/1945 N = 8ZI H]red~er 12~I/~9~5 N= 1.381
CAUSE OF DEATH (ICDA 8th REX~qSION CODES)
,hall Causes of Death Tuberculosis All Malignant Neoplagmg Cancer of Buceal Ca~4ty & Pharynx Cancer el Digestive Organs & Peritoneum
Cancer of E~ophagus C.~neer of Stomach
Cancer of Large Intestine C.ancer of Re~tum
Cancer of Bi]iary Passages & Liver Cancer of Pancreas
Cancer of Respiratory Sy_~tem Cancer of Bronchus, Trachea, Lung Cancer of Breast
All IJlerine C,'mcerx (Female.~ only) Cancer of CervLx" Uteri (Females only) Cancer of Other Female Genital. Organs Cancer of Prostate (Males only) Cancer of Test~s rind Other Male Genital OFgam
Cancer of Kidney Cancer of Bladder and Other Urinary Organs Malignant Melanoma of Skin Cancer of Eye Cancer of Central Nervoa~ System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Haematopoiefic T~ssue Lymphosarcoma & Reticalosareoma Hodgkins Disease Leukemia & AleukemJa Cancer o[Atl Othe~ Lymphopoietic Tissue
Benign Neop|asms/Neoplasms of Unspecified Nature Diabetes Mellitus Cereb.rovaseular Disease All Heart Disease Rhemnatie Heart Disease
I~hemic Heart Disease Chronic Endocard, Dis,; Other Myocard. Insuff.
H?~ertension with Heart Disease Hypertension w/o Heart Disease
Non-malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysema, Asthma Bronchitis Emphysema .Asthma
Ulcer of Stoma=h & Duodenum Cirrhosis of Liver Nephritis & Nephrosis .adl External Cat~ses of Death Accidents
Motor Vehicle Accidents
All Other Accidents Suicides Homicides & Other External Causes All Other Causes of De~th U:nkno~n Causes (in All Causes Category Only)
Hired < I940
Observed
SMR
Hired 1940-i945
Observed
SMR
805 83.3 **
7 107,0 163 94.0
5 122.1 50 9ff2
3 47;4
21 120;2 14 121.8
~ 2723
2 50.2
8 81.7 38 8&3
3~ 83,2 0 .....
399 783 4 113.8 98 92.4 1 33.9 26 85.1 3 60.4 12 162.0 ~ 58.6
0 1 33.5 6 103;0 35 94,2 3~ 96;9 I 6453
Hired > 1945
Observed
SMR
138 58.2 **
34 76. 9 1 57,3 i0 86.1 5 196_5 2 90,9
3 139,3 7 38.4 ** 6 34,7 **
27 89:6
3 12L9 6 124.5 0 ----
2 i83.0 0 2 255~8
13 10L5 ~ 53A 4 ~5;i * 3 62,6 5 95.5 3 ~60.8 21 148,9 98 83:7 281 80,3 ** 6 180:3 i84 7Z.0 :** 16 M6,1 23 M0~I 7 80-2 40 7426 22 69.8 3 2&0 ** t 43.5 1 14.5 *1 5L6. 4 93.4 5 65;7 14 115.0 37 47.4 ** 28 6L3 ** 11 53.5 * ~7 67~8 3 94A 6 24.2 *~ 84 65.9 ** 41
8 66.5
~ 234.7 0 -- 0 ~--
2 191.9 0 0 --4 51.3 1 91.4 0 0
3 274.4 ~ 121.2 30 64.5 117 69.3 1 48,5 83 71,4 2 33.1 5: 59.i I 2Z9 27 m0:7 12 87:0 5 88,6 0 3 91.7 2 t72.3 3 t30;8 6 86.2 6 102.9 31 49.3 16 3 13 76.3 4 167i0 I1 45.4 30 48,9 34
48.5 1 516,1. 3 384.1
169,8
0
3 86.8 1 235.2 0 1 71.5 1 ~.0 1 194.8 I 3:2.1 9 67,7 43 677 **
30 7.4~4 2 84.6 1. 25.4 0 4 37.9 * 1 18,3 1 54.3 t 445.7
0
0 - -- ## I 46,7 25 39.6 ** 15 53.5 * 9 61.2 6 44.9 * 2 66.6 8 26.0 ** 18 6:6,9 2
* SIGNIFICANT AT 5%, LEVEL; ** SIGNIFtCANTAT i% LEVEL ## SIGNII~'ICANT DEFICITAT 1% L,tSVEL. OBSERVED DEATHS = 0, SMR NOTCALCULATED
q'able 22 Cause SpecificSMRs for WHFFE FBMAJ~ES by Period of ttire
Port Arthur RefiaetyUpdate~ 1937-1987
Hired Before 0151/1940 N= 166 Hired Between 01/0t/1940 & ~/31/t94.5 N= 932 Hired ~ter 12D1]i,945 N = 680
CAUSE OF DEATH (ICDA 8th REVISION CODES)
All Causes of Death Tabereulosis All Malignant Neoplasms
Cancer of Bueeal Cavity & Pharyt~x Cancer of Digestive Organs & Peritoneum Cancer of E.~ophagus Cancer of Stomach Cancer of Large Intestine Cancer of 1}.eemm Cancer of Biliary Passages & Liver Cancer of Pan.ereas C~neer ofR.e, spiratnry S~lem Cancer of Bronchus, Trachea, Lung
Cancer of Breast All Uterine Cancers (Female& only) Cancer of Cervix Uteri (Females only) Cancer.of Other Female Genital Organs Cancer of Prostate (Males only) Cancer of Testes aud Other Male Genital Orga!~s
Cancer of Kidney Cancer of Bladderand Other Urinary Organs Malignant Melanoma of Skin Canee, r of Eye C.ant',er of Cem:ral Nervous System Cancer of Thyroid & Other Endocrine Glands Cancer of Bone Cancer of All Lymphatic, Haematopoietic ~ssue L)~np~osareoma & Reticulosarcoma Hodglfins Disease Leukemia & Ateukemia :Cancer of All Other Lymphopoiedc T~ssue
Benign Neoplasms/Neoplasms of Unspedfied Nature Diabetes Mellitus C~rebrovaseular Disease All Heart Disease Rheumatic Heart Disease Iseherric Heart, Disease Chronic Endceard. Dis.; Other Myocard. tnsaff, Hypertension with Heart Disense Hypertension w[o Heart Diseas~ Non -malignant Respiratory Disease Influenza & Pneumonia Bronchitis. Emphysema, Asthma
Bronchitis Emphysema Asthma Ulcer of Stomach & Du~lenum Cirrhosis of Liver Nephritis & Nephrosis
All External Causes of Death ,Accidents
Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes CategoryOnly)
Hired < 1940
Observed
SMR
72 0 ..... 20 1 5 1
3 0 0 ;1 1 1 5 4 3 2 0 0 1 0
0 0 .... 0 .... 0 0 0 0 0 1 4 7 17 0 12 0 0 0 ~ 1
120,2
146,2 519.9 139.5 817.2
206.0 -- ~ --135.2 59.2 6L9 20t.7 316,8 414.2 207.9
--449.4 ----
---
- --~~~ ------530~0 260.8 96,1 81.6 --73.3
---
59.2 55.5
0 .... 0
0 0 6 4 3 i 2 0 6 9
---
----210,9 195A 300.3 94.4 416.0
72,7
Hired 1940-1945 Observed SMR
148 0 50 0 .... 10 0
103.3
11.2.0
112.2 ---
5 2 0 2 11 II
10 3 0 ..... 3 0 0 1
1
138.2 319;9 --103.6 145.2 149,9 103,8 81.3
92,4
146A 284A
3 0 i 4 1 0 .... 0 3 i i 8
39 1
29
I I 0 7 3
21.7.3 --648,4 104,3 14L2
226,9 168.8 27.8 7L9 102,3 63.2 103~3 5t.7 89.5
882 97,7
~ --0 ---
3 85,8. 0 ---
9 78,4 4 55.2 3 69:7 1 33,4 3 i11.7 2 16 81.3 t4
Hired > 1945
Observed
SMR
47 128.3
19 i5g~0 1 646:3 5 242.4 ~} .... 2 659~2 1 i18.9 I 699.0
1 233.9 3 146,7 3 I51,1 5 i75,8
0 1 574~2
1 1712.9
1 93.4 0
224.1
2 1176.9 1 118,5 1 zi4.8 8 105.9
4 76.5
0 1 54 ,7 1 I42,5 0
5 98.6 4 133.1 3 152.4 t 95,0 1 77.9
7 1.33.0
* SIGNIFICANT AT 5%, LEVEL; ** SIGNIFICANT AT 1% LEVEL
Table 23
Distribution of Hourly and Salaried Workers All Cohort Members
Port Arthur Refinery Update, 1937-1987
Percent Time Salaried
0 (=100% Hourly) 25 50 75 90 1100 Unknown
No, Employees
14691 (82,3) 316 (1,8) 298 (1,7) 207 (1,2) 271 (1.5) 199i (11,2) 70 (0,4)
No, Deaths (%)
59~6 (8'7.2) 147 (2,2) 144 '(2,i) 92 (t,4) 109 (1.6) 346 (5.1) 35 (0,5)
Table 24 Cause Specific SMRs for ,ALL COHORT MEMBERS by ~PayStatus+
Port Arthur Refiuery Update, 1937-1987 E~cpeoted Deaths 3Bazcd on TEXAS DEATH RATES
Hourly N=14,691 .25-75% Sataraed N=821 90-100% Salaried N=2,262
CAUSE OF DEATH (ICDA 8th REVISION CODES)
.All Causes of Death Tuberculosis All Malignant Neoplasm s Cancer of Buecal Cavity & Pharynx
Cancer of Digestive Organs & Peritoneum Cancer of E~ophaffas Cancer of Stomach Cancer of Large Intestine Cancer of Rectum Cancer of Bitiary Passages & Liver Cancer of Pancreas Cancer of ?Re9piratory System Cancer of Bronchus, Trachea, Lung Can~er of Breast ,%11 Uterine Cancers (Female~ only) Cancer of CervL~ Uter~ (Females only) Cancer of Other Female Genital Creates Cancer of Prostate (Male~ only) Cancer of qi%stes and Other blale Genital Organ~
Cancer of Kidney Cancer of Bladder and Other Urinary Organs
Maligtmnt Melanoma of Skin Cancer of Eye Cane.er o Central Ner~ou,~ Syslem Cancer of ~yroid & Olher Endocrine Glands
Cancer of Bone Cancer of All Lymphatlie,. Haernatnpoie.tie Ti,q~ue Lymphosareoma & Reticutosarcoma Hodgkins Disease Ieukemia & Aleukemia Cancer of Alt Other Lymphopoietic ~I~ssue 13enign Neoplasms/Neoplasms of Unspecified Nature Diabetes Mellitus Cerebrovaseular Disease. All Heart Disease Rheumatic Heart Disease [schemic Heart Disease Chronic Endocard. Dis,; Other Myoeard. Insuff. Hypertension with Heart Disease Hypertension w/o Heart Disease Non -malignant Respiratory Disease Influenza & Pneumonia Bronchitis, Emphysenm, Asthma Bronchitis Emphysema Asthma Ulcer of Stomach & Duodenum Cirrhosis of Liver Nephritis & Nephrosls All External Causes of Death Accidents
Motor Vehicle Accidents All Other Accidents Suicides Homicides & Other External Causes All Other Causes of Death Unknown Causes (In All Causes Category On!y)
Hourly
Observed
SMR
:25-75% Salaried Obse~'ed .SMR
90-100% Salaried
Observed
S/v[R
5926
32 1284
30 323 22 84 98 .19 12 79 d~0~
381 14
5 1 .5
104
5 36 22 18
1 33 6
!2 I15
7 14 51 43 19 9t 431 2188 27 1704 41
:56 2I
311
113 93 19 68
6 23 68 48 492
324 153
171 101 67 587 331
96.5 ** 97.0 106.3 * 87.0 103,3 75.1 123.2 llL0 86.2 46,0 *~ 116.6 0;q.8
98,4 1t6.2 118~0 37,6 1.40.0 93.4 9373 138,1 75.2 118.1 t16;6 !20.8 I57.4 228.7 * 104.9 36:5 ** t3L8 1t0:0 128,4 158.8 t08. t 85,7 **
93.9 ** 88.2 89.3 ** 60.9 ~* 12I:6 81.5 79,4 ** 67.7 ** 80;6 * 92.8
79,4 66.1
73,8 67:0
~*
109.4
77.1 "~
82.61 *'~
76,3 **
88~9 103,8
56,4 **
84.3 **
383 5'6.4 ** 0 --87 88.4 3 104.8 24 96.3 1 ;~9,0 5 99,3 1i 147.0 ~ 220.7
0 =-3 53.3 20 5gA * 19 58;6 * 0 -- - 1 694:6 f t151.3 0
8 89~6 0 .... 3 .1~3:1 2 78;7 0~ 1 I241,8 3 129.0 O -- - 0 --9 9&1 3 183.7 t 117,3 2 50.0 3 tI1,5 4 433.1 * 7 104,3 37 92~8 148 743 ~* 2 80.8 119 71.0 *=*2 332 2 56,4 2 126,3
19 54~7 *'* 8 57.~ 6 56,2 2 105.5 2 24.4 * 2 308,2 4 150,7 5 6110 2 65,5
23 52.3 ** 18 53,5 7 49.1 1 ! 77.8 4 50.0 .i 18.6 38 68:3 * 7
455 71.7 **
1 34.1 10i 79,4 *
3 89.9
30 96.5
0 ----
6 98,5
8 81.4
3
l 37.5
~2 176,2
20 50-.5 *~
I9 50,4 ** 8 161.5 1 43.7 1 70.2 0 ---
8 89.0
0 ......
1 36,2
1 37.0 3 16.8
0 - -- -
3 89.5
1 2t.4.7
1 !83,6 t4 3 14~,3
3 2~8, t 4 77.8 4 111.0
5 365~8 *
8 84.3 30 59.0 ** 186 80.0 **
3 87.3 163 85.6 *
t 1.3.5 *
4 77.9
8 375,7 **
15 38,1 ** 10 59.0
2 18;2 **
0 2 24.6 * 0 ....
1 33~8 6 51.5 0 - -- #
30 41.2
23 51,5 ** 9 38.1 **
14 66: t
6 48,0 1 7.8 **
55 74.6 *
9
+ See text for definition of pay status.
* SIGNIFICANT AT 5%, LEVEL; ** SIGNIFtCANT A]' i% LEVEL # SIGN ,~ICANT DEFICITAT 5% LEVEL, OBSERVED DEATHS=0, SMR NOT CALCULATED.
Table 25 Lymphatic and Hematopoietic Tissue Cancers by Celt Type
~ Males Port Arthur Refinery Update, 1937-1987
Observed, Deaths
Expected DeathsI SMR (95% Confidence Limits)
ANIL (205.0)'CML (205.1) ALL (204,0) CLL (204.1) NHL (200,202)
t0 6 $ 3 30
3,082.
t 5.945 7. t 13.
10.044 42,233
62.7 84.4 259.6* 29,9* 7i.0
( 30~ I - 1I5.3) ( 31,0 - t 83.6) (11.2:1 ~ .51 i,5) ( 6.2 - 87,3) ( 47.9 - t01,4)
NM (203)
t9
19:390
98,0
( 59.0- 153.0)
I = Expeeled number of deaths based on rates tbr white males regardless of race (from Selvirt etal., 1983) 2 ~ Numbers:~n:pareaflaesesare~odesfortt~e Ir~ternafion~CtassificationofDi~ea~e~(ICD),gthRevi~io~ * = p<0.05
Abbreviations: AML = Acute Myeloid Leukemia CML = Chronic Myeloid Leukemia ALl. = Acute Lymphatic Leukemia CLL= Chronic Lymphatic iLeukemia NI--IL = Non-Hodgkin's L.v-mphoma MM = Multiple Myeloma
Table 26 S~tected Characteristics of DecedentsI with. Underlying Cause of Death Due to Acute Lymphatic Lettkemia
Port Arthur Refme~, Update, 1937-1987
Year of ID Hire
Age at Hire
Year Employ't Years Year of Terminated Worked Death
Age at Death
A 1910
32
1940
29.5 t940 62
B 1924 129 1959
34.8 1972 77
C 1936
22
11957!
20.9 t957 43
D 1943
54
1954
11.1 1962 72
E i944
43
1944
0.5 1983 82
F 1945
62
1956
t0.7 I956 73
G 1949
27
1975
26,7 1975 53:
H I953
22
1957
4.0 1961 30
i AI1 decedents were white males
Interval Since Hire
29.5 47.6 20.9 19.0 39.2 10.7 26.7 8~4
Note: Seven of the eight ALL deaths occurred in Texas.. Employees A, C, D,F, and G died in Jefferson County. Employees B and E died in Taylor and Nacogodoches counties, respectively. Employee H died in San Diego, Califo.nfia.
Table 27
Length of Employment Trend Analysis for Deaths Due to Acute Lymphatic Leukemia iPort Arthur Refiner3' Update, 1937-1.987
Employment Duration. Strata (yrs)
< 10
10-19
20+
Avg Employment Durali0n (yrs)
2,5
Obser~'ed Deafl~s Expected Dea~s
SMR SMR 95%. CI
2 1.25
I60.0~ 19..4-578.0
Chi square (trend): 0.23, p= 0.6333
I4.4
2 0.39
512.8 62.1-1652.5
3:3,0
4 1,45
2759 75.2-706.3