Document 5LE5g1YwOO3y11Eaa10nqYybJ

RUG-05-1993 08:18 '** UISTP UCM uestions & P.007/010 4* Ml | . J.U A for employees of Vista Chemical Company's Lake Charles VCM Plant in response to employee questions nswers at the July 14 meetings Q. What will Vista do If another brain tumor is found? place in an accessible location at the plant. It is antic ipated this should be completed in early August with A. We will continue to communicate with you re additions made as papers are received. garding what we are currently doing in response to the recent employee health problems and concerns. Dr. Dmmwright is actively pursuing the issue of medical screening for brain tumors; We believe our current efforts are the right ones to ad dress the present situation. Another brain tumor in Q. Based on the potential Inaccuracies of the near term would certainly add emphasis to our ef forts. However, it must be stressed that the recent brain tumors are not known to be related in terms of type or origin. death certificates, how can epidemiological studies be accurate? A. Many epidemiological studies are based on mor tality (death rate) from a disease. This is done for Q. Have we talked to other vinyl plants? A. Dr. Jack Drumwright, Vista Medical Manager, is discussing current health events with other chemical company medical directors to determine if other chemical companies are experiencing any brain tumor incidents, how they were discovered and what was done to respond to them. Vista also belongs to the Vinyl Institute and the Chemical Manufacturers Asso ciation. Those are industry groups that sponsor stud* ies of workers and promote safety and health practic es in the industry. Any pertinent information obtained will be shared with employees. * Q. Will Vista study our group, the LCVCM Plant? several masons, but in general, deaths are well de fined, consistently recorded, and the records are typi cally available. In many cases, mortality studies arc the only feasible type of study to do, especially for chronic diseases with long latency periods, such as cancer. However, the cause of death on death certificates is indicative of a judgment on primary cause of death and may or may not list complicating factors at the time of death, such as brain tumors. This may result m an underestimation of a particular cause, or an overestimation, such as a brain tumor that was due to a lung cancer metastasizing (spreading) to the brain. The result of any epidemiological study must be viewed with caution based on these potential prob lems, and efforts made to be as thorough and accurate A. We are currently attempting to review the medi as possible when reviewing records. cal and health records for employees and past em ployees known or suspected to have had cancer. Em 0. We don't care about studies with thou* ployees at the plant are providing us names and Dr. Drumwrijjht is attempting to find their records. This may be difficult because some records arc with Cono co and others may be held by private physicians. The matter of medical confidentiality and potential need for releases to obtain the information may slow the process. The plant population was included in the CMA study, which is in the literature binder available at the plant. At this time, no decision has been mode re garding further studies. sands of workers. Why don't you study us? A, A study of only the VCM plant, or even the VCM plant and our PVC plants, would involve a very small population and the results would probably not * be conclusive. Studies done to determine the relation ship of a disease or cause of death must have an ade quate sample size to assure that any differences, or excess, seen in death rates or disease rates, are not random occurrences, but are truly different from what the normal, or unexposed population would have. The reason for this is explained by two fundamen 4 tal statistical concepts that define the needed sample Q. How long wilt it take to answer our ques size (population studied) and power of the study, tions? which is the probability of detecting a real difference A. We cannot tell you exactly how long it will take in disease rates. The smaller the population studied, to address and resolve all of the issues raised by the recent employee health problems. Addressing your the less chance you have of detecting truly different disease or death rates. concerns and resolving the issues is a priority item with plant management and Houston staff. We have ordered relevant scientific papers not in our files to 1 (more) VAB.OOOl 192137 RUG-05-1993 08:19 UISTR UCM . Q.' What do we know about EDC/TARS expos ure effects? A. Quite a lot is known about EDC abort and long term exposure effects. Detailed information is availa ble to you through your plants hazard communication program and the Material Safety Data Sheets (MSDS). A summary follows. EDC is a central nervous system depressant and causes damage to die liver and kidneys. Short-term exposure to high concentrations of EDC is character ized by anesthetic effects as well as by headaches, dizziness, nausea and vomiting, weakness, trembling and stomach cramps. Severe exposure causes coma and death from respiratory and circulatory failure. Animal studies, mostly in mice and rats, have estab lished carcinogenic effects in rodents. EDC may be absorbed through the lungs, skin and gastrointestinal tract with resulting liver and kidney damage. 0. Can EDC and TARS be carried home on my clothes? A. Yes, under some conditions. Avoid contact with EDC by wearing protective gear and remove soiled clothing that is contaminated with ethylene dichloride (EDC). EDC is volatile at room temperatures and will evaporate rapidly. EDC does not remain in the air for very long. There is, however, a higher poten tial for significant amounts of EDC to remain in im pregnable surfaces such, as shoe leather. That is why only certain types of composition shoe soles are per mitted for plant workers. EDC has a very distinct odor at low levels. Many people smell it at 3 ppm or less. It's odor is a good warning property. Contami nated clothing should be properly stored until cleaned or destroyed, which will depend on the situation. Shoes with contaminated uppers should always be de stroyed. The danger with "TARS" is very similar although TARS are heavier in nature and may evaporate more slowly. The potential for TARS contaminated cloth ing to cause chemical bums or slowly release vapors into a storage area is even greater than that for EDC, Contaminated clothing should be professionally cleaned or destroyed, depending on the situation. Q. Can't one molecule of a carcinogen cause cancer? m A. This question cannot be answered with a simple yes or no. There is much scientific debate over what level or dose of exposure to a carcinogen will result in cancer. Most toxic chemicals have a threshold level below which no effects arc known to occur, or their effects arc reversible. This is based on our knowl edge of how the body "handles" the chemical and the way the toxic effect occurs. However, wc do not know as much about the wav carcinogens cause cancer, and cannot say for sure if a threshold exists, or if one exposure can cause cancer. P.008/010 There is clear evidence that the potential for cancer to occur is reduced when overall exposure is reduced. Q. A film shown In 1972 sold glioblastomas were s result of VCM exposure. Has this changed? A. We cannot find the film mentioned in the em ployee meeting. Before 1974, there was little, if any, information available regarding the chronic human health effects of vinyl chloride. Even in the 1974-76 period, when VCM became strictly regulated, the in formation available was mostly about the incidence of liver cancers, specifically angiosarcomas. Brain tumors, or glioblastomas, have been found in various studies of vinyl chloride exposed workers. The evidence showing the relationship between VCM and these tumors is conflicting. Q. Haven't more than 100 angiosarcomas been found in workers exposed to PVC and VCM? A. There is a worldwide angiosarcoma register kept. On this register there are currently 13S cases that have been reported. Thirty-eight of those are from the United States. Conoco Chemicals and Vista had none to report. Q. What about HCI and chlorine effects? A. Detailed information regarding the health effects of these chemicals can be found In your plant's hazard communication program. In summary, both of these chemicals are severe ir ritants to the eyes, skin, and upper respiratory tract. Irreversible tissue damage can oocur as a result of short exposure to high concentrations. The strong ir ritant properties serve as a good warning and, in gen eral, prevent long-term exposures. Many people can detect the odor of chlorine and HCI at levels below 0.5 ppm. Long-term or repeated exposure to chlorine and HCI may cause concision of the teeth, chronic irrita tion of the skin, and chronic lung damage. Q. Are EDC releases and exposures reported to OSHA? A. No. There is no specific requirement to report EDC releases or exposures to OSHA. The VCM standurd requires reporting "emergency exposures", under certain conditions, to OSHA but thera is no such rule for EDC. If five or more people are hospitalized as a result of EDC exposures during an emergency, a report to OSHA is required. * Q. Why don't you document high EDC expo sures tike you do VCM exposures? A. We do not document EDC exposures exceeding (more) S VAB.0001192138 , AUG-05-1993 08:19 1 UISTA UCM . the permissible exposure limit with a letter to the cm- . ployee as we do for VCM. However* it is routine for the plant to investigate over-exposures and emergen cy releases for all chemicals, including EDO* EDC exposure records are maintained in the same manner as VCM exposure records. Asa result of the company's investigations, infor mation is developed and kept regarding those people that had high exposure during any emergency. -- ' P.009/010 MJ.J1 raj A Q. Can different people get different can* cars from the same exposure to the same chemical due to Individual differences? individual has a distinct biochemical make-up. These individual biochemical differences can result m different responses to toxic chemicals or other stresses. Individual susceptibility can also vary due to such things as genetics, race, diet and age. Q. Do studies look at the total number of employees exposed or total number of em ployees at the plant? A. Each study is done differently. However, in gen eral epidemiological studies attempt to look at ex posed populations and not alt employees at a plant site using that chemical. The vinyl chloride studies that are available have looked at various plant popula tions and generally attempted to include only exposed or potentially exposed workers. Q. Do the chemicals here, VCM and EDC, have a cumulative effect? A. VCM and EDC are metabolised by the body and eliminated through various routes. They are not known to accumulate in body tissues the way lead does, and exert effects as a result of remaining in the body. r Q. Since Ross & FogJeman are the reason for this meeting wilt there be a study of their work habits? A. If we decide to do further studies of the LCVCM plant employees, this may be a part of the study. At this time that decision hasn't been made. We do know that in the early 70*s, the exposures at the plant due to general work practices were higher than they are today. Q. Are two brain tumors in a short-time in a email group like ours indicative of a prob lem? A. We don't believe so, especially not when they are of different types. Also, both arc found in the general population and are a "common type". Q. Would the problem Dan Ross had showup on the van chest X-Ray? A. No. Q. Did Dan Ross* cancer spread from an other site? A Medical information available to us does not indi cate any spreading. O* Did Mr. Fogieman have any apparent algns/eymptoms from the van exam? A. Several health problems were noted in the last exam, but were believed to be unrelated to his brain tun?2f` **wever, it is believed that his cancer was a rapidly growing one which developed since the last van exam. 0. Is Vista looking at any other tests be sides Cat Scans? A. Yes. However, there are no known direct screening methods to detect brain tumors. There are tests available that measure central nervous system dysfunction which may indirectly indicate a brain tu rnon We are evaluating the usefulness of the availa ble tests. Q. Are there brain tumors at Oklahoma City and Aberdeen? A. One has been seen at Aberdeen In the past. This tumor did not originate in the brain but spread from another site. This tumor occurred prior to 1984. t Q. What about the causes of death among children of employees? Will you look at those? A. We will look at all data presented to us if appro priate releases are also provided for these family members. Q. What are the types of cancer Ross & Fogleman had? A. According to the information available to us Ross cancer was Glioblastoma Multiforme (astrocy toma) and Fogleman's was Adenocarcinoma (meta static). Q. Will you get more info on Ross & Fogleman? A, We hope to, but this depends on the employees' wishes and approval. Q. Why isn't a Cat Scan part of a routine physical for us? w wm * wi *-! i nvi a routine screening u, a very specific diagnostic test ordered after consulta tion wah the appropriate physician and based on symptoms and medical findings. (more) VAB.0001192139 AUG-05-1993 08:20 UISTA UCM 9 * Q. What arc possible signs and symptoms of a brain tumor? A. The location of the tumor within the central ner vous system) and its biologic behavior determine the way the patient's signs and symptoms are presented* When a tumor grows slowly in a "silent" area of the brain, it may first cause a headache, nausea, vomiting, alteration in personality or changes in the level of consciousness due to increased intracranial pressure. A tumor within the speech or motor areas may cause general weakness, or dysphasia, long before other signs or symptoms are present Q. When used as a follow-up to signs and symptoms, can Cat Scans always detect tu mors? A. CT scanning provides the ability to visualize the central nervous system and possibly the early di agnosis of tumors. The addition of IV or IT contrast material has increased the detection of hidden tumors. Tissue diagnosis of intracranial tumors is required before beginning therapy. Despite the increased sen sitivity of current imaging techniques, many diseases - including tumors * may not be detected by this meth od. Q. Does cigarette smoking cause brain tu mors? A. There is no confirmed Jink between cigarette smoking and primary brain tumors. However* cigar ette smoking is well known to contribute to lung can cer which can frequently spread to the brain. Also, cigarette smokers in general have a higher susccptibil ity to many diseases. Q, Why do Vista blood results use higher normals for comparison? A. Ranges used for comparison are guidelines only, and vary between laboratories due to different Instru ments, methods, etc. It's important to remember that the normal ranges developed and reported by any la boratory are scientifically developed and reviewed by independent accrediting organizations. Also the nor mal ranges are based on data from different popula tions and regional differences may be seen. Q. Why do the van testing results take so long to get? A. Vista's medical department is notified immedi ately of any significant abnormalities found in the test results. Dr. Drumwright then notifies employees. The full report is generally provided to the employ ee at the time of the hands-on portion of the exam. However, if an individual wants his prior to that time, he or she can be provided with the report when it is first available from Health Examinetics. This is usu ally a 4-6 week time-frame.