Document 5Y2E5BVo7z1qVN0B26d3D8Re
AR226-1307-6
HHaesalktehlalnLdaboErnavtiorroynmfeonrtal Sciences
1090 Elkton Road Newark, DE 19714.
EFpriodme:miRoolbolgaCyP.rLoegoraaamzd
`Tel: (302) 366-6594 Fax: (302) 366-5207
Date:
To:
Subject:
January27,2003
DPaauvleBRosasmesrety,,WaWsahsihnigntgotnonWoWorrkkss
BAnetchoknyEdPelary,tiLs,s WPaosrhteington Works
Leigh Belcher, Haskell Lab
Gary Jopson, Haskell Lab Rudy Valentine, Haskell Lab
Gerry Kennedy, Haskell Lab Barbara Dawson, BMP Richard Wilder, M.D., IHS
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Epidemiology Files
Cancer IncidenceReport 1950-2001
`All-Cause Mortality Report 1957-2000
`Washington Works, Parkersburg, West Virginia
Aftearhiatusofseveral years, | am pleased to announce the resumptofitohne
Epidemiology Program's Standard Cancer IncidenceandAl-Cause Mortality
Survelliance Program for U.S. DuPont sites.
Attached please find the subject report from the Epidemiology Surveillance Program. If you have any questions, please donothesitatteo phone me.
Robin C. Leonard, Ph.D.
000031 ED6Rz40506341745
CanceErpiIndceimdieonlcoegyforSuWravseihlilnagntcoenRWepoorrkts Site 1956-2001
InterporfSeurtveialatncieDoanta reporte"dThfisrormep1o9rt53cotnhsiosutgshof20t0ab1aletstshheowDiunPgotnhteWnausmhbienrgstoonf cWaonrckesrsciateseisn
Parkersburg, West Virginia. For each specific cause the numberof observed
cU.aSs.esCoismcpoamnpyarpeopdultoattihoennbuymtbheerraetxiopoecfttehdeboabsseedrvoendtthoetehxepeexripeenccteeodfntuhmebeenrtsire
of cases. This ratio is the Standardized Incidence Ratio (SIR). This ratio is calculated only for those cancers for which at leastfivecases are observed. This
uisnbikeeclayutsoegtihveeasntaytuisstaicfaullesitnifomramtaetsiofno.r sImnaaldldintuimonb,ernsumabreervsersymaulncleerrttahina,n a5nmday wtarlolndbsa. dAusn tSoIcRhvaanlcuae oofc1c.u0rainncdeic,ataenstdhsaetltdhoemorbosperravseadntnsuimgnbiefircaonftCpaospeuslaitsion
`equaltotheexpected, and therefore no increased risk is indicated.
Accompanying the tables is adescriptive text that summarizes the main points.
`SoofuSurvreilclancee Dasta
(Cancercasesthatoccur amongactiveemployeesarerecordedinthe U.S. Company-wide Cancer Registry that was started in 1956. Through 1988, caseswere reporttotehdeRegistry primbyadiraginolseys entered on Accident and Health Insurance (A&H) claims andbydeath certificatesthataccompalnifye insurance claims filed by beneficiaries of deceased employees. Beginning in 1977, these sources wers supplemented by Cancer Registry Report forms `submittedby Company Medical personnel. Beginning in 2000, ascertainmeontf cancer cases Is accomplished by a combination of Cancer Registry Reports from the plant sites, a screening of health insurance claims data, and case capture
from death certificates acquired for the Mortality Registry.
Cancercases are includedintheobserved numbers for the piant sits ifthe
dpleargsnoonsiwsoriskuendtkhneorwena,ttthehepteirmseoonfidiIangcnlousidse.dIFnothrecoba serfs voerde whnis cuh mthbedfeaotrretohsfe
last knownsite atwhichheorsheworked.
MetohfAonadlyssis
Todetermine expected numbersofcases forthestandardizedanalysis,
caanndc5e-ryienacriadgenecceartaetgeosrifoers DaurPeocnotmpeumtpleodyfeoerse,ascphecciafniccefrordgieangdneors,is5-oybesaerrvteidme., `"eTahcehno,tfhtehoCsoemcpaatneygo-rwiiedsebrayttehseasrietepmoulptuilpaltiiedobny.Tthheespeurmsoonf-tyheearpsrcoondtruiobvcuetrtteaodsll
`age groupsisthe expected numob fcaesers. This approach constitutes an
1
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E1DR6L4Os063a1s46
aignet-eamdaiulstsetdanedxapredcizteeddannuamlybseirs,s wahnidchisibsagseenedraolnlyacptrueafleprlraendtbpeocpauluasteioinsp.rovides.
TeofSs ignit ficas nce
statisticBaelglyinsniginnigfiwciatnht tihnecr2e0a0s2esSourrvdeelclraenacseesR.epHoortwse,venro,styhmeb8ol5s%wiclolnrfeipdreensceent cinhtaenrgvael.arFiorusn,dtthheecShIoRcwailolfbseigpnriefsiecnatnecde.leTvehlerofeapr=e0.t0w5o, wprhiimarcyusrteoamsaornys,fiosratlhsios msaogmneiwthuadte aorfbitthreardyi.ffWereanchea)v,ealdoencgidweidthttoheemspthaabsifitzyeofthtehesiezsetoifmtahtee(StInRe w(itdneth of itnhveesctoingfaitdieonn.ceHionwtearvvealr),, tasretmheaiinnsditchaattorIsfotfhepo9s5s%ibcloennfeideednfcoerIfnutretrhvearl includes 1.0, then that finding is not statistically significant fop=r 05. the expIetcmtaeydbneutmhbaetr,thbeutobtsheer9v5ed%ncuonmfbiedrenfcoeraipnatretrviaclulmaarcyasutsleinicslgurdeeat1e.0r.thIann fhaicstoirnssatsasnocce,iiattdeodewsintohttnhis meodecrateefoelsxlcowestshsaotaftchaersresscy.anIftbheennouocmcbupeaortfiopnearlsornissk oaftdtihleutpiloanbntyidsastmaallf,roemxctehsesrcesatncoferthmeorpblaindti.tyIwnoaudldditbioen,ditfhfeicduultratodteiotneocftebxepcoasuusree maybe100shortforeffectstobemanilestedby excesscancercases. `appearsTotopbroovaidneexadcdeistsoonaflcainsfeosr,mwateiohnaivnetIhnocsoerpsoirtauatteidonisntihniwshriecphortthearetable sthhoatwlsiassn(SwIitRhgoutrpeersatohntaanle2id.re5n.tiTfhiciastiwoinl)lienndaibvildeuuaslctaonceexracmaisneessuicthhtahtitnygpseas aangde datiadginaogsnioss.isT,hdeseudartoaafoefttmepnligoiyvomeenunst,aagnododthie lnengtdhoifatsictmoewabheettthweeireonofhninroet the pattem presented is indicativeof occupationalriskfactors being invohved. other faIcttsorvse,rsyuicmhpoarstasnmtoktionugn,dedires,taanldcothhoalt uesxsc,eosrsfarimsiklmyahyistoocrcyu.rTbheisctayupesooeff information is not accumulated and analyzed in the foutine Registry suveilance analyses.
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EIDR6L40506341547
PFlanit:nSoedcfiicSnumgmarsyo--f WashirgtWoornks 1958T-a2b0l0e1.1 isOfthteh.eca4n2cetrypiensciodfecncaencseurrvreeiplolratnecde orephoartvefoorcWcausrhreidngItnoenmpWloorkyse:es af Washington Works, only 14types had atleas5t cases observed. These types of
cancer were colorectal (32 cases), pancreas (9 cases), larynx (6 cases), lung (81 cases in males), malignant melanoma (14 cases in males), female breast (8
mccaaalsseeesss))),,, mlpryyoemslptohaiotdiedl(ea1u9nkdecrahnsiiesatsi)(o,8cykctiaidscensses)y,u(as18n(dc3aucsnaessspe)es,c)ib,flimaeuddldtesiriptl(ees18m(yc1ea4slceoasms)a,esb(r7iancimnaas(la8ass)i.n eExxccieupdtefdor1b.l0.adderand kidney, nonsofthe confidence intervals around the SIFls
rang"Tihneg SfIroRmf1o.r1b5l1a0dd3e.r0c7.anTcehresien mnaulmebseIrss1.i9n4d,icwaittehatnhein9c5re%asceodnfriidskenfcore bilnatedrdvearl
cancer in males. All cases were male.
fromTh1e.3S6I1Rf0.o3r.6k5i.dnTehycesaencneurmibse2r.s30i,ndwiictahtethaen 8in5c%recaosnefdidreisnkcefoirnktierdvnaelyrcaanngciengr in males." All cases ware male
Figures 1and 2comparethe incidenceratesofbladdercancerandkichey
cafon rWec stVe irgir nia females and malesto theratesfor the U.S.and Ohio,
basedondata fromtherespectiveStateHealth Departmentsforthe year 1998.
WWeessttVViirrggiinniiaamweonmetnentdatnodthoahvaevheihgihegrhreartersaotefs obfobtlhak ddei r, abduntdnbnoltaekddey eryccaancnecre.r.
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Figur1e
CIoncmipdaernicseoAncroofsK(si1d9W9nA8ey,ataOenhsdi)oB,laadnddetrotCaalnUc.eSr.
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Ba
4 us Women|
i: rar wa [r-- he
WestVirginiawomen have igher badder cance han racomparison gSrroouuprse, but their kidney cancer rate is the loow ftheefs emat le comparison
Figur2e. ComparisonofKidney andBladderCancer
Incidence Across WVA, Ohio, and total U.S.
(1998 rates)
ifo
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Additional Information Specific to this Site Report
`Bladder Cancer
`Bladder cancer is the sixth most common cancer in the United States,
`tehxactliundi2n0g0n3otnh-emreelwialnl obmeaabskoiuntc5an7c,e4r0s0. nTehwecAamsearsiocfabnlCaadndecrercaSnoccieertdyieasgtniomsaetdesin
the United States (about 42,200 men and 15,200 women).
UnitedISnta2t0e0s3,(atbhoeurte 8wi,l6l0a0lsmoebneaanbdou3t,81020,5w0o0mdeena)t.hs from bladder cancer in the The following risk factors have ben linked to bladder cancer: + Smolng: Smoking is the most important isk factorforbladder cancer. Caanndcgeert-cnatuostihneg bclhoeomdi.cFalrsomitn htoebbalcocood,stmhoekyaeraerefaebrseodrbbeydtfhrekoimdtnheeylsuanngsd collact in the urine.These chemicals in the urine damage the cals that ne + Wtoheriknseixdpeoosfutrhee:blCeardtdaeirnacnhdemiinccarelassuetshede icnhtahnecedoyfeciandnucsetrrydhevaevleopbienagn. pluintkweodrtkoerbslaadtdeisrkcaInf gceoro.dtshaleertyfpyrpaecsotifceisnadrusetrnioets fuoslelcohweemd.icSamlosktehrastwmhaoy Wdoevreklwoiptihngcabnlcaodrd-ecracuasnicnegr.chemicals have an especially high risk of + Race: Whitesaro twotimesmore ikalytodevelopbladdercancerthan +AgCarheer:oATnfrihicacarbnilsaAkdmoedfreirbclIaanndfsdl.earmcmaantcieorn:goWehsiupcwhirtohniacgebl.adder inftations such as
urinary infections and kidney and bladder stones don't cause bladder
+ ccPaaennrccseeorrn,ahtlahveheyisahtaohvriyegbhoeefrberinisasdksodsfeocrficoaratmneicdnewgriat:nhPoiettohipenlrsatowummhoeors.thuadvieesh.ad bladder become cancerous. + Birthdefofe thecblt adds er: Veryrarely aconnbeetc weetntiheo belnly
buttonandthebladderfailsto disappearasItshouldbeforebirthandcan
+ Useofthe herb, Aristocholia Fangchi:This Chinese herb, taken by `some people to help them lose weight, has been linked to bladder cancer.
Kidney Cancer
now casTehseoAfmKeirdinceayncCaanncceerr(1S8o,c7i0e0tyiensmteimnaatnesdth1a2t,t1h0e0rienwwill obe amibonuetth3e0nU,n8i0t)0ed
States Intheyear2001, and about 12,100 people (7,500 men and 4,600 women)
will die from this disease. These statistics include both adults and children and
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EIDR6L40506351250
pienlcvlisu.deRreennaall cceellll ccaarrcciinnoommaasisasthweelmloasst tcroanmsmitoinonatlypcaellofckairdcnienyomcaasncoefrthinearednsal.
the kidInneaybwohuetn501 %s odfisccaosvaesr,edt.heInreannalthceelrl c2a5r%cionfopmeaophlaes tohte csapnrceeardwoiulslibdee.. * hfoauvnedmteotahsatvaesigzreodwn(slporcealaldyfoaurttshiedreatwhaey)Kitdoneoyt,hearndparintstohfetrheembaoidniynsgu2c5h%asit wtihle lungs or bones.
`The following risk factors have been linked to kidney cancer:
++ OSmvoekriunsge:ofSmcoarktianign pdaoiunbklielsletrhse:riPsakionfkgielltetrisncgonktiadinneiyngcapnhceern.acetin were
a`ovnacielapbolpeuilnatrhneonU-npirteesdcrSitpattieosnfmoerdoivcearti2o0nsy,eabrust.they have not been
= Awsobreksptlaocse:aSnodmkeisdtnuedyiceasnschero.w alinkbetween exposure fo asbestosinthe
+ cCaandcemri.uAml:soT,hceardemmiauymbmeaayninkcrbeeatsweetehne ccaandcmeiru-cmaeuxsipnogsuerffeecatnodfkidney
-
psrmoodkuicntgs.sWuocrhkearssbactatnerbiees,exppaionstes,dtoorwceakdimnigummaitetrhiaelsa.ir from working with
+ bGaesniceucnhitasnogfesh(meutrateiTodhnesiy):atGreeytnh.eesraaraesmoandweeurpeofsDNeAoaumnrdpbaarrleenttehs.e
K`iCdhnaenygetsuomrorms.uStoatmieoonifnsthceesrteaicnhgaanngeesscaarneiinnhcerreiatseedth(e prisekowfiodtehpvaefllaompieilnyg
hicsatuosreydofbryelnaatlercdalalmacagnec,afrohraevxaaamnplIen,cbryecaisgeadrreitstke) asnmdokseo.mecan be
+ gveonneHmiuptpaetli-oLni(ncdhaaungsey)n,dirnocmree:asTehsitshdecihseaansce,escoafusreednablycealnlciannhecreirtaednd
Tuotbheerrotyupsessocflecraonsciesr:.Patientswho have this disease often have cysts in
cthaenckeird.neys, iver, and pancranedaarse more likelytoget renal cell
+ Ddiiestthaignhdiwnefiagth,atn:dSroemnaelscteuldliceasnschero.w a linkbetweenbeingoverweight,&
+ Lmoanyg-dteeverlmodpiaClysytssisi:ntPheeoiplkeiwdnheoyshtahvaetbceanengiovnedriiasleytsoisrfeonra acleolngctaincmeer.
+
Age:RCCis rare between the ages
in chidrenandyoungadult;it of 50-70 years.
i
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adults
= NGoentdeenro:ugMhanisakrneotwwnicaebaosutitkheelycatougseetsroafnarelncaellclaclalnccaenrcaesratroseawyofmoerns.ure
ohtohwetrocapncreervs)enttf.ySoiuncsemsomkoe,kiynoguisshliosukdedtqouitthAslscoa,nfceyro(uawsowrklwaitshto
`asboercsadtmioums,besure tofolowgoodsafetypractices.
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`Recommendfoar Ftoilloown-usp
kidWneeycarnecceormbmeenedxtahmaitnceodmpfloretaenywocromkmhoinsatloriiteiseosnoftohceccuapsaatsioonfablleaxdpdoesruarned, ant
tahnedmebdlaidcdaelrrecacnocredrs.beWroevailesowerdefcoormhmeenpdretsheantcceonosfidoetrahtairoinskbeacGtiovresn ftoorKcnay
determining the feasibility of conducting a case-cohort study. This approach
Wparososuvolcididaeptrfiooovrnisodnewoiatsnhetrahiseessehoesfaslcmteohnnottouotflcoetmxoepbsoe.suurTsehepedotdfeoenrstiailgalnltaohfendScuaecnnhcaeabrlscetaaunsdaeylsywz(oibunalgdgfdoerr and
Kidney)
`conducted by the APME shoud provide Important infomation abot cancer Itis important to remember that the ongoing TFE epidemiology study being
t`hoauttwciolmlbe einadtonleetaostcpaatretgoofrtihzeeeWxapossuhriesnfogWrtodirofkfnserecnothjoorbts./tIansakdsdiotvieonr, ttihmeewwoirlkbe
`usefulfor acase-cohort studoyf the entire plant workforce. There Ispotentialfor leveraging these efforts to productive use in the surveillance program.
1t can anas nyqw uese tior ns, please do not hesitatetocall.
Sincerely,
Robin C. Leonard, Ph.D. Principal Epidemiologist, E. 1. duPontde Nemours, Inc.
7
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1957-2000 . Epidemiology Surveillance Report
All-Cause Mortality for the Washington Works Site
InterporfSeurvteialatncieDoatna causesThriesporretpeodrtfrcoanms1is9t5s7ofthtraobulgehs 2s0h0o0wianlgtthheeDnuuPmobnetrWsaosfhdienagtthosn fWroormkasllsite idneaPtahrskeirsscbuormgp,aWreedsttoVitrhgeinniau.mbFeorr eexapcehscpteecdbifaiscecdaousnetthheeenxupmerbieernocfeoofbtsheerved ran`etunitoimriebsUec.reSol.sfcuCdloeaamttephdaa.onnylTyhpiofposrurltahataistoiesnbitcyhaoteushSeetsarnoadftaidoredoaiftzthehdefooMrbowsrhteairlcvihteyadttRaoltteiahoset(fSevMxeRp)ed.cetaeTtdhhissare oubncseerrtvaeidn., aTnhdisIunslibkeelycaoguisvtheeeasntyatiussteifcuall eisntfoirmmaatteisonf.orIsnmaaldldintuomn,benrusmbareersvery smaller than 5 may well be due to chanco occurrence,andseldom represent
significant population trends. An SMR value of 1.0 indicates that the observed
ninudmicbaeterd.of dAecactohmspiasneyqiunagl tthoethtaebelxepseicstaedd,esacnrdiptthievreatfeoxrtetnhaotisnucmrmeaasreidzerisskthise main points. `SoofuSurvreilclancee Dasta ianrethreoDpUeo.arSt.tahCdsottmohptaahtneoyRc-ecwguiirsdtaermyMoobnrytgataihcettyicvRoeergapionsrtdarpyletBnhesaniteofwniatessdseditmvapirlsiioeodyneitnehs1ra9o5ur7ge.hredDeceaoatrthdhesd certificates that accompany if insurance claims fled by banefcaries of
deceased employees and pensioners. Deathsare ascritbotehde observed numbersfortheplantsite atwhich
twhoerekmepdaltoyteheetwiomrekeodfartettihreetmiemnte.ofdeath,orthesiteatwhichthepensioner MatohfoAnadlvssis
To determin expected numbers of deaths for the standardized analysis,
`mortality rates for DuPont employees and pensioners, specific for gender, 5-year time,and 5-year agecategoriesarecomputedforeachcauseofdeathobserved. "Then, the Company-wide rates are multiplied by the person-years contributed to eachof those categories by thesitepopulation. Thesum oftheproductsoverall
aingteemgarloluypsstIasntdhaerdeixzpeedcatneadlyn sisu , whmiocfb hdeise atgehrnse.rTalhliysparpepfreorraecdhbcoencsatuisteutitepsraonvides
age-adjusted expected numbersand is based on actual plant populations.
1
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EIDR6L40506351856
Teof Ssignitficasnce staistcBaelgliynsniignnigfwicianht tihnecr2e0a0s2esSourrvdeelclraenascees.RepHoortwse,venro,shymebo9l5s%wciolnrfeipdreensceent hainiltsseorcvshaoalnmagerewo.huanFdtitsathr,ebitSahMreyAc.hwaWiilcesobehfapvsrieagsdnefneitcacdia.ndceefTdohleoevrmeephoafarespit=z0w.eo0p5ir,imwsahiirzlyee aocfusstctheonmSsarMfyRo,r is
(the magnitude of the difference), alongwith the stability of the estimate (the
`i1wn.i0vd,etshhteogfnatthtoehna.ctofnHifoniwidenevgnecires,niontterrsevtamala)ti,incasasltlthyhaesfiigntnhdifeiic9caa5ntt%ooorcfsornppfoi=sdsei0nb5,lcea nienfeodrvfoarlfiunrctuhdeers tmay be that the observed number for a parcular cause s greater than
htfahicesteoirxnspsteaacsntsceoedc,iniatutdmeodboewsri,tnbhouttthnitsehcmeeo9sd5sear%artyceofneofxlicodewesntscheoafitndtheeerarvetahlc.amnaybteshtainlloniuonmcccbluuepdraeto1if.o0pn.earlIsniosnks at the pant is smal, or the pian is acenty buif or acquired, xcess mortalty
would be difftiocdeutlectt because of the small probabilityofthis population having any deaths.
To provide additional information inthosesituations in which there appearstobeanexcessofdeaths,wehaveincorporated inthisreport atable thatlists (without personalidentification) individualdeaths ifthatcauseshowsan
- prasented s ncicative of occupational isk actos being involved `SMRgreaterthan 2.5. Thiswillenableusto examine suchthingsasage at death,durationofemployment,andthe lengthoftimebetweenhireanddeath. "Thesedataoftengiveus agoodindicationas towhetherornot thepattem other Iatcitsovrse,rsyucimhpoar3tsamnotktionugn,dedrisett,analdctohhaotl uesxec,esors friaskmmiahyiostcocryu.rTbheiscatuyspeeooff information is notaccumulatedand analyzed in the routine Registry surveillance analyses.
2 000043 10R6z40506351957
PFlanit:nSoedcific Snumgmasryo--fWashinglWoornks 195T7a-b2l0e001.isTthhaeoanllly-ccaauusesemsoroafldiatayisnurfvoreiwlhliacnchetrheepoSrVtIfRorwWaasshgirneagtteornthWaonrk2s0: w9e5r%eCdlis=ea0.s9e5s-o6f.b94l)o;oadnadnedublaotoidHcorhmeianrtg doirsgeaansseiinnmmaalleess((SSMMRF==239.755:; 9th5o%SCMlA=f(o1r.e14u-8m.3a0t).c Nhoetaerttdhieseexacsleusniomnalcefs.1.0 in the confidence interval around
Two olher categories of Gicuiatory system diseases were signfcanty
elevated. These were acute myocardial infarction (SMR = 1.38; 95% Cl = 1.151.84); and atherosclerosis and aneurysm (SMR = 1.98; 95% Cl= 1.17-3.14).
`Recommendations
WashAinngitnocnreWaosrekdsi.sAknfoeramrolreirasltfuyddyuoentohheaeratrdtidsiosaasaosait stniostsitondeiwdfniontdiengnatty any occupational risk factors. Wa recommend the folowing: 1. Consider undertaking a feasiolty assessment for acase-cohortstudyfor
heart disease, with emphasis on detailed exposure assessment and identification ofotherriskfac forht earo tdir seas se.
2. Provide additional communications to workers conceming the known risk factorsforheartdisease,andconsider on-site preventive programs.
If you haveanyfurtherquestions,pleasedonot hesitatetocall me.
Robin C. Leonard, Ph.D. Principal Epidemiologist E.I duPontde Nemours, Inc.
3 --:
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