Document B86b4gJQaDp2krgeKepqbz8XX

"H5 27 '90 12* 56 TO lr>03741S09i r^CM 4.poi\ed E?iaefflioicjg r3i ~.22 APPLIED EPIDEMIOLOGY INC. February 27, 1998 Ms. Wendy K. Sherman Manager, Vinyl Chloride Health Committee Chemical Manufacturers Association 1300 Wilson Blvd. Arlington, VA 22209 Dear Ms. Sherman: Enclosed please find our "baseline" results for the CMA Vinyl Chloride Study cohort Specifically, these results reflect our re-calculation of all causes of death reported by Dr. Wong through 1982, as well as several additional causes of death not previously analyzed or reported (due to limitations of the available analytical packages ofthe time) and wi th at least two observed or two expected deaths. Our cohort differs from that analyzed by Dr. Wong in that we have identified and corrected numerous errors, restored several hundred cohort members not included in Dr. Wong's analyses and discovered some additional deaths. The details of these differences have been presented in earlier progress reports, and the final description will be detailed in our final report to CMA. Three columns of results are presented in the accompanying table: the first column contains results based on our cleaned and expanded cohort using the United States mortality rates as the reference (methodologically most comparable to Dr. Wong's results); the second set contains results using rates for the states in which each plant was. is located; and the third reflects Dr. Wong's results. Almost universally, our results mirror those of Dr. Wong. Most exceptions are due to some re arrangement of specific causes of death within broader disease categories, often reflecting the way deaths are coded over different time periods and in different states (e.g., liver cancers and cardiovascular disease deaths). The one result which might be considered a 'new" finding is the elevated SMR for "connective and soft tissue" cancers (three-fburths of the way down on page two), with SMR"381 using the United States reference rates (95% confidence interval 1 S3 to 785) and SMR=367 using state referent rates (95% confidence interval 147 to 755), based on seven observed deaths due to these cancers. (continued) RO. BOX 2424 AMHERST, MA 01004 (413) 256-3556 FAX (413) 256-3503 BFG41720 BFG 01232 rE3 2" '98 12:57 TO J.T03741S091 FROM fipp I led E? i denu o I o jij T-791 3. 33 (Ms. Sherman, page 2) Biologically, this observed excess might be related to the well-known association between vinyl chloride exposure and angiosarcoma of the liver, as angiosarcomas (tumors of the blood vessels) occurring outside of the liver are classified as soft tissue sarcomas. On the other hand, deaths due to angiosarcoma of the liver but erroneously recorded on a death certificate simply as "angiosarcoma" without specifying "ofthe liver" will be classified as a soft tissue sarcoma as well. Unfortunately, it is not possible to determine from the death certificate whether this has occurred. Nevertheless, this association has not been reported elsewhere to date; therefore, we believe that you may have some obligation to report this finding to EPA under the Toxic Substances Control Act. Please feel free to call if you have any questions about these baseline results. Thank you. Sincerely yours. Kenneth A. Mundt, Ph.D. enclosure . C BFG41721 BFG 01233 3 i? *93 \.2.'5( TO 17037415291 FROTH Hppiied ~p t i o I ojy 7-731 F. 34 Page 1 o f 6 BpG4l 722 BFG 01234 3 I"1 '90 12:57 TO 1703741S091 FROM Applied p;aemioioqy T-781 P.05 aIP. 01235 BpG4H24 Page 3 oj 6 01236 BFG4172s Page 4 o f 6 01237 -=3 2" '98 12:59 TO 1703741S09 FROM applied piaemvoIoy T-731 P.06 Page o f6i BFG4l 726 BFG 01238 27 '9B 12=59 TO 17037416291 FROM Applied Epidenuaiajy T-791 P.2S 'O * I BFG41727 BFG 01239