Document BRBnaze2Zyg4aZNRaxBoNzv5X

PROTECTED MATERIAL - MONSANTO INSURANCE COVERAGE LITIGATION August 1,1 980 MMWR 359 HeatWave - Continued Reported by H Bruce. MD, C Centner, MD, J Willierrti, MBA, RD Wodmer, MD, St Louis City Dtv of Health. HD Donneft Jr. MD. State Epidemiologist. Missouri State Dept of Social Services, CS Petty. MD. WJ Lene, Institute for Forensic Sciences, Defies County, Texes, JR Williams, MD, EL Berry. MD. Dattas Health Dept, CR Webb Jr. MD. State Epidemiologist, Texas State Dept of Neafth. JP Lofgren, MD, State Epidemiologist. R Young, MD. S FiUhugh. MD, Arkansas State Dept of Health. Bur of Epidemiology. CDC Editorial Mote. Because there is no agreed-upon definition of heatstroke or of the other illnesses that make up most heat-related mortality, a retrospective assessment of all death certificates within the affected areas will be needed to determine the impact of this heat wave. At this time, since there are unavoidable delays in reviewing death cer tificates in most jurisdictions, CDC has no estimate of heat-related mortality. The preliminary data reported above concur with published analyses of previous heat wave mortality in the United States in implicating poverty as an important risk factor (7) In possible contrast to the reports of large numbers of deaths in elderly people and urban residents in previous heat waves, the St. Louis data suggest that the additional deaths this year as compared to 1979 were not confined to the over-65 age group. The definitive results from Arkansas are expected to be useful in estimating the potentially considerable numbers of rural residents experiencing heat-related mortality. Reference 1. Hensehel A, Burton LL, Margolies L, Smith JH An analysis of the heat deaths in St. Louis during July 1966. Am J Public Health 1969. 59 2232-42. Glioblastoma Cluster in a Chemical Plant -- Texas In November 1978, a Texas petrochemical worker informed a local office of the Occupational Safety and Health Administration (OSHA) that he and several of his former coworkers had been diagnosed as having brain cancer. Epidemiologic investigation was undertaken and, while still ongoing, has identified 18 deaths due to orain tumor in former employees of a large, diversified, petrochemical plant on the Texas Gulf Coast (7). The workers' death certificates listed malignant, benign, or unspecified primary brain tumors* as the primary cause of death. Review of additional information has revealed that 15 of the 18 tumors were glioblastomas. Of the remaining 3, 2 were meningiomas and 1 was an astrocytoma grade I To determine whether this number of cases exceeds the expected, a cohort mortality study was initiated. Seventeen of the 18 cases met the study's case definition (death certificate diagnosis of brain tumor, white male, date of death between 1940 Bnd 1979) After appropriate adjustment for year of death and age at death. 11.2 such cases would have been expected (SMRt = 152) Preliminary analysis revealed a trend of increasing excess mortality with increasing length of employment t<10 years, SMR = 95,10-<20 years, SMR = 131,>20 years, SMR =304) Preliminary review of work records for the 18 cases reveals no obvious common exposure factor within the plant The cohort mortality study, a case-control study, and characterization of potential industrial exposures will continue. 'Categories 191,192,225. end 238 of the 8th revision of the International Classification of Diseases, adapted This case count does not include the original caller, whose cancer was determined to be metastatic, but does include his 4 coworkers. tStaoderdued Mortality Ratio - observed/expected X 100 STG 2433958 RSV0034005 PROTECTED MATERIAL - MONSANTO INSURANCE COVERAGE LITIGATION 360 MMWB August 1, I960 Glioblastoma - Continued Reported by Houston South Area Ofttce and Division of Technical Support. OSHA, Industry-wide Studies Br, Drv of Surveillance, Hazard Evaluation and Field Studies, National Institute tor Occu pational Safety and Health. CDC. Editorial Note: Bram cancer has been associated in humans with only 1 occupational agent, vinyl chloride 12). although numerous other agents, such as acrylonitrile, cause brain cancer in animals (3) Epidemiologic investigations have shown excesses of brain tumor m chemists ) and associations between brain tumor and employment in oil refineries and chemical plants iSfi). v The uniformity of cell type among these cases distinguishes this group from clinical , series in which greater histologic variety is noted Glioblastoma multiforme was, however, the predominant cell type among brain tumors in workers exposed to vinyl chloride {2). Since determination of vital status is complete in only 47% of the cohort in this study (3,106 out of 6,677 workers) and because the expected number of cases is calcu lated by assuming that those workers not yet located are still alive, the estimated SMRs probably underrepresent the true excess of brain tumor mortality in this population. Determination of a causative agent in this episode awaits further study. References 1 Alexander V, Lelfmgwell S, Lloyd W, Waxweiler R, Miller R Brain cancer in petroleum workers- > case senes report. American Journal of Industrial Medicine (in press). 2 Waxweiler RJ, Stringer W, Wagoner JK, Jones J, Meoplastic risk among workers exposed to vinyl chloride. Ann NY Acad Sci 1876.270 40-8 (Continued on page 365) TABLE I. Summary -- cates of specified notifiable diseases. United States ICumulaova totals include tamed end delayed reports through previous weeks.) DISfASf Aacpbft jnanwgttsk BruoilOM Ctotkanpox Diphthan* Ciipaptal'M foiwv tardiroptid borne A owpoc | Pest HifecinMii Hepatitis, V>rai Type B Typa A Typ* UMptefod Maiem Meefta IntbeoUl Merwruncoecal mfocoons Total Dvilan Miliary AWips Pai-ninn Rubella (German mRilai) Tetanus Tgbamitovi Tu'eram*# Typhoid fova. Typhus lever tiefc borne IRhy Ml spotted) Venereal ddeatet Gonorrhea Crvf in NMnyy Syphon pooiery 6 mcadyy Cwrfien Military Repeal m anunali 30th WEU EN9IN6 My M. 1110 123 2 802 11 3 379 549 207 *4 158 32 32 51 52 33 2 385 7 3 56 My 21 117$ 218 1 TH - 28 1 437 176 19 104 94 53 l 62 77 87 1 309 1 10 69 20,398 4.09 810 8 127 19.531 451 448 10 95 MEDIA* 197$ IDT* 174 8 T77 l 26 B 309 624 160 19 227 24 24 ea 157 41 106 2 630 a to 55 21,669 574 486 9 *78 CUMUUTIVY FIRST 30 MEEKS Mr is flu MrZI 1179 j MEfUAN j TIH-rart 2/214 101 153,373 2 345 120 4,727 15*281 6,731 1 .062 12,395 1,701 1,494 7 6*735 723 309) 37 15*702 86 229 540 2,246 80 164,202 6 351 156 8*146 16*886 5,740 367 11,231 1, 141 1,743 18 10*614 733 10,399 36 15*901 105 260 541 1*716 121 143,322 34 399 156 8,573 U*889 4,928 289 22*650 1,144 1*137 IT 15.244 733 14*380 36 17,322 80 216 561 550,185 15*215 14*812 174 3*832 553,305 15,360 13*662 1T1 2*789 551*768 15.629 13.662 176 1*73? TABLE I) Notifiable diseases of low frequency. United States Ambre* fiptuhim Cholera Congenial ruUUe ayndrpme Kahf It leprosy Lepiotprfovt (tow* 2 Flo. 1 Hawaii 11 Meow* CUM INC 25 4 19 105 36 PoiiomyiiiXit Total Pe*iyiK PmacosisIMass. t Fie 1, flush Habeas m man TridMOMiDlf 11 I) Typhus torar ftaabornelendernc murine) ITa, 1) Alt delayed repons will ba indited ei *> following war* a cumuiatry* jotali CUM till 6 4 47 72 40 STG 24-33959 RSV0034006 I I PROTECTED MA'^jjj^JAL - MONSANTO INSURANCE COVERAGE JTIGATION August 1, 1980 Gliuolasxoma - Continued 3 Mpltom C, Ciliberti A, DiMaio V Carcmog .y bioa^ays n rats of acrylonitrile administered b\ inhalation and ingestion Med Lav 1977,G8 <*uj A Olin GR, Ahlbom A The cancer mortality nmong Swedish chemists graduated during three dec adet Environ Res 1980.22 154 60 5. Theriault G, Goulet L A mortality study of oil refinery workers Journal 6f Occupational Medicine 1979,20 367-70. 6 Thomas TL, deCoufle P, Moure-Erase R Mortality among workers employed in petroleum refinery and petrochemical plants Journal of Occupational Medicine 1980.22 97-103 Follow-up on Mount St. Helens July 22 eruption of Mount St. Helens Mount St. Helens erupted 3 times on the evening of July 22. The eruptions (and their approximate duration) were at 5:13 pm (2 minutes). 6 26 pm (10 minutes), and 7 00 pm (3 hours), and effectively blew out the developing dome. Individuals with permits to be on the mountain were cleared from the hazardous zone aftBr the earthquake activity began; no fatalities occurred. There was some pyroclastic flow in the direction of the Spirit Lake area, but no mudflows or significant ashfall on the mountain. These eruptions, therefore, should not significantly increase any exist ing risks of flooding or other dislocations in the area. The ashfall was east-northeast of the mountain, in the general direction of the plume from the first eruption on May 18, although the total ashfall was less. The most heavily affected area was in northeast Washington, north of Spokane The hospitals in the CDC surveillance network, as well as other hospitals in the plume trajectory, rapidly provided unofficial estimates of ashfall in their communities Ait of the hospitals reported a 0to 1/8-mch accumulation, except in an area in northeast Washington (including Chewelah, Coiville, Ruby, and Metalme Falls--all north of Spokane), where 1/8-1/4 inch of ashfall was reported. Preliminary data on total suspended particulates (TSP) from the Environmental Pro tection Agency (EPA) Region X (Table 1) showed TSP increases in the plume path during the 24-hour post-eruption period, the peak levels measured were considerably lower, however, than those measured after the May 18 eruption. Addy, which is In the area that received the heaviest fallout, had an unconfirmed report of TSP of 4,497 jig/m3. Yakima and Richland, on the fringe of the plume, and Spokane showed lesser increases. TABLE 1. Preliminary reports of total suspended particulates (TSP) measurements. July 21-24,1980 Station Date Time frame (hours) TSP (ug/mM Addy Yakima Richland Spokane July 23 July 20-21 July 22-23 July 23-24 July 22-23 July 21 July 22 July 23 July 24 0-2400 900400 1800-1100 1100-900 600-600 0-2400 0-2400 0-2400 0-600 4,997 100 850 427 1,394 165 271 655 278 L STG 2*33960 I I RSV0034007