Document D1BYD8M8k6r8Gd0zK8npxV5

July 5, 1994 Clark Heath, H.D. Vice President for Epidemiology and Surveillance American Cancer Society 1599 Clifton Rd., N.E. Atlanta, GA 30329-4251 Dear Dr. Heath: FOR DISCUSSION AND REVIEW ONLY not for release I am writing this letter on behalf of the Chemical Manufacturers Association Vinyl Chloride Panel to express our concerns with a statement which occurs in the first full sentence of page fifteen of the American Cancer Society publication, "Cancer Facts & Figures - 1994." Referring to various risk factors for the production of lymphoma, this statement reads as follows: "Other possible risk factors include exposures to herbicides, industrial solvents, and vinyl chloride." We believe that a misunderstanding of this statement lead to the association of vinyl chloride with the incidence of lymphoma in an article in the April 25, 1994 issue of TIME Magazine (page 60). The description under the table entitled, "The Big Killers," implies that vinyl chloride exposure is a known, rather than a possible, risk factor for the production of lymphoma. Our concern is that this is an example of how others may misinterpret the statement in "Cancer Facts & Figures - 1994." Many studies have been conducted to better understand the possible health effects of vinyl chloride-exposed individuals. In some studies, an increased incidence of lymphoma was noted, but not in others. However, the largest epidemiology study ever conducted on vinyl chloride-exposed workers found no increase in the incidence of lymphoma. Presently, we believe there is insufficient evidence to establish a causal relationship between vinyl chloride exposure and any type of cancer except angiosarcoma of the liver (ASL), an extremely rare cancer. This view is consistent with the conclusion of Sir Richard Doll in his review of the human epidemiological data on vinyl chloride (Doll, R. (1988): Effects of exposure to vinyl chloride, An assessment of the evidence. Scand J Work Environ Health 14:61-78.) We respectfully request that a clause be added to the statement in question to correctly reflect the status of what is known about vinyl chloride. Possible wording to be added is (underlined and italics), R&S 144738 "Other possible risk factors include exposures to herbicides, industrial solvents, and vinyl chloride, although the evidence for a causal link with vinyl chloride exposure has not been established."