Document DGZwYxVe5y7QzDgkQaMRBw3jQ

STATE OF COLORADO Roy Romer, Governor Patti Shwayder, Acting Executive Director Dedicated to protecting and Improving the health and environment ofthe people ofColorado 4300 Cheriy Creek Dr. S. Denver, Colorado 80222-1530 Phone (303) 692-2000 Laboratory Building 4210 E. 11th Avenue Denver, Colorado 80220-3716 (303)691-4700 Colorado Department of Public Health and Environment March 23, 1995 Hasmukh C. Shah, Ph.D,, D.A.B.T. Manager, Vinyl Chloride Panel Chemical Manufacturers Association 2501 M Street, NW, Washington, DC 20037 Dear Dr. Shah, I have received your letter requesting permission to transfer Colorado death certificates from ENSR Health Sciences to Applied Epidemiology Inc. for the cohort mortality study ofvinyl chloride workers. I have enclosed a confidentiality agreement to be completed and signed by the responsible persons at AEI. Once I have received the completed confidentiality agreement, I will be happy to sign and return the permission to release form for ENSR. Good luck with this important research. Sincerely, Carol J. Garrett, Ph.D. Chief, Health Statistics CMA 120551 CONFIDENTIALITY AGREEMENT REQUESTING PARTY: Linda D. Dell AFFILIATION:________ Applied Epidemiology. Inc._________ ADDRESS: P.ftl Bov Amhprst MA nmOA-?49A RECORD TYPE TO BE USED: -m-QsmMiQ Qhr(--OM ___________ SPECIFIC INFORMATION TO BE ABSTRACTED: Date of Death,* Underlying cause FORMAT REQUESTED: 0 CmMom* oo^v O Hedooiytrt D Tp OWwrlwHri STUDY PROTOCOL SUMMARY (Purpose, follow-back planned, how results wB be released): This is an update!of an epidemiologic "study initiated by the Chemical Manufacturers Association in the early 1970's on 10.000 vinvl chloride workers. Applied Epidemioloot. Inc, will use NDX to identify decedents through 199^; request death certificates for aach-atate. in which deaths occurred,, "`and combine death records with those collected by Kenneth A. Mundt Elizabeth Smith Linda D. Dell Rose Luippold Rainer Noess - _____________________ I agree with the conditions for access to and use of confidential vital records information. (Agreement is to be signed by tf and key users/reseerehers.) Data: Signature Data: Data: Signature Data: / / HEALTH STATISTICS USE ONLY SPECIAL CONDITIONS FOR ACCESS: Approved by: Approved by: caiis^aM,ifaBEigyiwfcau j--^ o.~uawf, am* Kjw Date: Date: // ** No individual will be identified and no follow-back will be conducted. CMA 120552