Document J3rkdy5Ejew8qMmQgMamyyEJZ

V PROPOSED PROGRAM FOR MAINTENANCE MEDICAL RECORDS 1. Meet with Bob Bruno and have MID evaluate existing medical records computer programs and come up with one or a modification of one MID feels will provide us storage and recall of our examination records according to any parameter desired. (1st meeting held 25 October) 2. Meet with Personnel and/or medical persons at plants and obtain agreement or a suitable permanent medical record card for all locations. Use this card to record data and remarks from examinations and as a source document for computer input. (Discussed with M. Spurlock 29 October 1974. Discuss with Messrs. Spurlock-& Ball Wednesday, 30 October 1974). * 3. Meet with Drs. and Dr. Kuschner on standarization of pre-employment physicals, follow up physicals, and data to be kept. 4. Have MID people meet with Drs., who have previously agreed on medical data required for permanent records, and outline procedure for gathering of data, transmission to computer, recall, and who has authority to recall such info. Review personnel work record and requirements at this time. 5. Have MID report back results of study and proposed system. Circulate to Drs. and Dr. Kuschner, Martin Spurlock. Len Ball, Plant Managers, and Valley Forge Management for approval. 6. Following any necessary modifications, complete program and start gathering personnel work history, medical exams performed so far, and complete personnel record card. When all data has been gathered, prepare for transmission to MID. Use Industrial Hygienist to accompany MID team to assist in gathering information. 7. Industrial Hygienist to establish semi-annual audit to review records during visits to plants--assume by report that examination follow up is being recorded and then transmitted to data processing. AP00002914 A Gi&mccct&- CHEMICALS GROUP Five Executive Met), Swedetlord Boad, Wayne, Pa. 19087 October 23, 1974 Dr. Marvin Kuschner Professor and Chairman Department of Pathology State University of New York South Campus Health Science Center Building 6, Room 133 Staneybrook, New York 11790 Dear Dr. Kuschner: At the request of Ross Adams, I am transmitting to you the results of a conversation with Mr. Nick Wheeler, Teclmical Manager at the South Charleston Plant of Union Carbide. They have been conducting SMA-12 tests on all of their employees for approximately five years. Enough of these data have been reviewed for them to be in the position to state that they see no significant difference in the number of abnormal results in PVC workers as compared to administrative personnel or workers with other industrial exposures. These data have not been published, but they have been discussed by various Union Carbide personnel at intra-industry meetings over the past few months. Nick suggested that the best method of sharing this informa tion would be for some qualified physicians to call their Dr. E. Q. Hull, Divisional Medical Director at 304-747-4714 or Dr. R. W. Holland, Jr. at 304-747-2525. He sees no problem in making this information available to any competent person or group interested in the problem so long as the anonymity of the worker is protected. He is reasonably sure that the same data are available from the Texas City Plant. This can be confirmed through Dr. Hull. Nick is willing to assist us if it is needed in obtaining the infoimation. AP00002915 Dr. Marvin Kuschner October 23, 1974 Page TVo Dr. Blalock has expressed interest in the past in making comparative studies of industrial cohorts. It seems that we have available here a very good start on this type of program. Please let me know if I can be of assistance or obtain further information for you on this subject. /dw cc: Dr. Blalock A. R. Adams T. L. Carey R. Fleming J. T. Sebastianelli Mayo Smith AP00002916 &fikfyoducti- mut CfimicaOtV ,wc* INTEROFFICE MEMORANDUM J. Odom T. W. Herbig From Howard L. Watson Date 25 October 1974 Subject VCM - Physical Examinations - Former Employees. Re: My letter 23 September 19/4 on the subject. Pensacola Calvert City (Location, Organization, or Department) Valley Forge (Location, organization, or Department) Relative to my referenced letter, we now feel that we need to know all we can about our former employees who have had "significant'1 exposure to our PVC operations. Perhaps we will go after these individuals, rather than await their request. In individual discussions with Messrs. Adams, Herbig, Barr, Spurlock, and Dr. Khschner, we have interpretations of the meaning of "significant" ranging from one Cl) year in our PVC reactor operations to five (5) years in this area. In order for Mr. Fleming to reach a decision, we have been requested to secure the number of people involved if we use one (1) year in PVC, three (3) years in PVC, or five (5) years in PVC as a "cut off date" to satisfy our interpretation of "significant" exposure. Please review your records of former employees and advise me of the number of persons in each of the above one (1) year, three (3) years, or five (5) years categories at your earliest opportunity. Also advise the status of examination arrangements for the two former Calvert City employees who have previously requested an examination. HLW:heg cc: A. R. Adams I, f, T. L. Carey R. Fleming R. E. Jones Dr. Kuschner J. Kramer E. Primeau J. T. Sebastianelli G. B. H. Speed Howard L. Watson (320) AP00002917 INTEROFFICE MEMORANDUM ) Subject Date ln/lfi/74_________ Calvert.City Visit - 10/14/74 To _Dr. H. Knschner____________________ From___ Dr. A. R_ Adams_____________________ {Location, Organization, or Department) _____________ _____________________________ ; (Location, Organization, or Department) This memorandum will confirm various action points and open questions discussed during our visit to Calvert City. 1. Hr. Fleming will deliver the keynote address at the Americana Hotel in New York City on 31 October 1974. He is considering appropriate comments on the OSHA standard for vinyl chloride. Your written thoughts on the necessity for such a restrictive regulation will be appreciated. From a medical point of view what argument can be presented that the Ippm TWA Is safer than 25 ppm TWA? Is the 1 ppm TWA called for by the animal data vis a vis Dow's employee medical histories and other epidemiology introduced into evidence? Any appropriate comments you can give to Dick pn the medical foundations of this standard will be greatly appreciated. 2. In view of the obvious requirement for putting many employees into face masks for prolonged periods of time we need to know the impact of this requirement on employee health. You were to provide me with the name of a physician skilled In this field. It is my understanding from you that the forced air type of respirators now'being considered for use in the reactor building most likely will have to be humidified and that moist air presents special employee health problems due to bacterial contamination, etc. 3. The standard requires the company to provide a training program on the hazards of chronic exposure to vinyl chloride including specifically the carcinogenic hazard. We will try to get this from OSHA. If unsuccessful we will ask you to provide a video tape on this general topic. 4. The determination of regulated areas at various APCI locations handling VCH require a physical examination protocol for those assigned to regulated areas. We will need a standard protocol for all empolyees in this category as well as those with more than 10 years of exposure. (320) Dr. M. Kuschner Calvert City Visit -2- 16 October 1974 5. Howard Watson will Initiate a computer program to store medical histories at all plants subject to your approval as to suitability. 6. Our present medical protocol Is understood to be more Inclusive than that required by the new standard but we need a letter from you stating this fact. 7. It Is my understanding that from a medical viewpoint, It would be better to rotate an employee from a regulated area to a nonregulated area on a cycle with long periodicity than on a cycle with short periodicity, e.g. five years exposure and out is better than 10 years exposure and out even though only 4 hours of each 8 hour day was the employee expose during the 10 year cycle. 8. What protective garments do you recommend for male and female office workers exposed to more than 1 ppm TWA? 9. The new law requires that each employee exposed to an emergency shall be afforded appropriate medical surveillance. Please refer to the first page of the standard section b-5 for definition of "massive release of VCM" and comment on appropriate compliance to this request. ARA/df cc: 0. T. Barr T. L. Carey R. Fleming J. D. Kramer H. L. Watson CL- A.P00002919 AP00002920 INTEROFFICE MEMORANDUM To From J. P. Connors Howard L. Watson cc: With Attachment Subject Date 8 October 1974 Safety 8 Health - Consulting Physician Dr. William M. Blalock VF (Location, Organization, or Oapartment) VF (Location, Organization, or Department) T. L. Carey G. Edwards J. D. Kramer R. E. Schenck - (Original of Agreement) E. M. Spurlock Attached is a consulting services request to cover an agreement between Air Products and Chemicals and Dr. William M. Blalock, dated 26 September 1974. A copy of the agreement is attached and the original of it is attached to R. Schenck's copy. We have included the cost of this consulting service in our Valley Forge Manufacturing cost for FY75; and,therefore, no EA is required. The consulting agreement and this request have been reviewed and appropriately initialed by our Legal Department and both the agreement and this request has been signed by Mr. Carey. We have advised Dr. Blalcok that his monthly bill for these consulting services should be mailed to my attention at Valley Forge for my approval and I will forward it on to you for handling. You will note the effective date of this agreement is 1 September and,therefore, there will be charges for work done during September. Actual charges for future examinations at Calvert City or any of our other plants performed by Dr. Blalock, or any other charges as outlined in the agreement, are to be billed directly to the plants and paid by them as part of their operating expenses. If you have any questions concerning this agreement, please get back to me. HLW:heg Attachments Howard L. Watson (320) AP00002921 I REPORT #2 to A.P.C.I. Paul Kotin, M.D. February 27, 1974 The documents supplied by A.P.C.I. have been reviewed, and where appropriate . I have commented upon them either in personal meetings or in phone conversations. Summary of Meetings Since Report #1 On Tuesday, February 19, I was flown to Calvert, Kentucky in a company plane-. The day was spent at the Calvert City plant of A.P.C.I., and indepth discussions were held with Dr. A. Ross Adams and plant personnel, including the plant manager Mr. J. D. Kramer and staff associated with and responsible for the manufacture of polyvinyl chloride. A quick tour of the manufacturing facilities was made in order to observe the manufacturing procedures, the physical facilities, the plant equipment, and so on. Observations 1. Two of the large-volume ventilators were not in working condition. n 2. Even though the bagging process was not in operation, it was obvious that large amounts of polyvinyl chloride resin, some of apparently long-standing duration, were distributed throughout the bagging area. I cannot conceive that ^ this is not a significantly dusty area during operation. v. W"'*' 3. The rate of air turnover in the area of the polymerization tanks and in the ^ stripping area appeared inadequate, and an increase in air turnover rates as determined by measurement of air flow in various sections of the plant is strongly) recommended. 4. I did not see any workers wearing masks in any section<of the plant, and the one mask I saw hanging adjacent to the bagging area is, from an aerosol or fine dust suspension filtration point of view, inadequate. &W1-**'1 At midday I met with Dr. William M. Blalock, an internist (gastroenterologist/ hepatologist) who practices in Paducah. In the course of ouir two-hour discussion he agreed to serve as the monitoring physician for the employees of the Calvert City plant. We reviewed the vinyl chloride problem in deptfnand developed pre' liminary protocols and plans for physical examinations, x-ravy. examinations, and blood studies for Calvert City employees. A meeting was scheduled for Thursday, February 21, between Dr. Blalock and the plant manager so tthat arrangements could be made for the program to begin at the very earliest opportunity--in any event, before March 1. Dr. Blalock then conducted me on ottour of the laboratory 'facilities of Lourdes Hospital in Paducah, where I discussed ftaboratory needs with the hospital's chief pathologist. Dr. Blalock has agreed to be available for what ever testimony may be necessary incidental to his services aft A.P.C.I. Following these meetings I flew by corporation plane to Chicago to participate in a ( *. i .s> i\, AP00002922 t Report #2 toA.P.C.I. 2- - February 27, 1974 meeting of the M .C.A. medical task force which was chaired by Dr. Maurice Johnson of B. F, Goodrich. This evening meeting was attended by, among others, repre sentatives of Union Carbide, Firestone, Uni-Royal, and I.C.I., as well as Good rich. Also in attendance were Dr. Irving Tabershaw, of Tabershaw-Cooper Associates, and Professor Cesare Maltoni, an experimental pathologist from Bologna. Professor Maltoni presented his experimental data, and the implications of his research for the problems facing the vinyl chloride and polyvinyl chloride manu facturers were discussed. The remainder of the meeting was devoted to a discussion of proposed protocols for the examination and monitoring of employees as well as the review of vital data, including death certificates on deceased employees. The discussions centered primarily on the form of the physical and xray examinations that would be useful as well as on the nature and scope of the laboratory work. There was no final agreement on a protocol except in general terms. It is obvious at this time that there is no single test, or even combination of tests, that can be useful in predicting with any degree of reliability the special susceptibility or resistance of any person, nor are there any procedures which with any degree of reliability would be useful In predicting whether a given patient will develop an occupational cancer. All the participants at the meeting agreed to make a maximum effort to keep one another apprised of developments and to exchange information. In the course of pursuing other responsibilities, I participated in a review of potential hazards to workers using polyvinyl chloride in the preparation of polyvinyl chloride pipe from resin supplied by Air Products as well as other sources. This particular corporation is in the midst of performing analytical studies on air samples taken during the processing of resin into pipe. Preliminary results indicate very very minimal concentrations of the monomer which one might anticipate to be present as a contaminant of the polymer. . On February 26, during discussions with Mr. Stan Kelton. corporate director of health for Rohm and Haas, the matter of vinyl chloride was raised again. I obtained permission for representatives from A.P.C.I. If it so requests to visit Rohm and Haas' plant in order to see how Rohm and Haas responded to an analogous occupational situation in which workers were exposed to (Bis)CME. in addition, Rohm and Haas agreed to make available to A.P.C.I. copies of job descriptions of the corporate health director, the medical director, and the director of industrial hygiene, i will forward these promptly upon receipt. srV S! Comments .The discovery of sporadic cases continues. There can be little doubt that additional cases will appear in the future. Despite the absence of firm evidence, vinyl chloride is the prime candidate for this occupational hazard. The vinyl chloride monomer is more suspect than the polymer because of its chemical and physical properties and high reactivity with tissue and cellular components. The chemicals other than vinyl chloride used in the preparation of polyvinyl chloride are beginning AP00002923 Report #2 to A.P.C.l. -3- February 27, 1974 to recede in importance as suspects; however, they cannot be completely exonerated at this time. Vinylidene chloride, though discussed frequently as a possible carcinogenic or cocarcinogenic factor, is at present one more additional suspect. It is my intention to contact immediately several physicians in Pensacola for the purpose of identifying one who will assume responsibility for employee examinations at the Pensacola plant. I will also fly to the Pensacola plant at the very earliest opportunity, so that I can identify the needs more intelligently and be responsive to them. s. AP00002924 c?fa7%0ducti andCie*tuca& ALlfNTOWN, tA. 16 April 1974 Qffiet tf: V. Mayo Smith cci A. Ross Adams iL'L. Ball "u. T. Barr T. L. Carey/H. L. V/atson Richard Fleming (2) G. J, Mantel! E. M. Spurlock Dr. Paul Kotin (sent directly by W1S) \a f J AP00002925 4/16/74 A. R. Adams J. T. Barr T. L. Carey REPORT #3 to A.P. C.IE. M. Spurlock Paul Kotin, M.D. W. M. Smith April 2. 1974 The documents supplied by A.P.C.I. have been reviewed, and where appropriate they have been acted upon. Continuing liaison has been maintained by telephone with Dr. William Blalock in Paducah, Kentucky, and Dr. Barkley Beidelman in Pensacola, Florida. The results of ongoing employee surveillance were discussed, with special attention directed to those cases where abnormal findings were obtained either by physical examinations, laboratory tests, or x-ray. Liaison has been main tained also with Dr. Irving Tabershaw, of Tabershaw/Cooper Associates. !n addition, a number of phone conversations were held with W. Mayo Smith, and these calls were supplemented by exchange of correspondence. The employee examinations have progressed to the point where the results will be ready for review during the month of April. Meetings have been scheduled with both Dr. Blalock and Dr. Beidelman, with Dr. Blalock on April 5 and with Dr, Beidelman on April 23. At this time, each case presenting any abnormality will be reviewed in depth and a course of action will be developed as appropriate. At the very least, the medical surveillance recommendations of the National institute for Occupational Safety and Health, as transmitted to the Department o' Labor, will be followed, and additional steps will be taken where indicated. Parenthetically, it is interesting to note that these medical surveillance recommendations encompass the criteria and protocols developed by A.P.C.I. The death certificates from former employees in the Calvert City plant have been reviewed, and in conjunction with Tabershaw/Cooper Associates, those listing causes of death with any hint of suspicion are being pursued to verify a nonvinyl chloride-associated death. Of the fourteen deathes, there are six cases diagnosed as having cancer, and these are being researched. I have been invited to participate in vinyl chloride meetings sponsored by the New York Academy of Sciences on May 10 to May 11. My invitation is as an independent scientist/participant, and therefore I will not use up one of the three spaces ai lotted to A. P. C. I. NOTE Effective June 1, 1974, I have accepted the position of Vice President of Health, Safety and Environment of Johns-Manville Corporation, located in Denver, Colorado. In the interim, I shall continue to be of all possible service to A.P.C.I. in addition to which I shall try to identify candidates for the position of medical director of A.P.C.I. t AP00002926 L '*tucal T- "Baw INTER-OFFICE MEMORANDUM R'TCc-iVu.i^ Date: April 10, 1974 APR i ' Subject- Medical Tests at Calvert City Plant J. T. BARR To:__ From: R. Fleming E. M. Spurlock (Location, Organization, or Department) (Location, brganlzation, or Department) Dr. Kotin and I visited Dr. Blalock in Paducah for the purpose of reviewing the liver tests which Dr. Blalock had done for us. The last x-rays were taken on Friday, April 5 and Dr. Blalock was to complete his examinations by Tuesday, April 9. This will make a total of 292 people who have been tested at the Calvert City plant. Dr. Blalock had the tests of each employee laid out on a large sheet and he and Dr. Kotin went over roughly 120 employees in setting up the criteria for each test. From a cursory review of these, it was indicated that about 30% would have to be retested because they had more than one abnormality in their tests. Dr. Kotin felt that some of these were caused by the inaccuracy of the machine and to be certain, he requested that the retests be done by technicians by hand so that accurate readings would be obtained. Other abnormalities Dr. Kotin felt were caused by the individual's physical makeup. He stated that these changes are very subtle and would only show a change in three to six months, so these will be retested in 90 days. Dr. Kotin took with him to Denver a list of all the people who had been tested and he stated he would review them while traveling and would be back to me on Tuesday with his interpretation. There were several interesting points v/hich were raised during the meeting and they are as follows: 1. The question was asked by Dr. Blalock as to the payment of the hospital bills of those employees whom he may have to hospitalize to complete the tests. He asked If this hospitalization would be covered by the company hospitalization policy, under Workman's Compensation or would be paid for by the company. I informed him that it was rqy opinion they would be paid for by the company since we were not ready to declare this as a Workman's Compensation nor would we want to pay for It under hospitalization since this would not be paid for in full. I promised Dr. Kotin and Dr. Blalock that I would obtain a decision from you. 2. Dr. Blalock asked Dr. Kotin what he should charge for his services. This is a question which has been asked by Dr. Blalock on several occasions and no one was in any position to give him any guidelines. Dr. Blalock finally asked Dr. Kotin if he would review a proposal If he, Dr. Blalock, sent it to Dr. Kotin. Dr. Kotin agreed to do this. (320) AP00002927