Document MMQBZp7E99vrXEwp0w94xopjy

IMPERIAL CANCER RESEARCH FUND Cancer Epidemiology and Clinical Trials Unit UNIVERSITY OF OXFORD Arung Dirrtton Enwritui ProfciMr Sir Richvd DoU. d m., f ks. TihpAonc (0365} SJ762 Gibson Bui)din The RadclilTe Infirmar Oxford 0X2 6H. 22 December 1987 RD/CH Dr G.M. Paddle, Imperial Chemical Industries PLC, Epidemiology Unit, Alderley Park, Macclesfield, Cheshire SK10 4TJ. CCl " - . r-^ ROSS.^' V" i-C--' c-Yv O'4337 v.0' ..r rTvi' s%a^a Ca^caS I am sorry not to have replied to your letter of 20.10.87 before but it needed detailed attention and 1 was very hard pressed to complete a major report for NRPB on the UK atom bomb participants which had to be completed by a fixed date. I have now had time to think about Dr ten Berge's letter. He has a good point. I agree that only 20 of the 37 liver cancer cases causing death in the EHA study are in the Registry as having caused death before 31.12.82 whereas there should have been 29 (though I disagree with one of his numbers - I identified no. 31 in the Registry and failed to identify no. 29). Approximately 6 deaths from liver and gall-bladder concur were expected so that that that leaves approximately 11 deaths that are either angiosarcomas missed by the Registry, excess liver (or gall-bladder) deaths other than angiosarcoma, or an excess number of misdiagnoses. Any of these might be the true explanation, but meanwhile ay confident conclusion that Che only tumour of the liver produced by vinyl chloride is angiosarcoma is weakened. Nevertheless the fit with the British, Canadian, and Italian data makes me still put ay money on its truth - in which case a fair proportion of the 11 extra deaths must be angiosarcomas not picked up by the registry. This would be an important conclusion and makes it worth your crying to discover what the EHA liver cancer deaths actually were (nos. 2, 3, 4, 3, 6, 7, 9, 14, 16, 21, 24, 29, 30, 32, 33, and 34). Tw of them could conceivably be in the Registry with some wrong information (i.e. 9 Registry no. 32 and 37 Registry no. 19) but I doubt if they are. The other things we want to know are whether: (1) the missing Regis try cases cane from companies that did not participate in the EHA study (which might account: for Registry numbers 12 (though it seems unlikely that Firestone didn't) 23 (Great American Chemical Co.) and 32 (Monsanto), and (11) what were the certified causes of death of men who presumably should have been in the EHA study and (if liver or gall-bladder cancer) why weren't they there: namely 08, 10, 18, 19, 20, and 23 (and 12, 23, and 32 if the relevant companies were included). Is there any chance of your obtaining any of this information? With best wishes for the New Year, Office of the TwiidL P.O Bo* Chcntv No. 20H.1I CMA 006478 MINUUT M aM 1>D duor On^ mmmvhv* 00 irqpkton'rn tv .pi mPcJf'OiV.iaf v.in Imperial Chemical Industries Epidemiology Unit Dr. G.M. Paddle Alderley Park, Macclesfield Cheshire, SK10 4TJ Engeland geco<Uttonft0r0 veraonoen qp.,1piitM qp/-*,i,v Or-iqen pfO|eC1nummi*r v.nie 6463 afschnM /* z W. ten Berge, CVMD Ms 2 0 658/87 CVMD 10.9.1987 /6lf M`Ul Dear Geoffrey, Thank you for sending me your letter to Sir Richard Doll and his answer to you. From the answer of Doll I got the feeling that he had not understood completely my question. Therefore I want to make again my point clear to you. For that purpose I send you: - a copy of the list of liver cancers (table 17) of the USepidemiologic study on VC-exposed workers of Environm ntal Health Associates (EHA). - a copy of the list of US-ASL-deaths from the ASL-Registry of Dr. Bennett. The end of follow-up of the EHA-study was December 31, 1982. Up to that date 32 US-ASL-deaths were recorded in the ASL-Registry. Number 14, 15 and 25 were removed from the Registry, because they were not confirmed ASL-cases. So in table 17 of the EHA-study 29 of the 37 liver cancers should be due to ASL. To confirm this I tried to match the dates of birth, of death, of start and of termination of employment etc. of the US-ASL-deaths from the Registry with the same dates of liver cancer deaths (table 17) of the EHA-study. *$ 0.658.1(4.1) CMA 006479 MINUUT 0 658/87 CVMD 10.9.1987 2 However, matching failed for the following US-ASL-deaths from the Registry: a, 9, 10, 12, 18, 19, 20, 23, 29. Possible causes may be: - Not all polymerization plants with US-ASL-deaths were included in the EHA-study. - Wrong figures in the EHA-study as Sir Doll proposes. - Confirmed US-ASL-cases in the Registry were not as liver cancer recorded on the death certificates. This would suggest still more liver cancers? Shortly this is my problem. I have no further information to solve this. I would highly appreciate your help for clearing these findings. Kind regards, Central Department for Safety- and Environmental Matters, Wil ten Berge 1 Enclosure 00&480