Document MXrRMLDLJVxkxXqJQra7vmky

CONFIDENTIAL REGISTER OF CASES OF ANGIOSARCOMA OF THE LIVER DUE TO EXPOSURE TO VINYL CHLORIDE PREFACE : Acknowledgments, significant changes and comments REVIEW DATE 1 JANUARY 1986 1. The new cases in the Register are the following : France Germany UK 18 23, 2lt, 25, 26, 27 11, 12 2. There are amendments from the previous Register against the following cases: Germany 21, 22 US 36, 38 3. I would like to thank Dr De Sloover, Dr D M J Williams and Dr Friedel for informing me of new cases. k. For the case corrections I would like to thank Dr Friedel, Mr J T Barr and Mr R W Frase. 5. For other corrections and information, thanks to Dr D Forman, Mr J T Barr, Mr T II Sutherland and Mr N F Humphry. 6. I should be very grateful If all recipients of the Register could continue to keep me fully informed of any new cases, or, if they should hear of other Companies who have acquired a case of ASL, it would be much appreciated if I could be notified by the appropriate person. It is extremely helpful if new information is supplied in tabulated form, using the headings in the Register as far as possible. 7. I would like to thank the many people who have suggested research topics, and should be grateful if I could be kept up to date. 8. I shall be happy to supplyto any recipient of the Register a copy ofthe Paper "Exposureto Vinyl Chloride andAngiosarcoma of theLiver: a report ofthe Register ofcases" by Dr David Forman,myself, DrJohn Stafford and Sir Richard Doll, published in the British Journal of Industrial Medicine, November 1985 (**2: 750-753) Dr Brian Bennett Medical Department Imperial Chemical Industries pic Hillhouse Site P 0 Box 6 Thornton-Cleveleys Blackpool FY5 ^QD England '.` February 1986 ^06600 IMPERIAL CHEMI INDUSTRIES PLC UPX/ASL_2 - LA Index LIVER ANGIOSARCOMA CASES (REVIEW DATE - 1 JANUARY 1986) Table Sequence Belgium Canada Czechoslovakia France Germany Italy Page 1 2-3 4 5-8 9-14 15 ASL Case Numbers by year of Death (Table 6) ASL Case Numbers by year of flrBt exposure (Table 7) Western Europe PVC Producers - Start-up Dates vs ASL Cases (Table 8) USA PVC Producers - Start-up DateB vs ASL Cases (Table 9) Japan Norway Sweden 16 Canadian PVC Producers - Start-up Dates vs ASL Cases (Table 10) 17 East European PVC Producers - Start-up Dates vs ASL Cases 18 (Table 11) UK USA Yugoslavia 19-21 22-28 29 Japanese PVC Producers - Start-up Dates vs ASL Cases (Table 12) South 6 Central American PVC Producers - Start-Up Dates (Table 13) Incidence of Cases per annum (Table I) 30 Australasian PVC Producers - Start-up Dates (Table 14) Distribution of Cases by Country (Table 2) 31 Pattern of Cases by Factory (Table 3) 32 Latency Periods (Table 4A) 33 Distribution of Latency Periods (Table 4B-4JI) 34-40 Annual Geographical Incidence (Table 5) 41 8066E0 S$d CASES,4 Page 42 43 44 4 5+46 47 49 50 51 Pa 30 TAP I. (Review Date - 1 Jan 1986) Incidence of ASL Cases Per Annum By date of death 1955 ........................................................................................ 1 60 7 ......................................................................................... 1 8 ......................................................................................... 0 9 ;...................................... 0 1960 ......................................................................................... 0 1 ......................................................................................... 1 2 ......................................................................................... 1 3 ......................................................................................... 0 A ......................................................................................... 2 5 ......................................................................................... 0 6 ......................................................................................... 0 71 0 ......................................................................................... 5 9 ......................................................................................... 3 1970 ......................................................................................... 2 1 ......................................................................................... 3 2 ......................................................................................... 5 3 ......................................................................................... 8 A ......................................................................................... 5 5 .................................................... 11 6 ..........................................................................................11 7 ......................................................................................... 9 8 ..........................................................................................10 95 1980 ..........................................................................................10 1 ......................................................................................... 5 2 ......................................................................................... 2 39 A ......................................................................................... 5 5 ....................................................................................... ^_2 Total 117 N.B. I Does not include Italian 01 but does include Cerman 03. (if? //7- 2 The 1977 total Includes US cose 2A which is a Cholangiosarcoraa. 3 The 1982 total does not include US 33 and F 15 who are alive. A The 1983 total does not Include US 36 who is alive. WPX/ASL_2 - bANGIOCASES,35 606600 W* 31 Distribution of ASL Cases by Country TABLE (Review pate - 1 Jan 1906) 2 USA W Germany France UK Canada Sweden Yugoslavia Italy Czechoslovakia Japan Belgium Norway 35 *** 3L 26 ** 18 *** 11 10 13 5 **** 4 ***** 4 * .5 2 23 2 1 Total 120 * Omit ItOl - atypical case of PVC bag extruder. ** Includes CE03 aerosol can filler. *** Includes case US 2k which was diagnosed as Cholangiosarcoma & US 33, and 36j and F 15 who are alive **** Includes one monomer worker. ***** includes two monomer workers. i.e Western Europe North America Rest of World 67 A5 8 WI'X/ASL_2 - LANCIOCASES, 36 Total 120 01-6600 S9H 32 Pattern of AST. Cases by Factory (a) W Europe ABLE 3 (Review Date - 1 Jan 1986) Of tlie 67 cases in W Europe, 57 have occurred in clusters at 11 factories. Of the 26 Cerraan cases, 23 have occurred in clusters at A factories. ASL Case8 Dynarait, Troiedorf, Germany Chloe Chimie (Formerly RP) , St Fons, France BP, Barry, UK Wacker, Burghausen, Germany Kemanord, Sundsvall, Sweden PCUK, Brignoud, France CWU, Marl, Cermany ICI, Ilillhouse , UK Solvay, Tavaux, France Lonza, Waldshut, Germany Solvay, Jeraeppe, Belgium 11 8 8 7 5 5 3 3 3 2 2 57 NB: There are 32 pre 1962 PVC plants in W Europe; 18 of these have had ASL cases (Ref Table 8) (b) N America Of the A5 cases in N America, 38 have occurred at four factories out of a total of 5A factories:- In N America A3 plants have not had ASL cases. BFC, Louisville, US BFG, Shawinlgan, Canada UCC, S Charleston Coodyear, Niagara ASL Cases IA 10 10 A 38 NB: There are 28 pre 1962 PVC plants in N America; 11 of these hove had ASL cases (Ref Tables 9 6 10) (c) Rest of World The 8 ASL cases are believed to be in 1 cluster of A and 2 clusters of 2 cases, WPX/ASL_2 - LANGIOCASES,37 1-16600 ssy 33 (Review Date - 1 Jan 1986) Fable 4 a Latency Periods (Years from first Exposure to Diagnosis) W Europe Country Belgium France Germany Italy Norway No of Case3 2 18 26 4 1 Total Years 35 459 495 74 22 Average 17.5 25.5 19.04 18.5 22 N America Sweden UK 5 ir ' 67 122 254 1461 24.5 23.09 21.80 Rest of World US Canada 35 886 25.31 10 204 20.4 45 1090 24.22 Czechoslovakia 2 30 15.0 Summary Japan Yugoslavia 2 4 39 19.5 85 21.2 154 19.2 W Europe 67 1461 21 .80 N America 45 1090 24.22 Rest of World 8 120 154 2705 19.2 22.54 * Of the countries with >* 10 cases, France, UK and USA have an average latency period above below world average. WPX/ASL 2 - LANGIOCASES,3B St-6600 S9H