Document NNBMBbjOqkB5mvmKydN55k6pD

CHEMICAL MANUFACTURERS ASSOCIATION November 26, 1984 TO: OSHA Legal Contacts General Counsels' Group FROM: Claire BoccellaC& RE: AFL-CIO Legal Foundation Enclosed is a prospectus, prepared by the Industrial Union Department of the AFL-CIO, regarding an Occupational Health Legal Rights Foundation. The prospectus states that the impetus for the creation of the Foundation is the "fundamental failure of state workers' compensation programs to provide fair and adequate relief to workers who have suffered illness as a result of exposure to workplace health hazards." The purpose of the Foundation is to assist workers in bringing test cases to recover workers' compensation benefits and tort remedies for diseases resulting from workplace health hazards. The Foundation will target the following types of cases: cases involving hazards from toxic substances where there previously was no established association between workplace exposure and occupational disease, and where there is now reason to believe that many workers face a significant risk of harm; . cases on behalf of workers exposed to toxic substances that the medical community has long associated with worker health impairment who have been unable to obtain adequate legal representation; . cases where an important legal precedent could be established that could benefit many workers (see page 4-5 of the prospectus). CMA 046944 Formerly Manufacturing Chemists Association--Serving the Chemical Industry Since 1872 2501 M Street, NW Washington, DC 20037 Telephone 202/887-1100 Telex 89617 (CMA WSH) 2 The various state right-to-know laws could facilitate the bringing of these types of cases. The activities of the Foundation could also have an impact on state workers' compensation legislation. We will keep you informed of further developments relating to the Foundation. M. Freifeld R. Hertz C. Nolde R. Schumacher D. Evans CMA 046945 PROSPECTUS OCCUFATIORAL HEALTH LEGAL RIGHTS FOUHDATIOH 815 Sixteenth Street, N.W. Room 301 Washing-ton, D.C. 20006 (202) 842-7830 September 25, 1984 CMA 046946 SERVICES OF THE FOUNDATION 'Identify workers exposed to known hazards 'Screen cases for scientific and legal merit 'Notify exposed workers of their legal rights 'Provide lists of cooperating lawyers 'Recommend expert witnesses 'Provide scientific and legal review of testimony 'Provide a central data base for use by witnesses and attorneys. 'Share information developed in Foundation cases 'Provide educational opportunities for attorneys on occupa tional disease. CMA 046947 COWgHTS Purposes Background Functions Structure Finances Appendix: Editorial: Quantitative Estimates of Cancer in the Workplace Carcinogens/Carcinogenic Processes and Exposed Work Populations At Risk Occupational Cancer Hazards Amounts of Confirmed or Suspect Buman Carcinogens Potentially Available for Buman Exposure, 1940-79 Risk Factors Associated With Workplace Exposures to Five Bigh-Volume Buman Carcinogens/Risk Factors Associated With Workplace Exposures to Six Bigh-Volume Human Carcinogens Workplace Chemicals and Processes Associated With Reproductive Effects Non-Neoplastic Disease Clinically Confirmed Estimated Numbers of Workers in the Onited States With Potential Occupational Exposures to Known or Suspect Nephrotoxins, 1971-1972 Factors Associated with Work-Related Cardiovascular Disease Occupationally Related Unnecessary Disease, Disability, and Untimely Death CMA 046948 PURPOSES On June 7, at the International Conference on Disability Compensation for Occupational Disease in Hev York City, Industrial Union Department President Soward D. Samuel proposed a program to bring lawsuits on behalf of workers (and their families) who have suffered illness as a result of occupational health hazards. After discussions with the Executive Council of the Department, meetings were held with officers, attorneys and staff of the affiliates. On the basis of a unanimous, positive response, the Industrial Union Department has established a non-profit corporation: The Occupational Health Legal Rights Foundation. The purposes of the Foundation are to ensure that workers obtain adequate compensation when they have suffered illness from work place hazards, to educate workers about the existence of such hazards and steps they may take to safeguard their health and legal rights, and to exert pressure upon employers to eliminate or ameliorate such F hazards in the first place. BACKGROUND The primary impetus for creation of the Occupational Health Legal Rights Foundation is the fundamental failure of state workers' compensation programs to provide fair and adequate relief to workers who have suffered illness as a result of exposure to workplace health hazards. The basic concept of the workers' compensation system was sound when the system was initiated three-quarters of a century ago, and remains sound today. That concept is that workers ought to be CMA 046949 2 provided with a means to obtain fair and adequate compensation for illnesses and injuries arising from employment, regardless of who was at fault, without the cost and delay that accompany negligence suits brought in court. The reality has been, however, that state workers' c mpensation programs have utterly failed to honor this concept in the context of occupational disease. Most occupational disease is effectively excluded from the coverage of the workers' compensation lavs of some states. Other states impose unrealistic requirements concerning time or place of exposure, fail to define precisely compensable occupational diseases, or include restrictive definitions of causation that are out of step with current legal and scientific thinking. In those states where compensation is obtainable, the benefits provided are woefully inadequate. Although these problems have received increasing attention, they are difficult to correct because workers' compensation programs are operated on a state-by-state basis. The IDD, BCTD and AFL-CIO have proposed a comprehensive and uniform federal workplace disability compen sation system. As a result of vigorous opposition by the manufacturing and insurance industries to these proposals, afflicted workers cannot expect to achieve a satisfactory legislative solution in the near future. lacking meaningful legislative protection, many workers who have contracted occupational diseases, and the families of such workers, have resorted to negligence suits in court. This effort has produced CMA 046950 -3- mixed results. On the one hand, many of these lawsuits have achieved large verdicts in the workers' favor, sometimes including punitive damages. On the other hand, lawyers who traditionally handle such cas.-'-s typically require a contingency fee of 35 to 50 percent of the recovery, and lawyers who are not conscientiously dedicated to their clients' cause have in some cases counseled workers to enter into substandard settlements at amounts far below an objective valuation of the ease. Frequently, workers with valid claims go unrepresented at all because they lack information about their legal rights or access to competent counsel, or because negligence lawyers lack the resources or expertise to recognize the association between a workers' problems and conditions in the workplace. Moreover, discovery costs, including charges for xpert depositions, and other expenses have often been inflated or duplicated. Against this background, the ITO has undertaken to establish the Foundation, while at the same time remaining committed to obtaining federal legislation that assures adequate compensation for victims of occupational. disease. Dntil the Congress acts and an equitable system is in place and functioning effectively, we are determined to assist workers, within the framework of current law, to obtain the compensation they are due. The Foundation intends to tap for the benefit of workers both the existing compensation system and the desirable aspects of the private tort system. This will be done by helping to ensure that workers CMA 046951 4 with valid claims relating to workplace exposures have qualified legal representation at equitable costs. FUNCTIONS The Foundation's principal function will be the coordination and support of lawsuits brought on behalf of workers who have suffered illness from workplace health hazards. The Foundation will engage, as well, in educational activities to inform employees (and unions) of the nature and dangers of workplace health hazards, where to seek assistance, and how to enforce their rights. In the near future, the Foundation will focus its efforts and resources mainly on litigation activity. The Foundation's litigation activity will seek to ensure that workers or their families are fairly compensated for job-related illnesses, and that companies abate workplace health hazards as quickly as possible. To. these ends, and given the limited number of eases that the Foundation will be able to finance in its formative years, the Founda tion will concentrate its efforts on the following types of cases: 1. Cases involving hazards from toxic substances where there previously was no established association between workplace exposure and occupational disease, and where there is now reason to believe that many workers face a significant risk of harm. In such a situation, information uncovered during pretrial discovery or trial involving certain victims could be made available to lawyers of other victims of similar CMA 046952 -5- workplace exposures. This would broaden the impact of an individual suit. 2. Cases on beiiulf ofworkers exposed to toxic, substances that the medical community has long associated with worker health impair ment who have been unable to obtain adequate legal representation. Various populations of exposed workers have failed to benefit from the legal system either because they have been uninformed of their legal rights or because they have gone unnoticed by negligence lawyers. The Foundation will assist in providing representation to such workers and in drawing attention to their problems. 3. Cases where an important legal precedent could be established that could benefit many workers: (i) Suits against the workers' immediate employers in those states, such as Ohio and Vermont, where the "exclusivity" principle of the workers' compensation laws does not prohibit intentional tort suits against employers. (ii) Suits to establish that intentional torts arc not barred by state workers' compensation laws in states where that principle has not yet been established. (iii) Suits designed to produce large punitive damage verdicts. (iv) Suits against laboratories for misrepresenting data in their epidemiological studies, thereby understating the severity f health risks to workers exposed to a particular substance. (v) Suits against company doctors or industrial hygienists for practices that are unacceptable from an occupational health standpoint. CMA 046953 6 STKOCTtJRE The foundation has been sat up as a non-profit, tax exempt corporation consistent with Section 501(c)(5) of the Internal Revenue Code which is applicable to labor unions and related organizations. The Foundation is directed by a Board of Directors, whose members will be appointed by the IUD Executive Council. The officers of the Foundation include a President and Secretary-Treasurer, who will also be selected by IPD Executive Council. Assisting and advising the Board and Officers is an Advisory Council consisting of officers of those unions most likely to provide cases from among their membership. The Foundation has two committees that will play a critical role in determinations concerning whieh lawsuits to bring. The first is the Scientific Advisory Committee, which will comprise persons drawn from the medical and scientific community. This Committee will evaluate instances of suspected employment-related disease to determine the degree, if any, of actual health impairment and the actual association, if any, with workplace events or exposure. While the Committee's own expertise will enter into the judgments about these matters, it is not contemplated that it will conduct actual medical or scientific examinations, but it will assist in approving and securing the services of qualified experts to. do so. The chairperson of the Scientific Advisory Committee serves ex officio as a member of the Board of Directors of the Foundation. 046954 CMA 7 The second committee is the Legal Advisory Committee, which will comprise attorneys knowledgeable about occupational safety and health litigation, including counsel to unions Thi* Commitfcs. will perform the following functions: 1. Analyze and evaluate whether to pursue potential lawsuits consistent with the purposes of the Foundation. 2. Recommend attorneys or law firms to represent workers or their families in litigation coordinated or supported by the Foundation. 3. Periodically review the quality of the representation provided by lawyers who receive referrals through the Foundation. 4. Conduct practical seminars for interested lawyers in various locations throughout the country. 5. Review the case selection process and recommend to the Board categories of cases to be pursued or categories of cases to be dropped. The chairperson of this Committee will serve ex officio as a Director of the Foundation. A third committee -- the Executive Committee -- will be responsible for the general governance of the Foundation between meetings f the Board of Directors. The Executive Committee will have five members, which will include ex officio the President, the Secretary-Treasurer, and the chairpersons of the Legal Advisory Committee and the Scientific Advisory Committee, and one other Director. CMA 046955 -8- The Foundation will have an Administrator appointed by the Officers who shall supervise a small staff to handle administrative matters and investigate litigation prospects. To this end, the Administrator and staff will act as liaison with the AFL-C20 and its departments, international unions, local unions, exposed workers, and other persons and organizations that may seek the assistance of the Foundation on behalf of potential plaintiffs. The staff will conduct -- if necessary and appropriate -- on-site interviews or investigations. It will provide, with the advice of the Scientific and Legal Advisory Committees, lists of approved expert witnesses and, wherever possible and cost-effective, centralized data bases available to all participating attorneys. The litigation that the Foundation decides to coordinate and support will be handled, as noted, by attorneys recommended by the Legal Advisory Committee. The Foundation will establish a contingent fee schedule, for such representation, that reflects rates below the 35 to 50 percent customarily charged by plaintiffs' lawyers. The schedule would specify a percentage for recovery by settlement in the early stages of the litigation, and a higherpercentagefor recovery at or after trial. Whatever the percentages determined to be appropriate, any law firm that obtains any case as a result of a referral through the Foundation will have to agree that its charges for that case will be in accord with this restricted contingent fee. CMA 046956 9- As in incentive to encourage law firms to participate in handling such cases under the Foundation's standards, it is contemplated that the Foundation will establish a procn'" to assist plaintiffs for a specified maximum amount of money for all or some out-of-pocket expenses incurred for particular purposes -- for example, deposition transcripts, travel, photocopying, and expert witness fees. In this connection, the Legal Advisory Committee will draft model agreements for use by the Foundation, plaintiffs, and plaintiffs' counsel. Under such an agreement, at the successful culmination of the lawsuit, the plaintiffs will reimburse counsel for those expenses, and counsel, in turn, will return to the Foundation those monies advanced for expenses. Although the Legal Advisory Committee will endeavor to select only highly qualified counsel to handle cases referred to or supported by the Foundation, the Foundation nonetheless will exercise a coordinating role with the local counsel. Such coordination is necessary to ensure that cases are not settled precipitously or unfavorably, that the Founda tion's standards are met, and that legal research, discovery, and other litigation resources are efficiently shared among all counsel handling cases in which the Foundation is involved. To this end, the Foundation will assign counsel to serve as co-counsel in each such case, on behalf CMA 046957 10 - the Foundation. The designated co-counsel will participate actively in important litigation judgments made in each ease and will ensure that information and other resources generated in cases supported by the Foundation are efficiently shared. The designated co-counsel shall be recompensed by the Foundation for such services on an hourly, non-contingency fee basis. FINANCES As indicated by the foregoing discussion, the Foundation will incur administrative and operating expenses in implementing its bjectives, and will require substantial funds in order to advance litiga tion expenses. Although the Foundation should increasingly recover a portion of the expenses advanced, the recovery would not be complete barring the extremely unlikely event of a 100 percent success rate in litigation. The Foundation will be supporting cases that are on the frontiers of science and law. . in any event, recovery would be deferred pending the outcome of litigation. In order to meet the Foundation's need to finance its expected deficit, the Foundation will solicit contributions and loans from labor unions whose members will ultimately benefit from the activities of the Foundation. This is consistent with the labor movement's commitment to remedy the failings of other measures to ensure adequate workers' compensation and safe and healthful working conditions. Further, it is contemplated that the Foundation will charge fees to cover the costs of certain services it will provide in connection CMA 046958 - 11 tion for expenses advanced. The combined percentage of attorneys' fees and contingent payment to the Foundation would be set beneath the rates customarily charged by plaintiff* xdw^art fuj. handling such cases. Funding from these sources will not be available unless litigation is successfully completed. A first-year budget will be developed when the case load for that year has been determined. CMA 046959 Appgspri Editorial: Quantitative Estimates of Cancer in the Workplace Carcinogens/Carcinogenic Processes and Exposed work Populations At Risk Occupational Cancer Hazards Amounts of Confirmed or Suspect Human Carcinogens Potentially Available for Human Exposure, 1940-79 Risk Factors Associated With Workplace Exposures to Five High-Volume Human Carcinogens/Risk Factors Associated with Workplace Exposures to Six High-Volume Human Carcinogens workplace Chemicals and Processes Associated With Reproductive Effects Non-Neoplastic Disease Clinically Confirmed Estimated Numbers of Workers in the united States With Potential Occupational Exposures to Known or Suspect Nephrotoxins, 1971-1972 Factors Associated with Work-Related Cardiovascular Disease Occupationally Related Unnecessary Disease, Disability, and Untimely Death CMA 046960 American Journal of Industrial Medicine 5:341-342 (1984) EDITORIAL Quantitative Estimates of Cancer in the Workplace K<7 words: ocoipatioaal cinrrr The role of occupation in the etiology of human cancer has received increasing attention, particularly in the past decade. This issue contains a report of yet another group of workers at excess risk for cancer (woodworkers other than cabinet makers). In recent years, a variety of high volume solvents and other widely used chemicals have also been implicated as potential human carcinogens by animal bioassay data. Nevertheless, the identification of specific human carcinogens progresses slowly, and the general acceptance of the human carcinogenic potential of agents for which there are animal data and suggestive human epidemiological data has preceded even more slowly. This slowness has often been for valid scientific reasons. Confounding factors and methodological uncertainties may have affected epidemiological studies. Animal data are often limited by the small number of deaths and by the effect of agent toxicity. Corroborative studies may not always be available. Our scientific conservatism in accepting evidence of carcinogenicity for humans may be unduly severe and, as a result, our estimates of the importance of occupational cancer correspondingly diminished. In a recent analysis by Doll and Peto of the quantitative estimates of avoidable risks of cancer in America [Doll and Peto, 1981], 18 occupational agents or processes were considered '`established'' as carcinogens on the basis of human evidence. Thirteen medical and 12 social causes were similarly categorized. The International Agency for Research on Cancer (IARC) has published a virtually identical list of 18 agents causally associated with cancer in humans (Croup I compounds or processes) [IARC, 1982]. While the relative risks (observed/expected deaths) were uncertain for a number of the compounds because of relatively few deaths, a review of the IARC list shows that nine of toe agents or processes had relative risks of from about 50 to 500 for cancer of a specific site among some group of individuals. Eight had risks between about 5 and 50 and only one, the rubber industry, had a risk of the order of 2 for cancer at some sites. Any plausible frequency distribution of the relative risks of site-specific human occupational cancers would certainly have a large number of points with relative risks less than 5, were they to be known. In terms of accepted human carcinogens, we have clearly identified only the "tip of the iceberg." While most occupational carcinogens have yet to be fully accepted or even identified, deaths from toe "established" causes of occupational cancer account for at least 3% of all cancer deaths among both males and females in toe United Sates. In terms of impact on mortality, excepting cigarette smoking, occupation is toe most important specific factor quantitatively identified as causative of human cancer in the United Sates. In terms of agena, again excepting cigarette smoking, occupational exposure to asbestos is toe most important carcinogenic exposure, being associated * <M4 >U. T la-- I- CMA 46961 342 Nkfcofaoe with more than 8,500 deaths annually [Nicholson et al, 1982]. If one coruiden only deaths, the contribution of the identified causes of occupational cancer accounts for 6% of ail cancer, but for more than 12% of all cancer among blue collar workers, the only group actually at significant identified risk from occupation. It is generally accepted, based on comparisons of cancer incidence in different geographic areas, that "environmental factors" can contribute to at least 80% of United States cancer morality. Here "environmental frctors" are taken to mean the totality of the effeca of that which we eat, breathe or are otherwise exposed to. Dietary factors (high cholesterol or fiu intake, nutritional deficiences, etc.) generally have bees accorded an important role as a cause of human cancer. The recent review by Doll and Poo attributed 35% all of U.S. cancer to diet and suggested the contribution could even be twice as high. While diet must be of importance in human cancer etiology, there are yet no quantitative data chat allow a specific estimate to be made of the contribution of any dietary factor. Considering the existing evidence, only about 50% of the cancers in males can be associated at present with some specific agent (this includes some double counting because of synergistic effects). Thus, specific "accepted" occupational carcinogens account for at least 25% of the Identified causes of oncer among United States blue collar workers. As more occupational carcinogens are identified, this percentage will certainly rise. And in terms of preventable cancer, occupational neoplasms perhaps take pride of place. Certainly workers need no behavioral modification, as with cigarette smoking, to accept the advantage of cessation of exposure to workplace carcinogens. William J. Nicholson, PhD Environmental Sciences Laboratory Mount Sinai School of Medicine New York, NY. 10029 REFERENCES Doll R. Poe R (1911): Tht ousts of oncer Quantitative estimates of avoidable mbs of oncer is Ac United Sa&s today. J Nail Cancer 1st 66:1192-1307. lAJtC (1982): LUtC Monographs on Ae Evaluation of At Carcinogenic Risk of Chemicals in Humaa. Supplement d, October. 1912. Nicboisoo WJ, Perfcri G, Selikoff J (1982): Occupational exposure e asbsot: population at risk and projected mortality-- 1980-2030. Aa J lad Med 3259-311. / CMA 046962 C&RCXNOGZHS/CARCXSOGZHIC PROCESSES AHD EXPOSED WORK POFULATIOKS AT RISE Dnregulat da*Agents/Proceases P pulati n at risk Regulated as Agents/Proeesses Population at risk Asphalt fumes 500,000 Auramine*** 3,000 Benzene*** 2,976,000 Benzidine, dianisidine, and tdlidine-based dyes N Beryllium 30,000 B.^t and Shoe*** N 1,3-Butadiene 50,000 Cadmium 100,000 Carbon tetrachloride 56,500 Chloroform 40,000 Chloroprene 2,500 Chromate pigments 550,000 C al gasification 4,000 Coal tar products N Cutting oils (nitrosamines) 780,000 4,4'-diamlnodiphenyl-methane (DDM) 2,500 Dianisidine N Dimethylcarbamylchloride (DMCC) E Epichlorohydrin 85,000 Ethylene dibromide 660,000 Ethylene dichloride 34,000 Ethylene thiourea 3,500 Formaldehyde 100,000 Furniture*** 348,000 Hematite mining*** N Hexamethylphosphoric- triamine (BMPA) 5,000 Hexavalent chromium*** 175,000 Hydrazine and salts 100,000 Isopropyl refining*** 141,000 Methylene chloride 70,000 Nickel (oxides) 1,400,000 2-Nitropropane 100,000 n-Phenyl-beta-naphthylamine 15,000 Polychlorinated biphenyls (PCB) 12,000 Rubber products*** N Shale oil extraction E Tolidine N Trichloroethylene (TCE) 280,000 Uranium mining & milling N Vinyl bromide 26,000 Vinyl fluoride 32,000 Vinylidene chloride 58,000 Welding fumes N Woodworking 534,000 2-Acetylamino-fluorine Acrylonitrile 4-Aminodiphenyl* * * Asbestos*** Benzidine*** bis-Chloromethyl ether*** '..Vi ov*)i emission:. 1,2-dibromo-3-chloropropana (DBCP) 3,3*-Diehloro-benzidine 4-Dimethylam:taoa2o-benzine Ethylana oxida Ethyleneimine Inorganic arsenic*** (and compounds) Xepone Methyl ehloromsthyl athar 4,4-Methylene bis (1-ehloroaniline)(MOCA) alpha-Naphthylamine beta-Naphthylaaine* * * 4-Hitrobiphenyl n-Mitrosodimathylamine beta-Propiolactone Vinyl chloride*** E 125.000 E 2,479,900 2,200 E 10,000 N E 28,600 100.000 4`, 500 1.491.700 E .E "67,200 46,400 1,000 E E E 3.546.700 Notes; N, no satisfactory estimates at this time E, estimates of lass than 1000 workers expose *Deemed careinogens/carcinogenic processes for humans by IARC (WHO) Estimate for 1985 Direct production Source: Health, safety t Environment, Industrial Onion Dept., AFL-CIO CMA 046963 Sour : offic# of Technology Asseesaent, Asaesaaent of Taehnologiaa for Dotamining Cancer KiaXa froa tha Envlronacnt, June 1981. OCCUPATIONAL CANCER EAZAKSS Spent Cancer ane o> type Type or workers eioosed aorytonunla Lung, coion Manufacturers el aesa/at careating, Blankets. draperies, syntneue lure, and wigi xommobiehenyi Bladder Chemical worker* A'sr'nC and certain arsenic compounds Lung, skin. scrotum. lymphatic Worker* In tnt metallurgical industhex *he*c-dip workers, pesticide system, hemangiosarcoma el ina production workers, cseear ameuer worker*, vineyard workers, itv sacticide makers and sprayers, tanner*, miners (gold miner*) MMta Lung, larynx. Si trad. oleurof and Aspastos laciory worker*, lei til# worker*, rueoer-ti/e manutsetunng penioneaJ meoetneiioma industry worker*, miners inaulation worker*, shipyard worker* Aursmme and tha manufacture of aufomin* Benzene Btseaor Laukomia Dyestuffs manufacturers, rufioer workers, teslite dyer*, paint manufacturers Auooer-ura manufacturing industry workerx painter*, shoe manuiacluring worker*, ruooer cement workerx give ane vamisn workers, distiller*, snoerr.akar*. plastics worker*, cnenucai workers fanxidma Beryllium are certain Beryllium compounca BistcniorometnyOethor (BCMB Bladder, pancreas lung Lung Oyeworkar*. cnamieai women Beryllium workerx electronics worker*, missile pans producer* Worker* in plants proeucthg anion-exchange resins (Chemical workers) Caemium and certain cadmium Lung, preataic compounos Cadhuwm oroductton workarx matsllurgicaf workers, electroplating industry workarx cnamieai workers, jewelry workarx nueiesr workers, pigment workerx bsttety worker* Camon leirseMoriCs Chioremethyl methyl ether Uor Lung Piasnc work erx dry eiesner* Chemical worker*, worker* in plants producing ion escnsnge resin (CM MS Ovomium and certain Chromium compounds Coal tar pitch volatiles Coke o*en emissions Dimethyl sulphate Esienierenyenn Ethylene Okie* hematite and underground Lung, noaai sinuses Lung, scrotum Lung, kioney, prostate Lung LunQ, leukemia Lavkemix stomach ' Lung Chromatevproouetng industry worker*, acerylent snd aniline woree bleacher*, gtasx pciiery. pigment, and linoleum worker* Steel industry workarx aluminum potroom workerx foundry worker; Steel industry worker* coke pism workers Chemical workers, drug maker*, dyemsker* Chemical workers hospital work erx research lab worketx beekeeoerx lumigaier* Minor* hematite mining laoeropyi oils and tne Paranasal sinuses Isopropyl oil worker* manufacture of isopropyl oils Musraro gas I-naontnyiamma Mesoirstory tract Bladder, psnsroas Production worker* Dyewerkerx ruDBeMir* msnulactunng industry worktrx enemies! workerx manutseturer* of ceai gas. nickel retmerx cepper smene' electrolysis worker* Nickel (Certain compounds) Nasaf cavity, lung, larynx Nicxet reliner* and nicks! refining Oeiychionnated bipnenyt* (pca*i . Melanoma PCBs worker* Radiation. ionizing Skin, pancreas, brain, stomach, breast, salivary glsnas. thyroid, Uranium minerx mdiQtogistx rsdtogrsoherx luminous dial painter* Gi trCL pronchas. lympno>d trs- sin, leukemix multiple myeloma Madia lion, ultraviolet Soots, tar*, miner*! oils Thorium dioaioe Skin Skin. lung. bladder. Gl trset Lrver, Money, larynx leukemia Farmer*, sailers. arc weloer* Construction workerx tool erx chimney swetpx machinists Chemical workerx siettwermerv ceramic maker* incanoeseenl ix*r maker* nuclear reactor worker* gas mantle mekerx metal refine.", vacuum tube makers Vinyl cnienoa Liver, brain, lung, hematoiympho. Plasties factory workerx vinyl cnionot poiymeristien plant women Agent**) not idanilflod po>eiic system. breast Pancreas * stomacn Chemists Cost miners Brain, stomach Hematoiympheooietic system BiaoOor Erx kidney, lung Leukemtx br*m Colon, brain Petrochemical industry MuDPer industry worker* Printing pressmen Chemical worker* Fsrmer* Pattern and moo el maker* CMA 046964 Etopnagux stomacn. lung Oil refinery woner* &0UAC&&, !8Sifiw Mfiicm i \ ipm +*>.A^ttPiCT fB ** C*'***' M44k v*l lP*g 0ccu*l>ff|u ** **(* AtmtrvUiynw* (271 A) Risk Fnon Associated With Workplan Exposom To Fit High-Volume Kumaa CamwofTW ___ ______ OtcmieaJ Sites of primary anccn Occupations at risk Latency period (or (years) 198) NIOSH estimated numbers of workers potentially aposed Full + pan limeV Full time Arsenic Asbestos taunt Chromium Nickel Skin, lung, live, lymphatic system Lunt, pleura) and pcntonal meso thelioma, gastro intestinal tract Bone marrow Ocukesua) Nasal avity and sinuses, iun| Naa) avity and sinuses, lunt Miners, smelt en. insecticide makers and sprayers, chemical works*, oil refiners, vintners Miners, millers, taulf. insu lation and shipyard workers Explosive, benzene and rub ber cement workers, distillers, dye uses, primers, shoemakes Producers and processors of Cr. acetylene and aniline workers; bleachers; class, pottery, and linoleum workers; battery makes Nickd smelters, mixers, and roasters, electrolysis workers 10+ 4-S0 6-la 5-15 5-30 255.407 4J1.914 (arsenic oxides) 1JJ1.023 12J70 8J69 79,843 1,495.194 40,844 1.451.4J0 (exida) 237.686 1,569,169 (oxides) 232.684 Risk Factors Associated W ith Workplace Exposures To Six High-Volume Humaa Cirriaofm Chemical Acrylonitrile Sits of primary cancm Colon, hw| Carbon tetra chloride Ethylene oxide Beryllium Uv0 Leukemia, gxsirit cancer (suf sesied) Lunt Cadmium Prostate, respira tory traa, renal Vinyl chloride Angiosarcoma, lung, brain, hematoiytnphopoietic Occupations at risk Otemical workers and plastics workers Drydaning. machinists Hospital workers, laboratory work os, fumigators Beryllium workers, defense and acrospaee industry, nuclear industry Eretries! workers, paints*, battery plant and alloy workers Plastics industry Latency period for cancer (years) 1981 NIOSH estimated numbers of workers 'potentially exposed Full + pan umt Full time 20+ 374J12 25.245 1,378,912 21,457 144,129 2,767 15 + 855.073 106.633 (oxides) 1 J76.756 (oxides) 230,607 30+ 239.347 8,116 Source Davis et at 1)981). proa "Cineor Preventions Ae**ing Causes, Exposure, anfi Recent Trends in Mortality for O.S. Males 1968-1978", Davis, >.., Bridbord, K., and Schneidennan, M. ,* Teratogenesis, Carcinogenesis, and Mutagenesis 2:105-135 (1982) CMA 046965 Amounts of Coafirmed or Suipetl Human Carrinofem Petenuallj Available for Human Espounr. 1M0-79 -___________________________________________ ___________________ Substance, measure, unit Jd40-9 19J0-J9 1960-69 1970-79 Mealt Asbestos (U S. apparent consumption, thousand! of short tons) . 4.6r 7,419 V 7.361 *.rs Be?Ilium CIS. appareni consumption, tu'ltou of pOUitu., 65* >17* 33* Cadmium fU.5- production, millions of pounds) n* 305 sr Qtromite (US. apparent consumption, thouands of then tons) 7,992 13J77 13.136 11,579 Nidtd (US. consumption, 1.040 1,492 1,692 thousands of shon tons) White Arsenic (A*,0,) Conft* (U.S. apparstt consumption 343 22) 347 destial thouands of than tons, eiimiied) mdustry daa Synthetic Orpnnie ChemtoUs Ao?lonitrite (U.S. production, millions of pounds) 964f 6J24 14,047 lease* (US. produeion, millions of pounds) ISIS 6,663 49,363 93,203 Carbca Tetrachloride (US. produeion, millions of pounds) 1,705 2.763 5.196 9051 Chloroform (US. produeion, millions of pounds) 317 U96 2.120 Ethylene Oxide (US. produeion. millions of pounds) 6.127* 21059 43,464 Viuvl Chloride (US. production. Ml* 5.161 20,071 33,626 'IWO-JJ ftfura net avxflablt *1960 ftfura not available. *1975-79 ftfura Dot oviftnble. *1950-51 fifura not available. *1971-79 ftfum not available. fijure sho*-n include 1977 estimate. f1950-S3 ftfura not available. *JP50-32. 1954 ftfura not available. *)94<-j9 ftfura not available. Source U-S. Internal*! Tride Commission; U.S. Department or Interior, Bureau of Mine. * - From "Cancer Prevention: Assessing Causes, Exposures, and Recent Trenc in Mortality for D.S. Males 1968-1978*, D. Davis, %, Bridbord, and M. Schneidennan, Teratogenesis, Carcinogenesis, and Mutagenesis, 2:105-135 (1982) CMA 046966 " M WORKPLACE CHEMICALS AND PROCESSES ASSOCIATED WITH REPRODUCTIVE t.:7Z EVIDENCE IN HUMANS Anesthetic cases (In Hospitals) Anesthetic cases (nitrous oxide) Carbon Disulfide Chloroprene 1,2-dibromo-3 chloropropane (DBCP) Diethvlstilbestrol (DES) Ethylene dibromide (EDS) Bexachloroben2ene (HCB) Kepone Laboratory reagents Lead and other smelter emissions Methyl mercury Occupational exposure to pesticides Polychlorinated biphenyls (PCBs) Vinyl chloride Source: Health, Safety & Environment, Industrial Onion Dept. AFL-CIO CMA 046967 Source: Health, Safety & Environment, Industrial Union Department, AFL-CIO HON-KEOFIASTIC DISEASE CLINICALLY COKFIRHZD Aluminosis Asbestioaia Silicosis Shaver's Disease Berylliosis Byssinosis Pneumoconiosis of diatoaite Pneumoconiosis of kaolin Heavy metal poisoning' Carbon disulfide poisoning Carbontetrachloride poisoning Fluorocarbon arrythaia Bydrogensulfide poisoning CMA 046968 "The Work Rl*t*dness of Renal Disease", Landrigan, P.J., Coyer, R.A.. Clarkson, T.W., Sandler. D.P. Smith, J.H., Thun, M.J., Wedeen, R.P., Archives of Eflvi.ronment.al Health, vol. 39, no 3, May/June 1964, pp. 22S-230 Table 2.--Estimated Numbers of Workers in the United States With Potential Occupational Exposures* to Known or Suspect Nephrotoxins, 1971-1972 Lead! Cadmium! Inorganic Mercury! Uranium! Solvents* Silica* Arsenic! Pesticides* Beryllium* 614,607$ 51.572 37,593 1,163 3.373J39 174.614 5.929 16,356 10.510 * The phase "potential occupational exposure" derives from NIOSH's National Occupational Hazard Survey (NOHS), in which occupational groups are related to chemical exposures.* Environmental samples were not collected in the NOHS. A recordable potential exposure agent was defined as a chemical used in a worker's work area for at least 30 min/wk for at least 90\ of the weeks in a year and which presented the potential, in the surveyor's judgment, for contact with the worker in one or , more of its physical phases. 1 Known Nephrotoxin * Suspect Nephrotoxin $ Total exceeds 3.9 million because some workers have multiple potential exposures. 046970 ^ Cl1)* Condnon AiC to--* on ' on. M2 020 071 f 022 Pulmonary Tutortutowt lOT StocoiubtoCUbM* piacuria TUnmuO torhrai *01 p* p p p p 021 037 ; OV i 0 0.1. CWX3 ructotoM Cl Ttunui f lubrllalOl . Hrpaian A <Ot Hapwab 10 p p P p 0704 071 073 135444 1*00 Nen-A. Norn* Htparah (O) Rabm (O p p 0*"bho*i* IO p HrmanfioiaiLuifa of thr Uwr p Malifnani Nhptoam of Maul p Canon lOl 1*1 Miiipnani hhPmib of p laryni (Ol 1*2 Maltfnant Ntoptoam of Tra- p ehra. Irondito. and Um| (Ol i:ise. iu 170 17.7 iae in 204 203 20721 2*3.1 htoxiilialiumi iMN of Prmo. nruml (MN of nml Malipiam Hipplm of *onr ta Malrpnam Maopltom of Scroium p p p Malifnani Itooplaim of iadOrr tO) p Maltn*m (neplaam of Kidnry. Orhrr. and Umprcv *40 UrmaryOia( (OI lymphoid Uukarma. ACM* (Ol >4)oloid InAanui tout (Ol p p p tnahrolaukamia (O Htmefytic ynrmia. Won woo bwnunr |C p p 2*4J Apiawie Aaumia 101 p P.T* P,T -- " P - P ( P P - -- P P.T P.T P.T PTiytrtiant." mn*cal pwionnal.**1 mrd Ian mtm " P.T . Quartymm. tandblaum viol proemon. mmmf mil feundrm, caram* mdmfry " StOi MyrobaONium lubrrrulpul " " " P.T Smi(m<(. tarmm, ranrhm, human, Arid faoiapat " . Vmuua pawn.*' P.T Huim. hn handlm. ihrtp mduury wtukm" cooto, m ranchm. wt pathpiofi.'" francarlla lakrmu " *" P.T Shrpdrtdi. farmrri. button, tondlrn of imooned arrf/u mhftcn TM Wdn oi Abm" wwiiunmi. wirnnanan parhoi- 0*<u. oawn.*" P.T farmrn. itopfwidt. wirrinanani. lab wokm.'" laufhirrdomt work*n.'"*" rurafla tbonut wn "* P.T farm, ranehm.*" Ctowrtoium iwani *" P hbtoicaf pmcmrl." *"*" rnrmtiw rarr pmonnrl *" Rubrfla wm* " *** *" ( Day tarr centrr pah." **'orphan * V .*,*.! MrpJI* ! .iru*.""" " toardwen inoauion oaff," *" mrdital pmonnrl " P Nunn and ator." " " anrotouoloimt.** otphanaf* ktopdii* arrwi." - and mmiai notunn pad." mrd lab pmonnrl." *" *" prnrral drmi*i`** and oral aurprontpnmom " " " CMA 046971 P to aben tor hapaaa a and t f 1 P Vaiaiinanam. animal and |amr wanton*. lab rawaidon. imn. nneton. trappm *" P Pwnacmr bud brrrdrn. pm diop oaff. poukry pn>- Chlamidia puiaci.'" ductn. wirhnariant. too rmploym."* P Vlnyf thtottor ptoymanaaron ndusry." VItantn" Vinyl chlortor monomrr Anmical powetot*."" - P.T toraodr prim. rthinm tonwiur mahm." " *" " Hato-ood duu." *001 and diet mduory." " Radium thrmrat and (motinon* dial parraan.*** Unknown" ' Radium." " Chrorrmrm produem. mxruon uwn." Ouomam " Nickal imr*in| and nftninp," " *" Nrckai *" - P.T tobcdoi mdtuiot and uifiam."* MbMM."'" P P tobrito* indudry and uiiiim " **" Topudr eo*t om uorton Uranium and Duanpar mmm." Chromium produem and procnaon," utm Niekrl wnrkm, procanon, urn." " Jrtokm.'* Muard pu tormulpon."' ton tachanfr mm makm. ctomiai." *** - P Aabrooi mduBim and udkim.'*" WtoOb*3.tro*wp*."A(WAWraOimTTpIl.*1* a* Odd Radon daufhim." Chnxna. "" - " Nrekto."-"-" Aomrc."*" (touoard fat."* iilChioromTThyfl tohrr. cMoromrihto mrrhyi tihrr." * Aibawoi.""*"" *" *" - P 0>af pauam.'" radium ctomiot and lautmurt." Radium."*" - P.T Auomoic Idto Pprraim."" mmatoorkm.TM Cokt own *orkrn. pmiolrum rrfmm. ut duiHm." P ubbrr and dyr wokm." " " P P Cokr own atorkon.TM " kamrral/cunm| oHi **" Soot* and tan. tar dmaiain " " miidinr.'* *" alpha and ton naehihyl ammr." " aurammr** " " a. ninotepdmyf.'** tormrophrnyl " *" Cokr own amnwoto.*" ** -P tubbrr induory."* " Rad'dlopof" Unknown.*" tonumt radialon ***"" -- P Occupdani aikh npuiutr to btnirnr. Radipiopoa"*"' toirni""** *" * lonilini radaron " *" -- - P Occupamm kh tapoaurr to barurna. Rmimr.""**" " * P.T 14Awmoihin| and tomtor mduMry (laeiiofyic proemwt. anamcal ow vnrkma " Plaoo indudry " Dw. taHuleid. mtn indudry." Cooorr wdfat* " Anrm." ""* Tnmrnac anhydhdr " Napwhaimr" P hpfoiiwi mmudaaura." "* Otcupaitoni wah rapoMirr to btnatn*. TWT."4*1 O O* Raddoppi."* radium ctomroi and dial pauam *" tonauif raduon" *"-*" * 2M.0 2n.7 223.7 313 1 ApraruAocytov* O' Nruroor- p wa lO Mtitnmoflobnniiua (Ol p Tome toerphaiao Ol p Pftrttatan'l Q>j#^ fSc- p - P Octupoont w*h rrtnurrr ip brwarnr. Eaptouwa and pauieidi mdupnn." Pawa.ton. ^ynmn pharmacru<ah." * P.T taptoin to and dyr induwnn." "'""* Rrnrm*"" "* . Pho*ohoru*." inor|anit anmit." Aretot ammo and narp cpmpoundi lr.| antona. TWT, narollmril." " " *" P P 4 diary, imrktr. and foundry workm."-" EtoarPtot Chionnr producnon. tonary makm. funpctoc tormutoon " " trad.**" morpaiw and (Vto mrrtury " " " P - Manpanrw procrumt. tonrry makm. araidm*" Manpannr *" ** I ** > 337 7 Inflammdory and Tout Ncvropdhy <Ol m* CjU<3 IQ ue i 443.0 4*5 0 10 4*5.4. i NOM4 Wefl on innar lar lOl Raynaudt Wmnomenon (Sacsndaryl (Of fcnnnue AKtrpe AJ.aolnn 4*3 0. 507.* tarnnuc Adhma |0) 500 501 502m SOJm 104 Cftil-Ofkfn' Pnaumocomota Aibnow Siicowi TiInm Otromc trrylUwn Docaae of lh Um| ItmroryK chtcrmr CLJOjflior kwpi makerv ftmpcide lormularory.*" Inpanc nwcvcy " P.T P.T Pcantidcy," pumami. punuemuh* Furnaum mieuthary. Orf-tn-nf opKnmv."' Ptto4i0-Ubf* wlm* Uxkii mdupry " (Uvon m*n4iClunoj." * Plaucj hydraulic coke mdudne* Rariery. amaher. and toundry worker). Denimt" ddoraJkali aiorkery -- Oiloralkaii pUmv htnpodc makary. binary makary." jUdlUY,*** papar WlKHAlCMWm *** Anno tnd enemc com Henan*"'" kaerhyl iwfeayf baron* " TNT " n " m Tn-o-frW pheionaf Inoipmo itu '* *' ht>|iio mofctify * **." Or|*nc nmcnry." " Aery4ownd ^ mm *,T - hhOOi'iWiH Md radar IldVKim.* tapfmney mduamat" Moiefn'* liartamiihy. |(Mt bhyan Wm.* Moth repellini fprmuiaory. htmipaory." bp4n by*. twrboOt and pruodr uydu*nfi.'" AAlCIOWMOl* TWT."* toniiMt >id*ci * TM Ifdioifd ridolion " * NAOnihilont *" OnotoonmA.'" bciwo none.' tmb*ncki.'* " diam lawyer). |rmden. ehippery,'" Veryl ehlonde ppiymaruaiion mdwiry." * Whole body o> Vmy cMondy monemtr' P.T Farmer'* hint. baoaatom. M Inoo'i hint, wrberow). into worker) hint muthroom worker) hint maple bark 6mm* eheeae rrikher'y hint cohee worker") hint *Vmel Qilr'l kmt Rimer hmt wetmoM, wood KWir i hue, millerT hint-'1*' f,T P.T (fwn.n, *Hpy ond catily* maker) .* Myiiiothon*. adheme. pane totev*" Alloy. CJUlyp. refinery workary." Soidererv* nau. dyo.nosod mokfft* Foam worker*, laev makary. bNhopm." Pnmin* indvery." Niehef pi*ary." (An* " PVaoo mdupry."-TM Woodworker, huMim milin " Pmancm fennulaorv" Vow aovnit* nAHnum* *" * hocyind*.* Ownnmi ond CObik m AluminuAi loldmnt IUb.v Wwhiiic inhyondc." *** Ponmktehydc." Cum ntix-m Nisa." Ftom* Tnnollio nhydride w * * tod ctdir and An wood ddi* tocd/uidrmod nomj >wov" Cool mmerv" " Cod duo.**-*! Aibeytoi mduoney and Milurry " Qaomimcn. aandlhaaien. lilica proemtoA.* man meral, and ceram* mdu*n*y.'" ** Talc proceeion." Aiboboh**1*** '* TM yi.. mm.im ~ IS Talc" Saryllium tllor worker. cemmc and cathode my tub* maker, nudtar moo' worker." Ccnon mduory worker."."''" Ofyttum-" Conon. flu. hemp, and wu tyrannic 104.0. 50k. 1 170. I73J Acmi tyjnchiiv bnrumanad. P.T P,T P and Pulmonary tdorna Du* 10 fumei and Vapori (Ol Tone Mopaiiii IQ) PPP CMA 046972 Meltigrrmkm, fanHinr,** oil f4nm( indiatnoL' Alhal' and Wcadi mdiunci ' Sik> filwry. art waidan nine aod indudry* Paper and rff"|*rdn mdusnn. oh icfinmt1" Cadmium amtharv oecyiion '* Plaaia mdwilry." Sohwni Mhiicrt dry danfn,H pladia Indui- ny." lapievima and dy mduanct " " Fit* and wai*rproofin| addind lormglJion." " Plaano lormuUo^l.", Fvm>torv laaolmo, hr* nnn|uidwr formuldom. Oiainffojnt. (umipnt. fymrmc mm Iprmuiaiorv' Altunona.'*' Chlonna'" Naioten o*ld*^.,*' Sulfur daid(.'B Cadmium Tnmallaie anhydhd*.1* Carbon lairaehlondt,'" ehhnohsrm." i*iraehlproeihana,-* inchiarawayam " " Btoaohorui." TNT * Chloronaphlhawnoi "* Mhy44ndijn>linc trhyNno dituun^t.* Cmol.- 5*4 M3 * Aewia or Oirbnc donal Faduf* (O *04 InIanAliy, MaW 10) M2 Comae) and AKerpc Oarmanw (O P P.T P.T Sanary maken. blumbart iolda*r.* tlacrrolvric proenm. aryanital ora pwahint* '** Wopne lead."* Afvnt." lanary makary. n naWry. damntL'*' Inorfamc mercury,*" fluorocarbon tormuluon. km aaimguithar maktry.** Carbon latrachlondt." * Amifmctc manukaerwm.* (thylona |ycoi.* P P -- Fermulaiort.** Kpon.tf DSCP produced, ikrmuldory. and applicaiad.* "* OifarV^Vd^OfWSOIM.41*11* P.T P.T -- Uithor unnint pouhry Ornurry pUnu. kyh pachmt adhatnmy and Malamt mduirry. bod buildinf and repair." Irminn (a %.. euOm| o*U. aAma phenol, acdi. aliuliy. dararyantt); alaryanl lt>. nickel. Ouemaiay. formabahyda. dm. robber produety).'" biamal cauM* or injury and poAonm; (ooCuoandnal) mduda acetdam and am dauiked in tha ICO-k under the ( coday. A Unnacmary dnaaa* I Unnacnury dnabildy C Unnocauary umawafy daaih * InduwiyOctupanon Idimp ara a*ampn ordy TO Only miwrt an oecupairtnal cipenury can be aatabi><Aad *P ainiiui, T trailmam paa * anodiflad CD mbit 'Sentintl Betlth Events (Occupational); A Basis f r Physician Recognition and Public Bealth Surveillance* Rutstein, D.C.r Mullan, R.J., Praiier- T.H., Balperinr W.E. Meliua- J.M. .- Sestito, J.P. Archives of Environmental Bealth, vol. 39, no. 3, Hay/June 1984, pp. 159-168. ,