Document RajeYyn49GjmxLorZDbnGx1O7

"fRev. 1/94) Subpoena In a Civil Case Issued by the UNITED STATES DISTRICT COURT EASTERN _______________ DISTRICT O F ______MISSOURI. V.WILLIAM R. GAFFEY PETER MONTAGUE and ENVIRONMENTAL RESEARCH FOUNDATION, INC. SUBPOENA IN A CIVIL CASE CASE NUMBER:1 9 1 - 1 9 3 8 - 6 - C E S TO: Clayton F. Callis #2 Holiday Lane St. Louis, MO 63131 HU YOU ARE COMMANDED to appear in the United States District Court at the place, date, and time specified below to testify in the above case. PLACE OF TESTIM O NY COURTROOM DATE AND TIME ^1 YOU ARE COMMANDED to appear at the place, date, and time specified below to testify at the taking of a deposition in the above case. PLACE OF DEPOSrTlON DATE AND TIME Leritz, Plunkert & Brning, One City Centre, Suite 2 0 0 1 S.tL^s:;.v.MO:r - , 6 3 1 0 1 November 2 , 1 9 9 4 9 : 3 0 a-m-____ 13YOU*ARE COMMANDED to produce and permit inspection and copying of the following documents or objects at the place, date, and time specified below (list documents or objects): See Attachment "A" PLACE Leritz, Plunkert & Brning, One City Centre, Suite 2001, St. Louis, MO 63101 DATE AND TIME November 2, 1994 9:30 a .m . 1 1 YOU ARE COMMANDED to permit inspection of the following premises at the date and. time specified below. PREMISES DATE AND TIME Any organization not a party to this suit that is subpoenaed for the taking of a deposition shall designate one or more officers, 'directors, or managing agents, or other persons who consent to testify on its behalf, and may set forth, for each person designated, the matters on which the person will testify. Federal Rules of Civil Procedure, 30 (b )(6 ). f / H A feSUINl5 OFFICER SIGNATURE AND TTptE (INDICATE IF ATTORNEY FOR PLAINTIFF OR DEFENDANT) a a t t o r n e y fpr Environmental ^ ^ 1/ Research.Foundation, Inc. ISSUING OFFICER' S N AM E. ADDRESS AND PHONE NUMBER Edward M. -Roth, One City Centre, Suite 2001 St. Louis, MO 63101 , ~ (314)231-9600___ - (See R ule 45, Federal Rules o l C ivil P rocedure, P arts C & D on Reverse) If action is pending in district other than district of issuance, state district under case number. DATE 10/4/94 AO 88 (Rev. 1/94) Subpoena in a Civil Case __.IS: L-V* ; -- --; SERVED SERVED ON (PRINT NAM E) DATE SERVED BY (PRINT NAM E) ............. . PROOF OF SERVICE PLACE I I ' MANNER OF SERVICE TITLE I I I ' DECLARATION OF SERVER | I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Proof of Service is true and correct. ' Executed on DATE SIGNATURE OF SERVER ADDRESS OF SERVER j I Rule 45. Federal Rules of Civil Procedure, Parts C & D: (C) PROTECTION OF PERSONS SUBJECT TO SUBPOENAS. (1) A party or an attorney responsible for the issuance and service of a subpoena shall take reasonable steps to avoid imposing undue burden or expense on a person subject to that subpoena. The court on behalf of which the subpoena was issued shall enforce this duty and impose upon the party or attorney in breach of this duty an appropriate sanction which may include, but is not limited to, lost earnings and reasonable attorney's fee. (2) (A) A person commanded to produce and permit inspection and copying of designated books, papers, documents or tangible things, or inspection of premises need not appear in person at the place of production or inspection unless commanded to appear for deposition, hearing or trial. (B) Subject to paragraph (d) (2) of this rule, a person commanded to produce and permit inspection and copying may, within 14 days after service of subpoena or before the time specified for compliance if such time is less than 14 days after service, serve upon the party or attorney designated in the subpoena written objection to inspection or copying of any or a!) of the designated materials or of the premises, if objection is made, the party serving the subpoena shall not be entitled to inspect and copy materials or inspect the premises except pursuant to an order of the court by which the subpoena was issued, if objection has been made, the party serving the subpoena may, upon notice to the person commanded to produce, move at any time for an order to compel the production. Such an order to compel production shall protect any person who is not a party or an officer of a party from significant expense resulting from the inspection and copying commanded. (3) (A) On timely motion, the court by which a subpoena was issued shall quash or modify the subpoena if it(i) (i) .fails to allow reasonable time for compliance; (ii) requires a person.who is not a party or an officer of a party to travel to a place more than 100 miles from the place where ?jhaf,^person resides, is employed or regularly transacts business in person, except that, subject to the provisions of clause (c) (3) (B) (iii) of this rule, such a person may in order to attend trial be commanded to travel from any such place within the state in which the trial is held, or (iii) requires disclosure of privileged or other prote m atter and no exception or|waiver applies, or (ivj subjects a person to undue burden. (B) If a subpoena I (i) requires disclosure of a trade secret or other confidential research, development, or commercial information, or (ii) requires disclosure of an unretained expert's opinion or information not describing specific events or occurrences in dispute and resulting from the expert's study made not at the request of any party, or (iii) requires a person who is not a party or an officer of a party to incur substantial expense to travel more than 100 miles to attend trial, the court may, to protect a person subject to or affected by the subpoena, quash or modify the subpoena, or, if the party in -whose behalf the subpoenalis issued shows a substantial need for the testimony or material that) cannot be otherwise met without undue hardship and assures that the person to' whom the subpoena is addressed will be reasonably compensated, the court may order appearance or production only upon specified conditions. (d) DUTIES IN RESPONDING TO SUBPOENA. (1) A person responding to a subpoena to produce documents shall produce them as they are kept in the usual course of business or shall organize and label them to correspond with the categories in the demand. (2) When information subject to a subpoena is withheld on a claim that it is privileged or subject to protection as trial preparation materials, the claim shall be made expressly and shall be supported by a description of the nature of the documents, communications, or things not produced that is sufficient to enable the demanding party to contest the claim. ATTACHMENT A At the time and place set by the attached subpoena for your deposition to be taken, produce the following records for inspection and copying to the extent that you or your attorney have them in your possession, custody or control. 1. All documents constituting (a) minutes of meetings, (b) reports by or to or (c) communications from, to or among members or staff of the committee sometimes referred to as the "Nitro Health Study Task Force" which discuss or refer to any activiety contemplated or undertaken by the Task Force. 2. All documents discussing or referring to the creation, composition, organization, resources, mission, or purpose at any time of the committee sometimes referred to as the "Nitro Health Study Task Force." 3. All documents constituting or referring to press releases, "backgrounders," position papers, or public relations documents disseminated by any Person, including without limitation Monsanto Company or any chemical or paper industry trade or lobbying organization, to any Person, including without limitation any news organization, labor organization, medical association, governmental agency or governmental representative, or private public health agency, which discuss or refer to the Zack/Suskind or Zack/Gaffey studies or to the mortality experience at any time of any portion of the population of workers at Monsanto Company's Nitro, West Virginia plant exposed or potentially exposed to dioxin or other substances found in association therewith, 4. All documents constituting or referring to news or other media reports or accounts (including print and broadcast news media and scientific or public-health media) of the Zack/Gaffey study. 5. All documents constituting, discussing or referring to the presentation of the report of the Zack/Gaffey study at the 1981 International Dioxin Symposium, including documents actually presented at that conference. 6. All documents constituting, discussing or referring to public presentations, speeches or statements, or statements to the press by William R. Gaffey concerning (a) the mortality experience at any time of workers at Monsanto Company's Nitro, West Virginia plant exposed or potentially exposed to dioxin or other substances found in association therewith, including, without limitation, the presentation made by William R. Gaffey before the American Medical Association, Council on Scientific Affairs' Advisory Panel on Toxic Substances, 17 November 1983 and (b) other matters within the field of occupational or public health. 7. All documents discussing or referring to allegations of fraud, dishonesty, incompetence, or scientific inadequacy or irregularity in any of the Nitro worker studies or their authors, including, without limitation, all communications relating or referring to Dr. Cate Jenkins' allegations or comments regarding any of the Nitro Worker Studies performed by or for Monsanto Company. 8. All documents constituting, relating or referring to critiques, criticisms, reviews, or investigations of William R. Gaffey in connection with any of the Nitro worker studies. 9. All documents constituting, discussing or referring to Marcie Strauss's "Verbatim & Critique," including, without limitation, documents and communications used in its preparation and dissemination. 10. All attachments and materials that accompanied Marcie Strauss June 4, 1987 letter to Dr. Marilyn Fingerhut, a copy of which is appended as EXHIBIT "C" hereto. 11. All documents, including records of communications, which refer to this lawsuit, including, without limitation, any communications between William R. Gaffey and George Roush or any other Person. 12. All scholarly papers (reports, summaries, surveys, etc.) authored or co-authored by William R. Gaffey, whether ultimately published or unpublished. 13. All documents (including audio or video, recordings, press reports, personal communications, etc.) discussing or referring in any way to William R. Gaffey's character or integrity. 14. William R. Gaffey's Monsanto Company personnel file and/or any documents known to have been placed in it at any time that are no longer in that file, including, without limitation, documents which discuss or refer to the reasons or purposes for which he was originally hired and subsequently employed by Monsanto Company and his job responsibilities at any time. 3 H*Kr- 15. All documents relating or referring to the designation of William R. Gaffey as an expert witness in any litigation relating to dioxin, including in connection with the cases consolidated with and including Adkins et. al v. Monsanto Company. 16. All documents which discuss, refer to or record the payment of money to William R. Gaffey since his retirement from Monsanto Company. 17. All documents constituting or referring to payments, directly or indirectly, by Monsanto Company, to the law firms of Coburn & Croft or Lewis, Rice & Fingersh or otherwise for the benefit of plaintiff William R. Gaffey in connection with this lawsuit, including without limitation agreements under which Monsanto, directly or indirectly, has paid legal fees to either Coburn & Croft or Lewis, Rice & Fingersh, reimbursed William R. Gaffey for such legal fees, or otherwise compensated or made payment to Gaffey or his attorneys for matters relating to this lawsuit, from the inception of the lawsuit to the present. 18. All documents marked for identification at the depositions in the cases consolidated with the including Adkins et. al v. Monsanto Company of Ferdinand C. Meyer; Monte C. Throdahl, Clayton F. Callis and William R. Gaffey, as indicated in part by the pages appended hereto and identified, collectively, as Exhibit "DM . 19. Except to the extent already produced pursuant to the foregoing requests, all affidavits or transcripts (including, if available, notary certification page) of testimony (whether given at trial or deposition) by Judith Zack, Mary Gaffey, William Gaffey, Jan Yung, Raymond Suskind, George Roush, Clayton Callis, Monte Throdahl, Dan Bishop, and Ferdinand C. Meyer, together with copies of any 4 $> m exhibits identified or discussed by or presented to such witnesses during testimony or in such affidavit. 20. All communications between William R. Gaffey and any Person discussing or referring to any of the Nitro studies. 21. All communications between Judith Zack and any Person relating or referring to any of the Nitro studies. 22. All reports of conclusions and analyses of the Zack/Gaffey study, including, without limitation, prior drafts of the study report finally published. 23. All proposals, contracts, study plans, rationales, protocols, progress reports, for the Zack/Suskind study or any antecedent study however denominated considered' in its completion, whether completed or not, including any and all amendments, corrections, or other alterations to any of the foregoing, as well as all documents which refer to any of the foregoing. 24. All proposals, contracts, study plans, rationales, protocols, progress reports, for the Zack/Gaffey study or any antecedent study, however denominated, relied on or considered in the completion of the Zack/Gaffey study (whether such antecedent study was completed or not) , including any and all amendments, corrections, or other alterations to any of the foregoing, as well as all documents which refer to any of the foregoing. 25. Except to the extent already produced in response to the foregoing requests numbered 22 through 24, all documents constituting or referring in any way to any and all epidemiologic studies, investigations, tests, etc., however denominated and whether actually completed, 5 partially completed, proposed, or hypothesized, that did or would examine in whole or in part the mortality experience at any time of the population of workers at Monsanto Company's Nitro, West Virginia plant exposed or potentially exposed to dioxin or other substances found in association therewith, together with any control groups ("worker mortality studies") , including by way of example but without limitation (i) The Zack/Gaffey study, (ii) The Zack/Suskind study (iii) The study described in the published report of the Zack/Suskind Study as "an analysis of the chloracne cases and exposures not associated with this accident but rather with the normal TCP/2,4,5-T production processes"; (iv) The study performed by the National Institute for Occupational Safety & Health combining a Nitro worker population with populations from other plants and companies (including the "Dioxin Registry Report" for the Nitro plant); (v) the workers' union study conducted by or through Mt. Sinai Hospital. 26. Except to the extent already produced in response to the foregoing requests numbered 22 through 25 above, for each such study responsive to the foregoing requests, all records constituting or referring to: (a) any and all proposals, study plans, rationales, contracts, classification criteria, protocols, drafts and progress reports ("study documents"), including for each such study document actual or suggested amendments or corrections thereto or critiques thereof; (b) any and all records generated as part of the effort to hypothesize, propose, justify, design, or perform each study; and (c) any and all records generated by, between, among, directed to, or received by each study participant or subject that discuss or refer to any such study in any manner, including all records of Monsanto Company's "Nitro Health Study Task Force." 6 27. All documents referring to the table and handwritten notes titled, "Table 9 Observed and Expected Number of Deaths during 1955-1977 by Cause and 2,4,5-T Exposure Category Showing Proportional Mortality Ratios (PMRs) (Not Including Deaths from TCP Incident)", a copy of which is appended as EXHIBIT "E" hereto. 28. All communications discussing, describing or referring to whether or not a follow up to the Zack/Suskind study should consist of an "analysis of the chloracne cases and exposures not associated with this 1949 accident but with the normal TCP/2,4,5-T production processes" as proposed in the Zack/Suskind study. 29. All communications discussing, describing or referring to the participation of William R. Gaffey in any of the Nitro Worker studies, including without limitation the participation of William R. Gaffey in any of the Nitro Worker studies during the period he was employed by Stanford Research Institute or other academic institution. 30. All communications discussing, describing, or referring to the actual or proposed participation of Raymond Suskind in what became know as the Zack/Gaffey study, including, without limitation, documents which refer to any decision to omit Raymond Suskind as a co-author of what became the Zack/Gaffey study. 31. All communications referring to any follow-up study (actual or contemplated) to the Zack/Suskind study concerning the mortality experience at any time of the population of workers at Monsanto Company*s Nitro, West Virginia plant exposed or potentially exposed to dioxin or other substances found in association therewith, together with any control groups, including any communications to which Raymond Suskind, George Roush, Marcie Straus, Dan 7 Bishop, Ferdinand C. Meyer, Monte C. Therodahl, Clayton F. Callis or Richard Mahoney, members of the "Nitro Health Study Task Force," or representatives of the National Institute for Occupational Safety and Health, the Environmental Protection Agency, the United States Department of Justice, or any other agency of government (Federal, state or local) were participants or recipients. 32. All minutes of meetings of the Monsanto Company Board of Directors, Corporate Management Committee, Corporate Administrative Committee, any committee, task force, or other group created by or reporting to the Monsanto Company Board of Directors or any committee or subdivision thereof or any management-level group, which discuss or refer in any way to (a) any mortality study responsive to requests 1 through 4 above, (b) 2,4,5,-T, (c) trichlorophenol, (d) dioxin, (e) Agent Orange, (f) defendants in this action, (g) Rachel's Hazardous Waste News, including without limitation #171, (h)*William R. Gaffey, or (i) Judith Zack, together with any reports or documents reviewed or considered by any of the foregoing committee's or groups or any of their members in preparation for, during or as a result of such topics being discussed, presented to or considered by any such committee or group. 33. All documents constituting or referring to communications between Dr. Raymond Suskind (or any person acting on behalf of Monsanto) and any Person concerning the position of the American Medical Association (or of any body affiliated therewith) on the hazards of dioxin. 34. All records that refer to studies responsive to requests numbered 22 through 24 above, including records of communications with the press or public officials or employees of public agencies, peer reviews, records of litigation, post-study records, and any and all records reviewing, criticizing, or- otherwise discussing or referring 8 to the possibility of fraud, scientific irregularity or invalidity, inaccuracy, or incompetence in the conduct of each such study. 35. Except to the extent produced in response to any other request made herein, all documents constituting or referring to reviews, critiques or investigations of the Nitro Workers studies performed by Persons other than Monsanto employees, including without limitation, peer reviews and any investigations by the U.S. Environmental Protection Agency or other governmental agencies into matters relating to the Nitro worker studies, whether civil or criminal, actual or contemplated. 36. Except to the extent produced in response to any other request made herein, all documents constituting, discussing, or referring in any way to sampling and analyses of acnegens, dioxin, or other materials associated therewith at or near the Nitro plant, including but not- limited to such efforts by Monsanto, the U.S. E.P.A. , or any other entity, including (a) all sample plans, maps and other sampling site identification records, sample decoding information, protocols, sample handling and destruction records, laboratory communications, and analytical results; and (b) all affidavits or transcripts of testimony at trial or deposition, including all exhibits discussed or identified thereby, of all people who have testified in any case or proceeding about contamination of the Nitro plant premises with acnegens, dioxin, or other materials associated therewith. 37. Except to the extent produced in response to any other request made herein, all documents constituting, relating or referring to internal (Monsanto or Kettering) reviews, critiques or investigations of the Nitro worker studies, including, without limitation, investigations performed by Monsanto or any Person on behalf of Monsanto 9 into whether any or all of the Nitro worker studies were the product of fraud, dishonesty, incompetence or scientifically irregularity. 38. All documents discussing or referring in any way to any demand for retraction from Peter Montague of statements claimed to be defamatory. 39. All documents constituting or referring to any demand of retraction (actual or contemplated) of allegations of fraud or scientific inadequacy attributed to the Nitro worker studies or their authors, together with any such retraction actually made by any Person. 40. All documents which refer to the taking of any legal or public-relations action, actual or contemplated, against any person, other than defendants Peter Montague and Environmental Research Foundation, who published criticisms of the Nitro worker studies. II. DEFINITIONS AND INSTRUCTIONS Please interpret each of the preceding discovery requests in accordance with the following special definitions and instructions, as supplemented by the Federal Rules of Civil Procedure, the Federal Rules of Evidence, and jurisprudence thereunder; A. "Produce" means to produce any and all originals and any and all non-identical copies of the same document described in its or their most complete form, including, without limitation, any and all surviving portions thereof, and including any and all annexes, appendices, tabs, exhibits, indexes, cover sheets, transmittal letters, or other documents found attached to or 10 V in the same file with the same document or documents, including without limitation, whenever available, the file identification and identification of the system of records in which each document and any and all copies are found. Wherever you are asked to produce affidavits or trial or deposition transcripts, also produce any and all exhibits thereto. B. The words "document" or "record" shall have the same interpretation as "documents or other things" within the meaning of Fed. R. Civ. P. 34, and shall also include all drafts, alterations, modifications, changes or amendments thereof. C. The term "person" or "persons" includes not only natural persons, but also all forms or organizations including without limitation unincorporated associations partnerships, corporations, joint ventures, proprietorships, firms, syndicates, and all subsidiaries, affiliates, divisions, departments, branches or other units thereof. D. The term "communication" refers to any written or oral transmission of information, belief or opinion, including any correspondence, letters, telegraphs, telexes, notes, memoranda, reports, circulars, press releases, discussions or conversations. E. The connectives "and" and "or" shall be construed either disjunctively or conjunctively or both as necessary to bring within the scope of the discovery request all records that might otherwise be construed to be outside of its scope. F. Where words or terms are not defined, they shall be given their common and accustomed meaning within the context stated. 11  G. The words "dioxin or "dioxins" mean any or all of the congeners, homologues, or isomers of the monothrough poly- chlorinated classes of dibenzo-p-dioxins or dibenzofurans. H. For purposes of this discovery request, the words "dioxin" or "dioxins" shall also include 2,4,5-T and trichlorothenol or any waste byproducts thereof. I. The phrase "Zack/Gaffey study" shall encompass the final published report of the purported study exhibited hereto as EXHIBIT "A", as well as other study designs or results contemplated, performed, or generated as a follow-up mortality study to the Zack/Suskind study. J. The phrase "Zack/Suskind study" shall encompass the final published report of the purported study exhibited hereto as EXHIBIT "B", as well as other study designs or results contemplated, performed, or generated in connection with that study as finally published, irrespective of whether such designs or results were incorporated in the study as finally published. K. The phrase "Nitro worker studies" shall encompass not only the Zack/Gaffey study, and the Zack/Suskind study but also any or all other epidemiologic studies, investigations, tests, etc., however denominated and whether actually completed, partially completed, proposed, or hypothesized, that did or would examine in whole or in part the mortality experience at any time of the population of workers at Monsanto Company's Nitro, West Virginia plant exposed or potentially exposed to dioxin or other substances found in association therewith, together with any control groupsepidemiologic studies. L. The term "Monsanto Company11 shall encompass Monsanto Company together with all subsidiaries and divisions thereof. 12 6 Library of Congress Cataloging m Publication Data Main entry under baa* Human and envronmenlal risks of chlorinated dioros and related compounds (Environmental science research: v. 26) Proceedings of an international symposium on Chlorinated Dioxin* and Related Com pounds. held October 2S--29. 1961 in Arlington, Va. Includes bibliographical references and index I.Tetrachlorodi&enzodiaxin--Environmental asoecls-- Congresses. 2. Tetracnioro tfibenzodioxin--Toxicology--Congresses. 1. Tucker, Richard E. II. Young. AJvm L. tit Gray, Allan P. IV. Senes. OH545.P4H85 1982 ISBN 0-3 0 6 -4 1 1 7 0 *9 81'.8815 B2-1B121 *" i j i i ' ii \ ! i : Proceedings of an international symooaium on Chlorinated Dioxins and Related Compounds. hekJ October 2 5 - 2 9 . 1 9 8 1 , In Arlington, Vrptnia 1083 Plenum Press. New York A Division ol Plenum Publishing Corporation 2S 3 Spring Street. New York, N.Y. 1 0 0 1 3 A1 rights reserved No part of thts book may be reproduced, stored in a retrieval system, or transmitted ki any form cv by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Printed in the Urvted States ol America i j in'-. PREFACE Increasing internacional concern is being expressed regarcinr Che contamination of che environment wich polychlorinated dibenro^pdioxins (PCDDs) and polychlorinated dibenzorurans because certain o these chemicals have been shown co be highly toxic to animals anc are ubiquitous in the environment. They are known co be distributed as Contaminants of commercial products and as by-products from com bustion processes. . A considerable volume of Information has accumulated on these chemicals in the past two decades, particularly for the most toxic of them, 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). However, this body of knowledge has not succeeded in resolving genuine judgmental differences among experts in the field as to the degree of hazard to human health and the environment. In lithe of the widespread public concern, it is clearly imperative to come to grips with the continuing scientific controversy, to review the data assess the issues, to see where areas of agreement exist, sr.d where further research is needed to resolve remaining areas of disagree- *' sene. This volune represents an effort to contribute to these goals. The volume contains the Proceedings from an International Symposium on Chlorinated Dioxins and Related Compounds which was held October23 to 29, 1981, in Arlington, Virginia. The objectives of the meet ing were to bring together scientists from a-vide range of disci plines, all of whoa were directly concerned with one aspect or" another of the dioxin problem, co review the existing information, evaluate controversial data, present new data, identify areas of agreement, and indicate directions for future research. The 56 papers and-panel reports that comprise this volume testify to the success of the Symposium. The meeting was divided into nine sections: Definition of the Problem Analytical Chemistry Environmental Chemistry Animal Toxicology v L J t__. I F 1 J y u t-- rJ /il J ) o y '"J/ L t A MORTALITY STUDY OF WORKERS EMPLOYED AT THE MONSANTO COMPANY PLANT IN NITRO, VEST VIRGINIA Judith A. Zack and William R. Caffey Monsanto Company St. Louis, Missouri USA BACKGROUND The compound 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a highly toxic impurity that is formed in trace quantities during the production of 2,4,5-trichlorophenoxyacetic acid (2,A,5-T). Exposure to TCDD can cause chloracne, a skin disorder characterized by comedones, cysts, and abscesses.1 Outbreaks of chloracne have been reported among workers associated with the production of 2,4.5-T and 2,4,5-T based products. Such incidents resulting from both accidenta and routine occupational exposures have been reported from several countries.2 The first reported industrial accident involving exposure to TCDD occurred in 1949 at the Monsanto Company plant in Nitro, West Virginia. A total of 122 employees developed symptoms of chloracne following a trichiorophenol (TCP) process accident. An undetermined number of other employees developed symptoms of chloracne resulting from exposure to the regular operations concerned with 2,4,5-T pro duction over the period 1948-1969. Between* 1949 and 1953, Ashe and Suskind^*1* examined thirtyeight Nitro plant employees with chloracne. Twelve of these had developed symptoms of chloracne directly following the 1949 TCP acci dent; twenty-six other chloracne cases had resulted from exposure to the regular 2,4,5-T production operations. In addition to chloracne, other signs and symptoms were observed in this group. These included severe aches in the lower extremities, fatigue, nervousness and irritability, loss or decrease of libido, dyspnia, and vertigo. These findings are consistent with those that have been reported in. other industrial incidents.- 575 E76 J. A. ZACKAND W.R GAFF To examine the chronic health effects of exposure to TCDI, a mortality study of the Nitro plant employees vho had developed symptoms of chloracne following the 1949 TC? accident vas conduct! JThe study cohort was comprised of 121 of the 122 chloracne cases; i one female vho was living as of the endpoint of the studv was ezc; from analysis. At the tine of the incident, it was assumed that t I symptoms were caused by exposure to unknown products of decocpcsit \ From today's vantage point, these symptoms suggest exposure to TCI ' The 121--member study cohort, with a presumptive high-peak exposure ! to TCDD, was followed for mortality through 1978. The entire echo ;! vas traced: thirty-two deaths were observed and eighty-nine person I were confirmed as living. Analysis indicated no excess in total ' mortality or in deaths from malignant neoplasms. I I The study presented here examines the mortality of Nitre plan j workers who were assigned to an area of TCP or 2,4,5-T production, j with potential for,exposure to TCDD. The mortality of these vorke is examined in the context of the mortality experience of the tota Nitro plant worker population. j The Monsanto Nitro plant began operations in 1922, when the Rubber Service Laboratories purchased the plant as war surplus and began production of chemicals and additives for the growing rubber industry. In 1929, Monsanto Company purchased the Nitro plant ire: the Rubber Service Laboratories and entered the rubber chemicals j business. Over the years, the Nitro plant has diversified to when it now produces agricultural chemicals, paper chemicals, plasticiz* fine chemicals, and intermediates, in addition to rubber chemicals. The plant is* situated in the Kanawha River Valley, an area contain; ; one of the largest concentrations of chemical production facilities in the United States. Of the many chemicals used over the years at the Nitro plant, one has an established association with the occurrence of cancer ir man. Para-aminobiphenyl (PAS), used from 1941 through 1952 for use j as a rubber antioxidant and dye intermediate, vas shown in 1954 by ! Valpole et al.7 to induce bladder cancer in dogs. In 1955, Melick et al.8 confirmed the carcinogenicity of para-aminobiphenyl to man i with the reporting of bladder tumors among workers exposed to this ! chemical at two Monsanto plants. Para-aminobiphenyl vas produced a one plant and then transferred by tank car to the Nitro plant where additional processing vas carried out. The minimum duration cf exposure reported to have produced a bladder tumor is 133 days; the latent period has ranged from 15 to 35 years.9 An intensive screer. ing program vas instituted at Monsanto Company about 1955 to examir on a continuing basis, all workers exposed to this chemical. Sever deaths from bladder cancer have occurred among Nitro plant employee enrolled in this program. These seven deaths are included in the present study. MORTALITY STUDY OF WORKERS 577 Other chemicals with known health effects produced at the Nitre plant include aethyIparachion and carbon disulfide. The acute effect:of exposure to each of these chemicals have been described'**- vhile the chronic effects are less well understood. Besides p-aminobipheny; several other rubber chemicals are of potential health concern. For all of these, there is insufficient evidence to evaluate their carcin ogenicity to nan. Tetramethyl thiuram disulfide is considered an animal carcinogen11 and there is some evidence, although not suffi cient, that N-raethyl-N,4-dinicrosaniline is also an animal carcin ogen.12 For several other rubber chemicals, there is insufficient evidence to evaluate the carcinogenicity to animals. Novever, these chemicals have the potential for fopsing n i t r o s a m m e s , certain of vhich are known animal carcinogens.*J Zinc dimethyl dithiocarbanate. tetranethyl thiuram disulfide and tetramethyl thiuram monosulfide have the potential to form N-nitrosodimethvlamine. N-Nitrosomorpholine has been found in product samples of 2 - (morpholinothio) benzothiazole and 4,4'-dithiodimorpholine (Frisone, G.J., The General Tire and Rubber Company, unpublished data). Although several of the chemical compounds produced or used at ..the Nitro plant over the years have been associated with adverse health effects, no attempt has been made to relate chemical exposure to mortality with the exception of decedents exposed to the TCP or 2,4,5-T operations and potentially exposed to TCDD. As a result, the only specific hypothesis that can be tested is whether a relation ship exists between potential TCDD exposure and proportional mortal ity, especially for malignant neoplasms. The mortality for this group is examined in addition to that of the total Nitro plant worker population. POPULATION AND METHODS A study cohort was developed from the Nitro plant consisting of employees active on or after January 1, 1955 with one or more years of employment on the hourly roll prior to December 31, 1977. Salaried personnel who had never worked on the hourly roll were excluded from study because many of these employees had no appreciable exposure to the plant environment, and, for the most part, their exposure cannot be determined .from plant records. Females and non-white males were &lso excluded'b'ecause of their small numbers. The cohort was assembled using government earnings reports, Independent of the plant work history records. Annual earnings reports were available on a computer file from 1951 through 1977. .Names and social security numbers were identified from this source. \ Work history records were used to. supplement the earnings records. Information on race, sex, date of birth, date of hire, date of sepa ration, and, if deceased, 2,4,5-T exposure vas abstracted from these records Ascertainment of 2,4,5--T exposure was con fined to decedents only because it was too tedious to do for the entire cohort. The '78 J. A. ZACK AND W. R. GAFFEY information from che work history records vas used to determine vhi c. names identified from the annual earnings records net the cohort entrance criteria. Employees identified from the earnings records who terminated prior to 1955 were not included in this study because work history records for all such employees were not retained prior to this date. Exposure to 2,4,5-T was determined by assignment to a 2,4,5-T operation based on the work history records. 2,4,5-T exposure was determined for all but one decedent. Employees holding a job having plant-wide responsibilities with the potential for exposure to 2,4,5-T were, for the purposes of this study, considered to be nonexposed. The vital status of each member of the study cohort vas deter mined using standard follow-up techniques and ascertained as of December 31, 1977. Death certificates were coded by an independent nosologist for the underlying cause of death, according to the rules of the Eighth Revision of the International Classification of Diseases, Adapted. ^** Data for the total Nitro plant study population were analyzed by the modified life-- table method using the U.S. population as the standard. With this method of analysis, the age-,, race-, tine-, and cause-specific mortality rates for the U.S. general population are applied to the person-years lived classified by age, race, and time. A standardized mortality ratio (SHR) vas calculated for 23 selected cause of death categories. Cause-specific SHR's for 15 selected cancer sites were calculated for subgroups of the total Nitro plant study population defined by date of death, age at death, and year of hire. The statistical significance of the deviation in a SHR from 100 was tested using the formula: standard error of SHR - 100 vho. observed oeatns no. expected deaths If-the observed SHR differed from 100 by 1.96 standard errors, it vas regarded as significant at the 52 level. A SHR vas tested for significance only when the observed number of deaths vas five or greater.* Data Tor those deceased were also analyzed according to 2,4,5-T exposure using the proportional mortality method. In this case, the expected number of deaths is calculated on the basis of proportions of deaths observed in the U.S. general population. A proportional' mortality ratio (PHR) was calculated for 23 selected cause-of-death categories. FMH's were calculated separately for those exposed to 2,4,5-T and for those not exposed. The statistical significance of the deviation of a FHR from 100 was tested by calculating the 952 confidence interval for the PMR lor a given cause k according to the formula: confidence interval for PMR^ . NCconfldence limits for X of observed deaths) ^" where N number of observed deaths for all causes Both the standardized and proportional mortality analyses were conducted using the computer program developed by Honson.^ Tne observed mortality was compared to that of the United States white male population for the time period of study. RESULTS A total of 884 men were identified for study and traced for deaths through 1977. The entire cohort was successfully traced. Death certificates were obtained for all deaths. Seven hundred twenty-one (822) were verified as living and 163 (182) were confirmed dead by death certificates. _ . _______ . . . Tables 1-3 characterize the total Hitro plant study population by age at hire, year of hire, and length of employment. The dis tribution of the study population by age at hire indicates that the workers were fairly young at first hire (Table 1). Seventy-two percent of the study cohort were hired by age 30. Hone were hired at age 50 or above. Table 2 shows the distribution of the study population by year of hire. The majority of workers (75.32) were hired during the period 1940-1959, while smaller percentages of workers were hired prior to 1940 (10.82) and after 1960 (13.92). An examination of the study papulation by length of employment indicates a fairly even distribution over the intervals less than 10 years, 10-19 years, 20-29 years, and greater than 30 years (Table 3). Observed and expected deaths occurring during 1955-1977 among the total Hitro plant study population are shown by cause in Table 4. The SKR for all causes of death was 103 with 163 deaths observed and 158.10 expected. There were 35 deaths from malignant neoplasms with 30.92 expected, yielding a 5HR of 113. Singificantly elevated SHR's were seen for the categories of malignant neoplasms of the genitourinary organs and of the bladder. The SKR for bladder cancer was 989 with 9 deaths observed and 0.91 expected. This excess in bladder cancer deaths is reflected in the elevated SKR for malignant nioplasms of the genitourinary organs. A significantly elevated SKR is also seen for arteriosclerotic heart disease. There were 79 deaths from this cause with 59.40 expected (SKR 133). The 5MR for 'W 680 J. A. ZACK AND W. R. GAFFE' Table 1. Distribution of Total Nit.ro Plant Study Population by Age ac Hire Age at Hire . <20 20-29 30-39 40-49 50+ Total Number 122 518 191 53 0 834 Percent 13.8 58.6 21.6 6.0 0.0 100.0 Table 2. Distribution of Total Nitro Plant Study Population by Year f Hire Year of Hire Number Percent Prior to 1930 1930-1939 1940-1949 1950-1959 1960-1976 Total 21 74 361 305* 123 884 2.4. 8.4 40.8 34.5 13.9 100.0 Table 3. Distribucin of Total Hitro Plant Study Population by Length of Employment Length of Employment (yrs.) Number Percent <10 10-19 20-29 30+ Total 225 213 204242 884 25.5 24,1. / 23.1 27.4 100.1 \$ \I 1 'V Table 4. i. Cause of Death Observed and Expected Humber of Deathn During 1955- 1977 by Cause Shoving Standardized Mortality Ratios (SHR'S) for Total Nitro Pinnt Study Population TCDA Codes Bth Rev. Observed Expected ( > SHR r All causes of death. All malignant neoplasms Buccal cnvlty and pharynx Digestive orgnns and peritoneum Stomach Liver All other digestive organs Respiratory system Lung All other respiratory organs . Skin Genitourinary organs Bladder All other genitourinary organs Lymphatic and hematopoietic tissue Other sites Diseases of the nervous system and sense organs Diseases of the circulatory system Arteriosclerotic heart disease, including CHD All other diseases of the circulatory system Diseases of the respiratory system Diseases of the digestive system All other diseases External causes of death Number nt rink: Hfl4 Pcrnnn-ycars nt risk! 1396R.7 > *n < .0 5 140-209 140-149 150-159 151 155-156. 160-163 162-163 -- 172-173 185-189 188 -- 200-209 -- 320-389 390-458 410-413 -- 4 6 0 7 519 520-577 -- 800-998 163 35 0 4 1 0 3 14 14 0 0 12 9 3 1 4 0 92 79 13 6 5 5 20 ' 158.10 30.92 1.03 8.65 1.63 0.60 6.42 10.51 9.91 0.60 0.58 3.75 0.91 2.84 3.15 3.25 1.28 82.59 59.40 23.19 9.13 8.03 10.46 15.69 103 113 0 46 61 0 47 133 141 0 0 320' 989* 106 32 123 0 111 133* 56* 66 62 48* 127 t ic" C - c 7 P7 tP* j m *. . J. A. ZACK AND W. R. GAFrc ocher circulatory diseases was significantly low at 56. A signific deficit was also seen for the category of all other diseases where SKR was 8 with 5 deaths observed and 10.46 expected. Trends for malignant neoplasm deaths with calendar time are sh in Table 5. SMR's which increased consistently over the period 155 \ 1977 are seen for the categories of all malignant neoplasms and c a l !' nant neoplasms of the respiratory system. The SKR for all maligr.an neoplasms rose from 32 to 131. The SHR for malignant neoplasms c: respiratory system rose from 0 to 172 reflecting a SKR for lung can which increased from 0 to 181. Although based on very small number: the SKR for malignant neoplasms of the digestive organs and perircnt ' consistently decreased over tine from 99 to 26. The SMR for nalicn; neoplasms of the genitourinary organs peaked during the period 15501969. This is reflected in the SKR for bladder cancer which increa: from 0 in 1955-1959 to a peak of 1471 in 1960-1969 and decreased to 833 in 1970-1977. The analysis of observed and expected deaths from malignant ceo plasms by age at death revealed little in terms of consistent trerds vith age (Table 6). For most of the cause-of-deach categories, the SHR peaked at age 45-64 rather than continuing to rise vith incre2si age. Bladder cancer is one category where the SKR remained high at age 65 and over. ; The distribution of deaths from malignant neoplasms by year e hire is shown in Table 7. No deaths from malignant neoplasms were observed among workers hired after 1960. rThe SKR for all malignazt neoplasms was similar for those hired prior to 1945 and for those hired in the period 1945-1959. The greatest difference in SMR's be tween those hired prior to 1945 and those hired from 1945-1959 occurs with bladder cancer. The SKR for bladder cancer is highest for those hired prior to 1945 with a SKR of 1111. A subset of deaths identified from the total Nitro plant study population was studied separately. Table 8 characterizes the deced ents according to 2,4,5-T exposure. Of the 163 decedents, 58 (35.62) were considered to be exposed to 2,4,5-T based on their work history records, while 104 (63.8%) were considered to be non-exposed. The exposure of one decedent was unkown. The results of the proportional mortality analysis by 2,4,5-T exposure classificacion are presented in Table 9. The proportion cf cancer deaths among 2,4,5-T workers is lover than in the non-exposed group (FKR: 82 vs. 122). The FKR for lung cancer deaths is slightly higher in the exposed group (PKRi.ISS vs. 117). The proportion o: deaths due to bladder cancer is higher among the decedents not ex posed to 2,4,5-T. There were 7 deaths from bladder cancer among thes workers vith 0.65 expected (FKR " 1077). The PKR for bladder cancer among decedents exposed to 2,4,5-T was 909 vith 2 deaths observed and  TALITY STUDY OF WORKERS Table 5. I I I Observed and Expected Deaths from Malignant Neoplasms During 1955-1977 by Calendar Time Showing Standardized Mortality Ratios (SHR'S) for Total Nltro Plant Study Population =c Cause of Dcoth Calendar Time 1955-1959 i 1960-1969 1970-1977 Observed Expected SMR Observed Expected SMR Observed Expected SKR All malignant neoplasms 1 Buccal cavity and pharynx 0 Digestive organa and peritoneum 1 Stomach 0 Liver 0 All other digestive organs 1 Respiratory oystem 0 Lung 0 All other respiratory organs 0 Skin 0 Cent tourinary organs 0 Bladder 0 All other genitourinary organa 0 Lymphatic and hematopoietic 0 tissue Other sites 0 *p < .05 3; 13 0.11 1.01 0.25 0.09 0.67 0.07 .. 0.80 0.07 0.0? 0.33 0.09 0.24 0.40 0.34 32 13 00 99 2 0 :o 0 i0 149 . 2 04 0 ;4 0 :0 00 0 i5 05 00 0 *0 0 !2 11.81 n o 0.41 0 3.48 57 0.70 0 0.28 0 2.50 80 3.83 104 3.59 111 0.24 0 0.23 0 1.37 365 0.34 1471* 1.03 0 1.24 0 1.25 160 21 0 1 1 0 0 10 10 0 0 7 4 3 1 2 15.98 0.50 4.16 0.69 0.23 3.24 5.81 5.52 0.29 0.28 2.05 0.48 1.57 1.50 131 0 24 145 0 0 172 181 0 0 341 833 191 67 1.68 119 . 1* I Table 6. II (I Observed and Expected Deaths from Halignant Neoplasms During 1955-1977 by Age at Death Showing Standardised Hortality Ratios (SKR'S) for Total Nltro Plant Study Population Cause of Death * Age at Death <45 45-64 65+ Observed Expected SMR Observed Expected SMR Observed Expected SHR Ail malignant neoplasms 2 Buccal cavity and pharynx 0 Digestive organs and peritoneum 0 Stomach 0 Liver All other digestive organs Respiratory system 0 0 0 Lung 0 All other respiratory orgnna 0 Skin 0 Genitourinary organs 1 Bladder 1 All-other genitourinary organs 0 Lymphatic and hematopoietic 0 tissue Other sites 1 *p < .05, 2.39 0.06 0.51 0,10 0.03 . 0.38 ` 0.54 0.51 0.03 0.13 0.20 0.02 0.18 0.55 0.40 04 21 0 1o 04 0 ;i 0 1o 0 13 0 11 0 0 , i0 0 500 5000 0 0 \ :0 i 3 :2 1 1l 4 250 2 a1 i 16.85 0.67 4.58 0.85 0.32 3.41 6.36 5.99 0.37 0.31 1.43 0.39 1.04 1.60 125 0 07 118 0 88 173 184 0 0 210 513 96 63 1.90 105 12 0 0 0 0 0 3 3 0 0 8 6 2 0 1 11.69 0.31 3.57 0.6B 0.24 2.65 3.61 3.42 0.19 0.14 2.12 0.50 1.62 1.00 103 0 0 0 0 0 83 88 0 0 37 7* 1200* 123 0 0.94 106 m M C -AL1TY S TU D Y OF WORKERS V Table 7. Ii I Observed and Expected Deaths from Hslignant Neoplasms During 1955-1977 by. Tear of Hire Shoving Standardized Mortality Ratioo (SMR'S) for Total Nltro Plant Study Population Cause of Death Observed Expected SMR Observed Expected SMR Observed Expected SHR All malignant neoplasms 25 Buccal cavity and pharynx 0 Digestive organa and peritoneum 2 Stomach 0 Liver 0 All other digestive organa 2 Respiratory system 10 Lung . 10 All other respiratory organs 0 Skin 0 Genitourinary organs Bladder 9 8 All other genitourinary organs 1 Lymphatic and hematopoietic 1 tissue Other sltcB 3 *p < .05 . 21.30 0.70 6.27 1.21 0.45 4.61 7.14 6.73 0.41 0.31 2.90 0.72 2 . IB 1.95 2.03 117 0 32 0 0 43 140 149 0 0 310* 1111* 46 51 148 10 .0 2 1 :0 .1 .* 4 :4 io ;o ;3 1 :2 .0 1 '1 I 8.63 0.31 2.19 0.39 0.14 1.66 3.09 2.93 0.16 0.22 0.76 0.18 0.50 1.00 1.06 116 0 91 256 0 60 129 137 0 0 395 556 345 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.99 0.03 0.19 0.03 0.01 0.15 0.27 0.26 0.01 0.05 0.09 0.01 o.oa 0.20 0.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Table 0. 2,4,5-T Exposure Classification for Dccendents During ' 1955- 1977 Among Total Nltro Plant Study Population 2,4,5-T Exposure Classification t * Exposed Non-exposed Unknown Total Number of Deaths * 58 ' 104 l 163 Percent 35.6 63.8 0.6 100.0 cn CD Cn r i Table 9. Observed and Expected Number of Deaths During 1955-1977 by Cquee and 2,4,5-T .Expoourc Category Showing Proportional Mortality Ratios (PKR'S) Cause of Death 2,4,5-T Exposure Cntegory Exposed Non-exposed Observed Expected PHR Observed Expected PHK All malignant neoplasms Buccal cavity and pharynx Digestive organs and_peritoneum------ ------Stomach Liver All other digestive organs Respiratory system Lung All other respiratory organs Shin Genitourinary organa Bladder All other genitourinary organs Lymphatic and hematopoietic tissue Other sites Diseases oT the nervous system and sense organs Diseases of the circulatory system Arteriosclerotic heart disease, including CUD All other diseases of the circulatory system Diseases of the respiratory system Diseases of the digestive system All other diseases Externa 1 causes of death Total number of deaths: *p < ,05 9 0 0 0 0 0 6 6 0 0 2 2 0` 0\ 1. 0 31 27 4 2 1 3 12 58 10.94 0.38 2.'80 0.52 0.19 2.09 . 3.73 3.57 0.21 0.29 0.96 0.22 0.74 1.35 1.38 0.61 26.48 19.72 . 6.76 2.67 3.70 4.31 9.29 5B.no 82 0 0 0 0 0 159 168 0 0 200 909 0 0 72 0 117 137 59 75 27 70 129 25 0 3 0 0 3 8 8 0 0 10 7 3 1. 3 0 61 52 9 4 4 2 8 104 20.43 122 0.64 05.74 52 1.06 0 0.39 0 4.29 70 6.81 117 6.42 125 0.39 0.35 0 0 2.70 370* 0.65 1077* 2.05 146 2.07 48 2.12 142 0.83 0 55.34 110 39.68 131* 15.66 57 6.49 62 4.93 81 6.70 30 9.28 86 104.on J . A . ZACK AND W . R. GAFFEY n'.un i 4 l g ) i i w rr* c. Ii 587 | w-22 expected. PK?. s for both exposure groups are quire similar for : diseases of circulatory and respiratory system. Slight differences* I appear in the PMR's between the two groups for diseases of the diges- j tive system and all other diseases. However, the FHR's for both ' . groups are quite low. The PMR for external causes of death is slightlhigher in the exposed group (PH?.: 129 vs. 86). | A listing of the cancer deaths among the 2,4,5-T exposed is given i In Table 10. Table 11 listed the cancer deaths among the non-exposed group. DISCUSSION j The observation made many years ago of an apparent excess in ! bladder cancer among Nitro plant workers was confirmed and quantified , .in the mortality analysis of the total Nitro plant population presentee here. The SMR for bladder cancer was 989 and was the only statisti cally significant SHR among those for malignant neoplasms. Tne excess in mortality is not seen until 1960. The SHR peaked in the 1960's j and declined somewhat in the 1970*s. The excess also appeared to be [ ___ clustered in those decedents aged 65 years and older at death and in those hired prior to 1945. This would suggest that we should see a j further decline in the SHR for bladder cancer over time. I ] Although not statistically significant, the SHR for lung cancer i appears to be elevated. The SHR increased with calendar time and was ! highest in those hired prior to 1945. The elevation appears to be ] clustered in those aged 45-64 years of age at death (SHR 184) and i does not show a gradient with age. Further analyses to evaluate { trends in lung cancer deaths as they relate to occupation cannot be j carried out due to limitations in the*data collected in this study. The SHR for diseases of the circulatory system was elevated at : 111. This is most likely a reflection of the higher mortality from heart disease which has been observed for Charleston, West Virginia . and Kanawha County, West Virginia (unpublished data, Neas LM, 1979 and Enterline PE, 1979). For the total Nitro plant study population, there was a statistically significant excess in deaths from arteric^i sclerotic heart disease and a deficit in deaths from other circulatory diseases. This variation in the distribution of deaths from that of ! the U-S. nay be due to risk factor or medical care differences in the ; plant population and the local area. These may include differences in smoking habits, the availability and use of medical services and I the specificity of diagnoses, i The proportional mortality analysis of decedents by 2,4.5-T ... - exposure classification"Indicated no unusual patterns of mortality in the 2,4,5-T exposed. The proportional mortality ratio (FHR for malignant neoplasms was low (PKR - 82) in the exposed group. ' Lung cancer was the only site among the malignant neoplasms which was somewhat higher in the exposed group. I a i i Table 10. Deaths Due to Hallgnbint Neoplasms Among Nitro Plant Workers Exposed to 2,4,5-T Year of Birth Year of Hire Year of 1st Exposure Year of Term. I I Year of Death* * Smoking History* Cause of Death as Civen on Death Certificate 1917 1946 1951 1972 1972 : Cigarettes Carcinoma left lung with 1 mtastass (162.11 1911 194B 1955 1972 1972 Cigarettes Metastatic carcinoma of the lung (162.1) 1916 1946 '1959 1968 1960 Cigarettes Bronchiogcnlc carcinoma o-f right upper lobe (162.1) 1901 1911 1922 1944 1941 1945 1956 1948 1940 1963 * 1971 1972 1973 ;. 1975 1973- Ci garettes Cigarettes . Non-smoker Carcinoma lung with mtastases (162.1) Brnnchiagenlc carcinoma with cerebral metastoses (162.1) Bronchiogenic carcinoma with mtastass (162.1) 1923 1946 1950 1972 1972 C i g n m t e a 1902 . 1922 194fl 1966 1966 Nn-Sinkdr 1910 ,, 1944 1948 1968 1968 Non-smoker ' * Obtained by Interview with former coworkers of decedents. ** Included on the Nitro plnnt PAB roster. ( RenarnlI ted llposorcemi tlH.ij Metastatic carcinoma urinary bladder (188.0)** Carcinoma of the urtnnry bladder (188.0)** J . A . ZjSCK AND W . R. GAFFE r CU^vufM j o ion ite I In w Iuou I Table 11. Deaths Duo to Halignant Neoplasma Among Nitro Plant Workers Not Exposed to 2,4,5-T Year of Year of Year of Year of Smoking Birth Hire Termin. Deathi History* Cause of Death as Given on Death Certificate 1911 1945 1966 1968 Cl garet tea Carcinoma oF colon (153.8) 1904- 1935 1957 1957 Cigarettes Carcinoma of liver (157.9) 1899 1929 1959 1960 Pipe intraperitoneal carcinoma (158.9) 1905 * 1944 1970 1972 Cigarettes Carcinoma of lung (162,1) 1909 1943 1962 1962 Cigarettes Carcinoma of left lung (162.1) 1910 1927 1966 1970 Clgnrettes Pulmonary carcinoma (162.1) 1912 1944 1965 1965 Cigarettes Ca re inoma of apex of right lung (162.1) 1915 1937 1977 1977 Cigarettes Carcinoma of lung (162.1) 1915 1939 1969 1970 Cigarettes Carcinoma of lungs (162.1)' 1894 1944 1960 1964 Non-smoker Carcinoma of lung (162.1) 1912 1937 1973 1974 Cigarettes Carcinoma of lung (162.1) 1919 1946 1963 1964 Cigarettes Carcinoma of urinary bladder (188.0)** 1901 1933 1962 1977 Ci gnrettes Care 1noma of bladder (108.0)** 1897 ' 1941 .1962 ' 1965 Cigarettes Carcinoma of urinary bladder (188.0)** 1B98 1933 1962 1965 Smoked years ago Carcinoma of urinary bladder (188.0)** 1905 1943 1971 1975 Cl garet tes Carcinoma of bladder (188.0) 1098 1943 .1963 1970 Cigarettes Bladder tumor (108.0)** 1888 1944 1956 1970 Unknown Carcinoma D f bladder (188.0) 1905 1933 1969 1977 Cl gars Pros'tat Ic carcinoma (185.0) 1906 1946 1968 1977 Clga ret tes Care Inoma of prostate (185.0) 1925 1945 1973 1974 Smoked years ago Care 1noma oi prostate (185.0) 1919 1943 1972 1973 Cigarettes Hodgkin's Disease (201.0) 1901 1941 1964 1965 Cl gars Osteosarcoma arising from left arm (170.4) 1901 1943 1966 1977 Cigarettes Carcinoma of liver 6 pancreas (197.8) 1922 1944 1964 1964 Cl garet tcs Adenora re Inoma (109.0) A Obtained by interview with former coworkers of decedents. Ait Included on the Nitro pinnt TAR roatcr. ESO J. A. ZACK a n d w . r . g a p The PHR analysis is U n i t e d in chat an assessment of the tot: force of mortality cannot be made. The cnuse-specific PiiR's onlv- approxinate what an SMR analysis would have produced.^ The RKR analysis presented here estimates the cause-specific risks associ I vith 2,4,5-T exposure and potential TCDD exposure. It is interesting to compare the results of this study of N1 plant workers potentially exposed to TCDD with the results of the study of Nitro workers involved in the 1949 TCP accident. The vo involved in that incident had presumed TCDD exposure as evidenced chloracne. The results of the two studies are similar in that ne shows an excess in deaths from any site among malignant neoplasms 1 A recent study of Ott et al. found no excess in total mart, or in deaths from malignant neoplasms among workers exposed to 2, These workers were probably exposed to very low levels of TCDD si: no cases of chloracne were observed. Ocher studies of workers wht developed chloracne resulting from TCDD exposure have been conduct and have been reviewed.6 At the present time, data from these va: studies do not constitute corroborative evidence of a cancer risk rum for any particular .cancer site. ------- - -- ---------------- , \ i | i j REFERENCES ] 1. Greig, J.B.: The toxicology of 2,3,7,8-cetrachlorodibenzo-p- dioxin and its structural analogues. Ann. Occuo. Hvg. 22: i 411-420, 1979. 2. International Agency for Research on Cancer: Long-term hazar ^ of polychlorinated dibenzodioxins and polychlorinated diben j furans. IARC Internal Technical Report No. 78/001. Lyon: IARC, 1978. 3. Ashe, W.F. and Suskind, R.R.: Reports on chloracne cases, Monsanto Chemical Company, Nitro, West Virginia. Reports o I the Kettering Laboratory, December 1949 and April 1950. 4. Suskind, R.R.: A clinical and environmental survey, Monsanto I Chemical Company, Nitro, West Virginia. Report of the Kettering Laboratory, July 1953. 5. International Agency for Research on Cancer. IARC Monographs .the Evaluation of the Carcinogenic Risk of Chemicals to Kan. Vol. 15. Some Fumigants, the Herbicides 2,4-D and 2,4,5-T, Chlorinated Dibenzodioxins and Miscellaneous Industrial Chemicals. Lyon: IARC, 1977. 6. Zack,J.A. and Suskind, R.R.: The mortality experience of vori j exposed to tetrachlorodibenzodioxin in trichloropher.ol proci accident. J. Occuo. Hed. 22:11-14, 1980. 7. Walpole, A.L., Williams, K.H., and Roberts, D.C.: Tumours of I urinary bladder in dogs after ingestion of 4-aninodiphenyl- Brit. J. Industr. Med. 11:105-109, 1954. M O R T A L IT Y S T U D Y OF W ORKERS 691 d. Helick, W.F.: First reported cases of human bladder tumors due to a nev carcinogen - xenvlamine. J. Urol. 74:760-766, 195- f 9. Helick, V.F., Naryka, and Delly, R.E.: Bladder cancer due to exposure to para-aminobipheny1: a 17-year followup. J. Vrol. 106:220-226, 1974. -------- 10. Key, M.H.: Ocuppational Diseases: A Cuide to Their Recocniticr.. U. S. Departnent of Health, Education and Welfare, Public *i Health Service, Center for Disease Control, National >t Institute for Occupational Safety and Health- DHEW (NIOSH) I Publication No. 77-181. Washington: U.S. Government Printing 1 Office, 1977. 11. International Agency for Research on Cancer. IARC Monographs on it ii . the Evaluation of the Carcinogenic Risk of Chemicals to Man. Vol. 12. Some Carbamates, Thiocarbamates. and Carbaziaes. Lyon: IARC, 1971. 12- International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk of Chemicals to Man. . Vol. 1. Lyon: IARC, 1971. 13. Hagee, F.N.,: N-nitroso compounds and related carcinogens. In: Searle, C-E.(ed): Chemical Carcinogens. Monograph 176. H -- .-Washington: American Chemical Society, 1976. i 14. Eighth Revision, International Classification of Diseases, Adapted | for Use in the United States. U.S. Department of Health, Ed ucation, and Welfare, Public Health Service, PHS Publication No. 1693. Washington: U.S. Government Printing Office, 1977. :i 15. Monson, R-R.,: Analysis of relative survival and proportional mortality. Co p d u c . Bioced. Res. 7:325:332, 1974. 16. Decoufle, P., Thomas, T.H., and Pickle, L.W.: Comparison of the proportionate mortality ratio and standardization mortality ratio risk measures. An. J. Enideniol. 111:263-269, 1980. 17. Ott., G . , Holder, B.B., and Olson, R - : A mortality analysis of employees engaged in the manufacture of 2,4,5-trichloro- phenoxyacetic acid. J. Occuo. Med. 22:47--50, 1980. 9 Ii I yc,, v-?,O: riginal Artic' ) dty lo /i Journal ol Occupational ModicinB January 1980 Voi. 22 No. 1 The Mortality Experience of Workers Exposed to T etrachlorodibenzodioxin in a | Trichlorophenol Process Accident Judith A. Zack, and Raymond R. Suskind, W.D. A standardized mortality analysis was conducted on edones. cysts, pustules, and abscesses. Hepatic dysfunc workers exposed to tetrachlorodibenzodioxin in a trichlo tion. peripheral neuritis, disorders ot fat metabolism, and rophenol process accident at the Monsanto Company porphyria cutanea tarda are other frequently reported plant in Nitro, West Virginia. One hundred and twenty-one findings in these workers.1Chloracne has been shown to workers who developed ch/oracne resulting from this acci be essentially due to 2,3.7.8-tetrachlorodibenzodioxin dent on March 8, 7949. were selected lor study. Follow-op (TCDD)/ a byproduct in the synthesis of 2.4,S-T. The sub o f this group was 700% complete. The standardized mor ject of this paper is the chronic health effects of exposure tality ratio for all causes of death was shown to be 0.69, to TCDD. as reflected in the mortality experience ot a with 32 deaths observed and 46.41 expected, fo r the cohort of Monsanto Company workers who developed categories of malignant neoplasms and circulatory symptoms of chloracne following a trichlorophenol pro diseases, the standardized mortality ratios were 7.00 and cess accident at the Nitro, West Virginia, plant in 1949. 0.68. respectively. Because of the small size of the cohort Production of trichlorophenol began in the fall of 1948 and the relatively small number of deaths observed, the at the Nitro plant. In this process, the reactants results of this study cannot be considered conclusive. 1,2.4,5-tetrachIorobenzene. sodium hydroxide, and However, if is important that no apparent excess in total methanol were all added to the autoclave. Heat was ap mortality or in deaths from malignant neoplasms or plied and. when the pressure reached the desired point, the diseases of the circulatory system was observed in a group autoclave was vented. On March 8.1949, about six months o f workers with a high peak exposure to tetrachlorodiberb after production start-up, a violent reaction and decom zodioxin who were followed over a period o f nearly 30 position occurred when temperature and pressure within years. Thg~7sp/g~af7fi?s~stuuy. mVf-be-jncorpofaJtedwilA-- the autoclave became excessive. The relief valve opened those o f a larger study which w ^n clu cfe p^nCwotk&seir-- 1 and the fumes and tarry residues from the decomposed posed in the course oTX4^uichiGrophenoxyac'etic acid g contents of the autoclave were discharged into the at production during the period 1943 tQ il.969^: ^ ' mosphere and into the interior of the building. Employees who worked in the area of TCP production A wide variety of acute and sub-acute health effects or were involved in the clean-up began to develop symp toms immediately following exposure to the material has been reported in workers involved in the manufacture which was discharged from the autoclave. Symptoms in of 2,4,5-trichlorophenoxyacetic acid . (2,4,5-T) from cluded eye and respiratory tract irritation, headache, diz 2,4.5-trichlorophenol (TCP). The most consistent clinical ziness and nausea, and a severe irritant reaction of the ex finding is chloracne. a skin disease characterized by com- posed skin. After these initial symptoms subsided, the chloracne and other symptoms became evident. Ashe and C(LEOJpobrF<morJSocrefiuumtnnjokivortiv.hnlop.d(4.r0DhD0leflifrU>eNcrJjntrnoivrdrne)LrrmnintlhydebooellrIgMCnhiupndiclBrutcrlituvrfuldfu.oiMnlSdet EdlinCLnvoiviluiiorCnon.enmnmtMeeentOn.uuClJi6nHH3clieebraam6llttjhhii.(,MOMXiHoeni*iZtcSJr2nitn>kiog7. Suskind1** examined a total of 12 more severely affected workers on three occasions during the period of 1949 to 1953. Another 26 persons with chloracne, apparently not related to the accident, were also examined in 1953. The Journal of Occupational Medicine/Vol. 22. No. 1/January 1980 11 'WSUttUftl -- j , 1 1 ' ; i clinical symptoms in order ut relative frequency/ included acneform lesions: severe pains m muscles of upper and lower extremities, shoulders and thorax on exertion. fatigue: nervousness and irritability; decrease in Iihido. dyspnea: vertigo and intolerance to cold On examination, all of the cases had chloracne Several were severely hyperpigmented. especially on the face. Of the six workers ex amined in 19*19 and 1950. four had liver enlargement and one had sensory loss in one foot. Liver impairment as in dicated by hepatomegaly, tenderness and soreness in the right upper quadrant and epigastrium and a delayed pro thrombin time, was observed.11` In 1953. four of the six workers examined in 19*19 and 1950 were re-examined and six additional workers involved in the accident were also examined. The findings in this later examination indicated a general regression of both the cutaneous and noncutaneous symptoms which had been present earlier. All of the workers showed a marked improvement in their skin lesions -- there were residua of the acne and a few active lesions. In a few cases, workers continued to complain of aches and pains of the lower ex tremities and back, nervousness, excessive fatigue, and dyspnea. No clinical explanation for these complaints could be made based on the results of the physical ex a m in a tio n / The findings of the examinations bv Ashe and Suskind are consistent w ith those which have been reported in other industrial episodes which occurred subsequently/ The acute health effects of TCDD exposure are described in the literature.7 but little is known oi the chronic eifects Several reports describe the occurrence of cancer and other deaths in workers exposed to TCDD which suggests an association between exposure and the subsequent development of a variety of neoplasms1,1 These reports, however, are generally of small groups of workers with relatively short periods of follow-up and are considered to be preliminary in nature. In a 25-year follow-up study. 17 deaths were observed among a cohort of 75 German workers who had been involved in a 1953 TCP process accident.* O f the 17 deaths observed (11-25 expected depending on the choice of a control population), six were irom cancer (four or fewer expected), five from car diovascular disease (as expectedl two from suicide (fewer than one expected), one from liver cirrhosis; one from a urogenital tract disease, and two from external causes. Of the six cancer deaths, three were from stomach cancer in the age group 60-69, a number significantly higher than expected. Two other cancer deaths were from oat-cell carcinoma of the lung and one was from adenocar cinoma of the colon. A similar accident occurred in the Netherlands in 1963 in a factory producing 2.4,5-T/ Eight deaths have been observed among 93 exposed workers. Five or six of these deaths were from cardiovascular disease. The proportion . of deaths due to myocardial infarction was noted to be high. Jirasek et al* * and Pazderova1' followed 55 of the 78 Czechoslovakian workers who were affected by chlor acne resulting from occupational exposure to 2,4.5-T and pentachlorophenol. In this study, five deaths were ob served. These included two deaths from bronchiogenic carcinoma (less than one expected), one from-cardiovas cular disease, one from liver cirrhosis, and one from an accidental industrial intoxication In 1976. a TCP process accident in Meda. Italy, resulted in the contamination of a largo and densely populated area * A preliminary mortality study has been conducted in two of the 11 towns aftected. Thu overall mortality rate did not differ from that expected, but increases in deaths from liver cirrhosis and leukemia were suggested. The chronic toxicity or TCDD exposure to animals has been more extensively studied. TCDD toxicity has been thoroughly reviewed/ Chronic toxicity to TCDD is manifested by liver necrosis, thymic atrophy, and deple tion of the lymphoid organs. Two studies indicate that chronic administration of low levels of TCDD to rats is associated with an increased incidence of neoplasia. In one study, the oral administration of TCDD produced an increase in hepatocellular carcinomas and squamous cell carcinomas of the lung, hard palate/nasal turbinates, or tongue.' 1 In another study. TCDD fed to rats produced tumors in 38% of the test animals/1Neoplastic nodules and cholangiocarcinomas ot the liver were observed. The study reported'here w ill examine the mortality ex perience of a cohort of 121 employees involved in.ihe 1949 trichlorophenol process accident, with special em phasis on cardiovascular disease and on neoplasms, par ticularly of the stomach, liver, lung, and skin. Population and Methods In this study, the development of chloracne. a hallmark of TCDD exposure, was used to identify employees for study. The study population consists of all persons with chloracne which could be attributed to the1949 TCP pro cess accident. One hundred and twenty-two employees who developed chloracne following this incident were -identified from plant safety records dating to the time of the accident, and from workmen's compensation and plant medical records. One hundred and twenty-one white males were included in this study -- one female who was living as of the endpoint of the study was not in cluded tn this mortality analysis. It is assumed that all of the skin disorders recorded in the plant records represent true cases of chloracne and not other types of occupa tional or nonoccupational dermatitis. An analysis of the chloracne cases and exposures not associated with this accident but rather with the normal TCP/2.4.5-T produc tion processes will be the subject of a future paper. The data were analyzed by the modified life-table method using the updated Monson program/* In this method of analysis, the ager, race-, time- and causespecific mortality rates for a standard population (in this case, the population of the United States) are applied to the person-years lived classified by age. race, and time. A standardized mortality ratio was calculated as the ratio of the observed deaths to the expected deaths for 22 selected causes of death. The statistical significance of differences between observed and expected numbers was based on the Poisson distribution and statistical signifi cance was determined at the 5% level of significance/- For the purpose of analysis, each member of the study cohort was assumed to have entered the study on March 8.1949, the date of the accident. The vital status of each member was determined using standard follow-up tech- ejay*5-aisd-^5cert3mi^s-oLDecembeL33r1S7a,Foreach ~ p e ft^ Jrouno^"be"3ece55Ed;'3-'death-cgrtTfirate was ob- 12 Mortality Experience of Workers Exposed toTetrachlorodibenzodioxin/Zack and Suskind >t * - i u n a ' . l ^ a i U ' t t t t a . mU i r t i ) l I T X IMrf H m m C < K to jg itM fi J t t r i ^ l rW .'j, Table 1. -- observed and Expected Deaths Among-121 Males Exposed to Telrac til orcdi ben io dioxin ;- in a Trichlorophenol Process.Accident. . t-; Cause All causes ol death All malignant neoplasms Buccal cavity and pnarynv Digestive organs ana peritoneum Stoma cn Liver All other digestive organs Respiratory system Lung All other respiratory organs Skin Genitourinary organs Lympnanc ana hematopoietic tissue Other sites Diseases ot the nervous system and sense oraans Diseases at the circulatory system Arteriosclerotic heart disease, including coronary heart disease Atl oiner disease ol the circulatory system Diseases ol the respiratory system Diseases ol the digestive system At! atner diseases External causes ot death ICO Ho! (Eighth Revision^ u c fto g 140-Tag ' 150*159 151 ' 155*155 -- 160ME3 * " 15?.163 >v 4- *\ 172.173 185-.189 .. 200-209" -- -: 320-389 : 390-458 ],* 410*413 t . Observed 32 9 0 0 0 0 0 5 5 0 1 0 3 0 17 13 -- 460*519 ** 520*577 1 . .1 ' 800-998 4 1 0 2 3 Expected 46 41 9.04 0 30 2.59 0 50 0 18 1 91 3 0? 2.85 0.17 0.15 1.16 0 88 0.94 0 35 25 01 17.74 7.27 2.78 2.26 3 18 3 78 .. SMR . 0.69* 1 00 t 1 ' t 1 t 1.G6 1.75 t *i t t t t : 0.68 ' 0.73 .t t t t *. t *p < 0.05 tLes5 man 5 observed oearns tained. The underlying cause of death was coded to the 8th Revision of the International Classification of Diseases. Adapted11 by an experienced nosologist. Results A ll of the 121 members .of the study cohort were traced. Eighty-nine were verified living and 32 were verified deceased by death certificate. The results of the standardized mortality analysis of the 121-member study cohort are shown in Table 1 The standardized mortality ratio for all deaths is shown to be 0.69. with 32 observed deaths and 46.41 expected. This is the only statistically significant difference shown in this table. There were nine deaths from malignant neoplasms w ith 9.04 expected. There were no deaths from stomach or liver cancer. There were five lung cancer deaths versus 3.02 expected and one skin cancer death with 0.15 ex pected. The malignant tumor was a fibrous histiocytoma presumably of dermal origin, which is rare. There were three deaths from neoplasms of lymphatic and hematoppietic tissue with 0.88 expected. There -were 17 observed deaths from circulatory diseases with 25.01 expected. The standardized mortality ratio for circulatory diseases was low at 0.68. Case summaries for the cancer deaths are given in Table 2....... Discussion .*. Because the study cohort was small and only 32 deaths were observed, the results cannot be considered con clusive. Nevertheless, the analysis of the mortality ex perience of these workers indicated no apparent excess of total mortality or of deaths due to malignant neoplasms or circulatory diseases. The TCDG-exposed workers in the present study repre sent the largest group ever investigated after long-term follow-up. T he^jxteda^fot-inclusion.(presence_of. Jhe. A w o r k e r ^ , a t . t h e subsequent occurrencTofitHloracHeT^nirthe group to those with a signify * canfexpoTurVarthat time.-The latency period of 29 years ; , ti n. -- - ^ f/f^Tzr^i.v,->v r 'fs r - 7 ,f i ]i i i n 1Tig t =P K ` Table 2. -- Cancer Deaths Among a Cohort ol 121 Males Exposed to - Tetrachlorodibenzodioxin in a Trichlorophenol Process Accident. Year ol Birth 1909 1910 1911 1922 1915 1920 1919 1907 1910 Year at Hire 1943 1927 1939 1945 1939 1946 1943 . 1943 1929 Year at Death 1962 1970 - 1964 1973 1970 1978 1973 1971 197S Death Certificate Statement of Cause ol Death Lung cancer (162.1) Pulmonary carcinoma (162.1) Broncntogenic carcinoma (162.1) Broncmogemc carcinoma (162.1) Lung cancer (162.1) Malignant fibrous histiocyioma ol ** salt tissue origin (173.9) Hodgkin's disease (201.0) Lympnatic leukemia (204.9) Acute myelogenous leukemia (205.0) ' * Smoking history was Obtained By interviews with former co-workers ot the decedents Journal of Occupational M edicine/Vol. 22. No. 1/January 1980 asE sm aeanas Smoking History' Cigarettes Cigarettes Cigarettes Monsmoker Cigarettes Cigarettes * Cigarettes Pipe Cigarettes / . . *. -` -13 yrPlIL J:ill'l'.JEl!ijybTr is longer than that of any p f us study, and the follow up is complete. Therefore, alti.^ugh the cohort is small, it represents the best opportunity so far to study the long term effects of TCDD on mortality. By augmenting these data with the results of comparable mortality studies, the long-term effects of TCDD may be more definitely evaluated. PhyTlSlirs Kauotrhiorr*torwiiN*h-irloam(hiaUnkniMr wniihlatnhrei dTiulJrinc.oMllerctiRoanndy PkoIh . and Mfi References 1 In te rn a tio n a l A gency to r Research on C ancer (ARC M onographs on the E valuation o f the C arcinogenic Risk of Chem icals lo M a n Vol 15. Some fu m ig a n ts , the H e rb icid e s 2.4-D and 2,4.5-T. C hlorinated O ibeniodtoxins and M iscellaneous Industrial Chemicals. Lyon^lARC. 2.1977 K im m ig ] and Schulz KH O ccupational acne [so-called chloracne) due to the chlorinate d a rom atic cyclic esiers Den m ato/ogica 115 S40-546. 1957 3. Ashe W f an d Suskmd RR Reports on ch lo ra c n e cases. M o nsanto Chem ical Com oanv. N ilro . W est Virginia. Reports ol the Kettering Laboratoiv. D ecem ber 1949 and A p ril 1950 4 Suskind RR: A c lin ic a l and environm ental survey. Monsanto Chemical Com oany, N itro . W est Virginia. R eport of the Kettering Laboratory. July 1953 5 Suskmd RR C h lo ra c n e an d associated problem s R eport to the Conference of the N a tio n a l Institute o f Environm ental Health Sciences on C h lo rin a te d O ibe nzodio xm s an d D ibenzofurans. A p ril 3. 1973. b Suskind RR oracnc and associated health problem s in if*- m a n u fa ctu re of 2.-..J-T Report io the lo m t (,'o n lrrrn c e . N a tio n a l Irv Stitute of Environm ental Health Sciencrs International Agency lor Research on C a n c n . Lyon, f ranee, lanuars 11 1978 7 Young A L. C alcagm |A . Thalken C l. et at The to xico lo g y, rn viro n m e n ta l fate, and hum an risk associated w ith h e rbicide o ra n g r and its associated d io xin U S A n fo rce O c c u p a tio n a l and lr> vironm ental H ealth Laboratory Report O tH L TR-78-92. Brooks Air fo rc e Base. Texas. 1978 8 International A gency fo r Research on Cancer Long-term hazards o f p o lych lorina ted dibenrodioxins and po lych lorina ted diber zofurans 1ARC In te rn a l Technical Report No 76iC ai. Lyon. 1978 Dermatol9 lirasek L. K a le n ik y J. and Kubec K Acne chlorm a and porphyria cutanea tarda during the m anufacture o f herbicides CeiL 48:306-317. 1973 10. Jirasek L. K alensky |, Kubec K. et al Acne chlorm a, porphyria Dermatotcutanea tarda, and oth er m anifestations ol general poisoning during the m a n u fa ctu re o f herbicides II Cesk 49 145-157, 1974 11. Pazderova Lukas . N em cova M el al Chrome po iso ning by chlorinated hydrocarbons form ed m the production o l sodium 2.4 ,5 -trich lo ro p h e n o xya ce ta ie Prac L e i 26 332-339. 1974 12. Kociba R]. Keyes D C . Beyer J i. et al Results o l a tw o-year Pharmachrom e to x ic ity and on c o g e n ic ity study of 2 .3 .7.fi-tetiach lo rod ibenzo p-dioxin in rats lo iic o f A p p l coJ *6 279: 3Q3, 1978 13 Van M ille r |P. La lich | f . and A lle n [R Increased incide nce of neoolasms in rats eioo sed to low levels o l 2.3.7,8-tetrachlorodtbenzop-dioxin C hem oiphefe 6:537-544, 1977 Biomed14 M o nson RR A nalysis o l re la tive survival and p ro p o rtio n a l mor ta lity Compur Res 7 325-332. 1974 15 Eigth Revision. In terna tiona l C lassification o l Diseases. A dapted lo r Use in the U nited States U S . Departm ent of Health, Education and W e lfa re . P ublic H e a lth Service. PHS P u b lica tio n N o 1693 W a sh in g to n U S G ove rnm ent P rinting O lltc e . 1977 14 Mortality Experience ot Workers Exposed to Telrachlorodibenzodioxin/Zack and Suskind 'fi/ i H u m a n H e a lth E ffe c ts o f 2 ,4 ,5 -T a n d Its T o x ic C o n ta m in a n ts R. R. Suakind, M D , V . S. Hortzborg. PhD * * A clinical epidem iologic study w as conducted to determ ine tile long-term haalth e ffe c ts of w orkpiece ex p o su re to tila p ro c e ss of m anufac turing Bte herbicide (2,4,S-trichlorophenoxy)ecetlc acid Including conlimf-_ nanti such aa 2,3t7,EMetrechlorodIbenxo-p-dlaxJn. The population consisted of two cohorts; 204 ctesrly exposed and 163 not exposed. Among the eixppootsaedd , ecxlipniecrailenecveiddenccheloorfaccnhalordaecrvvealoppemrseinstte. dAInn a6s5s.7o%cia. tKioonnawoafathfeounnodt betw een tha persistence of chloracna and tha praaanca and severity of actinic else to el* of tha akin. Thara la an association betw een ex posure and tha history of gastrointestinal tract ulcar. Pulmonary function vafuaa among those who wara exposed and who currently smoked wara lower than thosa who w a rs not a x p o a a d and who currantty am ok ad. T ha d a ta aaaam b lad In tha study Indicate no evidence of Incraaaad risk for cardiovascular dlaaaaa, hepatic dlaaaaa, renal dam aga, or cantral or parlpharal narvoua ayalam problam a, (JAJUA 1W M ;251:2372-2380) J*'avSsamtiTaunffrapmnhryaaanoTnnihHipvetmTcilnadadsYteyvldrotirEtthrinoeiluhkiliowotle,dvaowcrhyeeogaeteioexste1xecndmdiHesniy9gnacgzfsddje7ErruraeasMtieodl0tacrprdcrRgehpdrimiolikera.nhcedceeBoeartneaidthricdnicnstItcltcehrT1lrtCese-eollox^9oa,ishdeenoIrSn4lpsLnfaoDaoftSf,-oanadisdtpowo,E(nso1rleueahfrrdogu9aqsuwpeeonrw42cyhunsepn-ga9,i(.eoetei4haelo(a2.pmca^af12nwirtl,mmca5olnTo,4tptt4ulh-aihtahaT^ahfle,wsytoi5den-anehcl-yitafhspdartenTrfobaaiaefcrgiadr)l~ceoaeaeole,rmwe.xc~hNeiocbmbmmlspijtwlildeandiiodfe-imeatoinitciniemerIrnennnrnnruonnegalrsgigtdgy-s)-,-t-,t,.e# CrMrann (UUe, Lk"^ V n T erf CW nrW lU J o r f C M , ko Vm a x erf L n > n i `* * rf iadredwsfebfinneraoecxnoyyarvaitlnvc,tsuitiltrethgoeeepaisesaadofrwuninekmtlosnneeadieieroana,.iddmtic,,noimnnueno,Tcteeebatseuofoahyrr,ysh'lmuveeectess,opsorlttpeaayeehahutvldniamnesoaoteanncwirnrpspcndaee*aytohatsxw(ocmtesic,nromono,hwaepefarlnscsafteoknddpooodnearedicemliraxkdfdrrhmcfxxssa.sgriae1iurtenrceaoAreaaaetnhieir)nissc*tnneorn,yuaedt*urhgdebdbea,presdxitlwi1tlliripaizaaiizd9atoebtmaeneh4enycrntiddd9dee-t,,, ~.^cptdrlia1trioer9l-eiviftedxcI5lhee'aaniih3Torocyes,lTxueoea1daigsdhrt9Gnhhnoha5^otdpd7tep(tosm,hTrettteaoC2ausocCntuAlcDnshoptbhyeTrhDslms-ome^Ieigp)mdmrs-ephutnyenweptbemdnciolrica.rrrtmnoxahrivoclcTesiieioahtspdhdir.nIiim1aees,odntnn.arrpe1eotdymce,il&dTfeihntiirviahfleeinboesiindemneatlrtdesndna.adlsiactansu.nrIiBn*g>nobe;dyasf-, . ' _^..4tempbaiipKlesfmobte0c'tm(SttcittneamehiShSanirucxn.oeaereafMooc6yvicsianyeT.caeuMSAersnpembdttcnp19npeleslasraent,ntoooceReujs1ac,'o,leesesepReaJ*semsxsodch.iaisnarr'a(r,c**rSmerrco)ifle*pewiarGeetsahe"cne*miotdeaoftawdnivxenhnJphoa'oafdxcfgGilnhafriigpdeieeeevtleseanohrdopocmoncacohebcnirTnttageprtfJydoafarvvredbevagctweloartetouaPnssol,arceeatrel,iioitn3eernticc'iar1aaoa)mrevesdh1c'oiuna.t1*ddet2,dhbeksln'tdcclm'ay.1a1eitl*scfselovl0ida-yeirhuat-tnn-aaczc0gcetrdanucemfrdenlgtheceFnoceeapauehaoeornaowgodpdelsa,lpiadrnkdleveornoln,nriubeiisseacu'ganoiddnpr,eleiia.rsrsh`tdtitseeT\stic1daacruouiisru.henlh,aJtpoysdewca1*tyl,'Mtag**hcrCnmbtnoes0kiohsrhap*te0vnshetssealyeedtdmalfeeerPe.ieeioylhacnedfw6os.slipodrorEaTofdPenrpleivtam3lhratdiecosf.nb,tna.irOlrreade,.c*aleemiaeorieiysio|trwAtpsrta**nlcDdnprdrtvetiosmftsie*esaeomh*th,hh.hsrtpaettDn*aas"7gyrnsvhorifoietyahrawc0oe"subsacptuooit"aeuSxpestrtseoooriuchn*nsiefnirdphoiminaioieesl.nnnisrasidcicgcR*eicarp,vehonh1ptadsattka*tlyoatts9ueaawyaiputihiaycnuiintenvesoir7voortlvnupaha.ioaccrariitfiaoad19ennenn-eno-f-e-ds,e1s-lf, ly." A CLINICAL 8TUDY . o2pWa.bcr1oYtIj,ieng5vac-re,tTaJimvaoppnenlradsowoncfratee,1tssht9sice7*roe9bken,deoxdtaaweummcwetcepieelnnldrioaenyti1ticeh9oeae4anxl*8tppooetrDosfxoeeatgd1hlmu9read6itmne9oNda. itwTtittrohhhaoneeee, !. ti 2 3 7 2 JLAUA, U s y n . 1 0 ^ -- Vot 2 6 t . H o. 18 2.4,&-T~--Sueklnd AHwtiberg lo del<rmme paxaible increased risks, on a was carried out by the Lipid Research long-term basil, for adverse cutaneous, Division (a National Institutes of Health pulmonary, cardiovascular, gaslraintrali- Center] of the University of Cincinnati nal (Gl), hepatic, renal. neurological, Medical Center using methods of the behavioral, and reproductive effects; ef- N ational Lipid Research Project." Includ feclJ on lipid meLaboliam and the posiibil- ing determ ination of plasma cholesterol, ily of increased risks for cancer. The population included thoae exposed to the proces accident as ---ell u those erposed plasm a triglyceride, plasma high-density lipoprotein (HDL) cholesterol, and esti m ated' plasms low-density lipoprotein ietnomcplnuloodryemdeeaslc,hmetumacinhcualfaascotpuperiripanetgofirtspterroascnedasaneadservmaineede (LDL) cholesterol values. Pulmonary func tnieornv ete sctoan, dEuCc tGio, nc hveesltorcoiteyn tmg eenaosgurraemm ,e nantsd, dence in contingency tables .ere used to compare the (wo exposure groups snd the fthrerqeueecnhciyoroafcnaebncoartemgaolrifeisndwinitghs roensppehcyt stio cal examination, pulmonary function test, and lipid analyses. Fisher's exact test was also used to compare the two exposure ginrgosu.psM awnittehl-Hreasepnescxteltoanreaplyrosdisu"ctivaex ufisnedd to compare the exposed group with the not eaxbpnoosremdagl rofuinpdiwngitsh roensppehcyt stoicafrleqeuxeanmcyinoaf chanics. The control group consisted of current or former employees of the same perform ed by the method described in Good gold and Ebcrstetn,** were done at the tion after adjustment for age group ( <50 and fc50 years) and with respect to fre plant who, according to intense- work tim e of the physical examination. The quency of abnormal findings on pulmo history and personal ark records, ero nerve conduction velocity messurementa nary function test or abnormal plasma never associated w ith the 2..S-T procesa were obtained for moat subjects from Lhe lipid levels after adjustm ent for smoking or its materials. peroneal nerve for m otor and the sural Status. Logistic regression analysis" wax Subject of the Study nerve for sensory function. Clinical laboratory analytes Included uwsietdh taobndoertmecatl afsisnodciinagtsionosn ofp. uelxmpoonsaurrye waTsh<e36to. tTahl enrue mwbeerre o<f19subhjeilcets meaxlaems,infievde black males, one male of Hispanic descent, one male of American Indian descent, and ten white females. One subject among the <19 was exposed to th e runaw ay reaction residue in 1H9 as a child. The seven nonwhite males, ten white females, and the white m ile exposed as a child ere rrcluded from this analysis. There were also 51 subjects w hose possible exposure was limited, poorly documented, and did not include work in th e 2,-US-T production process. They are not included in this daensailgynsaist.e dT h ebyr e me xapi no isnugr e36a7a s ufbojlelocwtss;w e(r1e) eposure w ithout qualification; 20-t sub jects who were involved in any aspect of the production of 2.4,5-T, including m ain tenance from 19<S to 1.969; and (2) no exposure: 163 subjects currently o r for merly employed a t th e asme plant but v, nevar.associated w ith any aspect of 2,4,5-T tpiroondufacctiiolintyo. r m aintenance of the produc All living employees, active,- retired, or term inated, as determ ined from company records, jwere asked to participate. To constitute.cohorts- of the target sample .lire, all those who volunteered participa tion in the study w ere examined: thus, it was not possible to random te the selec lion of participants. Of the living exposed personnel, approxim ately 61% voluntarily p artid pa Led in the stud y , as did approxi m ately <6% of the living not exposed perso n n el T hat only m o rta lity d ata a v a il-_ ahla for analysis at the tiras of this study were for personnel who were exposed to the runaw ay reaction m aterial*.11 Clinical Exam ination The Interviews and clinical examination wdWuiitrnhifnigeilndtf.hoWermVwede.ekcoJnuslyen tI`I wteo*re18c, o1n9d7u9c,teidn aBnlTodohdeu rrpiolnuaestimnwea alslai"bpcoiodrm-aftrpoalrecytteiaodnna lbyeysxiasmMoifentbapltaoi olohnd. " blood calcium, phosphorus, blood urea nitrogen, creatinine, blood urea nitrogen/ creatinine ratio, uric acid, glucose, total protein, albumin, globulin, alhumin/globulin ratio, total bitirabiD, direct bilirubin, SCOT. SGPT. alkaline phosphatase, iron, total lipids, sodium, potassium, chloride, GGTP. complete blood cell count and dif ferential cell count, thyroxine radioimmu noassay, and thyroxine-binding globulins. Urinalysis included routine examination as well as determination of coproporpayrtn and aroporoavnn values. (Values wers determ ined from a single void sample; hence, the measurements cannot be re garded as valid!) Analysis of D ata D ata from questionnaires and the sub je ct's medical history were coded by assigning numerical valoe* to the re sponses given. The subject's medical his tory and findings were coded using the System a cited Nomenclature of Medicine" System . Laboratory data were entered aa rfieecde.ivTehde. Dcaotma pwueterer kdeaytapunwcehreed caonmdpvaererid Swtiathtisttihcsal.oriAgninaalyl sfiislesSfyosrtemac"curcaocmy.puTthear package was used for data analysis. Aa tha analysis progressed, editing continued to ensure the greatest possible accuracy. M ultiple linear regression analysis'' wss used to compare the exposed group with the not exposed group and to compare the three chloracse subgroups with respect to p lu m lipid level, pulm onary, function values, clinical laboratory values, -and nenre conduction meaauramantx after ad justm ent for covariable*. Tha ooTariablea were age in the analysts of clinical labora tory values and nerve conduction measuremanta, age and smoking status (never, form er, and current) in the analyses of pulm onary function values and age, and smoking status snd alcohol status (never used, form erly used, and currently used) in the analyses of plasma lipid Talurs. Fish er's exact test" and the x' test for indepen ,, . * function test after adjustm ent for pack yueseadrs tosmdoekteedc.t Laosgsocliinateiaorn!mboedtweles"enwethree three chioracne groups and abnormal plas ma lipid levels after adjnatm ent for smok ing status. RESULTS D e m og ra p h ic In fo rm a tio n T(n7p9rgdsala0lsmttaa1tXeyhehhc2t.co.3nhrmoit46gasfatoheea.h-Dtdeti4e%f%p5etloooeun:ieue%n%,eeSeennonprrsemsnvmdcxlE*egotswxtoetiaeplnheteisopa)awadewntdewvoaoatdelgonirxdslenendmueetesrewydyce{hlpraderrcexyodeeePeeeptidoa1ipaoletahg<hlht.sgofrare2fii5cehfier.emssooggn%g)c0(t6oxeteders,ounPehdrh.0tnaexdi8,do.ni,aen<0msfrpr%oundasnror4peae-1gofgeetiptdc02suoete)nrsarasetops..c0ntaseooee0tpcdemthddh0doddu4%heeIcaibee1,wft6aupnpcx(entod,e)lin.tscpldtegte2v.ieaho,edaovroetsfr2ettxeehttseiiemtns:l3nigpoee1eysdoolT9lv4o3vyndonpnp.y.emn5..60hoa8.si8e,ldte6a7feorle%eegf%cAAeirul.iduyrcy7trapd1wnmimmwomar2ebovlhttenuhaLa:taalosheoacihe0wivetpinrn2nennlgorinlnte.essy%lsddiydeoed7ghlglte,.r,, * t -- A lcohol "and S m oking-- - - -- subniwtiA.hcstsyoaemaeeHtrtndteouefiht1snolsx9eyaftgupoo(snocurlftpdsyuonwtoeahrndrdootcregmo.ekfgeAn-acebgrrytlerormrc,eiotuotafshouephorminarp*gorignhsomoln.aknicce(dfte,o.uihWr0rcn,rs*e0narmsoh,0noeure1ntotnm'lnhodnyktoitepefsdivdtfmemeiieeoxfxsrrofonpiep)egkk0onorwwen0iscesnre1ieeaansfdg)dssst,. UUA. Way l l .'tO S - t-- Vof 261. No. TO 2 ^ 6 -T -- SuiUnd & ..2373 ye(T.xxe0oppa5uoor<pssePedhda<ag.ade1gnQrsdom)du.tiophfTkfeeehbrdnieysonltocrneeegxfylpeeerobcnsetteehtpdwdaaoegctehkrinoeh-yueeptetna.hnores-l Hlalory of U adlcal Probfam * jcoo5eglaoocctcusaywseoghbaeaAthgeetamchdhsrdha0xadtf.afnecriChohnhulcfhilvxle5eimefrrhciritrxrosTieiugf.bxcepencmemodcroCsiroseoratoe0osgpesha%aotltalsupceornTurpteootrutauhtnitspttetru%torumuorleileeotesoeobotrpoooenaresier,uop;rchoesorlprsipsspdsrfndnerfyierrrofswx.rsrroioratpesuemiitrdPtesca.yeeyxcoiiyigtdetonacpfyoasroneryscWdfsrWeebmdiaoecdrTpdruc^eeeuatnntcfnoriibtnmrtrfdsrplryteaoojhnnoaeroenrlgtmynol.ohbsouoeeaee.eioohgahlqeoewfofOoerosetreaeemGrstwumijcfrcfrmenteiretrderoelemIluasosuefdsdnoleoseo.uhaeonatorakyoxnclntdndIxuhiuiipphcsesanutawrmrbcsdepithundlgpimfoooceniagrtitenbmlsaili"ng.pnootetpgipolsoecnereanontaasrttmerroirrwthjmeefneegefhrc,a;hodtsnsnt,lsitfepoliRweetneatoteneoitrntshytoidetteeoeihrscom8uoalseecahrovhthaorrhehn'anrdttbemaetoshsemmr6totmpttpdsttghyfcnusehtaannGodtfaasoeowteerelx.ehhr.hootaere3poielnetaisetdt.pntvnntetcomaapbCeIgfssegiaaigorw%adesaWseoyadtpwxoocrostitfbtxIeocdaaqsaaenrfcuaoxnrcioofityttpfegmeteprponoosussrdonr,esufherghotrehmphrtmctoeexiisiitwooomltsmfumaedljcnneoeeehtrvensrspoeoeia5owiodnusoopyshr.nhpncpdayt,ncseeen0lesnpaans,epaoofosrmfwwehtceewaotltesranutfndssnrdtthatstaThofssafelsrnainytopoethtatl.meetoaraohia2yypnuye.npee'hgerehrclhhexs*defsepnsrilsqesns,ady(iteltyietpenonAftel4aeeyperorege1coeTgbseulaeraaia-c;astefbreert,onyorxemrrkete6rnhexgrmein5nuneietheirTooemapweceeamatsnxesforxtopn.ehepsspnr-xnvaeedenip6ntr)pe,pdipesrablsTppoaipemfnnooeieoodoge.lpnitee%dneoidbte,sowetyoeuhobtolsdsvdsdovronnaowdsdhltydralferwprusestuoipttsroihoiisielamBietastanooterudehhtceantcnitedeeorfrewhe,seboetagrhorena5rsehcisrotdooaiduepeeaovdrtdgetsdnssynddoynede,0dse1eefaddaeves.llt.. P ter) * < .0 0 0 1; ttk j* aoom oaruon crf tjjo , . k m i en ut i c m H tp# u r a la , 1 . 0 1 < P < . O S ; r i u n o ) ! y o /< g o*d. by F r* * * * t't * * a c i i m i .OK/^.IO, In4lpoMd. fo/4 r M. tir auel laal,f M i M k y LU n(*(iH 4 " * n l com fxru on Ot ip o d v nol i i p a n d K r e w g a m a . ^ P < . O O l; n n o l t i p o u d , * o U , b y R t N a `i n w l laal. **Vna aauraaa , bliotW canea, rao: colon Canoa,M O a i< P < .D I: in nM aapoaad, yoiy'g * ofcJ. by Fi#***" a u e l 700 ;vhl a a l . proatala canoa*. ona n ra nol .Q SC PC .T O ; ki np O M d . young 1 0 M, by F W l a i a a taal. tor M a m a * t - u ^ - a j a l c om oartaon o* a in o a a d to no< a ip o a a i l c r o a * Q a m la . t / * < . 0 0 0 l ; ln r e u p o a a d . young Old. by H a rai* a a a c t l*as_ |.O K P < . O l : tn u p e i i i . y<*y>g * o M . by F W ^ ' i a a a d Taal. .O O O t < . 0 0 1; In a xp o a a tt. y o u n g C*d. by F i-H - r 'a a u d I m I . .'.`.icrwwncs(tobttnncabhanneoheeiaaoabieantyioxaancxlleennsnrtAtgaitsfsrsdcedavatccttocetioihsycendioeeeenfoeolanorpeddotwrsudarbnsyeleno,-umtnsei,esoi,cdocfnfionnvteatspnfoltcohtaoifdeeridkdenlfcorcvlaTaatiewdeoratirewneesicsohteretaolnnxaoxdfe)/kolnabfroindoasatppcniesmtlf.nrgasuefibo0oteeeoonyoiirepr5psssfTsnlttfyfrcoduue,iruol2agogantaaesilsrrfp,hrlrbaemdneeifsiidtoonegacixlrn..sdce(tcewupttaepniihceerTiTeinotponnxoeiyorrenterr1fchnhete,onccsufrycie,(raecdeee/ecttehrTnceonadstpiartedyoacefsneehasstna(dieosexpmarba.xeaostsai8evaapfmemllifieevt0pyenswfekoroareaeeiptlptieust(nsieea2rlryn,wslalepnhpleserni)eie)sadenry.ag,nownossson.snntpefcriowsisiakhdbonottnieesigiAcneefzzaioalnoas!ridiindddaseess)--ft/t, 'wdcrwcr(eWlccdwbwHwnwweeinoonhiheeozhhmafeohsiiT-cnhrllpeftstsoporueoo2oaehesehtsdreeslnegrrsoin8reindesexdaaenceras)unieewpentierb.snsrtfeenneonrrtcxyhecietfetheesvooleesetoieophterahdceleweanmeotlactiodo.dorr/teeshectoiofa.thsireetndeeh(ei.mseananArddssTthxnsarleetlxtt'o,ypkaalpaytuaonwpteitoromdibln*pthtcareoanadhihli*oteo,spseiieiecyode'n.nua(suttnpuchscnei3ertebg.heaelcchleht-t)faadoogohynerwh.a6lodaatgotsrfrfcpclli9rhdeoaotrioloriiteewh)soymem.anuarn,rvreteucneagptahetxeeprepneewasrs.edrapduraonno*e,aennshleoaidntodse.muilcdiessigedai(orspWfaaeenodrpntoctg,lsdacienodcetliauoeh"eoenlfpvattirtnawinihhf,1oeygnerlcwsdfta0ooeogtvalieciiaenho7nztsagsobeotedtnrhip)edeoeoesaerrft..t 2374 JAMA. May 11. ig g ^ --Voi 251. No. 16 2.1.5*T-- Suaklod & hUrtzbaro ** / ' T abi 3.-- HialoryOfM*ctw;al PfO btam *CM<Kftcrt Slaut Kiic>oi*d O^iy rte by Ao t Cbtewkert* 2Ulw, +11V* -V :I* y*mlory * w\j-Kj*ry* 5*jiU N >nbonf AteOn* GorOrsrr td*ryimsmI U cow JtiinrfiWinnlTract tte rf G*<*e* <Milas*(**c*K7ttkn) Iteliyy Orfy (n-l O.fl S.O as a 3.0 s.s ta.a 44 (Cnu-itvnoln s.s .a aa.a io.a 140 33.2 2.a Ho Mf nte- KI f*f"l7 aso aa 170 0.0 a.e 14.3 00 Hi* lory f nOn-li ye i ae 0.0 S.3 0.0 a.3 .a 0.0 A <30 yr Cute-- t fn-I3) S.7 0.0 34 13.0 00 21.7 0.0 Ho KMalory (-131 33.3 0.0 ta.7 0.0 00 a.3 oo H l(OTf Only (n-aai SB 7,7 4 4 .a 7.7 oa 18.3 sa 00nnoov>CTUUi.*A4 o x o iA M n i erf Ffh--n * H cirfaF-cr-- cil*g onM , bom ter ffte total orauo ! ter i n nTM e* Qrauoa. --* tov te lo O* r^i fOI<.P<.03ter l>iirrorrfy.yo^teflroidbyT*loottertedgarniwiteccmln^ancy>!**. I OS < l* < , 10 ter c u a n , yo^r< irete by j* t*a | ter m l i gi 'd rrd tn c o n m jw ic r la tte i As-- 1SO yf Curry.1 (n-a-u a.o 3.s aa a 8.3 178 as a 30 oy ( >|a, ( 18J t0 aa aa 00 a.3 ia.s 00 'll A ~peagcoedrctryG(tiiihnixsedTalxirlinecaIdauoHnppadpWaaanjteeruoncoobineritletrttpoehsshdrsrlri.,leesesrtevneaaigiksiidwldeitcnn(gre3aineTob.tnng)atund.ugwoeatIig)tdfhurtprbhetaiewwotpothlacsloeorcme-ue,aateeohe*gtpnseghraitmrwsnc1tshesrgomrh)enotwmeaiaeu.eo.nautunsappahrpToatTmpidnlysoenleblaihuhlrbynri,alettmecpocnhsoeoegtarhoeohfthirudlebehtslnetate,ndocetehntcmoowgararorhybftanrSnegelhafilyyOmcuoortcee,edrhnftveeUeaoeyensreteepbpmffheuiorxleilnsea(sueabnaucprotrtraanbwjsdhaopsastensobdohltstpttecsUohnihueeeneor5oetserdaeeyssrrr0srr * It. % *1* 5f f Physical Examination Rssuits SOyotHy6Hbjasstc'becwi-'o0olui"oltooxgrolfggddnaTeoiiTuhoupnrmstteen8rodyhinjotuneheoolr9rcedhbeeegstsregferr,cohieari6wideernmlatlndsrp0aaglgeersirese*eednnrnnsmrridrsaeaiyasfgseaeedoensnoensgawen.naa1'rgsedrendcaHmd6titattDhsumdfehesorhd0gdogi8dsrayrrinaa/ceeneia50a9lesnnaasdo.o9offsfws5ttainsotooltteforDdoydtrtoe8tirrrrrm1ooleene0erleoiemiSr4ileaxdcaraaallmceicb-0sfda/piciigmggrdleodnnt/vitwesoceeeo9mvneuigmiHralsssnshan0leoadei.nselmiocsigrlguracddg656uteaFHremobd9y90htelvHfloosnileigoy.goscamnfiryyytgourrcfoolewoeeeoweuernendTfxfsfxmraaaueexgosaHiauea9pr9rserappivesmarnbbss0sdn5osg.oraolcljteasciseemlmoaaTfeaaugnrueotfcfnnnleneh8hradmomen4oitideddd*d0cnees.s.rr t.0/*8<<.O^O<O.l1; 0/>: vPtnai ter tloirmUitet e i l Kw olo mc comwpovn-oernf tetrfguo H| du *d r v n t u icre*4 te lo u a9** an oa ala. unt a . t.OO01 tetipOHd,youia rote,by Irte. 1.00K/*<.0t: Inno*Iipcmii.young rote,byFrfWl aud Irai. .0001tePC.OQ1;P vatea for Utntrf-Htenul OOrrvartcon tW upotel r not apo--d aeroaa ao 1 .0 0 0 K / ^ . 00 H Vi a ip o a te . ro te , by R w m 'i aaacl late. i^C .O O O l: In not arpoaad. ytnrf-3 ro te , by R a lW i aa'aci Irte. dcsaciIohiaptfaadnaqmaemcnrtahrtoonnncne2eppoueauaefciioTnnanr.ddddrispemllrnn7aersdmedavdeitthanet%,,osskr*mespsiaesrpeat.alna,vn,crlirtecyrtoeeTylmstaeeaauhsaaroyonofdtrctlfichdtilns,enalpienioinogkoceeiospiacl.l,arnr,ianlhsanwgelantabegcvaa,r.calhetatpihfnaoiihynkanhaosnncreeLstua2roddroismotdlaeeedckmnlda3sevftosslwetps.,.csgieee3elb9ssconcvieamneecTe.dso%o,,aof8fhrrausroen,nhoconimepe%aclttlmnkiecosaetrhageolutitehmweaa.lmrndansneeahfsosmcawsaerIlddcrctoeepactiartrutrbiaeoleharanhismcnedlufyolemtrrn.yilhcefaeegedeaanyreaseTit,stltraeierrgarsbhocrhb,sisee6hlnem,elaatpereeaayaall2aetegiaafcvyyehnr*att.mdnfc,aafo6es,aqrb,deeysdancrer%milutcuiscecoiedoirnoeleefishactiars.cineaertmnefe^nuoaloduoe.eebwrdidg,ibtmemsafivsmpaitueattieesktliBenlhheeeoanmligaaiaercessrdndnyee-yesssr-ll,,,,* cvdcraaueeesfaeftaofpwatghhoeiioknlxxhcxccouispernnaisrouamennunppAipndalntmdeesgnghuanneeeoooarittniaemasaadgegronlssslocsv,ylasercneeevehags5oyeefiuuals.dddtinctu.0snpietaitlrn..taamo.wologIgrrifhoge,gnAnobyTrnTiaaieefeaztenadceermholphrvthretiletauehtccirrhaeiwudaa*hmsarseceohoerev'lnbsoy3eivmieeegfrlbaaea.ndoiob0peiascyytaoegt.rsewunohrPfa1uhyaxcuexiauaitaces%dsesacaphnrstdpceccmsui,hysvenslocednuieuttyaveareeesxisyoeorucragoansletde.hivaxrrrflalreoeelnideyelmaepaofTxwcsnryaiicn,rafdotopintepcmnohehicgseisdgf'ooecoo5vneecle*eernrirotosten9eadhnnglyhoieenmaPrt,rufdllo.iud1hdaeyaisgoasreatifcp%ocatenonatsrPiylboaanahintctaloeedoearehynsnlecdeocvaiorctnisetdlon,heasenfwsenyaetaelveoirclridcvitn2ndntneoecieheanhn0oieotoaroieoeiar'ilfr-yeanenaeerca-4ftr-tltt W v: -WJ4, U *y I I . IO-*-- Vol 251, Ko. 18 2,4,5-T-- Suakied i. HnN<TJ -2370 FIm* -- | | |Ao-M voQarM* l o n e -Maio.la* Pvt - . o . . m . HriunA^ F 7 a 01 5. -- SQ rnlieanl C lin< al Finding* V C h lo ric S tilu s n t p o 3Kl O nly and by Aq i h*Mio*7 O na'y . (*-1 1.3 <7.1 5a..o0 0.0 C u Xr r ( , (n - 107] 0.0 74.B e.< 0.0 IQ.3 Ho H WXo t , 10.7 38.a 3.8 0.0 0.0 M itvy [ O" -f*rI a.a 31.3 0.3 0.0 0.0 Ag-a < 5 0 yr. % O(*a--i 231I 0.0 58.3 0.0 0.0 S.7 Ko M jUxy I"-13) 33.0 8.3 00 0.0 0.0 h k*Wiwy r (n --82) 0.0 St.Q 38 3.8 00 Ac 6 0 |r. X 0*T V --1 ("-*<) 0.0 70.8 10.7 1.3 lO 7 H iMstoory (*-10) 0.0 <3.8 83 0.0 00 *.Q I < A < . M : For O u v ra i d W a f w y jM lh * I f w c f ilo iO M C ita g a ria t In acm 14 y w n o r y x r o - i . b y j * l u i lo r t n )u "< ) n c i In c o n trp a n C T la b tM . t1-.0OIQ<I^<</ *. 0< 4. ; nl ; alorrmo a- nc fl MiMraIvc wn i,i cjohu nbgi f r Mm, tbtvya Ft fith*a* rt'if i *k *n*ccnl *I t dc a. la p o fl aa In a cm 6 0 y M ra o r o *o *r, b y y ' I m I lo r a i( O S < A < . 10; h no N aiory t f aci aq w . r ok). by FhW i u c t M , In c o n u n g a n c y Itb ia . ttmlangai lor pUvna fijn la r o l. (nrj-erxli. and 1b--dvnviry tooercavri b o U tia rd avra f c h n l la k m tvan api paoftc 0OTi pM/cannka aa Jalarrrmad by tf*a Manorial L xf R **arcfl Ploct. flalfnc rmnoa lor faO-danany Ipoorcl-- c/uaaatafot aara daAnad aa it o u ITm igaapaoA c lanm parcanli-# aa dalai-naMd by rfM Kabonal UxJ RaaaarOi Prcaacl. cwcecmaaomm5scciceeiw(etwgppaarmlnnohhl4gsheui0eaxrvplnsrrehaoeiesesgeh7lelllaosAesarpeAirttsoepdolaononyrnaeetso.ahlpursrotT1nhs3rcteear.ctsesa.totciaposioaaa'se%aetrtmrseiacoicboesosiefnicfscTapntltarlntannido,nscii)oececnntadoesoitsihwoo.hieki.cutictnnn.pneercefothoe,5nmaiuitOiuenast.eayrthronwnzencerdhhsardtsra1afiilreIstohrlstayuncseodini0ceitaeahdoforoewtosntiahafett.hdedsdmhnso3rilfnsmfnonillnatlsyeuie%ecoerirdboosdtbtdpirmttgeTyxataeshhenfriysshersileffiipahcmliaaeieshee:rnoginwaaxwsstccotttmbcemalrihdosnlaisottpnha.svrnssldnniecieweniiefieeossttesilileneofirdditshhsiozloudtfstiteciedhgnguaolu.heonceerr4tsloc(sresaasnilda,iertcda7thopTrfs*esisopictwanlrsno4asemturleloiieonhewcuttohaootn.gugvfmtapuxlf8apipleeihbosrefybnseihoiwkpss%aw.turrtonteuojrlrdiabnoteee.ohieceleeasirrlnstnti)asasscicndemfs(Isphhtu,niee)etdtispoeawtnhuneewoeiefse.xasnadglsloebfersraffcpdla,ceeibttfrnceoouIshcwtfwthahoxoevosratfheiiuuietcaaenospinnvnesaeiiinlannseavdes1gontsItroaodeenliriitltndhhnddnoyee1ecesllfrttt Plasm a Lipids TpdcwTgdqwopwAntLccftLfinsgItnwtirnroenhhihihoarueuehrlohiiDieeeghfflgioefpooPogorrWeottelfetttqrritnaecsLcssueihsueenlleellclhoduiethyeeiceeadpbrmrphcagoffeescsewnstacclcsswse'yinelRnxosfttnrthnwcemlasletooalneeteoaeaaaaipiroacaocmelrwudn(lrfrrsasisnryaoiwneyonesTdlioototlwsjsdtcepcghhesy;stutoweillilfacnehgsealfl,afHeieobts.bioetwitt,ioedwneerrcppnthefeeHohvsdlDilmcefiLrtheiederefdieeutanoieismhdaoDpoorDfrLrandrrpgltxttlgitfevauiebihuslla-6diigLaPerptvetdeLeofsineehtyet)oear*lrocarsffs-sreu,fydfsyeeiliuneoenocoottJhso-xa'ens,sndecdecnrupauhredtfujiTogtarww,cferhuhaenfe-nodnecsnoeemtloerornnrocbmfesHetetadrdll-seallitahocorletgyryslss!spim,dh.anwc(DeebnenfrpsetaedeTesenohgessteodeeoebraetLrer,eotfrwalseexehdcrLcntaonkcreoowrunbrxcepiltenalevociroieirofalhfylshoipnn_awlooegnghaeilreftnsaifieuc,noogtersiNllpctgoselleoecytiuesedltsoesinripenlPhxlefhiafdecdvu6eeoixesreexvieifpeslftndeese)lcte.bfpnaoaiptraoaHa.troilcLdoehf9jocttsouteolciTtstifoehtahrunsmeld0DDsinvrunaseerNoocnmeoiheeoanaateeedteddndsgiLLtlhyadrodseonslnld,nrs,,...t -..hacannwcttcsefaecgvsmwdcmfocFruachhochcaatooxeuntadhyarhnceheeiaoeanrneueoATodnvmrncpLmdllnnstlloietrsutmeaeonnyeoeluetgooegueedooueelfepnebrsdcrat,rpdhesewtfdgseisssa.s(aaoetenufsstw,ddtiT.csrThco,rearlrtewfrgccdoe.atenintehfaanlreduibrhophhasedTuewisstseoereoobtneonejnaeeilostmoshrttrughlldoNdutfdoiedc-oceeslaelohtswnt(resmoroenh.rsrtijhcoargtTosaatolgiuysfpvka.ceeei7eierabruefdca-vtdtanneseeativoil)oeraenpbnurntcaot.isin(rlgseaauucrmniwmdiaffeusle2osglsntioolnsnefihnpTu.ssowe)sgehchleolonlggpdlpfssieyrsnhnoaisorotdnfeodsoa7ger,speeohOasnoeltirerere)ccorafcinmbeferratltl,nvbdtwoilutilfthtoe,lchseccswioadweeiuiutsofoteetrtnaoiapel-ctwovtimrasawtpientseewonnwfnteuhiihtouwe,netwvfssdgrdghfdoatsselunaerexe:deb-colelagoaeksdorsreypylmeurrmwenentvsra(ih.nwfhndeocah"tn1er,nndaansoawewiiecesiwrofe)gseolcgsftdgsaeeoftnrurphsxfuehseeghmhairndeaensreeaeOeoedesspresedslreicrtdeseoncccgectoqgetilueihwLthdoaHlygtjkfihwnarsauhnatipluafetDhtvoa-uiplheiolttlcewaeDhutneoofsossehsonuarirertenLrttinooedgrtseofreorr/oLellopdds--. 2 3 7 8 JAMA. May 11. 100-1-- Vol 251. Ho. 10 2.4.6-T-- Su^Vnd 1 HortxEwo v J/ -1. T abl- 7 .-- C hky o - Slafua in Ejtp03*"d Only y P lasm a Up-da I Only C u m --1 Ho Tlt&yomr&i k0 o o 'o < - ' (M Htiwalt * X xse 0/ 213.18X4.87 87 144.00 2 14.M o t>. Owl 11.0 7.3 M 143.04 X 4 eg 13.2 ft X x s e 106 310.23 j 3.17 too 163.84 x 0.39 103 134 48 x 2.66 of %RxOsu9t* 4.0 io. i 3.0 ft X x c e / 30 304.W X 7.13 38 140.11 16.36 37 130.04 X 7.06 % Ou r.i 14.3 7.4 "dt 87 4 6 .8 4 1 1.17 3.0 106 44.03 1.31 14.3 38 4 7 .7 8 i3 .3 l 7.1 d umR*wd-byma Hno*no*rl pLUie--nJvfliMeWU OMlitPtrdo.jact-.^Rro*-)*sn*f*lC,anl idn ?lowdfowrihurcrr>-<S3--gooro<--koicOc7"uloi--ia[Mc4a ^ a n f 6a-v4adOaKaarvald-*a4a )fb\aonnmm**iao*a--(^<O>aaoaAAcd D1Oa/twnn[pMawniaiit aaaa daittaPiPi<<i--..OMialdS; b;foffromroaoomoHmpalaptraVornimgalgfTUhwp-*e^QuuaR*ncnmycyo4toi7otfuoitu-llo'-ifou-fr'-airnda,^nagat--Ua>taalaklanmma anRvavaaaerctNoroanenoaragro7Tu3pWa0.4 ouscv(wa3tafenaa)insdrttayhtOulswtyssuhscoeitebhg-(rcoye.lnid0oafies-rf1tarmcaii<ocasrcasenonPnonegke<tceidlon.iyi0safLgdtt5aDbeas)dtysnt,Lusaoosstatwcumcnhisid(doaot..iht0klfieft1iohsnecn<treghePrdlsods<oiitdergl.aa0gntvcnr5uianefos)ilee,t. Pulm onary Function Exam ination l%kIB**"'e*i>-`*:pfaOnaesvfudwtfe8aoef(optwftF(o1FruomhhvooFbdoFaaixx)eiffufVedhEfTf.nae`luerLerrsnjVCppssEioBlqfduoaecustmnaCcVAcnmhiteoooohksuoeCbeFvgooohmtsa(dre,ssrgheeimes.cadebFnonbttbanene)eemro/hdiarionvefFenmlnsEsoFsiddtsnonplruv.tnflttenicewacywwYtarapVEenygwires)eieargfrymlescretcgrtrgervohvmVeatC,yivisreweaeds}senpdroreerarneocaeannmde,frii,ioec-eneaduoldss/uadnncplouedittaiteFuvsrunflofmcpthgcenprerejdvovm-cpcdeueVedkturserrrcdxdutafoeadooaTtrssineiceeehsa.ooChfl,pfwldlrpmenn.tcndeasasuftmuebfrnvnetehfi,xamegsmstnsebaoeeteoerbnpsiaaeiic'vrepornalrotlasodriolroeuaoeeeakawepdaewdicnbtmuednyngpenrnrnnkrrgtotxleeexeaeeiariamcueda8ccetoerrpodvrperfdsaotrysee.swyeedtekytouooanvedcofamhomsexhldEolFefslnnbveaaslrseaen(eoepibeferyoerhxpnslcsniiETnMarusrsasfouadnetdsntaptiesosbafpp,anFbitse-'ppflrgvoowoMfrlbnowpauucottaostneMtermohhrshnaalcwotwdhrbrldbeeroahrcreiuolmpeneenakadrfineqoumieaaore)rr(vsdmore(nddnn8mnstmuonlproeFryT,eraotwir.ia)eerwahhnscaEmes.la77kae8rmwvfsnTocuea-teltaannb00fle0aetViehaeeivncnseorergah%%oro%dlattidldeynAeysoieei,,sessyenrretl.tff (.f:*. ' UA*A. u y I I . 1 0 8 4 -- V o 2 5 1 , N o. 18 IL wewsinFsvcttewrfepFtfdFcoiewmomxoxooxaEorViEheaasfprerplmptonVroosofndupCFdooeeotskkeebtee,jsihsfaerhescmeistxceioeefwedauxnpein.trdodptnsrpceirprsgeaemifeuocehm,dW,grwoftrfenspicetefhensgoeoidsoeeehrunrvnowirdnstegrcnrfelsorowaiemcynkbitraenitluct(wgoeF-uceeseouopTasptnunetErvesfgohamksn.wfraspitiseVrodreseiftgbboosreknwmiujdFn,l,ecapiuekfugeenninhitoanuonrtepsrcdfwaohtwnedrsk9rdtpistetedcteets)eie.u.beirnhlndwatFdriextayawAerreaceheegnnpEccfetivttxrvtemwtgteoetulwm(VeephiareodnrosTsoereororxloaewd..ofteunean/srs-psduienFrabeemsepguftoepexPapdsfrVshlbrraxs,eoceta.epeeejeeenhpsCmruumikdrectd9ndeieowctesrigct)rwenhicsrted.entnaaetaineuctetnwiNlnneenehineontrroattftddnhdgooodeeeoss-rtt Clinical Laboratory Finding TlddepGetlrahiexveheCpGsepWptetoiDtesedoroTsec,rdsDsirpPmtt,teaechhsndtdioifna-oannoorohtaaerfooogbstsdgarfstireieihatobhogfes,trefnwnunoxdert.spoirpreaftpsreoSinetm.cnooosnCoactupratoOneTrcuhlleetsloT3lehix.la0ndnre,eptwgviiriyocfoeefeetsapnlSeheralsesredGarhreolneianaPofxfvbacaTdopaeenfospu,oltsdk;rlnesaaaehdwrbtsl.daooeinmtennwehrrotiydnoeaneet * ^ drssoeuifetrfimecererecdenhlcaatetnoesgdeb.sebaaengtwdeepreelnelautreatdlh,ethnioctgkreeonxuipapogs N eurological Finding and Nerve C onduction Velocity M easurem ent cgoemttsfnriws2ccTmriawgpteunonecoexifhr7ooodraasseeuoerrptWgNca8nAaormlnj.brataeernronuteiuomdiuedeeekelnlbestgnAwtpdhpelseridpoursdneinity.tlegstevn.sniicfeiweifonstolr.nettngtotca1h(idfuerwheieneemggw^.othu0omAcqbreirmsec.nlr-3nooeejuieomTpr-apoetndxvnpnd5rae-ihNbrlremcahvepar-aldr,nebaoeoorteeoet--oelcufJwcdoispcoseudycieclseocxnceenlnodeyeohhenonses.tmduodredescddiureioitmtednonuafogdiaige,tnpapnrteerntifthleanpyJgaofreagloImasadnioaieordrma.vtsutrfnree.dsomtrhrllitipeeirdxltedfcfmwicueooeWluawfrenetodaobapneonhdeldrthgmfaoncrhsemaspecitonieoasiowdtatne,kootrirtohnnlduydtnrsyeeldnottcmwyddruasifaahtpd.emtwaewrhetitrteteohieTe2feeieoabnterforehr3esqeixmxaehlaebteeorp4noaeuaepplcweretencpnnshgstwnedeoocweswo*cueeeiennaasoscteccoherrreercguclitrorarhveooakimyothdreydereierclhaeef)nrlees- ECG and Roentgenographk: Reproductive Effects Finding wanWtEhnoCieNhdttGheosneeextdxfhpitpipnhfoaoofdersessaieerencte'ddeghinndsecgsegbwrttrhoyohxeuwue-aprnepgnsareoyet,twwhotfeheeieblxrermseeepexaorfcprvsictonoeeeomddsdrmeiinpodigpngasrarcosarteluneheidpdden.- fctpaaorivnhoerIAadymsnis,lfincaocaloobtirinhvmalmtdeeenepatxatbmboniprioioioarcrsntrlstoohehennshdof,poidnbrgasiemenrrpftotrefwiieuttaccahpepnitleepsrtona,ridfdwnenotucetfharscooaes.ttrrpihdmvreNesexela,geiptcwinimotfioahsteaineenrecd.de-r-- 2.4,5-T-- 5u*k**J Hrtrbwg 2377 f * Lf amoving urua. t o ru tie eta . on* -hOM (n*nor<*rf ttnclton tva* r**Ut a nomval and ia Incaud-d ki nva tool. Tol* 0 . - -Esposu/a Group M * * r \* o l Pw Conl-Pr dici *d Pulmonary Function Paramal** Adjusted lor Srryjking Slalua Function Pu m m tM FEV,- FVC' FEV.7FVC W F E F ^rt* SS--lze>fufcak<| H-rW Forrtw Pr mtr Total ... ... ... CXxpxDsHc d tor.iixs.oa to 1.43xa.cn eO.S3XZ.22 00.33*1.43 02.73* 1.17 70.* 2 0.S3 101.00*4.03 W10o5tX.E03xnsxwe3i.0i 3d I04.MX3.14 102.33 I 3.BS 104.42 x 1.57 IO077B..B.I0SO3**x04U.,53O43 r HS K3 0 0005 0.01S4 a0.c00o0w7 K3 ditions, at the same plant an d /o r other plants, between the late 1930s and 1979. Rubber processing chem icals ideatified by the subjects as o th er erpo * ' sures included diphenylguanidine, the benxothiazolesulfenam ides, derivatives of m -cresol, p-phenylenediam ine derivatives, and 4,4-dithicxiim orpholine. A dditional chem icals nam ed were ethyl parathion and m ethyl "FrEa"lVa1. rcVlat*- k>nrd u p n tory volum* fci 1 a; FVC, (oread v*tal C J p to t^ F E F ,,.m. toread mid-up*-tory parathion. phthalicanhydride,<r-and p-dichlorobenxene,a~ and p-nitraphe- nol, toluene and mercaptobenxothia- ^obfca 10.--- M a in M rr* Gonducbon V elocity* for tha E x p o *tra Groups and lo r if** CfUormcn* S ubg roup *' . H tn t Tm M * Category EJkpo*j| itK b O toa Fjod-1 X *S C CrO Uvut 54.00*2.34 (0] a i . o i * j j a (o) P irn-*i 4 1.77 * 0.47 (100) 43.53*0.53 (134) JwW 42.04 x 0.4 ( 160) 41 .40x 0.64 (12S) CNogtn*. tw o ry oVyf X t S i (n) 54 .02* 4.03 (3) 4 0 .54* 0.77 (tO) 41.14 x0.00 (51) O*on. curar* X is e oo 7 .8 4 X 4 .I t {6} 4 l3 S O . M (M ) 41.37x0.74 (74) C N o/io*. n n * X X S (n) 53.IOXO.OO (t) 4 0 .S I X 1.12 (34) ' 4 1.33 X 1.30 (3 6) `A juarad lor aga, (F aguata r m l. and tag tor lor compadaon o arpea ad vim not o ma fr a cNoraov ufagorU a vm raapad to lir a / , p a m a d , and raapad *0 !>-**/. paronaal, and n i. zole derivatives of tetramethylthiu- ramdisulfide, and trimethylquinoline pcovSictcemttnohhal-mdeauateaeerSiimbe2nlcpdmclepr,j3ia.lia<emvvnooci6lnT,cnlieao5yn7yocetohn~l,gmesewnbTeterndyieeientprpexaa-Ldnop,eanrhnpratar.oopd-eimeidatnrgonuanTrtdeirrgerttynhoatmeirdelnesmese,tpdudegsclhireabrnneoaeittjt-tibhisgeshnpeneuetocrexlkagdabtafaanbcsmjneim,ooelttnthihxccuwsoieielptrdhTnrsinssxoneuiaecpns2iedarbocuog1xiobrlamnr.esepbfl5pleuagoyp%htp1rdhsasyea2eduttnuesn.hhrerotyiiridoeee-rrf.- dwcbwpthaoaioererstrtrrsaehekiedasewgrnesepai.orssnae,draalsimbvisngaiteroenitltdtiahefbriceslienaxdnpebotofTneesatcewadbdtgsilef,eeefcenoora1fenh1nwt.dohcirveeTt.esshsteeiNlorxilneof \ Other Work Expo aura a of the Study Population wpdmrioouaOrtclketteihsepserslasreensitdnhuc/aonhtnhdreemec2ro.aicvnt.u5aat-ldaraTmyyiainwnangneadrdnweittosae,rixknaipindlnoltugesoserftcmdrotihenatoe-l COMMEHT cwttoihhnafeeidIllsntulhscsisaeahgttsrnunaidydtirafehaylisecci,inatpgesitnontetrcrpireiesupostnlfrioagceefttssttihhasodeetosnainfostastantitnauahdeltdeolyfwitrcco.itseiohktWaceh*ekodoininmrtnehtsfsrsieodtsdaheameilessrl 3370 JAMA. May 11. 1034-- Voi 261. Ko. 18 2 4.5-T--SuaUnd &H*rtib*rg K: lo- l k \ t. r k s rv: ?. 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Hdiarvl oi-fn JTR.*CJ(oi(ahn,a lSCC,A:SSAASS IUsa*u~-rrv`ailCa aliabc,. rp1ap9pnfm727ad9137..SNAu3nKr-aop2nl.2paX,8huan.mmoSbaoJaJtvuali_aisa`uai LSKaDant.orCdrIL.lOaYuVClAaosuro,#pkJv,pDWeJfurJojthubtUnlAinLro*iWyudAnjiPlarPwfyOotflrAuar VAPS1foo7rAtd7lAi1*ni-.. /PL1a9omd32D7o19O2ad..,Co,pdCPoa1pa.oll9Jraa2CTnop07ubhc..Duaam1apTpR1pmmf;7F-MiSa1UIn1EXD,-3*Al.oHl7tXAHao*u--aaoJlCmlJu.aarJ1m>o7i-c7lbaQrr^uo,iadpf-ofpPvffi7iC.tn6Urr-o9uonr9naay.*rC.-DliaMaoatmIo1T.., Blioxnrc hoi fR ih.*umT ha*n c fdiaoc*l a af ncdo ld(*o*nX mo amrr* CDtohdaocn-- t(dftinb3a2ran.vta'lHotfvuoPirlo-nal1cya9ucc7cha3lr5oAX0no1b. a1mOt8oal2idna-1a1JCdy8.i9lbiL,cunaatpoUprgohdaoicoshap. taCr*AJWrnannAid^. rRmDpiiXsApnmLraLraamtJfi<1fpm9Ss8ClaIa-oDJHnt0sUaocIda9mrah-ai2AaaS.t./aXSOnpadlecirartWfvutAii.rfdiaavCrliaaroiCdaryradUi.tCIo da/^ninonniflai EElosTvirnow0-- mtianC3fn-oLntr,tmhG1la7nMSw2iona. diiUhbL*ac. tiWoodnoirconrnanaariianaicnnbd*l UFNrtCcraAadi:nil0loartdiofdianilhaatbao*-f CUaicab/aifraanoaStaotno DUiooxriann*ityin, DLbiaal DLaonTaiLroOnf,mDaotC, 6*-*7y3.5o.1i9U6n2ab.yjaGc a: Tlarmt7ymtohrJaoraofdLiabraxa*poodaiaarrcin. :B Ar J r/unrd- fim i 196253:128-133. d2nTaiiAdo;oX33ic7o73*Tc.Jn.. 6a-oaCCW-*iftnjaooApattaduprlookabnpnpc1rsni*rb5ardfJ-yiiRvAoAtvnrJECmo,no*dDk-r-CmjkrU,b*oavaJGarrcauTaaorai**a.iufDyorLnl1otoa7ooFrs7JxAdcV6Dioair.5;af*iW5trPyL:i1t,5aal9t5rpHt7bi3tie(u9d-oTT;6dLfCC7ypit.AoNArDoI6,SfDnU--ieltUaiDtrrTaR.toa.*ioaio<*.l r1t937a90l.:'1FT68or^u-6a4nt-o--8f6r8eJ.iLc , iTtuhdoimaspsaoin2,DCJ5,-tSrLicrhxibofrnDxpbRJa,- cCEbDaahlon-mdal*4rxoisiU01iyrapr..ri*ioo-oo*AUmdrr*r-iUtpcTdboiNCe*boialoaarnidnriitiloaaaJointircoHyrindif.indm.lfFof1JBWr7o5f7icaa7o0o*lrh"1d0a.sx^aLoCtp3ohofTop9*orcopoti6fax-on1rrDl1iofa9brd0A7tiCa4tm7,Tyn.XJaoVoanSo7road:Lib1nfcmr-0ryrb6Uoi2asl-o15Ub1nck70.bcI7oa79kiy,ta.7r8l.ano^-J.lu5rFTaof(rto.i0rdinoo1J*if4-i-i 4itjr1op0*o.o2j,a aAonfH2IJn,J7Rfpir.-iLmV*aaLn1rsaaUchlllfloaarrnoJdnTibitaaKsmSaae-lsiL-dhfiianIdamop1i7al7na8d*; 12 jTi-273. -SiasWrtdA hUrtTborg ** Monsanto --------------------------------------------------------------------------------------------------------------------------------La w O EPa r t m e n T Monsanto Company 800 N. Linaergn Boulevard St. Loins. Missouri GO167 Phone: (314) 694-1000 March 16, 1990 Ms. Carol Van Strum 7493 E. Five Rivers Road Tidewater, Oregon 97390 . Re: Mortality Studies of Nitro Plant Population Dear Ms. Van Strum: Please find enclosed copies of the two mortality studies referenced during our telephone call today. I have also enclosed for your review, copies of the trial record regarding Dr. Roush and Dr. Suskind which relate to those studies. I have also included in this packet a chart which was prepared during the trial to illustrate for the jury the statistical manipulation which was being undertaken by the plaintiffs' lawyer to artificially create the impression that there was an excess in I cancer mortality at the Nitro Plant when as explained by bothDr. Roush and Dr. Suskind; the actual study data would lead to the opposite conclusion. * If you have any further questions regarding this litigation or the matters addressed in this correspondence, please feel free to give me a call at (314) 694-2821. Sincerely, j I \ | \j [ : j. [ [ \ j i DFS/dlr Enclosures CC: .Dan Bishop w/o enclosures Telephone: CAROL VAN STRUM Science Writer 7493 East Five Rivers Road Tidewater/ Oregon 97390 <503? 528--7151 Telefax:_____ (via vo ice line) April 2/ 1990 David, Snively Law Department Monsanto Company 800 N. Lindbergh Boulevard S t . Louis, Missouri 63167 Re: Information request Dear Mr. Snively: Thank you for the materials you sent from the Kemner case record. They are very informative, and I appreciate the trouble you took to copy them for me. Would it be possible for you to copy page 2 of the Monsanto Offer of Proof for me? It was missing from the copy of the Offer that I received. I also have a question about one document that puzz1es me. The attached copy of Table 9 was stapled into the copy of the 1983 Zack and Gaffey study that you sent me, in front of page 586 (Table 9) of the study. There is no exhibit number on this page; is it part of some other document in the record of the Kemner case? I would be most grateful if you could send me a copy of the document it is from. Thank you again for your courtesy and help. Sincerely, CVS:evs attachment Carol Van Strum ..Hh - i i l l ' * - , /j" p .iA lo V l lI*k.. M*IV ^>rr-t.i.'rV^ ----Critc-v<jo^e"i.por~ Wnci(o.v\(fP, T iM e 9 O bserved and Expec!ted Number Dealha During 1955-1977 by Cause and 5 r'J P n 2,4,5-T Exposure Category Showing Proportional Mortality Ratios (PHRs) 'xjV a.-- (Not Including Deaths from TCP Incident) * Cause of Death All cauaei of death Exposed Observe i)1 Expected 58 58.00 PHR 100 Non -Expos Observed Expected 89 89.00 e d. PHR 100 All malignant neoplasms Buccal cavity and pharynx Digestive organa and peritoneum Stomach Liver All other digestive organs Respiratory aystea Lung 9 10.94 82 a* 21 17.19 122 0 0.38 0 A* o . 0.64 0 0 2.80 0 5.74 52 * 0 0 0.52 0.19 0 0 C % l J L r r> 3 0 o 1.06 0.39 0 0 0 2.09 0 1 f a V J Jl * T 4.29 70 6 3.78 159 * > * * $ & ; 5.58 72 6 3.57 leaT^lS 4 5.26 76 All other respiratory organa 0 0.21 0 0 0.39 0 Skin 0 0.29 0 0 0.35 0 Genitourinary organa 2 0.96 20B 10 2.70 370* Bladder 2 0.22 909 7 0.65 1077* All other genitourinary organs 0 0.74 0 3 2.05 146 Lymphatic and hematopoietic tissue 0 1.35 0 1 2.07 48 Other sites Diseases of the nervous systea and tense organs (J j 0 1.38 0.61 72 0 3 2.12 142 0 0.83 0 Diseases of the circulatory systea 31 26.48 117 52. 47.37 110 'Arteriosclerotic heart disease, including CUD 27 19.72 137 43 33.63 128 All other diseases of the circulatory ayatem A 6.76 59 9 15.66 57 Diseases of the respiratory system 2 2.67 75 4 6.49 62 Diseases of the digestive systea All other diseases ' 1* 3 3.70 4.31 27 70 2 4.06 49 2 6.70 30 External causes of death 12 9.29 129 -a 9.28 86 Hy analysis shoved 65 deaths. * P<.05 I'JCloCK \ -ST^^ (cy i^ t Monsanto Monsanto Company 600 N. Lindbergh Boulevard SI. Louts. Missouri 63167 Phone: (314) 694-1000 April 11, 1990 _ UkW DEPARTMENT Carol Van Strum Science Writer 7493 East Five Rivers Road Tidewater, OR 97390 Re: Information Request Dear Ms. Van Strum: Thank you for your correspondence of April 2, 1990. Please find enclosed a copy of the missing page from Dr. Suskind's offer of proof. The other material which you referenced in your letter was inadvertently included with materials previously forwarded to your office. It is not a portion of a document in the court record of the Kemner case. To bring you current with the status of-that case, I note that the Kemner appeal was argued last week by the parties. Monsanto remains confident that the verdict will be reversed when the decision is issued by the Illinois Appellate Court. Sincerely, ! ii 1 I I j I f [ t I A:DFS-046.ch I r' report health effects he found in Monsanto's workers when asked by the West Virginia Compensation Commission, and of publishing studies intended to downplay the actual human health effects of dioxin. As a result of the extrema and unfair limitations placed upon his testimony and this Court's subsequent ban on his further testimony, Dr. Suskind never had the opportunity to respond to these charges, and to demonstrate that his recollection was totally accurate. The importance of Dr. Suskind's testimony to plaintiffs' punitive damage case is illustrated by the manner and length (18 days) of cross-examination of Dr. Suskind after a reasonably concise direct exam (2-1/2 .days), and the extensive, use of Dr. Suskind's testimony in the cross examination of Dr. James Webster, Monsanto's chief examining expert. Plaintiffs' counsel spent days cross-examining Dr. Jamas Webster, Monsanto's final medical expert, with the unclarified, and at times unduly and erroneously restricted, testimony of Dr. Suskind. In addition, misinformation offered by plaintiffs' counsel which was corrected and clarified by Dr. Suskind during his direct examination (which clarification was left unchallenged by plaintiffs* counsel despite 18 days of cross examination) relating to the number of workers reported by Dr. Suskind in his 184 health study as having cancer was used, nevertheless, in it's incorrect and unclarifiad state to cross examine Dr. Webster. (Tr. 6/8/87). This Offer of Proof demonstrates that Dr. Suskind's redirect examination is critical to Monsanto's'"-. 2 Monsanto r Monsanto Comoany SL600 N. UnaDCfn Boulevard Louis. Missoun 63167 Pnooe. p l 4 ) 69-1-1000 May 4, 1987 ENVIROME ENT. SAFETY & HEALTH Marilyn Fingerhut, Ph.D. National Insritune for Occupational Safery and Health Robert A." Taft Laboratories 4676 Columbia Parkway Cincinnati, Ohio 45226-1998 Dear Marilyn: I am enclosing the computer tape you requested in your memo dared April 10, 1987. I am sorry for the delay, bur I was on vacarion 1 the week you senr me the letter, and your request required much programming, data manipulation and editing on my parr. Please disregard any. data tape sent to you prior to this one. I used the I chronology sent to you on Nov. 12, 1985 to determine who was ' exposed, and I correcred some social security numbers and conflicting values for birth and hire dates. I cid not use the chronology senr ro you Feb. 8, 1983 because ir does nor accurarelv 1 reflecr the exposures. The files are identified in the following wav: COE5577: These are employees who were acrive between 1955 and , 1977, and whose work histories indicate that they worked in either a 2,4,5-T or NaTC? department. The start and end dares of these departments are listed in th chronology sent to vou on Nov. 12, 1985. E55: These are employees who were terminated prior to 1955 and were potentially exposed to 2,4,5-T. See part Ic of my memo sent to you on Nov. 7, 1986 for information on how these employees were identified. TCP: These are employees who were in the TCP accident study. I have included a female who contacted chloracne as a result of the accident, but wasn't included in the study. - h SUS: These are employees who were in the Suskind/Herttberg morbiaitv study and were exposed according to either the Monsanto , or University of Cincinnati exposure criteria. These criteria were described in part 5 of _mv memo dated Nov.' .7, 1986. rr-.please be aware that Dr.' Suskind used only the University of'Cincinnati's "Exposed" and "Non--exposed" categories in hrs study. iarilyn Fingerhut, Ph.D. 2 May 4, 1987 In addition to the usual header record variables that you are very |familiar with, I have added the additional variables you requested: a Monsanto and UC exposure variable for those in the iSuskind study, a data source variable for those in the B455 file |who were identified as potentially exposed from a source other 1than their personnel record, and a variable to indicate whether there was a a work record in our computer file. I have also added a date of termination derived from 941 forms to those in the B455 group who aid not have a personnel file. Since I combined so many different files using various computer programs, I made many diligent attempts to check that I was including everybody I was supposed to. I even compared my final |cohort to the names on the three lists I sent to you on Nov. 7, 11986. Unfortunately, I discovered that there were twenty-six Inames on my current file that weren't on those lists, ill. names were from the Suskind study and had a Jdonranro exposure code of either 1 or 2. (See attached list). I could not figure out ,why these omissions occurred, but I can assure you that this current file includes all the exposed Suskind cohort members. 'The record format for the header and work records on this tape 1is in the attachment and the tape specifications are: nor.-labelled, 9 track, EBCDIC characters, density=6250 B?I, LRECL=97, BLKSIZE=S208, RECFM=F3 and #RECS=63S2. If you have any questions, please feel free to call. Sincerely,. Marcie E. Strauss Epidemiologist ISNOUTTHECEEHRANURNLDIETISSETTDORNSI,CTAWTTEEOSSFT VD`WIIRSETGSRTINICVIATIRCGOINURIAT DJoAeMcEtehSaesMeEd. ,sAtaaDttKeIaNolS,f, ARadlmphinEis. trAadtokrins, ))) P l a i n t i f f s , >) v s . )> No. 81 MCOoNrSpAoNrTaOtioCOnM, PANY, a Delaware )] D efendant. )) takeCnLADYPoeTnlpOaoNbiseniFhtti.iaoflnCffsAo.oLfLf' ISthe tUt * * * * * * * * ' * * * * R e p o rte r: /`M. Joy" S prin ger v--'V# J ames M ay R eporting S ervice CERTIFIED SHORTHAND REPORTERS R.fl. 2 - BOX 65 EOWAHOSVILLE. ILLINOIS 62025 IN THE UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF WEST VIRGINIA CHARLESTON, WEST VIRGINIA JAMES M. ADKINS, Administrator ) of the Estate of Ralph E. Adkins, ) Deceased, et al, ) ) Plaintiffs, ) ) vs. ) No. 81-2098 MONSANTO COMPANY, a Delaware Corporation, ) ) ) Defendant. ) ) APPEARANCES : Messrs. Calwell, McCormick & Peyton, by W, Stuart Calwell, Jr., Esq. For Plaintiffs Messrs. Bowles, McDavid, Graff & Love, by Charles M. Love III, Esq. and P. Michael Pleska, Esq. For Defendant, Thomas M. Bistline, Esq. Monsanto Company Counsel. IT IS STIPULATED AND AGREED by and between counsel for the plaintiffs and counsel for the defend dant that the deposition of CLAYTCN F. CALLIS may be taken pursuant to Rule 26(a) of the Federal Rules of Civil Procedure, on behalf.ofthe plaintiffs.on July 1, 1983, at the Radisson Hotel,'Room 215,- 9th 6c: JAMES MAY REPORTING SERVICE Convention Plaza, St. Louis, Missouri, before M. JOY SPRINGER,a Notary Public within and for the County of Madison, State of Illinois; that the issuance of notice and deditnus is waived, and that this deposition may be taken with the same force and effect as if all Federal rules and statutory.requirements had been complied with. IT IS FURTHER STIPULATED AND AGREED that any and all objections to all or any part of this depo sition except objections as to form of the questions asked or answers given, are hereby reserved and may be raised on the trial of this cause; and that the signa ture of the deponent is not waived. . * *** k k k k k k k CLAYTON F. CALLIS produced, sworn and examined on behalf of the plaintiff deposes and says as follows: EXAMINATION BY MR. CALKELL: (Whereupon the reporter,-mrked J?lainf V tiffs1 Deposition Exhibit #170..(Monsanto JAMES MAY REPORTING SERVICE #235130 and #2.36181) consisting of 2 pages; Exhibit #171 (Monsanto #8322238, #3322244 and #8322245) consisting of 3 pages; Ex hibit #172 (Monsanto #8322554 and #8322555) consisting of 2 pages; Exhibit #173 (Monsanto #8322905) consisting of 1 page; Exhibit #174 (Monsanto #8331219) consisting of 1 page; Exhibit #175 (Monsanto #8326231) con sisting of 1 page; Exhibit #176 (Monsanto #233610 through/33612) consisting of 3 pages; Exhibit #177 (Monsanto #233618 and #233619) consisting of 2 pages; Exhibit #178 (Monsanto #231686 through 231688) consisting of 3 pages; Exhibit #179 (Mon santo #8321639 and #8321640) consisting of 2 pages; Exhibit #180 (Monsanto #8323058 through #8323060) consisting of 3 pages; Exhibit #181 (Monsanto #232571 through #232574) consisting of 4 pages; Exhibit #182 (Monsanto #8323145 and #8323146) con sisting of 2 pages; Exhibit #183 (Monsanto #8323173 through #8323176)consisting of 4 pages; Exhibit #184 0*insanto #233695) con sisting of 1 page Exhibit'r#85" 0ohsa.htb;:^3^v;. #8323203 through #8323205) consisting of -3 JAMES MAY REPORTING SERVICE X pages ; Exhibit ft186 (Monsanto #8331253 through #3331271) consisting of 17 pages; Exhibit #187 (Monsanto #3323177 and #8323178) consisting of 2 pages; Exhibit #188 (Monsanto #8323234 and #8323235) consisting of 2 pagas; Exhibit #1S9 (Monsanto #235615 and #235623) consisting of 2 pages; Exhibit #190 (Mon santo #8323245 through #8323248) consisting of 4 pages; Exhibit #191 (Monsanto #231738 and #231739)consis ting of 2 pages ; Exhibit #192 (Monsanto #8321904 and ,#8321905) con sisting of 2 pages; Exhibit #193 (Monsanto #231753 through #231756) consisting of 4 pages; Exhibit #194 (Monsanto #8323313 through #8323315) consisting of 3 pagas; Exhibit #195 (Monsanto #8323318 through #8323320) consisting of 3 pages; Exhibit #196 (Monsanto #8331273 and #8331274) con sisting of 2 pages; Exhibit #197 (Monsanto #8323334 through #8323336) consisting of 3 pages; Exhibit #198 (Monsanto #8323340 through #8323342) consisting of 3 pages; Exhibit #199 (Monsanto #8323354 through #8323356) consisting of 3 -pages; Exhibit -V 7'V--#200 (Monsanto #8323370 through #8323372) " JAMES MAY REPORTING SERVICE consisting of 3 pages; Exhibit #201 (Monsanto #236245 and 23 6246) cons isting of 2 pag s i Exhibit ^-202 (Monsanto #3323392 through #S323394) consisting of 3 pages; Exhibit #203 (Monsanto #236249, #236250, #236251 and #236252) consisting of 4 pages; Exhibit #204 (Monsanto #8331279 and #8331280) 2 pages; Exhibit #205 (Monsanto #8304330 through #8304385) consisting of 6 pages; Exhibit #206 (Monsanto;#230057 through #230061, and #8319596) consisting of 6 pages; Ex hibit #207, consisting of 1 page; and Exhibit #208 (Monsanto '#8323373 and #8323374, and #8323376) consisting of 3 pages. Q (By Mr. Calwell) What is your name? A Clayton F. Callis. Q How old a man are you, Dr. Callis? A 59. Q Why do they call youdoctor? A I have a Ph. D. Q What in? A Inorganic Chemistry. . .Q Where did you get that Degree? A ' University of -Illinois -Urbana-Champaign.; Q . When did you do that? JA M ES MAY REPO RTIN G SERV ICE ess m \ ..:/l I. I II d -'. _ISIOIUTTHHCEHSRAUNRNLDIETISESTDTORNSI,CTATETSO2STR VDWIIRSETGSRTINICVIATIRCGOINURIAT DJoAfeMctSehSaasMeEd. ,sAtaaPKttoI1a1olS,f, ARadlmphinEis. trAatdokrins,))) P l a i n t i f f s t )) v s . )) Ho. 81-2098 MCOoNrSpAoNrTaOtioCOnM, PANY, a Dalmsar ))) D efendant. )) takMenODNPoTenEpl aoCbis.eni httTiaoiHflnRffOs Do.oAff HLtha Reporter: M. Joy Springer .1 J ames M ay R eporting S ervice CERTIFIED SHORTHAND REPORTERS B.B. 2 - BOX 5 EDWAflOSVILLE. ILLINOIS 52023 >; j.. -- "r*~ n " ** 1> 1 y iv ' vy' V' 1 2 3 i1 4 5 6 7 8 9 10 11 ;i 12 i 13 14 15 16 17 ... 1 18 19 20 21 22 23 24 fr< 25 yi IN IUc UNITED STATES DISTRICT COURT SOUTHERN DISTRICT Of WEST VIRGINIA CHARLESTON, WEST VIRGINIA | JAMES M. ADKINS, Administrator ) of the Estate of Ralph E. Adkins, ) Deceased, et al, ) ) Plaintiffs, ) ) vs. ) No. 81-2098 MONSANTO COMPANY, a Delaware Corporation, -) ) ) ) Defendant. ) i | i 1 APPEARANCES: Messrs. Calwell, McCormick & Peyton, by W. Stuart Calwell, Jr., Esq. Messrs. Bowles, McDavid, Graff & Love, by P. Michael Pleska, Esq. and John Woods, Esq. Thomas M. Bistline, Esq. . / For Plaintiffs, For Defendant, Monsanto Company Counsel. I IT IS STIPULATED AND AGREED by and between counsel for the. plaintiffs and counsel for the defendant that the deposition of MONTE C. THRODAHL cay be taken pursuant to Rule 26(a) of the Federal Rules j f Civil Procedure, on July 19, 1983, at the Radis sen Hottl, -*T * Room 215, 9th Street and Convention Plaza, 'St. Louis, --/-- JA M E S MAY REPORTING SERVICE X .. - "; 1 Missouri, before M. JOY S^RING-EF., a Notary Public within and for the County of Madison, State of Illinois; that the issuance of notice and dedimus is waived, and that this deposition may be taker, with the same force and effect as if all Federal rules and statutory requirements had been complied with, IT IS FURTHER STIPULATED AND AGREED that any and all objections to all or any part of this deposition, except objections as to foi rm of the questions' asked or answers given, are hereby reserved and cay be raised on the trial of this cause; and that the signature of the deponent is not waived. k -k ****** KCNTE C. THRODAHL produced, sworn and examined on behalf of th e p la in tif f s deposes and says as follows: EXAMINATION BY MR. CALWELL: (Whereupon the re p o rter narked P lain tiffs Dep #8322918, osition Ex #8326238, h#i8b3i2t 3#1*.34656, #.832-31.4-*6*.*;-"**.* JAMES M A Y REPORTING SERVICE , 1 2 3 4 5 6 7 8 9 10 n 12 13 . 14 15 16 . . 17 18 19 20 21 22 23 24 25 WSSgSHBPIPIP* jl #8323203 through #8323205, #8323234, #8323235, #8323245 through #8323248, #236205 through #236208, #2362X2 through #236215, #8323313 through #8323315, #8323318 through #8323320, #8323334 through #8323336, #8323340 through #8323342, #8323370 through #8323372, #8323352 through #8323394, #236245, #236246, #236245 through ,#236252, #8323748 through #8323751, #8323831, #3323832, #235806 through #235808, #8323866 through #8323869, #8323876 through #8323879, #8324039, #8324040, #8324170, #8324171) consisting of 66 pages; Exhibit # 367 (Monsanto #8323075 through #8323079) consisting of 5 pages; Exhibit #368 (Monsanto #8326149 through #8326160, #8326129 through #8326142) consisting of 26 pages; Exhibit #369 (Monsanto #232571 through #232574) consisting .of ,4. pages; Exhibit #370 (Monsanto #233610 through #233612) consisting of 3 pages; Exhbit #371 (Monsanto #8305445, #8305446, #8305443, #8305444, #8305441, #8305442, #8305439, #8305440, #8306026, #8306025, #8306023, #8306024, #8306022, #8206021,' #8306020,' #8306019, '#8306018,V ,#8306017i::^ sS ^ consisting of 18 pages; E x h i b i t "#372**?(Mcxi- - JA M ES MAY R EPO R TIN G SERV ICE ----- UIRUJ . `. - 1 santo #8306242, #8306243) consisting of 2 2 pages; Exhibit #373 (Monsanto #8321750, 3 #8321751), consisting of 2 pages; Exhibit 4 #374 (Monsanto #236191 through #23-5193) .for 5 the purposes of identification.) >j : iI Q (By Mr.--Calwe 11) Would you s ta te your 7 name, please. 8 A Monte C. Throdahl. 9 Q What is your address, Mr. Throdahl? 10 A 36 Brlarcliff, St, Louis, 63124. 11 q And you*re obviously employed by 12 Monsanto Company, is that right? 13 A Right. 14 Q And are you aSenior Vice President? 15 A That's right. 16 Q I'd like to talk to you first about 17 your academic background, where did you go to school? 18 A How far back? 19 Q College. 20 A Iowa State University from *37 through 21 >41 -- that's 1937, not 18 -- Chemical Engineering. 22 Q Did you have any post-graduate courses? 23 A Yeah.* I had theAdvanced .Management 24 --i . sc V . . .... - i.i 25 O.K. Now, upon grat^t^'\`from':Iowa JAMES MAY REPORTING SERVICE il "I 5* , ISNOUTTHHEECRHNUANRDILTIESESTDTROISNCT,TAVTOEESSPTWDVIESISTRTRGVIICNIRTIAGCINOUIART JAMES M. ADKINS, A d m in istr a to r o f the E state o f Ralph E, Adkins, Deceased, et a l, P la in tiffs, vs. MONSANTO COMPANY, a D elaw are C orp oration , D efen d an t. ) ) ) ) ) )) N o. 81-2 0 9 8 ) ) ) ) ) PEHDDIeNpAoNsDitiCo.n MoEYf ER ta kthene opnl abi enht ai flff s o. f IIIIIIKlIff R ep o rter: M. Joy S p rin g er ' J am es M ay R epo rting S ervice CERTIFIED SHORTHAND REPORTERS R.R. 2 - BOX 65 EOWAROSV1LLE. ILLINOIS 62025 Ik : -IN THE UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF WEST VIRGINIA CHARLESTON, WEST VIRGINIA 3 4 JANES ADKINS, Administrator of the Estate of P.aloh E. Adkins, 5 Deceased, et a l , 6 \ Plaintiffs, 7 vs. S MONSANTO COMPANY, a Delaware Corporation, 9 10 Defendant. No. 81-2098 11 12 APFEARANGES: 13 Messrs. Calwell, McCormick Peyton, by V/. Stuart Calwell, Jr., Esc., Ecr the Plaintiffs; ^4 ?Tessrs. Bowles, McDavid, Graff Love, 15 by Charles M. Love, III, Esc., Per the Defendant. 16 17 13 IT IS STIPULATED AND AGREED by and between 19 counsel for the plaintiffs and counsel for the defendant 20 that the deposition of FERDINAND C. MEYER may be taken 21 pursuant to Rule 26(a) of the Federal Rules of Civil Pro 22 cedure, on behalf of the plaintiffs, on July 6, 1983, at -, -;23 ..the .Radis son -Hotel, .Room 215, 9th .-Street*and :Conventioh''jrT 24 Plaza, St. Louis, Missouri, before M. JOY SPRINGER a 25 Notary Fublic within and for the County of Madison, State JAMES MAY REPORTING SERVICE 4* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 IS 19 20 21 ,22 23 - 24 25 * ,ithvr* ee pages; Plaintiff's Deposition Exhibit #253 (Monsanto's I.D. #83232*15 through 83232^8, inclusive), consisting of four pages; Plaintiff's Deposition Exhibit #25** (Monsanto's I.D. #231728 through 231737, inclusive), consisting of ten paces: Plaintiff's Deposition Exhibit #255 (Monsanto's I.D. #832323** and 8323235), consisting of two pages; Plaintiff's Deposition Exhibit #256 (Monsanto's I.D. #8323217 through S323219 , Inclusive), consisting'...of three pages; Plaintiffs Deposition Exhibit -257 (Monsanto's I.D. #8323177 and 8323178), consisting of two pages: Plaintiff's Deposition Exhibit *253 (Monsanto's I.D. #233=95), consisting of one page; Plaintiff's Deposition Exhibit #259 (Monsanto's I.D. #8323203 through 8323205, inclusive), consisting of three pages; Plaintiffs -Deposition Exhibit #260 (?4onsanto 's I . D . #8323173, S323171*, 8323176 and 8323175), consisting of four paces; Plaintiffs Deposition Exhibit #261 (Monsanto's I.D. #83231**5 and 83231*i6), consisting of two pages; Plaintiffs Deposition #262 -(Monsanto's I.D.*-#8323065--- through 8323070, inclusive), consisting of six .. * pages: Plaintiffs Deposition Exhibit #263 - JAM ES MAY REPORTING SERVICE (Monsanto's I.D. 8323037 and 8323038), con sisting of two pages: Plaintiff's Deposition Exhibit 26*i (Monsanto's I.D. 231686 through 321688, inclusive), consisting of three pages; Plaintiff's Deposition Exhibit 265 (Monsanto's I.D. 83231^7 through 83231^9, inclusive), con sisting of three pages; Plaintiff's Deposition Exhibit 266 (Monsanto's I.D. 8330067 and 8330068), consisting of two pages; Plaintiffs Deposition Exhibit `267 (Monsanto's I.D. 8331208 8331209), consisting of two pages; Plaintiff's Deposition Exhibit 268 (Monsanto's I.D. 8331208 t and 8331209) , consisting of two pages; Plaintiff's Deposition Exhibit 269 (Monsanto's I.D. 832238*0, consisting of one page; Plaintiff's Deposition Exhibit 270 (Monsanto's I.D. 8330038), con sisting^ of one page; Plaintiffs Deposition Exhibit 271 (Monsanto's I.D. 236066 through 236069, Inclusive), consisting of four pages; Plaintiff's Deposition Exhibit 272 (Monsanto's I.D. 236065), consisting of one page; Plaintiff's Deppsition Exhibit 273 (Monsanto's I.D. 8325873, 832587^ and 8325872), consisting of three pages; Plaintiff's Deposition Exhibit ^27** (Monsanto's I.D. 236180 and 236 18I), consisting of two pages; JAMES M A Y REPORTING SERVICE Plaintiff's Deposition Exhibit #275 (Monsanto's -I.D...`#8326129 through 8326142, inclusive, and #83261^9 through 8326160, inclusive), consisting of twenty-six pages; Plaintiff's Deposition Exhibit #276 (Monsanto's I.D. #8331279 and 8331280), consisting of two pages; Plaintiff's Deposition Exhibit #277 (Monsanto's I.D. #235680) consisting of one page; Plaintiff's Deposition Exhibit -278 (Monsanto's I.D. #236249 through - 236 252, inclusive), consisting of four pages; Plaintiff's Deposition Exhibit #273 (Monsanto's I.D. *8323392 through 832339*1, inclusive), con?^ sisting of three pages;Plaintiff's Deposition Exhibit *28l (Monsanto's I.D. #83233*10 through 83233*12, Inclusive), consisting of three pages; Plaintiff's Deposition Exhibit #282 (Monsanto's I.D. #83331273 and 533127*1), consisting of two pages; Plaintiff's Deposition Exhibit #283 (Monsanto's I.D. #8330781), consisting of one page; Plaintiff's Deposition Exhibit #284 (Monsanto's I.D. #8300999), consisting of one page; Plaintiff's Deposition Exhibit #285 (Monsanto*s I.D. #8300998), consisting.of one ^ page; Plaintiff's Deposition Exhibit #286 ' (Monsanto's I.D. #8325604), consisting of one Plaintiffs Deposition Exhibit, #280 .(Monsanto's,.. T.n. JAMES MAY REPORTING SERVICE through 822227?. Inclusive), con- page; Plaintiff's Deposition Exhibit #287 (Monsanto's I.D, #8331712), consisting of one page;* and finally, Plaintiff's Deposition Exhibit #288 (Monsanto's I.D. *8331272), con sisting of one page. a Would you state your name, please? .ii Ferdinand C. Meyer. a And where do you live? A. I live at #18 P.oclare Lane in Town and Country, Missouri, 63131Cl ` And are you employed? A. No. I retired about three and a half years ago, February of 198 0. Retired from Monsanto? A. Yes. When you were employed by Monsanto what xas your last Job with them? A. I was Director of Special Projects in the Department of Medicine and Environmental Health. In St. Louis? A. Yes. Q Where did you attend college? A . Shurtleff College in Alton, Illinois. Q And what degree did you receive? A. A .5. JAMES MAY REPORTING SERVICE fs r Monsanto Monsanto Company 800 N. UnaPergh Boulevard St. Louis. Missouri 3167 Phone: (314) 69-1-1000 LAW DEPARTMENT March 16, 1990 Ms. Carol Van Strum 7493 E. Five Rivers Road Tidewater, Oregon 97390 Re: Mortality Studies of Nitro Plant Population Dear Ms. Van Strum: Please find enclosed copies of the two mortality studies referenced during our telephone call today. I have also enclosed for your review, copies of the trial record regarding Dr. Roush and Dr. Suskind which relate to those studies. X have also included in this packet a chart which was prepared during the trial to illustrate for the jury the statistical manipulation which was being undertaken by the plaintiffs1 lawyer to artificially create the impression that there-was an excess in cancer mortality at the Nitro Plant when as explained by both Dr. Roush and Dr. Suskind; the actual study data would lead to the opposite conclusion. If you have any further questions regarding this litigation or the matters addressed in this correspondence, please feel free to give me a call at (314) 694-2821. Sincerely DFS/dlr Enclosures CC: Dan Bishop w/o enclosures David F. Snively \ Telephone: CAROL VAN STRUM Science Writer 7493 East Five Rivers Road Tidewater# Oregon 97390 <503) 528-7151 Telefax:_____ (via voiceline) April 2, 1990 David Snively Law Department Monsanto Company 800 N. Lindbergh Boulevard St. Louis# Missouri 63167 Re: Information request Dear Mr. Snively: Thank you for the materials you sent from the Kemner case record. They are very informative, and I appreciate the trouble you took to copy them for me. Would it be possible for you to copy page 2 of the Monsanto Offer of Proof for me? It was missing from the copy of the Offer that I received. I also have a quest ion about one document that puzz1es me. The attached copy of Table 9 was stapled into the copy of the 1983 Zack and Gaffey study that you sent me# in front of page 586 (Table 9) of the study. There is no exhibit number on this page; is it part of some other document in the record of the Kemner case? I would be most grateful if you could send me a copy of the document it is from. Thank you again for your courtesy and help. Sincerely# . CVS:cvs attachment Carol Van Strum in- '*** "* |i**'*\f* -P|hj>i \oVP i^ \l>% *' I % r * rV 11' 1*''* f I*4 , C/?nCtro<i0^< i\.^p*UiCo c o c D Table 9 Observed and Expected Humber Death During 1955-1977 by Cause a n d n 2,4,5-T Exposure Category Showing Proportional Mortality Ratios (PHRa) *^o (Hoi Including Death from TCP Incident) 1 Cause of Death All causes of death All malignant neoplasms Buccal cavity and pharynx Digestive organa and peritoneum Stomach Liver All other dlgeatlve organa Exposed Hon - E x p o s e d Observed Expected PMR Observed Expected PHH 56 56.00 100 B9 69,00 100 9 10.94 62 21 17.19 122 0 0.36 0 0 0.64 0 t-o6sflt0 2.80 0J 0 0.52 0 3 5.74 52 0 1.06 0 I r a* 0 0.19 0 . V L 0 0.39 0 0 2.09 0 3 4.29 70 Respiratory ays tea Lung 6 3.76 159 4 5.58 72 6 3.57 liflTolsTfS 4 5.26 76 All other respiratory organs 0 0.21 0 0 0.39 0 Skin 0 0.29 0 0 0.35 0 Genitourinary organs 2 0.96 208 10 2.70 370* Bladder 2 0.22 909 7 0.65 1077* All other gealtourlnary organs 0 0.74 0 3 2.05 146 Lymphatic and hematopoietic tissue Other sites 0 1.35 0 C j 1.38 72 0 0.61 0 1 2.07 48 3 2.12 142 0 0.83 0 Diseases of the circulatory systea 31 26.46 117 i52 47.37 110 `Arteriosclerotic hesrt disease, Including CUD 27 19.72 137 43 33.63 128 All other diseases of the circulatory system 4 6.76 59 9 15.66 57 Diseases of the respiratory system 2 2.67 75 4 6.49 62 Dlaeaaea of the dlgeatlve system 1. 3.70 27 2 4.06 49 All other diseases 3 4.31 70 2 6.70 30 External causes of death 12 9.29 129 8 9.28 66 Hy analysis showed 65 deaths. * P<.05 t <ct.c_ * m 'J3 f f * 1 c Monsanto Monsanto Company 800 N. Undbargh Boulevard St. Louis. Missouri 63167 Phone: (314) 694-1000 April 11, 1990 LAW DEPARTMENT Carol Van Strum Science Writer 7493 East Five Rivers Road Tidewater, OR 97390 Re: Information Request Dear Ms. Van Strum: Thank you for your correspondence of April 2, 1990. Please find enclosed a copy of the missing page from Dr. Suskind's offer of proof. The other material which you referenced in your letter was inadvertently included with materials previously forwarded to your office. It is not a portion of a document in the court record of the Kemner case. To bring you current with the status of that case, I note that the Kemner appeal was argued last week by the parties. Monsanto remains confident that the verdict will be reversed when the decision is issued by the Illinois Appellate Court. Sincerely A:0FS-QA6.ch \T ; *'* > report health effects he found in Monsanto's workers whan asked by tha West Virginia Compensation Commission, and of publishing studies intended to downplay tha actual human health effects of dioxin. As a result of the extreme and unfair limitations placed upon his testimony and this Court's subsequent ban on his further testimony, Dr. Suskind never had the opportunity to respond to these charges, and to demonstrate that his recollection was totally accurate. The importance of Dr. Suskind*s testimony to plaintiffs' punitive damage case is illustrated by the manner and length (18 days) of cross-examination of Dr, Suskind after a reasonably concise direct exam (2-1/2 .days), and the extensive, use of Dr. Suskind's testimony in the cross examination of Dr. James Webster, Monsanto's chief examining expert. Plaintiffs' counsel spent days cross-examining Dr. James Webstar, Monsanto's final medical expert, with the unclarified, and at times unduly and erroneously restricted, testimony of Dr. Suskind. In addition, misinformation offered by plaintiffs' counsel which was corrected and clarified by Dr. Suskind during his direct examination (which clarification was left unchallenged by plaintiffs' counsel despite 18 days of cross examination) relating to the number of workers reported by Dr. Suskind in his 184 health study as having cancar was used, nevertheless, in it's incorrect and unclarifiad state to cross examine Dr. Webster. (Tr, 6/8/87). This offer of Proof demonstrates that Dr. Suskind's redirect examination is critical to Monsanto's 2