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A@ A/C Pipe PErxoedcuucteivrse ACsosmomciiattteioen International Affairs Committee U/cJL--- Vj. F. Welch, Vice President FROM. Internal Correspondence July 9,1982 DATE" Analysis of Kanarek et al Epidemiologic Studies SUBJECT. . REF: JFW correspondence, same title, February 23, 1982 ACTION REQUIRED: Review for information Enclosed is correspondence from an Associate Professor of Biostatistics and Public Health at Yale University School of Medicine. The letter reaffirms the findings of Dr. Kenny Crump's "Review of A Study of Asbestos in Drinking Water and Cancer in the San Francisco Bay Area." Dr. Walter received a copy of the report from J. Wister Meigs, M.D. of the Yale University School of Medicine. The Executive Committee will address the matter of publishing the Crump review in a peer reviewed medical journal at its July 22, 1982 meeting. JFW/ajb cc: A. Kahn, Esq. Kenny Crump, Ph.D. copies to: Executive Committee International Affairs Committee L. Ambler J. Cran L. Taylor E. van der P.est R. Dorner L. Giannitrapani N. Officer P. Hart A. Saoulis R. Jalan V. Pattabhi H. Hudson C. Barton S. Al-Tarkait M. Delcourt J. Cuvelier B. Giboin G. Zaviezo J. Rodrigues Dimatit J. Schmaus R02EI20601 Chrono CAP CO JEN 0012360 Yale University SCHOOL OF MEDICINE Department of Epidemiology and Public Health P.0. Box 3333 60 College Street New Haten, Connecticut 06310 June 16, 1982 J.F. Welch, Vice-President, A/C Pipe Producers Association, 1600 Wilson Boulevard, Suite 1308 Washington, DC 22209 Dear Ur. Welch: I have just read the report entitled "Review of a study of Asbestos in Drinking Water and Cancer in the San Francisco Bay Area", which was produced for you by Kenny S. Crump of Science Research Systems, Inc. My interest in this work is as a co-author on the 1980 paper in Journal of Environmental Health (first author J.W. Meigs), which approached the same problem as did Kanarek et al, but using Connecticut data. As you know, our study was essen tially negative, with respect to showing any association between cancer in cidence rates and asbestos concentrations in the water supply. In addition, despite the generally lower fiber concentrations in Connecticut water, we were confident that our study was in fact quite powerful, and would have dem onstrated any reasonable effect, had one existed. In view of the very discrepant results which Kanarek subsequently pub lished, I did communicate with her in an attempt to identify any methodologi cal problems which might explain some of the differences. The answers I re ceived, were quite vague, and left me with a general feeling of scepticism of her results. I was reassured to see that Dr. Crump reached somewhat the same conclusion. I would be grateful if you could include me on any mailing list which you might have for any further work you may be doing in this area. I am a statis tician-epidemiologist, presently on the faculty here at Yale; as of July 1, 1982, however, my address will bet Me Master University Department of Clinical Epidemiology & Biostatistics 1200 Main Street. West Hamilton, Ontario L8N 3Z5' Canada I would also be interested to know if you could give me the names of any suit able contacts in Canada who have worked .on this problem there. SW: dv Stephen u. .-waiter, rn-u. Associate 'Professor of Bicstatistic CAP CO JEN 0012361 OCTOBER 1, 1981 VOLUME #1 ISSUE #2 MINNESOTA STUDY FINDS NO LINK BETWEEN INGESTED ASBESTOS AND CANCER Interim results of an epidemiology study1 conducted by the Minnesota Department of Health recently reported no link between the ingestion of asbestos fibers in Duluth drinking water and the incidence of cancer. "In our opinion, there are currently no observed etiologic or causal associations between exposures to amphibole (asbestos) fibers in the Duluth drinking water supply and the development of cancer," concluded principal investigator Eunice E. Sigurdson, R.N., in an interim report. The ongoing study is funded by the Health Effects Research Laboratory of the Environmental Protection Agency (EPA) in Cincinnati, OH. The stated purpose of the study is to determine the effect on cancer incidence, if any, from the ingestion of amphibole fibers in the Duluth water supply during the time period 1969-1981. Fibrous amphiboles occur in Duluth's drinking water as a result of a nearby mining operation which discharged tailings into Lake Superior. Levels from one to 64 million fibers per liter (MFL) have been measured in tap water samples. Electron microscope studies show that the mean fiber length is 1.13 micrometers (microns) and the mean fiber width is 0.18 micrometers, a 6.5 to 1 length-to-width (aspect) ratio. The study compared Duluth cancer incidence during the period 1969-1971 with rates in Minneapolis and St. Paul, two cities with very similar age, sex, race distribution, socio-economic, occupational, and ethnic characteristics. In contrast to Duluth however, the water supplies in Minneapolis and St. Paul are virtually free of asbestos fibers. Cancer incidence rates during 1969-1971, (approximately ten years following the initiation of exposure to asbestos in Duluth water) are considered baseline rates to compare cancer incidence. The report concluded that "Rate differences between different geographic areas and through time occur without any apparent biologic reason." Comparing 1974-1976 Duluth cancer rates with the 1969-1971 results, the reseachers reported that cancer decreased among males for all (84) sites combined and for total gastrointestinal (GI), stomach, and colon sites in males and females. No cases of peritoneal mesothelioma were observed during the eight years of observation. 1600 Wilson Boulevard A Suite 1008 A Ailinglon. Va 22209 A (703) 841-1556 CAP CO JEN 0012362 These results are similar to those reported in an earlier study published by B.S. Levy, Sigurdson,2 et al in 1976. That work compared gastrointestinal cancer incidence for Duluth, Minneapolis, and St. Paul. The authors concluded, "This study detected no excess in total GI cancer incidence among Duluth residents in 1969-1972 and therefore suggests no effect in this period possibly attributable to high concentrations of asbestos-like fibers in Duluth tap water, a finding consistent with two recent mortality studies regarding this situation . . REFERENCES: X. Sigurdson, E. E., Minnesota Department of Health. "Interim Report of Cancer Incidence in Duluth during 1969-1976 as an Investigation of Health Effects from Ingestion of Amphibole Fibers in the Municipal Water Supply," April 30. 1981. 2. Levy, B. S.. Sigurdson. E. E. Mandel, J., Lauden. M.. and Pearson, J,, "Investigating Possible Effects of Asbestos in City Water: Surveillance of Gastrointestinal Cancer Incidence in Duluth, Minnesota," American Journal of Epidemiology, Volume 103, Number 4, 1976. 3. Mason, T. J., McKay. F. W., Miller, P. W., "Asbestos-Like Fibers in Duluth Water Supply: Relation to Cancer Mortality," Journal of the American Medical Association. 228, 1974. 4. Minnesota Department of Health: Gastrointestinal Cancer Mortality Data, 1955-1971, unpublished. CAPCO JEN 0012363