Document YjEObdm0jQBNk3Ye74Lvyazd0

November 11, 1976 MEMORj .NDUM \)CM ' TO: Matthew M. Swetonic FROM: Leonard S. Zahn SUBJEO T: Session on Vinyl Chloride at APCA Specialty Conference on "Toxic Substances in the Air Environment," Boston, Nov. 7-9i 1976 Tie program for this session was different from that in the program mailed recently by the Air Pollution Con trol Association. There were two additional reports from scientists at Laval University in Quebec and a B.F. Good rich Chemical Co. man replaced a scheduled speaker from Dow Chemical Co. The participation of four scientists from Laval in dicates increasing attention to vinyl chloride (VC) in Canaca's Province of Quebec and perhaps throughout that country. The Laval people are concentrating on the birth defeqt angle but are not excluding the cancer angle. I er e are highlights from the comments made by the varic us speakers. The order is that of the actual program, "Progress in a community vinyl chloride mortality analysis study" -- Gilles Theriault, Laval University. He did not actually present a paper but served instead as the coordinator for presentations by the Laval group. He in troduced each of his colleagues and made various comments, among them the following: There are three VC plants in Quebec (2 monomer, 1 polymeri s ation). A survey begun in 1973 turned up 12 cases of prim i ry liver cancer in Shawinigan (S), which has had a VC planjt in operation since 19^3* One angiosarcoma was found in a non-VC community (Chicoutomie?). VC is now linked with bladder cancer (on the basis of Itt ur a's findings -- see below). Another important aspect of \ C toxicity is its mutagenic effect, as is seen in the birt h defects reported in three Ohio towns and in the chro mo sc me breakages found in lymphocytes of VC workers. Data from death certificates are not too reliable, Hosf ital records provide more and better data. He hopes his group will be getting occupational data in regard to rest arch involving VC with birth defects and cancer. (At one point, a man in the con:; iderable industrial complex Teonard `-JyPahn " Pt LATlONS COUNSEv audience had been pointed out that a built up around S.) lJ anrf/4$socz'a es.Inc. (P. 0. BOX 223) 13 LINCOLN ROAD GREAT NECK, N.Y. 11021 (2121 895-7445 oooio 29/7 SA'- 2. 2 "Comparative study of cancer mortality between the towns of Shawinigan (S) and Drummondville (D) in Quebec over 10-year period" -- Hilda Ittura, Laval University, She r ported a study of total mortality, cancer mortality, and rtality from certain sites of cancer (lung, liver, bladdje r, pancreas, and brain) in the general population, in ma Les and in the 20-64--year age group in the period 1965- 74 in S and D. The study was based on data from death cer-- tifi ca tes. Ittura said her report was preliminary and that nothing coulc be concluded. However, the data provide enough clues to p3an new research that would establish "the reai effect over the workers and over the community exposed to PVC." ffer findings: 'otal mortality. (Per 1000 population) Higher in D than in S D was 9-59 in 1965, 9.2 in 1974, with average of 9.07 S 1 s average was 6.68, increasing from 5*67 in 1965 to 8.80 in 1 >74. Cn the 20-64-year group, S's rate was 4.94 in 1964 and rose to 6.26 in 1974. D's rate was 522 in 1964 and dropped to .81 in 1974. . In males of all ages, D had no great change (average of 11 03)- In S the rate was 6.94 in 1965, 10.70 in 1974 (aver- age 8.28). In males aged 20-64, S's rate in 1965 was 7*0, in 1974 it ' as 8.8l (average 7.04), In D it was 7*49 in 1965, 5*36 in :974 (average 6.79)* Cancer mortality. The average rate in D was 1.84, in S 1.5!' The rates were similar in the 20-64 group, averaging 1.39 in D and 1*33 in S. . In males of all ages the rates were similar, averaging 2 1 for D, 1.89 for S. Xn males 20-64, D's rate was 1.13 in L9651 193 in 1974 (average 1.47). S's rate was 1-37 in 196 i, 2.39 in 1974 (average 1*79) Mortality by cancer site. Rates were higher in S than m D for mortality from cancer of the lung, liver, bladder, pancreas, and brain, especially in males aged 20-64. The rate in S was 5*0 in 1965, 13*50 in 1974 (average 8.78). It wasj 2.82 in D in 1965, 6.49 in 1974 (average 5*22). Lung cancer -- The total population rate was 2.53 for S and 2.50 for D. In males 20-64, S's rate was 559, D's 3*99 Liver cancer -- The total population rate was 0.51 for S, 0.32 for D. In males 20-64, the rate in S was 0.66, in D th< re was not a single case 00j 3- P,mcreas cancer -- The total population rates were 0.90 for S and 0.6l for D. For males 20-64, rates were 1.06 in S and 0.72 in D. BLadder cancer -- The total population rate was O.51 S, 0. 29 in D. For males, 0.66 in S, 0.24 in D. B rain cancer -- There was a large difference in rates between the two communities but there were not sufficient cases to provide any statistical significance. 3. "An epidemiological description of 10 Canadian cases of angiosarcoma of the liver" -- Fernand Delome, Hopital Regicnal de la Mauricie and Laval University. In June 1974, after diagnosing an angiosarcoma in S, he undertook a sur vey that turned up 8 other cases, all in VC workers. He re cently found another case (the only one still alive) for a total of 10 cases. These are the only known cases of angiosarccma in Canada at this time. fis cases were described as follows: 4l--6l years old (average 50 years), 11-29 years of VC polymerization work (average 21 years, 1 month), considerable exposure to VC ranging from 5 years, 3 months, to 26 years (average l6 years, 10 months), average of 20.5 years from first ex posure to VC to diagnosis of angiosarcoma, all beer drinkers (onl r 2 drank more than a bottle daily), all cigarette smokers more than a pack daily), negative medical history, all live i near the VC plant. )elome also gave pathological descriptions of tissues from livers of the angiosarcoma patients. He said a liver angi sarcoma can develop after at least 4 years' exposure to V 2 and that it takes at least 10 years from the be ginning of exposure to tumor development. (He must have meanft for clinical indication of the tumor's presence.) 4. "Birth defects associated with VC exposure" -- Lise Goulet, Laval University. Her report was a description of a propo sal for a study on birth defects associated with cornmunity exposure to VC. (It seems some preliminary work is already in progress.) In her opening she referred to two studies (Selikoff and Infante) done on the effects in children of VC workers folJ owing the discovery of chromosome breakages in the workers. Regarding the Infante study, she said the methods used (ini erviewing males only and then extrapolating to the femalt s) "make the results less convincing." However, both stuc ies indicate something may be amiss. Finding of higher incidence rates of birth defects in a community where a VC plant is does not implicate VC as SAL 000:^02979 4. being the only agent responsible, Goulet said. The findings deserve attention and justify further research. 7he specifics of her proposal; Ihase 1. A.11 cases of birth defects and stillbirths from women who Hived in S (and South Shawinigan) from 1966-75 will be colitcted. The same will be done for D, a town matched in all respects but one -- there is no VC plant there. A VC planl has been in S since 1943 and the wind blows from the plan-f over the populated area of the town 89% of the time. Each case of birth defect and stillbirth will be pinpointed on m ps of the two communities. The rates for both towns will be compared; the proportion of birth defects and still births over live births also will be computed. The observed rate; will be compared with expected rates on the basis of provincial and national statistics. he geographic distribution of cases around the VC plant m S will be plotted. Records will be otained of the annual census of the total population and newborns in the 1966-75 period Hospital records will be studied because the data are not 'et available from the provincial record of birth defeet and stillbirths begun in 1970* There are five hospitals in tji e S area and she expects to be able to trace 95% of all irth defects. There is one hospital in D where, it's beli ved, most of the women of the area deliver their children. Three different hospital records will be checked: the mother's history at time of delivery; the baby's history (thi3 usually covers the first five days of life); and spe cial records kept for stillbirths. Ct is expected there will be about 400 births annually available for study from each community. There probably will be less than 10 birth defects and perhaps one or two easels a year of CNS malformation. Phase 2. 'lore detailed data will be needed in regard to residence, occupation and related information about the families of the births under study. The study is expected to take about eight months. "Occupational hazards: do they extend beyond plant bounldaries?" -- Peter F. Infante, NIOSH, Cincinnati. At the Sfi>L 00*29eo 5- outs et of his talk, Infante spoke in impromptu fashion in regari to questions about VC and birth defects that had been rais ed by Goulet. He said it was virtually impossible to assess an excess risk of birth defects from a cohort study of occupational exposures. There just aren't enough pregnancies, no woraen in the VC industry, he said. The CDC did a study of children born with CNS abnormal- itie in 17 cities that VC plants and birth defect monitor syst dms. Four cities had a significant excess and in two the exce s was able to be determined by monitoring less than half the irths. One would expect 5 out of 10 due to chance alone, he se id. hile we cannot say these findings are related to VC, Infarte continued, it seems from the data that continue to come in that with women living in large industrial complexes theri are excesses of children being born with birth defects The thrust of Infante's formal presentation was that a numb tr of toxic agents have spread from the work setting to the general environment and that many of them may have ad verse health effects now and in the future. He urged testing of new chemicals before they enter the marketplace. ile briefly reviewed the toxic effects of a number of subs :ance (lead, cadmium, asbestos, mercury, etc.) which are harmful to workers and to their offspring and also to the general public Infante then discussed the genetic effects of VC, sum marising the paper he and his colleagues published in The Lane at of last April 3* He said there were now at least four studies showing chromosome aberrrations in VC workers and an exceps of miscarriages in wives of such workers. le stressed that there are structural analogs of VC that could be harmful to man both as carcinogens and as muta gens. Vinylidene chloride is mutagenic, he said. Chloroprene seems to be both mutagenic and carcinogenic, he added, as d|o other substances chemically related to VC. He said vinylidene chloride had been cited as a mutagen in an article but that he.had been unable to get data on it. Someone in the audience said the reference apparently was to work done by Viola who had claimed induction of intestinal turners in animals with massive doses of the substance. There is r o real indication that vinylidene chloride is carcinogenic the speaker said. Infante singled out chloroprene as a harmful agent with a structure similar to that of VC. An angiosarcoma had re cently been identified in a polychloroprene worker, he said. Sal ooo.io: 98 6. Diring his talk, Infante gave what he said were new VC experimental data from Maltoni. Following are the figures, which pertain to exposure in rats: PPM Mammary Cancers Angiosarcomas 25 9 10 11 5 13 l7 3 o o 0 F jur mammary cancers were found in the controls. Infante did n>t say how many animals there were in each exposed group 6. "Ultrasound as a diagnostic tool for VC damage assess ment" -- K.J. Taylor, Yale University. Ultrasound is useful in examining changes in the liver and spleen, he said, and in tests he did in a Wales (UK) VC plant the technique showed changes indicative of changes related to VC exposure. >uch of his presentation consisted of slides of ultrasound scans (imaging). The technique is noninvasive, does not i nvolve radiation and requires no injection of a contrast mediu m AC exposure can lead to portal hypertension which often results in massive fatal hemorrhage, Taylor said. The portal vein in the VC workers he examined often showed up as a "tor tuous " vessel, he said. Exposure to VC can cause liver and spletn abnormalities and cancer of many sites, he said. Ultrasound is suitable for mass screening, Taylor said in rtxommending a study with this technique be done of VC workers and their families. "New applied technology for VC control in PVC manu facture" -- W.C. Holbrook, B.F. Goodrich Co. He said at the outs it that while VC is carcinogenic at certain levels, a numb ir of questions still remain to be answered. Exposure leveLs today for both workers and communities are far below thos5 of previous years. Industry is working effectively to cont rol and contain exposure to VC by employees and the gen eral public. He described various control procedures being used in VC plants. He also made available copies of Good rich's 1976 booklet, "Vinyl chloride and cancer -- A study in prevention." 8. "Personal monitoring for VC exposure" -- Philip W. West!, Louisiana State University. His technical presentation dealt with a small, simple personal minotor for VC exposure as veil as exposure of other hazardous gaseous materials, suet as CO, NO , chloroform, etc. He said the device, a bit larger than a silver dollar, was effective, reliable, had ooov )29B' 7. no mov .ng parts, needed no power supply, etc. It gives a linear response from 5 ppb t 50 ppm, he said. 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X 10 t 10 .S'W C'A -J Uj I Cj OJ O bJ cr UJ _J LT bJ ----J* c Q Ca a d^ ~ O O\ > X X U1 u t-- H- cr cr __J o cc c: t H cr c: JT Q LD e' t-t en .. i s V-A H | cr t-- G in V X -t. cr> C/J c--< 1 UJ u: UJ 1--J D O CZ :> Q O s; 2 rb V >- a c d s in UJ (-- o H-- --1 cr G _J Q cr G H* 2I *. cr G g cj r~ CJ --a 2 t- cr\ i-H _J --< 1 G t-- G Mm2 ) CJ V- X in crr->i < SAL 000103002 CANCER MORTALITY, SHfl^INIGAN-ORUMMONDUILLE, 1965-1974, RATE3/1,0C0 JL6S :-:3=ir _*fO m if. a -:/ir Jvs: ::^a li.O ?^o I /Jo \ Jr lZ T? 48 n TO 71 To 7s ID MM CM