Document a4y0pGpB4aaE4eeXQqGeyw7VY

workplace of a potentially toxic chernial every 20 minuta." The quotation, which tppean on p 1142 of my a rtidc. alto coma from this testi mony. Earlier, on May 23, 1977, Dr. Bingham tatified before the Sub* comittee on Compemiuon, Health and Safety of the House Education and Labor Committee. There she stated: "The extent of workplace health tragedy in Ameria is appalling. The NIOSH hat estimated that there are approximately 100 000 deaths each year from occupational disease; many of us in the environment medical community believe this to be an ex tremely conservative estimate. Nu merous chemicals and substances used in the workplace cause canoer in that exposed; others often result in irre versible disease." I could cite more of her remirks, but those above indiate the inten sity of Dr. Blnghtm's commitment to thwart occupational disease; I was merely attempting to convey the tenor of her commitment in my arti cle. I believe that a responsible case can be made for e correlation between in dustrialization and cancer. The Na tional Cancar Institute's environmen tal epidemiological branch has some convincing, if not absolute, evidence in the form of cancer maps (see ES&T. December 1975, p 1116), end pub lished reports (Hoover. R, and Fraumeni, Jr,, J. F., Environ. Res.. 9, 196-207 (1975); Blot, W. J,, sad Fraumeni. Jr., J. F-, Lancet. p 142 (1975); and Blot. W. l^etxL, Science. t9. 51-53 (1977)]. Industry is alio inertasing its epi demiological efforts. Du Pont, for ex ample. alerted to t possible problem with acrylonitrile from enimal studies, immediately redaead worker exposure to that chemical. Then, from en epidcmiolocicai study, Du Pont found a I.S times higher thin normal cancar rate among its scrytoaitrUe workers. New Jersey, which touts its status as the No. I chemical state, is concerned that all of its 21 countia exceed the : national anew mortality avenge. Glenn Pauhon. assistant comraimioaer of NJ.'s Dept, of Environmental Protectieu hss Mated: "It's Clear that industrial development is linked to anew. Bat it's not a simple picture; it'ts convexityof many dues.' Using NIH* compiler and CEQ's UPGRADE program. N.J. is now surveying, monitoring and analytics data to unravel that complexity. Do New Jerseyans cat an exorbitant amount of avoados? While it is undeniable that smoking and diet are principal causes of envi ronmental cancers (ES&T. December 1975, p 1116). Dr. Irving Sdikoffs (director of Mt. Sinai School of Med icine's Environmental Sciences Lab oratory. N.V.) body of research on asbestos workersclarly demonstrates that workers exposed to carcinogens, who also smoke, have a grater chance of contracting anser then exposed nonsmoking workers. According to the Americas Cencw Society's (ACS) I97S "Cancer Ftcts 4 Figures ": "Except for anew of the Jung. sge-idjusted cancer death rates Tn general are leveling ofT and in some cues dropping off." But there have been some unexplained increases in certain cancers, notably those of the pancreas, bladder and lung. This downward trend in cancer drath rata is not, however, the result of better preventive measures, but sterna from better medicai/surgicel are end treatment, a fact often overlooked by those citing ACS figures. Finally, I will allow the experts to spak to the question of occupational cancers. A survey of 300 members of the newly formed American Society of Preventive Oncology found that 60% felt that there is "lubeunttaT stiestifie evidence that large numbers of worken an now being exposed to aigniflant levels of known carcinogens. Only 20% of the 60%, however, felt that there is "lubetaatial evidence" that reduction of these exposures to very low (trivial) levels is worth the inherent expense. Another 20% thought the cots too expensive and the remaining 20% had no opinion. Nearly SO% of the respondents felt that there is e "large burden" of occupationally-caused oncer that ha yet to be identified. Lets R. Eater ESiT Wuhingtaa. D.C /OSHA Deer Sin The Special Report "OSHA on the Move" (ES&T. De cember 1977. p 1142). contains un proven assertions, undocumented numbers, factual errors, and mislead ing statements. On page 1142: "... NIOSH's con servative estimate of approximately 100 000 deaths each year from occu pation-related dincases." The number first appeared on page III of the I "President'i Report on Occupational (Safety and Health". October 1972. The 1972 Report referenced three scientific papers that examined mor tality among 14 000 workers at high risk (underground metal miners, ura nium miners, smelter workers). These arc fine papers, but what NIOSH did next was inexcusable by sortie alcu- Istion never made public they extrap olated mortality in this 14 000 worker sample to the entire US. work force. When asked later about the number. Dr. J. W. Uoyd of NIOSH said. "As you know, there is no way to enumer ate deaths due to or related to occu pational exposure because of failure by ettendiag physicians to recognize oc cupation u en etioiogiai factor for many diseases". In short. "100 000 daths" is pur* guesswork: nobody knows whet the reel number is. It doa not belong in e scientific journal. More undocumented numbers ap pear on page 1144 in a discussion of the National Occupational Hazard Survey (NOHS). For example: "one in every four workers may be exposed to ec OSHA regulated substance that cat aeee disease er death, and up to 40-50 millioe Americans may have been exposed to tn OSHA-regulated carcinogen ... during their working lifetime". The NOHS repan is not yet published and has yet to receive the scrutiny of the scientific community. Repented efforts by this office to ob> tsin t copy have met with repealed deferrals of the publication date-- currently set for March 197g. Quoting from ea unpublished report it not limited to the lay press: Dr. John Finktoo of NIOSH used some of the results in Congressional testimony last May. However, such prior "disclo sures'* ere not a justifiestioa for their UHiss scientific journal. Oa page 1146 a paragraph starts with the headline: "Chemicals: pre sumptive guilt." Here the author misleads by citing crude (not ageadjusted) anew dath rates for the yean 1900 end 1975, "The seventyfive years of U.S. industrialization." Ofcourse there's a big increase. But no mention of the conquest of infectious discecu such is typhoid tnd tubercu- loejR conquest made possibly by pat-1900 industrialization. This ausod s marked increase in average life span, reselling in e large increase ie the dath rates from diseases of old age, among them cancer. The dath raw for tuberculosis is now negligible. Yet the rate in 1900 for TB (194 per 100 000) was grater than the crude cancer death rate in 1975, which was 172 per 100 000. No men tion of the skyrocketing rates for lung cancer--widely believed by many au- Vetwne IS. Nwvmr 5, Mey t7 4*7 DUP 0936916 DU 038020 thsritics to bo aanciated with cigarette moki-!;. i form of personal pollution. No mention of the fact that the ageadjusted rate for ail aitet has been in creasing by only 0.2% for the put 20 years and went down 0.7% in 1973. Tlte article overstates cancer daath rates by a factor of 100 ("65 per 1000 in 1900 vs. 171.3 per 1000in-1973"). The crude rates cited are per 100 000 people, not per 1000. The total death rate in the U.S. was slightly under 9 per 1000 in 1973 for ail causes of death. Most misleading of all is the state ment following the words "presume tive guilt" and the report of crude cancer rates; "Many of the environ-1 mental factors now believed to cause ; cancer are substances generated in workplaces regulated by OSHA," followed by a cartoon saying "Warn- ing--this job may be haardous to ; your health." No mention of the Na- ' lional Cancer Institute estimate (Dr. i Guy Newell, 6/15/77) that "five} percent (of all cancer) is related to, occupational exposures such as ss-l bestos. vinyl chloride.. The problem of occupational cancsri is a serious one, and tbe chemical ia* dustry is making great stride* in con< trotting risk and preventing worker exposure to carcinogenic substanoMt ICnowledge is the limiting factor; as scientific knowledge sccumuiates the 5% figure quoted above will decrease. However, scare tactics in a scientific publication hurt tbs preventive efforts by diverting scientific effort from prevention to rebuttal. Kr'" hw'ivw Wilmington, DsL 19191 In reply to Mr. Smith's letter The long latency period from first exposure to a chemical or physical Ir ritant and the first msaifestatmi of disease, especially for cancers, makes estimating the number of deaths from occupational exposures very difficult and approximate at beet. Ncverthsims. Dr. J. W. Lloyd and his group at NIOSH made an attempt at devel oping 'rigorous" methodology to es timate this number. In a convcnKta, Dr. Uoyd (who is now at OSHA) WM ns* that a onepage cxpiaaatfca of the methodology used, entitled "Method Utilized by the Office of Occupational Health Sur veillance and Biometrics to Estimate the Annual Number of Death* from F- i-T,,/5*1*7 Sr vj * l 7J Occupational Disease." was tent to those requesting an explanation of the figure's derivation. _ Cuing several sources of evidence, including NCI's cancer maps, morbidity/monality studies of American complica tea isolating the occupational cause, so that epidemiologic studies of working populations are- frequently needed to determine the presence of occupational factors." Dr. Peters asks whether a clinician, and Swedish chemists and the rela tionship of air pollutants to respiratory diseases. Dr. Nicholas Ashford of on a cue-by-case basis, is liktiy to recognize t work-related causa of dis ease. He tnswers: 'Too often, the in- MITs Center for Policy Alternatives swer is, no. Our medical training doe* came up with what he terms "a back of not prepare us to recognize diseases of the envelope calculation" to substan occupational origin." tiate the rtaionabltnus of the 100 000 Concerning the National Occupa figure. tional Hazard Sumy: I worked from Dr. Ashford's reasoning can be this multivoiume report, which wu found in his testimony before the sent to me in November. A copy of the Senate Subcommittee on Labor of the Committee on Labor tad Public Welfare and the House Committee on Education and Labor (February 10-12, 1976). I quote from his testi report ws* not sent to Mr. Smith or to otJssts requesting it, simply because the survey was not in bound form and NIOSH did not have the wherewithal to reproduce the voluminous survey for mony: "Cancer is the secood leading each inquirer. cause of death in the U.S. today with an annual toll of 365 000 (actually 332 000 in 1977]. The incidence of cancer has risen rapidly with in dustrialization: in 1900,3.7% of death* ware due to cancer, but by 1961 the However, NIOSH told me that a copy of the survey was at the Wash ington office and wu available for critical review, study and reproduction by Mr. Smith or anyone else. The survey wu unpublished only in the proportion of deaths from this causa sense that a copy oouid not be obtained wss 16.5%. In part, improved diagnsia from NTIS; this information contained and longer lift expectancy due to de ia it wu freely available. creasing prevalence of previous health scourges are responsible for this dra matic increase. Nevertheless, then are indications that the true ineidanca of Tbe cancer death rates should have reed per 100 000 population; that was an error in the copy that never was corrected. cancar has in fact bean on the up- soring." Dr. Ashford states at a later point ia hi! testimony: "Of the 10 or 90% at esaesr which coaid be environmentally For Mr. Smith's information, my 1973 special report mentions the con quest of infectious diseases, especially through the chlorination of public drinking water supplies. While chlo caused, it is not presently known bow rination, plus a sophisticated array of much is occupationslly related. There antibiotics, has virtually eliminated seems to be a general consensus among cancer researchers and environmen talists that one-quarter to one-half of this figure is complicated by occupa tional factors." waterborne infectious diseases, chlo rination also leads to an increased formation of trihalomethanes. in cluding the known carcinogen chloro form. Does cur technological wizardry He ends his testimony by stating: "But let me come to this point: even if oaly 5% of heart disease, cancer, tad respiratory disease were in fact occapetiooaUy related, the annual number merely substituta on* risk for anoth er! Mr. Smith dee* not hesitate to us* the best-guess estimate of S% for that share of cancers related to occupa of occupationally caused deaths would tional exposure, white he. at the time be 60000. Thus, the public health time, deplores tht us* of the 100 000 servic* estimate of u many is 100 000 figure. Be that u it may. Let us as may not be unreasonable." sume that thf4% figure is coma. Five Dr. Lloyd's remarks, as quoted by percent of 365 000 cancer deaths in Mr. Smith, appear flippeM, but read 1973 amounts te 17 250 deaths (the | what Dr. John Peters, writing on the cocrtporabt* figure for 1977 is 19 100). Virginia Kcponc episode (ES4T. Ia unhytterical tones, that is a signifi December 1977. p 1190) in the New cant number of preventable deaths. Eaghnd Journal of Mtrickle (29B, 277 And, unfortunately, for the foreseeable (1978)] had to say: "Because the body future the number ofdeaths will rise as has a limited number of physiopathew a result of occupational exposure logic responses the occupational dis eases ere frequently difficult to dif ferentiate from naturally occurring disease. This situation, of course. 15-30 yean ago. Leia It. Eater 94 r Wtshlagtae. O.C ** Enubenmenai Science * Ttahnataj) l* 9 6 0 DU 038021