Document em05v6eDVomYreZXay5wEROJG

Court Upholds EPA's Decision On Vinyl Chloride | By Stephen Webmiel Staff Reporter o/The Wall Street Journal WASHINGTON - A federal appeals court, saying the Environmental Protec tion Agency has great leeway in setting clean air goals, upheld the agency's deci sion against tightening air pollution stan dards for vinyl chloride. In a 2-1 decision, the appeals court said , that whenever the health effects of differ ent levels of air pollution are uncertain, the EPA may set air quality standards that take into account the cost to industry and the technological feasibility of com plying. Environmental groups said the decision, if upheld on appeal, will permit the EPA to weaken federal air quality enforcement ef forts. "It's hard to imagine a statute that is clearer than the Clean Air Act when it says that health is the only factor to be considered in EPA's standards,'' said Da vid Doniger, lawyer for the Natural Re sources Defense Council. The group chal- ; lenged the EPA's handling of vinyl chlo ride regulations. But the appeals court. In an opinion written by Judge Robert Bork, didn't agree < that the law was dear. The court said that j because the benefits of setting lower levels . for vinyl chloride were unknown, the EPA 1 was entitled to consider factors other than ; public health, including a form of cost-ben- j efit analysis. Vinyl chloride, a gaseous chemical used j by Industry to manufacture plastics, is ; widely viewed as a cancer-causing sub stance. In 1976, the EPA announced air quality levels for vinyl chloride that industry was required to meet At the time, the EPA said federal law allowed the agency to set air standards that weren't way out of pro portion to Industry's cast In complying with -them. The standards were challenged by envi ronmental groups, and while the case was .pending, Jimmy Carter replaced Gerald Ford in the White House. The EPA agreed to settle the lawsuit by proposing tougher standards in June 1977. But the tough standards were never made final. Last year, the EPA withdrew them and proposed returning to the 1976 regulations.' The Natural Resources De fense Council appealed to the federal ap- peals court in the District of Columbia. | The appeals court relied on a 1984 Su-' preme Court ruling that said when a fed eral regulatory law is ambiguous, federal courts should give considerable weight to the decisions of the agency that enforces the law. The section of the federal clean air law that calls for regulation of hazardous pollu tion is ambiguous and the EPA's decision to consider cost "was reasonable," the ap peals court said. Judge Skelly Wright dissented, agreeing with the Natural Resources Defense Coun cil that the law "is as devoid of ambigu ity ... as any statutory provision probably can be." EPA officials said the ruling reaffirmed their view of the law. "We felt we had dis cretion in implementing this section of the law," said Charles Carter, an EPA assis tant general counsel. But the Natural Resources Defense ; Council's Mr. Doniger said that when the Supreme Court ruling "is taken to this ex- | treme. It's difficult to think of what Con- 1 gress could say to eliminate ambiguity." i He said the decision may affect other pending challenges to EPA standards for benzene and for radioactive air pollu tants. Mr. Doniger also argued that the ruling conflicts with past decisions of the appeals court and said he probably will ask the full ll-member appeals court to review it. U W - 13160 CHEMICAL MANUFACTURERS ASSOCIATION Record of Meeting f :eivei e- '96 URL 13761 Environmental Health Associates Date: September 6, 1986 Time: 9:30 a.m. List of Attendees: Place: Environmental Health Associates Oakland, CA William Gaffey Sally Cowles Donald Whorton Otto Wong Has Shah Monsanto Company Shell Oil Company Environmental Health Associates Environmental Health Associates CMA 1.0 Dr. Bill Gaffey discussed comments received by CMA on the Epidemiology Study of Vinyl Chloride Workers draft report. Some of the comments made by Air Products could not be incorporated in the final report because they would require additional work not included in the scope of work for the current contract. Dr. Gaffey will prepare a written record of comments that could not be addressed for various reasons. 2.0 EHA will revise the draft report based on the comments received and will submit the final report by the end of September. 3.0 A-Panel meeting will be scheduled soon after the final report is received to discuss a future course of action. 4.0 The meeting adjourned at approximately 12:00 noon. (xsirm __ , Has Shah, Ph.D. Manager, Vinyl Chloride Program CHEMICAL MANUFACTURERS ASSOCIATION March 17, 1986 D^ar Vinyl Chloride Panel) and Research Coordinator Member; DrI Brian BynSTtof ICI sent me the enclosed "Register of Cases of Angiosarcoma of the Liver Due to Exposure to Vinyl Chloride." Please note that the register is marked confidential, and therefore should be used for your internal purpose only. Also enclosed is an artile I received from Mr. John Barr on "Occupational Exposure and Brain Tumors." Sincerely, Has Shah, Ph.D. Manager Vinyl Chloride Panel ^ Enclosures 1% Formerly Manulactunng Chemists Association--Serving the Chemical Industry Since 1872. 2501 M Street, NW Washington, DC 20037 ^Telephone 202^887-1100 Telex 89617 (CMA WSH) Air Products and Chemicals, Inc. Be* 538 Allentown. PA 1QT05 Telephone (215) 481-4911 products z: 9i x n fl 27 February 1986 i Or. Has Shah Chemical Manufacturers Association 2501 M Street, N.W. Washington, D.C. 20037 Dr. Roy Gottesraan The Vinyl Institute Wayne Interchange Plaza II 155 Route 46 West Wayne, NJ 07470 Sirs: You may wish to bring the attached paper to the attention of your various committees Interested In vinyl chloride health effects. It describes VC as the only recognized central nervous system carcinogen. Johtf'T- Barr, Maannaaggier Regulatory Response JTB:pt>r 0608c Enclosure: Moss, 3. Toxicol. Environ. H. 16 703-711 <1985) OCCUPATIONAL EXPOSURE AND BRAIN TUMORS Andrew R,, Moss University of California, San Francisco, California Epidemiological evidence of an occupational risk of brain cancer has been reported in four industries where chemical exposures are likely, most recenf/y in a series of prospective studies in the petrochemical industry. However, only in the case of vinyl chloride exposure has an occupational central nervous system carcinogen been iden tified. This report reviews the convergence of epidemiological and laboratory evi dence that established the occupational carcinogenicity of vinyl chloride, and dis cusses in detail the current evidence for an occupational risk of brain tumors in the petrochemical industry. INTRODUCTION Primary brain tumors of the glioma series, which make up about half of all brain tumors, show a male-to-female ratio of about 1.5 to 1. Brain tumors in general appear to be increasing in incidence among older cohorts (Waxweiler et al., 1983). Thus brain tumors in general, and glioma series tumors in particular, are sometimes considered as a priori likely suspects in the search for occupationally related tumors. Furthermore, gliomas can be produced experimentally in rats by at least four groups of experimental chemicals: aromatic hydrocarbons, N-nitroso compounds, triazenes,and hydrazines. More recently, brain tu mors including gliomas have been shown to be produced by inhalation in rats by three industrial chemicals, bis(chJoromethyl) ether, vinyl chloride, and acrylonitrile (Maltoni et al., 1982). These experimental results, together with the established history of brain-tumor carcino genesis in vinyl chloride workers, have led many researchers to lend at least preliminary credence to reports of brain tumors occurring in other industries where there are chemical exposures. Most recently, a series of studies have suggested excess risk of brain tumors in the petrochemical industry. Evidence suggesting an excess of brain tumors has now been reported for at least four occupational groups: rubber workers (begin ning with Mancuso's investigations in the 1950s), chemists, vinyl chlo- This research was supported in part by gram 1 R01 OH 01557 from the National institute tor Occupational Satety and Health. Requests for reprints should be sent to Andrew R. Moss, Epidemiology and InuTn.i'miui Health, UCSF. San Francisco General Hospital, 995 Potrero Avenue, Bldg- W.ird 84 \in l mtv cisco, California 94110. 703 journal of Toxicology and Environmental Health 16:703-711, \w, Copyright C 1985 by Hemisphere Publishing Corporation URL 13765 704 A. R. MOSS ride workers, and petrochemical workers. However, the convergence of epidemiological and laboratory investigations that is usually ac* cepted as the informal criterion of proof in such situations has been hard to demonstrate (see, e.g., Cole and Merletti, 198C Doll and Peto, 1981). Thus, Mancuso's original observations in the rubber industry were not followed by the identification of any specific carcinogen, and the existence of an occupational risk of brain tumors in rubber workers is currently open to doubt (Mancuso, 1982; Symons et al., 1982). Braintumor risk in chemists has been shown only in a series of Swedish studies, and as yet no likely carcinogen has been identified (Olin and Ahtbom, 1982). The convergence of an epidemlologically identified risk and a suspected carcinogen has been demonstrated only among vinyl chloride workers. Thus Cole, in his surveys of occupational carcino genesis, recognizes only vinyl chloride as an established industrial brain carcinogen (Cole and Merletti, 1980). Doll and Peto, more con servatively, admit the brain only as a "possible" site of occupational carcinogenesis (Doll and Peto, 1981). The history of vinyl chloride as a central nervous system (CNS) carcinogen is discussed in the next sec tion. Historically, the establishing of occupational or environmental risks has often been a complex and drawn-out process, sometimes requiring decades for the development of a consensus on a particular exposure. Thus although the issue of excess risks of brain tumors in rubber workers is currently in debate, the persistence of reports of brain tumor excesses in this and other industries has, as it were, promoted brain tumors to the top of the list of tumors that may be associated with important occupational risk (along with lung cancer, leukemias and lymphomas, primary liver cancer, and, more recently, melanoma). This was the situation in 1978 when a cluster of brain tumors was reported in petrochemical workers in Texas, initiating a major wave of research into the subject. The petrochemical research is also reviewed in this article. VINYL CHLORIDE AS A BRAIN CARCINOGEN Cole observes that occupational carcinogens are usually recognized because they generate an unusually high rate among a small exposed population, and because they produce tumors that are otherwise un usual (Cole and Goldman, 1975). Vinyl chloride (VC) is the classic case of a carcinogen that has such an effect, producing in workers exposed to high levels of the gas the very rare angiosarcoma of the liver (ASL). The first reported case of ASL in a vinyl chloride worker was diagnosed at the B. F. Goodrich company in Louisville, Kentucky, in May, 1970; the second in March, 1973; and the third, at autopsy, in December, 1973 (Heath et al., 1976). Since the incidence of ASL in the United States OCCUPATIONAL EXPOSURE AND BRAIN TUMORS 705 was then 20-25 cases/yr, the appearance of 3 cases among a small group of workers prompted considerable concern. Furthermore, concurrent studies by Viola (1971) had shown skin, lung, and bone tumors in rats exposed to VC by inhalation. {Viola's carcinogenesis studies were re portedly an outgrowth of his work on acroosteolytis in VC-exposed workers. Hepatitis-like liver changes had been reported as early as 1949 (Nicholson, 1977).J. Following Viola, Maltoni demonstrated angiosarcomas in rats ex posed to VC in 1972 (Maltoni et al., 1982). This result was communicated to the Manufacturing Chemists Association, which following the dis covery of the third case at B. F. Goodrich, made public the finding of three cases of angiosarcoma in VC-exposed workers in the Wall Street Journal. With this announcement, a major effort began to study vinyl chloride workers, including a National institute of Occupational Safety and Health (NIOSH) follow-up study of 1294 workers with extensive VC exposure in four plants. A concurrent histopathology study reviewed tumors reported on death certificates of all workers in the four plants. The NIOSH study, published in 1976, showed very high relative risks in the category "biliary and liver cancer." The relative risk was 11 for workers with 10 or more years of exposure and 16 for workers with 15 or more years of exposure. Furthermore in the concurrent histopa thology study, 11 of 14 reported liver and biliary cancer cases on death certificates were ASL (Waxweiler et al., 1976). These observations have remained the primary epidemiological basis for the assertion of the carcinogenicity of vinyl chloride. However the study also observed a significantly increased relative risk for brain tumors, with 3 observed and 0.6 expected among workers exposed more than 15 years. At the same time Maltoni (1976a) reported that brain tumors as well as ASL could be produced in rats exposed to VC by inhalation. Furthermore the NIOSH histological study showed that 9 of 10 brain-cancer deaths in the VC worker cohort were glioblas toma multiformes (the most commonly occurring tumor in the glioma series). This proportion was thought to be unusually high. (However, it has been shown that the expected proportion of glioma-series tumors in such a series depends heavily on the number diagnosed at autopsy (Schoenberg et al., 1978)]. These results were sufficient for the devel opment of a reasonable consensus that brain tumors as well as ASL were associated with VC exposure. The primary evidence in the devel opment of the consensus was the correspondence between the human data and the laboratory inhalation studies, in which the exposure levels were thought to be close to human occupational exposures, (see, e.g., Wagoner and Infante, 1977). Vinyl chloride is the only occupational chemical carcinogen for which a correspondence exists. Waxweiler et al. (1983) also note that in the 9 glioblastoma multi forme cases identified in the VC workers histology study, the average 706 A. R. MOSS time since first exposure to vinyl chloride was 21 yr. Thus the epide miological observation of risk may have followed the oncogenic expo sure by a generation, and the circumstance of exposure could well have changed by the time the risk was recognized. This long latency period is characteristic of occupational carcinogenesis. The excess risk of mesothelioma in asbestos workers, for example is not generally ob servable until 20 yr after exposure (Selikoff, 1977). The long latency pe riod has important consequences in the case of brain tumors, which are not rare tumors. The identification of VC-produced brain tumors, currently the only accepted example of occupational CNS carcinogenesis, offers some important lessons for studies of other industries. First, vinyl chloride was identified as a CNS carcinogen because it produces, as its primary effect, the extremely rare ASL. The excess risk of brain tumors would probably not have been recognized if it had not "piggybacked" on the rarer tumor. Second, the brain was only recognized as an additional site of carcinogenesis because comparable ranges of tumors were seen in human and animal inhalation studies. There is no other occupational carcinogen for which such a correspondence is currently known. Third, the number of tumors reported in the primary study was very small: there were 3 cases in the high-exposure cohort, and 10 in the concur rent histopathology study. Fourth, the period between initial exposure and observation was so long that observed effects may in fact have been archaeology rather than epidemiology--the carcinogenic situa tion may well have no longer existed when the excess risk was ob served. BRAIN TUMORS ANO PETROCHEMICAL EXPOSURE The intensive study of brain tumors in the petrochemical industry began in 1978 when as employee at the Union Carbide plant in Texas City, Texas, reported a newly diagnosed brain tumor to the local office of the Occupational Safety and Health Administration (OSHA). A joint -study with the Oil, Chemical and Atomic Workers union (OCAW) and company representatives identified a total of 10 brain-tumor deaths and cases among workers at the plant (not including the original com plainant, whose tumor proved to be metastatic). This number was suf ficient for the OSHA office to request a formal study by NIOSH. A joint study, with Union Carbide researchers, was initiated. A proportional mortality study of OCAW members in South Texas was already in prog ress, and additional studies in other refineries and chemical plants were initiated over the next year. However, in 1979 both the Three Mile Island incident and the Fed eral declaration of emergency status for the Love Canal area took place. OCCUPATIONAL EXPOSURE AND BRAIN TUMORS 707 and in the ensuing controversies over environmental carcinogenesis the atmosphere became polarized between industry and govern mental-union forces. As a result, competing industry and govern ment-union studies were set up in several of the exposed petrochem ical cohorts in Texas and Louisiana. When a meeting was convened at the New York Academy of Sciences in 1980 to review the studies, a total of eight were presented, four from each group. The four govern mental-union studies uniformly indicated a twofold risk of brain cancer among petrochemical workers; the four industry studies uni formly failed to detect any excess risk. "To the innocent observer/' Science reported, "the crisp pattern of falling chips appeared at first sight to display blatant gerrymandering" (Lewin, 1980). It was also true, however, that the range of methods and cohorts involved was consid erable and that there was extensive methodological disagreement. Reeve et al. (1985) reviewed the issues. The primary methodological questions were (1>the tendency of proportional mortality studies, as carried out by NIOSH, to inflate cancer risk, and (2) the tendency of industry-wide cohort studies, as carried out by the industry groups, to bury small groups of at-risk workers in very large cohorts. These issues were not resolved as, with the new Federal administration in 1981, NIOSH capacity to continue the epidemiology studies was lost. With no pressure from the regulatory side, the industry studies appear to have slowed down also. However, most of the proportional mortality studies were eventu ally converted to standardized mortality form, and a review of these studies is now possible. Savitz and Moure (1984) have recently reviewed the six prospective studies of refinery workers that were initiated by labor-governmental and industry groups in 1979-1980. Table 1 is adapted from Savitz and Moure, with the addition of results from two studies of petrochemical plant workers, those of Waxweiler et al. (1983) and Reeve etal. (1983). (One study, that of Thomas etal. (1982); remains a proportional mortality rate study (PMR): the others use standardized mortality ratios.) All cohorts of petrochemical workers had low overall mortality, as is generally the case in studies of "healthy workers," and six of the seven for which all-site cancer mortality or incidence were reported showed lowered total cancer rates. [The exception was the PMR study of Thomas et al. (1982).] However, brain-tumor rates were elevated in all but two of the studies, the exceptions being the refinery-wide study of Wen et al. (1983), which included salaried workers, and the industry wide study of the British petrochemical industry by Rushton and Alderson (1981). There was additional evidence of an association in more detailed substudies. Thus Savitz and Moure (1984) note that while Hanis et al. (1982) report an overall relative risk of 1.02 for brain tumors in their study of the Baton Rouge Exxon refineries, a more highly exposed 706 A. R. MOSS TABLE 1. Relative Risk for Brain Cancer and Melanoma in Prospective Epidemiological Studies of Refinery and Petrochemical Workers*-* All cancers Brain Melanoma Study RR N RR N RR /V Theriault and Goulet, (1979) Rushton and Alderson, <1981) Schottenfeld et al. (1981) (mortality) Schottenfeld et al. (1981) (incidence) Thomas et a). (1982) (PMR) Hants et al. (1982) Wen et al. (1983) Waxweiler et al. (1983) Reeve et al. (1983) 0.89 25 3.90 3 0.89 1147 0.80 36 2.16 14 0.76 127 1.63 8 0.86 240 1-29 9 1.32 13 1.19 474 2.28 27 1.61 11 0.92 249 1.02 5 0.96 839 - 0.99 30 1.22 16 0.81 131 1.81 13 N/A N/A 1.09 25 -- -- * Adapted from Saviu and Moure (19841. * RR, relative risk; N, number. subgroup had a higher risk, in the Reeve et at. study of Dow chemical workers, while the overall relative risk was 1.09, the risk among workers hired before 1945 was 1.83 (Reeve et al., 1983). On the basis of the first six studies, Savitz and Moore comment that there was reasonably consistent evidence of a potential association between petrochemical exposure and brain cancer. The two chemical* plant studies appear to strengthen the association. In an independent review of ail NIOSH investigations in eight in dividual refineries and chemical plants in Texas, Reeve et at. (1983) note that inconsistencies remain in the piant-by-plant results, and that case* control studies within the studied cohorts show no consistent patterns of exposure. However the consistently elevated brain-tumor risk in the prospective studies appears sufficient at least for this line of research to continue. Savitz and Moure note that melanoma risk is rather consistently elevated in the studies of petrochemical cohorts, as well as brain-tumor risk. This result is of interest because of an emerging pattern in recent studies of nuclear fabrication workers. Hadjimichaei et ai. (1983), in their study of the United Nuclear facility in Connecticut, observed rel ative risks of 2.40 for brain tumors and 2.12 for melanoma, against an OCCUPATIONAL EXPOSURE AND BRAIN TUMORS 709 all-sites relative risk of 0.88. Furthermore, Wilkinson et al. (1983) ob served a tripled risk of brain tumors at the Rocky Flats nuclear plant, and Austin (1981) observed a tripled risk of melanoma at the Lawrence Livermore laboratory... Attempts to explain these risks by radiation ex posures have proved generally unsuccessful; the similarity with the pattern of risk among petrochemical workers suggests that perhaps the cause is in some other aspect of the fabrication process. CONCLUSION Although this review suggests that the issue of brain tumors in pet rochemical workers is at least worth further study, most of the pro spective studies appear to have been dropped. However, a second wave of large case-control studies of occupational exposure in brain tumors has now been set in motion (see Table 2). In these studies, all brain-tumor cases or deaths in a specific case-finding area over a spe cific period are interviewed, either in person or by proxy. These large studies may eventually resolve the issue of whether there is a genuine TABLE 2. Case-Control Studies Currently in Progress of Occupational Exposure in Glioma Patients Investigator Number of Number of Source Site cases controls of cases Location Thomas, T. 1., NCI Environmental Epidemiology Branch Preston-Martin, S., University of Southern California Moss, A. R,, University of California, San Francisco Buffler, P., University of Texas Ahlbom, A., Hudinge University Hospital, Sweden Musicco, M., Neurological Institute C. Besta, Milan CNS CNS Glioma Glioma Brain Meningioma/ glioma 600 300 500 650 350 800 600 Death certificate New Jersey' Louisiana 300 Incidence Los Angeles County 500 UC5F clinical Northern cases and death California certificates 870 Incidence Coastal Texas and Louisiana 300 Clinical cases Hundmge in 2 hospitals 3.600 Hospital cases Milan * From Muir and Wagner 0962) and P. Buffler, personal communication 710 A. R. MOSS excess risk in petrochemical workers. [However, Cole notes that such large case-control studies are only effective when the exposed group makes up at least 2-3% of the population studied (Cole and Goldman, 1975).] It should also be noted that while large case~controi studies of brain tumors may identify industry-wide risk, they cannot, by their na ture, identify the pattern of tumor sites associated with a specific ex posure. This latter information is generally accepted as important in establishing risk. In conclusion, the prospective studies of petrochemical worker co horts reviewed here suggest that there is an increased risk of brain tumors associated with petrochemical exposure, possibly accompanied by an increased risk of melanoma. No evidence of a specific carcinogen has been established, and while the current generation of large casecontrol studies will probably identify any overall risk in the industry, these studies will not identify the pattern of sites at risk. 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Waxweiler, R. ]., Moure-Eraso, R., Itaya, S. and Fraumeni |r., |. F. 1982. Mortality patterns among workers in three Texas oil refineries. /. Occup. Med. 24:135-141. Viola, P. L., Bigotti, A., and Cuputo, A. 1971. Oncogenic response of rat skin, lungs, and bones to vinyl chloride. Cancer Res- 31:516--522- Wagoner, |. K., and Infante, P. F. 1977. Vinyl chloride: A case for the use of laboratory bioassav in the regulatory control procedure. In Origins of Human Cancer-Book C--Human Risk Assessment, eds. H. H. Hiatt. J. D. Watson, and ). A. Winsten, pp. 1797-1805. Cold Spring Harbor New York: Cold Spring Harbor Laboratory. Waxweiler, R. |., Stringer, W., Wagoner, l. K., tones, )., Falk, H., and Carter. C. 1976. Neoplastic risk among workers exposed to vinyl chloride. Ann. N. Y Acad. Sci. 271:40-48. Waxweiler. R. J., Alexander, V., Leffingwell, S. S., Haring, M., and Llovd, I. W. 1983. Mortality irom brain tumor and other causes in a cohort ot petrochemical workers. /. Natl. Cancer Inst. 70.75- 81. Wen, C. P.. Tsai. S. P.. McClellan. W. A., and Gibson. R. L. 1983. Long-term mortality Mud\ oi Oil relinerv workers: I. Mortality of hourly and salaried workers. Am. I. Epidemiol. 118:526-542. Wilkinson, G. S., Voelz, G, L.. Acquaveila. |. F. 1983, Mortality among plutonium and other workers at a nuclear facility. Proceedings of the Midyear Topical Meeting of the Health Physics Society. In Epidemiology Applied to Health Phvsics. CONF-830101. Jan. 9- 13, 1983, pp. 328-337, LIVER ANGIOSARQCMA GASES awFimintf. VPH/A3. - ASL ATDRESS Q5CDLAITGN OF HEEISIER ADAMS Dr ARoss Air Product*, Allentown, Pa, USA BAGSHAW Dr IMM Norfllt Hydro, Newton. Aycllffe, IK BAND Dr P R rjiTvw Central Agenc? of British Colinhis, Vancouver, Canada BARNES Jnr W C Monsanto, St Louis, Missouri, USA BARR Dr J T Air Products, Allentown, Pa, USA BABRAlC Dr G AECRF, Gocmsntry, France BAXTER Dr Peter EMAS, Loodco, IK BEAIFRE M Govermnc of Quebec Cancer Registry, Canada BENECHDr M. Nephtachlale, Lavers, France BEKCrr Dr B ia HUlhouse, IK BEKEAZZI Dr P Inst of Occupational Health, Milan University, Italy BESCTE Dr Dynmait Nobel, Troladcrf, Gennany BISSV Dr C EMAS, Bootle, IK BOBREUI F E Georgia Gulf, Delaware City, USA 0CTER R W Fames* Plastics, Delaware City, USA BJBGESS Mr David Id Anericaa, Wilmington, Dalnaats USA SEEN Dr David Kemaoord, Stockholm, Sweden CAKHR Dr J T DIAS, Lcndca, IK CZLLA Mr C Enichem Pol Imerl, Milan, Italy CHANCE Mr M Id Runcorn, IK OAUS Mr P G OASIOi Mr B ARK, Bruaaela, TWijriw Norsk Hydro, Newton Aycllffe, IK OTIAS90I Dr J C Chios Qdsrle, Saint-Tons, France DAVIES Mr J G Id, Everberg, Belglta (2) EE SLOWER Dr Solvay & Cie, Bnmaela, Belghae DE VOS Mr A J Id Everberg, Belgium DUE Dr HU B F Goodrich, Akron, Ohio, USA DOLL Sir Richard Imperial Cancer Research Find, Oxford Univereicy, IK DCMEBCWSa S L Dow Chemical, Mtdlmri, Michigan, USA tmKTMrG AAE, Brussels, Belghn EMUNGER Mr H VKE, Frankfurt, Genmny SBCI Dr V Berufsgenoesenschaft dcr (hoischea Industries, Nurnbarg, Geramiy FAIR, Dr H Chronic Diseases Dtv, US Dept of Health & ftmen Selcaa, Atlanta, USA FERGUSCNDr DM Id Aaezlcaa, WllalngtA, Delaware, USA KSWANDrD Inpeilal Cancer Research Fund, Oxford University, IK ERASE R W DlverslTech General, Akrai, Ohio, USA ERJSXL Dr B P Bcrufegenpaaepecheft der Chesiechan Induatxlea, Heldelbfg, Germany GOLERG Prof L Duke Univ Medical Center, Durham, North Carolina, USA GOSZIOHI Jar Dr R E Teneco OmmLcals, Placafwey, Near Jersey, ISA GCfnEEMAN R T The Vinyl Institute, New York, USA HARRIS Dr W D Uniroyal Inc, Mlddlebury, Comarrlnm, USA HUL Dr G B Alberta Cmicsr Board, Edmonton, Canada HH1MAN Dr D W Dlmncnd Shamrock Ccerp, Dallas, Tens, USA HDDESER Dr R K_ BF Goodrich, Cleveland, Ohio, USA HXGSCN Mr J EMAS* Bootle, IK BOGG Dr U A Imperial Oil Ltd, Sarnie, Ontario, Canada HOWARD Dr J K University of Otago School of Medicine, Wellington, New Zeeland awHR? Dr N F Id Australia, Melbourne, Australia JAWERT Mr J ' Chios Chlaie, Faria, France JERVIS MrHR Id MUlbank, Lcnho IK KAKRH Dr Bruca IXgioot, Wilmington, Delaware USA XREl33t Dr R A BF Goodrich, Akron, Ohio, USA LALOQC Dr J P Solvay, Bruesela, Belglua IANRAK Dr John Dow Oiendeal Europe, Bergen, Switzerland LAURENCE Mr J SPI, New York, USA UMQ3KS-JQ1ES Sir telatophar. Chief fedlcal Officer, ICI, London IX LES Dr F I Victoria Hospital, Blackpool, Lancs, IK LELBAffl Prof VK Univereity of Bonn, West Genamjy LEVEQDE Dr G <EF Chlmle, AZF, Bullylea-Mlnaa, France LEVISCN Dr D A St Berdn1nmew*e Boepltal, London, UK LEWIS Dr P (hadcal Industries Aasodaciaa, London, IK URJVTER Mr Solvay, Brussels, Belgrfia LOSSAIO Dr J Atocham, Franoa -2- WFX/ASL - A5I AECFESS,2 ltin MAH1A8D Dr J K Medizinscha Abtellung, Lu2ern, Switzerland MALHCJIRA Anna Statistics Canada, Ottawa MA13CNI Prof C Institute dl Oocoiagla, Bologna, Italy MAHKE Prof Lo Medil-Anic-S, Milan, Italy MATT3BSSI Dr R Montedison, Milan, Italy MTTDU7ICN D Norsk Hydro, Newton Aycliffe, OK M*XA Mr Neste Oy, Espoo, Finland MWIESAND Dr R IARC, Lyons, France MOTT Dr A A EK^erial SAIC, Buenos Aires, Argentina MJNN Dr A Mxitanto, Brussels, ^g^-- HJtBZ Mxncxi Dr M Ri Bodsx>, Ifadrid, Spain MacSMEEN Prof KW Upstern Inflrnsry, Glasgow, Scotland NAKAMJFA S Japanese PVC Assoelatlcn, Tokyo O'SULLIVAN Dr JJ IQ Sworn, W. OLSON B G VC Safety Association, Louisiana, USA OMEN Dr R Ifcadee Union CbngreM, London, tK PA2XXE Dr G M IQ Central Medical Group, Alderley Parte, IK PAOLAIiaGA Dr S Montwileoa, Milan, Italy FOHTSt Dr Hans Haunt Sinai Medical Center, New York, USA POSSBERG Dr J Wacker-Chanle, Mulch, Ornery HJBS Dr A M TOHDHAM Dr J Arochew, Brlgnoud, France Canettan Centra for Occupational Health A Safety, Hendloon, Canada RAHSADD Dr J BP Racheichas, Antony, Fmcf RAISES P BICHASD Dr P Norsk Hydro, Pongrvnn, Norway Rhone Poulenc, Roussillon, Fmca BDBSCN Mrs D Saskatchewan Cencer Foundation, Regina, Canada RCGRIGUES Dr MTF ia, Seo Paulo, Brasil ROUSH Dr G Monsanto, St Louis, Missouri, USA RDTY Dr J Atochen, St Aubsn, Prune SALE Dr J NIOSH, Cincinnati, USA SARA0Q Dr R IARC, Lycos, Franca SOEFFESS Dr ML 1)94/090, Geleen, Holland SCSIEFER Dr H University of Manitoba, Winnipeg, Canada SERCttE Dr D Dianood Shaarxk, Dellas, USA SHAH Dr Ess (MA, Wrthiagwn W, USA SXGRIST Dr J Shell Otdflde, Berra L'Etaog, Frame 9H!H Dr C Division of Envlrcunancal Health, World Health Organisation, Geneve, Switaetimd SMQH Dr P M Llandough Hospital, Penarth, UR SFIRXAS Dr R NQ/N2H, Betheada, MaryUni, USA STAFKRD Dr J Saesrset, IK SIABERER Mr BASF, Lndwigshefon, Gstaany TttfflUBBD Prof CH University of Louisville, USA TER HAAR Dr Gary Ethyl Corporation, Baton Rouge, touts!ana, USA TCHflESCH Dr B Chendecbe Wsrrt Hula, Kxels Rsrk.1 inghaueen, Gemny THERIMI.T Dr Gillee MaGlll Uni-varsity, Montreal, Cmeda TfflKSS Prof Dr AM BASF, LukdgsNiafen, Gacwny 1HIIS-EVBQCN DC. E Honk Hydro, Focagrunn, Ncrtvy TH9PSGH Dr D H Oncer TTaaaant 6 Research Inundation, Nova Scotia, Quads TUDOIR Dr V Shall, An Dm Bag, Holland VAN DSR msm Dr S J Aid, Sasdburg, Sotih Africa UAXLMZ J R Esso, Sarnia, Ontario, Canada WA12EMH3S H ~ BF Goodrich, ClavaUnd, Ohio, Da VETOING S 0 Renamed, SeockhcOa, Sweden UEELER Dr D J IQ Blllna, IX UBEZZR R N Uhlan Carbide, South CUrlestcn, USA WISIGN Dr J ia Hlllhoiae, IX WHng X R WHJN9CI 0 Dupexial, Buenos Alias, Argentina EXectroehsaical Industries, Acre, Israel vmiAtfi Dr IMJ BP Owicals, Peoerth, IX VILSCN Prof R Harvard University, Cartridge, Massachusetts, USA WIGHT Dr A P IQ Wilton, IX YCS& J IQ Everberg, iwigtf Frees Dr B Bemetx, Medical Department, Imperial Chemical Xaduatrise Pic Rlllhouee Site, PO Bccc 4, ThorntotrClcveleys, Blackpool FY3 4QD, IX. February 1986 CONFIDENTIAL REGISTER OF CASES OF ANGIOSARCOMA OF THE Lira DUE TO EXPOSURE TO VINYL CHLORIDE - REVIEW DATE 1 JANUARY 1986 PREFACE s Acknowledgments, significant changes and concents 1* The new esses In the Register are the following : France Gsrmany UE 18 23, 24, 25, 26, 27 11, 12 2. There are amendments from the previous Register against the following cases: Germany 21, 22 US 36, 38 3. I would like to thank Dr De Sloover, Dr D M J Williams and Dr Friedel for informing me of new cases. 4. For the case corrections I would like to thank Dr FTiedel, Mr J T Barr and Mr B W Frame. 5. For other corrections and information, thanks to Dr D Fornan, Mr J T Barr, Mr T H Sutherland and Mr N F Humphry. 6. I should be very grateful if all recipients of the Begister could continue to keep me fully informed of any new cases, or, if they should hear of other Companies who have acquired a case of ASL, it would be much appreciated if I could be notified by the appropriate person. It is extremely helpful if new information is supplied in tabulated form, using the headings in the Register as far as possible. 7. I would like to thank the many people who have suggested research topics, and should be grateful if I could be kept up to date. 8. I shall be happy to supplyto any recipientof the Register a copy of the Paper "Exposureto VinylChloride andAngiosarcoma of theLiver: a report of theRegister of cases" by Dr David Forman,myself. DrJohn Stafford and Sir Richard Doll, published in the British Journal of Industrial Medicine, November 1985 (42: 750-753) Dr Brian Bennett Medical Department Imperiel Chemical Induatries pie Uillhouse Site P 0 Box 4 Thornton-Cleveleys Blackpool FY5 4QP England February 1986 sue nan Index Table Sentience Belglua 1 Canada Czechoslovakia France Ceraany Italy Japan Norway Sweden UK USA Yugoslavia Incidence of Cases per annua (Table 1) Distribution of Cases by Country (Table 2) Pattern of Cases by Factory (Table 3) Latency Periods (Table 4A) Distribution of Latency Periods (Table 4B-4H) Annual Geographical Incidence (Table 5) IMPERIAL CHEMICAL INDUSTRIES PLC LIVER ANGIOSARCOMA CASES (REVIEW DATE - 1 JANUARY 1986) WPX/ASL 2 - LANGI0CASES,4 Page i 2-3 4 5-8 9-14 15 16 17 18 19-21 22-28 29 30 31 ASL Case Nuabera by year of Death (Table 6) ASL Case Nuabers by year of first exposure (Table 7) Western Europe PVC Producers - Start-up Dates vs ASL Case8 (Table 8) USA PVC Producers - Start-up Dates vs ASL Cases (Table 9) Canadian PVC Producers - Start-up Dates vs ASL Cases (Table 10) East European PVC Producers - Start-up Dates va ASL Cases (Table 11) Japanese PVC Producers - Start-up Dates vs ASL Cases (Table 12) South 6 Central American PVC Producers - Start -Up Dates (Table 13) Australasian PVC Producers - Start-up Dates (Table 14) Pafie 42 43 44 45+46 47 48 49 50 51 32 33 34-40 41 rH i ftatU umuL cwmical iHwrnics ru: LIHI At(l*MleM Caaaa - (ImIw Dalai I Jaa ISO*) Amlrl l-HtDuWTH H- ITl1kAKtyitM WlfUlJ - UMCISCIHI,? 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Of oiACHoaia ACC AT 0IA8MMI* mu or irniMti to aiiMMii tuu or OATM or umau DBATH MI8T0UCICAL CORflBMATIM KSTIHATEP iiroauaa LXTEL OCCUfATIOM emu Ciltu RICMLIGMTS u OTHU oamum uwun n 14 IS (mau tW* H bn in u iBI ____________ 1 00.00.14 Lmu Kaliahai 00.00.40 01.04,7* 07 i* i* lt.0S.7B Yaa m ll|l*lireM la Ala ltu f SI IS *1, Hr FrlaBal air nil was a riattaaapltliHinina Bar Bpalaarahra > (a citclMaa 1 ika aaaafhagaa) at attribatbla liKMi Ml racatalaa* aa aa laBaatrial Alaaaaa lictei nnimi . If.10.91 Trio 41 II ii 11.14.?i Taa balaclava alaaaar ill wiktr. Briar pacatar. laiar ahlfc laaAar ttN m IjinU k.n,4i 07.4o.7B (Laibach Mfitld AIL *1 m im littiMMr) IS 1) 10 Ic7.d4.7i Taa Ilk Aataelavo ASL aa* uarkar till Napataeallalar IMA. Carclaaaa LaaBar aa* aaatar r 11 aaat laltar al lln Jim 1*00 eacloalaf Bata froa IV a r rrlaOal f K cticala * V laat laltar al lOtW hat ItOo aacloala* Bata Ilia M r frlaBal of BO Chaala wltMraalat HU caaa Aaglaaarcaa* caaflrwl 0B/7T. Boaa Oaiall at ihla * alaa caaaa t, II. IS. 1* 4 7 |laa la HIV laport far It IB Aa*laaarcaa alln*l, fall Batalla f illau alaca March 107) tlvan (a HIM H4 Inap *# far I97B. Plffaraal fatalla (Ivaa la rc Aaaoclata* Maaaaa bp Laibach aa* Maraiallar ItBI > >71. 88iEnun rut i) 3CRMAMT III--t * IHTltlM. CMHICM. lWHniU FIX LIVIR Aagloaarc-- CHM - (Ravlav Ratal I Jaa 19R4) Url/ASL_2 - IAMCIOCASRS.IR 12 4 s4 7 R 9 10 li * 19 14 IS 14 COUtriT AMR intauci m MHC OR 1KITUU UTI W OIRTW OMRUI factory 1 FIRST *C RIFORHRI 04TS or OfARNORtR ACB AT RIACNORIS lull OF RIP08VRR TO RIACH0RI1 mu or lilt OF tlFORURR FCATN RirrauwiCAL COMFIlHATlOa IRTIHATCR RIFOSRRR LIIU OCCUFATIOM OTHCI CAREER RICML1CRTS OTHER COMnHTR CCRHAMT 1? (RIORR glvaa mm Cmmm IS) II II II it II 00.00.17 IfMU TraiaRarf 01.11.41 14.04.71 41 M.N.l] --chat OaaR--rf u.u.ss TOT Ui.tt.3S Oya--It MiJwi ll.Ti.S4 00.OR.h u Si *0.00.11 IfMBli Inltlid 14.lt.U Tro" IS 00.00.11 lytaall itt.i6.Ti or--oit TraiaRarf irrsrtr- 00.09.79 yea--mm* cllalcal Itiar gat--) TraiaRarf 1s.i6.4i 2I.M.90 II SI 14 11 2t.0R.74 Taa f Jwioclm Bo Aatlaaareaaa Marker (Mdnat. Aaaaa1 raporl of Ua IbHk Rklaa Haalpballa HaRical laapactorata far 197R MR S47-I77 Rlvaa fall Ratafia. Tlayl ehlarIRa Rlaaaaa RtaR--aaR 02-02-71. 0a--pbagaal varlcaa. RaRlaleglcally a--flraaR aero 14 11 ll.lf.W la* Aataelava aataalvala. Uarbat IS II 12.ai.IO Taa iRfc Aataelava Hataataalat Uarkar UL Rr Raaeba laliar of 1S-04-R2 ta Or H F Uwi 11 II 14.167k)- Taa llRh Aataelava Raaaaaota Uaihat aRothaliaaa 1 liver irtil Itataataaaa Or iaaeba lattar ai IS-04-R2 to Or W <1 F Adorno 11 11 irmr Taa lh Aataelava NaaaaagJa Ulatkillou Usrfcar aaR aarkaR |a of llvar will Rrylag ahap IklMtlUi Or Raaeba lattar of 19-04-R2 ra Or V F Adam* 11IS u.n.ii Taa iRb Aataelava Oiargafcaed, Or Raaeba Nrtaataelag ASL Uorkar auh--aeilj Far-- lattar of 1J-C4-R2 to Rr V C F Adorno 68i.enan ra 14 CIMill ,>MI I UtmlAL CHOII CAL IMMSTMKS MX LIVIt ln|lowrci)M Cimi ( RV Patal 1 Jaa 1*04) WTX/ASL_2 - LANCIOCAOCS.It 1) * COURT*! AW MPBMMCa HO HAM OR Alt Of INITIALS mm 009KABT 3] OP 10.00.31 4 COWART Waakar 3 V^CTBBT 0rthaaaaa 0 miit *c BATS Of UPVMU OIAOHOOlt 1933 24.03.19 1 ACC AT OttBMOlO 32 9 TEARS OF UNSUll TO BIA6N00IS 24 10 II TKARS or HPOUM oatc or BOATS 11 >9.09.01 12 13 14 IS IST0UW1CAL OMPIOMATION COTlMATtO OZroflHOB um OCCUPATION OTIIKB CARKU NIURU.ICBTS Taa Uo Ckaal atrp (-100 ppa) llarkar - 14 OTN0B COMRCMTA real C*41|kl atataa aataataalaaA. PrlaAal lattat 10.04.03 34 BL W.OO.IS Waakar Oar- 1909 11.10.01 34 12 12 20.03.03 Taa Mick Aalaelava kaaaaa (-300 pfa) Claaaar Prat CAar (thialefc) lattar 22.00.01. PrtaAal lattar 19.04.03 l.lfk M.00.23 Wackar Oar*kaaaaa 19*0 20.09.01 SO It n 14.01.02 taa OlA* Palpelava Oaakat aaA iataclara Claaaar Oral Salaalr (Mulct) PriaAal lattar 19.04.03 rx 00.00.22 CM Marl 1931 14.00.20 34 23 22 22.11.01 Taa H|4 falyvatfcar dtraalc Bapacllia Ualkack). PrlaAal lattar 19.04.03 33 us 00.00.20 OVM.lt Trolafarf 1*33 10.01.03 33 20 u 02.02.04 Taa Hick Aatoelava Claaaar till 1922 Lalkacb. rrlafal lattat 19.04.03 06LtVWO i i k 4 2 a p 5 as -a i S S I 3 2 c 3D G--COJI r i|t (4 M t t t U L CHEMICAL IMMSTCIES PLC u r i / u u - UMGIOCAHS.ll z 6 ttn h r^ 17 MOMAT IHPCBtAI, COMICAL IHKJSTIIII PLC Lim UilMtreoM Cbm* - (BavlMf Batai I Job 1*04) NN/ASl_2 - LANOIOCASBB.22 2 34 amrrar aw rcaiMcs M AW M IMITIAU bate or bibtb 1 CBVMT > *. 7 o 10 11 12 13 14 ricroai nur vc umwi mtb or oiacnooio Ad AT ojacoosu YBAAS Of bxmmwi n BIAfiOOBIB riAAA or airotau data or tun IIBTOLOCICAL CONriBHATIOM ISTlHATtS BIMMUBB LCVCL OCCUPATION 1) ODKl CAtaea BJOOLIdTO 1* OTBBB PQIOIBIITB MOBWAT 1 AB I3.II.12 Mwah Bavaya A.M.U 11.12.71 M 12 21 BA.OI.72 T lh Iumw 4 IpAn talMlrn WftrvlMr Ctillnd by Or fhiiaIlMMi Of MB. U AfHB Hl| of Joaa I97B nr r atataA that AM haO Mm * Makar of a atartup iim. KH A fVC warn mAo la aaaa batlAlaft. Vfca VCM mi MM frao acatylaao eeienbo r^a SUttOR nrtllAL OBHICAL IRRRSTRISO rue t.IVER (UKregu C*mi - (tavlaw Ratal I Jaa 1808) Vrl/ASL_2 - unciocunr2) 1 S 18 ODROTlT tm ttrutuci 0 UM 08 IHITIAL8 MTIV8Wor l COOTART S8 0 f 10 II 12 11 18 FACTORY riart c HF088RI OATt OF 0IACM0BI8 ACB AT OIAONOOIO mu or 18708088 90 0IACN08I8 TSAIS or S1FOSB8B 0AT8 or R8AT0 IST0L0CICAL eoMriaiuTUM R8TUUT80 BSMMWi LBVtL OCCUTATIOM 19 QTHBR CA0881 8ICMLICHT8 18 oOoTm88nRrrs my * i M 7J.Ot.17 laMtarl SaaAavall 14.OR.9t 20.10.10 81 18 18 10.10.70 Taa PaJyaarkar 8 |102 L 1MI.II laMMrt hrimll 00.01.89 00.00.71 81 11 11 18.08.71 Vaa rot pcaAactiaa OS 88 10.08.10 ItMMri aatavail 00.09.87 18.01.78 81 19 11 19.0).78 Taa lob falywarbar 04 AL hatwrl18.11.18 aataratl 00.00.88 11.09.77 81 SI 11 11.01.77 Taa Hit 1988-19)1 yalymrlaatlaa uarbar <11 yta) 4 19901777 laraM* 0* F) 1809 tl.OS.t9 Realavail tt.M.M 11.11.80 81 18 21.11.80 Taa OlRh - 1988-1970 8 Taara 10Law Taara eayaaarlarltfaurga B19r7ia0r-1900 aparilK Mr AJoalla'a lattar at 20 Haiek 1710 caattraa U> mi a iMoaar warkar uba waa haavlly probably un aa tkaa a mimI raactar claaaar la flrat 12 yra af MrlijaMI baB baa. baavtly HfOMl. |a 1*78. Ilvar ataaiailliy laaatlRaMrcCml(I|HIiim|I I 1attar II.R. 77 ta COFIC NovLatlar el laA |78l fra. t OavlA lyraa la bla lattat at lat A*rU 1*18, *r Nmuum at IUC un la ImIh'i Ratlaaai kwl at 08 Naallh Rivaa 20-01-70 aa 4ata af Alasaeala ter Ge 01 Nl |HS- tar data 02. Wienan r*a l < fttui a 3| 4 UtfBBIAL CBBMICAL INDUSmu HC UVKB AAilaaarcaau CaMa - (|a*iv Batai 1 Jaa l44> 34 > B * 10 II 12 conmv am lUUfKI AM OB If IAU BATS Of B10TM amn flCIM nut we UMSMB ATI or DIACNOBli ACC AT BMCBMIS mu or UrMBBt TO BI4CMMIB YCAII or UTOSUBB BAT! or BCATB MISTOUUICAL 00NPUMA.T10M 13 111 3S yrx/uij - uibiocuii.k 14 IS OCOUfAXIOM OTMCB cum mcMLiaiTB 14 OTBEB cwhiti HS Ol IU t0.04.BI ici lllMaaa 44.44.44 43.ia.73 71 IB 22 o3.it.n III MO m 1444-7 VCH (rsi 4 (fl 4 1*47-4 Briar Calllar Calllar 1*44-41 yafar M(t 4*Vc Aataelaaa 23.12.71) ayaratar 13.12.72) 1*41-44 Briar U< aa4 Barry laacre 24-04074 yaga* 1314-4 a a AJW M JIB BT t 21.04.M ICI Barry 44.42.44 00.12.74 37 UllkMM 14.04.34 00.04.7* St DaAtaaa faArlcatloa eaaa 04 3.3 14.12.74 Ta U|k Balaclava alaaaa* Bayaaara llallaA to 2.44 - f.4* 23 10 12.14.7* Yaa Mlw- 34-9 Bra-war flah M4 Bacrla| Maat 33-4 vaMda Briar riaar aalaCaaaaca 34-34 TWPR-------------- tatMlna flak aacAar art*t 34-41 Ck*r|ik*4 Briar riaal 41-71 Vataaaa C 2/3 Maat S6isnan URL ^96 Mil * V*t **4 ml> mad - t*U M IWUHI ))< owi-ttu )|f wwfH} 44 001 44 DOf M (C wir.u. 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IUHH1 S-CV4I iMli *i*4 iHHig t 4 >!< !*(! <|*J >aij*4* M|44 IIMHd MUM** it tl l t* taoo'oo i>M| K'WIt ei ______12-------- wt* ...gia-iSL ,... au_- IlMf _________& ...mu ________sa IWIIMD CUK>r<H9IH nim N-mi *1*4 W-0941 M-tUI irj -WI It-tUI MU*M3M INKWII WM1VWH4HOO _______u_______.............11_______ ...11______ -- < 1t M*ll*#t It WVM IMtMXI jo tuva ji> imi t so iTioBfto" 4 IMUMIl ftMNOVIO jo iim XV BOV 44`01 *00 fimnvio 40 uvo IS'HCtO miwn M Ulll UOUtl ...-HU. ., Si____ ______________ * ____I____ (W(i **f ) l*3 ***> - *3 Vw**v*|0* mil 4B trtt'oc r to _ m lUfMO Ulll rmsim nuifiM 40 BIV vo am 0BV iBUMS - -- t ce'sKKwtomn - i ibv/mh 3-m snusmiKf ivsiwio -m*win M *'! PM* !l Hit Laat 1 ------------- ------1--------- 1 IMMtIAL CWM1CAL lMNITftllft PtC Live* MlnftrcMi Ceeae - (Davlew Ratal I Jan IftM) --------1------- --1------- ------j--------- --------,-------- ----------1---------- 14 11 VPX/UL 2 - UMUCUII.U ----------n---------- --n-- --n-- ----------n---------- It ssmrnr iumi m IVIUKI IIITUU MTt or itra M KIO> 12.OS.2S CDHrun r lunti Hwtf Plait re upoteaK 1S.02.S* pm or AC* AT DIAOHMlS OlACNQftlS 02.01.S Sft ruu or BXP0SU** TO DIAGNOSIS 13 VBAftft or om or sroftw* Kin is 24.02.ftl ISTOUKICAL COMPIMATIOM la* ftattHATeo xposwa mu OCCVPATIOD OTfle* caftan HIOOLICDTS MlH Polpworkar 2 pear* a* AcrjrloaKrile tala Pltat. tlaa prior to IftSO. 4 poara ear alatoaaac*. 3 paoca watac ear palatakap. 2 pear* la Bravlu Dock. OTMftt cawtiw* l* BJT 04.ft4.41 r lartr 21.01.M 01 ftS ftl 31 1ft 4.2 1ft.OS.M lai niafc - ii lal|clUHI Naavp ftaofta lafaraaclaa oatto (300 Iftftft-ftl. vektcio Arlver ftlvaa la Pf")- Law- ftpraparftrlar aatll llaal Ift Mika kegjar 1 Mi lllaaa. <30 ppa>. ll. Ilaw- latter lft.0ft.ftl fro* Dr ft N J Neftlue - HI HIM 21 aaathi <200 ppa) atrlppar ISIS-70. II SLP 00.OS.20 r ftarrp Ift.l2.ftS or.**.*! SI l 1ft ai.oft.os la* Iftfc Palpclaaaar IMS -ftl Haft ft-f Law 12-22 IMS-ftft. ftarvlea aparatar ftft-ftft. *lf Oparatar ft*-1ft. Laaftlai laaft Ift-ftl. 11 JT 2l.0l.il 101 HUIaMi lft.0ft.Sl 03.ftft.ftft 40 2ft 2ft ftft.ll.ftS Taa Low IftSl-Sft ftpar* ml lBk Sft-14 batftta* Law 14-ftS float IftSl-Sft. lalttlnt Oparatac itsft-as Latter of 04.ft4.IS r teal Daltk aaft letter af ftft.ftft.ftS Dr ft H ft ***** Doaapkataa) keaaerrkafte ftao ta aa*apfcea*al vactcaa ftaa ta Aaftlaaarcoae af (Ivor Latter 2ft.0ft.S ftr P 1 Lae Mid inn PM >1 NBA Him i IMPRRIAL CWMICAL (MNFSTRiRJ PLC tlVU l*|lmxtau baa* - (Eavtaw total l } **4) K ifitn of 4iia Ml - MONTH - tUI WPR/ABL_J - LAMOIOCiHO.l? " i2 4 S0 7 0 9 to 11 12 13 14 13 COMET AMO 1ITOUNCE 0 NAME M INITIALS OATS or UfO CONPANI Vactoov floor vc SIMOOM DATE OP OlAOWOIO ACC at 0IACNPSI9 TEAM Of SIPOSMI TO MNCObOlS TKAOS or DATE of ElPOSdU MATH 1STOUI6IC4L OONf10NATI00 ItTINAtn UMSMtC LEVEL OCCUPATION onus CAMEO ICMLICNTO 14 OTHER oomurs St i lari IF. 10.33 090 Laalr 00.12.40 03.03.11 49 14 21 01.03.12 Taa Parka villa i i 19.00.33 000 Laala- is.u.ss 00.01.TV IF 14 13 27.01.11 Taa vllla (01000 aapa 20.00.21) 03 Mwil IS.09.1S SOB Uwla- 10.11.4S 10.12.13 SO 20 24 19.12.13 Taa llwIMi* villa i 04 1i IS.01.24 re Ualf oo.or.92 19.00.41 43 IS 13 92.01.40 Taa villa OS i 3S.OI.I2 090 Lawlavllla 10.00.44 09.04.44 31 30 20 99.04.44 Taa i 00 up 23.11.20 OK Lawla- W.01.42 00.01.14 4S 12 12 14.97.79 Taa latll* villa i Jaaaat 1 1 ) I or Charlaa 01.0S.21 cc 0 Charla- IF.00.44 00.00.40 41 24 12 21.01.40 Taa T Burt ataa i ) 01 90.01.20 CaaAyaac llaiai* 01.10.44 00.04.41 41 IS IS 29.00.41 Taa fat Claaaar (Slack JaM 1974) p S3 Nlatatp jlvaa alllag Slaaa la Aaaala HI Art ACAD SCIENCES Rat 1 NT leal Pol 329 (1929) f Sc Opap paga 190 la 1974 Papar br Alia link 0 Caltlaa af Jm 1.7. 74 UNA PM Pat Claaaar (Cf Black) Oaf 1 klao Black JANA 1.7.74 P Par Claaaar (Cf Black) Lontavllla Courlar Journal 02-09-00 Pat Claaaar (Cf Black) *1 l Alaa Block af 1 Alas Black Pal Claaaar (Cf Black) af 1 Alaa Slack H Air Parca Pal Claaaar (Cf Slack) af 1 lauliilIU Tlaaa 23.7.7S Eallrai April 1974 Alaa Slack af 1 Oaf 1 86iMdri Pape VM IMPRRIAL CHEMICAL lHOUSTtllS PtC LIVBB InilNirctM Caeaa - (latlw Pact! I Jaa II**) UK ifiitt ol Patea OAT * MONTH - TU* |*I/aSL_2 - UNGI001III1I f* coomi up irpucmci oo 2 MM* OP INITIALS S pare or kian 4 COMPANY S* 1 s 9 10 It 12 1) 14 PACTOPY P1BST VC OATC OP exrososs IMMOSIS ABB AT DIAGNOSIS TIAA1 OP uposuib to IAG00SIS YEARS OP urosiwK BATS OP MATO NIltOLOCICAL CONFIRMATION RSTMETRO (zrosuaa LSVRL OCCUPATION IS OTHER CARRKR HIGHLIGHTS 14 OTNRR COUNRUTS HI Of Ujml Cattle' PI apart OS.ll.SI BOB Ualr villa 1S.03.4S OI.OS.74 4S I* 14 ll.0S.7S Yaa 1000 py. Raf 1 haa vcaap flpwrae ra fleet aapaaara. Loalaallla Tlaaa 19,10.74. 12.S.IS. IO.S.I4 10 I4.0B.I1 Baa*year Hlapara 12.04.31 eo.os.4o S3 u 17 IO.OS.40 Yaa taf 1 II 17.*S.Of BaaPyair Rlapara 14.10.44 00.01.10 11 IttlMI Pattataaa IS.01.4t 02.0S.49 Pa 41 SO . IS 20 IS llekarl 01.It.II occ Uwr4 ClaaPaata S Ourlr 11.13.41 IM OO.OS.74 SI SI IS I4.0S.70 19 S2.OS.49 24 17.04.M Yaa Yaa Yaa lap 1 RlSh 10 |ii 10 yra aa Utility 4 raactar ap. Saralca ap. (aat claaaar Hi**' - aaparata Dtyar ap. raw claaaap Strlppla* ap. aotaclavaa) S yra prior aarvica la lyre plaat Ml 1 V lattar f 24 Aptll I97S froa aaaall A Park to J T Raawell at MCA 1000 pp. Charlaatoa Rally Hall 2I.7.7S 14 Mvar 4lapaama4 aa anflaaarcnaa at llvar. lalara' attoa Rlvaa la lector 12 Nay 1904 froa i A Salp. IS Accewaiautl ABL - Mo aai- feace af VCN espoewre. 66tenan PH* 24 IHTMIAL CHEMICAL IHMMT9III9 fLC IU ttiiU LIVtl ili|tMrtau Cimi - (laflw Dalai I Jaa 1904) I 2 i 4 1t 1 9 10 II W Syataa at data# mv - Mount - mi WI/A5L_2 - MMCIOCMIt.il 12 11 14 19 14 cmwnv m iiruuci DO ium oa IIITUli hip of inn ' ODMTUn fAcrar > mrr vc MTK Of irosMB 0IMMO010 ACC AT 01ACN09I9 VKAtS 09 IIN1NI TO iiAcmsit VMM or UNMIOI OATS or MATO HISTOLOGICAL OONTtMtATIQM ESTIMATES 1IVOAUU UCViL OCCHPATIOM 0TH2I CMHI MICML1CHTA OTHEt onworra 51 1* Jaaaa Itvart 04.11.2* 90 Laalavllla 0.01.10 00.00.49 41 19 11 tMUllw 94.09.71 DM Laalaall la 21.04.11 11.10.74 41 19 It OMilla 22.04.It M Irikw Avaa Laka 11.09.94 00.00.71 4A 21 11 Ull DO.00.1) KC Chrlatlaa 1 Cbarla- 00.00.41 UH 19.04.79 AO 12 2* 11.00.17 Oaafyaar Ua|l 00.00.19 10.01.74 Chaatar 02.09.91 HCC HlaMa Cfcaila- 0D.U.44 ataa ail? 77 90 47 21 04 2 7,01.49 Vaa 1951-4 VCM palyoaclaatlaa fioa 1954 Tahla 4 la aawatda la Uaaaaar Arajr aaA atbar Taadaaajr to aarvlca. 0 Baaata 44-90 Araj CaaficaaA la M H Jahaaea Ur 07.00. 70 Taa | 14.10.90 ea II.10. 74 fcwt M HW-iaHM 14.10.00 Dr H N Johaaaa lattar at 24.7.91 eouIlnM hail 4 yaari altar Jlaaaatia 11 02.11.71 Vaa 17 r aataclaaaar t |>r# a* btol Tjrra Otara plaattciaai 4 CailoMt aparatla* OMilnM la H R JaOaaan Itr 07.09.70 Alaa tollla* Otaaa 19.01.74 12 04.04.74 Vaa 2000 DM Wllllaarport Saa Carat la 21 Jaaa 1979 Charlaataa llr Hall 21.7.79 19 90.01.74 Vaa MlOSH iaitar r 21.10.79 22 92.01.77 Vaa 20 yra with HCC at K latlraJ Hawa ralaaaa 13.2.77 ooae^tin Pat* Hi Bmt 4 ihpuial cnmical itammua plc LIWU ta|iH*rcH< Ca**a - l*(ii 1 Jm 1V44) UK apataa of ittn MY - HOWTO - tui UPX/AAI._2 - UMUIUCAUS.30 t J 4 9t 7 10 11 12 11 14 ll 14 00UKT11 AM IDMKt a gsA MM OK IOIYML* Mil OP min awui PACfUOT nut vc KIPOMtt ATt or OtACNOttt act at OlACWSIt CAM OP tipotnu to OlABHMlt YKAM OP BKPOKUtt OATI OP OKATO MT0UW1CAL COMlWiATlOM OTldATU tirotutt LtVIL OCCOPAtfOO Hi OTWt CB0HHTI >a M.1U) MO Laala- 11.11.4) 00.01.7* 92 > illa 1) 557305* Otaat VIUMMfl 0t.0V.9l UlM'. n " M iatclcu Hilt. Chaaieal CMwata !i Charlaa 17.H.I9 Wf f Aarla- 11)9 1/.05.77 U Mmi4 ttaa Haara il )l W) taoi al tram raj atar aaafj ra4 1* 1 1 aalaaht lat ar *f 9 K**i bar IttO ______ ______ ______ _______ _______ 20 S4.I2.74 Yaa u 04.04.71 1 Yaa Loalaallla tloaa 24.1.7* aid ha waa tha 10th At aictlo at alia Laaa af has 1 had diod bp 74.1.74 la hi a lattar af 14.0V.41 r N Jahaaoa coaflraa Ihla la tha eaaa daacrlbad bp Oaaaahar Yaohurra 4 Vao la Pab IV80 ta J Madlelaa Pol 70 a240 (MOON 71 I4> FT.607' Oalaatla- aarcaaa <R KaalaaAl 24/2/7V) Mt to high tor 14 rn mun - TO'm.' aalaaot of/ |M oa >t|I ratio laboarar It ad IIH-41 m, tiaparatoo Ma baaa lap! raalaa aspaaat aa Mi* flrat raaccar aa flttar alaaaar balpar, tbaa mi bacaa. abllc abtfl fitlar NIII17 aa* 1944 bacaaa ahllt y|illl7 aaa 24.04.45 aaplopaaat taralaatad 0 N Mtaaiar lattar af lt.t.77 to 1 Stafford alvaa datalla aa Caalaakl lattar af ffisr- (1 Par IVtO) aaggaata that MIOtH vlll r.tala aa ragl atar al.ira thl# aaoplaaa aap ba iimcI* atad with ASL. to Whaalar lattar af 20/2/7V aad laaa Kaolaski laltara af vm - 1 V08SV IbH  ft M g =1 * -si ill sm ft | * v- :iri> i ft m fmt' fmt --i ft* m aa si -!. j'ltisU h *: !fftt :tfot^.ttoo Uii 1 2- -::62S.s " Si. -3:3 1ft ft 3.t3oft . -88 . a 8 - ' 5 Soj S* SU* to ft ft ft to ft to ft ft ft :,! 3 to 4 2 3 3= l<|k g a S2'.38*"3-2 9H i s; 2I5 .* IH 2 2i; 3 to 2S1S f SI 2: :6^82236t hiL !,,:! eh if hi tStoo fit His ill Hl=s! H 2ft Jf1t tfo.t 1fftt :to8tfot 3ftot .tfot li.Sfij. m3f2t f.t !to 111! 3s. ill il ,? 5 slj 11- I s- zi Hsiis i s.s S' 31 S3 2 S5%i M8 8 fftt ft fffttt fftt !i a * i * ft 8 1=5- Iss 5*- , = ! -'SStoSljf -Si 12" ft. fchj 8 1*-.!! * 3 b 2: z s:i:24SH; ii tf%ot z si % s to to B B B 3 S-- ft fftt S Mft M -i li BS~.. ft -- s u:. ft 53 322 fc* hi ft Hi wft ft ft ft n *1 a %* * fi " 3 ft ^3 m 5? C3 ,, | ft ft st4o o* *.*.5 <- 2 S5 8i:?i ft o ft k 1? ! ill r i 5 ft it 1 3s 8ft .0 - |ls a e ttoo i 1ft ft 8 * 1! fftt s PtoW fftt f* a B B to M s 38 3 i fftt S ft s 6 s S 8i V lk ".: 68 168: il r i ft ft to B 8 a # s V ll ll s S3 86 l ft ft sa to N ft to toM s 8 to Pft fSt fftt ft HM A to URL 1380 ro rw 1/ tWIUUL CHEMICAL MUMTIIKt A (KITES WA HmI * LIMB ta|li>rcM CiMa - (htlM Betel 1 Jaa l*4> 2 2 4 24 7 4 1-------------------4 10 11 IK tyda at 4tt* Ml - MONTH - (Ul WPI/ASL_2 - LAMGIOCAMa.32 12 12 14 12 1* coumi AM >!>Mum MO HIM! 04 INITIALS SATt or urn COHTin TIC1M1 1 TIMT VC uposum MTS Of OlAONOOti ACI 4T BIA6H04U mu or CIPOMMK 10 OMSMSII HAM or Ait or IINMIU MAIN RI41QLOOICAL CONMIMATIOH ESTIMATES IlfUSOBI um OCCVTATIOH OtHKB CAACM HifiMLuam OIHM COMMCNTS i M MS 22 C If Olcaa* kMNU prUftlel 1 12-10-21 Naaa 00*07-79 71 II IS B lC|MN 04-14-11 Jar IK i LmImIU 4-00*2* U-42-C2 2* Ht 24 Nr IpCMi 24-41-24 MO Laalavllt 1422 01-11-12 40 US 22 II M 94-02-12 HOC 1 darlr >2-07-44 taa 10*07-0) 71 22-40*22 11m Oeaaral Aebtab Tlra Mi laMar Oa la 11-40-24 11-00-02 24 II 20 17 24 >1 14 (la rvc aotaclaaa eras) 17-02-01 lA MlM) aea 4aaa aaA larilUw aaaaa af Saath |1m aa 'Aalaiarrnor Ike Oaatb 1440-14)1 certificate lerleaa Jake lava la p*lpr Mr Cl rear' eaufaetere aaaal vrrAi eceapat Im LMITtM kettle 14)1-1444 epareter ' Tarlaaa Jake la la Mi 'MmIi ereoeJ P*C Irlmrf i ewtaclavae 1444-1472 Variaaa elarleal Jaka la TVC alfMrriaall * facility/ Mllrfi oi-oi-d. MfMUIlt* flvae la latter at 24 1441 Iraa Or HMUar C laraae af IfeMMir SprlaffUla ta Sr A Naaa at Haaaaata aropa. 21 Alta* taa NaktlpSe lacl4la| Talf Operate* a Prat Taaburre altar af II lag 1401 V Sr H H Jahaaaa latiar of IS Peb 1442. 10 24.04.01 a* Pair Operator Aaraclava Claaaar 14)2-42. 14*2 uit arc to kecoaa a Clara/aaa. Dill Jataaoa latter af 2 Nav 1411, 14 reb 140 Mi 1 Aug It*. 14 10-07-13 laa Ml|h Iraa 1444 |a 141). Ntllia Iraa 1411-1111 Sr Saeay latter ol 2 Sapr 1443. 17 Alive lee HsOerata 1424-2* labourer 1424-27 P*a4 kelper 1427-70 epereter 1470-72 electrlcleo 1472-praaaal operator V Uiairit latiar af 12 lapt I4l)i apattaA at aaOlaal my 11*2. Tasilas ceaaeacaO my 1441 E08entin * 2* IU fthaal 7 umui cmknical itauanni unite* LIVER ta|l*wrc*u CiMa - < BavJav lain I Jaa 1984) IK ifitw at ftata MV - MONTH - tUt WI/ASL_2 - UNBI0CACES.13 a 3 4 ft ft B ft 10 11 12 13 14 14 l 14 GOBNTftf ANN ItffMMCI 0 NAHf OB INITIALS MVK Of tun coffin ncmi nuT c UPOtUKB MTC Off BIMN0B1B act at siAcmftis (till Off EIFMOBE TO BlftCBOftll VKAIS OP (IffOBUBB am or MATH NISTOUMUCAL CONFIRMATION CBTUUTKO XPOSUII um OCCUPATION OTNU CABftXt ICHLIGNTa OTNU OOHMUTft n at Hr i tl oft 71 BW Uala- IU) 04 08 ft* M ft) u 04.0ft.84 Vaa Hlk Warfcaft larlM villa rtl*r)ff la PVC araa. la tfta aaflft lira waa 1 raactar claaaar 1992-73. lalaiaillaa 11vaa la lattar M.0B.B4 (com ItRl Joftaaaa M M Jilt at ax Ur Galvaft BB.B2.ftft lft.0l.B4 tl 20 20 2ft. 10.83 Taa NlBk sal pear- Praftaata ttlr 19ft1-1*82 liaaalw fraa kalpar la aaalar aparatar, alaaaaft raactara, Miippm Ml ncnair araaa aa Mil aa cknilni paratar- TfcroaBa ftopaala aaA lnAfali alaca UJft. Bill KMIMai tar actlMCItla 1*74. IMr Dr* a eara Imi ft aaalka katora IimI, ftaft paaaaft ataaftari rh}aUal aiar laatiaa > aaatha arllar. J Barf latlata ( 22.10.84 4 23/01/83. rag* it fOBOOLAVIA tHTSBIAL COSMCAL INOMTSlBS HX C*Hf (ItflM lalii Jaa I1M) UTI/ABL 2 - LUCIOOKI.U 2 2 4 2A 1S 4 10 11 12 11 14 11 14 coomi AMI ssrpuct KB AMO OS IOITIAU mti or INTO CGMPAM TICNOT riUT re An or nmMi IAG40S1A AOS AT 4IA0MM1S TSABS or KIMAIBI TO BlACOOOIS TSABS or EXPO!MU OATS or DSAIW NllTOUKtCAL COOriRMATIOM K9TIHATS4 Kiroswi LEVEL OCCUPATION onus CAOEEO HIGHLIGHTS OTHES CooMirrs INOMLAflA 02.04.14 00* fill 0.04.2) 01.04.7) 24 20 20 01.04.7) Va* Vlall ASK at al papa' a* laaltfc rarapactlva Val 17. FT !*- 1474 2 Uiu 44.44.24 12.41.72 41 22 IS 12.07.72 taa* lllU 0) 21.12.21 Jaga rut 44.04.24 11.01.74 42 If 22 11.01.74 Taa* llill rai PraAactlaa rn PraAactlaa *la Mi lattat af 3 Oct 1470. ftr Splrtaa of HtOOS cfcaataA Ika tatwa af Caaa 02 ta VCH praAactioa aaplapaa. Or Splitaa alaa aatlflaA a aaM Caaa 02 alaa a TON proAwctlaa Marker 04 ll.M.M lai Uiii ISiltrSI 02.04.71 44 20 10 02.04.70 Taa Hall % Boaa SaalaaM Lattac af I4tk JM 1110 aai IAIC lattat af 1 April 1*12 soetv^n x o00 MO^oOQNHONOO^ininNfi^oinMH 03 54 u u pH 4 pH 44 O hH 4 o 0 b B4 64 4 8O J= s > t_> pH u XA 4 4 pH C3r~3 c<o3 CD 4 1 4 H (a. 4 pH 4 A S O X c4 4* hH H A <n X > p> *1 r* o 4 03 M 1=PH -c tS 3 3 IPH wV4 4 9 4 * T3 X49 9 4 H --t U 4 C/3 B e 3 PH e m 4WW hH 4 O 0 *o B B 49 J pH 4 4 H PH 4 4 4 4 BOO *J O H T3 o 1 pH pH pH ph 4 4 4 xn u ww sOO O > hH w u +* 03 U oc r*. r- o> cs 00 os ft <e Os M 03 < u hh pH o a V o V X V X 4 X H (J 2 o H H JH 5 "4 <n o i rtnNe\Co^Nn Os O mhoeOMNn<fmNao>>Nn4in Pte go O' Os <-(Jfl M In c id e n c e o f ASL Cases P e r Annua Page 31 Distribution of ASL Cases by Country TABU_________ 2 (Review Date - 1 Jan 1986) USA W Cereany France UK Canada Sweden Yugoslavia Italy Czechoslovakia Japan Belglu* Norway 35 *** 26 ** 18 *** 11 10 5 **** 4 ***** 4* 2 2 2 1 Total 120 * OnIt ItOl - atypical case of PVC bag extruder. ** Includes GE03 aerosol can filler. *** Includes case US 24 which was dlagnosad as Cholangiosarcooia 6 US 33, **** includes one aonoarr worker. ***** includes two nonoaer workers. and 36; and P 15 who are alive. l.e Western Europe North Aaerlca Rest of World 67 45 8 WPX/ASL 2 - LANGIOCASES,36 Total 120 i.oeenn I Pattern of ASL Cases by Factory TABLE 3 view Date - i Jan 1986) (a) W Europe Of the 67 caaes In W Europe, 57 have occurred In dusters at 11 factories. Of the 26 German cases, 23 have occurred In clusters at 4 factories. ASL Cases Dynamic, iTrolsdorf, Germany Chios Chinie (Formerly RP), St Pons, France BP, Berry, UK Wacker, Burghausen, Germany Kemanord, Sundsvall, Sweden PCUK, Brignoud, France CWH, Marl, Germaoy 1CI, Hillhouse, UK Solvay, Tavaux, France Lonsa, Ualdshut, Germany Solvay, Jeneppe, Belgium 11 8 8 7 5 5 3 3 3 2 2 5T NB: There are 32 pre 1962 PVC plants In W Europe; 18 of these have had ASL cases (Ref Table 8) (b) N America Of the 45 caaes in N America, 38 have occurred at four factories out of a total of 54 factories:- In N America 43 plants have not had ASL cases. ASL Cases BFG, Louisville, US BFG, Shawinlgan, Canada UCC, S Charleston Goodyear, Niagara 14 10 10 4 38 NB: There are 28 pre 1962 PVC plants In N America; ll of these have had ASL cases (Ref Tables 9 A 10) (c) Rest of World The 8 ASL cases are believed to be In 1 cluster of 4 and 2 clusters of 2 cases. WPX/ASL 2 - LANGIOCASES,37 8Q8VW Page 33 TABLE 4A (Review Date - l Jan 1986) Latency Periods (Tears from first Exposure to Diagnosis) Country No of Cases Total Years Average H Europe Belgium 2 35 17.5 France i Germany IS 459 25.5 * 26 495 19.04 * Italy 6 74 18.5 Norway 1 22 22 Sweden 5 122 24.5 N America UK 11 254 23.09 * 6T 1461 21.80 Rest of Uorld US Canada 35 886 25.31 10 204 20.4 * 45 1090 24.22 Summary Csechoslovakla Japan Yugoslavia W Europe N America Rest of World 2 2 4 8 67 45 B 120 30 39 85 154 1461 1090 154 2705 15.0 19.5 21.2 19.2 21.80 24.22 19.2 22.54 Of the countries with > below world average. WPX/ASL_2 - LANGIOCASKS,38 caaes> France, UK and USA have an average latency period above world average, Gernany and Canada 608nun  > <futo>at JwUeV(0 <--cuoVQu -ft m ft o in m * m ON <n CM pH CM IO m CM 0pNH CfpO pH CM CM -o CM cn (M m CM CM MT inft CM CM HumO cm O a<M N n A a cm 00 ON fa n A to DISTRIBUTION OP LATENCY PERIODS TABLE 4B WPX/ASL 2 LANGIOCASES,39- cu-' OJ CO fa a o o ofa 3o Ve Page 35 TABLE 4C (Review date 1 January 1986) LAfAwCY_PERIOD OF ASL CASES TABULATED BY YEAR OP FIRST EXPOSURE MAX POSSIBLE LATENCY PERIOD YEAR OF FIRST EXPOSURE LATENCY PERIOD (NO OF YEARS) ARITHMETIC MEAN OF LATENCY PERIODS 47 1939 38* 46 1940 45 1 37,21,37,41 44 2 32,38 244 - 34.86 ~r 43 3 $8,14,32 4 28,11,24,20,24,34,39 718 - 26.59 5 27,22,28,29 "27 6 21,29,31,26,28,15,23, 30,35 39 7 29.24,29.28 38 8 28,24,34 9 1950 30,26,20 26,22,31,19,23,14,33 458 - 24.11 IT 1 19.28,17,28 34 2 21**,15 33 3 25,42,23,22,20,31,22 4 21,21,25,25,21,28***, 22 725 - 21.97 5 22.23,24,14,19,21,27 "37 27*** 24,28 6 21,12,27*** 29 7 19.17,15.13.16,28 28 8 18,18,15,17,20 9 16,21 368 - 16.73 1960 13,18,21 22 1 15,16,16,16,19,19,12 24 2 13,18.17,12.18 23 3 16,17,20,21 4 16,17 180 16.36 5 11,19 11 6 9,18 19 7 16 18 6 9 13 13 1970 VIOLA 14 2 ii 3 4 TOTAL 126 CASES MALTON1 GOODRICH 2706 - 22.55 ' * Cholanglosarcosa ** Aerosol can filler *** US33 and 36; and P15 still alive. WPX/ASL_2 - LANGIOCASES,40 URL 13811 TABLE 4p Page 36 (Review dace 1 January 1986) LATENCY PERIODS OF ASL CASES TABULATED BY YEAR OF FIRST EXPOSURE AND GEOGRAPHICAL LOCATION '' MAX POSSIBLE LATENCY PERIOD 47 46 45 44 43 39 38 34 33 29 28 24 23 19 l6 YEAR OF FIRST EXPOSURE VIOLA 1939 1940 1 2 3 4 5 6 7 8 9 1950 1 2 3 4 5 6 7 8 9 1960 1 2 3 4 5 6 7 8 9 1970 LATENCY PERIODS IN WESTERN EUROPE NORTH AMERICA 38* 37,41 38 28 27 21,29,31,33 29 28,34 30,26 26,22,31 19,28 21** 25,22,22 21,21,25,25 22,23,24,27***24,28 21,12 19.17,15,13.28 18,18 16,21 13,18,21 15,16,16,16,19,19 13,18,17,18 16,17,21 16 11,19 9,18 16 21,37 32,38 14,32 11,24,20,24,34,39 22,28,29 26,28,15,23,30,35 24.29,28 24 20 19 17,28 15 23,31 21,28*** 14,19,21,27 27*** 15 12 12 20 17 13 ROW 23,14 2i,i o 22 16 17,20 2 MALTONI 3 TOTAL CASES 6? 45 8 * Cholangioaareoaa ** Aerosol can filler *** US33 and 36; and F15 still alive WFX/ASL 2 - LANGIOCASES,41 TABLE 4g Page 37 (Review date 1 January 1986) PLANT START UP DATE LATENCY PERIODS OF ASL CASES IN SPECIFIC PLANTS (10 OR MORE CASES) NO OF CASES AVERAGE LATENCY PERIOD LOUISVILLE USA SHAWINXGAN CANADA S CHARLESTON USA TROISDORF W GERMANY 1940? 1941? 1939? 1954 12,14,15,19,19,20,24f27 f28,28,28,29,29 31 11,12,14,21,22,23,24,24,26,28 24,30,32,32,34,35,37,38,38,39 12,13,16,16,18,19,19,21,23,25,28 14 10 10 11 23.07 20.5 33.9 19 .09 WPX/ASL 2 " LANGI0CASES,42 Page 38 TABLE 4g (Review dace 1 January 1986) LATENCY PERIOD OP ASL CASES TABULATED BY YEAR OF FIRST EXPOSURE AND SPECIFIC PLANT (10 OR MORE CASES) YEAR OF FIRST EXPOSURE 1939 1940 1 2 3 4 5 6 7 8 9 1950 1 2 3 4 5 6 7 8 9 1960 1 2 S CHARLESTON USA LOUISVILLE USA 37 32,38 32 24,34,39 30,35 20 28,29,27 29.28 ik 19 15 31 28 14,19 * 12 SHAVINICAN CANADA 21 14 11,24 22 26,28 24 23 12 TROISDORF W GERMANY 21,25 23,28 12 13 16,16,19,19, 18 URL 13814 WFX/ASL_2 - LANGXOCASES,43 Page 39 TABLE 4G (Review dace 1 January 1986) PLANT START-UP DATE LATENCY PERIOD OF ASL CASES NO OF IN SPECIFIC PLANTS(4-9 CASES) CASES AVERAGE PERIOD SUNDSTALL SWEDEN 1945 16,19,27,29,31 5 24.4 yeare BRIGNOUD FRANCE ST FONS FRANCE 1950 1939 11,16,18,26,30 21,28,29,37,38,27,41,35 5 20.2 8 31.88 BARRY UK 1948 9,17,18,28,31,33,18,19 8 21.62 BURGHAUSEN V GERMANY NIAGARA USA 1933 1947 17,21,22,25,24,13,21 15,17,21,23 7 20.43 4 19 SPLIT YUGOSLAVIA 1941 20,20,22,23 4 21.25 WPX/ASL 2 - LANGI0CASES,44 Page 40 TABLE 4H (Review date 1 January 1986) LATENCY_PER10D_0P ASL CASESTABULATED BY YEAR OP FIRST EXPOSURE AMD SPECIFIC PLANT (4-9 CASES) YEAR OF FIRST EXPOSURE 1939 SUNDSVALL SWEDEN BRIGNOUD FRANCE ST FONS FRANCE BARRY UK BURGHAUSEN NIAGARA W GERMANY USA SPLIT YUGO- SLAVIA 1 2 3 4 5 6 7 8 9 1950 1 2 3 4 5 6 7 8 9 1960 1 2 3 4 5 6 7 8 9 1970 1 2 27* 31 29 19 16 26,30 37 38 29 28,34 21 18 16 11 _ 31,33 28 25 21 22,24 17 21 18 17 19 18 13 15,23 23* 17 20 22* 21 20 - * Monomer workers VPX/ASL_2 - LANGIOCASES,45 Page 41 TABLE 5 (Review Date ~ 1 Jan 1986) Annual Incidence of ASL Cases (Date of Death) by Geographical Area 1955 i 1961 2 4 7 8 9 1970 1 2 3 4 5 6 7 8 9 1980 1 2 1983 1984 1985 TOTAL t Western Europe 1 1 l 1 4 1 i 6 6 6 1 * 6 i i 6 4 2 North America 1 1 1 l l 5 2 1 2 1 4 2 4 r T 2 4 0 l 3 1 J3** Rest of World 1 3 1 i i! - - -' 8 Annual Total 1 1 1 1 2 1 5 3 2 3 5 8 5 11 ll 9 10 5 10 5 2 9 5 2 117 Cuaulatlve Total Key Events 1 2 3 4 6 7 12 15 17 Viola 20 25 33 Haltonl 38 Goodrich 49 60 69 79 64 94 99 101 110 115 117 Includes G03 aerosol can filler but oalts It 01 bag extruder ** Does not Include US33, and 36; and F IS* All still alive* WPX/ASL_2 - LANGIOCASES.46 ^8nan ?age 42 TABLE 6 (Review date 1 January 1986) ASL CASE NUMBERS BT YEAR OF DEATH AND GEOGRAPHICAL LOCATIONS (EXCLUDING IT01) KEY EVENTS WESTERN EUROPE NORTH AMERICA REST OF WORLD Viola Maltonl Goodrich 1955 6 7 8 9 1960 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 1980 1 2 3 4 5 Total FI G1 Swl G2 NUSw2.UKl.lt2 G3** * G4.G5.UK3 l03G6C7,G8,It3 B1 ,F4,F5 ,F6 ,F7 ,Sw3 F8,F9,G10,GU,C12,Sw4 F10.F11,G9,G13,G15 C16.G17 F12,F13,UK4,UK5,G18 UK6, UK7,G19,Sw5,G20,G2l It4,F14,UK8,G22,G23 G26 UK09,It5,Fl7,B2,G24,G25 UK10, F16, F18, G27 UK11. OKI2 66 Cl C2 OSS C3 US5 Cr2 C4,C3,US4,US7,US10 US12.US16 US11 C6.US2 C7 C8.US1.US3.US23 C9.US13 086,089,0818,0826 US19,US20,US22, C10,US21,US24* US27.US28 Tl.T2.Csl Japl Jap2,Y3 T4 US17, 0S29, US30, US3. ! US31 US35. US34, 0S38 OS37 43*** 8 * CholangloaareoM ** Aerosol *n filler *** Doss not include US33, and 36$ and F15. All still alive. URL1381B WPX/ASL 2 - LANGIOCASES,47 Page 43 TABLE 7 (Review date 1 January 1986) ASL CASE NUMBERS BY YEAR OF FIRST EXPOSURE ASP GEOGRAPHICAL LOCATION (EXCLUDING IT01) --^ KEY EVENTS WESTERN EUROPE NORTH AMERICA REST OF WORLD Viola Kaltoal 1939 40 l 2 3 4 5 6 7 8 9 50 1 2 3 4 5 6 7 8 9 60 1 2 3 4 5 6 7 8 9 70 1 -2 i Frll,Frl6 Frl4 UKl Sw2 Frl,Fr3 Sw4 Sw3 Fr9t Frl7 Frl2,Fr4 Fr7,Nl,UK8,tJK9 Swl ,UK5 G3** G15,It3,G26 G7 ,G8,UK4,G19 Gil,G16,G18, Frl5*** G23.G28 FRIO.Gl Pr8,G4,It2,G2,UR12 Tr6,B1 Fr2,It4 G5.G13,G25 G9,010,612.017.G20.G22 G6,UK6,G2l,B2 Frl3, UK7,Frl8 Sw5 FrS.UKll UR3, UK10 It5 G24 US24* C3.US27 US13, 0S29 C2.0S19 Cl tC5 ,DS5,US7,US28,US35 C4,US3,US9 C7,C9,US8 ,USU ,US21 ,0S3l C6.US22US26 US1 0S12 US16 Y2, C*2 US10, 0S32 USA CIO, US37 Japl,Y1 US18 ,US33*** T3 US2.CS17,US20,US34 US36*** US23 Cal Jap2,T4 C8 US6 US38 US30 Total 67 45 8 * Cholanglotareoma (US24) ** Aerosol can filler (G3) *** US33 and 36; and Fr 15 are still alive. URL 13819 W?X/ASL_2 - LANCIOCASES.48 Page 44 WK/ASL_2 - LANSIOCASES.49 (Review dace 9 January 1986) TABLE 8 WESTERN TOCTE PVC PBOXJCZRS ~ STABX^IP PETES y ASL CASES (CHTTEDC G03 & It.01) URL 13820 START-UP COCNIKT NAME CCHPANY N YEAR 1931 West Genueuv BASF LOCATION Ludwigshafen ASL CASE -UMBEL YEAR OF 1 1st Exposure i 1933 West Germany Wacker Burghausen 04.07.11.15.23.24 25157.54.55.53.55.69.601 1938 Italy tontecatlni Acna 1939 France Rhone Poulenc St Pons 03.09,10.11,14. 46.48.56,41,43. 15.16,17 35,41,46 1940 United Kingdom ICT Runcorn 1940 United Kingdom ia HUUouse 01,04,12 44,54.57 1945 Sweden Kemenord StndsvallCStockvik) 51.45.47.46,64 Switzerland Loaza Sins 1946 1&7 1948 France Khonc-Poulanc Italy Mrotediaoo United KtnorVTM BP Cham ftxmillcn Porto Marghera Barry 01 02 46 57 66.51,62.63.50.50 10.11 !<*. West Germany Marl 09.10.26 !61.61,53 1949 Belsdm Solvay Janeppa 01,02 58.62 1950 France Puk Brianoud 02,04.05.06.12 59.49,65.58.49 France Rhcne-Poulenc St Aubsn oJ 50 Holland Shell Persia Norway Norsk Berova 01 So 1951 Italy Montedison Brindisi 1952 Italy Montedison Teml 1$55 Austria Halvic Halleln France Italy Solvay Solvay Tavmnt Ferrara 08,13,18 65 57.63.63 55 Spain Rio Rodmo Hemeni ! United Kingdom BIP AvdLiffe Wbst Germany Hoectwt Ggjdorf 18 55 1954 i West Germany Dynamit TruLsdorf 01,02,06,12,16, 1 56,57^,6135.61, 17.19,20.21.22.27 54.61.62.61.55 1955 Spain frfcnsanco Iberia Monzon 1956 Spain Caiqsa Sabinanigo Hlspevlc Torrelavega 1956 West Germany Solvay Rhelabarg 1960 Italy S C Ravens 1960 West GsrxDsny Lanza Ravenna Waldstut 64 06.13 1 56 ! 627S5 1&2 Portugal Clres Oporto 1965 Franca Bhone-Poulanc Mantlucon Italy Fozzi Ferrandlne Weat Germany Wacker Cologne 1966 West Genanr H06SK KnapaackCFrankfurt) OS* 60 1967 Franca A30 Qdaie Bel an Spain Rio Rsdano Miranda da Ebro Greece 1968 Belaiifl Eaao Pappas Badiphil Dlavata Salonika Antwerp i 1969 United Klwden Vinataz Italy Riwfenr* Staveley Cagliari Sardine 1 | 1970 Italy SIR Porto Torres Sar United Kingdom ia Runcorn 1971 Italy S C Havas Ravems Spain Hlspevlc Martorell Sweden Kanenord Stamngsind United Kingdom ff Cham Bag!an Bay 1972 Flnlari Pekena Svartbeck Holland E6M Bfidt Limburg 1976 France Soc Art D'vlnyl Mazingarbe 19^ Spain Maneante Iberia Tarragona * Laboratory worker in P* --arch Department PA16AC, Mira Venice, caee not J^-i***-- (it 05), due not knowing start up date of the Plane. Page 45 TABIE 9 (Review dace 1 January 1986) USA P?C PRCPPCSS - START-UP DATES v ASL CASES SIAKIH3P OCMPANY Ntt YEAR 1939? *uoc LOCATION S Charleston ASL CASE YEAR OF NUMBER 1st exposub 07,13,19,21,24, 44,42,43,46,39, 27.28.29,31.35 41.44,42,46.44 1940? *BEG loulsvllls 01,02,03,04,05, 48,55,45,52,44, 06,09,16,17,22, 62,45,50,55,47, 26.33.34,37 47,54,55.53 1946? *UCC Texas City (Partially closed 1977) 1$4J Goodyear Niagara Falla 08,10,11.20 46.5l.46.55 i44a Firestone POttStOMQ 12 Unlroyel Palnesvllle (dosed 1975) 1950 Monsanto Springfield 32 5T (Closed 1975 1952 Dow ttldlad (No PVC since c 1975) BEG Avon Lake 118 54 1953 SPG Deer Park (Formerly Diamond) 1954 General Tire Ashtabula |36 54 1956 Air Produces (dosed 1984) Pensacola l Atlantic Refining Brooklyn(dosed late 1960s) Bordei Leominster (dosed 1984) Conoco Bebtoctvllle (dosed 1975) BEG Niagara Great American Fitchburg 25 58 Plastics (dosed 1983) Hooker HleksvUle (dosed 1980-81) Pautoeoco Paaalac (dosed 1984) 1957 Atlantic Tubing Cranston (dosed 196?) Teineco Flaaingtoa NJ 130 59 1958 Kevsor Century Saugus. Cal I960 BEG Weteon, Cal Air Producta Calvert City ;38 63 (closed March 1982 Da opened Octalter 1963) Borden 1962 Tenoeco Burlington SJ 1963 Couoco Aberdeen. Miss Stauffer Long Beach. Gal (dosed 1962) 1965 Conoco ** Assonet. Mbss (dosed by OUn 1975. see below) Ethyl Baton Bourn (Closed 1984) 1966 Oorrla Gulf Dalwmra City (Formerly Diamond) | General Ttre/Pmcaa It Pleasant WVa (dceed 1963) 1 BBS Henry. Ill _______J________ Stauffer Delawsge City (Sold to Formosa 1983) 196? Allied *** Palnesvllle, 0 | (sold to Robintedi) Hooke Burlington NJ 1 1968 Firestone Perrwille (Closed 1982) 1969 BEG Pedrlckton NJ Goodyear Plaouemine Olin ** Assonet, Mass (dosed 1975) (See above) 1971 (Formerly Conoco) Oklahoma City Conoco | 1 URL 13821 WEX/ASL2 - UK3DGASES50 Continued TABLE 9 (Continued) PSA PVC PRODUCERS - START-OP PATES vs ASL CASES START-UP YEAR 1972 1973 COMPANY NAME Nat Starch Borden Roblntech *** 1974 1975 1979 1983 Atlantic Tubing/ Tallvrand Shlntech Certain-teed Georsla Pacific Tenneco Firestone Formosa LOCATION ASL CASE NUMBER Meredosla. Ill Springfield Painesvllle, 0 (sold to Georgia Pacific who converted to polystyrene) Cranston RI (ClosetH552) Freeport, Tex Lake Charles Plaauemine, La Pasadena, Tex Plaquemine Point Comfort, Tex YEAR OP 1st EXPOSURE * My databank hae no information on UCC before 1946 or BEG before 19S0 ** Refers to same plant at Asaonet ***Refer to same plant at Painesvllle. Allied plant never operated again for PVC after it was sold to Roblntech. NB Some of the plants In this list were closed down, soma have changed ownership over the years, some have changed their product* WFX/ASL 2 - LANGI0CASES51 Page 47 TABLE 10 (Review dace 1 January 1986) CANADIAN P?C PRODUCERS - START-UP DATES vs A.SL CASES START-OP TEAR COMPANY NAME 1943 (1941?) Goodrich LOCATION Shawlnlgan ASL CASE NUMBER YEAR OF 1st EXPOSURE 01,02,03,04,05 44,43,41,45,44, 06,07,08,09,10 47,46,61,46,53 1951 Monsanto La Salle (Closed 1! 75) 1957 Goodrich Walland 1966 Esso Sarnia 1979 Diamond Shamrock Alb Fort Saskatchewan URL 13823 WPX/ASL 2 - LANGIOCASES ,52 Page 46 (Review date 1 January 1966) TABIE 11 EASTERS BLOC PVC FACTORIES - START-UP DATES vs ASL GASES START-UP COUNTRY NAME COMPANY NAME TEAR Pre 1939 East Germany State Comoanv 1941 Russia State Coons 1950 Yugoslavia Jugo Vlnil 1951 Czechoslovakia State Comps 1955 East Germany State Comns T5T6 Rumania State Comps 1957 Poland State Comps Rumania State Comps 1956 1959 1961 1963 1965 196? 1969 19^0 1972 1975 1976 1977 Rumania State Comps Hungary State Comps Rumania State Comps Yugoslavia Ohls Bulgaria State Comps Poland State Comos Russia State Comps Rumania State Comps Russia State Comps Yugoslavia Vlnllolastika Czechoslovakia State Comps Russia State Comps Yugoslavia Hip Rumania State Comps LOCATION Schopau Vladimir et al Split Novakv Bltterfeldt Icechlm Osweiclm (Dvorv) Tlrnavenl Turda Rlsnov Barents Borsod Borzestl Skople Varna Tarnow Dlerllnsk Rlmnicti Vilcea Volgograd Zadar Neratovlce Raluah Area Pancevo Rlmnicu Vilcea ASL CASE NUMBER 01.02.03.04 01.02 YEAR OF 1st Exposure 53.^0.54.48 57.50 URL 13824 WPX/ASL 2 - LANGIOCASES.53 Page 49 (Review dace 1 January 1986) TABLE 12 JAPANESE PVC PRODUCERS - START-UP DATES va ASL CASES START-UP TEAR 1950 T5TI 1952 1951 1955 1956 1957 1960 1964 1966 1$6> 1968 19^0 1971 1973 1974 COMPANY NAME Chisso Corp Ranegafuchi Rag Tekkoeha Mitsui Toatau Mitsubishi Mon Sumitomo Rag Denkl Kagaku Nippon Zeon Toa Gosei Rvo-Nichi Nippon Zeon Nisshln Kagaku Kureha Rasel Shlnatsu Rag Denki Kagaku Ranegafuchi Rag Chisso Corp Tokuvama Seksul San Arrow Ragak Sumitomo Rag Ryo-Niehi Shlnecsu Rag Chisso Corp Denkl Kagaku Ranegafuchi Rag Kawasaki Yukl Mitsui Toatsu Nissan Kagaku Shlnetsu Rag Tekkosha Asahi Glass Toyo Soda 1975 1977 Cantral Kagaku Tovo Soda Unknown LOCATION Minamata Osaka Sakata Nagovs Tokkalchl Kikumoto Shibukawa Rambara Tckushima Uozu Takoaka Takeo Nishiki Naoetsu Ohmi Takasaco Chiba Tokuvama Tokuyama Chiba Mlzushlma Tokuvama Mlzushlma Gol (Chiba) Kashina Kawasaki Sakai Chiba Kashina Tokkalchl Hayatsukl Sakata Yokkalshl Kawasaki Tokkalchl Kashina ASL CASE NUMBER TEAR OF 1st EXPOSURE 01. 02 33. srf URL 13825 WFX/ASL 2 - LANGIOCASES,54 Page 50 (Review date 1 January 1986) TABLE 13 SOUTH AND CENTRAL AMERICAN PVC PRODUCERS START-UP YEAR 1953 1954 l5T5 1956 1960 1961 1965 1966 1967 1968 1970 1971 1975 1976 1977 1978 1 1979 COMPANY NAME Monsanto Mexlca Policyd Geon Do Brazil Elchlor Electrochlor Vlolastlc Induce (SOC Pacamaoga (1967 start up PET Columbiana Carburo De Col Plastlcos Omega Prime* Policesa Petro Dow Polimeros Mex Rico Chemicals Petroplas Indust Reslstoc Huls Brasil Polychem Policyd PET Camacarl LOCATION Lecherla (Mexico) Mexico City (Mexico) Sao Paulo (Brazil) Sao Caetano (Brazil) Capltan Beraudaz(Argentlna) Mendoz (Argentina) Clnco Saltos (Argentina) Paramonga (Peru) ) Cartagena (Colombia) Medellin (Colombia) Mexico Puebla (Mexico1) Managua (Nicaragua) Conception (Chile) St Martin Puebla (Mexico) Guvanllla (Puerto Rico) EL Tablazo (Venezuela) Tlazcaie (Mexico) Cubato (Brazil) El Salvador Coatzacoalcos (Mexico) Camacarl Bahia (Brazil) ASL CASE NUMBER YEAR OF 1st EXPOSURE . URL 13826 WPX/ASL 2 - LANGIOCASES.55 i Page 51 (Review dace 1 January 1986) TABLE 14 AUSTRALASIAS PVC PRODUCERS START-UP TEAR COMPANY NAME Mid 1950 ICI AuaCralla 1960a B F Goodrich Lace 1970a ICI Auatralla LOCATION Botany, Sydney Melbourne Laverton Melbourne ASL CASE NUMBER YEAR OF lat EXPOSURE URL J3827 WPX/ASL 2 - LANGIOCASES.56