Document p18Mb7VNnZ6ryxwowk8eL16w

ICI Chemicals and Polymers Occupational Health Department Hillhouse Site P.O. Box 4 Thornton-Cleveleys Blackpool FY5 4QD Telephone Facsimile (0253) 661632 Direct Line (0253) 661370 Secretary (0253) B61444 Switchboard (0253) 664667 Telex 67483 ICIPLH G Dr H W Dietz B F Goodrich and Co 500 South Main Street AKRON Ohio 44318 USA Your ref Our ref C Chemicals and Polymers P Hillhouse Site JAN 18 1988 Date 7 Jan g8 Dear Dr. Dietz, ASL After the publication of the Doll Report, Dr. W. ten Berge, Statistician, belonging to DSM, Holland, has compared the number of cases of ASL in the Register against the number of cases in the USA, CMA VCM Epidemiological Study, He believes that he has found certain discrepancies and, as a result, wrote to Sir Richard Doll, through Dr. Geoff Paddle, asking for an explanation. I have, this morning, received a letter from Sir Richard, through Geoff Paddle, highlighting the differences between his report and that of the CMA. I am enclosing a copy of the letter detailing the points he has raised. If it is at all possible, I should be most grateful if you could help me to explain the anomalies, in order that I can communicate this information to Sir Richard Doll. I look forward to hearing from you. Kind regards. Yours sincerely. 21248002 B BENNETT M.A., M.B., B.Ch., B.a D.Obst.R.C.O.G. D.I.H., M.F.O.M. enc BFG11600 ICI Chemicals & Polymers Limited Registered in England No. 356535 Registered Office The Heath Runcorn Cheshire WA7 4QF A subsidiary of ICI IMPERIAL CANCER RESEARCH FUND Cancer Epidemiology and Clinical Trials Unit UNIVERSITY OF OXFORD Acting Director E/nerilui Profcitor Sir Richard Doll, D.M.. f.r.5 Telephone (086$) $3 76! 22 December 1987 Gibson Building The Radclifie Infirmary Oxford 0X2 6HE RD/CH Dr G.M. Paddle, Imperial Chemical Industries PLC, Epidemiology Unit, Alderley Park, Macclesfield, Cheshire SK10 4TJ I am sorry not to have replied to your letter of 20.10.87 before but it needed detailed attention and I was very hard pressed to complete a major report for NRPB on the UK atom bomb participants which had to be completed by a fixed date I have now had time to think about Dr ten Berge's letter. He has a good point. I agree that only 20 of the 37 liver cancer cases causing death in the EHA study are in the Registry as having caused death before 31.I2.82 whereas there should have been 29 (though I disagree with one of his numbers -- I identified no. 31 in the Registry and failed to identify no. 29). Approximately G deaths from liver and gall-bladder cancer were expected so that chat that leaves approximately 11 deaths that are either angiosarcomas missed by the Registry, excess liver (or gall-bladder) deaths other than angiosarcoma, or an excess number of misdiagnoses. Any of these might be the true explanation, but meanwhile my confident conclusion that the only tumour of the liver produced by vinyl chloride is angiosarcoma is weakened. Nevertheless the fit with the British, Canadian, and Italian data makes me still put my money on its truth -- in which case a fair proportion of the J1 extra deaths must be angiosarcomas not picked up by the registry. This would be an important conclusion and makes it worth your trying to discover what the EHA liver cancer deaths actually were (nos. 2, 3, 4, 5, 6, 7, 9, 14, 16, 21, 24, 29, 30, 32, 33, and 34). Two of them could conceivably be in the Registry with some wrong information (i.e. 9 Registry no. 32 and 37 Registry no. 19) but I doubt if they are. The other things we want to know are whether: (i) the missing Registry cases came from companies that did not participate in the EHA study (which might account for Registry numbers 12 (though it seems unlikely that Firestone didn't) 23 (Great American Chemical Co.) and 32 (Monsanto), and (ii) what were the certified causes of death of men who presumably should have been in the EHA study and (if liver or gall-bladder cancer) why weren't they there: namely 08, 10, 18, 19, 20, .''.nd 23 (and 12, 23, and 32 if the relevant companies were included). Is there any chance of your obtaining any of this information? With best wishes for the New Year, BFG1I601 "ll'T-A*- Office of lilt Fund. P.O Boi Nn 12?. Lincoln's inn Fieldt. London WC2A 3TX Rrnintned Charity No. 209(01 ~ir 21248003