Document rpZjzOEGaXmZKN4KpX40KVNw7

file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 1 1 SUPERIOR COURT OF THE STATE OF CALIFORNIA 2 FOR THE COUNTY OF LOS ANGELES 3 DEPARTMENT 323 HON. CAROLYN B. KUHL, JUDGE 4 WILLIAM MOLINA AND ) ANGELINA MOLINA, ) 5) PLAINTIFF, ) 6) ) 7 ) CASE NO. BC367800 VS. ) 8) SHELL OIL COMPANY, ET AL., ) 9) DEFENDANTS. ) 10 ___________________________) 11 REPORTER'S DAILY TRANSCRIPT OF PROCEEDINGS 12 MONDAY, OCTOBER 27TH, 2008 13 P.M. SESSION 14 APPEARANCES: 15 (FOR PLAINTIFFS) PAUL, HANLEY & HARLEY BY: KELLY A. MCMEEKIN 16 WES W. WAGNON 1608 FOURTH STREET 17 SUITE 300 BERKLEY, CA 94710-1709 18 19 (FOR DEFENDANTS) STEPTOE & JOHNSON, LLP BY: LAWRENCE P. RIFF file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (1 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 RUTH D. KAHN 633 W. FIFTH STREET 21 SUITE 700 LOS ANGELES, CA 90071 22 23 24 LISA C. RIDLEY OFFICIAL REPORTER 25 600 S. COMMONWEALTH AVE. ROOM 308 26 LOS ANGELES, CA 90005 27 VOLUME OF 28 PAGES 4001-4150, INCL. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (2 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 2 1 2 I N D E X FOR OCTOBER 27, 2008 3 4 VOLUME 5 6 DAY DATE TIME PAGE VOL. 7 MONDAY, OCTOBER 27, 2008 1:30 P.M. 4001 8 9 10 CHRONOLOGICAL AND ALPHABETICAL INDEX OF WITNESSES 11 12 WITNESS DIRECT CROSS REDIRECT RECROSS VOL. 13 WHYSNER, 4001-R 4022-W JOHN (RESUMED) 14 15 16 17 EXHIBITS 18 19 EXHIBITS I.D. IN EVD. VOL. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (3 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 132-20 - LYMPH NODE STRUCTURE 21 4010 22 133 - DOCUMENT 23 3- 24 25 4 - 26 27 28 COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (4 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4001 1 LOS ANGELES, CALIFORNIA; MONDAY, OCTOBER 27TH, 2008 2 1:30 P.M. 3 DEPARTMENT 323 HON. CAROLYN B. KUHL, JUDGE 4 5 6 (THE FOLLOWING PROCEEDINGS 7 WERE HELD IN OPEN COURT IN 8 THE PRESENCE OF THE JURY:) 9 10 11 THE COURT: ALL RIGHT. THE JURORS AND 12 ALTERNATES ARE AGAIN PRESENT. 13 MR. RIFF, YOU MAY PROCEED. 14 15 JOHN WHYSNER, 16 HAVING BEEN PREVIOUSLY DULY SWORN, RESUMED THE 17 WITNESS STAND AND TESTIFIED AS FOLLOWS: 18 19 DIRECT EXAMINATION (RESUMED) file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (5 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 21 BY MR. RIFF: 22 Q. DR. WHYSNER, PERTAINING TO THE 23 TOPICS I WANT TO TALK WITH YOU, I GUESS, ABOUT THE 24 TOXICOLOGY OF CANCER GENERALLY AND AS IT RELATES TO 25 BOTH A.M.L. AND THEN THE DISEASE IN THIS CASE, 26 N.H.L. 27 FIRST OF ALL, YOU AGREE, DO YOU NOT, 28 THAT BENZENE, C6, H6, IS AN ESTABLISHED HUMAN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (6 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4002 1 CARCINOGEN? 2 A. YES. 3 4 (INTERRUPTION IN 5 PROCEEDINGS.) 6 7 Q. BY MR. RIFF: AND IN YOUR OPINION, TO A 8 REASONABLE DEGREE OF MEDICAL AND SCIENTIFIC PROBABILITY, 9 WHAT IS THE HUMAN CANCER ASSOCIATED WITH BENZENE? 10 A. ACUTE MYELOGENOUS LEUKEMIA. 11 Q. OKAY, NOW, IN OUR, OUR DAILY LIVES, 12 ARE WE CUSTOMARILY EXPOSED TO OTHER KNOWN 13 ESTABLISHED HUMAN CARCINOGENS? 14 A. YES. 15 Q. CAN YOU GIVE US JUST EXAMPLES FOR 16 CONTEXT? 17 A. WELL, WE TALKED ABOUT ALCOHOL, I 18 MEAN, IN WHICH YOU, SOME PEOPLE AT LEAST ARE EXPOSED 19 TO A SMALL AMOUNT OF ALCOHOL FREQUENTLY AND THEY file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (7 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 DON'T, THEY DON'T GET CANCER IN ALCOHOL UNLESS THEY 21 REALLY GET SOMETHING CALLED CIRRHOSIS OF THE LIVER 22 WHICH IS A FIBROSIS OF THE LIVER. 23 IN OTHER WORDS, THEY DRUNK ENOUGH 24 ALCOHOL SO THAT THEIR LIVER ACTUALLY CHANGES ITS 25 FORM FROM ITS WAY IT IS NOT REALLY TO BE ABLE TO 26 PROCESS TOXINS AND SO FORTH. AND IT, ALL THIS 27 FIBROUS TISSUE FORMS BECAUSE OF CONSTANT INJURY. 28 AND THEN EVENTUALLY THAT CIRRHOTIC COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (8 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4003 1 LIVER CAN BE CANCEROUS. 2 Q. OKAY, SO THAT'S ALCOHOL AND LIVER. 3 ARE THERE ANY OTHER -- ARE THERE A 4 COUPLE MORE EXAMPLES, AGAIN, FOR CONTEXT OF 5 CARCINOGENS THAT WE ARE FREQUENTLY AND CUSTOMARILY 6 EXPOSED TO? 7 A. WELL, ONE -- ANOTHER ONE IS, BELIEVE 8 IT OR NOT, WHEN WE CHARBROIL STEAKS AND SO FORTH, 9 THERE ARE COMPOUNDS PRODUCED ON THE SURFACE THAT ARE 10 TASTY BUT ACTUALLY HAVE BEEN FOUND TO BE 11 CARCINOGENIC. AND THAT'S THE POLY-AROMATICS, 12 HYDROCARBONS AND THINGS LIKE HETEROCYCLIC AMINES. 13 SO THESE ARE COMPLEX COMPOUNDS BUT 14 THEY ARE, AT LEAST FROM AN EXPERIMENTAL STANDPOINT, 15 RELATIVELY POTENT CARCINOGENS AND THERE IS A FAIR 16 AMOUNT OF EVIDENCE THAT THEY ARE, THAT THEY COULD BE 17 CARCINOGENIC IN HUMANS AS WELL. 18 Q. ANYTHING ELSE? 19 WHAT ABOUT THAT BIG BRIGHT THING file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (9 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THAT SHINES IN THE SKY SOMETIMES? 21 A. WELL, THE SUN, OF COURSE, IF YOU GET 22 TOO MUCH SUN EXPOSURE YOU CAN GET SKIN CANCER OR 23 EVEN A WORSE FORM OF -- I MEAN, SKIN CANCER, BASAL 24 CELL OR SQUAMOUS CELL WHICH IS NOT VERY SERIOUS BUT 25 YOU CAN ALSO GET AN INCREASE INCIDENCE OF CANCER 26 THAT'S CALLED MALIGNANT MELANOMA WHICH CAN BE FATAL. 27 Q. OKAY. SO, OKAY, SO THOSE ARE 28 CARCINOGENS. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (10 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4004 1 NOW, LET'S TALK A LITTLE BIT 2 ABOUT -- I WANT TO TALK ABOUT WHAT GOES ON IN THE 3 LIVER IN HUMANS, RELATIVE TO THE SUBSTANCE BENZENE. 4 AND IT'S METABOLISM IN THE LIVER. 5 AND THEN AFTER AWHILE WE WILL TALK ABOUT HOW THAT 6 RELATES TO NON-HODGKIN'S LYMPHOMA. OKAY? THAT'S 7 THE TOPIC. ARE YOU WITH ME? 8 A. YES. 9 Q. SO A LIVER? 10 A. SORT OF. 11 Q. ALL RIGHT. 12 I WANT YOU TO ASSUME THAT SOMEBODY 13 BREACHES OR GETS SOME BENZENE IN THEIR SYSTEM 14 THROUGH DERMAL ABSORPTION. DOES THE BENZENE 15 EVENTUALLY FIND ITS WAY TO THE BLOOD STREAM INTO THE 16 LIVER? 17 A. EVENTUALLY, YES. 18 Q. AND IN THE LIVER, DOES IT -- WHAT 19 HAPPENS THERE? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (11 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. WELL, THAT'S WHERE IT IS TRANSFORMED 21 INTO METABOLITES. AND WE TALKED ABOUT THE FACT THAT 22 THESE METABOLITES ARE WHAT WE BELIEVE ARE 23 RESPONSIBLE FOR ACUTE MYELOGENOUS LEUKEMIA. ONE OF 24 THEM IS CALLED PHENOL WHICH IS A BENZENE WITH A 25 HYDROXIDE GROUP ADDED TO IT. IT IS BASICALLY AN 26 ALCOHOL OF BENZENE. 27 ANOTHER ONE IS HYDROQUINONE WHICH IS 28 A DYE ALCOHOL OF BENZENE. SO IT HAS TWO ALCOHOL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (12 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4005 1 GROUPS ON IT. 2 WHAT THE LIVER DOES IS JUST ATTACHES 3 THESE ALCOHOL GROUPS ON THERE IN AN ATTEMPT TO MAKE 4 IT MORE SOLUBLE AND ALSO THESE ALCOHOL GROUPS CAN 5 THEN BE ATTACHED TO SOMETHING ELSE THAT MAKES IT 6 MUCH MORE SOLUBLE SO THAT THE MOLECULE CAN BE 7 EXCRETED IN THE URINE. 8 Q. OKAY. 9 DID YOU TELL US THIS MORNING THAT IT 10 IS A METABOLITE OF BENZENE AND NOT THE BENZENE 11 ITSELF THAT IS THE HUMAN CARCINOGEN? 12 A. YES. 13 Q. IN THE LIVER, WHAT'S THE NAME OF THE 14 ENZYME, IF THAT'S THE RIGHT BIOLOGICAL CONCEPT, 15 WHAT'S THE NAME OF THE ENZYME RESPONSIBLE FOR THIS 16 BENZENE METABOLISM? 17 A. WELL, THE ENZYME GROUP IS A GROUP 18 CALLED CYTOCHROME P-450 AND THERE ARE MANY OF THEM. 19 AS A MATTER OF FACT, THAT'S WHAT I DID MY PH.D. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (13 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THESIS WORK ON. BECAUSE IN THE ADRENAL GLAND IT 21 ATTACHES HYDROXYL GROUPS TO STEROIDS THAT FORM THE 22 VARIOUS STEROIDS THAT THE ADRENAL GLAND PRODUCES. 23 SO THE FAMILY NAME IS P-450 AND THE 24 ONE THAT IS RESPONSIBLE FOR THIS PARTICULAR 25 METABOLISM IS P-4502 E1. 26 Q. OKAY. AND I SAID ENZYME AND YOU 27 SAID CYTOCHROME? 28 A. CYTOCHROME. THAT'S JUST THE NAME OF COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (14 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4006 1 IT, CYTOCHROME P-450. 2 Q. OKAY. WHAT'S ANOTHER -- WHAT'S A 3 RELATIVELY SIMPLE DEFINITION OF ENZYME? 4 A. ENZYME IS A PROTEIN THAT SPEEDS UP 5 REACTIONS IN THE BODY. IT'S A CATALYST. IT'S ON 6 THE -- IT'S A -- IT'S A PROTEIN CATALYST. 7 Q. NOW, HERE'S WHAT I WANT TO KNOW. 8 I WANT YOU TO ASSUME FOR THE SAKE OF 9 ARGUMENT THAT YOU HAVE A HUMAN BEING WHO'S EXPOSED 10 TO A LITTLE BENZENE BUT A LOT OF TOLUENE. OKAY. 11 SOME BENZENE BUT CONSIDERABLY MORE TOLUENE. 12 DO YOU UNDERSTAND WHAT I AM SAYING? 13 A. YES. 14 Q. WHAT HAPPENS IN THE HUMAN BODY WHEN 15 A PERSON IS EXPOSED TO A HYDROCARBON SOLVENT MIXTURE 16 THAT HAS A LETTER BENZENE AND A LOT OF TOLUENE WITH 17 RESPECT TO THIS MECHANISM OF METABOLISM IN THE 18 LIVER? 19 A. WELL, WHAT'S BEEN OBSERVED IN file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (15 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EXPERIMENTAL ANIMALS IS THAT THE METABOLISM IS 21 INHIBITED. 22 A TOLUENE TAKES UP THE, TAKES UP THE 23 SITES OF THE ENZYME SO IT IS NOT AVAILABLE FOR 24 BENZENE TO BE METABOLIZED. 25 SO ACTUALLY TOLUENE HAS BEEN SHOWN 26 TO INHIBIT THE FORMATION OF THE METABOLITES OF 27 BENZENE AND IT HAS ALSO BEEN SHOWN TO INHIBIT -28 REMEMBER, I TALKED ABOUT THESE GENOTOXICITY STUDIES COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (16 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4007 1 THAT WE LOOKED AT, IT ALSO INHIBITS THE FORMATION OF 2 GENOTOXIC COMPOUNDS. 3 Q. THIS IS A CORRECT STATEMENT IN YOUR 4 OPINION, TO A REASONABLE DEGREE OF MEDICAL OR 5 SCIENTIFIC PROBABILITY, THAT BENZENE IN HUMANS IS 6 LESS TOXIC FROM A CARCINOGENIC POINT OF VIEW WHEN 7 PRESENT CONCURRENTLY HIGH CONCENTRATIONS OF TOLUENE? 8 A. WELL, WE HAVE NOT DONE THE DIRECT 9 OBSERVATION OF THIS IN HUMANS, BUT THAT IS, THAT WAS 10 WHAT ONE WOULD PREDICT BASED UPON THE ANIMAL 11 TOXICITY STUDIES. 12 Q. OKAY. ALL RIGHT. NOW, I HAVE NOT 13 ASKED YOU IN THIS CASE TO COMPLETELY UNDERSTAND THE 14 RELATIVE BENZENE AND TOLUENE CONCENTRATIONS OF THIS, 15 OF THE VARIOUS SOLVENT MIXTURES FROM SHELL, CHEVRON 16 AND UNOCAL IN THIS CASE, HAVE I? 17 A. NO. 18 Q. NOW WHAT I WANT TO TALK ABOUT, WE 19 WERE JUST TALKING ABOUT ACUTE MYELOGENOUS LEUKEMIA file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (17 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 AND BENZENE METABOLITES IN THE LIVER. 21 THAT'S WHAT WE WERE JUST TALKING 22 ABOUT. DO YOU AGREE? 23 A. YES. 24 Q. NOW I WANT TO TALK ABOUT A DIFFERENT 25 DISEASE. I WANT TO TALK ABOUT NON-HODGKIN'S 26 LYMPHOMA. 27 IN YOUR OPINION, AS A PHYSICIAN, 28 DR. WHYSNER, TO A REASONABLE DEGREE OF MEDICAL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (18 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4008 1 PROBABILITY. WHAT PART OF THE BODY, WHAT ORGAN 2 SYSTEM IN THE BODY, ARE WE TALKING ABOUT WHEN WE 3 TALK ABOUT NON-HODGKIN'S LYMPHOMA? 4 A. THE LYMPHATIC SYSTEM, AND ESPECIALLY 5 THE LYMPH NODES. 6 Q. HOW IS THE LYMPH -- LYMPHATIC SYSTEM 7 AND ESPECIALLY THE LYMPH NODES, DIFFERENT FROM OR 8 NOT DIFFERENT FROM THE BONE MARROW -- WITHDRAWN. 9 SORRY. 10 ONE MORE QUESTION FIRST. 11 WITH LEUKEMIA, ACUTE MYELOGENOUS 12 LEUKEMIA, IN YOUR OPINION, AS A PHYSICIAN, 13 DR. WHYSNER, TO A REASONABLE DEGREE OF MEDICAL 14 PROBABILITY, WHAT ORGAN SYSTEM IN THE BODY IS 15 INVOLVED? 16 A. THE BONE MARROW. 17 Q. OKAY. SO WITH LEUKEMIA INVOLVING 18 BONE MARROW AND NON-HODGKIN'S LYMPHOMA INVOLVING THE 19 LYMPHATIC SYSTEM, ESPECIALLY THE LYMPH NODES, ARE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (19 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THOSE THE SAME SYSTEMS OR DIFFERENT ORGAN SYSTEM IN 21 THE BODY, IN YOUR OPINION AS A PHYSICIAN TO A 22 REASONABLE DEGREE OF MEDICAL PROBABILITY? 23 A. THEY ARE DIFFERENT ORGAN SYSTEMS. 24 Q. REMEMBER OUR DISCUSSION THIS MORNING 25 ABOUT DR. BRADFORD HILL AND HIS VARIOUS TENANTS OR 26 ELEMENTS THAT HE DESCRIBED TO HELP UNDERSTAND 27 CAUSATION IN, CAUSALITY, THAT'S WHAT WE WERE TALKING 28 ABOUT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (20 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4009 1 A. YES. 2 Q. HOW DOES THIS DISCUSSION THAT WE ARE 3 NOW HAVING ABOUT LEUKEMIA AND BONE MARROW AND 4 NON-HODGKIN'S LYMPHOMA AND THE LYMPHATIC SYSTEM, HOW 5 DOES THAT RELATE TO DR. BRADFORD HILL'S CAUSATION 6 ANALYSIS, IF AT ALL? 7 A. WELL, ANOTHER ONE OF THE -- THE ONE 8 THAT WE DIDN'T TALK ABOUT IS ELEMENTS OF HIS WAY OF 9 LOOKING AT STUDIES. 10 ALSO HAS TO DO WITH WHAT HE CALLED 11 COHERENCE OR BIOLOGICAL PLAUSIBILITY. 12 IN OTHER WORDS, IN THIS CASE, I 13 GUESS THE QUESTION IS, COULD YOU LOOK AT STUDIES OF 14 ACUTE MYELOGENOUS LEUKEMIA AND FROM THEN CONCLUDE 15 SOMETHING ABOUT NON-HODGKIN'S LYMPHOMA? AND KNOWING 16 ABOUT THE DEVELOPMENT OF THESE TWO DISEASES, YOU 17 KNOW, THAT WOULD BE AN IMPORTANT ELEMENT THAT ONE 18 COULD LOOK AT TO SEE IF ONE COULD USE THOSE OTHER 19 TYPES OF STUDIES? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (21 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. DID YOU PREPARE A SLIDE WHICH 21 DEPICTS IN A SCHEMATIC KIND OF WAY THE STRUCTURE OF 22 THE LYMPH NODE WITH A FEW WORDS OF DESCRIPTION ABOUT 23 HOW THE LYMPH NODE WORKS? 24 A. YES. 25 Q. AND, YOUR HONOR, MAY WE MARK AS 26 EXHIBIT 132-20 A PLATE CALLED "STRUCTURE OF THE 27 LYMPH NODE"? 28 THE COURT: YES, IT MAY BE SO MARKED. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (22 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4010 1 (EXHIBIT 132-20, LYMPH NODE 2 STRUCTURE, MARKED FOR I.D.) 3 4 Q. BY MR. RIFF: DID YOU PREPARE THIS? 5 A. ACTUALLY I TOOK IT IN ONE OF MY 6 LECTURES, MY COURSE. YES. 7 MR. RIFF: I PROPOSE TO DISPLAY 132-20. 8 MR. WAGNON: NO OBJECTION. 9 THE COURT: IT MAY BE DISPLAYED. 10 MR. RIFF: THANK YOU, YOUR HONOR. 11 Q. BY MR. RIFF: PLEASE DESCRIBE WHAT WE 12 ARE LOOKING AT IN THIS SCHEMATIC. KEEP YOUR VOICE UP, 13 PLEASE. 14 A. WELL, THIS IS ONE OF ABOUT 500, 15 THERE ARE ABOUT 5- TO 600 LYMPH NODES IN THE HUMAN 16 BODY. AND I THINK THE, FOR US, THE LYMPH ENTERS 17 FROM THE LYMPH VESSELS INTO THE LYMPH NODE AT 18 VARIOUS POINTS AND THEN THIS IS WHERE IT EXITS FROM. 19 NOW, THE PURPOSE OF THIS LYMPH GLAND file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (23 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 IS TO COMBAT INFECTIOUS DISEASE, PRIMARILY. 21 AND SO IT IS FILTERING THE BODY'S 22 TISSUE FLUIDS THAT ARE DRAINING BACK FROM THE 23 TISSUES BEFORE THEY GO INTO THE BLOOD SUPPLY THROUGH 24 THIS LYMPHATIC SYSTEM. AND IT GOES ALL OVER THE 25 BODY, THE LYMPHATIC SYSTEM DOES. 26 AND THIS, THIS SHOWS THAT THERE ARE 27 DIFFERENT PARTS OF THE LYMPH NODE. OKAY. 28 SO HERE'S THE MEDULLA AND THESE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (24 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4011 1 CONTAIN PRIMARILY T-CELLS. 2 AND THESE ARE WHAT ARE CALLED THE 3 GERMINAL CENTERS AND THESE ARE WHERE THE B-CELLS 4 RESIDE THAT ARE INVOLVED IN TRYING TO DETECT 5 ANTIGENS SO THAT THEY CAN PRODUCE ANTIBODIES. 6 NOW, WE ARE TALKING ABOUT 7 NON-HODGKIN'S LYMPHOMA. AS A MATTER OF FACT, WE ARE 8 TALKING ABOUT FOLLICULAR NON-HODGKIN'S LYMPHOMA. 9 AND THAT DISEASE ARISES IN THE FOLLICLES OF THE 10 LYMPH NODE. SO THAT'S WHERE THE DISEASE BEGINS. 11 Q. SO LET'S TALK ABOUT THE RISK FACTORS 12 FOR NON-HODGKIN'S LYMPHOMA, AS YOU APPRECIATE THEM, 13 AND THEN IN DUE COURSE WE WILL COMPARE THAT WITH 14 MR. MOLINA'S MEDICAL RECORD. 15 OKAY? 16 A. OKAY. 17 Q. SO IN YOUR OPINION, AS A PHYSICIAN, 18 AND HAVING DONE THE WORK YOU HAVE DONE IN THIS CASE, 19 DR. WHYSNER, WHAT ARE THE RISK FACTORS FOR file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (25 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 NON-HODGKIN'S LYMPHOMA IN HUMANS AND HOW WOULD YOU, 21 HOW WOULD YOU CATEGORIZE THEM OR LIST THEM? 22 A. OKAY. THE ONES THAT WE REALLY KNOW 23 ABOUT IN HUMANS ARE THOSE THAT ARE ASSOCIATED WITH 24 THINGS THAT PRODUCE SOME KIND OF IMMUNE DEFICIENCY. 25 ONE OF THEM IS AIDS OR H.I.V. VIRUS 26 INFECTION. 27 REMEMBER, WE TALKED ABOUT S.M.R.'S 28 AND WHAT IS A LARGE S.M.R. AND WHAT IS A SMALL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (26 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4012 1 S.M.R. 2 WELL, THE S.M.R. FOR HAVING AIDS AND 3 GETTING NON-HODGKIN'S LYMPHOMA IS APPROXIMATELY 100. 4 IN OTHER WORDS, THERE'S A HUNDRED FOLD INCREASED 5 RISK OF GETTING NON-HODGKIN'S LYMPHOMA IF YOU HAVE 6 H.I.V. VIRUS INFECTION AND HAVE DEVELOPED AIDS. 7 ANOTHER ONE ARE CERTAIN CONGENITAL 8 IMMUNO-DEFICIENCY SYNDROMES. UNFORTUNATELY, SOME 9 PEOPLE ARE BORN WITH DEFECTS IN THEIR IMMUNE SYSTEM. 10 ANOTHER ARE PEOPLE WHO ARE TREATED 11 WITH IMMUNO-SUPPRESSANT DRUGS. FOR EXAMPLE, FOR 12 ORGAN TRANSPLANTATION. 13 NOW, THESE S.M.R.'S ARE NOT AS GREAT 14 HAS THOSE FOR H.I.V. BUT THEY ARE CLEARLY GREATER 15 THAN THE GENERAL POPULATION. 16 AND I BELIEVE THOSE ARE THE MAJOR 17 ONES THAT HAVE BEEN ESTABLISHED AS RISK FACTORS OR 18 CAUSALLY ASSOCIATED WITH NON-HODGKIN'S LYMPHOMA. 19 Q. WELL, IN THE, IN THIS WORLD OF file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (27 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EPIDEMIOLOGICAL LITERATURE AND TOXICOLOGICAL 21 LITERATURE THAT YOU HAVE REVIEWED, ARE THERE, IS 22 THERE ANOTHER CATEGORY OF RISK FACTORS ASSOCIATED 23 WITH NON-HODGKIN'S LYMPHOMA THAT ARE LESS WELL 24 ESTABLISHED BUT STILL WARRANT A DISCUSSION AS A 25 POSSIBLE RISK FACTOR? 26 A. YES. 27 Q. AND WHAT WOULD YOU INCLUDE IN THAT 28 LIST? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (28 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4013 1 A. OH, PROBABLY THE ONES THAT ARE AT 2 THE TOP OF THAT -- I WILL REALLY MENTION ONE OTHER 3 ONE THAT IS A PROVEN RISK FACTOR AND THAT IS 4 APPARENTLY PEOPLE WHO HAVE A FAMILY HISTORY OF 5 LYMPHOMAS AND OTHER TYPES OF LYMPHOPOIETIC DISEASES 6 ALSO MAY HAVE AN INCREASED RISK OF NON-HODGKIN'S 7 LYMPHOMA. 8 BUT AT THE TOP OF THE LIST OF THOSE 9 THAT HAVEN'T REALLY BEEN PROVEN BUT THERE SEEMS TO 10 BE A LOT OF EPIDEMIOLOGY STUDIES THAT SUPPORT IT ARE 11 OTHER TYPES OF INFECTIONS. 12 ONE OF THEM -- ONE TYPE OF LYMPHOMA 13 IS ACTUALLY A LYMPHOMA THAT IS INSIDE THE INTESTINE. 14 IT IS A SPECIFIC TYPE OF LYMPHOMA. 15 AND THAT ONE SEEMS TO BE CAUSALLY 16 RELATED TO A BACTERIAL INFECTION, THE SAME ONE 17 THAT'S THOUGHT TO BE ASSOCIATED WITH STOMACH CANCERS 18 AND THAT'S HYLICOBACTORPYLORI. 19 HEPATITIS C. INFECTION, MAY BE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (29 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ASSOCIATED WITH AN INCREASED RISK OF NON-HODGKIN'S 21 LYMPHOMA. 22 THERE IS ONE TYPE OF LYMPHOMA THAT 23 IS ESPECIALLY PREDOMINANT IN AFRICA CALLED BURKETT'S 24 LYMPHOMA THAT IS ASSOCIATED WITH EPSTEIN BAR VIRUS 25 INFECTION. 26 SO THERE'S A LOT OF EVIDENCE 27 POINTING TO THE INTERPLAY OF NON-HODGKIN'S LYMPHOMA 28 BETWEEN VIRAL INFECTIONS AND IMMUNE PROBLEMS. IN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (30 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4014 1 OTHER WORDS, THE IMMUNE SYSTEM IS SOMEHOW ALTERED SO 2 IT CANNOT DEAL WITH THESE VIRAL INFECTIONS. 3 Q. WHAT ABOUT THE SUBSTANCE AGENT 4 ORANGE THAT DEFOLIANT THAT WAS USED IN VIETNAM? 5 A. WELL, AGAIN, THIS IS ONE THAT -- I 6 AM NOT SURE THAT THIS ACTUALLY RISES TO THE LEVEL 7 THAT IT IS SIMULTANEOUSLY CAUSALLY RELATED AND I 8 THINK DIFFERENT PEOPLE DEAL WITH IT DIFFERENTLY. 9 IT IS A COMPENSABLE DISEASE FOR 10 VETERAN'S. AGENT ORANGE EXPOSURE IS FOR PEOPLE WHO 11 HAVE NON-HODGKIN'S LYMPHOMA. SO THE NATIONAL 12 ACADEMY OF SCIENCES LOOKED AT THIS AND THEY 13 CONCLUDED THAT AGENT ORANGE EXPOSURE WAS ASSOCIATED 14 WITH AN INCREASED RISK FOR NON-HODGKIN'S LYMPHOMA. 15 Q. DR. WHYSNER, WHAT ABOUT OBESITY, 16 BODY MASS INDEX, WHERE DOES THAT FIT IN? 17 A. THAT'S ANOTHER ONE THAT HAS BEEN 18 STUDIED AND STUDIES ARE KIND OF MIXED ON THAT ONE. 19 SOME STUDIES SHOW AN ASSOCIATION, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (31 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 AND OTHER STUDIES HAVE NOT SHOWN AN ASSOCIATION. 21 Q. WHAT ABOUT CERTAIN DRUGS LIKE, WELL, 22 ANTIINFLAMMATORY MEDICATIONS, THAT KIND OF THING? 23 A. CHRONIC USE OF SOME 24 ANTI-INFLAMMATORY MEDICATIONS HAVE ALSO BEEN LINKED, 25 FOR EXAMPLE, PEOPLE WHO HAVE ARTHRITIS FOR A LONG 26 TIME AND HAVE TO TAKE A LOT OF NONSTEROIDAL 27 ANTIINFLAMMATORY DRUGS. 28 BUT AGAIN, IN THIS CASE, THE STUDIES COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (32 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4015 1 ARE MIXED. 2 SO SOME EPIDEMIOLOGY STUDIES SHOW 3 THAT THERE IS AN ASSOCIATION AND OTHERS HAVE NOT 4 SHOWN SUCH AN ASSOCIATION. 5 Q. ALL RIGHT. WELL, LET'S TALK ABOUT A 6 THIRD CATEGORY THEN OF THINGS WHICH, IN YOUR 7 OPINION, TO A REASONABLE DEGREE OF MEDICAL 8 PROBABILITY, WELL, THINGS FOR WHICH THERE IS NO 9 CONSISTENT EVIDENCE ONE WAY OR THE OTHER. 10 OKAY? 11 WHAT, THAT IS TO SAY, AGENTS OR 12 LIFESTYLE ISSUES THAT, FOR WHICH THERE IS NO 13 CONSISTENT EVIDENCE ONE WAY OR THE OTHER FOR 14 NON-HODGKIN'S LYMPHOMA. WHAT GOES ON THAT LIST, IN 15 YOUR OPINION? 16 A. WELL, THERE'S ANOTHER ANTI-EPILEPTIC 17 DRUG CALLED DILANTIN WHICH IS KIND OF AN INTERESTING 18 STORY WHICH IS WHEN WE WERE STUDYING PHENOBARBITAL 19 AND I WAS DOING AN EPIDEMIOLOGY STUDY WITH A FOLLOW file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (33 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 NAMED JORGEN OLSEN FROM THE DANISH CANCER REGISTRY, 21 WE WERE LOOKING AT PHENOBARBITAL AND LIVER CANCER. 22 AND IT TURNED OUT THAT WE DID SEE AN INCREASED RISK 23 FOR NON-HODGKIN'S LYMPHOMA WITH DILANTIN THAT HAS 24 NEVER BEEN REPLICATED. 25 BUT I HAVE SEEN IT REPORTED IN 26 TEXTBOOKS AND SO ON AND SO FORTH BUT THAT WAS ONLY 27 BASED UPON ONE STUDY AND IT WAS SOMETHING WE WEREN'T 28 EVEN LOOKING FOR. IT JUST CAME, CAME OUT IN THAT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (34 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4016 1 PARTICULAR STUDY. 2 SO THAT'S ONE I WOULD NOT CONSIDER 3 TO BE ASSOCIATED WITH NON-HODGKIN'S LYMPHOMA. 4 Q. WHAT ABOUT HAIR DYE? 5 A. I DON'T THINK THAT THE -- I THINK 6 THAT MORE RECENT PEOPLE WHO HAVE LOOKED AT THIS AND 7 MY REVIEW OF THE LITERATURE DOESN'T REALLY FIND THAT 8 HAIR DYES ARE ASSOCIATED WITH N.H.L. EITHER. 9 Q. WHAT ABOUT CIGARETTE SMOKE? 10 A. NO. THE SURGEON GENERAL KEEPS A 11 PRETTY CLOSE TAB ON THE DISEASES THAT HAVE BEEN 12 ASSOCIATED WITH CIGARETTE SMOKE. AND ONE OF THEM, 13 BY THE WAY, IS ACUTE MYELOGENOUS LEUKEMIA. BUT NOT 14 NON-HODGKIN'S LYMPHOMA. 15 Q. WHAT ABOUT ALCOHOL, THE STUFF IN 16 BEER AND WINE? 17 A. VERY LITTLE EVIDENCE. BUT AGAIN, 18 THERE ARE A FEW STUDIES WHERE THERE IS A SHOWN 19 INCREASE IN THE S.M.R. AND THEN THERE ARE OTHER file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (35 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 STUDIES THAT DON'T SHOW IT. 21 Q. OKAY. NOW, WE SPENT A LONG TIME 22 THIS MORNING TALKING ABOUT BENZENE IN THESE 23 HYDROCARBON SOLVENTS. 24 IN THESE THREE CATEGORIES THAT YOU 25 HAVE BEEN TELLING ME ABOUT, THE PROVEN AND POSSIBLE 26 AND NO CONSISTENT EVIDENCE, IN YOUR OPINION, TO A 27 REASONABLE DEGREE OF MEDICAL AND SCIENTIFIC 28 PROBABILITY, WHERE WOULD YOU PUT THE BENZENE AND COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (36 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4017 1 SOLVENT LITERATURE? 2 A. INTO THAT THIRD CATEGORY, WHERE, 3 AGAIN, THERE MAY BE ONE OR TWO STUDIES OR THREE 4 STUDIES THAT SHOW SOME INCREASED ASSOCIATION BUT THE 5 VAST MAJORITY OF OTHER STUDIES DON'T SUPPORT THOSE 6 STUDIES. 7 Q. OKAY. NOW, LET'S TALK ABOUT 8 MR. MOLINA. DR. WHYSNER, DID YOU HAVE AN OPINION, 9 TO A REASONABLE DEGREE OF MEDICAL PROBABILITY, WHY 10 MR. MOLINA GOT NON-HODGKIN'S LYMPHOMA? 11 A. YES. 12 Q. WHAT'S YOUR OPINION? 13 A. IT'S NOT KNOWN. 14 Q. ARE YOU FAMILIAR WITH THE TERM 15 IDIOPATHIC? 16 A. THAT'S ANOTHER WAY OF PUTTING IT. 17 MEDICALLY WE SAY IT IS AN IDIOPATHIC -- WELL, 18 USUALLY WE REFER TO A DISEASE AS BEING IDIOPATHIC. 19 YOU DON'T KNOW WHAT CAUSES THAT DISEASE. BUT IN THE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (37 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 SPECIFIC CASE, I WOULD SAY HIS CAUSE IS IDIOPATHIC; 21 WE JUST DON'T KNOW. 22 Q. YOU HAVE REVIEWED ALL OF HIS MEDICAL 23 RECORDS? 24 A. YES. 25 Q. HAVE YOU NOTED IN HIS MEDICAL RECORD 26 CERTAIN THINGS, AT LEAST, THAT ARE ON THIS LIST OF 27 RISK FACTORS SOMEWHERE, EITHER PROVEN OR POSSIBLE OR 28 NO CONSISTENT EVIDENCE? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (38 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4018 1 A. YES. 2 Q. LIKE WHAT? 3 A. WELL, OBESITY, MR. MOLINA HAS A 4 HISTORY OF OBESITY DATING BACK TO THE EARLY 1990'S, 5 AT LEAST. AND WITH AN INCREASED BODY MASS INDEX 6 WHICH WOULD PUT HIM IN THE OBESE CATEGORY. 7 THAT'S ONE. 8 HE HAS -9 Q. LET ME JUST STOP YOU. JUST SO WE 10 ARE COMPLETELY CLEAR ON THIS, YOU ARE NOT TELLING 11 THE JURY, ARE YOU, THAT IN YOUR OPINION HIS OBESITY 12 WAS, TO A REASONABLE DEGREE OF MEDICAL PROBABILITY, 13 THE CAUSE OF HIS NON-HODGKIN'S LYMPHOMA? 14 A. NO. 15 Q. OKAY. 16 YOU ARE JUST NOTING IT AS, WHAT, A 17 RISK FACTOR OUT THERE? 18 A. WELL, THAT IT IS ONE OF THESE OTHER 19 THINGS THAT HAS BEEN ASSOCIATED WITH NON-HODGKIN'S file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (39 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 LYMPHOMA IN SOME STUDIES BUT I WOULD SAY THAT IT 21 DOESN'T REACH THE LEVEL OF BEING CAUSALLY RELATED. 22 Q. OKAY. WHAT ELSE? 23 A. WELL, HIS USE OF NONSTEROIDAL 24 INFLAMMATORY DRUGS. 25 THE HISTORY IS A LITTLE BIT SPORADIC 26 ON THAT BUT HE HAS A LONG-STANDING ORTHOPEDIC 27 PROBLEM AND ALSO INDICATIONS THAT HE WAS TAKING 28 NONSTEROIDAL AND ANTIINFLAMMATORY DRUGS. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (40 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4019 1 Q. LIKE WHAT? 2 A. WELL, YOU KNOW -3 Q. WHAT IS N.S.A.I.D, A NONSTEROIDAL 4 ANTI-INFLAMMATORY DRUG? 5 A. I THINK THERE WAS A NOTATION OF 6 ASPIRIN FOR ONE, THAT'S ONE TYPE. 7 AND I CAN'T REMEMBER THE OTHERS. I 8 THINK, I THINK SOME OF THE CELEBREX OR SOMETHING 9 LIKE THAT WAS ALSO NOTED IN HIS -- BUT NOT THE 10 STEROIDAL TYPE, THESE ARE NONSTEROIDAL TYPES. 11 Q. AND ARE THERE OTHER THINGS IN HIS 12 MEDICAL RECORD THAT YOU HAVE NOTED THAT IMPLICATE, 13 IN SOME FASHION, AT LEAST, ONE OR MORE OF THESE RISK 14 FACTORS? 15 A. WELL, WE TALKED ABOUT OBESITY AND WE 16 TALKED ABOUT NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND 17 WE HAVE TALKED ABOUT CIGARETTE SMOKING AND THOSE ARE 18 THE, THOSE ARE THE THREE. 19 Q. OKAY, AND WHAT DID YOU, WHAT DID YOU file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (41 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 CONCLUDE BASED ON YOUR REVIEW OF THE MEDICAL RECORD 21 AS TO MR. MOLINA'S PAST SMOKING HISTORY? 22 A. WELL, THERE'S A NOTATION AND SOME 23 INDICATION HE HAD SMOKED FOR A NUMBER OF YEARS, ONE 24 SAYING 35 YEARS. 25 I THINK THERE'S SOME CONTROVERSY 26 ABOUT HOW MUCH HE ACTUALLY SMOKED. 27 BUT AGAIN, EVEN THOUGH I NOTED IT I 28 DIDN'T PAY TOO MUCH ATTENTION TO IT BECAUSE IT IS COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (42 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4020 1 NOT ONE OF THE -- IT IS NOT A PROVEN RISK FACTOR FOR 2 NON-HODGKIN'S LYMPHOMA. OKAY. 3 Q. SO, LET ME SEE IF I CAN SUMMARIZE 4 SOME OF YOUR BOTTOM LINES HERE AND THEN I WILL SIT 5 DOWN. 6 IN YOUR OPINION, TO A REASONABLE 7 DEGREE OF MEDICAL PROBABILITY, THE SOLVENTS TO WHICH 8 MR. MOLINA WAS EXPOSED, AT FIRESTONE DID NOT CAUSE 9 AND DID NOT INCREASE HIS RISK OF CONTRACTING 10 NON-HODGKIN'S LYMPHOMA. IS THAT TRUE? 11 A. YES. 12 Q. IN YOUR OPINION, TO A REASONABLE 13 DEGREE OF MEDICAL PROBABILITY, HIS EXPOSURE TO 14 BENZENE AT FIRESTONE DID NOT CAUSE NOR INCREASE HIS 15 RISK OF CONTRACTING NON-HODGKIN'S LYMPHOMA; IS THAT 16 TRUE? 17 A. YES. 18 Q. IF THIS WERE NOT A NON-HODGKIN'S 19 LYMPHOMA BUT A LEUKEMIA CASE INVOLVING ACUTE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (43 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 MYELOGENOUS LEUKEMIA, IN OPINION, TO A REASONABLE 21 DEGREE OF MEDICAL PROBABILITY, MR. MOLINA'S BENZENE 22 EXPOSURE, AS EXPRESSED IN PART PER MILLION WAS TOO 23 LOW TO HAVE BEEN A CAUSAL FACTOR INCREASING HIS RISK 24 OF CONTRACTING LEUKEMIA, A.M.L., IS THAT TRUE? 25 A. YES. 26 Q. OKAY, THOSE ARE ALL THE QUESTIONS I 27 HAVE FOR YOU. 28 THANK YOU. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (44 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4021 1 THE COURT: MR. WAGNON WHENEVER YOU ARE READY. 2 MR. WAGNON: YOUR HONOR, I HAVE -- I NEED TO 3 SET UP SOME EQUIPMENT. 4 THE COURT: SURE. THAT'S FINE. 5 MR. WAGNON: AND ALL I NEED IS FIVE MINUTES. 6 THE COURT: OKAY, NO PROBLEM. 7 LET'S TAKE ABOUT 10 MINUTES AND THEN WE 8 WILL SEE HOW WE GO. 9 OKAY? 10 MR. WAGNON: THANK YOU. AGAIN 10 MINUTES, 11 LADIES AND GENTLEMEN. 12 WE WILL SEE YOU BACK HERE AT 20 MINUTES 13 AFTER 2:00. 14 WE MIGHT HAVE TWO, TWO SHORT BREAKS THIS 15 TIME. 16 17 (AT THIS TIME, A RECESS 18 WAS TAKEN.) 19 file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (45 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 (THE FOLLOWING PROCEEDINGS 21 WERE HELD IN OPEN COURT IN 22 THE PRESENCE OF THE JURY:) 23 24 25 26 JOHN WHYSNER, 27 HAVING BEEN PREVIOUSLY DULY SWORN, RESUMED THE 28 WITNESS STAND AND TESTIFIED AS FOLLOWS: COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (46 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4022 1 THE COURT: THE JURORS AND ALTERNATES ARE 2 AGAIN PRESENT. 3 MR. WAGNON, YOU MAY PROCEED WHEN YOU ARE 4 READY. 5 MR. WAGNON: THANK YOU, YOUR HONOR. 6 7 CROSS-EXAMINATION 8 9 BY MR. WAGNON: 10 Q. GOOD AFTERNOON, SIR. 11 A. GOOD AFTERNOON. 12 Q. WHILE IT IS STILL REFRESH ON 13 EVERYONE'S MIND, I WANT TO ASK YOU ABOUT ONE OF THE 14 LAST AREAS THAT YOU COVERED DURING DIRECT 15 EXAMINATION. 16 AND YOU MENTIONED A NUMBER OF 17 DIFFERENT RISK FACTORS SUCH AS OBESITY, USE OF 18 NON-HODGKIN'S LYMPHOMA, NONSTEROIDAL 19 ANTI-INFLAMMATORY DRUGS, SMOKING AND MAYBE SOME file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (47 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OTHERS. 21 BUT I THOUGHT I HEARD YOU SAY THAT 22 THE BOTTOM LINE WAS THAT TO A REASONABLE DEGREE OF 23 MEDICAL PROBABILITY, THESE WERE NOT CONTRIBUTORY 24 FACTORS IN TERMS OF CAUSING HIS NON-HODGKIN'S 25 LYMPHOMA. DID I GET THAT CORRECT? 26 A. YES, THAT'S CORRECT. 27 Q. AND SO WHAT WE ARE LEFT WITH, AND I 28 JUST WANT TO CLARIFY THIS AS WELL, THAT IN YOUR COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (48 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4023 1 OPINION, THIS IS A CASE WHERE YOU JUST DON'T KNOW 2 WHAT THE CAUSE IS OF HIS NON-HODGKIN'S LYMPHOMA; IS 3 THAT CORRECT? 4 A. THAT'S TRUE. 5 Q. AND THE TECHNICAL TERM, THE SCIENCE 6 PEOPLE USE FOR THAT IS IDIOPATHIC; RIGHT? 7 A. THAT'S TRUE, YES. 8 Q. AND IDIOPATHIC MEANS SIMPLY UNKNOWN. 9 IT DOESN'T MEAN THAT THERE IS NO CAUSE, IT MEANS 10 JUST WHATEVER THE CAUSE IS, WE DON'T KNOW WHAT IT 11 IS; RIGHT? 12 A. WELL, WITH THE CLARIFICATION THAT 13 YOU ARE GIVING MR. RIFF IS THAT SOME DISEASES IT IS 14 COMPLETELY IDIOPATHIC. 15 IN NON-HODGKIN'S LYMPHOMA, THERE ARE 16 SOME INSTANCES WHERE YOU ARE PRETTY SURE THE CAUSAL 17 RELATIONSHIP COULD BE LIKE H.I.V. INFECTION OR 18 SOMETHING LIKE THAT. 19 IN THIS PARTICULAR CASE, WHICH IS file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (49 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THE VAST MAJORITY, WE DON'T KNOW WHAT THE CAUSE IS. 21 Q. NOW, YOU ARE A TOXICOLOGIST, OF 22 COURSE; CORRECT? 23 A. YES. 24 Q. AND YOU DID TALK ABOUT SOME 25 TOXICOLOGY TODAY IN TERMS OF WHAT HAPPENS TO BENZENE 26 WHEN IT GOES INTO THE LIVER; CORRECT? THAT WOULD BE 27 IN THE FIELD OF TOXICOLOGY? 28 A. YES. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (50 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4024 1 Q. AND SO WHAT YOU WERE TALKING ABOUT 2 THERE WAS A MECHANISM, INSOFAR AS WHAT SCIENCE 3 KNOWS, ABOUT THE FATE OF THAT PARTICULAR CHEMICAL IN 4 THE BODY; RIGHT? 5 A. YES. 6 Q. IS IT FAIR TO SAY THAT THAT LEVEL OF 7 DETAIL, AT THIS POINT IN TIME, THAT LEVEL OF DETAIL 8 IS NOT UNDERSTOOD FOR PETROCHEMICAL SOLVENTS ACROSS 9 THE BOARD? 10 A. I DON'T KNOW WHAT -- LEVEL OF DETAIL 11 REGARD WHAT? 12 Q. HOW THEY ARE METABOLIZED IN THE 13 BODY, EXACTLY WHAT THE METABOLITES ARE, WHAT THEIR 14 FATE IS, WHERE THEY GO, AND THOSE SORTS OF DETAILS, 15 THEY ARE NOT KNOWN YET, ARE THEY? 16 A. WELL, THERE ARE A LOT OF STUDIES ON 17 CHEMICAL -- ON OTHER PETROCHEMICAL SOLVENTS. I 18 MEAN, ALKYNES, ALKANES, TOLUENE, XYLENE, THERE HAVE 19 BEEN METABOLIC STUDIES AND I THINK, IN MOST CASES, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (51 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 WE DO KNOW THEIR METABOLISM AND DISTRIBUTION. 21 Q. WELL, IN A LOT OF CASES, WE DON'T 22 KNOW, WOULD YOU AGREE WITH THAT? 23 A. WELL, IF YOU CAN GIVE ME A SPECIFIC 24 EXAMPLE. I MEAN, I COULD -- WHICH PARTICULAR 25 COMPONENT ARE YOU THINKING ABOUT? 26 Q. THE PARTICULAR PETROCHEMICAL 27 SOLVENTS THAT HE WAS EXPOSED TO AT THE FIRESTONE 28 PLANT. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (52 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4025 1 A. WELL, THESE ARE MIXTURES OF 2 DIFFERENT CHEMICALS AND I THINK YOU WERE ASKING ME 3 ABOUT THE METABOLISM. AND AS A TOXICOLOGIST, I CAN 4 ONLY DISCUSS METABOLISM IN TERMS OF SPECIFIC 5 CHEMICALS THAT MAKE UP THAT MIXTURE. 6 SO IF YOU, IF WE ARE TALKING ABOUT A 7 PARTICULAR ONE, I MEAN, MAYBE, IF YOU MENTION ONE I 8 MIGHT TELL YOU WHAT IT IS OR I MIGHT TELL WHAT YOU 9 IT ISN'T. 10 Q. SO YOU HAVEN'T DONE AN ANALYSIS OF 11 ALL OF THE CHEMICAL CONSTITUENTS OF ALL OF THE 12 PETROCHEMICAL SOLVENTS THAT HE WAS EXPOSED TO AT 13 FIRESTONE, HAVE YOU? 14 A. YOU MEAN IN TERMS OF AN ANALYSIS OF 15 THE WAY IN WHICH THEY ARE METABOLIZED, IS THAT WHAT 16 YOU MEAN OR LITERATURE REVIEW? 17 Q. YES. 18 A. OR SOMETHING ELSE? 19 Q. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (53 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. WELL, I WOULD SAY THAT THERE ARE 21 SOME MINOR COMPONENTS OF SOME OF THEM THAT I HAVEN'T 22 REALLY LOOKED INTO. 23 Q. WELL, LET ME ASK IT A DIFFERENT WAY. 24 WITH RESPECT TO CAUSATION, DO WE 25 RELY PRIMARILY ON EPIDEMIOLOGY, THAT, HUMAN 26 EPIDEMIOLOGY STUDIES TO TELL US WHETHER OR NOT A 27 SUBSTANCE CAUSES A PARTICULAR DISEASE? 28 A. YES. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (54 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4026 1 Q. AND IS IT NECESSARY FOR US TO KNOW 2 ALL OF THE TECHNICAL DETAILS, FOR INSTANCE, YOU USE 3 THE EXAMPLE OF CIGARETTE SMOKE. 4 CIGARETTE SMOKE IS A CARCINOGEN THAT 5 HAS BEEN WELL-RECOGNIZED AND IS UNDERSTOOD TO BE, IS 6 A CARCINOGEN; CORRECT? 7 A. YES. 8 Q. AND THAT'S BASED ON EPIDEMIOLOGY 9 STUDIES; RIGHT? 10 A. YES. 11 Q. AND THE PRECISE MECHANISM OF ALL OF 12 THE COMPONENTS OF CIGARETTE SMOKE AND HOW THOSE 13 COMPONENTS CAUSE LUNG CANCER, THAT IS NOT FULLY 14 UNDERSTOOD YET, IS IT? 15 A. NO. 16 Q. SO -- BUT THAT DOESN'T PREVENT US 17 FROM MAKING A CONCLUSION USING EPIDEMIOLOGY, DOES 18 IT? 19 A. THAT'S CORRECT. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (55 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND SO IN THIS CASE, WE DO NEED THE 21 ASSISTANCE OF EPIDEMIOLOGY IN ORDER TO ADDRESS THIS 22 ISSUE OF CAUSATION, WOULD YOU AGREE? 23 A. WELL, AS I MENTIONED, THE BRADFORD 24 HILL ELEMENTS ALSO INCLUDE ISSUES RELATED TO 25 BIOLOGICAL PLAUSIBILITY. BUT I WOULD SAY THAT THE 26 MAIN, THE MAIN THRUST OF OUR UNDERSTANDING HAS TO BE 27 THE EPIDEMIOLOGY STUDIES. 28 Q. NOW, WITH RESPECT TO EPIDEMIOLOGY, COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (56 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4027 1 FIRST OF ALL, CAN YOU TELL US HOW MANY CLASSES THAT 2 YOU TOOK DURING YOUR MEDICAL TRAINING IN THE FIELD 3 OF EPIDEMIOLOGY? 4 A. WELL, I DON'T THINK THERE WERE ANY 5 SPECIFIC CLASSES IN EPIDEMIOLOGY. WE USED 6 EPIDEMIOLOGY IN TERMS OF TRYING TO UNDERSTAND WHAT 7 THINGS CAUSED DISEASE IN A LOT OF THE CLASSES. 8 Q. DOCTOR, HOW MANY CLASSES DID YOU 9 TAKE IN EPIDEMIOLOGY? 10 A. WE, IF YOU DEFINE -- HOW WOULD YOU 11 DEFINE A CLASS? 12 YOU MEAN A COURSE? A LECTURE? I 13 HAVE HEARD LECTURES IN EPIDEMIOLOGY BUT I CAN'T TELL 14 YOU HOW MANY. 15 Q. DOCTOR, DO YOU REMEMBER TESTIFYING 16 IN THE HOOPER TRIAL? 17 A. YES. 18 Q. AND LET ME READ TO YOU FROM THE 19 TRANSCRIPT OF THAT TRIAL A QUESTION THAT WAS ASKED file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (57 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 AND AN ANSWER THAT YOU GAVE. 21 MR. RIFF: EXCUSE ME, PLEASE. MAY I JUST LOOK 22 OVER YOUR SHOULDER AND SEE WHAT YOU PLAN TO READ. 23 NO OBJECTION. 24 MR. WAGNON: AT PAGE -- THE DATE OF THIS IS 25 AUGUST 9TH, 2005, TRANSCRIPT PAGE 2542 AT LINE 24 26 THROUGH LINE 26. 27 THE WITNESS: MAY I SEE THAT, BY THE WAY OR 28 NO? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (58 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4028 1 THE COURT: HE CAN JUST READ IT TO YOU AND 2 THEN IF THERE'S SOME PROBLEM, MR. RIFF WILL FIND IT AND 3 TAKE CARE OF THAT. 4 OKAY. 5 THE WITNESS: OKAY. 6 MR. WAGNON: (READING). 7 "Q. DOCTOR, HOW MANY CLASSES 8 DID YOU TAKE IN EPIDEMIOLOGY? 9 "A. I HAVEN'T TAKEN ANY 10 CLASSES IN EPIDEMIOLOGY." 11 THE WITNESS: WELL, THE WAY I UNDERSTOOD THE 12 QUESTION AT THE TIME MEANT, I THINK I WAS THINKING 13 CLASSES. I WAS THINKING COURSES. 14 BUT I HAVE HAD LECTURES ON EPIDEMIOLOGY. 15 I WAS JUST ASKING YOU WHAT YOU MEANT BY A CLASS. 16 IF YOU MEAN BY A COURSE, THEN I HAVEN'T 17 TAKEN ANY COURSES IN EPIDEMIOLOGY. 18 Q. BY MR. WAGNON: HOW MANY PROFESSIONAL 19 ORGANIZATIONS OF EPIDEMIOLOGISTS, DO YOU BELONG TO? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (59 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. NONE. 21 Q. ARE YOU A FELLOW IN THE AMERICAN 22 COLLEGE OF EPIDEMIOLOGY? 23 A. NO. 24 Q. HAVE YOU EVER RECEIVED AN AWARD FOR 25 YOUR WORK IN EPIDEMIOLOGY? 26 A. NO. 27 Q. NOW, WE HAVE TALKED ABOUT SOME 28 STUDIES WHERE THERE WERE TWO COHORTS INVOLVED. ARE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (60 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4029 1 YOU WITH ME? 2 A. NO. 3 Q. WELL, WE HAVE GOT THE EXPOSED AND WE 4 HAVE OVER HERE THE CONTROLS. OKAY. 5 COHORT STUDY? 6 A. WELL, THE COHORT STUDIES THAT I WAS 7 DESCRIBING ACTUALLY DIDN'T HAVE A CONTROLLED COHORT. 8 THEY WERE BEING COMPARED AGAINST WHAT ARE CALLED 9 STANDARDIZED MORTALITY STATISTICS WHICH ARE 10 AVAILABLE BUT I DON'T THINK I -- AS I MENTIONED, IF 11 THAT WAS TRUE, YOU WOULD BE TALKING ABOUT RELATIVE 12 RISKS. BUT IT IS A MINOR POINT. I AM JUST SAYING 13 THAT IT WASN'T -- THERE ARE NO TWO COHORTS. 14 Q. I AM JUST TRYING TO TALK BROAD 15 CONCEPTS HERE. 16 A. OKAY. 17 Q. OKAY. SO FOR CONTROLS, IF YOU ARE 18 USING, YOU MIGHT USE STANDARD STATISTICS DRAWN FROM 19 THE POPULATION AT LARGE; RIGHT? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (61 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. WE USE STATISTICS TO COMPARE YOUR 21 COHORT TO THE POPULATION AT LARGE; CORRECT. 22 Q. OKAY. BUT IS THE BASIC THEORY THAT 23 YOU ARE COMPARING A GROUP OF PEOPLE WHO ARE EXPOSED 24 TO THE TOXIN IN QUESTION TO A GROUP THAT IS NOT 25 EXPOSED? 26 A. YES. 27 Q. AND WOULD YOU AGREE THAT IF YOU HAVE 28 UNEXPOSED PEOPLE IN YOUR EXPOSED GROUP, THAT IT CAN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (62 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4030 1 MESS UP YOUR STATISTICS? 2 A. WELL, IT DEPENDS ON HOW YOU DO THE 3 ANALYSIS. 4 SOME PEOPLE ANALYZE ACCORDING TO 5 EVEN IN THE COHORT STUDIES, THEY HAVE FOUND 6 UNEXPOSED PEOPLE, THEY HAVE FOUND LOW EXPOSED 7 PEOPLE, THEY HAVE FOUND PEOPLE WHO HAVE, YOU KNOW, 8 MODERATE EXPOSURES AND THEY HAVE HIGH EXPOSURES. 9 SO IF YOU DESIGN YOUR COHORT STUDY 10 WHERE YOU ARE ACTUALLY LOOKING AT DIFFERENT EXPOSURE 11 GROUPS, IT WOULDN'T EFFECT IT. 12 IF YOU HAD ONLY TWO GROUPS AND YOU 13 HAD LOTS OF UNEXPOSED PEOPLE IN THAT, IT MIGHT 14 EFFECT YOUR STATISTICS. 15 IT MIGHT EFFECT THE VALIDITY OF THE 16 OUTCOME. 17 Q. SIR, IF THE DISEASE RATE THAT WE 18 FIND IN THE EXPOSED GROUP AND OUR CONTROLS ARE THE 19 SAME, THAT WOULD BE AN EXAMPLE OF A NEGATIVE STUDY; file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (63 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 RIGHT? 21 A. CORRECT. 22 Q. AND A NEGATIVE STUDY CAN MEAN THAT 23 WE HAVE FOUND NO EFFECT FROM THE EXPOSURE; RIGHT? 24 A. CORRECT. 25 Q. IT CAN ALSO MEAN THAT OUR STUDY 26 LACKS SUFFICIENT STATISTICAL POWER TO BE ABLE TO 27 DETECT AN EFFECT; CORRECT? 28 A. THAT'S CORRECT. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (64 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4031 1 Q. AND IT CAN ALSO MEAN THAT OUR STUDY 2 DESIGN MAY HAVE SOME INHERENT BIASES SUCH AS THE 3 HEALTHY WORKER BIAS THAT MIGHT MAKE THE EFFECT NOT 4 VISIBLE. WOULD YOU AGREE WITH THAT, SIR? 5 A. WELL, THE HEALTHY WORKER EFFECT 6 DEPENDS UPON THE DISEASE, IN TERMS OF MAGNITUDE. 7 THERE ARE SOME DISEASES THAT HAVE 8 HEALTHY WORKER EFFECTS AND THERE ARE OTHER WHERE IT 9 IS NOT A VERY SIGNIFICANT ISSUE. 10 Q. WOULD YOU AGREE, SIR, THAT BIASES 11 CAN BE A FACTOR THAT CAN MAKE IT DIFFICULT FOR YOU 12 TO SEE THE EFFECT OF AN EXPOSURE? 13 A. THAT'S GENERALLY TRUE, YES. IN ALL 14 OF THESE EPIDEMIOLOGY STUDIES. 15 Q. AND IF YOU GET A NEGATIVE RESULT 16 FROM YOUR STUDY, THAT IS, AN ODDS RATIO OF ONE, IT 17 MAY BE BECAUSE THERE IS NO EFFECT TO BE SEEN OR 18 BECAUSE, FROM PROBLEMS WITH YOUR STUDY DESIGN OR 19 YOUR SELECTION, THAT YOU HAVE MISSED SOMETHING THAT, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (65 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 IN FACT, IS THERE. 21 WOULD YOU AGREE WITH THAT? 22 A. WELL, NOW YOU ARE TALKING ABOUT CASE 23 CONTROL STUDIES WITH ODDS RATIOS. I AM NOT EXACTLY 24 SURE -- CAN YOU REPEAT THAT QUESTION AGAIN. 25 Q. WELL, SIR, YOU TALKED A MOMENT AGO 26 ABOUT THE NEED FOR CONSISTENCY AMONG THE STUDIES; 27 RIGHT? 28 A. NO, I KNOW, BUT YOU WERE TALKING COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (66 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4032 1 ABOUT COHORT STUDIES AND ALL OF THE SUDDEN YOU SAID 2 ODDS RATIOS AND I WAS TRYING TO RETHINK YOUR 3 QUESTION IN TERMS OF THAT DIFFERENT KIND OF 4 EPIDEMIOLOGY STUDY. 5 Q. SIR, JUST A MOMENT AGO YOU WERE 6 TALKING ABOUT -- WELL, LET'S COME AT THIS A 7 DIFFERENT WAY HERE. 8 YOU REVIEWED THE MEDICAL LITERATURE; 9 CORRECT? 10 A. YES. 11 Q. AND I WROTE DOWN A STATEMENT YOU 12 MADE, YOU SAID LOOKED AT ALL THE LITERATURE YOU 13 COULD FIND. IS THAT RIGHT? 14 A. THAT'S CORRECT. I DID A LITERATURE 15 SEARCH AND I LOOKED AT MOST OF THE LITERATURE, I 16 THINK, THAT THE PLAINTIFFS' EXPERTS HAD PUT TOGETHER 17 AS WELL. 18 Q. AND YOU KNOW HOW TO DO THOSE KINDS 19 OF MEDICAL SEARCHES FOR LOOKING FOR MEDICAL file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (67 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 LITERATURE; RIGHT? 21 A. YES. 22 Q. YOU KNEW THAT THIS CASE WAS ABOUT 23 PETROCHEMICAL SOLVENTS INCLUDING BENZENE? 24 A. YES -- WELL, YES. I MEAN, BUT I 25 WOULD TRY -- FOR BENZENE EXPOSURE ISSUES, I TRIED TO 26 GET STUDIES THAT WERE LOOKING PRIMARILY OR 27 EXCLUSIVELY AT BENZENE EXPOSURE. 28 Q. SIR, MY QUESTION WAS A SIMPLE ONE. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (68 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4033 1 DID YOU KNOW THAT THIS CASE INVOLVED 2 ALLEGATIONS OF EXPOSURE TO PETROCHEMICAL SOLVENTS 3 INCLUDING BENZENE? 4 A. YES, YES. I'M SORRY, I 5 MISUNDERSTOOD. 6 Q. AND LET'S TAKE A LOOK AT ONE OF THE 7 STUDIES THAT I BELIEVE WAS ON YOUR CHART BY HARDELL. 8 SIR, I'LL HAND YOU A COPY. 9 MR. WAGNON: YOUR HONOR, I HAVE SOME SUMMARY 10 INFORMATION INCLUDING THE NAME OF THE STUDY AND THE 11 POINTS THAT I WANTED TO ASK HIM ABOUT. THAT I'D LIKE TO 12 DISPLAY WITH THE COURT'S PERMISSION. 13 THE COURT: ANY OBJECTION? 14 MR. RIFF: NO. 15 YOUR HONOR, WILL THE WITNESS ALSO HAVE 16 THIS STUDY? IF THE WITNESS ALSO HAS THE STUDY, THEN I 17 HAVE NO OBJECTION. 18 THE COURT: OKAY, YOU HAVE GIVEN HIM A COPY 19 THAT HE MAY REFER TO. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (69 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 MR. WAGNON: I HAVE JUST HANDED IT TO HIM. 21 THE WITNESS: THIS ISN'T A STUDY THAT I 22 LISTED. 23 Q. BY MR. WAGNON: OKAY, WELL, THERE'S MORE 24 THAN ONE HARDELL STUDY, ISN'T THERE? 25 A. THAT'S CORRECT. 26 Q. AND THIS ONE IS THE ONE FROM 1981; 27 CORRECT? 28 A. THAT'S CORRECT. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (70 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4034 1 Q. AND JUST TO BE CLEAR, IT IS TITLED 2 "MALIGNANT LYMPHOMA AND EXPOSURE TO CHEMICALS, 3 ESPECIALLY ORGANIC SOLVENTS AND CHLOROPHENOLS AND 4 PHENOXY ACIDS, A CASE CONTROL STUDY." 5 CORRECT? 6 A. THAT'S CORRECT. 7 Q. AND I WANT TO ASK YOU SOMETHING 8 ABOUT SOME OF THE STATISTICS FOR THIS. 9 THIS BEING A CASE CONTROL STUDY 10 REPORTED A RELATIVE RISK; RIGHT? 11 A. YES. 12 Q. AND THE RELATIVE RISK IS ONE OF 13 THOSE STATISTICS THAT IF IT IS ONE, IT SHOWS NO 14 INCREASE BUT IF IT IS ABOVE ONE IT SHOWS AN INCREASE 15 THAT HAS BEEN DETECTED; RIGHT? 16 A. THAT'S CORRECT. 17 Q. IN THIS STUDY ON TABLE 5, THEY HAVE 18 A TABLE THERE REGARDING EXPOSURE TO ORGANIC 19 SOLVENTS. DO YOU SEE THAT? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (71 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. YES. 21 Q. AND THEY HAVE FOR THE RELATIVE RISK, 22 THEY HAVE FIGURES FOR VARIOUS TYPES OF EXPOSURES; 23 RIGHT? 24 A. YES. 25 Q. AND OVERALL THE RELATIVE RISK FOR 26 EXPOSURE TO SOLVENTS, THAT IS, IT'S IN THE COLUMN 27 LABELED ONE PLUS TWO IN ROMAN NUMERALS, THE RELATIVE 28 RISK WAS 2.4; RIGHT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (72 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4035 1 A. CAN YOU -- WHICH TABLE IS THIS IN? 2 Q. TABLE 5, MIDDLE OF PAGE 173. 3 A. YES. 4 Q. AND IN THE DISPLAY HERE, I HAVE 5 DISPLAYED IN PARENTHESIS SOME NUMBERS, A PAIR OF 6 NUMBERS FOLLOWING THAT. 7 YOU HAVE SEEN THOSE KINDS OF 8 NUMERICAL DISPLAYS FOLLOWING A RELATIVE RISK FIGURE, 9 HAVEN'T YOU? 10 A. YES. AS A MATTER OF FACT, I HAVE 11 SEEN -- I KNOW THIS STUDY PRETTY WELL. 12 Q. OKAY, WELL, THOSE NUMBERS, THOSE ARE 13 WHAT THEY CALL THE 95 PERCENT CONFIDENCE INTERVAL, 14 AREN'T THEY? 15 A. YES. 16 Q. AND THE 95 PERCENT CONFIDENCE 17 INTERVAL IS THE HIGH AND LOW RANGE WITHIN WHICH WE 18 ARE 95 PERCENT SURE THAT THE TRUE VALUE LIES 19 SOMEWHERE IN THAT RANGE; CORRECT? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (73 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. YES. 21 Q. AND CORRESPONDS TO A P-VALUE OF 22 WHAT? 23 A. I COULDN'T TELL YOU WITHOUT DOING 24 THE MATH BUT THE P-VALUES CAN BE VERY DIFFERENT FOR 25 THOSE DIFFERENT ONES. 26 Q. FOR 95 PERCENT CONFIDENCE INTERVAL, 27 A P-VALUE ISN'T .05 OR LESS? 28 A. I THOUGHT YOU WERE ASKING THOSE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (74 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4036 1 SPECIFIC ONES. BECAUSE, WELL, THEY WOULD BE 2 DIFFERENT FOR THOSE. 3 BUT IF YOU HAD ONE THAT WAS 4 BORDERLINE, IN OTHER WORDS, THE CONFIDENCE INTERVAL 5 INCLUDED, WAS 1.0, THEN IT WOULD BE 95 PERCENT. 6 Q. NOW, FOR CONFIDENCE INTERVALS, 7 THAT'S AN IMPORTANT FIGURE TO HAVE IF YOU ARE GOING 8 TO DETERMINE WHETHER OR NOT THE NUMBER IS 9 STATISTICALLY SIGNIFICANT, ISN'T IT? 10 A. YES. 11 Q. BECAUSE IF THE LOWER BOUND OF THE 12 CONFIDENCE INTERVAL IS BELOW ONE, THEN MOST PEOPLE 13 WILL SAY THAT'S NOT SIGNIFICANT, WOULD YOU AGREE? 14 A. EXCUSE ME? CAN YOU REPEAT THE 15 QUESTION. 16 Q. IF THE LOWER BOUND OF THE 95 PERCENT 17 CONFIDENCE INTERVAL IS BELOW ONE, MOST WOULD SAY 18 THAT IT IS NOT A SIGNIFICANT RESULT? 19 A. CORRECT. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (75 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND IN THE RESULTS HERE DISPLAYED 21 FOR SOLVENTS, IT HAS A RELATIVE RISK OF 2.4, MEANING 22 THE EXPOSED GROUP WAS MORE THAN TWICE AS LIKELY TO 23 DEVELOP THIS TYPE OF CANCER; CORRECT? 24 A. YES. 25 Q. AND THAT THE CONFIDENCE INTERVAL IS 26 1.5 TO 3.8, SO WE WOULD CALL THAT A SIGNIFICANT 27 RESULT; CORRECT? 28 A. YES. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (76 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4037 1 Q. AND THEN THIS STUDY WENT ON TO LOOK 2 AT THE RESULTS WHEN YOU BROKE IT DOWN INTO THE LEVEL 3 OF EXPOSURE, DIDN'T IT? 4 A. YES. 5 Q. AND IT BASICALLY BROKE IT DOWN TO 6 LOW DOSE AND HIGH DOSE; RIGHT? 7 A. YES. 8 Q. AND LOW DOSE SHOWED A LOWER RELATIVE 9 RISK THAT ACTUALLY ISN'T EVEN STATISTICALLY 10 SIGNIFICANT; RIGHT? 11 A. RIGHT. 12 Q. AND THE HIGHER DOSE SHOWED A HIGHER 13 LEVEL OF RISK; RIGHT? 14 A. YES. 15 Q. AND IN FACT, WHEN WE GOT UP TO THE 16 HIGHEST EXPOSURE OF STYRENE TRICHLORO BENZENE, 17 ACCORDING TO TABLE 5, WE GOT UP TO A RELATIVE RISK 18 OF 4.6, DIDN'T WE? 19 A. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (77 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND THAT'S STATISTICALLY 21 SIGNIFICANT, ISN'T IT? 22 A. YES. 23 Q. SO WHAT WE HAVE HERE IN THESE 24 INCREASING RELATIVE RISK NUMBERS WITH INCREASING 25 LEVELS OF EXPOSURE IS WE HAVE A DOSE RESPONSE 26 SHOWING UP STATISTICALLY, DON'T WE? 27 A. YES. ALTHOUGH, IN ORDER TO REALLY 28 CONFIRM THAT, YOU WOULD HAVE TO STATISTICALLY TEST COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (78 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4038 1 THE DIFFERENCE BETWEEN THE TWO GROUPS AND THEY 2 DIDN'T DO THAT. 3 BUT THERE IS AN APPARENT DOSE 4 RESPONSE, YES. 5 Q. OKAY. 6 LET'S MOVE ON. 7 THE STUDY ON THE FIRST PAGE CONTAINS 8 AN ABSTRACT; RIGHT? 9 A. YES. 10 Q. AND ONE OF THE THINGS IT SAYS IN 11 THERE IS ORGANIC SOLVENTS MAY BE A CAUSATIVE FACTOR 12 IN MALIGNANT LYMPHOMA; CORRECT? 13 A. YES. 14 Q. NOW, PARNELL, WHICH WAS PART OF A 15 SWEDISH GROUP; RIGHT? 16 A. HARDELL, YES. 17 Q. HARDELL, EXCUSE ME. 18 AND IN FACT, IN THIS AREA OF SOLVENT 19 EXPOSURE, THERE WERE A NUMBER OF SWEDISH STUDIES, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (79 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 WEREN'T THERE? 21 A. YES. 22 Q. LET'S MOVE ON TO THE NEXT HARDELL, 23 IN 1994. SHOW YOU A COPY. AND THE TITLE OF THIS 24 ONE IS "EXPOSURE TO PHENYLOXYACETIC ACIDS, 25 CHLOROPHENOLS OR ORGANIC SOLVENTS IN RELATION TO 26 HISTOPATHOLOGY, STAGE AND ANATOMICAL LOCATION OF 27 NON-HODGKIN'S LYMPHOMA," PUBLISHED IN CANCER 28 RESEARCH IN 1994. CORRECT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (80 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4039 1 A. YES. 2 Q. AND THIS, IF YOU WOULD TURN TO TABLE 3 2 -- WELL, ACTUALLY, LET'S JUST LOOK AT THE ABSTRACT 4 FIRST HERE. 5 MIDDLE OF THE ABSTRACT, DO YOU SEE 6 THE LINE WHERE IT READS "EXPOSURE TO ORGANIC 7 SOLVENTS YIELDED AN ODDS RATIO OF 2.4." DO YOU SEE 8 THAT? 9 A. YES. 10 Q. AND THEN THEY GIVE THE 95 PERCENT 11 CONFIDENCE INTERVAL OF 1.4 TO 3.9 MEANING IT WAS 12 SIGNIFICANT; RIGHT? 13 A. YES. 14 Q. AND -- WE HAVE A SUMMARY OF SOME OF 15 THE DATA IN THIS STUDY HERE. 16 IF YOU WOULD GO TO TABLE 2. 17 DO YOU HAVE IT? 18 A. YES. 19 Q. IT'S ON PAGE 2387? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (81 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. YES. 21 Q. AND IN THERE THEY HAVE LOW DOSE AND 22 HIGH DOSE RESPONSE FIGURES, DON'T THEY? 23 A. YES. 24 Q. OF THE ODDS RATIO WAS, FOR THE LOW 25 DOSE WAS 1.1 AND THE HIGH DOSE WAS 3.5; CORRECT? 26 A. YES. 27 Q. AGAIN, WHAT WE HAVE HERE IS A DOSE 28 RESPONSE AND A SIGNIFICANT RESULT IN TERMS OF THE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (82 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4040 1 OVERALL RELATIVE RISK LOOKING AT EXPOSURE TO 2 SOLVENTS AND LYMPHOMA; CORRECT? 3 A. YES. 4 Q. THERE'S ANOTHER SWEDISH STUDY THAT I 5 SUSPECT YOU ARE FAMILIAR WITH -- OH, THIS HARDELL 6 STUDY, IS THIS ONE YOU DID, QUOTE, IN YOUR SUMMARY 7 CHART? 8 A. WELL, BUT I WAS ONLY QUOTING THE 9 PART OF IT THAT ACTUALLY HAD TO DO WITH PETROLEUM 10 BASED SOLVENTS. THE PROBLEM WITH THIS STUDY, AS 11 WITH THE PREVIOUS STUDY, IS IT INCLUDES A LOT OF 12 DIFFERENT KINDS OF SOLVENTS INCLUDING CHLORINATED 13 SOLVENTS. AND SO I FOCUSED AND I THINK I HAVE IT IN 14 MY CHART BUT I ONLY FOCUSED ON THE PETROLEUM BASED 15 SOLVENTS. AND FOR EXAMPLE, IN THE PREVIOUS ARTICLE, 16 THEY TALK ABOUT THE ORGANIC SOLVENTS THAT THIS IS 17 THE ONE THAT YOU HAD MENTIONED PREVIOUSLY. THEY 18 SAID THAT SEVEN CASES AND THREE CONTROLS WERE 19 EXPOSED TO TRICHLOROETHYLENE. ONE CASE IN FIVE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (83 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 CONTROLS TO STYRENE, ONE CASE TO PERCHLOROETHYLENE 21 AND ONE TO BENZENE. 22 SO OUT OF ALL THE PEOPLE IN THIS 23 STUDY, THERE WAS ONLY ONE PERSON THAT WAS EXPOSED TO 24 A PETROLEUM SOLVENT. ALL OF THE OTHERS WERE THESE 25 CHLORINATED ORGANIC SOLVENTS. SO THAT'S WHY I 26 DIDN'T REFER TO THAT DOSE RESPONSE INFORMATION, NOR 27 DID I REFER TO THIS EARLIER PAPER BECAUSE IT WASN'T 28 RELEVANT TO THE ISSUE OF PETROLEUM SOLVENTS. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (84 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4041 1 Q. PAGE -- TABLE 2 ON PAGE 2387 LISTS 2 VARIOUS TYPES OF CHEMICALS; RIGHT? 3 A. YES. 4 Q. AND IT HAS A WHOLE SECTION THERE FOR 5 ORGANIC SOLVENTS, DOESN'T IT? 6 A. CORRECT. 7 Q. AND THAT IS SEPARATE FROM THE 8 CHLOROPHENOLS WHICH IS ABOVE IT; RIGHT? 9 A. YES. 10 Q. AND AMONG THE ORGANIC SOLVENTS ARE 11 LISTED THINGS LIKE THINNER -12 A. EXCUSE ME, THE ONES THAT ARE LISTED 13 ABOVE ARE HERBICIDES, PHENOXYACETIC ACIDS AND 14 CHLOROPHENOLS. 15 THE ORGANIC SOLVENTS CLEARLY INCLUDE 16 TRICHLOROETHYLENE, IT ALSO INCLUDES TURPENTINE WHICH 17 COMES FROM PINE TREES. 18 SO THEY HAVE LUMPED TOGETHER UNDER 19 ORGANIC SOLVENTS A WHOLE BUNCH OF DIFFERENT THINGS. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (85 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. YES, THEY HAVE INCLUDED WHITE 21 SPIRITS, HAVEN'T THEY? 22 A. THAT IS ONE THAT IS A PETROLEUM 23 BASED PRODUCT, YES. 24 Q. THAT'S ALSO KNOWN AS PAINT THINNER; 25 RIGHT? 26 A. CORRECT. 27 Q. AND THEY HAVE INCLUDED SOMETHING 28 CALLED THINNER; CORRECT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (86 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4042 1 A. THAT'S WORSE -- YES, THINNER BUT I 2 DON'T KNOW EXACTLY WHAT THINNER THEY ARE TALKING 3 ABOUT THERE BUT I WOULD CERTAINLY SAY WHITE SPIRIT 4 IS A PETROLEUM BASED SOLVENT. 5 Q. AND FOR THAT THEY CALCULATED AN ODDS 6 RATIO OF 3.2; RIGHT? 7 A. RIGHT. AND I THINK I HAVE ONE OF 8 THESE I HAVE IN MY CHART. THAT IS THE ONE THAT HAS 9 NOTED THAT, BECAUSE IT INVOLVED A PETROLEUM BASED 10 SOLVENT. 11 Q. LET'S MOVE ON TO THE NEXT SWEDISH 12 STUDY. ARE YOU FAMILIAR WITH OLSSON, O-L-S-S-O-N, 13 AND BRANDT, B-R-A-N-D-T, THE TITLE OF THIS IS "RISK 14 OF NON-HODGKIN'S LYMPHOMA AMONG MEN OCCUPATIONALLY 15 EXPOSED TO ORGANIC SOLVENTS" PUBLISHED IN 1988. 16 CORRECT? 17 A. YES. 18 Q. AND AGAIN, IT'S LOOKING AT THE 19 DISEASE OF INTEREST, NON-HODGKIN'S LYMPHOMA; file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (87 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 CORRECT? 21 A. THAT'S CORRECT. 22 Q. AND IT IS LOOKING AT ORGANIC 23 SOLVENTS; CORRECT? 24 A. AND AGAIN IT DOESN'T REALLY DEFINE 25 THIS AS -- I WAS TRYING TO CONCENTRATE ON PETROLEUM 26 BASE ORGANIC SOLVENTS. SO AS I MENTIONED BEFORE I 27 REVIEWED A LOT OF THE SOLVENT LITERATURE BUT 28 IN ORDER TO FOCUS ON WHAT WE ARE CONCERNED ABOUT IN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (88 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4043 1 THIS CASE, FOR ME TO INCLUDE IT IN MY TABLE IT WOULD 2 NEED TO BE SOMETHING ABOUT THE PETROLEUM BASE 3 SOLVENTS THAT MR. MOLINA COULD HAVE BEEN EXPOSED TO. 4 Q. SIR, THE -- ONE OF THE SOURCES OF 5 INFORMATION IS THEY RELIED ON PEOPLE'S HISTORIES OF 6 THEIR OCCUPATIONS; CORRECT? 7 A. COULD YOU REFER ME TO WHAT YOU ARE 8 LOOKING AT. 9 Q. SURE. OVER ON PAGE 248, RIGHT-HAND 10 COLUMN, MIDDLE OF THE PAGE, A VARIETY OF OCCUPATIONS 11 WAS ASSOCIATED WITH EXPOSURE TO SOLVENTS.; CORRECT? 12 A. YES. 13 Q. AND THEY INCLUDED REPAIR OF 14 MACHINES, WORK IN THE CHEMICAL INDUSTRY OR AS A 15 CHEMIST, WORK AS A PAINTER, WORK IN THE WOOD OR 16 FURNITURE INDUSTRY, PRINTING WORK, EMPLOYMENT IN THE 17 RUBBER OR PLASTICS INDUSTRY, SHOE MANUFACTURING 18 WORK, CLEANING WORK AND BIOLOGICAL WORK. 19 AND THOSE ARE IN DECREASING LEVELS file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (89 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OF PROPORTION; RIGHT, AMONG THIS GROUP? 21 A. YES. 22 Q. AND JUST TO BE CLEAR, A PAINTER, 23 THAT WOULD MEAN EXPOSURE TO THINGS LIKE PAINT 24 THINNER? 25 A. WELL, AMONG OTHER THINGS. PAINTERS 26 ARE EXPOSED TO ALL SORTS OF THINGS, PIGMENTS, 27 GLYCOLETHERS, YOU KNOW, THERE'S -- THERE'S A HUGE 28 VARIETY OF CHEMICALS IN PAINT, NOT JUST PAINT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (90 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4044 1 THINNER. 2 Q. WORK IN THE WOOD OR FURNITURE 3 INDUSTRY, THAT WOULD INVOLVE APPLYING PAINTINGS AND 4 VARNISHES THAT CONTAIN ORGANIC SOLVENTS; RIGHT? 5 A. VARIOUS TYPES OF ORGANIC SOLVENTS, 6 YES. 7 Q. PRINTING WORK. IN PRINTING WORK, 8 THAT'S KNOWN FOR EXPOSURE TO THINGS LIKE BENZENE OR 9 OTHER ORGANIC SOLVENTS? 10 A. NOT BENZENE SO MUCH AS FAR AS I AM 11 AWARE OF. 12 Q. ORGANIC SOLVENTS? 13 A. SOMETIMES ORGANIC SOLVENTS BUT AGAIN 14 THERE ARE OTHER, LOTS OF OTHER THINGS IN PRINTING. 15 Q. EMPLOYMENT IN THE RUBBER OR PLASTIC 16 INDUSTRY, THAT WOULD INCLUDE MR. MOLINA, WOULDN'T 17 IT? 18 A. I ASSUME SO, IF THAT'S WHAT THEY 19 MEAN BY RUBBER. I DON'T KNOW WHAT THEY MEAN BY file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (91 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 PLASTICS INDUSTRY. 21 Q. SHOE MANUFACTURING, THAT'S LONG BEEN 22 A SOURCE OF EXPOSURE TO ORGANIC SOLVENTS; CORRECT? 23 A. USUALLY IN THE DYES ALTHOUGH, AGAIN, 24 ONLY IN THIS CASE I THINK ONLY EMPLOYMENT IN RUBBER 25 AND PLASTICS WAS ONLY SIX PERCENT. SHOE WAS ONLY 26 FOUR PERCENT. 27 Q. LET'S LOOK AT THE, WHAT THE 28 STATISTICS SHOW. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (92 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4045 1 IF YOU WOULD JUST GO TO THE 2 LEFT-HAND COLUMN OF THAT SAME PAGE, TABLE 4, THEY 3 HAVE SOME FIGURES FOR LENGTH OF EXPOSURE ON THE JOB. 4 RIGHT? 5 A. YES. 6 Q. 120 MONTHS, 240 MONTHS, 360 MONTHS; 7 RIGHT? AND THEY HAVE ODDS RATIOS OF 1.8, 3.3, 6.0, 8 RESPECTIVELY; CORRECT? 9 A. YES. 10 Q. SHOWING AGAIN A DOSE RESPONSE 11 RELATIONSHIP, ISN'T THAT RIGHT? 12 A. WELL, I DON'T -- WHEN YOU SAY DOSE, 13 THIS IS ACTUALLY DUE TO DURATION OF EMPLOYMENT AND 14 WE ARE TALKING ABOUT PEOPLE WHO HAVE OCCUPATIONS. 15 IT MEANS HOW LONG THEY WERE IN THOSE OCCUPATIONS. I 16 DON'T KNOW THAT YOU CAN, YOU CAN ACTUALLY TRANSLATE 17 THIS INTO A DOSE OF ANYTHING. 18 Q. SO IT SOUNDS LIKE THE WRITERS WERE 19 MAKING THIS LOGICAL LEAP THAT THE LONGER SOMEBODY file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (93 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 WORKED WITH SOLVENTS, THE LARGER THE DOSE WAS THAT 21 THEY GOT EXPOSED TO. THAT'S THE LOGICAL LEAP THE 22 AUTHORS WERE MAKING, ISN'T IT? 23 A. WELL, THEY WERE USING THAT AS AN 24 ILLUSTRATION BUT, AGAIN, I DON'T THINK ONE CAN 25 CONCLUDE FROM THIS THAT EXPOSURE, IN PARTICULAR, TO 26 PETROLEUM SOLVENTS, IS INVOLVED IN THIS INCREASE 27 OVER TIME. 28 Q. WE ARE JUST TRYING TO GET A PICTURE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (94 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4046 1 HERE, AREN'T WE, BY TAKING LITTLE SNAPSHOTS FROM 2 DIFFERENT PLACES? 3 A. NO, WE ARE TRYING TO ANALYZE THE 4 LITERATURE ACCORDING TO A METHODOLOGY WHICH I 5 MENTIONED WAS THE BRADFORD HILL CRITERIA AND ONE OF 6 THE THINGS THAT ANOTHER PART OF THAT IS SPECIFICITY. 7 IN OTHER WORDS, YOU REALLY HAVE TO 8 MAKE SURE THAT WHAT YOU ARE LOOKING AT IS NOT ONLY 9 THE DISEASE BUT ALSO LOOKING AT THE CHEMICAL THAT 10 YOU ARE INTERESTED IN. 11 Q. DID YOU INCLUDE THIS STUDY IN YOUR 12 CHART? 13 A. I REVIEWED IT BUT I DIDN'T INCLUDE 14 IT IN MY CHART BECAUSE IT WASN'T SPECIFICALLY ABOUT 15 PETROLEUM BASE ORGANIC SOLVENTS. 16 Q. IN THE READING IN THE ABSTRACT IT 17 STATES: 18 "THESE FINDINGS SUPPORT 19 THE CONCEPT THAT OCCUPATIONAL file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (95 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EXPOSURE TO ORGANIC SOLVENTS IS A 21 RISK FACTOR FOR NON-HODGKIN'S 22 LYMPHOMA." 23 THAT'S THE CONCLUSION OF THE AUTHORS; 24 RIGHT? 25 A. AGAIN, THEY ARE LOOKING AT ALL 26 SOLVENTS IN MAKING THAT CONCLUSION. THEY ARE NOT 27 SAYING ANYTHING IN PARTICULAR ABOUT THE KINDS OF 28 SOLVENTS THAT WE ARE TALKING ABOUT HERE. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (96 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4047 1 Q. LET'S MOVE ON TO A STUDY BY BERLIN 2 ET. AL. HAND YOU A COPY. 3 AND THIS IS TITLED "CANCER INCIDENTS 4 AND MORTALITY OF PATIENTS WITH SUSPECT SOLVENT 5 RELATED DISORDERS" PUBLISHED IN 1995. 6 THIS STUDY LOOKED AT PEOPLE WHO 7 ALREADY HAVE SOME PROBLEMS FROM EXPOSURES TO 8 SOLVENTS; CORRECT? 9 A. YES, IT'S A COHORT STUDY. 10 Q. AND IT IS LOOKING, IN PARTICULAR, IT 11 IS LOOKING AT WOMEN WHO HAD BEEN EXPOSED TO SOLVENTS 12 AND ALREADY HAD SOME, LIKE NEUROLOGICAL SYMPTOMOLOGY 13 AS A RESULT OF THAT EXPOSURE, WOULD YOU AGREE? 14 A. I DON'T REMEMBER THAT SPECIFICALLY 15 ABOUT THIS STUDY BUT, YOU KNOW, IF YOU WANT TO POINT 16 OUT WHERE THEY SAY THAT. 17 Q. WELL, LET'S LOOK AT THE FIRST PAGE. 18 A. I DON'T HAVE ANY REASON TO DISAGREE 19 WITH THAT. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (97 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. FIRST PAGE IN THE ABSTRACT, AT THE 21 BOTTOM WHERE IT SAYS, "CONCLUSIONS," IT SAYS: 22 "THE STUDIES SHOWED AN 23 INCREASED RISK FOR MALIGNANCIES OF 24 THE HEMATOPOIETIC SYSTEM AND THE 25 UTERINE CERVIX AMONG PATIENTS 26 ORIGINALLY EXAMINED WITH REGARD TO 27 SOLVENT INDUCED DISORDERS." 28 A. YES, OKAY. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (98 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4048 1 Q. AND HEMATOPOIETIC SYSTEM, THAT'S IN 2 REFERENCE TO THE BLOOD-FORMING ORGANS; RIGHT? 3 A. CORRECT. 4 Q. DO SOME PEOPLE CONSIDER LYMPHOMA TO 5 BE A CANCER THAT HAS ITS ORIGINS IN THE 6 HEMATOPOIETIC SYSTEM? 7 A. I DON'T BELIEVE SO. FOR EXAMPLE, 8 HERE AT HODGKIN'S LYMPHOMA THEY ACTUALLY FOUND -9 THEY FOUND AN INCREASE BUT THEY DIDN'T REALLY FIND 10 IT FOR -- I DON'T REALLY KNOW WHAT THEY WERE TALKING 11 ABOUT HERE IN TERMS OF HEMATOPOIETIC SYSTEM. 12 USUALLY WHEN I THINK OF HEMATO, WE TALK ABOUT 13 LYMPHATIC AND HEMATOPOIETIC SYSTEM SO WE USUALLY 14 DISTINGUISH BETWEEN THE TWO OF THEM. I CAN'T TELL 15 YOU EXACTLY WHAT THEY WERE TRYING TO DESCRIBE HERE 16 IN THIS STUDY. 17 I MEAN, IF YOU WANTED TO POINT OUT 18 SOMETHING THAT YOU WERE PARTICULARLY INTERESTED IN. 19 Q. WELL, ISN'T ONE OF THE DISEASES THAT file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (99 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THEY LOOK AT NON-HODGKIN'S LYMPHOMA? 21 A. YES. 22 Q. AND IF YOU WOULD GO TO TABLE TWO ON 23 PAGE 365, THERE'S SOME DATA THERE? 24 A. YES. 25 Q. FOR NON-HODGKIN'S LYMPHOMA, IT SHOWS 26 A STANDARDIZED INCIDENCE RATIO WHICH, FOR OUR 27 PURPOSES, OPERATES THE SAME AS THESE NUMBERS, IN 28 OTHER WORDS, ONE MEANS NO EFFECT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (100 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4049 1 A. YES. 2 Q. BIGGER THAN ONE MEANS AN EFFECT. 3 AND THEY FOUND 1.9 FOR NON-HODGKIN'S 4 LYMPHOMA; CORRECT? 5 A. WELL, ONE -- IT DOESN'T MEAN AN 6 EFFECT, IT MEANS THERE'S AN ASSOCIATION. IN THIS 7 CASE, IT IS NOT STATISTICALLY SIGNIFICANT. BUT 8 AGAIN, I WANT TO POINT OUT THE FACT THAT, YOU KNOW, 9 I DON'T REALLY SEE ANY INDICATION HERE AGAIN THAT 10 THESE WERE PETROLEUM BASED SOLVENTS THAT WE WERE, 11 THAT ARE BEING STUDIED IN THIS STUDY. 12 THESE ARE PEOPLE WHO HAVE SOME KIND 13 OF A SOLVENT INDUCED DISORDER BUT IT'S PRETTY 14 NONSPECIFIC ABOUT WHAT WE ARE ACTUALLY, THE 15 CHEMICALS THAT WE ARE ACTUALLY DEALING WITH HERE. 16 Q. SO WHEN THEY REFER IN THE STUDY TO 17 ORGANIC SOLVENTS, THAT DOESN'T, THAT'S NOT SPECIFIC 18 ENOUGH AS FAR AS YOU ARE CONCERNED? 19 A. ORGANIC MEANS THAT IT HAS A CARBON file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (101 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 AND A HYDROGEN. IT DOESN'T TELL YOU ANYTHING ELSE 21 ABOUT ANYTHING ELSE THAT IT HAS. 22 THE DIFFERENCE BETWEEN AN ORGANIC 23 SOLVENT AND WATER, FOR EXAMPLE, WATER WOULD BE AN 24 EXAMPLE OF A NONORGANIC SOLVENT. 25 SO ALL THEY ARE REALLY TALKING ABOUT 26 IS SOLVENTS AND THESE ARE THE TYPES OF SOLVENTS THAT 27 ARE BEING USED TO DISSOLVE THINGS THAT CAN'T 28 NORMALLY DISSOLVE THINGS THAT WATER WOULD DISSOLVE. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (102 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4050 1 SO YOU USE WHAT ARE CALLED ORGANIC 2 SOLVENTS, AND THERE ARE A HUGE RANGE OF TYPES OF 3 CHEMICALS THAT ARE, THAT ARE UNDER THAT DEFINITION 4 OF ORGANIC SOLVENTS. 5 Q. IF YOU WOULD TURN TO PAGE 363 UP AT 6 THE UPPER RIGHT-HAND CORNER, THEY DESCRIBE THE MOST 7 COMMON JOBS AMONG THE STUDY PARTICIPANTS AND THEY 8 SAY, MOST OF THE WORKERS WERE EXPOSED TO A MIXTURE 9 OF SOLVENTS, PARTICULARLY WHITE SPIRIT, STYRENE AND 10 TOLUENE. 11 THOSE ARE FAMILIAR NAMES TO YOU, 12 AREN'T THEY? 13 A. THAT'S CORRECT. BUT AGAIN, THEY, 14 THEY WEREN'T RESTRICTING THIS TO, PARTICULARLY 15 PETROLEUM BASED SOLVENTS. 16 SO LET'S SET THIS ONE ASIDE. 17 Q. LET ME ASK YOU ABOUT PERSSON, 18 P-E-R-S-S-O-N. 19 A. I HAVE NEVER MET THE GENTLEMAN. I file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (103 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 DON'T KNOW. 21 Q. AND ONE IS ENTITLED "SOME RISK 22 FACTORS FOR NON-HODGKIN'S LYMPHOMA." IT IS 23 PUBLISHED IN 1999. 24 AGAIN, THIS IS ANOTHER SWEDISH 25 STUDY; CORRECT? 26 A. YES. UH-HUH. 27 Q. AND IT, ONCE AGAIN, LOOKS AT 28 NON-HODGKIN'S LYMPHOMA AND ITS RELATIONSHIP TO COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (104 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4051 1 SOLVENTS; RIGHT? 2 A. YES. 3 Q. AND LET'S LOOK AT SOME OF THE 4 SOLVENTS THAT ARE INVOLVED HERE. 5 OVERALL, THEY FIND FOR SOLVENTS AND 6 NON-HODGKIN'S LYMPHOMA AN ODDS RATIO OF 1.6; 7 CORRECT? 8 A. YES. 9 Q. AND WERE THEY ABLE TO FIND EVIDENCE 10 OF A DOSE RESPONSE RATIO, I MEAN DOSE RESPONSE 11 EFFECT IN THIS STUDY? 12 A. IF YOU COULD POINT -- I HAVEN'T SEEN 13 THIS STUDY FOR A WHILE SO -14 Q. WELL, I'LL TELL YOU, FROM WHAT I 15 SEE, IT DIDN'T SHOW IT. IT IS ONE OF THOSE THAT 16 JUST DIDN'T SHOW IT. MAYBE THE NUMBERS ARE TOO 17 SMALL TO NOTICE IT. 18 A. WHERE ARE THEY LOOKING AT? WHERE 19 ARE YOU LOOKING? THE LACK OF A DOSE RESPONSE. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (105 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. OVER ON -21 A. ARE YOU TALKING ABOUT TABLE 4? IT 22 SAYS SOLVENTS 2 TO 5 VERSUS 0 TO 1? 23 Q. YES. 24 A. THEY DIDN'T FIND -- OR IT IS 1.4 BUT 25 IT IS NOT STATISTICALLY SIGNIFICANT. 26 Q. RIGHT. THAT WAS FOR THE HIGH 27 EXPOSURE. 28 A. HIGH VERSUS LOW. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (106 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4052 1 Q. YES. BUT THEY ALSO LOOK AT WHITE 2 SPIRITS, THAT THAT IS A FAMILIAR NAME AND THINNER 3 AND BOTH OF THOSE FOUND SIGNIFICANT ODDS RATIOS OF 4 2.6 AND 1.9 RESPECTIVELY; CORRECT? 5 A. YES. 6 Q. AND SO THIS WOULD BE CONSIDERED TO 7 BE A POSITIVE STUDY? 8 A. YES. I WOULD THINK SO. I WOULD 9 THINK SO. 10 I AM NOT REALLY SURE IF THIS IS 11 1991, WHETHER OR NOT THIS IS A REPEAT OF A STUDY OF 12 ANOTHER STUDY OR NOT. 13 BUT YOU ARE CORRECT. IT DID SHOW AN 14 INCREASE FOR WHITE SPIRITS. AND I DON'T KNOW WHAT 15 THINNER IS AGAIN. BUT FOR WHITE SPIRITS. BUT 16 AGAIN, FOR BENZENE, THEY FOUND NO -- IN FACT, LESS 17 THAN EXPECTED, THEY FOUND A .8 FOR BENZENE IN THIS 18 STUDY. 19 Q. OKAY. DOCTOR, WE ALL WANT TO GET file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (107 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OUT OF HERE TODAY. SO I WANT TO MOVE ON TO THE NEXT 21 STUDY. DRIVER, I BELIEVE IT IS ONE YOU DID SITE? 22 A. YES. 23 Q. AND THIS IS TITLED "OCCUPATIONAL 24 EXPOSURES AND NON-HODGKIN'S LYMPHOMA IN SOUTHERN 25 SWEDEN," DATED 2004. 26 A. YES. 27 Q. AND YOU HAVE SEEN THIS ONE BEFORE, 28 HAVEN'T YOU? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (108 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4053 1 A. I DID. I PUT IT IN MY TABLE AS YOU 2 NOTED AND I PUT IT, I PUT THE AROMATIC HYDROCARBON 3 SOLVENT EXPOSURE, THE HIGH EXPOSURE ONE, THE 1.9 4 THAT THEY HAVE ON TABLE 3 BECAUSE I THOUGHT THAT 5 AROMATIC, AGAIN, AROMATIC HYDROCARBON SOLVENTS WERE 6 THE CLOSEST TO THE THINGS THAT WE ARE TALKING ABOUT 7 HERE IN THIS, IN THIS CASE. 8 Q. WELL, LET'S TAKE A LOOK AT THOSE 9 STATS. 10 SO THERE'S VARIOUS NUMBERS THAT WERE 11 PUBLISHED IN THIS STUDY AND WHICH ONE DID YOU CHOOSE 12 TO PUT IN YOURS? 13 A. I CAN POINT TO IT. IT'S ALMOST THE 14 HIGHEST ONE. IT IS THIS ONE (INDICATING), THE 1.9. 15 Q. FROM THE AROMATIC SOLVENTS? 16 A. RIGHT, BECAUSE TOLUENE IS AN 17 AROMATIC XYLENE. XYLENE IS AN AROMATIC SOLVENT. 18 BENZENE IS AN AROMATIC SOLVENT. THESE ARE THE ONES 19 THAT ARE OF PRIMARY INTEREST TO US. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (109 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. THE SOLVENT MIXTURES, THE AROMATIC 21 SOLVENTS ARE THE ONES HAVING BENZENE RINGS AND SOME 22 SIMILAR RING TYPE STRICTURES. 23 A. CORRECT. AND THOSE ARE THE ONES 24 THAT ARE PRIMARILY USED IN RUBBER SOLVENT. 25 Q. THOSE MIXTURES, HOWEVER, ALSO 26 CONTAIN WHAT ARE CALLED ALIPHATIC OR STRAIGHT LINE 27 MOLECULES AS WELL; CORRECT? 28 A. WELL, RUBBER SOLVENT IS PRIMARILY AN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (110 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4054 1 AROMATIC HYDROCARBON. IT IS BECAUSE THE PROPERTIES, 2 THE PROPERTIES OF THE AROMATIC SOLVENTS ARE THE ONES 3 THAT ARE, THE ONES THAT THE RUBBER INDUSTRY NEEDS 4 IN ORDER TO PRODUCE TIRES. 5 Q. SO THE SOLVENTS THAT ARE REPORTED IN 6 THIS STUDY DO SHOW AN INCREASE IN THE -- I MEAN, THE 7 ODDS RATIO IS ABOVE ONE FOR ALL OF THESE; RIGHT? 8 A. THAT'S CORRECT. I PUT IT IN MY 9 TABLE. AS YOU NOTICE, I DON'T WANT TO GET UP, IT 10 WASN'T STATISTICALLY SIGNIFICANT, HOWEVER, BUT LIKE 11 I SAID, I INCLUDED IT IN MY TABLE. 12 Q. AND SO THIS WOULD BE CONSIDERED TO 13 BE A POSITIVE STUDY? 14 A. NOT FOR AROMATIC SOLVENTS. AGAIN, 15 IT DOESN'T QUITE REACH STATISTICAL SIGNIFICANCE EVEN 16 IN THE, EVEN IN THE HIGH EXPOSURE GROUP. AND I 17 THINK THERE WERE ACTUALLY, THERE WEREN'T TWO. I 18 THINK THERE WERE ACTUALLY THREE GROUPS. YEAH, THERE 19 WAS NO EXPOSURE, LOW EXPOSURE, MEDIUM EXPOSURE AND file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (111 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 HIGH EXPOSURE. 21 SO I DON'T THINK YOU HAVE THOSE ON 22 THERE. 23 Q. FOR THE AROMATIC SOLVENTS IN 24 GENERAL, THEY DID AN ODDS RATIO CALCULATED AT 1.45 25 AND THAT'S A SIGNIFICANT RESULT; CORRECT? 26 A. OKAY. WELL, I USED -- WHERE ARE YOU 27 POINTING TO? 28 Q. WELL, I BELIEVE YOU CAN FIND IT IN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (112 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4055 1 THE ABSTRACT, THE TOP OF THE FIRST PAGE. AROMATIC 2 HYDROCARBONS. ODDS RATIO IS 1.45? 3 A. OKAY. I USED THE HIGH EXPOSURE 4 GROUP NUMBER, YOU KNOW, BUT I AGREE, YOU CAN ALSO 5 USE -- I DIDN'T SEE THAT IN ONE OF THE TABLES. 6 Q. I GUESS YOU DIDN'T SEE IT IN THE 7 ABSTRACT AT THE TOP OF THE FIRST PAGE? 8 A. NO, I DIDN'T -- I LOOKED FOR THEM 9 USUALLY IN THE TABLES IN THESE KIND OF STUDIES, BUT 10 YOU ARE CORRECT YOU COULD ALSO HAVE PUT THAT NUMBER 11 IN. 12 Q. THEY ALSO LOOKED AT THE QUESTION OF 13 INCREASED RISK ASSOCIATED WITH EXPOSURE TO GASOLINE, 14 DIDN'T THEY, ABSTRACT? 15 A. THAT'S TRUE. 16 Q. I MEAN, THEY FOUND INCREASE RISKS IN 17 WORKERS EXPOSED TO GASOLINE, THEY FOUND AN ODDS 18 RATIO THERE OF 1.46. 19 A. RIGHT, AGAIN, AS I SAID, WHEN I -- file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (113 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 WHEN I WAS LOOKING AT THESE STUDIES, I TRIED TO GET 21 AS CLOSE TO THE ISSUE OF RUBBER SOLVENT AS I COULD. 22 Q. NOW, IF YOU WOULD GO TO PAGE 16, 23 TABLE 3, THEY DO SOMETHING CALLED A MULTIVARIABLE 24 LOGISTIC REGRESSION OF MATRIX DERIVED EXPOSURES TO 25 HYDROCARBON, DO YOU SEE THAT? 26 A. MULTI-VARIANT, UH-HUH. WHERE ARE 27 YOU READING FROM? 28 Q. TABLE 3. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (114 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4056 1 A. OH, MULTIVARIABLE. OKAY, 2 MULTIVARIABLE LOGISTIC, MULTI-VARIANT IS SOMETHING 3 DIFFERENT. 4 Q. OKAY. AND THEN THEY'VE GOT A LOW 5 EXPOSURE, MEDIUM EXPOSURE AND HIGH EXPOSURE FOR 6 AROMATIC HYDROCARBON SOLVENTS WHICH I BELIEVE YOU 7 TOLD US A MOMENT AGO WHICH ARE THE ONES WE OUGHT TO 8 BE LOOKING AT; RIGHT? 9 A. CORRECT. 10 Q. AND FOR THE LOW, THE MEDIUM AND THE 11 HIGH, THERE'S A STEADY INCREASE IN THE ODDS RATIO, 12 ISN'T THERE? 13 A. THAT'S CORRECT. 14 Q. IT SHOWS A DOSE RESPONSE EFFECT? 15 A. WELL, IT IS HARD TO SAY BECAUSE, 16 AGAIN, ONLY ONE OF THESE, THAT'S THE LOW EXPOSURE 17 GROUP IS A STATISTICALLY SIGNIFICANT RESULT. 18 SO YOU KNOW, IF THEY WERE GOING TO 19 MAKE THAT, THEY WOULD HAVE, THEY SHOULD HAVE DONE A file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (115 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 TREND, WHAT'S CALLED A TREND ANALYSIS. AND I DIDN'T 21 SEE THAT THAT WAS, WAS SOMETHING THAT WAS DONE HERE. 22 BECAUSE IN ORDER TO MAKE THE SUPPOSITION OF A DOSE 23 RESPONSE, YOU HAVE TO STATISTICALLY COMPARE THE 24 DIFFERENT GROUPS. 25 Q. LET'S MOVE ON TO THE NEXT ONE. THIS 26 IS BY FONTE, F-O-N-T-E. 27 AND I BELIEVE WE HAVE NOW MOVED TO 28 ITALY, THIS IS AN ITALIAN STUDY; CORRECT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (116 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4057 1 A. WELL, THAT'S A TWO-PAGE -- I HAVE TO 2 ADMIT I DON'T BELIEVE I HAVE EVER SEEN THIS BEFORE. 3 IT'S IN A JOURNAL I HAVE NEVER HEARD BEFORE EITHER. 4 Q. WELL, LET'S GET THE TITLE? 5 A. MAYBE IT IS IN THE BOOK. 6 Q. THE TITLE IS "OCCUPATIONAL EXPOSURE 7 TO ORGANIC SOLVENTS AND NON-HODGKIN'S LYMPHOMAS" BY 8 RODOLFO FONTE AND GUILANO FRANCO PUBLISHED IN 1985; 9 CORRECT? 10 A. YES. 11 Q. AND THEY ARE CONCERNED WITH ORGANIC 12 SOLVENTS IN THIS CASE, AREN'T THEY? 13 MR. RIFF: EXCUSE ME, YOUR HONOR, FOUNDATION, 14 721(B). 15 THE COURT: DO YOU WANT TO TELL THE WITNESS 16 WHERE THIS COMES FROM, MR. WAGNON. 17 MR. WAGNON: SURE. LET ME FIND OUT FIRST. 18 Q. BY MR. WAGNON: SIR, HAVE YOU SEEN THIS 19 REPORT BEFORE? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (117 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. I MIGHT HAVE. YOU KNOW, AGAIN, THIS 21 IS ANOTHER STUDY THAT LOOKS AT, QUOTE, ORGANIC 22 SOLVENTS," AND IT IS ONLY A TWO-PAGE, TWO-PAGE 23 REPORT. IT SAYS "IN ALL NAMED SUBJECTS, 24 EXPOSURE --" 25 MR. RIFF: PARDON ME. COULD WE WAIT FOR THE 26 COURT'S RULING. 27 THE WITNESS: I'M SORRY. 28 THE COURT: I ASKED MR. WAGNON TO TELL THE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (118 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4058 1 WITNESS WHERE IT IS FROM. THAT'S WHAT I WANT YOU TO 2 TALK ABOUT. OKAY. 3 MR. WAGNON: OKAY, THIS IS FROM SOMETHING 4 CALLED I.R.C.S. MEDICAL SI. IT LOOKS LIKE VOLUME 13 AT 5 PAGE 580 TO 581. 6 A. DO YOU KNOW WHAT -7 Q. THAT IS A JOURNAL THAT YOU ARE JUST 8 UNFAMILIAR WITH? 9 A. I HAVE NEVER HEARD OF I.R.C.S. 10 DO YOU KNOW WHAT THAT STANDS FOR? 11 Q. I DO NOT. 12 ARE YOU FAMILIAR WITH THE 13 ORGANIZATION, THE UNIVERSITY THAT THESE PERSONS ARE 14 AFFILIATED WITH ACCORDING TO THE HEADING? 15 A. MY ITALIAN IS NOT VERY GOOD, I'M 16 AFRAID. 17 IT SAYS, "IN ALL NINE SUBJECT 18 EXPOSURE --" 19 MR. RIFF: EXCUSE ME, PLEASE. THERE'S NO file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (119 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 QUESTION. PLEASE WAIT. 21 THE WITNESS: OKAY. 22 Q. BY MR. WAGNON: SUFFICE IT TO SAY, YOU 23 HAVEN'T SEEN IT? 24 A. I DON'T KNOW, I SAID. 25 Q. AND YOU DON'T KNOW ANYTHING ABOUT 26 THE JOURNAL? 27 A. I DON'T KNOW IF I HAVE SEEN THIS, 28 BECAUSE AS I MENTIONED BEFORE, YOU ARE ASKING COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (120 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4059 1 WHETHER I HAVE REVIEWED IT. I MAY HAVE REVIEWED IT 2 AND I MAY NOT HAVE INCLUDED IT BECAUSE, FOR REASONS 3 THAT I MENTIONED, IT IS NOT REALLY ABOUT PETROLEUM 4 BASED SOLVENTS. BUT I CAN'T REMEMBER SITTING HERE 5 IF THAT IS TRUE OR NOT. 6 Q. AND LOOKING AT IT DOESN'T REFRESH 7 YOUR RECOLLECTION? 8 A. NO. 9 Q. LOOKING AT THE RELATIVE RISK THEY 10 REPORTED DOESN'T REFRESH YOUR RECOLLECTION? 11 BOTTOM OF THE FIRST PAGE. 12 A. NO. I DON'T REMEMBER THIS. 13 Q. THEN LET'S MOVE ON. 14 HOW ABOUT JAMES S. WOODS ET. AL., 15 1987, TITLE IS "SOFT TISSUE SARCOMA AND 16 NON-HODGKIN'S LYMPHOMA IN RELATION TO 17 PHENOXYHERBICIDE AND CHLORINATED PHENYL EXPOSURE IN 18 WESTERN WASHINGTON." 19 SIR, THIS APPEARS TO BE ABOUT file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (121 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 PESTICIDE EXPOSURE, DOESN'T IT? 21 A. I THINK IT IS HERBICIDES. 22 Q. OKAY, HERBICIDES. MY BAD. 23 BUT THEY COME ACROSS SOME 24 CONFOUNDING PROBLEMS BECAUSE THEIR SUBJECTS WERE 25 EXPOSED TO ORGANIC SOLVENTS. 26 IF YOU ARE LOOKING AT TABLE 7 ON 27 PAGE 905? 28 A. WELL, CAN YOU -- YOU MENTIONED COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (122 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4060 1 CONFOUNDING. I AM NOT EXACTLY SURE WHAT YOU MEAN 2 BY -- DO THEY TALK ABOUT CONFOUNDING ISSUES HERE? 3 Q. WELL, LET ME READ TO YOU WHAT THEY 4 DESCRIBED. 5 THEY SAY, TABLE SEVEN PRESENTS RISK 6 ESTIMATES ASSOCIATED WITH VARIOUS OCCUPATIONAL 7 AND/OR LIFESTYLE FACTORS THAT WERE OBSERVED IN THE 8 PRESENT STUDY TO INDEPENDENTLY ALTER THE RISK OF 9 S.T.S. OR N.H.L. AND THAT MIGHT THEREFORE BE 10 CONSIDERED AS POTENTIAL MODIFIERS OF THE EFFECT OF 11 CHEMICAL EXPOSURE ON CANCER RISKS. 12 IN OTHER WORDS, THEY WERE LOOKING -13 THIS STUDY IS LOOKING AT A DIFFERENT CHEMICAL 14 EXPOSURE BUT ALONG THE WAY THEY FIND THAT THERE'S 15 EXPOSURES TO ORGANIC SOLVENTS THAT MAY CONFOUND THE 16 PICTURE. THAT'S WHAT THEY ARE SAYING, ISN'T IT? 17 A. WELL, I GUESS, YOU KNOW, A LOT OF 18 PESTICIDES ARE DISSOLVED IN ORGANIC SOLVENTS AND I 19 AM NOT EXACTLY SURE -- I GUESS THEY WERE TRYING TO file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (123 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 TEASE THAT OUT SOMEHOW BUT AGAIN, I DON'T KNOW WHAT 21 KIND OF ORGANIC SOLVENTS WERE BEING USED AND THAT 22 CERTAINLY WASN'T THE MAIN PURPOSE OF THE, OF THEIR 23 PAPER. THEY WERE LOOKING, THIS WAS PRIMARILY A 24 PAPER ABOUT HERBICIDES AND CHLORINATED PHENOL. 25 Q. HAD YOU CONSIDERED THIS PAPER? 26 A. I BELIEVE THAT I DID. 27 Q. AGAIN, LIKE I SAID, THERE WERE, 28 THERE WERE LOTS OF PAPERS ABOUT ORGANIC SOLVENTS AND COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (124 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4061 1 THE DIFFICULTY I HAD WAS TO TRY TO FIND ONES THAT 2 WERE SPECIFICALLY ABOUT PETROLEUM BASE ORGANIC 3 SOLVENTS WHERE PEOPLE ACTUALLY DEFINE THAT. AND I 4 BELIEVE THAT I, I CERTAINLY HAVE THIS PAPER IN MY 5 FILES BECAUSE I AM VERY FAMILIAR WITH IT. AND SO I 6 WOULD ASSUME THAT I TOOK A LOOK AT IT AND DECIDED 7 THAT I COULDN'T REALLY PUT IT IN THE SAME TABLE AS 8 OTHER STUDIES THAT LOOK AT PETROLEUM BASE SOLVENTS. 9 Q. WELL, IN TABLE 7, THEY LIST ORGANIC 10 SOLVENTS AS ONE OF SEVERAL TYPES OF MATERIALS UNDER 11 INDUSTRIAL CHEMICALS; CORRECT? 12 A. WELL, I ONLY SEE -- I SEE INDUSTRIAL 13 CHEMICALS, ORGAN INSOLVENTS AND LEAD, ARSENIC AND 14 WELDING METAL FUMES. I SEE THREE HERE. 15 Q. YES. THE ORGANIC SOLVENTS, THEY 16 SHOW AN ODDS RATIO FOR NON-HODGKIN'S LYMPHOMA, DON'T 17 THEY? 18 A. YES. 19 Q. THE ODDS RATIO, 1.35, THAT'S file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (125 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 STATISTICALLY SIGNIFICANT; RIGHT? 21 A. THAT'S CORRECT. 22 Q. THAT WOULD BE CONSIDERED A POSITIVE 23 RESULT; RIGHT? 24 A. YES. 25 Q. I'M NOT SURE HOW TO PRONOUNCE THIS 26 NAME. SIEMIATYCKI. I'LL SPELL IT. 27 A. IT'S FROM MONTREAL. I'LL SPELL IT 28 FOR THE COURT REPORTER. IT'S S-I-E-M-I-A-T-Y-C-K-I. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (126 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4062 1 AND HOW WAS THAT PRONOUNCED? 2 A. I THINK IT'S SIEMIATYCKI. 3 Q. OKAY. I'LL ACCEPT THAT. 4 THIS IS TITLED "ASSOCIATIONS BETWEEN 5 SEVERAL SITES OF CANCER AND 12 PETROLEUM DERIVED 6 LIQUIDS." 7 AND AS YOU SAID, THIS COMES OUT OF 8 MONTREAL, DOESN'T IT? 9 A. YES. 10 Q. AND ONE OF THE THINGS THEY LOOKED AT 11 WAS NON-HODGKIN'S LYMPHOMA AND MINERAL SPIRITS? 12 A. YES. 13 Q. AND THEY LOOKED IN TABLE 6 FOR 14 THE -- A DOSE RESPONSE, DIDN'T THEY, TABLE 6, PAGE 15 498, MIDDLE OF THE PAGE, MINERAL SPIRITS, HYPHEN 16 HODGKIN'S LYMPHOMA. DO YOU HAVE IT? 17 A. YES. 18 Q. AND THEY HAVE FIGURES FOR 19 NON-SUBSTANTIAL EXPOSURE LEVEL AND SUBSTANTIAL file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (127 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EXPOSURE LEVEL; RIGHT? 21 A. YES. 22 Q. AND LET'S LOOK AT THOSE NUMBERS -23 MR. RIFF: CAN I JUST CONFER WITH COUNSEL FOR 24 A MOMENT. 25 THE COURT: YES. 26 Q. BY MR. WAGNON: THAT'S FOR HODGKIN'S 27 LYMPHOMA. I MEANT TO ASK YOU ABOUT NON-HODGKIN'S 28 LYMPHOMA. THAT'S THE ONE ON THE RIGHT, N.H.L. AND COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (128 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4063 1 CUTTING FLUIDS; RIGHT? 2 A. WELL, NON-HODGKIN'S LYMPHOMA IS THE 3 ONE ON THE TOP THAT IS ODDS RATIO IS .8, I THINK. 4 Q. AND MINERAL SPIRITS? 5 A. RIGHT. 6 Q. RIGHT. BUT IT IS CUTTING FLUIDS. 7 AND DID YOU FIND OUT WHAT CUTTING FLUIDS ARE, WHAT 8 KIND OF PETROLEUM DERIVED FLUIDS THOSE ARE? 9 A. WELL, CUTTING FLUIDS ARE NOT, THEY 10 ARE USUALLY CUTTING FLUIDS ARE USUALLY WATER-BASED 11 AND THEY CONTAIN VARIOUS KINDS OF AMINES IN THEM. 12 BY THE WAY, THIS WAS A STUDY, IF YOU 13 WILL NOTICE, ONE OF THE AUTHORIZES IS JERIN, 14 J-E-R-I-N., AND I BELIEVE THAT I HAD, I MEAN, THIS 15 IS A STUDY THAT I THINK WAS REPORTED IN 1998. 16 Q. YOU REPORTED ANOTHER STUDY BY ONE OF 17 THE AUTHORS OF THIS ONE? 18 A. CORRECT. 19 Q. BUT YOU DIDN'T REPORT THIS ONE; file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (129 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 RIGHT? 21 A. WELL, THIS ONE IS THE SAME THING. 22 IT DOESN'T SHOW AN INCREASE IN NON-HODGKIN'S 23 LYMPHOMA AND MINERAL SPIRITS. IN THE OTHER ONE, THE 24 1998 JERIN ARTICLE THEY LOOKED PARTICULARLY AT 25 TOLUENE AND XYLENE AND IT WAS CONSISTENT WITH THIS 26 WHERE THIS ONE WAS .8, THE TOLUENE WAS .9 AND THE 27 XYLENE WAS 1.0. 28 AND BY THE WAY, HODGKIN'S DISEASE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (130 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4064 1 AND NON-HODGKIN'S LYMPHOMA ARE, AGAIN, TWO 2 COMPLETELY DIFFERENT DISEASES. 3 Q. I'D LIKE TO CALL YOUR ATTENTION TO A 4 STUDY BY BLAIR, ET. AL., PUBLISHED IN 1993. 5 AND BLAIR IS A STUDY THAT YOU HAD ON 6 YOUR CHART, ISN'T IT? 7 A. YES. 8 Q. AND THE TITLE OF THIS STUDY IS 9 "EVALUATION OF RISKS FOR NON-HODGKIN'S LYMPHOMA BY 10 OCCUPATION AND INDUSTRY EXPOSURES FROM A CASE 11 CONTROL STUDY." 12 DID I READ THAT CORRECTLY? 13 A. YES. 14 Q. THIS LOOKED AT VARIOUS SOLVENTS 15 OTHER THAN BENZENE; RIGHT, AND INCLUDES SOME LOOK 16 INTO BENZENE AS WELL; CORRECT? 17 A. YES. 18 Q. I'D LIKE TO DIRECT YOUR ATTENTION TO 19 THE BOTTOM OF PAGE 304 AND THERE THEY SUMMARIZE SOME file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (131 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ODDS RATIOS FOR VARIOUS TYPES OF OCCUPATIONS WITH 21 DIFFERENT KINDS OF EXPOSURES; RIGHT? 22 A. YES. 23 Q. AND AT THE VERY BOTTOM OF THE PAGE 24 THEY LUMP TOGETHER PAINTING, PLASTERING AND 25 CEMENTING; CORRECT? 26 A. YES. 27 Q. PAINTING, AT LEAST, WOULD BE AN 28 OCCUPATION WHERE ONE IS EXPOSED TO THINNERS LIKE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (132 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4065 1 MINERAL SPIRITS? 2 A. AGAIN, AMONG OTHER THINGS. YES. 3 Q. CEMENTING, DO WE HAVE AN IDEA OF 4 WHAT THAT IS? MAYBE LIKE IN SHOE MAKING, THE USE OF 5 SOLVENT TYPE CEMENTS? 6 A. I DON'T KNOW WHAT CEMENT MEANS. I 7 USUALLY THINK OF CEMENT IN TERMS OF CONCRETE OR -- I 8 DON'T KNOW WHAT IT, EXACTLY, WHAT THEY MEAN. 9 Q. PROBABLY ISN'T CONCRETE THAT THEY 10 ARE TALKING ABOUT HERE, IS IT? 11 A. I HAVE NO IDEA. PLASTERING, THEY 12 ARE TALKING ABOUT PLASTERING SO, YOU KNOW, IF THEY 13 ARE TALKING ABOUT PLASTERING, WOULD THEY BE TALKING 14 ABOUT CONCRETE? 15 Q. WELL, LET'S LOOK AT WHAT THEY FINED 16 WITH THE NUMBERS FOR THESE CATEGORY, WHATEVER IT IS. 17 I MEAN, THEY HAVE TWO ODDS RATIOS, A 18 0.6 AND A 2.7. NOW, A 0.6, THAT'S BELOW THE MAGIC 19 NUMBER 1; RIGHT? THAT MEANS YOU ARE NOT SEEING, IN file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (133 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EFFECT? 21 A. CORRECT. 22 Q. AND 2.7, THAT MEANS YOU ARE SEEING 23 AN INCREASE, POSSIBLY DUE TO THE EFFECT OF THE 24 EXPOSURE; RIGHT? 25 A. WELL, IN THESE OCCUPATIONS OF 26 PAINTING, PLASTERING AND CEMENTING, I AM NOT EXACTLY 27 SURE WHAT MY -- BY DURATION OF EMPLOYMENT -28 Q. WHAT THESE ARE IS THIS PAIR OF COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (134 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4066 1 NUMBERS IS FOR PEOPLE WORKING LESS THAN 10 YEARS AND 2 MORE THAN 10 YEARS? 3 A. RIGHT. RIGHT. REAL ESTATE WAS THE 4 HIGHEST ODDS RATIO OF 3.7. 5 SO -6 Q. GO FIGURE, HUH? 7 A. RIGHT. I MEAN, I REALLY DON'T KNOW 8 WHAT THEY MEAN BY CEMENTING, WHETHER THAT HAS 9 ANYTHING TO DO WITH ORGANIC SOLVENTS. AND I DON'T 10 THINK REAL ESTATE DOES. 11 Q. BUT WHAT YOU DO SEE IS YOU SEE A 12 DIFFERENCE, A PRETTY SIGNIFICANT DIFFERENCE BETWEEN 13 THE SHORT, SHORTER TERM EXPOSURES AND THE LONGER 14 TERM EXPOSURE; RIGHT? 15 A. THE SHORTER DURATION OF EMPLOYMENT 16 AND LONGER DURATION OF EMPLOYMENT. 17 Q. OKAY. AND AGAIN, WOULD IT BE 18 REASONABLE TO ASSUME THAT THAT CORRESPONDED TO LOWER 19 DOSE AND HIGHER DOSE? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (135 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. WELL, NO. I MEAN, IT HAS TO DO WITH 21 DURATION AND EVEN IF DOSE WERE INVOLVED IT WOULD BE 22 DURATION OF DOSE. BUT LIKE I SAY, I DON'T THINK ONE 23 CAN CONCLUDE FROM THIS THAT THERE WAS ANY OR WHAT 24 THE CHEMICAL EXPOSURES ACTUALLY WERE. 25 Q. OKAY. LET'S MOVE ON. 26 I'D LIKE TO DIRECT YOUR ATTENTION TO 27 A STUDY BY MAO, M-A-O, AND OTHERS. THE TITLE OF THE 28 STUDY IS "NON-HODGKIN'S LYMPHOMA AND OCCUPATIONAL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (136 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4067 1 EXPOSURE TO CHEMICALS IN CANADA." 2 AND THIS ONE IS ONE YOU HAVE SEEN 3 BEFORE; RIGHT? 4 A. IT IS IN ONE OF MY TABLES, YES. IT 5 IS IN THE BENZENE TABLE. 6 Q. IT IS ON YOUR TABLE FOR WHAT? 7 A. BENZENE IN CANADA. IS 1.2, NOT 8 SIGNIFICANT. 9 Q. IT IS WHAT YOU REPORTED, ISN'T IT? 10 AND CAN YOU POINT OUT WHERE YOU GOT 11 THAT 1.2, NOT SIGNIFICANT FIGURE? 12 A. TABLE 3. 13 Q. I HAVE WHAT MAKES IT NONSIGNIFICANT 14 AS THE LAWYER BOUND IS .8; CORRECT? 15 A. YES. 16 Q. WHAT I'D LOOK YOU TO DO IS TURN THE 17 PAGE OVER TO TABLE 4. 18 A. RIGHT. 19 Q. AND THEY LIST EXPOSURE TO BENZIDINE? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (137 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. BENZIDINE IS AN AROMATIC AMINE. 21 IT'S AN ABSOLUTELY COMPLETELY DIFFERENT COMPOUND. 22 IT'S -- I HAVE WRITTEN A PAPER ON BENZIDINE. IT IS 23 USED TO MAKE DYE STUFFS. 24 Q. DYE STUFFS? 25 A. BENZIDINE BASED DYES, YES. 26 Q. IS IT A PETROCHEMICAL SOLVENT? 27 A. NO. 28 Q. LET'S MOVE ON THEN. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (138 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4068 1 REGO, DEFINITELY ONE YOU KNOW OF; 2 RIGHT? REGO FROM 2002, TITLED "NON-HODGKIN'S 3 LYMPHOMA'S AND ORGANIC SOLVENTS." THIS IS ANOTHER 4 GROUP OF ITALIANS; CORRECT? 5 A. I THINK THEY ARE BRAZILIANS. I KNOW 6 THE NAME MAYBE SOUNDS ITALIAN BUT I THINK THEY ARE 7 FROM BRAZIL. 8 Q. YES, I STAND CORRECTED. YOU ARE 9 RIGHT. 10 NOW, DIRECT YOUR ATTENTION TO THE 11 ABSTRACT, RIGHT IN THE MIDDLE THERE IT READS: 12 "AN ASSOCIATION BETWEEN 13 OCCUPATIONAL EXPOSURE TO ORGANIC 14 SOLVENTS AND NON-HODGKIN'S LYMPHOMA 15 WAS OBSERVED. ODDS RATIO 1.67." 16 DO YOU SEE THAT? 17 A. YES. YES. 18 Q. NOW, DO YOU CONSIDER THAT A 19 SIGNIFICANT FINDING OR NOT? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (139 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. WELL, I THINK YOU HAVE GOT IN HERE 21 N.S. WRITTEN ON THE PAPER, AND I MEAN, IT IS 22 STATISTICALLY NOT SIGNIFICANT AND, AGAIN, IT GOES -23 IT IS TALKING ABOUT ALL ORGANIC SOLVENTS BUT, AND IT 24 IS NOT STATISTICALLY SIGNIFICANT. 25 Q. AND THE REASON IT ISN'T 26 STATISTICALLY SIGNIFICANT IS BECAUSE THE 95 PERCENT 27 CONFIDENCE INTERVAL GOES DOWN TO .97, JUST BELOW 28 ONE; RIGHT? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (140 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4069 1 A. THAT'S CORRECT. 2 Q. IF IT WERE 3/100THS HIGHER, IF IT 3 CAME TO 1.00, WOULD THAT MAKE IT STATISTICALLY 4 SIGNIFICANT? 5 A. NO, IT WOULD HAVE TO BE ONE MORE 6 POINT POWER HIGHER. IT HAS TO NOT INCLUDE ONE. 7 Q. WHAT IF INSTEAD OF GOING TO THE 95 8 PERCENT CONFIDENCE INTERVAL WE ONLY WENT TO THE 90 9 PERCENT CONFIDENCE INTERVAL, THEN THIS WOULD BE A 10 STATISTICALLY SIGNIFICANT RESULT, WOULDN'T IT? 11 A. WELL, NOT ACCORDING TO THE 12 CONVENTIONS THAT MOST SCIENTISTS USE BECAUSE 90 13 PERCENT CONFIDENCE MEANS THAT YOU HAVE A 1 IN 10 14 CHANCE OF BEING WRONG JUST BY RANDOM, RANDOMLY. 15 AND AGAIN, AS I SAID, THIS IS A 16 STUDY OF ALL, QUOTE, ORGANIC SOLVENTS. 17 Q. WELL, IN THE DISCUSSION OVER ON PAGE 18 877, THEY CONCLUDE: 19 "WE FOUND A POSITIVE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (141 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ASSOCIATION BETWEEN NON-HODGKIN'S 21 LYMPHOMA AND OCCUPATIONAL EXPOSURE 22 TO ORGANIC SOLVENTS." 23 THAT'S WHAT THEY SAY, ISN'T IT? 24 A. WELL, THAT'S WHAT THEY SAY. BUT AS 25 YOU POINTED OUT, THE CONFIDENCE INTERVAL IS .97. SO 26 I DON'T EXACTLY UNDERSTAND -- I THINK THAT -- LET ME 27 SEE IF I CAN -- THE ONLY STATISTICALLY SIGNIFICANT 28 RESULT THAT I SEE HAD TO DO WITH THE DIFFUSE TYPE OF COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (142 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4070 1 NON-HODGKIN'S LYMPHOMA. BUT NOT THE FOLLICULAR. 2 BUT IT IS, AS I SAID, THEY DID A LOT OF DIFFERENT 3 STATISTICAL ANALYSES AND THEY PARSED IT OUT A COUPLE 4 OF THEM CAME UP SIGNIFICANT. BUT OVERALL IT'S -5 THEY ARE TALKING ABOUT ALL NON-HODGKIN'S LYMPHOMA. 6 I DON'T SEE ANY STATISTICAL SIGNIFICANCE HERE. 7 AND AGAIN, THIS IS NOT -- THIS IS 8 REFERRING TO ALL ORGANIC SOLVENTS. 9 Q. THE ONE THING THEY DID LOOK AT WAS 10 THE EFFECT ON TIME, DIDN'T THEY, IN TERMS OF HOW 11 LONG THE PERSON WAS IN THE WORKPLACE? 12 A. I DON'T SEE WHERE THEY HAVE -- YOU 13 MEAN DURATION OF EMPLOYMENT? IS THAT WHAT YOU ARE 14 TALKING ABOUT? 15 Q. CHART, TOP OF PAGE 878. FIGURE 1. 16 A. WELL, THIS IS A TIME SINCE FIRST 17 EXPOSURE. I DON'T -- THIS IS SOMETHING DIFFERENT. 18 THIS HAS TO DO WITH THE ISSUE CALLED LATENCY, I 19 THINK. I DON'T THINK THIS HAS TO DO WITH DURATION file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (143 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OF EMPLOYMENT. 21 Q. WELL, IF THEY REMAINED IN THE 22 EMPLOYMENT FOR THE PERIOD OF TIME, LATENCY AND 23 DURATION OF EXPOSURE WOULD OVERLAP; CORRECT? 24 A. WELL, I DON'T KNOW THAT WE KNOW THAT 25 HERE THOUGH. BUT LATENCY -- IF THAT IS TRUE, THEN 26 LATENCY AND -- YES, THAT WOULD BE CORRECT, IF THAT 27 WERE TRUE. 28 Q. AND WHAT THAT GRAPH SHOWS IS THAT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (144 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4071 1 FOR PERSONS, THE LONGER THEY WERE EMPLOYED, THE 2 LONGER THE LATENCY PERIOD, THE HIGHER THE ODDS 3 RATIO; CORRECT? 4 A. WELL, IT GOES UP AND IT GOES DOWN. 5 Q. WELL, WHAT'S THE HIGH POINT THEN? 6 A. I CAN'T READ THE NUMBERS HERE. IT'S 7 VERY SMALL NUMBERS. LIKE I SAID, IF THE LENGTH OF 8 EMPLOYMENT IS RELATED TO THE LATENCY HERE, THEN IT 9 WOULDN'T BE DOSE. IT WOULDN'T BE RELATED TO 10 DURATION BECAUSE THE LONGEST, THE GREATER THAN 35 11 YEARS HAS AN ODDS RATIO OF .53. 12 Q. IN THE CHART, IN TABLE ONE, THEY 13 DESCRIBE IT AS, IN THE DESCRIPTION, NON-HODGKIN'S 14 LYMPHOMA AND OCCUPATIONAL EXPOSURE TO ORGANIC 15 SOLVENTS, DISTRIBUTION OF ODDS RATIOS BY TIME 16 WINDOWS SINCE FIRST EXPOSURE. CORRECT? 17 A. CORRECT. 18 Q. AND THEN FOR THE 15- TO 20-YEAR 19 TIMEFRAME, THEY SHOW AN ODDS RATIO OF 5.35. THAT'S file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (145 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THE NUMBER THAT'S ON TOP OF THAT BIG BAR THERE; 21 RIGHT? 22 A. RIGHT. BUT YOU SAID TO ASSUME THAT 23 THIS WAS RELATED TO DURATION OF EMPLOYMENT THAT WAS 24 THE GREATEST FOR THE LONGEST DURATION OF EMPLOYMENT. 25 BUT THAT'S NOT WHAT THIS SHOWS. BECAUSE THE 26 LONGEST, IT IS QUITE SMALL. 27 Q. OKAY. WOULD YOU AGREE THAT THE 28 FIGURE, THE ODDS RATIO FOR THE 15 TO 20 YEARS IS, OR COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (146 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4072 1 16 TO 20 YEARS IS ALMOST TWICE FOR THE PREVIOUS 2 PERIOD OF 11 TO 15 YEARS? 3 A. FOR THE -- YES, FOR THIS DURATION 4 SINCE FIRST EXPOSURE. 5 Q. AND FOR THE ODDS RATIO FOR THE LESS 6 THAN FIVE YEARS, IT'S QUITE LOW? 7 A. YES. AND AS I MENTIONED, IT IS 8 QUITE LOW FOR GREATER THAN 35 AS WELL. 9 Q. SO ARE WE SEEING SOME SORT OF DOSE 10 RESPONSE HERE IN THESE FIGURES? 11 A. I DON'T KNOW HOW ONE CAN REALLY 12 RELATE THIS TO DOSE RESPONSE. LIKE I SAY, IT GOES 13 UP AND THEN IT GOES BACK DOWN AGAIN. 14 Q. LET'S MOVE ON TO KATO PUBLISHED IN 15 2005. THE TITLE IS "PERSONAL AND OCCUPATIONAL 16 EXPOSURE TO ORGANIC SOLVENTS AND RISK OF 17 NON-HODGKIN'S LYMPHOMA IN WOMEN" IN THE UNITED 18 STATES, EVIDENTLY; CORRECT? 19 A. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (147 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND DOESN'T THIS REPORT, FIRST OF 21 ALL, THIS IS A CASE CONTROL STUDY; RIGHT? 22 A. YES. 23 Q. THEY WERE LOOKING AT EXPOSURES TO 24 ORGANIC SOLVENTS AND THE RISK OF NON-HODGKIN'S 25 LYMPHOMA IN WOMEN? 26 A. WELL, IT SAYS IN THE ABSTRACT IS THE 27 PAINT THINNERS -- THEY WERE LOOKING AT THAT AND THE 28 ABSTRACT TALKING ABOUT PAINT THINNERS AND COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (148 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4073 1 TURPENTINE. YES. 2 Q. AND FOR PAINT THINNERS AND 3 TURPENTINES, THEY CALCULATED AN ODDS RATIO OF 1.46; 4 RIGHT? 5 A. THAT'S CORRECT. 6 Q. SIGNIFICANT RESULT; RIGHT? 7 A. THAT'S RIGHT. AS I MENTIONED, 8 TURPENTINE COMES FROM PINE TREES. 9 Q. FRITSCHI. FRITSCHI? 10 A. YES. 11 Q. THIS IS AUSTRALIAN; RIGHT? 12 A. THAT'S CORRECT. 13 Q. AND THE TITLE IS "RISK OF 14 NON-HODGKIN'S LYMPHOMA ASSOCIATED WITH OCCUPATIONAL 15 EXPOSURES TO SOLVENTS, METALS, ORGANIC DUSTS AND 16 PCB'S"; CORRECT? 17 A. YES. 18 Q. PUBLISHED IN 2005; CORRECT? 19 A. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (149 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND SO WE OBVIOUSLY AREN'T TOO 21 INTERESTED IN THE METALS, ORGANIC DUSTS OR THE 22 PCB'S, BUT IT DOES LOOK AT SOLVENT EXPOSURE, DOESN'T 23 IT? 24 A. RIGHT. IT LOOKS AT BENZENE, WHICH I 25 HAVE IN MY TABLE, WHICH IS 1.09, NOT SIGNIFICANT, 26 1.09. AND THEN IT HAS, WELL -- IT HAS OTHER 27 AROMATICS AND IT HAS CHLORINATED SOLVENTS. 28 Q. WELL, LET'S JUST LOOK AT THE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (150 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4074 1 ABSTRACT ON PAGE 1. LOOK AT THE BOTTOM PART WHERE 2 IT SAYS "RESULTS." 3 IT SAYS: 4 "THE RISK OF 5 NON-HODGKIN'S LYMPHOMA WAS 6 INCREASED BY ABOUT 30 PERCENT FOR 7 EXPOSURE TO ANY SOLVENT WITH A DOSE 8 RESPONSE RELATIONSHIP. SUBGROUP 9 ANALYSIS SHOWED THE FINDING WAS 10 RESTRICTED TO SOLVENTS OTHER THAN 11 BENZENE." 12 IN OTHER WORDS, THEY FOUND A POSITIVE 13 RESPONSE TO ORGANIC SOLVENTS BUT NOT TO THE BENZENE; 14 RIGHT? 15 A. THAT'S RIGHT. 16 Q. SO YOU INCLUDED IT IN YOUR CHART AS 17 A NEGATIVE WITH RESPECT TO BENZENE; RIGHT? 18 A. WELL, BECAUSE THEY HAD AN ACTUAL 19 ANALYSIS OF BENZENE SEPARATELY. SO I INCLUDED THAT. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (151 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 BUT AGAIN, LIKE I SAID, THE ISSUE OF ORGANIC 21 SOLVENTS, THESE -- THAT WHEN THEY LUMP THEM ALL 22 TOGETHER, THEY WEREN'T NECESSARILY PETROLEUM BASED 23 SOLVENTS. 24 Q. SO ARE YOU SAYING THAT ORGANIC 25 SOLVENTS, AGAIN, WAS TOO VAGUE FOR THIS TO BE 26 INCLUDED AS ONE OF THE POSITIVE STUDIES? 27 A. I BELIEVE SO. I MEAN, IT WAS 28 SPECIFIC FOR BENZENE WHEN THEY DID THAT ANALYSIS. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (152 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4075 1 Q. AND WHEN THEY LOOKED AT DURATION OF 2 EXPOSURE, THEY FOUND AN INCREASE FOR SOLVENTS AND 3 N.H.L.? 4 A. ARE YOU TALKING ABOUT THE ABSTRACT 5 AGAIN? 6 Q. NO. THIS IS OVER ON -- LET ME TRY 7 AND FIND YOU THE SPECIFIC PAGE REFERENCE. TABLE 5. 8 THEY LOOK AT EXPOSURE TO ANY 9 SOLVENTS, "NEVER. LESS THAN FOUR DAYS PER YEAR." 10 AND "MORE THAN FOUR DAYS PER YEAR." 11 AND THEY FOUND A DIFFERENCE BETWEEN 12 THE LESS THAN FOUR DAYS PER YEAR AND THE MORE THAN 13 FOUR DAYS PER YEAR; RIGHT? 14 A. YES. 15 Q. AND THEN THEY LOOK AT, IN TERMS OF 16 YEARS OF EXPOSURE, THOSE WITH LESS THAN FIVE YEARS 17 EXPOSURE WAS A SMALLER ODDS RATIO THAN THOSE WITH 18 MORE THAN FIVE YEARS OF EXPOSURE; CORRECT? 19 A. WELL, THERE WAS A TREND GOING FROM file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (153 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 NEVER TO LESS THAN FIVE TO FIVE PLUS. IT WAS 21 STATISTICALLY SIGNIFICANT. 22 Q. RIGHT. SO THAT SHOWS A DOSE 23 RELATIONSHIP; RIGHT, IF WE ASSUME THAT YEARS OF 24 EMPLOYMENT RELATES TO A HIGHER DOSE; RIGHT? 25 A. WELL, IT COULD RELATE TO OTHER 26 THINGS AS WELL. BUT AGAIN, AS I MENTIONED, THIS IS 27 FOR ANY SOLVENT AS THEY STATED. 28 THE COURT: MR. WAGNON, COULD I ASK THE JURORS COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (154 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4076 1 TO STAND AND STRETCHED A MINUTE. 2 THE COURT: SURE. 3 MR. WAGNON: SURE. 4 THE COURT: WE ARE GOING TO TRY TO GO WITHOUT 5 A BREAK SO WE CAN GET THROUGH THIS AFTERNOON. SO WHY 6 DON'T YOU JUST STAND FOR A MINUTE AND STRETCH IF YOU 7 WOULD, THANK YOU. 8 COUNSEL MAY DO THE SAME, IF YOU LIKE. 9 10 (INTERRUPTION IN 11 PROCEEDINGS.) 12 13 14 JOHN WHYSNER, 15 HAVING BEEN PREVIOUSLY DULY SWORN, RESUMED THE 16 WITNESS STAND AND TESTIFIED AS FOLLOWS: 17 18 DIRECT EXAMINATION (RESUMED) 19 file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (155 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 BY MR. WAGNON: 21 Q. MILIGI, M-I-L-I-G-I. 22 A. UH-HUH. 23 Q. THIS IS ONE THAT'S ON YOUR LIST, I 24 BELIEVE? 25 A. YES. 26 Q. AND YOU HAVE IT ON YOUR LIST ON 27 BENZENE EXPOSURES. LET'S GET THE TITLE FIRST. 28 THE TITLE OF THIS IS "OCCUPATIONAL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (156 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4077 1 EXPOSURE TO SOLVENTS AND THE RISK OF LYMPHOMAS." 2 CORRECT? 3 A. YES. 4 Q. PUBLISHED IN 2006. AND THESE GUYS 5 ARE ITALIANS; RIGHT? 6 A. YES. 7 Q. THIS IS LOOKING AT EXPOSURES, AGAIN, 8 TO ORGANIC SOLVENTS; RIGHT? 9 A. YES. 10 Q. AND NOW, YOU HAD IT ON YOUR LIST FOR 11 BENZENE AND UNDER THE ODDS RATIOS IT SAID IT ON YOUR 12 LIST, "NO TREND" AND DIDN'T PROVIDE ANY OTHER 13 INFORMATION, DID IT? 14 A. CORRECT. 15 Q. BUT THEY DO COVER AROMATIC SOLVENTS 16 AND NON-HODGKIN'S LYMPHOMA IN HERE, DON'T THEY? 17 A. WELL, I THINK I ALSO HAD IT ON THE 18 SOLVENT PAGE UNDER XYLENE AND TOLUENE, YEAH, I HAVE 19 IT ON THE FIRST -- IT'S THE FIRST ONE ON CASE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (157 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 CONTROL STUDIES OF THE N.H.L. AND PETROLEUM DERIVED 21 SOLVENT EXPOSURES AS WELL. AND IT SAYS THEY WERE 22 INCREASED BUT WITH NO TREND. 23 Q. WELL, LET'S SEE WHAT THEY SAY ON 24 PAGE 554, RIGHT-HAND COLUMN, NEAR THE BOTTOM. THEY 25 ADDRESS AROMATIC HYDROCARBONS. AND WE HAVE AGREED 26 THAT'S THE PROPER TYPE OF SOLVENT THAT WE SHOULD BE 27 TALKING ABOUT IN THIS CASE; RIGHT? 28 A. AGAIN, IN THIS CASE, I WAS TRYING TO COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (158 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4078 1 BE MORE SPECIFIC BECAUSE I KNOW THAT TOLUENE AND 2 XYLENE WAS A LARGE COMPONENT OF THE RUBBER SOLVENTS 3 AND SO I FOCUSED ON THAT PARTICULAR PART. BUT -4 Q. LET'S LOOK AT WHAT THEY SAY FOR 5 AROMATIC HYDROCARBONS. THEY SAY, "FOR AROMATIC 6 HYDROCARBON WE ALSO ANALYZED MEDIUM AND HIGH 7 INTENSITIES SEPARATELY AND WE OBSERVED A STRONGER 8 INCREASE IN RISK FOR SUBJECTS EXPOSED TO THE HIGH 9 INTENSITY." 10 AND THEN THEY HAVE A RELATIVE RISK 11 OF 1.9 THAT'S SIGNIFICANT; CORRECT? 12 A. YES. 13 Q. THEY GO ON TO SAY, "THERE WERE 14 ELEVATED NON-HODGKIN'S LYMPHOMA RISKS ASSOCIATED 15 WITH MEDIUM/HIGH EXPOSURES TO TOLUENE OF 1.8 RISK, 16 XYLENE, A 1.7 RISK, BENZENE, A 1.6 RISK, AND 17 DICHLOROMETHANE, A 1.7 RISK." 18 SO THEY HAVE TEASED OUT SEPARATELY 19 FOR THOSE DIFFERENT CHEMICALS, THE LAST ONE BEING file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (159 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ONE THAT IS NOT INVOLVED HERE; RIGHT? 21 A. THAT'S CORRECT. AND THAT'S 22 REFLECTED IN MY TABLE. I SAID INCREASE BUT NO 23 TREND. AND THEY ACTUALLY DIDN'T, I DON'T BELIEVE 24 THEY ACTUALLY QUITE REACHED STATISTICAL SIGNIFICANCE 25 AGAIN. BUT I THINK I INDICATED THEY WERE INCREASED 26 BUT WHEN THEY DID THE STATISTICAL TREND ANALYSIS 27 THEY DIDN'T FIND A TREND, WHICH IS THE THING THAT 28 YOU LOOK AT FOR DOSE RESPONSE. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (160 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4079 1 Q. WELL, LET'S GO TO THE RESULTS 2 SECTION ON THE ABSTRACT, AT THE PART LABELED 3 "CONCLUSION." 4 I MEAN, THEY CONCLUDE, THEY SAY: 5 "THIS STUDY SUGGESTS 6 THAT AROMATIC AND CHLORINATED 7 HYDROCARBONS ARE A RISK FACTOR FOR 8 NON-HODGKIN'S LYMPHOMA AND PROVIDES 9 PRELIMINARY EVIDENCE FOR AN 10 ASSOCIATION BETWEEN SOLVENTS AND 11 HODGKIN'S DISEASE." 12 NOW, THE HODGKIN'S DISEASE WE DON'T CARE 13 ABOUT BECAUSE THAT'S NOT INVOLVED IN THIS CASE. BUT THE 14 NON-HODGKIN'S LYMPHOMA WE CERTAINLY CARE ABOUT. THEY 15 FIND IT IS ASSOCIATED HERE, DON'T THEY? 16 A. WELL, AS I SAID, WHEN WE LOOK AT 17 THESE STUDIES, SOME -- THERE'S -- ASSOCIATION 18 DOESN'T NECESSARILY MEAN CAUSATION. WE HAVE TO LOOK 19 AT ALL OF THE STUDIES TO SEE IF THEY CORROBORATE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (161 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 EACH OTHER. AND SO ONE STUDY MIGHT SUGGEST, WHICH 21 THEY SAY, SUGGESTS SOMETHING. BUT I THINK THE 22 AUTHORS ARE BEING CAREFUL IN TERMS OF NOTING THAT 23 THAT'S WHAT THEY DO THE STUDIES FOR BECAUSE ONE 24 STUDY MIGHT SUGGEST IT BUT YOU HAVE TO TAKE THE 25 INFORMATION IN, YOU HAVE TO LOOK AT ALL OF IT FOR 26 CONSISTENCY. 27 Q. AND WE HAVE HAD MORE THAN ONE STUDY 28 HERE THAT'S MADE THAT SUGGESTION, HAVEN'T WE? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (162 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4080 1 A. I DON'T KNOW. HAVE WE? 2 HAVE THEY SAID THAT IN THESE 3 STUDIES? 4 Q. YOU DON'T THINK SO? 5 A. WELL, YOU HAVE GONE THROUGH A BUNCH 6 OF STUDIES THAT ARE ABOUT ORGANIC SOLVENTS AND 7 I HAVE GONE THROUGH A BUNCH OF STUDIES THAT ARE 8 ABOUT PETROLEUM BASED ORGANIC SOLVENTS AND I HAVE 9 DESCRIBED MY ANALYSIS. 10 Q. AND ORGANIC SOLVENTS AND PETROLEUM 11 BASED SOLVENTS ARE DIFFERENT THINGS AS FAR AS YOU 12 ARE CONCERNED? 13 A. BECAUSE ORGANIC SOLVENTS CONTAIN A 14 LOT OF DIFFERENT KINDS OF CHEMICALS, PARTICULARLY 15 CHLORINATED CHEMICALS AND ALSO OTHER THINGS LIKE 16 GLYCOL ETHERS AND SO FORTH. 17 Q. LET'S MOVE ON TO SOME OF THE BENZINE 18 STUDIES. AND I'LL GET TO HAYES BUT WE ARE NOT THERE 19 YET. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (163 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 VIANNA, VIANNA AND POLAN. 21 THIS IS BACK FROM 1979. THE TITLE 22 IS "LYMPHOMAS AND OCCUPATIONAL BENZENE EXPOSURE." 23 CORRECT? 24 A. YES. 25 Q. AND IN THIS STUDY, THEY LOOK AT 26 NON-HODGKIN'S LYMPHOMA AND SOLVENT EXPOSURE AND FIND 27 A SIGNIFICANT RELATIVE RISK; RIGHT? 28 A. WELL, WHAT THESE, THEY WERE LOOKING COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (164 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4081 1 AT WAS BENZENE AND/OR COAL TAR FRACTIONS, WHICH CAN 2 CONTAIN APPRECIABLE AMOUNTS OF BENZENE. 3 SO AGAIN, THE REASON I DIDN'T 4 CONSIDER THIS STUDY IS COAL TARS HAVE A LOT OF STUFF 5 IN THEM. AND WE WERE TALKING ABOUT POLYAROMATIC 6 HYDROCARBONS BEFORE. AND SO I DON'T THINK ONE CAN 7 LOOK AT THIS AS A STUDY PURELY ABOUT BENZENE 8 EXPOSURE. 9 A. OR SOLVENT OR -- PETROLEUM BASE 10 SOLVENT EXPOSURES. 11 SO THEY ARE REALLY TALKING ABOUT 12 COAL TAR FRACTIONS, WHICH ARE DIFFERENT. 13 Q. WELL, LET'S READ WHAT THEIR SUMMARY 14 SAYS: 15 "THERE WAS A SIGNIFICANT 16 EXCESS OF DEATHES CAUSED BY MAJOR 17 LYMPHOMAS IN MEN EMPLOYED IN 18 OCCUPATIONS WHERE BENZENE AND/OR 19 COAL TAR FRACTIONS ARE USED. THE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (165 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 INCREASE IN RISK WAS LIMITED TO 21 THOSE WHO WERE 45 YEARS OF AGE AND 22 OLDER AT DEATH AND OBSERVATION 23 WHICH IS CONSISTENT WITH THE 24 POSSIBILITY THAT CHRONIC EXPOSURE 25 MIGHT BE IMPORTANT. EVIDENCE FROM 26 OTHER STUDIES SUGGESTS THAT BENZENE 27 MAY ADVERSELY EFFECT THE 28 IMMUNOLOGICAL SYSTEM." COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (166 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4082 1 DID I READ THAT CORRECTLY, SIR? 2 A. YES. 3 Q. OKAY. SO YOUR COMMENT IS THAT THEY 4 DIDN'T SEPARATE OUT THE COAL TAR EXPOSURE WELL 5 ENOUGH FOR YOU? 6 A. YES. 7 Q. OKAY. LET'S MOVE ON THEN TO HAYES, 8 A STUDY I KNOW YOU ARE FAMILIAR WITH. 9 THE HAYES STUDY, AND I HAVE A COPY 10 FOR YOU HERE, THIS IS HAYES 1997, AND THE TITLE IS 11 "BENZENE AND THE DOSE RELATED INCIDENCE OF 12 HEMATOLOGIC NEOPLASMS IN CHINA." 13 SIR, THIS IS A STUDY THAT WAS, 14 ALTHOUGH THE PERSON IT WAS -- WHO WAS HAYES? 15 A. HAYES, I BELIEVE, IS PART OF THE 16 NATIONAL CANCER INSTITUTE. 17 Q. RIGHT. IT HAS HIS ADDRESS FOR 18 CORRESPONDENCE THERE AT THE BOTTOM OF THE FIRST PAGE 19 AT BETHESDA, MARYLAND; RIGHT? file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (167 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. YES. 21 Q. THAT WOULD BE N.C.I., NATIONAL 22 CANCER INSTITUTE? 23 A. THAT'S WHAT I SAID, YES. 24 Q. OR NATIONAL INSTITUTES OF HEALTH, I 25 GUESS, IS WHAT THEY LIST. 26 THIS WAS A STUDY THAT INVOLVED A 27 FAIRLY LARGE COHORT OF EXPOSED PERSONS, DIDN'T IT? 28 A. WELL, ACTUALLY, IT INVOLVED SEVERAL COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (168 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4083 1 DIFFERENT KIND OF COHORTS OF PEOPLE WHO HAD 2 EXPOSURES TO BENZENE. 3 Q. WELL, THE -- I'M TRYING TO FOCUS ON 4 THE NUMBERS INVOLVED HERE. 5 I MEAN, SOME OF THE OTHER STUDIES WE 6 HAVE BEEN LOOKING AT INVOLVED, YOU KNOW, ON THE 7 ORDER OF A FEW HUNDRED STUDY CASES; CORRECT? 8 A. WELL, I MEAN, THE PETROLEUM STUDIES 9 INCLUDE 300,000 PEOPLE. BUT, SO, IT'S -- IT'S A 10 REASONABLY LARGE STUDY. 11 Q. 78,000? 12 A. I DON'T KNOW. LET'S SEE HERE. 13 A. YES, 74,000, I BELIEVE. 14 Q. WELL, LET'S GET IT RIGHT. 74,828. 15 BENZENE EXPOSED; RIGHT? 16 A. YES. 17 Q. AND THIS IS THE ONE THAT YOU CITED 18 AS HAVING A RELATIVE RISK OF 3.0? 19 A. CORRECT. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (169 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. FIRST OF ALL, THE LARGER THE STUDY, 21 GENERALLY, DOES IT GIVE ONE BETTER CONFIDENCE IN 22 ONE'S NUMBERS, IF YOU HAVE A LARGER STUDY? 23 A. WELL, IF THE STUDY IS, DOESN'T 24 INCLUDE A LOT OF OTHER CHEMICAL EXPOSURES, YES. AS 25 I MENTIONED, THIS STUDY ACTUALLY IS A STUDY OF 26 SEVERAL DIFFERENT COHORTS WHICH THEY HAVE LUMPED 27 TOGETHER AND MY DIFFICULTY WITH IT IS THAT THEY ARE, 28 IN COMBINING THOSE PEOPLE AND SOME OF THEM HAVE COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (170 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4084 1 INCREASED INCIDENCE OF N.H.L. AND OTHERS DON'T. 2 Q. ONE OF THE CHARTS IN HERE, TABLE 2, 3 LOOKS AT THE DOSE RESPONSE TREND IN TERMS OF THE 4 DURATION OF EMPLOYMENT, DON'T THEY? 5 A. YES. 6 Q. AND THE FIGURES THAT THEY GIVE ARE, 7 SHOW, WELL, THEY GIVE YOU THREE CHOICES. THEY GIVE 8 YOU LESS THAN FIVE YEARS, 529 YEARS, AND 10 YEARS 9 PLUS; RIGHT? 10 A. YES. 11 Q. AND THEY SHOW AN INCREASE IN THE 12 RELATIVE RISK OVER THOSE THREE CATEGORIES, DON'T 13 THEY? 14 A. THAT'S CORRECT. 15 Q. AND IN FACT, THE OVER 10 YEARS, THE 16 RELATIVE RISK THEY SITE IS 4.2; RIGHT? 17 A. CORRECT. 18 Q. IN OTHER WORDS, THAT THE 19 PARTICIPANTS WERE FOUR TIMES MORE LIKELY TO DEVELOP file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (171 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THE CANCER THAN SOMEONE WHO WAS UNEXPOSED; RIGHT? 21 A. YES. 22 Q. THEY ALSO LOOKED AT DOSE RESPONSE IN 23 TERMS OF LOW DOSE, MEDIUM DOSE AND HIGH DOSE; 24 CORRECT? 25 A. WELL, THEY LOOK AT DOSE RESPONSE IN 26 TERMS OF THAT AND THEY ALSO LOOK AT DOSE RESPONSE IN 27 TERMS OF WHAT WE CALL CUMULATIVE PARTS PER MILLION 28 YEARS. SO THEY LOOK AT DOSE RESPONSE TWO DIFFERENT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (172 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4085 1 WAYS. AND THE AVERAGE P.P.M. EXPOSURE LEVEL, BUT I 2 WOULD SAY THAT THE -- THE WAY THAT WE HAVE USUALLY 3 LOOKED AT DOSE RESPONSE IN THESE STUDIES IS 4 CUMULATIVE P.P.M. YEARS. 5 Q. WELL, THE -- THEY DO A TREND FOR THE 6 AVERAGE ON P.P.M., DON'T THEY? 7 A. YES. 8 Q. AND YOU -- IT COMES UP WITH A 9 P-VALUE OF .04? 10 A. CORRECT. 11 Q. THAT WOULD MEAN IT IS A SIGNIFICANT 12 TREND? 13 A. YES. 14 Q. AND SO THAT MEANS THAT THERE IS A 15 DOSE RESPONSE EFFECT THAT'S BEING OBSERVED IN THIS 16 STUDY? 17 A. IN TERMS OF, LIKE I SAY, IN TERMS OF 18 THE AVERAGE PART PER MILLION OF EXPOSURE, YES. 19 Q. NOW, THE CONCLUSION THAT THEY COME file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (173 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 TO IS SET FORTH IN THE ABSTRACT ON THE FIRST PAGE, 21 IS THAT THE RESULTS OF THIS STUDY SUGGESTS THAT 22 BENZENE EXPOSURE IS ASSOCIATED WITH A SPECTRUM OF 23 HEMATOLOGIC NEOPLASMS AND RELATED DISORDERS IN 24 HUMANS. 25 NOW, HEMATOLOGIC NEOPLASMS, THAT 26 WOULD INCLUDE DISEASE SUCH AS NON-HODGKIN'S 27 LYMPHOMA; WOULDN'T IT? 28 A. YOU KNOW, I'M NOT REALLY SURE WHAT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (174 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4086 1 THIS TERM, THE WAY THEY ARE USING THIS TERM. 2 Q. YOU ARE NOT SURE WHAT THEY MEANT BY 3 THAT? 4 A. NO. 5 Q. WELL, THEY PARSED OUT SPECIFIC 6 DISEASES INCLUDING NON-HODGKIN'S LYMPHOMA, DIDN'T 7 THEY? 8 A. WELL, THEY DID STUDY IT, YEAH. BUT 9 AS I SAID, WHEN YOU ARE TALKING ABOUT THIS 10 CONCLUSORY STATEMENT, I AM NOT REALLY CERTAIN WHAT 11 THEY ARE REFERRING TO HERE. I KNOW THAT LATER WHEN 12 THEY PUBLISHED IN THE YEAR 2000, THEY ACTUALLY 13 QUESTIONED THE RESULTS THAT THEY FOUND REGARDING 14 NON-HODGKIN'S LYMPHOMA BECAUSE OF THIS DIFFERENCE 15 BETWEEN THESE FINDINGS AND THESE DIFFERENT COHORTS 16 AND THEY THOUGHT THAT MAYBE IT WAS DUE TO SOME OTHER 17 CHEMICAL EXPOSURE. 18 Q. WELL, THAT'S ONE OF THE PROBLEMS OF 19 DOING THESE KINDS OF STUDIES, IS IT HARD TO SEPARATE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (175 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OUT A PARTICULAR CHEMICAL THAT ONE IS EXPOSED TO 21 BECAUSE TYPICALLY THEY ARE EXPOSED TO MIXTURES OF 22 CHEMICALS; RIGHT? 23 A. WELL, EXCEPT -- PLIOFILM COHORT THAT 24 WE TALKED ABOUT THE RINSKI STUDY WAS, IT WAS PRETTY 25 CLEARLY ALL BENZENE EXPOSURE THESE PEOPLE HAD. 26 AND THIS STUDY THEY HAD CHEMICAL 27 WORKERS WHERE THEY HAD STATISTICALLY SIGNIFICANT 28 RESULTS AND THE CHEMICAL WORKERS INCLUDED PEOPLE WHO COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (176 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4087 1 ARE MAKING PESTICIDES AND ALL SORTS OF THINGS. 2 SO THAT'S MY DIFFICULTY WITH 3 UNDERSTANDING THIS STUDY. 4 AND AS I MENTION, I PUT IT IN MY 5 CHART AND I CALL THE 3.0 AS POSSIBLY STATISTICALLY 6 SIGNIFICANT ALTHOUGH THEY REPORTED IT YES AND NO IN 7 A COUPLE DIFFERENT PAPERS. 8 Q. THE STUDY BY FABBRO-PERAY, ANOTHER 9 FRENCH STUDY, YOU ARE FAMILIAR WITH THAT? 10 A. YES. 11 Q. AND THE TITLE OF THIS IS 12 ENVIRONMENTAL RISK FACTORS FOR NON-HODGKIN'S 13 LYMPHOMA, A POPULATION BASED CASE CONTROL STUDY IN 14 LANGUEDOC-ROUSSILLON, FRANCE." I'LL SPELL THAT, 15 L-A-N-G-U-E-D-O-C DASH R-O-U-S-S-I-L-L-O-N. 16 SO THIS WAS PUBLISHED IN 2001; 17 CORRECT? 18 A. YES. 19 Q. AND AGAIN, IT REPORTED AN ODDS RATIO file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (177 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OF 2.0, DIDN'T IT? 21 A. YES. I HAD THAT IN MY TABLE AND 22 THAT WAS THE ONE STUDY THAT WAS STATISTICALLY 23 SIGNIFICANT. 24 YOU ARE TALKING ABOUT CASE CONTROL 25 STUDIES NOW AS OPPOSED TO COHORT STUDIES OF BENZENE? 26 Q. SO THIS WOULD GO ON THE LIST OF 27 STUDIES THAT SUPPORT THE EXITANCE OF A CAUSAL 28 RELATIONSHIP? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (178 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4088 1 A. WELL, I DON'T KNOW IF I WOULD SAY 2 THAT IT SUPPORTS. IT SHOWS AN ASSOCIATION. IF 3 THERE WERE OTHER STUDIES THAT WOULD SHOW THE SAME 4 THING, THEN YOU MIGHT INFER A CAUSAL ASSOCIATION 5 WHERE WE DON'T SEE THAT. 6 Q. IT BROKE OUT SOME OF THE STATISTICS 7 IN TERMS OF NUMBER OF DAYS OF EXPOSURE, DIDN'T IT? 8 A. YES. 9 Q. FOR SOME REASON, THEY USED 810 DAYS 10 AS THE FLIP-FLOP POINT BETWEEN ONE GROUP AND THE 11 NEXT? 12 A. YES. 13 Q. AND FOR LESS THAN 810 DAYS, THE ODDS 14 RATIO WAS 1.7 WHICH WASN'T EVEN SIGNIFICANT, WAS IT? 15 A. EXCUSE ME, WHICH TABLE ARE YOU 16 REFERRING TO? 17 Q. LET ME GET YOU THE CITE. 18 A. I BELIEVE YOU ARE REFERRING TO TABLE 19 6 -- file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (179 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. TABLE 3. 21 A. OH, TABLE 3. OKAY. 22 Q. TABLE 3, CUMULATIVE IN THE MIDDLE, 23 CUMULATIVE NUMBER OF DAYS, THEY HAVE NEVER, LESS 24 THAN 810 DAYS, MORE THAN 810 DAYS. 25 A. YES. 26 Q. THEN THEY HAVE ODDS RATIOS? 27 A. YES. 28 Q. NEVER IS 1.0. LESS THAN 810 DAYS IS COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (180 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4089 1 1.7. GREATER THAN 810 DAYS IS 5.7; CORRECT? 2 A. YES. 3 Q. THEY RUN A P-VALUE OF THAT OF .02? 4 A. AS I MENTIONED THIS STUDY IS A 5 STATISTICALLY SIGNIFICANT STUDY, YES. THAT'S WHAT I 6 HAVE IN MY TABLE. 7 Q. ALL RIGHT. NOW, THERE ARE -8 STUDIES WE HAVE BEEN LOOKING AT HAVE BEEN STUDIES 9 THAT ARE INDIVIDUAL STUDIES RATHER THAN STUDIES THAT 10 HAVE ATTEMPTED TO GROUP TOGETHER AND LOOK AT MORE OF 11 THE LITERATURE AS A WHOLE. WOULD YOU AGREE? 12 A. WELL, WITH THE EXCEPTION OF THE 13 PETROLEUM WORKER STUDIES THAT HAD 19 DIFFERENT 14 STUDIES INCLUDED IN IT. 15 Q. WE WILL GET TO THAT, I PROMISE. 16 THE BRANDT, B-R-A-N-D-T, DID A 17 REVIEW ARTICLE IN 1987 TITLED "LEUKEMIA AND LYMPHOMA 18 RISKS DERIVED FROM SOLVENTS." CORRECT? 19 A. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (181 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 Q. AND HE, AS IS TYPICAL FOR A REVIEW 21 STUDY, HE REVIEWED THE VARIOUS STUDIES THAT HAD BEEN 22 PUBLISHED IN THE LITERATURE; RIGHT? 23 A. WELL, HE REVIEWED SOME OF THEM. I 24 AM NOT -- I DON'T KNOW WHAT VARIOUS STUDIES, WHETHER 25 OR NOT HE DID A COMPLETE REVIEW OR NOT. 26 Q. WELL, HE CONCLUDED THERE WAS AN 27 OCCUPATIONAL, THAT OCCUPATIONAL EXPOSURE TO ORGANIC 28 SOLVENTS IS ASSOCIATED WITH NON-HODGKIN'S LYMPHOMA, COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (182 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4090 1 WITH THE ODDS RATIO OF 3.3; RIGHT? 2 A. THAT'S WHAT HE, THAT'S WHAT HE 3 CONCLUDED. AGAIN, I AM NOT, I AM NOT SURE. I DON'T 4 BELIEVE THAT THIS WAS AN INDIVIDUAL STUDY. AS YOU 5 SAID, THIS WAS A REVIEW ARTICLE. 6 Q. RIGHT. 7 A. SO I AM NOT EXACTLY SURE WHAT, WHAT 8 STUDY HE IS BASING THAT UPON. 9 Q. HE IS REVIEWING THE LITERATURE AND 10 COMING TO A CONCLUSION ABOUT WHAT HE SEES AS THE 11 STATE OF THE ART AS OF 1987; RIGHT? 12 A. RIGHT. AGAIN, AS I POINTED OUT MANY 13 TIMES, HE'S TALKING ABOUT ORGANIC SOLVENTS IN 14 GENERAL. 15 Q. AND HE MAKES A CONCLUSION THAT 16 ORGANIC SOLVENTS IN GENERAL ARE RELATED IN A 17 STATISTICALLY SIGNIFICANT WAY TO NON-HODGKIN'S 18 LYMPHOMA; RIGHT? 19 A. WELL, THAT'S WHAT HE SAYS ABOUT ALL file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (183 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ORGANIC SOLVENTS, YES. 21 Q. OKAY. LET'S MOVE TO VINEIS, SPELLED 22 V-I-E-N-E-S. THE TITLE OF THIS "THE ROLE 23 OCCUPATIONAL EXPOSURE AND IMMUNODEFICIENCY IN B-CELL 24 MALIGNANCIES" PUBLISHED IN 1992. 25 YOU HAVE SEEN THIS BEFORE? 26 A. YES. 27 Q. ANOTHER REVIEW ARTICLE, THIS ONE 28 FROM AN ITALIAN? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (184 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4091 1 A. YES. 2 Q. AND HE CONCLUDES THAT THERE ARE 3 EXCESSES OF NON-HODGKIN'S LYMPHOMA THAT HAVE BEEN 4 OBSERVED IN POPULATIONS EXPOSED TO ORGANIC 5 SOLVENTS," THAT'S HIS CONCLUSION, ISN'T IT? 6 A. WELL, AGAIN, MOSTLY HE IS BASING IT 7 ON THE STUDIES THAT WE HAVE TALKED ABOUT. HE SAYS 8 UNDER "SOLVENTS," HE SAYS: 9 "ORGANIC SOLVENTS 10 COMPRISE A WIDE GROUP OF CHEMICALS 11 USED EXTENSIVELY IN INDUSTRIAL AND 12 AGRICULTURAL ACTIVITIES." 13 SO HE IS BASING THIS, AGAIN, ON -14 HE IS NOT DIFFERENTIATING BETWEEN DIFFERENT KINDS OF 15 ORGANIC SOLVENTS. 16 Q. NEXT WE HAVE PEARCE. 17 THIS IS TITLED "INCREASING INCIDENCE 18 OF NON-HODGKIN'S LYMPHOMA, OCCUPATIONAL AND 19 ENVIRONMENTAL FACTORS," PUBLISHED IN 1992. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (185 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 HE CONCLUDES: 21 "STUDIES HAVE FOUND AN 22 INCREASED RISK OF NON-HODGKIN'S 23 LYMPHOMA WITH WORK INVOLVING 24 EXPOSURE TO SOLVENTS OR RELATED 25 CHEMICALS." 26 THAT WAS HIS CONCLUSION; RIGHT? 27 A. WHERE ARE YOU READING FROM -- "OR 28 RELATED CHEMICALS"? COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (186 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4092 1 Q. YES. YOU WILL FIND IT IN THE 2 ABSTRACT. 3 A. YES, YES. INVOLVING EXPOSURE TO 4 WOOD, SOLVENTS OR RELATED CHEMICALS. 5 Q. RIGHT. THAT'S HIS CONCLUSION ISN'T 6 IT? 7 A. THAT'S WHAT HE SAYS, YES. 8 Q. OKAY. I GATHER YOU DISAGREE WITH 9 HIM, DON'T YOU? 10 A. WELL, I DON'T KNOW. I HAVEN'T 11 REALLY READ THIS PAPER IN AWHILE SO I WOULD HAVE TO 12 BE ABLE TO READ IT OVER TO COMMENT ON HIS 13 CONCLUSION. BUT CERTAINLY I DISAGREE WITH HIM 14 RELATED TO PETROLEUM BASED SOLVENTS. 15 Q. LET'S LOOK AT A PAPER BY 16 WEISENBURGER. 17 DO YOU KNOW WHO DR. WEISENBURGER IS? 18 A. I HAVE READ HIS TESTIMONY, YES. 19 Q. DO YOU KNOW HE TESTIFIED IN THIS file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (187 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 CASE? 21 A. THAT'S WHAT I SAID. I READ HIS 22 TESTIMONY IN THIS CASE, YES. 23 Q. AND HE WROTE THIS ARTICLE TITLED 24 "EPIDEMIOLOGY OF NON-HODGKIN'S LYMPHOMA, RECENT 25 FINDINGS REGARDING AN EMERGING EPIDEMIC," PUBLISHED 26 IN 1994; CORRECT? 27 A. YES. 28 Q. AND HE CONCLUDES "STUDIES SUGGESTING COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (188 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4093 1 AN ETIOLOGIC LINK." ETIOLOGIC MEANS CAUSAL; RIGHT? 2 A. I DON'T KNOW WHERE YOU ARE READING 3 FROM. EXCUSE ME. 4 Q. OKAY. LET ME -- OVER ON PAGE 21, 5 RIGHT-HAND COLUMN, BOTTOM. 6 HE STATES: 7 "EARLY STUDIES 8 SUGGESTING AN ETIOLOGIC LINK 9 BETWEEN SOLVENT AND OTHER CHEMICAL 10 EXPOSURES AND NON-HODGKIN'S 11 LYMPHOMA HAVE RECENTLY BEEN 12 CONFIRMED." 13 DID I READ THAT CORRECTLY? 14 A. YOU READ IT CORRECTLY. 15 Q. AND SO I GATHER THAT'S SOMETHING YOU 16 DISAGREE WITH; RIGHT? 17 A. WELL, I DISAGREE WITH IT RELATED TO 18 BENZENE AND TO PETROLEUM BASED SOLVENTS. 19 I MEAN, HE MENTIONS A LOT OF THINGS, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (189 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 OTHER KINDS OF CHEMICALS. BUT LIKE I SAY, I 21 DISAGREE RELATED TO THE PETROLEUM BASED SOLVENTS. 22 Q. OKAY. LET'S GO BACK TO A SWEDISH 23 AUTHOR NAMED PERSSON, P-E-R-S-S-O-N, PUBLISHING IN 24 1996, THE TITLE IS "OCCUPATIONAL EXPOSURE AND 25 MALIGNANT LYMPHOMA." 26 THIS IS ANOTHER ONE OF THE SWEDISH 27 AUTHORS; RIGHT? 28 A. YES. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (190 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4094 1 Q. AND THIS IS A REVIEW ARTICLE WHERE 2 HE REVIEWS WHAT THE EVIDENCE IS WITH RESPECT TO 3 ORGANIC SOLVENTS AND OTHER KINDS OF OCCUPATIONAL 4 EXPOSURES AND MALIGNANT LYMPHOMA; CORRECT? 5 A. YES. 6 Q. AND HE CONCLUDES "THE RELATIONSHIP 7 BETWEEN SOLVENT EXPOSURE AND MALIGNANT LYMPHOMA HAS 8 BEEN OBSERVED IN A GREAT NUMBER OF STUDIES." 9 A. WELL, AGAIN, HE IS TALKING ABOUT ALL 10 ORGANIC SOLVENTS AND HE IS TALKING ABOUT ALL 11 LYMPHOMAS WHICH WOULD INCLUDE HODGKIN'S DISEASE, AS 12 WELL AS NON-HODGKIN'S LYMPHOMA. 13 SO WE HAVEN'T REALLY REVIEWED THOSE 14 STUDIES OF HODGKIN'S DISEASE FOR THIS PURPOSE. 15 Q. WOULD YOU AGREE THAT HE CONCLUDES 16 THAT EXPOSURE TO SOLVENTS PLAYS A ROLE IN THE 17 EPIDEMIOLOGY OF MALIGNANT LYMPHOMA? 18 A. WOULD I AGREE THAT HE SAYS THAT? 19 Q. YES. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (191 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 A. YES, YOU READ IT CORRECTLY. 21 Q. OKAY. 22 AND LET'S GO BACK TO MR. REGO, 23 R-E-G-O. 24 MR. REGO, IN 1998, PUBLISHED A 25 REVIEW ARTICLE TITLED "NON-HODGKIN'S LYMPHOMA RISK 26 DERIVED FROM EXPOSURE TO ORGANIC SOLVENTS. A REVIEW 27 OF THE EPIDEMIOLOGIC STUDIES." 28 AND YOU HAVE READ THIS ARTICLE, COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (192 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4095 1 HAVEN'T YOU? 2 A. YES. 3 Q. HE KIND OF SUMS UP THE STUDIES. HE 4 COUNTS THEM. HE SAYS: "25 OUT OF 45 POSITIVE 5 STUDIES," THAT'S 55.5 PERCENT, FROM '79 TO '97. AND 6 HE COUNTS UP A TOTAL OF 54 STATISTICALLY SIGNIFICANT 7 ASSOCIATIONS BETWEEN NON-HODGKIN'S LYMPHOMA AND 8 SOLVENT EXPOSURES. 9 THAT'S WHAT HE CONCLUDES, ISN'T IT? 10 A. THE 13, YOU ARE TALKING ABOUT, THE 11 72.2 PERCENT? 12 Q. WELL, LET'S GET TO THAT. HE ALSO 13 FINDS THAT IN 13 OUT OF 18 STUDIES, THAT'S 72 14 PERCENT, IN WHICH SOLVENT EXPOSURE WAS MORE 15 ACCURATELY DEFINED, SUGGESTED ORGANIC SOLVENTS AS A 16 RISK FACTOR FOR N.H.L. 17 MR. RIFF: EXCUSE ME. I BELIEVE THAT WAS 18 MISREAD. 19 THE COURT: WELL, GO AHEAD, MR. WAGNON. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (193 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THE WITNESS: WELL, I MEAN, I REMEMBER THIS, 21 WHAT THIS SORT OF BROAD-BASED REVIEW ARTICLE DID WAS 22 LOOK AT ALL SORTS OF OCCUPATIONS, LOOK AT ALL SORTS OF 23 CHEMICALS, INCLUDING SOME THAT I DON'T REALLY EVEN 24 CONSIDER SOLVENTS THAT WERE COMMINGLED WITH SOLVENT 25 EXPOSURES. AND WE HAVE BEEN THROUGH A NUMBER OF STUDIES 26 HERE THAT TALK ABOUT SOLVENTS. 27 AND SO HE IS SORT OF DOING THE SAME KIND 28 OF COUNTING EXERCISE IN WHICH HE IS COUNTING UP HOW MANY COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (194 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4096 1 STUDIES THERE WERE THAT MIGHT HAVE FOUND A FINDING OF AN 2 INCREASED ASSOCIATION. 3 AND BUT, AGAIN, IT IS ALL ABOUT EITHER 4 OCCUPATIONS WHERE THERE'S SOME ROLE FOR ORGANIC SOLVENTS 5 BUT PEOPLE EXPOSED TO LOTS OF THINGS OR IT'S ABOUT ALL 6 ORGANIC SOLVENTS. 7 Q. SIR, ARE YOU FAMILIAR WITH THE CHIU 8 AN WEISENBURGER STUDIES PUBLISHED IN 2003 WHERE THEY 9 DID AN UPDATE OF THE EPIDEMIOLOGY IN NON-HODGKIN'S 10 LYMPHOMA? 11 A. REVIEW ARTICLE? 12 Q. YES. 13 A. I BELIEVE SO. 14 Q. AND THAT AGAIN CONCLUDED THAT 15 EXPOSURE, OCCUPATIONAL EXPOSURE TO SOLVENTS IS 16 ASSOCIATED WITH NON-HODGKIN'S LYMPHOMA, DIDN'T IT? 17 A. WELL, I DON'T RECALL THAT SPECIFIC 18 WORDING, BUT -19 Q. OKAY. HOW ABOUT THIS ONE. YOU file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (195 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 REMEMBER THIS ONE, MEHLMAN, TITLED "CAUSAL 21 RELATIONSHIP BETWEEN NON-HODGKIN'S LYMPHOMA AND 22 EXPOSURE TO BENZENE AND BENZENE CONTAINING 23 SOLVENTS," PUBLISHED IN 2006? 24 A. WELL, I AM FAMILIAR WITH MYRON 25 MEHLMAN FROM LITIGATION CASES. IS THAT THE SAME ONE 26 YOU ARE TALKING ABOUT? 27 Q. WELL, HE CONCLUDES THAT A LARGE 28 NUMBER OF STUDIES HAVE SHOWN A SIGNIFICANT COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (196 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4097 1 ASSOCIATION BETWEEN NON-HODGKIN'S LYMPHOMA AND 2 BENZENE OR BENZENE CONTAINING SOLVENTS, DOESN'T HE? 3 A. I'D HAVE TO SEE IT TO REMEMBER THE 4 WORDING. 5 WELL, IF HE IS TALKING ABOUT 6 PETROLEUM BASED SOLVENTS, I AM ASSUMING THAT THAT'S 7 WHAT HE MEANS BY -8 Q. LET'S LOOK AT THE ABSTRACT. 9 HE SAYS: 10 "BASED ON AN ANALYSIS OF 11 THE LITERATURE AND THE WEIGHT OF 12 THE EVIDENCE FROM NUMEROUS STUDIES, 13 IT IS REASONABLE TO CONCLUDE THAT 14 EXPOSURE TO BENZENE OR TO SOLVENTS 15 OR PRODUCTS CONTAINING BENZENE IS 16 CAUSALLY RELATED TO NON-HODGKIN'S 17 LYMPHOMA." 18 THAT'S HIS CONCLUSION, ISN'T IT? 19 A. OH, YEAH. AND AGAIN, IT IS BASED file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (197 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 ON, LOOK AT TABLE 19, ALL THE OCCUPATIONS THAT HE IS 21 BASING IT. THIS UPON, THESE ARE PEOPLE WHO ARE 22 EXPOSED TO ALL SORTS OF THINGS. EXPLOSIVE MAKERS, 23 INK MAKERS, MIRROR SILVERERS, OIL CLOTH MAKERS. I 24 MEAN, AGAIN, I THINK THAT I JUST DON'T THINK THESE 25 PEOPLE HAVE BEEN CAREFUL IN TERMS OF REALLY LOOKING 26 AT JUST BENZENE AND PETROLEUM BASED SOLVENTS. 27 Q. SIR, THE -- YOU HAVE ALLUDED TO THE 28 STUDY BY WONG AND RAAB. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (198 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4098 1 A. THAT'S ONE OF A STUDY OF WORKERS AT, 2 PETROLEUM WORKERS; RIGHT? THEY WERE WORKERS AT 3 PETROLEUM REFINERIES, PRIMARILY. 4 Q. THAT IS PEOPLE WHO WERE EMPLOYED AT 5 A PETROLEUM REFINERY; CORRECT? 6 A. THAT'S CORRECT. 7 Q. AND DID YOU NOTICE, FIRST OF ALL, 8 HIS COAUTHOR, GERHARD RAAB, IT SAYS THAT HE IS, I 9 GUESS HE IS EMPLOYED BY THE EXXON MOBIL CORPORATION? 10 A. HE IS AN EPIDEMIOLOGIST WITH THEM, 11 YES. 12 Q. AND SO THIS WAS A STUDY OF PETROLEUM 13 WORKERS THAT WAS DONE, IN PART, BY SOMEBODY WHO 14 WORKS FOR THAT INDUSTRY; RIGHT? 15 A. THAT'S TRUE. YES. 16 Q. AND IN FACT, THE STUDY WAS SPONSORED 17 BY THE AMERICAN PETROLEUM INSTITUTE, WASN'T IT? 18 A. I BELIEVE SO, YES. 19 Q. NOW, YOU ARE FAMILIAR WITH THE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (199 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 AMERICAN PETROLEUM INSTITUTE? 21 A. WELL, AS I MENTIONED, THEY SUPPORTED 22 THE WORK THAT I DID TO TRY TO FIGURE OUT WHAT THE 23 MECHANISM WAS BY WHICH BENZENE CAUSED ACUTE 24 MYELOGENOUS LEUKEMIA. 25 MR. WAGNON: YOUR HONOR, I WOULD REQUEST THAT 26 WE MARK AS EXHIBIT NEXT IN ORDER -27 THE COURT: IT WOULD BE 132, I THINK -- I'M 28 SORRY, WE HAVE A 132. 133. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (200 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4099 1 /// /// /// 2 (EXHIBIT 133, DOCUMENT, 3 MARKED FOR I.D.) 4? 5 Q. BY MR. WAGNON: SIR, I WILL HAND YOU A 6 COPY OF THIS. FOR THE RECORD, EXHIBIT 132 IS AN A.P.I. 7 TOXICOLOGICAL REVIEW OF BENZENE DATED SEPTEMBER, 1948. 8 THE COURT: ALL RIGHT, IT MAY BE MARKED FOR 9 IDENTIFICATION. 10 Q. BY MR. WAGNON: SIR, YOU ARE AWARE THAT 11 IN 1948 THE AMERICAN PETROLEUM INSTITUTE PUBLISHED THIS 12 TOXICOLOGICAL REVIEW ON BENZENE? 13 A. YES. 14 Q. YOU HAVE SEEN THIS DOCUMENT BEFORE, 15 HAVEN'T YOU? 16 A. YES. IN FACT, I HAVE LOOKED AT IT 17 IN A LOT OF DETAIL AND LOOKED UP THE REFERENCES THAT 18 IT IS BASED UPON. 19 Q. YES. AND THE -- IF YOU WOULD TURN, file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (201 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 IF YOU WOULD, TO PAGE 4, IN THE BOTTOM OF THE 21 LEFT-HAND COLUMN THERE'S A TITLE "SAFE LIMITS." 22 DO YOU SEE THAT? 23 A. YES. 24 Q. AND THEY DESCRIBE THE -- WELL, THEY 25 REFER TO THE AMERICAN STANDARD ASSOCIATION AND MOST 26 STATES HAVE SET AN ARBITRARY LIMIT OF 100 P.P.M. AS 27 THE MAXIMUM PERMISSIBLE BENZENE CONCENTRATION FOR 28 WORKERS EXPOSED TO THIS SUBSTANCE DURING AN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (202 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4100 1 EIGHT-HOUR DAY. CORRECT? 2 A. YES. 3 Q. AND THEN THEY GO ON AND DESCRIBE 4 SOME OTHER STATES HAVE SET SOME LOWER LIMITS. 5 BUT I WANT TO READ YOU THIS SENTENCE 6 AND SEE IF YOU AGREE WITH THIS. 7 "INASMUCH AS THE BODY 8 DEVELOPS NO TOLERANCE TO BENZENE AN 9 AS THERE IS A WIDE VARIATION IN 10 INDIVIDUAL SUSCEPTIBILITY, IT IS 11 GENERALLY CONSIDERED THAT THE ONLY 12 ABSOLUTELY SAFE CONCENTRATION FOR 13 BENZENE IS ZERO." 14 DID I READ THAT CORRECTLY? 15 A. YES. 16 Q. THAT IS WHAT THE A.P.I. 17 TOXICOLOGICAL SURVEY REGARDING BENZENE SAID BACK IN 18 1948, ISN'T IT? 19 A. WELL, I DON'T KNOW WHO SAID IT BUT file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (203 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THIS IS WHAT THIS DOCUMENT SAYS IN 1948. 21 Q. OKAY. 22 MR. WAGNON: THANK YOU, SIR. THAT'S ALL I 23 HAVE. 24 THE COURT: MR. RIFF. 25 MR. RIFF: HOW MUCH TIME WOULD I HAVE THIS 26 AFTERNOON WITH THIS WITNESS, YOUR HONOR, BEFORE YOU 27 BREAK FOR THE DAY? 28 THE COURT: WE MAY LOSE OUR STAFF. YOU CAN COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (204 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4101 1 BRING HIM BACK TOMORROW. THAT'S FINE WITH ME. 2 MR. RIFF: WELL, I MEAN IT'S -- COULD WE 3 HUDDLE AT SIDE BAR. 4 THE COURT: SURE. 5 6 (THE FOLLOWING PROCEEDINGS 7 WERE HELD AT THE BENCH:) 8 9 THE COURT: YES, HOW MUCH HAVE YOU GOT? YOU 10 HAVE A HALF HOUR, HAVEN'T YOU IT? 11 MR. RIFF: YES, I HAVE MORE THAN THAT, AND I 12 DON'T WANT TO TRY TO JAM IT. 13 THE COURT: ALL RIGHT, WE WILL BRING THEM BACK 14 TOMORROW. THAT'S FINE. 15 16 (THE FOLLOWING PROCEEDINGS 17 WERE HELD IN OPEN COURT IN 18 THE PRESENCE OF THE JURY:) 19 file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (205 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 THE COURT: OKAY, LADIES AND GENTLEMEN, WE ARE 21 GOING TO BREAK FOR THE AFTERNOON. LET ME TELL YOU WHAT 22 I ANTICIPATE TOMORROW AND COUNSEL WILL CORRECT ME AS 23 ALWAYS IF I AM WRONG. 24 I ANTICIPATE TOMORROW THAT WE WILL 25 FINISH WITH THIS WITNESS IN THE MORNING, HIGHLY LIKELY 26 BEFORE NOON, AND THEN I ANTICIPATE THAT OTHER THAN 27 ADMITTING EXHIBITS, THAT IS LIKELY TO BE THE END OF THE 28 EVIDENCE PRESENTATION. COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (206 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 4102-4150 1 NOBODY HAS CORRECTED ME YET. 2 SO MY ANTICIPATION IS THAT WE WILL BREAK 3 BEFORE NOON AND THAT YOU THEN WILL COME BACK ON 4 WEDNESDAY FOR CLOSING ARGUMENTS. 5 COUNSEL AND I NEED SOME TIME TO FINALIZE 6 JURY INSTRUCTIONS WHICH ARE VERY IMPORTANT. THERE MAY 7 BE SOME MOTIONS I HAVE TO DEAL WITH SO COUNSEL AND I 8 WILL BE BUSY THE REST OF THE DAY TOMORROW. 9 BUT WE WILL BREAK FOR NOON, AT NOON AND 10 I KNOW I HAD A QUESTION FROM ONE OF OUR JURORS ABOUT 11 GETTING BACK FROM LUNCH A LITTLE BIT LATE TOMORROW. SO 12 THAT'S NOT GOING TO BE A PROBLEM BECAUSE WE WILL BREAK 13 BEFORE NOON. YOU WILL BE OFF IN THE AFTERNOON AND THEN 14 YOU WILL BE BACK ON WEDNESDAY MORNING FOR CLOSING 15 ARGUMENT. 16 OKAY? 17 SO FAR SO GOOD. 18 OKAY. VERY GOOD. SO WE WILL SEE YOU 19 BACK HERE TOMORROW MORNING AT 9 O'CLOCK. file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (207 of 208) [10/18/2010 2:21:30 PM] file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt 20 REMEMBER, DON'T DISCUSS THE CASE AMONG 21 YOURSELVES OR WITH ANYONE ELSE AND DON'T FORM ANY 22 OPINIONS ON IT UNTIL IT IS SUBMITTED TO YOU RELATIVELY 23 SOON. 24 THANK YOU VERY MUCH. 25 (THE PROCEEDINGS IN THE ABOVE- ENTITLED MATTER WERE CONTINUED TO 26 TUESDAY, OCTOBER 28TH, 2008 AT 9:00 A.M.) 27 28 (THE NEXT PAGE IS 4151) COPYING RESTRICTED PURSUANT TO SEC. 69954(d) GOV. CODE file:///C|/Users/MadeK42/Desktop/whysner-upload/Whysner,%20John%20--%2010-27-08%20--%20pm.txt (208 of 208) [10/18/2010 2:21:30 PM]