Document rpz8Nze7a8aq60R4oVaDMgL2v

0S HARVARD SCHOOL OF PUBLIC HEALTH C OCCUPATIONAL HEALTH PROGRAM S HUNTINGTON AVENUE BOS(TSOiNV,)JM6ASDSAi3CKHQUSEETaTSoaOSC1 IS 732-1260 June 12, 1978 Mr. James Shriver Plant Manager 70 Worcester Street Indian Orchard, Mass. 01151 Dear Mr. Shriver: Hie National Institute of Occupational Safety and Health (NIOSH) has contracted with Harvard university to provide physician services to provide medical evaluations of potential hazards in the workplace. These investigations are carried out under the authority of Section 20 * of the Occupational Safety and Health Act. Information submitted to NIOSH and forwarded to us alleges exposure to vinyl chloride, acrylonitrile and other chemicals. Digestive and genito urinary tumors were also alleged. To begin to pursue this matter under our contract, I would appreciate a meeting with you and/or your representatives. Mr. William Westendorf indicates to me that June 27, 1978 might be a suitable day. If so, we would like to meet at your plant at 10 am on that day. We would be primarily interested in pursuing available data that could lead to a definitive answer as to whether this is or was a hazard. A plant tour could be helpful, certain coitpany records could be helpful. Accompanying me will be Dr. Richard Monson, Associate Professor of Epidsniology and a resident physician in our training program, yet to be determined. I hope this date is suitable an! I look forward to the visit. Sincerely yours. John M. Peters, MD Professor of Occupational Medicine Director, Occupational Health Program JMPiDMI OC: Dr. Richard Monson Mr. W.H. Westendorf Dr. Charles Xintaras Dr. Ttorn Wilcox RSV0024652 ^">7 DEPARTMENT OF HEALTH. EDUCATION, AND WELFARE pum ic Krpi.TH `irrcvtCE ItNHKhrii HIM AHf IfPtlH* H NATIONAL INSTITUTE FO OCCUPATIONAL SAPETY AND HEALTH ROBERT A. TAPT LABORATORIES AST* COLUMBIA PARKWAY. CINCINNATI. OHIO 4SIZ6 September 20, 1978 James Schriver Monsanto Plant Manager 70 Worchester Street Indian Orchard, Mass, 01157 Dear Mr. Schriver: Enclosed please find a SHEFS I preliminary report on the status of HHE 78-83 at the Indian Orchard, MA, Monsanto Chemical Plant. NIOSH has not yet completed plans for the continued study of this Health Hazard Evaluation but I will keep you informed of NIOSH's progress. Sincerely, Enclosure Thomas Wilcox, M.D. Medical Officer Medical Section, HETAB Xerox copies: G. L. Smith P. E. Bureau (2) 9/25/78 ( RSV0024653 MEMORANDUM DfiPARTMKNT OK Hr.AI.TH. KnUCATIOM. AND WM.I-'ARI; runt tr iu-ai.th m'hvii f CFNtr.R m* ntsrAst; cmnihoi naiional inyiimiif for >kniPAtiosAi sai j iy ano mcai tit f to : Director, DSHEFS Thru: Acting Chief, HETAB_____ Thru: Acting Chief, MS date: September 15, 1978 from : Medical Officer Medical Section, HETAB SHEFS I: HHE 78-83 Monsanto Chemical Company Indian Orchard, Ma. Dr. Peter's report states that with the data currently available there is no demonstrable effect of employment at the Springfield Monsanto Plant on cause of death. He suggests however that a retrospective cohort mortality study would provide a more complete picture of the cancer mortality experienced to date and give the best data possible either to support or refute the existence of an increased carcinogenic risk being associated with employment at the plant in question. He also suggests that any such proposed study have a mechanism for a review of its progress and outcome by an impartial scientist acceptable to both the company and concerned union members. Reportedly the Monsanto Corporation is planning to fund such a mortality study to be performed by scientists from a university affiliated school of Public Health. C. At the present time NIOSH feels that more information is required Dei Of c Wc u0ii ucv* luc iivti ucjv vu ^ui juw UK Health Hazard Evaluation. We are therefore requesting further information from the Monsanto Corporation about their proposed study. We are most interested in the cohort samp is sizar tha proposed method ot roiict;-up or roraer employees and the suitability of the available records for extraction of work histories and dates of employment etc. We also need to obtain more information about the work histories already obtained on workers who have developed Genito-Urinary or Gastro-Intestinal cancer. When this information has been received NIOSH can aecide how best to proceed with the Health Hazard Evaluation. I \ Thomas Wilcox, M.D. ii RSV0024654 HARVARD SCHOOL OF PUBLIC HEALTH OCCUPATIONAL MCALTH PflOGNAM l S'f i * c*3 muntinc*tom Avruut: DOSIOM. MAtfiACHUi*CtlU Oil <017) Professional Physicians Services 210-73-001S Health Hazard Evaluation 78-83 Monsanto Chemical Corporation Springfield, Massachusetts I. Date of Visit * * Visit conducted on June 27, 1978, by Drs. John M. Peters and Richard R. Monson, IX. * Introduction . , We were asked to determine whether* further studies or medical evaluations are necessary to clarify the occupational health status in this plant. This determination was made on the basis of the following: 1. Review of NICSH mortality study 2. Review of Monsanto mortality study ' *' 3. Visit to site of the Monsanto plant 4. Discussion with company and union representatives . 5.. Walk through survey of part of plant 6. Review of available personnel and medical records Discussions with Company personnel included; Mr. James Shriver - Plant manager , . Mr. Paul Bureau - Personnel manager Dr. Nessel - Plant physio'An ' ' ' Mr. Gar Fletcher - Plant Safety and Industrial Hygiene Dr. Ferd Myer - Corporate Msdical Department Ms. Judith Killeen Zack - Corporate Medical Department plus unit managers and foremen * Discussions with Union personnel included: Mr. Joe Bernardo - local president Mr. Roger Soucy - 3real vice president Mr. Ted Starceyk -- local secretary Manufacturing processes have been dynamic. Currently this plant employs OllDUti TOO IOlirl\/ 1/it 1 V hm C.n.lMwyi A CIM rN * are involved m research sivd dove3 opt^ii L uii plastics. Current processing includes: RSV0024655 HUE 78-03, p.2 ' .. 1. Saflcx ([olyvinyl butyral plastic) used for automobile windows. r Began in 1938. _ ' 2. Urea-formaldehyde glues and adhesives. For mare tlmn 25 years, 3.- Polystyrene-butadiene.' Since 1945. Used to be batch processed, new continuous. 4. Melamine resins 5. Mineral reinforced nylon - new 6. formaldehyde plant Discontinued processes include: 1, -Polyvinyl chloride - 1950-1974, intermittent * 2. Styrcne-acrylonitrile - 1974-1977, plastic coke bottles III. Health Hazard Evaluation 9 A. Study Design and Analytic Metdiods - The NI0SI5 study is a proportional . mortality study of 465 death certificates of 484 deaths occurring between 1950-1976. Monsanto's study involves 564 deceased employees who were also studied by proportional mortality. * B. Toxic Substance Medical Data . 1. Vinyl Chloride Vinyl Chloride enters the body by inhalation. It is a skin irritant and nervous system depressant. Light-headedness, nausea and dulling of the senses iray occur v;ith acute exposure. Chronic exposure of workers . involved in cleaning reactor vessels has resulted in acro-osteolysis, * Haynaud's phenomenon, sclerodermatous skin changes, and hepatic damage. Animal studies demonstrated hepatic toxicity at greater than 50 ppm. ' rmter emiiiLil inmlutiun suudies rovudleu cancer at multiple siues including liver, lung, brain, and kidney. Vinyl chloride' has been found to be associated with angiosarcoma. of the liver in humans. Excess cancer of the lung, the lympliatic and nervous systems has also been reported in exposed human populations. A time trend with increasing rates of all cancers in the exposed workers has been demonstrated. Vinyl chloride is regulated as a carcinogen. The acceptable level of exposure is as lew as technologically feasible and is currently 1 ppn. Medical survei 13ar.ee includes liver function studies and medical history of possible past exposure to other liver toxins. Long-term follcr.-.-up of corposod v.orkcrs is essential. 2. Acrylonitrile The chemical structure of acrylonitrile resembles that of vinyl chloride. It enters the bedv bv inhalation or rcreutanoous nbrornticn. '*"** " ' " " " A *-- *4 r " ---j rl* i ?a ^ y*v*s ^ ?i f > Art -- * *" *"' **.* * to concentrations above 20 ppm may produce nausea, vomiting, hcadacb.c, sneezing, weakness, and light-hcodcdncss. Other acute toxic effects are similar to cyanide poisoning. An excess of lung and colon cancer has been RSV0024656 i HUM 7R- p.3 . .after a .latent period of 20 years. Animjl ingestion and inhalation studies in rats revealed a wide variety of tumors, soma of which were carcinomas. In view of its potential as a human carcinogen, the expo sure level should L>o as law as feasible (<2 ppn). Careful medical follow-up and epidemiological study of exposed workers should bo obtained. 3. Styrene Styrene resembles vinyl chloride (vinyl benzene). It enters the body by inhalation or percutaneous absorption. It may produce dry, scaly dermatitis. Acute exposure to 50-100 ppn may produce irritation of the mucous mcmbrances of the eyes and upper respiratory' tract. Nervous system depression may occur and includes prolongod reaction time and decreased manual dexterity. Very high exposures may produce narcosis, cramps, and death due to respiratory center paralysis. Chronic .exposure may produce liver and kidney damage. Mandolic acid in urine has heenused to measure the intensity" of styrene exposure. Styrene oxide is a potent mutagenic agent. Workers in styrene-butadiene rubber plants have an excess mortality frem leukemia and lynrohema.- Inhalation studies in rats revealed an excess of tumors of the blood forming system in females. As a possible human carcinogen, exposure to styrene should be kept as law * as possible. * - * 4. - Butadiene Butadiene enters the body by inhalation. It is slightly irritating . to the eyes, rose, and throat. In high concentrations it may act ns a ' " lower respiratory tract irritant and as a narcotic causing CNS depression. It has been associated with an excess of leukemia and lymphana in styrene- possible until its role as a possible human carcinogen is clarified. 5. Formaldehyde . Route of. entry is by inhalation. Formaldehyde is very irritating to the mucous membranes of the respiratory tract and eyes at levels iibove 1-2 ppm. It is a skin irritant as well as sensitizer. Inhalation of high concentrations of formaldehyde may cause coughing, shortness of hroath, and pulmonary edema logical evidence exists in humans as yet. The TLV is 3 ppm a; iVT\*S* ' Ov*l % RSV0024657 hi; 78-03. p.4 6. Plieiiol Phenol enters the body )jy inhalation or chin absorption. It is both a shin irritant and sensitizer. Systemic effects of acute poisoning are weakness, diaphoresis, headache, tinnitus, shock, cyanosis, dark urine, and death. Kidney damage nnv occur. Chronic phenol poisoning is rare, but is chitractcrir.cd by vomiting, difficulty in swallowing, diarrhea, lad: of appetite, headache, fainting, dizziness, dark urine, mental dis turbances, and skin rash. Liver and kidney damage and skin discoloration may occur. Phenol may be detected in tlx: blood or urine. The current TLV is 5 ppm. C, Results and Discussion . / 1. The data frent the tv.o studies are consistent with no demonstrable |i effect of working at the Springfield plant on cause of death. This of | course is not the same as saying there are no-workers who developed I] disease and died from that disease because of their job. Hoover, if U this were the case the number of-such persons axe too few to be detected is in the current data, by the methods employed. . 2. The excess of cancer and specifically of pancreas cancer seen in the first 86 deaths probably resulted because persons wiio died from cancer t were selectively found. While this initial step was important and pointed . out Idle need for a carplete study., those initial results should not be interpreted as showing that working in the,Springfield plant causes cancer. . . 3. In the NIOSH and Monsanto reports, there were slight excesses of deaths frciu cancer of tdie yastru-intestinal tract. No work Jdstory , * information was available. However, at our visit, Judith Killeen Zack provided work history summaries for 4<5 persons with gastre--intesfinal v - 4.1WW W ew. i.W. J ^ h*,<u WjkJ i.t; n W* I ki ' review, no association is seen witn departments wnic'n would suggest . ." causality. Again, this is net to say that none exists, but only that if a. causal association does exist, it cannot be detected with the data currently available (see Tables I and II). Duration of employment in certain areas has not been considered. * 4, Monsanto indicated tint they arc negotiating with the University of * Pittsburgh Scliool of Public Health to do a retrospective cohort mortality study. Tilis should be done so as to identify the persons who tenainst wti" prior to receiving vested pension riohtn and who r.u?'r:c-:r.:;'ntlv d:,`d. A mortality study such as this would provide a complete picture of the cancer mortality exivu-i cnee lo date, and also would permit a none ermplete and appropriate examination cJ. work history. 5. One major problem with the proposed study wi 11 h* the difficult*.' m assembling work histories fran the microfilm. A large amount of extran eous material was microfilmed, and the cost and effort to abstract the needed information will be high - missing data will be unavoidable as wall. Alternative sources of information such as seniority lists and job qualification lists could be helpful if available. i i RSV002465R r Ifllli 78-R3, p.3 D. Conclusions On the basis of data available to us there appears to be little associa tion of occupation with mortality. IV. Recontncndntions Ws reccmnend that a cohort mortality study be conducted with the use of occupational information available on personnel and otlier records. If this study is conducted on the basis of an outside contract Vo a private institution, we recansend that a mechanism be found for an impartial scien tist, acceptable to both the company and concerned union merrlxsrs to review the progress and outccma of this study. The mortality experience slyould also be updated beyond 197G. V.References 1. Occupational Diseases: A Guide to Their Recognition, NIOSH (1977). 2. D.H. Wegman, J.M. Peters, R. Jaeger, W. Burgess, L. Boden. Vinyl Chloride: Can the Worker Be Protected: New England Journal of Madicine. 294: 653-657 (1976). * * . 3. Current Intelligence Bulletin:, Acrylonitrile. NIOSH (1977). 4. Proceedings of Styrene - Butadiene Briefing. NIOSH (1976). . 5. . 6. C. Maester et al. Mutagenicity of Styrene and Styrene oxide. Mut. Research 56: 147-152 (1977). * NIOSH Criteria Document: Occupational Exposure to Formaldehvde. Q976) 7. NIOSH Criteria Document: Occupational Exposure to Phenol. (1976) VX. Authorship and Acknowledgements This report was written by Drs. John M. Peters and Richard R. I-jcnscn who wish to thank both the Company and Union for their excellent cooperation. VII. Tables (attached) G?26yy RSV0024659 Cases DSDt. VIL U1** DIGESTIVE JgO PROSTATE CANCER - DEATHS DISTRIBUTKfs' BY .MOST REPRESECTATIVE DEPAICHEIiT WORKED _ ______________ V1 --I .................. I~`* ' ...................... ...............* Ml .. Prostats Pancreas Liver Stcmach Esoohacus 12 (3.27 Expt.) 6 (6.87 Ebqpfc.) 6 (3 Efrpt.) 10(7.7 Expt.) 6(4.2 Expt.) SHEET RESIKOX SAJLEX VUEPAK RES DOES. FOR-T^LDEHYDE LUSTREX PUD ' IDT. PfOD. xaidt. SHIPPIKG/MRTLS. YARD GUARDS SHIFT PDOL RES. - .3ERV. OTHER (ENG. , LAI7, LAB., STOREROOM) 2 1 i X 3 l 1 X 1 3 y 3 1 1 1 2 2 11 11 1 2 0 1 3 1 1 Colon/Rectal 16-U5.74 Ex-pt.) 5 2 2 1 2 1 1 1 1* * ** MONSANTO oJt?HINGFIEm PLANT f- DIGESTIVE AND PROSTATE CANCER DEATHS DISTRIIBUTION BY ' EVER WORKED D..E..P..A..R.TMENTS Cases Deot. Prostate Pancreas Liver Stomach Esophagus Colon/Rectal 12 (3.27 E:rpt.) 6 (6.87 Expc.) 6 (3 Expt.) 10 {7.7 Expt.) 6 (4.2 >:pt.) 16-~(15.74 Expt.) SHEET 6 RESINCX x SAFLEX VuEPAK , 3 1 RESL'-X'IES - Urtta fonr.ildehyde, ielanvine forma ld< hie FORNALDEHYDE LUSTEEX 3 PVC 1 1NT. PROD. TANK TRUCK KAINT. X SHIPPING/MAILS. 1 YARD . . 2 * GUARDS 1 SIOT ICOL RES.-SERV. OTHER {ENG., LAW, IA1J, STOREROOM) 2 34 21 1 1. 12 1 1 2 2 .. 1 1 1 11 1 1 2 21 3 1 3 2 3 2 1 1 3 1 *1 1 2 3 1 1 *5 1 3 1 1 1 11 3 8 1 1 7 5 2 1 1 1 5 \D 'v\N COO4 > GO Pi TOTAL 30 9 16 8 2 1 20 6 2 1 14 7 4 4 2 '4 12