Document vVMn0BYddag8YNY4ZQM2zxRRE

Mr. J. W. Whittlesey 46th Floor NEW YORK OFFICE Date October 28, 1980 /ojAfJVo From: Ron Ritchie " Re* ' Attached is a copy of the paper that Dr. Leffingwell wrote for presentation at the New York Academy of Sciences. Dr. Glenn and John Carvajal are listed on the cover page as authors but in the final version their names do not appear. Dr. Glenn has already forwarded a copy of this paper to Walt r Conrad. By way of Information, Leffingvell did not present this paper. He was unable to make it due to "family Illness". The paper, however, was not withdrawn. A.*. VORtSS*" ITO AWSMWt. SSI-6041 '4"-------------- RECEIVED NOVI 1980 J. W. whittles^ ucc 048456 Brain Cancer Cluster Investigation at the Union Carbide Corporation Plant Texas City, Texas Sanford S. Leffingwell, HD, )PH Richard Waxweiler, PhD David Glenn, K> John Carvajal, -- Victor Alexander, MD, MSH October, 1980 / uoc 048457  Introduction: In February of 1979, The National Institute for Occupational Safety and Health (NIOSH) of the Department of Health and Human Services, the Occupational Safety and Health Administration (094A), of the Department of Labor, and the Lhion Carbide Corporation began an investigation of a cluster of brain tumors at the company's Texas City, Texas plant. The initial events and the characteristics of the cases have been described by Or. Victor Alexander. Ne here describe the conduct and present status of a case-control study of occupational histories of employees of that plant who developed primary brain tuners. Methods and Materials: The method of case identification has been described by Dr. Alexander; the company was able to identify 12 cases, matching company records with lists of all adult males who were residents of surrounding counties and who died of malignant brain tumors yielded four more cases, three additional cases became ill and died during the course of * __ the study, and three cases have been found so far in the course of determining the vital status of all workers ever employed in the plant. Medical records and tissue specimens were obtained, where possible, and a best diagnosis was chosen from the available evidence. / ucc 048458 (10/1/80) Page 2 Following the advice f Schoenberg et al., we included all deaths due to primary intracranial neoplasms except those of the pituitary. This excluded one case with a metastatic lesion and one with a congenital anomaly but with no tumor found at autopsy. Two of the most recently discovered cases have not been included, pending confirmation of the diagnosis. Analyses of the residual 18 cases will be done both for the group as a whole and for the 15 proven gliomas. For each employee, the company completed coding sheets containing identifying personal data, date of each new job title or department code, Job code, department accounting code, and date of each layoff or date of termination. Vital status was coded, when knwn. Every SO**1 record was copied and sent to NI0& for independent ,, verification of coding. A random sample of the original records will be drawn by NI05H and used for verification of completeness of cohort identification. Six controls were drawn for each case from the pool of all people ever employed at the plant. Qses were matched to potential controls by race and sex; date of birth was matched to within three years; date of first hire for the control was before that of the case, but not more than three years before; the date the control was last employed was later than the case's last date of employment. The control could be living but, if dead, must not have died of a malignancy. Pools of controls meeting the criteria outlined above were formed and the actual controls used were drawn by random number from the pool. / 0 ... ucc 048459 (10/1/80) Page 3 The company provided translations for the job and department codes and provided a list of chemicals encountered in each major department group. The departmental coding schemes used for accounting purposes within the plant have changed over the years, so a common list tracing 4 the history of each department was prepared and all codes were transformed to conform to a single coding scheme. Althoutf* catalysts have dialed often, there appears to be no problem in characterizing the feedstocks, intermediate products, and output of each department through-the years the plant has been in operation. txansforming- Oepartwental^chmfcg ^ihgie^idCpagtaentTi codinQ^schene.mentioned-. abcve^ia*neariTfoplet40n^Urt!cwtt'canriot`ytt repcrtrtflcr chemicaieexposureaK Each job, department, and major department group represented by at least three cases was tested for possible significance by the test. Since this approach is a multiple sampling technique which should lead to about one 'significant" association for every twenty jobs, departments, or exposures considered, it is used here as an hypothesis generating mechanism, not as a means of properly testing * the typotheses. ft- mnp^wtwi, ftir (10/1/80) Results: Page 4 Oily one Job code, "Operator" was represented by more than three cases. Table 1 shows the distribution of operators among the cases and controls. There is no significant difference in proportions. itien analyzed by department accounting code, only the maintenance department, with eight cases, was represented by more than three cases. Table II shows the distribution of maintenance department workers among the cases and controls. Grouping the accounting codes into major departments did not yield any new concentrations of three or more cases. There were no significant differences in proportions.. A^mepof^ th-edd:esses<abowiv,or>rases`*>deatfrcertifiestea^ehowa^fto* clustering'. Discussion: *\ So far in the course of this investigation, no convincing association has been found between any historical exposure and the development of brain tumors at this plant. When cases and controls are analyzed by chemical exposures, an additional problem will be encountered: the exact exposure of a v / ucc 048461 (10/1/80) Page 5 maintenanceman is difficult to characterize accurately, due to their mobility throu^iout the plant. Fortunately, this can be corrected, at least in part, by further review of existing records. Some of the maintenance department employees had reasonably well defined exposures; for example, one case was an instrument repairman whose work rarely took him out of the instrument shop. Ne plan to define exposures of cases and controls who worked for the maintenance department as completely as possible and study the full data set. At that time, there should also be enough information at hand to study the exposures by latency. It is possible that the tumors seen are the result of a more general effect or exposure. We plan to examine the geographic location within the pJ^nt of cases and controls, to see if any pattern emerges, and will j^jtempt to determine the residence at time of first hire, to see if tnere appears to be any unusual clustering outside the plant. Finally, we must ask whether we are really seeing an effect of occupation. The excess of observed over expected reported earlier2, combined with an apparent excess when compared to local rates*, could be the- result- of chance. The reported correlations with duration of employment and latency since first employment argue against this hypothesis but do not refute it. Inquiry into exposures present in other populations with apparent excesses of brain tumors may provide needed additional clues. X > y* M<r uoc 048462 (10/1/80) Page 6 Table 1: Distribution of Operators Anong Cases and Controls I A. All Qses Operators Cases 9 Controls 49 ton-operators 9 59 Total 18 108 Odds ratio >1.2; X2 > 0.045; p greater than 0.75 Total 58 68 126 B. Proven Gliomas Operators- ton-operators Total Cases 7 8 15 Controls 40 50 90 Odds ratio >1.1; X2 > 0.024; p greater than 0.75 Total 47 58 105 ucc 048463 (10/1/80) Page 7 Table 11: Distribution of Maintenance Workers Among Cases and Controls 11 A. All Cases Maintenance workers Cases 7 Controls 46 Total 53 ton-maintenance workers 11 62 73 Total 18 . 108 .. 126 Odds ratio > 0.86; X2 * 0.087; p greater than 0.75 IB. Proven Gliomas maintenance workers ton-maintenance workers Total Cases 7 8 15 '/ Oontrols 37 53 90 , Total 44 61 ' 105 Odds ratio * 1.3; x2 0.163; p greater than 0.73 ti. / r-r& EMPLOYMENT RELATIONS NEWSLETTER______________ Page 7 in a preemployment physical to support a mptflm (or summary judgment seeking a ruling th^tfie employ* er*s action aid not violate the Asc Although the court recognbe^that such a nh^Mcal problem might justify a refusal to Bke oo>dsiness necessity grounds. It holds that a non-jprimnent risk of future injury does not permit the^employ^r to regard the applicant as incapablepCporforming a Jab that involves heavy lifting. E/E. Block, Lid. v. Mar&tqll, 23 FEP Cases 125WD. Ha. 1980). \ OSHA Developments % 1. DUTY TO RECORD ARGUABLE OCCUPATIONAL ILLNESSES CLARIFIED In a significant decision concerning an employer's obligation to record alleged occupational illnesses, the Review Commission has upheld a citation issued to General Motors Corp., Inland Division, for viola tions of 29 C.F.R. { 1904.2 which requires that all occupational illnesses be recorded on the OSHA Form 200'Log. 'Secretory of Hobor v. General Motors Corp., 10 OSHC 389 (Rev. Comm'n 1980). According to the unanimous decision, "employers must record illnesses in which the occupational en vironment either was a contributing factor to the illness or aggravated a pre-existing condition. Fur thermore, employers must record illnesses when, as in this case, there is medical evidence from personal physicians linking the illness and the occupational environment and no other medical evidence contra dicts the relationship." In the present case, GM bad received statements from personal physicians of three employees who were allegedly suffering "respiratory problems" and who were admittedly exposed during their employ ment to the toxic chemical, Toluene Diisocyanate (TDI). One physician stated that the patient's bronchitis was "possibly aggravated" by an un known workplace chemical while a second described the employee's condition as "allergic bronchitis caused by fume inhalation." The final physician flatly stated that the employee suffered "a reversible destructive airway disease probably related to ex posure to TDI." The record did not reveal what environmental records or medical qualifications the physicians used to make such determinations. GM disputed these conclusions and stated that it had no basis upon which to conclude that the con ditions were occupationally induced. Even though substantial alternative explanations were advanced by the employer, the Commission concluded that the strong policy favoring reporting of even arguable occupational illnesses required that all of the con ditions be* recorded absent countervailing medical examination indicating that the conditions were not occupationally caused. In a related development, Commissioner Cleary has directed review of an Administrative Law Judge (ALJ) decision upholding a willful citation for an employer's failure to record alleged cases of asbestos disease. Secretory of Labor v. Amoco Chemicals Corp., OSHRC Docket No. 78-248 (Rev. Comm'n Aug. 28, 1980). In that case ALJ Benjamin Usher found that the employer waTregifired t5~ehtef~certajn~illeged"ninesses in the lot even though neither the employer nor any private physician had in fact **3iignosed" any occupational illness,. The ALJ rea soned' that voluntary pulmonary examinations of Amoco employees provided the employer with infor mation which should have led the employer to make such a diagnosis. Since the Secretary's experts were willing to reach a diagnosis on the basis of informa tion developed by the Secretary, the employer's outside physicians should have also midcTthe diagnosis. / o On the basis of these decisions, it now appears that both the Secretary and the Commission believe that the recordkeeping regulations impose substantial obligations not only to record diagnosed cases but also to diagnose and record all arguable occupa tionally-induced illnesses. As yet, no judicial res olution of these and other recordkeeping obligations has been reached. REVIEW COMMISSION APPROVES \SETTLEMENTS CONTAINING EXCULPATORY LANGUAGE In a reversal of prior Commission precedent a divided Occupational Safety and Health Review Commission hassiated that the inclusion qt*<o-called "non-admission" clauses in settlemept^agreements submitted to the Commission willnolonger provide a basis for rejecting tbcvagreemant. As long as the propospaNscttlement is consistent with the criteria set jfut inSpur decision Dawson Bros. Mechcanicafr Controaors, 72 OSHARC 5/B8, 1 OSHC4024 (1972\and Commission Rule 100, particularly as to the abatement of the alleged bazpfas, the statutory purpose of assur ing a safo'and healthful workplaceNs served by a prompt voluntary disposition of tv contested /case/ * \\ ucc 048465 t Tuesday, October 28, lno Houston Chronicle !-*. f.- Page 4, Section 3.. /////po A Union Carbide disputes evidence <; | sa * -**''..... 'mmm .... 05HA names Texasr,, r . * -.r'l'tl .r0 V. in study of | "* ' I / f\'y'1' ' V ' - M - "*i T" I cancers^ Chronicle Newt Services r* lesrn3'8*-eT~lh'e'hext two year*____ Government occupational-health inves-J j company toxicologist* and OSHA-NIOSH tigator* say 18 brain cancer deaths among workers at the Union Carbide plant in Texas City were apparently Job- * , sccoJireapncotkrisastotsencyBdon.ingtinduoSerthorefSihnvoeZlstlt)ig,taSutifoenat.y*' m*nd':*-l- related, but company officials dispute the ' environmental affairs, said company offi- > claim. * . ... I cials were told six weeks ago by OSHA "Information available indicates that and N10SH that spokesmen for both agen this number of brain tumors is excessive cies would make presentations to the. and that the tumors are likely to be occu- 1 ' workshop. Browning said company offi- pationally related," tbe government' 1 cials understood that OSHA and NIOSH scientists said. 'would present papers on the ptudy of Tbe investigators said it was the "larg Union Carbide workers.' - l- est single series of presumably occupa- - "But a version of the paper we saw was pouiwfenw Onion Carbid*to.Tw at,, * r lafing a "protocol agreement' ' ,a,We all signed an agreement saying ' that one party was not to issue a state, * meat (on the study) without notifying the other parties," said Richey. "I don't ' understand what's going on." ^ - ' Company officials say the study that is tracing the backgrounds of some 8,900 . past and present Union Carbide employ-. | tionally related brain cancers" in medical just a progress report saying that tbe i . The brain cancer deaths -- four to five . times as many as those projected for study is proceeding, he said. "There was no new information. No new direction. I cant imagine they would release conse GaKeston County under normal condi- quential information without telling us tions--occurred between 1956 and 1980. abouttL" - - Their report, presented in New York by "Since H is a combined study you# Dr. Victor Alexander, of the Occupational . think they would have conferred with us ( Safety and Health AdngnistrationT- was first," said Browning. 1 ' T ~ ' i based on investigations by OSHA and Na- In the report, tbe Union Carbide plant l tional Institute of Occupational Safety at Texas City was described as a diversi : and Health sleuths.-- . . fied petrochemical manufacturing facility Studies by OSHA. N10SH and other . .with a large number of major product i | - * .* | * - |. * f ees is about five months from' completion. I * '' An'American Cancer Society epideml-; t. ologist said brain cancer deaths national-*. 1 ly have grown about 50 percent since 1940. J Other scientists questioned whether thenational rate of brain cancer was really^ ' rising. Dr. Leonard Kurland of the Mayo^ Clinic said his studies have shown the., brain cancer rate has been steady for the;last few decades near the clinic Uu- agencies have also turned up 27 brain lines. These have included ethylene, bu- ` Rochester,Minn. *: i cancer cases among present and former , tadiene,. naptha, alcohols, plastics and I workers at a Dow Chemical plant in Free- i resins, including vinyl chloride. * j ` port since 1951. " ``A preliminary estimate reveals a j f: Union Carbide officials said they know plant-wide excess brain cancer risk twice ) nothing about the findings released Mon that expected among 6,800 white males at ! day by OSHA and NIOSH. They say a the plant since 1941," the OSHA--NIOSH | study, begun in March 1979 by the two * r^Dorf ^ government agencies and the company, is Median age of those with fatal brain : not complete. cancer was 53; the youngest was 30 and i The scientists, who did not name the j ^ the oldest 66. Median employment was 21 < plant where they probed work histories oH!. yean. - - the 18 brain cancer .victims, reported at;* ( Dr. Ralph Cook, head of epidemiology ` opening sessions of e three-day, j for Dow, noted that 20 of the 27 victims at goveramentfunded New York Academy Dow were hired between 1940 and 1946, a of Sciences Workshop on Brain Tumors in time when the average age of a new hire , the Chemical Industry.; ,,... / . . was 10 years older than today owing to The Occupataonal.Health & Safety ; younger people being drained off by the * Newsletter -- printed privately and dis war effort. : - - ? **. .--.? Vtributed at the meeting -- identified the \., Cook said that, based on the older age ` company in the repost as Union Carbide at time of hire, some 24 of the 18,000 and said: - ............ I--___... * .people who worked at Dow during this, > "Company officials are expected tore-' period could be expected to die of brain fute tbe dau in tbe OSHA-NIOSH Report.'; cancer.-1- vJ" **' v Union Carbide does not acknowledge ei- i * Dr. Anthony Robbins of NIOSH said the ; ther an excess of brain tumors in the ^ government didn't get into the petro plant nor is it willing to link the cases to . chemical and cancer situation very deep- ! occupational exposure." V. 1 ly until two years ago. A Union Carbide spokesman, comment- [ "If anything it seems we art slow for ing on the report, said: workers still in the industry and possibly | : "Cvuunrrceunutly}, wne huav>ec nov riceausuoon two i exposed," be said.............. .. . believe there is any correlation between l /'If workers are exposed to something , . these tumors and occupational exposure.} - that causes this cancer we can be almost. . Our position is that Dr. Alexander's is an : certain that the malignancy can be pre . interim report and that more will *1 vented." Ron Rjchey, employee relations X ucc 048466