Document wgXYOK2B30591ZZ34DYexJkDD
V iy ' W-
.-Enviromen ta l Rfeseareh' Foundation
17 -Mot -94. 20:05
page 1- o f -9
':FAX^CORBHET ;.."-.; :;:i
:;To: ' i . : -
- v ; . ' : ' : : .-/-v--
;. Paul yerreil Carol Van Strum
`
"From:" .
-
. :Peter Montague
Environmental Research Foundation
' (410) 263-1534 (voice)" '
, . (4.10) 263^944'(fax): '
-:
;
;
9 pages {including this cover sheet)./y , : '.
Sentn 1M !~94-a t20:05. ' ' '
;v -
.Gomment: :
\:
.; . : .
In case you dorsi have this - it's the ' / - y
"MonsorT article that'Zack/Suskind cite.
* fr
Envronmental Research Foundation HQU~1Y'-1S34 19254 FR01 E .R aF.
:1?-Nbv-94' 20:05 10 ERF
page * o f 9
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326 mCBAm iti IflONSOM
abstracted J)* For the years 1925-34, the population was grouped in iD-ye&t age
groups <Mf* 5-14,. ,,854- ). For suocsedmg years, she pojmlatioa was grouped m
'five-year age jtoup$(0-4> 5-9,<* ^854-). For each age grcmp, the average population'
durisg each five-year period- (1925-29; 1930-34, . . 1 9 6 5 - 6 7 ) was cafcukted for
white mates, white females and -w h ite mates.
Stmehrd deaths. For -each year t a 1925 to-1967, foe numbers o f persons dying
.from selected, causes o f death wereabstracted from Doited States Vital Statistics (5),
sp ed fc for age, sex m d race. To date, iiiltoffitian n 23 categoric o f cancer and
34 categories o fother c&usestave been abstracted. Prior to 1933 foe data are derived
from the states inducted in the death- ^ istratiop aim . Tfee ap^tkne fareakfowa
ctttxesposutefo that for the standard popiilatfoia. T te a w a g e number of age-specife
deaths per y w withm each five-year time period was caiailated. For -each cause a
am se-oM caih code was .assigned, according to foe. i m t i i Revision o f the Inter-
.national Classification o f D isuses (6). M m t md&$ and c&tkg p ocectam change
with fon*^ -causes front different tm m were fpraiped aecoidmg to title o f cause of
faith rather than accreting to ICD code.
'
SftmMrd 'rates. For eadi ag^tlmc period for each race m d sexthe number f
deaths per 18#. population per year w cafafetedL For some five-year petiods -foe
TABLE -1
ftfioKmm t e s m MXCam m W Femmssxn-Uw stainsA cm om o m Age A$m YEAR. OF 03E&TS, E w s AS M W OP.t e M l$00 IteliMWW fESt Year
sslavivs mb
I numberso fdeaths for certain 'are assumed' to be those o f p
Ir are baaed oh.deaths from 1! I causes for white females are
for purposes o fpresentation*
Prop&rthmd'mprttditks. 1
number o f deafos-due to all c specific cause* The proportio mg to the age-time distrifeuti i Pr&portmmtearnerm&rt&h is the number o f deaths due f. to a specific caisc^n Propoiti> according to the. apMfiB # i
1
i Data i
I For each me&aber o f foe s race, age at entry, year .of
i deceased or lost to foIIowBi The- steps in the compite!
table has foe format ofTaMi upon foe program option se tables to be ponied,
ms- M30- . IS#- M0- 195-' 5SS>- 1955- 1WJ- J963-'
0--. ns . 13.0 123 9*7 . 7A 5J 53 44 3L8
5- 1.6 13 ht . M 0.6 . as- 0A 0.4 03
10- IS 13 . 1.0 03 0l5 - T R 'm 03 03 W
15- ' 23 Zl . hS
05 M as ' 0,5 0.5
m~ 23 ZI 2J 1.5 1.1 0.7 06 0J - ''0.6
25- - 4A 3.2 2M O . 13 03 07 03 0.7:
30- - 4,0 3.21
33 1 12 IjO 10 . 1.0
35- S3 4M 3.7 Z9 23 1.7 15 ' 15 15
40- S3 4J 50 , 3.9 33 2.7 24 23 2-4
45- t&l -- M 7.0 5.7 4J8` 43 . 3.7 3J 33
50- "ms m 93 S.6 7,4 6.4 5.7 5.5 5>
55- 2L 19.6 14.7 12.9 n.o - 93 S.t 8J 8.?
6~ 2M- W.6 65-' 49.2 - 45.4
224 ' 9.6 54.9 30.7
17.2 26.7
15.2 243
3,7 22.6
lis 203
12.4 22.5
70- 49*2 45.4 543 SU 453 404 36.6 ' 34,0 ' 13.4
75- m .2 07.9 923. 91.2 74.6 66*8 6Z6 573 550
.80r m:2 507.9 141.7 131,9 114.3' 1093 105.4 1004 . 944
SS4- 283,1 244.7 . 227.2 220.5 2083 19J4 196.0- 195M -2$>-'v
I J
*
S ttp L The death-rate: Step 2* H e age-year-ol
five-year groupies. Step } wThe age-time*]
A-person is assumed ` midpoint o f foe age * assumed to have ooci available to consider .alive until the comst leaving in foe sam e; live withdrawal is wit or July L As m w entered foe study in survival would be dt program is less prcci days o f survival are essentially m m m - i m anj -partial years c.
#
6 .jo 0 6 ed
SO=0g M-APH-U, . rT^BpOTti ^
*
RELATIVESURVIVALAN SRaVGKTiONAI' MORTALITY'
327
numbersofdeaUssfor cestaio arenotpublished; the ratesdimagrisse periods ..are assumed,to. fee those of jmcgduig or succeeding periods. The rate for. i-96$-fi& ase based on deaths from I95~l only, As ah example* total death rate for all senses- for white females are presented in Tafek 'L (The rates teve bm i truncated . for purposes of presentation.) ,
Proporimml moridifks. The iknomiuator of a proportional mortality is the number of deaths due to aBcauses. The numerator is the number of deaths due to a specific caw . The proportional mortalities .foreach cause were calculated, accord ing to the age-tisne distribution presented'in Table L
Pr&portmmdmmermortality. H ie denominator o fa proportional cancer mortality k the number o f deaths due to cancer. The numerator is die number o f deaths' dm to a specific cancer Froportioiial smeermoftalities were cakigf&ted for e&di cancer, accoidmg to the agfe-time distribution presented m Table L
Data A m&lysis Using Relative Survival
. -For each member o f the study echoed the following information is needed: sex, race, age. at entry, year o f entry, yean o f sttvival, status at m o f study (live,, deceased or lost to foStowHap)tead cause fdeaths where appropriate.
The steps in the-computer program asdescribed bdow. Except for stp S, each table has the forn ai o f 1TaMe 2. I t e data m&y m may n el be calculated, depending upon -tte|Q pain prion aetesL A lso, prions are -avaflUMe ns to the number of
. taU tt1$teiK inte&
' Step L The death rate matrix is read, ... - Step 2. "H iestg^-^ar^entfy distribution o f the study cohort is determined in
Jive-year grm^pmg^ Step 3, The agiHine-spetfic person-years of the study cohort are calculated.
A p r o a is assigned to hav&eatimd on-July i o f the year of entry and at the midpoint-of the age o f entry. If a .person is lost to folow-up withdrawal is asstmed to have ocxwred on July i o f the year o f withdrawal, (Options arc available to consider lost .persons to have died at the time of loss or to be alive unta rite comi dosing data o f the study.) A person entering m teavmg in the same p a r contribute 0,25 pem n-yeats. A person who is 'a live withdrawal is withdrawn at .the w m m m -dosing date, usually January 1 or Inly L A s-an. example, mmUm the person described by EM (7). He enteed the study in 1952 at age 23 and left in 1962, His person-years, o f survival would.be distributed as shown in Fig. 1. The method, used m this program is less precise for m. individual- than Miffs method* since the exact days- o f survival are not-computed. For the total population, however, essentially no error should be Introduced* since persons who are given too m m y partial- years,of survival are countefealaiioed by those- with too- few.
m
B'
diS3 01 .
9J"H3 WtteLJ SS-sSI f^GGI--lT --AON
5 . jo $ e 6 ed so "OS $6;AQJS-LT''. . uojq.epniiQi q c^ esey; leqaeuiuo-TiAna;
328 micum il womotf
The total persoit^ars in &study o f survival following mrm-oxm of tbe
m m ^ m rn () distributed m Illustrated lu Table 2
Step 4, 'The & ge4i .disttratioit of the oteerved deaths is detdhnivied. Tte
observed rate a it calcufeied fey dividing the observed deaths feythe person-
yem of survival.
5. The ^-tinia-spgcife expected deaths are calculated fey multiplying
standard death mtm by the ag4ime^peditc pemnnr .
years ofM w -m
~.
Fm,. h
YE. mmmm& % a p m m enteringst-age23 fea1952 aid f e a | 1961,
Ssep & Mortality ratim are calculated fey dividing each observed number of
deaths fey
o f deaths.
. Step?* TkpfofegfeiHty'&atthe observednumberofdeathsdiffers-^ig&IfaR^y
fmm the expected numbers o f deaths is c a la ite d usings m o d ifo a te of the
M p r o c e d u r e ($% A Mantel^H&enszd 2 is calculated fat .
. each marginal ratio as well as for the total bbservedfcsspectai ratio T k
Frisson approximation made m determiraig the variance- o f the expected
deaths, that isthe variance is assonoed^tieequatto tte mean of theexpctffti
deaths. -The resultant X* h conservative, that, is, It is less than the corre
sponding X1 'calculated using ike binomial variance. . Step`8. The relative: survival life table is calciated f/).. The standard .errors are
V estimated .according to the method o f Greenwood </0). For eadi year ^
survival, the following numbers .are calculated* as illustrate in Table
data in Table 3 are limited to the first ten years of follow-up): JLX- mimk"
starting .each interval; WX, 'number o f live withdrawals; U K number
to follow-up; OBS{DX), observed deaths; EXP(DX), expected death-*
. OS/EXP,'fiteerved/expected ratio.; SURV^ crude interval survival u *
. IIHAVESti!
I-4-. 1); XSR, relative CSRV crude cm m survival; SECRSR,8t
I^ssqs^Yeaksm Sdkvxva&m (2RCmSMCUPTB
Age 1ft- 1925- 1S30-
25-
3035-
as 93 '
' 40~ 1*5 43
4550-
1U I'M 105 4M 4ZS
'55- 14.0 533 . $23
m~ 63k 70, B~
5.8 ..513 960 AO 203 ..'633 as- 0 3 453 23 ' 100
m85*
23 1-0 ' M
Sum 49.8 2100 3773
ReMlTIWESbkvcwulRATTOFOR Esasowerwi
' Year LXW X UX0B(DX)EX&
0- 261, 1 0 m o 0
~ m i 0
v 568
4 539
5 A
521 497
T0 00 20 5 o
4 .12 >i 459' 24
0 0
424 20 0
' m
60" 40 '28 18 22 li 10 ` 11 1! :
14
n ta is
H 15 11 U 12 V
s -ni -2 9 6 0 465 2,
PBad
jo 5 9b
=M3 01
d-a -3 iTOJ S :61 S^BT-iT-fiON
SO502 ^6-aoih.-j . ooT-q.Bpano^ qpjresssa; xequsuracatAag -
HELTIVE3B&VIVAXATOIWQF09tTk0NA&. MORTALITY
329
# + !); BSR odtve -'initervai.'flurvivaf; SERSR, standard errar o f RSR;
GSURY*erndo eoumWw-sOTvivaS.C^te *+t); CRSR, retative cumnEative nmval;-SECRSIL mmm error e f CMSL
TARLE 2
Pm o m Y ea&sm-SsmvtvALm-A-Com&tm 761W mim Futm FbuAwijiaaTfeEATMewrw
ClOfiOft$A,OFTBffi.
ACCtmUITOTOAC5EAHPY M
, fi@
Age im~ 1925- i-
1 'm$- 13- 19- 1960- 1965- Sum
25-
3,3 LS- 3.5 43. 13
135
30- as 23 03 73 53 153 1M as 39.8
35- as 43 40 M 193 105 193 .33 SI.5
40- 35 ts 45 173 IB5 20-0 37.0 385 '.143 45 m o
45- 11,3` -I4.0 . 1S3 543 713 403 903 55.5 3.5 3913
50- ios ms 473 M3 -823 -1320 1203 1293 m s .15.5 m o
55-'. 14# 533 823 a w 053. 17*5 2563 2373 162 2X5 1214.8
.0- -18 ' 513 ` *o 1233 M S -1393 2953 3460 26X5 363 1543.8
m- 40, 213 33 II2LS 1173 2043 m s 343.3 3473 49-0 JS36.5
10- m ms 453, 523 1003 iL5 3 2025 32M 45 1186.3
7S-- .
23 m 313 37.5 mo 141,5 13 ISUO: 3X0 7023
SO ..15 ib 123 17-5 21-5 633 935 1063 1 332.0
*5+.
13 ., &5
..73 .325 433 65.0 11-5 142-5
Sum'. 4WT m .3773 .5353- imM 10625 144X5- 17403 msJ. 207.5 8072,0'
' TABLEA Kstrnsm Skvjvm.,1aiot-sm 761 WomemIta*0wiG Tseomeot re,Ca&cinomam r&
&Tmommmm (seeTestkm StescazpifONo?Bata)
-Yr t x WXe x GffigOHQEXRCDX CW/EXF SURV ESESGRSRCSURYCRE SECESE
e~ 761 1 o i - 660 0 t
2~ 6 1 0 4D 3- .5 . 3 0' . 284~ 539 3 1 $~ 521 2 .0 22 ~ 497 ' 5 0-- It 7- 481 12 0 . 10
459 24 0 i l
424' 20. 0 , ti I
14A
12332.7
3
113 '. 113 11-7 . '12.7 , 1X7 123
63 4.73.2 2.4 13 13 ' 0.9. 0.8
m
38- 30
31 M 33 35
35 37
,97 '39 36 .98 38 130 .98 131 M LOO 37 130
31 31 31
31 31 .01 -01 .O
31 .01
:88 .90 . M 53
.75 M .71' .77 .69 M
-66 ,75. .64 . ,75 .63 -75 .62 -75 .60 - ,16
31 M
M M M
32' M
M 32 M
-- .396 0 '465 .' 263.6
13 . -- -- r- -- ' -- --
QB/d
'6 JO grefied
d&B- 01
"d "B "3 WOdd SS sBT PQ&l-LT^-rtH
50 rF6-aoja-x'v. . uaiqtepuxLqa qcu sesea te^ewucaTAua
W -K ' /
o
0C3*.. ft
J&ELATTOE m j m W A L AND HK0P0B110NAL MORTAiSTY
33i
m h i as to tbs te siS o f caktil&tkmi and output cteiredL When a single cohort is sergeaed againstall ea&raofdeath, the cohort data is read ones m d ike person-pars o f survival are detem iued, Then each death m u matrix is multiplied by the personp ars matrix to obtain the expected nam bm of cause-specific deaths. Also the observed deaths according to eacli cause are oouated, 'When a single cause, usually aS deaths, is screened against m m y cohorts, only-the relative survival table h caleukied asad printed, ` The program fe w rites in- Fortran IV and currently is in operation on the.IBM 370/165 at the MIT-Harvard Computing Center, Most o f the program has been compiled and is sailed m a subroutine. A short program {5-25 lines)-m ist be written for each ran to describe the input characteristics of the study cohort and any selections to .fee made.. In addition,-several control cards are- needed.to describe t e i t e characteristics o ftfaeeohartm d ten d ed the various options described above.
QOMMEmS
The major advantage o f using rates from a standard population is that no formal comparison, group need fee assembled. In the case o f retrospective cohort studies extending back m m y years* this is difficult Further* since the standard rates are based on a large mmhgr o f deaths* the ra te are relatively stable. '
The met o f s t a t e d . population rates has several disadvantage characteristics of the .study population which are relate! to death {or disease) may be different from those o f the s t a t e d population JM procedures described in this paper take account only -ofag$s, time, sex m d w e differences. No account can bo. made, for example, o f t ie effect o f cigarette smoking on differences in observed m d impeded rate.. The effects o f tins proMem m y fee studied in several ways. If available, a .standard population wMdi is s te r n ly simitar to the study population may fee selected (3). An estimate ofthe maximum impact erfconfounding due to .mnfomdtng variables can feeraarie ( /, IS). Thebest way to evaluate suspected causal relationships is to study them in diverse groups using.diverse standard' populations, or*,if possible, to conduct cohort studies using a formal comparison group. Another- dkadvsntag arises.if two o r more study cohorts are compared to- the s t a t e d population.'If relevant demographic characteristics differ between,the two study group*, inferences' comparing the two. groups may not necessarily fee made by comparing their experience relative to the standard population (id, 17% For example '*frelative survival, is .a ta c tio n o f age, and If two study cohorts have different age distributions, .age-adjusted, relative .survival ra te must be calculated. A second possibility is to compare the two '-groups directly by using one group as the standard-.population and the other as the study population. This option is Bvaikble In tteprojpam .
The primary disadvantages o f studies using proportional mortality is'that disease m te are not obtained. A proportional mortality greater than om may result from a
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E n v iro n m en ta 1 R e se a r c h F o u n d a tio n 1 7 -Ho t -9 4 20.?38
page 1 o f 4
FAX COVER SHEET
To: `
'
Paul Merrell & Carol Van- Strum
,, From: Peter Montague Environmental Research Foundation (410) 263-1584 (voice) (410) 263-8944 (fax)
4 pages (including this cover sheet) Sent on 17-Nov-94 at 20:38
Comment: Comments on the missing cohort, which is no longer missing
Environmental Research Foundation
17 -37ov--94 20 s38
page 2 of 4
November 17, 1394 v
Hi, Carol,
;
1 have looked over the' memo entitled wChioracne Cases 'Mot Related
to 1949 TCP Accident.w Here are- my page-by-page comments. 1
will refer to pages by your hand-written page-number scheme. The
memo begins on pg. 22.
-
Page 22 :
Listed: 22 Active 13 deceased 4 unknown mortality statue
-1 33 TOTAL individual
Noteworthy about this page:
Illegible names: 11 (but SS #s are. legible}
Year of death provided f o r only 12 of 13 deceased; need year for
1 individual.
'
Cause of death code is given for 12 of 13 deceased, but 4 of the
codes are illegible; therefore need code for 5 individual
2 names are crossed out (line through them} -- why?
Date of birth missing for & individuals.
Page 23.;
Listed: 27 active 9 deceased 3 unknown mortality status 39 TOTAL "individuals
Noteworthy about this page:
Cause of death cede given for 3 deceased persons, but 2 are illegible; therefore need code for 2 individuals
Date of birth missing for 1 individual
Page 2 4 s ' .
Listed: IS active .14 deceased 6 unknown mortality status 1 no data on mortality status .33 TOTAL individuals
(not even a TJ)
Year of death provided for only 13 of 14 deceased; need year for 1 individual *-
Cause of death code is given for 13 of 14 deceased; therefore need code for 1 individual.
Env ireminenta1 Resear ch Founds tion
17 -No v -94 20 i38
page ..3 of 4
Date of birth missing, for 18 individuals, SB # missing for 1 individual
Page 25:
Listed:
7 active 17 'deceased 7, unknown mortality status 5 no data on mortality status 36 TOTAL individuals
(not even a U)
noteworthy about this page:-
Cause of death code given for 15 of 17 deceased; thereforep need code for 2 individuals.
Date of birth missing for 11 individuals. One record crossed out (line through it) -- why? BS # missing for 6 individuals.
Page 26s
Listed:
17 active 8 deceased 7 unimown mortality statue 5 no data on mortality status 37 TOTAL individuals
(not even a U}
Motworthy about this page:
Date of birth missing for 8 individuals. One individual crossed out (line through name) -- why? SS # missing for 4 individualo,
Page 27 ;
Listed: 7 active 8 deceased 1 7 unknown, mortality statue 15 no data on mortality status
.37 TOTAL individuals
(not even a U)
Noteworthy about this page:
Year of death.is given for 7 of 8 individuale, and 1 more is given .but with a question mark after it; therefore, need year for 1 individual.
Cause of death code given for only 2 of 8 individuals; thereforer need code for 6 individuale.
Date of birth missing for 15 individuals.
'Environmental Research Foundation 17 -Nov -94 20 s38 page 4 of 4.
2 name are' illegible & their acciai security numbers are illegible a' well, so they will be hard to identify without a cleaner copy of- tie memo. It is conceivable that there is a 3rd illegible name at the very -end of the list; if this were tr u e , it would bring the total nuifiber of individuals to 228 ,
SS # missing for 4 individual & illegible'for 2 individuals.
SUMMARY f "
Data i given on 227 individuals :
99 active' 69 deceased 34 unknown mortality status 26 no data on mortality status 227 TOTAL individual
(not even a U)
In sum, there are SO individuals 'for whom mortality statue I missing or is listed as WU B (presumably meaning Unknown)
Cause of death code ia missing or illegible for IS individuale (in addition to the 60 individuals for-whom mortality statue is unknown) ;
Year of death is missing or illegible for 3 individuals (in addition to the SO individuala for whom mortality status is unknown).
Data .of birth missing for 53 individualsTM
SS`# ie missing for 15 individuale
Conclusion: Thi DOES appear to be the missing cohort (!}.
PS: Date of birth is needed far everyone in the cohort; see article by Monson cited by Zack/Suskind aa their source for their computer program, Pg* 327 saye ?fyear of survival" are needed.
If we could get SS # for each of these individuals, perhaps Fingerhufc would let loose of her data on these individual exclusive of their names; I feel sure she has it all, but she won't give out the information, .claiming privacy rights for the, living persons. Just a thought.
PPSs Xffll see Clapp on Saturday & will ask him'how best to get info on these individuals.
y*--
-,,>s.-