Document ypvxVG4XRM1XRw5XxKR8XozX3
1 SUPERIOR COURT OF THE STATE OF CALIFORNIA
2 FOR THE COUNTY OF LOS ANGELES
3 CENTRAL CIVIL WEST
4
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5 LARRY THORPE AND JOANNE THORPE,
) )
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Plaintiffs,
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7 vs.
) No. BC348287 )
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SAFETY-KLEEN SERVICES, INC., et al.,
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Defendants.
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________________________________________)
10 A N D C O N S O L I D A T E D C A S E S .
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________________________________________)
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14 D E P O S I T I O N O F
15 D A V I D W . P Y A T T , P h . D .
16 L O N G B E A C H , C A L I F O R N I A
17 D E C E M B E R 1 7 , 2 0 0 8
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21 A t k i n s o n - B a k e r , I n c .
Court Reporters
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www.depo.com
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24 R e p o r t e d b y : S H E R I A . P L Y , C S R N o . 6 5 0 7 , R P R
25 F I L E N o . : A 2 0 9 2 C 4
1 SUPERIOR COURT OF THE STATE OF CALIFORNIA 2 FOR THE COUNTY OF LOS ANGELES
3 CENTRAL CIVIL WEST
4
)
5 LARRY THORPE AND JOANNE THORPE,
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Plaintiffs,
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7 vs.
) No. BC348287 )
8 SAFETY-KLEEN SERVICES, INC., et al.,
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Defendants.
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________________________________________)
10 A N D C O N S O L I D A T E D C A S E S .
)
________________________________________)
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13 14 D E P O S I T I O N o f D A V I D W . P Y A T T , P h . D . , t a k e n o n b e h a l f o f
15 t h e P L A I N T I F F S , a t 4 0 1 E a s t O c e a n B o u l e v a r d , S u i t e 8 0 0 ,
16 L o n g B e a c h , C a l i f o r n i a , c o m m e n c i n g a t 9 : 0 5 a . m . , o n
17 W e d n e s d a y , D e c e m b e r 1 7 , 2 0 0 8 , b e f o r e S h e r i A . P l y , C S R
18 N o . 6 5 0 7 , R P R .
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1 APPEARANCES
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3 FOR THE PLAINTIFFS:
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METZGER LAW GROUP
5 BY: RAPHAEL METZGER, ESQ.
401 East Ocean Boulevard
6 Suite 800
Long Beach, California 90802
7 (562) 437-4499
8 FOR THE DEFENDANT BC STOCKING DISTRIBUTING:
9
WILSON ELSER MOSKOWITZ EDELMAN & DICKER LLP
10 B Y : L A U R A K E L L Y , E S Q .
555 South Flower Street
11 S u i t e 2 9 0 0
Los Angeles, California 90071
12 ( 2 1 3 ) 4 4 3 - 5 1 0 0
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14 F O R T H E D E F E N D A N T S A F E T Y - K L E E N S Y S T E M , I N C . :
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JONES CARR McGOLDRICK, LLP
16 B Y : C H R I S C A R R , E S Q .
5307 E. Mockingbird Lane
17 S u i t e 6 0 0
Dallas, Texas 75206
18 ( 2 1 4 ) 8 2 8 - 9 2 0 0
-AND-
19 L E W I S B R I S B O I S B I S G A A R D & S M I T H L L P
BY: PATRICK J. FOLEY, ESQ.
20 2 2 1 N o r t h F i g u e r o a S t r e e t
Suite 1200
21 L o s A n g e l e s , C a l i f o r n i a 9 0 0 1 2
(213)250-1800
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1 APPEARANCES 2 3 FOR THE DEFENDANT PETROSOURCE: 4 (VIA TELEPHONE)
LUCE FORWARD 5 BY: ANDREA KIMBALL, ESQ.
600 West Broadway 6 Suite 2600
San Diego, California 92101 7 (619)236-1414 8 9 THE VIDEOGRAPHER: 10 DAN ACKLEY 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
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1 INDEX
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3 WITNESS: DAVID W. PYATT, PH.D.
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5 EXAMINATION BY:
PAGE
6 MR. METZGER
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INFORMATION REQUESTED:
8 (NONE)
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QUESTIONS WITNESS INSTRUCTED NOT TO ANSWER:
10 (NONE)
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E X H I B I T S:
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DEPOSITION
13 NUMBER
DESCRIPTION
PAGE
1 Multipage Curriculum
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Vitae David W. Pyatt
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15 2 16
Two-page "Testimony Given by Dr. David Pyatt"
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17 3
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One-page Literature List
Multipage Dec. 12, 2008 letter from Jeffrey Wood enclosing DVD directory
80 80
21 5
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Multipage list of studies directory
Two-page John Pearl summary
110 119
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Two-page Larry Hazlehurst summary
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1 E X H I B I T S:
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DEPOSITION
3 NUMBER
8
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DESCRIPTION Two-page Indirect Exposures Tables
PAGE 119
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Multipage Gasoline and AML Tables
One-page Mechanics and AML Table
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Multipage Benzene and AML Tables
Multipage Data Tables
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One-page 9-1-08 Invoice
One-page handwritten note
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Multipage Index of Expert File of Robert Peter Gale, M.D.
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One-page 7-28-08 Invoice
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1 LONG BEACH, CALIFORNIA, WEDNESDAY, DECEMBER 17, 2008
2 9:05 A.M.
3 ***
4 09:06:27
5
THE VIDEOGRAPHER: I am Dan Ackley, your
09:06:46
6 videographer, and I represent Atkinson-Baker Court
09:06:47
7 Reporters in Glendale, California.
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8
I am not financially interested in this action
09:06:52
9 nor am I a relative or employee of any attorney or any
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of the parties. Date is December 17th, year 2008. Time
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11 i s a p p r o x i m a t e l y 9 : 0 6 a . m .
09:07:01
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This deposition is taking place at the Metzger
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13 L a w G r o u p , 4 0 1 E a s t O c e a n B o u l e v a r d i n L o n g B e a c h ,
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14 C a l i f o r n i a .
09:07:10
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This is case number BC348287 entitled Thorpe
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versus Safety-Kleen. Deponent is Dr. David Pyatt. This
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17 i s V o l u m e 1 , b e g i n n i n g o f t a p e 1 . Y o u r c o u r t r e p o r t e r
09:07:20
18 i s S h e r i P l y .
09:07:22
19
Would counsel present please introduce
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20 t h e m s e l v e s .
09:07:26
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MR. METZGER: Good morning. My name is Raphael
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22
Metzger. I represent the plaintiffs in the Safety-Kleen
09:07:28
23 b e n z e n e l e u k e m i a c a s e s .
09:07:32
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MR. FOLEY: Good morning, Patrick Foley for
09:07:34
25 d e f e n d a n t S a f e t y - K l e e n S y s t e m s , I n c .
09:07:36
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MR. CARR: Chris Carr for Safety-Kleen.
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MS. KELLY: Laura Kelly for BC Stocking
09:07:40
3 Distribution.
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THE VIDEOGRAPHER: Please swear in the witness.
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5 09:07:44
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DAVID W. PYATT, Ph.D.,
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7
having been first duly sworn, was examined
09:07:44
8 and testified as follows:
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9 09:07:44
10
EXAMINATION
09:07:44
11 B Y M R . M E T Z G E R :
09:07:45
12 Q G o o d m o r n i n g , d o c t o r .
09:07:53
13 A H i .
09:07:55
14 Q W o u l d y o u i n t r o d u c e y o u r s e l f , p l e a s e .
09:07:56
15 A D a v i d P y a t t .
09:07:58
16 Q A n d w h a t t y p e o f a d o c t o r a r e y o u ?
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17 A I a m a t o x i c o l o g i s t .
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Q Okay. You are not a medical doctor; correct?
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19 A I a m n o t .
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Q Okay. You have been designated as an expert by
09:08:06
21 S a f e t y - K l e e n . A n d y o u h a v e t e s t i f i e d a s a n e x p e r t
09:08:13
22 w i t n e s s b e f o r e , h a v e y o u n o t ?
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23 A I h a v e , y e s .
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24
Q Okay. You are comfortable with the procedures
09:08:20
25 s o t h a t I d o n ' t n e e d t o r e v i e w t h e m w i t h y o u ?
09:08:26
8
1 A No.
09:08:28
2 Q You are not or you are?
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3
A I'm sorry. Yes, I am comfortable with them.
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4
Q All right. I will show you what has been
09:08:33
5 marked as Exhibit 1.
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6
(Deposition Exhibit 1 was marked for
09:08:38
7 identification.)
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Q BY MR. METZGER: And is that a copy of your
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9 curriculum vitae?
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A Yes. It is a little dated. There have been a
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11 c o u p l e o f c h a n g e s ; n o t h i n g s u b s t a n t i a l .
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Q Do you have a more current curriculum vitae
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13 w i t h y o u ?
09:08:51
14 A I m i g h t .
09:08:51
15
Q Could you retrieve that and we will mark that
09:08:52
16 a s a n e x h i b i t ?
09:08:54
17 A Y e a h . I w i l l h a v e t o d i s c o n n e c t m y s e l f . 09:08:55
18 Q T h a t ' s f i n e . S u r e .
09:08:57
19 A C a n I g e t i n b e h i n d y o u ?
09:08:58
20 M R . F O L E Y : S o r r y .
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21
THE WITNESS: If not, I probably can just tell
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22 y o u w h a t ' s d i f f e r e n t .
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Q BY MR. METZGER: While you are going through
09:09:09
24 s t u f f , i f y o u h a p p e n t o h a v e a c a s e l i s t , t h a t w o u l d
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25 a l s o b e e f f i c i e n t .
09:09:15
9
1 A Yes, I do.
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Q You might just keep that folder on the table.
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3 A Okay.
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4 Case list.
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5 Q Okay.
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6
A Mr. Metzger, I think I left it at home so we
09:10:07
7 can just use that one.
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8 Q All right.
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9 A I am not seeing it.
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10 Q O k a y .
09:10:15
11 A S o r r y .
09:10:16
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Q Well, then let's use Exhibit 1. And if you
09:10:17
13 w o u l d t e l l m e , f i r s t o f a l l , w h a t n e e d s t o b e a d d e d t o
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14 t h i s t o b r i n g i t c u r r e n t ?
09:10:24
15 A W e l l , w h a t I n o t i c e d w a s o n t h e a c a d e m i c
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16 a p p o i n t m e n t , t h e B i o m e t r i c s a n d P r e v e n t a t i v e M e d i c i n e ,
09:10:28
17 S c h o o l o f M e d i c i n e , t h a t h a s n o w b e e n r o l l e d i n t o t h e
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18 C o l o r a d o S c h o o l o f P u b l i c H e a l t h , w h i c h w a s o f f i c i a l l y
09:10:39
19
inaugurated this summer and that is where my appointment
09:10:43
20 h a s m o v e d t o , t h e S c h o o l o f P u b l i c H e a l t h .
09:10:47
21 Q O k a y .
09:10:50
22
A And that is what made me think that this one
09:10:51
23 m i g h t b e a l i t t l e b i t - - a l i t t l e b i t d a t e d .
09:10:54
24 Q O k a y .
09:10:57
25 A A n d t h e r e i s a t l e a s t t w o p a p e r s t h a t I
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10
1
published since this one was -- this CV was generated.
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2 Q What are they?
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3 A There was one on interpretation of
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4 biomonitoring data, kind of a follow up to this
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5 "Regulatory Tox Pharma" in 2007.
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6
And then there was one on formaldehyde and
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potential modes of action for formaldehyde with regard
09:11:38
8 to hematopoietic malignancies that was published in
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9 2008.
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Q Were both of those articles published in 2008?
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11 A Y e s .
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Q The first one regarding the interpretation of
09:11:53
13 b i o m o n i t o r i n g d a t a , i n w h a t j o u r n a l w a s i t p u b l i s h e d ? 09:11:55
14 A I t h i n k t h e y p u b l i s h e d i t i n t h e j o u r n a l 09:12:01
15
"Biomonitoring." I wasn't the first author. The other
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16
one was published in "Regulatory Tox and Pharm," and I
09:12:08
17 a m t h e f i r s t a u t h o r o n t h a t o n e .
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18
Q Who is the first author on the biomonitoring
09:12:15
19 a r t i c l e ?
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20 A P r e t t y s u r e i t i s S e a n H a y s , H - a - y - s .
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21
Q Does that article concern benzene at all?
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22 A N o .
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23
Q Does it concern chromosome abnormalities in
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24 s e c o n d a r y l e u k e m i a s ?
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25 A N o .
09:12:50
11
1
Q Okay. Is there anything else you would need to
09:12:50
2 add to your CV to bring it complete and current?
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3
A I don't -- nothing of -- nothing of substance.
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4
Yeah, it looks like the last abstract was in 2007. So I
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5 went to SOT, I went to SRA. SOT is -- you know what
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6 that is, Society of Toxicology, Society of Risk
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7 Assessment in 2008, presented abstracts, but I don't
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8 remember exactly what they were.
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9
So yeah, this one is about six months behind.
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10 Q O k a y . A n y o f t h e s e a b s t r a c t s t h a t y o u
09:13:33
11 p r e s e n t e d a t t h e s e m e e t i n g s , d i d a n y o f t h e m c o n c e r n
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12 b e n z e n e o r l e u k e m i a ?
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13
A No. Well, it might have concerned leukemia
09:13:41
14 b e c a u s e t h e f o r m a l d e h y d e w o r k w a s t r y i n g t o u n d e r s t a n d
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potential mechanisms by which formaldehyde could damage
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the bone marrow, if that happens. So it was related to
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17 k i n d o f a c h e m i c a l p r o c e s s i n t h e m a r r o w .
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18
The biomonitoring data is not -- that's simply
09:14:00
19 a m e t h o d b y w h i c h y o u c a n i n t e r p r e t b i o m o n i t o r i n g d a t a
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20 a s i t i s b e i n g p u b l i s h e d b y C D C o r w h o e v e r i s p u t t i n g
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21 t h e d a t a o u t .
09:14:15
22 ( D e p o s i t i o n E x h i b i t 2 w a s m a r k e d f o r
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23 i d e n t i f i c a t i o n . )
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24
Q BY MR. METZGER: Okay. And you have provided
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25 m e a t w o - p a g e d o c u m e n t e n t i t l e d , " T e s t i m o n y G i v e n b y
09:14:20
12
1 Dr. Pyatt" stating: "The following is a complete list
09:14:26
2 of deposition testimony."
09:14:30
3 Is that accurate?
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4 A Yes.
09:14:33
5 Q As of this date?
09:14:33
6 A Yes.
09:14:34
7 Q Okay.
09:14:37
8 A You figure prominently in that list.
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9 Q I do?
09:14:45
10 A U h - h u h .
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MR. CARR: How do you define "prominently"?
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THE WITNESS: Well, I think I have 10 or 11 and
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13 M r . M e t z g e r i s t w o o f t h o s e .
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14
Q BY MR. METZGER: Okay. Well, let's talk about
09:14:55
15 a f e w o f t h e m .
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16
The first one listed is Wilkerson versus
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17
Radiator Specialty Company, testimony given on May 17th,
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18 2 0 0 6 .
09:15:07
19 W a s t h a t a t a d e p o s i t i o n o r t r i a l ?
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20 A T h a t w a s a d e p o s i t i o n .
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21
Q And who took your deposition in that case?
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22 A D e n i s e C l a n c y .
09:15:18
23 Q D i d t h a t c a s e g o t o t r i a l ?
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24 A N o .
09:15:29
25 Q O k a y . H a v e y o u t e s t i f i e d a t a n y t r i a l s ?
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13
1 A No.
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2 Q Okay.
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3
A One hearing, but I think that might be close,
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4 but it wasn't a trial.
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5 Q What type of hearing was that?
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6
A It is at the very end of that sheet. It was
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7 called the Havner hearing in Texas.
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8 Q That is in the Cantu case?
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9 A Yes.
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10
Q Okay. There is a case listed here Henrickson
09:16:03
11 v e r s u s C o n o c o - P h i l l i p s w i t h t e s t i m o n y g i v e n o n A p r i l
09:16:14
12 1 7 t h , 2 0 0 8 .
09:16:20
13 W a s t h a t a d e p o s i t i o n ?
09:16:22
14 A Y e s .
09:16:24
15 Q W h o t o o k y o u r d e p o s i t i o n i n t h a t c a s e ?
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16
A I am sorry, I don't remember his name. It was
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17
a French name, started with a "P." Brett Young was my
09:16:28
18 c l i e n t s o h e c o u l d p r o b a b l y t e l l y o u , b u t I d o n ' t
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19 r e m e m b e r t h e g u y ' s n a m e . I h a d n e v e r m e t h i m b e f o r e . 09:16:41
20 Q B r e t t Y o u n g w a s t h e d e f e n s e a t t o r n e y ?
09:16:45
21
A Yes. He is who I was working with. The guy
09:16:47
22 t h a t t o o k m y d e p o s i t i o n , I h a d n e v e r s e e n h i m b e f o r e . 09:16:49
23 Q A n d w h a t t y p e o f c a s e w a s t h a t ?
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24 A T h a t w a s a g a s o l i n e c a s e a n d A M L .
09:17:03
25
Q There is a case here Saltonstall versus Dunn
09:17:17
14
1 Edwards, testimony given May 1, 2008.
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2 What was that case about?
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3 A I think it was an AML and a painter.
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4
Q Was it a deposition that you gave in that case?
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5 A Yes.
09:18:00
6 Q Who took your deposition?
09:18:00
7 A Stamos.
09:18:02
8 Q Greg Stamos?
09:18:04
9 A Yes.
09:18:05
10
Q Next one is Baker versus Chevron, testimony
09:18:16
11 g i v e n A u g u s t 1 3 t h , 2 0 0 8 .
09:18:20
12 W h a t t y p e o f c a s e w a s t h a t ?
09:18:23
13
A Baker is a closed down refinery and there were
09:18:25
14 s e v e r a l p l a i n t i f f s k i n d o f l u m p e d i n t o t h a t g r o u p t h a t
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15
are claiming exposures from this defunct refinery caused
09:18:40
16 t h e i r d i s e a s e s .
09:18:47
17 Q A r e a n y o f t h o s e h e m a t o l o g i c d i s e a s e s ?
09:18:53
18 A T h e y a l l a r e .
09:19:00
19 Q T h e y a l l a r e ?
09:19:00
20 A O f v a r y i n g - - v a r y i n g t y p e s .
09:19:00
21
Q About how many plaintiffs are there in that
09:19:00
22 c a s e ?
09:19:00
23 A I a m n o t s u r e . T h e r e w e r e f o u r t h a t w e r e
09:19:03
24 l u m p e d t o g e t h e r i n o n e s o r t o f t r i a l , I g u e s s , o r o n e
09:19:05
25 g r o u p . S o w e - - i n t h a t d e p o s i t i o n w e t a l k e d a b o u t
09:19:08
15
1 four.
09:19:13
2
Q Okay. When you say "we," who are you referring
09:19:14
3 to?
09:19:16
4 A Me and the guy that took my deposition.
09:19:27
5 Q Who is that?
09:19:29
6
A It was by phone and I never met him so I can't
09:19:30
7 tell you. Jason Levin from Steptoe & Johnson, Larry
09:19:33
8 Riff's group was the defense attorney. And the guy
09:19:39
9 called in and I remember -- I mean he introduced
09:19:43
10 h i m s e l f , b u t I d o n ' t r e m e m b e r h i s n a m e .
09:19:46
11
Q Okay. The next one listed is Stromberg versus
09:19:57
12 A s h l a n d , t e s t i m o n y g i v e n S e p t e m b e r 1 9 t h , 2 0 0 8 .
09:20:03
13 W h a t w a s t h a t c a s e a b o u t ?
09:20:10
14 A S t r o m b e r g w a s a n i d i o p a t h i c m y e l o f i b r o s i s
09:20:13
15 a s s o c i a t e d w i t h t o l u e n e e x p o s u r e .
09:20:19
16
Q Okay. Who took your deposition in that case?
09:20:28
17
A It was a law firm out of North Carolina that I
09:20:42
18 h a d n e v e r h e a r d o f b e f o r e .
09:20:47
19 Q W h o w a s y o u r c l i e n t i n t h a t c a s e ?
09:20:51
20
A Howard Jarvis. I don't know the name of his
09:20:53
21 f i r m . I t h i n k h e w o r k s t h r o u g h W o l f e i n K n o x v i l l e .
09:21:01
22
Q And most recently Oakley versus U.S. Steel,
09:21:07
23 t e s t i m o n y g i v e n N o v e m b e r 7 t h , 2 0 0 8 .
09:21:15
24 T h a t i s a b o u t a m o n t h a g o ?
09:21:19
25 A Y e s .
09:21:20
16
1 Q What type of case is that?
09:21:20
2
A Oakley was an AML case with alleged exposure to
09:21:33
3
benzene from Liquid Wrench. It was a Liquid Wrench case
09:21:39
4 and Lance Lubel was the plaintiff --
09:21:44
5 Q Attorney?
09:21:49
6 A -- attorney, yes.
09:21:49
7 Q Okay. All right. Have you given any
09:21:50
8 depositions since Oakley?
09:21:56
9 A No.
09:21:58
10 Q W e l l , l e t ' s s e e . S o I a m c o u n t i n g t h e m ,
09:22:03
11
looking at Exhibit 2, the depositions that you gave this
09:22:05
12 y e a r w e r e i n B e h y m e r , H e n r i c k s o n , S a l t o n s t a l l , B a k e r ,
09:22:10
13 S t r o m l a n d a n d O a k l e y a n d n o w t h i s c a s e t o d a y ; c o r r e c t ?
09:22:19
14 A S t r o m l a n d ? S t r o m b e r g ?
09:22:29
15 Q S t r o m b e r g .
09:22:33
16 A Y e s .
09:22:33
17
Q Oakley, and then today in the Safety-Kleen
09:22:34
18 c a s e s ?
09:22:36
19 A C o r r e c t .
09:22:37
20
Q And all of these cases involve a hematologic
09:22:44
21 m a l i g n a n c y ; c o r r e c t ?
09:22:50
22 A Y e s .
09:22:51
23 Q A n d t h e y a l l i n v o l v e d c l a i m s t h a t b e n z e n e
09:22:52
24 c a u s e d t h a t h e m a t o l o g i c m a l i g n a n c y . T r u e ?
09:22:55
25
A The Stromberg case -- well, I think, yeah, they
09:23:02
17
1
still -- they might be claiming it was a contaminant --
09:23:04
2 benzene contaminant in the toluene, but it was pretty
09:23:07
3 much a toluene exposure.
09:23:10
4 Q But toluene doesn't cause AML, does it?
09:23:12
5 A This was a myelofibrosis case.
09:23:16
6 Q Let me ask more generally.
09:23:19
7 Toluene does not cause hematologic
09:23:22
8 malignancies. True?
09:23:26
9 A Not in my view, no.
09:23:28
10
Q But benzene has been a contaminant of toluene?
09:23:29
11 A Y e s .
09:23:33
12
Q All right. So with respect to these -- well,
09:23:33
13 t o t h e s i x c a s e s i n w h i c h y o u h a v e g i v e n d e p o s i t i o n s
09:23:44
14 t h i s y e a r t h a t i n v o l v e d h e m a t o l o g i c m a l i g n a n c i e s , i n
09:23:47
15
every one of them, did you testify that benzene did not
09:23:52
16 c a u s e t h e h e m a t o l o g i c m a l i g n a n c y ?
09:23:55
17 A Y e s .
09:23:59
18
Q And is that also your opinion in the cases that
09:23:59
19 y o u a r e h e r e t o t e s t i f y a b o u t t o d a y ?
09:24:03
20
A That the benzene exposures were insufficient to
09:24:05
21 c a u s e t h e s e d i s e a s e s , y e s .
09:24:07
22
Q What do you mean that the benzene exposures
09:24:11
23 w e r e i n s u f f i c i e n t ?
09:24:14
24
A Well, there is benzene all over. There is
09:24:15
25 b e n z e n e i n f r u i t , t h e r e i s b e n z e n e i n e g g , t h e r e i s
09:24:17
18
1
benzene in background air. So it requires a sufficient
09:24:20
2 dose of a sufficient duration to increase a person's
09:24:26
3 risk of developing AML.
09:24:31
4
And AML is the only malignancy that I believe
09:24:33
5 has been definitively linked with high dose chronic
09:24:40
6 exposure to benzene.
09:24:44
7
Some of those cases were other malignancies
09:24:45
8 that I don't believe are linked positively to benzene
09:24:49
9 exposure.
09:24:52
10
Q Okay. The cases that we are here about today,
09:24:53
11 d o y o u a c c e p t t h a t t h e y a r e a l l a c u t e m y e l o g e n o u s
09:24:55
12 l e u k e m i a c a s e s ?
09:24:59
13 A Y e s .
09:25:00
14
Q All right. Now, when you say that there has to
09:25:00
15 b e a s u f f i c i e n t d o s e o f b e n z e n e o f a s u f f i c i e n t
09:25:07
16 d u r a t i o n , w o u l d y o u t e l l m e p r e c i s e l y w h a t t h e d o s e i s
09:25:09
17
that it has to be for it to be sufficient in your view?
09:25:17
18 A W e l l , I t h i n k m y v i e w i s b a s e d o n t h e
09:25:20
19 q u a n t i t a t i v e s c i e n t i f i c l i t e r a t u r e l i n k i n g b e n z e n e
09:25:23
20 e x p o s u r e t o a m e a n i n g f u l l y i n c r e a s e d r i s k o f A M L . A n d
09:25:27
21 t h a t l i t e r a t u r e s e e m s t o f a l l s o m e w h e r e b e t w e e n 5 0 a n d
09:25:32
22 5 0 0 p a r t p e r m i l l i o n y e a r s , t h e b e s t e x p o s u r e - - t h e
09:25:35
23 b e s t e s t i m a t e b e i n g 2 0 0 .
09:25:40
24
So in terms of the duration and the dose, they
09:25:48
25 a r e g o i n g t o h a v e t o c o l l e c t i v e l y g e t y o u s o m e w h e r e
09:25:50
19
1 around 550 or higher part per million years.
09:25:54
2
Q The part per million year is a cumulative dose
09:25:57
3 metric, is it not?
09:26:00
4 A Yes.
09:26:03
5
Q And is there any study that has established
09:26:03
6 t h a t c u m u l a t i v e d o s e i s t h e m o s t s e n s i t i v e m e t r i c f o r 09:26:06
7 assessing benzene leukemia risk?
09:26:12
8
A Well, in my view there are. I mean Otto Wong
09:26:16
9 discussed it in his '87 CMA sponsored study. In the
09:26:20
10
Glass paper they talk about what happens when you pull
09:26:25
11
cumulative exposures out of the analysis, then there is
09:26:28
12 n o l o n g e r a n y k i n d o f r e l a t i o n s h i p w i t h i n t e n s i t y .
09:26:31
13
And there has been discussion and there is
09:26:34
14
continual discussion about the most appropriate metric
09:26:36
15 o f e x p o s u r e t o c o r r e l a t e w i t h r i s k . B u t I d o b e l i e v e 09:26:39
16 t h a t t h e c u m u l a t i v e e x p o s u r e i s s t i l l v a l u a b l e a n d i s 09:26:44
17 s t i l l u s a b l e i n t e r m s o f a t t r i b u t i n g r i s k f o r A M L .
09:26:48
18 Q I s t h e r e a n y s t u d y t h a t h a s c o n d u c t e d a n 09:26:53
19 a n a l y s i s o f d i f f e r e n t d o s e m e t r i c s a n d s p e c i f i c a l l y
09:26:57
20
determined that the dose metric that is most sensitive
09:27:02
21 f o r p r e d i c t i n g l e u k e m i a r i s k i s c u m u l a t i v e d o s e ?
09:27:06
22 A I a m n o t s u r e t h a t a n y o n e h a s g o n e a b o u t 09:27:11
23 a d d r e s s i n g t h e q u e s t i o n t h e w a y y o u p o s e d i t .
09:27:13
24
Q Okay. You told me that the benzene exposure
09:27:16
25 h a s t o b e o f a s u f f i c i e n t d o s e a n d o f a s u f f i c i e n t
09:27:31
20
1 duration.
09:27:34
2
Are you able to tell me what the dose component
09:27:36
3 of that has to be as separate from the duration?
09:27:40
4
A Well, I am not sure that you could really do
09:27:47
5 that.
09:27:49
6
Q Can you tell me what the duration part has to
09:27:49
7 be separate from the dose component?
09:27:51
8 A That is really the flip side of the same
09:27:53
9 question. I mean --
09:27:55
10 Q W h a t i s y o u r a n s w e r t h o u g h ?
09:27:56
11
A I think that is the debate as to whether or
09:28:00
12 n o t - - i f y o u s i m p l y l o o k a t c u m u l a t i v e e x p o s u r e , t h a t
09:28:01
13
does not give you all the information that you probably
09:28:04
14 n e e d t o u n d e r s t a n d t h e r i s k a n d t h e b i o l o g y .
09:28:07
15
I think that would be generally accepted by
09:28:10
16 e v e r y o n e i n t h i s f i e l d , s o b o t h c o m p o n e n t s a r e
09:28:13
17 i m p o r t a n t .
09:28:16
18
Acute exposures do not increase one's risk of
09:28:17
19 l e u k e m i a , s o t h e r e h a s t o b e s o m e k i n d o f p r o l o n g e d
09:28:21
20 e x p o s u r e i n o r d e r t o s t a r t s e e i n g a n i n c r e a s e d r i s k .
09:28:24
21
Really low levels of benzene, no matter how
09:28:28
22 l o n g y o u a r e e x p o s e d t o t h e m , d o e s n o t i n c r e a s e o n e ' s
09:28:30
23
risk of developing AML. So there you have to have some
09:28:34
24 d e g r e e o f i n t e n s i t y .
09:28:38
25
When you combine those, you need to get
09:28:39
21
1
somewhere around 50 to 500 part per million years before
09:28:41
2
the scientific literature will support that you have an
09:28:44
3 increased risk.
09:28:48
4 Q You mentioned acute exposures.
09:28:52
5
What -- could you quantify that for me, what
09:28:55
6 you mean by that?
09:28:59
7
A Well, toxicologically usually acute exposure is
09:29:00
8 something short of less than 24 hours.
09:29:04
9
Q But in terms of when you said acute exposures
09:29:07
10 w i t h r e s p e c t t o b e n z e n e , w h a t d o y o u m e a n ? W h a t i s a n
09:29:10
11 a c u t e e x p o s u r e f o r b e n z e n e ?
09:29:16
12 A S o m e t h i n g l e s s t h a n 2 4 h o u r s .
09:29:18
13 Q O f a n y d o s e ?
09:29:19
14 A C o r r e c t .
09:29:21
15 Q I s e e .
09:29:21
16
And how many acute exposures of any dose does
09:29:22
17 i t t a k e t o c a u s e l e u k e m i a - - t o c a u s e A M L ?
09:29:26
18 A A c u t e e x p o s u r e s d o n ' t c a u s e l e u k e m i a .
09:29:30
19 Q N o t a t a l l ?
09:29:32
20 A N o t i n m y v i e w .
09:29:34
21
Now, if you start doing it more than once, then
09:29:35
22 i t ' s n o l o n g e r a c u t e . N o w y o u a r e s t a r t i n g t o t a l k
09:29:38
23 a b o u t i n t e r m i t t e n t p e a k e x p o s u r e s o v e r s o m e p r o l o n g e d
09:29:40
24 p e r i o d o f t i m e .
09:29:45
25
And there you can quantitate what those
09:29:45
22
1 exposures would end up being and you are going to be
09:29:48
2 comparing those to the quantitative epi. literature.
09:29:52
3
If you are just looking at intensity, pure
09:29:55
4 intensity, there are studies that have tried to
09:29:58
5 associate risk of leukemia with intensity of exposure
09:30:00
6
and those are consistent with the cumulative. They have
09:30:03
7 to be pretty high.
09:30:07
8
Q What are the -- how many peak and intermittent
09:30:08
9 exposures to benzene does it take to cause AML?
09:30:12
10
A I guess it depends on what you mean by peak and
09:30:17
11 h o w h i g h t h e y a r e . T h e o n l y t i m e t h a t h a s e v e r b e e n
09:30:20
12 q u a n t i t a t e d i n t h e e p i d e m i o l o g i c l i t e r a t u r e t h a t I ' m
09:30:23
13 a w a r e o f i s t h e s t u d y o n t h e D o w w o r k e r s p u b l i s h e d b y
09:30:27
14
Ireland where they saw an increased risk, but it was not
09:30:31
15 s t a t i s t i c a l l y s i g n i f i c a n t .
09:30:34
16
But nonetheless they saw an increased risk with
09:30:35
17
peaks over 100 part per million the numbers of days that
09:30:36
18 t h e y h a d a p e a k o v e r 1 0 0 p a r t p e r m i l l i o n c o r r e l a t e d
09:30:39
19 w i t h A M L r i s k .
09:30:43
20 Q N o w , y o u m e n t i o n e d t h e t e r m s " p e a k " a n d
09:30:45
21 " i n t e r m i t t e n t , " s o w h a t d o y o u m e a n b y t h e m ?
09:30:47
22
A Well, I think peak is peak. Peak is how high
09:30:51
23 i t g o t t o w i t h i n a c e r t a i n e x p o s u r e d u r a t i o n .
09:30:54
24 I n t e r m i t t e n t m e a n s i t h a p p e n s i n t e r m i t t e n t l y . I t
09:31:00
25 c o m e s - - i t i s n o t a c o n t i n u o u s m e t r i c . I t i s n o t a
09:31:04
23
1 continuous exposure.
09:31:08
2
Q Do you consider peak and intermittent benzene
09:31:10
3 exposures to be important in assessing leukemia risk?
09:31:12
4
A Well, as we have been talking about, I feel
09:31:18
5
like the epidemiological literature is the clearest with
09:31:21
6 regard to cumulative exposure. And those cumulative
09:31:25
7 exposures, however they have been calculated, will
09:31:28
8
contain peaks and intermittents because that is the way
09:31:32
9 people are exposed in the workplace.
09:31:36
10 Q I w i l l m o v e t o s t r i k e t h e r e s p o n s e a s
09:31:38
11 n o n r e s p o n s i v e .
09:31:40
12
Do you consider peak and intermittent benzene
09:31:41
13 e x p o s u r e s t o b e i m p o r t a n t i n a s s e s s i n g l e u k e m i a r i s k ?
09:31:43
14
A In terms of the -- how they contribute to the
09:31:47
15 c u m u l a t i v e e x p o s u r e , y e s .
09:31:52
16 Q B u t n o t o t h e r w i s e ?
09:31:57
17 A W e l l , h o w c a n t h e y n o t c o n t r i b u t e t o t h e
09:31:59
18 c u m u l a t i v e e x p o s u r e ?
09:32:01
19
Q I am just asking, you don't consider peak and
09:32:03
20 i n t e r m i t t e n t b e n z e n e e x p o s u r e s i m p o r t a n t i n a s s e s s i n g
09:32:05
21 l e u k e m i a r i s k i n a n d o f t h e m s e l v e s ; i s t h a t t r u e ?
09:32:09
22
A I don't know how you could do that. I don't
09:32:13
23 k n o w h o w y o u c o u l d a s s e s s t h e m i n a n d o f t h e m s e l v e s
09:32:14
24
except for how they contribute to the cumulative overall
09:32:17
25 e x p o s u r e w i t h t h e e x c e p t i o n o f t h e I r e l a n d p a p e r .
09:32:21
24
1
Q Now, does continuous low level benzene exposure
09:32:24
2 or intermittent low level benzene exposure present a
09:32:41
3 greater leukemia risk?
09:32:48
4
A I'm sorry, could you ask that again. You mean
09:32:49
5 between those two?
09:32:51
6
Q Between those two, continuous low level or
09:32:54
7 intermittent low level benzene exposure.
09:32:56
8
A Well, depending on what you mean by low level,
09:32:59
9
I don't think either one of them would contribute to the
09:33:01
10 r i s k .
09:33:04
11
So you'd have to quantitate low level and you'd
09:33:04
12
have to quantitate what you are referring to when you --
09:33:07
13
what do you mean by intermittent and what are the peaks.
09:33:08
14
Q Well, you have told us what intermittent means
09:33:14
15 t o y o u ; c o r r e c t ?
09:33:18
16 A Y e a h , n o t v e r y a r t i c u l a t e l y , b u t y e s .
09:33:19
17
Q Okay. Is intermittent or continuous exposure
09:33:22
18 t o a p a r t i c u l a r d o s e , w h i c h o f t h o s e p r e s e n t s t h e
09:33:25
19 g r e a t e r r i s k o f l e u k e m i a ?
09:33:30
20 A O h , I s e e w h a t y o u a r e s a y i n g .
09:33:32
21
Probably the only way that they have been
09:33:34
22 c o m p a r e d i n a w a y t o a l l o w a n a n s w e r t o t h a t i s i n t h e
09:33:37
23 a n i m a l s t u d i e s . A n d i n t h e a n i m a l s t u d i e s t h a t
09:33:42
24 l i t e r a t u r e i s p r e t t y c o n f l i c t e d .
09:33:45
25
There are some studies that indicate that high
09:33:47
25
1
dose intermittent exposure damages the marrow more than
09:33:49
2 that same dose over a continual basis.
09:33:54
3
But then there are other studies by Cronkite
09:33:57
4
that are exactly the opposite, so I don't think that is
09:34:00
5 totally known.
09:34:03
6
Q What case by Cronkite is totally the opposite?
09:34:04
7
A I don't remember the date. It was some of his
09:34:07
8 animal work.
09:34:09
9 Q Specifically for benzene?
09:34:11
10 A Y e s .
09:34:12
11 Q A n d w h a t d o y o u r e c a l l h i m f i n d i n g ?
09:34:15
12 A W h a t d o I r e c a l l h i m w h a t ?
09:34:18
13
Q Finding in the study that you can't identify.
09:34:19
14
A I think he published it in '87, but I am not
09:34:24
15
positive, that continuous exposure was more damaging to
09:34:28
16
the marrow than intermittent exposure on a per gram, per
09:34:33
17 m i l l i g r a m b a s i s .
09:34:39
18
Q Okay. When you say damaging to the marrow, are
09:34:41
19
you talking about a hematotoxic effect or a carcinogenic
09:34:44
20 e f f e c t ?
09:34:48
21 A I n t h a t c a s e i t w a s a h e m a t o t o x i c e f f e c t .
09:34:49
22
Q Are there any studies in animals that you can
09:34:54
23 i d e n t i f y t h a t h a v e s h o w n t h a t c o n t i n u o u s e x p o s u r e i s
09:34:56
24 m o r e c a r c i n o g e n i c t h a n i n t e r m i t t e n t e x p o s u r e s ?
09:35:03
25
A Not sitting here now, but I'm pretty sure that
09:35:13
26
1 is true.
09:35:15
2 Q What is true?
09:35:16
3
A That continuous exposure, that there is data in
09:35:17
4 animals looking at the carcinogenicity of benzene that
09:35:21
5
would support that same position. The Cronkite one, as
09:35:27
6 I recall, was 300 part per million year and it was a
09:35:29
7 hematotoxic effect.
09:35:33
8
But there are others where they have looked at
09:35:35
9
zymbal gland formation and find the lymphomas in various
09:35:37
10 r o d e n t s a n d h a v e c o m e t o t h e s a m e c o n c l u s i o n .
09:35:41
11 Q C a n y o u i d e n t i f y a n y o f t h e a u t h o r s ?
09:35:44
12 A I t h i n k o n e w a s H u f f , H - u - f - f . I j u s t
09:35:46
13 d i d n ' t - - I d i d n ' t p r e p a r e t o t a l k a b o u t t h e a n i m a l
09:35:49
14 s t u d i e s t o d a y .
09:35:51
15
Q Okay. Well, let me ask you, have you written
09:35:52
16 o u t y o u r o p i n i o n s f o r t h i s c a s e a t a l l ?
09:36:10
17 A N o .
09:36:12
18
Q How many opinions have you formed for this
09:36:13
19 c a s e ?
09:36:15
20
A Well, kind of thought they would just naturally
09:36:19
21 f l o w f r o m o u r d i s c u s s i o n , b u t I h a v e t h r e e o r f o u r .
09:36:22
22
Q Okay. Why don't you tell me what they are?
09:36:26
23
A So I guess the first one would be that this is
09:36:33
24
really a mineral spirits, Stoddard solvent case and that
09:36:38
25 i s w h a t S a f e t y - K l e e n p r o d u c e d .
09:36:43
27
1
Maybe you could extend it to that it is a
09:36:48
2
gasoline case, but it isn't a benzene exposure case, at
09:36:52
3
least not it my view since those things, mineral spirits
09:36:57
4 and Stoddard solvent and gasoline have been looked at.
09:37:01
5 So that would be one.
09:37:07
6
The second one would be that based on the
09:37:09
7
quantitative exposure assessments that I have seen from
09:37:13
8
both sides, from Dr. Nicas as well as from Dr. Sheehan,
09:37:18
9
none of the three plaintiffs had sufficient exposures to
09:37:26
10
benzene to meaningfully increase their risk of AML. So
09:37:31
11 t h a t w o u l d b e a n o t h e r o n e .
09:37:40
12
The third one, that Mr. Hazlehurst's AML
09:37:48
13
doesn't really fit with what we would think a chemically
09:37:55
14 i n d u c e d l e u k e m i a m i g h t l o o k l i k e . T h e o t h e r s , t o
09:38:01
15 v a r y i n g d e g r e e s , h a v e s o m e c h a r a c t e r i s t i c s t h a t a r e
09:38:06
16 c o n s i s t e n t .
09:38:11
17
I disagree with the notion that cytogenetic
09:38:20
18
changes in the absence of sufficient dose or cumulative
09:38:27
19 e x p o s u r e t o b e n z e n e i s a l l y o u n e e d t o b e a b l e t o
09:38:34
20 e s t a b l i s h e t i o l o g y ; t h a t t h e d o s e h a s t o r e a c h a l e v e l
09:38:39
21
that you would associate with an increased risk of AML.
09:38:47
22
And if that has been achieved, then the
09:38:53
23 c y t o g e n e t i c c h a n g e s w i l l g i v e y o u s o m e i n s i g h t a s t o
09:38:57
24 w h e t h e r o r n o t t h a t d i s e a s e w a s c a u s e d b y t h o s e
09:39:02
25
exposures, but not in -- the reverse is not true, in my
09:39:05
28
1 opinion.
09:39:09
2
So I disagree with plaintiff experts that take
09:39:10
3
the position that having a deletion on chromosome 5 is
09:39:19
4 sufficient evidence in and of itself to link it to
09:39:23
5 benzene exposure.
09:39:26
6
Q Okay. Let's talk about some of these things.
09:39:30
7
MR. CARR: Raphael, could I put something on
09:39:38
8 the record real quick to hopefully save time and
09:39:40
9 incapsulate.
09:39:43
10
We are also going to ask him to discuss
09:39:44
11
generally what hematotoxicity is, what genotoxicity is
09:39:46
12
molded into his opinions regarding mineral spirits and
09:39:51
13 g a s o l i n e , t h e i n h i b i t o r y e f f e c t s i n c e r t a i n m i x t u r e s . 09:39:54
14
You have already discussed some of the metrics
09:40:02
15 i n b r o a d t e r m s t h a t h e h a s l o o k e d a t , i n c l u d i n g
09:40:05
16 i n t e r m i t t e n t a n d l i f e t i m e c u m u l a t i v e d o s e a n d w e a r e
09:40:08
17 g o i n g t o a s k h i m t o d i s c u s s t h o s e .
09:40:13
18 M R . M E T Z G E R : O k a y .
09:40:17
19
MR. CARR: And to the extent that plaintiffs'
09:40:17
20 e x p e r t s h a v e t a k e n t h e p o s i t i o n t h a t c e r t a i n o f t h e s e 09:40:20
21 l e u k e m i a s a r e b e n z e n e i n d u c e d o r t h a t b e n z e n e w a s a
09:40:23
22 s u b s t a n t i a l c o n t r i b u t i n g f a c t o r , w e a r e g o i n g t o a s k
09:40:26
23 D r . P y a t t t o t a l k a b o u t t h a t a s w e l l .
09:40:30
24
MR. METZGER: What, substantial factor? I am
09:40:35
25 n o t f o l l o w i n g y o u .
09:40:38
29
1
MR. CARR: Both plaintiffs' opinions on
09:40:39
2
substantial factor and substantial factor with regard to
09:40:41
3 this chemical, meaning the comparison of the dose of
09:40:44
4 this chemical to the other doses.
09:40:49
5
MR. METZGER: I don't understand that at all,
09:40:54
6
but I am sure Dr. Pyatt will explain it if he can, if he
09:40:54
7 can understand it.
09:41:01
8 Okay. Thank you for that framework.
09:41:02
9
Q So this is a mineral spirits case and not a
09:41:11
10 b e n z e n e c a s e ?
09:41:13
11 A T h a t ' s m y v i e w , y e s .
09:41:16
12
Q Okay. Was there benzene in Safety-Kleen 105
09:41:18
13 s o l v e n t ?
09:41:26
14 A V e r y l o w l e v e l s , y e s .
09:41:28
15
Q What levels were there that you say are very
09:41:31
16 l o w ?
09:41:34
17
A You'd have to -- I'm probably not the best
09:41:36
18
person to be asked that, but low part per million in the
09:41:41
19 l i q u i d .
09:41:46
20
Q Do you have an understanding as to what the
09:41:47
21
benzene concentration of Safety-Kleen 105 solvent was in
09:41:49
22 C a l i f o r n i a s a y , f o r e x a m p l e , i n 1 9 9 0 ?
09:41:56
23 A I c a n f i n d t h a t i n f o r m a t i o n .
09:42:01
24
Q Let me just ask you, when you say low part per
09:42:10
25 m i l l i o n , w h a t r a n g e d o y o u p u t o n t h a t ?
09:42:12
30
1 A 10, 20 part per million.
09:42:14
2
Q Okay. Now, why do you call this a mineral
09:42:18
3 spirits case or a Stoddard solvent case or perhaps a
09:42:29
4 gasoline case but not a benzene case?
09:42:32
5
A Well, because Safety-Kleen solvent was mineral
09:42:36
6 spirits with -- or basically Stoddard solvent with
09:42:43
7 really low levels of benzene in them.
09:42:47
8
But the ATSDR, OSHA, there is no regulatory
09:42:49
9 body out there that considers mineral spirits or
09:42:55
10 S t o d d a r d s o l v e n t t h a t h a s t h e s e l e v e l s o f b e n z e n e i n
09:42:58
11 t h e m t o b e c a r c i n o g e n i c .
09:43:01
12
When you look at the animal data, any of the
09:43:04
13 d a t a , t h e r e i s n o e v i d e n c e t h a t t h e s e m a t e r i a l s c a u s e
09:43:06
14 c a n c e r i n p e o p l e .
09:43:10
15
And I would argue that is the same with
09:43:12
16 g a s o l i n e w h e r e i t h a s 1 0 0 , p e r h a p s 1 , 0 0 0 t i m e s t h e
09:43:14
17 c o n c e n t r a t i o n o f b e n z e n e t h a n t h e m i n e r a l s p i r i t s d o .
09:43:20
18
Q Well, Safety-Kleen 105 solvent is a product, is
09:43:24
19 i t n o t ?
09:43:28
20 A I g u e s s , y e s .
09:43:30
21
Q And it's not the same thing as mineral spirits,
09:43:32
22 i s i t ?
09:43:36
23 A W e l l , I t h i n k c h e m i c a l l y i t ' s v e r y c l o s e .
09:43:36
24 Q I t ' s n o t t h e s a m e , i s i t ?
09:43:39
25
A I would have to compare the actual chemical
09:43:41
31
1 compositions, but I think it is very close.
09:43:43
2
Q Does mineral spirits contain 12 known human
09:43:47
3 carcinogens in it?
09:43:53
4
A I don't know the answer to that. My guess is
09:43:58
5 no.
09:43:59
6
Q Does mineral spirits contain six known human
09:44:00
7 carcinogens in it?
09:44:04
8
A I would have to look at the examples, but no, I
09:44:06
9 don't think that is true.
09:44:09
10
Q How many known human carcinogens are you aware
09:44:11
11 o f t h a t a r e i n m i n e r a l s p i r i t s ?
09:44:14
12
A I am not aware of any with the exception of the
09:44:27
13 l o w l e v e l s o f b e n z e n e .
09:44:29
14
Q Okay. So if this product contained several
09:44:31
15 k n o w n h u m a n c a r c i n o g e n s , i t w o u l d n o t b e p r o p e r l y
09:44:36
16 c h a r a c t e r i z e d a s m i n e r a l s p i r i t s , w o u l d i t ?
09:44:39
17
A I don't know how to answer that question. I
09:44:50
18 d o n ' t - -
09:44:52
19 Q I f i t c o n t a i n e d s e v e r a l k n o w n h u m a n
09:44:52
20 c a r c i n o g e n s , w o u l d i t b e p r o p e r l y c h a r a c t e r i z e d a s
09:44:55
21 S t o d d a r d s o l v e n t ?
09:44:58
22 A I n m y o p i n i o n , f r o m w h a t I h a v e s e e n t h e
09:44:59
23 S a f e t y - K l e e n s o l v e n t i s v e r y s i m i l a r t o S t o d d a r d
09:45:02
24 s o l v e n t .
09:45:05
25 Q M o v e t o s t r i k e a s n o n r e s p o n s i v e .
09:45:06
32
1
If the product contained several carcinogens,
09:45:07
2 would it be properly classified as Stoddard solvent?
09:45:11
3
MR. FOLEY: Object. It lacks foundation.
09:45:15
4 Calls for speculation. Beyond the scope of what this
09:45:16
5 expert is here for.
09:45:19
6
You could go ahead and answer though, doctor.
09:45:21
7
THE WITNESS: I stand by my original answer.
09:45:24
8 As far as I can tell, it is very similar to Stoddard
09:45:25
9 solvent.
09:45:29
10
Q BY MR. METZGER: You have told me that twice
09:45:29
11 n o w , b u t I a m a s k i n g y o u a d i f f e r e n t q u e s t i o n ,
09:45:32
12 D r . P y a t t . I a m a s k i n g y o u a h y p o t h e t i c a l q u e s t i o n .
09:45:33
13
I'd like you to assume that the Safety-Kleen
09:45:36
14 1 0 5 s o l v e n t c o n t a i n s s e v e r a l c a r c i n o g e n s . I f t h a t i s
09:45:38
15 t r u e , w o u l d t h a t p r o d u c t b e p r o p e r l y c l a s s i f i e d a s
09:45:42
16 S t o d d a r d s o l v e n t ?
09:45:46
17
MR. FOLEY: Object that it's an incomplete
09:45:48
18
hypothetical. Lacks foundation. Calls for speculation.
09:45:49
19
THE WITNESS: I haven't seen any evidence that
09:45:52
20 t h a t i s t r u e .
09:45:54
21
Q BY MR. METZGER: I am not asking you that.
09:45:54
22
Do you understand what a hypothetical question
09:45:56
23 is?
09:45:58
24
MR. FOLEY: Objection. Argumentative.
09:45:59
25
THE WITNESS: That we are just making it up.
09:46:01
33
1
Q BY MR. METZGER: No. A hypothetical question
09:46:02
2 is not made up. I am asking you to make an assumption
09:46:05
3 that I believe I can prove at trial. I wouldn't just
09:46:10
4 make up something for a hypothetical --
09:46:16
5 A Okay.
09:46:19
6 Q -- unlike some people.
09:46:19
7
So I am asking you to assume that I have
09:46:23
8 evidence that there are several carcinogens in
09:46:26
9 Safety-Kleen 105 solvent.
09:46:29
10
Assuming that to be true, would you classify
09:46:33
11 t h a t p r o d u c t a s S t o d d a r d s o l v e n t ?
09:46:36
12
A I don't think it is Stoddard solvent, but I
09:46:42
13
think it is chemically very similar to Stoddard solvent.
09:46:44
14 Q O k a y . N o w , l e t m e a s k y o u w h y w o u l d y o u
09:46:48
15 c l a s s i f y t h e p r o d u c t a s S t o d d a r d s o l v e n t a t a l l w h e n
09:46:50
16 S t o d d a r d s o l v e n t i s n ' t e v e n u s e d t o m a k e i t ?
09:46:54
17
A Well, just because of the chemical composition
09:46:57
18 o f t h e s e m a t e r i a l s , t h e y s e e m t o m e t o b e p r e t t y
09:47:00
19 s i m i l a r .
09:47:02
20
Q What seems to be pretty similar to Stoddard
09:47:03
21 s o l v e n t ?
09:47:06
22
A Mineral spirits and the Safety-Kleen products.
09:47:07
23
Q You understand that the starting material so to
09:47:14
24
speak for Safety-Kleen 105 is mineral spirits; correct?
09:47:18
25
A That wouldn't surprise me, but no, I didn't
09:47:23
34
1 know that.
09:47:25
2
Q Okay. There is a difference between mineral
09:47:26
3 spirits and Stoddard solvent; isn't there?
09:47:28
4
A They are relatively subtle from a toxicological
09:47:31
5 point of view.
09:47:35
6 Q There is a difference; isn't there?
09:47:36
7
A There might be a small difference chemically
09:47:37
8 between percentages of this and that, but from a
09:47:40
9
toxicological point of view, I don't think they matter.
09:47:42
10
Q Stoddard solvent has a higher initial boiling
09:47:45
11 p o i n t t h a n m i n e r a l s p i r i t s , d o e s i t n o t ?
09:47:48
12 A I d i d n ' t k n o w t h a t .
09:47:50
13 Q A n d b e c a u s e S t o d d a r d s o l v e n t h a s a h i g h e r
09:47:52
14 i n i t i a l b o i l i n g p o i n t t h a n m i n e r a l s p i r i t s , i t w o u l d
09:47:56
15 h a v e a l e s s e r b e n z e n e c o n c e n t r a t i o n , w o u l d i t n o t ?
09:47:59
16 A T h a t s e e m s t r u e .
09:48:03
17
Q Okay. So why do you say that this is a --
09:48:05
18 w e l l , l e t m e a s k y o u , a r e y o u a w a r e t h a t S a f e t y - K l e e n
09:48:11
19 1 0 5 s o l v e n t i s h a z a r d o u s w a s t e ?
09:48:14
20
MR. FOLEY: Objection. Argumentative. Lacks
09:48:18
21 f o u n d a t i o n .
09:48:19
22 T H E W I T N E S S : N o .
09:48:21
23
Q BY MR. METZGER: Okay. If Safety-Kleen 105
09:48:22
24
solvent were hazardous waste, would you say that this is
09:48:26
25 a h a z a r d o u s w a s t e c a s e r a t h e r t h a n a m i n e r a l s p i r i t s
09:48:30
35
1 case?
09:48:33
2
MR. FOLEY: Same objection. And incomplete
09:48:34
3 hypothetical.
09:48:35
4
THE WITNESS: I don't even understand what you
09:48:37
5 mean.
09:48:38
6
Q BY MR. METZGER: Well, you have told me that
09:48:39
7
this is not a benzene case; it's a mineral spirits case.
09:48:40
8
MR. FOLEY: Objection. Argumentative.
09:48:44
9
Q BY MR. METZGER: But if in fact Safety-Kleen
09:48:45
10 1 0 5 s o l v e n t w a s n ' t m i n e r a l s p i r i t s b u t i t ' s h a z a r d o u s
09:48:47
11 w a s t e , w o u l d y o u t h e n s a y t h a t t h i s i s a c t u a l l y a
09:48:50
12 h a z a r d o u s w a s t e c a s e ?
09:48:54
13 A W e l l , y o u c a n c l a s s i f y l o t s o f t h i n g s a s
09:48:56
14 h a z a r d o u s w a s t e . I m e a n t h e r e a r e a l l k i n d s o f t h i n g s
09:48:59
15 t h a t w o u l d b e c o n s i d e r e d h a z a r d o u s w a s t e , h e a v y m e t a l
09:49:02
16 c o n t a m i n a t i o n , a l l k i n d s o f t h i n g s . I t w o u l d h a v e n o
09:49:07
17 r e l a t i o n s h i p w h a t s o e v e r t o t h i s p r o d u c t .
09:49:09
18
Whereas I think the relationship with mineral
09:49:12
19
spirits and Stoddard solvent is pretty clear. They are
09:49:14
20 v e r y c l o s e l y r e l a t e d .
09:49:17
21 Q O k a y . A l l r i g h t .
09:49:19
22
Now, your second opinion you told me was that
09:49:22
23
none of the three plaintiffs had sufficient exposure to
09:49:25
24 b e n z e n e t o m e a n i n g f u l l y i n c r e a s e t h e i r r i s k o f A M L .
09:49:29
25
What do you mean by the word "meaningfully"?
09:49:34
36
1
A Well, I mean from an epidemiologic point of
09:49:43
2 view, I mean that it is a statistically significant
09:49:47
3 finding and that it is likely reproducible with other
09:49:50
4 studies.
09:49:53
5
If you look at how EPA regulates benzene and
09:49:54
6 it's a linear extrapolation with their modeling, then
09:50:01
7 any dose has a quantifiable risk, but that is a public
09:50:05
8
policy type decision that I don't think matches with the
09:50:14
9 biology.
09:50:17
10
So a meaningful increased risk is going to be
09:50:18
11 s o m e t h i n g w h e r e y o u s e e s t a t i s t i c a l l y s i g n i f i c a n t
09:50:22
12 e l e v a t i o n s i n m o r e t h a n a s i n g l e s t u d y .
09:50:26
13
Q In more than a single epidemiologic study?
09:50:30
14 A C o r r e c t .
09:50:33
15
Q Okay. Well, isn't epidemiology too insensitive
09:50:34
16
an analytical technique to determine increased risks for
09:50:40
17 l o w l e v e l e x p o s u r e s ?
09:50:49
18 A W e l l , I h a v e h e a r d t h a t a r g u m e n t .
09:50:52
19 Q I s n ' t i t t r u e ?
09:50:54
20 A I ' m n o t s u r e w h e t h e r i t ' s t r u e o r n o t .
09:50:55
21
Q Okay. Now, your third opinion, you told me
09:50:57
22 t h a t M r . H a z l e h u r s t ' s A M L d o e s n ' t f i t w i t h w h a t a
09:51:13
23
chemically induced leukemia -- I actually didn't get it
09:51:18
24 a l l d o w n h e r e .
09:51:23
25 A I w a s p r o b a b l y r a m b l i n g .
09:51:25
37
1
Q But could you restate that since I didn't write
09:51:28
2 it all quickly enough.
09:51:31
3
A Well, Mr. Hazlehurst's AML was cytogenetically
09:51:32
4
normal which, in my view, is not consistent with what we
09:51:37
5 would think a chemically induced leukemia would look
09:51:41
6 like.
09:51:45
7
Q Okay. What does a chemically induced leukemia
09:51:45
8 look like?
09:51:49
9
A Well, that depends really on the chemical.
09:51:51
10
Q Well, what does a benzene induced leukemia look
09:51:53
11 l i k e ?
09:51:56
12
A Well, we've learned the most, in my view, about
09:51:57
13
benzene from looking at the chemotherapy and I think it
09:52:01
14 s e e m s t o m a t c h w i t h t h e a l k y l a t i n g c h e m o t h e r a p y t h e
09:52:04
15 b e s t .
09:52:08
16
And in those cases you would have potentially a
09:52:08
17 h y p o c e l l u l a r m a r r o w . Y o u w o u l d h a v e a p r e c e d i n g
09:52:11
18 p a n c y t o p e n i a , p e r h a p s a p r e c e d i n g d i a g n o s i s o f
09:52:18
19 m y e l o d y s p l a s i a a n d t h e r e w o u l d b e e v i d e n c e o f
09:52:23
20 c y t o g e n e t i c c h a n g e s .
09:52:26
21 Q W h a t c y t o g e n e t i c c h a n g e s ?
09:52:28
22
A The alkylating chemotherapy, you would see
09:52:30
23 p o t e n t i a l l y m o n o s o m e 7 o r d e l e t i o n s i n c h r o m o s o m e 5 a s
09:52:33
24
well as others, but those would be -- seem to correlate
09:52:40
25 t h e b e s t .
09:52:42
38
1 Q And those are exactly the chromosomal
09:52:45
2
abnormalities that Mr. Pearl and Mr. Machado had. True?
09:52:48
3
A I have not seen any evidence that Mr. Pearl had
09:52:52
4
monosome 7, but he did have a deletion in chromosome 5.
09:52:54
5
There are deletions in chromosome 5 in lots of AML cases
09:52:59
6 that have no evidence of exposure.
09:53:04
7
So I don't believe that in and of itself will
09:53:07
8 allow someone to say this was definitively a benzene
09:53:10
9 case or a benzene case of AML.
09:53:14
10
Mr. Machado did have those cytogenetic changes
09:53:17
11 b u t w a s a l s o p o s i t i v e f o r t h e P h i l a d e l p h i a c h r o m o s o m e ,
09:53:22
12 w h i c h I h a v e n e v e r s e e n a n y o n e a s s o c i a t e t h a t w i t h
09:53:26
13
benzene exposure or show that the 922 translocation can
09:53:30
14 b e c a u s e d b y b e n z e n e o r i t s m e t a b o l i t e s .
09:53:34
15
Q All right. Let's talk about each of these.
09:53:42
16
Is it true that Mr. -- both Mr. Pearl and Mr.
09:53:50
17 M a c h a d o h a d d e l e t i o n s o f c h r o m o s o m e 5 ?
09:53:54
18 A T h a t i s m y u n d e r s t a n d i n g , y e s .
09:54:00
19
Q Is it true that benzene causes deletions of
09:54:02
20 c h r o m o s o m e 5 ?
09:54:07
21
A There is evidence that it can do that. It
09:54:10
22 g e n e r a l l y i s t h o u g h t t o r e q u i r e v e r y h i g h d o s e s .
09:54:13
23
Q Is it true that Mr. Pearl and Mr. Machado both
09:54:21
24 h a d a b n o r m a l i t i e s o f c h r o m o s o m e 7 ?
09:54:26
25
A That I don't have a record of. I did not see
09:54:30
39
1 chromosome 7 in Mr. Pearl, but I might have missed it.
09:54:34
2 I did see that in Mr. Machado.
09:54:38
3 Q Would it be -- okay.
09:54:41
4
Is it true that benzene causes abnormalities of
09:54:45
5 chromosome 7?
09:54:50
6 A There is evidence that it can do that.
09:54:51
7
Q And is there evidence that benzene causes the
09:54:55
8 type of abnormality of chromosome 7 that Mr. Machado
09:54:58
9 had?
09:55:02
10
A The monosome 7, that seems to be the case under
09:55:03
11 t h e a p p r o p r i a t e e x p o s u r e c o n d i t i o n s . L o t s o f p e o p l e
09:55:08
12 h a v e m o n o s o m e 7 w i t h n o b e n z e n e e x p o s u r e .
09:55:11
13
Q And you have reviewed the cytogenetic records
09:55:20
14 f o r M r . P e a r l a n d y o u h a v e f o u n d n o e v i d e n c e o f a n y
09:55:24
15 a b n o r m a l i t y o f c h r o m o s o m e 7 ?
09:55:27
16 A I d i d n ' t - - I d i d n ' t s e e i t .
09:55:29
17
And yes, I did look at all of the biopsy
09:55:31
18 r e s u l t s a n d t h e c y t o g e n e t i c c h a n g e s . I t i s p o s s i b l e I
09:55:33
19 m i s s e d i t .
09:55:37
20
Q Okay. That would be an important thing to
09:55:38
21 m i s s , w o u l d i t n o t ?
09:55:40
22 A W e l l , i t ' s a n i m p o r t a n t f i n d i n g , b u t i t
09:55:42
23 w o u l d n ' t c h a n g e m y o v e r a l l o p i n i o n b e c a u s e h e h a d
09:55:45
24 d e l e t i o n i n c h r o m o s o m e 5 .
09:55:49
25
Q Why would that be a -- why is that an important
09:55:51
40
1 finding?
09:55:55
2
A Well, because of the subject that we are now
09:55:56
3 discussing, is that high dose exposure to benzene has
09:55:59
4 been linked to changes in those chromosomes.
09:56:03
5 Q Specifically chromosomes 5 and 7?
09:56:08
6 A Correct.
09:56:10
7 Q In AML?
09:56:11
8
A That is a harder question to answer. They
09:56:14
9 have -- they have seen those chromosome changes
09:56:17
10 a s s o c i a t e d w i t h c h e m o t h e r a p e u t i c a g e n t s t h a t a c t a s
09:56:21
11 a l k y l a t i n g a g e n t s a n d t h a t s e e m s t o f o l l o w t h e s a m e
09:56:27
12 p a t t e r n a s b e n z e n e .
09:56:29
13
They have shown that benzene can cause these
09:56:31
14 c y t o g e n e t i c c h a n g e s i n a p e t r i d i s h i n v i t r o . I t i s
09:56:33
15 v e r y d i f f i c u l t t o r e l a t e t h o s e e x p o s u r e s t o w h a t a n
09:56:38
16 o c c u p a t i o n a l e x p o s u r e m i g h t b e .
09:56:41
17
And there have been some studies where they
09:56:43
18 h a v e s h o w n t h a t u n d e r h i g h d o s e e x p o s u r e t o b e n z e n e ,
09:56:45
19 t h e y d o s e e i n c r e a s e s i n t h o s e f i n d i n g s i n p e r i p h e r a l
09:56:48
20 l y m p h o c y t e s .
09:56:53
21
Q But the abnormalities of chromosome 5 and 7 are
09:56:55
22 t y p i c a l l y a b n o r m a l i t i e s t h a t a r e s e e n i n A M L , a r e t h e y
09:56:59
23 n o t ? T h e y a r e n o t s e e n i n o t h e r d i s e a s e s ?
09:57:04
24
A There is a thing called 5Q syndrome, which is
09:57:08
25 n o t p e r s a y A M L . I t i s m o r e o f a m y e l o d y s p l a s t i c t y p e
09:57:12
41
1
process that doesn't always go to AML. And you can see
09:57:16
2 monosome 7 in other diseases, but by and large I think
09:57:20
3 what you are saying is correct.
09:57:25
4
Q Okay. Now, Mr. Pearl and Mr. Machado both had
09:57:26
5 complex karyotypes, did they not?
09:57:30
6
A Mr. Pearl and Mr. Machado, yes. Machado, for
09:57:33
7 sure. And Mr. -- yes.
09:57:41
8
Q And that is entirely consistent with a benzene
09:57:43
9 induced leukemia, is it not?
09:57:48
10
A As far as that goes, that is consistent with
09:57:55
11 m o s t c a s e s o f a c h e m i c a l l y i n d u c e d l e u k e m i a .
09:57:58
12 Q O k a y .
09:58:01
13
A But there are also many examples of complex
09:58:01
14
cytogenetic changes where there was no exposure history
09:58:05
15 a t a l l . S o y o u c a n ' t s e p a r a t e o u t t h e q u a n t i t a t i v e
09:58:12
16 e x p o s u r e f r o m t h a t s i n g l e f i n d i n g .
09:58:13
17
Q Can you tell me what chemicals are known to be
09:58:17
18
capable of causing the abnormalities of chromosome 5 and
09:58:29
19 7 t h a t M r . P e a r l a n d M r . M a c h a d o h a v e ?
09:58:35
20 A I h a v e n ' t s e e n a n y e v i d e n c e o f a n y .
09:58:57
21 Q O t h e r t h a n b e n z e n e , y o u m e a n ?
09:58:59
22 A W e l l , I d o n ' t b e l i e v e t h e i r e x p o s u r e s t o
09:59:01
23 b e n z e n e w e r e s u f f i c i e n t t o d o i t e i t h e r .
09:59:03
24
Q I am not asking -- we are not tracking, doctor.
09:59:05
25 I a m n o t a s k i n g y o u p a r t i c u l a r l y a b o u t w h a t c a u s e d M r .
09:59:08
42
1 Machado's or Mr. Pearl's AML. What I am asking you is
09:59:11
2 to focus on the types of chromosome abnormalities that
09:59:17
3 they had in chromosomes 5 and 7, those abnormalities.
09:59:23
4
What I am asking you is what chemicals are you
09:59:31
5 aware of that are capable of producing those
09:59:34
6 abnormalities?
09:59:38
7 A That they would have been exposed to?
09:59:42
8 Q No.
09:59:45
9 A In general.
09:59:46
10 Q I n g e n e r a l .
09:59:46
11
A Cyclophosphamide, Melphlan. There is a variety
09:59:47
12 o f o t h e r - - t h e n i t r o g e n u r e a s , t h e n i t r o g e n m u s t a r d s .
09:59:52
13 M e l p h l a n h a s s e v e r a l c o u s i n s t h a t a r e a l l a l k y l a t i n g
10:00:00
14 a g e n t s . T h o s e a r e a l l l e u k e m o g e n i c c h e m o t h e r a p e u t i c
10:00:06
15 a g e n t s t h a t p o t e n t i a l l y c o u l d c a u s e t h e s e c h a n g e s .
10:00:12
16 Q W h a t e l s e ?
10:00:15
17
A Radiation, ionizing radiation potentially.
10:00:18
18 Q W h a t e l s e ?
10:00:24
19
A Some squirrely evidence, but there is probably
10:00:26
20 a l i t t l e b i t o f e v i d e n c e a b o u t c i g a r e t t e s m o k i n g ,
10:00:31
21
although it doesn't tend to track with those changes too
10:00:34
22 o f t e n . A n d t h e n h i g h d o s e b e n z e n e e x p o s u r e .
10:00:38
23
Q Okay. So let's consider these. There is a
10:00:43
24 w h o l e b u n c h o f d r u g s t h a t y o u m e n t i o n e d w h i c h a r e
10:00:52
25 a l k y l a t i n g a g e n t s ; c o r r e c t ?
10:00:54
43
1 A Yes.
10:00:56
2
Q Did Mr. Pearl have any exposure to those drugs
10:00:58
3 before he developed AML?
10:01:02
4 A Not to my knowledge, no.
10:01:05
5
Q Did Mr. Machado have any exposure to those
10:01:07
6 drugs before he developed AML?
10:01:12
7 A Not that I am aware of, no.
10:01:13
8
Q Did Mr. Pearl have any exposure to those drugs
10:01:17
9
before he developed the abnormalities of his chromosome
10:01:23
10 5 a n d c h r o m o s o m e 7 ?
10:01:26
11 A N o t t h a t I a m a w a r e o f .
10:01:29
12
Q Did Mr. Machado have any exposure to alkylating
10:01:31
13 a g e n t s b e f o r e h e d e v e l o p e d t h e a b n o r m a l i t i e s t o
10:01:35
14 c h r o m o s o m e s 5 a n d 7 ?
10:01:42
15 A M a c h a d o , n o , n o t t h a t I k n o w o f .
10:01:44
16
Q Did Mr. Pearl have any exposure to ionizing
10:01:50
17 r a d i a t i o n b e f o r e h e d e v e l o p e d A M L o r h i s a b n o r m a l i t i e s
10:01:53
18 o f c h r o m o s o m e 5 o r 7 ?
10:01:58
19 A N o t t h a t I a m a w a r e o f .
10:02:00
20
Q Did Mr. Machado have any exposure to ionizing
10:02:01
21 r a d i a t i o n b e f o r e h e d e v e l o p e d A M L o r t h e a b n o r m a l i t i e s
10:02:04
22 t o c h r o m o s o m e 5 a n d 7 ?
10:02:09
23 A N o t t h a t I a m a w a r e o f .
10:02:12
24 Q Y o u m e n t i o n e d s o m e s q u i r r e l y e v i d e n c e o f
10:02:16
25 c i g a r e t t e s m o k i n g ; c o r r e c t ?
10:02:19
44
1 A Yes.
10:02:20
2
Q Do I take it then that you do not consider
10:02:20
3 cigarette smoking to be an established cause of
10:02:23
4 chromosome 5 or 7 abnormalities?
10:02:26
5
A I think the literature supports that cigarette
10:02:30
6 smoking is an established cause of AML, but the
10:02:32
7 cytogenetic changes associated with that have not been
10:02:37
8 very well characterized in my view.
10:02:41
9 Q So can you answer my question?
10:02:44
10
A So I don't think 5 or 7 have very good support
10:02:46
11 f o r b e i n g a s s o c i a t e d w i t h a c i g a r e t t e s m o k i n g i n d u c e d
10:02:49
12 A M L , b u t t h e r e m i g h t b e a s i n g l e s t u d y t h a t h a s s a i d
10:02:52
13 m a y b e t h e s e a r e t h e o n e s .
10:02:56
14
Q I am trying to ask a simple question, and that
10:03:00
15 i s d o y o u c o n s i d e r c i g a r e t t e s m o k i n g t o b e a n
10:03:03
16 e s t a b l i s h e d c a u s e o f a b n o r m a l i t i e s o f c h r o m o s o m e 5 a n d
10:03:08
17 7?
10:03:13
18
A I don't have a definitive answer for that. I
10:03:17
19 d o n ' t t h i n k t h e e v i d e n c e i s v e r y s t r o n g .
10:03:19
20
Q Do you think that the evidence is less than
10:03:25
21 p r o b a b l e a t t h i s p o i n t ? A t t h i s p o i n t i t i s a
10:03:27
22 p o s s i b i l i t y , b u t i t h a s n o t b e e n e s t a b l i s h e d t o b e a
10:03:32
23 p r o b a b i l i t y ?
10:03:34
24
A I guess that would depend on your definition of
10:03:35
25 p r o b a b i l i t y , b u t I t h i n k t h a t i s f i n e . I t i s a
10:03:38
45
1 possibility. And I think there are some studies that
10:03:40
2
suggest perhaps, but then there are others that say no.
10:03:43
3
And then there is a lot of evidence that they basically
10:03:46
4 don't know.
10:03:49
5
So that would be my position, that we just do
10:03:49
6 not know the cytogenetic changes that are likely
10:03:52
7 associated with cigarette smoking induced AML.
10:03:55
8
Q And when you say, "we don't know," you mean
10:03:58
9 that you don't know; correct?
10:04:00
10
A I mean the scientific and medical community
10:04:02
11 d o e s n o t k n o w .
10:04:05
12
Q Well, with due respect, doctor, you haven't
10:04:06
13 b e e n a p p o i n t e d b y a n y m e d i c a l o r s c i e n t i f i c b o d y t o
10:04:08
14 t e s t i f y a s a n e x p e r t i n t h i s c a s e ; c o r r e c t ?
10:04:11
15 A N o o n e h a s a p p o i n t e d m e - - I t h i n k I a m
10:04:15
16 f o l l o w i n g y o u r q u e s t i o n .
10:04:18
17 Q R i g h t .
10:04:20
18
You haven't been appointed by any medical body
10:04:20
19 o r s c i e n t i f i c b o d y t o b e a n e x p e r t i n t h i s c a s e ;
10:04:23
20 c o r r e c t ?
10:04:26
21 A O h , I t h i n k I s e e w h e r e y o u a r e g o i n g .
10:04:27
22
Well, no, but I have read all of the studies
10:04:30
23
that have linked cigarette smoking to AML and those that
10:04:32
24 h a v e d i s c u s s e d t h e c y t o g e n e t i c c h a n g e s .
10:04:35
25
And I feel like I am qualified to tell you that
10:04:37
46
1 they do not show a consistent pattern of cytogenetic
10:04:43
2 changes.
10:04:44
3 Q And that is your opinion?
10:04:44
4 A That is what the scientific literature
10:04:45
5 supports.
10:04:48
6 Q In your opinion?
10:04:48
7 A Yes.
10:04:49
8
Q Okay. I would ask you if you would be kind
10:04:49
9 enough to confine your testimony to your opinions as
10:04:52
10 o p p o s e d t o t h o s e o f t h e s c i e n t i f i c a n d m e d i c a l
10:04:54
11 c o m m u n i t i e s b e c a u s e y o u h a v e n ' t b e e n a p p o i n t e d b y t h e m
10:04:57
12 t o t e s t i f y a s a n e x p e r t i n t h i s c a s e .
10:04:59
13 O k a y ?
10:05:01
14
A Well, that is a semantical argument and I will
10:05:03
15 d o w h a t I c a n . I f e e l y o u c a n p o i n t i t o u t i f y o u a r e
10:05:07
16 n o t h a p p y w i t h m y a n s w e r .
10:05:10
17
THE VIDEOGRAPHER: Counsel, there is two
10:05:12
18 m i n u t e s l e f t o n t h e t a p e .
10:05:13
19 M R . M E T Z G E R : A l l r i g h t .
10:05:15
20
Q In any event, you would agree, would you not,
10:05:17
21
that cigarette smoking did not cause the chromosome 5 or
10:05:21
22 7 a b n o r m a l i t i e s o f e i t h e r M r . M a c h a d o o r M r . P e a r l ;
10:05:29
23 c o r r e c t ?
10:05:32
24 A I w o u l d a g r e e w i t h t h a t , y e s .
10:05:33
25
Q Okay. And so it is true, is it not, that the
10:05:35
47
1
only chemical to which they were exposed which are known
10:05:40
2
to cause the chromosome 5 and chromosome 7 abnormalities
10:05:44
3 in AML is benzene?
10:05:48
4
MR. FOLEY: Objection. Lacks foundation.
10:05:51
5 Calls for speculation.
10:05:52
6
THE WITNESS: It -- the basis of that question
10:05:55
7 ignores the reality that these cytogenetic changes
10:05:58
8 happen all the time with no chemical etiology.
10:06:02
9 Q BY MR. METZGER: What is the answer to my
10:06:07
10 q u e s t i o n ?
10:06:08
11
Is it true that the only chemical to which they
10:06:09
12
were exposed which is known to cause chromosome 5 and 7
10:06:10
13 a b n o r m a l i t i e s i n A M L i s b e n z e n e ?
10:06:13
14 M R . F O L E Y : S a m e o b j e c t i o n s .
10:06:18
15
THE WITNESS: The evidence in terms of a
10:06:20
16
quantitation, you know -- one molecule of Melphlan isn't
10:06:22
17 g o i n g t o d o t h i s .
10:06:28
18
So while the answer to your question -- the
10:06:29
19 s i m p l e a n s w e r i s y e s , y o u a l s o h a v e t o i n c l u d e w h a t
10:06:31
20 t h e i r e x p o s u r e s w e r e .
10:06:35
21
And there is no evidence in any literature that
10:06:36
22
these individuals' exposures can cause those cytogenetic
10:06:39
23 c h a n g e s t o b e n z e n e . T h e i r e x p o s u r e s t o b e n z e n e , i n m y
10:06:44
24 v i e w , a r e n o t s u f f i c i e n t t o c a u s e t h e s e c h a n g e s .
10:06:48
25
MR. METZGER: Okay. We need to take a tape
10:06:52
48
1 change so why don't we take a break.
10:06:53
2
THE VIDEOGRAPHER: Now going off the record.
10:06:55
3 T i m e i s 1 0 : 0 6 a . m . T h i s i s t h e e n d o f V o l u m e 1 , t a p e 10:06:56
4 No. 1.
10:07:04
5 (Brief recess.)
10:07:05
6
THE VIDEOGRAPHER: Now back on the record.
10:18:08
7
Time is 10:58 a.m. This is the beginning of Volume 1,
10:18:18
8 tape No. 2 in the deposition of Dr. David Pyatt.
10:18:21
9 Counsel?
10:18:26
10
Q BY MR. METZGER: Dr. Pyatt, before we took a
10:18:27
11 t a p e b r e a k a n d a b r e a k , w e w e r e t a l k i n g a b o u t t h e
10:18:30
12
various things that are known to cause abnormalities of
10:18:36
13
chromosome 5 and 7 and their relevance to Mr. Pearl and
10:18:42
14 M r . M a c h a d o .
10:18:47
15
I want to ask you a broader question now, and
10:18:48
16
that is, what are the chemicals or other things that in
10:18:52
17 y o u r o p i n i o n a r e k n o w n t o c a u s e A M L ?
10:18:59
18
A Well, the majority of AML cases have no known
10:19:08
19
etiology. So 80, 85 percent of them we don't know what
10:19:11
20 c a u s e d t h e m .
10:19:17
21 Q Y o u d o n ' t k n o w ?
10:19:18
22 A T h e y a r e u n k n o w n .
10:19:20
23 Q T o y o u ?
10:19:21
24 A T o t h e s c i e n t i f i c c o m m u n i t y .
10:19:21
25
Q Doctor, please don't speak on behalf of the
10:19:24
49
1
scientific community. You can speak -- you can tell us
10:19:26
2 your own opinions.
10:19:30
3
Let me try this: You understand that you are
10:19:31
4 testifying as an expert today; correct?
10:19:34
5 A Yes.
10:19:36
6
Q You understand that different experts can have
10:19:36
7 different opinions; correct?
10:19:41
8 A Yes.
10:19:42
9
Q And when you say, "the scientific community," I
10:19:43
10 a s s u m e t h a t y o u h a v e n o t a c t u a l l y d o n e a s c i e n t i f i c
10:19:46
11 s u r v e y o f t h e s c i e n t i f i c c o m m u n i t y t o a s s e s s t h e
10:19:49
12 o p i n i o n s o f a l l o f t h e m e m b e r s o f t h e s c i e n t i f i c
10:19:53
13 c o m m u n i t y o n p a r t i c u l a r i s s u e s ; i s t h a t c o r r e c t ?
10:19:56
14
A Well, on particular issues, that is true. But
10:20:00
15 w i t h r e g a r d t o w h a t w e a r e d i s c u s s i n g r i g h t n o w , t h e r e
10:20:03
16 a r e a l i m i t e d n u m b e r o f p u b l i c a t i o n s w h e r e p e o p l e h a v e
10:20:05
17 a t t r i b u t e d a p e r c e n t a g e o f A M L c a s e s t o k n o w n f a c t o r s
10:20:09
18 a n d t o u n k n o w n f a c t o r s .
10:20:14
19
And I have read all of those papers and they
10:20:16
20
are all very consistent that say about 80 or 85 percent
10:20:18
21 o f t h e m .
10:20:22
22
Q Okay. And based on that, you can express your
10:20:23
23 o p i n i o n ?
10:20:25
24 A T h a t i s w h a t I d i d .
10:20:26
25 Q R i g h t .
10:20:27
50
1
And I would ask you please not to purport to
10:20:27
2 express opinions on behalf of the scientific community
10:20:30
3
because they have not been designated as experts in this
10:20:33
4 case and you have not done a statistical survey or
10:20:38
5 published any article regarding their opinions.
10:20:42
6 All right?
10:20:46
7 A All right.
10:20:48
8
How about this: It is my opinion that 80 or 85
10:20:48
9 percent of them are unknown, which is consistent with
10:20:51
10 a l l o f t h e p u b l i c a t i o n s t h a t e x i s t o n t h i s i s s u e .
10:20:54
11 Q T h a t ' s f i n e .
10:20:56
12
Now, I am glad that we have that squared away,
10:20:58
13 b u t t h a t w a s n ' t w h a t I a s k e d y o u - -
10:21:05
14 A R i g h t .
10:21:06
15 Q - - a t a l l .
10:21:07
16 A R i g h t .
10:21:07
17
Q What I asked you was, please tell me what are
10:21:08
18 t h o s e c h e m i c a l s o r t h i n g s t h a t , i n y o u r o p i n i o n , a r e
10:21:10
19 k n o w n t o c a u s e A M L ?
10:21:13
20
A So then when you get past the 80 or 85 percent
10:21:15
21 t h a t w e d o n ' t k n o w w h a t c a u s e s t h e m , t h e n y o u h a v e g o t
10:21:20
22 t h e m a j o r i t y o f t h e r e m a i n d e r a r e c h e m o t h e r a p e u t i c
10:21:23
23 a g e n t s , e i t h e r a l k y l a t i n g a g e n t s o r t o p o i s o m e r a s e
10:21:29
24
inhibitors, two classes of chemotherapeutic agents that
10:21:31
25 a r e e s t a b l i s h e d l e u k e m o g e n i c c h e m i c a l s .
10:21:35
51
1
Then there is ionizing radiation. There is
10:21:41
2 high dose chronic exposure to benzene. There is
10:21:46
3 cigarette smoking. There are some viruses associated
10:21:49
4 with some types of leukemia but not AML.
10:21:52
5 So those -- that would be the list.
10:21:56
6 Q Okay. So is it true that Mr. -- neither
10:21:59
7 Mr. Pearl nor Mr. Machado nor Mr. Hazlehurst had
10:22:04
8 exposure to any chemotherapeutic agents prior to their
10:22:14
9 AML diagnosis?
10:22:20
10 A N o t t h a t I h a v e s e e n , n o . T h a t i s t r u e .
10:22:22
11
Q Okay. And that includes both alkylating agents
10:22:25
12 a n d t o p o i s o m e r a s e i n h i b i t o r s , t h e y h a d n o e x p o s u r e t o
10:22:28
13 t h o s e c l a s s e s o f d r u g s b e f o r e t h e y w e r e d i a g n o s e d w i t h
10:22:33
14 A M L ; c o r r e c t ?
10:22:36
15 A T h e y h a v e h a d n o e x p o s u r e t o t h e
10:22:38
16 c h e m o t h e r a p e u t i c a g e n t s t h a t a c t l i k e t o p o i s o m e r a s e
10:22:40
17
inhibitors. There is literature that we are all exposed
10:22:45
18 t o d r u g s o r c h e m i c a l s i n o u r d i e t t h a t m a y b e
10:22:48
19 t o p o i s o m e r a s e i n h i b i t o r s , b u t I d o n ' t b e l i e v e t h a t i s
10:22:53
20 w h a t c a u s e d t h e i r l e u k e m i a e i t h e r .
10:22:57
21
Q Okay. And is it true that Mr. -- none of the
10:22:59
22 p l a i n t i f f s i n t h e s e c a s e s h a d e x p o s u r e t o i o n i z i n g
10:23:02
23 r a d i a t i o n b e f o r e t h e y d e v e l o p e d t h e i r A M L ' s ?
10:23:05
24 A N o t t o m y k n o w l e d g e , n o .
10:23:08
25 Q T h a t ' s t r u e , w h a t I s a i d ?
10:23:10
52
1 A I'm sorry. Yes, that is true.
10:23:11
2
Q Okay. And is it true that cigarette smoking,
10:23:13
3 in your opinion, did not cause Mr. Pearl's and Mr.
10:23:17
4 Machado's leukemias?
10:23:21
5 A That is true.
10:23:24
6
Q Okay. Do you have an opinion as to whether
10:23:25
7 cigarette smoking caused the AML of Mr. Hazlehurst?
10:23:27
8
A I don't know whether it caused Mr. Hazlehurst's
10:23:33
9 AML or not, but I can say that cigarette smoking is an
10:23:36
10
established etiological risk factor for AML and I don't
10:23:41
11 t h i n k y o u c a n c o m p l e t e l y r u l e i t o u t .
10:23:45
12
Q All right. And why can't you completely rule
10:23:53
13 i t o u t ?
10:24:00
14
A Because it's an established risk factor for AML
10:24:03
15
and he had a sufficient exposure history of smoking that
10:24:08
16 w o u l d p u t h i m a t a n e l e v a t e d r i s k .
10:24:15
17
Q Benzene is an established risk factor for AML,
10:24:18
18 i s i t n o t ?
10:24:22
19 A C e r t a i n e x p o s u r e s c e n a r i o s , y e s .
10:24:23
20
Q But you are able to rule out benzene but not
10:24:30
21
cigarette smoking as the cause of Mr. Hazelhurst's AML?
10:24:32
22 A I a m .
10:24:38
23
The benzene has been quantitated so his benzene
10:24:41
24
exposure has numbers associated with it. The cigarette
10:24:44
25 s m o k i n g , l e s s s o .
10:24:48
53
1
And the epidemiologic literature, in my view,
10:24:48
2 is better in terms of the quantitation of benzene
10:24:51
3 required to give someone AML.
10:24:56
4
Cytogenetics for Mr. Hazlehurst are not
10:24:59
5 consistent with a chemical etiology, which would also,
10:25:02
6
in my view, limit the probability that cigarette smoking
10:25:06
7 caused his AML. I would think that those are probably
10:25:11
8 going to be cytogenetically abnormal as well.
10:25:16
9
But I don't think you can completely rule it
10:25:19
10 o u t b e c a u s e t h e r e i s q u i t e a b i t o f d i s c u s s i o n ,
10:25:21
11 a r g u m e n t , v a r i a b i l i t y , u n c e r t a i n t y a r o u n d t h e
10:25:25
12 c y t o g e n e t i c c h a n g e s a s s o c i a t e d w i t h s m o k i n g .
10:25:28
13
Q Okay. Now, you mentioned earlier something
10:25:35
14 a b o u t a h y p o c e l l u l a r m a r r o w .
10:25:41
15 F i r s t o f a l l , w h a t i s t h a t ?
10:25:47
16
A That when you go in and look in a person's bone
10:25:52
17
marrow with biopsies, there is a cellularity component,
10:25:55
18
how many cells are in there and the rest of the space is
10:26:02
19 f i l l e d u p w i t h f a t .
10:26:05
20
And you can have a hypercellular, too many
10:26:07
21 c e l l s i n t h e m a r r o w w h e r e y o u g o i n a n d l o o k a n d t h e r e
10:26:10
22
is not as much fat as you would expect and there is more
10:26:14
23 c e l l s .
10:26:19
24
Or you could have a hypocellular, which is too
10:26:19
25 f e w c e l l s i n t h e m a r r o w t h a t y o u w o u l d e x p e c t b a s e d o n
10:26:22
54
1 the age and the person.
10:26:26
2
Q And what -- when you mentioned a hypocellular
10:26:29
3 marrow, what was the significance of that to you?
10:26:35
4 A That in alkylating chemotherapy and some
10:26:38
5
literature on benzene, high exposure to benzene results
10:26:44
6 in a hypocellular marrow.
10:26:48
7
And that is frequently seen in myelodysplasias
10:26:51
8 that precede the development of AML following exposure
10:26:55
9 to alkylating chemotherapy.
10:26:59
10
So this bone marrow damage that is manifest as
10:27:02
11 a p e r i p h e r a l p a n c y t o p e n i a a n d s e e n i n t h e m a r r o w a s a
10:27:05
12 h y p o c e l l u l a r m a r r o w i s c o n s i s t e n t w i t h s e v e r e c h e m i c a l
10:27:10
13 i n s u l t .
10:27:14
14
Q And what is the relevance of that to these
10:27:17
15 c a s e s t h a t w e h a v e h e r e ?
10:27:19
16
A Well, I don't think it has much relevance to
10:27:25
17 t h e s e c a s e s b e c a u s e n o n e o f t h e s e p a t i e n t s o r
10:27:28
18 i n d i v i d u a l s h a d t h e l e v e l s o f b e n z e n e t h a t w o u l d c a u s e
10:27:32
19 a n y k i n d o f b o n e m a r r o w d a m a g e .
10:27:32
20 Q W e l l , I a m n o t q u i t e u n d e r s t a n d i n g .
10:27:35
21
Are you suggesting that Mr. Pearl, Mr.
10:27:37
22 H a z l e h u r s t a n d M r . M a c h a d o d i d n o t h a v e a h y p o c e l l u l a r
10:27:41
23 b o n e m a r r o w ?
10:27:47
24
A You asked me about what I thought an alkylating
10:27:50
25 a g e n t A M L w o u l d l o o k l i k e , a n d t h a t i s w h e r e I l i s t e d
10:27:55
55
1 the hypocellular marrow as a characteristic associated
10:28:00
2 with that type of chemical exposure.
10:28:04
3 Q I see.
10:28:07
4
So I think you are absolutely right. I
10:28:07
5 couldn't remember the context.
10:28:11
6
So you mentioned that a hypocellular marrow, a
10:28:13
7
preceding pancytopenia and myelodysplastic syndrome were
10:28:17
8 all characteristic of an alkylating induced AML?
10:28:24
9
A That is correct. And to the extent that it has
10:28:29
10 b e e n e v a l u a t e d , i t i s a l s o s o m e w h a t c o n s i s t e n t w i t h a
10:28:31
11 b e n z e n e i n d u c e d p r o c e s s .
10:28:36
12
Q What do you mean it is somewhat consistent with
10:28:37
13 a b e n z e n e i n d u c e d p r o c e s s ?
10:28:39
14
A Well, we just don't know as much. We just
10:28:41
15 d o n ' t k n o w a s m u c h a b o u t a n d b e n z e n e i t s a b i l i t y t o
10:28:44
16 c a u s e A M L a n d w h a t t h o s e d i s e a s e s l o o k l i k e .
10:28:48
17
There are studies going on now that potentially
10:28:51
18
will answer some of those questions, but we know a whole
10:28:53
19
lot more about people that get AML in the clinic and we
10:28:57
20 c a n f o l l o w t h e m a n d l o o k a t t h e i r c y t o g e n e t i c s a n d a l l
10:29:00
21 t h e s e o t h e r a s p e c t s t h a t w e a r e n o t r e a l l y a b l e t o d o
10:29:05
22 w i t h b e n z e n e .
10:29:07
23
Q There have been enumerable case reports over
10:29:09
24 t h e y e a r s , o v e r n e a r l y a c e n t u r y o f b e n z e n e i n d u c e d
10:29:14
25 h e m a t o l o g i c d i s e a s e . T r u e ?
10:29:18
56
1
A Well, I think it was just a figure of speech.
10:29:23
2 I don't know what "enumerable" means, but there have
10:29:25
3 been many.
10:29:28
4 Q There has been a whole lot?
10:29:29
5 A Yes, there has been a whole lot.
10:29:31
6
Q And you have reviewed those, have you not?
10:29:32
7
A I have reviewed them, probably not all of them.
10:29:34
8 I mean some were published in the teens, the twenties,
10:29:36
9 the thirties. And I couldn't get all of them, but I
10:29:38
10 h a v e r e v i e w e d m a n y o f t h e m .
10:29:42
11
Q You made an effort to do that as part of your
10:29:43
12 r e s e a r c h ; c o r r e c t ?
10:29:47
13 A Y e s , y e s .
10:29:48
14
Q And the marrows in those -- they are typically
10:29:52
15 w o r k e r s , a r e t h e y n o t ?
10:29:55
16 A Y e s .
10:29:56
17
Q The marrows in those workers who are exposed to
10:29:56
18 b e n z e n e a r e s o m e t i m e s h y p o c e l l u l a r ; c o r r e c t ?
10:30:02
19 A S o m e t i m e s h y p o c e l l u l a r ?
10:30:06
20 Q Y e s .
10:30:08
21 A Y e s .
10:30:09
22
Q And they are sometimes hypercellular; correct?
10:30:09
23
A There are definitely studies that would suggest
10:30:12
24 t h a t , y e s .
10:30:14
25 Q B e n z e n e c a n c a u s e b o t h t y p e s o f d a m a g e ,
10:30:15
57
1 hypocellularity and hypercellularity. True?
10:30:19
2
A Well, that is not totally known. I mean just
10:30:25
3 because there is a case report where they report a
10:30:28
4
hypercellular marrow, well, maybe that had something to
10:30:31
5 do with their benzene and maybe it did not. And you
10:30:34
6 could make the same argument with the hypocellular.
10:30:37
7
In my view, a hypocellular marrow is a more
10:30:40
8 consistent pathological picture for a benzene or an
10:30:44
9 alkylating agent induced AML.
10:30:47
10
Q Well, have you actually looked at those case
10:30:50
11
reports where workers heavily exposed to benzene, pure
10:30:53
12
benzene, had developed hematologic malignancy and their
10:31:00
13 m a r r o w s w e r e e v a l u a t e d ?
10:31:07
14
Have you looked at those to determine what
10:31:08
15 p e r c e n t a g e o f t h e m h a d h y p e r c e l l u l a r m a r r o w s a n d w h a t 10:31:10
16 p e r c e n t a g e o f t h e m h a d h y p o c e l l u l a r m a r r o w s ?
10:31:15
17
A I haven't ever done, you know, a five to three
10:31:20
18
comparison. Aksoy has published several review papers
10:31:23
19 w h e r e t h a t i s e x a c t l y w h a t h e d i d .
10:31:28
20
And you are correct, there are examples of
10:31:30
21
where, in his view, they were attributable to benzene.
10:31:33
22
And there is some that are hyper and there is some that
10:31:36
23
are hypo. I think the hypo are in a greater quantity,
10:31:39
24 b u t t h a t d o e s n ' t m e a n t h a t t h e h y p e r c a n n o t h a p p e n .
10:31:45
25
Rich Irons published a paper in 2005 out of
10:31:48
58
1 China and that is probably the most recent analysis of
10:31:52
2 what the bone marrow looks like in highly exposed
10:31:57
3
workers and in that case the majority were hypocellular.
10:32:01
4
Q And none of those, the subjects of Dr. Irons'
10:32:07
5 study, actually had AML. True?
10:32:12
6 A They did not have AML.
10:32:15
7 Q Okay. You also mentioned a preceding
10:32:17
8 pancytopenia.
10:32:23
9
Did either Mr. Pearl or Mr. Hazlehurst or Mr.
10:32:26
10 M a c h a d o h a v e t h a t ?
10:32:29
11 A N o t t h a t I r e c a l l . T h e r e w a s o n e m e d i c a l
10:32:37
12 r e p o r t o f M r . M a c h a d o - - I t h i n k i t i s M r . M a c h a d o - -
10:32:44
13 w h e r e i n ' 8 9 h e h a d s u r g e r y a n d t h e y s a w s o m e b l o o d
10:32:50
14 a b n o r m a l i t i e s t h a t , i f i t w e r e p e r s i s t e n t , t h e y m i g h t
10:32:53
15 c l a s s i f y i t a s p a n c y t o p e n i a , b u t a l l t h a t I s a w r e c o r d
10:32:58
16 o f w a s l y m p h o c y t o p e n i a a t t h a t o n e s n a p s h o t .
10:33:05
17
When a person develops AML, there is frequently
10:33:07
18
going to be pancytopenia at the time of diagnosis. I am
10:33:10
19 n o t s u r e t h a t t h a t r e a l l y t e l l s y o u a n y t h i n g a b o u t t h e
10:33:14
20 e t i o l o g y .
10:33:16
21
So this would be six months, a year previous to
10:33:17
22 t h e d i a g n o s i s w h e r e t h e y w e r e s e e i n g p e r s i s t e n t
10:33:18
23
refractory type changes in the blood. And I did not see
10:33:23
24 e v i d e n c e o f t h a t i n a n y o f t h e s e t h r e e p e o p l e .
10:33:28
25
Q Incidentally, regarding that cytopenia that you
10:33:30
59
1 observed in the medical records regarding Mr. Machado
10:33:34
2 when he was -- that was in connection with a surgery
10:33:37
3 that he had, was it not?
10:33:40
4
A It was prior to the surgery, getting ready for
10:33:41
5 it, that is my understanding, yes.
10:33:44
6 Q And you don't -- do you attribute any
10:33:45
7 significance to that finding to the etiology, to the
10:33:48
8 cause or progression of his AML?
10:33:50
9
A I think that it would be really hard to say. I
10:33:55
10
mean it was a single snapshot in time. It did indicate
10:33:57
11
at least at that one point there was something going on
10:34:00
12 w i t h h i s b l o o d .
10:34:03
13 Q A r e y o u a h e m a t o l o g i s t , b y t h e w a y ?
10:34:05
14 A N o .
10:34:07
15
Q Okay. Are you prepared to tell the jury in
10:34:07
16 t h i s c a s e t h a t h e h a d h i s d i s e a s e b a c k a t t h e t i m e h e
10:34:10
17 h a d t h a t s u r g e r y ?
10:34:13
18 A " H i s d i s e a s e , " b e i n g h i s A M L ?
10:34:16
19 Q Y e s .
10:34:18
20 A N o , n o .
10:34:19
21
Q Okay. Now, in your opinion is a preceding
10:34:19
22 p a n c y t o p e n i a c o n s i s t e n t w i t h a b e n z e n e i n d u c e d A M L ?
10:34:31
23
A I think there is evidence to support that, yes.
10:34:45
24
Q In your opinion, is the absence of a preceding
10:34:48
25 p a n c y t o p e n i a c o n s i s t e n t w i t h a b e n z e n e i n d u c e d A M L ?
10:34:55
60
1
A It is less so. I don't think -- it's not a
10:35:01
2 black or white issue. You can't say definitively that
10:35:04
3
if you have it or you don't have it that that is the be
10:35:08
4
all and end all, and therefore you can totally rule out
10:35:11
5 etiology.
10:35:15
6
But I do think that pancytopenia or evidence of
10:35:15
7 blood changes associated with marrow damage is
10:35:20
8 consistent with the pathology of benzene induced AML.
10:35:22
9
Q When you say that a -- that the absence of
10:35:28
10 p r e c e d i n g p a n c y t o p e n i a i s c o n s i s t e n t w i t h a b e n z e n e
10:35:31
11 i n d u c e d l e u k e m i a b u t l e s s s o , a r e y o u a b l e t o q u a n t i f y
10:35:39
12 t h e l e s s s o f o r m e ?
10:35:43
13
A You mean how much less consistent it is? No, I
10:35:47
14 c o u l d n ' t p u t a n u m b e r o n i t .
10:35:50
15 Q O k a y .
10:35:52
16
A But I do believe that it is inconsistent with
10:35:53
17 o u r u n d e r s t a n d i n g .
10:35:56
18 Q W i t h y o u r u n d e r s t a n d i n g ?
10:35:57
19 A W i t h - - r i g h t , m y u n d e r s t a n d i n g a n d t h e
10:35:58
20 p u b l i s h e d l i t e r a t u r e o n t h i s t o p i c .
10:36:02
21
Q Okay. Now, you also mentioned myelodysplastic
10:36:05
22 s y n d r o m e i n c o n n e c t i o n w i t h - - t h a t a p r e c e d i n g
10:36:12
23 m y e l o d y s p l a s t i c s y n d r o m e i s c o n s i s t e n t w i t h a
10:36:17
24 c h e m o t h e r a p y i n d u c e d A M L .
10:36:21
25 D i d I g e t t h a t r i g h t ?
10:36:24
61
1 A You did.
10:36:26
2
I mean I don't want to quibble, but there are
10:36:26
3 two big classes of chemotherapeutic agents and the
10:36:30
4 topoisomerase drugs will rarely have a preceding
10:36:33
5 myelodysplasia.
10:36:39
6
Q Okay. With a preceding alkylating induced AML?
10:36:42
7 A Yes, yes.
10:36:46
8
Q Did any of the three plaintiffs in these cases
10:36:49
9 have a preceding myelodysplastic syndrome?
10:36:52
10 A N o t t h a t I r e c a l l , n o .
10:36:56
11 Q H a v e y o u r e a d t h e d e p o s i t i o n s o f t h e
10:37:02
12 p l a i n t i f f s ' h e m a t o l o g i s t i n t h i s c a s e ?
10:37:04
13 A W h o i s t h a t , D r . G a l e ?
10:37:08
14 Q Y e s .
10:37:09
15 A I t r i e d . I t w a s a v e r y d i f f i c u l t r e a d .
10:37:12
16 Q W h a t d o y o u m e a n i t w a s a d i f f i c u l t r e a d ?
10:37:16
17
A I mean it was just a very difficult read. It
10:37:18
18 w a s h a r d t o f o l l o w . T h e r e w a s s o m u c h s e m a n t i c a l
10:37:20
19 a r g u m e n t , t h e r e w a s v e r y f e w q u e s t i o n s t h a t w e r e
10:37:25
20 a n s w e r e d d i r e c t l y .
10:37:28
21
It was hard for me to get at what the defense
10:37:29
22
attorney was asking and what his answer was. Sometimes
10:37:33
23
it would go on for pages before he would ever answer it.
10:37:36
24
And then I had forgotten what the original question was.
10:37:39
25
I am just telling you for me, it was a hard
10:37:42
62
1 thing to read.
10:37:44
2
Q Okay. Do you recall what Dr. Gale's opinion
10:37:45
3 was as to whether Mr. Machado had a preceding
10:37:51
4 myelodysplastic syndrome?
10:37:55
5 A I do not.
10:37:57
6 Q Okay. Have you read the deposition of
10:37:58
7 Dr. Bennett?
10:38:00
8
A No. My understanding is that it is still going
10:38:01
9 on.
10:38:04
10
Q Okay. Is a preceding myelodysplastic syndrome
10:38:06
11 c o n s i s t e n t w i t h i n d u c e d A M L ?
10:38:15
12
A With the caveat that we know less about what a
10:38:18
13
benzene induced AML is going to look like, I think that
10:38:21
14 i t i s , y e s .
10:38:25
15
Q Is the absence of a preceding myelodysplastic
10:38:25
16 s y n d r o m e c o n s i s t e n t w i t h a b e n z e n e i n d u c e d A M L ?
10:38:27
17
A With the caveat that I just described, that we
10:38:33
18
know less about the pathology of these diseases, I would
10:38:35
19 s a y t h a t t h a t i s i n c o n s i s t e n t w i t h a b e n z e n e i n d u c e d
10:38:38
20 A M L , t h e a b s e n c e o f a p r e c e d i n g m y e l o d y s p l a s i a .
10:38:42
21
Q Have you read the literature regarding that
10:38:51
22 p a r t i c u l a r i s s u e ?
10:38:55
23 A I h a v e .
10:38:55
24
Q And what does -- you have read Aksoy about
10:38:57
25 t h a t ?
10:39:03
63
1 A Uh-huh.
10:39:03
2 Q And what does Aksoy say about that?
10:39:04
3
A When Aksoy was writing, I am not even sure he
10:39:07
4 was using the terminology myelodysplasia.
10:39:10
5
Q Isn't it true that Aksoy -- well, Muzaffer
10:39:13
6 Aksoy was a Turkish hematologist who saw a lot of
10:39:15
7 benzene induced leukemias and other diseases from
10:39:20
8
Turkish shoe workers who were exposed to benzene; right?
10:39:25
9
A I wouldn't agree with that per say. I would
10:39:29
10 a g r e e t h a t h e w a s a T u r k i s h h e m a t o l o g i s t t h a t r e p o r t e d
10:39:32
11
on diseases that he believed might have been associated
10:39:37
12 w i t h t h e b e n z e n e e x p o s u r e .
10:39:39
13
Q Okay. And isn't it true that he concluded that
10:39:41
14 y o u d i d n ' t h a v e t o h a v e a p r e c e d i n g m y e l o d y s p l a s t i c
10:39:46
15 s y n d r o m e f o r b e n z e n e t o c a u s e l e u k e m i a ?
10:39:50
16
A I think he concluded that many of the cases
10:39:53
17
that he attributed to benzene had a pre-leukemic phase,
10:39:56
18 w h i c h i s w h a t h e c a l l e d i t . H e w a s n o t u s i n g t h e
10:40:00
19 t e r m i n o l o g y t h a t w e a r e u s i n g t o d a y .
10:40:03
20 Q O k a y .
10:40:05
21
A And I think the pre-leukemic phase, based on
10:40:06
22
current hematological diagnostic criteria would probably
10:40:09
23 b e m y e l o d y s p l a s i a , b u t i t d i d n ' t h a v e t o b e t h e r e , n o .
10:40:14
24 Q T h a t i s w h a t h e c o n c l u d e d ?
10:40:18
25 A Y e s .
10:40:19
64
1
Q All right. And are there other researchers who
10:40:19
2 have concluded likewise with Dr. Aksoy that you don't
10:40:26
3
have to have a preceding pre-leukemic or myelodysplastic
10:40:29
4 phase to have a benzene induced leukemia?
10:40:34
5
A My appreciation of the literature is that that
10:40:39
6 is more commonly seen than not.
10:40:42
7 Q Move to strike as non responsive.
10:40:44
8
What is the answer to my question, doctor?
10:40:46
9 A I thought I answered your question.
10:40:48
10
Q No. I will ask the court reporter to read it
10:40:51
11 b a c k a n d i f y o u c o u l d a n s w e r t h a t q u e s t i o n .
10:40:53
12 A O k a y .
10:40:54
13 ( R e c o r d r e a d . )
10:40:54
14
THE WITNESS: Well, all I can answer is what
10:41:22
15 o t h e r r e s e a r c h e r s h a v e p u b l i s h e d a n d w h a t I h a v e b e e n
10:41:23
16 a b l e t o g l e a n f r o m t h e i r p u b l i c a t i o n s .
10:41:26
17 Q B Y M R . M E T Z G E R : I a m n o t a s k i n g y o u t o
10:41:29
18 i n t e r p r e t t h e i r p u b l i c a t i o n s . I a m a s k i n g y o u w h e t h e r
10:41:31
19 y o u a r e a w a r e o f a n y o t h e r r e s e a r c h e r s l i k e D r . A k s o y
10:41:34
20 w h o h a v e c o n c l u d e d t h a t y o u d o n ' t h a v e t o h a v e a
10:41:37
21
preceding pre-leukemic or myelodysplastic phase to have
10:41:41
22 a b e n z e n e i n d u c e d l e u k e m i a ?
10:41:48
23
A I can't put my finger on one, but I wouldn't
10:41:50
24 a r g u e t h a t t h e y a r e o u t t h e r e .
10:41:53
25
Q Okay. Regarding the six -- I think it was six
10:41:54
65
1 cases in which you have given depositions this year
10:42:11
2
regarding benzene and AML or other hematologic diseases,
10:42:15
3
in every one of those cases was it your opinion that the
10:42:25
4
plaintiff was not exposed to enough benzene to cause the
10:42:28
5 disease?
10:42:31
6
A No. Sometimes my opinion was that the exposure
10:42:32
7
was irrelevant because no dose of benzene can cause that
10:42:35
8 disease.
10:42:37
9
Q Okay. So let me ask that then with respect to
10:42:38
10 t h e A M L c a s e s i n w h i c h y o u g a v e d e p o s i t i o n s t h i s y e a r ,
10:42:43
11 i s i t t r u e t h a t i n e v e r y o n e o f t h o s e c a s e s , y o u h a v e
10:42:49
12 t e s t i f i e d t h a t t h e b e n z e n e e x p o s u r e t h a t t h e p l a i n t i f f
10:42:56
13 h a d w a s i n s u f f i c i e n t t o c a u s e t h e p l a i n t i f f ' s A M L ?
10:42:59
14
A In the cases where that has been discussed,
10:43:07
15 t h a t h a s b e e n m y c o n c l u s i o n , y e s , t h a t n o n e o f t h e s e
10:43:09
16 i n d i v i d u a l s h a d s u f f i c i e n t b e n z e n e e x p o s u r e t o b r i n g
10:43:12
17 t h e m u p t o w h e r e I w o u l d c o n s i d e r t h e i r r i s k t o b e
10:43:16
18 s i g n i f i c a n t l y e l e v a t e d .
10:43:19
19
Q What do you mean by significantly elevated?
10:43:23
20 A W e h a v e a l r e a d y d i s c u s s e d t h a t . I t i s a
10:43:26
21 s t a t i s t i c a l l y s i g n i f i c a n t l y e l e v a t e d f i n d i n g i n t h e
10:43:29
22 q u a n t i t a t i v e l i t e r a t u r e t h a t i s c o n s i s t e n t a m o n g
10:43:32
23 d i f f e r e n t s t u d i e s .
10:43:36
24
Q Okay. Now, expanding the question beyond just
10:43:37
25
this year, in all the cases in which you have testified
10:43:42
66
1 where the plaintiff had AML, was it your opinion that
10:43:47
2
the plaintiff had not been exposed to enough benzene to
10:43:50
3 cause his AML?
10:43:54
4 A Yes.
10:43:55
5
Q And in all of the cases where the plaintiff did
10:43:57
6 not have AML, was it your opinion that benzene didn't
10:43:59
7 cause the disease because it doesn't cause the disease
10:44:02
8 in your opinion?
10:44:05
9
A Out of the ones that I have been deposed in,
10:44:10
10 y e s , t h a t i s t r u e .
10:44:12
11
Q What percentage of the cases that you consult
10:44:24
12 o n a r e y o u a c t u a l l y d e p o s e d i n ?
10:44:27
13
A From 2008 it was pretty high, which is why I
10:44:32
14
have given five or six depositions. 2007 I probably did
10:44:35
15 m o r e l i t i g a t i o n t y p e w o r k , b u t I o n l y g a v e o n e o r t w o
10:44:42
16 d e p o s i t i o n s . T h e y j u s t d i d n ' t g o v e r y f a r . S o i t ' s
10:44:45
17 h a r d t o s a y .
10:44:47
18 Q O k a y .
10:44:49
19
A I have been very busy this year so I really
10:44:50
20
have not done as much litigation work as I have in other
10:44:53
21 y e a r s .
10:44:57
22
Q Well, how much work do you do in other years?
10:44:59
23
A Oh, I try to keep it about 25 or 30 percent of
10:45:03
24 m y p r o f e s s i o n a l t i m e s p e n t . A n d t h a t i s g o i n g t o v a r y
10:45:07
25 d e p e n d i n g o n t h e d u r a t i o n o f t i m e t h a t y o u a r e l o o k i n g
10:45:11
67
1 at. It gets busy, then it goes away, and then it gets
10:45:17
2 busy again.
10:45:19
3 Q Okay.
10:45:19
4
A But I think over the course of my career since
10:45:20
5 I started testifying, I think that is a pretty fair
10:45:22
6 guess.
10:45:25
7
Q And this litigation work that you do which
10:45:26
8 compromises about 25 -- you try to keep about 25 to 30
10:45:28
9 percent of your time, what percentage of your income
10:45:32
10 d o e s t h a t w o r k g e n e r a t e ?
10:45:35
11 A T h a t i s a g o o d q u e s t i o n . P r o b a b l y m o r e .
10:45:40
12 Q M o r e t h a n w h a t ?
10:45:44
13
A Probably would be more than 25 or 30 percent
10:45:46
14
because a lot of my time -- like this past fall I spent
10:45:48
15
quite a bit of time teaching a toxicology class, but the
10:45:52
16 u n i v e r s i t y p a y s m e v e r y l i t t l e .
10:45:57
17
So if you average it all out, then the
10:45:58
18 l i t i g a t i o n m i g h t b e 4 0 o r 5 0 p e r c e n t o f m y , y o u k n o w ,
10:46:00
19 t o t a l i n c o m e .
10:46:03
20 Q O k a y . I t ' s a g o o d g i g ?
10:46:04
21
A What is that, the teaching? I like teaching.
10:46:09
22 Q O k a y . L e t ' s s e e . L e t ' s g o b a c k t o y o u r
10:46:14
23 o p i n i o n s .
10:46:24
24
You mentioned at one point in your testimony
10:46:29
25 G l a s s - - I t h i n k y o u s a i d t h e G l a s s s t u d y .
10:46:34
68
1 What study were you referring to?
10:46:38
2
A The publication from 2003 that she published
10:46:41
3 from the Health Watch Series.
10:46:47
4 Q Is that that article in the "Journal of
10:46:49
5 Epidemiology" --
10:46:52
6 A Yes.
10:46:54
7
Q -- entitled something like "Low Dose Exposure
10:46:55
8 to Benzene and Leukemia," something like that?
10:46:58
9
A That sounds right. I have it around here, but
10:47:02
10 y e s , t h a t s o u n d s - -
10:47:05
11 Q Y o u b r o u g h t t h a t w i t h y o u ?
10:47:05
12 A U h - h u h .
10:47:07
13 Q Y e s ?
10:47:08
14 A Y e s .
10:47:08
15
Q And is that something that the attorneys gave
10:47:14
16
you or something that you were familiar with before this
10:47:16
17 c a s e ?
10:47:18
18 A I w a s f a m i l i a r w i t h i t b e f o r e .
10:47:19
19
Q Okay. There is also a very large report that
10:47:22
20 w a s p u b l i s h e d . I t ' s t h e c a s e c o n t r o l s t u d y o f t h e
10:47:28
21 A u s t r a l i a n c o h o r t .
10:47:37
22
Do you know what report I am talking about?
10:47:39
23 A N o .
10:47:41
24
Q You are aware that there are the annual -- not
10:47:45
25 n e c e s s a r i l y a n n u a l b u t p e r i o d i c r e p o r t s , H e a l t h W a t c h
10:47:51
69
1 10, 11, 12 out of Australia?
10:47:55
2 A Yes.
10:47:58
3 Q Are you aware that there was also a large
10:47:58
4 report which is a case control study entitled, "Lympho
10:48:01
5 Hematopoietic Cancer in the Australian Cohort,"
10:48:04
6 something of that effect?
10:48:08
7
A I am very familiar with the technical report
10:48:10
8 that has that title.
10:48:13
9 Q That report.
10:48:14
10 A O k a y .
10:48:15
11 Q O k a y . S o y o u h a v e r e a d t h a t r e p o r t ?
10:48:15
12 A Y e s .
10:48:17
13
Q And is that something that the attorneys gave
10:48:17
14 y o u t o r e a d f o r t h i s c a s e ?
10:48:19
15 A N o .
10:48:20
16 Q Y o u w e r e f a m i l i a r w i t h t h a t b e f o r e ?
10:48:20
17 A I w a s .
10:48:21
18
Q Okay. I want to ask you some questions about
10:48:23
19
the subjects that Mr. Carr mentioned he might be asking
10:49:09
20 y o u a b o u t . O n e o f t h o s e w a s - - I t h i n k h e m e n t i o n e d
10:49:17
21 l i f e t i m e c u m u l a t i v e d o s e o f b e n z e n e .
10:49:23
22
Do you have an opinion -- well, I think you
10:49:31
23
mentioned earlier that benzene is in some food items and
10:49:34
24 i t ' s i n t h e a i r t h a t w e b r e a t h e ; c o r r e c t ?
10:49:38
25 A Y e s .
10:49:41
70
1
Q Do you have an opinion whether the cumulative
10:49:41
2 dose of benzene that we all receive from inhaling the
10:49:46
3 air wherever we live is a cause of leukemia?
10:49:50
4
A It is my opinion that it is not a cause of
10:50:02
5 leukemia.
10:50:05
6
Q And why do you consider that not to be a cause
10:50:06
7 of leukemia?
10:50:09
8
A Because it takes a lot more benzene to give a
10:50:11
9
person leukemia than what you are going to be exposed to
10:50:14
10 f r o m j u s t b a c k g r o u n d l i v i n g i n a n u r b a n e n v i r o n m e n t .
10:50:17
11
Q Do you know what a lifetime cumulative dose of
10:50:23
12 b e n z e n e i s f r o m i n h a l i n g t h e a i r i n C a l i f o r n i a ?
10:50:26
13
A I don't off the top of my head. It wouldn't be
10:50:31
14 t h a t d i f f i c u l t t o f i g u r e o u t , b u t n o , I d o n ' t .
10:50:34
15
Q Okay. In any event, it is your opinion that
10:50:36
16
the -- even though we are constantly exposed to benzene
10:50:41
17
by inhaling it in the air, that that low level exposure
10:50:44
18 t o b e n z e n e c o n t i n u o u s l y t h r o u g h o u t o u r l i f e d o e s n ' t
10:50:49
19 s i g n i f i c a n t l y i n c r e a s e t h e r i s k o f l e u k e m i a ?
10:50:54
20 A T h a t i s m y o p i n i o n , y e s .
10:50:59
21
Q Okay. Mr. Carr said that he was going to ask
10:51:29
22 y o u t o t e s t i f y a b o u t h e m a t o t o x i c i t y a n d g e n o t o x i c i t y .
10:51:33
23 W h a t a r e y o u r o p i n i o n s a b o u t t h a t ?
10:51:40
24
A I don't know. It would depend on what you are
10:51:44
25
asking. I mean I don't -- ask a question and I will try
10:51:47
71
1
to answer it, but I am not sure what -- that's just very
10:51:52
2 vague.
10:51:58
3
Q I agree, it is, and that is what he said so...
10:51:58
4 A Right.
10:52:01
5
Q So as you sit here right now, are there any
10:52:02
6 particular opinions regarding the hematotoxicity of
10:52:05
7 benzene that you have formed for this case?
10:52:07
8
A Well, I mean I think part of it might be that
10:52:11
9
low levels of benzene or, you know -- that is debatable
10:52:18
10 w h a t l o w i s , b u t l e v e l s o f b e n z e n e h a v e b e e n s h o w n t o
10:52:23
11 c a u s e c y t o p e n i a i n s o m e e x p o s e d w o r k e r s ; a n d t h a t t h a t
10:52:26
12 d o e s n o t n e c e s s a r i l y i m p l y t h a t t h o s e i n d i v i d u a l s a r e
10:52:31
13 g o i n g t o h a v e a n i n c r e a s e d r i s k o f A M L .
10:52:34
14
And you cannot extrapolate and say since you
10:52:37
15 s e e a s u b t l e c h a n g e i n t h e i r p e r i p h e r a l l y m p h o c y t e s ,
10:52:40
16 t h a t a l s o h e r e g o m e a n s t h a t t h a t p e r s o n i s a t a n
10:52:44
17 e l e v a t e d r i s k o f A M L ; t h a t t h o s e a r e d i f f e r e n t .
10:52:48
18
With the genotoxicity, I am assuming we were
10:52:52
19
talking about the doses of benzene that have been shown
10:52:55
20 t o c a u s e c y t o g e n e t i c d a m a g e a n d t h o s e a r e p r e t t y h i g h .
10:53:00
21 Q H o w h i g h ?
10:53:05
22
A Well, as far as the in vitro studies, it is
10:53:07
23 r e a l l y d i f f i c u l t t o s a y . I m e a n i t w o u l d b e d i f f i c u l t
10:53:10
24
to say how much benzene you would have to be exposed to
10:53:13
25 t o r e s u l t i n i n v i t r o c o n c e n t r a t i o n s o f t h e s e
10:53:16
72
1
metabolites in the bone marrow, so that is a really hard
10:53:20
2 extrapolation.
10:53:25
3
When they have looked at air concentrations,
10:53:26
4 Martin Smith's group has published two or three papers
10:53:29
5
out of China and it was 31 part per million that they --
10:53:33
6 above and below that they made comparisons with and
10:53:35
7 found a statistically significant difference.
10:53:39
8 Q That shows a dose response relationship,
10:53:43
9 doesn't it?
10:53:45
10
A It shows that they saw an increased risk of
10:53:46
11
these cytogenetic changes in individuals that had a time
10:53:48
12
weighted average of something greater -- eight-hour time
10:53:50
13 w e i g h t e d a v e r a g e o f g r e a t e r t h a n 3 1 p a r t p e r m i l l i o n .
10:53:52
14
Q Those studies did not show that there was no
10:53:56
15 r i s k b e l o w 3 1 p a r t s p e r m i l l i o n , d i d t h e y ?
10:54:00
16
A The group that they compare the upper with was
10:54:05
17 t h e l o w e r a n d i t w a s a s t a t i s t i c a l l y s i g n i f i c a n t
10:54:08
18
difference. They didn't use the lower and compare that
10:54:12
19 t o s o m e o n e t h a t h a d e v e n l o w e r e x p o s u r e s t h a n t h a t .
10:54:14
20
Q Do you interpret that study to mean that the
10:54:19
21 a u t h o r s c o n c l u d e d t h a t e x p o s u r e s b e l o w 3 1 p a r t s p e r
10:54:22
22 m i l l i o n d o n o t c a u s e c y t o g e n e t i c d a m a g e ?
10:54:28
23 A I d o n o t t h i n k t h a t t h a t i s w h a t t h e y
10:54:31
24 c o n c l u d e d .
10:54:33
25 Q O k a y .
10:54:34
73
1
A I think what they concluded was that there was
10:54:34
2 a statistically significant increase above 31 PPM.
10:54:36
3
Q And in the Australian -- well, Dr. Glass' paper
10:54:41
4 which you have mentioned, she compared different
10:54:50
5 exposure levels of workers in the cohort with the risk
10:54:57
6 of leukemia, did she not?
10:55:03
7 A Sure.
10:55:07
8 Q Right.
10:55:08
9
A Both -- both on an intensity level as well as a
10:55:09
10 c u m u l a t i v e p a r t p e r m i l l i o n b a s i s .
10:55:13
11 Q R i g h t .
10:55:15
12 A n d l e t ' s t a l k a b o u t t h e i n t e n s i t y .
10:55:16
13
What that showed was that -- that analysis
10:55:19
14
showed that exposures to benzene of an intensity of just
10:55:22
15 . 1 o r . 2 p a r t s p e r m i l l i o n s i g n i f i c a n t l y i n c r e a s e d t h e
10:55:31
16 r i s k o f l e u k e m i a , d i d t h e y n o t ?
10:55:36
17
A I think that would be greatly over-interpreting
10:55:38
18 t h a t f i n d i n g .
10:55:41
19
Q There was that finding in that data, was there
10:55:43
20 n o t ?
10:55:46
21 A T h a t n u m b e r w a s t h e r e , y e s .
10:55:47
22
Q Okay. And they also showed that the rate of
10:55:48
23 l e u k e m i a i n c r e a s e d w i t h i n c r e a s i n g i n t e n s i t i e s o f
10:55:56
24 e x p o s u r e , d i d t h e y n o t ?
10:56:02
25 A T h a t i s n o t t r u e . T h a t w o u l d b e w h y I a m
10:56:04
74
1 saying your -- that question is over-interpreting the
10:56:07
2
data. And in the next group up, .2 to .4, it went down
10:56:11
3 and was not statistically significant.
10:56:16
4
Then .4 to .8 on a time weighted average was
10:56:19
5 back up. And then .8 to 1.6, it was lower than all of
10:56:23
6 the three previous intensity measurements. That is a
10:56:27
7 very quirky dose response.
10:56:31
8
Q Was there a statistically significant trend?
10:56:34
9
A I don't recall that being done. And the other
10:56:38
10 p o i n t f o r t h o s e m e a s u r e m e n t s i s t h a t t h a t w a s t o t a l
10:56:42
11 l e u k e m i a s ; n o t A M L .
10:56:47
12
She also did a cumulative exposure for ANLL --
10:56:51
13
AML, we use them interchangeably -- but did not have the
10:56:56
14 i n t e n s i t y d a t a f o r t h a t .
10:57:02
15
Q Are you aware of any epidemiologic studies
10:57:10
16
outside of the workplace that have evaluated the risk of
10:57:18
17 l e u k e m i a f r o m b e n z e n e e x p o s u r e ?
10:57:26
18
A Well, I am aware of a lot of studies that have
10:57:35
19 a t t e m p t e d t o m a k e a s s o c i a t i o n s t o e n v i r o n m e n t a l l e v e l s
10:57:39
20 o f b e n z e n e a n d c h i l d h o o d l e u k e m i a , o t h e r d i s e a s e s .
10:57:43
21
They all suffer significantly from having very
10:57:53
22 p o o r t o n o e x p o s u r e q u a n t i f i c a t i o n a t a l l . S o t o t a k e
10:57:57
23
that data and try to, you know, make firm conclusions on
10:58:01
24 t h i s e n v i r o n m e n t a l s t u d y , i t i s i m p o s s i b l e t o d o .
10:58:06
25
Q Okay. Dr. Pyatt, as you sit here today, do you
10:58:13
75
1
know what caused the chromosome 5 and 7 abnormalities of
10:58:17
2 Mr. Pearl?
10:58:23
3
A I do not know. It was just part of the basic
10:58:24
4 pathology that lead to his AML.
10:58:31
5
Q Do you know what caused the chromosome 5 and 7
10:58:33
6 abnormalities of Mr. Machado?
10:58:36
7
A And as you ask about 7 in Mr. Pearl, I am still
10:58:39
8 not convinced that it was there, but I will take your
10:58:43
9 word for it. I don't know for Mr. Machado if --
10:58:46
10 Q T h e r e w a s a m a r k e r 7 .
10:58:49
11 A T h e r e w a s , o k a y .
10:58:50
12
Q Do you agree that the 5Q minus abnormality
10:58:55
13
which both Mr. Pearl and Mr. Machado had was significant
10:59:01
14 i n t h e d e v e l o p m e n t o f t h e i r l e u k e m i a s ?
10:59:11
15
A Good question. I think speaking on behalf of
10:59:18
16 m y u n d e r s t a n d i n g o f t h e s c i e n t i f i c a n d m e d i c a l
10:59:23
17 l i t e r a t u r e , t h o s e a r e n o n r a n d o m c y t o g e n e t i c c h a n g e s .
10:59:27
18 S o y e s , t h e y p l a y e d s o m e r o l e i n t h e d e v e l o p m e n t , t h e
10:59:31
19 p a t h o g e n e s i s o f t h e i r A M L .
10:59:37
20
Janet Rowley published some papers in the late
10:59:38
21 ' 8 0 s a n d i t w a s f o l l o w e d u p b y M i c h e l l e L e B e a u a n d
10:59:41
22
Larson and others in the '90s where they tried to clone
10:59:45
23 t h a t p i e c e o f t h e c h r o m o s o m e t o t r y t o u n d e r s t a n d w h a t
10:59:48
24
was going on there that would lead people that had that
10:59:50
25 d e l e t i o n t o d e v e l o p A M L w i t h t h e c a v e a t t h a t t h e 5 Q
10:59:54
76
1 minus syndrome doesn't do that.
10:59:58
2
But they found hematopoietic growth factors,
11:00:00
3 hematopoietic growth factor receptors, lots of things
11:00:05
4 that at least peripherally make sense in terms of the
11:00:08
5 pathogenesis of a hematopoietic disease.
11:00:12
6
So yes, I think that it's likely that that
11:00:17
7 played a role in the development of their disease. It
11:00:19
8 wasn't just a random cytogenetic change.
11:00:21
9
Q And do you agree that the monosome 7 that Mr.
11:00:24
10
Machado had also played a role in the development of his
11:00:28
11 A M L ?
11:00:33
12
A I would make the same argument that yes, most
11:00:35
13 p e o p l e w o u l d t h i n k - - m y i n t e r p r e t a t i o n o f t h e
11:00:38
14
scientific literature is that most authors think that it
11:00:40
15 m i g h t .
11:00:44
16
But monosome 7 is also frequently seen as an
11:00:44
17
evolutionary event, so it may not be causative. It may
11:00:48
18
have arised -- it may arise in the leukemia through its
11:00:53
19
development and evolution and may not have had anything
11:00:57
20
to do with the original transformation. So the data is
11:01:01
21 l e s s c l e a r o n t h a t o n e .
11:01:03
22
They have also cloned out the whole chromosome
11:01:05
23 a n d t h e r e i s n o t h i n g o n t h e r e t h a t r e a l l y m a k e s s e n s e ,
11:01:09
24
so they don't know why chromosome 7 -- my interpretation
11:01:11
25 o f t h e s c i e n t i f i c l i t e r a t u r e i s t h a t n o o n e c a n r e a l l y
11:01:14
77
1 define what it is on chromosome 7 that is associated
11:01:17
2 with AML.
11:01:20
3
Q Now, let's talk more generally about chemically
11:01:23
4 induced AML, which would include the chemotherapeutic
11:01:46
5 drugs which you mentioned.
11:01:51
6 Okay?
11:01:53
7 A Okay.
11:01:53
8 Q And perhaps I will ask it generally as to
11:01:55
9 chemically induced AML, but if you feel to answer the
11:02:00
10 q u e s t i o n y o u n e e d t o s p e c i f i c a l l y r e f e r t o a l k y l a t i n g
11:02:05
11 i n d u c e d A M L , f e e l f r e e .
11:02:08
12 A O k a y .
11:02:11
13
Q But here is the question: Can you approximate
11:02:12
14
what percentage of people or patients who have AML with
11:02:16
15 a b n o r m a l i t i e s o f c h r o m o s o m e 5 a n d c h r o m o s o m e 7 h a v e a
11:02:29
16 h i s t o r y o f e x p o s u r e t o c h e m i c a l s ?
11:02:37
17 A I c o u l d n o t d o t h a t s i t t i n g h e r e .
11:02:52
18 Q O k a y . T h e n l e t ' s t a l k s p e c i f i c a l l y a b o u t
11:02:55
19 a l k y l a t i n g i n d u c e d - - a l k y l a t i n g a g e n t i n d u c e d A M L .
11:03:00
20 A O k a y .
11:03:06
21
Q What does the literature indicate as far as
11:03:07
22 w h a t p e r c e n t a g e o f p a t i e n t s w h o h a v e a b n o r m a l i t i e s o f
11:03:10
23 c h r o m o s o m e 5 a n d 7 i n A M L h a v e p r i o r a l k y l a t i n g a g e n t
11:03:18
24 t h e r a p y ?
11:03:24
25
A Well, I think the literature would support that
11:03:28
78
1 those are frequently seen cytogenetic changes in AML
11:03:33
2 associated with chemotherapy.
11:03:38
3
If you looked at all of the AML's across the
11:03:40
4 country that have a 5 or a 7 or both -- I don't know
11:03:44
5 what that percentage is -- how many of those you could
11:03:48
6 then track back and say these diseases are related to
11:03:52
7 their chemotherapy.
11:03:55
8 Q Okay.
11:03:57
9
A I wouldn't mind taking a quick break, if that
11:04:10
10 i s a l l r i g h t .
11:04:13
11 Q Y e a h , l e t ' s d o t h a t .
11:04:14
12
THE VIDEOGRAPHER: Want me to change out tapes,
11:04:16
13 c o u n s e l ?
11:04:18
14 T H E W I T N E S S : A r e w e d o n e ?
11:04:19
15
MR. CARR: Yes. You are off the record.
11:04:21
16
MR. METZGER: Yes, change out the tape, sure.
11:04:23
17
THE VIDEOGRAPHER: Now going off the record.
11:04:24
18 T i m e i s 1 1 : 0 4 a . m . T h i s i s t h e e n d o f V o l u m e 1 , t a p e
11:04:26
19 N o . 2 .
11:04:31
20 ( B r i e f r e c e s s . )
11:04:32
21 ( M r . C a r r l e f t t h e p r o c e e d i n g s . )
11:11:31
22
THE VIDEOGRAPHER: We are now back on the
11:11:55
23 r e c o r d . T i m e i s 1 1 : 1 1 a . m . T h i s i s t h e b e g i n n i n g o f
11:11:55
24 V o l u m e 1 , t a p e N o . 3 i n t h e d e p o s i t i o n o f D r . D a v i d
11:11:58
25 P y a t t .
11:12:02
79
1 Counsel?
11:12:03
2 (Deposition Exhibit 3 was marked for
11:12:03
3 identification.)
11:12:03
4
Q BY MR. METZGER: Dr. Pyatt, I am showing you
11:12:03
5 what has been marked as Exhibit 3.
11:12:06
6 Would you tell me what that is?
11:12:09
7
A This is a list of topics that I thought might
11:12:11
8 be important and that I provided quite a bit of
11:12:17
9
literature that they sent to you sometime, this weekend
11:12:22
10 o r w h e n e v e r , b u t t h e y w o u l d a l l b e - - w o u l d f i t u n d e r
11:12:29
11 o n e o f t h e s e c a t e g o r i e s , t h e l i t e r a t u r e t h a t I
11:12:32
12 s u b m i t t e d .
11:12:35
13
Q Okay. Do you have a list of that literature?
11:12:35
14 A I d o n ' t . I t i s p r e t t y e x p a n s i v e .
11:12:38
15
Q Well, okay. I did receive a CD, I believe, and
11:12:40
16 m a y b e t w o . A l l r i g h t .
11:12:49
17
We will mark as Exhibit 4 this document, which
11:12:58
18 i s a l e t t e r f r o m t h e J o n e s C a r r f i r m t o m e e n c l o s i n g a
11:13:01
19
DVD of materials upon which Dr. -- it says Dr. Pyatt is
11:13:04
20 r e l y i n g o n . W e w i l l f i n d o u t a b o u t t h a t .
11:13:10
21 ( D e p o s i t i o n E x h i b i t 4 w a s m a r k e d f o r
11:13:13
22 i d e n t i f i c a t i o n . )
11:13:13
23
Q BY MR. METZGER: Would you take a look at this
11:13:13
24 a n d t e l l m e i f s o m e o f t h e l i t e r a t u r e t h a t y o u a r e
11:13:25
25 i n d i c a t i n g i s o n h e r e ?
11:13:30
80
1
A On this first page is -- well, actually this is
11:13:39
2
all stuff that they sent me. These were Becky exhibits.
11:13:43
3 I don't know what those are.
11:14:01
4
Q Well, let me tell you what -- first of all,
11:14:04
5 what this is. When I received the disk, I asked some
11:14:07
6 technical person to merely print out lists of
11:14:10
7 directories of what was on the disk and that is what
11:14:13
8 this is.
11:14:16
9
And what I'd like to know is the literature
11:14:18
10
that you are referring to on Exhibit 3, is that -- does
11:14:20
11 t h a t a p p e a r t o y o u t o b e i n c l u d e d h e r e ?
11:14:26
12 A N o .
11:14:30
13 Q O h .
11:14:31
14
MR. FOLEY: I will represent that there are two
11:14:32
15 d i f f e r e n t p r o d u c t i o n s o n t w o d i f f e r e n t d i s k s s e n t t o
11:14:34
16 y o u r o f f i c e , o n e o n t h e 1 2 t h a n d o n e o n t h e 1 3 t h .
11:14:36
17
I think the stuff on the 13th were the articles
11:14:39
18 t h a t t h e d o c t o r w a s j u s t t e s t i f y i n g a b o u t o r r e f e r r i n g
11:14:42
19 to.
11:14:45
20
MR. METZGER: Are you saying that there is
11:14:45
21 a n o t h e r d i s k t h a t I d o n ' t h a v e h e r e ?
11:14:46
22 M R . F O L E Y : C o r r e c t .
11:14:49
23
MR. METZGER: And I haven't reviewed for this
11:14:49
24 d e p o s i t i o n . I o n l y w a s a w a r e o f o n e d i s k .
11:14:50
25 M R . F O L E Y : O k a y .
11:15:00
81
1
MR. METZGER: Do you have a copy of the second
11:15:02
2 disk?
11:15:03
3 MR. FOLEY: It was --
11:15:04
4
THE WITNESS: I put it on a thumb drive because
11:15:05
5 my hard drive -- my CD burner broke last week and I
11:15:07
6
couldn't -- I mean I was trying to send it to their firm
11:15:11
7 and I couldn't.
11:15:15
8
So finally on Friday I put it onto a thumb
11:15:16
9 drive.
11:15:20
10
Q BY MR. METZGER: Do you have that with you?
11:15:20
11 A U h - h u h . T h e y g a v e i t b a c k t o m e .
11:15:21
12
MR. FOLEY: Actually I think I have a copy of
11:15:23
13 t h e d i s k . I t w a s s e n t b y F e d E x t o y o u r o f f i c e o n
11:15:25
14 D e c e m b e r 1 3 t h .
11:15:30
15
MR. METZGER: Well, I do need it. The question
11:15:31
16 i s h o w d o I - -
11:15:33
17
THE WITNESS: You can have the thumb drive.
11:15:36
18 J u s t s e n d i t b a c k t o m e w h e n y o u a r e d o n e .
11:15:38
19
Q BY MR. METZGER: I appreciate that. I mean
11:15:41
20
whether it is on a disk or a thumb drive, that -- either
11:15:42
21 o n e i s f i n e .
11:15:45
22
I am just trying to figure out how I could ask
11:15:47
23
you about it because I don't know what is on the disk or
11:15:50
24 t h u m b d r i v e .
11:15:55
25
MR. FOLEY: Let me do this: Let me see what's
11:15:55
82
1
on the -- let's go off the record for a minute. Is that
11:15:56
2 okay or do you want to stay on?
11:15:57
3 MR. METZGER: Sure, let's go off.
11:15:58
4
THE VIDEOGRAPHER: Now going off the record.
11:16:00
5 The time is 11:15 a.m.
11:16:00
6
(A discussion was held off the record.)
11:16:02
7
THE VIDEOGRAPHER: We are now back on the
11:19:51
8 record. Time is 11:19 a.m.
11:19:52
9 Counsel?
11:19:54
10
Q BY MR. METZGER: Okay. Dr. Pyatt, referring to
11:19:54
11 E x h i b i t 3 , t h i s i s a l i s t t h a t y o u p r e p a r e d ; r i g h t ?
11:20:01
12 A Y e s .
11:20:05
13
Q And at the top it says, "Literature List," and
11:20:05
14 t h e n i n p a r e n t h e s i s " S e n t . "
11:20:08
15
Does that mean that the attorney sent this to
11:20:11
16 y o u o r y o u s e n t i t t o t h e m o r w h a t d o e s t h a t m e a n ?
11:20:14
17 A T h a t m e a n s t h a t I s e n t i t t o t h e m t o t h e n
11:20:17
18 f o r w a r d o n t o y o u .
11:20:19
19 Q O k a y . A n d t h e t o p i c s h e r e a r e g a s o l i n e
11:20:20
20
literature, mineral spirits/Stoddard solvent, benzene in
11:20:29
21 s o l v e n t s , A M L l i t e r a t u r e , b e n z e n e a n d A M L , c o m p e t i t i v e
11:20:34
22 i n h i b i t i o n , H e a l t h W a t c h , p l i o .
11:20:39
23 I s t h a t t h e p l i o f i l m c o h o r t ?
11:20:43
24 A Y e s .
11:20:47
25
Q China, is that the Chinese cohort studies?
11:20:47
83
1 A Correct.
11:20:49
2 Q What is the next one?
11:20:50
3 A Refineries.
11:20:51
4 Q Refineries studies?
11:20:52
5 A Yes.
11:20:54
6
Q Then mechanics, then organic solvents, and then
11:20:54
7 benzene and cytogenetics?
11:20:57
8 A Correct.
11:21:00
9
Q So is this list an indication of literature
11:21:00
10 t h a t y o u h a v e g a t h e r e d , s t u d i e d a n d c o m p i l e d o n t h e s e
11:21:05
11 d i f f e r e n t t o p i c s ?
11:21:12
12 A C o r r e c t .
11:21:13
13
Q And the thumb drive that you gave me, does it
11:21:15
14
have directories which -- on it which match the subjects
11:21:19
15 o n E x h i b i t 3 ?
11:21:26
16
A I doubt it. It probably would have if I could
11:21:27
17
take the folder because this matches the folders that I
11:21:30
18 h a v e o n m y h a r d d r i v e . B u t t h e n I o p e n e d u p t h o s e
11:21:34
19
folders and pulled out the studies and put them all on a
11:21:37
20 h a r d d r i v e , s o i t p r o b a b l y w i l l n o t m a t c h u p t o t h i s .
11:21:40
21
Q So are there any folders or directories on the
11:21:44
22
thumb drive or is it just all of the studies themselves?
11:21:49
23 A I t h i n k i t i s j u s t a l l o f t h e s t u d i e s .
11:21:54
24 Q O k a y .
11:21:57
25
A And if it alphabetized them, it is going to be
11:21:58
84
1
a mess. Probably would have been better to keep them in
11:22:04
2
the folders, but it wasn't working when I was trying to
11:22:07
3 pull them over so ...
11:22:10
4 Q Do you have your computer here now?
11:22:11
5 A I don't.
11:22:13
6
Q All right. Well, I have asked my technical
11:22:13
7
person here to print out -- to copy that thumb drive on
11:22:17
8
to a disk and to print out the directory so we will see
11:22:23
9 what we actually have.
11:22:27
10 A Y e a h .
11:22:28
11 Q I a m g a t h e r i n g t h a t y o u a r e i n t e n d i n g t o
11:22:30
12
testify about each of the topics that are on Exhibit 3?
11:22:33
13
A Not necessarily. These were just the topics
11:22:38
14 t h a t I f e l t l i k e w e r e r e l e v a n t a n d i m p o r t a n t t o t h i s
11:22:41
15 c a s e . A n d m y r e l i a n c e o n a n y o f t h e l i t e r a t u r e a n d
11:22:44
16 t h o s e t o p i c s w o u l d b e d e p e n d e n t o n y o u r q u e s t i o n s a n d
11:22:51
17 w h e r e w e w e n t .
11:22:56
18
If we are going to talk about the pliofilm
11:22:57
19 c o h o r t , t h e n , y o u k n o w , I w a n t e d t o h a v e a l l o f t h e
11:22:59
20
studies so that I could rely on all of the studies that
11:23:02
21 a r e a s s o c i a t e d w i t h t h a t c o h o r t .
11:23:06
22
Q Okay. Well, are you relying on the studies
11:23:10
23
that are on the thumb drive in support of your opinions
11:23:16
24 i n t h e s e c a s e s ?
11:23:19
25 A Y e s .
11:23:20
85
1
Q So everything on the thumb drive you have read,
11:23:22
2
reviewed, considered and are relying upon in support of
11:23:26
3 your opinions in these cases?
11:23:29
4 A I think that is fair, yes.
11:23:31
5
Q Okay. I'm going to try to approach this kind
11:23:33
6 of in a macro approach initially. And then when I get
11:23:43
7 the list of articles, we might get a little more
11:23:47
8 specific.
11:23:50
9
But let me ask you generally then, what is it
11:23:51
10
about the gasoline literature that is on the thumb drive
11:23:53
11 t h a t s u p p o r t s y o u r o p i n i o n s i n t h e s e c a s e s ?
11:23:59
12
A That one actually I brought a hard copy of that
11:24:03
13
folder, so I have all of those studies. And I also have
11:24:07
14 t h e b e n z e n e a n d A M L s t u d i e s a s a h a r d c o p y b i n d e r
11:24:12
15 b e c a u s e t h o s e s e e m t o m e t o b e t h e m o s t p e r t i n e n t a n d
11:24:16
16 g e r m a n e .
11:24:19
17
The gasoline, to answer your question, since
11:24:20
18 t h a t f i g u r e d p r o m i n e n t l y i n D r . N i c a s ' e x p o s u r e
11:24:23
19 a s s e s s m e n t s , a t l e a s t f o r H a z l e h u r s t a n d P e a r l , t h e n I
11:24:29
20 t h i n k i t ' s i n s t r u c t i v e t o t h e j u r y o r w h o e v e r i s
11:24:32
21
thinking about this case, "Well, what does the gasoline
11:24:36
22 l i t e r a t u r e s a y ? W h a t d o t h o s e s t u d i e s s a y t h a t p e o p l e
11:24:40
23
who are highly exposed to gasoline in the workplace, do
11:24:42
24 t h e y h a v e a n i n c r e a s e d r i s k o f A M L ? "
11:24:46
25
And I think the answer is no, which is why the
11:24:48
86
1 ATSDR and OSHA and other regulatory agencies, none of
11:24:51
2 them classify gasoline as a human carcinogen, even
11:24:57
3 though it has one to two percent benzene in it.
11:25:00
4
So I do think that literature is germane to
11:25:05
5 this issue.
11:25:09
6
Q Okay. Do you have that binder here on the
11:25:10
7 gasoline literature?
11:25:13
8 A I do.
11:25:14
9 Q Let me see it, please.
11:25:15
10
I was hoping to find in this binder an index.
11:25:43
11 T h e r e i s n o n e ?
11:25:48
12
A I am not that organized, Mr. Metzger. Sorry.
11:25:49
13
Q You should have the attorneys do that for you.
11:25:52
14 I a m s u r e t h e y w o u l d b e w i l l i n g t o .
11:25:54
15
Okay. I am just going to take a quick look
11:25:59
16 t h r o u g h t h i s b i n d e r a n d a s k y o u s o m e q u e s t i o n s w i t h o u t
11:26:02
17 m a r k i n g i t a s a n e x h i b i t b e c a u s e h o p e f u l l y i t ' s a l l
11:26:05
18 g o i n g t o b e o n t h e C D t h a t i s b e i n g b u r n e d .
11:26:08
19 A Y e s , i t i s .
11:26:11
20
Q Okay. There is a tab here for "Bernardini 2005
11:26:15
21
Case Report" -- oh, I see. And you have the abstract of
11:26:24
22 t h a t ?
11:26:29
23 A Y e s .
11:26:30
24 Q O k a y .
11:26:31
25
A And I haven't -- for whatever reason, didn't
11:26:33
87
1 track down and find the whole study. Then I put the
11:26:35
2 abstract in there, but usually I try to get the whole
11:26:37
3 study.
11:26:40
4
Q Have you read that whole study by Bernardini?
11:26:41
5
A I don't think I have, no. Since it was a case
11:26:45
6 report, I wasn't as interested in it.
11:26:46
7 Q You have in here the Glass 2003 study,
11:27:10
8 "Leukemia Risk Associated with Low Level Benzene
11:27:13
9 Exposure"; correct?
11:27:15
10 A Y e s .
11:27:17
11
Q That is the study that we were talking about
11:27:17
12 b e f o r e t h a t y o u h a v e r e a d a n d c o n s i d e r e d b e f o r e t h i s
11:27:19
13 c a s e a n d f o r p u r p o s e s o f t h i s c a s e ; c o r r e c t ?
11:27:22
14 A C o r r e c t .
11:27:25
15 Q M a y I ?
11:27:59
16 A S u r e .
11:27:59
17 Q I w i l l k e e p i t a l l i n o r d e r .
11:28:00
18 A T h a t i s f i n e . I w i l l f i g u r e i t o u t .
11:28:02
19 Q J u s t d o a f e w t h i n g s .
11:28:05
20
Okay. So included in here you have some papers
11:29:51
21 f r o m t h e T r a n g u c h g a s o l i n e s p i l l , H a z e l t o n s t u d y ;
11:29:57
22 c o r r e c t ?
11:30:02
23
A Yes. That should -- that is probably under the
11:30:03
24 t a b f o r P a t e l 2 0 0 4 .
11:30:05
25
Q So you are familiar with her article which was
11:30:07
88
1 published I think in -- what was it -- "Archives of
11:30:10
2 Epidemiology" or --
11:30:12
3
A Yeah, I don't remember the journal, but yes, I
11:30:14
4 have read that study.
11:30:17
5 Q Archives of something, I think.
11:30:18
6 A Uh-huh. I think that's right.
11:30:20
7
Q Okay. Now, regarding the gasoline literature,
11:30:27
8
what workers in the gasoline industry, if I can call it
11:30:38
9 that, are most heavily exposed to benzene?
11:30:49
10
A I don't know the answer to that. I mean they
11:31:01
11 h a v e l o o k e d a t s e r v i c e s t a t i o n a t t e n d a n t s a n d t h e i r
11:31:03
12
exposures are measurable. They are not really high, but
11:31:10
13 t h e y h a v e g a s o l i n e e x p o s u r e .
11:31:15
14
They have looked at mechanics. I would say
11:31:17
15 p r o b a b l y t h e i n d i v i d u a l s t h a t a r e l i k e l y t o h a v e t h e
11:31:20
16
highest exposure to gasoline would be tank truck drivers
11:31:23
17 w h e n t h e y w e r e d o i n g b o t t o m l o a d i n g t y p e a c t i v i t i e s .
11:31:27
18 Q O k a y . A n d h o w m a n y - -
11:31:32
19 A I a m s o r r y , t o p l o a d i n g , t o p a c t i v i t i e s .
11:31:33
20
Q And regarding those particular workers, have
11:31:37
21 t h e r e b e e n e p i d e m i o l o g i c s t u d i e s t h a t h a v e e v a l u a t e d
11:31:41
22 t h e i r r i s k o f l e u k e m i a ?
11:31:45
23 A Y e s .
11:31:46
24 Q H o w m a n y ?
11:31:47
25 A R u s h t o n d i d i t , S n y d e r d i d i t . T h e r e i s
11:31:50
89
1 some -- when you look at the different workers in the
11:31:54
2 Elk Lodge, they looked at distribution, marketing
11:31:57
3 workers. Calling them tanker drivers, I know Rushton
11:32:02
4
did -- Leslie Rushton did, Rob Snyder did and Otto Wong
11:32:08
5
has done it, so there is at least three big tank driver
11:32:12
6 cohorts.
11:32:15
7
Q And you are familiar with all of those studies?
11:32:17
8 A I am.
11:32:19
9
Q And those studies showed an increased risk of
11:32:19
10 l e u k e m i a , d i d t h e y n o t ?
11:32:21
11 A I d i s a g r e e w i t h t h a t .
11:32:23
12
Q Okay. What about the Patel study, did that
11:32:25
13 s t u d y s h o w a n i n c r e a s e d r i s k o f l e u k e m i a f r o m
11:32:38
14 e n v i r o n m e n t a l e x p o s u r e t o g a s o l i n e ?
11:32:43
15
A I don't think the Patel study showed anything
11:32:44
16
that -- it is hard to rely on that study for anything at
11:32:45
17 a l l . T h e e x p o s u r e s w e r e v e r y l o w .
11:32:49
18
There was only two AML cases. There were no
11:32:52
19 c o r r e l a t i o n b e t w e e n w h e r e t h e y l i v e d i n t h e p l u m e a n d
11:32:57
20
what their exposures could have been. They were both in
11:32:59
21 t h e i r 6 0 ' s .
11:33:02
22
There were two smokers out of the four
11:33:02
23 l e u k e m i a s . S h e d o e s n ' t s a y w h i c h o f t h e t w o w e r e
11:33:05
24 s m o k e r s . I m e a n t h a t s t u d y r e a l l y d o e s n ' t s t a n d f o r
11:33:08
25 m u c h o f a n y t h i n g i n m y v i e w .
11:33:12
90
1 Q Were you involved in that case at all?
11:33:14
2 A No.
11:33:15
3 In that case, you mean the study?
11:33:15
4 Q The lawsuit.
11:33:17
5 A I didn't know there was a lawsuit.
11:33:27
6
Q Okay. Until we get that in here, you said you
11:33:28
7 had some other binders.
11:33:34
8 What other binders do you have here?
11:33:35
9
A I brought one other one. I am sure you have
11:33:37
10 s e e n a l l t h e s e , b u t t h i s i s t h e b e n z e n e a n d A M L , s o
11:33:40
11 t h e s e a r e a l l o f t h e q u a n t i t a t i v e e p i d e m i o l o g y s t u d i e s
11:33:44
12 t h a t I a m a w a r e o f t h a t h a v e r e a l l y l o o k e d
11:33:49
13
quantitatively at benzene exposures and associated risks
11:33:52
14 o f e i t h e r A M L o r l e u k e m i a , d e p e n d i n g o n t h e s t u d y .
11:33:56
15
Q Okay. And what other binders do you have?
11:34:04
16
A That is -- those are the only two that I was
11:34:09
17 w i l l i n g t o d r a g o u t h e r e .
11:34:12
18
Q Okay. Regarding -- looking at Exhibit 3, the
11:34:13
19 s e c o n d t o p i c y o u h a v e h e r e i s m i n e r a l s p i r i t s / S t o d d a r d
11:34:18
20 s o l v e n t .
11:34:21
21
Do you have any studies on that topic which
11:34:27
22 a d d r e s s h e m a t o t o x i c i t y o r l e u k e m i a ?
11:34:31
23
A Well, what I sent and what I have looked at is
11:34:38
24 t h e A T S D R T a l k s P r o f i l e o n S t o d d a r d s o l v e n t a n d t h e
11:34:42
25 g e n e r a l - - s o m e d a t a b a s e s o r t o f c o l l e c t i o n s o f
11:34:49
91
1 literature on mineral spirits and Stoddard solvent.
11:34:56
2
The hazardous substance database has an entry
11:35:00
3 for those. There is some regulatory literature out of
11:35:06
4
EPA. They don't have an Iris entry but some -- so that
11:35:09
5 is what I have reviewed. They are --
11:35:13
6
Q Well, are there any case reports included in
11:35:17
7
that material regarding workers who used mineral spirits
11:35:21
8 or Stoddard solvent and developed hematologic disease?
11:35:25
9
A There would not be a specific study included at
11:35:30
10
all. There would be just what was discussed within that
11:35:34
11 r e g u l a t o r y d o c u m e n t .
11:35:37
12
Q So have you actually reviewed the case reports
11:35:39
13
of workers who used mineral spirits or Stoddard solvent
11:35:41
14 a n d d e v e l o p e d h e m a t o l o g i c d i s e a s e ?
11:35:44
15 A I c a n ' t t h i n k o f o n e , n o .
11:35:48
16
Q Okay. Are there any particular documents in
11:35:49
17 t h a t c o l l e c t i o n o n m i n e r a l s p i r i t s o r S t o d d a r d s o l v e n t
11:35:55
18 w h i c h a d d r e s s t h e h i s t o r i c a l b e n z e n e c o n c e n t r a t i o n s o f
11:35:59
19 t h o s e p r o d u c t s ?
11:36:02
20
A I don't know the answer to that. I think they
11:36:09
21 d o , b u t I a m n o t p o s i t i v e .
11:36:11
22
Q All right. The third topic listed on Exhibit 3
11:36:14
23 i s b e n z e n e i n s o l v e n t s .
11:36:19
24 W h a t i s t h a t a b o u t ?
11:36:21
25
A I don't have many because this is sort of a
11:36:23
92
1
little outside of my interest and area of expertise, but
11:36:26
2
I had 10 or so studies that have evaluated the amount of
11:36:31
3 benzene that is in various solvents; for example, what
11:36:35
4 is in hydrotreated toluene now versus what might have
11:36:40
5
been toluene -- what might have been in toluene 30 or 40
11:36:45
6 years ago, and that kind of thing.
11:36:49
7
Q Okay. Are any of the studies in that group
11:36:50
8 studies regarding benzene in mineral spirits?
11:36:57
9
A I think so. I think probably that would have
11:37:03
10 b e e n w h e r e J o e F e d o r u k ' s s t u d y w o u l d h a v e b e e n a n d
11:37:06
11 p e r h a p s s o m e o f t h e s i m u l a t i o n s t u d i e s f o r L i q u i d
11:37:11
12 W r e n c h . S o I t h i n k t h e r e w o u l d b e s o m e i n t h e r e , y e s .
11:37:16
13
Q Okay. The fourth topic on Exhibit 3 is the AML
11:37:22
14 l i t e r a t u r e . T h i s i s w h a t , s t u d i e s a b o u t a c u t e
11:37:25
15 m y e l o g e n o u s l e u k e m i a g e n e r a l l y ?
11:37:31
16
A Yeah. This would be the one that would mess up
11:37:33
17 p r o b a b l y o u r a b i l i t y t o g o t h r o u g h a n d s a y , " T h i s i s
11:37:36
18 t h i s , " b e c a u s e t h e r e i s s o m a n y o f t h e m .
11:37:39
19
This is the literature that I have read and
11:37:42
20
reviewed through my professional career that have to do
11:37:44
21
with the development of AML and what people are thinking
11:37:47
22 w i t h r e g a r d t o t h e p a t h o g e n e s i s o f t h a t d i s e a s e .
11:37:50
23
Q The next topic, benzene and AML, that is this
11:37:53
24 b i n d e r h e r e ?
11:37:57
25 A I t i s .
11:37:58
93
1 Q All right. The next topic is competitive
11:37:58
2 inhibition.
11:38:03
3
Are you intending to render any opinions at
11:38:05
4 trial in this case regarding competitive inhibition?
11:38:08
5
A I might be asked to explain the concept to the
11:38:13
6 jury, in which case I would be happy to do that. I
11:38:17
7
haven't seen any exposures from either expert of benzene
11:38:21
8 and then the corresponding exposures that would come
11:38:27
9
from toluene or other things in the solvents that would
11:38:31
10
make me think that competitive inhibition was likely to
11:38:34
11 b e a n i s s u e .
11:38:40
12 Q O k a y .
11:38:41
13
A But if -- if you are going to try to take --
11:38:41
14
not you, but if you try to take benzene in low levels in
11:38:43
15
Stoddard solvent or Safety-Kleen or even gasoline up to
11:38:49
16
where they are going to give a person an increased risk
11:38:52
17 o f d e v e l o p i n g A M L , t h e n y o u h a v e t o a c c o u n t f o r t h e
11:38:55
18 o t h e r s o l v e n t s t h a t a r e g o i n g t o g o a l o n g w i t h t h o s e .
11:38:59
19
At those levels of exposure, I do believe that
11:39:02
20 c o m p e t i t i v e i n h i b i t i o n i s a n i s s u e .
11:39:05
21
Q Well, let's see if we can determine whether
11:39:08
22 t h i s w h o l e t o p i c i s a n i s s u e i n t h i s c a s e .
11:39:10
23
You have read Dr. Nicas' reports regarding the
11:39:12
24 e x p o s u r e s o f t h e s e p l a i n t i f f s ; c o r r e c t ?
11:39:17
25 A I h a v e , y e s .
11:39:22
94
1
Q At the doses reported in Dr. Nicas' exposure
11:39:23
2
assessments, do you believe that competitive inhibition
11:39:28
3 of the toxicity of benzene is at play?
11:39:36
4
A I don't know the answer, whether there is any
11:39:41
5
interaction effect on enzymatic metabolism. But even if
11:39:43
6 it's not, I don't believe those exposures are
11:39:50
7 sufficient.
11:39:54
8
So I don't think that you have to decrease the
11:39:55
9
toxicity of those exposures with competitive inhibition
11:39:57
10 t o r e n d e r t h e m s a f e r .
11:40:02
11
So I don't know whether at those levels you see
11:40:05
12 i t o r n o t , b u t I d o n ' t t h i n k i t m a t t e r s .
11:40:07
13
Q Well, that is what I am trying to get at. I
11:40:13
14
mean assuming that the only evidence that the plaintiffs
11:40:14
15 a r e g o i n g t o i n t r o d u c e r e g a r d i n g t h e d o s e o f t h e s e
11:40:19
16
individuals at trial is the information contained in Dr.
11:40:24
17 N i c a s ' r e p o r t s .
11:40:29
18 F o r t h o s e d o s e s , d o y o u b e l i e v e t h a t
11:40:31
19
competitive inhibition of the toxicity of the benzene by
11:40:35
20 o t h e r o r g a n i c s i s a r e l e v a n t i s s u e o r n o t ?
11:40:39
21
A Definitely it would not be a relevant issue for
11:40:47
22
Machado. Probably would not be a relevant issue for Mr.
11:40:50
23 H a z l e h u r s t . I f M r . P e a r l h a d e x p o s u r e s o f . 5 p a r t p e r
11:40:55
24
million benzene, then there would be accordingly higher
11:41:07
25
exposures to these other solvents. It is possible that
11:41:14
95
1 there could be some interaction effects.
11:41:18
2 Q Okay. Anything is possible.
11:41:20
3
Are you prepared to tell the jury that it is
11:41:22
4 scientifically probable that there was a competitive
11:41:24
5 inhibition of the toxicity of benzene through other
11:41:28
6 organics in the solvent?
11:41:31
7 A I would not say that it is probable, no.
11:41:34
8
Q Would the same be true for Mr. Pearl's exposure
11:41:37
9 to benzene from gasoline?
11:41:41
10 W e l l , l e t m e b r e a k t h a t d o w n .
11:41:47
11
Would the same be true for Mr. Pearl's exposure
11:41:49
12 t o S a f e t y - K l e e n 1 0 5 s o l v e n t w h i c h c o n t a i n e d g a s o l i n e
11:41:51
13 f r o m c a r b u r e t o r s t h a t h e c l e a n e d i n t h e p a r t s w a s h e r
11:41:58
14 m a c h i n e ?
11:42:03
15
A I think I understand your question. I don't
11:42:03
16 t h i n k i t m a t t e r s . I m e a n I t h i n k f r o m a - -
11:42:05
17 Q T h a t i s f a i r e n o u g h . T h a t i s a l l I n e e d .
11:42:08
18 A O k a y .
11:42:10
19
Q Now, there has been testimony that Mr. Pearl
11:42:11
20 a l s o o n o c c a s i o n c l e a n e d p a r t s w i t h g a s o l i n e i n a
11:42:14
21 b u c k e t , w i t h a b u c k e t o f g a s o l i n e .
11:42:20
22
Do you have an opinion as to whether the
11:42:26
23
benzene to which he was exposed in that circumstance is
11:42:29
24 s u c h t h a t i t s t o x i c i t y w o u l d h a v e b e e n c o m p e t i t i v e l y
11:42:34
25 i n h i b i t e d b y o t h e r o r g a n i c s i n t h e g a s o l i n e ?
11:42:43
96
1
A I would -- I would say the -- answer it the
11:42:51
2 same way, that it's possible, but I wouldn't say that
11:42:56
3 it's probable.
11:42:59
4
Q Okay. Is there any other exposure scenario for
11:43:01
5 any of the plaintiffs that you are aware of where you
11:43:05
6 would actually say that competitive inhibition of the
11:43:07
7 toxicity of benzene by other organics is actually
11:43:12
8 scientifically probable?
11:43:15
9
A Not based on what I have seen at this point,
11:43:18
10 no.
11:43:20
11
MR. METZGER: Well, if you see something else
11:43:23
12 a n d y o u a r e g o i n g t o c h a n g e y o u r o p i n i o n o n t h a t ,
11:43:24
13
counsel, will you let me know because otherwise I don't
11:43:26
14 s e e a n y r e a s o n t o a s k h i m a b o u t i t ?
11:43:29
15
MR. FOLEY: I think that is our obligation.
11:43:31
16
MR. METZGER: Okay. So we can consider that
11:43:33
17 t o p i c c l o s e d o u t .
11:43:35
18 Q H e a l t h W a t c h ?
11:43:39
19
A I have collection of the one that you mentioned
11:43:44
20 a s w e l l a s s o m e o t h e r s , t h e 9 t h R e p o r t , 1 1 t h R e p o r t ,
11:43:47
21
13th Report, Technical Report, Glass' study, letters to
11:43:52
22 t h e e d i t o r , G u n , a n d t h a t c a m e o u t l a t e r .
11:43:57
23
I have all of the cumulative literature that I
11:44:00
24 h a v e b e e n a b l e t o f i n d t h a t h a v e t o d o w i t h t h e
11:44:03
25 A u s t r a l i a n P e t r o l e u m I n s t i t u t e ' s H e a l t h W a t c h P r o g r a m .
11:44:06
97
1 Q And what relevance -- strike that.
11:44:11
2
What are you -- regarding that body of
11:44:14
3
literature, what is it that you are relying on from that
11:44:17
4 for your opinions in this case?
11:44:22
5
A The quantitative assessment between benzene
11:44:24
6 exposure and AML risk.
11:44:27
7
Q And which of those documents primarily address
11:44:30
8 that?
11:44:33
9 A Well, the technical report has a lot of
11:44:34
10 q u a n t i t a t i v e i n f o r m a t i o n i n i t , b u t I t h i n k i t i s
11:44:36
11
adequately summarized in Deborah Glass' work from 2003.
11:44:39
12
Q The pliofilm cohort, for what purpose are you
11:44:45
13
relying on the pliofilm cohort studies for your opinions
11:44:49
14 i n t h i s c a s e ?
11:44:55
15
A Same -- same answer. It is the quantitative --
11:44:55
16
quantitative benzene exposures associated with risks of
11:44:59
17
AML, both from a cumulative PPM year basis as well as an
11:45:02
18 i n t e n s i t y p a r t p e r m i l l i o n b a s i s .
11:45:08
19
Q What is it about the pliofilm cohort that --
11:45:15
20 w h a t i s i t a b o u t t h e i n t e n s i t y o f t h e d o s e s i n t h e
11:45:20
21 p l i o f i l m c o h o r t u p o n w h i c h y o u b a s e y o u r o p i n i o n ?
11:45:23
22
A Well, Rob Snyder published a paper in 1996
11:45:27
23 w h e r e h e w e n t i n a n d l o o k e d a t w h a t t h e t i m e w e i g h t e d
11:45:30
24 a v e r a g e e x p o s u r e s n e e d e d t o b e b e f o r e t h e r e w a s a n
11:45:35
25 e l e v a t i o n i n t o t a l l e u k e m i a r i s k a n d i n A M L r i s k .
11:45:39
98
1
And there was no elevation at anything below
11:45:43
2 about 20 part per million years -- I am sorry, 20 part
11:45:46
3 per million. So his analysis of that cohort supports
11:45:50
4 that you have to have exposures close to 20 part per
11:45:54
5
million before you are going to see an increased risk of
11:46:00
6 AML.
11:46:03
7
Q You when you say 20 part per million, are you
11:46:03
8 saying intensity or PPM years?
11:46:07
9
A No, 20 part per million over eight-hour time
11:46:10
10 w e i g h t e d a v e r a g e .
11:46:13
11 Q I s e e .
11:46:14
12
A So there is both. There is PPM years in that
11:46:14
13 a n a l y s i s , b u t t h e r e i s a l s o i n t e n s i t y .
11:46:17
14
Q Were there any workers in the pliofilm cohort
11:46:19
15
who had average intensity benzene exposures less than 20
11:46:22
16 p a r t p e r m i l l i o n ?
11:46:29
17 A O h , s u r e , t h e r e w e r e .
11:46:30
18 Q R e a l l y .
11:46:31
19 W h o ?
11:46:32
20
A Well, all of the dry side workers were far
11:46:33
21 l o w e r t h a n t h a t .
11:46:36
22 Q D r y s i d e , w e r e t h e y e v e n e x p o s e d ?
11:46:37
23
A Well, you asked if there were workers in the
11:46:40
24 c o h o r t t h a t h a d l e s s t h a n 2 0 . I a m t e l l i n g y o u t h e r e
11:46:42
25 w e r e a l a r g e a m o u n t o f w o r k e r s t h a t h a d l e s s t h a n 2 0 .
11:46:44
99
1
Q Okay. The dry side workers have been used as a
11:46:47
2 comparison group?
11:46:51
3
A Well, they are still part of the cohort and
11:46:53
4 they still had exposures less than 20.
11:46:55
5 Q Fair enough.
11:46:58
6
Were there any benzene -- strike that.
11:46:59
7
Were there any workers occupationally exposed
11:47:03
8
to benzene from pliofilm in the pliofilm cohort who had
11:47:05
9 average intensity exposures less than 20 parts per
11:47:12
10 m i l l i o n ?
11:47:16
11 A Y e s .
11:47:16
12 Q W h o w e r e t h e y ?
11:47:17
13
A I would have to go back and look at that study,
11:47:18
14
but he -- in his analysis there are data points looking
11:47:20
15 a t g r o u p s o f w o r k e r s t h a t h a d e x p o s u r e s l e s s t h a n 2 0
11:47:26
16 w h e r e t h e r e w a s n o e l e v a t e d r i s k . A n d t h e n a t 2 0 i s
11:47:29
17 w h e r e i t w e n t u p .
11:47:32
18
And if their exposures were one part per
11:47:33
19
million or half of a part per million, it doesn't matter
11:47:36
20
whether it is the control or dry side worker. I mean if
11:47:41
21
there is no elevated risk -- well, it wouldn't matter if
11:47:44
22 i t w a s t h e c o n t r o l , b u t t h a t i s n o t w h a t t h e y d i d .
11:47:48
23
Q So other than the Snyder study -- is this the
11:47:51
24 S n y d e r 2 0 0 5 ?
11:47:54
25 A 1 9 9 6 .
11:47:55
100
1
Q Okay. What other studies in that pliofilm
11:47:57
2 body of literature are you relying on?
11:48:04
3 A Well, when you asked me earlier in this
11:48:08
4 deposition what levels of benzene do I think result in
11:48:10
5 an elevated statistically significant risk of AML, I
11:48:16
6 think that is in large part driven by the pliofilm
11:48:21
7
cohort and various exposure assessments and analysis of
11:48:26
8 that cohort.
11:48:30
9
Q Okay. The China studies, those are -- what is
11:48:34
10 t h a t r e f e r r i n g t o ?
11:48:42
11
A This is the collection of studies started in
11:48:44
12 t h e l a t e ' 8 0 s - - m i g h t h a v e e v e n s t a r t e d e a r l i e r t h a n
11:48:48
13
that -- and went up to current for NCI in collaboration
11:48:53
14 w i t h C h i n e s e A c a d e m y o f P r e v e n t a t i v e M e d i c i n e a n d t h e y
11:48:58
15
published 15 or 20 papers looking at benzene workers in
11:49:02
16 v a r i o u s i n d u s t r i e s i n C h i n a .
11:49:05
17
Q Okay. Are there any papers in that collection
11:49:08
18 o t h e r t h a n t h e N C I C h i n e s e A c a d e m y o f M e d i c i n e p a p e r s ?
11:49:12
19
A Well, the earlier ones didn't have NCI in them.
11:49:26
20 Q O k a y .
11:49:30
21 A A n d t h e n t h e r e i s a t l e a s t o n e f a i r l y
11:49:31
22 a r g u m e n t a t i v e p a p e r r e g a r d i n g t h e p o t e n t i a l
11:49:35
23
quantification of benzene that took place in that cohort
11:49:40
24 b y B u d i n s k i i s t h e g u y ' s n a m e , y o u k n o w , p o i n t i n g o u t
11:49:43
25 t h e u n c e r t a i n t i e s a n d t h e i n c o n s i s t e n c i e s i n h o w t h e y
11:49:48
101
1 quantified benzene exposure, and he wasn't associated
11:49:53
2 with either one so...
11:49:56
3
Q And what are you -- generally what are you
11:49:58
4 relying on those studies for for your opinions in this
11:50:01
5 case?
11:50:04
6 A The same as the first two, that there is
11:50:04
7 quantification of a cumulative dose of benzene that is
11:50:06
8 required to increase the risk of AML.
11:50:09
9
And there is evidence about the intensity or
11:50:12
10
the time -- part per million in the air that is required
11:50:15
11 i n o r d e r t o s e e a n i n c r e a s e d r i s k o f A M L .
11:50:19
12
Q You are familiar, of course, with the Hays 1997
11:50:28
13 s t u d y ?
11:50:31
14 A Y e s .
11:50:32
15
Q And that is one of these studies that you are
11:50:32
16 r e f e r r i n g t o ; c o r r e c t ?
11:50:35
17 A I t i s .
11:50:35
18 Q A n d a r e y o u a w a r e t h a t t h e C a l i f o r n i a
11:50:36
19
Department of -- the California Environmental Protection
11:50:37
20 A g e n c y d i d a n a n a l y s i s t o a c t u a l l y r e f i n e w h a t t h e
11:50:44
21
exposures were to the -- that were reported in the Hays
11:50:50
22 s t u d y ?
11:50:58
23 A I d o n ' t k n o w w h a t C a l E P A h a s d o n e .
11:50:59
24
Q Are you familiar with the California -- CalEPA
11:51:02
25 P u b l i c H e a l t h G o a l d o c u m e n t f o r b e n z e n e ?
11:51:06
102
1
A I seem to have -- I recall reading it several
11:51:09
2 years ago.
11:51:11
3 Q Okay. And do you recall reading the
11:51:13
4
information in that document regarding what the average
11:51:15
5 exposures of the workers reported in Hays 1997 as less
11:51:21
6 than 10 parts per million actually were?
11:51:28
7 A No.
11:51:30
8
Q The refinery studies, what are you relying on
11:51:43
9 those for?
11:51:45
10
A Well, we have already kind of talked about it.
11:51:48
11 T h i s i s , y o u k n o w , t h e S n y d e r , t h e R u s h t o n , t h e W o n g .
11:51:51
12
Those are all sort of refinery petroleum worker studies.
11:51:54
13 T h e r e i s a l o t o f o t h e r s t h a t - -
11:51:59
14
Q Well, those were mentioned in the context of
11:52:02
15 g a s o l i n e ?
11:52:04
16
A Right. But they would be -- if I pulled out a
11:52:05
17
binder for refinery workers, they would be in there too.
11:52:07
18 Q O k a y .
11:52:12
19
A And this is -- and it's not -- this one is not
11:52:12
20 c o m p l e t e . I m e a n t h e r e i s s o m a n y o f t h o s e . I d o n ' t
11:52:13
21 h a v e a l l o f t h e m , b u t I h a v e a l o t o f t h e m l o o k i n g a t
11:52:15
22 w h a t t h e r i s k s o f l e u k e m i a a r e w i t h i n t h e r e f i n e r y
11:52:19
23 w o r k e r p o p u l a t i o n .
11:52:22
24
Some of them are germane if they have -- well,
11:52:23
25 I c o n s i d e r t h e m g e r m a n e i f t h e y h a v e q u a n t i t a t e d t h e
11:52:27
103
1 exposures within those cohorts. Sometimes they do;
11:52:30
2 sometimes they don't.
11:52:33
3 Q Okay. The next topic is mechanics.
11:52:34
4
What literature is that comprised of?
11:52:37
5
A 20 or so studies, cohort, small studies looking
11:52:42
6 at mechanics as a profession and their risks of
11:52:47
7
hematopoietic malignancies generally, AML specifically,
11:52:55
8 associated with being a mechanic.
11:53:00
9 Q So these are all epidemiology studies?
11:53:03
10
A Yes. There is one good review paper by Holtz
11:53:06
11 t h a t w o u l d a l s o b e i n t h a t p i l e .
11:53:09
12
Q Okay. So they are all epidemiology studies
11:53:11
13 t h a t y o u a r e t a l k i n g a b o u t h e r e ?
11:53:18
14 A I n m e c h a n i c s , y e s .
11:53:19
15
Q Okay. Have you reviewed the studies regarding
11:53:20
16 s p e c i f i c a l l y b e n z e n e e x p o s u r e s o f m e c h a n i c s ?
11:53:28
17
A I did not review those for this case, no, but I
11:53:34
18 h a v e s e e n t h e m t h r o u g h t h e y e a r s .
11:53:36
19 Q W h i c h o n e s h a v e y o u s e e n ?
11:53:38
20 A I r e m e m b e r s o m e b y L a t i n o n - - L a t i n o n .
11:53:42
21 Q A n y o t h e r s ?
11:53:49
22 A I c a n ' t t h i n k o f t h e m .
11:53:53
23 Q H a v e y o u r e v i e w e d t h e s t u d i e s r e g a r d i n g
11:53:55
24 e x p o s u r e s t o m e c h a n i c s o f b e n z e n e a s d e t e r m i n e d b y t h e
11:54:01
25 p r e s e n c e a n d q u a n t i f i c a t i o n o f b e n z e n e m e t a b o l i t e s ?
11:54:09
104
1
A It sounds familiar, but I can't put my finger
11:54:15
2 on it right now.
11:54:19
3
Q Okay. Have you read the papers regarding --
11:54:20
4 have you read the papers which have evaluated
11:54:28
5 genotoxicity in mechanics?
11:54:30
6
A I have seen a few. They are not in there.
11:54:33
7 Q Which ones are you aware of?
11:54:37
8
A I can't think of the authors, but I have seen a
11:54:41
9 couple.
11:54:43
10 Q H a v e y o u - - o k a y .
11:54:51
11
Have you ever compiled a list of studies
11:54:56
12
regarding -- epidemiology studies which are case control
11:55:00
13 s t u d i e s r e g a r d i n g s o l v e n t s a n d A M L ?
11:55:07
14 A W h a t d o y o u m e a n b y s o l v e n t s ?
11:55:18
15
Q I am talking about studies -- case control
11:55:20
16 s t u d i e s o f A M L p a t i e n t s w h i c h r e p o r t t h e r i s k s o f
11:55:25
17 l e u k e m i a o r A M L i n r e l a t i o n t o p r i o r s o l v e n t e x p o s u r e ?
11:55:31
18 A T h e r e a r e s t u d i e s t h a t h a v e d o n e t h a t .
11:55:39
19 Q C a n y o u i d e n t i f y a n y o f t h e m ?
11:55:41
20 A N o t w i t h o u t l o o k i n g a t m y l i s t .
11:55:42
21 Q W h a t l i s t ?
11:55:45
22
A Whatever the list you are going to provide me,
11:55:46
23 w h a t w a s i n t h i s o r g a n i c s o l v e n t p i l e .
11:55:47
24 Q O h , I s e e . O k a y .
11:55:51
25
So if we move on then to the organic solvent
11:55:55
105
1
pile or the category, is that a collection of literature
11:55:57
2 of organic solvents and hematologic disease?
11:56:02
3 A Yes.
11:56:08
4 Q And what are you relying on that for?
11:56:09
5
A Well, one is that it is difficult to -- to
11:56:11
6 evaluate that literature because the term "organic
11:56:15
7 solvent" can mean a lot of different things.
11:56:18
8
So sometimes there is chlorinated solvents;
11:56:20
9
sometimes there are is not. Carbon disulfide, there is
11:56:22
10 j u s t a l l k i n d s o f t h i n g s t h a t w o u l d b e c o n s i d e r e d a n
11:56:29
11 o r g a n i c s o l v e n t , s o i t i s h a r d t o u s e t h a t l i t e r a t u r e .
11:56:31
12
But there are some where they discussed the
11:56:36
13 r i s k a s s o c i a t e d w i t h p e t r o l e u m b a s e d s o l v e n t s a n d I
11:56:39
14 t h i n k t h o s e h a v e s o m e r e l e v a n c e t o t h i s c a s e .
11:56:42
15 Q W h i c h o n e s ?
11:56:44
16 A W e ' d h a v e t o l o o k a t t h e l i s t .
11:56:46
17 Q A l l r i g h t . L a s t c a t e g o r y , b e n z e n e a n d
11:56:47
18 c y t o g e n e t i c s , w h a t d o e s t h a t c o m p r i s e ?
11:56:50
19
A That is every study that I know of that has
11:56:54
20 l o o k e d a t e i t h e r c h r o m o s o m a l d a m a g e a s s o c i a t e d w i t h
11:56:57
21
benzene exposure historically or more recently specific
11:57:04
22 c h r o m o s o m a l c h a n g e s a s s o c i a t e d w i t h b e n z e n e a n d / o r i t s
11:57:13
23 m e t a b o l i t e s .
11:57:14
24
That includes workers, healthy individuals that
11:57:16
25 h a v e b e e n e x p o s e d t o b e n z e n e a n d l o o k i n g a t p e r i p h e r a l
11:57:20
106
1
lymphocytes. It includes the in vitro mechanistic work,
11:57:24
2 all of it.
11:57:30
3
Q Okay. Are you familiar with studies which have
11:57:32
4 evaluated genetic polymorphisms of susceptibility for
11:57:34
5 benzene induced AML?
11:57:39
6 A Yes.
11:57:41
7 Q And have there been genetic polymorphisms
11:57:42
8 identified which confer an increased susceptibility to
11:57:48
9 development of AML from exposure to benzene?
11:57:52
10
A That last part, the answer is no, but I think
11:57:55
11 t h a t b y e x t e n s i o n i t w i l l p r o b a b l y b e t r u e . W e
11:57:58
12
have shown -- the scientific community has shown that an
11:58:03
13 N Q 0 1 p o l y m o r p h i s m i n c r e a s e s s u s c e p t i b i l i t y t o b e n z e n e
11:58:08
14 i n d u c e d h e m a t o t o x i c i t y a n d i n c r e a s e s s u s c e p t i b i l i t y t o
11:58:13
15 a l k y l a t i n g a g e n t i n d u c e d A M L .
11:58:19
16
So I believe that it would probably also induce
11:58:21
17
increased susceptibility to AML, but that last piece has
11:58:24
18 n o t b e e n s h o w n t h a t I h a v e s e e n .
11:58:30
19
Q How would you go about showing it? What kind
11:58:32
20 o f s t u d y w o u l d y o u h a v e t o d o ?
11:58:36
21
A Well, I think they would be -- I think that's
11:58:38
22 p r o b a b l y s o m e t h i n g t h a t e i t h e r t h e N C I o r t h e S h a n g h a i
11:58:39
23
Health Watch study in China would be looking at would be
11:58:42
24 t h e p r o p o r t i o n o f p a t i e n t s w i t h A M L t h a t h a v e t h i s
11:58:46
25 p o l y m o r p h i s m i n t h e p o p u l a t i o n v e r s u s t h o s e t h a t d o n ' t
11:58:51
107
1 have disease.
11:58:54
2
Q Okay. And that is just one polymorphism, the
11:58:55
3 NQ01; correct?
11:59:05
4 A That's correct.
11:59:08
5
Q The other polymorphisms of susceptibility have
11:59:08
6 also been evaluated; correct?
11:59:12
7 A They have looked at various glutathione
11:59:14
8
transferases, epoxide hydrolase, myeloperoxidase. They
11:59:16
9 have looked at several. None of these really paint as
11:59:22
10 c o n s i s t e n t a p i c t u r e a s t h e N Q O 1 d o e s .
11:59:25
11 Q N o w , i f a p e r s o n h a s t h e t y p e o f N Q 0 1
11:59:29
12 p o l y m o r p h i s m w h i c h c o n f e r s s u s c e p t i b i l i t y t o b e n z e n e
11:59:43
13
induced disease, would that person develop or could that
11:59:50
14 p e r s o n d e v e l o p A M L f r o m b e n z e n e a t a l e s s e r d o s e t h a n
12:00:01
15 s o m e o n e w h o d i d n o t h a v e t h a t s u s c e p t i b i l i t y ?
12:00:06
16
A The mutations that confer the susceptibility of
12:00:16
17
mutation in the enzymatic activity of NQ01 is present in
12:00:22
18 f i v e t o 1 0 p e r c e n t o f t h e U . S . p o p u l a t i o n ; s o m e t h i n g
12:00:28
19 l i k e 1 5 t o 2 0 p e r c e n t i n t h e C h i n e s e p o p u l a t i o n .
12:00:30
20
So no, I think the answer to your question is
12:00:33
21 t h e r e i s n o e v i d e n c e t h a t t h a t ' s t r u e ; t h a t w h e n w e
12:00:37
22 l o o k e d a t p l i o f i l m a n d o t h e r c o h o r t s t h a t d e v e l o p e d - -
12:00:41
23
where individuals developed AML from a certain exposure
12:00:44
24 t o b e n z e n e , i t i s , i n m y v i e w , l i k e l y t h a t t h o s e
12:00:47
25 i n d i v i d u a l s w e r e t h e o n e s t h a t h a d t h i s s u s c e p t i b i l i t y
12:00:50
108
1 gene because they are the ones that got AML. Same
12:00:53
2 likely with China.
12:00:56
3
Q That wasn't studied in those cohorts, was it?
12:00:58
4 A No.
12:01:01
5 Q So you don't know whether those -- it's
12:01:01
6 actually possible that none of the pliofilm cohort
12:01:03
7 workers had that susceptibility polymorphism, is it?
12:01:09
8 A I guess it's possible, but if five to 10
12:01:15
9 percent of the U.S. population have it, then you would
12:01:17
10 f i g u r e 5 , 1 0 - - I m e a n i t ' s n o t n e w .
12:01:19
11
People in the fifties had it just like people
12:01:22
12 i n t h e 2 0 0 0 ' s h a v e i t . I t i s j u s t t h a t n o w w e c a n
12:01:24
13 i d e n t i f y i t a n d l o o k f o r i t a n d b a c k t h e n w e c o u l d n ' t .
12:01:28
14
Q As you sit here today, you don't actually know
12:01:31
15 w h e t h e r a n y o n e o f t h e p l i o f i l m c o h o r t w o r k e r s w h o
12:01:32
16 d e v e l o p e d A M L h a d t h a t N Q 0 1 g e n e t i c s u s c e p t i b i l i t y
12:01:35
17 p o l y m o r p h i s m . T r u e ?
12:01:40
18 A N o , t h e y d i d n o t l o o k .
12:01:42
19 Q Y o u d o n ' t k n o w ?
12:01:43
20 A I d o n ' t k n o w .
12:01:43
21
Q And that hasn't been evaluated in any cohort of
12:01:44
22 b e n z e n e e x p o s e d w o r k e r s , t o y o u r k n o w l e d g e ; c o r r e c t ?
12:01:48
23
A No, that is not correct. I mean they have
12:01:53
24 l o o k e d a t N Q 0 1 . I n t h e L a n s t u d y t h e y l o o k e d a t N Q 0 1
12:01:55
25 p o l y m o r p h i s m .
12:02:01
109
1 Q I misspoke.
12:02:02
2
That has not been evaluated in any cohort
12:02:03
3 studies in connection with AML; correct?
12:02:07
4
A To my knowledge, that is true. That is why
12:02:09
5 that last piece is still an uncertainty.
12:02:11
6
Q Okay. All right. I think we have now the CD
12:02:15
7
and a list and it does appear to be just an alphabetical
12:02:23
8 list without directories -- well, actually not true.
12:02:29
9 We will mark this list as Exhibit 5.
12:02:47
10 ( D e p o s i t i o n E x h i b i t 5 w a s m a r k e d f o r
12:02:49
11 i d e n t i f i c a t i o n . )
12:02:49
12
Q BY MR. METZGER: I will ask you to identify it
12:02:50
13 f o r m e , p l e a s e .
12:02:52
14
A This appears to be an alphabetized list of
12:03:23
15 s t u d i e s t h a t I p u t o n t o a t h u m b d r i v e t o s e n d t o y o u .
12:03:28
16 Q O k a y .
12:03:33
17
A And what this last page is, I don't know what
12:03:34
18 t h i s i s . I d o n ' t r e c o g n i z e i t a n d I d o n ' t r e c o g n i z e
12:03:38
19
this. This might be something that is just part of the
12:03:46
20 t h u m b d r i v e , k i n d o f i t s i n t e r n a l w o r k i n g s m a y b e .
12:03:48
21
Q Well, let's just leave it altogether and you
12:03:53
22 h a v e i d e n t i f i e d i t . L e t ' s p u t a c l i p o n i t .
12:03:58
23
Okay. Do you have any upcoming depositions
12:04:06
24 t h i s y e a r o r s c h e d u l e d f o r e a r l y n e x t y e a r ?
12:04:17
25 A N o .
12:04:22
110
1 Q Any trials coming up?
12:04:23
2
A Well, allegedly the Stromberg case might be
12:04:27
3
going to trial in March. I think this one is scheduled
12:04:32
4 to potentially go to trial in April.
12:04:37
5 Q Okay.
12:04:40
6
A And the Baker deposition, that might happen
12:04:42
7 sometime in '09 too, but that is all I can think of.
12:04:45
8
Q Okay. Do you have any papers that you have
12:04:49
9 submitted for publication which have not yet been
12:04:57
10 a c c e p t e d f o r p u b l i c a t i o n ?
12:05:00
11 A N o .
12:05:02
12 Q O k a y . A r e y o u - - h a v e y o u d o n e a n y w o r k 12:05:04
13 r e g a r d i n g t h e C h i n e s e - - s t r i k e t h a t .
12:05:10
14
Have you done any work regarding the Shanghai
12:05:16
15 s t u d y s p o n s o r e d b y t h e c o n s o r t i u m o f p e t r o l e u m
12:05:19
16 c o m p a n i e s ?
12:05:23
17 A N o , n o .
12:05:24
18
Q You haven't been involved in that at all?
12:05:24
19
A Well, I was in Rich Irons' lab when it first
12:05:28
20 c a m e a b o u t , s o I w a s a r o u n d w h e n t h e y w e r e d i s c u s s i n g 12:05:31
21 t h e f e a s i b i l i t y .
12:05:35
22
And when Dr. Irons went over there to kind of
12:05:36
23
get the lay of the land and look at the factories that
12:05:39
24 w o u l d p a r t i c i p a t e , a s I r e c a l l I t a u g h t a n i m m u n o l o g y 12:05:41
25
class on his behalf so that he could take the time off.
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1
But as far as the scientific participation, no.
12:05:48
2
Q Okay. Have you seen any of the data from those
12:05:50
3 studies?
12:05:53
4
A No. Just only what has been in the published
12:05:54
5 literature.
12:05:56
6
Q Okay. Are you currently doing any consulting
12:05:57
7 work for industry outside of the litigation context?
12:06:05
8 A For any industry?
12:06:11
9
Q Well, for the petroleum industry, petrochemical
12:06:13
10 i n d u s t r y .
12:06:18
11
A I would say sitting here right now, no, I am
12:06:20
12 n o t .
12:06:24
13
Q Do you currently have any funding or grants
12:06:28
14 f r o m a n y p e t r o l e u m i n d u s t r y ?
12:06:31
15 A N o , n o t a c t i v e .
12:06:35
16
Q What is the last project that you did for the
12:06:37
17 p e t r o l e u m i n d u s t r y ?
12:06:40
18
A We looked at the -- there have been some really
12:06:42
19
interesting analyses that have come out of UNC and David
12:06:50
20 R i c h a r d s o n l o o k i n g a t t h e p l i o f i l m c o h o r t a n d h e h a s
12:06:56
21
done some really interesting things about time to tumor,
12:07:00
22 a g e o f e x p o s u r e .
12:07:03
23
And even before that came out, there was
12:07:05
24
interest within the industry, and I believe that it was
12:07:08
25 u s e f u l t o d o a l l a l o n g , a n d t h a t i s t o t a k e P a m e l a
12:07:13
112
1 Williams -- the Williams exposure estimates that she
12:07:18
2
published in 2003 and see whether that -- that new, more
12:07:21
3 rigorous exposure data for the workers in pliofilm,
12:07:28
4 whether that changes the cancer potency or whether it
12:07:32
5 changes really the dose response relationship.
12:07:36
6
And so we did have a small grant from API to
12:07:38
7 take that data and to put it into a format whereby
12:07:42
8 epidemiological analysis can be done.
12:07:48
9
And that was all we did was put it into
12:07:51
10
spreadsheets from the Williams publication that then you
12:07:53
11 c a n c o n d u c t e p i d e m i o l o g i c a l a n a l y s i s o n t h a t d a t a .
12:07:57
12
They have asked us to submit a proposal to then
12:08:02
13
conduct that analysis on that data, which we are in the
12:08:06
14 p r o c e s s o f d o i n g .
12:08:10
15 Q W h o i s t h e " w e " y o u a r e r e f e r r i n g t o ?
12:08:12
16
A The "we" -- the "we" would be Sean Hays, my
12:08:14
17 p a r t n e r , L i s a H o w a r d , t h e t h r e e o f u s t h a t r e p r e s e n t
12:08:17
18 S u m m i t T o x i c o l o g y .
12:08:23
19
And then this one is a little over our head as
12:08:25
20 f a r a s e p i d e m i o l o g i c a n a l y s i s c o n c e r n s o w e h a v e
12:08:28
21 c o l l a b o r a t e d w i t h D a v i d G a r a b r a n t a t t h e U n i v e r s i t y o f
12:08:31
22 M i c h i g a n a n d p o t e n t i a l l y M i c h a e l G o o d m a n a t E m o r y
12:08:34
23 U n i v e r s i t y .
12:08:39
24
Q Okay. And you have spoken about two projects,
12:08:39
25
one which you have done and one which you are seeking to
12:08:44
113
1 do?
12:08:48
2 A Right.
12:08:49
3
Q For the project that you have done, what was
12:08:50
4 t h e p a y m e n t f r o m t h e A m e r i c a n P e t r o l e u m I n s t i t u t e f o r 12:08:51
5 that work?
12:08:57
6
A Oh, what we charged them? What they paid us
12:08:59
7 for it?
12:09:02
8 Okay, I got it.
12:09:03
9 Q I assume they were the same?
12:09:04
10 A Y e a h . I u n d e r s t a n d .
12:09:06
11
Q If they were different, I will take both.
12:09:06
12
A No, I was thinking about something like pat on
12:09:08
13 t h e h e a d k i n d o f p a y m e n t .
12:09:10
14
We charged them $13,000, I think, to do that.
12:09:12
15
Q Okay. And you have submitted the proposal to
12:09:15
16 A P I f o r t h e n e x t p h a s e ?
12:09:19
17
A We haven't yet, but it's on my desk to do as
12:09:21
18 s o o n a s I a m f i n i s h e d h e r e .
12:09:24
19
Q Okay. And what is the estimated duration of
12:09:25
20 t h a t s t u d y t h a t y o u a r e p r o p o s i n g ?
12:09:27
21 A W e l l , i t i s k i n d o f d e p e n d e n t u p o n o u r
12:09:32
22
epidemiologic people, but I would say we would probably
12:09:35
23 h a v e s o m e p r e l i m i n a r y r e s u l t s i n s i x o r e i g h t m o n t h s . 12:09:39
24
So I am guessing a year -- it would take us a
12:09:42
25
year to get from start to where we could have something
12:09:44
114
1 ready for publication.
12:09:47
2
Q What is the amount of funding that you are
12:09:49
3 seeking from API for that?
12:09:50
4 A I think the total budget is about 70,000.
12:09:52
5
Q Okay. What -- other than this project and the
12:09:57
6 past phase and the future phase which you are hopeful
12:10:07
7 will occur, what other work have you done for the API
12:10:09
8 since 2000?
12:10:14
9
A Since 2000? I guess the only other funded
12:10:18
10 p r o j e c t t h a t c a m e f r o m A P I , a n d i t w a s i n c o n j u n c t i o n
12:10:29
11
with this thing called the Benzene Task Force, which was
12:10:33
12 p a r t o f A C C , a l o t o f t h e s a m e c o m p a n i e s , b u t t h e y
12:10:37
13 w e r e n ' t a l l p e t r o l e u m c o m p a n i e s . T h e y w e r e c h e m i c a l
12:10:42
14 c o m p a n i e s t h a t a l s o h a d a n i n t e r e s t i n b e n z e n e .
12:10:45
15
We did a child specific risk assessment in the
12:10:48
16 V C E P T p r o g r a m - - y o u a n d I h a v e t a l k e d a b o u t t h a t
12:10:52
17 b e f o r e - - t h a t w e p r e s e n t e d t o E P A a y e a r a g o .
12:10:55
18 Q A n d h o w m u c h w e r e y o u p a i d f o r t h a t ?
12:10:58
19
A I was paid -- personally was paid $20,000 for
12:11:01
20
my work on looking at the susceptibility of children to
12:11:08
21
chemically induced leukemias, which I published a couple
12:11:13
22 p a p e r s o n .
12:11:17
23
I think Summit Toxicology probably had twice
12:11:18
24 t h a t . M a y b e 5 0 o r 6 0 , 0 0 0 . T h e w h o l e p r o j e c t w a s v e r y
12:11:22
25 e x p e n s i v e a n d I d o n ' t k n o w w h a t t h e w h o l e b u d g e t w a s .
12:11:25
115
1 The exposure piece was very expensive.
12:11:28
2
Q Okay. Your affiliation with Summit Toxicology
12:11:31
3 is what?
12:11:37
4
A I am a principal, co-owner. I don't think I
12:11:38
5
have given myself a title, but Sean is the president so
12:11:43
6 I guess I can be the vice president.
12:11:47
7 Q Other than -- you mentioned the ACC.
12:11:51
8
Is that the American Chemistry Council?
12:11:54
9 A Yes.
12:11:56
10
Q Formally known as the Chemical Manufacturers
12:11:56
11 A s s o c i a t i o n ?
12:11:59
12 A R i g h t .
12:12:00
13 Q A n d f o r m e r l y k n o w n a s t h e M a n u f a c t u r i n g
12:12:00
14 C h e m i s t s A s s o c i a t i o n ?
12:12:03
15 A I t h i n k t h a t i s a l l t r u e , y e s .
12:12:04
16
Q All right. Have you done any other work for
12:12:06
17 t h a t o r g a n i z a t i o n a n d a n y o f i t s i t e r a t i o n s , i t s
12:12:10
18 d i f f e r e n t n a m e s ?
12:12:17
19 A T h e w o r k t h a t I h a v e b e e n d o i n g o n
12:12:18
20
formaldehyde, it was for the Formaldehyde Council, which
12:12:20
21 i s k i n d o f i t s o w n l i t t l e b u s i n e s s e n t i t y , b u t i t i s
12:12:24
22
part of -- well, I certainly think of it as part of ACC.
12:12:28
23
I have gone to and participated in scientific
12:12:32
24 m e e t i n g s f r o m t h e O l e f i n s P a n e l , w h i c h i s p a r t o f A C C
12:12:38
25 t h a t h a v e a l o n g - s t a n d i n g i n t e r e s t i n b u t a d i e n e .
12:12:44
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1
So I have been involved in looking at the new
12:12:47
2 Czech studies that they are doing, the Houston Ship
12:12:52
3 Channel study, just analysis of the data that is out
12:12:56
4 there regarding butidiene.
12:13:00
5
THE VIDEOGRAPHER: You have three minutes,
12:13:02
6 counsel, on the tape.
12:13:03
7
Q BY MR. METZGER: What funding have you received
12:13:04
8 from Formaldehyde Institute or ACC for that?
12:13:06
9
A The Formaldehyde, they paid for that paper
12:13:10
10 w h i c h I s p l i t w i t h c o - a u t h o r . I t h i n k I p r o b a b l y g o t
12:13:17
11 2 5 , 0 0 0 f o r m y w o r k i n t h e r e . A n d s i n c e I a m a p o o r
12:13:22
12 w r i t e r , i t w a s n o t a v e r y g o o d p a y c h e c k f o r m e .
12:13:27
13
For the Olefins group, really not much. They
12:13:34
14
paid for my travel and my time to sit in these meetings
12:13:39
15 a n d d i s c u s s w h a t I k n o w a b o u t b u t a d i e n e .
12:13:44
16
Q Do you plan on attending the Benzene Conference
12:13:48
17 i n M u n i c h t h i s c o m i n g S e p t e m b e r ?
12:13:51
18
A I do. I was part of the original planning
12:13:53
19 c o m m i t t e e f o r t h a t .
12:13:55
20
Q Is anyone paying for your travel for that?
12:13:57
21 A I d o u b t i t .
12:13:59
22
Q Okay. Do you have any other notes here that I
12:14:00
23 h a v e n ' t s e e n ?
12:14:06
24 A N o , j u s t m i s c e l l a n e o u s j u n k .
12:14:07
25
Q I think we need to take a tape change. Let me
12:14:10
117
1
just take a look at that while we are changing tape.
12:14:13
2
THE VIDEOGRAPHER: Now going off the record.
12:14:15
3
Time is 12:14 p.m. This is the end of Volume 1, tape
12:14:16
4 No. 3.
12:14:20
5
(At the hour of 12:15 p.m. the luncheon
12:14:20
6
recess was taken, the proceedings to be
12:14:20
7 resumed at 1:00 p.m.)
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8
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(At the hour of 1:05 p.m. the following
12:14:20
2
proceedings were had at the same place
12:14:20
3 with the same persons present.)
12:14:20
4 01:04:35
5 12:14:21
6
THE VIDEOGRAPHER: Now back on the record.
12:16:40
7 T i m e i s 1 : 0 3 p . m . T h i s i s t h e b e g i n n i n g o f V o l u m e 1 , 01:03:31
8 tape No. 4 in the deposition of Dr. David Pyatt.
01:03:34
9 Counsel?
01:03:38
10
(Deposition Exhibits 6-15 were marked
01:03:38
11 f o r i d e n t i f i c a t i o n . )
01:03:38
12
Q BY MR. METZGER: Are you ready to proceed,
01:03:38
13 D r . P y a t t ?
01:03:41
14 A S u r e , t h a n k s .
01:03:42
15 Q R e v i e w i n g m y n o t e s f r o m t h i s m o r n i n g - -
01:03:43
16
THE VIDEOGRAPHER: Counsel, your microphone, I
01:03:47
17 t h i n k i t ' s o n t h e f l o o r t h e r e a c t u a l l y .
01:03:48
18 M R . M E T Z G E R : Y e a h , t h a n k y o u .
01:03:51
19
Q Reviewing my notes from this morning, you
01:03:55
20
mentioned something I didn't ask you about, and I think
01:03:58
21 t h a t w a s t h a t M r . M a c h a d o h a d t h e P h i l a d e l p h i a
01:04:00
22 c h r o m o s o m e a b n o r m a l i t y ?
01:04:05
23 A C o r r e c t .
01:04:08
24
Q Is that significant to you in your evaluation
01:04:11
25 o f c a u s a t i o n i n t h i s c a s e ?
01:04:13
119
1
A To some extent. I mean there is no evidence
01:04:21
2 that I have ever seen that benzene exposure has been
01:04:23
3 associated with the 922 translocation. And I don't
01:04:26
4 believe benzene exposure at any dose causes CML, which
01:04:29
5 is likely to have the 922 translocation.
01:04:32
6
So it just makes Mr. Machado's presentation and
01:04:35
7
his disease a little inconsistent with what a benzene or
01:04:39
8 a chemically induced AML might look like.
01:04:45
9 Q Because he had the 922 translocation?
01:04:51
10 A C o r r e c t .
01:04:54
11
Q Is that the same thing as the Philadelphia
01:04:54
12 t r a n s l o c a t i o n ?
01:04:57
13 A Y e s .
01:04:58
14
Q Okay. I guess while we are on this topic, were
01:04:59
15 t h e r e a n y o t h e r h e m a t o l o g i c , m o r p h o l o g i c ,
01:05:17
16 i m m u n o p h e n o t y p i c o r c y t o g e n e t i c a b n o r m a l i t i e s o r
01:05:27
17
features of Mr. Machado's AML that you considered to be
01:05:30
18
inconsistent with benzene induced AML other than what we
01:05:34
19 h a v e a l r e a d y d i s c u s s e d ?
01:05:40
20
A I think we have discussed it, lack of preceding
01:05:41
21 m y e l o d y s p l a s i a , b u t w e h a v e d i s c u s s e d t h a t i n s o m e
01:05:45
22 d e t a i l .
01:05:48
23 Q S a m e q u e s t i o n f o r M r . P e a r l ?
01:05:48
24
A Yes. The only characteristic of Mr. Pearl
01:05:56
25 w o u l d b e t h a t t h e e v i d e n c e - - m y i n t e r p r e t a t i o n o f t h e
01:05:59
120
1 scientific literature is that chemically induced
01:06:04
2 leukemias are notoriously difficult to treat.
01:06:07
3
And his was treatable, but I am not positive if
01:06:11
4 that is a totally fair comparison because a lot of the
01:06:15
5 older studies they didn't have a well matched bone
01:06:18
6 marrow transplant or a stem cell transplant that they
01:06:22
7 could use as therapy.
01:06:25
8
So had they had that option available to them,
01:06:27
9 then those leukemias -- those chemically induced
01:06:32
10 l e u k e m i a s m i g h t h a v e b e e n a s t r e a t a b l e a s M r . P e a r l .
01:06:35
11
So I don't believe that is necessarily that
01:06:38
12 f a i r o f a c o m p a r i s o n .
01:06:41
13 Q O k a y . A l l r i g h t .
01:06:43
14
You consider yourself to be an expert in
01:06:48
15 b e n z e n e i n d u c e d l e u k e m i a ; r i g h t ?
01:06:51
16 A Y e s .
01:06:57
17
Q But since you are not a medical doctor, you
01:06:58
18 d o n ' t s e e p a t i e n t s w h o h a v e t h o s e d i s e a s e s o r t r e a t
01:07:00
19 t h e m ; c o r r e c t ?
01:07:03
20 A I d o n o t , n o .
01:07:04
21
Q Okay. And have you personally done -- been
01:07:08
22
involved in any epidemiologic studies of benzene exposed
01:07:14
23 w o r k f o r c e s t o a s s e s s l e u k e m i a i n t h o s e w o r k f o r c e s ?
01:07:19
24 A W e l l , t h e a n s w e r i s n o , I h a v e n ' t .
01:07:24
25
Q Okay. So have you ever seen a benzene induced
01:07:26
121
1 leukemia?
01:07:38
2
A There have been cases that people brought to me
01:07:42
3
where there was substantial exposure or the possibility
01:07:48
4
of substantial exposure and there were cytogenetics and
01:07:54
5 characteristics that I was unable to rule out.
01:08:00
6 Q But have you ever actually seen a benzene
01:08:07
7 induced leukemia and said, "Yes, this is a worker who
01:08:10
8 actually has it. I'm convinced"?
01:08:13
9 A I think those cases would be the closest.
01:08:16
10
Q But you never actually came out and said that,
01:08:20
11 " T h i s w o r k e r h a s a b e n z e n e i n d u c e d l e u k e m i a " ; r i g h t ?
01:08:22
12
A Well, I don't know what you mean by "came out
01:08:27
13 a n d s a i d . " I t o l d t h e p e o p l e t h a t w e r e t a l k i n g t o m e
01:08:29
14
about this that there wasn't anything that I could do to
01:08:33
15 h e l p t h e m i n t h i s c a s e . T h e y a r e g o i n g t o h a v e t o d o
01:08:36
16 s o m e t h i n g e l s e b e c a u s e I c a n ' t h e l p t h e m .
01:08:40
17 Q S o t h i s w a s a l i t i g a t i o n m a t t e r ?
01:08:41
18 A Y e s .
01:08:43
19 Q H o w m a n y t i m e s h a s t h a t o c c u r r e d ?
01:08:44
20 A I c a n t h i n k o f t w o .
01:08:48
21
Q And tell me what the presentations were of
01:08:51
22 t h e s e t w o w o r k e r s .
01:08:56
23
Where you told -- you were speaking to the
01:08:59
24 d e f e n s e l a w y e r s ; r i g h t ?
01:09:02
25 A Y e s .
01:09:04
122
1
Q Okay. And what were the presentations of these
01:09:05
2
two workers that you told those defense lawyers that you
01:09:08
3 didn't think that you could help them?
01:09:12
4
A That they both had ample opportunity for high
01:09:14
5
dose exposure to benzene. They both used benzene in the
01:09:18
6 workplace. They had sufficient exposures within the
01:09:21
7 appropriate time window.
01:09:26
8
They had preceding myelodysplasias. They had
01:09:29
9 cytogenetic changes that were consistent. Both were
01:09:35
10 r e f r a c t o r y t o t r e a t m e n t . S o t h o s e c h a r a c t e r i s t i c s .
01:09:39
11
Q What were the cytogenetic changes that they
01:09:45
12 h a d ?
01:09:48
13
A One had monosome 7. And -- they both did.
01:09:49
14 T h e y b o t h h a d m o n o s o m e 7 .
01:09:54
15
Q And so the loss of one of the chromosome 7's?
01:09:57
16 A T h a t i s c o r r e c t .
01:10:03
17
Q Okay. All right. Let's take a look please at
01:10:13
18 E x h i b i t 6 .
01:11:09
19
And are these two pages typewritten notes that
01:11:09
20 y o u m a d e r e g a r d i n g M r . P e a r l ?
01:11:09
21 A Y e s .
01:11:34
22 Q A n d t a k e a l o o k a t E x h i b i t 7 .
01:11:38
23
Are those two typewritten pages notes that you
01:11:41
24 m a d e r e g a r d i n g M r . H a z l e h u r s t ?
01:11:44
25 A Y e s .
01:11:46
123
1 Q Did you also make some typewritten notes
01:11:47
2 regarding Mr. Machado?
01:11:49
3
A Sure seems like I did. I don't know where they
01:11:51
4 are.
01:11:54
5
Q Would you see if you can find those because I
01:11:56
6 didn't see them in your materials there.
01:11:58
7
A It was mainly just so that I could -- well,
01:12:01
8
this is the exposure stuff. And if they are not -- it's
01:12:09
9 not on the table somewhere, it must not have made it
01:12:34
10 i n t o m y b a g c o m i n g o u t h e r e . T h a t o n e o v e r t h e r e
01:12:36
11 d o e s n ' t h a v e a n y t h i n g i n i t .
01:12:41
12 Q W e l l , w h y d o n ' t w e d o t h i s - -
01:12:45
13
A I can certainly send it to you, provide it to
01:12:47
14 y o u .
01:12:49
15
Q Yeah. Why don't we do this: Why don't you
01:12:49
16 s e n d i t t o m e . A n d i f I f e e l t h a t I n e e d t o a s k y o u
01:12:52
17 s o m e q u e s t i o n s a b o u t i t , w e w i l l j u s t h a v e a s h o r t
01:12:54
18 t e l e p h o n i c r e s u m p t i o n o f t h e d e p o s i t i o n .
01:12:57
19 A S o u n d s f a i r .
01:13:00
20 Q O k a y . A l l r i g h t .
01:13:00
21
So let's start now with Exhibit No. 6. You
01:13:10
22 h a v e h e r e , " J o h n P e a r l , b o r n i n 1 9 6 0 . "
01:13:19
23
Is there any significance of that to your
01:13:23
24 a n a l y s i s ?
01:13:25
25
A No. I mean he was a relatively young person to
01:13:31
124
1 develop AML so I made note of that.
01:13:36
2
Q And does that, the fact that he was young, tend
01:13:40
3 to -- is that consistent with a chemically induced
01:13:46
4 leukemia as opposed to one that is not?
01:13:50
5
A Well, AML is a disease that the incident rate
01:13:57
6 increases precipitously with age. And so the incident
01:14:01
7 rate at people at John's -- at John Pearl's age have a
01:14:05
8
lower incident rate of leukemia than someone say 70, 65
01:14:13
9 or 70.
01:14:17
10
Q And does that tend to indicate that it would be
01:14:19
11
more consistent with chemically induced leukemia than an
01:14:25
12 a g e r e l a t e d l e u k e m i a ?
01:14:29
13
A Yeah. The way you worded that question, I
01:14:35
14 t h i n k t h e a n s w e r i s y e s .
01:14:39
15
Q Okay. You also wrote that he was a nonsmoker.
01:14:40
16 W h a t w a s t h e s i g n i f i c a n c e o f t h a t ?
01:14:43
17
A That cigarette smoking is an established cause
01:14:45
18 o f - - e t i o l o g i c a l r i s k f a c t o r f o r A M L .
01:14:48
19
Q And "healthy guy," what is the significance of
01:14:54
20 t h a t ?
01:14:57
21
A Not -- there is no significance. I think he
01:15:00
22 s a i d h e w a s a w e i g h t l i f t e r a n d j u s t t h i n g s t h a t I
01:15:02
23 p i c k e d u p f r o m r e a d i n g h i s m e d i c a l r e c o r d s .
01:15:05
24
Q Okay. The fourth bullet point you have is,
01:15:07
25 " H i s o r i g i n a l c y t o g e n e t i c s t u d y w a s c o m p l e x , i n c l u d i n g
01:15:21
125
1 minus 5 deletion (q1.1-33.)"
01:15:25
2
What was the significance that his original
01:15:32
3 cytogenetic study was complex?
01:15:35
4
A It was just taking note of what I saw in the
01:15:40
5 medical records. It wasn't necessarily significant or
01:15:43
6 not significant. It just was -- these were the things
01:15:46
7 that I picked up from reading his medical records.
01:15:50
8
Q Does a complex cytogenetic study or karyotype,
01:15:54
9 is that more consistent with a chemically induced
01:15:58
10 l e u k e m i a t h a n o n e t h a t i s n o t ?
01:16:01
11
A We talked about that. I think that when you
01:16:06
12 l o o k a t c h e m i c a l l y i n d u c e d l e u k e m i a s , y o u w i l l
01:16:08
13 f r e q u e n t l y s e e c o m p l e x c y t o g e n e t i c p i c t u r e , b u t t h e r e
01:16:12
14 a r e p l e n t y o f c a s e s o f A M L w h e r e t h e r e a r e c o m p l e x
01:16:16
15 c y t o g e n e t i c c h a n g e s w h e r e t h e r e i s n o k n o w n d o c u m e n t e d
01:16:20
16 e x p o s u r e t o a n y t h i n g .
01:16:24
17
So whether it is more or less consistent, I
01:16:25
18 c o u l d n ' t s a y d e f i n i t i v e l y .
01:16:27
19
Q We have already spoken about the minus 5. That
01:16:30
20 i s t h e c h r o m o s o m e a b n o r m a l i t y o n c h r o m o s o m e 5 t h a t w e
01:16:33
21 h a v e b e e n t a l k i n g a b o u t ; c o r r e c t ?
01:16:37
22 A Y e s .
01:16:38
23
Q Do you attribute any significance to the change
01:16:50
24 i n h i s c y t o g e n e t i c p i c t u r e f o l l o w i n g c h e m o t h e r a p y ?
01:16:53
25
A In relation to this case, no. I mean I think
01:17:01
126
1 that that is either -- it's either A, an evolutionary
01:17:03
2 event in the development of his disease or it had
01:17:07
3
something to do with his myeloablative therapy that they
01:17:10
4 gave him for the stem cell transplant.
01:17:14
5
Q The last bullet point you have, "His benzene
01:17:25
6
exposures per Dr. Nicas were driven by the introduction
01:17:28
7
of gasoline into the parts washer while carburetors were
01:17:31
8 being cleaned."
01:17:35
9 What is the significance of that?
01:17:35
10
A Just to remind me that that is what the -- Dr.
01:17:37
11 N i c a s ' e x p o s u r e w a s b a s e d o n .
01:17:41
12
Q Was there any significance to the fact that Dr.
01:17:48
13 N i c a s , a s y o u i n t e r p r e t i t , f o u n d t h a t t h e e x p o s u r e s
01:17:49
14 w e r e d r i v e n b y g a s o l i n e i n t h e p a r t s w a s h e r ?
01:17:55
15
A Well, yes, to some extent. I mean the gasoline
01:17:59
16 l i t e r a t u r e t h a t w e h a v e d i s c u s s e d , i n m y v i e w , d o e s n ' t
01:18:03
17
support a gasoline exposure increases one's risk of AML.
01:18:07
18
I don't believe there that there is enough
01:18:12
19 b e n z e n e m i n e r a l s p i r i t s o r S a f e t y - K l e e n o r S t o d d a r d
01:18:16
20 s o l v e n t t o i n c r e a s e o n e ' s r i s k o f A M L .
01:18:19
21
So you take a substance that has benzene in it,
01:18:22
22 n o t e n o u g h , a n d y o u p o u r i t i n t o t h e p a r t s w a s h e r , i t
01:18:24
23 j u s t d o e s n ' t m a k e s e n s e t o m e .
01:18:29
24 Q O k a y . A n y t h i n g b e y o n d t h a t ?
01:18:31
25 A N o .
01:18:32
127
1
Q All right. Now, you have written some opinions
01:18:35
2 here. Let's just take a look at those.
01:18:38
3
Your second opinion, "Mr. Pearl's exposures to
01:18:46
4
benzene from SK 105 and parts washing are lower than his
01:18:48
5 background exposures to benzene," did I read that
01:18:54
6 correctly?
01:18:56
7 A Yes.
01:18:57
8
Q What are you referring to as the background
01:18:57
9 exposures?
01:19:00
10
A I am referring to what Pat Sheehan calculated
01:19:01
11 f o r h i s e x p o s u r e q u a n t i f i c a t i o n , w o r k i n g i n t h e s h o p ,
01:19:05
12 j u s t h a d b a c k g r o u n d p e r D r . S h e e h a n .
01:19:11
13
Q So you mean the benzene in the air in the shop
01:19:17
14 a s o p p o s e d t o t h e b e n z e n e i n t h e - - j u s t i n t h e
01:19:20
15 e n v i r o n m e n t ?
01:19:26
16
A Well, I mean whatever Dr. Sheehan means. The
01:19:27
17 e x p o s u r e f r o m t h e s h o p , e x p o s u r e f r o m w a s h i n g p a r t s i n
01:19:34
18
gasoline in a bucket, exposure to gasoline in a part --
01:19:38
19
well, so I guess it would be exposure to benzene in the
01:19:42
20 s h o p p e r h i s c a l c u l a t i o n s .
01:19:46
21
Q He also has benzene in the air, does he not,
01:19:48
22 t h e a m b i e n t a i r ?
01:19:50
23 A Y e s .
01:19:53
24 Q S o i t w o u l d b e t h o s e t w o ?
01:19:54
25 A S u r e .
01:20:00
128
1
Q Do you think it's reasonable that Mr. Pearl's
01:20:04
2 exposure to benzene from the use of Safety-Kleen 105
01:20:10
3 solvent would be less than his exposure to benzene in
01:20:12
4 the air that we all breathe?
01:20:20
5
A From the solvent, yes. That seems -- that
01:20:26
6 seems plausible to me.
01:20:29
7 Q Why?
01:20:31
8 A Because there is not that much benzene in
01:20:31
9 Safety-Kleen solvent.
01:20:34
10
Q Well, whatever amount there is, wouldn't that
01:20:36
11 b e a d d i t i v e t o w h a t ' s i n t h e a i r ?
01:20:39
12 A W e l l , i f y o u w a n t t o l o o k a t h i s t o t a l
01:20:51
13
cumulative exposure, I guess that's right. But I think
01:20:53
14 w h a t D r . S h e e h a n d i d w a s t r y t o s e p a r a t e t h a t o u t a n d
01:20:56
15 s a y w h a t w a s h i s e x p o s u r e s t o b a c k g r o u n d , w h a t w a s t h e
01:20:59
16 a d d i t i o n a l c o n t r i b u t i o n t h a t h i s u s e o f S a f e t y - K l e e n
01:21:02
17
solvent might have made to his total overall exposures.
01:21:06
18 Q O h , s o - -
01:21:10
19
A All I am saying is that when you compare those,
01:21:12
20 i t i s n o t t o t a l l y o u t o f l i n e t o t h i n k t h a t h i s
01:21:15
21
exposures to solvents in the parts washer was lower than
01:21:18
22 h i s b a c k g r o u n d l e v e l s .
01:21:21
23
Q Well, let's not talk cumulatively for a moment.
01:21:22
24 L e t ' s t a l k a b o u t r e a l t i m e .
01:21:25
25
When Mr. Pearl was washing parts in the parts
01:21:27
129
1
washer machine using Safety-Kleen 105 solvent, according
01:21:30
2 to Dr. Sheehan, the concentration of benzene that he
01:21:35
3 inhaled was less than the concentration of benzene in
01:21:41
4 the air that we all breathe, wasn't it?
01:21:44
5
A I don't think that's the proper interpretation
01:21:48
6
of these numbers. I think he did what I am saying, that
01:21:50
7
he tried to calculate what the individual contributions
01:21:55
8 would be from using the parts washer, using the parts
01:21:59
9 washer with gasoline added, washing parts in a bucket
01:22:02
10 w i t h g a s o l i n e a n d o t h e r p o t e n t i a l s o u r c e s .
01:22:06
11
Q You have had a conversation with Dr. Sheehan,
01:22:09
12 h a v e y o u n o t ?
01:22:11
13 A I h a v e .
01:22:12
14 Q A b o u t a n h o u r ?
01:22:13
15 A S e e m s a b o u t r i g h t , y e s .
01:22:14
16
Q And did you ask him about that during that
01:22:15
17 c o n v e r s a t i o n ?
01:22:18
18 A N o .
01:22:19
19
Q We will talk more about the conversation, but
01:22:20
20 l e t ' s g o o n f o r n o w .
01:22:23
21
Your fourth opinion you write, "There were some
01:22:39
22 f e a t u r e s o f M r . M a c h a d o ' s - - w a i t a s e c o n d . W e a r e
01:22:42
23 l o o k i n g a t t h e s u m m a r y r e g a r d i n g M r . P e a r l a n d t h e
01:22:50
24 f o u r t h o n e , i t s a y s , " M r . M a c h a d o . "
01:22:53
25 A O h , y e a h .
01:22:55
130
1 Q Which one did you mean there?
01:22:56
2 A Yeah, this one was -- this one is for
01:23:02
3 Mr. Pearl.
01:23:05
4
Q So it should say "Mr. Pearl." That is what you
01:23:06
5 intended to say?
01:23:09
6 A No, because Mr. Pearl -- yes, yes, yes.
01:23:10
7
Q So correcting that, it says, "There were some
01:23:12
8 features of Mr. Pearl's AML that were consistent with
01:23:15
9 the chemically induced AML, but others that were not.
01:23:19
10
The cytogenetics is what one might expect. On the other
01:23:23
11 h a n d , c h e m i c a l l y i n d u c e d A M L a r e n o t o r i o u s l y d i f f i c u l t
01:23:29
12 t o t r e a t , a l t h o u g h S C T w a s n o t a v a i l a b l e f o r m a n y . "
01:23:31
13 T h a t ' s - -
01:23:36
14 A S t e m c e l l t r a n s p l a n t .
01:23:37
15 Q O k a y . " A l s o , t h e r e w a s n o e v i d e n c e o f a
01:23:39
16
preceding MDS. Based on these characteristics alone, it
01:23:41
17 w o u l d b e t o o c l o s e t o c a l l . "
01:23:46
18 D i d I r e a d t h a t c o r r e c t l y ?
01:23:49
19 A Y e s .
01:23:50
20
Q What do you mean it would be too close to call?
01:23:51
21
A That if I didn't know anything about the case
01:23:53
22
other than the presentation of the disease, I would not
01:23:56
23
be able to say yes, this looks like a chemically induced
01:23:59
24
leukemia versus no, this does not look like a chemically
01:24:03
25 i n d u c e d l e u k e m i a . I t h a s c h a r a c t e r i s t i c s o f b o t h .
01:24:06
131
1
When you factor in what his cumulative
01:24:09
2 exposures were, then that totally pushes it toward the
01:24:11
3
de novo and that benzene didn't cause it. That is what
01:24:17
4 I meant.
01:24:20
5
Q Okay. In reaching your conclusion that benzene
01:24:23
6 did not cause Mr. Pearl's AML, what standard are you
01:24:51
7 applying?
01:24:55
8 A I don't understand that question.
01:24:56
9
Q Are you -- are you reaching that opinion to a
01:24:57
10 s c i e n t i f i c c e r t a i n t y ?
01:25:00
11 A Y e s .
01:25:04
12
Q Okay. Let's take a look at Exhibit 7 regarding
01:25:23
13 M r . H a z l e h u r s t . Y o u h a v e t h a t h e w a s b o r n 1 9 4 8 .
01:25:26
14 A n y s i g n i f i c a n c e t o t h a t ?
01:25:38
15
A Same that we talked about, just what his age
01:25:39
16 w a s a t t i m e o f d i a g n o s i s .
01:25:42
17
Q You note that, "For at least five years prior
01:25:45
18
to his diagnosis, he routinely visited a doctor for pain
01:25:47
19 m e d i c a t i o n a n d s l e e p m e d i c i n e f o r c h r o n i c l o w b a c k
01:25:52
20 p a i n , " i s t h e r e a n y s i g n i f i c a n c e t o y o u r o p i n i o n ?
01:25:55
21 A N o .
01:25:58
22
Q Or the next sentence that says, "There was no
01:26:01
23
evidence of nausea, headaches or other systemic symptoms
01:26:03
24 d u r i n g t h i s t i m e " ?
01:26:08
25
A No. I mean the levels of exposure that both
01:26:09
132
1 experts -- exposure experts have talked about, I
01:26:11
2
wouldn't expect there to be any systemic manifestations
01:26:14
3 of toxicity to those.
01:26:21
4
Q Your next bullet point mentions that he was
01:26:29
5 diagnosed in 2005 and then that he was experiencing
01:26:39
6
shortness of breath following a tooth extraction and had
01:26:46
7 an elevated WBC.
01:26:49
8 That's a white blood count; correct?
01:26:51
9 A As I recall, that was how it originally
01:26:56
10 p r e s e n t e d .
01:26:57
11 Q I s t h e r e a n y s i g n i f i c a n c e o f t h a t i n i t i a l
01:26:57
12 p r e s e n t a t i o n f o r y o u r o p i n i o n ?
01:26:59
13
A Not the shortness of breath and the elevated
01:27:02
14 W B C , t h a t i s w h a t y o u w o u l d e x p e c t . W e h a v e a l r e a d y
01:27:04
15 t a l k e d a b o u t t h e n o r m a l c y t o g e n e t i c s .
01:27:08
16 Q O k a y . Y o u n o t e d h e h a d n o p r e c e d i n g M D S .
01:27:11
17
And then that he had a 20 pack-year history of
01:27:15
18 s m o k i n g . W h a t i s t h e s i g n i f i c a n c e o f t h a t ?
01:27:17
19
A As we discussed earlier, cigarette smoking is
01:27:19
20 a n e s t a b l i s h e d e t i o l o g i c a l r i s k f a c t o r f o r A M L .
01:27:22
21
Q Okay. You note that in October 2006, there was
01:27:29
22 o n e c e l l t h a t w a s p l u s 1 3 a n d m i n u s 1 9 . A n d t h a t b y
01:27:32
23 N o v e m b e r 2 0 0 6 , t h e r e w e r e t w o c e l l s w i t h t r i s o m e 1 3 .
01:27:37
24 W h a t i s t h e s i g n i f i c a n c e o f t h a t ?
01:27:41
25 A T h a t t h e r e w a s e v o l u t i o n g o i n g o n i n h i s
01:27:43
133
1 disease or that there were additional cytogenetic
01:27:47
2 changes associated with his induction therapy.
01:27:50
3
Q Which do you believe is responsible for those
01:27:57
4 changes?
01:28:00
5
A I don't think you can definitively say, but I
01:28:01
6 don't think you can rule out -- well, I know that you
01:28:03
7 cannot rule out the possibility that it was related to
01:28:06
8 the induction therapy.
01:28:10
9
Q Okay. So it could be either-or, either one or
01:28:11
10 t h e o t h e r ?
01:28:15
11 A I t h i n k t h a t i s f a i r .
01:28:16
12 Q O k a y . N o w - -
01:28:17
13
A I also pointed out that most cytogeneticists do
01:28:22
14
not consider a single cell -- findings in a single cell
01:28:28
15 t o b e e v i d e n c e o f a c l o n a l l e s i o n .
01:28:32
16
So the trisome 13 and the monosome 19 was
01:28:34
17 o b s e r v e d i n o n e c e l l a s I r e c a l l , s o t h a t r e a l l y i s n ' t
01:28:37
18 c o n s i d e r e d a p o s i t i v e f i n d i n g .
01:28:41
19
Q In October, but then a month later they found
01:28:42
20 t h e t r i s o m e 1 3 i n t w o m o r e c e l l s ?
01:28:45
21
A Right. So there probably most cytogeneticists
01:28:48
22
would think, okay, there probably is something going on,
01:28:50
23 b u t I t h i n k t h e d i a g n o s t i c c r i t e r i a i s s t i l l t h r e e
01:28:54
24 c e l l s . T h e y n e e d t h r e e c e l l s t h a t h a v e t h e s a m e
01:28:58
25 c y t o g e n e t i c c h a n g e t o s a y t h a t i t w a s c l o n a l .
01:29:01
134
1
Q Okay. Now, the purpose of chemotherapy is to
01:29:04
2 destroy cancer cells; correct?
01:29:10
3 A Yes.
01:29:14
4 Q And some chemotherapeutic agents are
01:29:15
5 specifically designed to knock out chromosome
01:29:20
6 abnormalities. True?
01:29:27
7 A Some are specifically designed to target
01:29:35
8 abnormal proteins that are associated with chromosomal
01:29:38
9 abnormalities, yes.
01:29:41
10
Q Okay. And that has the effect of killing the
01:29:44
11 c e l l s t h a t h a v e t h o s e a b n o r m a l i t i e s s o t h a t y o u d o n ' t
01:29:47
12 s e e t h o s e c h r o m o s o m a l a b n o r m a l i t i e s ; r i g h t ?
01:29:51
13 A R i g h t , p r e v e n t i n g t h o s e c e l l s f r o m
01:29:55
14 p r o l i f e r a t i n g a n d p a s s i n g o n t h a t g e n e t i c i n s t a b i l i t y .
01:29:57
15
Q So is it true that following chemotherapy --
01:30:02
16
well, in practice, a repeat cytogenetic study is done to
01:30:04
17
see if chemotherapy is working; in other words, if those
01:30:14
18 c y t o g e n e t i c a b n o r m a l i t i e s t h a t w e r e t h e r e i n i t i a l l y
01:30:19
19 r e m a i n t h e r e ?
01:30:23
20 A Y e s .
01:30:24
21
Q So the -- at least the short-term effect of the
01:30:24
22 c h e m o t h e r a p y i s t o r e d u c e o r e l i m i n a t e t h e c y t o g e n e t i c
01:30:29
23 a b n o r m a l i t i e s ?
01:30:37
24
A Well, I think that is a -- I think that is a
01:30:40
25 s i d e e f f e c t . T h a t i s a p e r i p h e r a l - - I m e a n w h a t t h e y
01:30:42
135
1
are trying to do is reduce the tumor burden of leukemic
01:30:45
2 cells that are positive for that cytogenetic change.
01:30:49
3 Q Right.
01:30:52
4
And as a result, hematologists are pleased when
01:30:53
5 they give chemotherapy to a patient and a subsequent
01:31:02
6 cytogenetic analysis shows that prior chromosome
01:31:06
7 abnormalities are no longer observed; right?
01:31:12
8
A That is an indication that they were successful
01:31:16
9 in their original treatment, yes.
01:31:18
10 Q R i g h t .
01:31:20
11
So isn't it true that the effect of the
01:31:21
12 c h e m o t h e r a p y i s a c t u a l l y t o e l i m i n a t e o r r e d u c e t h e
01:31:26
13 c h r o m o s o m a l a b n o r m a l i t i e s r a t h e r t h a n t o p r o d u c e t h e m ,
01:31:32
14 a t l e a s t s h o r t t e r m ?
01:31:35
15
A Well, I don't think that any hematologist or
01:31:37
16
pharmacologist would say that they are trying to design
01:31:41
17 d r u g s t o c a u s e c h r o m o s o m a l c h a n g e s , b u t t h a t d o e s n ' t
01:31:44
18 c h a n g e t h e f a c t t h a t t h e y d o .
01:31:48
19 Q I u n d e r s t a n d .
01:31:49
20
What I am getting at is when an oncologist or
01:31:50
21
hematologist gives a patient chemotherapy drugs, an AML
01:31:54
22 p a t i e n t , w h a t t h e y h o p e t o s e e i s t h a t , i f t h e r e w e r e
01:31:58
23
previously observed chromosomal abnormalities, those are
01:32:07
24 n o l o n g e r o b s e r v e d a f t e r c h e m o t h e r a p y ? T h a t i s w h a t
01:32:12
25 t h e y a r e l o o k i n g f o r a n d h o p i n g ; r i g h t ?
01:32:14
136
1 A Yes.
01:32:16
2
Q All right. So at what point in the process can
01:32:16
3 you say that the chemotherapy induced the chromosome
01:32:26
4
abnormality that is observed rather than eliminating it?
01:32:32
5
A Well, I think the point in the process will be
01:32:36
6 when the disease relapses, what it looks like. And if
01:32:40
7 it is different than the original presentation and now
01:32:45
8 there are new cytogenetic changes that you did not see
01:32:48
9 prior to the chemotherapy, you cannot rule out the
01:32:51
10 p r o b a b i l i t y t h a t t h e c h e m o t h e r a p y i s w h a t c a u s e d t h a t
01:32:54
11 a d d i t i o n a l c y t o g e n e t i c c h a n g e .
01:33:01
12
Q How long does it take for those additional
01:33:02
13
cytogenetic changes to occur as a result of chemotherapy
01:33:04
14 w h e r e t h e y a r e o b s e r v e d i n p a t i e n t s ?
01:33:09
15
A I'm probably not the best person to ask. I
01:33:11
16 m e a n I t h i n k t h e s e d i s e a s e s c a n r e l a p s e a s q u i c k l y a s
01:33:15
17 t h r e e m o n t h s .
01:33:19
18
Q Okay. Is there any significance to you of the
01:33:20
19 t r i s o m e 1 3 a b n o r m a l i t y t h a t M r . H a z l e h u r s t h a d ?
01:33:36
20 A N o .
01:33:40
21
Q It is a type of chromosomal abnormality that is
01:33:45
22 c l a s s i f i e d a s a n e u p l o i d y ; c o r r e c t ?
01:33:51
23 A Y e s .
01:33:54
24
Q And benzene does cause aneuploidy, does it not?
01:33:54
25
A I would agree that under appropriate exposure
01:33:59
137
1
conditions, you will see changes in chromosome numbers,
01:34:01
2 yes.
01:34:05
3
Q And the minus 19 is also a form of aneuploidy.
01:34:07
4 It's the loss of a chromosome; correct?
01:34:10
5 A Yes.
01:34:14
6 Q And benzene also does that, does it not?
01:34:14
7
A I have never seen any evidence that benzene
01:34:18
8 causes a monosome in 19 -- causes a loss of 19.
01:34:20
9 Q No, I am sorry. I meant more generally,
01:34:25
10
benzene does -- has the ability to knock out chromosomes
01:34:27
11 p r o d u c i n g m o n o s o m e s ?
01:34:33
12
A Particularly with monosome 7, that seems to be
01:34:36
13 t r u e .
01:34:39
14
Q Okay. All right. So you next write that,
01:34:39
15 " C u m u l a t i v e e x p o s u r e s p e r D r . S h e e h a n f r o m S K 1 0 5 a n d
01:34:52
16 g a s o l i n e w a s 0 . 6 P P M y e a r s " ; c o r r e c t ?
01:34:57
17 A R i g h t , y e s .
01:35:01
18
Q And by that do you mean that the cumulative
01:35:02
19 e x p o s u r e s t h a t M r . H a z l e h u r s t h a d f r o m S a f e t y - K l e e n
01:35:04
20 s o l v e n t a n d g a s o l i n e i n a S a f e t y - K l e e n p a r t s w a s h e r
01:35:11
21 o p e r a t i o n w a s . 0 6 P P M y e a r s ?
01:35:16
22
A That seems right. I think that is what he
01:35:19
23 s a i d .
01:35:22
24 Q A n d i s n ' t i t t r u e t h a t 0 . 6 P P M y e a r s i s
01:35:24
25 s u f f i c i e n t t o c a u s e A M L ?
01:35:27
138
1 A That is not true.
01:35:31
2
Q Okay. Your first opinion for Mr. Hazlehurst is
01:35:39
3 that "Mr. Hazlehurst was not exposed to sufficient
01:35:54
4
quantities of benzene to meaningfully increase his risks
01:35:58
5 for forming AML."
01:36:02
6
Was he exposed to sufficient quantities of
01:36:04
7 benzene to increase his risk of developing AML at all?
01:36:06
8 A Depends on who you ask.
01:36:13
9 Q I am asking you.
01:36:15
10
A Well, I don't think he was because I don't
01:36:15
11 b e l i e v e t h a t t h e l i n e a r m o d e l i s a p p r o p r i a t e .
01:36:18
12
Q And I am gathering from your response that
01:36:22
13 t h e r e i s a - - t h e r e a r e d i f f e r e n t v i e w s o n t h a t t o p i c
01:36:24
14 h e l d w i t h i n t h e s c i e n t i f i c c o m m u n i t y ; i s t h a t c o r r e c t ?
01:36:28
15
A On the linearized multi-staged model, it is a
01:36:32
16
policy decision that EPA uses to model most carcinogens.
01:36:34
17
Q So you are telling me that the EPA has adopted
01:36:47
18 t h a t , t h a t m o d e l ?
01:36:54
19
A The linearized multi-stage, yes. They invented
01:36:56
20 it.
01:37:00
21 Q I s e e .
01:37:01
22
Do other governmental agencies use that
01:37:06
23 a p p r o a c h ?
01:37:10
24
A I know of some that do and some that don't. It
01:37:12
25
depends on the chemical, depends on the disease, depends
01:37:15
139
1
on the agency. You know, even when you use a linearized
01:37:18
2 model, there are increased risks associated with that
01:37:23
3 modeling effort below which you don't have to consider
01:37:30
4 them.
01:37:34
5
Congress ruled on that in 1983 that anything
01:37:35
6 below 10 to the minus 6 was considered de minimus. So
01:37:38
7
even with a linearized model, there are increased risks;
01:37:43
8 one times 10 to the minus 7, for example, that the EPA
01:37:47
9 would consider insignificant.
01:37:49
10
Q What is the risk of developing AML from benzene
01:37:55
11 e x p o s u r e a t a c u m u l a t i v e l i f e t i m e d o s e o f 4 0 p a r t p e r
01:38:02
12 m i l l i o n y e a r s ?
01:38:11
13 A I c a n ' t r e m e m b e r . I d o n ' t k n o w .
01:38:23
14
Q Is it -- is the risk more than one times 10 to
01:38:25
15 t h e m i n u s 6 ?
01:38:29
16 A Y e s .
01:38:31
17
Q More than one times -- more than one times 10
01:38:31
18 t o t h e m i n u s 5 ?
01:38:35
19
A I don't think so, but I am not sure. Now that
01:38:37
20 i s u s i n g t h i s l i n e a r i z e d m o d e l , w h i c h i s p u r e l y a
01:38:38
21 t h e o r e t i c a l e x e r c i s e .
01:38:43
22
A more appropriate comparison of that 40 part
01:38:46
23 p e r m i l l i o n y e a r s i s g o i n g t o b e w h a t d o e s t h e
01:38:50
24 q u a n t i t a t i v e e p i d e m i o l o g y t e l l u s a b o u t p e o p l e w h o h a d
01:38:53
25 t h o s e e x p o s u r e s .
01:38:56
140
1
And there you will see that there is not a
01:38:58
2 statistically significant increase in AML associated
01:39:00
3 with those cumulative levels.
01:39:03
4 Q You are familiar with the OSHA benzene
01:39:19
5 standard?
01:39:21
6 A Yes.
01:39:22
7
Q When that was adopted, it's true, is it not,
01:39:25
8 that the standard was set, even though at the level of
01:39:30
9 the standard, there would be an increased risk of
01:39:37
10
leukemia from benzene using that model greater than one
01:39:41
11 t i m e s 1 0 t o t h e m i n u s 5 ?
01:39:50
12 A I w o u l d h a v e t o r e v i e w t h a t d o c u m e n t .
01:39:53
13
Q In fact, it was greater than one times 10 to
01:39:55
14 t h e m i n u s 4 , w a s n ' t i t ?
01:39:58
15
A I don't recall. I would have to review it.
01:40:01
16
Q Okay. Regarding your opinion No. 6, you write,
01:40:10
17
"It is not possible to rule out the role that cigarette
01:40:32
18 s m o k i n g p l a y e d i n t h e e t i o l o g y o f h i s d i s e a s e . "
01:40:36
19
You are referring to Mr. Hazlehurst; right?
01:40:42
20 A Y e s .
01:40:43
21 Q A r e y o u - - I u n d e r s t a n d t h a t .
01:40:43
22
But are you going to tell the jury that it is
01:40:44
23 s c i e n t i f i c a l l y p r o b a b l e t h a t c i g a r e t t e s m o k i n g d i d
01:40:49
24 c o n t r i b u t e t o h i s A M L ?
01:40:54
25
A I don't know how to answer that. I wouldn't
01:41:01
141
1
say that because I don't know how anyone could make that
01:41:02
2 determination.
01:41:05
3
What I will tell them is that the literature is
01:41:05
4
pretty clear that a cigarette smoking history, as large
01:41:08
5
as his or larger, does increase one's risk of developing
01:41:12
6 AML. That is as far as I could take it.
01:41:17
7 Q Okay. Your last point here, No. 7, "The
01:41:20
8 scientific literature on the mechanic profession does
01:41:28
9 not indicate that this profession puts one at an
01:41:31
10 i n c r e a s e d r i s k o f d e v e l o p i n g A M L " ; c o r r e c t ?
01:41:35
11 A Y e s .
01:41:38
12 Q Y o u h a v e r e v i e w e d t h e s t u d i e s - - c e r t a i n
01:41:39
13 s t u d i e s o n t h a t t o p i c ; c o r r e c t ?
01:41:41
14 A Y e s .
01:41:43
15
Q Did any of those studies report a statistically
01:41:44
16 s i g n i f i c a n t i n c r e a s e d r i s k o f A M L i n m e c h a n i c s ?
01:41:48
17 A I t h i n k t h e r e i s p r o b a b l y o n e .
01:41:52
18 Q B u t y o u d i s c o u n t t h a t s t u d y ?
01:41:55
19
A That is not true at all. Just because there is
01:41:58
20
one finding that finds an excess but then there is four
01:42:00
21
or five findings that do not find an excess, you have to
01:42:03
22 l o o k a t i t c o l l e c t i v e l y .
01:42:06
23
You have to weigh the entire literature
01:42:07
24 c o l l e c t i v e l y . Y o u c a n ' t p i c k o u t o n e s t u d y a n d s a y ,
01:42:09
25 " T h i s i s i t . T h i s i s t h e o n e . "
01:42:12
142
1
Q Well, let's take a look at those studies. We
01:42:14
2 will get to them in just a second.
01:42:23
3
Exhibit 8 is a list of literature that you have
01:42:26
4 prepared regarding indirect benzene exposures and
01:42:30
5 hematologic malignancy; is that correct?
01:42:36
6
A Well, yeah, a few studies that I have seen.
01:42:40
7
Most of these are associating or talking about childhood
01:42:44
8 leukemias --
01:42:47
9 Q Okay.
01:42:47
10
A -- which has relatively little relevance here.
01:42:48
11
Q And Exhibit 9 is your literature list regarding
01:42:51
12 g a s o l i n e i n A M L ?
01:42:54
13 A Y e s .
01:42:55
14
Q And now Exhibit 10 is your literature list
01:42:56
15 r e g a r d i n g m e c h a n i c s a n d A M L ; c o r r e c t ?
01:42:58
16 A Y e s .
01:43:01
17
Q And these are the studies that you considered
01:43:04
18 o n t h a t t o p i c ; c o r r e c t ?
01:43:07
19 A Y e s .
01:43:09
20
Q And how many of the studies on this list showed
01:43:13
21 a s t a t i s t i c a l l y s i g n i f i c a n t i n c r e a s e o f A M L i n
01:43:18
22 m e c h a n i c s ?
01:43:24
23 A N o n e .
01:43:39
24 Q H o w m a n y o f t h e m s h o w e d a s t a t i s t i c a l l y
01:43:57
25 s i g n i f i c a n t i n c r e a s e i n l e u k e m i a ?
01:44:00
143
1 A One.
01:44:19
2 Q Which one?
01:44:20
3 A Hunting, but there was only one AML case.
01:44:20
4 Q That is the Hunting study?
01:44:26
5
A 1995, so that is pretty small. There were two
01:44:28
6 leukemia cases, only one AML. It would be hard to put
01:44:32
7 too much emphasis on that study.
01:44:36
8 Q What about the Pasqualetti study?
01:44:38
9
A In the Pasqualetti study, the mechanics exposed
01:44:43
10 t o g a s o l i n e d i d n o t h a v e a n e l e v a t e d r i s k . A n d t h e
01:44:47
11 m e c h a n i c s o r g r o u p s o f w o r k e r s - - I d o n ' t r e c a l l w h i c h
01:44:51
12 o n e s t h e y w e r e - - e x p o s e d t o a r o m a t i c h y d r o c a r b o n s d i d
01:44:53
13 h a v e a n i n c r e a s e d r i s k .
01:44:57
14 Q H o w m a n y o f t h e s e s t u d i e s h a v e s u f f i c i e n t
01:45:01
15 s t a t i s t i c a l p o w e r t o d e t e c t a s i g n i f i c a n t i n c r e a s e i n
01:45:03
16 t h e r i s k o f A M L ?
01:45:07
17
A I don't -- I don't know the answer to that.
01:45:17
18
You would have to go through and do a power calculation
01:45:18
19 o n e v e r y o n e o f t h e m .
01:45:22
20 Q Y o u h a v e n ' t d o n e t h a t ; c o r r e c t ?
01:45:23
21 A N o .
01:45:25
22
Q So without knowing that, the fact that some
01:45:25
23 s t u d i e s d o n ' t r e p o r t a s i g n i f i c a n t i n c r e a s e c a n n o t b e
01:45:27
24 i n t e r p r e t e d t o m e a n t h a t t h e r e i s n ' t o n e ; c o r r e c t ?
01:45:31
25 A N o , I d i s a g r e e w i t h t h a t .
01:45:34
144
1 Q Take a look at Exhibit 12, please.
01:45:53
2 A Okay.
01:45:58
3 Q What are these documents?
01:46:04
4 A I a c t u a l l y t h o u g h t t h a t i t w a s s o m e t h i n g 01:46:08
5 t h a t - - t h a t J o n e s C a r r s e n t m e f r o m D r . G a l e , b u t i t 01:46:10
6 may have been from Dr. Brautbar, so I am not exactly
01:46:18
7 sure what it is.
01:46:21
8 Q On the first page, have you made some
01:46:23
9 handwritten notations?
01:46:27
10 A U h - h u h , y e s .
01:46:28
11 Q W o u l d y o u t e l l m e w h a t t h e y a r e .
01:46:29
12
A Well, I originally thought that the values
01:46:31
13 w r i t t e n d o w n f o r t h e R u s h t o n ' 9 7 p a p e r w e r e i n c o r r e c t 01:46:33
14 a n d I a m s t i l l n o t s u r e t h e y a r e n o t , b u t t h e y a r e
01:46:37
15 c l o s e .
01:46:39
16
And there is some -- it's written in there
01:46:40
17
several different ways, but the problem with that is a
01:46:43
18
little misleading just picking that one data point out.
01:46:47
19
Because if you look at the next exposure bin,
01:46:50
20
which is written over on the left-hand column, greater
01:46:53
21
than 0.4 part per million, then the AML risk is almost
01:46:57
22 h a l v e d , 0 . 4 3 .
01:47:01
23
So you can find these little quirky increases,
01:47:03
24 b u t w h e n y o u l o o k c o l l e c t i v e l y a t t h e o v e r a l l d o s e
01:47:07
25 r e s p o n s e , i t j u s t d o e s n ' t h o l d u p .
01:47:11
145
1
And that's the same for the last two points
01:47:13
2
down at the bottom where the 01 to -- sorry, 0.1 to 0.2
01:47:15
3 is listed, but the 0.2 to 0.4 is not listed. And then
01:47:21
4
the 4.4 to .8 is, but the .8 to 1.6 is not. That's just
01:47:27
5 inappropriate.
01:47:37
6 Q Okay. Exhibit 13 is an invoice that you
01:47:38
7 submitted to the Jones Carr firm?
01:47:44
8 A Yes.
01:47:47
9 Q That was for --
01:47:48
10
A Oh, this is how you knew. I am sorry, keep
01:47:50
11 g o i n g . K e e p g o i n g , I a m s o r r y .
01:47:52
12
MS. KIMBALL: Sorry to interrupt, but, Raphael,
01:47:58
13 I a m h a v i n g t r o u b l e h e a r i n g y o u . I f y o u c o u l d j u s t
01:47:59
14 s p e a k u p a b i t . T h a n k y o u .
01:48:03
15
MR. METZGER: Sure. I guarantee you I am not
01:48:04
16
saying anything of great interest, but I will speak up a
01:48:08
17 l i t t l e b i t .
01:48:10
18 M S . K I M B A L L : T h a n k y o u .
01:48:11
19
Q BY MR. METZGER: This was prepared September;
01:48:13
20 c o r r e c t ?
01:48:14
21 A T h a t s e e m s r i g h t , y e s .
01:48:16
22
Q Have you done work on this case since that
01:48:18
23 d a t e ?
01:48:20
24
A There was another invoice that I have submitted
01:48:20
25 f o r $ 1 , 5 0 0 - - o h , t h i s w a s 1 , 5 0 0 . S o t h e r e i s a n o t h e r
01:48:23
146
1 one around for 1,300.
01:48:29
2 Q Okay.
01:48:31
3
A And then I have done work in preparation for
01:48:31
4 today that I haven't totaled up.
01:48:33
5
Q And what work did you do in preparation for
01:48:35
6 today?
01:48:37
7
A Look at all the literature, review all of the
01:48:37
8 medical records, get ready for coming to this
01:48:40
9 deposition, prepare the studies that I sent.
01:48:43
10 Q D i d y o u m e e t w i t h t h e l a w y e r s ?
01:48:45
11 A W e m e t l a s t n i g h t f o r d i n n e r .
01:48:48
12 Q O k a y .
01:48:50
13
A And yesterday afternoon I met with Chris Carr.
01:48:51
14
Q And you told us that you had a conversation
01:48:56
15 a b o u t a n h o u r w i t h D r . S h e e h a n ?
01:48:57
16
A That's what I was laughing about. That is how
01:48:59
17
you knew that, because I had written it on this piece of
01:49:01
18 p a p e r . Y e s , I t a l k e d t o D r . S h e e h a n a b o u t a w e e k a g o .
01:49:04
19
Q Have you spoken with any other experts about
01:49:07
20 t h i s c a s e ?
01:49:09
21 A N o .
01:49:09
22
Q So tell me now, Exhibit 14, regarding your
01:49:11
23 c o n v e r s a t i o n w i t h D r . S h e e h a n , w h a t d i d h e t e l l y o u - -
01:49:15
24 w h a t d i d y o u a s k h i m , w h a t d i d h e t e l l y o u d u r i n g t h a t
01:49:17
25 c o n v e r s a t i o n ?
01:49:21
147
1
A The only -- the only thing that I really wanted
01:49:22
2 to know was why he didn't think it was appropriate to
01:49:25
3 take total -- an internal dose from milligrams from
01:49:30
4
dermal and any other source and back-calculate part per
01:49:36
5
million years from it, because I always thought that you
01:49:40
6 could do that.
01:49:43
7
And so we chatted about that. He explained his
01:49:45
8
methodology, what he did, and how he divided up, parsed
01:49:47
9
out the individual exposures, which made sense to me and
01:49:54
10 I c o u l d u n d e r s t a n d w h a t h e w a s d o i n g .
01:49:58
11
But the only real question I had was this
01:50:02
12
back-calculation, which is why he left it in milligrams
01:50:05
13 i n s t e a d o f c o n v e r t i n g i t i n t o a p a r t p e r m i l l i o n y e a r
01:50:08
14 b a s i s . A n d y o u c a n ' t d o t h a t .
01:50:12
15
You can convert it in into a part per million
01:50:14
16 y e a r b a s i s , w h i c h i s w h a t I t h o u g h t , b u t y o u h a v e t o
01:50:17
17 m a k e a s s u m p t i o n s a b o u t h o w m u c h t h e b r e a t h i n g i s g o i n g
01:50:21
18
to be and all these sort of exposure assessments to get
01:50:24
19 b a c k t o w h a t i t w o u l d e q u a t e t o . A n d h e d i d n ' t t h i n k
01:50:27
20 t h a t w a s a p p r o p r i a t e b e c a u s e y o u d o n ' t h a v e t h a t
01:50:29
21 i n f o r m a t i o n .
01:50:31
22
So the milligram -- expressing exposure to
01:50:32
23 b e n z e n e o n a t o t a l m i l l i g r a m b a s i s j u s t a l l o w e d f o r a n
01:50:35
24
easy comparison between the different sources of benzene
01:50:40
25 f o r t h e s e i n d i v i d u a l p l a i n t i f f s .
01:50:44
148
1 Q Okay.
01:50:47
2
A That is pretty much what I got out of that
01:50:48
3 conversation other than a few pleasantries since I
01:50:51
4 haven't talked to him in a while.
01:50:54
5 Q Do you know him?
01:50:56
6 A Uh-huh, yes.
01:50:57
7 Q How do you know him?
01:50:58
8
A Dr. Sheehan worked for Exponent when I was at
01:50:59
9
Exponent in 2004. He was out here in Oakland and I was
01:51:02
10
in Boulder and we didn't work on any projects, but there
01:51:07
11 w a s a c o m p a n y r e t r e a t t h a t I m e t h i m a t a n d w e w e r e o n
01:51:12
12 s e v e r a l c o n f e r e n c e c a l l s a n d t h a t k i n d o f t h i n g .
01:51:15
13
Q Okay. While we are talking about Dr. Sheehan's
01:51:18
14 a s s e s s m e n t , w a s t h e r e a n y t h i n g i n h i s a s s e s s m e n t t h a t
01:51:27
15 y o u d i s a g r e e d w i t h ?
01:51:31
16 A N o .
01:51:32
17 Q Y o u t h o u g h t h i s m e t h o d o l o g y w a s f i n e ?
01:51:34
18
A Well, to the extent that I understand all that,
01:51:36
19 I t h o u g h t i t w a s o k a y . S a m e w i t h D r . N i c a s . I
01:51:39
20
didn't -- you know, I can't really say that I understood
01:51:42
21 h i s n e a r l y a s w e l l . I t w a s n ' t - - t o m e i t w a s n ' t
01:51:44
22 w r i t t e n a s c l e a r l y a s P a t S h e e h a n ' s w a s .
01:51:51
23
Q Do you have any disagreements with Dr. Nicas'
01:51:53
24 m e t h o d o l o g y o r h i s c a l c u l a t i o n s o r h i s e x p o s u r e
01:51:57
25 a s s e s s m e n t s o f t h e i n d i v i d u a l s ?
01:52:01
149
1
A Well, I think there is some discussion about
01:52:02
2 the appropriateness of using the Fedoruk study and
01:52:04
3 whether there is better data out there.
01:52:08
4
But, you know, to my way thinking, in my point
01:52:10
5 of view was that even if you accept Dr. Nicas as being
01:52:14
6 absolutely correct, that is still insufficient benzene
01:52:19
7 exposure to relate -- to cause these people's disease.
01:52:23
8 Q I understand. Please answer my precise
01:52:26
9 questions though.
01:52:30
10
Do you criticize in any way Dr. Nicas'
01:52:31
11 m e t h o d o l o g y ?
01:52:35
12 A T h a t i s o u t s i d e o f m y a r e a , s o n o .
01:52:36
13
Q Do you criticize in any way Dr. Nicas' exposure
01:52:38
14 a s s e s s m e n t ?
01:52:41
15
A Not at this point. It is outside of my area,
01:52:43
16 no.
01:52:45
17
Q Is the evaluation of Dr. Sheehan's methodology
01:52:46
18 a l s o o u t s i d e o f y o u r a r e a ?
01:52:49
19 A Y e s .
01:52:51
20 Q I s t h e e v a l u a t i o n o f D r . S h e e h a n ' s d o s e
01:52:52
21 a s s e s s m e n t a l s o o u t s i d e o f y o u r a r e a o f e x p e r t i s e ?
01:52:59
22 A I w o u l d s a y i n t h i s f o r m a t , y e s .
01:53:00
23 Q I n t h i s f o r m a t ?
01:53:03
24 A W e l l , I a m a t o x i c o l o g i s t . I c a n d o d o s e
01:53:04
25
calculations myself. But in a formal setting like this,
01:53:07
150
1 h e i s t h e e x p e r t . T h a t i s h i s a r e a . H e w o u l d b e t h e 01:53:09
2 one to defend it.
01:53:13
3
Q Okay. Exhibit 15 is something that counsel
01:53:14
4 provided you?
01:53:20
5 A Sorry, I have -- oh, here it is.
01:53:22
6 Yes, yes.
01:53:26
7
Q Are there any other notes or writings that you
01:53:37
8 prepared regarding this case?
01:53:40
9
A No, except for the possibility of Mr. Machado,
01:53:43
10 w h i c h I w i l l - -
01:53:46
11 Q R i g h t .
01:53:49
12 A - - b e c a u s e I d i d t h e t w o , s o I a m p r e t t y 01:53:49
13 s u r e - - w e l l , i n f a c t I c o p i e d o n e o p i n i o n a n d t h e n I 01:53:51
14 w o u l d h a v e c h a n g e d i t , s o c l e a r l y I h a d s o m e t h i n g
01:53:54
15 w r i t t e n f o r M a c h a d o s o I w i l l f i n d t h a t a n d m a k e s u r e 01:53:56
16 y o u g e t i t .
01:54:02
17 Q O k a y . A n d h a v e y o u t o l d m e a l l o f y o u r
01:54:03
18 o p i n i o n s i n t h i s c a s e - - i n t h e s e c a s e s ?
01:54:12
19
A Yes, particularly since we went over those
01:54:15
20 l i t t l e s u m m a r y s h e e t s .
01:54:19
21
Q There is one thing I want to ask you. Yeah --
01:54:27
22 w e l l , w e h a v e n ' t d o n e t h a t f o r M r . M a c h a d o .
01:54:31
23
Are there any other opinions that you recall
01:54:34
24
that you wrote regarding Mr. Machado that you have not
01:54:37
25 y e t t o l d m e t o d a y ?
01:54:41
151
1 A No, no.
01:54:42
2
Q Okay. Okay. Subject to the receiving the
01:54:43
3 Machado summary that you prepared and any questions I
01:56:05
4 might have regarding that, I have concluded my
01:56:08
5 examination.
01:56:14
6 Any questions by other counsel?
01:56:14
7
MR. FOLEY: Let's go off the record for one
01:56:16
8 minute.
01:56:18
9 MR. METZGER: Sure.
01:56:18
10
THE VIDEOGRAPHER: Now going off the record.
01:56:19
11 T i m e i s 1 : 5 6 p . m .
01:56:19
12
(A discussion was held off the record.)
01:56:21
13
THE VIDEOGRAPHER: We are now back on the
01:58:03
14 r e c o r d . T i m e i s 1 : 5 7 p . m .
01:58:04
15
(Deposition Exhibit 16 was marked for
01:58:06
16 i d e n t i f i c a t i o n . )
01:58:06
17
MR. METZGER: All right. Dr. Pyatt has found
01:58:07
18 a n o t h e r i n v o i c e , w h i c h h a s b e e n m a r k e d a s E x h i b i t 1 6 .
01:58:09
19 Q I t i s d a t e d 7 - 2 8 - 0 8 ; c o r r e c t , d o c t o r ?
01:58:12
20 A Y e s . T h a t w a s t h e 1 , 3 0 0 o n e .
01:58:16
21
Q Was that the first invoice that you prepared
01:58:18
22 f o r t h i s c a s e ?
01:58:19
23 A Y e s .
01:58:20
24
MR. METZGER: Okay. So I think we are done for
01:58:21
25 t h e d a y .
01:58:32
152
1
And I propose that the court reporter may
01:58:34
2
forward the original transcript to the Jones Carr firm,
01:58:36
3
who will then forward it on to Dr. Pyatt; Dr. Pyatt, you
01:58:40
4 can have 30 days from the Jones Carr's firm receipt of
01:58:44
5
it to sign the transcript; you may sign it under penalty
01:58:49
6 of perjury so you don't have to round up a notary; you
01:58:53
7
can make any changes or corrections that you wish to the
01:58:56
8 testimony; if you do that, I would ask that you make
01:58:59
9 those on the pages where the testimony actually occurs
01:59:03
10 a n d a l s o t o l i s t t h e m o n a c o r r e c t i o n s h e e t w h i c h t h e
01:59:06
11 c o u r t r e p o r t e r w i l l p r o v i d e y o u a t t h e e n d o f t h e
01:59:09
12
transcript so that we may know where those changes are.
01:59:11
13 T H E W I T N E S S : T h a t i s f i n e .
01:59:15
14
MR. METZGER: If you would then forward that on
01:59:16
15
to the Jones Carr firm, they will notify all counsel of
01:59:18
16
the changes forthwith, and then forward the original on
01:59:21
17 t o m e ; a n d I w i l l p r e s e r v e i t , l o d g e i t w i t h t h e c o u r t
01:59:24
18
in advance of trial or hearing on reasonable request; if
01:59:29
19 f o r a n y r e a s o n t h e o r i g i n a l i s l o s t o r n o t s i g n e d , a
01:59:32
20 c e r t i f i e d c o p y m a y b e u s e d w i t h f u l l f o r c e a n d e f f e c t .
01:59:35
21 S o s t i p u l a t e d ?
01:59:39
22 M R . F O L E Y : Y e s .
01:59:41
23 M R . M E T Z G E R : O k a y .
01:59:42
24
THE VIDEOGRAPHER: Now going off the record.
01:59:42
25
Time is 1:59 p.m. This is the end of Volume 1, tape No.
01:59:44
153
1 4 and concludes today's deposition.
01:59:48
2 01:59:51
3
(ENDING TIME: 2:00 P.M.)
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1
STATE OF CALIFORNIA
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) ss
2
COUNTY OF LOS ANGELES
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4 I, the undersigned, declare under penalty of
5 perjury that I have read the foregoing transcript, and I
6 have made any corrections, additions or deletions that 7 was desirous of making; that the foregoing is a true and
8 correct transcript of my testimony contained therein.
9 EXECUTED this _______ day of _______________,
10 2 0 _ _ _ , a t _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(City)
(State)
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19 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
DAVID W. PYATT, Ph.D.
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AUTHETNheTIoCrifCgilieOnawPlYacsuesretilniefigectdRroeEna-iTclLareallgnyassclirgteipncethdnology.
1 REPORTER'S CERTIFICATION 2 3 I, SHERI A. PLY, CSR No. 6507, a Certified 4 Shorthand Reporter in and for the State of California do 5 hereby certify: 6 That the foregoing proceedings were taken before 7 me at the time and place therein set forth, at which 8 time the witness was placed under oath by me; 9 That the testimony of the witness and all 10 o b j e c t i o n s m a d e a t t h e t i m e o f t h e e x a m i n a t i o n w e r e 11 r e c o r d e d s t e n o g r a p h i c a l l y b y m e a n d w e r e t h e r e a f t e r 12 t r a n s c r i b e d ; 13 T h a t t h e f o r e g o i n g t r a n s c r i p t i s a t r u e a n d 14 c o r r e c t r e c o r d o f t h e t e s t i m o n y s o t a k e n . 15 I f u r t h e r c e r t i f y t h a t I a m n o t a r e l a t i v e o r 16 e m p l o y e e o f a n y a t t o r n e y o r o f a n y o f t h e p a r t i e s , n o r 17 f i n a n c i a l l y i n t e r e s t e d i n t h e a c t i o n . 18 I d e c l a r e u n d e r t h e p e n a l t y o f p e r j u r y u n d e r t h e 19 l a w s o f t h e S t a t e o f C a l i f o r n i a t h a t t h e f o r e g o i n g i s 20 t r u e a n d c o r r e c t . 21 22 D a t e d t h i s 1 9 t h d a y o f D e c e m b e r , 2 0 0 8 . 23 24 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 25 S H E R I A . P L Y , C S R N o . 6 5 0 7
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