Document ypwb09enbNvJdmKEa0pnz4Qxr

i Draft ! E-*. I S S I A. Mortality Study of Workers Employed at the Atonsanto Company Plant in Nitra, West Virginia Judith A. Zack August 14, 1980 The compound 2,3,7,3-tetrachlorodibenzo-p-dioxin (TCDD) is a highly toxic impurity that may be formed in trace quantities during the production of 2,4,5-trichlorophenoxyacetic acid m% (2,4,5--T). Exposure to TCDD can cause chloracne, .a skin dis order characterized by comedones, cyst5, and abscesses- Out breaks of chloracne have been reported among workers associated with the production of 2,4,5-T and 2,4,5-T based products. Such incidents resulting from both accidental and routine occupation al exposures have been reported from several countries.^ The first reported industrial accident involving exposure to TCDD occurred in 1349 at the Monsanto Company plant in Nitro, West Virginia. A total of 122 employees developed symptoms of chloracne following.a trichlorophenol (TCP) process accident. An undetermined number of other employees developed symptoms of chloracne resulting from exposure to the regular operations con cerned with 2,4,5-T production over the period 1948-1969. Between 1949 and 1953, Ashe and Suskind 3 '4 examined thirtyeight Nitro plant employees with chloracne. Twelve of these developed symptoms of chloracne directly following the 1949 TCP accident? twenty-- six other chloracne cases resulted from expo sure to the regular 2,4,5-T production operations- In addition to chloracne, other signs and symptoms were observed in this 'group. These included severe aches in the lower extremities, fatigue, nervousness and irritability, loss or decrease of libido, dyspnia, and vertigo. These findings are consistent with those that have been reported in .other industrial incidents. -1 - To examine the" hronic health, effects of xposure to TCDD, a mortality study of the Nitro plant employee-3 who-developed symptoms Of chloracne following the 1949 TCP accident was con- g d.ucted. The study cohort was comprised of 121 of the 122 r chloracne .cases; one female who was living as of the endpoint of the study was excluded from analysis. At the time of the incident, it was assumed that the symptoms'were caused from ` exposure to unknown products of decomposition". From"today's7 vantage point, these symptoms suggest exposure to TCDD. The 121 member study cohort, with a presumptive high-peak-exposure to TCDD, was followed for mortality through 1978. The entire cohort was traced: thirty-two deaths were observed and eightynine persons were confirmed as living. Analysis indicated no excess in total mortality or in deaths from malignant neoplasms. The study presented here examines the mortality of Nitro plant workers who were assigned to *an area of TCP or 2,4,5-T production, with potential for exposure to TCDD. The mortality of these workers is examined in the context of the mortality experience of the total Nitro plant worker population- The Monsanto Nitro plant began operations in 1922, when the Rubber Service Laboratories purchased the plant as war surplus and began production of chemicals and additives forthe growing rubber industry. In 1929, Monsanto Company pur chased the Nitro plant from the Rubber Service Laboratories* and entered tne rubber chemicals business- Over the years", the Nitro plant has diversified to where it produces agricultural chemicals, paper chemicals, plasticizers, fine chemicals, and -2- Jr intermediates, in addition to robber chemicals The plant is situated in the Kanawha River Valley, an area containing ane of the largest concentrations of chemical production facilities in the United States - Of the many chemicals produced over the years at the Nitro plant, one*has an established association with the occurrence of jcancer in man* Para-aminobipheny1 (p a b ), produced from 1941 through 1952 for use as a rubber antioxidant and dye intermediate, was shown in 1954 by Walpole et al. to induce bladder cancer in g dogs* In 1955 r Melick et al- confirmed the carcinogenicity of para-aminobiphenyl to man with the reporting of bladder tumors among workers exposed to this chemical at* two Monsanto plants, para--aminobipheny1 was produced at one plant and then transferred by tank car to the Nitro plant where additional processing was carried out* The minimum duration of exposure reported to have produced a bladder tumor is 133 days? the -latent period has ranged g from 15 to 35 years. An intensive screening program was instituted -at Monsanto Company about 1955 to examine, on a continuing basis, al1 workers exposed to this chemical. Seven deaths from bladder cancer have occurred among Nitro plant employees enrolled in this program. These seven deaths are included in the present study. Other chemicals produced at the Nitro plant with known health effects include methylparathion and carbon disulfide. The acute effects of exposure to each of these chemicals have been described ' while the chronic effects are less well under stood* Besides p-aminobiphenyl, several other rubber chemicals axe of potential health concern. For all of these, there is insufficient evidence to evaluate the carcinogenicity of these 3- - F E B -1 8 -1 9 9 4 13=10 FROM E . R . F . TO A L D E R -H IL L P.01 chemical* to man' iL^urad (tetramethyl thiux 4 disulfide) is considered an animal carcinogen^* and there la soma evidence although not sufficient that Eleatoper (N-methyI-N# 4-dinitroamiline) is also an animal carcinogen** For several other rubber a chemicals there is insufficient evidence to evaluate the carcin ogenicity to animals However these chem icals have the potential for forming nitro*amines, which are known animal carcinogens^^ Mathasan (zinc dimethyl dithiocarbamate) thiuxad (tetrmethyl tbiuram disulfide) and monothiurad? (tetramsthyl thiuram raonosulfide) have the potential to form N^itrosodiraethyJjusine.. N-nitrosomorpholine has been found in product samples of Santocure . KQR A (2- (oorpholinothio) benzothiazole) and Suifasan R (4/4'-dithiodimorpholine) (Prisons, G-J-, The General Tire and Rubber Company, unpublished data). Although'several of the chemical compounds produced at the Nitro plant over the years have been associated with adverse health effects, no attempt was made to relate chemical exposure to mortality with the exception of decedents exposed to the TCP or 2,4,5-T operations and potentially exposed*.to TCDD* AS a. result, the only specific hypothesis that can be_tested is whether a relationship exists between potential t c d d exposure and proper- . tional mortality, especially for malignant neoplasms. The mortal ity for this gro up is examined in addition to that of the total Nitro plant worker population. -4 F E B -1 8 -1 9 9 4 13=11 FROM E . R . F . TO ALDER--H I L L P .0 2 f-- BUClatio>n.11a1|nd MeiitL^ds * study cohort was developed from the *Nitro plant: consorting '- of employ* active on or after January 1, 1955 with on or more years of employment on the hourly roll prior to December 31, 1977. Salaried personnel who had never worked on the hourly roll were excluded from study because many of thse employees had no appreciable exposure to the plant environment* andy~ for* the ''most'-' pert* thsif exposure cannot be determined from'plant"records?** females aiid nan-white males were also excluded'because'of their small numbers. " :i : 1 '' * ? * * The cohort was assembled using government'earnings reports, 1 # Independent of the plant work.history records. Annual earnings - reports were available on .a computer file from 19 51 through 1977. Names and social security numbers were identified from-this source, work history records were used to supplement the eamipgs records. Information on race, sex, date of birth; date of hire, date of separation and, if deceased, 2,4,5-T exposure vas abstracted from these records. Aacertaiaaiant of 2',4,5-T expo- aura was confined to decedents only because it was too tedious * to do for the entire cohort. The information from the work.' history records was used to determine which names identified from the annual earnings records met the cohort entrance cri teria. employees identified from the earnings, records who terminated prior to 1953 wara net included in this study because work history records for all such employees were not retained prior to this data. F E B -1 8 -1 9 9 4 13=11 FROM E . R . F . TO A L D E R -H IL L P .0 3 A Exposure to vts datarained by as**gm&ent to a 2,4,3-T.operation baaed on the work history record*. 2,4,5-T exposure was determined for all but one decedent. Employees holding a job having plant-wide responsibilities with* the potential 'for exposure to 2,4,5-T were, for the purposes of this study# considered to be non-expo sod, ____ *-- r The vital status of each member of the a-tndy cohort was- ^ = -r determined using standard follow-up techniques and ascertained -_ as of December 31# 1977, Death certificates,-were coded by. an - independent nooolog1st for the underlying cause of--death, according to the rules of the Eighth Revision of the- interna- .. r 14 tlonal Classification of Diseases, Adapted. . -__ .'Deta for the total sitro plant study population were analyzed by the modified life-table method using the U..S. population as the standard.- Kith this method of analysis# the. age-# race-# time-# and cause-specific mortality rates for the U.9-- general - - population are applied to the person-years lived classified by age# race#-and time. A standardized mortality, ratio (SXRJ was- . calculated for 23 selected cause of death* categories-- Cause- - specific SKR's for 15 selected cancer site* were calculated . fqr .subgroups of the totud. Xltro plant study population defined- by date of death# age at death# and year af hire. The statisti cal significance of the deviation in a SMR from 1(30 was tested using the formulat - standard error of SMR * I00\fno\ observed deaths no. expected deaths -6 - FE B -1 8 --1994 13=11 FROM E . R . F . TO A L D E R -H IL L P .0 4 1 " % m . r . ' ! . , n . ' If the observed S8R differed from 100 by 1.96 standard ; 'errors# it; vs regarded as significant at the 51 level.' A SHE was tested* for significance only when the observed number of deaths was five or greater. Darts for those deceased were also analyzed according to 2,4,5-T exposure using the proportional mortality method- ik this case, the. expected number of deaths-,is calculated on the m +W m i . * * . - basis of proportional .mortality ratios fdr the U h .'general population- A proportional mortality ratio (PMR) was calculated for 23 selected cau*-ef-dath categories* ls were calculated ^separately for'those exposed to 2,4,5-T and for those not exposed. The statistical significance of the deviation of -ar-PMR- fromrlOO------ was tested by calculating the 95% confidence interval for the PMR for a given cause Tc according to the formula? confidence interval. m M (confIdence limits for \ of obsrervad death; for PMB^ exp^ where H number of observed deaths for all causes Both the standardised and proportional mortality analyses were conducted using the computer program developed by Monson,15 The observed mortality was compared, to that of the United States white male population for the time period of study. --7 F E B -1 8 -1 9 9 4 1 3 :1 2 FROM E . R . F . TO A L D E R -H IL L P. Msults A total of 885 men vers identified far study and traced * - for deaths through 1977. The entire cohort 'was 'successfully ` traced. Death certificates were obtained for all deaths. Seven hundred twenty-one (81%) were verified as living and 1BT4 (19%) were confirmed dead by death certificates. - Tables 1-3 characterise the-total Nitre plant rtndy-popu- -r- * * <*i . 0 mm ration by'age at hire, year of hire, and length of3imptorment.'z^ The distribution of the study population by'age at hire7indi- catsi'that the workers were fairly young at-firsthire (Tifelt l)~.Seventy-two percent of the study cohort were hirad^byagV 36. 4 Rone were hired at age 50 or above. . z~ ~ ' ' *Table 2 shows the distribution of the study population by--: year of hire. The majority of workers (75.3%) were hired during- the period 1940-1959, while smaller percentages of workers were hired prior to 1940 (10.8%) and after I960 (11.9%). An examination of the study population by length of employ ment indicates a fairly even distribution over the intervals leas than 10 years, 10-19 years, 20-29 years, and greater then 30 years (Table 3). Observed and expected deaths occurring Staring 1955-1977 among the'total Nitro plant study population' are- shown b y cause" In Table 4. The SMR for all causes of death was 103* with 163 deaths observed and 158.10 expected. There were 35 deaths from malignant neoplasms with 30.92 expected, yielding a SMR of 113. Significantly elevated SMR's were seen for the categories of - 8- F E B -1 8 -1 9 9 4 13=12 FROM E . R . F . TO A L D E R -H IL L P .0 6 /. ' r* malignant neoplasms of the genitourinary organs and of t "m bladder.. The SMR for bladder cancer vac 989 with 9 deaths observed and 0.91 expected. This excess in bladder candor deaths is reflected in the elevated SMR for malignant'neoplasms of the genitourinary organs. A significantly elevated SMR is also seen .for arteriosclerotic heart disease. There ere 79 deaths-ram this cause with 59.40'expected [SMR " 133).' The -*-* "I' SMR for other circulatory diseases was significantly low-at 56. A significant deficit was also aeen for the category of ail other diseases where the SMR was 48 with 5 deaths observed and 10.46 expected. Trends for malignant neoplasm deaths with calendar time axe shown, in Table 5. SMR*a which increase consistently over the period 1955-1977 are seen for the categories of all malignant neoplasms and malignant neoplasms of the respiratory system. The sh r for all malignant neoplasms rises from 32 to 131. The SMR for malignant neoplasms of the respiratory system rises from 0 to 172 reflecting a SKR for lung cancer which increased from 0 to 181. Although based on very small numbers# the SMR for malignant neoplasms of the digestive organs and peritoneum con sistently decreases over time from 99 to 24 The SMR for malig nant neoplasms of the genitourinary organs peaked during the period 1960-1969. This is reflected in the SMR for bladder can cer which increased from 0 in 1955-1959 to a peak, of 1471 in 1960-1969 and decreased to 833 in 1970-1977. The analysis of observed and expected deaths from malig nant neoplasms by age at death revealed little In terms of 9- F E B -1 8 -1 9 3 4 13=12 FROM E . R . F . TO A L D E R -H IL L P. consistent treads vrth 49 (Table 6)- For n&at of the cause- of-death categories, the 5MR peaked at age 45-64 rather than continuing to rise with increasing age. Bladder cancer is one category where the SHR remained high at age 65 -and over. m The distribution of deaths from malignant neoplasm* by -year of hire- is shown in Table 7 rto deaths from malignant 1: .i ,, neoplasms vers observed among workers hired after I960 The ;S: V T :: * - ... --- * SHR far all malignant neoplasms was similar for those hired prior to 1945 and for those hired in the period 1945-1959. - The .greatest difference .in SKR's between those hired prior to 1945 end those hired from 1945-1959 occurs with bladder cancer. The SMR for bladder canesr is highest for those hired prior to 1345 with a SMR of 1111. A subset of deaths identified from the total Nitro plant study population was studied separately. Table 8 characterizes the decedents according to 2,4.5-T exposure. Of the 163 deca dents, 58 (35.6I) were considered to be exposed to 2 #4 #5-T based -on their work history'records, while 104 (63.84) were considered m to be non-exposed. The exposure of one decedent was unknown. . _ . -The- results of the proportional mortality analysis by 2>4f5-T exposure classification are presented in Table 9. The proportion of canesr deaths among 2,4,3-T workers is lover than in the nan-exposed group (PMRi 82 n , 122) The PMR for lung cancer deaths is slightly higher in the exposed group (PHSh 159 vs* 117) . The proportion of deaths due to bladder cancer is higher among the decedents not exposed to 2,4,5-t . There were .7 deaths from bladder cancer among these workers with 0.65 expected (PMR m 1077). The FKR for bladder 10- F E B -1 8 -1 9 9 4 1 3 :1 3 FROM E . R . F . TO A LD ER -H IU L cancer eawng decedi-,cs exposed to 2,4,5-9 w u 909 with 2 .deaths observed and 0.22 expected. PMR's for- both expovara group ar quit limilar for discasai of circulatory and respiratory system. Slight differences appear in the 9MR1 between the two groups for diseases of the digestive.system * and all other diseases. However, the FttK's for both-group* 9^ are qu^te low The PKR for external causes-oft death is *- - slightly higher in the exposed group (PMfit 119 VSi 81)'-- - - A listing of the cancer deaths among the. 2>4,5-T exposed Is given in Table 10. . Table 11 listed the cancer death* -among the man-exposed group. F E B -1 8 --1 9 94 1 3 :1 3 FROM E . R . F . TO OLDER--H I L L P .0 9 Oiacuscion The observation of an apparent excess in bladder cancer ** anon? Nitro plant workers made many years ago was confirmed and quantified in the mortality analysis of the total Nitro "plant" population presented here. The SKR for bladder 'cancer ` "~war 989 and was the only statistically significant ~SM5l among those fqr malignant neoplasms. The excess in mortality is not" ^ seen until i960. The SKR peaked in the 1960's and declined someWhat in'tile 1970rs. The excess* also appeared to 7?'clustered in those decedents aged 65 years and older at death and 'in those hired prior to 1945 This would suggest that we should see e further decline in the SMR for bladder cancer over time. Although.not statistically significant, the Sk h for lung * cancer appears to be elevated. The SKR increased with calendar tine and was highest in those hired prior to 1945. The elevation appears to be clustered in those aged 45-64 years of age at death (SMS m 184) and does not show a gradient with age. Further analyses to evaluate trends in lung cancer deaths as they relate to occupation cannot be carried out due to limita tions in the date collected in this study. The SMS. for diseases of the circulatory system was ele vated at ill. This is most likely a reflection of the higher mortality from heart disease which has been observed for Charleston# West VJLrginia. and Kanawha County, West Virginia (unpublished data, Seas LM, 1979 and Enterline PE, 1979). For the total Nitro plant study population, there was a statistically significant excess in deaths from arteriosclerotic heart disease 12 FEB-18-1994 13114 FRDM E.R.F. TO ALDER-HILL P.10 and e deficit in d .ths from other circulate . disease*. This variation in the distribution a deaths from that the tf.S. stay bs due to risk actor or aedlcal care differences in the plant population and the local area-, These may include differ** eases in smoking habits the availability and use of medical - .i * services and the Specificity of diagnoses. TJie proportional mortality* analysis of decedents by 2,4,5-T exposure classification indicated no unusual patterns o'f mortality # in the 2,4,5-T exposed- The proportional mortality ratio (TOSH) for malignant neoplasms was low (pmr * 82)' in the non-exposed * "11 . 4 group* Lung cancer was the only site among "the*malignant no- ' plasms which was somewhat .higher in the exposed group* " The PStH analysis is limited in that an assessment of the total force of mortality cannot be made. The cause-specific TOSH1a only approximate what an SMR analysis would have produced^ T3ie fHtt analysis presented here estimates the cause-spedfic risks associated with 24,5~T exposure and potential TCDD expo sure- 17- A recent study by ett et al_ found no excess in total mortality or in deaths from malignant neoplasms' among workers exposed to 2,4,5-T. These .workers were probably"exposed to'' very low levels of TCDD since no cases of 'chloracne were observed/ Other studies of workers who developed chloracne resulting 'from TGBD exposure.have been conducted and have been reviewed. At* the present time, data from these various studies da not consti tute corroborative evidence of a cancer risk to man for any par- _ticular cancer site.* - 13- FEB-18-1994 13:14 FROM E.R.F. TO ALDER-HILL ` P.ll F E B -1 8 -1 9 9 4 13=14 FROM E . R . F . TO fiLDER-HILL P .1 2 r k. 11. International A% -9 for Researchon cane. * IARC Monographs on the Evaluation of the Carcinogenic Sisk of chemicals to.Man. vol. 11. Some Carbamatewr"Thiacarbaaates, and Carbamide*- Lyons XARC, 1976 12. International Agency for Research on Cxncar. _IARC Mono graphs on tha Evaluation of Carcinogenic Risk of Chemicals to Kan. Vol, 1 Lyons XARC, 1971* 13 Kagee PM: N-nitrnso compounds and related carcinogens* .... lot searle CE(ad) : Chemical carcinogens', Monograph 176, ;; - -- Washingtons American chemical Society, 1976, 11. __1^: 7*p".r:I 14, Eighth Revision, International Classification of Diseases; 4 Adapted.for use in the edited States, US. Department.of ., Health,'Educationr and Welfare, Public Health!Service*".1 " ' FHS Publication Ho, 1693, Washingtons. 0*S',.Government; . Printing Office, 1977, * ....... 151 Htsason SR: Analysis of relative survival and;proportional'" "T; mortality- Comput Biemsd Res 7:325-331* 197$:. .;'. r.^ 16. Decoufla P, Thomas TH, and Fickle LW: comparison, of.the .... proportionate mortality ratio and standardisation, mortality ratio risk measures. An J Epidemiol 111:263-269,;19H07 " 17, ott.G, Holder SB and Olson ft; A mortality.analysis of employees engaged in the manufacture of 2,4,S^richlotopfainoxyacetic acid, J Occnp M*4 22:47-50, 1930. . . . TQTfiL F.12 Tabla 1 Distribution o Total Nitro Plant Study Population b y Age at Hire Acre at Hire 420 20-29 30-39 40-43 50+ Total Number 122 518 191 53 0 884 Percent 13-8 53-6 21-6 6.0 0.0 100.0 f Table 2 Distribution of Total Nitro Plant Study Population- -'by Year of Hire Year of Hire "Prior to 1930 1930-1939 1940-- 1949 1950*1959 1360-1976 Total Number 21 74 361 305 123 684 P e r c e n t _____ 2.4 0.4 40.8 34.5 13.9 100.0 '- Table 3 Distribution of Total Nitro Plant Study Population by Length of Employment Length of Employment (yrs.) <10 10-19 20-29 30+ Total Number 225 213 204 242 884 Percent 25.5 24.1 23.1 27.4 100.1 Table 4 'Qbsarved and Bxpectsd Number of Deaths During 1955-1977 by Cause Showing Standardized Mortality Ration (SHR'S) for Total Nitro Riant Study Population Couse of Death ICDA Codes Atti Jlev. Observed Expected 8HR M l causes of Death M l malignant neoplasms Buccal aavity and pharynx : Digestive organs and peritoneum S toraach Li voi RII other digestive organa Respiratory system Lung All other respiratory organa Skin Genitourinary organs V Uladder All other genitourinary oi gene Lymphatic and hematopoietic tissue Other sites Diseases of the nervous system etid sense organs Diseases of the circulatory eyet an Arteriosclerotic heart dlsgae e, including CUD All other diseases of the cix culatory 'system Oiaeaaeo of the respiratory eyst era Diseases of the digestive syetei? * Ail other diseasee External cauaea of death Humber at riaki B04 Person-years at ri ski 13968.7 p < .05 L4-209 140-149 150-159 151 155,156 -- 160-163 162,163 -- 172,173 LB5-1B9 166 -- 200-209 -- 320-369 390-458 410-413 -- 460-519 520-577 -- BOO-990 16 y 35 0 4 1 0 1 14 14 0 0 12 9 3 1 4 0 92 79 13 6 .5 5 150.1 103 30.92 113 1.03 0 6.65 46 1.63 61 - 0.60 0 6.42 47 10.51 133 - 9.91 141 3.60 0 . . 0.50 0 3.75 320* 0.91 909 2.A4 106 3.15 32 . 3- 25 123 1.20 0 82.59 . 111 59.40 133* 23.19 56 9.13 66 B. 03 - 62 10.46 40* 20 15.69 __ U l Table 5 Observed and Expected Deaths fro Malignant Mooplaeroa During 1955-1977 by Calendar Time Showing Standardised Hurtality Ratios tBtfR'e) for Total Nitre Plant Study Population > 1i . ise .of Death 1955-1959 Observed Expected pMR . malignant neoplasms Duccal cavity and pharynx Digestive organa and peritoneum Stomach Liver M l other digestive organa Respiratory eyatea Lung All other respiratory organs Shin Genitourinary organa Bladder All other genitourinary organa Lymphatic and hematopoietic tissue Other sites 1 0 1 0 0 1 D 0 0 0 0 0 0 0 0 3.13 0.11 1.01 0,25 Q.09f 0.67 0.87 0.80 0.07 0.07 0.33 0.08 0.24 32 0 99 0 0 149 0 0 0 0 0 0 a 0,40 0 0.34 a Calendar Tima 1960-1969 . 1970-1977 Observed Expected 8MR Observed Expcctod SMR 13 11. BL 110 21 15. 96 131 0 0.41 0 0 0.50 0 2 3.48 57 1 4.16 24 0 0.70 o 1 0.69 145 0 0.28 0 0 0.23 0 2 2.50 00 0 3.24 0 4 3.83 104 10 5.81 17 2 4 3 .59 111 10 5.52 181 0 0.24 0 a 0.29 0 0 0.23 0 0 0.23 0 5 1.37 365 7 2.05 341 5 0.34 1471* 4 0.48 833 0 1.03 0 3 1.57 191 0 1.24 0 1 1.50 67 2 1.25 160 2 1.68 11-9 p < .05 # lb - Table 6 . Observed and Expected Deaths frean Malignant NaoplaBraa During 1955-1977 by Ago at Death Showing Standardized Mortality Ratios (BHR'el for Total tiitro Plant Study Population Age at Death cause of Death < 45 Observed Bxoacted SHR All malignant neoplasm* Buccal cavity and pharynx Digestive organa and peritoneum Stomach' Liver All other digestive organs Respiratory eyeten Lung All other respiratory organs fikin Genitourinary organa Bladder All other genitourinary organa Lymphatic and hematopoietic tissue Other sites 2 0 0 0 0 0 0 0 0 0 1 1 Q 0 1 2.29 0.06 0.51 0.10 0*03 0.30 0*54 0.51 0.03 0.13 0.20 0.02 0.18 B4 0 0 0 0 0 0 0 0 0 500 5000 0 0.55 0 0,4.0 2 30 45-64 . Observed Expected 8MR 21 16.05 125 0 0.67 4 4.5B 07 1 0.05 110 0 0.32 0 3 3.41 08 11 6.36 173 11 5.99 104 0 0.37 0 0 Q. 31 0 3 1.43 210 2 0.39 513 1 1.04 96 1 1.60 63 2 1. 90 10 5 65t Qbaarved Ski?acted 8MR 12 11,69 0 0.31 0 3.57 0 0.68 0 0.24 0 2.65 3 3.61 3 3,42 0 0.19 D 0.14 8 2.12 6 0.50 2 1.62 101 0 0 0 0 0 83 oh 0 0 377* 1200* 123 0 1.00 0 1 0.94 106 p < .03 P# Table 7 Obaorved and Bapected Deaths from Malignant Keoplesma During 1955-1977 by Yoar oi Hire Showing Standardised Mortality RatioB (SMft'aJ for Total Hit.ro Plant Study Population Year of [lire Canea of Death . Prior to 1945 1945-1959 . Obaarved Bxnaotad 3HR Obaerycd Bxpactad SUR All malignant neoplasma 25 Buccal cavity and pharynx Digestive organa and peritoneum 2 Stomach 0 Liver 0 Ail other digestivo organi 2 Respiratory system 10 Lung 10 All other respiratory organi' 0 Skin '- 0 Genitourinary organa 9 Bladder e All other genitourinary organa l Lymphatic and hauistopoietio tissue l Other altea 3 21.30 0.70 6.27 1.21 0.45 4.61 7.14 6.73 0.41 0.31 2.90 0.72 2,10 117 0 32 0 0 43 140 149 0 0 310 * mi * 46 1.95 51 2.03 146 10 0 2 1 0 1 4 4 0 0 3 1 2 0 1 6.63 0.31 2.19 0,39 0.14 1.66 3,09 2.93 0.16 0.22 0.76 0.10 0.56 116 0 91 256 0 60 129 137 0 0 395 556 345 1.00 0 1.06 94 196Q-1976 Observed _Expected_SM 0 0.99 0 0 0.03 0 0 0.19 0 0 0.03 0 0 * 0.01 0 0 0.15 0 0 0.27 0 0 0.26 0 0 0.01 0 0 0.05 0 0 Q .09 0 0 0.01 0 0 0.03 0 0.20 0 0 0.16 0 p < .05 Table 9 2.4.5- T Exposure Classification for Decendents During 1955-1977 Among Total Nitro Plant Study Papulation 2.4.5- T Exposure classification Exposed Non-exposed Unknown Tptal Number of Deaths Percent 58 104 1 163 35.6 63.8 0.6 100.0 . ft Table 9 Observed and Expected'Nuirber of Deaths During 1955-1977 by Cause and 2,4,S-T Exposure Category Showing Proportional Mortality Ratios (FHU'S) Cause n Daatt] 2,4,$-7 Exposure Category EXPOSED NON -B X fO S K D Qbevved Expected PUB Observed Expected PMR All joalignant neoplasms 9 ;o.94 62 , 25 20.43 122 Buccal cavity and pharynx Digestive organa and peritoneum a 0.38 0 0 2.BO 0 0 0.64 0 3 5.74 52 Stomach Diver All other digestive organs 0 .52 0 0 0.19 0 0 2.09 0 0 1.06 0 0 Q.39 0 3 4.29 70 Respiratory system 6 3.70 159 6 6.8L 11? Lung * All other respiratory organs 6 3.57 16B 0 0.21 0 e 6.42 125 0 0.39 0 Skin Genitourinary organs 0 0.29 0 0 0.35 0 2 0.96 20B 10 2.70 370* Bladder All other genitourinary organa 2 0.22 909 a 0.74 0 7 0.65 1077 * 3 2.05 146 Lymphatic and hematopoietic tissue Other sites 0 1.35 0 l 1.30 72 1 2.07 46 3 2.12 142 Diaeaeaa of the nervous system end sen as organs 0 0,61 0 0 0.63 0 Diseases of the circulatory system 31 26.48 1 117 61 55.34 n o Arteriosclerotic heart dlsooBC, lncl ding CHD 27 19.72 137 All other diseases of the circulator f system 4 6.76 ' 59 52 39.68 131* 9 15.66 57 Diseases of the respiratory system 2 2.67 75 4* 6.49 62 Diseases of the digestive aye ten All other diseases External causes of death Total nunter of deathsi ; 1 11 3 *2 58 3.70 27 4.31'! 70 9.,29, 129 58.00 T 4 4,93 61 2 6.70 30 a 9.28 86 104 104.00 TT I It. Table 10 Deaths Due to Malignant Meoplasme Aaiong Nitro Plant Workersi Exposed to 2,4jS-T Year of Birth 1 1917 Year of Mire 1946 Year of let Exposure 1951 Year of Term. 1972 Year of Death 1372 Smoking Cause of Death as Given on History* Death Certificate Cigarettes Carcinoma left lung with metastaeea (162.11 1911 1348 M 1918 1946 , i 1355 1959 1972 1968 1972 Cigarettes Hataetatlc carcinoma of tho lung (162.1) 1968 . Cigarettes Bronchiogenic carcinoma of right upper lobe (162.1) 1901 M 1944 1956 1963 1973 CLgarottee Carcinoma lung with nataataBOS (162.1) 1911 1941 1* 1922 ' 1945 194B 1948 1971 1372 1975 1973 Cigarettes Bronchiogenic carcinoma vjith cerebral metaetasea (162.1) Non-Smoker Bronchicgtmic carcinoma with metastasca (162.1) 1923 1902 1946 1922 1950 1948 1972 1966 1972 1966 Cigarettes Generalised lipoaarooma (171.9) Non-Smoker Metastatiu carcinoma urinary bladder (183.0)** 1910 1944 1940 1968 1968 Non-SiDokBr Carcinoma of the urinary.bladder (188.01** * Obtained by interview with former coworkera of decadents. * m Included on the Nltro plant roster. Death Dua to Malignant Neoplasms Among Nitra Plant Workers Not Bxposed to 2j4,5-T Year of birth 1911 1934 1B99 1905 1909 1910 1912 1915 1915 1094 1912 Year of Uice 1945 1935 1929 1944 1941 1927 1944 1937 1939 1944 1937 Year of Termin. 1966 1957 1959 1970 1962 1966 1965 1977 1969 1960 1973 Yuar of Death I960 1957 I960 1972 1962 1970 1965 1977 1970 1964 1974 Smoking JJlatorv* Cigarettes Cigarettes Pipe Cigarettes Cigarettes Cig&rattea Cigarette Cigarettes Cigarettes Non-smoker Cigarette Cause of Death as Qiven In Death Cart. Carcinoma of colon (153.B) Carcinoma' of liver (157.9) Intraperitoncal aarcinoma (158.9) Carcinoma of lung (162.1) Carcinoma of left Lung (162.1) eulr&onary carcinoma (162.1) Carcinoma of apex of right lung (162.1) Carcinoma of lung {162.1) Carcinoma of lungs (162.1) Carcinoma of lung (162.1i Carcincukd of lung (162.1) 1919 1901 1B97 1698 1905 1898 IBB B 1946 1933 1941 1933 1943 194 3 1944 1905 1906 1925 . 1933 1946 1945 1919 1943 ' 1901 1941 1901 1943 1922 1944 * Ol l.-{,, .,1 1.r 1n* n m | r*v) 1963 L962 1962 1962 1971 1563 1956 1969 I960 1973 1972 1964 1966 1964 1964 1977 , 1965 1965 1975 1970 1970 Cigarettes Carcinoma of urinary bladder (1B8.0)** Cigarettes Carcinoma of bladder (168.0)* Cigarettes Carcinoma of urinary bladder (186.0)' Snaked years ago Carcinoma of urinary bladder (1BB.0)* Cigarettes Carcinoma of bladder (186.0) Cigarettes Bladder tumor (lflfl.Q)* Unknown Carcinoma of bladder (166.0) 1977 1 Cigars Prostatic carcinoma (IBS.0) 1977 Cigarettes Carcinoma of prostata (105.0) 1974 Snaked years ago Carcinoma of proatate (185.0) 1973 Cigarettes Hodgkin*a Disease (201.0) 1965 1977 1964 rnwnrVpfo nf Cigars Cigarettes Osteosarccana arising from left arm j (170.4) { Carcinoma of liver 6 pancreas (197.8) Cigarette Adenocarcinoma (199.0) ** Tnrlnd^ r>r\ h/x Hi **r' rtlnnP Tun