Document zQN8NKj7mBmo3kj59O30OvBy0
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Cagen, Stuart Z SCC-CF-SS <stuart.cagen@shell.com> Thursday, June 23,2005 10:21 PM (GMT) Cagen, Stuart Z SCC-CF-SS <stuart.cagen@shell.com>; Tsai, Shan P SHLOIL-SHS <Shan.Tsai@shell.com>; Clegg, Patsy M SCC-CHSE-PC <patsy.c1egg@shell.com> FW: BHRC-TC... Handout for EA ConfCall - Fri 12110, llam EST 121004 DRAFT SHS EA ver 4.ppt
Memories... Of possible use for the call tomorrow morning. Looks like there will be a combined call tomorrow, with Otto joining the call with Tom, et al at 930 am Houston time
Stuart Cagen
Shell Chemical LP One Shell Plaza, 910 Louisiana, Houston, TX 77002-4916
Tel: +1 713241 1407 Fax: 3325 Other Tel: +1 8326463987 Email: stuart.cagen@sheILcom Internet: http://www.sheILcom/chemicals
"Business Success through HSSE Excellence"
-----Original Message----From: Bruce Jarnot [mailto:jarnotb@apLorg] Sent: Thursday, December 09, 2004 5:47 PM To: benzconsort-tc@listserve.apLorg Cc: Lorraine Twerdok; Howard Feldman Subject: BHRC-TC... Handout for EA Conf Call - Fri 12/10, llam EST
Attached is Tom Armstrong's handout (ppt file) for Friday morning's Exposure Assessment conference calL ..
Best Regards - Bruce.
-----Original Message----From: Bruce Jarnot Sent: Tuesday, December 07, 2004 10:50 AM To: benzconsort-tc@listserve.apLorg Cc: Howard Feldman Subject: BHRC-TC... REMINDER - EA Conf Call - Fri 12/10, llam EST Importance: High
Benzene Health Research Consortium (BHRC) Technical Committee -
REMINDER... we have a conference call scheduled this Friday, Dec 10th, to review Exposure Assessment (EA) progress in the Shanghai Health Studies with Tom Armstrong, Rob Schnatter and Yimei Zhou:
Date: Friday, Dec 10
Time: 11 :OOam - 2:00pm EST
Dial-in: 763/315-6900 (or toll free 866/448-6756)
SH ELL-MCCLU RG-052835
PIN code: 6828319# Best Regards - Bruce. ***** Bruce M. Jarnot, PhD., DABT American Petroleum Institute Regulatory and Scientific Affairs 1220 L Street, NW (Room 1025) Washington, DC 20005-4070 phone: (202) 682-8473 fax: -8031 email: jarnotb@api.org <mailto:jarnotb@api.org>
SH ELL-MCCLU RG-OS2836
Review of SHS Exposure Assessment
10 December 2004
Tom Armstrong
Rob Schnatter Yimei Zhou
DRAFT
1
SH ELL-MCCLU RG-OS2837
Overall Study Aims and Values
Case Control (PI: Otto Wong I Fu Hua)
Is NHL associated with benzene? If so, is NHL / benzene specific to NHL subtype?
What is shape of dose-response curve for NHL and AML? Provide comment on NCI NHL / benzene study
Disease Progression (PI: Rich Irons I Fu Hua)
Does benzene-induced disease have a distinct pattern? Does benzene-induced cancer progress through requisite steps? What is shape of dose-response curve for MDS and AA? May have impact on "safe" levels
Molecular Epidemiology (PI: Rich Irons I Fu Hua)
What is shape of dose-response for blood effects? (Phase 1, 2A) What is earliest marker for effects? (Phase 1, 2A, 28) Does benzene induce toxicity more readily in susceptible workers? (Phase 2A, 28)
Provides mechanistic insight; possible protection strategy in some settings Are there requisite steps for later markers (blood count decrements)? (Phase 2A, 28) Does benzene act on bone marrow differently than peripheral blood? (Phase 28)
If so, provides insight on mechanisms, thresholds Could provide new basis for dose-response
DRAFT
2
SH ELL-MCCLU RG-OS2838
Study Positives
State-of-the-art lab Improved diagnostic capabilities New WHO scheme for LH disease classification enabled Tissue storage allows future research Patient population directly benefiting from improved diagnoses / treatment Reputation for diagnosis reflected by more signatory hospitals Unique resource for research Preliminary results already suggest threshold for blood effects Preliminary results suggest bone marrow changes in absence of peripheral
blood Could be unique benzene signature for myelodysplasia Enhancing IH capabilities in Shanghai / China Comments / review Study obtained positive feedback at recent worldwide conference Esteemed SRP and ERB has favorably reviewed study Study may be helping to reduce benzene exposure in Shanghai
DRAFT
3
SH ELL-MCCLU RG-OS2839
EA Progress Summary
10? 100-200?
DRAFT
4
SH ELL-MCCLU RG-052840
Deliverables Associated with Each Study
Molecular Epidemiology
Scope
Phase 1: Phase 2A: Phase 2B:
2000 workers 1000 workers 200 workers
EMBSI Activities I Deliverables
Design Questionnaires Design Training of staff Abstraction forms Factory selection Exposure assessment QA/QC Statistical analysis Publication assistance Presentations assistance
Status
Complete Complete Complete Complete In progress In progress In progress Future Future Future
Actual Effort +5%
(see CC)
2X (see CC)
Future Future Future
DRAFT
5
SH ELL-MCCLU RG-OS2841
Deliverables Associated with Each Study (cont'd)
Disease Progression I Case Control
Planned Scope
BZ poisoning cases: Aplastic anemia: MDS: AML: NHL: Controls:
Total:
50 250 300 600 600 3600 5400
EMBSI Activities I Deliverables
Design Questionnaires design Training of staff
- Quest. administrators - Clinical coordinators - Exposure Assessment Control selection Exposure assessment QA/QC Some statistical analysis (DP) Some publications (DP) Some presentations (DP)
Status
Complete Complete Complete Complete Complete Complete Complete In progress In progress Future Future Future
Actual Effort
+20% +60-70% Retune +30% " + 20-30% " +20-30% +2-3X In progress Future Future Future
DRAFT
6
SH ELL-MCCLU RG-OS2842
EMBSln imeline
[ .a.C -e-l,l
EMBSI $ Plan $ Actual
-
Na
c -e-l,l
-
21i2 K 132 K
Ii
718 K 624 K
-
(")
a
Ol
:::J
-
"a<t
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-e-l,l
~
1,213K 1,192K
1,576K 1,533K
Project Milestones
Protocols approved Agreements with Fudan, CDC,IPHS
Lab & Studies Start Field testing, ME Pilots
Lab& Studies Start
EMBSI Planned Work
Protocols: write, review, approve
EMBSI Actual Work
Protocol write, review, approve
Staffing, EA support materials, training Troubleshoot, Monitor, Reviews
Design & ov,:::.rsight for EA - AMLlNHL Study (2) Questionnaire development
Staffing, EA support materials, training (1)
l
Design & OVerSight for EA - AMLlNHL Study
"I ;~~::::hoot, Monnor, "
JCML Database for EA (3): ------------------------------------------.~.i
Questionnaire development (4)
;-----------------------------------------------+i~i EMBSI reviews CDC lab &
I provides lab QA support(5)
Import delays (Chines regulation driven)
IPHS Role Change
EA crew to
Comments
Agreements & revisions with Fudan, IPHS, CDC
Fudan recruiting EA
questionnaires
_________________________________________________________.~ YZ begins support
SARS
Turnover
Notes: (1) Extended due to project start delays, changing agreements and Fudan staff reassignments
(2) Added per SRB request and budget increased (3) Need identified by PI Team
DRAFT
(4) Extended due to add in of AMLlNHL Study EA support
(5) Unanticipated need covered by EMBSI
New IH Lab
EA Reviews, EA Committee, Local management issues
7
SH ELL-MCCLU RG-052843
EMBSl-=.. imeline Forward P)a n
IJ')
o
C
-e-l,l
EMBSI $ Current Plan-1 ,650K
$ Proposed Plan
-1,650K
Does not include XOM sweat equity
Project Milestones Current
Project Milestones Proposed
oco Io"-
C
-e-l,l
C
-e-l,l
-2,OOOK -2,300K
End case accrualI
End EMB?I contract
I'-2800K
3,200K
Begin analyses
:
iPublications drafted
End case accrua Begin analyse , Publications drafted End EMBSI contract
EMBSI Current Planned Work
Troubleshoot, Monitor, Reviews
~i
Analyses DP, ME & P4blications prepared
EMBSI Proposed Work
Troubleshoot, Monitor, Reviews Additional on-site technical & management
~
Analyses DP, ME & -----------''----------i+~ Publications ~ repared
(facilitate increased technical resourcing, me:ntoring, communication; EA QA
oversight, facilitate on-going Fudan/lPHS co~tributions)
I
Analytical QA support
I
I
DRAFT
8
SH ELL-MCCLU RG-OS2844
SHS EMBSI BUDGET
1800000
1600000
1400000
1200000
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>
1000000
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800000
0
600000
400000
200000
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Month
DRAFT
-Spent - Control Budget
9
SH ELL-MCCLU RG-052845
Exposure Assessment Options
Review of strategies and study impacts
DRAFT
10
SH ELL-MCCLU RG-052846
Case Control Studies Tiered Design:
Expectation of Fewer Subjects Completed at Higher Tiers
Robust database, site visits, task data,
retro EA skills
Quantitative & Pattern of Exposure
SH ELL-MCCLU RG-OS2847
CC / DP Exposure Assessment Design
Hospital recruitment, cases of
BP 1 (10/year) AA 2 (50/year)
MDS 3 (GO/year)
AML 4 (120/year), NHL
5 (120/year)
Actual 8/day
Questionnaires
L...{) 1080 /year, 5/day
~
~
Initial exposure assessment - work history, -IPHS database - facility records, - Other
I
Two matched controls
selected per case
Fudan Exposure Assessment Team
Clarify or Verify & characterize main exposures
No or?
v
Construct Detailed Exposure Assessment Job - facility - exposure - time matrix
I Yes
Fudan Exposure Assessment Committee
I
Exposure reconstruction - historic measurements, history of changes in methods, facilities, materials, etc. - retrospective estimation - physical recreation
DRAFT
I
Exposure surveys - facility summaries - worker or surrogate exposure monitoring - air samples - biological monitoring
SH ELL-MCCLU RG-052848
EA Tiers: Design Basis for SH Studies
Case Control Studies DP Case Series (1) AMLlNHL, Broad DP (1)
Quantitative
-Quantitative doseresponse -Links to studies used in risk assessments
-Quantitative doseresponse -Links to studies used in risk assessments
ME Studies (2)
Phase 1
Phase 2A
Underway as planned Quantitative dose-response
Phase 2B
Links to studies used in risk assessments
SemiQuantitative Ranks
Qualitative Ranks
-Semi-Quant. "dose" response -Semi-Quant. causal link -Semi-Quant. link to studies used in risk assessments
Group differences in risk
-Semi-Quant. "dose" response -Semi-Quant. causal link -Semi-Quant. link to studies used in risk assessments
Group differences in risk
-Semi-Quant. "dose" response -Semi-Quant. causal link -Semi-Quant. link to studies used in risk assessments
Ever Exposed Never exposed
Association with disease
Association with disease
Note 1: For the CC/OP studies, all tiers have a "certainty" rating and these generally decrease at the higher tiers
Note 2: "lower tiers" not planned or needed in the ME studies. Semi-quantitative ranks may be applied in some factories for
Phase 1, but full quantitative assessment planned.
DRAFT
13
SH ELL-MCCLU RG-052849
CC/DP Studies - Bz EA Impact Analysis
Stop Point Quantitative
Semi Quantitative 0- 0.3 mg/m3 0.3 to 3 3to 40
> 40
Qualitative range No Low Medium High
Study Impact
Discussion
-Best evidence of causal links -Data for use in risk assessment -Currently planned for -10% of subjects
-Requires additional investigative effort for site reviews, additional retrospective EA skills, robust analysis of IPHS database and other quantitative data sources -Most difficult tier to complete -Costs - medium - high -Probability of Success -low -Value -high
-Improved evidence of causal links -Semi-quant. link to quantitative risk assessments
-Work site screening visits -Difficulty - medium -Costs - medium -Probability of Success - medium -Value - medium
-Risks by groups for stronger information or possible causal link for diseases of concern
-Difficulty - low - medium -Costs -low -Probability of Success - high -Value - low-medium
Read Here to
Top
Everexposed,never exposed
-Only potential relationship of benzene or other exposures to diseases of concern
-Questionnaire driven -Difficulty - low -Probability of Success - high -Value -low
SH ELL-MCCLU RG-052850
Go-forward Options
DRAFT
15
SHELL-MCCLURG-052851
Many Factors Lead to Project Success
Cultural & Political
Management
Technical
Resourcing I
16
SH ELL-MCCLU RG-OS28S2
Opportunities
Action Item
#1 yz assignment to Shanghai and more EA support
Expected Benefits
EA staff morale, productivity, leadership; understanding Fudan / IPHS drivers, EA qualifications, less EA staff resource diversion
Implementor EMBSI
#2
Fund extension of the study
Increase subject numbers, more insight on disease mechanisms (from ME/DP), more power for case control less chance of spurious findings
Oversight Committee
#3 Re-engage IPHS
More efficient factory selection, EA, more insight on IPHS database limitations
PI's
#4
Further support the Fudan team
Continuous Improvement of PI
Oversight Committee
collaboration, YZ effectiveness, post-
study prob. of lab utilization
#5
Periormindependent QAlQC audits of Fudan IH laboratory and field (questionnaire EA) work
Ensure data integrity
Member CO's, external resource
DRAFT
Enabler Technical/Oversight Committees FU's support PI involvement in EA
Technical/Oversight Committees Factory access through IPHS
PA/Member Companies
Technical/Oversight Committees
Technical Committee
17
SH ELL-MCCLU RG-052853
Recommendations:
Maintain Full Scope of SHS
Continue Planned Quantitative EA for CC/OP Studies
Continue Recruitment of Subjects for ME liB Maximizes Value of Study Results for Risk
Assessments Requires Extension through 2007 Requires Additional $3.3M Funding
DRAFT
18
SH ELL-MCCLU RG-OS28S4