Document zooJBZR70ak92B2L28bXLr9K0

o O Shell Oil Company Interoffice Memorandum APRIL 23, 1991 FROM: TO: S. R. COWLES, M.D C. A. LAMBOLEY F. K. BLACKARD L. L. MC DOWELL C. F. PHILLIPS L. C. WADDELL, M.D. C. E. ROSS, 0.0. W. L. HEITZ SUBJECT: EXTENDED MEDICAL SURVEILLANCE FOR ASBESTOS The attached information is forwarded to you for preview for our meeting on Friday, May 24, 1-2 p.m. in Conference Room 1023 OSP. S. R. Cowles, M.D Attachments cc w/attachments - W. A. Carpenter, Jr. R. R. Kienle J. M. Regnier R. D. Gerard E. W. Montgomery U CT9111301 - 0001.0.0 ABS-019107 U Shell Oil Company Interoffice Memorandum APRIL 23, 1991 FROM: S. R. COWLES, M.D., DR.P.H., MEDICAL DIRECTOR HEALTH SURVEILLANCE/EPIDEMIOLOGY TO: C. E. ROSS, 0.0., CORPORATE MEDICAL DIRECTOR SUBJECT: PROPOSAL FOR AN EXTENDED MEDICAL SURVEILLANCE PROGRAM FOR ASBESTOS SMSP PARTICIPANTS WITH POSITIVE FINDINGS AT RETIREMENT Background In 1981, the Shell Data Evaluation and Prioritization Team (D.E.P.T.) task force reviewed substances covered by Shell's Special Medical Surveillance Programs (SMSP) to determine whether or not the employees included in any of the programs should be eligible for medical surveil lance after retirement (Enclosure I). As a result of that review, eight substances were considered to be potential candidates for such a program but only two were recommended by D.E.P.T. for initial implementation. The two substances chosen by D.E.P.T, were vinyl chloride monomer (VCM) and epichlorohydrin (ECH). Both were chosen because of their potential carcinogenicity and because the amount of human data regarding these sub stances was considered incomplete. VCM was later dropped from considera tion when It was learned that most cases of angiosarcoma of the liver presented before the age of 65 and that no effective intervention was possible. A modified (5-year, one-time examination 5 years post-retire ment) program was developed and implemented for ECH. Only a very small number of Individuals were eligible for this program (less than 15 total per year) and no adverse health effects linked to ECH were uncovered by this program. At the end of five years that program ceased. Since 1981, there has been an explosion of asbestos related litigation (Enclosure II), and the development of a variety of Individual location specific programs to follow up Shell retirees with evidence of asbestosrelated conditions at the time of retirement. Some locations, such as Martinez, offer pulmonary specialist consultation and annual follow-up examinations to such individuals (Enclosure III). Deer Park has also followed a small group of retirees with suspected asbestos-related con ditions (Enclosure IV). In 1990, Westhollow Research Center asked to institute such a program (Enclosure V). Wood River Manufacturing Complex is facing a class action asbestos claim by former employees. Shell Corporate Medical Department has established an asbestosls registry for those asbestos SMSP participants found to have evidence for an asbestosrelated condition. All of these activities suggested the need to revisit the issue of a standardized extended medical surveillance program for asbestos. To this end, the following proposal has been developed. CT9109402 - 0001.0.0 ABS-019108 Proposal Dr. Marshall Anderson, an occupational medicine resident with the Univer sity of Texas School of Public HealtH, has prepared Enclosure VI which details the rationale for an extended medical surveillance program for asbestos according to the original 1981 D.E.P.T. criteria. Initially, Corporate Medical recommends confining such a program to those identified as having an asbestos-related condition at the time of retirement or to those former asbestos SMSP participants who are discovered to have such a condition after retirement and seek Shell follow-up. Content of the follow-up examination would be the same as for the existing Shell asbestos SMSP (Enclosure VII), annual frequency would also be the same. Modifica tion of the existing examination protocol and preseparation counselling sheet (Enclosure VIII) for asbestos would be needed to reflect follow-up of affected retirees. Implementation date would be dependent upon the timing of necessary approvals within Shell. Retirees known to be eligible for this program would need to be notified in addition to current active eligible employees at the time of retirement. Initiation of Approval Process First step Is to seek preliminary review and approval from Legal; ER/IR; Products, Manufacturing Technical; and Health and Safety. A meeting is planned for May 24 to describe the proposed program and discuss how it could best be implemented if accepted. S. R. Cowles, M.D. Enclosures (8) cc - L. C. Waddell, M.D. CT9109402 - 0002.0.0 ABS-019109