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1 Epidemiologic Techniques: How to Hide a Benzene Cancer Relationship: You can’t regulate if the Companies Lie A case study of Shell’s Benzene Historical.

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Presentation on theme: "1 Epidemiologic Techniques: How to Hide a Benzene Cancer Relationship: You can’t regulate if the Companies Lie A case study of Shell’s Benzene Historical."— Presentation transcript:

1 1 Epidemiologic Techniques: How to Hide a Benzene Cancer Relationship: You can’t regulate if the Companies Lie A case study of Shell’s Benzene Historical Exposure Study (BHES) Based on documents produced in toxic tort discovery The view expressed here are those of the authors; the documents are available for review at: /

2 Science denied Early 1900s Benzene first reported as toxic American Petroleum Institute says “Only safe concentration is zero.” 1977 Infante et al. published first cohort study assessing benzene/leukemia 1978 OSHA attempts to lower Benzene PEL from 10 ppm to 1 ppm Challenge by allied petroleum industry stays then overturns new PEL 1983 OSHA announces plans for new PEL by 1984, accepting evidence 1983 Shell Oil quickly conducts Benzene Historical Exposure Study (BHES) 1984 Shell Oil presents findings to OSHA 1985 Shell Oil BHES publication # Shell Oil BHES publication # OSHA collects enough evidence to reinstate 1 ppm PEL 1987 on – Shell continues to publish data follow-ups of faulty BHES study through 2006 – liability cases for occupational benzene exposure in courts.

3 3 Means more workers die Challenge by allied petroleum industry stays overturns lower PEL 1987 OSHA collects enough evidence to reinstate 1 ppm PEL Estimated extra deaths from this regulatory delay.

4 4 Benzene & Shell refineries Used in gasoline refinery processes Frequent addition to chemical blends Used as cleaning solvent, esp. during 1940s-50s. Benzene is understood to be a causal agent for Acute Myelogenous Leukemia (AML)

5 5 Shell refineries with excess deaths Wood River Manufacturing Complex (WRMC) & Deer Park Manufacturing Complex (DPMC) Wood River Manufacturing Complex (WRMC) & Deer Park Manufacturing Complex (DPMC) Elevated leukemia rates noted in mid-1970s as a result of a contractor worker lawsuit for compensation. Elevated leukemia rates noted in mid-1970s as a result of a contractor worker lawsuit for compensation.

6 6 Methods 1. Never admit a fault or wrong; 2. Never leave room for alternatives; 3. Never accept blame; 4. People will believe a big lie sooner than a little one; and 5. If you repeat it frequently enough people will sooner or later believe it. -Ludecke -Ludecke “I Knew Hitler”

7 7 How to Hide… Step 1 Never admit a fault or wrong Reassure everyone that there’s no evidence

8 8 The Lie – AP Wire Press Release 1983 Shell has found no link between benzene and the relatively high incidence of deaths from a certain type of leukemia in Texas & Illinois plants that handle the chemical

9 9 The Truth

10 10 How to Hide… Step 2 Repeat the Lie Report new (and flawed) evidence that shows “no relationship” between benzene and cancer

11 to OSHA/NIOSH

12 Lie to OSHA/NIOSH Our analysis has nevertheless failed to establish a causal relationship between benzene exposure and AML.

13 letter to OSHA/NIOSH Basis of “no causal relationship” was the report that 9 of 23 leukemia cases had “nil” exposure to benzene at the plants. Basis of “no causal relationship” was the report that 9 of 23 leukemia cases had “nil” exposure to benzene at the plants. Plus cases didn’t cluster in highest exposure jobs. Plus cases didn’t cluster in highest exposure jobs. Exposure estimates were based on reconstructed histories of work locations + peer interviews. Exposure estimates were based on reconstructed histories of work locations + peer interviews.

14 14 From a related study -You can fool some of the people…1983 “It must be recognized that this study’s negative result will generally be perceived as not highly persuasive” because.. Benzene, being highly volatile, may permeate nearly the entire facility and affect just “susceptible” individuals.”

15 15 Methods: Never leave room for alternatives Exposure assessments based on smell “I fear we will be seriously underestimating the exposure” Omitted from papers

16 16 Methods: Never leave room for alternatives The suggestion has been made previously that existing and available extensive leak rate data on petroleum refineries be combined with air pollution dispersion modeling techniques…The notable lack of enthusiasm among your experts concerns me.

17 17 Worker Exposures “disappeared” There was little evidence on exact worksites of people assigned to refinery- wide jobs such as laborer or carpenter. There was little evidence on exact worksites of people assigned to refinery- wide jobs such as laborer or carpenter. This meant there was no basis to establish ‘nil’ exposures This meant there was no basis to establish ‘nil’ exposures Nil = nothing; naught; zero, having no value or existence

18 18 The Truth - Worker Exposures “disappeared” The 7 “nil” exposure cases (refinery-wide workers) were either probably or definitely exposed

19 19 “None determinable” becomes “Nil” BUT: “I do not know” ≠ “Zero” Case No.Reported exposure categoryRaw data shows… I "none determinable to very slight" later “nil”Worked refinery-wide ( ) III"none determinable" later “nil” Worked refinery-wide (intermittent, duration approx 1 yr) V"none determinable" later “nil”Worked refinery-wide ( ) VI"very slight" later “nil”Worked refinery-wide ( & ) XI" ppm days"Worked refinery-wide ( ) XIV"none determinable" later “nil”Worked refinery-wide (13 wks) XV"none determinable" later “nil”Worked refinery-wide ( )

20 20 The Truth - Worker Exposures “disappeared” Wood River leukemia cases had a combined total of 164 years assigned to “refinery-wide” positions. You cannot say “subjects did not work in jobs identified as having the highest benzene exposures” if you don’t know where they worked!

21 21 Worker Exposures “disappeared” In a minimum of 4 cases, Shell ignored evidence of benzene use as a cleaning agent. Case No.Reported exposureBenzene as cleaner? Was this included in total exposure estimate? II"1,300-10,400 ppm days"very likely in laboratoryNo IV"25-70 ppm days"reported by intervieweesNo VII" ppm days"reported by intervieweesNo XI" ppm days"reported by intervieweesNo

22 22 Worker Exposures “disappeared” Accounting for direct use of benzene as a cleaning agent (highest exposure level) would have shattered the claim that people with AML didn’t work in the highest exposure jobs.

23 23 Published LIE “ONLY ONE ≠ NONE Cole P, McCraw D, Joyner R. Brief Communication: Excess Leukemia in a Refinery Population. JOM 1985/3/1;27(3): “This investigation has shown that the subjects did not work in jobs identified as having the highest benzene exposure” “Five [of the leukemia cases] spent most of their years as maintenance [Laborer] workers, but it is not known if they were ever assigned to benzene units.”

24 24 Data: “ONLY ONE ≠ NONE “Of potential significance is that the highest exposure jobs are not reflected in the work records of the diagnosed leukemia case. For example only one [a maintenance worker] of the Wood River cases worked in the highest exposure jobs related to the Cumene Plant”

25 25 How to Hide… Step 3 Populate the peer literature with articles repeating the point Repeat the lie as often as possible

26 26 Repeat the Lie Austin H, Cole P, McCraw D. A Case-Control Study of Leukemia at an Oil Refinery. Journal of Occupational Medicine. 1986/11/1;28(11): Incorporated same design flaws as earlier SMR studyIncorporated same design flaws as earlier SMR study Incorporated personnel misclassification errors, biasing outcome to the nullIncorporated personnel misclassification errors, biasing outcome to the null Key personnel were not blinded – invalidating studyKey personnel were not blinded – invalidating study “Thus the reason for the excess leukemia at this refinery was not identified.”

27 27 Repeat the Lie Wongsrichanalai C, Delzell E, Cole P. Mortality from leukemia and other diseases among workers at a petroleum refinery. J.Occup.Med. 1989/2;31(2): Mortality study on WRMC populationMortality study on WRMC population They admit a statistically significant elevated risk for leukemia at plantThey admit a statistically significant elevated risk for leukemia at plant But argue against a benzene relationshipBut argue against a benzene relationship Why? Key reason is Shell’s earlier two studies showed none Why? Key reason is Shell’s earlier two studies showed none “Several observations argue to some extent against the hypothesis that the excess [leukemia] is due to refinery [benzene] exposures.”

28 28 Eliminate the Honda Y, Delzell E, Cole P. An updated study of mortality among workers at a petroleum manufacturing plant. J.Occup.Environ.Med. 1995/2;37(2): Update of 1989 mortality study, checking to see if excess leukemia is now disappearing.Update of 1989 mortality study, checking to see if excess leukemia is now disappearing. Study incorporated systemic misclassification errors.Study incorporated systemic misclassification errors. Published study excluded relevant negative findings from the internal version.Published study excluded relevant negative findings from the internal version. “These results indicate that any occupational leukemogenic exposures at the plant have been reduced to the point where they are insufficient to cause leukemia.”

29 29 How to Hide a Benzene Cancer Relationship 1.Reassure everyone that there’s no evidence 2.Report new (flawed) evidence that shows “no relationship” 3.Populate the peer literature with articles repeating the point

30 30 Disclosures and contact Financial disclosure statement Financial disclosure statement D. Egilman consults at the request of lawyers representing patients with AML who have had benzene exposure.D. Egilman consults at the request of lawyers representing patients with AML who have had benzene exposure. Correspondence to: Correspondence to: David Egilman, MD, MPH 8 North Main Street Suite 404 Attleboro, MA Authors: D. Egilman, Scout, L. Kol, S. Bohme


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