1/7 and 13/88
Bennett had been copied with Doll’s letter to Paddle, concerning the Dr. ten Berge discrepancy and have received no explanation from the States about it yet. However, this did not keep Bennett from asking if Doll had yet decided when he would be able to publish his “superb piece of work in the literature,” explaining that the comments he had have received on the report, from the interested parties, had all been favorable and complimentary.
Doll told Bryan Bennett .he had not intended trying to get the Vinyl Chloride report published but would try to if Bennett really thought it would be worthwhile. He admitted that the needed to amend the report in the light of Bennett’s answers to the questions raised by the discrepancies suggested by Dr. ten Berge. Doll admitted that, irrespective of publication, resolving the discrepancies would be of great interest from the point of view of the completeness of the registry.
Doll had been advised by Bennett to make no acknowledgement as to who paid for the paper when it was finally published
2/25/88
On 2/25/88, Dr. Doll wrote a reply to the Scandinavian Journal thanking its editor for agreeing to publish the VCM review. Doll did ask for time to add a short note of acknowledgements
2/29/88
ICI furnished Doll a copy of Dr. Jones’ mortality study of VCM workers in the U.K. to use in the review he was writing, supposedly for the CMA, “world tonnage” or not. Dr. Doll sent Dr. Jones a copy of the report before it was accepted for publication, and had to ask whether the Jones’ report had ever been published: Doll claimed that without reference to Jones’ report his own would have been valueless. On the other hand, Doll said he didn’t want to get into the position they had been in over asbestos and would suppress the publication of his report if Jones was still negotiating the publication of his.
2/29/88
Prior to February 29, 1988, although Dr. Doll had originally understood the study was for the private use of the CMA-coordinated vinyl manufacturers, in accord with what the CMA-coordinated vinyl manufacturers had planned all along, they requested Dr. Doll to publish the paper (the critical review of epidemiologic studies) in the open literature, for the benefit of the entire world – he was told.
On February 29, 1988, Dr. Doll, inquiring as to the type of acknowledgment he ought to make of the financial support provided by the CMA-coordinated vinyl manufacturers (and others) in return for his critical review of the VINYL CHLORIDE literature in the Scandinavian Journal of Work, Environment and Health.
He was told not to make any acknowledgment of the generous financial support the companies had provided, whatsoever.
3/2/88.
Jones wrote back that his article would be published in the same Journal and issue as Doll’s was going to be
Doll was aware that the Jones article was not final, unpublished, and subject to change, but used in both his original “personal version of the paper for CMA and in the version submitted for publication and has on 10/3/86 had supposedly even agreed to treat the Jones report as confidential and not disclose it without permission.
3/2/88
Bryan Bennett (ICI) wrote Dr. Doll on 3/2/88 stating, without explanation, that he did not feel that any acknowledgements were required to any individuals are company, even including himself
( Doll had asked for Bennett’s “advice as to the acknowledgement” he should make to the CMA.)
Doll had also asked for information (2/29/88 ) on the discrepancies between the list of angiosarcomas used in Doll’s paper on the ICI ASL registry and those in table 17 of the Wong report, as raised by Dr. ten Berge.
3/29/88
On February 29, 1988, Sir Richard Doll requested advice from ICI’s Dr. Bennett as to the acknowledgement he should make to the Chemical Manufacturers Association.
Apparently, the best thanks Doll could give was to say absolutely nothing about who had funded the study.
Dr. Bennett (ICI) wrote Doll him back on 3/2/88 stating, without explanation, that he did not feel any acknowledgements were required to any individuals or company, even including himself.
4/18/88
On April 18, 1988, the Vinyl Institute commented on the Agency for Toxic Substances and Disease Registry’s (ATDSR) “Toxicological Profile for VINYL CHLORIDE,” and included objections to sections on Consumer Exposure in Cars, Human Exposures resulting from the leaching of Plastic Pipe in drinking water, as well as sections on the effects on offspring development, cancer risk estimates, genotoxicity, carcinogenicity and other diseases (most specifically about disease other than angiosarcoma).
7/11/88
Doll told Bennett that he and Foreman were SURE that they ought not publish anything more until they could sort out the discrepancies between the ICI registry and the U.S. cases reported in the EHA study to which Dr. ten Berge had recently drawn drew attention.
10/21/88
Bennett wrote Doll on his visit with Bill Gaffey on “apparent discrepancies” ICI admitted that the register had 37 ASL cases and the CMA study only had 20.This discrepancy was referred to as the “17 cases difference” Gaffey and Bennett tackled the situation by looking at each individual case which did not appear the ASL register or in the EHA study.
In typical CMA fashion, since the CMA-coordinated vinyl manufacturers were unable to fabricate the evidence they wanted, CMA simply declared the war over and themselves the winners. With no evidence, the group supposedly “resolves the discrepancy” by simply agreeing among themselves (here Gaffey/Bennett, and, now, Doll) that the apparent surplus of liver and gall bladder cancers were really undiagnosed ASL cases, the lack of evidence, and the failure of the group to develop such evidence notwithstanding .
Bennett told Doll that the histological specimens obtained in the course of the doomed “Reevaluation of liver an biliary tract cancer” study under By Dr, Wong in the 1980s did verify that at least some of the EHA liver cancer cases were really undiagnosed angiosarcomas., but that the CMA-coordinated vinyl manufacturers had simply been unable to acquire histological specimens due to confidentiality laws in the U.S.
10/21/88
On or about October 21, 1988, the VI HSEC submitted comments to the ATSDR in response to ATSDR’s request for comment on its toxicological profile for vinyl chloride.
12/6/88
Doll wrote Bennett that he hasn’t had time to spare to sort out the apparent discrepancies between the ASL registry and table 17 of the (EHA 1986 CMA report).He and Bennett are just guessing which ASL cases match which CMA Wong case: Doll thinks ASL 17 was the match for CMA 28, but Bennett thought ASL 9 was a better match. Similarly, Doll thought ASL 29 matched CMA Wong 31, but Bennett thought the match was 32. What he wanted to know was why CMA Wong 2, 3, 4, 5, 6, 7, 9, 14, 16, 21, 24, 29, 30, 32, 33 and 34 were not in the ICI ASL registry..
Doll specifically requested Bennett whether he had been able to come up with any evidence about the diagnoses of the “other cases ”creating the discrepancy and admitted that one either had to conclude that there was a suggestion of an excess of hepatocarcinoma of the liver from vinyl chloride that the number of angiosarcoma cases had been OVER ESTIMATED. Doll said that before writing any further report on their previous (really really low) prediction of the number of deaths to be expected from angiosarcoma, they had to find out the answers to the questions bout the discrepancy between the EHA and the ICI registry liver cancer cases.
1/3/89
Bennett wrote to Billy Gaffey at Monsanto in response to Doll’s 12/6/88 request for help on questions concerning the “apparent discrepancies” between the ASL registry and table 17 of the 1986 EHA paper
9/6/89
On September 6, 1989 the VCRC participated in a conference call at the CMA Headquarters in Washington, DC. [88]
11/17/90
Dr. Bennett wrote Doll a letter passing on his position as the official keeper of the angiosarcoma registry, and he was replaced by Dr. Jack Drumwright of Vista Chemical Company. Bennett claimed to have known Dr. Drumwright “personally, that he was Chief Medical Officer (CMO) of the Vista Chemical Company and very experienced in the VCM/PVC industry, altogether, a very good choice” to replace Bennett as grand pobah, keeper of the angiosarcoma registry.
1991
Dr. Otto Wong (ENSR Health Sciences) published the first article on studies conducted by EEH since 1982 and the 1st update of the 1972 CMA cohort since 1974.
This was the same study that the CMA Group had informed Dr. Doll, before he learned of the studies’ existence in 1986, was canceled by its sponsors, but which, Dr. Gaffey assured Dr. Doll, had not been cancelled. However, the rumors Dr. Doll had heard prior to 1986 were far more true than what Dr. Gaffey and Dr. Dietz led Dr. Doll to believe in 1986: Given the fact that the paper by Dr. Wong that the CMA-coordinated vinyl manufacturers had sent to Dr. Doll in 1986, with implied and express approval, had been reviewed extensively by the VCRC that same year, given the fact that the VCRC and the rest of the Panel had been following the update since the time it had begun in the late 1970s, they were certainly far more familiar with the study than Doll could ever be, given the fact that the VCRC had attacked both the study and its authors with a truly unprecedented degree of harshness, including extremely personal attacks on Dr. Wong’s very competence.
In fact, the sponsors did in a very real sense have every reason to believe they had successfully “canceled” the Wong study, precisely as Dr. Doll had heard (although certainly not on account of any “lack of funds” on the part of these huge multinational chemical companies who had sponsored his work, as Dr. Doll had said he had heard and, one might imply from his recount of the event, somehow naively entertained the notion might somehow possibly have been true).
Given the fact that publication of the Wong study might actually have served to undermine the study’s own beatification in the Doll review, the CMA-coordinated vinyl manufacturers could hardly justify allowing the Wong study to be published in the open literature, where anyone could read it for themselves.
The Wong study was already extremely valuable enough without the risk of publishing it in the open literature. Indeed, on its own terms (and without the spin Dr. Doll, and, as will be shown, Dr. Wong, could provide), the article could never have nearly the value as a published paper it already had as an unpublished paper relied upon by the famous Dr. Doll in its vastly overreaching review.
1991
Dr. Has Shah (CMA) indicated to Dr. Robert Hinderer (an employee of BFG, a company that, by no coincidence, happened to be involved in civil litigation involving brain cancer at the time) that CMA would notify ENSR / Wong that they had violated their contract.
As Dr. Hinderer told the Panel[xxvi], the next step would be for the whole Panel to consider what corrective actions were necessary and appropriate.
The CMA-coordinated vinyl manufacturers had already developed a plan according to which Dr. Wong would provide them with some sort of “clarifying comments” in a letter to the editor – comments that would disavow the significance of the study he had himself just published, and adopt the same “angiosarcoma only” position the CMA-coordinated vinyl manufacturers had previously caused Dr. Doll to express.
8/9/91
At some time prior to August 9, 1991, Dr. J.R. Drumright (Vista Chemical Co.) became responsible for maintaining “ICI Angiosarcoma Registry,” and used this position to locate experts to use against plaintiffs in future VINYL CHLORIDE litigation.
In 1991, the same paper by Dr. Wong that Dr. Gaffey had assured Dr. Doll had not been “canceled” prior to the time Dr. Doll, in significant part based his review article, was published in the American Journal of Industrial Medicine.
Not surprisingly, no-one outside the vinyl industry interpreted Dr. Wong’s study the way Dr. Doll had interpreted it, and the study was widely reported as confirming, yet again, the relationship between VINYL CHLORIDE exposure and brain cancer, liver cancer, and lung cancer shown by other studies.
The interpretation of the Wong paper in a manner directly contrary with the industry’s “angiosarcoma only” position should not be viewed as surprising. After all, despite the best efforts of the CMA-coordinated vinyl manufacturers, the data in the study still provided just such a confirmation.
Indeed “confirmation” of such prior findings of the multipotential carcinogenicity of VINYL CHLORIDE was no more than what the study reported in language that the sponsors had, in fact, considered far too clear, all notwithstanding Dr. Doll’s interpretation of the unpublished 1986 version of the paper to the contrary, and certainly contrary to the 1991 “retraction letters” to the editor that Dr. Wong would soon write (after, as will be shown, the sponsors exerted undue influence on Wong, accusing him of breaching his contract by publishing the VCM article with one hand, while offering him an opportunity to write his own meta-analysis of the world’s VCM literature to compliment the Doll paper on the other).
10/15/91
On October 15, 1991, the VI HSEC project coordinator (Roy Gottesman), wrote the medical directors of two companies actively involved in defending brain cancer tort cases brought by former vinyl chloride and polyvinyl chloride workers.
The two companies Gottesman wrote were BFG (Robert Hinderer) and Vista Chemical Company (Dr. Jack Drumwright).
The purpose of the letter was to inform them, on behalf of Frank Borrelli of Georgia Gulf, Chairman of the VI HSEC, that Dr. Wong had published the 1986 EHA report in the American Journal of Industrial Medicine, and that the report had been picked up by the trade press as confirming that the CMA / CMA cohort had experienced excess mortality from brain, as well as liver cancer, and also found increased mortality from soft tissue sarcoma, biliary tract cancer, etc.
10/21/91
When the news of the surprise appearance of the EHA / Wong study in the open literature occurred in October 21, 1991, 5 years after the CMA-coordinated vinyl manufacturers certainly believed they had successfully suppressed it after having providing it to Dr. Doll in late 1986 for use in his enormously influential review of the world’s literature the next year.
Among the Panel’s pretextual objections to the study’s publication were the following:
(1) Dr. Wong had Used the 7th rather than 9th revision of the International Classification of Disease;
(2) Dr. Wong had left the question of whether there was a relationship between VCM and brain cancer hanging;
(3) Although, Dr. Wong had mentioned the Doll paper in his paper, Wong had not interpreted his study in at all the same way Dr. Doll had (at least he hadn’t yet);
More seriously, from the view of the CMA-coordinated vinyl manufacturers, Dr. Wong had not submitted a Draft of his paper to them to review prior to the publication of the Wong study.
11/8/91
On November 8, 1991, J.R. Drumwright, the keeper of the angiosarcoma registry and Medical Director of Vista Chemical, wrote the VI (Gottesman), informing the VI Health Safety and Environment Committee (HSEC) that following Dr. Hinderer’s breach of contract claims based upon a claim that the Wong report had been published without having the CMA Panel review the report prior to publication, Dr. Shah had advised that CMA would soon be addressing the alleged breach of contract by Dr. Wong.
The Vista Medical director (like BFG, Vista also was a company that, by no coincidence, happened to be involved in civil litigation involving brain cancer at the time), advised the VI / SPI-coordinated vinyl manufacturers that, in any event, the study had been published and the industry must be cognizant of this when new litigation appeared in the future.
Dr. Drumwright expressed even more certainty than had Dr. Hinderer that some “clarification” by Dr. Wong of his reported findings would, indeed, be forthcoming. Dr. Drumwright only hoped that Wong’s presumed forthcoming presentation would receive adequate publication.
11/20/91
On November 20, 1991, Hasmukh C. Shah, Manager, VINYL CHLORIDE PANEL, wrote to the VCRC to schedule a conference call during the week of December 1, 1991, to decide on a course of action with regard to Wong’s alleged breach of contract by publishing the study that the CMA-coordinated vinyl manufacturers had begun in the late 1970s, finally completed in 1986, and suppressed thereafter.
Dr. Shah enclosed the alleged unauthorized publication by Wong, as well as the letters form Drs. Hinderer and Drumright that had originally raised the claim that Wong had breached his contract by publishing the article.
6/5/92
On June 5, 1992, the CMA VCM Panel, which included Vista and seven other U.S. VCM / PVC producers, discussed its concerns with Dr. Wong in a conference call.
The plan called for the group to write a letter to the editor of the American Journal of Industrial Medicine, and Dr. Wong had agreed to respond to the letter.
This information was to be held in confidence and no statement to the press was to be made unless asked for.
For the first time, the so-called issue of “diagnostic bias” was raised.
(“Diagnostic bias” was the idea that vinyl workers had access to better medical care than the general population and that, as a result, only appeared to have a higher incidence of brain cancer than the general population.)
However, nothing except wishful-thinking supported this dubious proposition. On the contrary, there is abundant evidence that the medical care and advice provided to American VINYL CHLORIDE workers was substandard and often deliberately compromised. For example, Dr. Drumwright, the so-called “keeper of the world’s angiosarcoma registry” had: never been published, received poor grades in school (having actually failed anatomy of the brain in medical school), and had no medical experience, except as a company doctor for Conoco and Vista, preceded by 7 or so years as the company doctor for a sawmill outside Memphis, Tennessee.
7/16/92
On July 16, 1992, “If- Needed Statement” on Wong Reviews CMA’s sponsoring of the Wong study and publication, examined the issue of brain cancer.
The report does not take into account that this apparent excess may be due, in whole or in part, to diagnostic bias; that is, that the cases received more attention because the patient received better care, was located closer to quality care facilities, had better insurance coverage, or otherwise was scrutinized more closely.
The VCM Panel[xxvii] believed that diagnostic bias may have played an important role in the increased number of cases of brain and central nervous system cancers reported in the study.
1993
In 1993, Shah (CMA), wrote the prearranged letter to the Editor containing a harsh critique of the Wong study in accord with the plan developed at the previous meetings and conversations among the members of the CMA-coordinated vinyl manufacturers, and Dr. Shah as well.
1993
To no surprise of the CMA (and VI)-coordinated Vinyl manufacturers, Otto Wong and Donald Whorton (formerly of EHA, now ENSR / Applied Epidemiology) replied to the CMA / Shah Letter to the Editor, and, also, to no surprise to anyone among the VINYL CHLORIDE manufacturers, Drs. Wong and Whorton did not disagree or defend their paper, but, instead, basically agreed with the CMA’s criticisms, as well as Dr. Doll’s interpretation of studies from both Europe and Canada as supporting the authors’ interpretation of the CMA study conducted in America that the observed brain cancer excess was not related to VINYL CHLORIDE exposure.
Recall that from the very beginning, in 1991, all the members of the CMA and VI coordinated vinyl manufacturers seemed completely confident that They also agreed with the diagnostic bias criticism.
Wong and Whorton also repeated Doll’s remarkable claim that, “in reality, all the American cohort studies were based on the same population” and that this large study “subsumed” the earlier smaller studies whose findings were at odds with the “angiosarcoma only” cover-story for VINYL CHLORIDE’s carcinogenicity that the industry had been developing since at least 1978.
Wong and Whorton disavowed the findings of their paper, concluding that their findings of excess brain cancer among the U.S. VINYL CHLORIDE workers previously reported was not likely related to exposure to VINYL CHLORIDE after all, but, instead, was most likely due either to chance, as Doll maintained, or to the diagnostic sensitivity bias discussed in the CMA’s letter to the editor.
The Panel at this time was [xxviii].
11/30/93
A Vista interoffice memo on CMA’s epidemiological update, bearing the date of November 30, 1993, stated that “an update is important to everyone in the VCM / PVC industry. If VCM is a problem, it is not just Vista’s problem . . . The study involves over 10,000 PVC / VCM workers . . . Results of the 1982 update were not published until just a few years ago. Lead author was Otto Wong. The study covers all forms of cancer but we are most interested in brain cancer due to the two cases at L.C. VCM and two cases at Aberdeen. Dow was involved with a brain cancer case at Goodyear. As of 1982, the brain cancer incidence rate is not high enough to conclude that VCM is a brain cancer agent. Our workers are aware of the CMA study and ask why it hasn’t been updated.”
The Panel at this time [xxix]
August 1995
As previously stated, it would take another 15 years before the CMA-coordinated vinyl manufacturers were sufficiently reassured that they could “safely” conduct a case control with absolute assurance (written even) that no adverse outcome was even possible.
Only then would the CMA-coordinated vinyl manufacturers conduct any type of brain cancer case-control study.
And Tamburro’s (of the University of Louisville, or UOL) study was not ordinary, by any criteria.
Not only did Tamburro openly predict a favorable result for the sponsors at the time he proposed it to them, the study employed extremely unorthodox, if not bizarre, so-called “parametric exposure assessments,” of Tamburro’s own devise.
However, as will be shown, by 1995, when perhaps more seemed at stake, Dr. Tamburro (UOL) demonstrated he was, at last, able to come up with a study that would be guaranteed not to find a relationship between VINYL CHLORIDE exposure and brain cancer.
His service was fraudulently intended and caused by the CMA-coordinated vinyl manufacturers to appear as if it were the independent work of the UOL / Dr. Tamburro. There would be no reference to the origin of the Tamburro-nested case control study in brain cancer VINYL CHLORIDE cases. So the CMA-coordinated vinyl manufacturers decided to do it later, i.e., never, and, in fact, the case control study was never performed.
The Tamburro cohort was based upon a fraudulently selected, and incomplete, so-called cluster of brain cancer cases from BFG, Louisville.
The origin of this 1991 brain cancer case control in personal injury tort litigation was planned to be, and has been, concealed by every CMA-coordinated vinyl manufacturers that has used, or referred, to the study. Neither the CMA, nor the CMA Vinyl Panel per se, had anything to do with soliciting the nested case control study of brain cancer victims previously employed in the vinyl industry. Instead, an outside attorney for PPG had caused Dr. Tamburro to propose to conduct a study in such a manner that none of the potential outcomes of the study would, allow a finding of such an association, by design. (PPG was another company that, by no coincidence, was then actively engaged in defending the very same brain cancer cases that Dow, BFG, and Conoco, Inc., and Vista Chemical had been aware of, and were all engaged in defending, at that same time.)
A PPG / Vista publication states: “Study after study has confirmed there is no evidence that vinyl affects human health — not for workers in the industry, not for people living near vinyl-related manufacturing facilities, and not for those who use the hundreds of vinyl consumer and industrial products.”
The Panel at this time was [xxx]
1996
In 1996, the CMA redacted a portion of the minutes for the November 14, 1972 Vinyl Panel Meeting.
CMA deliberately asserted a false claim of privilege as to the portion of the minutes that reflected the concern the Vinyl Panel[xxxi] members had about the absence of any time limit in the secrecy pledge and its failure to make any exception for disclosures to the government.
The absence of such a provision would become particularly relevant in the coming months when the defendants failed to reveal the important information they possessed at a presentation they gave NIOSH that purported to summarize their existing knowledge of adverse health effects associated with VINYL CHLORIDE exposure.
Since none of the speakers were lawyers and there was not even a CMA staff lawyer present to give CMA even a colorable basis for their privilege claims, each of the companies represented at this meeting have falsely asserted claims of privilege with regard to the Panels’ discussion of the illegal secrecy agreement with the European vinyl manufacturers.
This was only one example of the defendants’ continuing use of illegal means the defendants have employed since 1974 in order to conceal their misconduct with regard to this particular secrecy agreement. These illegal means have included the improper redaction, concealment and destruction of relevant evidence both in order to cover-up prior misconduct and even more importantly, in order to allow the CMA group to continue to commit similar acts of fraud and misconduct to remain undetected.
12/31/97
The CMA-coordinated vinyl manufacturers, as part of their litigation efforts in the Ross used Dr. Doll to issued a report in the entitled “Development of Knowledge of the Carcinogenicity of Vinyl Chloride" by Sir Richard Doll, Radcliffe Infirmary, Oxford. Virtually all of the unpublished information was furnished to him by attorneys representing the CMA-coordinated vinyl manufacturers. Dr. Doll had successfully testified for the CMA-coordinated vinyl manufacturers in the 1980s in the Dendinger case, after he had written his very favorable article for the vinyl industry claiming vinyl chloride only caused an extremely rare form of liver cancer, and no other malignant disease.
Dr. Doll was provided written information dated 4/4/74 that the additional records, identified by UCC and Charleston plant in 1974 numbered between 1,000 and 1,500. As will be shown, ended up with only a dozen more than one-thousand, the real number of eligible workers was over 3,100 workers.
7/24/98
Only or about 7/24/98, Dr. Doll first confirmed that the “1986” Wong paper he had only just found out had been published in 1991 was essentially same as the unpublished 1986 version Doll had relied upon so heavily in Doll’s critical analysis of the vinyl chloride epidemiologic literature in 1987. Dr. Doll had not even been advised that Wong’s paper had been published in the American journal in 1991.