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Next View-Master Picnic on Saturday, August 23rd
Former workers at the View-Master plant in Beaverton will gather for their annual picnic at Memorial Park in Newberg from 12:00am to 3:00pm Saturday, August 23, 2008. The View-Master plant operated at a site on Hall Street in Beaverton near Washington Square from the early 1950 ’s to 2000. Over 20,000 people worked at the plant at some time during this period.

The View-Master plant was owned by various companies, in the 1950’s-1968 it was known as Sawyer’s Inc. In the 70’s it was owned by GAF, Inc. Then it was called View-Master International, which was purchased by Tyco, Inc. that merged with Mattel in 1997. In the early years, slide projectors and other optical products were made in addition to the familiar View-Master 3D viewer with its slide reels. For many years, the plant was a major employer in Washington County.

The August 23rd picnic is being hosted and supported by a non-profit group, Victims of TCE Exposure (VOTE). VOTE currently has a small grant from the Oregon Community Foundation to conduct a health survey of former workers at the now closed and redeveloped View-Master plant. The health survey is designed to identify health problems that may have arisen due to exposure to a degreasing agent known as trichloroethylene (TCE) in the drinking water at the plant. High levels of TCE were found in the drinking water in 1998 when Mattel was preparing to close the plant. These levels were over 300 times higher than the EPA safety standard for TCE in drinking water. TCE is thought to have been in the well water for over 30 years.

There have been various efforts to mount health studies of the former View-Master workers. Only one study has been funded and successfully completed so far, a limited mortality study conducted by Oregon State Department of Health finished in 2003. This study reported excess deaths from kidney cancer for women that were over six times the expected rate, as well as excess deaths for pancreatic and liver/biliary duct cancer. In other TCE sites across the nation adverse health effects include autoimmune diseases, birth defects, and various other cancers. It is because the View-Master workers were exposed such high amounts of TCE over such a long period of time that these results strongly suggest the need for a more thorough study.

VOTE’s health survey is seeking information on a broad range of possible diseases in order to get a more general picture of TCE’s possible health effects. For purposes of its study, VOTE is interested in hearing from as many former View-Master workers as possible. If you worked at the plant (even for just a short time) or a family member did and you would be willing to participate in the survey, please contact VOTE at (503) 615-5963 or toll free at 1-800-305-3133. In order for the survey to be representative, VOTE needs to survey healthy former workers as well as those with a range of health issues.

Event:              View-Master Workers Annual Picnic hosted by Victims of TCE Exposure

Date / Time:    Saturday, August 16, 2008   12:00pm – 3:00pm

Place:               Newberg Memorial Park. South Blaine St. and South 5th Street
                        Newberg, OR. 97132

What Attendees should know:  VOTE will provide hamburgers, hotdogs and potato salad; View-Master workers are asked to bring a dessert and their own beverages.

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The Clinton/Dole TCE Reduction Act Making Progress in the Senate
July, 2008 The TCE Bill sponsored by Senator Hillary Clinton and Senator Elizabeth Dole is making progress. Please read the Senator’s press releases here.
You may track the bills progress at this link: www.govtrack.us
You can read a copy of the 15 page bill here: TCE Bill PDF
VOTE has asked Oregon’s Senators to lend their support to this bill. We ask that if you live outside of Oregon that you let your Senators know about this important legislation.

View Master Community Health Study Update
As announced in April of 2007 VOTE received a grant from the Oregon Community Foundation for the first phase of our community health survey of former View-Master Workers. We have made a lot of progress in the last year. We have been able to hire a medical consultant, we have doubled the surveys we normally conduct in a year and are making leaps and bounds in consolidating the information we have gathered into a database designed specifically for our purposes. We are hoping that our View-Master Community Health Study will be completed within the next 18 months. We still need assistance in the form of volunteers to help survey former View-Master workers. If you are interested please contact Amanda Evans at 503-615-5963.

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June 2008 View-Master Health Study’s Citizen’s Advisory Group (VMHS CAG) Meeting
Dr. Jae Douglas announced at the View-Master Health Study’s Citizen’s Advisory Group (VMHS CAG) meeting at the Beaverton Public Library that the View-Master Health Study proposal was denied funding for a third straight year, however the feedback they received on their proposal was far kinder than the previous year which gave them hope that if they refined their proposal further they may be successful in the next funding cycle. Dr. Douglas also introduced Oregon Department of Human Services Public Health Division’s new Epidemiologist of Environmental Health Assessment Program (EHAP) Sujata Joshi, MSPH who will now be in charge of the View-Master site as Dr. Douglas has been promoted. Questions for Sujata about the health study being conducted at the View-Master site can be submitted via this e-mail: sujata.joshi@state.or.us

Vote Takes Part in Grassroots Fight to Reverse Changes to IRIS
VOTE joins the fight with 49 other organizations and activists to urge the EPA to reverse changes the EPA made to their Integrated Risk Information System (IRIS). View the letter sent to the EPA here.

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Response to Presentation of Dr. Michael Kelsh by Dr. Tom Griffith, 4/16/08
Dr. Michael Kelsh gave a nice presentation of some of the methods and problems of epidemiology studies at our CAG meeting on Thursday, March 27. (Dr. Kelsh is an epidemiologist who works for the consulting firm Exponent, and he is the lead epicemiology consultant for Mattel.) The lack of time for questions and followup at our meeting may have left some false impressions, however. I will try to clear up a few of these points.

1. The numbers that Dr. Kelsh presented for the preliminary mortality study done by scientists at Oregon State Public Health did not seem to jibe with the final “Feasibility Study” report. The statistically significant findings in the final report included a proportional mortality ratio (PMR) for kidney cancer in women of 6.2, indicating that the 8 kidney cancer deaths found for women was 6.2 times that expected (when adjusted for age and gender) for the Oregon population more generally. Other statistically significant results reported were a 1.71 PMR for digestive organ cancers in men. This included gall bladder and biliary duct cancers in men that yielded an 8.41 MPR (based on just two cases).

I did some additional analysis on the reported data by adding in the 147 deaths not included in the original analyses because their gender was not known. This led to a MPR of approximately 4.0 for kidney cancer in men and women combined. There was also a 1.6 PMR for pancreatic cancer deaths based upon 19 cases and a 1.96 PMR for prostate cancer based upon 10 cases. These results are all statistically significant and certainly do indicate an elevation in cancer deaths for selected cancers, all of which have shown up in other TCE studies. (A PMR of 2.0 means that the risk of dying of that cancer is doubled; A PMR of 4.0 means that it is quadrupled.)

2. Dr. Kelsh suggested that the exposure levels for View-Master workers were not particularly high. This was based in part on the fact that TCE vapor levels measured in the plant in 1998 were not above allowed amounts. However, the levels in the drinking water were strongly elevated, with levels roughly 300 times the EPA recommended maximum for public drinking water (on the old standard) and 1500 times the more recently recommended standard. These standards are based upon the concept of allowing 1 additional death per million exposed, but they are crude estimates based upon extrapolations from much higher levels in animal studies. For an estimated 20,000 exposed workers at the View-Master plant, these levels would suggest between 6 to 30 excess cancer deaths, which is consistent with the Feasibility Study findings. A person who drinks the equivalent of several glasses of water during an 8-hour work shift is essentially continually exposed for 10 or more hours given the time it takes for the water to pass through the system. At the levels quoted above, this exposure is considerably higher than those involved in most water-supply studies. The large majority of workers at the View-Master plant had their primary exposure to TCE by drinking the water, not via vapor exposure. This is unusual for industrial studies involving TCE.

3. The average cancer incidence ratios that Dr. Kelsh quoted in his meta-analyses were computed in a manner that gave large mortality studies involving relatively low PMR values a larger weight than smaller cancer incidence studies that yielded higher ratios. If a simple average were used, higher average ratios would result. Using data from his papers and slides, a simple average yields 1.3 for liver cancer as opposed to the 1.14 value that he quoted, and 2.08 for non-Hodgkins lymphoma as opposed to 1.86. (I could not compute those for kidney cancer because he has not yet published that work, but the ratios would surely be over 2.0 if a simple average was computed and the studies involving high rates are included.)

4. Dr. Kelsh suggested that there was not much evidence of cancer rates increasing with increased exposure. However, in those studies in which more highly exposed subcohorts were identified, the cancer ratios generally do increase. For non-Hodgkins lymphoma, the subcohort yielded a simple-average ratio of 3.35 for the most highly exposed groups (or 4.31 if you included only the European studies, leaving out the Morgan et al. mortality study done by Exponent scientists including Dr. Kelsh.). This would certainly indicate that cancer rates increase with increased exposure.

5. Dr. Kelsh concluded that there was not enough evidence to indicate that TCE causes kidney cancer and certain other malignancies such as liver cancer and non-Hodgkins lymphoma. He cited, in particular, the inconsistency observed between different studies. The National Academy of Science committee that reviewed the TCE evidence disagreed with this conclusion. They pointed out that much of the variability between studies could probably be explained by differences in average exposure levels, which are not known with any degree of accuracy. Random variation can explain much of the remaining variability and, in fact, the uncertainty limits overlap for the majority of the studies, which would indicate that they are consistent. The committee felt that many (if not all) of the criteria are present to indicate causality, particularly for kidney cancer.

6. Although Dr. Kelsh and his colleagues at Exponent do careful work, many of their decisions and interpretations have the effect of minimizing the estimates of harm caused by TCE. Many of Exponent’s clients with TCE issues (including Mattel) are industries or military installations who are the “responsible parties” for TCE contamination. The perspective that Exponent provides are important for their needs, and in general have value for defining the debate. A more balanced perspective, such as that of the NAS committee, provides a more realistic picture.

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Oregon View-Master Health Study Focus Groups in Journal of Enviornmental Health

Environmental Health
The View-Master Health Study Focus Groups
Kathleen Krall, F.N.P, M.P.H.
Jae Douglas, M.S.W., Ph.D.
Nancy A. Perrin, Ph.D.
Donald Austin, M.D.
William E. Lambert, Ph.D.
Michael Heumann, M.P.H, M.A.

Abstract: Trichloroethylene (TCE), a common groundwater contaminant, was found at high levels at an Oregon work site in 1998. According to a recent report released by the National Research Council, “the evidence on carcinogenic risk and other health hazards from exposure to trichloroethylene has strengthened since 2001.” A convenience sample of thirteen former workers from the Oregon work site was recruited for a series of focus groups. Information obtained on plant processes, safety procedures, attitudes regarding medical record access, and opinions about proxy accuracy was subjected to qualitative content analysis. Workers recalled few safety policies and no training or support for control of safety. Most thought co-workers and family members would be the best source of proxy exposure information and favored granting access to medical records. Job-role mobility confirmed the importance of using a job or task exposure matrix. Information obtained will be used in development of an exposure assessment interview tool.

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Questions for the CAG's New Technical Advisor, Dr. Dan Wartenberg
1/22/08 View-Master CAG Chairman Tom Griffith posed these questions to Dr. Dan Wartenberg. Dr. Wartenberg has been chosen by the CAG as it’s technical advisor via special arrangements with Mattel. Unfortunately, the CAG has been unable to utilize this resource because Mattel and Dr. Wartenberg have not been able to reach a satisfactory agreement.

1. What are the advantages of the proposed nested-case-control study design for the View-Master situation? What will it be able to tell us?

2. What are the disadvantages of the proposed design? What questions will it not be able to address? What are the risks that this study will not illuminate real problems with the TCE exposure at View-Master?

3. It appears that the proposed study will provide information on the numerical incidence of the targeted diseases, but may not be able to compute standard incidence ratios (SIRs) as might be done in a cohort study. Will it be possible to estimate the relative incidence for these diseases from the information collected? If so, how would this be done?

4. One of the major problems with this study (and any such study) is the difficulty of estimating the exposure levels of workers to TCE. Does the proposed design provide sufficient flexibility in the exposure models to allow for threshold effects and other uncertainties?

5. The proposed design includes prostate cancer as a cancer to be used in one of the control groups. The assumption is that prostate cancer has not been strongly associated with TCE exposure in other studies. However, a number of studies do show elevation in prostate cancer rates for TCE-exposed groups. The feasibility study for the View-Master population reported a proportional mortality ratio of 1.69, which although it did not reach significance at the P = 0.05 level, may not have missed by much. Is there another cancer that would be a safer alternative for the male cancer controls?

6. The feasibility study also showed an elevated mortality rate for pancreatic cancer in both men and women. Had men and women been combined, the PMR of 1.76 would have been statistically significant given the numbers involved (17 cases). Is there a way of including pancreatic cancer in this study?

7. What other issues should we be raising given our desire to get the best possible information about effects of TCE exposure from this study?

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