United States
                  Environmental Protection
                  Agency
Environmental Research
Laboratory
Duluth MN 55804
                   Research and Development
EPA-600/S3-84-002    Jan. 1984
oEPA         Project  Summary
                   Evaluation  of  the Methods Used
                   to  Determine  Potential   Health
                   Risks  Associated  with  Organic
                   Contaminants in the Great Lakes
                   Basin

                   L. M. Schuman, C. P. Straub, J.  S. Mandel, S. Norsted, and J. M. Sprafka
                    The  results  of  a  pilot  study to
                   establish whether epidemiological
                   investigations should be conducted on
                   commercial  fishermen  to  form  an
                   association between PCB exposure and
                   health  suggest that "lake-bordering"
                   populations  (i.e., white populations)
                   experience higher rates of mortality due
                   to stomach  and esophageal cancers
                   than "non-lake  bordering"  counties.
                   This trend  is  consistent  when the
                   potential confounding factor of large
                   urban centers is removed.
                    This Project Summary was developed
                   by EPA's Environmental Research Lab-
                   oratory. Duluth. MN, to announce key
                   findings of the research project that is
                   fully documented in a separate report of
                   the  same title  (see Project Report
                   ordering information at back).

                   Introduction
                    A pilot study was initiated to determine
                   the feasibility of an epidemiologic inves-
                   tigation among commercial fishermen, to
                   assess the association between exposure
                   to PCBs and  health. Commercial fisher-
                   men were selected as a potential high-
                   risk population because of their fish con-
                   sumption habits and the availability of
                   licensing records from which a cohort
                   could be extracted. The purpose of this
                   pilot study was to evaluate three research
                   protocols to determine their effectiveness
                   as epidemiologic tools and the appropri-
                   ateness of commercial fishermen as a
                   cohort.
Results and Conclusions

  The  pilot study  accomplished  the
following-

 1. The addresses of all study subjects in
   Protocols I and II were verified. The
   format of Protocol III was structured
   such that the verification of subject
   location was not applicable.

 2. The response rates for Protocols I and
   II were similar (72% and 76% of the
   total cohort respectively).

 3. The response rate for Protocol III was
   44% after two mailings.

 4. Protocols I and II were more effective
   in producing:

    (a) answers in the correct format,

    (b) the highest response rates, and

    (c) the most accurate information.

 5. The differences between Protocols I
   and  II regarding  accuracy  of
   information  are  slight. Therefore,
   Protocol I appears to be  the most
   efficient and cost-effective  of the
   three protocols tested.

 6. The  fish   consumption  patterns
   among this  cohort,  obtained  by
   compiling  the  information  from

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     Protocols  I  and
     following trends1
II,  indicate  the
       (a)  a good distribution offish con-
           sumption per month among the
           cohort,

       (b)  a   good  distribution  of the
           numbed of years fish have been
           consumed  with this frequency
           among the cohort,

       (c)  a   good  distribution  of the
           quantity of fish consumed per
           year among the cohort, and

       (d)  the preferred consumption  of
           several target fish species from
           the Great Lakes among this
           cohort.

    These results suggest that commercial
  fishermen were  appropriate as a study
  cohort  and that Protocol  I would be the
  most effective and cost-efficient method
  of epidemiological ascertainment.

  Additional Findings
    An  analysis  of  the   morbidity and
  mortality patterns of the Great  Lakes
  populations  was conducted. State vital
  statistics regarding county fetal, neonatal,
  and infant death rates  and congenital
  anomaly   rates   were   examined  for
  Minnesota,  Wisconsin,  Illinois, Indiana,
  Michigan, and Ohio for  every  fifth year
  from 1950 to 1975 and for the year 1977.
  Furthermore, an evaluation of the county
  site, race, sex, and age-adjusted cancer
  mortality rates from the  National Cancer
  Institute's publication, U.S. Cancer Mor-
  tality: 1950-1969 was conducted.
  These analyses generated the follow-
ing conclusions:

   1. There  were  no significant  trends
     regarding the  percent differences
     for neonatal death rates and fetal
     death rates among "lake-bordering"
     and "non-lake  bordering" counties
     having rates2Ll standard deviation
     higher than  their respective state
     means.
   2. There was a slight trend regarding
     the difference  between percent of
     live  births  with  congenital
     anomalies among "lake-bordering"
     and "non-lake  bordering" counties
     having rates>.1 standard deviation
     higher than  their respective state
     means. This trend favored the "non-
     lake bordering" counties.

   3. The fertility rates for the eight states
     were not analyzed due to inconsist-
     ent reporting between states.
  4.  An evaluation of the cancer rates
     of the counties of the Great Lakes
     states,  stratified  according  to
     proximity to the lake, indicated  an
     increasing trend  with proximity to
     the   Lakes for  esophageal  and
     stomach cancers. These trends are
     still  apparent  after counties  with
     population centers_>100,000 have
     been excluded from the analysis.

  These  results  suggest  that "lake-
bordering"  populations (i.e., white
populations) experience higher rates of
mortality due to stomach and esophageal
cancers  than   "non-lake  bordering"
counties. This trend is consistent when
the potential confounding factor of large
urban centers is removed. There were no
apparent trends regarding the fetal death
rate, the neonatal  death rate, and the
percent of live  births with congenital
anomalies, among  "lake-bordering" and
"non-lake bordering" counties.
                      L M. Schuman. C. P. Straub. J. S. Mandel, S. Norsted. andJ. M. Sprafka are with
                        School of Public Health. University of Minnesota, Minneapolis, MN 55455.
                      W. R. Swain is the EPA Project Officer (see below}.
                      The complete report, entitled "Evaluation of the  Methods Used to Determine
                        Potential Health Risks Associated with Organic Contaminants in the Great
                        Lakes Basin," (Order No. PB 84-128 305; Cost: $34.00, subject to change) will
                        be available only from:
                             National Technical Information Service
                             5285 Port Royal Road
                             Springfield, VA22161
                              Telephone: 703-487-4650
                      The EPA Project Officer can be contacted at:
                             Environmental Research Laboratory
                             U.S. Environmental Protection Agency
                             Duluth, MN 55804
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