ML19323G625

Followup Responses to State of PA Second Set of Interrogatories.Includes Info Re Name of Hosp Where Cases of Hypothyroidism Were Reported.Related Correspondence

ML19323G625
Person / Time
Site:	Three Mile Island
Issue date:	05/20/1980
From:	Aamodt AFFILIATION NOT ASSIGNED
To:	PENNSYLVANIA, COMMONWEALTH OF
Shared Package
ML19323G626	List: ML19323G625 ML19323G633 ML19323G637
References
NUDOCS 8006060400
Download: ML19323G625 (13)

Text

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-& C / NN PA 5/20/80

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g? .g 9- g% N {--. United States of America REI.ATED CORRESPONDECH gc g f Nuclear Regulatory Conna.ssm.n g fore the Atomic Safety and Licensing Beard A "

Matter of Metropolitan Edison Ccq:eny, Three Mile Island Nuclear Station, L5it 1, D:cket 50-289 IOLIDW UP - AA!ODI DTIERROGATORIES OF (MMwDLTH OF PENNSYLVANIA (SECDND SED

10. Provide number of live births at each of five hospitals named in response to Interreg.1 for the time periods 7/1/78 to 12/2V78 and 1/1/79 to 12/31/79.

RESPOISE Liw Births Live Births Ecsoitals 7/U 78 - 12/31/78 1/1/79 - 12/31/79

1. Colucbia 61 168

2. Ephrata 369 702

3. Lancaster General 1344 2522

4. Lancaster Osteopathic 471 834

5. St. Joseph 518 1028 -

Source of live birth data is frem hospital reports provided to Pdnnsylva-nia Depar=ent of Health.

11. Provide nucber of infants screened during 1979 for Lancaster Osteo-

pathic and St. Joseph Hospitals.

RESPCNSE Nt=ber of Infants Screened Ecspital 1/1/79 - 12/31/79

1. Lancaster Ostecpathic 827

2. St. Jcseph 1031 Source of data is fr:m hospital reports provided to Pe=sylvania Depart-

rent of Health.

12. Of the .seven cases of hypothyrcidism repcrted in period Jan. - Dec.

1979, give date of birth of each case.

RESPONSE

Thir:y-four cases were reported fcr the State of Pennsylvania and seven for Lancaster County. The birth dates for the seven cases in lancaster County are:

o\

8006060 M (> >

' , ; PA 5/20/80 -

I fy Birthdate f Case # - -

e-p 1  :- .

1/11/79..

i 2

~

_:-- :r  : 6/23/ 79 3 . . .

7/8/79 4_ . _ . 9. _ . . _ _ _ _ . 7/31/79

~

5 7-i~ ::'~2. . ' ~--- --  : - --

8/2/79 -  : .

. r_ : .

. _. .:a = r . _ : :-- - . ::.m _ .

-r 10/7/79 F. 6 -

?

I-P - -- - - 11/29/79 25 21:9 - .-

Has Dr. Bouden resolved whether possible link between the defects ~~~-~

13..

.__and TMI-2 accident should be in.vestigated?

a. If so, why?

~ ~

"b.' If'not, why not? , --

ESPCNSE

.-- -1  :. __ :.:- .:: _ _ _ n.  ::-- . --

See_ attached report of. the Ccngenital Hypothyroid Epiaminlogical In-

. . _ _ _ _ . ..: :: . n._ _ . .

vestigative Panel at TAB A.

L_. . - - _ . . . .::: : - . .r - .

. :: . : . : :..:.:. .. i : : _: _ - . - -

~-

14. Has Dr. Bouden-detemined-whether links to any other envir::nmen-tal cause should be investigated?

_:. .".1.

a. If so, what envir:nmental effects? . . .

b. If not, why not.?. - 1 - _. .. . _,: ._

E PCNSE ' ~ - - - - ' -

_,See attached :eport of the Congenital Hypothy$cid Epidemiological _

Investigative Panel at TAB' AJ- - r .

15. Has Dr. Bouden established any basis for rejecticn of m enviren-mental link to the defects? Explain.

' ESPONSE Dr. Bouden at no time to the best of her recollection has stated that she rejected envircnmental significance to various cases of necnatal hypo-thyroidism other .than TMI-2. accident of March,-1979. See attached report ' '

at TAB A.

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e

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- PA 5/20/80 i

[. 16. Interreg. 4 restated as it was misunderstood. Iancaster data was 7tled to natimal data, which estah14=hed a base line. . Does naticnal data include all cases of neonatal hypothyroidism, or are those cases related to inheritance and those cases of undeveloped thyruid factored out:

a. What is the rate of occurrence nationally of (1) hypothy-roidism related to inheritance and (2) hypothyroidism related to totally undeveloped thyreid? -

RESPONSE

There are no national data from which to ascribe a national incidence rate for congenital hypothyroidism. 'Ihe data cit _ed come from the expe-Idenms of regicnal screening and follow up programs in several regions of North America. ~

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i l

. Quebec, Canada .

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. A regional program of several states in the Northwest, USA .

. A regicnal program of several states in New England, USA

. =- -

~~

Ncne of these prograns to asf kncwl'eds]e 'hai 5ttenptedto systenatically isolate separate incidence rates to all geographic areas of their -

i regicns. Inciden of 1/4000 to 1/6000 includes cases due to inheri-tance (dyshorrmogenesis) and cases due to defects of development (dysgenesis).

Rates of incidence for dyshorrenogenesis and dysgenesis vary signifi-cantly. There are no national data because the majority of states do _l not have large scale screening prograns from which to derive the data.

18. Have any cases been reported to date this year?

RESPCNSE Yes - 8 cases. -

26. Using answers provided to Interreg.12, indicate which bidu were full tem and weeks short er beyond full tem of others.

RESPONSE

These data are not available.

9

• : PA 5/20/80 c .

F.

f.

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l 27. Provide data for 1978 and 1979 by county in Pennsylvania showing:

i a. Number of births  :- x :: 7~ -- . - -

b. Number e of-Eve: births"-~ = " ~

? c. Nurter of infants screened

.j d. Number of cases of neonatal hypothyrcidism

- -~

RESPONSE - - - . .

. . . _ .: - - - _ _I . ; .-- .

i; a. Not available

{ . b. See attached Table at TAB B for live births for 1978.

. . . . = .. .: = x:1. =:.: 22 :. : , - .::

5 Informaticn for 1979 is not yet available.

~

.c- -- 5= - '. :1 n.,3: . :;r :. . .:: . 'e= ~. . . . . ...-.-

. . c. See att. ached Table at- T/.3. C.

. . . . _ - ..._.-2

d. See attached Table at TA3 C.

28A. Previde data 'for 1978 and 1979 by state giving sam information i

as requested in Interreg. 27.

? RESPONSE

• The follcuing statistics are related to the 190 hospitals and other

=;_r ?:: :: r . : . . . . p :. u ,. . .-

f

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. health care facilities located in the State.

..- = .- .:.: : :.::. :- u zr :. C _-

7/1/1978 - 12/31/78 1/1/1979 - 12/31/79

-i: -

. :. an :- " ^

i a. Nu:6er of births * *

. . .;. . . . . _. - .: z. .c. r m 52 ::

b. Nu: er of live births 77,808** 158,057**

c. Nu:2er of infants screened 80,049*** 157,365***

d. Nurter of cases of necnatal

--^ hypcthyroidism .: .~~ - - -

8 :~. -

34 -

• Not available! 2:r m.in_: 7 r" - --- - -

( ** Includes live births in hospitals and other health care faM14ties.

l T- - - .: ; i. . . :. : . . . ". *. .. .

Statistics are based en inferratien ecntained in the Feports of the Necnatal Metabolic Screening Program for Maternity Services in Hospitals and Institutions. These Feports are subritted by each of the 190~ hcspitals'and other health care facilities within the State l __2...to the Division of Parent and Child Health.

l

• • • Based cn Division coust.

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- . - _ - .=------ - - - - ~ . . -

. PA 5/20/80 28B. What is the pregnesis for each of the 1979 I.ancaster, Berks and Mcntgamery counties' hypothyroidism cases:

a. Have any died?

b. Have any had measureable brain damage?

c. What is their life e:gectancy?

RESPONSE .

a. Nct available.

b. Not available. _

c. Not available.

~

29. Provide nu: er of sti11 births at each of five hospitals named in respense to Inter:cg.1 for tim periods 7/1/78 to 12/31/78

• l and 1/1/79 to 12/31/79. '

RESPONSE _

Not yet available. .

_ AFFIDAVrf 0F EVELYN S. BOUDEN

. Camr:cnwealth of' Pennsylvania )

) SS County of Dauphin )

EVELYN S. BOUDEN, M.D., being duly sworn according to law, deposes and says that she is Director of the Divisien of Parent, Child and School Health, Pennsylvania Health Department, and that the informatien cantained in Ccnrenwealth's respense to Interregmcories Ncs.1, 2, 3 and 4 is true and correct to the best of her knowledge, information and ba14ef. -

)

Ergyc4 S. EQUDEN, M.D.

/ -

Director Divisien of Parent, Child and Schcol Fealth Pennsylvania Departrent of Health Swern to and subscr"2nd before me this .'., day _

of April,1980.

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NUTAE FUBLIC /

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PA 5/20/20

, . TAB A ii i PEPORI' 0F HE CONGENITAL In'POIHYPOID EPIIEMIOIIGICAL DNESTIGATIVE PANEL The Ccngenital. Hypothyroid Epidendological Investigative Panel was esta-blished by the Pennsylvania Department of Health to detext:ine the signi-ficanm of the conantraticn in several_ccunties of preven cases of ccn-genital hypctWr"= during 1979.

The largest nunber of cases occurred in I.ancaster County whe:s there weru  !

seven. Four cases occurred in Bucks, three in Lehigh, and two in Berks

• County. - - - - - - - l

'Ihe cases were found threugh the Depart: rent of Health's system of state-wide screening and follow up of newborns for phenylketcnuria and hypothy-roidism. By State regulaticn, newborns born in Fernsylvania are required 1

to be screened for these two diseases during the first week of life. The purpae is to _ detect .and_ treat . cases early in order to prevent mental retardaticn. - - - -

= : 4. . . .=-: -

The panel of emerts- cc:isihd of an epidemiologist frem the Birth Defects Branch of the Center for Disease Centrol, pediatric endocrinologists, gene-ticists, a specialist in maternal and fetal radicine and cne in radiation physics.

'Ihe consultants were presented data collected frem the start of the pro-gram, July 1,1978 to Decenber--31,1979.- 'Ihe data-included the number of 4Hed live births ~, the number of individuals screened, the nunber

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j of. cases detected, .their. clinical-characteristics and their geographic locaticn.

... I Per$cnal identih of patients was protected.

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y..-.... ~ . . . __ .

_ 3.

Data for five year patterss of cru_ de bir_th rates and catterns of ccngeni- '

tal ancmalies for the same_. counties,-and selected cities also were previd-ed.. . .. ... -

'Ihe censultants questiene'd staff oflhe Depart:ent of Neakth ko direct the screening pregram can :ning the program cperaticns and the data which were presented. --

Folicwing the censultants' deliberaticns, the fol2cwing ccnclusicns were drawn by them: f

- -~ --

(1) The data show no relationship ~o? cases of hypothyroidism to the -

Three Mile Island Nuclear 'Itc reacter accident.

(2) No other epidemiologic significancie'to the geographic disdu-

~

tien of cases .can be drawn at this time.

~ _~ '.C3) There is needto institute a uniform protocol fer assessment of each dew case of suspected congenital hypcthyrcidism prior to pzrept treatment.

, - 00 Missing data should-be collected from cases of ecngenital hypo-thyroidism who were detected f:rm the start of the program July 1 1, 1978.

, PA 5/20/80 REPORT OF DE CONGENITAL HYP03EPOID EPII:EM0 LOGICAL INVESTIGAIIVE PREL Page 2 (5) Periodic aview of statewide data should be centinued in crtier to determine whether they am of epidemiologic significance.

Panel me:6ers suggested that they again convene to aview updated in-formation within ene year fzun tra curant aview.

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.. TAB B -

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EA 5/20/80 i

PENNSYLVANIA DEPARTMENT OF HEALTH NEONATAL METABOLIC SCREENING PROGRAM

._... . 1978. LIVE BIRTHS BY COUNTY COUNTY # LIVE BIRTHS

~

Adams - 857 Allegheny - 16,189 Armstrong - 1,004 Beaver . - 2,609 Bedford - 653 Berks - 3,780 Blair - 1,900 Bradford -

896 -

Bucks - 6,493

Butler - 2,001 Cambria - 2,418 Cameron -

79 Carbon -

622 centre - 1,247 Chester - 4,022 Clarion -

593 _

Clearfield - 1,201 Clinton -

514 Columbia -

698 Crawford - 1,215 Cumberland - 1,988 Dauphin - 3,059 l ' Delaware - 6,778 Elk -

504

. .. Pcq3 2 J

PA 5/20/80 )

i COUNTY # LIVE BIRTHS Erie - 4,094 Faye:te - 2,208 Forest . 62

~

Franklin - 1,481 Fulton - 185 Greene - 567 Huntingdon -

512 Indiana - 1,254 Jefferson - 687 Juniata -

294 Lackawanna - 2,717 -

Lancaster - 5,550

. Lawrence -

f,317 Let'non -

1,447 Lehigh - 3,206 Luzerne - 3,808 Lycoming - 1,678 McKean -

684 Mercer - 1,553 _

Mifflin -

611 Monroe -

818 Montgomery - 7,073 Montour -

224 Northampton - 2,549 Northumberland - 1,238 Perry -

507 Philadelphia - 24,900

PA 5/20/80

, PIgo 3 COUNTY 4 LIVE BIRTHS Pike -

137 Potter _ -

285 Schuylkill - 1,865 Snyder -

439 -

Somerset .

1,138 Sullivan -

62 l Susquehanna -

521 Tioga -

O . 527 Union .

417 Venango -

880 Warren- ..

620 .

Washington . 2,703 Wayne ..

474 Westmoreland - 4,561 Wyoming -

- 429 York 4

- 3,828

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• _ea 6 O

O 49 e

. ~ -.. . . . . - . .. .. . -. -

, TAB C PENNSYLVANIA DEPARTMENT OF HEALTH NEONATAL HYPOTHYROIDISM SCREENING PROGRAM 1978 1978 1979 1979 County # Diagnosed # Infants # Diagnosed # Infants by Hospital Positives by- Screened Positives by Screened of Birth County of by Hospital County of by Hospital Birth Report Birth Report Adams 316 636 Allegheny 1 9,823 2 20,493 Armstrong ._ _ 299 674 i Banver . 944 1,707 Bsdford 177 380 Barks 1,725 2 3,763 Blair 1,273 1 2,516 Bradford - 553 1.109 Bucks 2,144 2 4,258 Butler 358 1,128 Cambria 1,227 1 2,593 Carbon 303 411 Centre 684 1- 1,356 Chaster 1,311 4,013 Clarion 261 504 Clocrfield 685 1 1,490 Clinton 265 430 Columbia 406 917 Crcwford 497 1,044 9

• PA 5/20/80 l PEgo 2 ,

, a

! l 1978 1978 1979 1979 '

County # Diagnosed # Infants # Diagnosed # Infants by Hospital Positives by Screened Positives by Screened  !

of Birth County of by Hospital County of. by Hospital. l Birth Report Birth Report )

Cumbarland . . - -1,003 2,132 1

i Dauphin 1 2,316 3 5,117

. l Dalaware 3,141 1 6,698 4

Elk 210 495 Erie .-. . .. -_

2,I91 2 -

4,528 Fayette 705 1,431 Franklin .. ..

1 756 1,514

~

Fulton 153 319 .

Greene ~ 189 362 Huntingdon 211

. .-. . . . -.13 4 .

1 Indiana ~ ' f9 6 Si6 ,

Jefferson 279 342 Lackawanna

^

1,649 3,247 2,359

~

Lancaster 1 6 5,2'08

~

Lawrence 750 1,481 Lebanon .

463 1,150 Lehigh 2,559 3 5,192 n

Luzorne 2,594 3,666 I Lycoming. .- . .. ..

1,001 1,953 ,

McKoan 322 584

- 6.e *.m y-_ _ , . ,__,.,,-g -..- - - - - ' - *r -" "M"' FP""' " " " ' '

. .. PA 5/20/lpaga 3 1978 1978 1979 1979 County # Diagnosed # Infants # Diagnosed # Infants by Hospital Positives by Screened Positives by Screened of Birth County of by Hospital County of' by Hospital Birth Report Birth Report Marcar 1 910 1,981 Mifflin 256 694 Monroe 428 776 Montgomery 3 4,835 4 11,106 Montour 440 884 i Northampton 571 1,164 Northumberland 380 729 Philadelphia 13,526 2 27,052 -

Potter 185 385 Schuylkill 767 2 1,536 Scmarset 493 1 941 Susquehanna 177 305 Tioga 234 376 Union 425 922 Venango 518 1,018 Warren 285 580 Washington 1,219 2,395 l

Wayno 99 287 ,

Westmoreland 2,074 4,082 l Wyoming 209 392 i

i York 1,624 3,775

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