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Frequently asked questions related to the Rosenborg case – with answers:

The NTNU management here attempts to answer some of the questions which have arisen over the past weeks following the media attention around the Rosenborg case. Please note that the answers represent the knowledge we hold about the case as of 08 January 2007. The FAQ will be updated continuously, and may gradually be expanded.

1. After all these years, why haven’t the experts managed to find a clear answer as to whether the laboratory work at Rosenborg may have caused cancer?

It is difficult to establish this type of connection and so far, the investigations have not produced any clear answers. Based on the reported cases in 1997, the occupational medical environment at St. Olav’s Hospital conducted two evaluations of possible connection. Both concluded that it is impossible to establish for certain that health damage can be related to former work environment conditions at Rosenborg. However, we can not rule out a potential connection.

The Cancer Registry of Norway, the National Institute of Occupational Health (STAMI) and Arbeidsmedisinsk avdeling (the Department of Occupational Medicine) at St. Olav’s Hospital are currently conducting a larger survey to find out whether students and staff at Rosenborg are overrepresented regarding cancer. Here, the national identity numbers are checked against the cancer registry. The goal is to obtain an overview of the number of cancer cases and the types of cancer present in the group. The survey will reveal whether any types of cancer are overrepresented compared to the occurrences of these cancer types in the general public. The results from this survey are expected to be available early in 2007.

At the same time, it is important to be aware of the fact that the number of cancer cases in the population is increasing. Every year, many people will die from the cancer types relevant to the Rosenborg case. So far, analyses from STAMI indicate that the number of haematological cancer among former students and staff that were discovered up until 2004 has a frequency similar to the occurrences in the population in general.

Since the late 1970s, comprehensive studies have been conducted internationally which have tried to map the connection between the exposure to certain organic solvents, including benzene, and increased risk of cancer. The results from these studies have not been clear either, but they reveal an increased occurrence of leukaemia among persons exposed to benzene over longer periods of time. However, many years may pass before the cancer develops.

2. What is haematological cancer?

”Haematological” means that it deals with the blood system/bone marrow. The term haematological covers a number of different diagnoses, including leukaemia, lymphoma, Hodgkin and non-Hodgkin diseases.
If you have questions regarding different cancer types and the occurrence of cancer, you may find a lot of useful information at http://www.kreftregisteret.no.

3. Why is this type of cancer the only one being mentioned?

Because both ionizing radiation and benzene are known to potentially cause haematological cancer.

4. Is it true that there have also been reported unusually high numbers of miscarriages and deformities with children of people who have worked at Rosenborg?

No investigation has been made regarding this. In an article in VG, the newspaper claims that three female students and staff have experienced miscarriages and very complicated pregnancies.
Since very many people have been part of the Rosenborg environment we must assume that several miscarriages and cases of deformities will occur by chance. We have no reason to suspect any risk in this respect.

5. Is lack of money or an attempt to hide the facts the reason why we after all these years still are unable to confirm or dispel the cancer suspicions?

No. The basis for the decisions made by NTNU has always been professional medical evaluations. Rector Torbjørn Digernes has repeatedly stated that he wants full openness regarding all aspects of this case.
In 1997, when the first four cancer cases were reported, the people from Rosenborg that were the most affected were informed at an internal information meeting. Soon after, NTNU addressed the matter in public at a press conference.
NTNU has prepared a report about the history of this case to the Norwegian Ministry of Education and Research. It is available at http://www.ntnu.no/info/svarbrev_kd.pdf (Norwegian only).

6. How many people have studied or worked at the facilities at Rosenborg?

As of today, we do not have full overview of the number of students and staff for the first period from 1960 to 1975. In the period from 1976 to 2000, a total of 7,600 persons performed laboratory work for shorter or longer periods of time, of which 7,075 were students. In addition, our records include 263 doctoral candidates and 293 staff, or former staff, who worked there from 1983.

7. Does everyone who has worked or studied at Rosenborg have increased risk of developing cancer?

As already mentioned, the studies conducted so far do not indicate any overrepresentation of cancer among people connected to Rosenborg. However, we can not rule out the possibility of a connection, which makes it difficult to define a risk group.

The background for the matter was four cases of haematological cancer where the persons affected used to have similar work situations. Three of the four cases were reported as occupational disease. All four had worked at the Department of Botany in the 1970s and 1980s. Following this incident, an investigation was carried out to find out whether others with similar work environment conditions at the laboratories at Rosenborg could be hit by cancer. This study resulted in a defined “follow-up group” of 49 persons. The health examination in 1997 did not reveal any additional cancer cases among the people in this group. This is the closest we have come in describing a risk group.

The next group that was contacted was former second degree level students – a group of 169 persons – at the Department of Botany. These people were informed about the case in a letter.
Since 1997, some people from Rosenborg which have developed cancer have contacted NTNU. There has been a significant increase in enquiries since the case was presented in the media on 4 December. So far, (as of 20 December 2006) one more case of haematological cancer related to Rosenborg has been reported.

8. How long must people have worked at Rosenborg to be at risk – who should be worried?

As of today, it is impossible to say for sure. Groups of researchers, students, and technical staff using the laboratories at Rosenborg were exposed differently as regards both substances and time.
Based on the reported cancer types, the attention so far has been focused on people who spent much time working with chemicals representing a health hazard and ionizing radiation. In general, we know that combinations of different types of exposure and constructional defects may increase the risk. Naturally, if the HSE guidelines (Health, Safety and Environment) were violated, it will also have a negative effect.

Division Director Erik Dybing at the Norwegian Institute of Public Health said that the investigation of the Rosenborg case most likely can not reveal which chemicals or radioactive substances that caused the cancer.

9. Why haven’t everyone who has studied or worked at Rosenborg been offered a health examination?

Medical experts have advised against examining everyone with a background from Rosenborg. Examining 7,600 persons will result in more false alarms than genuine findings. False, positive findings could lead to much unnecessary worry and anxiety that could last for several years before the situation is clarified. The experts also claim that a so-called screening of so many people will produce a misleading feeling of security since the results can be interpreted in several different ways. Persons that are healthy one day could have symptoms of cancer the next.
Even though the disease may not develop until many years later, experts believe that the likelihood of developing cancer decreases with the time that passes since the exposure to carcinogenic substances. A number of improvements were made to raise the standard of the laboratories and the ventilation system in the 1980s and 1990s, and seven years have passed since NTNU moved from the facilities at Rosenborg.

In 1997, when suspicion first arose, Arbeidsmedisinsk avdeling (the Department of Occupational Medicine) at St. Olav’s Hospital recommended a health examination of 49 people assumed to have been subject to the highest exposure to hazardous substances. A total of 43 persons accepted the offer, and no cancer was discovered. The same group was contacted in 2003 and will now be offered another health examination at the turn of the year 2006/2007.
In addition, a group of 169 second degree level students from the Department of Botany received a letter in 1997 which informed about the situation. The background was a report of four cases of haematological cancer among these students from Rosenborg. In January 2007, they received another letter from NTNU informing about the recent developments in the case.

10. Why has compensations been paid if you don’t know for sure that the laboratory work caused the cancer?

When a claim for compensation over a certain limit is made to a public university, the government represented by the Ministry of Education and Research is the right party to the case. In other words, it was not NTNU that negotiated the settlements and paid compensation, but the Ministry. NTNU provided the background material for the negotiations.
The government advocate dealt with the cases on behalf of the Ministry, and so far six settlements have been reached. Four settlements were reached with the surviving relatives of dead persons and two with people who suffered from cancer. Two cases are currently being considered by the Ministry (status as of 20 December 2006). Please note that a settlement based on the law of damages does not necessarily involve an acknowledgement of guilt.

11. What are the tasks of the two appointed committees?

The Norwegian Ministry of Justice has appointed an independent investigating committee that will conduct the necessary investigations to prepare an objective presentation and evaluation of the Ministry’s and NTNU’s handling of the case. The committee will investigate how the case was dealt with before and after the discovery of the cancer cases in 1997, including the role of the former Ministry of Education, Research and Church Affairs in this period. In this connection, the committee will investigate the Ministry’s handling of the claims for compensation.

The committee has five members and is headed by Gerd Ersdal, county medical officer in Troms. The committee will present its report by 1 June 2007. The mandate of the committee is available at http://www.odin.dep.no/id/norsk/dep/utvalg/012101-990828/dok-bn.html (Norwegian only).

In addition, the Ministry of Education and Research has appointed an advisory medical expert team which is lead by Division Director Erik Dybing at the Norwegian Institute of Public Health. The team includes medical experts within cancer epidemiology, occupational medicine, clinical medicine, and exposure to chemical substances and radioactive material. The team will evaluate the health-related extent of the case and attempt to clarify whether we have found everyone that might have suffered from disease because of their work in the laboratories. The team will also make suggestions for further measures that would be possible and appropriate in relation to former students and staff.

Finally, the team will evaluate whether this type of case could also be connected to other universities and university colleges in Norway.

12. Is it safe to work in the laboratories at NTNU today?

Based on our current knowledge, the health risk of working in our laboratories today is very low. The health and safety of our staff and students are a top priority. It shall be safe to study and conduct research with us. A lot of improvements have been made at NTNU since the 1960s and 1970s, as regards facilities as well as safety work. The laboratory activities have moved to the new science building which opened in 2000. These laboratories are of the highest standard. Health, safety and environment work, handling of waste, and training in laboratory work are far more systematic today than 20 to 30 years ago.

Read more about today’s lab safety in Universitetsavisa, or visit our web page about NTNU’s HSE systems and the HSE work at the Faculty of Natural Sciences and Technology, which accommodates most of NTNU’s laboratories.
Current HSE routines at the University include several different safety measures. One of these measures are so-called focused health surveys, which are conducted regularly in the environments assumed to have the highest risk. A new round of surveys will begin on Tuesday 2 January 2007 at the NT Faculty. This survey is not directly connected to the Rosenborg case, but is part of NTNU's regular HSE work. However, the capacity and the speed will increase as we have hired one more occupational nurse.

13. What kind of help can NTNU offer today to former Rosenborg students and staff?

If you think you might have been exposed, are worried, or simply want some more information, please contact Head of the HSE Section Anne-Beth Holte (tel. 73 59 80 27 or email: anne.holte@ntnu.no). The HSE Section is NTNU’s occupational health service. The section has a free and independent position and is subject to the same strict professional secrecy as other medical personnel. You can therefore contact the HSE Section in assurance that the information will not go further, not even to your leader/employer, unless you give your consent.

14. Where and when can I have a health examination?

If you are worried that you might be at risk of developing cancer, the HSE Section – following the advice from Arbeidsmedisinsk avdeling (the Department of Occupational Medicine) at St. Olav's Hospital – recommends that you contact your regular doctor. Answering the following questions prior to the consultation with your doctor may be of help:

• What did your work involve?
• Which risk factors were present?
• How long did the exposure last?
• Which protective equipment/devices were used?

We can not rule out the possibility that those who were subject to the highest exposure may have a certain risk of developing cancer. According to Arbeidsmedisinsk avdeling, the risk is still low and will most likely be reduced year by year. Unfortunately, no simple blood test or any other test will clearly reveal any potential cancer. If symptoms of severe disease are discovered, your doctor will make a requisition for a thorough examination that may confirm or dispel the suspicion.