RESUMO
Mortality from colon and rectum cancer has been reviewed in three cohorts working in 1933-1982 in two plants manufacturing and polymerizing acrylate monomers. The two cohorts with later dates of hire showed no excess mortality. In the earliest cohort, excess colon cancer seemed restricted to men employed extensively in the early 1940s in jobs entailing the highest exposures to vapor-phase ethyl acrylate (EA) and methyl methacrylate (MMA) monomer and volatile by-products of the EA/MMA polymerization process. The excess mortality appeared only some two decades after the equivalent of three years' employment in jobs with the most intense exposures. A smaller elevation in colon cancer mortality also appeared in a low-exposure group in the early cohort. Rectal cancer mortality was elevated in the same categories that showed excess rates of colon cancer death. Because of the lower rates, the rectal cancer results are more imprecise.
Assuntos
Acrilatos/efeitos adversos , Neoplasias do Colo/mortalidade , Metilmetacrilatos/efeitos adversos , Mutagênicos/efeitos adversos , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Neoplasias Retais/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Estudos de Coortes , Neoplasias do Colo/induzido quimicamente , Relação Dose-Resposta a Droga , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/induzido quimicamente , Tennessee/epidemiologiaRESUMO
In spite of recent advances in neonatal open repair for complex cyanotic heart disease, some patients require palliation with a systemic-to-pulmonary artery shunt. We report a 5-year experience (1985-1990) with 112 Blalock-Taussig shunts. Forty-six of the 92 patients had some variant of tetralogy of Fallot, with a wide spectrum of diagnoses in the remainder. The median age at surgery was 3 months. A classic Blalock-Taussig shunt was done in 26% (group I), and a 4- or 5-mm PTFE graft was utilized in the remainder (group II). The technical aspects of each of the procedures are reviewed. There were three early deaths in the entire group, none of them related to Blalock-Taussig shunt function. There was no incidence of early shunt insufficiency, bleeding, infection, limb ischemia, or pulmonary artery distortion. There was a 21% incidence of clinical congestive heart failure, seen somewhat more commonly in group I. The overall need for reshunting/open repair was similar in both groups, but there was a statistically longer interval between the initial Blalock-Taussig shunt and the second procedure in group I (21.6 vs 12.4 months). The Blalock-Taussig shunt remains a safe, reliable, and effective means of increasing pulmonary flow.