Mortality experience of a cohort of vinyl chloride-polyvinyl chloride workers.

These data are derived from early follow-up of individuals exposed for 5 or more years to vinyl chloride in a polymerization facility. At least 17 percent of the deaths that occurred were causally related to exposure to vinyl chloride. Longer periods of observation are required to provide information concerning the full spectrum of vinyl chloride-induced malignancies and their incidence among exposed workers. These data speak for the need to prevent exposure to vinyl chloride and for surveillance and early disease detection of those who have experienced vinyl chloride exposures in the past.

Pathology of angiosarcoma of the liver among vinyl chloride-polyvinyl chloride workers.

We described the histologic features of 13 hepatic angiosarcomas which developed in workers engaged in the polymerization of vinyl chloride to polyvinyl chloride. Although the histologic features varied considerably in different portions of the angiosarcoma in the same liver and in the angiosarcomas of the liver from different patients, many features were similar such as sinusoidal, papillary, and cavernous growth patterns coincident with the precursor lesions of proliferation and atypia of sinusoidal lining cells.

Changes in pulmonary function in workers exposed to vinyl chloride and polyvinyl chloride.

To determine whether occupational exposure to vinyl chloride gas and polyvinyl chloride dust is associated with changes in pulmonary function, spirometry and maximum expiratory flow-volume curves were obtained in 348 workers in a VC polymerization plant. The major finding was diminution in air flow in 200 workers (57.5 percent). This abnormality correlated with age and duration of exposure. A relationship with smoking was noted only in younger workers with exposures of less than 10 years. When age exceeded 40 years or exposure 20 years, prevalence of this impairment was similar in smokers and nonsmokers, suggesting that occupational or other environmental factors were operative.

Liver disease among polyvinyl chloride production workers.

A protocol for systematic testing of all employees of a chemical plant is presented. This factory manufactures polyvinyl chloride compounds and resins, ABS compounds and resins, and synthetic rubber. The results were reviewed, which led to the discovery of 2 additional cases of angiosarcoma and 11 cases of portal fibrosis. Two of the 11 cases were found to have developed in employees other than polyvinyl chloride production workers.

Across-shift changes in the pulmonary function of meat-wrappers and other workers in the retail food industry.

Pulmonary function was measured before, during, and after the end of the workshift in 83 workers in the retail food industry. All acute changes in forced expiratory volume in 1 s were standardized for lung size before the magnitude of the changes were compared between the workers exposed and unexposed to the use of hot wires for cutting plastic film. No association was found between acute drop in pulmonary function and either direct or indirect exposure in the absence of a history of asthma or allergy to inhaled materials. The borderline significance of an interaction term between exposure and asthma/allergy in a regression analysis suggests that workers with a history of asthma or atopy may have an acute response to hot-wire wrapping emissions.

Testicular cancer and occupational exposures with a focus on xenoestrogens in polyvinyl chloride plastics.

In a case-control study of 148 cases of testicular cancer and 314 healthy controls information was collected on lifetime working histories and specific exposures. The main finding was a six-fold increase in the risk for seminoma, one type of testicular cancer, among plastic workers exposed to polyvinyl chloride (PVC). No overrisks were observed for other plastics than PVC. There may be an aetiological link to xenoestrogens, i.e. chemicals in the environment with oestrogenic properties. Phthalates are used in PVC as plasticizer and have oestrogenic properties that could promote the growth of endocrine sensitive tumour cells. However, this "endocrine disruptors" hypothesis must be further evaluated in experimental models with regard to the causative mechanisms of the oestrogenic tumour promotion.

Long-term psychological distress among chemically exposed firefighters.

Long-term psychological effects of exposure to a dangerous chemical were evaluated in a sample of firefighters who fought a large polyvinyl chloride (PVC) fire. When compared with nonexposed firefighter controls (n = 22), the exposed firefighters (n = 64) had significantly higher levels of demoralization and specific emotional distress 22 months after the incident. Longitudinal analyses of a subsample of exposed firefighter subjects (n = 55) surveyed 5 to 6 weeks after the fire and again 22 months later revealed that there was no reduction in symptomatology over time. Some psychological distress scores actually rose significantly between time points. Distress scores were also significantly correlated between time points. These results have a number of intervention and public health implications.

[Use of functional telethermography in the diagnosis of some occupational diseases (due to vibrating tools; carbon disulfide; polyvinyl chloride]. / Sull'impiego della teletermografia funzionale nella diagnosi precoce di alcune tecnopatie (da strumenti vibranti; da solfuro di carbonia; da cloruro di vinile).

The AA. have considered occupational technopathies due to vibrating tools, carbon disulphide and polyvinyl chloride. The functional or organic involvement in the peripheric vascular system, attributable to the disease, has been evaluated by thermographic examinations, carried out in 35 patients, in basal conditions and, when possible, after cold-test. The results have demonstrated that functional thermography may be a reliable tool both in the early diagnosis and in the prognosis of occupational vascular diseases, especially when it can replace more traumatic methods (such as angiography) in the periodic controls: in fact, it can be sufficient to carry out a simple thermoscopy and to compare the result with the previous photo-thermogram.

Special communication. Polyvinyl chloride - vinyl chloride disease: an occupational health hazard.

Poly Vinly Chloride (PVC) is a very durable, practical and economical plastic, which is so wide spread in its use that it may become difficult to replace it. The annual amount of world production has been constantly increasing and has reached the figure of 8.5m tons. While PVC is so useful, the health hazards which accompany this plastic are causing alarm in the industrially developed countries. The hazards are severe and include defects such as Haemangioendothelial sarcoma (Angiosarcoma) of the liver, Acro-Osteolysis of the fingers and Sclerodermic type skin lesions. This paper illustrates the recent developments, the clinical findings and the measures necessary to control the disease. Moreover, this paper should help alerting the health authorities in the developing countries about the health hazards involved in the manufacture and utilization of PVC. Due to the restrictions imposed on PVC producing plants, there is a real eventuality that these plants may be transferred to the developing countries, where this disease is still unknown.