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QiV I ^ STATEMENT OF MARCUS M. KEY, M.D DIRECTOR NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH CENTER FOR DISEASE CONTROL DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PROPOSED PERMANENT STANDARD FOR VINYL CHLORIDE AT THE OCCUPATIONAL. SAFETY AND HEALTH ADMINISTRATION HEARING U.S. DEPARTMENT OF LABOR BEFORE ADMINISTRATIVE LAW JUDGE GORDON J. MYATT JUNE 25, 1974 swmMmm VIWJIII .--T ^eara-rf^v' -r-nCv-.y, .nZr&Z -, . ( STATEMENT ON PROPOSED PERMANENT STANDARD VOR VINYL CHLORIDE Mr? v". I am Dr. Marcus M. Key, Director of the National Institute for Occupational Safety and Health, a program of the Center for Disease Control, in the Department of Health, Education, and Welfare. Under the Occupational Safety and Health Act of 1970 we have responsibility to "...develop criteria dealing, with,toxic materials and harmful physical agents and substances which will describe...exposure levels'at which no employee will suffer impaired health or functional capacities or diminished life expectancy as a result of his work experience." The Institute is also authorized to "develop and establish recommended occupational safety and health standards." Because of the urgency of the vinyl chloride (VC) problem, we have not had time to develop formal criteria for exposure to VC although much of what we present today can serve that purpose. We have, however, recommended to the Occu pational Safety and Health Administration (OSHA), Department of Labor (DOL), i a recommended work practices standard with environmental monitoring and medical monitoring, and these have served as the basis for the presently proposed OSHA permanent standard for occupational exposure to VC developed under Section 6(b) of the Act. It should be noted that my memorandum of March 11, 1974, transmitting our recommended work practices standard to OSHA made reference to our inability to describe a "safe" exposure level, hence our recommendation was that where any employee is exposed to measurable concentrations of VC as determined by the recommended monitoring method which has a sensitivity of l ppm, he shall be afforded respiratory pro tection. This does not mean that an "acceptable" level is impossible to define. We have asked the Department of Health, Education, and Welfare Committee to Coordinate Toxicology and Related Programs to define procedures for designing animal studies and to determine the-compatibility of the esti mated carcinogenic hazard with a socially acceptable risk. These procedures, when developed, should give guidance to experimental design of animal toxicologic studies. In our opinion, the numbers of animals exposed in both the European and American studies have been too small to make statisti cally valid projections of no effect levels. The information I will present today is intended to supplement and up date NIOSH testimony presented at the February lb, 1974, OSHA Fact-Finding Hearing on Vinyl Chloride. It will cover four areas: 1. Epidemiology and Surveillance 2. Sampling and Analysis 3. Respiratory Protection f 4. Exposure Levels It is hoped that the hearing record can be kept open long enough to enable NIOSH to submit an updated report on current epidemiologic, industrial hygiene, and medical studies. The results of our first industrial hygiene survey will be available ir about one month. 925 f 1 Epidemiology and f.urvcillance On January 22, 1974, the National Institute for Occtipat:onal Safety and Health (NIOSH) was informed of three deaths from angiosarcoma of the liver' among polyvinyl chloride (PVC) production workers at the B. F. Goodrich plant in Louisville, Kentucky. Since that time, NIOSH has initiated a variety of activities concerned with assessing the extent of the problem and developing information required for effective control of exposure and protection of workers exposed to VC. Immediately following the report of January 22, NIOSH and its parent agency, the Center for Disease Control (CDC), organized a surveillance network to determine the number and distribution of cases of this rare disease and its relationship to occupational exposure to VC and/or PVC. The detailed results of this activity are shown in attached Table 1. Thus far, 18 cases of angiosarcoma of the liver in PVC production workers and one case in VC monomer production have been confirmed. Thirteen of these cases were reported from the United States and 6 from other countries. All f 13 of the U.S. cases and the one from Great Britain have been confirmed histopathologically by the National Institutes of Health, Ten of the U.S. cases are deceased; 3 are living. This distribution of cases from tbe United States and 4 other countries indicates that we are observing a newly recognized occupational disease associated with exposure to VC, angiosarcoma of the liver. /This form of liver cancer has heretofore been quite rare in the general population--only 20 to 30 cases have been reported annually in the U.S. The greater number of occupational cases seen in the U.S. is m rrr'-''1^.' 'kA`1 ^trofT? "Tv '3.-^"'*' ^im'v^r^v-^r-.n iiABWMpsy.iaqi;.ia*wp.'!T<"'~yryj^?gy?rNV -4- probably a reflection of the earlier initiation and greater intensity of surveillance activities- here. As regards the distribution in the United States, we have seen that the 13 cases have been reported from a number of plants in different parts of the country. These include 7 cases from the B. F; Goodrich plant at Louisville, Kentucky, 3 cases from the Goodyear plant at Niagara Falls, New York, 2 cases from the Union Carbide plant at South Charleston, West Virginia, and a single case from the Firestone plant at Pottstown, Pennsylvania. Although we are aware of several factors, such as job duties and degree and length of exposure, which may account for differences in occurence, too little information is available at this time to evaluate such differences. The average age at death for the PVC production workers was 48.5 years which is about 7 yjars younger than the average age at death from liver cancer in the male population of the United States. The estimated latent period for this disease based on the experience of the 18 PVC production workers is on the order of 20 years. This is consistent with observations on other occupational cancers w. th latencies varying between 15 and 25 years. Within the past two weeks, we have also identified two deaths from angiosarcoma of the liver in men employed at plants utilizing PVC to fabricate other products. A summary of the surveillance activities in Connecticut, which led to the discovery of those cases, is given in the CDC Morbidity and Mortality Report for the week ending June 22, 1974. oo^ 92? -5- Although ve have accelerated our efforts to identify and evaluate the cases of angiosarcoma of the liver, it will be several months before ve can expect to complete this activity. . The evidence accumulated to date on the cancer experience'of the poly merization workers, along with the evidence of induction of the same unique tumor in two animal species exposed to VC down to and Including 50 ppn, is convincing evidence that these liver tumors resulted from exposure to VC. During the course of MOSH/CDC surveillance and epidemiological activities of the past several months, we have become aware of other possible health effects of exposure to VC. Of major importance among these is a disabling liver fibrosis. This condition independent of angiosarcoma has been noted in workers from one of ine United States plants and has been observed in almost a third of the men working in one of the German plants. This condition has also been noted in most of the U.S. cases of angiosarcoma of the liver associated with PVC production. It is not yet known whether the fibrosis is a precursor of angiosaicoma of the liver or to what extent it occurs f among workers exposed to VC. Clinical descriptions of several of the U.S. cases of angiosarcoma and of hepatic fibrosis are given in the CDC Morbidity and Mortality Report for the week ending Feoruary 9, 1974, and in an article by Falk, Creech, Heath, Johnson and Key to be published soon in the Journal of the American Medical Association. W 92$ { i.- \ -6- According to an industry sponsored mortality survey of U.'S. polymer ization workersthis population shows a deficit in overall cortality when compared to the U.S. male population. Yet to be determined is the significance of the report of. cancers other than angiosarcoma of the liver which appear to be related to estimated exposure. As part of. its surveillance activities, NIOSH has compiled an extensive bibliography of the world literature on VC (Appendix I) to provide guidance to the Department of Labor, other government agencies and investigators throughout the world who are concerned with this problem. A NIOSH mortality study is presently underway at 5 PVC production plants, and a medical cross-section survey of current and former polymerization workers and controls is being designed jointly by NIOSH and CDC, "he objectives of the cohort mortality study are 1) to compare the t mortality of individuals who have worked in VC plants with that of the general populations; 2) to compare mortality patterns within the population of VC workers, based upon estimated occupational exposure and time since first exposure; and 3) to compare mortality among VC workers with the mor tality of other occupational groups. The most time consuming step, vital status ascertainment, is expected to be 85% completed by the end of the summer and totally completed by December on all plants except one. The major purposes of the medical survey are 1) to determine those / diagnostic laboratory procedures best suited for detection of liver disease W 929 -7- among workers at VC polymerization plants; 2) to identify as completely as possible those workers or former workers with liver abnormalities so that they may be referred for appropriate medical evaluation and therapy; and 3)- to identify other medical illnesses conceivably related to VC exposure. 2. Sampling and Ana? ysis The" field sampling and analysis method for VC previously recommended by NIOSH with a sensitivity of 1 ppm, required the use of a 250 cc glass gas sampling tube, and subsequent analysis by gas chromatography. Subsequent research by NIOSH has indicated that alternatively a charcoal tube can be used for collection of VC which permits the collection of integrated personal samples. We recognize that gas chromatographic procedures are now available with a sensitivity of several parts per billion, but it should be realized that laboratory instrument conditions are seldom practicable for field use. NIOSH research is continuing in this important area of sampling and analysis. f 3. Evaluation of Respiratory Protection Questions regarding the effectiveness of cartridge and canister type respirators led NIOSH to evaluate the performance of approved respirator organic vapor cartridges and canisters against VC. Four makes of organic vapor cartridges and 4 makes of organic vapor gas mask canisters were tested against various concentrations of VC at a focW 930 flow rate consistent wit! a moderately heavy work rate. The effect of relative humidity ou service life was also investigated. These tests show a cartridge life, based on 10% break-through,.to be 40'to 75 minutes at 50 ppm, 50% rele ;ive humidity, depending upon the manu facturer. Also canister life at 100 ppm, 50% relative humidity, was shown to range from 200 to 350 minutes again depending on the manufacturer. It should be noted that the service life decreases as the ambient relative humidity increases. Gas mask, face piece leakage is typically 17 of the ambient concentration. At 100 ppm ambient concentration, 1 ppm leakage could be expected. Because '* the odor threshold of VC is considerably higher, a worker would have no indi cation as to whether he is or is not being adequately protected. Therefore, it is the position of NIOSH that the only suitable respiratory protection devices for VC are supplied air respirators or positive pressure selfcontained breathing apparatus. at determining present and past worker exposure to VC and other liver toxins, and work practices, and control procedures utilized to nduce and eliminate such exposures. These investigations have involved VC jroduction plants, VC polymerization and copolymerization plants and PVC processing (fabricating) plants (i.e,, compounding, extrusion molding, calendering, thermoforming. -9- binding, foams, fibers, and plastisol operations). Walk-through surveys of one VC plant and 7 PVC plants have been, conducted to date. Air sampling surveys for VC have been conducted -in 7 PVC fabrication plants and the data herein presented. Also, a detailed industrial hygiene survey of one PVC plant has been conducted but results will not be available until next month. Polymerization Plants The walk-through surveys of the polymerization plants were conducted to determine which plants would be selected for the detailed industrial hygiene surveys from which the documentation of worker exposures would be obtained. Process information, plant layouts, air sampling data collected by the plant, work practices and control procedures were noted and obtained, during the walk-through surveys. The criteria for selection of the 7 plants were based primarily on the needs of the overall epidemiological study. These criteria required that the plants (1) were in operation for at least 15 years; (2) had a large worker population; (3) were located in States f where vital statistics could easily be obtained; and (4) have an "in-house" medical program. N The polymerization plants observed during the walk-through surveys used the suspension, emulsion, and solvent processes. The only process not observed to date is the bulk process. _ The one plant (from the initially selected 7) where a detailed indutrial hygiene survey has been conducted was selected because of its age (39 years of production), the fact that it is one of only two plants using the solvent process to product PVC, and cases of angiosarcoma of the liver in employees of the plant have been s reported. 932 -10- In the first and second quarter of FY'75, NIOSH will conduct detailed industrial hygiene- surveys in at least 3 additional polymerization plants. They will be selected from the 6 remaining plants where walk-through surveys were conducted and from other plants that utilize the bulk process to give a cross-section of the different processes utilized by polymerize VC. Eased on the walk-through surveys of the 7 plants and the one detailed industrial hygiene survey, a brief summary of NIOSH observations is presented in Table 2. This table presents the major sources of VC releases within the PVC plants and work practices and control procedures that can be utilized to reduce and/or eliminate there emissions. VC (Monomer) Production Plants The VC plant that was visitied on a walk-through survey used the ethylene oxychlorination process. No plant using the acetylene process has been visited. Due to a limitation of personnel and time, it was decided that further detailed surveys of VC plants would be done under contract. $ This survey will be completed in June 1975 and will consist of documenting the previously mentioned exposure data, etc. for VC plants based on detailed, industrial hygeien surveys of at least 3 plants that wd-ll be selected to be representative of the industry. Based on the walk-through survey of the VC plant, a brief summary of the NIOSH observations about the major sources of VC releases within VC plants and work practices and control procedures that can be utilized to reduce and/or eliminate these emissions is presented in Table 3. ] -11- Fabrication Plants The air sampling surveys of 7 PVC fabrication plants were conducted at the following operations: extrusion, thermoforming, calendering and plastisol processing. In general, any process involving the heating and/or mixing of PVC resin can result in the release of VC. A compilation of NIOaH's air sampling survey data from 7 PVC fabri- ' cation plants is presented in Table 4. Table 5 summarizes the environmental findings from our studies in PVC fabrication plants. Breathing zone samples, that is, actual measured exposures to VC, ranged from 0,3 to 12 ppm with a mea- of 3 ppm; and estimated time weighted average (TWA) exposures were approximately 2 ppm. The latter estimate was made by combining "Breathing Zone" samples with "Area" samples. Peak levels of at least 300 ppm were measured in the PVC fabrication plants. However, extended exposures to such concentrations are quite improbable, since these levels exist only at "contamination sources" rather than at normal work sites. Maintenance and repair workers, however, my be exposed to such levels. i Further data will be available when the aforementioned contract study is completed. NIOSH's recommended work practices standard was.meant originally to t>e applied to the manufacture of synthetic polymer from VC. In view of the finding of appreciable concentrations of VC in fabrication operations and the reports of angiosarcoma in monomer production and in secondary manufacture, we recommend that exposure to this carcinogen be controlled whenever it is encountered in the workplace. TABLE 1 V*, CONFIRMED CASES OF LIVER ANGIOSARCOMA AMONG WORKERS EXPOSED TO VINYL CHLORIDE OR POLYVINYL CHLORIDE June 25, 1574 COUNTRY CASE # 'V Sweden 02 BIRTH DATE 11-27-11 United States 01 ^United States 02 United States 03 United States 04 United States 05 United States 06 United States 07 United States 08 United States 09 United States 10 Unit ed States 11 United States 12 United States 13 W. Germany 01 W. Germany 02 Great Britain 01 Xorvay 01 Sweden 01 00-00-22 00-00-34 00-00-15 00-00-24 00-00-12 00-00-29 05-03-22 05-06-20 00-00-31 08-16-13 05-27-09 11-17-18 12-01-21 07-26-31 06-04-30 00-00-01 12-23-15 06-23-27 United States 14 United Stotoa 15 00-00-13 00-00-25 1st VC or PVC EXPOSURE^ DX ANGIO SARCOMA AGE AT DX VC MONOMER PRODUCTION WORKERS 00-00-45 05-15-72 61 POLYMERIZATION WORKERS 12-09-48 11-15-55 11-28-45 07-06-52 06-19-44 01-17-62 08-00-44 10-07-46 05-28-45 06-00-51 10-14-46 09-13-49 08-19-44 10-14-57 10-01-57 00-00-46 03-00-50 08-14-51 03-00-71 05-00-70 12-00-73 08-00-67. 04-00-64 02-00-74 00-00-68 08-00-61 03-01-74 05-00-68 03-00-70 05-00-69 05-00-74 00-00-71 00-00-69 12-00-72 12-20-71 02-00-70 49 ' 36 58 43 52 45 45 41 43 55 61 50 53 40 39 71 56 43 COMPOUNDERS, FABRICATORS, ETC 08-18-38 00-00-00 06-00-73 07-00-72 60 47 YRS 1st EXP TO DX 27 22 14 28 ' 15 20 12 24 15 29 17 23 20 30 14 11 26 22 19 36 00 TQT YRS EXP 23 16 13 28 15 18 *; 12 18 15 17 17 23 15 30 14 11 20 21 .. 1'8 00 00 DATE OF DEATH 08-16-72 03-03-73 09-28-71 12-19-73 01-07-68 04-09-64 Alive 03-23-68 08-29-61 ALIVE 05-10-63 03-16-70 05-02-69 ALIVE 12-14-71 01-25-69 12-00-72 01-04-72 10-20-70 , 07-03-73 02-15-73 W indicates unknown date Table 2 MAJOR VINYL CHLORIDE EMISSION SOURCES IN POLYVINYL CHLORIDE POLYMERIZATION AND COPOLYMERIZATION PLANTS if Sources of Vinyl Chloride Emissions Work Practices and Control Procedures That Can Be Utilized to Reduce And/Or Eliminate the Emissions I. Polymerization reactor cleaning a. Reduction in the frequency of cleaning b. Automate cleaning"process c. Maximize purging of reactor before and during employee entry .into reactor d. Employee use of air supplied respirators (type prescribed by OSHA) when cleaning reactors 2. Venting vinyl chloride from processing equipment internally within the plant Repipe vented vinyl chloride emissions to a recovery system or completely remove -vinyl chloride from vented air prior to release 3. Quality control sampling of process a'. Redesign sampling points to eliminate excess pipe downstream of sampling valves .in order to reduce the amount of vinyl chloride lost after sampling b. Employee collecting sample should wear air supplied respirator as prescribed by OSHA k. Process leaks from such things as pumps, valves, flanges, gaskets, etc. a. Use direct reading vinyl chloride, sampling device on a routine basis for early detection of process leaks b. Change pump seals, agitator packing, etc. to designs better suited to prev^ht leaks 5. Tank car loading and unloading a. Eliminate vinyl chloride that is exhausted while loading and unloading tank cars by piping changes and venting to recovery system or completely removing vinyl chloride from vented air prior to release b. Employee use of air supplied respirators (type prescribed by OSHA) while connection and disconnecting 1 ines ViO'W 936 *v*,V t^sojsm^siatisssassa '.'l-v:t,iritem i Va>r^ Table 2 (Continued) ti 6. Vinyl chloride monomer filter changing a. Reduce frequency of monomer filter changing i b. Employee use of air supplied respirator (type prescribed by OSHA) while changing or cleaning filter 7. Polyvinyl chloride waste disposal Properly cover all polyvinyl chloride waste barrels, drums-, bins, etc. 8. Packaging (bagging and drumming of polyvinyl chloride) a. Improve local exhaust ventilation at bagging and drumming stations to reduce polyvinyl chloride dust and vinyl chloride gas emissions b. Clean baghouses and other control devices frequently to insure top efficiency of ventilation system c. Employee use of air supplied respirators (type prescribed by OSHA) while cleaning baghouse. otW 937 MAJOR VINYL CHLORIDE EMISSION SOURCES IN VINYL CHLORIDE MONOMER PRODUCTION PLANTS Work Practices and dontrol Procedures That Can Be Utilized to Reduce And/Or Eliminate the Emissions a, Eliminate'vinyl chloride that is exhausted while loading.and unloading tank cars by piping changes and venting to recovery system or completely removing vinyl chloride from vented air prior to release b. Employee use of air supplied respirators (type prescribed by OSHA) while connecting and disconnecting 1 ines a. Redesign sampling points to eliminate excess pipe downstream of sampling valves in order to reduce the amount of vinyl chloride lost after sampllng b. Employee collecting sample should wear air supplied respirator as prescribed by OSHA al Use direct reading vinyl chloride sampling device on a routine basis for early detection of process leaks b. Change pump seals, agitator packing, etc. to designs better suited to * prevent leaks * 938 686 ^ Table 4 Fabrication Product Type Re?in Exposure Levels of Vinyl Chloride in PVC Fabrication Plants NIOSH Data (summary of 7 Plants) Location and Operations A. Operators' Breathing Zone Samples (measured exposures) 1.film jaste 2. film 20.mil film 3.film 12 mil film 4.flex. sheet suspension 5-nolded products ;omped.cubes over mixing vessel, dumping bags packing table, behind cutter packing table, behind cutter film sealing, operator's position Holding machine operator B; Area Samples (probable exposures) 1 mlded products comped cubes 2. V ft It 3. ' " II 4. " 5. " " II II 11 It 6.film 20 mil film 7. * 12 mil film B.molded products comped cubes 9.film suspension Itf'." suspension 11." suspension trimming table 8 feet from mold machine 4 inches from cutter outlet 12 InchSs from cutter outlet 24 inches from cutter outlet 22 inches above hopper *Tork st :tion near press side of heater section sxtruder line, next to cutter nixing area- operation shut down nixing area - operation shut down film sealing unit at operator's position C. Source Samples (possible exposures) 1. raw material 2. - It- J It 4 j* O* 7. film S/ilm 9polded products W. " " paste suspension comped cubes paste paste paste paste paste comped cubes II II 11 .'film 12.' " 13.mold strip m / IT If 20 mil film 12 mil film comped cubes 11 II withdrawing sample from bag tt II tl II If II II It H 1* II 11 Tl tl fl If tl Tl If It withdrawing sample from oven 6 inches from feed pan on a film coater 1 foot above injection molder (4 samples at this spot) 1 inch above injection molder (2 samples at this.spot) near intake to press above inlet to hooting section 12 inches from extruder die head feed hopper Cone. Results PPM Summary 2 Max. = 12 PPM 0.3 0.3 12 <fl. 3____ Min. = <0.3 Median "0.3 Mean = 3 > t PPM=->/fL=/.<vr-- <0.3 Max. = 8 PPM <0.3 Min. = <0.3 <0.3 Median= 0.3 <0.3 ' Mean = 1.2 <8.3 >-JL PPM= 1/11=9% 0.5 0.3 0.4 0.8 <4 8 '. 10. ' Max. = 340 PPM 340 Min. =<o.3 <3 Median = <1 1 Mean =18 ^ 2 >1 PPM=10/21=487 <1 . .1 . <0.3 <0.3 0.3 0.5 0.7 <0.3 <0.3 * t j! Kti I l M li % zr. $ to f;A % , V. y F? $ Z Table 5 Summary of Exposure Levels to Vinyl Chloride in PVC Fabrication Plants 1. Film and Molded Products (NIOSH Data) Gas Concentrations-PPM^A) Max. Min. Median Mean >1 ppmw a a. Operator Breathing. Zone ' 12 b. Area Samples 8 c. Source Samples 340 <0.3' c) 0.3 3 <0.3 0.3 . 1.2 <0.3 <1 18 2/5=40% 1/11=9% 10/21=48% (A) PPM = pa., of gas per million parts of air mixture (B) > = greater than (C) < = less than t \ 'M ... ;4> copy . Dr. Karcuo Key, Director J.'IOSH ;ne.' (900) b3-1530 H idniaiologic Hotes end Reports - Angioasrcoiaa of i Liver - |^onncoticut 210 , continued on page 216 fcMDEttlOLOCtC NOTES AND StfOJtTS ANGIOSARCOMA OF THE LIVER - Cannmfnd Finn January 1935 thtoa(h December 1973, 8 cam of Kitfoutwcn of the Ihw wen reported to the Connecticut TUmej Rfflrtry: the diarnott* of hepatic angomoomf ha twee Noiinord an 6 of three ten by prthotofzm u the National Cancer Inttitutc. One t*e tun duptowd in 1950, I la 1967, and 4 In 19?; and 1973. The 1950 caw occurred ia mdtm of notth-ccntral Connecticut, wttUc the S more recent cases me** farad In reddentt of 4 timely adjacent communion in lire MUtfantcm portion of the itaietFisurc 1). Two of Ihe pabenti appear to hate had occupational expanirc to polyvinyl chtondc (PVC% One, a 47-ywoM n*o diagnosed In January 1973, had been employed for the 10 Rpa I CASES OF AM30SARC0Krt OF THE LIVE* by Mace or residence COKNTCnCUT - IMVI*13 '5? 55S" 1 iwSL/ !" Wwwls" pmrdinr years at an accountant in a factory whitb producer *inyl rheeit and processes PVC rpm; it it reported Out be /frequently sorted the production area of the plant. Another patient, a dl-year-oid man diagnosed tn June J973, had wortwl from 193J through 1971 in an dwidui pmdnctc marrvfao luring concern, and from 19j>fc throu.-dt 1963 ha bad operated (Continued on hart paftf waTMrr*7 V-; Owwtm rv*M n^mi \ ILLEGIBLE DOCUMENT tohJ 941 'I'i 2\(t Morbldilv r ANGIOSARCOMA - Continued r-*.;!ti!K!>' there v.Jii;h pp!i;J r^Min conulnii'f PST in *m'v. >i ut'iii -.!*!'. .r,nteri.il Another * ; ..ticr.ti v.ho t.,,7 -.v.. ixcyp^jirriil < vr l\: t\T !.jJ f.r:i limy lime Te.-`. rr.f* of '.hr Su m ford m 0;ir ol t b tie m .. 7j yrj;.'.d rr.-'r., :tl 1 `*>7, vino h..t '.or J hi*, cni.r: ' *c .tfen ' mPsi <>! :*ir r'r.'tr'ral pro.bi.t* fYrti'ry mintinorij ahsTie, Hr bed voti-rd *1 4 fitefn-'iie.' f;.*-jn 1^17 Vj i-'-.', n a meiai .'mm to IdJi tibd *i i U'N-'I cutter fr. ni !^4< m.ti! >.n ei'iimpr'ii in 1 Ut- J. ,i*fijiiirini.lly hr h-d ; t*i>toiy of .homi'e slcehc1- inf.r* tu ". *1 hr cui.i m v.ji an S.i-y; rcn.'iS. vcrain. , liotivewte nml retard wi. ljo nav ihucum-ttl in Dr.tmher l'*'1?. Khr had Inedior ,1:'jeart wiiliiri I;~ n=i7v f-i l!:nmt * product' p:nt. Ihrte a* :o fciM'irY of ^v-ipatitrnai vt ul pvlvitij oonmumiy r\r*or'.ifr to PS'C lor the 2 rrtnarninf p.'itteim. One i> s hLsiirieuc in north-vTr'.ti! Cor.r.rvi'.cmt. the oihci in unrnipkiSird. divided pirn vhro-tic alcoholism "he* hn*! moved If Connecticut from Nr*' Yori: City 4 month* brfrre lui ditsnosy: in May V>~?- None of tha 6 confirrr.rd Jist'.r**.** hsd H'.r.v.r, vepovure tr thnrrum dioxide f!} or 10 jrirnleii compounds. O'. 2 ruTcr ri UtOM*. Specif;.<.-N to induce apjpiajie'oms of the Infer tti man. ity hn-torv, hi m htd excanrve rv portire to arrmo* <;m:V*. None liid a p*u Ithtory of bcpilitir. Tuv had h/slur.-m of aUtriKiiism. noted, but none ire hrmun to have t.M.tn other jv-.ic'itiiily ht-pilfloclc drupr *>r mcdeaiiioiiv by St'bca W Oitiyrmr. MD. Otiff. Ckn-mt D.sf^ts CnnttiH St t not;. HarotJ ,S. S-m-u. .11 U . Corr.'miztoiirr <./ ticsUil, sxi tX-.nrwh' .V i.Uiyd. Sf O . fnm* J*i/jitVse t'f HfJ-h, Ctr-trieffictil \'?f fypartrernr t-f Ihr Smir-nrl JnsMntf of Onufwc-.vJ Ssfrit erd ff.xl.'h. tm<i thr Carcyr ves/ Birth Drj'rrii lJ.iwon. Bureau vf pt- drmioioty. CDC. t EdiltirinJ Nr>le Rocon l p fxirrt t.'.4i have drarrihrd !3 ri'. of fndn- vtfvtirr.- of the birr are.one. mm ' .`J .n Uu` tyr.liie'V of H441iOvn'l*U. i4n14 &o4*4l44 044V4*,i,**1iO44i14A. *W1* 4MHr4ti I1HK. 4 4MH.W / C Irrtflir. r-||d44 rf MaWWKWl r'lbit MBW i. i*H. W.U W * > *tB, ^:.t4^ Gr'***v* *- &w4*v<i,. P/.CVi. Tti ^ M tiiti H*t4 pry *J*'t**ini fi1 b tiu < a Of WWPta*< t IbdaTt twi ** "fCp * t bC WMi iitutpV.iwtaf|1Mu#Mtiv Unh`"*H* Ru* l>r*ti /IM ;: . . PVT i.nvl fhlosi-li i" I'wntr ITirre no.:. ,, 1i- Mirr^i that St M any h^vc hern '.'-.r v.'.e.'.r nf f.rp;v; in *.h;';C `Z'/'l ).`i ii;i prfttnt t-'T*.* ^ o! p.cratu ore Uri.ni'rJ i: men Hi.1 ! i nu Vr/r.wN rtp,'#\ntr i't S'l'M., i.;*t vtim ,ti..t v.te/i. v.-.tS PY( V.'.;1: :>*.* t:"'J'.PC' ri!.'! ::-h rn> tj-.;' tr,wr;11'yn rtp'..u- tn PVr end inrip'arrom.t o* thr liie:. Ihet d. ra;J. tl.. jv y.'l'.nly el *.:> .i I e;'.hrf v'e.:.! : ,.h:.-' :rv..'-t t`::r riiifri '.. h !. r.tedrd to .kfinr thr n.*`*i tut; f.'.lt'!' ;n pritoNi n/n.- tnnc wi.'ii.vd reiiti i`VC. V:i: cid'iinno'- Vu> > in :hiv study o; .:niv.':^rct. m. . t thr tnei i:: 2 priveir *!;' iivii no tv.op.tiiuwl etpi'*"'' "' vinyl eh'.tnde. i'.n tM'io -*r.a> have hrd eoirio's.nity <v^n.u:i. is :-ho v.fiToverre bjl cvtaWhhv'-s ro v?V.yil conneet-er. It mi; hi K'. eire.ted \i;. .thr-Pmi* ol rt-.la from ;hr 1; :^ Na!;i'r.-.i f :nrcr Survey trial approvrijtfiy d.c;*aiof `strorra of thr fort vo.ii5 nr:'.u inCo't'vNtirtH in * ifV.m prni'd that srpMusmateij* '.!.< erve* todld rveear rn the i prevjrrwOt- uirruioord n>ui-il in. III I'M:; Ck-ppr-v 1- d-cnr.p the vierse .ntervy',. I piSetnto'.crjc intmtiphoit of eddr iron*' i -vi of hr..noi-reom: U:ai ntr.y he fvtirj :* bsvr h,d powifrle community cvpufuie to t-.nyj cblcodr u.tii N- niiee. n to itnify i!:r siemfn-ance of tltrur eauei. Pifnrnnr , I d Set* Ibm* I, Abhin JD. C;i n'i* d> Moil* U Runt ML' Mf t ranty >*-d t-ilet litr rtfer'.t ftihmuif idirunsiiitiuo of i)Wk:. ijnai r ivt-f 2. Kz'-' i 14', K..U l.'. Orynw J. Hidhaid Jf: Hi T trzcorrt sk' iner ic,*m ehiie..; tiwnir ir.loxi.'itxr: by fovlrr'i tuie lion. (?-.e- iJ.Sib-S;?. "*.S r. Cr hi 'n Dnrne Cnniiof. AneKwiKnm* of lfcr !h*rj xmerj p-1! i.ryi rt-.'ir .w M^4fri - WrcmfSy. Morb'doy sr4 Morttiity tinin Rro i i-.-va. v )>e jure 4. L'rp'.n JL Jt. i b.nwo Vtv .vtpirvic<jn of ihr ii't i in IV rtus-- fatioir. o rvxrayiibiitfear. J li.e Me*J fb I .*.V Jf. lyre i. liil II. Irf0i CV It. ICr\ V;M: lnpuhnidud ptnrevitoov li Mi.* I(74 L, Mril'en C. Ltfrimoy G. fii.jnoermrny hmauayi .*( ttr.yf 'Wnriii torrent iri.'n. In fityeici n: Nro- Vojli A.idrrry o| Sermor TScsmy Goi'f ** i .it .lv of Vmvl * P.cymrnI Oi'e:uJ( NrI* V.re fii. . :.;. !1 '.*.,1 inti t* td^ven k lh* *pnt'"t**i tJi jwmii ftaimnr irt p*ptt' t. w 4H*r*' pV/ftapt pe^ppNiYi pi a'-lamtIJSf wi|W ** u<4 li iailai*VPp *4 M*p|T.f Ip fcpi'lR pMlMi, *p Mmm Cm w>r Atii*. tvipt v-s+mm \r ** Vhi#**tr Man DKHWPvWi^tio.i No, (CD?) 74-SF17 U^rtVtf'AftTV-TVT C*r HtM/rH.lDttCATtC*, PUbtTCHtAl-THStRVlCt CIK'I ffrMV.' *M Att *!* <>f 0FF2OAI UNIS h^Ur.f asti fftt*i U.V Ul 4t 4'** n <( v, >*% i l ILLEGIBLE DOCUMENT 942r I t.* \ S &EL. A BIBLIOGRAPHY ON VINYL CHLORIDE Prepared by the Office of Occupational Health Surveillance and Biometrics and Office of Research and Standards Development t National Institute for Occupational Safety and Health May 22, 1974 943 List c<! Journal Abbrey ia L I O'in Ann Occ Hyg - Annals of Occupational rvgionc Arch hr.-/ Health -- Arch ivo-s of Envi rcnmentnl Hc-alLh Arch Tux - Archives; of Toxicology Arkh Path - Arkhis katologii (Archive:; of Pathology) Arch Derm - Archives of Dermatology Arch T H and Occ Med - Archives of TnJiisCri.nl Hygiene and Occupational Medicine ATi-LAJ - American industrial Hygiene AssociationJournal Biochem J - Bioch:mi cal .Journal '(England) .. Br Mad J Bui - Bri tish Medi cal. Journal Bulletin Br J Dorra - British Journal of Dermatology Br J Ind Med - British Journal of Industrial Medicine Bull of Hyg - Bulletin of Hygiene C.A. - Chemical Abstracts Can Med Assoc J - Canadian Medical Association Journal Chem Eng - Chemical Engineering Clin Chen - Clinical Chemistry Env Res - Environmental Research Farnakol Toksikol - Farmokalogiia i Toksikalogiia (Moscow) Gaz Woda - Gaz, Koda i Technika Sanitarna (Eolish) Gig Sanit - Gig i Sanit (USSR) Gig Truda - Gigiena Truda i Professionlnye Zabolevaniya (USSR) Hyg and Sanit - Hygiene and Sanitation (USSR) J Chem. Er.g Data ~ Journal of Chemical and Engineering Data J Occ Med - Journal of Occupational Medicine J Pharr: Sci - Journal of Pharmaceutical Sciences J MCI - Journal of the National Cancer Institute J App Chen - Journal of Applied Chemistry JAMA - Journal of the A.merican Medical /Association JMA Georgia - Journal of the Medical Association of Georgia Lancet - The Lancet (British) Labor Pyg and Occ Dis - Labor Hygiene and Occupational Diseases (USSR) Med Lav - Medico Lavoro (Milan) NE J Me.d - New England Journal of Medicine T & AP - Toxicology and Applied Pharmacology Vrach Delo - Vrachebnoe Delo The numbers to the left of each entry in the Mbliogranhv correspond to the file in which the articles are kept at N10SH. EBQI 944 ?ir> AJJbright, li.i'.:. ('inyl Chlorine l'ro.y'^jcs. Fug 74:173-39, J9A7 ?] i Albright', I,,. : 1 !,inu L a o Lure of Vinyl Chi or idc , Ohem Eng 76:219-2 6, 1967 212 Albright, L.F.: Polymerization of Vinyl Chloride. Ohem Eng 74:15158, 19f7 213 Albright, J.. F, : Vinyl Chloride Polymerization by Suspension Processes Yields Polyvinyl Chloride Resins. Chen trip, "74:1 45-52, 1967 . ' ' . 214 Albright, L.i-.: Vinyl Chloride Polymerization by Emulsion, -Bulk * and SoluLicn Processes. Chen Eng 74:85-92 , 1967 156 Ar.ghelescu, F. et al: Clinico-Patboeonic Considerations of Raynaud's in the Workers of the Polyvinyl Chloride Industry. Kedicina. Interne 21(4):473-82, 1969 032 Antcnvuzhenke, V.A.: Occupational Vinvl Chloride Intoxication. Gig Truda l?(3):50-52, 1968 176 Antonyuzhenko, V.A., Golova, I.A. and Aliyeva, N.K.: The State of the Analyzer Functions During Chronic Occupational Intoxication with Certain Substances Having a Narcotic Effect'. Gig Truda 9:19-22, 1972 261 Arkhipov, A.S., Marchenko, Ye.N., Filatova, V.S., Egorov, Yu L., Novoselova, T.I. and Martynova, A.P.: Technical Progress in the Chemical Industry and Work Hygiene. Gig Truda 17(8):1-5, 1973 t OSS Autian, J.: Toxicity, Untoward Reactions, and Related Considerations in the Medical Use of Plastics. J Pharm Sci 53(11):1289-1301, 1964 100 Baretta, E.D., Stewart, R.D. and Mutchler, J.E.: Monitoring Exposures to Vinyl Chloride Vapor: Breath Analysis and Continuous Air Sampling. ATHAJ 30(6):537-44, 1969 026 Basalayev, A.V., Vazin, A.N. and Kochetkov, A.G.: Pathogenesis of Changes Which Appear During Long-Term Exposure to Vinyl Chloride. Gig Truda 16(2):24~27, 1972 018 Basalayev, A.Y.: Experience with the use of' large-frame photofluorography in examining skeletal bones of persons occupationally dealing with unsaturnted hydrocarbons of the Ethylene series (olefins) and their chlorine derivatives (Vinyl Chloride, Trichloroethylene). Cig Truda 14(11):34-37, 1970 272 Benoit, J.P.: Aero-osteolysis'4--A Nov; Occupational Disease of the Plastics Industry. Paris, France 54(624-54-69):83-89, 1969 273 Benoit, J.P.: Occupationally Induced Acro-osteolvsis. Lvon, France (88), 1967 ! 00^1 945 B. Hergwc: !i , : Pim"- Hvd : oc.:rii' I, i f",] i ! : i i' / oi.u 1 1 :<-.i t r. .tv! 7i::v! f-ii I iii i (if as Aerosol Prove11 anLa and M! L nrcr.. Koiuiie! ! k-Pn rfcs Brngi n lUinrJ : s R (1 -2) : 20-3 2, ]') 70 087 BLschoi'f, F. : 0r, nic Polymer H ioco-patchllity and Toxicology. r.l in 18(9) 69-94, 19 7 2 120 Boettncr, H.A. ar.d l-V-ics, B. : An Analyt:cu1 System lor Identifying the Volatile Pyrolysis Products of Plastics. A1.HA,7 23:535, 1567 'VTl 140 Boytsov, A.h'.:- Problems of Industrial Hygiene in Kc-vv Plants for the Manufacture of Svnthetic Resins and Pla'stics, Cig Truda 11:20-27, 1963 ' 012 Brand, K.G., Buoen, 1..C. and Brand, I.: Corcinogeno:; is From Polymer Implants: Nev.7 As vert s from Chromosomal and Transplantation Studies During Premalignancv. J MCI 39(4):66379, 1967 252 Broussard, C.: Pathology cf Polyvinyl Resins. Folia Medica 52(2) :102-108, 1969 275 Chatelain, A. and KotLllon, P.: Un Syndrome D'Acro-ostolyse D'Originc Profcsiormelle et de Constatation Nouvelle en France. T Radiol Electrol. 48:277-80, 1967 130 Clayson, B.R.: Chemical Carcinogenesis. Little Brovin and Company, Boston ppl01-12, 1962 126 Cook, W.A., Ciever, P Binn.an, B.D. and Megnuson, H.J.: Occupational Acroosteolysis II. An Industrial Hygiene Study. Arch linv Health 22(1):74~82, 1971 276 Cordier, J.M., Fic-vez, C. and Lcfevre, M.J.: Cah Med Travail 4:14, 1966 277 Cornish, 11.H. and Abar, F..L.: Tonicity of Pyrolysis Products of Vinyl Plastics. 19(1):15-21, 1969 325 Creech, J.L. and Johnson, H.N.: Angiosarcoma of Liver in the Manufacture of Polyvinyl Chloride. JOM 16(3):150-51, 1974 077 Cylwik, B.: Histological and Histochemical Changes Observed in Liver During Experimental Polyvinyl Chloride Pneumoconiosis. Rocz Akad Med Kialymstoku 17":93-111 , 1972 208 D'yachuk, I.A.: A Contribution to the Hygienic Evaluation of PVC Floor Tiles for Apartments. Hyg and Snnit 35(3):424-27, 1970 198 Danzigor, 11.: Accidental Poisoning by Vinvl Chloride--Report of Two Cases. Can Med Assoc J 82(16):S2S-30, 1960 t i r _?_ 940 I- i l '-in-i! , V. : Ccou' i ] Am V I 'a >1 v:. i T . h: i`:- i don 1ologica1 Study. Arch i,:,v l -- aith 22(1) : M-7 3, 1 ri / ' 127 Hods <>", V , 1):,.n , B.D. , Wh ; to! a , V.::., a T M ,, . /. moon , 0- o- aticnal A'-r 1. O'; t 1 ol V'; ; y, '] ! T . A V !. i:il c r- J S in dy. Arch bnv He'.ill r) .*- \ x ) . i y 1 , 19/1 280 Dev a c, A. , K'sr.-i-jici , L., J>:r ic-Kuzie,. D . and 'Paroc. 1 r- - V . . the Kxt.rr.,-;i tics -Asscvi .itt'd with V ir.yi CIrlo.-ida. Polymer: i on A ?hCV Occupational Disease. Zagreb , Yugoslavia, 91(1)::-17, 1969, 143 Vila tovn, V.S.: The Uygieni c Mvn 1 * i Ai i" 111 : of He.'/ 'foehniClogical Procenr.es ir. the Choni cal Industr y. Labor liyg ana Our Mize CSSS I!: 1-6, I960 151 Filatova, V.f.. .-rod Autenyu/.bunko, V.A.: Hygienic- Conditio:./ cf Lr bor Disease Race of Workers Involved in the Product i on of Pol; vinyl Chloride Suspension, In' :>/namics Over a Kar.bor of Yea,;. ' Truda 4:32-34, 1971 157 Filatova, V.S., et al: Problems cf Labor Hygiene and the r'uaiir Status of Workers in the Proruction of PVC Latex. Gi2 7r-. 8:9-14, 1965 202 Filatova, V.S. and Gronsbery, Ye.Sh.: Sanitary-Hygienic Working Conditions in the Production of PVC Resina and Measures far Improving These. Conditions. Gig Senit 1:38-42. 1957 162 Gabor S. , Radu, M. , l'rc-da, >:. . a.orucc S. and T'.'avrd L.: Biochemical Changes In W..; kers Occupied in Vir.yl Calorics Synthetics and Polymerize', ion. Igiena 13(5):409-18, 1964 263 Gabor S., Radu, H. and Manta, I.: Certain Biochemical Indexes of the Blood in Workers Exposed to Toxic Substances (benzene, chlorobenzene, vinyl chloride). C.A. 61:61313, 1964 146 Gavruseyko, O.M. and Filatova, V.S.: Hygienic Evaluation of Certain Tynes cf Drying Waits Used in the Chemical Ir.dur.trv. Gig Truda 1(2):32-39, 1959 112 Gonkinn, T.I., et al: The Evaluation of Hamful Substances fren Sene Polwinvl Chloride Floor Coverings. Sb Tr Vses Nauch-Iss Inst Nov Stroit 14:13, 1966 254 Gitsio.-}, C.T.: Acro-ostcol'-sis in PVC Workers. The Medical Bulletin 31 (1): 49-56', 1971 096 Grigorescu, I. and Tuba, Ch.: _ Vinyl Chloride; Industrial Toxicclogic Aspects. Rev Ciiizi 17(8} : 499-501 , 1 966 201 Cvonsberg, Ye.Sh.: Deterr-.ina.ti on of Vinvl Chlorii in Air. Cig Sanit 11:43- 4, 1954 -3- j Jr, 947 25! ti runuhurg, Yo. 9.];, : Col /,i i.'._'tri c nr. i n.i t. i ' , of Vinyl C,'--ridr i -- Air. i! i ;.i i or-s ka ;j a i'rcmy.s 1 '.t s >;t A 2 ( 7) 30- 3 1 , ) 946 119 ffui-r.H , W. L. , i n cl II a be rr.: , 5.: 1 o': t e j 'ey Profil-1. of Vinyl .ncd l'oj yo i u f ; ii i e Pia.lii'. and 'jL.mi' Addltiv.. .. Tech I'.-.w Tech Conf Soc Plant: Eng, .NY Soc, 1967; C.A. 6 9: 1 ,'06n , 196 5 10.3 Harris, D.K.: Si,ra^ Hs/.ntds in tin* Manufacture and Use of Pinttics. iir J Inti Yeti 16:221, 3959 149 Harris, D.K.: Health Problems in the Manufacture and Use c- Plastics. Ur .1 Ind Mi-d 10:255-68, 1953 192 Harris, D.K. and Adams, W.G.F.: Acro-osteolysis Occurring in Men Engaged In the Poly: 'erizatioc of Vinyl Chloride. 1'r Mod J 3:712-14, 1967 227 Rnepor, W.C.: Occ & Environ Cancer of Urinary System, Yale University Press, New Haven, 1969 129 Dnieper, W.C. and Conway, W.D. : Chemical Carcinogenesis and Cancers. Charles C. Thomas, Springfield, Mass. op.353-65, 1964 021 Jensen, S., Je.rnclov, A., Lange, R. , and Palmork, K.H.: Chlorinated By-Products from Vinyl Chloritle. Prcducticn a New Source of Marine. Pollution. FAO (Food Agric Orgap U.N.) Fi&h Rep 99:170, 1971 139 Juhe, S., Lange, C.E., Stein, G. and Veltman, G.: Sclerodsrm Raynaud's Syndrome and Acrc-Osteolysis in Workers in the Polyvinyl Chloride Producing Industry. Deutsche Mediainische Wcchenschrift, 97(43):1922-23, 1972 3 47 Kal'ir.anovich, F.L.: Sanitary-Chemical Characteristics of Polyvinyl Chloride Fluor Coatings. Hyg and Sanit 33(2) :274-S0, 1968 135 Key, M.M.: Occupational Dermatitis from Plastics. JMA Georgia 57:421-25, 1968 004 Kogan, A.K. and Tugnrinova, V.N.: On Tlie Blastomogenic Action of Polyvinyl Chloride. Vop Onkol 5:540-65, 1959 006 Kogan, A.K. and Raikhlin, N.T.: Dynamics of hupho!ogical Changes in Which Develop Around Plastic Implants . the Process of Malign!nation. Ark?: Path 23(1?):62-68, 2961 163 Kotulski, B.: Characteristics and Treatment of Waste Waters from Product ion of Vinyl Resins. Ca.z Woda 33(10) :336-39, 1964 025 Kramer, C.G. and Mutclilcr. J.E.: The Correlation of Clinical and Environmental Measurements for Workers Fxnosed to Vinvl Chloride. AI1LU 33(1) : 19-30, 1972 .310 189 092 267 190 323 350 351 260 024 253 1.90 -i'i . Kub 11 r , !!.: Tl i- i'hva i o.big i imI Pror'erii.o:; ',1 fa. Vt> ;ol. Pi ope11 A - r os o1 A; 9 ( 4 ) : 4f, - b 0 , 1 9 6 4 ' 1 1 Kudryavtseva, O.P.: C!i.rf,^P. o ri:;f i. cs of Electrocardingraphit Oh.'I fiat's in Patients / J c h Chronic Intox.i cat I on Dut to VivM Chloride. Cjg Truda 1 4 (8) : 54-5e, 1970 Lange, .lulu-, 8., Stein,C. and Veitnan, G.: 'I ;;rj So-c.nl led [ nv 1 Chloride Distune--an Occupational Systemic Sclerosis. International Archive?; of Occupation:;]. Ileal t h .32 (I/2) : i-32, 1974 Lefauz, R.: Practical Toxicole ;v of Plastics. CRC Press, Cleveland, Ohio pn81-83, 1968 Lester, "D., Crcenherc, L.A, and Adams, W.R. : "ffects of Single and Repented Exposures of Humans and Rats to Vinyl Chloride. A1HAJ 24(3):265-75, 1963 Levina, M.M., Filatova, V.S., Belaya, E.G. , Ashirova, S.A., Xikhomirov, Yu P., Levin, A.L. , Mostinskaya, R.2. and Kuznetskii, B.E.; Hygienic Evaluation of Construction Projects, Expansion and Reconstruction of Plants Producing Certain Organochlorine Products. Gig Sanit 4:86-87, 1973 Little, K.: What's in PVC? Lancet 7563:351-2, 1968 Little, K. and Parkhouse, J.: Tissue Reactions to Polymers, The Lancet 857-61, 1962 Maltcni, C,: Occunational Carcinogenesis. International Congress Series 322 Vol. 2 Cancer detection and Prevention, 1973 Maltoni, C. and Le Famine, G.: Le Potenzialita dei saegi sperimentali nulla predizione dei rischi cncogeni ambientali. Un esemnio: il Cloruro di Vinile. A.cademia Nazionale de Lei Lincei, 1974 Mancuso, T.F.: Cancer and Vinyl Chloride-Polymerization Iitnlications, Problems and Needs. Technical Paper, Feb. 1974. Submitted for internal discussion and planning on occupational cancer and other health problems to the Industrial Union Department AFL-CI0 Markowitz, S.S., McDonald, C.J., Fethiere, VJ. and Kerzner, M.S.: Occupational Acroosteolysis. Arch Derm 106(8):239-23, 1972 Marsteiler, H.J., Lelbach, W.K., Muller, R., Juhe, S., Lange, C.E., Kt'hne.r, 11.G. and Veltman, G. : Chronic Toxic. Liver Damage in Workers of PVC Producing Plants. Deutsche Modizinisehe Wochenschrift 98:231 1-14", 1^73 Mastremat.teo, K. , Fisher, A.M., Christie, II. and Danziger, II.: Acute Inhalation Toxicity of Vinyl Chloride to Laboratory Anlnsis. ATHAJ 21(5):3^4-98, I960 -5- ,v!iX O :`d , (', .1' , 15 /") Oceupa l i '-a': 1 1) i .-;c.i:. 3 J Bur:!. .D.M 1 2 (6) :';/' i . O.V., Vd Lrievn, V. ivsis of Water iot Chen I-id as try FS :inr; Bezus, iy , V. D. : Pela rcgranh uf Polwi :>.v 1 Chloride c.'.'jcL i f.r. 47(A);252-55, 1971 The Misgeld, Y., Stolp'i i;::;, H.J. and Schulte, S.: Intoxication by Vizr/i Cii 3 or i oo Polymers and/or Their Additives.. V. Haut-GoseC 1 Kr 43(11):425-36, 1973 Morris, C.11. : Vinyl Plastics: Their Dermatological end Chemical1 Aspects.. Arch 7. H f< Oce Med 8:539-39, 3953 Wc-rris, H.E.: Interacted Pollution Control. Pat'.oleum Refiner 33(12):229-31, 3954 Micti, C., Pl-LtuzccI lis, V. and I'usano, V.: Pheographic Observations On Workers in The Plastics Industry. Securitas 55(8) :(585-94, 1970 O'Mara, M.M. , Crider, L.B. and Daniel, R.D. : Combustion Products Tree. Vinyl Chloride Monomer. AIHAJ 32(3) : 153-56, 1971 Oppenaeimar, B.S., Opnenhaitier, F.T., Stout, A.P. and Danishefsky, I.: Malignant Tumors Resulting from Embedding Plastics in Rodents. Science 118:305-306, 1953 O-jnenheir.sr, B.S., Onnenheir.er, E.T., Danishefsky, I., Stout, A.P. and Eirich, IMP..: Further Studies of Polymers sj Carcinogenic Agents in Animals. Cancer Research 15:333-40, 1955. C.-uenhclmcr, B.D., Or.penheir.or, E.T. and Stout, A.P.: Sarcomas Induced in Rodents; by Imbedding Various Plastic Films. Proceedings of the Society of Experimental Biology and Medicine 79:306-69, 1952. Patty, F.A.: Industrial Hvgiene and Toxicology Vol IT. Interscier.ee Publishers, Mew York up.1303-05, 1963 Pegun, J.S.: Contact Dermatitis from Plastics Containing Triaryl Phosphates. Er .T Darn ' 78: 626-31, 1966 Ponov, b.A. and Yablochkin, V.P.: Sanitary-Chemical Characteristics of Products of Degassing of PVC-Based Polymer Film. Gig Sanit 32:100-102, 1967 Popov, L.A. ;md Yablochkin, V.D.: Characteristics of Gases Released by Polvvir.v] Chloride Film, llvg and Sanit 32(7) : 114-17, 1967 Fushin, 0.A.: Diver and Bile Duct Disorders in Workers Engaged in Production of Certain Types of Plastics. Sov Med J (Moskva) 28(2):132-35, 1965 -r>~ CxW 950 l -57"Iv - -^4U.i.a^. : Ua... - .UlA Oil Barieva, M. d D: nr-'v/!. S.: rn'-.-utic ition o.` Lhe Bln:: Vo runic Act io'i of Polyvjn vl Cillorir'o to sin Used in the Food Tndusf Onknlc In for; ... r is i oi.-cn Pie In tin Pri! lz!."iiLe 3:2 4-2B, ]j GO 7 Paikhlin, M,T . and Korn A.K.: T'd? Dove 1 od:~ enl and Malignant Tran:-;: ' mat i. or; o: Connertive '1 i ssne Can r.ules Fom'Din aroun. 1 :.ip l an i r. of I'l ;r L Ic Mat eri ;;'J . Problems of Oncol7(9) : i 1252, 1 9 61; Vc : Cukol 7:13-17, 1961 155 P.TJiy.inLsev^ , :>. and Ger yaehova, L.A.: Glucoc ertoid Function of Adrenal Cortex In Pat lent.s With Chronic lntoxicati on wj th Certain Unsaturuted Chlorinated Hydrocarbons. Gig Truda 12(]2):3 6-19 , 196S 005 Russell, F.E.. Simmers, ".!!., Hirst, A.E. and Pudenz, R.P. : Tenors Associated with imbedded Polymers. J HCI 23(2) :305--3 1, 1959. IBS Schottek, V.'.: Vinyl Chloride Toxicology. Chemische Technik 21 (11):703-11, 1969 237 Shabad, L.M.: Plastics Carcinogenesis, Some Experimental Data and Its Possible Innortanee for Clinic and Prophylaxis of Cancer. Potential Carcinogenic Hazards from Drugs, UICC Monograph Series Vol 7 pp.lSS-195, 1967 144 Shelley, P.G. and Sills, E.J.: Monomer Storage and Protection. Chemical Engineering Progress 65(4):29-35, 1969 1S2 Smirnova, N.A. and Granik, N.P.: Delayed Sequelae of Acute Occupational Poisoning with Certain Hydrocarbons and Their Derivatives. Gig Truds 14(5):50-51, 1970 042 Smyth, H.P., Jr, and Weil, C.S.: Chronic Oral Toxicity to Rats of a Vinyl Chloride-Vinyl Acetate Copolymer. T & AP 9(3):501-5O4, 1966 266 Sokol, W.N., Aelony, Y. and Beall, G.N.: Meat Wrappers Asthma. JAMA 226(6):639-41, 1973 291 Sporn, A. et al. Investigations into the Toxicity of Extracts of Plasticised and Won-Plasticised Polyvinylchloride Stabilised with Ethyl Crotonate; Bucarest, Rumania, 20(6): 323-30, 1971 111 Springer, E.: Bioassay Studies cf the Toxicity of a Vinyl Chloride- Vinylidene Chloride Mixed Polymer and Two Substances Which Can be Used to Stabilize Disnersions. Z ges llyg 11:442-47, 1965; Bull of Kyg 40:135S, 1965 I 00S Stankevich, K.I.: Experimental Data on the Blastomogenic Effect of Coumnrone and Polyviavl Chloride Plates. 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