Document 2q0LayKbaDBJREEG4R09rDq96

Lay translation which should be verified by medical translator. f SeutEche Medizinische ffochenscbrift, *>8 (43) P 2034-2037 1973 .' "On the So-called Vinylchloride Disease" By S. JUhe, G. . Lange, G. Stein, and G. Veltman University Skin Clinic of Bonn Director: Prof. Dr. Leinbrock Since 1958, when the first information on the hazardous health aspects to workers in the vinylchloride manufacturing Industries was found, and especially since 1?65, when the came `effects were found affecting workers in the polyvinylchloride industry (PVC), and through further reports on this subject (3* 4 7 8, 12, 28), attention has been drawn to thie branch of the chemical industry. This deals with a disease similar to a skin and bone affecting scleroderma, but a disease un explainable in etiology and pathogenesis. The main symp toms of this have been the Raynaud syndrome, nodular to large area dense skin alterations and band-like osteolysis In the finger phalanges. We could report our first observations on this disease type in Germany in 1972 (15 16, 17). Ac the clinical picture m ras at first comparable to a specialized fora of Degressive 1 scleroderma, we submitted all employees to a painstaking '.*3 W BFG09264 \I 2 . Internal examination to determine if visceral participation was also present. Recently, we reported completely 08) on the results found up until the end of 1972. These reveal nev aspects to he used in the judgement of this disease and, as we believe, also may give new suggestions in the research. * The 13 workers examined in the April-Dec ember 1972 time period were 29 to 52 years old (average age: 39 years), and had worked at least two, and at most 18 years' (average period: 0 7. years) in a FVC-manufacturing plant at alternating jobs, although mainly as autoclave cleaners. The first disease symptoms appeared one and one-half to three and one-half years after first working there in eleven patients, and in two eases seven and eleven years after first working. Symptoms and Findings t ir. The most frequent initial symptoms of the anaanetical N. details are increasing sensity to coldness in the hands and -feet, a feeling of deafness, and crawling parletosis. In -addition, pressure pain in single fingers, a thickening of the end finger joints and weakening of the nails as well as general complaints of excessive tiredness, forgetfulness and slowing down, syncopal dizziness, nauseau during work, ------- Increased perspiration and upper abdominal pain. A major role in the diagnosis of this disease is played by the alteration of the skin: Seven patients proved to have drumctick-like (clubbed) thickened finger end phalanges (club procurements and shortening, watch-glass nails, shortening of ftT n n c rs T 'y BFG09265 3 . the sail plate). We saw scleroderma-like skin alterations In 8 patients: small knots or more spread out; very coarse and relatively sharply defined, usually covering the surface skin projecting infiltrate on the outstretched hands, the distal third of the arms under the elbow, and'the area of the cheeks. Three patients had no clinical skin alterations. The histology findings of the excision specimens (from the left or right hands) of all patients were relatively unip form. Besides hyperorthocytosis and epidermidosis, there was an expansion and increase of capillaries in the upper cutis. An increase, widening and homogenation of the collagen bundle and a clear rarefaction and fragmentation of the elastic fibers was evident. The same findings lr the epi dermis and the fibers of tho upper cutis were proven to exist in the patients without clinical skin alterations. The histology alterations in the epi'dermls and the collagen connective tissues are similar to the edematosis to infiltra tive stage of progressive scleroderma. Here, however, a clearly defined border is seen between that of possible but to some extent considerable injury of the elastic fibers and the vessel alterations. So far, circulation disturbances are the most common symptoms: Nine of thirteen patients complained of this, and is fact eight of them gave this complaint as their first symptom. The degree of complaint ranged from increased sensitivity to the cold and "akrozyanose" to the Raynaud t N i090011 BFG09266 / 4 \ 4 syndrome (four patients). The circulation obstruction could be Judged objectively nith the aid -of temperature measure- nests, determination of the time required to rewarm after exposure to the cold, capillary microscopy, and arm-hand arteriography. In so case did oscillography and plethysmo graphy result is a certain pathological prognosis. Prom this, one can ascertain that the origin of the circulation obstruction is in the periphery and not in immediate range. of the large blood vessels. This consideration is supported by the angiographic trd capillary microscopy results. Four patients with sensitivity to the cold were proven to have 'ampule-like widenicgs of the capillaries in the nail joints Just as described in `he Raynaud syndrome (14)* All seven patients v;ho underwent arteriography showed pathological vessel images. The alterations ranged from a slight narrow ing of the Aa. digitalos palmares propriae et communes with 'single segmentary localized closure^ to a high degree of *dteno6is and segmentary closures, and even to the extent of $he loss of contents by the arteries in the entire length 'of the finger and clear 6tcnosis of the entire hand Joints, s ` After the examination until this point, it appeared that a direct relationship existed between the length of exposure and the amount of vessel damage. . The most obvious x-ray results of this diseace were the b&nd-Ukc. osteolysis between Frocecsul unguicularis and the m phalangcn on single or all fingers in six of the patients. 0 0 w 1090012 1 BFG09267 ! 5 In' addition, fragmentation and border defects of the Pro cessus unguiculares could be found is six patients* It is also possible to determine different degress of bone alter ation: in light cases only a small lytic zone is visible, and in the advanced'stage the phalange is almost fully de stroyed and the Processus unguiculares mounts onto the basis of the phalanx cap-like. A full restitution of the bone is not to be expected based upon the facts at this time (23,24). Remarkable herein is the solid correlation Of acroosteolysis' and the club-lllte expansion of the end phalanges. Thus, th'; 'drumstick fingers" are an expression Of the lytic bone process and not of an internal disease. An examination cf the blood building system and coagu lation draws our attention to this remarkable finding: all 'thirteen patients showed light to serious throsibopeny. The :thrombozytic count lay repeatedly between 30,000 and Tl90C0/JxJl (under a normal limit of \^0t0CQ/ut)- In a -sternal puncture given to six patients in search for an explanation, there resulted in no case a reference to the ^obstruction of the 'thrombosytopoese",- osteomyelofibrosis, or osteomyelcsclerose. The other examinations showed no deviations from the norm, except for a slight reticulocis in eight patients (between 16 and 26 %), and a slight leu kopenia in five patients ,(2350 to 3950 leudocytec^-L ). Reticulosis and leukopenia may bo caused by the splenomegaly In the twelve patients. At this time, it is not clear if BFG09268 21090013 V 6 the thrombopeny is also so caused( but It Is probable that It deeds with a turnover disturbance or an Increase in disin tegration in the periphery. It was observed in the anamnese that three patients re ported recidivisic pain in the left upper abdoaen and one patient reported pain in the right upper abdomen and a feel ing of fullness, as earlier diseases of "Leber and Milz," yet long-time intake of medicines or extreme alcoholism were not * discerned. However, three patients without the scleroderalike 6kin condition and acroosteolysis> had record histories pointing to a chronic liver ailment (Esophagus varices bleed ing,- splenoral anastomosis;portal hypertonus; esophagus varices, splenomegaly*) The brorosulfaline retention was % clearly increased, but by comparison the values for serumtransaminase and-phospbates were for the most part nothing out of the ordinary. This discrepancy could also be proven in the other ten patients. Four patients had esophagus varices, and In twelve cases splenomegaly was proven scintallgrapbically. The laparoscopic and liver biopsy results of five patients, which were available to us at the end of 1972, showed remarkable agreement: surface area of the liver clearly or finely waved, capsule fibrosis, increased bloodand lymph-vessels, histologicaly a slight to clear fibrosis of the portal system and indifidual cell necrosis, and slight coarse fat droplets. The result, that we could further ver ify at this time let us express the following theory: Except 21090014 BFG09269 7 for the slightly toxic alterations of the liver cells, this results fron the expanuion of the connective tissues in the ' portal system into the diffuse circulation in the liver. In advanced stages this leads to an interhepatic block (most like ly because of the hlnderanees in the height of the portal system, possibly similar to a sinusoidal block), with esophagus varices. It remains to be found if the splenomegaly is only is a secondary condition or if this primarily the direct result . of toxic changes. Of nine patients examined in the lung functions (anamnese, x-rayc, .spirometry, entire body plethysmography, and blood gas analysis) after references pointed to mainly restrictive alterations, eight of these patients showed partial insuffi- % ciencies. Further research must be undertaken to determine if these disturbances can be. traced back to the fact that similar changes occur in the lungs as in the collagen and elastic supporting tissues of the skin, that is, that a beginning diffuse lung fibrosis is the cause of these disturbanees. The Initiating Factor . - This paper is concerned with an industry-caused disease, in rbich the symptoms Include (arranged in order of most common occurrence) tbrembopeny, splenomegaly, toxic liver damage, ventilation blockage, circulation obstruction, and skin and ' bone alteration. This complex of symptoms has not yet been 21090015 BFG09270 i 8 been assigned to a known syndrome. It Is unexplained etioi- ogically and pathogenlcally. _ Is It possible to obtain a certain insight in the etiology and pathogenesis by a comparison of our results with those previously recorded l.n literature? What is then possible to be the initiating factor? It a simultaneous pressure and temperature increase, liquid vinylchloride is polymerized to polyvinylchloride with the addition of water and various additives, depending upon the different properties desired. In different countries, Independent of the additive type, the Raynaud syndrome and acroosteolysis was present in workers cleaning autoclaves. The symptoms appear so characteristic that it lead in the past year to the disease designation of "occupationally- conditioned acroosteolysis" and was advanced to a diagnosis position (28). It is not assumed that the additives, differ ing by type, country of production and methods, play an import ant role, but the harmful combination of these with the vinyl- phloride can not be completely excluded. Therefore vinyl- chloride, the substance present in the largest amount, be comes the main point of our interests. The monomer vinyl- chloride is pumped over a closed system of an autoclave. The exit possibilities of the gas - and thus the' Inhalation possibilities - consist then in more places within the pro duction procecs: m 1. Permeability of the autoclaves (intake and offtake) // 0 21090016 BFG09271 9 during polymerization and recovery processes. well2. In the discharging and opening of the autoclaves as as in the drying process of the finished polyvinylchloride. The residual gas consists of up to S&& vinylchloride (6) and often leads to leaden tiredness and short-lasting disorientation 'in the employees. 3. From the polymer precipitation on the walls of the kettles. Therefore, from the technical viewpoint. It is completely possible that vinylchloride initiates the hereby described disease. Some facts are already known about the effect of vinylchloride on human anc* animal organisms. The narcotic effects have long been recognized (22). Since 1958, reports have re peatedly been cade concerning the angioneurotic obstructions and the Foynnud syadreso in workers (1, 10, 21). XU the literature one finds single references to the intoxication of vinylchloride, wherein a reversible dizziness, light to very noticeable giddiness, disorientation, skin appearing as a* . a 2-degree burn, and lessened blood coagulation have been determined symptoms (6, 9, 11). One worker died as a re sult of poisoning. With the use of experiments involving animals, lung oden, blood congestion in the lung^ liver, and kidneys, as well as decreasing blood coagulation could be proven (20). In long term experiments it was possible to produce centrolobular degeneration in the liver and necrosis with foamy / vacuolization as well as periportal cellular infiltration (26). i BFG09272 V 21090017 10 Recently, reports were node concerning skin, lung, and bone tumors and obstructions in the bone' structure (27) These results, based on animal experiments, lead again in 1970 to a depression of the MAX (maximum occupation concentration) to 100 ppm (13). It is not yet known to us the regulations concerning gas concentrations at the occupational site. The symptoms related in the framework of this disease (Raynaud syndrome, toxic liver changes, obstruction in the . bone compositions and prenarcotic syndrome) may then be pro duced by vinylchloride. Thus, in the`knowledge of the occu pational site we can express the conjecture that long term exposure to vinylchloride is at least a, if not even the disease-initiating factor. The fact that the name "occu pationally-caused acroosteolysis" hints only at a not necessarily determining symptom shows that a new name should .be coined. V/e have proposed the designation "so-called Vinylchloride disease" for this syndrome because this disease, influenced by the participation of numerous organs, obtains the character of a system disease. Pathogenesis The pathogenesis is, as before, unexplained. On the basis of our research we discussed the theory that the disease as a pathogenetic principle in the furthest sense is caused by an obstruction on the connective tissue' or the vessel * * connective tissue. In addition, as our theory shows that the toxic agent is effective not only per lnhalatloncm, but v JL030018 BFG09273 V. ' 11 aleo perkutan, the fact exists that only uncovered main arteries exhibit scleroderma-like coatings and that the band-like os teolysis is only found on the finger phalanges. We saw sclerOderaa-like rirfn alterations as well as acroosteolytosis only In workers who had worked a long period with the cleaning of autoclaves. This can perhaps be explained by the fact that 600-1000 ppa of vinylchloride could be measured in the area of the autoclave walls (5). As an indication based upon the obstruction of the connective tissues, we saw the qualitative and quantitative alterations' of the skin and the multipli cation of collagenic fibers in the portal system of the liver. The increase and expansion of the capillaries was visible by capillary microscopy and histology in the upper cutis, in addition to the peripheral circulation obstruction proved clinically, angiographically, and tbcroographically. Even the alteration of the bone (osteolysis as a result of trophic obstruction by damage to the vasa nutricia) and the lung (restrictive and obstrictive ventilation blockage) can be *synonomously explained. The prognosis of the disease judged quite optimistically by earlier literature-appears quite serious to us, especially with, respect to thrombopeny, `splenomegaly, and portal hypertension. According to our observations of alterations in the bone, this disease should be judged with reserve. / Conseouences for the Practice The triassic formation of this disease system, serious 6T00C0T BFG09274 12 prognosis end relatively high mortality (iron our investigation certainly nore than 10JS) has led prevailingly youn men to sol icit us to place the following suggestions: 1* Execution of epidemologic and preventative medical experi mental tests. In our opinion, it is not sufficient any more to search for only Raynaud syndromes and knotty skin alter* ations because these symptoms , as characteristic as they are, already show the advanced stage of disease. Perhaps more ( . important, controls to determine the thrombozytic count in regular tine periods should be given to all employees of PVC- producing industries. . This should take workers with a con stant throabopeny out of this branch of the Indus cry, as this appears to be the first objective symptom, before further and more serious internal damage occurs. 2. ITo employment given to those with liver diseases or circu latory problems. 3. Regular gas concentration measurements in different work sites to avoid exceeding the MAK limit. Experienced tech nical improvement with the goal of greatest possible automation, andimprovement of the ventilation conditions to reduce the possibilities of gas inhalation to the lowest amount possible. If. Compensation to diseased workers and recognition of this disease as liable to indemnity by inclusion in the list of BKVO. 5* More research, especially with animals, using vinylchloride with special consideration to the skin, bones, lungs, liver, and Bpleon* -I 02006012 t<r; ar 'T.'A-J--'IVl!. I BFG09275 V 13 bibliography i 14 littniux. p) iUrW'tfV*. I- M. Own. L Ww- llAalitiwL fmJwankwAw dm lam dm K*<JIAt4>VfM(ii(, St. Mil (%'(ln*Wi Verbs lM(|t C. V. &WII' Ijyaitrf b A* wda*u yiliclmm dr Me4. MifiM |4*4 II M|. 411. Q) liulNt, A.T.A.K. V*iin. A. C- bAdlnr. 0 ikt |Mkn|(PM f AMfH <M M 4 bc> tf o^tnic A Htitf *J fl> jjarirfi 64 7*. fni.ltM. 14 0*0. *t pi Cfcmfih, A-. F. HanlUm? IM <*K.1 M iwImiMtl! 1 n 4m ***alk m Fr*o. J. AMnL UjwI,4I (IS0U277. H) Cm4mi J. IL, C. Rrm. M. J. lilim, Irwin: Acammafraa n mam uwcirfi din dsmx wMfi furies ta Mmriff dam. CiU AlmL Tmiil 4 (iftf). 1. P) CmI, v. A., r. M. Cirrrf, I. p. Pdaim A i. Mipnttw OcnfiiNMil 'fail. Jt A* (dinirul kf|pfM rady. Ani. iiifiiwia. Hlfli 21 0)71), >4. |B DiaiV. H-j AuMwitl poimniai I; a>l A'aiiJt. Cawi. mi A*wc l.2r^bt2k PI Mama*. A. tL, V. A. Cask. W, M. IViifUtitc. H. L Otnpimul a%tmt*tsoi, w, I. Aw tp4caiklofoil wtdy. Afdi. cwiiwm. Ktik-22 (U7I|, <L 0) Mim, V. W-. . P. Din**u, V. M. YkhtHaam, A. N. M. Na/. K J. UiFunMt OetWMti**il ki*^ Ifl. A dames* wady. Ards, cnatioam. HI* 22 M. 0) Owtiti*. 1_ X J. Vane? Octvp*. mil buitli lad iuimwri Kma JdEmm Ka. SC 0)37?. Na. 41 (1>4U. VAX Df<. UUr, man mi ||J) JirKr. S, C. Vetimnu Zuf KSamk lev u*. VnykfAnaJXrrn^.e* L Imam MiMiiln lioyrnw 4*9 lafciiaa 4*1 dflMdta Mihm, 2?. a. IT71 (Ml M? X C4. liAfr; &**?irwii inift Miwfrti*dwtf|r; lifiil fbrudm*M4catnFdVACk+aYatnMmttiacUndnaaaaInHAnmn. PnJL ad. VaA/. 17 |in_ Mil ITT) )wh* X. C-X Uh*. C. Saia, 6. Vtkmaai Zaf UaA dm aa* Viayti ditaiAKrMbWiL )Ama<ir.t Dwadx CtwtiK&afc (* AibtUarUsa, 24.td.t97Z. (It) Uat*. C/L L Jake. C, Sana. CK.fMVtUlunRiu-:iOmn bmr|.wVliibs IiA.ilfafnIdfiim rtlriMc.' bu. Aid. AikiwaX n Crack. 091 Uacc, C.X. S. Jill*. H. J. Mam crrjlrr, A. Metier. C. Vtfcrsam Uba acbidm >a tibaca dcr (. Vmyti dlonAKnnUick. J*bimir*a| Deal* dm CncUactiab (** ArUawudua It. i. 1972. CD) ManaaMin. A. M. Ftiktv, M. CKratic. H. Osatitcr; Am Ma* Unk MBtnrp a/ myl Atirir aa Itbf4r mattk. Anar, afatf. Hn- Aa. J. 21 fl9*0j JM; |MII iai Malm*. X L* X X Zitbsia M4> Iniittriii T*wkvlfr 114 uraiarp in in* raJwM* im ( rudo (lUmcn Amsterdam 1944). 6!) OXeftH?, A. Li A arw accnp nia it disrate it km, /. accay. Mai U (19701. ZI4. (223 Implti, A. S., C O. take TW naaiknk acinm af nlf dtiidc. J. fkinucal np. Tk. at 224. (2K Vim, CN S. Jiik, OX Lnd. C. Vfltma*.' Oficalytta ns dca ladpkalaatca dn Hia^Utitfil. hiadi. IUai|iMi(. lit (U7)|, 40. 09) Fflataaa, V.S.L). tsbkfcanava. L S. CraaWr|: Hyp*** mkriMi a die pikieat f nt*l dtifidc. Ci#. Tf. f*mi> ZaM 1 (MM), Is smart in KM* Hcatifc tnpn. Akm. 40 (1940) Km 4*0.4. pi) Karrta. P. Li Halih paWcm in Pa filM)li(WR and m ai rtima. One.J. Mam; Mad. 10 (1911). 2)1: par* m: MiLca. C.L.U ZitAak M4> Inda-trul TaatinUfy * 0**am 4of> ia ik 9mdaa *? fiwwai af ttiiM ((lam*) Aaawiia MM|, HI (U| Hank, P.Z.V.C. F. Alim: Ana aitialem a*aan*nt *n mm cft*taml la d fwlyi*Mr.MMHi at *myl AlmJi. *. add. ). IMT.J. 70. pjj HffttAIn, M. (Hng It CtaaA ImndULAt AikinihMlt. T.tAAa |iaA>irWnadandt 4rffa**v| vaa MUA'mu (Vtdaf CMaa: Man* b* 1970, 04 Iraki Ha hiipkn OadUa taepkianMi*ara ia I;u|d dr1 Mdm 04) Srcia, Gm S. Jtika. XX Laaft. G. V*kmam Skckmcriadanaifta M da* aaf. VajIdtinJiKiMkaai. kaM|nyrm, in Dad. linSariu. LJ. Dninm. M. ViUikw Cntaktii U madia! mNlnnwtir fradam da iluam tit mad. Mad. mmi ltm*4 U (t)Oi. NT. CB TmUUna, T. K_ F. Oyaa. V. X ta*n Tha d amyl Ati*dt a tlnttmmtl by tryaamd tipma ta likffiMfr tatjia Amar. odaatr. Hit. Ait. 1. Zl 11941). 2)9; tat mi Mtteca, K. 1.. X L. ZrOivh UJ li Matriil Twakala^ and Dtmmatip in At Fradwbtaatk d P^mi| mi lUrna (llmar. Aamdra 19*4). Oft Vwb, 7. L.A i<am. A. Cimai Oa.*tma mprrn a# ti ika. tia|, ad tian a* *mH mlar^Jn. Camay An. J* (IMI),4IA UB *tiM. MXrmak, C F.Tatvm, J. L. Cxtd; Ocawtnmnp 1m19w0,m77r7lf.ia, y Aaw mad. Ad 201 Dt. Suunne liiVe. Dr. OL Lance, Dr. C. Stria, hot. Or. C. Vrtiinan SS Doan I, Vnufbrrf 4 I .t t BFG09276 21090021 snsi CXrmicol Aftrwcta vd 79. \m -j* hi intracellular media in all pevwm* undei ~tody. Irf C level ia r-sas. GuMavirou, 1C. A. G. (Aktiebnlmg Banco \Vi.*s.:. * 4, 9lMl |tUvm dnreiwd with act. Tbe K level . *utrarcllular Sv 4. 332.817 (Cl. B Old), 13 Jan 1973. Appl. VtTjf7. ir. ,\*ay media inmavt) with act, that .n inter** iuUr Lp ia* ;erth 1271: 4 pp. TH a--. eorf-t* --Verp^m. e-/-- . . rally Cimsl. These findings scree with i!.** Ineraiutc t!-*:a *4 tbe aiwUuiU mi at ita a ule Am l occupational ilrr*es at in tins OH hicb atm. air temp., above tbe aboebrnt surface and through wbicl* t* . nie, vibrations and industrial du*t on electrolyKte, Smlfef>tawlle4ri\fm. from I lie bottom rartying drops bnruen: *v *.e top 1 th c'nlt.ota.aeirrulau..c line fr#:n the t.prj tUt^i.Atinin b * Vi 23182f Importance of polonium-210 delerminaboa ia tho lut returning xpd. bve bent i* ti*e tott^i*. and a mil; Pa i:c 1 u. print of workers in uranium mines. Panov, !>.; IVitovic. D.; the circulation line for grinning fn iNvcbtn.. Novak, L.: Djnrdjrvic, V. (In*t. Labor Med. Radiol. hu., I. G. Zewi Belgrade. Yugoslavia). Swr'h*. J/rrf. 1972. Y3MI) f-1P 21191b Determination of m?br;moaatt of some suorncci (Dutg). A study nl 1V9 workers in the uranium 4 Va<w- ia ait. 'Jaavr. G Swr'aov* . .; lihp^va, *2. A. alavia who were exposed to Kn at well at rats living under the U S S R. 366,%J9 i CL C a* fu. 1973. Appl. 2-* hep 197*.. tame conditions shuwed that it is not possible to del. the con From tJtkrytiy*, Jsafirer.. rtun Trth lt7* tamination by Kn and its degradation products by testing the .%47), *4. ' The aralyted sample * ai; was t-tvv *r-o*.gh urine for **Po. No correlation eaists between tbe cones, of MPo entrainment vpiRiirv ti'led *rifc a fine-erained itwvtast iiur * hi the urine and the concn. of Kn in the work environment. wilisri to com. tL-* %*** e> hrmi inai.-'scd :*.l i*. . J. J. P*hl Lc4ii;:d3nd blnwicg u*e f-u-1. ->u! r wiv. .i*.? c. . 23183g Hand tremor induced by industrial exposure to in* t):* g^vanalyaer for further di`* . 4^.1'et'.rdin>*. .+ organic mercury. Wood* Ronald \V.. Weiss. Ana B.; Weiss* acuTaty of anal., air was p^r-.U *.ag t it.*, Bernard (Sch. Med. Dent., Untv. KmhfUcr, Rochester. N. V.). mbstances. During subsequent be2tir.g, air br*. .** j--, Arfk. nraa. Health 1973, 2ii(5). 249-32 (Eat). Hand tremor for supplying tbe substances into the us anatY -er. in 2 subjects with industrial Hg exposure decreased after cessation 23192) Test tube for carbon dioxide aew>:atat. At*c~- of exposure and the subjects became asymptomatic after 3J5 gcwllsclsaft GjoAs.IL Ger. OJfca. 2,131.693 (C-. G <Ie. A;r months. The extent of hand tremor wa* evaluated by requiring 1973, AppJ. P 21 31 333-H, 13 Oct 1971; 3 pp. Th- i-n.rartn: the subjects to maintain a force of li>*40 g with tbe forefinger mi a range of COi test tubes, useful for automotive cfhau : ^ cs, linger trough attached to a strain gauge. I*r.4urmance improved extended by an AlsO*'>supp'/s!ed KOH prelaycr. 1 ur. Uvr w.. after the subjects were removed from Hg ceposure. .made by drying in vocuo at 1U)* a mist, contg. Al ls. 2 Raymond Zehnpfennig mmllOOsandKOHtJhr KOJ1 in 7?m! H0) latr! ..d - -ten- 231Mb Sanitary-hygienic appraisal of working conditions ing with llffi 1 cl. A -* n.:t bang bed ul tbi ca*% 10. during the welding of metal covered with p~"*ective coats. lTot- vol. % COiat :: rus 4t. *4 0.11. scnko.C. A.; Danilov, V. 1.; Timchcnko. A. X.; Xenanovich, 23193k Oxidation caUlyxer lor exhaust gasvi A. V.; Trubilko, v. 1,; SxvChenkov, V. A. rKhark*. Xauchmv ' Seito: Uchida, Sumio: Kori, Yeshiso; Kaw Isaled. Inst. Gig. Tr. Profsabol.* Kharkov, USSR), .irsaoml, Okamuto, Osamu (Hitachi Mku>eni Co., Ltd.. a. fCoa* Svtrko 1973, 20(2), 65-A (Russ). Air samplts were taken using 73 27,988 (Cl. 13(9)G11). 13 Apr PJ73. Appl. T: :.^4,12 A. a specially equipped welder's helmet an- analysed for dust, 1971; 3 pp. A'pcrovskitc-type A.Br.,MeO* .'A, alk. eart. phenol, CO, HT, acrolein, phthalic anhy ride, NO*. Mn, and metals; B, rare eaith metai>; Me. Ke group metals: v,0."WMM SiO|. Tests were run with and without general ventilation. oaidn. catalyzer for exhaust cuts from a ear oft chcm Weldings were both hand-operated and automatic on a 10-mra prepd. by heating the acetate mist, at 000* for 6 h". > .wdcr:u,. coated steel plate. Gas-cutting wa also cx~md. The coatings mixing with NH.HCOw pressing in a pipe-form, a::d heating at were a glypthalir (I) a - phcnoi-formaldchy le (II) and a poly 1200* for I hr to obtain a sinter of 83% poros*t** .i v-rkw * el' ethylene (III), in 23 thickness. The results arc compared even at 1000* (or lone periods and is not poisour i -j. 1 ' >N5 anc \ with the mas. permissible concns. I is tite 1< ut and III the most compds. objectionable II, with ZnO, is toxic. Oiaf Thomsen 23194m Adsorbent of prisarmis gases. ;*.vsr-. 23!SSj Hygienic certification of the huCdin; projects de- , Jtpxs. 73 27.939 fCi. I3(3:C:i2.. 13 Apr - .. 1 1 velopmeot, ami reconstruction of plants producing organochlorine 4% 60,973, 13 Aug 1971: 4 pp. N and S o<.des m cuh. j. . ::x. products. Levina. M. M.; Filatova, V. S.; Belaya, E. G.; absorbed on a spinel-type cxide cemtg. one or rz. re Ashirova. S. A.; Tikliomirov, Yu. P.; Levin,- A. L.; Mostin- metals, e.g. Cu, Ti, V, Cr, Mn, and Fc troupe a*t , .* * < skaya, R. Z.; Kusnctskit, B. . (Inst. Gig. Tr. Profsabol.* slk. earth metals on aetive carbon ac.1 dcsorbt r... Gorki, USSR). <7g. Sanit. 1973, (4), 80-7 (Russ). Certifica sola. " ; -rt: tion of building plans, ^development. and reconstructions of 2319Sn Device-for recycling exhaust gts ! : a .* *: : Slants manufg. PVC along with a favorable solution of sanitary* Cussoa. Charles (Pan American Chemical Cw Itu..? S. Afr.tu ygienic problems appear to depart from hygienic requisites. 72 01.635 (Q. C *01). 25 Oct 1972. Fr. Appl 71 l. *30. 09 Poor ventilation in plants manufg. vinyl chloride, poivchloro- 1971; C pp. The exhaust gases of a heat eagi*-e jr rtcj :led * prcnc, and trichloroethylene ts poor and does not conform to reduce the amt. of NO* in the final c.T.uent. 7hs t \- ..utt ga. r> ttds. Architectural modifications should be employed to effect arc recycled below the discharge for return ;o the va*s: * .he hygienic stds. John Howe Scott gases are passed into a caulyuc purirln. unit where tje v. . re 23 If6k Studies of combustion with a sludge burner. Wics- cycle of exhaust gases is varied with supply of fut* to tr.e rr...;ae. enberger, J. (Ccr.). Itcurr, Lnit Betr. 1973* 17(1). 24-C (Ctrl. Henry H. Gi: :n A 40 to 1300 kg /hr sludge burner burns combustible industrial 23196p Smoke abatement in the oesulfarUatiaa af iron. waste sludges with a min. of soot or CO. The sludsc is atomised Bractsch. Peter; Domalski, Willi: Echrcns, Alantrro . .ahl- tu the notxle by a stream of compressed air or steam and elec, wrrke Peine-Salxcitter A.-G.) Ger. Oflea. 2.150.905 >4 C fired. Tlit burner fires into a suitably insulated rr.uiT.e furnace 21<), 26 Apr 1973. Appl. P 21 30 963.9-24. 13 Ovt Is " ; , p. chamber from which combustion products may be removed for The development of moke in the desulfurixatio* * v.- Tim wj anal. Using a 100 kg/hr model burner, old crankcase oil and lac reduced by adding shda-cemrnt-fiuorite mixts v .. ?. V- 7***i quer solvent wasus were burned with a min. of snot or CO. Less Na metasiheate for fixation of the volatile \i.* : .:;k- h *! fUmmablc materials can be foully burned if other lUmmablc cmnpn. t*i the soda. A mixt. conu. xii 1*3, p.rtuiid vrn.rat i;h gases are used m place of rompresed air or steam. J. II. Lrfiin aml flineiu tl% was suitable U* the deblfuriaaiHM M l*e it 13T4-4(R)*. 23197q Removal of sulfur oxides from chimney gas. Ta 23187m Aircraft Emissions: Impact on Air Ovality end naka. Takuvhi; llAtlori, Jfiru>hi; Matxum<*t<i, Sfcin 'hakai Feasibility of Control (Ofiee of Air Programs AHTD-0757). Chemii-al Industry Co., Ltd.) Japan. Kokai 73 26 edC Cl. Urileti State* Environmental Protection Agency. Otlire of Air 13(U)F2),(J7 A.r li)73. Appl. 71 82.227. 13 Jul !t*7l. i . Program* (USKPA, Off. Air Programs: Research Triangle Park* in chimney gas are removed by passing, at Ilf ml min f* . u X.C.i 1972,60 pp. hr, through a .*unui of bh) g of 4^1 mm diam. fv'.-.-v cr u 23188a Air Pollution Aspects of Emission Sources: Pulp and SrCO*. which a;c prepd. by mixing SeCOi with b*' v* * Paper Industry. A Bibliography with Abstracts (Uaitad States diaiontacewua earth and pitch, molding, and ism;. Environmental Protection Agency Publication No. AP-131). The pellets are regenerated by treating with 20re N4 ' Untied Maw* Environmental I'roirriiun Agem-y, Air PoKutikM for J hr. Cil'Oi and lbiCU* are unuuble. K n Tolmidl Information Center fUSHI'A, Air htllut. Terh. in 23l98r Pottrslunr aulfate lecovenr la the snt.*i form Cent.. Krwanli TrtiU Park, K.C.). 1073. ItW pp, eul'ur dioxide-containing vain gsaea. Von ^ 23IN9p Air Pollution Translations: A BtUscrsshy With SlHbilh, lvi!wrl* fill ewe. Wolfaaoc 11** .It, I*. Abstracts. Vol. 3 ilfmfad hutst Environmental Protection Ger. Ofien. 2.147.427 iO II )*/ ..Marl Agency Publication Ho. AP-120*. l ulled btaiea liftvtrrmmenul 427.1. 23 Srp 1U7I; * t*t* wa * Pml*< ivm Agency, Information Service* Division (C.SEl'A, Air eonig. N, CO. ami Oh m.ti; -u .* *ith * .. Pollut. Tcth. Inlor. Cent: Kesaarrh ftisnik Park. N'.C.l. SO* by wuliini with a k>ll kCl i!r Jusi. i , 1973,230 pp. from a diaphragm ekvivotyt:* pla**t. Die K*?s*. 'tvim-rf r:. oountemirrent wa*!.mg |ir*r-- ii oxidised by an .e * < air at 3G-lUi*/3*24 atm and kO is *!J(I to the oxirtued vm.. . 23l90g Abaorbor for purifying sulfur dlotlda-eonf Ining 'flu# lower the soly. of KiRh. The KSO* ia filtered oil and the fit* I 21U9U022 BFG09277 h Pact 149 59--Air Pdlutmti. lad. //>*. VO. 79.1973 13*497 139494k Products of the thermal breakdow of expanded orcur, pwsabty tluring else next century, and will melt pJsr ire polystyrene. Inv^ivuk, K.C.: K.4uar, A. 1. (USSR}. Add*** ca|is. ilet'reasing the altwdo of (lie lurth*s surfote, sk*win< the m/. 1077. till). 11 -.* iUim). |%>|mwU*1 ;*4j'sljrrriw *4 lee j* r*ul.twNi of I lie ftVu.* nr.I t),e cyvlinr of nutrients de different type* a p\Ynljr.*n! at I'-Ik** .uni tie ptuliMK were trean-, increasing sen level, flwliiu* coastal |4.iins, ami imv-ev* naly/nl l*y a vrrt uniMtivr mrt)vl. Tlie xw|us ing we itliering fwuf-vs ami rlianring Unit animal and |ffont prndaKtta wouin !!. CO, CIL. CM I,. CtMt. CMb. CM I.. CMU. ertetysiefii* to lie ileuimeiit of human J. IVia 139491k Atmospheric releases from Tarapur. Ahraltam, P.; 13049Sra Nitrogen oxides, nuclear weapon testing. Coacorde, I'aittSiik, O.; l*oraioesv;tran. f. (llh:l#ha At. Res. (\nt., sad stratospheric oxoae. (4.lMitnh, I*.; Tul, A. I*.; ha<. hily, Imlia). /Wmr J, Jimri. an. JfmJth 1971, I.K.*t), I7l-M| J. SC; SnuiMtn*, 1C. L; Nvw**ei. K. I.. fMrtr**4. Off.. Anti* (ling). Tlie safeguard feature^ eneinevrv<l into tlie Tarapur At. aaeQ. Knd.). A\itmre 1973, 244IMIS), MS-AI (Knr). INfwrr Station. Imlia, to miiiiitiixe, eraitnJ, and ns*nit*r the The iviala. of NO, in the aiavk wave of e*pln*HiM< .ivard. with atm. pJIntanit from tlie station art (lecriM. Tlie Kmate the UMiut of nuclear rjpnm in tlir atm. o cjkil. ami ciMiifmrcd |eevileil Inr tbe eflluents from tlic stathet arc discus*el. The with that expected fnmi llie engine ebu<4 (VMliulk of tWrta y spectra of tlie efflocnfs are presculeil ami tbe r.idmoeiire of OnwflnJo. each flying in tlic Mra|iM*l*ere fiw >10 hr every isotopes are identifieil. Tbe nwjie constituents of the day of the rear. NO, injn'timt into the *trai**iliere from past waste are i<ntfl|<c of Xe and Kr. Data tut actual releases are aucirar f\|44iw are rqulr. to large ih*4. of fully operational given. Tlie mas. value of activity released is very murb less Cmranlea. Anal, of the Oi rrrnriU rrvealno drtecta14c cliangcs than (lie max. prrmi*il4e release. * the total atm. O* during awl after |eri*als of aim tear nr.i|m 130492m CcaccnDatigns of uranium in the air of a uranium lestme im|4yng that niavdvc NO, injections into tlic strata* refinery and in urine of the workers. Okalny-dti. II.; liiki. Sphere do not up*et tlie Oi layer. S. Heaverman i394Sftn Spectropboteractric determination of stnaD amounts of dimethyl sulfate in sir. Tomcryk, lUmiia; Itajerska. jud* visa |U>fidck Badam.Kn*wtjnwv Prrciu. Ilarwniknw, Meiers. Pol.). Ciena. Ansi. (Ilnrsav) 1071.1K(3>. .Ml-!) (Pol). MrSO was abonrlied ia pyridine. V-ntcthylpyriIiniuiii sulfate liralcd with OJ.Y NaOII. and the resulting ghitamualdchydc (1) was reacted with t*hXH st pll 51 to form 1 liani' whose absorbance M.; Watanabe, S.; llonro, S.; Surukt M. (Natl. !n*t. Katloal. Sri., OuIm, JapanI. Haifa ftmtsari 1977. 7tt), t.ad-5 (Japao)., U eonens. in tlie refinery air were U.G X 10 *M to 3.7 X U)"* and in the urine of the worker*. 3.9 X 10"* to 3.fi X 1*1"* g-V Tlie concn. in the air was lii^iwr than backgnmral by ac .^der of 2-4 nod that in tlie urine was higher Ilian that in t?*c general puMic. There Ittgh levels in tlie urine are due to ini.laiioo of higlKr concn*. of air borne U in th working cnvi/>*nmcnt. eras measured at 4.84 nm (rnolar absnrptiviiv :*.4 X 10*). The 139493a Work hygiene and effectiveness of health ifieasurrs method permits the deta. of 0.15 v(CH*)SU/l. of air with an in the manufacture of chlorinated terpeaes. Ass.in.va. S. A. error A. Jannwski (USSR). A*atuk. Tr. Jsninzrni, Gas. /rW. (.'iversh. Vrmrk+i 139497p Emission spectregrapbic determiaation of non- 1971. No. OH. 20-30 (Russ). Chlorinated trrpenes are wklriy homogeneity of laboratory samples of iadustri.d dusu. kiiintt, ured as insecticides. For agricultural purpose* apu*tk emulswei* Andrrej; Grajpel, Auilr/rj (I'uiv. Jaetellimslci. Cr:nvw, Pul.). of polychlr;iincnc (I) and fwdyrhheieampliene 111) are u*nl. Cheaa. Am*tl. JHornnr) 1971. ISO), ftU-M (l*n ). IHtst *ani|4c* Tltcy are toxic tojiumans, penetrating through res|nratii.n and were fused with K*SOi and C<hO (interna* stil.) ami esciteil in alinimtary mnsils'and skin. He max. pcrr.ri.dble iimcn. <4 oa a.c. arc; anal, lines stre: F`e I 7a. i .`134.5,1'b t ^HOJ, 1 and 11 in w*orking areas is 0.2 mg^m*. Ou::plieie. wpineiir. I. Si 1 2KS.2, Al I 30K.2. Ca f 3<W.4. Mg II 2*40.3. Mn I 27U.M, II, and Cl were detd. in 31K0 samples of factory air. For '.R^I Cr it I'M.!). Cu I 327.4, and Co i 30.H.7 nm. Xonlioniogeneiiy of tlie samjdes the conen. of 1 was 1.5-10 time* greater titan the was judged from tlic scattering of the relative intensity of tltc max. permissible concn. During 11 prodn. tlie max. permissible snail, lines of the elements and internal sld. Tbe method was concn. was exceeded 5> or fi-f4il. The skin penetration rate sed at ramlom to investigate. dusts Pur. the marten steel was high. The skin of employees in 3 factories was studied, smelting process. A. Janowski liy shift end. the ennen. on uncovered )>art of the skin and 139493q Exhaust emission of the Otto ergise duriag fcscck- csp. hoi^s was GU>-lb mg/dm:. The hignesi concn.. 2.te*l*f.> int combustion. Ebcrnn-ICberlwirst. Robcr*;<jT*ruden, 1 Hasan: mg/dma. was on tlie skin of opc^tcr* pouring tlie 11. Toe Schwarcbaucr. Gerd ilnst. Verbrenmingskmftmavh. Kraft* covered parts of skin had a concn. of O-0.4 n.g/Um*. Mnlical fahrwes., Tech. Hnchsch. Wien, Vienna, Austria). Erdeel examinations show that 1 /3 of the tested workers had nervous A'Me, Eritos, Peircrkrm. Brtnnst.-Ckrm. 1972. 25(12). 715-18 system changes and 2/3 had subirophic and atrophic rev, i:ai*cy (Gcr). Varying air: fuel rate, compression ratio or ignition organ cltangc*. J. Su^-iika advance produces engine knock and also influence exhaust emis 139494p Effects of asbestos on the pleurao. Le*ol>?e. K.; sions. Combustion temp, raises with knock as does the NO* emission. The hydrocarlion emission is lower with knock than normal, providing air: fuel rate or ignition changes have caused knock, but higher due to changes of the compression rate. The Hacenguc, A.; Legrand. M. (Cent. Pncumol., Hop Ucauirn. Clichy, Fr.). JVeur. Prtsse Med. 1973, 2*22), NP.-4 F"r*. * Thoracotomic and necroscnpic findings following e* > cre to mbexto* dust are described. The primary lesion. *la: Hyalin HCX% 11C1IO- sad Ofcmissions, ss well as odor, increase rapidly with knock intensity. Knock intensity 0-100 was measured with tlie standard knocknietcr in the ASTM-CFR-Test engine (MOZ). pleural plaque, devoid of clinical symptoms, MrSdotu contain* nny asbestos fiber. Later these plaques become calcifird nsd th; calcification continues even after termination of asbvtK exp'w sure. In 15-20 years same workers develop'd pachypleuritis. l!0489r Accurate measurement of cadmium ia airborne Benign recidiving exudative pleureia can be produced by jdeitiw KrticuUtes. Zdrojewski. A.; Ouickert, X.; Dubois, L. (Chem. v., Environ. I`rot. Serv., Ottawa; Out.), iat. J. Enrtron. lu/. Ckrm. 1971,2(4), .TIH1 (Kng). Tlie accurate and rapid measurement of Cd in airborne particulate* is dcscriiicd, with dust; this may develop intu mesothelioma, esp. with exposure to crocithilite. Geo. Sac 139495q Technical progrets in the chemical industfj tad industrial hygiene. Arkliipov, A. S.; Manitenku, Ft. N.; particular ref. to high*vol. air samples collected on glass fiber Filatova. V.S.; Ivgurov, Yu.L.; Novo^e!o>*a, T. I.: Martynova. filters. Tlie melius! inv<4ves the arid digestion of a part of A. I*. (Tsentr. In*t. Usoversh.. Moscow*. Giz *rr the filter followed by anal, using at. absorption |rtro*ropy. Prof. Zahol. 1973, (8), 1-5 (Kuwj. Tlie effective uventf equip Tlic use of both conventional flume at. alisorptMtu ami at. absorp ment, architectuod <le*ign, ventilation metlaaN. ^*te fc;"\v`:ng tion with a graphite furnace atomiser rn studied. Tlie Cd and final treatment, anil measurement siivl eliuu itim: .i fu:w*. delfts. were free of natrii error. Small interferenres by oilier gav. ami avrowd cmiwiuih art dcwribeil. H. Sir-** Vrc elements could le accurately taken into account. For a lytucnl 139496r Hygienic evaluation of working conditions in v-*aa sir sample of 2*X) m4. tlic OI amt. can he detd. with accuracy chemical plants operating an the open air. FiUtova. V. 2 down to -- 2 ng m*. I kin*. kkw this level are (nivmIiIc at the Vimtgrailuvsi. V. K.; Jladikirovu. L. S. (InH. f*ic. Tr. iTid- expense of tltc speed and simplicity of tlic method, "lie possi sabnl.. Gorki, USSR), fog. 7V. Pr*f. Zubd. 1973, >, H-ll bility of a turti-unifurm distribution of Cd on the expowd filter, (Kuss). Key trchnnl. equipment at 2 new Nil* anl vinyl tad the chance of actidcnial contamination of tlie filler or prepd, chlnrule plants were placed in the otirn air. Working c%**i Utions sm|4c by traces of Ci* rc sim di^uwil. and industrial hyglcuc ut Ueq plants are satMa'tory. 139490] Fossil fuel burning and carbon dioxide. Pessi E. Stroaitr; mistic view. l*ylko-ict. K. M. (USA). Camments Earth .Sri., , 139497s Changes In working conditions and health status Cnfijf. 1977. .*I<1). 1 .V 22 (Fin*). Freon .Viut. .Vi. Ahstr. of workers of oil refinerifs in connection with techoical progress. 1971, 28(3), .Vifgf. The impact of tlie combustion of (owil MukUameiova, G. M.; IHilyan^kii. V. A.; Aiikiawa, V. A.: fuels oa tlie CO, concn. in lie atm. and tlie iimuqurfRit fie MuMoeva, N. A.; CKtmvskaya. R. S.: Ilra^induya, L. L.* Earth eewsystems ore postulated. Tlie rate of fossil fuel con Makar'cva. I.. M.; Gaiioov, M. F\; Kmri'y.mova. A. T sumption increased an av. 4..Vj/yr during tlie |ut century (lost. Gig. I*i*isahul.# Ufa, USSR). Gig. Tr. W7J. causing n steady lioiFlup in atm. and eanic CO*. Mn-lunismi <M), 5-K (kttv). A nan|arative anal, evainn*. of w.<*ker a* by wltit h t'(*i is fctrv.ved Ifotit tlie aim. ami sea water hy srrlimrntary fh esses are reviewed. Uakns. ilww that 1y I nmR had t^lKel awl mwUil into I lie atm. '/ I ones the CfA removed by meanii snlimentary pvutvsses. wlm h are the l*b relinerivs ma.lv in HC7 <<0 ami IM7l 71 slum. ! C slaniRol Cav*ai4e duiirri m health (with a *evwe fnis-l up *. Id yr). Tlie uumlwr fw*rm with avtlwmc aiut nvura.-lwow syndromes, liypemwiu, unenua, lla.HiiUvyuqwnU. -*ul primarily Iwsynic. If COi levels in tlie aim. iwmimie to clumiic rrmiiu* greatly iloilunl. Smie fuiwlsoul vhaia* trtiv. inacose catasliophit warming of the surface of tlic earth will tics uf tlie liver im|irived. retsuns esaind. in liCiFri *4U Its! 4 BFG09278 k A/0: /sfi7 .,14. Xi BFG09279