Document EQMZG868oKM2eJmLMDpqOQO4
L Am Epidaaiolafical Study
Bertram D- Dimmmt, HD; Warren A. Coon Walter .If. Whitehouee HD; and Harold J. Magonoon, HD, Aon Arbor. Mich; and Theodore Uitehech, HD, Plumir, Aria
prWtary information m at manufacture, aoma m naadad to avaluato
tod with detail* snwp
do them might rotate to |faa
AOL. Accordingly, ilia
raiata' Amodatkm Induatrial Health (
tal and Induatrial Health aa of Jan L MV) to conduct an nddniihilinlfal arm rf ^
PVC induatiy in Ilia Uattad (Ma md
Canada to moat their it^aMMr to fe
worhma and the public.
the extant at the pooMtaa among PVC
aa By aatahltahlng a with AOL. it wm
the rtah of hnaftng AOL m wNNa tha
PVC praam. It wo*
AOL mina
amkf with the
synttwata etaga or it
Aiowtatatah.]
FMar, it ana hoped that tha epMmtae-
Y~* ~J ,
**1 rr i"' J,i "
hi PVC
la tha
at AfOLi
hr-
ftmhh
> to
In addHkm. it Arch Entire* Health--Vot a. Jm 1971
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020928
OCCUPATIONAL ACROOSTtOLYAIM--DINNAN IT At
RACI W I Other. :i*) '
_Sotf Sm#
(5-U) I
ASX______ SIX X t <l5=T*T (V)
Do let trite In Ihle lex Cere.
OSPT. *0.____ [18-1)
COMPAIY SZRVICX DAIS. ~KM> T (20-31) (
ARX YOU (RIOT) (LOT) HADDf (M)
to aiswb ns rottowxio qubsyiom , PUT A CXXOS AtOUBD YOU AISWB?. rOftXXAITUt MOUAY IS THXDAY ARD
sway (YXS) (D)
Bare you noticed SUDOIB whiteness. blanehlnf, er
paleness of the f Infers of year
non ham (YXS)
UR HAD (YXS)
(D) (D)
SD
Have you noticed a sudden redness er blueness ef
the f infers of your
RIOT HAD
UR HAD
If YOU HAYS I0T1CXD Alt OF THX ABOVX,
are these ehanfes broufht an by cold
(YXS) (D)
*8
1
(YXS) (YXS)
(D) dfV (0)
ar
HAYS YOU* HAIDS OR RIOTS SXH BOTHfltD
tin AIY OF TH1 YOUOtIK I
Tinf1inf er pins and needles
RIOT HAD
feelinf
UR HAD
tarn feelinf In hands er fInfers
RIOT HAD UR HAD
(YXS) (YXS)
(Yisr (YXS)
(W) av (IS)
(D) (D)
99
Cold feelinf la hands er flasers
RIOT HAD UR HAD
(YXS) (YXS)
(D) (D)
SO
lunbness, fInfers fall asleep
RIOT HAD UR HAD
(YXS) (YXS)
(D) (D)
SI
Stiffness, fullness, ertlfhtness XIOHT HAD
ef fInfers
UR HAD
(YXS) (YXS)
(D) (SO)
S3
peln et finsertips
UR HAD (YXS) (10)
Arth fjwvxM HnttA--Vol St. Jtm 1971
OCCUPATIONAL ACBOOgTtOLYSIS--MNMAN IT AL
Neva ran not lead ear of Um following changes of lha akin of
iroorbands, wrists, wramst
Thlekaaing of the skin
*(YIS) (10)
54
If r*. is it on (MAIDS) (MISTS) (AMS)
Mite, raised patobos of akin
*(YBS) (gQ)
30
It ywa. is it on (MMDS| tm**i (AMS)
M&tiShglMlM If rM, is it
*(TBS) (SO)
38
(HUM) (MISTS) (ASMS)
Miar skin patches
*(T1S) (MO)
57
If 70S. is it on (HAMD5) (MISTS) (ASMS)
Snail, raised arsas, or lungs
loss than 1/S iaob around
*(Y1S) (MO)
38
(MOT Inaludingwarts)
If ros. is it on (HAIDS) (MISTS) (ASMS)
Haws rott boon bothered br base fingornail troublast
Pita ar soars af tba fingarnails
(YXS) (MO)
tldgas ar araaking af tba fingarnails (TBS) (MO)
Mawa ran usad band-bald powor tools or air-driven tools at work in tba post six roars t
(BAHT) (OMCZAMK) (USS IMAM OMCX A MR) (MX7M)
41
Mawa raa aver broken, fraaturad, or
crushed aflngerf (TBS) (MO)
If 70S* SOS it tba
(RIGHT)
48 or (LI7T) band?
Mieb finger was injured
(Tbunb) (Index) (Middle) (Ring) (Little)
(Tbunb) (Index) (Middle)
(Ring) (Little)
43
Arc* Emeitwm Hamttk--Vol It. Jm 1971
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020930
M OCCUPATIONAL ACftOO&TtOLYSIS--DINHAN CT AL
eolacted N^b <rf Mrtoi theOd with AOL be etudbd hi the citwkai feaeartfc unit of tho Uafventtp of Mkftdpm Madical Cbkr.i ftoeioMfy, Rom* nd no amino*
if*
WnmOMfiMiofinubr AkMMm
A mow d^dtho dntiiiilinn of tho proe-
and oonpomSbd h reported dmAm b tMi im* A Mrf mfimar tteopmtfmiB
I* af tho
lo *o PVC
In order to determine the reliability of
logionJ putma a pilot mm wao carried oat at ana largo plant Following thia, minor
amp
non. Since tho lattar would b* aipactad to omr |p tirfrequrndy in a population not at rak of dcmlopim AOL, it could bo and m a prfcne Jndfcutor of tho exbtaam of AOL.
ha*lag AOL and tho other not having it Canporioon af prevalence of drfecta wMh
tho Iknah control population of 1407 mm niggimd that aO deiecte uoiarad in tho PVC population with a gnator fraqumey than hi tho control population (Tahlo 1). iwmiiii wv i|iiiiiim-- w nmiif riwided by an imaeoidabia biaa which minimined tho value of the TOcvaaeh population n a control group, it, idmtiflcatiou narha wiwi <pmq not m iMuy oorana m
IMH V W UUDIftM QBB*
Furthermore, ae h apparent from praviouo dkctmiom of the u*y flhn otmnnaliUn linear radiolucmt defects could bo nwifined with old trauma, tho ahomeo of a tuft might
Arth Ekiatoh Health--Vol n. Jm 1971
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020931
OCCUPATIONAL ACROOSTCOLYSIS--DINItAN ST AL
reported to occur hi eonjmction with AOL* thoaa x-ray 81b afcnormalhfae tanotetad to AOL wura grooved aa dated It
Containing (ho z-aay 8k tedhp and Rayaand't, aaaeaal dtognoatie criteria wen aat^ (Ttebio S). The iWagnnaHc oitorte ter
worteen while category 1 indadad todhridte-
wen lomd to be eonaialaat with dd traone, dfaaaaa other than AOL* wngonltol or temflial defects, etc. Thehtetocy of pcimns in
ria far AOL. Category 4 <
Ote hv tti Mditf mb ha Victte Mtoi am known to be aaaoctoled with the totor atagw of AOL tort am not to
ray ftoi Wtap todudad adaroete of tha phalanges (daiad 7), widmtag of tha tuft (dated 8) or ot tha d^t (dated 9), and aoft-tjmpe chrihtog (dated 10). Finally, tw loohad with auaptoiou upon any hraty dateda invcfvfaw mdttela team naardaaa of whatfaar they wan AOL-^wdfle (to, defects
2 to 6).
In addition to thoaa defects previously
that though not rMagntwtir. x-ray flaw far AOL. Category 5 faadndad thoaa with daadral AOL x-ray itea dateda (2 to 5 and 1,8,
n----O- 7 WIB-W----SMM W>imAt-ftM. w-- x - w -tm- ptcttoaty) and Raynaud1* phmnaimna Category 8 had typteal AOL bona afcnoriaaBtias (aa diagnaaad to categnry S) tori '"Murat Raynaud-podthw rapUae to tha aaadicol
--Madirai and work ray ihn raporta nan. They wi pundwd, and atorad in pular. Quality oontral dwtfctog of tha carda, aatog a 28% ror of 0.1% among throa canto
-
An* Enriro* Hroltk--Vol !?. Jon 1971
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020932
OCCUPATIONAL ACNOO8TMOLY8I8--DINMAN ST AL
at to ftinHw At of to job totoiMdi
hr "
l/U ""
> in varteoo Jote dtotag to yrm, it wm to an too tostfaa of iftta
wtare hio taQjr or awfefcr mk wo dtodad hotawn tae or non jota. Itoa, If a to opto am half to too pototo* oaa to-
of 6/13 m tapad to am nmtofd*>2
atoflted to to < toUtototyof
Stofl.*'"* ^
title far tot too ported ao oorigHBto Tho itoofaing 80%. or 0/13. of hte too woo itortotod ovwr m or ohm
of otagnment By tfak aotod, job apori-
Artk Imww Hmttk W 0, Jtei 071
of 6,011 wortaro, of
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020933
OCCUPATIONAL ACROOttTSOLYSIS--DINMAN XT AL
which 96.4% wweerne aawnn;: 96.7% mk white, 4.1%
Ttete Itei.n . inn m
>wa
Napra, mi 02% odar. The
IW-ex-Ctey: >mr>n
Ipenteawef Detect femnwia nte
with the median and nodd
ran* bring 36 to 99 years. Thme worker! hr env pkyadby ttoarpontiomat 32 ptenta in the United Stetee and Canute; of the 32 pirnSe, all but
wuaaoi laaeeareeio
t -- -- -- -- -- -- -- -- -- --
t ------------ t - - - - t t i j i|
+ +++++++++ + 4- + + +E +
eWnMHWNMMMUMKMun
Thie
in PVC eynthaew. TSnTi
92% of the PVC
i huhntry in thie
The popcdetiori at
rwk a total of
21,510 i
n lor attri-
pUed our
criteria
for AOL (in x-ray Ifan de-
fecte 2 to 6 pfcn Raynaud'.
a). UUag thie
raceme aWi cmaertMX
1 eWnCi me euMSaneH* MX
irecemsmUMHiMOt
tetert. cemamnrtra etec
Tam
i^rs
eio IJ71
ur MU
e>t * 4t t a>
l.eee 41 t aa a
N) 14 a 0 0 ueai r a 0 0
M4 a 1 0 0 MU 74 ie aa a
wv found that the
cnw of AOL WOT BHO 10 KOTI PUN.
t QM.rtl.iuCite **. iw Sije.M !'. eCuiwmciioft. t inn dwr.rt.rWCk al MX, eWi SayiwoO'. pCwiwwwnow.
I X-ny. cJwracWrlate al MX, acuwvt Raynaud'. pCwnenwnon al time at
Urine dime mme dtagncetic criteria (Tbfale 3). we detected at 21 ptenta which bad all
r pan but without Raynaud's phenomenon at time hi cate- of survey). We detenniwad by follow-up that
fonrOanc L or lew than a total of two huh- of thaao three worfcara. two had manlfcated
viduak hi
3 (Raynaud's Raynoud's phencmanon during the 196ffs
t) or dUpmartn otagoty prior to any praexpoeure. The third sublet
4 ("AOL questionable" x-ray 6hn without RaynaMfo) at both. Tb dstwmhw whether
than hub a rtek of developing AOL among tnOH WOnittf WOT M
a re-x-rayed subsequent to the i
iatic of AOL: Raynaud's i
'.In view of this **!
etiacted for further a
a third popu- that 24 of 26 workers with eevere AOL-type
by the Ave pfawta
6hn defecte had --nriated Raynauife
cjcciuteveiy with
we believe it is appropriate to
the flnUwd PVC-ptududag teft
pood- Huh theee two afaberettons in order daflnitively to dtegnoae AOL. Thus, wing aa
ridual ptenta hi which ttwre raowiiwd a our criteria Raynaud's
qumtkm of AOL's rxtetenm. Urn dtetribu- Anger defects qualified aa above or both, 26
tkm of dtegnootlc mteporteo among
found to have dearly aeUbiiahed
four population* appears in Table 4. The reason far requiring the
of AOL.
of x-ray Abu abnormality and Raynaud'i
phenouwion to retehllrii the iMagnorie of AOL bocomm apparent t
of the three individuate in
__ _____
ry 5 (ie, x-ray Alma characteristic of AOL the msnfaer of
dete mined hi each of the four
Arch Emtiram HfltA--Vat ft. torn I$71
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020934
68 TM
OCCUPATIONAL ACROO67EOLY8I8-0INUAN ET AL Wlwi to to to to AOL
Planta w*h CAHl Of AOL
Pllhti toUtOut C*W* o< MX
Plant* with UOtt>OflW9 cai*a of AOt
Plant* compoundiqg only
Ma. _% WsW* ' '"J " 41 2.S0 1JU 1* ate 2J**
Tom 1 ,*23 2413
14 1.70 S17 SSI I an 4SS 4SS
i i i i i i i i i i ft:
TstosCrarisesft Asm
rto of
AOCt k
Pasuisbew Rons* 25-44 4)43 9120 121 1*0 ltl-220 221-200 201 140 141 400 401-440 4*1 -MO
r-o.oi.
Raynaud'*. < dtMtflf or txnh.
d. t* <
. abNa mdi braufM an by band ar bady
-/
I 2I \3 3'* where is die n
ahMendphtoe!
of population toe of i
plant iroup* having ana, ton, Am. ate,
through do positive rrspon-- to questions
concerning rig to symptoms. A graphioal
reprmrntotion of tto frequency with whidt
respondents noted bilateral hand tt**"*
in those plants where AOL was believed to
occur and in those free of AOL is provided
in the Figure.
Tto one-tailed Kofanogorov-ftnifnov (K-
S) totesenple test* waa applied to the too
distributions. Tto
ed to tto
AOL-free plant group (see above). Tto
tribution of positive signs and symptoms
were found similar in both groups. Aooord- ______ , wa formd, by the urn of____
ingly, for tto "AOL-free** papulation in tto anefrto** that tide peripheral vascular dieor-
Figure, we have included tto sarplujsss of <to was signiicantly ratotod to AOL Ttot the compounding plants. On tto basis of is, those qmstiano which sppnsr to to esmaffirmative responses concerning the pres sietsntiy anewmad positively m a gronp mm-
ence of any symptoms, this test indicated mituts a dutosr of symptoms or a Into, to
thet these two distributions did not stem from a common population pool < P < 0.001).
This K S teat indicates that tto frequency of occurrence of tto asymptonwtic state (is.
addition, each symptom is sasodatad with factors by kotos called "loadings,** whhh
weigh tto sssodstional strength of tto feetor to tto question at hand. Is, tto mem-
Ar*h Knriron Hntlth--Vol tl, Jrn It71
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020935
OCCUPATIONAL ACB0O6TEOLYSI8--UINMAN ST AL
CamtUtivt * of Fopvlotioo
'ofAOLT^MWtOgattnaW^oTtom (minHnwiiin fcSf*7
at <Mi
at riak <rf AOL
te lop.
nwt
ThO bgieolly laada to w waretoaHnw of
** relatha prevalence of Raynaufe pita-
iiwmww t tm vrtoua ptonl popidaUnn
RayuawTa
ia more frequently areoriatod
iMiiwl h i
Itobibiiit
AOL (/<001)
low* blow Dm "AOUrear piaoto wd
toe mminwilfcii Inwhnni (Ittb ). V
indeed the "AOUm" ptonto ininil a
popntoOoa at no OpiiWnt rito of frying
ing tola dtoowtea, one reltf* tator that Ray-
natafa phinn--io nay oeew anreag toe
Art* F.mnrom Hfmttk--Val , Am 1971
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OCCUPATIONAt ACftOOSTSOLYBIS--DlNMAN ST At
71
>t**W
atawawe a*rt*r cw^m twwwil*. 1*41 1444
f
(i. nenwer H*ewa s *na a> at am. as
Tattf Iirliri M n*k. fMcMr Mmline. 1.047
ToW
f88(lv
cWiina *W*Ubw. 1.042
la* 1 (anew 1447 M MOW
J|I. J..MMMT 1.002 40 Mrwi
74 1447
74 i.oea
1 41 1 44
(MpNkM|gMI,
. Mi n. 41
TMM Mn M.fM4. imUmUm**. 1447
TOO me Mrt tear. Dm at iWk, 4,711
(if+ion t
1 *47 * 17 '
(10+10t 1 .on -
4.711
I hi M
(7044*7 J_ 4.711 " 140'
TIM Ml MOT In WC
jl|yl*0iii. 71410
WrC*W*y
>4 I
71410 "eu'
cm* *w m*i> TVCMiir
Oy lOOII *i MW> 4*t-
t hm On yyUMiWr Mmm; 0* *Mn t* <HMtk uliirlii I MMf 4 ww* *
tornem Aiim mmtWhm:iOInnCMUr g4w*MWnltot I'lillMi1ll1ta*4r 44m*4mMMUiMcM*mm> } *****
nci
with AOL: only < ker or reactor
oo bog-
tag. Ri hoo o ftrao
with AOL. Ths i rahn of AOL of not
rfok (total populrthn at rhi. UM7) a tone all warfare having a faMoqr of and Job oaporfanco. Tot Job rotepnrioo forger than
500 man. tho pnvafonee rata ot AOL by Job wao greeted for begnr-paefcon (on* caat of AOL par 88 warfare at rick oat of a total population of 880) and factor oporaton (one am mr 80 at rhk out of a total
population of 808). On tho bade of aumontho at rid, the pnwlaw of dear-cut
AOL n even non etrQdngiy aawciafoj with raartor Haanon; thie Job had a ptwvakm rale of one oaaa pn 7tl aaimada at risk t12J84 total man-montha at riak).
Ainoni thoaa John reporting kQOO or more man-montha at riak. no other Job category approached thie prevalence rata
Tho quootfon might U ptente with AOL di8er*d tide dfcordor hi rw doty tom in mote not iadfcnto Dotnoih
Job. In addftfc to tho as
AOUtbeni
MV Ifoe might law npnund only or
minimal enaa of thfo (faonfcrUIovirw <rf
the x-ray flhna and medical guff
of the 74 men In diagnostic oefcjjry 8
Raynaud** pbnwmawu) mvaaMU men who might law been manlfling * eoriy
phoee or minimal degree of AOL Adw of
then men hod morghwi defect>. Vhout
whan pnaonce the rwllnlngieti cnuknnnl
agrea and two more had tuft and riaft, with aoft-
of the latter aubaequetiUy
dubbing
pie aatrolytie leakna). The other eight
Attk fmvM Hnltk--Vol ft, Jm 1971
XUM
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020938
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I 020941
OCCUPATIONAL ACHOOSTWOLY8I8--COOK KT AL
If
2
2
prmamie
at rte^dllorido
dmcribed by AJbritf*'-* wm tend to bo hi
cutrmt me Oim of Dm bieotvse the Me
tin of hydnmn <fctoride wife acetylne to
the prsnnee cl a meric ddoride eatolyeL
1
la the ether pianw, 1, 2-dfchloroeCheae ie pyndyaed la the jmanee rf chlorine ee a
catalyst for the prwrtortton of vinyl **A~**r
used, wHh the HO predated fa the letter at PhfrehpT CMiriii Pisdnriton Phly.
vinyl dtloride cm be pradaood la eeeerd-
variation among dtihraat pleats. Ttmtmi
inc frees 60,000 to IMMXn, dvadhg on condition uadm which it Ie pruAieod. Hie
and solvent A typical ed in the line dieet (Pig
paper. Per more complete iblilb nienwr may be made to the papers by Alright"
Are* Kmeirm Htmltk Vet jy. Jmm mi
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020943
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020946
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020948
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020952
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020954
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