Document G5rNKNvx8a54VVzQgNr0kDMJY

Harold J. Maom'sox, M,D. Director THE UNIVERSITY OF MICHIGAN INSTITUTE OF INDUSTRIAL HEALTH MEDICAL CENTER ANN ARBOR, MICHIGAN 48104 June 2, 1969 C. U. Dernehl, M.D. Union Carbide Corporation 270 Park Avenue New York, New York 10017 Dear Dr. Dernehl Attached is an errata sheet listing corrections to the MCA-IIH report on acroosteolysis which we sent you on April 1, 1969. Would you please attach this to your copy of the report. We are sorry for these typographical errors which escaped our proof reading. Sincerely yours HJMnnld ATT. UCC 100729 N. MCA Report Errata Sheet 1. Pg. 3, 2nd line also 4th line, 2nd paragraph: five years should be changed to six years. 2. Pg. 44, Table X: Asterisk beside Plant No. "V" should be deleted. Asterisk should be placed next to "plant No." designated "U" 3. Pg. 65, Table XX: Delete "1" under Diagnostic Category "4" for Corporation No. 4. Add "1" under Diagnostic Category "4" for Corporation No. 5. 4. Pg. 66, Table XXI: Delete "1" under Diagnostic Category No. 4. for Plant "K". Add "1" under Diagnostic Category No. 4 for Plant L. 5. Pg. 70, Table XXIV: Delete present table, insert new Table as follows: Table XXIV Distribution of Raynaud*s Phenomenon Between Plants with Probable, Possible and No Cases of AOL, Corrected For Male' Population Plants wit: AOL Plants without AOL Plants with ? AOL Plants Compd only Dx Cat. 3* Number % Total ' Male Pop. Dx Cat. 0-2* 41 2.5 1582 19 0.82 2294 14 1.7 817 1 9 0.23 438 *Includes males only Total* ' 1623 , 2308 830 .439 UCC 100730 . . Errata Sheet - MCA Report Page 2 .6 Table XXXII, Pg. 82, under "Job 19" first 3 lines should be deleted, and replaced as follows: Tt Total response per job 893 Total man-months per job Ratio, case/mos. Dx 5,6 13 , 21172 21171 1 1629 JT 7. Table XXXV, Pg. 85: First two columns on left in upper half of Table should be deleted, and replaced as follows: Diagnostic Category 5,6 Case/Man-Months Incidence^ 1/800 1 3 14 17 NB: Note this correction deletes job 19 from this column UCC 100731 PREFACE--LIMITATIONS OF THE STUDY This study was undertaken to determine the prevalence of acroosteolysis in the P.V.C. Industry and to identify those occupational exposures presenting a high risk of this disease. In interpreting the data that follows we would urge careful consideration of these cautions: i 1. The fact that a company or plant does not seem to have any cases of the disease at the time of the survey does not rule out the possibility that cases may develop subsequent to the study, 2. Some of the early manifestations of the disease, e.g., Raynaud's phenomenon, and some nonspecific x-ray changes, may occur in diseases other than acroosteolysis. Thus, the interpretation of this symptom complex or of nonspecific x-ray changes presents particular difficulty in determining the presence or absence of the disease in a particular plant, cf. Table XXII. 3- The over-all prevalence rate of acroosteolysis determined in the present study is sufficiently low that the apparent absence of the disease in certain small plants may not reflect a true absence of the disease or hazard, but simply reflects insufficient experience. Therefore, we strongly recommend that: (l) continuing medical surveil lance and, (2) measures directed toward minimization of hand cleaning of reac tors be undertaken in all plants regardless of presence or the apparent absence of cases of acroosteolysis. UCC 100732 PROPOSED AOL SURVEILLANCE 1. Sample one C-Autoclave per week to determine vinyl chloride concentration, 2. Sample one D-Autoclave per month, if available. 3. Take 3 samples per autoclave: (a) After preparation is complete - at entry. (b) 1 hour after cleaning has begun (C-Autoclaves only). (c) At termination of cleaning. 4. Collect samples in breathing zones when possible. 5. Analyze for vinyl chloride by vapor phase chromatography or other suitable method. 6. When 10 C-Autoclaves and 5 D-Autoclaves have been tested, stop sampling and: (a) Review all data. (b) Calculate mean levels of exposure. (c) Calculate exposure-time. (d) Adjust ventilation program to keep levels below 50 ppm vinyl chloride, or (e) Provide respiratory protection if (d) cannot be accomplished. 7. Any possible cases of AOL will be removed from exposure to monomer or resin. 8. Preplacement and pre-transfer exams will be performed before people begin a long term work assignment in vinylite area. This exam will include: (a) Hand x-rays (b) Medical history of (1) trauma to hands; (2) scleroderma; (3) Raynaud's disease; and (4) abnormal cold response. 9. Annual examination of (1) operators; (2) pipefitters; (3) machinists; (4) laborers; (5) riggers; and (6) salaried supervision who are assigned to monomer or poly merization areas. Exams to include all items in 8 above, plus other procedures which may be indicated. UCC 100733 10. In event of trauma to finger-tips of those employees under surveillance x-rays will be taken to up-date their file and keep a current picture of status of distal phalanges. 11. Other air sampling to be done as time permits: (a) General work areas and control rooms. (b) Tanks and vessels where slurry is stored, (c) Resin storage areas. (d) Bagging areas. 12. All employees working in autoclaves will wear non-porous gloves. 13. Document for files preparation procedures in use. UCC 100734