Document N2oj6ME0Rr54jXNVOn9wv9eLE
TOXICOLOGY AND APPLIED PHARMACOLOGY 44. 581-591 (1978)
Resolution of Dose-Response Toxicity Data for Chemicals Requiring Metabolic Activation: Example--Vinyl Chloride1
P. J. Gehring.: P. G. Watanabe.2 and C. N. Park2
Toxicology Research Laboraton'. Health and Environmental Research, and Physical Research Laboratory, Math Applications. Dow Chemical USA., Midland. Michigan 48640
Receaea August 30, 1977; accented November 4. 1977
Resolution of Dose-Response Toxicuv Data for Chemicals Requiring Metabolic Activation: Example--Vmyl Chloride. Gehring. P. J., Watanabe. P. G., and Park. C. N. (1978).
Toxicol. Appl. Pharmacol. 44, 581-591. The toxicity of many chemicals results from
biotransformation products formed from the chemical rather than from the chemical per se. In such cases, me incremental response may become aimimshingly smaller with increasing dose or exposure oecause activation of the cnemical to tne toxic form follows apparent MichaelisMenten rather than apparent nrst-order kinetics. To illustrate this concept, rats were exposed to concentrations ranging from 1.4 to 4600 ppm of tv.l chloride for 6 hr, and the total amount metabolized was determined. The amount metabolized followed apparent Michaelis-Menten kinetics. For rats, the logantnmic probability incidence of angiosarcoma versus the amount of vmvi chloride metabolized rather than the exposure concentration of vinyl chloride is linear. Assuming no threshold in spue of evidence to the contrary, extrapolation of the data below the range of doses causing experimentally observable responses predicted an incidence of 0.01% hepatic angiosarcoma in rats exposed to 4.6 ppm of vinyi chloride. Theoretical extension of the extrapolation to humans after adjusting for metabolic and body mass differences was under taken. The theoretical extrapolation for man exposed daily for 8 hr to 1 ppm suggests an incidence of 1.5 per 100.000.000. This theoretical incidence, although a likely overestimate because of a less than predicted incidence in men exposed to 200 ppm and greater, as well as evidence for a threshold in rats, is less than that exDected to occur spontaneously. The concepts evolved from this analysis reveals why pharmacoxinetics must be considered in designing toxicology experiments as well as m interpretation of the resulting data.
There exists a great deal of uncertainty in predicting the potential response of exposure to chemicals at concentrations below those producing an experimentally discernible response. This is particularly true when the response to the chemical in question is oncogenesis. Statistical projections recommended for assessing the risk of exposure to doses of oncogenic chemicals lower than those producing an observable response include those based on logarithm probability curves (probit curves), logistic curves, or linear curves (one-hit curves) (FDA Advisory Committee on Protocols for Safety Evaluation, 1971). One of the most commonly used statistical projections for risk assessment has been that promoted by Mantel and Bryan (1961) in which a logarithm probability pro-
1 This study was funded by the companies supporting the vmyl chloride projects being administered by the Manufacturing Chemists Association. Washington. D.C.
: Health and Environmental Research. Dow Chcrmcai L.S.A.. Midland. Michigan 48640. manuscript No. B 600-176-77.
' Physical Research Laboratory. Dow Chemical (J.S.A.. Midland. Michigan 48640.
581
0041-OOKX 7S 0441-05K 1S02.00/0 Copyright C, 1978 bv Academic Press, Inc. All nehis of reproduction in anv form reserved,
Printed m Great Britain
R&S162524
5!2
GEHRISG. WATANABE. AND PARK
jecuon with a slope of 1 is utilized. A flaw innate to all of these methods is that the doseresponse information used to make the projection is based on the dose of chemicai administered to the animal rather than the quantity of the administered dose giving rise to the response: the latter may either increase or decrease disproportionately as the administered dose is increased.
The use of high doses to reveai the chronic toxicity incurred with exposure to a chemical is a common, scientifically defensible practice if judgment and scientific rationale are used in designing the experiments and in assessing the resulting data. However, such doses frequently overwhelm the enzymatic processes for activation of the chemical to the toxic form or for deactivation of the toxic form to an innocuous form. In this paper, it is demonstrated how the dose-dependent activation of \inyl chloride to an oncogenic product must be considered in resolving the dose-response of rats exposed via inhalation to Mnvl chloride.
METHODS
Material. Vinyl chloride (MC-'.abeled) was synthesized from 1.2-dichloro( 1.2uClethane (New England Nuclear. Lots. No. 819-221 and 819-292. 5.0 and 4 5 mCi/mmol. respectively) directly prior to use (Wagner et at.. 1975). Nonlabeled VC (Matheson Gas Products) of 99.9% Durity was mixed with the 1JC-labeied material to obtain the desired specific activity.
Animals. Male Sprague-Dawiey rats (Spartan Research Laboratory) weighing 200250 g were used throughout the stucy. Food and water were provided ad libitum except during the exposure. Exposures were conducted between 9:00 am and 3 :00 PM (EST). Groups of three to six rats were exposed to various concentrations of l4C-VC for 6 hr.
Exposure and procedure. The rats were exposed by inhalation under dynamic conditions in a 30-liter glass inhalation chamber. The mean analytical concentrations of VC measured by gas chromatography were 1.4 + 0.3 (SD). 9.3 0.2. 24.7 + 1.4, 51=2. 109 23.250 2. 511 r 11. 1020 = 13, and 4600 311 ppm. Details of this exDOSure and the method of analytical determinations have been reported previously (Watanabe et al.. 1976a). Immediately following the 6-hr exposure to various concentrations of UC-VC (1.4--1600 ppm), the rats were killed by a blow to the head, and the carcass was analyzed for total radioactivity (Watanabe et al., 1976b). Previous studies have shown that only a smaii percentage of radioactivity (< 1296) is excreted as metabolites other than 1JC-VC per se during 72 hr following a 6-hr inhalation exposure (Watanabe et al.. 1976a). A large proportion of the 12% is comprised of MCO. excretion 72 hr after exposure. Furthermore, very little urine is excreted during the exposure period. Thus, the nonvolatile radioactivity determined immediately after exposure in the tissue and carcass is a good estimate of the total amount of metabolized VC.
RESULTS
Consistent with the results of previous studies (Watanabe et al.. 1976a.b). the metabolism of VC by rats does not increase proportionately with increasing concentrations ot VC being inhalea (Table 1). The nonlinearity of the amount of VC
R&S162525
dose-response: vinyl chloride
583
metabolized during 6 hr ofexDosure to various concentrations of VC appeared to be in accordance with Michaelis-Menten kinetics as described by the equation:
In this equation, i and V^. are the velocity and maximum velocity, respectively, for the biotransformation of VC expressed as microgram equivalents of VC metabolized per 6 hr. S and are the concentration of VC being inhaled and the Michaeiis constant expressed as micrograms of VC Der liter of air. respectively.
TABLE 1
P \RA.METERS FOR DESCRIBING THE METABOLISM OF INHALED VlN-iL CHLORIDE (VC) L'SING
M 1CH AELIS-M ENTF,N KINF.TICS
Exposure concentration S (ppm of VC)
1.4 4 25 51 104 250 511 1020 4600
5<gofVC liter of air r
5.6 2 5.0 64.L) ! 30.6 279.0 640.0 1508.2 261 1.2 11776.0
tiug of VC metaDolizetr 6 hr)
50 z 5 542 = 26
z 42 i I 6 1 i -C" 2406 - ] - t
5826 r 545 6265 - 555 425" i 765 '-'255 - 1467
i. s
8.33 10.52 8.70 9.04 8.62 5.98 4.79
1.63 0.79
I ppm of VC - 2.56 ug of VC liter of air. Determined from the total radioactivity in the carcass. Mean ; SD.
To ascertain whether Michaeiis-Menten kinetics were applicable, the data in Table 1 were analyzed in accordance with the linear Wooif-Augustinson-Hofstee trans formation of the Michaelis-Menten equation tSegel. 1976).
It can be seen from the plot (Fig. 1) that the data appear to lie along a straight line thus verifying, at least visually, the Michaelis-Menten model. L'n and Kcan be estimated by the ordinate intercept and the slope of the line or they can be estimated directly by fitting the nonlinear Michaelis-Menten model. Both procedures yield similar parameter estimates. The estimates derived by fitting the model directly are 8558 1147 (SD) jug of VC metabolized and 860 - 159 (SD) tig of VC liter of air for l'm and Km respectively.
Once a means is obtained to calculate the amount of VC metabolized by rats as a function of exposure, it is then possible to relate the untoward effects associated with VC exposure to the amount biotransformed rather than the exposure concentration of VC per se incurred by rats exposed to VC.
R&S162526
V
V 534 GEHRING. A ATANABE, AND PARK
Fig. 1. Metaoolism o:' unyl cmonde analyzed in accordance with the Woolf-Augusunson-Hofsiee
linearized form of the Michaelis-Memen equation. Values of r and v/S were taken from Table 1. The line
was fit bv imear regression analysis. The correlation coefficient. R. was 0.88.
Maltom and Lefemine (1975) reported the incidence of hepatic angiosarcoma in rats exposed to different concentrations of VC. 4 hr/day. 5 days/week for 12 months and subsequently held for observation until death (Table 2). Before attempting to relate these data to the amount of VC biotransformed in accordance with the MichaelisMenten equation using the previously determined values of Vm and ATm, the value for Vm
TABLE 2 Correlation between Exposure Concentration of Vinyl Chloride. Metabolism and
Induction of Hep atic Angiosarcoma in Rats
Exposure concentration S(uz of VC. S(ppm of VC) liter of air)1'
i'(,g of VC metabolized^ hr)
Percentage incidence of
hepatic log v angiosarcoma1
10.000 6.000 2.500
500 250
50
25.600 15.560 6,400
1.280 640 128
5.521 5.403 5.030 3.413 2.435
739
3.742 3.733 3.702 3.533 3.386 2.869
15 22 22
12 7 2
eg of VC metabolized I
' corrected for 4-h- exposure. e55S
4/6 = 5706
6 hr 1
1ug ot A C metabolized XTir
5'06
of VC| 5fug/ liter)
l860(ugy liter) + 5(//g/liter )l.
` From Maitoni and Lefemine i iv'5).
B&S162527
DOST response: vinyl chloride
;;;
must be adjusted for the shorter exDosure duration used by Maltoni and Lefemine. 4 versus 6 hr. This adjustment is accomplished by muliioivine VTi by 4/6. Thus, the amount of VC biotransformed daily by rats exposed to the various concentrations used in the experiment of Maltoni ana Lefemine can be calculated from the equation:
, of VC \ , uz 5 "06 (----------- 1 5 (
4 hr 1 liter
860 i 4g ; l lil^r
Ug
lirer
t J.'
The resulting values for v are gi\en in Table 2. Figure 2A. depicts a logarithm probability plot (promt plot) of the incidence of
hepatic angiosarcoma observed in rats by Maltoni and Lefemine (1975) versus the amount of VC biotransformed for 4 hr of exposure, r. or the exposure concentration. S. The incidence of hepatic angiosarcoma in rats is linear with respect to log v but not log S. The line drawn for log v versus tumor incidence (Fig. 2) was determined by using a probit regression analysis program, and the equation relating the incidence of hepatic angiosarcoma to log v was:
probit response = --1.625 - 1.543 log r
<41
Using the foregoing equation, a orojection beiow the lex els of exposure producing an experimentally discernible resoonse has been made (dashed line). Assuming no
Fig. 2. (A) Metabolism of vinyl chionde expressed as log r iMicrograms of VC metabolized/4 hr
versus percentage incidence of hepanc angiosarcoma (probability scaie). (B) Exposure concentration expressed as log S (pans per million) versus the percentage incidence of hepatic angiosarcoma. The probit
equivalents of the percentage incidence are shown on the right-hand oramate. The solid line is the best tit for experimentally observed responses while the dashed line represents extrapolation below those doses
producing an observable response assuming no threshold.
J 586 GEHRING. WATANABE. AND PARK
Enreshoid for the induction of angiosarcoma in rats exposed to VC. the exposure concentration Droducing one angiosarcoma in 10.000 rats can be calculated. The probit percentage representing an incidence of 0.01% is 1.28. Substitution of this value into the Eq. ;41 yields:
Log v = 1.8827. l- = 76.53 u% of VC metabolized/4 hr
Using Ea. (3). the concentration of exposure to VC needed to give this value for r is 11.66 gig liter or 4.6 ppm (approximate 95% confidence limits obtained by substituting the upper and lower 95% confidence limits for v in Eq. (3) and solving for S are 0.038." ppmi. Hence, exposure of rats to 4.6 ppm of VC for 4 hr daily. 5 davs/week for 1 year can be expected to produce one angiosarcoma per 10.000 rats if the dose-response curve remains valid at exposures, less than those producing a discernible experimental resDonse.
DISCUSSION
For many chemicals, toxicity may not be a function of exposure to the chemical Der se. but rather to a biotransformation product of the chemical. Frequently, production of a toxic metaoolite is dependent upon envzmatically mediated reactions which are classically described by Michaeiis-Menten kinetics. Since enzymatically mediated reactions are concentration dependent and saturable, toxicity resulting from exposures to chemicals requiring activation to a toxic form cannot be related directly to the magnitude of exposure or dose. In such a case, it is necessary to determine the amount of the chemical undergoing biotransformation as a function of dose or exposure before a meaningful dose-resoonse relationship can be established.
There is considerable evidence that vinyl chloride requires bioactivation to produce tumors. Metabolic activation is required to induce mutations in bacteria exposed to VC (Bartscn et at.. 1975: Malavielle et at.. 1975: Rannug et at.. 1974). Covalent binding of UC to hepatic macromolecules in rats (Watanabe et at.. 1978) exposed to 14C-VC also requires bioactivation. Covalent binding of electrophiles to DNA has been associated with tumorigenesis.
For vinyl chloride-induced hepatic angiosarcoma in rats, a logarithmic probability plot (probit plot) of the incidence versus the amount of vinyl chloride metabolized, v. over a ranee of exposures from 50 to 10.000 ppm of VC gives a classical straight line (Fig. 2A). The dose-response relationship is not a straight line when plotted as a function of the exposure concentration. S (Fig. 2B). These results support further the conclusion that VC requires biotransformation to an active metabolite for tumori genesis. Furthermore, a more reasonable evaluation of the dose-response data for vinyl chloride-induced tumorigenesis requires knowledge of the amount of VC activated as a function of exposure. After arbitrarily excluding data acquired from rats exposed to concentrations of VC exceeding 500 ppm in the experiment of Maltoni and Lefemine (19751. Schneiderman et at. (1975) extrapolated the remaining data to predict an incidence of 0.01% hepatic angiosarcoma in rats exposed to 1 ppm of VC. This number is reasonably close to our prediction of 4.6 ppm of VC for the same incidence. If Schneiderman et at. (19751 had used all of the data, a dose-response curve with an
R&S162529
DOSE-RESPONSE: VINYL CHLORIDE
587
unrealistically shallow slope would have resulted and the oredicted level causing 0.01%
heDatic angiosarcoma would have been much smaller, on the order of 0.00001 ppm.
The concents developed herein allow use of all of the data presented by Maltoni and
Lefemine (1975) to construct a dose-response curve on a scientifically defensible basis.
Assuming that the resulting aose-response curve can be projected beyond e range of
the experimentally discernible responses, the exposure concentration .quired to
produce an incidence of 0,01% hepatic angiosarcoma in rats is 4.6 ppm.
Aside from interpreting toxicity data for chemicals requiring activation to a toxic
form, there are some practical implications of the concepts presented herein for
designing experiments to assess the toxocitv, including carcinogenicity, of such
cnemicals. For these chemicals, increasing the concentration above the apparent K^
will produce diminishingly smaller increments in the response: no increase in the
response is to be expected when the exposure concentration is two or three times K
Since total dose is a function of exposure time as well as concentration, it is important
to determine the effect of exoosure time on the response. As shown in Eq. (3). the oniv
parameter influenced by exposure time is
which is increased linearly with time.
Therefore, after the concentration to which the animals are exposed becomes two to
three times Km, the amount metabolized, c. will increase linearly with increasing
exoosure time. For this reason, the gradation of incidence of angiosarcoma in rats
exposed to high concentrations of VC will become a function of exposure time rather
than concentration. This reasoning makes it imperative that the duration of exposure as
weil as exposure concentration be considered in evaluating the results of epidemio
logical studies of people exposed to high concentrations of VC in the work environment.
Unless the dose-dependent, Michaelis-Menten type pharmacokinetic parameters are
resolved prior to designing the experiment, the results may be robbed of much of their
value for characterizing the cose-response function for the untoward effects observed.
Thus, the current approach using the maximum tolerated dose as defined presently and
fractions thereof may be scientifically unsound if the objective is to assess the potential
toxicity of exposure to much lower doses or exposures. For some chemicals detoxifica
tion of the chemical per se or reactive metabolites formed from the chemical may also be
dose-dependent and saturable leading to a build-up of toxic materials. In such cases, the
incremental responses to increasing doses or exposures will become disproportionately
larger rather than smaller (Gehring and Blau. 1977).
In the foregoing analysis of the dose-response data for the induction of angio
sarcoma in the rat. no threshold for the response was assumed. As indicated, extra
polation below the range of doses resulting in an observable response may overestimate
the response in rats because there is evidence that detoxification of reactive metabolites
of VC may occur more efficiently in rats exposed to concentrations of VC below 50
ppm (Watanabe et al.. 1976c i. Indeed, further analysis of the data reported by Maltoni
and Lefemine (1975) also provides an indication of a practical threshold. In a subse
quent presentation of these data, it was revealed that the latencies for the development
of hepatic angiosarcoma were, respectively. 64. 70. 78. 81. 79. and 135 weeks for rats
exposed to 10,000, 6000. 2500. 500, 250. and 50 ppm of VC (Maltoni. 1975). These
results indicate that at some low levels of exposure the time required for induction may
exceed considerably the life exoectancy for rats. This is consistent with the work of
others suggesting that multiples of a lifetime may be required for expression of cancer in
R&S162530
f 88 GEHRING. WATANABE, AND PARK
response to low doses of a carcinogen (Druckrev, 1967; Albert and Altshuler, 1973). Thus, extrapolation of the data obtained for rats below the range of exposures causing a discernible response may be expected to overestimate the projected incidence.
The ultimate objective of a toxicoiogical study is to develop data which can be used to assess the potential risk for man. It is worthwhile to utilize the concepts presented herein to achieve this objective realizing fully that such extrapolation is fraught with uncertainties. The basic assumptions made are:
fi) Induction of angiosarcoma is related to the amount of reactive metabolite of VC per unit of mass.
(ii) Exposure of rats for 12 months approximates exposure of workers for their working life.
(iiit There is no threshold for the induction of angiosarcoma in either rats or man which likely overestimates the assumption of risk as discussed above,
fiv) The efficiency of the metabolic processes involved in the conversion of VC to the reactive form is proportional to the body surface area. Since data for the bio transformation of VC by man are not available, the most logical basis for translation of the animal data to man would seem to be on the basis of body surface area.
The last assumption deserves comment. There are considerable data in the literature showing that metabolism in general and other physiological parameters as well are reiatable directly to the surface area of the body (Schmidt-Nielsen. 1970: Pinkel, 1958). For this reason, administration of biologically active chemicals to various species frequently gives an equivalent response when the dose is administered in proportion to the surface area of the body, that is dose per square meter of body surface (Pinkel. 1958). This relationship is gaining recognition in estimating the risk incurred by man from exposure to chemicals in the environment (Committee on Safe Drinking Water. National Research Council. 1977). In utilizing this relationship it must, however, be recognized that the original relationship was developed for biologically active agents. Since metabolism and other physiological processes involved in detoxification are more active in smaller animals, the dose of a biologically active chemical per unit of mass required to produce a given effect increases as the body decreases, while the dose per unit surface area remains relatively constant. However, for a chemical requiring activation to the biologically active toxic form, the total amount transformed will be roughly proportional to the body surface area. Since toxicity is a function of the concentration of the active form in tissue, this total amount transformed must then be normalized for mass to estimate an equivalent response.
Using aforementioned rationale, the maximum velocity, Vm, for a 70 kg man can be estimated by calculation using the 1% \ alue obtained for a 0.250-kg rat. The Vm of man for VC will be:
or
1.85 m:
Vm (man) = 8558 ug, 6 hr)
= 35 1829//g/6 hr.
0.045 m;
dose-response: vinyl chloride
589
where the values 1.85 and 0.045 m2 are the body surface areas of a 70-kg man and a 0.250-kg rat. respectively (Pinkel. 1958). For an 8-hr exposure, the value is 469.105 ug/8 hr. In order to use this number to theoretically estimate the response in man using data collected in rats, the Fm for man must be adjusted to a mass equivalent to that of rats since toxicity is a function of concentration in tissue. To do this the number is divided bv 70 kg/0.25 kg or 280. The resulting Vm for man on a mass equivalent basis to that of rats is 1675 jug/8 hr. Using this value, the amount of VC transformed to a reactive form by man on a mass equivalent basis to rat is given by the equation:
1675 ug/8 hr - 5(tze/iiter) i;(ug/8 hr) = -- ------------------ ---
860 Ltg/ liter - S(/iz, liter)
(5)
Using this equation, the amount of VC transformed by man on a mass equivalent basis to rats was calculated as a function of exposure concentration and the expected incidence of angiosarcoma estimated from Ea. (4) (Table 3i.
For men exposed to greater than 200 ppm of VC. the incidence of angiosarcoma has been reported to be 0.02% (Fox and Collier. 19"). Hence, the theoretical calculated incidence using data from rats exceeds that currently detected by approximately 50-fold. This may indicate that people are less sensitive than rats to the induction of angiosarcoma, or it may indicate that a practical threshold for the induction of angiosarcoma had been attained. Consistent with this latter possibility is that v on a mass equivalent basis to rats for men exposed to 200 opm is 625. This number lies below that for rats exposed to 50 ppm. As indicated previously, angio sarcoma observed in rats exposed to 50 ppm occurred oniy in a rat that lived 135 weeks (Maltoni. 1975). Further, this rat did not die as a result of the angiosarcoma but was killed. Thus, as indicated previously, projection of the data collected in rats below the range of exposures producing an observable response may overestimate the incidence.
TABLE 3
Theoretical Amounts of Reactive Product Formfd from VC 3x a 70-kg Man Exposed Continuously for 8 hr and the Corresponding Expected Incidence of Angiosarcoma as Predicted from Data Collected in Rxrs Assuming no Threshold
Exposure concentration
Theoretical percentage Probil incidence of r<jjg of VC metabolized*'8 hr) log ! response1 angiosarcoma1
(ppmi 200 50 5 1
Uig/liierV
' 12 I2S 12.8 2.56
625 217
2," j 2.68
^ > * 1.98
1.02 0.11
24.6 1.5 4 0.52 3.74 x 10-4
4.97
o.-o -0.54
1.5 x 10-*
1 ppm = 2.56 ui liter. . has been calculated using ihe Michatflis-Memen equation .me- calculatin'.! me I for man from :he I determined for rats. This calculation was made by assuming ` :s proportional to hodv surface
urea and subsequemlv adjusting it to a mass equivalent to that of rats. See text. The expected nrobit response was calculated from probit Hu .'l (see texti. Subsequently the
T.eoretical percentage incidence ot angiosarcoma was determined irom me respective oroon.
:90 GEHRING. WATANABE, AND PARK
In spite of the likelihood of overestimating the incidence of angiosarcoma in rats or
man. the incidence predicted for people exposed to 1 ppm. the current OSHA
(Occupational Safety and Health Act) standard, is very small (1.5 per 100 million).
This value which is likeiy an overestimate is below the expected incidence of
spontaneous angiosarcoma reported to be 20 to 25 cases in the U.S. annually (Makk et
aL 1976). In summary, it has been demonstrated that the incidence of VC induced angio
sarcoma in rats is related not to the concentration of exposure but rather to the amount
of VC biotransformed. Biotransformation of VC by rats is a dose-dependent process
characterized by Michaeiis-Menten type kinetics. The concepts evolved from this anaiysis reveal why pharmacokinetics must be considered in designing toxicology
experiments as well as in interpretation of the resulting data. Having characterized the
dose-response for induction of angiosarcoma in rats as a function of the amount of VC
biotransformed, a theoretical estimate of the incidence expected to occur in exposed
men was undertaken using the data collected in rats. For daily 8-hr exposures to 1 ppm.
the predicted incidence is 1.5 in 100.000.000 which is less than that expected to occur
spontaneously. This predicted incidence is likely an onverestimate of that which will
occur as a result of exposure to 1 ppm because there is some evidence for at least a
practical tnreshoid in botn rats and man. There are no illusions that this estimate by extrapolation of data outside the range of doses causing experimentally observable
responses and subsequently to man is without flaws. However, the rationale used
represents a new approach which utilizes more logic than methods employed currently
for such extrapolation.
REFERENCES
Albert. R. E.. and Altschller. B. (1973). Considerations relating to the formulation oflimits for unavailable populauon exposures to environmental carcinogens. In Radionuclide Carcinogenesis, Proceedings of the llth Annual Hanford Biology Symposium at Richland. Washington, pp. 234-255.
Bxrtsch. H.. Malavielle. C.. and Montesano. R. (1975). Human, rat and mouse liver mediated mutasenicitv of vinyl chloride in Salmonella tvphimurium strains. Int. J. Cancer 15.429-137.
Committee on Safe Drinking Water (1977). Summary Report: Drinking Water and Health. Advisory Center on Toxicology. Assembly of Life Sciences. Washington. D.C.
Drlckrey. H. (1967). Quantitative aspects in chemical carcinogenesis. In Potential Carcinogenic Hazards From Drugs. Evaluation of Risks (R. Trubant, ed.), UICC Monograph Series. Vol. pp. 60-78. Springer-Verlag, Berlin.
Food and Drug Administration Advisory Committee on Protocols for Safety Evaluation (1971). Panel on Carcinogenesis Report on Cancer Testing in Safety Evaluation of Food Additives and Pesticides. Toxicol. Appl. Pharmacol. 20.419-438.
Fox. A. J.. and Collier. P. F. (1977). Mortality experience of workers exposed to vinyl chloride monomer in the manufacture of polwinvl chloride in Great Britain. Brit. J. Ind. Med. 34. 1-10.
Gehring. P. and Blau. G. (1977). Mechanisms of carcinogenesis: Dose-response. J. Environ. Pathol. Toxicol., in press.
Makk. L.. Delmore, F,. Creech. J. L.. Ogden. L. L., Fadell. E. H.. Songster. C. L.. Clanton. J.. Johnson. M. N.. and Christopherson, W. H. (1976). Clinical and momnoioeic effects of heoatic angiosarcoma in vinyl chloride workers. Cancer 37. 149-163.
Malavielle. C,, Bartsch. H.. Barbin. A.. Camus. A. M.. and Montesano. R, (1975). Mutagenicity of vinyl enionde. chloroethyleneoxide. chloroacetaldehyde and chloroethanol. Biochem. Biophys. Res. Commun. 63. 363-370.
R&S162533
DOSE-RESPONSE: VINYL CHLORIDE
: 91
Maltonl C, (197S). The values of predictive experimental en\ironmentai carcinogenesis. An example: Vinyl chloride. Ambio 4. 18-23.
Maltoni. C.. and Lefemine. G. 119751 Carcinogenicity assays of \inyl chloride: Current results.Ann. S.Y.Acad. Sci. 246. 195-224.
Mantel. N.. and Bryan. W. R. (196!). "Safety" tesune of carcinogenic agents. J. Sat. Cancer Inst. 27. 455-470.
Pinkel. D. (1958). The use of body surface area as a criterion of drug dosage in cancer chemo therapy. Cancer Res. 18. 853-856,
Rannug. U.. Johansson. A.. Ramel. C.. and Wachtmeister. C. A. (19"4i. The mutagenicity of vinyl chloride after metabolic activation. A mbio 3. 194-197.
Schmidt-Nielsen. K. (1970). Energy metabolism body size, and prooiems of scaling. Fed. Proc. Fed.Amer. Sac. Exp. Biol. 29. 1524-1532.
Schneiderman. M, A.. Mantel. N,, and Brown. C. C. (1975). From mouse to man--or how to set from the laboratory to Park Avenue and 59th Street. Ann. S.Y. Acad. Set. 246, 237248.
Segel. I. H. (1976). Biochemical Calculations. 2nd Ed., pp. 236-237. Wilev. New York. Wagner. E. R.. Muelder. W. w,, Watanabe. P. G.. Hefner, R. .. Jr.. Braun. W. H.. and
Gehring. P. J. (1975), Gas chromatographic method for me preparation of UC-labelled sinvl chloride. J. Labeled Compounas 1 1. 535-542. Watanabe. P. G.. McGowan. G. R.. Madrid. E. 0.. and Gehring. P. J. (I976ai. Fate of 'C-vinyi chloride follownne innaiation exposure in rats. Toxtcol. Appt. Pharmacot. 37. 4y-59. Watanabe. P. G.. McGowan. G. R.. and Gehring, P. J. < 1976b). Fate of IJC-vinyl chloride after single oral administration in rats. Toxicol. Appi. Pharmacol. 36. 339-352. Watanabe. P. G.. Hefner. R. E,, Jr., vnd Gehring. P. J. (1976c). Vinyl chloride induced depression of hepatic nonprotem sulfhvdryl content and effects on oromosulphthalem (BSP) clearance in rats. Toxicology 6. 1-8. Watanabe. P. G., Zempel. J. H.. Pegg. D. G.. and Gehring. P. J.. (1978). Hepatic macromoiecuiar binding following exposure to vinyl chloride. Toxicoi. Appl. Pharmacol., in
press.