Document R2p6a2Bx1er667KvLqVj227ME

R&S 108105 BIO-MEDICAL RESEARCH DOCUMENT DESCRIPTION FORM 0000170 63__________68 69 ) Duplicate In all cards: --^ /9sy ir year as-1961- File number [Right justify [Numeric only] Author(s), as Last Name FS (No Punctuation) and coden for journal as JAKA preceeded -by-one blank space 71_____ 78 l/CL. Sub-Index Code Title of Report; end with space-hyphen-hyphen-space. Follow with Index Terms, separated from each other with -comma-space. Avoid other punctuation; do not abbreviate. 12 * . ,,. 61 62 yOa ! v ;///? y / 0 Co/? /. ST / <C / t_ T /ca?.6/)p ,c/ c/1 /<)/c/ a cc-- o /? y>/(f, __ <3-^" C-/l /z-O T/Cj T^/r.c./T ~f>TLa ^*7 1 v-- 21 22 23 24 /') - V:Vt-sr/<sjr*-A'7/P. s tC ' A^Juirce (Journal, Vol., Number, Pages, Date ) 12 -J- t (Z-/rs: /tyed- 0: o~ /pG7-- /o'V f ft/c^y /^77- ^ 7~W *~ 61 62 31 32 Brief Summary' 61 62 61 62 63 64 R&S 108106 V bio-medical research document description form 63 0000171 68 69 76 Duplicate in all cards:--> year as-1961- File number [Right justify [Numeric only] Author(s), as Last Name FS (No Punctuation) and coden for journal as JAMA preceeded by one blank space 20 21 sJJERo/71j= *J~. 3 40 41 r - 0555 7778 1 l/<0 Sub-Index Code 60 61 62 11 12 13 Title of Report; end with space-hyphen-hyphen-space. Follow with Index Terms, separated from each other with comma-space. Avoid other punctuation; do not abbreviate. ,o , 61 62 21 "75<p/t.o-V5 22 U/ 23 24 Source (Journal, Vol., Number, Pages, Date ) 12 2-3/ <^*4, /? 7^" 61 62 31 32 Brief Summary 12 10 SUMMARY: //&>-- 61 62 61 62 63 64 , .Ouas'dons and Ar.swsrrs R&S 108107 Hazards of Aerosol Hair Sprays sored by the FDA in Salt. Lake City, where about 3P0 and Aniiperspirards lieautieians (that segment of the population most likely to Present evidence implicates vinyl chloride pas in some be overexposed to hair-spray use) wore studied.1 Results of Q cases of sarcoma of the liver. Smce soma of the hair this study are now being tabulated and probably will be sprays in common use contain vinyl resin that is, I bel.eve, a com published. pound derived from vinyl chloride, I am concerned about the haz As a precautionary measure, prompted by the data gen ards that may be associated v.-ith fheir dai'y use. Do these hair erated by groups involved with eveupar.iur.a! hazards, vinyl sprays really coniain-baHardous-cornponents? If so, what are they chloride has been eliminated as an aerosol propellant. and whaf'harm do they causef Has there boon a change in hair "spray composition since the Food and Drug Administration (FDA) became interested in these products? What hazards are associ ated with the use of antiporspirants and other types of aerosol preparations? Ramon rt.. 1 ah, 0,0 Buffalo, Nr Tims," while all the final results of all the scientific studies that could (and may) be. undertaken are not in as yet, the present state of knowledge gives aerosol products, in nor mal use, a clean bill of health. Josm* c jqro'.c. rvi AMA ChicjsQ t*i [Vu$i This question was referred to two consultants, whoso discussions are as follows: A Currently available hair sprr.vs in normal use do not. contain hazardous components. Improper use A The use of vinyl chloride as an aerosol propel lant was a common practice up until the time the public and scientific community became, alerted to the probable causality between vinyl ehlwide and the inci (spraying into the eyes, spraying into a plastic bag and dence of angiosnicmru; of Dm liver. Marketing cf aeroscl then placing one's head into the bap) can result in hazard product;; containing vinyl chloride has bran placed under a ous exposures. Similarly, under nounal conditions of use, him hy the FDA; also, ihe Consume;' Ftoduel Safety Com other types of personal aerosols (such as deodorants and mission has served no!ice that such pro-duets may consti- feminine hygiene sprays) or household aerosols coniuin no tuie a hazard, thereby bringing them under regulation of hazardous components in presently available products. the Fedo.al I't,-,/.a>'dous .'vuiote.nce A-cl ((.'/,-cm li'cc/t, March There is an Inter-Industry Aerosol .Safety Su:>.-o;niniUcc '1, 107-1; Oct. Hi, 107-1). that has sponsored a series of studios on propdlant sys Aside from the. earonogonie risk Dial may be. pc.-vd by tems and ingredients sprayed from, aerosols. While there the inh;h;-ition of vwy! chloride, there is Die hazard of an arc a number of projects the subcommittee lias yet to enm- other sort ati.endii',;: th',- chronic inb.-i.-iLion of Da; m.'jyc picte, the studies as of now are said to indicate that the ubiiiuibi'.s fluorinr.ti-d kyd-.-.x-e-'hon p:-->po!!nnts (eg, the aerosol "safety range is tremendous in normal uso." How Frc;on-type compound.-') T'hoie gaaes have been sr.own to es or, the suheumirit!re is considering additional studies send viza the rnyi's-ndlmo to i-pi'-iepliriuc, thereby creating relative to particulate-matter distribution and retention n risk of ve.nM ividar nnhythmir.-',. li: ndiiitiou, related by Die respiratory system and the acute, Mibciuonic, and compounds (eg, h.uk/.kaue) that me employed as mms- chronic o!feats on the respiratory system of impelled theiic agents have beer linked to casi. s of jaundLe in pa- aerosolized partieuiatu matter. One must, of course, dilfeieutiato between externa! aerosol sprays and ihe interna! (thruai) spray used fur me dicine.! purposes; comment1; in Dm literature arid public press do not always tnal.e udeip.miu dialinciion between these two ciiii'cronl. tynes of spray.-.. tient;;; ant; the inerem- -d inei'.hi'IV.'w of ^ pontancous r.hur- lions aeving; pcegno.ni opera-Ji 'g-ro I'-U' .-orsound. In ncidi*ion to the j' ivpenrm[. 11 - ;\v r.iyr coni a in. for- liet : nci-l i>ar(, synD- eiiv pul', '-li as ji A,,vinyl- pyrr. hdane and pul;, v iayl ace-.m-', or r.atuially d w ived polyp ides fm !,n d h v Da; d;. n-.uiatioi' .. f iuwf There have been a number of report.-, in the medical lit erature mu- the pad h'i yea).; on adver-v '.'factions to some of the compuiu-ni-; of por.-fv.a! emr-'i!.;. The-.-e n>- l.'ur!-; have tv.-ullvd i;i large-.-;:-;;!" tf.s sponsored hy in dustry or by gmvri-u'-ci'i to dr ioi inii.e if: a nck-iibm- .-.Uidy what f;c,!;; arc. Yin;-; :\v, ;dl .-'.ieb on''.tr'diod studio;-, haw i;l.-ntif;,1 r.o leu-i!.!-.- adverse readi.'iia. This i"- purl;jfek't n and n,!;.. gen. li;: if 7'; :r Diet' pel;, ue. re e iitlv!) sn sp.'-i in citnDiini;;; : '>;> several i- >*> of "D/w urn-is" gram o-.ms of ,n,i` v ' ' . VJ 1, the :`i`' V.i'O in wl 1 -il JlSS'.I--1 :c:: -.1. ij.iWeVf'l'. ;; f ' i' n mom . r .( sLiaiias im -f : mid beam;.: :r ;o*`-. e,t. , Ihe i-videuef. i . j:'i. )' ;F i - c ;".s to wh--il a Dm poly: 'r ;-m'ti- f g-'-;;. k/a. 'i }A-'!Vinorx. : ehid-s.;, 1 am (eld, a u-renDy eeiiiji'oi! d inves; < i,m '-p.'in- nylp; .Dii'vW anti / '1 v:;.\ i ietna.- , : ,iT( ucl fur me. i to* J **<} I"/ G> w>;i' i Ti n v \\ ' 'L\ C ).> If* ` t . N , L" . 'M ? ,nt .... 1 .I i ., r ,, f,. t,, , , t V t 1 )> * \ < *'! It 1 O a- '* * n r i t , . . . f(! l i 1 I :i .u l. , " V I '..y*. if <-. . r- .--.r V-'D.e , ,.,../i' j t;,, , f > . .. 1.. v i t -.ip.:, ` viw, I M. Side. In1, : ia'l u of pr-'i'-ia :.wnr i' ,;;f r ; :: 1. , a.: in the c >>( i'-'v.- -; ! i'!-e > prays, h ; ; l.-.e.i il i. u> (r-ruli: ``O n' - 1 i al wily p-i'-im o .1 V`o: ;o oino-o Id i`n of 1 id ; 11 i: a- -- w be eh; i v't.. a the 'fAl.V,. tsjich in,. ;'; .. y0| C...A An- -.vir. l::-7 Jolie'shne:. t,bc:'t tightness, and fever generally ap- pear seven.! heurs after a:i exposure. ForlimsUL ' i v* ef fect.-; are rl-i'1. Aiug ami reveisibc , and jwl a!! persons are affected !y the sousi;i\ity t.rtion -- mani fested ns a tiarrowb'g of the siv.r.ll ahways. Hew ever, sa j- copUbio pavurms ami thojo will, known cardin: cm-1 pulmo nary dhtotckwa arc especially at risk and should, of course, avoid unnecessary exposure. The pulmonary hazards of aaliponpirnnts, on the other hand, have htou studied more recently in laboratory ani mals by Drew ut a,!.1 'I'hoy were come mad with one of the more popular ingredients, a polyethylene glycol complex of aluminum chloride-hydroxide. A granulomatou:: lesion was observed at the bifurcation of the bronchoxlvcolar ducts (reversibility of the lesion was undeterminable). In addition, though mixed-function oxidase activity of the liver mit rosomos was muttered, lung microsomal activity was diminished. Admittedly, the concentration and extent of exposure in experimental studios may exceed condi tions that might be encountered in actual use by nun. Meanwhile, other antiporspirnnt agents based on zir conium are under scrutiny by the FIJA. Although some mar.uf.u'fureis have assorted that extensive inhalation studies of their zirconium formulations have presented no evidence of lung disorders, zirconium c'rdorhyJiv.Lo compo sition:; have, been suspect. It is reasonable to expect, Ihotofeve, that the dula for other zirconium compounds bo ir refutable before those compounds are judged safe for human use. In summary, it must be eon.-lnded that all aerosol con sumer products are potentially dangerous to humans. Even if medical evidence ir, lacking' or inconclusive as to how harmful these products are, their ease of acre.-,lability, inadequate labeling, and widespread use fend to give a frd.se sense of security. Then, ten, many consumers do not exercise good judgment--either because of apathy or igno rance-and cmisc I non fly expose themselves, or others, to far greater cxcc.s-.es than the manufacturer and govern ment regulatory agencies may have anticipated. Fl II V.'Asrta.MS A7. \ Dv.ia; ihg'in; o.' finv.rcnMOuUtl, Pi.iM'C. -in'.! CCcwiMMiCinif M-?,*llh dvcagv 1. Drew RT, fltipt.'i HX, r?.'ntl Ht( et al: hA rlaiion dUi^iijs u'ltli a ylycni Coii|l*;*.'C of 1971. .{/'*! Hneiron Health i'ti-.TJl-Xiu Tociinigucm f-jr wrevsniion ci Mogcconuial Sufyica! Iniociicns f~*'j Cur hospital sure'cal statf is rtudypq postoperative wound Mw-i mtectiens, os;::.,c,i.'.tly inos..i due to gi.g.Uiy/ococcus ne/eus, with the purpose of re.iaoing and ror.cibiy eiiminniinn such infec tious Can your co.iCiulP.nt vepaW :i.i!.'Op,.I statistics on nosoco- rr.in! wound inlcoi-eriS and si;r;j.'ait invcstijativs and remedial procedures? (If-CiVtC MXiN'M. WJ) Or-T'Hj 'Oir J. NY Stugiral wound infections have nut yet been elimi \ in.ited, wen in very low-risk popuhitions. Approxiniairly off to I::-,' of g'uiei'.d-urgieal oat it-rds are futim! to acquire surgical wound sepsis when uoi.uceminl infectious ;uv carefully .sought.1' While Slaphiihn m-ms aureus con tinue.; to be an important pathogen -it was isolated frnm Iff..', of infected surgical w omuls in a group of hospitals co-j operating in Com ter fur lleu.-aso Con trol studies--acrohicjf Gram-negative organism are implicuted more frequently, being isolated from about -'.TV. of infected wounds (Center for Uisea-m Control, unpublished data). One cannot use the n.w.dju.sbd data of other institu tions to duikio an acceptable rale of surgie.d wound infectioti, few these rates are markedly influenced by the types of procedures performed, the characteristics of patient populations served, and the efiiciency of surveillance. Therefore, many hospital infection committees look at the infection rate of a relatively standard population (such as patients with clean surgical wounds er herniorrhaphy pa tients) as an index of their success in controlling these infections. Concerted efforts on the part of physicians and their hospit.il co-workers can do much to minimize the occur rence of nosocomial infections. Tim technical skill and medical judgment of the attending surgeon are among the mort important variables determining the risk of in fection; earefill attention to standard aseptic technique, adequate debridement, anatomic closure, and other basic aspects of good surgical care do much to assure a rela tively low incidence of wound infection. The effects of these practices on the occurrence of infections are diffi cult to evaluate, and il. is unlikely Unit meaningful stan dard.-'. governing them can be established. On the other hand, many other important variald.es can bo influenced by ihe hospital; indeed, some are the hospital's specified rcxpon.jibiiitios. First, where called for, infected patients must he appropriately isolated to prevent cross infection,1 Second, educational programs for personnel must stress modern infocthm-conirn! practice. Third, inappropriate use of antimicrobials must be discouraged. Fourth, a cfoan environment must be maintained, and effective ster ilization ami disinfection must be assured. Finally, hospi tals should conduct effective surveillance of ail nosocomial infections, not just surgical wound infections, [f an epi demic or other problem is recognized, a thorough epide miologic investigation is th.cn indicated. Most state and local health departments provide epidemiologic and labo ratory support to hospitals for those investigations. __ Other measure.; used by sonic hospitals to prevent noso comial surgical infections, such, as the routine culturing of sample.; from personnel, air, or environmental surfaces, are expensive and of dubious value in reducing the inci dence or in prcdh.ting Urn risk of nosocomial infection; ac cordingly, these rsntiue measures are uof considered to lie imperial',f components of a hospital infection control pro gram. IT. OirjN. Ml) Cent--/- Jcr Diti/MSJ CuoJful AlwifiU l. CtcM-G I*J, woiif.-U, An`h ; l\i.t [wrAii.t* 7`: A ftw-w.ir rro.pfvtiw sLiiiJy of ^.*,019 'v,;rj;?vui 9), l!*M. nA'-'iin;;.. The ini' .vr\e ,( liou *:f <!v .;>i ivii-.tj n :-t\! M' \ :;rin (> u'Jkt J'.utimn, .'t '*1? *.y <>i` S- K i'nt.ni_\l_ S"r<j ]t-t19'!' r. / t-l-it >,,. T- ,}< 'ii.fi,, iat` I' r tit V/i'Vui:-,1)1', ('rovcri'i.u ct i 'inline OiJioj, I'J.O. R&S 108108 11:0.1 JAMA. Marsh M. 1075 4 Vol S31, Mo 12 a.'d Ar-ircc*