Document RJ5Z6m6E5xXydwmwJ6kz3GyKa

R&S 113781 BIO-MEDICAL RESEARCH DOCUMENT DESCRIPTION FORM 63 68 69 76 Duplicate in all cards:--> 0000421 year as-1961- File number [Right justify fNumeric onlvl Author(s), as Last Name FS (No Punctuation) and coden for journal as JAMA preceeded by one blank space 1 _____ 20 2140 4160 61 62 A'A/PA/'9'SMP-J A-p/ir 7778 I I/O- 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; 12 C do not abbreviate. J 61 62 21 22 0e? 7~~ fryts (rjrjtsrexs firstsa? /~z L/0s*7---- 23 24 Source (Journal, Vol., Number, Pages, Date) 12 /n nrr-7--r < >* j-- J". rrn i > jz-Pj&ji is/A?Af*r/F- QdLrrMrtr*.*-< Yt rro** * rr ~ r ................ ' WV " 'V B H? f . er/'*e'7' ?? ^TiS /*? 7r FPf/Z,* Brief Summary 12 10 SUMMARY: 61 62 31 32 61 62 61 62 63 64 H <<^7 vct HrrtixuAA ** t*'. R&S 113782 iNTHSSIS OF THE RESULTS OF THE EPIDEMIOLOGICAL INVESTIGATION Q'aRRTED OUT in ITALY ON WORKERS EXPOSED TO VCM 0000421 The investigation has started on the first days of Z975 and ; involved approx.two years of work. Plants concerned : - Porto Marghera - Brindisi - Terni - Ravenna - Fenara - Rosignano - Ferrandina - Cagliari - Porto Torres - Bollate - Villadossola - Borgaro Torinese MONTEDISON MONTEDISON MONTEDISON ANIC SOLVAY SOLVAY LIQUICHIMICA SIR RUMIANCA SIR RUMIANCA MONTEDISON (pilot-plant) MONTEDISON (pilot-plant) SIR (pilot-plant) It has been considered "exposed11 all the workers living or dead,exposed presently or in the past to vinyl chloride for a minimum period'of six months. I llhe investigation has been carried out on 4713 workers,equal tjo SIS of the exposed oneii.lt has bepn possible to ascertain the death of 64* workers,but it is not sure that it is a question of the totality of the deaths which happened in workers exposed during the period taken into due consideration (.from starting of production of VCM ;up to 1975) Synthesis Enployeers Employeers Contract Work Contract Work U icodifigd Dead 0 l presently exposed ex exposed presently exposed ex exposed Total Total 3.071 1.2S9 3U 36 4.713 64 4.787 .Taking into account the fact that "time of exposure" and "level of exposure" change, we have been able to calculate an index of exposure and consequently divide the workers into three exposure classes to be considered indicative* A Synthesis of workers Exposure Class* low average high 1.088 2.446 1.107 1 l unca lculated 70 | I Clinical instrumental and laboratory investigations Lung: Hands: Liver: Urine: 1 0lood: {Endothelium: X-ray photograph of the chest - | cytological examination of expectoration . X-ray photograph of hands - j photopletismographic of the ten fing rs in basis conditions and after cold tost SGOT and SGPT - gamma GT - alkaline 1 * phosphatase - bilirubinemia comp let examination -I- cytological examination of sediment in case of hematuria I, complet hemocromocytometrio examination -- calculation of platelets I /r\ study of the vascular centre of eye bott m The above information has been recorded in an epidemiological filing-card. Results X-rav photograph of the chest Stressing of the bronchial filling Report "compatible" with neoplasia Results tbc Others 28 % 2 cases (in one confirmed) 5,7 % In the single classes of age the frequency of report" str ssing of the filling" increases with time of exposure. R&S 113783 / I It has been noted, in workers :*.n sacking,drying up and stores. 2 3 cases of pneumoconiosis in workers, which surely have had no further exposures to organic or inorganic dusts. 1 * ! Cytology of spitting j No significant fact has been shown. j X-ray photograph of hands jNoraal ' D A 0.* 1 J- # 4? ^ M<* A * 1 MA tS 4.000 165 137 27 j ,PhotoT>lctiS!nographic examination ( >3. 77 workers have followed the basis .did the tracing after cold test* tracing and 3-866 During the basis tracing 150 cases showed pathological nodifications and 74-2 did the same during the cold test. 96 workers (2,5/S) showed pathological modifications of the 'basis tracing as vrcll as of that after cold test; their distribution in different classes showed that frequency of contemporaneous pathological modification of the two tracings increases in accordance with the increased exposure, quantified by index as well as by time. R&S 113784 Examination of the eye bottom This examination has been carried out on 4.066 workers. The more significant results are as follows : sclerosis hemorrhages 1 crossing 4S8 14 63 i Insofar sclerosis regards, there is no correspondence betwe n frequency of report and index of exposure. Vascular svndromc j Among the 3*212 workers submitted to X-ray photograph examination of hands, photopletismographic examination and of eye bottom, four workers {0,12%) showed contemporaneous pathological modification of the three examinations. I  * 4* N'o significant findinds concerning RBC, hemoglobin and V;T5C have been noted. It has been noted 339 cases (7,555) of thrombocitopenia in statistically significant progression with increase of exposure. Analysis of urine Normal Hematuria Albuminuria Hematuria + Albuminuria Glycosuria Urobilinuria 3.822 237 266 22 68 182 83 % 5,2 % 5, S 55 ' 0,5 % 1,5 % 40 % The frequency of the microhematuria resulted in relation ! with the index of exposure. | V Liver functions The more frequent pathological changes are the increase of the ganrnn GT in 2,8,355 of cases and the presence of hepatomegalia in 44,5% of cases* Among whom in which an important hepatomegalxa is noted, ; there are more frequent also the thrombocytopenia,acrosthqolisis or the patologic photopletismographic value: consequently I a syndrome due to vinyl chloride is to be supposed. I i Mor-to li tv Cause of death Infarct myocardium Other cardiopathies Encephalonvasculopathy Tumours Trachea Lur. c Lachrymal sac Esophagus Stpmach Encephal n Bladder Liver partial total Total 9 1 6 l6 1 6 l 0ML 1 1 3 4 R&S 113785 r &S 113786 -5 Heoatic angiosarcoma Adenocarcinoma cholecysts Peritonaeum Cutaneous Testes Leukemia Hodgkin 3 1 1 1 1 2 2 Chronic aggressive hepatopathy , 5 Renal failure 3 Other causes 8 Not taken into due consideration (Terai plant) 2 30 16 2 64 It appears from the above that among workers exposed to vinyl chloride the cause of death "tumour" is quite more representative if compared with the expectations. FM/S-u 20th Febr.1578 b {