Document RaEDb6EooG5wK99v4NKZ54yja

c > * r1 f* o DUvoCc. 3w 7w6,*3J-*L f"7t^ ft u> NOTE PdAwkJ`tt)i\tA4 / concerning the evaluation of the data on the vinyl chlCfToe disease cases In the management districts Cologne I-South and Ntirnberg /f- In 1973, disease cases were reported for the first time in the management districts Cologne I and Nttrunberg which occurred in the manufacture of vinyl chloride in the firms Dynamit Nobel AG, Troisdorf Knapsack AG, Knapsack Wacker-Chemie, Burghausen According to the status of 4-20-1974, a total of 106 disease cases have been reported in the Cologne I management district and 6 disease cases in the Numberg management district. 105 disease cases have occured in the firm Dynamit Nobel AG, 1 disease case in the firm Knapsack and 6 disease cases in the firm Wacker-Chemie, Burghausen. To what extent in the reported diseases it concerns exclusively cases which were caused by vinyl chloride must still be checked. The claimed symptoms speak for a causing by vinyl chloride. The disease phenomena however also can be an expression of an occupation-indepen dent, constitutional disease. Occupational illnesses have been recognized up to" this'- time itt 2? cases* an 85 cases doubtfexists' aS; to- -the 'presence* of* % an occupational illness according to List No. 9, an occupational illness is to be rejected with probability in 3 cases, in one compensation case the con nection is extremely questionable. IO qC$2VZ BFG30165 2 doubtful cases occupational illness present no occupational illness connection with, occupational activity very questionable Total: BV Cologne I 80 22 3 wOmberg 5 1 total 85 23 3 1 106 _2_ 6 _____________1_ 112 In the 85 doubtful cases, 11 deaths are found, which concern exclusively the firm Dynamit Nobel AG. Of these, according to the information of Mr. Zwahr (Management district Cologne I) in'4 cases suspicion should have been thickened that the deaths are causally in connected with the occupational action of vinyl chloride. According to the previously known diagnoses, death was caused by the follwoing ailments: * 1 angiosarcoma 1 liver sarcoma 1 bronchial sarcoma 2 heart infractions 1 esophagus varices bleeding ' *' * l'-r,eticulosarcoma" 1 apoplexy 3 deaths of unknowncause Of the 23 disease cases in which a present of an occupational illness is to be proceeded from with certainty according to List No. 9 of the Attachment to 7. BKVO, an approved decision has been granted in 20 cases. In 3 cases, of course the approving expert opinions have already been made, however the granting of a decision is still pending since certain doubt exists with regard to the level of the MdE. In the 23 disease cases, the following disease symptoms have been observed: BFG30166 3 20 cases thrombocytopenia 17-cases liver damages 16 case splenomegaly 9 cases lung function disturbances 3 cases sclerodermal skin infiltrates 1 case leukopenia 1 case temperature deficiency of the hands 1 case enlarged Brontaleinretention (sic) 1 case vessel changes in the eye 1 case Raynaud syndrome 2 cases acroosteolysis Animal experiments with vinyl chloride lead to damages in: liver, spleen, central nervous system, skin, white and red blood' picture, bones, kidneys, thyroid, heat peritoneum and lungs as well as to disturbance of the blood clotting and to tumors of the skin, the upper respiratory tract and the bones. The following damages are described in* the literature by vinyl chloride with humans: narcotic action liver fibrosis spleen enlargement arterial changes (Morbus Raynaud) scleroderman skin changes reduction of the blood platelets band shaped acroosteolyses of the finger and phalanges restrictive ventilation disturbances blood pressure elevation thyroid function disturbances BFG30167 24353003 i&y' 4 heart damages (from expert opinions of Dr. Gross, Dr. Bolt and Dr. Buchte in the Erkrankungssache Hasenberg and No. 12 of the proposal) in all previously recognized cases several of the symptoms described in the literature could be determined. In the recognized disease cases, the concerned workers have complained of the following ailments: buzzing in the ears strong white coloration of the fingers in the cold headaches spots before the eyes feeling of fatigue cold feeling of hands and feet dizziness * breathing shortness in climbing stairs pain and tingling in the legs pains in the liver and the spleen vicinities - loss of appetite vomiting insomnia A large part of these ailments is also to be observed with an irregularity of the autonomic nerve system. Therefore, in my opinion the conclusion must be drawn that vinyl chloride also influences the autonomic nerve system. To the extent that statements are available up to this time, it could be established that practically all the victims were active in the autoclaves or in the autoclave area or at the centrifuge. Only in 3 cases has another r BFG30168 24353004 . : +U,:. : 5 nork area been determined, namely one at the press (Case Mo, 28 of the com- ' pilationl and at the drying screen (Case No. 33 of the compilation) as well as in the experimental laboratory of Farbwerke Hoechat AG (Dr. Bier, today Director at Dynamit Nobel AG, Troisdorf--Case No. 84 of the compilation). The period of the occupation according to the observation stands in no relationship to the seriousness of the diseases. Rather it is to be concluded that the intensity of the action and the disposition determine the level of the damage. Thus in the case in which a MdE of 20 was established, it could be observed that the exposure time was between 3/4 year and 14 years. Up to this time, the following exposure times have been determined with 12 checked disease cases: 1 x 60% MdE - Exposure time 5 years 1 x 30% ** - " 2" . 7 x 20% " - " between 3/4 and 14 years 3 x below 20% " - " - 5, 11 and 14 years In the previously recognized compensation cases, the following MdE state ments have been established d$dS-; beboMk,^^^. MdE 20% - 9 MdE 30% - 1 MdE 60% - 2 In 3 compensation cases, the acknowledged expert opinions are already present. The proposed MdE (30%, 40%, 70%) in each case must be checked once more on the medical side. A conference with Dr. Ernst, Technical Inspector in the Ndrnberg manage ment district showed that the different types of manufacturing should be very difficult to represent *and Dr. Earnst will send us immediately a short outline SQQSSSt^ BFG30169 6 concerning the individual methods of manufacture. However he notes that he did not intend to go into detail since he is.preparing a publication directly for this and for this reason does not wish to give out his previously obtained information* Heidelberg, April 22, 1974 S/Br/U signed BFG30170 9QQIBSZVZ