Document X781qVzJ609zgYgY0qVqne0dR

'/ / ' ^ sli f- \J/ . -JF- TRANSLATION: Bognar, Z., E. f. Czeizel, ' and N \- X. Szentesi: / ' ,2,- A /- i i '-'J f*r ^ ' * "5 <fJL. ' Jr!\'/V?) ~J~ /i.l'l EPIDEMIOLOGICAL STUDY ON THE REPRO ftol DUCTION OF PVC FACTORY WORKERS. (PVC-iizem5en dolgozok rcprodukciojanak epi- dcmiologiai vizsgalata.) Ovvosi, Hetilapj Vol. 120, No. 30, pp. 1,819--1,821, 1979. Schopf-Merei Hospital and Maternity Center, National Institute of Public Hygiene (Director: Dr. B. Toth), Laboratory of Human Genetics. [The cfty can not be established -- Tv. Ed.]. /6bd Protection of the health of factory workers is a task of high priority in the Hungarian health care system. In part, it requires improvement in the quality of industrial health services, and in part it requires more profound research in this area. This applies especially to female workers: the im portance of monitoring their reproductive processes is also stressed in the 4* resolution on population policy. The study of the causes of unsuccessful pregnancies has not Infrequently called attention to the possibility of exogen ous harmful effects, which can be linked primarily with occupational exposure. Therefore, the study of these effects from chemical substances is also an im portant task. Such studies are possibly mainly by means of animal experiments. However, extrapolation of the data and conclusions obtained from these experi ments to the human body is always uncertain. Along with other human studies, this justifies the priority of epidemiological studies. R&S 133464 JUSTIFICATION OF THE EXAMINATION OF PVC FACTORY WORKERS The results of an epidemiological study on the reproduction of workers ex posed to PVC (polyvinyl chloride) and its monomer, vinyl chloride (VC) , are re ported in this paper. The study was made necessary because of the following four factors: 1. Within the framework of the division of labor in COlfECON countries, the production of PVC is shifting to Hungary, and thus the study of this issue / vyj 3 in Hungary is of the greatest practical importance to all the socialist coun tries. 2. The carcinogenic effect of the PVC monomer, vinyl chloride (via its metabolites; chloroacetaldehyde and chloroethylene oxide) can be considered proven; the carcinogenic effect of inhaled vinyl chloride was demonstrated first in animal experiments [15, 20]; later, a significant increase in the in cidence of an otherwise rare type of liver tumor among workers handling vinyl chloride was demonstrated in various studies [2, 3, 8, 12, 16]. The frequency of hepatic angiosarcoma is surprisingly high (according to some authors, one out of 200 PVC workers can be expected to develop such tumors after a 12-year exposure), Increased incidence of tumors of other localizations (brain ) also appears probable. 3. According to the current state of knowledge, almost every carcinogen can also be considered to he a mutagen, and mutagenicity can be demonstrated at an earlier date, which makes gene damage a sensitive indicator. Thus, amo^ others, chromosome studies have offered the possibility of early detection of incipient damage in PVC workers. This is why five reports [4, 6, 7, 17, 18, 19] furnishing evidence of a significant increase in the frequency of chromo some aberrations and based on the study of 7, 11, 13, 56, and 45 PVC workers, respectively, which were published during the period 1975-1976, after studies that provided experimental evidence of the mutagenicity of vinyl chloride metabolites [1, 13, 14], have caused a great sensation in the literature. This significant increase in the frequency of chromosome aberrations was ob served i'n Ducatman et al. [4] after exposure times of 9 to 29 years, and by Funcs-Cravioto et al. [6] after exposure times of 4 to 28 years. Two teams [7, 17] did not report the length of exposure. We observed a significant 2 increase in the frequency of chromosome aberrations in 45 workers who had been exposed to a combination of monomer and polymer for 0.5 to 13 years at the PVC plant of the Borsodi Begyi Kombinat [Borsod Chemical Company -- Tr. Ed.] [18, 19]. The frequency of chromosome aberrations in 7 of these workers exceeded the confidence limit of the controls chosen from within the factory (mean + two standard deviations). We found a positive correlation between the distri bution of cases with aberrations and the length, of the exposure, in contrast to other reports in the literature. 4. Based on the studies of Nov-th American, British, and Scandinavian re searchers, it appears that PVC factories can be a source of risk not only for the workers working there, but also for their- descendants, and even for the population living in the surrounding area. Significantly increased fetal mor tality was observed among the offspring of workers exposed to vinyl chloride [10]. Significant increases in the frequency of cancer, spontaneous abortion, and in utero anomalies were observed in a population of about 150,000 living in three cities around a PVC plant in the U.S.A, [9]. EXPERIMENTAL MATERIAL AND METHOD In the fall of 1975, following previous chromosome studies, an epidemiologi cal survey was carried out to examine data on the reproduction of workers in a PVC division of the 5orsod Chemical Company. The survey, covering 231 workers, was. based on a questionnaire and interview. The workers were divided into three groups: ,1. The internal control group included 65 men and IS women (= 83 workers' who '..'ere not involved in the production and granulation of VC and PVC; these workers were selected mainly from the control center of the Borsod Chemical 3 R&S 133466 R&S 133467 i Company, from the electrical shop, and from the fertilizer manufacturing plant. These Markers were not exposed directly to any other chemical substan<^ either. 2. PVC (polymer) group: 52 men and 27 women (=79 workers) engaged in production of the polymer. 3. VC (vinyl chloride) group: 63 men and 6 women (= 69 workers) enagaged in synthesis of the monomer. (We would like to point out the fact that a strict segregation of the workers into either a PVC group or a VC group does not fully reflect reality bevause, in the interest of labor organization, some of the workers in one group are temporarily assigned jobs characteristics of . the other group.) The following data were recorlied during the questionnaire survey: r. Personal data IX. Job data ixr. Social conditions rv. Anamnesis V. Data on spouse vr. Obstetrical anamnesis VII. Gynecological anamnesis vnr. Data concerning family planning attitude IX. Data obtained from plant physician X.. Other examination data RESULTS AND DISCUSSION 1. The first task is comparison of the obstetrical data Cor the period before and after possible exposure to VC and EVC (evaluation with each subject as her own control). b According to our previous data, the. effect of indirect closure must also be taken into account 11X3 - Clndirectly exposed subjects (internal control) are defined as subjects working at the same chemical plant -- in this case at the Eorsod Chemical Company -- but who were not exposed directly to chemical sub stances, who were not engaged in the synthesis of chemical substances, etc., e.g., the clerical staff.) Based on the data in Tables 1, 2, and 3, it can be stated that the frequency of spontaneous abortions and stillbirths show'ed a sig nificant increase after the beginning of exposure compared with the correspond ing values for the period before exposure, both in the internal control and in the VC group. (The data obtained for the PVC group are not evaluable because of the low number of cases.) The increased involvement in the women suggests primarily the possibility of teratogenicity. However, it is impossible to rule out mutagenicity because of the increased embryonal mortality in both sexes. Tmp'ortant data: the frequency of spontaneous abortion and stillbirth is highest after exposure for 10 to 13 years among both men and women. This finding is remarkable partly because of the fact that the PVC plant w*as established 13 years ago, and partly because of the correlation with the results of the pre vious chromosome studies. The incidences of premature delivery, infantile mortality, mortality at higher age, and mental retardation cannot be evaluated because of the small number of cases involved. There were no significant dif ferences between the three groups concerning the incidence of difficulty in becoming pregnant [27.8%, 18.5%, and 33.3% of the women). The three observed cases of congenital malformation (spina bifida cystica, so-called congenital dislocation of the hip, and adolescent idiopathic scoliosis) are too few for a valid evaluation. It is interesting to note that all three cases occurred' among offspring of male workers; it is notable that they occurred in the PVC 5 R&S 133468 group after exposure. Spina bifida is remarkable, because it was also observed by other authors in children of PVC workers [5] , and thus vinyl chloride ex posure may also be a possible provoking factor. R&S 133469 TABLE 1. DATA ON REPRODUCTION OF THE INTERNAL CONTROL GROUP. (a) Ivhctslaos cpottcid (bX tlau U [in F4rfi NO fgyuit F^rf NO Cgyuil CuMdok ^co^ndui) (ahoJ JluUuti rn4ny vort) 25 11 30 S*ul4w*ii (g) iim4nyk Bjlroi 50 28 94 Sponiin (h) v(4I4s M*8i 24 4 20 45 7 52 V/ftlOiuWtqU No 2 1 3 5* 3'* 8** % (3.6) (3.6) (3.6) (1UH42.9) 15.4 No -- --- -- %-- -- -- " ** p <0,001 4 0.01* p> 0.001 KEY: (a) before possible exposure; (b) after possible exposure; (c). men; (d) women; Cel total; Cf) number of families Cwith obstetrical events) ; (g) number of obstetrical events; Ch) spontaneous abor tion + late fetal death; and (i) congeni tal anomaly. 2. Comparison of the occurrence of chromosome aberrations and of the data concerning reproduction. The relationships between the chromosome aber rations and the data on reproduction cannot be evaluated because of the rela tively small number of cases and because of overlapping of cases. 3. Relationship between the occurrence of chromosome aberrations and alcohol consumption. The incidence of chromosome aberrations and alcohol con sumption cannot be evaluated partly because of the unreliability of the data concerning alcohol consumption, and partly because of the small number of cases involved. (Both VC and ethyl alcohol are metabolized with the participation 6 TABLE 2. DATA ON REPRODUCTION OF THE FVC (POLYMER). GROUP. 1Itfreuiyiti eipojio'6 (b) u(4n F4rfj Nfl CoruK F4Ni N5 fgyuit C<*I4dok (f) (C) (d)(e) isJntt (ihol esurnlfty voll) 4 48 6 S(u>4siii eitmdnyel, ttim*. 9 9 15 9 SpCrtlirt vt4!4s (n) k4JI tuUfozii No 2 --2 % (33.3) - (13.3) -- (*Ad4iinii4g No %-- _-- __ 39 4 13 ---- __ __ KEY: Ca) before possible exposure; (b) after possible exposure; (.c) men; (.d) women; (.e) total; Cf) number of families Cwith obstetrical events); (g) number of obstetrical events; (.h) spontaneous abor tion 4 late fetal death; and (i) congeni tal anomaly. R&S 133470 TABLE 3. DATA ON REPRODUCTION OF THE VC (MONOMER). GROUP. ta7 ldt( F4.^i N3 Esyuit flrti rsr u(4o N9 Ssyutt Ci/UJok (f) (c)(d)(e) uimi (4K0I clamlny volt)/ v 5 SxuNmti \S/ ui.M 19 S,*>on(in ('Vi'N 4 20 5 33 rw;z4ti No % 3" 2" 5" (10.7) (40.0) (15.2) f No z~ % Q____________ 3** -- (10.7) - 3-0.1) KEY: (.a) before possible exposure; (.b) after possible exposure; (c) men; (d) women; (e) total; (f) number of families (.with obstetrical events; (g) number of obstetrical events; (h) spontaneous abor tion + late fetal death; and (.i) congeni tal anomaly. of alcohol dehydrogenase: one intermediate product of VC is chloroacetaldehyde, 7 R&S 133471 .*> these facts nay suggest the development of a possible synergism*! 4. Overall Evaluation of the Results. We were unable to demonstrate an^| relationship between the incidence of diseases (diseases of the heart or ves sels, diabetes, hypertension, gastric ulcer, tuberculosis, tumor, arthropathy) and the job-related data (length of employment, employment at the Borsod Chemi cal Company, type of job, harmful occupational .factors), The epidemilogical survey on reproduction of VC and PVC workers does not rule out a possible human mutagenic effect of vinyl chloride exposure, in agreement with the results of the chromosome studies. The recent studies also suggest the possibility of a teratogenic effect. However, all these are only premonitory signs. Yet, two tasks derive even from these findings: the quality of health protection of the workers must be improved, and reproduction studies must also be repeated in the_ future on a large number of workers. 1 Acknowledgment. We are indebted to Dr. Peteme Ruzicska and Mr. Laszld Csosz for their assistance in carrying out the survey. "Summary. An epidemiological survey was conducted covering 231 workers working in a PVC plant and other divisions of the Borsod Chemical Company. According to the results of the survey, and in agreement with the results of previous chromosome studies and data in the literature, long-term exposure to low doses of vinyl chloride can have mutagenic and tetratogunic effects in man. 8 i RErERENCES 1BO0A1.0M; 1. P:rijrA. H. C. it mttal: Nilur*. 15*73, JiJ. 941. -- ?, J. 3.: J. Amer. n*cd. As*. 1974, JJ. 229. -- J. Cfffch. J, L, .fohasnn, M. JV.` J, Occup Mvd. 1974, 7, 133. -- 4. Duectmen. A. 7C. ft fntnH; Mutation Re*. 1973. 31, 183. 3. F.jwnds, L. D, fftfjal; Lancet. 1973. 77. Ih4|. -- 8. Funci*Cravio- to, F. is mtsai; Lancet 19*5. I, 439. --* 7, 7, lm it mtiai; Mutation Re*. 1973. 34, 112. (abstract), -- 3. Kotmb^rQ. B,, Mo(*iw. C.: Wk *Envtrnn,-l(lth 1974, /J, 12, *-- 9. /pnli S. it mital; Orv, Hetil 1977, Hi, 31. -- 10. 7n/an(r, P. F, it ftnei; Lancet. 1978. 7, 734. -- 11. tfirqly J. is rittzt: Arch Environ. Cont. Tox. 1979, 4. 709 -- \2. Li. F, I., Harry. D. S.: Lancet, 1974, /, 131. -- 13. Lopneno. S. is mfiei: Mutation Res. )47fl. 34, 114. (abstract). -- 14, Macrnujjon. J,m Ramti C.; Mutation Res. 197, JI. 113. (abstract), -- 15. MrtKoni. Le/cminr, C.; Environ. Res. t974, 1, 387, -- 18, Afonsoii, R, fL it Mtsai: Lancet. 1974, //, 397. " 17. Purchase. /. F. H. it mUqt: Lancet. 1975, 77, 410. -- I. Sjcntrii 7. is r-,(sei: Medical Genetics. Prnc. 7 Ihe Symposium at Dcbreven--HajHus,z"b<7ld, Hungary. 197a. Excerpta Medico. Amsterdam--Oxford. 1977. 297. -- 19. Jccnferi /. it mfial; Mutation Res. 1978, J7, 313. -- 20. Viofe. P. L. it Cancer Res. 1971, 37. 3l. KEY: es ratsai = et al. R&S 133472 9. h\'i)5i nZTiLkf V, 120(30)1 Si<f-21 ((??) V'W il rjrrirv. O. awtall, U*. A..* Awny me- G.: Infiriion. 1976. 4. 5 4. ino. -- lit. Mfyrrt, ^ t hot Is of anliliinlics, .1 I a 1m ra lory mumml. Medical En- "I /l, et mrjmJ; Anlinitcrnh Ad- CUrrwdhrr. U7fl. 70. *1cyclopedia loe., Nov York. IfiM. -- 7. CJriiennviMf, f?.. -- Hi. .V<7*mfliiir. J\ rt (xai; Jllsch. meet. VAchr. 1(7^ /Imer*. (*., Gloria. /!..* lidccUnii. JTJTii, 4. Suppl. 4. 6H1. J0|, 1277, -- 2*1. Smirfriv C. C., Soiirfi'M. W. |,^ :i~ -- i. Grui'mvaJdJ. (i. niftfll: Irdvrlmn. P.7fl, 1, 5tjipJ. 4. 370. -- X Itufl mi. r. J.t SitnUrrkttft' M. S.t feci ion, I97ii, 4. Suppl. 4, 3(7. -- 21. Sehfft, At,: An. > nf*iin.Prch. 107(1, 2ft. *'72. -- 22. SrJuvr. M,; Infr*. Nnhof. J. J. Jr.: Antmdcrnh. Ad, Chcmnllirr. IP71, 3, lion, 1976. 4. Suppl. 4, UM -- 2.1. Sefoivr. M.; ln. t ,t7. -- |<). Srtnrr, IV. rrKsoi; Infection. M#7ii 4, Suppl. fee l ion. 1976, 4. Sup pi. 4. 255. -- 24. Shrtt/omy. i I. 417. -- 11. Jonu.mii. M.. Jitfandfr, J,, Puririfilf, G.: Infection. 157fi, 4, Suppl. I. 431. -- U, Kixx J, ft mfwti: Ini. J. Clin Pharmacol. 1175, J2. .172. -- 1.1. Mrt.ilrraky, J ej mftni; F.urop. J. Canter, 1071, J, fill. -- (4. (\nnffw*, IS.: Infection. 1976. 4. Suppl. 4. 204. 15. ijnrU\ It., Ki'mmtnch. S3., fJzuuJfo, G.: lnf<'dinn. l!7n. f. Suppl 4. IflS. -- 10 f-ufhv. 11.: Schweiz. mcd. V/schr. 1076, 70S, 450, -- 17. Maii/f, G.r 5cta*J, K. PPulvcrtr, C. J,, .T/Mirfcunu. If, J.: Chemotherapy. 1070, 22, i-- 25. Slutdorntf. 5., Utir C.t Shitdnmii. If. J.: Infection yhSpf-Meryl Kdrhoi e* Anyovedelmi Kolponl, 107(1, 4, Suppl. 4, 3(12, -- TC. Stone, If: II. rf mttnt: Ann. Oiiogot KoiegetDcijugifi Inlerel Sure. 1075. fAJ, fiflft -- 57- Wnttt, J. A. /* mtini: An(J. pdigoigolot ToiK Befo dr.), microh. Ad. Chcmulhcr. 1972. 2. 431. --> 7ft. Wtinsln^ M. J. ft mJtaf; J. Antibi'd. 1070, 23. 551. -- 20. Young, ^hmongenetiVoi (.abortjldiium U. &. Iftudci, W. L.: Anllmlcrob. An. Oirmolher. lYjj^ i. en. PAJC-Uzcmbcn dolgozok carcini'O-n cffrklu'Al (l`. 20): kr`bb ' Hban mci*i11pi1asl nyrrl a kulnnbcn ntk.i maj. lumoitfk r)dfi*rfilAUn.>k *iicnifikAnt. mrqnovrkr- dv^e vimlkluriddal dolqnrd munkA^Mii.in (2. ,1. ft. 12, 16). A mAj-anqiiitarcirna qyaVrn?.uta fHlutuVn maqas (cjtycs Slcrrdk szerjnl jrlrnlkrrrArvrl 12 dv*cs cxpnriein uUn mindrn 20b. rVC-munk.i' e<r- teben ssamnlni kcll). MAs lokalir.Aeidju lum<vt>k (afjv) fokornlt clufordulAsa is vnlnszmiinrk Utark. 3- Mai ludAsunk szerinl srabAlynnk IckinlhrUi. hoqy esaknem minden careinnqcn anvae eqybrn Tnutapvn is. viszonl a mutaq,*mfAs hamarabb mu- Uthald ki vs a pen^likai anyaq ArlalmAnak t'r rr. keny intlikAlnra. -- f'ibhck krizrilt -- a kr^m*'- srdmavirtq.Mai lehrUV';ci't Irrrmlhet ^ FVC-mun- kAsok kerdddu Arlalmamak knrai fclismcrru-rr. reprodakeiojanak fipp rzrrl kcllrli olyan nan.y fcltunvsl az irtxtalomban -- a vimlktarid mrlabohlj.iinak muUqcm- cpicicmioiogiai vizsgalata UsAt kivTlelcscn Iqaztrid vtisq.ll.tink (1. 13. HI utAn -- H"5--"&-ban ar ar nl kt'Hr-s (4. ft. 7. I", 1ft. o.s/ttt.t n.: i wi lluiptrtirniim (3 mlj unp,*1t(ni. Bogndf ZoUort dr,, Cfa^iel End'e 4i Sienleii 111von 15), am**iy 7, II. 13. 5ft es 4ft rVC-rminVAs lain alapj.in a kromosrdma-rrndcllcnrssveek Micnl* fikAns rmclkcdcset Igaiolla. Dfienfmein i:s ml?ni (11 JAVA 1.1, AT OK: Siiisz,icniiQS ': injikio Srlt*/uphf*n b^l<*i;r|( hi'^M (d'ln Al ^rUkvV''^ (rnfllurld krn>i^ *. i ptrlthlulrlrtl nn* OIvvAl lli i-*-$ Jtvvrinwn fqfy*inl<n Ik blzloMtii*, inunki' iviApUs (oRlniWoflni.lnuk. rehDI)UAckO *lMr*l1Asr. (.l,rNJAVAM.ATOK: FVrklmiHlIlmui. rn<ii<UAvirnliklt jAn) blre*^rli. drprrMihW AOAniM-AS tA AI.KAIJKA7.ASJ Kianting Adjitlt. aA (m C*.-rilip ,'Mj.ut nrnnh.m I. (hiirilltnn jill.il ih.m 3 ml- arrifl)' 1 mlhmA. ar Inlrki'tAi h^lruk-'ni iniki<ld1rMi|'Jt m<rii*n i injijil civvff 1 ml-ff fnirlhflj. Ar "pilm.Mi^` *................ utAn Afl f.>l( iH>.-rnhvji , --1.ni1 ntCMir. TnrlA r^ri^n 3--4 < imk/'nt * tvt.lj'l.'ff :n In r;rtctlrn ciOiOccmheiti- A kura Idihtarum-i ]-4 "*n 1 # 1^ irht-i, ,jp. tlf c*vr^ cjcirk* : l(f>iMnlli V^rrlfiT ^ijlvnijibl? Ipentml preriulcllv iitpridf InirnitVftjhi* vdia* riArrhb pitlch'iHMir hnldiu, nrm (iu<iroinit t* uri>l<'ptikumm*i > kfzcliSi lclr<iriflirnl. MKU.r.KlIAT.VSoKt ,1 llvir.ipi-ritfiilthhi iIpklP^M^k rn>'lti`*i>l fiH'inrtl. kill iki nnljrn akNihl*l>i; l <'i iiiii'ko'i brutUKAi kAv^uicn (-11 t.riv miilvi ^I'nlkfirn'k w m-- i* tit.Mur ni.mr>k. J t j, 1. AI1.1l4b.111 ncm tVIk rl h IlKldpfildQt kfurl/i nift-.MiniNt^et rv^m inrlk irulc^^i'Mt*', PHAI rili!kA<*n -- l --3 ml TrrinMi'i mirlr^lAl kaprt.ku li* ni; iMnink r.Mit Imnftpp IInnjrhr <'*;l .\linf li'kni ^ Vi-rrli"-* -- jiimnk I'lnit' 'iri*n in ll*"kh.il,nnk k|v#A**i* a t>rri) tivnni ikI.im jipwiM'KM, AinmtlJiiiUrt i*h 1< m'j*'.runl''thi*H'k, r.<m nrr*Vbrn -- AimnlAnn mA* nrurn. mfam li Veiikurnnkii'ir -- pJ<*pr#^,tin Aiikulhnt kl. mini ^ ikprou.im rtiH 15 ko|Al tthrl jidn^ cibkkrni* ili'd A bui"i ml* (* CvA^k'k/ntHOi.rsrvMiATAK: A*m GY03YSZER- j -- lihrtHliif.Unkk.i frvfn.11 hn14t.1i frrtilMk); -- ajrmpftihornlntfiicumnltkftl fvautfnniirlcler ri tjinprrulT hntAi ryfn*mdirj. ARUGYAR, Budapest X. I MIVM.SM.kirTf.S: nAr Itrnioii'n, ** t'Tliftiftn HS,, iknitnftil.ih.-m -- nt4t einhrintniilkiji hnlltn a vlttrilMnk tffrln kfi.-ptmtl Mfcr^mfwrrc ham i:vi"mvt/rrrklr* ha- ^mkVan -- AtkAintftVJii.i n^fn afAnUtoi, Kaiam .ilail (oVoTnit 1Avlg; ,1/a|ni>g A <virrirr fr*rvfl'ifl* til An --I# **rn bflul vj* fnlyamaini nrifn a kur* UI0- liiriainn *tai lArnvivn vrrmitl- mn<niban %ny rr^eijrri trn|*ntnl UT<n. Alkalm.irA* KnMi WMhrliifnj) alalt Mist tiptfo Unit (ociraiilafil. Ilaainilai fimi u amp- MriuniUr Mi:f-jrCiV/f.Ss O *vl Ciak v^nyff adhatA kl. Ar aont randrlkfrrf ar-rlnl hilrrtm alk alfirnmall lim^l:lh**|f(. At a trakrfndAl^i nndorA| ipak'>f11*"* rffidfliiftl * *y*<y\rf Javftllnlnl itrrlnM b1rafy r^Ofn, a belf* iy*j(ykricltifre irrUlfinr^ ipakmaiiB iiiri^kra. CAOMAOOLAnt 3X1 mlri amp. Ml ri: Jl X I ml-n amp. T4.-- ri. R&S 133473 0--25. Funcj-Crcrioto i!i mftfti (ft) 4--2ft eves ex- pvniciu utAn cszleUe erl. Krl srrrrdcsoporl (7, 17) exporieios idnt ncm kbr.blt. Ma^unk a Tlnr^odi Ve* F-Rtv57.se fcii ny i rlUilasunk et^rik kicmrllrn Ton las * frlndaU nr uzcmrkbvn dalcoz6 munk.i,wk ^ccsise- pcnck vddelinc. Zz cpyr&zl ar. uztTnr'p/'^T.srudyyi un1;;51at mimWnjcnek cmeli^vt. mnsrcsr* ar ilycn jellccu kutntAsok rlmelyitescl tesri siuVs^rcssv. | Kvilbndscn vonatki7.ik minder a noclelgornkra: repj redukciiSs folynmnlnik fiRyrlcmmcl kisrrestack 1 fonlnssArjAl a fidpesed^spolilikai haUirorat Is alA* Hi,ir7a. A sikcrtclen Icvhcssrcck nkainnk kulat.lsa | nRyvmis nemeirysrcr eppen olvan cxoncn a itaimak ^ IrhclosrfftTc hi via fcl a figyrlfnct, amrly dsusorb.m 1 a munkahclyi exporieidval Ichei kapcsoialfH. Fnn* Ins fclndat crert p^ldilul a kcmikAUAk ilyct u'Anyu KntAsainak vizsR.Mala is. Errc elsosorban AUnlkiscrlelcs Jchclosejjrk adddnnk. Ar ilycn virsqalalakbtVl t nyert acta Uric, ill. kdvclkcrtcl^sek human cxlrapo* ( Ini Asa azonban mindiR bizonylatan. Er. inrickulja --, feyeb humAn vizsgAlaioie mcllctt -- ar epidemio- lo^iai virs^Aklnk clot^rbe kcrulcsvl. qyi KombinAt PVC qyarcuysvcvben il.ft--13 escs *-- kcvcrlcn mtmomrr, ill. polimer -- rxpttriexdn.ik kitctl 4ft dafenrriban Upa^rfaltuk a kr'>mr'rr4m.i* rciidcllrnesscq-'k sri^niftkAns emclkrdt^cl (1ft. l!J) Koruluk 7 sremely rcndr)lrnrscc-tTirkci haladtdk mep az iizemi Vnnlrojl csrlrk konhdrncia limit (Atlaq + ket standard drviAcio) rrlckvl. A rcndrllrnrs csciek mc^oszIAsa cs ar expnzicios ido kitynti -- srrmben a inbbi iredalmi kiirJessel -- pin'.iv kurrclacint lalalur.k. J 4. Ar e'zak-aVnrrik.u. ancnl v* skandinAv ku- talnk virscalatai atapjan Ocy lunik, hoqy a PVClirrmrk nemesak ar oil dnlqnzu munkAsuk, h.mem utndalk. sol a kdrnycrd icriilelen did laknssAti rvszerr i s eeri lyfnrrAsok Ichcinek. Vinriklorid exprtricidr 'k kilelt riolqordk utddai kdrcbrn a map.r.ili halAlnr-is snqnilikar t cmclkcdvsti 6srlrllck (l^). Eqv CSA-bdi PVC-uzcm kdrul 3 vArnsban vft> minlccy 150P00 lakos knzoU p*'dii sriqnifikansan mrgndil n rak. spent.in vclcles ^s vcIrsruJclrtt I A PVC~*>tl dolgoid mim^djok uuLspoMldnal< rcndellcflcssegvk gyikori5Ag.< (0). j mdokld^a ; MunkanVb.m a FVC-vel (pnlivinUklerid), ill. t armak mnnorncrjcvel, a VC-vcl (vini'.klnri'l) doJ^oJ zd munkdsnk reprodukeiojinak cpidcmioi6;(ial vizs* galaUrol szAmolunk be. I A viisgAUlnt nepy tenyezo telle sniks?gcssfi: 1. A KGST-orszARnkon belOl lorUnu munkat mcgnfztA* sarAn a PVC-jeyArUs siiJypantja hnzAnkj ra tfvudik Ai, b,*y a srneialisi.i nrs7ARnk kototl cls6j snrban hazA'ikban van a leRnauynbb qyakorlali je- lcnlds<?qc a k^rrfi^s UnulmAnj'nrA'Anak. 2, A PVC monomcrj^nck, a vimlklnridnnk (ttio ' laboUtj.ii: a klArncctaldrhid fix rklArcll14naxid rt^ v^n) r;ikot .iktizo batata bizonyilotlnak lekinthrtd: 1 cldsziir AlUtkisvrlelekbcn iqaT.olUk ar inhalAcid Orroii Helilfip 1777. 120. fvlolTom, 30. nom V'lcspdlrtii onycy CJ mtkfsrcr U7S ntren -- a knr.ibban vpc***lt V.ir,m"/r,fcn'i.t- vii.'eAtatok.il kdvelOx'n -- rpidcmioleOai fflmrri't u- Certtink n Oorsndi Vcr^'l KemblnAl PVC c^Arvc.' ben a dolcoifk reproilukeitSs artntalnak mfRhat.trf';.i. s.lra. A 2.11 dnlcnrAra ktlcrjedd viMiUlal kerrit'ori mddsrerrel, kikrrriez^rs nlapon ('r1<n(. A rlolcvAkal hArom esopertra n/tnllok: I. Az u/rmi knnlrnll csoperlba a VC. ill. PVC rlA- AlUtA'Avai, crnnulAIA'Av.il nern (rctalkorA *,*rrnAlyrk -- dnnl'Vn a OVK vrrrrU''Vorpmlj,1bAt. a vittani-Mr- rrM mubrlybdl, vnlormut m'jtr.leyaepArtA d:"m^cy- s^ebtM kikrrUIA 65 fArfl + 1ft oA ^ M italeofd ke- nilL akik ImrrerfrnuJ ecr^b vrcyl espotleiAnak vm vnltak kit^ve. 2 A (TVC fp*limrr) fmp-'itat a iWirrrr rl.*si'll,i SJival \* (cih * :7 nd -- 7 0 a-il*.*. Vritill J A VC li imlkJontP et.eporlb.i a m-mi'nirr rtdil- liUs.it.il (ndatko/d m f>rfi + fi nd - f-'t t-'ole-*;** kr* full. tPel jrcrflnrnk nronbun h(vnl a htjclmcl rr R&S 133474 t~ '.* r >r ; ,1 l^nvrCv lm:y a d|Rn>5>k ninrv l<i>ltmv;i)a7j;io VC, nilnl mkPsVC*i't,CnV,#HvtroMrlVniifcntwk innua1Vr.l}ri**lrrnt iklui'nWt rintl/ti'ieaH'iiu'nrlsreu>.lntr;aiit*: nyiUisnk rgyik esnpntbd u masikba cWPmlul.f 1, MbIJjfll fir ummi koiilroll eoporl r*prodwkci<S datni CtaHrlok f.ihoJ niul^Sirii \ r^*irr4ny vOl|) 5ruN'*.7?fi 't^ escrrftnyrk si dm* Spo"l4n vc4ftfs * ItdsiSi Ichtlttgea CxpOliCid .._fT6TL til.In FA?J Ub* Epyuj t F<diH m S'___ nil- Cgyuti 25 U 36 56 26 64 24 4 70 45 7 51 hanito/it ' Vinjtoieii ' tanrtc.Jeoestig No X (3.6) (3.6} (3.6) 0 UK*2.9) 16.4 No % ** p <0.001 0,0)> p> 0.001 2, (4b*4tl A PVC (polimar) t soport Mprodukcids d*Ut - v' leheisdfjesenDoziaO (*? Cwl-ldtik --ThrNr--ti ifoii..____.._.utA*i_________-- NO r CHUI! Fdi NO Ecvuit (A S.'Am.i (ahfll smftSttsu Ht.t*tt*4ny voll) SluldM!ll 4 46 6 a9 rsi*m4nyrli sr.lms Spnr>tin vcldUn 0 5 15 0 4 13 . . X* maggait h.il.lloiAs No 2 _2 (33,3) __ (U.3) _ _ _ VcIcsiulelcH %tandcllanvtttfg No -- -- -- -- __ 3. A VC (monom*r) cioport f *produkcti) datftl leht*tigs ep<jtlc6 !AM utAn ftrti N6 fnvult F4r(i NO EqyuII CntUilQk M.ITM (.thol .rwW'.trXl E-M-m.-rny voll) 5.% * tc-tt t>V'n4nyli *fJm* Sjtr min vri^l/s * Midi 19 IliiJIoiJi No * Velcsf ulclotl r*-*idfcflanttsg No ** % 3** 2 5* * (10.7) (40.0) (15.2) 1** -- (10.7) -- 3" (0ti> A krrdcive* feJm-V^s .wAn tch'tlclre kcrWltk t HOvetkrr.u ndalnk: I. S/crHrlyi ,nl;ilfrk 31. Mtiiikrthflr* ad.itok 111. SxmrtnU* heN/cl (V. AnninnAAs V. JpWnsbir* ari.tlai * VI. Szulev.cli an.imiirris VII. Ni:y'i;>*:isJ-a i nnamn^/is VJtl. Csalndtcivoi'-ti m.n:atnrlAs adatal IX. 0!%wtvosI .nlulnk X. Efiyeb vU*g;iiati nclalok iIff. ^zlAs kiixiiU ax ns^zcfiicurs -- ccyirsxt uz alkn- y4i/Acids ndaMk mcubizbalullan^aRa. mji*rcsrt a 'Vi* c'scl't/am rmatl -- nent rrlckrlhcltV (A VC cs (dd.tlktihol miinWhsmu'.i cr.yaranl az afk"fni(.d<*''sidfnttciiAx en/mt ku/.ccnmk"dc<cvcl Inrurik: cbb- bibnl kbnaccl.ddchid. uU'.bbibiil acclnlttchid ox rtyik ktV/.li icrmck -- v/ vali'*s/imj<athcli egy eset- jf^cs sxincrct';l{i halas kialaktilA^il.) j 4. Az adatnk r>sz<Vnij|.iM 'rN'kc)csc A jiiunitAhelyi adulnk (munkAban rib'dtdlt idt. IJVK mun* 0s<rcHifdnt'j A Ftnrsndi Vri:yi Knmbinat PVC cyarrRy'Ck'vbcn. ill mAs munkuhidyein 231 cpidrminlciai vizst'.ilatut vi-RrzN'-k rl. Vi7*i;.il.itaik rri'dnir-ny#*/ *rcnnt -- cs<zhanRban korubbi kr.* mnsmmaviisgalalaik crcdmcnyciscl cs m trntl.P.mi ad-itnkkal -- a 1arti*s kis dinisu vmilklorid espn- zicio emberre mutagen, ill, tcr^lngm Ichct. rnODAl.OM: 1. /IfltfjfA. )f, C. ft fiftoi; Nalurc. IfiTi. ]$$, fit. -- i. ntnrti, /. fl ; J, Amcr. merj A** n:*. JJ. ::.r -- 3. Crrrc**, J. U. t\J .V.; J. ^ t*cis7.piny. muuk;v jvllci;i\ numkabclyi urlalmak) Occup. Med. ir>"4. J6. ISO. -- Durnr^mi. A K ft Ercdmenyck es wcobtfiitfic* <\ bclCRscjjck -.InfnrdttlAm (sziv, cr, cukurbn;. m.> 1. A tcbctsvfccs VC. ill. PVC exported idcjcnck kcsdeUHoi szAmftolt cxpowcio eltilti, ill. expoticio utdni szulcszeU aria loir dsszcvctcsc (bnknnlroi)<K `e,k vcrnyonui*. Rvonanlckcly, tbc. tumor, iiulcti) y'd,'>xitU nss/.rfii;.'Rrst ncm tudlunk kimtilnmi. A VC Jrs PVC tIniRttznk repr^dukeiojara x'onatkozu cpi- crlckdcs) :tz clsd Mndnt. Korabbl inpaszlalalaink dcfioldRiii Mrncrcsiink -- nssibaneban krom<- . iidmaviTSRAlaii adntamkkal -- ncm z;i#ja ki a vi- szrrint a kiizvctrlt cxpuzicio HutAvivnl is szAmnlni kcll (ll). {Kozuefrtt cxpimaUak (uzemi knnlroll) ftilklnrid rxpozicin csclicRcs Human mulnRcn HalA* nlatt nznkat a Azpme)y*lcrt crljtik, nkik six nrioU ve- )i)l. Jclrn vizsj.'ilnlunk at csctlrRcs irraiiup'n hatas ftyi uzemben -- jelen tsclben Porsndi Vcftyi KnmbinAl -- drjltfozmk, 6c tiozvciUn vc^yl cxpozicftnnk fl-bWmcRcl is fHveil. Mimlczck .iznnban esnk fi^. tyclmrrztctd ji lek. Ket IccndiV uinnb.m cbbul is adn- nincscnck kitiivc, vegyi any.sRnk rludlliUsavnl, for- d>k. FRyrcs/.l fnkn7ni kcll a munkavcilclcm szin- mulnzasavtil sib. nem ingtolkiiznnk--pl.adminiuV . vnpiilAt., masirszt a kcsnbbickbcn. nagvnbb rsrt- rativ dolgnzok.J Az 7,, 2.t 3. tahlAznt adalai alApjAn '<i.imon meg kcll ismctclni a rcprndukci'ts vizsgA- mcRallapilhaljuk. hi>Ry a spanlAri vcbUcsrk -- hal- * blnkat is. Mulalnn Re*. J). in) -- 3 Ed^ondi. f. O. r 1 mfjrti: L^inccl. I^IS. IK li'PS. -- S. funn11*'- fo. T. c* wifjfli.* brtnccl. It^'S. t. -- 7. Jfmurrn, S. rs r^i*fu: Mulaimn rtrs I97S. J*, 112. iab'ir.tcll -- B. Ilnjrnb^ro, D. Mrlinj, C..' Wk.-Ern trnn.-I llth. lt>7t. I). 1DB. -- fl. Icoli 5. ft miml: Orv. llrlil IflTT. U*. .11. -- 10. In/a'ifr. f*. )*. ri mfjoi; l-'mcrl. 1'tTS 1, 1M. -- It, Kitolv 3. ci Afeh fln^ircn. Cnnf. T*x. 19*^. *, lafl -- 11. Lrr, F. K. Oorryt O 5.: t-incrl tflU, ). 1.116. -- 13. Krtprienn, ft. ft mfjni: Mulapon lies. I'ltft. J*. lit. fntalract), -- 14. Moi/tui*tn. ),. nnrncl. C..' Mutation Firs. J'. 115. C.dtOr,iil> -- 11. Malloai, C.. L.c/cr*iinf. C.i Fnvin>n. Re* lIT4. 7. 167, -- tft MnoifiPi, R. ft, ft mfifli; t^*ncrt. //, 1fl7. -- 17. rrjrc/jo.ir. /. /*. /f. f "iftfil' L-tn<**t P'lS. /). 4M1. -- IB Srrnlrd I. ft mini: Mistical G^ortie*. f'rnc. if tl*e St'nu?<(tum at t>cbret'cn -- lt.>|i!u*r*`l,*/l*, vasAiilclcsck (.'yakoris.i^a szitnifikans cmclkodi*st niulai ax expoziad ttldn a korubbi, cxpozi'cid clolli ndntnkhnz kcpcsl min) nz lizcmi kontrull, mind a VC csoporlbnn. (A PVC esopnrt adalai a nafjyon Kd<rriivli*wi{rrttiifftt, Eznlnrv s;rcln**nk k7il- Picsel mnnrlnnt Or. ftuncsko {Vfcmrnrk fcwiak a (clmcres lebunvolitasaban rvvujtoU scuil<cgu* licit. Hungary, I'Gfi. r.scfrpta M**slca. AnuUnl.vii->xf.i d. 197*. "ifll. -- tfl. Sztmm t. ft nhci; Mmain*n ft*** 31. 1V.I. -- 20. Viola. F. t ri mljal: Canrrr Hf* 1971, JJ. 514. alaesnny c?clxzam mia't ncm t'rU'kclhclok.) A nok fokoKrtlt tTitUeltscRc cluHinrbim a icraitu/cnild* 1c1* hclost'Ret vi'U (cl. Visianl mimlkcl nembfn ivszlclt (nkp7,nU nuRT.aii balu'ozas mmll a mutaecniLAs .vm yarlialn Hi. Fontos aria l: niind a mk, mind a frrfiak rsrtcbcn a Jrip-iaKasabb sjmnCan vcltMcj-- halva^/.ub'brs dtifnrduUvsi Ryak^nsaR a 10--13 vvex munkahelyi rxpitti *mx cxnpnrlban van. Kx r/jy- GLUDES1H Icrtollcnitoizcr rrl a PVC-uzcn> alapilasanak idnpnn1;a (a vizs- atl S3 evvei), p^xrcszl a krrtmitsziimavbj:* Ralali ada1nkn;il kapgU ido uxxzcfuRRcsxcJ vnlA po zitiv knrrclaciii mialt fiy^'clcmi'c mvUn. A HorasxuIt'lcx, csccwinnhalabizas. kesubbi Kalalozas, crlclml JpCyatrko^saR cluforduJax a Hia csclszamnk mialt nrm crlvitclhclu. Nchczi'.clt lebn be cxrs kapesdn a h;irnm csnpnrt kib.Ou )<'nycRCfl dlcrcst ncm talAU l\ink (27.Un;tl cs 33.3"',, a nGk kw.bll). M cxziclt 3 vcJcsziilclcU f<ndcllcnosscR (xpina bifida cystkus. un. conRcnilali:. oipoficam cs adnJcxccn* idiopalbiAs scoliosb) tillsti'osan kevAx a reAlis rrL6- keicsbrz. fcrdckivt, hnfiy mindcRyik ferfiak CiUSdjA- han; ScnycRcs, bogy a VC cxnporlban ax cxpozici6 ribin jcicnlkcztck. A spina bifida nzrrt 6rdcmivl kC- lr>n fiRyclmcl, mivrl mts szczzok (5) is cszIcllAk PVC-munkAsok jiycrmckdbcn, cs igy IclrcjulUibcn mint provnkalA IcnycaoncJc a viniJHJorid capoii* oonnfc js .szerepe Ichct. . L rl' ; B> i *0 % K L :'r .r \ ( .gjivi.* ) tlnUff'C'd, it>*ot>d b lungitid ^olov t!. 'nloiBi IfMo'VB-ipun. AIKAIMAZHATO: - *]umi. muflOfOO i''U|'OCh4'*i hui?l. d'd^^cl, rtjr^b owo>;. ri mOonroo Td'got. - 1u-6oIcte rodoir6oo\ (cniouoo. wupt'oogn. *coo. bfooeboicop. aaiioicoo * tonomftef"*! fi cgr*b VtTM u16r6t m mCut"). - anaeit>iM<o1og>o< 9co it tut lot. toi^Voi. loooiroii fUtfiiot (6nitft,,t. fuiit, itb ), - ouriiol6qroi bctcndfipift *t tttl lortorda*, tolommi intubfltorot moib(jld fiutiAlt )>o<4i&t le-tlolScnilf *if. Am: 1 t.ift 5 Ji|t M.- Fl ?<M.- Tl XtBJt RCSZLCTLS tSMtunOMKH CpoAjo: 2. A kromnsznmakAinsod.isnk clrifordulA.vi ^ a reprodukeins adalok ibzcvcli-sc. A kromoszoina* kArosotSasnk ca a rcprod\>kci6s nrialok koxnUi sxcfuRRcsrk -- a relative kin Atfedo csclstAm mUtt -- imm crtdkelhelwk, 3. A knm\s7.nmakai lscxlasok cldfordulAsa ^ ax alknbolfuRVasztAs kibikti dsszcfdnRcs. A kromo* sx6makArosodAsok clofofdulasa is ax alkohoift>- j2_a__n--a. JL F1N0HVCGYS2ERGYAJI til? Burfon'U. It''ot u. 3i. forqalmono: RtAKAl Vtgjmbfl 1HI Bwdopeil. u. 54-40, I! 102'- !