Document X7ba5Y0epNOXa6eKmMRbx7jzw

' //>C/7^' MANUFACTURING CHEMISTS ASSOCIATION Minutes of Meeting 'icrrf' JOINT SESSION Of the MANAGEMENT CONTACTS OF COMPANIES SPONSORING THE VINYL CHLORIDE RESEARCH PROGRAM and the TECHNICAL TASK GROUP ON VINYL CHLORIDE RESEARCH MCA Conference Room 9:00 AM Washington, D.c. January 25, 1974 PRESENT: T. R. Aalto A. R. Adams L. H. Ballou, M.D. A. M. Barnes J. T. Barr Z. G. Bell, Jr. W. J. Boyne R. S. Brookman A. S. Cummin C. H. Dernehl, M.D. Ernest Dixon for W. S Ferguson B. W. Duck D. P. Duffield, M.D. H. E. Everson W. D. Harris Richard Henderson for M. R. Gasgue, M.D. E. Q. Hull, M.D. W. M. Iliff Tenneco Chemicals Inc. Air Products & Chemicals, Inc. Firestone Plastics Company/Division of the Firestone Tire & Rubber Company Imperial Chemical Industries Limited, Plastics Division Air Products & Chemicals, Inc. PPG Industries, Inc. Borden Chemical/Division of Borden, Inc. Firestone Plastics Company/Division of the Firestone Tire & Rubber Company Borden, Inc. Union Carbide Corporation Allied Chemical Corporation British Petroleum Company, Ltd. Imperial Chemical Industries Limited, Mond Division Diamond Shamrock Corporation UNIROYAL, Inc. 01in Corporation Union Carbide Corporation Uniroyal Chemical Division of UNIROYAL, Inc. ASI 00007078 angiosarcoma of the liver in Goodrich vinyl chloride workers that were the subject of their press release of January 23. This information had earlier been presented to NIOSH and the Kentucky officials, January 22 and 23, respectively. He also described their program of clinical surveillance, including SMA-12 profiles, on all employees with vinyl chloride exposure. Dr. Zwicker then related the steps Goodrich has taken to minimize exposures, from those involving improved maintenance, housekeeping, and plant ventilation to changes in work practices. He stressed the uncertainties inherent in estimating employee exposures from random grab samples for atmospheric analyses, and described their use of portable indicating instrumentation (a Century Organic Vapor Analyzer) in detailed surveys of the work areas to identify locations for installation of permanent sampling probes for their centralized, automatic monitoring equipment (based on a Bendix 8401 Total Hydrocarbon Analyzer). This instrument, although not specific for vinyl chloride, is reliable, responds rapidly, and has an essentially linear response over three decades^of concentration of vinyl chloride vapors in the air. A^-pSper describing their system, "An Instrumental System for the Monitoring of Vinyl Chloride Monomer in Plant and Laboratory Work Areas," by L. B. Crider, was distributed to those present. Dr. Zwicker also described Goodrich's procedures for informing employees at risk of the nature and status of the problem, and the steps that are being taken by Goodrich for their protection. Employee briefings, in small groups, were conducted by management. At the request of the employee, consultation with medical staff is being provided on an in dividual basis. Dr. Irving R. Tabershaw, consultant to Goodrich and president of Tabershaw-Cooper Associates (the firm conducting the industry-sponsored mortality study of vinyl chloride workers) then was called upon to comment on the significance of the events related by the Goodrich representatives. Although acknowledging that identification of the pathology observed with vinyl chloride exposures was still tentative, he stressed the overwhelming likelihood that the three cases of angiosarcoma of the liver were related to industrial factors, and that at present, vinyl chloride exposures were by far the most significant common factor in their industrial exposure histories. ASI 00007079 -5- ) of the problem. It was the consensus that this could best be done if they were to join the group in the sponsorship of any expanded and accelerated research programs that it might under take. MCA was asked to extend a renewed invitation to VCM and/ or PVC producers who had declined to join the group at the time of its formation. 2.3 MCA Participation in OSHA Hearings In anticipation of public hearings by OSHA on the emergency standards they are expected to propose for vinyl chloride, MCA was asked to prepare testimony for possible presentation at such hearings. The MCA statement would be limited primarily to a narrative history of the activities of the Association and the members of the group of companies supporting the animal exposure and epidemiological studies now underway under MCA's aegis. 3. Formation of Task-Group Units It was moved, seconded and carried that the TTGVCR be instructed to organize three sub-task groups to expedite the development of plans and recommendations in the three areas referred to in item 2.1 above. 3.1 Medical Sub-Task Group Dr. M. N. Johnson was appointed by the Chairman to serve as leader pro-tem of a medical group to develop recom mendations for guidelines for industry practices in the medical surveillance of workers at risk to vinyl chloride occupational exposures. Such guidelines may include, but are not limited to, recommendations as to pre-employment and routine physical ex amination procedures and standards, diagnostic criteria for the recognition of early or incipient injury from vinyl chloride exposures, and the medical management of such injury should it occur. Those initially named to serve on the medical group include L. H. Ballou, M.D. (Firestone), C. H. Dernehl, M.D. (Union Carbide), D. P. Duffield, M.D. (ICI), E. M. Dixon, M.D. (Allied Chemical), R. W. McBurney, M.D. (Diamond Shamrock), and George Roush, Jr., M.D. (Monsanto). ASI 00007080 -7- 1. S. Juhe, C. E. Lange, G. Stein, G. Veltman, Deutche Medizinische Wochensckrift, 98. 2034-2037 (1973) 2. Kolner Stadt.-Anzeiger, 14 December 1973 3. Weser Kurier, No. 300, p. 11, 20 December 1973 4. Frankfurter Allgemeine Zeitung, 20 December 1973 5. Der Spiegel, No. 50 (1973) 6. Frankfurter Allgemeine Zeitung, 2 January 1974 5. Future Meeting Schedule The next meeting of the TTGVCR will be held at the Sheraton O'Hare (North), near O'Hare Airport, Chicago, on Wednesday, February 20, 1974. The Sub-group on Work Practices will meet Tuesday AM, at that hotel, in the suite of the TTGVCR officers, and the Research Coordinators will meet there at 2:00 PM the same date. If other sub-groups are to meet in conjunction with this meeting of the TTGVCR, they will be so notified. The TTGVCR meeting agenda will be distributed shortly. Respectfully submitted Kenneth D. Johri'son, Ph.D. Secretary, Technical Task Group on Vinyl Chloride Research KDJ:mb Minutes Subject to Approval January 30, 1974 Distribution - Technical Task Group on Vinyl Chloride Research - Vinyl Chloride Research Management Contacts - Attendees of Meeting cc : Mr. D. M. Elliott Dr. Tiziano Garlanda ASX 00007081 GEORGE E. BEST VICE PRESIDENT SECRETARY-TREASURER INFORMATION COPY MANUFACTURING CHEMISTS A^lc^lATION W5 CONNECTICUT AVENUE, N.W. WASHINGTON, D. C, 20009 (202) 483-6126 January 25, 1974 Marcus M. Key, M. D. Director National Institute for Occupational Safety and Health Public Health Service Department of Health, Education and Welfare 5600 Fishers Lane Rockville, Maryland 20852 Dear Mark: As you well know from our meeting in July 1973, MCA has a de p Interest in research into problems which have arisen concerning vinyl chloride monomer (VCM). We now understand that NIOSH has immediate plans to initiate further action resulting from the voluntary report to you by B. F. Good rich of possible health hazards at its Louisville, Kentucky, facility. We wish to reaffirm our strong desire to work with NIOSH as you see fit and pledge our hill cooperation and support. Naturally, we would like to meet with you and participate in any ongoing program at the earli st possible time. We believe the technical expertise within MCA member companies could be particularly helpful in the areas of defining health hazards asso ciated with VCM production, workplace and medical surveillance and work practices necessary to limit exposure. I am writing offering our services because of my former responsi bilities as technical director. These duties now have been assumed by Mr. A. C. Clark. I trust 1 will hear from you soon and that you will then have the opportunity to meet Mr. Clark. Sincerely, ASI 00007082 cAmvaJK 73-12-27 v/-ec<xfe (u^t fw*a W<Mt Deutsche Medizinische Wochenschrift, 1973 (43) p. 2034-2037, ( "On the So-called Vinylchloride Disease" By S. Jtlhe, G. E. Lange, G. Stele, and G. Veltman University Skin Clinic of Bonn Director: Prof. Dr. Leinbrock Since 1958. when the first information on the hazardous health aspects to workers in the vinylchloride manufacturing industries was found, and especially since 1963. when the same effects were found affecting workers in the polyvinylchloride industry (PVC), and through further reports on this subject (3# 4 7 8, 12, 28), attention has been drawn to this branch of the chemical industry. This deals with a disease similar to a skin and bone affecting scleroderma, but a disease un explainable in etiology and pathogenesis. The main symp toms of this have been the Raynaud syndrome, nodular to large area dense skin alterations and band-like osteolysis in the finger phalanges. We could report our first observations on this., disease / type in Germany in 1972 (15 16, 7). As the clinical picture was at first comparable to a specialised form of progressive scleroderma, we submitted all employees to a painstaking ASI 00007083 3 the nail plate)* We saw scleroderma-like skin alterations In 8 patients: small knots or more spread out; very coarse and relatively sharply defined, usually covering the surface skin projecting infiltrate on the outstretched hands, the distal third of the arms under the elbow, and the area of the cheeks* Three patients had no clinical skin alterations* The histology findings of the excision specimens (from the left or right hands) of all patients were relatively uni;* * form* Besides hyperorthocytosis and epidermidosls, there was an expansion and increase of capillaries in the upper cutis* An increase, widening and homogenation of the collagen bundle and a clear rarefaction and fragmentation of the elastic fibers was evident. The same findings in the epi dermis and the fibers of the upper cutis were proven to exist in the patients without clinical skin alterations* The histology alterations in the epidermis and the collagen connective tissues are similar to the edematosis to.infiltra tive stage of progressive scleroderma* Here, however, a clearly defined border is seen between that of possible but to some extent considerable injury of the elastic fibers and the vessel alterations* So far, circulation disturbances are the most common symptoms: Nine of thirteen patients complained of this, and in fact eight of them gave this complaint as their first symptom. The degree of complaint ranged from increased sensitivity to the cold and "akrozyanose" to the I&ynaud ASX 00007084 In addition, fragmentation and border defects of the Pro cessus unguiculares could be found In six patients. It is also possible to determine different degress of bone alter ation: in light cases only a small lytic zone is visible, and In the advanced stage the phalange is almost fully de stroyed and the Processus unguiculares mounts onto the basis of the phalanx cap-like. A full restitution of the bone is not to be expected based upon the facts at this time (23,24). Remarkable herein is the solid correlation of acroosteolysis and the club-like expansion of the end phalanges. ^Thus, the 'drumstick fingers" are an expression of the lytic bone process and not of an internal disease* I An examination of the blood building system and coagu lation draws our attention to this remarkable finding :> all thirteen patients showed light to serious thrombopeny. The :thrombozytic count lay repeatedly between 30,000 and i19*GC0/^.Jl (under a normal limit of 130,0C0Ati). . In.a sternal puncture given to six patients in search for an 'explanation, there resulted in no case a reference to the obstruction of the 'thrombosytopoese", osteomyelofibrosis, or osteomyelcsclerose. The other examinations showed no deviations from the norm, except for a slight reticulocls in eight patients (between 16 and 26 %), and a slight leu kopenia in five patients (2350 to 3950 leudocytes/i^jl). Reticulosis and leukopenia may be caused by the splenomegaly in the tw lve patients. At this time, it is not clear if ASI 00007085 7 for the slightly toxic alterations of the liver cells, this results from the expansion of the connective tissues in the portal system into the diffuse circulation in the liver. In advanced stages this leads to an interhepatic block (most like ly because of the hinderances in the height of the portal system, possibly similar to a sinusoidal block), with esophagus varices. It remains to be found if the splenomegaly is only is a secondary condition or if this primarily the direct 'result * .I * of toxic changes. . Of nine patients examined in the lung functions (anamnese, x-rays, .spirometry, entire body plethysmography, and blood gas analysis) after references pointed to mainly rites* trictive alterations, eight of these patients showedpartial insuffi C ciencies. Further research must be undertaken to determine If these disturbances can be traced back to the fhct that similar changes occur in the lungs as in the collagen and lastic supporting tissues of. the skin, that is, that a * * beginning diffuse lung fibrosis is the cause of these* dis* turbances. ^ The Initiating Factor This paper is concerned with an industry-caused.disease, In which the symptoms include (arranged in order of most common occurrence) thrombopeny,/splenomegaly, toxic liver damage, ventilation blockage, circulation obstruction, and skin and / tbone alteration. This complex of symptoms has not yet been ( ASI 00007086 ) 9 during polymerization and recovery processes. 2. In the discharging and opening of the autoclaves as well as in the drying process of the finished polyvinylchloride. The residual gas consists of up to 90% vinylchloride (6) and often leads to leaden tiredness and short-lasting disorientation in the employees. 3. From the polymer precipitation on the walls of the kettles. Therefore, from the technical viewpoint, it is completely possible that vinylchloride initiates the hereby described disease. Some facts are already known about the effect of vinyl chloride on human and animal organisms. The narcotic effects have long been recognized (22). Since 1958, reports have re- t peatedly been made concerning the angioneurotic obstructions and the Raynaud syndrome in workers (1, 10,' 21). In the literature one finds single references to the intoxication of vinylchloride, wherein a reversible dizziness, light to very noticeable giddiness, disorientation, skin appearing as a 2-degree burn, and lessened blood coagulation have been -* * * determined symptoms (6, 9, 11). One worker died as a re sult of poisoning. tflth the use of experiments involving animals, lung * odem, blood congestion in the lung$ liver, and kidneys, as well as decreasing blood coagulation could be proven (20). In long term experiments It was possible to produce centrolobular degeneration in the liver and necrosis with foamy vacuolization as well as periportal cellular infiltration (26). ASI 00007087 11 Iso perkutan, the fact exists that only uncovered main arteries exhibit scleroderma-like coatings and that the band-like os teolysis is only found on .the finger phalanges. We saw sclerOderma-like skin alterations as well as acroosteolytosis only In workers who had worked a long period with the cleaning of autoclaves. This can perhaps be explained by the fact that 600-1000 ppm of vinylchloride could be measured In the area of the autoclave walls (5)* As an indication based upon the * obstruction of the connective tissues, we saw the qualitative and quantitative alterations of the skin and the multipli cation of collagenic fibers in the portal system of the liver. The increase and expansion of the capillaries was visible by capillary microscopy and histology in the upper cutis, in addition to the peripheral circulation obstruction proved clinically, angiographically, and thermographically; Even tiie alteration of the bone (osteolysis as a result of trophic obstruction by damage to the vasa nutricia) and the lung (restrictive and obstrlctive ventilation blockage) can be synonomously explained. The prognosis of the disease judged quite optimistically by earlier literature-appears quite serious to us, especially with respect to thrombopeny, "splenomegaly, and portal hypertension. According to our observations of alterations in the bone, this disease should be judged with reserve. Consequences for the Practice The triassic formation of this disease system, s rious ASI 00007088 t ) 13 BIBLIOGRAPHY Literatus, ghkutation. Foradiungthtnd'.ie dee Lan- fll Anphrta'.'u. 1M. Omni, F. tkrhri- dci NorJrhein-Wevifalen. Nr 1541 Urt-u. L. IM tardcurviAer Verlag. Koln 17*4). C Dohrin-vu. V, Garca Const.lcraui (li) Juhe. C- Vcltman. Zid kiin.lt (iMico-painjeniK Jwpn f.-nontcnuiui tier tog. Vtnyl.tilnnJ-kra r;*.t.t I. Imer- Itipniud b fli^nciiiirti Jin indutuia natmnalci Simpitiunt dcr Terksinrc pvlijonim de .:n!. McJ. imctna der chemiadtcn Induatne. 27. 4. IP72. (uc.) 21 (1*47). 471. 0A Juhc S., C.-E. Lange: SkicroJermie- (I) Ijlibn, A. V., A. K. Valin, enige Hauiveranderungen, Bapnawd- A. C. IMnIni: On thi pnhi>|irnn Spndrom und Akroat-eel.icn bn Ar- of change* developing due to a lung- beitem dcr PVC-hctitellcnden Induatne. mm expovate lu the effect of vir.pl- Oil*, mcd. Wadir, 77 (177i. 1722. Tilondc. G.g. T(. prof. Zabot. 1* 0773). 14. (IT) Juhe S.. C.-E. Lange, C. Mein, C. Veltman: Zur Klimk dcr mg. Vmpl- ^ p) Ckntliiii, A.. P. Monllon: Un ehlorid-Knnkhcit. JahrnragnngDcuctdw aiadrome d'acra-oateulyic d'ungine Cewliidiaft fur Atbeuamedaia, pmfettioncllx et de contrition nuuvelle 2*. 10. 1772. m France. J. lidml. lcvtn>l. 41 (17*7). 277. (1A Lange, C.-E., S. Juhe, C. Stein. C. Vcltman: Die cog. Vinyl*iorid- (A Cordirr, J. M.. C. Fierce. M. J, Kraakheit - cine bctuftbrdir.gra Spatcno ' Ufc, A- Serrui: Acmoatcnlrae CT klettiM} Int. Ardt. Arfeciramed., im Ifaioni cutanco xaaociett diet Jcu* Dfudt. owner* affectea an nettoyaga dauiiv di*n. Cah. Med. Travail 4 (1141, 1. (171 Lange, C.-E., S. Jdhe, H. J. Martte|let, B. Mulier, C. Vcliar labir (I) Cask, V. A., P. M. Cmr, 1. D. athiden im 1ahmen dcr mg. Vinyl- Dinman, H. J. Magnumn: Occupational dilond-Krankheit. jahrettigang Deot- ocrooatcolym. II. An induamal hygiene the Ccicllidiaft fur Aricituudiaia erudp. At*. cotironm. Mlth 22 II. S. 1772. 0771). 74. u4Z01 hUattomattco, E.. A. M, Fiaher. |fi Danuger, H.: Accidental pohoning H. Chnirie, H. Danzigcv. Ann inha Bp vinyl dilnidt. Canad. mcd. Auuc. lation toxicity of vinyl dilor.de to j. *2 (17*01.121. Inhoramtp animala. Amer. iaduatr4 Dtnman. A. D.. V. A. Conk. V. M. Whitahouae. H. i, Magnueon: Occupational acmetieoKvit. I. An epidemiological ttudp. Arch, environm. Tilth 22 (1771), Cl. Hyg. Am. -J. 21 (17*0: 274; giaiett int Maltcn, It. .. B. L. Ziclhaia fed.): . Induitriel Toxicology end Dermirotcgy in the Production and Ptocmtcg of PUmki (Elaevicr: Amaterdam 17*4). it) Doiaon, V. fi., B. D. Dinmjn. M. Whhtbou*. A. N. M. Naar. M, J. Megmiaon: Occupational a.roo- (21) O'Conner, B. B.: A nev occupautm nal diaetac it bom. J. occup. Mod. 12 (1770), 224. tnolpau. III. A clinical atudp. Arch, ^222) Fcoplea, A. 1, C. D. Leaker The oeironm. HI* 22 (1771). 12. ancathetic action of vinlp *londe- (7) Dublin, U J., B. J. Vane Occupa J. Pharmacol, exp. Ther. 4g ;17221. 2B4. tional haaardt and diagnotoc cience. (22! Stein. C., S. Juhe, C.-L Lange, BaDatin No. 212 (1772). Bulletin No. 41 0741), U.S-A. Dept. Labor; tilicn in: Danaigrr (A. C. Vcltman: Bandfnnmgt Oateolraca in den Endphaiangcn dec Handakcietn. Fonadir. BAntgcnatr. Ill (17731. 40. (Ml Filatova, V. 1., L. J. Balakhonova, L I. Cfonabrrg: Hygienic condinnna in * dm production uf vinvl diloridc. Cig. Tr. pro!. Zabol 1 (17iti. (; ainert in Public Health Eagia. Abatv. 40 (17*0) Ka 4, p. *. 01) Harrit, D. K.: Health problem* in *e manufacture and nt or plaiuct. Bra. J. induarr. Med. 10 (1712), 225; Mriclt m: Mal.en. K. 1.. B. L. Ziclhvia led.): bidoatnal Toaivolwgp and DermaWlugp la the Production and Pruvrtvmg I Plattua (Elacmcr; Anutrrdim 14*4). 141. 0 Hattie. Ik. K., 47. C. P. Adanu: Allotmentvut occurring in men ci>tnd io the polpmcr-tatutn of vmpl dilenJt. Beit. med. 17*7.2, 712. PJ! Henaditer, M. (Hng )- Ceaundhmuathidbdic Arbemunre. Tu.ikuhw gitdi-arbe 'timed nmtchc tegninoung von MAK-B'crttn (lerieg Ckcrait. Meinbeta 1772). 04) Jecobp, H.r Peripherv DurthblutunpLrankheiten i.n ly.jgtl Jet blikro- (24) Stein, C_ S. Juhe, C.-E. Lange, C, Vrltman: Skclettverlndcrangen bei der tog. Vinylthlond-Krenluicn. Bomgenprama, un Orudt. Oft Suciu, I.. J. Dreiman, M. Valaakai: Conttibutii la aiudiu! imholnavinjar produce de danin de viml, Med. menu (Buc.) 12 (lH2i, 717. (2A Torkehon, T. B-. F. Open. V. K. Bo we: The tuucitp uf vnyl dtlnride an dctermintd by repeated eapovore to iahnraTotp ammait A met. iaduatr, Hyg. An. J. 22 (17*1). 227; artiett in: Mtlrea, K. E., B. L. Zieihatt (cJ.): Induatrial Tuxicologv and Dermatology in the Production and Pruutaaing of Plaitwi (Elaevicr: Amaterdam 17*4). Viola, P. L-, A. Bigoni, A. Caputo: Oncvgemc tnponae of tat tlua. lunga. and bonea to vmrl dilotuk. Cancer Bea. 21 (1771). II*. Vilaon, B. H.. . t. McComudi. C. F. Tatum, J. L. Crcedi: Occupational acrwateolyaia. J. Amer. med. Aia. 201 (17*7). 177. Dr. Susinne liiSe. Dr. C.-E. Lange, Dr. C. Stein. Prof. Dr. C. Veltmyn Univcrt:tiin-Hau:k!inik 33 Bonn 1, Venujbctg ASI 00007089 - 4* '* m 1 CONFIDENTIAL. "ppied by MCA. .anuary 30, 1974 Translations Unit/TR. 12.S97b/'-'MrB/VG 8 January 1974 PVC GAS: 40 MSN TAKEN ILL Doctors say: "Very serious" Reference: KtJlner Stadt.-Anzeiger, 14.12.73 EB Troisdorf - More than 40 workers at the Dynamit-Nobel Works in Troisdorf bei Siegburg have been attacked by a severe illness which is brought on by gases released during the production of the plastic polyvenyl (sic) chloride (PVC). Doctors at the Bonner UniversitNtskliniken (Bonn University Teaching Hospitals), who have been studying the PVC-sickness for some time, describe it as very serious. It can, in severe cases, prove fatal, particularly in younger men. The most serious symptoms are said to be sensations of giddiness and cold, headaches, swollen finger joints, bone atrophy, difficulties in breathing, reduced blood clotting capacity and liver damage. (Gee Panorama) 1 I * Circulation % j. . Mr G J Sleddon, DS0-320 I Dr D Winter, F-11 Translations Unit, R-J/G i A$I 00007090 Copi d by MCA. January 30, 1974 i Ref: Weser-Kurier. No. 300. 20.12 1973. p. 11 Insidious Disease Chemical Workers threatened by Hideous Disease due to PVC Gas Poisoning Bonn Ministry sets up Special Committee of Enquiry Bonn (our own correspondent). Chemical workers directly engaged in PVC autoclave production in large chemical factori s are threatened by a new and serious disease. At least 40 employees of a Troisdorf factory are reported to be poisoned by dangerous vinyl chloride gas. "A serious prognosis" for the victims, according to the Bonn skin specialist Professor Gunther Veltmann. Mortality from PVC gas poisoning is reported to be "relatively high" and particularly serious in young male work rs. According to the medical specialists the frightening consequences of the gas poisoning are reflected in the softening of the bones in hands and feet, enlargement of liver and sple n, severe effects to blood formation and coagulation, and as sociated grave lung disorders. The victims have increasing difficulty with breathing, and varicose veins can form in the esophagus. This previously unknown disease, according to Professor Veltmann, is "irreversible," i.e. incurable. No remedy has so far been discovered, and the only thing that can be treated is the defective organ. The victim can only look forward to in creasing disablement and insidious encroachment of the disease. Experiments on animals are now being commenced to study the causes arid course of the illness and to find antidotes. This evil disease is not even recognized yet as an occupational illness. As a result of the alarming medical reports. Federal Labour Minister Arendt has set up a special committee to in vestigate and report back. The more seriously affected victims are now claiming disablement pensions. However, they have as yet no entitlement to a pension, since this particular illness is not yet officially recognized as an occupational disease by the health authorities. 1 The Committe for Dangerous Raw Materials of th Federal Labour Ministry consid rs that regular m dical inspection of workers ngaged in plastics production is essential. Guidelines ASX 00007091 * lpied by MCA V cJnuary 30, 1974 Translations Unit/TR.12.897a/EMS/VS 4 January 1974 PVC DISEASE TO BE INVESTIGATED Reference: Frankfurter Allgemeine Zeitung, 20.12.73 Bonn/Troisdorf 19 December Many cases of illness among persons employed in the PVC plant at Dynamit Nobel AG in Troisdorf have caused concern among the local population. As Dynamit Nobel AG confirmed on Wednesday, 43 workers so far have shown symptoms of the mystery illness, which is known only as "PVC disease" at present. Two foreign workers are said to have become completely incapable of working already. PVC (polyvinyl chloride) is a widely used plastic that is produced by a number of other chemical companies apart from Dynamit Nobel AG. How seriously the situation is regarded is apparent from a statement issued by the West German Minister of labour on Wednesday to the effect that the government had instructed investigations to be carried out into the hitherto unknown causes of the disease. Details are to be laid down in January by a panel of experts. According to the Ministry of labour, the relevant employers* association is working on the assumption that the disease is caused by vinyl chloride. It was stated that the Ministry of Labour Committee considers that operatives working in the neighbourhood of PVC autoclaves must be medically examined. When the various cases of illness became known local factory inspectorates ordered steps to be taken to provide increased health safeguards on the plant. The symptoms of the condition are unconsciousness, attacks of dizziness, changes in the hands and feet, headache and nausea. According to a report from the works in question, the first cases of physical damage to workers in the PVC plants were observed in Germany in the Spring of 1972* Dynamit Nobel have been producing PVC since 1951. The Press Section at the Troisdorf works stated that: The government industrial medical officer, in agreement with the Chemical Industry Employers' Association, has instructed Professor Rudolf Gross, who holds the chair of Medecine at the University of Cologne to examine some of the affected persons and to produce a report. 6 patients from the PVC plant have now been examined by Professor Gross at the university teaching hospital. A report on some of his findings will be issued in December. ASI 00007092 TH 12902 Translation from Der Spiegel No 50/1973 Copied by MCA ^.Jiuary 30, 1974 MEDICINE Dangerous Plastic * A new and deadly occupational disease has been discovered by Medical Specialists in Bonn: workers engaged in the production of FVC risk incurable diseases of the liver. Pipes and Venetian blinds, curtains and films and whole host of articles in common use are made from FVC, a hard, durable plastic which can be moulded into almost any product. German producers alone have distributed almost a million tonnes of polyvinyl chloride over the country in the last year. PVC has so far been responsible for the death of as yet unknown numbers of chemical workers. For the production of this much desired material, wiich can be combined in so many different ways with plasticisers, fillers and pigments that it has become one of the leading products of the plastics age within the last twenty years, is apparently very much more dangerous than had beei previously been assumed. Medical specialists of the Bonn University Clinics have this year diagnosed a "vinyl chloride disease" in at least 40 of the 120 FVC workers in a labouring chemical factory. However, the number of cases is probably considerably higher than this. According to preliminary comments made by the doctors this newly discovered "occupational illness" is characterised by a "serious prognosis and e relatively high mortality rate in men of predominantly younger age groups". According to Prof. Glinther Veltman writing in the "Deutsche Medizioische Wochenschrlft" : "Certainly more than 10# as revealed by our enquiries". This occupational disease first came to the notice of dermatologist Veltman and his team in the form of characteristic changes to the skin, particularly in the fingers. However, they were soon forced to the conclusion that still worse was to be revealed by this already well-known PVC symptom : vinyl chloride harms blood and blood vessels, bones, nerves, liver and lungs. As summed up by Veltman : "A disease of the system". This plastics material apparently places at risk only those individuals actually present when the colourless vinyl chloride gas, obtained from mineral oils, is liquefied under pressure and compressed to form powder in the large reactors known as "autoclaves". This "polymerisation process" is necessary to produce the PVC which is then sold as ,lHostalit" (Farbwerke Hoechst) or "Vinoflex" (BASF): Products which are not toxic as far as the end consumer is concerned, unless, in the words of plastics experts, "Plasticisers migrate from them". Those cases In which these toxic substances have been liberated from such materials have indeed been reported for a considerable period of time. * On the other hand, the "closed system" of the autoclaves gives rise tc dangerous leakages. The Bonn Medical Specialists have been investigating "possibilities of gas leakages and associated inhalation risks" at numerous points ir. the production process. VC-gas escapes when the reactors are discharged and opened as well as through "leaks in the autoclaves". For many years doctors have been aware of the toxic natur of the gas and its narcotic effect. Almost without excepti n personnel engaged on the cleaning of autoclaves complain of feeling "dopey", giddiness and headaches. For this reason the "maximum allow;.bl concentration" ("MAK") of the VC gas has been rep atedly reduc d. According to Veltman, however, "we have s far not been aware of regular gas concentration measurem nts being carried out on production sites." ASI 00007093 Cop' -<3 by MCA Translation: TR,1V ^17 Jan.Jry 30, 1974 Ref: Frankfurter Allgemeine, Zeitung, 2 Jan 74 LIVER DAMAGE IN PVC PRODUCTION In spite of abundant warning signs no adequate supervision^ Like many other occupational diseases, the damage incurred during the production of polyvinyl chloride, or PVC, ie only now, more than >0 years after the start of industrial PVC production, being fully realised. The scale of the health hazard involved in PVC production was first exposed in a publication by doctors of Bonn University Teaching Hospital (Universitfltsklinik Bonn), who found skin damage, changes in the ends of fingers and toes, as well as liver and spleen damage, in 45 workers at Dynamit Nobel AG*a PVC plant in Troisdorf, According to reports by H J Marsteller of the Medical Klinik and Susanne Juh of the Skin Klinik in the "Deutschen Medizinischen Wochenschrift" (Vol. 98, p 2311), 45 of the 120 workers in this plant have so far been exhaustively examined in Bonn, Some of these patients were suffering from skin changes, in others the examination was carried out on prophylactic grounds. Most of these workers were found to be suffering from various types of liver damage of obscure origin. In addition to enlargement of the liver, biochemical malfunctions of the liver were detected. Histological tissue changes were finally established. Since, in spite of the diversity of the liver changes all the patients had been engaged in PVC production for 1.5 to 21 years. This can only be an occupational disease involving PVC, In 1963 circulatory disorders, inflammation -\nd hardening of the skin, thyroid deficiency and enelargement of the liver in PVC workers were reported for the first time in Roumania. It was only after re-publication of this work in 196? that similar observations were reported in Germany, France, England and the United States. But here the emphasis was on changes to fingers and toea. This led, according to the Marsteller and Jtihe report, to "attention being directed to the liver damage first noted in PVC production in the Soviet Union in_ 1949". , i The scientists are making no statements about the prognosis of the PVC liver damage. Even the frequency of this illness among other PVC producer:' is unknown. Possibly the threat to personnel is heavily dependent on local working conditions. Since the morphological picture of these liver changes corresponds to chronic toxemia, such aa also occurs from contact with chlorinated hydrocarbons, eg chloroform, the health risk could be determined by the concentration of the gaseous initial product, vinyl chloride, in the atmosphere. Since such a hazard was certainly not unforeeeable, and must indeed have been expected iti view of the existing publications, the question arises as to whether either the v.nyl . chloride concentration or the health of the workers were properly supervised in these plants. ASI 00007094