Document Znz3bYVLxJmxomYyZZoq50jLd

15 July 1983 JUlRECEIVED 2 0 1983 DOW CHEMICAL U.S.A. MIDLAND. MICHIGAN 48640 Phillip Landrigan, Ph.D. NIOSH R. A. Taft Laboratories 4676 Columbia Parkway Cincinnati, OH 45226 W. E. Halpern, Ph.D. NIOSH R. A. Taft Laboratories 4676 Columbia Parkway Cincinnati, OH 45226 We recently received two articles from Gigiena Truda I Professinal Nye Zabolevania. Unfortunately, as with many Russian articles the mortality study gives so little data it is of limited value. The total number of deaths and the number of deaths per group are not given. It is not clear if exposed and control groups had equally diligent searches for cancer. The results do not appear to be consistent with U.S. or English studies although the claimed exposure concentrations are in general agreement (1 mg/M^ approx. 0.5 ppm). Interestingly, no angiosarcomas are reported. I invite your comments on the second article. Sincerely yours, T. R. Torkelson, Sc.D. Health & Environmental Sciences 1803 Building Enclosures R. Cook, M.D. W. Cooper, M.D. W. Gaffey M. Johnson, M.D. J. Lawrence C.^Stetk, J. Stafford, Ph.D. I. Tabershaw, M.D. C. Tamburo, M.D. R. Waxweiller, Ph.D. R. Wheeler AN OPERATING UNIT OF THE DOW CHEMICAL COMPANY CMA 006027 RECEIVED JUL 2 0 1983 Fedotova, I. V.:* The Incidence of Malignant Tumors Among Workers Engaged in the Manufacture of Vinyl Chloride and Polyvinyl Chloride** [0 rasprostranennosti zlokachestvennykh novoobrazovanii sreli rabochikh, zanyatykh v proizvodstvakh vinilkhlorida i polivinilkhlorida] No source given. Gigiena Truda I Professional NYE Zabclevania, : 30-32 (1983) * The Institute of Labor Hygiene and Occupational Illnesses, Gorkii. Translated from Russian by the Ralph McElrov Co., Custom Division, 2102 Rio Grande, Austin, Texas 78705 USA CMA 006028 Code: 101-1479-1 THE INCIDENCE OF MALIGNANT TUMORS AMONG WORKERS ENGAGED IN THE MANUFACTURE OF VINYL CHLORIDE AND POLYVINYL CHLORIDE Summary Epidemiologic survey of the incidence of malignant tumors in 3 groups of workers varying by the degree of exposure to vinyl chloride (VC) has revealed increased incidence of tumors in the group of sub facts working in the most adverse conditions, characterised by a high concentration of VC in the air of work site. The influence of VC on the incidence of oncologic diseases was found to be significant (P<0.001). Pulmonary carcinoma, malignant neoplasms of the lymphatic and hemopoietic tissue occur among males of the examined group more often than among the ootulaiion at large. In women the incidence of gastric carcinoma and malignant neoplasms of the lymphatic and hemoooietic tissue is significantly higher than among the population at large (?<3.0S). In the last decade the carcinogenic effect of vinyl chloride (VC) has been established in experiments on animals (Maltoni and Lefemine, 1974; Lee et al., 1977; N. N. Stovbur et al., 1979) . Some foreign researchers believe that VC increases the risk of the appearance of such tumors as hepatic hemangiosarcoma, malignant neoplasms of the lungs, brain, and hemopoietic system in workers engaged in the manufacture of VC and polyvinyl chloride (PVC) (Creech and Johnson, 1974; Tabershaw and Caffey, 1974; waxveiller et al., 1976), Tomatis CHA 006029 Page 2 et al (1978) in a review of monographs of the International Agency for Cancer Research for 1970-1977 listed VC among factors which are carcinogenic for man. In connection with this, there was great interest in a study of the spread of malignant neoplasms among people working in contact with vinyl chloride in Soviet VC and PVC plants, which was then the goal of the present work. The studies were carried out on workers in three groups which had varying degrees of contact with VC. The first group included people who worked under the most unfavorable working conditions, beginning since 1939, when VC was considered to be a nontoxic substance and the level of VC in the air of production spaces was not regulated. The concentrations of VC in the work zones in individual areas reached thousands of milligrams per m^. The second group included workers of a modern PVC plant. The level of air contamination here was significantly lower than in the first group, with the average concentration in 3 various areas of the plant ranging from 30 to 300 mg/m . The third group included people who were engaged in the production of VC monomer. In these plants working conditions were the most favorable, with the concentration of VC in most air samples not exceeding the MAC (maximum allowable concentration) for VC which was approved in 1957 (30 mg/m 3 ), and the average concentration was 6-8 mg/m^. The data on the numerical and age-sex makeup of the workers at these plants in the period from 1939 through 1977, which were needed to evaluate the rate of malignant tumors, were obtained in the personnel division of the enterprises. The data on oncological diseases were taken from the materials 006030 Rage 3 of the municipal oncological dispensary, the archives of the Civil Registry Office, the patient histories and the hospital charts of the patients. Histological verification of cases of malignant tumors reached 60%. 3232 people were included in the survey. In calculating the disease rate in the experimental group we considered not only the number of persons observed, but also the periods of observation (B. MacMan et al., 1965) and compared them with the average parameters of the disease rate of the population of the city in which the investigated plant was located and in the RSFSR for three years (1959, 1969, 1975), since 90% of all cases of malignant tumors which we found among people in contact with VC occurred in the 1957-1977 period. The reliability of the differences of the standard parameters at a significance level ? = 0.05 was determined from the con fidence limits of the frequency of malignant tumors (V. V. Dvoirin, 1979). As can be seen from the table, which presents the ratios of the level of the oncological disease rate in the investigated group of the population of the city and the RSFSR, the frequency of malignant tumors among workers of VC and PVC plants is slightly lower than that of the population of the city (0.9) and higher than among the municipal population of the RSFSR (1.1) . Among the male population of the cohort there is a higher rate of lung cancer (1.6-fold) and of malignant tumors of the lymphatic and hemopoietic tissue compared to the male population of the city and of the RSFSR. The oncological disease rate of women who have worked in contact with VC is also higher than that of the female population of the city and of the RSFSR by factors CMA 006031 Page 4 of 1.1 and 1.3, respectively, owing to more frequent cases of stomach cancer (2.1 times higher than in the city, ? < 0.05 and 2 times higher than in the RSFSR) and malignant tumors of the lymphatic and hemopoietic tissue (4.5 and 5.6 times higher, respectively, ? < 0.01) . The differences in the frequency of malignant tumors of the lymphatic and hemopoietic tissue are reliable for both sexes (? < 0.05). The standardized disease rate for malignant tumors in the first group of workers was 1.0 (calculated with respect to the city) and 1.2 (with respect to the RSFSR), while in the second group these figures were 0.3 and 0.4, and in the third group they were 0.5 and 0.6, respectively. Thus, the highest disease rate is seen in the first group, which is evidently due to the effect of the high, from the modern point of view, concentration of VC on the workers in the first years of operation of these plants. In analyzing the dependence of the frequency of malignant tumors on the dates the workers entered into contact with VC one can also trace an increase of the ratio of the standardized disease rate for more postponed periods. Thus, among workers who arrived at the VC and PVC plants in 1939-1949, it was 1.0 with respect to the city and 1.3 with respect to the RSFSR, it was 0.9 and 1.1 among those beginning work in 1950-1959, 0.8 and 0.9 for those beginning work in 1960-1969, and 0.3 and 0.4 for those beginning work in 1970-1977. Fox et al. (1976) believed that factors of occupational selection and self-selection act in groups of industrial workers, and that the disease rate of this group should theoreti cally be lower than among the population. Thus, the practically CMA 006032 Page 5 identical frequency of malignant tumors in the group of workers in contact with high concentrations of VC (first group) compared to the population now compels us to suggest the existence of an unfavorable effect on the part of the industrial environment, the more so that in the groups of workers subjected to lower concentrations of VC, which could be considered internal control groups, the rate of malignant tumors was lower than among the population. By using analysis of variance, we found that VC has a reliable effect on the frequency of malignant tumors (? < 0.001) . The results of this study made it possible to recommend practical measures aimed at improving working conditions in VC and PVC plants. Conclusions 1. It was established that effect of VC on the frequency of malignant tumors in persons engaged in the production of VC and PVC is statistically reliable (P < 0.001). 2. The highest rate of malignant tumors was recorded in the group of workers exposed to high concentrations of VC. 3. The most significant differences in the rate of tumors of individual localization compared to the population, are observed for stomach cancer in women and malignant tumors of the lymphatic and hemopoietic tissue for both sexes. CMrt 006033 Page 6 References [X] Dvoirin, V. V. In: Zpddsrdologiya rakz v siranakh S".' [The epidemiology of cancer in Comecon countries]. Moscow, 1979, p. 55-86. [2] Stovbur, N. N., Kurlyandskii, B. A., Turusov, V. S. In: Gigisna. i taksikolegiya vysokomolskulyarnykh soedinenid i kkirdaksskogo syv'ya [Hygiene and toxicology of high-molecular compounds and chemical raw materials]. Leningrad, 1979, p. 288-289. [3] Cruch, J. L., Johnson, M. N., J. occup. Med., 1974, V. 16, p. 150-151. [4] Fox, A. J., Collier, P. F. Brit. J. prev. soc. Med., 1976, V. 30, p. 225-230. [5] Lee, C. C., Bhandare, J. C., Winston, J. M. et al., Environm. Hlth Prespect., 1977. V. 21, p. 25-32. [6] P'yu. T., Ipsen, D. Prdrr.enenie epidemiologiaheskikh. mstodcv gvi izuckenii neinfekvsionnykk zdbolevanii [The use of epidemiological methods in the study of noninfectious diseases]. Moscow, 1965. [7] [8] [9] [10] Maltoni C., Leftmine G. -- Environm. Rea.. 1974, v. 7. p. 387--405. Taberstuue-1. R,, Gaffey V. R. -- J. occup. Med., 1974, v. 16, p. 509--518. Tomatis L. Agthe C.. Bartseh H. et al -- Cancer Res^ 1978, v. 38, p. 855--877. Waxvedler R. I., Stringer IT,, Wagoner I. K. et al. -- Ann. N. Y. Acad. Scl, 1976, v. 271, p. 40--48. CMA 00&034 Page 7 Table I. Race of malignant tumors of individual localization among people working in VC and PVC plants. Key: 1. Localization 2. Men 3. Women k. Both sexes 5. All malignant tumors 6. Including tumors of 7. the stomach 8. trachea, bronchi, lungs 9. skin 10 breast 11. neck of the uterus .12 lymphatic and hemopoietic tissue Note: Factors for city (numerator) and RSFSR (demoninator) were taken as unity. The asterisk denotes that differences of relative indices are statistically reliable. CMA 00603 : v,-ork lies in lirr.ates ,'ity of idensa-.oelds. .gienic )d ior of colgenous :rosols to be ua of r con- bigh, yflK 1B-006.04-057-02:547.413.133.2 H. B. <tEflOTOBA 0 PACnPOCTPAHEHHOCTH 3J10KAMECTBEHHWX H0B00EPA30BAHHH CPEHH PAEOHHX, 3AHJITUX B fIPOH3BOilCTBAX BHHHJIXJIOPHflA H nOJTHBMHHJIXJlOPHJIA Mhctiitvt rnrHeau Tpyja h npo<|>3a6QJieBaHHfi, r. TopaKHii B nocaeaHee jecsrrHJieTHe (Maltoni h Lefemine. 1974: Lee h coaBT., 1977; H. H. CtobGvp h coaBi., 1979) b BKcnepHMeHTe Ha HvHBOTHHX yCT3HOBHTH KaHIiepOreHHOe jefiCTBHe BHHH.TXJiopHja (BX). HexoTopwe 3apy6ea<HHe aBtopu cHHTa- K)T, HTO BX nOBbimaeT pHCK 803HHKHOseHHB y paOonux npoHSBoacTB BX h no- .iHBHHH.ixaopHja (I1BX) pnaa onyxoaeft, t3khx xax reMaHTHocapKOMa neneHH, 3aoKaHecTBeHHHe H0BOo6pa3OB3HHH ;ierKHX, M03ra. KpOBeTBOpHOH CHCTeMbi (Creech ;t Johnson, 1974: Tabershaw h Caffey, 1974; Waxveiller h coaBT., 1976). Tomatis h coaBT. (1978) b o63ope MOHorpadjHfl MexcayHapoiiHoro areHTCTBa no n3yneHHJO paxa 3a 1970-- 1977 rr. yno.MHHa.iH BX b HHC-ie xaHueporeHHbix jns neJiOBeKa ibaKTOpOB. B CBH3H c \'Ka3aHHbiM npejcTaB-isuio fioabuioft HHTepec H3yneHHe pacnpocrpaHeHHOCTH 3.10KaHeCTBeHHbIX H0B00fipa30aaHHfi cpejH pafioTarouiHx a KOHTaKTe c BHHH.lX.IOpHJOM B VC-IOBHHX OTeHeCTBeH- HblX npOH3BOJCTB BX H ITBX, HTO H nO- cayHCH.io ue.Tbso HacTosuieft pafioTbi. HccaezoBaHHH npoBCJeHbi y pafiOTa- kjuihx 3 rpvnn, b pa3Hoft CTeneHH koh- TaKTHpvrouiHX c BX. B 1-kj rpvnnv bohi.ih -iHua, pafioTaBiime b caMbix HefijiaronpusTHbix ycaoBHHX Tpyja, HaHHHas c 1939 r.. xorja BX CMHTaaca hctokchhHbiM BeiuecTBOM, h cojepnraHHe ero b B03jyxe npoH3BOJCTBeHHbix noMeuieHHii He HopMupoBaaocb. KoHueHTpaunw BX b 30He jbixaHHs pafioHHx Ha oTie-ibHux vnacTKax jocrurajin tnchh MHaanrpaMM b 1 m3. Bo 2-to rpynny bouijih paGonne coBpeMeHHoro npoH3BoacTBa nBX. ypoBeHb 3arpH3HeHHOCTH B03ayxa 3jecb 6bia 3HaHHTeabHo HHHte, new s 1-ft rpvnne, CpejHHH KOHUeHTpaUHH Ha pa3aHHHbIX vnacTKax npoH3BOJicTBa Koaefiaaacb ot 30 jo 300 mt/m3. B 3-fo rpynny Ghjih BKaioneHU .ihiu, paGoTaBtune b npoH3soacTBax noavneHtia MOHOMepa BX. B 3THx uexax vcjiobhh Tpyja Gbum nanGoaee G.iaronpHHTHbie, co-iepHtaHHe BX b SoabuiHHCTBe npoG B03jyxa He npeBbimaao nZIK jaa BX, yTBepHtaeHHyro b 1957 r. 130 Mr/M3), cpeaHfljt KOHueHTpauhh cociaBHaa 6--8 mt/m3. HeofixojHMhie jjih oueHKH ypoBHH 3aCoaeBaeMocTH 3aoKanecTBeHHbiMH hobo0fipa30BaHHHMH CBejeHHH O HHCaeHHOM H B03pacTHO-noaoBoM cocTaBe paGoTaBIUHX Ha jaHHhIX npOH3BOJCTBax B nepHoa c 1939 no 1977 r. Ghjih noJiyneHbi b OTieae xaipoB npeanpHsmiH. JlaHHwe oG OHKoaoniHecKHX 3a6oJieB3HHHX BWKonnpoBaaHCb H3 MaTepuaaoB ropoacnoro ohKoaorHHecxoro jHcnaHcepa, apxHBa 3arca, HCTopim 6oae3HH h aMGyjiaTopHfaix KapT CoabHbrx. riicTOaorHHecKaa sepH4>HKauHa caynaeB 3a6oaeBaHHa 3aotcaHeCTBeHHblMH H0B006pa30BaHHHMH JOCTHraeT 60 %. ^iHcaeHHocTb KoropTbi co- CTaBHaa 3232 HeaoBeKa. Gigiena Truda I Professional NYE Zabclevania, 4: 30-32 (1983) npH BWHHC onwTHofi Korc HHC.70 HafijKJ Hafi.iiojeHHa coaBT., 1965) Hbi.Mii noKa3ai ceneHi'H ropo. ho H3VHae.Moe 3a 3 roja (19 90 % Bcex c.r BoofipaaoBaHH iXH -THU, KOHT' XOJHTCH Ha ni TOBepHOCTb pi hmx noKa3aTe 1 TH P = 0.Q5 o: Hbi.w npeaeaa: HhlX H0B006d 1979). Kax BHaHO Hbl COOTHOUiei CKOii 3a6oaeB; ropTe Hace.ieH TOTa 3JioKaiec cpeaH pafioHH: HecKoabKO hh; ropoja (0,9) j cKoro naceaen 3a6o.iCBaeHOCTfc p uoKanecTBeHMUMi HUX JIOKajIMMUHK aoxa^nzauxn Bee 3.ioKaiecTBeHHhie HOBO- o6pa30BaHHX B tom qHC-ie: >Kyaxa Tpaxea, SpOHXOB, .lerxoro KOXCH voflOTOoft TKejiesu rnefiKH M3TKH viHMiJiaTH'ieCKOH H KpOBeTBOp HOH TKarni ripHMeaa hi (iHcaHTeJib) h P( 3a ejHHHny. 3ae3; wax noxaaaTejieft ChA 006036 fifWiWr -'ll.* .V'Tt* i-- Ilpn BbiHHc.ieHiiH 3a6o.ieBaeMocTH 3 onbiTHoi": KoropTe vHHTbiBa.ni He ro.ibKO hhc.10 Ha6.iKDjae.Mhix, ho TaK/Ke cpoKu Hafi.i-ojeHHH 3a HiiMH (B. Max MaH h coaBi.. 1965) h cpasKHBa.iK c vcpejHeH- HbiMii n0Ka3aTe.iH.MH 3a6o.ieBaeMocTH Ha- ce.ieH;:n ropoja, B KOTOpOM pacno^o>Ke- ho H3y-:aeMoe npoii3BoacTBo, h PCOCP 3a 3 roaa (1959, 1969, 1975). nocKo.ihKy 90 "0 3ce.\ c.iynaeB 3.ioKaHecTBeHHbix ho- B006pa30BaHHft, BbIHB.ieHHbIX H3MH Cpe jH .1HU, KOHTaKTHpOBaBIUHX C BX, npHxojHTCH Ha nepHoa 1957--1977 rr. Hoc- TOBepHOCTb pa3.1HHHfi CTaHjapTH30BaH- hwx noKa3aiejieft npw vpoBHe 3HanHMocth P=0,05 onpeaeJisi.iH no joBepHTe-ib- hhm npeaeaaM nacTOTbi 3.ioKaHecTBeH- HblX HOS006pa30BaHHli (B. B. ZtBOfipHH, 1979). Kax bhjho H3 Tafi.iHUM, rae npHBeaeHb; cooiHomeHiis ypoBHH oHKO-iorHneckoh 326o.ieBae.Mocni b H3yneHHofi koropie Kace.ieHHH ropoaa h PC<DCP, nacTOTa 3.10K3HeCTBeHHbIX H0B006pa30BaHHH cpean pafioHHX npOH3BOJCTB BX H nBX HeCKO.lbKO HHDKe, new CpejH HaCe.ieHH5I ropoaa (0.9) h Bbune, neM cpean ropojCKoro Hace.ieHHJi PC<t>CP (1.1). 3afio.ieiaeMocTb pafioHHx npoHsaoacn BX h II BX UOKlMeCTBeMHUMM H0B006pB30MHHBMM OTACJlb' HUX .lOKUHSailHM .loKi.-tmiaH* KW }KenuiH MW 06a non* Bee 3.icKaiecT- oeHHbie hobooCpaaosaHHH B tom HHcne: ^e.n>MKa TpaxeH. SpOHXOB, leTKoro KOHQt VO.TOHHOH H<ene3u mefiKH M3TKH .iHMftaTHHeCKOH H KUOBCTBODHOH TK3HH 0s ~iTT 0.8 1.0 0.9 1.6 0,5 0.7 1.4 2.5 11 "u- 09 ~ 2.1* 1.0 2,0 --U~ 0.9 1.4 0.6 0,5 0,7 0.7 0.9 0,9 1.3 1.3 1.0 1.0 0,8 0.8 4.5* 2.1* 5.6* 3.4* n p h e 1 a h 11 e. noita3aTeJiH no ropoay (3HC.iHTe.ib) h PCOCP (3Ha.MeHaTe.lb) npHHJtTu 3a eajiHHny. 3ae3aoHKa -- paiiHHHa oTHOCHte^b- Hhix noxa3aTe.ieA cT3THcninecKH AocroaepHU. CpejH MyxcKoro cocTaBa KoropTbi otv.enaeTCH 6o.iee BwcoKasi 3a6o.ieBae- Mocib paxoM .lerxoro (b 1,6 pa3a), a TaKHte 3.10KaHeCTBeHHbIMll HOB006pa3O- aaHHHMH .IHMtpaTHHeCKOil H KpOBeTBOpHOH TK3HH KaK no CpaBHeHHKD C MVJKCKHM Hace.ieHHeM ropoia, Tax h PCOCP. OHKO.iorHHecKan 3a6o.ieBae.\iocTb H<eH- UIHH, pa60TaBWHX B KOHTaKTe C BX, Bblrne TaKOBOft HceHCKoro HaceaeHHJi ropo aa h PC<t>CP b 1,1 h 1,3 pa3a cooTBeTcrBeHHO 3a cneT 6oaee HacTbix c-iynaeB paxa H^e.iyjKa (b 2,1 pa3a Bbirne, new no ropoay, P<0,05 h b 2 -- neM no PCOCP) H 3.10KaHeCTBeHHbIX HOBOo6pa- SOBaHHii .lHM(p3THHeCKOii H KpOBeTBODHoft TKaHH (b 4,5 h 5,6 paaa cooTBeTciBeHHO, P<0,01). HoCTOBepHfal pa3.1HHHH B qacTOTe 3JiOKaMecTBeHHhix HOBoo6pa3oB3HHH -IHMCpaTHHeCKOH H KpOBeTBOpHOft TxaHH h j.ih o6ohx nonoB (P<0,05). CtaHaapnooBaHHaH 3a6ojieBae.MOCTb 3.10KaHCCTBeHHbIMH H0B006pa30BaHHHMH b 1-ft rpynne pa6oTaKnunx cocTaBH.ia 1,0 (H3 pacHCTa no ropoay) h 1,2 (H3 pacneTa no PCQCP), bo 2-A -- 0,3 h 0,4, B 3-fi -- 0,5 H 0,6 COOTBeTCTBeHHO. TaKHM o6pa30M, HaHfioJibiHHH ypoBeHb 3a6ojie8ae.MocTH OTMenaeTCH b 1-ft rpvnne, HTO, nO-BHaHMOMy, CBH33H0 C B03aefiCTBHeM Ha pa6oHHX b nepBbie rojbi skc- n.iyaTaUHH 3THX npOH3BOaCTB BbICOKOft c COBpeMeHHOft TOHKH 3peHHH KOHUeHTpa- uhh BX. npH aHaaH3e 3aBHCHMOCTH HaCTOTbl 3aOKaHeCTBeHHbIX H0B006pa3OBaHHil OT epOKOB BCTynjieHHH B K0HT3KT C BX TaK- Hce npocaejKHBaeTca pocr coothouichhh CT3H2apTH30BaHHOH 3a6o.ieBaeMOCTH ansi 6o^ee OTaa.ieHHbix nepnoaoB. Tax, cpean pafioHHX, norrynHBuiHX Ha npOHaBonCTBa BX h nBX B 1939-- 1949 rr,, OHa cocTaBJiH.ia 1,0 H3 pacneTa no ropo ay h 1,3 H3 pacneTa no PCCP, cpejH nocTynHBiiiHX Ha pafioTy b 1950 -- 1959 rr. -- 0,9 H 1,1 cootbctctbchho, b 1960--1969 rr.--0.8 H 0,9, B 1970-- 1977 rr. --0,3 h 0,4. Kax CHHTajoT Fox h coaBT. (1976), B rpynnax npoMhtuiJieHHhix pafioHHx aeftcTByroT (paicropu npo<teccHOHajibHoro ot6opa h caMOOTfiopa, npHHeM h 3a6o^eBaeMOCTi 3Toro KOHTHHreHTa TeopeTHHeCKH flOJIJKHa 6bITb HHHte, HeM cpean Hace.neHHH. TaKHM o6pa3oM, npaKTunecKH oaiiHaKOBaa no CpaBHeHHKD c Hace.neHHeM HaCTOTa 3JIOKaHeCTBeHHbIX HOBOo6pa30- BaHHfl b rpynne pa6oTaromHX b koht3k- Te C BHCOKOft KOHUeHTpaUHeft BX (1-51 rpynna) yxe 3acTaBnneT npeanoaontuTb 31 - **^r w _ - .-*. -*i^"3T-:v- b.'' fc^- .'ssaptve-.r-/* !~ '1 * rpeS. i.T1 -'1y it- H2.THHHC He6.TaronpHSITHOrO 3.1HSHH3 npOH3BOJCTBeHHOH Cpeibl, TeM fio.iee HTO b rpynnax pafiosHx, noasepraBuiaxCH B03JeftCTBHK) MeHee BbICOKOH KOHIieHTpa- iihh BX, KOTopue mojkho cTOTaTb rpvn- na.MH BHVTpeHKero kohtpo.ih, 3a6o.ieBaeMOCTb 3.10Ka'4eCTBeHHhIMH H0B006p33QBaHHHMH >rase, HCM CpeJH HaCe.ieHHH. npHMemiB aHcnepCHOHHhifi aHaJiH3. HaM yaa^OCb BbJSBHTb AOCTOBepHOe BJlHHHHe BX Ha HaCTOTV 3.10KaHeC7BeHHblX HOBOo6pa30BaHHft (P<0,001). Pe3y^bTaTbi HCcneaoBaHHa no3Bo.iH.iii peKOMeHjOBaTb ajih BHeapeHHS b npaxthkv MeponpHHTHH, HanpaBJieHHwe Ha y.TyqmeHHe vcjiobhh Tpyja b npoH3BoacTBax BX h flBX. BbIBOIbl. 1. yCTBHOB.ieHO JOCTOBep- Hoe BJiHHHHe BX Ha sacTOTy 3JiOKasecTBeHHbix H0Boo6pa3OBaHHii v pafiOTaioIUHX B npOH3BOJCTBaX BX H nBX (P<0.001). 2. HaHfio.ibuiHft ypoBeHb 3a6o-ieBae- MOCTH 3JIOKaHeCTBeHHbIMH H0B006pa308ahhhmh 3aperHCTpHpOBBH b rpynne pa6oHHX, nOJBepraBUIHXCH B03Aef(CTBHI0 Bhl- COKOH KOHIieHTp3IIHH BX. 3. HaHfioJiee cymecTBeHHbie no cpaBHfiHHIO C Hace.leHHeM pa3.1HHHH ypOBHH 3afione3aeMocTH onyxoJMMH oTje-ibHoii .ioKa.iH3anHH Ha6^KUaKTCH p:.ih paxa Hce.iyiKa y ^eniuim h 3-iOKaHecTBeHHbix HOB006pa30BaHHfl .IHMtbaTHHeCKOft II Kpo- BCTBOpHOli TK3HK J.13 OfiOHX nO-lOB. .1 H T E P A T y P A Zsolsuh 3 B. -- 3 kh.: SnHaeMHOJiorHsi paxa b cTSaKax C3B. M., 1979, c. 55--86. C'oeC.yD H. H., Kyp.i.indcxuu S. A., Typycoa 3 C. -- 3 kh. Turne-ia u roKc::Kc.ion:s du- coKOMo.ieKv.iKpiitiN coejHHeHin'i ii xir-nme- cuoro c&ipbH. 1979. c. 288--289. Cruel: J. L,, Johnson .'.1. .V. -- J. occup. Med.. 1974, v. 16. d 150--151. Fox A. Collier P. F. -- Brit. J. prev. joe. Med., 1976. v. 30, p. 225--230. Lee C. C, _Bhan.do.re I. C., Winston /. .if. et al. -- Environm. Hlth Persnect.. 1977. v 21, p. 25--32. fltio T,, linceH J. npHv.eHe.Hiie snHaeMiio.'.oni- tecKHx MeTOJoa npH iisyMeHHit HeHH<t)eKmion. Hbix safioneBaHHii. M.. 1965. Maltoni C., Lefemme G. -- Eavironm. Res.. 1974. v. 7, p. 387--405. Tabershate I. R., Gaijey W. R.--J. occup. Med., 1974, v. 16, p. 509--513. Tomatis L.. Agthe C., Bartsch H. et al. -- Cancer Res.. 1978. v. 38, p. 555--877. Waxveiller R. J., Stringer W., Wagoner J. K. et al. -- Ann. N. Y. Acad. Sci., 1976, v. 271, p, 40--48. noeryniura t5.0l.rj THE INCIDENCE OF MALIGNANT TUMORS .AMONG WORKERS ENGAGED IN THE MANUFACTURE OF VINYL CHLORIDE AND POLYVINYL CHLORIDE. I. V. Fedotova Epidemiologic survey oi the incidence of malignant tumors m 3 groups of workers vary ing by the degree of exposure to vinyl chloride (VC) has revealed increased incidence of tumors in the group oi subjects working in the most adverse conditions, characterized by a high concentration of VC in the air of work site. The influence of VC on the incidence of onco logic diseases was iound to be significant (P<0.001). Pulmonary carcinoma, malignant neoplasms oi the lymphatic and hemopoietic tissue occur among males of the examined group more often than among the population at large. In women the incidence of gastric carcinoma and malignant neoplasms of the lymphatic and hemopoietic tissue is signifi cantly higher than among the population at iarge (P<0.Q3). VAX SIS.632:[547.391.3+675.743.221-07:612.433.65.018 II. A. MAKAPOB, K. H. MAKAPEHKO O BJIHflHHH METHJIMETAKPHJ1ATA H BHHHJ1XJ10PH5A HA COMATOTPOnHyiO <t>yHKUHIO THnOd>H3A Hkcthtvt ninieHW tpyaa h npo<p3afiojiesaHHH, r. fcpuKHii B coBpe.MeHHOM npoH3BoacrBe n.iaerMaCC HBX023T UlHpOKOe IipHMeHCHHe MeTII.lMeT3KpH.iaT (MMA) H BHHH.IX.IOpiu (BX) -- TOKCHHHue BemecTBa, o6.laaaratiiHe HapKOTHseciniM jeftcTBHeM. ZI^HTe.ibHoe nocryn-ieHite hx b opraHH3M pafiosero conpoBOHcaaeTCH pa3BiiTneM K.lHHHHeCKOH K3pTHHbI XpOHHHeCKOft HHTOKCHKatiHH, j.iH Koxopoft xapaKTepHo nopa/KeHHe (}3yHKiiHOHa.ibHbix erpyKiyp ro.ioBHOro Mora (B. A. AHTOHKSHteHKO), B TOM HHC.16 H 5H3HIie(j)a.lbH0fi OfiAaCTH. PaHee hsmh '6bi.io noKa3aHo, hto 3to BeiuecTBo jaeT BHpajKeHHbift coMaTOTponHHHHnifiHpyiowHH acfitpeKT (H. A. MaKapoB). OdiHaKo ocTaBa.iocb HescKo, He.M ofiyc.ioBJieH naTo.ioniHecKiiH atJxjjeKT MMA: AeflctBHeM Ha juaHuetJiaJibHbie UeHTphl H.1H HenOCpe5CTBeHHO Ha 303HHodiHAbHbie KJieTKH a2eHornno6n3a. HvHcaajica b jTOHHeHHH ii Bonpoc' o cneuii- $HHHOCTH AaHHOrO AefiCTBHH -- CBOHCT- 3eH JIH 3TOT HHrHCHpVIOIUHft (jjeHOMCH To.ibKo MMA H.m ero mohcho noJiyviiTb npt SAC l SHX npa Heii coc 2H.1 CTe: CTB CKO 34 X.1C HOC Bt 6a3 rop XH>. 6a3 ueH 60 (78 BeK 150 O.lt POT HbJ? MOE Bpe KOH Aa3 y H faiK Hr/ THX fpa KHH -ia sec: Tep' TpO Tafi. T3B V 6c ieB 7a c 6e3 1I 6o.i .ie ::oh CTI v.eH 3 3Tf OS I pa3i (ner Hblfl Te.it ni6i 3T01 D06038 --- -.*v"' .-* *** 'a*,*.*?. rtVaigr naaff MHHHCTEPCTBO 3\P\R00.\P\HtHM)l cccp BCH 0RJ3H0E IH' `IIIOF. (IBUlFCTilU r rwrm TPYAA OCHOB\H 3 1957 T05X u npotfjeccuoHaAbHbie AHPEJIb 1983 4 m 3a6oA6BaHUH M0CK3A M E2 HUH HA* EjKeMecaMHWH HayMHO-npaKTHMecKHfi ttypHa.l YAK 612.786.1 B. 3. P03EH5J1AT PABOTOCnOCOBHOCTb HEJ10BEKA H nPOBJlEMbl EE nOEbllUEHHJ! ypa.ii.cKHA .lecoiexHniecKaH hhctmtvt mm. .leKHHCKoro Kc'.:covc.*.a. CaepxioBCK npoSaeMa pa6oTOcnoco6HocTn aeaoBeKa 33HHMaeT BaJKneftuie Mecro a $H3ho.ioriiH h raraeHe Tpyaa. flpn paccMOTpcHini noKSTHa pa6oio- cnocofiHOCTH caeaveT npitHHTb ornpaBHoe onpeae.ieHHe, nocKo.ibKy eauHOft tohkh 3peHUH 3aecb eme hct. fto HarneMy MHe* hhk3, Hawfiojiee npneMaeMo caeayiouiee onpeaeaeHHe, pa6oiocnoco6HOCTb -- Be.HIHHKa (})yHKUHOHa.lbHhIX B03M0>KH0CTefi opraHH3Ma, xapaKTepii3yiowaHCH 3<pq>eK- tom :.taKCHMa.7bHoro vchjihs, hjih, noaHee, KOJIHHeCTBOM H KanecTBOM pafiOTbl npit HanpnjKeHHH MaxcHMa-ibHofl iimeH- CIIBHOCTH H.1H a.THTeabHOCTH. XUyMH COCTaB.TRHDUXHMH ee HBJIRK3TCR MaKCHMa.IbHO B03.M0/KHbie 4>H3HOJIOrHHeCKHe 33TpaTbl il 3CpCfaeKTHBH0CTb 3THX 3aTpaT. npoHJiJTK3CTppveM cKa3aHHoe Ha npiiMepe ousHKH $H3HReatoA pa6oTocnoco6* hocth. Ha npaKTHKe HcnoJib3yeTca aBa noaXOiia, KOTOpbie HeTKO CQOTBeTCTBVIOT JBVM Ha3B3HHbIM COCTaB.'IJUOIIlHM pa60TOcnocofiHocTH: I) onpeaeJijuoT npeawibHbie ypOBHH (}>H3H0.30rHHeCKHX 3aTpaT nyTeM n3MepeHna MattcHMajibHoro noTpeS.ieHHH O2, 2) onpeaejiaror 3<i><t>eK- THBHocTb (|)H3HonorHqecKHX 3aTpaT (sax 6bi Kna opraHH3Ma) Ha ochobc H3BecTHoro TecTa PWCiro- 3th noaxoaw hhotaa npoTHBonocTaB.unoTcs, MejKay reM ohh aonoJiHRKJT apyr apyra, xapaxTepii- 3va cooTHouieHne Meacjy coctoB.ihioiuhmh pa6oTocnoco6HOCTii. TpyaosaH aeaTeabHOCTb b otjihhhs ot CnOpTHBHbIX COpeBHQBaHHft BbinOJIHHeTCH, xax npaBnao, He npH MaKCHMajibHbix Ha- rpy3Kax. npaKTHaecKoe 3HaaeHne oueH- kh pa6otocnoco6HOCTH, RB.IHIOUieHCa B aaHHOM caynae noTeHuna.ibHoft xapaxie- pHCTHKOft, COCTOHT B TOM, HTO OHa OTpa- HcaeT Be.iHHHHy $yHKUHOHaabHoro pe3epBa, t. e. pa3HHixbi Mencay npeaeJibHhiMH B03M0JKH0CTHMH H pafiOHHM ypOBHCM 43ii3noaorHHecKoro HanpnjKeHHa. Ha.nimie.M TaKoro pe3epBa oOecneaHBaiOTCsi KaaecTBO h HaaencHocTb npH Bbino.iHSHHH pafiOTbi, a TaKHce npeaynpeHcaeHHe nepeyTOM.ieHHH, Beayiuero k p33bhthio npeanatoaoniH, riocaeaHHii momcht itucraa BicaioHaioT b ca.MO noHimie pafioTO- CnOCOfiHOCTH (A. 0. HaBaKaTHKHH H B. B. KphiJKaHOBCKaa), xoth, crporo roBopa, cneayeT oinocHTb 3to k aoae ee, aonycTHMOfi aaa pea.iH3auHH, t. e. k peraaMeHTHpyeMofi Be.THHHHe pafioaero HanpaJKeHHS H COOTBeTCTBeHHO 3aUlHTH0fl 30HW, C03aaBaeM0ft (JjyHKUHOHaJIbHHM pe3epB0M. PafioTocnocofiHocTb He c.ieayeT HaeHTH4>HUHpOBaTb C aByMH apyrHbOI nOHHTHaMH, 6JIH3KHMH K HSii, HO ae/KaiUHMH B HHbix ofiaacTHx -- a c<{>epe comiajibHO3K0H0MHaecK0ii 11 b c$epe npaBOBoii. cfarHeHa Tpyaa h npo4>eccnoHaw7hHbie safioaeaaHna*, 1983 CMA 00^039 OE20T0BA H. B. 0 pacnpocTpaHemiocTii 30 FEDOTOVA, I. V. The incidence of mali- j. ICKaMCCTBCHHfalX HOB0Ofipa3OBaHIUl CpeaH crnin; tumors among workers engaged in paficmix, 3aKSTiiix b npoH3BoacrBa.\ biihh.i- the manufacture of vinyl chloride and poly* k. iccii,za h no.iHBHHH.ix.iopiiaa :ny! cilloridc MAKAPOB H. A.. MAKAPEHKO K. II. O 3.r,!s>;iiH MeTii.iMeTaKpH.'.aTa n bhhii.ix.io- p::;a na co\iaTOTponHyio (pyHKtiiiio riino<pH33 32 MAKAROV, I. A.. MAKARENKO. K. I. The effect oi me:hy| methacrylate and vinvl cnionde on hypophyseal somatotropic func tion 3.10BIIHA H. C.. dP^KECKHH B. B. Otja.GSHHbie noc.TejCTBiia jeitCTBHH cTepona iOfi3op -iKTepaTypw) 36 ZLOBINA, N S,, 3RZHESKY, V. V Late results oi styrene efiect (review of litera ture) KpaTKHe coofiuieHHH Brief Communications KIIPII.IbHVK n. n,, MABAH H. M. Nc.io- aiiH Tpyaa h HeKOTOpue <pn3Ho.ioni'iecKHe noKa3aTe.ni y pafiomi.x XMenetpadpiiK K.1HMEHK0 r. fl,, K03.10B M. A.. .110- TOB A. II., MHP01UHHMEHK0 A. 5., CA3EHK0BA H. E. CocTosHHe d>H3Ho.ionniecwtx mvHKUHfi y paSotHHU, 3aHHThix 3pHTe.ibHo-Har:pHiKeHHWMii Biuavn pafior npw nesucoxov ypoBHe jBHraTe-ibHOii aKTHBHocTH MIIXE.lbCOH 2. A., BHHOTPAJOB C. A. nyrii npodjH.iaKTHKH .30Ka.3bHb!X ox-iaatjeki:u pwfioofipafioTMHKOB Ha cyjax KXPHAYX .1. A. OnTiiMH3auHB Tpypa .via* uihhhctob a.ieKTpoxocTOBbix KpaHOB uexa oGamra OKaTbiiueit TPHHEBHH B. A. K Bonpocy o TpcHHposxax opraHH3:>ia ie.ioBeKa b rHnepOapHiecKnx YC.10BHHX TVP6HH E. B.. A.l^blPEBA M. B,, MHJIKOB .1. E. IlaMeHeHHe HeKovophix noxaaaTe-iefi HepBHofl chctcmm y pafioTaioiuHX a KOKtaKTe c cpia.iaTHUMH rtnacTmtmKaTopa.Mii 3PMAH M. H,, 5AVMAHE M. 3., C.lHHbKO B. H,, yCTHHEHKO A. H,, BEPIIH f. E., KPACHOKYICKAH .1. M. OcoPeHHOcTH caHHTapHOH cT3HaapTH3auHH ajpo30.3H xapfiOKpoMeHa b B03ayxe pafioteH 30Hbt npoH3BopcTBeHHbix noMenieHiifi niT.lHHA A. T.. ITCEB C. 2., BPIOXOBEU T. T. Mopio.iorHiecKHe h3mbhchhh opranos ^HBOTHhix. noaBepraBiunxcH HHra*iHuuoKKoft 3aTpaBKe aKDii.3HHTpH.30M PA3.IAP0BA H. H,, P0J1HHK0B A. B.. APOHOBA E. H., UIV5 0. A.. TAPIUEHIIH B. 0. PHnieHniecKan oueHKa riHTaHHH DifiOTHHKOB n.IBBVHHX SypOBUX VCTaHOBOK KacntiiicKoro 6acceftHa IIxcpcpMauiia coaeTCKOro TOKCHKO.iorHiecKoro ueHTpa 38 KIRILCHUK, P. P.. CHABAN, I. M. Work ing conditions and some physiologic para meters in workers of hop factories 40 KLIMENKO, G. Ya,, KOZLOV. M. A.. LYUTOV, A. I.. MIROSHNICHENKO. A. B,, SAYENKOVA. N, E. Physiologic functions in female workers engaged in work involv ing vision exertion and low levels oi motor activity 41 MIKHELSON, D. A,, VINOGRADOV. S. A. Approaches to prevention oi cooling oi workers of factory ships 43 KARNAUKH. L. A. Optimization oi work oi electric travelling crane operators at pel let calcination shops 45 GRINEVICH, V. A, Training of the human body under hyperbaric conditions 46 TURBIN, E. V.. ALDYREVA. M, V., MILKOV, L. E. Changes in some nervous system characteristics m workers exposed to phthaiate plasticizers 48 ERMAN, M. I.. BAUMANE. M. E.. SUNKO, V. N.. USTINENKO. A. N.. VERICH, G. E.. KRASNOKUTSKAYA. L. M. Features oi sanitary standardization of carbocromen aerosol in'the air of enclosed work environ ment 50 GITLINA, A. G.. GUSEV. S. D,, BRYUKHOVETS, T. G. Morphologic changes in the organs of animals exposed to acryi nitrile inhalation challenge 52 GAZDAROVA, I. N.. RODNIKOV. A. V. ARONOVA, E. N,, SHUB, 0. A., GARSHENIN, V. F. Hygienic evaluation of nutrition oi workers at' the pontoon drilling rigs of the Caspian sea 54 Information of the Soviet Toxicologic Centre XpOHHKa I1AHK0BA B. 5. BcTpeia c BeTepanaMH TDVJ3 Current Events 59 PANKOVA, V. B. Meeting with work vete rans PeUCHSHM ryJSOBCKHn T. A. PeitCH3im Ha khhtv P B. SopHceiiKOBoft. THrneHa Tpyja npH aoPbi-ie no.ie3Hbix HCKonaewux OTKpbtTbiM cnocc5iv. M., MeaiimiHa. 1982 r. 176 c ii.i.i Book Reviews 59 GUDZOVSKY. G. A. Review of the book by R. V. Borisenkova. Occupational hygiene in strip mining of mineral resourses. Moscow, Meditsina Publishers, 1982 I. A. Makarov, K. I. Makarenko*: The Effect of Methyl Methacrylate and Vinyl Chloride on Hypophyseal Somatotropic Function** [0 vliyanii metilmetakrilata i vinidkhlorida na somatotropnuyu funktsiyu gipofiza] *Institute of Labor Hygiene and Occupational Illnesses, Gorkii **Received June 16, 1982 Gigiena Truda I Professional NYE Zabclevania, : 32-36 (1983) ranslated from Russian by the Ralph McElroy Co., Custom Division 102 Rio Grande, Austin, Texas 78705 USA CMA 006041 to *3 Code: 101-1479-2 THE ;CT OF METHYL METHACRYLATE AND VINYL CHLORIDE ON HYPOPHYSEAL SOMATOTROPIC FUNCTION The basal STH level and its time course were studied in insulin or glucose tolerance tests in 24 normal subjects and 134 workers exposed to methyl methacrylate and vinyl chlo ride. Examination of workers engaged in chemi cal industry showed that many of them had paradoxical responses to insulin or glucose challenge, that may be due to toxic affection of the diencephalic region, and an abrupt in hibition of adenohypophyseal STH-production that also may be referred to the effect of these chemicals on the hypothalamus. As an example of the STH-inhibiting action of methyl metha crylate. the authors describe a case of acro megalia that ceased to progress as the patient started working in conditions of exposure to high concentrations of this ether. In a modern plastics plant methyl metacrylate (MMA) and vinyl chloride (VC) are widely used - toxic substances which have narcotic action. Long-term entry of them into the body is accompanied by development of a clinical picture of chronic intoxication, for which damage to 'functional structures of the brain is characteristic (V. A. Antonyuzhenko), including damage in the diencephalic region. We demonstrated earlier that this substance produces a pronounced somatrotropin-inhibiting effect (I. A. Makarov). However, it was still unclear what caused the pathological effect of MMA: action on the diencephalic centers or directly on the eosinophil cells of the adenohypophysis. The question of the specificity of this action also needed to be cleared up - is this inhibiting phenomenon inherent only to MMA or can it be produced under the effect of other industrial toxins ? CMA 006042 Page 2 Studies were carried cur on 134 workers ci the chemical industry and 24 functionally healthy people who had never worked in the chemical industry. The main group consisted of two subgroups. The first group included 100 workers from an organic glass (OS) plant, who were exposed to MMA, of which 51 suffered from chronic intoxication with MMA, while the second group consisted of 34 workers of a polyvinyl chloride (PVC) plant, of which vinyl chloride disease had been diagnosed in 26. Only the base level of the somatotropic hormone (STH) was investigated in the control group, while for the workers of the chemical industry, in addition to the base level, we investigated the concentrations of this hormone 30, 50 and 120 minutes after glucose loading (78 workers) or insulin loading (56) . The glucose was administered per os (50 g). Insulin was administered in an amount of 0.15 U per kg body weight. STH in the blood serum was determined by a radioimmunological method with the aid of a diagnosis kit made by the Sorin Company (Franca). Along with the STH the glucose level in the blood was tested by the glucosoxidase method. The basal STH level of the control group was 5.4 0.2 ng/ml, which corresponds to the data of other reserachers (S. A. Vasyukova and A. M. Granovskava-Tsvetkova; M. I. Balabolkin). The glucose level was 71.0 t 4.0 mg%. A reliable depression of the somatotropic function of the adenohypophysis was characteristic for the chemical workers (see table). An especially pronounced depression of STH output was seen in those suffering from occupa tional diseases before they had been removed from contact with the neurotropic toxins. The STH concentration was slightly higher in the workers without occupational illnesses, in the patients with those illnesses afcer they had ended industrial contact with MMA and VC, but the concentration nevertheless CMA 006043 Page 3 differed reliably from that in the control group. In spite of the fact that MMA and VC differ significantly in chemical structure (the former is an ester, while the latter is a chlori nated hydrocarbon), they produce approximately the same somatotropin-inhibiting effect* Evidently, this effect of these toxins is related to their nonspecific narcotic action on the central nervous system. An analogous effect has been observed for another narcotic substance - ethyl alcohol (Tamburrano). The STH and glucose dynamics during the insulin test and the glucose tolerance test is shown in the figure, from which it can be seen than administration of insulin is accompanied by an increase of the concentration of STH in the blood, which is evidence of stimulation of the eosinophil cells of the adenohypophysis, but even against a background of such stimulation the maximum level of this hormone did not reach the basal level for healthy people. The normal reaction, which was expressed in an elevation of the STH level during the development of hvooglycemia, was observed only in 32 of the 56 tested workers of the chemical industry, in 10 there was a paradoxical reaction consisting of a reduction of the STH level with a decrease of the concentration of glucose in the blood, and in 14 there was no reaction of the hypophysis cells to the changing glucose level. A gradual stable increase of the STH level as hypoglycemia became deeper was observed in 21 of the 32 patients with normal reaction, while in 11 patients the elevation of the hormone level was very brief, and was followed by a decrease of the STH concentration in the blood, in spite of the development of pronounced hypoglycemia. This brevity of the reaction of the adenohypophysis in workers of the chemical industry is evidently 00&044 Page 4 related to absence of reserves of this hormone in the eosinophil cells of this gland. The reaction in the form of an initial elevation of the STH concentration, which is then replaced by a drop of this concentration, was basically observed in persons suffering from chronic occupational intoxication with MMA. During the glucose tolerance test STH was not detected in any of 4 samples for 3 of the tested workers, paradoxical reactions were observed in 10 workers - an elevation of the STH at the same time as an elevation of the glucose concentration in the blood, in 23 workers the STH level did not change as the glucose level increased, and in 42 of those examined there were normal reactions consisting of a decrease of the STH level as hyperglycemia developed. In 4 patients, who were put in the group with a normal somatotropic reaction to glucose, the decrease of the STH level was preceded by a pronounced elevation of it in the peripheral blood. This elevation of the STH level was usually observed at the moment the ascending branch of the sugar curve became a descending branch and was probably due to a significant elevation of excitability of the nervous system, during which pulses from the glucoreceptors, which regulate the STH output, reached the adenohypophysis not only in the development of hypoglycemia, but even when there were negligible variations of the concentration of carbohydrates in the blood. This phenomenon was characteristic only for those patients with chronic intoxication with MMA. We do not have data on the direct effect of the investigated narcotic toxins on the STH-producing cells of the adenohypophysis. The noted depression of STH output under the effect of MMA and VC, the existence of frequent paradoxical reactions both to glucose and to insulin may be evidence of toxic damage to the diencephalic region in the development of chronic intoxication CMA 006045 Page 5 by these substances. It is just this interpretation which other researchers give to the paradoxical reactions of STH to the indicated irritants (M. I. Salabolkin; G. G. Kyandaryan and A. S. Ametov; Wright). The degree of depression of the somatotrophic activity of the hypophysis under the effect of MMA and VC was practically the same, which is evidence of identical analogous toxic damage to the hypothalamus, while glucose or insulin loadings reveal a significant difference. A pronounced change of the STH level at the smallest variations of the glucose concen tration in the blood was characteristic for persons suffering from MMA intoxication, while pronounced variations of the glucose level did not cause a significant change of the STH index in those suffering from intoxication with VC. It is probable that this difference is due to the different action of these substances on the receptor apparatus of the vessels. Activation of the glucoreceptors, which control STH output, was observed in intoxication with MMA, while their activity was suppressed in vinyl chloride disease. The data obtained on the nonspecific STH-inhibiting effect of industrial toxins of narcotic action can be used as a sufficiently reliable and very sensitive criterion of chronic occupational intoxication. The soundness of using STH, and not some other hormone of the adenohypophysis, as an indicator of toxic damage to the hypothalamus is due to its unidirected only in a direction of a decrease of concentration - effect under exposure to industrial toxins. A phasewise type of toxicogenic changes is characteristic for other tropic hormones (thyrotropin, follicle-stimulating, luteinizing): first an increase, and then a decrease of their concentration in the blood, which sharply reduces the diagnostic value of these changes. CMA 006046 Pace 6 We consider that a drop of the STH level below 2 r.g/ml is a symptom of a pronounced toxic action on the nuclei of the hypothalamus. When the other neurological symptoms which are most often used to establish a diagnosis of an asthenic syndrome in combination with autonomic-sensitive polyneuritis appear, the concentration of STH in the blood is at the 0.6-0.9 ng/ml level, i.e., the changes of this hormone proved to be the earliest symptom which allows us to suspect occupational neurotoxicosis. It is striking that in nine-tenths of the people who had worked for long periods of time wioh these neurotropic toxins and who had not been diagnosed as having occupational illness, the STH level remained significantly reduced after they had left contact with these substances, which is evidence of irreversible organic microchanges in the nuclei of the hypothalamus, even though these changes could not be caught by neurological methods. The absence of complete normalization of the STH level in most of the workers with long lengths of service (without occupational illnesses) of the OS and PVC plants confirms our opinion regarding the very high diagnostic sensitivity of the method of determining the STH in the blood serum. At the present time, two neurological syndromes are used as the main diagnostic criteria for establishing a diagnosis of occupational illness: the asthenoneurotic and the astheno-organic, when there is autonomic-sensitive polyneuritis present (V. A. Antonyuzhenko). However, they do not always reflect the depth of damage to the subcortical centers. An investigation of STH in two groups of patients with occupational illness - with asthenoneurotic (35 workers) and astheno-organic (48 workers) syndromes - showed the very same concentration of STH in the blood serum - 1.1 0.1 kg/ml. In those cases where a more detailed study of the degree of toxic effect on the subcortical centers CMA 006047 Page 7 was needed the determination of the STH proves to be mere informative. An illustration of the STH-inhibiting effect of the industrial toxins of narcotic action is one of our clinical observations. Patient E., 40 years of age, entered the clinic on October 24, 1975. She had grown and developed normally. At age 17 she had begun to be troubled by severe headaches without visible causes, the features of her face began to enlarge, and her fingers began to thicken. However, neither the patient herself, nor her parents, who had noted these changes, paid proper attention to them. A year after the appearance of these symptoms she began to work as an instrument worker in the catalyst installation at an OS plant, where she was exposed to significant concentration of MMA. Some time after beginning contact with this substance the enlargement of the zygomatic processes and the nose and the thickening of the fingers stopped. At 21 she married. She had six pregnancies, of which two proceeded to term and four ended in abortions. In spite of such powerful stimulation of the function of the acidophil cells of the adenohypophysis, neither the facial features, nor her field of vision, nor her fingers began to change. At the beginning of the 1970s, after 14 years of contact with MMA, headaches appeared again and gradually grew in intensity. Later there appeared weakness, irritability, paresthesia of the upper extremities and shooting pains in the vicinity of the heart. Acromegaly of the facial features, a barrel-shaped rib cage, and thick thumbs were observed objectively. Craniography revealed enlargement of the dimensions of the Turkish saddle CMA 006048 Page 3 (craniocaudal 15 nun, dorsoventral IS mm) and an abrupo thinning of its posterior wall. Changes of the fundus of the eye and narrowing of the fields of vision were not observed. Taking into account the data of the sanitary-hygienic description of working conditions and the long period of work in contact with MMA, the absence of progression of the eosinophil adenoma of the hypophysis, we evaluated her complaints as the initial signs of occupational neurotoxicosis. Chronic occupational intoxication with MMA and eosinophil adenoma of the hypophysis in a phase of remission were diagnosed. The patient was transferred to work away from contact with MMA. In 1977 a significant improvement of her condition was seen in a dynamic control examination: the headaches had almost completely stopped, the weakness, irritability and pains in the heart had vanished. The STH level in the blood was 9.5 ng/kg. In a glucose tolerance test the STH concentration in the blood practically did not change, varying from 9.5 to 10 ng/ml. In a second craniography of the osteal accretions changes were not seen. Narrowing of the fields of vision was not detected. In our opinion, it was specifically the STH-inhibiting effect of MMA which was the reason for the cessation of growth of the eosinophil adenoma of the hypophysis in this patient. Growth did not resume even after six pregnancies, which often cause acromegaly to progress. The STH-inhibiting effect of MMA and VC , which we have established, is evidently related to their narcotic action on the hypothalamus, specifically on the ventromedial nucleus. CMA 006049 Page 9 References [1] Antonyuzhenko, V. a., et al. Gig truda, 1972, No. 9, p. 19-22. [2] Balabolkin, M. I. Sekrecsiva gornona rosea v norne i patologii [Secretion of growth hormone in the norm and in oathology]. Moscow, 1978. [3] Vasyukova, E. A., Granovskaya-Tsvetkova, A. M. Klin, med., 1977, No. 4, p. 124-127. [4] Kyandaryan, G. G., Ametov, A. S. Probl. endokrinol., 1978, No. 5, p. 37-39. [5] Makarov, I. A., Makarenko, K. I., Salrain, A. A. Endokrinnava sis tana organizma i toksicheskie faktory vneshnei sredy [The endocrine system of the body and toxic factors of the environment]. Leningrad, 1979, p. 134-135. [6] Tamburrano, G. et al. Cited in Balabolkin, M. I. [7] Wright A. D. et al. -- Proc. roy. Soc. Med_ 1970, v. 63, p. 221--226. CMA 006050 Page 10 STH and glucose dynamics when insulin tolerance and glucose tolerance tests were run on workers exposed to VC and MMA. Time is plotted along the abscissa (in minutes): I - insulin tolerance tests; II - glucose tolerance tests; 1 - workers in contact with MMA; 2 - workers in contact with VC; continuous lines - glucose level; dashed lines - STH level. CM* 0605i Pace 11 Basa level of STH in various subgroups of examined workers. STH level, ng/ml Subgroup____________________ MMA VC Persons suffering from occupational illnesses who have not been taken out of contact with the toxic substances 0.70 ; 0.10 (24) 0.80 d 0.26 (9) Persons suffering from occupational illnesses who have been removed from contact with toxic substances 1.46 0.39 (27) 1.23 ; 0.25 (15) Persons in contact with industrial toxins 2.18 i 0.60 (33) 1.30 c 0.50 (10) Persons who were in contact with industrial toxins in Che past 2.34 0.71 (16) Note. Number of examined people indicated in parentheses. CMA 00&052 Ha.iHHHe HeC^aronpiWTHoro b.ihhhhh npoK3BOZCT36HHoii cpeabi, tcm fionee HTO 3 rpynnax paPoHHX, noaBepraBitiHXCH 3032eHCT3E10 MeHee BHCOKOH KOHUtHTpaUHE 3X, KOTOpfale MOJKHO CTHTETb rpynnaMH BHvrpeHHero KOHTpo.is, 3afioJieBaeMOCTb 3-ioKa?eCTBeHHbIMH H0B00fipa30B3HHHMH KHJKe, ecm cptlH HaceJieHHH. ripHMeHHB IHCnepCHOHHhlH aHaHH3, HaM yaajiocb BbisBHtb aocroBepHoe bjihhhhc BX Ha qacTory 3JioKaqecTBeHHbix hoboo6pa303aHHfi (P<0,QQ1). Pe3V.7bTaTbI HCCJItaOBaHHH II03B0JIHJIH peK0MeHZ03arb ansi BHeapeHHH b npax- THiry MeponpHHiHE, HanpaB^eHHhie Ha ynyqineHHe vcjiobhh Tpyaa b npOH330flCTBax BX h nBX. BbiBoabi. 1. YcTaHOBJicfio aocTOBepKoe B-THEKHe BX Ha qacTCrry 3JiOKanecTBSHHblX H030o6pa30BaHHH v pafioTaro- HEX B HpOH3BOaCTBaX BX H nBX (P<0.001). 2. HaH6o.ibmHfi yposcHb 3afioJieBae- MOCTH 3.10KaqeCTBeHHhIMH HOB0O6pa3OBahhhmh 3apsrHCTpHpoBaH b rpynna pafioHHX, nOJBepraBinHXCH B03,iefiCTBHI0 BtlCOKOH KOKSeHTpaUHH BX. 3. HaH6aaee cymecTBeHHbie no cpaBHeHHXJ C EaCB.'ieHHCU pa3JIHHHJI ypoBHH 3a6o^eBaev.ocTH onyxojiHMH OTawibHofl .iQKa"H3aiiHH HafiJimaiOTCH sjix paxa se/iyiKB y jKenmHH h 3JiOKaqecTBeHHUX H030o6pa30BaHHfi .IHMtjjaTHHeCKOfi H KpO* BeTBOpHOfi TK3HH 2.TH 060HX nOJIOB. .THTEPATyPA JaoLpan 3. B. -- B ke.: SnEfleMKO.'iorBE paxa b crpasax C3B. M, 1979, c. 55--86. Croe:j-js H. H., Kupaahockuu B. A., Typyeoa B. C. -- B km.: ntrueua k TOKciiKonorns suC0K0,M0JieKy.uipnnx coejHHeHHii h xhmhmccKoro Cbipba. .1., 1979, c. 288--289, Cruch J. L.. Johnson M. N. -- J. oceup. Med., 1974, v. 16, p. 150--151. Box A. J., Collier P, F. -- Brit. J. prev, soc. Med., 1976, v. 30, p. 225--230. Lee C. C., Bbandore I. C., Winston J. M. et al. -- Environm. Hlth Perspect, 1977, v. 21, p. 25--32. ribio T., Mneen 2. npHMeueHHe anHaeMHonornvcckhx mctojob np HavneHHH HenH<{>eKUHOHHbix 3a6o.ieaaHKM. M,, 1965. Maltoni C., Lefemine G, -- Environm. Rea.. 1974, v. 7, p, 387--405. Tabershats I. R., Gaffey W. R. -- J. occup. Med., 1974, v. 16, p, 509--518. Tomatis L.. Agthe C, Bartseh H, et al.-- Cancer Res, 1978, v. 38, p. 855--877. Waxveiller R, Stringer W,, Wagoner /. K. et al. --Ann. N, Y. Acad. Sci., 1976, v. 271. p. 40--48. nocTyaitaa 19.01.fi THE INCIDENCE OF MALIGNANT TUMORS AMONG WORKERS ENGAGED IN THE MANUFACTURE OF VINYL CHLORIDE AND POLYVINYL CHLORIDE. /. V. Fedotova Epidemiologic survey of the incidence of malignant tumors in 3 groups of workers vary ing by the degree of exposure to vinyl chloride (VC) has revealed increased incidence of tumors in the group of subjects working in the most adverse conditions, characterized by a high concentration of VC in the air of work site. The influence of VC on the incidence of onco logic diseases was found to be significant (PcO.OOl). Pulmonary carcinoma, malignant neoplasms of the lymphatic and hemopoietic tissue occur among males of the examined group more often than among the population at large. In women the incidence of gastric carcinoma and malignant neoplasms of the lymphatic and hemopoietic tissue is signifi cantly higher than among the population at large' (P<0.05). V3K 613.32:(547.3*l.:-r7S.7U.2J]-07:lS.433JS.01S li. A. .MAKAPOB, K. H. MAXAPEHKO O BJIHRHHH METHJIMETAKPHJIATA H BHHHJIXJIOPHAA HA COMATOTPOnHyiO *yHKUH10 THno<lH3A HacTBTyT turnemi rpyna h npo$sa6ojieiaHHA, r. TopbioiA B COBpe.MeHHOM np0H3B02[CTBe TIJiaCTMacc HBXC2HT UIHpOKOe npHMCHCHHe MeTH.~JitSTcKpH.TaT (MMA) H BHHH.TXJIOpH2 (BX) -- TOKCHHHbie BeiUSCTBa, 06- hazaiOtllHS HapKOTHHeCKHM jeflCTBHeM. Zl.THTe.-bHoe nocrynjieHHe hx b opraHH3M pafioiero conpOBOxuaeTCH pa3BHTHCM KJTHHHEeCXOH KapTHHhl XpOHHHftCKOfl HHToKc;tKH7tH, 2.th KOTopofi xapaKTepHo nopasteHHe tvHHiHOHa.ibHsix crpyioyp ro.TOBHCTO v.bra (B. A. Ahtohiokshko) , 3 TOM HHC.ie H 2H3HUe4)2JlbH0ft Ofi^aCTH. PaHee h3mh 6biJio noKa3aHo, hto 3to BemecTBO jaer BUpHJKeHHbifi coMaTOTponHHHHTHCHpyjouiHS aiJj^eicT (H. A. MaxapoB). OjHaxo ocraBajiocb Hescno, <te.M oCycJiOBJieH naTOJiorHHecKHfl 34>4>eKT MMA: jeiicTBHeM Ha AHSHuecjjajibHbie IieHTpbl H2H HenocpeaCTBeHHO Ha 303HHOiJjH.TbHbie K-ieTKH aieHorHno<}3H3a. Hy- HtaaJICH B JTOHHCHHH H BOnpOC O CTieUH4>HHHOCTH JiaHHOrO aefiCTBHH -- cboAct- BeH JIH 3T0T HHTHfiHpyiOmHH tJJCHOMeH TOJibKO MMA hjih ero mohcho no^yqHTb 32 Gigiena Truda I Professional NYE Zabclevania, 4: 32-36 (1983) ITpH iefiCTSHH ap H20B. Hcc-ieioBaHKH : HHX XHMHHeCKOH npaKTHqecxH 320f Heii He pafioTaBU cocroK.ia H3 2 no; 2HJIO 100 pafiOHH creiuia (OC), no; CTBHIO MMA, H3 1 CKOfi HHTOKCHKam 34 pafioHHx npoH x.Topaaa (nBX), HOCTHpOBaHa BHH B KOHTpO.tbHOH T 6a3a.TbHbiH ypoi ropMona (CTf), xHMHHecKOH npov Sa3ajibHoro ypoB ueHTpanRio iaHH 60 h 120 mhh noc (78 HtnoBex) hjii Bex). rJiiOK03y (50 r). HHcy.iHH 0,15 EH Ha 1 Kr pcrnce KpoBH onp HHM MeTOIIOM c MOB <{)KpMbI <501 BpeMeHHO c CTI KOHUeHTpaUHKJ 233HblM MeTOAOU y ilHU KOHTJC hhh ypoBeHb CT ht/mji, tto cooti THX aBTOpOB (E. rpaHOBCKas-LLBe' khh) . KoHiiejrrpa .Ta 7I,04,0 mt qecxoft npoMbitn: TepHO aocTOBepiTponHoft 4)VHKQ> TafijiHny). Oco6 aaB^eHHe BhipaP y SoJibHbix c npt jieBaHHHMH no b Ta c HefipoTpont; 6e3 npot^eccHOH SoJIbHblX C TaKH Jie npexpaaieB MOHTaKTa c AIM CTr 6biha Hecx v.eHee nocTOBepi 3aTeheft b kohtp pH Ha to hto AL pa3HHTCH no J (nepBbifi -- 3<j3Hp hhh yr-nesonopo reJibHO ojiHHaK< rnfinpywiHHii 3 3T0T 3({l(beKT yx npH aeflcTBHH apyrax npOMbniiAeHHbix haob. HccAeaosaHHH npoBeaeHbt y 134 pa6oXHMHHeCKOft npOMHIIl.ieHHOCTH H 24 npaKTH^ecKH 3aopoBbix ahu, HHxoraa b neft ae pafioTaBuiHX. Ochobh3h rpynna cocroH^a H3 2 noarpynn. B nepByio bxo- ahao 100 pafioHHX npoH3BOacTBa oprcreoa (0C). noaBeprajcuiHXCH B03AeftCTBHIO MMA, H3 KOTOpbIX 51 C XpOHHHeCKOft HHTOKCHKaHHeft MMA, BO BTOpVIO-- 34 pafioHHX np0H3B0BC7Ba iioahbhhhaxAopaaa (IIBX), ns KOTopux y 26 jnarHOCTHpOBana BHHHAXAOpHAHait 6oAe3Hb. B KOHTpoJibHofi rpynne H3ynaAH toabko 6a3a^bHUfi ypoBCHb coMaToTponHoro ropMOHa (CTr), Toraa Kate y pafioinx XHMHHeCKOH npOMblUIAeHHOCTH, riOMHMO 6a3a.ibHoro ypoBHH, HccAeaoBaAH kohneHTpauHJO iaHHoro ropMOHa nepe3 30, 60 h 120 mhh nocjie Harpyaxn rAK>xo3ofi (78 HMOBeK) HAH HHCVAHHOM (56 HejIOseK). r^i0K03y aasaAK nepopa-itHo 150 r). Hhcvahh bboahah H3 pacneTa 0,15 EH Ha 1 xr Maccu. CTr b cwbopoTKe KpoBH onpeaeAXAH paaHOHMMyHHblM MeTOlOM C nOMOUlblO JHarHOCTHKVmob $KpMbi <Sorin (<t>paHHHJi). OaHoBpeMeHHo c CTT b kdobh uccAeaoBaAH KOHUeHTp ailHIO MK5K03bI TAKJK030KCH- ja3HbiM MeroAOM. y ahq KOHrpoJibHoft rpynnu 6a3a.ib- Hbift ypoBeHb CTr paBHHACS 5,4=0,2 Hr/MA, HTO COOTBeTCTByeT AaHHbIM apyrsx aBTopoB (E. A. BacjOKOBa h A. M. rpaHOBCKaa-UBeTKOBa; M. H. BaaafioAKHH). KoHQeHTpaaHH r.lK3K03bI COCTaBAH- .ia 71,0^4,0 Mr %. Hah pafiOHHX xhmhHeCKOft nOOMbilU.ieHHOCTH 6bIAO XapaKrepHo aocroBepHoe noaaBAeHHe coMaroTponHoft (pvHKaHH aaeHorHno<i)H3a (cm. rafi-iHuy). OcofieHHO Bbipa;xeHHoe noaaBJieHHe BbipafiOTKH CTr Ha6AWAaAocb y fiOAbHwx c npo4eccHOHa.ibHbiMH 3a6o* AeBaHHHMH AO BHBeaeHHH HX H3 X0HT3Kra c HeftporponHbiMH saaMH. y pafioHHX 6e3 npo^eccHOHaabHhix 3a6oaeBaHHft, y fioJibHHx c raKHMH 3a6oaeBaHHSMH nocae npeKpameHHH npOH3BoacTBeHHoro KOHTaKTa c MMA h BX kohubhtp3Qhh CTr 6 fa:a a HecxoAbKO Bbirne, ho tcm He :.:eHee aocTOBepHO OTAHxaaacb ot noxasaTeaeft b KOHTpoabHOft rpvnne. HecMoTps Ha TO HTO MMA h BX cyuxecTBeHHo pa3KHTCH no XHMHHecKOMy CTpoeHHio (nepBblfi -- s4>Hp, BTOpOH -- XAOpHpOBaHHbift yraeBoaopoa), ohh aaiOT npHfiAHSHTEAbHO OJHHaKOBblH COMaTOTpOnHHHH- rnfiHpywiBHft sdxbeKT. Ilo-BHAHMOMy, 3T0T 3(pcJ)eKT VKa3aHHMX H308 CBH33H C EuajibHuii ypoBeHb CTT b pasjiKHHbHt noarpynnax o6aieioiaHHux pafioHMX Hoarpyrini VpoicMb CT7, Hr/Mji MMA BX 5o.ibHbie npotpec- CHOHaAbHUMX 3a6o.ie3aHHSM, He BMBeaeHHue H3 KOHTaKTa c TOKCXBHhlMH BelUeCTBlMK BcwibHUe npotpec- CXOHa.1bHbl.MK safojieBatmflMH, BuaeieHHue H3 KOHTiKTa c TOK- BC* mecrBaMH Jlxna, K0HT2KTHpywawe c npoMbmuiexHbtMH fUUMH JIhra b npom.'toM KOHT3KTKpOBMB* nntt c npoMbim.icxHUMH xaaMH O./O-vO.lO (24) 1.4fr0.39 (27) 2.180.60 (33) 2,34i0.7t (16) 0,80-^0.26 (9) 1,230.25 (IS) 1,30-0,50 (10) npKMenaHHe. B cxoCxax yxasaxo mhmo oBcxeaoxaHHMX. HX HeCneUHtjjHHeCKHM HapKOTHHeCKHM aeflcTBHeM Ha QeHTpaAbHyxj HepanytoCHcreMy. AHaaorHHHoe aeficrsHe HafiawaaAocb h y apyroro HapxoTHHecxoro BemecTBa -- BTHAOBoro cnupTa (Tamfaur* rano). HHHaMHxa CTr h rai0K03bi npH npoBeaeHHH HHCVAHHOBOft npofibl H TeCTa ToaepaHTHocTH k rAioKosc npeacTaBAe* Ha Ha pHcyHxe, H3 xoToporo bhaho, hto BBeaeHHe HHcyAHHa conposoxtaaeTCH pOCTOM KOHUeHTpaSHH CTr B XDOBH, CBHAeTeAbCTByWOIHM O CTHMymUHB B03HH0(pHAbHhix xaeTOK aaeHorHnodJH3a, ho aa> xce Ha 4>OHe Taxoft cTHMyAxunz MaxcHMaabHHft ypoBeHb ropMOHa He aocTHra* eT 6a3aAbHOrO ^*pOBHH y 3AOpOBbIX AHU. HopMaAbHaa peaxaHH, BbipaxcaBinaxcH b noa'beMe ypoBHH CTr npH pe3bhthh rHnorAHxeMHH, HafiAioaaAacb roAbxo y 32 H3 56 OfiCAeAOBaHHblX pafiO'THX xhmhneexoft npoMbiuiaeHHocTH, y 10 oTMenaaacb napaaoxcaAbHaa peaxiiKH, 3axaioHaBinaHCH b CHHx:eHiiH ypoBHH CTr npn yMeHbineHHH xoHneHTpaunn na>oK03bi b xpoBH, y 14 ahq oTcyrcTBOBaAa peaxnHH KAeTOK rnnotpH3a Ha MeHsnoniHftcH >*poBeHb rAK}K03bt. nocreneHHoe CTafiHAbHoe vBeAHHeHHe ypoBHH CTr no Mepe yravdaeHHS rHno- 31 VCrX i \ '^0 r15 / !t '5-;-r;j: c*. /i 1 i ! :t' < ; -S I / c-.:rrV I *Cr../I.e|/ *Ur :jjir is oji so mo xs maxso is Ijikz.vkkz C7F tt r.TOK03U np npoBeaeHHH kh- cy.ij'HOTO.TepaH'nioro k r.DOKOSOTO.:epanTHoro Te* CTOs v psCosHx, nosseprawuiHXcs aosaeScrsHio BX h MMA. na och i;ui:sc -- (i mhh), / -- tsctk mie- Pbitthoctii k HKey.utKv; // -- tctu TtaepiKTHocm k raicxait: / -- KOKTiKTiipyioiuiie c MMA; J -- xohtbk- TjuHp; vtpOyl*EKKTti!pCxB3;eX:-- Cypp.olOIeUnHkhlCCTart.IHHH -- ypoltNB IMWKO- r.THKftMKH HaC.iwaa.ioct y 21 hs 32 fio.itHttx c HODMa.iHHOH peatmHeii, Toraa k3k y 11 fio.itHtix noateM ypoBHH rop- MCH3 fitl.1 OHeHb KpaTK03peMeHHbIM, 3a hhm c.ieaoBa.io cHHsxeHHe KOHneirrpaiiHH CTr B KpOBH, HeCMOTpH H3 p33BHTHe Bbl- paxceHHoft ninor.iHKe.MHH. Taxaa xpaTKo- Bpe.MeHHocrb peaxmns aaeHornnoitH3a y pafio^HX XHMHHeCKOfi npOMhlUI.ieHHOCTH, no*aHaHMOMy, cBH3aHa c OTcyrcTBHeM peaepsoB 37oro ropMOHa b 3O3HH0$H.ibhhx saeTKax 5Ke.ie3hi. PeaxiiHX b BHae nepBOHaqa.ibHoro noateMa KOHneHTpauhh CTT, cMeHHiomerocH 3aieM naaeHH* eM ee, b ochobhom Ha6nioaajiacb y fiojibHt:x c xpOHHiecKOH npodjeccuOBajitHOfi HHTOKCEXailHeft MMA. npH npoBeaeHHH Tecra tqjiep3hthocth k r.iK5K03e y 3 oficieaoBaHHbix pafiOHHx CTr He fibi.i o6HapvaceH hh b oahoS H3 4 npofi, y 10 HafinjoaaaHCb napaaoit- ca.ibHbie pearaiHH -- noateM CTr oaHo* BpeMeaHo c noateMOM xofmeHTpauitR r.1J0K03H B KPOBH, y 23 ypOBCHb CTr npH noateMe KOHiieHTpanHH rnxDxoabi He H3eiujJicH, y 42 o6cjieaoBaHHtix OTMene- hh HopMa.ibHbte peaKUHH, 3axjuoHax}- uiHecsi b cHHHteHHH ypoBHH CTr npH pa3* bhthh rnnepr.iHKeMHH. Y 4 6o:ibHHx, otneceHHHx k rpvrnie o6c-ieaoBaHHHX c HOpMaJIbHOH COMaTOTponHOft peaKDHefi Ha r.iK03y, cHHHteHHio ypoBHH CTr npeauiecTBOBaa BHpasxeHHHH noatCM ero b nepHtpepHHecKoft KpoBH. 3tot noateM ypoBHH CTr o6hhho Hafijiroaaa- ch b MOMenr nepexoaa Bocxoaniaero xo- .leHa caxapHoii xpHBoii b HHcxoasnimft h, BepoHTHO, 6h.i ofiycaoB.ieH 3HaHHTeab* HHM nOBbimeHHeM B036vaHM0CTH HepB- Hoii CHCTeMti, npn KoropoM HMnyvibCbi c r.iWKopeuenTopoB. pery.iHpvrouiKx BHpa* 6otkv CTr, nocTyna.iH b aaeHorHnocpH3 He TO.IbKO npH pa3BHTHH rHnor.iHKeMHH, ho aance npH He3Ha4HTejibHbix xoaefiaHH* six KOHiieHTpamiH yr.iesoaoB b kpobh. yKa3aHHHfi (peHOMeH 6h.i xapaKTepen TOAbKO a.lH 6o.1bHHX C XpOHHHeCKOH HH* TOKCHKauneS MMA. y Hac HeT aaHHHx o HenocpeacTBen- HOM B.1HSHHH H3yHeHHMX H3pK0THHeCKHX siaob Ha CTr-npoayuHpyrauiHe k.ictkh aaeHorKnoc{)H3a. OTMeneHHoe noaaB.ie* Hue BHpafioTKH CTr non b-ihshhcm h BX, Ha.iHHHe HacTHX napaaox- ca.ibHbix peaKunfi Kax Ha r.isoKoay, Tax H Ha IIHCyJIHH MOrVT CBHaeTe-IbCTBOBaTb o TOKCHHecKOM nopaxceHHH aHBHue^sa.ib- HOfl Ofi.iaCTH npH P33BHTHH XpOHHHeCKOl'l HHTOKCHK3UHH 3THMH BeiueCTBaMH. Hmchho TaKyjo HHTepnpeTauHK) napa- aoKca.ibHHM peaKUHHM CTT Ha >'Ka3aH- Hbie pa3apaxvHTe.m aaroT apyrse bbto* pn (M. ft. BaaafioaKHH; T. T. KHHia- pHH k A. C. Amctob; Wright). CTeneHb noaaB.ieHHH COMaTOTpOIIHOfi aKTHBHOCTH rHnod)H3a npn BoaaeflcTBHii MMA h BX fibi.ia npaKTHHecKH oaHHaxoBoft, tro cbh- aeTeabCTsyeT 06 oaHHanoBOM aHaaorHH* hom TOKCHHecKOM nopaJKeHHH rHnoTaaa- Myca, Toraa nax Harpv3KH r.iroK03oii h.ih hhcv.ihhom bhhbjihiot cyuiecTBeHHyio pa3HHIiy. HJIJI 6oabHHX C HHTOKCHKaaHefl MMA 6h.io xapajcrepHO BHpaxceHHoe H3- MeHeHHe ypoBHH CTr npH MaaeftiuHX KonefiaHHHx kohuchtpaiiHH rai0K03H b KpOBH, RpH HHTOKCHKaUHH BX BHp35KeH* Hbie KO.iefiaHHSI VpOBHH r.1K5K03H He npH* Boan.iH k cymecTBeHHOMy H3MeHeHHso noKa3aTea CTr. BeposiTHo, aaHHoe pa3* JIHHHe CBH3aHO C pa3HHM aeHCTBHeM 3THX BemecTB Ha peuerrropHHfl annapaT cocy- aoB. npH hhtokchkaiiHH MMA Ha6aioaa* aacb aKTHBHsauHa rJiroKOpeuerrropoB, peryanpyioiiiHX BwpafiOTKy CTr, npH bh- HHaX.IOpHaHOfl 6oae3HH HX aKTHBHOCTb noaaB.ismacb. rio.iyHeHHHe aaHHne o HecneuHiJiH* qecKOM CTr-HHrHfiHpywmeM bjihhhhh npoMHirtaeHHHx siaob HapKOTHiecKoro aeflcTBHH Moryr Chtb Hcnoab30BaHbi Kax oahh H3 aocraroHHO Haae*HHx h oaeHb xyBCTBureatHbix KpHTepwes xpoHHHecxoft npo^eccHOHa.ibHofi HHTOKCHxauHH. Ue- aecoo6pa3HocTb Hcnoab30BaHHsi hmchho CTr, a He xaxoro-ro HHoro ropMOHa aaeHorHnot{)H3a b xaaecTBe HHaHxaTopa ToxCHxecxoro nopaweHHH rnnoTaaaMvea o6vc.iOBaeHa oahoh anp 3Ba eHHHM -- 34 TO.IbKO B CTOpO! uni; -- ero B.1J npo.MHUI.ieHHblX HWX rOp.MOHOB Xy.lOCTHMV.IKpy: mcTo) xapaKTet HHX H3MeHeHHfi; 337e.M naaeHHe 3H, 4T0 P63KO CH U6HHOCTb 3TIIX t Mbl CHHTaeM, sxeHHoro tokch^ napa rHnoTa.ia5 ypoBHH CTr hh;- hhh apyrnx Hei mob, HaHfioaee i nocraHOBKH ai: CSIHapOMa B CO1-' HVBCTBHTeabHHM ueHTpauHH CTr ypoBHe 0,6--0,9 aaHHoro ropMosnee paHHHM npn 3anoao3pHTb np T0KCHK03. 06paiaaer Ha y */io Jihu, oik HeilpoTpOITHHMH nocTaBaen aHar 3a6oaeBaHHH, nc Taxra c sthmh b( ociaBaacsi 3HaHH rOBOpHT 0 Heofif MHKpOH3MeHeHHS ca, XOTH HeBpO.3TH H3MeHeHHH OicyTCTBHe noaihh CTr y fiojibii; uihm cTa:xeM ( 3a6oaeBaHHS) nnoaTBepxtaaeT h BHCOKO& AHarHC hocth MeToaa or pOTXe KPOBH. B HacTosmee anarH03a npocfsei hhh b xanecTBe t ckhx xpHTepneB .lorHxecxHx chha cxHfl h acreHoo; hhh BereTaiHBHO HCBpHTa (B. A. . ohh He Bceraa o* sxeHHH noaxopxc BaHHe CTr b 2 r 4>eCCHOH3JIbHHM TeHOHeBpOTHHCCK acTeHoopraHinec ciiHapoM a m ii -- n KOHUeHTpaiiHK) 1 CMA 0060 jj TO.IbKO B CTOpOHV CHHJKeHHH KOHUeHTpa- ui!L' -- ero B.iHHHHeM npH BoajeftcTBim -pCMum.ieHHhix juob. iljia jpyrnx Tpon- Hhix ropMOHOB (nipeoTponHoro, cpoji.in* KV.iocTHMy.iHpyiowero, .iHTeHHH3Hpyio- uiero) xapaKTepa 4a3HocTb TOKCHxoreH- .-:bix H3MeHeHKK: CHana-ia yie.iH'temie, a aareM naae.HHe xoHueHTpauHH hx b xpo- 31!. HTO pe3KO CHHHtaeT AHarHOCTHHeCKVlQ UeKHOCTb 3THX H3MeHHHS. Mbi c'lHtaeM, hto noKa33Te.ieM Bbipa* AeHHoro TOKCH'iecKoro bo3JsActbhh Ha ajpa rnnoTa^aMvca HB.iaeTca naje.HHe ypoBHx Ctr HHHc'e 2 ht/ma. ripa noB.ie- HHH JpyrHX HeBpOJOrHHeCKHX CHMITTO- M03, KaHfio.iee Hacro ncno.ib3yeMhix 2JIH r.ocTaHOBKH anarH03a acreHHHecKoro ;HHipo.Ma b coneTaHHH c BereraTHBHO- `fySCTBHTMbHblM nO.IHHeBpHTOM -- KOH- uer-rrpaiiHH CTr b kpobh HaxoiHTCH Ha ypcBHe 0,6--0,9 ht/m-i, t. e. h3m6HHKH ;'a:-:Horo ropMOHa oita3biBaiOTCH HaH6o- -ee paHHHM i7pH3Haxo.M, no3B0.7JnomHM 3anoi03pHTb npoiJieccHOHaJibHbift Heftpo- TOKCHK03. OfipamaeT Ha cc6h BHHMaHHe to, hto y ~/io .ihu, ^JiiiTe.ibHo paCoTaBiiiHx c HefipOTpOnHHMH SUaMH, KOTOpbIM He fibl.T noctas^eH 2HarH03 npoipeccHOHa^bHoro 3a5o,ieBaHHH, nocae BbiBeieHMa H3 koh73 XT2 C 3THMH BeilieCTBaMH VpOBeHb CTF OCTaBa.TCS 3HaHHTe.TbHO CHHJKeHHhlM, HTO roBopirr o HeofipaiHMwx opraHHHecKHX MHXpOH3MeHeHHHX b ajpax rWIOTaJiaMVca. XOTH HeBpoJiorHHecKHMH MeTOaa.MH 3TH H3MeHenHH y.ioBHTb He yuaBaaocb. OTCVTCTBHe nOJIHOfi HODMaJIH3aUHH vpoBH CTT V fiOJIbUIHHCTBa pafiOHHX C 6oJlbuiiiM cranteM (6e3 npoieccHOHajibHbix 3aoo.ieBaHHii) npoii3BOflCTB OC h FIBX nozTBepJKaaer Hame mhchhc 06 oneHb 3b.'C0K0ft AHarHOCTHHeCKOft HVBCTBHTeJIbhocth MeTona onpeaejieHHH CTT b cmbo- OOTKe KpOBH. B nacToamee BpeMH npn nocraHOBKe jHarao3a npo<}>ecCHOHajibHoro 3a6ojieBa- HHH 3 KaneCTBC OCHOBHbIX JIHarHOCTHHeCK3X KpHTepKeB HcnOJlb3yeTCH 2 HeBpO.lorHiecKHx CHHapOMa: acreHOHespoTHHe- ckhi'j h acTeHoopraHHHecKHii npH Ha.iH- lirH BereTaTHBHO-HVBCTBHTeJlbHOrO nOJIH- HeBptrra (B. A. AHTOHJOHieHKo). OaHaxo o:-:h He Bcerja OTpaataioT niyfinHy nopa* irieHHH noaxopKOBbix ueHTpOB. Hccne.no- 3SHne CTT b 2 rpvnnax fio.ibHbix c npo- oeccHona^bHbiM 3a6ojieBaHHe.M -- c ac- TeHOHeBpOTimecKHM (35 HejioBetc) h acTCHoopraHHHCCKHM (48 HenoBeK) c;::-:*ooMaMH -- noKa3a.io oanv h tv we xoHueHTpaumo CTf a cuBopoTKe Kpo- bh--1,1=0,1 kt/ma B Tex cnynaHX, Korja neooxoJHMO So.iee aeTa.ibH*oe hc- cjiejoaaHiie CTeneHii TOKCHHecxoro 303- jeflCTBiiH Ha nojxopKOBbie tieHTpw, 6o- .iee HHcpopMaiHBHbiM OKa3biBaeTcs onpe- ae.ieHHe CTr. Hji.iwcTpaunefi CTF-HHrHfiHpyfoiuero BJIHHHHH npOMbim.ieHHbIX HJOB HapKO* THHeCKOrO jeftCTBHH HB-iaeTCH OJHO !I3 H3UIHX iwlHHHHeCKHX Ha6.1K>AeHHH. E-bs, 40 .1st, nocryniua b k.ihhhky 24/X 1975 r, Poc.ia h paBBiisa.aacb HopMa.ibHo. B 17-jjeTHeM soapacTe Sea bhxhmux npKiKK Haia.'in SeenoKOHTb cH.tbHue ro^oBHUe So.ih. cTa.iH VKpynHBTbca MepTN .iHua h yTo.amaTbc na.ibuu pyK. OaHaxo hh caMa So.ibHax, hh aaMeTKBixiHe am nepeMtHLi poanrenH He npuaaJiH km jto.iHtHoro 3HaHeHHB. Mepea ran noc-ie nous* aeHHK aaHKbix chmiitomob nocrynHaa paSoTaTb annapartHiieA KaTajiH3aT0pH0H ycraHoBKH b uex npoHaBOictaa OC, rae noasepra-iacb soaaeAcrshk) aHamiTe-ibHiax KOHiieHTpauHft MMA, Heoea ueKOTOpoe bpe.MH nocae Haiajia KOHTaKia c yxa* 3aHHbiM BeuiecTBOM npexpaTttaocb yBe-iHuewHe cxy.iosbu OTpocTKOB, Hoca, VTS-nueHite na.ibuea pyx. B 21 roa Buutaa sawym. H.vteaa 6 SepeMtHHOCTefl. H3 KOTOPUX 2 3aKOHHIt.HICb poaaMH, 4 -- aSopTaMH. HecMOTpx Ha raxoe MOiBHoe cmMyaHposaHHe ^vhkhhh auHaotpn.ibHbtx KJieTOK aaeHorHnotpH3a. hh HepTbi .lima, hh nojia 3pehhh, hh naabuu pyx He Hataas MeHaibCH. B Hataae 70-x roaos, nocae 14 ,ieT KOKTiKTa c MM.A, cHosa nonBHaucb raaoBHue So.th, hhTeHCHBHocTb KOTopux nocTeneHHo HapacTaaa. BnocaeacTBHH noxsKaHCb caaSocTb, paaapa^HTe-ibHOCTb, nape<rre3HH aepxHHx KOHetHocTeit, koaxmiHe SoaH b oSaacTH cepaua. OSbexTHBHO OTMe<taaHCb axpoveriaoKaHOcTb <tepT wiHua, SotKOoSpasHaii rpvaHas K.ieTxa. toacTbie KQpoTKHe naabuu pyx. KpaHHorpatpHx bw* HBaxaa yBe-iHitHHe paswepos T^'peuxoro ceaaa (KpBHHoxayaaabHUi) 15 mm. aopcoBeHTpaabHWH 18 mm) h peaxoe HcTOH*teHHe aaaHen ctwikh ero. H3MeHeHHit raaaHoro aHa h cyixeHitH noaeit 3Pehhx He oSHapyHCHsaaocb. y<tHTUBan aaHHbie caHHTapHO-ntrHeHHMecxort xapaxiepHcTHKH ycaoBHit Tpyaa it aaHTeabHbiit CTa* pafioTbi a xOBTaxie c MMA, OTcyTcraHe nporpeccitpoBaHRx BoaHHOtpHabHOfl aaeHOMbt thno4>H3a, HMeiomHecx y ScuibHoit acaaoSbi mu pacneHH.iH xax HanaabHue BsaeHHH npotpeccaoHaabHoro HeApoioxuiKosa. Buaa auantoctHpotaHa xpOHHtecxax npotpeccHOHiabHait HHTOKCHxaiihh MMA h 303HHo4>HabHax aaeHowa rano^H3a b <pa3e peMHccxH. BoabHax nepeBeaexa Ha pa6oTy BHe xoHTattTa c MMA. B 1977 r. npR aitHaMuqecxoM xoHTpoabHOM oScaeaosaHHH OTMena-ioCb 3HaMitTeabHoe yayqmeHHe coctohhiik SoabHOft: posth npexpaTH.iHCb roaoBHue fioaH, itcqe3aH caafiocTb, pa3apaxH- TeabHocrb h 5o.ih b cepaue. yposeHb CTr xpo- Bit 9,5 Kr/xr. npit nposeaeHmt TecTa roaepaHThocth k raioxose xoHueHTpauHH CTT e xposH npaxTHqecxn He H3MeHttaacb. xoaefiaitcb ot 9,5 ao 10 Hr/.vta. npH noBTOpHOft KpaHi'.orpaipHH napacTaHHA kocthux itaMeHeHini He oSapyRteHO. CyiKeHiii't noaeii apeHHx He BUHBaeHo. no h-ameMy mhchhio, hmchho CTT- HHrHfiiipyiomee aeflcTBHe AltHA Sbi.io rtpHHHHoi* npeKpameHHH pocTa 303HH0- 4>H.ibHo3 a^eHOMbi riinoqjHaa y aroft Co.TbHofi. Poct He bo3o6hob.ihj1Cst ia;Ke nocie 6 fiepeMesHocrefi, nacro npoBoiiHpytomitx nporpeccHpoBaHHe axpoMeratijth. yCTaH03."HH0e H3MH CTT-HHrHGHpy- io:uee B.THHKiie MM.A h BX, no-BHaHMO- MV, CBS33KO C HaOKOTHHeCKHM aeflCTBH* e.M hx Ha ninoTa.iaMvc, b h3C?hocth Ha aeHrpo.MeaHa.ibHoe jupo. ."IHTEPATyPA AnToxtoxeHKo B. A. a ap.-- Hir. Tpyaa, 1972, As 9, e. 19--22. cac5o/.kuh ,\f. M. CeKpeuHn ropMOHa pocra b HOOMe h naTo.iorHH. M., 1978. EaciOKoaa E. A., roaHoecKan-llaeTKoaa A. M. -- K.ihh. Mea.. 1977, V 4. c. 124--127. X.-ndapxH r. r., Anaroe A. C. -- ripoS.i. saao- KpHHO.i., 1978. .Vs 5, c. 37--39. .'.'CXCPOB ii. A.., AIOJCZptHKQ K. M., CoMtUH A. A. 3sacK?:iEKaH cncrewa opraHHSMa h tokchmcCKHe ipaKTOpu BHeniHefl cpexia. .1., 1979, c. 134--135. i amourrano G. et al. -- LIkt. 5ajia6o.nKMH M. 11. Wneht .4. D, ei ai.--Proe. rov. Soc. Med., 1970. v. 63, p. 221--226. H:oc-yr.x;-.a 5 M it THE EFFECT OF METHYL METHACRYLATE AND VINYL CHLORIDE ON HYPOPHYSEAL SOMATOTROPIC FUNCTION. /. A, Makarov, K, I Makarenko The basal STH level and its time course were studied m insulin or glucose tolerance tests in 24 normal subjects and 134 workers exposed to methyl methacrylate and vinyl chlo ride. Examination of workers engaged in" chemi cal industry showed that many of them had paradoxical responses to insulin or glucose challenge, that may be due to toxic afiection of the diencephalic region, and an abrupt in hibition of adenohypophyseal STH-production that also may be referred to the effect of these chemicals on the hypothalamus. As an example of the STH-inhibiting action of methyl metha crylate, the authors describe a case of acro megalia that ceased to progress as the patient started working in conditions of exposure to high concentrations of this ether. yAK 613.632:547.336.141]-OS6.S(04S.I) H. C. 3.T05HHA, B. B. 5P0KECKHH OTflAJIEHHblE IIOCJIEflCTBHH flEHCTBHR CTHPOJIA (0530P JIHTEPATyPW) Heentry? rarneHU Tpyaa h npo$3a6o.teBaHH>i AMH CCCP, Mocxaa 3o3mo;hc:ts oma.teHHUX noc-ieacTBHft 103ae/icraas crnpo.ta iiayHa.iacb a npoH3oacTBe h a ycnoBKxx sxcnepHstexTa. HoKa3aHo, wro npn BbtoaCoTKe craExapTOB npenentHo aonycTHMKX KosneHTpaunit ana reparoreHuux coejHHexxB uenecoodpaaKO ycraHOBHTb do.iee mHpoxae npe* ae-iK CesonacEo'cTH (K. XcmmuekmI. Crapo.i aa- paay c nenoTopUMH MOHOMepaMH aomea b xaTa- .icr TepaToresEbix areHTOB (Shepard). TeHerHiftcKoe aeftcTBHe cTHpaia aayjaaocb y A.THTe-isKo pafioTaxnuax b npoR3SOAcrse npa bbcokom cocepataHHa crapo-ta b aoaiyxe. Tax. a itpoi:3BOdcTBe cremionnacTHKOBUx H3aeroft aa oc:-:cae no.tKSCHpHhix cmas npn xoxaeHTpaaaxx crapona, paaEBtx 200--300 ppm (Meretoja a coaBT.), a Kynsty'pe .ihmcIjohhtob 16 padouix aacrOTa xdos:ocomhhx adeppaiiHH (XA) cocraaa,ia 10--26% (s KOHTpoJie ae npeawmana 4%). Haadatee rann'iuaiMU HapytneaHaKx dwro pasptaBfai xpot.iocoM. Ajtop noJiaraioT, tto cthpoji k. ia xaKOK-TO H3 ero neTadoTOToa odoiuaeT aupa^eHHMM MyrareHHUM cioActiom. 3tot buboa ae uaute.t ncATBepHcaeaHa > padore Fieig a eo- asr., me Hcc.ieAOBa.taca aacTOTa XA y padora- rautnx b npoH3aoACT3e crapana a no-iacTxpoaa (xacroTa XA cooTBeTCTaeaHO dtua paaaa 1.5-- l, 9 % npa 2 % a HOHipo-ie). H nama rpynne padoaax, aaesiux b npoassoscTBe EBAemift hb no.tKCTKpo.ia, eacroTa XA cocraBjnma epeaHe.v 5.3%, aocTitraa y ome-ibHWX Jin 20%. Oah2ko apyrHe aBTOpu no.iyjK.TO xasHue, caHJere-ibCTByiotUHe o b03M0ikhom noBpeaiaajo* utea aeKcrBKH CTHpo.ia. Hogstedt a cojbt. aaC.tiOAa.iH XA y .ihu, padoTawuiHx c no.iHSpHp- HhiMH cv.o-tas:n b npoH3BojcrBe .ioaok (aottseBT- pattHH CTMpo-ia 50--400 Mr/M1). Hbctoti XA y padoTaiomitx h kohipotohux ,iiiu paaHa s epeaHe.v cooTBeTcrseHHo 10,8 a 52 %. B mieacKOM npoHaaoacTBe KaaeaaA as ciex- nonaacTHKOB hb ocHoae noaHBipKpHMx cmo.i (Andersson h coaBT.) Had.txtaaaacB 2 rpymtu padoTawanx npa epeaaea KOHueaTpanaa cTupoia 137 a 1204 mm1, a Taatae KCHTpo-ibHiie .iHua. HaHaeHhi cymecTseHRue paaaaaHE b aaCTOTe XA CpeAH BKCnOHHpOBaHHbtX H KOHTpjUIbHhix .ihu (cooTBercTBeHMO 7,9 h 3,2%). He ot- MeaeHO pa3.iKMiiH weatay cpeaaHMH BeJiaaitHaMH XA b rpvnnax. Ho a nepaoi'i rpynne duria ycra- H0B.ieHa 3aBHCHM0CTb HapaCTBHHH aaCTOTU X.Y ot craata paOoxaiouuix. Bo3MoatHocTb KaHueporeHHOro paexa npocaeaceaa Ha padoaax a npoasBoacTBax noTOCTKpana h cTiipoJi-dyraaHeaoaoro nayayaa. Hmcjotck aaaHua, cBKaeTe.ibCTByiouae o KaHueporeHHoA onacaocTH cTapoaa, npoaajiaiotueiic)! a neaaeMBex a TOMipoMax (y 6 hs 140 aeaoaex b npoaaBoacrse cTHpo.i-dyTaaaeuoBoro aayayxa). B 1978 r. onydTOKOBaHhi aanaue o aaaTMbhom Had.iioaeHHH aa padoTHHKiMM, KOHTatmipoBaBtutiMK co cTHpoaoM (Nicholson a coaat.). Ha 560 padoaax co craweM padoTu b npoHasoacrae no.iHCTnpo.ia He Meaee 5 Atr, bbetux noa Hafi.tioaeHHe b I960 r., a 1965 r. npoaonacaaR padoiy 233, vnunH c npOKaaoacTaa 241, yMepia 83. OatHaaeuaE cMepTaocrb duna 106,41. Pax du.i npHHHHoA cwepTH 17 aenoBex, b tom aHcae y 1 ot .leftaeMHH (UTK) h y 1--ot tom4>omm (-10). Hs 21 c.iyaaE aaperacTpapoeaHHoa CMapTH y padoaax, ymeauiax c npoH3Boacraa ao 1960 r., y 1 npaaHHOH dbiuia 7IK, y 1 -- 710 a ewe y 1 -- coaeTaHHe 7IK c HmeMHaecKoA doJieaHbio cepaaa. H3 444 c-iyaaea CMepnr padoaHx, xoraa-To npopadoTaawax a btom npo3Boa* 36 I i erte Oo.tee 5 y;c, 5 -- 3sa.t*aav::s . .iy-cHKMe aan.-iae, tt-tiCTByici 0 ::: npadete co cr;; Paa Kc^ieacsat KesKE bc tit pe:y.tj73?K ini)': npn sosaeitcr MercCo.ni'v.a ero e 3 1978 r. dm aa.-tb: peay.tbraiH ;i OKHCH ciKpcaa a.teiKH BepxsnteaK! OUSHHBS.tHCb* K3HU 11 ero MeradcAKra ,iaHo cpaaaeaiie 3 CTCM3X. 3 KV.IbTV' UKtOTOHCHiKOCT# C we. ae.w CTHco.ta. ci;:po.ia r.i.iztvzn aesi cTHpc.i (Paigf B to ate apestx hi 381.), nQK23M3a)0II wecTB saaHci:? ot ra. He BbiSMBan a .iht cTKpcna ctk? cxoacTBo a uitTore II OKHCH C7HpO.1I (Meretoja n coaai 3ve AposogK.i}' pa MTO CTHpC.I Heat: 0Ki:cb cn:po.ia CL COCTBB.1E.10 ; BaHHH ancTMx np KCHTpojie.M oda se: uiesiie peuecciiBEbt $H.tbHofl vcaeaH MTO CTHpO.I He BhlX xpo.vocost. Kp Macrcry MHKpoaae KH73HCKHX XOMSEKC Kankaanpaa a ';CT3HOB.ieE0, TTO TpKxnopnponaH, v. hoh njde.li: 3apoa! aoe ;i svdpiioTOKC okhch cnipo.ia. Cnjpo.i .lerao : OOIUO paCTBOpHM a ipcHHKaTb vepe3 : S.iodHha; Eiovaara 3ET.), nOSTOMV oc iicc-ieaoaaHHE XA ape.va OepesieKKocHhix c.iacrv.acc, h pacTe ao 20 Mec. . HecxH aocroiepHM napyuieHiiEx, ero. Te.tiCTB03CTb 0 K. ctk K XPO.':OCOS!HM c-ieacTstieM bo OereMeiiHocTii (\'ai KaHueporeaKoe veKTe Ksy^anoeb vavxax Mbtuieii 11 Oepe.veitHocTH asoa sax nepopa.ibHO, ' Ti.tiKaa cvepraoc- ecTHMM odoero no. *e aoae. Tauate kocts noTOMcrsa. 1 -ic*! Meatay noaont acTHhi.Mii He varan / CMA 006057 VIII 1931 r. II 3 C K OK, b 11 a e m. bi rpvza na ocKoae :ii;i n a.ittK- la.tbHbiX 3a- r.epsKanp*- ;o--?y;oBof! .six. ycratpoieccKeii. liarRocrtucn itx dopwax o-c.resesHe neiKx eymcmae .-.it- 37K3U rpv- sszHrpaa) work and VA. L.S., V., DOL- WSKAYA, gmsov.k, ^nnent- ~rirk enviuterorises I. Phytic factor VA. LA.. tnd phygcr.cmm '.in* toois A. I.. ier.iation tnditions, ers. and v,, UZUIHEPXEr.:cr.: o; Lgarian ENTYE- `unction women struetion ' comah carciparation > l 0E3OTOBA H. B. 0 pacnpocTpaHeHKocTii 30 FEDOTOVA. I V. The incidence oi mali a.iOKaiecTBeHHux HOBobdpaaoBaHHii cpeaH gnant tumors among workers engaged in padoSRX, saHarux b npoH3BOjcrgax bhhh.-- the manufacture of vinyl chloride and polv- x-iopnza h no.THHHH.ix.iopKaa vinv! chloride l* MAKAPOB H. A., MAKAPEHKO K. II. 0 b*to*hhh MemiMeraKpH-iaTa h BUHK.tx.io- 32 MAKAROV. I. A.. MAKAP.ENKO. K. I . The eifeet of methyl methacrylate and 7piui na coiiaTOTporiHyjo ^yHKtitix} nmottina chloride on hypophyseal somatotropic fune- lion 3JI05HHA H. C,, BPJKECKHH B. 3. Ot- na.ieHMue nocneacrsHa jshctbuh crepona <Ofi30p ntiTcpaTypbi) 36 ZLOBINA. N. S.. 3RZHESKY. V. V. Late results oi styrene eiiec: (review of litera ture) KpaTXHc coodtueHHB Brief Communications KHPHJIbHYK n. n., HAEAH H. M. Vmobub Tpvna h HeKOTopae (pHSHonornMecKtie noKa3aT*.in y padoxHx XMeaecpaflpHK KJIHMEHKO T. H.. K03.10B M. A.. .HOTOB A. H.. MHPOIUHHHEHKO A. 5.. CA3EHKOBA H. E. CocroaHHe <pH3no.noni'ieCKHX SVHKUHH V padOTHHll, SaHBTllX 3pi(Te.tbHO-KaiipxtKeKKbiMH BtuasiH pa dor npn neats* cokom ypoane aBHraTMbrtofl axTHBRocTH MHXE-IbCOH 3. A., BHH0TPA20B C A. riyTi! npodiH.iaKTKKH noRa.ibHiix oxnaxtae* Ktii'i pu6oodpa0OT<tKOB ua cyzax KAPHAVX VI. A. OnntMH3auHB rpyza MauiHHHcroa aneKTpoMOcroBUX xpaHOB uexa odjtcxra OKaibiniefi TPHHEBHH B. A. K aonpocy o rpeHiipoBxax opraHHjMa ^e-ioBexa b rHnepdapHiecKHX ycjioBHxx TVP5HH E. B,, AJIilblPEBA M. B., MHCKOB .1. E. HaweHeHMe HexOTOpux noKaaareneii HepBHoft cHcreMsi y padoTaxniiHX b KOHTBKTe c qjraxaTHKMK nxacTHtpHKatopaMH 3PMAH M. H., BAYMAHE M. 3., C.lHHbKO B. H,, yCTHHEHKO A. H., BEPHH T. ., KPACHOKiTCKAE .1. M. OcoSexHoeni caHHTapHoS craHaapTHaauHH aapoao-ut KapdoKpOMeRa b so3jyxe padoteft 30HH np0H3B0dCTBBRHBIX noMetlieHHfi rHT.iHHA a. r.. rycEB c. a., bpkj- XOBEI1 T. T. Mopitoa-iorHRecxHe RBMeHeHHa opraHOB jrhbotmhx, lionBepraBUHXcx HHra.mUHOHHOH aarpaBKe aKpH.IHHTpH.IOM rA3JAPOBA H. H, POaHHKOB A. B,, apohoba e. h.. uiyb o. a., tapuie- HHH B. <t>. THmeKHvecxaR oucHxa nHxaHH* padoTHHKOB nnaByRHX dypoawx vcraHOiox KaenHHexoro dacceiiaa HmpopMBUHR coBeTCKoro roKCRKo-iorRoecxoro ueuTpa 38 KIRILCHUK. P. P.. CHABAN, I. M. Work ing conditions and some physiologic para meters in workers oi hop factories 40 KLIMENKO. G. Ya.. KOZLOV, M. A., LYUTOV, A. I.. MIROSHNICHENKO. A, B., SAVENKOVA. N. E. Physiologic functions in female workers engaged in w'ork involv ing vision exertion and low levels of motor activity 41 MIKHELSON. D. A., VINOGRADOV. S. A. Approaches to prevention of cooling of workers oi factory ships 43 KARNAliKH. L, A. Optimisation of work of electric travelling crane operators at pel let calcination shops 45 GRINEVICH. V, A, Training of the human body under hyperbaric conditions 46 TURBIN, E. V.. ALDYREVA. M. V., MILKOV, L. E, Changes in some nervous system characteristics in workers exposed to phthalate plasticizers 48 ERMAN, M. I.. BAUMANE. M. E.. SLINKO. V. N.. USTINENKO. A. N.. VERICH, G. E., KRASNOKUTSKAYA, L. M. Features oi sanitary standardization of carbocromen aerosol in the air of enclosed work environ-' ment 50 GITLINA. A. G,, GUSEV. S. D., BRYUKHO- VETS, T. G. Morphologic changes in the organs oi animals exposed to acryl nitrile inhalation challenge 52 GAZDAROVA, I. N.. RODNIKOV, A. V., ARONOVA, E. N.. SHUB, 0. A.. GARSHENIN, V. F. Hygienic evaluation of nutrition of workers at' the pontoon drilling rigs of the Caspian sea Information of the Soviet Toxicologic Centre XpoMRia TIAHKOBA B. 5. Berpeia c BeTepaHaMtt Tpyaa Current Events 59 PANKOVA, V. B. Meeting with work vete rans PeueitSMH rVG303CKHn T. A. PeueK3HR Ha Knnrv P. B. BopHceHKOBOfi. TarHeHa Tpyjta npK aodbtve no.te3Hhix HcxonaeMbix otkpwtwm cno- coCom. M., MeaHUHRa, 1982 r. 176 c im.i. Book Reviews 59 GUDZOVSKY, G. A. Review of the book by R. V. Borisenkova. Occupational hygiene in strip mining of mineral resourses. Moscow, Meditsina Publishers, 1982 _i-- ii^s--f-- ***-. "1-*<>ar*,tfc'`'ir-";* WSrw'n' /'SEr^T ti.-. - MHHMCTEPCTBO 3APAB00XPAHEMHH CCCP BCECOK53HOE HO'IMOE OEUIECTBO riirilEHHCTOB FMFMEHA OCKOBAH 8 IBS7 rosy AflPEJlb 1983 4 u npocfjeccuoHaAbHbie 1 KS 3a6oAeB atiuji MOCKSA ME3HUHHA- *tMecfl<<HUH HayvHO-npaKTMMecKHM xypttiA yAK 612.76S.1 3. 3. P03EHBAAT PABOTOCnOCOBHOCTb KEJ10BEKA H nPOEJTEMM EE nOBblUIEHHA ypz.IbCKKH .leeOTBXHJt^eCKMS HHCTKTVT KM. 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Ha.m. HiieM raxoro peaepBa o6ecneiHBaioTCH xanecTBo h HaaeacHocn. npH BbinoAHeHHii pafioTH, a TaxHce npeaynpeacaemie nepeyroM.ieHHH, Beayinero x pa3BHTHio npeanaTOAorHH. nocieaHiiA MOMeHTHHoraa BKAKmaiOT s caMo noHHTHe pa6oTocnoco6HocTH (A. 0. HaBaxaTHKHH B. B. KpbuxaHOBCxaH), xoth, crporo ro* Bopa, cjiejveT othochtb 3to k jo.ie ee, jonycTHMoft a.in pea.iH3amtH, t. e. x per.1 ameHTHpy6moil se.mHHHe pa6oaero HanpHJKeHHH H COOTBeTCTBeHHO 3amHTH0fl 30hh, coaaaBaeMoft 4jyHXUH0Ha.ibHMM pe3epBo.M. Pa6oTOcnoco6HocTb He cieayeT HaeH- THC{)HUHpOBaTb C flByMH apyrilMH nOHRTH- HMH, 6.1H3KHMH K HeA, HO .leHCaiUHMH B HHbIX Ofi.iaCTHX -- B CtJ)epe COUHaAbHO* SKOHOMHHecKOH ii b c4>epe npaBOBOH. <THrHeHa Tpyaa h npo^sccHOHajibHue 3a6o.7eaaHMK>, 1983