Document a1GZbQJO3z46E27yE2Qy81Kdb

12230 Wilkins Avenue, Rockville, Md. 2CS52 (Phone: 301 770 6170) Board of Editorial Advisers: Cesar A. Caceres, M.D. Washington, D.C. Leighton E. Cluff, M. D. Gainesville, Fla. Peter H. Forsham, M. D. San Francisco, Calif. Oscar B. Hunter Jr., M.D. Washington, D.C. Carroll Leevy, M.D. Newark, NJ. C. Walton Lillehei, M.D. New York, N. Y. Richard H. Marshak, M.D. New York, N. Y. John H. Moyer, M.D. Philadelphia, Pa. 2 January 1975 IM 2/1 Hastings-Vinylchloride C16523-X Dr. John L. Creech, Jr. 806 Medical Towers Louisville, Kentucky Dear Dr. Creech: I thought you night like to see a copy of the article on your work that we are planning to run. We make every effort to maintain accuracy, but I would still appreciate your checking this copy. As this is a news report, not a journal paper, our publishing the article in no way im plies authorization on your part. Although no one will hold you responsible for what we print, I know you share our concern that what we print is accurate. If there are any factual errors, please call us collect immediately. I don't like to rush you on this, but our schedule does not leave us much time. If I don't hear from you within a week, I will assume that there are no errors. If you have not already sent us illustrative material and your photograph, we would appreciate your doing so. This material can, of course, be returned. Thank you for your cooperation. Cordially, Enclosure BFG66245 vvyy xwcyyllhvl/yvv l;.pc IWI Iw im - "'-I - hustings if.523-X vrnylcMniidc t ('(jnccrn that exposure in vinyl 'chloride, the, rfionotnei ol the plastic polyvinyl chloride, may cause Itvei canter ni oilier, occupational disoidcis may he unneces sary for present woikers, according in two physicians who have been treating work ers from polyvinyl chloride plants for sev eral years. Greater concern for workers' health and safety and improved controls on ex posure levels in the plants may have eliminated the danger before ihe connec tion between vinyl chloride and angiosar- coma was discovered. Drs. John I.. ( receh Jr . of I.ouisville, ami V. K. Nin. Rowe, of the Ouw Chemical Company. Midland. Mich., agreed in separate inter 2? views with fsintsvi Mimut.i Ni.ws. CM Hl'iecu woikers have been reported with angiosarcoma, an exceedingly rare 3S cancer that is always fatal. A more com- ^ mon condition associated with vinyl chloride exposure is aero-osteolysis, a skin disease charnt'iei i/c<l by blanching or pain in the fingers (Raynaud's syndiomc); thickened, noilular patches of skiu on the hantls; ami the disintegration of the distal bones of the fineers. Dr. Rowe told this newspaper that he**-- ' > feels that present workers in vinyl chloride^--- -i--* _ plants do nm face a very great hazard either angiosarcoma or skin disease ( s - cause exposure levels in most plants mak- ` ing polyvinyl chloride are now much lower fi--j than they were previously. g T< There have been no reports of vinylEsjUsU j chloride-related health problems at the /SSxb'lfi** , Dow plants, where operations have main- tained consisicnily low levels of exposure. Apparently the protective measures ;,l- ' ready in effect have been adequate to pre- tZ ` vent angiosaicoma. acro-osfcolysis. oi ^ scleroderma. he said. Dr. ( receh. who has seen many of the _ reported cases of angiosarcoma and was EaPw'Pli the first to iccogni/e the associalion of the ^rr---- R liver tumnis with vinyl ciiloitde exposure, agreed that there is probably little dangcf (or present workers. Both the aero-osteolysis and the an giosarcomas weie found mainly in those workers who cleaned out the reaction ket tles, whete`t|ie: levels of vinyl chloride were in the iang<-\nf hundteds of thousands of pans pet ui'dliou. WmV.eis in he same job may now lace no exposure whaler levet because they work with a self contained respiratory system that eliminates at! atmospheric pa'iocles of vinyl chloride, he said. Nunc ol the patients with angiosar comas had skin diseases that could be re- luted In their vinyl chloride exposme. Of I* cases of acio-oslcnlyvis ohscived by Or. ( rcech. no patients had an> dciecli- ble liver abnormalities. because of ihe observed carcinogenic activity of vinyl chloride and the associa tion between the plastic ami vauons -.kin di .orders. ii sconied lil ely lft.il -in in creased ttn.idciicc ol skin Illinois nnidil be foimrl in exposed v-oikers However, no .rich increase wav found, ami there weic no skiu linitors in any ol Ihe patients with angiosarcomas. liver changes, or splr^flmnjaly that could he attributed to vinyl uilonde. Dr. Creech said. Despite the report of one person w ho developed angiosarcoma after living dow nwind from a poly vinyl chloride plant, there is probably no dangs'r to people liv ing around such plants, he said. Since even workers within the plants who worked within Ml feel of the reaction kettles have not developed the cancer, tl seems that the small amounts of vinyl chloride that might escape to die outside would have little clTcet. Ihe one reported case was probably a chance occurrence. Dr. Creech suggested. There is also evidence that angiosar comas produced by vinyl chloride and other angiosarcomas are two different en tities. Cases that have been reported dial are not related to vinyl chloride often have distant metaslases of the tumor, most fre quently to ihe lungs. None of the patient' with angiosarcoma linked to vinyl chloride have distant metastases. although sonic have had -pread of the cancer to the lungy by direct extension, invading through the di;^v hragm. he said. While this may he small comfort to pa tients who now face a certain death from ihe disease. Ihe absence of uielastases lias proven m indicate a good piognosis in other types of cancer. end dr. .john I creeeh. jr.: K0O medical 10wcis; lutiisville. kentucky hr dr. v. k. rowc: dow chemical com pany: midland, micltigau BFG66246