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Current Injelligence Angiosarcoma of the LiverTo make an early determination of the distribution and extent of primary liver cancer, and more specifically, angiosarcoma of the liver among workers exposed to vinyl chloride, the National Institute for Occupational Safety and Health (NIOSH), Center tor Disease Control, has requested members of the medical community in the United States and abroad to report information on known or suspected cases. As shown in the table, 26 cases have been reported to date from six countries. Sixteen of these are from the United States. Although cases have been ob served from four distinct work areas, the majority (81%) were formerly employed as reactor cleaners at plants where vinyl chloride was transformed into polyvinyl rhlnnHa PrtMitflan rrnft fmA/H rjcot nf angiosarcoma or me liver have been reported from four polymerization plants in the United States. While an exact estimate of the risk for polymerization workers must await completion of follow-up, it is already apparent that the disease rate for this group is extremely high. The total work force currently em ployed at U S. polymerization plants is about 5,000. No adequate data on prior vinyl chloride exposure levels of polymerization workers is available, but it is thought that past exposures may have frequently exceeded the TLV of 500 ppm. For the polymerization workers the median age at diagnosis of angiosar coma of the liver is 45 years with a range from 36 to 71 years, and the median in terval from first exposure to diagnosis is 20 years with a range from n to 30 years. Too few cases have been repotted from the other work areas to provide stable estimates of age and latency. Persons interested in obtaining further information should contact ). William Lloyd, Sc.D., Director. Office of Oc cupational Health Surveillance and Biometrics, NIOSH, 5600 Fishers Lane, Room 3-32, Park Building, Rockville, MD 20652. in Vinyl Chloride/Polyvinyl Chloride Workers Tibi* 1. -- lepertod Cuts of Liver Anfiournma in Workiri Eiposad to Vinyl Chloride or Polyvinyl Chloride. Country StiiriM Ctectaslovtkit #* **** amtm Grt BnUin Nonviy Snedtn United Stilts United Suits limlid SIMs United Stiles United Stitts United States United Stitts Unittd Stitts Unittd Stitts United Stitts United SUta Uflittd States Umttd Stitts Umtid States W. Gtrminy W tetniny Gnat Britan Undid Stitn Unind Stmts W. Gtrnutty 1st VC 01 A| Yrs Cut Oirth * PVC Antie- it It* tip. it*. om* Eipcur* Sirarm* 01 t 01 VC Mononur Producthh Workers #2* 1127-11 00 0045 OS-15-72 61 27 Ntrfcif* ni AWAITING nmiit Z2 Aitni i n*t* VLiniuo oi- 00-0041 00 00 46 12 00 72 71 or 17 23 15 03-00 50 12 20 71 56 oi- 062327 0814-51 02-00 70 43 oi- 1017 23 12 0948 03-03-73 49 02- 06 19 33 1115 55 05 00*70 36 03* OS-2515 11-28-45 12-19-73 58 04- 01 15-24 07 06 52 08 19 67 43 OS* 01 25-12 961944 04-09-54 52 06* 00-00-29 01-17-52 02-00 74 45 07* 05-0322 08 0044 00*00-68 45 or 05 06-20 10 0746 08 00 51 41 or 00-00-31 05 2845 034)1 74 43 10* 00-1613 06 12 51 05 00 58 55 n* 0527-09 101446 03-00-70 61 12* 11-17-11 09 13 49 05-0249 50 13* 120121 08*19 44 05-00 74 53 16* 11-04 27 050850 00 00 69 41 01 07-2631 10 14 57 00-00-71 40 02 06-04-30 10 01 57 00-00 69 39 s! 26 22 19 22 14 28 15 20 12 24 15 29 17 23 zo 30 17 14 n Compenoders, ftbrrcttors, Etc 02* 09-0014 00-0046 0200-70 65 M 00-00 13 08-18 38 06-00-73 60 15* 0040*25 00-00-00 07 00 72 47 24 36 00 Other VC Eipourt 03 00-00-00 00-00-00 0040-00 43 14 Tot Tri om* tio Duth -- 23 08*16*72 20 12-00-72 21 01-04-72 18 10 20-70 16 0303 73 13 0928 71 28 12 19-73 15 0107-68 18 04-0944 12 ALIVE 18 032348 15 08 2941 17 ALIVE 17 05*10*68 23 03 16 70 15 0502 69 30 0704-74 4 032749 14 12-14 71 11 01-2549 11 1200 70 Not* 1 00 07 03-73 Note 2 1 5 GO 02 15-73 Note 3 0Q OOOQOO Note 4 Not* 1 Poufini PVC al nurture onto hone Stitt Noli I Machine ootiMoi comtnt M*ctttel wir* ndh PVC plastic uitnIttNn Not* 3 Accountant it imtnl Wiricatian pltnts (work history under rtrww) Not* 4 Lo*din| pemiod* cans ith VC proetlltnt Ml S Duttons: Strom* (possrhiy enjiosirtomi'). beer. Possibility M lOMratued neoplasm of the rettetilowdotheliil cell * Matos mrcroseoprally endtrmod ontosarcomp of tho lire. "W Matos unkiwem d*ti CMA 013908 Journal of Occupational Medicine/Vol. 16, No. 12/December 1974 809 APPENDIX A