Document gQX5G4ag9eLXLdkBxnxwXjEG

1 #251. INTOXICATION BY VINYL CHLORIDE POLYMERS AND/OR THEJR ADDITIVES V. Misgcld, U. J. Stolpmann and Sibyl)e Schulte Steglitz Clinic of the Free University of Berlin, Skin Clinic and Out-Patient Department (Director: Prof. Dr. H. W. Spiek), Institute of Pathology (Director: Prof. Dr. W. Masshoff) Translation of: "Zur Intoxikation durch Vinylchlorid-Polynerisate und/oder deren Begleitstoffe," Z. Haut-Gcschl. Kr., Vol. 48, No. 11, 1973, pp. 42S-VJ6 SPI -13049 ^-"-'nr*- tv'ini iA ^-it inti>li*ii I #251. INTOXICATION liY VINYL CHLORIDE POLYMERS AND/OR TlllIIK ADDITIVES V. Misgcld, H. J. Stolpmann and Sibyllc Schulte Translation of: "Zur Intoxikation durch Vinylchlorid-Polymerisutc und/odar dcrcn Bcglcitstoffe," Z. Haul-Geschl. hr., Vol. 48, No. 11, 1973, pp. 425-430 (4 The complex pattern of damage as the result of handling a plastic became known to us when a situation arose involving difficulties in differential diagnosis. The synopsis of the individual findings, job history data, and the literature on the subject enabled us to discover an occupational disease caused by long-term skin contact with vinyl chloride polymers (PVC) and/or their additives. Juehe and Lange [6] published in 1972 a short article on "Skin Changes of the Sclcrodernal Type, Raynaud's Syndrome and Acroosteolysis in Workers in the PVC Manufacturing Industry" (see also [7]). They were able to show that nothing of the kind had been reported in the German literature (see also [15]). The case histories wc have chosen as examples should contribute to propagating knowledge of damage caused by a particular set of industrial circumstances in the attempt to ensure that intoxication by vinyl chloride polymers and/or their additives, which occurs today with variegated symptoms, including extracutaneous symptoms, no longer escapes diagnosis -- as we must suppose it does at the present time. I Patient observation: Mr. E. B., Identification No.: 22 28 06 021; telephone installer, age 50, admitted to FUB Steglitz Skin Clinic in December 1972; admission No. 1376610. 4 Case history: First difficulties about 4 years ago on the hands: swelling mainly' on the left, paresthesia, weakness; continuous intensification of these symptoms over the years, increasingly painful radiating sensations in the hand and forearm. Two years ago, clear tendency to hardening of the thus far edematous swellings of hands, in particular the forearms, with discomfort upon moving fingers and hands and r.otoricity when writing; whitish finger color after cold stimulus. Arthralgia at the lower extremitics,.disconfort of the upper abdomen, severe discomfort through sinistral acoustic phenomena such as hissing and whistling, etc., with damage to the right car and hearing impairment which had been present since childhood. For y'cars, symptomatic treatment under the diagnosis of a rheumatic disease. i ; Hospitalized for in-patient investigation with progressive scelodcrir.a suspected. Skin findings upon admission: Both hands with tight, pronounced, pittable edema, more distinct on the left than on the right side, and the skin was firmly A attached to the underlying tissues; diffuse* skin patches; pi loons' areas unaffected. Pale whitish-yellowish appearance of the. int egumont of the hands, striking xntensi t icatioji <^t the pale color tone when the list was clenclu C1 car ' - .x,^ j i c - v w SPI - 13050 ) i I dcrmatosclcrosis of both forearms with relatively sharply defined ramifications of these phenomena toward the distal upper arm. Remaining integument and frenulum of the tongue without striking changes; in the center face and over the cheek bones discrete telangiectasis which apparently had existed for some years (Figures 1 and 2). Figure 1. Edema of the Hand IsTiich Can Still be Pitted, Skin Attached to Underlying Tissues. Pale color of the region involved, face and frenulum of tongue without changes. Figure 2. Edema of the Hands More Noticeable on the Left Than on the Right, Diffuse Skin Patches, Pileous Regions Predominantly Intact. Derma tosclerosis on both forearms. Tentative diagnosis upon admission: Progressive scleroderma; edemotous or sclerosing stage. Disease of the rheumatic type with pscudoscleroderma in the upper extremities. Further findings: No abnormal results or values in the following: ESR/differential blood count/electrophoresis/IV glucose/IS uric acid/IS total cholesterol/IS tri- glyceride/IS creatinine/IS GOT/IS GPT/IS alkaline phosphatase/Quick test/IS iron/IS CPK/ urine status/total porphyrin, porphobilinogen delta-aminolevulinic acid, hydroxyyproline in the urine/IS sodium/IS potassium/IS total calcium/IS inorganic phosphate/Kassermann rcaction/rheumatoid factor/AST/Quantitative immunoglobulin/C- and complcment/antinuclear antibodics/rfirect immuno fluorescence investigation of the skin area involved for IgG, IgA, IgM, C_, fibrin inclusions. X-ray investigation: Area kymogram of hcart/thoracic organs/shoulder joints, elbow joints, knee joints, ankle joints, and iliosacral joints, esophagus/ /gastroduodenal tract/excrction urogran/kidney r\-ray/EKG/lung function tost/ /capillaroscopy. Neurological and ophthalmological consultant investigation. Pathological results: X-ray investigation: Noth hand s with striated translusee nee near the joints in the region of the proximal and middle phalanges, art oriography of SPI -13051 i the hand: all finger arteries visualized only after intra-arterial administration of PriscoJ; no morphological vascular changes. Visual lymphography of the upper extremities: Condition of primary lymph nodes more obvious on tne left than on the right. EMG: Somewhat myopathic form of the ml! potential of the digital flexor, attributable to the edema. Histological investigation (file No.: 1563/72; HcVvG Vtunica elastica/ /toluidine blue/ alcian blue/Gicmsn (Figures 3 and 4): epidermis with lamellar orthohyperkcratosis, circumscribed acanthosis and [Translator's Note: 4 words illegible] cutis and subcutis clearly edematized, occasional visualization of netachromatizcd material. Impressive damage of the tunica elastica with rupture of fibers and swelling of fiber fragments. Broadening of the collagen bundle of fibers and dissociation of the connective tissue by the interstitial edema. In the subepidermal region striated zones with incipient homogeneous visualization of the connective tissue. Striking packing of individual dermal arterioles, sometimes broadened and evident homogenized media of smaller vessels, with Unbonate prominences, (Translator's Note: half of a line illegible]. There was sometimes a perivascular round-cell proliferation, consisting mainly of lymphocytes, with infrequent histiocytes and mast cells. Dilated lymph capillaries. Pronounced swelling of dermal nerves, with clear formation of vacuoles inside them. Appendages of.the skin without change. Figure 3. Fdenatized Corium, Dissociated and Sometimes Widened Collagen Bundles of Fibers. Thickened tunica media of smaller vessels, swollen cndothclia; peri vascular round-cell proliferation. Dilation of lymph capillaries, barge increase in volume of dermal nerve cords. Magnificat ion X DO. ---xJ:--------------------------------------------------------------'Translator's Note: expansion unknown. -3- Figure 4. Increase in Volume of Fiber Bundles, Clear Vacuolization. Magnification [Translator's Note: a 3 digit number beginning with 7, last 2 digits are illegible]. SPI -13052 / Electron microscopo findings: Considerable lymph dilation with a high degree of flattening ot the endothelium and thickening of the lymph (Figure 5a). High degree of interstitial protein-rich edema with relaxation and, in parts, considerable dissociation of the previously paraplastic substances (Figure 5b); intcrfibril lr.r edema of the collagen fibers, no destruction of collagen (average period approximately 6*10 A), swelling and local destruction on and in the elastic fibers (moth-eaten appearance) and clumping of clastic.fiber material (Figures 6a and b). (Translator's Note: illegible word] blood' vessels (arterioles and capillaries) with swelling of the endothelium, sporatic small perivascular round-cell infiltrates (lymphocytes and histiocytes), also disseminated mast . cells, partially triggering the typical granula. Pronounced perineural and i endoneural edema (Figure 7a): axon edema in medullated and non-medullated nerves, also local destruction and vacuoles in the axon. No destruction in the myelin sheath, no cell reactions (Figures 7b and c). 1 Figure 5a. Electron Microscope of a Strongly Dilated Lymph Capillary Filled with Thickened Lymph (L) with Considerably Flattened Endothelium (E). Pericapillary slanting and diagonal sections of collagen fibrils (KF), moderately intense intcrfibrillar * edema. At the bottom, section of a mescnchvnal cell (M) with nucleus (K). Electron microscope magnification X 16,000. Figure 5b. Electron Microscope Magnification of a Section of the Coriiim: Considerable Protein-Rich Edema (EW) with Dissociation of the Previously Existing Fibers and Fibrils. Destruction in and on the elastic fibers (EF) looking noth- -eaten. Electron microscope magnification X 12,800. 1 Audiogram: December 1972 combined bilateral hearing difficulty; late January 1973 clcaf damage to the cochleae as well. Further x-rny investigations: vertebral block, cervical vertebrate 2/3; osteochondrosis and spondylosis deformans' C5 to C7; slight degree of scoliotic false posture, slight osteochondrous changes and spondylosis deformans of the thoracic vertebrae; marked changes in the area of L 5 to S 1; upper and lower jaw merely lacunar. Ort hoped i o. Consti 11 ant__i nvost i '.-..it i on: Incipient degenerative changes of the spine; no connection could be made with the skin changes. SPI -13053 9 Figure 6a. (Upper Right) u.b.2: Electron Microscope Magnification of a Section of the Corium: Con siderable Interstitial Edema with Dissociation of Collagen Fibrils (KF) and Elastic Fibers (EF). Cyto- Pl asm and karyoplasni (K) of the 4 fibrocytes (F) normal. Electron microscope magnification X 12,000. Inset: Magnification of destruc X i. tion in and on the elastic fibers 1 (t). Electron microscope magni i fication X 19,000. Figure 7a. Electron Microscope Magnification of a Section of the Corium with Medullatcd (mX) and non-medullated (N) nerves: clear perineural and endoneural edema. Schwann's cells (S) arc normal. Perineurally, one normal fibrocyte (F) and collagen fibrils (KF). Electron microscope magnification X 16,000. Tentative diagnosis: Edema or dernatosclcrosis of the upper extremities, of unclear etiology. Job background: For the past ten years had been laying polyvinyl chloride (PVC) pipe. Scaling the pipe with thin fluids'(PVC glues containing e.g., butynol and tetrahydrofuran (Tnngit glue made by Henkel). The glue was applied with a rag held in the left hand so that the glue flowed more intensively over the left hand and forearm than the right, and a layer of adhesive film accumulated. After work, this was removed cither by rubbing or with butanol or methylene chloride. Final diagnosis: Intoxication by vinyl chloride polymers and/or their additives^ Translator's Note: expansion unknown. SPI -13054 .1 Figure 7b. Electron Microscope Magnification of a Cross Section i of Non-nedullated Nerves (N) of the Corium: Local Destruction ii (t) in the Axon and Marginal Thickenings. Electron micro scope magnification X 40,000. Figure 7c. Electron Microscope Magnification of Section of Non-medullated (N) and Mcdullated (mN) Nerve from the Corium with Axon Edema (1). Myelin sheath (My) intact. Electron microscope mag nification X 26,400. Epicrisis: The 50-year-old telephone installer fell sick about 4 years ago with swelling, paresthesia and weakness of the hands, especially the left hand; these changes became more pronounced in the course of time; painful sensa tions appeared in the hand-forearm region; tendency to edematous swelling leading to sclerosing; fingers turned whitish when scratched. For years, unsuccessful attempts at treatment with the disease of a rheumatoid disease, admitted for in-patient treatment with the tentative diagnosis of progressive scleroderma. When he was admitted to the hospital the skin changes showed signs of the edematous and sclerosing stage of progressive scleroderma, they also pointed to so-called pseudoscleroderma [5] with various basic conditions, e.g., a disease of the rheumatoid type. The laboratory diagnosis and morphological and functional findings, taken on the basis of suspected progressive scleroderma or rheumatoid disease, ruled out the tentative diagnosis and pointed to damage by vinyl chloride polymers and/or their additives on the basis of job history and pertinent literature. Discussion The course and symptoms of the disease of our patient fitted well into the Variegated clinical spectrum of poisoning by PVC and/or additives, as may be gathered from the literature on the subject (1, 3, 6, 7, S, 14, 15, 16]: with (probable) dependence on factors given by the individual type ofj work, changes appear with a specific set of subjective symptoms (Table 1), functional (Table 2), and morphological changes (Tables 5, 4, and 5), with differential accentuation and for overlapping of individual symptoms in accordance with rules winch are not initially clear. Incorrect diagnosis of the changes, i.e., ascribing them to a rheumatoid disease or progressive (aero-.) scleroderma is frequent; this is also found in the case history of our patient. It should be pointed out that, in particular, the typical location and l prominence of the hone lesions are 'pathognomonic in nature. The distinguis bin char.ict er i si ic of aeroostcolys is t[H], s^e also discussion or nomenclature a iv nosology of disdnse groups) may be delimited by x-ray examination from the familiar acroosteolysis, the idiopatIdeally unfamiliar acroosteolysis, and -6SPI -13055 familiar osteosclerosis with acroostcolysis [9, 1C] and should -- after precise analysis of the clinical symptoms and the course of the disease taken together with job history -- in the future be classified as occupational poisoning. TABLE 1. SPECTRUM OF SUBJECTIVE SYMPTOMS (Almost exclusively in the am and leg regions, and very little in the shoulder girdle) Sensation of cold Burning, tingling and feelings of numbness, weakness and tension Arthralgia, pain caused by pressure, various pronounced sporadic painful sensations Also: Discomfort of the upper abdor.on, hissing in the ears, dizziness TABLE 2. SPECTRUM OF FUNCTIONAL CHANGES (Almost exclusively in the upper extremities, not always bilateral) Paling of one or more fingers (dead finger phenomenon) After cold stimuli, when clenching the fist, or in particular positions of the arm; Raynaud's syndrome or Raynaud-like syndrome Spontaneously or after cold stimuli Movement impeded Spasms of the hand arteries and/or brachial arteries Also: Visual impairment, liver function disturbances TABLE 3. SPECTRUM OF MACRCMORPHOLGGICAL SKIN CHANGES (Almost exclusively in upper extremities) Mpderate bluish, pale-whitish, ivory-colored, dirty yellowish, and bright colors. Nodular, knotty, pl3que-like, undulated, more or less raised and xanthoma-like infiltrations. Diffuse skin patches, pileation retained Shortened and watch-glass-1 ike nails Swelling of hands or fingers and/or forearm Extension of changes to forearm or upper arm region Drumstick fingers Impairment of skin's ability to slide over the supporting tissues Tight edematous waxy sclerotic consistency of integument Also: Bloated mask-like facial features Flntlish indurations in the cheek region -7- SPI -13056 w . ^ - - e .*-/ In studying the contamination of the air in the vicinity of shn ft-type driers, when drying polychloroviny1 rcr.in, vinyl chloride was not found in 82.3"* of the samples. In the remaining samples its content varied f.-on 0.7 to 0.12 ng/1, while the air samples in which vinyl chloride was found were collected in the vicinity of the fresh resin, in areas not equipped w.j th local exhaust fans. In areas where driers using the V. I. Stroganov system arc in operation, there is a significant contamination of the air by dust from the finished product. The dust escapes when the examination doors of the furnace are opened (in case the technological process is disturbed), during the crushing and sifting of the resin. The dust concentrations of polycholorovinyl resin at the oven varied from 20 to 507 ng/m1, while the crushing and sifting processes as well as the bagging, produced from 25.5 to. 62.5 mg/m'. In some cases, the vicinity of shaft-type driers was found to .have a high air temperature (23-37.5 with an outside temperature of 11.5-23.5). In order to improve the sanitary working conditions for those engaged in the operation of shaft-type driers, it is necessary to equip all areas with raw materials to be dried with a local mechanical exhuast fan. It must also be provided in places where the finished product is likely to produce dust that could enter the air. Drum-type driers are used for drying coarse, fine, granular and firable materials; brown and anthracite coal, sand, clay, phosphorites, grain, granulated sugar, sawdust and the like. In the operation which we examined, the drum-type drier was used for drying crystalline salts of the sulfates of ammonium and sodium. A drum-type drier (Figure 5) consists of a rotating drum, 2 m in diameter and 10 m long, connected at one end with a furnace and at the other end with a loading bunker for the dry product as well as a gas pipe for trapping the furnace gases which have been exhausted. There are metal shelves inside the drum. The drum is rotated by an electric motor, acting through a gearbox. The ammonium and sodium sulfate salts to be dried are fed into the drier by a screw conveyor. Drying is carried out using furnace gases at temperatures up to 220. The dried salt is transported by a screw conveyor and an elevator to the bunker for storing the finished product. The operation of the apparatus consists of monitoring the instruments and adjusting the salt drying process. In the course of drying salts in a drum-type drier, the air is not con taminated by toxic substances because a vacuum is produced in the drier. Meteorological conditions in production areas near driers are unfavor able. In winter the air temperature was lS-32 and in summer from. 21-55. The highest temperatures were recorded at. the window of a drum-type furnace through which the operator checks the feed of salts into the drier. An air shower should be provided at this point.- \' \ ' "7- i.i SPI -13057 T'i*h' ,M i> .tv A rt> J < IttitiM i 'A r tflifc U i ( O A t i n * r .Wa i- " TABLE 4. SPECTRUM OF MICEOMORPllOI.r/;ICAL SKJN CHANGES Flattening of rote function Interstitial edema, deposition of metachronatic, fine-granular, and filamentary materials Plate-like fibrosis of the corium near the epidermis, thickonin;; of collagen fibers and edematous relaxation of the collagen fiber bundle Fragmentation or circumscribed clumping of the tunic clastica Thickening of dermal arteries, hypertrophy of the tunica media, fibrosis of the intima, endartoriitis or endarteriolitis Dilation of lymph capillaries Inflammatory and predominantly lymphocytic pcrvascular proliferation with few histiocytes, involvement of mast cells Degeneration of finest nerve fibers________________________________ TABLE 5. SPECTRUM OF X-RAY CHANGES (Almost exclusively, phalanges of the hand -- often excluding ringed fingers') Cortical changes Circumscribed rarification Crescent-shaped defects Periarticular erosion of interphalangeal joints Striated translucence to the extent of osteolysis of the pseudo-fracture type Central osteolysis Shortening and/or swelling of the ends of the phalanges Acroosteolysis Circumscribed (reparative) structural thickening Also: Osteolysis of ulna, radius, clavicle, patella Widening of iliosacral foramina Our data and deductions on the etiology of the syndrome arc extremely scanty. PVC was synthesized by Regnault in 1S3S (see [12]), and large-scale manufacture began in 1927 [10] and the first publication reporting damage caused by handling PVC appeared in Romania in 1903 [13]. In 1957, the German literature still contained no mention to danger to the health in discussion of the syndrome [10]. Other patterns of damage arc mentioned [2] especially the acutclv toxic ones [<]. Keichardt [15] found in 1970 that, despite the fact that Germany produces no less PVC than other countries, no disease attributable to it has been found; in 1972 Juehe and Vcltman [7] and Juehc and Lange [6] published their observations on the topic. From the relevant publications [1, 3, 8, 10, 15, 16] it can be deduced that only long-term close skin contact with incomplete VC polymers or various medium-to-high molecular intermediates (resins) and/or their aggressive additives such as plasticizers, stabilizers, accelerators, inhibitors, etc., lend to chronic toxicity. The characteristic pattern of damage is thus far known only in workers in the PVC m.anufuc: ur ing industry who have to scrape off the residue, whose exact composition is unknown, from autoclave walls -8- SPI -13058 (polyclcancr [16]). On the other hand, diseases of the kind described here never appeared in those working with completely dcpolymcrized, inert, and physiologically harmless plastics [16]. It is found from the literature that the pattern of damage is to be interpreted as the result of factors which may be chemical, mechanical (con tinuous scratching and scraping with polyclcaners) or individual (only 3.0 to A.S% of people doing the same kind of work are involved [1, 16]). On the basis of the job history of our patient, who for years had to spread liquid PVC in his work as a telephone installer, no decisive pathogenic roles can obviously be ascribed to the "mechanical" factor described above. For the "individual" factor it should be noted that it is probably to be seen as individual contact of various intensities with the responsible agent. The degree of strictness with which the individual observes or supervises the work instructions can also explain the varying frequency with which the syndrome is to be observed, and the differing periods (months to years) before the symptoms became patent. The job history of our patient instructively supports this interpretation of the "individual" factor: he was injured earlier and more extensively because of his special job causing his extremities to be coated with the film-like "special" polymer. The mechanism by which the "chemical" industrial toxicological factor comes into play can in the first instance only be sketched: the subjective symptoms and functional changes -- supported by macromorphological and micromorphological findings -- point to a (initial?) neurovascular disturbance. More details will be given on the etiology and pathogenesis of the syndrome in a Iter publication [13). For prognosis and therapy of the disease after discontinuance of harmful contact while on the job, we may sav that the skin changes revoer spontaneously [6, 8] and the latter can be promoted whenever possible by physical therapy, as observed in our patient. However the bone lesions can progress even after work is suspended, finally terminating and recovering. Summary Case histories of chronic intoxication caused by intensive,long-lasting skin contact with incomplete vinyl chloride polymerization products and resins and/or their additives arc presented. Paresthesia, functional, and macromorphological and micromorphological changes build up to a variegated pattern of symptoms. A syndrome of scleroderma-like dermatosis, Raynaud's and dead finger syndromes and pathognomonic bone defects arc characteristic. When these symptoms are taken together with the occupational circumstances, this easily nisinterprctablc disease can be diagnosed. \ -9- SPI -13059 BIBLIOGRAPHY t. C.ii*ti i in'*. A., !; V . Mom ti's-: L"*' S'n- dn:iu* il*A<ro-C'f. si'OrU'is i'cm'rl* Cl d-.- C''i' 1 1 .it *f> . <Ovi .a' fft l r.invf. J. i'. iJ.w V.''Kir q\. ^S, 22* -`2*0 K Sr : Vc, * ;rn ^v*i A.l'iitin mil Kur,uro/:c.i. n... 'ucil. Vs'tuir. 116, *$} -- <S7 V'/t.'-l y V. K . V. \ G. T. Aero* i'MCOi V *n (''.C; > N!.n n llio I'n!s r.irl: \ of Virnt r.cii. y.c'.i. j. -.:r<`.7) / it;. 4. ) !r si: hi: h. [).. r. i- o>i k 2< t i. C. ; ?o*f: * ncuf i: % cr .ni.iin* -Jurt \*cr ;I inrv^ tiut t^t*rrcr:<,n A c c t' *. tw'n bom Ur:<4Ai:j; tnit VmyJ^Jrr;Ji!w ;i!-Cvpi'' mcii`5. AfCi. *!Wp.m. tv (io::v y (akovua, 5.: ['ui-JoiMi-ioJi-rmicf*. cJt. Klin. C7, 1151-- M5^ (I9&;;. . * l(. (*> i s* i(. IT: l *1. rr*iut!***'!. N p|ltl*1l il>`r I * I r iin(.! n. III**!* 41/1 i. l-\ lu'Vn*, 11^1 1i, i4u' l {*. At'flt.V. I S, 5TSJ -- 5Jm. I i.m%VW* \Vr IJ. S*vifM*Nv. t l.'J., V. Mim.iiu & Sr. |\itMiui>r: */r %* *!% S>'*lf***'i* %! t nut !! lUfctt' Hoi n*!{ **tcr Jcrut Hv>;U'ic- 9 U'l I v*n ^ I tt Wt IvfkMua,;). 6. fum, 5. *: C.-f. V.!**r/*Jo/:nc #.uc;c 1 iw: v ifir*;* (. ,:.n. ir*.;*w*V.n' !rom u.isi * \U'r f.i U At rowfn n Mt-J. Vsif, ->/, r*;j- 7. Jt;nr. V. 'C G. Z.r r.i:ii\ i!**r so**. VifivIvSlofuMxnr.V .*11. | !:iur.tit>ii fk.tlct S>nipo\ion tl.r ccr Cic* iiiisi.cn TG D"7. S. Mailv,oi ;:z. S. S. <". J. .\t.Donu. W. I'miiii v M. >. S: a/Sf *: AcrocMU*o!\m, Ac. Derm. 1*6, 7i9--. 220 (:vr.'>. 9. Mnutos, L. Ii., & O, C. Mrir*: Cu:j- nco.*t l.cwoni ir it. Ari. I);rm. (CUw.x-c), iZf. 22<~227 10. Ocrirt. H.: 4uu4t Kvflitx^/ic? Au:, it?. r-s K. J'hAfin. 237, 77-- 137 (I-57). H.> . n , I.. I. ; M ( o.tliiNii(u It .#*.nl ti ir.<.<r jCi* tins* *fc vli'fMt i ?* f .ml, \! J, Ittit'fii. I'Kat.l is 15. Vi ill M.Utif, II.: I >v* l I ill tK-r NumiMnfiimtuUfie. I;crw5*%k*im.u**vn IN*. 2$--}4 (1V7C). 16. W*u\s# K. If., \V. I'.. M(.0*k wir a, f'. Ir. Tatum & J. 1.. Ckimii: ( Aa>;* tti**M J AvMni'lvnlw w f. At:>v*f. Mci! A>v. 7wl, >77--5S1 (ivr*7j. '+ . yp+*<- ** \ \ \ -10- SPI - 13060 mfce Oi>--/Iir foltulion, lnrt. Ity/f. Vol. 79, 1973 139497 130484k Products of the thermal breakdown of expanded occur, possibly during 1 lie next century, and will melt polar ir polystyrene. Invnnyuk, K.G.; Kol>7.nr, A. 1. (USSR). Lilcinot caps, decreasing the albedo of the Earth's surface, slowing th Proizvod, 1072, (10), 44-.r> (Russ). Kxpatulcri polystyrene of deep circulation of the means and the cycling of nutrients in th different types was pyrolyzcd nt 1500 and the products were oceans, increasing sea level, flooding coastal plains, and increas analyzed by a very sensitive chrotnalog. method. The gaseous ing weathering processes and changing both animal and plan products contain Hi, CO, ClI., C,II,, C1U1, Calls, C7IU, CII. ecosystems to the detriment of luunan populations. J. rich 139491k Atmospheric releases from Tarapur. Abraham, P. 139485m Nitrogen oxides, nuclenr weapon testing, Concorde, Pattuaik, D.; Paramcsvaran, S. (Ilhabha At. Res. Cent. and stratospheric oxone. Goldsmith, I'.; Tuck, A. h\; hoot, Bombay, India). Indian J. Environ. Health 1971, 13(3), 171-8 J. S.; Simmons, IC. I-.; Ncwson, R. L. (Mcleorol. Off., Brack (Eng). The safeguard features engineered into the Tarapur At nell, Engl.). Nature (London) 1973, 244(54IS), 545-51 (Eng). Power Station, India, to minimize, control, and monitor th The prodn. of NO, in the shock wave of explosions nssoed. with atm. pollutants from the station arc described. The limit the testing of nuclear weapons in the atm. is ealed. and compared prescribed for the effluents from the station are discussed. Th with that expected from the engine exhaust products of llccts 7 spectra of the effluents arc presented and the radioactiv of Concordes, each flying in the stratosphere for >10 hr every isotopes arc identified. The major constituents of the gascou day of the year. NO, injections into the stratosphere from past waste arc isotopes of Xc and Kr. Data on actual releases ar nuclear explosions nrc cquiv. to large nos. of fully operational given. The max. value of artivity released is very much les Concordes. Anal, of the Os records reveal no detectable changes than the max. permissible release. in the total atm. Os during and after periods of nuclear weapon 139492m Concentrations of uranium in the air of a uraniur testing implying that massive NO, injections into the strato refinery and in urine of the workers. Okabayashi, II.; Ilik sphere do not upset the Oa layer. S. Bravcrman M.; Watanabc, S.; Ilongo, S.; Suzuki M. (Natl. Inst. Radio 139486n Spectrophotometric determination of small amounts Sci., Chiba, Japan). Hoken Ilutsuri 1972, 7(3), 151-5 (Japan of dimethyl sulfate in air. Tomcxyk. Danuta; Bajcrska, Jad- U concns. in the refinery air were 9.0 X 10'" to 3.7 X 10** g/1 wiga (Osrodck Badaw.-Rozwojowy Przcm. liarwnikow, Zgicrz, and in the urine of the workers, 3.9 X 10-7 to 3.0 X 10"* g/1 Pol.). Chem. Anal. (Warsaw) 1973, 18(3), 543-9 (Pol). Me,.SO. The concn. in the air was higher than background by an orde was absorbed in pyridine, (V-mcthylpyridinium sulfate heated of 2-4 and that in the urine was higher than that in the gener; with 0.2N NaOIl, and the resulting glutaconaldchydc (I) was public. These high levels in the urine arc due to inhalation o reacted with PhNH, at pH 5.5 to form I dianil whose absorbance higher concns. of air borne U in the working environment. was measured at 484 nm (molar absorptivity 3.4 X 10`). The 139493n Work hygiene and effectiveness of health measure method permits the detn. of 0.15 7-(CH,)jSO./1. of air with an in the manufacture of chlorinated terpenes. Ashirova, S. A error <5%. A. Janowski (USSR). Naurh. Tr. Leningrad. Cos. Inst. Usovcrsh. Vrache 139487p Emission spectrographic determination of non 1971, No. 98, 20-30 (Russ). Chlorinated terpenes are widcl: homogeneity of laboratory samples of industrial dusts. Rokosz, used as insecticides. For agricultural purposes aquatic emulsion Andrzej; Grajpcl, Andrzej (Univ. Jagicllonski, Cracow, Pol.). of polychloropincne (I) and polychlorocamphcne (II) arc used Chem. Anal. (Harrow) 1973, 18(3), 593-8 (Pol). Dust samples They are toxic to humans, penetrating through respiration am were fused with K5S1O7 and Co,0, (internal std.) and excited in alimentary canals and skin. The max. permissible concn. o an a.c. arc; anal, lines were: Fe I 297.3, Zn 1 334.5, I'b I 280.2, I and II in working areas is 0.2 mg/m3. Camphene, ar-pinene, I Si 1 288.2, A1 1 308.2, Ca 1 364.4, Mg n 280.3, Mn 1 279.8, II, and Cl were detd. in 3180 samples of factory air. For 90/, Cr 11 284.9, Cu 1 327.4, and Co 1 308.7 nm. Nonhomogeneity of the samples the concn. of I was 1.5-10 times greater than thi was judged from the scattering of the relative intensity of the max. permissible concn. During II prodn. the max. permissible anal, lines of the elements and internal std. The method was concn. was exceeded 5- or 0-fold. The skin penetration rate used at random to investigate dusts from the marten steel was high. The skin of employees in 3 factories was studied smelting process. A. Janowski By shift end, the concn. on uncovered parts'of the skin ani 139488q Exhaust emission of the Otto engine during knock esp. hands was 0.3-10 mg/dm7. The highest concn., 2.9-10! ing combustion. Ebcran-Eberhorst, Robert; Gruden, Dusan; mg/dm1, was on the skin of operators pouring the II. Thi Schwarzbaucr, Gerd (Inst. Verbrennungskraftmasch. Kraft- covered parts of skin had a concn. of 0-0.4 mg/dm7. Medica fahrwes., Tech. Hochsch. Wien, Vienna, Austria). Erdoel examinations show that 1/3 of the tested workers had nervou Kohle, Erdgas, Petrochcm. Brcnnst.-Chcm. 1972, 25(12), 715-18 system changes and 2/3 had subtrophic and atrophic respirator; (Ger). Varying air: fuel rate, compression ratio or ignition organ changes. J. Suschka advance produces engine knock and also influence exhaust emis 139494p Effects of asbestos on the pleurae. Lesobre, R. sions. Combustion temp, raises with knock as does the NO- Hagcngue, A.; Legrand, M. (Cent. Pneumol., Hop. Beaujon emission. The hydrocarbon emission is lower with knock than Clichy, Fr.). Nouv. Presse Med. 1973 , 2(22), 1491-1 (Fr) normal, providing air :fuel rate or ignition changes have caused Thoracotomic and necroscopic findings following exposure tc knock, but higher due to changes of the compression rate. The asbestos dust are described. The primary lesion, the hyalir HCN-, HCHO- and 0,-emissions, as well as odor, increase pleural plaque, devoid of clinical symptoms, seldom contain: rapidly with knock intensity. Knock intensity 0-100 was any asbestos fiber. Later these plaques become calcified and thi measured with the standard knockmeter in the ASTM-CFR-Test calcification continues even after termination of asbestos expo engine (MOZ). sure. In 15-20 years some workers developed pachypleuritis 139489r Accurate measurement of cadmium in airborne Benign rccidiving exudative pleuresia can be produced by asbesto: particulates. Zdrojewski, A.; Quickert, N.; Dubois, L. (Chem. dust; this may develop into mesothelioma, esp. with exposure Div., Environ. Prot. Serv., Ottawa, Ont.). Int. J. Environ. to crocidolite. Geo. Sag Anal. Chem. 1973, 2(4), 331-41 (Eng). The accurate and rapid >> 139495q Technical progress in the chemical industry and measurement of Cd in airborne particulates is described, with industrial hygiene. Arkhipov, A. S.; Marchenko, E. X.; particular ref. to high-vol. air samples collected on glass fiber Filatova, V. S.; Egorov, Yu. L.; Novoselova, T. I.; Martynova, filters. The method involves the acid digestion of a part of A. P. (Tscntr. Inst. Usoversh., Moscow, USSR). Gig. Tr. the filter followed by anal, using at. absorption spectroscopy. Prof. Zabol. 1973, (8), 1-5 (Russ). The effective use of equip The use of both conventional flame at. absorption rind at. absorp ment, architectural design, ventilation methods, waste recycling tion with a graphite furnace atomizer was studied. The Cd and final treatment, and measurement and elimination of fumes, detns. were free of matrix error. Small interferences by other gas, and aerosol emissions arc described. Iv. Strossbcrg elements could l>c accurately taken into account. F'or a typical 139496r Hygienic evaluation of working conditions in some air sample of 2000 m3, the Cd amt. can be detd. with accuracy chemical plants operating in the open air. Filatova, V. S.; down to ~2 ng/m3. Detns. below this level arc possible at the Vinogradova, V. K.; Bashkirova, L. S. (Inst. Gig. Tr. Prof- expense of the speed and simplicity of the method. The possi zaboi., Gorki, USSR). Gig. Tr. Prof. Zabol. 1973, (8), 8-11 bility of a non-uniform distribution of Cd on the exposed filter, (Russ). Key tcchnol. equipment at 2 new Nil, and vinyl and the chance of accidental contamination of the filter or prepd. chloride plants were placed in the open air. Working conditions sample by traces of Cd are also discussed. and industrial hygiene at these plants arc satisfactory. 139490j Fossil fuel burning and carbon dioxide. Pessi E. Strossbcrg mistic view. Pytkowicz, R. M. (USA). Comments Earth Sri., 139497s Changes in working conditions and health status Ceophys. 1972, 3(1), 15--22 (Eng). From Nurl. Sri. Abslr. of workers of oil refineries in connection with technical progress 1973, 28(3), 5602. The impact of the combustion of fossil Mukhamctova, G. M.; Polyanskii, V. A.; Sukhanova, V. A.; fuels on the CO, concn. in tlie atm. and the consequences for Mustacva, N. A.; Ostrovskaya, R. S.; Braginskaya, L. L. Earth ecosystems are postulated. The rate of fossil fuel con Makar'cva, L. M.; Gazizov, M. F.; Eiucl'yanova, A. P. sumption increased an av. 4.5%/yr during the past century (Inst. Gig. Pofzabol., Ufa, USSR). Cig. Tr. Prof. Zabol. 1973 causing a steady buildup in atm. and oceanic CO,. Mechanisms (8), 5-8 (Russ). A comparative anal, examns. of workers at by which CO, is removed from tire atm. and sea wnter by oceanic the Ufa refineries made in 1957-00 and 1970-71 showed sub sedimentary processes are reviewed. Calais, show that by stantial favorable changes in health (with a service record up tc I960 man had produced and injected into the atm. 05 times 10 yr). The number of persons with asthenic and neurasthenic the CO, removed by oceanic sedimentary processes, which arc syndromes, hypotension, anemia. thrombocyto|>ciiia, and primarily biogenic. If CO, levels in the atm. continue to chronic gastritis greatly declined. Some functional characteris increase catastrophic warming of the surface of the earth will tics of the liver improved. Persons exntnd. in 1970-71 still had SPI -13061 23181 Chemical Abstracts Vol. 79,1973 Page 308 SPI -13062 in intracellular media in all persons under study. The Ca level in gases. C.ustavsson, K. A. G. (Akticbolag Bahco Ventilation, blood plnsma decreased with age. The K level in intracellular Swed. 352,817 (CL Old). 15 Jan 1073, Appl. 6973/71, 28 May media increased with age, that in intercellular liqs. was practi 1971; 6 pp. The app. consists of an absorption column with a cally const. These findings agree with the literature data ol the limestone suspension at its bottom, a tube reaching immediately effect ot occupational stresses as in this ense high atm. air temp., above the absorbent surface and through which flue gases pas- noise, vibrations and industrial dust on electrolyte metabolism. from the bottom carrying drops of absorbent to the top of th< E. Strossbcrg column, a circulation line from the top of the column to its botton 23182f Importance of polonium-210 determination in the for returning sepd. absorbent to the bottom, and a mill located ii urine of workers in uranium mines. Panov, D.; l'ctrovic, 11.; the circulation line for grinding the recirculated absorbent. Novak, L.; Djordjcvic, V. (Inst. Labor Med. Radiol. 1'rot., I. G. Zewi Belgrade, YuRoslavia). Smrem. Med. 1072, 23(11), 0-10 23191h Determination of microamounts of some substance (BuIr). A study of 290 workers in the uranium mines of Yugo- In air. Gazicv, G. A.; Sotnikov, E. E.; Filippova, S. A slavia who were exposed to Rn as well ns rats livinR under the U.S.S.R. 366,409 (Cl. G Oln), 16 Jan 1973, Appl. 29 Sep 197( same conditions showed that it is not possible to det. the con From Otkrytiya, Iznbret., Prom. Obraztsy, Toearnye Znaki 1973 tamination by Rn and its degradation products by testinR the 50(7), 84. The analyzed sample of air was passed through a urine for ,lol'o. No correlation exists between the cones, of ,l#Po entrainment separator filled with a fine-grained absorbent (durin in the urine and theconcn.of Rn in the work environment. cooling) to cone, the substances being analyzed, followed b J. J. Pohl heating and blowing the coned, substances with a gas carrier int 23183g Hand tremor induced by Industrial exposure to in the gas analyzer for further detn. and recording. To increase th organic mercury. Wood, Ronald \V.; Weiss, Ann B.; Weiss, accuracy of anal., air was partly absorbed together with analyze Bernard (Sch. Med. Dent., Univ. Rochester, Rochester, N. Y.). substances. During subsequent heating, air behaved as a Carrie Arch. Environ. Health 1973, 26(5), 249-52 (EnR). Hand tremor for supplying the substances into the gas analyzer. in 2 subjects with industrial Hr exposure decreased after cessation 23192j Test tube for carbon dioxide measurement. Aue: of exposure and the subjects became asymptomatic after 3.5 gescllschaft G.m.b.H. Ger. Often. 2,151,693 (Cl. G Oln), 19 A; months. The extent of hand tremor was evaluated by requiring 1973, Appl. P 21 51 693.8, 13 Oct 1971; 5 pp. The measurin the subjects to maintain a force of 10-40 g with the forefinger on a range of COj test tubes, useful for automotive exhaust gases, w; finger trough attached to a strain gauge. Performance improved extended by an AljOj-supported KOH prelayer. The layer w: after the subjects were removed from Hr exposure. made by drying in vacuo at 100 a mixt. contg. AljOi (0.1-0. Raymond Zehnpfennig mm) 100 g and KOH (28 g KOH in 72 ml HtO) 15 ml and moister 23184h Sanitary-hygienic appraisal of working conditions ing with HjO 1 ml. A 20 mm long bed of this mass absorbed 1 during the welding of metal covered with protective coats. Prot- vol. % CO, at test gas vols. of 0.11. senko, G. A.; Danilov, V. 1.; Timchenko, A. N.; Nenartovich, 23193k Oxidation catalyzer for exhaust gases. Watanabx A. V.; Trubilko, v. I.; Savchenkov, V. A. (Khark'. Nauchno- Sexto; Uchida, Sumio; Kori, Yoshizo; Kawakami, Akira Issled. Inst. Gig. Tr. Profzabob, Kharkov, USSR). Avtomat. Okamoto, Osamu (Hitachi Makuseru Co., Ltd.) Japan. Koke Svarka 1973, 26(2), 65-8 (Russ). Air samples were taken using 73 27,988 (CL 13(9)G11), 13 Apr 1973, Appl. 71 61,334, 12 Au a specially equipped welder's helmet and analyzed for dust, 1971; 3 pp. A perovskite-type A,Bi_,MeOj (A, alk. eart phenol, CO, HF, acrolein, phthalic anhydride, NO,, Mn, and metals; B, rare earth metals; Me, Fe group metals: x, 0.01-0.9 SiO>. Tests were run with and without general ventilation. oxidn. catalyzer for exhaust gases from a car or chem. plants i Weldings were both hand-operated and automatic on a 10-mm prepd. by heating the acetate mixt. at 900 for 6 hr, powdering coated steel plate. Gas-cutting was also examd. The coatings mixing with NHxHCOj, pressing in a pipe-form, and heating a were a glypthalic (I) a phenol-formaldehyde (II) and a poly 1200 for 1 hr to obtain a sihter of 85% porosity. It works we ethylene (III), in 25 pm thickness. The results are compared even at 1000 for long periods and is not poisoned by Pb, S and with the max. permissible concns. I is the least and III the most compds. K. Kodama objectionable II, with ZnO, is toxic. Olaf Thomsen 23194m Adsorbent of poisonous gases. Inagaki, Koshir 23185j Hygienic certification of the building projects de Japan. Kokai 73 27,989 (Cl. 13(9)G112), 13 Apr 1973, Appl. 7 velopment, and reconstruction of plants producing organochlorine 60,973, 13 Aug 1971; 4 pp. N and S oxides in exhaust gases ar products. Levina, M. M.; Filatova, V. S.; Belaya, E. G.; absorbed on a spinel-type oxide contg. one or more transitio Ashirova, S. A.; Tikhomirov, Yu. P.; Levin, A. L.; Mostin- metals, e.g. Cu, Ti, V, Cr, Mn, and Fe groups and one or mor skaya, R. Z.; Kuznetskii, B. E. (Inst. Gig. Tr. Profzabol., alk. earth metals on active carbon and desorbed by dil. NaOl Gorki, USSR). Gig. Sanit. 1973, (4), 86-7 (Russ). Certifica soln. K. Kodama tion of building plans, development, and reconstructions of 23195n Device for recycling exhaust gas for a heat engine plants manufg. PVC along with a favorable solution of sanitary- Cusson, Charles (Pan American Chemical Co. Inc.) S. Africa: hygienic problems appear to depart from hygienic requisites. 72 01,665 (Cl. C 10*), 25 Oct 1972, Fr. Appl. 71 12,730, 09 Ap Poor ventilation in plants manufg. vinyl chloride, polychloro- 1971; 6 pp. The exhaust gases of a heat engine are recycled t prene, and trichloroethylene is poor and does not conform to reduce the amt. of NO, in the final effluent. The exhaust gase stds. Architectural modifications should be employed to effect are recycled below the discharge for return to the intake; th hygienic stds. John Howe Scott gases are passed into a catalytic purifin. unit where the vol. re 23186k Studies of combustion with a sludge burner. Wies- cycle of exhaust gases is varied with supply of fuel to the engine enberger, J. (Ger.). Wasscr, Luft Belr. 1973, 17(1), 24-6 (Ger). Henry H. Ginsberg A 40 to 1500 kg/hr sludge burner bums combustible industrial 23196p Smoke abatement in the desulfurization of pig iron waste sludges with a min. of soot or CO. The sludge is atomized Braetsch, Peter; Domalski, Willi; Behrens, Manfred (Stahl in the nozzle by a stream of compressed air or steam and elec, werke Peine-Salzgitter A.-G.) Ger. Often. 2,150,965 (Cl. C fired. The burner fires into a suitably insulated muffle furnace 21c), 26 Apr 1973, Appl. P 21 50 965.9-24, 13 Oct 1971; 9 pp chamber from which combustion products may be removed for The development of smoke in the desulfurization of pig iron wa anal. Using a 100 kg/hr model burner, old crankcase oil and lac- reduced by adding soda-cement-fluorite mixts. contg. 50-70, uer solvent wastes were burned with a min. of soot or CO. Less Na metasilicate for fixation of the volatile Na:0 formed by de ammable materials can be totally burned if other flammable compn. of the soda. A mixt. contg. soda 63, Portland cement 28 gases are used in place of comprescd air or steam. J. H. Lcftin and fluorite 9% was suitable for the desulfurization of Fe a: 1350-400. 23197q Removal of sulfur oxides from chimney gas. Ta 23187m Aircraft Emissions: Impact on Air Quality and naka, Takushi; Hattori, Hiroshi; Matsumoto, Seiji (Saka Feasibility of Control (Office of Air Programs APTD-0757). Chemical Industry Co., Ltd.) Japan. Kokai 73 26,689 (Cl United States Environmental Protection Agency, Office of Air 13(9)F2), 07 Apr 1973, Appl. 71 52,227, 13 Jul 1971; 6 pp. SO Programs (USEPA, Off. Air Programs: Research Triangle Park, in chimney gas are 94% removed by passing, at 10 ml .'min for 3( N.C.). 1972,60 pp. hr, through a column of 800 g of 4-6 mm diam. pellets contg 23188n Air Pollution Aspects of Emission Sources: Pulp and SrCOj, which are prepd. by mixing SrCOj with bentonite o; Paper Industry. A Bibliography with Abstracts (United States diatomaccous earth and pitch, molding, nnd igniting at 700 Environmental Protection Agency Publication No. AP-121). The pellets arc regenerated by treating with 20% NajCOj at 30' United States Environmental Protection Agency, Air Pollution for 3 hr. CaCOj and 13aCOj arc unsuitable. K. Kodama Technical Information Center (USEPA, Air Pollut. Tech. In 23198r Potassium sulfate recovery in the purification o form. Cent.: Research Triangle Park, N.C.). 1973, 166 pp. sulfur dioxide-containing waste gases. Yon Scmcl. Georg 23189p Air Pollution Translations: A Bibliography With Schibilla, Eduard; Strcwe, Wolfgang (Ulidc, Friedrich G.m.b.H. Abstracts, Vcl. 3 (United States Environmental Protection Ger. Often. 2,147,427 (Cl. B Old), 29 Mar 1973, Appl. P 21 41 Agency Publication No. AP-120). United States Environmental 427.1, 23 Sep 1971; 7 pp. The waste gases from a power plan' Protection Agency, Information Services Division (USEPA, Air contg. N, CO, and COj contaminated with SOi are freed fron Pollut. Tech. Infor. Cent: Research Triangle Park, N.C.). SOj by washing with a KOH-KC1 soln. obtained as waste liquoi 1973,250 pp. from a diaphragm electrolytic plant. The KtSOi formed in thr countercurrent washing process is oxidized by air or O-enrichcd air at 6O-10()/3-24 atm and KC1 is added to the oxidized soln. to 23190g Absorber for purifying sulfur dioxide-containing flue lower the soly. of KtSO. The KtSO< is filtered off and the fil- 2427 [Feb. 15, 1074] TOXICOLOGY 23140*23156 23149. KONIET7.KO, II.*, 1. FLKTKH, K. VFTTFH and H. WFICHARDT. (Inal. Arbottsmed., Unlv. Turb., Fronrisbergst. 31, 7400 Tuebingen, W, Gcr.) Fclduntcrauchungcn in Loosungsmltlclbctricbcn. 2. Trtemelrlarhr KFG-Ucbcrwachung bcl LocnungsmlttclarbcHrm an Trlchloracthylcn-Wasrhanlagcn. | Field ptmltra in solvent factories: 2. Tcicmctrlc FFO-controi in workers of a snl* vent factory on trlchlorocthvlcno-haslns.| ZFNTRALUL ARBKTIS" MFD AHHFlTSSCmjTZ 23(5h 129-133. Ulus. 1973.--Tcicmctrlc EEG controls were done In 6 healthy males working on open basins containing trichloroacetic acid and trlchloroellunol. The results were compared with the concentrations of these compounds tn the air and blood trlehloroethanol levels. Comparative controls were made In 4 of Ihesc workers on other days under similar working conditions but without exposure to the chemicals. The EEG change determined In 4 workers during exposure was the appearance of a waves with Increased amplitudes.--D. S. 23150. NOVAKOVA, SP., S. DINOEVA and S. DANON. (United Res. Inst. Ind. Hyp. Labor Prot., Sofia, Dulg.) Experimental*noe obosnovanlc predcl'no dopusttmoi kontsentratsil patorana v vodc vodoemov, fAn experimental basis for maximal permissible concentrations of patoran In surfarc waters.] GIG SAN1T 38(35: 86-89. IllusT 1973. [In RussVj--The toxic effect and the permissible concentrations In water of the pesticide patoran (N-4-bromphcnl-N'-methyl bromide) were studied. Tests at concentrations of 0.125, 0.25, 0.5, 1, 2, 4, 8 and 16 mg/1 revealed that patoran has an adverse effect on the organo leptic properties of water. A threshold was observed at 0.2 mg/l. Concentrations up to 20 mg/l did not affect the self-purification of reservoirs. At a concentration of 50 mg/l, patoran prolonged the existence of microorganisms. In acute experiments in rats, the LD50 was 3875 mg/Vg. In acute and scmiacute experiments, patoran inhibit ed tissue respiration and oxidative-reductive processes In cells and led to toxic damage to liver, kidneys and spleen, including a tendency toward development of cirrhosis of the liver. Chronic experiments In 210 white rats over a 6 mo. period under 5 experimental conditions at dally doses of 0.1-80 mg/kg revealed that above 0.1 mg/kg, patoran adversely affected white and red blood cells,'disturbed enzyme equili brium, Inhibited tissue respiration and cellular oxidation-reduction processes-and affected the liver, kidneys and spleen. Changes were dose-related. The limiting sign of damaging effects of patoran Is Its Influence on the organoleptic properties of water. It is concluded that 0.20 mg/l Is the maximum permissible levels of patoran In reservoirs.--M. D. S. 23151. FEL'DMAN, N. G. and M. V. VENDILO. (F. F. Erisman Inst. Hyg., Moscow, USSR.) Delstvie alifatichesklkh spirtov na zrltePnyi analizator (nelrogistologlchcskoe tsslcdovanle). (Effect of aliphatic alcohols on the visual analyzer (ncurohistologlcal Investiga tion).! GIG TR PROF ZABOL 17(3): 55-56. 1973. (In Russ. ) -- Adult rabbits were subjected daily for 6-7 mo. to 4-hr inhalation of aliphatic alcohols (methanol, hexanol, hoptanol, nonyl alcohol and decyl alcohol) to refine the level of the maximum allowable concentra tion in air of work zones. Neurohlstological Investigations were con ducted after killing the experimental animals. An investigation of the optic nerve, chiasma, and tract showed phenomena of Irritation of the majority of nerve fibers, expressed by corkecrew-llke convolutions of the fine nerve fibers and Infiltration of protoplasm along the course of the thick fibers. These phenomena were accompanied by prolifera tion of neuroglia hyperemia of the vessels and dilation of the peri vascular spaces. Maximum changes were noted on passage of the chiasma Into the optic tract and minimum changes in the optic nerve. A comparison of the results of the neurohlstological and cleclrophyslologiral investigations established the similarity of methanol and the other alcohols with respect to the character and expressivity of action on the visual analyzer. The neurophysiological data confirm ed the need to reduce the maximum allowable concentration of methanol and other aliphatic alcohols to levels not causing functional and morphological changes of the visual analyzer. --M. D. S. 23152. KASKEVICH, L. M. and V. P. BEZUGLYI. (Inst. Hyg. Toxicol. Pestle. Polym, Plast. Subst., Kiev, USSR.) Sostoyanle Zdorov*ya, rabotayushrblkh s tetrnmetlRiurandisul'fidom (TMTD) v usloviyakh kontroPno-srmennykh laboratorit l semennykh zavodov. [State of health of persons working with tetramrthvlthiuram (TMTD) at seed control laboratories and seed farms.| GIG TH PROF ZABOL 17(3): 49-51. 1973. |In Russ.]--The majority of the 195 examined persons having occupational contact with tetramcthylthlram disulfide (TMTD) at seed control laboratories and seed farms had a poor tolerance for this preparation, which was expressed by Irritation of the upper air passages and complaints indicating its general toxic effect (headaches, fatigue, pains tn the heart region, etc.). The most frequently observed changes were tn the cardiovascular system, pre dominantly tn the form of myocardial dystrophy (21.5) and the hepato biliary system (22'>?). Liver pathology was manifested more often by hcpafocholccystHls and more rarely by chronic hcpattdUes of toxico chemical etiology of a mild degree predominantly, with feebly express ed disturbances of the protein production, carbohydrate, and urobilin excretory functions of the liver. In 7.6% of the examinees thyroid pathology was noted, Including hyperplasia, diffuse enlargement of the Il-HI degree, and In i case caneer. In persons working with TMTD for a longtime,hematological changes, characterized by the develop ment of moderate hypochromic anemia and a tendency toward leuko penia with neutropenia and coslnopcnla, and changes In memorytes were noted. The data obtained Indicate the need for close medical control when working with TMTD with the conduction of hematological investigations.--M. D. S. 23153. IL1CHKINA, A. G. (Dcp, Communal Hyg., Lenlngr. Sanlt.Hyg. Med. Inst., Leningrad, USSR.) Eksperlmentarnye dannye k gigicnlcheskomu normlrovaniyu dlgldropcrekisl mcta-diizopropilbcnzola v vodc vodoemov. (Experimental data for hygienic standard!* atlon of dihydropcroxldc mcta-dilsopropylbcnze in surfare waters.! GIGSAN1T 38(3): 108-110. 1973. |In Huss.|--Vuantitalive chemical analysis of dihydroperoxide meta-diisopropylbenzene (DHP-M) was done In surface waters. Stability, stimulating effect on growth of saprophytic microflora, bacteriostatic and bactericidal effects were evaluated. DHP-M had an adverse effect on the process of minerali zation of N-contalnlng organic substances. Toxicological studies wert done in white rats, rabbits and chick embryos. Concentrations of DHP-M should not exceed 1 mg/l. Toxicological data was the limiting factor.--M. D. S. 23154'. EVANS, J. C., R. J. EVANS, A. HOLMES, F. F. HOUNAM, DIANE M. JONES, A. MORGAN and M. WALSH. (Health Phys. and Med. Dlv., At. Energy Res. Establ., Harwell, Berks., Engl., UK.) Studies on the deposition of Inhaled fibrous material in the respiratory tract of the rat and its subsequent clearance using radioactive tracer techniques: I, UICC crocidollte asbestos. ENVIRON RES 6(2): 180-201. Illus. 1973.--Radioactive tracer methods were used to study the distribution of crocidollte [possible cause of tumors in miners] between the upper and lower respiratory tracts after single short inhalation exposures of the nose only type. The UICC [International Union Against Cancer] standard reference sample of crocldolite re vealed that 50 + 5*2 of the deposited asbestos was in the lower respira tory tract. After 30 days the lung content of crocidollte was reduced to 73% of the initial value. Autoradiography was used to study the distribution of asbestos within the lung immediately after exposure and after 30 days. The clearance of crocidollte from the respiratory tract was also followed by the measurement of radioactivity in feces. -C. M. M. 23155. GOKINA, M. S. Funktsional'noe sostoyanle miokarda i sosudistyi tonus u rabochlkh, podvergavshlkhsya dlitePnomu vozdeistviyu okisl ugleroda. [Functional state of the myocardium and vascula; tone of workers exposed for a long time to the effect of carbon monoxide. 1 GIG TR PKOF ZADOL 17(3): 51-52. 1973. [In Russ.|-- The contractile ability of the myocardium and vascular tone of worker exposed for a long time to CO in small concentrations was investigate The vascular tone of 203 workers was studied by osclllography, and the propagation velocity of the pulse wave and functional slate of the myocardium were determined by electro- and polycardiography with the use of functional tests: orthostatic with physical exercise and nitroglycerin. Initial signs of diffuse involvement of the myocardium and hypoxia, which Intensified after physical exercise and an ortho static position, were established on the ECGs of 12.3'7 of (he workers examined over a 6-yr period. The contractile ability of the myo cardium did not change In a considerable number of the workers (78). Machinists with a long service period and mechanics with short service had Initial signs of decreased contractile ability of the myo cardium, elicited by means of the functional lest with nitroglycerin. There was a direct relation between the level of the average diastolic arterial pressure and propagation velocity of the pulse wave. --M. D. S. 23156. STULOVA, E. A. (Clin. Branch, Gorki Inst. Ind. Hyg. Occup. Die., Dzerzhlnsk, USSR.) Kharaktorlstlka sostoyaniya termoregulyatsll prl khronlcheskoi Intoksikatsii vinilkhlorldom. (Char acteristics of the state of thermoregulation in chronic vlnvl chloride poisoning.! GIG TR PROF ZABOL 17(3K 53-55. 1973. (In Russ.j --The state of thermoregulation in chronic vinyl chloride poisoning, which often occurs with eubfebricity but sometimes with a more appreciable increase of temperature (to 38-39'C), was studied in 40 men and 56 women aged from 25-45 yr working In contact with vinyl chloride for 3-15 yr. The data obtained showed that different mani festations of thermoregulatory disturbances are observed in persons with chronic vinyl chloride poisoning. The acrohypothcrmia, a decrease of the rate of arterial flow, spasm of capillaries and spasm of medium caliber arteries that were noted In the patients unconditior ally disturbed heat emission, but it was difficult to attribute these disturbances to the state of the peripheral circulation. A clinical physiological analysls'of the data Indicated that the disturbances were due to Impairment of the functioning of the hypothalamic-brain stem structures. This is confirmed by the fact that they arc combinewith disturbance of heat production. Thermoregulation should be studied for early detection of chronic vinyl chloride poisoning. --M. D. S. SPI -13063 Preprint of International Congress Series No. 322 Advances in tumour prevention, detection and characterization Vol. 2: Cancer detection and prevention Proceedings of the Second International Symposium on Oncer Detection and Prevention, Bologna, April 9-12, 1973. 1974, Exccrpta Mcdica, Amsterdam. (ISBN 90 2190228 1) Occupational carcinogenesis Cesare Maltoni Istituto di Oncologia 'F. Addarii'and Centro Tumori, Bologna, Italy Occupational carcinogenesis is one of the most interesting, tragic, important and difficult fields in oncology. It is interesting from the scientific point of view because it represents, dramatically, an experiment in carcinogenesis made on humans and it may teach us a lot about the natural history of tumours. It is tragic from a human point of view, because work which is per se a natural necessity of life, should not, at least, cause cancer. It is socially important because oncogenic factors increasingly are produced and diffused in occupational environ ments. Moreover from the factories they spread to the general environment, so that they come to be an ecological problem. Finally, occupational carcinogenesis is a difficult field to approach, because the care of the workers' health is often in conflict with the product ive interests of the factories. Industry has done a lot for experimental carcinogenesis, related to occupational can cer; often however the result is merely to prove the carcinogenic effect in animals of agents which have already proved to be carcinogenic for man: this is equivalent to saying that many people die of cancer but some make their living from cancer. On the other hand emotional arguments should be avoided. Thus I am aware that speaking on occupa tional carcinogenesis is a complex and difficult task. Experimental carcinogenesis did not start with the experiment of Yamagiwa and Ichi kawa in 1915, but rather in the 16th century with the observation of the so-called `mountain disease' in miners of Joachimisthal. This disease was recognized at the end of the last century as pulmonary carcinoma, which we now know is due to radio-active pollution, present in those mines. In 1775 Percival Pott in `Chirurgical Observations' de scribed a cancer of the scrotum in chimney sweepers and he correlated it with the black soot. In 1894 Unna reported on the frequency of skin cancer found in maritime workers, and he considered it due to excessive exposure to sun light. In 1895 Rehn, a surgeon from Frankfurt, reported at the congress of the German Society of Surgeons, 3 cases of bladder tumours found among 45 workers from a factory which produced fuchsine. He thought that the tumours were caused by aniline, but in fact it was shown, several decades later, that they were due to other aromatic amines. In 1902 at a meeting of the Medical Society of Hamburg, Fricben presented a case of a cutaneous tumour found on the hand of an employee of a factory producing X-ray apparatus. This employee used his hand for radiological demonstrations. The frequency of reports on occupational cancer has been increasing with the increase of industrialization, mainly due to the progress of chemistry. The most important thing to do in occupational carcinogenesis is to try to recognize occupations which may re present an oncogenic risk, and to identify the agent or agents which cause the risk, and also to try to assess the degree of risk. If the risk is related to an agent already known to be oncogenic for man, its detection in the occupational environment should be considered sufficient for undertaking preventive measures. On the other hand if the risk is related to agents, whose effects on workers have not yet been studied and are therefore not yet known, then we have to evaluate the risk they represent for workers. This can be done by means of epidemiological investigations and experimental testing. Most oncogenic occupa tional agents have been identified on the basis of retrospective epidemiological studies. The progress in and the development of this branch of oncology should facilitate systematic experimental testing of agents heavily released in the occupational environ- SP1 -13064 2 ment. In other words epidemiological evidence in man should he avoided. Experimental tests on animals are the more relevant to man, the more they reproduce the conditions of human exposure and eventually induce in animals the same tumours that they induce in man. In this case, the results of experimental tests may be considered largely equivalent to epidemiological evidence in man. On the other hand if an agent causes any kind of tumour in animals, in whatever experimental conditions, it should be considered potentially carcinogenic for man. To consider an agent definitely carcinogenic for man on such a basis, would be an excess, but no time should be lost before retesting it in more appropriate conditions. To reproduce experimentally the conditions of occupational exposure is often difficult and costly. Furthermore we have to consider that the number of agents in the occupational environ ment is large and increasing. Thus, new agents to which workers may be exposed should be submitted first to the easiest and quickest tests, however incomplete those tests may be. Then, for those agents inducing tumours in the experimental animals in these conditions, more precise and sophisticated experimental tests should be devised. The validity of experimental testing and the prerequisites for validity have been a matter of long discussions in international TABLE 1 Incidence of subcutaneous sarcomas in rats, following local infection of some inorganic pigments Treatment No. of animals Chromium yellow (lead chromate) Chromium orange (lead chromate)Molybdenum orange (lead chromate and molybdenum chromate) Cadmium yellow (cadmium sulphide) Iron red (iron oxide) Iron yellow (iron oxide) Controls 40 40 40 40 40 40 60 No. of tumours 26 26 36 15 1 0 0 FIG. 1 * Apparatus for inhalation of controlled doses of gaseous compounds, in the Experimental Unit of the Istituto di Oncologia di Bologna. 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UMoqs sjb sABSSBotq sssq) uo sjjussj Apsg -jbsA isd suo) 000`000`3I J pssnpojd jusssid )b si )i puB `sjBipsui JS)U1 IBSIUJSqS B SB PUB )USA)OS B SB `S3I)SBld JSq)0 PUB UBJBS UI JSUlAlOdoS B SB `UISSJ spuoiqs jAupAiod jo uonsjBdsjd sq) in pssn si 34 -souBjjoduji [Bijjsnpui )bsj3 jo ()sjy sq) A[JBjn3i)-red) sjb qoiqM `(VA) JSiuououi s)B)son jAuia jo pus O/v) jsiuouoiu spuojqo jAuia jo AsssEOiq A)piusSoupjB3 b Suuujojjsd mou sjb sm sn)BJBddB siq) qq^ (I `3!d) 3)n)i)sui jno jo )iun |B)ustuusdxa sq) ui sjbsA om) usq) sjouj joj 3utuoi)3unj ussq soq spunoduioo snossn3 jo uoijB|Bqui joj snjBJBddn ub mom `AJiunoo 3uanoqq3isu Aub jo ua\o jno ui ppoui Aub puij oj sjq* )OU SJSM SM pUE SUO ppnq O) PS)UBM SM USqM pSJOAOOSlp SM SB `SJEJ S)tnb SI Sn)EJBddB sqX 'sssop psijoj)uo3 jo uoi]B|Equi snonupuoo joj snicjcddB xsidiuos b jo A)inqB|iBAB sq) ssqduii sjnsodxs jo Asm JS))iq sqj. `uoiiEinqui Aq ps)ss) sq mou pjnoqs 'suoi)ipuo3 sssq) ui oiusfloinojED sq O) UMoqs spunoduioo sq) `sjojsq pa*s ussq scq )EqM iuojj stusiu3id uoji uei|) jsi'isij psjspisvioo sq pjnoqs S)usui3id mniuipBS pun lumtuojqo )Bqj SJBoddB Apnop ); iqpp sssq) uioj..| 'SjusmSid oiubSjoiii suios jo uoiissfu; snosucinoqns sq) jo s)is sq) )E (SEiuosjES) sinouin) jo uoi)3npui sq) uo ps)jodoj sje r)cp ') sjqex uj qsu 3uis9o3uo |iM)us)od apq) jo Bspi siuo* sai3 Abui `sjnoj Aio)BJidS3J sq) Aq A\uieui pssodxs si unit ipiqM o) 'spunodiuos jo )bj sq) ui uoiissfui snosuninsqns sqi s|diiii:xs joj `Suiissi issjjsdun `os|y ssnuiiuos sjnsodxs [Euoiicdnsso 3ui)sixs sqi suii)unsiu sq) ui `ssinos jo )nq 'suoissiuiuios pus s3ui)ssuj c 4 Hc z6 s >c ba JZ 5 TABLE 2 Preliminary results o f carcinogenicity bioassay o f vinyl chloride monomer (VC) and o f vinyl acetate (VA) (From C. Maltoni, G. Lefemineand L Gualano, in press) C 9O e 9 f ja <9 e c -< t t9 Eoh 8o 'c5> < .3 JofDca JatS>. Z co 66 >> N i X. lj C << *6n & Mn o d n cED 3 3 ^ < w c Liver (C) No. Othe sites No. ind/i site No. wl_> 0 CaEO "w o H o Z 23uOL o cno I u *3 1 IN 00 so ro 60 1 | 0IN0 3= 1 1 s /"s wS5 M *4 IN Qw S 1 ^4 fO IN IN 1 VO 00 VO <o ^4 1 1 VO IN 1 r> m N- o n 1 1 n VO IN IN I W li *o VO OVOn OVOv IN a _ 8 S go --s ooo Eutm. IN VO N < > O > t- u > C1l*. O U> O >8 9 1 1 # 11 Mo rv"rij nn <O*1s VO vrO- vvOt 0*o0 rrv*-o U.. u > r- o/> > IN EfwVv > E O > | 1 OO | VO z 3o H V ll 50 V III treat me 22 (A) Metastns to lung. (B) Metastases to liver and/or to lung and spleen. (C) Metastases to lung. (D) Angiosarcomas in subcutaneous fibrosing angioma. (E) 2 intrabruminal angiosarcomas (1 next to spleen and 1 next to ovary); 1 ossifying angiosarcoma of neck. (F) 1 pulmonary angiosarcoma; 1 angiosarcoma of uterus, ft'- 1 intrabdominal angiosarcoma (next to spleen); 1 intrathoracic ossifying angiosarcoma. (H) 2 zymbal glands adenomas; 1neurilemmoma of the ear: l mamrr.iry carcinoma; 1 cystoadenocarcinoma o f ovary. (I) Sebaceous gland carcinoma o f skin. (L) Zymbal glands adenoma. (M) Minimal deviation he patoma. (N .' zymbal glands adenoma; 1 salivary glands carcinoma. SPI -13067 Cytologjcal classes (Papanicolaou) 20 c > -*111 $ .c > > 11!1 1 .c i > -- -- <N | -- -- -- 1 f*1 r- /) oo l i .3 (a a 2 -- N fO ^ Ot P' fft r-*\ lOO<NOOV--) 00 00 00 -- so vn-- m t* a8*4S mSoa ha g* i9 ou o-sc Z3 Nr*) Ow-> t^O^- N <N -- "*T jsw >hoa. 3 u. <fflUQ (2 5 i Ea E SOiN-*niN <NN I NNW) -a -- o 3o .*2* a B<9 3CU p ^ ^ ^ vn | Nha(S io No No. 63 14 100 14 82 6 75 8 100 ---- ---- -- ---- 8 2 25 1 12 17 1 6 14 1 7 t: M <0 I o8 tcj E<P0 *t(5t9. JTe SoOs V0O0 <ONV 0000 Os ! s E I * ct<a3 *s oP* *ws .O3. P .C3L 2^ oC*> 5 C>%l. o z 1 r n<s to r1 m rv -- w- !- .8 K^ 2 2 i* ac otE 8 tS\ i8f-i aco H< -- Po* *na 6* w-- <-Nn<N ,' 8 * H*>5.eoc ev-. > >* o Z rs o fo | o Z fo*-3S/) Vh,a! as as* OcO *2_2 O7i *7iMni IQ *h>>a a => -o M Veo* S| h- *2 g^ .gO M O S *9 y3a nE E o 2 a2. u .H m* Os vOs <9 O H 8 Up to 5 6-10 11-15 Over 15 Production of chromium pigment SPI -13068 6 (b) highly suspected carcinogens, when strong experimental and/or some epidemio logical evidence is present, (c) potential carcinogens, when experimental data give some indication of carcino genic action of a compound on an experimental animal. According to their effects, the carcinogenic agents may be classified as strong or medium. The agents, which have been definitively proved or are suspected to be oncogenic for man on an epidemiological basis, are listed in Table 5, together with the target tissues and the degree of evidence. The list of the agents present in the occupational environment, which, on an experimental basis should be considered highly suspect or potentially carci nogenic for man, is reported in Table 6. TABLE 5 Agents proved or suspected to be oncogenic for workers on an epidemiological basis Agents U.V. radiations X-rays Uranium ore Arsenic Asbestos Evidence + + + (+) + Chromium Nickel Iron ore Bis-chloromethyl ether Benzene lsopropylic oil Soot, tars, mineral oils, cutting oils Carbon black Mustard gas Aromatic amines + + (+) + + (+) + + + + Tumours Skin carcinomas Skin carcinomas Leukaemias Pulmonary carcinomas Skin carcinomas (lung carcinomas) Lung carcinomas Pleural mesotheliomas (abdominal malignancies) Lung carcinomas Lung carcinomas Carcinomas of nasal and paranasal cavities Lung carcinomas Lung carcinomas Leukaemias Carcinomas of paranasal cavities Skin carcinomas Lung carcinomas Laryngeal carcinomas Bladder and upper urinary tract carcinomas TABLE 6 Agents suspected to be carcinogenic for workers on an experimental basis Beryllium Cadmium Cobalt Lead Selenium Zinc Carbon tetrachloride Chloroform Vinyl chloride Pesticides (DDT, aldrin, dieldrin, Aramite, DMDT, Amizol, Thiuram) Thiourea and related compounds Tannins Detergents Alkylating agents Nitrosamines Azo-dyes Oestrogens SPI -13069 7 In Italy carcinogenic occupational risk exists for workers who are: (a) exposed to chromates, mainly the ones working in factories where chromates are produced; (b) exposed to nickel, mainly the ones exposed to nickel-carbonyl; (c) exposed to asbestos, mainly the ones who extract it from its natural source, or workers in factories where asbestos is used for manufacturing; (d) in factories making shoes, purses and raincoats, exposed to benzene; (e) in factories producing carbon black from mineral oils; and (f) in the dye and rubber industries, exposed to aromatic amines. In our country occupational tumours have been observed in many of the above men tioned workers. 21 lung carcinomas have been found among less than 200 workers in a chromate factory in Northern Italy. Pleural mesotheliomas have been discovered among workers in asbestos mines. A number of leukaemias have been found among shoe-makers, who were heavily exposed to benzene, in factories in Lombardy (Vigevano), Bologna Province and Tuscany. The incidence of bladder and other urinary tract carcinomas among workers in 5 Italian dye-stuff factories are shown in Table 7. In these factories workers had been exposed to 0-naphthylamine, benzidine, a-naphthylamine, Auramine, fuchsine, 3,3'-dichlorobenzidine. Now in our country the production of 0-naphthylamine and benzidine has been withdrawn. One may conclude that prevention of occupational carcinogenesis is a very urgent problem. The methods of prevention may be summarized as follows: 1. correct experimental testing of all newly used agents; 2. up to date epidemiological data from various categories of workers exposed to risk; 3. legislative measures forbidding the production and the utilization of agents which have been shown to be oncogenic on an epidemiological and/or an experimental basis, especially if the said agents are strong carcinogens; 4. measures of technical protection, when weak or doubtful carcinogens continue to be produced or employed; these protective measures should be periodically examined by Public Health Inspectors; 5. specific medical checks to make possible, on the one hand, the early detection of preneoplastic lesions and tumours, and on the other, the quantitative evaluation of the risks through the incidence of these changes. It is my opinion that the value of medical checks is mainly to evaluate the risk that is epidemiological. Early detection of occupational tumours which, as already shown, are mainly located in the respiratory and urinary tract, has been, I think, over-emphasized. We know that these tumours are multicentric. In other words all the target apparatus is in some way affected by the carcinogenic process. TABLE 7 Frequency of carcinomas of the urinary tract among workers of 5 Italian dye-stufffac tories exposed to aromatic amines Factory Total No. of exposed workers A B C D E Total 286 386 213 13S 135 1,155 No. of workers with carcinoma Bladder Renal pelves and ureters 17 1 87 5 44 4- 71 159 7 Total 18 92* 44 4 8 166 * In 1 case bladder and upper urinary tract tumours were coexistent. SPI -13070 8 Concerning the urinary tract, in a systematic histological study, I have seen that in patients with bladder tumours, dysplastic and cancerous foci may be detected from renal pelvis to urethra. Therefore it is obvious that in such conditions early diagnosis can achieve very little. We may diagnose some tumours quite early, but on the basis of 15 years' experience with periodic checks of workers exposed to high risk, I doubt that periodical medical examination has a real bearing in saving people with occupational cancer although detected early, or in prolonging their life span. Thus my position is in sharp contrast with those who claim to `protect' (!) workers exposed to carcinogenic risk with medical examinations. / do believe that the potentialities of medical examinations should be evaluated at an international level. In conclusion, I would like to emphasize the need of a close collaboration among scientists, public health services, workers unions and industries, to evaluate the risks and to devise preventive measures for avoiding or minimizing occupational tumours. References Fiieben (1902): Fortschr. Rontgenstr., 6, 106. Pott, P. (1775): In: Chirurgical Observations, relative to the cataract, the polyps of the nose, the can cer of the scrotum, the different kinds of ruptures and the modification on toes and feet Hower, Clarke and Pollins, London. Unna, P. G. (1894): In: Histopathologie der Hautkrankheiten, p. 719. Hirschwald, Berlin. Yamagiwa, K. and Ichikawa, K. (1915): Mitt. med. Fak. Tokyo, 15, 295. SPI -13071