Document kD3Brbg10nYKKzO0QwZyporeV

OLOWY | Vol. SW4I| 5 riven in vivo selectively Inhibit* (or 10*00 min iwlMpUwlf lTP* of |NA polym*r*M to rat li**r tor th* ayatliesls la vt-o of t'l *pe - sI ` Im RNA remain* blocked tor several kotro.--J. T. L, 3 BROOKS. ROBERT D. Jr. ant JAMES A. VICK. (Dap. Ram* acoW - alter Rh< ArniT Into, Ret.. Walter ItoH Army IM, Cent., Washington, D. C. 2001*. USA.) Toxicological studies of be* eeoom la mice, dogs and i,,ocfceya. AM BEE J 11217): 250-331. 1V72.--Vtnonx id Apia melllfrra wa* Inteclsd, either l.t. or *.., Into experimental animals. I.V. infoctloaa canned a precljdtou* decraao* In blood prvaure within IS are in both do*l and monkey*. It alto decreared heart rale and dejweased reaptration. Doaafta at 5 mg/kg la dofa, or I.S mr/k| la modieya, 1.*., aimed death tram eardloeaaralar failure. Similar reaper.*** nr* noted altar *jc. ta)*cttoo*, bat madlaa lathal donees uere higher: 200 mg/kg la dog* tad SO n|/k| la monkeys. The forme r la equivalent to about 2000 bae atlnda. Smaller Mapr were total to mice. Other physiological reaction* are acted. --J. D. Hitchcock. 34271. ULANOVA, I. P,, A. I. KHALEPOaad A. I. EITING0N. (InoA lad. Hti. Occup. Di,, Acad. Med. Set. USSR, Moaeow. USSR.) Isaledo- ,*anle komulyatlvnykh arotate khimlrheMRIi aoedtoeari aa porocoeoa urovne kak oaaova procooclroeanlyi kkroalcheek(kb lalckaVutoU. ISiuriv Into cumulative orocertlea of chemical compounds at the Ihraah- old level ai a ban* tor orncnoatleattoo at chronic mtoaoalncs.l CJQ fK Wl UXBCr T in:ttWruM.|-HCmiJlMtau properties el chemical compound* at the threahold at their acuta actloa nr* analyaed. Camalatloa coefficient* nr* dadacad from tha integral leal chaniaa mad with rafaraoe* to th* aammary-thruthold ealua fan- hiring th* taMtloMl ataU at th* aerron syeUat. Than eoatnclauu poured to ha math Inferior to coefllcleat* cl carnal*Him determlaed with refereaee to th* aairnal lethality figure*. Tha fnlatlnn cool- deleoU at tha threshold loeol supported a well-marked cwmwlatteu ca pacity el baoaaaa, carhaa tetrachloride, m-nmlaobewaotrinuorlde had mor^nUa*. This ne ewpported hr tha Mb dtrtvad boa chmtc ex periment*. eooatdartaf CCtaaad benaeaa, alao by tha avaltab!* ctlalcal aad kygteale obaamttcaa. Th* astlmatad coafflcteat el canulatloa between the areaa el chronic actim aad coefficient a f emnulatina lor tha aubataaeoi mater atiafr at tha threahold level waa 0,M. TMa makso It poaalbla to farecart pooolhlo hwhpndi of chrualc polaoalac. Tha iavaotlfatlM time waa cd down to a maximum of 1 mo,*nl, P. K. 4^773. KOBUUYA. H. ,, L. E. CEDVMM, F. 1L -AKHOVSXU mad O. P. ARKHIPOVA. (Cant. tea. tat. Tub*rc,, hha. lamlth USSR, Moecow, USSRJ laochanlo proattaaamootl gtetogemaBTSeMkh bar'aro* pri raxllcMyth ruxbtmakb glpeitarlehaMot ckalcenatatl * ekaparlBHnl*. (PenneablliiT of Mato baamatlc barrlera In dltlcrent ractmea of experimental hmartarte uiTnail lou.l teAf KWRANKTKlflL 170):il-U.ulii J*n.|BaLamm.i-E- ptrlaeatally, 70 |daii ptg* nr* *Ub)*cMi to 100% O* In Onnpdlc (1-24 ap to 3 ata) aad tori* (4-S ala) ruglma* of hyperbaric uxygexmUoa for IM hr. ndolgp aad radlaacUeo tedtealto* (ikh ofruptaaayda-d*3 u 10,000 U/kg aad wUh 14J pet aettritr h 1 ml) mar* aa*d to aaaaaa aariona permeeMUty terate la th* Mato ImtaaHc barrier* at tha lap, U*or, kKhmys, eydesa. mjocardbM aad hula. TUe ragiataa nr* aeeoaaptalad by a mfni ml lacraaa* of vaacatar walla permaaMlUy. comhtioaadbT ftractmxl Imiob* of Omliato Mrtk tnrrtar*. With tbtrapmdlc regime*, vaacuter permmtlHtT roe* aaly la th* opteea, Unr and kidntjs, L.la.Bt ocgaei with aa tecireasteg frtlcn*) ac tivity madar hyperbaric caygaMloa. *adwa* aat aetcapded by hietootractaral rtesgaa of lb* mala elimeta Mtb* hlrin hematic tarter. --J. L. S.' 34734. COfDEH, D. W,, P. C. OLOTFf md T. S. SEXTO. (Peatot. Od. Dep. Blot Sd,, Slmoa Praaer UM*. Peraahy 1, B. C, Cam.) MrsxL*.Ltffifvtiinwacctf iffcW ataiitfa flncfclai^HW.a* nd f*elkIs liquid chromatognphy) cotma* nn <n*d to ideuflfy wad qnantUul* orgaaochloride parnkMa refldu**. Sach aiMOY Uttlltt pica r OP 1. or 2% OY 1 ptaa OV 2IS. They dtd act amlafaciorUy aaporal* th* anmpiMda ofa-chkiiiteae, pcbloMbm autUwhm aad i_<teachlorepoalde. Caa chroaaatosnpk Wen Tck HI 310 wllh Nl-Sl electron copur* detector method waa employod I* thia apartmeat. --J. P. K. 34775. WALT3CHEWA, W. (PoradNaatMt. Arbattaachda. Berddr,, Bled. Patko NapeCo* 34, Sdla. Bids-). M. SUtTEWA aad |. MCHA1LOW. Hudeaurmeadarai^ca bei uclaaaa Rattaa del it duunleche VenbreicbimgTea HKhrlsultit. (Teei~i- fliaaaa due to tom- tarui nhalidatratloa cf dchal euUel* to rma.1 lUTV mTiitja. UUtAI *f*/4): lls-uo. Ilino, in. |Cagj. emamJ^PoBowtas Ions t*im ^kl-naMMo latimirefiq hi rata, men Mmona la (he pm colli ^^elariy to epeiailiRSoeds eoald ho demuoatreted Tory lew chans- ohaareed la the liver* and klit uy. Nidtal eeltete had a aa- &Mcy^ ^CTlone effect on teaUcular parenrbywia.--A. B. M. 34T7S. BASALAEV, A. V, A. N. VAEBt nd A. a. KOCHETKOV. **! K`m GoA- lad, Gorki, UBR.) K ptopnn Immdl, i ari Mttel'i i uafaldiM ildltVirtb (PathogenMe *1|lAr. II. I1I| Fl&S *a*9. tuxkx of cMncrc drvitloplne lo ImHmn fiinogrt1 to Ihf chlorlaT~(JG TR ftrd^fifc . mrl" summ.|-*Ribbl(e and rain which I Intel permlenlbte concentratlrni (" tons ell -round examination by piya putlogleal end roentgenodenaltometrlc methoda. Ckincn eteclrlc adtelty ol th* hypottalamue, hypcndrenalinemia and lunri.ee- al troubtea of the cardiovascular system nre disclosed. Itevcloptr.-w of r*sorptive menlfcatallone la the hone (leave was brougte one mor phologically and oxteoporodi-racntgenDtegleally. An is drawn as to s hay Importance of hypothalamic dyafunctloo n ttee mtho- Stoaala of th* dlaaaa, tWa dysfunction flying rtne to neurohumoral ad neurovascular trout)lea leading to the development of dystroptec pro- cease* In the bon* tlsaua.--P. L. W. 34777, BAZIN, SUZANNE aad ALBERT DELAUNAY. ICNRS. Inst. Pasteur, Sent. Pathol, Exp.. P2-Carehea. Tr.) Action cxercee par Oes . idaliaetl lathyrosenaa aur le eoUagrne da granulomee. (Actaq ea- erted be lathyrogenlc aubatancei on the collagen of granulwu.l c I UEfib B&AUctsACJkb Sd itftD SG KAY (pAfoS* J7W4i: tli-ui 1>73.Potyvtayl eponges were ImpUnled s.c. la Wlatar rma. Tea days later, pealclUamiae waa glna orally In a done of 30 mg/1*0 g of write*, la another gioiy. d-mercaptoethylamliM waa given is a dose of O.S mg/100 g, i.p. Graaalomalou* tlseuc awroodag Um tpapt asd n- ml Mia owr* extracted to slew aednt aad acid aolMI* refll|i a cot- tagaa lablteai SO'aadiaaobM* eoUagsa. Both drugs gar- riawrabk raeelfl. They did sot modify th* total rollsgca cd normal MUa. hot de- creeaad th* caltegta of gramitomnloim tlsscn aUgMIy, Nemral aotiteta eoDasaa **d lacreaaad aad laaohftol* codagra decreased te toxa types of tUao*. The Isbite cottegea Inertseed la tha gnaaloaia and dato- labad la the Mia. Tha aeld aobMto cottagaa teeiuaaad >M( la Bt S'rtaukiint and 30% te the Mia. Tnfanantertdir bonds la ealla^w wtech are sentUlve to bthyrofoo* aro comparabte la graaaloas aM te nor mal Ml*.--M. D. S. 34771, KUDZDtA, G. D. aad D. I. GOLOVAN*. (A. N. Itertee-n Ktev Rn, taaL Goa. PMUc Hyg., Kiev, U3SIL) SravalteTnaya oteeMm gar- bit*idoe gmppy khlorbeoxolncf klalocy aualterao-tekaOtolnsIrheMla motodon 1 swtodom kul'tar fCoorn*relive aaalurydcmtcalog- lal aad cell-culture erahmtma of the caiorbeoxotc acid herb irate srotM.1 TWCiTBELO '1. "UFW.lUaa. UW1 lEacL aumaaj--Cara of chronic sanitary-goaloologiral experirnim on rabbit* aad a MaMy tf tha aftect of eblorbeaaote harbicicte gno> tadmxte that th* niMa by these 1 methoda eooearalag th* tcmiclty of M* barttetoteo n la ride A Th* aa* of c*U*cultimw method far rapid byfteofe mtallm of Bo loc- Idty of imt herbicides Is pnanteteg aad farther teveetigigtoM of (tea method are jimtlflad. -P. L. W. 34773. COOPER, PHILIP ate STEPHEN H. TOLDf3. (Drp. SurgBroa Veteran* Admla. Hasp, Broax, N. Y. 104S3, USA.) botooea amckteg Matsry aad comet!cations Immediately aW (or duode^t ulcer: W gVOlJ ktt MUrW-JU Mo aeldaBou I* glyea of aa aaaorlaftea hecueeu emddq aad i tg>oa, aor between teiiktog and oparattea aiortallty, soc I tag aad Mya lo discharge- The moet uhilua tread la | able, aaaMly, pauaofs over 50 have mors coMpflcitloaa aad a tegher mortality rate ttea those muter 10. Ia spU* af She nbtmb bip atindmr of fttekta tachxted te this report the eewteteg bobite- Bte ap* dtetribmio*, and dteaaa rate te tba popatetioa Merited ar* gMte Iteb betweaa amMlag blatetteo teban oa tea aamo patloM at diHaerar Hail. This may have rnmdted from Me fH| and accaracy d tha tohruatton glyea to lb* examiner by Va pltoM. Pew, If any, paoldM ahoaM be draws from thia leaanrrh. Waeidta apply paly te teoflM priaTnpirittTi flnitlnf* ami iVi nd *iqf| ki lnq ijaga alTailaaf Miklq upon the patlaat alter aurgery far dm teal uteer dlaaaa*.--R. M. D. 34730. U1TTSA, P. M. tad L. A. MOraOPA. (Fee. Postgrad. lted_ RlM Med. !aM,, Mb, USR.) O kUakheMkh oaobeoostyMh ihigoTayfcb aollaevrltoe, Tcualcxl traits af alcMofte uufiaeeritlaj ZM NE>- ropatol pskhia1'K1us>iubxkwa T&f ui-ai. vm. [EagL emum.)--Th* trait* el alcchotlc potywewitla la 371 Madiad. Faa amla cBalcal eaiteafa of Ott dteaaa wore ( Th* Boat characteristic and frwqottd form of alcoholic potymmuli w the aywdroms of alugglab panlyate te the |myta of the lower exueaaitleo. A moow commas and mixed fora of poiyaam-itls, sonomtel and ateeHc form*, were rarely observed.--J. P. K. 34731. ETEGER. ROBERT E. (Coop. Ext. Sere., N. M. I Laa Crneea, N. It. USA.) NaMe* steals ooteonoa to hamaaa. J RANGE MANAGE 11(1): f1-11. UTI.-X Wmi^y U of Ma kml* prUdptea, lb* ytewta. loaie parte, eymptmai and some gamanl I lor aevoral commooty Ltee yteMa te th* U4Jt.--C. T. 3. 34733. PARB, RENE-RAYMCMD aad ANMX-MAME TC3KZR. (Fac. Pbarm., Lab. Matiere Mod., 4-*v*. Obarvatthre, 75-Paria A Pr.) Pagbiwhlarna foulpeas afrjratowa. i mhllatteInMteeetLalrokyteA.fr(ficaa toalc FmamtUareoa eaoecmBy'in g illegible document JAMA, Nov 5. 1973 Vol 226, No 6 Meat-Wrapper's Asthma A New Syndrome? William N. Sokol, MD; Yosscf Aelony, MD; Gildon N. Beall, MD Three patients employed as meat wrappers developed respiratory symptoms when exposed to the fumes of a polyvinyl chloride film cu* *:th a hot wire. The patients were middle-aged women who smoked cigar-::es and demonstrated reversible airway obstruction on pulmonary funct :n testing. The cause of their symptoms is not known, but some ingred iit of the polyvinyl chloride film is suspected. e have recently treated five hour* of work. She *tni2hiL.-u rv- W three patients who are em action to the fumet prut-teed wwi '.rw ployed as meat wrappers plastic film was cut whh s hot v-.-*. Her lems. and In all who had severe respiratory three, the onset of res pswryhomebnptothmes were most breathlessne*# her from com)>lcting the nr. r.'tvr. cay's .V pt: t: *. tay# --..-.ted V# piratory difficulty followed oqiosurc the week progressed, ter eympt. ~j stiff to fumes produced by cutting with a occurred after four to five hours i -rap hot wire a plastic film made of the ping. but each day they seemed to .tr.-eas* common polymci, polyvinyl chloride. in intensity. She had art. .wad a uf We are reporting these cases because eigarettea each day for IS t but we suspect the phenomenon is not un stopped when her ayrapt .rj hegar_ There common, yet it has not been reported previously in the medical literature. was no personal dr faeTv history ' *> xema, bay fever, or art^ti Tii .t-ttiiiu wai first examined when 1 sever* -t :->> Report of Casas of wheeaing forced Ur leave 'i At CaS> L-A CO-je*r-old woman who had worked as a supermarket meat wrapper for ten yean without respiratory diffi culty was first seen in 1372. Following the introduction of a new plastic film to wrap the meat, abe began to experience dysp nea, coughing, and wneeslng after four to that time, result* of phy*:al exairttxtion were normal, except for a Us end-' r.-;-;ratory whet.es and moderate expirv.::y J*r- Uy. Complete blood cell c.tr.t. er/thr:-.-yte sedimentation rate, roctir.e assays, urinalysis, YDRL test fo. *--htU<. and chest x-ray film wtr.- within t.:rttil limits. Skin tests for rtzmon Frotr. the Department of Medicine (Drs. Sokot, Aelony, and Deal), Harbor Cenrraf Hospital, Tamr.ee, Calif; and UCLA School of Medicine, Loo A molca (Dr. Beall). Dr. Sokol W a Fellow in were all negative. Tests of pi - :ary function showed a mild'.-strjvti*.^ iefeet with a decreased vital v-atn.tty it: in creased residual lung rv?t.t;i--e AQeigy and laendigr and Dr. Aelooy li a Fellow la Respiratory Diacase at Hart<or Gen eral HuapitaL Hrprini request* to Harbor General Hospital, lOno W Canon St, Torrance, CA 905U9 (Or, So- to brondradilator therapy. Treatment with or".y a.lc t hronchixlilators relit'r.,r jy-tt ~ = She has been able to i*. r .- t- toll. and continue working It v,i.inz r - r. - Meat-Wrapper's Ailftmi-k'd ei j 39 86Z8Z0 SVU dilators orally each workday. Discontinua tion of therapy is followed hy recurrence of iv'heeding and dyspnea ai work. No med iation is required in the evening or on cokends. Cask 2,-A -15-year-old woman experi enced dyspnea w hile working as a super market -neat wrapper. She had worked at this market for ton years without respira tory ilitlicully until soon after a process was introduced to w rap the meat in a plas tic film cut with a hot wire. While wrap ping, the patient noted the gradual onset of breathlessness and wheezing, and she was forced to leave work. She felt well but did not work for the next six months. On returning to meat wrapping, she developed shortness of breath and wheezing within 20 minutes. The dyspnea became so dis turbing that she eame to hospital emer gency room. The'patient had smoked a pack of ciga rettes a day fur 26 yean. Her family his tory and personal history were negative for asthma, hay fever, eczema, or atopy. Results of physical examination (five hours after leaving work) were normal. Complete bloc-1 cell count, erythrocyte sedimentation rate, routine blood determi nation, latex fixation. VDttL test fur syph ilis, and chest x-ray film were within nor mal limits or negative. Skin tests with common allergens were negative. Pulmo- Mrv function testing showed a ile.-r'-ased faximal expiratory flow rate that im proved w->th bronehodilation. The patient was given bronehodilators orally to take prophylactically. Using this medication, she has been able to wrap meat inter mittently without any respiratory symp toms. She is asymptomatic after work and on weekends, requiring no medications at those times. Cask 3.-A 64-year-old woman hud a three-year history of intermittent wheez ing and coughing. Her illness began six years after she started working in a super market as a meat wrapper. A few weeks before her symptoms commenced, the wrapping material was changed to a plas tic film, which she cut with i wire heated to 161 C. Many people working in the area complained of the fumes produced when the film was cut. One of her co-workers was unable to wear his contact lenses near the fumes, and another developed cough ing when exposed to the fumes. Thirty minutes a.'tor first inhaling these fumes, the patient noted tightness in her chest, followed by whoexing, shortness of breath, and coughing. Her symptoms improved af ter moving away from the fumes hut re turned on reexposuro. She denied having idache, chills, fever, or sore throat In next nine months, she continued to ex perience dilficully only during working hours. During one severe episode, she was hospitalized for pneumonia and asthma. On returning to work, she developed wheezing and breathlessness, requiring readinissiun to hospital. Her symptoms eventually developed after working hours and on weekends. Believing that her res piratory problem was related to the plastic fumes, she quit her job. In the ensuing two years, she has developed nonseasonal wheezing, shortness of breath, and cough ing, punctuated by upper respiratory in fections. She currently develops one-flight dyspnea and produces one quarter of a cup of sputum daily for approximately four months of the year. The patient smoked one pack of cigarettes per day for nine years, but she stopped smoking when her present illness began. History sliowed a contact dermatitis but no previous history of hay fever, rhinitis, or asthma. Her family history ia negative for atopy or asthmr. The results i>: physicrl examination were within -,-.nl !. u:` *, 'x ->pt for her chest, wh.-: ;.:wwed cattved wheezes i expiration and persistent bibasiUr crepi tant rik-J. Laf-uratory testa including a complete blow! cell count, cry throcyte sedimentation rate, VDRb test for syphilis, and routine blood chemistries were within normal lim its. An x-ray film of the chest showed mild overinflation, with apica1 capping of both upper lobes. Histoplasnin and inter mediate strength tuberculin Usa rare negative. A coceidioidin skin test gave 10 mm of induration at 46 hours. Intradermal tests to com-non allergens were negative. Pulmonary function studies showed a de creased vital capacity and an increased functional residual capacity. The forced vi tal capacity responded to bronehodilation. Nitrogen washout was increased to 4.6% retention after seven minutes of oxygen breathing, with a normal of <2%. Comment These three case reports strongly suggest that a causal relationship ex ists between the inhalation of plastic fumes and respiratory symptoms, tn each instance, the plastic film was polyvinyl chloride made by the same manufacturer. All patients had worked in similar areas and had no respiratory symptoms wrapping meat with othor materials for six to ten years prior to the use of the polyvinyl chloride film. In each patient, symp toms occurred only after exposure to the polyvinyl chloride fumes. Too areas where the meat was wrapped were rather crowded, without special ventilation for fume removal, and were chilled to approximately il C. The patients had worked in these same areas, however, before the in troduction of polyvinyl ihlori-Jc and had experienced no symptoms. The time required for devolcpmcnt of symptoms was brief (30 minutes) in patients 2 and 3 and was delayed (five hours) in patient 1. In patient 3, symptoms eventually occurred inde pendently of fume exposure, r-d she now has chronic dyspnea and pro duces sputum. Patients 1 and 2 have symptoms onl/ on exposure to the plastic fumes. All three patients smoked cigarettes (10 to 6 yean) be fore their illnesses, and all three had reversible airway c: -rruction on pul monary function testing. Ncne dem onstrated - peripheral eosinephilia, reactions to common allergens ad ministered by intracutancous skin testing, roentgenographic abnormal ities, or marked personal or family history of alcpy. We do not know the frequency of thi; syndrome, but we suspect it is not rare. The first patient te(d us about the second patient The third patient came independently but has told us about a co-worker (whom we have not seen) who has suffered sim ilar symptoms apparently from expo sure to the polyvinyl chloride film. We have learned from local physicians of two other patients with similar his tories. Unfortunately, we have not been able to study these patients. The manufacturer of the polyvinyl chloride film used by these meat wrappers has informed us that be cause of previous reports from several cities of respiratory problems associ ated with polyvinyl chloride fumes produced in the meat wrapping pro cess, an investigation of the matter has already been completed. The in vestigation, in which poly vinyl chlo ride film was pyralyxcd and the resulting gases identified and quanti tated, concluded that these fume did not present any hazard to meat wrap pers. Other investigators, however, have suggested that polyvinyl chkride docs have toxic potentialities. Guess and Habennan' implanted polyvinyl chloride slivers into rabbit muscle, which resulted in'an unusual number of eosinophils in a foreign-body gran uloma with numerous giant tells, while the control plastic (polyethyl ene) showed only the usual nnntaxic, noncusinuphilic-coulrining, foreignbody reaction, tn addition, pure pnly- 640 JAMA. Nov 5, 1973 Vo) 226. No 6 Meat-Wrapper's Asthma--Sokol et al' vinyl chloride rosin destroyed cells in in vitro cultures. The cell culture inhi bition experiments have been inde pendently confirmed.-' There is some evidence that the eosinophil-rich for eign-body reaction noted by Guess and Habcrman may be seen in hu mans. Szcndc cl at' dcscriliod a 31year-old factory employee who shov eled polyvinyl chloride dust. His chest roentgenogram showed manyminute nodules, along with an inter stitial fibrotic pattern. Lung biopsy specimens showed a foreign body sur-. rounded by a granuloma, with strik ing cosinophilia. The foreign body could be dissolved with a polyvinyl chloride solvent, cyclohexanol. The problem posed by our patients is whether fumes generated from heated polyvinyl chloride are toxic. Cornish and Abar* pyrolized polyvinyl chloride polymers in a stream of air by gradually raisii i the temperature from ambient to 600 C. Exposure to this air stream supplemented with oxygen produced pulmonary edema and interstitial edema in rats. Some animals also showed focal bronchial and intra-alveolar hemorrhage. It is doubtful, however, if this level of ex posure was ever experienced by our patients. Our patient resemble somewhat those individuals, first described by Harris,1 who experienced respiratory difficulty when exposed to heated Tef lon. This syndrome has been called polymer fume fever. The symptoms include ailztks of tightness of the chest, difficulty in breathing, some times with a dry, irritating cough, and fever beginning several hours af ter exposure to the heat-degradation products of polytclraliuoroelliylene (Teflon). Recovery is rapid and usu ally complete. The patients who de velop this syndrome work in plants where polytetralluoroethylene is pro cessed, and smoke cigarettes. The plastic adheres to the cigarell- and is given otf when heated to >.300 C as a very line particulate sublimate. The syndrome is thought to be due to the inhalation of this sublimate.-` Our patients differed from those w ith polymer fume fever by not expe riencing chills, fever,.or sore throat. This example of a polymer-fume-relatcd syndrome, coupled with the evi dence that polyvinyl chloride may have some toxic potential strengthen our suspicion that the patients' symp toms are caused by exposure to the polyvinyl chloride fumes. Cornish and Abar' have reported that carbon monoxide and hydrochlo ric acid-are the products of major tox icologic importance from the combus tion of vinyl chloride polymer. O'Mara ct al,* in describing the combustion profile of vinyl chloride monomer, noted phosgene as well as hydrochlo ric acid and carbon monoxide. Hydro chloric acid and phosgene are both bronchial irritants that could conceiv ably cause the patients* symptoms. Conclusion Although the cause of the syn drome is unclear anil w c have nr.'t doscriljotl three ca-e.-, it seem.- a*l\ i-ahlcto call this matter to general a-.-.en* tion to gain some idea of it.- preva lence uml to inform p!.\#-ciar.- and their patients of the potential hazard of fumes from polyvinyl ehlorid-. References 1. Guess W. llatverman S. T,-v;*-ity pr : cf \inyl snd pokuk.-irnr pbilir. .- J i - jJ:,- IjioV timmtil .Viu r Kts 2 31.- 1 2. Dinman K!>. cl al: 0.\-.:aoor^. zero- osteolysis. Artlt /.' irun H<nl:< rjiil-t 1 ;1 3. .'ilcnde B, ct al: Pneum-.'-.:-ii ea:~rJ by tiie inhalation of polyvinyU-h-.-r.de d_-: i Car61:C33-43n,ls;o. 4. Cornish II, Alar E; Tow:. of p.^-k product* of vinyl plastics, dm cf-aiil 1915-21,1909. a. Harris 1)K: Polymer-fume fever. ,;er 210OM-lOH.19.tt. C. Williama N. Smith KK: Piksirr.f-,-- fi ver.-MATA 219 14:-1SS9. l?:i 7. Lewis CL, Kertr GR: An cr Ceinic mer-fume fever. .7.4.V.4 191i3TV;;-,Is-*"' 8. Polymer fume fever,edit-rsl. La--*- T-- 2S. 1972. 9. O'Mar* MU, Crider LB. Iksiel KL bastion products from rinvl ,-i:*ridc ir.- -.r-jt. Am /id ties d 32:153-1*:. 1971. CORRECTION Wrong Pollution.--Two error; curruti in IV seeutiu u.. L.t anagrams page of the Sept IT V-ze (225:1435. 1973). The title of the booklet on p.7I> tion should have been given as "T Physician's Guide to Odor IV tion," not air pollution tpzragrap' or water pollution (paragraph a ILLEGIBLE DOCUMENT JAMA, Nov 5, 1973 s Vol 226. No 6 Meat-Wrapper's Asthma--et a; 6A1