Document rxg9neNzYeNVyKdkMwb69g6dE

The broncho-respiratory organs of workers, manufacturing goods from FVC Vertkin, Yu, I,, Kamontov, Yu, R. Gigiena Tr. Prg. Zabolev, 14i29-32(1970) With increased production of plastic materials, the working-, and the hygienic conditions of workers in this field of the chemical .industry are always more often the object of hygienical and pathological research. How ever, not all questions in this field are elucidated in the same extent. In particular, the process of manufacturing goods from polyvinyl chloride (FVC) was studied considerably less, than the production of PVC itself. Among others, this question can be associated with the influence of a whole series of unfavorable factors on the workers. As Karpova, N, I, has demonstrated, in the air of the working chambers, FVC dust is always present in such con centrations, which exceeds the permissible limit, and during some operations it exceeds this limit 10 or even 100 time.(the use of respirators has been foreseen only for operations, accompanied by maximum pulverization). Since FVC is subjected to thermal treatment, one can expect the appearance in the air of products of its decomposition. But in the examined samples, hydrogen chloride was either missing, or was detected in insignificant amounts. Besides PVC, in small volumes, plasticizers, stabilizers, dyes, etc. are used. Therefore in the different work-shops? in insignificant concentra tions, chlorinated biphenyl and lead compounds were found. The workers were subjected to noise, high temperatures and humidityj the execution of a series of manufacturing operations requires definite physical stress. Based on the conducted analysis, PVC dust can be considered as the main unfavorab le factor, common in the whole production. R f CHIVED SEP 41980 Shirley D. Conner UCC 068807 Vertkin -2- In a few experimental works it was demonstrated# that PVG dust has the capability to cause in animals changes of chronic pneumonia and weakly ex pressed pneumofibrosis (A, P. Golovatok, 1963. 1966; N, Sjj Shlyakhetskii) Since the data of the literature, available for us about the unfavor able influence of PVC is restricted, we decided to conduct studies on the health conditions of workers, employed in the manufacturing of goods from PVC. A comprehensive hygienic characterization of their work was given in the mentioned publication by N. I. Karpova. The examination, in 1967, of workers in this production (V. G. Artamonova and coworkers with the partici pation of one of the authors of this work) permitted to reveal a considerab le frequency of neurasthenic syndrome @8used by vegetative dystonia and functional lesion of the cardiovascular system. About 7 % of the exam ined individuals complained of coughing, dyspnea and pain in the chest was mentioned even more often. Stetoaccustical deviation from the normal was found only in individual cases; the results of the respiratory tests in the overhelming majority of inspected individuals turned out to be within the normal limits. Thus, no clear indication of pathology of the broncho-res piratory organs was ascertained. The examination of one part of the workers continued in the clinic of professional diseases; special attention was devotaed to the organs of the respiratory system. With the aid of a spirograph the vital capacity of the lungs (VCL) was determined with the usual and with forced methods. VCL was evaluated by nomograms, suggested by S. N, Sorinson, The forced VCL was registered on a kymograph at a velocity of 20 mm/sec with subsequent calculation of the Tiffno index (TI) i.e. the part of the volume, exhaled after the first second of the forced exhalation (V7E), of the whole VCL, UCC 068808 Vertkin -3- By means of a pneumotachometer the maximum velocity of the air current of the exhalation (MVF) was examined. Tests with forced exhalation was used for the evaluation of the condition of the bronchial tract, Therewith we counted as normal a TI value of 80 - 90%, the lower limit of the norm 70%i for MVP we accepted as normal limit 85 % as the proper value, i.e. the production of VCI (in liters) to the coefficient 1,2 (G. 0. Badalyan). The minute Volume of respiration (KVR) was determined with a gaseous device in the seated position for 3 hours after the breakfast with previous half an hour rest. The examination itself and the calculation of the respiratory equivalent (RE) was carried out according to a universal method. All in vestigated individuals were subjected to chest rentgenoscopy and rentgenography, and also to overal therapeutical, neurological and hematological examination. The obtained data were subjected to careful statistical pro cessing, 96 workers (93 women and 3 men) were examinedi the length of the servict time up to 5 years had only 8 individuals, up to 10 years and more - 2/3rd of the group (68 persons). About half of the examined individuals (46) were younger than 40 years. Complaints of coughing, dry or with thin mucous sputum appeared in 11 individuals. In 7 of them (not smoking women) stetoaccustical symptoms in combination with pertinent rengenological data and the results of the respiratory tests led to the diagnosis of not sharply expressed chronical bronchitis with recent sickness. Only one patient was younger than 40. The "dusty" exposure was in 3 patients extended from 5 to 7 years, in 4 from 16 to 19 years. In 3 workers the rentgenolocial changes reminded to the picture of interstitial pneumonia, although the clinical and hematological data did not permit to make this diagnosis. VCL appeared to UCC 068809 Ver'tkin -4- be decreased (less than 85# of the normal) only in one case. On the other part, in more than half of the cases it exceeded 115#* attaining sometimes 140-156# of the normal value. The bronchial tract, according to the data of MV?, was lesioned only in 2 of the 64 individuals. According to the data of VFE determination, explicit lesion of the bronchial tract was found in more than 7 persons (from 60) the TI index was less than 70$. These were preponderantly persons with considerable working time under dusty conditions (6 - 12 years) and with clinical appearance of bronchitis and emphysema of the lungs. In 20 individuals the TI was within the limits of 70 - 79#, i. e. it was close to the low normal limit. All these persons were in the age group of up to 45 years and 13 of them - up to 40 years and overhelmingly with long "dusty" work exposure of 12 - 16 and even with 26 years, For us the most important results seemed to be the determinations of MVR. This examination was carried out on 40 persons and in 22 cases MVR found 8 liters and more. According to the opinion of the majority of the authors, this should be evaluated, as exceeding the normal. For a more com prehensive evaluation of the conformity< proper factual hVR with the con sideration of the sex, the age, the height and the weight the RE was calcul ated. Only in 5 cases was it less than 3* in 13 cases it was 3-3,9 and in all the other cases it was 4 and more. Let us mention, that the normal RE, according to the most widely spread opinion should not exceed 3.1 - 3.2; some authors consider the value 4 as bordering value. Consequently, in a lesser degree, in half of the cases MVR actually exceeded the normal value. ucc 068810 Vertkin -5- At the X-ray examination only in 5 individuals was the deviation from the normal picture of the pulmonary^pattern not mentioned. In the other cases the change was expressed in a greater or smaller extent. Intensifi cation in the rhizosphere (in 35 individuals), sharp intensification on all extentions of the pulmonary lobes (in 14 individuals) and fibrous deformation of the pattern from large mesh to reticular (in 32 persons) while the character of the changes of the pulmonary pattern (delicate reti culation, small alveolar structure) indicated a perilobular development of the conjunctive tissues. Sometimes elements of the pulmonary pattern, si milar to pneumoconiosis nodules, which we evaluated as "crossing-over" linear changes of the interstitital tissues appeared. The vascular pattern appeared convulsed, like fractured elements, sharply deviating from radial pattern, often dense parallel stria, expressing peribronchial changes,were observed.. The described picture appeared with great frequency and well ex pressed in the right pulmonary lobe in its low-middle section. The shades of the radices of the lungs were widened, consolidated, ramified. Often the deformation of the radix was observed, while maintaining its structure. Significant differences among the workers in the different workshops were not found. With the age, the frequency of the found changes increased, however, it was observed in persons with long "dusty" service time Thus the fibrous deformation of the pulmonary pattern appeared on all the pul monary extensions in 16 workers with long service time, younger than 40. In the overhelming majority of the cases, the expression of pulmonary fib rosis was combined with increased MVR numbers. The use of RE for the eva luation of the MVR value did not confirm the regularity of such a com bination in the same person, although the contingent, as a whole, was cha racterized with considerable frequency of both, pulmonary fibrosis and the UCC 068811 Vertkin -6- increased pulmonary ventilation. The observed pathology of the respiratory system - according to our opinion - is connected with the action of un favorable factors of industrial environment. This explains:,, first, the considerable frequency of the described changes, secondly, more or 1 ss their mono-type character, and finally that they were found in all the age groups, including the young, not smoking persons with not aggravated pulmonary anemnesis. The question arises, with which of the factors from the complex of un favorable industrial factors can one connect the development of the found pathology. It is known, that the lengthy influence of hydrogen chloride can cause pulmonary fibrosis, as the result of long lasting chronic bron chitis. Pneumo-fibrosis can be the consequence also of very strong poison ing effects of high hydrogen chloride concentrations. However, let us mention, that in multiple examinations of therair-medium, hydrogen chlo ride was completely missing, or was seldom found, but in concentrations of less than the permissible limit. Evidently, at the overhelming majority of chestthe examined persons with distinct) rentgenological symptoms, the anamnestic, stetoaccustical, functional phenomena to which one could attribute the chronic influence of hydrogen chloride, were missing, therefore the suggest ion, that they play a determining role is not sufficiently founded for us. It seems more likely to us, that the observed changes are caused by intensive and long lasting influence of FVC dust. The physical stress and the meteoro logical factors can have a contributing influence, increasing the pulmonary ventilation and with this the amount of inhaled dust itself. ucc 068812 Vertkin -7- Results 1. The conducted examinations permitted to reveal in considerable part of the workers, employed in the manufacturing of goods from FVC, monotype changes in the system of respiratory organs, 2. Very likely, these changes can be explained by the influence of un favorable factors of industrial environment, in the first place with inten sive and long lasting contact with PYC dust. UCC 068813 earlier on the BCG than on the ECG. In most patients the absolute arterial pressure fi gures were normal, but of frequent occurrence were failing of the oscillatory index, asymmetry of the curves and symptoms of respiratory dystonia. YAK 6IS.23/.24-057.9:STS.e || 0 C0CT09HHH BPOHXO-JIErOHHOrO AIUIAPATA y PABOTAIOUIHX HA nPOH3BOACTBE H3AEJ1HR H3 flOJlHBHHHJIXJlOPHAA R E C E I j/ Ej 3] 10. H. 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HeyaiiBHTeabHo, mto y noaaBaxtomero fioabuiHHCTBa oficaeaoBaHHbix c neTKoft peHTreHoaorHHecKofi citMnTOMaTHxoft OTcyTCTBOBa.iH aHaMHecTHnecKHe, cTeToaxycTHHecxHe, (pyHxuHOHaabHue nposiBaeHHsi, xoropue mojkho Cbiao 6hi npHnacaTb xpoHHMecxoMy B03aeflcTBHK> xaopHcroro Boaopo aa, no3TOMy npeanoaoxeHHe o ero peiuaiomeH poaH xaweTcsi HaM HeaoCTarowno o6ochOBaHHHM. SoAee BepoHTHoft npeacTaBaseTCH CB3b HafiaeHHbix H3MeHeHIlli C HHTeHCHBHhIM H flAHTe.IbHblM B03AeflCTBHeM HbiaH tlBX. n3iiMecKoe HanpHjKeHHe h MeTeopoaontMecKHii Caltrop Moran HMeTb cnocoficTBytomee 3HaweHiie, yBeaHHHBan aeromyio BeHTHaamno h TeM caMbiM KO.iHHecTBO HHraanpyeMOH nbiaH. BblBOAbl 1. riponeaeHHoe o6caeaoBaHne no3Boauao BbiflBHTb y 3HaiHTeabHoft HacTii pa6otaiomHx, 3aHHTbix Ha npoH3BoacTBe H3ae.mft hs no.mBiiHHa* x.iopnaa, oAHOTiinHbte H3MeHeHHH cncTeMbi opraiioB abixaHHH, 31 z o t1 O ucc 068816 Jft* *'*>: Vv'r.-* 2. 3th H3MeHeHHH, no BCeft BepOHTHOCTH, MOryT fihITb OfilHCHeHM B03. aeftcTBHeM HeCjtaronpHHTHbix tpaxTopoB npoiiaBOACTBeHHoA cpeau, b nenByio onepeflb hhtchchbhum h AAHTe/ibHbiM kohtbktom c nu/ibio ttojihbhhhjt' xAopHAa. J1HTE P ATyp A ApTaxoHosa B. T. 11 ap. B kh.: Bonpocu caHiiTapHoft oxpaHU BHeuiHeft cocau runieHU Tpyaa h npotpMaaKTHKH hh^bkuhohhux 3a6oaeaaHnfl. JI., 1967, c, 12. --Baa a* "{ f- O Kihh. Men., 1962, Nk 4, c. 88. -- Toaobstiok A. n. Bpai. ae.io, 1953 11. c. 107, -- Kapnoaa H. H. B kh.: Bonpocu caimTapHoA oxpaHu BHeuiHefl cpeau' rnrHetiu tpyxa n npoipnaaKTHKH hhiJ)kuhohhux 3a6oaeaaHft. J]., 1967, c. 40. -- Codhh' coh C. H. Tep. apx., 1958, a. 4, c. 17. -- III a a x e ukh A H. C. B kh.: MaTepiiaau 19-ft riayiHoft dyatHHecKOH KOH^epeHUHH. Cmo.ichck. Men. HH-Ta. CuojieHCK, 1966, c. 65. ON THE STATE OF THE BRONCHOPULMONARY SYSTEM IN WORKERS ENGAGED IN THE MANUFACTURE OF ARTICLES MADE OF POLYVINYLCHLORIDE Yu. Vtrtkin, Yu. R. Mamontov Summary A detailed examination of 96 workers engaged in the manufacture of articles made of polyvinylchloride showed a considerable number ol them to present alterations in the respiratory organs of one and the same type (changed bronchovascular pattern, increa sed pulmonary ventilation at rest). These should, most probably be ascribed to the effect of adverse factors of the industrial environment, and first of all --to intensive and long term exposure to the polyvinylchloride dust. Judgement as to the nature and degree of correlation of the revealed functional and morphological changes can be formed only on the ground of further dynamic observations. yiiK sis.s4-07.eie.isi.s-e> CPABHHTEJlbHOE H3y4EHHE CHCTEMbl CBEPTbIBAHHfl KPOBH IIPH PA3JIH4HMX HECfIEIlH<PH4ECKHX 3ABOJIERAHHJ1X JlETKHX riblJlEBOfl H HEnUJlEBOd 3TH0JI0THH C. r. EpaMHH, E. A. AeaSaAHH, M. 4. Tqmhjih (EpeBaH) HHCTHTyT rHrueHu Tpyaa k npo<Ji3*ao.ieBaHHft, HucTirryT ycoBepuiencTBoaaHHSi Bpaneii (nocTyfiM.fi* a peaaKuan 23/1 1970 r.) OflHOft H3 OCHOBHblX npHHHH HapyUieHHfl B CHCTeMe CBepTbIBaHHH KpOBH y OojIbHhIX XpOHHteCKHMH HCtieUH(pHHeCKHMH 3a<50JieBaHHHMH JierKHX nBJiaeTCH rnnoxcHH, Ha KOTOpyx) opraHH3M pearapyeT phaom npwcnocoCiH' TBJibHbix npoueccoB, HanpaBvreHHbix b nepByio ouepeAb Ha KOMneHcauHK}HeaocTaTKa xncjiopoAa. Ilo ashhum pnaa aBTOpoB (3, nep/iHx; A. H. Xypa, H Ap-)i npH THIIOKCHH Ha6jHOAaiOTCH CABHni B CHCTeMe CepOTOHHH -- rHCTaMHH, Bbl3biBat01KHe H3MeHeHHH CBepTblBaiomeft Cn0C06H0CTH KpOBH. Tax, BBeAeHHe rHCTaMHHa jkhbothhm a axcnepHMeHTe rphboaht k ocboCojKAeHHK) renapHHa. OAHaKO Bonpoc o tom, ocBofioKAaeTcsi ah AOCTaTouHoe KOAHuecTBO renapHHa aah npeAOTBpameHHH o6pa30saHHH tpomOob y HeAOBexa np HapyuieHHH reMoAHHaMHKH b mx/iom Kpyre xpoBoofipameHHH, OCTaeTCH HeBblHCHeHHUM. H3BecTHo, mto xpoHHnecxHe HecneiiHtpHHecxHe 3a6o.ieBaHHH JierxHX MOryT OCJ1QJKHHTLCH aTepOCUiepOTHHeCKHMH H3MeHeHHHMH, CnOCOfiCTBylOIUHMH Tp0Mfi006pa30BaHH!O. IlpHCTeHOHKbte TpOMfibl MOryT 6blTb KaK, cvieACTBHeM, Tax h npHHHHoA aiepoMaT03a h apTepHocmiep03a (B. H. Ky3~ hhk; Aschoff, 1930; 1939; Apitz). HaxoHeu, AoxasaHO, hto aioOoA socna/iH- Te.ibHbift npouecc b opraHH3Me conpoBoxcAaeTca axTHBauweA (paxTopoBCBepTblBaHHfl H TOpMOJKeHHeM tpHfipHHO/lHTH'teCKOA 3KTHBHOCTH KpOBH. yuHTbiBan H3.ioweHHoe Bbiuie, Mbi nonuTaAHCb npoc/ieAHTb 3a H3weHehhhmh noxa3aTe/ieA xoaryjiorpaMMbi y Co/ibHbix xpoHHHecxHMH HecnettHtpHgecKHMH 3a0OAeB3HHHMH AeCKHX. Jljm BblHBACHHH 33BHCHMOCTH CABHTOBCO CTOpOHbl CHCTeMhI CBepTblBaHHH KpOBH OT XapaKTepa 3a60.ieBaHHH HaMH. 32 UCC 068817 `lo 1. [U'I'o^'.uh pemrtiiorpaMMa "...hoi'i i./:eTMi Kpo.niKa iienocpeacTtiiiio noc.ii? m(Tp;iTpaxea.iMioro Bne-ti.ifi Biuecii ok noil uiniiia d <J*i mo- .lorii'irOKOV pacTRope. 2. PeiirmiorpaMMa 1130.u1pon.mi.biv pa3j\TM\ bo3jv.\om .icrKiix Turn we KpoouiKa qepe3 3 iifcima noc.ie sarpacKii. jiiaiHTcviiiHcc fr\:('mK? n aoipcp-.ta- hmhiM/kc.hichrcnAmnioprnojpami<\tu Ha q c-<pfeocmi:ee-Mneo-- ina.i^nQM t-Ticio ..nati>;>arMa.nbHf.ft lo.m npaaoro .ierK<v-i .i C.:i j. .iuho i or.-.e.ie 4natl>p.'r\ia,,i.'U ft ir\ni neacro UCC 068818