Document wg86B3rV0BYYoeenNBVnNVyGB

2602. LONG-TERM EXPOSURE Jttho, Susannc u. Lange, C.-E. (1972). Sklerodermieartige UautverSnderungen, Raynaud-Syndrom und Akroosteolysen bei Arbeitern der FVCherstellenden Industrie. Dt. Bed. Wschr. 97. 1922. Exposure to about 300 ppm vinyl chloride may have an adverse effect on liver function (BEBRA Bull. 1972, Vt_, 492), and under certain cir cumstances industrial exposure to vinyl chloride may be followed by softening of the bones of the extremities, by neurological and circul atory disturbances and by liver enlargement. The paper cited above describes seven patients who reported symptoms of illness after working for 1-3'5 yr on polymerization processes for PVC production. Their symptoms included hypersensitivity to cold, paraesthesia, deafness, blanching of the fingers, pressure-pain in the finger-tips and loss of grip. Later, swelling of the terminal finger joints and changes in the nails developed. In single cases, failure of vision, abdominal pain or giddiness was reported. Five patients developed Raynaud's syndrome, five a drumstick-type thickening of the finger-tips and prominent hour-glass deformation of the nails, and five had swollen fingers with nodular infiltration of. the finger webs, the back of the hand and the region distal to the elbow. Banded osteolysis of the terminal phalanges of the fingers appeared in five of the seven. Clinical tests showed indications of liver dysfunction in two of the patients end obstructive respiratory disease in one. Three patients showed skin changes characteristic of the early inflammatory stage of a progressive scleroderma. So far, the pathogenesis of this array of effeots remains obscure. SPI -13011 OLOdY [Voi. 55(e)] 3555 riven in vivo selectively Inhibits (or 10-60 min a nueleoplasmlc type of "NA polymerase in rat liver but the synthesis In vivo of all species of tear RNA remains blocked for several hours.--J. F. L. a BROOKS, ROBERT ft. Jr. and JAMES A. VICK. (Dep. Pharmacow .alter Reed Army Inst. Res., Walter Reed Army Med. Cent., Washington. D. C. 20012, USA.) Toxicological studies of bee venom in mice, dogs and monkeys. AM bTvEJ 112(7): 250-251. 1972.--Venom td Apis mellitera was injected, cither l.v. or s.c., into experimental animals. I.V. injections caused a precipitous decrease In blood pres sure within 35 sec in both dogs and monkeys. It also decreased heart rate and depressed respiration. Dosages of 5 mg/kg in dogs, or 2.5 mg kg in monkeys, i.v., caused death from cardiovascular failure. Similar responses were noted after s.c. Injections, but median lethal dosages were higher: 200 mg/kg in dogs and 50 mg/kg In monkeys. The former is equivalent to about 2000 bee stings. Smaller dosages were fatal to mice. Other physiological reactions are noted. --J. D. Hitchcock. 34772. ULANOVA, I. P.. A. I. KHALEPOand A. I. EITINGON. (Inst. Ind. Ilyg. Occup. Dis.. Acad. Med. Set. USSR, Moscow. USSR.) Issledovanie kumulyativnykh svolstv khimlchoskikh soedinenii na porogovom urovne kak osnova prognozirovaniya khronicheskikh intoksikatsti. ISludy into cumulative properties of chemical compounds at the thresh old level as a basis for prognostication of chronic poisonings,! GIG TR I'KOF ZABOL 16(3): 36-39. 1912. (Engl. 8umm.|--Cumulative properties of chemical compounds at the threshold of their acute action were analyzed. Cumulation coefficients were deduced from the Integral test changes and with reference to the summary-threshold value fea turing the functional state of the nervous system. These coefficients proved to be much inferior to coefficients of cumulation determined with reference to the animal lethality figures. The cumulation coef ficients at the threshold level supported a well-marked cumulative ca pacity of benzene, carbon tetrachloride, m-aminobenzotrlfluoride and morpholine. This was supported by the data derived from chronic ex periments, considering CCI4 and benzene, also by the available clinical and hygienic observations. The estimated coefficient of correlation between the areas of chronic action and coelficients of cumulation for the substances under study at the threshold level was 0.99. This makes it possible to forecast possible developments of chronic poisoning. The investigation time was cut down to a maximum of 1 mo.--J. P. K. 1773. KOBULIYA, N. S,, L. E. GEDYMIN, F. R. HYf 'AKHOVSKJl and O. P. ARKHIPOVA. (Cent. Res. Inst. Tuberc., Mii^ lea1th USSR, Moscow, USSR.) Izuchenie pronitsaemosti gistogemanCheskikh bar'erov pri razlichnykh rezhimakh giperbaricheskoi oksigenatsii v eksperimente. [ Permeability of histo-haematic barriers in different regimes of experimental hyperbaric oxygenation.I EKSP KHIRANESTEZIOL 17(2): i 1-33. Ulus. 1972. [Engl, summ.) --Ex perimentally, 70 guinea pigs were subjected to 100% O2 in therapeutic (1-2.2 up to 3 ata) and toxic (4-5 ata) regimes of hyperbaric oxygena tion for 1-4 hr. Histology and radioactive indication (with streptomy cin-835 in 20,000 V/kg and with 14.2 pCl activity in 1 ml) were used to assess various permeability levels in the histo-hematic barriers of the lungs, liver, kidneys, spleen, myocardium and brain. Toxic regimes were accompanied by a universal increase of vascular walls permeabil ity, conditioned by structural lesions of the histo-hematic barriers. With therapeutic regimes, vascular permeability rose only in the spleen, liver and kidneys, i.e,, in.the organs with an increasing functional ac tivity under hyperbaric oxygenation, and was not accompanied by hlstostructural changes of the main elements of the histo-hematic barrier. -J. L. S. 34774. CONDER, D. W,, P. C. OLOFFS and Y. S. SZETO. (Pestol. Cent., Dep. Biol. Set., Simon Fraser Univ., Burnaby 2, B. C,, Can.) GLC separation of heptachlor epoxide oxychlordane, a- and y-chlordane. BULL ENVIRON CONTAM TOXICOL 7(1): 33-35. 1472.--GLC [gas liquid chromatography] columns were used to identify and quantitate organochlortde pesticide residues. Such as 3% 0V 1, 2% SE 30 plus 6`, OF 1, or 2'i OV 1 plus 51 OV 210. They did not satisfactorily sep arate the oompounds of n-chlordane, y-chlordane oxychlordane and heptachlorepoxtde. Gas chromatograph Micro Tck MT 220 with Nl-63 electron cepture detector method was employed In this experiment. --J. P. K. 34775. WALTSCHEWA, W. (Forschungslnst. Arbcitsschutz, Berufikr., Illvd. Petko Napetov 34, Sofia, Bulg.), M. SLATEWA and I. MICHAILOW. Hodenveraenderungen bel weissen Ratten durch chrooIsche Verabreichung von Nickelsulfat. jTestlcular changes due to long term administration of nickel sulfate In rala.l EXP PATHOL (JENA) 6(3/4): 116-120. Ulus 1972. [Engl. summ.|--Following long-term l-sulfate Intoxication In rats, severe lesions in the germ cells .cuLrly in spermtogenesls could be demonstrated. Very few chang- observed In the livers and kidneys. Nickel sulfate had a select^ oxlous effect on testicular parenchyma.--A. B. M. 14776. BASALAEV , A. V.. A. N. VAZIN and A. G. KOCHETKOV. [S'. M. Kirov Cork. Med. Inst., Gorki, USSR.) K patogenezu Izmenenll, rotnlkayushchlkh pri dlltel'nom vosdetstvll vtnilkhlortda. I Pathogenesis 3551 (Mar. 15.1913] TOXICQ of changes developing due to long-term exposure to the effect of vinylchloride ,1 GIG TR i'HOF ZAIIOL 16(2): 24-27. Ulus. 1972. [Engl, summ.|--Rabbits and rats which inhaled vinylchloride fumes in a max-/* Imal permissible concentration (0.03-0.04 mg/1), underwent a 6-mn.jC long all-round examination by physiological, biochemical, hiatomorphologtcal and rocntgcnodensltometrlc methods. Changes in the blo-^^ electric activity of the hypothalamus, hyperadrenalincmta and function al troubles of the cardiovascular system were disclosed. Development of resorptive manifestations in the bone tissue was brought out mor phologically and osteoporosis--rocntgenologically. An inference is drawn as to a key Importance of hypothalamic dysfunction in the patho genesis of the disease, this dysfunct' si giving rise to neurohumoral and neurovascular troubles leading to development of dystrophic pro cesses In the bone tissue.--P. L. 34777. BAZIN, SUZANNE and Al VERT DELAUNAY. (CNRS, Inst. Pasteur, Serv. Pathol. Exp., 92-Garches, Fr.) Action exercee par des substances lathyrogenes sur le coilagene de granulomes. [Action ex erted by lathyrogcntc suhstances on the collagen of granulomas.! Ch HEBD SEANCES ACAD SCI SER D SCI NAT (PARIS) 274(4): 618-620. 1972.--Polyvinyl sponges were Implanted s.c. in Wistar rats. Ten days later, penicillamine was given orally in a dose of 20 mg/100 g of weight. In another group, 0-mercaptoethylamtne was given in a dose of 0.5 mg/100 g, l.p. Granulomatous tissue surrounding the sponges and nor mal skin were extracted to give neutral and acid soluble collagen, col lagen labile at 60' and Insoluble collagen. Both drugs gave comparable results. They did not modify the total collagen of normal skin, but de creased the collagen ol granulomatous tissue slightly. Neutral soluble collagen was increased and insoluble collagen decreased in both types of tissue. The labile collagen increased in the granuloma and dimin ished in the skin. The acid soluble collagen increased 200% in the granuloma and 30% in the skin. Intermolecular bonds in collagen which are sensitive to lathyrogens are comparable In granuloma and in nor mal skin.--M. D. S. 34778. KUDZINA, G. D. and D. I. GOLOVAN'. (A. N. Marzeeva Kiev Res. Inst. Gen. Public Hyg., Kiev, USSR.) Sravnltel'naya otsenka gerbltsldov gruppy khlorbenzolnoi kisloty sanitamo-toksikologlcheskim metodom i metodom kul'tur ktetok. [Comparative sanitary-toxicolog ical and cell-culture evaluation of the chlorbenzoic acid herbicide group,| VRACHDELQ 1. 125-128. Illus. 1972. |Engl, summ.|--Data of chronic sanitary-toxicological experiment on rabbits and a study of the effect of chlorbenzoic herbicide group indicate that the results by these 2 methods concerning the toxicity of the herbicides coincided. The use of cell-culture method for rapid hygienic evaluation of the tox icity of some herbicides is promising and further investigations of this method are justified.--P. L. W. 34779. COOPER, PHILIP and STEPHEN H. TOLINS. (Dep. Surg., Bronx Veterans Admin. Hosp., Bronx, N. Y. 10463, USA.) Relationship between smoking history and complications immediately following sur gery for duodenal ulcer. MT SINAI J MED 39(3): 287-292. 1972.-- No evidence is given of an association between smoking and complica tions, nor between smoking and operative mortality, nor between Slack ing and days to discharge. The mo6t obvious trend is probably predict able, namely, patients over 50 have more complications and a higher mortality rate than those under 50. In spite of the relatively large number of patients Included in this report the smoking habits, the age distribution, and disease rate in the population studied are quite likely to differ from the general population. Some inconsistencies were found between smoking histories taken on the same patient at different times. This may have resulted from the quality and accuracy of the informa tion given to the examiner by the patient. Few, if any, generalities should be drawn from this research. Results apply only to Immediate postoperative findings and do not apply to long-range effects of smoking upon the patient after surgery for duodenal ulcer disease.--E. M. D. 34780. USITSA, F. M. and L. A. MOTROVA. (Fac. Postgrad. Med.. Riga Med. Inst., Riga, USSR.) O klinicheskikh osobennostyakh alkogol*nykh pollnevrltov. [Clinical traits of alcoholic polyueuntis.l ZHNEVROPATOL PSIKH1ATRIM S S KORSAKOVA 72(5): 647-651. 1972. [Engl. summ.|--The traits of alcoholic polyneuritis in 27 patients were studied. Four main clinical variants of the disease were distinguished. The most characteristic and frequent form of alcoholic polyneuritis was the syndrome of sluggish paralysis in the parts of the lower extremi ties. A more common and mixed form of polyneuritis, sensorial and atactic forms, were rarely observed.--J. P. K. 34781. STEGER, ROBERT E. (Coop. Ext. Serv., N. M. State Univ., Las Cruces, N. M., USA.) Native plants poisonous to humans. J RANGE MANAGE 25(1): 71-72. 1972.--A summary is given of the toxic principles, the plants, toxic parts, symptoms and some general comments for several commonly toxic plants in the U3A.--D, T. S. 34782. PARIS, RENE-RAYMOND and ANNE-MARIE TESSIER. (Fac. Pharm., Lab. Matlere Med., 4-ave. Observatoire, 75-Paris 6. Fr.) Presence de substances du groupe des Cucurbltaclnes Chez diverges Eupborblaceea toxiques afrtcalnes, notamment chez Maprounea membranacea Pax et K. Hcfm. [ Presence of substances of the group o< cu; curtltadnea In various Alrlcan toxic Euphorbiaceae especially in SPI -13012 1167 (Jan. IS. 1973] TOXICOLOGY 11445-11458 ENVIRONMENTAL AND INDUSTRIAL TOXICOLOGY Vi aWn: I'ublte Health'*- Occupational Health. Radiation Health 11445. JONES, R. D. (Phnrm. Dtv., I. C. I. Ltd., Aldcrley Park, Macclesfield, Cheshire, Engl., UK.), B. T. COMMINS and A. A. tFRNK. Blood lead and carboxyhaemoglottln levels In London taxi drive^i. LANCET (NORTH AM ED) "2(7772): 302-303. 1972.--Among SO London taxi drivers the mean blood-lead was 28.7 ug/100 ml. There was no dUtcrenre o( statistical significance In the blood-levels of smokers and hon-smokers, nor between the blood-leads o( night-shut and day-shift drivers. Carboxyhentoglobin levels of smokers were significantly higher than those of non-smokers, and the levels were significantly higher In day drivers than In night drivers. t 11440. MC NTIRE, MATILDAS, and CAROL R. ANGLE. (Dep. Pedlatr.. Unlv. Nebr. Coll. Med.. Omaha, Nebr. 68105, USA.) Air lead: Relation to lead In blood of black school children deficient in glucose-P-p Imsphate dehydrogenase. SCIENCE (WASH) 177(4048): 520-522. Illus. 1972.--Black children (44) at 2 elementary schools within 0.7 mi of a battery plant had significantly higher (P<0.01) concentrations of Pb in their bloods (34.1 9.7, pg/lOOmm, mean + SD) than 122 students (26 J 7.1) at 7 schools 1-3 mi distant; 5 mol Later there was a comparable difference between red cell Pb values (54.1 * 18.5 vs. 37,4 _* 12,6). Among the blacks, those deficient In glurose-6-phosphate dehydrogenase had a higher (P<.005) concentra tion of Pb in the blood after correction for anemia (32.9 + 9.7) than the nondeficient (25.7 * 8.8), and a higher concentration in the red cells (47J * 14.7 as compared to 35.6 * 15.8 P< .001); the enzyme effect was independent of geographic location. t 11447. MARKOWITZ, SAULS., CHARLES J. MCDONALD (Roger Williams Gen. Hosp., 825 Chalkstone Ave., Providence, R. I. 02908, USA.). WILLIAM FETHIERE and MARVIN S. KERZNFR. Occupational acroosteolysls, ARCH DERMATOL 106(2): 219-223. IUus. 1972.-Occupational acroosteolysls is an unusual disease In which affected persons have sclerodermoid-like lesions of the skin, conditions similar to Raynaud's phenomenon, and asymptomatic, bony defects of the extremities. Evidently, the disease is confined solely to workers in the plastics industry, specifically those engaged in the production of polyvinyl chloride from vinyl chloride. The Incidence of the disease is unknown but is thought to occur In 3% or less of workers. t 11448. WILDISH, D.J. (Fish. Res. Board, Can. Biol. Stn., St. Andrews, N. B., Can.) Acute toxicity of polyoxyethylene esters and polyoxyethylene ethers to S. salar and G. oceanicus. WATER RES 6iPr759-7627TDus. 1972.--P olyoxyethylene ethers are more toxic to aquatic fauna than polyoxyethylene esters. Polyoxyethylene (4) lauryl ether Is 9 times more toxic than polyoxyethylene (14) monolaurate at the ILL [Incipient lethal levels] to Salmo salar and 14,000 times more toxic at the 96-hr LC50 [lethal concentration median] to Gammarus oceanicus Sergestrale. t 11449. HOFMANN, A. (Inst. Toxlkol., E. Merck Darmstadt, D-6100 Darmstadt 2, West Ger.) and M.NEUFEU3ER. Tierexperlmentelle Untersuchungen zur gewerbetoxlkologischen Beurteilung von 2-chloraethyllsocyanat. [An investigation of 2-chloroethyl Isocyanate in laboratory animals with regard to the implications as a potential occupational hazard?] ARCH TOXIKOL 29(1): 73-84. Illus. 1972. [Engl, summ.]--The acute oral toxicity of 2-chloroethyl Isocyan ate (CAIC) is 396 mg/kg lor male rats and 630 mg/kg for female mice. The extremely small quantity of 5 pi CAIC caused severe irritation in the eyes of rabbits, particularly of the conjunctiva. The skin was also affected considerably. Inhalation experiments, Involving a new version of a proven method for generating air-vapor mixtures, pro duced no evidence of systemic toxicity, but let CAIC be classified ' as an Irritant vapor to the respiratory tract. The LC50 for rats is 6J ppm after exposure for 6 hr, while rats In 2 experiments involving 10-day exposures to vapor concentrations of 3.1 and 3.8 ppm, respec tively, survived. After a fortnight's withdrawal following each experi ment, histological examinations showed tracheobronchitis and broncho pneumonia but no pathological change in any other organ examined. A threshold limit value (TLV) of 0.02 ppm was suggested. t 11450. JOSE, FRANCISCO R. (Dep. Physiol. Hyg. Nutr., Unlv. Philipp., Manila, Philipp.) A study of lead hazard in some lead process ing industries, ACTA MED PHIUPP 8(2): 48-54. 1972.--Two battery pUnta, 2 paint establishments and 1 company manufacturing lead oxide were studied to evaluate the extent and intensity of Pb hazard* Methods of evaluation used were levels of Pb in air* and urinary Pb, ' tippled red cell count and clinical manifestations suggestive d Pb intoxication among employees in the establishments. Levels of Pb in air* Pb concentration in the urine and stippled red cell count were /higher in the lead oxide and battery plants than In those engaged In paint manufacturing. Clinical manifestations suggestive of Pb poisoning were also more frequent. Good correlation was observed between the laboratory findings and the clinical manifestations indica tive of mild Pb poisoning* t 11451. GOODWIN, JOHN W. (Day, Ztmmermann, Inc., Lone Star Div,, Texarkana, Tex. 75501. USA.) Twenty years handling TNT in a shell loading plant. AM IND HYG ASSOC J 33(1). 41-44. Illus. T$72.~In the handling of TNT within the munitions industry, human exposure to this substance cannot be completely avoided. The goal of a Preventive Medical Program is to prevent such exposures from causing any permanent damage to workers. Exhaust ventilation with wet scrubbers, use of protective clothing, mandatory practice of good personal hygiene, and careful medical supervision have combined to accomplish this goal. The use of the 'Hiymol Turbidity Test in such a program was a valuable Indicator of liver malfunction. t 11452. KRAMER, C. G. (Dow Cbem. Co., Midland, Mich. 4B640, USX J and J. E. MUTCHLER. The correlation of clinical and environmental measurements for workers exposed to vinyl chloride, AM tND HYG ASSOCJ 33(l): 19-30. illus. 1972.--A method is described for die statistical consolidation and correlation of environmental measurements and clinical findings using as an example a group of healthy male workers exposed routinely to vinyl chloride for periods up to 25 yr. Retrospective in nature the study reveals several statis tically significant effects from chronic exposures to vinyl chloride and traces of vtnylidene chloride. t 11453. EL-DAKHAKHNY, ABDEL-ARIZ and YASSIN M. EL-SADK. (Dep. Occup. Health, High Inst. Public Health, Alexandria Univ., Alexandria, UAR.) Lead in hair among exposed workers. AM IND HYG ASSOC J 33(1): 31-34. Illus. 1972.--In a study performed on 67 Pb exposed workers, a correlation was found between levels of Pb in hair and the biochemical and clinical findings. A Pb level In hair of more than 30 pg/g could be considered as a sign of excessive ~ level. 1454. LAUWERYS, R., R. DELBROECK and M. D. VENS. (Unite Toxicol. Pathol. Travail, Catholic Univ. Louvain, Ave. Chapelle-aux Champs 4, 1200 Brussels, Belg.) Automated analysis of delta-aminolaevullnlc acid in urine. CLIN CHIM ACTA 40(2): 443-447. Ulus. 1972.--The addition of an Internal standard of 8 -aminolevulinic acid to the urine allows the colorimetric determination of this metabolite without the need of a preliminary chromatographic separation. The speed and accuracy make the procedure suitable for the periodic control of workers exposed to Pb. ' 11455. MKSIC.J. and S.HUKOVIC. (Inst. Farmakol. Tikslkol., Med. Fak,, Sarajevo, Yugosl.) Uzroci nastajanja kronicnog opstruktivnog bronhitlsa u radnika cme metalurgije. (Causes of chronic obstruc tive bronchitis in ferrous metallurgy workers.I ARH HIG RADA TOKSKOL 22(1): 9-32. Ulus. 1971[recd. 1972]. [Engl, summ.]--An analysis was performed on 400 people working and living under differ ent conditions of exposure to air pollution. Respiratory symptoms were questioned and the ventilation function of the lungs, O? and CO2 content of arterial blood, presence of allergic phenomena, data on smoking habits and the consequences In pulmonary and cardiovascular systems were studied. The 8 metal Ions that constituted the dust were Investigated. Experiments were also performed on frogs (Rana ridlbunda).--J. F. L. 11456. GONCHARUK, E. I., A. A. POLYANSKII, I. I. SHVADCO and A. A. CHKIN. (Dep. Public Hyg., Kiev Med. Inst., Kiev, USSR.) Fazovye lzmenenlya funktsll shchitovidnoi zhelezy u krys pri khronicheskom vozdeistvll dibromantina. (Phase alterations of thTrotd function In rats exposed to the chronic activity of dibromanthm.l GIG SANIT 36(10): 108-109. Illus. lT(l[recd. 1972).--The functional condition of the thyroid was studied In rats with 1-131 after drinking HgO with dibromanthin concentrations close to those found in swimming pools disinfected with this chemical. In the 1st mo. there was some excitation of thyroid function. In a 4 mo. experiment, this latter effect was replaced at later periods by pronounced inhibition. Harmful effects on humans are not certain.--N. L. G. 11457. FROLOVA, A. D. (On the methods of studying biotransformatlon of poisons in organisms.! PRAC LEK 24(2/3): 61-66. 1972. [Czech, and Engl, summ.]--The mechanism of the toxic effect of Industrial poisons was discussed. The lack of methods for identifica tion of chemical substances and products of their transformation in biologic material, made these studies rather difficult. Simple methodic approach affording Indirect assessment of the fate of foreign substance* In the organism had not yet lost its importance. The effectiveness of proposed simple procedures for studies of the fate of poisons was demonstrated with 3 representatives from the series of fhiorated compounds.--J. A. L. 11458. FISEROVA-BERGEROVA, VERA (Reprints: Vera FlserovaBcrgerova Thomas. 145 S.E. 25th Road, Miami. Fla. 33129, USA.) and J. LUDVDC CETTL. Elektricky model pro vstrebavanl metabolistnus a vyhicovanl benzenu u cloveka, fElectric model for the absorption metabolism and excretion of benzene in man.l PRAC LK -44(2/3): 56-60. Illus. 1972. [Russ, anti Engl, summ.]--The values for the resistance and capacities In the electrical analogue were derived by analogy to physiological factors for a 70 kilo man (blood flow la tissue. SPI - 13013 s (V 176. THE STATE OF THE ANALYZER FUNCTIONS DURING CHRONIC OCCUPATIONAL INTOXICATION WITH CERTAIN SUBSTANCES HAVING A NARCOTIC EFFECT V. A. Antonyuz.hcnko, I. A. Golova anil N. K. Aliyeva (City of Cor'kiy) Institute of Occupational Hygiene and Occupational Diseases Translation of: "Sostoyaniyc Analizatornykh runktsiy I'ri Khronichcskoy Professional'noy Intoksikatsii Nckotoryni Veshchestvami," Gig. Truda, 9, pp. 19-22, 1972. Soviet literature contains a significant number of publications devoted to the study of analyzer functions during various forms of occupational pathology' (E. A. Drogichina et al.; L. G. Okhyanskaya; V. G. Osipova and L. G. Okhnyanskaya; Z. F. Nestrugina; B. A. Atchabarov et al., and others). In a number of studies the high sensitivity of certain analyzers to the effect of toxic agents is pointed out. Thus, according to the data of V. Ye. Ostapkovich et al., the vestibular apparatus has an elevated sensitivity to substances which exert a narcotic effect (benzine, vulcanizing gases). A complex investigation of the analyzer functions having the goal of revealing the degree of involvement of each of the analyzers, as well as a study of the mechanisms of formation of their disorders during exposure to various harmful factors are of interest. We studied the state of the basic analyzer functions (taste, olfactory, vestibular, auditory, visual) in 60 patients with a pronounced form (second and third stage) of occupational intoxication caused by inhalation exposure to narcotics. In half the patients (in 30) intoxication with unsaturated and chlorinated hydro carbons (ethylene, propylene, 'vinylchloricd, trichlorethylene, and others) was noted, while the remainder suffered from methylmethacrylate intoxication. The intoxication appeared as a syndrome of the so-called vegetative-sensory polyneuritis against a background of significant asthenization with the presence of more or less pronounced brain stem symptoms. The latter, in pronounced cases, were repre sented by profound oculomotor disorders (strabismus of the - [i 1 legible]- Maghandi variety, nystagmus, tremor of the eyeballs with the -[illegible]- phenomenon of them, and also by disorders of swallowing, with hypotrophy of the tongue, and hypothalamic paroxisms. In mildly pronounced cases one detected only mild oculomotor and trigeminal [Translator's note: the word is blurred, but it appears to be deficiency]. During, the study of the anafyzer functions the data of clinical examinations were used. Moreover, for investigating each of the analyzers individually, a combination of special methods were employed which made it possible to study excitation, lability, and their adaptational capacity. As a control, six practically' healthy people of an analogous ace composition were examined; these people had not been in contact with toxic substances (they were clinical associates of ours). The obtained numerical figures were statistically processed. NN V r mmy 1 SPI -13014 The most pronounced, clinically clear deviations were found witli respect to the vestibular analyzer. In patients with gross brain stem symptom:;, these i deviations organically entered the clinical picture of intoxication and were evidenced by complaints of dizziness, indeterminate sensation of unsteady gait, . sensation of the ground moving beneath the feet, and unsteadiness of surrounding objects. ^ Objectively during this process, close misses during the finger-nose test were revealed as well as unsteadiness in the Romberg position. Similar clinical signs of vestibular inadequacy were detected less seldom among a group., of persons with microorganic brain stem symptoms and were also less pronounced. They were not J found at all in the control. The use of load tests made it possible to establish disorder of vestibular function among all patients, frequently identically pronounced on both sides. The caloric test proved most adequate. An investigation of caloric nystagmus (washing the outside auditory passage with 60 ml water at 19 for 10 seconds) in more than i one-half of the patients revealed complete absence of vestibulo-motor reaction. In the remaining cases, a decrease in excitability of the vestibular apparatus was | noted; this was manifested in lengthening of the latent period and shortening of the duration of nystagmus to 10-15 seconds (in the norm 60-80 seconds). In addition to this, in one-third of the patients (more frequently in patients with pronounced brain stem symptoms), the caloric test revealed an enormous vegetative reaction with whitening of the face, cold sweat, bouts of vomiting with subsequent deterioratior of overall condition for several hours or even days. The rotation test was particular' poorly tolerated by these patients. We refrained from carrying out this test further after two patients experienced short term respiratory failure during the test. An investigation of the optokinetic nystagmus in a significant portion of the patients revealed its rapid exhaustion with the appearance of "lapses" in tracking movements of the eyes. Active fixation of attention and glance (calculation of the hearing range) made possible an increase in the amplitude and uniformity of nystagmus in a number of cases. The subjectively estimated disorders of visual function are intimately linked with the pathology of the vestibular analyzer. Most of these disorders were caused by the inadequacy of the oculomotor apparatus. An attempt actively to fix a glance on an object frequently caused dizziness, 3nd a sense of nausea with reddening or paling of the face. In pronounced cases the patients were forced to refrain from <i >1 reading and watching television transmissions. An investigation of'the analyzer function in the indicated categories of patients W3S extremely difficult, while in certain'- of_ them (three) it proved to be impossible. In the absence of oculomotor disorders, most of the patients did not complain of disorders of vision. Nevertheless an examination of the state of the visual analyzer -- adequate optic chronaxia, adaptation to darkness, and the critical frequency of blending flashes caused a change in all indices in most patients. The curve of adequate optic chronaxia was sharply altered. 'As a rule, i^was of a fluctuating'character, frequently with an increase toward the end of the investigation.* The level of the curve reflecting the adaptation capacity of the visual analyzer principal ly decreased toward the end of the investigation. IrTan overwhelming majority of the patients, the critical frequency of merge blinks also proved to be diminished. With respect to the remain ing analyzer functions investigated by us (auditory, taste, olfactory), none of the patients revealed any active complaints with respect to disorders affecting them. However in a special questionnaire, success was achieved in establishing inadequacy of certain of these in part of the subjects. litis primarily pertain to the auditor)' analyzer. Thus, disorders in the sphere of the auditory analyzer appeared in the to::. of more difficult perception of the spoken voice with good heavahility of sounds, I in a number of cases poor tolerance to extreme noises was noted. 2 r* SPI -13015 During an objective examination, in two-thirds of the patients a slight and 'most frequently identical bilateral decrease in hearing was revealed; this took the form of different type.*; of andi omet ri c curves. Somewhat more frequently, an ascending type of audiogram was found with a decrease in hearing with respect to low frequency tones down to 35-40 db. However, there were also curves with two slopes which were characterized by increased thresholds of both low and high frequency tones flap to 40-45 db) with preservation of normal hearing in the speech zone (1,000-2,000 Hz). In a number of eases a slight decrease in hearing throughout the entire frequency range was noted. In the control group the thresholds of tonal audiometry in both air and bone transmission were 0-10 db, which is in agreement with the data of the literature. With respect to the degree of functional mobility of the auditory analyzer, judgment was made by the maximum duplication of rhythmic stimuli and according to the critical interval of differentiating between two sounds. An increase in the interval of discretion was revealed as well as a decrease in the critical frequency of merging of sound bursts. During the special examination of the taste analyzer by the drop stimulus method, taking into account the taste zones of the tongue, a statistically reliable increase in the threshold of noting bitterness was revealed (0.005 t 0.00023) and with respect to sweet stimuli (3.4 t 0.31) (P < 0.01). The sensitivity to acid and salt was within the limits of the norm in most patients. In a number of cases, in addition to an increase in the threshold of sensitivity, there was an inversion of the taste sensations: acid was perceived as salt while salt was perceived as acid or as a bitter taste. A residual effect was also frequently noted (up to. 1-2 hours) after placing a bitter substance on the tongue. Similar data were also obtained during a study of the olfactory analyzer. The investigation of olfactory function carried out by the Elsberg-Levi method revealed in most patients an increase in the threshold of olfactory sensitivity to thymol and camphor to 16-18 mm, while at the same time the threshold with respect to coal tar and Rosemary remained withing the limits of the norm. In addition to dissociated hyposmia, in most patients an increase in the time of adaptation was noted as well as a slow down in the restoration of the original threshold after load. Hence, as the result of a special investigation, inadequacy of all the analyzer functions investigated by us was found. The most profound in clinically well-defined changes were detected in the sphere of the vestibular analyzer. Disorders of the remaining analyzer functions most frequently were of a subclinical character. An analysis of the revealed vestibular disorders makes it possible to theorize a significant deficiency of its central regions. This indicates a character of dis orders of optokinetic nystagmus?-as well as the presence of dissociation between the d.egree of pronouncement of the vestibulomotor and vestibulovegctativc reactions with predominance of the latter. There is every basis to hypothesize a significant involvement of the vestibular nuclei of the brain stem, which is indicated by the pronounced clinical picture of vestibular insufficiency, as well as by the presence of other symptoms of brain stem pathology. N \3 9 SPI -13016 Disorders in the sphere of the other analyzers arc primarily linked with inadequacy of their cortical terminus, which provides for finely specialized functions. These types of disorders arc particularly clearly revealed during the examination of the auditory, taste and olfactory analyzers. For the very visual analyzer, pronounced deficiency of the central neural mechanisms is characteristic, as is th.eir significant degree of exhaustion, which is possibly worsened to a certain extent by the oculomotor disorders. The functional dynamic character of the Tcvealed disorders in the sphere of the visual, auditory, taste, and olfactory analyzers in the presence of local brain stem pathology provides a basis to evaluate them as a manifestation of dysfunction of the brain stem's reticular formation. It is in fact this formation which is primarily damaged during long term exposure to narcotics, which are the cause of intoxication in the patients examined by .us. REFERENCES AriaC-ipoo D. A.. MoiiiscmH B C. n r. t a c I". /I. aC. ymit.. not. ;i rojvj. 6-.vv. 1007. .V? 1. e. 42.-- it |> o r a u u tt a 3. A . O x u ii u c k & n il. |\ :i ap. Tpyni.i A >111 C.'CCP. I001. t. 31. c. 0.-- JIccTpyrniio 3 0. Cayv.'iasi n i:Ccty.tnh -ji:i>i npa iipo'i'aaioi.fiiKaaiuix nixa-.-NMii srria.i.ia.vii. A.uopeji. ii:cc. i;'ana. Xopaxo:, i I93S.-- Oc a no no II. T. far. Tpy.ia. 1037, .V* 3. c. 41.-- O c t a n i: o n a n If If. M a a .; - kob /I. I'... M a k a ji c u i; o 10. il. Li mi.: MoTcpao.iu I i'i Bcccoiooii. Kna'Jirp.'immi an ' " poiuic'i .inornociaac. >kctie;>xu.<e Tpyaornocr-C.iiocni ii npo',,ia.H!.Ti:k-c npo I'CCcaouo.'.Liii.ix aaio.ioaoiiiia xMvii'icri.ori onio.uinm. M.. 1071, c. 101.-- O x a h :i c k a a il. f. Tpynu . A.'WI CCCP. 1931. t. 31. c. 23. .. ** - -If-/ /' V \ WV*VI M'UII I * 4 SPI -13017 Page 111 4--Toxicology Vol. 78,1973 67845 cancerous line. Corbon disulfide [75-15-01 formed during the decompn. of rdithnn is important in poisoning with this com|>d. In the absence of dithincnrlmmntes, edithon does not form ethylene thiourea |96-45-7| in the nnimnl, 67835c Experimental radmium poisoning. 2. Effect of protein and calcium deficiency in chronic cadmium rat poisoning. Abe, Tomoko; Tanaka, Seisukc; Itnknwa, Yoshinori (Doshisha Women's Coll., Kyoto. Japan). Nippon Elseigaku Zasshi 1972, 27(3), 308-15 (Japan). The av. body wt. of rats fed a low or high protein diet contg. cadmium (7440-43-9) was decreased as compared with controls. This body wt. loss was accompanied by cervicodorsal lordosis, dorsolumhar kyphosis and scoliosis. The Cd-fed rats also showed increased Cd levels and decreased magnesium (7439-95-4) and zinc (7440-66-6) levels in bones. Calcium (7440-70-2) levels in red muscle and white muscle was increased in the Cd-fed rats. The addn. of Ca to a hijh protein diet contg. Cd partially counteracted the toxicity of 67836f Chromosome breaking effect of a gasoline additive in cultured human lymphocytes. Soderman, Gunilla (Inst. Genet., Lund, Swed.). Hereditas 1972, 71(2), 335-8 (Eng). Trimethyl phosphate (512-56-1), a gasoline additive, added to cultured human lymphocytes increased the no. of cells with chromosome aberrations. Both the no. of cells with breaks and the no. of breaks/cell increased with increasing dose and exposure time. With the longer exposure time many cells with rearrangements were obsd., indicating that DNA repair takes place despite the presence of trimethyl phosphate. 67837g Cadmium-induced testicular injury and alteration* of androgen aynthesis in brook trout. Sangalang, G. B.; O'Halloran, M. J. (Fish. Res. Board Canada, Halifax, Nova Scotia). Nature (London) 1972, 240(5382), 470-1 (Eng). cin retention, was decreased in all the animals anesthetized, hut the least decrease was obsd. in animals pretrented with I-fICI, possibly because less CHCli was needed to maintain anesthesia in these animals. 67840c Effects of chemical irritants and tobacco smoke condensate on the chorioallantoic membrane of the fertile hen's egg. Comber, It.; Grasso, 1\ (Group Kes. Dev. Cent. Brit.-Am. Tob. Co., Ltd., Southampton, Engl.). Chem.-Biol Interactions 1973, 6(1), 25-34 (Eng). The effects of various materials on the chorioallantoic membrane of the 10-da\ incubated fertile hen's egg were studied. The materials producec thickening of the membrane in the following decreasing order o potency; croton oil, formaldehyde (50-00-0|, flue-cured tobacci smoke condensate, acetic acid (64-19-7), cigar tobacco smoke condensate, phenol [ 108-95-2), Na chloride (7647-14-5) carrageenan, coloidal silica, and glycerol (56-81-5). Histol. stud} indicated that croton oil and tobacco smoke condensate inducec local haemorrhage and necrosis, followed by hyperplasia. A tes procedure for comparing the irritant activity of tobacco smoke condensates was developed. The procedure involved measurin; the max. thickness of the membranes at 72 hr after application o the condensates. 67841d Effects of A'-tetrahydrocannabinol (A*-THC) anc DDT on the hepatic microsomal metabolism of A'-THC anc other compounds in the rat. Kupfer, David; Levin, Elan Burstein, Sumner H. (Worcester Found. Exp. Biol., Shrewsbury Mass.). Chem.-Biol. Interactions 1973, 6(1), 59-66 (Eng) (CH,)4M Ms Ms The exposure of the brook trout (Salvelinus fontinalis) to 25 ppb cadmium (7440-43-9) in 300 1. of fresh water for 24 hr induced hemorrhagic necrosis in the testis. Histol. examn. of the damaged tissues revealed that a large no. of erythrocytes were surrounding and invading the testis lobule. The testis prepn. from the fish exposed to Cd failed to produce ll-ketotestosterone (I) [564-35-2] from pregnenolone (145-13-1) in the incubation medium. The yields of 110-hydroxytestosteone [1816-85-9] and testosterone [58-22-0] were higher in the control than in the Cd-incubate. 67838h Antidotes for hexachlorobutadiene. Kurchatov, G. V. (USSR). Gig. Primen., Toksikol. Pestits. Klin. Otravl. 1971, No. 9, 264-8 (Russ). From Ref. Zh., Khim. 1972, Abstr. No. 91557. Unithiol (1) . (4076-02-2), mercaptide, and cysteine 152-90-41 when given hypodermically or intragastrically 20-30 min before the administration of hexachlorobutadiene (II) [87-68-3] and again right after the poisoning, in amts, comprising a 2-fola equimol. excess in relation to I, effectively reduced I intoxication. I analogs such as the 2,3-dimercaptopropane sulfonic acid amine salt (38555-04-3), especially mono- and diethanolamine salts were the most active. Their curative effect was evident with LDm doses of II (300 mg/kg) and also with a 90% LD dose of II. I and its JV-contg. analogs prevented the II-blockade of SH groups in proteins such as thiol enzymes and low-mol. wt. thio compds., by entering the reaction with its own SH groups and combining with the active centers of II. 67839J Effect of chloroform anesthesia on dog*. Dhillon, K. 8.; Paul, B. S. (Punjab Agric. Univ., Punjab, India). Indian J. Anim. Sci. 1972, 42(6), 450-2 (Eng). Hematol. parameters M //"K5 (CHjIjNKU, uch as blood clotting time and hematocrit percentage were not affected by the administration of chloroform [67-66-31 in oxygen (7782-44-7| or in a mixt. of O and nitrous oxide (10024-97-2) to dogs, or by the administration of CHCL in an O-NjO mixt. to animals premedicated with 0.2 mg oxymorphone-HCt (I-HCI) |357-C7-3)/kg, 2.2 mu triflupromazine-HCl (II-HCI) (1098-60-8)/= kg, or with a mixt. of I (0.1 mg/kg) and II (1.1 mg/kg). Except for changes in the heart rate, there was no other effect on the electrocardiogram. Liver efficiency, a* indicated by bromoaulfal= The i.p. administration of 25 mg A'-tetrahydrocannabinol (I) (1972-08-3)/kg/day for 9 days, or of 50 mg 1/kg/day for 3 days tc rats, or the oral administration of 50 mg I kg/day for 1 day and 36 mg I/kg/day on the subsequent 2 days, did not affect the in vitro hepatic microsomal demethylation of aminopurine (58-15-1) and p-chloro-N-methylaniline (932-96-7), or the oxidative metabolism of I-I4C. Similarly neg. effect was shown following the oral administration of a whole marihauna ext. The i.p. administration of 25 mg DDT [50-29-3]/kg/dav for 3 days increased about 2-fold the oxidative metab. of I, demonstrating that the microsomal oxidn. of I can be enhanced by an inducer of the monooxygenase system. 67842e Histological and histochemical changes in liver during experimental poly(vinyl chloride) pneumoconiosis. Cylwik. Bogdan (Akad. Med., Bialystok, Pol.). Rocz. Akad. Med. Bialymstoku 1972, 17, 93-111 (Pol). Hepatic changes such as clouding of the parenchyma, microfocal necrosis, and decreased glycogen [9005-79-2] and protein content were obsd. in rats exposed to 97 g PVC (9002-86-2) dust/mJ for 1-4 months. As the exposure time increased, inflammatory infiltration, hyperplasia of spurious ducts, and focal hyperplastic growth of reticular fibers appeared, and fatty degeneration was sometimes obsd. I. Kloczko 67843f Fibrogenic activity of aluminum and its compounds. Ligacz, Jerzy (Inst. Med. Pracy, Zabrze, Pol.). Med. Pr. 1972, 23(4), 349-55 (Pol). The i.p. administration of dusts contg. aluminum [7429-90-5] or A1 compds. induced peritoneal fibrosis in rats. The fibrogenic activity was correlated with the hemolytic activity of the compds., and the intensity of fibrogenesis decreased in the order Al, aluminum hydroxide (21645-51-2), aluminum acetate (139-12-8), and aluminum oxide (1344-28-1). J. Lange 67844g Leukocyte recruitment- through airway walls by condensed vegetable tannins and quercetin. Kilburn, Kaye H.; Lynn, William S.; Tres, Laura L.; McKenzie, Wayland N. (Med. Cent., Duke Univ., Durham, N. C.). Lab. Invest. 1973. 28(1), 55-9 (Eng). Polymorphonuclear leukocytes appeared beneath the basement membrane, between epithelial cells, and on luminal surfaces of the intrapulmonary airways and tracheas of hamsters and guinea pigs exposed for 4 hr to aerosols of crude and refined exts. of cotton mill trash, cotton mill dust, and quercetin (117-39-5), a polyphenolic monomer present in many vegetables. Intratracheal killing by fixation of the lungs of anesthetized exposed rodents using osmium tetroxide suspended in fluorocarbon (FC-80) kept the recruited cells on bronchial and tracheal surfaces while other fixatives did not retain them. This is suggested as a new rapid assay for inhalation toxic effects. 67845h Neurophysiological findings in chronic carbon disulfide poisoning. Descriptive study. Scppalainen, Anna Maija; Tolonen, Matti; Karli, Pauli; Hanninen, Helena; Hernberg, Sven (Inst. Occup. Health, Helsinki, Finland). Work, Environ., Health 1972, 9(2), 71-5 (Eng). Frequent occurence of an org. psychosyndrome and redn. of sensorimotor SPI -13018 5215 [No*. 1, 1073] PUBLIC HEALTH 51630-5)033 Sept. Anopheles varus. An. hyrennus, and An. suhplrtua arc highly toophlltc. The lsT2 of these species did noTBltc man during this work; a few An. subplctus bit man In the daytime. An. annularis. M. anrtulifcra, M. uniformts, C, gcltdus, and C. trttarntorhvnrhus showed zoophlly; they were more attracted to cows than man during this work. C. plptons fattenns and Ac. nrgyptl showed slight anthropophlly. Twenty species of resting mosquitoes were collected at night compared to only 14 species In the daytime. Number of mosquitoes collected per man-hr at night was approximately 50% higher than that collected In the daytime. Although C. trltacnlorhynchus feed mainly at night, a considerable number orthem fed in the daytime also. Ac. acgyptl and Ac. alboplctus were more active during the daytime. In Dacca C. plptons fatigans, C. tritaentorhynchus, Ac. acgyptl, and Ac. atboptetus arc likely to be tfiF Important species in the transmission of various mosquito-borne epidemic diseases.--R. L. K. inanimate See also: Food and Industrial Microbiology Soil Microbiology Toxicology - Foods, Food Residues, Additives and Preserva tives 51629. MORRIS, ALAN H. (U. S. Army Inst. Surg. Res., Brooke Army Med. Cent., Fort Sam Houston, Tex. 78234, USA.) Nebulizer contamination In a burn unit. AM REV RESPIR DIS 107(5): 802- BOB. Illus. 1973,--The degree of bacterial contamination of aerosol- generating equipment In use at the U. S. Army Institute of Surgical Research was assessed, and the effectiveness of a decontamination program recommended by the American Thoracic Society was demon-* strated. Before Institution of the decontamination procedure, bacteria * were recovered from 46'* of 382 specimens that were collected from the ncbuUzation chambers of equipment used on 15 patients. Of the specimens, 24% were contaminated with gram-negative organisms. Pseudomonas species represented 54% and Provldcncia stuartil 21% of the^gram-negatlve organisms cultured. After the introduction of a decontamination program, bacteria were recovered from only 3.6% of 612 specimens that were collected from the nebutization chambers of equipment used on 27 patients (P< 0.001). Aerosol-producing Inhala tion therapy equipment, a potential source of infection in a burn unit, can be maintained relatively free of bacterial contamination with an appropriate decontamination program. 51630. CHOI. DONG WIK (Dep. Parasitol., Kyungpook Natl. Untv. Sch. Med., Taegu, South Korea.) and SUP LEE. Incidence of para- sites found on vegetables collected from markets and vegetable gar- densln Taegu area. KOREAN J PARASITOL 10(1): 44-51. 1972. (Korean summ. J-- Parasitic eggs and larvae of humans were collected from lettuce (Lactuca satlva). young radishes (Raphanus sntlvus) and Chinese cabbage (Brassica pcklncnsis). The species of parasites and the approximate mean number of parasitic eggs ^200 g of washed vegetable leaves were investigated. Vegetables collected from markets showed 5 spp. of parasite eggs (ascarid, trlchurid. Trichostrongylus, ClonorcMs and hookworms) and 2 larvae (filariform and rhabditoid). A number of eggs and larvae of undetermined species were also observed. The percentage of ascarid eggs was 49.0%. Trichostrongy- lus eggs 18.or;, filariform larvae of hookworms 19.7% and rhabditoid larvae of hookworms 0.T?. Lettuce, young radishes and Chinese cabbage collected from markets showed a parasite level ranging from 23.2-91.9T;. In vegetable gardens, Chinese cabbage showed levels of 91,9%; lettuce showed 49.0'? positive levels of ascarid eggs. Filari form tarva was twice as high In Chinese cabbage then In lettuce and young radishes. Studies showed that washing vegetables significantly reduced the rate of filariform larvae. The mean number of ascarid egg'200 g of vegetable was 7.5 in young radishes, 3.1 In lettuce and 0.5 in Chinese cabbages.--J. L. S. ' were positive In 30, 44 and 53T of the cases respectively. The greatest number of eggs was found by the 2nd method. No tlnal pre- fcrcnce could be cstabltshcd.--N. L. G. 51833. MANGI. RICHARD J. (Dep. Intern. Med., Yale Unlv. Sch. Med., New Haven, Conn. 06510, USA.) and VINCENT T. ANDRIOLE. Contaminated .slelhosrnpes' A potential source of nosocomial Infec tions. YALE .1 HIOL MED 45(G): G00-604. 1972| reed. 19731.-Stcthoscopcs used by hospital personnel were evaluated as a potential source of pathogenic bacteria which might be responsible for bacterial spread to, and colonization of, hospital patients. The significant decline In bacterial colony count following simple swabbing of the head of a stethoscope with 70alcohol Indicates a solution to this potential danger. Organisms Isolated were Staphylococcus epldermldts, St. aureus, Escherichia coll, Erwtnla, Serratia, Klebsiella, Proteus vul garis, Pseudomonas aeruginosa, diphtheroid species. Bacillus spp., a-Strcptococeus, molds, streptomycetcs, Enterohactcr A and Entero- bactcr B.--J. E. F. DISINFECTION AND VECTOR CONTROL (Includes Pesticides) Set also: Disinfection, Disinfectants and Sterilization Ecology (Environmental Biology) - Animal, Wildlife Manage ment-Aquatic, Terrestrial ,, Economic Entomology (includes CheUcerata) - Animal Pests, ,, i . Chemical and Physical Control, General; Apparatus Food and Industrial Microbiology Invertebrate, Comparative and Experimental Morphology, Physiology and Pathology Parasitology (includes Ecto- and Endoparasites) Pest Control, General (Includes Plants and Animals); Pesti cides; Herbicides Public Health - Communicable Diseases, Disease Vectors, Epizoottology, Sewage Disposal and Sanitary Measures Toxicology - Food, Food Residues, Additives and Preserva tives 51634. NELSON, CARL L. and ALAN SETH GREENWALD. (Dep. Orthop. Surg., Clcvc. Clin., 9500 Euclid Ave., Cleveland. Ohio 44106, USA.) Clean air and total hip arthroplasty. CLEVE CLIN Q 39(3): 101-107. Illus. 1972,-- There is little data to prove that clean air systems In operating rooms reduce Infection. The system docs reli ably reduce bacterial contamination at the wound site. The absolute relationship between bacterial contamination and infection rate remains unanswered. The clean air system combined with rigid attention to tissue technique, careful preparation of the patient, control of activity in the operating room and insistence on reliable housekeeping has produced an infection rate of 5 deep wound Infections in more than 1000 total hip replacement arthroplasties.--F. W. ENVIRONMENTAL HEALTH AIR. WATER AND SOIL POLLUTION See also: Allergy Ecology (Environmental Biology) - Bioclimatology and Biometeorology, Limnology, Oceanography Economic Entomology (includes Cheltcerata) - Chemical and s. Physical Control, General; Apparatus Pest Control, General (includes Plants and Animals); Pesti cides; Herbicides Soil Microbiology Soil Science Toxicology 51631. LEDEDEVA, N. S. (All-Union Res. Inst. Railroad Hyg., Moscow, USSR.) O vozmozhnosti ispol'zovanlva fckal'nogo cntcrokokka r kachestvc sanitarno-pokazntcrnngo mlkroorganlzma v mcstnkb mnssovykh skoplcntl lvudcl. [possibility of using focal enternroert as a sanitary Indicator at places oi mass gatherings of people, j GIG SANIT i(l): 115-116. 1972.-- Isolation of fecal enterococci from surfaces, e.g., waiting-room benches, scats In railroad-car compart ments, drinking points In the station and cars, H2O faucets and toilet seats, revealed epldemiologlcally hazardous objects.--M. D. S. 51632. SAVCHENKO, L. P., F. I. BUTS and L. M. POPOVA. (Rostov Res. Inst. Med. Parasitol., Rostov-on-Don, USSR.) Sravnltel'naya otsenka cffcktlvnostl nekotorykh sanltarno-germlntologlchesklkh melodov isslcdovantya pochvy. (Comparative evaluation of the effcctlvrnms of some sanltary-hclmlnthologlcal methods for soil tudlr,.| MED PARA/lTOL I'ARA'/.IT IJOl.KZN 41(3): 303-364. 1^72.--Soli from mlrrofocl of Intensive ascarlasis and trlchoccphallals was tested by 3 methods: Vasllskll and Heftcr's, Hefter and Rodlonovli's, and, Luglna'a. The 1st required special apparatus and plankton filters, the 2nd required only an electric centrifuge, the 3rd required a plastic plate In addition to the centrifuge. The tests -- ^ 51G35. .IERNELOV, ARNE (Swed. Water Air Pollut. Res. Lab., 400 00 Gothenburg. Swed.). RUTGER ROSENBERG and SOREN JENSEN. Biological efforts and physical properties In the marine environment of aliphatic chlorinated bv-products from vlnvl chlorkU^prfvlurtion. WATER RES 6(10): 1181-1191. Illus. 1972,--A mixture o( shortchained aliphatic hydrocarbons, the so called EDC-tar, is formed as a byproduct from vinyl chloride production in quantities of about 75,000 tons annum"* in Northern Europe. Most of this is dumped Into the sea. In 1970, concentrations of EDC-tar from the North Sea were as high as 10% of that causing acute toxic effects on marine organisms. The behavior of some components of the EDC-tar in the marine environment was studied. Dumped Into the sea, E*DC*tar has a tendency to disperse and to adhere to particles. Acute toxicity of these Cl-C components, evaluated by LC50 48 hr tests, was about 2.5-9 ppm for some marine animals. Accumulation factors of between 10 and 3 x 103 were estimated for animals presented to EDC-contaminated sea water. Accumulation tn cod fed with EDC-conlammatcd shrimp was higher In liver than In muscle. Excretion was rapid when feeding was discontinued, and the biological half-lives of the Cl-C compounds were a few weeks. Sublcthal EDC*conccntrations`produced disorders In growth in the polyehaete Ophryotrocha labrontca and reduced swimming ability In the barnacle Pntnnus bnlanotdew, In Allium ccpa, c-mltotlc effects of EDC-tar were observed. SPI-13019 Obersichten }tsch. mcd. XCschr. 98 (1973), 2034-2037 <g) Ceorg Thicme VerUg, Stuttgart Dber die sogenannte Vinylchlorid-Krankheit S. juhe, C.-E. Lange, G. Stein und G.Veltman Uoivtnicacs-Hautklinik Bona (Dtrektori Prof. Dr. Leinbnxk). Seitdem 1958 erste Mitteilungen iiber gesundheitliche Schaden bei Arbeitern der Vinylchlorid(VC)-herstellenden Industrie (10) und 1963 iiber solche bei Arbeitern der PoIyvinylchlorid(PVC)-herstellenden Industrie (25) bekannt wurden, ist die Aufmerksamkeit durch weitere Berichte mehrfach auf diesen Zweig der chemiscben In dustrie gelenkt worden (3, 4, 7, 8, 12, 28). Es handelt slch dabei um ein in den Haut- und Knochenveranderungen sklerodermie-ahnliches, in Atiologie und Pathogenese ungekliirtes Krankheitsbild, als dessen Leitsymptome bisber Ravnaud-Syndrom, knotige bis flachenhafte dcrbe Htnttverandecungen und bandtbnnige Osceolysen der Fingerendphalangen galten. t)ber erste Beobachtungen dieses Krankheitsbildes in Deutschland konnten wir 1972 berichten (15, J.6, 17). Da das klinische Bild zunachst an eine Sonderform der progressiven Sklerodermie erinnerte, unterzogen wir alle Arbeiter einer sorgfaltigen internen Untersuchung, um zu klaren, ob auch hier eine viszerale Beteiligung vorhanden ist. Ober die bis Ende 1972 vorliegenden Ergebnisse, die fur die Beurteilung der Krankheit neue Aspekte erbffnen und -- wie wir glauben -- auch der weiteren Forschung neue Anregung geben diirften, haben wir hurziidi ausfiilulich beriuitet (IS). Hier sullen die \vesentlichsten Gesichtspunkte zusammenfassend dargestellt werden. Die von April bis Dezember 1972 untersuchten 13 Arbeiter waren 29 bis 52 Jahre alt (Durchschnittsalter 39 Jahre) und mindestens 2, langstens 18 Jahre (durchschnittlich 7 Jahre) in einem PVC-herstellenden Betrieb an wechselnden Arbeitsplatzen, iiberwiegend .jedoch als Autoklavenreiniger tatig. Erste Krankheitssymptome traten bei elf Patienten lVz bis 3V2 Jahre, bei zwei Patienten 7 und 11 Jahre nach Beschaftigur.gsbeginn auf. Symptome und Befunde Von den anammstischen Angaben sinu als haufigste Erstsymptome vermehrte Kalteempfindlichkeic an Handen und FuGen,Taubheitsgefiihl undKribbelpaxasthesien zu nennen. AuSerdem wurden Druckschmerz in einzelnen FTngerkuppen, Verdickung der Fingerendglieder undNagellockerung sowie Allgemeinbeschwerden wie scarke Miidigkeit, Verlangsamung und VergeGlichkeit, synkopenartiges Schwindelgefiihl, Obelkeit am Arbeitsplatz, vermehrtes Schwitzen und Oberbauchbeschwerden angegeben._ Eine wesentliche Rolle lcommt den Hautverandemngen in der Diagnostik-des Krankheitsbildes zu: Sieben Patienten wicseu tromnielsciilegeiauig verdickte Fiugerendphalangen auf (kolbige Auftreibung und Verkiirzung,Uhrglasnagcl, Verkiirzung der Nagelplatte):-Bei acht SPI -13020 Nr. 43, 2*. Oktober 1973. 9S. Jg. Jiihe u. Die *ogennntc Vinylchlorkl-Krankbcit Z035 SPI -13021 Patienten sahen wir sklerodermic-ahnliche Hautveran derungen: kleinknotige oder mehr plattenartige, sehr derbe, relativ schaif abgegrenzte, meist ernas liber das Hautnivcau erhabene Infiltrate an den Handstreckseiten, Knochenveriinderungen lassen sich verschiedeneSchweregrade unterscheiden: In leichteren Fallen ist nur eine schmale lytische Zone sichtbar, in fortgeschrittenem Sta dium ist der Phalangenschaft fast vollig zerstort, der :m distalen Drittel der Unterarmbeugeseite und im Processus unguicularis sitzt der Basis der Phalanx hau- Wangenbereich. Drei Patientcn hatten keine klinischen benformig auf. Eine vollige Restitution des Knochens ist Hautveranderungen. nach den bisherigen Befunden nicht zu erwarten (23, 24). Relativ uniform war der histologische Befund der von alien Patienten entnommenen Probeexzisionen (rechte oder linke Hand). Neben Hyperorthokeratose und Epidermisatrophie waren eine Erweiterung und Vermehrung der Kapillaren in der oberen Cutis, eine Vermehrung, Bemerkenswerterweise besteht eine feste Korrelation von Akroosteolysen und kolbiger Auftreibung der Endphalangen. Somit sind die Trommelschlegelfinger Ausdruck des lytischen Knodienprozesses und nicht Sym ptom einer internen Erkrankung. Verbreiterung und Homogenisierung der kollagenen Die Untersuchung des blutbildenden Systems und der Biindel und eine deutliche Rarefizierung und Fragmen .Blutgerinnung liel? uns auf einen bemerkenswerten Be tation der elastischen Fasem nachweisbar. Bei den Pa fund aufmerksam werden: Alle 13 Patienten wiesen eine tienten ohne klinische Hautveranderungen lieSen sich leichte bis erhebliche Thrombopenie auf. Die Thrombo- die gleichen Befunde an der Epidermis und an den Ge- zytenwerte lagen wiederholt zwischen 30 000 und faSen in der oberen Cutis nachweisen. Die histologischen 119000/pl (untere Normgrenze 150 000/(xl). Die zur Kla- Veranderungen an der Epidermis und dem kollagenen rung dieses Befundes bei sechs Patienten vorgenommene Bindegewebe erinnern an das odematose bis infiltrative Sternalpunktion ergab in keinem Fall I linweise auf eine Stadium der progressiven Slderodermie. Ihr gegeniiber 'Storung der Thrombozytopoese, eine Osteomyelofibrose ermoglichen aber die teils ganz erhebliche Schadigung oder -sklerose. Die iibrigen Untersuchungen zeigten bis der elastischen Fasem und die GefaSveranderungen eine auf eine leichte Retikulozytose bei acht Patienten (zwi eindeutige Abgrenzung. schen 16 und 26%o) und eine leichte Leukopenie bei fiinf Durchblutungsstorungen sind bisher das haufigste Patienten (2350 bis 3950 Leukozyten/pl) keine wesentli- Symptom: Neun der 13 Patienten klagten dariiber, acht chen Normabweicliungen. Retikulozytose und Leuko von ihnen gaben diese Beschwerden sogar als Erstsym- penie diirften durch die bei zwolf Patienten nachgewie- ptom an. Dabei reicht die Beschwerdeskala von ver- sene Splenomegalie bedingt sein. Niclit zu deuten ist starkter Kalteempfindlichkeit und Akrozyanose bis hin bisher die Thrombopenie, obwohl zu vermuten ist, dal? m Raynaud-Syndrom (vier Patienten). Die Durch- es sich um eine Umsatzstorung oder einen verstarkten eiutungsstorungen konnten mit Hilfe von Temperatur- Abbau in der Peripherie handelt. messung, Bestimmung der Wiedererwarmungszeit nach Kalteexposition, Kapillarmikroskopie und Arm-HandArteriographie objektiviert werden. Oszillographie und Plethysmographie ergaben bei keinem Untersuchten einen sicher pathologischen Befund, so dal? man wohl folgern kann, dal? die Ursache fiir die Durchblutungs storungen in der Peripherie und nicht im Bereich der grol?en GefaSe zu suchen ist. Diese Oberlegung wird gestiitzt durch die angiographischen und kapillarmikroskopischen Befunde: Bei vierPatienten mit Kalteempfindlich keit waren am Nagelfalz ampullenartige Erweiterungen der Kapillaren nachweisbar, wie sie beim Raynaud-Syn drom beschrieben wurden (14). Alle sieben arteriographierten Patienten wiesen pathologische GefaSbilder auf. Die Veranderungen reichten von leichter Einengung der Bei der Erhebung der Anamnese war bemerkenswert, dal? drei Patienten rezidivierende Schmerzen im linken Oberbauch angaben und ein Patient liber Schmerzen im rechten Oberbauch und Vpllegefiihl berichtete, friihere. Erkrankungen von Leber und Milz; langfristige Medikamenteneinnahme oder starker Alkoholgenul? jedoch nicht eruierbar war. Allerdings fanden sich bei drei Pa tienten ohne sklerodermie-artige Hautveranderungen und Akroosteolysen anamnestisch Hinweise auf eine chronische Lebererkrankung (Osophagusvarizenblutung, splenorenale Anastomose; portaler Hypertonus: Osophagusvarizen, Splenomegalie). DieBromsulfalein-Ketention war deutlich erhoht, dagegen waren die Werte fiir die SerumTransaminasen und -Phosphatasen im wesentlichen unauffallig. Diese Diskrepanz liel? sich auch bei den ubrieen A*4. ^lUl'udC ct CimiiuUlaU* iillt Vci> zehn Patienten nachweisen. Bei vier Patienten bestanden einzelt segmented lokalisierten bis zu hochgradigen Ste- Osophagusvarizen, bei zwolf war szindgraphisch eine nosen und segmentiiren Verschliissen, zum Teil sogar Splenomegalie nachweisbar. Die laparoskopischen tmd Fullungsausfall der Arterien auf der gesamten Finger- leberbioptischen Befunde, die uns bis Endc 1972 von fiinf. lange und deutlicher Stenosierung auch der Hohlhand- Patienten zur Verfiigung standen, zeigen eine auf- bogen. Nadi den bisherigen Untersuchungen sdieint eine fallige Obereinstimmung: Leberoberflache fein oder deut- direkte Beziehung zwischen der Expositionsdauer und lidi gewellt, Kapselfibrose, vermehrte Blut- und Lymph- dem AusmaS der GefaSschiidigung zu bestehen. gefaBzeichnung, histologisch eine leichte bis deutliche Auffalligster rontgenologiscber Befund dieser Krank,t sind bandformige Osteolysen zwischen Processus unguicularis undPhalangenschaft an einzelnen oder alien Fingern bei seeks Untersuchten. Zusatzlich konnten bei scchs Patienten Eragmentationcn und Randdefekte der Processus unguiculares fcstgestcllt werden. Audi bei den Fibrosicrung der Portalfelder und Einzelzellnekrosen, leichte grobtropfige Verfettung. Diese Befunde, die wir inzwischen weiter absichern konnten (19)-,"lassen uns folgende Vermutung aussprechen: Aul?er Icichten toxisdien Veranderungen an denLeberzellen kornnit csdurch Bindegewebsvermehrung in den portalen Feldem zu dif- 036 JGhe u. a.: Die sogenannre Vinylchlorid-Krankhcit Dmcxhe Mcdinaisdkc Wodkcntchrift fusen Durchblutungsstorungen in der Leber und in fortgeschrittenen Stadien zu einem intrahepatischen Block (wohl wegen des llindernisses in Ilohe der portalen Felder am ehesten als prasinusoidaler Block denkbar) mit Osophagusvarizen. Ob die Splenomegalie nur sekunJar bedingt ist oder ob diesem Befund aucb primar toxische Veriinderungen zugrunde liegen, bleibt noch zu kliiren. Bei tlberprufung der Lioigenfunktion (Anamnese, Rontgenuntersuchung, Ruhespirometiie, Ganzkorperplethysmographie, Blurgasanalyse) zeigten sich bei neun Patienten Hinweise auf vorwiegenJ restriktive Veranderungen, bei acht Patienten bestand eine Partialinsuffizienz. Ob diese Storungen darauf zuriickzufiihren sind, dafi sich an der Lunge ahnliche VeranJerungen abspielen wie am kollagenen und elastischen Bindegewebe der Haut, also eine beginnende diffuse Lungenfibrose zu grunde liegt, miissen weitere Untersuchungen zeigen. Der auslosende Faktor fiihrt bei den Arbeitcrn haufig zu bleierner Mudigkeit und kurzzeitiger Dcsorientiertheit; 3. aus den in den Polymerisatniederschlagen der Reaktorinnenwand enthaltenen Kavernen (5). Vom technischen Ablauf her bestunde also durchaus die Moglichkeit, dafi Vinylchlorid das hier eroitcrte Krankheitsbild auslost. Ober dieWirkungen desVinylchlorids auf denmenschlichen und tierischen Organismus ist bereits einiges gesichert. Seine narkotische Wirkung ist seit langem bekannt (22). Gber angioneurotische Storungen bis hin zum Raynaud-Syndrom bei Arbeitern der Vinylchloridherstellenden Industrie wurde seit 1958 wiederholt berichtet (1, 10, 21). Vereinzelt finden sich in der Literatur Hinweise auf Intoxikationen mit Vinylchlorid, wobei reversibles Schwindelgefiihl, leichte bis ausgepragte Benommenheit, Desorientiertheit, Hauterscheinungen wie bei einer Verbrennung zweiten Grades und verminderte Blutgerinnung als Symptome festgestellt wurden (6, 9, 11). Ein Arbeiter starb an den Vergiftungsfolgen. Es handelt sich um ein beruflidi bedingtes Krankheitsbild, dessen ffihrende Symptome (nach der Haufigkeit geordnet) Thrombopenie, Splenomegalie, ein toxischer Leberschaden, Ventilationsstorungen, Durchblutungs storungen, Haut- und Knochenveranderungen sind. Dieser Symptomkomplex ist keinem bisher bekannten Syn drom zuzuordnen. Atiologie und Pathogenese sind ungeklart. Gelingt es, durch Vergleich des bisher aus der Literatur Bekannten mit unseren Ergebnissen einen gewissen Einblick in Atiologie und Pathogenese zu gewinnen? Was ist als auslosender Faktor denkbar? Flfissiges Vinyldilorid polymerisiert nach Zugabe von Wasser und zahlreichen, nach den Eigenschaften des gewiinschten Kunststoffes untersdiiedlichen Additiven bei gleichzeitiger Druck- und Temperatursteigerung zu Polyvinylchlorid. UnabhangigvonderArtdcrZusatzstoffe wurden in verschiedenen Landern bei Autoklavenreinigern ein Raynaud-Syndrom und Akroosteolysen festge- stellt. Diese Symptome schienen so kennzeichnend, dafi sie in den letzten Jaliren zur Krankheitsbezeichnung be- rufsbedingte Akroosteolyse* fiihrten und zur Diagnose- stellung gefordert wurden (28). Es ist nicht anzunehmen, dafi die nach Herstellungsland und -verfahren verschie denen Additive eine wesentliche Rolle spielen.wenn auch ,.J* V\>rr*Vvn'-t,!.*Nn::vV-U'vJ*r ntcat*. schlossen werden kdnnen. Damit riickc das Vinyldilorid, die mengenmafiig am srarksten vertretene Substanz, in den Mittelpunkt des Interesses. Das Monomer Vinyl- chlorid wird zunachst fiber ein geschlossenes System in die Autoklaven gepumpt. Moglichkeiten des Gasaustrit- tes - und damit der Inhalation - bestehen jedoch innerhalb Jcs l'roduktiotisprozesses an mehreren Stellen: 1. Undichtigkeiten am Autoklaven (Zu- und Ableitungen) wahrend der Polymerisation und beim Rfickge- winnungsveifahren; 2. beim Ablassen und Offnen der Autoklaven sowie bcim Tr.)d.<nungsprozcl> Jcs fertigen Polyvinylchloride. Das Restgas besteht zu 90% aus Vinylchlorid (6) und Tierexperimentell konnten als Folge einer akuten Intoxikation mit Vinylchlorid Lungenodem, Blutstauung in Lunge, Leber und Niere sowie eine verminderte Blut gerinnung nachgewiesen werden (20). In Langzeitversuchen lieGen sich an der Leber zentrolobulare Degene ration und Nekrosen mit schaumiger Vakuolisierung sowie periportale zelligeInfiltration erzeugen(26). Jiingst wurde fiber Haut-, Lungen- und Knochentumoren und Storungen im Knochenaufbau berichtct (27). Diese tiercxperimentellen Befunde fiihrten dann 1970 erneut zu einer Senkung des MAK-(maximale Arbeitsplatzkonzentration-)Wertes auf nun 100 ppm (13). Ober regelmaGige Gaskonzentrationsmessungen am Arbeitsplatz ist uns bisher nichts bekanntgeworden. Die im Rahmen der geschilderten Krankheit angefuhrten Symptome: Raynaud-Syndrom, toxisdie Leberveranderungen, Storungen im Knochenaufbau und pranarkotisches Syndrom, sind also durch Vinylchlorid auslosbar, so dafi wir in Kenntnis der Arbeitsplatzverhaltnisse den dringenden Verdacht aufiern, dafi langfristige Vinylchlorid-Exposition zumindesr eine, wenn nicht sogar die krankheitsauslosende Ursache ist. Weil aufierdem das Kranheitsbild durch Mitbeteiligung zahlreicher Organe den Charakter einer Systemkrankheit erhalt und die Bczeichnung berufsbedingte Akroosteolyse nur auf ein fiir die Prognose sicher nicht entscheidendes Symptom ninweist, tiaben wir die Bezeidmung sogenannte Vinylchlorid-Krankheit vorgesdilagen. Pathogenese Die Pathogenese ist nach wie vor ungeklart. Aufbauend auf unseren Befunden sprechen wir aber die Vermutung aus, dafi der Krankheit als pat'nogenetisches Prinzip im weitescen Sinne eine Storung am Bindegewebe oder Gefiifibindegewebe zugrunde liegt. Fiir die Auffassung, dafi das toxische Agens nicht nur per inhalationem, sondern audi perkutan wirksam wifd, spricht die Tarsache, dafi nur unbekleidete Hauptpartien sklerodcrmie-artige Umwandlung zeigen und dafi die bandformigen Osteoiyscn SPI -13022 Ni. 43, 26. October 1973. 98. Jr. Jiihe u. a.: Die sugenannte Vinykhlorid-Krankheit nur an den Fingcrendphalangen gefunden wurden. Sowohl sklcrodermie-artige Hautveranderungen als auch wstcolyscn sahen wir nur bei Arbeircrn, die lang1.--ig mit dcr Autoklavenreinigung beschaftigt waren, was viclleichc dadurch erklart wird, dal? in Nahe der Autoklavenvvand 600-1000 ppm Vinylchlorid gemessen werden konnten (5). Als Hinweis auf eine zugrunde liegende Stoning am Bindegewebe sahen wir die qualitativen und quantitativen Veranderungen des kollagenen und elastischen Bindegewebes der Haut, die Vermehrung kollagcner Fasern in den portalen Feldern der Leber, die kapillarmikroskopisch und histologisch in der oberen Cutis sichtbare Vermehrung und Erweiterung der Kapillaren ebenso an wie die klinisch, angiographisch und thermographisch nachweisbaren peripheren Durchblutungsstorungen. Auch die Veranderungen am Knochen (Osteolysen als Folge trophischer Storung durch Schadigung der Vasa nutricia) und der Lunge (restriktive und obstruktive Ventilationsstorungen) konnten gleichsinnig gedeutet werden. Die Prognose der Krankheit in der Literatur bisher recht optimistisch beurteilt scheint uns im Hinblick auf Thrombopenie, Splenomegalie und portale Hypenension ernst, und auch hinsichtlich der Knochenveranderungen sollte sie nach unseren Bcobachtungen mit Zuriickhaltung gestellt werden. Konsequenzen fur die Praxis r' Trias Systemkrankheit, ernste Prognose und relativ .v__. Morbiditat (nach unseren Erhebungen bisher sicher mehr als 10%) uberwiegend junger Manner veranlaGt uns, folgende Forderungen aufzustellen: 1. Durchfiihrung epidemiologischer und praventivmedizinischer Untersuchungsreihen. Dabei reicht es unserer Ansicht nach nicht mehr aus, nur nach RayriaudSyndrom, knotigen Hautveranderungen und bandformigen Osteolysen zu fahnden, da diese Symptome - so charakteristisch sie sind - schon den fortgeschrittenen Erkrankungsgrad kennzeichnen. Vielmehr sollten au(?erdem in regelmaSigen Zeitabstanden bei alien Angehorigen der PVC-herstellenden Industrie Kontrollen der Thrombozytenzahl durchgefiihrt werden, um Arbeitcr mit einer konstanten Thrombopenie -- sie scheint das erste objektivierbare Symptom zu sein -- aus diesem Industriezweig herauszunehmen, ehe sich weitere schtverwiegende interne Befunde hinzugescllen. 2. Keine Einstellung von Arbeitern mit Leberkrankheiten oder Durchblutungsstorungen. 3. Regelmalsige Gaskonzentrationsmessungen an verschiedenen Arbeitsplatzen, um Oberschreitungen des MAK-Wertes zu vermeiden. Verfahrenstechnische Verbcsscrungen mit dem Ziel weitestgehender Automatisierung und Verbesserung der Beliittungsverhaltnisse, die Moglichkeiten einer Inhalation von Gasen auf vlindestmal? zu reduzieren. 4. Entschadigung schon erkrankter Arbeiter und Anerkennung dcr Krankheit als entschadigungspflichtige Berutskrankheit durch Aulnahme in die Liste zur BK.VO. 5. Tierexpcrimentelle Untersuchungen mit Vinylchlorid unter besonderer Beriicksichtigung von Haut, Knochen, Lunge, Leber und MiJz. Literatur (1) Anghelctcu, F. M. Otoiu, E. Dohrincscu, L. Hagiparaschiv-Dossios, G. Dobrincscu. V. Ganca: Cunsideratii clinico-patcgcnicc JMipra fcnomcnului Raynaud Jj muncitorii din indusrrta policlorurii dc vinil. Med. interna (Buc.) 21 (1569), 473. (2) Basalaev, A. V., A. N. Vazin, A. G. Kochetkov: On the pathogenesis of changes developing due to a long* term exposure to the effect of vinylchloride. Gig. Tr. prof. Zabol. 16 (1972), 24. (3) Chatelain, A., P, Motillon: Un syndrome d'acro-osteolyse d'origine professionelle ec dc consracion nouvelle en France. J. Radiol. Electro!. 48 (1967), 277. (4) Cordier, J. M., C. Fievez, M. J. Lefevre, A. Sevrin: Acroosteolyse ct lesions cutanees associees chez deux ouvriers affecres au nertoyage d'autoclaves. Cah. Med. Travail 4 (1966), 3. (5) Cook, W. A., P. M. Giever, B. D. Dinman, H. J. Magnuson: Occupational acroosteolysis. 11. An industrial hygiene srudy. Arch, environm. Hlth 22 (1971), 74. (6) Danziger, H.: Accidental poisoning by vinyl chloride. Canad. med. Assoc. J. *2 (I960), 828. (7) Dinman, B. D., W. A. Cook, W. M. Whitehouse, H. j. Magnuson: Occupational acroosteolysis. 1. An epidemiological study. Arch, environm. Hlth 22 (1971), 61. (8) Dodson, V. N., B. D. Dinman, W. M. Whitehouse, A. N. M. Nasr, H. J. Magnuson: Occupational acroo steolysis. HI. A clinical study. Arch, environm. HI* 22 (1971), 83. (9) Dublin, L. J., R. J. Vane: Occupa tional hazards and diagnostic science. Bulletin No. 582 (1933), Bulletin No. 41 (1941), U.S.A. Dept. Labor; zitiert in: Danziger (6). zirkulatton. Forschungsberichtc des Lan des Nordrhein-Westfalen, Nr. 1585 (Wcstdcutschcr Verlag: Koln 1966). (15) Jiihe, S.t G. Velrman: Zur Klinik dcr sog. Vinykhlorid-Krankheit 1. Inter nationales Symposium der Werksirzre der chemisdicn Industrie, 27. 4. 1972. (16) Juhe S., C.-E. Lange: Sklerodermiearrige Hautveranderungen, Raynaud* Syndrom und Akroosreolysen bei Arbeitern der PVC-herstellenden Industrie. Dtsch. med. Wschr. 97 (1972). 1922. (t7) Juhe S., C.-E. Lange, G. Srcin, G. Veltman: Zur Klinik dersog. Vinylchlorid-Krankhett. Jahrestagung Deutsche Gesellschaft fur Arbeitsmedizin, 26. 10. 1972. (18) Lange, C.-E., S. Jiihe, G. Stein, G. Veltman: Die sog. VinylchloridKrankheit - eine berufsbedingte System* sklerose? Int. Arch. Arbeitsmcd., im Drudc. (19) Large, C.-E., S. Juhe, H. J. Marsteiier, R. Muller, G. Veltman: Leberschaden im Rahmen der sog. Vinylchlorid-Krankheit. Jahrestagung Deut sche Gesells*afr fiir Arbeitsmedizin 18. 5. 1973. (20) Mastromatteo, E., A. M. Fisher, H. Christie, H. Danziger: Acute inha lation toxicity of vinyl chloride to laboratory animals. Amer. industr., Hyg. Ass. J. 21 (1960) 394; zitiert in: Malten, K. E., R. L. Zielhuis (ed.): Industrial Toxicology and Dermatology in the Production and Processing of Plastics (Elsevier: Amsterdam 1964). (21) O'Conner, R. B.: A new occupatio nal disease is born. J. occup. Med. 12 (1970), 234. (22) Peoples, A. S., C. D. Leake: The anesthetic action of vinly chloride. J. Pharmacol, exp. Ther. 48 (1933), 284. (23) Stein, G.> S. Jiihe, C.-E. Lange, G. Velrman: Bandformige Osteolysen in den Endphalangen des Handskeletts, Fortschr. Rontgenstr. 118 (1973), 60. (10) Filatova, V. S., L. }. Balakhonova, E. S. Gronsberg: Hygienic conditions in the production of vinyl chloride. Gig. Tr. prof. Z2bo! 1 (1958), 6; zitiert in Public Health Engin. Abstr. 40 (1960) No. 4, p. 6. (11) Harris, D. K.: Health problems in the manufacture and use of plastics. Brit. J. industr. Med. 10 (19 >3), 255; zitiert in: Malten, K. F., R. L Zielhuis (ed.): Industrial Toxicology and Derma tology in the F-oduction and Pracrs^in ot Plastics *Eisev:er: Amsterdam 1964), 143. (12) Harris, D. K., W. G. F. Adams: Aero-osteolysis occurring in men engaged in the polymerisation of vinyl chloride. Brit. med. J. 1967/3, 712. (13) Hcnschler, H. (Hrsg.): Cesundheitsschadlidie Arbeitsstoffe. Toxikologisch-arbeirsmedizinische Begriindung von MAK-Werten (Vcrlag Chcmie: Wcinheint 1972). (14) Jacoby, H.: Periphere Durchblu* tungskrankheiren im Spiegel der Mikro- (24) Stein, C., S. Jiihe, C.-E. Lange, G. Veltman: Skelettveranderungen bei der sog. Vinylchlorid-Krankheir. Rdnrgenpraxis, im Druck. (25) Suciu, 1., J. Drejman, M. Vataskai: Contribute la studiul imbolnaviritor produse de clorura dt vinil. Med. interna (Buc.) 15 (1963), 967. (26) Torkelson, T. R., F. Oyen, V. K. Rowe: The toxicity of vinyl chloride as determined by repeated exposure to laboratory ar.irmlj. Arr.cr. indust;, llyg. Ass. J. 22 (1961). 339; zit:crt in: Malten, K. E., R. L. Zielhuis (cd.): Industrial Toxicology and Dermatology in rhe Production and Processing of Plastics (Elsevier. Amsterdam 1964). (27)' Viola, P. L., A. Bigotri, A. Caputo: Oncogenic response of rar skin, lungs, and bones to vinyl chloride. Cancer Res. 31 (1971), 516. (28) \\ ilson, R. H., W. E. McCormick, C. F. Tatum, J. L. Crcedi: Occupational acroosteolysis. J. Amer. med. Ass. 201 (1967), 577. Dr. Susanne Jiihe, Dr. C.-E. Lange, Dr. G. Stein, Prof. Dr. G. Veltman UniversirHrs-Hnutklinik 53 Bonn 1, Venusberg SPI -13023