RESUMEN
OBJECTIVE: The objective of this investigation was to examine the health impact of and medical response to a mass casualty chemical incident caused by a vinyl chloride release. METHODS: Key staff at area hospitals were interviewed about communication during the response, the number of patients treated and care required, and lessons learned. Clinical information related to the incident and medical history were abstracted from hospital charts. RESULTS: Hospital interviews identified a desire for more thorough and timely incident-specific information and an under-utilization of regionally available resources. Two hundred fifty-six hospital visits (96.2%) were at the facility closest to the site of the derailment. Of 237 initial visits at which the patient was examined by a physician, 231 patients (97.5%) were treated in the emergency department (ED) and 6 patients (2.5%) were admitted; 5 admitted patients (83.3%) had preexisting medical conditions. Thirteen of 14 asymptomatic ED patients were children under the age of 10 years. One hundred forty-five patients (62.8%) discharged from the ED were diagnosed solely with exposure to vinyl chloride. CONCLUSIONS: Continuous emergency response planning might facilitate communication and better distribution of patient surge across hospitals. Individuals with multiple medical conditions and parents and caretakers of children may serve as target groups for risk communication following acute chemical releases. (Disaster Med Public Health Preparedness. 2017;11:538-544).
Asunto(s)
Servicios Médicos de Urgencia/métodos , Incidentes con Víctimas en Masa/estadística & datos numéricos , Cloruro de Vinilo/envenenamiento , Adolescente , Adulto , Anciano , Niño , Preescolar , Comunicación , Planificación en Desastres/métodos , Servicios Médicos de Urgencia/normas , Servicios Médicos de Urgencia/estadística & datos numéricos , Socorristas/psicología , Servicio de Urgencia en Hospital/organización & administración , Femenino , Personal de Salud/psicología , Humanos , Masculino , Persona de Mediana Edad , New Jersey , Cloruro de Vinilo/toxicidad , Recursos HumanosRESUMEN
OBJECTIVE: In 2012 in New Jersey, a train derailment resulted in the puncture of a tanker car carrying liquid vinyl chloride under pressure, and a resulting airborne vinyl chloride plume drifted onto the grounds of a nearby refinery. This report details the investigation of exposures and symptoms among refinery workers. DESIGN AND SETTING: The investigation team met with refinery workers to discuss their experience after the derailment and provided workers a self-administered survey to document symptoms and worker responses during the incident. Associations among categorical variables and experiencing symptoms were evaluated using Fisher's exact test. PARTICIPANTS: Twenty-six of 155 (17 percent) workers present at the refinery or driving on the access road the date the spill occurred completed the survey. MAIN OUTCOME MEASURE(S): Any self-reported symptom following exposure from the vinyl chloride release. RESULTS: Fifteen workers (58 percent) reported ≥1 symptom, most commonly headache (12, 46 percent). Three (12 percent) reported using respiratory protection. No differences in reporting symptoms were observed by location during the incident or by the building in which workers sheltered. Workers who moved from one shelter to another during the incident (ie, broke shelter) were more likely to report symptoms (Fisher's exact test, p=0.03); however, there are only limited data regarding vinyl chloride concentrations in shelters versus outside. CONCLUSIONS: Breaking shelter might result in greater exposures, and managers and health and safety officers of vulnerable facilities with limited physical access should consider developing robust shelter-in-place plans and alternate emergency egress plans. Workers should consider using respiratory protection if exiting a shelter is necessary during a chemical incident.
Asunto(s)
Accidentes de Trabajo , Liberación de Peligros Químicos , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/análisis , Cloruro de Vinilo/envenenamiento , Estudios Transversales , Femenino , Humanos , Masculino , New Jersey , Exposición Profesional/efectos adversos , Vías FérreasRESUMEN
OBJECTIVE: To evaluate the effects of polymorphisms in XRCC1 and APE1 genes on vinyl chloride (VC)-induced chromosomal damage in peripheral lymphocytes. METHODS: In this study, 317 workers occupationally exposed to VC were recruited from a factory in Shandong Province, China. The micronucleus (MN) frequency in peripheral lymphocytes was used as an indicator of chromosomal damage. Polymerase chain reaction-restriction fragment length polymorphism and created restriction site combined with restriction fragment length polymorphism were used to determine the five single nucleotide polymorphisms in XRCC1 and APE1 genes in the base excision repair pathway. The association of chromosomal damage with these polymorphisms and the haplotype of XRCC1 was analyzed using Poisson regression and PHASE 2.0.2. RESULTS: It was found that among the VC-exposed workers, individuals with XRCC1 polymorphisms (-77C/T, Arg194Trp, Arg280His, and Arg399Gln) had a significantly higher MN frequency than those with homozygous wild-type genotypes, with frequency ratios (FR) as follows, respectively: FR = 1.21, 95%CI: 1.05â¼1.39 (P < 0.05); FR = 1.14, 95%CI: 1.00â¼1.38 (P < 0.05); FR = 1.26, 95%CI: 1.11â¼1.44 (P < 0.05); FR = 1.23, 95%CI: 1.08â¼1.46 (P < 0.05). APE1 Asp148Glu was found of no significant relationship with MN frequency. Haplotype analysis of XRCC1 demonstrated that the MN frequencies in subjects with CTAA/CTAA and CCAA/CTAA were significantly higher than that in those with TCGG/TCGG (FR = 1.19, 95%CI: 1.02â¼1.32, P < 0.05; FR = 1.41, 95%CI: 1.02â¼1.87, P < 0.05). Furthermore, association was found between accumulated exposure to VC and XRCC1 polymorphisms (-77C/T, Arg194Trp, Arg280His, and Arg399Gln) after adjustment for age, sex, drinking, and smoking. CONCLUSION: VC can induce chromosomal damage even when the exposure level is lower than the national occupational health standard of China (PC-TWA: 10 mg/m(3)); the polymorphisms in XRCC1 and APE1 are associated with chromosomal damage induced by VC.
Asunto(s)
ADN-(Sitio Apurínico o Apirimidínico) Liasa/genética , Proteínas de Unión al ADN/genética , Exposición Profesional/efectos adversos , Polimorfismo de Longitud del Fragmento de Restricción , Cloruro de Vinilo/envenenamiento , Adulto , Femenino , Haplotipos , Humanos , Masculino , Micronúcleos con Defecto Cromosómico , Persona de Mediana Edad , Proteína 1 de Reparación por Escisión del Grupo de Complementación Cruzada de las Lesiones por Rayos X , Adulto JovenRESUMEN
Hepatotoxicity is the most common organ injury due to occupational and environmental exposures to industrial chemicals. A wide range of liver pathologies ranging from necrosis to cancer have been observed following chemical exposures both in humans and in animal models. Toxicant-associated fatty liver disease (TAFLD) is a recently named form of liver injury pathologically similar to alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD). Toxicant-associated steatohepatitis (TASH) is a more severe form of TAFLD characterized by hepatic steatosis, inflammatory infiltrate, and in some cases, fibrosis. While subjects with TASH have exposures to industrial chemicals, such as vinyl chloride, they do not have traditional risk factors for fatty liver such as significant alcohol consumption or obesity. Conventional biomarkers of hepatotoxicity including serum alanine aminotransferase activity may be normal in TASH, making screening problematic. This article examines selected chemical exposures associated with TAFLD in human subjects or animal models and concisely reviews the closely related NAFLD and ALD.
Asunto(s)
Hígado Graso/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Animales , Biomarcadores , Histocitoquímica , Humanos , Exposición Profesional/efectos adversos , Factores de Riesgo , Cloruro de Vinilo/envenenamiento , Cloruro de Vinilo/toxicidadAsunto(s)
Carcinógenos Ambientales/envenenamiento , Cloruro de Vinilo/análogos & derivados , Animales , Pruebas de Carcinogenicidad , Carcinógenos Ambientales/química , Carcinógenos Ambientales/toxicidad , Exposición a Riesgos Ambientales/efectos adversos , Humanos , Ratones , Estructura Molecular , Exposición Profesional/efectos adversos , Ratas , Cloruro de Vinilo/envenenamiento , Cloruro de Vinilo/toxicidadRESUMEN
El policloruro de vinilo (PVC) es el polímero que ocupa el tercer puesto en el mercado de producción de plásticos a nivel mundial. Como consecuencia de la exposición crónica, los operarios pueden desarrollar cambios óseos degenerativos, Raynaud, trastornos circulatorios en extremidades, trombocitopenia y lesiones cutáneas semejantes a esclerodermia; esto se conoce como enfermedad por cloruro de vinilo. Presentamos un paciente masculino de 24 años de edad que presenta fenómeno de Raynaud, cefaleas, malestar en manos y pies, sensación de frío, fatiga y pérdida de apetito asociado a exposición a policloruro de vinilo. El estudio de la microcirculación cutánea periungueal por videocapilaroscopía muestra alteraciones estructurales y funcionales características. Se recomienda un seguimiento multidisciplinario estricto de los trabajadores expuestos a PVC.
Asunto(s)
Humanos , Masculino , Adulto , Enfermedad de Raynaud/diagnóstico , Enfermedad de Raynaud/etiología , Enfermedad de Raynaud/inducido químicamente , Capilares/ultraestructura , Cloruro de Vinilo/envenenamiento , Compuestos de Vinilo/envenenamiento , Enfermedades Profesionales/etiología , Enfermedades Profesionales/inducido químicamente , Enfermedades Profesionales/patología , Microscopía , Uñas/irrigación sanguíneaRESUMEN
Two cases of angiosarcoma of the liver (ASL) are, to the best of our knowledge, the first literature reports of such cases identified among hairdressers and barbers who used hair sprays containing vinyl chloride (VC) as a propellant. The cases were exposed to VC aerosols between 1966 and 1973, for 4-5 year periods. Modeling indicates estimated peak levels of VC exposure ranging from 129 ppm to 1234 ppm, and average exposure ranging from 70 ppm to 1037 ppm, based upon assumptions of use and number of air exchanges per hour. As ASL is a sentinel cancer for exposure to VC, identification of these cases raises concern about the contribution of VC to hepatocellular carcinoma (HCC), a much more common type of liver cancer, as well as other VC-related cancers among hairdressers and barbers. Had manufacturers acted in a responsible manner, VC never would have been introduced as a propellant into consumer products such as hair sprays, pesticides, and paints.
Asunto(s)
Propelentes de Aerosoles/envenenamiento , Industria de la Belleza , Cosméticos/envenenamiento , Hemangiosarcoma/inducido químicamente , Neoplasias Hepáticas/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Cloruro de Vinilo/envenenamiento , Anciano , Resultado Fatal , Femenino , Humanos , Exposición por Inhalación/efectos adversos , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversosRESUMEN
OBJECTIVE: To study the relationship between expression of cytochrome P4502E1 (CYP2E1) in human lymphocytes, variant CYP2E1 genotype, exposure to vinyl chloride monomer (VCM), and liver abnormalities in VCM-exposed workers. METHODS: A case-control study was performed on 90 male occupationally exposed workers and 42 matched male nonexposed controls. Data were collected based on health surveillance, workplace investigation and questionnaire Survey. Total RNA and DNA were isolated from peripheral blood lymphocytes, and CYP2E1 mRNA expression was determined using RT-PCR, and the presence of CYP2E1 polymorphisms was identified based on PCR-RFLP. RESULTS: The mRNA expression of CYP2E1 in exposed workers (0.89+/-0.46) was significantly higher than in nonexposed controls (0.61+/-0.35) (P < 0.01). Logistic regression analysis demonstrated a statistically significant association between CYP2E1 mRNA expression levels and liver abnormalities in the VCM-exposed workers (OR = 3.66, P < 0.05). The genotype frequency for CYP2E1 variants among VCM-exposed workers was not significantly different between workers with liver abnormalities and those without. CONCLUSIONS: Liver abnormalities in subjects exposed to VCM are positively associated with expression of peripheral blood lymphocyte mRNA, which is significantly increased in exposed workers compared to nonexposed controls. Therefore, CYP2E1 mRNA levels may be useful for health surveillance and protection of VCM-exposed workers.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Citocromo P-450 CYP2E1/genética , Linfocitos/efectos de los fármacos , ARN Mensajero/biosíntesis , Cloruro de Vinilo/envenenamiento , Adulto , Estudios de Casos y Controles , China , Citocromo P-450 CYP2E1/biosíntesis , Citocromo P-450 CYP2E1/sangre , Humanos , Hepatopatías/sangre , Hepatopatías/enzimología , Hepatopatías/patología , Linfocitos/enzimología , Linfocitos/fisiología , Masculino , Exposición Profesional/efectos adversos , Polimorfismo Genético , ARN Mensajero/sangreRESUMEN
OBJECTIVES: The purpose of this study was to examine whether polymorphisms in the XRCC1 DNA-repair protein can affect the base excision repair capacity to remove etheno-DNA adducts induced by vinyl chloride exposure that account for the occurrence of mutant biomarkers of effect seen in exposed workers. MATERIALS AND METHODS: Using polymerase chain reaction-restriction fragment length polymorphism and fluorescence polarization techniques, we examined the effect of three x-ray cross complementing-1 protein polymorphisms, at codons 194, 280 and 399, on the occurrence of mutant biomarkers in ras-p21 and p53 induced by vinyl chloride exposure in a cohort of 211 French vinyl chloride workers to correlate differences in genotype with differences in the presence of these biomarkers. Also, cell cultures of lymphoblast lines from a pair of individuals, one homozygous wild-type and one homozygous variant for the codon 399 polymorphism, were exposed to the reactive intermediate of vinyl chloride, and, using an enzyme-linked immunosorbent assay, levels of etheno-DNA adducts generated and repaired were measured and compared. RESULTS: After adjusting for age, smoking, alcohol drinking and cumulative vinyl chloride exposure, compared to workers who were homozygous wild-type for all alleles, the odds ratio for the presence of either biomarker increased to 2.0 (95% CI: 1.0-3.9) for workers with any one variant allele and to 2.4 (95% CI: 1.1-5.2) for workers with more than one variant allele. Data from the cell culture experiments indicating that repair of etheno-DNA adducts is considerably better in wild-type cells compared to polymorphic cells were supportive of the epidemiologic results. CONCLUSIONS: This study provides further evidence that polymorphisms in XRCC1 can be an important biomarker of susceptibility in populations exposed to agents that produce damage removed by base excision repair.
Asunto(s)
Aductos de ADN/genética , Reparación del ADN , Proteínas de Unión al ADN/genética , Polimorfismo Genético , Cloruro de Vinilo/envenenamiento , Adulto , Anciano , Codón/genética , Estudios de Cohortes , Daño del ADN , Francia , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Cloruro de Vinilo/metabolismo , Proteína 1 de Reparación por Escisión del Grupo de Complementación Cruzada de las Lesiones por Rayos XRESUMEN
OBJECTIVE: To investigate liver function in vinyl chloride workers and assess its relation with current/past occupational exposure to vinyl chloride monomer (VCM). METHODS: A medical examination including the execution of liver function tests (LFTs) and liver ultrasonography was executed in a group of 757 workers with a long-standing service in the production of VCM/polyvinylchloride (PVC). Cumulative and maximum VCM exposures were calculated. History of viral hepatitis and alcohol intake were carefully investigated. Regression analysis explored the association between abnormal LFTs and a group of possible determinants (VCM cumulative and maximum exposure, BMI, age, history of viral hepatitis, alcohol and triglyceride levels). Also, synergistic effect between VCM and a history of hepatitis was analysed, as well as the possible association between VCM exposure and aspartate aminotransferase/alanine amino transferase (AST/ALT) ratio >1. Distribution of abnormal LFTs was also assessed in relation to the results provided by liver ultrasonography. RESULTS: The most frequently abnormal serum parameters were, in decreasing order: total cholesterol (27.3%), triglycerides (12.2%), total bilirubin (9.1%), gamma glutamil transpeptidase (GGT; 9.0%) and ALT (8.2%). The AST/ALT ratio >1 was present in 28.1% of workers. Abnormal LFTs were not found to be associated with current or past VCM exposure. High ALT resulted positively associated with BMI, AST with alcohol intake, GGT with alcohol intake and triglycerides. No synergistic effect on LFTs of exposure to VCM and a history of hepatitis was observed. The AST/ALT ratio >1 was not found to be associated with VCM exposure. The prevalence of abnormal LFTs was higher in case of liver steatosis (ALT) or periportal fibrosis (GGT), but not in case of pure hepatomegaly, as documented by ultrasonography. CONCLUSIONS: Liver function assessment only including LFTs is not able to detect VCM-induced liver damage, but reveals alterations due to non-occupational factors, such as dietary and/or metabolic disfunctions. The LFTs are however of importance to detect conditions that could recommend avoidance of exposure to VCM and are useful for medical counselling and health promotion purposes.
Asunto(s)
Pruebas de Función Hepática/métodos , Hígado/fisiopatología , Exposición Profesional , Cloruro de Vinilo/envenenamiento , Adulto , Femenino , Humanos , Italia , Hígado/diagnóstico por imagen , Hígado/metabolismo , Masculino , Persona de Mediana Edad , UltrasonografíaAsunto(s)
Neoplasias/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Cloruro de Vinilo/envenenamiento , Hemangiosarcoma/inducido químicamente , Hemangiosarcoma/epidemiología , Humanos , Neoplasias Hepáticas/inducido químicamente , Neoplasias Hepáticas/epidemiología , Metaanálisis como Asunto , Neoplasias/mortalidadRESUMEN
We have recently demonstrated a significant dose-response relationship between vinyl chloride exposure and mutant p53 biomarkers in humans. The aim of this study was to examine a common polymorphism in the DNA repair gene XRCC1 as a potential biomarker of susceptibility modifying this relationship, consistent with the known mechanism of production of p53 mutations via vinyl chloride-induced etheno-DNA adducts, which are repaired by XRCC1. A cohort of 211 French vinyl chloride workers were genotyped for the XRCC1 codon 399 polymorphism (CGG>CAG; Arg>Gln). Among the homozygous Arg-Arg individuals, 34% were biomarker positive compared with 47% in the heterozygous Arg-Gln individuals (adjusted odds ratio 1.73, 95% CI0.93-3.22) and 66% in the homozygous Gln-Gln individuals (adjusted odds ratio 3.95, 95% CI 1.68-9.28), with a significant trend for increasing Gln allele dosage (p=0.002). These preliminary results suggest that a common polymorphism in a DNA repair gene can be an important biomarker of susceptibility for chemically induced genetic damage.
Asunto(s)
Daño del ADN/genética , Proteínas de Unión al ADN/genética , Exposición Profesional/efectos adversos , Cloruro de Vinilo/envenenamiento , Adulto , Anciano , Alelos , Estudios de Cohortes , Citocromo P-450 CYP2E1/genética , Reparación del ADN , Genes p53/efectos de los fármacos , Genes p53/genética , Marcadores Genéticos/genética , Predisposición Genética a la Enfermedad/genética , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Polimorfismo Genético , Proteína 1 de Reparación por Escisión del Grupo de Complementación Cruzada de las Lesiones por Rayos XRESUMEN
Occupational exposure to vinyl chloride (VC) is causally related to liver angiosarcoma, whereas there is inconsistent epidemiologic evidence for other neoplasms. Two pooled analyses of worker cohorts from 56 plants in North America and Europe provide the most comprehensive and updated data on cancer risk among workers exposed to VC. These included over 22,000 workers, with a total of 640,000 person-years of observation, followed-up for up to 50 years. Overall, a total of 1,778 cancer deaths were observed versus 1,829.46 expected, corresponding to a standardized mortality ratio (SMR) of 0.97 (95% confidence interval (CI)=0.93-1.02). Excluding 71 confirmed angiosarcomas, there were 60 deaths from liver cancers versus 44.35 expected (SMR=1.35, 95% CI=1.03-1.74). Lung and laryngeal cancer mortality were significantly lower than expected (SMR=0.88 and 0.59, respectively). The SMRs for soft tissue sarcoma, brain, lymphoid and haematopoietic system cancers were not materially different from unity. Thus, the aggregate data from over 20,000 VC workers in North America and Europe exclude any excess mortality from lung, laryngeal, soft tissue sarcoma, brain, lymphoid and haematopoietic neoplasms. There appears to be a slight excess of liver cancer other than angiosarcoma, which is difficult to interpret and is likely due to residual misclassification of angiosarcomas.
Asunto(s)
Hemangiosarcoma/etiología , Neoplasias Hepáticas/etiología , Exposición Profesional , Cloruro de Vinilo/envenenamiento , Estudios de Cohortes , Estudios Epidemiológicos , Europa (Continente)/epidemiología , Hemangiosarcoma/mortalidad , Humanos , Neoplasias Hepáticas/mortalidad , Neoplasias/etiología , Neoplasias/mortalidad , América del Norte/epidemiología , Oportunidad Relativa , Factores de RiesgoRESUMEN
OBJECTIVE: A meta-analysis was made of studies addressing occupational exposure to vinyl chloride in relation to cancer mortality. METHODS: Two recently updated multicenter cohort studies and six smaller studies were identified. For selected neoplasms, standardized mortality ratios (SMR) and 95% confidence intervals (95% CI) were abstracted (or calculated from raw data). In cases of lack of heterogeneity (P-value > or = 0.01), meta-analyses were conducted using a random-effects model. RESULTS: With SMR values ranging from 1.63 to 57.1, all six studies for which these ratios could be obtained suggested an increased risk of liver cancer. For four of these studies, excesses persisted when known cases of angiosarcoma of the liver (ASL) were excluded. The meta-SMR for liver cancers other than ASL (based on the 2 large cohorts) was 1.35 (95% CI 1.04-1.77). The meta-SMR for lung cancer was 0.90 (95% CI 0.77-1.00, based on 5 studies), although higher SMR values were reported in early studies. The meta-SMR for brain cancer, based on 5 studies, was 1.26 (95% CI 0.98-1.62). For soft tissue sarcomas, the meta-SMR based on 4 studies was 2.52 (95% CI 1.56-4.07). The meta-SMR for lymphatic and hematopoietic neoplasms in the 2 large studies was 0.90 (95% CI 0.75-1.01), although 3 of the smaller studies reported significant excesses. CONCLUSIONS: Apart from the known risk of ASL, workers exposed to vinyl chloride may experience an increased risk of hepatocellular carcinoma and soft-tissue sarcoma; however, these results may have been influenced by the underdiagnosis of true ASL. Increased mortality from lung and brain cancers and from lymphatic and hematopoietic neoplasms cannot be excluded; mortality from other neoplasms does not appear to be increased.
Asunto(s)
Neoplasias/inducido químicamente , Neoplasias/mortalidad , Enfermedades Profesionales/inducido químicamente , Enfermedades Profesionales/mortalidad , Exposición Profesional/efectos adversos , Cloruro de Vinilo/envenenamiento , Humanos , Factores de Riesgo , Factores de TiempoRESUMEN
Individuals who lived near 2 electronic manufacturing plants were exposed to odorous chlorinated solvents by inhalation (directly) and by out gassing from well water. An exposure zone was defined by concentrations of trichloroethylene, 1,1,1-trichloroethane, tetrachloroethylene, and vinyl chloride in groundwater. The author adopted trichloroethylene as a "shorthand" for the exposure designation. Residents complained of impaired recall and concentration, and of dizziness; therefore, the focus of this investigation was brain functions. Neurobehavioral functions, Profile of Mood States, frequencies of 35 symptoms, and questionnaire responses provided by 236 residents from exposure zones were compared with responses provided by 161 unexposed regional referents and by 67 Phoenix residents who lived outside the exposure zone areas. Pulmonary functions were measured with spirometry. Residents of the exposure zones were compared with regional referents, and the former had significantly (p < .05) delayed simple and choice reaction times, impaired balance, delayed blink reflex latency R-1, and abnormal color discrimination. In addition, these individuals had impaired (1) cognitive functions, (2) attention and perceptual motor speed, and (3) recall. Individuals who lived in exposure zones had airway obstructions. Adverse mood state scores and frequencies of 33 of 35 symptoms were elevated. In conclusion, individuals who lived in the exposure zones had neurobehavioral impairments, reduced pulmonary functions, elevated Profile of Mood State scores, and excessive symptom frequencies.
Asunto(s)
Exposición a Riesgos Ambientales/efectos adversos , Exposición por Inhalación/efectos adversos , Síndromes de Neurotoxicidad/etiología , Solventes/envenenamiento , Tricloroetileno/envenenamiento , Contaminantes Químicos del Agua/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Arizona/epidemiología , Estudios de Casos y Controles , Causalidad , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Monitoreo Epidemiológico , Volumen Espiratorio Forzado/efectos de los fármacos , Humanos , Exposición por Inhalación/análisis , Persona de Mediana Edad , Pruebas Neuropsicológicas , Síndromes de Neurotoxicidad/diagnóstico , Síndromes de Neurotoxicidad/epidemiología , Características de la Residencia , Solventes/análisis , Encuestas y Cuestionarios , Tetracloroetileno/análisis , Tetracloroetileno/envenenamiento , Tricloroetanos/análisis , Tricloroetanos/envenenamiento , Tricloroetileno/análisis , Salud Urbana , Cloruro de Vinilo/análisis , Cloruro de Vinilo/envenenamiento , Capacidad Vital/efectos de los fármacos , Contaminantes Químicos del Agua/análisisRESUMEN
Travelling from Belgium to the BUNA works in Schkopau, ten of eighteen tank wagons filled with vinyl chloride (VC) derailed on the Magdeburg-Halle railway line just outside Schönebeck station. One wagon exploded and four others went up in flames. Buildings and trees in gardens located in the immediate vicinity of the track caught fire and burned. Four owners of garden plots suffered burns. A total of 28 people received inpatient treatment in a nearby hospital, another 268 people were treated as outpatients. The typical symptoms of fume poisoning such as headache, nausea, irritations of respiratory tract and eyes were the primarily diagnosed problems. The vegetation was damaged by flue gases and developing HCl causing fire and caustic burns. Fire brigades and special task forces succeeded to control the looming danger of health and environmental hazards by cooling the burning wagons and pumping the liquid gases from the tank wagons. Vinyl chloride which was released over several days was measured in residential areas to be 0.06-8 ml/m3 air. Vinyl chloride is a gas which is heavier than air. When exposed to light it will be degraded within a few days. A technical guide concentration of 3 ml/m3 air has been adopted for its cancerogenic potential. Dioxin values measured in soils and plants were in the natural range of 20 ng I-TE/kg DS. These values increased to 8300 ng at the very seat of the fire only. With the water used for fire fighting vinyl chloride penetrated into the groundwater revealing values of up to 73 mg/litre. A total of 292 urine samples taken from patients and members of the rescue forces, residents and a control group were tested for their contents of the VC metabolite thiodiacetic acid. However, this number does not allow to draw any conclusions with regard to a potential increase in the risk of cancer. With 0.27, 0.43 and 0.37 mg/litre of urine, the mean values are in the normal range for unexposed people. Only three cases showing values of up to 3.1 mg/litre indicated that a real exposure had taken place. The environmental and health authorities have evaluated the results of the measurements at site. They had set up a consultancy service and were integrated in civil forums. When the project "Extension of the vinyl chloride plant" for PVC production at Buna Sow Leuna Olefinverbund GmbH will be completed, deliveries of vinyl chloride by rail and road will be unnecessary in future. However, the problem of transporting dangerous goods and a complex training of task forces will continue to be of topical importance.
Asunto(s)
Accidentes de Tránsito , Carcinógenos , Contaminación Ambiental , Explosiones , Incendios , Vías Férreas , Cloruro de Vinilo/envenenamiento , Carcinógenos/análisis , Monitoreo del Ambiente , Contaminación Ambiental/análisis , Alemania , Humanos , Cloruro de Vinilo/análisisRESUMEN
We investigated the effects of vinyl chloride monomer exposure on the liver of 86 workers by measuring beta-glucuronidase, arylsulfatase A, adenosine deaminase, 5'-nucleotidase and routine liver function enzymes in the sera of the workers. In 21 of them, three or more of these parameters were raised, with a significant decrease in the level of blood glutathione and a significant increase in the enzyme activity level of glutathione S-transferase. Of these 21 workers, 14 had fatty liver infiltration, 8 of whom were also suffering from liver enlargement. Also, 4 workers had liver enlargement without fatty infiltration and 3 had enlarged spleens. The study highlights the need for vigilance in environmental monitoring and medical surveillance of workers exposed to this chemical.
Asunto(s)
Carcinógenos , Hígado Graso/inducido químicamente , Hepatomegalia/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Esplenomegalia/inducido químicamente , Cloruro de Vinilo/envenenamiento , 5'-Nucleotidasa/sangre , Adenosina Desaminasa/sangre , Adulto , Estudios de Casos y Controles , Cerebrósido Sulfatasa/sangre , Egipto , Monitoreo del Ambiente , Hígado Graso/diagnóstico , Hígado Graso/enzimología , Hígado Graso/prevención & control , Glucuronidasa/sangre , Glutatión Transferasa/sangre , Hepatomegalia/diagnóstico , Hepatomegalia/enzimología , Hepatomegalia/prevención & control , Humanos , Pruebas de Función Hepática , Masculino , Evaluación de Necesidades , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/enzimología , Enfermedades Profesionales/prevención & control , Exposición Profesional/análisis , Salud Laboral , Esplenomegalia/diagnóstico , Esplenomegalia/enzimología , Esplenomegalia/prevención & controlRESUMEN
The chromosomal aberration assay with peripheral blood lymphocytes has been used routinely during the last three decades to survey exposure of humans to various genotoxic agents. A large number of biomonitoring studies are based on this genetic endpoint. A great deal of data exists on occupational, life-style or medical exposure situations but less evidence of the validity of the assay is available with regards to environmental exposure. In the present paper we report our investigations on the impact of pollution in two different populations using chromosomal aberrations in human peripheral blood lymphocytes as a biomarker of chronic exposure to heavy metals and dioxins/furans for a long period and as a biomarker of acute exposure to accidentally released vinyl chloride in the air. In order to study genotoxic effects (chromosomal aberrations) of heavy metals and dioxins/furans, 52 exposed individuals from a polluted area were compared to 51 matched controls from a distant non-industrialized area. A statistically significant increase was observed in the frequency of chromosomal aberrations in peripheral blood lymphocytes from the exposed population (1.90% aberrant cells vs. 1.11% for the controls). In the case of the vinyl chloride accident, chromosomal aberrations were analyzed in peripheral blood lymphocytes from 29 potentially exposed and 29 non-exposed individuals (matched controls). The exposed group showed a statistically significant increase in the frequency of aberrant cells (1.47% vs. 1.07% for the controls).
Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Aberraciones Cromosómicas , Cromosomas Humanos/efectos de los fármacos , Exposición a Riesgos Ambientales/efectos adversos , Accidentes de Trabajo , Adulto , Biomarcadores , Recuento de Células , Daño del ADN , Dioxinas/efectos adversos , Monitoreo del Ambiente , Femenino , Furanos/efectos adversos , Alemania , Humanos , Linfocitos/citología , Linfocitos/efectos de los fármacos , Masculino , Metales Pesados/efectos adversos , Persona de Mediana Edad , Cloruro de Vinilo/envenenamientoRESUMEN
In order to explore the specificity of serum bile acid (SBA) chromatograph in the diagnoses of different kinds of hepatosis, we investigated by means of gas chromatography the changes of serum bile acids in workers who exposed to hexogen or chloroethylene and in patients who suffered from hepatosis such as acute jaundice hepatitis, chronic active hepatitis, cirrhosis and liver cancer. The results revealed different disturbances of SBA occurring in the liver injuries induced by the two kinds of hepatotoxicant. Serum lithocholic acid (LCA), deoxycholic acid (DCA) and chenodeoxycholic acid (CDCA) in workers exposed to hexogen and wre significantly different from those of the control group respectively (P < 0.01, P < 0.01, P < 0.05); on the other hand, only serum LCA and DCA went up in workers exposed to chloroethylene (P < 0.0005, P < 0.001). The main changes both concentrated on the secondary bile acids. In acute jaundice hepatitis, chronic active hepatitis, cirrhosis and liver cancer, serum LCA, DCA, CDCA and cholic acids (CA) all went up in different degrees compared with the control group respectively (P < 0.005, P < 0.025, P < 0.005, P < 0.005). But no difference was noted among the 4 kinds of bile acids (P > 0.5), except that between CA and CDCA. These provided the evidence of the diagnosis and identification of clinical hepato-biliary diseases and occupational liver injures.