CLINICAL MANIFESTATIONS IN VINYL CHLORIDE POISONING

As civilization developed, man passed through the Stone Age, the Iron Age, and the Bronze Age. Now we are living in the Plastics Age. As supplies of iron, copper, lead, and other metals decrease, they are replaced mostly by plastics. The conquest of space and Mount Everest, the rapid development of industry, and the higher standard of hygiene and clothing would not have been possible without the development of the plastics industry. Plastics are obtained from salt, petroleum, wood, methane, gas, quartz, etc. Because our country possessed these raw materials, the plastics industry was developed and large plants were built. Simultaneously with the development of the plastics industry, studies for observing the health status of workers exposed to the new chemicals were initiated. There has been a rapid increase in the number of chemicals used, and we do not yet know all the adverse effects of these new chemicals. Some substances cause diseases in man which cannot be reproduced in animals, such as, arterial hypertension, Raynaud’s phenomenon, scleroderma, and gastricduodenal ulcer, and unfortunately, when animals are exposed to toxic substances, they cannot describe the onset and evolution of the disease. Plastics, as finished articles, are considered generally harmless. The problem is, to what extent do the monomers or substances used in the chemical industry determine acute or chronic effects in the human organism. In 1961, the study of clinical and biological manifestations in workers of two plants manufacturing vinyl chloride from acetylene and hydrochloric acid was begun. The workers were examined before the opening of the plant and then periodical examinations were performed. Some of them were admitted to the Clinic of Professional Diseases for ascertainment of the diagnosis. In the medical literature we consulted, we found few data on clinical and experimental effects of vinyl chloride. Mastromatteo er al.*” have shown that in a concentration of 10-30% vinyl chloride caused pulmonary, hepatic, and renal congestion in 5 rats, 5 mice, and 5 guinea pigs. Plesitzer et al.’ have shown that chronic exposure to vinyl chloride vapors causes toxic angioneurosis in man. Danishevsky and Egorov’ showed that the monomers react aggressively, causing destructive changes in the tegument and mucosa, some of which are allergenic. Tessier and Harvieux” described 17 cases of chemical dermatitis in 145 worken employed in the plastics industry. We wanted to follow up the workers exposed to vinyl chloride and other toxic substances in order to obtain a more complex clinical picture and to detect the bio-toxicologic effects of vinyl chloride. In addition to clinical and biochemical investigations, Prodan et al.n*” from our department studied experimentally the acute and chronic effects on various animals;