Epidemiological study of respiratory disease in workers exposed to polyvinylchloride dust.

Abstract

The respiratory health of workers exposed to polyvinylchloride (PVC) dust has been investigated in 818 men sampled from the work force of a factory manufacturing PVC. In a crosssectional survey, the lung function and prevalences of respiratory symptoms and chest radiographic abnormalities were compared with estimates of individual PVC dust exposures based o, detailed occupational histories and current measurements of respirable PVC dust. Complaints of slight exertional dyspnoea were associated with PVC dust exposure, though age and smoking effects were much stronger. The forced expired volume in one second (FEV,) and forced vital capacity (FVC) were inversely related to dust exposure after age, height, and smoking effects had been taken into account. This effect was seen principally in cigarette smokers, and there was suggestive evidence that PVC dust exposure and cigarette smoking interacted in the reduction of FEV, and FVC. Gas transfer factor was not related to dust exposure. The chest radiographs were read according to the ILO U/C classification by three experienced readers. One reader recorded a low prevalence of small rounded opacities, and these were not related to age or dust exposure. Another reader recorded a higher prevalence of small rounded opacities category 0/1 or more, and these were related to age but not to dust exposure. The third reader recorded the highest prevalence of small rounded opacities (though none greater than category 1/1), and these were independently related both to age and to PVC dust exposure, indicating an effect of PVC dust on the appearances of the chest radiograph. These appearances were so slight that only the higher sensitivity of this reader in the interpretation of profusion of small rounded opacities on the ILO U/C scale enabled detection of this effect of PVC dust. In conclusion, exposure to PVC dust is associated with some deterioration of lung function, slight abnormalities of the chest radiograph, and complaints of slight dyspnoea. The mean decline in FEVy associated with the average dust exposure experienced in the study was small, though some of the men with higher dust exposures may have suffered clinically important 1h)ss of lung function as a result of their occupation.

A mortality study of vinyl chloride monomer workers employed in the United Kingdom in 1940-1974.

“…Pos sible health effects of PVC dust have been the subject of a number of studies (2,15,16,21,26), although some doubt remain s as to whether the recorded changes in lun g function and radiographic app earance are indi cativ e of any increa se in respiratory disease.…”

Regression of polyvinylchloride polymer pneumoconiosis

“…Alternatively, we may Discussion Pulmonary reaction to polyvinylchloride poly-have documented an earlier stage or milder form of PVC pneumoconiosis, where macromer dust has been documented in epidemiological [2][3][4][5] and histological studies. [6][7][8] phage mediated fibrosis is limited and largely reversible.…”

Bronchitis in relation to work.

“…The results of this investigation showed no relationship between dust exposure indices and cough and sputum. But there was a positive relationship, most marked for current smokers, between breathlessness and dust exposure and, similarly, a negative relationship between forced expiratory volume in 1s (FEV,.,) and dust exposure (8). These relationships suggested the possibility of an interaction between cigarettes and polyvinyl chloride dust and caused the speculation that smokers may contaminate their cigarettes with polyvinyl chloride and thereby inhale pyrolysis products.…”