Chromosome investigations of workers exposed to cadmium in the manufacturing of cadmium stabilizers and pigments.

Chromosome analyses were undertaken on 14 workers exposed to cadmium and the results were compared with a corresponding control group. All probands have been employed for many years in cadmium pigment and stabilizer production plants (between 6 and 25 years). The results of the clinical investigations were, for the most part, unspecific, although at the same time some parameters were above the normal (transaminase, beta 2-microglobulin deposit in the urine, as well as cadmium in the blood and urine). The chromosome analyses were undertaken on the lymphocytes of the peripheral blood with the aid of the so-called "micromethod." Metaphases, 150 per person, were analyzed. The statistical evaluation was made according to the Fisher-Yates test. The chromosome aberration rate of the group investigated was not higher than that of the control group, inclusive and exclusive of gaps.

Mutagenicity study of workers exposed to alkylene oxides (ethylene oxide/propylene oxide) and derivatives.

Employees of plants where alkylene oxide is manufactured or processed were subjected to mutagenicity studies carried out on lymphocyte cultures in accordance with the methods of Moorhead at al, de Jong and Anders. The employees were divided into four groups, according to their periods of exposure: (1) Long-term exposure for more than 20 years; (2) exposure for less than 20 years; (3) long-term exposure and accident (ethylene oxide inhalation or skin contact); and (4) accident, i.e., brief high exposure to ethylene oxide. Measurement of the concentrations in various sections of the plant yielded values of up to 3 ppm under conditions of normal operation. However, this figure rose briefly to 1900 ppm under plant breakdown hat workers were subjected to higher exposure in the past. One hundred metaphases per person were analyzed for chromosome aberrations. The results are given in Tables 1 through 4. A significant increase in the aberration rate was found only in employees in Group 1. This was confirmed by a control examination carried out one year later. The employees of groups 2, 3 and 4 displayed no significant increases. However, in evaluating these findings, it should be noted that the employees had been in contact with a wide range of substances and products in the course of their occupation, which means that the increased aberrations rate found cannot be attributed unequivocally to exposure to a particular substance.

[Severe side-effects of treatment with D-penicillamine (author's transl)]. / Schwere Nebenwirkungen bei der Therapie mit D-Penicillamin

In a 53-year-old woman an acute allergic thrombocytopenia (acute Werlhf's disease) occurred after treatment with D-penicillamine for one month which led to death. In two further patients transitory platelet deficiencies were observed after six and two months which regressed completely in six months and four weeks, respectively. One of the patients had nephrotic syndrome and a retrobulbar neuritis at the same time. Both symptoms were equally transitory and could not be demonstrated five weeks after cessation of therapy. In a further case a lethal Lyell syndrome developed three weeks after therapy was started. These observations show that during D-penicillamine treatment weekly, and later fornightly, blood counts should be performed. In the occurence of thrombocytopenia, leucopenia or anaemia treatments should be stopped; Signs of drug intolerance together with exanthemata should also led to a critical review of the indications and the dosage. D-Penicillamine should not be used when hypersensitivity to penicillin exists or when cell deficiencies have occurred after anti-reheumatic medication. The development of proteinuria should also result in withdrawal of the drug. Therapy with D-penicillamine requires conscientious follow-up urinalyses and blood counts as well as attention to allergic rashes.

[The problem of malignant deuteropathy following cytostatic therapy]. / Beitrag zum Problem maligner Zweiterkrankungen nach zytostatischer Therapie

Among 17,676 patients admitted to our clinic between 1965 and 1974, we have observed 22 cases of malignant deuteropathy-either after cytostatic therapy or radiation, or as "spontaneous" primary multiple tumors. Their catamneses were analyzed. Seven cases raise a strong suspicion that cytostatic therapy may have induced a cancer. A statistical analysis is not possible with our group of patients. To avoid an inadmissible evaluation of these individual observations, they were compared with the 10 "spontaneous" double tumors observed during the same period. Advances in our knowledge of this field are, in our opinion, to be expected of central cancer registers.