RESUMO
Recognition that vinyl chloride could be hepatotoxic led to a survey of workers to determine whether changes had been induced by past exposure, and to evaluate standard liver function tests as monitors of early liver abnormalities. Standard liver function tests were found to be unsuitable for the detection of such abnormalities in the population at risk. Of 487 workers examined, 102 (20-9%) had abnormalities on initial testing but only two were finally shown to have portal hypertension; in both cases, thrombocytopaenia provided the first diagnostic evidence since liver function tests were normal. Furthermore, 40 (35-7%) of 112 control subjects had initial test abnormalities. A sample of 19 workers with various exposures to vinyl chloride monomer were examined blind by greyscale ultrasonography. Five with minimal or no exposure were confirmed as normal but 12 of the remainder had abnormalities. These consisted of an enlarged portal vein (seven instances), splenomegaly (eight), and changes in hepatic texture (seven). Five of these 12 cases had previously been considered normal. It was concluded that greyscale ultrasonography had many advantages over standard methods for screening workers exposed to hepatotoxic chemicals, and should be the subject of a large scale evaluation.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Doenças Profissionais/induzido quimicamente , Ultrassonografia , Cloreto de Vinil/efeitos adversos , Compostos de Vinila/efeitos adversos , Adulto , Humanos , Hepatopatias/diagnóstico , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnósticoAssuntos
Hepatopatias/diagnóstico , Doenças Profissionais/diagnóstico , Esplenopatias/diagnóstico , Ultrassonografia , Cloreto de Vinil/efeitos adversos , Compostos de Vinila/efeitos adversos , Adulto , Doença Hepática Induzida por Substâncias e Drogas , Exposição Ambiental , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Esplenopatias/induzido quimicamente , Ultrassom/instrumentaçãoAssuntos
Hepatopatias/epidemiologia , Doenças Profissionais/epidemiologia , Vigilância da População , Cloreto de Vinil/efeitos adversos , Compostos de Vinila/efeitos adversos , Biópsia , Doença Hepática Induzida por Substâncias e Drogas , Exposição Ambiental , Dedos , Humanos , Fígado/patologia , Hepatopatias/fisiopatologia , Doenças Profissionais/induzido quimicamente , Osteólise/induzido quimicamente , Reino UnidoRESUMO
Age-standardised mortality-rates for a population of 2100 male workers exposed to vinyl chloride for periods of up to 27 years do not show any excess of total or cause-specific mortality. 1 case of angiosarcoma of the liver was identified just outside the study period. There was no suggestion of an increased frequency of deaths from the more common malignant diseases.
Assuntos
Indústria Química , Doenças Profissionais/mortalidade , Cloreto de Polivinila/efeitos adversos , Polivinil/efeitos adversos , Adulto , Idoso , Transtornos Cerebrovasculares/mortalidade , Doença das Coronárias/mortalidade , Inglaterra , Exposição Ambiental , Gastroenteropatias/mortalidade , Neoplasias Gastrointestinais/mortalidade , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Doenças Profissionais/induzido quimicamente , Fatores de Tempo , Neoplasias da Bexiga Urinária/mortalidade , País de GalesRESUMO
Industrial exposure to several potentially hepatotoxic agents, such as vinyl-chloride monomer may occur, and there is a need for non-vasive, diagnostic techniques to detect and monitor progressive pathological processes in liver or spleen. Grey-scale ultrasonography permits display of detailed anatomy and pathology in the liver, portal veins, and spleen. The combination of fine resolution, non-invasiveness, absence of ionising radiation hazard, and portable equipment makes the technique ideal for screening populations at risk.
