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Vinyl Chloride-Associated Liver Disease
- PAUL D. BERK, M.D., F.A.C.P.;
- JAMES F. MARTIN, M.D.;
- ROBERT S. YOUNG, M.D., F.A.C.P.;
- JOHN CREECH, M.D.;
- IRVING J. SELIKOFF, M.D.;
- HENRY FALK, M.D.;
- PHILIP WATANABE, Ph.D.;
- HANS POPPER, M.D., F.A.C.P.; and
- LOUIS THOMAS, M.D.
Abstract
Although polyvinyl chloride has been produced from vinyl chloride monomer for more than 40 years, recognition of toxicity among vinyl chloride polymerization workers is more recent. In the mid 1960s, workers involved in cleaning polymerization tanks were found to have acro-osteolysis. In 1974, the same population of workers was found to be at risk for an unusu al type of hepatic fibrosis and angiosarcoma of the liver. We describe two cases of vinyl chloride-associated liver injury, one of hepatic fibrosis and one of angiosarcoma. Histologic features of these lesions are similar to the hepatic fibrosis and angiosarcomas resulting from chronic exposure to inorganic arsenicals. Preliminary studies suggest that the toxicity of vinyl chloride may result from formation, during high-dose exposure, of active metabolites by mixed function oxidases of the liver. Epidemiologic studies indicate an increased incidence not only of liver disease, but also of cancers of the brain, lung, and possibly other organs.
Article and Author Information
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▸An edited transcription of a Combined Clinical Staff Conference at the Clinical Center, Bethesda, Maryland, 14 November 1974, by the National Institute of Arthritis, Metabolism, and Digestive Diseases, National Institutes of Health, U.S. Department of Health, Education, and Welfare.
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▸Requests for reprints should be addressed to Paul D. Berk, M.D.; Chief, Section on Diseases of the Liver, Digestive Diseases Branch, National Institute of Arthritis, Metabolism, and Digestive Diseases, Bldge 10, Room 4D-52, National Institutes of Health; Bethesda, MD 20014.
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- Received February 16, 1976.
- Accepted March 2, 1976.
