Ho S F, Phoon W H, Gan S L, Chan Y K
Department of Industrial Health, Ministry of Labour, Singapore.
J Soc Occup Med. 1991 Spring;41(1):10-6. doi: 10.1093/occmed/41.1.10.
Thirteen workers with persistent abnormalities in one or more liver function tests (LFT) at a vinyl chloride monomer (VCM) polymerization plant were investigated. Twelve workers were found to have VCM-induced liver dysfunction based on circumstantial evidence. They were employed between 1971 and 1982 when the VCM levels ranged from 1 to 21 p.p.m. After 1982 when the environmental VCM levels were controlled to below 1 p.p.m., no cases of VCM-induced liver dysfunction were detected. In most cases, glutamic pyruvic transaminase was the earliest parameter to be raised. The second most common parameter is serum gamma glutamyl transpeptidase. The latent period ranged from 1 to 13 years. An improvement in their LFT results was shown by 83.3 per cent of workers within 6 months to 2 years after removal from further VCM exposure. For workers who returned to VCM work, their LFT became abnormal again. Liver scans showed hepato and/or splenomegaly in most cases. Liver biopsies on 9 workers were reported as 'non-specific fatty changes' of varying degrees. These observations highlight the need for continual vigilance with environmental monitoring and medical surveillance of VCM-exposed workers.
对一家氯乙烯单体（VCM）聚合厂13名一项或多项肝功能检查（LFT）持续异常的工人进行了调查。根据间接证据，发现12名工人患有VCM引起的肝功能障碍。他们于1971年至1982年受雇，当时VCM水平在1至21 ppm之间。1982年以后，当环境VCM水平控制在1 ppm以下时，未检测到VCM引起的肝功能障碍病例。在大多数情况下，谷丙转氨酶是最早升高的指标。第二常见的指标是血清γ-谷氨酰转肽酶。潜伏期为1至13年。83.3%的工人在停止进一步接触VCM后的6个月至2年内，其LFT结果有所改善。对于返回VCM工作岗位的工人，其LFT结果再次异常。肝脏扫描显示大多数病例有肝肿大和/或脾肿大。对9名工人的肝脏活检报告为不同程度的“非特异性脂肪变性”。这些观察结果强调了对接触VCM的工人进行环境监测和医学监测持续保持警惕的必要性。
