[Acro-osteolysis caused by vinyl chloride]

Translated title of the contribution: [Autom. eng. transl.] [Acro-osteolysis caused by vinyl chloride]

Nicola Magnavita

Research output: Contribution to journalArticlepeer-review

Abstract

[Autom. eng. transl.] I read the article by Zocchetti et al with great interest and emotion. (1) on acroosteolysis. Emotion because that of supervising a factory whose workers were exposed to vinyl chloride was my first professional assignment, just a few days before my Medical Degree, just enrolled in the School of Specialization in Occupational Medicine directed by Prof. Angelo Iannaccone, in far 1977. Under the guidance of prof. Antonio Bergamaschi, in the Department of Occupational Medicine of the Policlinico Gemelli, housed in those years what Prof. Giuliano called "the casuistry no longer numerous, but better followed" by CVM intoxicated. To the scrupulous revision of the cases of acroosteolisi contained in the article I therefore want to add the one we published on the then most authoritative magazine of the sector (2) and the further five cases that emerged from the longitudinal study of the cohort of 37 workers, which we presented in 1988 in Florence ( 3). In this work, unfortunately of limited accessibility, a statistically very significant correlation was observed between the severity of the bone lesions, ordinarily classified according to gravity and diffusion, and the degree of Raynaud's phenomenon (p = 0.002 by Spearman's rho test and tau of Kendall). Both acroosteolytic-type lesions and small areas of bone resorption (pseudo-cysts), with a juxta-articular site, located mostly in the carpal bones, underwent spontaneous remission within 6-12 months from the end of exposure. . In the cohort, followed by serial controls for times between 2 and over 15 years, the vasospastic symptoms were improved or reduced and the signs of morphea or localized scleroderma of the hands were attenuated, all without calcinosis; however in one case, which to our knowledge is the only one in the literature, the prolonged contact of the lower limbs of the worker with fresh PVC resin containing high concentrations of unreacted monomer in the emptying operations of the storage bunkers had caused a scleroderma localized to the lower limbs, with subcutaneous calcifications still evident two years after the cessation of exposure. These are observations that seem to me interesting, many years later, and I am therefore grateful to Zocchetti and Coll. that allow me to bring them to the attention of scholars. And I allow myself to formulate an answer to their question: "What can be said, at this point in history, regarding Italy"? The attitude of the academic authorities and the scientific society towards this professional disease, undoubtedly inconvenient due to the presence in our country of so many production plants, was not the most enlightened. I just want to remind you that the above work was introduced by the Chairman with the words: "Once again we will hear about vinyl chloride", after which my speech was commented with a: "Well, if it's done, let's hope not having to hear more about vinyl chloride "and, of course, there was no debate. Thanks, therefore, to Zocchetti, who returns the word to me after so many years.
Translated title of the contribution[Autom. eng. transl.] [Acro-osteolysis caused by vinyl chloride]
Original languageItalian
Pages (from-to)395-395
Number of pages1
JournalLA MEDICINA DEL LAVORO
Volume101
Publication statusPublished - 2010

Keywords

  • Acro-Osteolysis
  • Carcinogens
  • Humans
  • Occupational Diseases
  • Vinyl Chloride

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