Occupational Medicine 1991;41:10-16
© 1991 Society of Occupational Medicine
research-article |
Persistent Liver Dysfunction among Workers at a Vinyl Chloride Monomer Polymerization Plant
Department of Industrial Health, Ministry of Labour Singapore
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.
Requests for reprints should be addressed to: Dr S. F. Ho, Senior Medical Officer, Department of Industrial Health, Ministry of Labour, 37 Halifax, Singapore 0922