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Preliminary results and comparison of Japanese, Finnish, and United States carbon disulfide microaneurysm studies.

Leffingwell-S; Marsh-D; Albright-B; Lee-S
Proceedings of the Eleventh Conference on Environmental Toxicology, Dayton, Ohio, November 18-20, 1980. Dayton, OH: Air Force Aerospace Medical Research Laboratory, 1981 Jun; :323-337
Retinal angiopathy was first associated with carbon disulfide when Goto and Hotta (1967) found increased incidence of retinal small hemorrhages or microaneurysms, nephropathy, anemia, and a variety of subjective symptoms among workers exposed to carbon disulfide in a rayon plant in Japan (Goto and Hotta, 1967; Goto et al., 1971; Goto et al., 1972). Additional studies in Japan and Yugoslavia supported these findings and demonstrated an abnormal response to corticosteroid-augmented glucose tolerance testing among workers exposed to carbon disulfide (Hernberg et al., 1970; Hotta et al., 1972). Although there was no information on exposure level in these early reports, and they were often flawed by small comparison groups, there seemed no strong reason to doubt a connection between carbon disulfide exposure and a microangiopathy mediated by abnormal glucose metabolism until Raitta (1974) reported results of her examinations of 100 workers exposed to carbon disulfide in a Finnish rayon plant previously described by scientists at the Institute of Occupational Health in Helsinki. Aneurysms were much less common in both the exposed and unexposed groups in Finland than in Japan; no effect of carbon disulfide was found on the prevalence of aneurysms; and there was no effect on blood sugar which could be detected by a standard glucose tolerance test not augmented with corticosteroids. Bias in selection of the Japanese cohort was considered the most likely explanation. In 1976, Sugimoto, Goto and Hotta (1976) reported a "five-year follow-up on retinopathy due to carbon disulfide". They concluded that retinopathy progressed more in the group that remained exposed and that regression in grade of retinopathy occurred significantly more often in workers removed from carbon disulfide exposure than in those remaining in the same work site. While environmental levels again were not given, they recommended reduction in the Japanese TLV (60 mg 1m 3, or about 19 ppm) for carbon disulfide. By 1977, the Japanese and Finnish groups had combined forces and completed a collaborative study of workers in each country. Environmental levels in the Japanese plant, described in 1976 by Tolonen and others were in the same range as those in the Finnish plant (Sugimoto et al., 1977). The ophthalmologic report essentially confirmed the earlier findings that. retinopathy was rare in Finland, more common in Japan, and associated with carbon disulfide exposure in Japan but not in Finland (Sugimoto et al., 1976). About this time, planning was begun for NIOSH's cross-sectional medical and industrial hygiene study of workers exposed to low levels of carbon disulfide. With findings suggesting a problem in Japan and Yugoslavia but. no problem in Finland, it seemed prudent to determine where U.S. workers fit in this scheme.
Organic-sulfides; Cardiovascular-system; Cardiovascular-system-disorders; Eye-disorders; Retinal-disorders
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Proceedings of the Eleventh Conference on Environmental Toxicology, Dayton, Ohio, November 18-20, 1980