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August 12, 1974

Need for Research for Protective Measures Against Chronic Chemical Injury

Author Affiliations

Union Hospital of Cecil County Elkton, Md

JAMA. 1974;229(7):763-764. doi:10.1001/jama.1974.03230450013005

To the Editor.—  In cases of cancer due to industrial chemicals, several years of exposure may occur before any malignant neoplasm can be detected. Our previous studies1-3 of patients exposed to solvent vapors indicated damage to the liver and pancreas before a definite increased rate of malignancy was noticed. Recently, increase of angiosarcoma of the liver has been reported among workers in polyvinyl chloride plants, usually after years of exposure.We now have a patient, a 30-yearold man, who has worked for seven years in a polyvinyl chloride plant. For four years, he cleaned tanks used for storing vinyl chloride. He has complained lately of great fatigue. A liver and pancreas scan (Figure) shows his liver to be small, about 1,200 gm instead of the more than 1,500 gm expected for a patient of his height and weight. The inferior edge of the liver shows an irregular concave profile.