[IRRITANT GAS POISONING].
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We present a patient with accidental chlorine gas poisoning who died from pulmonary thrombosis due to a marked increase in hemostatic factors such as von Willebrand factor after recovering from the acute poisoning.
Acute gas poisoning is one of the most important medicosocial problems in the developing countries. An outbreak of acute inhalation exposure to hydrogen selenide occurred in Delhi, India. This report includes our findings on epidemiological, clinical and biochemical investigations in 31 cases hospitalized immediately after the gas poisoning.
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A high incidence of cancer of the respiratory tract has been reported among former workers in a poison gas manufacturing plant which operated on Ohkunojima from 1927 to 1945. This report provides evidence of a high incidence of chromosome abnormality and sister chromatid exchange (SCE) rate among the former workers, as well as cytogenetic changes in two patients among the former workers with chronic myelocytic leukemia (CML). A chromosome study of seven former workers with chronic bronchitis revealed a stable type of aberration, the average abnormality being 10.9 +/- 4.4 percent, which is equivalent to those of atomic bomb survivors exposed at 1.2 km from the hypocenter. The SCE rate observed in 16 former workers ranged from 4.9 +/- 2.1 to 17.8 +/- 3.9, which was significantly higher than in the control group (p < 0.03). One of the CML patients showed an extremely high percentage of missing Y chromosomes along with t(9;22) translocation which is a specific chromosome aberration for the disease. Furthermore, the patient had almost a 3 times higher SCE rate compared to the control group and a high incidence of chromosome abnormality (12.1%) of the peripheral lymphocytes. These results suggest that the development of leukemia in this patient was strongly related to poison gas exposure.
Okunojima, a small island in the Inland Sea of Japan, off the shore of Takehara city was notorious for the production of poison gases from 1927 to 1945. Of the gases produced there, yperite and lewisite were the most poisonous and caused severe residual damage. It has been ascertained by studies conducted to date that the retired workers of this poison gas factory have a high risk of various types of malignant tumors including cancers of the respiratory tract. Such cancers observed in the retired workers from the poison gas factory are characterized by the following clinical features. Cancers are mainly central-type tumors with the site of development distributed from the airway to the hilar region and histologically, squamous and undifferentiated cell carcinoma predominate. Recently, the occurrence of malignant tumors has been discussed in relation to suppressed immune competence. Such disturbance of the immunological surveillance system seems to induce malignant changes of normal cells. On the other hand, we have demonstrated that the retired workers often showed impaired immunity. Therefore we considered that potentiation of immunity might possibly prevent the occurrence of malignant tumors and we took steps to enhance the immune competence of the retired workers with N-CWS. Its effect in preventing carcinogenesis will be shown in the near future.
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In March and April 1983, an epidemic of "mysterious gas poisoning" occurred in the Jordan West Bank region, affecting more than 900 persons, predominantly schoolgirls. That both Arabs and Israelis believed there was an etiologic poisonous substance reflected their longstanding conflict. Israeli newspaper reports, opinions by Arab and Israeli physicians, and the emotional climate in Djenin Hospital contributed to the generation and propagation of this belief. The author discusses the specific difficulties he met in investigating the outbreak.
Former poison-gas workers were found to have a high incidence of respiratory neoplasia. The development of cancer in these people could be suppressed by the administration of Nocardia rubra cell-wall skeleton. Efforts to improve the prevention and treatment of lung cancer include studies of telomerase activity and genetic aberrations in samples from patients with cancer, monitoring of the concentration of anti-cancer drugs, and studies of the feasibility of gene therapy with adenovirus vectors.
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