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Staphylococcal adherence to polyvinyl chloride and heparin-bonded polyurethane catheters is species dependent and enhanced by fibronectin.

Intravenous hyperalimentation has improved the survival of premature infants. However, long-term placement of intravenous catheters may result in the development of catheter-related sepsis. Fibronectin in plasma contains binding sites for staphylococcal species as well as marked affinity for inert plastics and therefore may provide a substrate for bacterial adherence to indwelling catheters. We determined the adherence of labeled [( 3H]leucine) coagulase-positive (CPS) and coagulase-negative (CNS) staphylococci to untreated and fibronectin-coated polyvinyl chloride (PVC) and heparin-bonded polyurethane (HBP) catheter segments and quantitated the binding of 14C-labeled, purified fibronectin to these catheters. PVC catheter segments bound significantly more CNS than CPS (P less than 0.05), while HBP catheters bound more CPS than CNS (P less than 0.05). Fibronectin significantly increased the adherence of CPS to PVC catheters (P less than 0.05) and CNS to HBP catheters (P less than 0.05). PVC catheters bound more fibronectin (P less than 0.0001) than did HBP catheters. Catheter composition may influence the spectrum of nosocomial pathogens to which infants are susceptible through different bacterial adherences and interactions with adhesive proteins.

Bacterial Adhesion↗

Lung function in workers exposed to polyvinyl chloride dust.

Several reported studies on the effects of polyvinyl chloride (PVC) dust in animals and man have been conflicting. The present study of the ventilatory function of 509 male workers exposed to PVC dust was made in 1977. Altogether 104 men exposed to PVC dust only, 112 men exposed to non-chlorinated solvents only, and 293 men exposed to a mixture of both completed the MRC questionnaire on respiratory function and performed simple spirometric tests (forced expiratory volume in one second and forced vital capacity). No differences were found between the three groups after allowance was made for age, height, and smoking. When exposure and smoking effects were considered separately, the latter was shown to be the dominant cause of reduced lung function. In this study work with PVC dust has not produced deleterious effects on ventilatory function.

Adult↗

Respiratory illness caused by overheating of polyvinyl chloride.

On 9 August 1979, 62 (30.8%) of 201 workers and one of 60 management personnel in a polyvinyl chloride (PVC) fabricating plant developed acute upper and lower respiratory irritation, headache, nausea, and fainting. All were taken to hospital; none died. Sixty of the patients were women. Interviews two weeks later with 57 affected and 14 unaffected workers disclosed that illness had followed exposure to fumes from an overheated (362 degrees C) PVC extruding machine. Fumes were emitted from 1100 until 1150; cases occurred from 1100 until late afternoon. All workers who became ill worked west of the overheated extruder, and the affected manager had visited that area. The earliest cases occurred closest to the machine, and incidence decreased (from 53.3% to 15.4%) with distance westward. This pattern was consistent with plant ventilation. Incidence rates in men and women did not differ (p greater than 0.1). At two and 14 weeks, pulmonary function testing of workers with persistent pulmonary symptoms showed abnormalities in 13 of 16 and in 9 of 11 respectively; the group with persistent symptoms contained an excess of non-smokers and of those with previous respiratory illnesses. One kilogram of PVC heated to 300 degrees C releases an estimated 12.9 g of hydrochloric acid (HCl) and 4.9 g of carbon monoxide (CO). We attributed the outbreak to exposure to toxic HCl and CO and rejected the hypothesis of mass psychogenic illness.

Carbon Monoxide Poisoning↗

Incidence of cancer among vinyl chloride and polyvinyl chloride workers.

The results of a follow up study of the incidence of cancer and the mortality in a cohort of 454 male workers producing vinyl chloride and polyvinyl chloride are presented. The study population was restricted to employees with more than one year's work experience in the study plant between 1950 and 1969 and the cohort was followed up from 1953 to the end of 1979. Twenty three new cases of cancer were observed compared with 20.2 expected; one case of liver angiosarcoma was found. Five cases of lung cancer were found (2.8 expected) and four cases of malignant melanoma of the skin were observed (0.8 expected). The possibility of a causal relationship between exposure to vinyl chloride and the development of malignant melanomas is discussed.

Adult↗

Polyvinyl chloride pneumoconiosis.

A 53-year-old man, who had been exposed for 23 years to polyvinyl chloride (PVC) in the bagging area of a vinyl chloride polymerisation plant, presented with a diffuse micronodular infiltrate on his chest radiograph. Light microscopy of lung obtained by drill biopsy showed a diffuse infiltration with histiocytes and multinucleated giant cells, with some collagen formation. Ultrastructural studies showed foreign particles in the macrophages, which were identical with PVC powder viewed under the electron microscope. Incubation of PVC powder with human lung macrophages in vitro showed that the macrophages englufed the powder to give a similar ultrastructural appearance.

Cytoplasm↗

Uterine artery embolization in sheep: comparison of acute effects with polyvinyl alcohol particles and calibrated microspheres.

PURPOSE: To compare the effects on the myometrium of polyvinyl alcohol (PVA) particles and calibrated microspheres (MS) in embolization of the uterine arteries in sheep. MATERIALS AND METHODS: Superselective and bilateral embolization of the uterine arteries was performed with PVA particles and calibrated MS within 24 hours after artificial ovulation in 26 adult nonpregnant sheep. PVA particles of four diameters, 150-250, 250-400, 400-600, and 600-1,000 microm, were compared with calibrated MS of similar diameters, 100-300, 300-500, 500-700, and 700-900 microm, in eight groups of sheep. Evaluation was based on histopathologic study of uterus, ovaries, and vascular pedicles after sacrifice 5 days after embolization. The scores of necrosis, the diameter of occluded arteries, and the number of particles were determined. The scores of uterine necrosis were compared by using nonparametric tests (Mann-Whitney U and Kruskal-Wallis). Spearman rank test was used for correlations. RESULTS: PVA particles clumped more readily than did MS. Small particles had a higher score (P =.02) of uterine necrosis than did large particles. PVA particles produced more necrosis than did MS. Size of MS and diameter of occluded arteries showed significant correlation (rho = 0.762, P <.001). Size of PVA particles and diameter of occluded arteries showed no correlation. PVA particles occluded vessels of a wider range of size than did calibrated MS. CONCLUSION: PVA particles are associated with intense uterine necrosis and extensive arterial occlusion regardless of size. Calibrated MS, which are associated with less uterine necrosis, permit a segmental arterial occlusion correlated with size.

Angiography↗

Experimental canine hepatic artery embolization with polyvinyl alcohol foam particles.

Segmental and complete hepatic artery embolization with Ivalon (polyvinyl alcohol) particles (0.25 to 1 mm) was performed in 12 dogs to evaluate hepatic function alterations and histopathological changes. In dogs undergoing segmental embolization, liver function alterations were minimal and the liver was normal, both grossly and microscopically, at autopsy. In dogs undergoing complete hepatic embolization, only two had significant elevation of SGOT and alkaline phosphatase levels, which normalized in 2 and 4 weeks; one of these two dogs also had an elevated bilirubin level. A focal hepatic infarct was observed both grossly and microscopically in one dog and only microscopically in four dogs. Two dogs died of pancreatic abscess due to unintentional pancreatic embolization. The study suggested that segmental embolization with Ivalon particles was well tolerated by dogs, and complete hepatic embolization resulted in hepatic function changes and focal infarction comparable with Gelfoam embolization.

Alkaline Phosphatase↗

Acoustic properties of polyvinyl chloride gelatin for use in ultrasonography.

Visualization of superficial structures with conventional rapid scanners has been difficult. A solid flexible polyvinyl chloride (PVC) gelatin slab used as a stand-off material can provide a constant scan distance and thus overcome the problem of poor near field resolution. PVC gelatin expands the capability of the 3-4 MHz transducer to delineate superficial structures. We report on the acoustic properties of the PCV gelatin, including the values of velocity and attenuation as a function of both frequency and temperature, and the comparison of data with published values of velocity and attenuation for water, soft tissue, and a phantom material.

Gelatin↗

Exposure of patients to phthalates from polyvinyl chloride tubes and bags during dialysis.

The exposure of patients to the plasticizer di-(2-ethylhexyl)phthalate (DEHP) from polyvinyl chloride (PVC) tubes and bags during dialysis has been investigated. In vitro studies of the migration of DEHP from hemodialysis tubes into plasma revealed a migration coefficient of 7.7 micrograms/ml/h. An artificial kidney did not influence the plasma concentration of DEHP. The calculated exposure from a single hemodialysis can be as much as the total annual exposure using continuous ambulatory peritoneal dialysis (CAPD). CAPD fluids in PVC bags contain low concentrations of DEHP and its hydrolysis product mono-(2-ethylhexyl)phthalate (MEHP). These phthalates were analyzed in serum from patients receiving both CAPD and hemodialysis using gas chromatography. A group of patients not yet on dialysis treatment was used as control. In no case could MEHP be detected. The DEHP concentration was 0.8-4.2 micrograms/ml serum in the 17 hemodialysis patients after dialysis and 0.1-0.9 microgram/ml in 4 of the CAPD patients. In 3 of the CAPD and all of the predialysis patients, DEHP could not be detected (less than 0.1 microgram/ml).

Diethylhexyl Phthalate↗

Differences in vitamin A content of enteral feeding solutions following exposure to a polyvinyl chloride enteral feeding system.

This research was conducted to determine if there were significant differences in the vitamin A content of two enteral feeding solutions following timed exposure to a polyvinyl chloride (PVC) enteral tube feeding system. This study took place in the laboratory setting with procedures designed to simulate clinical conditions with respect to rate of flow and time of exposure. Feeding solutions (Ensure Osmolite and Vivonex High Nitrogen) were sampled, placed in PVC feeding system pouches (Vivonex Delivery System, Norwich-Eaton Pharmaceuticals, Norwich, NY) and permitted to drip from the pouches at a constant rate. Solution remaining in the pouches was sampled at intervals for a period of six hours, and all samples were analyzed for Vitamin A content using spectrophotometric methods. Statistical analysis of the data indicated no significant difference in Vitamin A content of either feeding solution following six hours of exposure to a PVC enteral tube feeding system.

Enteral Nutrition↗

Nitroglycerin adsorption to a combination polyvinyl chloride, polyethylene intravenous administration set.

Loss of nitroglycerin (NTG) from intravenous solutions to intravenous bags and administration sets has been well documented. This study was designed to examine a commercially available low adsorption administration set that was compatible with a volumetric infusion pump. A solution of NTG 100 micrograms/ml in dextrose 5% in glass bottles was used. Six study administration sets were tested. The infusion sets were connected to the NTG-containing glass bottles, filled as rapidly as possible, placed in the infusion pump, and set at the appropriate rate. Effluent was collected for NTG assay initially, and at 20 and 40 minutes, and 1, 1.5, 2, 3, 6, and 24 hours. The effects of flow rate were studied at 0.2 and 1.0 ml/min. The tubing performed similarly to other polyvinyl chloride (PVC)-containing sets at 0.2 ml/min and similar to non-PVC sets at 1.0 ml/min. The effect of an initial flush with 20-100 ml of 100 micrograms/ml NTG was also examined. An initial flush of 20 ml of 100 micrograms/ml NTG solution was found to enhance delivery of NTG immediately. NTG aliquots were stored frozen in glass vials prior to assay by high performance liquid chromatography.

Adsorption↗

[Determination of dibutyltin compounds in polyvinyl chloride resin by capillary gas chromatography].

Dibutyltin compounds (DBTC) in polyvinyl chloride resin (PVC) were examined by capillary gas chromatography using a flame photometric detector (FPD). DBTC was extracted with a carbon tetrachloride-methanol (2:1) mixture under reflux. The extract was mixed with a hydrobromic acid solution. Dibutyltin dibromide was converted to dibutyldipentyltin (DBDPeT) by the Grignard reaction with pentylmagnessium bromide and then subjected to gas chromatography. A linear correlation between the amount of tin and peak height was observed in the range of 7.8 to 250 pg of tin on log-log paper. Recoveries of DBTC added to PVC were 92.6-108.1%. The results show that this procedure is more useful and sensitive (the detection limit is 3-4 pg, as tin) than previous methods reported.

Chromatography, Gas↗

Pulmonary manifestations of vinyl and polyvinyl chloride (interstitial lung disease). Newer aspects.

Newer varieties of occupational lung diseases primarily due to the vast increase in industrial technology have been reported recently. Preeminent among such newer agents are vinyl chloride (VC) and polyvinyl chloride. Very few cases have been reported, in Europe only, with descriptive histopathologic changes. To our knowledge, no pathologic studies of VC exposure have been described in the American literature. The biopsy abnormalities in our patients disclosed desquamation of alveolar macrophages into the alveolar lumina and minor interstitial and alveolar inflammatory changes. Pulmonary function abnormalities included restrictive insufficiency. Preventive therapy consists of the avoidance of further exposures, frequent industrial hygiene monitoring, and total avoidance of tobacco smoke, as well as associated atmospheric pollutants. Thus far, none of these patients has exhibited evidence of pulmonary neoplasms. All three patients survived their occupational injuries, and two are still disabled to varying degrees. Urine and blood levels of phthalic acid derivatives were elevated in two patients, the exact significance of which is not fully known. It probably represents a toxicologic response, but must be further pursued before conclusions can be reached.

Adult↗

The effectiveness of polyvinyl chloride plastic bands impregnated with permethrin as a control for the northern fowl mite, Ornithonyssus sylviarum (Canestrini and Fanzago), infesting caged laying chickens.

Caged White Leghorn hens were used to study the effectiveness of polyvinyl chloride (PVC) bands impregnated with 10% permethrin (50 mg/active ingredient/band) for control of the northern fowl mite (NFM), Ornithonyssus sylviarum (Canestrini and Fanzago). The PVC bands were attached two ways, either to the leg of the bird or to the cage floor. Leg band treatments included one, two, three, four, and six birds banded (one band per bird) per cage of six birds. Cage band treatments included one, two, and four PVC strips attached to the cage floor. The attachment of PVC bands to cages was very effective in controlling NFM. Birds in the treatment with four bands attached to the cage floor were essentially mite free for the duration of the 19-week test. Based on this test, the leg banding technique does not seem to be as effective or practical for controlling NFM on caged layers as is attachment of the bands to the cage floor. The use of permethrin-impregnated PVC bands or strips attached to the floor of poultry cages shows promise for effective NFM control and for relieving stress on birds resulting from conventional spraying or dusting treatments.

Animals↗

An 11-year longitudinal study of the occupational dust exposure and lung function of polyvinyl chloride, cement and asbestos cement factory workers.

Standardized questionnaires and lung function tests were administered in 1973, 1980, and 1984 to 126 workers occupationally exposed to polyvinyl chloride (PVC) dust, to cement dust, or to asbestos cement dust until 1974-1978 and to PVC thereafter. The workers in the last group were assigned to two asbestos exposure categories (heavy and slight). The decline in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0) was analyzed with regard to the length of time since the data of first employment. After adjustment for age, height, and smoking status at the date of first employment, the decline in FVC and FEV1.0 among the nonsmokers-light smokers was slightly accelerated with length of employment in the PVC and slight asbestos exposure groups and markedly accelerated with time since first employment in the heavy asbestos exposure group. The heavy smokers in all the exposure groups had FVC and FEV1.0 predicted values that were lower than those of the nonsmokers-light smokers; these differences remained constant with length of employment. Cessation of asbestos exposure for about 10 years did not seem to change lung function decline.

Adult↗

Occupational lead exposure in Finland. IV. The polyvinyl chloride plastic industry.

One hundred and fifty-two workers from ten polyvinyl chloride (PVC) plastic factories were studied for lead exposure. Blood lead (Pb-B) concentration was measured for all the workers, urinary delta-aminolevulinic acid (ala) for 130 workers, erythrocyte alpha-aminolevulinic acid dehydratase (ala-d) activity for 59 workers, and blood hemoglobin concentration or 93 workers. The median Pb-B for all the workers was 37 mug/100 ml, and the highest median found for one factory was 63 mug/100 ml. The highest single Pb-B value found was 126 mug/100 ml. The jobs with the heaviest lead exposure were those of mixing and weighing lead stearate powder. It is assumed that replacing the powder with a granule form of lead stearate will diminish the hazard of lead exposure in the future. Urinary ALA concentrations and erythrocyte ALA-D activities corresponded well with the Pb-B concentration, but the hemoglobin values did not show any relation to lead exposure. It is concluded that in the PVC plastic industry of Finland the risk of exposure to lead is high and regular health examinations should be performed.

Aminolevulinic Acid↗

Elevated CEA levels in polyvinyl chloride workers.

Plasma CEA titer was measured in 200 polyvinyl chloride workers. A positive test was obtained in 48.3% of this high risk population as compared to 9.2% for a normal healthy population.

Carcinoembryonic Antigen↗