The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: a cross-sectional study 15 years after retirement
Open Access
- 6 June 2013
- Vol. 3 (6), e002785
- https://doi.org/10.1136/bmjopen-2013-002785
Abstract
Objectives To assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM). Design Cross-sectional study. Setting Allier, one of the major areas of polyvinyl chloride production in France. Participants We screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants. Primary and secondary outcome measures These participants underwent a medical examination including a capillaroscopy, symptoms of Raynaud and comorbidities, as well as a survey to determine exposure time, direct or indirect contact, type of occupation, smoking status and time after exposure. A double blind analysis of capillaroscopic images was carried out. A control group was matched in age, sex, type of occupation. Results 179/761 retired workers were only exposed to VCM at their work, with 21 meeting the inclusion criteria and included. Exposure time was 29.8±1.9 years and time after exposure was 15.9±2.4 years. Retired workers previously exposed to VCM had significantly higher capillaroscopic modifications than the 35 controls: enlarged capillaries (19% vs 0%, p2=0.63), dystrophy (R2=0.51) and capillary length (R2=0.36). They also had higher symptoms of Raynaud (19% vs 0%, p=0.007) without correlation with capillaroscopic modifications. Conclusions Although VCM exposure was already known to affect microcirculation, our study demonstrates residual long-term abnormalities following an average of 15 years’ retirement, with a time-related exposure response. Symptoms of Raynaud, although statistically associated with exposure, were not related to capillaroscopic modifications; its origin remains to be determined.Keywords
This publication has 52 references indexed in Scilit:
- A cross-sectional exploration of smoking status and social interaction in a large population-based Australian cohortSocial Science & Medicine, 2012
- Validation of exposure assessment and assessment of recruitment methods for a prospective cohort study of mobile phone users (COSMOS) in Finland: a pilot studyEnvironmental Health, 2011
- The Danish Health Examination Survey 2007-2008 (DANHES 2007-2008)Scandinavian Journal of Public Health, 2011
- Glutathione S-transferase M1 and GST T1 genetic polymorphisms and Raynaud’s phenomenon in French vinyl chloride monomer-exposed workersJournal of Human Genetics, 2006
- Historical cohort study of 10 109 men in the North American vinyl chloride industry, 1942–72: update of cancer mortality to 31 December 1995Occupational and Environmental Medicine, 2000
- Nail-fold capillaroscopy in the study of microcirculation in elderly hypertensive patientsArchives of Gerontology and Geriatrics, 1996
- Exposure to vinyl chloride monomer: report on a cohort study.Occupational and Environmental Medicine, 1987
- Veränderungen der Hand- und Fingerarterien bei der VinylchloridkrankheitRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 1980
- In vivo observations of skin capillaries in workers exposed to vinyl chloride. An English-American comparison.Occupational and Environmental Medicine, 1978
- Occupational acroosteolysis. Report of 31 casesJAMA, 1967