title: Acute and chronic liver toxicity resulting from exposure to chlorinated naphthalenes at a cable manufacturing plant during World War II.
abstract: Historical records were used to reconstruct an outbreak of chlorance and acute liver toxicity due to chlorinated naphthalene exposure at a New York State plant which manufactured "Navy cables" during World War II. A cohort mortality study was conducted of the population (n = 9,028) employed at the plant from 1940 to 1944. Vital status was followed through December 31, 1985. The study found an excess of deaths from cirrhosis of the liver [observed (OBS) = 150; standardized mortality ratio (SMR) = 1.84; 95% confidence interval (CI) = 1.56-2.16]; cirrhosis deaths were elevated to a similar degree in the 460 individuals who had chlorance (OBS = 8; SMR = 1.51; CI = 0.65-2.98). The SMR for "non-alcoholic cirrhosis" (OBS = 83; SMR = 1.67; CI = 1.33-2.07) was similar to the SMR for "alcoholic cirrhosis" (OBS = 59; SMR = 1.96; CI = 1.49-2.53). There was no evidence for increased alcoholism in the overall cohort based on mortality from alcohol-related causes of death other than cirrhosis (SMR for esophageal cancer = 1.01 and for deaths from alcoholism = 0.99). We conclude that the excess mortality from cirrhosis of the liver observed in this cohort is due to the chronic effect of chlorinated naphthalene exposure.
authors.affiliation: Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Ward
authors.forename: A M
authors.initials: AM
authors.lastname: Ruder
authors.forename: A
authors.initials: A
authors.lastname: Suruda
authors.forename: A B
authors.initials: AB
authors.lastname: Smith
authors.forename: C A
authors.initials: CA
authors.lastname: Fessler-Flesch
authors.forename: S H
authors.initials: SH
authors.lastname: Zahm
mesh_terms: D000208:Acute Disease; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury; D002908:Chronic Disease; D004196:Disease Outbreaks / Q000266:history*; D005260:Female; D049673:History, 20th Century; D006801:Humans; D008103:Liver Cirrhosis / Q000266:history / Q000401:mortality; D008107:Liver Diseases / Q000453:epidemiology / Q000266:history*; D008297:Male; D009281:Naphthalenes / Q000009:adverse effects*; D009518:New York / Q000453:epidemiology; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000266:history*; D016273:Occupational Exposure / Q000266:history*; D012189:Retrospective Studies; D013997:Time Factors; D014857:Warfare
chemical_list: D009281:Naphthalenes