Abstract

This study aimed to investigate the potential hepatotoxicity, nephrotoxic, and hematotoxic effects of simultaneous occupational low-level exposure of shoe workers to a mixture of organic solvents. The study included 16 male and 55 female workers and non-exposed subjects (n = 60) in the control group. Along with a standard sets of hematological, liver enzymes (aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT), bilirubin total, bilirubin direct, blood glucose, urea, and creatinine were analyzed in all participants. Indoor air quality was monitored using a Gasmet Dx − 4000 multi-component analyzer. Despite the concentration levels of individual chemicals in shoe production units were below the permissible limits, the equivalent exposure (Em) values calculated based on the American Conference of Governmental Industrial Hygienists (ACGIH) and National Institute of Occupational Safety and Health (NIOSH) occupational exposure limits were higher than 1. Statistically significant increase of biochemical parameters (aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), total bilirubin, and direct bilirubin) was obtained in exposed workers of both genders compared with controls (p < 0.001). Calculated liver damage risk scores were significantly higher in both females and males compared with controls (p < 0.001). The multivariate logistic regression analysis showed that direct bilirubin was the most important predictor of organic solvent mixture exposure in the studied group of workers. These results suggest that combined exposure to organic solvents even at low concentrations may lead to hepatotoxicity.

摘要

本研究旨在调查制鞋工人同时职业性低水平接触有机溶剂混合物的潜在肝毒性、肾毒性和血液毒性影响。该研究包括 16 名男性和 55 名女性工人和非接触对象（n = 60) 在对照组中。除了一组标准的血液学、肝酶（天冬氨酸氨基转移酶 (AST)、丙氨酸氨基转移酶 (ALT) 和 γ-谷氨酰转肽酶 (GGT)、总胆红素、直接胆红素、血糖、尿素和肌酐）外，还对所有参与者进行了分析。室内空气质量使用 Gasmet Dx − 4000 多组分分析仪进行监测。尽管鞋类生产单元中单个化学品的浓度水平低于允许限值，但根据美国政府工业卫生学家会议计算的等效暴露 (Em) 值(ACGIH) 和美国国家职业安全与健康研究所 (NIOSH) 职业接触限值均高于 1。生化参数（天冬氨酸氨基转移酶 (AST)、p  < 0.001)。与对照组相比，女性和男性的肝损伤风险评分均显着高于对照组 ( p  < 0.001)。多元逻辑回归分析表明，直接胆红素是研究组工人中有机溶剂混合物暴露的最重要预测因子。这些结果表明，即使在低浓度下同时接触有机溶剂也可能导致肝毒性。