High levels of hippuric acid in the urine of Thai press workers

Toluene is an important toxic volatile agent found in many modern industrial processes. Toluene exposure is of particular concern because of the ongoing exposure of thousands of workers in industrial plants and recent research has indicated that toluene/exposure can result in chronic toxicity. The monitoring and control of toluene exposure among at-risk workers is necessary. Urine hippuric acid determination is a helpful test monitoring groups of at-risk workers. In this study, urine samples were obtained from 20 control subjects and 48 press workers from a factory in Bangkok. Each subject gave a specimen of urine; each specimen was analyzed for hippuric acid level by the Ohmori method. The average urine hippuric acid level in the control group was 0.23 +/- 0.15 mg/gCr (range = 0.05 - 0.58 mg/gCr) while that of the experimental group was 0.37 +/- 0.37 mg/gCr (range = 0.06 - 0.18 mg/gCr). A significant higher urine hippuric acid level among the press workers was found (p = 0.03). Based on this study, the prevention of exposure to toluene among high-risk workers is recommended.

Metabolite ratio of toluene-exposed rotogravure printing plant workers reflects individual mutagenic risk by sister chromatid exchanges

The study involved a group of 42 printing plant workers and a control group of 45 blood donors. At the working places, the ambient air-toluene concentration amounted from 141 to 328 mg/m(3). Sister chromatid exchanges (SCEs) were significantly elevated by three units in the exposed group. In this group, the concentration of urinary toluene metabolites was also considerably increased-hippuric acid was four times higher and the o-cresol and p-cresol fractions were twice as high. Results of toluene monitoring of ambient air- or blood-toluene concentrations did not show any relationships with individual SCE. While these SCE values revealed only a weak relationship with the corresponding hippuric acid data, a significant correlation with the cresols, which are known to be more genotoxic than hippuric acid, appeared in highly exposed workers. An attempt was made to consider the individual metabolic balance of toluene excretion products. For that reason individual cresol to hippuric acid ratios were calculated and related to corresponding SCE values. In all investigated subpopulations of the exposed group, this ratio correlated with SCE at a level of high significance. This strong interrelationship is a powerful argument for the genotoxic behavior of toluene. Furthermore, the individual metabolic balance, as a consequence of genetic polymorphism, should be considered in the discussion about genetic risk of toluene.

Impact of human variability on the biological monitoring of exposure to toluene: I. Physiologically based toxicokinetic modelling

Using an approach involving physiologically based toxicokinetic (PBTK) modelling and Monte Carlo simulation (MCS), we investigated the impact of the biological variability affecting the parameters (e.g. physiological, physicochemical, biochemical) which determine toluene (TOL) kinetics on two exposure indicators (EIs): urinary excretion of o-cresol (o-CR), measured at the end of an 8 h exposure at 50 ppm, and unchanged TOL in blood (B-TOL) sampled prior to the last shift of a 5 day workweek. Population variance was described by assuming normal, or lognormal, distribution of parameter values and assigning to each one+/-2 S.D. (or+/-2 G.S.D.). PBTK-MCS (n=1000) resulted in a geometric mean (G.M.) of 0.635 mmol/mol creatinine for urinary o-CR, upper and lower limits (95%) ranging from 0.23 to 1.75, whereas, the GM for B-TOL was 120.6 microg/l (95% limits: 64.5-225.7). Overall, the results showed that this approach facilitates the prediction of the range of BEI values that could be anticipated to occur in a group of workers exposed to a chemical.

Impact of human variability on the biological monitoring of exposure to toluene, phenol, lead, and mercury: II. Compartmental based toxicokinetic modelling

In order to quantify the effect of human variability on a wide range of biological exposure indicators (EIs), a general compartmental model was developed and tested on several chemicals. The model consists of four compartments. In a first step, it was applied to four chemicals: toluene (TOL), phenol (Ph), lead (Pb), and mercury (Hg). Individuals were to be exposed 8 h a day, 5 days a week. Physiological parameter values were set to consider a physical workload of 50 W 12 h/day and at rest for the remaining 12 h. Monte Carlo simulations were carried out using realistic distributions of physiological and metabolic parameters. The variability extent index (VEI) and the main parameters of influence were determined for each of the EIs. The results were in agreement with literature data. The present compartmental model provides a fair description of the toxicokinetic (TK) variability of very different chemicals. It will, therefore, further be applied to investigate the variability of a wide range of biological indicators.

Cranial MR findings in chronic toluene abuse by inhalation

BACKGROUND AND PURPOSE

Chronic abuse of toluene by inhalation causes variable white matter changes and thalamic hypointensity on T2-weighted MR images. The purpose of our study was to assess cranial MR findings in a large series of patients who chronically abuse toluene-containing solvents to investigate the factors causing the qualitative variability of white matter changes and thalamic hypointensity.

METHODS

We studied the neurologic signs, symptoms, and cranial MR findings in 41 patients who chronically abused thinner, a toluene-containing solvent. We classified white matter changes as diffuse or restricted. We tested the associations of the development of white matter lesions and thalamic hypointensity with patient age at onset of abuse and duration of abuse.

RESULTS

MR images revealed white matter lesions in 46% of the patients, atrophic dilatation of ventricles and sulci in 27%, and thalamic hypointensity in 20%. White matter changes were restricted in 53% and diffuse in 47%. The development of white matter changes and thalamic hypointensity were significantly associated with duration of abuse longer than 4 years (P <.05 and P <.01, respectively).

CONCLUSION

White matter changes seem to start in the deep periventricular white matter, and they spread into peripheral white matter, causing the loss of gray matter-white matter differentiation with continued toluene abuse. The deposition of iron due to demyelination and axonal loss is the most probable mechanism for the thalamic hypointensity found in solvent abusers.

The effect of cigarette smoking on urinary hippuric acid concentration in Thai workers with occupational exposure to toluene

Urine hippuric acid determination is helpful for monitoring of group of workers at risk for exposure to toluene. However, some problems about the external source of variation are mentioned. Some studies have indicated that smoking is an important external source of variation for determination of urine hippuric acid level while the others stated the opposite findings. This study was conducted in an attempt to study the difference of urine hippuric acid between smoking and non smoking subjects in a press workers group. Urine samples were obtained from 46 workers (all male) who worked as press workers in the same press factory in Bangkok. The individuals were classified as control (non smoking, N = 26) and experimental (smoking, N = 20) according to their smoking. All samples were analyzed for hippuric acid level. The average urine hippuric acid level for the control were (0.35 +/- 0.31 mg/gCr) and experimental group (0.40 + 0.45 mg/gCr) were respectively. No significant difference was found between urine hippuric acid level between both groups. The data from the current study indicates that smoking does not influence the urinary hippuric acid levels in this study group.

Neuropsychologic impairment and MRI abnormalities associated with chronic solvent abuse

OBJECTIVE

Individuals chronically abusing organic solvents have been reported in the medical literature for almost four decades to have a variety of neurological abnormalities. Most have been single case reports or studies in small numbers of individuals. The purpose of this study was to evaluate the neurologic and neuropsychologic effects of chronic solvent abuse in a larger group of individuals and compare the results to a control group of other drug abusers. Attempts to estimate a dose-response relationship between solvent abuse and either neuropsychological tests or magnetic resonance imaging (MRI) abnormalities were also undertaken.

METHODS

A sample of 55 solvent abusers was compared to a sample of 61 users of other drugs, especially cocaine and alcohol, on a battery of cognitive and neuropsychological tests. Fifty of the solvent abusers and 51 members of the comparison sample also underwent MRI of the brain. Comparisons were made by means of multivariate analysis of variance and covariance.

RESULTS

Compared to the general population, both groups performed poorly, scoring below the mean on most neuropsychological measures. Solvent abusers performed more poorly than the comparison sample on measures of working memory and executive cognitive functions. Both groups showed evidence of abnormal MRI findings, but a greater percentage of the solvent abuse group showed such abnormalities. No clear dose-response relationship was seen between solvent abuse and abnormalities on neuropsychological tests, but a strong dose-response relationship was seen in the presence of MRI abnormalities.

CONCLUSION

The findings in this study document widespread cognitive impairment, which could not be attributed to the effects of solvents entirely. These findings expand upon previous data regarding neurological abnormalities in solvent abusers, by demonstrating a dose-response relationship with MRI abnormalities. An unexpected finding was the high prevalence of neuropsychological impairment and MRI abnormalities among the comparison group. The results of this study has implications regarding low-level solvent exposure, as in the occupational setting, suggesting that MRI may be a more useful tool to sort out the presence of neurological abnormalities rather than neuropsychological tests. Since no dose-response relationship was seen between solvent abuse and neuropsychological testing, reliance upon these tests in assessing neurological injury from solvents is a highly dubious practice.

Psychomotor performance and subjective symptoms at low level toluene exposure

OBJECTIVES

Possible effects of long term occupational exposure to toluene below the level of 100 ppm on psychomotor performance and subjective symptoms were investigated in a cross sectional approach.

METHODS

From German rotogravure printing plants 278 male workers, mean age 39.8 years, mean duration of employment 14.9 years, were examined. A mean lifetime weighted average exposure (LWAE) of 45.1 ppm toluene in ambient air was found for 154 exposed workers (rotogravure printing area), with a mean current exposure of 24.7 ppm. The corresponding data for a second group of 124 workers with very low exposure (endprocessing area) had LWAE of 9.3 ppm and a current exposure of 3.3 ppm toluene. Psychomotor performance (steadiness, line tracing, aiming, tapping, and peg board) and subjective symptoms were examined.

RESULTS

No significant differences between the two exposure groups were found by analysis of variance (ANOVA). By stepwise linear regression analyses there were weak associations of LWAE with one performance variable and two symptoms scales, but the results were not significant after correction for the alpha error. Psychomotor performance was mostly affected by age (maximum explained variance up to 13%), and handedness (up to 9%), whereas subjective symptoms are mostly affected by anxiety (up to 38%).

CONCLUSIONS

The weak associations between long term exposure to toluene should be used to indicate further longitudinal investigations. The results of this cross sectional study show no obvious dose response relation for psychomotor functions and subjective symptoms among workers exposed to toluene at a current exposure level of 1-88 ppm.

Developmental neurotoxicity: do similar phenotypes indicate a common mode of action? A comparison of fetal alcohol syndrome, toluene embryopathy and maternal phenylketonuria

Developmental neurotoxicity can be ascribed to in utero exposure to exogenous substances or to exposure of the fetus to endogenous compounds that accumulate because of genetic mutations. One of the best recognized human neuroteratogens is ethanol. The Fetal Alcohol Syndrome (FAS) is characterized by growth deficiency, particular facial features, and central nervous system (CNS) dysfunctions (mental retardation, microencephaly and brain malformations). Abuse of toluene by pregnant women can lead to an embryopathy (fetal solvent syndrome, (FSS)) whose characteristics are similar to FAS. Phenylketonuria (PKU) is a genetic defect in phenylalanine (Phe) metabolism. Offspring of phenylketonuric mothers not under strict dietary control are born with maternal PKU (mPKU), a syndrome with similar characteristics as FAS and FSS. While ethanol has been shown to cause neuronal death, no such evidence is available for toluene or Phe and/or its metabolites. On the other hand, alterations in astrocyte proliferation and maturation have been found, mostly in in vitro studies, which may represent a potential common mode of action for at least some of the CNS effects found in FAS, mPKU, and FSS. Further in vivo and in vitro studies should validate this hypothesis and elucidate possible molecular targets.

Neurobehavioral disturbances arising from occupational toluene exposure

BACKGROUND

Neurotoxicity of long-term exposure to toluene is known at higher levels than 50 ppm and is suspected at lower levels.

METHODS

A cross-sectional study carried out in two printing plants on 129 blue collar workers explored such a low level exposure of toluene. With 231 samples of ambient air, toluene concentration was estimated from 0 to 18 ppm in Plant A (offset) and from 2 to 27 ppm in Plant B (heliogravure). Outside any period of acute exposure, the workers answered a self-administered questionnaire on neurotoxic symptoms, EUROQUEST, and performed six psychometric tests on a computer-assisted version of battery NES.

RESULTS

After adjustment for confounders, we found significant relationships only between present exposure and Digit Span Forwards (DSF) performance (decrement is 1 digit for 40 ppm, P=0.04) and Digit Span Backwards (DSB) performance (decrement is 1 digit for 25 ppm, P=0.01). Neurotoxic symptoms were not significantly correlated with current exposure. No association was found between estimated cumulative exposure and either psychometric performances or neurotoxic symptoms.

CONCLUSION

In this study, low present exposure levels to toluene were associated with decrements of memory test performances.

Solvent abuse in pregnancy: a perinatal perspective

OBJECTIVE

To review the scope and sequelae of solvent abuse in women presenting to a Manitoba teaching hospital.

METHODS

Fifty-six patient charts with a diagnosis of solvent abuse in pregnancy were identified through computer search in the medical records of Winnipeg Health Sciences Centre, General Hospital. These charts were reviewed and data obtained from birthing records and associated pediatric charts.

RESULTS

Renal tubular acidosis was diagnosed in three patients (5.3%). Two patients (3.6%) had adverse neurological sequelae. One patient was diagnosed with brain damage, including expressive aphasia. Twelve patients (21.4%) delivered preterm infants. Nine infants (16.1%) had major anomalies. Seven infants (12.5%) had fetal alcohol syndrome (FAS)-like facial features. Six neonates (10.7%) had hearing loss.

CONCLUSION

Substance abuse in pregnancy is associated with severe maternal and neonatal sequelae. Physicians must be aware of this increasing problem in the obstetrical population and assistance should be offered to each woman, ideally before a woman becomes pregnant, but at least at the first contact a pregnant woman makes with the health care community.

Multicenter field trial on possible health effects of toluene. I. Toluene body burdens in workers of the rotogravure industry

Ambient air toluene concentrations as well as corresponding individual blood toluene levels were measured under conditions of a field trial, as basis for a correlation with possible acute effects. While the results of various psycho-physiological and medical evaluations after acute (Neubert et al., 2001) and long-term toluene exposure (Gericke et al., 2001) are published in accompanying papers, this publication deals with the exposure levels and body burdens characteristic of workers in the rotogravure industry in Germany at the time of the investigation (1993-1995). Besides providing some information on the exposure at various work-areas under occupational conditions, the correlation between a time-weighted average of the ambient air concentration with the corresponding blood toluene levels is analyzed. Limitations of such an attempt and possible pitfalls are discussed. In the largest field study so far performed on toluene exposure, 12 companies of the German rotogravure industry (and a total of 1528 volunteers) participated. Altogether, complete data sets, i.e. on both ambient air as well as blood toluene levels, were obtained from 1244 male and 124 female participants of the rotogravure industry with quite different degrees of toluene exposure. Rotogravure printers and their helpers were exposed to the highest toluene concentrations in ambient air. On the day of the evaluation, of 806 male volunteers within this group (of 1261 with verified exposure in air), 35 were exposed to a time-weighted average of 100 ppm (i.e. 375 mg/m(3)) or above, and 155 of the printers to concentrations between 50 and 100 ppm. Of the remaining 455 male participants of the rotogravure factories ('non-printers and helpers'), only three were exposed to toluene concentrations above 50 ppm. Only one of the 124 women working in the rotogravure factories was exposed to an average toluene concentrations above 100 mg/m(3) (i.e. 27 ppm). In 66 of the male volunteers toluene levels in blood of >850 microg/l were measured and 14 showed levels exceeding 1700 microg/l. When attempting to predict the resulting individual blood toluene levels from measurements of ambient air concentrations under field conditions, a considerable uncertainty is to be expected. We found a correlation coefficient of the regression curve of about 0.70, with numerous outliers (and a variation of the 12 factories between 0.52 and 0.88).

Multicenter field trial on possible health effects of toluene. III. Evaluation of effects after long-term exposure

In rotogravure industry, contributing considerably to mass color printing of catalogues and magazines, toluene is still extensively used as paint solvent, and many printers have been exposed to this chemical for several decades. Information on adverse health effects associated with long-term toluene exposure is still controversial. In a multi-center study, adverse health effects possibly associated with long-term toluene exposure were evaluated. In 12 rotogravure factories, 1226 male volunteers were recruited, and sufficient information on exposure and on medical data was compiled for about 1077 of them. Evaluations included: physical examination, standard tests of psycho-physiological and psycho-motoric performances, self-report of subjective symptoms, and data on a variety of laboratory blood tests. The medical data were correlated with the length (months) of toluene exposure, and a rough estimate of the extent of exposure (i.e. highly exposed printers and their helpers versus employees working at locations with low or negligible toluene exposure). A small reference group (n=109) was selected from companies of the paper industry. When linear regression curves were calculated (test results versus duration of exposure), extremely low overall coefficients of determination (r(2) adj.) of a few percent were estimated within the data clouds, with sometimes statistically significant P-values. Closer analyses revealed a strong influence of the confounding factor age, no clustering of abnormal values of highly toluene-exposed volunteers, and the vast majority or all values of the highly and long-term toluene-exposed participants staying within the reference ranges. Thus, no medical relevance of P-values <0.05 could be recognized in this evaluation, and there may have been some border-line deviations or results largely occurring by chance in the large trial. In a small cluster of the many rotogravure printers toluene-exposed for more than 20 years, the highest systolic blood pressure values of the study were found, but many possible confounding factors were not taken into account. Data on acute exposure and possible effects are presented in accompanying papers (Neubert et al., 2001a, Neubert et al., 2001b). Restricting the conclusions to the end points evaluated as well as the apparent limitations of the evaluation, no evidence was found that long-term occupational toluene exposure extending over several decades in the rotogravure industry in the Western part of Germany was convincingly associated with chronic adverse health effects or convincingly altered surrogate markers in still working male volunteers. Several peculiarities and pitfalls arising when interpreting medical data associated with such a type of environmental exposure must be considered. Reversibility of alterations previously induced at higher levels of toluene-exposure, as well as a healthy workers effect, cannot be excluded for some of the medical end points evaluated.

Multicenter field trial on possible health effects of toluene. II. Cross-sectional evaluation of acute low-level exposure

Data on possible acute effects of today's relevant low-level exposure to toluene are contradictory, and information on possible effects of exposure under occupational conditions is largely lacking. In a controlled, multi-center, blinded field trial, effects possibly associated with acute toluene exposure were evaluated in workers of 12 German rotogravure factories. Medical examinations (inquiries on subjective symptoms, and standard tests of psycho-physiological and psycho-motor functions) were performed on almost 1500 volunteers, of whom 1290 were toluene-exposed (1178 men and 112 women), and about 200 participants served as references (157 men and 37 women), but the main aim of the trial was to reveal dose-response relationships. All volunteers were of the morning work-shift (6 h exposure). Both individual ambient air concentrations (time-weighted average) during the work-shift, as well as blood toluene concentrations after the work-shift were measured. Therefore, the medical data could for the first time be correlated with the actual individual body burden (blood toluene level) at the time of testing. In order to largely exclude confounding by chronic toluene exposure, kinetic measurements as well as the psycho-physiological and psycho-motoric tests were performed before and after the work-shift. Except for minor statistical deviations, neither convincing dose-dependent acute effects could be demonstrated with regression analyses in male volunteers at the exposure levels evaluated, nor were significant differences found when applying group statistics (highly toluene-exposed group versus volunteers with negligible exposure). Due to the rather large number of participants, the predictive power of the study is high, especially when compared with previous publications. In two psycho-physiological tests, a few more female volunteers with quite low toluene body burdens (<340 microg/l blood) showed relatively low scores when compared with participants of the reference group. Although evidence for a medical relevance is meager, the small numbers of participants, in both the exposure and the reference groups, hamper a reliable interpretation of the results concerning exposure levels above 85 microg toluene/l blood, and it is difficult to take confounding factors adequately into account. For the end points evaluated and under occupational conditions, neither blood toluene levels of 850 to 1700 microg/l (in the highest exposure group [EXPO-IV] with 56 participants), as measured 1/2 (+/-1/2) h after the work-shift, nor ambient air concentrations (time-weighted average over 6 h) between 50 and 100 ppm (188-375 mg/m(3)) were convincingly associated with alterations in psycho-physiological and psycho-motoric performances or increased the frequency of subjective complaints in male volunteers. For higher dose ranges of toluene exposure (i.e. >1700 microg toluene/l blood [or >100 ppm in ambient air]), our data set is too small for far reaching conclusions. Our data are insufficient for conclusions on a possibly higher susceptibility to toluene of some female workers. Results of kinetic studies and possible effects of long-term exposure are discussed in two accompanying publications (Neubert et al., 2001; Gericke et al., 2001).

Efficacy of a new class of perfluoropolyethers in the prevention of irritant contact dermatitis

Perfluoropolyethers (Fomblin HC products) are chemical non-reactive polymers with special physico-chemical properties that recently showed promise as protective preparations in the prevention of irritant contact dermatitis. We evaluated the efficacy of a new class of perfluoropolyethers (perfluoropolyether phosphate, Fomblin HC/P2) in the prevention of experimentally induced cumulative irritant contact dermatitis if applied prior to irritation. A panel of 20 healthy volunteers was tested with a repetitive irritation test using 4 standard irritants (sodium lauryl sulphate of highest purity, sodium hydroxide, lactic acid and toluene) in a randomized double-blind study. Application sites were assessed clinically and by the use of bioengineering techniques (transepidermal water loss and chromametry). Three gel preparations each containing 5% perfluoropolyether phosphate showed significant efficacy against irritation due to sodium lauryl sulphate and sodium hydroxide, while one test preparation containing 2% showed inferior benefit, indicating a dose-related effect. Preparations containing perfluoropolyether phosphates can be recommended for workplaces with water-soluble irritants. Further studies under real workplace conditions are indicated.

Decreases of natural killer cells and T-lymphocyte subpopulations and increases of B lymphocytes following a 5-day occupational exposure to mixed organic solvents

The authors examined the effects of organic solvents on lymphocyte subpopulations in blood. Natural killer and T-lymphocyte subpopulations and B (CD19+) -lymphocytes were measured with flow cytometry in 16 male rotogravure printers on a Friday and on the following Monday. Numbers of all 3 subpopulations of natural killer cells (i.e., CD57+ CD16+, CD57- CD16+, and CD57+ CD16- cells), 2 subpopulations of T lymphocytes (CD4+ CD45RA+ and total CD8+ cells), and total lymphocytes on Friday were significantly fewer than those found on the following Monday. Conversely, the number of B lymphocytes on Friday was significantly larger than the number on Monday. The number of B lymphocytes was significantly correlated with blood toluene levels on Friday. The alteration in the number of CD57+ CD16+ NK cells from Friday to the following Monday was correlated inversely with the corresponding change in exposure level of toluene on Friday. The authors suggest that the effects of mixed organic solvents (primarily toluene) are recoverable decreases of natural killer cells and T lymphocytes and increases in B lymphocytes.

Color vision and occupational toluene exposure

We examined the relationship between acquired color vision loss and exposure to toluene and total hydrocarbons among 125 male workers. Seventy-two toluene-exposed printers were compared with 34 workers from the same photogravure plant with ambient background exposure, and with 19 workers from a bookbinding plant located in the same town (nonexposed). Environmental mean toluene exposure level at workstation was estimated from individual 8-h sampling. Historic exposure data from the last 30 years were used to construct two cumulative exposure indices, one for toluene and one for total hydrocarbons. Airborne toluene levels were overall lower than the current Threshold Limit Value (TLV) of 50 ppm. Color vision was assessed by the Lanthony D-15 desaturated panel. Color vision loss was quantitatively established by the Color Confusion Index (CCI) and classified by type of acquired dyschromatopsia according to Verriest's classification. CCI was positively related to current airborne toluene levels, and cumulative exposure indices for toluene and total hydrocarbons (.18< or =r< or =.35). Odds ratios of acquired dyschromatopsia were significant for current airborne toluene, toluene, and total hydrocarbon past exposure (1.27 [1.02-1.58], 1.21 [1.04-1.39], 1.15 [1.02-1.31], respectively). In conclusion, this study suggests that the Lanthony D-15 desaturated panel detects early neurotoxic effects among workers exposed to toluene.

Prevalence of neuropsychiatric and mucous membrane irritation complaints among Palestinian shoe factory workers exposed to organic solvents and plastic compounds

BACKGROUND

Long-term exposure to organic solvents is associated with neuropsychiatric and mucus membrane irritation. In developing countries, efforts to secure a good working environment are inadequate and protection against chemical exposures is often neglected.

METHODS

In a cross-sectional survey, the prevalence of self-reported health complaints and the association with long-term exposure to solvents and plastic materials in the work environment was studied among 167 shoe-factory workers. Prevalences and adjusted prevalence ratios (PR)were calculated in Cox regression. 95% confidence intervals were estimated for PRs of adverse health effects.

RESULTS

Overall, the workers reported high prevalences of neuropsychiatric and mucus membrane complaints: headache (65%), mental irritability (53%), tingling of limbs (46%), and sore eyes (43%). Cleaning work was associated with tingling of limbs (PR = 1.8, 1.0-3.2), sore eyes (PR = 1.9, 1.1-3.3), and breathing difficulty (PR = 2.0, 1.0-3.9); plastic work was associated with tingling of limbs (PR = 1.8, 1.2-2.9)and sore eyes (PR = 1.7, 1.1-2.7); and varnishing was associated with breathing difficulty (PR = 1.9, 1.1-3.5).

CONCLUSIONS

The high prevalence of self-reported health complaints and the exposure-outcome association could be due to volatile organic solvents (dichloromethane, n-hexane)and plastic compounds (isocyanates and polyvinyl chloride). Absence of a satisfactory work environment is likely to contribute to high exposure levels.

Toluene mineralization and growth potential of Pseudomonas putida PaW164 under toluene-limiting conditions

Toluene-induced cells of Pseudomonas putida PaW164 (pWWO-164) were monitored for growth potential, maintaining the TOL plasmid, and potential toluene mineralization activity in toluene-amended and nonamended soil. A follow-up study was done in a carbon-free mineral salts solution to obtain further information on physiological changes that occur during starvation. These studies showed that there was a larger decline in colony forming units (CFUs) recovered on a toluate- or benzoate-defined mineral salts medium than on a complex agar medium, a greater percent decrease of CFU than of potential mineralization activity, no decrease in direct counts, and no loss of the TOL plasmid during starvation. Toluene-induced cells also showed an increasing lag time and a decreasing potential for mineralization of (14)C-toluene with starvation. In contrast, the lag time for mineralization of glucose was longest at the onset of starvation and reached a minimum by 3 days; thereafter, the potential for glucose mineralization remained high.

Review of the epidemiological evidence relating toluene to reproductive outcomes

This review examines the epidemiological evidence for adverse reproductive outcomes from those occupational studies that present toluene-specific findings. Clinical investigations of the reproductive effects of toluene abuse are also examined. Six occupational studies reported associations between toluene and spontaneous abortion, two between toluene and congenital malformation, and three between toluene and reduced fertility. The spontaneous abortion studies provided the most suggestive evidence for an association with toluene. However, the potential for bias in some of these studies, the relatively homogeneous nature of the populations examined (e.g., four of the six studies evaluated similar groups of Finnish workers), and the multiple chemicals to which most workers were simultaneously exposed suggest cautious interpretation of these findings. Also, spontaneous abortion has generally not been observed as a major problem among highly exposed women who abuse toluene during pregnancy. The results of the occupational studies should be considered "hypothesis generating". Truly prospective studies with individually monitored data on toluene exposure and early fetal loss are needed to more definitively investigate this issue.

Solvent exposures at shoe factories and workshops in Hebron City, West Bank

Exposure to organic solvents has been reported to increase the risks for acute and chronic health effects among shoe industry workers. In developing countries, protection against chemical exposures is often not provided. The study was conducted to identify working conditions and estimate the concentrations of organic solvents used in shoe factories and workshops in Hebron City. Personal interviews containing questions related to personal protective equipment (PPE) were used to identify working conditions, and samples collected from factories and workshops were analyzed using gas chromatography. Geometric means (GMs) were calculated for the solvents. Six major organic solvents were detected in the factories. Acetone (GM = 51.5 mg/m3, GSD = 3.82) was common in gluing tasks. Dichloromethane (GM = 47 mg/m3, GSD = 2.62) was common in cleaning tasks. Heptane, methylethyl ketone, n-hexane, and toluene were common in gluing tasks. Four major organic solvents were detected in the workshops: acetone (GM = 32.3 mg/m:3, GSD = 6.33), toluene (GM = 70.3 mg/m3, GSD = 3.06), n-hexane (GM = 19.4 mg/m3:, GSD = 2.65), and methylethyl ketone (GM = 130 mg/mM3, GSD = 1.5). 81% of the factory workers had never used respiratory protective equipment, and 92% had never used work clothes. 97% of the workers in the workshops had never used respiratory protective equipment, 94% had never worn gloves, and 90% had never used work clothes. Exposures to solvents in the absence of personal Protective equipment, tasks barriers, and mechanical ventilation can adversely affect health.

Toluene alters mu-opioid receptor expression in the rat brainstem

Toluene is an ototoxic organic solvent widely used in industry and could be a cause of sleep apnea. Acute toluene administration in rats induces an increase in the number of neural cells immunostained for mu-opioid receptors in several brainstem nuclei, such as the inferior colliculus, dorsal and lateral periaqueductal gray and dorsal raphe, without changes in the superior colliculus and the interpeduncular and lateral reticular nuclei. These data suggest that mu-opioid receptors could be involved in toluene-induced neurotoxic effects on the physiological regulation of breathing during sleep, and auditive function.

Cognitive functions in workers exposed to toluene: evaluation at least 48 hours after removal from exposure

OBJECTIVES

Long-term exposure to toluene may result in subtle impairment of cognitive functions. However, it is not clear whether this impairment is due to the presence of the solvent in the body or if it persists after its elimination from blood. The aim of this study is to compare cognitive functions between toluene-exposed workers (at least 48 h after removal from exposure) and non-exposed workers.

METHODS

Seventy-two workers exposed for at least 5 years to toluene (9 to 467 ppm) completed a questionnaire and psychometric tests. The results were compared with those of 61 non-exposed workers. An alveolar air sample was taken just before the tests to ensure the absence of toluene.

RESULTS

Results of the vocabulary test were slightly better in exposed (correct words: 21 +/- 0.6) than in non-exposed workers (19 +/- 0.8) (P < 0.05). No differences were found for simple reaction time, digit symbol, digit span, continuous tracking test, color word and switching attention test.

CONCLUSIONS

The results of this study do not support the notion of the persistence of cognitive effects of toluene after elimination of the solvent from blood.