Determination of o-cresol by gas chromatography and comparison with hippuric acid levels in urine samples of individuals exposed to toluene

Hippuric acid is the most frequently used biomarker in the biological monitoring of occupational exposure to toluene. This product of solvent biotransformation may be also found in the urine of individuals who have not been exposed to the solvent. A smaller fraction of the absorbed toluene is oxidized to aromatic compounds including ortho-cresol, which is not found significantly in the urine of nonexposed individuals. An analytical methodology whereby gas chromatography with flame ionization detection is utilized for determination of o-cresol in urine of workers exposed to toluene is described. The levels obtained were subsequently compared to hippuric acid levels determined in the same urine samples. The analytical method has demonstrated an adequate precision (intra- and interassay coefficient of variation in the range of 2.4-5.4%) and average recovery of 98%. The samples for o-cresol determination were obtained from workers exposed to toluene in three different industrial activities. The concentration range found in exposed groups varied from < 0.21 to 2.8 micrograms/ml. The o-cresol values in the urine did not differ significantly among the exposed groups analyzed at the 5% level. The o-cresol and hippuric acid values found in the urine samples showed a significant correlation at the 1% level. These results may represent an additional contribution to studies for a definitive evaluation of the validity of o-cresol as a biomarker of exposure to toluene.

Positron emission tomography studies of healthy volunteers--no effects on the dopamine terminals and synthesis after short-term exposure to toluene

Despite extensive research, the mechanisms for the effects of organic solvents on the central nervous system are still unknown. One mechanism proposed is that solvents interfere with the synthesis of neurotransmitters. In the present study 11 male healthy volunteers were exposed during 15 min to 100 p.p.m. toluene at light physical exercise, and the dopamine decarboxylase activity and number of terminals in putamen were measured before and after exposure by positron emission tomography. Two different tracers were used [beta-11C]L-DOPA for decarboxylase activity during the in vivo synthesis of dopamine, and [11C]nomifensine to estimate the number of terminals. Although there was a slight increase in the rate of dopamine synthesis in the putamen after the exposure, this difference was not statistically significant (P = 0.4). No effect was observed with regard to the uptake of nomifensine. There was no significant relationship between the dose of toluene and rate of dopamine synthesis, and no significant correlation between the time from end of exposure to start of the PET-camera and DOPA. Our findings indicate that short term exposure to 100 p.p.m. of toluene does not affect the rate of dopamine synthesis or the number of presynaptic terminals.

The central nervous system and exposure to toluene: a risk characterization

The principal health outcome of exposure to toluene is dysfunction of the central nervous system. Effects range from fatalities and severe neurological disorders in toluene abuse situations to deficits in neurobehavioral function in occupational populations. An Inhalation Reference Concentration (RfC) of 0.4 mg toluene/m3 or 0.1 ppm was developed by the U.S. EPA to protect general populations chronically exposed to toluene. The RfC was derived from results of an occupational study involving Asian workers who developed neurobehavioral deficits at a mean toluene exposure level at the time of the study of 88 ppm. The derivation incorporated several uncertainty factors, one of which was a factor of 10 to account for sensitive subpopulations. Recent evidence indicates that some Japanese and possibly other Asian populations harbor a defective gene for aldehyde dehydrogenase, and thus exhibit a decreased rate of toluene metabolism. Although it is not known if reduced metabolism by aldehyde dehydrogenase also was a factor in the occupational study, preshift blood levels of toluene were considerably higher than preshift levels from non-Asian workers exposed to similar air levels of toluene. The elevated blood levels are consistent with defective metabolism but remain to be confirmed. Inasmuch as air levels of toluene in urban environments are about 10-fold lower than the RfC, an adequate measure of protection is afforded by the RfC with or without an uncertainty factor for sensitive subgroups. However, the uncertainty factor for sensitive subgroups should be retained because there is no information regarding toluene metabolism in children.

Petrolatum prevents irritation in a human cumulative exposure model in vivo

BACKGROUND

Protective creams (PCs) have been studied in different models indicating a protective effect of some products. In order to compare PCs in different studies, a generic reference standard should be available.

OBJECTIVE

The purpose of this study was to investigate if petrolatum prevents epidermal barrier disruption induced by various irritants in a repetitive irritation test (RIT) and to assess its potential as a standard reference product.

METHODS

White petrolatum was evaluated against a set of 4 irritants [10% sodium lauryl sulphate (SLS), 1% sodium hydroxide (NaOH), 30% lactic acid (LA) and undiluted toluene (TOL)] in the RIT. Twenty subjects were tested on the paravertebral skin of the midback. Irritation was assessed by visual scoring, transepidermal water loss and colorimetry.

RESULTS

Petrolatum was very effective against SLS, NaOH and LA irritation, and it provided a moderate protection against TOL.

CONCLUSION

Petrolatum can be recommended as a standard reference substance against which PCs may be compared as it is effective against water-soluble and water-insoluble irritants in a standardized test procedure.

[Liver function in patients exposed to a toluene in a hydrocarbon processing plant]

Since the hepatotoxic role of toluene in exposed workers from the petroleum and petrochemical industries chronically exposed to low concentration has no been entirely dilucidated, this transversal study was undertaken in order to clarify the situation in the local industries. A group of 33 non-exposed men workers of such industries (group control, aged 33.0 +/- 4.88 years) were compared with 33 toluene-exposed men (aged 35.0 +/- 9.33 years) from the related industries, with a minimal of 6 months exposition time to toluene and without liver disease history. In addition to a complete occupational diseases medical history, each subject was tested by both a venous blood sample (to determine prothrombin, total and fractioned bilirubin, total and fractioned proteins, liver enzymes and cholesterol) and urine sample (hippuric acid). Also the environmental concentration of toluene in working areas was determined by gas chromatography, which was below the recommended standard levels in working areas. Although the analyzed parameters were in the normal range, it was observed that those workers with known alcohol ingestion and toluene exposition had several abnormalities. The results of this study confirm that toluene may have a synergistic hepatotoxic effect in toluene-exposed workers that are alcohol consumers. The alcohol in considered as a confounding factor and it is not possible to rule out in the etiology of hepatic changes detected in the study.

Brainstem auditory evoked potentials in individuals exposed to long-term low concentrations of toluene

Brainstem auditory evoked potentials (BAEPs) were examined in 49 workers employed in a printing press, who were occupationally exposed to low concentrations of toluene for an average of 20.3 years, and in 59 subjects in a control group. In the group of exposed workers, a significant decrease was found in all wave amplitudes examined, a significant prolongation of P1 wave latency, and an increased interval of interpeak latencies (P3-P5), indicating that the extramedullary and high medullary part of the auditory pathway are biologically most frequently affected by chronic exposure to low concentrations of toluene. The level of exposure to toluene in both groups was evaluated by defining the concentration of toluene in peripheral blood and the concentration of hippuric acid and ortho-cresol in urine.

Human performance during exposure to toluene

PURPOSE

The purpose of this research was to examine the effects of inhalation of toluene on respiratory function and neuropsychological performance of humans.

METHODS

We exposed six healthy adults to 100 ppm toluene or air (control) for 6 h, in a double-blind, randomized fashion, with exposures separated by at least 14 d and including 30 min of exercise at a level that quadrupled minute ventilation. Blood and exhaled air toluene levels were measured before, during, immediately, and 1 and 2 h post-exposure. Lung function was measured before and immediately after exposure. Three repetitions of two computerized neuropsychological tests were performed, including a brief standard neuropsychological battery (ANAM) and a 1-h complex performance test (SYNWORK). Statistical analysis of the psychological data was conducted as a repeated measures ANOVA.

FINDINGS

Following exercise, the mean blood and exhaled air toluene levels averaged 1.5 micrograms and 28 ppm, respectively. Lung function was unchanged post-exposure. On the SYNWORK test, the Composite score obtained over time during toluene exposure was lower than that during room air (F = 29.20, p = 0.005), with the score from the final hour reduced by 10%. On standard neuropsychological tests, latency but not accuracy proved the sensitive measure for five of the seven subtests presented.

CONCLUSIONS

Performance of complex tests and response time to simple brief tests can be disrupted by toluene inhalation at 100 ppm. Differences in performance between air and toluene conditions were greatest after exercise, indicating that physical activity may enhance the response to volatile organic solvents.

Colour vision impairment in workers exposed to low concentrations of toluene

Colour vision was examined by the Lanthony-D-15 desaturated test in 41 women exposed to toluene and in 29 non-exposed referents. Toluene exposure was evaluated by methods of environmental and biological monitoring. In the exposed group the median value of toluene in air was 35 ppm (range 11.2-49.9 ppm). Quantitative colour vision impairment was expressed as colour confusion index and colour confusion index corrected for alcohol intake. Qualitative impairment was expressed as normal, yellow-blue, red-green range or complex impairment. Statistical analysis showed the index values to be significantly correlated with age in both groups. In the exposed group they were significantly higher than in the non-exposed group. There was no significant difference in the prevalence of impairment in the blue-yellow range between the examined groups, although the prevalence of impairment in the exposed group was higher than in the non-exposed one. Results suggest that exposure to low toluene concentrations may induce colour vision impairment in women.

Newborn renal tubular acidosis associated with prenatal maternal toluene sniffing

Sniffing of volatile organic solvents containing toluene, such as acrylic paints, glues, adhesives, paint thinners, varnishes and shoe polishes, has become increasingly frequent in recent years. Renal tubular acidosis is one of a number of human complications reported in the offspring of mothers inhaling toluene during pregnancy. This article reports a case of a premature newborn with renal tubular acidosis probably due to maternal sniffing of paint containing toluene. Characteristics of this condition are described as well as its medical management. With increasing frequency of maternal glue and paint sniffing, more cases of newborn renal tubular acidosis will likely appear. Physicians should be prepared to manage neonatal tubular acidosis that may accompany maternal toluene sniffing in order to lessen newborn morbidity and/or mortality.

Criminal responsibility and solvent exposure

This case report contains the history of a man's exposure to benzene, trichloroethylene, and toluene. J suffered acutely from classic symptoms of toxic exposure to these compounds, such as fatigue, clumsiness, staggering, and hematopoietic depression. During his medical hospitalization, he was exposed to further organic insults, such as being treated with medications like Cytoxan and medications to treat an abscess in his right parietal lobe. After the acute exposure and after the abscess had resolved, his functioning on neuropsychological testing was still depressed, as he had a Full Scale IQ of 105, whereas at the time of the forensic evaluation he had a Full Scale IQ of 114. It would therefore appear that he did have some mild deficits when originally discharged from the hospital. While he reported having continual mental status changes at the time of the offense and even at the time of the forensic evaluation, it was not felt that these played a significant role in the commission of the offense. Comprehensive forensic evaluation suggested that psychological reactions to his illness and an underlying personality disorder were more direct contributors to the criminal acts. J was therefore recommended and ultimately found to be responsible for his behavior, according to the law.

Contrast sensitivity in organic-solvent-induced chronic toxic encephalopathy

This is a study of visual contrast sensitivity in a series of subjects with previously diagnosed occupational organic-solvent-induced chronic toxic encephalopathy. Contrast sensitivity was measured for 16 subjects using the Vistech VCTS 6500 chart. The results were compared with age-stratified normal data. Six of the 16 subjects (37.5%) recorded abnormal contrast sensitivity results. Monocular abnormalities were found for two (33%) of these subjects. Statistically significant abnormalities in contrast sensitivity were observed at the intermediate spatial frequencies of three cycles per degree (cpd; P < .0005), 6 cpd (P < .025), and 12 cpd (P < .01). We conclude that contrast sensitivity is abnormal in some cases of occupational organic-solvent-induced chronic toxic encephalopathy. Intermediate spatial frequency channel neurones in the visual system may be more vulnerable to solvent toxicity than those of low or high spatial frequency. Contrast sensitivity testing may be a useful adjunct in the diagnostic process for this disease. Further research involving larger numbers of subjects is recommended.

Rapid determination of O- and P-cresol isomers in urine from workers exposed to toluene by high-performance liquid chromatography using a graphitized carbon column

A simple and rapid procedure is described that permits the simultaneous determination of o- and p-cresol in urine of workers of other individuals exposed to toluene. The urine samples are enzymatically hydrolysed and analysed by high-performance liquid-chromatography with a detection limit of 0.2 mg/L, one fifth of the biological threshold limit value for o-cresol (1 mg/g), a specific marker of toluene exposure. A graphitized carbon column Hybercarb-S, that exhibits an excellent selectivity for aromatic positional isomers, was used with 1% phosphoric acid-acetonitrile (70:30, v/v) as mobile phase and a detection wavelength of 271 nm. The overall accuracy for o-cresol determination was 4.5% at 5 mg/L and 8% at 0.5 mg/L. The cresol isomers were sufficiently resolved from endogenous materials to avoid the need for any extraction step, and the method appears suitable for monitoring workers accurately under the permissible level of exposure for occupational medicine purpose.

The allergens of nail polish. (I). Allergenic constituents of common nail polish and toluenesulfonamide-formaldehyde resin (TS-F-R)

Nail polish that has completely dried on the fingernails contains water-soluble components that attain the skin during extensive but transient contact. This was proven by water extraction of thin layers of nail polish that had been painted onto glass plates and allowed to dry for 3 days. Comparing the isolated fractions and compounds with known nail polish ingredients revealed that the water-soluble substances are para- and ortho-toluenesulfonamide, dibutyl phthalate and 3 constituents of toluenesulfonamide-formaldehyde resin (TS-F-R), which is the basic material of almost all nail polishes sold worldwide. 12 female patients with proven nail polish allergy were patch tested with 21 nail polish components, including those isolated. Only 2 fractions were positive. These contained a monomer and a dimer created during condensation of TS-F-R. Their structures were elucidated. The 3rd compound, a trimer, remained negative, except in 1 case.

White matter changes caused by chronic solvent abuse

PURPOSE

To examine the brain damage of solvent abusers in Japan, where pure industrial toluene is frequently abused.

METHODS

Twenty solvent abusers 17 to 33 years of age with 7.2 +/- 4.0 years of abuse were examined with a 1.5-T MR imaging system.

RESULTS

White matter hyperintensities in cerebrum, brain stem, and cerebellum on T2-weighted images were found in seven cases. The extent of white matter change was most clearly shown on proton density-weighted images. The patients with restricted white matter change and intermediate white matter change showed white matter hyperintensities in the brain stem and cerebellum on T2-weighted images, in some cases, with additional hypointensities in the corresponding T1-weighted images. These patients had mainly abused pure toluene. The patients with diffuse white matter change showed obvious brain atrophy, including hippocampal atrophy and thinning of the corpus callosum. These patients had mainly abused lacquer thinner.

CONCLUSION

There are some patients with restricted but severe enough change to cause the neurologic symptoms in specific regions, such as the brain stem and/or cerebellum, before the brain atrophy becomes apparent. This suggests that the restricted white matter change represents not only an early change of diffuse white matter change, but at least in some cases also represents a qualitatively different change than that of diffuse white matter change. We suggest that pure toluene has a possible relation to this qualitative difference.

Effects of ALDH2, CYP1A1, and CYP2E1 genetic polymorphisms and smoking and drinking habits on toluene metabolism in humans

In this study, we evaluated the effects of ALDH2, CYP1A1, and CYP2E1 genetic polymorphisms and smoking and drinking habits on the toluene metabolism. The study subjects were 92 male workers who handle toluene in a printing factory, an electrical parts factory, and a painting workplace in Japan. Their exposure levels to toluene were monitored using the diffusion-type sampler. Benzyl alcohol concentrations in their blood and hippuric acid (HA) and creatinine concentrations in their urine at the end of a workshift were determined. The genotype of ALDH2 was classified into the homozygous genotype of a normal ALDH2 gene (NN), the homozygous genotype of an inactive ALDH2 gene (DD), and the heterozygous genotype of normal and inactive ALDH2 genes (ND). The genetic polymorphism of CYP1A1 and CYP2E1 were also determined by restriction fragment length polymorphism (RFLP). A strong correlation between the personal exposure level and the urinary HA concentration was observed. Regression lines were calculated after being divided by the five factors, i.e., ALDH2, CYP1A1, CYP2E1, smoking, and drinking. The HA formation from toluene was significantly (p < 0.001) different among the genotypes of ALDH2. The slopes of the regression lines decreased from NN to ND to DD in this order. The benzyl alcohol concentration in the blood of the DD group was significantly higher than that found in the NN and ND groups. This result demonstrates that ALDH2 polymorphism affects the oxidation of benzyl alcohol to benzoic acid. The toluene metabolism was also affected by CYP1A1 polymorphism. The slope for the Ile/Ile (the predominant homozygous allele) group was significantly lower than that for the Ile/Val (the heterozygous allele) and Val/Val (the rare homozygous allele) group after correction for creatinine. A drinking habit significantly (p < 0.05) reduced urinary HA concentration in the NN group. A smoking habit also significantly (p < 0.05) reduced urinary uncorrected HA concentration in both the NN and ND groups. In a multiple regression analysis, ALDH2 and the drinking habit were significantly (p < 0.01) associated with HA excretion after toluene exposure with and without correction for creatinine, and the corrected HA concentration was also significantly (p < 0.01) increased in the Ile/Val and Val/Val group of CYP1A1. The smoking habit reduced the corrected HA concentration (p < 0.05); however, the polymorphism in the 5'-flanking region of CYP2E1 did not affect HA appearance in urine.

Cranial MRI in chronic thinner intoxication

We studied a 19-year-old man with thinner and toluene poisoning for 5 years by CT and MRI. Symmetrical lesions were seen in the basal ganglia and cingulate gyri.

Auditory and vestibular functions after single or combined exposure to toluene: a review

Toluene is a widely used organic solvent, heavily employed in many manufacturing industries. Recently, evidence has begun to accumulate on the deleterious effect of toluene exposure has on the auditory and vestibular systems. Although little published information exists regarding these effects, the reported findings indicate a need for further investigation. The results of such investigations may dramatically affect occupational hearing conservation practices and legislation. Both human and animal studies will be summarized in discussing the effects of toluene alone or in combination with noise or other chemicals. Gaps in scientific knowledge are highlighted to assist future research.

Exposure to complex mixtures: implications for biological monitoring

It is well recognized in industrial and environmental health that man is exposed simultaneously to more than one chemical. Interaction may take place in the metabolism of chemicals absorbed in combination or in sequence, especially when the chemicals share similar chemical structures. It is further conceivable that the extent of possible metabolic interaction will depend on the intensity of exposure. Moreover, the metabolism of chemicals may be modified by social habits, especially smoking. No systemic and comprehensive studies however have been reported in literature, possibly because the combinations of the chemicals are various and the exposure intensities vary greatly. In a survey of factories where workers were exposed to either benzene alone (20 ppm as GM and 86 ppm as max.), toluene alone (38 and 86 ppm) or a combination of both, the urinary levels of phenol (a metabolite of benzene) and hippuric acid (that of toluene) were significantly lower among the co-exposed workers as compared with the levels in workers who were exposed to either benzene or toluene alone (Inoue et al. (1988) Int. Arch. Occup. Environ. Health 60, 15-20). In contrast, a similar factory survey on the workers exposed to a mixture of toluene (3 ppm as GM) and xylenes (3 ppm for the sum of the 3 isomers) revealed that increments in urinary hippuric acid and methylhippuric acid levels were equal to the values after individual exposure (Huang et al. (1994) Occup. Environ. Med. 51, 42-46). Furthermore, the hippuric acid levels in the urine of workers exposed to toluene (18 ppm as GM) were not reduced by the co-exposure to MEK (16 ppm) or IPA (7 ppm) (Ukai et al. (1994) Occup. Environ. Med. 51, 523-529). In a human volunteer study with repeated exposures, metabolic interaction took place when the subjects were exposed to a combination of 95 ppm toluene and 80 ppm xylenes (mostly m-isomer), whereas no interaction was detected after the exposure to a combination of 50 ppm toluene and 40 ppm xylenes (Tardif et al. (1991) Int. Arch. Occup. Environ. Health 63, 279-284). From the observation it appears likely that due caution should be exercised when the intensity of the combined exposure is high but not necessarily so when the exposure is low. The threshold remains yet to be established.

Exposure to benzene and urinary concentrations of 8-hydroxydeoxyguanosine, a biological marker of oxidative damage to DNA

OBJECTIVES

Benzene is an established animal and human carcinogen. The mechanism of benzene toxicity, particularly its leukaemogenic effect, is not fully understood. The modified base 8-hydroxy-deoxyguanosine (8-OHdG) is a sensitive marker of the DNA damage due to hydroxyl radical attack at the C8 of guanine. This damage, if left unrepaired, has been proposed to contribute to mutagenicity and cancer promotion. We conducted this biomonitoring study with the aim of evaluating the association between excretion of 8-OHdG and level of exposure to benzene and other aromatic compounds among occupationally exposed people.

METHODS

A random sample of 65 filling station attendants from Rome, Italy was studied for personal exposure to benzene, toluene, and xylenes, and excretion of 8-OHdG. Information about age, length of employment, smoking habits, and diagnostic exposure to x rays was collected by questionnaire. An average yearly level of exposure to benzene and methylbenzenes was calculated for each filling station attendant on the basis of about seven repeated personal samples collected during one year. A spot sample of 20 ml of urine was collected from each worker. Concentrations of 8-OHdG were determined by high performance liquid chromatography (HPLC) with coupled columns.

RESULTS

A mean (SD) concentration of 1.36 (0.49) mumol of 8-OHdG/mol of creatinine was measured. A significant correlation was found between urinary 8-OHdG and exposure to benzene (r = 0.34). In a multiple regression analysis relating the concentration of urinary 8-OHdG with the age, length of employment, smoking, diagnostic exposure to x rays and personal exposure to benzene, an increase of 0.15 mumol/mol creatinine in urinary 8-OHdG/unit increase in the natural logarithm of the average yearly benzene concentration was estimated.

CONCLUSION

This study shows a dose-response effect between personal exposure to benzene and urinary 8-OHdG concentration; further studies are needed to clarify the biological significance of 8-OHdG as a marker of cancer risk.