Fernández-D'Pool J, Oroño-Osorio A
Instituto de Medicina del Trabajo e Higiene Industrial, Facultad de Medicina, Universidad del Zulia, Venezuela.
Invest Clin. 2001 Jun;42(2):87-106.
A descriptive and cross sectional study was conducted to determine whether hepatic function changes in workers occupationally exposed to a mixture of organic solvents, were due to the exposure or confusing factors. A non random sample of 77 workers, operators and supervisors of the Olefin Plant I and II of a petrochemical industry in Maracaibo, Venezuela, was used. Their mean age was 29 +/- 7 years, and had at least one year of exposure to the solvents. This sample was compared with a group of employees of the administrative offices or control panel workers, with a mean age of 36 +/- 8 year and with similar anthropometric characteristics. Workers with a known history of liver disease, blood transfusions and diabetes mellitus were excluded of the study. In addition to a complete occupational disease medical history and a physical examination, serum samples were obtained to determine the activity of the aspartato aminotransferase (AST), alanin aminotransferase (ALT), gamma glutamiltransferase (GGT), alkaline phosphatase (AF), the concentration of the total bile acids (BAS), the surface antigen of hepatitis B(HbsAg) and the hepatitis A virus antibodies: AntiHAV-IgG and the AntiHAV-IgM. An urine sample was taken and analyzed by standard methodology to determine urinary phenols. The air concentrations of benzene, ethylbenzene, toluene and xylene were analyzed by gas chromathography. The serum activities of the liver enzymes, the concentration of bile acids and urinary phenols were not influenced by the exposure to the solvents. The increase of the activity of GGT was associated with obesity and alcohol consumption. The antibodies of the surface antigen of hepatitis A-IgM were normal in both groups and the antibodies for the antigen of hepatitis A-IgG presented a prevalence of 6% in the exposed group and 9% in the non exposed not being associated with liver abnormalities. The individual air concentrations of the solvents were below the environmentally permissible concentrations, except one sample of benzene (1, 14 ppm) that was over the allowed limit. The total maximum concentration of the mixture of organic solvents, resulting of the sum of fractions of each organic solvent, was within the allowed limits. In conclusion, obesity and alcohol consumption, and not the occupational factors, seem to be responsible for the alteration in GGT in workers of these Olefin Plants.
开展了一项描述性横断面研究,以确定职业性接触有机溶剂混合物的工人肝功能变化是由于接触所致还是其他混淆因素引起。研究采用了委内瑞拉马拉开波一家石化行业烯烃厂I和II的77名工人、操作员和主管组成的非随机样本。他们的平均年龄为29±7岁,且至少有一年的溶剂接触史。该样本与行政办公室员工或控制面板工人组成的一组对照进行比较,对照组平均年龄为36±8岁,人体测量特征相似。有已知肝病、输血史和糖尿病史的工人被排除在研究之外。除了完整的职业病病史和体格检查外,还采集了血清样本以测定天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ-谷氨酰转移酶(GGT)、碱性磷酸酶(AF)的活性、总胆汁酸(BAS)的浓度、乙型肝炎表面抗原(HbsAg)以及甲型肝炎病毒抗体:抗HAV-IgG和抗HAV-IgM。采集了尿液样本并采用标准方法进行分析以测定尿酚。通过气相色谱法分析了苯、乙苯、甲苯和二甲苯的空气浓度。肝酶的血清活性、胆汁酸浓度和尿酚不受溶剂接触的影响。GGT活性升高与肥胖和饮酒有关。两组甲型肝炎表面抗原IgM抗体均正常,甲型肝炎抗原IgG抗体在接触组中的患病率为6%,在未接触组中的患病率为9%,且与肝脏异常无关。除了一个苯样本(1.14 ppm)超过允许限值外,各有机溶剂的个体空气浓度均低于环境允许浓度。有机溶剂混合物的总最大浓度,即每种有机溶剂分数之和,在允许限值范围内。总之,肥胖和饮酒而非职业因素似乎是这些烯烃厂工人GGT改变的原因。