Ikeda Masayuki, Ukai Hirohiko, Kawai Toshio, Inoue Osamu, Maejima Yuki, Fukui Yoshinari, Ohashi Fumiko, Okamoto Satoru, Takada Shiro, Sakurai Haruhiko
Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto, Japan.
Toxicol Lett. 2008 Jul 10;179(3):148-54. doi: 10.1016/j.toxlet.2008.05.003. Epub 2008 May 18.
This study was initiated to identify a marker of choice to monitor occupational exposure to toluene through quantitative evaluation of changes in correlation coefficients (CCs), taking advantage of a large database. Six known or proposed exposure markers in end-of-shift blood (B) and urine (U) were studied, i.e., toluene in blood (Tol-B) and benzyl alcohol, benzylmercapturic acid, o-cresol, hippuric acid and toluene in urine (BeOH-U, BMA-U, o-CR-U, HA-U, and Tol-U, respectively). To construct a database, data on 8-h time-weighted average intensity of occupational exposure to toluene and resulting levels of the six exposure markers in blood or urine were cited for 901 cases from previous four publications of this study group and combined with 146 new cases. In practice, 874 cases (all men) were available when extremely dilute or dense urine samples were excluded. The 874 cases were classified taking the upper limit (from 120 ppm to 1 ppm) of the toluene exposure concentration, and the CCs for the six markers with TWA toluene exposure intensity were calculated. For further evaluation, the 874 cases were divided into 10 per thousand in terms of TWA toluene exposures, and several 10 per thousand were combined so that sufficient numbers of cases were available for calculation of the CCs at various levels of toluene exposure. Perusal was made to know whether or not and which one of the six makers gave significant CC even at low level of toluene exposure. The CCs for BMA-U, o-CR-U and HA-U with TWA toluene exposure were well >0.7 when toluene exposure was intense (e.g., up to 60-100 ppm as the upper limit of the exposure range), but were reduced when the upper limit of toluene exposure was less than 50 ppm, and the CCs were as small as <==0.2 when the upper limit was about 10 ppm or less. In contrast, Tol-U and Tol-B were correlated with exposure to toluene down to the <or=3 ppm range. The CC for BeOH-U was <0.1 almost throughout the exposure ranges. Further analyses showed that the CCs for all markers (except the CC for BeOH-U) were >0.4 when the cases in the 60th-100th per thousand were examined. The CCs for Tol-U and Tol-B were >0.3 also for cases in the 0th-60th or 30th-70th per thousand, whereas the CCs for other four markers were <0.3. In over-all evaluation, it was concluded that HA and o-CR are among the markers of choice to monitor occupational toluene exposure at high levels, and that only un-metabolized toluene in urine or in blood is recommended when toluene exposure level is low (e.g., 10 ppm or less). Toluene in urine may be preferred rather than that in blood due to practical reasons, such as non-invasiveness.
本研究旨在利用一个大型数据库,通过对相关系数(CCs)变化进行定量评估,确定一种用于监测职业性甲苯暴露的理想标志物。研究了6种已知或提议的班末血液(B)和尿液(U)中的暴露标志物,即血液中的甲苯(Tol-B)以及尿液中的苯甲醇、苄基硫醚氨酸、邻甲酚、马尿酸和甲苯(分别为BeOH-U、BMA-U、o-CR-U、HA-U和Tol-U)。为构建数据库,引用了该研究组此前4篇出版物中901例病例的职业性甲苯暴露8小时时间加权平均强度以及血液或尿液中6种暴露标志物的相应水平数据,并与146例新病例的数据相结合。实际上,排除极稀或极浓尿液样本后,有874例病例(均为男性)可用。根据甲苯暴露浓度上限(从120 ppm到1 ppm)对这874例病例进行分类,并计算6种标志物与甲苯暴露强度时间加权平均值(TWA)的相关系数。为进行进一步评估,将874例病例按甲苯TWA暴露量分为千分之十组,并将若干个千分之十组合在一起,以便有足够数量的病例用于计算不同甲苯暴露水平下的相关系数。仔细研究以确定6种标志物中是否有以及哪一种在低甲苯暴露水平时也能给出显著的相关系数。当甲苯暴露强烈时(例如,暴露范围上限高达60 - 100 ppm),BMA-U、o-CR-U和HA-U与甲苯TWA暴露的相关系数远大于0.7,但当甲苯暴露上限低于50 ppm时相关系数降低,当上限约为10 ppm或更低时相关系数小至<0.2。相比之下,Tol-U和Tol-B与低至≤3 ppm范围的甲苯暴露相关。BeOH-U的相关系数在几乎整个暴露范围内均<0.1。进一步分析表明,当检查千分之六十至千分之一百的病例时,所有标志物(BeOH-U的相关系数除外)的相关系数均>0.4。对于千分之零至千分之六十或千分之三十至千分之七十的病例,Tol-U和Tol-B的相关系数也>0.3,而其他4种标志物的相关系数<0.3。总体评估得出结论,HA和o-CR是监测高水平职业性甲苯暴露的理想标志物之一,当甲苯暴露水平较低(例如10 ppm或更低)时,仅推荐尿液或血液中未代谢的甲苯。由于诸如非侵入性等实际原因,尿液中的甲苯可能比血液中的甲苯更受青睐。