Stengel B, Cénée S, Limasset J C, Diebold F, Michard D, Druet P, Hémon D
INSERM U 170 (National Research Institute on Health and Medicine, Unit 170), Villejuif, France.
Scand J Work Environ Health. 1998 Aug;24(4):276-84. doi: 10.5271/sjweh.321.
This study assessed immunologic and early renal effects of chronic toluene exposure.
In a longitudinal study of 92 printers and 74 referents, 145 subjects had pre- and poststudy samples of blood and urine taken for the following measurements: immunoglobulin E (IgE), antiglomerular basement membrane (anti-GBM) and antilaminin (anti-LAM) antibodies in blood; creatinine and beta2-microglobulin in blood and urine; and microalbumin, N-acetyl-b-D-glucosaminidase (NAG) and alanine-aminopeptidase in urine. Creatinine clearance was calculated according to the Cockroft-Gault formula. Eight-hour personal air samples were collected twice to assess present exposure to toluene. A job-exposure matrix was developed to estimate past cumulative exposure. Information about potential confounders was recorded by questionnaire. Multiple regression analysis was performed to study dose-effect relations adjusted for age and smoking.
No subject was positive for anti-GBM antibodies, and only 12 were positive for anti-LAM. No relation was observed between the markers studied and present exposure to toluene except that creatinine clearance was higher among the exposed subjects than among the referents. A dose-response relation was observed between cumulative toluene exposure and both IgE and NAG excretion. No interaction was observed between hypertension and exposure, but the relationship with NAG did not persist when subjects with hypertension were excluded. Past or present exposure did not alter the 2-year trend of any marker studied.
According to the results of this study, toluene at 50 ppm is not related to detectable renal dysfunction. The increased IgE levels associated with present and past exposure require further investigation.
本研究评估慢性甲苯暴露的免疫和早期肾脏影响。
在一项对92名印刷工人和74名对照者的纵向研究中,145名受试者在研究前后采集了血液和尿液样本,用于以下测量:血液中的免疫球蛋白E(IgE)、抗肾小球基底膜(anti-GBM)和抗层粘连蛋白(anti-LAM)抗体;血液和尿液中的肌酐和β2-微球蛋白;以及尿液中的微量白蛋白、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和丙氨酸氨基肽酶。根据Cockcroft-Gault公式计算肌酐清除率。两次采集8小时个人空气样本以评估当前甲苯暴露情况。建立了工作暴露矩阵以估计过去的累积暴露量。通过问卷记录有关潜在混杂因素的信息。进行多元回归分析以研究调整年龄和吸烟因素后的剂量-效应关系。
没有受试者抗GBM抗体呈阳性,只有12人抗LAM呈阳性。除暴露组受试者的肌酐清除率高于对照组外,所研究的标志物与当前甲苯暴露之间未观察到相关性。在累积甲苯暴露与IgE和NAG排泄之间观察到剂量反应关系。未观察到高血压与暴露之间的相互作用,但排除高血压患者后,与NAG的关系不再存在。过去或当前暴露未改变所研究任何标志物的两年趋势。
根据本研究结果,50 ppm的甲苯与可检测到的肾功能障碍无关。与当前和过去暴露相关的IgE水平升高需要进一步研究。