Liver injury has long been associated with occupational exposure to a wide variety of chemicals. The controversial data existing in relation to hepatotoxicity of organic solvents might be explained as a consequence of the different exposures or it may well be that the tests used for evaluating liver function might not be sensitive enough to detect any mild changes at an early stage. To study liver function during exposure to solvent mixtures, we determined serum bile acid (SBA) concentrations as compared with conventional liver function tests in a selected group of workers (n = 30) occupationally exposed to a mixture of organic solvents (mostly toluene, xylene, acetone, n-butylacetate, n-butanol, ethylacetate) and in a reference group (n = 20). The mean levels of liver enzyme activities and bilirubin concentrations in the two groups were similar, whereas mean SBA levels increased in the exposed group (8.0 +/- 6.0 mumol/l vs 2.8 +/- 1.4 mumol/l) and the difference as compared with the controls was significant (P less than 0.01). In 73% of the exposed workers, SBA levels were higher than 5.6 mumol/l (the cut-off value) as compared with 5% of the controls. These results demonstrate the higher sensitivity in detecting liver dysfunction achieved with the SBA test as compared with conventional hepatic function tests. As increased SBA concentrations are considered to reflect an impairment of anion transport across the liver, higher SBA levels in the group of workers exposed to organic solvents might be explained as a slight and early sign of liver dysfunction. Therefore, SBA determination in biological monitoring of workers exposed to potentially hepatotoxic chemicals might be proposed.
SummaryTwo cases of bronchial asthma due to spiramycin in workers of a pharmaceutical factory are reported. The subjects complained of cough, breathlessness and symptoms of asthma at work when coming into contact with spiramycin's powder. The symptoms cleared when away from work for more than 3 or 4 days.Inhalation challenge tests by aerosolization of solutions of spiramycin reproduced asthmatic reactions dual in type in both patients, the immediate component of the response has not been previously described for this antibiotic.Furthermore, one of the patients developed an immediate asthmatic reaction also after inhalation of a solution of adipic acid, and additive to bind spiramycin and diminish its irritant action. The reaction was obtained at a non‐irritant concentration of the acid, was reproducible and inhibited by previous administration of sodium cromoglycate: this finding and the failure to elicit the reaction in the other patient suggest a hypersensitivity reaction to this substance.
Oral cortisone glucose tolerance tests were performed in 66 CS2-exposed workers and in 66 individually matched control subjects. Results indicate a higher and significant (p less than 0.001) prevalence of latent diabetes in the CS2-exposed group (72.7%) as compared with the control group (16.7%), and the existence of a positive and significant (p less than 0.001) correlation between blood glucose values and exposure index. Possible mechanisms of action involving zinc metabolism and pyridoxine metabolism are discussed.
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