In over-all evaluation, hippuric acid, followed by un-metabolized toluene and omicron-cresol, is the marker of choice for occupational toluene exposure. When toluene exposure level is low (e.g., 2 ppm), un-metabolized toluene and benzylmercapturic acid in urine may be better indicators. Detection of un-metabolized toluene or benzylmercapturic acid in urine at the levels in excess of the LODs may be taken as a positive evidence of toluene exposure, because their levels in urine from the controls are below the LODs. The value of benzyl alcohol as an exposure marker should be limited.

Taking the non-invasive nature of sampling together, Tol in the end-of-shift spot urine sample appears to be the marker of choice for biological monitoring of occupational exposure to Tol at low levels such as <2 ppm as a geometric mean.

The objective of this study was to evaluate the usefulness of laser Doppler imaging (LDPI) of the skin blood flow for assessing peripheral vascular impairment in the hand-arm vibration syndrome (HAVS). The subjects were 46 male patients with HAVS, aged 50 to 69 yr, and 31 healthy male volunteers of similar age as controls. A cold provocation test was carried out by immersing a subject's hand on his more severely affected side into cold water at a temperature of 10°C for 10 min. Repeated image scanning of skin blood flow of the index, middle, and ring fingers was performed every 2 min before, during, and after the cold water immersion using a PMI-II laser Doppler perfusion imager. The mean blood perfusion values in the distal phalanx area of the fingers were calculated on each image. The patients suffering from vibration-induced white finger (VWF, n=20) demonstrated significantly lower skin blood perfusion at each interval of the test as compared with those without VWF (n=26) and the controls (p<0.01, ANOVA). The blood perfusions in the HAVS patients were associated with the severity of the symptoms as classified by the Stockholm Workshop scale for vascular staging. When a subject was considered to be positive if any of the tested fingers showing a decreased blood perfusion and/or a delayed recovery pattern, the sensitivity was 80.0%, and the specificity was 84.6% and 93.5% for patients without VWF and the controls, respectively. These results suggest that the LDPI technique could provide detailed and accurate information that may help detect the existence of impaired vascular regulation to cold exposure in the fingers of workers exposed to hand-transmitted vibration.

No abstract

This study was initiated to evaluate o-cresol and benzylmercapturic acid in urine in comparison with other biomarkers, as tools to estimate the intensity of occupational exposure to toluene at low levels. In total, 108 solvent exposed workers (engaged in tape production) and 17 non-exposed controls (all men) participated in the study. The surveys were conducted in the second half of working weeks. Diffusive sampling was conducted to measure 8-h time-weighted average intensity of occupational exposure to toluene. Blood and urine samples were collected at the end of a working shift. Blood samples were subjected to analysis for toluene (Tol-B), and urine samples were analyzed for benzyl alcohol (BeOH-U), benzylmercapturic acid (BMA-U), ocresol (o-CR-U), hippuric acid (HA-U) and toluene (Tol-U) by the methods previously described. The toluene concentrations in workplaces were low in general, with a geometric mean (GM) and the maximum concentration of 1.9 ppm and 8.8 ppm, respectively. The statistical analyses of the six biomarkers for correlation with air-borne toluene showed that both Tol-B and Tol-U gave a high correlation coefficient of 0.58 to 0.61 (p<0.01), whereas the coefficients for BeOH-U and BMA-U together with HA-U were all low (up to 0.22, depending on the correction for urine density) and statistically insignificant (p>0.10) in most cases. o-CR-U had an intermediary coefficient of 0.20 (p<0.05). Comparison with previous publications disclosed that BeOH-U, BMA-U and HA-U correlate with toluene in air when the exposure is intense (e.g., 50 ppm or above), but no longer proportional to air-borne toluene when the exposure is low, e.g., 2 ppm. Such appeared to be also the case for o-CR-U. In over-all evaluation, the validity of o-CR-U in monitoring occupational exposure to toluene at low levels (e.g., 2 ppm) appear to be limited, and BMA-U is not an appropriate biomarker. BeOH-U and HA-U are also inappropriate for this purpose. Only Tol-B and Tol-U may be employed to estimate toluene exposure at low levels.