Serum bile acid as a screening tool in workers occupationally exposed to mixtures of organic solvents

Abstract

The aim of the present study was to find out the potential impact of occupational exposure to mixtures of organic solvents on liver function tests. Serum bile acid (BA) was evaluated as a marker of early hepatic derangement and compared to routine liver function tests. The study included two comparable groups: 57 male workers exposed to organic solvents from a paints factory and 59 administrative male controls. Occupational and medical data and serum analysis for liver function parameters (BAs, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total and direct bilirubin) were obtained. Bile acids showed significantly elevated mean levels in the exposed workers compared to the controls (50.2 ± 47.9 and 5.4 ± 2.7 µmol/L, respectively, p < 0.01). Bile acids were elevated in almost all exposed workers (87.7%) but in none of the controls. Bile acids had significant positive correlation with duration of exposure to organic solvents and lifetime hydrocarbon exposure score (HES) (p < 0.01 and p < 0.05, respectively). All other liver function tests exhibited normal mean levels and did not show statistically significant differences between both groups. The performance of BA versus combined liver enzymes is evaluated using receiver-operating characteristic (ROC) curve and likelihood ratios. The area under the curve was significantly high (0.687 > 0.5, p = 0.012) and had optimal decision level (8 µmol/L). Serum BA can be recommended as a screening test for exposure to organic solvents. It can be suggested for follow-up every 1-2 years or accordingly.

Use of bile acids as potential markers of liver dysfunction in humans

“…Geographically, these studies were performed in the United States, [ 34 , 44 , 48 , 52 ] Australia, [ 37 , 39 , 41 ] Spain, [ 36 , 38 ] Germany, [ 26 , 43 ] Canada, [ 46 , 47 ] Thailand, [ 31 , 40 ] Indonesia, [ 28 ] Egypt, [ 27 ] Austria, [ 29 ] Brazil, [ 30 ] Israel, [ 32 ] China, [ 35 ] Lithuania, [ 42 ] France, [ 45 ] United Kingdom, [ 49 ] Argentina, [ 50 ] and Japan. [ 53 ]…”

Environmental Working Conditions, Lung Function and Total Serum Bile Acids of Spray Painters Exposed to Organic Solvents in Ile-Ife, Nigeria

“… 16 , 38 This was similar to findings from a study of 57 Egyptian workers exposed to organic paints, where assessment of serum total bile acids was the only liver function test that was affected in the exposed group without an increase in the frequency of impaired liver-related symptoms, even at short duration of exposure or with low exposure levels. 15 A limitation of the present study was that personal exposure to VOCs could not be quantified, as personal gas samplers were not available. However, the use of a sensitive VOC gas monitor and air sampler in the breathing zone of workers provided a useful estimate of total VOCs in the workshops.…”

“…Total serum bile acids (TSBA) is a useful biomarker and has been reported to be better than the liver enzyme test as a biomarker of solvent-induced hepatotoxicity. 15–17 It is also cost-effective, which makes its use pragmatic in resource-constrained settings like Nigeria. Pulmonary function assessments of welders, flour mill workers and sawmill workers have been performed in Nigeria, but spray painters have been sparsely studied.…”

Inside‐tube solid‐phase microextraction as an interlink between solid‐phase microextraction and needle device forn‐hexane evaluation in air and urine headspace

“…In this study, the phase separation technique was used for filling an adsorbent inside a needle trap device (NTD). Organic solvents such as n-hexane pose a common health hazard in the workplace (Attarchi, Labbafinejad, & Mohammadi, 2010;Hady, Metwally, Gendy, Elserougy, & Helmy, 2014). n-Hexane is used in footwear and glue industries.…”