Urinary levels of proteins and metabolites in workers exposed to toluene

We measured urinary excretion of albumin and retinol-binding proteins to investigate the occurrence of early renal dysfunction in 45 paint workers exposed principally to toluene, and in the same number of unexposed control subjects matched individually for sex and age. Two biological indicators of personal toluene absorption, namely urine hippuric acid and o-cresol, were also measured in the exposed subjects. A significantly higher level and increased prevalence of elevated retinol-binding protein in the urine of exposed workers was found, whereas no significant difference in urinary albumin concentration was seen between the two groups. Urinary concentrations of retinol-binding protein was correlated (r = 0.399, P less than 0.006) with that of o-cresol, but not with hippuric acid or employment duration. The results suggest a dose-dependent early tubular effect due to toluene exposure that might be useful for monitoring individuals exposed to toluene at work.     

Effects of smoking and drinking habits on urinary o-cresol excretion after occupational exposure to toluene vapor among chinese workers

The relationship between the time-weighted average intensity of exposure to toluene and o-cresol concentration in shift-end urine was investigated in nearly 500 factory workers of both sexes in China, together with a similar number of nonexposed control subjects. Toluene concentration (25 ppm as geometric mean and 550 ppm as the maximum) was monitored by diffusive sampling using carbon cloth as adsorbent followed by gas chromatographic (GC) analysis. o-Cresol (up to 7 mg/1) was measured by GC after acid hydrolysis of samples. Urinary o-cresol levels correlated significantly (r = 0.69–0.77; p < 0.01) with toluene exposure in men, women and the two sexes in combination, regardless of correction for urine density. When compared with hippuric acid, however, o-cresol was less sensitive as an indicator of exposure to toluene and is not a suitable biological marker for detecting low level toluene exposure. Since urinary o-cresol level was significantly reduced by smoking, drinking, and the two habits combined, it cannot be considered reliable as an indicator of exposure to toluene. © 1994 Wiley-Liss, Inc.     

Mutual metabolic suppression between benzene and toluene in man

Summary The exposure intensity during a shift and the metabolite levels in the shift-end urine were examined in male workers exposed to either benzene (65 subjects; the benzene group), toluene (35 subjects; the toluene group), or a mixture of both (55 subjects; the mixture group). In addition, 35 non-exposed male workers (the control group) were similarly examined for urinary metabolites to define background levels. A linear relationship was established between the intensity of solvent exposure and the corresponding urinary metabolite levels (i.e. phenol, catechol and quinol from benzene, and hippuric acid and o-cresol from toluene) in each case when one of the three exposed groups was combined with the control group for calculation. Comparison of regression lines in combination with regression analysis disclosed that urinary levels of phenol and quinol (but not catechol) were lower in the mixture group than in the benzene group when the intensities of exposure to benzene were comparable, indicating that the biotransformation of benzene to phenolic compounds (excluding catechol) in man is suppressed by co-exposure to toluene. Conversely, metabolism of toluene to hippuric acid was suppressed by benzene co-exposure. Conversion of toluene to o-cresol was also reduced by benzene, but to a lesser extent. The significance of the present findings on the mutual suppression of metabolism between benzene and toluene is discussed in relation to solvent toxicology and biological monitoring of exposure to the solvents.     

甲苯接触者生物监测指标研究——尿中马尿酸和邻甲酚浓度

对32名职业接触甲苯、18名志愿受试者和77名非职业接触甲苯者的尿中马尿酸及邻甲酚的测定,发现在非接触者中,尿中马尿酸存在日间波动,邻甲酚排出量极少。工人和志愿者接触甲苯后,尿中马尿酸即开始上升,到脱离时达高峰,以后迅速下降,4小时左右降到正常本底水平,班末尿中马尿酸浓度与空气浓度相关(工人:r=0.64,志愿者:r=0.78)。尿中邻甲酚在低浓度接触者中,难以检出,但在高浓度接触时,班末尿中邻甲酚与空气浓度相关(工人;r=0.63,志愿者;r=0.65)。马尿酸和邻甲酚作为甲苯生物监测指标可结合使用。     

Exposure of workers to a mixture of toluene and xylenes. I. Metabolism.

The urinary excretion of hippuric acid and methylhippuric acid was studied in workers (233 subjects; 122 men and 111 women) exposed to toluene and xylenes in combination and in non-exposed controls (281 subjects; 141 men and 140 women) recruited from the same factories or factories of the same regions. Smoking and drinking habits of the subjects were obtained by medical interviews. From each worker, one urine sample was collected at the end of a shift and analysed for hippuric and methylhippuric acids by high performance liquid chromatography. Air samples for the estimation of toluene and xylenes were collected with diffusive personal samplers. There was a linear correlation between the time weighted average exposure either to toluene or xylene isomers and the concentrations of hippuric acid or methylhippuric acid isomers in urine. Essentially no difference was found in the correlation between quantitative exposure and excretion in the three xylene isomers. Comparison of the slopes of regression lines indicated the absence of metabolic interaction between toluene and xylenes at the measured concentrations. The metabolism of toluene and xylenes was significantly reduced among smokers or drinkers compared with non-smokers and non-drinkers.     

The validity of urinary metabolites as indicators of low exposures to toluene

Summary Exposure to toluene was studied in a group of 14 subjects working in a printing industry, who were exposed to this solvent only. Environmental monitoring was carried out using personal samplers for the whole workshift over three consecutive days. Toluene TWA concentrations ranged from 37 to 229 mg/m³. At the end of the workshift on each day of investigation, urine samples were collected for the determination of hippuric acid and ortho-cresol. Hippuric acid was also determined for urine before the workshift and on the Saturday and Monday mornings after the end of exposure; hippuric acid was also determined in 16 controls over the same five-day period. At the end of the workshift, hippuricuria levels in exposed workers always turned out to be statistically different from pre-workshift levels and those of the controls.The end-of-workshift hippuricuria levels of exposed workers were significantly correlated with the mean daily environmental concentration (TWA): in the three days of comparative study, we found r = 0.63 (P < 0.05) on Day 1, r = 0.90 (P < 0.001) on Day 2, and r = 0.87 (P < 0.001) on Day 3. Orthocresol turned out to be correlated with daily exposure less significantly than hippuric acid: r = 0.49 (n.s.) on Day 1; r = 0.78 (P < 0.001) on Day 2, and r = 0.65 (P < 0.05) on Day 3. Using all available data (41 observations), a very significant correlation (P < 0.001) was found between the TWA and both metabolites (r = 0.80 for hippuric acid; r = 0.68 for o-cresol). The values of the two metabolites in the end-of-workshift urine samples (41 observations) also turned out to be well correlated (r = 0.70; P < 0.001). The authors conclude that hippuric acid is a valid test for evaluating even low exposures to toluene.This work was supported by research grant no. 83.02580.56 from the Italian National Research Council (CNR), applied project Preventive and Rehabilitative Medicine     

Biomonitoring of occupational toluene exposure

Summary Toluene exposure was studied in 20 workers employed in painting and hand-finishing in an art furniture factory. Toluene was determined in the environmental air of places of work and in the alveolar air and blood of the workers. Hippuric acid and cresols were also tested in the workers' urine. Blood and urine tests were carried out before the work shift on Monday and Friday morning and at the end of the work shift on Friday afternoon. The other tests were performed on Friday afternoon only. Alveolar toluene concentrations, which were significantly correlated with environmental toluene concentrations (r= 0.6230; P < 0.01), corresponded to 19.4% of the toluene concentration in the atmosphere. Blood toluene was also found in painters on Monday morning and was significantly correlated with the other parameters. On Friday afternoon it was three times higher than the environmental toluene concentration. Urinary o-Cresol was highly correlated with toluene in the atmosphere, in blood and with hippuric acid in urine. On the basis of the slope of the regression line the ratio between urinary o-Cresol and blood toluene concentration was 0.99. At the end of the work shift urinary hippuric acid concentration was highly correlated with o-Cresoluria and with toluene in blood and in the atmosphere.     

Distribution of urinary hippuric acid concentrations by ALDH2 genotype.

OBJECTIVES--To clarify the relation between the genetic polymorphism of ALDH2 (low Km aldehyde dehydrogenase) and toluene metabolism. METHODS--The study subjects were 253 toluene workers (192 men and 61 women with an age range of 18-66). The genotypes of ALDH2 were classified by artificial restriction fragment length polymorphism into the homozygous genotype of normal ALDH2 (NN), the homozygous genotype of an inactive ALDH2 (DD), and the heterozygous genotype of normal and inactive ALDH2 (ND). The concentrations of hippuric acid (HA), the main metabolite of toluene, was determined in urine specimens of 253 toluene workers. The HA measurements in previous occupational health examinations were also referenced. The HA concentrations corrected for creatinine (HA/C) were compared with the biological exposure index (BEI) for toluene, which is 2.5 g/g creatinine. To estimate the toluene exposures, urinary o-cresol concentrations were also determined and compared with another BEI for toluene--that is, 1.0 mg urinary o-cresol/g creatinine. RESULTS--Incidence of each genotype in the toluene workers was almost the same as that in non-exposed controls who lived in the same area as the toluene workers. The incidence of each of the three genotypes also did not differ by smoking habit. Mean urinary HA concentrations were not significantly different in the groups with the different genotypes of ALDH2. The HA concentrations of > 70% of the 890 total samples were < 1.0 g/l. The number of urine samples > 3.0 g/l was 28 (5.4%) in the NN group and 19 (6.4%) in the ND group. No urine samples in the DD group were > 3.0 g/l HA. The distribution of urinary HA in the DD group was significantly different from those in both the NN and ND groups (P < 0.05). Seven (4.9%) of the 136 total specimens in the NN group and four (4.7%) of the 82 total specimens in the ND group exceeded the BEI. There were, however, no urine specimens that exceeded the BEI in the DD group. The maximum HA concentration after correction for creatinine in the DD group was 1.86 g/g creatinine. The percentages of urine specimens in which o-cresol concentrations exceeded this BEI were 14.3% in the NN group, 9.1% in the ND group, and 15.4% in the DD group. Therefore, the exposure rate for all three genotypic groups of workers was almost the same. CONCLUSIONS--The HA concentrations of toluene workers with ALDH2 DD genotype were lower than those of the NN and ND genotypes when they were exposed to relatively high concentrations of toluene. The exposures of the DD group were suspected to be underestimates because they were based on the BEI for the NN genotype.     

Comparative evaluation of biomarkers of occupational exposure to toluene

Objectives This study was initiated to make comparative evaluation of five proposed urinary markers of occupational exposure to toluene, i.e., benzyl alcohol, benzylmercapturic acid, o-cresol, hippuric acid and un-metabolized toluene. Methods In practice, six plants in Japan were surveyed, and 122 Japanese workers (mostly printers; all men) together with 12 occupationally nonexposed control subjects (to be called controls; all men) agreed to participate in the study. Surveys were conducted in the second half of working weeks. Time-weighted average exposure (about 8 h) to toluene and other solvents were monitored by diffusive sampling. End-of-shift urine samples were collected and analyzed for the five markers by the methods previously described; simultaneous determination of o-cresol was possible by the method originally developed for benzyl alcohol analysis. Results The toluene concentration in the six plants was such that the grand geometric mean (GM) for the 122 cases was 10.4 ppm with the maximum of 121 ppm. Other solvents coexposed included ethyl acetate (26 ppm as GM), methyl ethyl ketone (26 ppm), butyl acetate (1 ppm) and xylenes (1 ppm). By simple regression analysis, hippuric acid correlated most closely with toluene in air (r = 0.85 for non-corrected observed values) followed by un-metabolized toluene (r = 0.83) and o-cresol (r = 0.81). In a plant where toluene in air was low (i.e., 2 ppm as GM), however, un-metabolized toluene and benzylmercapturic acid in urine showed better correlation with air-borne toluene (r = 0.79 and 0.61, respectively) than hippuric acid (r = 0.12) or o-cresol (r = 0.17). Benzyl alcohol tended to increase only when toluene exposure was intense. Correction for creatinine concentration or specific gravity of urine did not improve the correlation in any case. Multiple regression analysis showed that solvents other than toluene did not affect the levels of o-cresol, hippuric acid or un-metabolized toluene. Levels of benzylmercapturic acid and un-metabolized toluene were below the limits of detection [limit of detections (LODs); 0.2 and 2 μg/l, respectively] in the urine from the control subjects. Conclusions In over-all evaluation, hippuric acid, followed by un-metabolized toluene and o-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.     

Effect of ethanol,cimetidine and propranolol on toluene metabolism in man

Summary In a climatic exposure chamber four healthy volunteers were exposed to 100ppm toluene, 100ppm toluene + ethanol, 100ppm toluene + cimetidine, and 100ppm toluene + propranolol for 7h each at random over four consecutive days. A control experiment and 3.5 h of exposure to 200 ppm toluene were also performed. Ethanol inhibited toluene metabolism by 0.5 as expressed by the urinary excretion of two of the metabolites of toluene, namely o-cresol and hippuric acid. In agreement with this, the mean alveolar concentration of toluene was greater by 1.7 during ethanol exposure; 45 min after discontinuation of exposure the increase was by 3.3. Neither cimetidine nor propranolol changed toluene metabolism significantly. The results indicate that ethanol may prolong the time interval in which toluene is retained in the human body in persons simultaneously exposed to ethanol and toluene. When using o-cresol or hippuric acid in biological monitoring of persons occupationally exposed to toluene, the consumption of ethanol should be considered.Supported by grants from the Working Environment Fund, Denmark     

Occupational chronic exposure to organic solvents

Summary A group of printing workers (n = 34) exposed to toluene was examined according to the concentrations of hippuric acid, phenol, o-cresol, and (m+p)-cresol in urine. The average concentration in the air of the workroom was 23 ppm. It is shown that, besides hippuric acid, small amounts of o-cresol. which is not a normal constituent of urine, were formed from toluene. The occurrence of o-cresol could be proved by mass spectrometry. On account of the small amounts of benzene present in industrially used toluene—in this case 0.025%—the average concentration of phenol in urine of the exposed group was significantly higher statistically than in urine from the controls .     

Excretion of hippuric acid and m- or p-methylhippuric acid in the urine of persons exposed to vapours of toluene and m- or p-xylene in an exposure chamber and in workshops, with specific reference to repeated exposures

Ogata, M., Takatsuka, Y., and Tomokuni, K. (1971).Brit. J. industr. Med.,28, 382-385. Excretion of hippuric acid and m- or p-methylhippuric acid in the urine of persons exposed to vapours of toluene and m- or p-xylene in an exposure chamber and in workshops, with specific reference to repeated exposures. Four male volunteers were exposed to 200 p.p.m. of toluene for five one-hour periods separated by one-hour intervals. The excretion curve of hippuric acid showed multi-peaks, and almost concided with a theoretical curve previously described. The fraction of the toluene absorbed which was accounted for as hippuric acid was only slightly lower than after a single exposure.

In a paint spraying shop exposure was measured both from the concentrations of toluene in the air by a Kitagawa detector and from the exceretion of urinary hippuric acid. The results were in general agreement, with a correlation coefficient of 0·67.

Urinary hippuric acid and methylhippuric acid were determined on urines from two workers in a shipbuilding yard who used paint thinned with toluene and xylene. The concentrations of the acids varied from day to day depending on the kind and the duration of work. From the concentrations found the mean concentrations to which the workers were exposed were calculated as a fraction of the maximum allowable concentration (M.A.C.). One worker was, on this evidence, exposed to more than the combined M.A.C. on three days out of six.

     

Exposure to toluene increases the urinary excretion of D-glucaric acid.

Workers at a printing plant exposed to low concentrations of toluene (43-401 mg/m3, median 155 mg/m3) had increased urinary D-glucaric acid (3.55-5.12 mmol/mol creatinine) excretion at the end of the shift compared with controls (2.45-3.35 mmol/mol creatinine). No increase was found after the summer holiday (1.92-2.89 mmol/mol creatinine) but excretion had increased two weeks later (4.05-5.55 mmol/mol creatinine). These changes in the excretion of D-glucaric acid were not correlated to levels of exposure, to changes of urinary hippuric acid and o-cresol half lives (three to eight hours), nor to o-cresol/hippuric acid concentration ratios when measured at the end of daily exposure. Since a significant intra and interindividual variability of urinary D-glucaric acid was found in all groups, urinary D-glucaric acid excretion is suitable to monitor group but not individual exposure.     

Occupational chronic exposure to organic solvents XII. O-cresol excretion after toluene exposure

Summary Thirty-five printing workers were investigated according to their external and internal exposure to toluene. The concentration of toluene in the air of the working place was determined using stationary air sampling and gas chromatography. To determine the levels of toluene in blood as well as the concentrations of o-cresol, hippuric acid, and phenol in urine, biological specimens were collected at the end of exposure. The parameters were determined by gas chromatography and gas chromatography/mass spectrometry. According to our results, o-cresol concentrations higher than 5.3 mg per litre of post-shift urine might indicate an external exposure higher than the present MAK-value of 200 ppm.     

Exposure to toluene increases the urinary excretion of D-glucaric acid

Workers at a printing plant exposed to low concentrations of toluene (43-401 mg/m3, median 155 mg/m3) had increased urinary D-glucaric acid (3.55-5.12 mmol/mol creatinine) excretion at the end of the shift compared with controls (2.45-3.35 mmol/mol creatinine). No increase was found after the summer holiday (1.92-2.89 mmol/mol creatinine) but excretion had increased two weeks later (4.05-5.55 mmol/mol creatinine). These changes in the excretion of D-glucaric acid were not correlated to levels of exposure, to changes of urinary hippuric acid and o-cresol half lives (three to eight hours), nor to o-cresol/hippuric acid concentration ratios when measured at the end of daily exposure. Since a significant intra and interindividual variability of urinary D-glucaric acid was found in all groups, urinary D-glucaric acid excretion is suitable to monitor group but not individual exposure.     

Urinary benzylmercapturic acid as a marker of occupational exposure to toluene

OBJECTIVE: To examine if benzylmercapturic acid (or N-acetyl- S-benzyl cysteine) in urine can be used as a marker of occupational exposure to toluene. METHODS: A factory survey was conducted in the latter half of a working week. A group of 46 men, who volunteered for the study, was engaged in ink preparation, surface coating or printing work. Diffusive samplers were used to measure average solvent exposure in an 8-h shift. End-of-shift urine samples were analyzed for benzylmercapturic acid (BMA) by a modification of an HPLC method originally developed for phenylmercapturic acid determination. RESULTS: The workers were exposed primarily to toluene [TOL; 13 ppm as the geometric mean (GM) and 86 ppm at the maximum] together with isopropyl alcohol (<1 and 4 ppm), ethyl acetate (2 and 127 ppm) and methyl ethyl ketone (2 and 142 ppm). BMA in urine correlated closely [correlation coefficient ( r) =0.7] with TOL in air, irrespective of correction for urine density. The lowest TOL concentration at which urinary BMA increased to a measurable level was approximately 10 ppm, and urinary BMA could separate the exposed from the non-exposed when TOL exposure was 15 ppm or higher. CONCLUSIONS: BMA in end-of-shift urine samples is a good marker of occupational TOL exposure. Urinalysis for BMA is sensitive enough to detect TOL exposure at 15 ppm, and therefore BMA appears to be more sensitive than hippuric acid and possibly o-cresol as a urinary marker of TOL exposure.     

A new derivatization procedure for the analysis of hippuric acid and m-methyl-hippuric acid by gas chromatography

Summary The industrial solvents, toluene and xylene, have physicochemical properties that can be hazardous to the workers exposed. Since hippuric acid and m-methyl-hippuric acid represent the products of toluene and xylene biotransformation in urine, they are used as biological markers in studies on occupational exposure to these solvents. Several methods have been used to determine hippuric acid and m-methyl-hippuric acid —either based on gas chromatography or on high-performance liquid chromatography. In this study we propose the derivatization of hippuric acid and methyl-hippuric acid using methanol in acid medium (HCl), a low-cost reagent with a low level of toxicity. The method has been routinely used in our laboratory for 1 year and has proven to be a reliable procedure for the biological control of occupational exposure to toluene and/or xylene.     

Toluene itself as the best urinary marker of toluene exposure

Head-space gas chromatography (GC) and high-performance liquid chromatography (HPLC) (with fluorescence detectors) methods were developed for toluene (TOL-U) and o-cresol (CR-U) in urine, respectively. In order to identify the most sensitive urinary indicator of occupational exposure to toluene vapor (TOL-A) among TOL-U, CR-U, and hippuric acid in urine (HA-U), the two methods together with an HPLC (with untraviolet detectors) method for determination of HA-U were applied in the analysis of end-of-shift urine samples from 115 solvent-exposed workers (exposed to toluene at 4 ppm as geometric mean). Regression analysis showed that TOL-U correlated with TOL-A with a significantly higher correlation coefficient than did HA-U or CR-U. With regard to the TOL-A concentrations at which the exposed subjects could be separated from the nonexposed by the analyte, TOL-U achieved separation at < 10 ppm TOL-A, whereas both HA-U and CR-U did so only when TOL-A was 30 ppm or even higher. The ratio of the analyte concentrations at 50 ppm TOL-A to those at 0 ppm TOL-A was also highest for TOL-U. Overall, the results suggest that TOL-U is a better marker of exposure to toluene vapor than HA-U or CR-U.     

Chronic occupational exposure to toluene

Summary Chronic occupational exposure to toluene was studied in a factory preparing tarpaulins. Seventy-eight workers were studied; 46 were exposed to various concentrations of toluene in air (20–200 ppm), 32 were unexposed workers in the same factory. In many cases the exposure had lasted for 10–20 years. The urinary hippuric acid excretion at the end of work shift showed good correlations to toluene concentrations in air, and it seems to be a good measure of exposure. The hippuric acid in urine samples collected overnight showed that elimination of toluene still occurs several hours after exposure. Most of the biological parameters measured showed no correlation to toluene exposure. The blood leukocyte count did show slight positive correlations to toluene exposure, but even this parameter stayed inside the range of normal values. The occurrence of chronic diseases, drug using habits, and drinking and smoking habits did not show any correlations to toluene exposure.This study has been supported by the grant of Y. Jahnsson Foundation in Finland     

Method for simultaneous determination of six metabolites of toluene, xylene and ethylbenzene, and its application to exposure monitoring of workers in a printing factory with gravure machines

For the biological monitoring of exposure to solvent composed of toluene, xylene, and ethylbenzene used in a printing factory with gravure machines, we developed a HPLC method for the simultaneous determination of urinary metabolites of this solvent, i.e. hippuric acid, o-, m-, and p-methylhippuric acid, mandelic acid and phenylglyoxylic acid. Except for phenylglyoxylic acid, urinary concentrations of the metabolites determined by the present method correlated well with the air concentrations of the respective solvent components. Hence the present method is useful in monitoring solvent exposure. In 91 workers of the printing factory and 53 control subjects, we also determined the concentrations of some phenolic metabolites and confirmed that o-cresol is a useful indicator for monitoring toluene exposure.