Epidemiological study of gastrointestinal and liver effects of carbon disulfide

Summary In the framework of an extensive health survey, 119 viscose rayon workers exposed to carbon disulfide (CS₂) and 79 workers from other plants not exposed to any toxic agent in the working environment underwent a gastrointestinal examination including a self-administered questionnaire, abdominal palpation, percussion and a number of liver function tests. In the viscose rayon factory the working conditions have not changed since 1932. Personal monitoring performed in 17 jobs showed CS₂ exposures varying from 4 to 112 mg · m^–3. For each individual a cumulative CS₂ exposure index (CS₂ index) was calculated. Univariate analysis of the questionnaire findings showed significantly higher prevalences of anorexia (37.0% vs 11.4%, P<0.0001), vomiting (12.6% vs 3.8%, P = 0.04), and recent weight loss (10.9% vs 1.3%, P = 0.009) in the exposed than in the non-exposed workers. The exposed workers had a larger total number of gastrointestinal complaints and a larger proportion reported at least one complaint at least once a month than the non-exposed ones. Abdominal tenderness was very rare in both groups. In multiple logistic regression analysis, adjusting for alcohol intake, smoking, body mass index (BMI), coffee consumption, commuting time, stress at work, shift work, educational level, family history of ulcer disease and intake of medication, significant associations with exposure were found for anorexia (P = 0.0001), nausea (P = 0.009), vomiting (P = 0.002) and flatulence (P = 0.03). Stress at work was a determinant for quite a few digestive complaints, but shift work was not significantly associated with any of them. The exposed workers had significantly lower median values for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) than the non-exposed (11.0 vs 13.5 mU/ml, P = 0.0008; 12.0 vs 13.0 mU/mL, P = 0.01, respectively. The values for liver size and -glutamyltransferase (GGT) were significantly higher in the exposed than in the non-exposed workers (72 vs 67 mm, P = 0.002; 13 vs 11 U/1, P = 0.0003, respectively). The alkaline phosphatase (AP) activity did not differ significantly between the two groups. In multiple linear regression, adjusting for alcohol, pharmaceuticals consumption and BMI, there was a slightly significant negative association between exposure and AST (P = 0.04) and positive association with liver size (P = 0.002) and GGT (P = 0.0001). Alcohol was positively associated with GGT, and BMI with ALT and GGT.