Epidemiology, clinical presentation, treatment, and follow-up of chronic mercury poisoning in China: a retrospective analysis.

BACKGROUND: There are no reports on the incidence of chronic mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with chronic mercury poisoning. METHODS: Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. RESULTS: First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3 %), kidney (16.4 %) and breathing (8.0 %). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.50 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months. CONCLUSIONS: Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.

Impact of Petroleum Exposure on Some Hematological Indices, Interleukin-6, and Inflammatory Markers of Workers at Petroleum Stations in Basra City.

Background: Occupational and environmental exposure to several pollutant factors such as petroleum products containing benzene has toxic effects on different body systems. The hematopoietic system and immune system are among the affected systems. This study aims to investigate the effect of benzene exposure on some blood parameters of workers at several fuel stations in Basra city, as well as to reveal if the continuous exposure may induce an inflammatory response, which is reflected by changes in some hematological and inflammatory markers. Methods: The study included two groups of males. The first group consists of 72 exposed workers at petrol stations in different locations in the Basra city. The other group is the control group, which consists of 75 nonexposed subjects (students and faculty members of the college). Different hematological parameters (WBC, RBC, HGB, MCV, MCHC, and MCH) have been evaluated. Serum concentrations of IL-6 and hs-CRP were estimated in all workers and nonexposed using enzyme-linked immunosorbent assay (ELISA). Results: Data showed significant hematological changes in the exposed workers, and that anemia was a common disorder among them. Furthermore, there was a significant decline in WBC and different types of WBC including lymphocytes, monocytes, and neutrophils in the exposed workers. Erythrocyte sedimentation rate and serum levels of interleukin-6 and hs-CRP were significantly higher in exposed workers than in nonexposed. A significant correlation was identified among blood parameters, while a strong inverse correlation was identified between both MCHC and ESR. The most significant inverse correlation was found between RBC and IL-6 and MCH with hs-CRP. In addition, a significant negative correlation was found between monocytes and IL-6. Conclusion: The changes in all hematology and inflammatory parameters refer to damage in the hematopoietic system due to continuous exposure to vapors of petrol products, which also result in a significant increase in interleukin-6.

Unexpected effect of dry olive leaf extract on the level of DNA damage in lymphocytes of lead intoxicated workers, before and after CaNa2EDTA chelation therapy.

The CaNa2EDTA chelation therapy is often practiced with antioxidant supplementation. Dry olive leaf extract (DOLE) is natural product with antioxidant and DNA protective properties. The effects of DOLE on the levels of DNA damage were investigated ex vivo in peripheral blood lymphocytes (PBLs) of 19 workers occupationally exposed to lead (Pb), before and after CaNa2EDTA chelation therapy. DOLE demonstrated pronounced radical scavenging activity in concentrations ≥1 mg/mL, and showed no genotoxicity per se, in concentrations 0.125-1 mg/mL. The level of DNA damage in PBLs of workers before chelation therapy was elevated (24.21 ± 14.26) compared to controls (6.0 ± 3.37). The incubation of PBLs before chelation therapy with selected concentration of DOLE lead to a severe increase of DNA damage (64.03 ± 20.96), exhibiting prooxidant rather than antioxidant effect. After the five-day CaNa2EDTA chelation regimen, DNA damage in PBLs of workers decreased (8.26 ± 4.62) significantly compared to baseline. Treatment of PBLs with DOLE after chelation, again produced high level of damage (41.82 ± 23.17) and the acute prooxidant effects of DOLE remained, but, DNA damage was less severe than before chelation. The DOLE exhibits prooxidant effect in presence of Pb in lymphocytes of exposed workers, and its effect is less pronounced following the removal of Pb after standard chelation therapy.

Effectiveness of Essence of Chicken in Improving Cognitive Function in Young People Under Work-Related Stress: A Randomized Double-Blind Trial.

Work-related stress (WS) can result in considerable and extensive changes in physiological and psychological performance. WS beyond the optimal levels induces anxiety, confusion, exhaustion, and burnout. Chronic WS affects neurocognitive performance, particularly attention and visuospatial memory. Essence of chicken (EC) has been reported to improve neurocognitive function after mental stress.To investigate the beneficial effects of EC in improving neurocognitive performance under WS, we conducted a randomized, double blind trial. Total 102 young workers in New Taipei City with high WS, evaluated using the Individual Subjective Perception Job Stress Scale scores (>36 for job leaders and 33 for nonleaders) were recruited. Fifty-one participants received 70 mL of EC and 51 received a placebo daily for 2 weeks. Blood tests and neurocognitive assessment were performed before treatment, at the end of treatment, and 2 weeks after treatment.EC improved the performance of participants with high depression scores in the form-color associative memory test, used for assessing short-term memory. Although creatinine and glutamic-pyruvic transaminase (GPT) levels increased in week 2, but the levels returned to the baseline in week 4. Blood urea nitrogen (BUN) levels decreased in week 4.EC significantly improved short-term memory in participants with high WS and concomitant depressive mood, although it slightly increased GPT and creatinine levels and reduced BUN levels. The long-term treatment effects of EC warrant further investigation.

Cardiovascular Diseases Risk Factors in oil and gas workers: a ten years observational retrospective cohort.

OBJECTIVES: The study aim was to examine the trend of major clinical biochemistry factors associated with cardiovascular diseases and dyslipidemia onset over a 10-year period (2000-2010) in Oil and Gas workers. METHODS: The information extracted from "Computerized management of individual medical services database" regarding 439 Italian workers of an oil and gas company were analysed. RESULTS: A constant and significant increase of the average Body Mass Index and serum cholesterol were found, and in particular in workers < 36 years: BMI was 24.4 (2000) and 25.8 (2010) with p < 0.001, and cholesterol was 188.3 mg/dL (2000) and 206.5 mg/dL (2010) with p < 0.001. CONCLUSION: Analysed variables are the most important risk factor for cardiovascular, neurological and neoplastic diseases, as well as they reduce life expectancy. Occupational medicine in particular in extreme working environmental conditions, such as for workers in oil and gas companies, monitoring health status and promoting healthy life style, has a strategic role to perform cost-effective strategies to reduce health risks, thus improving the workers lifestyle.

Biological monitoring of Italian soldiers deployed in Iraq. Results of the SIGNUM project.

BACKGROUND: Leukemia/lymphoma cases reported in 2001 among United Nation soldiers or peacekeepers deployed to the Balkans aroused alert on the exposure to depleted uranium. Recent epidemiological studies carried out in different European countries among peacekeepers who served in the Balkans failed to demonstrate a higher than expected risk of all cancers but, mostly due to their limitations in size and follow up time, leave open the debate on health risk of depleted uranium. The aim of SIGNUM (Study of the Genotoxic Impact in Military Units) was to identify potential genotoxic risk associated with the exposure to depleted uranium or other pollutants in the Italian Army military personnel deployed in Iraq. METHODS: Blood and urine samples were collected before and after the deployment from 981 Italian soldiers operating in Iraq in 2004-2005. As, Cd, Mo, Ni, Pb, U, V, W, and Zr were determined in urine and serum. DNA-adducts, 8-hydroxy-2'-deoxyguanine and micronuclei frequency were evaluated in blood lymphocytes. Three different genetic polymorphisms, GSTM1, XRCC1, OGG1 were analyzed. RESULTS: Significant T0-T1 reduction in the total concentration of uranium, increases for Cd, Mo, Ni, Zr, and decreases for As, Pb, W, and V in urine and plasma were observed. Increases in oxidative alterations and in micronuclei frequency, included in the range of values of non-occupationally exposed populations, were observed at the end of the period of employment. CONCLUSIONS: Our results did not detect any toxicologically relevant variation of DNA-damage biomarkers related to the deployment in the operational theater.

Low serum 25-hydroxyvitamin D is associated with increased risk of stress fracture during Royal Marine recruit training.

UNLABELLED: The aim of this study was to investigate vitamin D status and stress fracture risk during Royal Marine military training. Poor vitamin D status was associated with an increased risk of stress fracture. Vitamin D supplementation may help to reduce stress fracture risk in male military recruits with low vitamin D status. INTRODUCTION: Stress fracture is a common overuse injury in military recruits, including Royal Marine (RM) training in the UK. RM training is recognised as one of the most arduous basic training programmes in the world. Associations have been reported between serum 25-hydroxyvitamin D (25(OH)D) and risk of stress fracture, but the threshold of 25(OH)D for this effect remains unclear. We aimed to determine if serum 25(OH)D concentrations were associated with stress fracture risk during RM training. METHODS: We prospectively followed 1082 RM recruits (males aged 16-32 years) through the 32-week RM training programme. Troops started training between September and July. Height, body weight and aerobic fitness were assessed at week 1. Venous blood samples were drawn at weeks 1, 15 and 32. Serum samples were analysed for 25(OH)D and parathyroid hormone (PTH). RESULTS: Seventy-eight recruits (7.2 %) suffered a total of 92 stress fractures. Recruits with a baseline serum 25(OH)D concentration below 50 nmol L(-1) had a higher incidence of stress fracture than recruits with 25(OH)D concentration above this threshold (χ(2) (1) = 3.564, p = 0.042; odds ratio 1.6 (95 % confidence interval (CI) 1.0-2.6)). Baseline serum 25(OH)D varied from 47.0 ± 23.7 nmol L(-1) in February, to 97.3 ± 24.6 nmol L(-1) in July (overall mean 69.2 ± 29.2 nmol L(-1), n = 1016). There were weak inverse correlations between serum 25(OH)D and PTH concentrations at week 15 (r = -0.209, p < 0.001) and week 32 (r = -0.214, p < 0.001), but not at baseline. CONCLUSION: Baseline serum 25(OH)D concentration below 50 nmol L(-1) was associated with an increased risk of stress fracture. Further studies into the effects of vitamin D supplementation on stress fracture risk are certainly warranted.

Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers.

N-Acetylcysteine (NAC) could be included in protocols designed for the treatment of lead toxicity. Therefore, in this study, we decided to investigate the influence of NAC administration on homocysteine (Hcy) levels, oxidative damage to proteins, and the levels of iron (Fe), transferrin (TRF), and haptoglobin (HPG) in lead (Pb)-exposed workers. The examined population (n = 171) was composed of male employees who worked with Pb. They were randomized into four groups. Workers who were not administered any antioxidants, drugs, vitamins, or dietary supplements were classified as the reference group (n = 49). The remaining three groups consisted of workers who were treated orally with NAC at three different doses (1 × 200, 2 × 200, or 2 × 400 mg) for 12 weeks. After the treatment, blood Pb levels significantly decreased in the groups receiving NAC compared with the reference group. The protein concentration was not affected by NAC administration. In contrast, Hcy levels significantly decreased or showed a strong tendency toward lower values depending on the NAC dose. Levels of the protein carbonyl groups were significantly decreased in all of the groups receiving NAC. Conversely, glutamate dehydrogenase activity was significantly elevated in all of the groups receiving NAC, while the level of protein thiol groups was significantly elevated only in the group receiving 200 mg of NAC. Treatment with NAC did not significantly affect Fe and TRF levels, whereas HPG levels showed a tendency toward lower values. Treatment with NAC normalized the level of Hcy and decreased oxidative stress as measured by the protein carbonyl content; this effect occurred in a dose-dependent manner. Moreover, small doses of NAC elevated the levels of protein thiol groups. Therefore, NAC could be introduced as an alternative therapy for chronic Pb toxicity in humans.

Laughing Gas in a Pediatric Emergency Department-Fun for All Participants: Vitamin B12 Status Among Medical Staff Working With Nitrous Oxide.

The efficiency of nitrous oxide in an equimolar mixture with oxygen or in concentrations up to 70% is approved for short painful procedures. Evaluation of the vitamin B12 levels in anesthetic staff applying nitrous oxide showed reduced vitamin B12 plasma levels. This study examines the vitamin B12 status of medical staff working with nitrous oxide in a pediatric emergency department (ED). Medical staff of the ED at the University Children's Hospital Zurich participated. The vitamin B12 status was evaluated by measuring homocysteine, methylmalonic acid, vitamin B12, blood count, and the MTHFR C677T genotype. As a control group, medical personnel working in the "nitrous oxide-free" pediatric intensive care unit were recruited. RESULTS: The parameters for the vitamin B12 status of all participants were in the reference range, and there were no significant differences for the 2 groups. By trend, the ED staff showed higher vitamin B12 levels. The ED staff members were slightly older (P = 0.07) and had higher hemoglobin levels (P < 0.04) compared with the pediatric intensive care unit staff. CONCLUSIONS: The use of nitrous oxide (50%-70%) with a demand valve is safe for the vitamin B12 status of medical personnel in the ED.

The effects of black soybean (Glycine max var.) on chronic cervical pain of sedentary office workers in a northern Chinese population.

Chronic cervical pain is a common symptom of sedentary office workers. Black soybean (Glycine max var.) has rich necessary nutrients for the therapy of chronic pain. Thus, it may ease chronic cervical pain. To prove our claim, 260 sedentary office workers with chronic pain were recruited and they consumed the defined diets at breakfast, lunch, and dinner with 1 g, 5 g and 10 g (3 g, 15 g, 30 g daily) cooked black soybean for 24 weeks. Visual analog scale (VAS), neck disability index (NDI) pain scores and short-form 36 (SF-36) health survey questionnaires were applied in the study. The levels of N-methyl-D-aspartate receptors (NMDAR) were measured. The VAS and NDI pain scores reduced and SF-36 scores increased in a 15 or 30 g black soybean daily group compared with a 3 g black soybean daily group after a 24-week therapy (P < 0.05). The 30 g black soybean daily group was better than the 15 g black soybean daily group in relieving chronic cervical pain of sedentary office workers (p < 0.05). The levels of NMDAR were lower in the 15 or 30 black soybean daily group than those in the 3 g black soybean daily group (P < 0.05). Black soybean can ameliorate chronic cervical pain by down-regulating the levels of NMDAR.

Identification of cross-reactive carbohydrate determinants in subjects reporting work-related respiratory symptoms.

INTRODUCTION: The role of cross-reactive carbohydrate determinants (CCDs) in diagnostics of occupational allergy remains unclarified and its clinical relevance is still questioned. The aim of the study was to assess the frequency of positive response to CCDs in the subjects with suspected occupational allergy and the relationship between other diagnostic test results and final diagnosis. MATERIAL AND METHODS: The study group included 201 patients. They underwent clinical examination, skin prick test (SPT) to common and occupational allergens, specific serum immunoglobulin (sIgE) determinations, spirometry and specific inhalation challenge test. Moreover, sIgE to CCDs from bromelain was assessed in all subjects. RESULTS: Occupational respiratory allergy was recognized in 64.3% of CCD-positive and 52.4% of CCD-negative patients. Positive SPT results to common and occupational allergens were found in 64.3% and 35.7% of CCD-positive subjects, respectively. In all subjects with CCDs, the sIgE to grass pollens as well as to occupational allergens were detected. The total IgE level > 100 kU/l was significantly associated with the presence of sIgE to CCDs. CONCLUSIONS: sIgE to CCDs were found in 7% of subjects suspected to suffer from occupational respiratory allergy. The presence of CCDs is not significantly associated with occupational respiratory allergy. It is also not more frequent in subjects reporting work-related respiratory symptoms in whom occupational allergy was not confirmed. The elevated total IgE level was related with CCD positivity. In patients with suspected occupational allergy, the presence of sIgE to CCDs in serum did not indicate the irrelevance of positive sIgE to occupational allergens.

Selenium and exposure to fibrogenic mineral dust: a mini-review.

Individuals exposed to fibrogenic mineral dust may exhibit an impaired antioxidant system and produce high levels of reactive oxygen and nitrogen species through immune cells, contributing to the perturbation of immune cell function, inflammation, fibrosis and lung cancer. The lung diseases which are caused by inhalation of fibrogenic mineral dust, known as pneumoconioses, develop progressively and irreversibly over decades. At the moment there is no known cure. The trace element selenium has potent antioxidant and anti-inflammatory properties mediated mainly through selenoproteins. Research has demonstrated that selenium has the ability to protect against cardiovascular diseases; to kill cancer cells in vitro and reduce cancer incidence; and to immunomodulate various cellular signaling pathways. For these reasons, selenium has been proposed as a promising therapeutic agent in oxidative stress associated pathology that in theory would be beneficial for the prevention or treatment of pneumoconioses such as silicosis, asbestosis, and coal worker's pneumoconiosis. However, studies regarding selenium and occupational lung diseases are rare. The purpose of this study is to conduct a mini-review regarding the relationship between selenium and exposure to fibrogenic mineral dust with emphasis on epidemiological studies. We carried out a systematic literature search of English published studies on selenium and exposure to fibrogenic mineral dust. We found four epidemiological studies. Reviewed studies show that selenium is lower in individuals exposed to fibrogenic mineral dust. However, three out of the four reviewed studies could not confirm cause-and-effect relationships between low selenium status and exposure to fibrogenic mineral dust. This mini-review underscores the need for large follow-up and mechanistic studies for selenium to further elucidate its therapeutic effects.

Baseline serum ß-carotene concentration and mortality among long-term asbestos-exposed insulators.

BACKGROUND: Although interventional trials demonstrated that moderate-dose ß-carotene supplementation increases lung cancer mortality in smokers and asbestos-exposed workers, differences in serum concentrations in absence of supplementation have not been studied in asbestos-exposed workers. METHODS: A mortality analysis was performed to assess the relationship of nonsupplemented serum ß-carotene to all-cause and cancer mortalities using 1981 to 1983 serum ß-carotene concentration measurements from 2,646 U.S. white male insulators (mean age, 57.7 years). Multivariable-adjusted Cox proportional hazard models that included terms for age, duration of asbestos exposure, smoking, season, and region were fitted to estimate mortality HRs and 95% confidence intervals (CI) according to serum ß-carotene concentrations. RESULTS: Median follow-up was 12.8 years and 984 (33.8%) subjects died during the follow-up period, including 415 deaths from overall cancer and 219 deaths from lung cancer. The overall mortality HR for a serum ß-carotene increase of 10 µg/dL was 0.97 (95% CI, 0.96-0.99). Compared with the lowest quartile, HRs were 0.90 (95% CI, 0.76-1.07) for the second (38-65 µg/dL), 0.80 (95% CI, 0.67-0.96) for the third (66-104 µg/dL), and 0.63 (95% CI, 0.51-0.77) for the highest serum ß-carotene quartile (≥105 µg/dL). There was no association between serum ß-carotene and overall cancer mortality (HR, 1.00; 95% CI, 0.97-1.02) or lung cancer mortality (HR, 0.99; 95% CI, 0.96-1.02). CONCLUSIONS: Higher nonsupplemented serum ß-carotene concentrations were negatively associated with all-cause mortality among asbestos-exposed individuals. IMPACT: Serum ß-carotene can be a marker of one or more determinants of reduced mortality in asbestos-exposed workers. Cancer Epidemiol Biomarkers Prev; 24(3); 555-60. ©2014 AACR.

Biological monitoring of exposure and effects in workers employed in a selenium-processing plant.

PURPOSE: The aim of the study was to assess external and internal selenium exposure and potential biological effects in employees working in a selenium-processing plant. METHODS: Twenty male employees of a selenium-processing plant (exposed) and 20 age-matched male individuals without occupational selenium exposure (controls) participated in the study. Exposure to selenium at the workplace was determined by personal air sampling. Internal exposure was assessed by measuring total selenium concentration in plasma after a workshift and after holidays as well as by measuring the selenium concentration in urine before and after shift and after holidays. The activity of glutathione peroxidase (GPx) in blood and the prothrombin time were determined as biological effect parameters. RESULTS: The exposure to selenium in the workplace air ranged from 8 to 950 µg/m(3) and exceeded in a large part current occupational exposure limits. The selenium levels in plasma samples of the exposed ranged from 49 to 182 µg/L during exposure and were significantly higher than the plasma levels observed after holidays as well as in the control group. The selenium concentration in pre- and post-shift urine samples did not differ significantly, and the average urinary selenium levels of the employees (18-1,104 µg/g creatinine) were significantly higher than those measured after holidays or determined in controls. Both the concentration of selenium in plasma and in urine did not correlate with the current external exposure of the employees at the workplace. However, we found a strong and significant association between the two biomonitoring parameters. In spite of the considerable high external exposure to elemental selenium, we did not find any effect on the GPx activity in blood as well as on the prothrombin time. CONCLUSIONS: Both the selenium levels in plasma and urine may be used as biological monitoring parameters for the assessment of chronic occupational exposure to selenium. Nevertheless, the toxicokinetics of the urinary excretion of selenium remain still unclear and require further investigations. Moreover, our findings emphasise the necessity of a re-evaluation of occupational exposure limits for elemental selenium and inorganic selenium compounds.

The influence of beta-carotene on homocysteine level and oxidative stress in lead-exposed workers.

BACKGROUND: Oxidative stress is involved in lead toxicity. This suggests that some antioxidants may play a role in the treatment of lead poisoning. In the light of this, the aim of the study was to determine whether beta-carotene administration reduces oxidative stress and homocysteine level in workers chronically exposed to lead. MATERIAL AND METHODS: The exposed population included healthy male workers exposed to lead who were randomly divided into 2 groups (mean blood lead level ca. 44 microg/dl). Workers in the 1st group (N = 49, reference group) had no antioxidants, drugs, vitamins or dietary supplements administered, while workers in the 2nd group (N = 33) had beta-carotene administered in a dose of 10 mg per day for 12 weeks. Biochemical analysis included markers of lead-exposure and the level of malondialdehyde (MDA), an oxidative stress biomarker. We also measured the level of homocysteine (Hcy) and thiol groups as well as the activity of superoxide dismutase (SOD) and its isoenzyme EC-SOD in serum. RESULTS: After supplementation, the level of MDA significantly decreased, compared to baseline, by 16%, and to the reference group. When compared to the reference group, Hcy level was also significantly decreased. However, the level of thiol groups was significantly higher after supplementation with beta-carotene compared to the reference group. Analogically, the activity of SOD and EC-SOD was significantly higher compared to the baseline and to the reference group. CONCLUSIONS: Despite some controversies over antioxidant properties of beta-carotene, our results indicate that its antioxidant action could provide some beneficial effects in lead poisoning independent of chelation.

Beta-carotene reduces oxidative stress, improves glutathione metabolism and modifies antioxidant defense systems in lead-exposed workers.

The aim of this study was to determine whether beta-carotene administration reduces oxidative stress and influences antioxidant, mainly glutathione-related, defense systems in workers chronically exposed to lead. The population consisted of two randomly divided groups of healthy male volunteers exposed to lead. Workers in the first group (reference group) were not administered any antioxidants, while workers in the second group (CAR group) were treated orally with 10mg of beta-carotene once a day for 12weeks. Biochemical analysis included measuring markers of lead-exposure and oxidative stress in addition to the levels and activities of selected antioxidants. After treatment, levels of malondialdehyde, lipid hydroperoxides and lipofuscin significantly decreased compared with the reference group. However, the level of glutathione significantly increased compared with the baseline. Treatment with beta-carotene also resulted in significantly decreased glutathione peroxidase activity compared with the reference group, while the activities of other glutathione-related enzymes and of superoxide dismutase were not significantly changed. However, the activities of glucose-6-phosphate dehydrogenase and catalase, as well as the level of alpha-tocopherol, were significantly higher after treatment compared with the baseline. Despite controversy over the antioxidant properties of beta-carotene in vivo, our findings showed reduced oxidative stress after beta-carotene supplementation in chronic lead poisoning.

Ethylbenzene-induced hearing loss, neurobehavioral function, and neurotransmitter alterations in petrochemical workers.

OBJECTIVE: To estimate hearing loss, neurobehavioral function, and neurotransmitter alteration induced by ethylbenzene in petrochemical workers. METHODS: From two petrochemical plants, 246 and 307 workers exposed to both ethylbenzene and noise were recruited-290 workers exposed to noise only from a power station plant and 327 office personnel as control group, respectively. Hearing and neurobehavioral functions were evaluated. Serum neurotransmitters were also determined. RESULTS: The prevalence of hearing loss was much higher in petrochemical groups than that in power station and control groups (P < 0.05). Compared with the control group, scores of neurobehavioral function reflecting learning and memory were decreased in petrochemical workers (P < 0.05), as well as acetylcholinesterase activity. Negative correlation was shown between neurobehavioral function and acetylcholinesterase. CONCLUSIONS: Ethylbenzene exposure might be associated with hearing loss, neurobehavioral function impairment, and imbalance of neurotransmitters.

Organic solvent-induced bipolar disorder: a case report.

Many studies have reported neurological and neuropsychiatric symptoms, including a significantly increased risk of depression and suicide, from exposure to low to moderate levels of organic solvents. However, few studies have reported a link between organic solvent exposure and bipolar disorder. The authors present a case of a 43-y-old man who developed new-onset bipolar disorder following exposure to organic solvents in a textile printing plant. The man had elevated blood levels of several common solvents. His symptoms abated following avoidance of solvent exposures at his workplace and after nutritional and sauna detoxification treatments that one of the authors formulated to clear xenobiotics. Following avoidance and detoxification, the patient's blood concentrations of organic solvents fell to undetectable levels and his manic symptoms disappeared, with no significant recurrences over the past 13 y, as evaluated by the authors and his other physicians.

Association of blood lead and mercury with estimated GFR in herbalists after the ban of herbs containing aristolochic acids in Taiwan.

OBJECTIVE: This study was undertaken to explore the association of estimated glomerular filtration rate (GFR) with exposure to aristolochic acids (ALAs) and nephrotoxic metals in herbalists after the ban of herbs containing ALAs in Taiwan. METHODS: This cross-sectional study recruited a total of 138 herbalists without end-stage renal disease or urothelial carcinoma from the Occupational Union of Chinese Herbalists in Taiwan in 2007. Aristolochic acid I (ALA-I) was measured by ultra-high-pressure liquid chromatography/ tandem mass spectrometry (UHPLC-MS/MS) and heavy metals in blood samples were analysed by Agilent 7500C inductively coupled plasma-mass spectrometry. Renal function was assessed by using a simplified Modification of Diet in Renal Disease Study equation to estimate GFR. RESULTS: Blood lead was higher in herbal dispensing procedures (p=0.053) and in subjects who self-prescribe herbal medicine (p=0.057); mercury was also higher in subjects living in the workplace (p=0.03). Lower estimated GFR was significantly associated with lead (ß=-10.66, 95% CI -18.7 to -2.6) and mercury (ß=-12.52, 95% CI -24.3 to -0.8) with a significant interaction (p=0.01) between mercury and lead; however, estimated GFR was not significantly associated with high ALA-I level groups, arsenic and cadmium after adjusting for other confounding factors. CONCLUSIONS: We found that lower estimated GFR was associated with blood lead and mercury in herbalists after the ban of herbs containing ALAs in Taiwan. The ALA-I exposure did not show a significant negative association of estimated GFR, which might due to herbalists having known how to distinguish ALA herbs after the banning policy. Rigorous monitoring is still needed to protect herbalists and the general population who take herbs.