Desarrollo de funciones de la enfermería del trabajo en la vigilancia de la salud laboral por exposición a tóxicos: el tolueno como ejemplo / Occupational Health Nurses' Role in the Occupational Health Surveillance of Exposure to Toxics: Toluene as a Case Study

Introducción: El tolueno, hidrocarburo aromático presente en varios productos, se absorbe principalmente por vía respiratoria y afecta diferentes sistemas corporales. Los enfermeros/as del trabajo son clave para detectar exposiciones agudas y crónicas. Además, son responsables de recolectar y procesar las muestras para su biomonitorización. Sin embar-go, la información sobre los requisitos de recogida y manipulación, así como de intervencio-nes enfermeras es escasa y heterogénea. Objetivo: Revisar la bibliografía disponible sobre el tolueno y la enfermería del trabajo, iden-tificar requisitos de recogida y procesamiento de muestras, así como los signos y síntomas de exposición y relacionarlos con diagnósticos e intervenciones enfermeras.Métodos: Se realizó una revisión bibliográfica aplicando la estrategia PICO, no limitada por tipo de documento, fecha o idioma en PubMed, Web of Science y Scopus. Se clasificaron los signos y síntomas según sistema y prueba de enfermería realizada durante el examen de salud, identificando diagnósticos e intervenciones enfermeras.Resultados: No se encontraron estudios sobre tolueno y enfermería del trabajo. De 60 citas identificadas, 6 artículos señalaban requisitos de recogida de muestras. Se identificaron signos y síntomas de acuerdo a las pruebas de enfermería y se relacionaron con diagnósti-cos e intervenciones de enfermería.Conclusiones: La presencia de la enfermería del trabajo en la literatura científica sobre to-lueno es escasa. Los criterios de recogida de muestras son heterogéneos y limitados. No se han encontrado estudios que relacionen signos y síntomas de exposición al tolueno con diagnósticos e intervenciones enfermeras. Se propone un cuadro relacional novedoso. Son necesarios estudios de toxicología laboral desde la perspectiva de la enfermería del trabajo (AU)

ntroduction: Toluene, an aromatic hydrocarbon present in various products, is primarily absorbed through the respiratory tract and can affect different body organs. Occupational health nurses play a key role in detecting acute and chronic exposures. They are also re-sponsible for collecting and processing samples for biomonitoring. However, information on the collection and handling requirements, as well as nursing interventions, is scarce and heterogeneous.Aims: We reviewed the existing literature linking toluene and occupational health nursing, identified sample collection and processing requirements, as well as signs and symptoms of exposure, and related them to diagnoses and nursing interventions.Methods: We conducted a literature search using the PICO strategy, without limitations on document type, date, or language, in PubMed, Web of Science, and Scopus databases. Signs and symptoms were classified according to the system and nursing test performed during the health examination, identifying possible diagnoses and nursing interventions.Results: We found no studies linking toluene and occupational health nursing. Seven out of 60 identified documents were selected, which provided information on sample collection requirements. Signs and symptoms were identified based on nursing tests and related to diagnoses and nursing interventions.Conclusions: The presence of occupational health nursing in studies on toluene is scarce. Sample collection criteria are heterogeneous and limited. There were no studies relating signs and symptoms of toluene exposure to diagnoses and nursing interventions. Further studies on occupational toxicology are needed from a nursing perspective. (AU)

Efectos neurológicos en trabajadores expuestos a tolueno. Revisión sistemática / Neurological effects in workers exposed to toluene. Systematic review

Introducción y objetivo: el tolueno es un disolvente orgánico derivado del benceno empleado en diversas indus-trias, con potenciales efectos nocivos para los trabajadores. Este estudio pretende conocer los posibles efectos neurológicos que presentan los trabajadores expuestos a tolueno.Material y métodos: revisión sistemática de estudios publicados en inglés y español entre enero/2000-diciem-bre/2021. Las bases de datos consultadas fueron MEDLINE, WOS, Scopus, Embase, LILACS, IBECS y Cochrane Li-brary. La calidad de los estudios se evaluó mediante la declaración STROBE y el nivel de evidencia mediante los criterios SIGN.Resultados: Se incluyeron 14 estudios observacionales (calidad entre 13-18, nivel de evidencia entre 2+ y 3). Ocho estudios examinaron síntomas neurológicos inespecíficos y alteraciones del comportamiento encontrando un au-mento de síntomas como cefalea, náuseas o vómitos, y una disminución del rendimiento motor y atención en tra-bajadores expuestos a tolueno (p<0,05). Cuatro estudios examinaron los efectos visuales, encontrando valores de Índice de Confusión de Color (CCI) más elevados en el grupo expuesto (p<0,05). Por último, dos estudios examina-ron los efectos del tolueno sobre la audición en co-exposición con ruido, observando en uno de ellos agravamiento de la pérdida auditiva en ambiente ruidoso (concentración media 33-164,6ppm), (p<0,001); mientras que en el otro estudio no se observaron efectos a concentraciones ≤50ppm.Conclusión: la exposición laboral a tolueno produce efectos neurológicos como síntomas inespecíficos, alteracio-nes del comportamiento, y efectos en la visión y en la audición. No obstante, es necesario realizar estudios con mejor diseño y calidad metodológica, ajustando factores de confusión y con mayor tamaño muestral (AU)

Introduction and objective: toluene is an organic solvent derived from benzene used in various industries, with potential harmful effects for workers. This study aims to determine the possible neurological effects of workers exposed to toluene.Material and methods: Systematic review of studies published in English and Spanish between January/2000-De-cember/2021. The databases consulted were MEDLINE, WOS, Scopus, Embase, LILACS, IBECS and Cochrane Library. Study quality was assessed using the STROBE statement and the level of evidence using the SIGN criteria.Results: 14 observational studies were included (quality between 13-18, level of evidence between 2+ and 3). Eight studies examined non-specific neurological symptoms and behavioral alterations, finding an increase in symptoms such as headache, nausea or vomiting, and a decrease in motor performance and attention in workers exposed to toluene (p<0.05). Four studies examined visual effects, finding higher Color Confusion Index (CCI) values in the exposed group (p<0.05). Finally, two studies examined the effects of toluene on hearing in co-exposure with noise observing in one of them aggravation of hearing loss in noisy environment (mean concentration 33-164.6ppm), (p<0.001); while in the other study no effects were observed at concentrations ≤50ppm.Conclusion: occupational exposure to toluene produces neurological effects such as nonspecific symptoms, behav-ioral alterations, and effects on vision and hearing. However, it is necessary to carry out studies with better design and methodological quality, adjusting for confounding factors and with a larger sample size (AU)

Involuntary Emotional Expression Disorder in a Patient With Toluene Leukoencephalopathy.

OBJECTIVE: Inhalant users may develop toluene leukoencephalopathy, a devastating neuropsychiatric disorder. We present a case of toluene-induced damage to the corticospinal and the corticonuclear tracts, which presented with involuntary emotional expression disorder. METHODS: Case study of a 20-year-old man with a 3-year history of frequent solvent abuse was admitted to the Neuropsychiatry Unit of the National Institute of Neurology and Neurosurgery because "he could not speak or walk" but would keep "laughing and crying without reason". RESULTS: Neuropsychiatric examination revealed pathological laughter and crying, facial and speech apraxia, a bilateral pyramidal syndrome, and lack of control of urinary sphincter. Magnetic resonance imaging revealed a highly selective bilateral damage to the pyramidal system and the somatosensory pathway. SPECT imaging showed left fronto-parietal hypoperfusion. CONCLUSIONS: This document provides support for the understanding of involuntary emotional expression disorders as a differential diagnosis in the clinical practice of psychiatrists, as well as the functional anatomy of these conditions.

Neurotoxicidad en trabajadores petroquímicos con bajos índices de exposición a disolventes orgánicos / Neurotoxicity among petrochemical workers with low exposure indexes to organic solvents

Resumen: Objetivo: Estimar el desempeño neuropsicológico y su asociación con la exposición a disolventes orgánicos (DO) en trabajadores petroquímicos en México. Material y métodos: Estudio transversal en 203 trabajadores: 102 expuestos a DO y 101 no expuestos. Se evaluó el desempeño neuropsicológico con Neurobehavioral Core Test Battery y la exposición a DO con la medición de metabolitos de exposición para tolueno, xilenos y benceno. Resultados: Los trabajadores expuestos presentaron un peor desempeño en todas las pruebas (p<0.05), excepto en la prueba de Santa Ana. Esto se corroboró con modelos de regresión; los trabajadores expuestos a DO tuvieron un mayor número de errores y realizaron las pruebas en mayor tiempo (p<0.05), además de presentar mayores probabilidades de padecer síntomas de neurotoxicidad (OR: 2.93; IC95%: 0.96, 8.96). Conclusiones: La exposición ocupacional a disolventes orgánicos, aun a niveles permitidos por la normatividad mexicana vigente, se relacionó con un menor desempeño neuropsicológico.

Abstract: Objective: To estimate the neuropsychological performance and its association with exposure to organic solvents (OS) among petrochemical workers in Mexico. Materials and methods: Cross-sectional study including 203 workers: 102 exposed to OS and 101 non-exposed. Neuropsychological performance was evaluated with Neurobehavioral Core Test Battery. Exposure to OS was evaluated with the metabolites from exposure to toluene, xylenes and benzene. Results: Exposed workers presented with a worse performance in all tests (p<0.05), except for Santa Ana test. This was corroborated with regression models; workers exposed to OS had a higher number of mistakes and performed the tests in longer time (p<0.05), together with having greater odds of neurotoxicity symptoms (OR: 2.93; 95%CI: 0.96, 8.96). Conclusions: Occupational exposure to organic solvents, even at levels allowed by current Mexican standards, was related to an impaired neuropsychological performance.

Involuntary Emotional Expression Disorder in a Patient With Toluene Leukoencephalopathy / Trastorno de expresión emocional involuntaria en un paciente con leucoencefalopatía por tolueno

ABSTRACT Objective: Inhalant users may develop toluene leukoencephalopathy, a devastating neuropsychiatric disorder. We present a case of toluene-induced damage to the corticospinal and the corticonuclear tracts, which presented with involuntary emotional expression dis-order. Methods: Case study of a 20-year-old man with a 3-year history of frequent solvent abuse was admitted to the Neuropsychiatry Unit of the National Institute of Neurology and Neurosurgery because "he could not speak or walk" but would keep "laughing and crying without reason". Results: Neuropsychiatric examination revealed pathological laughter and crying, facial and speech apraxia, a bilateral pyramidal syndrome, and lack of control of urinary sphincter. Magnetic resonance imaging revealed a highly selective bilateral damage to the pyramidal system and the somatosensory pathway. SPECT imaging showed left fronto-parietal hypoperfusion. Conclusions: This document provides support for the understanding of involuntary emotional expression disorders as a differential diagnosis in the clinical practice of psychiatrists, as well as the functional anatomy of these conditions.

RESUMEN Objetivo: Los usuarios de inhalantes pueden contraer leucoencefalopatía por tolueno, un trastorno neuropsiquiátrico devastador. Se presenta un caso de daño inducido por tolueno en el tracto corticoespinal y corticonuclear, que se manifestó con un trastorno involuntario de la expresión emocional. Métodos: Un varón de 20 años con antecedente de 3 años de abuso de solventes ingresó en la Unidad de Neuropsiquiatría del Instituto Nacional de Neurología y Neurocirugía porque «no podía hablar ni caminar¼ y presentaba episodios súbitos de risa y llanto sin razón aparente. Resultados: La valoración neuropsiquiátrica reveló risa y llanto patológicos, apraxia facial y fonatoria, síndrome piramidal bilateral y ausencia de control del esfínter urinario. La resonancia magnética cerebral mostró un daño bilateral muy selectivo del sistema piramidal y la vía somatosensorial. La imagen de tomografía computarizada por emisión monofotónica mostró hipoperfusión frontoparietal izquierda. Conclusiones: Este documento proporciona apoyo para la comprensión de los trastornos de la expresión emocional involuntaria como diagnóstico diferencial en la práctica clínica de los psiquiatras, así como de la anatomía funcional de estas condiciones.

Intoxicación por tolueno / Toluene poisoning

Resumen El ser humano está inmerso en un entorno donde inhala, ingiere o absorbe muchas sustancias químicas, de las cuales toman relevancia las exposiciones en los lugares de trabajo y las que causan la muerte en la práctica médico forense. El tolueno es un inhibidor neuronal asociado con daño progresivo del sistema nervioso central y periférico, su toxicidad puede ocurrir por inhalación involuntaria o deliberada y puede llevar incluso a la muerte. Se realizó una revisión bibliográfica en diferentes bases de datos, de los artículos publicados referentes al tema de los últimos ocho años, con el objetivo de revisar las características del químico, el metabolismo, las intoxicaciones agudas y las crónicas, así como sus implicaciones letales. Se concluye que para mejorar la pericia médico legal, al valorar casos de intoxicacion por tolueno se deben de contemplar los criterios de causalidad en los casos de enfermedad laboral y en sospecha de causa de muerte es fundamentantal el resultado toxicológico ante la ausencia de hallazgos específicos en la autopsia.

Abstract The human being is immersed in an environment where he inhales, ingests or absorbs many chemical substances, in forensic medical practice the exposures in the workplace and those that cause death take on relevance. Toluene is a neuronal inhibitor associated with progressive damage of the central and peripheral nervous system, its toxicity can occur by involuntary or deliberate inhalation and can even lead to death. A bibliographic review was carried out in different databases, of the published articles referring to the subject of the last eight years, with the objective of reviewing the characteristics of the chemical, the metabolism, both acute and chronic poisoning and its lethal implications. It is concluded that to improve the legal medical expertise when assessing cases of toluene poisoning, causality criteria must be considered in cases of occupational disease and in suspected cases of death the toxicology result is fundamental in the absence of specific findings in the autopsy.

Secondary visual loss due to inhalation and cutaneous poisoning by methanol and toluene. Presentation of a clinical case. / Pérdida visual secundaria a intoxicación inhalatoria y cutánea por metanol y tolueno. A propósito de un caso.

Methanol poisoning is often described in the literature, but not transdermal or inhalational poisoning. It usually involves variable multi-organ damage, among which visual, neurological, and gastrointestinal involvement, as well as the metabolic and electrolyte changes that can lead to death. Contact with toluene by occupational or intentional inhalation may also cause neurological abnormalities. This article describes the case of a female patient who was seen in the Emergency Department due to bilateral visual loss secondary to accidental poisoning (inhalation-transdermal) with a solvent containing methanol and toluene. She had a favourable outcome during admission after treatment with ethanol in perfusion and corticosteroids.

Biomarkers of susceptibility and effect in car painters exposed to organic solvents / Biomarcadores de susceptibilidad y efecto en pintores de carros expuestos a solventes orgánicos

Abstract Introduction: Car painters are routinely exposed to organic solvents classified as carcinogenic and mutagenic substances. Objective: To characterize the population susceptibility and evaluate the genotoxic effects of exposure to organic solvents. Methods: A cross-sectional study comparing a group of car painters exposed to organic solvents with a non-exposed group. CYP2E1 polymorphisms and the presence of micronuclei in lymphocytes were determined. Results: One hundred twenty-two workers participated in the study: 62 who worked in car paint shops and were exposed to solvents, and 60 who were not exposed. There were statistically significant differences between the two groups regarding micronucleated cells and nucleoplasmic bridges frequencies (p=0.042 and p=0.046, respectively; exact likelihood ratio). Significant differences were found at the interaction between the CYP2E1 genotype c1c1 and occupational exposure to solvents, with higher frequencies of micronuclei (p= 0.013) and micronucleated cells (p= 0.015). However, when the frequencies of micronuclei, micronucleated cells and nucleoplasmic bridges in the exposure group were compared between the c1c1 and c2c2/c1c2 allele groups of the CYP2E1 polymorphism, statistically significant differences were found. Conclusions: This study confirms that when workers with CYP2E1 polymorphisms, specifically the c1c1 genotype, are exposed to organic solvents, they are more likely to have somatic cell mutations, a condition associated with increased susceptibility to diseases such as cancer

Resumen Introducción: Los pintores de vehículos automotores están rutinariamente expuestos a agentes como los solventes orgánicos, capaces de producir efectos mutágenos y carcinógenos. Objetivo: Caracterizar la susceptibilidad poblacional y evaluar los efectos genotóxicos debidos a la exposición a solventes orgánicos. Métodos: Estudio de corte transversal que comparó a un grupo de pintores de carros expuestos a solven tes orgánicos con un grupo de personas no expuestas. Fueron determinados tanto los polimorfismos de CYP2E1 como la presencia de micronúcleos en linfocitos. Resultados: Participaron 122 personas, 62 trabajadores de talleres de pintura de autos expuestos a solventes y 60 personas no expuestas. Con relación al cuestionario Q 16, 32% de los expuestos refirieron síntomas sugestivos de neurotoxicidad. Las frecuencias de células micronucleadas y de puentes nucleoplásmicos fueron significativamente mayores en los expuestos que en los no expuestos: p= 0.042 y p= 0.046, respectivamente, Razón de verosimilitud exacta). Fueron halladas diferencias significativas en la interacción de CYP2E1 (c1c1) y la exposición ocupacional a solventes, con mayores frecuencias de micronúcleos (p= 0.013) y de células micronucleadas (p= 0.015). Conclusiones: Este estudio reafirma que los trabajadores expuestos a solventes orgánicos con polimorfismos de CYP2E1, específicamente con genotipo c1c1, tienen mayor probabilidad de presentar mutaciones en las células somáticas, condición asociada con una mayor susceptibilidad a enfermedades como el cáncer

Involuntary Emotional Expression Disorder in a Patient With Toluene Leukoencephalopathy.

OBJECTIVE: Inhalant users may develop toluene leukoencephalopathy, a devastating neuropsychiatric disorder. We present a case of toluene-induced damage to the corticospinal and the corticonuclear tracts, which presented with involuntary emotional expression disorder. METHODS: Case study of a 20-year-old man with a 3-year history of frequent solvent abuse was admitted to the Neuropsychiatry Unit of the National Institute of Neurology and Neurosurgery because "he could not speak or walk" but would keep "laughing and crying without reason". RESULTS: Neuropsychiatric examination revealed pathological laughter and crying, facial and speech apraxia, a bilateral pyramidal syndrome, and lack of control of urinary sphincter. Magnetic resonance imaging revealed a highly selective bilateral damage to the pyramidal system and the somatosensory pathway. SPECT imaging showed left fronto-parietal hypoperfusion. CONCLUSIONS: This document provides support for the understanding of involuntary emotional expression disorders as a differential diagnosis in the clinical practice of psychiatrists, as well as the functional anatomy of these conditions.

Evaluación de la exposición a solventes orgánicos en pintores de carros de la ciudad de Bogotá / Evaluation of exposure of auto painters to organic solvents in the city of Bogota

Introducción. Los pintores de vehículos automotores están expuestos a solventes puros o mezclas, los cuales se han asociado con efectos neurológicos, mutagénicos y cancerígenos. Objetivo. Caracterizar las condiciones de salud y de trabajo de individuos expuestos a solventes orgánicos empleados en talleres de lámina y pintura de carros de Bogotá. Materiales y métodos. Se hizo un estudio transversal descriptivo en el que se caracterizaron las condiciones de salud y de trabajo de individuos expuestos a solventes orgánicos en talleres de lámina y pintura en Bogotá. Se comparó un grupo de trabajadores expuestos a solventes orgánicos con un grupo no expuesto. Se determinaron las concentraciones de benceno, tolueno y xileno en el aire, se hizo una encuesta individual y se midieron los ácidos fenil-mercaptúrico, hipúrico, orto y para-metilhipúrico en orina. Los resultados de las mediciones y de la encuesta se correlacionaron para establecer el panorama de exposición. Resultados. Hubo diferencias estadísticamente significativas entre la población expuesta y la no expuesta a solventes (p<0,001) en cuanto a los tres metabolitos de benceno, tolueno y xileno. Se encontraron correlaciones positivas entre el tolueno en el aire y el ácido hipúrico en la orina de los individuos expuestos (ro=0,82), y entre el xileno en el aire y el ácido o-metilhipúrico (ro=0,76). Los valores del ácido hipúrico estuvieron por encima de los límites permisibles en 11 trabajadores y, los de ácido p-metilhipúrico, en ocho de ellos. No se registraron valores de ácido fenil-mercaptúrico por fuera del límite permitido. Conclusión. Los pintores de carros están expuestos a niveles altos de solventes orgánicos en sus sitios de trabajo, y no tienen condiciones adecuadas de higiene y seguridad industrial para realizar sus labores.

Introduction: Painters of automobiles are exposed to pure and mixed solvents that have been associated with neurological effects and carcinogenic mutations. Objective: To characterize the health and work conditions of individuals who are occupationally exposed to organic solvents used in sheet metal and auto body shops in Bogota. Materials and methods: Descriptive, cross-sectional study that characterizes the health and work conditions of individuals exposed to organic solvents in sheet metal and auto body shops in Bogota. A group exposed to the solvents was compared to an unexposed group. Air concentrations of benzene, toluene and xylene (BTX) were determined, individual questionnaires were administered and phenylmercapturic, hippuric and ortho- and para-methylhippuric acids were measured in urine. The results of the measurements and the questionnaires were correlated to determine the exposure panorama. Results: For the three BTX metabolites, statistically significant differences (p<0.001) were found between the population exposed to the solvents and the unexposed population. For the exposed population, positive correlations were found between toluene in air and hippuric acid in urine (rho=0.82) and between xylene in air and o-methylhippuric acid in urine (rho=0.76). Hippuric acid values exceeded permissible levels in 11 workers and p-methylhippuric acid exceeded permissible levels in 8 workers. None of the phenylmercapturic values exceeded the limit. Conclusion: Auto painters are exposed to high levels of organic solvents at the workplace and do not have adequate industrial health and safety conditions to perform their jobs.

Audição e exposição ao tolueno - uma contribuição para o tema / Audition and exhibition to toluene - a contribution for the theme

Introdução: Com os avanços tecnológicos e as mudanças nos processos produtivos, os trabalhadores estão expostos a diferentes agentes físicos e químicos em seu ambiente laboral. O tolueno é um solvente orgânico presente em colas, tintas, óleos, dentre outros. Objetivo: Comparar os achados literários que evidenciam que trabalhadores expostos simultaneamente a ruído e solventes têm maior probabilidade de desenvolverem uma perda auditiva de origem periférica. Método: Revisão de literatura a respeito da perda auditiva ocupacional em trabalhadores expostos a ruído e tolueno. Resultados: A exposição isolada ao tolueno também pode desencadear uma alteração dos limiares auditivos. Estes achados audiométricos, por ototoxicidade a exposição ao tolueno, apresentam audiogramas semelhantes ao por exposição ao ruído, o que torna dificultoso diferenciar um resultado audiométrico de exposição combinada - ruído e tolueno - e exposição apenas ao ruído. Conclusão: A maioria dos estudos foi projetado para gerar hipóteses e deveria ser considerado como passos preliminares de uma pesquisa adicional. Até hoje os agentes no ambiente de trabalho e seus efeitos têm sido estudados de maneira isolada e os limites de tolerância destes, não consideram as exposições combinadas. Considerando que os trabalhadores estão expostos a múltiplos agentes e que a perda auditiva é irreversível, os testes implementados devem ser mais completos e todos os trabalhadores devem fazer parte do programa de prevenção auditiva, mesmo expostos a baixas doses do limite de exposição recomendado...

Introduction: With the technological advances and the changes in the productive processes, the workers are displayed the different physical and chemical agents in its labor environment. The toluene is solvent an organic gift in glues, inks, oils, amongst others. Objective: To compare solvent the literary findings that evidence that diligent displayed simultaneously the noise and they have greater probability to develop an auditory loss of peripheral origin. Method: Revision of literature regarding the occupational auditory loss in displayed workers the noise and toluene. Results: The isolated exposition to the toluene also can unchain an alteration of the auditory thresholds. These audiometric findings, for ototoxicity the exposition to the toluene, present similar audiograms to the one for exposition to the noise, what it becomes difficult to differentiate a audiometric result of agreed exposition - noise and toluene - and exposition only to the noise. Conclusion: The majority of the studies was projected to generate hypotheses and would have to be considered as preliminary steps of an additional research. Until today the agents in the environment of work and its effect they have been studied in isolated way and the limits of tolerance of these, do not consider the agreed expositions. Considering that the workers are displayed the multiples agent and that the auditory loss is irreversible, the implemented tests must be more complete and all the workers must be part of the program of auditory prevention exactly displayed the low doses of the recommended limit of exposition...

Niveles urinarios de fenol y ácido hipúrico en trabajadores de una empresa de pintura automotriz / Urinary levels of phenol and hippuric acid in workers at an automotive paint manufacturing company

La problemática mundial de exposición a solventes se centra en torno al benceno y sus derivados, considerados peligrosos a la salud aún en bajas concentraciones. Con el propósito de complementar un estudio de monitoreo ambiental para benceno y tolueno, realizado previamente en una empresa de manufactura de pintura automotriz, se planteó como objetivo de esta investigación, determinar los niveles urinarios de fenol y ácido hipúrico, considerados indicadores biológicos para la exposición ocupacional a benceno y tolueno. Se llevó a cabo un estudio descriptivo de corte transversal, en 43 trabajadores del sexo masculino (25 expuestos y 18 no expuestos). Se aplicó una encuesta, se tomaron muestras de orina al final de jornada, se midieron las concentraciones de fenol por cromatografía de gases y ácido hipúrico por un método espectrofotométrico. Se hizo el análisis estadístico y comparación de grupos. Se encontró que en el grupo expuesto el nivel medio de fenol urinario fue 5,54 mg/g-creat, significativamente por debajo (p<0,05) del índice biológico aceptado (BEIs: hasta 50 mg/g-creat). Para el ácido hipúrico se obtuvo 325 mg/l como nivel medio, significativamente inferior (p<0,05) al BEI fijado para este metabolito (hasta 1400 mg/l). No se encontraron diferencias significativas para los valores de fenol y ácido hipúrico urinario entre el grupo expuesto y el grupo no expuesto (P>0,05). Estos resultados confirman que los trabajadores de la empresa en estudio están laborando bajo condiciones adecuadas.

Worldwide, the problem of exposures to solvents are focused on benzene and its derivatives, which are considered hazardous to health even at low concentrations. As a supplement to an environmental monitoring study of benzene and toluene, previously conducted at an automotive paint manufacturing company, the objective of this study was to measure urinary phenol and hippuric acid levels, as biological indicators of occupational exposure to benzene and toluene, respectively. The design was cross-sectional and involved 43 male workers (25 exposed and 18 non-exposed). A questionnaire was administered, and post-shift urine samples were obtained and analyzed by gas chromatography for phenol concentratons and by spectrophotometry for hippuric acid concentrations. We found that, among exposed workers, mean urinary phenol was 5.54 mg / g-creatinine, significantly lower (p<0,05) than the allowable biological exposure index (BEI: 50 mg / g-creatinine). For hippuric acid, the mean concentration was 325 mg/ l, also significantly lower (p<0,05) than the corresponding BEI for this metabolite (up to 1400 mg / l). No significant differences in urinary phenol and hippuric acid concentrations were found between the exposed and non-exposed groups (P>0,05). These results confirm that employees at this company are working under appropriate conditions.

Estudo retrospectivo dos níveis de ácido hipúrico urinário em exames de toxicologia ocupacional / A retrospective study analysis of urinary hippuric acid levels in occupational toxicology exams

O ácido hipúrico é o principal metabólito do tolueno, solvente amplamente utilizado em processos industriais e com importantes efeitos tóxicos, fato que justifica a preocupação em monitorar regularmente sujeitos com risco de exposição ocupacional a este solvente. O objetivo deste trabalho foi avaliar os níveis de ácido hipúrico encontrados em trabalhadores submetidos à monitorização biológica. Foi realizado um estudo retrospectivo com dados dos anos de 2002 a 2005, no qual foram analisados os resultados e a situação do empregado na oportunidade do exame (periódico, demissional e admissional). Os resultados indicam uma redução significativa nos níveis de ácido hipúrico em 2005. Exames periódicos obtiveram resultados superiores aos exames admissionais e demissionais, e não foi verificada diferença significativa nas proporções dos sujeitos agrupados de acordo com a situação funcional em cada um dos intervalos estabelecidos segundo o valor de referência e o índice biológico máximo permitido. Os níveis de ácido hipúrico detectados indicam um baixo de risco de exposição ao tolueno na população avaliada, provavelmente em decorrência da preocupação crescente com a implantação de medidas de higiene ocupacional.

Hippuric acid is the primary metabolite of toluene, a solvent widely used in industrial processes with considerable toxic effects, a fact which justifies regularly monitoring individuals with occupational exposure to this solvent. This work aims at evaluating urinary hippuric acid levels found in workers subject to biological monitoring. A retrospective study was carried out with data referring from 2002 to 2005, in which exams results and employment status were analyzed (periodic, post-employment, and pre-employment exams). Results indicate a significant reduction in hippuric acid levels for 2005. Periodic exams presented higher results than pre-employment and post-employment exams. No significant difference was found in individuals grouped according to their status in each of the established intervals, their reference numbers, and maximum biological levels allowed. Hippuric acid levels detected indicate low risk of toluene exposure for the population under evaluation, probably due to a growing concern with the deployment of measures regarding occupational hygiene.

Exposición prenatal a drogas de abuso: efectos diferidos e imprinting (desprogramación celular) / Prenatal exposure to drugs of abuse: delayed effects and imprinting (Cell Deprogramming)

El uso de drogas de abuso es un grave problema de salud y problema social en todo el mundo. Se conocen muy bien los efectos en salud de la exposición aguda o crónica a drogas de abuso. También que causan efectos directos en la placenta o en órganos en desarrollo de los embriones, causando malformaciones congénitas. Existe sin embargo muy poca información sobre efectos diferidos de la exposición a estos agentes durante las últimas etapas del desarrollo fetal o las primeras etapas de desarrollo postnatal.Estos agentes causan alteraciones irreversibles en la diferenciación y programación celular, que pueden ser consideradas como malformaciones bioquímicas y funcionales, responsables de alteraciones funcionales orgánicas o neuroconductuales que favorecenel desarrollo de enfermedades más tarde en la vida. En el presente trabajo se describen los efectos persistentes de la exposición a drogas de abuso ilícitas (opiáceos, cocaína, ketamina, tolueno, cannabinoides y anfetamina y sus derivados) y a drogas de abusolegalmente permitidas (alcohol etílico - nicotina y consumo de tabaco no se describen por formar parte de publicación previa en Cuadernos). Exposición a estos agentes favorece el desarrollo de una serie de enfermedades y alteraciones de la conducta más tarde en la vida. Además, se presenta evidencia que la exposición prenatal a varios químicos (plomo, el plaguicida malatión, bisfenol) y a varias drogas de abuso (opioides, etanol, cannabinoides) determinan cambios persistentes que favorecen el desarrollo de adicciones a drogas de abuso más tarde en la vida. Se concluye que, además de los problemas sociales y de salud derivadas del uso por adultos de drogas de abuso, la exposición fetal causa cambios que determina el desarrollo de varias enfermedades más tarde en la vida, incluyendo adicción a drogas de abuso. En consecuencia, la legislación gubernamental que restrinja el acceso y uso de estas drogas...

The use of drugs of abuse is a serious health and social problem through all the world. The eff ects of acute and chronic exposure of drugs of abuse on health are well known. They also cause direct eff ects on placenta o the developing embryo organs, causing congenital malformations. There is however very scarce information on the delayed eff ects of exposure to these agents during the last stages of fetal development or the early stages of postnatal development. These agents cause irreversible alterations in cell diff erentiation and programming, that could be considered as biochemical and functional malformations, responsible of functional organic or neurobehavioral alterations that favors the development of diseases later in life. The present report describes persistent effects of prenatal exposure to illicit drugs of abuse (opiates, cocaine, ketamine, toluene, cannabinoids, and amphetamine derivates) and to legal drugs of abuse (ethyl alcohol; nicotine and tobacco smoking are not reviewed since they were analyzed in a previouspublication in Cuadernos). Exposure to these agents favors the development of a myriad of diseases and behavioral alterations later in life. In addition, evidence is presented that prenatal exposure to various chemicals (lead, the pesticide malathion, bisphenol) andseveral drugs of abuse (opioids, ethanol, cannabinoids) determine persistent changes that favor the development of addictions to drugs of abuse later in life. It is concluded that, besides the known health and social problems derived by adults use of drugs of abuse, fetal exposure causes changes that determine the development of various diseases later in life, including drug addiction.Therefore, the dictation of Governmental regulations to decrease access to and use of these drugs, including the “softest” drugs such as cannabinoids, is fundamental to protect future generations health...

Avaliação da estabilidade e atividade antioxidante de uma emulsão base não-iônica contendo resveratrol / Evaluation of antioxidant activity and stability of an emulsion base containing non-ionic resveratrol

Vários são os fatores que podem ocasionar a instabilidade de uma emulsão, destacando-se a oxidação, reação prevenida pelo emprego de antioxidantes. O butil-hidróxi-tolueno (BHT) tem sido um dos antioxidantes sintéticos mais utilizados em formulações cosméticas, porém, a busca da indústria farmacêutica e cosmética pelo emprego de produtos de origem natural tem sido cada vez maior. Visto isso, o objetivo do presente trabalho foi a incorporação do resveratrol, um composto fenólico encontrado principalmente em uvas bem como em vinhos tintos, em uma emulsão base não-iônica para avaliação do perfil de estabilidade e atividade antioxidante em comparação a uma emulsão base não-iônica contendo o BHT. O perfil de estabilidade foi analisado pela observação das características organolépticas, determinação do pH e espalhabilidade, e atividade antioxidante através do teste com o radical livre 2,2-difenil-1-picrilhidrazila (DPPH). Em relação à estabilidade, a altas temperaturas, a emulsão contendo BHT mostrou-se superior à emulsão contendo resveratrol. Pela análise da atividade antioxidante, o resveratrol tanto na sua forma de extrato seco, como quando incorporado na emulsão, demonstrou significativa superioridade em relação ao BHT, podendo ser sua utilização uma alternativa viável em preparações cosméticas, devido ao seu grande potencial antioxidante.

There are several factors that can lead to the instability of an emulsion, highlighting the oxidation, a reaction prevented by the use of antioxidants. The butylated hydroxytoluene (BHT) has been one of the most used synthetic antioxidants in cosmetic formulations; however, pharmaceutical and cosmetic industries have shown considerable interest regarding the search for the use of natural products. Based on this, the objective of this work was the incorporation of resveratrol, a natural phenolic compound found mainly in grapes as well as in red wines, into a non-ionic emulsion basis for assessing the profile of stability and antioxidant activity, as compared with a non-ionic basis emulsion containing BHT. The profile of stability was examined by the observation of the organoleptic characteristics, determination of pH and spreadability, and the antioxidant activity through the Radical Scavenging DPPH test. The results showed that the emulsion containing BHT was more stable than the emulsion containing resveratrol, when high temperature was used. For the analysis of the antioxidant activity, the resveratrol, in both forms of incorporation, showed significant antioxidant activity in comparison to BHT, suggesting that resveratrol may be a viable antioxidant alternative to be used into cosmetic preparations.

Exposição a agentes químicos e ruído em indústria de couro / Exposure to chemical agents and noise in tanneries

Este estudo tem como objetivo investigar a relação entre a perda auditiva e a exposição ocupacional ao ruído e ao tolueno. A população em estudo foi composta por 73 trabalhadores de curtume. Para conhecer a história clínica e ocupacional dos trabalhadores, aplicou-se um questionário. Para avaliação da exposição ocupacional, realizaram-se avaliações ambiental e biológica do tolueno e avaliações audiológica e dos níveis de ruído. Os valores obtidos na avaliação ambiental e biológica estavam abaixo dos limites estabelecidos pelas NR 7 e 15. Os níveis de ruído em diversos setores da indústria foram superiores ao máximo permitido pela NR 15, chegando a 97.8 dB(A). As perdas auditivas encontradas no grupo ruído (GR) e no grupo ruído e agente químico (GRAQ) foram significativas quando comparadas ao grupo controle através da análise estatística SPSS®, T-Test p<0,01. Este estudo demonstrou fatores de impacto na saúde e na qualidade de vida dos trabalhadores. Portanto, fazem-se necessárias a revisão dos programas e a implementação de medidas que reduzam os riscos de forma a prevenir e evitar danos à saúde do trabalhador.

This study aims at investigating the relationship between the hearing loss and the occupational exposition to noise and toluene. Seventy-three tannery workers were the subject of this study. A questionnaire was used to obtain information on the workers' clinical and occupational history. To evaluate the occupational exposition, an environmental and biological survey on toluene was held, together with noise and audiologycal evaluations. The results of the environmental and biological evaluations were below the levels established by NR 7 and 15. The noise levels in several sections of the industry were above the maximum allowed by NR 15, reaching 97.8dB(A). The hearing losses found in the noise group (GR) and noise and chemical agents (GRAQ) groups were significant when compared, through the statistic analysis SPSS®, T-Test p<0,01, to the control group. This study demonstrated impact factors in workers' health and life quality. Due to this, the programs must be revised and measures to reduce the risks must be implemented in order to prevent hazards to workers' health.