RESUMO
BACKGROUND: There is an epidemic of chronic kidney disease (CKD) of unknown etiology in Central American workers. OBJECTIVES: To investigate changes and job-specific differences in kidney function over a 6-month sugarcane harvest season, explore the potential role of hydration, and measure proteinuria. METHODS: We recruited 284 Nicaraguan sugarcane workers performing seven distinct tasks. We measured urine albumin and serum creatinine and estimated glomerular filtration rate (eGFR). RESULTS: eGFR varied by job and decreased during the harvest in seed cutters (-8·6 ml/min/1·73 m(2)), irrigators (-7·4 ml/min/1·73 m(2)), and cane cutters (-5·0 ml/min/1·73 m(2)), as compared to factory workers. The number of years employed at the company was negatively associated with eGFR. Fewer than 5% of workers had albumin-to-creatinine ratio (ACR) >30 mg/g. CONCLUSIONS: The decline in kidney function during the harvest and the differences by job category and employment duration provide evidence that one or more risk factors of CKD are occupational.
Assuntos
Fazendeiros , Nefropatias/epidemiologia , Doenças Profissionais/epidemiologia , Proteinúria/epidemiologia , Saccharum , Adolescente , Adulto , Albuminúria , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Nefropatias/sangue , Nefropatias/fisiopatologia , Nefropatias/urina , Masculino , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Doenças Profissionais/sangue , Doenças Profissionais/fisiopatologia , Doenças Profissionais/urina , Proteinúria/sangue , Proteinúria/fisiopatologia , Proteinúria/urina , Adulto JovemRESUMO
OBJECTIVE: Determining whether chromium levels in urine samples were higher than limits and contrasting them with alterations in the health of people living and working in the San Benito neighbourhood of Bogotá. METHODS The total amount of chromium in urine was measured as a biological marker of exposure in a sample of 827 people. This was contrasted with health alterations attributed to chromium exposition. Exposure was defined by being whether current economic activity was related to working in a tannery. Two groups were defined: being directly exposed (26%) and having potentially high exposure (73%). RESULTS: 6.3% presented >10 ug/L chromium levels (4.64% to 7.96% confidence interval). No significant statistical differences were found between both groups. 34.3% presented a diagnosis of possible attribution to chromium exposure, of whom 23.3% were due to otorhinolaryngologic issues, 6.5% to dermatological ones, 2.9% to ophthalmologic ones and 1.6 % to oral cavity issues. The remaining 65.7% of cases were not related. >10 ug/L levels and living in the particular neighbourhood in question were associated (4.94 odds ratio; 1.18%-20.69% CI). The results suggested a connection between economic activity and health alterations due to chromium components. CONCLUSIONS: The people involved in producing leather have a significant risk of presenting clinical conditions attributed to chromium exposure (4.33 OR; 3.12-6.02 CI). San Benito s inhabitants are being exposed to chromium as if they were actually working in a tannery as they are in daily contact with chromium or its components through non work-related activities, such as environmental contamination. Concern at such exposure should lead to further in-depth studies.
Assuntos
Cromo/urina , Doenças Profissionais/urina , Exposição Ocupacional , Curtume , Adulto , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Saúde da População Urbana , Adulto JovemRESUMO
Objetivo Determinar si los niveles de cromo en orina están más altos de los permitidos y contrastarlos con alteraciones de salud en personas del barrio San Benito en Bogotá. Métodos En una muestra de 827 personas, se cuantificó cromo total en orina como biomarcador de exposición y se contrastó con alteraciones de salud atribuibles a exposición a cromo. La exposición se definió, por la "Ocupación actual" relacionada con la labor en curtiembres. Se definieron dos estratos: "Directamente expuestos" 26 por ciento y "Potencial alta exposición" 73 por ciento. Resultados Un 6,3 por ciento presentó niveles de cromo >10 ug/L (intervalo de confianza: 4,64-7,96 por ciento). No se encontraron diferencias estadísticamente significativas entre los dos estratos. El 34,3 por ciento presentó diagnósticos posiblemente atribuibles a la exposición a cromo. El 23,3 por ciento otorrinolaringológico; 6,5 por ciento dermatológico; 2,9 por ciento oftalmológico; 1,6 por ciento cavidad oral y el 65,7 por ciento no relacionados. Se halló asociación entre niveles >10ug/L y residir en la zona (OR 4,94 IC:1,2- 20,7 por ciento). Los resultados sugieren asociación entre ocupación y alteraciones de salud atribuibles a la exposición a compuestos de cromo. Conclusiones Las personas que participan del proceso productivo del cuero tienen un riesgo significativo de presentar hallazgos clínicos posiblemente atribuibles a la exposición a cromo, OR 4,33 (3,12-6,02). La población general se esta viendo expuesta de manera no diferente a aquella con ocupación relacionada con las curtiembres, lo que puede deberse a que los habitantes del sector están en contacto con cromo o compuestos por vías diferentes a la ocupacional, como contaminación ambiental.
Objective Determining whether chromium levels in urine samples were higher than limits and contrasting them with alterations in the health of people living and working in the San Benito neighbourhood of Bogotá. Methods The total amount of chromium in urine was measured as a biological marker of exposure in a sample of 827 people. This was contrasted with health alterations attributed to chromium exposition. Exposure was defined by being whether current economic activity was related to working in a tannery. Two groups were defined: being directly exposed (26 percent) and having potentially high exposure (73 percent). Results 6.3 percent presented >10 ug/L chromium levels (4.64 percent to 7.96 percent confidence interval). No significant statistical differences were found between both groups. 34.3 percent presented a diagnosis of possible attribution to chromium exposure, of whom 23.3 percent were due to otorhinolaryngologic issues, 6.5 percent to dermatological ones, 2.9 percent to ophthalmologic ones and 1.6 percent to oral cavity issues. The remaining 65.7 percent of cases were not related. >10ug/L levels and living in the particular neighbourhood in question were associated (4.94 odds ratio; 1.18 percent-20.69 percent CI). The results suggested a connection between economic activity and health alterations due to chromium components. Conclusions The people involved in producing leather have a significant risk of presenting clinical conditions attributed to chromium exposure (4.33 OR; 3.12-6.02 CI). San Benito´s inhabitants are being exposed to chromium as if they were actually working in a tannery as they are in daily contact with chromium or its components through non work-related activities, such as environmental contamination. Concern at such exposure should lead to further in-depth studies.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Cromo/urina , Doenças Profissionais/urina , Exposição Ocupacional , Curtume , Colômbia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Saúde da População Urbana , Adulto JovemRESUMO
The aim of this work was to verify whether there are statistically significant correlation between the concentrations of lead in blood (Pb-B) and urine (Pb-U). Electrothermal atomic absorption spectrometry was used in the determination of lead concentration in biological material. Venous blood and spot urine were collected from workers occupationally exposed (95), adults (130) and children up to 15 years old (22) environmentally exposed. After a test showing significant differences between Pb-U and the three categories previously determined, cutting points for Pb-U were established to predict Pb-B values by the ROC curve. Thus, it is expected that Pb-B is lower than 10 microg.dL-(1) with Pb-U up to 0.55 microg.dL-(1), whereas lead levels in blood below 27.6 microg.dL-(1) are expected when the amount of the metal in urine is lower than 2.05 microg.dL-(1). So, urine can be used to replace blood for the assessment of the occupational exposure to lead. However, caution is advised in the case of environmental exposure, since urinary lead should be used just as an estimation of the metal content in blood.
Assuntos
Intoxicação por Chumbo/diagnóstico , Chumbo/sangue , Chumbo/urina , Doenças Profissionais/diagnóstico , Exposição Ocupacional/análise , Adulto , Biomarcadores/análise , Indicadores Básicos de Saúde , Humanos , Intoxicação por Chumbo/sangue , Intoxicação por Chumbo/urina , Doenças Profissionais/sangue , Doenças Profissionais/urina , Curva ROC , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Adulto JovemRESUMO
O objetivo deste trabalho foi verificar se há correlação estatisticamente significativa entre as concentrações de chumbo no sangue (Pb-S) e urina (Pb-U). A espectrometria de absorção atômica eletrotérmica foi utilizada na determinação da concentração de chumbo no material biológico. As amostras de sangue e de urina foram coletadas entre trabalhadores expostos ocupacionalmente (95) e entre adultos (130) e crianças até 15 anos (22) expostos ambientalmente. Após um teste que mostrou diferenças significativas entre Pb-U e as três categorias previamente determinadas, pontos de corte em Pb-U puderam ser fixados para a predição dos valores de Pb-S pela curva ROC. Assim, para Pb-U até 0,55 µg.dL-1, pode-se esperar que Pb-S seja menor do que 10 µg.dL-1, ao passo que níveis de chumbo no sangue até 27,6 µg.dL-1 são esperados quando o teor do metal na urina é menor do que 2,05 µg.dL-1. Logo, a urina pode ser utilizada em substituição ao sangue para avaliação da exposição ocupacional ao chumbo. Contudo, recomenda-se cautela no caso da exposição ambiental, devendo-se utilizar o chumbo urinário como uma estimativa do conteúdo do metal no sangue.
The aim of this work was to verify whether there are statistically significant correlation between the concentrations of lead in blood (Pb-B) and urine (Pb-U). Electrothermal atomic absorption spectrometry was used in the determination of lead concentration in biological material. Venous blood and spot urine were collected from workers occupationally exposed (95), adults (130) and children up to 15 years old (22) environmentally exposed. After a test showing significant differences between Pb-U and the three categories previously determined, cutting points for Pb-U were established to predict Pb-B values by the ROC curve. Thus, it is expected that Pb-B is lower than 10 µg.dL-¹ with Pb-U up to 0.55 µg. dL-¹, whereas lead levels in blood below 27.6 µg. dL-¹ are expected when the amount of the metal in urine is lower than 2.05 µg.dL-¹. So, urine can be used to replace blood for the assessment of the occupational exposure to lead. However, caution is advised in the case of environmental exposure, since urinary lead should be used just as an estimation of the metal content in blood.
Assuntos
Adulto , Humanos , Adulto Jovem , Intoxicação por Chumbo/diagnóstico , Chumbo/sangue , Chumbo/urina , Doenças Profissionais/diagnóstico , Exposição Ocupacional/análise , Biomarcadores/análise , Indicadores Básicos de Saúde , Intoxicação por Chumbo/sangue , Intoxicação por Chumbo/urina , Doenças Profissionais/sangue , Doenças Profissionais/urina , Curva ROC , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Adulto JovemRESUMO
Airline pilots divided into two groups of age (over and under 50 years) were studied before, during and after westbound (Madrid-Mexico City-Madrid, n = 12) and eastbound (Madrid-Tokyo-Madrid, n = 21) flights. A group of 10 age-matched people staying in Madrid were submitted to the same tests and served as a control group. Changes in urinary 6-sulphatoxymelatonin (6-aMTs) and free cortisol excretion (determined in 6-hr intervals) were measured by radioimmunoassay. Using wrist actigraphy, the circadian locomotor activity rhythm (LAR) was also monitored. Maximal baseline excretion of 6-aMTs occurred between 00:00 and 12:00 hr and maximal excretion of cortisol took place between 6:00 and 12:00 hr in the control group. Analysed globally, older pilots exhibited significantly lower values of 6-aMTs than younger ones. In both flight directions, pilots maintained the pattern of excretion of 6-aMTs, corresponding to baseline. The return flight to Madrid from Mexico and Tokyo coincided with a maximum in 6-aMTs excretion. Pilots kept the cortisol pattern found in the control group, with those over 50 years of age exhibiting significantly lower cortisol values than the younger ones. A 7-hr delay in acrophase of LAR after 2 days in Mexico City was found after cosinor analysis, and similar pre-flight values were found after returning to Madrid. An 8-9-hr acrophase advance of LAR was observed after arriving in Tokyo, with acrophase on the post-return flight day still being advanced 3 4 hr as compared to pre-flight values. Decreases in the amplitude of LAR in older pilots were found at Mexico City, as well as at Tokyo stopover and on post-flight day. Data confirm the occurrence of internal desynchronization in airline crewmembers after transmeridian flights.
Assuntos
Hidrocortisona/urina , Síndrome do Jet Lag/fisiopatologia , Síndrome do Jet Lag/urina , Melatonina/análogos & derivados , Melatonina/urina , Atividade Motora/fisiologia , Doenças Profissionais/fisiopatologia , Doenças Profissionais/urina , Adulto , Aeronaves , Ritmo Circadiano/fisiologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Espanha , Tóquio , ViagemRESUMO
The relationship between concentrations of ALA-U and Pb-S for two groups of workers is reported. The first group consisted of workers from a telephone company, and the second, of workers from battery factories with average Pb-S equivalent to 17.3 (g/dl (6.2-39.4) and 61.5 (g/dl (41.1-91.0), respectively. The aim of this study was to evaluate the utilization of ALA-U levels as a screening test for different levels of lead in blood by means of High Performance Liquid Chromatography (HPLC) and of spectrophotometry. A significant correlation was found between measured ALA and levels of blood lead (R = 0.739 - first group; R = 0.902 - second group; p < 0.001). The validity of ALA-U test to evaluate different levels of lead in blood was also studied. By using ALA levels of 3mg/g creatinine as a threshold to detect levels of lead in blood equal to or higher than 20 (g/dl, the test results, for the workers in the first group, showed sensibility of 92% and specificity of 90%. In both groups, the false positives as well the false negatives were lower than 10% which was enough to validate the test.
Assuntos
Ácido Aminolevulínico/urina , Intoxicação por Chumbo/urina , Doenças Profissionais/urina , Adulto , Brasil , Cromatografia Líquida de Alta Pressão , Humanos , Intoxicação por Chumbo/sangue , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Doenças Profissionais/sangue , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espectrofotometria UltravioletaRESUMO
Penicillamine was administered, per os, in patients who had been working with lead for several years, showing signs and symptoms suggesting chronic lead intoxication, so as to evaluated the test of lead chelation. A positive response allowed further treatment. Daily elimination of urinary lead, delta-aminolevulinic acid and coproporphyrin were evaluated. Weekly assays of hematic lead, protoporphyrin IX and the activity of the enzyme delta-aminolevulinic acid dehydratase were performed. The result show penicillamine to be an alternative to ethylene diamine tetra acetic acid in the chelatable lead mobilization test and prove that it is an excellent alternative in the treatment of chronic lead intoxication.
Assuntos
Terapia por Quelação , Intoxicação por Chumbo/tratamento farmacológico , Chumbo , Doenças Profissionais/tratamento farmacológico , Penicilamina/uso terapêutico , Administração Oral , Adulto , Biomarcadores , Doença Crônica , Humanos , Chumbo/urina , Intoxicação por Chumbo/urina , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/urina , Penicilamina/administração & dosagemRESUMO
In order to find out genetic variability and its possible association with chromosomic damage, we studied the ABO, Rh and MN blood groups as well as the ability to taste PTC, ear lobe type and mid-digital hair, in 77 workers exposed to lead oxides. 23 people who worked near the source of lead (internal control) and 20 people not exposed to lead (external control). From each person a blood sample was taken for chromosome analysis in cultured lymphocytes and for lead determination, at the same time an urine sample was taken for delta-aminolevulinic acid (ALA) determinations; at the same time an urine sample increased chromosome damage, blood lead levels and urinary ALA, were found as compared with both controls. Differences were statistically significant. As for genetic marker frequencies differences were found only for the Rh factor, between the internal control and both the external control and exposed workers. No significant association was found between genetic markers and chromosome damage. Association was observed between blood lead levels, and urinary ALA with some genetic markers like ABO and MN blood groups and ear lobe type.