OCCUPATIONAL HYDROCARBON EXPOSURE AND NEPHROTOXICITY - A COHORT STUDYAND LITERATURE-REVIEW

Hydrocarbon exposure has been shown to play an important role in the d evelopment of renal dysfunction in several occupational settings. In t his study, renal screening was performed in a group of paint sprayers with exposure to hydrocarbon-based paints, recruited from a car manufa cturing plant where personal protective equipment was widely used. The hydrocarbon exposure scores and various markers of renal injury were compared between these subjects and a group of paint sprayers from a p revious study who did not use personal protective equipment regularly. Cumulative hydrocarbon exposure scores were calculated from a validat ed questionnaire. Serum creatinine, urinary total protein, albumin, tr ansferrin, retinol-binding protein, and N-acetylglucosaminidase were e valuated. Both groups experienced heavy hydrocarbon exposure but spray ers who regularly used personal protective equipment had significantly reduced exposure scores due to improved skin and respiratory protecti on. A significant number of sprayers from both groups had elevated lev els of serum creatinine. Interestingly, urinary N-acetylglucosaminidas e activity, a marker of proximal tubular damage, was abnormal in a sig nificant proportion of sprayers in the unprotected group but normal in those with improved protection. Our results are in keeping with the h ypothesis that hydrocarbon exposure through paint spraying may result in active proximal tubular damage which may be reduced by improvement of protection at the worksite. However, renal impairment independent o f tubular injury may result from chronic paint exposure, even with imp roved protection.