Occupational Exposure to Paints Causes Impairment of Kidney Functions

doi:10.4236/jep.2011.25061

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Journal of Environmental Protection, 2011, 2, 533-536

doi:10.4236/jep.2011.25061 Published Online July 2011 (http://www.scirp.org/journal/jep)

Occupational Exposure to Paints Causes

Impairment of Kidney Functions

Saeed S. Al-Ghamdi

Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia.

Email: [email protected]

Received April 13th, 2011; revised May 21st, 2011; accepted June 27th, 2011.

ABSTRACT

It has been suggested that exp osure to organic solvents may have a role in the impa irment of kidney function that may

progress to kidney failure. However, this has never been evaluated with an appropriate analytical study of the kidney

functions of those people who are chronically exposed to these chemicals. This study was designed to measure the kid-

ney function of car painters in the city of Makkah, Saudi Arabia. Fifty workers were selected at random for this study

and compared to thirty male medical students wh o were taken as a control grou p. Blood samples were co llected for the

analysis of kidney function. The levels of blood urea nitrogen (BUN), creatinine, and uric acid were scientifica lly high-

er in the tested group compared to the control group. In addition to this, the levels of these parameters were signifi-

cantly higher in the serum of car painters who worked in this industry for more than ten years compared to painters

who worked for less than ten years. Moreover, the number of car painters who were not using protective gloves and

masks during working hours were 43 and the number of car painters who visited specialized clinics because of kidney

problems were 45 of the 50 tested volunteers. These findings support the hypothesized association of solvent exposure

with the development of chronic renal failure. They should prompt clinicians to give greater attention to patients’ oc-

cupational exposures. Routine monitoring of kidney functions and the use of protective materials are of greater impor-

tance to minimize the occupationa l diseases caused by organic solvents.

Keywords: Organic Sol vents, Uric Acid, Creatinine, BUN, Kidney

1. Introduction and Methods

An occupational disease is any chronic ailment that

occurs as a result of work or occupational activity. It is

an aspect of occupational safety and health, typically

identified when it is shown that it is more prevalent in a

given body of workers than in the general population, or

in other worker populations.

Occupational renal diseases provide models for under-

standing environmental renal diseases. Kidney damage in

few workers induced by heavy exposure to identifiable

toxins indicates what to expect among the large popula-

tion exposed to low levels of organic solvents dispersed

in the larger environment [1,2]. Organic solvents are a

class of chemical substances that are widely used in large

volume in various manufacturing products including the

paints. The possible role of organic solvent exposure in

the development and/or the progression of chronic renal

failure still is a controversial scientific issue more than

forty years after the earliest study by Beirne and Brennan

[3].

Many epidemiological and recent experimental studies

were conducted to prove the effects of these chemicals

on kidneys and define the mechanism of action [4-8].

Although some of these studies were criticized for their

methodological weaknesses with respect to sample size

and inaccuracy in case of definition or exposure assess-

ment, most of them showed significant associations of

solvent exposure with various types of kidney disorders

[9-13]. These studies, however, never tested the kidney

function of people with occupational chronic exposure to

organic solvents. I therefore investigated the effect of

organic solvent exposures in a cohort of fifty volunteer

car painters with the mean of the serum level of uric acid,

creatinine and blo od urea nit r ogen (BUN).

2. Materials and Methods

2.1. Exposure Assessment

Fifty male volunteer painters were asked about their life-

time occupational activities by train ed interviewers using

a questionnaire designed for this purpose. For each vol-

Occupational Exposure to Paints Causes Impairment of Kidney Functions

534

unteer; age, nationality, duration of exposure, health stat us,

and use of protective materials were recorded. Working

conditions and frequ ency of use (every day, at least once

a week, occasionally) were also recorded. Thirty male

volunteer medical students were used as a negative con-

trol for this study.

2.2. Kidney Function Analysis

Blood samples were collected for measuring the levels of

uric acid, BUN, and creatinine using the Dimension

Xpand plus instrument, Dade behring, USA.

2.3. Statistical Analysis

Results are presented as mean  S.E.M. Means were ob-

tained from six rats from each group. Statistical analysis

was performed using one way ANOVA (Kruskal Wallis

test) except for the diuretic activity where the Mann

Whitney test was used, and the statistical significance

was assured when P < 0.05.

3. Results

3.1. Blood Analysis

Kidney function tested for the uric acid, creatinene and

BUN all showed significantly higher (P < 0.05) levels of

these parameters in the serum of the car painters com-

pared to the control group (Figure 1).

3.2. Duration of Exposure

Analysis of the car painters’ duration of exposure shows

that the level of the uric acid, creatinine, and BUN in the

serum of the tested volunteers who worked for more than

ten years in the car painting industry were significantly

higher (P < 0.05) than those who spent less than ten

years in the industry (Figure 2).

3.3. Use of Protective Materials

According to the questionnaire records, only seven out of

fifty volunteer car painters were using protective gloves

and masks during their working hours (Figure 3).

CR EA TIN IN EU RIC ACIDBU N

mg/dL

TE ST

CONTROL

Figure 1. Serum levels of the uric acid, creatinine, and BUN

of the studied groups.

CREATININEURIC ACIDBUN

mg/dL

>1 0 ye aar s

<1 0 ye aar s

Figure 2. Comparing the levels of serum uric acid, create-

nine and BUN in car painters who were exposed for more

than ten years with those who were exposed for less than

ten years.

Figure 3. Numbers of painters who were using gloves and

masks during work hours.

3.4. Complaining of Kidney Disorders

According to the questionnaire records, car painters who

visited hospital complaining of kidney pain were higher:

43 out of 50 (Fig ur e 4).

4. Discussion

Due to their high lipophilicity, organic solvents may cause

physiochemical damage to the renal glomeruli and tubule

[14]. Moreover, short-term exposure to these solvents have

been shown to cause tubular necrosis, a life-threatening

situation characterized by oliguria and azotemia [15,16].

By observational assessment of the work place, I noticed

that all areas I visited were semi-closed with n o adequate

ventilation, which meant that painters’ exposure to sol-

vents exceeded the threshold limit value recommended

for the mixture by the American Conference of Govern-

mental Industrial Hygienists (ACGIH).

Several recent studies have suggested that a relation-

may exist between exposure to occupational organic sol-

vents (gasoline, gasoline-based paint spray, jet fuel, min-

eral turpentine) and diseases of the kidney, particularly

malignancy and various forms of glomerulonephritis [17-

Occupational Exposure to Paints Causes Impairment of Kidney Functions535

Complain

No complain

Figure 4. Number of car painters in the tested group who

complained of kidney pain.

21]. Retrospective exposure assessment was a critical

issue in many of the previous studies. My method is

based on a detailed and structured questionnaire and

blind evaluation of exposures by experienced car painters

and has proven to be very reliable. An important strength

of this study, is that I assessed the kidney function of

people who were chronically exposed to paints that con-

tain organic solvents and noticed the higher levels of

serum creatinine, uric acid and BUN of the painter over

the control. My findings are strongly supported by re-

cording the painters who visited urologists for kidney

problems. These findings are independent of age and eth-

nicity.

Different mechanisms of action are probably response-

ble for the initial events leading to renal tubular cell

damage. Unfortunately, for the majority of solvents, the

early critical effects are still speculative. The h igh serum

levels of creatinine, uric acid and BUN are considered to

be indicators for the damaging of the tubular epithelium.

Fortunately, nephrotoxicity caused by organic solvents is

reversible once the exposure has ceased. The damaging

of tubular epithelium can be recovered, where it takes

about three weeks for the tubular epithelium to regene-

rate. Recovery may be complete, but depending on the

severity of the intoxication and the previous status of

renal function, some degree of renal insufficiency may

persist [13].

The solvent exposure was associated with increased-

baseline proteinuria and the relationship with end-stage

renal disease (ESRD) [18]. This relationship tends to

weaken after adjustment and suggests that solvent ne-

phrotoxicity may be mediated partly by enhancing pro-

teinuria, a major risk factor for kidney disease progres-

sion. In support of this hypothesis, several occupational

studies have shown that workers who were exposed to

various types of solvents (both aliphatic and aromatic

hydrocarbons) had higher levels of albuminuria as well

as low molecular weight proteinuria, which is consid-

ered to be a marker of tubular injury, as compared with

non-exposed work ers [19-21].

The limitation of this study, which should be noted, is

urine analyses for protein because of technical reasons.

However, previous cohort and cross-sectional studies

[22-24], which have proven the association between

chronic exposure to solvents and albuminurea seem to be

adequate. Occupational renal diseases are important be-

cause they are entirely preventable. For this reason, the

majority of car painters in this study who were not using

the protective materials during painting complained of

kidney problems and visited specialist clinics for consul-

tation. In addition, renal disease produced by heavy ex-

posure to industrial toxins by relatively few workers pro-

vides a clinical basis for understanding the consequences

of low-dose exposure to the general population from en-

vironmental pollutants. The known toxins that produce

kidney disease in the workplace are limited to the heavy

metals plus silica and certain organic compounds, par-

ticularly halogenated hydrocarbons, employed as Indus-

trial solvents [16]. However, the absence of information

on the adverse renal effects of other industrial pollutants

does not prove that no such effects occur. In this study,

the relationship between the background of the painters

and the impairment of the kidney function were not sig-

nificant. Even though, the probability that the genetic

basis of individual susceptibility can not be neglected.

The contribution of organic solvents to renal disease of

painters based on individual susceptibility may become

clearer after certain genetic polymorphism investigations.

5. Conclusions

It can be concluded that these results corrobo rate with an

association between renal disorders and exposure to or-

ganic solvents. They provide new evidences of the po-

tential role of so lvents in the development of k idney dis-

eases. This might be prevented by using protective mate-

rials and carrying out routine tests of kidney function.

6. Acknowledgments

This study was supported by a grant from the Center for

Medical and Medical Sciences Researches, Umm Al-Qura

University.

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