Multiple Chemical Sensitivity in Chemical Laboratory Workers

BACKGROUND: Multiple Chemical Sensitivity (MCS) is an acquired disease which etiology remains unknown. It is characterized by the development of sensitivity to certain chemical products. Most of the hypotheses formulated to explain the syndrome associate it to a previous exposition to some kind of volatile chemical. University researchers in chemical laboratories suffer a phenomenon of multi-exposition to chemical agents at low concentration during long periods of time although in an irregular form. Many of these chemical agents have similar properties to those suspicious of causing MCS. This article studies the prevalence of MCS in laboratory researchers. METHODS: The study group is university researchers in chemical laboratories. The control group was obtained from administrative personnel who work in the same universities and therefore, are not exposed to chemical products from the laboratories, but have the same exposition to the rest of environmental polluting agents from the area and from the buildings of the university. In this study, it is used the Quick Environmental Exposure and Sensitivity Inventory (QEESI) (sensitivity of 92%/specificity of 95%). RESULTS: The results showed that the prevalence of MCS for the university researchers is not related to exposition by inhalation to multiple chemical agents, at low concentration. CONCLUSIONS: The results disagree with one of the main etiological hypotheses of MCS, which is based on the existence of hypersensitive people, who presents a response after prolonged expositions to very low concentrations during a long period of time.

IgA nephropathy in a laboratory worker that progressed to end-stage renal disease: a case report

BACKGROUND: IgA nephropathy (IgAN) is the most common form of glomerulonephritis, a principal cause of end-stage renal disease (ESRD) worldwide. The mechanisms of onset and progression of IgAN have not been fully revealed, and epidemiologic studies have yielded diverging opinions as to the role of occupational exposure to organic solvents in the initiation or worsening of IgAN. As the authors encountered a laboratory worker with IgAN that progressed to ESRD, we present a case report of IgAN progression due to dichloromethane exposure along with a review of literature. CASE PRESENTATION: A 41-year-old male laboratory worker began to experience gross painless hematuria after two years of occupational exposure to toluene. Although clinical follow-up was initiated under the impression of IgAN based on clinical findings, the patient continued to work for four more years in the same laboratory, during which he was in charge of laboratory analysis with direct exposure to a high concentration of dichloromethane without proper protective equipment. During that time, his renal function rapidly worsened and finally progressed to ESRD 10 years after the first clinical symptoms. The result of exposure assessment through reenactment of his work exceeded the occupational exposure limit for dichloromethane to a considerable degree. CONCLUSIONS: The causal association between occupational solvent exposure and IgAN is still unclear; therefore, this case report could be used as a basis to support the relevance of occupational solvent exposure to IgAN and/or its progression. Early intervention as well as close monitoring of laboratory workers exposed to various organic solvents is important to prevent or delay the progression of glomerulonephritis to ESRD in the occupational setting.