Urine Methyl Hippuric Acid Levels in Acute Pesticide Poisoning: Estimation of Ingested Xylene Volume and Association with Clinical Outcome Parameters

To determine the relationship between the oral ingestion volume of xylene and methyl hippuric acid (MHA) in urine, we measured MHA in 11 patients whose ingested xylene volume was identified. The best-fit equation between urine MHA and ingested amount of xylene was as follows: y (ingested amount of xylene, mL/kg) = −0.052x² + 0.756x (x = MHA in urine in g/g creatinine). From this equation, we estimated the ingested xylene volume in 194 patients who had ingested pesticide of which the formulation was not available. Our results demonstrated that oxadiazole, dinitroaniline, chloroacetamide, organophosphate, and pyrethroid were xylene-containing pesticide classes, while the paraquat, glyphosate, glufosinate, synthetic auxin, fungicide, neonicotinoid, and carbamate classes were xylene-free pesticides. Sub-group univariate analysis showed a significant association between MHA levels in urine and ventilator necessity in the pyrethroid group. However, this association was not observed in the organophosphate group. Our results suggest that MHA in urine is a surrogate marker for xylene ingestion, and high urine MHA levels may be a risk factor for poor clinical outcome with some pesticide poisoning.

Avaliação dos riscos associados ao uso do xilol em laboratórios de anatomia patológica e citologia / Assessing risks concerning the use of xylol in cytology and pathology laboratories

Neste estudo, realizou-se uma avaliação do risco ocupacional relacionado ao uso de xilol, ao qual estão expostos técnicos de oito laboratórios de citologia e anatomia patológica que atendem a população do Recife e de cidades do interior de Pernambuco. A coleta das informações deu-se por meio de questionários que podiam ser respondidos marcando-se alternativas de múltipla escolha. Deu-se destaque às informações decorrentes do uso do xilol relacionadas à saúde ocupacional e à percepção de risco na manipulação e no descarte dos rejeitos. Os resultados mostraram que a utilização de equipamentos de proteção individual e coletiva está sendo negligenciada. Dentre os entrevistados, 80% observaram mudanças na saúde após alguns anos de exposição ao xilol. Mesmo assim, apenas 6,6% deles fazem controle anual da presença de xilol no organismo pela dosagem de ácido metilhipúrico na urina. Constatou se que 76,6% dos entrevistados descartam o resíduo diretamente na pia, pois não existe um local para descarte de rejeitos. Frente aos dados encontrados, sugere-se que há necessidade de educar o trabalhador numa visão prevencionista em relação aos riscos ocupacionais e ambientais provenientes do uso deste agente químico.

In this study a diagnosis of occupational exposure related to xylol use bytechnicians in cytology and anatomic pathology was carried out in eight laboratories which care for the population of Recife and towns in the interior of the state of Pernambuco. Data were obtained by multiple choice questionnaires. Emphasis was given to information concerning occupational health and perception of risk when using xylol and disposing waste. The results showed that personal and collective protection equipment have being neglected. Eighty percent of the people interviewed had noticed changes in health after they had been exposed to xylol for some years. However, only 6.6% of them went through annual evaluation to check the presence of xylene in their organisms, by methyl hippuric acid determination in urine. It was noticed that 76.6% of the people interviewed disposed waste directly into a sink, as there was not a proper place for waste disposal. Data showed the need for workers training on a preventive view in relation to occupational and environmental risks.

Effect of Sodium Benzoate on Change of Urinary Hippuric Acid and Methyl Hippuric Acid among Workers Coexposed to Toluene and Xylene / 대한산업의학회지

OBJECTIVES: This study was performed to investigate the effect of drink containing sodium benzoate on the change of urinary hippuric acid (UHA) and methyl hippuric acid (UMHA) excretion among workers coexposed to low toluene and xylene. METHODS: Study subjects were 55 male shipbuilders who were divided into 3 groups; nonexposed group (n=10, who were not exposed to organic solvent and had drunk sodium benzoate), exposed A group (n=24, who were coexposed to toluene and xylene, and had drunk sodium benzoate), and exposed B group (n=21, who were coexposed to toluene and xylene, and had not drunk sodium benzoate). The study methodology consisted of questionnaire survey, urinary analysis for metabolites of toluene and xylene before and after drinking with or without sodium benzoate, and personal air sampling of toluene and xylene. RESULTS: Before drinking, there was no significant difference in UHA or UMHA between the exposed A and B groups. After 1.5 hour of drinking, UHA of the exposed A group was significantly higher than that of the exposed B group. After 3 hours, however, UHA of the exposed A group was decreased to the level of the exposed B group, regardless of the ambient toluene level. UMHA exhibited no significant difference between the exposed A and B groups regardless of time and ambient toluene level. The regression model showed that drinking of sodium benzoate was positively correlated with UHA after 1.5 hours of drinking, but not after 3 hours. In addition, sodium benzoate didn't affect UMHA. CONCLUSIONS: This study showed that sodium benzoate initially increased UHA temporally but that its effect disappeared after 3 hours. In the medical examination of toluene exposure workers, the ingestion of drink containing sodium benzoate should be forbidden during the 3 hours prior to urinary sampling.