Liver disease associated with occupational exposure to the solvent dimethylformamide
An attempt is made to characterize an outbreak of liver disease among workers in a fabric coating factory; and to determine the outbreak's cause and natural history and strategies for clinical recognition, treatment, and prevention. Fifty-eight of sixty-six workers participated in the study. All had standard liver function tests at least once. Forty-six workers completed a questionnaire; 27 had more extensive clinical evaluation for recognized liver abnormalities. A plant-wide outbreak of liver disease was recognized after a new employee presented with signs and symptoms of hepatitis. Evaluation of the worksite showed that dimethylformamide, a widely used industrial solvent and known hepatotoxin, was being used to coat fabric in poorly ventilated areas without appropriate skin protection. No other major hepatotoxic exposure was identified. Overall, 36 of 58 (62%) workers tested had elevations of either aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels. Enzyme abnormalities occurred almost exclusively in production workers (35 of 46 were abnormal), whereas only 1 of 12 nonproduction workers showed any elevations in enzyme levels (P less than 0.0001). Serologic tests excluded known infectious causes of hepatitis in all but 2 workers and changes characteristic of toxic liver injury were confirmed by histologic examinations of biopsy specimens from 4 workers. The ratio of AST to ALT levels was one or less in all but 1 worker. After modification of work practices and removal of workers most severely affected from exposure, improvement in liver enzyme abnormalities and symptoms in most patients were seen, although some patients showed persistent elevations of enzyme levels.
- Research Organization:
- Yale Univ. School of Medicine, New Haven, CT (USA)
- OSTI ID:
- 6968601
- Journal Information:
- Ann. Intern. Med.; (United States), Vol. 108:5
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
ORGANIC SOLVENTS
HEALTH HAZARDS
OCCUPATIONAL EXPOSURE
HEPATITIS
LIVER
OCCUPATIONAL DISEASES
PERSONNEL
POLYURETHANES
TEXTILE INDUSTRY
BODY
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
GLANDS
HAZARDS
INDUSTRY
MATERIALS
ORGANIC COMPOUNDS
ORGANIC POLYMERS
ORGANS
PETROCHEMICALS
PETROLEUM PRODUCTS
PLASTICS
POLYAMIDES
POLYMERS
SOLVENTS
SYNTHETIC MATERIALS
560300* - Chemicals Metabolism & Toxicology