Document B5o290G8OZXwXnxRJvZzQZNvE

EXX-MOR-003134 THt MfO/CAi MUlUtIH INDUSTRIAL HYGIENE LABORATORY TESTS AS AN ADJUNCT TO MEDICAL CONTROL OF OCCUPATIONAL DISEASES* J. W. HAMMOND** tabbies' D m m2 f X5 --n 00 > INTRODUCTION This outline was prepared for lecture notes to medical students who would mainly be Jn general practice. If properly used, both air and urine tests provide essentially the same Informatloo-the severity of exposure to the poison In question. Industrial hygienists and physicians alike have been slow to make use of many advantages offered by chemical urine analysis. These advantages nre: Under normn) conditions, thoy picture nc* curately employees' exposure to many toxic substances as well ns does atmospheric analyses; they represent total absorption from all sources (inhalation, Ingestion and skin nbsorptlon); the effects of solubility In body fluids is gauged by urinary excretion of mnny elements} and exi posure in mnny cases can bo evaluated after it has ceased by delayed urinary excretion of toxio substance. Last, but not least, only the nbsorptlun of a chemical element can cause an Increase In excretion of that some element in body fluids. Tho chief disadvantages are: Toxic substances may cause Injury hi panning through the body In chemically detectable amounts; excreted poison U mdy approximately proportioned to excreted concentrations nnd often there Is a delayed response In increased excretion with start of Absorption or exposure becmiw chemicals may be pnrtly stored In the iHxly Id some extent. The variation In urinary concentration caused by varying fluid IntnVe can lie reduced by adjusting the specific gravity In n medium value. Many industrial chemicals have not been studied relative to ratio of excreted nmounts nnd ntmnspheric exposure. All such data should bo published to expand the industrial hygienist's nhlllly to use this valuable tool In exposure evaluation. AbrSS^u^Twu^ lh8 Gulf 008,1 Sect[on' AIHA Industrial IlyglwLu-Humbla Oil & PeRnlM* Cn. 23, IWH, Kell; W 0 HroisNs usoMroxr rsm am ah adjunct ro mimcai EM003027 tHt MiOlCAl UJIUllH LABORATORY TESTS This discussion is based on the assumption that the physician sees the patient after the exposure to the industrial environment and there Is*no prior information of value: on the patient, the materials to which he was actually exposed, the concentrations of atmospheric contami nant!, and amount of skin contact he had in carrying out his normal work-. We want to discusj briefly the laboratory tests that can be made on specimens to help to differentiate occupational disease* from those diseases that may be due to non-occupatlonal agents or factors. It must be kept In mind that to cover such a broad subject in the short period available that the interpretation must be limited to reaction of normal healthy workers. h Material: Inorganic inert dust; silica, asbestos, etc. Tests: There is no known specific chemical or physical laboratory test for pneumoconiosis diagnosis. The most characteristic physical and chemical properties of these dusts are their Inertness; therefore, there are insignificant products excreted that have been Identified as those associated with exposure, with the exception of asbestos bodies. ,, 2. Material: Lead compounds. rests; Urinalysis is specific. Blood analysts Is specific, Porphyrin is helpful but not specific. Stippled cell count is helpful but not specific. Method: Dithlxone colorimetric. Norma] range: 0.00-0,Ofl mgm, lead per liter of urine. 0.00-0.07 mgm, lead per 100 eo. of blood. Significant range: 0.03-0.15 mgm. lead per liter of urine. 0.07*0.12 mgm. lead per 100 cc, of blood. Dangerous range: >0.17 mgrn, lead per liter of urine, >0.12 mgm. lead per 100 cc. of blood. Remarks: Inok at the attached chart for correlation between urinary value* for lead and atmospheric value as found by a large industrial company's medical division. If patient has serious Iddney impair ment, results are not accurate. Interpretation of urinary values In light of spedfio gravity Is helpful. M INDUfTft/Al HTOIfNI UflOOATOar Tins AS AW ADJUNCT TO SUPfCOi 3. Material; Mercury and its compounds. Tests: UrinaJysisisspeciflc. Blood analysis is specific. Method: Dithlxone and electroprecipitation. Normal range: 0.00-0.10 mgm. per liter of urine, Significant range: 0.10-0.2 mgm. per Jiter of urine. Dangerous range: >0.25 mgm. per liter of urine. Remarks: Mercury Is more readily excreted than lead. The ratio of excreted mercury to absorbed mercury is. higher than in the case of lead. 4, Material' Cadmium. Tests: Urinalysis is specific. Method: Dithizone. Normal range: 0.00-0.05 mgm. per liter of urine. .Significant range: 0.05-0.07 mgm, per liter of urine. Dangerous range: >0.07 mgm. per liter of urine. Remarks: The Industrial usage of eadmlum has been limited; there fore, there Is not much data on correlation of cadmium in the en vironment to urinary values. 5. Material Nickel-only nickel carbonyl, Tests: Urinalysis Is specific. Analysis of hair is specific. Method: Colorimetrically with potassium dithlonlite. Normal range: 0,00 mgm. nickel per liter of urine. Significant and dangerous range; Any detectable amount of nickel In urine. 6, Material Solid arseoic compounds. Tests: Urinalysis Is specific. Analyses of hair and fingernails ore specific. ' Method: Cutzelt. ' , Normal range: 0.00-0.02 mgm. per liter Df urine. Significant range: 0.03-0.04 mgm. per liter of urine. 51 EM003028 EXX-MOR-003135 V EXX-MOR-003136 THt MIPfCAX lUUrUN Dangerous range! >0.05 mgm. per liter of urine. Remarks: Arsenic may be found in the hair for several months after exposure has ceased. 7. Material Arsine. Tests: Urinalysis Is specific. Analyses of hair and fingernails are specific. Method: Cutzeit. Normal, sJgnificant and dangerous ranges; Any detectable arsenic In mine, hair, and fingernails following exposure to arsine signifies danger. 8. Material: Manganese. Tests: Urinalysis Is specific but only positive while exposure is con* tinning. Blood analysis U specific and shows manganese longer than urine does after exposure ceases. Method: Colorimetric by strong oxidising agent. Normal range: 0.000.01 mgm. per lifer of urine. Significant and dangerous range: >0.010 mgm. per liter of urine. In blood normal range: 0.012-0.015 mgm, per 100 ml. 9. Material Copper. Tests: Urinalysis is specific. Method: Colorimelrio with ammonium hydroxide. Normal range; 0.00-0.034 mgm. per liter of urine. Significant ranges 0.04 to 0.1 mgm. per liter of urine. Dangerous range: >0.1 mgm. per liter of urine. m 10. Material: Chromium. Tests: Urinalysis is specific. ' Method: Colorimetric with hemotoxylia or Iwliphenylcarbazlde, Normal range; nil. Significant range; Any detectable amount in urine, iNDViruAi Htotim usoaaroar risrs At ah amvnct ro audicai 11..Material Radioactive compounds; radium, uranium, thorium, etc. Teste: Urinalysis Is specific. Exhales active gas: radon, thoron, etc. Method: Geiger counter. Normal range; nil. Significant and dangerous range: Amount indicating daily expo sure of KM curies per cubic meter of air. . Remarks: Uranium of Itself Is one of the most toxic elements. 12. Material Fluorides, Tests: Urinalysis Is specific. Method: Thorium nitrate titration. Normal range: 0.00-3.00 mgm. per liter of urine, Significant range: >3.0 mgm, per liter of urine. Dangerous range: >5.0 mgm. per liter of urine, 13. Material: Carbon monoxide. Tests: Blood analysis for carbon monoxide-hemoglobin is positive and specIBc. Method: Pyrotannic acid and reagent of sodium hyposulflte, sapo- nlne with sodium oxalate. * Normal range: 0-10 per cent In smokers. Significant range: >20 per cent carbon monoxide hemoglobin. Dangerous range; >35 per cent carbon monoxide hemoglobin. 14. Material' Benzol. Tests: Urinalysis for inorganlc/organlc sulfates is specific within four hours after exposure cease*. Method: Barium sulfate precipitation. Normal range; B5-D5 per cent urinary sulfate as inorganic form. Significant range: >85 per cent urinary sulfate a* inorganic form. Dangerous range: >70 per cent urinary mlfate as Inorganic form. Remarks: Specimen should be collected at end of work period within four hours after exposure has ceased. ss EH003029 TNI MMP1CAI tUUrtlN 15. Material: Tricbiorethylene. Tests: Urinalysis for trichloracetic acid. 'Method: Reaction of Fryiwara. Normal range: 0.0-5.0 mgm. per Uter of urine. Significant range: 5.0-50 mgm. per liter of urine. Dangerous range: >50 mgm. per liter of urine. Remarks: All hydrocarbon of aliphatic series having three chlorine atoms on a carbon atom metabolizes to give trichloracetic add. It Is excreted at maximum of 24 days after exposure and up to 14 days In detectable amounts. 10. Material Carbon disulfide. Tests: Urinalysis and analysis of exhaled air are specific for 24 hours after last exposure. Method: Cupric acetate In ethanol. Normal range: nil. Significant and dangerous range: Any amount. 17. Materials Phenols, aniline, xylldlne, and organic nitrates. Tests: Urinalysis Is specific for unchanged compounds. Method: Appropriate for specific compounds in small amounts. Normal range: nil. Significant and dangerous range: Any detectable quantity. 18. Material*: Toluene and/or Styrene. Teris: Urinalysis for hippuric add, but It is not spedfic. Blood analysis is specific for these solvents if collected within 24 hours after last exposure. . Methods Ether extraction and nitrogen determination. Normal range: 0.5-0.9 gn. per liter of urine. Remarks: Urinary hippuric acid correlates well with atmospheric exposure. 54 1NOUST0MI HTOlINf lAIOJUrOXr HITS AM AH 4PJUMCT TO MSPfCAJ. 19. Material: Organic amine. Tests: Blood examination for Heinz Bodies. Method: Stain and microscopic examination. 20. Material: Naphthalene. Tests: Urinalysis for naphthol glucuronate. 21. Materials:-Organicinsectiddes. - Tests.* Urinal>'iis for orgxnlc chloride. Methods Ether extraction and combustion. Normal range: nil. Significant range: any detectable amount. Dangerous range: >10p.p,m. - Remark; Any detectable increase or unusual amount of organic chlorides should be Investigated. EM003030 S3