title: Serum bile acid as a screening tool in workers occupationally exposed to mixtures of organic solvents.
abstract: The aim of the present study was to find out the potential impact of occupational exposure to mixtures of organic solvents on liver function tests. Serum bile acid (BA) was evaluated as a marker of early hepatic derangement and compared to routine liver function tests. The study included two comparable groups: 57 male workers exposed to organic solvents from a paints factory and 59 administrative male controls. Occupational and medical data and serum analysis for liver function parameters (BAs, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total and direct bilirubin) were obtained. Bile acids showed significantly elevated mean levels in the exposed workers compared to the controls (50.2 ± 47.9 and 5.4 ± 2.7 µmol/L, respectively, p < 0.01). Bile acids were elevated in almost all exposed workers (87.7%) but in none of the controls. Bile acids had significant positive correlation with duration of exposure to organic solvents and lifetime hydrocarbon exposure score (HES) (p < 0.01 and p < 0.05, respectively). All other liver function tests exhibited normal mean levels and did not show statistically significant differences between both groups. The performance of BA versus combined liver enzymes is evaluated using receiver-operating characteristic (ROC) curve and likelihood ratios. The area under the curve was significantly high (0.687 > 0.5, p = 0.012) and had optimal decision level (8 µmol/L). Serum BA can be recommended as a screening test for exposure to organic solvents. It can be suggested for follow-up every 1-2 years or accordingly.
authors.affiliation: Department of Public Health and Community Medicine, Benha Faculty of Medicine, Benha, Egypt.
authors.forename: Hala Mostafa
authors.initials: HM
authors.lastname: El Hady
authors.affiliation: Department of Environmental and Occupational Medicine, National Research Centre, Cairo, Egypt.
authors.forename: Fateheya
authors.initials: F
authors.lastname: Metwally
authors.affiliation: Department of Public Health and Community Medicine, Benha Faculty of Medicine, Benha, Egypt.
authors.forename: Mahmoud Fawzy
authors.initials: MF
authors.lastname: El Gendy
authors.affiliation: Department of Environmental and Occupational Medicine, National Research Centre, Cairo, Egypt safaaser@yahoo.com.
authors.forename: Safaa
authors.initials: S
authors.lastname: Elserougy
authors.affiliation: Department of Environmental and Occupational Medicine, National Research Centre, Cairo, Egypt.
authors.forename: Mona Adel
authors.initials: MA
authors.lastname: Helmy
mesh_terms: D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood*; D016022:Case-Control Studies; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D066192:Manufacturing Industry; D008403:Mass Screening / Q000379:methods; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D010150:Paint / Q000009:adverse effects*
chemical_list: D001647:Bile Acids and Salts