Time course of blood parameters in printing workers with cholangiocarcinoma.
OBJECTIVE
We previously reported a cluster of cholangiocarcinoma patients among proof-printing workers who were exposed to 1,2-DCP for a long term. The present study was conducted to evaluate blood parameters in these proof-printing workers during and after exposure.


METHODS
Health examination records during employment and after retirement were obtained for ten cholangiocarcinoma patients to analyze their blood parameters. The patients and/or their relatives were also interviewed about lifestyle and occupational history.


RESULTS
All study patients were exposed to 1,2-DCP for 6-17 years. Red blood cells, hemoglobin, hematocrit, total cholesterol, triglycerides, and fasting plasma glucose were within the standard ranges for almost all patients, but the γ-glutamyl transpeptidase (γ-GTP) levels exceeded the standard range during 1,2-DCP exposure for six patients. Two of the six patients were diagnosed with cholangiocarcinoma during 1,2-DCP exposure, and the other four patients were diagnosed 1-9 years after termination of exposure. The remaining four patients had γ-GTP levels within the standard range during 1,2-DCP exposure, but had increased γ-GTP levels thereafter, and were diagnosed with cholangiocarcinoma 4-10 years after termination of exposure. Aspartate aminotransferase and alanine aminotransferase levels started to increase following the increase in γ-GTP levels.


CONCLUSIONS
Workers exposed to 1,2-DCP should be provided with periodic health examinations during and after exposure. In the examination, even small increases in γ-GTP levels should be considered a signal of early development of cholangiocarcinoma.
Department of Occupational and Environmental Management, University of Occupational and Environmental Health.
Shinji
S
Kumagai
Norio
N
Kurumatani
Akira
A
Arimoto
Gaku
G
Ichihara
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001650:Bile Duct Neoplasms / Q000097:blood* / Q000139:chemically induced / Q000175:diagnosis; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000097:blood* / Q000139:chemically induced / Q000175:diagnosis; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced; D016273:Occupational Exposure / Q000009:adverse effects*; D011327:Printing; D011407:Propane / Q000031:analogs & derivatives* / Q000097:blood / Q000633:toxicity; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; C004765:propylene dichloride; D011407:Propane