title: Cross-sectional study on N,N-dimethylformamide (DMF); effects on liver and alcohol intolerance.
abstract: OBJECTIVE
  There are still concerns regarding occupational exposure to hepatotoxic DMF. This study was designed to evaluate possible liver damaging effects of DMF under current workplace conditions in synthetic fibres industries.
  
  
  METHODS
  Among other laboratory parameters, liver function parameters (alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase and gamma-glutamyltransferase), the mean corpuscular erythrocyte volume (MCV) and carbohydrate-deficient transferrin (CDT) of the workforce of two companies present at the days of study were investigated. Internal exposure to DMF was assessed via three different biomarkers [sum of N-methylformamide and N-hydroxymethyl-N-methylformamide, N-acetyl-S-(N-carbamoyl)cysteine (AMCC) and 3-methyl-5-isopropylhydantoin (MIH)]. Alcohol consumption was assessed by means of direct ethanol metabolites (ethylglucuronide and ethylsulfate).
  
  
  RESULTS
  None of the tested liver enzyme activities showed a positive association with any of the three exposure markers, nor did CDT and MCV. CDT was negatively associated with AMCC and the ALP activity negatively with all three exposure markers. Changes in liver function are seen mainly in conjunction with ethanol consumption but also with increasing body weight and age. MCV was associated with smoking. Almost half of the workers stated to experience alcohol flush reaction.
  
  
  CONCLUSIONS
  The present study indicates that long-term exposure to DMF, which was specified by median urinary AMCC levels of 4.84 mg/g creatinine and DMF haemoglobin adduct levels of 60.5 nmol/MIH/g globin, respectively, does not result in any adverse liver effects. In contrast, these DMF exposure levels still elicit certain alcohol intolerance reactions.
authors: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schillerstr. 25, 91054, Erlangen, Germany. sonja.kilo@fau.de.
authors: Sonja
authors: http://orcid.org/0000-0003-4966-2497
authors: S
authors: Kilo
authors: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schillerstr. 25, 91054, Erlangen, Germany.
authors: Thomas
authors: T
authors: Göen
authors: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schillerstr. 25, 91054, Erlangen, Germany.
authors: Hans
authors: H
authors: Drexler
mesh_terms: D000111:Acetylcysteine / Q000031:analogs & derivatives / Q000652:urine; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000503:physiopathology*; D020751:Alcohol-Induced Disorders / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D004126:Dimethylformamide / Q000009:adverse effects / Q000031:analogs & derivatives / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods; D004909:Erythrocyte Indices; D005559:Formamides / Q000032:analysis; D006801:Humans; D006827:Hydantoins / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis
chemical_list: C472969:3-methyl-5-isopropylhydantoin; D015415:Biomarkers; D005559:Formamides; D006827:Hydantoins; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C052469:N-acetyl-S-(N-methylcarbamoyl)cysteine; C042331:N-hydroxymethyl-N-methylformamide; D004126:Dimethylformamide; D003404:Creatinine; D000111:Acetylcysteine; C002950:methylformamide
keywords: AMCC; Alcohol intolerance; DMF; Liver; N,N-dimethylformamide; NMF