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• Bilirubina e acidi forti e solventi non clorurati
• (12/11/2004 10:43)

Sottopongo a tutti i colleghi il seguente quesito:
Un lieve aumento della Bilirubuna totale e/o frazionata ( esclusa la sindrome di Gilbert) può essere causata da un 'esposizione a prodotti chimici come acidi forti ( ac. solforico, cloridrico, fosforico) e solventi ( acetone, etilen-glicole ) ?
La mia non è una richiesta provocatoria, o dettata da da impreparazione professionale, ma desidero avere un parere qualificato da colleghi che stimo, per obbiettare a quanti stanno sollevando un polverone in una azienda di mia gestione. Gradirei anche sapere se ci sono publicazioni scientifiche in merito?

carlitos way

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• Re: Bilirubina e acidi forti e solventi non clorurati
• (13/11/2004 13:24)

il uesito è interesante e estremamente qualificato e ualificante...cerchiamo un pò tutti insieme i letteratura scientifica in merito sul web e contattiamo docenti universitari....
Un saluto y carlitos

Nonnoguido

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• Re: Bilirubina e acidi forti e solventi non clorurati
• (14/11/2004 08:01)

In dati in letteratura medica sono un po’ contrastanti: il Sartorelli non include l’Acetone tra le sostanze epatotossiche.

Qualche organizzazione statunitense invece sì, come ho potuto constatare dai seguenti siti di cui riporto alcuni estratti:

1) OSHA ANSWERS

“What are the main health hazards associated with breathing in acetone?
A single case report suggests slight kidney and liver damage may have occurred following a severe exposure to acetone. There are insufficient details available to draw conclusions from this report.
What are the long term health effects of exposure to acetone? (...)
INHALATION: Most human population studies indicate that acetone would not produced significant health effects following long-term exposure. In a series of studies, no statistically significant differences in causes of death or clinical laboratory results were observed in 948 employees exposed to up to 1070 ppm acetone over 23 years. Another study which reviewed 18 years of industrial experience with employees in a cellulose acetate production facility did not show an increased incidence of illness. One other study did not find significant changes in clinical chemistry tests conducted on 60 employees who had worked at least 5 years in the acetate fibre manufacturing industry (exposures of 550-1050 ppm).
No conclusions can be drawn from other reports which have described effects following long-term acetone exposure. These reports are limited by factors such as the small number of workers studied, the fact that other exposures may have contributed to or caused the observed effects and/or possible self- reporting biases. In one study, 110 men were exposed to a mean concentration of 361 ppm acetone for an average of 14.9 years. These men reported more heavy headedness, nausea, faintness, weight loss, eye irritation than a comparison group with no acetone exposure. They also did not perform as well on some neurobehavioural tests (reaction time and digit span tests). A few historical reports have also described long-term exposure effects such as irritation of the airways, throat, stomach and occasionally, dizziness, attacks of giddiness and a loss of strength.
Will acetone act in a synergistic manner with other materials (will its effects be more than the sum of the effects from the exposure to each chemical alone)?
Acetone has increased the liver toxicity of chemicals, such as carbon tetrachloride, chloroform, trichloroethylene, bromodichloromethane, dibromochloromethane, N-nitrosodimethylamine and 1,1,2-trichloroethane, the lung toxicity of styrene and the toxicity of acetonitrile and 2,5-hexanedione in laboratory animals. It appears to inhibit the metabolism and elimination of ethyl alcohol, thereby potentially increasing its toxicity. Acetone can either increase or decrease the toxicity of 1,2-dichlorobenzene, depending on the concentration of acetone used.
Is there potential for acetone to build-up or accumulate in my body?
Acetone is a normal by-product of mammalian metabolism and is found in virtually every organ and tissue, and in the blood. Acetone can enter the body by inhalation, ingestion or skin contact. Acetone is metabolized by a number of routes to compounds, which are used by the body to make glucose and other products of intermediary metabolism, with the generation of carbon dioxide. Acetone is excreted both unchanged, and following metabolism, mainly as carbon dioxide. The main route of excretion is in the expired air, with very little excreted in the urine. Respiratory excretion is complete within 20 hours after inhalation. The amount of unchanged acetone excreted in the urine increases with increasing exposure concentration and duration, and with exercise during exposure. “
2) da ATSDR FAQ:
“How can acetone affect my health?
If you are exposed to acetone, it goes into your blood which then carries it to all the organs in your body. If it is a small amount, the liver breaks it down to chemicals that are not harmful and uses these chemicals to make energy for normal body functions. Breathing moderate- to-high levels of acetone for short periods of time, however, can cause nose, throat, lung, and eye irritation; headaches; light-headedness; confusion; increased pulse rate; effects on blood; nausea; vomiting; unconsciousness and possibly coma; and shortening of the menstrual cycle in women.
Swallowing very high levels of acetone can result in unconsciousness and damage to the skin in your mouth. Skin contact can result in irritation and damage to your skin.
The smell and respiratory irritation or burning eyes that occur from moderate levels are excellent warning signs that can help you avoid breathing damaging levels of acetone.
Health effects from long-term exposures are known mostly from animal studies. Kidney, liver, and nerve damage, increased birth defects, and lowered ability to reproduce (males only) occurred in animals exposed long-term. It is not known if people would have these same effects.”
Qui di seguito, poi, l’ATSDR parla anche di metodi per valutare l’intossicazione possibile da Acetone, ma il test dovrebbe essere effettuato nell’arco di due/ tre giorni:

“Is there a medical test to show whether I 've been exposed to acetone?
Methods are available to measure the amount of acetone in your breath, blood, and urine. The test can tell you how much acetone you were exposed to, although the amount that people have naturally in their bodies varies with each person. The tests can 't tell you if you will experience any health effects from the exposure.
The test must be performed within 2-3 days after exposure because acetone leaves your body within a few days. These tests are not routinely performed at your doctor 's office, but your doctor can take blood or urine samples and send them to a testing laboratory.”

3) Ancora, da un Material Safety Data Sheet di Austin, TX :

“Exposure to acetone may enhance the liver toxicity of chlorinated solvents. Acute: Causes severe eye irritation. Causes irritation to skin, mucous membranes and respiratory tract. Chronic: Dermatitis, eye damage. Target organs: Liver, kidneys. “

4) E infine l’NSC (National Safety Council – Chemical)

“Health effects:
When acetone is inhaled, it irritates the eyes, nose and throat. When ingested, it causes dizziness, headaches, light-headedness, dermatitis, and possible unconsciousness. Prolonged or repeated contact with the liquid may dry and defat the skin and cause dermatitis. High exposures may damage the liver and the kidneys; long-term exposure can cause chronic nose and throat irritation. “
In sostanza mi pare di capire che per poter valutare un’eventuale intossicazione del fegato si potrebbe anche ricorrere ad un dosaggio dei metaboliti dell’Acetone (compiuto da un laboratorio serio) oltrechè valutarne la presenza nell’ambiente di lavoro come giustamente detto dai coleghi: del resto questo dovrebbe essere fatto anche in virtù del D.L. 66 o no?

(Che bello poter finalmente parlare di argomenti professionali senza provocatori tra i piedi...)

Guido Marchionni