Engin Tutkun

Analysis of the hematological and biochemical parameters related to lead intoxication

In parallel with industrial advancements, number of the occupational diseases secondary to chemical exposure is increasing. The chemical agents in the work places affect various organ and tissue systems, leading to chronic diseases. In this study, the cases diagnosed with occupational disease due to exposure to lead were studied and importance of the environmental forensic sciences on this issue was emphasized. A hundred and ninety patients diagnosed with occupational disease related to lead intoxication in Ankara Occupational Diseases Hospital between 01/01/2009 and 31/12/2009 were included in the study. Twenty cases were used as the controls. Sociodemographic characteristics, serum chemical parameters and hematological parameters of the patients were retrospectively assessed. Mean age of the cases included in the study was 35.3±8.69. Hemoglobin (Hb) (p=0.018) and Mean corpuscular volume (MCV) (p<0.001) values were found significantly lower in the patients with lead exposure than in the controls. Gamma glutamyl transferase (GGT) was significantly lower in the patients with lead exposure than in the controls (p=0.002), whereas alkaline phosphatase (ALP) was found higher (p<0.001). In thyroid function test (TFTs) panel, free triiodothyronine (fT3) levels were found significantly higher in the patients with lead exposure than in the control group (p=0.01), while Thyrotrophin-stimulating hormone (TSH) levels were lower (p<0.001). No significant difference was found in terms of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values. In the correlation analysis; serum level of serum lead (Pb) was correlated positively with ALP values and negatively with Hb, MCV and TSH. Considering its effects on the biochemical and hematological parameters, a detailed investigation should be carried out in the cases with lead exposure, which occupies an important place among the occupational diseases.

Serum biochemical markers of central nerve system damage in children with acute elemental mercury intoxicatıon

Objective. Acute mercury intoxication among children can occur through unintentional exposure, and neurotoxicity is one of the main findings in acute exposures. In this study, we aimed to study the central nerve system markers, namely neuron-specific enolase (NSE), S100B, and glutamate receptor (GRIA 1) levels and discuss the mechanisms of central nerve system damage and whether these parameters could be used as markers of acute elemental mercury intoxication neurotoxicity. Materials and methods. This is a case-control study which includes 169 children with acute elemental mercury intoxication, who were exposed to mercury in the school laboratory from a broken jar, and 45 sex- and age-matched controls without mercury exposure. Patient group were divided into three subgroups according to the neurological examination performed during the admission. Neuropathy Group included the children with neurological symptoms including peripheral neuropathy and decreased muscle strength (n = 39) (with or without dilated pupils). Dilated Pupil Group included the children who had mid-dilated/dilated pupils (n = 52). Asymptomatic Exposure Group included the children who did not have any neurological symptoms (n = 78). Serum NSE, S100B, GRIA 1, blood, and urine mercury levels were determined. Results. NSE, S100B, GRIA 1, and blood mercury levels were significantly higher in exposed group than the nonexposed subjects (Median values NSE 22.4 ng/mL, 17.2 ng/mL; S100B 0.09 ng/mL, 0.08 ng/mL; GRIA 1 70.6 pg/mL, 54.1 pg/mL, and blood mercury 15.2 μg/L, 0.23 μg/L for exposed and nonexposed groups, respectively). GRIA 1 levels found to differ between exposed and nonexposed groups and it has also been found to be increased in the subgroups with positive neurological findings compared to that in neurological finding negative groups. S100B levels were found to be increased in exposed and having neurological symptom groups. There was not a significant difference between exposed-not having neurological symptom patients and control group. NSE levels were found to be higher in all subgroups when compared to those in controls, however there was not a significant difference between the subgroups. Conclusion. Serum NSE, GRIA 1, and S100B were increased with mercury exposure. GRIA 1 and S100B levels were observed to have the power to discriminate neurological symptom positive and negative groups. The increase in S100B levels are thought to be protecting the neurons and preventing further NSE elevations.

Immunomodulation and Oxidative Stress in Denim Sandblasting Workers: Changes Caused by Silica Exposure

Abstract Workers in denim sandblasting are at a high risk of developing silicosis, an occupational lung disease caused by inhaling crystalline silica dust. The development and progress of silicosis is associated with the activation of the immune system and oxidative stress. In the former, interferon-gamma induces both neopterin release and the enzyme indoleamine [2, 3]-dioxygenase (IDO) in various cells. The determination of the kynurenine-to-tryptophan ratio and neopterin concentration has proven to be an efficient method to monitor the activation status of IDO and cellular immunity. The present study aimed to investigate whether occupational silica exposure leads to any alterations in neopterin levels, tryptophan degradation, and activities of superoxide dismutase (SOD) and catalase (CAT), agents in the antioxidant defense system. Fifty-five male denim sandblasting workers and twenty-two healthy men as controls were included. Mean neopterin and kynurenine levels, kynurenine-to-tryptophan ratio, and SOD activity were higher in subjects with silicosis compared to non-exposed controls (all, p<0.05). Neopterin levels and kynurenine-totryptophan ratios were positively correlated (p<0.05); however, no correlation was observed between length of employment and the measured parameters. Some of the measured parameters were significantly affected by the severity of the pathology. Our results suggest that silica exposure activates the cellular immune response. The increased neopterin levels and tryptophan degradation confirm the possibility of their use as an indicator of cellular immune response. Sažetak IMUNOMODULACIJA I OKSIDATIVNI STRES U RADNIKA U PJESKARENJU TRAPER PLATNA: PROMJENE UZROKOVANE IZLOŽENOSTI SILICI Radnici u pjeskarenju traper platna izloženi su visokom riziku od silikoze, profesionalne plućne bolesti uzrokovane udisanjem čestica silikatne prašine. Razvoj i progresija silikoze povezani su s aktivacijom imunosnog sustava i oksidativnim stresom. Pri aktivaciji imunosnoga sustava, interferon-gama potiče otpuštanje neopterina i enzima indoleamina [2, 3]-dioksigenaze (IDO) u različitim vrstama stanica. Određivanje omjera kinurenina i triptofana te koncentracije neopterina pokazale su se učinkovitim metodama praćenja aktivacijskoga statusa IDO-a i staničnog imuniteta. Ovaj rad istražuje uzrokuje li profesionalna izloženost silici promjene u razinama neopterina, degradaciji triptofana i aktivnosti superoksid dismutaze (SOD) i katalaze (CAT), agenata u antioksidativnom obrambenom sustavu. U istraživanju je sudjelovalo 55 muških radnika u pjeskarenju traper platna i 22 zdrava muškarca u kontrolnoj skupini. Srednje vrijednosti razina neopterina i kinurenina, omjera kinurenina i triptofana, te aktivnosti SOD-a bile su više u radnika oboljelih od silikoze nego u kontrolnoj skupini (p<0,05). Razina neopterina i omjer kinurenina i triptofana bile su u pozitivnoj korelaciji (p<0,05). Međutim, korelacija nije uočena između mjerenih vrijednosti i radnog staža. Neke od mjerenih vrijednosti bitno su ovisile o težini patologije. Dobiveni rezultati daju naslutiti da izloženost silici uzrokuje aktivaciju staničnog imunosnog odgovora. Povećane razine neopterina i degradacije triptofana potvrđuju mogućnost njihova korištenja kao pokazatelja staničnog imunosnog odgovora.

Effects of Occupational Silica Exposure on OXIDATIVE Stress and Immune System Parameters in Ceramic Workers in TURKEY

ABSTRACT Silica is the second most common element after oxygen, and therefore, exposures to crystalline silica dust occur in a large variety of occupations such as metal foundries, constructions, and ceramic, quarry, and pottery industries. Since crystalline silica exposure has been linked with silicosis, lung cancer, and other pulmonary diseases, adverse effect attributed to this element has be a cause for concern worldwide. Silica dust exposure in workers is still considered to be important health problem especially in developing countries. The aim of the study was to investigate the effects of occupational silica exposure on oxidative stress parameters including the activities of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPx), and levels of total glutathione (GSH) and thiobarbituric acid reactive substance (TBARS) as well as immune system parameters such as interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, and IL-10 and tumor necrosis factor (TNF)-α in Turkish ceramic workers. In this study, nearly 50% of Turkish ceramic workers were diagnosed with silicosis. Eighty-four percent of these silicotic workers were found to present with profusion category 1 silicosis, whereas controls (n = 81) all displayed normal chest radiographs. Data demonstrated a significant decrease in levels of GSH and activities of CAT, SOD, and GPx, but a significant increase in MDA levels and activity of GR in all workers. Further, workers possessed significantly higher levels of IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, and TNF-α. These observations suggest that ceramic workers may have impaired antioxidant/oxidant status and activated immune system indicative of inflammatory responses.

Arsenic exposure associated with decreased bone mineralization in male

Abstract Objective: Arsenic (As) exposure may cause several medical problems. There were a few studies investigated whether it has affected bone tissue in women. However, there was no study in men. The aim of this study was to evaluate associations between bone mineral density (BMD) and As exposure in men subjects. Material and methods: We enrolled in this study 254 subjects who due to chronic As exposure suspected and 82 subjects as a control group. Hair As levels were detected by a hair analysis (Varian AA240Z Zeeman Atomic Absorption Spectrometer, USA). BMD measurements were obtained using dual-energy X-ray absorptiometry instrumentation. We investigated associations between the hair As levels and BMD measurements. Results: The frequency of osteoporosis and osteopenia was found to be 0.8% and 54.5%, respectively, in the As exposure group. The frequency of osteoporosis was found to be 1% and osteopenia was 32.4% in control subjects. There was significant difference between two groups (p < 0.001). Hair As level has a median 1.01 (min: 0.06 and max: 25.71). There were no significant correlation between hair As levels and BMD measurements. Conclusion: According to our observations, As exposure was associated with bone metabolism. Possible cause of osteopenia may be exposure to As. Further investigations are needed to estimate the relationship between As and bone metabolism.

Exposure to mercury among dental health workers in Turkey: correlation with amalgam work and own fillings.

Purpose: To investigate the current status of exposure to mercury (Hg) among dental health workers in Turkey. Methods: A total of 115 persons working in the same hospital were included in the study and were divided into three groups. Group 1 consisted of 67 dentists; group 2 consisted of 21 dental personnel who work with amalgam, and group 3 consisted of 27 control subjects who work in the same hospital but are non-dental personnel. The number of amalgam fillings that have been made by the dentists and the number of own fillings of the subjects were recorded. Results: Plasma Hg levels were found to be 3.76 ± 1.84, 3.54 ± 1.83, and 2.69 ± 0.97 µg/L in groups 1, 2, and 3, respectively. Hg concentrations in group 1 were significantly higher than the control group. There was no significant difference between groups 1 and 2. The number of amalgam fillings made by the dentists in the previous year correlated significantly with plasma Hg levels (r = 0.378, p < 0.01). There was no significant correlation between the own amalgam fillings in the teeth of the subjects and Hg levels. Conclusion: Preventive measures for protection from exposure to Hg are necessary for occupational health in dentistry and proper industrial hygiene rules should be emphasized to avoid contamination during work.

Aggravated neuromuscular symptoms of mercury exposure from dental amalgam fillings

Dental amalgam fillings are widely used all over the world. However, their mercury content can lead to various side effects and clinical problems. Acute or chronic mercury exposure can cause several side effects on the central nerve system, renal and hepatic functions, immune system, fetal development and it can play a role on exacerbation of neuromuscular diseases. In this case, we will present a patient with vacuolar myopathy whose symptoms were started and aggravated with her dental amalgam fillings.

Ultrasonographic measurement of the femoral cartilage thickness in patients with occupational lead exposure.

The objective of the present study is to compare distal femoral cartilage thicknesses of patients with occupational lead exposure with those of healthy subjects by using ultrasonography. A total of 48 male workers (a mean age of 34.8±6.8 years and mean body mass index (BMI) of 25.8±3.1 kg/m2) with a likely history of occupational lead exposure and age- and BMI-matched healthy male subjects were enrolled. Demographic and clinical characteristics of the patients, that is, age, weight, height, occupation, estimated duration of lead exposure, and smoking habits were recorded. Femoral cartilage thickness was assessed from the midpoints of right medial condyle (RMC), right lateral condyle (RLC), right intercondylar area (RIA), left medial condyle (LMC), left lateral condyle (LLC), and left intercondylar area (LIA) by using ultrasonography. Although the workers had higher femoral cartilage thickness values at all measurement sites when compared with those of the control subjects, the difference reached statistical significance at RLC (P=0.010), LMC (P=0.001), and LIA (P=0.039). There were no correlations between clinical parameters and cartilage-thickness values of the workers. Subjects with a history of lead exposure had higher femoral cartilage thickness as compared with the healthy subjects. Further studies, including histological evaluations, are awaited to clarify the clinical relevance of this increase in cartilage thickness and to explore the long-term follow-up especially with respect to osteoarthritis development.

Evaluation of DNA Damage Using 3 Comet Assay Parameters in Workers Occupationally Exposed to Lead

The aim of this study was to investigate the association between DNA damage and blood lead levels in individuals occupationally exposed to lead. To evaluate this association, 61 workers exposed to lead were monitored in terms of DNA damage in blood lymphocytes. The levels of DNA damage were measured according to 3 comet assay parameters, including tail intensity (TI), tail moment (TM), and DNA tail (DNAt). A statistically significant positive correlation was found between the lead levels and TI, TM, and DNAt (p <.01). Smoking had independent effects on DNA damage. A statistically significant difference was observed between smokers and nonsmokers in regards to DNA damage parameters (p <.05). In addition, the lead and DNA damage levels in smokers were found to be significantly higher than the levels observed in nonsmoking workers (p <.05). Our results show that exposure to lead induces genotoxic effects in peripheral lymphocytes, as measured by comet assays.

8-Hydroxydeoxyguanosine as a Useful Marker for Determining the Severity of Trichloroethylene Exposure

ABSTRACT The aim of this study was to determine 8-hydroxydeoxyguanosine (8-OH-dG) levels in trichloroethylene (TCE)-exposed workers. Oxidative stress biomarkers and biochemical parameters were monitored among 26 TCE-exposed workers and 78 age-matched control subjects. Levels of urinary 8-OH-dG were analyzed by liquid chromatography tandem mass spectrometry. Urinary 8-OH-dG levels were significantly higher for TCE-exposed group (p < .001). Spearmans correlation test revealed positive correlations between urinary trichloroacetic acid levels and age, urinary 8-OH-dG, urinary total oxidant status, and urinary total antioxidant status (p = .042, p < .001, p < .001, and p < .001, respectively). 8-OH-dG may be a useful marker to determine the extent of TCE exposure.