Search

Objectives: The aim of this study was to investigate renal function and immunologic markers among chloralkali workers with long-term low exposure to mercury vapor., Methods: Forty-seven currently exposed workers were compared with reference workers matched for age in a cross-sectional design., Results: The mean urinary mercury concentration was 5.9 (range 1.1-16.8) nmol/mmol creatinine (Cr) for the exposed workers and 1.3 (range 0.2-5.0) nmol/mmol Cr for the referents. The chloralkali workers had been exposed for an average of 13.3 (range 2.8-34.5) years. The activity of N-acetyl-beta-D-glucosaminidase in urine (U-NAG) was higher in the exposed workers (mean 0.18 U/mmol Cr versus 0.14 U/mmol Cr, P=0.02). Associations between current urinary mercury, cumulative urinary mercury, and cumulative urinary mercury per year (intensity) and U-NAG, autoantibodies to myeloperoxidase (anti-MPO) and proteinase 3 in serum, respectively, were observed. The activity of U-NAG and anti-MPO was increased in the workers with the highest exposure, as assessed by their mean intensity of exposure. The highest activity of U-NAG was observed in the exposed workers with the lower concentrations of selenium in whole blood., Conclusions: The study indicates an effect of exposure on the kidney proximale tubule cells, possibly modified by individual selenium status, and an effect mediated by neutrophil granulocytes.

Chromosome aberrations and micronuclei in peripheral lymphocytes were studied in 29 male chloralkali workers previously exposed to mercury vapor and in two matched reference groups comprising 29 nitrate fertilizer workers and 29 customs and police officers. The study was performed using whole-blood cultures with and without hydroxyurea and caffeine to inhibit deoxyribonucleic acid synthesis and repair, respectively. No significant differences in the frequencies of chromosome aberrations and micronuclei were observed. However, a nonsignificant increase in chromosome breaks and dicentrics was found in the subgroups with high urinary mercury peak levels or high cumulative mercury exposure. An increased prevalence of "high" scores of chromatid breaks in the inhibited cultures, exceeding the 75th percentile of all of the subjects studied, was observed for the chloralkali workers when compared with both reference groups. No evident cytogenetic effects were observed among the chloralkali workers with the methods used in the present study.

Incidence of cancer and mortality were studied among 674 men exposed to mercury vapour for more than one year at two chloralkali plants. Mercury excretion in urine had been monitored among the workers at the two plants since 1948 and 1949. An individual cumulative urinary mercury dose was calculated, based on about 20,000 urinary mercury measurements. The incidence of cancer and the mortality were followed up from 1953 to 1989 and 1953 to 1988 respectively. The general Norwegian male population served as a reference population. There was a lung cancer excess of borderline significance (standardised incidence ratio = 1.66, 95% confidence interval = 1.00-2.59). The introduction of a 10 year latent period before developing lung cancer did not increase the incidence ratio. The excess may be partly explained by the smoking habits in the cohort or possibly by exposure to asbestos. No excess of cancer was found in the target organs for mercury toxicity--namely, the kidney and the nervous system. No significant excess mortality was found for nephritis and nephrosis or nonmalignant diseases of the nervous system.

Seventeen former chloralkali workers were followed through the regular determination of urinary mercury for nearly two years after the cessation of exposure to mercury vapor in a study of the time course of urinary mercury elimination. Their duration of exposure ranged from 3 d to 35.5 years. A one-compartment model for urinary mercury elimination was applied. The urinary mercury concentration declined at a rate indicating a half-time of 91 d. When corrected for an individual base-line level of urinary mercury resulting from sources of mercury intake not related to work, the half-time was 72.4 [95% confidence interval (95% CI) 63.2-81.7] d, with a mean elimination rate constant of 0.011 (95% CI 0.008-0.013).d-1. The day-to-day variability of the urinary mercury concentration averaged 22%, expressed as the coefficient of variation between urine samples delivered on three consecutive days.

Urinary albumin concentration (U-alb) and N-acetyl-beta-D-glucosaminidase (U-NAG) and glomerular basement membrane antibodies (a-GBMs) in serum samples were measured in 77 chloralkali workers previously exposed to mercury (Hg) vapour and 53 age matched referents. The exposure ceased on average 12.3 (range 1-35) years before the study. The mean exposure time was 7.9 (range 1.1-36.2) years. The mean yearly urinary Hg concentration (U-Hg) was 531 nmol/l. The concentrations of the urinary isoenzymes NAG A (U-NAG A) and NAG B (U-NAG B) were determined in 30 highly exposed subjects and 30 referents. No differences in U-alb or U-NAG, U-NAG A, or U-NAG B were found between the groups. Higher concentrations of a-GBMs were found among subjects who stopped exposure a short time before the study, but there was no association between a-GBMs and U-alb. The U-NAG and U-NAG A were negatively correlated with storage time. The results may suggest that microalbuminuria and enzymuria reported in subjects with ongoing exposure to Hg vapour are reversible in most instances.

A cross sectional study of aspects of their neurology was carried out on 77 chloralkali workers previously exposed to mercury (Hg) vapour and compared with 53 age matched referents. The chloralkali workers had been exposed for an average of 7.9 years at a concentration of 59 micrograms Hg/m3 in the working atmosphere. The individual mean urinary concentration of Hg for each year of exposure was 531 nmol Hg/1. On average the exposure had ceased 12.3 years before the examinations. Both the median sensory nerve conduction velocity and the amplitude of the sural nerve were associated with measures of cumulative exposure to Hg. An association was also found between years since first exposure to Hg and aspects of the visual evoked response. Previously exposed subjects with postural tremor or impaired coordination also had alterations in visual evoked response. These results may indicate an effect of previous exposure to mercury vapour on the nervous system, possibly in the visual pathway, cerebellum, and the peripheral sensory nerves.

The concentrations of total mercury (B-Hg), inorganic mercury (B-IHg), and methyl mercury (B-MeHg) in whole blood, urinary mercury (U-Hg), and selenium in urine (U-Se) and whole blood (B-Se) were determined in 74 chloralkali workers previously exposed to Hg vapour, and compared with 51 age matched referents. Dental amalgam state, fish consumption, and exposure related indices were studied with regard to the determined elements. A significant relation between the surface of dental amalgam and U-Hg (Pearson's r = 0.63, p < 0.001) was found among the referents. Mean U-Se was significantly lower (p < 0.001) among the subjects previously exposed to Hg (34.1 nmol/mmol creatinine) compared with that for the referents (42.6 nmol/mmol creatinine). A significant negative relation between the cumulative Hg dose and U-Se was also found. The mechanisms and the clinical significance of these findings are not clear. No relation between current U-Hg and previous occupational exposure to Hg was found among subjects in whom exposure had ceased more than one year before the study.