Handbook of Solvents - George Wypych - ChemTech - Ventech!

1358 Nachman Brautbar
The study by Lagure, et al, 31,32 showed significantly increased risk of solvent related
glomerulonephritis of 4.9. That this increased risk of glomerulonephritis follows a dose-response
relationship was shown in the study of the populations examined by Ravnskov, et
al., 34,35 Bell, et al., 33 Porro, et al., 36 Yaqoob, et al., 37,38 Nuyts, et al., 39 and demonstrates: 1)
temporal relationship between exposure to solvents and the development of kidney disease,
2) a dose-response relationship, strongly showing the causal link between solvent exposure
and glomerulonephritis. The study by Nuyts, et al., 39 examined a large population of 272 patients
with chronic renal failure and assessed several occupational exposures, among those
were hydrocarbons. The increased risk of chronic kidney disease in the form of renal failure
in patients exposed to solvents was 5.45. The study of Askergren et al. 45 looked into kidney
functions in patients exposed to various organic solvents, specifically excretion of red blood
cells in the urine in 101 patients exposed to solvents as compared to 39 non-exposed controls.
Those who were exposed to organic solvents significantly excreted more cells than the
ones who were not exposed. These studies showed the role for organic solvent exposure in
the development of damage to the glomerules since excretion of red blood cells represents
damage to the glomerules rather than tubules. That exposure to solvents is associated with
glomerular damage rather than tubular damage fits with the various case reports and
case-control studies and further suggest a plausible causal connection between exposure to
industrial solvents and glomerular damage leading later on to chronic glomerulonephritis.
The study by Bell et al. 33 studied 50 patients who had organic solvent exposure and biopsy-proven
proliferative glomerulonephritis. They have shown that none of these patients
had evidence of any other systemic disease or preexisting infection, and compared those
with 100 control subjects matched for age, sex and social class. This study is important
since exposure assessment was done and showed significantly greater exposure scores in
patients with glomerulonephritis compared to the control subjects. Furthermore, the degree
of exposure was significantly higher in those patients who have more severe
glomerulonephritis than those who have less severe glomerulonephritis, further indicative
of a dose response relationship. This is a study which demonstrates significant statistical association,
as well as dose response relationship between solvent exposure and kidney damage
in the form of glomerular lesion and end-stage glomerulonephritis, ranging from mild to
chronic severe glomerulonephritis. The study by Daniell et al. 26 evaluated the risk of developing
glomerular lesion associated with hydrocarbon exposure and showed a does-response
relationship and variations in disease severity in relation to the exposure intensity.
They showed an increase risk of developing glomerular nephritis, ranging from 2.8 to 8.9
fold increase as compared to the non-exposed population. There was clear temporal relationship
between the exposure, absence of any other causes, a dose-response relationship
which further validated the observations of Bell et al. 33 and conclude that intense or
long-term exposure (low-level but long-term or short-term and high levels) to commonly
used industrial solvents played a causal role in the development of glomerular damage and
chronic glomerulonephritis.
In a comprehensive study, Yaqoob et al. 46 performed a population study which looked
into 3 groups of healthy men working in 3 different areas of a major car manufacturing
plant. They have studied 3 groups, Group 1 included 112 paint sprayers exposed to a
paint-based mixture of hydrocarbons, Group 2 which was composed of 101 transmission
shop workers with exposure to petroleum-based mineral oils, and Group 3 which was comprised
of 92 automated press operators with minimal background exposure to lubricating