Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2004 Apr;61(4):312–317. doi: 10.1136/oem.2003.007153

Biological monitoring of kidney function among workers occupationally exposed to trichloroethylene

T Green 1, J Dow 1, C Ong 1, V Ng 1, H Ong 1, Z Zhuang 1, X Yang 1, L Bloemen 1
PMCID: PMC1740740  PMID: 15031388

Abstract

Aims: To investigate the nephrotoxic potential of trichloroethylene in a currently exposed population using sensitive urinary markers of kidney toxicity.

Methods: Renal dysfunction was monitored in a cross-sectional study of 70 workers currently exposed to trichloroethylene. An age and sex matched control population of 54 individuals was drawn from hospital and administrative staff.

Results: The mean exposure to trichloroethylene, estimated from urinary trichloroacetic acid concentrations, was 32 ppm (range 0.5–252 ppm) with an average duration of exposure of 4.1 years (range 1–20 years). Significant differences between the exposed and control populations were found for nephrotoxicity markers N-acetylglucosaminidase (NAG) and albumin, and for the mode of action marker, formic acid. However, neither NAG nor albumin showed a significant correlation with either the magnitude or duration of exposure to trichloroethylene. There was a significant correlation between urinary formic acid and trichloroacetic acid concentrations. Within the exposed population there were dose dependent increases in urinary methylmalonic acid concentrations and urinary glutathione S-transferase α activity. Although still within the control range, these changes were clearly dose dependent and consistent with one of the proposed mechanisms of trichloroethylene induced kidney toxicity.

Conclusion: Although there was no evidence of kidney toxicity within the population studied, the results suggest that kidney damage could occur at exposure concentrations higher (>250 ppm) than those encountered in this study.

Full Text

The Full Text of this article is available as a PDF (268.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berg K. J., Kristoffersen D. T., Djøseland O., Hartmann A., Breistein E., Lund K. K., Narverud J., Nossen J. O., Stenstrøm J. Reference range of some enzymes and proteins in untimed overnight urine and their stability after freezing. Clin Chim Acta. 1998 Apr 27;272(2):225–230. doi: 10.1016/s0009-8981(98)00011-4. [DOI] [PubMed] [Google Scholar]
  2. Bernauer U., Birner G., Dekant W., Henschler D. Biotransformation of trichloroethene: dose-dependent excretion of 2,2,2-trichloro-metabolites and mercapturic acids in rats and humans after inhalation. Arch Toxicol. 1996;70(6):338–346. doi: 10.1007/s002040050283. [DOI] [PubMed] [Google Scholar]
  3. Boeniger M. F. Formate in urine as a biological indicator of formaldehyde exposure: a review. Am Ind Hyg Assoc J. 1987 Nov;48(11):900–908. doi: 10.1080/15298668791385787. [DOI] [PubMed] [Google Scholar]
  4. Bosomworth M. P., Aparicio S. R., Hay A. W. Urine N-acetyl-beta-D-glucosaminidase--a marker of tubular damage? Nephrol Dial Transplant. 1999 Mar;14(3):620–626. doi: 10.1093/ndt/14.3.620. [DOI] [PubMed] [Google Scholar]
  5. Brüning T., Bolt H. M. Renal toxicity and carcinogenicity of trichloroethylene: key results, mechanisms, and controversies. Crit Rev Toxicol. 2000 May;30(3):253–285. doi: 10.1080/10408440091159202. [DOI] [PubMed] [Google Scholar]
  6. Brüning T., Golka K., Makropoulos V., Bolt H. M. Preexistence of chronic tubular damage in cases of renal cell cancer after long and high exposure to trichloroethylene. Arch Toxicol. 1996;70(3-4):259–260. doi: 10.1007/s002040050271. [DOI] [PubMed] [Google Scholar]
  7. Brüning T., Lammert M., Kempkes M., Thier R., Golka K., Bolt H. M. Influence of polymorphisms of GSTM1 and GSTT1 for risk of renal cell cancer in workers with long-term high occupational exposure to trichloroethene. Arch Toxicol. 1997;71(9):596–599. doi: 10.1007/s002040050432. [DOI] [PubMed] [Google Scholar]
  8. Brüning T., Sundberg A. G., Birner G., Lammert M., Bolt H. M., Appelkvist E. L., Nilsson R., Dallner G. Glutathione transferase alpha as a marker for tubular damage after trichloroethylene exposure. Arch Toxicol. 1999 Jun-Jul;73(4-5):246–254. doi: 10.1007/s002040050613. [DOI] [PubMed] [Google Scholar]
  9. Brüning T., Vamvakas S., Makropoulos V., Birner G. Acute intoxication with trichloroethene: clinical symptoms, toxicokinetics, metabolism, and development of biochemical parameters for renal damage. Toxicol Sci. 1998 Feb;41(2):157–165. doi: 10.1006/toxs.1997.2401. [DOI] [PubMed] [Google Scholar]
  10. Chia K. S., Mutti A., Tan C., Ong H. Y., Jeyaratnam J., Ong C. N., Lee E. Urinary N-acetyl-beta-D-glucosaminidase activity in workers exposed to inorganic lead. Occup Environ Med. 1994 Feb;51(2):125–129. doi: 10.1136/oem.51.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Dow J. L., Green T. Trichloroethylene induced vitamin B(12) and folate deficiency leads to increased formic acid excretion in the rat. Toxicology. 2000 May 5;146(2-3):123–136. doi: 10.1016/s0300-483x(00)00156-6. [DOI] [PubMed] [Google Scholar]
  12. Goeptar A. R., Commandeur J. N., van Ommen B., van Bladeren P. J., Vermeulen N. P. Metabolism and kinetics of trichloroethylene in relation to toxicity and carcinogenicity. Relevance of the mercapturic acid pathway. Chem Res Toxicol. 1995 Jan-Feb;8(1):3–21. doi: 10.1021/tx00043a001. [DOI] [PubMed] [Google Scholar]
  13. Green T., Dow J., Foster J. R., Hext P. M. Formic acid excretion in rats exposed to trichloroethylene: a possible explanation for renal toxicity in long-term studies. Toxicology. 1998 May 15;127(1-3):39–47. doi: 10.1016/s0300-483x(98)00020-1. [DOI] [PubMed] [Google Scholar]
  14. Norman E. J., Martelo O. J., Denton M. D. Cobalamin (vitamin B12) deficiency detection by urinary methylmalonic acid quantitation. Blood. 1982 Jun;59(6):1128–1131. [PubMed] [Google Scholar]
  15. Ring E., Zobel G., Erwa W., Haim-Kuttnig M. Urinary excretion of N-acetyl-beta-D-glucosaminidase in proteinuric states. Child Nephrol Urol. 1992;12(1):15–18. [PubMed] [Google Scholar]
  16. Vamvakas S., Brüning T., Thomasson B., Lammert M., Baumüller A., Bolt H. M., Dekant W., Birner G., Henschler D., Ulm K. Renal cell cancer correlated with occupational exposure to trichloroethene. J Cancer Res Clin Oncol. 1998;124(7):374–382. doi: 10.1007/s004320050186. [DOI] [PubMed] [Google Scholar]
  17. Waller K. V., Ward K. M., Mahan J. D., Wismatt D. K. Current concepts in proteinuria. Clin Chem. 1989 May;35(5):755–765. [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES