Study Of Health Care And The Intervention Of Vitamin C On Workers Exposed To Dimethylformamide

OBJECTIVE To discuss the laws and action mechanisms of DMF on liver injury of workers and provide recommendations to choose health surveillance programs that is not occupational health surveillance programs of DMF;To study whether vitamin C can be used to protect the liver function of workers exposed to DMF and the dose-effect relationship between them.METHODS To investigate the health condition of DMF exposed workers in four leather business corporations and analysis the relationship between the concentrations of DMF and related abnormal indicators. 240 male workers qualified from pre-defined occupational health examination were choosed , According to the exposure concentration and processing factors, four groups were divided equally: high exposed group A and B, low exposed group and placebo group. Other 60 non-DMF operation male workers were choosed from these companies as a control group. The research subjects were continuously administrated with vitamin C or starch and the serum total protein (TP), albumin (ALB), globulin (GLB), alanine aminotransferase (ALT), aspartate aminotransferase (AST),γ-glutamyltransferase GGT (γ-GT), alkaline phosphatase (ALP) and other biochemical index were detected once a month. Urine N-methylformamide (NMF) were measured immediately with gas chromatography mass spectrometry while workers got off work. Comparing the advantages and disadvantages of the routine occupational physical examination with simple examination, related recommendation were provided. SPSS12.0 statistical package are used for statistical analysis of the results.RESULTS 1.The rate of gastrointestinal symptoms of each group before taking pills: Control group is 8.3%, low-concentration group is 18.3%, the placebo group is 20%, high concentration group A and B are 28.3%. Urinary NMF levels of each group after getting off work before treatment: control group 0 mg/L, low concentration group 15.1 mg/L, placebo group 15.3 mg/L, high concentration group A 40.1 mg/L, high concentration group B 40.2 mg/L. The rate of liver dysfunction in each group before taking pills: control group 8.3%, low-concentration group 28.3%, placebo group 30%, high concentration group A 46.7%, high concentration group B 48.3%.2. administration 1 month later, the rate of gastrointestinal symptoms of each group: control group and low concentration group 8.3%, placebo group 18.3%, high concentration group A 21.7%, high concentration group B 16.7%. There are no significant differences among low concentrations group, high concentration group A and B before administration (P> 0.05), but decreased trend. Urinary NMF levels of each group at the end of classes: control group 0 mg/L, low concentration group 6.1 mg/L, placebo group 15.1 mg/L, high concentration group A 26.3 mg/L, high concentration group B 15.2 mg/L. Low concentrations, high concentrations of group A, B are lower after treatment, the difference was significant (P <0.01). Rates of abnormal liver function in each group: control group 8.3%, 10.0% of low concentration group, placebo group 28.3%, the high concentration group A 21.7%, the high concentration group B 11.7%. Low concentrations, high concentrations of group A, B are lower after treatment, the difference was significant (P <0.05).3. Taking medicine 2 month later, the rate of gastrointestinal symptoms of each group: the control group 8.3%, 8.3% in the low concentration group, placebo group 18.3%, the high concentration group A 15.0%, the high concentration group B 10.0%. High concentration of group B is lower than before treatment (P <0.05), the rest was no significant difference. Urinary NMF levels of each group at the end of classes were: control group 0 mg/L, low concentration 5.2 mg/L, placebo 15.4 mg/L, high concentration A 19.3 mg/L, high concentration B 11.0 mg/L. Low concentrations, high concentrations of group A, B are lower than before treatment, the difference was significant (P <0.01). Rates of abnormal liver function in each group: control group 6.7%, 8.3% of low-concentration group, placebo group 26.7%, the high concentration group A 20.0%, the high concentration group B 10.0%. Low concentrations, high concentrations of group A, B are lower than before treatment, the difference was significant (P <0.05).4. Taking medicine 3 month later, the rate of gastrointestinal symptoms of each group: the control group 6.7%, 8.3% in the low concentration group, placebo group 20.0%, the high concentration group A 11.7%, the high concentration group B 10.0%. The low concentration group and the high concentration of group B are lower than before treatment (P <0.05), the rest was no significant difference. Urinary NMF levels of each group at the end of classes were: control group 0 mg/L, low concentration 5.4 mg/L, placebo 15.5 mg/L, high concentration A 16.3 mg/L, high concentration B 8.8 mg/L. Low concentrations, high concentrations of group A, B are lower than before treatment, the difference was significant (P <0.01). Rates of abnormal liver function in each group: control group 6.7%, 8.3% of low-concentration group, placebo group 28.3%, the high concentration group A 16.7%, the high concentration group B 8.3%. Low concentrations, high concentrations of group A, B are lower than before treatment, the difference was significant (P <0.05).5. After taking medicine three months later, the serum albumin showed no significant between workers exposed to DMF worked for different segment (P> 0.05); G increases while the length of service operations exposed to DMF increases, A / G increases while the length of service operations exposed to DMF reduces, the difference was significant (P < 0.05).6. The results of ALT, AST,γ-GT and ALP in each group before treatment and take medicine 3 months: the control group and the placebo group: serum enzyme showed no difference before and after treatment (P> 0.05). Low concentrations: before and after testing, the result of ALT andγ-GT are significant different, after the test they were significantly lower than pre-test (P <0.01); AST, ALP difference was not significant (P> 0.05). High concentration of A, B: before and after test ALT, AST andγ-GT were significant differences, after the test was significantly lower than pre-test (P <0.05); before and after the test ALP was no significant difference (P> 0.05). CONCLUSION 1. Adequate vitamin C can prevent the DMF-induced acute liver dysfunction, whether the prevention of chronic liver injury remains to be observed.2. Acute liver dysfunction and urinary NMF content of the end of class show a positive linear correlation. After taking VitC, urinary NMF reduced, but remained to show a linear correlation with serum enzyme indicators, urinary NMF level can be used as a biological exposure limit for workers exposed to dimethylformamide.3. The occupational health surveillance programs of DMF need to be improved, appropriately shorten physical examination cycle and simplified the medical test are positive significant.4.DMF-induced acute liver injury in workers was linearly related to urinary NMF level, chronic liver injury might be related to A/G levels.