Routine renal function tests are
insensitive for detection of subclinical renal
impairment. A marker of early renal affection is
needed for screening of workers at risk. In this
study the activity of urinary N-acetyl-B-Dglucosatninidase
(NAG) was measured to detect
early renal changes in healthy and ill groups of
workers exposed to nephrotoxic chemicals. The
efficacy of NAG was compared with that of
urinary B2-microglobulin. The studied groups
included 132 subjects: 37 chemical laboratory
workers exposed to aliphatic hydrocarbon
solvents, 33 car painters exposed to aromatic
hydrocarbon solvents and 26 plumbers exposed
mostly to lead fumes and a control group of 36
clerks, matched the exposed groups in age, sex'
and residence. Exposure indices included
lifetime hydrocarbon exposure score (HES),
Lead in blood (Ug/dL) and lifetime exposure
score for lead (LES-Pb).
Levels of urinary NAG differed significantly in
all groups compared to controls. Unlike B2-
microglobulin, NAG levels showed a strong and
consistent correlation with cumulative exposure
indices (HES and LES-Pb). Furthermore, an
exposure-effect relationship existed between
NAG and HES in solvent-exposed normotensive
subjects. NAG levels were higher in solventexposed
hypertensives than normotensives.
These results support the use of urinary NAG in
periodic screening of workers at risk, especially
hypertensives and those with renal disease. |
