Bladder cancer screening and monitoring of 4,4′-methylenebis(2-chloroaniline) exposure among workers in Taiwan
Bladder cancer screening and monitoring of 4,4′-methylenebis(2-chloroaniline) exposure among workers in Taiwan
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DOI：
10.1016/j.urology.2005.02.031
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发表时间：
2005-08-01
期刊：
影响因子：
2.1
通讯作者：
Shih, TS
中科院分区：
文献类型：
--
作者：
Chen, HI;Liou, SH;Shih, TS
目标。膀胱移行细胞癌与职业性暴露于4,4′-亚甲基双（2-氯苯胺）（MBOCA）有关。在四家MBOCA制造工厂进行了一项监测工作环境中MBOCA水平和筛查膀胱癌的计划。本研究采用美国职业安全与健康管理局第24号分析方法测量空气中MBOCA浓度。总共招募了70名接触mboca的工人和另外92名未接触mboca的工人进行筛查。所有患者均行尿隐血检查、尿细胞学检查、尿肿瘤标志物核基质蛋白检查和腹部超声检查。采用静脉尿路造影和膀胱镜检查证实膀胱癌的存在。空气中MBOCA浓度以净化区最高（0.23 ~ 0.41 mg/m(3)），洗涤区次之（0.02 ~ 0.08 mg/m(3)），中和区次之（0.05 ~ 0.06 mg/m(3)）。这项研究确定了一名患有膀胱癌的在职工人。此外，我们还发现1名工人在尿细胞学上怀疑有恶性细胞，1名工人的细胞学不典型合并肉眼血尿。尽管非典型尿细胞和核基质蛋白22肿瘤标志物的患病率在mboca暴露工人和未暴露工人之间整体或按性别分组没有显著差异，但男性暴露工人的潜血阳性患病率（18%）略高于男性未暴露工人（7%）。本研究结果支持了其他研究的结论，即MBOCA对人类具有潜在的致癌性。需要采取控制措施，防止因吸入和皮肤吸收而过度暴露。
Objectives. Transitional cell carcinoma of the urinary bladder is associated with occupational exposure to 4,4'-methylenebis(2-chloroaniline) (MBOCA). A program to monitor MBOCA levels in the work environment and to screen for bladder cancer was performed at four MBOCA manufacturing factories.Methods. The U.S. Occupational Safety and Health Administration analytic method No. 24 was adopted in this study to measure air MBOCA concentrations. A total of 70 MBOCA-exposed workers and another 92 nonexposed workers were recruited for screening. Urine occult blood tests, urine cytology, tests for the urine tumor marker nuclear matrix protein, and abdominal ultrasonography were performed in all patients. Intravenous urography and cystoscopy were used to confirm the presence of bladder cancer.Results. The air concentration of MBOCA was greatest in the purification area (0.23 to 0.41 mg/m(3)), followed by the washing area (less than 0.02 to 0.08 mg/m(3)) and neutralization area (less than 0.05 to 0.06 mg/m(3)). This study identified a current worker with proved bladder cancer. In addition, we also identified 1 worker with suspected malignant cells on urine cytology and 1 worker with atypical cytology combined with gross hematuria. Although the prevalence of atypical urinary cells and the nuclear matrix protein 22 tumor marker was not significantly different between the MBOCA-exposed workers and nonexposed workers as a whole or when grouped by sex, the prevalence of positive occult blood was marginally significantly (P 0.055) greater in male exposed workers (18%) than in male nonexposed workers (7%).Conclusions. The findings of this study support the conclusions from other studies that MBOCA is potentially carcinogenic to humans. Control measures are needed to prevent overexposure from inhalation and skin absorption.