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Exposure to 5-nitro-o-toluidine (5-NT) results in liver damage, Japanese doctors have found. The discovery came after three workers from one factory were referred to the same hospital with liver damage over 13 days. All were working with 5-NT powder in an enclosed factory area. One other worker with liver disease was not admitted.
The coincidence prompted questioning of all 15 workers in that area about symptoms and a hygiene investigation—into working practices; material safety data sheets (MSDS); and the workers' backgrounds, medical history, and previous liver function tests. All had full biochemical analysis for liver function and tests for hepatitis A, B, and C; the three admitted workers had tests for CMV and EBV infection.
Those admitted had severe liver damage, and, 17 days after the first admission, three more workers showed damage and two were admitted. Fortunately, liver function gradually improved. The six most severely affected had handled 5-NT the most—4–5 hours, 12–20 times—compared with the others providing occasional relief, exposed only 1–3 times. Liver damage was not related to any other factor.
The work entailed hand scooping 5-NT powder, unavoidably creating an airborne suspension. The workers were in the habit of loosening their respirators slightly for comfort during short breaks taken in the work section—presumably inhaling the powder.
Toxicity of 5-NT is not proved but highly likely. Despite only one other reported instance of liver damage occupationally—after incidental exposure in one man—Shimizu et al believe that those exposed to 5-NT need regular monitoring of their liver function.
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