Toxic hepatitis in occupational exposure to solvents

Table 1 Clinical-diagnostic types of occupational toxic hepatitis

Type of disease	ALT	ALP	γ-GT	Bilirubin	Bile acids
Hepatocellular	> 2 ULN	N	> 2	Elevated levels	Elevated levels
Cholestatic	N	> 2 ULN	> 4	Normal or moderate level	Elevated levels
Mixed	> 2 ULN	≥ ULN	> 2	Normal or moderate level	Elevated Levels

ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; GT: Glutamyl transferase; ULN: Upper limit of normal; N: Normal value. Normal value, ALT 9-63 U/L; ALP 38-126 U/L; γ-GT 7-50 U/L; Bilirubin 0.20-1.5 mg/dL; Bile acids < 10 μmol/L.

Table 2 Main features of the solvents described

Solvents	Organoleptic properties	Main uses	Main mode of absorption
Dimethylformamide	Water-soluble liquid	Production of organic chemicals, resins, fibers, paints, inks and adhesives	Inhalation
	Colorless	Vinyl resins, adhesives and epoxy formulations	Skin
	Odorless	Purification and/or separation of acetylene
	Polar polymer	Production of polyacrylic or cellulose triacetate fibres and pharmaceuticals
		Industrial paint
		Protective coatings, films, printing inks and adhesives
		Pharmaceutical industry
		Formulation of pesticides
Dimethylacetamide	Colorless	Organic chemistry	Inhalation
	Water miscible	Vinyl resins	Skin
	High boiling point	Cellulose derivatives	Gastric
	Polar	Polyacrylonitrile
	Greasy	Linear polyesters and styrene
		Production process of antibiotics like cephalosporins
		Production of X-ray contrast media
		Manufacture of polyimide resins, polysulfones and cellophane
Trichloroethylene	Non-flammable liquid	Volatile anesthetic (in the past)	Inhalation
	Clear	Food industry (e.g., the decaffeination of coffee and the	Skin
	Pleasant smell	preparation of flavoring extracts from hops and spices)	Gastric
	Volatile
	Organic compound
Tetrachloroethylene	Colorless liquid	Dry cleaning and metal cleaning,	Inhalation
	Volatile	veterinary anthelmintic, textile industry,	Skin
	High stabile	automotive and other metalworking industries,	Gastric
	Non-flammable	dry-cleaning industry
Carbon tetrachloride	Liquid	Refrigerant	Inhalation
	Easily evaporates	Pesticide	Skin
	Sweet smell		Gastric
	Unpleasant smell (> 10 ppm)
Xylene	Flammable liquid	Resins, gums, rubber cleaners, degrease paints, lacquers, varnishes,	Inhalation
	Light-colored or colorless, strong odor	adhesives, cements, inks, gasoline	Skin
Toluene	Refractive liquid	Paints, coatings, synthetic fragrances, adhesives, inks, cleaning	Inhalation
	Colorless	agents, pharmaceuticals, dyes, cosmetic nail products, and	Skin
	Flammable soluble in water	synthesis of organic chemicals
	Pungent odor
Chloroform	Colorless	Pharmaceutical industry	Inhalation
	Sweet-smelling	Dyes and pesticides
	Dense liquid	Reagent
		Anesthetic