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Exposure to Ethylene Oxide in Hospitals: Biological Monitoring and Influence of Glutathione S-Transferase and Epoxide Hydrolase Polymorphisms

¹ Industrial Toxicology and Occupational Medicine Unit, Catholic University of Louvain, Brussels, Belgium and ² Occupational and Environmental Medicine Unit, ³ Staff Safety and Environment, and ⁴ Department of Biostatistics, University of Zurich, Zurich, Switzerland

Requests for reprints: Philippe Hotz, Occupational and Environmental Medicine Unit, University of Zurich, Medizinische Poliklinik USZ, Rämistrasse 100, CH-8091 Zurich, Switzerland. Phone: 41-44-255-97-47; Fax: 41-44-255-98-52. E-mail: philipp.hotz{at}usz.ch

Ethylene oxide is considered as a human carcinogen. A biomarker of exposure would be a useful instrument to assess the risk in occupationally exposed workers. This cross-sectional study aimed at examining (a) whether the urinary excretion of a metabolite of ethylene oxide, 2-hydroxyethyl mercapturic acid (HEMA), could be used for monitoring occupational exposure and (b) whether glutathione S-transferase (GST) and epoxide hydrolase genotypes influenced biological monitoring. Exposure to ethylene oxide was measured by personal sampling in 80 hospital workers (95% of those eligible). HEMA concentrations were determined in three urine samples (baseline, end of shift, and next morning) by liquid chromatography with tandem mass spectrometry. GSTs (GSTT1, GSTM1, and GSTP1) and epoxide hydrolase (EPHX1) were also genotyped. The influence of exposure, genotypes, and several other factors was examined in multiple regression analyses. Exposure was always <1 parts per million. On a group basis, exposure and a non-null GSTT1 genotype increased the HEMA concentrations in the urine sample collected at the end of the shift and these factors remained statistically significant after considering possible confounding or modifying factors. (Cancer Epidemiol Biomarkers Prev 2007;16(4):796–802)