Ambient Melamine Exposure and Urinary Biomarkers of Early Renal Injury.

Information about environmental exposure to melamine and renal injury in adults is lacking. We investigated this relationship in 44 workers at two melamine tableware manufacturing factories in Taiwan (16 manufacturers, eight grinders, ten packers, and ten administrators) and 105 nonexposed workers (controls) at one shipbuilding company who were enrolled in August-December of 2012. For melamine workers, personal and area air samples were obtained at the worksite over 1 workweek (Monday-Friday). In the same week, pre- and post-shift one-spot urine samples were collected each workday and one first-spot urine sample was collected on each weekend morning and the following Monday morning. For each control, a one-spot urine sample was collected on Friday morning. A blood sample was also obtained from each participant at this time. Melamine levels were measured in air, urine, and serum, and early renal injury biomarkers were measured in urine. Urinary melamine concentrations in manufacturers increased sharply between pre- and post-shift measurements on Monday, remained significantly elevated throughout the workweek, and decreased over the weekend; changes in urinary melamine concentrations were substantially lower for other melamine workers. Manufacturers were exposed to the highest concentrations of ambient melamine and had significantly higher urinary and serum melamine concentrations than did the controls (P<0.001). Urinary melamine levels were positively associated with urinary N-acetyl β-d-glucosaminidase (NAG) levels but not microalbumin levels, and the detectable β2-microglobulin rate increased in the manufacturers group. In conclusion, ambient melamine exposure may increase the levels of urinary biomarkers of renal tubular injury in this occupational setting.

[1]  L. Trasande,et al.  Dietary phthalates and low-grade albuminuria in US children and adolescents. , 2014, Clinical journal of the American Society of Nephrology : CJASN.

[2]  V. Jha,et al.  Chronic kidney disease: global dimension and perspectives , 2013, The Lancet.

[3]  Kai-Uwe Eckardt,et al.  Evolving importance of kidney disease: from subspecialty to global health burden , 2013, The Lancet.

[4]  Yongning Wu,et al.  Analytical chemistry, toxicology, epidemiology and health impact assessment of melamine in infant formula: recent progress and developments. , 2013, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[5]  Yi-Ting Lin,et al.  Can melamine levels in 1-spot overnight urine specimens predict the total previous 24-hour melamine excretion level in school children? , 2013, Clinica chimica acta; international journal of clinical chemistry.

[6]  Ming-Tsang Wu,et al.  A crossover study of noodle soup consumption in melamine bowls and total melamine excretion in urine. , 2013, JAMA internal medicine.

[7]  G. Xie,et al.  Melamine-Induced Renal Toxicity Is Mediated by the Gut Microbiota , 2013, Science Translational Medicine.

[8]  Ming-Tsang Wu,et al.  Melamine induces human renal proximal tubular cell injury via transforming growth factor-β and oxidative stress. , 2012, Toxicological sciences : an official journal of the Society of Toxicology.

[9]  M. Yassine,et al.  Development of a hydrophilic interaction liquid chromatography-mass spectrometry method for detection and quantification of urea thermal decomposition by-products in emission from diesel engine employing selective catalytic reduction technology. , 2012, Journal of chromatography. A.

[10]  D. Barr,et al.  Quantification of melamine in human urine using cation-exchange based high performance liquid chromatography tandem mass spectrometry. , 2012, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[11]  J. Coombes,et al.  Biomarkers in chronic kidney disease: a review. , 2011, Kidney international.

[12]  Ming-Tsang Wu,et al.  Low exposure to melamine increases the risk of urolithiasis in adults. , 2011, Kidney international.

[13]  J. Chan,et al.  Hong Kong Chinese school children with elevated urine melamine levels: A prospective follow up study , 2011, BMC public health.

[14]  E. Siew,et al.  Biological markers of acute kidney injury. , 2011, Journal of the American Society of Nephrology : JASN.

[15]  Ming-Tsang Wu,et al.  High melamine migration in daily-use melamine-made tableware. , 2011, Journal of hazardous materials.

[16]  Serafino Pantano,et al.  Urinary clusterin, cystatin C, β2-microglobulin and total protein as markers to detect drug-induced kidney injury , 2010, Nature Biotechnology.

[17]  Gang-yi Liu,et al.  Determination of melamine and cyanuric acid in human urine by a liquid chromatography tandem mass spectrometry. , 2010, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[18]  W. Cheng,et al.  Determination of urine melamine by validated isotopic ultra-performance liquid chromatography/tandem mass spectrometry. , 2009, Rapid communications in mass spectrometry : RCM.

[19]  G. Chertow,et al.  Melamine nephrotoxicity: an emerging epidemic in an era of globalization. , 2009, Kidney international.

[20]  Samson S. Y. Wong,et al.  Diagnosis and spectrum of melamine-related renal disease: plausible mechanism of stone formation in humans. , 2009, Clinica chimica acta; international journal of clinical chemistry.

[21]  J. Toribio,et al.  Contact allergic dermatitis from melamine formaldehyde resins in a patient with a negative patch-test reaction to formaldehyde. , 2008, Dermatitis : contact, atopic, occupational, drug.

[22]  E. Elm,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies , 2007, The Lancet.

[23]  S. Pocock,et al.  Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies , 2007, BMJ : British Medical Journal.

[24]  S. Ellenberg.  Food and Drug Administration (FDA) , 2005 .

[25]  T. Estlander,et al.  Formaldehyde‐negative allergic contact dermatitis from melamine‐formaldehyde resin , 2003, Contact dermatitis.

[26]  E. Zimerson,et al.  Occupational dermatoses in composite production. , 1999, Journal of occupational and environmental medicine.

[27]  R. Stone,et al.  Lung cancer mortality among industrial workers exposed to formaldehyde: a Poisson regression analysis of the National Cancer Institute Study. , 1992, American Industrial Hygiene Association journal.

[28]  A. Choobineh,et al.  Respiratory morbidity induced by occupational inhalation exposure to formaldehyde. , 2011, Industrial health.

[29]  S. Pocock,et al.  [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies]. , 2008, Revista espanola de salud publica.

[30]  Manoj Kumar.  STONE DISEASE _______________________________________________________________ Obesity, weight gain, and the risk of kidney stones , 2005 .

[31]  B. N. Gupta,et al.  Clinical evaluation of workers handling melamine formaldehyde resin. , 1992, Journal of toxicology. Clinical toxicology.

[32]  R. G. Price.  The role of NAG (N-acetyl-beta-D-glucosaminidase) in the diagnosis of kidney disease including the monitoring of nephrotoxicity. , 1992, Clinical nephrology.

[33]  Price Rg.  The role of NAG (N-acetyl-beta-D-glucosaminidase) in the diagnosis of kidney disease including the monitoring of nephrotoxicity. , 1992 .

[34]  K. Peltonen,et al.  Determination of melamine in air by high-performance liquid chromatography with ultraviolet detection. , 1987, Journal of chromatography.