Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Can prosthetic limbs made too quickly cause kidney damage?: a pilot study

  • Petrofsky, Jerrold S. (Department of Physical Therapy, School of Allied Health Professions, Loma Linda University) ;
  • Browne, Mary (Program in Orthotics and Prosthetics, Department of Physical Therapy, School of Allied Health Professions, Loma Linda University) ;
  • Jamshidi, Mahyar (Program in Orthotics and Prosthetics, Department of Physical Therapy, School of Allied Health Professions, Loma Linda University) ;
  • Libo-on, Anthony (Program in Orthotics and Prosthetics, Department of Physical Therapy, School of Allied Health Professions, Loma Linda University) ;
  • Lee, Haneul (Department of Physical Therapy, School of Allied Health Professions, Loma Linda University)
  • Received : 2014.11.03
  • Accepted : 2014.11.30
  • Published : 2014.10.26
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The use of chemicals for building prosthetic sockets present the possibility of being hazardous and unsafe due to off-gassing. The purpose of the present study was to investigate if freshly made materials used in prosthetic sockets causes off-gassing that would penetrate the skin and cause damage to the kidneys or blood. Design: Cross-sectional study. Methods: In this research, the off-gassing effects during the initial curing process of styrene monomer, vinyl ester resin, epoxy methacrylate resin, benzene-1, 3-dimethaneamine, trimethylhexanedlamine, and paratertiarybutylphenol were analyzed. Acid detection strips were placed inside newly fabricated mock-prosthetic sockets and left overnight in a closed environment to find out if acid was present in the invisible fumes. The plastic was worn by 9 subjects and urinalysis was made after 48 hours to test for any kidney or blood toxicity of the resins. Results: After wearing the plastic cuff for 48 hours, the ratio of protein to creatinine in the urine was raised to an abnormal level in five out of nine subjects. Four out of the nine subjects showed normal protein to creatinine ratios after wearing the device. The results showed that damage to the kidney occurred from wearing the resins after curing in half of the subjects. Conclusions: It is very important to conduct patient intakes which includes the assessment of renal function. Off-gassing in vented chambers may be needed to protect both prosthetists and patients.

Keywords

References

  1. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil 2008;89:422-9. https://doi.org/10.1016/j.apmr.2007.11.005
  2. Adams PF, Hendershot GE, Marano MA; Centers for Disease Control and Prevention/National Center for Health Statistics. Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10 1999;(200):1-203.
  3. Keogh K. Improving diabetes advice could reduce the need for amputations. Nurs Stand 2014;29:11. https://doi.org/10.7748/ns.29.2.11.s13
  4. Ahmad N, Thomas GN, Gill P, Chan C, Torella F. Lower limb amputation in England: prevalence, regional variation and relationship with revascularisation, deprivation and risk factors. A retrospective review of hospital data. J R Soc Med 2014;107:483-9. https://doi.org/10.1177/0141076814557301
  5. Ahmad N, Thomas GN, Chan C, Gill P. Ethnic differences in lower limb revascularisation and amputation rates. Implications for the aetiopathology of atherosclerosis? Atherosclerosis 2014;233:503-7. https://doi.org/10.1016/j.atherosclerosis.2013.12.039
  6. Assi R, Al Azzi Y, Protack CD, Williams WT, Hall MR, Wong DJ, et al. Chronic kidney disease predicts long-term mortality after major lower extremity amputation. N Am J Med Sci 2014;6:321-7. https://doi.org/10.4103/1947-2714.136910
  7. Smith DG, Michael JW, Bowker JH, American Academy of Orthopaedic Surgeons. Atlas of amputations and limb deficiencies: surgical, prosthetic, and rehabilitation principles. 3rd ed. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2004.
  8. Marks GE. Manual of artificial limbs ... an exhaustive exposition of prothesis. New York: A. A. Marks; 1905.
  9. Watson BA. A treatise on amputations of the extremities and their complications. Philadelphia: P. Blakiston Son & Co.; 1885.
  10. Lesage J, Stanley J, Karoly WJ, Lichtenberg FW. Airborne methylene diphenyl diisocyanate (MDI) concentrations associated with the application of polyurethane spray foam in residential construction. J Occup Environ Hyg 2007;4:145-55. https://doi.org/10.1080/15459620601133779
  11. Meylemans HA, Harvey BG, Reams JT, Guenthner AJ, Cambrea LR, Groshens TJ, et al. Synthesis, characterization, and cure chemistry of renewable bis(cyanate) esters derived from 2-methoxy-4-methylphenol. Biomacromolecules 2013;14:771-80. https://doi.org/10.1021/bm3018438
  12. Kaaria K, Hirvonen A, Norppa H, Piirila P, Vainio H, Rosenberg C. Exposure to 2,4- and 2,6-toluene diisocyanate (TDI) during production of flexible foam: determination of airborne TDI and urinary 2,4- and 2,6-toluenediamine (TDA). Analyst 2001;126:1025-31. https://doi.org/10.1039/b102022f
  13. Kaaria K, Hirvonen A, Norppa H, Piirila P, Vainio H, Rosenberg C. Exposure to 4,4'-methylenediphenyl diisocyanate (MDI) during moulding of rigid polyurethane foam: determination of airborne MDI and urinary 4,4'-methylenedianiline (MDA). Analyst 2001;126:476-9. https://doi.org/10.1039/b009549o
  14. Vilanova WV, Carvalho-Junior JR, Alfredo E, Sousa-Neto MD, Silva-Sousa YT. Effect of intracanal irrigants on the bond strength of epoxy resin-based and methacrylate resin-based sealers to root canal walls. Int Endod J 2012;45:42-8. https://doi.org/10.1111/j.1365-2591.2011.01945.x
  15. Scarparo RK, Grecca FS, Fachin EV. Analysis of tissue reactions to methacrylate resin-based, epoxy resin-based, and zinc oxide-eugenol endodontic sealers. J Endod 2009;35:229-32. https://doi.org/10.1016/j.joen.2008.10.025
  16. Kolstad HA, Juel K, Olsen J, Lynge E. Exposure to styrene and chronic health effects: mortality and incidence of solid cancers in the Danish reinforced plastics industry. Occup Environ Med 1995;52:320-7. https://doi.org/10.1136/oem.52.5.320
  17. Romaguera C, Grimalt F, Vilaplana J. Paratertiary butylphenol formaldehyde resin in prosthesis. Contact Dermatitis 1985;12:174.
  18. Kark RM. A primer of urinalysis. 2nd ed. New York: Hoeber; 1963.
  19. Graff L. A handbook of routine urinalysis. Philadelphia: Lippincott; 1983.
  20. Harr RR. Medical laboratory science review. 4th ed. Philadelphia: F.A. Davis; 2013.
  21. Hook JB. Toxicology of the kidney. New York: Raven Press; 1981.
  22. Spitalnik SL, Arinsburg SA, Jhang JS. Clinical pathology: board review. Philadelphia, PA: Elsevier Saunders; 2015.
  23. Ricotta MC. A consumer's guide to laboratory tests. Amherst, NY: Prometheus Books; 2005.
  24. Lippincott Williams & Wilkins. Professional guide to diagnostic tests. Philadelphia: Lippincott Williams & Wilkins; 2005.
  25. Race GJ, White MG. Basic urinalysis. Hagerstown, Md: Medical Dept., Harper & Row; 1979.
  26. Rennke HG, Denker BM. Renal pathophysiology: the essentials. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2010.
  27. American Society of Clinical Pathologists. Council on Clinical Chemistry. Workshop on urinalysis and renal function studies. Chicago: 1962.
  28. Arneill JR. Clinical diagnosis and urinalysis. A manual for students and practitioners. Philadelphia and New York: Lea Brothers & Co.; 1905.
  29. Bourne LB, Milner FJ, Alberman KB. Health problems of epoxy resins and amine-curing agents. Br J Ind Med 1959;16:81-97.
  30. Zeliger HI. Lipophilic chemical exposure as a cause of cardiovascular disease. Interdiscip Toxicol 2013;6:55-62.
  31. Zeliger HI. Lipophilic chemical exposure as a cause of type 2 diabetes (T2D). Rev Environ Health 2013;28:9-20.
  32. Mogensen CE, Schmitz O. The diabetic kidney: from hyperfiltration and microalbuminuria to end-stage renal failure. Med Clin North Am 1988;72:1465-92. https://doi.org/10.1016/S0025-7125(16)30717-9
  33. Montaguti P, Melloni E, Cavalletti E. Acute intravenous toxicity of dimethyl sulfoxide, polyethylene glycol 400, dimethylformamide, absolute ethanol, and benzyl alcohol in inbred mouse strains. Arzneimittelforschung 1994;44:566-70.
  34. Matanoski GM, Tao XG. Styrene exposure and ischemic heart disease: a case-cohort study. Am J Epidemiol 2003;158:988-95. https://doi.org/10.1093/aje/kwg247
  35. Matanoski GM, Tao X. Case-cohort study of styrene exposure and ischemic heart disease.Res Rep Health Eff Inst 2002;(108):1-29; discussion 31-7.
  36. Matanoski G, Elliott E, Tao X, Francis M, Correa-Villasenor A, Santos-Burgoa C. Lymphohematopoietic cancers and butadiene and styrene exposure in synthetic rubber manufacture. Ann N Y Acad Sci 1997;837:157-69. https://doi.org/10.1111/j.1749-6632.1997.tb56872.x
  37. Schwartz MD, Dell'Aglio DM, Nickle R, Hornsby-Myers J. Federal environmental and occupational toxicology regulations and reporting requirements: a practical approach to what the medical toxicologist needs to know, part 2. J Med Toxicol 2014;10:415-27. https://doi.org/10.1007/s13181-014-0411-6
  38. Schwartz MD, Dell'Aglio DM, Nickle R, Hornsby-Myers J. Federal environmental and occupational toxicology regulations and reporting requirements: a practical approach to what the medical toxicologist needs to know, part 1. J Med Toxicol 2014;10:319-30. https://doi.org/10.1007/s13181-014-0410-7