Determination of Carcinogenic Toluena Detox Mass In Printing Industrial Workers In Surabaya

Background This study aims to calculate the intake of foods rich in CYP2E1 enzymes and glutathione to increase toluene detoxication. Methods has the while has concentration. shows fats bind exposure sum, weighted


Results
All respondents who were at work showed benzene concentrations below the threshold value (TLV). Foods containing CYP2E1 enzyme included beef liver, salmon and sh oil while food with glutathione included grapes, avocados and asparagus.

Conclusion
Adequacy levels of CYP2E1 enzymes and glutathione are different and varied. The effective dose required by each respondent depends on body weight, length of work, and toluene concentration at work.
In sum, the greater the toluene concentration, the greater the dietary needs which are rich in enzymes and CYP2E1 glutathione. Each respondent can choose benzene detox food depending on their needs and appetite.

Background
Almost every workplace has a threat in the form of hazardous chemicals. One source of danger is found in printing industry 1 . One of the chemicals in question is toluene 2 . Toluene is safe for the environment and health if it does not exceed the threshold value of 50ppm 3 .
In printing, toluene is used as an organic solvent used in various processes 4 . Aside from being a solvent, the volatile property makes it desirable as a fast-drying and useful printing material on high-speed printing presses. Its use dominates work activities (75%). The biggest use of toluene (around 50-200 ppm or 188 mg / m 3 ) is done in the automatic cleaning process 5 . Toluene (C 6 H 5 CH 3 ) is an aromatic hydrocarbon group with the physical properties of colorless, sweetsmelling and spicy liquid like benzene. Toluene is soluble in diethyl ether, ethanol, benzene, chloroform, glacial acetic acid, carbon disul de and acetone, insoluble in cold water with water solubility of 0, 561 g / L at 25 o C 6 7 . Short-term toluene exposure occurs through inhalation, eye contact, skin contact and swallowing. In the long run this enters the body by inhalation. It causes damage to the liver and kidneys, peripheral nerve neuropathy, changes in the bone marrow, etc. This can happen if workers do not use Personal Protective Equipment (PPE) such as gloves and masks 9 .
Activities to reduce or even eliminate toxins in chemical compounds in the body that usually use biotransformation 10 11 . Biotransformation is a change in catalysts that are catalyzed by certain enzymes in living things. The aim is to convert nonpolar to polar, then hydrophilic so that it can be removed from the body. Biotransformation occurs in two phases. The rst phase is the functional phase where the functional group matches the oxidation, reduction and hydrolysis reactions. Then the second phase is the phase of the conjugate reaction which involves several types of endogenous metabolites in the body in the endoplasmic reticulum 12 .
This can be performed by using food as a detoxi cation. The food ingredients used need to contain certain substances, for example CYP2E1 enzyme and Glutathione. Foods that contain CYP2E1 include sh oil, salmon and beef liver 13 . Foods that contain glutathione are asparagus, avocados and grapes 14 .

This is in line with a research conducted by Abdul Rohim Tualeka, et al in 2019 on Requirements
Prediction for Toluene Detox with Foods Intake Rich in CYP2E1 Enzyme and Glycine to Prevent Nerve and Kidney Damage at Shoe Home Industry Workers in Romokalisari Surabaya, which concluded that the level of adequacy everyone's enzymes and glycine CYP2E1 are different and varied. This suggests that the greater the concentration of toluene, the greater the food requirements which are rich in the enzyme and CYP2E1 glycine 15 . Even so, research using the food approach as a detoxi cation of toluene is limited.
Based on the background above, this study aims to calculate the intake of foods rich in CYP2E1 enzymes, namely sh oil, salmon and beef liver as well as glutathione-rich foods such as asparagus, avocados and grapes as detoxi cation of toluene in the printing industry in Surabaya. An effective dose is also needed for detoxi cation of toluene.

Method
The research design used was a cross sectional method. Research subjects were workers in the printing industry in Surabaya with a total sample of 30 respondents. The variables calculated were toluene concentrations, average work per day (hours) of respondents, duration of work (years), working time per week (days) and body weight. Measurement of toluene concentrations in the work environment used the NIOSH 1501 (2003) measurement method with aromatic hydrocarbon sampling methods. Air samples were taken using a personal calibrated sampler pump. The lter used to absorb toluene vapor is SKC 226-01 charcoal tube. Air samples were analyzed using Gas Chromatography-Flame Ionization Detector (GC- 16 . Measurements of the average work day, duration of work per year and working time per week were performed by using in-depth interviews with respondents. Measurement of respondent's body weight used manual measurement method with body scale. Willingness to participate in the study was made in writing through informed consent and this study had received prior ethical approval by the Ethics Committee of the Faculty of Public Health, Airlangga University.
After all variables were obtained, the respiratory rate and toluene intake of carcinogens per respondent were determined. Below is the formula for toluene carcinogenic intake per respondent per day: After the detox enzyme mass value per respondent per day was obtained, the mass calculation of toluene detox food per day was calculated using the following formula: Below are the enzymes contained in 100 grams of food Comparative diagram analysis between toluene concentration and respondent's weight shows that the respondent with the highest weight has the highest toluene concentration, while the respondent with the smallest weight has average toluene concentration. Research based on the research of Faradisha, et al in 2019 shows that toluene compounds are lipophilic (fat soluble) fats will bind toluene into residues in the body. It is assumed that the more obese respondents affected by toluene, the higher the health risk due to exposure toluene 18 . In sum, there is lower toluene toxicity in obese people than in low weighted people.

Detoxi cation of Toluene by Foods Rich in CYP2E1 Enzymes
The negative impact of toluene exposure on printing workers can be reduced or even eliminated, one way is by detoxifying the body's poisons. One detoxi cation method that can be used is food. Several publications using cells, animals, and clinical studies have shown that food-based components and nutrients can modulate the process of conversion and excretion of toxins from the body 19 . About 25-40% of toluene is inhaled by humans, then expelled by expiration. The remaining 60-75% are metabolized in the liver to benzyl alcohol.
Toluene will be converted to benzyl alcohol through a hydroxylation reaction. The reaction was carried out by members of the cytochrome P450 (CYP) in the liver, namely CYP1A1, CYP1A2, CYP2B6, CYP2C8, and CYP2E1 20 . Then, benzyl alcohol will be metabolized into benzaldehyde by CYP and alcohol dehydrogenase enzymes through oxidation reactions. CYP is more active than the alcohol dehydrogenase enzyme. A small amount of benzaldehyde will be converted to benzylmercapturic acid, while most of the other will be converted to benzoic acid. Benzoic acid will be metabolized to hippuric acid, which will be excreted through urine 21 .
Consumption of suitable substances can detoxify toluene from the body, such as foods that contain the enzyme CYP2E1. High concentrations of the CYP2E1 enzyme are found in some foods such as beef liver, salmon and sh oil. The content of the CYP2E1 enzyme in 100 grams of beef liver is 5.6 mg, in 100 grams of salmon is 6.6 mg and 100 grams of sh oil is 7.2 22 .
In Fig. 3, the effective dosage of each food is different depending on the individual's physical and toluene levels in his body. The higher the concentration of toluene, the higher the mass of toluene detoxi cation for beef liver, salmon and sh oil. This effective dose is also in uenced by the weight and duration of work of the worker. This research is based on previous research, which states that it has a synergistic relationship with the concentration of substances 23 . Detox toluene food can be selected by each respondent based on their toluene concentration and taste. If the respondent is not interested in consuming beef liver, they can consume salmon, sh oil and vice versa. The consumption of each food can be arranged by each respondent and divided into several days according to the needs of the respondent's food intake.

Detoxi cation of Toluene by Foods Rich in Glutathione
The enzyme responsible for glutathione metabolism is the enzyme glutathione s-transferase (GST). It involves antioxidant responsive elements and xenobiotic response elements. Many foods upregulate this enzyme, including avocados, asparagus, grapes, broccoli, carrots, tomatoes, etc. Genetic, gender, and perhaps body weight variations can play a role in the effects of dietary factors on the GST enzyme 24 .
In addition to foods containing the CYP2E1 enzyme, foods containing glutathione are also bene cial in this regard. High concentrations of glutathione are found in some foods such as avocados, asparagus and grapes. The content of glutathione in 27.7 grams of avocado, 100 grams of asparagus 28.3 and in 100 grams of wine is 7,9 25 .
Based on the results of an effective dose of avocado, asparagus and grapes that the body needs to detox toluene from the body as shown in Fig. 4, the effective dose of each food differs depending on the individual's physical and toluene levels in his body. The higher the concentration of toluene, the higher the mass of toluene detoxi cation. This effective dose is also in uenced by the weight and duration of work of the worker. Detox toluene food can be selected by each respondent based on their toluene concentration and taste. If the respondent is not interested in consuming avocados, they can consume asparagus, grapes and vice versa. The consumption of each food can be arranged by each respondent and divided into several days according to the needs of the respondent's food intake.

Conclusion
All respondents were at work with toluene concentrations below the threshold value (TLV). Food intake containing CYP2E1 enzymes (beef liver, salmon and sh oil) and gluttation (avocado, asparagus and grapes) is expected to increase toluene detoxi cation. The effective dose required by the respondent depends on body weight, length of work, and toluene concentration at work. The higher the concentration of toluene, the higher the food needs to contain the enzyme CYP2E1 and glutathione that the body needs.    Effective Doses of Foods Containing Glutathione for Toluene Detox