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Laboratorium voor Toxicologie, Universiteit Gent, Harelbekestraat 72, B-9000 Gent, Belgium
a Author for correspondence. Fax 32.9.264 81 97; e-mail Andre.DeLeenheer{at}rug.ac.be
| Abstract |
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Key Words: indexing terms: 4-aminophenol occupational medicine aniline stability
| Introduction |
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For use as a monitoring method to detect groups of workers at risk of (excessive) exposure to aniline, the determination of total p-aminophenol in urine specimens should be fast and simple to perform. Gas chromatography has been used to identify oxidation dyes, including aminophenols, on human hair (12). The method includes an extensive extraction procedure and involves mass spectrometry for detection. In another report, various phenols, including p-aminophenol, were extracted by supercritical fluid extraction and analyzed by using gas chromatography with atomic emission detection (13). This complex approach was not performed on biological samples, nor was it quantitative. Analysis of p-aminophenol by using HPLC is done for water analysis (14)(15), with direct injection or simple preconcentration, and to quantify p-aminophenol as a degradation product of paracetamol in aged pharmaceutical formulations after dissolution in methanol (16). One group reported the urinary analysis of various phenols, including p-aminophenol, by using HPLC and solvent extraction (10). However, the method was developed primarily for phenol and the cresols, resulting in the elution of the polar p-aminophenol in the eluent front. In real biological samples the p-aminophenol peak becomes completely obscured by endogenous urine constituents, preventing qualitative as well as quantitative interpretation. In our laboratory we were not able to reproduce this chromatographic method on real biological samples. The HPLC methods involve UV, fluorometric, and electrochemical detection. The latter principle, based on p-aminophenol being easily oxidized to p-iminoquinone, is also used in a p-aminophenol biosensor. That report involves this rather complex system to determine alkaline phosphatase activity after the catalyzed hydrolysis of p-aminophenylphosphate (17). The most frequently used method in biological exposure monitoring is, however, based on a simple colorimetric test in which p-aminophenol, after an acid hydrolysis step, is reacted with phenol in an alkaline medium to form an indophenol dye (2)(3)(18). The same principle was used in a procedure to measure paracetamol in serum after enzymatic hydrolysis (amidase) to an equimolar amount of p-aminophenol (19)(20). It provided a fast, simple, and reliable method, albeit for a 100-fold higher concentration interval.
Our aim was to develop and validate a suitable method for urinary p-aminophenol based on enzymatic deconjugation and the indophenol reaction and to automate it with a clinical analyzer to provide a simple and quick screening test to be used in toxicology and occupational medicine.
| Materials and Methods |
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calibrators
A stock solution of p-aminophenol was prepared by
dissolving 20 mg in 10 mL of acetonitrile. Serial dilution of this
stock solution with water yielded working solutions at concentrations
of 20, 50, 100, 200, 500, and 1000 mg/L. The stock solution and
subsequent aqueous calibration dilutions were all made in brown
glassware and on a daily basis, immediately before use, to avoid
deterioration.
samples
Urine samples were obtained from healthy adult volunteers, some
after having received a 500-mg paracetamol dose, or from potentially
exposed workers at the end of their workshift. The samples were kept in
well-closed containers, without additives, in the dark and
refrigerated. Before analysis their creatinine content was determined.
All procedures and experiments were in compliance with the regulations
and ethical standards of our university's ethical committee. Subjects
participating in the paracetamol experiment all gave informed consent.
instruments and equipment
Spectrophotometric studies were performed on a Philips Analytical
PU8740 UV/Vis Scanning Spectrophotometer with printer/plotter
(Cambridge, UK). A Roche Cobas Mira® (Basel,
Switzerland) automated clinical analyzer was used for the analysis
procedure. Dilutions of calibrator solutions were made with a Hamilton
Digital Dilutor (Bonaduz, Switzerland).
final method
Enzymatic hydrolysis.
All urine samples were first
adjusted to pH 5.0 with 2 mol/L HCl. Then, 900 µL of this urine was
mixed with 100 µL of H2O or aqueous calibrator in the
case of calibration samples. To 250 µL of this mixture in Roche
500-µL sample cups, 50 µL of an enzyme solution (sodium acetate
buffer 1 mol/L, pH
4.5:ß-glucuronidasearylsulfatase:H2O; 50:5:45) was
added. The cups were closed and incubated overnight for 1720 h at
37 °C.
Colorimetric assay.
In the final automated procedure,
three pipetting steps were used. CAPS buffer (160 µL; 100 mmol/L, pH
12.0) with 10 µL of an aqueous MnCl2 solution (1.0
mmol/L) and 2.5 µL of H2O (step 1) were mixed
consecutively with 10 µL of the color reagent (an aqueous 48.0 mmol/L
resorcinol solution) and 2.5 µL of H2O (step 2), and
finally 25 µL of the hydrolized sample with another 5 µL of water
wash (step 3). Absorbance measurements were made every 25 s and
the change in absorbance (
A) at 550 nm was calculated
between the initial absorbance and the absorbance after a total
incubation time of 15 min. The assay was performed at 37 °C.
Calibration.
For calibration purposes, urine samples
from healthy individuals were supplemented with the respective aqueous
calibrators to a final concentration of respectively 2.0, 5.0, 10.0,
20.0, 50.0, and 100.0 mg/L p-aminophenol. The samples were
taken through the whole analytical procedure and the resulting
calibration curve (
A vs concentration) was calculated by
using weighted least-squares regression analysis, with a weighing
factor of 1/x2. An intercept significantly
different from zero is obtained, as normal human urine always contains
a certain amount of p-aminophenol and is due to nonspecific
color production (vide infra) of the reagents in the alkaline medium.
For every analytical run, a sample for which urine was substituted by
doubly distilled water was analyzed in duplicate. The resulting
A allows a separate assessment of the contribution of the
nonspecific reagent coloration in the overall y-intercept
obtained by regression analysis. This value is then used in the
calibration and concentration calculations by subtracting it from the
individual
A values.
validation procedures
Precision.
The precision of the assay was evaluated by
using the NCCLS EP5 procedure with two replicates per specimen per run
and two runs per day for 20 days. Estimates of within-run and total
standard deviation were determined at low (2.5 mg/L), medium (50.0
mg/L), and high (90.0 mg/L) concentrations. A "blank" urine pool
was used to prepare supplemented samples on a daily basis, starting
from a freshly prepared stock solution, because unconjugated
p-aminophenol is very unstable in solution.
Accuracy.
Accuracy was evaluated by analyzing urine
samples, supplemented with known concentrations of
p-aminophenol (2.5, 50.0, and 90.0 mg/L), on 15 different
days. Again, a "blank" urine pool was used to prepare the samples
on a daily basis, starting from a freshly prepared stock solution.
Recovery of added analyte was calculated.
Sensitivity.
The detection limit of the assay, defined
as the concentration at a signal-to-noise ratio of 3, was determined by
analyzing, in fivefold, a "blank urine" and the same urine
supplemented at a concentration of 2.5 mg/L. The difference between the
means of both
A measurement sets (signal) was divided by
the difference between the highest and lowest
A reading
for the "blank" sample (noise). Both samples were serially diluted
and reanalyzed until a signal-to-noise ratio of 3 was obtained. The
limit of quantification was defined as the lowest point in the
calibration curve that can still be measured with acceptable
reproducibility (CV <15%).
Specificity.
To investigate the specificity of the
method, a urine pool (containing 13 mg/L p-aminophenol) was
supplemented with several drugs at a concentration of 100 mg/L and
related compounds at 50 mg/L. These samples were then batch analyzed,
in duplicate, with every five samples an aliquot of the "blank"
urine pool. The interference of each compound is calculated as the
apparent percent change in the p-aminophenol concentration
of the urine pool, relative to the amount added.
stability
A stability study for p-aminophenol was conducted over
a 40-day period. A urine pool was aliquoted into 1-mL portions, which
were kept either refrigerated (7 °C) or frozen (-20 °C). On a
regular basis, a sample of each set was analyzed and the
p-aminophenol concentration determined. As calibrator
solutions rapidly show discoloration on standing, this degradation
process, most probably oxidation, was also investigated. Aqueous
calibrator dilutions were prepared, as usual, in concentrations of 25
mg/L and 500 mg/L, aliquoted in 250-µL portions, and kept either
refrigerated or frozen. On several days within the 40-day period, a
sample of each set was used to supplement a "blank" urine, which
was then analyzed to determine the added concentration. In all cases
the samples were stored in the dark.
| Results and Discussion |
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Indophenol reaction.
The p-aminophenol color
formation reaction is based on the oxidative coupling with an aromatic
compound containing an electron-donating group, in an electrophilic
aromatic substitution. The resulting quinonimine dyes were already
produced in the early decades of industrial dyestuff chemistry
(23). In the serum paracetamol method
(19)(20), various color reagents were
investigated and the authors finally used 8-hydroxyquinoline. We found
this to be unsuitable for our p-aminophenol assay because
adaptation to the urine matrix and to the much lower concentrations we
aimed to detect inevitably resulted in precipitate formation in the
analyzer cuvette, inhibiting the photometric measurement. We also found
the reagents to be rather unstable in the alkaline buffer used.
Instead, we chose resorcinol as color reagent combined with a high-pH
buffer (CAPS, pH 12) and MnCl2 as an oxidant to increase
the speed of the oxidative coupling reaction. We used three separate
reagents, instead of one, combined in the CAPS buffer. Resorcinol is
readily oxidized in alkaline medium and MnCl2 is
transformed into MnO, which precipitates. These solutions, in water,
are stable for at least 1 month and can be prepared in higher
concentrations. This allows the use of smaller volumes in the reaction,
thus promoting the color intensity and consequently also the
sensitivity. We optimized the overall reaction for concentration of the
reagents, the order in which they are mixed, the measurement time, and
the final pH of the reaction mixture, which is directly related to the
intensity of the color. The criteria for optimization were always the
speed of the reaction, thus the time needed for completion, and the
linearity in the calibration, especially in the lower concentration
range.
The concentration of resorcinol as well as MnCl2 is
the lowest concentration for which the
A for a given
p-aminophenol concentration no longer increases with
increasing reagent concentration. The order in which the reagents are
mixed influenced the linearity of the calibration curve. We found that
adding the sample in the last step markedly improved the linearity in
the lower concentration range. All validation experiments have been
done for a measurement time of 10 as well as 15 min. A measurement time
of 15 min proved slightly better, and as the Cobas analyzer can start a
new pipetting sequence while a previous sample is being measured, an
extra 5 min of reaction only results in a marginal increase of analysis
time, even for a whole batch of samples. As can be seen from Fig. 1
, the final procedure resulted in a fast reaction that is
virtually complete within 10 to 15 min. From this figure it is also
clear that a certain amount of color formation (increased absorbance
reading) starts after addition of the resorcinol (second small square)
to the alkaline medium and before sample is added (third small square),
because the Cobas analyzer combines every addition step with an
absorption measurement. This is the nonspecific color formation, as
already mentioned, that is independent of the sample and that is
accounted for in the calibration.
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Upscaling of the reaction allowed a spectrum to be taken of the
indophenol reaction product. Fig. 2
shows this spectrum, and it is clear that a broad maximum is
achieved at 576 nm. The Cobas Mira analyzer has filters for a limited
number of wavelengths, of which 550 and 600 could be used. We explored
both and found that at 550 nm, better linearity was consistently
obtained in the calibration process.
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assay validation
Precision.
Samples supplemented with
p-aminophenol at three different concentrations were
analyzed and the supplemented concentration calculated with a complete
set of calibrators for every measurement batch. In Table 1
the obtained within-run and total reproducibilities are
presented for the three concentrations. CVs are very good for the
medium and high concentrations. For the low concentration the
reproducibility was somewhat worse, although still very much
acceptable. In this respect, a distinct influence of the linear
regression calibration was observed because a small change in the
response for one of the higher points resulted in a comparatively large
effect on the accuracy of the samples with low concentrations. The
protocol equally permits separate estimation of day-to-day and
between-run reproducibility, and these were all close to zero. We
deviated from the NCCLS protocol in one way: Because of the instability
of p-aminophenol in aqueous solutions, the supplemented
samples were freshly prepared on a daily basis instead of batch
prepared once before the whole experiment. Consequently, one aspect of
the reproducibility data is due to natural variations in the weighing
and diluting process of preparing the samples.
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Accuracy.
The accuracy of the assay, as assessed by the
analytical recovery of calibrators added to urine, was (mean ±
SD, n = 15) 102.8 ± 7.3% for a concentration of 2.5 mg/L,
103.9 ± 3.6% for a concentration of 50.0 mg/L, and 96.8 ±
3.0% for a concentration of 90.0 mg/L. Both the accuracy and precision
data illustrate the suitability of the proposed assay for the
quantitative analysis of p-aminophenol in urine under normal
physiological conditions (below ± 10 mg/L (1)) as
well as after exposure.
Calibration curves and linearity.
We preferred to
construct calibration curves in the same matrix, urine, as the unknown
samples to be analyzed. In this way, potential interferences of the
matrix, either promoting or inhibiting the color formation, were to a
large extent accounted for. Moreover, the use of non-matrix calibrators
represents no real advantage in terms of benchwork or analysis time as
no extraction step is present. To maximally improve the accuracy and
precision in the lower concentration interval, the calibration curves
were constructed by using weighted linear regression analysis. A
weighing factor of 1/x2 emphasizes the
importance of the lower calibration concentrations and drastically
improves their respective residuals. All of the calibration plots
generated gave a good linear response, and a correlation coefficient of
>0.999 was observed between the
A and the various
calibration concentrations. We found a slope of (mean ± SD,
n = 5) 0.00529 ± 0.00034 (mean SE of slope 0.00073), an
intercept of 0.06167 ± 0.00826 (mean SE of intercept 0.03406),
and a mean SE of estimate of 0.06202.
The already-mentioned nonspecific coloration, which is used in the
concentration calculations, is an unfortunate result from the
discoloration of resorcinol when added to the alkaline medium. Upon
using a urine matrix for calibration, the y-intercept one
gets in regression analysis is made up of both "endogenous"
p-aminophenol and this nonspecific coloration. When an
endogenous compound in supplemented calibrators results in a
substantial y-intercept, unknowns are corrected accordingly
in the calculations. Use of the overall intercept in this case would,
however, incorrectly overestimate the unknowns, as it consists of a
part, the nonspecific coloration, present in calibrators as well as
unknowns for which no correction is needed. It is therefore neccesary
to assess both contributions independently. The nonspecific coloration
can, logically, not be assessed with the urine matrix, as this always
contains a certain amount of p-aminophenol. It is therefore
measured in a water sample together with each calibration, then the
resulting
A is subtracted in the calculations from all
measured
A values.
In a separate series of experiments, we investigated and confirmed the
validity of this procedure. Through the found nonspecific coloration in
water samples, the p-aminophenol concentration of several
different batches of blank urine (from volunteers ages 2675) could be
measured by using the standard calibration approach. Subsequent use of
these different urines (n = 9) to prepare and analyze eight
individual calibration curves then allowed the calculation of the
nonspecific coloration for each of these urine batches from the
resulting overall y-intercept minus the respective
previously assessed "endogenous" p-aminophenol
concentration. All nonspecific coloration measurements (0.035888
± 0.001940, mean
A ± SD), either in water or in
urines of different sources, were equal, disregarding natural
variances.
Sensitivity.
We calculated the detection limit of the
assay to be 0.9 mg/L p-aminophenol. By using the
aforementioned definition, a concentration of 2.0 mg/L was considered
the limit of quantification. Taking into consideration the
concentrations of p-aminophenol found in individuals without
occupational exposure (below ± 10 mg/L) or with possible
nonoccupational exposure, which is managed by establishing a biological
threshold limit in the order of 30 mg/L (1)(2)(3),
our objective of a monitoring test to detect groups of workers at risk
is more than met. When considering analytical sensitivity, defined as
the ability of an analytical procedure to produce a change in signal
for a defined change in quantity, one can see from the slope of the
calibration curve that the assay does not perform equally well. We
found it impossible to enhance the obtained signal for a defined change
in quantity through various optimization experiments.
Specificity.
The method proved to be highly specific for
p-aminophenol. We analyzed several commonly used
prescription drugs and drugs of abuse as well as some related compounds
likely to be potential interferents on the basis of their chemical
structure. Table 2
presents the results we found for these compounds, the
interference calculated as described before. No significant
interference was present, especially not when the within-run variation
data are considered. To our knowledge and after an extended
computerized literature search, no reference-quality method or
generally accepted thoroughly documented alternative providing
quantitative data (in urine) was available for a comparison-of-methods
study. Earlier screening methods especially lack an in-depth
quantitative approach, which precludes sample data comparison.
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application of the assay
In an early stage of our research, a stability study was initiated
because it was obvious that p-aminophenol in solution
(especially in protic solvents such as water and methanol) is very
unstable and readily oxidizes. We used the quantitative aspect of our
assay to observe the concentration change in time of samples (urinary
or aqueous) kept under various conditions. In Fig. 3
A, a graphical representation of the stability of urinary
p-aminophenol is shown. As we analyzed a normal human urine
pool, the "endogenous" p-aminophenol is mainly in the
conjugated form. Under these conditions, measured
p-aminophenol concentrations are stable over at least a
40-day period, whether kept frozen or refrigerated. The stability of an
aqueous solution of p-aminophenol is illustrated in Figs. 3B
and C. Obviously, the unconjugated compound is much less stable and
degrades quickly when kept nonfrozen. The degradation of free
p-aminophenol is most probably due to oxidation to a
quinonimine, at least in a first stage, quickly resulting in a visible,
brown discoloration. Conjugation, either glucurono- or sulfo-, prevents
this inital step, thus protecting the compound. A marked difference was
observed when solutions were prepared in solvents such as water,
methanol, ethanol, or acetone vs acetonitrile. Very early in our
experimental work we found that solutions made in the latter solvent
turned brown at a much slower rate. We therefore used this solvent in
the preparation of the stock calibrator solution.
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The final assay procedure is being used in our laboratory in an ongoing
occupational health screen. It is essential that samples be taken at
the end of the (potential) exposure or within 2 h after exposure
because 89% of p-aminophenol is eliminated within 24 h
postexposure (3). A total of 140 samples have so far been
analyzed by using the final analysis scheme, and in Fig. 4
, a frequency distribution of the measured concentrations is
presented. Although sources differ, an alarming exposure to aniline is
suspected when the p-aminophenol concentration in urine
exceeds 50 mg/L, and a reasonable biological threshold limit value is
proposed in the order of 30 mg/L (1). None of the samples
examined so far exceeded this limit.
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To evaluate the possible influence of normal-dose paracetamol intake on
p-aminophenol excretion, six volunteers (4 men and 2 women,
ages 2775) were asked to take a 500-mg paracetamol dose immediately
after producing a blank urine sample. All (at least 4 to up to 8)
following urine voidings were collected and analyzed. The results are
shown in Fig. 5
. The peak p-aminophenol excretion occurs around 2 to
4 h after intake, and it remains <25 mg/L. Also, the
p-aminophenol concentration quickly normalizes ~6 h after
intake. Consequently, one can reasonably conclude that, considering the
50 mg/L alarming exposure limit, paracetamol intake does not interfere
with the value of the test for occupational health screening purposes.
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The proposed colorimetric assay provides a fast and simple way for the quantitative determination of urinary p-aminophenol. It differs from the existing p-aminophenol measurement approaches in its automation, its fully validated quantitative aspect, its operational simplicity, and it being specifically adapted to urine analysis. It can advantageously be used in routine clinical laboratories in toxicology and occupational medicine.
| Acknowledgments |
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| References |
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The following articles in journals at HighWire Press have cited this article:
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C.-F. Chen, Y.-T. Tseng, H.-K. Tseng, and T.-Z. Liu Automated Spectrophotometric Assay for Urine p-Aminophenol by an Oxidative Coupling Reaction Ann. Clin. Lab. Sci., July 1, 2004; 34(3): 336 - 340. [Abstract] [Full Text] [PDF] |
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