Correlation between 6PPD-Q and immune along with metabolic dysregulation induced liver lesions in outdoor workers

Outdoor workers who are exposed to traffic-derived pollutants often suffer from a range of diseases, with liver disease being particularly notable. Recently, a rubber stabilizing additive antioxidant N-(1,3-dimethylbutyl)-N'-phenyl-p-phenylenediamine (6PPD) and its transformed-quinone product 6PPD-quinone (6PPD-Q) attracted attention. However, their implication for human health remains inadequately elucidated. In this study, outdoor and indoor workers were recruited to analyze 6PPD and 6PPD-Q distribution in their serum and urine. Simultaneously, blood cell counts, liver function, renal function, blood glucose level, and lipid profile were evaluated by 23 physiological parameters. For the first time, we found that the concentrations of 6PPD (0.54 - 1.66 μg L^-1) and 6PPD-Q (0.58 - 4.04 μg L^-1) in outdoor group serum were two- and three-fold in the indoor group, respectively. Compared with indoor workers, 18 biochemical parameters, notably total bilirubin and indirect bilirubin, were elevated in outdoor workers (p < 0.05). A computed tomography scan showed liver lesions in 60% of the outdoor group, whereas only 30% of the indoor group. The statistical analysis exhibited that significant positive correlations exist between the serum 6PPD-Q and immune cell counts, total bilirubin, indirect bilirubin, and triglycerides in human beings (p < 0.05). The logistic regression implied that for each 1 μg L^-1 increase of 6PPD-Q in serum, the risk of human liver lesions increased by 2.31 times. Our results suggest that outdoor exposure is associated with increased concentrations of 6PPD-Q in serum, which could potentially influence glucose and lipid metabolism, immune cell regulation, and liver health.