Adrenocortical suppression in workers employed in manufacturing synthetic glucocorticosteroids: solutions to a problem.

Earlier studies showed gross adrenocortical suppression in three workers employed in manufacturing synthetic glucocorticoids. A further nine had either recognisable abnormalities of their responses to tetracosactrin or evidence of chronic skin contact with glucocorticoids. By 1978 the mean morning cortisol concentration of 20 workers employed in active steroid processes was 235 nmol/1 +/- 28.6 (8.5 microgram/ml +/- 1.04), which was significantly lower than the value of 428 nmol/l +/- 37.7 (15.5 microgram/ml +/- 1.40) obtained in a control group of 19 men (p less than 0.005). The mean morning cortisol of workers employed in processing steroids believed to be physiologically inactive, 306 nmol/l +/- 22.4 (11.1 microgram/ml +/- 0.81), was also significantly lower than this control group (0.01 greater than p greater than 0.005). Improvement of protection for workers together with operational and plant changes resulted in a significant rise in the mean morning cortisol values of workers until, in 1979, men employed in all steroid processes had concentrations that did not differ from those of a control group.