Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study

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Therefore, the purpose of this study is to analyze the relationship between benzene and Risk Quotient (RQ) benzene concentrations with Malondialdehyde (MDA), Blood Urea Nitrogen (BUN), and creatinine levels in workers exposed to benzene in car painting workshops in Surabaya. Methods This study used an observational design with a cross-sectional method conducted at two car paint workshops in Surabaya. The study population was all workers exposed to benzene in the two car paint workshops, aged between 20-65 years in 2019. The sample was taken using an random sampling method, involving 30 respondents. Inclusion criteria included workers exposed to benzene and willing to participate, while exclusion criteria included workers with a liver or kidney disease history. The variables studied included benzene concentration, benzene RQ (benzene metabolite), malondialdehyde (MDA) levels as a marker of oxidative stress, and indicators of kidney function (BUN and creatinine levels). Data were analyzed using descriptive and bivariate analysis with Pearson correlation test. Results There was no significant relationship between concentrations, RQ benzene, and MDA levels in workers in painting in Surabaya (p> 0.05). There was no significant relationship between benzene concentration, BUN levels, and creatinine levels in paint workers in Surabaya (p> 0.05). There was no significant relationship between benzene RQ and BUN and creatinine levels in paint workers in Surabaya (p> 0.05). Conclusions This study's results indicate that benzene's effects do not lead to impaired kidney function. The benzene RQ variable in this study did not become a determining factor in BUN and creatinine levels in workers. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/12-1419/v3", "name": "Relationship between benzene concentration, MDA levels and kidney..." } } ] } Home Browse Relationship between benzene concentration, MDA levels and kidney... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Tualeka AR, Aziz MY, Perumal V et al. Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.12688/f1000research.140287.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] Abdul Rohim Tualeka https://orcid.org/0000-0003-1855-4813 1 , Mohd Yusmaidie Aziz https://orcid.org/0000-0002-2519-3131 1,2 , Velu Perumal 1,3 , [...] Tamilanban Thamaraikani https://orcid.org/0000-0002-3240-0645 1,4 , Roslan Rosnon https://orcid.org/0000-0003-4903-7368 1,5 , Salsabila Novianti 6 , Pudji Rahmawati 7 , Ahsan Ahsan 8 Abdul Rohim Tualeka https://orcid.org/0000-0003-1855-4813 1 , Mohd Yusmaidie Aziz https://orcid.org/0000-0002-2519-3131 1,2 , [...] Velu Perumal 1,3 , Tamilanban Thamaraikani https://orcid.org/0000-0002-3240-0645 1,4 , Roslan Rosnon https://orcid.org/0000-0003-4903-7368 1,5 , Salsabila Novianti 6 , Pudji Rahmawati 7 , Ahsan Ahsan 8 PUBLISHED 05 Sep 2025 Author details Author details 1 Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, East Java, 60115, Indonesia 2 Department of Toxicology, Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam Kepala Batas, Penang, 13200, Malaysia 3 Jabatan Rekabentuk Perindustrian Fakulti Rekabentuk dan Senibina, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia 4 Department of Pharmacology, SRM College of Pharmacy,, SRM Institute of Science and Technology (Deemed to be University), Kattankulathur, Tamil Nadu, 603203, India 5 Department of Social & Development Sciences, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia 6 Department of Environmental Health, Faculty of Public Health,, Airlangga University, Surabaya, East Java, 60115, Indonesia 7 Department of Development of Islamic Society, Sunan Ampel State Islamic University Surabaya, Surabaya, East Java, Indonesia 8 Faculty of Nursing, Brawijaya University, Malang, East Java, Indonesia Abdul Rohim Tualeka Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Writing – Original Draft Preparation Mohd Yusmaidie Aziz Roles: Data Curation, Investigation, Supervision, Validation, Visualization, Writing – Original Draft Preparation Velu Perumal Roles: Data Curation, Formal Analysis, Validation, Writing – Review & Editing Tamilanban Thamaraikani Roles: Formal Analysis, Validation, Writing – Review & Editing Roslan Rosnon Roles: Formal Analysis, Validation, Visualization, Writing – Review & Editing Salsabila Novianti Roles: Project Administration, Visualization, Writing – Review & Editing Pudji Rahmawati Roles: Formal Analysis, Validation, Writing – Review & Editing Ahsan Ahsan Roles: Formal Analysis, Validation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Car painting workers are at risk of health problems, particularly kidney disorders, due to exposure to solvents containing benzene as the main ingredient in the car painting process. Therefore, the purpose of this study is to analyze the relationship between benzene and Risk Quotient (RQ) benzene concentrations with Malondialdehyde (MDA), Blood Urea Nitrogen (BUN), and creatinine levels in workers exposed to benzene in car painting workshops in Surabaya. Methods This study used an observational design with a cross-sectional method conducted at two car paint workshops in Surabaya. The study population was all workers exposed to benzene in the two car paint workshops, aged between 20-65 years in 2019. The sample was taken using an random sampling method, involving 30 respondents. Inclusion criteria included workers exposed to benzene and willing to participate, while exclusion criteria included workers with a liver or kidney disease history. The variables studied included benzene concentration, benzene RQ (benzene metabolite), malondialdehyde (MDA) levels as a marker of oxidative stress, and indicators of kidney function (BUN and creatinine levels). Data were analyzed using descriptive and bivariate analysis with Pearson correlation test. Results There was no significant relationship between concentrations, RQ benzene, and MDA levels in workers in painting in Surabaya (p> 0.05). There was no significant relationship between benzene concentration, BUN levels, and creatinine levels in paint workers in Surabaya (p> 0.05). There was no significant relationship between benzene RQ and BUN and creatinine levels in paint workers in Surabaya (p> 0.05). Conclusions This study's results indicate that benzene's effects do not lead to impaired kidney function. The benzene RQ variable in this study did not become a determining factor in BUN and creatinine levels in workers. READ ALL READ LESS Keywords Benzene, malondialdehyde, kidney function, car painting workshops, safe work Corresponding Author(s) Abdul Rohim Tualeka ( [email protected] ) Close Corresponding author: Abdul Rohim Tualeka Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Tualeka AR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Tualeka AR, Aziz MY, Perumal V et al. Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.12688/f1000research.140287.3 ) First published: 30 Oct 2023, 12 :1419 ( https://doi.org/10.12688/f1000research.140287.1 ) Latest published: 05 Sep 2025, 12 :1419 ( https://doi.org/10.12688/f1000research.140287.3 ) Revised Amendments from Version 2 References have been added as suggested, focusing on recent sources from the last 10 years and scientific journals. We have revised the manuscript by adding detailed descriptions of the statistical analysis, addressing the sampling method with its limitations, and including the formula for calculating benzene dose intake, all by the reviewer’s suggestions. We acknowledge that individual or descriptive measurement results (such as mean, standard deviation, and range) for MDA, BUN, and creatinine were not presented in the original manuscript. These parameters were indeed measured and analyzed about benzene exposure, and the results are presented through correlation and significance testing (Tables 5–8). However, as individual or aggregate measurement data (e.g., mean and SD) were not retained in the original dataset, we are unable to provide a detailed descriptive table. We have added explanations regarding discrepancies with existing theories in the discussion section. We have revised the manuscript to clarify that the role of CYP450 enzymes is a proposed mechanism and recommend measuring CYP450 in future research. We have combined the last two sentences in the conclusion section to improve clarity and flow as recommended. We have clarified the type of risk in the abstract by specifying that car painting workers are at risk of health problems, particularly kidney disorders, due to exposure to benzene-containing solvents in the car painting process. We have updated the reference to the regulation by replacing the outdated Minister of Manpower and Transmigration Regulation Number 13 of 2011 with the current regulation issued in 2018. Additionally, we have clarified that this regulation applies specifically in Indonesia. We have revised the sentence to accurately reflect the biochemical process We have now clarified the definition and purpose of RQ in the Methods section. References have been added as suggested, focusing on recent sources from the last 10 years and scientific journals. We have revised the manuscript by adding detailed descriptions of the statistical analysis, addressing the sampling method with its limitations, and including the formula for calculating benzene dose intake, all by the reviewer’s suggestions. We acknowledge that individual or descriptive measurement results (such as mean, standard deviation, and range) for MDA, BUN, and creatinine were not presented in the original manuscript. These parameters were indeed measured and analyzed about benzene exposure, and the results are presented through correlation and significance testing (Tables 5–8). However, as individual or aggregate measurement data (e.g., mean and SD) were not retained in the original dataset, we are unable to provide a detailed descriptive table. We have added explanations regarding discrepancies with existing theories in the discussion section. We have revised the manuscript to clarify that the role of CYP450 enzymes is a proposed mechanism and recommend measuring CYP450 in future research. We have combined the last two sentences in the conclusion section to improve clarity and flow as recommended. We have clarified the type of risk in the abstract by specifying that car painting workers are at risk of health problems, particularly kidney disorders, due to exposure to benzene-containing solvents in the car painting process. We have updated the reference to the regulation by replacing the outdated Minister of Manpower and Transmigration Regulation Number 13 of 2011 with the current regulation issued in 2018. Additionally, we have clarified that this regulation applies specifically in Indonesia. We have revised the sentence to accurately reflect the biochemical process We have now clarified the definition and purpose of RQ in the Methods section. See the authors' detailed response to the review by Said Moselhy READ REVIEWER RESPONSES Introduction Benzene is a carcinogenic unsaturated closed-chain aromatic hydrocarbon compound ( ATSDR, 2007 ). Benzene has been known as a good organic solvent for various processes in the industry such as the rubber industry, shoes, paint solvents, components in motor fuels, components in detergents, pesticides, and pharmaceutical manufacturing ( Keman & Sincihu, 2022 ; Tuasikal et al., 2022 ). One informal sector that is often exposed to benzene is the car paint shop. The car painting work area is one of the areas that requires attention due to its increasing number with a large risk of occupational diseases. The car painting process uses solvents containing benzene as the main ingredient in the work process which can have a detrimental effect on health ( Hasylin et al., 2022 ; Saironi et al., 2023 ). These materials enter the body through absorption with more presentation through inhalation due to exposure to steam in the process of spray painting ( Hosseinzadeh et al., 2023 ). Continuous benzene exposure can cause health effects. The body is continually exposed to benzene which causes symptoms and signs of chronic poisoning such as headaches, dizziness, nausea to vomiting, and slow-in-pale reactions due to anemia which is often accompanied by bleeding under the skin and mucosa ( Chaiklieng et al., 2021 ; Hu et al., 2021 ; Vatsa & Bhatt, 2025 ). The clinical effects of benzene systemically cause cardiovascular, respiratory, neurological, gastrointestinal, liver, kidney, endocrine and reproductive systems, dermatology, local effects, hematological, immunological, metabolic, and allergic reactions ( ATSDR, 2007 ; Cordiano et al., 2022 ; Gupta & Gupta, 2020 ; Pant, 2024 ). In 2007 the ( American Conference of Governmental Industrial Hygienists (ACGIH), 2007 ) issued a benzene chemical threshold of 0.5 ppm and since 1997 benzene has been confirmed to have carcinogenic properties in humans (Al = confirmed human carcinogen). The National Institute for Occupational Health and Safety (NIOSH) in 2010 set a recommended exposure limit or REL (Recommended Exposure Limit) of 0.1 ppm for 8 working hours ( NIOSH, 2010 ). The threshold value of chemical factors at work according to Minister of Manpower and Transmigration number 13 in 2011 is 0.5 ppm. The benzene exposure pathway enters the human body in three ways, namely absorption through the skin, inhalation, and ingestion. Inhalation is a very important route to consider because benzene has volatile properties ( ATSDR, 2024 ). Benzene which enters the body oxidizes to proteins, lipids and produces Malondialdehyde (MDA) ( Oyerinde et al., 2023 ; Tualeka et al., 2020 ). An increase in MDA levels is a sign of an increase in free radicals in the blood. Increased MDA levels even become a benchmark to determine the risk of cancer that will occur in workers exposed to benzene ( Guo et al., 2023 ). Exposure to benzene in high content causes narcotic effects and irritation to the eyes and airways ( Cordiano et al., 2022 ) . Long-term exposure to low content can result in bone marrow suppression and can be associated with leukemia events or other blood cell disorders ( Sun et al., 2021 ). The population of workers who work in the car painting industry or use benzene can be exposed to the highest exposure levels. For this reason, special attention needs to be paid to workers for occupational safety and health. Exposure to benzene and alkyl benzene has been linked to kidney and liver injury and kidney cancer ( Abduljalel & Al-Saadi, 2022 ; Seyyedsalehi et al., 2025 ; Wahlang et al., 2021 ). Other research conducted in Indonesia also stated that as many as 256 child workers in the Cibaduyut Bandung slipper and shoe industry were listed as being threatened by various types of diseases such as liver and/or kidney damage and even leukemia ( Setiowati, 2018 ). That is due to bad habits and an unhealthy work environment so workers in the Cibaduyut Bandung sandal and shoe industry inhale and ingest benzene compounds contained in the glue they use to make sandals. Examination of creatinine level in the blood is one of the parameters used to assess kidney function, because the concentration in plasma and its excretion in urine in 24 hours is relatively constant ( Gounden et al., 2024 ). This serum creatinine reflects the most sensitive kidney damage because it is produced constantly by the body ( De Rosa et al., 2023 ; Gyurászová et al., 2020 ). In addition, high Blood Urea Nitrogen (BUN) levels have been associated with adverse kidney effects suggesting that BUN is a useful marker for predicting the development of kidney disease ( Mahmood et al., 2024 ; Seki et al., 2019; Zhu et al., 2020 ). Therefore, the purpose of this study is to analyze the relationship between benzene concentration and RQ benzene with MDA, BUN, and creatinine levels in workers exposed to benzene in a car painting workshop in Surabaya. Methods This research is an observational study with a cross-sectional design conducted in two car painting workshops in Surabaya that use benzene as a solvent in the production process, namely in Kalijudan and Jemursari. The population in this study were all workers exposed to benzene in two car painting workshops in Surabaya, totaling 90 people aged 20-65 years in 2019. The research sample was taken using an accidental sampling method involving 30 respondents. Inclusion criteria were workers between 20-65 years old who had worked in the workshop for at least 1 year. Exclusion criteria were workers with a previous history of liver or kidney disease and workers not willing to provide blood samples. The variables studied included benzene concentration, RQ of benzene (a metabolite of benzene), malondialdehyde (MDA) levels as a marker of oxidative stress, and indicators of renal function such as blood urea (BUN) and creatinine levels. Benzene concentration and benzene RQ were considered as exposures, representing the level of exposure to benzene and its metabolic products. MDA levels were examined as an outcome reflecting oxidative stress status. Renal function parameters (BUN and creatinine levels) are outcomes that indicate potential renal effects. To account for possible influences on these relationships, age, and duration of exposure were considered as possible confounding variables. In contrast, smoking status was considered a modifier effect due to its potential to interact with benzene exposure. Data measurements were made by sampling workplace air using gas chromatography for benzene concentration and benzene RQ. MDA levels were measured using spectrophotometric assay on blood samples. Renal function markers, BUN, and creatinine levels were assessed through blood tests conducted at a clinical laboratory. An attempt was made to overcome participant selection bias through the incidental sampling method, although this method may introduce some bias due to its non-randomized nature. Data measurements and bias Benzene concentration and RQ benzene data were collected through air sampling in the workplace, utilizing gas chromatography as the assessment method. MDA levels, indicative of oxidative stress, were measured using spectrophotometric assays on blood samples. Kidney function markers, BUN, and creatinine levels, were assessed through blood tests conducted at a clinical laboratory. Efforts were made to address participant selection bias through the accidental sampling method. While this method might introduce some bias due to its non-random nature, its pragmatic approach allowed for data collection from the available workforce, considering practical constraints. The sample size, comprising 30 respondents, was determined based on available resources while aiming to capture a representative subset of the population. The study employed a comparative approach between the two workshops to explore potential differences in variables of interest and their interactions. This approach facilitated a more nuanced understanding of the relationship between benzene exposure, MDA levels, and kidney function within the specific context of the car painting workshops in Surabaya. Determination of exposure doses Exposure doses in the context of benzene exposure for car painting workers in Surabaya are typically calculated based on various parameters and factors: Benzene concentration levels in the workplace air, measured in parts per million (ppm), serve as a primary indicator of exposure intensity. Worker-specific factors like body weight, duration of exposure (hours/day, days/year), and exposure duration (years) are considered in dose calculations. Breathing rate (m 3 /hour) is also factored in to estimate the amount of benzene inhaled by workers during their shifts. The research paper provides insights into the calculation of benzene exposure doses using a Risk Quotient (RQ) approach: RQ values are calculated by dividing the benzene intake by a reference concentration (RfC), indicating the level of health risk associated with benzene exposure. Higher RQ values (≥1) suggest increased health risks due to benzene exposure, while lower values (<1) indicate a lower risk level. Understanding exposure doses is crucial for assessing the health risks associated with benzene exposure and implementing appropriate preventive measures to safeguard the well-being of car painting workers in Surabaya. Results Characteristics of Respondents Exposed to Benzene at a Car Painting Workshop in Surabaya Respondent characteristics include age, sex, level of education, and work area. Table 1 presents the distribution of characteristics of workers exposed to Benzene in a car painting workshop in Surabaya. Table 1. Distribution of Characteristics of Workers Exposed to Benzene at Car Painting Workshops in Surabaya. Characteristics of Respondents Frequency Percentage Age 20-25 8 29.6 26-35 3 11.2 36-45 9 33.3 46-55 6 22.2 56-65 1 3.7 Sex Male 26 96.3 Female 1 3.7 Level of Education Primary 3 11.1 Junior High 11 40.8 Senior High 12 44.4 University 1 3.7 Working Area Kalijudan 17 63 Jemursari 10 37 Most (33.3%) industrial workers aged 36-45 years and the majority (96.3%) was male with the highest level of education being SMA/SMK (44.4%). Most (63%) workers work in the Kalijudan area. Benzene concentration Based on Table 2 of 27 respondents there were 21 respondents (77.8%) with benzene concentrations above the Threshold Value (> 0.5 ppm) and 6 respondents (22.2%) with benzene concentrations below the Threshold Value (≤ 0.5 ppm). Table 2. Distribution of Benzene Concentration to Workers Exposed to Benzene at Car Painting Workshops in Surabaya. Benzene Concentration Total N % >0,05 ppm 21 77.8 ≤0,05 ppm 6 22.2 Total 27 100 Benzene RQ Health risk characteristics are stated as Risk Quotient (RQ, Risk Level), shown in Table 3 and are calculated by dividing the intake or intake (Ink) by reference (RfC). The calculation results of Risk Quotients (RQ) can indicate the level of health risks of workers due to exposure to benzene in the work environment. If the RQ value is more than or equal to 1 (RQ> 1) then workers exposed to benzene have health risks due to benzene exposure. If the RQ value is less than 1 (RQ <1), then workers exposed to benzene are safe from health risks due to benzene exposure. Based on the RQ calculation in Table 4 , the majority of workers (92.6%) have RQ≥1 values for benzene exposure, which means the majority of them have health risk impacts due to benzene exposure. Table 3. Calculation of RQ on Benzene Workers on Workers Exposed to Benzene at Car Painting Workshops in Surabaya. No Benzene Concentration (ppm) Weight (kg) tE (hours) fE (days) Dt (years) Breathing Rate (m 3 /hour) RFC Benzene Benzene dose Intake Benzene RQ 1 0.6768 63 7 312 25 0.627442 0.0003128 0.107155 146.787 2 1.4933 63 7 312 15 0.627442 0.000313 0.141856 194.235 3 1.4933 55.5 9 312 25 0.599451 0.000313 0.329663 451.388 4 0.6768 54 7 312 1.5 0.593401 0.000313 0.007093 9.71323 5 1.4933 49 8 312 2 0.571944 0.000313 0.025334 34.6883 6 1.4933 80 7 312 2 0.680198 0.000313 0.016147 22.1095 7 0.1678 48 7 312 10 0.56739 0.000313 0.012612 17.2699 8 0.1678 63 7 312 11 0.627442 0.000313 0.011689 16.0057 9 0.1678 66 9 312 8 0.637715 0.000313 0.010604 14.5200 10 0.6768 43 8 312 5 0.543098 0.000313 0.031060 42.5295 11 0.6768 54 8 312 3 0.593401 0.000313 0.016214 22.2016 12 0.6768 62 9 312 4 0.623909 0.000313 0.022272 30.4966 13 1.4933 74 11 312 12 0.662981 0.000313 0.160424 219.659 14 1.4933 65 7 312 10 0.634344 0.000313 0.092669 126.886 15 1.4933 72 7 312 20 0.65693 0.000313 0.173277 237.258 16 1.4933 50 7 312 0.08 0.576405 0.000313 0.000908 1.24405 17 1.4933 55 8 312 12 0.597453 0.000313 0.141462 193.695 18 1.3891 70 7 312 0.5 0.650709366 0.000307925 0.00410555 1.3891 19 1.5328 70 7 312 2 0.650709366 0.000307925 0.01812105 1.5328 20 1.3891 45 7 312 1 0.553137966 0.000307925 0.01085759 14.6705 21 14.6705 70 7 312 0.83 0.650709366 0.000307925 0.07197656 1.3891 22 1.3891 55 7 312 18 0.597452745 0.000307925 0.17271336 1.3891 23 1.3891 50 7 312 0.83 0.57640508 0.000307925 0.00845178 1.3891 24 1.3891 85 9 312 10 0.693585486 0.000307925 0.09266977 1.3891 25 1.3891 52 7 312 3 0.585066321 0.000307925 0.02981505 1.3891 26 1.3891 50 7 312 5 0.57640508 0.000307925 0.05091437 0.9282 27 1.3891 47 7 312 15 0.562740929 0.000307925 0.15864065 0.0414 avg 1.653 59.6 7.6 312 8.2 0.611773 0.000311 0.071063 66.8960 Table 4. Distribution of Benzene RQ Frequency to Workers Exposed to Benzene at Car Painting Workshops in Surabaya. RQ Total N % Unsafe (≥1) 25 92.6 Safe ( <1) 2 7.4 Total 30 100% Relationship between Benzene concentration and MDA Based on the test results in Table 5 there is no significant relationship between Benzene concentration and MDA levels in workers exposed to benzene in a car painting workshop in Surabaya with a P value> 0.05. Table 5. Statistical Test Results between Benzene and MDA Concentrations. Variables P -Value Correlation coefficient N Benzene concentration 0.179 -0.266 30 MDA Relationship between RQ Benzene and MDA Based on the test results in Table 6 there is no relationship between RQ Benzene and MDA levels of workers exposed to benzene in a car painting workshop in Surabaya (P> 0.05). Table 6. Statistical Test Results between RQ Benzene and MDA. Variables P -Value Correlation coefficient N Benzene RQ 0.597 0.106 30 MDA Relationship between Benzene Concentration and Kidney Function Based on the test results in Table 7 there was no significant relationship between Benzene concentrations, BUN levels and creatinine exposure of workers exposed to benzene in car painting workshops in Surabaya (P> 0.05). Table 7. Statistical Test Results Between Benzene Concentration and Kidney Function. Variables P -Value Correlation coefficient N Benzene concentration 0.238 -0.235 30 BUN level Benzene concentration 0.790 0.054 30 Creatinine levels Relationship between RQ Benzene and Kidney Function Based on the test results in Table 8 there was no significant relationship between Benzene concentrations, BUN levels, and creatinine exposure of workers exposed to benzene at a car painting workshop in Surabaya (P> 0.05). Table 8. Statistical Test Results Between Benzene Concentration and Kidney Function. Variables P -Value Correlation coefficient N Benzene RQ 0.537 0.124 30 BUN level Benzene RQ 0.397 -0.170 30 Creatinine levels Discussion The results showed that there was no significant relationship between concentration, RQ benzene, and MDA levels in workers in a car painting workshop in Surabaya (p> 0.05). This is in line with research conducted on workers in shoe factories that benzene concentrations do not have a significant relationship with MDA levels ( Tualeka et al., 2019 ). However, according to research conducted by ( Odewabi et al., 2014 ) in Nigeria, exposure to free radicals especially benzene in gas station workers can increase MDA levels in workers. Research by ( Suparno et al., 2018 ) also stated that high plasma malondialdehyde (MDA) levels are markers of oxidative stress that will cause DNA and RNA disturbances. Previous research suggests that oxidative stress might be related to pathogenesis and the development of kidney disease, where it is suspected that malondialdehyde might play an important role in the pathogenesis of glomerulosclerosis ( Kuo et al., 2005 ). In other studies, oxidative stress has progressively increased and is associated with the degree of kidney dysfunction in patients with chronic kidney failure ( Dounousi et al., 2006 ; Terawaki et al., 2004 ). Antioxidant activity plays a crucial role in mitigating the oxidative stress induced by benzene exposure in car painting workers in Surabaya. Benzene exposure leads to the generation of reactive oxygen species (ROS) and free radicals, causing oxidative damage to cells and tissues. Antioxidants help neutralize ROS and free radicals, thereby protecting cells from oxidative stress and potential damage. There was no significant relationship between benzene exposure, BUN levels and creatinine in painting workers in Surabaya (p> 0.05). Research conducted by ( D’Andrea & Reddy, 2018 ) in children showed no significant differences in serum creatinine levels between groups exposed to benzene and those not exposed. Although BUN levels were found to be significantly reduced in groups exposed to benzene compared with unexposed group (P = 0.001). Although studies related to the effects of benzene exposure specifically on kidney function (creatinine and BUN) are limited, previous studies related to the exposure of organic solvents to kidney function have been conducted to support this study. Research conducted by ( Elfar et al., 1998 ) found no statistically significant differences between the groups exposed to organic solvents and the control group regarding kidney function and there was no significant relationship between the two and the length of exposure to organic solvents. This opinion is also strengthened by research conducted by ( Kaukiainen et al., 2004 ) who found a negative relationship between serum creatinine levels and exposure to organic solvents. Cytochrome P450 enzymes (CYP450) play a crucial role in the detoxification of various xenobiotics, including benzene. CYP450 enzymes are involved in the metabolism of benzene to less toxic metabolites through a process known as biotransformation. In the context of benzene exposure, CYP450 enzymes are responsible for converting benzene into reactive metabolites, which can then be further metabolized and excreted from the body. The detoxification process mediated by CYP450 enzymes helps in reducing the harmful effects of benzene on the body, particularly in preventing the accumulation of reactive intermediates that can lead to oxidative stress and cellular damage. Understanding the role of CYP450 enzymes in benzene metabolism is essential for assessing the detoxification capacity of individuals exposed to benzene and for developing strategies to mitigate the toxic effects of benzene exposure on various organs, including the kidneys. Hoek et al. (2003) did not find any effect from exposure to organic solvents on effects to the kidneys. The lack of an association between kidney effects and the intensity or duration of exposure can be associated with individual vulnerability. Vulnerability to benzene can vary due to its effects which arise, in part, from genetic variations in metabolism, DNA repair, genome stability, and immune function ( D’Andrea & Reddy, 2018 ). In the present study, the effects of benzene have not led to impaired kidney function, yet limited to acute exposure. In addition, the presence of toluene exposure inhaled by labor (measured at the same time as the measurement of benzene exposure using the OVM method) has antagonistic properties against benzene toxicity. According to ( Inoue et al., 1988 ) workers exposed to a combination of benzene and toluene will experience decreased levels of phenol in the urine compared to those exposed to benzene or toluene separately. Therefore, further research can find out whether there is an antagonistic effect between benzene and toluene on creatinine and BUN levels. There was no significant relationship between benzene RQ, BUN levels and creatinine levels in paint workers in Surabaya (p> 0.05). RQ calculation is calculated by dividing the intake or intake (ink) by reference (RfC). Therefore, one factor that influences the value of RQ is the amount of benzene intake. Based on the theory of ( Louvar & Louvar, 1998 ) in determining the assessment of exposure (exposure assessment) regarding the amount of chemical intake received by individuals, the exposure time factor, duration of exposure, body weight and frequency of exposure have a significant contribution in determining the intake of xenobiotic material intake at body to cause health effects. Other factors such as duration of exposure, time of exposure, frequency of exposure, nutritional status, etc. can contribute in the event that there is no effect of the benzene RQ variable on kidney function. In this study, benzene intake in workers was relatively small and the work period of the worker was also not long at 8.2 years (<10 years). In sum, the benzene RQ variable in this study was not a determining factor in its effect on the results of BUN and creatinine levels. Limitations Cross-sectional design restricts the ability to establish causal relationships between variables, which means that it captures data at a single point in time. Longitudinal studies would provide more robust evidence of the relationship between these variables. The study is conducted in only two car painting workshops in Surabaya, potentially limiting generalizability to other settings. The utilization of the accidental sampling method might introduce selection bias, as workers with greater awareness of health risks might be more inclined to participate, affecting the external validity of findings. Furthermore, age range selection (20-65 years) might lead to varying susceptibility levels and differences in exposure duration, potentially influencing the direction and magnitude of associations observed. The limited sample size (30 respondents) might hinder the ability to detect small but significant effects, impacting the study's statistical power. As the study relies on self-reported data for certain variables and uses laboratory assessments for others, measurement bias and misclassification could occur. Assessing antioxidant activity, such as levels of glutathione (GSH) and other antioxidants, could provide valuable insights into the protective mechanisms against benzene-induced oxidative stress. Antioxidant status can influence the susceptibility of individuals to benzene toxicity and may modulate the impact of benzene exposure on kidney function. Further studies investigating antioxidant activity in relation to benzene exposure and kidney function could enhance our understanding of the mechanisms underlying benzene-induced nephrotoxicity and oxidative damage in exposed populations. Despite these limitations, the study's findings contribute to the existing understanding of the complex interplay between benzene exposure, oxidative stress, and kidney function in car painting workshops. Conclusion In this study, the majority of respondents (77.8%) were exposed to benzene concentrations above the Threshold Value (>0.5 ppm). The majority of workers (92.6%) had RQ≥1 against benzene exposure, which means the majority of workers were affected by benzene exposure. There was no significant relationship between benzene concentration and RQ on MDA level in workers (p>0.05). There was no significant relationship between benzene concentration, BUN level, and creatinine level in workers (p>0.05). There was no significant relationship between benzene RQ, BUN level, and creatinine level in workers (p>0.05). Ethical statement Ethical approval was obtained from the Universitas Airlangga, Faculty of Dental Medicine ethics committee (605/HRECC.FODM/IX/2019). Informed consent The objectives and protocols of the study were explained to the participants and obtained written informed consent from each subject before participation in the study. Data availability Underlying data All data underlying the results are available as part of the article and no additional source data are required. Acknowledgments The authors would like thank to the rector of Airlangga University. The authors would like to acknowledge Relationship between Benzene Concentration, MDA Levels and Kidney Function in Car Painting Workshops in Surabaya. References Abduljalel ME, Al-Saadi RN: Toxicopathological effect of benzene, toluene, ethylbenzene, and xylenes (BTEX) as a mixture and the protective effect of citicoline in male rats followings 90-day oral exposure. REDVET-Revista Electrónica de Veterinaria. 2022; 23 (3). American Conference of Governmental Industrial Hygienists (ACGIH): Threshold Limit Values and Biological Indices. Cincinnati: 2007. ATSDR: Benzene: Relevance to Public Health. ATSDR; 2007. Publisher Full Text Reference Source ATSDR: Benzene. 2024. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 30 Oct 2023 ADD YOUR COMMENT Comment Author details Author details 1 Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, East Java, 60115, Indonesia 2 Department of Toxicology, Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam Kepala Batas, Penang, 13200, Malaysia 3 Jabatan Rekabentuk Perindustrian Fakulti Rekabentuk dan Senibina, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia 4 Department of Pharmacology, SRM College of Pharmacy,, SRM Institute of Science and Technology (Deemed to be University), Kattankulathur, Tamil Nadu, 603203, India 5 Department of Social & Development Sciences, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia 6 Department of Environmental Health, Faculty of Public Health,, Airlangga University, Surabaya, East Java, 60115, Indonesia 7 Department of Development of Islamic Society, Sunan Ampel State Islamic University Surabaya, Surabaya, East Java, Indonesia 8 Faculty of Nursing, Brawijaya University, Malang, East Java, Indonesia Abdul Rohim Tualeka Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Writing – Original Draft Preparation Mohd Yusmaidie Aziz Roles: Data Curation, Investigation, Supervision, Validation, Visualization, Writing – Original Draft Preparation Velu Perumal Roles: Data Curation, Formal Analysis, Validation, Writing – Review & Editing Tamilanban Thamaraikani Roles: Formal Analysis, Validation, Writing – Review & Editing Roslan Rosnon Roles: Formal Analysis, Validation, Visualization, Writing – Review & Editing Salsabila Novianti Roles: Project Administration, Visualization, Writing – Review & Editing Pudji Rahmawati Roles: Formal Analysis, Validation, Writing – Review & Editing Ahsan Ahsan Roles: Formal Analysis, Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 05 Sep 2025, 12:1419 https://doi.org/10.12688/f1000research.140287.3 version 2 Revised Published: 05 Jun 2024, 12:1419 https://doi.org/10.12688/f1000research.140287.2 version 1 Published: 30 Oct 2023, 12:1419 https://doi.org/10.12688/f1000research.140287.1 Copyright © 2025 Tualeka AR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Tualeka AR, Aziz MY, Perumal V et al. Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.12688/f1000research.140287.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 05 Sep 2025 Revised Views 0 Cite How to cite this report: Polyong CP. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r412476 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-412476 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Sep 2025 Chan Pattama Polyong , Bansomdejchaopraya Rajabhat University, Bangkok, Thailand Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.186720.r412476 Reasons for Rejection Major Concerns Outdated or Misapplied Standards -The manuscript relies on outdated occupational exposure limits (e.g., ACGIH TLV of 0.5 ppm), whereas the most recent TLV (2025) is 0.02 ppm. Mixing different ... Continue reading READ ALL Reasons for Rejection Major Concerns Outdated or Misapplied Standards -The manuscript relies on outdated occupational exposure limits (e.g., ACGIH TLV of 0.5 ppm), whereas the most recent TLV (2025) is 0.02 ppm. Mixing different reference values (OSHA PEL, NIOSH REL, ACGIH TLV, national regulations) without justification undermines the validity of the conclusions. -Reference to ATSDR documents is inconsistent (2007 vs. 2025), and the source and value of the reference concentration (RfC) for risk calculations are not clearly stated. Misdefinition and Misuse of the “Risk Quotient (RQ)” -The paper incorrectly defines RQ as a metabolite of benzene measured by gas chromatography. In toxicology, RQ (or Hazard Quotient) is the ratio of exposure/intake to a reference concentration or dose, not a laboratory measurement. -Without a clear definition, formula, and source of RfC, the reported RQ values are not meaningful or interpretable. Weak Study Design and Sampling -Cross-sectional design with accidental sampling (n=30) from only two workshops has low external validity and high selection bias. -Inconsistency in sample size reporting (27 vs. 30 participants) is problematic. -“Smoking” is cited as an effect modifier, yet no stratified or interaction analysis is presented. Exposure Assessment and Quality Control -Details about air sampling are insufficient: it is unclear whether personal or area samples were collected, for how long, and according to which standardized method (e.g., NIOSH 1501). -No information is provided on LOD/LOQ, calibration, blanks, or QA/QC procedures. -Mention of OVM in the discussion is inconsistent with the methods section. Non-Specific Biomarkers -Malondialdehyde (MDA) is not a specific biomarker of benzene exposure and is prone to methodological interferences. -More specific biomarkers such as S-phenylmercapturic acid (SPMA) or trans,trans-muconic acid (tt-MA) should have been used. -Kidney function was assessed only with BUN and creatinine, which are insensitive to early renal injury. More sensitive markers (e.g., KIM-1, NGAL, NAG, β2-microglobulin, eGFR, albuminuria) are recommended. Inadequate Statistical Analysis and Reporting -Results are presented only as p-values without measures of central tendency, variability, effect size, or confidence intervals. -No multivariable analysis to adjust for confounding factors (age, duration of exposure, smoking, co-exposures such as toluene) was performed. -Methods for statistical testing are not specified. Over-Interpretation and Internal Inconsistency -The paper concludes that workers are “affected” by benzene exposure (based on RQ≥1) despite finding no association with MDA, BUN, or creatinine. -Antagonistic effects of toluene are discussed without having measured toluene exposure. -The introduction broadly discusses systemic toxicity but the study only measures oxidative stress and crude renal endpoints. Ethical and Occupational Health Issues -No mention of ethical approval, informed consent, or follow-up for at-risk workers. - No recommendations for occupational control measures (e.g., substitution, ventilation, respiratory protection), which are critical when reporting high exposure levels. Minor but Important Issues -Language and Terminology : The manuscript contains repetitive and confusing phrasing (e.g., “benzene RQ and benzene concentration…”). -Tables and Figures : Tables are incomplete, lack units, and contain inconsistencies (e.g., decimal separators, missing totals). - References : Citations are inconsistent in style and some are outdated. Authors should update references to the latest authoritative sources (e.g., ACGIH TLV 2025, ATSDR 2025). - Formatting : There are errors in decimal notation (commas vs. points), which can lead to misinterpretation of values. Even though this study has major methodological limitations and requires substantial revision, it is clear that the authors have made an important effort to address a relevant occupational health issue. With a stronger study design, updated exposure assessment, and more specific biomarkers, future research from this team could make a meaningful contribution to the field. I encourage the authors to continue developing their work in this area. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Occupational Health, Toxicology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Polyong CP. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r412476 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-412476 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Indrayani R. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r411883 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-411883 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Sep 2025 Reny Indrayani , University of Jember, Jember Regency, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.186720.r411883 The author has responded ... Continue reading READ ALL The author has responded to most of the comments. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Occupational Safety and Health; Industrial Hygiene I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Indrayani R. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r411883 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-411883 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 05 Jun 2024 Revised Views 0 Cite How to cite this report: Indrayani R. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r388556 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-388556 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Jun 2025 Reny Indrayani , University of Jember, Jember Regency, Indonesia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.167506.r388556 Literature: (1) The cited literature is not sufficiently up-to-date (e.g., Inoue et al., 1988). (2) Fewer than 30 references are used, and only about 60% of them are derived from scientific journals. Among ... Continue reading READ ALL Literature: (1) The cited literature is not sufficiently up-to-date (e.g., Inoue et al., 1988). (2) Fewer than 30 references are used, and only about 60% of them are derived from scientific journals. Among those, only approximately 35% were published between 2013 and 2023. (3) Some references are also not traceable (e.g., Elfar et al., 1998). Suggestion: Increase the number of references, particularly from scientific journals, and prioritize using recent sources (preferably from the last 10 years) to enrich the discussion. Methods: (1) The statistical analysis used in the study is not described (e.g., what types of tests were applied?). (2) The use of accidental sampling is not appropriate for an analytical observational study; random sampling should be used instead. (3) The formula for calculating benzene dose intake is not provided. Results: There is no table presenting the measurement results of MDA, BUN, and creatinine levels. Discussion: (1) There is no scientific explanation regarding the discrepancies between certain findings and existing theories (e.g., between RQ and MDA). The authors mostly cite previous studies whose results are in agreement with existing theories. Even when prior studies support the current findings, the potential reasons for any observed inconsistencies with established theories remain unexplained. (2) The authors briefly mention Cytochrome P450 enzymes (CYP450) as a possible explanation for anomalous findings, but the relevance needs to be clarified. Since CYP450 was not measured in this study, it may be better suggested for future research. Conclusion: The last two sentences should be combined into one for better clarity and flow. Other Remarks: a. In the abstract: “Car painting workers are at risk because…” – the type of risk is not specified and should be clarified. b. In the introduction: (1) The statement “Minister of Manpower and Transmigration number 13 in 2011 is 0.5 ppm” refers to a regulation that is no longer valid, as it has been replaced by a newer regulation issued in 2018. It should also be clarified that this regulation applies in Indonesia. (2) The sentence “Benzene which enters the body oxidizes to proteins, lipids and produces Malondialdehyde (MDA)” is incorrect. Benzene is not oxidized into proteins or lipids; rather, its metabolism increases reactive oxygen species (ROS), which act as oxidants. (3) There is no explanation provided about the Respiratory Quotient (RQ) or the purpose of calculating it, although it is suddenly included in the study objectives. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Occupational Safety and Health; Industrial Hygiene I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Indrayani R. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r388556 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-388556 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Barbieri G. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r343487 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-343487 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Dec 2024 Giulia Barbieri , University of Verona, Eurac Research, Verona, Italy Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.167506.r343487 This study examined the effects of benzene exposure on oxidative stress (MDA) and kidney function (BUN, creatinine) in 30 car painting workers in Surabaya. No significant relationships were found between benzene levels, oxidative stress, or kidney function markers (p > ... Continue reading READ ALL This study examined the effects of benzene exposure on oxidative stress (MDA) and kidney function (BUN, creatinine) in 30 car painting workers in Surabaya. No significant relationships were found between benzene levels, oxidative stress, or kidney function markers (p > 0.05), suggesting that benzene exposure did not impair kidney function or cause oxidative stress at the levels studied. The most problematic aspect of the work is the absence of description of the methods employed for the statistical analysis, which are just briefly mentioned in the abstract. Smoking status is mentioned as effect modifier, but then univariate analysis are performed without taking it into account. Data to replicate the above-mentioned analyses are not sufficient. The evidence from results is very weak (univariate analyses, small samplesize, etc) and prevents the causal interpretation of associations. Supporting literature is not accurate, some links are broken (e.g. NIOSH), others are misplaced (e.g. Coresh et al), reporting imprecise evidences (e.g. D'Andrea et al), or even not existing (e.g. Elfar et al). Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Epidemiology and biostatistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Barbieri G. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r343487 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-343487 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Moselhy S. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r286910 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-286910 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Sep 2024 Said Moselhy , Ain Shams University, Cairo, Egypt Approved VIEWS 0 https://doi.org/10.5256/f1000research.167506.r286910 The authors responded to comments. ... Continue reading READ ALL The authors responded to comments. It is recommended for acceptance Competing Interests: No competing interests were disclosed. Reviewer Expertise: Biochemistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Moselhy S. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r286910 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-286910 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 30 Oct 2023 Views 0 Cite How to cite this report: Moselhy S. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.153625.r241777 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v1#referee-response-241777 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 14 May 2024 Said Moselhy , Ain Shams University, Cairo, Egypt Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.153625.r241777 Dear editor - Subjects groups, sampling, exclusion and inclusion criteria , parameters, not clear. - What is the role of CYP450 for detoxification. - GFR and clearance should be done. - What about antioxidant activity? ... Continue reading READ ALL Dear editor - Subjects groups, sampling, exclusion and inclusion criteria , parameters, not clear. - What is the role of CYP450 for detoxification. - GFR and clearance should be done. - What about antioxidant activity? - How doses of exposure determined Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Biochemistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Moselhy S. Reviewer Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.153625.r241777 ) The direct URL for this report is: https://f1000research.com/articles/12-1419/v1#referee-response-241777 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 19 Jun 2024 Abdul Rohim Tualeka , Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, 60115, Indonesia 19 Jun 2024 Author Response GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. Competing Interests: No competing interests were disclosed. GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 19 Jun 2024 Abdul Rohim Tualeka , Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, 60115, Indonesia 19 Jun 2024 Author Response GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. Competing Interests: No competing interests were disclosed. GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 30 Oct 2023 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 3 (revision) 05 Sep 25 read read Version 2 (revision) 05 Jun 24 read read read Version 1 30 Oct 23 read Said Moselhy , Ain Shams University, Cairo, Egypt Giulia Barbieri , University of Verona, Eurac Research, Verona, Italy Reny Indrayani , University of Jember, Jember Regency, Indonesia Chan Pattama Polyong , Bansomdejchaopraya Rajabhat University, Bangkok, Thailand Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Polyong C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Sep 2025 | for Version 3 Chan Pattama Polyong , Bansomdejchaopraya Rajabhat University, Bangkok, Thailand 0 Views copyright © 2025 Polyong C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reasons for Rejection Major Concerns Outdated or Misapplied Standards -The manuscript relies on outdated occupational exposure limits (e.g., ACGIH TLV of 0.5 ppm), whereas the most recent TLV (2025) is 0.02 ppm. Mixing different reference values (OSHA PEL, NIOSH REL, ACGIH TLV, national regulations) without justification undermines the validity of the conclusions. -Reference to ATSDR documents is inconsistent (2007 vs. 2025), and the source and value of the reference concentration (RfC) for risk calculations are not clearly stated. Misdefinition and Misuse of the “Risk Quotient (RQ)” -The paper incorrectly defines RQ as a metabolite of benzene measured by gas chromatography. In toxicology, RQ (or Hazard Quotient) is the ratio of exposure/intake to a reference concentration or dose, not a laboratory measurement. -Without a clear definition, formula, and source of RfC, the reported RQ values are not meaningful or interpretable. Weak Study Design and Sampling -Cross-sectional design with accidental sampling (n=30) from only two workshops has low external validity and high selection bias. -Inconsistency in sample size reporting (27 vs. 30 participants) is problematic. -“Smoking” is cited as an effect modifier, yet no stratified or interaction analysis is presented. Exposure Assessment and Quality Control -Details about air sampling are insufficient: it is unclear whether personal or area samples were collected, for how long, and according to which standardized method (e.g., NIOSH 1501). -No information is provided on LOD/LOQ, calibration, blanks, or QA/QC procedures. -Mention of OVM in the discussion is inconsistent with the methods section. Non-Specific Biomarkers -Malondialdehyde (MDA) is not a specific biomarker of benzene exposure and is prone to methodological interferences. -More specific biomarkers such as S-phenylmercapturic acid (SPMA) or trans,trans-muconic acid (tt-MA) should have been used. -Kidney function was assessed only with BUN and creatinine, which are insensitive to early renal injury. More sensitive markers (e.g., KIM-1, NGAL, NAG, β2-microglobulin, eGFR, albuminuria) are recommended. Inadequate Statistical Analysis and Reporting -Results are presented only as p-values without measures of central tendency, variability, effect size, or confidence intervals. -No multivariable analysis to adjust for confounding factors (age, duration of exposure, smoking, co-exposures such as toluene) was performed. -Methods for statistical testing are not specified. Over-Interpretation and Internal Inconsistency -The paper concludes that workers are “affected” by benzene exposure (based on RQ≥1) despite finding no association with MDA, BUN, or creatinine. -Antagonistic effects of toluene are discussed without having measured toluene exposure. -The introduction broadly discusses systemic toxicity but the study only measures oxidative stress and crude renal endpoints. Ethical and Occupational Health Issues -No mention of ethical approval, informed consent, or follow-up for at-risk workers. - No recommendations for occupational control measures (e.g., substitution, ventilation, respiratory protection), which are critical when reporting high exposure levels. Minor but Important Issues -Language and Terminology : The manuscript contains repetitive and confusing phrasing (e.g., “benzene RQ and benzene concentration…”). -Tables and Figures : Tables are incomplete, lack units, and contain inconsistencies (e.g., decimal separators, missing totals). - References : Citations are inconsistent in style and some are outdated. Authors should update references to the latest authoritative sources (e.g., ACGIH TLV 2025, ATSDR 2025). - Formatting : There are errors in decimal notation (commas vs. points), which can lead to misinterpretation of values. Even though this study has major methodological limitations and requires substantial revision, it is clear that the authors have made an important effort to address a relevant occupational health issue. With a stronger study design, updated exposure assessment, and more specific biomarkers, future research from this team could make a meaningful contribution to the field. I encourage the authors to continue developing their work in this area. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Occupational Health, Toxicology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Polyong CP. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r412476) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-412476 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Indrayani R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Sep 2025 | for Version 3 Reny Indrayani , University of Jember, Jember Regency, Indonesia 0 Views copyright © 2025 Indrayani R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The author has responded to most of the comments. Competing Interests No competing interests were disclosed. Reviewer Expertise Occupational Safety and Health; Industrial Hygiene I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Indrayani R. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.186720.r411883) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v3#referee-response-411883 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Indrayani R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Jun 2025 | for Version 2 Reny Indrayani , University of Jember, Jember Regency, Indonesia 0 Views copyright © 2025 Indrayani R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Literature: (1) The cited literature is not sufficiently up-to-date (e.g., Inoue et al., 1988). (2) Fewer than 30 references are used, and only about 60% of them are derived from scientific journals. Among those, only approximately 35% were published between 2013 and 2023. (3) Some references are also not traceable (e.g., Elfar et al., 1998). Suggestion: Increase the number of references, particularly from scientific journals, and prioritize using recent sources (preferably from the last 10 years) to enrich the discussion. Methods: (1) The statistical analysis used in the study is not described (e.g., what types of tests were applied?). (2) The use of accidental sampling is not appropriate for an analytical observational study; random sampling should be used instead. (3) The formula for calculating benzene dose intake is not provided. Results: There is no table presenting the measurement results of MDA, BUN, and creatinine levels. Discussion: (1) There is no scientific explanation regarding the discrepancies between certain findings and existing theories (e.g., between RQ and MDA). The authors mostly cite previous studies whose results are in agreement with existing theories. Even when prior studies support the current findings, the potential reasons for any observed inconsistencies with established theories remain unexplained. (2) The authors briefly mention Cytochrome P450 enzymes (CYP450) as a possible explanation for anomalous findings, but the relevance needs to be clarified. Since CYP450 was not measured in this study, it may be better suggested for future research. Conclusion: The last two sentences should be combined into one for better clarity and flow. Other Remarks: a. In the abstract: “Car painting workers are at risk because…” – the type of risk is not specified and should be clarified. b. In the introduction: (1) The statement “Minister of Manpower and Transmigration number 13 in 2011 is 0.5 ppm” refers to a regulation that is no longer valid, as it has been replaced by a newer regulation issued in 2018. It should also be clarified that this regulation applies in Indonesia. (2) The sentence “Benzene which enters the body oxidizes to proteins, lipids and produces Malondialdehyde (MDA)” is incorrect. Benzene is not oxidized into proteins or lipids; rather, its metabolism increases reactive oxygen species (ROS), which act as oxidants. (3) There is no explanation provided about the Respiratory Quotient (RQ) or the purpose of calculating it, although it is suddenly included in the study objectives. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Occupational Safety and Health; Industrial Hygiene I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Indrayani R. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r388556) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-388556 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Barbieri G. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Dec 2024 | for Version 2 Giulia Barbieri , University of Verona, Eurac Research, Verona, Italy 0 Views copyright © 2024 Barbieri G. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study examined the effects of benzene exposure on oxidative stress (MDA) and kidney function (BUN, creatinine) in 30 car painting workers in Surabaya. No significant relationships were found between benzene levels, oxidative stress, or kidney function markers (p > 0.05), suggesting that benzene exposure did not impair kidney function or cause oxidative stress at the levels studied. The most problematic aspect of the work is the absence of description of the methods employed for the statistical analysis, which are just briefly mentioned in the abstract. Smoking status is mentioned as effect modifier, but then univariate analysis are performed without taking it into account. Data to replicate the above-mentioned analyses are not sufficient. The evidence from results is very weak (univariate analyses, small samplesize, etc) and prevents the causal interpretation of associations. Supporting literature is not accurate, some links are broken (e.g. NIOSH), others are misplaced (e.g. Coresh et al), reporting imprecise evidences (e.g. D'Andrea et al), or even not existing (e.g. Elfar et al). Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Epidemiology and biostatistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Barbieri G. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r343487) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-343487 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Moselhy S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Sep 2024 | for Version 2 Said Moselhy , Ain Shams University, Cairo, Egypt 0 Views copyright © 2024 Moselhy S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors responded to comments. It is recommended for acceptance Competing Interests No competing interests were disclosed. Reviewer Expertise Biochemistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Moselhy S. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.167506.r286910) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v2#referee-response-286910 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Moselhy S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 14 May 2024 | for Version 1 Said Moselhy , Ain Shams University, Cairo, Egypt 0 Views copyright © 2024 Moselhy S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear editor - Subjects groups, sampling, exclusion and inclusion criteria , parameters, not clear. - What is the role of CYP450 for detoxification. - GFR and clearance should be done. - What about antioxidant activity? - How doses of exposure determined Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Biochemistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 19 Jun 2024 Abdul Rohim Tualeka, Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, 60115, Indonesia GFR and clearance should be done --- However, in this study, GFR and clearance measurements were not performed. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Moselhy S. Peer Review Report For: Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study [version 3; peer review: 2 approved, 2 not approved] . F1000Research 2025, 12 :1419 ( https://doi.org/10.5256/f1000research.153625.r241777) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1419/v1#referee-response-241777 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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