Flodin U, Landtblom A-M, Axelson O
Division of Occupational and Environmental Medicine, Department of Health and Environment, Linköping University, S-581 85 Linköping, Sweden.
Occup Environ Med. 2003 Jan;60(1):66-8. doi: 10.1136/oem.60.1.66.
Volatile anaesthetics are chemically related to organic solvents used in industry. Exposure to industrial solvents may increase the incidence of multiple sclerosis (MS).
To examine the risk among nurse anaesthetists of contracting MS.
Nurses with MS were identified by an appeal in the monthly magazine of the Swedish Nurse Union and a magazine of the Neurological Patients Association in Sweden. Ninety nurses with MS responded and contacted our clinic. They were given a questionnaire, which was filled in by 85 subjects; 13 of these were nurse anaesthetists. The questionnaire requested information about work tasks, exposure, diagnosis, symptoms, and year. The number of active nurse anaesthetists was estimated based on information from the National Board of Health and Welfare and The Nurse Union. Incidence data for women in the region of Gothenburg and Denmark were used as the reference to estimate the risk by calculation of the standardised incidence ratio (SIR).
Eleven of the 13 nurse anaesthetists were exposed to anaesthetic gases before onset of MS. Mean duration of exposure before diagnosis was 14.4 years (range 4-27 years). Ten cases were diagnosed in the study period 1980-99, resulting in significantly increased SIRs of 2.9 and 2.8 with the Gothenburg and the Danish reference data, respectively.
Although based on crude data and a somewhat approximate analysis, this study provides preliminary evidence for an excess risk of MS in nurse anaesthetists. The risk may be even greater than observed, as the case ascertainment might have been incomplete because of the crude method applied. Further studies in this respect are clearly required to more definitely assess the risk.
挥发性麻醉剂在化学上与工业中使用的有机溶剂相关。接触工业溶剂可能会增加多发性硬化症(MS)的发病率。
研究麻醉护士患MS的风险。
通过在瑞典护士联盟月刊和瑞典神经疾病患者协会杂志上发布呼吁来识别患有MS的护士。90名患有MS的护士做出回应并联系了我们的诊所。他们收到了一份问卷,85名受试者填写了问卷;其中13名是麻醉护士。问卷要求提供有关工作任务、接触情况、诊断、症状和年份的信息。根据国家卫生和福利委员会及护士联盟提供的信息估算在职麻醉护士的数量。以哥德堡地区和丹麦女性的发病率数据作为参考,通过计算标准化发病率(SIR)来估算风险。
13名麻醉护士中有11名在患MS之前接触过麻醉气体。诊断前的平均接触时长为14.4年(范围4 - 27年)。在1980 - 1999年研究期间确诊了10例病例,与哥德堡和丹麦的参考数据相比,标准化发病率分别显著增加至2.9和2.8。
尽管本研究基于粗略数据且分析略显粗略,但它为麻醉护士患MS的额外风险提供了初步证据。由于所采用的方法粗略,病例确定可能不完整,因此实际风险可能比观察到的更大。显然需要在这方面进行进一步研究,以更明确地评估风险。