Teixeira Cleide Fernandes, Augusto Lia Giraldo da Silva, Morata Thais C
Faculdade Integrada do Recife, Recife, PE, Brasil.
Rev Saude Publica. 2003 Aug;37(4):417-23. doi: 10.1590/s0034-89102003000400005. Epub 2003 Aug 20.
To examine the peripheral auditory disorders in a group of workers exposed to organophosphate and pyrethroid insecticides, used in vector control campaigns.
The prevalence study examined a population of 98 individuals who sprayed insecticides in campaigns for the prevention of Dengue, Chagas disease and Yellow fever. The sampling approach was finalistic, and included the workers in a health district of Pernambuco, during the year 2000. A questionnaire was used to collect data on occupational and non-occupational risks, safety measures utilized, family history of auditory problems and health symptoms. Previous noise exposure history was also investigated, since noise can be a confounding factor for hearing loss. Hearing sensitivity and middle ear function were assessed by pure tone audiometry.
Among those exposed to insecticides, 63.8% demonstrated a hearing loss. For the group of workers exposed to both noise and insecticides, hearing loss was observed in 66.7% of the cases. The median exposure time necessary to detect high-frequency losses was 3.4 years for workers exposed to both agents and 7.3 years for workers exposed to insecticides only. Hearing thresholds were poorest among workers exposed to both agents. Auditory damage for those with combined exposures to the two factors was more severe than the hearing losses observed among those exposed only to insecticides.
There is evidence that exposure to insecticides was associated with peripheral sensorioneural hearing loss and that noise exposure can potentiate the ototoxic effects of insecticides. It is necessary to evaluate this possible association through epidemiological studies.
研究一组参与病媒控制活动、接触有机磷和拟除虫菊酯类杀虫剂的工人的外周听觉障碍情况。
这项患病率研究调查了98名在登革热、恰加斯病和黄热病预防活动中喷洒杀虫剂的人员。抽样方法是目的性抽样，纳入了2000年伯南布哥州一个卫生区的工人。通过问卷调查收集职业和非职业风险、所采取的安全措施、听觉问题家族史及健康症状等数据。由于噪声可能是听力损失的混杂因素，因此还调查了既往噪声暴露史。通过纯音听力测定评估听力敏感度和中耳功能。
在接触杀虫剂的人员中，63.8%表现出听力损失。在同时接触噪声和杀虫剂的工人组中，66.7%的病例出现听力损失。对于同时接触两种因素的工人，检测到高频听力损失所需的中位暴露时间为3.4年，而仅接触杀虫剂的工人为7.3年。在同时接触两种因素的工人中，听力阈值最差。同时接触两种因素的人员的听觉损伤比仅接触杀虫剂的人员所观察到的听力损失更为严重。
有证据表明，接触杀虫剂与外周感觉神经性听力损失有关，并且噪声暴露会增强杀虫剂的耳毒性作用。有必要通过流行病学研究评估这种可能的关联。
