Labrèche F P, Cherry N M, McDonald J C
School of Occupational Health, McGill University, Montreal, Quebec, Canada.
Br J Ind Med. 1992 Dec;49(12):820-5. doi: 10.1136/oem.49.12.820.
Three hundred and eighty one men admitted to hospital for the first time with any psychiatric diagnosis were individually matched for age and year to patients admitted to general hospitals. An occupational history was obtained from 90% of this study group by telephone interview or mail. Exposure to solvents was assessed by three methods, individual rating of each job recorded, application of an exposure matrix based on job title, and assessment of lifetime job histories of selected case-referent pairs. A sample of individual ratings used in the analysis was compared with ratings made by five experts. The panel values tended to be lower but all six sets of ratings correlated well. There was no increased risk of psychiatric illness among subjects exposed to moderate or greater solvent concentrations for at least 10 years (odds ratio (OR) 1.0, 90% confidence interval (90% CI) 0.7-1.4, individual rating; OR 1.1, 90% CI 0.6-2.0, job title matrix; OR 0.9, 90% CI 0.5-1.7, lifetime assessments). At higher exposures the risk was increased--although not to a statistically significant degree--especially for cases with non-psychotic diagnoses (ICD-9 codes 300-316). This negative result, by all three methods of assessment of exposure, contrasted with that from a parallel investigation of cases of organic psychoses and cerebral degeneration.
首次因任何精神疾病诊断入院的381名男性,在年龄和年份上与综合医院的患者进行了个体匹配。通过电话访谈或邮件,从该研究组90%的患者处获取了职业史。通过三种方法评估溶剂暴露情况:记录每份工作的个体评级、应用基于职位名称的暴露矩阵以及评估选定病例对照对的终生工作经历。将分析中使用的个体评级样本与五位专家的评级进行了比较。专家小组的评级往往较低,但所有六组评级的相关性都很好。在至少10年接触中度或更高溶剂浓度的受试者中,精神疾病风险没有增加(优势比(OR)为1.0,90%置信区间(90%CI)为0.7 - 1.4,个体评级;OR为1.1,90%CI为0.6 - 2.0,职位名称矩阵;OR为0.9,90%CI为0.5 - 1.7,终生评估)。在更高的暴露水平下,风险有所增加——尽管未达到统计学显著程度——尤其是对于非精神病性诊断(国际疾病分类第九版代码300 - 316)的病例。通过所有三种暴露评估方法得出的这一阴性结果,与对器质性精神病和脑变性病例的平行调查结果形成对比。