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喷漆工人中溶剂混合物的神经毒性。II. 神经学、精神病学、心理学及神经放射学检查结果

Neurotoxicity of solvent mixtures in spray painters. II. Neurologic, psychiatric, psychological, and neuroradiologic findings.

作者信息

Triebig G, Barocka A, Erbguth F, Höll R, Lang C, Lehrl S, Rechlin T, Weidenhammer W, Weltle D

机构信息

Institute and Policlinic of Occupational- and Social Medicine, University of Heidelberg, Germany.

出版信息

Int Arch Occup Environ Health. 1992;64(5):361-72. doi: 10.1007/BF00379547.

Abstract

A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10-44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes "special features of depression" and "loss of interest and concentration" occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

开展了一项多学科横断面研究,以检测有机溶剂的慢性神经毒性。参与研究的有105名喷漆工,他们长期接触溶剂(10 - 44年),还有一个由58名建筑工人、电工和水管工组成的对照组,这些人没有职业性接触溶剂。样本在年龄、暴露前智力水平、职业和社会经济地位方面进行了匹配。在控制了潜在的非职业性混杂因素(神经精神疾病、代谢紊乱、高血压、酒精摄入)后,最终83名喷漆工和42名对照者进入研究。评估包括工作史、自评问卷、神经学检查、使用现况检查(PSE)进行的精神病学分析、心理测试以及脑部计算机断层扫描(CAT)。体格检查和神经学检查未发现中枢或周围神经系统有明显疾病的病例。精神病学分析的一个重要结果是,“抑郁特质”和“兴趣与注意力丧失”综合征在喷漆工中出现的频率明显高于对照组。进一步分析表明这与30年以上的慢性暴露以及溶剂暴露期间反复出现的急性神经毒性作用有关。根据病前智力水平进行调整后,心理测试和能力测试均未显示出能力集有任何统计学上的显著差异;这一发现支持了仅存在轻度精神功能障碍的推测。相关性分析表明主观健康投诉与长期溶剂暴露之间存在关联;然而,年龄因素的影响不能完全排除。(摘要截选至250词)

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