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二硫化碳对人造丝制造工人脑部磁共振成像影响的六年观察性队列研究。

Six year observational cohort study of the effect of carbon disulphide on brain MRI in rayon manufacturing workers.

作者信息

Nishiwaki Y, Takebayashi T, O'Uchi T, Nomiyama T, Uemura T, Sakurai H, Omae K

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Occup Environ Med. 2004 Mar;61(3):225-32. doi: 10.1136/oem.2002.006932.

Abstract

AIMS

To clarify whether the current occupational exposure limit (OEL) for carbon disulphide (CS2) is low enough to prevent the occurrence of adverse effects on the cerebrovascular system.

METHODS

A total of 432 male workers exposed to CS2 and 402 male referent workers in 11 Japanese viscose rayon factories were studied at baseline; 750 of these were followed up. Brain MRI was performed at both baseline and follow up surveys. Changes in the number of hyperintense spots in T2 weighted images (HIS), which point to so-called "silent cerebral infarctions", were evaluated over six years. A total of 666 subjects (217 exposed, 125 ex-exposed, and 324 referent subjects) who twice received brain MRI were subjected to analysis. Mean duration of exposure to the end of the study was 19.6 years for the exposed workers. The geometric mean CS2 (ppm) and TTCA (mg/g creatinine) concentrations for the past six years were 4.9 and 1.6 for all exposed workers, 5.8 and 1.9 for spinning/refining workers, and 2.7 and 0.9 for other exposed workers, respectively.

RESULTS

Exposed subjects showed a significantly higher risk for an increase in the number of HIS over six years. Odds ratios adjusted for possible confounders in the exposed and ex-exposed workers were 2.27 (95% CI 1.37 to 3.76) and 1.33 (95% CI 0.70 to 2.54), respectively. No exposure-response relations were observed in a number of analyses among the exposed workers.

CONCLUSIONS

Exposure to CS2 under the current Japanese OEL, 10 ppm, might increase the number of HIS in brain MRI. However, results should be interpreted with caution.

摘要

目的

明确当前二硫化碳(CS2)的职业接触限值(OEL)是否足够低,以防止对脑血管系统产生不良反应。

方法

对日本11家粘胶人造丝工厂的432名接触CS2的男性工人和402名男性对照工人进行了基线研究;其中750人接受了随访。在基线和随访调查时均进行了脑部磁共振成像(MRI)检查。对T2加权图像(HIS)中高强度斑点数量的变化进行了评估,这些斑点提示所谓的“无症状脑梗死”,研究为期六年。对666名两次接受脑部MRI检查的受试者(217名接触者、125名曾经接触者和324名对照受试者)进行了分析。到研究结束时,接触工人的平均接触时长为19.6年。所有接触工人过去六年的CS2(ppm)几何平均浓度和2-硫代噻唑烷-4-羧酸(TTCA,mg/g肌酐)浓度分别为4.9和1.6,纺丝/精炼工人分别为5.8和1.9,其他接触工人分别为2.7和0.9。

结果

接触组受试者在六年内HIS数量增加的风险显著更高。对接触工人和曾经接触工人中可能的混杂因素进行调整后的优势比分别为2.27(95%置信区间1.37至3.76)和1.33(95%置信区间0.70至2.54)。在对接触工人进行的多项分析中未观察到接触-反应关系。

结论

在日本当前10 ppm的OEL下接触CS2可能会增加脑部MRI中HIS的数量。然而,对结果的解释应谨慎。

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