Lee C-Y, Jung S-J, Kim S-A, Park K-S, Ha B-G
Department of Occupational and Environmental Medicine, Gumi CHA Medical Center, College of Medicine, Pochon CHA University, Gumi, Korea (South).
Occup Environ Med. 2006 Oct;63(10):688-93. doi: 10.1136/oem.2005.023580. Epub 2006 May 25.
To investigate the incidence of N,N-dimethylacetamide (DMA) induced hepatic injury among new elastane fibre workers and to explore factors relating to DMA induced hepatic injury.
Elastane fibre workers exposed to DMA were monitored for hepatic injury. Four hundred and forty new workers employed from 1 January 2002 to 31 July 2004 were included as study subjects. DMA exposure estimates were based on urinary N-methylacetamide (NMA) concentrations.
There were 28 cases of DMA induced hepatic injury. The overall incidence of DMA induced hepatic injury among new elastane fibre workers was 0.089/person-year. Incidence rates were 7-10 times higher in high exposure groups than in low exposure groups. Fewer DMA induced hepatic injuries occurred among workers employed for a longer period. Workers whose exposure duration was more than seven months showed no hepatic injury in either the high or low exposure groups. Exposure category and duration of employment were significant variables in the multiple logistic regression analysis.
Results suggest the existence of dose dependent DMA induced hepatic injury. The inverse relation between the incidence of DMA induced hepatic injury and duration of employment may reflect a type of healthy survivor effect or tolerance to DMA induced hepatic injury.
调查新型弹性纤维工人中N，N - 二甲基乙酰胺（DMA）所致肝损伤的发生率，并探讨与DMA所致肝损伤相关的因素。
对接触DMA的弹性纤维工人进行肝损伤监测。纳入2002年1月1日至2004年7月31日雇用的440名新工人作为研究对象。DMA暴露评估基于尿中N - 甲基乙酰胺（NMA）浓度。
有28例DMA所致肝损伤病例。新型弹性纤维工人中DMA所致肝损伤的总体发生率为0.089/人年。高暴露组的发生率比低暴露组高7至10倍。工作时间较长的工人中发生的DMA所致肝损伤较少。暴露持续时间超过7个月的工人在高暴露组和低暴露组中均未出现肝损伤。在多因素逻辑回归分析中，暴露类别和工作时间是显著变量。
结果表明存在剂量依赖性的DMA所致肝损伤。DMA所致肝损伤发生率与工作时间之间的负相关关系可能反映了一种健康幸存者效应或对DMA所致肝损伤的耐受性。
