Matsuoka Masato
Department of Hygiene and Public Health (I), Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Brain Nerve. 2007 Jun;59(6):591-6.
In this review, the recent findings of central nervous system (CNS) or peripheral nervous system (PNS) dysfunction induced by occupational exposure to organic solvents are described. While acute, high-level exposure to almost all organic solvents causes the general, nonspecific depression of CNS, it is still not clear whether chronic, low-level occupational exposure causes the chronic neurological dysfunction which has been called "organic solvent syndrome", "painters syndrome", "psycho-organic syndrome" or "chronic solvent encephalopathy". At least at lower than occupational exposure limits, chronic and low-level organic solvent exposure does not appear to cause the "sy mptomatic" neurological dysfunction. The chronic, moderate- to high-level exposure to a few organic solvents (such as carbon disulfide, n-hexane and methyl n-butyl ketone) affects CNS or PNS specifically. The substitutes for chlorofluorocarbons, 2-bromopropane and 1-bromopropane were shown to have the peripheral nerve toxicity in the experimental animals. Shortly after these observations, human cases of 1-bromopropane intoxication with the dysfunction of CNS and PNS were reported in the United States. Neurological abnormalities in workers of a 1-bromopropane factory in China were also reported. Thus, the possible neurotoxicity of newly introduced substitutes for ozone-depleting solvents into the workplace must be considered. Enough evidences indicate that some common solvents (such as toluene and styrene) induce sensorineural hearing loss and acquired color vision disturbances in workers. In some studies using magnetic resonance imaging (MRI), cerebral atrophy, patchy periventricular hyperintensities and hypointensities in the basal ganglia were found in solvent-exposed workers as have been shown in toluene abusers (toluene leukoencephalopathy). Further studies using the neurobehavioral test batteries, neurophysiological measurements and advanced neuroimaging techniques are required to detect the "subclinical" dysfunction of nervous systems in workers exposed to organic solvents at low-level.
在本综述中,描述了职业性接触有机溶剂导致中枢神经系统(CNS)或周围神经系统(PNS)功能障碍的最新研究结果。虽然几乎所有有机溶剂的急性、高剂量接触都会导致中枢神经系统的一般性、非特异性抑制,但慢性、低剂量职业性接触是否会导致被称为“有机溶剂综合征”“画家综合征”“精神器质性综合征”或“慢性溶剂性脑病”的慢性神经功能障碍仍不清楚。至少在低于职业接触限值的情况下,慢性、低剂量有机溶剂接触似乎不会导致“有症状的”神经功能障碍。少数有机溶剂(如二硫化碳、正己烷和甲基正丁基酮)的慢性、中高剂量接触会特异性地影响中枢神经系统或周围神经系统。已证明氯氟烃的替代品2-溴丙烷和1-溴丙烷在实验动物中具有周围神经毒性。在这些观察结果出现后不久,美国报告了1-溴丙烷中毒导致中枢神经系统和周围神经系统功能障碍的人类病例。中国一家1-溴丙烷工厂的工人也报告了神经异常情况。因此,必须考虑新引入的消耗臭氧层溶剂替代品进入工作场所可能产生的神经毒性。有足够的证据表明,一些常见溶剂(如甲苯和苯乙烯)会导致工人出现感音神经性听力损失和后天性色觉障碍。在一些使用磁共振成像(MRI)的研究中,在接触溶剂的工人中发现了脑萎缩、脑室周围散在的高信号和基底节区的低信号,这与甲苯滥用者(甲苯白质脑病)的情况相同。需要进一步使用神经行为测试组合、神经生理学测量和先进的神经成像技术来检测低剂量接触有机溶剂的工人神经系统的“亚临床”功能障碍。