牙科助理的神经症状：一项横断面研究。
Neurological symptoms among dental assistants: a cross-sectional study.
机构信息
Institute of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway.
出版信息
J Occup Med Toxicol. 2008 May 18;3:10. doi: 10.1186/1745-6673-3-10.
BACKGROUND
Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure.
METHODS
All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41), as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64) in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest).
RESULTS
The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs.
CONCLUSION
There is a possibility that the higher occurrence of neurological symptoms among the dental assistants may be related to their previous work exposure to mercury amalgam fillings. This should be studied further to assess the clinical importance of the reported symptoms.
背景
牙科助理在为补牙准备材料方面协助牙医。在 1980 年之前，挪威最常用的补牙材料是汞合金，但到 2005 年，其用量已降至所有补牙材料的 5%左右。汞合金通常是银、铜、锡和汞的合金。挪威在 1994 年之前使用的是含铜量特别高的汞合金。金属汞具有神经毒性。尽管牙科助理接触汞，但针对其健康状况的研究很少。由于接触汞，人们对该工作群体中目前是否存在慢性神经症状存在疑问。本研究旨在比较可能因工作中接触补牙汞合金而暴露于汞的牙科助理与无此类接触的类似医护人员之间发生神经症状的情况。
方法
所有仍在工作且出生于 1970 年前的海于格松县工会档案中的牙科助理都受邀参加（响应率 68%，n=41），同时还邀请了相同年龄组中具有相似背景的随机选择的助理护士（响应率 87%，n=64）。参与者填写了一份自我管理的邮寄问卷，其中包含人口统计学变量、生活方式因素、肌肉骨骼、神经和身心症状（Euroquest）的问题。
结果
牙科助理报告称神经症状、身心症状、记忆、注意力、疲劳和睡眠障碍问题的发生率明显更高，但情绪问题没有更高的发生率。经方差分析调整年龄、教育、饮酒、吸烟和人格特质后，结果显示这些症状主要来自手臂、手、腿和平衡器官。
结论
牙科助理神经症状发生率较高可能与他们之前接触汞合金补牙材料有关。应进一步研究以评估报告症状的临床重要性。
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