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职业性苯乙烯暴露与神经行为功能:一项重复测量的队列研究。

Occupational styrene exposure and neurobehavioural functions: a cohort study with repeated measurements.

作者信息

Seeber Andreas, Bruckner Thomas, Triebig Gerhard

机构信息

Institute of Occupational Physiology at the University of Dortmund, Dortmund, Germany.

出版信息

Int Arch Occup Environ Health. 2009 Aug;82(8):969-84. doi: 10.1007/s00420-008-0382-5. Epub 2008 Nov 19.

Abstract

OBJECTIVE

Associations between occupational styrene exposure and cognitive as well as psychomotor functions were investigated with a view to answering three questions: (1) are the published results for neurobehavioural impairment reproducible, (2) if such effects exist, are they related to current or to chronic exposure and (3) if effects exist, are there reductions in the effects during an exposure-free period.

METHODS

Workers from a boat-building plant, some of whom were laminators, were investigated in groups of low (n = 83, mean mandelic acid MA + phenylglyoxylic acid PGA = 53 mg/g creatinine), medium (n = 101, 230 mg/g creat.) and high (n = 29, 928 mg/g creat.) levels of exposure to styrene. The mean job tenure was about 6 years. In addition, subgroups chronically exposed to low-short (n = 30, lifetime weighted average exposure mean 184 mg/g creat. for 6 years) and high-long (n = 16, 693 mg/g creat., 15 years) styrene levels were analyzed. The examinations were carried out during normal working days and during the company holidays. A symptom questionnaire and the tests Benton visual retention, symbol digit substitution and digit span for cognitive functions as well as choice reaction, aiming, peg board, tapping, and steadiness for psychomotor functions were administered. Co-variance analyzes with repeated measurements and linear regressions were used for statistical analysis. Co-factors were education, age, job tenure, long-term alcohol consumption, and German as mother tongue. In some cases also the activity as a laminator was considered.

RESULTS

Symptoms were not related to exposure. The tests for cognitive functions generally revealed (all variance analyses) no exposure-related associations. Only the linear regressions of Benton test results showed significant correlation with parameters of chronic exposure which was still evident as a tendency in the work-free and exposure-free period. Most tests for psychomotor functions also revealed no relationships with exposure. However, the peg board test results showed significant correlations with chronic exposure which disappeared during holidays. The activity as a laminator--considered in addition to exposure parameters--was significant as a factor to explain the variability of psychomotor variables.

CONCLUSION

Acute exposures to up to 40 ppm styrene and long-term exposures to about 27 ppm averaged over a period of 15 years were not identified as being associated with an elevated risk of developing impaired cognitive and psychomotor functions or increased symptom levels with the tests applied. This statement must be qualified by two exceptions: performances in the Benton test and in a finger dexterity test were associated with parameters of long-term exposure as a dose-response relationship, but not with current exposure.

摘要

目的

研究职业性苯乙烯暴露与认知及精神运动功能之间的关联,以回答三个问题:(1)已发表的神经行为损伤结果是否可重复?(2)若存在此类影响,它们与当前暴露还是慢性暴露有关?(3)若存在影响,在无暴露期影响是否会降低?

方法

对一家造船厂的工人进行调查,其中一些是层压工,按照低(n = 83,平均扁桃酸MA + 苯乙醛酸PGA = 53毫克/克肌酐)、中(n = 101,230毫克/克肌酐)、高(n = 29,928毫克/克肌酐)苯乙烯暴露水平分组。平均工作年限约为6年。此外,还分析了长期低剂量短期暴露(n = 30,终生加权平均暴露量为184毫克/克肌酐,持续6年)和高剂量长期暴露(n = 16,693毫克/克肌酐,持续15年)的亚组。检查在正常工作日和公司假期进行。发放了症状问卷,并进行了用于认知功能的本顿视觉保持、符号数字替换和数字广度测试,以及用于精神运动功能的选择反应、瞄准、钉板、敲击和稳定性测试。采用重复测量的协方差分析和线性回归进行统计分析。协变量包括教育程度、年龄、工作年限、长期饮酒以及以德语为母语。在某些情况下,还考虑了层压工的活动情况。

结果

症状与暴露无关。认知功能测试(所有方差分析)一般未显示出与暴露相关的关联。只有本顿测试结果的线性回归显示与慢性暴露参数有显著相关性,在无工作和无暴露期这种相关性仍有明显趋势。大多数精神运动功能测试也未显示出与暴露的关系。然而,钉板测试结果与慢性暴露有显著相关性,在假期期间这种相关性消失。除暴露参数外,层压工的活动作为解释精神运动变量变异性的一个因素具有显著性。

结论

对于所应用的测试,未发现急性暴露至高达40 ppm苯乙烯以及15年期间平均长期暴露至约27 ppm与认知和精神运动功能受损风险升高或症状水平增加有关。但有两个例外需要说明:本顿测试和手指灵活性测试的表现与长期暴露参数呈剂量反应关系,但与当前暴露无关。

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