Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Appl Toxicol. 2012 Oct;32(10):777-82. doi: 10.1002/jat.1681. Epub 2011 Apr 5.
The aim of this study was to investigate if visual analogue scales (VAS) of objective symptoms could be validated against objective measurements in exposure studies of chemical vapours in humans. This validation comprises the results of symptom ratings of irritation and objective measurements of effects of the eye, nose and throat from studies of nine different chemicals. The objective measurements included blinking frequency as a measure of eye irritation, acoustic rhinometry of nose irritation and the lung function parameter FEV₁ of irritation in the throat and airways. The statistical analyses were performed with logistic quantile regression. The results show no overall clear correlation between symptom ratings of irritation and objective measurements, although some statistically significant association was found. The last rating of eye irritation during the exposure was significantly correlated at the 75th percentile to the change in blinking frequency during exposure compared with before (P = 0.013). There was also a significant association between ratings of discomfort in the nose and decrease of the minimal nasal cross-sectional area at the 75th percentile (P = 0.016). Further, a nonsignificant association between ratings of discomfort in the nose and decrease in nasal volume was found. No correlation between FEV₁ and ratings of discomfort in the throat or breathing difficulty was detected. There is a relationship between subjective symptoms and objective measures regarding eye and nose irritation at low chemical exposure levels. Thus, the results of this investigation support the use of VAS in chamber exposure studies and could consequently be expanded into field studies.
本研究旨在探讨在人体接触化学蒸气的暴露研究中，客观症状的视觉模拟量表 (VAS) 是否可以与客观测量值相吻合。这种验证包括对 9 种不同化学物质的研究中眼睛、鼻子和喉咙刺激症状评分的结果，以及对眼睛刺激的眨眼频率、鼻子刺激的鼻声反射测量和喉咙及呼吸道刺激的 FEV₁ 等客观测量结果。统计分析采用逻辑分位数回归。结果表明，刺激症状评分与客观测量值之间没有总体上的明确相关性，尽管发现了一些具有统计学意义的关联。暴露期间最后一次眼部刺激评分与暴露期间眨眼频率的变化呈正相关（75 分位数，P=0.013）。鼻子不适评分与最小鼻截面积的降低也存在显著相关性（75 分位数，P=0.016）。此外，还发现鼻子不适评分与鼻体积的减少呈正相关。但是，FEV₁ 与喉咙不适评分或呼吸困难评分之间没有相关性。在低化学暴露水平下，主观症状与眼睛和鼻子刺激的客观测量值之间存在一定关系。因此，本研究结果支持在室暴露研究中使用 VAS，并且可以扩展到现场研究中。
