Shih Hsu-Tzu, Yu Chin-Lin, Wu Ming-Tsang, Liu Chiu-Shong, Tsai Chon-Haw, Hung Dong-Zong, Wu Chun-Shing, Kuo Hisen-Wen
Department of Occupational Medicine, Kuang Tien General Hospital, Taiwan, Institute of Environmental Health, China.
Toxicol Ind Health. 2011 Sep;27(8):691-9. doi: 10.1177/0748233710395348. Epub 2011 May 4.
Short-term exposure to a high concentration (TWA > 100 ppm) of toluene can cause hepatotocixity and neurotoxicity in humans. Data on the effects of exposure to low levels of toluene, however, are controversial. In addition, few studies on the effects of toluene exposure on the autonomic nervous system have been conducted. Urine samples from 34 male factory workers in Taiwan who were exposed to low levels of toluene either intermittently (n = 13) or continuously (n = 21) were taken on a Monday morning after a 2-day hiatus and at the end of the workweek on Friday evening. Urinary hippuric acid levels were measured using high-performance liquid chromatography (HPLC). A complete blood work-up was also performed for each subject. The prevalence and severity of neurotoxic symptoms were investigated by a self-reported questionnaire, a neuropsychiatric battery, and sympathetic and peripheral nerve function tests. The mean value of urinary hippuric acid corrected for creatinine (Cr) was 0.34 ± 0.18 g/g Cr on Monday morning and 0.43 ± 0.26 g/g Cr on Friday evening. The difference in the mean value of urinary hippuric acid between the two periods (p < 0.01) and the odds ratio of impairment of sympathetic (OR = 4.13, p = 0.11) and peripheral nerves (OR = 6.94, p = 0.074) were higher in workers continuously exposed to toluene. In addition, workers who were continuously exposed to toluene had a lower mean platelet count (216 ± 41 × 10(6) /µL) than workers who were intermittently exposed (252 ± 40 × 10(6)/µL), (p = 0.018). Furthermore, there was a positive relationship between neurological abnormalities and a self-reported neuropsychiatric measurement (r = 0.35-0.66, p < 0.05) in all workers. These data suggest that continuous exposure to low levels of toluene may be associated with sympathetic and peripheral nerve dysfunction and sub-clinical hematological damage. Further research needs to be carried out regarding how chronic exposure to low-levels of toluene affects workers.
短期接触高浓度（时间加权平均浓度>100 ppm）的甲苯可导致人类肝脏毒性和神经毒性。然而，关于接触低水平甲苯影响的数据存在争议。此外，关于甲苯暴露对自主神经系统影响的研究很少。在台湾，从34名男性工厂工人中采集尿液样本，这些工人间歇性（n = 13）或持续性（n = 21）接触低水平甲苯。样本采集时间为周一上午（经过两天休假后）和周五晚上工作周结束时。使用高效液相色谱法（HPLC）测量尿马尿酸水平。还对每个受试者进行了全血细胞检查。通过自我报告问卷、神经精神成套测验以及交感神经和周围神经功能测试来调查神经毒性症状的患病率和严重程度。周一上午校正肌酐（Cr）后的尿马尿酸平均值为0.34±0.18 g/g Cr，周五晚上为0.43±0.26 g/g Cr。两个时间段尿马尿酸平均值的差异（p < 0.01）以及持续性接触甲苯的工人交感神经（比值比=4.13，p = 0.11）和周围神经损伤的比值比（比值比=6.94，p = 0.074）更高。此外，持续性接触甲苯的工人平均血小板计数（216±41×10⁶/µL）低于间歇性接触的工人（252±40×10⁶/µL），（p = 0.018）。此外，所有工人的神经学异常与自我报告的神经精神测量之间存在正相关（r = 0.35 - 0.66，p < 0.05）。这些数据表明，持续接触低水平甲苯可能与交感神经和周围神经功能障碍以及亚临床血液学损伤有关。关于长期接触低水平甲苯如何影响工人，还需要进一步开展研究。
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