Edling C, Ekberg K, Ahlborg G, Alexandersson R, Barregård L, Ekenvall L, Nilsson L, Svensson B G
Department of Occupational Medicine, University Hospital, Uppsala, Sweden.
Br J Ind Med. 1990 Feb;47(2):75-82. doi: 10.1136/oem.47.2.75.
Long term occupational exposure to organic solvents may cause adverse effects to the central nervous system. This collaborative study between six Swedish departments of occupational medicine examines the overall prognosis in terms of working capacity, symptoms, and psychometric test performance for individuals occupationally exposed to organic solvents. After re-analyses of the data from an initial clinical investigation of 111 men, the subjects were divided into two subgroups: one group of 65 with symptoms but no impairment on the tests and one group of 46 with toxic encephalopathy (symptoms and test impairment). At least five years after the initial examination the subjects were asked to attend a re-examination that included a structured medical interview and a psychometric investigation. The results indicate that effects on the central nervous system persist even when exposure has ceased. In the group of 46 more men had stopped working and were receiving sickness or early retirement pensions. This group also had reduced activity levels with regard to everyday life, leisure activities, and education or training and more neuropsychiatric symptoms. There was no support for the view that a solvent induced toxic encephalopathy is a progressive disease comparable with presenile dementia such as Alzheimer's disease or Pick's disease. If a worker was removed from exposure when he presented symptoms without signs of impairment in intellectual function recovery was seen in most cases.
长期职业性接触有机溶剂可能会对中枢神经系统产生不良影响。瑞典六个职业医学部门开展的这项合作研究,考察了职业性接触有机溶剂的个体在工作能力、症状及心理测试表现方面的总体预后情况。在对111名男性的初步临床调查数据进行重新分析后,研究对象被分为两个亚组:一组65人有症状但测试无损伤,另一组46人患有中毒性脑病(有症状且测试有损伤)。在初次检查至少五年后,研究对象被要求参加一次复查,复查内容包括结构化医学访谈和心理测试。结果表明,即使接触已经停止,对中枢神经系统的影响依然存在。在46人组成的那一组中,更多男性已停止工作并领取疾病或提前退休养老金。该组在日常生活、休闲活动以及教育或培训方面的活动水平也较低,且有更多神经精神症状。没有证据支持中毒性脑病是一种类似于早老性痴呆(如阿尔茨海默病或皮克病)的进行性疾病这一观点。如果一名工人在出现症状但无智力功能损伤迹象时就停止接触有机溶剂,那么在大多数情况下都能看到其恢复。