Zamysłowska-Szmytke Ewa, Sliwińska-Kowalska Mariola
Klinika Audiologii i Foniatrii, Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland.
Med Pr. 2013;64(1):83-102.
This manuscript presents an overview of current knowledge on the influence of organic solvents on the hearing and balance systems. The authors analyzed--the literature data concerning the results of all human and the most relevant animal studies, published untill 2012. Moreover, the guidelines for occupational medicine specialists were proposed on the basis of literature review and the authors' own scientific experience. The literature data and our studies revealed the increased risk of hearing loss in workers exposed to organic solvents only, and well documented potentiation of harmful effects of combinedexposure to organic solvents and noise. Hearing impairment is mainly observed in high frequencies, but lower frequencies can also be involved (0.5-4 kHz). The impairment induced by exposure to organic solvents is mild, up to several dBs. In the combined exposure to noise and solvents, the noise effect predominates. Organic solvents affect the central pathways of vestibular system although unilateral or bilateral vestibular hypofunction might also be a possible consequence of solvent exposure. Occupational exposure to organic solvents is a risk factor for hearing and balance impairments. Therefore, workers exposed to solvents should be covered by hearing loss prevention programs. Speech in noise test (HINT) and posturography seem to be the most suitable tests for hearing and balance prevention programme for organic solvent exposed workers.
本手稿概述了目前关于有机溶剂对听力和平衡系统影响的知识。作者分析了截至2012年发表的所有关于人类和最相关动物研究结果的文献数据。此外，在文献综述和作者自身科学经验的基础上，为职业医学专家提出了指导方针。文献数据和我们的研究表明，仅接触有机溶剂的工人听力损失风险增加，并且有充分记录显示，有机溶剂与噪声联合暴露会增强有害影响。听力障碍主要出现在高频，但低频（0.5 - 4千赫）也可能受到影响。有机溶剂暴露引起的损伤较轻，可达几分贝。在噪声与溶剂联合暴露中，噪声的影响占主导。有机溶剂会影响前庭系统的中枢通路，尽管单侧或双侧前庭功能减退也可能是溶剂暴露的一个可能后果。职业性接触有机溶剂是听力和平衡功能受损的一个危险因素。因此，接触溶剂的工人应纳入听力损失预防计划。噪声环境下言语测试（HINT）和姿势描记法似乎是针对接触有机溶剂工人的听力和平衡预防计划最合适的测试方法。
