Estrin W J, Bowler R M, Lash A, Becker C E
Department of Neurology, University of California, San Francisco.
J Toxicol Clin Toxicol. 1990;28(1):1-20. doi: 10.3109/15563659008993472.
Ethylene oxide is now frequently used to chemically sterilize heat-sensitive materials in the hospital setting. Previous reports of neurotoxic effects of ethylene oxide have been described in animals and humans. Recent reports suggest that cognitive deficits may be associated with chronic low-level ethylene oxide exposure. We undertook this study of hospital workers with chronic ethylene oxide exposure and compared them with a non-exposed control group in an attempt to detect neurological and neuropsychological abnormalities. Ethylene oxide breathing zone levels of up to 250 ppm in exposed subjects were reported. All evaluations were done without examiners' knowledge of exposure status of the subjects. The exposed group was found to have a statistically significant lower P300 amplitude, bilaterally hypoactive distal deep tendon reflexes and poorer performance on neuropsychological tests involving psychomotor speed. Exposed subjects acknowledged more symptoms and higher levels of depression and anxiety. Nerve conduction velocities and EEG spectral analysis were similar in both exposed and control groups as were scores on most psychological tests. Based upon this information and prior reports, ethylene oxide should be considered in a differential diagnosis of neuropsychological, peripheral and central nervous system dysfunction in workplace settings associated with ethylene oxide exposure.
环氧乙烷现在经常用于医院环境中对热敏材料进行化学消毒。先前已有关于环氧乙烷对动物和人类神经毒性作用的报道。最近的报告表明，认知缺陷可能与长期低水平接触环氧乙烷有关。我们对长期接触环氧乙烷的医院工作人员进行了这项研究，并将他们与未接触的对照组进行比较，试图检测神经和神经心理异常情况。据报告，接触组受试者的环氧乙烷呼吸区水平高达250 ppm。所有评估都是在检查人员不知道受试者接触状况的情况下进行的。发现接触组的P300波幅在统计学上显著较低，双侧远端深部腱反射活动减弱，并且在涉及精神运动速度的神经心理测试中表现较差。接触组受试者承认有更多症状，抑郁和焦虑程度更高。接触组和对照组的神经传导速度和脑电图频谱分析相似，大多数心理测试的得分也相似。根据这些信息和先前的报告，在与环氧乙烷接触相关的工作场所环境中，对神经心理、外周和中枢神经系统功能障碍进行鉴别诊断时应考虑环氧乙烷。
