长期接触二硫化碳的人造丝工人的内膜中层厚度增加。

Increased intima-media thickness in rayon workers after long-term exposure to carbon disulfide.

作者信息

Schramm Axel, Uter Wolfgang, Brandt Meike, Göen Thomas, Köhrmann Martin, Baumeister Thomas, Drexler Hans

机构信息

Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.

Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

出版信息

Int Arch Occup Environ Health. 2016 Apr;89(3):513-9. doi: 10.1007/s00420-015-1091-5. Epub 2015 Oct 9.

DOI:10.1007/s00420-015-1091-5

PMID:26452498

Abstract

INTRODUCTION

Long-term exposure to carbon disulfide (CS2) is associated with increased cardiovascular mortality. However, previous studies on actual vascular changes showed heterogeneous results. Intima-media thickness of the carotid arteries (IMT) represents an established marker of atherosclerosis and a reasonable surrogate marker for cardiovascular risk. IMT was examined in a large cohort of CS2 exposed workers and the association with cumulative CS2 exposure analysed.

METHODS

In a cross-sectional examination, 290 exposed and 137 non-exposed workers in a German rayon-manufacturing plant were assessed. Individual cumulative exposure was calculated from this assessment combined with the results of two cross-sectional studies in 1992 and 1999 and department-specific annual means of ambient (CECS2) and individual biological (CETTCA) monitoring results obtained 1992-2009. Furthermore, cumulative duration of working in CS2-exposed departments (CEYEARS) was calculated. Examination included assessment of a broad set of known cardiovascular risk factors and IMT measurement of the carotid arteries on both sides. Multiple linear regression analyses were performed with IMT as outcome and three variants of cumulative exposure (duration of exposure, cumulative CS2, and cumulative TTCA) as well as categorised maximum CS2 exposure, all adjusted for cardiovascular risk factors.

RESULTS

All models of cumulative exposure showed a significant increase in IMT in the group with the highest level of exposure: CEYEARS > 20 years, β = 0.045 mm; CECS2 > 270 ppm × years, β = 0.052 mm; CETTCA > 33 mg/g creatinine × years, β = 0.038 mm. Alternatively, addressing maximum exposure, workers with CS2 exposure of >10 ppm in at least 3 years exhibited a significant IMT increase (β = 0.068 mm).

CONCLUSION

Long-term CS2 exposure is an independent risk factor concerning IMT changes. The amount of IMT increase, in a similar range as that associated with other cardiovascular risk factors, might be clinically relevant.

摘要

引言

长期接触二硫化碳（CS2）与心血管疾病死亡率增加有关。然而，先前关于实际血管变化的研究结果并不一致。颈动脉内膜中层厚度（IMT）是动脉粥样硬化的既定标志物，也是心血管风险的合理替代标志物。我们在一大群接触CS2的工人中检查了IMT，并分析了其与CS2累积暴露的关联。

方法

在一项横断面检查中，对德国一家人造丝制造工厂的290名接触工人和137名未接触工人进行了评估。根据此次评估结果，结合1992年和1999年两项横断面研究的结果以及1992 - 2009年期间特定部门的环境（CECS2）和个体生物（CETTCA）监测结果的年均值，计算个体累积暴露量。此外，还计算了在接触CS2部门的累积工作时长（CEYEARS）。检查包括评估一系列已知心血管危险因素，并测量双侧颈动脉的IMT。以IMT为结果变量，以累积暴露的三种变体（暴露时长、CS2累积量和TTCA累积量）以及分类的最大CS2暴露量为自变量，进行多元线性回归分析，并对心血管危险因素进行校正。

结果

所有累积暴露模型均显示，暴露水平最高组的IMT显著增加：CEYEARS > 20年，β = 0.045 mm；CECS2 > 270 ppm×年，β = 0.052 mm；CETTCA > 33 mg/g肌酐×年，β = 0.038 mm。另外，考虑最大暴露量时，至少3年CS2暴露量>10 ppm的工人IMT显著增加（β = 0.068 mm）。