Mikkelsen S, Jørgensen M, Browne E, Gyldensted C
Acta Neurol Scand Suppl. 1988;118:1-143.
In recent years, the possible role of occupational solvent exposure as a cause of chronic effects on the brain has been a matter of increasing concern. The present study was undertaken with the purpose of further investigating this problem, trying to minimize confounding owing to effects of recent solvent exposure and a 'healthy worker' effect. This was accomplished by studying a historical cohort of painters. The material consists of a random sample of 85 painters, and as a non-exposed control group of 85 bricklayers, selected in the same way. Parts of the study are based on this sample supplemented by a sample of 9 painters and 14 bricklayers, selected among subjects with a high degree of complaints on mental impairment. On the basis of a detailed interview on previous solvent exposure, the painters were divided into three groups with low, medium and high solvent exposure, respectively. As signs of organic brain damage we used the degree of dementia and performance in psychometric tests as assessed at a neuropsychological examination; the degree of dyscoordination as assessed from clinical neurological tests; and the degree of cerebral atrophy as assessed from CT-scans of the brain. CT-scans were performed only on a specially selected subsample. The degree of dementia, dyscoordination, and cerebral atrophy increased significantly with the degree of solvent exposure. A similar, but non-significant association was found for the relation between performance in psychometric tests and solvent exposure. The degree of dementia, of dyscoordination, and of cerebral atrophy were positively associated with each other, suggesting that they reflect different aspects of a common underlying factor, an organic brain damage. A review of the literature compared with the results of the present study suggests that a number of studies may have been biased towards negative findings owing to the inclusion in the study material of large proportions of subjects with a solvent exposure that is too little to increase the risk of an organic brain damage. Conflicting results between different studies on performance in psychometric tests may also arise from insufficient adjustment for primary intellectual level.(ABSTRACT TRUNCATED AT 400 WORDS)
近年来，职业性接触溶剂作为导致大脑慢性影响的一个可能因素，已日益受到关注。本研究旨在进一步调查这一问题，尽量减少因近期接触溶剂的影响和“健康工人”效应导致的混杂因素。这是通过对一组历史队列的油漆工进行研究来实现的。研究材料包括从85名油漆工中随机抽取的样本，以及同样方式选取的85名泥瓦匠作为未接触组对照。部分研究基于该样本，并补充了从有高度精神损害主诉的受试者中选取的9名油漆工和14名泥瓦匠样本。根据对既往接触溶剂情况的详细访谈，油漆工被分别分为低、中、高溶剂接触三组。作为有机脑损伤的指标，我们采用神经心理学检查评估的痴呆程度和心理测量测试表现；临床神经学检查评估的不协调程度；以及脑部CT扫描评估的脑萎缩程度。CT扫描仅对一个特别选取的子样本进行。痴呆程度、不协调程度和脑萎缩程度随溶剂接触程度显著增加。在心理测量测试表现与溶剂接触之间发现了类似但不显著的关联。痴呆程度、不协调程度和脑萎缩程度之间呈正相关，表明它们反映了一个共同潜在因素——有机脑损伤的不同方面。与本研究结果相比，文献综述表明，由于研究材料中纳入了大量接触溶剂过少以至于不会增加有机脑损伤风险的受试者，许多研究可能偏向于得出阴性结果。不同研究在心理测量测试表现方面的相互矛盾结果，也可能源于对初始智力水平的调整不足。（摘要截选至400字）
