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职业性溶剂暴露与法国 CONSTANCES 研究中认知表现的关联。

Association between occupational solvent exposure and cognitive performance in the French CONSTANCES study.

机构信息

Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France

Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France.

出版信息

Occup Environ Med. 2020 Apr;77(4):223-230. doi: 10.1136/oemed-2019-106132. Epub 2020 Feb 19.

Abstract

OBJECTIVE

The objective of this study was to evaluate the association between occupational exposure to solvents and cognitive performance in middle-aged and early-ageing participants, taking into account the working environment.

METHODS

In the French Cohorte des consultants des Centres d'examens de santé (CONSTANCES) cohort, 41 854 participants aged 45- years completed a self-reported, lifetime occupational exposure questionnaire. Exposure to solvents (gasoline for hand washing, trichloroethylene, white spirit, cellulosic thinner) was first considered as a binary variable (exposed/not exposed). We computed number of solvent types to which participants were exposed, solvent exposure time and delay since last exposure. Cognitive performance was assessed and analysed in reference to norms of neuropsychological battery previously established in CONSTANCES according to age, sex and education. Multiple linear and modified Poisson regression were used to estimate the associations between solvent exposure and cognitive performance adjusting for individual and environmental characteristics, and working conditions (night shift, repetitive and noisy work).

RESULTS

Men had a greater risk of global cognitive impairment when they were exposed to gasoline (relative risk (RR)=1.12, 95% CI 1.03 to 1.22), white spirit (RR=1.14, 95% CI 1.05 to 1.25) or cellulosic thinner (RR=1.17, 95% CI 1.06 to 1.31) at the workplace, even after adjusting for confounders. Women exposed to white spirit or exposed for more than 20 years had poorer global cognitive performance.

CONCLUSION

These findings strengthen our understanding of the detrimental effect of solvent exposure on cognitive health not only in men but also in women for the first time, in a large general population middle-aged and early-ageing sample from France, taking into account working conditions.

摘要

目的

本研究旨在评估中年和早期参与者职业暴露于溶剂与认知表现之间的关联,同时考虑工作环境。

方法

在法国顾问健康检查中心队列(CONSTANCES)队列中,41854 名年龄在 45-岁的参与者完成了一份自我报告的终生职业暴露问卷。首先,将暴露于溶剂(用于洗手的汽油、三氯乙烯、白油、纤维素稀释剂)视为二分类变量(暴露/未暴露)。我们计算了参与者接触的溶剂类型数量、溶剂暴露时间和最后一次暴露后的延迟时间。根据年龄、性别和教育程度,根据先前在 CONSTANCES 中建立的神经心理成套测验的正常值,评估和分析认知表现。使用多元线性和修正泊松回归来估计溶剂暴露与认知表现之间的关联,调整个体和环境特征以及工作条件(夜班、重复性和嘈杂工作)。

结果

男性在工作场所暴露于汽油(相对风险(RR)=1.12,95%置信区间(CI)1.03 至 1.22)、白油(RR=1.14,95%CI 1.05 至 1.25)或纤维素稀释剂(RR=1.17,95%CI 1.06 至 1.31)时,更有可能出现整体认知障碍,即使在调整了混杂因素后也是如此。女性暴露于白油或暴露时间超过 20 年时,整体认知表现较差。

结论

这些发现首次在法国一个大型中年和早期一般人群样本中,考虑到工作条件,不仅在男性中,而且在女性中,加强了我们对溶剂暴露对认知健康的有害影响的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4df8/7079188/f28f8eaf6f8e/oemed-2019-106132f01.jpg

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