Maizlish N A, Fine L J, Albers J W, Whitehead L, Langolf G D
Br J Ind Med. 1987 Jan;44(1):14-25. doi: 10.1136/oem.44.1.14.
Workers with long term exposure to mixtures of organic solvents below regulatory limits have been reported to experience mild, but clinically detectable, sensory or sensorimotor polyneuropathies. In conjuction with a cross sectional study of behavioural performance a clinical neurological evaluation was conducted among printers and spray painters to examine dose response relations. All 240 subjects completed an occupational history and symptom questionnaire and underwent a clinical neurological examination. On average, subjects had been employed on their current job for six years. Classification of solvent exposure for each subject was based on exposed versus non-exposed job titles and observations during an industrial hygiene walk-through or on the measured concentration of solvents in full shift personal air samples. The average full shift solvent concentration was 302 ppm for printing plant workers and 6-13 ppm for workers at other plants. Isopropanol and hexane were the major constituents. Neurological abnormalities consistent with mild polyneuropathy were found in 16% of subjects; none was clinically significant. Exposed/non-exposed comparisons showed slightly higher frequency of symptoms in the exposed subjects which was not related to solvent level. Subjects categorised as exposed during the walk- through survey also had poorer vibratory sensation measured at the foot and diminished ankle reflexes. In multiple linear regression models, however, controlling for age, sex, alcohol intake, and examiner, no significant (p less than 0.05) relation was found between solvent concentration and poor neurological function except for two point discrimination measured at the foot. This investigation has not provided evidence for dose related adverse neurological effects from exposure to moderately low levels of solvent mixtures for a relatively short duration, although this may be due to the shortness of exposure duration, the type of solvent exposure, or to selection factors.
据报道，长期接触低于监管限值的有机溶剂混合物的工人会出现轻微但临床上可检测到的感觉或感觉运动性多发性神经病。结合一项关于行为表现的横断面研究，对印刷工人和喷漆工人进行了临床神经学评估，以检查剂量反应关系。所有240名受试者都完成了职业史和症状问卷，并接受了临床神经学检查。平均而言，受试者从事当前工作已有六年。根据暴露与未暴露的工作岗位以及工业卫生巡查期间的观察结果或全时个人空气样本中溶剂的测量浓度，对每个受试者的溶剂暴露进行分类。印刷厂工人的全时平均溶剂浓度为302 ppm，其他工厂工人为6 - 13 ppm。异丙醇和己烷是主要成分。在16%的受试者中发现了与轻度多发性神经病一致的神经学异常；均无临床意义。暴露组与非暴露组的比较显示，暴露组的症状发生率略高，但与溶剂水平无关。在巡查调查中被归类为暴露的受试者在足部测量的振动感觉也较差，踝反射减弱。然而，在多元线性回归模型中，在控制年龄、性别、酒精摄入量和检查者后，除了足部测量的两点辨别力外，未发现溶剂浓度与神经功能不良之间存在显著（p小于0.05）关系。这项调查没有提供证据表明，在相对较短的时间内接触中等低水平的溶剂混合物会产生与剂量相关的不良神经影响，尽管这可能是由于暴露时间短、溶剂暴露类型或选择因素所致。
