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有机溶剂暴露。一项针对职业暴露的护理人员和工业喷漆工的横断面流行病学调查,特别关注神经系统。

Exposure to organic solvents. A cross-sectional epidemiologic investigation on occupationally exposed care and industrial spray painters with special reference to the nervous system.

作者信息

Elofsson S A, Gamberale F, Hindmarsh T, Iregren A, Isaksson A, Johnsson I, Knave B, Lydahl E, Mindus P, Persson H E, Philipson B, Steby M, Struwe G, Söderman E, Wennberg A, Widén L

出版信息

Scand J Work Environ Health. 1980 Dec;6(4):239-73. doi: 10.5271/sjweh.2609.

Abstract

In the present epidemiologic study 80 car or industrial spray painters with long-term low level exposure to organic solvents were examined and compared with two matched reference groups of nonexposed industrial workers (80 persons in each group). The aim of the study was to investigate the possible effects of the solvent exposure on health. The investigation included psychiatric interviews, psychometric tests, neurological, neurophysiological and ophthalmologic examinations, and computed tomography of the brain. The painters' previous and present exposure was carefully assessed by interviews and on-the-job measurements both at modern places of work and in a reconstructed model of a workshop from 1955. On the basis of the psychiatric interviews the psychiatric symptoms were rated according to a specially designed scale of 46 different items, graded in seven steps of increasing severity. The psychological performance was assessed by a battery of 18 tests. The neurological and neurophysiological examinations comprised visual evoked responses (VER), electroencephalography (EEG), and computerized EEG analysis (SPA) for the central nervous system and electroneurography (ENeG), the estimation of vibration sense thresholds, and a quantified neurological examination for the peripheral nervous system. The ophthamologic examination concentrated on the condition of the lens. Statistically significant differences between the exposed individuals and referents were found for psychiatric items indicative of a slight cerebral lesion (ie, a neurasthenic syndrome). The psychometric tests revealed statistically significant differences between the groups with respect to reaction time, manual dexterity, perceptual speed, and short-term memory. No differences were found with respect to performance on verbal, spatial, and reasoning tests. Significant differences between the groups were also found for the majority of the neurophysiological parameters measuring peripheral nerve functions, the most pronounced occurring in the long, sensory fibers. Moreover EEG and VER showed some differences between the groups, as did the results of the ophthalmologic examination and the computed tomography. Finally, it should be emphasized that the exposure levels, as measured at modern places of work and in the reconstructed workshop from 1955, were found to be considerably lower than the valid threshold limit values in Sweden.

摘要

在本次流行病学研究中,对80名长期低水平接触有机溶剂的汽车喷漆工或工业喷漆工进行了检查,并与两组匹配的未接触有机溶剂的产业工人对照组(每组80人)进行了比较。该研究的目的是调查溶剂暴露对健康可能产生的影响。调查包括精神病学访谈、心理测试、神经学、神经生理学和眼科检查,以及脑部计算机断层扫描。通过访谈以及在现代工作场所和1955年车间重建模型中的在职测量,仔细评估了喷漆工过去和现在的接触情况。根据精神病学访谈,按照一个专门设计的包含46个不同项目的量表对精神病症状进行评分,该量表按严重程度递增分为七个等级。通过一组18项测试评估心理表现。神经学和神经生理学检查包括针对中枢神经系统的视觉诱发电位(VER)、脑电图(EEG)和计算机化脑电图分析(SPA),以及针对周围神经系统的神经电图(ENeG)、振动感觉阈值估计和定量神经学检查。眼科检查主要关注晶状体状况。在表明轻微脑部病变(即神经衰弱综合征)的精神病学项目方面,发现暴露个体与对照组之间存在统计学上的显著差异。心理测试显示,两组在反应时间、手部灵活性、感知速度和短期记忆方面存在统计学上的显著差异。在语言、空间和推理测试的表现方面未发现差异。在测量周围神经功能的大多数神经生理学参数方面,两组之间也存在显著差异,最明显的差异出现在长感觉纤维中。此外,脑电图和视觉诱发电位在两组之间也显示出一些差异,眼科检查和计算机断层扫描的结果也是如此。最后,应该强调的是,在现代工作场所和1955年重建车间所测量的暴露水平,被发现远低于瑞典有效的阈限值。

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