McConnell R, Keifer M, Rosenstock L
Division of Environmental and Occupational Medicine, Mount Sinai School of Medicine, New York, New York.
Am J Ind Med. 1994 Mar;25(3):325-34. doi: 10.1002/ajim.4700250303.
To evaluate chronic effects of acute organophosphate pesticide poisoning, quantitatively determined vibrotactile thresholds were measured as an index of peripheral neuropathy among agricultural workers in Nicaragua. Thirty-six male workers were evaluated between 10 and 34 months after hospitalization for acute organophosphate poisoning and compared to an age- and sex-matched community reference group. Vibrotactile thresholds were measured quantitatively in right and left index fingers and right and left great toes. Study subjects were stratified into three groups: 1) never poisoned; 2) poisoned with organophosphates other than methamidophos, agents which have not been reported to cause peripheral neuropathy; and 3) poisoned with methamidophos, a peripheral neurotoxin. For all digits, there was a statistically significant trend of increasing age- and height-adjusted thresholds across these three exposure categories. Over one fourth of patients previously poisoned with methamidophos we studied had abnormal vibrotactile thresholds. These results suggest that previously reported cases of organophosphate-induced delayed polyneuropathy may represent only the worst disease in a spectrum of impairment, a sequela of exposure that may be much more common than previously thought.
为评估急性有机磷农药中毒的慢性影响，在尼加拉瓜的农业工人中，对定量测定的振动触觉阈值进行了测量，以此作为周围神经病变的指标。36名男性工人在因急性有机磷中毒住院后10至34个月接受了评估，并与年龄和性别匹配的社区参照组进行了比较。对右手和左手食指以及右、左大脚趾的振动触觉阈值进行了定量测量。研究对象被分为三组：1）从未中毒；2）中毒但接触的是除甲胺磷之外的有机磷，据报道这些药剂不会导致周围神经病变；3）中毒且接触的是甲胺磷，一种周围神经毒素。对于所有手指，在这三种接触类别中，经年龄和身高调整后的阈值存在统计学上显著的上升趋势。我们研究的曾接触甲胺磷中毒的患者中，超过四分之一的人振动触觉阈值异常。这些结果表明，先前报道的有机磷诱发的迟发性多发性神经病病例可能仅代表一系列损伤中最严重的疾病，这种接触后的后遗症可能比先前认为的更为常见。
