Stĕtkárová I, Urban P, Procházka B, Lukás E
Department of Neurology, Postgraduate Medical School, Thomayer's Hospital, Prague, Czechoslovakia.
Br J Ind Med. 1993 Jun;50(6):520-7. doi: 10.1136/oem.50.6.520.
Somatosensory evoked potentials (SEPs) were used to evaluate possible subclinical impairment of the nervous system due to occupational exposure to toluene and styrene. A group of 36 rotogravure printers with severe exposure to toluene, 20 workers with severe exposure to styrene in a glass laminate manufacturing plant, and a comparison group of healthy subjects were studied. The severity of exposure was documented by measurements of toluene and styrene concentrations in breathing zone air, by hippuric acid concentration in urine in the group exposed to toluene, and by urinary mandelic acid concentration in the group exposed to styrene. Somatosensory evoked potentials were measured by stimulation of the median nerve at the wrist and the tibial nerve at the ankle. Peripheral conduction velocities (CVs) in both extremities and central conduction time (CCT) after tibial nerve stimulation were significantly decreased in both exposed groups. Significantly prolonged latencies of peripheral and cortical SEPs to median nerve stimulation as well as cortical SEPs to tibial nerve stimulation were found in workers exposed to styrene. Some abnormalities in SEPs at peripheral or spinal and cortical levels were found in eight workers exposed to toluene and six workers exposed to styrene. Of these, in three workers exposed to toluene and two to styrene increased CCT and delayed latencies of cortical responses at normal conduction values in the periphery were found. A trend for increased frequency of abnormal SEPs with duration of exposure to toluene and styrene and alcohol abuse was found. Abnormalities in SEPs in the exposed groups are most probably of multifactorial origin. Central SEP abnormalities in both exposed groups could indicate early signs of subclinical dysfunction at spinal and cortical levels and could be due to toluene or styrene exposure probably potentiated by alcohol consumption in the group exposed to toluene.
体感诱发电位(SEPs)被用于评估因职业接触甲苯和苯乙烯而可能导致的神经系统亚临床损伤。研究了一组36名严重接触甲苯的凹版印刷工人、20名在玻璃层压板制造工厂严重接触苯乙烯的工人以及一组健康对照者。通过测量呼吸带空气中甲苯和苯乙烯的浓度、接触甲苯组尿液中马尿酸的浓度以及接触苯乙烯组尿液中扁桃酸的浓度来记录接触的严重程度。通过刺激腕部正中神经和踝部胫神经来测量体感诱发电位。两个暴露组双下肢的外周传导速度(CVs)以及胫神经刺激后的中枢传导时间(CCT)均显著降低。在接触苯乙烯的工人中,发现正中神经刺激的外周和皮层SEP潜伏期以及胫神经刺激的皮层SEP潜伏期显著延长。在8名接触甲苯的工人和6名接触苯乙烯的工人中发现了外周或脊髓及皮层水平的SEP一些异常。其中,在3名接触甲苯的工人和2名接触苯乙烯的工人中,发现CCT增加且外周传导值正常时皮层反应潜伏期延迟。发现异常SEP的频率有随着接触甲苯和苯乙烯的时间以及酗酒而增加的趋势。暴露组SEP异常很可能是多因素起源的。两个暴露组的中枢SEP异常可能表明脊髓和皮层水平亚临床功能障碍的早期迹象,并且可能是由于甲苯或苯乙烯暴露,在接触甲苯的组中可能因饮酒而加剧。