Wang J D, Chen J D
Center for the Research of Environmental and Occupational Disease, College of Medicine, National Taiwan University, Taipei, Republic of China.
Environ Res. 1993 Apr;61(1):107-16. doi: 10.1006/enrs.1993.1054.
The purpose of this study was to determine the prevalence rates of acute and chronic neurologic symptoms among paint workers and the association of such symptoms with the severity of exposure to mixtures of solvents. Two paint manufacturing factories and 25 various kinds of spray painting factories were selected for study. Air concentrations of organic solvents were measured by personal samplers and were analyzed by gas chromatography. A total of 196 workers were given a screening neurological examination and a questionnaire on acute and chronic neurologic symptoms. A detailed personal medical history and a profile on alcohol consumption and medication were also included. The results showed that xylenes and toluene were the major solvents found in almost all the air samples with average contents of 50 and 24% on a weight basis of 73 air samples. We classified workers according to different exposure patterns and different air concentrations of breathing zones: high (8-hr hygienic effect, 0.25-9.86; median, 1.66), short-term high (hygienic effect, 0-3.38; median, 0.12), and low (hygienic effect, 0-0.38; median, 0.12). All workers showed no overt neurological signs such as ataxic gait, poor coordination, or muscle weakness. After excluding those workers who consumed more than 280 g of alcohol per week (n = 8), took antihypertensive medications (n = 4), or were treated with antipsychotic agents (n = 1), we found that the severity of exposure was associated with acute symptoms of headache and chest tightness and chronic symptoms of dizziness, easy fatigability, depressed mood, and palpitation. There was no association between peripheral neurological symptoms and the severity of exposure. Workers in the high exposure group were 2.7 times more likely to develop two or more acute symptoms and 3.3 times more likely to develop three or more chronic symptoms of the central nervous system than the low exposure group. After modeling by multiple logistic regression, we concluded that exposure to a medium level of mixtures of solvents (hygienic effect exceeding 1.66) may produce acute and chronic central neurological symptoms.
本研究的目的是确定油漆工人中急性和慢性神经症状的患病率，以及此类症状与接触溶剂混合物严重程度之间的关联。选择了两家油漆制造厂和25家各类喷漆厂进行研究。通过个人采样器测量有机溶剂的空气浓度，并采用气相色谱法进行分析。共对196名工人进行了神经系统筛查检查，并就急性和慢性神经症状进行了问卷调查。还包括详细的个人病史以及饮酒和用药情况。结果显示，二甲苯和甲苯是几乎所有空气样本中发现的主要溶剂，在73个空气样本中，按重量计平均含量分别为50%和24%。我们根据不同的接触模式和呼吸区不同的空气浓度对工人进行分类：高（8小时卫生效应，0.25 - 9.86；中位数，1.66）、短期高（卫生效应，0 - 3.38；中位数，0.12）和低（卫生效应，0 - 0.38；中位数，0.12）。所有工人均未表现出明显的神经体征，如共济失调步态、协调性差或肌肉无力。在排除每周饮酒超过280克的工人（n = 8）、服用抗高血压药物的工人（n = 4）或接受抗精神病药物治疗的工人（n = 1）后，我们发现接触严重程度与头痛和胸闷等急性症状以及头晕、易疲劳、情绪低落和心悸等慢性症状相关。周围神经症状与接触严重程度之间无关联。高接触组工人出现两种或更多急性症状的可能性是低接触组的2.7倍，出现三种或更多中枢神经系统慢性症状的可能性是低接触组的3.3倍。经过多因素逻辑回归建模后，我们得出结论，接触中等水平的溶剂混合物（卫生效应超过1.66）可能会产生急性和慢性中枢神经症状。
