Lindgren K N, Masten V L, Ford D P, Bleecker M L
Center for Occupational and Environmental Neurology, Baltimore, MD 21211, USA.
Occup Environ Med. 1996 Jul;53(7):472-7. doi: 10.1136/oem.53.7.472.
To determine if measures reflecting chronic occupational lead exposure are associated with performance on neuropsychological tests.
467 Canadian male lead smelter workers (mean (SD) age 43.4 (11.00) years, education 9.8 (3.18) years, years of employment 17.7 (7.43), and current blood lead concentration (B-Pb) 27.5 (8.4) micrograms dl-1) were given a neuropsychological screening battery. Time weighted average (TWA) and time integrated blood levels (IBL) were developed from B-Pb records obtained through regular medical monitoring (mean (range) TWA 40.1 (4.0-66.4) micrograms dl-1, mean IBL 765.2 (0.6-1625.7) micrograms-y dl-1). 14 neuropsychological variables were included in three multivariate analyses of covariance, with each exposure variable as the grouping variable (high, medium, and low) and age, education, score on a measure of depressive symptoms, and self reported alcohol use as the covariates. Groups did not differ in history of neurological conditions.
Neither the B-Pb, TWA, nor IBL was significant by multivariate analyses of covariance (MANCOVA). When years of employment, a suppressor variable, was included as a covariate, IBL exposure groups differed significantly on digit symbol, logical memory, Purdue dominant hand, and trails A and B.
A dose-effect relation was found between cumulative exposure (IBL) and neuropsychological performance at a time when current B-Pb concentrations were low and showed no association with performance.
确定反映慢性职业性铅暴露的指标是否与神经心理学测试表现相关。
对467名加拿大男性铅冶炼工人(平均(标准差)年龄43.4(11.00)岁,受教育年限9.8(3.18)年,工作年限17.7(7.43)年,当前血铅浓度(B-Pb)27.5(8.4)微克/分升)进行了神经心理学筛查。时间加权平均(TWA)和时间积分血铅水平(IBL)是根据通过定期医学监测获得的B-Pb记录得出的(平均(范围)TWA 40.1(4.0 - 66.4)微克/分升,平均IBL 765.2(0.6 - 1625.7)微克 - 年/分升)。在三项多变量协方差分析中纳入了14个神经心理学变量,每个暴露变量作为分组变量(高、中、低),年龄、受教育程度、抑郁症状量表得分和自我报告的饮酒情况作为协变量。各组在神经系统疾病史方面无差异。
通过多变量协方差分析(MANCOVA),B-Pb、TWA和IBL均无显著差异。当将工作年限(一个抑制变量)作为协变量纳入时,IBL暴露组在数字符号、逻辑记忆、普渡优势手以及A和B项连线测验上存在显著差异。
在当前B-Pb浓度较低且与表现无关联时,发现累积暴露(IBL)与神经心理学表现之间存在剂量 - 效应关系。