Lundberg I, Michélsen H, Nise G, Hogstedt C, Högberg M, Alfredsson L, Almkvist O, Gustavsson A, Hagman M, Herlofson J
Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
Scand J Work Environ Health. 1995;21 Suppl 1:1-44.
Neuropsychiatric effects were examined among 206 men, of whom 135 had been house painters and 71 had been house carpenters, affiliated with their respective trade unions for at least 10 years before 1970. Their lifetime organic solvent exposure was evaluated through the aid of an interview. Relevant potential confounding factors were accounted for in the statistical analysis. Neuropsychiatric symptoms compatible with chronic toxic encephalopathy were more common among the painters than among the carpenters, and these symptoms became increasingly prevalent with increasing cumulative solvent exposure. On only one of 12 psychometric tests, block design, did the painters perform worse than the carpenters, and in this test the painters' performance deteriorated with increasing cumulative exposure. For the majority of the psychometric tests, and for the coordination tests, there were no differences between the painters and carpenters, but the painters with "low" exposure tended to show better, and "heavily" exposed painters worse, results than the carpenters. The 52 painters with the heaviest cumulative exposures and 45 carpenters were examined for psychiatric diagnosis according to DSM-III, with electroencephalography and auditory evoked potential, P-300. Three painters and two carpenters had diagnoses compatible with an organic mental disorder. There were no overall differences between the painters and carpenters, either for the visually examined electroencephalograms or the P-300 latencies. The excess of neuropsychiatric symptoms among the painters was probably causally linked to solvent exposure. However, these symptoms seemed only rarely, if ever, serious enough to entail a psychiatric diagnosis. Concerning other outcomes, the investigation may not lead to a determination of whether the exposure-response relationship among the painters, with no difference between the entire group of painters and carpenters, is caused by solvent exposure or by selection factors within the group of painters.
对206名男性进行了神经精神影响方面的检查,其中135人曾是房屋油漆工,71人曾是房屋木匠,他们在1970年前至少已加入各自的工会10年。通过访谈评估了他们一生当中有机溶剂的接触情况。统计分析中考虑了相关的潜在混杂因素。与慢性中毒性脑病相符的神经精神症状在油漆工中比在木匠中更为常见,并且这些症状随着累积溶剂接触量的增加而愈发普遍。在12项心理测试中,只有一项即积木图案测试,油漆工的表现比木匠差,并且在这项测试中,油漆工的表现随着累积接触量的增加而变差。对于大多数心理测试以及协调性测试,油漆工和木匠之间没有差异,但“低”接触量的油漆工往往比木匠表现更好,而“高”接触量的油漆工则比木匠表现更差。根据《精神疾病诊断与统计手册》第三版(DSM - III),对累积接触量最高的52名油漆工和45名木匠进行了精神疾病诊断,并进行了脑电图和听觉诱发电位P - 300检查。三名油漆工和两名木匠被诊断为符合器质性精神障碍。无论是视觉检查的脑电图还是P - 300潜伏期,油漆工和木匠之间都没有总体差异。油漆工中神经精神症状过多可能与溶剂接触存在因果关系。然而,这些症状似乎极少(如果有的话)严重到需要进行精神疾病诊断。关于其他结果,该调查可能无法确定油漆工群体中暴露 - 反应关系(整个油漆工群体与木匠群体之间无差异)是由溶剂接触还是由油漆工群体内部的选择因素引起的。