Sim M, Dick R, Russo J, Bernard B, Grubb P, Krieg E, Mueller C, McCammon C
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Occup Environ Med. 1997 Apr;54(4):229-35. doi: 10.1136/oem.54.4.229.
To determine whether long term potroom workers in an aluminium smelter are at increased risk of neurological disorders.
Cross sectional study of 63 current and former aluminium potroom workers first employed before 1970 and with at least 10 years of service. A group of 37 cast house and carbon plant workers with similar durations of employment and starting dates in the same smelter were used as controls. The prevalence of neurological symptoms was ascertained by questionnaire. Objective tests of tremor in both upper and lower limbs, postural stability, reaction time, and vocabulary were conducted. All subjects were examined by a neurologist.
No significant differences in age, race, or education were found between the two groups. Although the potroom group had higher prevalences for all but one of the neurological symptoms, only three odds ratios (ORs) were significantly increased; for incoordination (OR 10.6), difficulty buttoning (OR 6.2), and depression (OR 6.2). Tests of arm or hand and leg tremor in both the visible and non-visible frequencies did not show any significant differences between the two groups. Testing of postural stability showed no definitive pattern of neurologically meaningful differences between the groups. There were no significant differences between the two groups in reaction time, vocabulary score, or clinical neurological assessment.
The objective measures of neurological function provided little support for the finding of increased neurological symptom prevalences in the potroom workers, although increased symptoms may be an indicator of early, subtle neurological changes. The results provide no firm basis for concluding that neurological effects among long term potroom workers are related to the working environment, in particular aluminium exposure, in potrooms. These findings should be treated with caution due to the low participation of former workers and the possibility of information bias in the potroom group.
确定铝冶炼厂长期在电解车间工作的工人患神经疾病的风险是否增加。
对63名1970年前首次就业且至少有10年工作经验的现任和前任铝电解车间工人进行横断面研究。选取37名在同一冶炼厂工作年限和入职时间相似的铸造车间和碳素车间工人作为对照组。通过问卷调查确定神经症状的患病率。对上下肢震颤、姿势稳定性、反应时间和词汇量进行客观测试。所有受试者均由神经科医生进行检查。
两组在年龄、种族或教育程度上无显著差异。虽然电解车间组除一种神经症状外,其他所有神经症状的患病率都较高,但只有三个优势比(OR)显著增加;即动作不协调(OR 10.6)、扣纽扣困难(OR 6.2)和抑郁(OR 6.2)。可见和不可见频率下的手臂或手部及腿部震颤测试在两组之间未显示出任何显著差异。姿势稳定性测试未显示两组之间在神经学上有明确意义的差异模式。两组在反应时间、词汇得分或临床神经学评估方面无显著差异。
神经功能的客观测量几乎无法支持电解车间工人神经症状患病率增加这一发现,尽管症状增加可能是早期细微神经变化的一个指标。这些结果没有确凿依据得出长期在电解车间工作的工人的神经影响与工作环境,特别是电解车间的铝暴露有关的结论。由于前工人参与度低以及电解车间组存在信息偏倚的可能性,这些发现应谨慎对待。