Rydzewski B, Sułkowski W, Miarzyńska M
ENT Department, F. Raszeja Municipal Hospital, Poznań, Poland.
Int J Occup Med Environ Health. 1998;11(3):235-45.
The evaluation of olfaction is not only widely applied and undeniably valuable in clinical diagnostics but it is also of interest to industrial medicine. It should be borne in mind that in certain workplaces, particularly in the chemical industry, the olfactory receptor has to act as an organ which warns the worker against threatening intoxication, and this is possible only when it functions properly. Cadmium, as a highly toxic metal, found widely in industry and in the environment, is frequently included in the list of chemicals known to cause olfactory impairment. The purpose of this study was to evaluate olfaction in workers occupationally exposed to cadmium. The correlation between olfaction and concentrations of cadmium in urine, blood and in the workplace air as well as employment duration was examined in workers of the "CENTRA" S.A., an electrochemical plant in Poznań. In this plant cadmium-nickel batteries are produced, and there is chronic occupational exposure to cadmium in quantities exceeding maximum allowable concentration (MAC). A group of 73 workers aged 20 to 60 years (42.0 +/- 18.0), employed from 4 to 24 years (12.5 +/- 8.5) were examined. Of the 73 workers who completed the evaluation, 53 people (72.7%) were smokers (10-40 cigarettes per day). In addition to medical history, medical and ENT examinations, blood and urine tests were taken and olfactometry performed. Olfactometry was performed according to Elsberg and Levy's method, modified by Pruszewicz, in which natural coffee as well as aniseed, lemon and mint oils were used. The quantitative and qualitative olfactory disorders were evaluated on the basis of the established odor detection threshold (ODT) and odor identification threshold (OIT). The examinations revealed numerous cases of hyposmia (26.0%) and parosmia (17.8%) and one case of anosmia (1.4%). In the majority of people with olfactory disorders, hypertrophic changes in the nasal mucosa, dependent on the duration of employment, were identified. Statistically significant relationship between olfactory impairment and cadmium concentration in blood, urine and the workplace air was observed. However, such a relationship was not found in regard to the duration of employment. The study indicated the need to carry out routine olfactometries. The results of these examinations could be the ground to perform certain preventive and therapeutic procedures.
嗅觉评估不仅在临床诊断中得到广泛应用且具有不可否认的价值，在工业医学领域也备受关注。应当牢记，在某些工作场所，尤其是化学工业领域，嗅觉感受器必须发挥作用，作为一种器官警告工人防范潜在的中毒风险，而这只有在其正常运作时才有可能实现。镉作为一种剧毒金属，在工业和环境中广泛存在，经常被列入已知会导致嗅觉损害的化学物质清单中。本研究的目的是评估职业性接触镉的工人的嗅觉。在位于波兹南的一家名为“CENTRA”的电化学工厂的工人中，研究了嗅觉与尿液、血液及工作场所空气中镉浓度以及工作年限之间的相关性。在这家工厂生产镉镍电池，存在长期职业性接触镉且接触量超过最大允许浓度（MAC）的情况。对一组年龄在20至60岁（42.0 +/- 18.0）、工作年限为4至24年（12.5 +/- 8.5）的73名工人进行了检查。在完成评估的73名工人中，有53人（72.7%）吸烟（每天10至40支）。除了采集病史、进行医学和耳鼻喉科检查外，还进行了血液和尿液检测以及嗅觉测量。嗅觉测量采用经普鲁谢维茨修改的埃尔斯伯格和利维方法，使用天然咖啡以及茴芹油、柠檬油和薄荷油。根据既定的气味检测阈值（ODT）和气味识别阈值（OIT）对嗅觉的定量和定性障碍进行评估。检查发现大量嗅觉减退病例（26.0%）和嗅觉倒错病例（17.8%）以及1例嗅觉缺失病例（1.4%）。在大多数有嗅觉障碍的人中，发现了与工作年限相关的鼻黏膜肥厚性改变。观察到嗅觉损害与血液、尿液及工作场所空气中镉浓度之间存在统计学显著关系。然而，在工作年限方面未发现此类关系。该研究表明有必要开展常规嗅觉测量。这些检查结果可为实施某些预防和治疗程序提供依据。
