Chiappino G, Broich G, Mascagni P, Picchi O
Dipartimento di Medicina del Lavoro, Università degli Studi di Milano.
Med Lav. 1998 Jul-Aug;89(4):283-91.
Olfactory testing has been of minor interest in Occupational Health due to the lack of testing methods able to detect malingering. On the other hand there is evidence that occupational exposure to several, mainly neurotoxic, substances may result in olfactory damage. We have combined three different testing methods in one package in order to assure a forensic-degree level of results. The package consists of: 1. primary neuron functionality testing with a single olfactory stimulant; 2. olfactory-trigeminal discrimination testing with regular sniff-test; 3. odor identification score by Doty's UPSIT test. Final judgement of a link between olfactory system impairment and occupational exposure to chemicals requires a good knowledge of the present and past occupational exposure and of the general conditions of the patient. It requires collaboration between the Occupational Health specialist and the expert in Olfactology and may be completed with endoscopy, radiography and other specific controls. We suggest that a more extensive use of appropriate olfactory testing should be established at least for special risk groups of workers. This will not only detect occupational health damage that would otherwise have remained unknown, but can also furnish new information on the neurotoxic effects of many inhalable chemicals.
由于缺乏能够检测伪装的测试方法，嗅觉测试在职业健康领域一直不太受关注。另一方面，有证据表明，职业接触多种主要具有神经毒性的物质可能会导致嗅觉损伤。我们将三种不同的测试方法整合在一个组合中，以确保达到法医学级别的结果。该组合包括：1. 使用单一嗅觉刺激物进行初级神经元功能测试；2. 通过常规嗅探测试进行嗅觉 - 三叉神经辨别测试；3. 通过多蒂的UPSIT测试进行气味识别评分。要最终判定嗅觉系统损伤与职业性化学物质接触之间的关联，需要充分了解患者当前和过去的职业接触情况以及一般状况。这需要职业健康专家与嗅觉学专家之间的合作，并且可能需要通过内窥镜检查、放射成像和其他特定检查来完成。我们建议至少应为特殊风险的工人群体更广泛地使用适当的嗅觉测试。这不仅可以检测到原本会不为人知的职业健康损害，还可以提供有关许多可吸入化学物质神经毒性作用的新信息。
