金属结构加工作业对作业者神经行为功能的影响

目的以金属结构加工作业环境为现场,探索多种职业病危害因素同时作用对作业者神经行为功能的影响。方法以某船厂金属结构加工车间工人为观察组,以同厂其他车间工人为对照组,应用神经行为检测评价技术对研究对象实施检测评价,比对观察组与对照组神经行为功能的异常改变,以及暴露时间与神经行为功能异常改变的相关关系。结果观察组在心算、视觉保留、记忆扫描、视简单反应时、听数距广度和数字筛选6个项目上劣于对照组,差异有统计学意义;神经行为能力与暴露时间呈负相关;观察组各项指标的异常率明显高于对照组,但各项指标的分布特征与对照组并没有明显的差异。结论尽管不同的职业病危害因素毒作用靶器官不同,但是早期的健康损害可以表现为神经行为功能的异常改变,因此,在明确职业暴露史的前提下,神经行为检测评价结果对作业者早期健康损害的评价具有重要的参考价值。     

Comparison of neurobehavioral function in workers exposed to a mixture of organic and inorganic lead and in workers exposed to solvents

The neurobehavioral effects of lead (organic and inorganic) and organic solvents were compared in 386 U.S. workers (52 reference, 190 lead, and 144 solvent workers). The association between neurobehavioral test performance and duration of exposure to lead or solvents was also examined and compared. The neurobehavioral test battery consisted of examiner and computer-administered neurobehavioral tests, a test of olfactory function, and questionnaires that assessed neuropsychiatric symptoms. Adjusted mean differences on the neurobehavioral test scores were estimated by comparing the exposed group to the referent group using linear regression and adjusting for premorbid intellectual ability, age, and race. Both lead and solvents were associated with diminished neurobehavioral performance in all neurobehavioral areas tested. Specifically, while lead and solvent exposure had the same magnitude of adverse effects on tests of manual dexterity, lead exposure was associated with greater adverse effects on memory and learning tests but with less adverse effects on executive/motor tests and on a test of olfaction than solvent exposure. An elevated number of neuropsychiatric symptoms was reported by 7% of the referent group, 43% of the lead group, and 15% of the solvent group. For exposure duration of ?10 years, more neurobehavioral decrements were found in the solvent group relative to the lead group. However, for exposure duration of ?18 years, the lead group showed more decrements than the solvent group. Overall, these data suggest differences in neurobehavioral functioning between the lead (organic and inorganic) and solvent exposed workers examined in this study.     

Neurobehavioral changes among shipyard painters exposed to solvents

Painters in three shipyards, exposed to a wide variety of solvents, were examined. A short battery of performance tests, a detailed occupational history, and a special questionnaire to assess acute (prenarcotic, transitory) and chronic (persistent) neurologic symptoms was administered. The results of the neurobehavioral performance tests demonstrated decrements in central nervous system function in painters when compared with a control group matched for age, sex, race, and education. The prevalence of reported acute neurological symptoms among painters was increased significantly compared to other occupational groups in the same yards; for chronic, persistent symptoms the difference was not statistically significant. Performance test scores were significantly, negatively correlated with chronic symptoms but not with acute symptoms. No significant correlations between performance test scores and duration of solvent exposure or between symptoms and duration of solvent exposure were observed. The reversibility of such symptoms and of decrements in central nervous system function after cessation of exposure is still uncertain.     

Dose-related subclinical neurobehavioral effects of chronic exposure to low levels of organic solvents.

One hundred eight-seven workers (mean age +/- SD; 42 +/- 8.8 years) in two paint manufacturing plants were examined to determine if sustained low-level exposure to mixed organic solvents resulted in the painters' syndrome (a psycho-organic syndrome). The test battery consisted of a medical and occupational questionnaire, the Present State Examination, the Zung Depression Scale, the Scandinavian Questionnaire 16, a neuropsychological battery, and vibration thresholds. Solvent exposure, expressed as total hydrocarbon of combined selected solvents, was quantitated using 13-15 years of personal breathing zone samplings. Linear regression analysis controlling for several confounding variables demonstrated significant correlations between increasing exposure to mixed organic solvents and neurobehavioral performance for vibration threshold and several neuropsychological tests. Dose-related effects of chronic solvent exposure on neurobehavioral outcomes (all subclinical) were shown, but "typical" symptoms characteristic of the painter's syndrome were not found.     

Neurobehavioral performance among agricultural workers and pesticide applicators: a meta-analytic study

Chronic low level exposure of agricultural workers and applicators to pesticides has been found to be associated with different degrees of decrement in cognitive and psychomotor functions. The goal of this study was to use meta-analysis to (1) identify and quantify neurobehavioral deficits among agricultural workers and pesticide applicators, and (2) analyse the potential confounders or moderators of these neurobehavioral deficits. Seventeen studies, reporting on 21 independent cohort groups, were included in the meta-analysis. These studies involved 16 neuropsychological tests providing 23 different performance measures that constitute the neurobehavioral constructs. All tests and measures of the neurobehavioral functions of attention, visuomotor integration, verbal abstraction and perception constructs showed significant decrements for exposed participants. One out of three tests of memory, two of five tests of sustained attention, and four of eight tests of motor speed constructs also showed significant decrements. Nine out of these 15 effect size distributions demonstrated significant heterogeneity across cohorts. A search for cohort-level variables (eg, agricultural workers vs applicators, duration of exposure, age and percentage of male participants) to explain this heterogeneity was largely unsuccessful. However, for one test, Block Design, the duration of exposure was positively associated with performance decrements. Furthermore, it was also found that performance decrements on this test were smaller for older participants. Increasing the number of studies and using more consistent methodologies in field studies are needed.     

Evaluation of dermal absorption and protective effectiveness of respirators for xylene in spray painters

Objectives To determine the contribution of dermal absorption on the total exposure dose and the performance of respirators in the field for xylene in spray painters. Methods Eighteen male spray painters worked at shipyard were recruited for this study. The subjects were monitored during a 3-day-work period using a repeated-measures study design. Personal exposure to xylene outside and inside mask were collected using two 3 M model 3500 organic vapor monitors, respectively. Urine was collected before and after the work shift and urinary methyl hippuric acid (MHA) was determined. Total 98 of air and urine samples were obtained, respectively. Results Air sampling results showed that workers were primarily exposed to xylene and ethyl benzene. Xylene and ethyl benzene concentrations outside the mask were 52.6 ± 63.7 (mean ± SD) and 33.2 ± 32.4 ppm, and concentrations inside the mask were 2.09 ± 2.74 and 1.79 ± 2.16 ppm, respectively. The median workplace protection factors of respirators for xylene and ethyl benzene were 25.0 and 17.4, respectively. On average, workers could reduce xylene inhalation by 96% and ethyl benzene inhalation by 94% for wearing respirators. A significant correlation (R ² = 0.935; P < 0.001) was found between the WPFs for xylene and ethyl benzene. Total urinary MHA concentration was 240.2 ± 42.3 (mean ± SE) mg/g creatinine, whereas urinary MHA via skin absorption was estimated to be 202.1 ± 40.1 mg/g creatinine. The contribution of dermal absorption to the total exposure dose of xylene was 64 ± 4.3%. Conclusion The present study showed that inhalation of solvent vapors in workers decreased as a result of wearing respirators and dermal exposure became the main contributor to the total body burden of solvents. Because workers had different attitude and behavior to wear respirators, the measured workplace protection factors varied. It is therefore equally important to prevent from being exposed to solvents through skin for shipyard spray painters.     

Changes in psychological performances of solvent-poisoned and solvent-exposed workers

The changes in psychological performances associated with long-term exposure to organic solvents and solvent mixtures were studied in a group of 56 male workers diagnosed as having an occupational disease caused by solvents. Their mean duration of exposure was 9.1 ± SD 8.3 years, and they were exposed mainly to halogenated and aromatic hydrocarbons and to mixtures of paint solvents. The psychological performances of these solvent-exposed patients were compared with those of 98 styrene-exposed workers and a nonexposed group of 43 construction workers. The applied psychological test variables were factor analyzed, before other statistical analysis, in order to clarify what they measured in the present study. The solvent-exposed group was characterized by a decline in visuomotor performance and decreased freedom from distractibility. The poor visuomotor performances were also related to the long duration of solvent exposure in this group of patients. The index applied for the exposure level revealed no significant relationships to psychological performances among the solvent-exposed patients. The psychological performances of the styrene-exposed group differed only very slightly from those of the non-exposed workers.     

Respiratory effects of exposure of shipyard workers to epoxy paints

Epoxy resin systems have been associated with occupational asthma in several case reports, but medical publications contain little on the potential adverse respiratory effects of these chemicals in exposed worker populations. To further evaluate the association of workplace exposure to epoxy paints and respiratory dysfunction, the cross workshift changes in pulmonary function and symptoms of 32 shipyard painters exposed to epoxy paints were compared with 28 shipyard painters not exposed to epoxy paints. The prevalence of lower respiratory tract symptoms was significantly higher among painters exposed to epoxy paints compared with controls. Among exposed painters the mean cross workshift change in forced expiratory volume in one second (FEV1) (-3.4%) was greater than the decrement in the non-exposed group (-1.4%). A significant linear relation was seen between % decrement in FEV1 and hours of exposure to epoxy paints. This study suggests that epoxy resin coatings as used by shipyard painters are associated with increased lower respiratory tract symptoms and acute decrements in FEV1. Adequate respiratory protection and medical surveillance programmes should be established in workplaces where exposure to epoxy resin systems occurs.     

Respiratory effects of exposure of shipyard workers to epoxy paints.

Epoxy resin systems have been associated with occupational asthma in several case reports, but medical publications contain little on the potential adverse respiratory effects of these chemicals in exposed worker populations. To further evaluate the association of workplace exposure to epoxy paints and respiratory dysfunction, the cross workshift changes in pulmonary function and symptoms of 32 shipyard painters exposed to epoxy paints were compared with 28 shipyard painters not exposed to epoxy paints. The prevalence of lower respiratory tract symptoms was significantly higher among painters exposed to epoxy paints compared with controls. Among exposed painters the mean cross workshift change in forced expiratory volume in one second (FEV1) (-3.4%) was greater than the decrement in the non-exposed group (-1.4%). A significant linear relation was seen between % decrement in FEV1 and hours of exposure to epoxy paints. This study suggests that epoxy resin coatings as used by shipyard painters are associated with increased lower respiratory tract symptoms and acute decrements in FEV1. Adequate respiratory protection and medical surveillance programmes should be established in workplaces where exposure to epoxy resin systems occurs.     

Nocturnal oxygen desaturation,as assessed by home oximetry,in long-term solvent-exposed workers

Recent studies have suggested that occupational exposure to solvents may be a cause of sleep apnea. Digital oximetry during one night was performed in solvent-exposed offset printers (n = 21) and in a control group (n = 21), using a Palco 400 Pulse Oximeter. The threshold for recording was set at an arterial oxygen saturation (SaO₂) of 90%. Furthermore, computerized neurobehavioral tests (NES) and a solvent-related complaints questionnaire (NSC-60) were administered. The mean exposure time was 15 years (SD = 10). Hygiene measurements revealed a large number of different solvents and a cumulative exposure between 15% and 97% of the “cumulative TLV.” The exposed workers had more solvent-related complaints, especially regarding mood (analysis of covariance, P = 0.02), than the nonexposed workers. The neurobehavioral tests indicated that hand-eye coordination was significantly worse in the exposed group (analysis of covariance, P = 0.03). The frequency of nocturnal desaturation was significantly higher in the printers (1.7 events/hr ± SD = 1.5) than in the controls (0.6 events/hr ± SD = 1.3) (Mann-Whitney test, P < 0.01). Also, the duration of desaturation was longer in the exposed workers: 3.2 min/hr (SD = 3.2) vs 1.2 min/hr (SD = 2.3) (Mann-Whitney test, P < 0.01). In the analysis of covariance, exposure (P = 0.04) and the interaction between smoking and exposure (P = 0.02) were shown to contribute significantly to the excess of nocturnal desaturation in the exposed. The same was true for the mean duration of desaturation (exposure: P = 0.02 and interaction exposure smoking: P = 0.02). The significant interaction was due to a more pronounced effect of solvent exposure among the nonsmoker group. No relation was found between the excess of complaints or the neuroperformance effects and the oximetry data. These data reinforce the presumption that occupational solvent exposure might contribute to sleep-disordered breathing. Am. J. Ind. Med. 32:656–664, 1997. © 1997 Wiley-Liss, Inc.     

无铅汽油对神经行为功能和单胺类神经递质代谢产物的影响

目的 探讨职业性无铅汽油接触以对神经功能和单胺类神经递质代谢的影响。方法 应用WHO推荐的神经行为检测组合（NCTB）对92名汽油作业工人和88名对照工人进行神经行为测试,同时用高效液相色谱法－电化学法联检测定其尿中高香草酸（HVA）和香草扁桃酸（VMA）的浓度。结果 接触组明显存在忧郁－沮丧的不良情绪状态,简单反应时慢于对照组,数字跨度、提转捷度、数字译码和目标追中学踪得分明显低于对照组,且行为功能得分随浓度的增高而降低;汽油接触工人尿中HVA和VMA浓度均降低。结论 提示职业性低浓度接触无铅汽油油可影响神经行为功能和单胺类神经递质代谢。     

Primary DNA damage in peripheral mononuclear blood cells of workers exposed to bitumen-based products

The genotoxic effect of occupational exposure to bitumen-based products was determined by the extent of DNA strand breaks and alkali-labile sites of the DNA of peripheral mononuclear blood cells from seven roofers, 18 road paving workers, and nine bitumen painters. In order to evaluate short-term genotoxic effect the workers were investigated on Fridays and on Mondays after a weekend free of occupational exposure. The roofers (all cigarette smokers) showed a significantly (P < 0.002) 43% higher mean level of alkaline DNA strand breaks on Friday than did the ten smoking controls included in this study. Also, comparison of the individual levels of alkaline strand breaks on Mondays and on Fridays revealed a significant increase (P < 0.05, Wilcoxon test) during the work week. In the road paving workers and the bitumen painters no statistically significant difference in the mean levels of alkaline strand breaks could be found compared to controls either for the measurement on Mondays or for that on Fridays. However, interesting tendencies were observed. As in the group of roofers, the mean level of alkaline DNA strand breaks as well as the majority of the individual levels of alkaline strand breaks of road paving workers was higher on Fridays than on Mondays. In contrast, bitumen painters exhibited a relatively high level of alkaline DNA strand breaks on Mondays and a decreased mean level of strand breaks on Fridays. DNA adducts could be detected at a low level (up to 2.9 adducts per 10⁹ bases) in 10 of 14 road paving workers and bitumen painters using the ³²p-postlabelling assay. The number of DNA adducts correlated with the years spent in the present job. Road paving workers and bitumen painters showed only suggestive evidence for a possible genotoxic effect due to their occupational exposure. Because we cannot exclude the formation of DNA cross-links in these workers, a more detailed investigation of the hazard is urgently needed. For roofers, substantial genotoxic damage in peripheral mononuclear blood cells was observed in this study.This study contains parts of an M.D. thesis by G. Boettler     

Neuropsychological function in retired workers with previous long-term occupational exposure to solvents

OBJECTIVES: It is plausible that neurodegenerative processes of aging might have a contributing role in the development of chronic effects of exposure to organic solvents. This study evaluated the risk for neuropsychological deficits among retired workers, relative to their histories of exposure to occupational solvents. METHODS: This cross sectional study evaluated retired male workers, 62-74 years of age, including 89 people with previous long-term occupational exposure to solvents (67 retired painters and 22 retired aerospace manufacturing workers), and 126 retired carpenters with relatively minimal previous exposure to solvents. Subjects completed a standardised neuropsychological evaluation and psychiatric interview, structured interviews for histories of occupational exposure and alcohol consumption, and questionnaires assessing neurological and depressive symptoms. RESULTS: By comparison with the carpenters, the painters on average reported greater cumulative alcohol consumption and had lower scores on the WAIS-R vocabulary subtest, usually presumed to reflect premorbid intellectual functioning. These findings, however, were not sufficient to account for the other study findings. Controlling for age, education, vocabulary score, and alcohol use, the painters had lower mean scores on test measures of motor, memory, and reasoning ability; and a subgroup of aerospace workers with moderate to high cumulative exposure to solvents (n = 8) had lower mean scores on measures of visuomotor speed, and motor, attention, memory, and reasoning ability. Subjects were more likely to have an increased number of relatively abnormal test scores (three or more outlier scores on 17 test measures) among both the painter group (odds ratio (OR), 3.1; 95% confidence interval (95% CI) 1.5 to 6.2) and the subgroup of aerospace workers with higher cumulative exposure (OR 5.6; 95% CI 1.0 to 38). The painters, but not the aerospace workers, reported significantly more neurological and depressive symptoms. CONCLUSIONS: The findings are consistent with residual central nervous system dysfunction from long-term exposure to organic solvents, persisting years after the end of exposure.

 

     

Neurotoxicity of solvent mixtures in spray painters

A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10-44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes "special features of depression" and "loss of interest and concentration" occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS)     

职业接触甲醛对工人神经行为功能的影响

[目的]评价职业接触甲醛对暴露工人精神情绪和神经行为功能的影响。[方法]调查分析昆山市存在甲醛职业危害企业18家,采用WHO推荐的神经行为功能测试组合,对65名甲醛接触工人和70名对照组工人进行神经行为功能测试。[结果]18家企业甲醛平均浓度为0.43mg,mg/m~3,最高达3.11 mg/m~3,超标暴露点达29.1%。暴露组工人数字跨度、视觉保留、正确打点数和二次打点总和低于对照组,差异有统计学意义(P<0.05);紧张一焦虑、抑郁一沮丧升高,有力一好动项降低,与对照组比较差异有统计学意义(P<0.05)。[结论]长期职业性接触甲醛可导致工人明显精神情绪和神经行为改变,为暴露工人的早期损害提供了两个有意义的标志。     

雷达部队电磁辐射对作业人员神经行为功能的影响

目的 评价雷达部队作业环境电磁辐射对作战人员情感状态和神经行为的影响并提出相应的防护策略。方法 采用问卷调查进行自觉症状调查。采用神经行为核心测试组合(NCTB)的POMS量表和神经行为功能综合测试仪对辐照人员和对照组进行调查测试。结果 辐照组明显感到视觉疲劳;POMS量表中辐照组疲惫感明显增加;目标追踪实验辐照组总的打点数(χ²=6.808,P<0.05)显著小于对照组。左右手交叉实验总次数辐照组显著小于对照组(χ²=14.820,P<0.01)。结论 电磁辐射对职业人群的心理状态、手部作业能力和作业效率产生明显影响。     

Health effects associated with sulfuryl fluoride and methyl bromide exposure among structural fumigation workers.

OBJECTIVES: This study assessed the health effects associated with occupational exposure to methyl bromide and sulfuryl fluoride among structural fumigation workers. METHODS: A cross-sectional study of 123 structural fumigation workers and 120 referents in south Florida was conducted. Nerve conduction, vibration, neurobehavioral, visual, olfactory, and renal function testing was included. RESULTS: The median lifetime duration of methyl bromide and sulfuryl fluoride exposure among workers was 1.20 years and 2.85 years, respectively. Sulfuryl fluoride exposure over the year preceding examination was associated with significantly reduced performance on the Pattern Memory Test and on olfactory testing. In addition, fumigation workers had significantly reduced performance on the Santa Ana Dexterity Test of the dominant hand and a nonsignificantly higher prevalence of carpal tunnel syndrome than did the referents. CONCLUSIONS: Occupational sulfuryl fluoride exposures may be associated with subclinical effects on the central nervous system, including effects on olfactory and some cognitive functions. However, no widespread pattern of cognitive deficits was observed. The peripheral nerve effects were likely caused by ergonomic stresses experienced by the fumigation workers.     

The effects of solvent exposure on memory and motor dexterity in working children

OBJECTIVES: Children working in vehicle spray-painting, mechanical, and other trade workshops are at significant risk of exposure to organic solvents and, as a result, may be at significant risk of developing clinical and subclinical signs of neurotoxicity. This study reports on the association between exposure to solvents and neurobehavioral performance on a number of non-computerized tests for working children exposed to solvents in comparison with nonexposed working children and nonexposed children at school. METHODS: A convenience cross-sectional sample of 300 male children aged 10-17 years was recruited for study. The exposed working group and the two nonexposed groups (working and nonworking school) were matched, as far as possible, on geographic location of residence and age. Neurotoxic effects were assessed through a questionnaire and the child's performance on a selection of neurobehavioral tests. RESULTS: Exposed working children scored worse on the overall neurotoxicity symptoms score (mean=6.8; standard deviation [SD]=3.6) compared with the nonexposed working children (mean=1.3; SD=2.0) and school children (mean=1.2; SD=1.8). Analysis of the non-computerized neurobehavioral tests demonstrated that exposed working children performed significantly worse than the two nonexposed groups on the motor dexterity and memory tests. Results of the mood test showed that exposed working children were more angry and confused than the nonexposed groups. CONCLUSION: There is an association between exposure to solvents and lower neurobehavioral performance, with significant neurobehavioral deficits among children exposed to solvents in comparison with working children not exposed to solvents and nonworking school children. Memory and motor dexterity appear to be particularly affected in solvent-exposed working children.     

甲苯作业对工人神经行为功能的影响

对接触甲苯工人(暴露组)和对照组工人采用神经行为核心测试组合(NCTB)进行神经行为测试。结果暴露组在目标追踪、数字译码、数字跨度及视觉记忆测试等方面与对照组相比差异有显著性(P<0.05)。说明接触甲苯对作业工人的神经行为功能可产生一定的影响。