Cross-sectional epidemiological study on neurotoxicity of solvents in paints and lacquers

Summary In a multi-disciplinary retrospective study we examined 105 house painters employed for at least ten years (median 27 years, range 10–36 years). Fifty-three workers from various professions (non-painters), who were matched with regard to age, occupational training and socio-economic status served as the control group. In both groups no cases of a clinically manifest polyneuropathy or encephalopathy were found. The neurophysiological examinations (EEG and NCV-measurement) showed no differences in painters and controls that would indicate adverse effects of organic solvents. There were no cases with neuroradiological findings of a diffuse cerebral atrophy. Furthermore the evaluation of certain brain structures (ventricular diameter, cella media index) of the CAT films did not reveal any significant differences. In the neurobehavioral tests significant differences in the results were only found in the subtests change of personality and short term memory capacity in a subgroup of painters with repeated prenarcotic symptoms at the workplace. Ambient air monitoring measurements at 30 representative work-places showed that the concentrations of the main components of the solvent-mixtures were well below the MAK-values. The results of the Erlangen Painter Study does not confirm former epidemiologic findings from other countries, mainly Denmark. However, there are some aspects, such as minor solvent exposure in German house painters, insufficient diagnostic and etiological procedures as well as mis-classifications which may explain the different experiences.     

Solvent-related health effects among construction painters with decreasing exposure

BACKGROUND: The prevalence of solvent-related symptoms among construction painters is unclear due to their declining exposure. METHODS: A questionnaire study was conducted on 1000 male Finnish construction painters and 1000 carpenters. Symptom questions were combined with exposure parameters, medical history, and health behavior. RESULTS: Highly significant associations were found between cumulative intensity of long-term solvent exposure (CE-LT) and symptoms of memory and concentration, and mood. CE-LT was a better measure of solvent exposure than the number of years as a painter. Exposure was also associated with diagnosed psychiatric disorders, hypertension and arrhythmia. Recent exposure in the 1990s had no major effect on symptoms. CONCLUSIONS: The results strengthen the dose-response relationship of exposure and long-term neurotoxic effects. No clear association was found between recent exposure and symptoms. Cardiovascular effects in solvent-exposed construction painters is further suggested.     

Intervention research in construction: A hypothetical case study of painters

This paper presents a theory on which to base intervention research in the construction industry, along with a hypothetical case study involving construction painters. The hypothetical case is based on data from research in a three-state study of construction painters currently under way. Difficulties facing researchers who conduct research in construction are described. Advantages of the intervention research design for construction are discussed. © 1996 Wiley-Liss, Inc.     

Prognosis of symptoms in patients with diagnosed chronic organic solvent Intoxication

Summary The profile and prognosis of symptoms of 87 patients (mean age 38.6 years) in whom a chronic organic solvent intoxication due to tri- or perchloroethylene or mixtures of solvents had been diagnosed 3–9 years earlier were examined by means of an interview.Both at the time of diagnosis and upon reexamination, the most common symptoms were abnormal fatigue, memory disturbances and headache. Also dizziness, sleep disturbances, sensory symptoms in the extremities, mental depression, concentration difficulties, psychic irritability, emotional lability, tremor and nausea were present in over 60% of patients at the time of diagnosis. Upon reexamination, 52% of the intoxication patients with no other contributing neurological disease felt that their overall subjective condition was better than at the time of diagnosis, 21% felt that it was worse, and 27% reported no change. Most of the individual symptoms had more often changed for the better than for the worse; the differences were statistically significant with regard to abnormal fatigue, headache, dizziness, sleep disturbances, nausea, and emotional lability, whereas memory disturbances had changed in the opposite direction. Younger persons, who had had a longer follow-up period and without regular check-ups at the Institute of Occupational Health seemed to have better prognosis at the group level. Due to the great variation between the individuals, the prognosis was, however, impossible to predict in individual cases.     

Work-related health symptoms among compost facility workers: a cross-sectional study

Background

Industrial composting is a relatively new and expanding activity. Several studies indicate that compost workers are at risk to develop health symptoms. The aim of this study was to assess the prevalence of work-related health symptoms among compost workers compared with control subjects.

Methods

A questionnaire was distributed among 62 workers (31 exposed and 31 non-exposed workers). Data were analyzed using simple and multiple logistic regression analyses.

Results

Workers exposed to organic dust reported significantly more often respiratory, irritation (e.g., eyes, nose and throat), gastrointestinal, and skin symptoms than the non-exposed group. Moreover, all work-related symptoms were significantly more often reported by exposed than non-exposed workers. After adjustment for smoking status and age, the associations between exposure and respiratory, gastrointestinal, and skin symptoms remained statistically significant, in particular if these symptoms were work-related.

Conclusions

This study confirms that workers at compost facilities are at risk to develop occupational health problems, most likely related to organic dust exposure.     

有机溶剂对印刷工人神经行为功能影响的研究

目的探讨有机溶剂对印刷工人神经行为功能的影响。方法采用WHO推荐的神经行为核心测试组合(NCTB)对某印刷厂100名工人和同地区的81名制衣厂工人进行测试。结果100名工人接触甲苯的浓度为158.2 mg/m3,NCTB测试项目中的情感状态各项指标:简单反应时中的最快反应时、目标追踪中的总打点数与正确打点数、数字跨度及视觉记忆与对照组比较,差异均有显著性(P<0.01)。结论职业接触有机溶剂对神经行为功能有一定的影响。     

安庆市医用放射工作人员健康现况研究

目的 通过对安庆市接触医用放射线的工作人员健康状况进行分析,寻找医用放射线接触的高危人群,以期为今后实施干预措施提供循证依据.方法 采用普查的方法,对安庆市686名医用放射人员进行体格检查和职业史、家族史、病史的问询.结果 医用放射人员心电图异常率为15.55％,肝脏疾病患病率为19.38％,胆囊疾病患病率为16.20％.10～19、20 a～工龄组放射人员染色体畸变或微核检出率分别是9.85％和8.74％,比0～9a工龄组放射人员染色体畸变或微核检出率(3.67％)高;三级医院的普通放射人员染色体畸变或微核检出率为15.69％,比二级医院及二级以下医院的普通放射人员染色体畸变或微核检出率(3.76％、3.57％)高,差异有统计学意义(均P＜0.01).二级以上医院的普通放射和放疗、介入放射人员眼晶状体异常检出率分别是15.61％、13.11％,比CT人员眼晶状体异常检出率(3.70％)高;三级医院的普通放射人员眼晶状体异常检出率为23.53％,比二级医院和二级以下医院的普通放射人员眼晶状体异常检出率(13.44％、9.64％)高,差异有统计学意义(P＜0.05或P＜0.01).结论 长期接触小剂量的辐射会给眼、细胞遗传物质、血液、心脏等身体的多系统带来不同程度损伤,而且这种损伤随着工龄和工作量的增加而加重,表现有一定的剂量-反应关系;二级以上医院从事普通放射、放疗、介入和放射工龄10 a以上人群是以后重点监测和干预人群.     

Acute health effects common during graffiti removal

Objective: The aim of this study was to identify possible health effects caused by different cleaning agents used in graffiti removal. Methods: In 38 graffiti removers working 8-h shifts in the Stockholm underground system, the exposure to organic solvents was assessed by active air sampling, biological monitoring, and by interviews and a questionnaire. Health effects were registered, by physical examinations, porta7ble spirometers and self-administered questionnaires. The prevalence of symptoms was compared with 49 controls working at the underground depots, and with 177 population controls. Results: The 8-h time-weighted average exposures (TWA) were low, below 20% of the Swedish permissible exposure limit value (PEL) for all solvents. The short-term exposures occasionally exceeded the Swedish short-term exposure limit values (STEL), especially during work in poorly ventilated spaces, e.g. in elevators. The graffiti removers reported significantly higher prevalence of tiredness and upper airway symptoms compared with the depot controls, and significantly more tiredness, headaches and symptoms affecting airways, eyes and skin than the population controls. Among the graffiti removers, some of the symptoms increased during the working day. On a group basis, the lung function registrations showed normal values. However, seven workers displayed a clear reduction of peak expiratory flow (PEF) over the working shift. Conclusions: Though their average exposure to organic solvents was low, the graffiti removers reported significantly higher prevalence of unspecific symptoms such as fatigue and headache as well as irritative symptoms from the eyes and respiratory tract, compared with the controls. To prevent adverse health effects it is important to inform the workers about the health risks, and to restrict use of the most hazardous chemicals. Furthermore, it is important to develop good working practices and to encourage the use of personal protective equipment. Received: 23 June 2000 / Accepted: 01 November 2000     

Increased acquired dyschromatopsia among solvent-exposed workers: an epidemiology study on 249 employees of an aluminum-foil printing factory

Objective: To analyze the effects on color vision of chronic exposure to mixtures of solvents including ethyl acetate, ethanol, and ketones among the workers of a large factory specializing in the manufacture of photoengraved aluminum packaging. Methods: We analyzed a group of 129 subjects who had been exposed to solvents for more than 3 years (mean age 40 years, range 25–59 years) and a nonexposed group of 120 subjects (mean age 41 years, range 21–57 years). The two groups had a similar length of service (17 and 19 years on average, respectively). The exposed subjects consumed more tobacco and alcohol than the nonexposed workers. The study involved administration of the Lanthony D-15 desaturated test. The subjects were classified as having or not having dyschromatopsia on the basis of Lanthony's criteria and the chromatic confusion index (CCI) was calculated according to Bowman's method. After observation of the work stations and analysis of an occupational questionnaire the findings were used to construct a cumulative exposure index covering the whole of each subject's working life. Air samples were taken at each work station and in each production sector to determine current exposure. Results: The average cumulative exposure index was 194 (median 174, range 27–513). The average hygienic effect index (according to ACGIH recommendations), regularly used for atmospheres containing mixtures of products, varied between 12% and 27% of the occupational limit values permitted under French legislation. As regards color vision, 23% of the exposed group had dyschromatopsia, as did 13% of the nonexposed group, with the odds ratio (OR) adjusted for age and consumption of tobacco and alcohol being 1.99 (1.02, 3.89). The analysis of the dose-response relationship according to the cumulative exposure index showed an OR of 1.59 for the lowly exposed group (index ≤174) and an OR of 2.40 for the highly exposed group (index >174) as compared with the nonexposed group. Subjects with complex color vision loss (n=23) had a significantly higher cumulative exposure index than those with blue-yellow loss (n=23; 232 versus 155; P=0.04). The CCI was on average higher in the exposed group, but the difference between the two groups was not significant. Conclusion: The results of this study are in favor of an increased risk for impairment of chromatic discrimination among workers exposed to mixtures of solvents including mainly ethyl acetate, ethanol, and ketones. Received: 10 September 1996 / Accepted: 12 December 1997     

广州工厂职工健康自评和吸烟者戒烟意愿研究

目的 调查工厂职工的健康状况和戒烟意愿,为开展控烟工作提供科学依据.方法 采用横断面调查方法对668名广州不同工作类型工厂职工的吸烟行为、自评健康状况和戒烟意愿进行问卷调查,吸烟者尼古丁依赖性用fTND问卷进行调查,自评健康和戒烟难度与某些因素的关系用logistic回归模型分析.结果 (1)男性工人吸烟者348人,吸烟率为65.0%;女性工人吸烟者4人,吸烟率为3.0%.与朋友或其他吸烟者在一起、在家或休闲时以及饭后吸烟最常见,占男性经常吸烟者的90.6%.(2)男性经常吸烟和戒烟者自评健康状况比普通同龄人差者占10.7%,高于偶吸和从不吸烟者(5.1%),调整年龄和文化程度后,OR值为2.22(95%CI 1.08～4.59).(3)男性经常吸烟者想过戒烟的占50.5%,其中自评健康状况比同龄人差、差不多和好者分别占73.3%、50.0%和37.2%,差异有统计学意义(P=O.009).自评戒烟难度≤30分、31～60分和60分以上的分别占26.9%、24.9%和48.2%,自评戒烟难度(≤30分和＞30分)比数比随周围同事吸烟人数和尼古丁依赖性的增加而增大.结论 男性职工经常吸烟或戒烟者自评健康较偶吸或从不吸烟者差,自评健康较差者多数想过戒烟,戒烟难度主要与周围同事吸烟和尼古丁依赖有关.     

A proportional mortality ratio study of workers in a construction equipment and diesel engine manufacturing plant

The mortality of 461 workers who were employed 10 or more years in a Midwest engine and construction equipment plant was examined, using the method of proportional mortality ratios. Both state and national deaths were used as the standard population. Major exposures in this plant included solvents, cutting oils, and metal fumes and dusts. However, precise exposure data were not available. Among white males, no significant deviations from expected deaths were found. Among black males, significant excess deaths were found for all malignant neoplasms combined, for cancer of the pancreas, and for non-Hodgkin's lymphomas. Proportional cancer mortality ratios produced similar results, although the excess of pancreatic cancer in blacks was only significant among those with 20 or more years of service. Although complete occupational histories were not available, these results may provide hypotheses for future studies of workers in heavy machinery production.     

Cancer in Illinois construction workers: A study

A series of case-control studies using subjects from the Illinois State Cancer Registry have been conducted. Logistic regression was used to control for age and history of tobacco and alcohol use. Construction workers were consistently found to be younger than other subjects and to have used alcohol and tobacco more often. Significant positive associations between cancer of the stomach and welding (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.09, 4.09), lung cancer and employment in the construction industry (OR = 1.18, 95% CI = 1.02, 1.26), and lung cancer and welding (OR = 1.68, 95% CI = 1.03, 2.76) were found. Significant negative associations between cancer of the colon and welding (OR = .54, 95% CI = .29, 1.00), cancer of the prostate and employment in the construction industry (OR = .76, 95% CI = .65, .89), cancer of the prostate and plumbing (OR = .44, 95% CI = .38, .50), cancer of the prostate and metal working (OR = .43, 95% CI = .19, .93), and bladder cancer and employment as an electrician (OR = .60, 95% CI = .36, 1.00) suggest that construction workers did not consistently experience excesses of cancers known to be associated with tobacco use, and an overall excess of sites not known to be related to tobacco use may have occurred. © 1993 Wiley-Liss, Inc.     

广州市工厂职工吸烟行为与尼古丁依赖性调查

目的 调查工厂职工吸烟行为和尼古丁依赖性,为控烟提供科学依据.方法 横断面调查广州市668名不同工作类型工厂职J二的吸烟行为和尼古丁依赖性,后者采用国际问卷FTND进行评价;尼古丁依赖性与某些因素的相关性采用logistic回归分析.结果 (1)曾吸烟率男性65.0%(348/535,其中经常吸55.5%,偶吸5.4%,戒烟4.1%),女性3.0%(4/133);男性一线工人、安全主任目前吸烟率分别为67.6%和64.5%.(2)男性经常吸和偶吸者轻度尼古丁依赖分别占66.7%和89.7%;经常吸烟者烟龄越长尼古丁依赖性越高,一线工人和安全主任尼古丁依赖性较高.结论 男性工人和安全主任的吸烟率较高,但轻度尼古丁依赖者占大部分,可作为首期戒烟干预的首选对象.     

张家港市流动人口乙肝病毒感染现况调查

目的 掌握张家港市流动人口乙型肝炎病毒感染状况,为今后乙型肝炎防治工作提供科学依据。方法 采用单纯随机抽样,利用酶联免疫吸附试验方法检测乙肝表面抗原（hepatitis B surface antigen,HBsAg）和乙肝表面抗体（hepatitis B surface antibody,HBsAb）。结果 共调查张家港市流动人口1 516人,男性占69.0%,中青年居多。HBsAg总阳性粗率为9.6%,性别差异无统计学意义（χ²=0.06,P=0.851）,而不同年龄组间差异有统计学意义（χ²=9.37,P=0.015）。HBsAb总阳性率为50.9%,男性高于女性（χ²=7.31,P=0.007）。不同性别、不同年龄组间乙肝疫苗接种率差异有统计学意义（均有P<0.05）;有乙肝疫苗接种史者,其HBsAg阳性率降低（OR=1.64,95% CI：1.15~2.34,P=0.006）。结论 张家港市流动人口感染状况调查在乙型肝炎的传播流行上具有重要意义。加强乙型肝炎的健康教育,提倡良好的卫生习惯,推行免疫接种,是预防乙型肝炎传播流行的必要和切实可行的措施。     

A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine

Objectives: To assess the health effects of hexamethylenetetramine (HMT) on the airways and the skin of workers in the chemical industry. Methods: A cross-sectional study was performed with 17 employees of a HMT-producing chemical plant and 16 control subjects from the plant. In addition, we examined 4 out of 5 subjects who had left the production for medical reasons during the last 10 years. Anamnestic data, total and specific IgE to four environmental allergens, lung function and bronchial responsiveness to methacholine were assessed by standard procedures. Skin prick tests (SPT) and patch tests were performed with known sensitizing substances and HMT 100 mg/ml and 2% pet and aq. Results: A high number of exposed subjects and controls reported symptoms during the previous year (64.7% vs 68.8%), most of them were not related to work. Work-related symptoms and objective parameters did not show differences between groups. No sensitizations to HMT as assessed by SPT or patch tests were found. Among those who had left the HMT production for medical reasons, 2 former baggers showed sensitizations to HMT by patch tests. These reported eczema during exposure but lost symptoms after removal from exposure. Geometric mean HMT concentrations as assessed by personal sampling were 0.3 [95% confidence intervals (CI) 0.1; 0.9] mg/m³ in shiftleaders and 0.6 (95% CI 0.3; 1.1) mg/m³ in baggers. Conclusion: High exposures to HMT may cause allergic contact dermatitis. There was no evidence of an increased risk for occupational asthma at mean airborne HMT concentrations below 1 mg/m³. Received: 4 February 1999 / Accepted: 10 July 1999     

北京市城乡老年人口基本健康状况调查

目的了解北京市城乡老年人口的基本健康状况,为制定卫生政策、合理配置卫生资源,完善服务体系提供科学依据。方法横断面研究,采用多阶段分层整群抽样方法选取调查对象,调查使用统一的问卷,由调查员进行面对面调查。结果666名调查对象中感觉身体好或者很好的只有31.84%,有21.62%的感觉不好或很不好。在过去1个月内,近四分之一的调查对象偶尔或经常出现伤心沮丧的情况;近二分之一的偶尔或经常出现失眠多梦的情况。结论为了适应老年人在心理健康方面需求,要大力增强对老年人的社会关怀和支持。     

饮水中微囊藻毒素对人群健康影响的横断面研究

目的 初步了解饮水中微囊藻毒素（ＭＣ）对人体健康的影响。方法 采用横断面研究方法,在泰兴肝癌高发区两个不同饮水类型的学校里分别随机抽取１１１名和９２名学生,对其进行调查,并采集静脉血,检测血清中乙型肝炎病毒（ＨＢＶ）感染标志物及血清丙氨酸氨基转移酶（ＡＬＴ）、γ－谷氨酰转移酶（γ－ＧＴ）、碱性磷酸酶（ＡＬＰ）水平。按照ＨＢＶ感染进行分层,比较两组人群血清三种酶学水平的差异。结果 两组人群三种酶学指     

Adverse health effects in children associated with moisture and mold observations in houses

This work was conducted to study the health effects in children associated with observations of moisture or mold in their homes. A random sample of 310 houses in Finland was studied during the years 1993-1994. In all, 204 children 15 years old or younger were living in 110 houses. The houses were investigated for visual signs of moisture by a surveyor, and observations of mold were reported by the parents. Thus, two different definitions of exposure were used in the analysis. Health data was collected by a postal questionnaire. Exposure to moisture or mold significantly increased the risk of respiratory infections and respiratory symptoms as well as non-respiratory symptoms in both the preschool and schoolchildren. In preschool children, exposure to moisture significantly increased the risk of hoarseness and in the schoolchildren, the risks were significantly increased of cough without phlegm, nocturnal cough, sore throat and rhinitis. Preschool children exposed to mold had significantly increased risks of nocturnal cough and eczema, and they also had significantly more episodes of common cold than the non-exposed children. If schoolchildren had been exposed to mold, this significantly increased their risk of nausea and led to difficulties in concentration. They also had a significantly higher number of doctor visits than the non-exposed children.