混合有机溶剂作业工人职业病危害探讨

目的 探讨使用混合有机溶剂对工人潜在的健康影响.方法 选择13家存在接触混合有机溶剂作业的企业,以663名工人为接触组;以不接触化学毒物的510名机关工作人员为对照组,观察相应的健康损害效应.结果 工作场所混合有机溶剂质量浓度存在超标情况;接触组头痛、头晕、失眠、食欲不振、乏力、慢性咽炎、牙龈出血、记忆力减退等发生率高于对照组,窦性心律异常、脂肪肝、肝脏回声增粗、白细胞减少、丙氨酸氨基转移酶增高发生率高于对照组,差异均有统计学意义(P＜0.05或P＜0.01).结论 混合有机溶剂对作业工人的身体健康容易造成不同程度的损害,应控制和减少职业接触,保障作业工人的健康.     

Autonomic and peripheral nervous system dysfunction in workers exposed to mixed organic solvents

Summary To assess possible solvent-induced dysfunction of the autonomic and peripheral nervous systems, 11 solvent-exposed workers and 11 age-matched unexposed controls were examined using the coefficient of variation in electrocardiographic R-R intervals (CV_RR) and the distribution of nerve conduction velocities (DCV). Two components of CV_RR, i.e., the C-CV_RSA and CCV_MWSA, were also examined, which are considered to reflect parasympathetic and sympathetic activities, respectively. The workers had been occupationally exposed to toluene and/or solvent mixtures such as thinners, for 35–360 months. In the solvent-exposed workers, the CV_RR and C-CV_RSA were significantly reduced compared with unexposed controls. Similarly, the faster velocities of the DCV and median nerve conduction velocities were significantly slowed. The reduction in the CV_RR was significantly correlated with duration of exposure in the solvent-exposed workers. These data, despite the small sample size and the variety of organic solvents, suggest that organic solvents may affect both the faster myelinated nerve fibers and autonomic nervous activity (principally, parasympathetic component).     

某鞋厂347例接触混合有机溶剂作业工人肝脏B超检查结果分析

目的 探讨长期低浓度接触混合有机溶剂对制鞋作业工人肝脏的影响。 方法 对生产车间使用甲苯、苯、二氯乙烷、正己烷等混合有机溶剂的某鞋业工厂347名工人(接触组)和工厂无毒物接触史后勤人员321人(对照组)进行肝脏B超检查,比较两组检查结果。 结果 生产车间使用的有机溶剂的时间加权平均浓度均未超过职业接触限值。接触组弥漫性肝回声音改变、肝大的检出率均高于对照组,上述指标在两组间比较,差异均有统计学意义(χ2=27.8、12.5,P<0.05)。将两组各分成6个工龄段,弥漫性肝回声改变的检出率在工龄大于等于2年(4个工龄段)的两组员工间比较,差异均有统计学意义(χ2=8.9、10.2、10.2、10.5,P<0.05),两组的异常检出率均随着工龄的增加而升高。 结论 较长时间接触混合有机溶剂对作业工人肝脏可能存在慢性损害,应注意预防。     

Prenarcotic and neuraesthenic symptoms among Dutch workers exposed to organic solvents

A population of 379 Dutch workers exposed to organic solvents was compared with a non-exposed population of 443 workers with regard to the prevalence of prenarcotic and neuraesthenic symptoms. Participants completed a questionnaire to collect information about their occupational history, exposure to organic solvents, and the occurrence of symptoms. The results of the study indicated that workers exposed to solvents have a higher reporting rate of prenarcotic symptoms than workers not exposed to solvents. The prevalence of chronic neurotoxic effects, however, in the form of neuraesthenic symptoms was only weakly associated with reported exposure to organic solvents. The influence of work stress in the development of these symptoms is perhaps more important than the role of exposure to organic solvents. It is concluded that the organic solvent syndrome type I, as defined by an international workshop, is not an important health hazard among Dutch painters.     

黄磷生产企业职工健康状况调查报告

目的：摸清乡镇企业黄磷生产过程中,有害物质对作业工人的危害程度,为改善作业环境的劳动条件。预防职业相关疾病的发生提供科学依据。方法：依据卫生部制定的《卫生防疫工作规范》劳动卫生分册中的规定,进行劳动卫生学调查。结果：连续2a调查发现,生产环境中的有害物质主要是黄磷和磷化氢,共监测生产环境中黄磷21份,均超过国家卫生标准;磷化氢20份,有8份超过国家卫生标准,五氧化二磷21份,氟化氢14份,均未超过国家卫生标准;监测黄磷厂职工健康状况,335人中,有肺病变的187人,占55．82％,有骨质疏松的69人,占20．60％;肝功能异常的24人,占7．16％,肺部病变,骨质疏松的发生率随着接毒工龄的增加而逐年上升,生产工人高于行政后勤人员。结论：人体长期吸入低于国家卫生标准规定浓度的黄磷,磷化氢气体时,亦可造成对人体健康的损害。     

Prenarcotic and neuraesthenic symptoms among Dutch workers exposed to organic solvents.

A population of 379 Dutch workers exposed to organic solvents was compared with a non-exposed population of 443 workers with regard to the prevalence of prenarcotic and neuraesthenic symptoms. Participants completed a questionnaire to collect information about their occupational history, exposure to organic solvents, and the occurrence of symptoms. The results of the study indicated that workers exposed to solvents have a higher reporting rate of prenarcotic symptoms than workers not exposed to solvents. The prevalence of chronic neurotoxic effects, however, in the form of neuraesthenic symptoms was only weakly associated with reported exposure to organic solvents. The influence of work stress in the development of these symptoms is perhaps more important than the role of exposure to organic solvents. It is concluded that the organic solvent syndrome type I, as defined by an international workshop, is not an important health hazard among Dutch painters.     

混合性有机溶剂中毒1例报告

报道1例氯乙烯和正已烷等多种有机溶剂混合物中毒患者,表现为头晕、头痛、呕吐,四肢抽搐,意识障碍,经积极治疗,1个月后病情明显好转出院.     

Effects of coexposure to noise and mixture of organic solvents on hearing in dockyard workers

Questionnaire and audiometric data of 701 dockyard workers (517 noise and organic solvent mixture-exposed and 184 noise-only-exposed) were referred to 205 control subjects not exposed to either noise or solvents. The odds ratio (OR) of hearing loss was significantly increased by approximately 3 times in the noise-only group and by almost 5 times in the noise and solvent group. A moderate effect of solvent ototoxicity, in addition to noise, was observed on hearing threshold at a frequency 8 kHz. ORs for hearing loss were 1.12 for each increment of 1 year of age, 1.07 for every decibel of lifetime noise exposure (dB-A), and 1.004 for each increment of the index of lifetime exposure to solvents. The results suggest an additive damaging effect of coexposure to noise and organic solvents to the auditory organ.     

Knowledge, attitude and practice regarding organic solvents among printing workers in Hong Kong

To find out the prevalence of good knowledge, appropriate attitude and safe practice among printing workers exposed to organic solvents in Hong Kong, and to see if safe practice was influenced by the knowledge of and the attitude towards the harmful effects of organic solvents as well as other factors. The survey was conducted in a sample of 501 male printing workers from 28 factories in Hong Kong. The knowledge of and attitude towards the harmful effects of organic solvents, as well as the good practices adopted by the workers when handling solvents were explored using a questionnaire. Multiple logistic regression analysis was conducted to identify the major factors that influenced the knowledge, attitude and practice of workers. The prevalence of good knowledge, appropriate attitude and safe practice was low, being 20.4%, 38.4% and 22.0% respectively. Good knowledge was positively associated with awareness of the relevant legislation and past drinking behavior and negatively associated with current smoking. Appropriate attitude depended on having good knowledge and younger age. Safe practice did not depend on knowledge and attitude, but was positively associated with being informed of safety precautions and being supplied with chemical information by supervisors. The majority of workers believed that their employers, the Government and other statutory bodies should be responsible for providing information on chemicals, but very few of them actually obtained information from these sources. More workers preferred publications and talks rather than television as the means of obtaining further knowledge on chemicals. Front line supervisors have a pivotal role to play in improving safe practices of workers by informing them of the necessary precautions and supplying the relevant chemical information.     

Effects of shift work on autonomic and neuromotor functions in female nurses

Thirty-seven nurses with shift work, working under a rotating three-shift system, and 37 nurses without shift work, having worked during the daytime for one or more years prior to this study, were examined to assess the effects of shift work on cardiac autonomic and neuromotor functions. Their ages ranged from 25 to 58 yr. The electrocardiographic (ECG) R-R interval variability, %LF and %HF (i.e., proportions of sympathetic and parasympathetic activities, respectively), and LF/HF ratio were computed by means of autoregressive spectral and component analyses. The %LF and LF/HF ratio were significantly larger in the nurses with shift work than in those without shift work, although there was no significant difference in the heart rate-corrected QT interval on ECG between them. And, hand-ear coordination differed significantly between the nurses with shift work and those without. Despite the presence of potential selection bias, it is suggested that shift work in nurses may cause not only a long-term sympathodominant state but also some neuromotor impairment.     

Combined effects of noise and mixed solvents exposure on the hearing function among workers in the aviation industry

This study aims to evaluate the effect of occupational exposure to noise and organic solvents on hearing loss in the aviation industry. The study population comprised 542 male workers, who worked in avionics jobs in Kimhae, Korea, who kept records of work environment evaluations and medical examinations. The Cumulative Exposure Index (CEI) was constructed to assess the lifetime cumulative exposure of the workers, and pure tone audiometry (PTA) data of the workers from their biannual medical surveillance was used to assess hearing loss. The prevalence of hearing loss found in the group exposed to noise and mixed solvents simultaneously (54.9%) was higher than those in the other groups (6.0% in the unexposed, 17.1% in the noise-only, and 27.8 % in the exposed to only a solvents mixture). The relative risks, adjusted for age, were estimated to be 4.3 (95 % CI 1.7-10.8) for the noise-only group, 8.1 (95% CI 2.0-32.5) for the noise and solvents group, and 2.6 (95 % CI 0.6-10.3) for the solvents-mixture group. These suggest that chronic exposure to mixed solvents had a toxic effect on the auditory system. This raises the issue of whether hearing conservation regulations should be applied to all workers exposed to solvents.     

Impairment of colour vision in workers exposed to organic solvents

OBJECTIVES—To investigate loss of colour vision related to exposure to solvents and the role of three enzyme polymorphisms in modifying the risk in exposed workers.
METHODS—A sample was studied of 68 male dockyard workers and 42 male community controls with and without neuropsychological symptoms from a previous cross sectional study. Indices of cumulative and intensity based exposure to solvents were calculated for all subjects. Alcohol, drug, and smoking histories were obtained. Colour vision was tested by Lanthony D15d colour vision test. Genotype of glutathione S-transferase M1 and T1 and N-acetyltransferase 2 polymorphisms were determined.
RESULTS—The relation between impairment of colour vision and exposure to solvents was investigated with multiple regression techniques. Increasing annual exposure to solvents was significantly associated with reduced colour vision (p=0.029). Impairment of colour vision was not associated with neuropsychological symptoms as measured by the Q16 solvent symptom questionnaire. No significant association was found between acquired impairment of colour vision and genetic polymorphisms when GSTM1, GSTT1 or NAT2 phenotypes were included in the analyses.
CONCLUSIONS—Exposure to mixed solvents is associated with impairment in colour vision, the risk increases with increasing exposure. The risk of impairment of colour vision was not altered in this study by the presence of different GSTM1, GSTT1 or NAT2 polymorphisms.


Keywords: colour vision; organic solvents; genetic polymorphisms     

职业接触某些有机溶剂工人心电图变化分析

目的 观察皮革塑料企业职业接触多种有机溶剂的工人心电图变化.方法 以当地5家皮革塑料企业284名接触多种有机溶剂的工人作为观察组,选择未接触有机溶剂危害因素的商场工作人员作为对照组,进行职业健康监护,同时开展现场职业卫生学调查.结果 观察组心电图异常率(74.30%)显著高于对照组(27.25%),观察组心电图异常改变(窦性心律不齐、心动过缓、左室高电压、ST-T波改变)检出率高于对照组;其中配料工或接触工龄较长的工人心电图异常改变检出率均较高.结论 职业接触有机溶剂能导致心电图的异常变化且存在时间-剂量反应关系.