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首页> 外文期刊>Occupational and environmental medicine >Neurobehavioural effects of occupational exposure to cadmium: a cross sectional epidemiological study.
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Neurobehavioural effects of occupational exposure to cadmium: a cross sectional epidemiological study.

机译：职业性接触镉的神经行为影响：横断面流行病学研究。

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BACKGROUND: A patient with unexplained minor behavioural changes associated with an axonal sensorimotor polyneuropathy had a history of chronic occupational exposure to cadmium (Cd). Although animal studies have shown that Cd is a potent neurotoxicant, little is known about its toxicity for the human central nervous system. The aim of this study was to investigate the toxic potential of chronic occupational exposure to Cd on neurobehavioural functions. METHODS: A cross sectional epidemiological study was conducted ina group of Cd workers and an age matched control group. Eighty nine adult men (42 exposed to Cd and 47 control workers) were given a blinded standardised examination that consisted of computer assisted neurobehavioural tests (neurobehavioural examination system), a validated questionnaire to assess neurotoxic complaints (neurotoxicity symptom checklist--60, NSC-60), and a standardised self administered questionnaire to detect complaints consistent with peripheral neuropathy and dysfunction of the autonomic nervous system. Historical and current data on biomonitoring of exposure to Cd, either the highest value of Cd in urine (CdU in microgram Cd/g creatinine) of each Cd worker during work (CdUmax) or the current value (CdUcurrent) of each control, were available as well as data on microproteinuria. RESULTS: Cd workers (CdUmax: mean (range), 12.6 (0.4-38.4)) performed worse than the controls (CdUcurrent: mean (range), 0.7 (0.1-2.0)) on visuomotor tasks, symbol digit substitution (p = 0.008), and simple reaction time to direction (p = 0.058) or location (p = 0.042) of a stimulus. In multiple linear regression analysis, symbol digit substitution, simple direction reaction time test, and simple location reaction time test were significantly related to CdUmax, (beta = 0.35 (p < 0.001), beta = 0.25 (p = 0.012), and beta = 0.23 (p = 0.021) respectively). More complaints consistent with peripheral neuropathy (p = 0.004), complaints about equilibrium (p = 0.015), and complaints about concentration ability (p = 0.053) were found in the group exposed to Cd than in the control group, and these variables correlated positively with CdUmax (peripheral neuropathy: beta = 0.38, p < 0.001; equilibrium: beta = 0.22, p = 0.057; concentration ability: beta = 0.27, p = 0.020). CONCLUSION: Slowing of visuomotor functioning on neurobehavioural testing and increase in complaints consistent with peripheral neuropathy, complaints about equilibrium, and complaints about concentration ability were dose dependently associated with CdU. Age, exposure to other neurotoxicants, or status of renal function could not explain these findings. The present study also indicates that an excess of complaints may be detected in Cd workers before signs of microproteinuria induced by Cd occur.
机译：背景：患有无法解释的轻微行为改变并与轴突感觉运动性多发性神经病相关的患者，有长期职业性接触镉（Cd）的病史。尽管动物研究表明Cd是有效的神经毒剂，但对其对人中枢神经系统的毒性知之甚少。这项研究的目的是调查慢性职业性接触Cd对神经行为功能的毒性潜力。方法：在一组镉工人和一个年龄匹配的对照组中进行了横断面流行病学研究。对89名成年男性（42名接触镉和47名控制人员）进行了盲目标准化检查，包括计算机辅助神经行为测试（神经行为检查系统），这是一种经过验证的问卷，用于评估神经毒性症状（神经毒性症状清单-60，NSC- 60），以及标准化的自我管理问卷，以检测与周围神经病变和自主神经系统功能障碍相符的主诉。可获得关于镉暴露的生物监测的历史和当前数据，包括每个镉工作人员在工作中尿中镉的最高价值（以微克Cd / g肌酐为单位的CdU）（CdUmax）或每个对照的当前值（CdUcurrent）。以及微量蛋白尿的数据。结果：镉工人（CdUmax：平均值（范围），12.6（0.4-38.4））在视觉运动任务，符号数字替换（p = 0.008）上的表现比对照（CdUcurrent：平均值（范围），0.7（0.1-2.0））差），以及对刺激方向（p = 0.058）或位置（p = 0.042）的简单反应时间。在多元线性回归分析中，符号数字替换，简单方向反应时间测试和简单位置反应时间测试与CdUmax显着相关，（beta = 0.35（p <0.001），beta = 0.25（p = 0.012）和beta = 0.23（分别为p = 0.021）。与对照组相比，镉暴露组中与周围神经病变相符的抱怨（p = 0.004），对平衡的抱怨（p = 0.015）和对集中能力的抱怨（p = 0.053），这些变量呈正相关。 CdUmax（周围神经病变：β= 0.38，p <0.001;平衡：β= 0.22，p = 0.057;集中能力：β= 0.27，p = 0.020）。结论：视行为运动在神经行为测试中的减慢以及与周围神经病变一致的抱怨，平衡的抱怨和集中能力的抱怨的增加与CdU剂量相关。年龄，接触其他神经毒剂或肾功能状况不能解释这些发现。本研究还表明，在由镉引起的微量蛋白尿征兆出现之前，在镉工作人员中可能会发现过多的抱怨。

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