NEUROLOGICAL ABNORMALITIES ASSOCIATED WITH REMOTE OCCUPATIONAL ELEMENTAL MERCURY EXPOSURE
NEUROLOGICAL ABNORMALITIES ASSOCIATED WITH REMOTE OCCUPATIONAL ELEMENTAL MERCURY EXPOSURE
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DOI：
10.1002/ana.410240510
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发表时间：
1988-11-01
影响因子：
11.2
通讯作者：
BROMBERG, MB
中科院分区：
文献类型：
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作者：
ALBERS, JW;KALLENBACH, LR;BROMBERG, MB
我们检查了502名受试者，其中247人在20至35年前有职业汞元素暴露，以确定潜在的与暴露相关的神经异常。暴露者与未暴露者之间差异不显著（p < 0.05）。然而，多元线性回归分析表明，在暴露间隔的尿汞测量中，神经功能下降与暴露增加之间存在一些显著的相关性。与其他受试者相比，尿汞峰值水平高于0.6 mg/L的受试者表现出明显的力量下降、协调性下降、震颤增加、感觉下降、巴宾斯基反射和鼻反射患病率增加。此外，临床多发性神经病变受试者的峰值水平明显高于正常受试者（0.85 vs 0.61 mg/L, p = 0.04），但暴露时间没有增加（20.1 vs 20.8季度，p = 0.34）， 28%的峰值水平高于0.85 mg/L的受试者有临床多发性神经病变的证据，而其余受试者中有10% （p = 0.005）。尽管暴露与年龄无关，但几项神经学测量显示了显著的年龄-汞相互作用，表明自然神经元磨损可能掩盖了先前暴露相关的亚临床异常。
We examined 502 subjects, 247 of whom had occupational elemental mercury exposures 20 to 35 years previously, to identify potential exposure-related neurological abnormalities. Few significant (p < 0.05) differences existed between exposed and unexposed subjects. However, multiple linear regression analysis demonstrated several significant correlations between declining neurological function and increasing exposure as determined by urine mercury measurements from the exposure interval. Subjects with urine mercury peak levels above 0.6 mg/L demonstrated significantly decreased strength, decreased coordination, increased tremor, decreased sensation, and increased prevalence of Babinski and snout reflexes when compared with the remaining subjects. Furthermore, subjects with clinical polyneuropathy had significantly higher peak levels than normal subjects (0.85 vs 0.61 mg/L; p = 0.04), but not increased exposure duration (20.1 vs 20.8 quarters; p = 0.34), and 28% of subjects with peak levels above 0.85 mg/L had clinical evidence of polyneuropathy, compared with 10% of remaining subjects (p = 0.005). Although exposure was not age dependent, several neurological measures showed significant age-mercury interaction, suggesting that natural neuronal attrition may unmask prior exposure-related subclinical abnormalities.