Neurology:在锰暴露的焊工中帕金森疾病进展呈剂量依赖性

2016-12-30 xing.T MedSci原创

暴露于含锰的焊接烟尘可引起剂量依赖性的帕金森疾病进展,尤其是上肢运动迟缓、肢体僵硬及语音和面部表情功能受损

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,旨在明确在焊工中普遍流行的帕金森表型是否呈进展性,以及明确这种进展性是否与含锰的焊接烟尘暴露程度有关。

这是一项基于工会的纵向队列研究,研究人员组织了一名运动障碍专家对886名美国焊接工人进行了1492人次的检查,其中有398名工人进行了606人次的检查并从研究之初开始随访了9.9年。研究人员进行了线性混合模型回归,以累积锰暴露作为独立变量和以统一帕金森病评定量表第三部分的运动检查(UPDRS3)每年变化情况作为主要结果,UPDRS3分类作为次要结果。主要暴露指标是累积锰暴露为在具体工作中估计的每年多少mg锰/立方米。

帕金森疾病进展随着累积锰暴露增加而增加。具体而言,研究人员观察到每年每1mg锰/立方米的暴露引起的UPDRS3每年变化为0.24(95%可信区间为0.10–0.38)。暴露与上肢运动迟缓、上下肢僵硬以及语音和面部表情功能受损的进展密切相关。在密闭空间进行焊剂芯电弧焊接的焊接工人和在首次焊接暴露5年内进行基础检查的工人中焊接暴露与疾病进展之间的相关性特别明显。

由此可见,暴露于含锰的焊接烟尘可引起剂量依赖性的帕金森疾病进展,尤其是上肢运动迟缓、肢体僵硬及语音和面部表情功能受损。

原始出处:

Brad A. Racette, et al. Dose-dependent progression of parkinsonism in manganese-exposed welders. Neurology. December 28, 2016.

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