职业性铝接触对作业工人言语功能的影响

Effects of occupational exposure to aluminum on verbal function of workers

目的探讨职业性铝接触对作业工人总体认知水平和言语功能的影响。方法于2019年7至8月,以整群抽样方法收集山西省某铝业集团公司460名工人为研究对象,其中接触铝的工人232人为接触组,未接触铝人员228人为对照组,采集血样后以电感耦合等离子体质谱法(ICP-MAS)测定血铝浓度,接触组根据血铝浓度中位数(M)分为高接触组和低接触组;采用蒙特利尔认知评估(MoCA)量表评价研究对象总体认知功能和言语功能,比较各组总体认知功能和言语功能评分差异,以非条件logistic回归分析轻度认知障碍(MCI)的可能影响因素。结果接触组和对照组年龄、工龄、文化程度和饮酒状况差异均有统计学意义(P<0.05)。与对照组比较,接触组MoCA总分、动物命名测试(ANT)得分和类别流畅性(CFT)得分更低,差异均有统计学意义(P<0.05);接触组ANT满分率低于CFT满分率(P<0.05);与对照组比较,高接触组MoCA总分、ANT评分和CFT评分均更低,差异有统计学意义(P<0.05)。以60μg/L为界分组时,高接触组’MoCA总分、ANT评分和CFT评分低于低接触组’,差异均有统计学意义(P<0.05)。logistic回归分析显示,工龄、血浆铝浓度、ANT评分、CFT评分和SR评分为职业性铝接触作业工人MCI的影响因素(P<0.05)。结论职业性铝接触可导致工人言语功能受损,ANT评分、CFT评分、SR评分越高,文化程度越高,发生MCI的风险就越小。

Objective To explore the effect of occupational aluminum(Al)exposure on workers'overall cognitive level and speech function.Methods In July 2019,by using cluster sampling method,the group of 232 exposed to Al from an Al plant in Shanxi Province were selected as the exposed group,and the group of 228 not exposed to Al were selected as the control group.The blood Al concentration was determined by inductively coupled plasma mass spectrometry(ICP-MAS).The exposed group was divided into high exposure group and low exposure group according to the median(M)concentration of Al in serum.The general cognitive function and speech function were evaluated with the Montreal Cognitive Assessment Scale(MoCA),and the differences in the general cognitive function and speech function between the groups were compared,and non-conditional logistic regression was used to analyze the possible influencing factors of mild cognitive impairment(MCI).Results There were significant differences in age,working age,education and drinking status between Al exposed group and control group(P<0.05).The total MoCA score,animal naming tese(ANT)score and category fluency repetition(CFT)score in Al exposure group were lower than control group and the differences were statistically significant(P<0.05).The full rate of ANT was lower than that of CFT in Al exposure group(P<0.05).The total MoCA score,ANT score and CFT score in the high exposure group were significantly lower than those in the control group(P<0.05).The score of MoCA,ANT and CFT in high exposure group were lower than those in low exposure group between the level of serum aluminum>60μg/L group and≤60μg/L group(P<0.05).Logistic regression analysis showed that working age,serun Al concentration,ANT score,CFT score and SR score were the possible influencing factors of MCI in occupational Al exposure workers(P<0.05).Conclusion Occupational Al exposure can lead to impaired speech function of workers,the higher the ANT score,CFT score and SR score,the lower working age and serum Al concentration,the lower risk of MCI.