铝暴露对作业工人延迟回忆的影响

Effects of aluminum exposure on delayed recall of workers

目的探讨铝暴露对作业工人延迟回忆的影响。方法采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)北京版和听觉词语学习测验(Auditory Verbal Learning Test,AVLT)对山西省某铝厂435名作业工人进行延迟回忆评估。根据血铝浓度的P_(33.3),P_(66.7)将研究对象分为低、中、高暴露组(分别以T1、T2、T3组表示)。采用多元logistic回归分析模型分析铝暴露工人轻度认知功能障碍(mild cognitive impairment,MCI)影响因素。结果三组工人均为男性。在年龄、婚姻状况、家庭人均月收入、吸烟、饮酒等方面差异无统计学意义(均有P>0.05)。在工龄、文化程度上比较,差异均有统计学意义(均有P<0.05)。三组在MoCA和AVLT中,延迟回忆指标均有统计学意义(均有P<0.05)。多元logistic回归分析模型显示听觉词语学习测验延迟回忆(Auditory Verbal Learning Test-long Recall,AVLT-LR)评分≥6(OR=0.860,95%CI:0.769~0.960)时,发生MCI的风险降低;当文化程度越低(OR=3.556,95%CI:1.589~7.957),插入词语个数(OR=1.415,95%CI:1.070~1.871)和重复词语个数(OR=1.419,95%CI:1.043~1.931)越多、没有采用记忆策略(OR=2.124,95%CI:1.119~4.032)发生MCI的风险增加。结论铝暴露可以影响作业工人延迟回忆功能。MoCA和AVLT量表的评估可以判断延迟记忆受影响情况,两个量表相结合更好找出可能有MCI倾向的工人。

Objective To explore the impact of occupational aluminum exposure on delayed recall of workers.Methods A total of 435 workers in an aluminum factory in Shanxi province were evaluated for delayed recall using Montreal Cognitive Assessment Scale(MoCA)(Beijing Edition)and World Health Organization/University of California at Los Angeles Auditory Verbal Learning Test(AVLT).According to the blood aluminum concentration,the subjects were divided into low,medium and high exposure groups(T1,T2 and T3).Multiple logistic regression analysis was used to analyze the influencing factors of mild cognitive impairment(MCI)in aluminum exposed workers.Results All subjects are men.There were no significant differences in age,marriage,family monthly income,smoking and drinking among the three groups(P>0.05).There were significant differences in working age and educational level among the three groups(P<0.05).The delayed recall indexes in MoCA and AVLT of the three groups were statistically significant(P<0.05).Multiple Logistic regression analysis showed that AVLT-LR score≥6 was the protective factors of MCI(OR=0.860,95%CI:0.769-0.960);less education(OR=3.556,95%CI:1.589-7.957),more inserted words(OR=1.415,95%CI:1.070-1.871)and repeated words(OR=1.419,95%CI:1.043-1.931),no memory strategy(OR=2.124,95%CI:1.119-4.032)were the risk factors of MCI.Conclusions Occupational aluminum exposure can damage workers’delayed recall.The evaluation of MoCA and AVLT scales can determine the impact of delayed call and the combination of the two scales can better identify workers who may be prone to MCI.