CEREBRALNA KORTIKALNA ATROFIJA I KOGNITIVNA DISFUNKCIJA U RADNIKA ZAPOSLENIH U FABRICI OBUĆE "AIDA"
Avdibegović E, Hasanović M, Pajević I, Pavlović S.
Klinika za Psihijatrijske bolesti, UKC Tuzla, Tuzla, Bosna i Hercegovina

CILJ: Cilj rada je analizirati učestalost pojave cerebralne kortikalne atrofije i kognitivne disfunkcije u radnika Fabrike obuće "Aida" u odnosu na izlaganje udisanju organskih isparljivih materija u toku radnog procesa.

ISPITANICI I METODE: U radu je analizirana grupa od 38 radnika zaposlenih u Fabrici obuće "Aida", a koji su liječeni na Psihijatrijskoj klinici UKC Tuzla od 1999.-2003. godine i u kojih je utvrđeno postojanje cerebralne kortikalne atrofije. Utvrđivanje cerebralne kortikalne atrofije vršeno je kompjuterizovanom tomografijom. Područje kognitivnog funkcionisanja ispitivano je primjenom Wechsler-ove skale. Podaci o radnom mjestu, dužini radnog staža dobiveni su od socijanog radnika preduzeća. Za dijagnostikovanje psihičkih poremećaja i utvrđivanje postojanja drugih faktora rizika cerebralne kortikalne atrofije korišten je dijagnostički intervju.

REZULTATI: U analiziranoj grupi pacijenata 98% su osobe ženskog pola, a prosječna starosna dob je 47,8 godina. U odnosu na dužinu radnog staža 63% pacijenata radi od 25-31 godinu, a 37% pacijenata od 18-24 godine. Ispitanici su sav svoj radni staž proveli u Fabrici obuće "Aida". U odnosu na radno mjesto 72% je bilo na poslovima koji su zahtijevali direktan kontakt sa isparljivim orgnaskim materijama. Indirektno izlaganje isparljivim organskim materijama bilo je u 28% pacijenata. Kod svih pacijenata utvrđena je kortikalna cerebralna atrofija kompjuterizovanom tomografijom. Primjenom Wechsler-ove skale utvrđeno je postojanje kognitivne disfunkcije u području mehaničkog i logičkog pamćenja, perceptualne organizacije, audio-vizuelne percepcije. Nizak index pamćenja utvrđen j kod 43% pacijenata, na donjoj granici je bio kod 26% na donjoj granici normalnog indexa pamćenja. U odnosu na psihičke poremećaje 57% je sa depresivnim poremećajem, 24% sa anksioznim poremećajima, 6% sa posttraumatskim stresnim poremećajem i 3% je imalo organski afektivni poremećaj. Između grupe koja je bila direktno izložena organskim isparljivim materijama i grupe sa indirektnim izlaganjem nema statistički značajne razlike u odnosu na kognitivno funkcionisanje (P>0,05).

ZAKLJUČCI: Dobiveni rezultati upućuju da radnici koji su duže vremena izloženi isparljivim organskim materijama u toku radnog procesa imaju statistički značajno izraženiju kognitivnu disfunkciju u odnosu na radnike sa manjim radnim stažom. Podaci upućuju da nema statistički značajne razlike između radnika sa direktnim i indirektnim izlaganjem isparljivim organskim materijama. Prisustvo kortikalne cerebralne atrofije i kognitivne disfunkcije u radnika Fabrike obuće "Aida" navodi na zaključak da u cilju prvencije razvijanja kognitivnog propadanja zaposlenih da je neophodno poduzeti odgovarajuće mjere zaštite na radu i ispitivanja o stepenu ekspozicije zaposlenih isparljivim organskim materijama.


CEREBRAL CORTICAL ATROPHY AND COGNITIVE DYSFUNCTION IN WORKERS EMPLOYED TO SHOE FACTORY "AIDA"

Avdibegović E, M. Hasanović, Pajević I, Pavlović S. Department for Psychiatry of the University Clinical Center Tuzla, Medical School of Tuzla University, 75000 Tuzla, Bosnia and Herzegovina

AIM: The aim of this paper is to analyze the occurrence rate of cerebral cortical atrophy and cognitive dysfunction among workers in the Shoe Factory "Aida" in regard of the exposure to evaporable organic substances during the process of operation.

SUBJECTS AND METHODS: The group of 38 employees in the Shoe Factory "Aida" treated at the Department for Psychiatry of the University Clinical Center Tuzla, from 1999 to 2003, and diagnosed with cerebral cortical atrophy, is analyzed in this paper. Computed tomography (CT scan) is used to determine the presence of cerebral cortical atrophy. The Wechsler scale is applied to assess cognitive functioning of a person. Data about working place and the length of service are gathered by social worker in the factory. Diagnostic interview is conducted to diagnose mental disorder and to determine the presence of other risk factors for cerebral cortical atrophy.

RESULTS: Out of total sample, the 98% are female with an average age of 47,8 years. In regard of the length of service, it has been found that the 63% of the patients have from 25 to 31 years of working experience, and 37% of the patients are at service in duration of 18 to 24 years. The subjects gained all their working experience in the Shoe Factory "Aida." In regard of working place, the 72% were performing their duties that require immediate contact with evaporable organic substances. Indirect exposure to evaporable organic substances counts in 28% of the patients. Cortical cerebral atrophy is visualized on the CT scan in entire sample. Using Wechsler scale, the presence of cognitive dysfunction in mechanic and logic memory, perceptual organization and audio-visual perception is determined. Low memory index is found in 43% of the patients, while being at the lowest normal level in 26% of the patients. In regard of the presence of mental disorders, depressive disorder is found in 57%, anxiety disorder in 24%, post-traumatic stress disorder in 6%, and 3% of the sample is found to be affected by the organic affective disorder. There was no statistically significant difference regarding cognitive functioning between the group that has been directly exposed to the effects of evaporable organic substances and the group indirectly exposed to the same.

CONCLUSION: The results indicate that the workers with longer length of service, which have been exposed to the effects of evaporable organic substances during the process of operation have statistically higher score in cognitive dysfunction than those exposed over a shorter period of time. The gathered data showed that there is now statistically significant difference between the workers with direct and indirect exposure to evaporable organic substances. The presence of cerebral cortical atrophy and cognitive dysfunction in workers employed by the Shoe Factory "Aida" points the necessity to inquire the level of exposure to evaporable organic substances during the process of operation. Besides, the conclusion to be drawn is that the adequate measures of occupational health should be taken in order to prevent a cognitive deterioration of employees.

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