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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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