[논문]Multiple Chemical Sensitivity in Chemical Laboratory Workers

Perez-Crespo, Juan; Lobato-Canon, Rafael; Solanes-Puchol, Angel

doi:10.1016/j.shaw.2018.03.001

Multiple Chemical Sensitivity in Chemical Laboratory Workers 원문보기

Safety and health at work : SH@W, v.9 no.4, 2018년, pp.473 - 478

Perez-Crespo, Juan (Health & Safety Office, Miguel Hernandez University) , Lobato-Canon, Rafael (Department of Pathology and Surgery, Miguel Hernandez University) , Solanes-Puchol, Angel (Department of Health Psychology, Miguel Hernandez University)

Abstract ▼ AI-Helper

Background: Multiple Chemical Sensitivity (MCS) is an acquired disease which etiology remains unknown. It is characterized by the development of sensitivity to certain chemical products. Most of the hypotheses formulated to explain the syndrome associate it to a previous exposition to some kind of volatile chemical. University researchers in chemical laboratories suffer a phenomenon of multi-exposition to chemical agents at low concentration during long periods of time although in an irregular form. Many of these chemical agents have similar properties to those suspicious of causing MCS. This article studies the prevalence of MCS in laboratory researchers. Methods: The study group is university researchers in chemical laboratories. The control group was obtained from administrative personnel who work in the same universities and therefore, are not exposed to chemical products from the laboratories, but have the same exposition to the rest of environmental polluting agents from the area and from the buildings of the university. In this study, it is used the Quick Environmental Exposure and Sensitivity Inventory (QEESI) (sensitivity of 92%/specificity of 95%). Results: The results showed that the prevalence of MCS for the university researchers is not related to exposition by inhalation to multiple chemical agents, at low concentration. Conclusions: The results disagree with one of the main etiological hypotheses of MCS, which is based on the existence of hypersensitive people, who presents a response after prolonged expositions to very low concentrations during a long period of time.

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문제 정의

The main hypothesis relates the prevalence of MCS with the exposition to multiple chemical agents at a low or very low concentration (limit of standardized detection systems) in air and always below the threshold limit values. The objective of this study is to test the hypothesis: the relationship between the long-term exposition to chemical agents and the increase in the prevalence of the MCS in the university researchers in chemical laboratories.
The members of the control group were chosen among the personnel who work in the same universities, but who only carry out administrative tasks, and, therefore, are not exposed to chemical products from the laboratories but have the same exposition to the rest of the environmental polluting agents from the area and from the buildings of the university. Therefore, the goal of this work is to detect differences in the prevalence of the syndrome between groups exposed to chemical agents during work in the laboratories and those who are not.
This article tries to increase the knowledge on this syndrome, studying its prevalence in a very specific group of workers. The group selected comprises university researchers in chemical laboratories.
After this process, the affected people will become sensitive to very low concentrations of several chemical products, whereas the rest of the people would tolerate them without trouble. This study assumes the hypothesis that people suffer a mechanism of sensitizing after being exposed intermittently to very low concentration of certain volatile chemicals during long periods of time (years of exposition).

가설 설정

1. The prevalence of MCS among the university researchers of the chemical or biological laboratories in our sample is not related to exposition by inhalation of multiple chemical agents at a low or very low concentration (limit of detection systems) and always below the threshold limit values. Prolonged expositions by inhalation of several polluting chemicals coming from university research laboratories, in concentrations well below the limits to be considered safe to avoid their well-known nonstochastic effects, are not correlated with the prevalence of the MCS.
The QEESI has five scales: symptom severity, chemical intolerance, other intolerance, life impact, and masking index. According to the score in the first three scales of the questionnaire, the sensitive individuals to MCS will be differentiated from the nonsensitive ones. The other two scales would help to identify the severity of the affectation (life impact) and the exposition to agents that mask the symptoms of MCS (masking index).

제안 방법

Finally, some limitations to this study should be assessed. First, it should be noticed that the study does not approach other types of expositions to chemical agents which could be related to the causes of this syndrome as the accidental exposition to high concentrations of volatile chemicals. Second, the population studied is limited to a specific geographical area, and the number of participants is not big enough for a more detailed study among the subgroups.

대상 데이터

A total of 1,084 questionnaires were distributed among the two universities’ employees: 446 in the University of Alicante (UA) and 638 in the University Miguel Hernandez of Elche (UMH), and 514 of them were received complete.
The data were collected in two phases. In the first phase, from June 2011 to October 2011, 400 questionnaires were received. After analyzing the results of the first phase, the necessity for extending the number of participants was detected (to improve the statistical validity of the conclusions).
This article tries to increase the knowledge on this syndrome, studying its prevalence in a very specific group of workers. The group selected comprises university researchers in chemical laboratories. Indeed, the university personnel who work in laboratories of investigation with chemical products suffer a phenomenon of multiexposition [7,8] to chemical agents at very low concentrations and by different routes, not only inhalation.
The individuals studied are employees from two Universities of the province of Alicante, in Spain: the University of Alicante and the University Miguel Hernández de Elche.
Twenty groups of investigation from the UA from the disciplines of chemical sciences and chemical engineering participated in the study; furthermore, the members of the three units of technical services of investigation also participated in the study. Overall, from the 285 members of the former units, 128 valid questionnaires were received, which indicates a participation of 44.

이론/모형

The scales of the QEESI are quantitative; therefore, to establish relations with nominal variables, a t test should be used. For the study of normality and independence of the scales of QEESI questionnaire, the Kolmogorov-Smirnov function and the runs test were used, respectively. It was appraised that all the scales associated with the questionnaire QEESI do not have normal distribution, except for the scale “other intolerance.
From the previous results, it is concluded that for the scale “other intolerance,” the t test can be used. The rest of the scales do not have a normal distribution, and therefore, the t test cannot beapplied; instead, the Mann-Whitney U test was used.

성능/효과

2. Therefore, the obtained results disagree with one of the main etiological hypotheses of MCS, which is based on the existence of hypersensitive people who present a response after prolonged expositions to concentrations well below the necessary ones to cause the conventional nonstochastic effects.
Second, the population studied is limited to a specific geographical area, and the number of participants is not big enough for a more detailed study among the subgroups. Third, there are differences in the percentages of individuals with atopic skin between the control group and the laboratory workers, and the proportion of women who had given birth to at least one child (Table 2), in both the cases, is higher in the control group. These factors could have influence in the prevalence of MCS.

후속연구

Further studies could be proposed to increase the knowledge on the MCS prevalence, for example, the study on workers exposed to recurrent high concentrations of volatile chemicals with irritant effects. It is suspected that this group of workers could present much higher prevalence than the general population [17].
Furthermore, the individuals’ job history was not revised, which could mean there are potential confounders that can be assessed in further studies.
First, it should be noticed that the study does not approach other types of expositions to chemical agents which could be related to the causes of this syndrome as the accidental exposition to high concentrations of volatile chemicals. Second, the population studied is limited to a specific geographical area, and the number of participants is not big enough for a more detailed study among the subgroups. Third, there are differences in the percentages of individuals with atopic skin between the control group and the laboratory workers, and the proportion of women who had given birth to at least one child (Table 2), in both the cases, is higher in the control group.

참고문헌 (17)

1 Documento de consenso Sensibilidad Química Múltiple 2011 Gobierno de España. Ministerio de Sanidad. Política Social e Igualdad Madrid
2 Helen Dwight Reid Educational Foundation Multiple chemical sensitivity: a 1999 consensus Arch Environ Health 54 3 1999 147 149 10444033

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3 Lacour M. Zunder T. Schmidtkle K. Vaith P. Scheidt C. Multiple Chemical Sensitivity Syndrome (MCS) – suggestions for an extension of the US MCS-case definition Int J Hyg Environ Health 208 2005 141 151 15971853
4 Eisa D. Helm D. Mühlinghaus T. Birkner N. Dietel A. Eikmann T. Gieler U. Herr C. Lacour M. Nowak D. Pedrosa Gil F. Podoll K. Renner B. Wiesmüllerb G.A. Worm M. The German Multicentre Study on Multiple Chemical Sensitivity (MCS) Int J Hyg Environ Health 211 2008 658 681 18502687
5 Winder C. Mechanisms of multiple chemical sensitivity Toxicol Lett 128 2002 85 97 11869820

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6 Caress S.M. Steinemann A.C. National prevalence of asthma and chemical hypersensitivity: an examination of potential overlap J Occup Environ Med 47 5 2005 518 522 15891531

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7 Almeida M.F.M. Ferrari I. Luna H. Chromosomal aberration analysis in workers exposed to chemical and biological hazards in research laboratories Environ Res 97 2005 330 334 15589242

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8 Pérez J. Estudio del síndrome de sensibilidad química múltiple en trabajadores de laboratorios universitarios [Master's thesis] 2016 Universidad Miguel Hernandez Elche https://dialnet.unirioja.es/servlet/tesis?codigo=54076
9 Nogué X. Dueñas A. Ferrer A. Fernández J. Sensibilidad química múltiple Med Clínic 136 15 2011 683 687
10 Kauppinen T. Pukkala E. Saalo A. Sasco A.J. Exposure to chemical carcinogens and risk of cancer among Finnish laboratory workers Am J Ind Med 44 2003 343 350 14502761

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11 Miller C.S. Prihoda T.J. The Environmental Exposure and Sensitivity Inventory (EESI): a standardized approach for measuring chemical intolerances for research and clinical applications Toxicilogy Ind Health 15 1999 370 385
12 Fernandez-Solà J. Nogué S. Sensibilidad química y ambiental múltiple JANO 1662 2007 27 30
13 Andersson M.J. Andersson L. Mats B. Millqvist E. Nordin S. The idiopathic environmental intolerance symptom inventory: development, evaluation, and application J Occup Environ Med 51 7 2009 838 847 19542897

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14 SPSS for Windows, version 16.0 2007 SPSS Inc Chicago
15 Ortega A. Sensibilidad a múltiples compuestos, una enfermedad comúnmente inadvertida Med Clínic 125 2005 257 262
16 Chun C. Sung K. Kim E. Park J. Self-reported multiple chemical sensitivity symptoms and personal volatile organic compounds exposure concentrations in construction workers Build Environ 45 2010 901 906

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17 Nogué S. Fernández-Solá J. Rovira E. Montori E. Fernández-Huerta J.M. Munné P. Multiple chemical sensitivity: study of 52 cases Med Clínic 129 3 2007 96 99

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Multiple Chemical Sensitivity in Chemical Laboratory Workers 원문보기

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Multiple Chemical Sensitivity in Chemical Laboratory Workers 원문보기

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