만성유기용제 폭로에 의한 정신신경학적 이상소견의 현장진단방법 개발에 관한 연구

Development of an On Site Diagnostic Tool to Detect Neuropsychiatric Impairment due to Chronic Organic Solvent Exposure

A study has been conducted on developing questionnaires to serve as on site diagnostic tools for the early detection of neuropsychiatric impairment among workers chronically exposed to low-level organic solvents. Two drafts of tentative questionnaires have been developed as follows; several question items were selected from questionnaires which were administered to workers exposed to organic solvents in previous studios and were grouped into each symptom category based on the presence of its association using Guttman scaling method, then these selected items were reviewed by neuropsychiatry specialists. The final draft of the questionnaire (total symptom score=36) was developed by selecting 33 question items which had more than a 0.88 Guttman coefficient of reproducibility in each symptom category from a pilot study in which these tentative questionnaires were administered to workers manufacturing soles. Three plants using organic solvents and one plant never using organic solvents as a control group were selected to test the reliability and validity of the developed questionnaires. The major organic solvent in the workplace environment detected by a personal air sampler and GC/MSD nab toluene. The concentration of toluene in air from the department using organic solvent was statistically different from that of the department never using organic solvent. The concentration of toluene from almost all of the workplace did not exceed the allowable level. There was no statistically significant difference between the concentration of urinary hippuric acid from the workers of the department using organic solvent and that of the department never using it. Total symptom score of the plant never using organic solvents was 9.8 and those of the three plants using organic solvents were 15.6, 14.7, and 13,7 respectively. In order to evaluate the validity of the questionnaires, the workers from two different departments of the plant in which usage of organic solvents are totally dofferemt were compared. The total symptom score was 17.8 for workers of the department using organic solvent and 13.5 for the department never using organic solvent and scores of each symptom group between exposure and non-exposure group also showed statistically significant difference. The finding that total symptom score of the exposure group increased as the duration of employment increased indirectly suggests the usefulness of the developed questionnaire to assess the health effects of chronic exposure to organic solvents. The correlation coefficient, which was calculated to evaluate the test-retest reliability, was 0.581 (p=0.001). The coefficient of Crohnbach which reflects the internal consistency of the questionnaire was 0.91. In conclusion, the reliabilty of the questionnaire was well maintained over the time lapse between the two administrations of the questionnaire and despite the seasonal difference.