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Contribución de los tests neuropsicológicos para el diagnóstico de la intoxicación crónica por mercurio metálico
Abstract
In order to evaluate the contribution of the neurobehavioral tests battery in the diagnosis of mercurialism, a cross sectional study was made with a group of 180 workers exposed to the metallic mercury, that was compared to 180 workers not exposed to the metallic mercury in a same company, respecting the homogenity in relation to the variables of sex, age, schooling and jobs executed. The tests are chosen based on the capacity to detect functional alterations in the central nervous system, particularly in the memory, coordination, perception, attention, emotional states, concentration, speed of movements and precision in performing tasks. The results showed significant statistic differences between the groups in the following tests: mechanical skill of Leon Walther - TAM (discs, counts, dotting); concentration attention battery of Toulose Pieron and Welchsler Adult Intelligence Scale - WAIS (numerical symbols) indicating a deficit in the speed of movements, manual agility, coordination, concentration focus, cognitive efficiency and motor perceptive speed. The tests are instruments of high importance in the diagnosis of mercurialism.
O presente artigo discorre acerca do impacto ambiental do mercúrio em lâmpadas fluorescentes descartadas no Instituto Federal de Sergipe. Desse modo, criou-se um modelo matemático para calcular a quantidade de mercúrio exposto ao ambiente proveniente de lâmpadas fluorescentes em desuso no Instituto Federal de Sergipe, Campus Lagarto, e seu impacto ambiental. Os resultados indicam que os 50.000 mg (50 g) iniciais de mercúrio contemplam sua totalidade de decomposição a partir do primeiro ano após o descarte. Sendo o limite de tolerância biológica de 0,000033 g de mercúrio por grama de creatina urinária, o mercúrio descartado no Instituto Federal de Sergipe não é somente suficiente para contaminação interna, como a expande também para uma área abrangente de contaminação externa. Observaram-se, através de questionários, que o Município de Lagarto, Estado de Sergipe, não possui pontos de coleta, indispensáveis para o cumprimento da logística reversa das lâmpadas e, por esta causa, os 1.800 alunos do Instituto Federal de Sergipe, Campus Lagarto, bem como o restante da população local, cerca de 100 mil habitantes, são obrigados à realização inadequada do descarte de lâmpadas devido à má implementação da lei instituída para a Política Nacional de Resíduos Sólidos (Lei nº 12.305/2010). (PIBIC-EM/CNPq).
Objetivou-se estudar a intoxicação por mercúrio metálico em trabalhadores de uma indústria de lâmpadas elétricas no Estado de São Paulo, Brasil. Foram investigados 71 trabalhadores, dos quais 61 (85,92%) apresentaram quadro de intoxicação crônica por mercúrio. O tempo de exposição dos trabalhadores estudados variou de 4 meses a 30 anos. Dentre os intoxicados foram detectadas alterações de coordenação motora em 57 (80,30%), neurológicas, em 56 (78,88%), de memória, em 51 (71,83%), no exame clínico, em 47 (66,20%), psiquiátricas, em 45 (63,38%) e da atenção concentrada, em 37 (52,10%).
Subjective symptoms and psychological performances on a computer-administered test battery were studied among a group of 60 chlorine-alkali workers and their matched referents. The exposure time of the group exposed to inorganic mercury vapor had been about 14 years, and the estimated long-term average exposure had been about 25 micrograms/m3 of air. The exposed workers had an actual mercury concentration of 51.9 (SD 25.0, range 15-150) nmol/l in blood and 84.1 (SD 56.6, range 15-260) nmol/l in urine. Neither perceptual motor nor memory nor learning abilities of the mercury-exposed workers showed any disturbances in a comparison with the referents. However, the exposed group reported statistically significantly more memory disturbances than the referents. Strain caused by three-shift work was a possible cofactor for other increased subjective symptoms, namely, for sleep disorders, fatigue, and confusion.
In a cross-sectional study the psychological test performances of a group of 36 male chlorine-alkali workers were compared with the level of exposure to mercury and to the corresponding results of referents. The mercury exposure had lasted for at least 10 years and had been controlled by regular health examinations and urine analyses. Several dose indicators were calculated. The more heavily exposed workers performed more poorly on the verbal intelligence test (Similarities) than the referents did. Impairments in the memory tests showed a statistically significant correlation with the actual exposure level, especially with the actual concentration of mercury in blood. The monitoring of mercury in blood can be useful in health surveillance programs. The level of mercury in the air was calculated from the dose indicators. The results support the recommended exposure limit of 25 micrograms/m3 for metallic mercury vapor in the air as a level avoiding adverse effects in exposed workers.
52 workers of a plant transforming Hg mineral were subjected to psychological investigation in order to detect behavioral alterations which might be related to Hg exposure. A group of 29 subjects living in the same area was used as the control. The test battery included reaction times, mental efficiency measures, and personality indexes for a total of 33 variables. Results were analyzed through statistical elaboration using parametric tests. Efficiency and memory measures could discriminate exposed individuals from controls; for the personality profiles, an interpretation explaining the differences observed is proposed in terms of a dynamic profile having different characteristics in the different groups studied. Reference to existing literature is made to verify any possible correlation with other authors' findings.
"Patologia da mercurio e suoi composti"
- V Foà
- L. Caimi
"Rapporti tra esposizione a mercurio e condizione di salute in un gruppo di lavoratori addetti alla distillazione di mercurio in uno stabilimento della provincia di Siena"
- G Angotzi
- MG Cassito
- D Camerino
- R Cioni
- E Desideri
- A Franzinelli
- R Gori
- F Loi
- E. Sartorelli
"Efeitos da exposição ocupacional ao mercúrio em trabalhadores de uma indústria de lâmpadas elétricas localizada em Santo Amaro, São Paulo, Brasil"
- C. Zavariz
- D.R.M. Glinna