Abstract
ObjectivesTo assess whether contemporary solvent exposures in the vehicle collision repair industry are associated with objectively measured neuropsychological performance in collision repair workers.MethodsThe RBANS battery and additional tests were administered to 47 vehicle collision repair and 51 comparison workers randomly selected from a previous questionnaire study.ResultsCollision repair workers performed lower on tests of attention (digit span backwards: -1.5, 95% CI -2.4, -0.5; digit span total: -1.7, CI -3.3, -0.0; coding: -6.1, CI -9.9, -2.8; total attention scale: -9.3, CI -15.9, -2.8) and the RBANS total scale (-5.1, CI -9.1, -1.2). Additional tests also showed deficits in visual attention and reaction time (Trails B: -11.5, CI -22.4, -0.5) and motor speed/dexterity (coin rotation dominant hand & non-dominant: -2.9, CI -5.3, -0.4 and -3.1, CI -5.6, -0.7 respectively). The strongest associations were observed in panel beaters. Applying dichotomised RBANS outcomes based on the lowest percentile scores of a normative comparison group showed strongly increased risks for attention (5th percentile: OR 20.1, 95% CI 1.5, 263.3; 10th percentile: 8.8, CI 1.7, 46.2; and 20th percentile: 5.1, CI 1.5, 17.6, respectively). Those employed in the industry for ≤ 17 years (the median work duration) generally had lower scores in the attention domain scale and RBANS total scale compared to those employed >17 years suggesting a healthy worker survivor bias, but trends were inconsistent for other domains.ConclusionsThis study has found significant deficits in cognitive performance in collision repair workers despite low current airborne exposures in New Zealand.
Highlights
Millions of tons of organic solvents are produced globally each year and used in many industrial processes,[1] including the automotive repair industry where they are used extensively in raw form, and in bodywork fillers and various spray coatings
Collision repair workers performed lower on tests of attention and the RBANS total scale (-5.1, CI -9.1, -1.2)
Applying dichotomised RBANS outcomes based on the lowest percentile scores of a normative comparison group showed strongly increased risks for attention (5th percentile: OR 20.1, 95% CI 1.5, 263.3; 10th percentile: 8.8, CI 1.7, 46.2; and 20th percentile: 5.1, CI 1.5, 17.6, respectively)
Summary
Millions of tons of organic solvents are produced globally each year and used in many industrial processes,[1] including the automotive repair industry where they are used extensively in raw form, and in bodywork fillers and various spray coatings. In a recent questionnaire survey of 370 collision repair workers and 211 comparison workers, we reported that collision repair workers in New Zealand continue to have a significantly increased risk of symptoms of neurotoxicity, including neurological (e.g. numbness, tingling or decreased sensation in extremities, dropping things unintentionally, balance problems, etc.), mood, memory, and concentration symptoms.[10] This is despite considerable changes in technology and health and safety practices in this industry and an associated decline in solvent exposures over the past 2 decades.[11] it is unclear whether these effects extend to cognitive deficits as measured by objective neuropsychological tests. Previous studies using these tests have reported reductions in attention span and sustained attention, immediate and delayed memory and motor speed.[5, 7, 8, 12] the findings have been inconsistent with some studies showing no association, suggesting that workers may be at risk of only ‘mild’ symptoms.[13,14,15,16] Alternatively, the inconsistent results may be due to small sample sizes for most studies, inadequate control for confounding, insufficiently sensitive neuropsychological tests,[17] or underestimation of the importance of relatively small average changes measured across workers.[18]
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