Annals of Occupational and Environmental Medicine

  • 제23권4호
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  • Pages.439-449
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  • 2011
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  • 1225-3618(pISSN)
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  • 2052-4374(eISSN)
대한직업환경의학회 (The Korean Society of Occupational & Environmental Medicine)
권호 표지

화학물질 흡입자의 후천성 색각이상 평가

Assessment of Acquired Color Vision Impairment in Inhalant Abusers

  • 김명효 (국립부곡병원) ;
  • 김연철 (영남대학교병원 산업의학과) ;
  • 이규화 (영남대학교병원 산업의학과) ;
  • 전만중 (영남대학교병원 산업의학과) ;
  • 사공준 (영남대학교병원 산업의학과)
  • Kim, Myeong-Hyo (Bugok National Hospital) ;
  • Kim, Yeon-Cheol (Department of Occupational and Environmental Medicine, Yeungnam University Hospital) ;
  • Lee, Kyu-Hwa (Department of Occupational and Environmental Medicine, Yeungnam University Hospital) ;
  • Jeon, Man-Joong (Department of Occupational and Environmental Medicine, Yeungnam University Hospital) ;
  • SaKong, Joon (Department of Occupational and Environmental Medicine, Yeungnam University Hospital)
  • 발행 : 2011.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 국립부곡병원과 국립법무병원에 입원한 신경독성 화학물질 흡입자를 대상으로 흡입제 노출이 후천성 색각이상에 미치는 영향을 평가하고자 하였다. 방법: 국립부곡병원과 국립법무병원에 입원한 신경독성 화학물질 흡입자 총 81명을 흡입군으로 하고, 비슷한 연령대의 국립부곡병원 사무직 직원 41명을 대조군으로 총 122명을 대상으로 2009년 6월부터 12월까지 색각검사를 수행하였다. 면접조사로 대상자의 일반적 특성, 음주력, 흡연력, 화학물질 흡입 시작시기, 흡입제 종류, 일회 흡입량 및 빈도, 흡입기간에 대해 조사하였다. 색각이상은 Lanthony D-15 desaturated 색각검사를 이용하여 정성분석으로 색각이상을 형태적으로 분류하고, 정량분석으로 총색채차점수를 Bowman법으로 지수화하고, 총색채차점수 65.1 또는 색혼란지수 1.26 이상일 때 색각이상으로 판정하였다. 결과: 화학물질 흡입제 흡입군 우안의 총색채차점수 75.58${\pm}$21.07, 색혼란지수 1.34${\pm}$0.37은 대조군 총색채차점수 61.25${\pm}$6.79, 색혼란지수 1.09${\pm}$0.12에 비해 유의하게 높았고, 흡입군 좌안의 총색채차점수 75.47${\pm}$ 23.63, 색혼란지수 1.34${\pm}$0.42는 대조군 총색채차점수 62.49${\pm}$7.14, 색혼란지수 1.11${\pm}$0.13에 비해 유의하게 높았다(p<0.001). 색각이상자는 흡입군 우안 50명 (61.8%), 좌안 48명(59.2%), 대조군 우안 11명 (26.8%), 좌안 13명(31.7%)으로 흡입군에서 유의하게 많았고, 색혼란지수에 의한 색각이상자도 흡입군에서 우안 38명(46.9%) 좌안 35명(43.2%), 대조군에서 우안 4명(9.8%), 좌안 7명(17.0%)으로 흡입군이 유의하게 많았다(p<0.01). 제3색형 색각이상의 색혼란지수는 흡입군 우안 1.38${\pm}$0.25로 대조군 우안 1.25${\pm}$0.12보다 유의하게 높았다(p<0.05). 흡입군에서는 망막손상이 더 진행되었음을 반영하는 제1색형(적록색각이상)이 4명(4.9%), 제2색형(적록청황색각이상) 11명(13.6%), 복합형 12명 (14.8%)이었으나, 대조군은 없었다. 후천적 색각이상 유무를 종속변수로 한 다중 로지스틱 회귀분석에서 흡입기 간(OR=1.20, 95% CI: 1.03~1.40)이 유의한 변수로 나타났다. 결론: 신경독성 화학물질 흡입은 색각이상을 발생할 수 있으며, 흡입제의 흡입과 관련된 조건 중 흡입기간이 후천성 색각이상에 유의한 영향을 주는 변수이다.

Objectives: This study was conducted in order to evaluate the effects of inhalants on color vision impairment. Methods: The inhalation group consisted of 81 neurotoxic chemical substance abusers at Bugok National Hospital and Institute of Forensic Psychiatry, Ministry of Justice. The control group consisted of 41 employees of Bugok National Hospital. The Lanthony D-15 desaturated hue test was administered to both groups. For the qualitative analysis, we classified the results by the morphological characteristics of color vision impairment. For the quantitative analysis, we calculated the total color distance score (TCDS) and the color confusion index (CCI) and determined that the individual was abnormal if the TCDS was over 65.0 or the CCI was over 1.25. Results: The TCDS of the inhalation group was 75.58${\pm}$21.07 and the CCI was 1.34${\pm}$0.37 in the right eye, and 75.47${\pm}$23.63 and 1.34${\pm}$0.42, respectively in the left eye. These results are higher than those found for the control group. In regards to the TCDS, 50 (61.8%) of the abusers in the inhalation group had color vision impairment in the right eye and 48 (59.2%) had impairment in the left eye. 11 (26.8%) of the employees in the control group had color vision impairment in the right eye and 13 (31.7%) had impairment in the left eye. In regards to the CCI, 38 (46.9%) of the abusers in the inhalation group had color vision impairment in the right eye and 35 (43.2%) had impairment in the left eye. 4 (9.8%) of the employees in the control group had color vision impairment in the right eye and 7 (17.0%) had impairment in the left eye. The results of multiple logistic regression analysis for acquired color vision impairment showed that the inhalation period (OR=1.20, 95% CI: 1.03~1.40) was the significant variable. Conclusions: These findings indicate that the inhalation of neurotoxic substances may impair the color vision, and the period inhaled with neurotoxic substances is significant variable affecting on the acquired color vision impairment.

키워드

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