INCREASED ACQUIRED DYSCHROMATOPSIA AMONG SOLVENT-EXPOSED WORKERS - ANEPIDEMIOLOGY STUDY ON 249 EMPLOYEES OF AN ALUMINUM-FOIL PRINTING FACTORY

Objective: To analyze the effects on color vision of chronic exposure to mixtures of solvents including ethyl acetate, ethanol, and ketones among the workers of a large factory specializing in the manufacture o f photoengraved aluminum packaging. Methods: We analyzed a group of 12 9 subjects who had been exposed to solvents for more than 3 years (mea n age 40 years, range 25-59 years) and a nonexposed group of 120 subje cts (mean age 41 years, range 21-57 years). The two groups had a simil ar length of service (17 and 19 years on average, respectively). The e xposed subjects consumed more tobacco and alcohol than the nonexposed workers. The study involved administration of the Lanthony D-15 desatu rated test. The subjects were classified as having or not having dysch romatopsia on the basis of Lanthony's criteria and the chromatic confu sion index (CCI) was calculated according to Bowman's method. After ob servation of the work stations and analysis of an occupational questio nnaire the findings were used to construct a cumulative exposure index covering the whole of each subject's working life. Air samples were t aken at each work station and in each production sector to determine c urrent exposure. Results: The average cumulative exposure index was 19 4 (median 174, range 27-513). The average hygienic effect index (accor ding to ACGIH recommendations), regularly used for atmospheres contain ing mixtures of products, varied between 12% and 27% of the occupation al limit values permitted under French legislation. As regards color v ision, 23% of the exposed group had dyschromatopsia, as did 13% of the nonexposed group, with the odds ratio (OR) adjusted for age and consu mption of tobacco and alcohol being 1.99 (1.02, 3.89). The analysis of the dose-response relationship according to the cumulative exposure i ndex showed an OR of 1.59 for the lowly exposed group (index less than or equal to 174) and an OR of 2.40 for the highly exposed group (inde x >174) as compared with the nonexposed group. Subjects with complex c olor vision loss (n = 23) had a significantly higher cumulative exposu re index than those with blue-yellow loss (n = 23; 232 versus 155; P = 0.04). The CC-I was on average higher in the exposed group, but the d ifference between the two groups was not significant. Conclusion: The results of this study are in favor of an increased risk for impairment of chromatic discrimination among workers exposed to mixtures of solv ents including mainly ethyl acetate, ethanol, and ketones.