Efectos neuropsiquiátricos por solventes orgánicos en personal de un hospital de segundo nivel de atención
Resumen
Introducción: La exposición ocupacional a solventes orgánicos puede asociarse con alteraciones neuropsiquiátricas; existe evidencia limitada en personal de limpieza hospitalaria. Objetivo: Analizar los efectos neuropsiquiátricos de la exposición a solventes orgánicos en el personal de limpieza e higiene del Hospital General de Zona No. 46. Métodos: Estudio observacional, transversal y analítico en 61 trabajadores. Se aplicaron cédula sociodemográfica-laboral y cuestionario EUROQUEST. La sintomatología se definió con punto de corte ≥110. Variables continuas: mediana (p25–p75; bisagras de Tukey); categóricas: n (%). Comparaciones: U de Mann–Whitney y χ²/Fisher. Se estimaron razones de prevalencia (RP) crudas y ajustadas mediante regresión de Poisson con enlace log y varianza robusta. Resultados: 45.9% (28/61) presentó EUROQUEST ≥110. Los dominios con mayores puntajes fueron: trastornos psicosomáticos (mediana 21.0, RIC 17.5–23.0), hiperestesias sensoriales (mediana 16.0, RIC 12.0–18.5) y síntomas cognitivos (mediana 14.5, RIC 11.5–16.0). En el modelo ajustado, las horas de exposición por jornada se asociaron con mayor prevalencia (RPa=1.24 por hora; IC95% 1.08–1.43). Conclusión: Casi la mitad presentó sintomatología; la intensidad diaria se asoció de forma ajustada. Se recomienda vigilancia médica y fortalecimiento de controles preventivos.
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Afshari, D., Nourollahi-Darabad, M., Pourshoja, H., Almasi Hoseini, S. M., & Almasi Hoseini, S. N. (2022). Effect of the neurotoxic symptoms and the demographic factors on the work ability index of operating room nurses. Journal of Occupational Health and Epidemiology, 9(1), 55–62. https://doi.org/10.61186/johe.9.1.55
Alipour, N., Heidarimoghada, R., Babamiri, M., Mahdiyoun, S. A., Seaidnia, H., Asadi Fakhr, A., (2020). The association between demographic variables and the prevalence of neurotoxic symptoms in operating room personnel. Journal of Occupational Hygiene Engineering, 7(2), 8–13. https://doi.org/10.52547/johe.7.2.8
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5.ª ed.). American Psychiatric Publishing.
Atenta, K., Thetkathuek, A., Phatrabuddha N., Kunawudhi, G., Chernbumrung, T., & Na Songkhla, K. (2019). Effects of Organic Solvents Exposure on Nervous System among Migrant Workers in a Toy Manufacturing Factory, Pathumthani Province. Thai Journal of Toxicology, 34(2), 46–59. https://li01.tci-thaijo.org/index.php/ThaiJToxicol/article/view/242493
Bernal Márquez, F. J. (2000). La gestión de los residuos peligrosos: Técnicas de prevención en la generación de suelos contaminados.
Carter, N., Iregren, A., Söderman, E., Olson, B. A., Karlson, B., Lindelöf, B., (2002). EUROQUEST—A questionnaire for solvent related symptoms: Factor structure, item analysis and predictive validity. Neurotoxicology, 23(6), 711–717. https://doi.org/10.1016/S0161-813X(02)00039-6
Centers for Disease Control and Prevention (CDC). (2024, diciembre 10). Chemical hazards risk factors: Healthcare workers. https://www.cdc.gov/niosh/healthcare/risk-factors/chemical-hazards.html
Daniell, W. E., Claypoole, K. H., Checkoway, H., Smith-Weller, T., Dager, S. R., Townes, B. D., (1999). Neuropsychological function in retired workers with previous long-term occupational exposure to solvents. Occupational and Environmental Medicine, 56(2), 93–105. https://doi.org/10.1136/oem.56.2.93
De Souza Souza, R., Antunes Cortez, E., Gomes do Carmo, T., & Santana, R. F. (2016). Enfermedades profesionales de los trabajadores de limpieza en los hospitales: Propuesta educativa para minimizar la exposición. Enfermería Global, 15(2), 522. https://doi.org/10.6018/eglobal.15.2.218311
Ergün, D., Ergün, R., Ergan, B., & Kurt, Ö. K. (2018). Occupational risk factors and the relationship of smoking with anxiety and depression. Turkish Thoracic Journal, 19(2), 77–83. https://doi.org/10.5152/TurkThoracJ.2017.17055
Furu, H. M., Sainio, M., Hyvärinen, H.-K., & Kaukiainen, A. (2019). Limitations of periodical health examinations in detecting occupational chronic solvent encephalopathy. Occupational and Environmental Medicine, 76(9), 688–693. https://doi.org/10.1136/oemed-2019-105858
García, M. A. I. (2008). Exposición laboral a disolventes. Instituto Sindical de Trabajo, Ambiente y Salud (ISTAS). http://istas.net/descargas/Exposici%C3%B3n%20laboral%20a%20disolventes.pdf
Hasylin, H., Abdul-Mumin, K. H., Pg-Hj-Ismail P. K., Trivedi, A., & Win, K. N. (2022). A preliminary assessment of health and safety in the automobile industry in Brunei Darussalam: Workers’ knowledge and practice of organic solvents. International Journal of Environmental Research and Public Health, 19(23), 15469. https://doi.org/10.3390/ijerph192315469
Hinz, R., ’t Mannetje, A., Glass, B., McLean, D., & Douwes, J. (2022). Neuropsychological symptoms in workers handling cargo from shipping containers and export logs. International Archives of Occupational and Environmental Health, 95(8), 1661–1677. https://doi.org/10.1007/s00420-022-01870-8
Instituto Nacional de Estadística y Geografía (INEGI). (2024, diciembre 4). Salud mental. https://www.inegi.org.mx/temas/salud/
Järvholm, B., & Burdorf, A. (2017). Effect of reduced use of organic solvents on disability pension in painters. Occupational and Environmental Medicine, 74(11), 827–829. https://doi.org/10.1136/oemed-2017-104421
Joshi, D. R., & Adhikari, N. (2019). An overview on common organic solvents and their toxicity. Journal of Pharmaceutical Research International, 28(3), 1–18. https://doi.org/10.9734/jpri/2019/v28i330203
Juárez-Pérez, C. A., Aguilar-Madrid, G., Sandoval-Ocaña, J., Cabello-López, A., Trujillo-Reyes, O., Madrigal-Esquivel, C., (2019). Neuropsychological effects among workers exposed to organic solvents. Salud Pública de México, 61(5), 670. https://doi.org/10.21149/9800
Juárez-Pérez, C. A., Rodríguez-Jiménez, A., Martínez-Santiago, G., Mercado-Calderón, F. A., Trujillo-Reyes, O., Aguilar-Madrid, G., (2022). Occupational solvent exposure and neuropsychological effects in Mexico. Salud Pública de México, 64(3), 290–298. https://doi.org/10.21149/12916
Klaassen, C. D. (2018). Toxic effects of solvents and vapors. En C. D. Klaassen (Ed.), Casarett & Doull’s toxicology: The basic science of poisons (9.ª ed., cap. 24). McGraw-Hill Education/Medical.
Lundberg, I., Högberg, M., Michélsen, H., Nise, G., & Hogstedt, C. (1997). Evaluation of the Q16 questionnaire on neurotoxic symptoms and a review of its use. Occupational and Environmental Medicine, 54(5), 343–350. https://doi.org/10.1136/oem.54.5.343
Marhuenda, D., Prieto, M. J., Cardona, A., Roel, J. M., & Oliveras, M. A. (2015). Adaptación transcultural y validación de la versión española del EUROQUEST. Neurología, 30(4), 201–207. https://doi.org/10.1016/j.nrl.2013.12.011
Medina-Mora, M. E., Orozco, R., Rafful, C., Cordero, M., Bishai, J., Ferrari, A., (2023). Los trastornos mentales en México 1990-2021: Resultados del estudio Global Burden of Disease 2021. Gaceta Médica de México, 159(6). https://doi.org/10.24875/gmm.23000376
Mesnil, M., Defamie, N., Naus, C., & Sarrouilhe, D. (2020). Brain disorders and chemical pollutants: A gap junction link? Biomolecules, 11(1), 51. https://doi.org/10.3390/biom11010051
Mestdagh, I., van Bergen, L., Kocken, C., Heyvaert, V., Cras, P., & Van Den Eede, F. (2019). Diagnosing solvent-induced chronic toxic encephalopathy: the effect of underperformance in neuropsychological testing. International Journal of Psychiatry in Clinical Practice, 23(3), 171–177. https://doi.org/10.1080/13651501.2019.1571210
Moussa, A., Brahim, D., Mechergui, N., Ziedi, H., Ayed, W., Ernez, S., (2023). Neuropsychological effects of occupational exposure to organic solvents: A study of 37 cases. European Psychiatry, 66(S1), S962–S962. https://doi.org/10.1192/j.eurpsy.2023.2043
National Institute for Occupational Safety and Health (NIOSH). (1987). Organic solvent neurotoxicity (NIOSH Publication No. 87-104). Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/docs/87-104/default.html
Nilson, L. N., Bäckman, L., Sällsten, G., Hagberg, S., & Barregård, L. (2003). Dose-related cognitive deficits among floor layers with previous heavy exposure to solvents. Archives of Environmental Health, 58(4), 208–217. https://doi.org/10.3200/AEOH.58.4.208-217
Robledo, F. H. (2015). Capítulo IV. Solventes. En Riesgos químicos. Ecoe Ediciones.
Rojas, C. G. (2023). Solventes orgánicos y sus efectos neuropsiquiátricos en trabajadores de limpieza, conservación y patología de la UMAE Hospital de Oncología de Centro Médico Nacional Siglo XXI [Tesis de licenciatura, Universidad Nacional Autónoma de México]. Repositorio UNAM. https://ru.dgb.unam.mx/bitstream/20.500.14330/TES01000847715/3/0847715.pdf
Saha, A., & Tripathi, S. R. (2014). A study on neurobehavioral performance of workers occupationally exposed to solvent in synthetic resin manufacturing. Toxicology International, 21(3), 264–268. https://doi.org/10.4103/0971-6580.155346
Sainio, M. A. Sr. (2015). Neurotoxicity of solvents. En Handbook of Clinical Neurology (pp. 93–110). Elsevier.
Seo, S., & Kim, J. (2018). An aggravated return-to-work case of organic solvent induced chronic toxic encephalopathy. Annals of Occupational and Environmental Medicine, 30, 27. https://doi.org/10.1186/s40557-018-0232-1
Sindicato Nacional de Trabajadores del Seguro Social. (2023, octubre 11). Contrato colectivo de trabajo 2023–2025. Gobierno de México. https://www.imss.gob.mx/sites/all/statics/pdf/CCT-2023-2025.pdf
Stephan-Recaido, S. C., Peckham, T. K., Lavoué, J., & Baker, M. G. (2024). Characterizing the burden of occupational chemical exposures by sociodemographic groups in the United States, 2021. American Journal of Public Health, 114(1), 57–67. https://doi.org/10.2105/AJPH.2023.307461
Su, F.-C., Friesen, M. C., Stefaniak, A. B., Henneberger, P. K., LeBouf, R. F., Stanton, M. L., (2018). Exposures to volatile organic compounds among healthcare workers: Modeling the effects of cleaning tasks and product use. Annals of Work Exposures and Health, 62(7), 852–870. https://doi.org/10.1093/annweh/wxy055
Tang, C. Y., Carpenter, D. M., Eaves, E. L., Ng, J., Ganeshalingam, N., Weisel, C., (2011). Occupational solvent exposure and brain function: an fMRI study. Environmental Health Perspectives, 119(7), 908–913. https://doi.org/10.1289/ehp.1002529
Van Valen, E., Wekking, E., van Hout, M., van der Laan, G., Hageman, G., & van Dijk, F. (2018). Chronic solvent-induced encephalopathy: Course and prognostic factors of neuropsychological functioning. International Archives of Occupational and Environmental Health, 91(7), 843–858. https://doi.org/10.1007/s00420-018-1328-1
Varona-Uribe, M., Ibáñez-Pinilla, M., Briceño-Ayala, L., Herrera, D., Chuaire-Noack, L., Martínez-Agüero, M., (2020). Biomarkers of susceptibility and effect in car painters exposed to organic solvents. Colombian Medical Journal, 51(1), e3646. https://doi.org/10.25100/cm.v51i1.3646
Vázquez-Salas, A., Hubert, C., Portillo-Romero, A., Valdez-Santiago, R., Barrientos-Gutiérrez, T., & Villalobos, A. (2023). Sintomatología depresiva en adolescentes y adultos mexicanos: ENSANUT 2022. Salud Pública de México, 65, s117–s125. https://ensanut.insp.mx/encuestas/ensanutcontinua2022/doctos/analiticos/16-Sintomatologia.depresiva-ENSANUT2022-14827-72384-2-10-20230619.pdf
Wang, Y., & Du, P. (2024). Acute organic solvent toxic encephalopathy: A case report and literature review. Biomedical Reports, 21(5), 163. https://doi.org/10.3892/br.2024.1851
Xiang, Y., Zhang, X., Tian, Z., Cheng, Y., Liu, N., & Meng, X. (2023). Molecular mechanisms of 1,2-dichloroethane-induced neurotoxicity. Toxicology Research, 39(4), 565–574. https://doi.org/10.1007/s43188-023-00197-x
Xiao, J. Q., & Levin, S. M. (2000). The diagnosis and management of solvent-related disorders. American Journal of Industrial Medicine, 37(1), 44–61. https://doi.org/10.1002/(sici)1097-0274(200001)37:1<44::aid-ajim5>3.0.co;2-k
Yoon, J. H., Seo, Y., Jo, Y. S., Lee, S., Cho, E., Cazenave-Gassiot, A., (2022). Brain lipidomics: From functional landscape to clinical significance. Science Advances, 8(37), eadc9317. https://doi.org/10.1126/sciadv.adc9317
Derechos de autor 2026 Xóchitl Matías Hernández, Fernando Carrillo Ponte, Rosario Zapata Vázquez, Silvia María Guadalupe Garrido Pérez, Aidee Luz Del Carmen Cuevas Carballo, Argeo Romero Vazquez
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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