Changes in autonomic regulation in workers under conditions of long-term fluoride intoxication

I. Martynov, Nikolaу I. Panev, A. V. Yamshchikova, A. Fleishman
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Abstract

Introduction. Long-term intake and accumulation of fluoride compounds in the body, in addition to pathological changes in the bronchopulmonary system, bone tissue, liver, leads to changes in the regulatory systems, primarily the autonomic ones, in the conditions of chronic fluoride intoxication. The aim of the study was to assess the nature and severity of the changes in autonomic regulation in workers of the main occupations in aluminum production under exposure to chronic fluoride intoxication. Material and methods. We examined fifty two male workers of aluminum production over the age range from 40 to 56 years; work experience was more than 15 years. Autonomic regulation was assessed using spectral analysis of the heart rate variability, highlighting oscillations in the ranges of very low frequency (0.004–0.08 Hz), low (0.09–0.16 Hz), and high frequencies (0.17–0.5 Hz). Results. Analysis of the heart rate variability made it possible to identify 4 groups of subjects: 16 individuals had a moderate decrease in variability and a predominance of low-frequency oscillations, 12 subjects examined cases had a pronounced decline in variability in all frequency ranges; a decrease in the capabilities of autonomic regulation was manifested during a test with hyperventilation by an increase in very low frequency oscillations frequency indicating the need for activation of suprasegmental autonomic centers. In 24 subjects, the stable predominance of low-frequency oscillations indicates an enhancement in sympathetic influence. In response to the hyperventilation test, most of them (18 subjects were included in the group 3) showed an increase in low and very low frequency oscillations as a sign of a violation of baroreceptor regulation. Limitations. The study was limited by the number of workers with long-term work experience in aluminum production who underwent an in-depth medical examination. Conclusion. Changes in autonomic regulation are observed in the majority of aluminum production workers with long-term work experience, which gives grounds to recommend a study of neurovegetative status using heart rate variability analysis during preventive examinations to identify individuals at high risk of developing comorbid diseases.
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长期氟中毒条件下工人自律神经调节的变化
导言。在慢性氟中毒的情况下,除了支气管肺系统、骨组织、肝脏的病理变化外,氟化合物在体内的长期摄入和积累还会导致调节系统(主要是自律神经系统)发生变化。本研究的目的是评估铝生产中主要职业的工人在接触慢性氟中毒后自律神经调节变化的性质和严重程度。材料和方法我们对 52 名年龄在 40 至 56 岁之间、工作年限超过 15 年的铝生产工人进行了检查。通过对心率变异性进行频谱分析,评估了自律神经的调节情况,突出显示了极低频(0.004-0.08 赫兹)、低频(0.09-0.16 赫兹)和高频(0.17-0.5 赫兹)范围内的振荡。结果通过对心率变异性的分析,可以确定 4 组受试者:16名受试者的心率变异性中度下降,以低频振荡为主;12名受试者在所有频率范围内的心率变异性都明显下降;在过度换气测试中,自律神经调节能力下降,表现为极低频振荡频率增加,表明需要激活上段自律神经中枢。在 24 名受试者中,低频振荡的稳定优势表明交感神经的影响增强了。在过度换气试验中,大多数受试者(第 3 组包括 18 名受试者)的低频和极低频振荡增加,这表明气压感受器的调节功能受到了破坏。局限性。这项研究受到接受深入体检的具有长期铝生产工作经验的工人人数的限制。结论。在大多数有长期工作经验的铝生产工人身上观察到了自律神经调节的变化,因此有理由建议在进行预防性体检时利用心率变异性分析对神经神经系统状态进行研究,以识别有患合并症风险的高危人群。
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