ORIGINAL ARTICLE

Six year observational cohort study of the effect of carbon disulphide on brain MRI in rayon manufacturing workers

Y Nishiwaki¹, T Takebayashi¹, T O’Uchi², T Nomiyama¹, T Uemura¹, H Sakurai^1,3 and K Omae¹

¹ Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
² Kemeda General Hospital, Japan
³ Occupational Health Research and Development Center, Japan Industrial Safety and Health Association, Japan

Correspondence to:
Correspondence to:
Dr Y Nishiwaki
Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; nisiwaki{at}sc.itc.keio.ac.jp

Aims: To clarify whether the current occupational exposure limit (OEL) for carbon disulphide (CS₂) is low enough to prevent the occurrence of adverse effects on the cerebrovascular system.

Methods: A total of 432 male workers exposed to CS₂ and 402 male referent workers in 11 Japanese viscose rayon factories were studied at baseline; 750 of these were followed up. Brain MRI was performed at both baseline and follow up surveys. Changes in the number of hyperintense spots in T2 weighted images (HIS), which point to so-called "silent cerebral infarctions", were evaluated over six years. A total of 666 subjects (217 exposed, 125 ex-exposed, and 324 referent subjects) who twice received brain MRI were subjected to analysis. Mean duration of exposure to the end of the study was 19.6 years for the exposed workers. The geometric mean CS₂ (ppm) and TTCA (mg/g creatinine) concentrations for the past six years were 4.9 and 1.6 for all exposed workers, 5.8 and 1.9 for spinning/refining workers, and 2.7 and 0.9 for other exposed workers, respectively.

Results: Exposed subjects showed a significantly higher risk for an increase in the number of HIS over six years. Odds ratios adjusted for possible confounders in the exposed and ex-exposed workers were 2.27 (95% CI 1.37 to 3.76) and 1.33 (95% CI 0.70 to 2.54), respectively. No exposure-response relations were observed in a number of analyses among the exposed workers.

Conclusions: Exposure to CS₂ under the current Japanese OEL, 10 ppm, might increase the number of HIS in brain MRI. However, results should be interpreted with caution.

Keywords: carbon disulphide; arteriosclerosis; brain MRI; cohort study

Abbreviations: BMI, body mass index; HDL, high density lipoprotein; HDL-C, high density lipoprotein cholesterol; HIS, hyperintense spots; MRI, magnetic resonance imaging; OEL, occupational exposure limit; SBP, systolic blood pressure; TLV, threshold limit value; TTCA, 2-thiothiazolidine-4-carboxylic acid

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