いわゆる夜勤病・ビル病についての臨床的研究 : 血液性状および心電図所見を中心として
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概要
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Lately we notice an increase of visitors at clinics in big cities, who come as out-patients with a good deal of complaints, esp. with a number of symptoms ascribable to circulatory and digestive disorders. Such cases are often found among night workers or those who are engaged in a busy, but monotonous, kind of work at offices, shops or factories in physiologically poor working environment, such as those deprived of the blessing of sunshine all day long, and may, therefore, be named "Night Worker's Disease" or "Building Worker's Disease (disease which affects a person who either works or lives in a concrete building)". The author attempted to analyze such disease conditions from clinical point of view. Subjects of study were females in the 18-31 age bracket, without fever, leucocytosis and abnormal roentgenological findings of the chest-so that organic and infectious diseases might be excluded-and also free from parasitic diseases as ascertained by fecal examination, and with no serious menstrual disorders. Group I consisted of 9 shop-girls with heavy complaints who were working on the basement floors of department-stores, Group 11 12 clerks also with heavy complaints, Group III 14 girls who were working in bars or cabarets, and the control group 14 healthy girls. As a result of the comparative study of 47 such cases, the following findings were obtained: (1) Re. symptoms, cold limbs, palpitation and other symptoms of circulatory system, pyrosis nausea, epigastric distress,constipation and other symptoms of digestive system, as well as vartigo and stiffness of shoulders were seen in high frequencies in all of the three subject groups. Furthermore, night worker's group was seen to develop additional symptoms which might be ascribed to nervous system, such as headache and insomnia. (2) Weight/height ratio was markedly lower in Groups I and III than in the control group; and the mean (average) arterial blood pressure was significantly lower in Group III. 3) Re. blood picture, both hemoglobin values and red-cell counts decreased in the three groups as compared with the control group; M.C.V. more or less increased in all the three groups, most conspicuously in Group III. (4) Decrease of serum-albumin values, Gros Volues (SHIBATA's method), serum-cholesterol values and serum K/Na was detected in all of the three groups-esp. in Groups II and III to a high degree. (5) By electroca diographical study, increase of QT ratio and decrease of ventricular gradient were observed in all of the three subject groups. (6) By experiment on rabbits in starvation, the above-mentioned results were successfully reproduced as regards body weigth, hemoglobin values, serum-albumin values, K/Na and electrocardiographical findings i.e. QT ratio and ventricular gradient. On the ground of such findings, it was observed that those in physiologically poor conditions developed more or less distinct clinical signs and symptoms similar to those seen in the state of undernutrition, esp. hypoalbuminemie, and that, in view of the developmental stage of the disease condition, the status of "Building worker's Disease" among daytime workers might be safety classified as the transitive atate from good health to "Night Worker's Disease"
- 社団法人日本産業衛生学会の論文