目的 探讨职业性铝接触对作业工人心理、神经行为、认知及自主神经功能的影响。方法 从广西某大型铝厂选取110名男性铝作业工人为接触组，并从铝厂下属的服务公司中以接触组的年龄和文化程度构成匹配选取110名工人设为对照组。采用世界卫生组织推荐的神经行为核心测试方法对工人的心理情感和神经行为进行测试，利用简易智力状态量表（MMSE）评估认知功能，并检查自主神经功能改变。同时监测作业环境和工人血清、尿液样本中铝含量。结果 配料、电解和铸造3个车间空气中铝的平均浓度分别为（6.45±1.23）、（7.02±1.45）和（6.95±1.86）mg/m³，明显高于对照组环境铝浓度（F=7.463，P<0.001）；接触组工人的血清和尿液铝含量亦均显著高于对照组（P<0.05）；情感状态问卷调查结果显示，接触组“困惑－迷茫”和“紧张－焦虑”得分值均明显高于对照组（P<0.05），而其余指标的差异无统计学意义（P>0.05）；神经行为功能检测发现，简单反应时、数字译码、正确打点数和打点总数均显著低于对照组（P<0.05），而其余指标的差异无统计学意义（P>0.05）；接触组MMSE评分总分及地点定向、语言即刻记忆、注意和计算、短程记忆、言语表达的评分及最大与最小R-R间隔比值（Rmax∶Rmin）均明显低于对照组（P<0.05）；工龄>10年工人在地点定向、语言即刻记忆、注意和计算、短程记忆、语言理解和言语表达方面的分值均明显低于工龄<5年受试者（P<0.05）。结论 职业性铝接触可以引起作业工人出现明显的心理状态、神经运动速度、准确性、协调能力及副交感神经调节功能的改变。

Objective To investigate the effects of occupational aluminum exposure on psychology, neural behaviors, cognitive function, and autonomic nervous function of workers. Methods A total of 110 male aluminum-exposed workers of a large aluminum plant in Guangxi were selected as subjects of the exposure group and 110 workers from the service company affiliated to aluminum plant whose ages and education levels matched those of subjects were selected as controls of the control group. WHO neuro-behavior core recommendation test was adopted to evaluate the psychological feelings and neural behaviors of all workers. The cognitive function was evaluated by the mini-mental state examination (MMSE) and the changes of autonomic nervous function were examined. Aluminium levels of working environment and serum and urine samples of workers were monitored. Results The average air aluminum levels of the batch preparation workshop, electrolysis workshop, and casting workshop were (6.45±1.23), (7.02±1.45), and (6.95±1.86) mg/m³, which were significantly higher than that of the control group (F=7.463, P<0.001). Serum and urinary aluminum levels of the exposure group were significantly higher than those of the control group (P<0.05). The results of questionnaire survey of psychological feelings showed that scores of “confused-puzzled” and “nervous-anxious” of the exposure group were significantly higher than those of the control group (P<0.05) and the differences of other indexes were not statistically significant (P>0.05). Neurobehavioral function detection showed that simple reaction time, digital decoding hit points and management, and the correct number of the exposure group were significantly lower than those of the control group (P<0.05) and the differences of other indexes were not statistically significant (P>0.05). The total score of MMSE and scores of place orientation, immediate memory and language, calculation and attention, short-term memory, and verbal expression and Rmax∶Rmin of the exposure group were all significantly lower than those of the control group (P<0.05). Scores of place orientation, immediate memory and language, calculation and attention, short-term memory, verbal expression, and language understanding of workers who had exposed to aluminum for more than 10 years were significantly lower than those of workers who had exposed to aluminum for less than 5 years (P<0.05). Conclusion Occupational aluminum exposure can cause obvious changes of psychological state, nerve movement speed, accuracy, coordination ability, and parasympathetic nerve regulation function of workers.