Neuropsychological effects among workers exposed to organic solvents.

OBJECTIVE: To assess neuropsychological performance among workers at a paint factory in Mexico City. MATERIALS AND METHODS: During 2004 and 2005 we assessed the neuropsychological performance of 208 workers who were exposed to organic solvents at a paint factory, mainly toluene and xylene. We categorized workers into low and high exposure groups using a cumulative index for toluene, based on times spent in different tasks. We evaluated cognitive and motor functions with 13 neuropsychological tests. RESULTS: We found lower attention, longer time to complete the test ß=5.5 (R2=12.3%), and a lower score in the motor-cognitive test ß=-15.7 (R2=19.5%) in the high exposure group through multiple linear regression model analysis, with adjustment for age and education. CONCLUSIONS: Our results are similar to the ones reported in the literature, but the effects are less severe, probably due to lower exposure to organic solvents.

OBJETIVO: Evaluar el desempeño neuropsicológico de los trabajadores de una fábrica de pintura en la Ciudad de México. MATERIAL Y MÉTODOS: Se evaluó el desempeño neuropsicológico de 208 trabajadores expuestos a disolventes orgánicos, principalmente tolueno y xileno, en una fábrica de pintura en la Ciudad de México durante 2004 y 2005. Se categorizaron en grupos de baja y alta exposición con un índice acumulado de tolueno con base en el tiempo empleado por actividad. Se evaluaron funciones motoras y cognitivas con 13 pruebas neuropsicológicas. RESULTADOS: Se registró un tiempo más largo para completar la prueba ß=5.5 (R2=12.3%) y una puntuación baja en la prueba motor-cognitiva de ß=- 15.7 (R2=19.5%) en el grupo de alta exposición en los modelos de regresión lineal múltiple, ajustados por confusores. CONCLUSIONES: Los presentes resultados son similares a los reportados en la literatura, aunque los efectos son menos graves, probablemente debido a la baja exposición.

Neuropsychological effects among workers exposed to organic solvents / Efectos neuropsicológicos en trabajadores expuestos a disolventes orgánicos

Abstract: Objective: To assess neuropsychological performance among workers at a paint factory in Mexico City. Materials and methods: During 2004 and 2005 we assessed the neuropsychological performance of 208 workers who were exposed to organic solvents at a paint factory, mainly toluene and xylene. We categorized workers into low and high exposure groups using a cumulative index for toluene, based on times spent in different tasks. We evaluated cognitive and motor functions with 13 neuropsychological tests. Results: We found lower attention, longer time to complete the test β=5.5 (R2=12.3%), and a lower score in the motor-cognitive test β=-15.7 (R2=19.5%) in the high exposure group through multiple linear regression model analysis, with adjustment for age and education. Conclusion: Our results are similar to the ones reported in the literature, but the effects are less severe, probably due to lower exposure to organic solvents.

Resumen: Objetivo: Evaluar el desempeño neuropsicológico de los trabajadores de una fábrica de pintura en la Ciudad de México. Material y métodos: Se evaluó el desempeño neuropsicológico de 208 trabajadores expuestos a disolventes orgánicos, principalmente tolueno y xileno, en una fábrica de pintura en la Ciudad de México durante 2004 y 2005. Se categorizaron en grupos de baja y alta exposición con un índice acumulado de tolueno con base en el tiempo empleado por actividad. Se evaluaron funciones motoras y cognitivas con 13 pruebas neuropsicológicas. Resultados: Se registró un tiempo más largo para completar la prueba β=5.5 (R2=12.3%) y una puntuación baja en la prueba motor-cognitiva de β=-15.7 (R2=19.5%) en el grupo de alta exposición en los modelos de regresión lineal múltiple, ajustados por confusores. Conclusión: Los presentes resultados son similares a los reportados en la literatura, aunque los efectos son menos graves, probablemente debido a la baja exposición.

Validez factorial del <> (CESQT) en una muestra de maestros mexicanos / Factorial validity of the <> (CESQT) in a sample of Mexican teachers

Since the term burnout began to be used in the mid 1970's to refer to the process of deterioration in the care and professional attention given to users of human service organizations (public service, volunteer, medical, human social service, educational organizations, etc.), a variety of instruments have been developed to measure this phenomenon. A review of the literature makes it possible to conclude that among these measurement instruments the Maslach Burnout Inventory (MBI) has been used with the greatest frequency to measure the burnout syndrome, regardless of the occupational characteristics of the sample or the source of the burnout. While the most commonly employed burnout measure has been the MBI, researchers have been troubled by some of the psychometric limitations of this scale: a number of authors have suggested that a three-factor structure might not be appropriate; some items are not associated with their factors; Cronbach's alpha values are low for the Depersonalization subscale; different versions of the instrument evaluate the same phenomenon, etc. Other instruments used to evaluate burnout (for example Burnout Measure) do not satisfactorily operationalize the definition of the syndrome. The deficiencies in the instruments used for evaluating burnout have led to the development of the <> (CESQT) (Spanish Burnout Inventory). The theoretical model underlying the CESQT is based on the concept that burnout is a response to chronic job stress that stems from problematic interpersonal work relationships, and it develops in those individuals who work with people, quite frequently in service sector professionals who are in direct contact with the end-users. It is characterized by cognitive deterioration (loss of enthusiasm toward the job), emotional deterioration, and attitudes and behaviours of indifference, indolence, withdrawal and sometimes, abusive attitudes toward the client. In some cases, feelings of guilt appear. The psychometric model of the CESQT contains twenty items distributed in four dimensions such as: 1. enthusiasm toward the job (five items), defined as the individual's desire to achieve goals at work because it is a source of personal pleasure; 2. psychological exhaustion (four items), defined as the appearance of emotional and physical exhaustion due to the fact that at work s/he must deal daily with people who present or cause problems; 3. indolence (six items), defined as the appearance of negative attitudes of indifference and cynicism toward the organization's clients; 4. guilt (five items), defined as the appearance of feelings of guilt for negative attitudes developed on the job, especially toward the people with whom s/he establishes work relationships. The purpose of this study is the validation of the CESQT in Mexican primary education teachers. A four factor model, like that of the original model presented, was hypothesized. Materials and method The sample consisted of 698 primary education public school teachers in the area of Iztapalapa of the Federal District (Iztapalapa, Mexico). With regard to gender, 133 (19.10%) were men and 541 (77.50%) women. In the remaining 24 questionnaires (3.40%) gender was not identified. The mean age was 42.49 years. The <> was applied, using the version for professionals working in education (CESQT-PE). This instrument contains 20 items distributed into four dimensions called: enthusiasm toward the job (5 items) (α=.76), psychological exhaustion (4 items) (α=.82), indolence (6 items) (α=.73), and guilt (5 items) (α=.79). Low scores on Enthusiasm toward the job, together with high scores on psychological exhaustion and indolence, as well as on guilt, indicate high levels of burnout. The questionnaire was applied in 51 schools. Results The <> was high for all the items, with values superior to .40. All of the items contributed to increasing the internal consistency of the subscales they were part of. All of the subscales presented Cronbach's alpha values superior to .70. The factorial model obtained an adequate data fit for the sample: Chi²(164) = 481.01 (p<.001), AGFI = .91, RMSEA=.055, NNFI = .91, CFI = .92, and ECVI(.60-6.16) = .86. The results confirmed the hypothesis formulated. All of the factorial loadings were significant with high values, superior to .50. All of the relationships between the dimensions of the CESQT were significant for p< .001. The subscales of the CESQT presented values of skewness and kurtosis within the range of normality, with the exception of Enthusiasm toward the job, which presented asymmetry values outside the range ± 1, although the values were not extreme (S = -1 .71, K=3.96). Discusión The purpose of the study was to analyze the psychometric quality of the CESQT and its subscales in Mexican teachers, in order to evaluate the transnational validity of the instrument. The <> values obtained for the items are relatively high, which indicates that each of the dimensions of the CESQT-PE can be considered as a lineal function of the items that make it up. Therefore, all of the items make it possible to adequately predict the score of the scale and distinguish between individuals with high vs. low scores in the respective subscales. The results confirmed the hypothesized factorial structure. The four-factor structure fit the model according to all the fit indices considered, except the Chi-square test, which is an index that depends on sample size and finds a poor model fit with large samples. Based on the results obtained, it can be concluded that the factorial model adequately reproduces the theoretical model of the CESQT. The final scale is made up of four dimensions that evaluate the cognitive impairment (lack of enthusiasm about the job), emotional and physical deterioration (Psychological exhaustion), and attitudinal deterioration (Indolence), of the individual, together with the appearance of guilt feelings. These results confirm the results obtained in Spain, Chile and Portugal, and in Mexico with a sample of doctors. The Cronbach's alpha values obtained indicate that the internal consistency is good for the four subscales, and for the entire CESQT-PE scale. The skewness and kurtosis values were also good for the subscales, as values inferior to ±1 were obtained, except for the Enthusiasm toward the job subscale. The values obtained for the percentiles recommend using the 90th percentile instead of the 66th to draw conclusions about the individuals with high levels of burnout. The results of the study contribute to the psychometric validation of the theoretical model with four dimensions originating from the questionnaire, and to the transnational validation of the instrument. These results also make it possible to conclude that the CESQT, in its version for education professionals (CESQT-PE), is a reliable and valid instrument for evaluating burnout in Mexico. A slight deficiency of the instrument in this study has to do with the skweness value obtained for the Enthusiasm toward the job subscale, although further studies are necessary before conclusions can be drawn about possible modifications.

El <> (burnout) (en adelante SQT) ha sido definido como una respuesta al estrés laboral crónico al que están sometidos los profesionales de servicio que trabajan en contacto directo con humanos. En las investigaciones realizadas sobre el SQT, el instrumento para la medición que más se ha utilizado es el Maslach Burnout Inventory (MBI). Pero, este instrumento presenta insuficiencias psicométricas, y otros instrumentos de evaluación del SQT no operacionalizan de manera adecuada la definición del síndrome. Las insuficiencias en los instrumentos utilizados en la actualidad para la evaluación del SQT han llevado al desarrollo del <> (CESQT). El CESQT está formado por cuatro dimensiones denominadas: 1. Ilusión por el trabajo, definida como el deseo del individuo de alcanzar las metas laborales porque supone una fuente de placer personal. 2. Desgaste psíquico, definida como la aparición de agotamiento emocional y físico debido a que en el trabajo se tiene que tratar a diario con personas que presentan o causan problemas. 3. Indolencia, definida como la aparición de actitudes negativas de indiferencia y cinismo hacia los clientes de la organización. 4. Culpa, definida como la aparición de sentimientos de culpa por el comportamiento y las actitudes negativas desarrolladas en el trabajo, en especial hacia las personas con la que se establecen relaciones laborales. El objetivo de este estudio es la validación del CESQT en maestros mexicanos de educación básica. Se hipotetizó un modelo de cuatro factores como el del modelo original. Material y método La muestra la formaron 698 profesores de educación primaria de escuelas públicas. Según el género, 133 participantes fueron hombres (19.10%) y 541 mujeres (77.50%). En 24 cuestionarios (3.40%) no se respondió a la pregunta sobre el género. Asimismo, se aplicó el <>, en su versión para profesionales que trabajan en la educación (CESQT-PE). Es importante señalar que bajas puntuaciones en ilusión por el trabajo (cinco reactivos, (α=.76), junto a altas puntuaciones en desgaste psíquico (cuatro reactivos, (α=.82), indolencia (seis reactivos, α=.73) y en Culpa (cinco reactivos, α=.79) indican altos niveles del SQT. El cuestionario se aplicó en 51 escuelas. Resultados Para todos los reactivos la homogeneidad corregida fue alta, con valores superiores a .40. El modelo factorial obtuvo un ajuste adecuado a los datos para la muestra: Chi²(164) = 481.01 (p<.001), AGFI = .91, RMSEA=.055, NNFI = .91, CFI = .92 y ECVI(.60-6.16) = .86. Los resultados confirmaron la hipótesis formulada. Todas las cargas factoriales resultaron significativas con valores altos, superiores a .50. Discusión Los valores de homogeneidad corregida obtenidos para los reactivos son relativamente altos, lo que indica que cada una de las dimensiones del CESQT-PE se puede considerar como una función lineal de los reactivos que la componen. Los resultados han confirmado la estructura factorial hipotetizada. La estructura de cuatro factores ha alcanzado el ajuste del modelo a través de diversos índices de ajuste considerados. Todas las dimensiones presentan valores adecuados de consistencia interna. Los valores de asimetría también han sido buenos para las subescalas, excepto para la subescala de Ilusión por el trabajo que ha excedido ligeramente el criterio de ±1. Los resultados del estudio contribuyen a la validación psicométrica del modelo teórico de cuatro dimensiones origen del cuestionario, y a la validación transnacional del instrumento, y permiten concluir que el CESQT, en su versión para profesionales de la educación (CESQT-PE), resulta un instrumento fiable y válido para evaluar el SQT en México.