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健康相关生活质量与多氯联苯和二苯并呋喃暴露:禹城队列 30 年随访。

Health related quality of life and polychlorinated biphenyls and dibenzofurans exposure: 30 years follow-up of Yucheng cohort.

机构信息

Department of Health Business Administration, Hung-Kuang University, Taichung, Taiwan, ROC.

Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan, ROC.

出版信息

Environ Res. 2015 Feb;137:59-64. doi: 10.1016/j.envres.2014.11.020. Epub 2014 Dec 6.

Abstract

BACKGROUND

Quality of life (QOL) can be affected by diseases, disasters, and exposure events to environmental factors. However, whether health-related QOL (HRQOL) might be adversely affected by exposure to dioxin-like chemicals 30 years ago is unknown.

METHODS

We studied people who were poisoned to polychlorinated biphenyls (PCBs) and dibebenzofurans (PCDFs) due to ingestion of contaminated rice oil in 1979 in central Taiwan, and were called Yucheng (oil-disease in Chinese) people. In 2008, we conducted a survey in 1305 exposed people by mailed questionnaire, which included HRQOL by World Health Organization (WHO) quality of life-BREF (WHOQOL-BREF) Taiwanese version. A total of 240 Yucheng subjects aged 18-65 years satisfactorily completed the Questionnaire. For comparison, we obtained information from the database of 2001 National Health Survey conducted by the National Health Research Institute and Bureau of Health Promotion, Department of Health, Taiwan. Data from age-, sex-, and county-matched background individuals were extracted using 1:3 match. HRQOL among Yucheng people with/without skin manifestation and unexposed referents were compared, while adjusting for other factors by multiple regression analyzes.

RESULTS

The Yucheng people had significantly reduced scores in the physical, psychological, social, and environmental domains as compared to the referents. Those with skin manifestations were more severely affected than those with no skin manifestations, suggesting a dose-related effect on QOL in exposed people.

CONCLUSION

We show for the very first time that poisoning due to persistent organic pollutants PCBs and PCDFs can affect QOL 30 years after the exposure, especially among those most severely poisoned.

摘要

背景

生活质量(QOL)可能会受到疾病、灾害和暴露于环境因素等因素的影响。然而,人们是否会因为 30 年前接触二恶英类化学物质而导致健康相关生活质量(HRQOL)受到不利影响还不得而知。

方法

我们研究了 1979 年在台湾中部因食用受污染的食用油而中毒多氯联苯(PCBs)和二苯并呋喃(PCDFs)的人群,这些人被称为“油症患者”。2008 年,我们通过邮寄问卷对 1305 名暴露人群进行了一项调查,其中包括世界卫生组织(WHO)生活质量简表(WHOQOL-BREF)台湾版的 HRQOL。共有 240 名 18-65 岁的油症患者满意地完成了问卷。为了比较,我们从台湾卫生署健康局和国民健康研究所的 2001 年全国健康调查数据库中获取了信息。通过 1:3 的匹配,从年龄、性别和地区匹配的背景个体中提取数据。使用多元回归分析调整其他因素后,比较了有/无皮肤表现的油症患者和未暴露的参照个体的 HRQOL。

结果

与参照个体相比,油症患者在生理、心理、社会和环境领域的得分明显降低。有皮肤表现的患者比没有皮肤表现的患者受到的影响更为严重,表明暴露人群的 QOL 存在剂量相关效应。

结论

我们首次表明,暴露于持久性有机污染物 PCBs 和 PCDFs 30 年后会影响 QOL,尤其是对中毒最严重的患者影响更大。

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