Noel Julia, Habib Al-Rahim R, Thamboo Andrew, Patel Zara M
Department of Otolaryngology, Head & Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94305, USA.
Sydney Medical Program, University of Sydney, Edward Ford Building A27, Sydney, New South Wales 2006, Australia.
World J Otorhinolaryngol Head Neck Surg. 2017 Mar 6;3(1):9-16. doi: 10.1016/j.wjorl.2017.02.005. eCollection 2017 Mar.
Olfactory dysfunction is known to have significant social, psychological, and safety implications. Despite increasingly recognized prevalence, potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale. The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction.
Cross-sectional analysis of the 2011-2012 and 2013-2014 editions of the National Health Examination and Nutrition Survey was performed. The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States. There is an interview and physical examination component which includes demographic, socioeconomic, dietary, and health-related questions as well as medical, dental, physiologic measurements, and laboratory tests. 3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database. The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors, occupational or environmental exposures, and urinary levels of environmental and industrial compounds.
In both subjective and objective analysis, smell disorders were significantly more common with increasing age. While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss, they, along with Hispanics, performed more poorly on odor identification than Caucasians. Those with limited education had a decreased prevalence of hyposmia. Women outperformed men on smell testing. Those reporting exposure to vapors were more likely to experience olfactory dysfunction, and urinary levels of manganese, 2-Thioxothiazolidine-4-carboxylic acid, and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell disturbance. In odor detection, elevated serum levels of lead and urinary levels of 2,4 dichlorophenol were associated with anosmia and hyposmia, respectively.
This study provides current, population-based data identifying demographic and exposure elements related to smell disturbances in U.S. adults. Age, race, gender, education, exposure to vapors, urinary levels of manganese, 2-Thioxothiazolidine-4-carboxylic acid, 2-Aminothiazoline-4-carboxylic acid, 2,4 dichlorophenol, and serum lead levels were all implicated in smell disturbance. Care should be taken in interpretation due to lack of consistency between subjective and objective measures of olfaction as well as limitations related to population-based data. Prospective trials are indicated to further elucidate these relationships.
嗅觉功能障碍具有重大的社会、心理和安全影响。尽管其患病率日益受到认可，但嗅觉丧失的潜在风险因素记录随意，相关知识规模有限。本研究旨在确定与嗅觉功能障碍相关的潜在人口统计学和暴露变量。
对2011 - 2012年版和2013 - 2014年版的国民健康检查与营养调查进行横断面分析。所利用的调查报告来自美国各县每年约5000人的全国代表性样本。调查包括访谈和体格检查部分，涵盖人口统计学、社会经济、饮食和健康相关问题，以及医学、牙科、生理测量和实验室检查。从上述基于人群的数据库中确定了2011年至2012年的3594名成年受访者和2013年至2014年的3708名受访者。根据人口统计学因素、职业或环境暴露以及环境和工业化合物的尿液水平，确定自我报告疾病的频率以及气味识别测试的表现。
在主观和客观分析中，嗅觉障碍均随年龄增长而显著更常见。非西班牙裔黑人和非西班牙裔亚裔人群主观嗅觉丧失的报告可能性较低，但他们与西班牙裔人群在气味识别方面的表现均不如白种人。受教育程度有限者嗅觉减退的患病率较低。女性在嗅觉测试中的表现优于男性。报告接触蒸汽的人更有可能出现嗅觉功能障碍，主观嗅觉障碍受访者的尿液中锰、2 - 硫代噻唑烷 - 4 - 羧酸和2 - 氨基噻唑啉 - 4 - 羧酸水平较低。在气味检测中，血清铅水平升高和尿液中2,4 - 二氯苯酚水平升高分别与嗅觉丧失和嗅觉减退相关。
本研究提供了基于当前人群的数据，确定了与美国成年人嗅觉障碍相关的人口统计学和暴露因素。年龄、种族、性别、教育程度、接触蒸汽情况、尿液中锰、2 - 硫代噻唑烷 - 4 - 羧酸、2 - 氨基噻唑啉 - 4 - 羧酸、2,4 - 二氯苯酚水平以及血清铅水平均与嗅觉障碍有关。由于嗅觉主观和客观测量之间缺乏一致性以及基于人群数据的局限性，在解释结果时应谨慎。需要进行前瞻性试验以进一步阐明这些关系。
