Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.
Biomed Res Int. 2020 Sep 17;2020:6195975. doi: 10.1155/2020/6195975. eCollection 2020.
Previous studies confirmed that chronic arsenic exposure could lead to pigmentary changes and hyperkeratosis. However, skin health-related quality of life (HRQoL) among people under lifetime arsenic exposure remains underappreciated. Our study is aimed at investigating several patient-reported outcomes in a population under chronic arsenic exposure. . A cross-sectional study was conducted in communities in Shimen, China. Dermatologists performed skin examinations for participants. Patient-reported outcomes (PROs) included HRQoL, itch, sleep quality, and symptoms of anxiety and depression. The Dermatology Life Quality Index (DLQI) was used to measure skin HRQoL. The numerical rating scale (NRS) was used to measure the intensity of itching. Sleep disturbance was measured by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression were measured by two-item Generalized Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2), respectively.
A total of 464 participants suffering from arsenic-related skin lesions finished the assessment of DLQI. Pigmentary changes and arsenical keratosis were not associated with the patient-reported outcomes except PHQ-2. Hair arsenic exceeding 1 g/g was associated with higher itch NRS and DLQI ( < 0.05). Itch NRS (adjusted = 0.80, 95% CI: 0.70-0.90, < 0.01) and hair arsenic concentration (adjusted = 0.12, 95% CI: 0.01-0.24, < 0.05) were independently associated with the DLQI.
HRQoL, sleep quality, and mental wellbeing are impaired in residents under chronic arsenic exposure. Itching and hair arsenic are independent risk factors for impaired HRQoL.
先前的研究证实，慢性砷暴露可导致色素变化和过度角化。然而，终生砷暴露人群的皮肤健康相关生活质量（HRQoL）仍未得到充分重视。本研究旨在调查慢性砷暴露人群中的一些患者报告结局。一项横断面研究在中国石门社区进行。皮肤科医生对参与者进行皮肤检查。患者报告的结果（PROs）包括 HRQoL、瘙痒、睡眠质量以及焦虑和抑郁症状。皮肤病生活质量指数（DLQI）用于衡量皮肤 HRQoL。数字评分量表（NRS）用于衡量瘙痒的强度。睡眠障碍通过匹兹堡睡眠质量指数（PSQI）进行测量。焦虑和抑郁分别通过两项广泛性焦虑障碍（GAD-2）和患者健康问卷（PHQ-2）进行测量。
共有 464 名患有砷相关皮肤损伤的参与者完成了 DLQI 的评估。除 PHQ-2 外，色素变化和砷角化病与患者报告的结果无关。头发砷含量超过 1μg/g 与更高的瘙痒 NRS 和 DLQI 相关（<0.05）。瘙痒 NRS（调整 = 0.80，95%CI：0.70-0.90，<0.01）和头发砷浓度（调整 = 0.12，95%CI：0.01-0.24，<0.05）与 DLQI 独立相关。
慢性砷暴露居民的 HRQoL、睡眠质量和心理健康状况受损。瘙痒和头发砷是 HRQoL 受损的独立危险因素。
