消防员中甲状腺过氧化物酶抗体阳性的相关因素：一项横断面研究
Correlates of Positive Thyroid Peroxidase Antibodies Among Firefighters: A Cross-Sectional-Study.
作者信息
Ogunsina Kemi, Koru-Sengul Tulay, Rodriguez Valentina, Caban-Martinez Alberto J, Schaefer-Solle Natasha, Ahn Soyeon, Kobetz-Kerman Erin N, Lee David J
机构信息
Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
出版信息
J Endocr Soc. 2022 Aug 23;6(10):bvac125. doi: 10.1210/jendso/bvac125. eCollection 2022 Oct 1.
CONTEXT
Exposure to endocrine disrupting chemicals (EDCs) are associated with underactive thyroid glands, and possibly autoimmunity. Firefighters are exposed to EDCs from flame retardants; however, the prevalence and risk factor associations of thyroid antibodies among firefighters are unknown.
CONTEXT
We aimed to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and associated sociodemographic and occupational risk factors among firefighters.
METHODS
Firefighters attending professional health and safety conferences between November 2018 and January 2020, and with no prior diagnosis of thyroid disease were invited (n = 278) to submit a health survey, blood samples, and complete a thyroid ultrasound. The survey assessed for sociodemographic and occupational characteristics, including a history of familial thyroid disease, smoking, firefighter tenure, and job rank, radiation exposure, and mitigation practices of occupational exposures. Serum thyroid peroxidase antibody (TPOAb) was also assessed.
RESULTS
Approximately 39.9% of firefighters evaluated had a positive TPOAb test. The mean age for those TPOAb positive was lower than those who tested negative (41.4 ± 7.9 vs 43.1 ± 7.9 years, = 0.07) but this difference was not significant. Firefighters with a family history of thyroid disease had a statistically significant higher prevalence of TPOAb compared with those without a family history (60.0% vs 37.5%, = 0.02); this association remained significant after adjusting for sociodemographic and occupational factors (odds ratio 2.99; CI, 1.31-6.85).
CONCLUSION
The prevalence of TPOAb is high among firefighters in our study, and family history is a significant determinant of testing positive for TPOAb. Firefighters may benefit from TPOAb and thyroid stimulating hormone tests, and screening for family history of thyroid disease at baseline employee medical check-ups. This finding suggests the need for further studies.
背景
接触内分泌干扰化学物质（EDCs）与甲状腺功能减退有关，也可能与自身免疫有关。消防员会接触到来自阻燃剂的EDCs；然而，消防员中甲状腺抗体的患病率及其危险因素关联尚不清楚。
背景
我们旨在确定消防员中甲状腺过氧化物酶抗体（TPOAb）的患病率以及相关的社会人口统计学和职业危险因素。
方法
邀请了2018年11月至2020年1月期间参加职业健康与安全会议且既往无甲状腺疾病诊断的消防员（n = 278）提交健康调查问卷、血液样本并完成甲状腺超声检查。该调查评估了社会人口统计学和职业特征，包括家族性甲状腺疾病史、吸烟情况、消防员任期、职位等级、辐射暴露以及职业暴露的缓解措施。还评估了血清甲状腺过氧化物酶抗体（TPOAb）。
结果
接受评估的消防员中约39.9%的TPOAb检测呈阳性。TPOAb阳性者的平均年龄低于检测阴性者（41.4 ± 7.9岁对43.1 ± 7.9岁，P = 0.07），但这种差异不显著。有甲状腺疾病家族史的消防员TPOAb患病率在统计学上显著高于无家族史者（60.0%对37.5%，P = 0.02）；在调整社会人口统计学和职业因素后，这种关联仍然显著（优势比2.99；可信区间，1.31 - 6.85）。
结论
在我们的研究中，消防员中TPOAb的患病率较高，家族史是TPOAb检测呈阳性的一个重要决定因素。消防员可能会从TPOAb和促甲状腺激素检测以及在员工基线体检时筛查甲状腺疾病家族史中受益。这一发现表明需要进一步研究。
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