Sweeney M H, Fingerhut M A, Arezzo J C, Hornung R W, Connally L B
Industrywide Studies Branch, National Institute for Occupational Safety and Health, Centers for Disease Control, Cincinnati, OH.
Am J Ind Med. 1993 Jun;23(6):845-58. doi: 10.1002/ajim.4700230603.
Reports of human exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) describe signs and symptoms consistent with exposure-related peripheral neuropathy. In a cross-sectional study, prevalence of peripheral neuropathy was measured in 265 workers exposed 15 years earlier to chemicals contaminated with TCDD and in 244 unexposed, age-, race-, gender- and community-matched comparisons. Cases of peripheral neuropathy were defined from examination, electrophysiologic and quantitative sensory tests, and symptoms. Exposure was assessed by measuring lipid-adjusted serum TCDD levels. The mean serum TCDD level for workers (220 parts per trillion (ppt)) was significantly higher than for referents (7 ppt) (p < .0001). Thirty-two percent of both worker and referent groups met the case definition for peripheral neuropathy. In the logistic regression analyses, serum TCDD level was not related to peripheral neuropathy. These data suggest that despite continued high serum TCDD levels, peripheral neuropathy is not a long-term sequela of high exposure to TCDD-contaminated chemicals. However, the study cannot preclude the occurrence and subsequent resolution of acute effects caused by high exposure, as experienced in Seveso and possibly by some workers, while exposed to high levels of TCDD-contaminated substances.
关于人类接触2,3,7,8-四氯二苯并对二恶英(TCDD)的报告描述了与接触相关的周围神经病变相符的体征和症状。在一项横断面研究中,对265名15年前接触过受TCDD污染化学品的工人以及244名年龄、种族、性别和社区匹配的未接触者进行了周围神经病变患病率的测量。周围神经病变病例通过检查、电生理和定量感觉测试以及症状来确定。通过测量脂质调整后的血清TCDD水平来评估接触情况。工人的平均血清TCDD水平(220万亿分之一(ppt))显著高于对照组(7 ppt)(p <.0001)。工人组和对照组中均有32%符合周围神经病变的病例定义。在逻辑回归分析中,血清TCDD水平与周围神经病变无关。这些数据表明,尽管血清TCDD水平持续较高,但周围神经病变并非高接触受TCDD污染化学品的长期后遗症。然而,该研究不能排除高接触引起的急性效应的发生和随后的消退,如在塞韦索所经历的,以及一些工人在接触高浓度受TCDD污染物质时可能经历的那样。