Lohmann K, Pröhl A, Schwarz E
Schleswig, Christian-Albrechts-Universität, Kiel.
Gesundheitswesen. 1996 Jun;58(6):322-31.
The data of 466 subjects suffering from neurologic disorders which are suggested to be caused by neurotoxic agents in their environment retrospectively was evaluated and documented. Among these cases there were 151 subjects with symptoms of Multiple Chemical Sensitivity Disorder (MCSD). The relationship between the neurological health impairments and neurotoxic agents in the environment of these patients was characterised using five different categories (probable = A, possible = B, uncertain = C, unclarified = D, not probable = E). From the 466 patients 320 subjects (69%) could be assigned to the categories A and B, respectively. Within theses 320 cases with chronic neurotoxic health impairments 136 subjects (79 females and 57 males) showed signs of MCSD. Age and gender of cases as well as duration and character of exposure to neurotoxic substances retrospectively were assessed from the explicit files of the patients, which had been made anonymous for this purpose. Frequency of characteristic symptoms of neurotoxicity were analysed. Results are given for patients with neurotoxic health impairments with MCSD (n = 136) and without MCSD (n = 184). Neurotoxic substances which were used as indoor wood preservatives (mainly Pentachlorophenol and/or Lindane) were found to be the causative agents in 63% of the cases with neurotoxic health impairments and MCSD. Other important neurotoxic substances to which the patients were mainly exposed were organic solvents (25%), formaldehyde (15%), dental materials (15%), pyrethroides (13%), and other biocides (19%) (multiple exposures were possible). The time of exposure was calculated as being > or = 10 years for 55% of the patients with MCSD and for 50% of the group with neurotoxic health impairments but without MCSD. Out of the 184 cases with neurotoxic health impairments but without MCSD there were 22%, and out of the 136 cases with MCSD there were 39% who showed all symptoms of chronic fatigue syndrome. 53% of the cases with MCSD had an allergic disposition compared to only 20% of the cases without MCSD. This work is not a controlled epidemiological study but a retrospective documentation and evaluation of data related to environmental medicine. With the present documentation in this purely descriptive manner the proof of a causal relationship was not possible or intended. But because corresponding epidemiological studies are lacking, this documentation can give important information on characteristic features of Multiple Chemical Sensitivity Disorder and chronic neurotoxic health impairments. Such information is essential for planning and carrying out epidemiological studies urgently needed in this field.
对466名患有神经系统疾病的受试者的数据进行了回顾性评估和记录，这些疾病被认为是由其环境中的神经毒性物质引起的。在这些病例中，有151名受试者出现多重化学敏感性障碍（MCSD）症状。使用五种不同类别（可能=A，可能=B，不确定=C，未阐明=D，不太可能=E）来描述这些患者环境中神经健康损害与神经毒性物质之间的关系。在466名患者中，分别有320名受试者（69%）可归为A类和B类。在这320例慢性神经毒性健康损害病例中，有136名受试者（79名女性和57名男性）表现出MCSD症状。回顾性地从患者的明确档案中评估了病例的年龄和性别，以及接触神经毒性物质的持续时间和性质，为此已对档案进行了匿名处理。分析了神经毒性特征症状的频率。给出了患有MCSD（n=136）和未患有MCSD（n=184）的神经毒性健康损害患者的结果。发现用作室内木材防腐剂的神经毒性物质（主要是五氯苯酚和/或林丹）在63%的神经毒性健康损害和MCSD病例中是致病因素。患者主要接触的其他重要神经毒性物质是有机溶剂（25%）、甲醛（15%）、牙科材料（15%）、拟除虫菊酯（13%）和其他杀生物剂（19%）（可能存在多重接触）。55%的MCSD患者和50%的有神经毒性健康损害但无MCSD的患者的接触时间计算为≥10年。在184例有神经毒性健康损害但无MCSD的病例中，有22%表现出慢性疲劳综合征的所有症状，在136例MCSD病例中，有39%表现出该症状。53%的MCSD病例有过敏倾向，而无MCSD的病例中这一比例仅为20%。这项工作不是一项对照流行病学研究，而是对与环境医学相关数据的回顾性记录和评估。以这种纯粹描述性的方式进行目前的记录，不可能也无意证明因果关系。但由于缺乏相应的流行病学研究，该记录可以提供关于多重化学敏感性障碍和慢性神经毒性健康损害特征的重要信息。这些信息对于规划和开展该领域迫切需要的流行病学研究至关重要。
