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台湾“油症”事件13年后慢性肝病和肝硬化导致的死亡率增加。

Increased mortality from chronic liver disease and cirrhosis 13 years after the Taiwan "yucheng" ("oil disease") incident.

作者信息

Yu M L, Guo Y L, Hsu C C, Rogan W J

机构信息

Department of Public Health, National Cheng Kung University Medical College, Tainan, Taiwan.

出版信息

Am J Ind Med. 1997 Feb;31(2):172-5. doi: 10.1002/(sici)1097-0274(199702)31:2<172::aid-ajim6>3.0.co;2-1.

Abstract

In 1979, a mass poisoning involving some 2,000 persons occurred in central Taiwan from cooking oil contaminated by polychlorinated biphenyls (PCBs) and their heat-degraded byproducts, including polychlorinated dibenzofurans (PCDFs). The responsible health department registered cases for clinical purposes between 1979 and 1983. The exposed persons are referred to as the "yucheng" (oil disease) cohort. PCBs and PCDFs are toxic chemicals widely dispersed in the environment and in human tissue, which persist long after exposure. The consequences of exposure to these agents are not well understood. We traced the cohort through December 31, 1991, and compared overall and cause-specific mortality of 1,837 "yucheng" subjects with age, gender, and calendar time-specific mortality rates for the Taiwan general population. Eighty-three deaths were identified from 23,404 observed person-years. Even though the overall standardized mortality ratio (SMR) was 0.8 (95% confidence interval (CI) 0.7-1.0), there was a substantial elevation in the mortality rate for chronic liver disease and cirrhosis (10 deaths, SMR = 2.7, 95% CI = 1.3-4.9). Mortality from malignant neoplasms and other causes was not significantly different from that of the Taiwan population. PCB/PCDF exposure appears to promote the development of severe liver disease, perhaps in combination with known risk factors such as infection with hepatitis B virus. Further follow-up of this young cohort is necessary to see if the consequences include hepatic cancer.

摘要

1979年,台湾中部发生了一起约2000人中毒事件,中毒原因是食用油被多氯联苯(PCBs)及其热降解副产物污染,其中包括多氯二苯并呋喃(PCDFs)。负责的卫生部门在1979年至1983年期间为临床目的登记了病例。这些受暴露者被称为“油症”队列。多氯联苯和多氯二苯并呋喃是广泛散布于环境和人体组织中的有毒化学物质,暴露后会长期存在。人们对接触这些物质的后果了解并不充分。我们对该队列追踪至1991年12月31日,并将1837名“油症”受试者的总体死亡率和特定病因死亡率与台湾一般人群按年龄、性别和日历时间划分的死亡率进行了比较。在23404人年的观察期内确定了83例死亡。尽管总体标准化死亡比(SMR)为0.8(95%置信区间(CI)为0.7 - 1.0),但慢性肝病和肝硬化的死亡率大幅升高(10例死亡,SMR = 2.7,95% CI = 1.3 - 4.9)。恶性肿瘤和其他病因导致的死亡率与台湾人群无显著差异。多氯联苯/多氯二苯并呋喃暴露似乎会促进严重肝病的发展,可能是与诸如感染乙肝病毒等已知风险因素共同作用。对这个年轻队列进行进一步随访很有必要,以观察其后果是否包括肝癌。

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