Case-Control Study of Paresthesia Among World Trade Center-Exposed Community Members. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Marmor, Michael; Thawani, Sujata; Cotrina, Maria Luisa; Shao, Yongzhao; Wong, Ericka S.; Stecker, Mark M.; Wang, Bin; Allen, Alexander; Wilkenfeld, Marc; Vinik, Etta J.; Vinik, Aaron I.; Reibman, Joan
• Is Part Of: Journal of occupational and environmental medicine. Volume 62:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: electrodiagnostic neurologic measurements -- neuropathic symptoms -- paresthesia -- peripheral neuropathy -- small nerve fiber density; Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; Occupational Medicine -- Periodicals; Environmental Medicine -- Periodicals; Environmental health; Medicine, Industrial; Periodicals; Electronic journals; 616.9803
• DOI: 10.1097/JOM.0000000000001828
• Languages: English
• ISSNs: 1076-2752

Abstract

Abstract : Objective: To investigate whether paresthesia of the lower extremities following exposure to the World Trade Center (WTC) disaster was associated with signs of neuropathy, metabolic abnormalities, or neurotoxin exposures. Methods: Case-control study comparing WTC-exposed paresthesia cases with "clinic controls" (WTC-exposed subjects without paresthesias), and "community controls" (WTC-unexposed persons). Results: Neurological histories and examination findings were significantly worse in cases than controls. Intraepidermal nerve fiber densities were below normal in 47% of cases and sural to radial sensory nerve amplitude ratios were less than 0.4 in 29.4%. Neurologic abnormalities were uncommon among WTC-unexposed community controls. Metabolic conditions and neurotoxin exposures did not differ among groups. Conclusions: Paresthesias among WTC-exposed individuals were associated with signs of neuropathy, small and large fiber disease. The data support WTC-related exposures as risk factors for neuropathy, and do not support non-WTC etiologies. Abstract : Supplemental Digital Content is available in the text